Polski tygodnik lekarski (Warsaw, Poland : 1960)最新文献

Chemotaxis, spontaneous migration, phagocytosis, expression of the receptors of Fc Ig fragments and of C3 component of complement has been examined in blood of 51 patients with obesity divided into 3 groups with: 1. disturbances in carbohydrate and lipid metabolism, 2. disturbance in lipid metabolism, 3. no symptoms of metabolic diseases and 20 healthy controls. A comparison of the characteristics of neutral granulocytes in the blood of the healthy controls before and after fat rich meal has been performed. Obtained results indicate that high concentration of lipids, decrease granulocyte activity therefore could be the cause of the decrease of immunological defence.

In order to analyse anxiety and depression states observed during the treatment of lymphoproliferative diseases, a group of 23 patients were studied. For assessment of the variables the following was used: history taking, psychological observation and psychometric techniques. The obtained results point to various dynamics of anxiety and depression. The intensity of anxiety states decreases during single as well as successive courses of chemotherapy. Depression states intensify during one course with a tendency for mood lowering with prolonged treatment duration. Therapeutic conclusions: 1. It is necessary to minimize anxiety attitudes, particularly during the first phase of the treatment (cognitive psychotherapy). 2. In deep depression it is indicated to use antidepressants and supportive psychotherapy.

Plasma concentrations of interleukines 1, 3, 6, 8 and platelet derived growth factor (PDGF) were estimated in 45 patients with leukaemias. Among patients were 12 with acute myeloblastic leukaemia-AML (type M1 according to FAB classification), 9 with chronic granulocytic leukaemia-CGL, 10 with blastic crisis of CGL (CGL-BC) and 14 with chronic lymphocytic leukaemia-CLL (in 1 and 2 stage according to Rai classification). Additionally the concentration of IL-3 was measured in 10 patients with exacerbation of CLL. Control group consisted of 12 health volunteers. The concentrations of interleukines and PDGF were determined by means of radioimmunoassay or immunoradiometric assay. In the patients with AML, CGL-BC and CLL significant increase of concentrations of IL-1B, IL-6 were found. The patients suffers from CGL and CGL-BC had increase concentrations of IL-3, but patients with CLL-interleukin 8. The concentrations of PDGF were significantly decreased in the patients with AML, CGL-BC, and CGL. The differences of concentrations of studied interleukines can confirm their great significance in proliferation of leukaemic cells. The decrease of concentrations of PDGF in myelocytic leukaemias may reflect thrombopoietic disturbances in these illnesses.

In 1981-1990, 584 patients with non-Hodgkin malignant lymphoma, 209 women and 375 men, aged between 17 and 75 years, were treated at the I Department of Medicine and Department of Hematology, Silesian Medical Academy in Katowice. In this group the primary localization outside lymph nodes was seen in 26 patients (9 women and 17 men), i.e. 4.6% of all patients with malignant non-Hodgkin lymphomas. Most frequently digestive tract was involved-19 patients (73.1%). Twenty three patients were treated surgically followed by chemotherapy and/or irradiation. Not operated patients were treated with either chemotherapy or both radio- and chemotherapy. Complete remission was achieved in 17 patients (65.4%), partial remission in 4 (15.4%) patients. Five patients did not respond to therapy (19.2%). A mean survival time was 49.4, 14.3, and 6.4 months, respectively.

Among 82 patients with L-LP in clinical stage IV, 14% were found to have monoclonal gammapathy and 22% polyclonal gammapathy. The other classes of immunoglobulins were not affected. In 78%, cell immunity was impaired. Decrease in T cell count (CD2+ and CD3+) in blood was found. Particularly T helper cells (CD4+), to a lesser degree T suppressor cells (CD8+) were affected. The life time of patients varied from 3 to 120 months. 60% of deaths were caused by infection.

Among 200 patients treated for chronic granulocytic leukaemia (CGL) 6 (3%) cases have been selected in whom a second synchronic or metachronic neoplasma coexisted. In one patient CGL was the first neoplasma and skin basalioma the second in line. In the remaining fife; Thyroid adenocarcinoma, adeno-carcinoma of the bowl (bis), epithelial carcinoma of the penis, epithelial carcinoma of the pulmonary, were followed respectively CGL as secondary tumor in same patient.

Retrospective investigations were carried out in 50 patients with L-LP in clinical stage IV. All those patients died of this disease. The life time of the studied patients varied from 2 to 120 months and the median was 29 months. Advanced age, co-occurrence of anaemia and increased serum gammaglobulin level were found to be bad prognostic factors. No correlation was found between life time and tumour size, platelet number, lymphocyte count of blood and bone marrow.

The aim of the study was to evaluate bone mineralization in the patients with multiple myeloma. The examinations were performed in 49 patients (25 men and 24 women). Seven patients were before chemotherapy and 42 patients were treated with chemotherapy. All of them received prednisone. The bone mineral density was measured by dual-energy X-ray absorptiometry with Lunar spine (L2-L4) in AP projection, femoral neck and total body were examined. There was a decrease of bone mineral density in 35 patients in at least one place (T-score more than 2 SD below normal of young healthy persons). There was no correlation between densitometric results and the duration of multiple myeloma, or chemotherapy. The decrease of bone mineral density (expressed es T-score) of lumbar spine (for the patients without spinal degenerative changes) was higher than that of femoral neck (p < 0.05). The decrease of bone mineral density (expressed as T-score) of lumbar spine and femoral neck was more pronounced than that of total body (p < 0.001). Bone densitometry, especially of lumbar spine and femoral neck and less of total body is indicated in the patients with multiple myeloma. The result of this examination may be considered as an independent parameter of disease intensity.

Various hemostatic abnormalities that can be met in the course of apparently unrelated diseases are caused by antiphospholipid antibodies (APA). Nearly on half of the population with antibodies detectable in serum suffer from systemic lupus erythematosus (SLE) or the disease will be diagnosed in the future. The supposition considering that APA do not bind phospholipids directly becomes popular recently. They bind serum beta 2-Glycoprotein. The APA-beta 2 GIP complexes speed up prothrombin activation and make beta 2 GIP less available for serum C- and S-protein transformation. APA are a heterogenous population of antibodies. Postinfectious APA differ from those found in autoimmune diseases. Thrombotic events caused by APA are treated according to general principles. Steroid therapy is essential in treatment programme of SLE with APA. In severe cases it is supplemented by intravenous cyclophosphamide. Plasmapheresis and intravenous immunoglobulins are of limited usefulness. In severe resistant thrombocytopenia one can try to introduce Danazol carefully.