impact of immunoglobulin E serum levels on clinical presentation and immunological status in graves' hyperthyroidism

There is growing evidence pointing to the involvement of IgE in the pathogenesis of Graves' disease. Despite this evidence, the diagnostic significance of IgE in Graves' hyperthyroidism is still not established. Therefore, forty-six patients with hyperthyroid Graves' disease were studied together with twenty patients with toxic nodular goiter and 25 age and sex matched healthy subjects. Quantitative estimation of IgE. antithyroid perioxidase [Anti-TPO] and antithyroglobulin [Anti-Tg] were analyzed by sandwich ELISA. Peripheral blood CD3+, CD4+ and CD8+ were analyzed by direct immunoflourescence. Natural killer activity was measured by a standard 4-hour Cr[51] releasing assay. The data of the present study revealed significant elevation of IgE, Anti-TPO and Anti-Tg antibodies in hyperthyroid Graves' disease [196.54 +/- 199.4 IU/ml, 219.3 +/- 66.41 lU/ml and 278.8 +/- 86.51 IU/ml respectively] than in toxic nodular goiter [49.4 +/- 51.97 IU/ml, 57.15 +/- 13.29 IU/ml and 116.55 +/- 67.94 IU/ml respectively] or control subjects [44.32 +/- 43.4 IU/ml. 50.32 +/- 10.07 IU/ml and 94.8 +/- 10.79 IU/ml respectively]. Hyperthyroid Graves' patients with IgE elevation had increased incidence of ophthalmopathy, increased clinical and biochemical severity of the disease and increased thyroid autoantibodies titres together with reduced natural killer activity in comparison to patients with normal lgE serum levels. Graves' patients with clinically evident ophthalmopathy had significantly higher levels of IgE, Anti-TPO and Anti-Tg antibodies besides reduced natural killer activity than those without ophthalmopathy. From this study, it is concluded that IgE determination in hyperthyroid Graves' disease could define a subgroup of patients with altered clinical and immunological profiles. Hyperthyroid Graves' patients with ophthalmopathy have more marked immunological changes despite nonsignificant differences in clinical or biochemical severity of the disease in comparison to patients without ophthalmopathy

Diurnal variability of blood pressure, autonomic function tests, QT measurements and hemostasis in diabetic patients with hepatosplenic schistosomiasis

In our locality, hepatosplenic schistosomiasis [HSS]: is frequently encountered in association with diabetes mellitus. Diurnal variability of autonomic nervous system and hemostasis had been previously suggested in diabetic patients but not proved in HSS. The impact HSS on diurnal variability of heart rate, blood pressure, QT interval. QT. dispersion autonomic nervous system and hemostasis had not been previously studied in diabetic patients. Therefore, we studied ninety-five female patients: 30 patients with type 2 diabetes [diabetic group.], 30 patients with hepatosplenic schistosomtasis [HSS group], and 35 patients with combined diabetes mellitus and HSS [combined group] and thirty age-matched healthy women [control group]. The coexistence of diabetes mellitus and HSS affect many of the studied parameters. The combined group had more significant deterioration of deep breathing test: valsalva test and blood pressure response to sustained handgrip together with reduced plasma fibrinogen and euglobulin lysis time in comparison to the diabetic group. Altered diurnal variability of deep breathing test. Mean blood pressure and hemostasis were found in the combined group in comparison to the diabetic group. Loss of diurnal variability of Corrected QT interval [QTc] was also found in the three studied groups of patients in comparison to the control group. QTc and QT dispersion [QTD] were significant increased and correlated with autonomic function tests in the three studied groups of patients. it is concluded that, diurnal variability of autonomic nervous system, blood pressure and hemostasis should be considered during assessment of these variable Day-night difference in autonomic nervous system and arterial blood pressure together with hemostatic changes observed in the combined group in comparison to the diabetic group could be a possible explanation for the reduced occurrence and altered timing of cardiac events in the combined group. QTc and QTD are sensitive, noninvasive, simple predictors of cardiac autonomic dysfunction and could be used routinely to identify patients with autonomic dysfunction and increased cardiovascular risk

Short versus long term effect of lithium on pituitary thyroid axis

Although the antithyroid effect of lithium is well known in thyrotoxicosis, there is no general agreement about its effect in euthyroid subjects. Furthermore, the duration of therapy may modify its antithyroid effect. In the thyrotoxic patients, short term use of lithium is effective and safe method to achieve euthyroidism. However, long term use needs close supervision and manipulation of the dose. In euthyroid patients even short term use of lithium is associated with subclinical hypothyroidism which is much more frequent than previously suggested and replacement thyroid therapy should be used from the start so as to avoid subclinical hypothyroidism and prevent fluctuations in the thyroid function that could induce affective disorders

Effect of some opioid agonists [morphine and fentanyl] on blood picture in pregnant rats

This work was conducted on pregnant and non pregnant rats aiming to study the effect of opiod agonists [Morphine and fentanyl] on blood picture and immune system. The pathological changes in liver, spleen and kidney that accomapany their administration were also studied in mothers as well as, their offsprings. The experiments were done after single and repeated administration It revealed that: i. Morphine has a toxic effect on the haemopioetic and immune systems and this effect depends on the dose and duration. ii. Fentanyl is more safe than mrorphine. iii. Pregnancy potentiates the effect of opioids. iv. The offsprings suffer from opiods more than mothers due to inadequancy of the enzyme system metabolising the drug. So, it is better to decrease the dose of opiods during labour and avoid any treatment containing opiods during pregnancy

Effect of diuretics on some respiratory function tests in bilharzial patients with and without ascites

This work comprised 20 male bilharzial patients, devided into 2 groups, 10 bilharzial patients without ascites, 10 patients with ascites and in addition, 10 healthy subjects as a control group. All cases were subjected to thorough history taking, complete clinical examination and the following investigations: urine and stool analysis, blood urea, serum creatinine, x-ray chest, electrocardiography and ventilatory function tests particulary 1C, ERV, FVC, FEV[1], MVV, FMEF, FMEFT, FEF and AVI. Percutaneous transsplenic portal manometry was done for nonascetic and ascitic group, and the intraperitoneal presure was measured for ascitic group only. Bilharzial patients without ascites have obstructive ventilary defect only, while patients with ascitis has combined obstructive and restrictive defects, and diuretics improved these defects. There is negative correlation between portal venous pressure and intraperitoneal pressure and all ventilatory function tests except FMEFT where the correlation is positive. From the preceeding we can see that diuretics are of value in improving organ funciton not only in the ascitic bilharzial patients but also in the non ascitic cases and wherever oedema is interferring with function i.e. interference with digestion in patients with portal hypertension or ascites, and interference with ventilation due to oedema of the bronchial mucosa

Relation between clinico-radiological grading and respiratory functions in bilharzial corpulmonale

This work comprised 18 patients with variable degrees of bilharzial corpulmonale and 18 control subjects of different age and sex. They were subjected to thorough clinical examination and different laboratory, radiological, electro-cardiographic and pulmonary function investigations. It was found that, respiratory functions was impaired in patients with bilharzial corpulmonale, both restrictive and obstructive ventilatory dysfunctions. The clinical grading gives an diea about the obstructive dysfunction while radiological grading given an idea about the restrictive ones. On the other hand the clinical grading more or less equal to the radiological grading, So, the clinical examination can tell us abuot the expected radiological findings in those patients

Studies of some enzymatic and protein fractions in some renal disorders II Nephrotic syndrome

The study included 20 children with nephrotic syndrome, their age ranged from 2-12 years, of both sexes10 normal children of matched age six with the diseased children and form the same socioeconomic standard were chosen. For each of the patients, the following investigations were done: 1- Determination of urinary proteins. 2- Determination of creatinine level both in urine and serum. 3- Detemination of the activities of the following enzymes both in urine and serum. A] Lactate dehydrogenase [LDH]. b] alkaline phosphate enzyme [ALp]. c] Gamma-Glutamyl transferees [Gamma-GT]. The results showed that the concentration of the studied urinary proteins were found significantly higher in nephrotic group compared to normal. The difference in the molecular weight of these proteins contributed to the difference in their relative concentration in urine. In more severe renal affection, where the glomerular permeability in markedly increased proteins of higher molecular weight such as IgA appear in urine. A significant higher values of creatinine both in serum, urine its clearance in nephrotic group compared to normal is observed

effect of haemorragic shock on the lungs and heart of dogs, a histochemical study

Six mongrel dogs were subjected to haemorragic shock gy lowering systolic arterial tensien from 120-130 mmHg to 50 mmHg. Their heart and lungs were studied histoachemically after three hours of hypotention and compaired with two control animals. The myocardium showed diminished acid phosphatase activity, the enzyme being liberated from the disrupted lysosomes and esaping from the cells. Lysosomal discruption liberates lysosomal hydrolytic enzymes causing cell damage with escape of cell constituents. Lactic dehydrogenase activity was supposed to increase to cope with increased latic acid production but it was diminished owing to its escape from myocardial cells. Nonspecific esterase showed no change in activity probably due to its increased activity being balanced by its escape from the cells. Its activity probably is related to the change in substrate utilization by the hypoxic myocardium. Alkaline phophatase activity increased denoting enhancenment of transfer across capinary endothelium. The same explanation are true regarding the lung, but being more tolerant to hypoxia, these enzymes did not escape from the cells by the end of the experiment thus showing increased intracellular activity