Hyperglycemia, insulin and slower growth velocity may increase the risk of retinopathy of prematurity.

OBJECTIVE: Strategies to reduce Retinopathy of Prematurity (ROP) have focused primarily on respiratory management. Hyperglycemia (HG) and insulin use, risk factors for adult diabetic retinopathy, as well as growth rates may be modifiable variables useful to reduce ROP. STUDY DESIGN: This was a retrospective chart review of all infants born at <30 weeks gestation from 2003 to 2007 who survived to discharge in our neonatal intensive care unit (NICU). All whole-blood glucose values (BG in mg dl(-1)) done in the first 29 days of life were collected for analysis. RESULT: BGs were done at least every 3 to 6 h for the first 48 to 96 h of life, then every 6 to 24 h thereafter, as long as infants remained on hyperalimentation. Hyperglycemia was defined as mild (BG 151 to 180), moderate (181 to 210) or severe (>210). Insulin use (given if BG>180 to 210) was also noted for each simultaneous BG. ROP was classified as none, mild (stage 1 to 2) or severe (stage 3 to 4). Growth velocity (g kg(-1) per day), length and head circumference were also analyzed. In all, 372 infants mean (s.d.) gestational age 27.6 (1.4) weeks, mean (s.d.) birth weight 994 (242)g had 18,649 BGs analyzed. 103 (28%) of the infants had mild ROP and 29 (8%) had severe ROP. 137 (37%) of the infants received at least 1 day of exogenous insulin (median days 9, range 1 to 26). Higher cumulative mean BG, more episodes of HG, and more insulin exposure were associated with an increased incidence and severity of ROP. Ordinal logistic regression identified lower gestational age, male gender, fetal growth restriction, slower NICU growth velocity, and higher BG as predictors for severity of ROP. However, insulin use was a stronger predictor than BG, and replaced it in the risk model. CONCLUSION: After adjusting for important risk factors, HG and especially insulin use in premature infants may increase the risk of ROP. In addition, slower NICU growth velocity, but not rates of head or length growth, was predictive of ROP.

[Diagnostic evaluation of HLA sera obtained as a result of cooperation between the Institute of Hematology and blood donation stations]. / Ocena diagnostyczna surowic ukladu HLA uzyskiwanych we wspólpracy Instytutu Hematologii ze stacjami krwiodawstwa.

The aim of the cooperation between the Laboratory of Leucocyte and Platelet Immunology, Institute of Haematology and Blood Donation Stations was typing of anti-HLA sera from the blood of pregnant women. During 18 months of this cooperation 477 sera were studied. In 255 sera (53.1%) lymphocytotoxic antibodies were demonstrated and their specificity was determined. The types anti-HLA sera will be used for determination of HLA antigens in blood donors donating blood in the Stations. The results of these determinations, technical problems and conclusions drawn from this cooperation are discussed. Continuation of this cooperation will contribute to further limitation of the import of anti-HLA sera.

Occurrence of HLA antigens in patients with ankylosing spondylitis and in their families.

The HLA typing (A and B loci) was performed in 55 individuals with ankylosing spondylitis (a.s.) in 74 relatives of their families and in 394 normals. HLA B-27 antigen was found in 80% of tested patients with a.s. The relative risk for B-27 being 30.1 and for A2 -- 1.65. In patients with a.s. lacking B-27 antigen the course of the disease did not differ from that in B-27 positive subjects. Uveitis has been revealed in 36.4% of B-27 patients and only in 9.9% of those negative for B-27. The results obtained in families display four different patterns as concerns genetics and morbidity: 1) in all 3 generations the presence of B-27 was accompanied by a.s., 2) in none of tested family members (diseases or healty) the B-27 antigen was confirmed, 3) there was correlation between B-27 and the disease symptoms, 4) the incidence of a.s. was associated with B-27 homozygotism. The results favour the idea that B-27 antigen is a disease determining factor, however, there is probably another allelic gene (nes) cooperating with B-27 locus. The B-27 homozygotism increases markedly the risk for a.s. The course of the diseases seems to be determined by environmental factors.

Psoriasis vulgaris and pustulosis palmaris et plantaris and the HLA system.

The frequency of locus A and B antigens in 39 patients with pustulosis palmo-plantaris and in 16 patients with psoriasis vulgaris was determined in comparison with a control group of 394 healthy subjects. The data obtained in the psoriasis vulgaris group confirmed the literature data (increased frequency of B 13 and B 17 antigens). In the pustulosis palmo-plantaris group only the patients with the histopathologically confirmed psoriasis pustulosa showed a statistically significant increase of B 12 antigen which has not been reported so far.

Genetic polymorphism of FUC (EC 3.2.1.51.) in Polish population.

In a sample of the Polish population numbering 271 persons three FUC phenotypes were encountered by cellulose acetate gel isoelectric focusing (CAGIF). The frequencies of FUC1 and FUC2 genes were 0.653 and 0.347, respectively. The FUC system has proven to be of high value for paternity testing.

Salivary secretion of blood group substances in multiple sclerosis patients.

Inspired by the widely discussed problem of a possible genetic background of multiple sclerosis we have undertaken a trial of determining the relationship between the hereditary trait conveyed by a single gene, i.e. the salivary secretion or nonsecretion of blood group substances, and the occurrence of this disease. The investigations have shown that in the population of western Poland the nonsecretors of blood group substances into their saliva have a statistically significant chance of developing multiple sclerosis than secretors of these substances.

Anti-tumor antibodies in lung cancer patients. Immunofluorescence study using various indicator cells.

By means of indirect immunofluorescence a number of primary lung cancer patient sera and control sera were tested for anti-tumor antibody activity on living tumor cells as a substrate. Antibodies against surface antigens were the most frequently detected in autologous system (in 65%) on cells derived from fresh surgical material of lung cancer. They were also found in 50% of cases using tumor cells from primary short-term culture. When established cell line of lung cancer was used (E-14) in allogeneic system, the antibodies were detected in only 22% of examined lung cancer sera. Absorption of positive sera with homogenates of normal tissues did not abolish their specific activity. Positive reactions were confined to squamous cell type of bronchogenic carcinoma.

HL-A matching in thrombocyte and leukocyte transfusions.

A panel of 150 Rh+ and Rh-- donors was tested by the NIH-microcytotoxicity test against 90 antisera determing 21 HL-A antigens. For platelet and leukocyte transfusions, donors compatible in ABO and Rh groups as well as in HL-A antigens, were used. In some cases the donor and recipient were compatible in three HL-A antigens, in other cases the degree of compatibility was less satisfactory. Platelet and leukocyte concentrates were prepared by double thrombo- and leukocyte-pheresis. Before transfusions the cross cytotoxicity test with donor's lymphocytes was performed. No transfusion accidents occurred; in some patients a beneficial effect was noticed.