[Respiratory distress syndrome in newborns of diabetic mothers in the years 1987-1998]. / Wystepowanie zaburzen oddychania u noworodków matek z cukrzyca w latach 1987-1998.

The aim of the study was to estimate which factors contribute to high frequency of RDS in our newborns of the diabetic mothers treated with intensive insulin therapy. The study material consisted of 574 newborns (394 from GDM and 180 from IDDM mothers) born in the years 1987-1998. In the analysed group there were compared: frequency of occurrence of RDS, severity of RDS as well as factors which can contribute to occurrence of RDS. That was found that, in the PGDM group prematurity, low Apgar score and delivery by caesarean section and in the GDM group--prematurity, low Apgar score and male sex are factors contributed the most to occurrence of RDS. That was also found that the risk of occurrence of RDS in the PGDM group was 5 to (transient tachypnoe) to 3 times (RDS) greater than in the GDM group. We conclude that PGDM and prematurity are factors the most connected with the occurrence of RDS in newborns born to diabetic mothers.

[Estimated levels of fructosamine in venous blood of pregnant women and in cord blood]. / Wspólzaleznosc miedzy stezeniem fruktozaminy we krwi zylnej kobiet rodzacych oraz we krwi pepowinowej.

In the study there was estimated maternal (Fm) and cord blood (Fc) fructosamine levels in 151 diabetic (58 PGDM and 93 GDM) and 100 control subjects on the day of delivery. It was found that Fm and Fc levels in PGDM and GDM groups were significantly higher than in the control group. It was also found the significantly positive correlation between Fm and Fc levels in all study groups. It leads to the conclusion that pregnant diabetic women and their fetuses were hyperglycemic during the last 2 weeks of pregnancy. Our results indicate that on the basis of maternal fructosamine levels it is possible to apply on indirect estimation of metabolic status of the fetus.

Specific Stimulatory Effect of LH on the Synthesis of delta4 Gestagens and Androgens in Adrenocortical Cells in vitro.

The aim of this study was to answer the question whether gonadotropins are able to stimulate the synthesis of delta4 gestagens and androgens in adrenals by the same way as in gonads. Adrenal cells of male guinea pigs (n=12) and adrenocortical cells of sows (n=2) were isolated with collagenase 1A and DNA-se and used in two separate experiments. Cell suspensions divided in quadruplicate number of aliquots for each test were preincubated (1 h) and then incubated (h) with high purity pLH-USDA, pLH-GPZ (this was used only in one experiment), pFSH-NIH (the residual contamination of this preparation with ACTH was not excluded) and ACTH1-24. The concentrations of progesterone (P), 17alpha-hydroxyprogesterone (OH-P), androstenedione (A), testosterone (T) and cortisol (F) in the incubated cells were estimated by RIA. The stimulatory effect of two high purity pLH preparations on P, A and T synthesis in guinea pig adrenal cells and pig adrenocortical cells was demonstrated. Moreover, the synthesis of OH-P in pig adrenocortical cells was also stimulated. It may be concluded that these results are specific for LH, since the used pLH-USDA was deprived of any residual ACTH contamination and pLH-GPZ was chromatographically homogenous. These preparations also showed indirect evidences of the activation of steroid 3beta-hydroxysteroid dehydrogenase/isomerase (3beta HSD) which catalyses the synthesis of these four delta4 steroids from their delta5 path precursors. The LH dependent activation of this enzyme in adrenals, which was demonstrated in this work, supported the well known observations of its independence of ACTH. As high as 6-times increase of P synthesis and 2-5 times increase of OH-P synthesis under the influence of pLH in pig adrenocortical cells (consistent with the species of LH) needs the induction of the labile protein i synthesis, since the cholesterol transport into mitochondria and the extent of pregnenolone and its derivatives synthesis depends on that protein. The influence of LH on adrenal steroidogenesis indicates that adrenal cells are the target not only for ACTH but also for LH. The influence of the used pFSH specimen on adrenal steroidogenesis resembles that of ACTH, including the increase of cortisol synthesis. Due to this similarity and lack of evidences of excluding residual ACTH contamination of such pFSH specimen, these results are considered nonspecific. Thus, the problem of FSH influence on adrenal steroidogenesis is still open. Regardless of that, the presented demonstration of specific LH effect appears to be an original contribution to the basic knowledge on adrenal steroidogenesis.

[Usefulness of fiber-sigmoidoscopy in diagnosis of bleeding from the lower part of the digestive tract]. / Przydatnosc fibrosigmoidoskopii w diagnostyce krwawien z dolnego odcinka przewodu pokarmowego.

Out of 1000 consecutive fiber-sigmoidoscopic examinations performed using the CF-P 10 S flexible recto-sigmoidoscope, 350 examinations carried out in patients with overt rectal bleeding were subjected to analysis. Among other, 132 cases of haemorrhoids, 47 cases of proctitis, 64 cases of ulcerative colitis, 39 cases of cancer and 37 cases of adenomatous polyps were diagnosed. Only in nearly 3% of cases the examination failed to provide diagnostic conclusions. In 13.4% of cases fiber-sigmoidoscopy failed to show any lesion which led to further diagnostic management (coloscopy and/or large intestine X-ray examination). The usefulness is stressed of fiber-sigmoidoscopy in the diagnosis of bleeding from the lower part of the digestive tract as well as the need for its possibly early performance as the first examination in each case of rectal bleeding.

[Sliding hiatal hernia in endoscopic examination]. / Przepuklina wslizgowa rozworu przelykowego przepony w badaniu endoskopowym.

Among 1000 successive endoscopic examinations carried out in the first 6 months of 1990 in a laboratory of endoscopy 443 cases (44.3%) of sliding hiatus hernia were analysed. The examination was carried out with an Olympus GIF-Q10 fibroscope without pharmacological premedication. The diagnosis was based on the criteria described by Dagradi and Trujillo at all. In 296 cases sliding hiatus hernia was the only pathological abnormality in the endoscopic examination. In 85 cases it was associated with mucosa inflammation in the oesophagus, and in 1 case with carcinoma of the oesophagus. No correlation was found between frequency of endoscopic finding of hiatus hernia and sex and age. The analysis showed that in 110 out of 172 cases earlier routine radiological examination (63.9%) failed to demonstrate the hernia, whose direct signs were found in endoscopic examination. In no case radiological findings suggested the presence of oesophageal changes. It seems that endoscopic diagnostic of sliding hiatus hernia may contribute to explanation of the cause of "non-characteristic" gastric symptoms which in over half the cases were the cause of referral of the patients to this examination.