Diagnosis and treatment of recurrences of duodenal ulcer perforation after its closure

In a work, the information about the patients who had their duodenal ulcer once (836 case), or twice (28) perforated is analysed. Recurrency of a perforative ulcer after its closure was noted in 1.4% of cases. After closure of a perforating ulcer, it is expedient to watch and examine the patients in a specialized institutions. In disease recurrency after closure of a perforative ulcer and ineffective therapy, the performance of radical operation preventing the subsequent development of a disease complication is indicated.     

Plexus avulsion and spinal cord injury increase the serum concentration of S-100 protein: an experimental study in rats.

The possibility of using the presence of the glial-cell-derived protein S-100 in serum as a marker for neuronal damage caused by spinal cord injury and plexus avulsion injury was investigated in 144 adult rats. After a spinal cord injury had been induced at the thoracic level or a plexus avulsion injury at the lumbar level, blood samples were taken and analysed for S-100 protein by a monoclonal two-site immunoluminometric assay. The two types of neurotrauma changed the kinetics of serum S-100 in different ways. After spinal cord injury it rapidly increased and within 72 hours had reached a concentration about 5 times that of the control animals. Three peak concentrations occurred at 3, 12, and 72 hours, respectively, and differed significantly from those of the control group (p < 0.05). After six days the values had returned to normal. After lumbar plexus injury alone there was no significant increase in the concentration of S-100. These results suggest that the concentration of S-100 protein in serum may be used as an early diagnostic tool for detecting neuronal damage caused by spinal cord injury or plexus avulsion associated with damage to the root entry zone.     

Acute myocardial infarction with isolated ST-segment elevation in posterior chest leads V7-9: "hidden" ST-segment elevations revealing acute posterior infarction.

OBJECTIVES: This study was done to determine whether electrocardiographic (ECG) isolated ST-segment elevation (ST) in posterior chest leads can establish the diagnosis of acute posterior infarction in patients with ischemic chest pain and to describe the clinical and echocardiographic characteristics of these patients. BACKGROUND: The absence of ST on the standard 12-lead ECG in many patients with acute posterior infarction hampers the early diagnosis of these infarcts and thus may result in inadequate triage and treatment. Although 4% of all acute myocardial infarction (AMI) patients reveal the presence of isolated ST in posterior chest leads, the significance of this finding has not yet been determined. METHODS: We studied 33 consecutive patients with ischemic chest pain suggestive of AMI without ST in the standard ECG who had isolated ST in posterior chest leads V7 through V9. All patients had echocardiographic imaging within 48 h of admission, and 20 patients underwent coronary angiography. RESULTS: Acute myocardial infarction was confirmed enzymatically in all patients and on discharge ECG pathologic Q-waves appeared in leads V7 through V9 in 75% of the patients. On echocardiography, posterior wall-motion abnormality was visible in 97% of the patients, and 69% had evidence of mitral regurgitation (MR), which was moderate or severe in one-third of the patients. Four patients (12%), all with significant MR, had heart failure, and one died from free-wall rupture. The circumflex coronary artery was the infarct related artery in all catheterized patients. CONCLUSIONS: Isolated ST in leads V7 through V9 identify patients with acute posterior wall myocardial infarction. Early identification of those patients is important for adequate triage and treatment of patients with ischemic chest pain without ST on standard 12-lead ECG.     

Study of the glucocorticoid function of the adrenals in patients with diabetes mellitus using a minor dexamethasone test

The purpose of the paper is to define the state of glucocorticoid function in 37 male and female patients with types I and II diabetes mellitus of various degree of compensation before and after dexamethasone blockade of the hypothalamohypophyseoadrenal system (0.5 mg 4 times for 2 days). The level of cortisol in the plasma was determined by a radioimmunoassay using Sorin kits. Statistical data processing was performed using the d-3-28 computer. In patients with types I and II diabetes mellitus at the stage of compensation the level of plasma cortisol did not differ from that of persons without diabetes mellitus; in decompensation of types I and II diabetes mellitus its considerable increase was noted. After the dexamethasone test the more pronounced was a degree of decompensation of diabetes mellitus, the higher was the level of cortisol, i.e. there was resistance to dexamethasone inhibiting action, especially in type I which could be accounted for by deeper metabolic derangements in this type of diabetes mellitus and an increase in the threshold of sensitivity of the hypothalamic centers to dexamethasone. Therefore the minor dexamethasone test could be used for determination of a degree of metabolic compensation of patients with diabetes mellitus.     

Effects of weightlessness on bone mass and osteoclast number in pregnant rats after a five-day spaceflight (COSMOS 1514)

Five pregnant growing rats were orbited for 5 days aboard the Soviet COSMOS 1514 biologic satellite. The bone effects of weightlessness were studied and compared to those of five pregnant rats kept in vivarium and five pregnant conditioned rats. Bone histomorphometric studies were performed to investigate the early effects of weightlessness in loaded (tibia-femur) and unloaded (thoracic and lumbar vertebrae) bones. A short exposure to weightlessness does not induce any change in bone mass and inner structure in either type of bone. In unloaded bones, the number of osteoclasts per square millimeter of the trabecular surface significantly increased when measured after histochemical demonstration of tartrate-resistant acid phosphatase. It is likely that a stimulation of bone resorption activity occurs in the trabeculae of unloaded bones during the early phase of a spaceflight. In tibia, osteoid seam thickness and total osteoclastic resorption surfaces at the endosteal level were not modified.