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Biomedical subjects

E Kelemen

Publications and source records attributed to E Kelemen.

At least 37 records · Page 2Linked to original sources
PubMed1993

Graft-versus-host disease in bone marrow transplantation: experimental, laboratory, and clinical contributions of the last few years.

Graft-versus-host disease (GVHD) is a major and often lethal complication of bone marrow transplantation. Research of the past few years has greatly expanded our understanding of the disease and enriched the arsenal of preventive and therapeutic procedures. The present review attempts to give a survey of experimental and clinical GVHD, updating essential knowledge with the latest information until July 1993. The covered topics include the complex immune pathomechanism of acute and chronic GVHD in murine models, the pathogenic role of major, minor, and other antigenic disparities, laboratory markers predicting GVHD, factors influencing appearance and course of the disease, the relationship between GVHD and the graft-versus-leukemia effect, and novel experimental and clinically tested preventive and therapeutic modalities. Finally, the authors set forth their perspective on the most relevant questions in GVHD-related research.

Animals↗
PubMed1993

Non-supralethal mitobronitol/cytarabine/cyclophosphamide conditioning without irradiation before bone marrow transplantation for accelerated chronic granulocytic leukemia: apparent absence of acute graft-versus-host disease.

Cytostatic chemotherapy instead of supralethal total body irradiation (TBI) has been increasingly used as an alternative myeloablative regimen before bone marrow transplantation (BMT). While irreversible azoospermia/amenorrhoea seems to occur less frequently with such conditioning, graft-versus-host disease (GVHD) remains unaffected. Five-year disease-free survival in accelerated chronic granulocytic leukemia (CGL), after BMT with matched sibling grafts has been 0.10-0.30. Mitobronitol, cytosine arabinoside, and cyclophosphamide were used for conditioning. Patients were transplanted with unmanipulated HLA/MLC identical sibling bone marrow. For recovery, a pathogen-low room was available without air filtering and laminar airflow. Seven of eight accelerated-CGL patients were engrafted: full allogeneic reconstitution was detected in four and mixed chimerism in three patients. Five out of the seven engrafted patients survived at least nine months (median = 42 months), two are considered cured (8-9 years survival). The four leukemia-free survivors displayed full allogeneic reconstitution and presented symptoms of chronic GVHD. One patient became a genetically verified father. Acute GVHD and veno-occlusive liver disease (VOLD) were absent in all patients, diffuse interstitial pneumonitis (IP) occurred in one case. Non-supralethal conditioning with mitobronitol/cytarabine/cyclophosphamide in accelerated-CGL allows allogeneic bone marrow reconstitution with survival and cure rates comparable to those achieved with other protocols using TBI or busulphan conditioning. Unlike the latter treatments, however, our protocol leads to fewer transplant-related complications including acute GVHD, IP, VOLD, and azoospermia/amenorrhoea.

Adult↗
PubMed1992

Pregnancy in idiopathic aplastic anemia (report of 10 patients).

This paper reports on 6 patients with severe, 2 with moderate and 2 with mild aplastic anemia who had a total of 18 pregnancies after the diagnosis. All four pregnancies that occurred during the active state of severe and moderate aplastic anemias were electively terminated. Two out of 14 pregnancies that occurred during the long-term remission were electively terminated for non-medical reason, two spontaneous abortions occurred and 10 live births were seen. All offspring were healthy at follow-up. During pregnancy the circulating blood cell levels decreased in 1 out of 6 pregnancies in patients who were in remission from mild and moderate aplastic anemias, and in 4 out of 8 pregnancies in patients who were in remission from severe aplastic anemia. In all 5 cases that showed a relapse during pregnancy the remission recurred following the termination of pregnancy. The data presented suggest that aplastic anemia in long-term remission can unpredictably relapse during pregnancy, but its final outcome appears not to be affected by pregnancy. Furthermore, there is no correlation between the pre-pregnancy clinical course and the events during pregnancy. The outcome of pregnancy during the remission of aplastic anemia seems beneficial, and spontaneous delivery should be preferred.

Abortion, Therapeutic↗
PubMed1992

Pregnancy in aplastic anemia treated with fetal liver and bone marrow hemopoietic cells and antithymocyte globulin.

This report describes a patient who had severe refractory anemia and thrombocytopenia during her first pregnancy. She had a remission after delivery but two years later aplastic anemia refractory to steroid and splenectomy developed. After treatment with steroids and antithymocyte globulin the patient had repeated infusions of hemopoietic cells derived from fetal liver and bone marrow, leading to a 7-year remission during which time she had a further successful pregnancy. The patient had a relapse one year later.

Adult↗
PubMed1991

[Ultrasonic diagnosis with secretin stimulation in patients with pancreas divisum].

The diagnostic value of secretin provoked abdominal ultrasound was studied on 34 patients with pancreas divisum and on 20 control subjects. The patients received a 1.0 unit/kg body weight dose of secretin. The degree of ductal expansion and the time required to return to the initial state were registered and these values were compared to the clinical diagnosis. The control subject's ductal diameters prior to secretin administration were 1 mm in all cases (maximum expansion 2 mm, return to the initial value within 10 minutes). The pancreas divisum patients could be placed in two groups based on their initial ductal diameter. Fourteen patients had initial ductal diameters of 2 mm or greater (A group mean +/- SD: 2.4 +/- 0.3) while 21 patients had an initial value of less than 2 m (B group; 1.7 +/- 0.3). Following secretin administration the ductal diameter of the A group's patients increased on average +/- SD to 1.3 +/- 0.5 times the initial value and in the B group 3.2 +/- 1.1 times the initial value (p less than 0.01). In the A group the ductal diameter returned to its initial value within 10 minutes, while it took 35 minutes for the same to occur in the B group. A relationship can be observed between the clinical diagnosis, the initial ductal diameter, the degree of expansion following secretin administration and the time required to return to the initial state.

Adult↗
PubMed1991

[Amphotericin B resistant severe hepato-splenic candidiasis, responding to fluconazole, in a patient following bone marrow transplantation].

A 23 year old woman with Philadelphia-positive chronic granulocytic leukaemia underwent a 3/4 HLA identical bone marrow transplantation. During the neutropenic period, a septic condition developed which was caused by Candida albicans. Administration of Amphotericin B for 63 day was ineffective including an attempt to give the drug through the truncus coeliacus. Finally the sepsis disappeared during fluconazole treatment.

Adult↗
PubMed1991

C-reactive protein inhibits binding of platelet-activating factor to human platelets.

Serum concentration of C-reactive protein (CRP), a prototypical acute-phase protein rises dramatically in response to tissue injury or inflammation. We report here that CRP (1-20 micrograms/ml) inhibited platelet-activating factor (PAF)-induced aggregation of human platelets in time-, and dose-dependent manner. This inhibitory action of CRP was nearly completely removed by treatment with anti CRP antiserum. At higher concentrations (20-100 micrograms/ml), CRP stabilized platelet membrane against the detergent-like effect of beta-deoxy-lysolecithin. Furthermore, CRP (10 micrograms/ml) diminished specific [3H]PAF binding to platelets and displaced previously bound labeled PAF from platelets. These results suggest that by depressing the bioavailability of PAF, CRP may be an important modulator of platelet activation during acute inflammatory reactions.

Antibody Formation↗
PubMed1991

[Perioperative myocardial infarct].

Retrospective analysis has been carried out with the surgical material of 9 years in the wards of surgical character of a county hospital to determine the incidence and main clinical characteristics of perioperative myocardial infarction. Data of 61 patients were processed in order to answer the questions. Age, arteriosclerosis causing disturbance of organ perfusion and the change of blood pressure in the perioperative period play the main role in the development of this complication of high mortality. Detailed clarification of the coronary state before the elective operation, a possible aortocoronary bypass operation appear to prevent most effectively the pathological picture.

Adult↗
PubMed1991

Multiple myeloma in pregnancy.

This is a report on pregnancy complicated by multiple myeloma. Severe refractory anemia was present throughout the pregnancy and multiple myeloma was diagnosed in the second trimester. The anemia ceased after delivery but recurred one year later along with other signs of disease progression. The infant remained healthy after a 2-year follow-up.

Adult↗
PubMed1991

Secretin provocation ultrasonography in the diagnosis of papillary obstruction in pancreas divisum.

The diagnostic value of secretin provoked abdominal ultrasound was studied on 34 patients with pancreas divisum and on 20 control subjects. The patients received a 1.0 unit/kg body weight dose of secretin. The degree of ductal expansion and the time required to return to the initial state were registered and these values were compared to the clinical diagnosis. The control subject's ductal diameters prior to secretin administration were 1 mm in all cases (maximum expansion 2 mm, return to the initial value within 10 minutes). The pancreas divisum patients could be placed in two groups based on their initial ductal diameter. Fourteen patients had initial ductal diameters of 2 mm or greater (A group mean +/- SD: 2.4 +/- 0.3) while 21 patients had an initial value of less than 2 mm (B group; 1.7 +/- 0.3). Following secretin administration the ductal diameter of the A group's patients increased on average +/- SD to 1.3 +/- 0.5 times the initial value and in the B group 3.2 +/- 1.1 times the initial value (p less than 0.01). In the A group the ductal diameter returned to it's initial value within 10 minutes while it took 35 minutes for the same to occur in the B group. A relationship can be observed between the clinical diagnosis, the initial ductal diameter, the degree of expansion following secretin administration and the time required to return to the initial state.

Ampulla of Vater↗
PubMed1990

[Analysis of the effectiveness of pilocarpine in the management of xerostomia].

The authors have studied the "sympathetic like" side effect of pilocarpine after single injection (1 mg/100 g b.w., i.p.) of the drug. They developed a system for the continuous automatic recording the amylase activity of the saliva secreted by the parotid glands of rats, "in situ". Pilocarpine stimulus was characterized by a peak in amylase activity--regularly observed in the first 40-60 min--which was additive to the cholinergic amylase secretory response. After this the amylase secretion was continued with lower activity. The role of a beta-adrenergic component in the pilocarpine stimulus appears to be supported by the finding that propranolol (2.5 mg/100 g b.w., i.p.) pretreatment applied 30 min prior to the pilocarpine stimulus prevented the appearance of the characteristic amylase peak. These data support that the beta-adrenergic side effect triggering the periodical synthesis of export proteins during the course of pilocarpine treatment accounts for the selative efficiency of pilocarpine in the therapy of xerostomia.

Amylases↗
PubMed1988

Eosinophilic spleen colonies are produced in rat-marrow-transplanted but not in murine-marrow-transplanted mice.

Differential counts of about 5000 splenic clusters and colonies developing in whole-body-irradiated mice and rats were made, using semi-serial histological sections prepared 9 to 12 d after transplantation with bone marrow haemopoietic cells. The investigated mouse and rat spleens were from syngeneically, allogeneically, or xenogeneically transplanted recipients. Splenic eosinophil clusters were always found when rat eosinophil-producing progenitors were present in the inoculum, whereas murine inocula failed to produce splenic eosinophilic clusters even in the syngeneic mouse. The limiting factor in the production of splenic eosinophilic clusters was the appropriate donor progenitor/committed stem cell itself. Changes in the percentages of eosinophil clusters with the number of injected cells and with increased doses of irradiation, as well as formation of rat eosinophil colonies in mice, as against mainly clusters in rats, themselves show that regulatory mechanisms of the recipients also play a role. These regulatory mechanisms cannot be attributed to the splenic microenvironment.

Animals↗
PubMed1987

What kind of morphologically recognizable haemopoietic cells do we inject when doing foetal liver infusion in man?

There is no agreement, how to define the age of the embryo/foetus. From the 15th (fertilization) week onwards the whole foetal liver contains some 10(9) free haemopoietic cells. Before, and up to the 30th-34th weeks, the liver is the main site of haemopoiesis. The differential of embryonic smears (up to wk 9) differs from that of foetal ones. The first invasion of circulating primitive erythroblasts seeding in the liver (early 5th wk) is accompanied by the appearance of a lot of sinusoidal macrophages. Definitive erythropoiesis expands during the 6th-7th wks. Granulocytic representation peaks at 15-16 wks. Megakaryocytes are small and have few nuclei/nuclear lobes. Five to 8, or even more per cent of single haemopoietic cells were lymphoid-like cells in the 5th-6th wk liver smear. These cells precede the development of any lymphoid structure in the foetus. Ordinary lymphocytes amount to less than 2% between 10 and 18 wks, and reached 3% at wk 24. Percentage of dyserythropoietic nuclei in smears has been used to decide whether the injected cells could be regarded as 'physiological' cells. Ten out of 11 apparently healthy foetuses, delivered by hysterectomy/hysterotomy for maternal interest, aged 10 1/2 to 20 1/2 weeks, had mean 4.5% liver dyserythropoiesis. Extremely high dyserythropoiesis was associated with multilineage, instead of overwhelmingly erythroid haemopoiesis.

Cell Differentiation↗