Biomedical subjects
Publications and source records attributed to K Nikolov.
The serum and urine beta 2-microglobulin levels were determined in patients with chronic recurrent pyelonephritis and in healthy controls. The urine beta 2-microglobulin level was considerably increased in the patients with chronic recurrent pyelonephritis which is linked with the activity of the disease.
Serum IgA, C3 and circulating immune complexes were examined in 20 patients with morphologically proved chronic glomerulonephritis with mesangial IgA precipitates and in 39 clinically healthy controls. The immune complexes were analyzed. 10 patients were with Berger's disease, 8 patients--with secondary IgA glomerulonephritis accompanying chronic liver disease and 1 patient was with Henoch-Schönlein's purpura. No significant differences were found between the mean values of IgA, C3 and the circulating immune complexes in the patients and the healthy controls as well as between the actively ill patients and those in remission. IgA and IgM in the immune complexes were significantly higher in the patients than in the healthy controls. IgA level in the immune complexes was significantly higher in the patients with active disease than in the patients in remission. In the patients with liver disease C3 and C4 often were not found in the immune complexes. In these patients it is possible that aggregates of immunoglobulins are found instead of immune complexes. The IgA level in the immune complexes could serve as a criterion for the disease activity.
25 families with 607 members were studied. 165 persons of them suffer from hereditary angioneurotic edema and 28 persons had died from this disease. The clinical forms of the disease are discussed. A classification of angioneurotic edema caused by C-inactivator deficiency is presented. The importance of the examination of C1 inactivator (quantitatively and qualitatively) and of C4 complement fraction in patients with hereditary angioneurotic edema is pointed out.
In patients with various forms of ischemic heart disease the following indices were examined by radial immunodiffusion: alpha-1-acid glycoprotein, alpha-1-antitrypsin, haptoglobin, alpha-2-glycoprotein, beta-2-glycoprotein, immunoglobulin, C3 and C4 complement fractions. The changes in the serum glycoproteins during the acute phase of myocardial infarction are pointed out. The changes in the immunoglobulins and the complement fractions in patients with ischemic heart disease are discussed. Their determination in patients with stenocardia and past myocardial infarction is of no diagnostic value.
The changes in the level of glycated proteins and some factors of coagulation were studied in 30 patients with diabetes mellitus--15 with and 15 without diabetic retinopathy. The mean level of glycoalbumin was elevated (2.9 +/- 0.8 mg) HMF (mg protein) without an authentic difference in the two subgroups. Glycohemoglobin was also increased (means--13.6 +/- 1%) in all studied subjects The activity of antithrombin III was high (means--222 +/- 53%) and the concentration--reduced--means--22.1 +/- 2.2 mg%, without authentic difference in the two subgroups. The concentration of alpha-2-macroglobulin, as well as its activity showed no significant deviations. Factor VIII (von Willebrand) was within reference limits (means--97.04 +/- 15.06%) with a tendency to lower values in the group without diabetic retinopathy. Fibrinogen level (means--4.3 +/- 1.2 g) was within the reference range, and FDP--increased in the majority of the examined. A syndrome of intensified latent coagulability, equivalent to chronic decompensated DIC, determined by the basic dismetabolism and non-enzymatic glycating of proteins has been outlined. The changes are more marked in the cases with diabetic retinopathy.
Factor VIII/von Willebrand antigen (VA), part of the molecule of plasma factor VIII, realizes the interaction between platelets and vascular endothelium and the triggering of primary hemostasis. The modern diagnostics and treatment of the complicated acquired thrombocytopathies are impossible without the investigation on the concentration of factor VIII/von Willebrand antigen. The immune coagulation method used allows the objective, exact and fast determination of VA--referent values have been developed in healthy subjects. The patients with blastic leukosis studied--28 and with chronic myeloleukemia--18, all with severe endogenous complicated thrombocytopathy, functionally and biochemically confirmed, showed normal values of VA/von Willebrand antigen. On the contrary, a slightly elevated VA was established in patients with diabetes with no vascular-degenerative syndrome, corresponding to the activation of platelet functions and to enhanced adhesiveness in particular, contributing to thrombotic complications. The data obtained are discussed in connection with the etiopathogenesis of the separate kinds of thrombocytopathies and the necessity of substitutive therapy.
The basic contemporary methods for determination of serum antibodies against DNA are compared. The immunoenzyme methods are recommended because of their accessibility. The high frequency of antibodies against DNA in lupous patients is pointed out. The antibodies against extractable nuclear antigens (Sm and RNP) in rheumatic patients are also determined. The results are compared with these of a control group of healthy persons and patients with non-rheumatic diseases. The antibodies against extractable nuclear antigens are found most frequently in lupous patients.
The total hemolytic complement (CH50) was studied in the serum of 54 patients suffering from rheumatoid arthritis (RA) and in the synovia of 30 of them. The C3 complement fraction was examined in the serum of 49 patients and in the synovia of 30 patients. The C4 complement serum-fraction was examined in 42 patients and in the synovia of 30 patients. 40 healthy persons and 21 patients with osteoarthritis served as a control group. The results showed a slight increase of CH50 in the serum and decrease in the synovia of the patients with RA compared to the control groups. The serum values of C3 and C4 of the RA patients did no differ from those of the healthy persons but the synovial C3 and C4 values were lowered. A reverse correlation was found between the CH50 in the synovial fluid and the phagocyte percentage in the fluid (r = -0.43). CH50, C3 and C4 determination is important for clarification of some pathogenetic mechanisms in RA. Their decrease reflects the degree of immunologic activity.
The anti-actinic antibodies were determined via counter electrophoresis on cellulose-acetate in 35 clinically healthy subjects and 57 patients with various forms of IHD. Antibodies were established in only three out of the healthy subjects and with low titres (1:2). Positive anti-actinic antibodies were established 82.8% of the patients with IHD. Their origin and importance for the pathogenesis of the disease are discussed.
Ninety four subjects were examined, 42 of them with chronic obstructive pulmonary disease (COPD) and 52--healthy. The following indices followed up: immunoglobulins G, A, M, fraction of the complement--C3 and C4, alpha 2-macroglobulin (alpha 2MG), alpha 1-antitrypsin (alpha 1 AT). The following methods were applied: radial immunodiffusion according to Manccini et al and counter-electrophoresis on cellulose-acetate. Antisera and standards of the firm "Behring"--FRG were used. The data obtained are compared with those from the group the healthy subjects. Changes were established, manifested in increased level of immunoglobulin (IgG) and considerable reduction in the values of alpha 1AT, in the patient, with exacerbated form of COPD. No substantial deviations in IgA, complement fractions and alpha 2MG were established.
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The anti-DNA antibody titer (heat denatured, native and monostranded) was studied in 61 patients with psoriasis and 41 healthy controls. Positive titers of anti-DNA antibodies were established in 19.3% of the psoriatics and in 4.9% of the controls. Antibodies against heat-denatured DNA were discovered in 8.2% of the patients and in 0% of the healthy persons; against native DNA in 18% of the psoriatics and 4.9% of the controls and against monostranded DNA in 31.7% of the psoriasis patients and 9.8% of the control group. In general, the percentage of the positive titers of anti-DNA antibodies in psoriatics was about 4 times higher than that of the healthy controls.
The authors discuss the B-cellular lymphomas, producing various kinds of monoclonal paraproteins as well as parts of them--light or heavy chains. A case of a patient with lymphoplasmocytic malignant lymphoma, producing monoclonal IgM in pentamer form mainly, as well as in Valdenström disease but without the symptoms characteristic for it--hyperviscosity and hemorrhagic diathesis, is described. The disease has been histologically, cytologically and electron microscopically diagnosed. Attention is paid to the long-term relatively benign course and subsequent malignant course with manifested laboratory changes as well as change in the objective state, requiring the monotherapy to be substituted for active complex treatment, though the effect was unsatisfactory, with a fatal outcome of the inflammatory complications and progressive anemia. The place of the case in Kiel classification of malignant lymphomas is discussed.
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