Analysis of reasons for falls of hemiparetic inpatient rehabilited patients

Background. Patients undergoing rehabilitation in rehablitation wards particulary those focused on geriatry or neurology are expose to falls.It is connected with advanced age and also their illness essence.
This kind of falls appears to be very important problem because some of them could lead to severe physical contusion or loss of trust in own ability and fear against the activities.
The aim of this study was to analyse incidence of falls in all groups of patients rehabilited in the ward, the causes of falls and consequences of them and estabilshing the preventional rules for hemiparetic patients after stroke or operated brain's tumors.
Material and methods. The prospective study was conducted during 2000 year. We used erlier prepared record of falls included data conected with age, diagnosis, day of hospitalisation, causes, circumstances and consequences of falls.
Results. Among 724 observed inpatient rehabilited patients falled 46 persons what is 6,3%.
The most often falls concerned hemiparetic patients (8,7% rehabilited patients).
In group with patients after cranio-cerebral trauma falls were registered in 18,1% rehabilited. Walking without support was the most frequent circumstance of falls (27%).
In 9 % of falled patients suffered from consequences as local petechie, swellings, tenderness of soft tissue whereas 1 patient needed to be transfered and observated in traumatic ward after fall.
Conclusions. From this analysis come that restriction of ussing sleeping and psychotropic pills, creation of save enviroment, isolation of group of patients predisponated to falls are very important factors in prevention of falls.     

Determination of chromium and selected elements in multimineral and multivitamin preparations and in pharmaceutical raw material

The content of elements in pharmaceutical preparations is one of the indispensable factors of the evaluation of their quality. In the present work, the following macro- and microelements Ca, Cr, Cu, Fe, Mg, Mn, Mo, P, Se and Zn were determined in multimineral and multivitamin preparations and in pharmaceutical raw material. Inductively coupled plasma mass spectrometry (ICP-MS) and electrothermal atomic absorption spectrometry (ET AAS) were used throughout the study. The examined samples were dissolved in a high-pressure microwave system using concentrated nitric acid. The effect of the carbon residue in the digest solution on the determination result was eliminated by introducing an equation correcting the ArC+ interference with 52Cr.     

Polymorphism in the P-glycoprotein drug transporter MDR1 gene: a possible link between environmental and genetic factors in Parkinson's disease

P-glycoprotein is a membrane protein encoded by the MDR1 gene, which demonstrates functional polymorphism. It is present in endothelial cells of the blood-brain barrier, thus limiting accumulation of its substrates in the central nervous system. Many epidemiological studies suggest an association between pesticides, which are substrates for P-glycoprotein, and Parkinson's disease. It was hypothesized that polymorphism of the MDR1 gene could modulate interindividual susceptibility for the disease in subjects exposed to pesticides. In a pilot case-control study involving 107 Parkinson's disease patients (30 early onset and 77 late onset patients; 59 exposed to pesticides and 48 non-exposed) and 103 controls, C3435T polymorphism of the gene was analysed. No statistically significant correlation between MDR1 gene polymorphism and Parkinson's disease was found. The 3435TT genotype was noted more frequently, but not significantly, in patients with early onset compared to late onset disease (23.3% versus 10.4%, respectively). A significant association between patients with parkinsonism exposed to pesticides and C3435T polymorphism of the MDR1 gene was found. Comparing the exposed and non-exposed patients, a statistically higher frequency of heterozygous subjects was observed (72.9% versus 47.9%, respectively). This genotype was associated with a significant, almost three-fold increased risk of disease. Similarly, a higher frequency of 3435TT subjects was revealed in exposed subjects (15.5%) compared to non-exposed patients (12.5%). In exposed versus non-exposed subjects, patients carrying at least one 3435T allele (i.e. homozygous and heterozygous) had a significant, five-fold higher risk of Parkinson's disease. Thus, it appears that mutation of the MDR1 gene predisposes to damaging effects of pesticides, and possibly other toxic xenobiotics transported by P-glycoprotein, leading to Parkinson's disease.     

Treatment results of treatment for congenital, unilateral microcoria and pupil displacement--case report

The purpose of this report was to present rarely occurring developmental anomaly of congenital unilateral microcoria and pupil displacement. We present a case of a boy, who underwent a plastic surgery of pupil at age of 3 year. Despite of relatively tardy onset of treatment and existing profound amblyopia (light perception with projection), a full vision recovery was achieved after 4 years of occlusion therapy.     

Non-arteritic anterior ischemic optic neuropathy--case reports

Nonarteritic anterior ischaemic optic neuropathy usually caused by hypertension, diabetes and hypercholesterolaemia is quite a common disease. Within its symptoms two are the most important: deep and often not reversible visual aquity loss and visual field defects. The decrease of visual aquity may be the first sign of systemic illness, which is noticed by a patient. In many cases the correct diagnosis and anti-oedematous, anti-inflammatory and vascular treatment may improve their visual function and general condition.     

Structure and biological activity of cationic [PtLCl(DMSO)]NO(3).DMSO complex containing a chelated diaminosugar: methyl-3,4-diamino-2,3,4,6-tetradeoxy-alpha-L-lyxopyranoside

Cationic platinum(II) complex [Pt(C(7)H(16)N(2)O(2))(DMSO)Cl]NO(3).DMSO containing one chloride anion, methyl-3,4-diamino-2,3,4,6-tetradeoxy-alpha-L-lyxopyranoside (C(7)H(16)N(2)O(2)) and dimethylsulfoxide (DMSO) molecules forming a square-plane has been prepared and characterised, both spectroscopically and by single-crystal X-ray diffraction. Biological tests performed using leukemia L1210 cells have shown that toxicity of the title complex is similar to that of cisplatin.     

Cases of ineffective anti-hepatitis B vaccination--own observations

Between 1999-2001 there were 6 patients with acute hepatitis B, previously vaccinated according to the recommended schedule of anti-hepatitis B immunization for adults, hospitalized in the Department of Infectious Diseases (Bytom, Silesian University Medical School). The study presents epidemiological and clinical analysis of these cases. Special attention is paid to possibility of immune response failure in spite of anti-hepatitis B vaccination. It is emphasized, that efficiency of active hepatitis B prophylaxis should be verified by estimation of serum anti-HBs antibodies, especially in patients with planned surgery.     

Synthesis and cytotoxic activity of conjugates of muramyl and normuramyl dipeptides with batracylin derivatives

The synthesis of MDP (muramyl dipeptide) or nor-MDP (normuramyl dipeptide) conjugates modified at the peptide part with batracylin (BAT) or batracylin derivatives is described. Batracylin was synthesized by our modified method (Scheme 3). The synthesis of BAT via this modified route now appears to be feasible on a multigram scale. Preliminary screening data obtained at the National Cancer Institute (NCI, Bethesda, MD) have revealed that the conjugates did not expose any cytotoxic activity even at 10(-4)-10(-8) M or microg/mL. During tests performed at Medical University of Gdansk, Poland, two analogues 11c and 11e reduced the proliferation of Ab melanoma cells in vitro compared with batracylin alone (Table 2, Figure 1).     

Synthesis and antitumor activity of conjugates of muramyldipeptide or normuramyldipeptide with hydroxyacridine/acridone derivatives

A series of MDP (muramyldipeptide) or nor-MDP (normuramyldipeptide) analogues modified at the C-terminus post of the molecule by a formation of an ester bond between the carboxylic group of isoglutamine and the hydroxyl function of the respective derivatives of 4-carboxamide-acridine/9-acridone or 1-nitro-9-hydroxyalkylaminoacridines were synthesized as potential anticancer agents. The compounds O-(1-O-benzyl-N-acetyl-muramyl-l-alanyl-d-gamma-isoglutaminyl)-9-(ethylamino)-1-nitroacridine ester 3j and O-(1-O-benzyl-N-acetyl-muramyl-l-alanyl-d-gamma-isoglutaminyl)-9-propylamino-1-nitroacridine ester 3k exhibited high in vitro cytotoxic activity against a panel of human cell lines, prostate cancer and AIDS-related lymphoma (ARL). Analogue 3j was also active in vivo in the hollow fiber assay. Antitumor activity of both compounds were tested in vivo against difference human tumor xenograft, but only analogue 3k showed in vivo activity against sc UACC-62 melanoma in mice.     

Opposite reaction of ERK and JNK in ischemia vulnerable and resistant regions of hippocampus: involvement of mitochondria

Delayed ischemic death of neurones is observed selectively in CA1 region of hippocampus at 3-4 days of reperfusion. Signals generated immediately during and after ischemia are further propagated by a variety of kinases, proteases and phosphatases. Tissue samples from dorsal (vulnerable) and abdominal (resistant) parts of gerbil hippocampi were collected to determine the activation state of key signaling molecules: Akt, Raf-1, JNK, ERK1/2 in the course of reperfusion after 5 min of global cerebral ischemia. Western blot analysis of phosphorylated forms of the kinases revealed persistent activation of JNK, being limited mostly to vulnerable CA1 region. On the contrary, activation of ERK, although observed transiently in both parts, was enhanced for a longer time in the abdominal hippocampus. The levels of the active/phosphorylated Akt and Raf-1 kinases did not change significantly during the recovery period. No significant correlation between postischemic JNK activation and c-Jun phosphorylation or its contribution to AP1-like complex formation was found. In contrast, the amount of active JNK linked with mitochondrial membranes was significantly increased and preceded neuronal death in CA1. In the same period of time the AP1 complex, augmented in CA1 region, did not appear to contain a classical c-Fos protein. These results are consistent with the theory that either long-lasting activation of JNK and/or contrasting ERK and JNK activities in critical time of reperfusion, contribute to selective apoptosis of CA1 neurons. This, in connection with the translocation of activated JNK to mitochondria and time/regional differences in AP1 binding protein complexes can affect final postischemic outcome.