Increased levels of cytokines in cerebrospinal fluid of children with aseptic meningitis caused by mumps virus and echovirus 30.

We measured levels of pro-inflammatory cytokines in the cerebrospinal fluid (CSF) of patients with mumps meningitis, enteroviral echovirus 30 meningitis and children without central nervous system infection to investigate whether these molecules were involved in the pathogenesis of viral meningitis. The CSF was obtained from 62 children suspected with meningitis. These patients were classified to the mumps meningitis (n = 19), echovirus 30 meningitis (n = 22) and non-meningitis (n = 21) groups. The concentrations of interleukin-1 (IL-1), interleukin-1 soluble receptor type 2 (IL-1R2), interleukin-8 (IL-8), human interferon gamma (IFN-γ) and human tumour necrosis factor alpha (TNF-α) were determined by immunoassay. A significant increase was noted in the levels of IL-8, TNF-α and IL-1R2 in the CSF of both meningitis groups as compared to controls. The concentrations of IFN-γ and IL-1 differed significantly only between the mumps group and control. The levels of IL-1, IFN-γ and TNF-α were significantly higher in mumps meningitis when compared to the echovirus 30 group. Of all cytokines examined, only IFN-γ correlated with pleocytosis (r = 0.58) in the mumps meningitis group. The increased CSF cytokine levels are markers of meningeal inflammation, and each virus may cause a specific profile of the cytokine pattern.

Norovirus infections in children under 5 years of age hospitalized due to the acute viral gastroenteritis in northeastern Poland.

The primary aim of this study was to evaluate the frequency and seasonality of norovirus infection in hospitalized Polish children under 5 years of age, and a secondary aim was to compare the clinical severity of norovirus and rotavirus disease. The prospective surveillance study was carried out from July 2009 through June 2010. Stool samples from 242 children hospitalized due to acute viral gastroenteritis were tested for rotavirus group A and adenovirus with commercial immunochromatographic test and for norovirus with EIA assay. Single norovirus infection was found in 35/242 (14.5%) patients and in a further 5 (2.1%) children as co-infection with rotavirus. Overall, norovirus was detected in 16.5% of stool specimens. Norovirus infections tended to peak from October to November and again from February to March. In autumn months and in February, the proportion of norovirus gastroenteritis cases was equal or even surpassed those of rotavirus origin. Both norovirus and rotavirus infections most commonly affected children between 12 and 23 months of age. The low-grade or no fever was significantly more common in children infected with norovirus (94.3%) compared to rotavirus cases (52.9%). Overall, norovirus gastroenteritis was less severe than rotavirus disease with regard to 20-point severity scale (p < 0.05). Noroviruses have emerged as a relevant cause of acute gastroenteritis in Polish children. There is a great need for introducing routine norovirus testing of hospitalized children with gastroenteritis.

Norovirus and Rotavirus--two major causative agents of sporadic viral gastroenteritis in hospitalized Polish children.

PURPOSE: The aim of the study was to establish the main etiologic agents of acute viral gastroenteritis and to asses the severity of illness associated with the different viral agents of gastroenteritis in children hospitalized during spring/summer season 2008. MATERIAL AND METHODS: 181 stool specimens were collected from children under 5 years of age, hospitalized with acute viral diarrhea from April to September 2008. Commercial enzyme immunoassay kits were used to detect noroviruses. The immunochromatographic tests for combined detection of rotaviruses and adenoviruses were performed routinely in our department in all in-patients suspected for viral gastroenteritis. RESULTS: A viral etiologic agents were detected in 108 of 181 (59.7%) samples tested. Dual viral pathogens (rotavirus and norovirus) were found in 3 of 181 (1.7%) samples. Rotavirus was the most common viral pathogen found in the study group (86/181; 47.5%), followed by NV (19/181; 10.5%) and adenoviruses (3/181; 1.7%). Approximately, 60% of acute gastroenteritis episodes occurring in children less than 5 years of age were accounted for by infection due to rotavirus and/or norovirus. Norovirus cases were clinically indistinguishable from those of rotavirus origin in children aged less than 2 years whereas they were slightly milder in older group of patients. CONCLUSIONS: Rotavirus infections are leading cause of children's hospitalization in spring months whereas Norovirus infections during spring/summer time. There is a great need to apply molecular diagnostic tools to determine the actual and monitoring the changing etiology of acute enteritis in Polish population.

Elevated levels of MMP-9 and TIMP-1 in the cerebrospinal fluid of children with echovirus type 30 and mumps meningitis.

Matrix metalloproteinases are involved in leucocyte invasion into the central nervous system (CNS) during meningitis. The aim of the study was to determine whether there are differences in the expression patterns of matrix metalloproteinase-9 (MMP-9) and the tissue inhibitor of metalloproteinase-1 (TIMP-1) in the cerebrospinal fluid (CSF) of patients with meningitis caused by one of two known distinct viral agents. Concentrations were measured by using an enzyme-linked immunosorbent assay (ELISA) in 16 children with mumps meningitis, in 25 children with echovirus type 30 meningitis and in a control group of 23 children without any CNS infection. Increased levels of MMP-9 were found in children with mumps (median 0.48 ng/ml; P < 0.001) and enteroviral meningitis (median 2.76 ng/ml; P < 0.001) compared with that in controls (median: 0.01 ng/ml). Concentrations of TIMP-1 greatly exceeded concentrations of MMP-9 and were elevated in children with mumps (median: 56 ng/ml) and echovirus type 30 meningitis (median: 55 ng/ml) compared to controls (median: 17 ng/ml). No significant differences in MMP-9 or TIMP-1 levels were detected between the two meningitis groups. The MMP-9/TIMP-1 ratio was greater in children with echovirus type 30 than in those with mumps meningitis. There was no correlation between MMP-9 levels and total CSF cell count. MMP-9 correlated with CSF absolute neutrophil count in children with echovirus type 30 meningitis (r = 0.431; P < 0.05). The concentration of MMP-9 is higher in children with viral meningitis, possibly because of infiltrating polymorphonuclear cells present in the initial phase of the disease.

Increase in adhesion molecules in cerebrospinal fluid of children with mumps and mumps meningitis.

Adhesion molecules play a key role in leucocyte migration into the central nervous system (CNS). Concentrations of endothelial-derived soluble intercellular adhesion molecule-1 (sICAM-1) and leucocyte-originated soluble L-selectin (sL-selectin) in cerebrospinal fluid (CSF) of children with mumps meningitis (mononuclear pleocytosis, n = 33) and mumps (absence of pleocytosis, n = 9) were compared with values from age-matched control group (n = 19). In 14 patients from the meningitis group, adhesion molecule levels together with albumin concentration were estimated in paired CSF/serum samples to calculate concentration quotients and determine molecule intrathecal release. Both sICAM-1 (median 3.44 versus 0.86 ng/ml; P < 0.0001) and sL-selectin (median 29.91 versus 8.52 ng/ml; P < 0.0001) concentrations in CSF were increased in mumps meningitis patients compared with controls. Increased levels of the selected adhesion molecules were also observed in mumps patients without CNS involvement when compared with controls (median sICAM-1: 1.14 versus 0.86 ng/ml, sL-selectin: 13.54 versus 8.52 ng/ml; P < 0.01). Additionally, the concentration of adhesion molecules was found to correlate with CSF leucocyte count. Considerable correlation of sICAM-1 and sL-selectin quotients and corresponding albumin quotients suggests that a majority of the soluble adhesion molecules originated from the bloodstream. Analysis of adhesion molecule levels demonstrated indirect evidence of brain-derived fractions. Our results suggest the involvement of adhesion molecules during the early phase of mumps meningitis.

The prevalence and clinical significance of antiphospholipid antibodies in the patients with systemic sclerosis--preliminary report.

PURPOSE: The aim of our study was to evaluate the prevalence of anticardiolipin and anti-beta2-glikoprotein I (anti-beta2GPI) antibodies in patients with systemic sclerosis (SSc) and to correlate the presence of these antibodies with clinical and serological features of the disease. MATERIAL AND METHODS: 22 patients (21 women and 1 man) fulfilling the ACR classification criteria of SSc were included into the study. In all SSc patients a detailed clinical evaluation including skin and internal organ involvement was performed. Moreover, the measurements of antitopoisomerase I (anti-Scl-70) and anticentromere (ACA) antibodies were done in all patients studied. Anticardiolipin antibodies in IgM and IgG class and anti-beta2GPI antibodies in IgM, IgG and IgA class were evaluated using ELISA kits (Hycor Biomedical and DiaSorin). RESULTS: Anticardiolipin antibodies were found in 10/22 (45.5%) patients with SSc, in 6/12 (50%) with diffuse SSc and in 4/10 (40%) with the limited SSc. Anticardiolipin antibodies in the IgG class were observed in 4/22 (18.2%) patients, and in the IgM class in 9/22 (40.9%) subjects. Anti-beta2GPI antibodies were found in 9/22 patients (40.9%), of which 3/22 (13.6%) had antibodies in IgG class, 4/22 (18.2%) in IgM class and 3/22 (13.6%) in the IgA class. Anti-beta2GPI antibodies were found exclusively in the patients in whom the anticardiolipin antibodies were also present. An association between the presence of antiphospholipid antibodies and internal organ involvement (pulmonary fibrosis, pulmonary hypertension and the alterations of oesophageal function) was not significant. No significant correlation was found between the presence of anticardiolipin or anti-beta2GPI antibodies and the presence of anti-Scl-70 or ACA antibodies. CONCLUSIONS: The results of our study indicate that the prevalence of anticardiolipin antibodies and anti-beta2GPI antibodies is relatively high in patients with SSc. A more detailed assessment of the relationship between the presence of antiphospholipid antibodies and the clinical and serological features of SSc requires further studies on the larger group of patients and a several years of follow-up.

Concentration and microheterogeneity of acute-phase glycoproteins in patients with systemic lupus erythematosus.

PURPOSE: To determinate glycosylation of selected acute-phase glycoproteins (AGP, ACT, CP) and serum concentration of this proteins in Systemic Lupus Erythematosus (SLE) patients. PATIENTS AND METHODS: The study was carried out on 35 patients with active SLE and 15 healthy volunteers. The immunological measurements were performed at first day of hospitalisation, before receiving treatment. The concentration of CRP, AGP, ACT and CP were evaluated by electroimmunoassay using anti-AGP, anti-ACT, anti-CP antibodies. CRP levels were determined by radial immunodiffusion with anti-CRP antibodies. The microheterogeneity of the acute phase proteins was assessed by agarose affinity electrophoresis using Con A as a ligand, as was described by Bøg-Hansen. RESULTS: Between SLE patients and control group statistically significant differences (p < 0.01) were observed in serum concentration of all investigated parameters. There were no significant differences in serum acute-phase proteins levels with regards to patient's age, sex and disease activity. The reactivity coefficients: AGP-RC, ACT-RC, CP-RC in SLE patients were similar to the healthy group. The precipitate curves were similar in both groups. The main difference was in the area of the precipitant, which was bigger in the SLE patients. CONCLUSIONS: Configuration of analysis serum concentration and heterogeneity of acute-phase proteins is one of important diagnostic tests in SLE.

[Mast cells in chronic gastritis of children]. / Komórki tuczne w przewleklym zapaleniu blony sluzowej zoladka u dzieci.

Mast cell involvement in chronic gastritis in children was analyzed. 25 children with normal mucosa (controls), 20 children with chronic gastritis and 28 children with chronic gastritis and infected Helicobacter pylori were included to the study. Bioptic material from antrum and corpus of the stomach were stained with toluidine blue and anti-human mast cell tryptase to evaluate mast cell density. Changes in mast cells number were also estimated in 7 children before and after successful eradication of Helicobacter pylori infection. Mast cell density was significantly greater in children with chronic gastritis with or without Helicobacter pylori infection when compared to the controls. Mast cell degranulation was demonstrated by electron microscopy in children with chronic gastritis and infected Helicobacter pylori. Mast cell through it's numerous mediators may play a key role in chronic gastritis especially when Helicobacter pylori infection is present.

Study of p53 protein expression in prostate cancer.

The aim of this study was the immunohistochemical evaluation of p53 protein expression in localized prostate cancer (Pca) following radical prostatectomy and analysis of its relationship to chosen anatomo-clinical and morphological parameters of the tumours. The present investigation included material from 28 randomly selected patients undergoing radical prostatectomy. Tissue sections were fixed in 10% buffered formaldehyde solution, embedded in paraffin and stained immunohistochemically with the anti-human p53 protein monoclonal antibody. The immunolocalization of p53 protein was performed using the Labelled Streptavidyn Biotin (LSAB) method. The p53 protein expression was semiquantitatively assessed in neoplastic cells and the reaction present in more then 25% of tumour cells was accepted as the threshold of positivity. No correlation was found between p53 protein expression and Gleason score, pT stage, lymph node metastases, seminal vesicles invasion, positive or negative surgical resection margins, age of patients. However, p53 protein expression and capsular penetration was found statistically significantly correlated.

The gastrointestinal mast cell in health and disease.

Mast cells are metachromatic cells found widely throughout the body. In gastrointestinal tract they reside particularly in mucosa having close contact with external environment. Their certain role in health and disease remains unclear. Mast cells seem to be involved in lots of allergenic and non-allergenic inflammatory events taking place throughout the gastrointestinal tract including IgE-dependent hypersensitivity reaction, gastritis with or without Helicobacter pylori infection, Crohn's disease, ulcerative colitis, irritable bowel syndrome. Mast cell involvement in certain inflammatory processes in gastrointestinal tract were reviewed.

Fetotoxic effect of 2,4-dichlorophenoxyacetic acid (2,4-D) in rats.

The fetotoxic effect of 2,4-dichlorophenoxyacetic acid (2,4-D) was investigated. Histological and histochemical changes in the liver of newborn, jung and adult rats exposed to the herbicide from the prenatal period to the end of an experiment were evaluated. The experiment used 90 male and female, Wistar, aged to 10 weeks rats, divided into two groups: I-control-30 and II-60 animals which received the water solution of 2,4-D acid sodium salt in a daily dose of 250 mg/kg b.w. It was given with drinking water every day. The animals were sacrificed after 24 hours, 4, 6, and 10 weeks of the experiment. The results obtained showed that the administration of 2,4-D acid to rats in the prenatal and postnatal period, in a dose inducing subacute intoxication leads to histological and histochemical changes in the liver. The observed changes indicate disorders in energetic processes in hepatocytes and are morphological exponents of detoxicative processes there. They are most intensified with newborn rats. It suggest also, the pregnants ought not to work with 2,4-D and should avoid any contact with herbicides belongs to the 2,4-dichlorophenoxyacetic acid group.

Ultrastructural changes in rat hepatocytes in acute intoxication with 2,4-dichlorophenoxyacetic acid (2,4-D).

The hepatotoxic effect of 2,4-dichlorophenoxyacetic acid (2,4-D) was investigated. Ultrastructural changes were evaluated in transmission electron microscope. The experiment used 60 male Wistar rats divided into two groups: I--control-18 animals and II--42 animals which received chemically pure 2,4-D acid by gastric gavage in a dose of 200 mg/kg b.w. The animals were sacrificed after 12, 24, 48 hours and 4, 10 and 30 days of the experiment. The results obtained indicate that the administration of 2,4-D acid to rats in a dose inducing acute intoxication leads to ultrastructural changes in the liver, which suggest nonspecific reversible adaptative-type damage to parenchymal cells. The changes observed indicate disorders in energetic processes in hepatocytes and are morphological exponents of detoxicative processes there.

Morphological changes in mitochondria and lysosomes of hepatocytes in acute intoxication with 2,4-dichlorophenoxyacetic acid (2,4-D).

The hepatotoxic effect of 2,4-dichlorophenoxyacetic acid (2,4-D) was investigated. Ultrastructural changes were evaluated under a transmission electron microscope. Certain histoenzymatic reactions were examined (to acid phosphatase according to Gomori (AP) and to succinic dehydrogenase (SD) according to Nachlas) in parenchymal cells of the rat liver in acute intoxication induced by this herbicide. The experiment used 60 male Wistar rats divided into two groups: I-control--18 animals and II--42 animals which received chemically pure 2,4-D acid by gastric gavage in a dose of 200 mg/kg b.w. The animals were sacrificed after 12, 24, 48 hours and 4, 10 and 30 days of the experiment. The results indicate that the administration of 2,4-D acid to rats in a dose inducing acute intoxication leads to histoenzymatic and ultrastructural changes in the liver, which suggest nonspecific reversible adaptive-type damage to parenchymal cells. The changes observed indicate disorders in energetic processes in hepatocytes and are morphological exponents of intense detoxicative processes.

[Frequency of giardiasis in children with chronic abdominal pain coming from North-East Poland]. / Rozpowszechnienie zarazenia pier wotniakiem Giardia lamblia u dzieci z przewleklymi bólami brzucha w pólnocno-wschodniej Polsce.

Chronic or recurrent abdominal pain constitutes a serious diagnostic and therapeutic problem in childhood. The gastrointestinal, biliary tract or renal lesions often produce the chronic abdominal pain in children. Among causative factors of the chronic abdominal pain the infection with Giardia lamblia is more and more often taken into account. The sample of 112 patients hospitalized during the period from 1992 to 1993 in two departments of the University School of Medicine in Bialystok and in three pediatric wards of the Municipal Hospital in Bialystok, was assessed. In all children the duodenal aspiration was performed. The following questions were evaluated: 1. What is the frequency of giardiasis in children coming from north-east Poland and presenting chronic abdominal pain? 2. Is there any specific spectrum of symptoms of giardiasis in children? Based on the results of the duodenal fluid examination, the infection with G. lamblia was diagnosed in 77 (67.75%) children. The analysis of the clinical symptoms indicated that only failure to thrive and recurrent episodes of the loose stools were significantly more frequent in infected children compared with uninfected. The frequency of the other symptoms like nausea, headache, vomiting, constipation, fever or allergic skin lesions was similar in both study groups.

Pathological changes in rats hepatocytes on acute lindane poisoning.

Histological, histochemical and ultrastructural examinations of the liver were carried out on rats. The animals were given crystalline lindane intragastrically, in a dose evoking acute intoxication, (1/3 LD50). Then the rats were decapited after 1, 3, 10, 20 and 36 days following pesticide administration. The obtained results indicate, that acute lindane intoxication produces morphological changes in the rat liver, which evidence a disturbance inenergetic processes of hepatocytes and they are reversible and adaptative.

[Early central nervous system complications following purulent meningitis and encephalitis in children from 1 month to 2 years of age according to the etiological factor]. / Wczesne powiklania ze strony osrodkowego ukladu nerwowego u dzieci w wieku od 1 miesiaca do 2 lat w przebiegu ropnego zapalenia opon mózgowo-rdzeniowych i mózgu w zaleznosci od czynnika etiologicznego.

Open anterior fontanel cerebral ultrasonography was performed in 113 children aged between 1 month and 2 years, infants with purulent meningitis and encephalitis. It revealed early CNS complications in 50 patients (44.2%). The treatment protocol was adjusted for different types of complications. All children were discharged home and referred for further care to paediatricians and neurologists. Transfontanel ultrasonography is of great value for evaluating different types of complications following CNS infections.

[Adverse events following immunization: AEFI in 17 children between 0 and 2 years of age]. / Niepozadane odczyny poszczepienne u dzieci w wieku od 0 do 2 lat.

Adverse Events Following Immunization (AEFI) are disadvantageous side effects of preventive vaccination. In 1993 we found 17 cases of AEFI out of 1440 children between 0 and 2 years of age who had received BCG, diphtheria-tetanus-pertussis, measles or poliomyelitis vaccine. They were classified as reactions in 14 children (0.9%) or complications in 3 children (0.2%). Twelve adverse reactions followed DTP vaccination (0.8%), two followed BCG vaccination (0.14%), another two measles vaccination (0.14%) and one followed poliomyelitis vaccination (0.07%). Both generalized and local symptoms were present and they regressed with no further complications. Two children who had received BCG were noted to have a deeply placed abscess at the injection site remaining scar as well as axillary, submandibular and cervical lymph nodes enlargement within 6 months. In a 3 months old child, after the first injection of DTP vaccine, convulsions and consciousness disorder occurred. Transfontanel ultrasonography revealed intraventricular haemorrhage. After one year of intensive neurological care child's health state was improved. In spite of using still more and more safe vaccines none of them is the ideal one--the one with no adverse events following vaccination. Vaccination technics, distribution and storage of vaccines are to be improved which may result in decrease number of AEFI.