The effect of large dose prednisone therapy on immunological markers in multiple sclerosis

The effect of large-dose prednisone therapy (3960 mg over 56 days) on humoral immunological markers and MRI pattern was studied in 25 patients with clinically definite multiple sclerosis. There was a decrease in levels of some studied markers (TNF in CSF, MBP level, IgG index, kappa chains in urine and kappa/creatinine ratio) after the treatment, but the differences reached statistical significance in some groups only. The decrease of total lesion area in MRI was not statistically significant. The obtained results proved clearly, that the above mentioned immunological markers might be helpful for monitoring of therapy in MS patients.     

The evaluation of the use of antineoplaston AS2-1 treatment in subacute sclerosing panencephalitis

A follow-up study was carried out of 16 SSPE patients two years after completion of 6-month treatment with Antineoplaston. The study was based on an inquiry sent to the families of the patients and on control examinations at the clinic. In the period of follow-up 6 patients died, all had the downhill type of disease course and their mean survival was 18 months. Out of the remaining 10 patients 4 are in stationary condition and the remaining ones had minimal worsening. A more detailed clinical analysis showed that half the patients were in contact with and general orientation in the environment, but impairment of motor functions made difficult in most cases self-care and self-dependent functioning. All patients had evident changes in brain MRI. The survival time of the patients has been as yet from 2.5 to 5.5 years (mean 3.9 years). The results of the treatment with Antineoplaston AS2-1 + isoprinosine are comparable with those observed during isoprinosine alone treatment but significantly worse than those after administration of Propionibacterium granulosum with isoprinosine. This suggests that Antineoplaston AS2-1 fails to modify importantly the natural course of SSPE.     

Cervical cord damage caused by discopathy coexistent with borreliosis (diagnostic difficulties)

Borreliosis is a systemic disease proceeding chronically, in stages and with dermatological, rheumatological and cardiological manifestations. In international terminology the name Lyme borreliosis is most commonly used. Recently the number of the incidents of this disease has increased in Poland as well, particularly among those employed in forests located in endemic regions, which has been confirmed in publications. In this article we present an unusual case of the coexistence of Borrelia burgdorferi infection with cervical medulla injury resulting from discopathy observed in a 65-year-old patient, who additionally suffered from arterial hypertension and diabetes.     

Neurological status improvement in central pontine myelinolysis in alcohol-dependent patient

The authors report a case of central pontine myelinolysis in a woman aged 30 years addicted to alcohol since at least 30 years. In the diagnosis the principal role was played by MRI. Attention is called to the disproportion between massive brainstem lesion and relatively low extent of neurological symptoms and signs. The patient had a several-weeks alcohol detoxication treatment and general supportive treatment. During that tine the neurological signs regressed nearly completely which suggests considerable reversibility or compensation of brainstem lesions in this syndrome.     

The costs of Alzheimer's disease treatment: the rationale of acetylcholinesterase inhibitors use?

The costs of Alzheimer's disease treatment in the era of acetylcholinesterase inhibitors use are critically discussed.     

Enzymatic Markers of Cyclosporine Nephrotoxicity in Patients after Renal Transplantation

Toxicity of cyclosporine (CsA), an immunosuppressive drug widely used in transplantation, to the transplanted kidney creates a serious side effect. Therefore, searching for sensitive indicators of nephrotoxic action is well worth the effort. In this work we decribe the results of estimation of urine concentration of lysosomal enzymes widely present in the kidney: N-acetyl--D-glucosaminidase (NAG), its isoenzyme NAG-B and -glucuronidase (-Gr). The studies were conducted in various periods after transplantation of kidneys, on patients under various treatments and receiving different doses of CsA. The results indicate a substantial dependence of the activity of NAG and NAG-B on CsA doses and the period after transplantation. The enzyme proved to be also a sensitive indicator of graft rejection. No such dependence was observed in the case of -Gr.     

Diagnostic Application of AAP Isoenzyme Separation

We describe the separation of alanylaminopeptidase (AAP) from urine into two isoenzymes: a particulate and a soluble form. The separation was accomplished using ion-exchange column chromatography on DEAE-52 cellulose. The purity of the isolated forms was confirmed electrophoretically. We attempted to create a method allowing the quantitative assessment of AAP isoenzymes in urine based on electrophoretic separation in 7.5% polyacrylamide gel with subsequent densitometric analysis. The content of AAP isoenzymes in examined urine was estimated using ultracentrifugation. The differences in the content of cytosolic and microsomal forms were observed suggesting the possibilities of using AAP isoenzymes in diagnostics. Furthermore, the effect of temperature on the activity of AAP separated on DEAE-52 cellulose was studied.     

Post-steroid elevations of intraocular pressure in patient after radial keratotomy

PURPOSE: The evaluation of frequency and amplitude of IOP elevations in patients after RK who were administrated topically dexamethasone. MATERIAL AND METHODS: RK was carried out in 90 eyes (55 patients). All these patients had been treated topically with 0.1% dexamethasone (Maxitrol, Alcon) since the first day after surgery till the period of 3 months in lowering doses. IOP was measured using air-puff tonometer (Reichert, USA) before surgery and on 1, 2, 3, 14, 30, 50, 90 day after RK. In case of IOP elevations the measurements were made more often. RESULTS: The mean IOP before surgery was 14.88 +/- 2.86 mm Hg for women and 16.14 +/- 2.83 mm Hg for men. In the period of 3 months after RK maximum IOP increased significantly both for women (mean: 21.46 +/- 7.51 mm Hg) and men (mean: 26.14 +/- 8.87 mm Hg). IOP higher than 25 mm Hg was observed in 35 eyes (37.7%). These IOP elevations were observed more often in men than women but this difference was not statistically significant. There was no correlation between frequency of IOP elevations and preoperative refractive error or the age of patients. CONCLUSIONS: The usage of steroids after RK requires careful monitoring of IOP. This subject needs further studies to answer if these IOP elevations can damage eye functions.     

The evaluation of morphological status of bulbar conjunctiva after long-term antiglaucoma drug therapy

The aim of this study was to examine the histopathologic picture of bulbar conjunctiva in glaucoma patients receiving topical antiglaucoma treatment. MATERIAL AND METHODS: Generally healthy patients with primary open angle glaucoma (POAG) and primary angle closure glaucoma (PACG) were included in our study. Conjunctiva specimens were obtained from the area of further fistula of 51 patients undergoing trabeculectomies and assessed by routine histopathological staining. RESULTS: Non-specific inflammatory infiltration, thickening of the epithelium, decreased numbers of Goblet cells, proliferation of fibroblasts, collagen deposition and fibrosis were observed in the obtained material. Changes in cellular profile and in the extracellular composition of bulbar conjunctivas in patients receiving long-term topical antiglaucoma treatment were detected.     

Trans-sclerally fixated PC-IOLs: six year of investigations

PURPOSE: To present the results of PC IOLs transscleral fixation to the ciliary sulcus in six years follow-up. MATERIAL AND METHODS: 152 eyes in 3 groups: 15 eyes with primary fixations of PC IOLs, 92 eyes with secondary fixations of PC IOLs and 45 eyes with secondary fixations of PC IOLs combined with penetrating keratoplasty. RESULTS: Postoperative corrected visual acuity was 0.5 or better in 32.2% of cases, the most common complications in our material was CME (9.9%), lens tilt (4.6%) and increase of IOP (3.95%). CONCLUSION: Transscleral fixation of PC IOLs offers good visual outcome with relatively low rate of complications and is recommended in cases with inadequate posterior capsule support.