Substantia nigra hyperechogenicity in Polish patients with Parkinson's disease.

BACKGROUND: Hyperechogenicity of the substantia nigra (SN) measured by transcranial sonography (TCS) is a characteristic feature observed in patients with Parkinson's disease (PD). To our knowledge, no SN hyperechogenicity data are available for Polish population. Moreover most of studies come from few centres, which used the one type of ultrasound device. The main aim of the study was to investigate the association between PD and SN hyperechogenicity measured by sonographic machine, not assessed so far. MATERIALS AND METHODS: In this study cross-sectional study SN hyperechogenicity was evaluated in 102 PD patients and 95 control subjects. Midbrain was visualised by Aloka Prosound 7 ultrasound device. SN area measurement, the relation to the clinical features of PD, inter- and intra-observer reliability were evaluated. RESULTS: We confirmed that SN echogenicity is significantly increased in PD patients compared to control subjects (p < 0.001). The area under curve for PD patients vs. controls was 0.93. Receiver operating characteristic analysis indicated a cut-offs for SN echogenicity at 0.19 cm² with accuracy equal to 90%, specificity - 86% and sensitivity - 93.7%. The SN hyperechogenicity was not related to PD clinical findings. Reliability was good if an experienced sonographer performed the SN measurements. CONCLUSIONS: This study shows that the SN abnormality observed by TCS isa specific feature, which can be helpful in the process of PD diagnosing.

Characterization of anti-ECA antibodies in rabbit antiserum against rough Yersinia enterocolitica O:3.

Enterobacterial common antigen (ECA) is a characteristic surface component in bacteria belonging to the Enterobacteriaceae family. It is generally integrated in the outer membrane via a linkage to phosphatidylglycerol (ECA(PG)) and at the same time in some special cases via a linkage to lipopolysaccharide (ECA(LPS)); the latter form is immunogenic. Yersinia enterocolitica O:3 expresses both ECA(PG) and ECA(LPS). To study whether ECA-immunogenicity of Y. enterocolitica O:3 is temperature-regulated, rabbits were immunized with ECA-expressing Y. enterocolitica O:3 bacteria grown at 22 and 37°C. To induce minimal amount of anti-LPS antibodies, immunization was performed with YeO3-c-trs8-R, an LPS mutant missing both O-polysaccharide and the outer core hexasaccharide. However, abundant antibodies specific for LPS core were still present in the obtained antisera such that the reactivity of ECA-specific antibodies could not be detected. To obtain "monovalent" anti-ECA antisera, the sera were absorbed with ECA-negative bacteria. Absorption with live bacteria removed efficiently the anti-LPS antibodies, whereas this was not the case with boiled bacteria. Western blotting revealed that the specificity of the monovalent anti-ECA antiserum was different from that of a monoclonal anti-ECA antibody (mAb 898) as it did not react with ECA(PG), and this suggested that in Y. enterocolitica O:3 ECA(LPS) only one or two ECA repeat unit(s) is/are linked to LPS. Both ECA(PG) and ECA(LPS) expression were found to be regulated by temperature and repressed at 37°C.

Negative results of antiendomysial antibodies: long term follow up.

Fifteen patients with intestinal villous atrophy, but simultaneously negative results of antiendomysial antibodies (EMA) were studied. Two patients were finally diagnosed as having coeliac disease. The predictive value of negative results of EMA assessment in children suspected of coeliac disease is high, approaching 86.7%.

[Mycology perirenal abscess as a complication of choledochoduodenal anastomosis due to stenosing papillitis]. / Ropien okolonerkowy pochodzenia grzybiczego w przebiegu pooperacyjnym u chorego po zespoleniu przewodowo-dwunastniczym z powodu papillitis stenosans.

This elaboration presents the seldom case of perirenal abscess insued after choledochoduodenoanastomosis. It refers to 71 years old patient, who was treated in General Hospital Biala Podlaska, Department of Surgery, with good results. Aetiology of that abscess is very seldom too, because it is concerned with Candida sp.

[Mediastinal abscesses and empyema of the pleural cavity after iatrogenic fracture of the sternum]. / Ropien sródpiersia i ropniaki oplucnej w wyniku jatrogennego zlamania mostka.

A case report presents fracture of sternum during the resuscitation and in continuity iatrogenic hematoma and afterwards abscessus of mediastinum, and empyema the both of pleura cavities. Fracture of thorax wall is rather often event, but in the most, it has not adverse effects. This case refers to 68 years old patient, who had one of the most serious complications: abscessus of mediastinum, empyema of left and right pleura cavities with perforation outside the anterior wall of thorax. He was treated in General Hospital Biala Podlaska, Department of Surgery with good results and was extracted home as well-being patient after 35 days spent in hospital the second hospitalisation.

[Epidemic of Pneumocystis carinii infection in infants]. / Epidemiczne zakazenie Pneumocystis carinii u niemowlat.

Epidemic intra-ward infection caused by Pneumocystis carinii was described. 18 infants and small children were ill from among 21 treated in the infants ward. The diagnosis was given on the grounds of cytologic examination of bronchial excretion from subglottic region.

[Serum triiodothyronine and thyroxine levels in children with celiac disease]. / Stezenie trijodotyroniny i tyroksyny w surowicy u dzieci chorych na celiakie.

The study was aimed at determining relationship between thyroid function and the type and degree of malabsorption. Serum triiodothyronine (T3) and thyroxine (T4) levels were determined in children with celiac disease and the secondary malabsorption. Hundred fifty five children aged between 6 months and 7 years were followed up 3 years. Coeliac disease was diagnosed with classic Interlaken criteria. All children were divided into three groups: group I--57 children aged between 6 months and 3 years with suspected celiac disease; group II--55 children aged between 2.5 and 6 years after gluten-free diet therapy; group III--52 children aged between 3 and 7 years after gluten provocation test. Serum T3 and T4 levels for each group were compared with those in children with normal gut mucous membrane. Blood serum T3 and T4 were assayed with OPIDI kit (manufactured in Swierk). Serum T4 levels were significantly lower in children with mucous membrane atrophy in comparison with dystrophic children and normal gut mucous membrane. Both serum T3 and T4 were significantly lowered in the youngest children upto 12 months of life with mucous membranes atrophy. Serum T3 and T4 concentrations were below the normal values in 4 youngest children. Blood serum T3 and T4 levels did not depend on the morphology of the intestinal villi in children treated with gluten-free diet (some children did not observe the diet and had atrophic lesions to the mucous membrane of the small intestine). Blood serum T3 level was relatively increased in children of group II with mucous membrane regeneration; in comparison with the value determined in the period of active disease.

The telephone: an overlooked technology for prevention in family medicine.

Annual influenza vaccination has long been recommended for the elderly population. Despite this recommendation, immunization rates have remained very low. This study measured the effects of two approaches to the provision of influenza immunization to the 65-years-and-over age group in a single family practice. The "drop-in" group (N=123) was informed of the availability of the vaccine at visits made during the vaccination period. The "phone" group (N=120) was notified of the availability of the vaccine by telephone and was invited to come in for the shot. An immunization rate of 50.8% for the "phone" group and 26.8% for the "drop-in" group was obtained (P=.0002). These results contrast strongly with the overall immunization rates of 5.9% and 9.5% obtained during the previous two years, when no active immunization policy was in place. The telephone approach was found to benefit the type of patient at greatest risk from influenza: the chronically ill and the aged. It is clear that having a defined immunization policy substantially improves the provision of influenza vaccination. The authors discuss the effectiveness and practicality of these approaches to the delivery of influenza vaccine and their applicability to other forms of prevention in family medicine.