Regulacja funkcji kanałów jonowych Na+ przez receptory opioidowe

Receptory opioidowe typu ц należą do grupy receptorów opioidowych, które m odyfikują funkcję licznych efektorów błonowych (cyklaza adenylowa, kanały jonow e K+, Ca++ i Na+) i cytoplazmatycznych (aktywacja fosfolipazy A2, kinazy białkowej typu C, kinazy МАРК, hamowanie kinazy białkowej typu A). Fosforylacja potencjałozależnych kanałów jonowych Na+ przez kinazę białkową typu A i С prowadzi do zmiany kinetyki prądu jonowych N a+. Celem pracy było zbadanie mechanizmu transdukcji sygnału od receptora opioidowego typu ц do potencjałozależnych kanałów jonowych. Receptory opioidowe aktywowano przez podanie DAM GO - syntetycznego, specyficznego agonisty receptora ц. Podanie DAMGO wywoływało spadek amplitudy oraz zmianę kinetyki prądu jonowego Na+ w neuronach niepiramidowych. Efekt był hamowany po podaniu inhibitorów kinaz białkowych A i C. Z kolei podanie aktywatora kinazy A i С zmieniało kinetykę i amplitudę prądu jonowego N a+ w sposób podobny do DAMGO. W neuronach piramidowych kory przedczołowej nie wykazano wpływu aktywacji receptora opioidowego typu ц na prąd jonow y N a+. Wnioski: W neuronach niepiramidowych kory przedczołowej aktywacja receptorów opioidowych typu ц moduluje funkcje potencjałozależnych kanałów jonowych Na+ w mechanizmie zależnym od kinazy białkowej A i C.Praca była finansowana z budżetu Komitetu Badań Naukowych Projekt No: KBN-0575/P05/2005/28 oraz z budżetu Akademii Medycznej w Warszawie projekt No: 1MA/W2/2005Zadanie pt. „Digitalizacja i udostępnienie w Cyfrowym Repozytorium Uniwersytetu Łódzkiego kolekcji czasopism naukowych wydawanych przez Uniwersytet Łódzki” nr 885/P-DUN/2014 dofinansowane zostało ze środków MNiSW w ramach działalności upowszechniającej naukę

Autoimmune meningitis and encephalitis in adult-onset still disease – Case report

Introduction Adult-onset Still disease (AOSD) is a rare systemic inflammatory disease of unknown cause. Its symptoms usually include persistent fever, fugitive salmon-colored rash, arthritis, sore throat (not specific), but it may also lead to internal organs’ involvement, which presents with enlargement of the liver and spleen, swollen lymph nodes, carditis or pleuritis – potentially life-threatening complications. In rare cases, AOSD can cause aseptic meningitis or/and encephalitis. Case presentation We report a case of 31-year-old male patient, who was referred to neurological department for extending diagnostics of frontal lobes lesions with involvement of adjacent meninges. Abnormalities have been revealed in brain MRI, which was performed due to persistent headaches, visual disturbances, fever, fatigue and cognitive decline. Wide differential diagnosis was performed including laboratory findings, contrast enhanced MRI, MR spectroscopy, flow cytometry and finally brain biopsy to exclude neoplastic or infectious origin. Final diagnosis of autoimmune meningoencephalitis in adult-onset Still disease has been made. Conclusion Adult-onset Still disease is a rare cause of inflammatory changes in central nervous system, which if diagnosed, may be treated successfully with steroids (commonly available agent), intravenous immunoglobulins or more specific immunomodulating regiments

An unusual presentation of Listeria monocytogenes rhombencephalitis

We describe a case of 52-year-old woman with a medical history of Crohn's disease presented abrupt fever, asymmetrical multiple cranial nerve palsies and focal neurological symptoms localized to the brainstem. The patient was initially diagnosed with ischaemic stroke, because of acute clinical course and results of neuroimaging. Cerebrospinal fluid analysis revealed mild infection with negative Gram staining and culture. Final diagnosis of Listeria monocytogenes brainstem infection (rhombencephalitis) was set up on the basis of further clinical course and positive blood cultures. Listerial rhombencephalitis should be kept in mind in immunocompromised adult patients who develop fever, asymmetrical multiple cranial nerve palsies and focal neurological symptoms localized to the brainstem even without typical neuroimaging, cerebrospinal fluid findings and negative cultures. Early diagnosis and adequate antibiotic treatment is of crucial importance

Midbrain and bilateral paramedian thalamic stroke due to artery of Percheron occlusion

Introduction Bilateral thalamic strokes are rare manifestations of posterior circulation infarcts. Usually the etiology is cardioembolic or small vessel disease combined with individual anatomical predisposition. The symptoms include a variety of neurological deficits depending on thalamic structure involvement, such as paresthesias or numbness, hemiparesis with increased reflexes and Babinski sign, third cranial nerve palsy, speech and cognition disturbance, memory impairment and stupor. Neuroimaging usually reveals ischemic loci in adequate thalamic nuclei. Case presentation We report a case of 61-year-old man, active smoker (25/per day, 50 pack-years) with untreated hypertension who presented at admission consciousness impairment (Glasgow Coma Scale score 9 points), left pupil dilatation without reaction to light, left eye deviation downwards and outwards, vertical gaze paralysis and left-sided hemiplegia. Initial brain computed tomography (CT) was normal. Brain magnetic resonance with diffusion weighted imaging and fluid attenuation inversion recovery sequences (MR DWI/FLAIR) performed on admission showed ischemic changes in bilateral thalami, which were confirmed in routine MRI. Thrombosis of basilar artery and cerebral venous was excluded in CT angiography. Further diagnostic assessment revealed hyperlipidemia, paroxysmal atrial fibrillation and renal cancer with hepatic metastases. Conclusion Bilateral thalamic stroke due to artery of Percheron occlusion is a rare presentation of stroke, which can be overlooked in routine CT scan. If diagnosed, it requires further evaluation for stroke risk factors, especially cardiovascular disorders associated with increased embolic risk

Enzymatic replacement therapy in patients with late-onset Pompe disease – 6-Year follow up

Introduction Late-onset Pompe disease (LOPD) is a progressive metabolic myopathy, affecting skeletal muscles, which, if untreated, leads to disability and/or respiratory failure. The enzyme replacement therapy (ERT) improves muscle strength and respiratory function and prevents disease progression. We present a 6-year follow-up of 5 patients with LOPD treated with ERT. Methods Five patients with LOPD received ERT: two started treatment in 2008, other two in 2010 and one in 2011. All patients received recombinant human alpha-glucosidase in dose 20mg/kg intravenously every two weeks. Physical performance was assessed in 6-minute walk test (6MWT) and spirometry was performed to examine FVC and FEV1. Liver enzymes, CK levels were also assessed. Results The walking distance in 6MWT increased by average 16.9±2.26% in the first three years of treatment. Similar changes were detected in spirometry: the most significant FVC increase was observed in two patients with the highest FVC values before treatment, which increased to normal values adjusted for age and sex in three years of treatment, that is by 28% and 34%. In two other patients FVC reached 88% and 76% of predicted values. ERT also improved the liver and muscle enzymes levels. Conclusion The improvements of exercise tolerance and FVC were observed in all patients in the first three years of treatment and were the most pronounced in the longest-treated patients and with the least severe neurological and respiratory symptoms. Our research suggests that early start of the ERT results in higher improvement of respiratory and ambulation functions

Comprehensive imaging of stroke – Looking for the gold standard

Background and purpose Stroke is the third cause of death worldwide. In recent decade there has been a marked progress in treatment and prevention of stroke, which was possible largely due to modern neuroimaging techniques. Early radiological confirmation of the diagnosis allows for introduction of fibrinolytic therapy and evaluation of ischaemic penumbra. Material and methods We have analysed clinical and imaging data of 92 patients with early stages of stroke. The sensitivity, specificity and possible influence on the choice of treatment were assessed for different neuroimaging techniques, including diffusion weighted and perfusion imaging in patients with hyperacute and acute stroke. Results A non-contrast computed tomography (CT) allowed for the detection of early ischaemic changes with an overall sensitivity of 38% and 42% in patients in hyperacute phase. In a perfusion CT study the perfusion abnormalities in the area corresponding to the clinical symptoms were present in 79% of patients. The sensitivity of diffusion weighted imaging (DWI) alone was 95% and in conjunction with perfusion MR reached 100%. Conclusions Our study proves that advanced neuroimaging modalities allow for a substantial increase of sensitivity when detecting changes in patients with acute ischaemic strokes and confirming the clinical diagnosis. We believe that MR in combination with DWI should be the imaging methods of choice in diagnosing acute stroke patients. Perfusion adds significant diagnostic value to structural techniques, particularly in clinically ambiguous cases. In cases with a clear clinical picture the data provided by a non-contrast CT study is sufficient for therapeutic decision making

In situ simulation training in First Aid. Pilot study. First aid in a dangerous workplace

Abstract Purpose The aim of the study was to evaluate the newly develop course prepared for the employees working in the forest and mountain environmentMethodology 31 people participated in the course. They were employees of Roztocze National Park and the Forestry Commission Lutowiska. A diagnostic survey was implemented in a form of a questionnaire. The respondents were provided with two original questionnaires and a telephone survey. Surveys were anonymous and voluntary.Findings The average assessment of First Aid knowledge before the workshop was 2.48 and majority of participants assesed First Aid as difficult. After the workshop, the respondents assessed the knowledge on average as 3.87 and as much as 58% declared that definitely would provide First Aid to a stranger; 81% to a close person. Over 80% of respondents noticed the need of  regular training in First Aid.Research implication The analysis showed that regular improvement of First Aid skills is required by the participants. The training should be adjusted to the group’s needs in terms of the program, teaching techniques and the place of training. There is a need to implement such training on a wider scale among forestry and mountain workers.OriginalityUncovering the gaps in First Aid training in mountain and forest workers in their professional training

Self-Identification of Polish Academic Economists with Schools of Economic Thought

The paper presents the results of a research conducted in 2014–2016, aimed at characterising the milieu of the Polish academic economists with respect to their self-identification with modern schools of economic thought. Using econometric modelling, the social variables determining the theoretical choices made by the economists themselves were identified. We found that the largest group of the Polish academic economists identifies themselves with new institutional economics. Nearly half of the respondents declared their association with heterodox approaches, while only about a quarter of the respondents showed association with economic orthodoxy. Such a structure of self-identification of the Polish academic economists with schools of economic thought distinguishes it from the ones in other European countries, such as Italy and Germany