Maps of Ventricular Activation Time (VAT) Differences in Children on Peritoneal Dialysis - a Pilot Study.

BACKGROUND: Decrement of glomerular filtration rate leads to many serious complications that cause both functional and structural impairments of the other organs. Long-term clinical observations of children and teenagers with end-stage renal disease (ESRD) showed that more than one third of those patients manifested various cardio-vascular conditions. The aim of the study was to analyze possible disturbances in the heart ventricular conduction system by using a technique of ventricular activation time (VAT) differences in ESRF children on peritoneal dialysis (PD) with normal electrocardiogram (ECG) examinations. MATERIAL AND METHODS: The study group comprised 10 ESRD children (mean age: 13.6 ± 2.31 years) on peritoneal dialysis - group I. The control group (group II) consisted of 26 age-matched healthy children with no clinical evidence of renal or cardiac disease and with normal 12-lead ECG recordings. Each of the ESRD patients was also subjected to the standard ECG examination. In order to capture possible heart conduction abnormalities, body surface potential mapping (BSPM) recordings were performed in PD patients between the successive dwells ('on empty abdomen') with a HPM-7100 Fukuda Denshi system. Based on the source ECG data, the original technique of a VAT difference map was then applied. RESULTS: Differences between VAT values for the two examined groups of children, controls and ESRD patients on PD, were significantly pronounced in the region of the right upper anterior thorax, the entire left thorax and nearly in the total back. Such a pattern of VAT delays indicates a pathological electric transmission in the intraventricular conduction system of the left anterior fascicle of His bundle. CONCLUSION: 1. VAT maps (isochrone maps) can be useful to detect abnormal spreading and depolarization through the heart ventricles. 2. Map of VAT value differences makes it possible to identify early disturbances in the left His bundle branch in ESRD children treated with peritoneal dialysis regardless of normal 12-lead ECG. 3. Further studies on a larger group of children with ESRD on PD are required to verify the preliminary observations presented herein.

Cognitive disorders in type 2 diabetic patients with recognized depression.

OBJECTIVES: The most important factors in the pathogenesis of cognitive disorders in diabetes mellitus (DM) are metabolic changes directly caused by hyperglycemia. Impairment of cognitive function is accompanied by a decrease in cerebral insulin. Insulin improves cognitive processes, including somatosensoric cognitive functions. Cognitive disorders are especially pronounced if diabetic patients suffer also from depression. MATERIAL AND METHODS: The evaluation of cognitive functions, especially sensomotoric skills were obtained from three study groups (aged 37-52 years): 30 healthy subjects, 40 diabetic patients with clinically documented depression and 30 depressive patients without DM. The sensomotoric skills were carried out using a SPS-2001E apparatus - a computer working stress simulator. The examination with Beck Depression Inventory (BDI) were also performed in all the investigated persons. RESULTS: Sensomotoric skills investigation revealed slight cognitive disorders in the early stages DM (subgroup IA) and its intensification according to increasing BDI scores and HbA1c blood concentration (from subgroup IA to IC). Intensification of sensomotoric cognitive disorders was significantly higher (p<0.001) in the depressive patients with DM (group I), than in these without DM (group III). CONCLUSIONS: The obtained results suggest that coincidence of aggravating factors, such as depression and metabolic disorders in DM, may cause mutual interactions leading to premature and more intense cognitive impairment. The method proposed by the authors may serve as a screening examination in early diagnosis of CNS disorders reflected by somatosensoric cognitive disorders. The presented work indicates importance of sensomotoric skills investigation for the early diagnosis of the nervous system damage related to DM.

[Analysis of the holter records in miners working at the deepest located work stations in copper mines of the Legnica-Glogow copper mining district]. / Wyniki analizy zapisów holterowskich u górników zatrudnionych na najglebiej polozonych stanowiskach pracy kopalni miedzi legnicko-glogowskiego okregu miedziowego.

BACKGROUND: Microclimate at mining stations consists of numerous parameters, such as air temperature, humidity, air flow velocity and rock temperature. These parameters have an impact on thermal work conditions. MATERIALS AND METHODS: The investigation was performed on 71 operators of mining machines from sections G-6 (group I) and G-11 (group II), aged 23-50 years, with mining experience of 7-25 years. One part of operators worked in air-conditioned chambers (subgroups A) and the other in chambers without air-conditioning (subgroups B). The continuous heart rate (HR) recording was taken during the whole shift. RESULTS: Average values of HR in subgroup B were significantly higher than in subgroup A, especially between 8:00 and 9:00, but the increased HR did not exceed the border line of 140 bpm. CONCLUSIONS: The results did not show significant deviation in the range of HR in operators working in unfavorable climatic conditions. They demonstrated benefits from using air-conditioned chambers to reduce effects of hot microclimate.

Brain-stem auditory evoked potentials in children and adolescents with anorexia nervosa.

OBJECTIVE: In the course of anorexia nervosa (AN), the central nervous system (CNS) undergoes both anatomic and functional changes that may cause disturbances of stimulation transmission in the sensory areas of CNS. Method of brain-stem auditory evoked potentials (BAEPs) was used in the children with AN to test the auditory pathway transmission. MATERIALS AND METHODS: The study included 37 children and adolescents, aged 10-18 years, with clinically diagnosed AN. BAEPs were recorded after a click stimulation of 75 dB intensity. Then, wave I latency (response from the auditory nerve) and inter-peak latency I-V (IPL I-V; response from the brain-stem) were analyzed. RESULTS: Abnormalities of the BAEPs recordings were noted total in 32.4% of the study patients. Predominantly (in 24.3%), a decreased transmission within the brain-stem, expressed as the IPL I-V prolongation, was observed. It was also found that the percentage of the abnormal BAEPs results and the degree of IPL I-V prolongation were increasing together with enhancing AN severity. CONCLUSIONS: IPL I-V prolongation observed in the AN children reflects a disturbed neural transmission in the brain-stem section of the auditory pathway and can be ascribed to impairments in the nerves myelin sheath.

Visual perception in acoustically deprived and normally hearing children.

In the present study an attempt was made to establish if and to what extent auditory deprivation modifies the processes of visual analysis and synthesis. The study included 54 children aged 10-16 years with hearing impairment attending the School and Educational Center for Children with Hearing Impairment in Wroclaw (group I) and 127 children with normal hearing acuity attending public schools (group II), forming a reference group. Hearing impairment in the children of group I was from 60 to 100 dB. In 9 of these children the hearing impairment was inherited, while in some others it was acquired and resulted from rubella during the mother's pregnancy (5 subjects) or a severe disease course in childhood, for instance cerebral meningitis (4 subjects) and otolaryngologic antibiotic therapy (7 subjects). In the remaining subjects the reason for auditory deprivation was unknown. Hearing impairment, apart from genetically conditioned causes, appeared in the first months or years of life. The general intellectual level of the examined children was similar to that of their control counterparts, which was confirmed by school psychologists during a routine examination. The examination was performed by means of two tests from the Nonverbal Score of the Wechsler Intelligence Scale for Children: Puzzles and Block Design. The children with a hearing deficit generally needed more time to perform the tasks than those with normal hearing. The investigated parameters of visual perception improved in correlation with age, but the dynamics of these changes were different in the two study groups.

Interhemispheric cerebral asymmetry detected by VEPS in diabetic patients with recognized depression.

OBJECTIVES: The present study was undertaken in order to verify the hypothesis stating that patients with depression exhibit some abnormalities concerning a cerebral symmetry. For this purpose, an analysis of the relationship between the VEPs (Visual Evoked Potentials) results and the depressive symptoms intensification, as well interrelation between depressive and diabetic symptoms were performed. MATERIAL AND METHODS: VEPs recordings were obtained from the two study groups (both aged 20-45 years), 20 healthy subjects and 32 diabetic patients with clinically documented depression. The VEPs examination was carried out using a computer system called STELLA (Stimulated Electroencephalogram on Line Analyzer). RESULTS: VEPs examinations revealed a cerebral symmetry in the all control subjects and in 10 out of 32 diabetic patients with depressive disorders. It is noteworthy that 22 of 32 diabetic patients (68.8%) showed a hemispheric asymmetry in the VEPs recordings. Of 12 patients with a moderate depression, 10 showed the left cerebral laterality, and 2--the right laterality. In turn, all 10 patients with major depressive disorder (MDD) demonstrated in the VEPs recordings a significant cerebral laterality with the right hemisphere dominance. CONCLUSIONS: The obtained results suggest that interhemispheric cerebral asymmetry might be considered a specific feature of depression, and, if this is a case, it could justify a conclusion that right hemisphere dominance could be a neurophysiological marker of MDD. It should be emphasized that intensification of the depressive symptoms has an unfavorable influence on course of diabetes mellitus, its self-control and severity of following complications.

[Profile of selected cytokines in various forms of uveitis]. / Profil wybranych cytokin w zapaleniach blony naczyniowej róznego typu.

PURPOSE: The estimation of the level of selected inflammatory mediators in serum of patients with various types of uveitis. MATERIAL AND METHODS: The level of IL-1, IL-6 and TNF was assessed by means of microbiological tests and ELISA test in the group of 60 patients with uveitis, divided as regards to the character of uveitis and the type of the treatment and in control group. RESULTS: The levels of IL-1, IL-6 and TNF were higher in serum of patients with uveitis then in the control group. Patients with known etiology of uveitis had higher level of IL-6 and TNE Patients with autoimmunological etiology of uveitis had higher level of IL-1 and IL-6 than volunteers in control group. CONCLUSIONS: Higher levels of cytokines in serum of patients with uveitis than in control group indicate the activation of immunological response in various types of uveitis.

[Effect of psychotherapy on autonomic balance in VDT-operators with somatoform disorders]. / Wplyw psychoterapii na napiecie ukladu wegetatywnego u operatorów VDT z zaburzeniami nerwicowymi.

BACKGROUND: The omnipresence of stress-inducing factors that stems from the permanent development of our civilization results in a constantly growing number of people with neurotic disorders. Computer technology, a very new labor technique, has become a stressful factor. Stressful factors initially affect the central nervous system, which modifies vegetative functions. The autonomic balance can be a measurable indicator of disease severity. MATERIALS AND METHODS: The study group consisted of 50 VDT-operators with neurotic disorders. Twenty five healthy VDT-operators formed the control group. The autonomic balance was investigated with Holter monitoring. Each of the 50 neurotic VDT-operators were qualified for a 3-month psychotherapy. RESULTS: The analysis of Holter recordings proved that the applied model of psychotherapy significantly reduced the number of sympathicotonics in favor of normotonics in the study group (p < 0.01). CONCLUSIONS: The Holter analysis can be considered as a reliable indicator of the effect of psychotherapy.

Fluctuations of gastrin, motilin and total bile acid levels in porcine blood before and after feeding.

In four young healthy pigs, the radioimmunological determinations of serum gastrin, plasma motilin and total serum bile acids were performed during four hours of the interdigestive state and up to one hour after standard feeding procedure. In 24-hr fasted animals, gastrin, motilin and bile acid concentrations fluctuated and duration of oscillation periods was similar to the length of the interdigestive motor cycle. However, only motilin peaks were temporally correlated with bile acid peaks. Feeding did not abolish motilin and bile acid fluctuations and significantly decreased serum bile acid level. It is concluded that the relationships among gastrin, motilin and bile acids are in part different in pigs from those in man and dog and still some controversy exists as to the regulatory role of both hormones mainly in the postprandial state.