Biomedical subjects

J Kvasnicka

Publications and source records attributed to J Kvasnicka.

At least 19 recordsLinked to original sources

PubMed2000

Increase of adhesion molecules, fibrinogen, type-1 plasminogen activator inhibitor and orosomucoid in growth hormone (GH) deficient adults and their modulation by recombinant human GH replacement.

OBJECTIVE: GH deficiency (GHD) is usually associated with a higher incidence of cardiovascular disease (CVD). The aim of this study was to establish whether patients with GHD, like those with CVD, show an increase in fibrinogen (FBG), type-1 plasminogen activator inhibitor (PAI-1), acute phase response proteins (APR), and soluble adhesion molecules. The effect of recombinant human GH (rhGH) replacement, on these parameters was also investigated. PATIENTS AND DESIGN: Concentrations of PAI-1 antigen (Ag), adhesion molecules sE-selectin, sP-selectin, and intercellular adhesion molecule-1 (sICAM-1), FBG and levels of APR orosomucoid (ORM), and 'negative APR' transferrin (TRF) were established in 11 panhypopituitary (PHP) patients (eight men and three women, age median 39.0 years, body mass index (BMI) 27. 49 +/- 3.89 kg/m2) before and after 12-month replacement with rhGH. Control values were obtained by examination of 33 healthy age and sex matched subjects (24 men and nine women with BMI 24.16 +/- 1.99 kg/m2). RESULTS: PHP patients had higher concentrations of ORM (0.80 +/- 0.25, vs. 0.61 +/- 0.20 g/l; P = 0.05), FBG (3.22 +/- 0.48, vs. 2.57 +/- 0.47 g/l; P = 0.001), PAI-1 Ag (97.12 +/- 33.23, vs. 44.11 +/- 21.40 microgram/l; P = 0.001), sE-selectin (72.42 +/- 28.35, vs. 42. 80 +/- 12.60 microgram/l; P = 0.004), sP-selectin (221.26 +/- 75.12, vs. 104.79 +/- 26.01 microgram/l; P = 0.001) sICAM-1 (409.75 +/- 137.78, vs. 228.10 +/- 37.54 microgram/l; P = 0.001), and lower levels of TRF (2.14 +/- 0.40, vs. 2.76 +/- 0.39 g/l; P = 0.001) than controls. After 12-month rhGH replacement the patients showed an increase of TRF (2.64 +/- 0.84 g/l, P = 0.037) and decrease of soluble adhesion molecules (sE-selectin 57.98 +/- 27.04 microgram/l, P = 0.01, sP-selectin 121.74 +/- 50.42 microgram/l, P = 0.007; and sICAM-1 279.95 +/- 88.32 microgram/l, P = 0.005), which then, similarly to the ORM (0. 67 +/- 0.12 g/l) and FBG level (2.82 +/- 0.51 g/l), did not statistically differ from the values in the control group. CONCLUSION: rhGH replacement led to modulation of the 'inflammatory response' in panhypopituitary patients. This modulation occurred locally at vascular endothelium level where after rhGH replacement, sE-selectin, sP-selectin and sICAM-1 concentrations decreased, a similar effect as in the systemic inflammatory response, as was also apparent from the changes in acute phase response protein levels.

Adult↗

PubMed1999

Insulin action and fibrinolysis influenced by vitamin E in obese Type 2 diabetes mellitus.

Increased oxidative stress, hypofibrinolysis and insulin resistance are present in obese Type 2 diabetic patients. It is supposed that treatment with antioxidant alpha-tocopherol (vitamin E) could not only decrease free radical production, but also ameliorate insulin action. We evaluated the effect of 3 months administration of vitamin E (600 mg daily) on insulin action examined by hyperinsulinemic clamp in 11 obese Type 2 diabetic patients. Oxidative stress and fibrinolysis were also determined. The administration of vitamin E caused a decrease of glucose disposal rate (26.6 +/- 9.5 vs 21.3 +/- 7.5 micromol/kg/min, P < 0.02) and of metabolic clearance rate of glucose (3.7 +/- 1.6 vs 2.9 +/- 0.8 ml/kg/min. P < 0.02). A decrease of insulin receptor number was observed on erythrocytes after vitamin E (284 +/- 84 vs 171 +/- 59 pmol/l, P < 0.01). Significantly higher plasma malondialdehyde (MDA) concentration documented an increased oxidative stress in diabetic patients as compared with healthy persons (3.13 +/- 0.68 vs 1.89 +/- 0.18 micromol/l, P<0.001). An inverse relationship was found between MDA concentration and insulin sensitivity expressed by glucose disposal rate (r = -0.73). Vitamin E further worsened the hypofibrinolysis documented by a decrease of tissue plasminogen activator (P < 0.01) without changes in its inhibitor PAI-1. In conclusion. our results demonstrate that higher doses of vitamin E may further deteriorate insulin action and fibrinolysis in obese Type 2 diabetic patients.

Adult↗

PubMed1999

[Splenectomy].

The authors ANALYZE the problem of splenectomy from the historical point of view and also the problem of splenectomy indication. Two different periods separated by a short time interval are compared. Recently the indications for splenectomy have changed because of introduction of new drugs in hematologic treatment. The number of "traumatological" splenectomy remains constant. (Tab. 2, Ref. 18.)

Czech Republic↗

PubMed1999

[Hemostasis and levels of cytoadhesion molecules in gestational diabetes].

OBJECTIVE OF STUDY: Assess interrelations between parameters of haemostasis, fibrinolysis, acute stage proteins and cytoadhesive molecules in gestational diabetes (GDM), which in susceptible women is actively induced by insulin resistance. METHODS: In 33 pregnant women where based on the glucose tolerance test (75 g glucose) GDM was revealed, repeatedly fibrinogen values were assessed (FBG 4.38 +/- 0.98 g/l), the antithrombin III activity (ATIII% 103.83 +/- 14.9), t-PA Ag(4.82 +/- 3.35 ng/ml), PAI-1 Ag (158.04 +/- 57.7 ng/ml), D-dimer (234.99 +/- 455.36 ng/ml), plasma proteins-orosomucoid (ORM 0.506 +/- 0.14 g/l), C reactive protein (1.34 +/- 0.96 g/l), transferrin (3.77 +/- 0.79 g/l), prealbumin (1.86 +/- 0.83 g/l) and alpha-2-macroglobulin (A2M 2.01 +/- 0.62 g/l) and cytadhesive molecules sICAM-1 (230.8 +/- 57.76 ng/ml) and sE-selectin (35.50 +/- 16.55 ng/ml). These findings were compared with parameters of the glucose and lipid metabolism and some anthropometric data (BMI, weight increments during pregnancy and birth weight of the infant). RESULTS: After statistical evaluation in GDM positive correlations of FBG and BMI were found (r = 0.871, p = 0.007) and also with the weight increment during pregnancy (r = 0.934, p = 0.0007). Hyperfibrinogenaemia is however probably compensated in stabilized cases of GDM by a higher production of t-PA (FBG:t-PA Ag, r = 0.782, p = 0.003). In GDM a marginal positive correlation between the value of the "atheroindex" and the infant's length was found r = 0.744 p = 0.0547). sE-selectin levels in GDM correlated inversely with ATIII activity (r = -0.905, p = 0.0028). CONCLUSION: The higher body weight of pregnant women with GDM is probably associated with a higher risk of thrombophilia (elevated fibrinogen). If in pregnant women infection develops with release of inflammatory cytokines, inducing on the endothelium expression of E-selectin, deterioration of thrombophilia (due to a decline of ATIII) activity must be foreseen.

Acute-Phase Proteins↗

PubMed1999

Changes of signal-averaged ECG in normal subjects after one year.

Repeated signal-averaged electrocardiograms (SA ECG) were recorded twice with a mean interval of 13 months in 11 healthy volunteers in order to acquire basic information on long-term changes of SA ECG. After one year the duration of filtered QRS remains the most stable parameter of SA ECG on the contrary to parameters describing end of fQRS--i.e. both HFLA and RMS. Moreover fQRS seems to have better specificity in comparison to HFLA and RMS. An estimation of significant long-term changes in individual parameters of SA ECG was obtained. According to our results, only changes in QRS +/- 13 ms, fQRS +/- 8 ms, HFLA +/- 22 ms and RMS +/- 17 microV should be considered significant when found in a long-term follow-up of patients with a heart disease.

Adult↗

PubMed1999

[Anemia and its treatment with peroral anti-anemia agents in women during the postpartum period].

The prevalence of anaemia during pregnancy and post partum is according to the literature and many years clinical experience high. In the submitted work we investigated the incidence of sideropenic anaemia in women during the first three months after a spontaneous delivery, changes of clinical and laboratory indicators of anaemia during this period and the possible effect exerted by administration of iron and iron plus folic acid resp. Ninety pregnant women in the 35th to 39th week of pregnancy were at random divided into three equally sized groups and the following were assessed: haemogram, indicators of iron reserves, serum concentrations of folic acid, vitamin B12, erythropoetin and soluble transferrin receptor, liver tests, total protein + electrophoresis, acute stage proteins. In the first group (T) the women were given, starting on the 4th day after delivery 1 tablet of Tardyferon per day for two months. To the second group (F) for an equal period 1 tablet of Tardyferon Fol per day was administered. Women in the control group (K) had no medication. In the investigation women with medium and severe pregnancy anaemia were not included nor women taking during pregnancy or previously iron preparations or those treated in the past by blood transfusion. After spontaneous delivery (women who had Caesarean section or forceps delivery were eliminated from the study) the women were subjected to the same examinations as before delivery. These examinations were made on the fourth day after delivery and then after monthly intervals for a period of three months. At the same time the subjective condition of the mothers was evaluated after delivery, focused on the development of symptoms typical for anaemia and the possible effect of administered treatment. The investigation was completed by 60 women. During treatment no allergic or other serious side-reactions to the administered drugs calling for discontinuation of treatment were recorded. The results of the investigation proved that laboratory and clinical indicators of post-partum anaemia reached more quickly normal values in women treated with iron preparations. The authors did not detect a single and supreme marker of sideropenic anaemia in the early post-partum period. This is one of the reasons why the authors recommend iron administration to all women after spontaneous delivery. In the authors' opinion examination of the blood count on the fourth day and assessment of the serum ferritin concentration one month after a spontaneous delivery in selected mothers (e.g. after an above average peripartal blood loss) is desirable. Addition of folic acid to iron is of no special value during the post-partum period. Iron substitution in women after spontaneous delivery should be, with regard to the long persisting sideropenia, administered at least for three months. The dose of 80 mg elemental iron per day is sufficient for mild or medium post-partum anaemia. Addition of mucoprotease and ascorbic acid to iron preparations is useful because it increases the compliance of the patients and thus also its effectiveness. The preparation Tardyferon meets the above criteria and is therefore a good choice for the treatment of post-partum anaemia.

Administration, Oral↗

PubMed1999

The brain lesion influences the numbers of peripheral blood leukocytes in the rat.

The mutual relationship between the central nervous and immune system are intensively studied. The lesion of distinct structures of the rat brain such as septum influence the model immune response such as lymphocyte proliferation and delayed skin hypersensitivity. Employing the model of the damage of septum in the rat brain by electrolesion we demonstrated the decrease of the number of peripheral blood leukocytes, mainly cells exhibiting CD25 and CD45RA antigens in the rat. The striatum destruction has much lower influence on the studied parameters, which suggests a specific effect of the septum on these hematological parameters.

Animals↗

PubMed1998

[Can normalization of vascular cytoadhesive activity be explained by the anti-atherosclerosis effect of growth hormone?].

BACKGROUND: The increased mortality caused by premature atherosclerosis has been shown among patients with hypopituitarism receiving conventional hormone treatment but with unsubstituted growth hormone deficiency. This experience belongs among the most important arguments in favour of replacement with growth hormone. The mechanisms of the antiatherogenic effect of growth hormone are poorly understood. The protective effect of growth hormone on the vascular endothel and its intervention in the clotting process, which have not been yet elucidated, may be the causative factors. METHODS AND RESULTS: The endothelial damage as given by measuring of circulating soluble cytoadhesive molecules sE-selectin, sP-selectin and intercellular adhesive molecule 1 (ICAM 1) was measured in 15 adult panhypopituitaric patients before and after 1 year treatment with recombinant human growth hormone. The blood levels of all of these cytoadhesive molecules decreased significantly (p < 0.01) during the treatment. None of the concomitantly followed coagulation tests (prothrombin time, activated partial thromboplastin time, fibrinogen, antithrombin III, von Willebrand's factor and D-dimer) was significantly changed during the treatment. The tendency to decrease (p = 0.054) was observed with antithrombin III. CONCLUSIONS: The decrease of circulating cytoadhesive molecules in blood during the treatment of growth hormone gives evidence for its protective effect, either direct or mediated, on the vascular endothel. These findings could bring an explantation for the premature atherosclerotic changes in hypopituitarism and antiatherogenic effect of growth hormone.

Adult↗

PubMed1998

[Soluble TNF and IL-2 receptors in patients with breast carcinoma].

BACKGROUND: Cytokines were shown both to enhance tumour growth and formation of metastases and to inhibit proliferation of tumour cells. TNF alpha may mediate apoptosis and necrosis of cancer cells, the exact role of IL-2 remains to be elucidated. Plasma levels of TNF alpha and TNF and IL-2 soluble receptors (sTNF-R, sIL-2R) should thus be in some relation to the biological characteristics of the breast cancer. METHODS AND RESULTS: Plasma levels of TNF alpha, sTNF-R I and II and sIL-2R were measured in 31 women with different stages of breast cancer both before the institution of the therapy and after 3 months of the treatment. Plasma levels of both types of sTNF-Rs were higher in patients with breast cancer than in controls (sTNF-R I-2166.6 +/- 568.9 VS. 1121.3 +/- 260.6 pg/ml, p < 0.001, sTNF-R II-3792.8 +/- 958.9 vs. 1996.2 +/- 404.3 pg/ml, p < 0.001) with no significant difference between clinical stages. Plasma levels of both sTNF-R (0.871, p < 0.001) and sIL-2R tightly correlated one with each other. Plasma levels of TNF alpha decreased after treatment (from 3.92 +/- 1.86 to 3.40 +/- 1.15 pg/ml, p < 0.001), but plasma levels of sTNF-Rs and sIL-2R were not influenced by the treatment. CONCLUSIONS: Plasma levels of soluble TNF receptors may thus serve as a non-specific marker of the untreated breast cancer. Their relation to other biologic characteristics of this tumour is not clear. It remains also to be clarified if the long-term treatment leads to the normalization of sTNF-Rs plasma levels.

Adult↗

PubMed1998

Increase of soluble cytoadhesive molecules sE-selectin and sICAM-1 and hyperfibrinogenaemia in patients with polytrauma without septicaemia.

Multiple organ failure with thrombophilia is suggested to occur in the course of polytrauma with septicaemia. The aim of the study was to investigate fibrinogen level, other proteins of acute phase response: positive-orosomucoid and negative-transferrin and soluble cytoadhesive molecules in plasma of patients (n = 28) with polytrauma (I-II. stage according to Hannover score) without detectable bacteraemia until 36 hours post injury. The patients treated by massive blood transfusion were excluded. An increase of fibrinogen (Fbg pts 4.34 +/- 2.5 g/l versus control 2.55 +/- 0.55 g/l, p < 0.01), orosomucoid (ORM pts 1.47 +/- 0.8 g/l versus control 0.54 +/- 0.18 g/l, p < 0.01), SE-selectin (sE-sel. pts 92.11 +/- 79.4 g/l versus control 46.6 +/- 29.6 g/l, p < 0.05), sICAM-1 (sICAM pts. 698.3 +/- 54.4 versus control 255.6 +/- 58.0 g/l, p < 0.01) and a decrease of transferrin (Trf pts. 1.77 +/- 0.82 versus control 2.83 +/- 0.71 g/l, p < 0.01) were observed in this patients with polytrauma. We suppose that an increase of fibrinogen and cytoadhesive molecules sE-selectin and sICAM-1 may be induced in patients with polytrauma due to a "non-septic" inflammatory acute phase response in the course of wound healing process after tissue injury too.

E-Selectin↗

PubMed1998

Haemostasis, cytoadhesive molecules (sE-selectin and sICAM-1) and inflammatory markers in non-insulin dependent diabetes mellitus (NIDDM).

Non-insulin dependent diabetes mellitus (NIDDM) is connected with a higher incidence of macrovascular atherosclerotic disorders. The aim of the study was to detect any difference in levels of "cardiovascular risk factors"--fibrinogen, PAI-1 and inflammation response (documented by an increase of protein of acute phase orosomucoid) and of soluble cytoadhesive molecule sE-selectin and sICAM-1 (as markers of endothelial dysfunction) in blood plasma of 118 patients with NIDDM in comparison to the levels in blood plasma of 59 healthy persons as a control group. We observed higher levels of fibrinogen (fibrinogen level was 3.44 +/- 1.02 g/l in NIDDM pts versus 2.44 +/- 0.55 g/l in control group, p < 0.01) and PAI-1 Ag concentration was 159.7 +/- 110.3 ng/ml in NIDDM pts versus 51.43 +/- 24.64 ng/ml in control group, p < 0.01) together with an increase of acute phase protein orosomucoid as a "inflammatory response marker" (orosomucoid concentration was 0.85 +/- 0.23 g/l in NIDDM pts versus 0.54 +/- 0.18 g/l in control group, p < 0.01) in patients with NIDDM. The increase of these "cardiovascular risk factors" levels will be probably induced by higher activity of inflammatory cytokines IL-1 beta and/or TNF alpha in NIDDM patients, because both are inducers of orosomucoid fibrinogen and PAI-1 synthesis. This hypothesis is also supported by observation of higher levels of soluble cytoadhesive molecules sE-selectin (sE-selectin level was 64.25 +/- 26.8 ng/ml in NIDDM pts versus 46.64 +/- 29.57 ng/ml in control group, p < 0.01) and sICAM-1 (sICAM-1 level was 307.71 +/- 86.2 ng/ml in NIDDM pts versus 255.6 +/- 58.0 ng/ml in control group, p < 0.01) in patients with NIDDM. Both cytoadhesive molecules are produced by endothelial cells which are influenced by IL-1 beta and/or TNF alpha. According to these findings we suppose that an "inflammation" plays an important role in the evolution of atherosclerotic process at NIDDM together with the known influence of glucose and lipid metabolism pathology.

Cardiovascular Diseases↗

PubMed1998

The effect of glycosaminoglycan sulodexide on oxidative stress and fibrinolysis in diabetes mellitus.

Glycosaminoglycan sulodexide may influence morphology and functional properties of the basement membranes in microvessels. The aim of this study was to evaluate the effect of sulodexide administration on albuminuria and on different biochemical variables indicating endothelial dysfunction, oxidative stress and fibrinolysis in diabetic patients. Twenty diabetic patients of both types with micro- or macroalbuminuria were selected for sulodexide treatment. Daily dose of 600 U (60 mg) was injected intramuscularly five days a week. Fifteen doses were applied during 3 weeks. The patients were examined before and after treatment as well as 6 months later. No changes of diabetes control were observed during the study and after 6 months of wash-out period. Significant decrease of albuminuria (p < 0.001) was observed during the sulodexide administration with the following increase to pretreated values during the wash-out period. A decrease of serum N-acetyl-beta-glucosaminidase (NAG) activity (p < 0.03) at the end of treatment as compared to pretreated values was found in the whole group of diabetic patients. Slight reduction of oxidative stress expressed by malondialdehyde and superoxide dismutase was apparent after treatment but no simultaneous change in fibrinolysis was observed. Sulodexide may have some protective effects influencing functional properties of the basement membrane as manifested by lowered albuminuria. In addition, it may slightly decrease oxidative stress in diabetic patients and it could stabilize endothelial cells.

Acetylglucosaminidase↗

PubMed1998

[Complications of prevention and treatment of erythrocyte alloimmunization (case reports)].

OBJECTIVES: The treatment of late recognized alloimunization with intraumbilical transfusions is more difficult and more often connected with complications. MATERIAL AND METHOD: Between 1991-1997 we performed 70 intraumbilical transfusions in 25 fetuses for erythrocyte alloimunization. Six fetuses (24%) were hydropic in the beginning of the treatment. Eleven fetuses were delivered before 36 weeks of pregnancy. Two immature neonates (660 g and 1320 g) had intraventricular hemorrhage with neurologic complications. In six cases the transfusion was complicated by severe bradycardia of the fetus, but only twice the pregnancy was to be terminated by cesarean sectio during 24 hours after the procedure. Two of the 25 fetuses died antenataly and one postnataly, all of them primary hydropic. Two neonates had severe late onset anemia. CONCLUSION: Fetal alloimune anemia should be treated before onset of hydrops. The study was supported by the grant of IGA Ministry of Health CR No. 3200-3.

Adult↗

PubMed1998

[Splenectomy--an analysis of problems].

The authors discuss problematic of splenectomy on the historical view and also on the problematic indication to splenectomy. They compare two different periods in the small lapse of time. In the last period was the mowe in the indication spectrum to the splenectomy in the continuity with the application of new hematological medicaments in the practice. The number of "traumatological" splenectomy is constant.

Hematologic Diseases↗

PubMed1998

Prenatal determination of fetal RhD (rhesus positive) type by an amplification of DNA.

Examination of RhD genotype (Rhesus D gene) from amniotic cells (or chorionic villi cells) by PCR amplification of DNA can be done at early stage of pregnancy. Due to some missing exons in the Rh partial D variant (e.g. DVI), it is necessary to use different PCR systems to get relevant results. The localization of primers in our three PCR systems is on the different exons (10, 7, and 4 + 5). The advantage of PCR technique is prenatal detection of RhD of fetus from nonerythrocytes suspension (e.g. from an amnion fluid cell sediment) in comparison to a "standard" haemagglutination serological technique which uses blood erythrocytes only. The possibility of this technique to distinguished the heterozygous (D/d) or homozygous (D/D) fathers can help the clinicians in decisions about the management of further prevention of the hemolytic disease of newborn.

Amniotic Fluid↗

PubMed1998

[Diagnosis and therapy of erythrocyte alloimmunization in pregnancy].

INTRODUCTION: By preventive administration of anti-D globulin the number of cases of Rh isoimmunization declines steadily. Severe untreated isoimmunization may lead via foetal hydrops to intrauterine death, sometimes already during the 18th-19th week of gestation. The purpose of prenatal diagnosis in pregnant women with isoimmunization is to assess the danger or affection of the foetus, its prognosis and the mode of monitoring of the foetus. It is necessary to decide in time on intrauterine therapy by transfusion of erythrocyte mass and to assess the optimal time of delivery with regard to the risk of prematurity and foetal erythroblastosis, as well as with regard to intrauterine therapy. The objective of the present work was to test the protocol in the treatment of erythrocytic isoimmunization of the foetus. METHOD: During the period between January 1991 and October 1997 the authors investigated two groups of pregnant women: with a hydropic (n = 5) and non-hydropic (n = 20) foetus at the onset of treatment. In both groups amniocentesis and umbilical puncture were indicated. The authors investigated the number of cordocenteses and the volume of transfused blood per pregnancy, the number of complications and their type, gestation age of the foetuses on delivery, their birth weight, the condition of the neonates after delivery and on discharge to home care. RESULTS: During the mentioned period the authors administered 70 intraumbilical transfusions to 25 foetuses. The transfusion was not repeated more than eight times. The baseline haematocrit of non-hydropic foetuses was 26 (14-34), treatment was started on average during the 28th week (23rd-33rd). Pregnancy in women with a non-hydropic foetus was terminated during the 35th (27th-40th) week, with a mean weight of the foetuses of 2439 g (870-3520). Of 25 treated foetuses 6 were hydropic (24%) at the onset of treatment. The initial haematocrit of hydropic foetuses was 10.7 (4-19.8), treatment was started on average during the 28th (23rd-33rd) week. Pregnancy of women with hydropic foetuses was terminated during the 30th (25th-36th) week, the mean birth weight being 1838 g (660-3500). DISCUSSION: The very favourable therapeutic results in non-hydropic foetuses are in great contrast with the therapeutic results of moribund hydropic foetuses. CONCLUSION: The basic prerequisite of successful treatment by intraumbilical transfusion is to concentrate risk pregnancies in specialized centres with a high standard neonatological team for intensive care of pathological neonates.

Blood Transfusion, Intrauterine↗

PubMed1998

[Levels of lymphocyte subpopulations in peripheral fetal blood in Rh(D) erythrocyte isoimmunization in pregnancy].

INTRODUCTION: In the foetus in utero predominates a considerable percentage of immunologically so-called naive lymphocytes of the T and B series. The objective of the presented work was to assess by means of flow cytometry and labelled monoclonal antibodies quantitative changes in cell sub-populations of the foetal immune system before the foetus is altered by severe heamolysis as a result of Rh(D) isoimmunization. METHOD: The authors obtained by intrauterine puncture of the umbilical cord peripheral blood from 10 foetuses with isoimmunization during the 23rd-35th week of gestation, confirmed by the direct Coombs test and with a mean haematocrit value of 30.8% +/- 8.02. These findings were compared with values in the peripheral blood stream in a control group of 35 foetuses during the 18th-39th week of pregnancy with normal intrauterine development (haematocrit 34.2% +/- 5.87). The authors assessed the haemogram and CD signs in the lymphocyte population. RESULTS: In the peripheral bloodstream of foetuses with erythrocyte isoimmunization the authors did not detect, as compared with the control group (p > 0.01), a lower haemoglobin level (10.6 +/- 2.77 g/dl vs. 11.9 +/- 2.03 g/dl) a lower haematocrit (30.8% +/- 8.02 vs. 34.2% +/- 5.87) and fewer leucocytes 5.1 +/- 2.39 x 10(9)/l versus 6.97 +/- 3.29 x 10(9)/l. In foetuses with Rh(D) isoimmunization the authors found a higher percentage of T(CD3+) lymphocytes (79.0% +/- 11.23 vs. 73.7% +/- 12.79, but did not prove an increase of activated T lymphocytes (%DR+ from CD3+) (1.0% +/- 0.52 vs. 1.3 +/- 0.58). The percentage ratio of T helper cells (CD+) was higher than in the control group (61.0% +/- 10.25 vs. 56.1% +/- 12.45). In foetuses with Rh(D) isoimmunization there was no difference in the ratio of CD8 positive cells (24.1% +/- 8.23 vs. 23.6% +/- 7.26). Suppressor T cells (CD8+CD11b+) were fewer (4.1% +/- 1.24 vs. 7.5 +/- 11.23) than in the control group. The number of NK cells in foetuses with Rh(D) isoimmunization was 5.1% +/- 3.26 vs. 6.9% +/- 3.86, in isoimmunized foetuses there is a higher ratio of so-called naive T helper cells Th1 (CD4+ CD45 RA+) 49.3% +/- 12.71 vs. 43.0% +/- 12.88. When assessing naive B1 cells (CD19+CD5+), the authors did not find a difference between the two groups (10.4% +/- 6.20 vs. 9.06% +/- 12.1). The ratio of CD4: CD8 in the group with isoimmunization was higher than in the control group (3.1 +/- 1.39 vs. 2.5 +/- 1.13). CONCLUSION: In isoimmunized foetuses in the initial stages of haemolysis no detactable immune response with significant changes in the lymphocyte sub-populations was found.

Female↗

PubMed1998

A new method of estimation of the optimal AV delay by using pulse oximetry in DDD paced patients.

The paper gives a detailed description of a new method for estimating the optimal AV delay in dual chamber paced patients, which is non-invasive, not dependent on the examinator, not time consuming and inexpensive. In principle, the pulse oximetry signal obtained by common finger probe was used to measure the change in its time course after changes in pacemaker stimulation. The Eagle 4000 monitor, manufactured by Marquette USA, was used for measurements and digitizing the data and then this data was analyzed using a portable personal computer with original programs developed in Famulus v. 3.5. Our results were compared to the standard method for optimizing AV delay which uses the direct measurement of blood pressure in the ascending aorta. Twenty-four patients with Physios pacemakers were enrolled in the pilot study. Measurements showed a positive correlation (r = 0.982, N = 432) between the changes in the pulse oximetry amplitude and changes in the pressure pulse amplitude measured in the ascending aorta by a catheter-tip manometer. These results indicated that this new method could be a possible alternative to the currently used techniques for AV interval optimization.

Cardiac Pacing, Artificial↗