[The antiphospholipid syndrome in systemic connective tissue diseases]. / Antifosfolipidni sindrom u sistemskim bolestima vezivnog tkiva.

The aim of the study was to prove the incidence of antiphospholipid syndrome (APS) in systemic connective tissue disease (SCTD), especially in systemic lupus erythematosus (SLE) and to find out serologic markers of APS. Of 94 patients with SCTD followed up in the last three years 80 had SLE, 7 Sjogren's syndrome, 3 systemic vasculitis, 2 combined systemic connective tissue disease, 1 rheumatoid arthritis, 1 Sjogren's syndrome with vasculitis. Antiphospholipid antibodies (ApSt) were determined by ELISA method. In 31 of 80 patients with SLE (38.07%) antiphospholipid antibodies were proved. In lo of 31 (32.26%) signs of systemic lupus or the presence of APS markers have not been found, while 21 of 31 (67.74%) had some of clinical manifestations of APS (most commonly thrombocytopenia or vascular thrombosis) with evolution of the basic disease. Among our patients with SLE the most common finding was IgG antibody isotype-in 14 or 66.66% of cases. In 5 of 7 patients with Sjogren's syndrome ApAt were proved without clinical evolution of the basic disease and APS. Only 2 of 7 patients of this group showed, together with more increased ApAt, mild evolution of the basic disease and manifestation of APS (livado reticularis and recurrent venous thrombosis).

[The importance of using various methods in the determination of serum immune complex levels]. / Znacaj primene razlicitih metoda za odredivanje koncentracije imunih kompleksa u serumu.

Concentration of immune complexes (IC) in the serum of patients with various diseases (glomerulonephritis systemic lupus erythematosus--SLE, rheumatoid arthritis--RA and with positive antibodies to human immunodeficiency virus--HIV+) has been determined using two methods: PEG precipitation and laser nephelometry (NL) of binding to Latex = C1 12q complement components in aqueous media. The presence of antiimmunoglobulin antibodies, that is, rheumatoid factor (RF) and its eventual effect on the precision of measurement of IC using LN C1q method has been determined by LN-Latex RF method. The results have shown that the increased IC values obtained by one method can be within physiological levels if the other method was applied and vice versa. Depending on the group of examinees such negative correlation ranged from 33% to 64%. This is the result of already known limitations of the studied methods and confirms the necessity of simultaneous application of different methods for determination of IC concentration. Regardless of anticomplementary activity of serum rheumatoid factor its presence in the serum has not shown to have any effect on the precision of determination of IC concentration using IC by LN- C1q method.

Effects of some anti-inflammatory drugs on 12 blood constituents: protocol for the study of in vivo effects of drugs.

We investigated the in vivo effects of acetylsalicylic acid, diclofenac, indomethacin, ibuprofen, and ketoprofen on the concentrations of various blood constituents. Total protein, glucose, calcium, and inorganic phosphate were not significantly affected by any of these drugs. Ketoprofen had no definite influence on any constituent. Acetylsalicylic acid induced an increase in cholesterol, triglyceride, and iron; albumin, uric acid, and creatinine decreased with ibuprofen therapy. Urea nitrogen increased in patients treated with diclofenac or indomethacin. Our protocol for the study of in vivo drug effects is discussed.

Interference by analgesic and antirheumatic drugs in 25 common laboratory assays.

Twenty five different analytical procedures, commonly used in clinical laboratories, were investigated for interference by eight analgesic and antirheumatic drugs. Ten of the investigated assays showed no statistically significant interference. Acetylsalicylic acid interfered in six assays (for glucose, uric acid, protein and cholesterol). Aminophenazone significantly decreased glucose, bilirubin and protein values, whereas caffeine affected four methods (for glucose, protein and iron). No definite influence of phenobarbital could be detected on any assay. Glucose, uric acid and iron values were altered in the presence of diclofenac. Indomethacin interfered in glucose, urea, uric acid and protein assays. Samples containing ibuprofen had altered creatinine, bilirubin and iron values, whereas ketoprofen interfered in glucose and iron determination.

Effects on analgesic and antirheumatic drugs on the assay of serum enzymes.

Interference by some commonly used analgesic and antirheumatic drugs in the spectrophotometric and colorimetric assays of serum enzymes was examined. None of the investigated methods was significantly influenced by caffeine, phenacetin, ibuprofen or indomethacin. Acetylsalicylic acid affected the continuous assays of creatine kinase and lactate dehydrogenase (with pyruvate as substrate), and the colorimetric assay of alanine aminotransferase. Aminophenazone interfered with the colorimetric method for determination of aspartate aminotransferase and alanine aminotransferase, while phenobarbital interfered only with the continuous method for lactate dehydrogenase (with L-lactate as substrate). Ketoprofen interfered with the colorimetric assays of lactate dehydrogenase and aspartate aminotransferase, while diclofenac affected the continuous assay of aspartate aminotransferase. None of the tested drugs interfered with the continuous methods for the determination of alkaline phosphatase and alpha-hydroxybutyrate dehydrogenase.

Renovascular hypertension associated with bilateral aldosteronoma.

The authors present a 35-year-old male patient with renovascular hypertension caused by the stenosis of both renal arteries of the right kidney. Two years after the diagnosis of hypertension was made, an endarterectomy was performed but a successful correction of the upper stenotic artery was not achieved. During the next 2 years the hypertensive disease was uncontrollable with antihypertensive medications and gradually entered into a malignant phase. In addition to the atrophy of the right kidney, an adenoma of the left adrenal gland was revealed (19.75 g) which was operated on. Left adrenalectomy had only a transitory benefit on blood pressure level. Five months later an adenoma of the right adrenal gland was diagnosed and together with the ischaemic right kidney was operated on (right adrenalectomy and nephrectomy) which definitely cured the hypertension. The chronological sequence of events and the course of the disease in the patient point to the possibility that long-standing hyper-reninaemia, due to renal ischaemia, may cause the development of multiple bilateral adrenocortical adenomas and that secondary aldosteronism may transform into primary.

[The quality of preserved blood]. / Kvalitet konzervisane krvi.

The examinations of 30 blood samples each preserved with three Yugoslav different ACD-solutions were performed. The blood samples were stored at 2-6 degrees C and examinations were performed at the day of blood donation and after on the 7th, 14th and 21st day during the storage. Differences in hematocrit (well known dilution effect of the ACD-solutions used) and intensive morphological and chemical changes were found in all blood samples regardless the type of ACD-solution used. It was shown that the permanently increasing number morphologically altered erythrocytes (echinocytes and spherocytes) and the excessive release of hemoglobin and potassium from erythrocytes were occurred during the storage of blood samles. Too, there were noticed significant decrease of pH values enormous accumulation of ammoniac and other metabolic producta.

[Pathohistological study on the effect of various methods of osteosynthesis on the osteogenesis in experimental fracture of the lower jaw]. / Patohistoloska proucavanja uticaja nekih metoda osteosinteze na osteogenezu u uslovima eksperimentalne frakture donje vilice.

The lower jaw of 60 dogs was fractured and effects of wire and three variants of chemical osteosynthesis have been followed up concerning validity, course and rapidity of osteogenesis. A wire of 0.4 mm in the diameter was applied in wire osteosynthesis and autopolymerizing acryalte ("Simplex" Galenica) in chemical osteosynthesis with briding of the fracture line interfragmentarily or mixed with bone scrapings. The pathohistological examinations performed 7, 14, 21, 60 and 90 days after the intervention and osteosynthesis employment have shown that there is no difference in validity, course and rapidity of osteogenesis in fractures of the lower jaw under conditions of wire and pure chemical osteosynthesis. Since there is no histochemical obstacles and taking into account advantages of chemical over wire osteosynthesis it should be recommended in fractures of the lower jaw.