[Case report of a patient with knee gout]. / Prikaz bolesnika s gonagrom.

A 46-years old male presented with an attack of gout (knee arthritis or gonagra). It is interesting that the patient was HLA B27 positive antigen found a couple of years ago, but on admission he had a normal findings of uric acid in serum, while cytological examination of synovial fluid obtained from knee joint no urates were found. Therefore, diagnostically besides gout arthritis a reactive arthritis as well as other connective tissue diseases were considered. In further diagnostic procedure arthroscopy was performed and in biopsy specimen from the cyst of lateral condyle of right femur urates were found. One day after the arthroscopy was performed a clear clinical picture of podagra developed. After the diagnosis was made the treatment of gout arthritis with Indometacyn began, and with improvement of inflammation, surgery was performed--cyst excochelation of lateral condyle of right femur with filling of the defect with an autologous graft from iliac crest.

Red blood cell glycerol lysis and hematologic effects in occupational benzene exposure.

Forty-nine female workers in the shoemaking industry, exposed to a solvent mixture containing benzene and twenty-seven non-exposed controls, were investigated. Concentrations of benzene and toluene in the working atmosphere, as well as benzene and toluene in blood and phenols in pre- and post-shift urine as parameters of biological monitoring, were determined. In order to assess hematotoxic risk, a complete blood cell count with differential, hemoglobin, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, reticulocytes, serum iron, alkaline phosphatase in neutrophils and red blood cell glycerol lysis time were determined in all subjects. Benzene concentrations in the workplace atmosphere at the shoemaking factory ranged from 1.9 to 14.8 ppm (median = 5.9). Significant difference in benzene in blood (p = 0.005) and phenol in post-shift urine (p = 0.003) between exposed workers and controls confirmed exposure to benzene. Hemoglobin level (p = 0.02) and mean corpuscular hemoglobin concentration (p = 0.0002) in the shoe workers were lower, and band neutrophils (p = 0.005) and mean corpuscular volume (p = 0.03) higher, than in controls. Red blood cell glycerol lysis time was significantly higher (p = 0.000001) in shoe workers (X +/- SD = 41.6 +/- 8.9) than in controls (X +/- SD = 31.1 +/- 6.5) and showed a significant correlation with exposure biomarkers. The results confirm that benzene exposure below 15 ppm may produce qualitative abnormalities, particularly macroerythrocytosis and increased red cell glycerol resistance, in the absence of an overt quantitative decrease in circulating blood cells. Increased resistance to the hemolytic action of glycerol is a potentially useful biological monitoring procedure in medical surveillance of benzene exposed workers. The results of this study suggest that potential threshold concentration for hematologic effects of benzene is lower than 15 ppm.

Laryngeal cancer and blood selenium levels.

Blood selenium concentrations in 43 patients with laryngeal cancer and 47 normal subjects were determined by atomic absorption spectrophotometry. No significant differences in selenium values were observed in sera from the cancer patients when compared with controls, but there were significant differences between patients with advanced (T4) supraglottic cancers and the normal controls. These results suggest that lower blood selenium levels in this latter group of laryngeal cancer patients may be a consequence of their disease rather than its cause.

Nasopharyngeal cancer and blood selenium level.

A case-control study of nasopharyngeal carcinoma was performed in Zagreb from 1989 until 1993. Blood selenium concentrations were determined in 34 patients with nasopharyngeal cancer and 47 normal subjects by means of the atomic absorption spectrophotometric method. The sera of nasopharyngeal cancer patients showed no significant differences in selenium values from the sera of normal individuals, but there were significant differences between patients with enlarged cancer (T4 stage) and normal individuals. The results suggest that lower blood selenium levels in this group of nasopharyngeal cancer patients may be a consequence of their disease, rather than the cause of the cancer.

T cell subset composition in remission phase of systemic connective tissue diseases.

The proportions and numbers of peripheral blood mononuclear cells bearing T-cell markers (CD3/HLA-DR, CD4/CD29, CD4/CD45, CD8/CD56) were analyzed using two-color flow cytometric analysis in patients with systemic lupus erythematosus (SLE), rheumatoid arthritis (RA) and Sjögren's syndrome (SS) in the remission phase of the diseases. The number of T cells (CD3+) in the blood was significantly decreased in SLE patients only; in these patients, but also in RA patients, an increased number of activated T cells (CD3+ HLA-DR+) was found. The number and proportion of helper T cells (CD4+) were decreased in SLE and SS, and normal in RA patients. In contrast, helper-inducer (CD4+ CD29+) and suppression-inducer (CD4+ CD45+) cells were both significantly increased in RA patients, decreased in SLE (only CD4+ CD45+ significantly) and unchanged in SS patients. Interestingly, however, the proportions of helper-inducer cells relative to total helper (CD4+) cell pool were significantly increased in all three groups of patients, whereas the proportion of suppression-inducer (CD4+ CD45+) cells was significantly decreased, but in SLE patients only. It is thus possible that this parameter is most pertinent to the disease status in the model studied. The population of CD8+ cells appeared more abundant in SLE patients, and the pool of CD8+ CD56+ cell was significantly enlarged in RA patients. It appears that the remission phase of disease in RA, SLE and SS patients still contains a substantial activation of the immune system, but the respective mechanisms are quite different in RA patients on one side, and SLE and SS patients on the other side.(ABSTRACT TRUNCATED AT 250 WORDS)