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At least 235 records · Page 13Linked to original sources
PubMed2005

[Rhabdomyolysis, disseminated intravascular coagulation and acute renal failure after severe narcotics intoxication (MDMA, THC, amphetamine)].

More often we are faced with the cases of young people (who are in a serious condition) who land in ICU, because of severe narcotics intoxication, which they took occasionally on the concerts, discotheques and social events. From 1997 we observed rapid increase of admission to hospitals due to amphetamine, MDMA (2,3-methylenedeoxymethamphetamine which is a main component of a tablet called ecstasy) and THC (9-d tetrahydrocannabinols which are a component of sunn hemps) intoxication and decrease of opioid's poisoning. 23 years old patient was admitted to ICU in critical condition after severe narcotics intoxication. Patient was deeply unconscious (GCS 3) with tetraplegia and high temperature (39.6 degrees C). He had endotracheal tube (artificially ventilated) and hypovolemic shock with circulatory insufficiency (blood pressure was supported by 3 catecholamines). We observed many petechias and ecchymoses which suggested vascular haemorrhagic diathesis. It was found that the patient had disseminated intravascular coagulation and rhabdomyolysis with acute renal failure which was treated by dialysis. After 26 days of intensive treatment the patient was conscious, he had also efficient circulatory and respiratory system but with slight improvement of neurological state. In this condition he was admitted on nephrology ward to continue the treatment and start rehabilitation. The presence of high concentration of amphetamine, MDMA and THC in blood, extreme dehydration and electrolytes disturbances caused rhabdomyolysis, DIC syndrome and acute renal failure which make the prognosis worse and complicate the treatment. Estimating probability of death of this patient in SAPS II scale (Simplified Acute Physiology Scale) he has bad prognosis (86 points gives 95% of death probability). The patient is alive (what is a big success), probably thanks to quick arrival to specialized medical centre and dialysis treatment which was started early.

Acute Kidney Injury↗
PubMedDate not supplied

Effects of acute and chronic treatment with magnesium in the forced swim test in rats.

The antidepressant-like activity of magnesium, the non-specific N-methyl-D-aspartate glutamate receptor antagonist, in the mice forced swim test was demonstrated previously. In the present study, the effects of this biometal were studied in the rat forced swim test. Magnesium (MgCl2) at doses ranging from 15 to 50 mg Mg/kg reduced the immobility time in the forced swim test, thus exerting antidepressant-like activity. To evaluate tolerance to this effect, we also performed experiments with the following acute/chronic magnesium treatment schedule: chronic saline and saline challenge at 0.5 h before behavioral experiments (S + S), chronic saline and magnesium challenge (S + Mg), chronic magnesium and saline challenge (Mg + S), chronic magnesium and magnesium challenge (Mg + Mg). The antidepressant-like effect of magnesium was demonstrated in the group treated acutely with magnesium (S + Mg) but not in the chronically treated group (Mg + S) and (Mg + Mg). It is interesting to note that in Mg + Mg group serum concentration of magnesium was quite similar to the S + Mg group (6.44 vs. 6.08 mg/100 ml, respectively), which displayed antidepressant-like effect. The results confirmed that magnesium administered acutely induced the antidepressant-like effects also in rats. However, contrary to mice, chronic treatment with magnesium induced tolerance to this effect in rats.

Animals↗
PubMed2005

[Horizontal glottectomy--oncological and functional results. Part II. Morphology of the glottis and perceptive-acoustics characteristic of the voice and speech after horizontal glottectomy].

INTRODUCTION: The authors showed findings concerning glottis morphology and perceptual-acoustic characteristics of voice and speech after partial classical (PCGLg) and extended glottic partial laryngectomy (PEGLg). MATERIAL AND METHODS: 10 patients (9 M., 1 F. average age 56 (min. 47 max. 65) were examined. All patients were undergone glottic partial laryngectomy: a) classical (n = 5) b) extended of vocal process (n = 3) with (n = 2) or without (n = 1) the removal of the mucous false folds, c) extended of part of arytenoid cartilage with (n = 2) or without (n = 1) the removal of the mucous of the false folds. The following examinations were executed: phoniatric, videolaryngoscopic and perceptual-acoustic analysis. RESULTS: After PCGLg and one extended of vocal process, voice and speech has mostly characterized of features of hypofunction dysphonia. Hyperfunction was found in patients after removal of the mucous of the false folds due to leucoplakia. In case of removing of a part of arythenoid cartilage the notable or entire standstill or lack of full phonatory closure were found. The phonetical-acoustic analysis showed that in patients using melodious voice, the character of the source of actuating was periodically-noise, with the component of noise in all range of the course of the acoustic signal of voice. The parameters such as F0, jitter, shimmer does not make coherent conclusions and are less useful in the assessment of the quality of voice. CONCLUSIONS: In case of the resection of the part of the arythenoid cartilage during glottis laryngectomy, we take into account lack of full phonatory closure and using whisper by the patients. Obtaining the reliable conclusions needs continuations of the investigations and increasing number of patients. These researches are in progress.

Aged↗
PubMed2005

Expression of recombinant forms of human 21.5 kDa myelin basic protein and proteolipid protein in CHO cells.

MBP and PLP are major structural protein components of myelin. Both proteins play a functional role in formation of myelin sheath and in maintenance of its compaction. Immune responses to MBP and PLP have been implicated in the pathogenesis of multiple sclerosis (MS), an auto-immune disease of the central nervous system. Recombinant forms of both proteins isolated and purified from bacterial or insect cell systems are commonly used to study the specificity of auto-response in MS. We have prepared recombinant forms of MBP and PLP stably expressed in CHO cells. Several clones with proper cytoplasmic MBP or surface PLP localization were obtained and characterized by flow cytometry and indirect immunostaining. CHO cells expressing the recombinant forms of MBP and PLP can be very useful in studies on the autoimmune mechanism of MS.

Animals↗
PubMed2005

Influence of systemic photochemotherapy on regulatory T cells and selected cytokine production in psoriatic patients: a pilot study.

BACKGROUND: Psoriasis is a chronic autoimmune inflammatory disease of the skin with strong genetic and environmental risk factors and is regarded as a Th1 cell-type disease. The aim of our study was to evaluate the effect of one-month PUVA (Psoralen Ultraviolet A) therapy on a regulatory T-cell subpopulation (CD4+CD25+) and the production of some cytokines. MATERIAL/METHODS: The study was performed on the group of 12 patients with severe psoriasis. They were put on PUVA therapy for one month. We analyzed the level of CD4+CD25+ regulatory T cells using a FACSCalibur cytometer and CellQuest Software. The production of IFN-gamma (interferon-gamma), TNF-alpha (tumor necrosis factor alpha), IL (interleukin) -10, IL-5, IL-4, and IL-2 by lymphocytes was estimated by using a CBA system. The control group consisted of 11 healthy volunteers. RESULTS: We found that the production of INF-gamma, TNF-alpha, IL-2, and IL-10 in psoriatic patients before PUVA application increased significantly compared with the control group. In patients after PUVA therapy we observed decreased production of TNF-alpha and a decreased number of CD4+CD25+ cells in the blood compared with the same group of patients before the treatment. CONCLUSIONS: It was demonstrated that systemic PUVA therapy led to a marked reduction in CD4+CD25+ T cells and a change in cytokine production.

Adult↗
PubMed2004

[Mycobacterium kansasii infection in chronic thromboembolic pulmonary hypertension (CTEPH), report of two cases].

Mycobacterium kansasii infection leads to significant morbidity both in immunocompetent and immunocompromised patients. 7 subtypes of M. Kansasii were identified so far. Subtypes 1 and 2 are known to be pathogenic to humans, subtypes 3-7 are commonly isolated from the environment and rarely cause disease. In the present study we report on two cases of chronic thromboembolic pulmonary hypertension (CTEPH) complicated by M. kansasii infection. Disease was recognized according to ATS criteria. Resolution of lesions was observed in both patients in the course of antituberculous treatment. These are to our knowledge the first recognized cases of M. Kansasii infection in CTEPH. Chronic hypoxemia with impaired lung metabolism could be responsible for susceptibility to infection with nonpathogenic subtype 4 of M. Kansasii.

Adult↗
PubMedDate not supplied

[Production and preliminary characteristics of polyclonal antibodies specific to SSTR2A and SSTR5 receptors in the pituitary gland].

The increasing interest in somatostatin receptors (SSTR) is mainly due to their involvement in the regulation of hormone secretion and the role in somatostatin analogue treatment of patients with pituitary adenomas. The efficiency of this treatment is highly dependent on receptor expression in tissue which on the protein level requires specific anti-receptor antibodies for testing. In this paper we introduced the principles for the production of several polyclonal antibodies specific for C-terminal intracellular part or N-terminal extracellular part of SSTR2A and SSTR5 receptors. The antibodies were highly specific for peptides used for immunization of animals, had low cross-reaction activities for other SSTR2A and SSTR5 peptides and reacted with receptors on immunoblots and in immunohistochemistry. The final verification of the antibodies' specificity would allow us to perform the research concerning the structure and posttranslational modifications of SSTR and avoid dependency of commercial sources.

Adenoma↗
PubMed2005

[Early diagnosis of renal diseases--preliminary results from the pilot study PolNef].

Continuous increase of the number of patients with chronic kidney failure which require renal replacement therapy, in Poland as all as over the world, demands the analysis of epidemiological situation concerning renal diseases. Early diagnosis of nephropathy permits not only an adequate treatment, but also facilitates the introduction of the therapy that slows the progression of kidney failure. The aim of the pilot study PolNef was an attempt to evaluate the epidemiology of renal diseases in Poland on the basis of a randomly selected population from a city numbering 60 thousand people. As a screening test, allowing to distinguish patients requiring further diagnostic of nephropathy, the microalbuminuria dipstick test accompanied by blood pressure measurement and questionnaire was accepted. Microalbuminuria was detected in more than 18% of the population investigated up till now. It was more frequent in male, in obese, and in smokers. More than 33% of all participants consulted by the nephrologist required permanent nephrological care and for the next 32% another nephrological consultation in 6 to 12 month should be ordered. Decreased clearance of creatinine was found in above 17% participants and 6 patients were referred for further treatment because of new diagnosis of renal tumor. Identification in investigated population patients with of an early stage of kidney disease needs further nephrological diagnosis and treatment is especially important from the point of view of every single patient and also may bring substantial economic benefits for health protection system as well.

Aged↗
PubMed2005

[Transient psychiatric abnormalities in patients with acute myocardial infarction].

UNLABELLED: Psychiatric abnormalities (PA) are often observed in patients (pts) in the Coronary Care Units. The origin of such abnormalities is not always clear, but it is known that they may aggravate patients status and interfere with further treatment. The aim of this study was to analyze the factors potentially predisposing to the occurrence of PA in pts with acute myocardial infarction (AMI). MATERIAL: The study group consisted of 200 consecutive pts hospitalized due to AMI. In 63 of them (Group A) the in-hospital course was complicated by PA (agitation, anxiety, hallucinations). Sex- and age-matched 63 pts of the remaining 137 pts which had not PA were control group (Group B). METHODS: The data related to coronary artery disease history, AMI diagnosis and treatment were withdrawn from hospital reports. Second group of parameters was focused on history of central nervous system (CNS) diseases, vision and audition ability, stimulant or drug addiction. The data about patient's employment and familial status, level of education, self-estimation of quality of life (QoL) in hospital were the third group of parameters. The second and third group of data were questionnaire-based information. RESULTS: There were no significant differences between groups in arrhythmias, localization of AMI, percentage of pts with high level of education, neither living alone or with family, jobless, retired or employed ones. Also self-evaluation of QoL was distributed similarly. The parameters which differed Group A versus Group B were respectively: history of CNS diseases (48% vs 20%, p<0,05), in particular--CNS traumas (18% vs 2,3%, p<0,05) and ischemic episodes (10% vs 0%, p = 0,039), thrombolytic (non-percutaneous interventional) treatment 23,8 vs 4,6%, p<0,05), handicap of visual ability (16% vs 0%, p--0,012), nicotinism (30% vs 9,1%, p<0,05), left ventricle ejection fraction <40% (34% vs 5%, p<0,05), treatment with atropine (12,7% vs 0%, p = 0,012) or amiodarone (16,7% vs 0%, p = 0,037). CONCLUSION: History of neurological diseases, thrombolytic treatment, left ventricle ejection fraction <40%, handicap of visual ability, nicotinism and amiodarone or atropine in pharmacological treatment are factors which may be helpful to predict PA in pts with AMI. Cumulation of such factors increases a risk of occurrence of transient psychiatric abnormalities. Proper psychoactive pretreatment should be applied in pts with such profile in purpose to avoid behavior related complications.

Adult↗
PubMed2006

Results of severe sepsis treatment program using recombinant human activated protein C in Poland.

BACKGROUND: Recombinant human activated protein C (drotrecogin alfa [activated]--DAA) demonstrated in Phase III controlled clinical studies significant reduction of mortality in patients with severe sepsis and high risk of death. The aim of the study was to assess the therapeutic efficacy of DAA in patients included in the National Severe Sepsis Register in Poland. MATERIAL/METHODS: The analysis included 3233 cases of severe sepsis reported between 04.2003 and 11.2005. 302 patients (9.3%) were treated with DAA. The clinical course of the disease in DAA and non-DAA treatment groups was compared. Logistic regression models for the effects of independent variables on the risk of death (dependent variable) were developed. RESULTS: In the patients treated with DAA, the relative risk of death was lower by 31% than in those who were not treated. In a multivariate logistic regression model, the use of DAA was, independently of the patient's age, severity of the clinical condition and type of organ dysfunction, the most significant mortality-reducing factor in severe sepsis. CONCLUSIONS: The use of DAA in the treatment of severe sepsis proved to be a very effective method of mortality reduction. Controlled nationwide surveillance program contributed to its effective utilization. The National Severe Sepsis Register proved to be a very useful instrument for assessment of the course of the disease and treatment efficacy.

APACHE↗
PubMed2006

[Ablation of atypical, fast atrio-ventricular nodal tachycardia in a pregnant woman--a case report].

We describe a case of a 24-year-old pregnant woman (35 hbd) who was admitted because of fast (240 bpm) supraventricular tachycardia which required electrical external cardioversion (transesophageal atrial pacing and drugs were ineffective). She underwent RF ablation during which a single RF application effectively cured atypical atrio-ventricular nodal tachycardia. The duration of fluoroscopy was 53 seconds. The child was delivered on time and with no complications.

Adult↗
PubMed2005

[Juvenile dermatomyositis in 12 years old girl].

We would like to present a selected case of 12-aged girl, with recognition of dermatomyositis (DM). At the age of 11 in the normally developing child, erythematous-oedematous changes have appeared on the face, particularly intensified in the vicinity of the orbital cavities (so called: pseudoglasses), as well as erythema and teleangiectasis on the dorsum of hands and small-sized diarthroidal joints (the Gottron's symptom). Subsequently, lower physical efficiency and distinctly weakness in the child's extremities occurred. In EMG (quadriceps muscle of the thigh) myogenous traits have been proven. Neurological examination revealed as follows: muscular weakness (adynamia), mainly lower limbs (grade 3 in the Lovett's scale, along with decreased loss of muscles tone), lack of the periosteal reflex near lower limbs, positive Gower's symptom and increased anterior spinal curvature. In the biochemical examinations accelerated erythrocyte sedimentation rate (ESR), and a rise of activity in muscles enzymes were stated. In the child's blood serum, we disclosed antinuclear antibodies ANA (type of granular luminescence, titre 160), to be rather evident to presence of autoimmunological process. During examinations of the musculocutaneus specimen, DM-markers have been detected. Capillaroscopy proved specific presence of numerous vessels, multiple capillary tubes, individual gemmated vessels and completely invisible dermatomyositous border. Patient was treated with per os sterid--Encorton at the initial dose of 2 mg/day, every other day during the lapse of 6 weeks to reach the normal CPK-activity, and consequently clinical picture under "on-line" surveillance, gradually reducing a specific medicine up to maintenance dose through 18 months. At present, the patient is subjected to check-up and monitoring by Neurological Outpatient and Rehabilitain Clinic for Children.

Antibodies, Antinuclear↗
PubMedDate not supplied

[A two-year evaluation of the development of preterm babies born in the region of Warsaw: a prospective cohort study Prematuritas].

AIM: Complex evaluation of the development of infants until the end of the second year of life, including neurological and sensory development. A prospective cohort study. POPULATION AND METHODS: 1) 264 premature babies born between 24 and 32 weeks of gestation during the period 1st of Oct 1998 and 30th of Sept 1999 in the region of Warsaw. 2) Age of examination at: 4th, 8th and 12th month of postconceptional age and 18th and 24th month of calendar age. 3) Neurological examination according to modified Denver's test, including the development of motor skills, coordination of vision and movement, speech and social contacts. Final division of development into: normal, uncertain and pathological. 4) Cerebral palsy was diagnosed according to the definition and classification proposed by the European Commission in 2002. 5) Retinopathy of prematurity (ROP): back of the eye (Fison's speculum) examination conducted from the 30th day of life, and follow-up depending of the escalation of changes. In cases of diagnosed ROP, stage 3 or 4 laser photocoagulation was performed. 6) Hearing examination: behavioral evaluation, in cases of uncertain or abnormal results ABR (auditory brain stem response) was carried out. RESULTS: 162 children participated in the examination at the age of 2, which comprises 87% of the study population. While evaluating motor and sensory development of study population at 2 years of age, normal development was seen among 88% of children, cerebral palsy of different types (with majority of serious cases) was diagnosed in 8% of children and 2 children were blind. Uncertain development was stated for 4% of children, and 1 of them was deaf. 20% of children experienced delay in speech development and hyperactivity. Among babies born before 28th week of gestational age, 2-3 times higher percentage of 3rd stage of retinopathy of prematurity (ROP) was stated in comparison with developed countries. Nevertheless, no case of blindness was observed in this group of children, which may prove effective screening and effective therapy. At the same time 65% of children with 3rd stage ROP have some problems with vision (squint, short sightedness). The incidence of bronchopulmonary dysplasia-BPD (16%) and chronic lung disease (CLD) (11%) were relatively low. However, the percentage of hospitalization among children with CLD under the age of 2, which was caused by respiratory problems, was 37% compared to 28% of children in which CLD was not diagnosed. CONCLUSIONS: 1) The incidence of cerebral palsy in our study is not different from the results of other authors and was the highest among babies born before 29 weeks of gestation. 2) In the cerebral palsy group, higher incidence of tetraplegia was found, which may be connected with higher prevalence of hemorrhagic changes (IVH grade III or IV) and hypoxic -- ischaemic changes (PVL). 3) A relationship was found between cranial ultrasound (US) at 40 weeks of postconceptional age after PLV and the child's motor development at 2 years of age: normalization in the US was connected with correct development. 4) Incidence of ROP grade 3 was stated to be three times higher compared to other authors. No case of blindness was stated, which proves effectiveness of screening and treatment procedures. 5) Only one case of deafness due to congenital malformation was found. 6) The incidence of bronchopulmonary dysplasia (BPD) and chronic lung disease (CLD) was comparable to data from developed countries. However, the percentage of hospitalization for all respiratory problems among children with CLD under the age of 2 was twice as high as in the remaining population. 7) Developmental disorders such as: hyperactivity, delay of speech and vision problems (strabismus and short sightedness) indicate the need for continued evaluation of this group of children up to school age (5-7).

Cerebral Palsy↗
PubMed2006

The cerebral form of toxocarosis in a seven-year-old patient.

INTRODUCTION: Toxocarosis is a consequence of human infection by Toxocara canis larvae. There are symptomatic (visceral, ocular) and asymptomatic courses of toxocarosis. The cerebral form is very rare. CASE REPORT: We present a seven-year-old patient who developed a cerebral form of toxocarosis. She demonstrated focal neurological symptoms (epilepsy) confirmed by neuro-imaging and histopathological examinations. A positive test for toxocarosis essentially completed the other outcomes. On the basis of the clinical picture and the conducted tests a diagnosis of a cerebral form of toxocarosis was established. Mebendazole was applied in treatment.

Animals↗
PubMed2005

[Metabolic syndrome in obese children].

UNLABELLED: The aim of the study was to evaluate the incidence of metabolic syndrom's abnormalities in obese children and family risk factors. MATERIAL AND METHODS: We examined 280 (M/F 127/153) children in the age of 14.2 +/- 2.5 years with obesity duration 9.4 +/- 4.1years. The control group consisted of 70 (M/F 31/39) normostenic children matched according to age and stage of puberty. RESULTS: In the group of children with obesity, family history (I and/or IInd degree relatives) of: obesity was stated in 78.0%, hypertension 42.9% and diabetes mellitus type 2 in 44.6%, all these three risk factors together were present in 16.3%. Abdominal adiposity was noted in 66.8% (WHR > or = 0.9/0.85), hyperinsulinemia 0'(> or = 20 microUI/ml) in 30.7%, I/G (> or = 0.30 microUI/l/mg%) in 22.9%, IGT in 13.2%, fasting hyperglycemia (6.1-7.1 mmol/l)--5.4%; serum lipids (mmol/l): Ch-T (> or = 4.81) - 43.2%; LDL-Ch (> or = 2.6) - 62.5%; HDL-Ch (< or = 0.9) - 51.4%; TG (> or = 1.7) - 30.4%. Hypertension (> 130/85) in 6.4%. Metabolic syndrome (of three or more abnormalities) was stated in 50% children with abdominal adiposity. CONCLUSIONS: (1) Metabolic syndrome is present in obese children. (2) Current literature and our own study indicate the necessity of early prevention through constant education of correct nutrition and physical activity.

Adolescent↗
PubMed2005

[The function of eye and vision system in children and youth treated with vigabatrin--our own experiences].

PURPOSE: The aim of this study is to find the relationship between visual function changes and vigabatrin treatment continuation or discontinuation. MATERIAL AND METHODS: 19 patients (11 males, 8 females) from 8 to 20 years old, treated with vigabatrin because of partial epilepsy, were examined. Best corrected visual acuity, contrast sensitivity and static visual field were done. The examinations were repeated after 1-2 months and after 1-2 years. The longest follow-up was about three years (one girl). In some children from this group additional elctrophysiologic tests (ERG, EOG according to ISCEV standards), were done. RESULTS: Corrected visual acuity was 5/5 in all eyes. Contrast sensitivity was normal and it was not changed in follow-up period. Abnormal visual field was found in more than half of examined patients. The improvement of visual field occurred after vigabatrin discontinuation, but in one patient the improvement occurred although vigabatrin treatment was continued. Most of the patients refused control ERG and EOG, but in first examination decreased or border b-wave amplitude after "flicker 30Hz" was found. CONCLUSIONS: In some patients treated with vigabatrin reversible visual field changes occurred. Multicentre study should be performed, to solve the problem of relationship between visual field changes, vigabatrin and other antiepileptic treatment. All tests in group of epileptic patients are difficult because of poor cooperation.

Adolescent↗
PubMedDate not supplied

[Malignant neoplasms localised in the parameningeal region in children treated at two Polish oncological centres-diagnostic and therapeutic dilemmas].

UNLABELLED: Malignant neoplasms localized in the parameningeal region include mainly soft tissue sarcomas (MTM), non-Hodgkin s lymphomas (NHL-B) and, less frequently, nasopharyngeal carcinomas. The aim of the study was to analyze diagnostic and therapeutic problems in children with parameniingeal neoplasms treated in Departments of Paediatric Oncology in Gdansk and Lublin between 1992 and 2004. MATERIAL AND METHODS: The study includes 32 patients (M/F: 23/9), aged 2 to 17 years, mean 6,3 years. In 17 children MTM was diagnosed: in nine NHL-B-cell and in six--nasopharyngeal carcinoma (lymphoepithelioma). The diagnosis of NHL-B and undifferentiated MTM were made in two children treated previously for NHL-nonB and retinoblastoma. Two cases of NHL appeared in a girl with ataxia-teleangiectasia syndrome. RESULTS: Initial symptoms lasted from 2 weeks to 24 months, mean 4,5 months for the whole group. In NHL patients mean period ofsymptoms was 4,5 weeks, in MTM- 5,5 months and in lynmphoepithelioma--7 months. Symptoms associated with the tumours localisation (snoring, breathing through the mouth, epistaxis, chronic purulent rhinitis, dysphagia and earache) predominated and were treated initially as upper respiratory tract infections. Cervical lymph nodes enlargement was observed in 30% children with MTM and 83% with lymphoepithelioma. Most of patients presented with highly advanced stages of neoplasms. MTM and NHL-B treatment was conducted according to the protocol approved by the Polish Paediatric Solid Tumours and Leukaemia/Lymphoma Studies Group. In patients with lymphoepithelioma different treatment schemes were administered, including chemo- and radiotherapy. Good response to therapy was found in 13/32 patients (41%). The group included 24% children with MTM (all with embryonic subtype), 56% with NHL-B and 67% with lymphoepithelioma. All these patients attained complete remission after standard line I therapy. But 13 children with MTM, four with NHL-B and two with lymphoepithelioma required more aggressive line II treatment because ofpoor response to therapy (NR) or relapse. Finally, 20 of 32 followed-up patients (62,5%) are in durable complete remission from 10 months to 11 years 4 months (mean 4 years) after therapy discontinuation. This group consists of all nine patients with NHL-B, 67% children with lymphoepithelioma and 41% with MTM. In six children (30%) persistent complications of oncological treatment occurred, including: hypoacusia, postradiation defect of the eye ball, postsurgical facial nerve palsy and cranio-nasal fistula complicated with pneumocephaly. A patient with MTM of maxillary sinus developed a second neoplasm 2 years after first therapy. This was glioblastoma multiforme located in the left parietal lobe (outside the radiation field). At present, the boy is in complete remission 2,5 years after treatment for the second tumour Among 32 children with parameningeal neoplasms 11 patients died (nine with MTM and two with lymphoepithelioma), all in the phase of disease progression (five NR and six after relapse). In two of them (with MTM) the direct cause of death was myelosupressive, gastrotoxic and infectious complications of antitumour therapy. One child still undergoes treatment for MTM relapse.

Adolescent↗
PubMed2006

Assessment of the inflammatory process by endomyocardial biopsy in patients with dilated cardiomyopathy based on pathological and immunohistochemical methods.

INTRODUCTION: Myocarditis may lead to dilated cardiomyopathy (DCM) in immunogenetically predisposed individuals. The diagnosis of myocardial inflammation is currently based on histopathological and immunohistochemical methods. Previous studies indicate that inflammatory cardiomyopathy occurs in approximately 50% of patients with DCM. AIM: The goal of the study was to assess the inflammatory process in patients with DCM by endomyocardial biopsy using histopathological and immunohistochemical methods. METHODS: Endomyocardial biopsy specimens was examined using routine histopathological methods and immunochemical staining for T lymphocytes (CD3(+), n=84), major histocompatibility complex I (HLA ABC, n=48) and II (HLA DPQR, n=84) antigens and the adhesion molecules ICAM-1 (n=51) and VCAM-1 (n=48) in 84 patients (69 male, 15 female; mean age 35.0+/-10.5 years) with angiographically-confirmed DCM. Familial disease occurrence was noted in 14 (16.7%) patients. Cardiac samples obtained from 18 patients who died of non-cardiovascular causes were used as a control group. RESULTS: Myocarditis was diagnosed, according to the Dallas criteria, in 8 (9.5%) patients. The frequency of inflammatory cardiomyopathy, defined as the presence of >2 CD3(+) T lymphocytes per high-power field (hpf) in myocardial biopsy, was 14.3%. When broader criteria were applied (presence of >2.0 CD3(+) lymphocytes/hpf and/or 1.5 CD3(+) lymphocytes/hpf in multiple foci and increased expression of class I/II HLA), inflammatory cardiomyopathy was diagnosed in 32.1% of patients. Inflammatory activation of the endothelium, indicated by increased expression of at least three adhesion molecules (class I and II HLA, ICAM-1, VCAM-1), was present in 22 (45.8%) patients. The expression of HLA DPQR, HLA ABC and ICAM-1 was observed on the endothelium of capillaries and larger vessels, interstitial cells, and the surface of activated lymphocytes; immunohistochemical reactions were diffuse. In patients with markedly elevated expression of the aforementioned adhesion molecules, the expression was also present on cardiomyocyte cell membranes. VCAM-1 was restricted to the endothelium of individual small veins. The control group did not demonstrate any signs of myocarditis, inflammatory cardiomyopathy or inflammatory endothelial activation. CONCLUSIONS: The application of immunohistochemical methods to myocardial biopsy in order to identify the inflammatory cell phenotype and the presence of adhesion molecules permits the diagnosis of inflammatory cardiomyopathy in 14% or 32% of patients, depending on the criteria used, while conventional pathology allows for this diagnosis in 9% of patients. The observed frequency of inflammatory cardiomyopathy, defined as the presence of >2 CD3(+) T lymphocytes/hpf in the myocardium, was lower (14%) than in previous studies, while the frequency of inflammatory endothelial activation was similar (45%).

Adult↗