[Changes of selected immunological parameters after cardiopulmonary bypass in postop period]. / Wplyw krazenia pozaustrojowego na wybrane parametry odpowiedzi immunologicznej z uwzglednieniem przebiegu okresu pooperacyjnego.

The aim of the study was to evaluate the influence of changes of chosen immunological parameters on postoperative course patients after cardiopulmonary bypass operation. Complement components C3, C4 and immunoglobulins IgA, IgG, IgM were taken into account. The group consisted of 70 patients, 51 men at mean age 52.6 +/- 10.8 years and 19 women at mean age 50.7 +/- 11.0 years. All patients were operated in moderate hypothermia 26-32 degrees C with use of crystalloid cardioplegia. We used membrane oxygenators: Safe II (Polystan), Monolyth (Sorin), Maxima (Medtronic) and Bentley (Baxter). In 36 patients with multivessel coronary artery disease the internal thoracic artery and saphena vein grafts were performed. 27 patients underwent the valve prosthesis implantation procedure and 7 correction of the congenital heart dis-ease. The mean extracorporeal perfusion time was 127.5 +/- 51.0 min. The mean aortic cross-clamping time was 65.6 +/- 26.9 min. 6 blood samples were taken in the time periods called from 0 to 5: 0--before the operation, 1--right after the operation, 2--1 day after the operation, 3--3 days after the operation, 4--7 days after the operation, 5--14 days after the operation. All the immunological parameters were measured at the Technicon RA-1000 System device using plasma antibody serum of Behring Company. We compared two groups: 1) 21 patients extubated at operation day with 42 patients extubated at 1-th postoperative day, 2) 38 patients with postoperative organ failure with 32 patients without organ complications. The intubation time was shorter in patients with higher levels of C3 (to 7-th day) and C4 (at 1-th postoperative day). The postoperative organ failure were more frequently in patients with lower postoperative C3 (to 3-th day) and with lower C4 at 1-th postoperative day. The postoperative changes of immunoglobulins IgA, IgG, IgM were similar in patients with complicated and uncomplicated postoperative course.

The influence of DHEA on serum lipids, insulin and sex hormone levels in rabbits with induced hypercholesterolemia.

The authors estimated the influence of dehydroepiandrosterone (DHEA) administration, a potential antiatherogenic agent, on serum lipids, sex hormones and insulin levels in male rabbits fed on an atherogenic diet. They concluded that (1) DHEA administration has an unfavorable impact on the serum lipid profile; (2) an atherogenic diet causes insulin resistance; (3) the glucose and insulin levels are not related to DHEA in normally fed rabbits and in rabbits with hyperlipoproteinemia; (4) an atherogenic diet causes a slight increase of estradiol concentration; (5) DHEA treatment has no significant effect on testosterone and estradiol concentrations in both normally fed rabbits and those on an atherogenic diet; (6) DHEA administration has an anti-obesity effect.

[Plasmapheresis in the treatment of hepatic coma complicating viral hepatitis]. / Plazmafereza w leczeniu spiaczki watrobowej wiklajacej wirusowe zapalenie watroby.

Therapeutic plasmaphereses using CS 3000 Fenwal Cell Separator were performed in 4 women and 2 men, aged between 17 and 44 years, with hepatic coma complicating acute viral hepatitis type B. One to four plasma exchanges per patient were performed, usually at the volume of 3000 ml per procedure. Two patients at II and IVa period of the coma, according to Aboun classification, survived. Four patients at II, III and two at III/IV period of the coma died. The authors suggest that in some cases exchange of large volumes of plasma in the treatment of hepatic coma complicating acute viral hepatitis may be a lifesaving procedure.

[Effect of epirubicin on the heart conduction system in patients with Hodgkin's disease]. / Wplyw epirubicyny na uklad bodzcotwórczy i bodzcoprzewodzacy serca u chorych na chorobe Hodgkina.

24 patients (12 women and 12 men) aged 17 to 70 years with Hodgkin's disease in the clinical stages IIA-IVB were treated according to the polychemotherapeutic schemes containing epirubicin (epiDX). Using the 24-hour ambulatory ECC on the day before and the day of drug application as well as after completion of the therapy, heart rate, arrhythmias and conduction abnormalities were estimated. There was statistically insignificant decrease in heart rate (mean, minimal and maximal) on the day of epiDX administration and after therapy completion. Arrhythmias in form of supraventricular and ventricular extrasystoles including bigeminy and couplets of VES in one patient and two episodes of atrial tachycardia in another one on the day of drug injection were noticed. In 2 young women occurred interruption of sinus rhythm lasting longer than 3 sec., due to sinus arrest in one and due to 2:1 sinus exit block in the second one. The above mentioned disturbances were in majority of patients not associated with clinical symptoms. The authors conclude that the reduction in heart rate and SVES formation might be in the majority of patients neurogenic but in some of them as well as VES generation result from epiDX action.

[Secondary polycythemia as an example of the paraneoplastic syndromes]. / Czerwienica wtórna jako przyklad zespolu paraneoplastycznego.

The modern views on the coexistence of secondary polycythaemia with benign and malignant tumours of varying origin are reviewed describing certain mechanisms determining this association. The diagnostic management of secondary polycythaemia is outlined calling attention to the necessity of ruling out coexistence of a neoplasm.

[Hodgkin's disease and non-Hodgkin's lymphoma in 2 sisters]. / Ziarnica zlosliwa i chloniak nieziarniczy u dwóch sióstr.

For the first time in the Polish medical literature an appearance is presented of malignant lymphogranulomatosis and of a non-Hodgkin lymphoma in two sisters. A discussion on the etiology of the condition is presented on the ground of the cytogenic studies and tissue compatibilities antigens as well as of the literature of the subject. Genetic background of the two different diseases in two sisters is stressed.

[Effect of brown enriched Livex on the general condition of patients with proliferative diseases of the bone marrow and lymphatic system]. / Wplyw Livexu brazowego wzbogaconego na stan ogólny chorych z chorobami rozrostowymi szpiku i ukladu chlonnego.

Brown Livex, a preparation of animal blood in doses of 5.0 g twice daily was given to 33 patients with proliferative diseases of bone marrow and lymphatic system during and after treatment with cytostatic agents. The course of treatment was 3 months. The effect of the preparation was studied on the wellbeing of the patients, body weight, general fitness (Karnofsky scale) and the levels of haemoglobin, haematocrit and beta-lipoproteins. The control groups comprised 20 patients with similar diseases and similar cytostatic treatment. In the studied group a positive effect was observed of the preparation on weight gain (26 out of 33 patients), well-being (24 of 33) and general fitness (17 of 33). In the control group during the same-time of observation weight loss was noted in 11 of 20 cases, well-being deterioration in 7 of 20, and decreased general fitness in 7 of 20. Livex treatment had no effect on haemoglobin level, haematocrit value, total serum protein, albumins and beta-lipoproteins.

[Guillain-Barré syndrome]. / Zespól Guillain-Barré.

A case of the Gullain-Barré syndrome was observed in a woman aged 18 years. The course was acute and fatal. Sedimentation plasmaferesis was applied in the treatment. A peculiarity of the case was the ascending course of paralysis and coexistence of encephalomyelitis.

[Secondary erythrocytosis in 3 cases of neoplastic disease]. / Nadkrwistosc wtórna w 3 róznych przypadkach choroby nowotworowej.

Three cases of tumor-associated (so called "paraneoplastic") erythrocytosis are described. In a 24 year old man with adrenal gland cancer hematological parameters normalized shortly after surgery, but he died 8 weeks later because of the dissemination of the disease. In a 48 year old man with hypernephroma of the left kidney and in a 49 year old woman with the left cerebral hemisphere meningioma Hb level, hematocrit and red blood cell count normalized after tumor removal and remained within normal range 39 and 7 months respectively. It is suggested that a probability of the neoplastic disease as a cause of erythrocytosis should be taken into account.

Monocytes in Hodgkin's disease.

It should be stated, there exist many abnormalities of monocytes function in HD patients, while examined in vitro. Their biological significance in vivo remains to be elucidated. The disturbances of monocyte-macrophage system certainly influence the immunoregulation mechanism, especially T-cell-macrophage cooperation and this way augment the immune deficite observed in patients with HD, increase their susceptibility to infections and may be an additional factor favoring tumour dissemination, particularly in the advanced stages of the disease.

Assessment of interferon production in patients with chronic nonviral diseases by whole blood or whole bone marrow techniques.

Hundred and fifty-four samples of heparinized blood from patients with chronic toxoplasmosis, chronic brucellosis, lung diseases, psychiatric affective disorders, healthy individuals and neonates, were obtained. The experimental material included also 14 bone marrow samples from patients with hematological diseases or lung cancer. The whole cell populations were treated with several classical IFN inducers and supernatants were assayed for IFN activity in human lung adenocarcinoma cell line A 549 using VSV or EMC viruses as challenge. The response of WBC to NDV or PHA + PMA was high and remarkably stable in majority of cases except listed below. The levels of IFN induced by LPS were low. The response of WBMC to IFN inducers closely resembled the response of WBC. Low IFN levels in samples of stimulated WBMC from some hematological patients were connected with low cellularity. WBC from psychiatric patients with affective disorders weakly responded to stimulation with NDV. This suggested an existence of deficiency of IFN alpha production connected with affective disorders. Also WBC from cord blood failed to react to PHA + PMA and were poorly responsive to NDV.