Control of the RIA method as viewed from the standpoint of the investigation on the kinetics of the insulin-125I-antibody reaction

In this paper attempts were made towards the optimalization and the control of some parameters of the RIA reaction.Basing on the law mass action, as well as on the Scatchard's and Sips's equations, the equilibrium constants for the reversible reaction: insulin-¹²⁵I-antibody for different incubation temperatures were calculated. Moreover a characteristic of the antiinsulin antibody by means of the heterogeneity coefficient was done, as well as the values of the thermodynamic function increments were calculated, which made possible to point out explicitly the optimal shape of the standard curve.     

Effect of therapeutic drug monitoring of amitriptyline and genotyping on efficacy and safety of depression therapy

Modern pharmacotherapy is based on precise adjustment of a dosage schedule to individual requirements of patient. Therapeutic drug monitoring is a method that allows for a more effective treatment approach, especially in the case of a narrow therapeutic index of a drug. Tricyclic antidepressant drugs are characterised by narrow therapeutic index as well as relationship between serum drug concentration and side effects. It was demonstrated that interindividual variability of blood concentrations of tricyclic antidepressant drugs is related to genetic polymorphism of oxidating enzymes participating in metabolism of these drugs. The aim of the study was to estimate the impact of therapeutic drug monitoring of tricyclic antidepressant drugs as well as genotyping on efficacy and safety of endogenous depression therapy. The study included 9 patients with established diagnosis of endogenous depression. Blood serum concentrations of amitryptyline was measured by fluorescence polarisation immune assay (FPIA, Abbott system). Genotype of cytochrome P450 isoenzyme CYP2D6 was determined using PCR-RFLP method. It was demonstrated that monitoring therapy of tricyclic antidepressant drugs in combination with determination of the genotype seems to be more safe and effective. Monitoring therapy and genotyping may be less expensive than the costs of prolonged hospitalisation and risk of side effects.     

Assessment of blood flow velocity during cognitive stimulation in persons with suspected hydrocephalus

The aim of this work is to evaluate middle cerebral arteries (MCA) blood flow velocity changes during performance of linguistic and visuospatial cognitive tasks. Two groups were investigated: eight patients with suspected hydrocephalus without perceptible cognitive disturbances, and eight healthy persons. Blood flow velocity in left and right MCA was recorded with transcranial Doppler sonography while the examined patients were performing three different tasks. The analysis of the results showed differences between the groups concerning both increase of blood flow velocity values and performance patterns. Compared to healthy individuals less increase in blood flow velocity during performance of all tasks and no difference in haemodynamic changes between both hemispheres during task performance were observed in patients with hydrocephalus. The results obtained suggest, that the pattern of functional lateralization in brain in patients with suspected hydrocephalus is probably changed.     

Posttraumatic ectopic calcification as an additional pathologic factor of brachial plexus palsy

The authors describe a case of a 54-year-old male, who was attacked with a broken bottle and wounded in left supraclavicular region. No neurologic deficit was observed immediately after injury. Some days later signs of upper trunk brachial plexus palsy were detected. Gradually symptoms of the Erb syndrome have developed. He was operated on 5 months after injury. During surgery no discontinuity of the brachial plexus was found. Unexpectedly there were an inner scar and free bony fragment compressing the upper trunk and the suprascapular nerve. Both the scar and bony fragment were carefully dissected and removed. Result of surgery: pain relief, restoration of normal sensation and partial restoration of biceps function.     

Stimulating amino acids in epilepsy: possibilities of treatment

Stimulating amino acids (glutamine and aspargine) play an essential role in epileptogenesis. Activating receptors NMDA, AMPA, kainate and metabotropic influence a conduction of ion canals and a beginning, duration and extinction of epileptic discharges. Some of the new anti-epileptic drugs introduced in the recent years modify functioning of glutamine receptors subtypes. It is expected that they can also decrease a release of glutamines, amplify a GABA-ergic suppression and block sodium channels. Most information about these drugs in epileptogenesis was received in animal experiment which is an excuse for a lack of certainty in a parallel referring their mechanisms to the central nervous system in a man. Treatment resistant focal or general epilepsies and some epileptic syndromes are the most often appearing indications for using agents producing an effect on activating amino acids system. They are most often used in an added therapy, more rarely in a monotherapy. Some negative comments concern not very clear influence on cognitive functions, however some hope arises due to a potential neuroprotective mechanism being a result of a decreased glutamine release. The drugs blocking a stimulating transmission should be a good supplement for a present possibilities of epileptic treatment.     

Is there an effective neuroprotective treatment of Parkinson's disease? (therapeutic possibilities against the background of etiopathogenetic concepts

The author presents current views on neuroprotective strategies in therapy of idiopathic Parkinson's disease. They are the result of different aetiopathogenetic concepts of Parkinson's disease. The concepts of loss of nigral cells as a result of aging, apoptosis or genetic defect (alpha-synucleine) are not sufficiently proven and their role is only hypothetic. Therapeutic use of nerve growth factors seems to be a promising novel strategy but there are technical problems how to deliver them to the brain. One of the most and widely acceptable concept is the theory of the role of oxidative stress in pathogenesis of Parkinson's disease. It was a scientific basis for clinical trials with selegiline (DATATOP, SINDEPAR, PDRG) which results were unfortunately disappointing, mostly because of symptomatic effect of selegiline. Another interesting concept seems to be the excitotoxicity of amino acids (like glutamate) and amantadine is the well known drug with recently discovered antagonism to NMDA receptors. In only one retrospective clinical trial in humans its neuroprotective effect was proven, but we need now well prepared prospective trials with this drug to confirm this result. So far, despite the hopes concerning selegiline no one effective neuroprotective agent is available in treatment of Parkinson's disease.     

Comparison of neurological status in patients treated in a stroke unit with those treated in classical care model

140 patients with stroke (69 men and 71 women) aged 71.7 +/- 12.4 treated in the general neurology were compared with 102 patients (46 men, 56 women) aged 71.5 +/- 11.2 treated in the stroke unit during the period 1.11.95 to 31.10.97. Neurological status and state of environmental dependency during the discharge time were similar in both groups, but the state of motor performance was significantly better in the group of patients treated in the stroke unit. In the stroke unit collaboration between nurses and rehabilitants makes it possible to increase the time of rehabilitation and to introduce the elements of exercises which can be done by patients under control of nurse.     

The application of dysarthria profile tests in ALS patients for the detection of speech disturbances

Dysarthria is an invalidating disability in ALS patients with motor neuron degeneration in the bulbar region. The methods to assess dysarthric disorders in ALS are seldom described in publications. This study was performed in 43 patients who had definite (n = 23) or probable (n = 20) ALS (of the bulbar group n = 15, of the limb group n = 28, mean age = 57.07 (range: 36-69 yr.)) according to WFN criteria. The method based on quantitative tests of dysarthria profile (by Robertson, 1986) was used and the results were compared with 37 age, sex-matched, healthy control subjects. Our study showed the existence of disturbances in all dysarthria profile tests which were of the statistic significance and more frequent as compared to the control subjects (p < 0.01). The analysis showed that quantitative assessment of some dysarthria profile tests (5 out of 8) might be useful in clinical practice to detect dysarthria in ALS patients. Using the dysarthria profile tests we also demonstrated that preclinical dysarthric processes occur among the limb ALS group.