[Circulatory and respiratory systems in children after surgical correction of atrial septal defect type II (ASD II)]. / Uklad krazenia i uklad oddechowy dzieci po operacji ubytku przegrody miedzyprzedsionkowej typu drugiego (ASD II).

The main objective of the study was to evaluate the conditions of circulatory and respiratory system 1-5 years after surgical correction of atrial septal defect (ASD II) in 112 children who had been operated at Silesian Medical Centre in Katowice in 1989-1993. Obtained results were compared with these ones found in the group of 60 healthy children. Mean age of study group was 7.78 +/- 4.46 years at the time of examination and 5.34 +/- 3.98 at the time of the operation. Twenty older children in the mean age 11 +/- 4.5 years (necessity for cooperation) were selected from the study group to perform the respiratory system tests. These tests were performed 7 days prior to operation and repeated 8 to 12 months afterwards. The following indices were determined: FVC--forced volume capacity, FRC--functional residual capacity, RV--residual volume, TLC--total lung capacity, FEV1--forced first second expiratory volume, PEF--peak expiratory flow, MEF 75-50-25% FVC--maximum expiratory flow at 75-50-25% of forced volume capacity, ITGV--intrathoracic gas volume, Raw-respiratory tract resistance, CL, st--static compliance of lung, DL, CO[SB]--lung diffusion capacity for carbon monoxide and D/VA--Krogh transfer coefficient. Circulatory system tests included: medical interview, physical examination, routine and 24-hour ambulatory ECG, echocardiography. There was found that children after ASD II closure have efficient circulatory system and most of them have normal ECHO results. Almost 40% of the children within 1 to 5 years following ASD operations have cardiac arrhythmias found in 24-hour ECG, but significant arrhythmias are seen only in 17.8% of the subjects. Most of the rhythm disturbances were mild. Significant arrhythmias and sinus node dysfunction were observed more frequently among the children who underwent surgical correction than in the healthy control group. Statistically significant deterioration of lung diffusion capacity for carbon monoxide (DL,CO[SB]) and Krogh coefficient (D/VA) has been found after the surgery. Thus, it is concluded that some pulmonary abnormalities may persist or even increase after successful ASD operation.

[Undiagnosed double aortic arch causing respiratory disturbances after 15-years]. / Nierozpoznany przez 15-lat podwójny luk aorty jako przyczyna zaburzen oddychania.

The double aortic arch is a very rare vascular anomaly belonging to a group so called vascular rings. The pressure of abnormal "doubled" aorta on the trachea and esophagus is a cause of sometimes sever symptoms of the respiratory tract such as dyspnea, stridor or cyanosis and recurrent respiratory infections. The authors present a case of a 15 year old boy who had stridor, cough and recurrent respiratory infections. Due to the symptoms the boy was treated for bronchial asthma. Correct diagnosis of double aortic arch was made after the X-ray examination of the chest with barium in the esophagus, followed by bronchoscopy, angiographic and NMR examinations. Surgery treatment was successful.

Clinical characteristics of primary mitral valve prolapse syndrome in children.

Sixty-seven children (40 girls and 27 boys) suffering from primary mitral valve prolapse (MVP) were studied. The age of these subjects was 5 to 18 years with the mean 12.8 +/- 3.3 years. MVP was diagnosed on the basis of physical and echocardiographic examination. In every case following studies were performed: routine and 24-hours ECG (according to Holter method), echocardiography, and physical performance test (according to Bruce protocol). The cause of referring the child to cardiologist were: cardiac murmur with/or midsystolic click in 85%, chest pain in 31%, feeling of cardiac palpitations in 40%, loss of consciousness in 40%, increased fatigability in 22%, feeling of dyspnoea in 10.5% (there were often more than one symptom in the same subject). Familial inheritance of MVP was suggested in over 20% of our patients. Asthenic constitution with orthopedic disorders (e.g. important scoliosis, pectus excavatum etc.) was found in about 20% of studied children. In 15% so called silent MVP was recognized. In 19% of subjects mitral valve leaflets inspection indicated their thickening and redundancy. In 67% routine ECG showed abnormalities of cardiac rhythm, conduction or repolarization. During Holter monitoring rhythm disturbances were detected in 22% of patients. Physical performance test results were normal in every case.

Papillomaviruses in human skin warts and their incidence in an Argentine population.

Human papillomavirus genomic types present in human warts of an Argentine population were studied. HPV DNA from single warts was obtained using an alkaline extraction procedure that resulted in a clean DNA preparation, which could be analyzed with several endonucleases. This method was used to isolate and insert the HPV DNAs of two genomic types into the Bam HI site of the pBR322 plasmid. Restriction maps of both HPV DNAs were constructed. According to these maps, one of the genomic variations was identical to HPV1a and the other to HPV2a. The incidence of HPV2 and of HPV1 in different types of skin warts was studied by a dot blot hybridization assay. Twenty-two out of 28 common warts were positive for HPV2 and negative for HPV1; four were positive for HPV1 and negative for HPV2 and two were negative for both. Five out of six plantar warts were positive for HPV1, and one was negative for both. Three out of seven filiform warts were positive for HPV2, three were positive for both probes, and one was negative for both. Southern blot analysis of HPV2 positive samples indicated that 80% were HPV2a and 20% another subtype not yet characterized. All plantar warts contained HPV1a. Msp I/Hpa II restriction analysis confirms previous results indicating that HPV1a DNA is partially methylated, while no evidence of methylation was found for HPV2a DNA.