Antibodies to viruses of the herpes group in glomerulonephritis of membranous,membranoproliferative and IgA types

Sera of 25 patients with membraneous glomerulonephritis (MGN), 16 with membranoproliferative glomerulonephritis (MPGN) and 54 with IgA glomerulonephritis (IgA GN) were studied for complement-binding antibodies to herpes simplex virus (HSV), cytomegalovirus (CMV) and antibodies to various Epstein-Barr virus (EBV) associated antigens, as also for the titres of these antibodies. The sera of 220 normal individuals served as controls, 120 controls being used for each case. Anti-HSV titres of ≧1∶64 were found to occur in the sera of all three GN groups in a higher proportion than in those of the controls. This was also valid for the complement-binding antibodies to CM, although here the differences were not invariably significant. IgA antibodies reacting with EBV capside antigen (EBVCA) were likewise of statistically increased frequency in IgA GN, as also in MPGN, and in these two groups the geometric mean of the reciprocal value of the IgA antibody titres was also higher than either in the controls or in MGN. The results of the studies carried out within 6 months after onset of renal disease point to an EBV infection, either fresh or having taken place in the recent past, in 20 cases. These data are compatible with a direct or indirect role of EBV in the production and/or persistence of certain types of GN. The high anti-HSV and CMV titres suggest that in a number of patients with renal disease the immune responses to certain types of the HSV group may be abnormal.     

Biochemical, clinical and genetic analysis of various aminoacidopathies (non-ketotic hyperglycemia, maple syrup urine disease, histidinemia, tyrosinemia)]

The genetical types were classified according to the clinical findings and biochemical results in cases of 13 newborn/children suffering from various aminoacidopathies. The genetical types were: 3 neonatal and 4 infantile types were found out of 7 non-ketotic disease (MSUD) patient was infantile type with 9.1 per cent keto acid decarboxylase activity in leukocyte homogenate. Among the 3 histidinemic patients 1 was severe neonatal type and 2 cases were chronic types. The 2 treated tyrosinemic children proved to be type III. (chronic with rickets).     

Iron therapy in mental aberrations (pica) in childhood

Besides of four pica cases (eating of dirt, paper, cotton, oakum, sand, lime, chalk) the authors report on a girl with trichophagia. The treatment of choice in pica consists in a sufficient supply of iron. The authors suggest that the intravenously administered iron acts on some centers of the central nervous system.     

The role of intraoperative ultrasonic studies in abdominal surgery

Intraoperative echography is a new field of application of the ultrasound diagnostics. With a special intraoperative examination head the parenchymal abdominal organs may be examined directly in the course of the operation. The intraoperative echo-examination of the tumors and cysts of the liver and pancreas as well as of nephroliths and gallstones is routinely applied in several institutions abroad. The authors report on their initial experiences with intraoperative ultrasonography of different abdominal organs.     

Intrascrotal and testicular solid masses in childhood

A retrospective study was performed between 1985 and 1994 on paediatric patients operated for asymptomatic intrascrotal or testicular palpable masses. Tumour was suspected in each case and it was surgically explored. Twenty-six children were affected, their age ranging between 9 days and 14 years. In 11 cases testicular torsion, in 4 epididymitis and in another 2 dystrophic calcification were found. Tumours, including rather rare alterations, were observed in only 9 children. The present results draw attention to the tumour-like occurrence of testicular torsions and other benign alterations of the scrotum.     

Postmarketing surveillance-one of the key issues in drug development.

The terms "postmarketing surveillance" or "human phase IV studies" are applied to all those examinations which are performed with a drug following its registration. The principles, methods of these examinations are discussed on the basis of international experiences. The authors also give some examples from Hungarian practice referring to this subject. They consider postmarketing examinations to be as important as the clinical pharmacological examinations preceding the introduction of a drug. The usefulness, role of a drug in the therapy may be definitely determined on the basis of the results of these studies.     

Late results after repair of partial atrioventricular septal defect in adolescents and adults

From January 1966 through December 1985, 29 adolescents and adults underwent surgical repair of a partial atrioventricular septal defect at our institution. The patients included 20 females and 9 males, whose ages ranged from 16 to 47 years (mean, 27.6 +/- 10.1 years). Preoperatively, 24 patients were in New York Heart Association functional class I or II, and 5 were in class III. The pulmonary artery systolic pressure ranged from 22 to 62 mmHg (mean, 38.3 +/- 12.7 mmHg). The pulmonary-to-systemic flow ratio ranged from 1.4 to 2.9 (mean, 2.3 +/- 0.5). Upon left ventriculography, regurgitation through the left atrioventricular valve was trivial or nonexistent in 4 patients (13.8%), mild in 14 (48.3%), moderate in 10 (34.5%), and severe in 1 patient (3.4%). All patients underwent patch closure of the ostium primum defect, and all but 2 underwent partial or complete suturing of the septal commissure. One patient died within 30 days, for a hospital mortality of 3.4%. The follow-up period ranged from 7 to 25 years (mean, 15.2 +/- 5.3 years). Postoperatively, all patients were evaluated with 2-dimensional and Doppler echocardiography. One patient underwent early implantation of a permanent pacemaker for persistent complete heart block. Three patients succumbed to late death 10, 15, and 21 years after operation. Among the 25 long-term survivors, 1 patient required late valve replacement because of severe left atrioventricular valve regurgitation. Nine (37.5%) of the other 24 long-term survivors had little or no regurgitation. Of the 11 patients with moderate-to-severe preoperative left atrioventricular valve regurgitation, 4 had moderate postoperative regurgitation. Seventeen patients had a moderate or severe persistent apical systolic murmur. At the latest follow-up in 1991, 5 (20%) of the 25 long-term survivors had significant arrhythmias. At 25 years, the actuarial survival rate was 78.9% +/- 25.6%. All 25 surviving patients were in New York Heart Association class I or II. The rate of freedom from reoperation was 77.7% +/- 25.9%. We conclude that, in adolescents and adults, correction of a partial atrioventricular septal defect entails little risk and is likely to improve the patient's functional status. Repair of the left atrioventricular valve yields good results, even at long-term follow-up.