Dexamethasone and adrenocorticotropin suppress prolactin secretion in humans

It has been demonstrated that the regulatory pathways mediating basal and/or stimulus-induced prolactin (PRL) release in mammals are highly sensitive to adrenal corticoid inhibitory influence. We have investigated the effect of four different doses of dexamethasone (DEX) and the effect of adrenocorticotropin on PRL secretion in 197 patients (169 female, 28 male; age: 18–66 yr) with suspected hypercortisolemia—but only those with a normal glucocorticoid suppression test were involved in the study—and in 66 female patients (age: 18–39 yr) with suspected adrenocorticotropin-dependent hyper-androgenism. Overnight (1 mg), low-dose (0.5 mg every 6 h for 2 d), high-dose (2 mg every 6 h for 2 d), and long-lasting administration of DEX (0.5 mg every 6 h for 5 d) resulted in a significant decrease in PRL levels compared to the baseline. Similarly, a reduction in PRL levels could be detected following injection of adrenocorticotropin (250 μg). In hyperprolactinemic patients, the DEX-induced increase in PRL (ΔPRL, expressed in percentage of baseline) was significantly larger compared with normoprolactinemic subjects in all groups except those who received high-dose DEX) or adrenocorticotropin. These data clearly indicate that the secretory function of PRL cells in humans is sensitive to changes in the activity of the hypothalamo-pituitary-adrenal axis in a dose-dependent manner.     

Hand-assisted laparoscopic technique (HALS) in colorectal surgery (Case reports and review of the literature)

Hand-assisted laparoscopic surgery (HALS) is a new technique in which the surgeon's hand is introduced to the abdominal cavity through a mini-laparotomy, while pneumoperitoneum is maintained. We describe the technique of HALS used successfully in the treatment of two patients of colorectal disease. We describe current literature and our initial clinical experience. Our conclusion is that, besides colorectal surgery, HALS technique may prove useful for other abdominal procedures as well; however its real value should be estimated in prospective randomized trials.     

Combined postoperative treatment of malignant supratentorial gliomas with vincristine sulphate and radiotherapy

Summary The results of combined irradiation and intravenous Vincristine therapy applied to 18 malignant glioma patients after operation and reoperation are reported. Histological examination of the first 15 tumours showed that 12 were glioblastomas and 3 malignant astrocytomas. Tumours removed by reoperation were glioblastomas.Combination therapy consisted of the immediate postoperative administration of 6–12 mg VCR (0.08–0.1 mg/kg) over an 8–14 days period followed by 2 courses of telecobalt irradiation giving a total dose of 5,000 rads. Most patients received a second course of 8–12 mg VCR 6 months after surgery. The total dose of VCR was 15–22 mg. Irreversible toxic effects were not observed.The results obtained with combination therapy were somewhat better than those achieved with radiotherapy alone. The mean survival time was 9 months. Patients lived after re-operation for at least as long as they had after a first operation. Death did not occur within a period of 6 months following surgery.     

Effect of the DNA isolation method on the results of multiple fluorescent PCR and DNA fragment analysis

INTRODUCTION: The quality of the nucleic acids has tremendous effects on the results of molecular diagnostic tests. METHODS: The authors have isolated DNA from amniotic fluid samples by using rezin-binding and silica adsorption methods. In the case of the rezin-binding technique they used both frozen and fresh samples. The quality of the isolated DNA was compared by fluorescent PCR and DNA fragment analysis. RESULTS: With the use of the rezin-binding method on frozen samples the authors obtained more PCR fragments following the fluorescent PCR amplification. The gender and the aneuploidy screening is easier from the electrophoretogramms using better quality DNA. Out of the three studied DNA isolation method the silica adsorption seemed to be the best for the fluorescent-PCR and DNA fragment analysis. DISCUSSION: The authors found the silica adsorption method is more suitable for DNA isolation from amniotic fluids for fluorescent PCR and DNA fragment analysis amplification. They suppose silica adsorption DNA isolation results in a total removal of the PCR inhibitors.     

Continuing care of patients with cardiovascular risk in general practice: patients with dyslipidemia and their care

INTRODUCTION: The role of dyslipidemia is essential in the development of atherosclerosis, therefore continuing care of dyslipidemic patients is an extremely important task in cardiovascular prevention. AIMS: This study was aimed to investigate continuing care of dyslipidemic patients in general practices. Method of the study was a questionnaire survey, 397 patients of 39 general practices were involved into the study. RESULTS: The cause of their continuing care was hypercholesterolemia in 91.7%, hypertriglyceridemia in 69%, decreased HDL-C in 18.4%, and these alterations frequently occurred together. Hypertension in 77%, disturbances of carbohydrate metabolism in 41.7%, increased BMI in 43.2% were found. Patients were smokers in 26.5%, given up smoking in 13.2%. They had cardiovascular problems in 56.5%, cerebrovascular problems in 18.6% and peripheral vascular ones in 20.3%. Patients were treated with lipid lowering drugs in 87.7%, statins were used in 81.7%, fibrates in 29.6% and both of them in 11.5%. The main results of continuing care were: in the whole group frequency of cholesterol level > 5.2 mmol/l decreased by 13%, frequency of triglyceride level >1.7 mmol/l decreased by 4%; cholesterol target values were reached in 3% of patients with high cardiovascular risk, in 22.2% of patients with medium risk, and in 66.7% of patients with mild risk. CONCLUSIONS: These results suggest that there is a need for more intensive drug treatment of dyslipidemic patients to reach the target lipid levels, and for regular assessment of continuing care of these patients.     

Our experiences with nephrectomy with special emphasis on using biocompatible materials

We performed 43 open partial nephrectomies with different indications between 1996 and 2004, most of them (29) for renal cancer. We used different types of biocompatible materials for haemostasis. We describe our own recommendations and what is described in literature.     

Experience with radiofrequency ablation in the treatment of unresectable pelvic recurrence of rectal cancer

More than half of colorectal cancers are located in the rectum, and the number of such cancers is increasing. In Hungary colorectal cancers are diagnosed predominantly in advanced stages. In the last five years 736 patients with colorectal cancer were operated on at our Department, with the following stage distribution: Dukes A 10%, BI 10%, B2 31%, C 36% and D 13%. The local recurrence rate is decreasing since the introduction of total mesorectal excision and preoperative radiation. Effective treatment options are however poor for unresectable pelvic recurrences. Chemo- and radiotherapy have severe limitations in this advanced stage cancer. In recent years there are a few publications on the minimal-invasive radiofrequency tumour ablation (RFTA) technique, which is an effective treatment for primary and metastatic liver carcinomas and is a new palliative for the local treatment of pelvic recurrence. The aim of this study was to assess the response to treatment using ultrasound-guided radiofrequency ablation in two patients with unresectable pelvic recurrent rectal cancer.