Diffusion tensor imaging findings in the multiple sclerosis patients and their relationships to various aspects of disability.

BACKGROUND: The aim of the study was to assess microstructural changes within strategic brain regions in multiple sclerosis (MS) patients, using diffusion tensor imaging (DTI), with regard to various aspects of disability. MATERIAL AND METHODS: The study comprised 50 patients with relapsing-remitting MS (37 women, 13 men, mean age 36.4 yrs) and 27 age- and sex-matched controls. Using DTI, fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were obtained within corpus callosum (CC), both thalami (TH) and middle cerebellar peduncles (MCP). Disability was assessed using Expanded Disability Status Scale (EDSS), MS Functional Composite (MSFC), Symbol Digit Modalities Test (SDMT) and Fatigue Severity Scale (FSS). DTI indices were compared between the patients and controls and in the MS group - referred to disability measures. RESULTS: Significant decrease in FA and increase in ADC within CC and both TH were found in MS patients compared to the controls. DTI indices within CC and TH correlated significantly with SDMT score, and within TH and MCP - with MSFC manual dexterity measure. CONCLUSIONS: Changes in DTI measures in normal appearing white and grey matter in the MS patients indicate subtle alterations of the tissue integrity. An occult damage to the strategic brain regions may contribute to various aspects of disability due to MS.

In vitro biocompatibility of Ti-45S5 bioglass nanocomposites and their scaffolds.

Titanium-10 wt % 45S5 Bioglass nanocomposites and their scaffolds were prepared by mechanical alloying (MA) followed by pressing, sintering, or combination of MA and a "space-holder" sintering process, respectively. An amorphous structure was obtained at 15 h of milling. The crystallization of the amorphous phase upon annealing led to the formation of a nanostructured Ti-10 wt % 45S5 Bioglass composite with a grain size of approximately 7 nm. The in vitro cytocompatibility of these materials was evaluated and compared with a conventional microcrystalline titanium. During the studies, established cell line of human fibroblasts CCD-39Lu was cultured in the presence of tested materials and its survival rate, and proliferation activity were examined. Furthermore, the influence of the Ti-45S5 Bioglass nanocomposites and microcrystalline titanium was tested on the growth of Candida albicans yeast. Biocompatibility tests carried out indicate that the nanocomposite Ti-10 wt % 45S5 Bioglass scaffolds could be a possible candidate for dental implants and other medicinal applications.

Risk score based PEG Interferon alpha 2b and Ribavirin treatment response estimation model for genotype 1 chronic hepatitis C patients.

PURPOSE: Attempt to create simple practical algorithm for prospective assessment of PEG interferon/ribavirin related treatment response in individuals with chronic hepatitis C (CHC) basing on the risk factors defined prior to the treatment initiation. MATERIAL/METHODS: Retrospective assessment of 45 female and 39 male previously untreated CHC patients aged 20 to 73 years, with genotype 1, undergoing standard treatment with PEG-IFNa2b+RBV was performed. For the final analysis 78 patients were included (38 effectively treated and 40 treatment failures). Thirty-six sustained virological response (SVR) related factors, which were routinely measured before treatment initiation were compared (including physical, biochemical, serologic and histopathologic). From this group the risk factors of the highest predictive value for treatment failure were selected. Cut-off values for statistical significance were defined for each parameter, with risk score (RS) calculated and compared in the group with and without SVR. RESULTS: Seven factors related to treatment failure were identified: HCV>600000 IU/L, blood platelet count <150000/ul, GGTP>45 IU/ml, total serum protein<7.8 g/dl, glycaemia>105 mg/dl, detectable HBc IgG antibodies and cirrhosis. In the group with RS 1 the likelihood of SVR was 70% (p<0.028), while in patients with RS 3 the response was reduced to 23.8% (p<0.016), with no SVR achieved among patients with RS >3. CONCLUSIONS: Low risk score (0-2) is associated with high probability of treatment success with scores >3 predictive for treatment failure. The presented model is a simple tool for prediction of treatment success for clinical use before PegIFN/RBV treatment initiation among genotype 1 CHC patients.

Serum iron parameters in patients with alcoholic and chronic cirrhosis and hepatitis.

BACKGROUND: The aim of our study was to asses the serum iron status of patients with various forms of hepatitis and cirrhosis of the liver and to determine the correlation between the degree of hepatocyte damage and the status of serum iron parameters. MATERIAL AND METHODS: The study involved 136 subjects with chronic viral hepatitis type C (group I, n=71) and type B (group II, n=29), alcoholic cirrhosis of the liver (group III, n=15), postinflammatory cirrhosis of the liver (group IV, n=13), and alcoholic hepatitis (group V, n=8). In all these patients, serum alanine (ALT) and aspartate (AST) aminotransferase activity were used as a secondary measure of necroinflammatory activity. The serum iron status measurements included iron concentration (Fe), total iron-binding capacity (TIBC), transferrin saturation, and ferritin concentration. RESULTS: Our study results led us to conclude that the mean value of serum iron concentration did not differ significantly among the analysed groups (p>0.05). The transferrin value - estimated as the total iron-binding capacity (TIBC) - was significantly lower in alcoholic cirrhosis of the liver in comparison to both chronic hepatitis C (p<0.004) and chronic hepatitis B (p<0.04). The transferrin saturation was statistically the higher in group III in comparison with both group I (p<0.0031) and group II (p<0.024). Serum ferritin was significantly higher in cirrhotic patients regardless of etiology, in comparison with patients with chronic viral hepatitis (p<0.045). We found correlation between an increase of both AST and ALT and a higher level of ferritin in patients with chronic hepatitis type C (p<0.005, p<0.02) and type B (p<0.05, p<0.03) and alcoholic hepatitis (p<0.05). CONCLUSIONS: In the course of chronic liver diseases we may observe slight irregularities in iron status relating to both the serum and store pool of this element. The most significant disturbances are seen in patients with alcoholic cirrhosis of the liver.

[Hepatitis B virus vaccination among Polish surgeons from the county of Western Pomerania]. / Lekarze specjalnosci zabiegowych województwa zachodniopomorskiego, a szczepienia przeciw wzw typu B.

UNLABELLED: Orthopaedic surgeons are at risk of acquiring hepatitis B virus, so preventive measures, including the vaccination, are important. OBJECTIVE: To determine surgeons" prevention through vaccination against hepatitis B and to access the frequency of "sharps" injuries during surgery. METHODS: An anonymous questionnaire prepared by A. Lowenfels from New York Medical College, USA was distributed between May and July 2001 to 182 members of surgical staff. Twelve hospitals located in the city of Szczecin (4 academic, 4 municipal) as well as located within a 45-mile radius in the county of Western Pomerania, Poland took part. RESULTS: 9.3% of the surgeons who responded had been infected with hepatitis B virus (group I), 79.7% had been immunised against hepatitis B (group II). The rest 11%, mainly of the age > 47 years, had never been vaccinated nor infected (group III). The median number of puncture injuries was 10 per year and the number of hours spent in the operating room--59 per month. There was no statistically significant difference in the variables such as: sex, surgical status, sub-specialty or type of hospital between the groups. CONCLUSIONS: The coverage with the vaccine should be improved. A lot of surgeons who replied take high risk of percutaneous blood exposure and thus possibility of infection with HBV, but every tenth has never been vaccinated nor infected. The complete information on the risk of hepatitis B and on the safety and efficiency of active immunisation should be supplied not only among medical students, but surgical experienced staff as well.

[A case of meningitis and uveitis caused by Spirochetes of the genus Leptospira]. / Opis przypadku zapalenia opon mózgowo-rdzeniowych i naczyniówki w przebiegu zakazenia kretkiem z rodzaju leptospira.

A case of meningitis and uveitis caused by spirochetes of the genus leptospira is reported in 21 year old man.