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FUNCTIONAL MORPHOLOGY OF THE SPLEEN. THE CURRENT KNOWLEDGE
JAKUBOVSKY, J., PORUBSKY, J.
The spleen was till the first half of the twentieth century considered to represent an organ of no special significance. Nowadays its clearance function and position in the immunity system is thorougly investigated. Informations on its cellular composition and compartments are sufficient. The problems coinciding with circulation in the spleen are solved. The study of interactions of T and B lymphocytes regarding the development of humoral immunity do not provide clear results. Unclear remain also the relations of extracellular and cellular structures. The localisation of the spleen in blood circulation and large amount of migrating lymphocytes justify its significant position in the protection of host against infections spreading haematogenously. It is not inevitable for survival, but its removal increases the risk of unmanagable infections carried by bacteria with polysaccharide capsules. The microenvironment in the spleen enables intercellular relations and determins the development of immune reactions. Microcirculaton enables it to function as a biological filter without the neccessity of specialized filtrating structures being present. In consequence of blood filtration everything leaks into the extravasal space. Subsequently all components normally constituting the blood return back into the blood within vessels. That is why no special structures are formed in order to filter individual components from the blood. All components that should not be present in the blood are excluded extravasally. The substances which are not let through the wall of sinuses into the blood, remain in the marginal zone and in the red pulp. The macrophages of the marginal zone and red pulp destroy and degrade the unrequired substances. (Ref. 26.)
Key words: spleen; structure; function.
Bratisl Lek Listy 1995; 96: 637-641
THE DIAGNOSIS AND TREATMENT OF ERECTILE DYSFUNCTIONS
BREZA, J.
Objectives: Erectile dysfunction (ED) is the most frequent
form of male sexual dysfunctions. The incidence is not known.
Approximately 10% of men suffer from ED. Aging is concomitted
by an exponential increase in the occurrence of erectile dysfunctions.
Some groups of men (suffering from diabetes, alcoholism, ICHS,
renal diseases) yield several times higher values of their occurrence.
In general, ED (formerly impotentio coeundi) can be defined as
an inability to achieve erection and maintain it for an appropriately
long period enabling sexual intercourse.
Etiopathogenesis: The etiology includes psychological,
neurological, arterial, sinusoidal, venous and hormonal factors
which participate in erectile function. ED arises predominantly
in consequence of impaired haemodynamics of the penis. It develops
either due to insufficient blood inflow into the erectile bodies
or due to their excessive drainage. The traumatic lesions of penile
vessels are less frequent. Drugs and medicaments play a significant
role among etiologic factors causing erectile dysfunctions.
Diagnosis: No regulations and principles are generally
valid in coincidence with examination of patients with erectile
dysfunction. The signs of neurologic, hormonal and vascular defects
are detected. An objective method of examination of erectile capacity
of the penis resides in the monitoring of penile nocturnal tumescensions.
The examination of arterial system of the penis provides information
on the perfusion flow and blood pressure in the cavernous arteries.
The vascular structures of the penis and their functions can be
evaluated by means of duplex ultrasonography and flowmetry. The
quality to arterial supply of erectile bodies is evaluated by
dynamic examination of arteries prior to and after intracavernous
application of vasoactive substances. The functional state and
size of venous leak from the cavernous bodies are evaluated by
dynamic cavernosometry.
Therapy: The application of vasoactive substances meant
a significant contribution to the diagnosis establisment and therapy
of erectile dysfunctions. They have a common feature which resides
in their myorelaxation effect and thus in their ability to induce
erection by means of relaxation of the smooth muscles of cavernous
bodies. Intracavernous application of vasoactive substances is
the mostly spread means of therapy of erectile dysfunction as
a whole, frequently with no regard to the etiology. Surgical therapy
of vasculogenous impotence is based on knowledge concerning the
impact of vascular lesions on the haemodynamics of erectile function
of the penis. The revascularisation operations are aimed at the
regeneration of normal haemodynamic conditions in the penis.
Conclusion: Sexual life is currently considered as a proportion
of life of individuals. The physicians therefore have to seek
ways of how to help the patients who due to acquired erectile
dysfunctions are handicapped in the establishment of family harmony
and sexual life. (Ref. 31.)
Key words: erectile dysfunctions; erection; impotence; sexuality.
Bratisl Lek Listy 1995; 96: 642-650
THE TECHNIQUE OF MULTIORGAN PROCUREMENT (HEART, LIVER, KIDNEYS)
DANNINGER, F., BREZA, J., MRAZ, P., PETRASOVIC, M.
A significant growth in transplatation activity has been recorded in the past decade, namely in transplantations of the heart and liver. The numbers of transplantations of the lungs, and of the combination of pancreas with kidneys have increased to a smaller extent. The number of transplanted kidneys has become stabilized during the past several years. The development of organ transplantations led to a change of conception in the procurement of cadaveric organs from the until now performed procurement of a single organ to multiorgan procurements where in addition to the kidneys at least one other organ is procured. In countries with the highest number of multiorgan procurements the latter form as many as 80 % of the total number of cadaveric procurements. Since January, 1, 1995 a principle has been officially recognized in the Slovak Republic where an agreement with organ donation is presumed. Procurements of organs do not take place in cases when the donors have made during their lives a written or any other kind of declaration disapproving any intervention into their corporal integrity. Organs are also not procured in cases of foreigners, persons under legal sentence and those whose identities cannot be proved. The authors describe the technique of multiorgan procurement (heart, liver, kidneys) as well as contraindications to procurements of individual organs. (Fig. 2, Tab. 1, Ref. 12.)
Key words: multiorgan procurement; transplantation of organs.
Bratisl Lek Listy 1995; 96: 651-654
NOCNY A DENNY PRIJEM POTRAVY U LABORATORNYCH POTKANOV KMENOV WISTAR A KOLETSKY
SIDLO, J., ZAVIACIC, M., KVASNICKA, P.
Background: Rats have an extraordinary expressive circadian
organization and prefer the dark as the optimal condition of its
life environment. During darkness, the rhythm of its several parameters
reaches the acrophase.
Main purpose: The aim was to establish the differences
in the level of food-intake of laboratory rats of the Wistar strain
and in those of the spontaneously obese rats of the Koletsky strain
by means of ad libitum feeding under natural light-dark conditions.
Methods: The levels of day and night food consumptions
in both strains of rats, Wistar and the spontaneously obese Koletsky
strain, were studied within the period from January 10th to 20th,
(males), and from April 16 to 26, 1990, (females). The animals
were fed by Larsen's diet under natural light conditions. The
data were evaluated by means of the t-test.
Results: It was detected that during the period between
5 o'clock PM and 6 o'clock AM the male rats of the Wistar strain
consumed 80 % and the female rats 79 % of their total daily amount
of food. Food consumption of the Koletsky rats during the period
from 5 o'clock PM to 6 o'clock AM in males reached the value of
72 % and in females 74 %.
Conclusions: There were detected significant differences
in circadian food-intake in both strains. Besides the nocturnal
preference in food-intake of Wistar rats, which is in accordance
with the data gained from literature, a similar food-intake with
expressive diurnal-nocturnal differences exists also in the spontaneously
obese Koletsky rats. Daily food consumption in these male rats
was significantly higher when compared to the Wistar strain. (Tab.
1, Fig. 1, Ref. 5.)
Key words: Wistar rat; Koletsky obese rat; ad libitum feeding; food consumption; nocturnal and diurnal differences.
Bratisl Lek Listy 1995; 96: 655-657
RECONSTRUCTIVE OPERATIONS ON OUR CLINICAL MATERIAL
FRANKOVICOVA, M., BOBER, J., ARENDARCIK, F., MARTINCEK, M., KUBIKOVA, M., HARBULAK, P., KRIEGEROVA, K.
The authors present the results of reconstructive vascular operations performed during the period from 1990 to 1994. According to the criteria of the European Vascular Surgery Council the lowest patency was recorded in the distal type of femoropopliteal bypases in the lower extremities. They emphasize the necessity to apply the "Graft Surveillance Programme" in vascular consultation centre. (Tab. 2, Ref. 7.)
Key words: vascular reconstructive operations.
Bratisl Lek Listy 1995; 96: 658-660
SELECTIVE VULNERABILITY OF NEURONS AFTER EXPERIMENTAL HEART CARDIAC
ZACHARIAS, L., VANICKY, I., MECHIROVA, E., MARSALA, M., MARSALA, J.
The study was aimed at the analysis of vulnerability of the olfactory
bulb neurons in dogs after experimental heart arrest lasting for
15 minutes and recirculation lasting for 1 hour. By means of the
Nauta degenerative neurohistologic method the reactions of individual
types of nerve cells in the olfactory bulb were investigated.
Nauta-positive granules were observed in the cytoplasm of the
mitral and tufted cells of the olfactory bulb, which are of dopaminergic
character. The granulations were present in the cellular areas
which are rich in Nissl substance. The granular and short-axon
cells of GABA-ergic character which contain a small amount of
Nissl granules lack the Nauta-positive granules. Similarly, the
Nauta-positive granules were absent in the axon hillock of mitral
cells which under normal conditions do not contain the Nissl substance.
These results justify the conclusion that ischemia lasting for
15 minutes and one-hour recirculation primarily affect the excitatory
neurons rich in the Nissl substance. (Fig. 4, Ref. 16.)
Key words: ischemia; neurons; bulbus olfactorius; Nauta method.
Bratisl Lek Listy 1995; 96: 661-665
MECHANICAL HEART VALVULAR PROSTHESIS WITH SPHAERICAL SHAPE AND OPEN CENTRE
SIMKOVIC, I., BOLF, J.
A mechanical valve prosthesis is described with central blood flow. The generations I and II of the mechanical valve obstruct the blood flow and cause turbulence with undesirable consequences. The opening in the centre of Simkovic-Bolf valve preserves the laminar blood flow, reduces the trauma of blood and myocardium stress. Our new valve represents a mechanical valve prosthesis of generation III. (Fig. 5, Ref. 16.)
Key words: mechanical valvular prosthesis; turbulence; laminar blood flow.
Bratisl Lek Listy 1995; 96: 666-668
POSTOPERATIVE ANALGESIA BY EPIDURALLY ADMINISTERED COMBINATION OF TRAMADOL AND CLONIDINE
MASAR, O., ZELINKOVA, M., PECHAN, J., KRCMERY, S., HANUSKOVA, D., BUZUKASVILI, M.
Postoperative analgesia inhibits the stress cascade with negative
effects on whole organism. Therefore the spectrum of drugs used
for soothing postoperative pain quickly widens. The epidural route
appears as being logical, since due to the direct effect in the
transmission and processing of pain it suffices with a lower dosage.
The authors refer to a group of 30 patients postoperatively treated
by a combination of tramadol and Clonidine administrated by means
of an epidural catheter. 26 patients evaluated the induced analgesia
as excellent or sufficient. (Tab. 3, Ref. 4.)
Key words: analgesia; epidural route; tramadol.
Bratisl Lek Listy 1995; 96: 669-670
VARIOUS HISTOLOGIC AND ULTRASTRUCTURAL FINDINGS IN RENAL GLOMERULI BIOPSY
DANIS, D., POPRAC, P., NYITRAYOVA, O., SLUGEN, I., PAVLOVIC, M., NYULASSY, S., KOVAC, A., FURKOVA, K.
On the basis of 506 renal biopsies performed within a six-year
period (237 of which were evaluated electron-microscopically)
the authors discovered that in 11 cases the diagnosis based on
electron microscopic examination had to be corrected or supplemented
by the diagnostic statement of membranous glomerulonephritis.
These cases included 1 boy (HBsAg positive), 2 men and 8 women
were middle aged. 5 women were treated due to polyarthritis. All
cases when examined light-microscopically yielded a pattern evaluated
as normal, or as minute abnormalities of glomeruli. Half-thick
sections were not sufficient for the diagnosis. 3 cases of biopsies
yielded a variously developed chronic tubulointerstitial nephritis,
two cases were accompanied with polyarthritis.
On the basis of the latter the authors consider the electron microscopic
examination as indicated: 1. in cases when the diagnosis statement
is not achieved by other examinations, 2. findings are in the
range of the so-called variable norm, 3. in all cases of minute
abnormalities in glomeruli detected without elctron microscopy,
4. the impact of any of effective drugs cannot be excluded, 5.
the diagnostic conclusion based on renal biopsy and the clinical-laboratory
pattern of the disease are inconsistent.
The authors assume that especially the fourth and fifth groups
are going to be gradually supplemented and made more precise.
(Fig. 1, Ref. 5.)
Key words: renal biopsy; electron microscopy indication; minute abnormalities in glomeruli.
Bratisl Lek Listy 1995; 96: 671-674