Interleukin-12 and tumour necrosis factor-alpha equilibrium is a prerequisite for clinical course free from late complications in children with type 1 diabetes mellitus

The objective of the study was to analyse levels of IL-12 and TNF-alpha and relate the findings to the occurrence of microangiopathy in children with type 1 diabetes mellitus (DM). We examined a group of 123 children with type 1 DM. Serum levels of IL-12 and TNF-alpha were measured by an immunoenzymatic ELISA technique. TNF-alpha and IL-12 tended to be simultaneously present or absent in the sera of 50% of the children who had not developed complications, thus indicating a state of cytokine's equilibrium. Among the patients with an established retinopathy, two IL-12/TNF-alpha combinations were visible. Either a lack of detectable TNF-alpha was accompanied by measurable IL-12 serum concentrations or TNF-alpha incidence was associated with undetectable IL-12 values. Simultaneous lack of TNF-alpha and presence of IL-12 was associated with a better prognosis as these patients had a significantly lower albumin excretion rate. The state of equilibrium between TNF-alpha and IL-12 is beneficial in patients at early stages of the disease, prior to the occurrence of complications. Shifting the equilibrium towards TNF-alpha seems to promote late complications. It may suggest that a disharmony between pro- and anti-angiogenic function of these cytokines underlie the mechanism by which TNF-alpha and IL-12 shape the disease course.

[Ocular and orbital symptoms of Wegener's disease]

Wegener's granuloma occurs most commonly in upper respiratory tract, in lungs and in kidneys. In many cases ocular and orbital disturbances may be accompanied by changes in the nose and sinuses. These disturbances occur as: superior orbital fissure syndrome, orbital apex syndrome or ocular fascicle atrophy. The authors present the symptoms of these disturbances in 3 patients treated at Otolaryngological Clinic, Medical University of Gdańsk. On the bases of clinical symptoms and radiological results (CT and MRI) the assessment of pathogenesis of ocular and orbital symptoms was made in each of these cases, with special regard to the mode and result of the treatment.

[Glassy-carbon intrascleral implant in the ultrasonographic image (presentation a and B)]

We present the ultrasonographic examination of the orbit of 34-years-old patient after evisceration of the right globe. During the operation the glassy-carbon implant was inserted into the scleral socket. The aim of the article is the comparison of ultrasonographic examination of the orbit without globe with the intrascleral glassy-carbon implant and with the glassy-carbon ball placed in the water.

[Surgical treatment of eyelid neoplasms with regard to reconstructive methods]

Results of surgical treatment of lid neoplasms, taking into account cosmetic effects are presented. The age of patients ranged from 28-78 years, with 58% above 60; 69% of them were males. The choice of surgical method depended on the advancement of the neoplasms, their localization and the age of patients. During 2-year follow-up no recurrence was observed and the functional and cosmetic results of treatment were satisfactory.