Immune regulation in allergic asthma

Hippokratia 1997, 1(1):15-23

PV Margari

Abstract

Several lines of evidence derived from animal and human models indicate that Th2-lymphocytes, mast cells, eosinophils, basophils and epithelial cells, importantly contribute to the pathogenesis of both acute and chronic components of allergic inflammation in asthma. Each of these cells represents a source of multiple cytokines and mediators that may have overlapping, synergistic, or even antagonistic effects. Some of the cells and mediators, that participate in the inflammatory process may help to down regulate the reaction, while cytokines that mediate certain proinflammatory effects may have other actions that are anti-inflammatory. Yet, despite these important changes in our thinking about the nature of allergic asthma, a complete understanding of the mechanisms that initiate and perpetuate the mucosal inflammation in this disease have proven to be quite elusive. The "riddle of the allergic reaction", remains to be completely solved.

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Pregnancy and delivery after renal transplantation

Hippokratia 1997, 1(1):24-27

G Vergoulas, Gr. Miserlis, F. Solonaki, D. Kanetidis, V. Traianos, V. Papanikolaou, G. Imvrios, D. Gakis, D. Takoudas, A. Antoniadis

Abstract

It is known that women of reproductive age after renal transplantation can conceive and deliver normal babies. From Jan 1979 to Dec 1994 seven transplanted women had twelve pregnancies. Six pregnancies gave normal babies. There were one automatic and five therapeutic abortions. Women with normal deliveries were 24 year old (range 18-28 years) and were taking triple drug immunosuppression (methylprednisolone, azathioprine, cyclosporine) during pregnancy. Serum creatinine was 1.03 mg% (range 0,8-1,4 mg%) before conception and 1.0 mg% (range 0.7-1.5 mg%) after delivery. There was no proteinuria before conception, during pregnancy or after delivery. Mean arterial blood pressure was 120/83 mmHg (range 100/80-140/100 mmHg) before conception and 122/80 mmHg (range 100/70-140/100 mmHg) after delivery. One woman with mild hypertension continued taking her antihypertensive drug and had normal delivery. Acute rejection episodes were not recorded during or after these pregnancies. The therapeutic abortions were done because of social reasons and because of uncontrolled diabetes mellitus combined with hypertension. In conclusion women with renal transplantation can have conception and normal pregnancy without derangement of graft function or elevation of arterial blood pressure.

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Continuous curvilinear capsulorhexis complications

Hippokratia 1997, 1(1):28-34

A. Avramides, G. Sakkias, . Ahtaropoulos, E. Goula, P. Traianidisis

Abstract

The aim of our work is to present the complications and difficulties of continuous curvilinear capsulorhexis with cystotome in extracapsular cataract extraction. 1242 capsulorhexis with Blumenthal's cystotome have been performed at our Department during last year. Viscoelastics were always used. Complications observed included: tear disorientation, difficulties in nuclear expression and intracapsular lens extraction, zonular or posterior capsular rupture with or without vitreous loss, anterior capsule fibrosis and intraocular lens decentration. In conclusion this effective capsulotomy technique which allows the "in-the-bag" intraocular lens implantation requires a lot of experience and skill, is more difficult to be performed with a cystotome than with a forceps and can create problems during nucleus hydrodissection and hydroexpression.

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HLA-DR expression in Chronic Hepatitis C

Hippokratia 1997, 1(1):35-39

K Patsiaoura, E. Katsiki, S. Papaemmanouil, A. Aggelidis, M. Leontsini

Abstract

It is known that women of reproductive age after renal transplantation can conceive and deliver normal babies. From Jan 1979 to Dec 1994 seven transplanted women had twelve pregnancies. Six pregnancies gave normal babies. There were one automatic and five therapeutic abortions. Women with normal deliveries were 24 year old (range 18-28 years) and were taking triple drug immunosuppression (methylprednisolone, azathioprine, cyclosporine) during pregnancy. Serum creatinine was 1.03 mg% (range 0,8-1,4 mg%) before conception and 1.0 mg% (range 0.7-1.5 mg%) after delivery. There was no proteinuria before conception, during pregnancy or after delivery. Mean arterial blood pressure was 120/83 mmHg (range 100/80-140/100 mmHg) before conception and 122/80 mmHg (range 100/70-140/100 mmHg) after delivery. One woman with mild hypertension continued taking her antihypertensive drug and had normal delivery. Acute rejection episodes were not recorded during or after these pregnancies. The therapeutic abortions were done because of social reasons and because of uncontrolled diabetes mellitus combined with hypertension. In conclusion women with renal transplantation can have conception and normal pregnancy without derangement of graft function or elevation of arterial blood pressure.

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Pediatric surgical cases in "Hippokratio" General Hospital of Thessaloniki during a seven-year period from 1989 to 1995. Education and experience in pediatric anesthesia: Myth or reality?

Hippokratia 1997, 1(1):40-49

A. Zambouri, CH. Brajou, M. Ventouri, Z. Kanonidou, P. Papastephanou, M. Koulali, S. Gavopoulos

Abstract

The third building (building C) of "Hippokratio" General Hospital has 7 Surgical Departments (Department of Pediatric Surgery, Otolaryngology, Orthopedics, Ophthalmology, Neurosurgery, Urology and General Surgery). The first five perform many surgical procedures in neonates, infants and children. This pediatric surgical case was decided to be recorded and studied retrospectively for a seven-year period from 1989 to 1995. The cases of each surgical department were studied separately. The total number of cases in which anesthesia was given was collected and the following were recorded: 1) the number of pediatric surgical cases, 2) the type of operation performed, 3) their distribution in 5 age-groups: 0-30 days, >1 month-1 year, >1 year-2 years, >2 years-5 years and >5 years-14 years, 4) the monitoring that was used, 5) the age-related specific problems (difficulty in venipuncture, in tracheal intubation, etc.), 6) the occurrence of complications (bradycardia, laryngospasm, postoperative vomiting). During the seven-year period from 1989 to 1995 a total number of 37.266 anesthetics were given in an equal number of surgical procedures. From these, 14.827 (40%) were performed in neonates, infants and children aging from 0 days to 14 years. This great number of pediatric anesthetics has provided valuable clinical experience to our anesthesiologists. This experience in pediatric anesthesia has improved dramatically the quality of anesthetic care for neonates, infants and children in our hospital.

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Paracetamol poisoning and its management. Case report

Hippokratia 1997, 1(1):50-55

G.Th Vasiliadis, N. Evgenidis, N. Nikolaidis, K. Mpountas, O. Giouleme, A Darbouk, P. Katsinellos, I. Triantopoulos

Abstract

Paracetamol poisoning, is thought internationally to be, as one of the most common reasons of drug-induced hepatotoxicity, potentially fatal. In our country the incidence of paracetamol-induced hepatotoxicity is not known. Nonetheless, sensitisation and vigilance about this condition and the relatively new one alcohol-acetaminophen syndrome would lessen the severity of liver damage. It is of great importance to administer NAC in the first 8-10 hours from the paracetamol overdosage, but should be emphasized that NAC must be given in all patients, who have taken paracetamol more than 150 mg/Kg, regardless of the time of presentation in hospital. In cases of liver failure due to paracetamol, the patients should be guided to a special center for the possibility of liver transplantation.

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