[Prenatal diagnosis of a brain tumour--an example of diagnostic and therapeutical algorithm].

The authors describe their cooperation in the diagnosis and treatment of a newborn with malignant brain tumour (rare case of carcinoma of the choroid plexus) recognised by means of prenatal sonography and magnetic resonance. The case history is an example of modern algorithm of diagnostic and therapeutic procedures in perinatal medicine and the necessary multicentre collaboration.

Detection of cytomegalovirus in infant cerebrospinal fluid by conventional PCR, nested PCR and PCR-Digene.

The possibility of amplification of human cytomegalovirus (HCMV) DNA in cerebrospinal fluid (CSF) for the diagnosis of HCMV central nervous system (CNS) infection in infants was studied. Single-step PCR, nested PCR and PCR-Digene were used to assay CSF specimens from 37 patients. Criteria for patient inclusion in the study were: 1. clinical manifestations suggesting CMV neuroinfection such as seizures, hypertonia, hypotonia, intracranial calcification, microcephaly, chorioretinitis; 2. any of the following symptoms: anaemia, hepetomegaly, prolonged cholestatic jaundice, or hepatitis, splenomegaly, thrombocytopenia, intrauterine hypotrophy; 3. serologic presentation, and/or positive results for CMV infection obtained by single-step PCR and PCR-Digene in urine and/or blood. PCR-Digene results were positive in 6 CSF samples. Four CSF samples were positive by nested PCR and 1 CSF sample by single step PCR. We found that the double PCR was about ten or more times more sensitive than single PCR and the PCR-Digene was only three times more sensitive than nested-PCR. The results were correlated with serology. Thirty-three out of 37 examined patients were seropositive (ELISA IgG); ELISA IgM gave positive results in 9 patients. In control studies, cells infected with other members of the herpes virus family were negative with these methods, which suggest that amplification combined with primers from the IE and the L-region of CMV is specific. In conclusion, nested-PCR seems to be the best method for early diagnosis of CMV infection in CSF due to an absence of false positive results and its high specificity and sensitivity.

Development conditions and principles for identification of cow's milk protein hypersensitivity in infants.

The authors studied a group of 153 infants presenting pneumonia and/or bronchitis suspected to be immunized to cow's milk proteins (cow's milk allergy). The diagnosis was confirmed in 96 children (62.7%), which is 20.8% of hospitalized infants presenting respiratory tract diseases. Factors influencing the occurrence of family cow's milk intolerance and the type of infant feeding were analyzed thoroughly. Our own principles of diagnosing hypersensitivity to cow's milk proteins, considering the family history suggesting the possibility of cow's milk hypersensitivity, the occurrence of recurrent wheezy bronchitis and symptoms of the gastrointestinal tract were established. The diagnostic usefulness of LMIT with cow's milk allergens was assessed.

[Clinical characteristics of infections with cytomegalovirus in infants from personal observations]. / Charakterystyka kliniczna zakazen wirusem cytomegalii u niemowlat na podstawie wlasnych obserwacji.

An infection with cytomegaly virus had been diagnosed in 13 infants (including 4 neonates examined up to 2 weeks of life) out of 960 infants hospitalized within 3 years. Clinical examination most frequently revealed hepato- and splenomegaly, pneumonia and neurological disorders, and during a further stage of the clinical course psychomotoric retardation was noted in 7 out of 13 infants, and hearing loss in 5 out of 13 infants. A specific immunoglobulin G preparation (Cytotect) has been successfully used in all children, producing recovery or clinical improvement together with serologic improvement.

[Coexistence of Toxoplasma gondii and Cytomegalovirus infections in infants]. / Wspóøistnienie zarazen pierwotniakiem Toxoplasma gondii i wirusem cytomegalii u niemowlat.

Coexistence of Toxoplasma gondii and Cytomegalovirus infection in 3 dystrophic newborns is discussed. Also the not very characteristic course of the infection is stressed.

[Long-term clinical observation of children with passively acquired anti-Toxoplasma antibodies]. / Dlugotrwala obserwacja kliniczna dzieci z biernym przeniesieniem przeciwcial przeciwtoksoplazmowych.

A group of 20 children born to mothers, suspected of active toxoplasma infection during gestation, was analysed. Multispecialist examinations carried out in children for the period of 2-3 years have shown that the specific antibodies were acquired transplacentally. This enabled to exclude an active infectious process in children.

Chronic diarrhea due to VIPoma in two children.

The diagnosis of vasoactive intestinal poly-peptide-secreting tumor (VIPoma) was established in two boys on the basis of watery diarrhea with hypokalemia, elevated plasma levels of vasoactive intestinal polypeptide (VIP) (range of 55-94 pmol/L), and presence of a tumor of the left adrenal gland. Despite celiac angiography, VIP estimation in blood samples taken from different parts of the body, and exploratory laparotomy, localization of the tumor in one child in vivo was unsuccessful. In the other boy, computed tomography revealed a large tumor in the left adrenal gland. Following the removal of the tumor, diarrhea ceased, and 10 days after surgery, the plasma level of VIP was 5 pmol/L. Histologically, the tumors in the two boys were found to be ganglioneuromas. The diagnosis of VIPoma is simple but localization can be very difficult. Surgical removal of VIPoma is often rewarding.