Results of the Fontan operation with no early mortality in 248 consecutive patients

Background: The Fontan operation has undergone several modifications and today is the primary way to treat a broad spectrum of congenital heart defects. Aim: The purpose of this study is to present the results of treatment of children with a single ventricle operated by the same surgical team and managed according to a uniform strategy. Methods: In the years 2007-2015, in 248 children aged 3.7 +/- 2.6 years and weighing 14.6 +/- 6.1 kg with a single ventricle, Fontan surgery was performed. In 56 (22.6%) children surgery was based on the creation of an intra-atrial lateral tunnel, and in 192 (77.4%) patients extracardiac modification was performed. In most patients, the operation was carried out with the normothermic cardiopulmonary bypass, on a "beating heart" without aortic cross-clamp. The average cardiopulmonary bypass time was 53.9 +/- 23.9 min. The most common indication for surgery was hypoplastic left heart syndrome (53.6%). All patients with a single ventricle referred to our hospital for the Fontan procedure were enrolled into the surgery programme. Results: All patients survived the operation and were discharged home. Thirty-six (14.5%) patients were extubated in the operating room, in other patients the mean duration of the mechanical ventilation was 9.7 +/- 16.1 h (median 7 h). The average time of hospitalisation in the whole study group was 17.5 +/- 18.5 days (median 15 days). After surgery, in four children transient seizures occurred, and three patients had an ischaemic stroke. Conclusions: Developing and obeying a fixed perioperative protocol is crucial for low mortality and small number of complications after Fontan operation

Zespół utraty białek u pacjentów z pojedynczą komorą serca po operacji Fontana

After more than 40 years of treatment of single-ventricle heart with the Fontan pathway there is a large group of patients exposed to poorly known complications, such as a protein-losing enteropathy. The article discuses contemporary theories regarding the etiology and pathomechanisms of this syndrome, presents the clinical picture and available diagnostic and therapeutic methods.Po ponad 40 latach leczenia serca jednokomorowego sposobem Fontana istnieje obecnie duża grupa pacjentów narażonych na dotychczas mało poznane powikłania, do których należy zespół utraty białek z przewodu pokarmowego. W artykule omówiono współczesne teorie dotyczące etiologii i patomechanizmów rozwoju, przedstawiono obraz kliniczny, a także zaprezentowano dostępne metody diagnostyczne i lecznicze zespołu

Arabidopsis cyclin-dependent kinase gene Cdkg;2 is involved in organogenic responses induced in vitro

The Arabidopsis CDKG;2 gene encodes a putative cyclin-dependent Ser/Thr protein kinase of unknown biological function. This gene shows structural similarity to animal and human cyclin-dependent (PITSLRE) kinases. This study used the homozygous knockout cdkg;2 mutant based on T-DNA insertional line SALK_090262 to study the effect of mutation of the CDKG;2 gene on explant response and in vitro plant regeneration. For callus induction and proliferation, hypocotyls and cotyledons of 3-day-old seedlings of cdkg;2 and A. thaliana ecotype Col-0 were cultured on solid MS medium supplemented with 2,4-D (2 mg l-1). Organogenesis was induced after callus transfer on MS + TDZ (0.5 mg l-1). The initiation time of callus and shoot induction differed between the mutant and control cultures. Shoot regeneration after callus transfer on MS + TDZ was delayed in cdkg;2 (31 days versus 7 days in Col-0). Shoots formed on callus derived from Col-0 hypocotyls but not on cotyledon-derived callus; in cdkg;2, shoots developed on both callus types. Mutant shoots did not form roots, regenerants were dwarfed, and inflorescences had small bud-like flowers with a reduced corolla and generative organs. Abnormalities observed during cdkg;2 organogenesis suggest a role of CDKG;2 as a regulator of adventitious root initiation

Comparative study of metals accumulation in cultured in vitro mycelium and naturally grown fruiting bodies of Boletus badius and Cantharellus cibarius

Cantharellus cibarius Fr. (chanterelle) and Boletus badius Pers. (bay bolete) harvested from natural sites in Poland were used to derive in vitro cultures. The optimal medium composition for cultures was developed. Concentrations of the chosen elements (Zn, Cu, Fe, Mg, Ni, and Cd) in mycelium samples were measured by means of atomic absorption spectrometry. Fe concentration in the analyzed mushroom materials was in the range 215.4–680.3 μg/g dry weight. Mean values of Mg were respectively (in micrograms per gram dry weight) 541.8 for mycelium of C. cibarius cultured in vitro and 1,004.1 for C. cibarius fruiting bodies and 928.9 for the mycelium of B. badius cultured in vitro and 906.4 for B. badius fruiting bodies. The mean concentrations of Zn were 442.7 μg/g dry weight in mycelium from in vitro cultures of B. badius and 172.1 in B. badius fruiting bodies and 131.9 in the case of C. cibarius in mycelium from in vitro cultures and 95.5 for the C. cibarius fruiting bodies. Cu exhibited a reversal tendency, i.e., the element concentrations in naturally grown mushrooms were significantly higher (43.57 μg/g dry weight for C. cibarius and 43.54 μg/g for B. badius) than in cultured in vitro mycelium (12.47 μg/g for C. cibarius and 4.17 μg/g for B. badius). Ni was found in lowest concentrations ranging from 0.33 to 1.88 μg/g dry weight. Toxic metal Cd was found in relatively high concentrations in naturally grown species (0.79 μg/g dry weight—1.02). The lowest was the concentration of Cd in C. cibarius mycelium from in vitro culture—0.06 μg/g dry weight—a bit higher than it was in the B. badius mycelium (0.21 μg/g)

The role of focal infections in the pathogenesis of psoriasis and chronic urticaria

Introduction: The Focal Infection Theory, originally presented at the beginning of the 20th century, postulates that systemic diseases can be caused by microorganisms that arise from the focus of infection. Foci of infections have been described as sinuses, adenoids, tonsils, teeth, genitourinary tract, gall bladder and kidneys. A focus of infection is defined as the area that can occur in any part of the body, contains a pathogen (microorganism) and is usually asymptomatic. There are discordant opinions about the role of focal infections in the pathogenesis of psoriasis and urticaria. Aim: To establish whether there is a higher incidence of focal infections in patients with chronic urticaria and psoriasis. Material and methods: We retrospectively reviewed 129 patients with a history of psoriasis and chronic urticaria: 58 women and 71 men treated in the Department of Dermatology of the Jagiellonian University Medical College in Krakow. Results: In the analyzed group, 11 patients had a dental consultation, 58 - laryngological consultation and 29 women had a gynecological consultation. The most common examples of focal infection were tonsillitis, upper respiratory tract infections, sinusitis, dental caries and genitourinary tract infections. Aggravating factors were similar to previously described. Conclusions: A high incidence of focal infections in patients with psoriasis and urticaria suggests that infections may play a significant role in the pathogenesis of these skin disorders. Treatment of infection foci may play the key role in the remission of skin changes