Energetic metabolism of the placenta and vascular blood flow as criteria for the choice of drugs in risk pregnancy--results of our investigations

Object of this paper was to estimate the vascular resistances of the placenta and the lactate/pyruvate-quotient influenced by 8 and 40 mu/min orciprenaline and 320 micrograms/min papaverine. 38 placentas were tested in extraorganic circulation. The content of lactic acid and pyruvic acid was determined in the perfusion solution flowing out of the umbilical vein. Pressure was registered with cymograph. Infusion of 8 micrograms/min orciprenaline diminishes the lactate/pyruvate-quotient and the vascular resistances. 40 micrograms/min orciprenaline causes spasm of placental vessels in the terminal phase of examination. In this group the processes of oxygenation were limited by the oxygen content in the perfusion solution. Papaverine turned the metabolism of the placenta to an anaerob way and the antispasmodic effect was shortlasting.--Therefore the drug effect results out of a metabolic and a spasmolytic component. In risk pregnancy there has to be considered in addition to the spasmolytic the metabolic effects, too.     

Peculiarities of multiple pregnancy: epidemiology

The epidemiology of multiple pregnancy is complex and depends on various factors including age, race, genetic and environmental factors, season of conception and, more recently, iatrogenic factors. In recent years, twinning rate increased dramatically especially in countries where ovulation induction and assisted reproductive technologies are widely used. Multiple pregnancies are most frequent in Nigeria where majority of them are dizygotic. The lowest frequency of twinning is observed in Japan where almost 70% of multiples are monozygotic. This paper discusses genetic, environmental and sociocultural factors which are related to the "epidemic" of multiples.     

The effect of chitosan on the stability and morphological parameters of tablets with Epilobium parviflorum Schreb. extract

The study is a continuation of research on manufacturing oral solid drug form containing extract from Epilobium parviflorum Schreb. This study aims at investigating the usefulness of selected high-molecular substances with particular consideration of chitosan (Ch), silicified microcrystalline cellulose (Prosolv) and croscarmellose sodium (Vivasol) as a carrier of E. parviflorum Schreb. extract in oral solid drug form in the process of direct tableting. In one series the alternative technological process (with initial granulation) was applied. The polymer carriers of extract were selected so as to obtain shorter disintegration time in relation to the earlier published studies and stability after longer time of storage. The effect of chitosan was estimated on selected morphological parameters of practical relevance during storage. The obtained results allow to state that the applied high-molecular adjuvant substances proved to be useful in adequate proportions in the production of tablets from dry extract from Epilobium parviflorum Schreb. through direct pressing of the tablet mass. The tablet properties in all series were in accordance with obligatory standards also after longer time of storage (12-month). The tablets formed from E. parviflorum Schreb. extract with chitosan can be included into preparations of sustained release time of the biologically active substances.     

Relationship between impaired apoptosis of lymphocytes and distribution of dendritic cells in peripheral blood and synovial fluid of children with juvenile idiopathic arthritis

INTRODUCTION: The pathogenesis of juvenile idiopathic arthritis (JIA) is not fully understood. Recently the present authors described disturbed apoptosis of JIA lymphocytes in both peripheral blood (PB) and synovial fluid (SF) as well as an abnormal distribution of blood dendritic cells (BDCs) between the PB and SF in this disease. Possible relationships between these events during the development of JIA process are assessed here. MATERIALS AND METHODS: Lymphocyte apoptosis and BDC counts were assessed in the PB and SF of untreated JIA children. Lymphocyte apoptosis was analyzed by the Annexin-V/propydium iodide assay. Total DC (TDC) number was based on the sum of three BDC subpopulations determined using a panel of monoclonal antibodies against BDC antigens (BDCA): myeloid type 1 (mDC1, BDCA-1(+)/HLA-DR(+)/CD19(-)), myeloid type 2 (mDC2, BDCA-3(+)/HLA-DR(+)/CD14(-)), and plasmacytoid (pDC, BDCA-2(+)/HLA-DR(+)/CD123(+)). Cells were enumerated by the flow cytometric "single-platform" method. The concentration of tumor necrosis factor (TNF)-alpha and the distribution of particular lymphocyte subtypes in both PB and SF were also investigated. RESULTS: There was significant positive correlation between apoptosis of PB lymphocytes and SF TDC count (p=0.002) as well as SF TNF-alpha concentration (p=0.007). SF TNF-alpha levels also correlated with SF TDC count (p=0.003). Moreover, JIA SF was distinctly enriched with CD4+ and CD8+ T lymphocytes and included CD4(+)/CD25(high) cells as well. There was significant positive correlation between the number of CD4(+)/CD25(high) cells and SF JIA BDC count (p=0.015). CONCLUSIONS: These data suggest a possible link between impaired apoptosis of PB/SF lymphocytes and increased recruitment of PB BDCs to SF and other elements of the immune system in JIA, including regulatory CD4+/CD25high cells.     

Personalized vaccination? II. The role of natural microbiota in a vaccine-induced immunity

Inter-individual variation in immune response to widely used prophylactic vaccines against infectious diseases is strongly influenced by sex, MHC (Major Histocompatibility Complex), age and current hormones status of vaccinated individuals. Numerous findings showed that microorganisms residing at different sites of human or animal body (natural microbiota), especially in the gastrointestinal tract, appear to contribute to nearly every element of the host's physiology. Recently, the microbiota is also supposed to be an underappreciated yet, but very important factor responsible for diverse vaccine efficacy observed in humans from developing vs. developed countries. In the article, selected aspects of the microbiota-host relation are presented: importance of the gut microbiota in the development of both the intestinal mucosal and systemic immune responses, bacteria of a predominant role for the immunity (e.g., SFB, Segmented Filamentous Bacteria), and several clinical observations on the varied immunogenicity of the same vaccines in different human populations. In the light of our current knowledge, manipulation of the microbiota by probiotics and/or prebiotics is becoming a realistic therapeutic and prophylactic strategy for many infectious, inflammatory and even neoplastic diseases within the gut but it may be also used for improving vaccine efficacy.     

Infekcyjne zapalenie mięśni u dzieci

Infectious myositis is a rare group of childhood diseases with different aetiologies and clinical manifestations. Myositis may be caused by viral, bacterial, fungal and parasitic agents. At times, clinical picture alone provides information about suspected pathogen responsible for infection. Viral myositis usually manifests as a generalized muscular pain with involvement of many muscles. Bacterial infection typically manifests as a focal myositis with high fever and muscle abscess formation. In immunocompromised or immunosuppressed patients fungal myositis may occur, which is characterized by severe septic course and uncertain prognosis. Occurrence of pain and swelling of limbs or eye socket, along with a typical medical history, and accompanying high eosinophilia in blood, suggests parasitic myositis. In order to make an accurate diagnosis and implement appropriate treatment, medical data from interview, clinical picture, biochemical tests, microbiological and serological findings, ultrasound, CT- or MR-imaging and biopsy of muscle tissue should be performed.     

Pneumocephalus after shunt in a patient with hydrocephalus. A case report and review of the literature

Pneumocephalus in hydrocephalic shunted patients is very rare. So far only 46 cases have been described in the literature. A case of pneumocephalus in a patient with shunted hydrocephalus, and the diagnostic and therapeutic problems were described. A 38-year-old woman suffered from a subacute headache, dizziness and bradyphrenia. Eight years ago, the ventriculo-atrial shunt was implanted due to idiopathic hydrocephalus, and the shunt was changed 2 months before the present admission (ventriculo-peritoneal valve). CT and MRI revealed pneumocephalus, but neither clinical nor radiological symptoms of the CSF fistula were found. After temporary ligation of a distal catheter, the anterior fossa and a sellar area were directly repaired via right fronto-temporal craniotomy, with a good outcome. In the case of pneumocephalus in hydrocephalic shunted patients, the direct closure of the skull base fistula via craniotomy combined with restoration of the proper shunt function is usually the most effective treatment. If the site of the fistula can not be established, dural cranioplasty in the most likely site of the fistula is recommended.     

Influence of folic acid in primary prevention of neural tube defects

OBJECTIVE: The aim of the study was to analyze the incidence of neural tube defects in Lublin Province between 1990 and 2000 after application of primary prevention with folic acid. MATERIAL AND METHODS: A total of 293,039 newborns were analyzed. RESULTS: Neural tube defects were diagnosed in 53 newborns. CONCLUSION: Reduction of frequency of meningocele was shown after application of primary prevention with folic acid in 1998. Meningoceles were most frequent in 1992 (1.32/1000) and in 1998 frequency of these defects was reduced and in 2000 was down to 0.62/1000 births.