Analysis of changes in the percentage of B (CD19) and T (CD3) lymphocytes,subsets CD4, CD8 and their memory (CD45RO), and naive (CD45RA) T cells in children with immune and non-immune thyroid diseases

Graves' disease (GD) is an autoimmune thyroid disease caused by immunological abnormality. The immune cells (lymphocytes T and B) which infiltrate the thyroid gland play a key role in the development of autoimmune thyroid disease (AITD). The aim of this study was to evaluate the differences between distribution of T (CD3) lymphocytes, subsets CD4, CD8, and their memory (CD45RO), and naive (CD45RA) T cells and B (CD19) lymphocytes in the peripheral blood of patients with Graves' disease (GD) (n = 33, mean age 15.9 +/- 5.9 years) and non-toxic nodular goiter (NTNG) (n = 25, mean age 15.2 years), in comparison to age- and sexmatched healthy control subjects (n = 25, mean age 15.9 years). The percentages of peripheral blood lymphocyte subsets were analyzed by three-color flow cytometry using a Coulter EPICS XL cytometer. In the untreated Graves' patients we observed an increase in the percentage of CD19+ (p<0.007, p<0.003), CD4+ (p<0.004, p<0.017), CD4+CD45RO+ (p<0.04, NS), CD4/CD8 ratio (p<0.002, p<0.001) and a decrease in the percentage of CD8+ (p<0.02, p<0.02), CD4+CD45RA+ (p<0.04, p<0.03) cells in comparison to the healthy control subjects and euthyroid Graves' patients. These abnormalities were absent in children with non-toxic nodular goiter. In addition, the levels of CD3+, CD4+CD8+, CD8+CD45RO+ T cells and CD8 lymphocytes co-expressing CD45RA and CD45RO antigens were similar in all groups and no statistically significant differences were found in comparison to the healthy controls. In the untreated Graves' patients we found a positive correlation between serum levels of fT4 and fT3 and the percentage of CD19+ lymphocytes (r = 0.45, p<0.01, r = 0.37, p<0.04), between serum level of fT4 and the percentage of CD4CD45RO (r = 0.4, p<0.02) lymphocytes and between concentration of TRAb and CD4+ (r = 0.38, p <0.04) and CD19+ (r = 0.39, p<0.016) cells. Statistically significant negative correlations existed between TRAb, TPO-Ab or TG-Ab concentration in blood serum and the percentage of CD8+ lymphocytes (r = -0.55, p<0.002; r = -0.41, p<0.02; r = -0.51, p<0.004), and between fT4 concentration and the percentage of CD8+ (r = -0.39, p<0.02) lymphocytes. No such correlation was detected in patients with non-toxic nodular goiter. We conclude that the abnormal distribution of B lymphocytes, memory and naive T cell subsets in the peripheral blood in children and adolescents with untreated Graves' disease suggests their role in the development of autoimmunity. The normalization in the percentage of these immune cells after thyrostatic treatment in comparison to newly diagnosed patients confirms the immunomodulatory effect of methimazole therapy.     

Treatment of metabolic syndrome: drugs often but diet always - a case report

A case of a 32-year-old male with obesity and hypertension who was admitted to hospital with suspected acute myocardial infarction (MI) is presented. An initial diagnosis of MI was ruled-out, however, diabetes and marked hypertriglyceridemia were detected. Introduction of diet and proper diabetes control with insulin caused a marked decrease in triglyceride and cholesterol levels. After discharge the patient did not comply to dietary recommendations and stopped fibrates due to gastro-intestinal side effects which resulted in a marked elevation in lipid levels. Finally, statin therapy and better compliance to dietary recommendations resulted in the normalisation of cholesterol level, a marked decrease in triglyceride concentration and a loss of 5 kg of body weight. The need for combined treatment consisting of pharmacologic agents and life-style changes is stressed.     

Evaluation a range of the motion of knee during femoral lengthening by Ilizarov method

Background. Extensory contracture of the knee joint is a constant problem during thigh lengthening procedures. Its occurrence is dependent on such factors as rehabilitation, the construction of the Ilizarov apparatus, the extent of the lengthening, and the etiology of the shortening.
Material and methods. Between 1998 and 2001, 34 children were treated for thigh shortening. Contracture occurred in all cases.
Results. The dynamics of the lengthening process were strictly associated with the development and elimination of any contracture that appeared. If the indicated rules are followed, extensory contracture of the knee joints always resolved within several months after removal of the Ilizarov apparatus.
Conclusions. The importance of the proper rehabilitation program is equal to that of the surgical procedure. Limiting the number of impulses and localizing them is helpful in later rehabilitation.     

Terson syndrome in a course of cerebral aneurysm--clinical assessment

40 patients with ruptured cerebral aneurysm were screened by an ophthalmologist for the presence of Terson syndrome (TS) and other forms of ocular haemorrhages. Terson syndrome was found in 10% of cases and 37.5% of cases presented other forms of ocular bleeding. The most significant neurological symptom leading to diagnose TS, was coma episode occurring in any moment of clinical observation.     

Scarlet fever in Poland in 2001

In 2001, as compared to 2000, a 29.5% decrease in the number of scarlet fever cases was noted. The incidence was 15.2 per 100,000 population and was one of the lowest since the World War I. In particular voivodeships incidence ranged from 5.7 to 28.8 per 100,000 population. In urban areas the incidence was 32.3% higher than in rural ones. Of all registered cases 91.9% were children under 15 years of age. The age distribution of scarlet fever cases in 2001 was similar to the distribution observed in the last decade. The highest incidence was noted among children aged 6 and 5,169.1 and 155.1 per 100,000 respectively. About 2.1% of all cases were hospitalised. No scarlet fever deaths were noted.     

Hepatitis B in Poland in 2001

2,394 cases of hepatitis B (including 114 infections with both HBV and HCV) were reported in 2001 in Poland; the incidence rate was 6.2 per 100,000 population. The total number of cases decreased by 431 and incidence rate by 1.1 comparing to 2000. From 1993 to 2001 decline in number of cases was 5.5 times. This decline was mainly the result of vaccination of children and high risk patients though the improvement of sterilisation procedures could be of significance, especially in persons below 60 years of age. About 96.3% of all cases were hospitalised. Regional differences in both, the incidence rate and percentage of hospitalizations were observed. The incidence of hepatitis B per 100,000 was higher in urban (7.0) than in rural (4.9) population. The lowest incidence (0.4) was observed in children aged 0-4 years; in older children (5-9 years of age) the incidence rates were 4.5 in boys and 2.2 in girls. The highest ranging incidence, from 5.5 to 8.2 was found in the age group 15-24 years, especially in boys and young men (from 7.4 to 11.6) living in urban areas.     

Myxopapillary ependymoma of the lateral ventricle with local recurrences: histopathological and ultrastructural analysis of a case

An exceptional case of a recurrent intracranial ependymoma of myxopapillary type arising from the lateral ventricle is reported in a 37-year-old man. This distinctive morphological variant of ependymoma is virtually restricted to the region of cauda equina and filum terminale or occasionally to pre- or post-sacral soft tissue. The intracranial cases of myxopapillary ependymoma are extremely rare and are generally associated with the primary ependymal tumour at the typical lumbosacral site. This case of intraventricular myxopapillary ependymoma did not demonstrate any MRI evidence of a primary spinal cord tumour. Moreover, the initial diagnosis of this histologically benign tumour was followed by two tumour recurrences during the three-year follow-up period. To our knowledge, this is the third documented case of a primary intraventricular myxopapillary ependymoma and the first one of intracranial localisation associated with local recurrences.     

Changes of percentages in immune cells phenotypes and cytokines production during two-year IFN-β-1a treatment in multiple sclerosis patients

Abstract. Objective: The aim of the study was to find out whether INF--1a influences the immune profile of peripheral blood (PB) leukocytes in MS patients. Method: We have studied 20 patients with relapsing-remitting form of MS treated with INF--1a using twocolor cytometry. We determined immune cells phenotypes and production of some cytokines: IL-4, IL-10, IL-12, IFN-, before drug administration and after starting the treatment. Results: In MS patients an increased percentage of CD14⁺CD86⁺ cells and CD3⁺CD25⁺ cells was noticed after 6, 9 and 12 months of INF--1a therapy. Among cytokine-producing cells we noted an increased fraction of CD3⁺IL-4, CD14⁺IL-10 and CD14⁺IL-12 cells after 12 months, which decreased to the level observed before treatment after 24-month therapy. Conclusions: IFN--1a treatment was associated with significant changes in immune response. This effect was mostly evident within the first year of treatment.