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Biomedical subjects

M Ambrus

Publications and source records attributed to M Ambrus.

At least 19 recordsLinked to original sources

[Chronic post-mastectomy pain].

BACKGROUND: Surgery results in chronic pain in 7-80 percent. One of the most studied is chronic post-mastectomy pain. The prevalence was 40-50 percent in studies performed abroad. As this problem has not yet been studied in the Czech Republic, a retrospective prevalence study was performed to asses the extent of the problem and risk factors for development of chronic post-mastectomy pain. METHODS AND RESULTS: After ethic committee approval an anonymous questionnaire was developed and distributed in various oncology department and patients'organisations. Response rate was 100 percent, 330 questionnaires were processed. Chronic post-mastectomy pain (lasting longer than 3 months after surgery) was described by 69 (20.9 per cent) women. The pain was permanent in 17 and transient in 46 cases, not specified in 6 cases. The pain intensity was predominantly mild or moderate. Risk factors were younger age (below 55-60 years, p=0.0098), less extensive surgery (tumourectomy vs. mastectomy, p=0.0017), intensive post operative pain (p=0.0002) and radiotherapy (p=0.0174). Trend in chemotherapy (p=0.0778) was observed. CONCLUSIONS: The prevalence of chronic post-mastectomy pain was lower in our study comparing to studies in other countries. The reason remains obscure in spite of detailed analysis.

Chronic Disease↗

[Progress in surgical treatment may improve the quality of life in patients with breast surgery for malignant tumors].

Breast cancer surgery (BCS) is a common procedure performed in women. Chronic postmastectomy pain (PMP) has been reported in as many as 22-72 percent of patients. There are no published reports in Czech Republic. This study was performed to evaluate the prevalence and risk factors of PMP. An anonymous questionnaire was given to women after attending oncology departments in various hospitals during 3-month period. All 176 questionnaires have returned. The average age was 63.6 (SD 11.2) years, BMI 26.3 (SD 4.0). There was 23.6% of PMP prevalence in our group. The risk factors were younger age (below 60, p < 0.001, below 65, p < 0.01 resp.) and type of surgery (total mastectomy vs. tumour removal, p < 0.01). The prevalence of PMP in our study was significantly lower than in other studies. The age of our group was higher, than in other studies, but it does not explain the difference. We can hypothesise the reason is improved surgical technique.

Breast Neoplasms↗

Kinetics of mixed lymphocyte reaction after blood transfusions.

The kinetics of mixed lymphocyte reaction (MLR) was studied in an unrelated pair of potential kidney graft donor and recipient. The recipient immunological reactivity to donor cells was specifically modulated by donor blood transfusions. Prior to transfusions, recipient MLR to donor lymphocytes expressed as per cent of the relative response (% RR) was 85.73. It dropped to 43.75 on the 21st posttransfusion day, and was as low as 19.16 on the 151st day (5th month). Next, a gradual increase in MLR occurred. The % RR increased to 46.15 in the 9th month and returned close to the pretransfusion level, to 78.30, in the 12th month. Transplantation of the kidney from the potential donor was not performed.

Blood Transfusion↗

Cryoglobulinaemia and cryofibrinogenaemia in IgA nephropathy: a follow-up study.

Sera and plasmas from 50 patients with IgA nephropathy (IgA-NP) have been investigated for the presence of cryoglobulin (CG) and cryofibrinogen (CF), respectively, 2-5 cryoprotein determinations being made for each patient. CG was transiently found in 20 of 50 patients (40%), but in none of 20 healthy blood donors, whereas CF was found in 37 of 50 patients (74%) and in 4 of 20 healthy blood donors. The cryoprecipitates were of single and mixed component types. All but 2 of the patients with CF had haematuria. Nearly all of them had histories of long exposure to the cold as manual workers at the onset or recognition of their disease. There was no clinical remission during a 2-to-5-year follow-up if cryoproteinaemia persisted. A certain correlation was detected between the composition of the CP and the renal immunohistological findings. It is suggested that renal deposition of circulating CF or local formation of CF might be responsible for the tubulo-interstitial fibrocellular changes, which are of prognostic importance.

Adolescent↗

Double labelled T suppressor lymphocytes in the thymus of a patient with myasthenia gravis: morphological and immunological characteristics.

Double labelled lymphocytes were prevalent in the thymus of a 32-year-old woman with myasthenia gravis. The simultaneous presence of both E and C3b surface receptors was demonstrated. Focal paranuclear acid phosphatase activity of the cells supported their T cell origin. Histological analysis revealed a hyperplastic thymus with germinal centres in one lobe and an unusual transition to "thymoma-like" diffuse sheets of thymocytes and large thymic epithelial cells in the other lobe. Immunological studies of isolated cells from the "thymoma-like" region revealed a high percentage of E rosettes (96%), EAC rosettes (87%) and IgG-EA rosettes (60%). The large number of "active" rosettes (94%) indicated high avidity of receptors for sheep red blood cells. The postoperative accumulation of acid phosphatase positive T cells with C3b surface receptors in the peripheral blood was striking. These characteristics suggest that this cell population represents an activated T subset (TG) with a certain degree of immaturity similar to a particular stage of foetal T cell development (prothymocytes).

Adult↗

Circulating immune complexes in patients with IgA glomerulonephritis.

Fourty-four patients with IgA-glomerulonephritis (IgA GN) were studied for circulating immune complexes (IC) repeatedly in the course of disease on the evidence of four different methods suited for the detection of IC, viz. complement consumption assay, Clq-solubility test and two tests based on PEG-precipitation, and of indirect signs pointing to the presence of IC. Joint assessment of the direct and indirect signs (positivity of a minimum of 2 indirect signs or any of the direct signs) permitted to ascertain the presence of circulating IC in 72 per cent of the patients and in 63.3 per cent of the examined sera. There was no close relationship between the presence of IC and the clinical activity. On the other hand, in 16 patients positive for the rheumatoid factor (RF) the renal biopsy material revealed extensive vascular lesions. The findings suggest that the circulating IC, some of which contain RF, play a part in the pathomechanism of IgA GN and are involved in the production of the vascular abnormalities in this disease.

Adolescent↗

Serologic studies of hepatitis viruses for their aetiologic role in chronic liver disease.

Serum samples from 130 patients with chronic (persistent or active) hepatitis, including cirrhosis, and 70 patients with chronic alcoholic disease, all confirmed by biopsy, were examined by counter electrophoresis (CEP) for HBsAg. The patients were residents in the South-Transdanubian region of Hungary. Of the former 25%, of the latter 3%, proved positive. In 138 of the cases, 4 different tests were performed, viz. CEP, complement fixation, reverse passive haemagglutination (RPH) and radioimmunoassay (RIA). The results were positive in 24, 36, 43 and 60%, respectively, in chronic hepatitis and in 4, 6, 8 and 14%, respectively, in cases of alcoholic origin. Serum samples from the same patients were tested for anti-HBs and anti-HBc. Positive anti-HBs was found in 24% of the patients with chronic hepatitis and in 26% of those with alcoholic liver disease. The presence of anti-HBc was demonstrated in 42% and 38%, respectively. Joint evaluation of RPH-positive and anti-HBc positive cases on the one hand and of RIA-positive and anti-HBc positive cases on the other resulted in 68% and 71% HB virus-related positivity, respectively. The present study failed to furnish evidence in support of the presence of hepatitis A virus of its involvement in the aetiology of chronic liver disease.

Adolescent↗

HLA antigens in chronic active hepatitis.

Seventy-five patients (28 HBsAg-positive and 28 HBsAg-negative) with chronic active hepatitis (CAH) were studied for HLA antigens. In the whole material, the HLA antigens were distributed as in the controls, with the only exception of the HLA-A9 antigen, the frequency of which, as compared with the controls, was moderately increased (37.4% against 22.7%). It was mainly the HBsAg-negative group which showed a significant increase in the frequency of the HLA-A9 antigen (42.9%). In the HBsAg-negative group, as compared with the HBsAg-positive group, where the frequency of HLA-A2 was 53.2%--and as compared with the controls, too--it was relatively low 29.3%. The frequency of HLA-A1 and HLA-B8 was not increased in any type of chronic active hepatitis. HLA-B8 was less frequent in the HBsAg-positive than in the HBsAg-negative group (10.6% against 21.4%).

Chronic Disease↗

Levamisole treatment of acute viral hepatitis and HBsAG-positive chronic active hepatitis.

A fundamental role is attributed to the pathological immune response in the development of chronic hepatitis B. By virtue of its non-specific immune modulatory effect, levamisole is capable of improving impaired T-cell function. Hence, studies with treated and control groups were performed in determine the effect of levamisole in acute viral hepatitis and chronic active hepatitis B. In acute hepatitis B, levamisole promoted the normalization of GPT, the elimination of HBsAg; this improvement was preceded by higher GPT values and increased titres of IgG, IgA, and of anti-HBcore. In chronic active hepatitis in the first few months of treatment a moderate increase of the GPT and HBsAg levels occurred, followed later by a decrease of these values. At the same time the phytohaemagglutinin reactivity of lymphocytes increased, and so did the ratio of circulating active T-cells.

Acute Disease↗

IgA glomerulonephritis. Mesangial IgA deposition without systemic signs (Berger's disease).

Renal biopsy specimens from 204 patients with glomerulonephritis or nephrotic syndrome have been studied. In ten of the patients not suffering from acute poststreptococcal glomerulonephritis, systemic lupus erythematosus or Schönlein-Henoch syndrome, diffuse, selective mesangial IgA deposition was observed. Clinically, persistent microscopic haematuria, mild proteinuria and, except in one patient, normal renal function were found. Light microscopically the histological picture was dominated by a diffuse or focal increase in volume of the mesangial matrix, and mild mesangial cell proliferation. Exceptionally, there was also crescent formation. Immunofluorescence revealed large IgA, IgG and C3 deposits, as well as small IgM and fibrinogen deposits in the mesangial glomeruli. The authors' assumption that immunocomplexes containing a secretory component might be implicated in the pathomechanism of Berger's disease, could not be proved.

Adolescent↗

Cellular immune responses and lymphocyte populations in chronic hepatitis.

Cellular immune responsiveness was examined in chronic persistent hepatitis, chronic active hepatitis and alcoholic liver disease by the use of the lymphocyte transformation test in response to PHA and to allogenic liver mitochondria, inhibition of leukocyte migration, delayed-type skin tests and non-immunospecific granulocyte function tests. Lymphocyte markers, E and EAC rosette forming cells were used for the study of lymphocyte populations. The results have confirmed that the T-cell borne cell-mediated immune function is impaired in chronic active hepatitis, as also in a number of cases of chronic persistent hepatitis.

Adolescent↗

The role of hepatitis B surface antigen in the pathogenesis of glomerulopathies.

The frequency of hepatitis B surface antigen (HBsAg) has been studied in the sera and renal biopsies of 276 patients with various forms of glomerulonephritis (GN), the nephrotic syndrome and other nephropathies. Using a modified Hepanosticon method, HBs antigenemia was detected in 32 of 196 patients (16.3%) with immune complex (IC) GN and the nephrotic syndrome. Indirect immunofluorescence revealed HBsAg in 33 renal biopsy tissue specimens (16.8%). HBsAg was found in the sera of four of the 80 remaining patients with other renal diseases (5%), and in the renal biopsy tissues of another four (5%). Antibody against HBsAg could only be demonstrated in the serum of one glomerulonephritic patient. The sera of 18,799 normal blood donors were used as controls; of these 186 (0.99%) had positive tests for HBsAg. It is concluded that, in some patients with GN and the nephrotic syndrome, HBsAg-containing IC may be implicated in the development and/or progression of the disease.

Adolescent↗

[Cellular immune response and concentrations of serum immunoglobulins in patients with Hodgkin's disease (author's transl)].

The cellular immune response was explored by us with the help of tuberculin and DNCB reactions in 73 cases of Hodgkin's disease. Serum immunoglobulins were simultaneously determined. Tuberculin and DNCB reactions had significantly been decreased before treatment. A significant augmentation of the IgA is remarkable in tuberculin and DNCB positive groups. The positivity of the cutaneous tests is only temporarily lowered by radiation therapy, the difference being not significant, while IgM values in patients who had undergone radiation therapy are remaining at a lower level. Patients in remission revealed a positivity in tests that was approximating the values before treatment. Lower values were observed in all the three groups of immunoglobulins; the decrease of the IgM-values was significant. In case of a relapse, a significant decrease of positivity developed, accompanied by significantly increased values of IgA in tuberculin and DNCB negative groups. Only insignificantly positive values of the cutaneous tests were seen in the course of cytostatic treatment, and the values of the IgM were significantly decreased.

Dinitrochlorobenzene↗