Guillain-Barre syndrome in patient with Burkitt's lymphoma and type 2 diabetes mellitus.

Although peripheral neuropathies are commonly observed in patients with non-Hodgkin's malignant lymphomas (NHML), Guillain-Barre syndrome (GBS) belongs to the occasional complications of lymphoproliferative disorders. It appears in less than 0.3 per cent of NHML. It is worthy of note that in the reported case there occurred three independent risk factors of peripheral neuropathy: Burkitt's lymphoma, chemotherapy and type 2 diabetes mellitus. Based on clinical course, EMG finding and neuropathological examination, in spite of normal cerebrospinal fluid protein content, GBS as a paraneoplastic disorder was diagnosed. It was assumed that chemotherapy and diabetes mellitus conduced to severe neuropathy.

[Selected parameters of blood platelet function in patients with myeloproliferative syndrome]. / Wybrane parametry funkcji plytek krwi u chorych z zespolem mieloproliferacyjnym.

Symptoms of hemorrhagic diathesis and/or thrombotic complications are observed in patients with myeloproliferative syndrome (m-p.s.). It is emphasized that there is a meaningful direct and indirect share of blood platelets in the mentioned disturbances of hemostasis. Therefore in own investigations an attempt was made to evaluate the morphology and function of blood platelets in patients with various forms of m-p.s., as well as to find an answer to the question: do any differences in morphology and function (activation) of blood platelets appear in patients with m-p.s.?, and is activation of blood platelets always accompanied by the symptom of hemorrhagic diathesis or past thrombotic episodes (the second ones evidenced in the patients anamneses)?, do the blood platelets in idiopathic thrombocytopenia (one of the forms of m-p.s.), differ morphologically and functionally from platelets in other forms of m-p.s. The investigation comprised 45 patients, in whom m-p.s. was diagnosed at Department of Hematology PAM (28 women, 17 men) aged from 36 to 82 years (mean age 58.10 + 10.61). The diagnosis of m-p.s. in each patient was established on the basis of clinical picture and laboratory examinations (blood morphology, hematocrit, FAG score, histopathological examination of bone marrow). In patients the accomplished determination concerned blood platelets count, mean blood platelet volume, platelocrit, volume range of blood platelets, coagulation time by Duke's method. The function of platelets was estimated with the help of the following studies: aggregation of blood platelets under the influence of ADP according to Born's method, concentration of beta-thromboglobulin (beta-TG) and platelet factor--4 (PF-4) in plasma by ELISA method. In order to pay due consideration to the effect of blood platelets count exerted on the concentration of beta-TG and PF-4, a supplementary parameter was introduced, the so-called beta-TG and PF-4 standardized. That allowed for studying the platelets in all patients under the same conditions. The results of own investigations have shown that most of the patients with m-p.s. had disturbances involving the morphology of blood platelets (Tab. 2) and increased activity of platelets, being expressed by a rise in concentrations of beta-TG and PF-4 in plasma (Fig. 1, 2) and by abnormal aggregation of platelets due to ADP influence. Moreover, the determination of beta-TG and PF-4 concentration in plasma in thrombocytopenia states, particularly in patients with idiopathic thrombocytopenia ought to be performed after the standardization of platelets count, the finding being also supported by the results of own investigations (Tab. 3). There may be compliance with the viewpoint expressed in the literature that the results of studying the morphological parameters of blood platelets and their function (activation) in m-p.s. are not a prognostic factor for the appearance of thrombotic complications and/or hemorrhages.

[Some clinical symptoms and allergens on asthma-prurigo syndrome]. / Niektóre objawy kliniczne oraz alergeny w zespole asthma-prurigo.

The group of 146 patients suffering from asthma-prurigo syndrome (85 adults and 64 children) have been inquired in many various clinical centers. It was established that in 79.6% of the patients the first symptoms of illness appeared already in infancy and only 28.2% of the patients had negative familiar anamnesis on the allergy. In 73.2% of the patients with asthma-prurigo syndrome the symptoms of atopic dermatitis persisted longer than asthma symptoms and in 89.9% of them asthma-prurigo symptoms accompanied other form of allergic diseases. The most important causal allergens provoking asthma-prurigo symptoms were: house dust (in 64.4% of the patients), chocolate (in 42.2%), cat epithelia (in 40.2%) and cow milk proteins (in 29.5% of the patients).

[Changeability of respiratory tract and skin symptoms in patients with asthma-prurigo syndrome under the influence of emotional and environmental factors]. / Zmiennosc nasilenia objawów ze strony dróg oddechowych i skóry u chorych z zespolem asthma-prurigo pod wplywem czynników emocjonalnych i srodowiskowych.

In a group of 228 patients suffering from asthma-prurigo syndrome the influence of emotional state, permanent residence and season time on dynamic of the clinical symptoms were studied. The evaluation of emotional state in 80 adult patients was carried-out by means of Eysenck Personality Inventory. The emotional state had less negative influence on the exacerbation of the symptoms upon children then in adults (especially on their skin symptoms). It was confirmed that the patients with high level of neurotic symptoms revealed easier the exacerbation of asthma and skin disorders under the influence of emotional stress. The climatic treatment on the sea-side was more efficient for them than any mountain climatic cure, especially in the treatment of airways symptoms. Similarly, the summer season brought the relief of their symptoms from both the respiratory and skin symptoms.

[Results of treating patients with highly malignant non-Hodgkin's lymphomas; comparison of treatment efficacy with CHOP and CBVPM-AVBP]. / Wyniki leczenia chorych na chloniaki nieziarnicze o wysokiej zlosliwosci; porównanie skutecznosci leczenia schematami CHOP i CBVPM-AVBP.

The treatment of highly of 43 patients with highly malignant non-Hodgkin lymphomas were analysed and assessed. These patients were treated at the Department of Hematology, Pomeranian Medical Academy within 1981-1990. The process was advanced in 76% of and localization of the tumour outside lymph nodes was also seen in 79%. The results of treatment with CHOP regimen used during the first 5 years were compared with CBVPM-AVBP used in 1986-1990. CBVPM-AVBP regimen proved more 4 effective (55% of the complete remissions) than CHOP regimen (37.5% of the complete remission). Mean duration of the complete remission (survival free from the relapse) was 27.5 (1-88) months. Complete remissions were easier to achieve in patients with centroblastic lymphoma in higher percentage. These patients survived longer than those with other highly malignant lymphomas. The authors conclude that further intensification of chemotherapy in case of highly malignant non-Hodgkin lymphomas is justified.

[A case of centroblastic lymphoma of the thyroid gland]. / Przypadek chloniaka centroblastycznego tarczycy.

A case of a 49-year male patient with centroblastic lymphoma of the thyroid gland is presented. Centroblastic lymphoma was diagnosed with cytological and immunocytochemical examination of the biopsy specimen, and verified with histological examination of tumor section collector intraoperationally. Diagnosed tumor was classified as II AE degree. No signs of lymphocytic thyroiditis co-existing with centroblastic lymphoma were noted. The patient was treated chemically with CBVPM/AVBP regimens for 8 months. Complete remission still lasting, i.e. 96 months after completion of chemotherapy, was achieved.

Concentration of dopamine in plasma, activity of dopamine beta-hydroxylase in serum and urinary excretion of free catecholamines and vanillylmandelic acid in women chronically exposed to carbon disulphide.

The authors studied 140 women, selected at random, aged 22-55, divided into two groups. Group I (control) included 50 women, mean age 40.1 +/- 1.7 years. Group II included 90 women, mean age 39.7 +/- 2.1 years, chronically exposed to 15.6 - 21.84 mg/m3 of carbon disulphide from 0.5 to over 20 years. It was found that women chronically exposed to CS2 showed significantly lower levels of dopamine and lower activities of DBH (p < 0.001), significantly lower urinary excretion of adrenaline (p < 0.001), but insignificantly lower excretion of noradrenaline and vanillylmandelic acid.

The pattern of some lipid fractions in the serum of women chronically exposed to carbon disulfide.

The present study was performed in 307 women, aged 25 to 55 years (mean 42.7 +/- 4.7). The control group included 70 women, aged 42.1 +/- 3.5 years, who had previously had no contact with CS2. The study group included 237 women, age 42.9 +/- 5.1 years, chronically exposed to 5 to 7 ppm level of CS2, monitored daily using a spectrophotometric method. It was found that quantitative abnormalities in the lipid fractions of blood in women chronically exposed to CS2 appear after the age of 39 years. They were manifested by a significant increase in the serum levels of total cholesterol and LDL-Ch, and a decrease in HDL-Ch. No differences were noted as to the concentration of free fatty acids between both groups.

[Clinical characterization of "asthma-prurigo" syndrome with emphasis on risk factors]. / Charakterystyka kliniczna zespolu "asthma-prurigo" z uwzglednieniem czynników przyczynowych.

In a group of 228 patients with Asthma-Prurigo syndrome in 82.5% of patients the onset of skin lesions was earlier than the onset of asthma. It was found that the early onset of atopic dermatitis suggests the greater probability of subsequent asthma. In 88.6% of patients also other allergic diseases were diagnosed, and rhinitis allergica was observed most frequently. In the investigated group of patients urticaria chronica idiopathica or physical urticarias were not observed. Among 228 patients with Asthma-Prurigo syndrome, 74.6% of patients pointed to house dust as one of the most frequent causative factors. The house dust similarly to other inhalant allergens, somewhat more frequently had influence on the course of atopic dermatitis than on the course of asthma. Contrary to this observation according to patients food allergens (milk, eggs, fish, chocolate) aggravated or induced the relapses of skin lesions much more frequently than asthma. It was shown how often patients noticed adverse reactions due to penicillin and sulphonamides.

[Studies on the possibility of desensitizing patients sensitive to plant pollens and house dust by an oral route]. / Badania nad mozliwoscia odczulania pacjentów nadwrazliwych na pylek roslin i kurz domowy metoda doustna.

Oral hyposensitization was carried out in 26 patients with pollinosis and in 67 patients sensitive to house dust with all year symptoms of allergic disease of the skin, airways or conjunctivitis. The patients were hyposensitized with grass pollen extracts and house dust produced by Lab. Sevac. The pollen allergen was administered before the pollinating season, in increasing doses during 18 weeks. The following concentrations were used: 0.1 PNU, 1.0 PNU, 10 PNU, 100 PNU, and 1000 PNU. The house dust allergen was administered in the same manner, using the same concentrations and time during autumn and winter. In the group of patients with plant pollinosis 10 out of 26 did not experience any symptoms of the disease after hyposensitization. In 9 further patients the symptoms were milder. In the group of 44 patients with atopic dermatitis sensitive to house dust, a complete cure was seen in 62% of the patients. In further 25% milder symptoms were observed. In the group of 11 patients allergic to house dust and with the asthma-prurigo syndrome, the respiratory and dermatologic symptoms resolved completely or diminished in 3 and 6 patients respectively. In the group of 7 patients with dermatitis and full year rhinitis, complete resolvement of symptoms was seen in 2 patients and diminished symptoms in 3 cases. In the group of 4 patients with conjunctivitis full resolvement of symptoms was observed in 3, while partial in 1. Only in 3 out of 93 treated subjects intolerance of this therapy was found.(ABSTRACT TRUNCATED AT 250 WORDS)