Biomedical subjects
Publications and source records attributed to J Sipos.
Castleman's disease is an example of the so-called atypical lymphoproliferative disorders. The optimal therapy of this morphologically and clinically heterogeneous disease is largely unknown. The authors report three cases of multicentric Castleman's disease (two hyalin vascular and one mixed variant). They analyze the pathogenesis, clinicopathologic features and management of this rare entity and review the literature.
Authors present a multiparameter pathological study in a case of rapid biclonal primary plasma cell leukemia. The immunohistochemical data revealed aberrant phenotypes (monocyte, epithelial and T-cell) probably in connection with microenvironmental influences. Biclonality can be attributed to class switching during malignant transformation. Static image cytometry showed aneuploidy. The blasts of this process are active immunoregulatory cells.
Clinical and immunological findings of 74 patients with chronic hepatitis C have been reported and experiences with interferon-alpha treatment of 31 patients are summarized. In addition, the first results of anti-HCV screening of blood donors are also briefly described. Transfusion in the history was noted in 69% of patients and the time, elapsed from the transfusion to the diagnosis was a mean of 7.15 +/- 8.1 years. Concerning the severity of the liver disease, chronic persistent hepatitis was established in 40%, active hepatitis in 45% and cirrhosis in 15% of the patients, respectively. Cholestasis was recorded in 32% of the cases. A significant elevation of serum immunoglobulin levels was noted in 83%, an antibody to liver specific protein (anti-LSP) has occurred in 80%, cryoglobulinaemia in 44% and circulating immune complexes in 33% of the patients. Natural killer cell activity of peripheral blood mononuclear cells significantly decreased. HLA B8 and DR3 antigens were found with elevated frequency (36.6% and 42.1%). Recombinant interferon-alpha at a weekly dose of 3MU thrice, for six months, has normalized serum alanine aminotransferase in 45% of patients and a sustained remission was found in 26%. The treatment resulted in the clearance of HCV-RNS from the serum in 40% of patients and that well correlated with the complete remission. In the good responders, a decrease in CD4+ cell count and a moderate decrease in CD8+ cell count as well as a transient rise in B cell count were seen during the treatment. Mitogen-induced lymphoproliferative response and natural killer cell activity increased. Predictors of response were as follows: female sex, shorter time elapsed from transfusion, absence of HLA, A1, B8, DR3 and serum anti-HBc negativity. Anti-HCV has been found in 0.33--0.38% of blood donors screened, and it is suggested, that a liver disease accompanied with elevated serum alanine aminotransferase, may be present in about 25-30% of anti-HCV positive symptom-free persons.
OBJECTIVES: We prospectively evaluated the accuracy of a gestational age-independent method of detecting abnormal growth, the transverse cerebellar diameter/abdominal circumference ratio, and compared this with standard ultrasonographic methods of growth assessment. STUDY DESIGN: We prospectively studied 825 low-risk obstetric patients and 250 patients having risk factors for fetal macrosomia (n = 92) or growth retardation (n = 158). Measured fetal parameters included the biparietal diameter, head circumference, transverse cerebellar diameter, abdominal circumference, and femur length. The estimated fetal weight, head circumference/abdominal circumference, cerebellar diameter/abdominal circumference, and femur length/abdominal circumference ratios were calculated. Reference curves for these parameters were created from a cross-sectional analysis of the low-risk group. Univariate analysis was used to determine the sensitivity, specificity, predictive values, and odds ratios of each individual parameter in identifying a small- or large-for-gestational-age infant. A multivariate logistic regression model with a variable selection procedure was then used to determine whether significance remained when we controlled for other parameters. RESULTS: Within the low-risk group, the transverse cerebellar/abdominal circumference ratio was gestational age independent between 14 and 42 weeks with a mean of 13.68 +/- 0.96. A value exceeding 2 SD of the mean was significantly associated with birth or a small-for-gestational-age infant, being abnormal in 98% and 71% of asymmetrically and symmetrically growth-retarded infants, respectively. Significance was maintained in the multivariate regression model. The ratio was not helpful in detecting the large-for-gestational-age infant. CONCLUSION: The fetal transverse cerebellar diameter/abdominal circumference ratio is an accurate, gestational age-independent method of identifying the small-for-gestational-age but not the large-for-gestational-age infant.
The relationship between the fetal TCD and the AC throughout pregnancy was investigated in a prospective, cross-sectional study of 700 well dated, normal pregnancies between 14 and 42 weeks of gestation and tested in 30 known SGA infants. Fetal measurements included the TCD, AC, BPD, HC, and FL. The TCD/AC ratio was calculated for each patient. Statistical analysis using linear regression and Student's t-test was performed. Strong correlation existed between gestational age and transcerebellar diameter (R2 = 0.9464), between gestational age and AC (R2 = 0.9685), and between TCD and AC (R2 = 0.9561). The TCD/AC ratio was normally distributed with a mean +/- SD of 13.69 +/- 0.94% (median, 13.71%). The 10th and 90th percentiles were 12.50% and 14.86%, respectively. The ratio remained constant throughout pregnancy with respect to gestational age (R2 = 0.0084). A TCD/AC ratio greater than the 90th percentile was present in 87% (26/30) known SGA infants. The TCD/AC ratio is a stable, gestational age-independent parameter that may be useful in the early detection of fetal growth abnormalities.
The cytoprotective effect of different types of 4h-pyrido[1,2-a]pyrimidin-4-one derivatives was investigated. Short synthesis of the investigated compounds was depicted. The gastroprotective effect was determined against acidified ethanol induced mucosal lesions in rats. The most effective compounds belong to unsaturated 4-oxo-4h-pyrido[1,2-a]pyrimidine-3-carboxamide derivatives, and the most active one contains a methyl group in position 6 and a cyclopentyl group on the nitrogen of the carboxamide group. Further pharmacological, biochemical and clinical studies may justify, that the representative of this type of compounds may be useful as prophylactic agents against gastric damage caused by non-steroidal antiinflammatory agents.
By analysing their newborn patients of 15 years the authors confirm the earlier observation, that the subcapsular haematoma is a common finding at postmortem examination of the newborns dying during neonatal period. The association of the pathological symptoms of hypoxic origin of the other organs observed at autopsy and the decreasing incidence of subcapsular haematoma as a results of obstetrical and neonatal intensive care make this disease of hypoxic origin probable. In spite of common subcapsular haematoma the haemorrhage of liver causing haemascos is relatively uncommon. In their five patients suffering from liver rupture they observed two types of this (immediate and delayed rupture of liver's capsule), which also differed from one another in their clinical picture. They are drawing attention to general use of ultrasound in diagnostics which means a new chance to diagnosis in alive of both types.
Autoantibodies reacting with the galactose-specific hepatic asialoglycoprotein receptor--a liver-specific component expressed on the surfaces of hepatocytes--are often found in patients with chronic active hepatitis of presumed autoimmune origin. As part of an investigation into whether these anti-asialoglycoprotein receptor antibodies might be involved in the development of periportal liver damage in chronic active hepatitis, livers of ether-anesthetized rats were perfused in situ with polyclonal guinea pig anti-rabbit asialoglycoprotein receptor or murine monoclonal anti-human galactose-specific hepatic asialoglycoprotein receptor antibodies in excess at less than 8 degrees C or, as a control, with guinea pig anti-human plasma protein antibodies or normal guinea pig serum. Rapid (1 min) antegrade (by way of portal vein) or retrograde (through hepatic veins by way of vena cava) perfusions were performed in a nonrecirculating (once-through) mode in Ca+(+)-free medium. Blocks of liver tissue were immediately snap-frozen and the distribution of the antibody examined in cryostat sections by using an avidin-biotin immunohistochemical technique. In all of the perfusions with anti-asialoglycoprotein receptor (six antegrade, seven retrograde), the antibodies were found to be prominently and almost exclusively deposited on liver cells in the periportal areas. No deposition of immunoglobulins was detected in livers perfused with the control guinea pig sera. The findings suggest that the asialoglycoprotein receptor is expressed at high density mainly on cells in zone 1 of the hepatic lobule, and this may have implications for the development of periportal liver damage in chronic active hepatitis.
An immunohistochemical technique for the detection of the hepatic asialoglycoprotein receptor (ASGP-R) in cryostat sections of liver by polyclonal and monoclonal anti-ASGP-R antibodies is described. The procedure is based on the alkaline-phosphatase-avidin-biotin complex (ABC-AP) system and important features include fixation of the sections with periodate-lysine-paraformaldehyde (with or without dichromate) and an absolute requirement for blocking of endogenous biotin activity. The sensitivity of the technique is such that binding to ASGP-R can be detected with femtomolar concentrations of monoclonal anti-ASGP-R antibodies and, with polyclonal antisera, approaches that of a radioimmunoassay.
An enzyme immunohistochemical technique for the localisation of liver membrane antigens in tissue sections by antisera raised in guinea pigs against the liver preparation known as "liver specific membrane lipoprotein (LSP)" was developed, based on the alkaline phosphatase avidin biotin complex (ABC AP) system. Of a wide range of fixatives and fixation conditions investigated, a short (five minute) exposure of cryostat sections to Bouin's fluid provided the most satisfactory results and--together with procedures to block endogenous biotin and alkaline phosphatase--yielded clear sections with no background staining or other artefacts to interfere with specific staining patterns. The sensitivity of the technique approaches that of a radioimmunoassay, as shown by the staining of the sinusoidal domains of hepatocellular plasma membranes by the guinea pig anti-LSP antisera at dilutions up to 1/50,000. Apart from its reliability and sensitivity the procedure offers additional advantages over techniques such as indirect immunofluorescence in that it provides a permanent preparation with well defined morphological details which can be seen by ordinary light microscopy.
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The recirculation of lymphocytes and cell-mediated immunity show profound alterations in alcoholic liver disease. The use of cianidanol corrects a lot of these disturbances, in that: a) it can modify the receptor avidity of hepatocytes, b) it reduces the cell-mediated immune reactivity against liver specific protein antigen, diminishing the auto-immune reactions in alcoholic liver disease, c) it has no effect upon the conjugation process between the hepatocytes as target cells and cytotoxic effector cells, d) it decreases, however, the number of hepatocytes damaged after the conjugation process, and e) as a potent free-radical scavenger, it inhibits the cytotoxic effect of natural killer cells and monocytes, and in the same manner prevents the alteration of the hepatocyte membrane.
This paper deals with the immuno-pathological characteristics of tick-borne encephalitis. With the appearance of neurological signs, there is a strong T cell reaction in th peripheral blood. The following seven days are characterized by the appearance of specific cell-mediated reaction in the peripheral blood; in the cell-mediated reaction in the peripheral blood; in the cerebrospinal fluid, an increasing number of B cells and specific antibodies can be detected. After a week, the percent positivity of cell-mediated immune reactions is higher and there is a T cell dominance in the cerebrospinal fluid. Intact cellular immunity against specific antigen is required for the management of this disease. There are major differences in the results obtained from patients suffering from meningitis alone and those suffering from meningoencephalitis.
The synthesis of 9-substituted-pyrido[1,2-a]pyrimidines are described. The new compounds exhibit antiatherosclerotic effects. The 3-ethoxycarbonyl-6-methyl-4-oxo-6,7,8,9-tetrahydro-4H-pyrido[1,2-a]pyrimidine-9-acetic acid (Chinoin-123) has the most favourable effects.
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Based on the investigations of patients the migration inhibition assay proved to be a useful method for the detection of antitumorous cellular immunity. Out of the twenty patients tested 15 gave migratory inhibitory effect against specific tumor antigen. In 8 cases out of the above 15 the blocking activity of sera has been proved. This blocking activity is bound to IgA subclass. The complement played an "unblocking" role. The modifying role of serum factors in cellular immunity against tumors was discussed.