Crosstalk Between Co-cultured A549 Cells and THP1 Cells Exposed to Cigarette Smoke.

Cigarette smoke (CS) is considered as a major etiological factor in the pathogenesis of chronic obstructive pulmonary disease. In this study we used A549 cells and THP-1 cells grown for 24 h in monoculture or in co-culture in CS-conditioned media and changes in their proliferation, viability, acetylated histone H3 levels and expression of extracellular antigens CD14, HLA-DR, CD11a, and CD11b were assessed. CS was highly toxic to A549 cells but not to THP1 cells. In A549 cells, oxidative stress reached the highest values after 1 h of CS exposure and then decreased. In THP1 cells oxidative stress was lower and increased progressively with time. CS decreased proliferation of A549 and THP1 cells by about 80% and 21%, respectively. CS did not alter acetylated histone H3 levels in A549 cells, while in THP1 cells the levels were reduced by about 35%. CS significantly increased expression of CD14, HLA-DR, CD11a, and CD11b in THP1 cells. In co-culture, naïve or CS-pretreated THP1 cells significantly protected A549 cells against CS toxicity but had higher death rates. These results show that epithelial cells are more fragile to CS than monocytes and that CS-activated monocytes may protect epithelial cells against CS-induced cytotoxicity.

Tregs and HLA-DR expression in sputum cells of COPD patients treated with tiotropium and formoterol.

Immune cells expressing the activation markers HLA-DR and regulatory T cells (Tregs) may be involved in the regulation of chronic inflammation in chronic obstructive pulmonary disease (COPD). In this study we analyzed native and activated cell profiles in sputum of 22 stable COPD patients receiving formoterol (F) or formoterol + tiotropium (F + T) for 3 months. Cells were isolated from induced sputum and were examined on Coulter flow cytometer using fluorescent antibodies specific for CD3, CD4, CD8, CD14, CD19, CD25, CD127, and HLA-DR antigens. Cell profiles and cell activation were assessed by analysis of HLA-DR, CD25, and CD127 co-expression in double-stained samples. Tregs were defined as CD4⁺CD25(high) CD127(low) cells. We found that the combined therapy significantly decreased the CD8⁺ cell number (p < 0.01). At baseline, HLA-DR was expressed in about 10 % of sputum T or B cells and a higher expression was found on monocytes. The HLA-DR expression on lymphocytes, but not monocytes, was significantly lower (p < 0.01) in patients treated with F + T. Fractions of activated [CD4⁺ CD25⁺] cells were also significantly lower in the combined therapy group, except for the subpopulation of CD4⁺CD25(high) CD127(low) cells which was not altered. We conclude that tiotropium in add-on therapy to formoterol affects Treg cell profiles and decreases HLA-DR expression in airway lymphocytes.

The rehabilitation of children with cerebral palsy: problems and current trends.

This article describes the currently accepted principles for the comprehensive treatment of children with cerebral palsy. Emphasis is given to the importance of the quickest possible diagnosis of even slight damage to the central nervous system, the implementation of early and continuous rehabilitation by a rehabilitation team, and the participants of physicians from other specialties. In comprehensive rehabilitation it is essential for a pediatric neurologist, a pediatrician, an orthopedic surgeon, a psychologist, and an education specialist to take part in the program. The primary constituent elements of comprehensive treatment for children with cerebral palsy are skillful selection of rehabilitation methods, pharmacological support as needed, orthopedic interventions, and essential orthopedic equipment. Success, however, depends on the active and complete involvement of the child's parents in comprehensive treatment from the first days after the child's birth.

[Rehabilitation after stroke in patients with diabetes mellitus]. / Rehabilitacja chorych po udarze mózgu ze wspólistniejaca cukrzyca.

Diabetes mellitus is not only one of the fundamental risk factors for stroke, but it may also constitute a significant impediment and limitation of rehabilitation process in diabetic patients after stroke. Insufficiently controlled diabetes or insufficient insulin therapy inadequately carried out, especially during the period of acute cerebrovascular complications, may increase the risk of repeated stroke or increase the size of ischaemic area. In patients suffering from diabetes the course of stroke is more severe, cerebral oedema appears more often and mortality is higher. In the present paper methods of rehabilitation and results achieved in a group of patients with stroke and a group of patients with stroke and diabetes mellitus are described, as well as effects of rehabilitation in both those groups. Fifty one (20%), out of 251 patients with cerebral stroke in the past who were rehabilitated in a Rehabilitation Department in 1997, had diabetes mellitus lasting, on average, 21 years. Individual rehabilitation programme for each patient was arranged collectively, taking into consideration restrictions necessary in the course of diabetes, including education of patients. Multidirectional assessment of initial condition and condition after termination of the rehabilitation was carried out taking into consideration the scale of lesions (the Brunnstrom stages), functional scales and the quality of life index (the Barthel index). More objective parameters, i.e. the index of symmetry of loading of lower extremities and walking speed, were also applied. All the patients with both stroke and diabetes mellitus completed the planned rehabilitation programme, although the initial condition of patients with concomitant diabetes was worse than that of patients with stroke only, as far as most of the applied parameters of assessment were concerned. Also improvement achieved in diabetic patients was not observed in each of the parameters examined and differed from that achieved in the group of patients with stroke alone. We found, that in-hospital rehabilitation of patients with stroke and concomitant diabetes mellitus (even long lasting) resulted in a measurable and significant improvement of their condition evaluated multidirectionally, and that diabetes mellitus coexisting with stroke is not a contraindication to in-hospital rehabilitation. In patients with concomitant diabetes mellitus significant disturbances of during the rehabilitation were not found course diabetes mellitus. However they all required meticulous care and monitoring of carbohydrate metabolism, and the average time of their hospitalisation was longer by about 3 days.

[Diabetes and multiple sclerosis]. / Cukrzyca a stwardnienie rozsiane.

We report four patients who had multiple sclerosis associated with diabetes mellitus. Multiple sclerosis and diabetes mellitus share clinical, epidemiological and immunological features. The association between these two putative autoimmune diseases may suggest a similar pathogenic mechanism.

[Use of biological vicarious biofeedback in the rehabilitation of patients with brain damage]. / Zastosowanie biologicznego zastepczego sprzezenia zwrotnego w rehabilitacji chorych z uszkodzeniami mózgu.

The mechanisms of feedback not controlled by our consciousness play an essential role in the functions of the central nervous system in the process of programming of activities, behaviour and control of these functions. In case of deviations or errors of activities the possibility of their immediate correction exists. Brain damage after trauma or caused by tumour disturbs these normal feedback mechanisms producing very varying symptom complexes. In such cases it is advantageous to introduce vicarious feedback based mainly on visual and auditory afferentation. The authors present own original methods used in the rehabilitation of such patients using vicarious feedback with elbow crutch with light and sound signalling in walk learning, and platform for attitude stability exercises. The earlier obtained results of rehabilitation by this method in a large group of patients after stroke, and preliminary observations of patients after trauma and after tumour operations justify recommendation of the method.

[Evaluation of the condition of patients with post-stroke hemiplegia and the progress in their rehabilitation]. / Ocena stanu chorych z niedowladem polowiczym poudarowym i postepu w rehabilitacji.

The authors describe a method of documentation for assessing the condition of the patient on the basis of own experiences with over 1200 patients after stroke and a review of the pertinent literature. In a comprehensive evaluation of the condition of the patient after beginning of rehabilitation treatment and after its completion the participants were: the attending physician, a neuropsychologist, a kinesitherapeutist and a logopedist. All aspects having an influence on the functional state were taken into consideration: motor ability, contact with the surroundings, psychic state, sphincter control, cardiovascular efficiency, ventilatory efficiency, sensory function, general functioning. This method makes possible a reliable, objective and comparable documentation to be obtained, which facilitates assessment of the progression in treatment and the methods used in the treatment.