Different distribution of c-kit positive interstitial cells of Cajal-like in children’s urinary bladders

We describe the presence of c-kit positive interstitial cells of Cajal-like (ICCs-like) in the walls of the urinary bladders of children. An immunohistochemical study of specimens, obtained at autopsy from either the trigonum (Group A) or the corpus (Group B), was performed using antibodies against c-kit (CD 117). Histological morphometry of the immunoexpression of c-kit positive ICCs-like was performed by means of image analysis system. The c-kit positive ICCs-like were identified by their morphology and counted in the vesical muscle layer in ten adjacent high power fields, each of 0.0479 mm2. The areas of the epithelial and subepithelial layers containing c-kit positive mast cells (rounded body with no dendritic processes) were neglected. The results were expressed as the number of ICCs-like cells per mm2. Differences between groups were tested using unpaired Student&#8217;s t-test preceded by evaluation of normality and Levene&#8217;s test. Results were considered statistically significant if p < 0.05. In Group A, the mean number of ICCs-like cells was statistically significantly higher (41.5 cells/mm2) than in Group B (30.4 cells/mm2), p < 0.05. ICCs-like cells were found within the smooth muscle layer of the urinary bladder. There was a different distribution of these cells in particular parts of the bladder, which was probably due to the different roles of the trigonum and the corpus in the bladders of children. (Folia Histochemica et Cytobiologica 2011; Vol. 49, No. 3, pp. 431&#8211;435

Thoraco-omphalopagus twins: different perinatal circumstances, different outcome

Two pairs of omphalopagus twins were encountered at the Polish Mother's Health Institution in Lodz, Poland during the past 15 years. In the first set the prenatal diagnosis was not established and the delivery of the twins in a regional hospital was a complete surprise. Both babies died. In the second case the conjoined twins were diagnosed prenatally, surgical separation was successful, and both twins survived. The prenatal identification of conjoined twins is of cardinal importance for the planning of delivery and possible separation

Novel dressing materials accelerating wound healing made from dibutyrylchitin

Dibutyrylchitin (DBC), a soluble chitin derivative, is a polymer with confirmed biological properties. DBC was obtained in the reaction of shrimp chitin with butyric anhydride, carried out under heterogeneous condition, in which perchloric acid was used as a catalyst of reaction. Production of DBC batches was carried out on a half - technical scale line. If DBC parties were examined by infrared spectrometry, size exclusion chromatography and viscometry. DBC with molar mass of 132 x 10(3) daltons was used for the manufacturing of DBC fibres and DBC non-woven materials. DBC non-woven fabrics after gamma-sterilisation were applied to a group of nine patients with different indications. DBC dressing materials were used exluding the use of other medical products. Satisfactory results of wound healing were achieved in most cases, especially in cases of burn wounds and postoperative/posttraumatic wounds and various other conditions causing skin/epidermis loss

Peritonitis caused by a giant trichobezoar ventriculi – a case report

Summary Bezoars are the most common foreign bodies of gastrointestinal tract. They contain swallowed hair, different fibres, seeds, nut shells, sweets or drugs. Clinical manifestations vary, depending on the location and size of bezoar, from “no symptoms” to “acute abdomen” syndrome. In this case report, the authors describe a giant trichobezoar from the stomach of an 18-yearold girl, who had been admitted to the gynecological department with syndromes suggesting an ovarian cyst torsion. The preoperative diagnosis was not confirmed and a giant trichobezoar was found and removed during the surgery

Znaczenie badania echokardiograficznego w przepuklinie pępowinowej (Pp) u 83 płodów w materiale Zakładu Diagnostyki i Profilaktyki Wad Wrodzonych ICZMP i Uniwersytetu Medycznego w Łodzi w latach 1999-2006

Material and Methods: It was a retrospective analysis of fetal echocardiography results (analysis of congenital heart defect (CHD) and functional abnormalities in normal heart anatomy) in 83 fetuses diagnosed and treated in the same institution. Results: In our group of fetuses, the most common structural defect, in addition to omphalocele, proved to be CHD. In the group of omphalocele, normal heart anatomy and functional abnormalities (tricuspid regurgitation, myocardial hypertrophy, arrhythmias) , the hospital stay was longer comparing to the group of omphalocele, normal heart anatomy and normal heart study (t – test p=0,005). CHD was a bad prognostic factor and most fetuses/newborns did not survive (Chi-square 0,0005, Fisher test 0,000032). In the group of omphalocele and normal heart anatomy based on fetal echocardiography, the survival rate was 70%. The omphalocele and CHD survivors (n=3) had been only those, who did not require a cardiac surgery in first month of postnatal life. Conlusion: Echocardiography exam of fetus with omphalocele and CHD and functional abnormalities has diagnostic and prognostic value.Streszczenie Cel pracy: Ocena przydatności badania echokardiograficznego u płodów z przepukliną pępowinową (Pp), zarówno w odniesieniu do oceny budowy serca płodu jak i zmian czynnościowych w układzie krążenia, przy prawidłowej budowie serca płodu. Materiał i metody: Analizie retrospektywnej poddano wyniki badań echokardiograficznych 83 płodów z przepukliną pępowinową z materiału Zakładu Diagnostyki i Profilaktyki Wad Wrodzonych Instytutu Centrum Zdrowia Matki Polki i Uniwersytetu Medycznego w Łodzi. Wyniki: Przepuklina pępowinowa najczęściej współistniała z wadą serca, stanowiącą zły czynnik prognostyczny (test Chi-kwadrat 0,0005, test Fishera 0,000032). Przeżyły tylko te dzieci, które w okresie noworodkowym nie wymagały operacji kardiochirurgicznej. W grupie płodów z Pp i prawidłową budową serca, ale z anomaliami czynnościowymi stwierdzano istotnie dłuższy czas leczenia szpitalnego po porodzie, w stosunku do grupy noworodków bez zmian czynnościowych w prenatalnym badaniu echokardiograficznym (t-test p=0,005). W grupie płodów z Pp i prawidłową budową serca potwierdzoną w badaniu echokardiograficznym, odsetek przeżyć wyniósł 70%. Wnioski: Badanie echokardiograficzne u płodów z Pp ma znaczenie diagnostyczne i rokownicze przy stwierdzeniu wady serca (złe rokowanie) oraz zaburzeń czynnościowych serca (dłuższy pobyt noworodka po operacji w szpitalu)

Assessment of the usefulness of ultrasound screening in fetal ovarian cysts

Abstract Objectives: The aim of the study was to assess the usefulness of ultrasound in management and prognosis in fetal ovarian cysts. Material and methods: The study included 38 fetuses with cyst in abdominal cavity, who, between 1995 and 2006, underwent an ultrasound examination in our unit at the Polish Mother’s Memorial Hospital in Lodz , The Department for Diagnosis and Prevention of Birth Defects. Results: In all 38 fetuses with cyst in abdominal cavity we have diagnosed 27 (74%) cases of ovarian cyst. In 14 (74%) fetuses cysts regressed spontaneously, including all cysts ≤40mm (n=7). In 3 cases with cysts &gt;40mm needle aspiration has been successfully performed, without any further complications. Surgical neonatal treatment has been performed in 5 cases in prenatal cysts &gt;40mm without prenatal aspiration. In 3 cases cysts &gt;40mm regressed spontaneously. Ovarian cysts in 22 (81%) cases were an isolated malformation; in 5 (19%) cases other malformations were present. Conclusions: 1. Fetal ovarian cysts ≤40mm required only ultrasound assessment and, in majority of cases, revealed the tendency to spontaneous regression. 2. Cysts &gt;40mm in maximal diameter have signaled complications more often and required surgical procedure after birth. 3. In utero, aspiration of fetal ovarian cyst &gt;40mm may lead to cyst regression, making the surgery after birth unnecessary

Fetal echocardiography in fetal ovarian cysts

Abstract Objectives: The aim of the study was to evaluate the outcome of fetuses with ovarian cysts in relation to fetal echocardiography. Material and methods: In the Department for Diagnosis and Prophylaxis of Birth Defects at the Polish Mother's Memorial Hospital in Lodz fetal echocardiography was performed in 21 fetuses with ovarian cysts between the years 1995-2006. Outcomes: In 18 out of 21 (86%) fetuses we have found normal heart anatomy (NHA) and in 3 fetuses congenital heart defect (CHD). In 7 out of 18 (39%) fetuses with NHA there were functional anomalies, including 5 fetuses with hypertrophy. Four neonates with hypertrophy required surgical procedures after the delivery. Prenatal hypertrophy was not observed in case of only one neonate which was operated after the delivery. Conclusions: 1. Fetal echocardiography studies were very often abnormal in fetus with ovarian cysts (mainly as functional anomalies). 2. Functional anomalies detected in fetal echocardiography more often resulted in surgical procedures after the birth, whereas normal heart study was more often connected with spontaneous regression of ovarian cyst (p=0,0265)

Diaphragmatic hernia in Reference Hospital ICZMP – diagnostic problems and outcome

Objectives: The aim of the study was to analyze US/ECHO examinations in fetuses with diaphragmatic hernia (DH) diagnosed and treated in our institution from 1994-2006, and their follow-up. Material and methods: Retrospective analysis of the data base from Department for Diagnoses & Prevention of Fetal Malformations, Research Institute of the Polish Mother’s Memorial Hospital: 14 481 fetal echo/ultrasound examinations in 10 077 fetuses have been analyzed to retrieve 115 fetuses with DH. Results: The mean gestational age at the targeted US/ECHO examination was 30 wks. There were 8 terminations of pregnancies (at mean 21 wks), 6 intrauterine demises, 60 neonatal deaths after delivery (in 1-3rd day of postnatal life), 8 deaths after surgery, 19 neonates were discharged home and in 14 cases the follow-up could not be monitored. The most common anomalies accompanying DH have been central nervous system anomalies (20%), polyhydramnion (16%) and cong heart defects (10%). In this subgroup, there was 100% mortality. Isolated DH has been diagnosed in every third case. In this subgroup, 27 neonates had undergone surgery and the survival rate was 70%, however since 2004 there was not a single death on record. Conclusions: Late gestational age of US/ECHO examinations in our tertiary center suggests that DH has been relatively difficult to detect during ultrasound screening. DH and the other structural malformations have been a lethal disease in our series in 100%. Isolated DH was much less frequent and was present in every third case (29%), and in this group the survival rate was 70%, regardless of the way of the delivery (CS or Vaginal)

The assessment of intra-abdominal pressure with the Polish prototype of intra-bladder pressure gauge -the own experience

Abstract The abdominal compartment syndrome (ACS) results from an acute increase of intra-abdominal pressure and may lead to severe organ dysfunction. The authors described their own experience of measurement of intra-abdominal pressure as a prevention of ACS with use of intrabladder pressure (IBP) gauge of own conception and construction. The IBP was measured during operations and postoperative period of 100 patients by a Polish gauge constructed in Technical University of Łódź. Since December 2000 through November 2007 we measured IBP in 100 patients (85 newborns, 15 children from 1 to 3 years old) operated on because of: gastroschisis -52, omphalocele -24, congenital diaphragmatic hernia -9, abdominal wall hernia after primarily non-surgical treatment of giant omphalocele -15. In 13 patients who underwent staged repair postoperative IBP measurement decided of timing, frequency and extent of silo reductions and timing of final abdominal closure. We did not observe symptoms of abdominal compartment syndrome in our patients, there were no deaths as a result of complications due to high intra-abdominal pressure since the introduction of IBP measurement. Conclusions: 1) We recommend measurement of IBP as an objective, non-invasive and simple method to evaluate the intra-abdominal pressure and prevention of abdominal compartment syndrome. 2) Intra and postoperative measurement of IBP helps to avoid the compartment syndrome and its dire consequences