Salivary and serum interleukin 6 and basic fibroblast growth factor levels in patients with oral squamous cell carcinoma.

AIM: A role of various cytokines has been implicated in the pathogenesis of many carcinomas, and albeit the role of interleukin 6 (IL-6) and basic fibroblast growth factor (bFGF) in sera has been studied in patients with oral carcinomas, data upon salivary IL-6 and bFGF are lacking. The aim of this study was to evaluate levels of IL-6 and bFGF in the saliva and serum of patients with oral squamous cell carcinoma. METHODS: Salivary and serum IL-6 and bFGF were evaluated in a group of 33 patients (28 men, 5 women) with oral squamous cell carcinoma (OSCC), age range 40-73 years , mean 54.05 years. Control group consisted of 23 healhy participants, mean age 25 years. RESULTS: Serum IL-6 and bFGF levels were not significantly different between patients with OSCC and healthy controls. Elevated levels of salivary IL-6 and bFGF in patients with OSCC when compared to the healthy controls were found (p<0.001). CONCLUSIONS: The conclusion is drawn that higher levels of salivary IL-6 and bFGF in patients with OSCC might originate from the local production, probably from carcinoma cells.

Striational autoantibodies: quantitative detection by enzyme immunoassay in myasthenia gravis, thymoma, and recipients of D-penicillamine or allogeneic bone marrow.

Striational autoantibodies (StrAb) are a useful serologic marker of thymoma in patients with myasthenia gravis (MG). We compared a standard immunofluorescence method with a new enzyme immunoassay (EIA) for detection of StrAb. Retrospective testing of 264 stored sera by the two methods yielded well-correlated results (58 sera were positive by both assays; r = 0.8). For 104 patients with spontaneously acquired MG or thymoma, results were 100% concordant, of which 53% were positive. For 34 recipients of D-penicillamine, StrAb were found in 15% by EIA and in 6% by immunofluorescence. StrAb were detected in two of four bone marrow recipients by EIA and in one by immunofluorescence. Prospective testing of 434 fresh sera (of which 49 were positive by the two methods) yielded discordant results in only 4. Serial EIA quantitation of StrAb in two patients with MG and thymoma proved useful in monitoring immunosuppressant therapy and in a third patient predicted recurrence of the tumor. A high prevalence of StrAb was detected by both assays in elderly patients with spontaneous MG, but StrAb were more readily quantifiable by EIA. The EIA method proved to be highly sensitive and specific for detecting StrAb in patients with thymoma with and without MG, in patients treated with D-penicillamine, and in those with graft-versus-host disease after bone marrow transplantation.

Antibodies to Tamm-Horsfall protein in patients treated with extracorporeal shock wave lithotripsy (ESWL).

The aim of this study was to determine antibodies to Tamm-Horsfall protein in patients with nephrolithiasis treated with extracorporeal shock wave lithotripsy (ESWL). The values of antibodies to Tamm-Horsfall protein were determined by direct enzyme immunoassay. No statistically significant differences (P > 0.05) were observed for the IgG and IgM classes of antibodies between the groups of healthy subjects and patients with nephrolithiasis before, and 30 and 60 days after ESWL. The values of IgA class determined 30 days after treatment were significantly higher (P < 0.05) in patients, which could be due to the stimulation of the immune system. The highest values of antibodies to Tamm-Horsfall protein were obtained in both groups in the test with secondary antibodies directed toward IgM class, implicated at the presence of cross-reactive antibodies. Determination of antibodies to THP subunits isolated form urine of patients with nephrolithiasis should be performed.

[Cellular immunity and the autoantibody system in polymyositis and dermatomyositis]. / Stanicna imunost i sustavi autoantitijela u polimiozitisu i dermatomiozitisu.

Polymyositis and dermatomyositis are clinical forms of inflammatory muscle diseases of unknown etiology. Cellular immunity seems to have great importance in pathogenesis of the idiopathic inflammatory myopathy. It is well known that specifically sensitised lymphocytes from the peripheral blood of patients with polymyositis and dermatomyositis may secrete various mediators (e. g. lymphokines) and be cytotoxic to muscle cell tissue culture as well. In recent years, a variety of anti-muscle antibodies and antibodies to nuclear and cytoplasmic antigens have been identified in the serum of patients with idiopathic inflammatory muscle disease, but their role in this clinical syndrome is still unknown. In this review article authors bring out some of the current state of knowledge about polymyositis and dermatomyositis related autoantibody systems, including biochemical characteristics of the target antigens, epidemiological and clinical significance, and possible role of these autoantibodies in the development of the disease.

[Clinical importance of antinuclear antibodies]. / Klinicko znacenje antinuklearnih protutijela.

Determination of antinuclear antibodies in the sera of patients with multisystem connective tissue disease has a long clinical application. In the review article authors report on their clinical significance and describe the types of antinuclear antibodies; anti-DNA antibodies, antihistone antibodies, anti-RNA-protein complexes and other antinuclear antibodies. The methods of laboratory determination of antibody types are discussed as well as their application in the diagnosis of autoimmune and multisystem-rheumatic diseases.

[Paraneoplastic autoimmune neurologic syndromes]. / Paraneoplasticki autoimuni neuroloski sindromi.

Paraneoplastic neurologic syndromes are group of distant nonmetastatic neurologic manifestations of malignant diseases. In last few decades a major advance in understanding their etiology and pathogenesis has been achieved. Larger series of patients have been reported allowing more detailed clinical research of particular syndromes. To practicing physician they can be a first clinical sign in diagnosing a neoplasm. In these conditions immunologists can test new theories in tumor immunology and autoimmunity. To the oncologists they can serve as a model in development of new modalities of treating malignant tumors. Neurologic syndromes that can be explained as autoimmune reactions initiated by the development of malignancy are presented in this paper.

[The mastocytosis syndrome]. / Sindrom mastocitoze.

A female patient with the history and clinical signs suggesting cutaneous and systemic mastocytosis is reported. The diagnosis of cutaneous mastocytosis was confirmed by the Darier's sign as well as by histologic analysis of the skin. An X-ray film of the bones showed an infiltration of the mast cells into the skeletal system what was also cytologically and histologically proven. The patient was treated only symptomatically because of the benign course of the disease. A current literature data on mastocytosis syndrome are discussed.

[Hospitalization for systemic connective tissue diseases in Croatia in 1997: examples of the use of hospital morbidity registery data bases]. / Hospitalizacije zbog sistemskih bolesti vezivnoga tkiva u Hrvatskoj 1997. godine: primjer uporabe baze podataka registra bolnickog morbiditeta.

By using the explanatory analysis methods, we examined a possible model for the utilization of the Croatian Hospital Morbidity Register data for decision making in the managerial process for national health system development. To build a draft informational model, data were selected on 843 cases hospitalized in 1997 for diseases M30-M36 (ICD-10) in 45 health institutions. This was used as an index of the diagnostically/therapeutically most demanding group of rheumatic autoimmune diseases. Treatment standards were established for our health system for the patients having an M30-M36 disease by classifying Croatia's health institutions into four clusters by intensity of hospitalization, and by analyzing demographic characteristics and the length of stay by disease entity. These standards could represent a good informational base for forming consensus group panels to deal with inpatient treatment problems of patients with systemic connective tissue diseases.

[Tuberculosis in systemic connective tissue diseases]. / Tuberkuloza u tijeku sistemskih bolesti vezivnog tkiva.

Six female patients who developed tuberculosis during the treatment of connective tissue diseases are presented. Underlying disease--systemic lupus erythematosus, rheumatoid arthritis, and polymyositis--with its numerous immunopathologic processes essentially decreases resistance of the organism to infections. Tuberculosis usually accompanies chronic, exhausting diseases and tends to involve patients with the decreased immunity. The use of glucocorticoids and immunosuppressive agents has been shown to have a significant influence on the suppression of the immune system. Thus, tuberculosis is a dangerous, very often fatal complication in the course and treatment of connective tissue diseases.

[Analysis of the flow of medical information from Croatia into the world]. / Analiza tokova medicinskih informacija iz Hrvatske u svijet.

It is commonly thought that an article published in a renown international journal gives its authors better chances for visibility. The present paper aims at answering three questions: (a) does an article published in a top international journal guarantee that its authors will be visible, (b) is an article published in a domestic journal (not covered by ISI) completely inaccessible to the international public, and (c) which are the information flows and how far does the medical information from Croatia reach. Selected was a corpus of 60 authors, who simultaneously publish in foreign journals and in Lijecnicki vjesnik (LV). The corpus consists of 1053 articles published in the 1961-1986 period. Out of these, 369 articles were published in LV and 684 in foreign journals; 177 among them are covered by the Science Citation Index. A total of 4481 citations were collected for the entire corpus of 1053 articles. The citations pertain to 506 articles, i.e. 48% of articles were cited. There are 190 cited and 83 uncited journals. The citations were distributed among 890 journals. Although the studied authors published their papers in renown international journals, a number of examples proves that this does not guarantee their visibility. An article published in LV need not necessarily remain inaccessible to the world--this depends on the article itself. The present analysis provides a compendious insight into the transfer of information from Croatia into the world. The data from citation analysis enable the deduction of "average number of citations per paper". With an appropriate interpretation it can be used as an indicator of information transfer.

[Intermittent intravenous cyclophosphamide application in patients with systemic lupus erythematosus]. / Intermitentna intravenska primjena ciklofosfamida u bolesnika sa sustavnim eritemskim lupusom.

The aim of this paper is retrospective analysis of data from patients in whom the indication for cyclophosphamide (CF) pulse therapy was established in our department. Indications for CF pulse treatment were lupus nephritis (LN) alone or associated with central nervous system lupus. CF was administred in the dose of 500-1000 mg/m2 intravenously once monthly for the 6 months and once every 3 months thereafter. Patients were treated with adequate dose of glucocorticoids and other symptomatic therapy. The effect of applied therapy has been analysed by monitoring proteinuria, serum creatinine concentration, creatinine clearance, ESR, ANF titer and total complement hemolytic activity. Initial therapeutic procedure has been completed in 25/30 patients. The reasons for discontinuation in 5/30 patients were as follows: end-stage renal failure in spite of therapy (1), psychosis and lost of compliance (1), recurrent pancytopenia and subsequent sepsis (1), death non related to SLE (1) and failure to show at follow-up (1). Significant improvement of all control parameters was observed in the majority of patients in whom the therapy was completely conducted. 16/25 patients continued therapy for the next 18 months and in only 1/16 patients therapy was discontinued because of end-stage renal failure. In other 15/16 patients further improvement of control parameters was observed, although not so expressed as in the first 6 months. The most frequent complications were infections (16 infections were microbiologically proved and there were probably more infections). Alopecia (2), haematuria (1) and amenorrhoea (1) were also observed. Relatively low incidence of complications may be explained by careful patient monitoring. Considering that therapeutic success is defined not only by the improvement of renal function, but by stopping of further progression of renal failure, it can be concluded that intermittent CF pulse therapy showed good effect on LN in patients with clear indication.

[Systemic lupus erythematosus]. / Sustavni eritemski lupus.

Systemic lupus erythematosus (SLE) is a multisystemic inflammatory rheumatic disease of unknown etiology. It is understood that immune complexes have dominant role in the pathogenesis of the disease with vasculitis being the basis of many clinical manifestations. SLE is considered to be the autoimmune disease because of many autoantibodies, some of them with the known pathogenetic role. Characteristic features of the disease are skin manifestations, arthritis, serositis as well as various tissue and organ lesions, particularly that of the kidney and nervous system. On the basis of disease activity and organ involvement the decision on the institution of immunosuppressive therapy is made.

[Clinical importance of laboratory tests in rheumatology]. / Klinicko znacenje laboratorijskih pretraga u reumatologiji.

Knowledge of mechanisms of rheumatic diseases has a continuing influence on the introduction of many laboratory tests to be used for establishing diagnosis or monitoring the activity of rheumatic disease. In the article presented are autoantibodies characteristic for distinct inflammatory rheumatic diseases, the role of serum complement activity, immune complexes, HLA-typing as well as other laboratory parameters needed for the diagnosis of rheumatic disease. The methods of synovial fluid analysis are described. Presented are laboratory investigations used by rheumatologists for the evaluation of activity of inflammatory rheumatic diseases and successful treatment together with investigations necessary for the evaluation of side-effects of treatment.

[Spondyloarthropathies]. / Spondilartropatije.

The spondyloarthropathies are a group of inflammatory joint diseases which are classified together because they share many clinical, epidemiologic and genetic features. Criteria and terminology, role of genetic factors and infection, disease mechanisms as well as the characteristics of some disease entities in diagnostic and therapeutic approach are presented.

[Detection of changes in the microvasculature in systemic connective tissue diseases--report on methods]. / Detekcija promjena na mikrovaskulaturi kod sistemskih bolesti vezivnog tkiva--prikaz metoda.

The aim of the paper is to draw attention to the possibility of an early detection of microvascular changes in systemic connective tissue diseases by the serial application of capillaroscopy, dermothermometry and digital photophlethysmography. A detailed review of diagnostic methods as well as the description of own protocol of their application is presented.