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Biomedical subjects

W Samborski

Publications and source records attributed to W Samborski.

At least 19 recordsLinked to original sources

Acute phase proteins serum concentrations in children are related to urinary iodine excretion.

PURPOSE: The paper presents links between iodine provision and selected acute phase proteins' (APP) serum concentrations as well as their glycosylations profiles (investigated with the use of affinity immunoelectrophoresis with Concanavalin A as ligand) in children. MATERIAL AND METHOD: 116 children (58 girls and 58 boys) were enrolled. Iodine level was measured in the morning (7:30-8:30) urine portion, using Cr-As method. According to iodine level children were divided into two groups. The first one consisted of 56 children with decreased iodine level (lower than 100 micrograms/L), second--60 children with iodine level higher than 100 micrograms/L. In serum the concentration of ferritin, beta2-microglobulin (beta2-MG), thyroxin (T4), triiodothyronin (T3), thyrotrophic hormone (TSH) were measured by radioimmunoassay (BELORIS, Belarus). Concentrations of APP: C-reactive protein (CRP), alphal-acid glycoprotein (AGP), alphal-antichymotrypsin (ACT), alphal-antitrypsin (AT), haptoglobin (Hp), alpha2-macroglobulin (A2-M), ceruloplasmin (Cp) and transferrin (Tf) were measured in sera samples by rocket immunoelectrophoresis acc. to Laurell with antibodies and standard from DakoCytomation, Denmark. Microheterogeneity of AGP, ACT and Tf was estimated using affinity immunoelectrophoresis with ConA as a ligand, acc. to Bøg-Hansen. RESULTS: It was established, that CRP level was lower than upper limit of normal range. Levels of other investigated proteins were reliably dependent on the level of iodine. Especially for AGP lower level was observed for children of the group with low iodine level. In children with low iodine level along with the decrease of serum AGP concentration altered glycosylations profile was observed, namely decrease in the content of variant non-reactive to ConA (W0) and increase in content of weakly reactive (W1) and reactive (W2) variants content, which resulted in increase of the reactivity coefficient (AGP-RC). Similar tendency in alterations of distinctly glycosylated variants in relation to iodine level could be shown for ACT. Serum concentration of any investigated protein was not dependent on the concentration of the hormones of pituitary-thyroid system. CONCLUSIONS: It seems that the influence of the iodine level is direct, not via thyroid hormones. It could be suggested that in euthyroid children with low iodine excretion with urine a hidden iodine deficiency is already registered by the regulatory mechanisms and a kind of acute phase reaction is started, may be in order to increase iodine uptake and storage.

Acute-Phase Proteins↗

Alterations of lymphocyte subpopulations in choroidal melanoma patients undergoing surgery.

PURPOSE: The alterations of lymphocyte subpopulations assessment after surgery in choroidal melanoma patients compared to cataract patients. MATERIAL AND METHODS: 12 patients with malignant melanoma of the choroid, 10 patients subjected to surgery due to cataract. Methods--flow cytometric measurement of absolute lymphocyte count, the number of all T cells (CD3+), T helper lymphocytes (CD3+ CD4+), T cytotoxic lymphocytes (CD3+CD8+), B lymphocytes (CD19+), NK cells (CD3-CD16+) and T cells (CD3+) cells with gammasigma TCR, on the day of surgery and two days after it. RESULTS: Comparable numbers of cells were observed in both groups prior to surgery, but the behavior of some populations differed: CD3+, CD3+CD4+ cells increased in melanoma patients whereas they decreased in reference group, the number of T lymphocytes with gammasigma TCR was significantly higher in melanoma patients before surgery and it did not differ after it. CONCLUSIONS: Though there were no significant differences in lymphocyte subpopulations between melanoma patients and the reference group, it seems that the presence of tumour influences the reactivity of the immune system to the trauma (surgery).

Adult↗

Development and psychokinetic therapy of children suffering from West Syndrome--an overview.

Paper presents reasons leading to the West Syndrome, disturbances occurring in the child's development and possible rehabilitation programmes. Psychological rehabilitation of a child with West Syndrome is multilateral, but its main aim is to improve the quality of life, social adaptation and optimizing of the cognitive functioning. Taking into consideration the psychokinetic retardation occurring in the West Syndrome because of prenatal, perinatal or postnatal disturbances apart from pharmacotherapy an intensive psychokinetic stimulation based on plasticity of the brain should be stressed out. Only the complex, intensive and long lasting rehabilitation of a child may secure to it the best possible development.

Child↗

Open trial of mirtazapine in patients with fibromyalgia.

BACKGROUND: Some positive therapeutic effects in fibromyalgia syndrome (FS) were reported with both tricyclic and new antidepressant drugs as well as serotonergic agents (5HT2 and 5HT3 receptor blockers). METHODS: In the present study, a novel antidepressant drug mirtazapine, 15-30 mg/day, has been used in 29 patients with FS in an open trial. RESULTS: Twenty-six patients completed the six-week study. Ten (38%) were considered responders on account of the reduction of > or =40% on pain, fatigue and sleep disturbances and remission of depressive symptoms at the end of study. Eighteen patients had at least moderate depression before mirtazapine treatment and 8 patients presented mild depressive symptoms. Reduction on main symptoms of FS after 6 weeks of mirtazapine treatment significantly correlated with the reduction in depression. However, the percentage of responders and patients with > or = 40% reduction on main symptoms of fibromyalgia was similar in high and low depression groups. CONCLUSIONS: The results obtained suggest that mirtazapine may be promising method of FS treatment. Further double-blind placebo-controlled studies are required to confirm these results.

Adrenergic alpha-Antagonists↗

Intra-articular treatment of arthritides and activated osteoarthritis with the 5-HT3 receptor antagonist tropisetron. A double-blind study compared with methylprednisolone.

BACKGROUND: Since the good effect of intra-articular injections of the 5-HT3 receptor antagonist tropisetron in patients with arthritides and activated osteoarthritis has already been demonstrated in pilot studies, the effect of tropisetron is compared with that of methylprednisolone here. OBJECTIVES: In a double-blind study, 34 patients with gonarthritides or activated osteoarthritis (18 patients with rheumatoid arthritis, 16 patients with osteoarthritis) were treated with a single intra-articular injection of 10 mg tropisetron (18 patients) or 40 mg methylprednisolone (16 patients). Before treatment as well as one and three weeks later, the intensity of rest pain and pain following exercise was measured with the visual analog scale (VAS) for pain and the clinical findings in the knee joint were recorded. RESULTS: By means of the intra-articular tropisetron treatment, the inflammatory joint process with arthritides and activated arthroses could be influenced in a similar way as with corticosteroid treatment. No significant differences were detected. CONCLUSION: According to the results presented here, the intra-articular treatment with the 5-HT3 receptor antagonist tropisetron in patients with gonarthritides and activated arthroses was about equally effective as those for treatment with corticosteroids. Therefore, it can be used as an alternative in patients for whom concomitant diseases like diabetes and hypertension make it difficult to use corticosteroids. Whether increasing the tropisetron dose may further improve the results remains to be determined in future studies.

Adult↗

Effects of antidepressant mirtazapine on fibromyalgia symptoms.

PURPOSE: Fibromyalgia syndrome (FS) is a form of non-articular rheumatism. The main criteria are the widespread musculoskeletal pain and tender points at multiple characteristic sites which are associated with several vegetative and functional symptoms. Depression is the most frequent psychiatric concomitant of FS. Etiology is unknown, connection between disturbances of serotonin metabolism and pathogenesis is postulated. Pharmacological therapy with analgetic and nonsteroidal antiinflammatory drugs is not very effective. Positive effects were reported in some patients treated with antidepressant drugs, especially serotonergic agents. MATERIAL AND METHODS: In the study a novel antidepressant drug mirtazapine was used characterized by selective blockade of 5-HT2 and 5-HT3 receptors. In an open trial participated 29 patients with FS, who met 1990 ACR criteria for fibromyalgia. All were treated with mirtazapine for 6 weeks. Intensity of pain, sleep disturbances, fatigue and other symptoms were measured using visuale analogue scale, severity of depression was evaluated with HDRS and BDI. RESULTS: An open trial completed 26 patients, the majority of them experienced a clinical improvement at the end of the study as a consequence of > or = 40% reduced intensity of fibromyalgia symptoms as well as reduced severity of depression. The significant correlation between reduction in depression after 6 weeks of mirtazapine treatment with the reduction on all four main symptoms of FS suggests a common pathophysiology of depression and symptoms of fibromyalgia. The data thus far obtained indicate the blockade of 5-HT2 and 5-HT3 receptors with mirtazapine as an effective and promising method in FS. CONCLUSIONS: Further double-blind placebo-controlled study are required to confirm our results.

Adult↗

Interleukin-10 and interleukin-6 in lupus erythematosus and rheumatoid arthritis, correlations with acute phase proteins.

We sought to investigate the influence of interleukin-10 (IL-10) and IL-6 on the acute phase proteins (APP) in systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). IL-10, IL-6, Creactive protein (CRP), alpha-1-acid glycoprotein (AGP), and alpha1 antichymotrypsin (ACT) serum levels were determined in one hundred-eight patients (71 with SLE, 37 with RA). Quantification of the serum IL-10 level showed increased levels in SLE and RA patients as compared to healthy controls. Serum IL-6 level was found to be elevated in SLE and RA patients. A correlation between IL-10 and IL-6 serum level was found only in SLE. CRP and AGP serum levels were increased in RA as compared to controls, whereas in SLE only AGP was found elevated. A statistically significant correlation between IL-6 serum level and CRP, AGP and ACT was found only in RA. No correlation between IL-10 and serum level of CRP, AGP and ACT was established. Since IL-10 has a potent immunosuppressive activity, we expected it to be negatively correlated with APP levels. Surprisingly, IL-10 did not correlate with APP either in SLE or RA patients. However, the elevation of IL-10 serum levels in SLE and RA and the correlation between IL-10 and IL-6 in SLE may suggest that IL-10 may play a central role in inflammatory connective tissue diseases.

Acute-Phase Proteins↗

The lymphocyte phenotype in patients with primary fibromyalgia.

The aim of this study was to examine the lymphocyte phenotype in fibromyalgia (FB) patients. Nineteen patients [18 females, 1 male] who met the ACR classification criteria for FB were recruited into the study. The fluorescence of leukocytes was measured using Ortho Cytotron Absolute flow cytometer. Ortho-mune monoclonal antibodies [OK-Combo-Tests] were used for determination of the following antigens: CD3/CD19, CD3/HLA-DR, CD4/CD8, CD45RA/CD4. Serum IgE was established with ELISA [Merck, Germany]. There were no differences in percentage of CD3, CD19, CD4, CD8, CD3/HLA-DR and CD4/CD45RA cells as compared to healthy controls. We found a negative correlation between CD4 and CD8, CD3DR and IgE, CD8 and IgE concentration. The positive correlation between CD3 and CD3DR, CD3DR and CD8 was observed. The inhibitory effect of CD8+ cells subpopulation on B-cells and thereby on IgE production in patients afflicting for allergy has been already observed. Moreover, the symptoms to allergy has been found in about 50% of our patients. Taken together the data thus far obtained present a coexistence of symptoms of allergy and FB.

Adult↗

Do changes in clinical improvement in rheumatoid arthritis patients treated with immunosuppressive drugs reflect the changes in acute phase proteins?

We sought to investigate whether clinical improvement after immunosuppressive treatment reflects changes in acute phase response (APR) in rheumatoid arthritis (RA). Fifty-eight patients (pts) were treated with methotrexate (MTX), nineteen with intravenous cyclophosphamide (CTX), and fifteen with cyclosporin A (CSA). C-reactive protein (CRP), alpha-1-acid glycoprotein (AGP), alpha-1 antichymotrypsin (ACT), and alpha-1 antitrypsin (AT) serum levels were measured by nephelometry or rocket immunoelectrophoresis. Clinical improvement was observed in 67% MTX pts, 53% CTX pts, and 47% CSA pts. Baseline serum levels of CRP, AGP, ACT, and AT were significantly higher as compared to healthy controls. After MTX and CTX therapy CRP level significantly decreased. The decrease in serum level of ACT and AT in CTX treated patients was also observed. All analyzed acute phase proteins remained substantially elevated after CSA therapy despite a clear reduction in disease activity. We established a correlation between changes in disease activity and all acute phase proteins (APP) in MTX and CTX pts. From our study we can conclude that clinical improvement after immunosuppressive treatment correlated with quantitative changes in all APR markers in MTX and CTX treated pts, and none in CSA pts. Although measurement of APP remains the best marker for monitoring RA pts, not always they properly reflect changes in disease activity.

Acute-Phase Proteins↗

Cold-induced vasospasm in patients with fibromyalgia and chronic low back pain in comparison to healthy subjects.

Using capillary videomicroscopy of the nail fold, the frequency of cold-induced vasospasm and capillary hemodynamic parameters were studied after application of cold in 50 patients with primary fibromyalgia, 50 patients with chronic low back pain, and 50 healthy controls. Cold-induced vasospasm was detected in 38% of the patients with fibromyalgia. In this group it was significantly more frequent than in the patients with chronic low back pain (20%, p < 0.05) and healthy subjects (8%, p < 0.001). In the fibromyalgia group, the magnitude of vasospasm as measured by the capillary blood flow deceleration after cold application correlated negatively with the pain intensity as measured by pain score (r = -0.3839, p < 0.01). No differences in clinical appearance were found between patients with and without cold-induced vasospasm in both the fibromyalgia and low back pain group.

Adult↗

Comparison of microheterogeneity of alpha-1-acid-glycoprotein in serum and synovial fluid from rheumatoid arthritis patients.

Microheterogeneity of alpha-1-acid glycoprotein was studied using affinity immunoelectrophoresis with concanavalin A as a ligand in the samples of serum and synovial fluid obtained at the same time from 22 patients with rheumatoid arthritis. Individuals with intercurrent infection or other illnesses were excluded from the study. The results were expressed as reactivity coefficient (RC). Disease activity was evaluated by Mallya-Mace Activity Score, Lansbury Joint Index and laboratory tests. In most of the studied samples the glycosylation pattern was similar, composed of a nonreactive variant and 2 reactive (the first and the second) with Con A variants. In seven samples of synovial fluid an extra third peak representative of the strongly reactive one with Con A fraction was observed. It was the cause of the remarkable elevation of AGP-RC. Moreover, the level of IgM and IgA RF was higher in the synovial fluid derived from these patients--with the presence of the third peak in AFF-EP with Con A--than in those without the considered fraction.

Adult↗

[Serotonin concentration in serum of patients with generalized tendomyopathy (fibromyalgia) and chronic polyarthritis].

The serum concentration of serotonin (S-5-HT) was measured in 31 patients with primary fibromyalgia, 21 patients with rheumatoid arthritis (RA) (15 of them with secondary fibromyalgia) and 20 healthy volunteers. Both patients with primary fibromyalgia and rheumatoid arthritis had significantly lower S-5-HT levels when compared to healthy controls, and S-5-HT concentrations in patients with secondary fibromyalgia were even significantly lower than those of RA-patients. Unlike the patients with rheumatoid arthritis, a significant correlation between S-5-HT level and the number of "tender points" as well as mean pressure tenderness at 24 different points was found in patients with primary fibromyalgia. Conversely, in patients with rheumatoid arthritis the S-5-HT level correlated significantly with erythrocyte sedimentation rate. These results suggest different pathological mechanisms of S-5-HT decrease in patients with primary fibromyalgia and rheumatoid arthritis. On the other hand, they raise the question whether secondary fibromyalgia may be a pathogenetically different syndrome mimicking symptomatically primary fibromyalgia.

Adult↗

[Acquired platelet storage pool deficiency in rheumatoid arthritis].

A 64-year-old woman with a 15-years-history of rheumatoid arthritis developed generalized hemorrhagic diathesis. Routine coagulation tests revealed a slightly diminished platelet count only. Platelet aggregation in vitro induced by ADP, collagen, thrombin, arachidonic acid and ristocetin were reduced. The patient's plasma aggregating activity was significantly diminished which was due to a decrease of the intraplatelet nucleotide pool. The number of mepacrine labelled bodies as well as dense bodies in electron microscopy was below the normal values as well. Moreover, the intraplatelet concentration of cyclooxygenase--malonylodialdehyde (MDA) and lipoxygenase pathway products were lowered. Total platelet immunoglobulin G and M contents were significantly increased. The platelet survival time (in vitro aspirin method) was slightly shortened. Finally the diagnosis of delta-acquired platelet storage pool deficiency (delta-SPD) was established and possibilities of treatment were discussed.

Arthritis, Rheumatoid↗

[Can thermal therapy of ankylosing spondylitis induce an activation of the disease?].

A randomized, open, controlled study was carried out in eight patients with spondylitis ankylosans, in a cross-over procedure including total body cryotherapy and whole spine paraffin mud packs. The effect of both therapies on clinical status and different laboratory data was investigated. No clinical changes were seen after either therapy; in contrast, in answering the spine function questionnaire patients reported an improvement after cryotherapy and a worsening after thermotherapy, but because of the small number of patients no positive conclusion was possible. The acute phase proteins (alpha-1-AGP, alpha-1-ACT, alpha-2-haptoglobin and alpha-2-coeruloplasmin) did not show any changes, only CRP increased after thermotherapy and declined after cryotherapy. Interesting changes were seen in the glycosylation profile of alpha-1-AGP: after thermotherapy an increase of bi-antennary oligosaccharides occurred, observed as appearance of a third peak in the affinity immunoelectrophoresis with con A and an increase of reactivity-coefficient of alpha-1 and glycoprotein which was also seen in the exacerbation of AS. This shows, that an activation of the inflammatory process may be possible by thermotherapy (perhaps because of an amplification of Il-6 production), but not by cryotherapy. Similar studies should be conducted in larger numbers of patients.

Acute-Phase Proteins↗

[Recording muscle spasm in the musculus erector spinae using in vivo 31P magnetic resonance spectroscopy in patients with chronic lumbalgia and generalized tendomyopathies].

Using 31P nuclear magnetic resonance, the following parameters were determined in the resting musculus erector spinae of five patients suffering from chronic low back pain, five patients with fibromyalgia, and five healthy controls: Inorganic phosphate (Pi), phosphocreatine (PCr), ATP gamma, ATP alpha, ATP beta. The intracellular pH was derived from the chemical shift of Pi referenced to the PCr resonance. In addition, the Pi-Index was calculated according to the formula: Pi/(Pi + PCr). We discovered a tendency towards a shift of the Pi resonance in the alcalic direction, which was the larger, the stronger muscle spasm was found on palpation. The pH showed the most reliable relationship to the clinical status of muscle spasm. The surprising finding that there is no acidification within the spasmed muscle indicates that generalized hypoxia does not exist in this tissue. This has already been shown with PO2 measurements. An intracellular acidification is only recorded during maximal isometric contraction. Thus, ischemia cannot be responsible for pain experienced during muscle spasm.

Acid-Base Equilibrium↗

[Intraindividual comparison of whole body cold therapy and warm treatment with hot packs in generalized tendomyopathy].

In a cross-over study, the short-term efficacy of whole-body cold therapy and hot mud packs in patients with generalized tendomyopathy (fibromyalgia) was compared. As a pain assessment, visual analog scale and so-called pain score were measured; dolorimetry of the 24 tender points and eight control points was performed as well. Using these methods, we found that there is a significant improvement of all parameters examined during a 2-h period of measurements after cold application, and a marked improvement was also detectable 24 h after this therapy. In contrast, only pain score values showed a slight decrease immediately after hot mud-pack therapy, and no significant differences were found in visual analog scale and pressure tenderness as measured dolorimetrically. Central inhibition of nociceptors as a result of an activation of A-delta system as well as a blockade of gamma-motoneurons are discussed to be a mechanism of action of whole-body cold therapy, resulting in a decrease in muscle tonus. Long-term studies are needed to determine, if there is any enduring effect of whole-body cold therapy on pain in the patients with generalized tendomyopathy.

Cryotherapy↗

[Comparative studies of the incidence of vegetative and functional disorders in backache and generalized tendomyopathies].

The incidence of 14 different vegetative and functional symptoms in patients with generalized tendomyopathy (fibromyalgia), chronic low back pain syndrome, and healthy controls was compared. The presence of these symptoms was a common finding in patients with generalized tendomyopathy. Although not so frequent, a number of these symptoms was also found in patients with chronic low back pain syndrome. Our findings suggest that presence of 7 or more symptoms is typical for generalized tendomyopathy and could be used as an additional criterium for diagnosis and classification of this disease. Further prospective studies are needed for confirming the hypothesis that chronic low back pain syndrome could lead to generalized tendomyopathy.

Adult↗

[Pressure point studies in generalized tendomyopathy (fibromyalgia) (comparison of various methods)].

There are different methods used for examination of tender-point pressure tenderness, which is one of the two most important criteria for diagnosis of generalised tendomypathy (fibromyalgia). When 11 of 18 tender points must be painful under the pressure of 4 kg for fulfilling the criteria of American College of Rheumatology (ACR), we require 12 of 24 points to be tender when pressed with a force less than 2 kg using dolorimeter. We have found that our method have a significantly higher specificity with about the same sensitivity, when compared with by ACR proposed method. Specificity and sensitivity depended on method used for pressure application and not on points examined. In view of our findings, we propose for scientific purposes dolorimetric measurement of pressure tenderness as being more reliable although more time-consuming method.

Adult↗