Najnowsze techniki biologii molekularnej w profilaktyce przewlekłych zakażeń wirusowych

Postęp medycyny i związany z tym postęp technik biologii molekularnej stworzyły daleko idące możliwości kontrolowania i zapobiegania powikłaniom w przebiegu przewlekłych chorób wirusowych, takich jak zakażenia wirusowe wątroby oraz wirusem ludzkiego niedoboru odporności (HIV) Jeszcze kilkanaście lat wstecz niemożliwe było dokładne kontrolowanie poziomu wiremii oraz serokonwersji wirusa HBV podczas zakażeń. Od kilku lat istnieją już w pełni wystandaryzowane i wykorzystywane w diagnostyce metody biologii molekularnej, potwierdzające zakażenia HCV, HBV oraz HIV nawet podczas nieobecności przeciwciał we krwi pacjenta, wykrywające bezpośrednio obecność genomu wirusa. Coraz częściej wykorzystuje się również techniki pozwalające monitorowanie stanu zakażenia oraz szybkie reagowanie na zmiany zachodzące w organizmie zakażonego. Do wyżej wymienionych technik należy przede wszystkim odmiana reakcji PCR, czyli ilościowy PCR w czasie rzeczywistym (Real-Time PCR) czy sekwencjonowanie kwasów nukleinowych. Każda z tych technik pozwala nie tylko na wykrycie zakażenia na poziomie dotychczas nieosiągalnym, lecz również na jego skuteczne obserwowanie i skuteczne leczenie. Przy pomocy reakcji Real-Time PCR możliwe jest określenie ilości cząstek wirusa w badanej jednostce objętości krwi. Technika sekwencjonowania pozwala na dokładne określenie typu wirusa, a co za tym idzie zjadliwości. Wszystkie te techniki wzięte razem pozwalają na dokładne określenie ilości wirusów we krwi oraz na skuteczną walkę z nimi.Progress either in medicine or molecular biology technics induces perspective possibilities of control and complication prevention in case of chronic viral diseases such as viral hepatitis and HIV infection. Accurate control of HBV viremia and seroconvertion level during infection was impossible several years ago. For the last couple of years molecular biology methods for HCV, HBV and HIV infection have been generally accepted and used for diagnosis, even without antibodies detectable in blood. Infection monitoring technics, such as Real-Time PCR, nucleic acid sequencing have been usefull and fl ow cytofl uorometry, have been useful in rapid reacting on changes in the infected patient state. Each of the mentioned technics provides either the infection detection on the level unavailable in the past, or efficient observation and, consequently, proper treatment of the infection. Real-Time PCR allows to defi ne the quantity of viral molecules in the volume of tested blood sample. Sequentioning technic provides viruses type ane virulence defi nition. The combination of all the other hand the cytofluorometry technic allows to defi ne precisely the quantity of viral proteins presented on the infected cells and detect other blood proteins expression. The combination of all those technics provides accurate defi nition of virus ammount and efficient treatment

Treatment of degenerative cervical spondylosis with radiculopathy. Clinical practice guidelines endorsed by The Polish Society of Spinal Surgery

Introduction Degenerative cervical spondylosis (DCS) with radiculopathy is the most common indication for cervical spine surgery despite favorable natural history. Advances in spinal surgery in conjunction with difficulties in measuring the outcomes caused the paucity of uniform guidelines for the surgical management of DCS. Aims The aim of this paper is to develop guidelines for surgical treatment of DCS. For this purpose the available up-to-date literature relevant on the topic was critically reviewed. Methods and results Six questions regarding most important clinical questions encountered in the daily practice were formulated. They were answered based upon the systematic literature review, thus creating a set of guidelines. The guidelines were categorized into four tiers based on the level of evidence (I–III and X). They were designed to assist in the selection of optimal and effective treatment leading to the most successful outcome. Conclusions The evidence based medicine (EBM) is increasingly popular among spinal surgeons. It allows making unbiased, optimal clinical decisions, eliminating the detrimental effect of numerous conflicts of interest. The key role of opinion leaders as well as professional societies is to provide guidelines for practice based on available clinical evidence. The present work contains a set of guidelines for surgical treatment of DCS officially endorsed by the Polish Spine Surgery Society

Treatment of lumbar disc herniation with radiculopathy. Clinical practice guidelines endorsed by The Polish Society of Spinal Surgery

Introduction Herniated lumbar disc (HLD) is arguably the most common spinal disorder requiring surgical intervention. Although the term is fairly straightforward, the exact pathology and thus the clinical picture and natural history may vary. Therefore, it is immensely difficult to formulate universal guidelines for surgical treatment. Aim The aim of this paper is to organize the terminology and clear the inconsistencies in phraseology, review treatment options and gather available published evidence to address the clinical questions to create a set of clinical guidelines in relevant to the topic. Methods and results Twelve queries, addressing optimal surgical treatment of the HLD have been formulated. The results, based on the literature review are described in the present work. The final product of the analysis was a set of guidelines for the surgical treatment of symptomatic HLD. Categorized into four tiers based on the level of evidence (I–III and X), they have been designed to assist in the selection of optimal, effective treatment leading to the successful outcome. Conclusions The evidence based medicine (EBM) is becoming ever more popular among spinal surgeons. Unfortunately this is not always feasible. Lack of uniform guidelines and numerous conflicts of interest introduce flaws in the decision making process. The key role of experts and professional societies is to provide high value recommendation based on the most current literature. Present work contains a set of guidelines for the surgical treatment of HLD officially endorsed by the Polish Spine Surgery Society

Influence of flexible bronchoscopy on the concentration of exhaled nitric oxide

Wstęp: Stężenie tlenku azotu w wydychanym powietrzu (eNO) jest nieinwazyjnym parametrem przydatnym w ocenie stanu zapalnego dróg oddechowych, w szczególności użytecznym do monitorowania astmy. Celem pracy była ocena, czy występuje stan zapalny drzewa oskrzelowego mierzony wydalanym eNO wywołany wykonaniem bronchofiberoskopii (BF). Materiał i metody: U 41 chorych (wiek 29-74 lat) stężenie eNO zmierzono aparatem Sievers 280 Nitric Oxide Analyzer przed BF i 24 godziny po niej. W grupie kontrolnej (12 zdrowych osób w wieku 22-65 lat) stężenie eNO również oznaczono 2-krotnie z 24-godzinną przerwą między pomiarami. Wyniki: W grupie badanej średnie stężenie eNO przed BF (15,0 &#177; 8,0 ppb) było znamiennie większe (p < 0,05) niż w grupie kontrolnej (6,9 &#177; 5,6 ppb). W grupie badanej nie zaobserwowano znamiennej statystycznie zmiany stężenia eNO po BF (15,0 &#177; 8,0 vs. 17,0 &#177; 7,9 ppb). Procedury przeprowadzone w trakcie BF, takie jak: płukanie oskrzelowe, szczoteczkowanie oskrzelowe lub biopsja oskrzela, nie wpłynęły na eNO u badanych chorych. W grupie kontrolnej średnie wartości eNO przed badaniem i po 24 godzinach od badania były podobne (6,9 &#177; 5,6 ppb vs. 7,1 &#177; 5,9). Odpowiednio zmiany eNO po 24 godzinach obserwacji (spadki i wzrosty), wyrażone jako procent części na miliard (% ppb), także były podobne w obu pomiarach u badanych chorych i w grupie kontrolnej. Wnioski: Bronchofiberoskopia i związane z nią procedury nie wpływają w istotny sposób na stężenia NO w wydychanym powietrzu.Introduction: Exhaled nitric oxide (eNO) is noninvasive parameter useful on estimation of airways inflammation, especially useful in monitoring of asthma inflammation. The aim of the study was estimation of bronchial tree inflammation after flexible bronchoscopy (FB) using eNO concentration. Material and methods: In 41 patients (aged 29 to 74 yrs) eNO measurements using Sievers 280 Nitric Oxide Analyzer were performed before and 24 hours after FB. In control group (12 healthy persons aged 22 to 65 yrs) eNO measurements were also performed twice at 24 hours interval. Results: In examined patients the mean eNO concentration before FB (15.0 &#177; 8.0 ppb) was significantly higher (p < 0.05) than in controls (6.9 &#177; 5.6 ppb). In examined patients we did not observe the significant changes in eNO after FB (15.0 &#177; 8.0 vs. 17.0 &#177; 7.9 ppb). The procedure of bronchial washing, bronchial brush or bronchial biopsy did not influence the results in examined patients. In control group the mean eNO results before and after 24 hours were similar (6.9 &#177; 5.6 ppb vs. 7.1 &#177; 5.9). The relative eNO changes after 24 hours of observation (decreases and increases), expressed as a per cent of parts per billion (% of ppb), were similar both in examined patients and controls. Conclusions: BF and associated procedures does not influence on eNO concentration

Feasibility and accuracy of new insertion technique of S1 transpedicular screw. Computed tomography-based morphometric analysis

Objective To assess feasibility and accuracy of a new insertion technique of S1 transpedicular screw. Summary of background data Transpedicular stabilization in the first sacral vertebra (S1) is a technically demanding surgical procedure with inherent risk of loosening of the implant. A modification of the technique was recently proposed, along with the analytical verification which was performed based on the available literature. In the study, we performed radiological assessment of screws inserted into the S1 using the classical and modified techniques. Methods The analysis was performed in two parts. The first part was performed on eight cadaver specimens after implantation of the screws. In the second part, we used computed tomography images of patients with degenerative disk disease with a superimposed representation of screws. The thickness of the posterior cortex adherent to the screws, screw trajectory and their position with regard to the spinal canal was measured. The area of posterior cortex in contact with the screws was also calculated. Results The contact length and area was found to be two times greater for screws introduced with the modified technique. The convergence angle was comparable between the techniques, despite the shift of entry point. There was no canal breach, although with the modified technique the screws passed closer to the spinal canal. Conclusions The modified technique is considered safe. In this technique, the screws pass through a thicker portion of the posterior cortex compared to the classical technique that aims at improving the stability of the fixation

Vibroacoustic diagnostics of a radial microturbine and a scroll expander operating in the organic Rankine cycle installation

The article presents the results of vibroacoustic research on a prototypical 4-stage radial microturbine and a scroll expander operating in the organic Rankine cycle with the low-boiling fluid HFE7100. The high-speed microturbogenerator had the electrical capacity of 3 kWe at the nominal speed of 24000 rpm. The low-speed expander with a capacity of 1 kWe and a nominal speed of 3600 rpm was made by Air Squared. The frequency characteristics and overall vibration level (vibration velocity Vrms) measurements were conducted for both the microturbine and the expander, depending on the rotational speed and on the power consumption of electrical energy receivers. The level of noise emitted by the microturbine and expander was also determined. The research was carried out for various electrical loads of the expansion devices generators running in the ORC system. The devices were tested in the following electric power ranges: from 550 We to 1150 We (scroll expander) and from 800 We to 1800 We (radial microturbine). Based on the obtained results, dynamic state assessment of the tested machines was performed and their noise and vibration levels were analysed

Applying plant lectins to assay the effect of environmental pollution on the glycosylation of human placenta

Our study was designed to establish whether air pollution in urbanized industrial centers of southern Poland affects the process of glycosylation in a full-term human placenta. This process of glycosylation was analyzed by the quantitative determination of the binding of WGA and LCA lectins to placental villi. The study was performed on human placentas collected in 1990-91 and 2000-01 in regions of southern Poland differing in their degree of environmental pollution: the highly polluted areas of Upper Silesia and Cracow agglomeration. The Bieszczady area with low pollution was considered the control. The concentrations of nitrogen and sulfur oxides and the concentration of aerosols were used as markers of the degree of air pollution. The direct immunofluorescence reaction of the placenta tissues with fluorescein-labeled (FITC) lec-tins was used. The staining of the placenta tissues was examined under a fluorescence microscope linked to an analysis system. A microdensytometric method was used to assay the amount of tissue-bound lectins. The results showed no significant effect of the three main air pollutants in the study areas in southern Poland, i.e. nitrogen and sulfur oxides and high level of aerosols, on the structure of WGA-and LCA-specific glycoconjugates in human placenta. However, the marked quantitative changes in th

Investigation of dynamic properties of the microturbine with a maximum rotational speed of 120 krpm – predictions and experimental tests

Advances in the development of analysis and design methods for fluid-flow machines have enabled both their multi-criteria optimisation and miniaturisation. To decrease the size of such a machine whilst, at the same time, maintaining its output power level, the rotor’s rotational speed needs to be increased. It is the reason for serious difficulties with respect to the rotor dynamics and the selection of a bearing system. This article discusses the simulation analysis and experimental research carried out on a prototypical microturbine, designed for use in a domestic ORC (organic Rankine cycle) cogeneration system. During the design process, the basic assumption was to develop a turbomachine, whose dimensions would have been as small as possible and whose output electric power would have been about 1 kilowatt. A supersonic impulse turbine, with a nominal rotational speed of 100,000 rpm, was used in order to obtain high flow efficiency. The maximum speed of the rotor was determined at a level of 120,000 rpm. The article presents the results of analyses made at the design stage and preliminary results of the experimental research. The numerical simulations covered the bearing system optimisation and the rotor dynamics analysis. Next, based on the outcomes of these analyses, a decision was made to use non-conventional gas bearings which are fed by the low-boiling medium’s vapour that comes from the ORC system. Within the framework of the experimental research, the dynamic behaviour of the turbogenerator was examined in terms of the rotational speed and produced energy. The performed measurements are proof of very good dynamic properties of the tested machine and after the research was over it was concluded that there were absolutely no signs of wear of the turbogenerator’s subassemblies