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Biomedical subjects

K Lukács

Publications and source records attributed to K Lukács.

At least 19 recordsLinked to original sources

Peripheral sensory nerve dysfunction in children and adolescents with type 1 diabetes mellitus.

The aim of the present study was to investigate peripheral sensory nerve function in diabetic children and adolescents without neurological symptoms. Ninety-two children and adolescents with Type 1 (insulin-dependent) diabetes mellitus (mean +/- SD age: 14.2 +/- 2.1 years, diabetes duration: 5.8 +/- 3.0 years) and 80 healthy control subjects (age: 13.8 +/- 2.2 years) matched for age, sex, body mass index, and height standard deviation score were involved in the study. Using a sine-wave transcutaneous stimulator, current perception threshold (CPT) testing at 2000, 250 and 5 Hz was performed on the left median and peroneal nerves. Diabetic children had increased CPT at 2000 Hz on both nerves as compared to the control group (median (interquartile range), median nerve: 2.43 (2.20-3.43) vs 1.80 (1.51-2.60) mA, p = 0.02; peroneal nerve: 3.51 (2.81-4.82) vs 2.70 (2.04-3.70) mA, p = 0.01). Twenty-one (23%) of patients had CPT values higher than that of any healthy individual. Of these, elevated CPT was observed in 9 (9.8%) patients on the median nerve, in 8 (8.7%) patients on the peroneal nerve, and in 4 (4.3%) patients on both median and peroneal nerves. Using multiple logistic regression analysis, worse long-term metabolic control and advanced puberty were independently predictive of peripheral sensory nerve dysfunction as the dependent variable (adjusted OR (95% CI): 3.4 (1.2-6.2), p = 0.01, and 2.8 (1.1-5.6), p = 0.03, respectively). In conclusion, evidence of peripheral sensory nerve dysfunction is not rare in children and adolescents with diabetes and can be demonstrated by CPT testing in asymptomatic patients. Poor metabolic control is a risk factor for such subclinical neuropathy, and pubertal development may be involved in the pathogenesis of diabetic peripheral neuropathy.

Adolescent↗

Prospective assessment of severe hypoglycaemia in diabetic children and adolescents with impaired and normal awareness of hypoglycaemia.

To establish whether impaired hypoglycaemic awareness is associated with increased rate of severe hypoglycaemia and to assess clinical predictors of severe episodes without warning symptoms a prospective study of 130 insulin-dependent diabetic children and adolescents was undertaken for 1 year. Using a structured questionnaire, 48 patients reported impaired awareness and 82 reported normal awareness of hypoglycaemia at baseline of the study. The two groups did not differ regarding clinical and metabolic characteristics. Episodes of severe hypoglycaemia were recorded for 1 year. The rate of severe hypoglycaemia was higher in the group with impaired awareness than in the group with normal awareness (p < 0.0001). Of the severe hypoglycaemic episodes, 34.0% developed without warning symptoms. Patients with impaired awareness experienced more severe episodes without warning symptoms than those with normal awareness (p = 0.0054). Severe hypoglycaemia occurred more frequently in patients with impaired awareness aged 6 years and less (p = 0.0041) than in older counterparts. Impaired awareness reported at baseline [adjusted odds ratio (OR): 5.8; p =0.0021], age 6 years or less (3.4; p = 0.0121), previous severe episode (4.8; p = 0.0043) and more than 5 % of home blood glucose readings 3.3 mmol/l or less in the preceding month (4.2; p = 0.0211) proved to be independently predictive of severe hypoglycaemic events without warning symptoms. In conclusion, impaired hypoglycaemic awareness is associated with an increased rate of severe hypoglycaemia in diabetic children and adolescents. One third of severe episodes developed without warning symptoms. Impaired awareness, young age and recent biochemical or severe hypoglycaemias are independent risk factors for such episodes. Avoidance of hypoglycaemia should be a priority in preschool children with diabetes.

Adolescent↗

Enhanced progression of urinary albumin excretion in IDDM during puberty.

OBJECTIVE: To determine whether the progression of urinary albumin excretion rate (AER) is higher during puberty than before or after this period. RESEARCH DESIGN AND METHODS: A prospective study was conducted in which normoalbuminuric prepubertal (n = 20), pubertal (n = 28), and postpubertal (n = 26) IDDM groups matched for diabetes duration and long-term metabolic control were followed for 3 years. At 6-month intervals, 24-h urine collection was used to determine AER. RESULTS: AER increased significantly over a period of 3 years in the pubertal (P = 0.001) and postpubertal (P = 0.003) subjects but not in prepubertal subjects. The annual progression of AER was significantly higher in the pubertal group than in the prepubertal (P = 0.001) or postpubertal (P = 0.001) groups. Six pubertal, two postpubertal, and none of the prepubertal subjects developed microalbuminuria (AER > or = 20 micrograms/min on two consecutive occasions) over a 3-year period (P = 0.047). Multiple logistic regression analysis showed that the risk of development of microalbuminuria was increased in pubertal subjects compared with the prepubertal and postpubertal subjects (adjusted relative risk [95% CI]: 4.3 [1.5-9.3], P = 0.012, and 2.1 [1.1-5.0], P = 0.023, respectively). CONCLUSIONS: Puberty represents an independent risk of the development of microalbuminuria in diabetes. This findings suggests that the endocrine changes of puberty lead to an accelerated process of early kidney damage in diabetes. In pediatric diabetes care, screening for microalbuminuria is needed soon after the onset of puberty.

Adolescent↗

[Sesamoid osteoopathy of the foot].

Taking parts of sesamoids in several arthroosteopathies of 160 males and 156 females in the retrospective study were investigated. On the comparative dorsi-plantar, oblique, inversion and eversion pedal plain films could demonstrate bony hypotrophy and hypertrophy of sesamoids in 124 (39.55%) of 316 subjects. Until the dorsi-plantar radiographs were obtained with 15 degrees cephalic tube angulation, then the oblique, inversion and eversion ones were unangled. Radiographically the sesamoid osteopathies were divided into mild (grade 1, 36 of 124 cases), moderate (grade 2, 44 of 124 cases) and severe (grade 3, 44 of 124 cases) forms. The affictions involved the constant sesamoid bones of forefeet (1st and 5th metatarsophalangeal joints) exclusively. Sesamoid osteopathy was clinically specified by the serious locomotive pain of ball of the feet as well unfavourable chances against conservative treatment.

Adult↗

Decrease in the carbamylcholine-induced chemotaxis of monocytes in myasthenia gravis.

The carbamylcholine-induced chemotaxis of monocytes was decreased in patients with myasthenia gravis, whereas no change was found in the C5a-induced locomotion of these cells compared with that of the normal controls. The decrease in the chemotaxis induced by carbamylcholine correlated with the severity of clinical symptoms. The beneficial effect of thymectomy was also reflected in the improvement of chemotaxis. The method is simple, not expensive and could be used in the diagnosis of myasthenia gravis.

Carbachol↗

[Essential hypertension caused by a virilizing adrenal tumor].

Authors report here an interesting case of a woman who has been treated for essential hypertension for 12 years. Beside the hypertension, an extreme virilization appeared. A large adenoma, originated from the left adrenal gland have been explored behind the clinical picture. After surgical removal of the adenoma, adrenocortical hormones decreased to the normal levels. Systemic blood pressure decreased considerably the virilisation showed gradual involution. The correct treatment of the patient was a decade late, resulting in the development of encephalopathic syndromes.

Adrenal Cortex↗

Function of monocytes in patients with systemic sclerosis.

Functions of monocytes from the peripheral blood of 23 patients with systemic sclerosis were investigated in vitro. The yeast phagocytosis, opsonized yeast phagocytosis and binding of EA (erythrocyte-antibody) particles were found to be normal. A depressed chemotactic response was demonstrated against a zymosan-activated, complement-derived chemotactic factor. In 12 cases, monocytes were cultured for 168 hours. By the 5th and 7th days, the initially depressed chemotactic activity of monocytes returned to normal as compared to controls. This fact supports the speculation that the decreased chemotaxis cannot be caused by an intrinsic abnormality of monocytes/macrophages in systemic sclerosis.

Adult↗

Altered monocyte functions in patients with angioimmunoblastic lymphadenopathy.

Monocyte function was investigated in ten patients with angioimmunoblastic lymphadenopathy (AILD). Although spontaneous migration, phagocytosis and opsonisation of monocytes were unimpaired, the chemotactic response and erythrocyte-antibody-rosette (EA-rosette) formation were decreased significantly. The migratory response of normal monocytes was inhibited on preincubation with serum from AILD patients. It is suggested that the immune abnormality in AILD, previously thought to involve T-B and natural killer lymphocytes, extends to the monocyte-macrophage system.

Adult↗

Effect of dialysable leukocyte extract on the mononuclear leukocytes in Hodgkin's disease.

Therapy with dialysable leukocyte extract repeated 6 times, had a beneficial effect on the impaired functions of mononuclear leukocytes in Hodgkin's disease. The decreased phagocytosis and chemotaxis of monocytes increased almost to the values of healthy controls. There was no significant change in the C3b receptor activity of the patients' monocytes but their pathologically increased EA rosette formation showed some correction during dialysable leukocyte extract therapy. The number of T cells bearing histamine and IgG Fc receptors was reduced initially and increased during therapy but this effect was only temporary. The results suggest that the stimulating effect of dialysable leukocyte extract on cellular immunity was due partly to the correction of mononuclear phagocyte functions rather than an effect on lymphocyte subpopulations in Hodgkin's disease. The beneficial effect of transfer factor on mononuclear phagocyte function may affect the rate of tumour progression and reduce the number of severe infections in patients with Hodgkin's disease.

Antigen-Antibody Complex↗

Inhibitory effect of monocyte reactive antibodies on monocyte chemotaxis in systemic lupus erythematosus.

Presence of different types of autoantibodies is a basic feature of systemic lupus erythematosus (SLE). Though monocytes, macrophages play an important role in cellular immunity, autoantibodies against monocytes have not been sufficiently studied. The authors used automatic fluorochromatic assay to detect monocyte reactive autoantibodies in the sera of SLE patients. Of SLE 35.5% sera showed complement-mediated monocytotoxic activity against healthy monocytes. Monocyte reactive SLE sera as well as monoclonal antibodies against human monocytes inhibited chemotaxis of control monocytes. The results suggest that monocyte reactive autoantibodies may play a role in the decreased monocyte number and defective monocyte functions observed in SLE.

Antibodies, Monoclonal↗

Local intestinal immune response to Escherichia coli heat-labile (LT) enterotoxin: LT antitoxin levels in healthy, diseased and antigen-fed pigs.

With purified LT toxin and IgA, specific anti-LT enterotoxin activity was demonstrated in small intestinal contents of 27 pigs. After 60 days of age, rise in intestinal LT antitoxin titer was observed. Feeding LT containing E. coli antigen increased LT antibody levels in the intestinal secretions, but decreased antibody titers in sera. In post-weaning E. coli diarrhea LT antibody levels in intestinal secretions and sera decreased significantly. This phenomenon can be related to the occurrence of the frequently observed post-weaning E. coli diarrhea.

Animals↗

Immunological properties of porcine enterotoxigenic Escherichia coli heat-stable (ST) enterotoxins.

Cross-linking semipurified and purified heat-stable enterotoxin (2023 ST) to carrier proteins with glutaraldehyde pigs and rabbits were immunized. With ST antisera thus raised, a relatively simple, two-step method for isolation of ST is described. The method involved immunoadsorbent column chromatography procedure, and elution of the retained material with 6 M urea at pH 3.0 yielded purified ST with enterotoxin activity, controlled in suckling mouse test. ST purity was checked with a special staining technique in PAGE, anionic-exchange chromatography and immunodiffusion.

Animals↗

Stimulating effect of tuftsin and its analogues on the defective monocyte chemotaxis in systemic lupus erythematosus.

Monocytes and macrophages are engaged at various levels of cellular immune reactivity. In addition to their function in the defensive mechanism directed at infective agents, they also play a basic role in immune complex elimination and antigen handling. Previous experiments revealed that systemic lupus erythematosus (SLE), the main representative of the autoimmune diseases, is associated with impaired monocyte chemotaxis. The endogenous basic tetrapeptide tuftsin and 6 of its analogues were examined in vitro for their stimulating capacity on the chemotactic responsiveness of monocytes derived from patients with SLE. The monocyte migration assay was carried out by a modified Boyden technique and quantified by the leading front distance method and by counting the total distance covered by the monocyte locomotion. Tuftsin and 3 of its analogues significantly increased the defective chemotaxis in SLE. The tetrapeptides effective on chemotaxis also stimulated random migration and phagocytosis of the monocytes, albeit to a lesser extent. Structure-activity relationships, as well as the influence of the clinical stage of the disease were also examined. Experimental evidence leads to a favourable prediction for the immunotherapeutic value of these oligopeptides for the control of infections and the progression of the disease in patients with systemic lupus erythematosus.

Adolescent↗

Effects of immune complexes from SLE patients on human monocyte locomotion and Fc receptor function.

The effect of immune complexes (IC) isolated from systemic lupus erythematosus (SLE) sera with polyethylene glycol and gel filtration on the chemotaxis and Fc receptor function of healthy monocytes was examined. Even at a low protein concentration (1 microgram/ml = 1 mg/l) ICs inhibit monocyte chemotaxis. ICs from patients with SLE nephritis are more inhibitory than ICs from patients without renal disease. The inhibitory effects of ICs on monocyte chemotaxis and Fc receptor activity are similar, suggesting a relationship between the chemotactic and Fc receptor function of monocytes. Analysis of the ICs by enzyme-linked immunoassay showed no correlation between the quantity of IgG, C3, and anti-DNA in the IC samples and their effects on monocyte function.

Antibodies, Antinuclear↗

Potentiation of the defective monocyte chemotaxis in Hodgkin's disease by in vitro tuftsin treatment.

In vitro pre-incubation of monocytes derived from patients with Hodgkin's disease with tuftsin (50 micrograms/ml) significantly restored the deficient chemotactic responsiveness of these cells to the complement-derived factor C5a, as demonstrated by a monocyte migration assay based on the Boyden technique. Potentiation of the chemotactic responsiveness of monocytes was most significant after elective splenectomy. The results indicate that the specific receptors required for tuftsin activities may be available on the monocyte membranes in Hodgkin's disease. Since tuftsin is a natural, non-immunogenic tetrapeptide that can also be produced synthetically, it may provide a new therapeutic approach in Hodgkin's disease to at least partial restoration of the defective cellular immunity.

Adult↗