Search

Endothelial injury occurs in atherosclerosis, infectious, rheumatic and vasculitic processes, leading to activation of transcription factors and endothelial expression of various cytokines and adhesion molecules. Endothelial cell cultures represent a valuable tool in research activities, with emphasis on the principal characteristics of angiogenesis, inflammatory response, transduction signals and endothelial functionality. In the laboratory of tissue cultures we prepared primary endothelial cultures by their isolation from the umbilical vein. This model system has been used to investigate the endothelial activation in vitro, adhesion alterations of immunocompetent cells to endothelium, adhesion molecule expression in the disease course monitoring and anti-inflammatory treatment. (Tab. 1, Fig. 5, Ref. 45.)

Effect of immunotherapy with Transfer factor administered for a period of three months was studied in a group of ten epileptic patients, treated with carbamazepine or primidon previously and throughout the study. Out of eight patients, who finished the study we could notice significant reduction of epileptic discharges in eight patients. The results of this study prove that addition of immunomodulatory treatment to patients with intractable epilepsy could substantially improve the course of the disease in some patients. (Tab. 1, Fig. 5, Ref. 13.)

Unlabelled: The links of epileptic seizures with febrile diseases, as well as with common infections are generally known. Similarly, physicians are aware of the coincidence of epileptic activity with immunity disturbances, as well as of the effects of the antiepileptic drug phenytoin on the immunity system. Disturbances of immunity are commonly reported in 30% of the population. Our clinic is a consilliary regional centre for torpid epilepsies and sleep defects. The aim of study is to document the occurrence of immunity disturbances in unsuccessfully treated patients (5-25 years of age) with generalised convulsive epilepsy (GENKONV-GK) in a group containing 50 patients, and with partial epilepsy with complex symptomatology (PARTKOMP-PK) in a group containing 75 patients. At the same time, this studys objective resided in seeking evidence of the positive effect of immunomodulatory therapy. In all patients, the basic diagnosis had been stated in coincidence with the origin of epilepsy during hospitalisation in neurologic wards. In 1993-1995 our clinic supplemented the electrodiagnosis by a series of routine EEG which was focused at the recurrence of the disease. As a rule, each of the patients was subdued to a 24-hour EEG monitoring on the 12-canal apparatus. Individual supplementation by CT, MR and USG of the brain, the arrangement of anti-epileptic therapy and basic immunological examination were made during the first year of investigation. Still, after the stabilisation of anti-epileptic therapy (monitoring) and indicated immunomodulatory therapy was added., Results: The immunologic examination was negative in 4 patients, all being members of GENKONV group. Atopy was found in 56% of GK group, and in 65% of PK group. Disturbances of specific cellular immunity were revealed in 80% of the patients of the GK group, and in 85% of PK group. The signs of inflammatory activity and other signs of allergy were present to a lesser extent., Conclusions: Out of the amount of 125 patients only 3.2% yielded no disturbances of immunity. The application of immunomodulatory therapy appears to represent a promising supplementary-stabilisation therapy. (Tab. 2, Fig. 4, Ref. 5.)

The authors present epidemiological data about congestive heart failure, its most common etiology and prognosis. They justify the performance of heart transplantation (HTx) in the treatment of congestive heart failure. They analyze the present state of HTx in the world and describe also the history of HTx in Slovakia. They present the review of contraindications and indications for the inclusion of recipients into the HTx programme and describe the further fates of these patients. They regard the HTx as an integral component of the therapeutical approach to the precisely defined group of patients with otherwise refractory congestive heart failure. (Tab. 4, Fig. 6, Ref. 38.)

On the basis of 506 renal biopsies performed within a six-year period (237 of which were evaluated electron-microscopically) the authors discovered that in 11 cases the diagnosis based on electron microscopic examination had to be corrected or supplemented by the diagnostic statement of membranous glomerulonephritis. These cases included 1 boy (HBsAg positive), 2 men and 8 women were middle aged. 5 women were treated due to polyarthritis. All cases when examined light-microscopically yielded a pattern evaluated as normal, or as minute abnormalities of glomeruli. Half-thick sections were not sufficient for the diagnosis. 3 cases of biopsies yielded a variously developed chronic tubulointerstitial nephritis, two cases were accompanied with polyarthritis. On the basis of the latter the authors consider the electron microscopic examination as indicated: 1. in cases when the diagnosis statement is not achieved by other examinations, 2. findings are in the range of the so-called variable norm, 3. in all cases of minute abnormalities in glomeruli detected without electron microscopy, 4. the impact of any of effective drugs cannot be excluded, 5. the diagnostic conclusion based on renal biopsy and the clinical-laboratory pattern of the disease are inconsistent. The authors assume that especially the fourth and fifth groups are going to be gradually supplemented and made more precise. (Fig. 1, Ref. 5.).

The authors examined consecutive renal biopsies from 43 patients with minor glomerular abnormalities and from 35 patients with chronic tubulointerstitial nephritis (in the least affected glomeruli). The findings were evaluated according to WHO criteria of minor abnormalities. They found that significantly more frequently lipid drops were found in minor abnormalities (6:0), as well as changes in the capillaries of glomeruli (breakdown 1:7), wrinkling (15:29-highly significant even after correction of p)) in tubulointerstitial nephritis. The incidence in another 15 compared indicators there was not significantly different. With regard to the assembled results the authors consider the morphological finding of minor glomerular abnormalities as non-specific changes, and adaptational glomerular changes in response to various noxious substances. Therefore it is necessary to evaluate purely morphological findings of minor abnormalities carefully and in a differentiated manner, in particular in conjunction with treatment.

The authors treated eight children with corticoid dependent syndrome caused by minor abnormalities of the glomeruli with Cyclosporin A. They administered Cyclosporin, 5 mg/kg/24 h., for a period of 8-16 weeks. In three patients they used Cyclosporin A alone, 5 children were given in addition 10 mg Prednisone per day. They achieved complete remission in all patients. During treatment they monitored haematological and biochemical parameters as well as Cyclosporin A levels; before treatment and after its termination they examined also immunological indicators. They did not observe any serious side effects of treatment.

In patients with the malignant tumor of bone (17 osteosarcomas, 8 Ewing tumors) longterm observations were made, and namely at the beginning of the disease, after the surgical removal of the tumor, during chemotherapy and in the terminal phase of the disease. The observations concentrated on the following selected immunology parameters: active lymphocytes T, lymphocytes T, lymphocytes B, large granular lymphocytes, IgG, IgA, IgM and circulating immune complexes. In non-treated patients prior to diagnosing the disease, reduction of active lymphocytes T was found out while the total lymphocytes T remained unchanged. However, no significant differences were found out between benign and malignant tumors. The surgical removal of the tumor results in the change in imunologic indicators, the increase of active lyphocytes T, lymphocytes T and the decrease in the circulating immune complexes. The change is of temporary nature, the subsequent deterioration is caused by both the progression of the disease and chemotherapy. The values of immunoglobulins and lymphocytes B fluctuated during the whole course of the disease in physiological levels. The observation of active lymphocytes T and lymphocytes T can be used for monitoring of the immunosuppression in cytostatic treatment. The levl of IgG is differentially diagnostically used to distinguish between the tumor and inflammatory processes.

The development of cytotoxic T-lymphocytes is controlled by genes of the HLA complex and occurs, in the majority of cases, when the responding and stimulating subjects differ both in HLA-A, -B and HLA-D/DR antigens. We examined a married couple for kidney transplantation and found that they differed in HLA-A, -B antigens and were identical in HLA-DR antigens. The negative results of the MLC test confirmed the serological findings. Nevertheless, cytotoxic T-lymphocytes developed despite HLA-D/DR identity. The presented case is one of the few published exceptions to the rule governing the development of cytotoxic T-lymphocytes.