Successful Orthotopic Heart Transplantation With Positive Crossmatch in a Hyperimmunized Child on Mechanical Circulatory Support-Case Report.

In the pediatric population there is a shortage in the number of hearts available for transplantation. However, sometimes a heart transplant is urgently required to save lives. The problem arises when the patient is hyperimmunized and there is a positive crossmatch with the only available donor. We present such a case of a 9-year-old patient with dilated cardiomyopathy on ventricular assist device, in whom it was possible to perform a successful HT and also apply a successive prevention against graft rejection.

Heart Transplantation as a Result of Pediatric Inflammatory Multisystem Syndrome in an Adolescent.

Several reviews have shown that COVID-19 in children is a relatively mild disease. However, a rare complication affecting children and adolescents after COVID-19 has been identified. Pediatric inflammatory multisystem syndrome temporally associated with COVID-19 (PIMS-TS), which in some cases manifests itself as a hyperinflammatory syndrome with a multiorgan failure, may lead to death. We report a case of a 17-year-old patient who was admitted to the hospital with cardiogenic shock of unknown etiology. The disease was life-threatening, thus necessitating mechanical ventilation, circulatory support, and extracorporeal therapy due to renal and liver dysfunction. The patient tested negative for SARS-CoV-2 Reverse Transcription Polymerase Chain Reaction. Other infectious causes of illness were excluded. However, the patient had a positive IgG antibody test result and high levels of interleukin-6, which helped to diagnose PIMS-TS. Intravenous immunoglobulin and steroid therapies were initiated, unfortunately, with poor outcome. The patient's critical condition, particularly end-stage heart failure, led to mechanical circulatory support implantation and finally orthotopic heart transplantation. After the surgery, the patient's condition improved gradually. PIMS-TS manifests itself with different clinical images and as a state of varying severity, ultimately causing multiorgan dysfunction with shock resembling toxic shock syndrome. Ultimately, myocardial complications of PIMS-TS necessitated heart transplantation in the described patient.

Population Structure of Phytophthora infestans from a Single Location in Poland Over a Long Period of Time in Context of Weather Conditions.

Phytophthora infestans (Mont.) de Bary is a destructive potato pathogen. Changing weather conditions are among the factors that influence the pathogen population structure. In this study, 237 P. infestans isolates were collected from a single unprotected experimental field in an area with high late-blight pressure located in Boguchwala in the southeastern part of Poland during 15 growing seasons (2000-2014). The isolates were assessed for mating type, mitochondrial haplotype, resistance to metalaxyl, virulence, and polymorphism of 14 single-sequence repeat markers (SSRs). The results revealed 89 unique genotypes among the 237 P. infestans isolates. Eighty-seven isolates belonged to genotype 34_A1, which was detected in all the years of research except 2012. Isolates of P. infestans from individual years were very similar to each other, as shown by Nei's genetic identity based on 14 SSR markers. The obtained results on isolate characteristics were analyzed in terms of meteorological data (air temperature and precipitation) and indicated that frost, long winters, and hot, dry summers did not directly affect the P. infestans population structure. We described the variability in metalaxyl resistance and virulence among isolates of the P. infestans genotype 34_A1.

QTL for tuber morphology traits in diploid potato.

A diploid, potato mapping population consisting of 149 individuals was assessed in three consecutive years for important agronomic and quality traits: tuber shape, regularity of tuber shape, eye depth, mean tuber weight, and tuber flesh color. Analysis of variance showed that the genotype had the largest influence on the phenotypic scores but effect of the genotype × year interactions was also strong. Using this data and an existing genetic map, a quantitative trait loci (QTL) analysis was conducted. From four to seven QTL were detected for each trait except tuber flesh color, which was determined by a major QTL on chromosome III explaining 76.8% of the trait variance. Additionally, a minor QTL for flesh color was localized on chromosome II. For the other traits, significant QTL were detected: for tuber shape on chromosome X, for regularity of tuber shape on chromosome III, for eye depth on chromosome IV, and for tuber weight on chromosome I. Some detected QTL confirmed previous studies, but new ones were also identified.

Quantitative trait loci for tuber blackspot bruise and enzymatic discoloration susceptibility in diploid potato.

Tuber tissue discolorations caused by impact (blackspot bruising) and enzymatic discoloration (ED) after tuber cutting are crucial quality traits of the cultivated potato. To understand the complex genetics of the traits, quantitative trait locus (QTL) analysis using diploid mapping population and diversity array technology (DArT) markers was performed. The phenotypic assessment included the complex evaluation of blackspot bruising susceptibility through two methods: rotating drum (B RD) and falling bolt (B FB) in combination with the evaluation of enzymatic discoloration. Because of observed in-practice relationship between bruising susceptibility and tuber starch content (TSC), analysis of starch content-corrected bruising susceptibility (SCB) was performed. QTLs for bruising were detected on chromosomes I, V with both test methods. The rotating drum method enabled the detection of additional QTLs on chromosomes VIII and XII. Analysis of SCB enabled the identification of the major QTL on chromosome V and two weaker QTLs on chromosomes VIII and XII, independently of starch content. The QTL for bruising detected on chromosome I overlapped with the most significant QTL for tuber starch content. This QTL was not significant for starch content-corrected bruising susceptibility, and the effect of the QTL on chromosome V was enhanced for this trait. The QTL analysis of ED revealed the contribution of seven QTLs for the trait, located on six chromosomes, including these detected for the first time: a major locus on chromosome V and minor QTLs on chromosomes VII and X, which were specific for the trait. The QTL for ED on chromosome VIII was co-localized with the marker for polyphenol oxidase (POT32). The phenotypic correlation between bruising and ED was confirmed in QTL analyses of both traits, and the QTLs detected for these traits overlapped on chromosomes I, V, and VIII. Our results should provide a basis for further studies on candidate genes affecting blackspot bruise susceptibility and enzymatic discoloration.

Awareness of Influenza and Attitude Toward Influenza Vaccination Among Medical Students.

In Poland, influenza vaccination coverage among both the general population and healthcare workers is low. The aim of the study was to evaluate attitudes towards influenza vaccination among final-year medical students compared with first-year students at medical schools in Poland. Students were asked about the last season's influenza vaccination and what the reasons were for having, or not having, the vaccination. The knowledge of influenza was assessed using a 10-point visual analog scale. The study group consisted of 712 medical students, 404 in the first year and 308 in the final year (35 % and 31 % of all students in those years, respectively). Final-year students believed they had a better knowledge of influenza (OR = 3.33; CI95 %: 2.54-4.39). They answered questions about influenza immunizations (OR = 0.59; CI95 %: 0.44-0.78) and vaccination recommendations in pregnant women correctly more frequently (OR = 0.21; CI95 %: 0.16-0.28). The influenza vaccination rate among students in the 2014/2015 season was similar (17.1 % in the first vs. 15.9 % in the final year, NS). Among the final-year students, the reason for not having the vaccination was mainly financial and not any other. We conclude that although medical students' knowledge about influenza increases in the course of study, it did not much affect their unwilling attitude toward vaccination.

Development of somatic hybrids Solanum × michoacanum Bitter. (Rydb.) (+) S. tuberosum L. and autofused 4x S. × michoacanum plants as potential sources of late blight resistance for potato breeding.

KEY MESSAGE: Phytophthora infestans resistant somatic hybrids of S. × michoacanum (+) S. tuberosum and autofused 4 x S. × michoacanum were obtained. Our material is promising to introgress resistance from S. × michoacanum into cultivated potato background. Solanum × michoacanum (Bitter.) Rydb. (mch) is a wild diploid (2n = 2x = 24) potato species derived from spontaneous cross of S. bulbocastanum and S. pinnatisectum. This hybrid is a 1 EBN (endosperm balance number) species and can cross effectively only with other 1 EBN species. Plants of mch are resistant to Phytophthora infestans (Mont) de Bary. To introgress late blight resistance genes from mch into S. tuberosum (tbr), genepool somatic hybridization between mch and susceptible diploid potato clones (2n = 2x = 24) or potato cultivar Rywal (2n = 4x = 48) was performed. In total 18,775 calli were obtained from postfusion products from which 1,482 formed shoots. The Simple Sequence Repeat (SSR), Cleaved Amplified Polymorphic Sequences (CAPS) and Random Amplified Polymorphic DNA (RAPD) analyses confirmed hybrid nature of 228 plants and 116 autofused 4x mch. After evaluation of morphological features, flowering, pollen stainability, tuberization and ploidy level, 118 somatic hybrids and 116 autofused 4x mch were tested for late blight resistance using the detached leaf assay. After two seasons of testing three somatic hybrids and 109 4x mch were resistant. Resistant forms have adequate pollen stainability for use in crossing programme and are a promising material useful for introgression resistance from mch into the cultivated potato background.

Marker-assisted selection of diploid and tetraploid potatoes carrying Rpi-phu1, a major gene for resistance to Phytophthora infestans.

The Rpi-phu1 gene originates from an interspecific hybrid between Solanum stenotomum and S. phureja, and confers a high level of resistance to Phytophthora infestans (late blight) in potato. The Rpi-phu1 was introduced by crossing at the diploid level into the S. tuberosum gene pool and then transferred to the tetraploid level by means of 2n gametes. Tetraploid lines carrying the Rpi-phu1 were selected for further crosses. A molecular marker GP94, linked in mapping population 97-30 with the Rpi-phu1 (6.4 cM), was applied to other unselected populations (2 diploid and 1 tetraploid), and was shown to be useful in marker-assisted selection (MAS) of the resistant individuals. GP94 was applied also in commercial breeding in 2 tetraploid populations. Although the marker allele of GP94, characteristic for the Rpi-phu1 presence, was rare in the S. tuberosum gene pool, it seemed to be common in 2 other sources of resistance to late blight: S. ruiz-ceballosii and S. kurtzianum.

Tagging QTLs for late blight resistance and plant maturity from diploid wild relatives in a cultivated potato (Solanum tuberosum) background.

Phytophthora infestans causes an economically important disease of potato called late blight. The epidemic is controlled chemically but resistant potatoes can become an environment-friendly and financially justified alternative solution. The use of diploid Solanum tuberosum derived from European tetraploid cultivars enabled the introgression of novel genes encoding foliage resistance and tuber resistance from other species into the modern cultivated potato gene pool. This study evaluated the resistance of the obtained hybrids, its quality, expression in leaflets and tubers and its relation to the length of vegetation period. We also identified genetic loci involved in late blight resistance and the length of vegetation period. A family of 156 individuals segregating for resistance to late blight was assessed by three laboratory methods: detached leaflet, tuber slice and whole tuber test, repeatedly over 5 years. Length of vegetation period was estimated by a field test over 2 years. The phenotypic distributions of all traits were close to normal. Using sequence-specific PCR markers of known chromosomal position on the potato genetic map, six quantitative trait loci (QTLs) for resistance and length of vegetation period were identified. The most significant and robust QTL were located on chromosomes III (explaining 17.3% of variance observed in whole tuber tests), IV (15.5% of variance observed in slice tests), X (15.6% of variance observed in leaflet tests) and V (19.9% of variance observed in length of vegetation period). Genetic characterization of these novel resistance sources can be valuable for potato breeders and the knowledge that the most prominent QTLs for resistance and vegetation period length do not overlap in this material is promising with respect to breeding early potatoes resistant to P. infestans.

The novel, major locus Rpi-phu1 for late blight resistance maps to potato chromosome IX and is not correlated with long vegetation period.

Despite the long history of breeding potatoes resistant to Phytophthora infestans, this oomycete is still economically the most important pathogen of potato worldwide. The correlation of high levels of resistance to late blight with a long vegetation period is one of the bottlenecks for progress in breeding resistant cultivars of various maturity types. Solanum phureja was identified as a source of effective late blight resistance, which was transferred to the cultivated gene pool by interspecific crosses with dihaploids of Solanum tuberosum. A novel major resistance locus, Rpi-phu1, derived most likely from S. phureja and conferring broad-spectrum resistance to late blight, was mapped to potato chromosome IX, 6.4 cM proximal to the marker GP94. Rpi-phu1 was highly effective in detached leaflet, tuber slice and whole tuber tests during 5 years of quantitative phenotypic assessment. The resistance did not show significant correlation with vegetation period length. Our findings provide a well-characterized new source of resistance for breeding early and resistant-to-P. infestans potatoes.

[Computerized infusion test. II. Clinical use]. / Skomputeryzowany test infuzyjny. II. Zastosowanie kliniczne.

In 39 patients with intracranial lesions the resorption resistance was measured using an own computerized infusion test. A high usefulness of this test was demonstrated in the diagnosis of hydrocephalus and for establishing indications to ventriculocardiac valve implantation. In patients after craniocerebral injuries a rise was observed of the resorption resistance immediately after trauma in cases with subarachnoid haemorrhage. Later on, this resistance decreased gradually reaching a stable value after 1-2 years. Data obtained in the infusion test make possible establishing of optimal intracranial pressure and choice of an appropriate valve. The determination can be performed intraoperatively.

[Computerized infusion test. I. The method]. / Skomputeryzowany test infuzyjny. I. Metoda.

Biophysical aspects and the method of the Computerized Infusion Test (CIT) developed in the Neurosurgical Clinic of the Medical Research Center, Polish Academy of Sciences, are presented. The CIT is a development of classical methods of estimating the cerebrospinal fluid outflow resistance. It is based on a clinically tested mathematical model of the intracranial pressure-volume compensating mechanisms. The CIT enables the etrapolation of the infusion curve in cases when it is impossible to reach the upper steady during the constant infusion test because of the ICP exceeding values estimated as being critical.

CSF absorptive capacity in patients without intracranial pathology.

The role of changes in CSF inflow in patients without intracranial pathology has been studied. The CSF outflow resistance has been calculated, by dividing the CSF pressure rise by the speed of intrathecal saline infusion. The average CSF pressure rise produced during infusion test (infusion 2 ml/min) amounted to 11.15 mmHg. The calculated CSF outflow resistance equaled to 5.58 +/- 1.1 mm Hg/ml/min. On-line computer assisted analysis during infusion test helps to shorten the procedure and makes it more precise.

A fast method of estimating the elastance of the intracranial system.

The authors describe a fast method for estimating the elastance of the intracranial system in man. The method consists in constructing the so-called amplitude-pressure (Amp-P) curve which describes the relationship between the amplitude of pulse-related oscillations in cerebrospinal fluid pressure and the basic level of intracranial pressure. The Amp-P curve consists of two straight lines, and the point of intersection of these lines is thought to indicate the intracranial pressure level at which there occurs a qualitative change in the functioning of compensatory mechanisms of the intracranial system. The authors applied the method to examine the Amp-P curves of 10 patients without intracranial pathology and found that they provide a good description of the state and dynamics of the intracranial system. Preliminary data obtained in patients with intracranial pathology indicate that the method is a valuable tool in the diagnosis and treatment of neurosurgical patients.

[Statistical correlation between lactate concentration and acid-base equilibrium in cases of brain tumors, craniocerebral injuries and meningitis]. / Ocena statystyczna wspólzaleznosci stezenia kwasu mlekowego i równowagi kwasowo-zasadowej w plynie mózgowo-rdzeniowym w przypadkach guzów mózgu, urazów czaszkowo-m57OZGOWYCH I ZAPALENIA OPON

Statistical significance of correlations between lactate concentration and pH value as well as pCO2 in the cerebrospinal fluid was assessed in patients with brain tumours, craniocerebral injury and meningitis. After calculation of correlation indices it was found that with increasing lactate level the correlation between this level and the pH and pCO2 of the cerebrospinal fluid increases. Correlation coefficients were far from their maximal values (+1 or -1) which indicates absence of a direct cause-and-effect relationship between lactate concentration and both remaining values. The analysis of results in the group with lactate level exceeding 30 mg/100 ml demonstrated lowest correlation coefficients between these values in patients with meningoencephalitis.

A method of estimating intracranial decompensation in man.

A new method of estimating intracranial decompensation in man is described. An on-line computer system is connected to an intracranial pressure (ICP) monitoring system to compute regression plots of mean ICP vs standard deviation; standard deviation is used as a measure of ICP instability. Two zones with distinctly different slopes are a characteristic feature of these plots. It is thought that the changes of slope signify intracranial decompensation.

[Statistical analysis of cerebrospinal fluid acid-base equilibrium and cerebrospinal fluid lactate concentration in cases of brain tumors, cerebrocranial injuries and meningoencephalitis]. / Ocena statystyczna równowagi kwasowo-zasadowej i stezenia mleczanów w plynie mózgowo-rdzeniowym w przypadkach guzów mozgu, urazów czaszkowo-mozgowych i zapalenia opon mózgowo-rdzeniowych

A statistical analysis of CSF lactate concentration and CSF pH and PCO2 was performed. The values were obtained from 211 samples taken from 76 neurosurgical patients. The values of pH and pCO2 were classified in three groups corresponding to the following three ranges of lactate concentration: below 15 mg%, 15-30 mg%, over 30 mg%. The mean values and standard deviations were calculated: suitable tests: F, t (Student), C (Cochran and Cox) were used. It was established, that statistically significant changes of CSF acid-base balance were present at lactate levels over 30 mg%. Next, the patients with lactate concentrations over 30 mg% were analysed. They were divided into three groups according to etiology: inflammatory changes, injuries, tumours. It was shown, that the CSF acid-base balance in patients with brain tumours is less disturbed then in patients with inflammatory changes or brain injury.