Prothrombotic risk factors in ischemic stroke and migraine in children.

OBJECTIVE: To evaluate the contribution of antiphospholipid antibodies (aPL) and thrombomodulin (Thm) in the pathogenesis of stroke and migraine in children. MATERIALS AND METHODS: Ninety children were included in the study: 30 children (4-15 years) after an ischemic stroke of an unknown etiology; 30 migrainous patients (8-15 years), who were hospitalized in the Department of Developmental Neurology, Medical University of Gdansk, Poland, and 30 healthy children of the same age. RESULTS: The statistical analysis showed an increase in the values of anticardiolipin antibodies (aCL), anti beta2-glycoprotein 1 (beta2-GP1) and Thm in children with stroke and migraine than in the control group. The resultant values were higher, but stayed at standard. CONCLUSION: The possible role of prothrombotic factors in individual cases of pediatric stroke and migraine cannot be excluded.

A case of multisymptomatic relapsing polychondritis in a 22-year-old woman.

A case of multisymptomatic relapsing polychondritis in a 22-year-old woman. We report a case of a 22-year-old woman with relapsing polychondritis (RP)--a rare and little known systemic autoimmune disease characterised by episodic inflammation of cartilaginous structures (ear, nose, bronchi, trachea, larynx, ribs, cardiovascular system). This patient presents with a seven-year history, initiated by the saddle nose. The patient developed a multitude of symptoms: auricular chondritis, ocular symptoms, recurrent arthritis, respiratory complications (laryngotracheomalacia, bilateral vocal cord palsy), sensorineural hearing loss and enchondroma of the humeral bone. The examination of an auricle biopsy by an immunofluorescent method and a positive serum reaction from the patient to normal cartilage supported the immunological nature of relapsing polychondritis. Treatment consisted of orally administered prednisone and diaminodiphenylsulfone (Dapsone).

Metal ion-flavonoid associations in bilayer phospholipid membranes.

The complexation process of the transition (Cu(2+), Fe(2+)) and heavy (Pb(2+)) metals with flavonoids (quercetin and rutin) was studied. The investigation was conducted using the spectrophotometric method in a medium containing phosphatidylcholine liposome membrane and in methanol. The Benesi-Hildebrand method was used to determine the constants of flavonoid-metal complex formation of the "charge transfer" type, and the Gibbs free energy change for that process. It was found that both quercetin and rutin are very effective at complexing transition atoms in both methanol and in the lipid bilayer. Pb(II) ions were only complexed in methanol. A short discussion is given on the importance of metal coordination processes in the context of lipid membrane peroxidation.

IL-8 concentration in coronary sinus blood during early coronary reperfusion after ischemic arrest.

OBJECTIVE: Activation of the inflammatory response is an important factor contributing to complications of cardiopulmonary bypass. Increased level of proinflammatory cytokine - IL-8 has been reported during coronary artery bypass grafting (CABG) operations with the use of cardiopulmonary bypass. The aim of this study was to find out whether the heart is the main source of IL-8 during early coronary reperfusion. METHODS: IL-8 concentration in coronary sinus before clamping and 5, 10, and 15 min after declamping of the aorta as well as in radial artery blood before clamping and 10 min after declamping of the aorta, was assessed in 30 patients undergoing CABG surgery. RESULTS: We observed increase in IL-8 concentration in coronary sinus blood after declamping of the aorta, however no difference between coronary sinus and arterial blood concentration was noted. The median value of IL-8 concentration in coronary sinus blood was 1.85 pg/ml before ischemia and 15.4, 20.3, and 29.3 pg/ml in 5, 10 and 15 min after aortic declamping, respectively. Our additional finding was that there was a negative correlation between IL-8 level and hemoglobin saturation with oxygen in coronary sinus blood 10 min after coronary reperfusion. CONCLUSIONS: We conclude that the heart is not the main source of IL-8 in early coronary reperfusion, although coronary reperfusion induces its release.

Significance of tumor necrosis factor alpha in patients with long-standing type-I diabetes mellitus.

Fifteen out of the forty-five patients with long-standing diabetes mellitus type I were characterised by the presence of TNFalpha in the sera when examined on several occasions over a period of five years. TNFalpha-producing patients had a better control of the disease and a smaller percentage of them suffered from diabetic complications as compared with those not producing this cytokine. TNFalpha-producing patients had lower levels of the proinflammatory markers - IL6 and CRP, and higher concentrations of ACTH and cortisol than those not producing this cytokine. We suggest that TNFalpha released systemically in diabetic patients stimulates the hypophysis-adrenal axis, and in that way indirectly ameliorates autoimmune response occurring during the advanced phase of the disease.

[Anticardiolopin antibodies as a risk factor in stroke]. / Przeciwciala antykardiolipinowe jako czynnik ryzyka udaru niedokrwiennego mózgu.

The level of anticardiolipin antibodies (aCL) in sera of 53 patients with ischemic cerebrovascular disease aged 35-55 years with mean age 48.4 +/- 5.03, was studied using a solid phase enzyme immunosorbent assay (ELISA). The investigation was done half year after the ischemic stroke. The control group consisted of 21 healthy participants matched for age and sex. The presence of aCL was found in sera of 17 persons (32.1%), in 9 it was IgG class antibodies. It was indicated that the risk of repeated cerebral ischemic events was relatively higher in aCL positive patients than in aCL negative. Relapses were found in 6 aCL positive patients (35.3%) (in 5 cases from the group of 9 IgG positive) and in 2 persons (5.6%) aCL negative patients. The existence of aCL can be helpful to determine pathogenesis of the disease and its prognosis.

[Asymptomatic bacteriuria in women diagnosed with systemic lupus erythematosus (SLE)]. / Bakteriomocz bezobjawowy u kobiet z rozpoznaniem tocznia rumieniowatego ukladowego (T.R.U.).

The aims of our research were: estimation of asymptomatic bacteriuria (a.b.) incidence in population of women with systemic lupus erythematodes (SLE), evaluation its clinical significance and examination of bacterial colonisation of nostrils and pharynx in SLE patients with a.b. 85 women aged 24-77 (mean 49.3) with mean SLE duration 7.8 (range 1-32) years were examined. All of them fulfilled ARA criteria for the classification of SLE. Among group of patients with a.b. were counted women who had significant bacteriuria > or = 10(4) in ml urine in two cultures. Asymptomatic bacteriuria was found in 14 cases of 85 women with SLE (16.5%). In two following urine cultures bacteria from family Enterobacteriaceae were dominated: the same types of bacteria were in 85.7%--bacteriuria persistens, in others 14.3% were observed change of bacteria--bacteriuria transistens. In 9 from 14 patients with (64.3%) a.b. very massive growth of Staphylococcus aureus in culture from vestibulae of the nose swab was, in other cultures very massive growth of physiological flora was seen. All patients with a.b. were in clinical remission of SLE and they had no clinical symptoms of infection in urinary tract in 5 months of observation. However clinical significance of asymptomatic bacteriuria and pathogenic bacteria colonisation of nostrils as a precedence to symptomatic infections needs further investigations.

[Microalbuminuria in patients with systemic lupus erythematosus]. / Mikroalbuminuria u pacjentów z rozpoznaniem ukladowego tocznia rumieniowatego (u.t.r.).

The aim of the investigation was microalbuminuria evaluation as an early symptom of renal involvement in systemic lupus erythematosus (SLE). Thirty patients aged 18 to 66 years (mean: 39,4 years) with mean duration of SLE of 6,3 years (range: 0,5 to 22 years) were examined. All of them fulfilled the preliminary criteria of the American Rheumatism Association for the classification of SLE. During the study none of patients had clinical or laboratory symptoms of nephropathy, hypertension, diabetes mellitus and heart failure. Microalbuminuria was measured by immunoturbidimetric method and the urine microalbumin concentration was expressed as the ratio microalbumin-creatinine concentration in 24 hour urine [equation: see text] Ratio I was 3,36 (+/- 2,76) in patients suffering from SLE comparing to I = 1,35 (+/- 0.89) in normal controls (p < 0.001). There was no correlation between increasing microalbuminuria and patients age and duration of disease. There was also no correlation between microalbuminuria and erythrocyte sedimentation rate or immunological activity parameters (i.e. antinuclear antibodies, anti dsDNA antibodies, levels of C3 and C4 components of complement).

Antiphospholipid syndrome in systemic lupus erythematosus--immunomorphological study of the central nervous system; case report.

We present a case of a 44-year-old female with systemic lupus erythematosus (SLE) with secondary antiphospholipid syndrome (APS). The patient died in the 15th year of the disease. The paraffin sections of the brain and spinal cord were examined using routine histological methods and immunohistochemistry with monoclonal antibodies against CD31, FVIIIAg and polyclonal antibodies IgG, fibrinogen and C3. Numerous thrombi-recent, organized and recanalized and focal vasculitis were seen. The immunopositive reaction in thickened vessel walls for CD31 and FVIIIAg indicated the process of the local incorporation of the thrombi. The immunoreactivity for fibrinogen, IgG and C3 suggests the immunological complexes formation in vessel walls, perivascular astrocytes and neurons.

[Evaluation of diagnostic sensitivity using ARA criteria in 108 patients with systemic lupus erythematosus studied retrospectively]. / Ocena czulosci diagnostycznej kryteriów ARA w grupie 108 chorych na toczen rumieniowaty ukladowy badanych retrospektywnie.

We studied usefulness of ARA criteria for the classification of sle in 108 outpatients with diagnosis established during long term follow-up. Sensitivity of ARA criteria was 96.3% and excluding tests for anti dsDNA and anti Sm antibodies was 93.5%. That means less than 10% false negative diagnoses. When at least 2 ARA criteria are present immunological tests of high specificity should confirm the diagnosis.

Vitamin D status of patients with femoral neck fractures.

Thirty-nine patients admitted to hospital with fractures of the neck of the femur had mean serum 25-hydroxycholecalciferol (25-(OH)D3) levels markedly lower than that of young healthy controls. There was also a significant seasonal variation in these 25-(OH)D3 levels, values in winter being about half those in summer. It is suggested that vitamin D deficiency plays an an important role in the pathology of old age.