Promjene razine izotipova specifičih imunoglobulina u atopičara i zdravih ispitanika prije i tijekom prirodne izloženosti peludu biljke Ambrosia elatior L.

The physiologic way of responding to allergens in healthy subjects is not fully understood, nor the immunopathological mechanism in patients with allergies. Despite the accepted theory of Th1-type immune response in healthy subjects that should result in the formation of "blocking antibodies" and thus the absence of a clinical symptoms of allergic disease, no such increase was observed during the natural exposure of the Ambrosia elatior plant pollen. For one immunoglobulin class (sIgG2) slight fall in serum levels was shown, which could, theoretically, play a role in neutralizing the circulating allergen. The characteristics of humoral immunity in people with allergic diseases during the natural exposure of the pollen of the Ambrosia elatior plant is not only an increase in sIgE levels but also increase in some other classes and subclasses, traditionaly classified as Th1 immunoglobulin (A1, G3, G4). The results of this study show that the natural exposure of allergic persons to the environmental allergen has the similar effect on increase of sIgG4 in allergic persons comparable to those in hyposensitisation. Therefore, the rise of IgG4 is probably not by itself a mechanism that leads to clinical improvement in hyposenzitized patients. That argument, together with the high level of allergen-specific serum sIgM levels and also other imunoglobuline classes, dispute against the "theory of blocking antibodies". The results obtained could be used for further research in patients with allergy, primarily the investigation of total barrier function, dynamics of immunoglobulin classes and subclasses in other body specimens (nose and mucous membrane biopsies), determination of blood allergen levels and determination of sIgE using this quantitative method, possible differences in sIgM and other sIg levels in patients with anaphyllaxis, potential therapeutic application of sIgG2 antibodies as well as research in immune cells and their mediators. That way, a more complete insight about immune events in healthy people and patients with allergies could be obtained

Routine coagulation testing in acute stroke

Uvod: Promjene u sustavu hemostaze mogu pridonijeti razvoju tromboembolijskih i hemoragijskih bolesti. Stoga je glavni cilj ovoga rada bio istražiti povezanost koagulacijskih pretraga koje se uobičajeno određuju po prijemu bolesnika s akutnim moždanim udarom (MU), njihov odnos s (pod)tipovima MU-a i ishodom nakon akutnoga MU-a. Materijali i metode: Retrospektivno su pregledani podatci o 262 pacijenta hospitaliziranih u razdoblju od siječnja do lipnja 2011. godine na Klinici za neurologiju Zavoda za cerebrovaskularne bolesti Kliničke bolnice „Sveti Duh” suspektnih na akutni moždani udar. Klasifikacija MU-a temeljena je na kliničkoj slici i nalazima neuroradiološke obrade, dok se ishod MU-a procjenjivao pomoću modificirane Rankinove ljestvice. Analizirani su rezultati koagulacijskih pretraga: PV-INR APTV, fibrinogena i D-dimera prilikom prijema pacijenata u bolnicu. Za sve pacijente izračunat je i omjer D-dimera i fibrinogena. Rezultati: U konačnu analizu uključena su 74 pacijenta, 67 s ishemijskim MU-om, od čega je u 22 pacijenta MU klasificiran kao lakunarni, a u 10 pacijenata kao hemoragijski. Nađena je umjerena, ali značajna pozitivna korelacija između vrijednosti D-dimera i modificirane Rankinove ljestvice (r = 0,470, CI% = 0,271-0,631; P < 0,0001). Tijekom hospitalizacije preminulo je 16 % bolesnika. Vrijednosti D dimera po primitku u bolnicu bile su statistički značajno više u bolesnika koji nisu preživjeli u odnosu na bolesnike koji su preživjeli MU (604 naspram 224 μg/L, P < 0,0001) kao i u bolesnika s dijagnosticiranim ishemijskim MU-om klasificiranim kao nelakunarni u odnosu na bolesnike s klasificiranim lakunarnim MU-om (294 naspram 206 μg /L. P = 0,02). Vrijednosti drugih koagulacijskih pretraga i omjera D-dimera i fibrinogena nisu se značajno razlikovale među ispitivanim grupama. Zaključak: Istraživanje je pokazalo da su povišene vrijednosti D-dimera povezane s lošijim ishodom nakon akutnoga MU-a te da njihovo određivanje po primitku može biti indikativno u smislu prognoze i ishodaIntroduction: Changes in haemostatic system could contribute to the development of thromboembolic and haemorrhagic disease. The main objective of this study was to explore the relationship between coagulation tests commonly used in the clinical settings on patient’s admission, stroke types and patient’s outcome. Patients and methods: Patients’ hospital charts and documentation were retrospectively reviewed for 262 patients admitted to the Stroke and Intensive Care Unit, Department of Neurology at “Sveti Duh” University Hospital, Zagreb, Croatia from January to June 2011 under the suspected diagnosis of acute stroke. Classification of stroke types was primarily based on clinical picture and imaging studies, whereas degree of patients’ disability and outcome was measured by modified Rankin Scale (mRS). Results of the coagulation test PT-INR, APTT, fibrinogen and D-dimer performed on admission were recorded. For all patients the D-dimer to fibrinogen ratio was also calculated. Results: Total of 74 patients were enrolled in the study, 67 with ischemic stroke whereby 22 of them were classified as patients with lacunar stroke and 10 as patients with haemorrhagic stroke. During hospitalisation 16% of patients did not survive. The median D-dimer value on admission was significantly higher in non-survivors than in survivors (604 vs. 224μg/L, P < 0.0001), as well as in patients with ischemic non-lacunar stroke in comparison to lacunar stroke (294 vs. 206 μg /L. P = 0.02). Although moderate, significant correlation was observed between elevated DD levels and mRS scale (r = 0.470, CI% = 0.271-0.631; P < 0.0001). Other coagulation parameters, as well as D-dimer/fibrinogen ratio, considered in the study did not show any significant difference between stroke type or survival. Conclusions: Our study revealed that increased DD levels in acute phase of the stroke are associated with stroke outcome and that their determination on admission could be indicative of prognosis and outcome

Hemangioblastoma of the cerebellum : the correlative pathology with the computed tomography

U radu je morfološki prikazano 28 slučajeva hemangioblastoma malog mozga, koji su analizirani metodom kompjutorizirane tomografije na nativnim presjecima, kao i nakon aplikacije kontrastnog sredstva, u svim slučajevima uz primjenu kontrastnog sredstva tijekom pregleda. Analiziran je smješ­ taj muralnog nodusa i cističnog dijela tumora u odnosu na tkivo malog mozga. Kompjutoriziranom tomografijom utvrđene su morfološke kvalitete stijenke tumorske šupljine i solidnog dijela tumora, a u odnosu na neke druge tumore. Pojedini dijelovi tumorskog tkiva potvrđeni su patohistološki. Nagla­ šena je važnost mogućnosti vizualizacije morfološ­ kih tkivnih osobitosti metodom kompjutorizirane tomografije.Cerebral hemangioblastoma has been morphologically presented in 28 cases. The method of analysis was the computed thomography on native crossections before and after application of contrast, and with the application of contrast during the examination in all cases. The position of mural nodus and cystic part of the tumor in relation to the tissue of cerebellum has been analyzed. The morphologic qualities of the tumor paries and the solid part of the tumor were established, also in comparison to some other tumors. Some parts, of the tumor tissue were pathohistologically verified. The importance of the possibility of visualisation of the morphologic tissue specificities by the computed tomography is pointed out