[Incidence of osteoporosis discovered during prophylactic tests in women from the Northeastern region of Poland]. / Czestosc wystepowania osteoporozy w badaniach profilaktycznych kobiet regionu Polski pólnocno-wschodniej.

In at random well-chosen group of 803 women one passed investigation of thickness of bone of forearm or limb not dominating. All examined were divided into two groups: women before menopause and after menopause. Bone mineral structure was estimated in individuals by thickness of osseous mass--BMD. Criteria of osteoporosis was coefficient T-score, which value one accepted peaceably with recommendations of WHO. Osteoporosis steps out considerably more often in women after menopause and grows together as the years go after last menstruation.

[Risk of osteoporosis occurrence and body mass index BMI in the population of women of the Northeastern region of Poland]. / Ryzyko wystapienia osteoporozy a wskaznik masy ciala BMI w populacji kobiet regionu Polski pólnocno-wschodniej.

In group 775 of women from region of north-eastern Poland, in period before and after menopause we estimated mass of body on the ground values of coefficient BMI. Values of coefficient between 18.5 and 24.9 were accepted as normal according to WHO. In chances of stoutness we qualified the type counting coefficient WHR. At all examined one passed estimation of thickness of tissue osseous bones of forearm. In rated frequency of occurrence of osteoporosis at examined women. One ascertained, that overweight and stoutness indeed puts into influences on lowering frequencies of occurrence osteoporosis and favors the maintenance correct thickness.

[Maternal plasma and amniotic fluid interleukin-6 and tumor necrosis factor-alpha levels in imminent preterm labor]. / Stezenie interleukiny-6 i czynnika martwicy nowotworu-alpha w surowicy krwi i plynie owodniowym ciezarnych z zagrazajacym porodem przedwczesnym.

DESIGN: Our purpose was to investigate the maternal plasma and amniotic fluid interleukin-6 and tumor necrosis factor-alpha levels in women with imminent preterm labour. MATERIAL AND METHODS: The present study was designed to evaluate IL-6 and TNF-alpha levels in 93 pregnant women with threatened preterm labour and 40 women with normal pregnancy. Maternal blood samples were collected by routine forearm venipuncture at admission during routine laboratory tests. Amniotic fluid was collected through hysterectomy during caesarean delivery from women at term but not in labour and by amniotomy or hysterectomy from women with preterm labour. RESULTS: Maternal plasma and amniotic fluid IL-6 and TNF-alpha concentrations were significantly elevated in women with preterm labour (premature rupture of membranes and uterine contractions) compared to gestationally matched, non-labouring controls.

[Maternal plasma and amniotic fluid interleukin-6 levels in imminent preterm labor]. / Stezenie interleukiny-6 w surowicy krwi i plynie owodniowym ciezarnych z zagrazajacym porodem przedwczesnym.

Our purpose was to investigate the maternal plasma and amniotic fluid interleukin-6 levels in women with preterm labour. The present study was designed to evaluate IL-6 levels in 93 pregnant women with threatened preterm labour and 40 normal pregnant. Maternal blood samples were collected by routine forearm venipuncture at admission during routine laboratory tests. Amniotic fluid was collected during hysteretomy during caesarean delivery from women at term but not in labour and by amniotomy or hysteretomy from women with preterm labour. Maternal plasma and amniotic fluid IL-6 concentrations were significantly elevated in women in preterm labour (premature rupture of membranes and uterine contractions) compared to gestationally matched, non-laboring controls.

[Estimation of blood viscosity in woman at puerperium]. / Ocena lepkosci krwi u poloznic.

Marks of blood viscosity in different states of physiology and of pathology of man are well-supplied documentary evidence. One recognized also influence of blood viscosity on disclosure of some disease processes. Period pregnancy and labour joins with changes of volume and of composition of blood circulation. Authors decided to price blood viscosity in period puerperal and to compare these given to universally coming to light anaemia's woman in puerperium. Investigations one passed in groups pregnant and woman in puerperium from different degree exacerbations of anaemia. Obtained results of stickiness one achieved to morphological parameters of blood. One ascertained, that blood viscosity is less at woman in puerperium than at women pregnant and grows less together from degree anaemia's.

Insulin-mediated alterations in S-adenosylmethionine decarboxylase expression in H-ras transformed cells of varying degrees of malignancy.

Cell growth regulation is a highly complex process. The present study demonstrates a novel link between alterations in insulin-mediated regulation during malignant conversion and the expression of S-adenosylmethionine decarboxylase, a key regulatory activity in the biosynthesis of polyamines. H-ras transformed mouse 10 T 1/2 cell lines exhibiting increasing malignant potential were investigated for possible insulin-mediated changes in S-adenosylmethionine decarboxylase gene expression. Selective induction of S-adenosylmethionine decarboxylase gene expression was observed, because, in contrast to nontransformed 10T 1/2 cells, only H-ras transformed cells capable of only benign tumour formation or H-ras transformed metastatic cells exhibited marked elevations in S-adenosylmethionine decarboxylase mRNA levels. Evidence for regulation of S-adenosylmethionine decarboxylase gene expression at both transcriptional and post-transcriptional levels was found. Evidence was also found for a cycloheximide sensitive regulator of S-adenosylmethionine decarboxylase gene expression in H-ras transformed metastatic cells, whose effect, in combination with insulin, resulted in a further augmentation of S-adenosylmethionine decarboxylase gene expression. This regulation was not present in H-ras transformed cells capable of only benign tumour formation. These results suggest that insulin can modulate S-adenosylmethionine decarboxylase gene expression in H-ras transformed cells and further suggests a mechanism of insulin stimulation of transformed cells wherein alterations in the regulatory activity of S-adenosylmethionine decarboxylase gene expression are critical and constitutes a part of an altered growth regulatory program associated with cellular transformation.

[Analysis of the frequency of diseases during twin pregnancy, methods of its completion and complications ascertained in newborns from personal clinical materials]. / Analiza czestosci schorzen towarzyszacych ciazy blizniaczej, sposobów jej zakonczenia i powiklan stwierdzanych u noworodków w materiale wlasnym kliniki.

One analysed course 49 of pregnancies and labours, which one took place in Clinic of Obstetrics Medical Academy in Bialystok in years 1997-1999. Most frequent complication of bigeminal pregnancy was premature labour (53.1%). Considerable percentage of gemellary pregnancies was delivered of caesarean section. In chances of pregnancies finished before term--62% and 57% in pregnancies finished in term. Indication to caesarean section was most often threatening intrauterine infection of embryo at premature departure amniotic fluid in premature delivery and complications of preeclampsia in delivery at term. Labour in operating way was more profitable for new-born child than childbirth ways of nature.

[The role of endothelium in normal pregnancy and pregnancy complicated by preeclampsia]. / Rola sródblonka naczyniowego w ciazy prawidlowej i powiklanej EPH gestoza.

Endothelial cell dysfunction is thought to play a role in preeclampsia and the reduced production by vascular endothelial cells of the antiaggregatory and vasodilatory factors is well documented. The present study was designed to evaluate endothelial cells function in preeclamptic and healthy pregnant subjects. The nitric oxide plasma concentration in women with preeclampsia was significantly lower as compared with normotensive pregnant women. A significant increase in ET concentration was found in preeclamptic women as compared with normal pregnant patients and normal non-pregnant. The plasma concentrations of von Willebrand factor were significantly increased in healthy pregnancy as compared with preeclamptic patients. The results of our study demonstrate a significant endothelial cells damage in preeclamptic patients. Whether these observations contribute to the vascular pathophysiologic features of preeclampsia remains to be proved.

[The role of nitric oxide and blood platelets in pathogenesis of preeclampsia]. / Rola tlenku azotu (NO) i plytek krwi w patogenezie EPH gestozy.

The aim of this study was to evaluate the concentration of nitric oxide and the platelet function in preeclamptic and normal pregnant women. The patients with preeclampsia had new hypertension (diastolic blood pressure consistently > or = 90 mmHg with previously lower readings), new proteinuria and generalized oedema that subsequently regressed after delivery. Blood was collected by routine forearm venipuncture before delivery. The following parameters were evaluated: nitric oxide, beta-TG and PF4. The nitric oxide plasma concentration in women with preeclampsia was significantly lower compared with normotensive pregnant women. beta-TG and PF4 concentrations were significantly increased in patients with preeclampsia. Whether these observations contribute to the vascular pathophysiologic features of preeclampsia remains to be proved.

Isoenzymes of N-acetyl-beta-hexosaminidase in complicated pregnancy.

The activity of N-acetyl-beta-hexosaminidase was found to be significantly higher in the placentas collected after delivery from women in puerperium with symptoms of prolonged pregnancy or complicated by EPH gestosis, than in placentas from normal pregnancy. Isoelectrofocusing of placenta homogenates showed the presence of isoenzymes A, P and B of N-acetyl-beta-hexosaminidase. Different isoenzyme A patterns in homogenates were observed in placentas obtained from normal and prolonged pregnancies and in those complicated by EPH gestosis.

Evaluation of the anterior cruciate ligament of the knee: comparison between partial flexion true sagittal and extension sagittal oblique positions during MR imaging.

OBJECTIVE: To compare partial flexion true sagittal (FS) magnetic resonance (MR) images with extension sagittal oblique (ESO) MR images with regard to delineation of the anterior cruciate ligament (ACL) in the knee. DESIGN: To establish the appropriate degree of flexion of the knee joint, two human cadaveric knee joints were used as a supplementary technique. FS and ESO images then were performed in 17 knees with an intact ACL and six knees with a torn ACL. In 22 of the 23 knees in which the MR diagnosis of intact or torn ACL corresponded to that derived from arthroscopy, the paired MR images were rated by a three-point scale. RESULTS: FS images were rated superior to ESO images in 53%, 41% and 47% of cases with regard to femoral attachment sites, midportions and tibial attachment sites of intact ACLs, respectively. FS images allowed better assessment of disrupted ACLs and residual ligamentous structures. Overall the FS images were either equal to or better than the ESO in the majority of cases. CONCLUSION: FS images are useful when the ACL is not well visualized in initial ESO images.

[Alterations in the content of collagenous constituents of amniotic fluid in the course of EPH-gestosis]. / Zmiany w zawartosci skladników kolagenowych plynu owodniowego w przebiegu gestozy-EPH.

OBJECTIVES: EPH-gestosis may cause placental insufficiency and affect the metabolism of placenta and fetus. Various metabolites of amniotic fluid may reflect the fetal metabolism. DESIGN: It was decided to compare the content and some biochemical features of hydroxyproline-containing collagenous constituents in the amniotic fluid derived from normal gestations and gestations affected by EPH-gestosis. MATERIALS AND METHODS: Amniotic fluid was taken during labour (full-term gestations) by amniocentesis from 10 healthy women (control group) and 10 women with EPH-gestosis. UV-absorption spectra, protein and hydroxyproline were measured in non-dialyzed and dialyzed amniotic fluid. Hydroxyproline-containing collagenous constituents of amniotic fluid were chromatographed on Sephadex G-200. RESULTS: Statistical differences in concentrations of total and non-dialyzable hydroxyproline between normal and gestotic amniotic fluid were not found. In contrast to that, gestotic amniotic fluid contains more dialyzable hydroxyproline (6.2 mg/ml) than normal fluid (4.5 mg/ml; p < 0.05). Molecular sieving on Sephadex G-200 shows that this difference is due to higher content of low molecular collagen degradation products. CONCLUSION: Amniotic fluid, derived from pregnancies complicated by EPH-gestosis, contains higher amount of low molecular collagen degradation products than normal amniotic fluid. It is probably the result of more intensive degradation of fetal and placental collagen.

Collagenous constituents of amniotic fluid.

The amniotic fluid (AF) was fractionated by dialysis, gel filtration and SDS/PAGE, and submitted to the assay of collagenous constituents. The collagenous character of peptides and proteins of amniotic fluid was confirmed by hydroxyproline (Hyp) assay and treatment with bacterial collagenase followed by electrophoresis and gel filtration of the digestion products. It was found that AF contains collagen degradation products but the classical method of Hyp determination described by Woessner (Arch. Biochem. Biophys., 1961, 93, 440-447) gives overestimated values due to the interference with other AF components. Fractionation of AF on Sephadex G-100 column allowed to remove the interfering material and to estimate the actual Hyp content which equals to approx. 6.2 microg/ml. About 70% of Hyp was found in low molecular dialyzable products and the rest (about 30%) appears to be a constituent of nondialyzable collagenous polypeptides of the molecular mass of about 7.9-26.3 kDa. It is suggested that such collagenous polypeptides may be the products of proteolytic conversion of collagen precursor (procollagen) into the monomeric form of this protein. No high molecular forms of collagen, corresponding to alpha-subunits, were found.

Multicenter evaluation of dual-therapy (omeprazol and amoxycillin) for Helicobacter pylori-associated duodenal and gastric ulcer (two years of the observation).

Treatment with the proton pump inhibitor (omeprazole) and single antibiotic (amoxycillin), two synergistic compounds, can cure Helicobacter pylori (H. pylori) infection, but this therapy is not as effective as had been expected. However, some studies show promising results. The aim of our study was to evaluate the effect of two weeks dual-therapy with omeprazole (O) and amoxycillin (A) on gastric (GU) and duodenal ulcer (DU) patients: ulcer healing, eradication of the H. pylori and recurrence rate of the ulcer. We studied 216 patients (aged 18-70) endoscopically proven GU (58 patients) and DU (158 patients). Rapid urease test from the two antrum biopses and two antral and two corporeal biopses using Giemsa stain method for confirmation of the H. pylori infection were used. The patients were treated with omeprazole 20 mg BID and amoxycillin 1.0 g BID for 2 weeks and investigated every 4 months during 2 years. Clearance effect of Hp infection was achieved in 65.1% GU and 66.4% DU patients. Eradication ("check point" after 4 months) in 43% DU and 56.6% GU patients was confirmed. Reinfection rate was found in 16% during 2 years. We conclude--dual-therapy (O and A) is not sufficiently effective to be recommended as an anti-H. pylori treatment. H. pylori eradication prevents recurrence of peptic ulcer and is an important issue in attempts to achieve permanent ulcer healing.

[Collagen degradation products in amniotic fluid]. / Produkty degradacji kolagenu obecne w plynie owodniowym.

It was found that amniotic fluid (38-42 Hbd) contains hydroxyproline in concentration about 10 micrograms/ml. Gel filtration and dialysis demonstrated that most of hydroxyproline exists in a form of low molecular weight products. Furthermore, it was found that amniotic fluid contains a protein which eluates during gel filtration in void volume of the column. It gives a positive reaction for hydroxyproline but the absorption spectrum of such product is not characteristic for this amino acid. Furthermore, it is not digested by bacterial collagenase. It allows to conclude that amniotic fluid (38-42 Hbd) does not contain collagenous proteins. Only low molecular weight degradation products were found. Only part of them is susceptible on the action of bacterial collagenase.

Localization of specific joint causing hindfoot pain: value of injecting local anesthetics into individual joints during arthrography.

OBJECTIVE: The purpose of this study was to evaluate the utility of selective injection of local anesthetic into hindfoot articulations for localizing the source of posttraumatic pain and to compare clinical response with the severity of degenerative change in the various articulations evident on plain radiographs or CT scans. SUBJECTS AND METHODS: Anesthetic arthrography was performed in 18 patients with posttraumatic hindfoot pain. In all, 32 joints were assessed: 15 talocalcaneonavicular, 11 subtalar, five ankle, and one calcaneocuboid. Following intraarticular injection of a mixture of equal amounts of meglumine diatrizoate 60%, lidocaine 1%, and bupivacaine 0.25%, patients were asked to grade the degree of pain relief they experienced on a scale from 0% to 100%. The degree of degenerative changes seen on preliminary radiographs and CT scans was graded blindly and retrospectively by an experienced musculoskeletal radiologist using a 3-point scale (grade 0 indicated a normal joint, grade 1 indicated mild to moderate degenerative change, and grade 2 indicated severe degenerative change). The value of findings on both routine radiographs and CT scans as predictors of the degree of symptomatic relief obtained from specific joint injections was determined. Arthrodesis was performed in nine patients on the basis of the results of anesthetic injections. RESULTS: The degree of pain relief experienced after intraarticular injection of anesthetic correlated with the severity of degenerative change as assessed by routine radiography in 15 of 32 joints and as assessed by CT in eight of 18 joints. In 14 of 32 joints assessed by routine radiography and in seven of 18 joints assessed by CT, the amount of pain relief achieved by anesthetic arthrography was less than that predicted by imaging evidence of degenerative disease. In five of 32 joints judged normal on plain film radiographs, significant pain relief was experienced following anesthetic injection, resulting in a change in the proposed surgical procedure. Long-term follow-up indicated satisfactory results in eight of the nine patients in whom arthrodesis was performed. CONCLUSION: Selective intraarticular anesthetic injections afford a direct method of confirming the site of hindfoot pain and may aid in surgical planning, because plain film radiography or CT may underestimate or poorly indicate the most symptomatic articulations.

Diffuse idiopathic skeletal hyperostosis: diagnostic significance of radiographic abnormalities of the pelvis.

Retrospective evaluation of the osseous pelvis in 93 patients with severe diffuse idiopathic skeletal hyperostosis (DISH) revealed 14 locations of radiographic abnormalities. Two osteoradiologists independently studied these sites for abnormalities in a prospective, blinded fashion in 103 patients over the age of 45 years. Lateral radiographs of the thoracolumbar spine were quantitatively and qualitatively evaluated to determine whether DISH, spondylosis deformans, or a normal spine was present. Statistical analysis was performed for evaluation of interobserver reliability, the relationship between pelvic and spinal abnormalities, and the significance and predictive values of pelvic abnormalities for DISH versus non-DISH and DISH versus spondylosis deformans. Although significantly higher frequencies and greater extents of radiographic abnormalities at 10 of 14 pelvic locations were noted for DISH compared with non-DISH, this number decreased to four of 14 locations when compared with spondylosis deformans. The alterations in three of these four pelvic sites consisted of ossification of ligaments. These changes appear to be good indicators of the presence of spinal DISH and support the concept that DISH is an entity separate from spondylosis deformans.

Computed tomography with multiplanar reformation and three-dimensional image reconstruction in the preoperative evaluation of adult hip disease.

Computed tomography (CT) with multiplanar reformation and three-dimensional (3D) image reconstruction was used pre-operatively to outline the bony morphological changes and femoral-acetabular relationships in 25 adult patients suffering from hip disease. Diagnoses included ischaemic necrosis of the femoral head, osteoarthritis, rheumatoid arthritis, calcium pyrophosphate dihydrate (CPPD) crystal deposition disease, previous trauma and chronic dislocation. Polyethylene models of the femora and acetabula were constructed from three-dimensional contouring of CT data and compared with resected specimens in patients subjected to subsequent total hip arthroplasty. Information provided by this imaging technique was useful in both selecting and guiding the most appropriate surgical procedure and it was found that models depicted the actual bony contours with reasonable accuracy. CT combined with multiplanar reformation and 3D analysis may be the optimal pre-operative means of assessment of the diseased adult hip.

Destructive spondyloarthropathy in hemodialysis patients. Report of four cases and prospective study.

A destructive spondyloarthropathy is reported in four patients undergoing maintenance hemodialysis for chronic renal disease. In a separate investigation a controlled, prospective radiographic study of the cervical spine revealed this spondyloarthropathy in 4 (15%) of 26 long-term dialysis patients. A single disc level was involved in three patients, and two disc levels were involved in one patient. This spondyloarthropathy correlated with the duration of dialysis but not with the radiographic evidence of renal osteodystrophy or severity of laboratory abnormalities associated with hyperparathyroidism. Three of these four patients also had discovertebral erosions or destruction involving the lumbar spine. Cervical spine flexion views revealed evidence of ligamentous laxity or instability in three (12%) dialysis patients, all with vertebral resorption and disc space narrowing. It is postulated that this instability may contribute to the development of cervical discovertebral lesions or be a secondary manifestation of disc destruction.

Perspective: three-dimensional imaging of the musculoskeletal system.

An evaluation of musculoskeletal disorders in 202 patients using three-dimensional CT displays has revealed the usefulness of the technique, especially in patients with fractures of skeletal areas with complex anatomy, articular disorders of the hip, and spinal stenosis. In some cases, plastic models of diseased areas have been created from the CT data and are reasonably accurate, providing a graphic representation of the disease and the ability to perform rehearsal surgery. A preliminary investigation of three-dimensional displays of MR images indicates that the technique is feasible, although its clinical practicality requires further analysis.