Biomedical subjects
L Konopka
Publications and source records attributed to L Konopka.
[Capillary blood flow in the calf muscles after infusion of a low-molecular dextran and gelatin solution].
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Recurrence of thrombocytopenia in patients splenectomized for idiopathic thrombocytopenic purpura.
The effects of splenectomy in the treatment of chronic idiopathic thrombocytopenic purpura (ITP) were analysed in 177 subjects (118 adults and 59 children) operated upon between two and 25 years earlier. In 145 patients, thrombocytopenia regressed immediately or within 2 months after the operation. Regression of thrombocytopenia later during follow up was observed in a further 14 cases. Recurrence of thrombocytopenia after good immediate result of splenectomy developed in 32 patients. In 13 cases the recurrence was transient but in the remaining 19 patients it was long-lasting. In these cases presence of accessory spleens was suggested by the absence of Howell-Jolly bodies in the peripheral blood smear and demonstrated by splenic scan in 16 cases, and confirmed in 13 out of 15 splenectomized patients. Resplenectomy caused in 12 patients permanent disappearance of thrombocytopenia.
[Cyclic AMP content in peripheral blood T and B lymphocytes in healthy subjects and patients with chronic lymphatic leukemia].
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[Immunostimulation in chronic lymphocytic leukemia (author's transl)].
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Preliminary evaluation of immunotherapy in patients with Hodgkin's disease.
The clinical course of 38 patients with Hodgkin's disease in the stage of remission was evaluated. The material consisted of two groups of patients: 1. submitted to immunotherapy and 2. control group. In 16 cases immunostimulation was performed with BCG vaccine, including four cases treated with BCG vaccine and levamisole and 3 patients were given levamisole only. In some patients, immunotherapy restored normal immunologic reactivity, as shown by the reversion of negative tests of delayed hypersensitivity. In all patients treated with levamisole caused normal blastic transformation of PHA-stimulated lymphocytes. In the group of patients treated with immunotherapy relapses of malignant lymphogranulomatosis were observed in 10.6% of cases, and in the control group--in 15.7%. The patients of both groups remain under continuous clinical surveillance.
[Cytotoxic activity of K-lymphocytes (killer cells) in Hodgkin's disease].
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[Immunological status and the results of levamisole treatment of patients with lymphocytic leukemia].
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Effect of cyclic adenosine monophosphate on the in vitro DNA synthesis in lymphocytes of patients with chronic lymphocytic leukemia.
Deoxyribonucleic acid (DNA) synthesis was investigated in vitro in T and B lymphocyte populations isolated from peripheral blood. The synthesis was determined by measurements of 3H-thymidine incorporation. Only T lymphocytes isolated from peripheral blood of healthy subjects as well as patients with chronic lymphocytic leukemia (cll) showed proliferative ability after stimulation with phytohemagglutinin (PHA). DNA synthesis rate in normal T lymphocytes was enhanced by exogenous cyclic adenosine monophosphate (cAMP) added to lymphocyte culture together with PHA in concentrations of 10(-5) and 10(-4)M. Higher concentrations (10(-3) and 10(-2)M) of this nucleotide inhibited DNA synthesis in the lymphocytes of healthy subjects as well as cell patients. Impairment of 3H-thymidine incorporation observed in cll (in non-isolated cell populations) seems to be due to the presence of non-proliferating lymphocyte B population.
Immune condition in patients with Hodgkin's disease.
In 40 cases of Hodgkin's disease (24 untreated patients and 16 patients in remission) the immunological humoral and cell-mediated competence was studied using test of hypersensitivity of DNCB and PPD, blastic transformation and the ability of 3H-DNA synthesis in lymphocytes stimulated with PHA and PWM, and in some cases, with PPD. In all patients the concentration of serum immunoglobulins was determined as well. Impairment of immunological reactivity was found in about 40% of patients, on the average, in various stages of the disease and during remissions following treatment with cytostatic agents and radiotherapy. The most frequent abnormality found in 52.5% of cases was impairment of blastic transformation of lymphocytes stimulated with PHA in vitro. In 60% of cases negative results of intradermal test with PPD and in 75% of patients the DNCB test was negative. No correlation could be found between impairment of the immune competence in this disease and the clinical stage and/or type of histological changes in lymph nodes.
Haem synthesis in sideroblastic anaemia.
Measurement of delta-aminolaevulinic acid (ALA) synthetase has been performed in bone marrow of 24 normal subjects and 20 patients with sideroblastic anaemia (five congenital, two pyridoxine-responsive, 12 primary acquired and one secondary form due to isoniazid therapy). ALA-synthetase activity without added pyridoxal-phosphate in vitro was decreased in four of the congenital cases, and in all 12 primary acquired cases. In two of these 16 cases with low ALA-synthetase activity and in a case with sideroblastic change secondary to isoniazid therapy, the enzyme activity was corrected to normal by pyridoxal-phosphate in vitro. ALA-synthetase activity was normal in both cases of pyridoxine-responsive anaemia while they were receiving pyridoxine therapy but in one of these cases, studied at repeated intervals after withdrawal of pyridoxine therapy, the bone marrow ALA-synthetase activity fell to very low levels unless pyridoxal-phosphate was added in vitro. In this case the Km of the enzyme for pyridoxal-phosphate was substantially greater than that of a control sample. Haem synthetase activity was reduced in the bone marrow of two of six cases of primary acquired sideroblastic anaemia and in one congenital case tested but was normal in the pyridoxine-responsive patient studied on pyridoxine therapy. Nevertheless, this patient showed reduced incorporation of 14C-labelled delta-aminolaevulinic acid into bone marrow haem. It is concluded that both congenital and primary acquired sideroblastic anaemia are a heterogenous group of disorders, with different defects in haem synthesis, reduced activity of delta-aminolaevulinic acid synthetase being common but not invariable in both types. Pyridoxine-responsive (congenital) sideroblastic anaemia may be due to the presence of an abnormal ALA-synthetase apoenzyme which requires excessive amounts of the coenzyme, pyridoxal-phosphate, to achieve normal activity; other abnormalities of haem synthesis may also be present.
[Effect of gelatin and dextran infusion on the reticuloendothelial system].
The purpose of this study was evaluation of the phagocytic ability of peripheral blood leucocytes and reticuloendothelial system of the lungs, liver and spleen after one infusion of plasma-substituting preparations: Fluigel and dextran 70 in volumes of 20 ml/kg of body weight. The experiments were done in rabbits. The response of the reticuloendothelial system was assessed on the basis of its ability of eliminating foreign erythrocytes labelled with 51Cr from the circulating blood and radioactivity accumulation in the liver and spleen. It was found that infusion of Fluigel and dextran produced transient changes in the function of the reticuloendothelial system with increased number of granulocytes and a fall of their radioactivity 3 and 6 hours after infusion, reduced ability of pulmonary 51Cr accumulation and increased storage in the spleen observed 24 hours after infusion.
[Treatment of aplastic anemia with oxymetholone].
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[Recurrence of hemorrhagic diathesis in patients splenectomized for idiopathic thrombocytopenic purpura].
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[Delayed results of splenectomy in chronic idiopathic thrombocytopenia in children].
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[Vitamin B-12 metabolism in Immerslund-Naiman-Gräsbeck syndrome].
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[Hematologic and surgical problems connected with splenectomy in elderly patients].
The authors carried out a clinical analysis of problems connected with splenectomy in elderly patients treated surgically at the Institute of Haematology in the years 1965-1972. Out of 24 patients aged above 60 years 12 were analysed clinically (8 females and 4 males). Splenectomy was done in these patients from haematological indications (haemolytic anaemia, thrombocytopenia, pancytopenia). In all these cases indications to splenectomy, the course of operation and postoperative period as well as late therapeutic results were assessed. The analysis of these elderly patients showed that the criteria of indications for splenectomy were the same as in other age groups. The choice of surgical method depended in these cases on the clinical and haematological findings, a lack of permanent improvement after conservative treatment, contraindications to immunosuppressive treatment and results of isotope investigations (particularly the values of the spleen-liver index). In most splenectomized patients there were no complications during the operation and in the postoperative period. In 2 cases only acute circulatory failure was observed immediately after the operation. Evaluation of late results showed that the effects of the operation were similar to those in other age groups.