Acta medica Hungarica最新文献

Recently, in vitro production of interleukin-2 receptor induced by mitogens have been shown to be impaired in autoimmune disorders including organo-specific autoimmune diseases. The aim of this study was to investigate serum levels of soluble interleukin-2 receptor in 20 untreated patients with Graves' disease and to follow up their changes in relation to clinical picture and TSH-receptor-, anti-thyroglobulin-, anti-microsomal as well as anti-eye muscle antibodies. Soluble interleukin-2 receptor level was significantly increased in newly-diagnosed Graves' patients compared to controls (667 +/- 270 vs. 205 +/- 45 U/ml) (P less than 0.001). Among the patients sera those with active infiltrative ophthalmopathy had higher soluble interleukin-2 receptor levels than those without eye symptoms (810 +/- 313 vs. 525 +/- 180 U/ml). Soluble interleukin-2 receptor level was normalized in Methimazole-treatment-induced remission in the majority of patients except those with ophthalopathy. In five patients the soluble interleukin-2 receptor levels were studied after interruption of thyrostatic therapy; an increase was observed in three patients; thereafter hyperthyrosis relapsed in two cases. Furthermore, a correlation was found between soluble interleukin-2 receptor levels and TSH-receptor antibodies, however, the association with other immune parameters examined was not significant. In conclusion, an enhanced level of soluble interleukin-2 receptor was detected in patients with untreated Graves' disease. This finding might play a significant role in regulation of impaired cell-mediated immune mechanism and has a prognostic value for relapse of autoreactive processes.

Cranial Computed Tomography (CCT) findings in 123 patients suffering from Parkinson's syndrome were compared with a sex- and age-matched normal control group. Signs of supratentorial atrophy--cortical and subcortical--were more significantly marked in the Parkinson group. In both groups, signs of atrophy were more prevalent in men than in women. Parkinsonian women also more frequently showed limited features, such as lacunar lesions, around the lateral ventricles. Moreover, in these patients atrophy was marked in the frontal cortex.

In two generations of a family followed up for 15 years, nine patients suffering from myasthenia gravis were observed. The family, being of special genetic importance, is unique in the literature.

A total of 37 prenatal diagnoses were analysed: 10 observations in which one of the parents carried a Robertsonian translocation and 27 observations in which one a reciprocal translocation was carried by one of the parents. The segregations of the inherited chromosome structural rearrangements were analysed in relation to the methods of ascertainment of the anomaly in the family, and the types of rearrangement. The mode of ascertainment proved to be a very useful indicator of the risk: those cases ascertained through abnormal livebirths had a 44% risk in our series, but there was no unbalanced fetus in the group ascertained through recurrent abortions.

Serum elastase-type activity, elastase inhibitory capacity and their relation to lipids were examined in 140 male patients with ischaemic vascular disease (coronary, cerebral, peripheral) and in 60 control subjects. Serum elastase-type activity was found to be significantly lower, inhibitory capacity significantly higher, in the groups of patients than in the controls. HDL- and HDL2 cholesterol as well as apo A concentration showed significant negative correlation with elastase inhibitory capacity both in atherosclerotic and in control subjects.

Prostaglandin E2 (PGE2), sodium, potassium and creatinine were determined in the blood and urine of 50 renal transplant recipients treated for at least one year post transplantation with cyclosporine A or azathioprine as immunosuppressive agent. Fourteen healthy subjects were used as a control group. The urinary PGE2 excretion was significantly decreased in the renal transplant recipients on azathioprine therapy while it was unchanged in the patients treated with cyclosporine A. At the same time, a significant decrease in urinary excretion of sodium and potassium was found. On the other hand, a high elevation of blood PGE2 concentration was observed while no significant changes were seen in sodium and potassium in the blood of these renal transplant recipients. It is suggested that an association exists between urinary PGE2 reduction and immunosuppressive treatments in renal transplant recipients and that PGE2 may regulate intrarenal haemodynamics and influence renal tubular electrolyte excretion. Finally, urinary PGE2 can be used as an indicator of successful renal transplantation.

The 6-keto-prostaglandin-F1 alpha content (as the stable break-down product of prostacyclin) of rat antral and fundic gastric, as well as of duodenal mucosa, significantly increases after 1, 5 and 10 mg/kg orally administered colloidal bismuth subcitrate treatment. The results indicate that (i) colloidal bismuth subcitrate-induced stimulation of endogenous prostacyclin content ("adaptive cytoprotection") of rat gastroduodenal mucosa may contribute to its therapeutic effect; (ii) the effect of colloidal bismuth subcitrate is not due exclusively to the bismuth content of the molecule, but seems to be connected with the structure of colloidal bismuth subcitrate itself; (iii) the effect seems to be dose-dependent, showing a dose-response relationship.

Evaluation of the results of plasmapheresis therapy is reviewed on 160 patients suffering from myasthenia gravis. This new therapeutical procedure is considered very valuable: improvement can be achieved in 63% of the patients during the therapy, a further improvement in 30% after it. Plasmapheresis is especially effective for patients in respiratory crisis-prone state, for drug-resistant cases and for preparation patients for surgery. Plasma exchange therapy may be combined with other forms of immunosuppression with benefit. Thymectomy and plasma exchange are considered to be the main therapeutical procedures in myasthenia gravis.

A significant increase was found in the number of white blood cells, including neutrophils, in the peripheral blood of patients during plasma exchange. However, the spontaneous chemiluminescence of peripheral white blood cells (basically characterized the activated state of neutrophils) was not elevated. This finding suggests a relative deficiency in the metabolism of neutrophils during plasma exchange. This idea is supported by the observation that the levels of malonyldialdehyde in plasmas, after plasma exchange, do not increase, indicating that the activation dependent lipid peroxidation in neutrophils did not take place.