[Congenital hyperammonemia in neonates treated with hemodiafiltration]. / Hiperamonemia wrodzona u noworodków leczonych z zastosowaniem hemodiafiltracji.

Inborn defects of urea cycle often results in life-threatening hyperammonemia in neonates. The initial therapy of this disease comprises administration of benzoate sodium, arginine, lactulose, neomycin, and restrictive alimentation based on carbohydrates. Renal replacement therapy for ammonia removal should be considered for the most severe cases. We present a case report of two neonates with very rare inborn urea cycle disorders--deficiency of argininosuccinate lyase and carbamyl-phosphate synthetase, treated with spontaneous arterio-venous haemodiafiltration.

Leukocytes and endothelium interaction as rate limiting step in the inflammatory response and a key factor in the ischemia-reperfusion injury.

Leukocyte-endothelium interactions play a key role in regulation of the inflammatory response, leukocytes migration and ischaemia-reperfusion injury. These adhesive reactions controlling the circulation of leukocytes, are key parts of immune surveillance arising from extravasation of neutrophils, and migration into tissue to eliminate invading microorganism. They also play important role in the generation of ischaemic-reperfusion injury of different organs including brain. Plasma levels of soluble adhesion molecules may be a diagnostic marker of the systemic endothelial injury. It is likely that the next few years bring new therapies to control leukocyte-endothelial interaction by directly inhibiting the adhesion molecules or by modulating their expression.

[Analysis of perinatal death at the Institute of the Health Center of the Polish mother in 1995, 1996 and 1997. The reason for making changes in the accountability for perinatal death]. / Analiza zgonów w okresie perinatalnym w Instytucie Centrum Zdrowia Matki Polki w latach 1995, 1996 I 1997. Przyczynek do koniecznosci wprowadzenia zmian w sprawozdawczosci na temat umieralnosci okoloporodowej.

Perinatal death's causes of fetuses and newborns from single and twin pregnancies delivered at the PMMHI from 1995-1997 were discussed. Data from the Pathology Department were analysed and compared to information regarding prenatal US + ECHO diagnoses coming from the Department for Diagnoses of Congenital Malformations at the PMMHI. The most frequent cause of death of fetuses and newborns from single pregnancies were congenital malformations (42%). In twins there prevailed such typical for multiple pregnancies' death causes as TTTS (27%), intrauterine demise of one of the twins (17%). Premature labor occupies the second most frequent cause of death both in single and multiple pregnancies. Most of perinatal deaths may be predicted prenatally by means of ultrasound and fetal echocardiography.

Can magnesium sulfate reduce the risk of cerebral injury after perinatal asphyxia?

Hypoxia-ischemia produces brain damage by processes that continue for many hours after reoxygenation/reperfusion. This provides a window of opportunity for therapy aimed at preventing further loss of brain cells. Sulfate magnesium can prevent posthypoxic brain injury by blocking glutamate receptors within the calcium (Ca++) ion channel. We used sulfate magnesium in nine newborn infant after perinatal hypoxia. We investigated the brain damage, by ultrasound examination, on third day, in first, second and third week, and third, sixth month of life. We have estimated the neurological development in the first week of life and third and twelfth month of life. We did not find deviations in ultrasound examination. We did not observe convulsions. We did not observe any side effect of this therapy. The examination at 1 of year of life in all of children was correct.

Monitoring of rat islet allografts with dithizone after induction of donor specific transplant tolerance by intrathymic administration of soluble alloantigens.

Transplantation of whole pancreas or pancreatic islets remains a promising approach to treatment of diabetes mellitus. Since there is no efficient method presently known for in vivo detection of pancreatic islet rejection, we have utilized dithizone [DTZ] to monitor the survival of transplanted islet allografts following the induction of tolerance by a new strategy of deliberate introduction of donor antigens into the adult thymus. In this study, we examined the morphology of islet allografts in vivo and in vitro following pretreatment with intrathymic (IT) inoculation of 2 mg soluble Ag obtained from 3M KCl extracts of resting T-cells with or without ALS immunosuppression in the WF-to-Lewis combination. Fresh isolated rat islets stained pink 3-5 minutes following exposure to medium containing 0.12 mM DTZ solution in DMSO. Intravenous (i.v.) injection of DTZ solution into unmodified recipients of islet allografts that had rejected their grafts showed massive degranulation of islets which did not stain pink with DTZ. This was confirmed by microscopic finding of fibrosis and lymphocytic infiltration. In contrast, i.v. injection of DTZ solution into long-term recipients of islet allografts at 50, 100, and 150 days after transplantation showed viable islet cells which stained crimson red with DTZ and the findings were confirmed with microscopic sections. This study demonstrates that DTZ is an effective means of in vivo and in vitro identification of transplanted pancreatic islets and suggests that this strategy may have potential clinical application in the diagnosis of the pancreatic islet rejection.