Czynny i bierny transport leków w łożysku ludzkim

The human placenta, characterized by the processes of passive transport and facilitated diffusion, contains numerous active transport proteins, usually located in the microvilli of the syncytiotrophoblast or in the endothelium of the capillaries of the villi. These proteins use either the energy from ATP hydrolysis or other mechanisms resulting, among others, from the formation of the maternofetal ion gradient, which facilitates the transfer of various endogenous substances or xenobiotics across the body membranes. The proteins either trigger the efflux of these substances from the fetal tissues via the placenta into the maternal bloodstream, or conversely, they accumulate them in the fetal tissues. Both the placenta and the fetus are equipped with independent systems of enzymes of 1st and 2nd phase of substrate metabolism, such as CYP450, glucuronyltransferase or sulphatase. An active therapy with a wide range of drugs, often at high toxicity levels, either shortly before or during pregnancy, has naturally posed a question concerning the degree of impermeability of the placental barrier and how effectively it can be crossed, including any possible negative embryotoxic or teratogenic consequences. Such hazards seem to be quite real, as many drugs are substrates for ABC transporters. Also the placenta itself, including its structure, is subject to vast transformations during pregnancy, which may be observed as the thinning of the barrier separating the maternal blood from the fetal one, from 20-30μm in the first trimester of gestation down to 2-4μm in the third trimester of gestation.Streszczenie W łożysku ludzi oprócz transportu biernego oraz dyfuzji ułatwionej zawartych jest wiele aktywnych białek transportowych zazwyczaj zlokalizowanych w mikrokosmkach syncytiotrofoblastu lub w śródbłonkach naczyń włosowatych kosmków. Wykorzystują energię z rozpadu ATP lub inne mechanizmy wynikające między innymi z formułującego się gradientu jonów pomiędzy płodem i matką sprzyjają przenikaniu przez błony różnorodnych substancji endogennych lub ksenobiotyków. Kreują albo ich wyrzut z tkanek płodu przez łożysko do krwi matki lub wręcz przeciwnie kumulują je w jego tkankach. Samo łożysko i płód dysponuje samodzielnymi układami enzymatycznymi pierwszej i drugiej fazy przemian substratów takimi jak: CYP450, glukuronylotransferazy czy sulafatazy. Aktywne postępowanie terapeutyczne z wykorzystaniem szerokiej gamy leków niejednokrotnie o wysokim poziomie toksyczności w okresie przed ciążowym oraz w ciąży rodzi pytanie na ile bariera łożyskowa jest szczelna oraz na ile jest skutecznie pokonywana z możliwymi negatywnymi konsekwencjami o charakterze embriotoksycznym lub teratogennym. Groźba wydaje się być całkowicie realna, bowiem wiele leków to substraty dla transporterów ABC. Również samo łożysko i jego struktura ulega w trakcie ciąży głębokim przewartościowaniom czego miarą może być redukcja dzielącej barierę krew matki od krwi płodu z 20-30μm w pierwszym trymestrze ciąży do 2-4μm w trzecim trymestrze ciąży

Three-layered osteodural plasty for severe anterior skull base and facial injuries. Report of eleven cases

Background and purpose The upper cranial trauma of high force and wide area of application leads to fractures of calvaria, the skull base, and the viscerocranium. The aim of the study was to present eleven patients treated for severe anterior skull base and facial defects by means of three-layered osteodural plasty. Materials and methods The operative tactics consisted of bicoronal incision, bifrontal craniotomy, closure of the dura mater damage with a pericranium, reconstruction of bone defects with autologous bone grafts and plasty with anteriorly pedicled pericranial flap on the supratrochlear and supraorbital vessels. Results During follow-up, which lasted 2–7 years, none of the patients developed any early or late postoperative complications. Conclusions The three-layer osteodural plasty of severe anterior skull base injuries with the use of autologous bone grafts for the reconstruction of craniofacial skeleton resulted in a good final functional, morphological and aesthetic outcome in all patients

Perinatal outcome analysis of twin pregnancies at the Department of Obstetrics and Gynecology Central Clinical Hospital of Ministry of Interior and Administration in Warsaw in the years 2005-2006.

A group of 59 twin pregnant women who gave birth at the Department of Obstetrics and Gynecology Central Clinical Hospital of Ministry of Interior and Administration in Warsaw in the years 2005-2006. The patients have been divided into four groups: spontaneous twin pregnant women (n=16), twin pregnant women after in- vitro fertilization (IVF) (n=11), twin pregnant women after in-vitro fertilization with intracytoplasmic sperm injection (ICSI) (n=29) and twin pregnant women after ICSI and transfer of frozen embryos (n=3). In one case intrauterine death of one of twins in the 34th week of gestation has been noticed. The cause of the death was umbilical cord wrapped around his neck. The gestation was ended with cesarean section and Apgar score of the second twin was 8 in the fifth minute. In one case there was an urgent indication for a cesarean delivery of children with a very low birth weight (because of intrauterine infection, preterm labor in progress) and in three cases at least one of twins with a low birth weight. Among the group 19 women (32%) have given birth prematurely. The Apgar score in the first, third and fifth minute has been statistically significant and inversely proportional dependent only on the gestational age. There were no differences in birth weight among study groups regardless the way of conception. Only two spontaneous twin pregnant patients have had a vaginal labor. By the remaining 57 patients there has been an elective cesarean section in thirty five cases and there has been an urgent indication for cesarean section in twenty two cases

Bridge Structures Cracks – What Made that Phenomena so Common?

AbstractThe common phenomena – cracks appearance on newly built reinforced concrete bridge structures - is being detected in Poland for several years now. That phenomena is regarded as threatening in case of bridge structures, despite the fact that reinforced concrete theory considers cracks as a standard concrete performance. Cracks are very likely to appear on concrete surface. Cracks are usually detected during concrete surface treatment before protective coating laying. Cracks appear on monolith structures, mainly at the slab spans and foreheads as well as, at support columns in a minor range. Concrete surface cracks openings reach up to 2mm size. The experience gained throughout consulting works on cracked structures are discussed in that paper. The influence of concrete surface mechanical cleaning prior the protective coatings laying on the crack “visual” intensification was also discussed herein. Crack openings measurement rules, as well as the most common mistakes made during the crack measurements and their real value assessment were described in the paper. The maximal crack opening allowances fluctuations in Polish and European concrete Codes were also discussed here. It was proved that the spotted crack opening increase is caused by the codes changes and by bold reinforcing cover. The bold cover is regarded as the corrosion protection of reinforcing bars. The cover bold and crack opening allowance dependency was discussed in the paper. The effect of Euro codes and the Minister of Transport and Maritime Economy Ordnance from May 30th 2000 titled “Technical requirements for highway engineering structures and their locations” simultaneous obligation on reinforced concrete structures cracks assessment was deliberated.At the conclusion the necessary modifications in crack assessment practice were claimed. The cracks should be assessed on the basis of homogenous code system. Their openings are dependent straight forward from the reinforcement cover thickness. One should avoid crack measurement at the sections, at which the crack edges are mechanically shattered. The crack opening assessment should be dependent on cover thickness. The rod anti shrinkage activity reaches the cover depth approximately to the depth equal to the rod diameter only. That fact should be taken under consideration during crack assessment

Polish Experiences in Handling Water Hazards during Mine Shaft Sinking

The geological structure of most Polish mining regions is rich in groundwater, making shaft sinking difficult. In recent years, more than a dozen shafts, some almost 700 m deep, have been sunk in Poland using various methods of water hazard elimination. The vast majority of shafts that pass through aquifer formations have been sunk using artificial rock freezing, waterproof tubing, and concrete lining. Generally, this system has proven to be very effective. However, there have been cases of complications during sinking, including occasional flooding. This paper presents two cases of highly problematic flooding in shaft sunk using the freezing method, both leading to considerable construction delays and a significant increase in shaft sinking costs. The first case involved water inflow into the bottom section of the R-XI shaft at KGHM with rocks near the melting point of ice. In the other case, problems occurred passing through an Albian layer in the S. 1.3 shaft sunk for the Lubelski Węgiel Bogdanka S.A. mining corporation, where the freezing process was carried out while it was necessary to heat the rocks in the upper part of the shaft to protect the final lining from damage

High-density surface electromyography maps after computer-aided training in individual with congenital transverse deficiency: a case study

Background: The aim of this study was to determine whether computer-aided training (CAT) of motor tasks would increase muscle activity and change its spatial distribution in a patient with a bilateral upper-limb congenital transverse deficiency. We believe that our study makes a significant contribution to the literature because it demonstrates the usefulness of CAT in promoting the neuromuscular adaptation in people with congenital limb deficiencies and altered body image. Case presentation: The patient with bilateral upper-limb congenital transverse deficiency and the healthy control subject performed 12 weeks of the CAT. The subject’s task was to imagine reaching and grasping a book with the hand. Subjects were provided a visual animation of that movement and sensory feedback to facilitate the mental engagement to accomplish the task. High-density electromyography (HD-EMG; 64-electrode) were collected from the trapezius muscle during a shrug isometric contraction before and after 4, 8, 12 weeks of the training. After training, we observed in our patient changes in the spatial distribution of the activation, and the increased average intensity of the EMG maps and maximal force. Conclusions: These results, although from only one patient, suggest that mental training supported by computer-generated visual and sensory stimuli leads to beneficial changes in muscle strength and activity. The increased muscle activation and changed spatial distribution of the EMG activity after mental training may indicate the training-induced functional plasticity of the motor activation strategy within the trapezius muscle in individual with bilateral upper-limb congenital transverse deficiency. Marked changes in spatial distribution during the submaximal contraction in the patient after training could be associated with changes of the neural drive to the muscle, which corresponds with specific (unfamiliar for patient) motor task. These findings are relevant to neuromuscular functional rehabilitation in patients with a bilateral upper-limb congenital transverse deficiency especially before and after upper limb transplantation and to development of the EMG based prostheses

Biedronki (Coleoptera: Coccinellidae) odłowione przy użyciu samołówek świetlnych w trzech kompleksach leśnych we wschodniej i centralnej Polsce

Chrząszcze z rodziny biedronkowatych (Coccinellidae), jako ważny czynnik ograniczający liczebność stawonogów powodujących szkody w uprawach, są częstym obiektem badań entomologicznych. Do odłowów stosuje się różne metody, przy czym do rzadziej wykorzystywanych należy metoda przywabiania chrząszczy do światła. W niniejszych badaniach zastosowaliśmy tę metodę do odłowu biedronek w rezerwacie Jata k. Łukowa oraz w dwóch kompleksach leśnych położonych w granicach administracyjnych Warszawy: w rezerwacie Las Bielański i w Lesie Młocińskim. Nocne odłowy owadów do samołówek świetlnych prowadzono w latach 2018 i 2019 między marcem a listopadem, jednak biedronki wpadały do pułapek w okresie od kwietnia do września. Łącznie na trzech stanowiskach odłowiono 347 osobników Coccinellidae należących do 16 gatunków. Największe bogactwo gatunkowe (15 gatunków), a jednocześnie najmniejszą średnią liczebność biedronek (1,3 osobnika na próbę) odnotowano w Jacie. W Lesie Bielańskim stwierdzono 9 gatunków i średnio 4 osobniki na próbę, a w Lesie Młocińskim 4 gatunki i średnio 2,2 osobnika na próbę. Na wszystkich trzech stanowiskach gatunkiem dominującym była Calvia decemguttata (L.). Wysoki udział miały również Harmonia axyridis (Pallas) i Vibidia duodecimguttata (Poda). Większość odłowionych osobników biedronek (71%) należała do gatunków pozbawionych ubarwienia ostrzegawczego, co może pośrednio świadczyć o ich nocnym trybie życia

Surgical Treatment of Wounds Using Stem Cells in Epidermolysis Bullosa (EB)

Epidermolysis bullosa (EB) is a group of hereditary skin diseases, or genodermatoses, characterized by the formation of severe, chronic blisters with painful and life-threatening complications. Despite the previous and ongoing progress in the field, there are still no effective causative treatments for EB. The treatment is limited to relieving symptoms, which—depending on disease severity—may involve skin (blisters, poorly healing wounds caused by the slightest mechanical stimuli, contractures, scarring, pseudosyndactyly) and internal organ abnormalities (esophageal, pyloric, or duodenal atresia; renal failure; and hematopoietic abnormalities). The last decade saw a series of important discoveries that paved the way for new treatment methods, including gene therapy, bone marrow transplantation, cell therapy (allogenic fibroblasts, mesenchymal stem cells [MSCs], and clinical use of induced pluripotent stem cells. Tissue engineering experts are attempting to develop skin-like structures that can facilitate the process of healing to promote skin reconstruction in injuries that are currently incurable. However, this is incredibly challenging, due to the complex structure and the many functions of the skin. Below, we characterize EB and present its potential treatment methods. Despite the cure for EB being still out of reach, recent data from animal models and initial clinical trials in humans have raised patients’, clinicians’, and researchers’ expectations. Consequently, modifying the course of the disease and improving the quality of life have become possible. Moreover, the conclusions drawn based on EB treatment may considerably improve the treatment of other genetic diseases