[Systemic mixed connective tissue disease--Sharp's syndrome]

Sharp's syndrome is a systemic mixed connective tissue disease that is defined with specific ribonucleoprotein antibody (U1RNP). The key diagnostic criterion is positive antinuclear antibodies in stain form. The disease is primarily localized on joints, muscles and skin; however, there are not widely used diagnostic criteria. There are USA, Mexican and Japanese diagnostic criteria. A 18-year-old male who fulfilled Sharp's diagnostic criteria is presented in the paper. In this patient the disease was manifested in pleura and pericardium. We wish to point out the importance of immunologic approach to the aetiology of pleural and pericardial inflammatory effusions in young patients, as well as the therapeutical dilemmas in the treatment of the disease.

[Renal cancer presenting as parietal-temporal cerebral metastasis and a persistent fever]

SUMMARY

The authors report the clinical case of a 48-year-old man presenting with persistent fever, in whom a brain tumour was detected. Histological examination of the resection specimen revealed metastasis from a renal cell carcinoma. The primary tumour was discovered on the right kidney which was then resected. The early postoperative course was favourable, but no long-term follow-up is available.

[Bronchial reactivity in chronic obstructive bronchitis]

The frequency and the degree of bronchial hyperreactivity was investigated in 92 patients suffering from chronic obstructive bronchitis. Bronchial reactivity was examgned by the inhalator acetylcholine test, with the use of a 5 mg dose of acetylcholine, diluted in 1 ml of sodium-chloride solution. The pulmonary function was estimated upon the results of parameters received by forced expiration and body plethysmography. The results have shown the obvious bronchial hyperreactivity in 42 percent of all patients suffering from chronic obstructive bronchitis. The average quantity of acetylcholine, which is supficient to provoke a bronchial reaction, is 3 mg, with a moderate bronchoconstrictory response, localized mostly in the large airways. The author concludes that the inhalator provocative test by cholinergic agent solution may safely be applied in patients suffering from chornic obstructive bronchitis.