Hepatic and Pancreatic Glycosphingolipid Phenotypes of the Neurological Different Rat Strains

Among three commonly used strains of laboratory rats,Wistar rats perform more neurological tasks better then Lewis and Sprague-Dawley (SD) rats. Liver is the main site of insulin-like growth factor (IGF) production and pancreas is the exclusive site of insulin production. Insulin stimulates neuronal development and appropriate IGF-I input is critical in brain growth. Glycosphingolipids (GSLs) are important mediators of insulin secretion and action. Therefore, this study investigated GSL phenotypes of liver and pancreas with hypothesis that they are different in three rat strains. Total GSL fractions (neutral and gangliosides) were analysed by high performance thin-layer chromatography (HPTLC). Complex gangliosides were detected by HPTLC immunostaining using cholera toxin B subunit after neuraminidase pretreatment. Wistar rats had the highest liver weight/body weight ratio and SD rats had the highest pancreas weight/body weight ratio. Ganglioside GM3 was more expressed in the liver of Wistar compared to Lewis and SD rats. SD rats contained scarce quantities of GD1a and b-series gangliosides in the liver compared to Wistar and Lewis rats. Pancreatic b-series ganglioside content was also the lowest in SD rats. This study represents differences in the hepatic and pancreatic ganglioside phenotypes of three rat strains that could influence IGF and insulin secretion and action

Hepatic and Pancreatic Glycosphingolipid Phenotypes of the Neurological Different Rat Strains

Among three commonly used strains of laboratory rats,Wistar rats perform more neurological tasks better then Lewis and Sprague-Dawley (SD) rats. Liver is the main site of insulin-like growth factor (IGF) production and pancreas is the exclusive site of insulin production. Insulin stimulates neuronal development and appropriate IGF-I input is critical in brain growth. Glycosphingolipids (GSLs) are important mediators of insulin secretion and action. Therefore, this study investigated GSL phenotypes of liver and pancreas with hypothesis that they are different in three rat strains. Total GSL fractions (neutral and gangliosides) were analysed by high performance thin-layer chromatography (HPTLC). Complex gangliosides were detected by HPTLC immunostaining using cholera toxin B subunit after neuraminidase pretreatment. Wistar rats had the highest liver weight/body weight ratio and SD rats had the highest pancreas weight/body weight ratio. Ganglioside GM3 was more expressed in the liver of Wistar compared to Lewis and SD rats. SD rats contained scarce quantities of GD1a and b-series gangliosides in the liver compared to Wistar and Lewis rats. Pancreatic b-series ganglioside content was also the lowest in SD rats. This study represents differences in the hepatic and pancreatic ganglioside phenotypes of three rat strains that could influence IGF and insulin secretion and action

West Syndrome with Periventricular Leukomalacia: Ten-year Clinical Study

The aim of the study was to evaluate magnetic resonance imaging (MRI) findings in infants with periventricular leukomalacia (PVL) andWest syndrome (WS) and determine the neurodevelopmental outcome in children withWest syndrome and PVL. Ultrasound and brain MRI were performed in 37 infants with recognized PVL. PVL was categorized according to De Vries, whereas West syndrome was categorized according to International League Against Epilepsy 1989. West syndrome in our patients developed during the first 2 years of life. The most common interictal abnormality was hypsarrhythmia. All, except two patients had delayed development and various degrees of mental retardation.The most characteristic neuroimaging findings were major reduction in cerebral cortical gray matter volume, reduction in the volume of brain myelin, and delayed myelination. These findings may explain the anatomical association between the West syndrome onset and PVL and intellectual and cognitive deficit in premature infants with PVL

Management of fetal supraventricular tachyarrhythmia - case report

The conduction system of the fetal heart is defined by the16th week of gestation when it matures and normally produces a regular rhythm and rate between 110 and 160 beats per minute (bpm) for the remainder of the pregnancy. Deviations from these parameters are fetal arrhythmias. They are diagnosed in 2% of unselected pregnancies. They are mostly benign and transient but some of them are persistent and associated with structural defects or can cause heart failure, fetal hydrops and intrauterine death. Routine prenatal care includes screening for fetal arrhythmias in the second and third trimester with fetal ultrasound examinations which include a view of the four cardiac chambers and both ventricular outflow tracts. The fetal outcomes are improved upon appropriate antepartum diagnosis and care. Here we present a pregnancy and multidisciplinary management, prenatal evaluation and intervention with maternal transplacental treatment of a 28-year-old female, gravida II, para II, in 28+5 weeks of gestation with fetal arrhythmia, in tertiary university hospital. She had a history of previous caesarean section, in the 40th week of gestation due to an infection of the synus pylonidalis. We confirmed suspected fetal arrhythmia as supraventricular tachyarrhythmia without fetal hydrops, based on the ultrasound doppler M mode imaging, and started transplacental administration of antiarrhythmyc agent, digoxin. It has been considered the first line agent for treatment of fetal supraventricular tachycardia but higher maternal doses are required to maintain a therapeutic serum level. We converted fetal heartbeat into normal sinus rhythm after three days of administration of digoxin. We continued to monitor the fetus once a week with controlling levels of digoxin and electrolytes in maternal blood until the end of the pregnancy at 38+6 weeks of gestation

Neurodevelopmental Outcome in Children with Periventricular Leukomalacia

The purpose of this study was to question the correlation of different grades of periventricular leukomalacia (PVL) and subsequent neurodevelopmental outcome. In a prospective study we followed 52 preterm infants. Infants were divided into three groups according to their cranial ultrasound findings of PVL (De Vries classification). Seventeen children had PVL 1, 20 children had PVL 2, and 15 children had PVL 3. All 15 (100%) children with PVL 3 developed cerebral palsy with additional visual perceptual dysfunctions and epilepsy. Children with PVL 1 had high frequency of mild neuromotoric delay and visual impairment. PVL 2 and 3 have great predictive value for subsequent severe neurodevelopmental disorder which refers to cerebral palsy, different cognitive deficits, vision impairment and epilepsy. We have determined that due to high frequency of visual impairment and epilepsy we need to include neurophysiologic examinations very early in children with PVL lesions

Premature ovarian insufficiency

Premature ovarian insufficiency (POI) is a clinical syndrome defined as the loss of ovarian activity before the age of 40. POI is a life-changing diagnosis, with profound physical and psychological consequences. Spontaneous POI affects approximately 1% of women under the age of 40. However, the rising incidence of iatrogenic POI is of increasing concern. POI is a heterogeneous, multifactorial disorder, and in the majority of cases the etiology is unknown. The diagnosis of POI is based on the presence of amenorrhea and of an elevated gonadotropin level. Hormone replacement therapy should be used at least until the average age of menopause to alleviate the symptoms of hypoestrogenism and to prevent severe long term consequences especially those of cardiovascular diseases and osteoporosis. The treatment of these women should be coordinated by a multidisciplinary team. Women with POI should be informed that there is a small chance of spontaneous pregnancy. IVF with donor oocytes represents the highest chance for pregnancy in these patients. Further research is needed to identify the population in risk in a timely manner and to find mechanisms that can prolong, recover, or preserve ovarian function

Koža vrlo nedonošenog novorođenčeta – fiziologija i skrb

Skin is a multifunctional human organ. It has a protective, regulatory and sensory function. Skin of the very premature newborn is underdeveloped with defi cient functionality and has to be observed and treated as an immature organ in need of special care and interventions. Appropriate prevention and compensation of water and heat losses is obligatory as preserving the integrity of the skin and therefore of the entire body.Koža je multifunkcionalan organ. Ima zaštitnu, regulacijsku i senzornu funkciju. Koža vrlo nedonošenog novorođenčeta nepotpuno je razvijena i smanjene funkcionalnosti, stoga je treba shvatiti kao nezreli organ koji zahtijeva posebnu njegu i liječenje. Primjerena prevencija i kompenzacija gubitaka vode i topline obvezna je kao i očuvanje integriteta kože a time i cijelog organizma

Immunohistochemical level of IGF1R, VEGF, Fas-a and Fas ligand in placentas from pregnancies complicated by idiopathic intrauterine fetal growth retardation and intrauterine fetal growth retardation associated with preeclampsia

Uvod: Intrauterini zastoj rasta (IUZR) je klinički sindrom. Može se prezentirati sam ili udružen s drugim bolestima, najčešće s preeklampsijom (PE). U intrauterinom zastoju rasta udruženom s preeklampsijom (IUZR+PE), osim nedostatne funkcije posteljice, prisutna je i majčina simptomatologija kao posljedica endotelne disfunkcije. Kronična uteroplacentarna ishemija prisutna u IUZR-a narušava proces rasta i razvoja posteljice. Receptor inzulinu sličnog čimbenika rasta-1 (IGF1R), vaskularni čimbenik rasta (VEGF), Fas i FasL su čimbenici koji sudjeluju u rastu i razvoju posteljice. Istraživanje imunohistokemijske razine gore navedenih čimbenika može nam pomoći u rasvjetljavanju razlika između idiopatskog intrauterinog zastoja rasta (I-IUZR) i IUZR+PE-om. Dosadašnja istraživanja nisu odvajala I-IUZR-a i IUZR+PE-om. Cilj: Cilj je bio ispitati imunohistokemijsku razinu IGF1R-a, VEGF-a, Fas-a i FasL-a u decidualnim stanicama (DC), resičnom trofoblastu (VTB), izvanresičnom trofoblastu (EVTB), krvnim žilama posteljičnih resica i krvnim žilama decidue basalis u posteljicama iz trudnoća kompliciranih I-IUZR-om, IUZR+PE-om te posteljicama kontrolne skupine. Dodatni ciljevi su bili ispitati broj resica, broj krvnih žila posteljičnih resica i omjer broja krvnih žila posteljičnih resica i broja resica u ispitivanim posteljicama; ispitati povezanost IGF1R-a s FasL-om u ispitivanim dijelovima posteljica u skupini I-IUZR, IUZR+PE i kontrolnoj skupini; ispitati povezanost IGF1R-a i VEGF-a s brojem krvnih žila, brojem resica i omjerom broja krvnih žila posteljičnih resica i broja resica u posteljicama I-IUZR-a, IUZR+PE-om i kontrolnim posteljicama. Materijal i metode: Istraživanje je uključivalo 30 posteljica iz trudnoća kompliciranih I-IUZR-om, 30 posteljica iz trudnoća kompliciranih IUZR+PE-om i 60 posteljica iz urednih trudnoća. Klinička dijagnoza IUZR-a postavljena je kada je masa novorođenčeta bila <10. percentila za dob trudnoće korigirana prema paritetu i spolu, a dijagnoza PE-e prema strogim kriterijima za arterijsku hipertenziju i proteinuriju. Upotrebom specifičnih protutijela za IGF1R, VEGF, Fas i FasL određivana je imunohistokemijska razina istih semikvantitativnom HSCORE metodom. CD31 je korišten kao biljeg endotelnih stanica. Broj resica i broj krvnih žila posteljičnih resica određivan je pomoću Olympus BX 41 mikroskopa i Olympus Cell D1 analizatora slike u svakom uzorku posteljice na 10 vidnih polja. Rezultati: Dob trudnoće kod porođaja u skupini IUZR+PE bila je značajno manja u odnosu na dob trudnoće u skupini I-IUZR-a i kontrolnu skupinu. Pronađena je statistički značajno viša imunohistokemijska razina IGF1R-a u EVTB-u, krvnim žilama posteljičnih resica i krvnim žilama decidue basalis posteljica iz trudnoća kompliciranih I-IUZR-om nego u skupini posteljica iz trudnoća kompliciranih IUZR+PE-om i kontrolnoj skupini posteljica. U VTB-u posteljica I-IUZR-a postojala je statistički značajno viša imunohistokemijska razina IGF1R-a naprama VTB posteljica iz trudnoća kompliciranih IUZR+PE-om. Imunohistokemijska razina VEGF-a viša je u DC i krvnim žilama decidue basalis iz trudnoća kompliciranih I-IUZR-om, nego u posteljicama kontrolne skupine. Imunohistokemijska razina Fas-a je u krvnim žilama decidue basalis posteljica kontrolne skupine statistički značajno viša nego u posteljicama iz trudnoća kompliciranih I-IUZR-om. Imunohistokemijska razina FasL-a statistički je značajno viša u DC-ma, VTB-u, EVTB-u, krvnim žilama posteljičnih resica i krvnim žilama decidue basalis u posteljicama iz trudnoća kompliciranih I-IUZR-om, nego u posteljicama trudnoća kompliciranih IUZR+PE-om. U DC-ma, VTB-u i krvnim žilama posteljičnih resica posteljica iz trudnoća kompliciranih IUZR+PE-om imunohistokemijska razina FasL-a bila je niža nego u skupini I-IUZR-a i kontrolnoj skupini posteljica. Posteljice I-IUZR-a imaju statistički značajno veći broj krvnih žila posteljice i broj resica nego posteljice iz trudnoća kompliciranih IUZR+PE-om i kontrolne skupine posteljica. Omjer broja krvnih žila posteljičnih resica i broja posteljičnih resica jednak je u svim ispitivanim posteljicama. Postoji slaba negativna povezanost između imunohistokemijske razine IGF1R-a i FasL-a EVTB-a posteljica iz trudnoća kompliciranih I-IUZR-om. Postoji slaba pozitivna povezanost između IGF1R-a EVTB-a i VTB-a s omjerom broja krvnih žila posteljičnih resica i broja resica u posteljicama trudnoća kompliciranih IUZR+PE-om. U urednim trudnoćama postoji slaba pozitivna povezanost između IGF1R-a DC-a i omjera broja krvnih žila posteljičnih resica i broja resica. Postoji slaba pozitivna povezanost između imunohistokemijske razine VEGF-a EVTB-a posteljica kompliciranih I-IUZR-om i omjera broja krvnih žila posteljičnih resica i broja resica. Zaključak: Rezultati ove studije pokazuju značajnu razliku u imunohistokemijskoj razini IGF1R-a, VEGF-a, FasL-a i Fas-a u ispitivanim dijelovima posteljica iz trudnoća kompliciranih I-IUZR-om u odnosu na posteljice komplicirane IUZR+PE-om i posteljice urednih trudnoća. Za razliku od posteljica I-IUZR-a, posteljice iz trudnoća kompliciranih IUZR+PE-om pokazuju samo promjenu u imunohistokemijskoj razini FasL-a i to na VTB-u, krvnim žilama posteljičnih resica i krvnim žilama decidue basalis. Gore navedno upućuje nas da posteljice I-IUZR-a aktiviraju mehanizme zaštite u svrhu smanjivanja hipoksičnog oštećenja posteljice i sprječavanja aktivacije endotelnih stanica.Introduction: Intrauterine growth retardation (IUGR) is a clinical syndrome. It can be presented isolated also known as Idiopathic intrauterine growth retardation (I-IUGR) or in association with other diseases, most frequently with pre-eclampsia (IUGR+PE). Chronic uteroplacental ischemia present in I-IUGR, as well as in IUGR+PE is responsibile for disturbed placental growth and development. IUGR+PE is also presented with endothelial dysfunction, responsible for maternal symptoms. Insulin growth factor receptor 1 (IGF1R), vascular endothelial growth factor (VEGF), Fas and FasL are factors involved in placental growth and development. Immunohistochemical expression studies of these factors could help us to enlight the differences between I-IUGR and IUGR+PE. So far none of the researches have distinguished these entities. Aim: Aim of the study was to investigate immunohistochemical expression of IGF1R, VEGF, Fas and FasL in decidual cells (DC), villous trophoblast (VTB), extravillous trophoblast (EVTB), blood vessels of the chorionic villi and decidua basalis in placentas from I-IUGR, IUGR+PE and placentas from normal pregnancies and to compare them. Additional aim was to determine number of villi, number of blood vessels of chorionic villi and number of blood vessels per villi in placentas included in the study and to compare them. We wanted to determine the correlation between IGF1R and FasL in studied placental segments for all placental groups. Likewise, we set to investigate the correlation of IGF1R and VEGF with number of villi, number of blood vessels of chorionic villi and number of blood vessels per villi in placentas included in the study. Materials and methods: Investigation included 30 placentas from pregnancies complicated by I-IUGR, 30 placentas from pregnancies complicated by IUGR+PE, and 60 placentas from normal pregnancies. Clinical diagnosis of IUGR was made when birth mass of newborn was < 10. percentile for the pregnancy age, corrected for sex and parity, and diagnosis of PE was made under strict criteria for arterial hypertension and proteinuria. Immunohistochemical expression of IGF1R, VEGF, Fas and FasL was determined by HSCORE method using specific antibodies. CD31 was used as an endothelial cells marker. Number of villi and number of blood vessels of chorionic villi was determined with the use of Olympus BX41 microscope and Olympus Cell D1 image analayser in each placental sample per 10 fields of view. Results: Pregnancy age was significantly lower in IUGR+PE group compared to I-IUGR group and controls. Immunohistochemical expression of IGF1R in EVTB, blood vessels of chorionic villi and blood vessels of decidua basalis was significantly elevated in I-IUGR group compared to placentas from pregnancies complicated with IUGR+PE and controls. Immunohistochemical expression of IGF1R was significantly higher in VTB from I-IUGR placentas compared to IUGR+PE placentas. Immunohistochemical expression of VEGF was significantly higher in DC and blood vessels of decidua basalis in I-IUGR compared to placentas from normal pregnancies. Immunohistochemical expression of Fas in blood vessels of decidua basalis in placentas from control group was significantly higher than in I-IUGR and IUGR+PE placentas. Immunohistochemical expression of FasL was significantly higher in DC, VTB, EVTB, chorionic villi blood vessels, blood vessels of decidua basalis in I-IUGR placentas compared to IUGR+PE placentas and placentas from control group. FasL immunohistochemical expression was significantly lower in DC, VTB and chorionic villi blood vessels from IUGR+PE placentas than in placentas from I-IUGR and normal pregnancies. In placentas from I-IUGR group there was significantly higher number of chorionic villi blood vessels compared to IUGR+PE and control placentas, while there was no difference in the ratio between the number of chorionic villi blood vessels and number of chorionic villi in all investigated placental groups. There is a weak negative correlation between immunohistochemical expression of IGF1R and FasL on EVTB in I-IUGR placentas. There was a weak positive correlation between immunohistochemical expression of IGF1R on EVTB and VTB and ratio of blood vessels/number of chorionic villi in placentas complicated with IUGR+PE. Weak positive correlation was determined between immunohistochemical expression VEGF on EVTB and ratio of blood vessels/number of chorionic villi in placentas complicated with I-IUGR. Placentas from normal pregnancies show weak positive correlation between IGF1R on DC with ratio of blood vessels/number of chorionic villi. Conclusion: Results of presented study show significant difference in immunohistochemical expression of: IGF1R, VEGF, Fas and FasL in examined placental parts from I-IUGR placentas in contrast to IUGR+PE and control placentas. Unlike I-IUGR placentas, placentas from pregnancies complicated with IUGR+PE show difference in FasL immunohistochemical expression in VTB, chorionic villi blood vessels and blood vessels of decidua basalis. All of the above indicate that I-IUGR placentas activate protective mechanisam in order to diminish placental hypoxic injury as well as endothelial cell activation

Immunohistochemical level of IGF1R, VEGF, Fas-a and Fas ligand in placentas from pregnancies complicated by idiopathic intrauterine fetal growth retardation and intrauterine fetal growth retardation associated with preeclampsia

Uvod: Intrauterini zastoj rasta (IUZR) je klinički sindrom. Može se prezentirati sam ili udružen s drugim bolestima, najčešće s preeklampsijom (PE). U intrauterinom zastoju rasta udruženom s preeklampsijom (IUZR+PE), osim nedostatne funkcije posteljice, prisutna je i majčina simptomatologija kao posljedica endotelne disfunkcije. Kronična uteroplacentarna ishemija prisutna u IUZR-a narušava proces rasta i razvoja posteljice. Receptor inzulinu sličnog čimbenika rasta-1 (IGF1R), vaskularni čimbenik rasta (VEGF), Fas i FasL su čimbenici koji sudjeluju u rastu i razvoju posteljice. Istraživanje imunohistokemijske razine gore navedenih čimbenika može nam pomoći u rasvjetljavanju razlika između idiopatskog intrauterinog zastoja rasta (I-IUZR) i IUZR+PE-om. Dosadašnja istraživanja nisu odvajala I-IUZR-a i IUZR+PE-om. Cilj: Cilj je bio ispitati imunohistokemijsku razinu IGF1R-a, VEGF-a, Fas-a i FasL-a u decidualnim stanicama (DC), resičnom trofoblastu (VTB), izvanresičnom trofoblastu (EVTB), krvnim žilama posteljičnih resica i krvnim žilama decidue basalis u posteljicama iz trudnoća kompliciranih I-IUZR-om, IUZR+PE-om te posteljicama kontrolne skupine. Dodatni ciljevi su bili ispitati broj resica, broj krvnih žila posteljičnih resica i omjer broja krvnih žila posteljičnih resica i broja resica u ispitivanim posteljicama; ispitati povezanost IGF1R-a s FasL-om u ispitivanim dijelovima posteljica u skupini I-IUZR, IUZR+PE i kontrolnoj skupini; ispitati povezanost IGF1R-a i VEGF-a s brojem krvnih žila, brojem resica i omjerom broja krvnih žila posteljičnih resica i broja resica u posteljicama I-IUZR-a, IUZR+PE-om i kontrolnim posteljicama. Materijal i metode: Istraživanje je uključivalo 30 posteljica iz trudnoća kompliciranih I-IUZR-om, 30 posteljica iz trudnoća kompliciranih IUZR+PE-om i 60 posteljica iz urednih trudnoća. Klinička dijagnoza IUZR-a postavljena je kada je masa novorođenčeta bila <10. percentila za dob trudnoće korigirana prema paritetu i spolu, a dijagnoza PE-e prema strogim kriterijima za arterijsku hipertenziju i proteinuriju. Upotrebom specifičnih protutijela za IGF1R, VEGF, Fas i FasL određivana je imunohistokemijska razina istih semikvantitativnom HSCORE metodom. CD31 je korišten kao biljeg endotelnih stanica. Broj resica i broj krvnih žila posteljičnih resica određivan je pomoću Olympus BX 41 mikroskopa i Olympus Cell D1 analizatora slike u svakom uzorku posteljice na 10 vidnih polja. Rezultati: Dob trudnoće kod porođaja u skupini IUZR+PE bila je značajno manja u odnosu na dob trudnoće u skupini I-IUZR-a i kontrolnu skupinu. Pronađena je statistički značajno viša imunohistokemijska razina IGF1R-a u EVTB-u, krvnim žilama posteljičnih resica i krvnim žilama decidue basalis posteljica iz trudnoća kompliciranih I-IUZR-om nego u skupini posteljica iz trudnoća kompliciranih IUZR+PE-om i kontrolnoj skupini posteljica. U VTB-u posteljica I-IUZR-a postojala je statistički značajno viša imunohistokemijska razina IGF1R-a naprama VTB posteljica iz trudnoća kompliciranih IUZR+PE-om. Imunohistokemijska razina VEGF-a viša je u DC i krvnim žilama decidue basalis iz trudnoća kompliciranih I-IUZR-om, nego u posteljicama kontrolne skupine. Imunohistokemijska razina Fas-a je u krvnim žilama decidue basalis posteljica kontrolne skupine statistički značajno viša nego u posteljicama iz trudnoća kompliciranih I-IUZR-om. Imunohistokemijska razina FasL-a statistički je značajno viša u DC-ma, VTB-u, EVTB-u, krvnim žilama posteljičnih resica i krvnim žilama decidue basalis u posteljicama iz trudnoća kompliciranih I-IUZR-om, nego u posteljicama trudnoća kompliciranih IUZR+PE-om. U DC-ma, VTB-u i krvnim žilama posteljičnih resica posteljica iz trudnoća kompliciranih IUZR+PE-om imunohistokemijska razina FasL-a bila je niža nego u skupini I-IUZR-a i kontrolnoj skupini posteljica. Posteljice I-IUZR-a imaju statistički značajno veći broj krvnih žila posteljice i broj resica nego posteljice iz trudnoća kompliciranih IUZR+PE-om i kontrolne skupine posteljica. Omjer broja krvnih žila posteljičnih resica i broja posteljičnih resica jednak je u svim ispitivanim posteljicama. Postoji slaba negativna povezanost između imunohistokemijske razine IGF1R-a i FasL-a EVTB-a posteljica iz trudnoća kompliciranih I-IUZR-om. Postoji slaba pozitivna povezanost između IGF1R-a EVTB-a i VTB-a s omjerom broja krvnih žila posteljičnih resica i broja resica u posteljicama trudnoća kompliciranih IUZR+PE-om. U urednim trudnoćama postoji slaba pozitivna povezanost između IGF1R-a DC-a i omjera broja krvnih žila posteljičnih resica i broja resica. Postoji slaba pozitivna povezanost između imunohistokemijske razine VEGF-a EVTB-a posteljica kompliciranih I-IUZR-om i omjera broja krvnih žila posteljičnih resica i broja resica. Zaključak: Rezultati ove studije pokazuju značajnu razliku u imunohistokemijskoj razini IGF1R-a, VEGF-a, FasL-a i Fas-a u ispitivanim dijelovima posteljica iz trudnoća kompliciranih I-IUZR-om u odnosu na posteljice komplicirane IUZR+PE-om i posteljice urednih trudnoća. Za razliku od posteljica I-IUZR-a, posteljice iz trudnoća kompliciranih IUZR+PE-om pokazuju samo promjenu u imunohistokemijskoj razini FasL-a i to na VTB-u, krvnim žilama posteljičnih resica i krvnim žilama decidue basalis. Gore navedno upućuje nas da posteljice I-IUZR-a aktiviraju mehanizme zaštite u svrhu smanjivanja hipoksičnog oštećenja posteljice i sprječavanja aktivacije endotelnih stanica.Introduction: Intrauterine growth retardation (IUGR) is a clinical syndrome. It can be presented isolated also known as Idiopathic intrauterine growth retardation (I-IUGR) or in association with other diseases, most frequently with pre-eclampsia (IUGR+PE). Chronic uteroplacental ischemia present in I-IUGR, as well as in IUGR+PE is responsibile for disturbed placental growth and development. IUGR+PE is also presented with endothelial dysfunction, responsible for maternal symptoms. Insulin growth factor receptor 1 (IGF1R), vascular endothelial growth factor (VEGF), Fas and FasL are factors involved in placental growth and development. Immunohistochemical expression studies of these factors could help us to enlight the differences between I-IUGR and IUGR+PE. So far none of the researches have distinguished these entities. Aim: Aim of the study was to investigate immunohistochemical expression of IGF1R, VEGF, Fas and FasL in decidual cells (DC), villous trophoblast (VTB), extravillous trophoblast (EVTB), blood vessels of the chorionic villi and decidua basalis in placentas from I-IUGR, IUGR+PE and placentas from normal pregnancies and to compare them. Additional aim was to determine number of villi, number of blood vessels of chorionic villi and number of blood vessels per villi in placentas included in the study and to compare them. We wanted to determine the correlation between IGF1R and FasL in studied placental segments for all placental groups. Likewise, we set to investigate the correlation of IGF1R and VEGF with number of villi, number of blood vessels of chorionic villi and number of blood vessels per villi in placentas included in the study. Materials and methods: Investigation included 30 placentas from pregnancies complicated by I-IUGR, 30 placentas from pregnancies complicated by IUGR+PE, and 60 placentas from normal pregnancies. Clinical diagnosis of IUGR was made when birth mass of newborn was < 10. percentile for the pregnancy age, corrected for sex and parity, and diagnosis of PE was made under strict criteria for arterial hypertension and proteinuria. Immunohistochemical expression of IGF1R, VEGF, Fas and FasL was determined by HSCORE method using specific antibodies. CD31 was used as an endothelial cells marker. Number of villi and number of blood vessels of chorionic villi was determined with the use of Olympus BX41 microscope and Olympus Cell D1 image analayser in each placental sample per 10 fields of view. Results: Pregnancy age was significantly lower in IUGR+PE group compared to I-IUGR group and controls. Immunohistochemical expression of IGF1R in EVTB, blood vessels of chorionic villi and blood vessels of decidua basalis was significantly elevated in I-IUGR group compared to placentas from pregnancies complicated with IUGR+PE and controls. Immunohistochemical expression of IGF1R was significantly higher in VTB from I-IUGR placentas compared to IUGR+PE placentas. Immunohistochemical expression of VEGF was significantly higher in DC and blood vessels of decidua basalis in I-IUGR compared to placentas from normal pregnancies. Immunohistochemical expression of Fas in blood vessels of decidua basalis in placentas from control group was significantly higher than in I-IUGR and IUGR+PE placentas. Immunohistochemical expression of FasL was significantly higher in DC, VTB, EVTB, chorionic villi blood vessels, blood vessels of decidua basalis in I-IUGR placentas compared to IUGR+PE placentas and placentas from control group. FasL immunohistochemical expression was significantly lower in DC, VTB and chorionic villi blood vessels from IUGR+PE placentas than in placentas from I-IUGR and normal pregnancies. In placentas from I-IUGR group there was significantly higher number of chorionic villi blood vessels compared to IUGR+PE and control placentas, while there was no difference in the ratio between the number of chorionic villi blood vessels and number of chorionic villi in all investigated placental groups. There is a weak negative correlation between immunohistochemical expression of IGF1R and FasL on EVTB in I-IUGR placentas. There was a weak positive correlation between immunohistochemical expression of IGF1R on EVTB and VTB and ratio of blood vessels/number of chorionic villi in placentas complicated with IUGR+PE. Weak positive correlation was determined between immunohistochemical expression VEGF on EVTB and ratio of blood vessels/number of chorionic villi in placentas complicated with I-IUGR. Placentas from normal pregnancies show weak positive correlation between IGF1R on DC with ratio of blood vessels/number of chorionic villi. Conclusion: Results of presented study show significant difference in immunohistochemical expression of: IGF1R, VEGF, Fas and FasL in examined placental parts from I-IUGR placentas in contrast to IUGR+PE and control placentas. Unlike I-IUGR placentas, placentas from pregnancies complicated with IUGR+PE show difference in FasL immunohistochemical expression in VTB, chorionic villi blood vessels and blood vessels of decidua basalis. All of the above indicate that I-IUGR placentas activate protective mechanisam in order to diminish placental hypoxic injury as well as endothelial cell activation

NEW APPROACH TO ETIOLOGY FACTORS IN TREATMENT OF NEONATAL SEIZURES

Novorođenče ima ograničeni repertoar iskazivanja teškoća, pa su konvulzije često jedina neurološka manifestacija ozbiljne bolesti središnjeg živčanog sustava ili pratećega podliježećeg poremećaja. Incidencija neonatalnih konvulzija kreće se od 3,5-4,4/1000 živorođene djece s tendencijom povećanja smanjenjem životne dobi. Konvulzije koje se dogode nezrelom mozgu mogu uzrokovati ireverzibilne promjene neuronskih sinapsa i tako mogu biti odgovorne za razvojne poremećaje mozga, što čini podlogu za nastavak konvulzija. S obzirom na kliničku sliku, EEG promjene kao i kasniju prognozu dijelimo ih na dobroćudne i teške.epileptičke sindrome. One mogu bit uzrokovane genetskim poremećajima kao što su konvulzije ovisne o piridoksinu, neketotična hiperglicinemia, nedostatak sulfitne oksidaze, konvulzije koje reagiraju na folnu kiselinu i nedostatak protein- transportera glukoze (GLUT-1 deficiency) te benigne obiteljske konvulzije zbog poremećaja kalijevih kanala. Konvulzije izazvane ovim poremećajima često su refrakterne na uobičajenu antiepileptičku terapiju. Rana dijagnoza novorođenačkih konvulzija je važna, jer često otkriva prisutnost teških strukturalnih poremećaja mozga koji u podlozi imaju genetski poremećaj i zahtijevaju specifično liječenje.Neonatal convulsions are a very alarming and in the most cases the only manifestation of an underlying neural disorder. Seizures occur in 3.5-4.4/1000 live births. Convulsions in the immature brain can cause irreversible changes to the synapsis and can cause progress of convulsions. According to clinical manifestations, EEG changes and outcome, disorders are divided into benign and severe epileptic syndromes. Seizures may also be caused by genetic disorders, several of which are benign, familial, and caused by channelopathies involving potassium channels. Convulsions caused by these disorders are often pharmaco resistant to antiepileptic therapy. This review also discusses epileptic syndromes seen in neonates, including early myoclonic encephalopathy and Ohtahara syndrome. Early diagnosis of these disorders is important for detecting structural brain changes which have a genetic cause and need specific treatment