Comparison of the Degree of Exercise Tolerance in Children After Surgical Treatment of Complex Cardiac Defects, Assessed Using Ergospirometry and the Level of Brain Natriuretic Peptide.

Children who underwent surgery for complex congenital heart defects present worse exercise capacity than their healthy peers. In adults and adolescents, heart failure is assessed on the basis of clinical symptoms using the New York Heart Association (NYHA) score, while in an infant Ross scale; heart failure can also be evaluated by other parameters. The purpose of this study was to compare the degree of exercise tolerance in children after surgery for complex heart defects, assessed by the ratio of maximum oxygen uptake (VO2max) and the brain natriuretic peptide (N-terminal fragment of the prohormone brain-type natriuretic peptide [NT-proBNP]) concentration.The study group consisted of 42 children, ages 9 to 17 years (mean 14.00 ±â€Š2.72). Among them there were 22 children with tetralogy of Fallot (ToF) after total correction, 18 children with transposition of the great arteries (d-TGA) after the arterial switch operation, and 2 children with single ventricle (SV) after the Fontan operation. All but 1 child were in NYHA class I. The control group consisted of 20 healthy children. Outcomes of interest were the ratio of VO2max, determined during ergospirometry, and the level of NT-proBNP. The statistical analysis was performed and the groups were considered significantly different for P < 0.05.There was no statistically significant correlation between NT-proBNP and maximum oxygen uptake (VO2) kg min in the study group compared with the control group.The VO2max in the test group had a mean value less (34.6 ±â€Š8.0) than controls (38.4 ±â€Š7.7), and the differences were statistically significant (P = 0.041). In contrast, the average concentration of NT-proBNP in the study group was higher than controls (117.9 ±â€Š74.3 vs 18.0 ±â€Š24.5), and these differences were statistically significant (P < 0.001).After operations for complex heart defects (ToF, TGA, and SV), children have worse heart function parameters and exercise capacity than the healthy population. To control this, we recommend postoperative ergospirometry and determination of NT-proBNP concentrations.

[Terson syndrome--a literature review]. / Zespól Tersona - przeglad pismiennictwa.

Tersone syndrome was first described in 1900 as haemorrhages in the eye that occur as a consequence of intracranial hemorrhage. The main cause of the syndrome in adults is a subarachnoid hemorrhage following the rupture of intracranial aneurysm. The pathogenesis has not been fully understood. It is believed that the increase of intracranial pressure results in the hemodynamic changes in ocular vessels. Reported symptoms include decrease of visual acuity following generalized symptoms such as headache, loss of consciousness and meningealsigns. Physical examination usually reveals vitreous hemorrhage (classic Terson's syndrome) and other forms of intraocular hemorrhage. The authors reviewed the available literature on the Terson's Syndrome. Clinical presentation, pathogenesis, diagnosis, and available treatment options are presented and discussed, considering the rare occurrence of this disease.

[Estimation of volume of pleural fluid and its impact on spirometrical parameters]. / Ocena objetosci plynu w jamie oplucnej i jego wplyw na parametry spirometryczne.

UNLABELLED: In the course of various diseases, there is an accumulation of fluid in the pleural cavities. Pleural fluid accumulation causes thoracic volume expansion and reduction of volume lungs, leading to formation of restrictive disorders. The aim of the study was to estimate the volume of pleural fluid by ultrasonography and to search for the relationship between pleural fluid volume and spirometrical parameters. MATERIAL AND METHODS: The study involved 46 patients (26 men, 20 women) aged 65.7 +/- 14 years with pleural effusions who underwent thoracentesis. Thoracentesis was preceded by ultrasonography of the pleura, spirometry test and plethysmography. The volume of the pleural fluid was calculated with the Goecke' and Schwerk' (GS) or Padykula (P) equations. RESULTS: The obtained values were compared with the actual evacuated volume. The median volume of the removed pleural fluid was 950 ml. Both underestimated the evacuated volume (the median volume 539 ml for GS and 648 ml for P, respectively). Pleural fluid removal resulted in a statistically significant improvement in VC (increase 0.20 +/- 0.35 ; p < 0.05), FEV1 (increase 0.16 +/- 0.32 l; p < 0.05), TLC (increase 0.30 +/- 0.58 l; p < 0.05) and PEF (0.37 +/- 1 l/s; p < 0.05) CONCLUSIONS: Pleural fluid removal causes a significant improvement in lung function parameters. The analyzed equations for fluid volume calculation do not correlate with the actual volume.

Synthesis and analysis of activity of a potential anti-melanoma prodrug with a hydrazine linker.

A potential anti-melanoma prodrug containing a phenolic activator, a hydrazine linker, and a nitrogen mustard effector - (N-{4-[bis-(2-chloroethyl)amino]benzoyl}-N'-(4-hydroxybenzyl)hydrazine) has been synthesized in seven steps. Spectrophotometric measurements of its oxidation by tyrosinase showed a rapid increase of absorbance at 337 nm. HPLC analysis demonstrated that two major products were formed. However, during the reaction one of the products was converted into the other. The stable product with a maximum of absorption at 337 nm was isolated and identified as 5,6-dihydroxy-1H-indazol-1-yl 4-[bis-(2-chloroethyl)amino]benzoate. It was formed by a cyclization of the enzymatically generated o-quinone. This reaction was unexpected, since the acylated hydrazine nitrogen atom should not be sufficiently nucleophilic to attack the o-quinone ring. This cyclization prevented the effector release from the enzyme-activated prodrug. As a result, the prodrug showed only limited specificity for B16-F10 murine melanoma cells compared to reference cell lines. When applied in solid tumors in mice it showed slightly higher activity than the parent mustard drug (4-[bis-(2-chloroethyl)amino]benzoic cid), but significantly lower activity than melphalan, a commercial mustard drug with a structure resembling tyrosine, occasionally used in the treatment of melanoma.

Short communication: subtyping of Mycobacterium kansasii by PCR-restriction enzyme analysis of the hsp65 gene.

Mycobacterium kansasii is one of the most common causes of pulmonary disease resulting from nontuberculous mycobacteria (NTM). It is also the most frequently isolated NTM species from clinical specimens in Poland. The aim of this study was to investigate the distribution of M. kansasii subtypes among patients suspected of having pulmonary NTM disease. Fifty clinical isolates of M. kansasii recovered from as many patients with suspected mycobacterial lung disease between 2000 and 2010 in Poland were genotyped by PCR-restriction enzyme analysis (PCR-REA) of partial hsp65 gene. Mycobacterium kansasii subtype I was the only genotype to be identified among the isolates, both disease-associated and non-disease-associated. Isolation of M. kansasii subtype I from clinical specimens may be indicative of infection but may also merely represent colonization.

Green oncology: cultivating sustainability in medical oncology.

INTRODUCTION: Green oncology is a new conceptual and operational paradigm of oncology, which compared to the traditional biomedical model focused on the interest of a single patient and on its exclusive relationship with the doctor, represents a complex evolutionary step towards clinical activities that have to be eco-responsible of the potential current and future impact on the human, professional, structural, technological, and organizational environment, where they arise, as well as on the biosphere. DEFINITION: Green oncology works through ethical and managerial choices that incorporate, besides the traditional criteria of efficiency and effectiveness, the criterion of cultural, economic, environmental, and social sustainability as they are fair, livable, and possible to be realized.

The impact of new cancer drugs in real practice oncology: a monoinstitutional experience.

Urgent solutions range from re-engineering of the macroeconomic basis of cancer costs (e.g. value-based approaches to bend the cost curve and allow cost-saving technologies), greater education of policy makers, and an informed and transparent regulatory system. We have analyzed a total of 856 cancer patients were registered in the onco-AIFA for various drugs. The results have shown that 38.1% of patients have received only few drug administrations and their treatment was stopped within 4 or 12 weeks (depending on the type of the drug schedule). We have examined the reasons, why their treatment was immediately suspended.

[Expression of selected angiogenesis markers and modulators in pre-, peri- and postmenopausal women with ovarian cancer]. / Ekspresja wybranych markerów i modulatorów angiogenezy u chorych na raka jajnika w okresie przed-, okolo- i pomenopauzalnym.

INTRODUCTION: One of the most commonly assessed angiogenesis markers is microvessel density which is determined on the bases of specific endothelial antigen expression (CD34, CD105). Angiogenesis modulators include growth factors and their receptors (EGFR), proteases and their inhibitors, oncogenes and suppressor genes (p53). OBJECTIVE: The aim of the study was to evaluate whether there are any differences in selected angiogenesis markers and modulators expressions in ovarian cancer patients with different menopause status. MATERIAL AND METHODS: The study included 100 women, age 30-70, who underwent surgical treatment due to ovarian cancer. As far as their menopause status was concerned, the women were divided into three groups: pre-, peri-, and postmenopausal. Microvessel density was assessed on the basis of CD34 (MVD(CD34) and CD 105 (MVD(CD105) expression. Additionally, tumor tissue p53 protein and EGFR expression were investigated. Active EGFR form in blood serum samples of cancer patients was assessed before the surgery. RESULTS: Microvessel density, assessed on the basis of CD34 and CD105 expression, as well as p53 and EGFR expression were similar in all three groups of patients. Active EGFR serum concentration in women with ovarian cancer did not prove to be significantly different and did not depend on the menopause status. CONCLUSION: Intensity of the angiogenesis process does not depend on the menopausal status of women and is similar in pre-, peri- and postmenopausal patients.

Generation of C57BL/6 knockout mice using C3H x BALB/c blastocysts.

The International Mouse Knockout Consortium aims to generate a knockout mouse for every single gene on a C57BL/6 background. Our ability to generate such mice is hampered by the poor economics of producing blastocysts to achieve germline transmission of C57BL/6 embryonic stem (ES) cells. We demonstrate superior utility of (C3H x BALB/c)F1 blastocysts compared with BALB/c blastocysts, with blastocyst numbers and germline transmission from subsequent chimeras at a rate 2- to 3-fold higher than that produced with BALB/c blastocysts.

[Pulmonary mycobacteriosis--the diagnostic challenge. The authors' experience]. / Mikobakteriozy pluc--trudnosci diagnostyczne doswiadczenia wlasne.

UNLABELLED: The diagnosis of NTM-related pulmonary disease is based on clinical symptoms, radiological features and several positive cultures of one and the same NTM species from samples obtained from the respiratory tract. Short hospitalization usually does not enable sufficient diagnostic procedures to meet the diagnostic criteria, and this may lead to the reduction of diagnostic sensitivity. The aim of the study was to draw attention to NTM-related pulmonary disease, to share the authors' experience in the diagnosing of pulmonary mycobacteriosis and to indicate the possibilities of improving the diagnostic accuracy in this disease. A group of 31 patients with sputum, bronchial washing and/or bronchoalveolar lavage fluid (BALF) NTM-positive cultures was selected from a cohort of 245 patients evaluated for tuberculous and nontuberculous mycobacterial diseases (total number of 1277 specimens were invastigated). In two of them NTM related pulmonary disease was diagnosed (caused by M. kansasii and M. avium) at the course of initial evaluation. In the remaining 29 patients the microbiological data did not allow to establish the diagnosis of mycobacterial lung disease mainly due to a small number of samples from the respiratory tract. From this group 13 patients were reevaluated within 3 - 6 months from the initial investigation. This allowed to identify two new cases of mycobacteriosis (M. kansasii and M. avium). Thus among 31 patients with NTM positive cultures from respiratory tract specimens 4 patients (4/31, 12,9%) met the diagnostic criteria for mycobacterial disaease. CONCLUSION: Microbiological analysis of an adequate number of samples in symptomatic patients with radiological features suggestive for NTM-related pulmonary disease increses the diagnostic sensitivity in pulmonary mycobacteriosis. Identification of the species in positive cultures is of great importance.

[Panoramic radiograms in evaluation of caries of the first molars as an important health problem of developmental age]. / Zdjecia pantomograficzne w ocenie próchnicy pierwszych trzonowców jako wazny problem zdrowotny wieku rozwojowego.

The aim of the paper was to evaluate carietic lesions of first permanent molars on the basis of panoramic radiograms. The material comprised 128 panoramic X-rays taken in patients aged 10 to 16, before the onset of orthodontic treatment and in the course of treatment (at 7 months to 5 years; mean 2.45). Teeth with carietic lesions, fillings, endodontically treated teeth, periapical lesions as well as extractions were evaluated. Relatively few first molars radiologically did not show any signs of pathology or state after treatment. It is noteworthy that the percentage of healthy and yet untreated teeth decreased from 26.76% in the first examination to 19.34% in the second radiogram. Only in 4 patients all first molars showed no signs of pathology on both radiograms. It was stated that high frequency of dental caries of first molars was a considerable problem of developmental age. Diagnosis of such lesions due to radiographic examinations leads to prompt treatment and prevention of consequences of early extractions, such as malocclusion and developmental disorders of maxillo-facial skeleton.

Optimisation of conditions of visualisation of dental crowns in dental radiography.

Digital X-ray imaging systems are an alternative to conventional intraoral radiograms. In the paper there are discussed the possibilities of application of different digital radiography tools as well as density measurements in optimization of diagnostics of pathological lesions of teeth crowns. There were analyzed 1,491 digital intraoral radiograms obtained in 985 patients in the Digora Soredex digital radiography system. On all taken X-ray pictures there were evaluated the crowns of teeth in cases of primary and secondary caries, dental fillings, internal resorption, traumatic lesions of incisors as well as the relationships between deep carietic lesions and pulp horns as well as root furcation. An attempt was made to assess the possibilities of differentiation of cervical caries and cervical burn-out. In the paper there were presented the optimal options of digital radiography software in diagnostics of the discussed pathological lesions.