Study on the Sequential Combination of Bioethanol and Biogas Production from Corn Straw.

The objective of this study was to obtain two types of fuels, i.e., bioethanol and biogas, in a sequential combination of biochemical processes from lignocellulosic biomass (corn straw). Waste from the agricultural sector containing lignocellulose structures was used to obtain bioethanol, while the post-fermentation (cellulose stillage) residue obtained from ethanol fermentation was a raw material for the production of high-power biogas in the methane fermentation process. The studies on obtaining ethanol from lignocellulosic substrate were based on the simultaneous saccharification and fermentation (SSF) method, which is a simultaneous hydrolysis of enzymatic cellulose and fermentation of the obtained sugars. Saccharomyces cerevisiae (D-2) in the form of yeast cream was used for bioethanol production. The yeast strain D-2 originated from the collection of the Institute of Agricultural and Food Biotechnology. Volatile compounds identified in the distillates were measured using gas chromatography with flame ionization detector (GC-FID). CH4 and CO2 contained in the biogas were analyzed using a gas chromatograph in isothermal conditions, equipped with thermal conductivity detector (katharometer) with incandescent fiber. Our results show that simultaneous saccharification and fermentation enables production of bioethanol from agricultural residues with management of cellulose stillage in the methane fermentation process.

A case report of an adolescent with cluster headaches following neck trauma: Coincidence or trigger?

Posttraumatic headaches usually have tension-type or migraine-like characteristics. A correlation between head trauma and cluster headaches (CH) has been previously reported. CH in children are rare and require thorough differential diagnosis. We present an original case of a 15-year-old boy with cluster headaches associated with allodynia probably evoked by a neck trauma. Severe headache attacks started one month after neck trauma. At the beginning clinical presentation of our patient's headaches was very misleading. Headaches were bilateral and associated with infection. Initial diagnosis of sinusitis was made. During further observation headaches have become unilateral with typical for CH associated symptoms and additionally with allodynia. Other causes of secondary CH like cervicogenic headaches, brain tumor and vascular malformation have been excluded. The boy has undergone prophylactic treatment based on flunarizine and gabapentin with good result. Possible pathogenesis of our patient's headaches has been proposed and diagnostic traps discussed.

[Bell's palsy in malopolska's children in 2010-2014 years]. / Porazenie obwodowe nerwu twarzowego u dzieci w Malopolsce w latach 2010-2014.

BACKGROUND: Peripheral facial nerve palsy (Bell' palsy, BP) is a not rare diseases in children, being the most common acquired mononeuropathy. AIM: The authors of this study wanted to determine whether the occurrence and course of paralysis changed in the past 5 years (2010-2014). MATERIALS AND METHODS: The study involved Lesser Poland region, where the majority of children with paralysis are hospitalized at the Pediatric Neurology Department of University Children's Hospital in Krakow. These children in subsequent years were admitted to our department without any limitations. A review of clinical documentation of 125 patients, in terms of demographics, the coexistence of other diseases, seasonality, the degree of paralysis, location of paralysis, the prevalence of the recurrence was made. Changes in the structure of the nerve VII in MRI and CT, pharmacological treatment, applied rehabilitation, the degree of improvement and time of hospitalization were analyzed. RESULTS: Similar distribution of occurrence and gender of children with BP in Lesser Poland region within 5 years were observed. The predominance of the girls resulted from demographic composition of the population. BP occurred most frequently in summer and winter. In more than half of children BP occurred in the course of acute systemic infection or craniofacial infection and in 5/125 BP followed head injury. Children with infections required antibiotic therapy. Left-sided paralysis was found in the majority of children and almost half of patients needed protection of the cornea of the eye (significant degree). In 12% of children structural changes within the facial nerve were found. In these children antiviral treatment was used and hospitalization time was more than 20 days while in the majority of children hospitalization lasted 15 days. In 8 (6.4%) children with recurrent BP kinezytherapy, electrical stimulation and laser therapy were applied. Steroid therapy was not used. Only 7/125 chil. dren had mild impairment of the eye closing at the discharge and the others received nearly complete recovery. CONCLUSIONS: Inflammatory etiology is the most common in children with BP. BP occurs more often in the summer and winter. Severity of paralysis was significant in more than half of hospitalized children. Children with structural changes within the nerve VII required longer hospitalization and comprehensive treatment.

[Neurophysiological methods in evaliuation of neurorehabiltation in children]. / Przeslanki neuroelektrofizjologiczne dla rehabilitacji neurologicznej dzieci.

The authors reviewed neurophysiological methods, which are used in the evaluation of children referred for neurorehabilitation. Rehabilitation techniques which may stimulate or provoke pathological changes in EEG must be ruled out. Electrophysiological and clinical improvement allow for the extension and intensification of rehabilitation. Normal EEG pattern ensures the safe use of techniques consisting of neuromuscular re-education or passive verticalisation, electrotherapy and thermotherapy. Quantitative and qualitative assessment of cognitive impairment is based on neuropsychological tests and endogenous evoked potentials (most often P300). Presence of cognitive dysfunction needs the use of neuropsychological and neurologopedic therapy. Based on results of exogenous evoked potentials appropriate neurorehabilitation program (physiotherapy, kinezytherapy) can be determined and clinical outcome predicted. EMG allows appropriate usage of applications, patterns and principles in the PNF method (such as compression, stretching, resistance), adapting them optimally to the possibility of a child. ENG estimates conduction in motor and sensory nerves. Based on the results nerve impairment can be localized, severity and character of damage estimated (demyelinating, axonal or complex) and course of the disease and treatment monitored. Short characteristics of 37 children with Guillain-Barre syndrome referred for rehabilitation was presented. Special attention was drawn to floppy infants. Results of neuroelectrophysiological examinations determine suitable rehabilitation program adjusted to the course of central nervous system impairment.

[The influence of child's behaviour on the course of neurological diagnosis]. / Wplyw zachowania dziecka na przebieg diagnozy neurologicznej.

INTRODUCTION: Among the huge amount of neurological diseases that cause diagnostic difficulties, there happens, from time to time an additional difficulty--disorders of psychogenic origin, and among those- conversion disorders. Until now there still is no satisfactionary explanation for the neurobiological basis of conversion. The explanations offered by psychology are also rather general, based on the tradition of psychoanalysis. Aside from how deeply one understands its mechanisms, when suspecting a psychogenic origin of the symptoms observed, one should be especially careful. It is far too easy falling in the trap, that hysteria sets for us, suggesting to be the patient's one and only disease that should be dealt with. AIM OF THE STUDY: To show the difficulties and dangers when making a diagnosis of functional disorders, both from the physician's and psychologist's point of view. MATERIAL AND METHODS: Presenting cases of 6 patients, whose behaviour and symptom presentation suggested a psychogenic background of the disorders, and only few of the psychological tests' results differentiated between the organic and the psychogenic group. RESULTS: In the presented group there were 3 children diagnosed with conversion disorder, and 3 diagnosed with neurological diseases. The psychological test results only partly differentiated between both groups, not allowing any interpretation to be based on quantitative results only. CONCLUSIONS: 1. Even though medicine has made such a huge step forward, conversion disorders can still cause serious diagnostic difficulties. 2. Leaving our knowledge about human mind aside, we are continously eager to base our judgement on the most vivid elements, that present to us most clearly. 3. That line of thinking puts us in jeopardy of missing the obvious: that a histerical person can also suffer from another condition of a very organic origin.

[Rehabilitation outcome in children with cranial trauma and hypoxaemia of the brain]. / Wyniki usprawniania dzieci po ciezkich urazach czaszkowo-mózgowych i niedotlenieniu mózgu.

BACKGROUND: Traumatic brain injury is one of the most common causes of children's disability and death. AIM OF THE STUDY: The goal of this study was to present the effects of improvement treatment in patients who suffered various types of brain trauma, to discuss their motor functions as well as the emotional state and behavioural disturbances. One of the aims was also to present complications which took place reagardless of complex rehabilitation. MATERIAL AND METHODS: In this study we describe the state of 5 patients. The patients were assessed with the Ashworth and RLAS scales before and after the complex rehabilitation. The programme of rehabilitation was designed individually for each patient depending on his RLAS score. The complications developed after 6 months of treatment are described. RESULTS: In one case only- in a girl with hemiparesis- the state of nearly independent motor functioning was achieved. The other patients are bedridden or dependent on a second person when moving in a wheelchair. The girl with hempiparesis and another girl with spastic quadriparesis remain in the best verbal contact. Both of them however present with profound cognitive, emotional and behavioural deficits. The other patients are unable to reach any verbal communication. Because of swallowing problems some of the patients had feeding tube or tracheostomy performed. Each patient had an individually designed rehabilitation programme. CONCLUSIONS: The outcome of rehabilitation treatment in patients with profound traumatic brain injury is very individual. The best outcome was achieved in a girl with hemiparesis who suffered brain injury in a car accident, and worse in children after brain hypoxaemia.

[Significant neuropsychological impairment in children with normal MRI results]. / Istotne deficyty neuropsychologiczne u dzieci z prawidlowym wynikiem neuroobrazowania MR.

The aim of the present work was to present significant cognitive impairment in 7 children with normal neuroimaging and electroencefalography results. In 6 children we observed difficulties in verbal auditory learning, in 3 visual memory impairment, and in 1 a disorder of visuo-spatial analysis and synthesis abilities. The clinical examinations performed during the diagnostic process (MRI, CT, Eeg) revealed no neurobiological correlates of the observed neuropsychological impairment. The authors used the cases described to remind, that even though current neuroimaging techniques seem excitingly promising in the diagnostic process, psychological and neuropsychological assessment remains the most sensitive method for the measurment and description of cognitive functions.

[Baclofen dose in a screening test and in a baclofen pump filling--is there any differences]. / Dawka baklofenu w tescie baklofenowym a rzeczywista w czasie leczenia.

Spasticity is one from many clinical signs appearing in head and spinal cord injury and it is characterized by increased muscle tone with increased tendom reflex and reccurent spasms. Intrathecal baclofen therapy is surgical method for treatment of severe spasticity and a pump implantation is preceded by baclofen screening test. In this study we compared a bolus intrathecal injection given in a screening test with doses uses for filling a baclofen pump. In selected group we observed increased Baclofen dose due to dose given in screening test.

[Assessment of spasticity therapy with baclofen pump in children]. / Ocena wyników leczenia spastycznosci u dzieci za pomoca pompy baklofenowej.

THE AIM OF THE STUDY: The aim of this study was to assess of treatment of spasticity in children with baclofen pump, before and after pump implantation. MATERIAL AND METHOD: In a group of 17 patients with spastic hemiparesis, with a different etiology, 2 groups were separated. In the group of 12 the most injured children, spasticity was measured by The Modified Ashworth Scale, before and after baclofen pump implantation. In the group of 5 patients spasticity was assessed by The Modified Ashworth Scale, functional benefits were evaluated with the Barthel index score, and the digree of disability with the Rankin Scale. RESULTS: In the group of 12 patients, after pump implantation, was observed reduction in spasticity to 2 points in the Modified Ashworth Scale and this effect improves general ease of care and passive excersises. In the second group 3 of 5 patients, have started to walk alone or with orthopedic help. CONCLUSION: Intrathecal baclofen therapy resulted in the good effects in treatment of spasticity in the both groups.

[Physical and other methods therapy of the spasticity in children]. / Neurorehabilitacja i inne sposoby leczenia spastycznosci u dzieci.

BACKGROUND: Spasticity is a very bothering symptom, which aggravates disability and prevents in many cases a successful treatment. THE AIM: The aim of this paper was to remind different methods of treatment of spasticity, with a special attention to neurorehabilitation. RESULTS: In the research the complex pathogenesis of spasticity was referred, as well as factors influenced its aggravation and associated symptoms. Methods of evaluation of degree of spasticity were also recalled. The advantage and disadvantage of neurorehabilitation were also discussed. NDT-Bobath method as well as other kinesiotherapy methods were described with the necessity to make individualised program. The methods of rehabilitation which help in the reduction of muscle tone were refered, as well as the importance of botulin toxin, in the context of lack of efficacy of drugs in the reduction of spasticity, which cannot in fact help to reach better results of rehabilitation. The effectiveness of spasticity therapy with baclofen pump and other surgical methods were also mentioned. CONCLUSIONS: The decision to treat spasticity must be justified and depended on its intensity. It is necessary to develop new methods to obtain the durable effect of therapy of spasticity.

The prevalence of C807T mutation of glycoprotein Ia gene among young male survivors of myocardial infarction: a relation with coronary angiography results.

INTRODUCTION: The glycoprotein complex Ia/IIa (GP Ia/IIa) is a major collagen receptor on platelets and other cell types. Recently, linked polymorphisms within the coding region of the GP Ia gene (C807T and G873A) related to GP Ia/IIa surface expression have been identified. The 807T/873A allele is associated with high expression, whereas the 807C/873G allele is associated with low surface expression of GP Ia/IIa. Subsequently, the 807T allele was found to be associated with coronary artery disease (CAD) and cerebral infarction in younger patients. Moreover, platelet thrombus formation is significantly influenced by genetic variations of the GPIb alpha and GPIa receptors and is dependent on the blood flow rate. AIM: 1. To determine the frequency of C807T polymorphism of the GPIa gene in young survivors of myocardial infarction (MI) and 2. to evaluate the relationship between the intensity of CAD in the coronary angiography examination and the 807C/T genetic status of the patients. METHODS: 102 young male survivors of MI (YSMI) -- mean age 43, range 29-49 years, mean age at the time of the first episode 37+/-3 years -- were studied. Obesity was found in 15%, diabetes in 14%, hyperlipidemia in 87%, hypertension in 22% and smoking history in 90% of cases. Familial CAD and/or MI were confirmed in 50% of patients. The control group consisted of 106 healthy volunteers with a negative family history of CAD, both medical staff members and blood donors (mean age 40, range 18-42 years). The genetic study was performed using genomic DNA obtained from peripheral blood leukocytes. The C807T polymorphism of platelet glycoprotein Ia (GPIa) was investigated using the PCR method introduced by Santoso et al. RESULTS: Coronary angiography (Siemens Bicor system) revealed single-artery disease in 34%, two-artery disease in 36% and three-artery disease in 26% of patients. In two patients there were no signs of CAD. The C807T polymorphism of GPIa was found in 73.5% of investigated patients (heterozygotes CT 59.8%, homozygotes TT 13.7%). The CC genotype was confirmed in 26.5% of patients. A similar analysis performed in the group of healthy men showed C807T polymorphism of the GPIa gene in 73.6% (CT in 58.5% and TT in 15.1% of persons, ns). CC genotype was found in 26.4% of persons. Interestingly, the T genotype frequency was similar in patients with three- or two-artery disease in comparison with patients with single-vessel or without CAD (49.3% vs. 50.7%, respectively, ns). In 75 YSMI carrying C807T polymorphism of the GPIa gene additional genetic abnormalities were confirmed in 21 patients - BclI polymorphism of b-chain fibrinogen gene, G4070A and G1691A (FV Leiden) mutation of factor V gene and C677T polymorphism of methylenetetrahydrofolate reductase gene. Partial occurrence of combined polymorphisms was found. This was confirmed independently of the number of coronary arteries involved. CONCLUSIONS: Our results may question the potential role of C807T the GPIa anomaly as a single genetic abnormality predisposing young men to coronary artery disease.

[Non traumatic spinal syndromes in children]. / Nieurazowe zespoly rdzeniowe u dzieci.

BACKGROUND: Spinal cord syndromes are caused by trauma in most cases, but the non traumatic spinal syndromes are needed to be urgently diagnosed and treated. THE AIM OF THE STUDY: It was to assess the prevalence of non traumatic spinal syndromes among hospitalized children with diseases of the nervous system and diagnostic analysis, therapy and its course. MATERIAL AND METHODS: The group of 16 children age 0,5-18 years hospitalized in the years between 1996-2005 in the Department of Child Neurology in Krakow. The diagnosis was based on neurological assessment, imaging, cerebrospinal fluid examination and other data. Pharmacology, surgery and physiotherapy were performed as a treatment. The modified Rankin scale was used to assess the motor function after the spinal disorder. RESULTS: The non traumatic spinal syndromes were identified in 0.3% of hospitalized children. In 5 cases they were caused by infection etiology, in other 3 cases the congenital spinal cord malformations were diagnosed. Three children had spinal tumors, in a single case the haematoma, vertebral dislocation, the vertebral fracture with bulging of the annulus fibrosus of the intervertebral disc, isolated bulging and MRI hiperintensive lesion of unknown etiology were seen. Two patients, which were most motor impaired past away, the intramedular tumor caused the middle motor dysfunction, the others spinal syndromes elicted minor disability. CONCLUSION: The most common etiology of the non traumatic spinal syndromes, rare in hospitalized children, were inflammation, congenital spinal malformation and neoplastic tumors. Three fourths of the children had mild and other more severe handicaps due to non traumatic spinal syndromes.

[Neurorehabilitation in children with thoracic outlet syndrom and its assessment]. / Postepowanie neurorehabilitacyjne u dzieci z zespolem górnego otworu klatki piersiowej i ocena jego wyników.

OBJECTIVES: Thoracic outlet syndrome (TOS), a rare clinical condition develops as a consequence of compression of the brachial plexus and/or subclavian vessels in the thoracic outlet area. THE AIM: The aim of this research was the clinical and electrophysiological evaluation of results of therapeutic rehabilitation in female patients diagnosed with TOS. MATERIAL AND METHODS: 3 girls diagnosed in the Department of Pediatric Neurology and Neurophysiology Laboratory and treated in the Neurorehabilitation Division at the University Children's Hospital were evaluated. The TOS diagnosis was established in children aged 12-14 years with the use of doppler examination of subclavian vessels. Two girls underwent conservative management and in the third case surgical decompression and subsequent neurorehabilitation was provided. The methods of conservative management were addressed to relaxation of scalenic muscles, flexibility of cervical and thoracic vertebral column, stretching of pectoral smaller muscles, relaxation and relief of cervical vertebral column, and postural correction of shoulder girdle. The treatment plan assumed improvement of balance of muscle tone, postural correction and diaphragmatic mode of breathing. The first evaluation was conducted before rehabilitation, the control evaluation after 12 months of treatment using Lowet test, load tests, Doppler examination of subclavian vessels and electrophysiological tests (ENG, EMG and SEP) as well. RESULTS: Rehabilitation treatment increased the muscle strength, without significant proficiency improvement of patient upper extremities. The control electroneurography, electromyography and Doppler examinations did not reveal improvement after a conservative management. However, the surgical decompression led to deliberation of subclavian artery, stopped progress of muscle atrophy and normalization of SEP latencies as well. CONCLUSIONS: A 12-months of comprehensive rehabilitation treatment of children with TOS improved significantly a muscle mass and strength. Significant improvement of range of motions, however neurophysiological improvement was not observed. The surgical decompression combined with neurorehabilitation in 1 child caused normalization of somatosensory potentials.

[Assement of clumsiness in children with partial and generalized epilepsy]. / Ocena wystepowania niezgrabnosci ruchowej u dzieci z padaczka czesciowa i uogólniona.

THE AIM OF THE STUDY: Epilepsy in the developmental age is connected in some cases with disorders of gross motor dysfunction, but in the others every day motor activity is not disturbed. Although it does not mean that in children with epilepsy there are not diagnosed any different motor disorders. Aim of the study was to determined the differences between epilepsy with and without gross motor function disorders, the appearance of clumsiness in children with partial epilepsy and primary generalised. MATERIAL: The study was performed on a group of 40 children with idiopathic epilepsy, 23 with idiopathic partial seizures and 17 with generalised. In this group boys predominated (14/23 and 11/17). The average age of both groups was not significant different (12.5 and 13.4). The assessment of gross motor function and intellectual development was normal. METHODS: The assessment of clumsiness was performed by using 10 tests classifying 3 categories of movement: co-ordination, integration, balance. To diagnose the type of epilepsy the common used clinical, electrophisiological and neuroimaging procedures were done. The statistic assessment was performed by using T-test for independent probe. RESULTS: There were no differences between groups of children in 2 test evaluating balance, which were normal. Children with generalised epilepsy had normal results in other 5 test. The lower results were observed in children with partial epilepsy in 8 and with generalised in 3 tests, but this difference was not statistically significant (VAR2/VAR1 = 0.793 and AR3/VAR1 = 0.965). Results of children with partial seizures were lower in 8 tests, but it was not statistically significant(VAR3/ VAR2 = 0.827). The most expressive difference was seen in the test of balance with jumping. CONCLUSION: Children with partial epilepsy are a little more clumsy than children with primary generalised epilepsy.