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Biomedical subjects

M Sćukanec-Spoljar

Publications and source records attributed to M Sćukanec-Spoljar.

13 recordsLinked to original sources
PubMed2001

Etoposide as the basic and interferon-alpha as the maintenance therapy for Langerhans cell histiocytosis: a RTC.

The treatment of patients who suffer from a disseminated form of Langerhans cell histiocytosis (LCH) is still controversial. So far, few larger randomized studies have been performed. The authors present 3 patients with a disseminated form of LCH--4 months, 9 months, and 2 years old, respectively. The lesional Langerhans cells in each patient showed positive immunohistochemical reaction to S-100 protein and the presence of Birbeck granules was confirmed by electron microscopy. All the patients were treated with etoposide (VP-16), 200 mg/m2 for 3 consecutive days, with 15 cycles at intervals of 3 weeks between each cycle, followed by maintenance therapy with IFN-alpha. All 3 patients reached complete stabile remission. The patients were young, at high risk, with multiple-organ involvement of LCH, and two of them had obvious signs of organ dysfunction at presentation, suggesting a poor prognosis. All remain disease-free several years after therapy. The results suggest that INF-alpha may prevent recurrences in high-risk patients.

Antibodies, Viral↗
PubMed2001

Immunohistochemical analysis of human serum sickness glomerulonephritis.

AIM: To analyze pathological and immunohistochemical characteristics of glomerulonephritis in human serum sickness. METHODS: Renal biopsy specimens from two female patients with serum sickness that ensued after application of anti-lymphocyte horse globulin for aplastic anemia were analyzed by light microscopy, immunofluorescence, and electron microscopy. To prove the depositions of foreign protein, frozen sections were incubated with fluorescein-conjugated anti-horse protein serum. Immunohistochemical analysis was performed on B5-fixed paraplast-embedded tissue or frozen acetone-fixed sections with the primary antibodies for molecules/cell markers CD35, CD43, CD45RO, CD68, CD2, lysozime, L26, and S100. RESULTS: Diffuse proliferating and necrotizing glomerulonephritis with crescents was found. There were coarse granular mesangial, subepithelial, subendothelial, and intramembranaceous deposits of mainly horse globulin, C3, and IgG. Most mesangium infiltrating cells were macrophages and T-lymphocytes. Electron microscopy revealed hypertrophy of podocytes, but immunohistochemistry did not show their normal CD35 (C3b-receptor) staining. Apart from epithelial cells, main crescent forming cells were macrophages and T-lymphocytes. Rare dendritic cells and abundant infiltration of macrophages, T-lymphocytes, and neutrophiles were found in the interstitium. CONCLUSION: In severe serum sickness, glomeruli and tubuli are destroyed beyond the range usually seen in other types of glomerulonephritis caused by immune complexes, except in cases with widespread crescents. Hypertrophy of podocytes and loss of their normal C3b-receptor staining has not yet been described in the literature. C3b-receptors on podocytes could play a role in pathogenesis of glomerular injury caused by immune complexes.

Adult↗
PubMed2001

Hypokalemic metabolic alkalosis--three case reports.

The two most common forms of inherited normotensive hypokalemic metabolic alkalosis are Bartter's and Gitelman's syndromes. Bartter's syndrome typically present with normal or increased calcium excretion. Hypomagnesemia occurs in only one third of affected individuals. In contrast, hypomagnesemia and hypocalciuria are considered hallmarks of Gitelman's syndrome. In most patients, the symptom of muscle weakness and polyuria occur early in life, which may be attributed to potassium depletion. Despite hyperaldosteronism, the patients tend to be normotensive, which is at least explained by vascular hyperresponsiveness to prostaglandins. Therapeutic approaches to Bartter's and Gitelman's syndromes include potassium supplementation, prostaglandin synthesis inhibitors (nonsteroid anti-inflammatory agents), aldosterone antagonists and converting enzyme inhibitors. Three patients with hypokalemia, normal blood pressure, metabolic alkalosis, hyperreninemia and hyperaldosteronism are described. Two patients had Bartter's syndrome and one patients had Gitelman's syndrome.

Adult↗
PubMed2000

Complete remission of cryoglobulinemic glomerulonephritis (HCV-positive) after high dose interferon therapy.

We report the case of a 64-year old woman with hepatitis C virus infection, mixed cryoglobulinemia type II (IgG + IgM kappa) and cryoglobulinemic glomerulonephritis. The patient was treated with the standard dose of recombinant interferon alpha-2b (3 million units 3 times a week) for one year, resulting in complete clinical remission and undetectable levels of serum hepatitis C virus RNA. AST and ALT normalized and proteinuria decreased from 2.78 to 0.98 g/day. However, a relapse occurred when therapy was stopped. Additional therapy with interferon-alpha (5 million units 3 times a week for 9 months) resulted again in quick and prolonged remission. The clinical course of our patient showed sustained clinical and virologic response after high-dose interferon-alpha treatment confirming the usefulness of interferon alpha in treatment of patients with cryoglobulinemic glomerulonephritis. Our observation is in agreement with others, suggesting that recommended standard dosage and duration of initial treatment with interferon alpha should be re-evaluated. Although our patient had sustained virologic and clinical response after interferon alpha monotherapy, recent studies clearly support combination therapy of interferon alpha and ribavirin for treatment of chronic HCV infections.

Antiviral Agents↗
PubMed1999

Quantitative tissue carcinoembryonic antigen (T CEA) assay as a screening test for severe dysplasia in colorectal adenomas.

Relationship between the serum (S CEA) and the tissue (T CEA) carcinoembryonic antigen concentrations with regard to the degree of dysplasia in colorectal adenomas was investigated. Our study included 56 single or multiple colorectal adenomas in 46 patients. The measurements of T CEA concentrations were performed using the quantitative CEA-EIA method (Abbott) modified for wet tissue, obtained from heads of the adenomas. As a control point the mucosa near adenoma and the rectal mucosa were used. Our results suggest that the T CEA concentrations from the head of the adenoma demonstrate a highly significant difference between mild and severe dysplasia (P < 0.001), between mild dysplasia and invasive adenocarcinoma (P < 0.001) and a significant difference between mild and moderate dysplasia (P < 0.05). On the other hand, the S CEA concentrations corresponding to these cases showed no such differences. In conclusion, we suggest the quantitative measurement of T CEA concentrations as a screening test for severe dysplasia in colorectal adenomas.

Adenoma↗
PubMed1989

[Tissue carcinoembryonic antigen: a screening test for increased cell proliferation?].

A relationship between the tissue and serum concentrations of carcinoembryonic antigen (CEA) as determined by the enzymoimmunoassay (EIA) was studied in 46 patients with colorectal carcinoma and 47 patients with gastric carcinoma. The values were then compared to those obtained in the control group of 64 healthy subjects. Serum CEA concentrations were measured in all of them, whereas tissue CEA concentration was determined in the rectal and gastric mucosa homogenates in 30 and 34 subjects, respectively. As expected, no differences were observed in the levels of serum CEA concentrations in either of the healthy subject subgroups. The serum CEA concentrations were found to be at the normal level of 2.5 ng/ml. In both subgroups of healthy subjects, the tissue CEA concentration was found to significantly differ, but the same was in colorectal and gastric carcinomas as compared to the normal rectal and gastric mucosa. When the process extent according to Dukes' classification in 22 patients with colorectal carcinoma operated on was compared to the relationship between the tissue and serum CEA concentrations, the serum CEA concentration of CEA was shown to depend on the tumor mass, regardless of the level of the specific tissue CEA concentration. Unusually high values of tissue CEA concentration, along with normal serum CEA concentration, were observed in 3 healthy subjects. A relationship between the tissue and serum CEA concentrations according to the degree of differentiation, studied in colorectal carcinomas, revealed significantly lower values of tissue CEA concentration in poorly differentiated carcinomas (P less than 0.01), whereas serum CEA concentrations did not show any such difference.

Adult↗
PubMedDate not supplied

[Strumal carcinoid tumor of the ovary--histologic and electron microscopy characteristics of the tumor].

Strumal carcinoid tumor is a very rare primary tumor of the ovary in which carcinoid is admixed with tissue resembling thyroid follicles. We report a 44-year-old women with benign strumal carcinoid tumor of the ovary and without any clinical symptoms. Histochemical and electron microscopical examinations of the tumor showed intracytoplasmic dense core secretory granules, indicating that this neoplasm is a pure carcinoid tumor with acinar differentiation resembling thyroid tissue.

Adult↗
PubMedDate not supplied

[Primary neuroendocrine carcinoma of the skin (Merkel cell tumor)].

Three cases of neuroendocrine carcinoma of the skin studied by light and electron microscopy and by immunohistochemical methods, are presented. It is generally accepted that these tumors originate from Merkel's cells. Some consider that they belong to the group of APUD-omas. Positive findings of epithelial (EMA, CAM 5.2) and neuroedocrine marker (NSE) in these three cases support the hypothesis of neuroendocrine differentiation in a neoplasm of epithelial origin.

Antigens, Neoplasm↗