Band 1, Heft 3

Natural killer (NK) cells provide the first line of defence against pathogens and tumors. Their activation status is regulated by pro-inflammatory cytokines and by ligands that either target inhibitory or activating cell surface receptors belonging to the immunoglobulin-like, C-type lectin or natural cytotoxicity receptor families. Apart from non-classical HLA-E, membrane-bound heat shock protein 70 (Hsp70) has been identified as a tumor-specific recognition structure for NK cells expressing high amounts of the C-type lectin receptor CD94, acting as one component of an activating heterodimeric receptor complex. Full-length Hsp70 protein (Hsp70) or the 14-mer Hsp70 peptide T-K-D-N-N-L-L-G-R-F-E-L-S-G (TKD) in combination with pro-inflammatory cytokines enhances the cytolytic activity of NK cells towards Hsp70 membrane-positive tumors. Based on these findings cytokine/TKD-activated NK cells were adoptively transferred in tumor patients. These findings were compared to results of clinical trials using cytokine-activated NK cells.

The environmental and life-style changes associated with developing industry and agriculture, especially the exposure to endocrine disrupting chemicals (xenobiotics), are considered as causes of the increasing incidence of male reproductive system disorders. Most of the xenobiotics, which harmfully influence the male reproductive system, reveal estrogen-like (xenoestrogens) or anti-androgenic activity. Recent data have revealed physiological roles of estrogens in the male, however, there are evidences that estrogen-like substances may lead to many undesirable symptoms in the male i.e. gonadal dysgenesis, genital malformations, cryptorchidism, decreased fertility potential and testicular neoplastic changes. The number of xenoestrogens is still growing in the environment, whereas the mechanisms of their action are still not exactly known. They can be harmful not only to the present but potentially also to the next generations.

The intermediate filament protein vimentin is a potential target antigen for autoantibodies in some infectious and autoimmune diseases. Because endothelial cells contain an extensive interconnecting cytoplasmic network of vimentin, we examined the relationship between anti-vimentin and anti-endothelial cell antibodies (AECAs). We measured the level of anti-vimentin antibodies in patients with systemic autoimmune diseases (n=42), healthy blood donors (n=58), and patients with acute inflammation and showing anti-vimentin immunofluorescence (n=50). AECAs were detected by indirect immunofluorescence in human umbilical vein endothelial cells. Anti-vimentin antibodies were detected by indirect immunofluorescence in HEp-2 cells, and levels of anti-vimentin antibodies were measured using an enzyme-linked immunosorbent assay. We did not find significant differences in anti-vimentin levels between AECA-positive and-negative samples for any of the groups; however, serum anti-vimentin antibody levels were significantly higher in patients with acute non-autoimmune inflammatory diseases than in patients with systemic autoimmune diseases or healthy controls. There were no differences between the levels of anti-vimentin antibodies between patients with systemic autoimmune diseases and healthy individuals. The anti-vimentin antibodies levels also did not correlate with the AECA positivity.

Lymphotoxin-α (LTA) is a cytokine involved in inflammatory reactions. NFKBIL1 is a regulator of the NF-κB complex. The study investigated the associations of LTA 804 C>A and NFKBIL1-63 T>A polymorphisms with the use of statin and acetylsalicylic acid (ASA) treatment in relation to myocardial infarction (MI). The study population comprised of 600 Finnish individuals who underwent coronary angiography volunteering for the Angiography and Genes Study. Genotypes were detected by the TaqMan 5′ nuclease assay. We found a interaction between the LTA genotype (p=0.002) and the NFKBIL1 genotype (p=0.012) and statin treatment in relation to MI. Subjects with the LTA AA or the NFKBIL1 AA genotype were at a 2.77 (95% CI:1.22-6.24) and 2.85 (95% CI:1.22-6.66) times higher risk, respectively, of suffering an MI when compared to other genotypes among statin non-users. ASA treatment also modulated associations between LTA and NFKBIL1 genotypes and MI (p=0.015 and p=0.028 respectively). The NFKBIL1-A-LTA-A haplotype showed a 61% increase in the risk of MI compared to the NFKBIL1-T-LTA-C haplotype among statin non-users. Anti-inflammatory medication modifies the genotype-related risk of MI, suggesting that subjects with LTA and NFKBIL1 AA haplotype might especially benefit from the treatment.

TT virus (TTV) was suggested to be the etiologic agent for non A-E hepatitis but this could not yet be proven due to high detection rates not only in hepatitis but also in healthy persons and sensitivity differences of PCR methods employed. The aim of this study was to evaluate TTV DNA positivity in non A-E hepatitis cases, chronic HBV and HCV hepatitis cases and healthy blood donors via PCR systems that target all regions of the viral genome used for viral detection. 23 non A-E hepatitis, 28 chronic HCV, 21 chronic HBV cases and 56 healthy blood donors were included in the study and evaluated by PCR protocols that target 5′-UTR, 3′-UTR and N22 (ORF1) regions. As a result, 3′-UTR and 5′-UTR PCR had comparable detection rates that were higher than N22 PCR. Differences in detection rates among study groups were not statistically significant for any PCR method. Hepatic enzyme levels of the patients were not correlated with the presence of TTV DNA. Detection rate was significantly higher for Non A-E hepatitis group when positivity rates from all methods were combined. These results suggest an alteration of viral genotypes in Non A-E hepatitis which might be associated with pathogenesis.

The purpose of this study was to determine the frequencies of hereditary and familial breast cancers among Lower Silesian women. The questionnaires, dealing with cancer episodes in first-and second-degree relatives, were sent to 5,000 females, who were diagnosed with breast cancer between 1984 and 2005. Twenty-five percent of the questionnaires were completed and returned. Their analysis and further counseling revealed that 24.9% of the responders met the criteria for familial breast cancer (FBC), including 10.5% definitive cases. Mutations in BRCA1 were detected in 32.5% and 1.9% of patients with definitive and suspected FBC, respectively. They all represented three of the abnormalities of the BRCA1 gene: 300T/G, 4153delA and 5382insC. No mutations of BRCA2 were found in material studied. Although a fraction of FBCs identified in our study was similar to those described in other European countries and in the United States, the percentages of genetic mutations seen on routine tests were relatively low. Consequently, the standardized analysis of oncological pedigree seems to be a more valuable diagnostic tool if patients with familial aggregations of breast cancer are targeted in a prophylactic context only.

When conducting prevalence surveys pressure ulcers were found in participants clearly identified not to be at risk. This article determines and analyses persons in German hospitals and nursing homes who suffer from pressure ulcers but are not at risk. In the years 2002, 2003 and 2004 there were 7,097 nursing home residents and 23,966 hospital patients examined in annual pressure ulcer prevalence surveys. A risk assessment according to the Braden Scale was performed for each participant on the day of the survey. “Not at risk” participants were defined by Braden score cut-off > 20 points. There were 440 of 3,012 (14.6%) persons with pressure ulcer who were considered not to be at risk. In hospitals, 16.1% of all patients with pressure ulcers were not at risk, in nursing homes it was 8.2%. A high variance between medical specialties and individual institutions was found in the number of those not at risk but with pressure ulcer. In the group not at risk, persons with and without a pressure ulcer differed regarding activity and friction and shear in nursing homes. In hospitals those persons differed regarding age and all single items of the Braden scale apart from sensory perception. Pressure ulcers that are more severe, located at the hip or lower back or the origin of which is unknown are more likely to be considered to be at risk by the Braden risk assessment tool. The results may indicate insufficient abilities of the Braden scale for certain kind of pressure ulcer wounds.

Postoperative intragastric enteral feeding in cardiac surgery patients is frequently complicated by delayed gastric emptying. The aim of the study was to evaluate how early postoperative gastric enteral nutrition affects the gastric emptying in coronary artery by-pass graft (CABG) surgery patients. In the prospective, randomized study 40 patients treated at intensive care unit after CABG surgery were studied. Patients were divided in two groups: enteral feeding group E (20 patients: age 59±8 yr.; male 70%) and control group C (20 patients: age 58±10 yr.; male 80%), respectively. Paracetamol absorption test was used to evaluate gastric emptying. In the group E postoperative gastric supply of enteral formula begun 18 hours after surgery and after 6 hours the supply was stopped and paracetamol solution was administrated by nasogastric tube. The patients in group C for.rst 24 hours received only crystalloid solutions intravenously and paracetamol solution by nasogastric tube. Blood samples were obtained at 0 (t0), 15 (t+15), 30 (t+30), 60 (t+60) and 120 (t+120) min after administration of paracetamol. The values of plasma paracetamol concentration (PPC) at 15 and 120 min were significantly higher in group E vs. group C: (t+15) 3.3±2.5 vs. 1.7±1.9 and (t+120) 5.2−2.8 vs. 3.3±1.6 (p <0.05). The PPC values at 30 and 60 min were higher, but not signi.cantly, in group E vs. group C: (t+30) 3.7±2.0 vs. 2.9±2.7 and (t+60) 5.1±3.2 vs. 3.9±3.5 (p = NS). The area under the PPC curve was 429 ± 309 in the E group vs. 293 ± 204 in the group C (p < 0.05). In conclusion an early postoperative gastric administration of nutritients after CABG surgery stimulates the gastric emptying.

The short-term effects of ambient black smoke concentrations on total non-accidental, cardiovascular and respiratory mortalities in Nis, during the 2000-2003 period, were investigated. Daily measurements for black smoke (BS), as well as the daily number of deaths have been collected. Generalised linear models extending Poisson regression were applied. The e.ects of time trend, seasonal variations, days of the week, temperature, humidity and air pressure were adjusted. The per cent increase in the daily number of total deaths associated with a 10 μg/m3 increase in BS was 1.13% (0.08–2.20%). The e.ect size was slightly higher for cardiovascular mortality (1.25%, 95% CI: 0.53–1.97%). There was no signi.cant association between air pollution and respiratory mortality. These results indicate that current levels of ambient BS have signi.cant e.ects on total and cardiovascular mortalities in Nis.

A 53-year old female patient, who presented with retrosternal pain, which could be ascribed to reflux oesophagitis and gastritis, furthermore stated recurrent palpitations, sweating and the feeling of uneasiness. In routine laboratory investigation hyperthyroidism and hypercalcaemia were detected. Further testing revealed elevated TSH receptor antibodies and a parathyroid hormone level within the normal range. Scintigraphically a homogeneous, but increased uptake was found. In ultrasonography guided fine needle aspiration biopsy of a nodule parathyroid hormone was verifiable by immunochemical means. Under thyrostatic treatment with carbimazole the patient became euthyroid, simultaneous a decrease of serum calcium levels could be observed. Parathyroid hormone level remained in normal range. After confirmation of Graves’ disease and adenoma of the parathyroid gland parathyroidectomy in combination with near total resection of the thyroid gland was performed. In conclusions concomitant Graves’ disease and primary hyperparathyroidism is rare, but should be considered in case of persisting hypercalcaemia after the patient became euthyroid again, when parathyroid hormone level is in normal range or elevated. Thus a potentially required second operation can be avoided. By ultrasonography guided fine needle aspiration biopsy and immunochemical processing adenomas of parathyroid glands can be localized preoperatively.

Pyoderma gangrenosum is an inflammatory dermatosis of uncertain etiology, often associated with chronic inflammatory bowel or rheumatoid disease. It predominantly affects the skin. A systemic organ involvement caused by aseptic neutrophilic abscesses, however, fundamentally influences the prognosis. A patient with idiopathic pyoderma gangrenosum insufficiently responded to a conventional immune suppressive therapy and the disease proceeded aggressively. During treatment with Infliximab, partial remission was achieved intermediately. However, a recurring endocarditis, led to a lethal outcome of this patient.