Slovakia
online
Volume 97 / No. 4/ 1996
IMMUNOPATHOGENIC MECHANISMS OF AUTOIMMUNE PROCESSES: AUTOANTIGENS
BUC M.
The primary function of the immune system is the recognition of the
organism’s own structures (self) which are to be tolerated, and alien structures
(non-self) which are to be eliminated. In some cases, however, the immune
mechanisms react against their own structures thus resulting in autoimmune
processes which lead to autoimmune diseases. The paper analyzes the problem
of autoantigens (sequestered, modified, cross-reacting), superantigens
and the problem of cryptic determinants in the development of autoimmune
processes, namely on the basis of the loss of the central or periferal
tolerance. (Tab. 4, Fig. 5, Ref. 38.)
Key words: antigen presentation, autoimmunity, autoantigens, HLA-system,
heat shock proteins, immune response, superantigens, tolerance.
Bratisl Lek Listy 1996; 97: 187–195
CONCENTRATION OF GLUTATHIONE IN ERYTHROCYTES, CERULOPLASMIN AND TRANSFERRIN IN SERUM, AND THEIR ROLE IN ANTIOXIDATIVE PROTECTION
MEKINOVA D., BENO I., VOLKOVOVA K., STARUCHOVA M., TATARA M.
All organisms are protected from harmful reactive oxygen which is produced
also under physiological conditions by a complex antioxidative system.
Our work was aimed at the ascertainment of the level of reduced and oxidated
glutathione in erytrocytes of healthy people, the concentrations of ceruloplasmin
(GSH) and transferrin (GSSG) in the serum, as well as the invetigation
of the relationship to antioxidative enzymes — Cu, Zn-superoxide dismutase
(SOD), catalase (CAT) and Se-glutathione-peroxidase (GPx) in erythrocytes.
We discovered a mutual direct linear correlation between the levels of
GSH, GSSG, CPL and TRF, indirect linear relation between the concentrations
of TRF, GSH, GSSG and activities of SOD and GPx, between the concentrations
of CPL and GPx activities, and a direct linear relation between concentrations
of GSH and TRF with CAT activity. The results indicate to a mutual dependence
of investigated nonenzymatic antioxidative factors and antioxidative enzymes.
(Tab. 2, Fig. 4, Ref. 13.)
Key words: antioxidative enzymes, glutathione, ceruloplasmin, transferrin.
Bratisl Lek Listy 1996; 97: 196–199
SURGICAL TREATMENT OF PATIENTS WITH TRANSPLANTED ORGANS
VAJO J., PALINSKY M., MYDLIK M., JANIK M., PONIST J., KUNDRAT I., STUBNA J., SCHWARTZ P.
Patients after successful transplantation with immunosuppressive therapy
form a "new circle of surgical patients" who can develop various
surgical diseases, or injuries which bring about an inevitable urgent or
planned surgical treatment.
The authors present the results in three patients with transplanted
organs (1993—1995) who were subdued to various surgical treatments. The
first patient underwent a classical cholecystectomy, choledochotomy, and
extraction of concrement from the choledochus after orthotopic transplatation
of the heart. The second patient underwent transplantation of the kidneys
precedingly to bilateral subtotal resection of both lobes of the thyroid
gland due to marked bilateral nodal goitre intervening deeply retrosternally
with a severe pressure syndrome on trachea and oesophagus. The immediate
and long-term results were excellent. Orthotopic transplantation of the
heart in the third patient preceded to intercostal drainage of the thorax
and evacuation of pus due to an extensive empyema of the thorax and septic
state, and later thoracotomy and decortication with extirpation of the
substantial part of the empyema sack was performed with an excellent immediate
and long-term effect. The authors present the principles which must be
inevitably fulfilled in coincidence with successive surgical treatment
in patients with transplanted organs in a permanent immunocomplex regime.
(Fig. 2, Ref. 11.)
Key words: transplantation, posttransplantation operations.
Bratisl Lek Listy 1996; 97: 200–203
CIEVNE KOMPLIKACIE REKONSTRUKCNEJ A REPLANTACNEJ CHIRURGIE
FRANKOVICOVA M., BOBER J., BLAZEJOVA J., SUDAK M.
Authors deal with the causes of complications in reconstructive and
replantation surgery of the hand. The most common complications are of
vascular origin. Early revision, removal of all devitalized tissue and
autoplastics of arteries and veins combined with ATB treatment contribute
to their successful management. (Fig. 7, Ref. 6.)
Key words: vascular complications, reconstructive surgery, replantation
surgery.
Bratisl Lek Listy 1996; 97: 204–207
THE IMAGING OF TRANSPLANTED LIVER
WEILL F.S., HRUSOVSKY S.
The study brings about the newest information on possibilities of imaging
the liver, its vessels, biliary ducts and further organs in coincidence
with liver transplantation. (Fig. 7, Ref. 39.)
Key words: imaging of liver, liver transplantation, duplex ultrasonography.
Bratisl Lek Listy 1996; 97: 208–215
TREATMENT OF LOWER CERVICAL SPINE FRACTURES (C3—C7)
LOHNERT J., LATAL J., MALY M., HUDEC J., BAKA J.
Spinal surgery dealing with reparation of injury consequences by stabilisation
implantates is a relatively new surgical branch. The experience and results
at individual departments in Slovakia in this field differ significantly
as to their qualitative degree.
The Trauma Surgery Department IVZ in Bratislava and the National Rehabilitation
Center in Kovacova cooperate since 1989 in a mutual spinal programme. 177
out of 189 patients survived after undergoing a surgical treatment due
to the injury of the lower cervical spine performed from 1988 to 1994.
68 patients (Frankel A, B, C) were included into the spinal programme.
The authors present the therapeutical results evaluated according to morphologic,
neurologic, functional and subjective criteria.
The most frequently used stabilizing method is the so-called method
of Caspar and the technique of Morscher, the latter being less frequently
applied. Both methods are fully secure, causing minimal blood loss, perfectly
stable as to the angle and axis. Both techniques enable a sufficient approach
to the decompression of the spinal cord. Since they do not demand any additional
external rigid fixation, they are excellently tolerated by patients and
only minimally restrict movement. (Tab. 2, Fig. 4, Ref. 8.)
Key words: cervical spine fractures, Caspar’s technique, surgical
treatment of fractures.
Bratisl Lek Listy 1996; 97: 216–219
LAPAROSCOPIC CHOLECYSTECTOMY VERSUS CLASSICAL CHOLECYSTECTOMY
MAZUCH J., CUPKA I., BRUNCAK P., GEC K., PELC J., MACHAN L., ZAHER M.
The authors evaluated the results after classical (CCHE) and laparoscopic
cholecystectomies (LCHE) in the period from March 16 1994 to June 30 1995.
In this period they operated on 408 patients, out of which 208 were operated
by the laparoscopic technique. There were no differences in postoperative
morbidity. The mortality after laparoscopic surgery was 0 % and the classical
cholecystectomy reached the morbidity of 1.4%. Complicated patients were
usually operated in the classical way. The time of hospitalisation after
LCHE was 5.2 days and after CCHE 8.3 days. The results of LCHE were as
follows: morbidity 10.5 %, conversions 2.4 %, reoperations 1.4 %, and no
leakage of the bile duct. We saved 40 % of costs using LCHE. All these
facts show that LCHE is advantageous, secure and well tolerated by patients.
The patients prefer comfort after the operation, good cosmetic effect and
a short hospital isation. CCHE did not lose its position, especially in
complicated cases. (Tab. 5, Ref. 21.)
Key words: classical cholecystectomy, laparoscopic cholecystectomy,
complications.
Bratisl Lek Listy 1996; 97: 220–223
CLINICAL DIAGNOSTICS, SOME PARTICULARS, AND THERAPY OF THE BUERGER’S DISEASE
PUCHMAYER V.
Some authors still doubt that the Buerger’s disease is an independent
disease entity and differs principally from obliterating atherosclerosis.
This is why the author draws attention to many specific characteristics
of this disease and differences which distinguish it from atherosclerosis
of peripheral arteries. After some introductory notes the author presents
that the prevalence of thrombangiitis in Europe ranges from 0.5 to 2 %
out of all ischemic diseases of limbs, while in Japan it reaches 20—30
%. Previously the ratio of affliction of men and women was 100:1; presently
some authors present the ratio being 10:1. The upper limbs are usually
afflicted by this disease much more often than by obliterating atherosclerosis,
and frequently already at the beginning of the disease. The main and only
proved risk factor is smoking. However a predisposition is necessary (the
predisposition is more frequent in the yellow race). The Buerger’s disease
is an autoimmune disease responding to the antigen-antibody complex. Laboratory
results are positive in coincidence with inflammatory markers, especially
in recurrent cases. Histology appoints to inflammatory vascular lesions,
sometimes accompanied by a positive finding of IgG deposits, IgM, and immunocomplexes.
Clinically, particularly peripheral vessels are afflicted, the disease
is initiated usually before 40 years of age and is of a typical arteriographic
pattern. It is also characteristic for its migrating phlebitis. The clinical
picture has some specific features. The disease can be localized also in
the coronary, cerebral and visceral arteries.Besides the general procedures
in ischemic diseases of the limbs, the therapy must necessarily, respect
also some particulars, as e.g. antiinflammatory therapy (antibiotics, antirheumatics,
corticoids) and some specific surgical procedures. (Ref. 75.)
Key words: Buerger’s disease, endangiitis obliterans, thromboangiitis
obliterans.
Bratisl Lek Listy 1996; 97: 224–229
CROHN’S DISEASE IN THE ADULT POPULATION IN SLOVAKIA
PRIKAZSKA M., LETKOVICOVA M.
The requirement of preparing a fundamental epidemiological study concerning
the incidence of Crohn’s disease in Slovakia became very important after
the splitting of Czecho-Slovakia. The authors in cooperation with the regional
gastroenterologists present the study concerning the incidence of this
inflammatory bowel disease in the Slovak Republic up to 30th April 1994.
The multidimensional Kruskal—Wallis test for analyzing statistical differences
in incidence of Crohn’s disease according to age, sex, and regions was
used. Cluster analysis was used for investigation of the regional differences.
This study has shown that there is 6.75 cases of Crohn’s disease per 100
000 inhabitants in Slovakia. There are no differences in incidence rate
of Crohn’s disease between the regions. There are differences between the
districts: some of districts have both, absolutely and relatively high
number of cases, and in another districts, young people are more involved
in the analysed disease. The highest age specific incidence rate of Crohn’s
disease was between 30—49 years. (Tab. 1, Fig. 7, Ref. 14.)
Key words: epidemiology, Crohn’s disease, statistical analysis,
regional differences.
Bratisl Lek Listy 1996; 97: 230–233
LONG-TERM RESULTS OF SURGICAL THERAPY IN PULMONARY METASTASES OF GERMINATIVE TESTICULAR TUMOURS
SCHNORRER Jr. M., ONDRUS D., CARSKY S., BELAN V., MATOSKA J.
The authors analyse 34 cases of surgeries performed due to residual
pulmonary metastases with germinative testicular tumours. Good results
in the length of survival are ascribed to thoracotomy, or sternotomy with
the resection of metastatic foci, i.e. the only method which reliably ascertains
the biological nature of residual pulmonary lesion after chemotherapy.
(Tab. 1, Fig. 2, Ref. 17.)
Key words: testicular tumours, pulmonary metastases, chemo-therapy.
Bratisl Lek Listy 97, 1996, c. 4, s. 234–236