Demonstration of cardiac arrhythmias in multi-infarct dementia and ischemic stroke using Holter monitoring.]

The occurrence of the cardiac arrhythmias was estimated by using 24-hour ECG Holter monitoring in 30 patients with multi-infarct dementia and in 30 with ischaemic stroke. Holter monitoring revealed pathological cardiac arrhythmias in 36.7% patients with multi-infarct dementia and in 40% with single ischaemic focus in the brain. It also allowed to reveal more frequent occurrence of cardiac arrhythmias in patients with ischaemic stroke (40%), than standard ECG (17%).     

An ex vivo model for functional studies of myofibroblasts

Migration, proliferation and invasive growth of myofibroblasts are key cellular events during formation of granulation tissue in situations of wound healing, arteriosclerosis and tumor growth. To study the invasive phenotype of myofibroblasts, we established an assay where arterial tissue from chicken embryos was embedded in fibrin gels and stimulated with growth factors. Addition of serum, PDGF-BB and FGF-2, but not VEGF-A, resulted in an outgrowth of cellular sprouts with a pattern that was similar to the organization of cells invading a provisional matrix in an in vivo model of wound healing using the chicken chorioallantoic membrane. Sprouting cells were defined as myofibroblasts based on being alpha-smooth muscle actin-positive but desmin-negative. There was no contribution of endothelial cells in outgrowing sprouts. The acquired myofibroblastic phenotype was stable since sprout-derived cells resumed sprouting in a growth factor-independent manner when re-embedded as spheroids in a fibrin matrix. Invasive growth and sprouting of vascular smooth muscle cells was not limited to chicken cells since a similar response was seen when spheroids composed of purified primary human aortic smooth muscle cells were embedded in fibrin. Finally, a technique for flat visualization of the three-dimensional sprouting and a quantification method is described. This ex vivo model allows quantitative analysis of invasive growth and differentiation of vascular smooth muscle cells and fibroblasts into myofibroblasts.     

Transforming growth factor-beta1 and IL-13 response to allergen predict steroid needs in asthmatic children

BackgroundThe remission of asthma, which is induced during specific immunotherapy (SIT) or appears spontaneously in children is not completely understood and predictors of this phenomenon are still undefined.ObjectiveTo assess CD4⁺CD25⁺Foxp3⁺ Treg cells and cytokine/proliferation response to allergen-specific stimulation of PBMC as predictors of steroid sparing effect of SIT and steroid dosage needs without SIT during 5 years of follow-up in asthmatic children.MethodsThis is a 5-year long study of 32 asthmatic children, sensitive only to house dust mite (HDM). Eighteen children who had completed 5 years of HDM SIT – SIT group, and 14 children without SIT as a control group were studied. All patients had baseline clinical/immunological assessment; before and after observation the minimum effective ICS dose was defined and lung function was measured.ResultsIn children from SIT group minimum effective ICS dose was reduced more than in children from control group (median reduction 65% vs. 0%; p < 0.001). Among patients in control group asthma severity was reduced after 5 years of observation in those who had at baseline higher TGF-beta1 and lower IL-13 answer to allergen stimulation of PBMC. Better response to 5 years immunotherapy was observed in those who had at baseline higher TGF-beta1 and lower proliferation answer to allergen stimulation of PBMC.ConclusionSimilar processes may decide on both, SIT-induced and spontaneously appearing, reduction in asthma severity. Immunotherapy was much more effective than pharmacotherapy in our study. IL-13 overproduction may impede reduction of disease severity in asthmatic children independently from TGF-beta pathway.     

Obesity and related consequences to ageing

Obesity has become a major public health problem. Given the current increase in life expectancy, the prevalence of obesity also raises steadily among older age groups. The increase in life expectancy is often accompanied with additional years of susceptibility to chronic ill health associated with obesity in the elderly. Both obesity and ageing are conditions leading to serious health problems and increased risk for disease and death. Ageing is associated with an increase in abdominal obesity, a major contributor to insulin resistance and the metabolic syndrome. Obesity in the elderly is thus a serious concern and comprehension of the key mechanisms of ageing and age-related diseases has become a necessary matter. Here, we aimed to identify similarities underlying mechanisms related to both obesity and ageing. We bring together evidence that age-related changes in body fat distribution and metabolism might be key factors of a vicious cycle that can accelerate the ageing process and onset of age-related diseases.     

Encephalomalacia in the distribution of the posterior cerebral and superior cerebellar arteries: the CT and radionuclide examination

The case described concerns the clinical diagnosis of a vascular focus in the distribution of the posterior cerebral and superior cerebellar arteries. Up to now both carotid and vertebral angiography were required. Nontraumatic CT and radionuclide studies have allowed demonstration of the etiology of the disease in the occipital and cerebellar region without further neuroradiology examinations with contrast. Clinical diagnosis by using neuroradiological methods in the detection of infarct in the region of the posterior cerebral and cerebellar artery is seldom observed. The case of a vascular focus in the distribution of the posterior cerebral and superior cerebellar arteries was diagnosed using the above methods.     

Influence of sinus surgery in rhinometric measurements

The objectives of this prospective study were to clarify how well acoustic rhinometry (AR), computed tomography volumetry (CTV), rhinomanometry (RMM), and the visual analogue scale (VAS) identify changes in intranasal pathology after endoscopic sinus surgery in patients with chronic sinusitis. The measurements were performed in 44 nasal cavities of 11 patients pre- and postoperatively, 6 of whom underwent middle meatal antrostomy and 5 of whom underwent ethmoidectomy. The AR and RMM results were compared with those obtained with CTV and VAS. Furthermore, a favourable outcome in sinus surgery was obtained with all of the methods. The results showed clearly that endoscopic sinus surgery significantly changes the intranasal geometry and can be obtained reliably using rhinometric measurements. Both AR and CTV identified statistically significant (p < .05) volume changes in the nasal cavities. The AR and CTV results correlated generally well (r = .72) with each other, but wide differences were seen between the operative groups. Correlation in the ethmoidectomy group was very strong (r = .93) but weak in the middle meatal antrostomy group (r = .37). In the nasal function measurements, nasal obstruction decreased significantly (p < .05) after the surgery. The changes were clearly obtained using RMM and VAS (p < .05). Correlation between these methods was generally poor (r < .30), but a difference was again seen in the operative groups. In the ethmoidectomy group, correlation was moderately good (r = .55) but weak in the middle meatal antrostomy group (r = .29). We concluded that rhinometric methods are reliable tools for evaluation of operative outcome in endoscopic sinus surgery patients. Inspiratory resistance measured with RMM and nasal obstruction assessed with VAS appeared to measure separate parameters in nasal function.     

Correlation between rhinometric measurement methods in healthy young adults

The most common rhinometric measurement methods used in modern rhinology are acoustic rhinometry, rhinomanometry, and nasal peak expiratory flow (PEF) rate. In this prospective study, we wanted to clarifiy whether the parameters given by these three methods in the same subject support each other and can be used simultaneously in clinical practice. We also wanted to define the dimensions of normal nasal geometry and function based on these three methods. The rhinometric measurements were done in 249 healthy white subjects consisting of 171 women and 78 men. The geometry was analyzed with regard to body mass index (BMI) and smoking habits. The result could he used as some kind of reference value for the same kind of patient cohort as when rhinological pathology is investigated. The measurements obtained by acoustic rhinometry showed only statistically significant correlations between the measured volume and minimal cross-sectional area in the nasal cavities (r = 0.959). Rhinomanometry showed only a statistically significant correlation between the measured resistance in expiration and inspiration (r = 0.977). Acoustic rhinometry, rhinomanometry, and nasal PEF did not show any correlations and the BMI did not have any effect on the results. Although the smoking group was relatively small in this cohort, the rhinometric methods showed smaller nasal cavity volume, higher resistance, and lower nasal PEF values. Based on these results, we recommend the use of these three rhinometric methods as independent instruments in rhinological examinations. However, in the pathological nose, e.g., smokers, the methods show equal changes in measurements. It is important to measure at least acoustic rhinometry and rhinomanometry at the same time in clinical practice to achieve good quality of examinations.     

Der Einfluß der Röntgenstrahlen auf den Cholesteringehalt des Blutes von Carcinomkranken

Ohne ZusammenfassungMit 1 Textabbildung     

Comprehensive insight into human aminoacyl-tRNA synthetases as autoantigens in idiopathic inflammatory myopathies

Autoantibodies against aminoacyl-tRNA synthetases (anti-AARS) belong to the group of the myositis specific autoantibodies (MSAs). Their association with the onset and development of the idiopathic inflammatory myopathies (IIM) implies their participation in the pathogenesis of the diseases. Since the appearing of anti-Jo-1 and other anti-AARSs is related to characteristic immunogenetic and clinical features, they can be considered specific markers in diagnosis and classification of patients affected by IIM. Here, we present an overview of anti-AARSs, their chemoattractant properties, their detection methods, genetic risks, and protective factors.