Morphological assessment of thin basement membrane disease.

Thin basement membrane disease is more common than IgA nephropathy or Alport syndrome, which are also associated with the presence of erythrocyturia. Very few reports on the disorder are available in the Polish literature. The objective of this work was to analyze the results from 83 patients with thin basement membrane syndrome as well as to formulate a proposal of strict morphological assessment criteria for the disorder. Attention was drawn to the requirement of thickness of the lamina densa rather than the entire basement membrane thickness and a sufficiently high number of loops featuring thinned lamina densa, namely at least 80% of loops, being taken into account. Occurrence of other morphological changes associated with the disorder and clinical symptoms other than erythrocyturia was also highlighted.

Independent reaching of the sitting position depends on the motor performance in the 3rd month of life.

OBJECTIVE: Sitting is one of milestones in motor development. However, reaching of the sitting position must precede achieving the ability of independent sitting. Qualitative assessment of motor performance at 3 months of age, with the prospective quantitative assessment of the function of independent reaching of the sitting position at the age of 8 months. PATIENTS AND METHODS: 125 children, 51 girls and 74 boys (born at term n = 78; born prematurely n = 47) were subject to prospective assessment of motor development with qualitative characteristics at the age of 3 months and quantitative characteristics at the age of 8 months. In parallel, the children were subjected to neurological assessment. Risk factors that could potentially affect motor development were analyzed. RESULTS: Children who at the age of 3 months performed at least 13 /15 qualitative elements in the prone position and at least 13/15 qualitative elements in the supine position, at the age of 8 months reached independently the sitting position. Poor qualitative assessment at the age of 3 months and a higher prevalence of risk factors increased the risk of non-reaching the sitting position. In the prone position, the pelvis, lower limbs, the arms and shoulders showed the most expressed differences between the children who reached or did not reached the independent sitting. For the supine position, the pelvis and lower limbs, as well as the extension of the spine and correct alignment of the shoulders showed the most expressed differences. CONCLUSIONS: Proper qualitative development at the age of 3 months is a good predictor of the achievement of independent reaching of the sitting position at the age of 8 months.

Qualitative motor assessment allows to predict the degree of motor disturbances.

OBJECTIVE: Early diagnosis is necessary in order to determine neurological integrity and the potential risk of improper development, and also to undertake possible early intervention. The quantitative assessment consists of observation of motor development, and provides information about whether a child performs an activity (movement) expected at a given life period. The qualitative assessment of motor performance verifies whether a specific activity is performed properly. The papers aims to demonstrate the motor performance assessment sheet for infants at the age of 6 months and assessment of qualitative elements of 3rd month at the age of 6 months. SUBJECTS AND METHODS: 173 infants (76f/97m) were assessed by a neurologist and a physiotherapist at the age of 6 and 9 months. The neurologist set the final diagnosis at the age of 16 months. Additionally, the physiotherapist assessed qualitative elements typical of the 6th month and of the 3rd month. Risk factors possibly affecting motor performance were considered. RESULTS: The assessment performed by the neurologist and the physiotherapist demonstrated high conformity. Infants with varying degrees of developmental delay and with cerebral palsy at the age of 6 months have still not achieved all of the qualitative characteristics typical of the 3rd month of life, nor proper performance for the 6th month. The low Apgar score and the presence of intraventricular haemorrhage affected the motor development at the age of 6 months. CONCLUSIONS: The author's motor development assessment sheet applied at the age of 6 months proves to be a sensitive research tool and demonstrates good predictive value.

The effect of moderate hypoxia on free sterols: content and pattern in white matter.

Wistar rats underwent moderate hypoxia by exposing them to a respiratory gas mixture containing 7% oxygen, for 30 min. The myelin was analyzed at 4 h 24 h, day 14, and day 60 after hypoxia. The group of neutral lipids isolated from myelin was analyzed by GC-MS (gas chromatography-mass spectrometry) to separate and measure free sterols. In the myelin of hypoxia treated animals the pattern of free sterols was variable. Cholesterol concentration decreased with the changes in the content and composition of sterols present in smaller amounts. These changes may indicate the disturbances in some steps of cholesterol biosynthesis and metabolism in pathologic conditions. The appearance of sterols characteristic for plants (beta-sitosterol) was noticed in myelin of experimental animals. The possible reason for the presence of this sterol in animals may be the result of its intake during feeding, however, biosynthesis can not be excluded.

[Lipid image in glioblastoma multiforme]. / Obraz lipidów w glejaku wielopostaciowym.

Changes in the content and composition of lipids in brain tumours of different degree of malignancy are still the subject of numerous scientific studies. It is known that in developing brain tumours structural and functional changes of its cells, take place, in which lipids play a crucial role. The examination of the lipid spectrum was conducted in a material extracted from tumour adjacent areas (by means of fenestration) as well as from tumours themselves in 11 patients (mean age 56.8 yrs). Based on histological studies all the tumours were qualified as glioblastoma 4th degree of malignancy. Lipids were isolated from the tumours as well as from their adjacent areas. Later on they were separated, using column chromatography and thin-layer chromatography, into three classes: phospholipids, galactolipids and neutral lipids. Separated lipids were subjected to quantitative analysis by spectrophotocolorimetric method. In comparison to adjacent areas, in tumours distinct changes of lipid levels were noticed in all analysed lipid classes. Statistical analysis showed significant decrease of phospholipids (elements stabilizing cell membranes) in tumours in comparison to their adjacent areas (Wilcoxon's test: p < 0.05). At the same time in tumours an increase of level of plasmalogens took place: phosphatidylcholine (PC) (PPC), phosphatidylethanolamine (PE) (PPE) typical elements of malignant tumours, responsible for cross cell membrane transportation processes. This phenomenon was accompanied by changes of levels of PC/PE and PC/SM (sphingomyelin) ratios connected with adhesiveness and other membrane features. Changes in the level of lipids, and phospholipids in particular, in glioblastoma 4th degree of malignancy in comparison to adjacent areas can indicate the pathological processes in cells of these tumours.

[Enzymatic activity in cerebrospinal fluid in the monitoring of the brain lesions following intracranial tumors]. / Aktywnosc enzymów w plynie mózgowo-rdzeniowym po operacjach guzów wewnatrzczaszkowych.

After intracranial tumour surgery edema, ischaemic and haemorrhagic changes are developing in the brain. It causes leakage of certain intracellular components and enzymes into extracellular and cerebrospinal fluid. This study includes 46 patients operated on for cerebral tumours. Lumbar CSF was obtained in postoperative course and the activity of AST, ALT, LDH, alpha HBDH, CK, gamma GT and oxygen concentration were estimated. In the control group were 10 patients suffering from sciatic pain and CSF was obtained during radiculography. For diagnostic and prognostic purposes of biochemical markers statistical analyse methods were employed and comparisons with clinical factors were carried out. In conclusions we suggest that enzymes AST, alpha HBDH, CK and oxygen content give valuable additional information of postoperative brain damage.

[Use of a video questionnaire for assessment of asthma prevalence in school children as part of the ISAAC epidemiological study]. / Zastosowanie video-kwestionariusza w ocenie czestosci wystepowania astmy oskrzelowej u dzieci szkolnych w badaniach epidemiologicznych ISAAC.

The aim of this publication is the comparison of the data characterizing asthma prevalence obtained from standardized questionnaire (SQ) and video-questionnaire (VQ) used in epidemiological study ISAAC--Poznan. Number of positive answers to questions concerning wheezing ever, current wheezing, night symptoms were lower in VQ. The percentage of children reporting exercise induced asthma didn't differ in both methods. Severe asthma attacks were reported more frequently in VQ. VQ may eliminate the differences in perception and interpretation of asthma symptoms, but presentation of severe symptoms leads to underestimation of asthma problem.

[Prevalence of allergic diseases in schoolchildren in Krakow and Poznan (based on a standardized ISAAC questionnaire)]. / Wystepowanie chorób alergicznych u dzieci szkolnych w Krakowie i Poznaniu (na podstawie badan ankietowych ISAAC).

The study population included children aged 6-7 and 13-14 years from primary schools in Kraków (2302 and 2967 children respectively) and Poznan (3132 and 4069 children respectively). The prevalence was assessed using ISAAC questionnaire. In younger age group the number of children with diagnosed asthma and presenting asthma symptoms was significantly higher in Kraków than in Poznan. In older age group higher percentage was observed in Kraków in relation to wheeze ever and nocturnal cough during last year. Pupils from Kraków had symptoms of allergic rhinitis and were diagnosed as allergic rhinitis more frequently than from Poznan. Symptoms suggestive for skin allergy were more often observed in Kraków, but the differences were significant in relation to symptoms during last year in both age groups and in relation to symptoms ever in older age group. Our study revealed discrepancy between the prevalence of symptoms of asthma and allergic rhinitis and the prevalence of established diagnosis.

[Congenital toxoplasmosis in the Poznan region]. / Toksoplazmoza wrodzona w województwie poznanskim.

Among 3,734 women, hospitalized for giving birth, 58.9% had a positive Toxoplasma serological test (DA). No clinical expression of congenital toxoplasmosis was observed in 4,311 newborns; seven had a false positive ISAGA test with cord blood. Only 24% of the women were aware of congenital toxoplasmosis and only 3% were serologically examined before. Health education should be intensified and serological tests more commonly performed especially in the risk groups.

[Application of computer systems in perinatology. I. Review of computer systems]. / Zastosowanie systemów komputerowych w perinatologii. I. Przeglad systemów komputerowych.

The main elements of the computer system used in medical practice are discussed. Typical application possibilities of microcomputers in perinatal medicine are described.

[Application of computer systems in perinatology. II. Organization of computer systems in intensive care of the fetus and newborn]. / Zastosowanie systemów komputerowych w perinatologii. II. Organizacja systemu komputerowego w intensywnym nadzorowaniu plodu i noworodka.

The main computer systems used in perinatal medicine are described, with particular reference to the systems of analysis of perinatal data, analysis of cardiotocogram, obstetric ultrasonogram, assessment of the heart function of the newborn, records of respiratory activity in newborns, and use of computers in parenteral alimentation of newborns.

[Mathematical foundation for biophysical methods in fetal monitoring. I. Fetal electrocardiography]. / Podstawy matematyczne biofizycznych metod monitorowania plodu. I. Elektrokardiografia plodowa.

The authors discuss the foundations of mathematical analysis of fetal electrocardiograms, with particular reference to the obtaining of ECG signal by indirect method, and signal processing.

[Mathematical foundations for biophysical methods in fetal monitoring. II. Cardiotocography]. / Podstawy matematyczne biofizycznych metod monitorowania plodu. II. Kardiotokografia.

The principles of mathematical analysis of cardiotocographic records are described, together with the methods of calculation of the baseline, oscillations, short-term and long-term variability, and cardiotocographic analysis in frequency range.

[Mathematical foundation for biophysical methods in fetal monitoring. III. Magnetocardiography, phonocardiography, polycardiography, and Doppler blood flow analysis]. / Podstawy matematyczne biofizycznych metod monitorowania plodu. III. Magnetokardiografia, fonokardiografia, polikardiografia, analiza dopplerowska przeplywów krwi.

Magnetocardiography, phonocardiography, polycardiography and blood flow analysis based on Doppler phenomenon are described discussing the importance of these methods in fetal monitoring in pregnancy and labour.

Quantification of the fetal heart rate variability by spectral analysis in growth-retarded fetuses.

The analysis of short-term variability of fetal heart rate in the frequency domain was performed. The fetal activity states (quiescence, trunk rotation, body movements, fetal breathing movements) were taken into account. The differences between the shapes of power spectra in physiological and growth-retarded fetuses were discussed.

A comparative study of usefulness of quantitative parameters in the description of cardiotocogram records.

This study was an attempt to choose the optimized set of the features obtained from cardiotocogram records, which could explain in the best way the variability of foetal acid-base status parameters at labour. We prepared a package of the procedures in FORTRAN language which provides the possibilities for automatic detection and recognition of the long-term variability such as accelerations and decelerations and assessing some parameters connected with short-term variability (among other things oscillation bandwidth and number of baseline crossings). The acquired variables were subjected to multivariate statistical analysis to estimate the predictive power of a particular parameter. We used the described method to predict the variation of the foetal scalp blood pH and base deficit. This let us construct a set of variables which explains the maximal part of the variability of gasometric parameters. It affords possibilities for the estimation of the relative power of a particular component calculated from the cardiotocogram pattern. We obtain 41.7% of the explained variance for pH and 38.3% for base deficit.