Brain metabolism alterations in patients with anorexia nervosa observed in 1H-MRS

The causes of metabolic brain changes in patients with anorexia nervosa are still not fully explained. The purpose of this study was to use the 1H-MRS method in investigating metabolic changes in the brain of patients with anorexia nervosa. We studied 10 patients for visible alternations in brain metabolism and compared the results to healthy controls. 1H-MRS was acquired by the method of single voxels in white and grey matter. Proton MRS was performed after image guided localization using stimulated echo acquisition mode (STEAM) sequence with a short echo time of 20 ms. For data evaluation we used standard Siemens software and the additional PC. Choosing of the MRS sequences was related with particular interest in metabolites of short time echo: myoinositol and lipids. Besides this we evaluated peaks of: N-acetylaspartate (NAN), creatine (Cr) and choline (Cho). The results show significant differences in the levels of metabolites connected with fatty metabolism. In white matter we observed the reduction of lip-peak. The data was evaluated approximately and presented as lip:Cr. We did not observe any differences in other metabolites. As far as we know similar results had been reported and our study confirmed significant disorders in metabolism of these chemicals in patients with anorexia nervosa.     

Shiga toxin 1 targets bovine leukemia virus-expressing cells

Direct evidence that Escherichia coli Shiga toxin (Stx) acts against bovine leukemia virus (BLV)-expressing cells was obtained. The active A subunit of Stx type 1 (StxA1) targeted a selected population of permeable cells expressing BLV and inhibited BLV replication in a culture of bovine peripheral blood mononuclear cells. Cells were cultured with and without StxA1, and at various times cells expressing BLV were identified by being stained with MW1 monoclonal antibody specific for the BLV protein gp51. Before culture, permeable cells were tagged by uptake of one of the following: acetoxymethyl of 2',7'-bis-(2-carboxyethyl)-5-(and 6)-carboxyfluorescein (BCECF), BCECF conjugated to 70-kDa dextran, or 70-kDa dextran conjugated to fluorescein. The tagged cells costaining with anti-gp51 were selectively eliminated in StxA1-treated cultures. Electron microscopy analysis of purified B lymphocytes showed sharply reduced numbers of BLV particles in StxA1-treated cultures.     

Monochorionic, diamniotic triplet pregnancy complicated by twin reversed arterial perfusion sequence. Postpartum autopsy of placenta and acardiac fetus

The twin reversed-arterial-perfusion sequence (TRAP) is a severe complication of monochorionic twin pregnancies characterized by the hemodynamic dependence of a "recipient" twin from a "pump" twin. The recipient twin exhibits lethal abnormalities including acardia and acephaly. The pump twin has a mortality rate of 50% as a result of high-output heart failure. We present a case of a 24-year-old female, gravida 2, para 2, with monochorionic diamniotic triplet pregnancy. The sonographic examination at 18 weeks' gestation revealed acardiac-acephalus fetus. Reversed arterial perfusion sequence was confirmed with Doppler sonography. Postpartum autopsy examination of placenta and acardiac fetus (acardius anceps) was detailed described.     

Use of specific immunoglobulin G antibody avidity in the differential diagnosis of active and chronic Toxocara canis infections

To differentiate between acute and past Toxocara canis infections, a modified enzyme-linked immunosorbent assay, based on the dissociation of antigen-antibody complex with 6 M urea solution was used to measure levels of avidity of specific immunoglobulin G antibody against Toxocara canis excretory-secretory antigen. IgG avidity index was determined in the sera of 212 patients, divided into two groups with various stages of Toxocara infection. Patients were classified according to time period, from the onset of clinical symptoms or first positive serology result. Low IgG avidity index was found in the sera of 6.6% of patients in the acute phase, and all samples from the chronic stage of infection were characterized by high avidity values above 0.5 (mean 0.74). It was documented, that the avidity test for specific IgG antibodies is a valuable diagnostic method that helps to distinguish the early from the later phase of Toxocara canis infection. Indications for anti-parasitic treatment according to immunological activity of Toxocara infection were discussed.     

Diagnostic difficulties in primary mesothelioma

A 54-year-old woman with a history of fatigue and shortness of breath was found to have a pericardial effusion and mild mediastinal lymphadenopathy. Video-assisted pericardioscopy revealed thickened pericardium studded with multiple nodules. Histologically the tumor was diagnosed as papillary adenocarcinoma. The site of the primary tumor could not be identified. As lung cancer is one of the most frequent causes of pericardial metastases the patient was treated with cisplatin and vinblastin. Following 5 courses of chemotherapy--given over a 4 month period--the amount of pericardial effusion and pericardial thickness did not change. The material from pericardial biopsy was reexamined and positive immunostaining for calretinine was found. The final diagnosis was primary pericardial mesothelioma of epithelioid type. Palliative radiotherapy of mediastinum was planned but the patient deteriorated and died due to disease progression with venous thrombosis and superior vena cava syndrome. The case illustrates the difficulties in establishing diagnosis of primary pericardial mesothelioma which is a rare tumor with poor prognosis.     

Quality of life in children with cochlear implants and their families (Program Schwarzenberg)--initial report

The aim of the study was to present the results of international evaluation program "Quality of Life in children and their families--Schwarzenberg Initiative". The parents of children under 15 years old was asked to fill out specially prepared questionnaires. 1240 children from 9 countries participated in the study. In Poland 60 families filled out the questionnaires. 80 questions concerned several topics, including reaction of parents to the first information about impaired hearing of their child, using hearing aids before and after implantation, evaluation of behaviour in kindergarten and in school. This initial report describes only a few important topics. In 27.7% of Polish families the impaired hearing of their child was a cause to stop the work of one of the parents, to decrease time of work or to change the place of work in 9.1%. In most of the children the perception of sound was noticed. Only a few families from Austria, Slovenia, Swiss and Italy reported unsatisfactory results after implantation. Implantation increases quality of life of implanted children and their families.     

Results of treatment tinnitus patients using TRT in ENT Rehabilition Center in Poznań

The authors describe results of treatment tinnitus patients using TRT method. Since 4 years over 2000 patients were diagnosed and part of them were treated on basis neurophysiological model. In details the authors inform about method TRT and estimated results of audiological examination and treatment.     

Exposure to ticks and erythema chronicum migrans among borreliosis patients in Lower Silesia

The aim of the study was the analysis of Lyme borreliosis cases notified by Clinic for Infections Diseases in Wroc?aw in connection with exposure to ticks in year 2002. In the analyzed group of patients tick bites were confirmed in 77.9% and the most common places of exposition were forest regions in Lower Silesia (Masyw Slezy, Wzgórza Twardógorskie, Kotlina K?odzka, Wzgórza Trzebnickie, Bory Dolno?laskie) and in Wroc?aw area. EM appeared in 55.8% cases. In cases of multiple ticks professionally exposured persons EM appeared only in 22.2%.     

SPECT imaging of cerebral arteriovenous angiomas. A preliminary report

BACKGROUND AND PURPOSE: The purpose of this study was to demonstrate scintigraphic evaluation of cerebral perfusion in patients with intracranial hemangiomas. MATERIAL AND METHOD: The examination was carried out in 12 patients aged from 12 to 67 years. In all the patients cerebral angiomas were previously diagnosed and all of them were qualified for intravascular embolization. Brain scintigraphy was performed after IV injection of 99mTcECD and included the dynamic phase with images obtained every 2 seconds for 1.5 minutes and SPECT imaging. The semiquantitative analysis of regional cerebral blood flow was based on the comparison between activity in two symmetrical regions of interest. Cerebral angiography combined with intravascular embolization followed the scintigraphic examination. RESULTS: Based on angiograms, the size of the nidus was estimated at 1.0 to 9.0 cm. In 8 patients the dynamic study showed an increased tracer accumulation in the region of angioma. On SPECT images the nidus was visualized as focally decreased perfusion in all cases. A decreased tracer accumulation in the area adjacent to the nidus was detected in 8 patients. The ratio of activity in the region of angioma to activity in normally perfused tissue calculated using the semiquantitative analysis was 52% to 89%. CONCLUSIONS: SPECT images and dynamic phase of cerebral perfusion scintigraphy allow perfusion changes caused by the presence of intracranial angiomas to be identified.