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Background: B-chronic lymphocytic leukemia (B-CLL) is the most common adult leukemia in the Western countries. Any routinely used staging system does not distinguish exactly the probable course of the disease at the time of diagnosis. Therefore the new prognostic factors, which help to assess the optimal therapeutic plan of patients, are searched intensively., Methods and Results: We evaluated 154 patients with the B-CLL at the time of diagnosis--133 of them were retrospectively divided into two groups--one with stable form and the other with progressive form of the disease. We compared these two groups of patients with some of the prognostic factors (absolute lymphocyte count, the level of C-reactive protein, lactatdehydrogenase, beta-2-microglobulin, tumour necrosis factor, the immunoglobulin levels, the expression of CD38, FMC7, surface immunoglobulins, the type of bone marrow infiltration, and the cytogenetic abnormalities (trisomy 12, del(13)(q14), del(17)(p13) a del(11)(q23)). We found higher absolute lymphocyte count, level of beta-2-mikroglobulin, tumour necrosis factor, expression of CD38, light chains lambda, lower expression of FMC7 and less frequent nodular type of bone marrow infiltration by the patients with progressive disease. The correlation of the cytogenetic abnormalities and the course of the disease or stage according to the RAI et al. [27] staging system were not significant may be due to the small number of evaluated patients and short period of follow up., Conclusion: The routine evaluation of some risk factors in patients with B-chronic lymphocytic leukemia at the time of diagnosis helps to distinguish those with the probable more aggressive course of the disease and have the implication for the design of risk-adapted treatment strategies. The prognostic impact of the cytogenetic abnormalities and other risk factors has to be evaluated on larger group of patients during longer follow up period and repeated evaluations.

The authors made a comprehensive examination of 16 patients--epileptics, alcoholics, psychotic subjects and patients after cerebral contusion. The patients were subjected to a neurological, psychiatric, psychological examination as well as to a morphological examination (X-ray, CT, NMR), physiological examination (EEG, polysomnography, evoked potentials), immunological examination and SPECT. The majority of patients had positive CT and SPECT findings suggesting focal brain damage. These results could be explained only in exceptional cases by injury, the majority was of unknown aetiology. With this corresponded focal EEG abnormalities and in particular sleep disorders, sometimes subjective but always detectable by objective methods. There was always a shortage of REM, sometimes also NONREM sleep. Half the patients were subjected to an immunological examination which was always positive and comprised elevated acute stage proteins and proteins associated with the stress reaction. Numerous data in the literature and the authors' experience indicate that the mentioned pathological findings are not incidental and form, independently on the aetiology, an integrated unit for which the term cerebropathy can be used. A primary role is played by the epileptic focus and its quality, i.e. above all the rate of discharge and site and humoroergic systems of the brain stem, in particular their efficiency and mutual balance. The events have a programmed sequence. At the beginning an epileptic focus develops which influences the surrounding area, secondary and tertiary foci are formed and the thalamo-cortical system is affected. Soon this is followed by an apparent influence of the epileptic activity on structures of the brain-stem. The consequence are changes affecting sleep, mood, mental performance, immunity, endosecretion and paroxysms. Subsequently individual symptoms are already prepared but have a different latency of manifestation and the latter depends also on external provoking influences. The thalamo-cortical reaction is characterized by the manifestation of epileptic paroxysms and sets in after a different interindividual incubation following injury. The same applies to the hippocampal reaction manifested by the organic psychosyndrome. Some symptoms such as changes of immunity, sleep or endosecretory function are not necessarily manifested if the influence of the focus on structures of the brain-stem is not sufficiently intense. Conversely if the effect on the brain-stem and limbic structures is greater and the effect on the thalamo-cortical system smaller, psychotiform behaviour develops. Then there are marked changes of phoria, dynamogeny, rate, affectivity, sleep and hormonal secretion and its equilibrium.

Sixteen patients-epileptics, alcoholics, psychotics and post-contusion cases-were subjected to neurological, psychiatric, psychological, morphological (X-ray, CT, NMR), physiological (EEG, polysomnography, evoked potentials), immunological and SPECT examination. Most had CT and SPECT signs of focal brain damage. The results were but exceptionally due to injury, most were of unknown etiology. This tallied with EEG focal abnormalities, mainly sleep disorders, sometimes subjective ones, but invariably detectable objectively. In each case there was REM, in some also NONREM sleep deficiency. Half of the cases were tested immunologically, each time with positive results: increased levels of acute-phase protein and stress-reaction proteins. As copious literature and our experience show, the above pathological condition, rather than being accidental, constitute regardless of etiology, an integrated entity which could be called "programme cerebropathy". The primary role is played there by the epileptic focus and its properties, in particular, the speed of discharge and localization and brain stem humoroergic systems, i.e., their performance and mutual balance. There is a program sequence of events, first, and epileptic focus acting on the neighborhood, the rise of secondary and tertiary foci, and influence over the thalamocortical system. Soon afterwards, epileptic activity begins to act on brain-stem structures. This results in changes in sleep, mood, psychic output, immunity, endosecretion, and in paroxysms.

By means of microparticles labelled by radioactive strontium 85Sr (3M, USA) the authors in two experiments established cardiac output and local blood flow through bones and certain other organs and tissues of rats in two distinct age categories (35 and 90 days, 45 and 110 days). The results of both experiments showed 1) significant decrease of blood flow in skull, lumbar vertebrae, distal epiphysis, distal metaphysis and thighbone diaphysis and tibia in older rats of both sexes (proof of previous results with 86Rb), 2) constantly significant decrease of blood flow through a skin sample taken from the ventral side of the trunk and 3) nonconstant increase of blood flow through kidneys of older rats. The causes of observed changes are not known, physiological importance to be supposed particularly as regards the circulatory changes in bones, is also not clear.

By means of microparticles labelled by radioactive strontium 85Sr (3M, USA) the authors in two experiments established cardiac output and local blood flow through bones and certain other organs and tissues of rats in two distinct age categories (35 and 90 days, 45 and 110 days). The results of both experiments showed 1) significant decrease of blood flow in skull, lumbar vertebrae, distal epiphysis, distal metaphysis and thighbone diaphysis and tibia in older rats of both sexes (proof of previous results with 86Rb), 2) constantly significant decrease of blood flow through a skin sample taken from the ventral side of the trunk and 3) nonconstant increase of blood flow through kidneys of older rats. The causes of observed changes are not known, physiological importance to be supposed particularly as regards the circulatory changes in bones, is also not clear.