[Long-term prognosis in children with minor glomerular abnormalities]. / Dlhodobá prognóza detí s malými abnormalitami glomerulov.

The authors evaluated the course and prognosis of the disease in 109 children with minor glomerular abnormalities manifested clinically in 45.9% as nephrotic syndrome (NS), in 33% as nephritic syndrome (GN), in 11.9% as isolated haematuria (IH) and in 9.2% as Schönlein-Henoch's purpura (PSH). In NS 78% of the children had before biopsy of the kidneys frequent relapses, 22% were resistant to cortisonoids. After biopsy all children were given cortisonoids, 94% immunosuppressive treatment with cytostatics and some of the children additional treatment. The number of resistant cases declined to 10% and the mean number of relapses from four to one in 12 months. Children under five years had more relapses (P less than 0.05) but also more complete remissions (P less than 0.001) than older children. Relapses occurred up to 10.2 years after the onset of the disease (mean = 4 years). With advancing age and duration of the disease their number declined after treatment. An adverse symptom was resistance to cortisonoids and immunosuppressive treatment, major haematuria and persisting hypertension but not immunological activity (elevated level of immune complexes, reduced C3, positive immunohistochemical finding in renal tissue). The morphological finding which at the onset was slightly beyond the range of minor abnormalities had a poorer prognosis when associated with greater clinical activity. The group developed 88% complete remissions and 6% CHRI. After 22 years the probability of survival in complete continual remission is 66%, the probability in CHRI is 10% (with morphological progression). In nephritic syndrome the children were given after biopsy prednisone in 80.6% and cytostatics in 44.4%. In PSH this treatment was given to 100% and 60% of the children, in IH to 61.5% and 7.7%. On evaluation in nephritic syndrome complete remission was recorded in 47.2%, after 0.4-10.5 years since the onset of the disease; 30.6% did not improve and in 2.8% CHRI developed. In PSH remission developed in 60% after 0.8-6.9 years, no improvement was recorded in 20%, incl. 10% where CHRI developed after a resistant course of NS. In IH 84.6% of the patients did not improve, but in none the renal function deteriorated. The course was in all instances milder than in NS, most frequently only with microscopic haematuria and/or slight proteinuria, respectively minor immunological activity. In the entire group of minor glomerular abnormalities complete remission was achieved in two-thirds of the children, in one quarter the disease did not improve, incl. 4.6% where CHRI developed, always associated with progression of morphological changes.(ABSTRACT TRUNCATED AT 400 WORDS)

[Treatment of nephrotic syndrome with cyclosporin A]. / Liecba nefrotického syndrómu cyklosporínom A.

The authors treated eight children with corticoid dependent syndrome caused by minor abnormalities of the glomeruli with Cyclosporin A. They administered Cyclosporin, 5 mg/kg/24 h., for a period of 8-16 weeks. In three patients they used Cyclosporin A alone, 5 children were given in addition 10 mg Prednisone per day. They achieved complete remission in all patients. During treatment they monitored haematological and biochemical parameters as well as Cyclosporin A levels; before treatment and after its termination they examined also immunological indicators. They did not observe any serious side effects of treatment.

[Immunologic parameters in insulin-dependent diabetes mellitus in children]. / Niektoré imunologické parametre inzulínodependentného diabetes mellitus u detí.

Evaluation of some immunological indicators in a group of 31 patients. In 80.6% patients IgG and IgM values were elevated, in 77% the total lymphocytes were reduced. Significantly reduced C3 levels were recorded in 46.6% and reduced C4 levels in 83.3%, in particular during the period of decompensation. Serum antibodies against islet cells of the pancreas were found in particular during the first two years of the disease.

Bioaccumulation of metals from a nickel smelter waste in P and F1 generations of exposed animals. II. Modulation of immune processes.

A group of female Chinchilla rabbits was exposed through inhalation to the metal aerosol derived from dumped waste of a nickel smelter. The experiments were carried out in a field exposure station. Increased levels of tissue immune complexes were found in the myocardium and lungs of P females, whereas F1 rabbits (exposed both prenatally and 6 weeks postnatally) from the same group of P females had significantly elevated serum circulating immune complexes as compared to controls. In P rabbits, nonspecific serum tumoricidal activity was increased by 8.2%, while in F1 animals the increase was by 14%. Transplantation immunity was examined in a group of inbred Lewis rats following the transplantation of a skin allograft from the ear of inbred Berlin-Druckrey rats. The mean time of allograft survival in animals following i.v. administration metal dust suspension 2 days prior to transplantation, was prolonged as compared to controls. On day 22 after allograft transplantation, lactate dehydrogenase activity was found to be reduced in peripheral lymphocytes, and the liver and spleen weight proved to be diminished. These findings suggest a modulating effect of the metal dust from a nickel smelter regarding nonspecific serum tumoricidal activity and transplantation immunity as well as immune complex formation.

Modulation of peripheral lymphocyte and alveolar macrophage activity by magnesite emissions.

Modulation of alveolar macrophage and peripheral lymphocyte activities in rats exposed to magnesite emissions was tested under field and laboratory conditions. The field exposure test were conducted in a locality near a magnesite ore processing plant, the time observation was 18 weeks. The laboratory exposure tests were performed in an inhalation chamber at a constant magnesite dust aerosol concentration of 50 mg . m-3; the animals were exposed 4 hours a day, 5 days a week for a period of 70 days. Eighteen weeks of exposure to magnesium-polluted ambient air was found to increase the number of alveolar macrophages, to stimulate acid phosphatase activity in these cells, and to enhance activity of peripheral B lymphocytes to form EAC rosettes. The inhalation chamber experiments, evaluated after 46 and 70 days of exposure, resulted in an enhanced acid phosphatase activity of alveolar macrophages, enhanced lactate dehydrogenase activity of peripheral lymphocytes and in an increased percentage of B lymphocytes in blood, depending on exposure time. The activation of peripheral lymphocytes and alveolar macrophages observed in rats exposed under field and laboratory (here in dependence on exposure time) conditions clearly suggest that the cells participating in the induction and expression of the immune response are distinctly modulated in their activity by in vivo exposure to magnesite dust.