Lege Artis Medicinae

[Stephen d'Irsay]


OCTOBER 27, 1993

Lege Artis Medicinae - 1993;3(10)

[In the medical history literature of the inter-war years, I was struck several times by an unusual name: Stephen d'Irsay. I suspected that behind the name was an author of Hungarian origin, but this suspicion was confirmed only recently, and at the same time the outlines of an interesting human destiny, a not insignificant medical career, began to emerge. ]



Further articles in this publication

Lege Artis Medicinae

[The origin of serum catalase in healthy subjects and in some diseases]

GÓTH László

[The activity of serum catalase is highly increased in acute pancreatitis, hemolytic disorders and in some liver diseases, but there is no data on its tissue origin. The serum catalase activity was determined by a spectrophotometric assay in healthy subjects (n = 4275) as well as in increased erythropoesis (n = 424), in hemolytic diseases (hemolytic anemia = 12, megaloblastic anemia = 28, Zieve syndrome = 8, hemorrhage = 38), in acute pancreatitis, (n = 111), in liver diseases (fatty liver = 21, alcoholic hepatitis = 42, acute yellow atrophy = 18, toxic hepatitis = 15), and in liver congestion due to cardiac circulatory failure (n = 28). These diseases yielded increased serum catalase activity. This enzyme has no tissue specific isoenzymes, therefore mathematical and statistical approaches were used. The correlation between serum hemoglobin and serum catalase was analysed. The catalase release was estimated from the time activity curves of serum catalase and compared to its tissue equivalent. In healthy subjects about 60 percent of serum catalase derived from the erythrocytes and the rest from other tissues. During enhanced erythropoesis and in hemolytic diseases, similarly to hemoglobin, its source was the erythrocyte pool. In acute pancreatitis also the erythrocytes might be responsible for the increased serum catalase level. in some liver diseases as well as in liver congestion due to cardiac circulatory failure the increase of serum catalase derived from the liver cells. The diagnostic analysis of serum catalase requires the consideration of its increase as well as its origin. ]

Lege Artis Medicinae

[The surgical treatment of shoulder instability]


[The author briefly reviews the static and dynamic stabilizing system and the biomechanics of the shoulder and describes his principles and techniques of the surgical treatment of instability. A modified Bankart procedure is used for recurrent anterior dislocation. Bone blocks are implanted in cases of locked posterior dislocation. Different forms of cranial instability are described as well as partial and total superior glenoidal lesions. The author discusses surgical procedures used in the treatment of these instabilities. Cranial instability leads to impingement syndrome, which results in rotator cuff lesions. These lesions increase instability and the increased impingement leads to further rotator cuff damage. This vicious cycle can be interrupted by surgical intervention.]

Lege Artis Medicinae

[Clinical application of specific antibodies in immunotherapy of transplantation]


[In organ and tissue transplantation practice as well as in the therapy of autoimmune, haematological, immunological and oncological diseases, the possibility for applying immunotherapy is occuring more frequently. The paper deals with all those reagents which are primarily of polyclonal or monoclonal immunglobuline origin and play a significant role in the various cell-bound immune reactions on the surface of lymphocytes. In addition to the anti-lymphocyte or/rather anti-thymocyte globuline as well as the Orthoclone (anti-CD3 monoclonal antibody) reagents well known in clinical practice, it also refers to other lymphocyte surface anti-marker monoclonal anti-bodies (anti CD4, -CD8; anti TCR, anti-LFA reagents) under clinical trial. The article reviews the possible uses of the group of immunotherapeutical reagents in the clinical practice of Kidney and bone marrow transplantation. The pharmacological mechanism, side effects, and prospects for a wider use of these reagents in the future are discussed.]

Lege Artis Medicinae

[Prenatal follow up of a complex cardiac malformation complicated with complete AV block]

SZABÓ István, CSABAY László, NÉMET János, HAJDÚ Júlia, PAPP Zoltán

[In a congenital disorder of heart development where the complex cardiac malformation is pared with complete atrioventricular block heart rate is stabile between 50–60 beats/min. Transfer of atrial impulses through the AV node is fully blocked and the slow rhythmic heart beat is maintained by a ventricular pacemaker. In a case of such a complete cardiac malformation recognized in week 32 of gestation and the AV block complication caused stabile 57–58 beat/min bradycardia. 2-di mensional, pulsed and color Doppler ultrasonography was used to identify the disorder and to follow up the intrauterine condition of the fetus. Cardiotocography (CTG) could not generate appreciable results at such a low heart rate. During observation no centralization of fetal circulation causing intrauterine hypoxia was recorded. Updated knowledge on the pathogenesis and obs tetrical management of the fetal third degree AV block is also presented. In this case ultrasonography allowed clear-cut identification of the disorder and also ensured correct evaluation of the intrauterine status of the fetus when other diagnostic methods for evaluation were not applicable. ]

Lege Artis Medicinae

[Eurpean Concerted Action on Thrombosis and Disabilities Angioma Pectoris Study]


[Patients with more than 50% stenosis in one or more coronary arteries had significantly higher fibrinogen levels (p<0.0001). Reduced fibrinolytic activity was also observed in patients with coronary artery stenosis, mainly due to higher levels of plasminogen activator inhibitor-1 (PAI). Decreased fibrinolytic activity was strongly associated with diabetes, elevated triglyceride levels, smoking and impaired left ventricular systolic pump function. Cholesterol levels correlated mainly with protein C and plasminogen levels.]

All articles in the issue

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Hypertension and nephrology

[The beginning and difficulties of peritoneal dialysis at the end of the last century - Part I. International experiences]


[The theoretical background of peritoneal dialysis dates back to the 18th and 19th century. It was in 1923 when the first experimental and clinical experiences were summarised by Ganter from Munich. Of the Hungarian researchers Stephen Rosenak’s name can be mentioned, who was working in this field in Bonn in 1926 and later in London and New York. Obstacles to the spread of this treatment method was the lack of appropriate abdominal catheters, biocompatible solutions and equipment. The intermittent technique of the method was time consuming and, due to the conditions of that time, peritonitis frequently developed. The spread of the method was facilitated by the catheter constructed by Tenchkoff towards the end of the 1960s, the automatization of the treatment and later continuous ambulatory peritoneal dialysis (CAPD) described by Popovich and Moncrief. Further development of the method became possible by the use of the two-litre plastic bags instead of the bottled solution and later a twin-bag system employing the “flush before fill” technique. The occurrence of peritonitis developing during the treatment gradually decreased, in which Stephen I. Vas of Hungarian origin, working in Toronto as a professor of microbiology played an important role by constantly improving and modifying the principles of the therapy. Besides the infection in the abdominal cavity the bioincompatibility of the dialysis fluid presented another problem, which was solved by the use of essential amino acids, icodextrin instead of glucose and bicarbonate instead of lactate. By the turn of the century it became clear that the survival rate of peritoneal dialysis is very similar to that of hemodialysis in the second and third years following the treatment, while in relation to the quality of life it proved to be better. This observation has been proved in numerous clinical studies in the past decade and has been refined with regard to patients’ age, their primary and accompanying diseases. It is my intention to give account of the Hungarian experiences with peritoneal dialysis in the second part.]