Facile and Electrically Reliable Electroplated Gold Contacts to p-Type InAsSb Bulk-Like Epilayers.

Narrow band-gap semiconductors, namely ternary InAsSb alloys, find substantial technological importance for mid-infrared application as photodetectors in medical diagnostics or environmental monitoring. Thus, it is crucial to develop electrical contacts for these materials because they are the fundamental blocks of all semiconductor devices. This study demonstrates that electroplated gold contacts can be considered as a simple and reliable metallization technology for the electrical-response examination of a test structure. Unalloyed electroplated Au contacts to InAsSb exhibit specific contact resistivity even lower than vacuum-deposited standard Ti-Au. Moreover, temperature-dependent transport properties, such as Hall carrier concentration and mobility, show similar trends, with a minor shift in the transition temperature. It can be associated with a difference in metallization technology, mainly the presence of a Ti interlayer in vacuum-deposited contacts. Such a transition may give insight into not only the gentle balance changes between conductivity channels but also an impression of changing the dominance of carrier type from p- to n-type. The magnetotransport experiments assisted with mobility spectrum analysis clearly show that such an interpretation is incorrect. InAsSb layers are strongly p-type dominant, with a clear contribution from valence band carriers observed at the whole analyzed temperature range. Furthermore, the presence of thermally activated band electrons is detected at temperatures higher than 220 K.

Mechanical chest compressions as a last-ditch attempt to salvage a profoundly hypoxic but normotensive patient with a massive pulmonary embolism.

Massive pulmonary embolism is a common cause of morbidity and mortality. For patients presenting with massive pulmonary embolism, severe hypoxia is usually associated with severe hypotension. These patients should be considered for thrombectomy should thrombolysis and respiratory support fail to improve their condition. Should thrombectomy not be available or suitable, consideration should be given to offering mechanical chest compressions to 'break up the clot'. We describe a case in which this seemingly led to survival and full recovery.

Radon and Neoplasms.

Radon is a carcinogenic factor, but the effects of the potential carcinogenicity of radon progeny on the human body during the prenatal period have not yet been explored. Based on data regarding the half-lives of radon-222 and radon-220 and their progeny, this paper considers their potential effects on the human body in the prenatal period. Radon-220 represents a small fraction of the total radon concentration in the air, but the dose of radon-220 progeny may have a significant effect in the prenatal period, as the precursors of polonium-212 exhibit substantially longer half-lives than the corresponding precursors of polonium-214. Theoretically, it is possible that radon-220 decay products, particularly polonium-212, are the predominant emitters of alpha particles in the prenatal period. Studies aiming to establish a relationship between exposure to radon during pregnancy and the subsequently observed incidence of childhood neoplasms should consider this observation.

Vasorelaxing properties of the perivascular tissue of the human radial artery.

OBJECTIVES: Perivascular adipose tissue (PVAT) surrounding the human internal thoracic artery exhibits anticontractile and vasorelaxing properties associated with the adipocyte-derived relaxing factor (ADRF). The goal of our study was to assess if perivascular tissue of the human radial artery (RA) also exhibits such anticontractile/vasorelaxant properties. It could be especially relevant in preventing RA spasms. METHODS: The study was performed on isolated segments of human pedicled RA. Its skeletonized fragments were suspended on stainless steel wire hooks and gradually contracted with serotonin to establish the concentration-effect relationship in the presence/absence of PVAT. Skeletonized arterial segments were precontracted with a single dose of 10-6 M serotonin (EC80). The 5-ml PVAT aliquots (from PVAT incubated in Krebs-Henseleit solution) were transferred to the RA tissue bath resulting in its relaxation. Subsequently, we investigated if ADRF is dependent on endothelial vasorelaxants (nitric oxide and prostacyclin). We attempted to find the potassium channel responsible for mediating the activity of ADRF using different potassium channel blockers. RESULTS: RA without PVAT contracted more strongly in response to serotonin compared to RA with PVAT [Emax: 108.3 (20.2) vs 76.1 (13.5) mN]. The PVAT aliquot relaxed precontracted RA rings at 43% (2.4%) [72.2 (15.6) to 41.0 (5.6) mN]. ADRF is independent of endothelial vasorelaxants; hence, the addition of NG-monomethyl-l-arginine and indomethacin did not change the vasorelaxant response. Neither of the potassium channel blockers participated in the activity of ADRF. CONCLUSIONS: PVAT of human RA exhibits anticontractile/vasorelaxant properties that are inherently associated with ADRF secretion. We confirmed the endothelial-independent mechanism of the activity of ADRF. However, we failed to find the potassium channel responsible for the action of ADRF.

Stand-Alone Left Atrial appendage occlusion for throMboembolism prevention in nonvalvular Atrial fibrillatioN DiseasE Registry (SALAMANDER): protocol for a prospective observational nationwide study.

INTRODUCTION: Atrial fibrillation (AF) is a prevalent disease considerably contributing to the worldwide cardiovascular burden. For patients at high thromboembolic risk (CHA2DS2-VASc ≥3) and not suitable for chronic oral anticoagulation, owing to history of major bleeding or other contraindications, left atrial appendage occlusion (LAAO) is indicated for stroke prevention, as it lowers patient's ischaemic burden without augmentation in their anticoagulation profile. METHODS AND ANALYSIS: Stand-Alone Left Atrial appendage occlusion for throMboembolism prevention in nonvalvular Atrial fibrillatioN DiseasE Registry (SALAMANDER) will be conducted in 10 heart surgery and cardiology centres across Poland to assess the outcomes of LAAO performed by fully thoracoscopic-epicardial, percutaneous-endocardial or hybrid endo-epicardial approach. The registry will include patients with nonvalvular AF at a high risk of thromboembolic and bleeding complications (CHA2DS2-VASc Score ≥2 for males, ≥3 for females, HASBLED score ≥2) referred for LAAO. The first primary outcome is composite procedure-related complications, all-cause death or major bleeding at 12 months. The second primary outcome is a composite of ischaemic stroke or systemic embolism at 12 months. The third primary outcome is the device-specific success assessed by an independent core laboratory at 3-6 weeks. The quality of life (QoL) will be assessed as well based on the QoL EQ-5D-5L questionnaire. Medication and drug adherence will be assessed as well. ETHICS AND DISSEMINATION: Before enrolment, a detailed explanation is provided by the investigator and patients are given time to make an informed decision. The patient's data will be protected according to the requirements of Polish law, General Data Protection Regulation (GDPR) and hospital Standard Operating Procedures. The study will be conducted in accordance with the Declaration of Helsinki. Ethical approval was granted by the local Bioethics Committee of the Upper-Silesian Medical Centre of the Silesian Medical University in Katowice (decision number KNW/0022/KB/284/19). The results will be published in peer-reviewed journals and presented during national and international conferences. TRIAL REGISTRATION NUMBER: NCT05144958.

Heat Shock Factor 2 Protects against Proteotoxicity by Maintaining Cell-Cell Adhesion.

Maintenance of protein homeostasis, through inducible expression of molecular chaperones, is essential for cell survival under protein-damaging conditions. The expression and DNA-binding activity of heat shock factor 2 (HSF2), a member of the heat shock transcription factor family, increase upon exposure to prolonged proteotoxicity. Nevertheless, the specific roles of HSF2 and the global HSF2-dependent gene expression profile during sustained stress have remained unknown. Here, we found that HSF2 is critical for cell survival during prolonged proteotoxicity. Strikingly, our RNA sequencing (RNA-seq) analyses revealed that impaired viability of HSF2-deficient cells is not caused by inadequate induction of molecular chaperones but is due to marked downregulation of cadherin superfamily genes. We demonstrate that HSF2-dependent maintenance of cadherin-mediated cell-cell adhesion is required for protection against stress induced by proteasome inhibition. This study identifies HSF2 as a key regulator of cadherin superfamily genes and defines cell-cell adhesion as a determinant of proteotoxic stress resistance.

Skeletonization of internal thoracic artery affects its innervation and reactivity.

OBJECTIVE: The studies showing the superior characteristics of ITA graft and its impact on the clinical results of coronary artery surgery were performed with ITA harvested almost exclusively as a pedicle. This study assesses the impact of ITA skeletonization on its innervation and reactivity. METHODS: Segments of skeletonized and non-skeletonized ITA were stained with antibodies against protein S-100 to look for the presence of sympathetic nerve fibers. The functional studies were performed on segments of discarded human pedicled ITA that were divided into two 3mm rings, one skeletonized and another non-skeletonized. We compared concentration-effect relationships for the contraction to norepinephrine and endothelium-dependent relaxation to acetylcholine and bradykinin, as well as endothelium-independent relaxation to sodium nitroprusside in skeletonized and non-skeletonized segments of the same ITA. RESULTS: Skeletonized ITA was devoid of protein S-100 positive nerve fibers. It contracted stronger (maximal response 37.0+/-2.04 vs. 25.4+/-1.83mN (P<0.001)) and was twice as sensitive to norepinephrine: pD(2) 6.03+/-0.10 vs. 5.70+/-0.12 (P=0.035). The endothelium-dependent relaxation responses did not differ between skeletonized and non-skeletonized ITA rings. The skeletonized ITA rings appeared over 10 times more sensitive to sodium nitroprusside: pD(2) 6.66+/-0.20 vs. 5.59+/-0.37 (P=0.012)-potency ratio 11.61. The maximal responses did not differ significantly: 112.0+/-6.71 vs. 129.4+/-16.4% (P=0.33). CONCLUSIONS: Skeletonization results in sympathectomy of ITA. It has no effect on endothelium-dependent relaxation but increases reactivity of ITA to norepinephrine. This augmented response to alpha-agonist is small, in comparison with over a ten-fold increase in sensitivity to sodium nitroprusside. Pedicled and skeletonized ITA are functionally significantly different vessels when studied in vitro.

Postoperative serum troponin T concentration in patients undergoing aortic valve replacement does not predict early postoperative outcome.

BACKGROUND: The measurement of serum cardiac troponin T concentration (cTnT) after aortic valve replacement (AVR) provides the opportunity to assess the degree of myocardial damage and may have some prognostic value. AIM: To determine whether elevated troponin level is related to patient outcome. METHODS: We investigated patient outcome and postoperative serum concentration of troponin T in 79 patients who underwent AVR. Serum levels of cTnT were measured within 24 h of AVR. We searched for the occurrence of subsequent adverse events i.e. requirement for intraaortic ballon pump (IABP) or inotropic support, prolonged Intensive Care Unit (ICU) stay, and in-hospital death. RESULTS: Serum concentration of cTnT after AVR increased significantly compared to the preoperative value. We found significant positive correlations between aortic cross-clamp time (r = 0.23, p = 0.04), cardiopulmonary bypass time (r = 0.4,p = 0.00029), duration of the surgery (r = 0.30, p = 0.008), and postoperative cTnT level. Three (4%) patients required IABP support, 37 (46%) patients required inotropic support, and 11 (14%) patients had a prolonged ICU stay (> 48 h). Thirty eight (48%) patients required either inotropic support or IABP insertion. At least one adverse event occurred in 44 (56%) patients. Median postoperative serum cTnT concentration was 0.31 ng/mL (interquartile range 0.23-0.60 ng/mL). We failed to find a statistically significant difference in postoperative cTnT level between patients with and without adverse events. According to multiple logistic regression analysis, the postoperative serum level of troponin T was not independently associated with adverse patient outcome. Diabetes mellitus, patient age and left ventricular ejection fraction below 50% were significant independent predictors of adverse events after AVR. The area under receiver operating curve (AUROC) for postoperative serum troponin T concentration as a determinant of various adverse outcomes was never significantly different from 0.50. CONCLUSIONS: Serum cTnT concentration is frequently - if not universally - elevated after AVR. Serum level of troponin T measured on the first postoperative morning is a poor predictor of patient outcome after AVR and should not be relied on when planning postoperative care.

Crystal structure and microstructure of synthetic hexagonal magnesium-cobalt cordierite solid solutions (Mg(2-2x)Co(2x)Al4Si5O18).

Co(2+)-containing cordierite glasses, of nominal compositions (Mg(1-x)Co(x))2Al4Si5O18 (with x = 0, 0.2, 0.4, 0.6, 0.8 and 1), were prepared by melting colloidal gel precursors. After isothermal heating at 1273 K for around 28 h, a single-phase α-cordierite (high-temperature hexagonal polymorph) was synthesized. All materials were investigated using X-ray powder diffraction and field-emission scanning electron microscopy. The crystal structure and microstructure were determined from X-ray diffraction patterns. Rietveld refinement confirmed the formation of magnesium-cobalt cordierite solid solutions. The unit-cell volume increased with the increase of cobalt content in the starting glass. The crystalline microstructure of the cordierites was interpreted using a mathematical model of a polycrystalline material and characterized by prevalent crystallite shape, volume-weighted crystallite size distribution and second-order crystalline lattice-strain distribution. Hexagonal prismatic was the prevalent shape of α-cordierite crystallites. Bimodality in the size distribution was observed and interpreted as a consequence of two paths of the crystallization: the nucleation from glass of µ-cordierite, which transformed into α-cordierite with annealing, or the nucleation of α-cordierite directly from glass at high temperatures. Scanning electron microscopy images agreed well with crystalline microstructure characteristics determined from the X-ray diffraction line-profile analysis.

TGF-beta(1), IL-10 and IL-4 in colostrum of allergic and nonallergic mothers.

OBJECTIVE: To determine transforming growth factor (TGF) beta(1), interleukin (IL) 4, and IL-10 concentrations in human milk and to assess the relationship between allergic disorders in mothers and the content of the interleukins in their milk. MATERIAL AND METHODS: Thirty allergic and 46 healthy mothers were included in the study. Colostrum was collected 2-3 days after delivery. Cytokine concentrations were determined with commercial enzyme-linked immunosorbent systems. RESULTS: TGF-beta(1)was found in milk from 23 women in the control group (53.49%) and 11 in the allergy group (37.93%). When TGF-beta(1) was present, the median concentration was higher in the allergy group than in the control (61.5 and 30.4 pg/mL, respectively; P < 0.004). IL-10 was present in the colostrum of all the women and the median IL-10 concentration did not differ between the allergy (50.5 pg/mL) and control (51.5 pg/mL) groups. The probability of occurrence of a positive IL-4 value in the allergy group was greater than in the control group (chi-squared [df=1] = 2.60, P < 0.053). Median IL-4 level did not differ significantly between the two groups (0.5 and 0.5 pg/mL respectively). CONCLUSIONS: TGF-beta(1) was detected less often in the colostrum of allergic mothers than in that of mothers without allergy (but the difference was not statistically significant). IL-4 was found more often in the colostrum of allergic mothers than nonallergic ones. The allergy status did not correlate with IL-10 concentration.

[Role of transforming growth factor beta1 (TGF-beta1) in the pathogenesis and clinical course of chronic hepatitis in children]. / Rola transformujacego czynnika wzrostu beta1 (TGF-beta1) w etiopatogenezie i przebiegu klinicznym przewleklych zapalen watroby u dzieci.

UNLABELLED: Transforming growth factor-beta1 (TGF-beta1) is known to play a key role in processes of cell proliferation and differentiation. It also plays an important role in modulation of the immune response. Various diseases may arise both from excessive and insufficient activity of this cytokine. THE AIM OF THE STUDY was to evaluate the role of TGF-beta1 in the pathogenesis of chronic hepatitis (Ch.h.) and to assess whether TGF-beta1 level in plasma or its tissue expression can be useful in diagnosing and monitoring of clinical course of this disease. PATIENTS AND METHODS: Twenty-one children with chronic hepatitis were included in the study and 42 healthy children constituted the control group. Liver function tests and TGF-beta1 plasma levels measured by ELISA method were evaluated in both groups of patients. In liver tissue obtained by needle biopsy, the histopathological grading and staging of hepatitis was evaluated, TGF-beta1 protein was assessed by immunohistochemical methods and TGF-beta1 gene expression was measured by reverse transcription and real-time polymerase chain reaction. RESULTS: In chronic hepatitis group of patients the plasma TGF-beta1 level did not differ from the control group and did not correlate with grading and staging of the liver tissue while positive correlation was observed with gamma-glutamyl transpeptidase activity in the serum. There was no correlation between tissue TGF-beta1 expression and TGF-beta1 plasma level and staging or grading in liver tissue. TGF-beta1 gene expression correlated positively with ESR and ALAT activity but no correlation with TGF-beta1 plasma level, TGF-beta1 gene or protein expression, grading or staging in liver tissue were observed. CONCLUSION: 1. In children with chronic hepatitis, TGF-beta1 plasma level is not related to grading or staging in the liver tissue. This finding may be due to low level of fibrosis observed in the studied children. 2. It appears that local expression of TGF-beta1 in liver tissue should not be used as a sole marker in differentiating and monitoring the course of chronic hepatitis. 3. In children with chronic hepatitis assessment of liver TGF-beta1 gene expression is not helpful in the evaluation of pathological changes in liver tissue. 4. Due to the relatively low number of patients in the analysed groups it seems advisable to perform similar complex studies in larger groups of children with chronic hepatitis.

[Gene polymorphism of transforming growth factor beta1 (TGF-beta1) in the pathogenesis and clinical course of chronic hepatitis in children]. / Polimorfizm genu transformujacego czynnika wzrostu beta1 (TGF-beta1) w etiopatogenezie i przebiegu klinicznym przewleklych zapalen watroby u dzieci.

UNLABELLED: Transforming growth factor beta1 (TGF-beta1) is a cytokine modulating the immune response. The role of TGF-beta1 gene polymorphisms in the incidence and modification of the clinical course of these diseases has been recently evaluated. THE AIM of the study was to assess the relation between TGF-beta1gene polymorphism and the incidence of chronic hepatitis, the course of the disease, TGF-beta1 level in plasma and TGF-beta1 mRNA expression in liver tissue. PATIENTS AND METHODS: The studied group comprised 21 patients with chronic hepatitis including 10 with HBV infection, 4 with HCV infection and 7 with autoimmune hepatitis (AIH). Forty-two children were included in the control group. Analysis of four studied polymorphisms of TGF-beta1 gene was based on CAPS (Cleaved Amplified Polymorphic Sequence) method, TGF-beta1 level in plasma was estimated using sandwich ELISA. TGF-beta1 mRNA expression was evaluated by reverse transcription and real-time polymerase chain reaction (Real-Time PCR). RESULTS: No correlation between studied polymorphisms and the incidence or clinical course of chronic hepatitis was found. There were no significant differences in TGF-beta1 level in plasma and mRNA expression depending on polymorphisms of TGF-beta1 gene. CONCLUSIONS: 1. The polymorphisms of TGF-beta1 gene do not appear to influence the incidence and clinical course of chronic hepatitis in children. 2. Due to relatively low number of patients in the analysed groups it seems advisable to perform similar complex studies in larger groups of children with chronic hepatitis.

[Role of leptin in immunodeficiency in children with protein-calorie malnutrition]. / Rola leptyny w deficytach odpornosci u dzieci z niedozywieniem bialkowo-kalorycznym.

The article based on current literature, reviews physiological properties of leptin and the influence of nutritional state on its production. Leptin is the pleiotropic hormone secreted by adipocytes. Besides participation in the regulation of energy balance, it influences the immunological system and improves the state of immunity, both inborn and acquired. In protein-caloric malnutrition leptin secretion is reduced which may cause immunity deficit, especially of the cellular type. The authors also discuss the usefulness of measuring leptin serum concentration for evaluation of treatment of malnourished children.

[Chronic hepatitis B in children--is it still a real problem?]. / Przewlekle zapalenie watroby typu B u dzieci--problem nadal aktualny?

Over one million people all over the world die every year due to the complications of HBV infections. This problem is particularly important in Asia, Africa and in the West Pacific region where HBV infection is widely spread (from 5-20% up to 80% of all infected people in the world). In these regions HBV infections are transmitted mostly perinatally or during early childhood. In North America and in West Europe where after introducing anti-HBV vaccinations less than 2% of the population is affected, infections are usually transmitted by intravenous drug abuse, sexual intercourse, or much less frequently by blood transfusions. The immaturity of immune system in young children is responsible for the fact that nearly 90% of HBV infections acquired in infancy and 40-70% of HBV infections before the age of 3 years, result in chronic viral hepatitis. Therefore, the choice of an efficient and safe therapy is one of the most important problems. In this paper current data concerning indications for treatment and side-effects of interferon-alpha and lamivudine therapy in children with chronic viral hepatitis type B are presented.

[Inflammatory bowel disease in children--an analysis of the clinical symptoms and selected biochemical parameters]. / Nieswoiste zapalenia jelit u dzieci--analiza obrazu klinicznego i wybranych parametrów biochemicznych.

AIM OF THE STUDY: an analysis of clinical symptoms and laboratory tests in children with inflammatory bowel disease (IBD). PATIENTS AND METHODS: eighty-nine children with IBD (58 with ulcerative colitis (UC) and 31 with Crohn's disease (CD) diagnosed on the basis of clinical symptoms, endoscopic and histopathological examination, were qualified into the studied group. Disease activity was evaluated by using Truelowe-Witts scale for UC and PCDA9 scale for CD cases. Forty-two children without acute or chronic inflammatory diseases constituted the control group. RESULTS: the frequency of such clinical symptoms as: diarrhea, fever, weight loss, abdominal pain, weakness, constipations, anemia, joints pain, vomits, and jaundice was comparable in children with UC and CD while intestinal bleeding was significantly more frequently observed in patients with UC than with CD (P<0.05). There was no statistically significant difference in BMI between patients with UC and CD. Cole's index was significantly higher in children with UC than with CD (P<0.05). Hemoglobin level and serum iron level were statistically significantly lower in patients with CD than in the control group (P<0.05). Mean leukocyte count in children with CD was significantly higher than in the control group (P<0.05). Neutrophils percentage in patients with UC and CD was significantly higher than in the control group (P<0.05). Platelet count was significantly higher in all children with IBD than in the control group (P<0.05). Mean serum CRP level was significantly higher only in children with CD while ESR was significantly higher in both groups of IBD patients. Mean serum gamma-globulin level was statistically significantly higher in children with UC and with CD but no significant differences were observed in serum IgA, IgG, and IgM levels among the analyzed groups. Serum GT level was higher in children with CD than in the control group while serum ALT and AST level did not differ significantly among the analyzed groups of patients. CONCLUSIONS: 1. Serum C-reactive protein level is one of the most valuable markers for monitoring the course of IBD, especially CD, in children. 2. In patients with IBD systematic monitoring of liver function parameters (especially parameters of cholestasis) is necessary as severe hepatic complications may occur. 3. Further search for new sensitive and specific markers monitoring the course of inflammatory bowel diseases is needed.

[Mesenteric lymphadenopathy - a valid health problem in children]. / Limafadenopatia krezkowa- czesty problem kliniczny wieku dzieciecego.

THE AIM: of the study is to evaluate the reasons of mesenteric lymphadenopathy and its clinical picture in hospitalized children. MATERIAL AND METHODS: the study was performed on 127 children (49 girls and 78 boys age of 8 months to 18 years; mean age 9 years and 3 months) hospitalized in the Department of Paediatrics, and Paediatric Gastroenterology and Oncology, Medical University of Gdansk. Ultrasonography showed enlarged abdominal lymph nodes in all children. According to definition of mesenteric lymphadenopathy, the clinical course of disease was analyzed in children, in whom there were at least three lymph nodes in ultrasonography with the peroneal diameter of 5 mm or more. Inflammatory parameters were examined in all children. In selected cases culture, viral and parasitic, as well as endoscopic examination, were also performed. RESULTS: analyzing accompanying clinical symptoms, it was found, that abdominal pain was the most dominant complaint in children with mesenteric lymphadenopathy; it was observed in 63 children (49.6%). In 33 (26%) of them the pain was the sole complaint, while in the rest vomiting and fever were present. 8 children (6.3%) with generalized lymphadenopathy were diagnosed. Ultrasonographic evaluation demonstrated that numerous enlarged lymph nodes were present the most frequently, in 65 (51.2%), less numerous, in 42 (33.1%), while sparse lymph nodes were seen only in 20 (15.7%) children. In 85 patients (66.9%) long axis of the lymph nodes reached min. 10 mm, in 39 (30.1%) was smaller than 10 mm, in 3 (2.4%) exceed 20 mm. Conglomerates of lymph nodes were described in 9 (7.1%) patients with various diagnosis (acute diarrhea - 3 children, ulcerative colitis - 3 children, celiac disease, cytomegaly, lambliosis). Tendency to invagination was observed in 5 (3.9%) children. In 4 of them acute infection (acute diarrhea, pneumonia) with high inflammatory parameters was diagnosed. Elevated inflammatory parameters were present in 42 (33.1%) patients. Examining the reasons of the abdominal lymph nodes enlargement, it was found that primary mesenteric lymphadenopathy was the most frequent diagnosis; it was recognized in 27 (21.3%) children. In 20 (15.7%) lymphadenopathy was caused by acute diarrhea, in 19 (14.9%) patients - by respiratory tract infection. Cytomegaly was recognized in 4 (3.1%), toxoplasmosis in 3 (2.3%), lambliosis in 9 (7.0%) patients. Both gastritis and colitis were diagnosed in 12 (9.4%) children. In 7 (5.5%) patients generalized lymphadenopathy with unknown etiology was described. In single cases other diseases were diagnosed. CONCLUSIONS: the enlargement of mesenteric lymph nodes frequently causes abdominal pain in children, being an indication for laboratory investigations. Vomiting and fever are the most common other symptoms in these patients. Ultrasonographic examination usually shows large enlargement of lymph nodes, sometimes in conglomerates, with tendency to invagination. Acute diarrhea and respiratory tract infection are the most frequent reasons of the enlargement of abdominal lymph nodes. In about 20% of the children primary mesenteric lymphadenopathy is diagnosed.

[Congenital extrahepatic biliary atresia as a cause of cholestasis in newborns and infants]. / Wrodzona atrezja dróg zólciowych zewnatrzwatrobowych jako pryczyna cholestazy u noworodków i niemowlat.

UNLABELLED: Congenital extrahepatic biliary atresia (CEBA) is one of the most common causes of cholestasis in newborns and infants. THE AIM OF THE STUDY: was the analysis of clinical presentation, results of laboratory and imaging investigations as well as clinical outcome of children with extrahepatic cholestasis caused by CEBA. MATERIALS AND METHODS: the analyzed group included 15 children aged from 2 weeks to 4 months. Data concerning: pregnancy and delivery, newborn's health condition, faeces color; jaundice onset, manifestation of coagulation disorders coexisting malformations and disorders of other systems were obtained. The following investigations were performed: biochemical tests evaluating the function of the liver and cholestasis (serum bilirubin concentration and fractions, bile acids in serum, AlAT, AspAT, GGTP, FALK activities, serum electrophoresis, prothrombin index). We also performed tests focusing on hepatotropic infections, - metabolic disorders tests and in all children - ultrasound of the abdomen, scintigraphy of the bile ducts - HEPIDA. 14 children had undergone hepatoportoenterostomy, modo Kasai. RESULTS: jaundice, acholic stools and hepatomegaly were present in all children. The serum concentration of bilirubin and its conjugated fraction and bile acids in all children were increased. GGTP and FALK activities were markedly elevated in all children. Aminotransferases activities elevations were observed, more distinctively for AST. Active cytomagalovirus infection was detected in 3 children. Abdominal ultrasound revealed gallbladder in 7 children, whereas intrahepatic bile ducts were described as normal in 12 cases. In all cases the HEPIDA scintigraphy showed no passage of the tracer to the GI tract even after 24 hours delay. Hepatoportoenterostomy was performed in 14 children, 5 of them had liver transplantation. CONCLUSIONS: 1. There is still not one effective and specific diagnostic method in differentiating between the causes of cholestasis in the newborns and infants. Thus many investigation methods should be run simultaneously. 2. Congenital atresia must be definitely excluded before cholestasis with other background is finally diagnosed. 3. The hepatoportoenterostomy should be considered as the first line treatment in children with CEBA. Most cases will need liver transplantation in the future.

[Giardiasis in children - clinical diversity and diagnostic problems based on own experience]. / Zakazenia giardia lamblia u dzieci- zmiennosc obrazu klinicznego i trudnosci diagnostyczne w swietle doswiadczen wlasnych.

UNLABELLED: Parasitosis still remains a significant pediatric health problem, despite improving hygienic conditions and social awareness. THE AIM OF THIS STUDY: was to analyze clinical manifestations of Giardia lamblia infection in children hospitalized in the Department of Pediatrics, Pediatric Gastroenterology and Oncology of Medical University of Gdansk. MATERIAL AND METHODS: studied children included 49 patients aged 2.2 - 17.3 years: group I children below and group II above 5 years of age. The patients were admitted for further diagnosis of unexplained clinical manifestations in outpatient care. Parasitosis was confirmed by immuno-enzymatic technique detecting protein GSA 65; only in one child parasites cysts were found by microscopic technique in faecal samples obtained from infected children. RESULTS: chronic abdominal pain was noted in 16 (72.7%) children in group I and in 22 (81.5%) patients in group II. Chronic diarrhea was observed in 20 (90.9%) children in group I and in 4 (14.8%) in group II. Ultrasound scans revealed mesenteric lymphadenopathy in 42 children (16 in group I and 26 in group II). CONCLUSIONS: chronic and recurrent abdominal pain was the main clinical complain and chronic diarrhea in children under 5 years of age. In few cases hepatobiliary involvement was observed, which might suggest a changing clinical course of giardiasis. Most of the children presented with mesenteric lymphadenopathy, which was confirmed by abdominal ultrasound scan. Thus, this method should be included in the diagnostic algorithm, if parasitosis is considered.

[Immune components of human milk]. / Skladniki mleka kobiecego wspomagajace uklad odpornosciowy dzieci karmionych piersia.

Many benefits of breast-feeding have been generally accepted. In the article the constituents of human milk supporting the immune system of breast fed babies are reviewed. The effect of maternal undernutrition on immunological properties of breast milk is also presented.

[Short bowel syndrome in children - own experience]. / Zespól krótkiego jelita u dzieci-obserwacje wlasne.

THE AIM: of this study was to analyze the clinical status of children with short bowel syndrome (SBS) shortly after the resection and during following years. MATERIAL AND METHODS: we reviewed retrospectively 5 children with SBS aged from 2 years and 7 months till 14 years and 5 months, who were on total parenteral nutrition due to intestinal resection. The resection was performed, when they were either newborns or infants. In the analysis we considered somatic development and laboratory tests results. In 4 cases the cause for extensive bowel resection were congenital anomalies of the intestine, in one case it was intestinal necrosis as result of invagination. RESULTS: in all children there was diarrhea, during postoperative period and when oral caloric intake was increased and when loss of weight was observed. Most common complications included hypochromic anaemia and cholestasis. Moreover, in 2 children with resection of distal region of the ileum and ascending colon, we observed vitamin B12 deficiency and recurrent lactic acidosis due to secondary biotin deficiency. Catheter complications were one of the main problems. 3 patients developed sepsis. Occlusion or mechanic damage of the catheter were also observed. Despite initial severe retardation in somatic development, final anthropometric evaluation in all children was found to be normal. CONCLUSIONS: 1. Congenital intestinal and mesenteric defects were the most common reasons for SBS in the youngest children. 2. Parenteral nutrition is the cardinal element in the management. It was crucial for survival and further normal somatic development, even in children after extensive intestinal resection. 3. Lactic acidosis due to biotin deficiency must be considered if acid-base balance restoration is complicated in children with SBS. 4 Children with SBS after resection need long-term and multi specialistic medical care.