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Biomedical subjects

K Pavelka

Publications and source records attributed to K Pavelka.

At least 19 recordsLinked to original sources
PubMed1992

[Use of pulsed steroid therapy in active rheumatoid arthritis].

The authors implemented a prospective double blind, controlled study where they administered to a group of 34 patients with active rheumatoid arthritis either three pulses a 1000 mg methyl prednisolone in a small infusion or an infusion with placebo. They proved a very favourable effect--after five days a marked diminution of morning stiffness was recorded, as well as a diminution of pain during locomotion and rest and general improvement of the patient's condition. After two weeks the effect declines but even after 8 weeks the difference, as compared with the initial value, was still significant, while this was not the case after placebo. The sedimentation rate increased after the initial decline to the baseline level. A number of immunological indicators (decline of immunoglobulins, IgG rheumatoid factor, rise of C3 and C4 complement levels and rise of T lymphocytes) suggest an anti-inflammatory and immunosuppressive action persisting for several weeks although the mentioned results were not statistically significant (the majority at the very borderline of significance, probably significant in a larger number of patients). The authors confirm the reactive safety of this treatment, emphasize the necessity to investigate contraindications of treatment (diabetes mellitus) and the necessity to follow up patients in inpatient facilities.

Arthritis, Rheumatoid↗
PubMed1992

[Replacement of hip joints with total endoprostheses in patients with ankylosing spondylitis].

In the Rheumatological Institute in Prague the authors made a retrospective investigation in patients with ankylosing spondylitis affecting the hip joints where one or two endoprostheses of the hip joints were made. In all these patients they evaluated the subjective complaints of the operated extremity, they made a clinical examination of the extent of mobility and evaluated X-ray pictures. The group of 20 patients was examined in this retrospective investigation approximately five years after operation. From the total of 32 endoprostheses 20 were cemented and 12 were without cement. From the total number of patients only four reported slight pain in the area of the operated hip joint without signs of loosening on the X-ray picture. The extent of mobility of all endoprostheses was very satisfactory, the mean abduction in men was 27.6 degrees, in women 30.7 degrees, flexion 84 degrees in men and 97 degrees in women. As revealed by X-ray, the hip joints were affected most frequently by coxitis, osteoplastic changes were detected in six patients. Enthesopathies of a small or medium extent were found in almost all patients. Heteroplastic bone was evaluated according to Brooker's criteria, in the investigated group only type I was found. It may be stated that the submitted group of results of endoprostheses in ankylosing spondylitis is a very satisfactory solution which improves the patient's mobility and thus restores the quality of life.

Adult↗
PubMed1992

Correlation between knee roentgenogram changes and clinical symptoms in osteoarthritis.

The main purpose of this study was to analyze the relationship between clinical symptoms and roentgenographic changes in patients with incipient osteoarthritis of the knees (OA). One hundred and sixty-two patients (126 women, 36 men, mean age 59 years) with established osteoarthritis of the knee were examined. Patients performed subjective self-assessment using Lequesne's questionnaire (index of severity for OA of the knee) and had frontal and lateral roentgenograms of both knees. Validity of the indices as reflections of individual symptoms was documented. A statistically significant correlation was found between clinical and patient indices (r = 0.327, p < 0.0001) as well as a very weak correlation between the clinical and roentgenogram indices (r = 0.196, p = 0.286). However, there was no correlation between the patient index and roentgenogram index (r = 0.065, p = 0.47). For the assessment of severity and progression of the disease, items reflecting acute irritation (swelling, effusion, increased joint temperature, pain during passive motion) were more reliable than items reflecting chronicity (muscular atrophy, decreased range of motion, crepitus). This study confirmed that Lequesne's questionnaire is a suitable tool for assessing subjective symptoms as well as for generating a condensed measure of disease severity. In addition, sclerosis, narrowing and osteophytes were proved to be important features characterizing the OA process.

Female↗
PubMed1991

Consistent cytogenetic aberrations in hepatoblastoma: a common pathway of genetic alterations in embryonal liver and skeletal muscle malignancies?

Cytogenetic analyses of four consecutive hepatoblastomas revealed near-diploid stemline karyotypes with relatively simple chromosome aberrations. Cytogenetic abnormalities shared by each tumor included trisomy for all of part of chromosome 2 and trisomy for chromosome 20. In two cases, partial trisomy for chromosome 2 resulted from direct duplication of long arm material with the shortest region of overlap being 2q23-2q35. In one tumor, each metaphase also contained a variable number of double minute chromosomes found not to derive from NMYC amplification. Interestingly, trisomy for 2q and trisomy 20 are also characteristic events in pediatric embryonal rhabdomyosarcomas. Furthermore, others have reported loss of heterozygosity for the short arm of chromosome 11 in both hepatoblastoma and childhood embryonal rhabdomyosarcoma, and both these malignant diseases are associated with Beckwith-Wiedemann syndrome. These cytogenetic and molecular findings suggest a parallel pathway of genetic steps in the initiation and/or progression of tumors of embryonal liver and skeletal muscle.

Carcinoma, Hepatocellular↗
PubMed1991

Levels of the soluble receptor for interleukin-2 in serum of patients with rheumatoid arthritis.

The authors assessed, using the method of sandwich enzyme immunoassay (ELISA), the soluble receptor for interleukin-2 (s-r IL-2). In patients with rheumatoid arthritis mean values of 620.5 = 500.0 u./ml were recorded which was significantly higher than in patients with osteoarthritis (p less than 0.001) (313.3 +/- 155 n./ml) and in healthy controls (181.7 +/- 159.6 n./ml). In patients with rheumatoid arthritis a correlation was found between the activity of the disease expressed by means of Lansbury's index (r = 0.61, p less than 0.01). There was no correlation between s-r IL-2 and the sedimentation rate (r = 0.32, p = n.s.). The author reviews the literature and discusses the hypothesis that s-r IL-2 acts as a competitive inhibitor for interleukin-2.

Adolescent↗
PubMed1991

Cytogenetic abnormalities in uterine leiomyomata.

Uterine leiomyomata are thought to be monoclonal tumors; however, the factors involved in the neoplastic proliferation of uterine leiomyomata are unknown. The purpose of the present study was to characterize uterine leiomyomata using cytogenetic techniques. Thirteen leiomyoma specimens were obtained by hysterectomy or myomectomy. Short-term cultures were successfully established for all specimens, and metaphase spreads were prepared by conventional techniques. Clonal chromosome rearrangements were detected in seven leiomyoma specimens (54%). These rearrangements involved chromosome bands 12q14-15 in five specimens, including three tumors with a specific translocation, t(12;14)(q14-15;q23-24). Chromosome rearrangements involving chromosome band 7q22 were identified in two specimens. A normal 46,XX karyotype was observed in six specimens. Myometrial specimens from two patients with abnormal leiomyoma karyotypes were normal cytogenetically. These results suggest that spontaneous chromosome rearrangements may be responsible for the initiation and proliferation of leiomyoma growth.

Adult↗
PubMed1990

[Levels of soluble receptors for interleukin-2 in the serum of patients with rheumatoid arthritis].

The authors assessed, using the method of sandwich enzyme immunoassay (ELISA), the soluble receptor for interleukin-2 (s-r IL-2). In patients with rheumatoid arthritis mean values of 620.5 = 500.0 u./ml were recorded which was significantly higher than in patients with osteoarthritis (p less than 0.001) (313.3 +/- 155 n./ml) and in healthy controls (181.7 +/- 159.6 n./ml). In patients with rheumatoid arthritis a correlation was found between the activity of the disease expressed by means of Lansbury's index (r = 0.61, p less than 0.01). There was no correlation between s-r IL-2 and the sedimentation rate (r = 0.32, p = n. s.). The author reviews the literature and discusses the hypothesis that s-r IL-2 acts as a competitive inhibitor for interleukin-2.

Adolescent↗
PubMed1990

[The effect of nonsteroidal antirheumatic agents on articular cartilage].

The authors submit a review on the influence of non-steroid anti-rheumatic drugs on the articular cartilage. First they review the general literature and then discuss the effect of different NSA on cartilage, taking into account their classification into six groups with regard to their chemical composition. Experience is based practically only on laboratory and experimental work and the results therefore cannot be mechanically applied in clinical medicine. However, NSA which do not have a negative impact on the cartilage of experimental animals are probably also safer in clinical practice. In this country the following NSA are available: diclofenac, piroxicam and thia profenic acid.

Animals↗
PubMed1990

Chromosome aberrations in uterine smooth muscle tumors: potential diagnostic relevance of cytogenetic instability.

Cytogenetic studies were carried out on a low-grade metastatic uterine leiomyosarcoma and on a large degenerating uterine leiomyoma. The leiomyosarcoma and leiomyoma were hyperdiploid and hypodiploid, respectively, and both tumors contained multiple consistent chromosome aberrations. In the patient with leiomyosarcoma, flow cytometric studies of proliferative foci from a previously resected uterine leiomyoma revealed near triploidy, suggesting that the leiomyosarcoma was metastatic from an unrecognized malignant uterine primary lesion. The leiomyosarcoma was characterized by extreme cytogenetic instability, whereas the leiomyoma demonstrated cytogenetic stability. The present cases and review of the literature on leiomyosarcomas and leiomyomas reveal cytogenetic instability to be very common in leiomyosarcomas (present in 8 of 10 cases) and uncommon in leiomyomas (present in 1 of 25 cases). A grading system is described which might be useful in evaluating the diagnostic and prognostic relevance of cytogenetic instability in uterine, and other, malignancies.

Aged↗
PubMed1990

Agranulocytosis in a patient with primary Sjögren's syndrome.

The authors describe a case of primary Sjögren's syndrome, which was complicated with severe autoimmune agranulocytosis quite sensitive to immunosuppressive therapy. Agranulocytosis is a very rare complication of this autoimmune rheumatic disease as opposed to leucopenia. A remarkable feature of the presented case is the fact that correct diagnosis of primary Sjögren's syndrome has not been settled for almost 25 years. The disease has manifested only in the form of arthropathy imitating rheumatoid arthritis.

Agranulocytosis↗
PubMed1989

Prognostic implications of cytogenetic studies in an intensively treated group of children with acute lymphoblastic leukemia.

We assessed the prognostic significance of leukemia cell cytogenetics by analyzing bone marrow aspirates obtained at time of diagnosis in 165 children on a single protocol for acute lymphoblastic leukemia (ALL). These children were assigned to six mutually exclusive cytogenetic categories as follows: (1) hyperdiploid, with 50 or more chromosomes (n = 35); (2) hyperdiploid, with 47 to 49 chromosomes (n = 11); (3) diploid (n = 42); (4) pseudodiploid (n = 34); (5) hypodiploid (n = 9); and (6) insufficient data (n = 34). At a median follow-up of 5 years, there were no statistically significant differences between any of these cytogenetic categories in either event-free or overall survival. Those children with chromosomal translocations (n = 26) appeared to fare the same as those lacking translocations (n = 105). The absence of karyotypic prognostic significance was observed not only within the overall group, but also when the results were stratified by standard-risk and high-risk status. Of the specific structural chromosome changes that we studied, only the Philadelphia chromosome (Ph) appeared to confer a poor prognosis, although there were too few such cases to achieve statistical significance. Although we did not detect the event-free survival differences that have been described previously in hyperdiploid, hypodiploid, and pseudodiploid childhood ALL, our findings must be viewed as preliminary given the small number of children in some of the cytogenetic categories. We think that the prognostic implications of these cytogenetic features might have been nullified by improvements in therapy.

Adolescent↗
PubMed1989

[The dynamics of the analgesic effect of non-steroidal antirheumatic drugs. Ibuprofenlysinate versus diclofenac].

In a double-blind clinical study, the analgesic effects of ibuprofen-lysinsalt and diclofenac were compared in 59 patients with rheumatoid arthritis. In the first phase, the patients were given either 1,000 mg ibuprofen-lysinsalt or 50 mg diclofenac at 8.00 a.m. Pain intensity was assessed by the patient with the aid of the visual analog scale (VAS) and a sliding numerical scale. With respect to the rate of onset of the effect and the course of the pain, no statistically significant differences were seen between the two drugs. In a second phase, in which the already mentioned doses of the drugs were administered 3 times a day for 7 days, there was again no significant difference in pain. Drug tolerance was considered very good by 90% of the ibuprofen-lysinsalt group, and 67% of the diclofenac group. Ibuprofen-lysinsalt is a universal, well-tolerated analgetic which can also be used to combat arthritic pain. The somewhat better analgesic effect of ibuprofen-lysinsalt was too small to be statistically significant.

Arthritis, Rheumatoid↗
PubMed1989

[Indicators of the advance and rate of progress of radiographic changes in patients with rheumatoid arthritis and their correlation with clinical and laboratory criteria].

In a double blind study with hydroxychloroquine sulphate used for treatment of rheumatoid arthritis the correlation of six X-ray criteria of progression of RA, based on calculation of the narrowing of the articular spaces and erosions (Sharp and Amos) and 23 clinical and laboratory criteria was assessed. Before treatment a satisfactory correlation of the majority of clinical and laboratory criteria with X-ray criteria was found. As after one-year treatment the majority of clinical criteria improved significantly and X-ray criteria did not differ significantly before and after treatment, the authors found very few correlations between changes of clinical and X-ray criteria, in particular after a dose of 20 mg/day. The X-ray criteria recommended by Sharp and Amos are not sensitive enough to be used for the evaluation of changes of the X-ray picture after one-year treatment with anti-rheumatic drugs which modify the course of RA. This applies in particular to more advanced cases.

Arthritis, Rheumatoid↗
PubMed1989

Hydroxychloroquine sulphate in the treatment of rheumatoid arthritis: a double blind comparison of two dose regimens.

A controlled, double blind, parallel group, long term study of hydroxychloroquine sulphate in the treatment of rheumatoid arthritis, comparing daily doses of 200 mg and 400 mg, is described. The trial involved 54 patients with moderate disease activity who had not previously received antimalarial drugs. Forty three patients completed the one year treatment. The groups receiving different doses were homogeneous and did not differ in any of the 25 monitored indicators. Both dose regimens were effective, and a significant reduction of disease activity was observed after one year's treatment. Of the nine laboratory and 11 clinical indices of efficacy monitored, no statistically significant differences were reported, but in the group of patients treated with the 400 mg daily dose the number of side effects was three times greater. As there have been no reports of retinopathy with hydroxychloroquine at daily doses of 200 mg the effectiveness of this dose is of practical importance.

Arthritis, Rheumatoid↗
PubMed1989

[Measurement of keratan sulfate levels in synovial fluid in joint diseases].

The authors describe their own modification of the ELISA method for the assessment of the epitope of keratate sulphate (KS) in synovial fluid. Considerably elevated values of KS were found in patients with gouty arthritis and reactive arthritis, as compared with patients with rheumatoid arthritis. The KS levels in the exudate of patients with osteoarthritis were significantly higher than in patients with rheumatoid arthritis. In patients with rheumatoid arthritis a negative relationship was found between the KS level in the exudate and the activity of the disease. A relationship was found between KS in the exudate and the interleukin-1 level in the exudate. Finally the authors discuss the importance of assessment of cartilage fragments in body fluids by immunochemical methods and future development trends of this discipline.

Adult↗