Nutritional Status and Selected Adipokines in Children with Irritable Bowel Syndrome

BACKGROUND

The aim of this study was to assess the nutritional status and serum concentrations of adipokines in children with irritable bowel syndrome (IBS) and healthy controls. We also sought to evaluate their relation to metabolic parameters.

METHODS

We studied 33 IBS patients (11 girls, 22 boys) aged 5-17 years and 30 healthy age-matched controls (11 girls, 19 boys). The analysis included anthropometric measurements, body composition parameter measurements using bioimpedance, and biochemical tests and measurements of serum concentrations of leptin, adiponectin, chemerin, and omentin-1.

RESULTS

The results of the anthropometric measurements were comparable between the patients and the controls. The patients had higher triglycerides, HOMA-IRs, and chemerin concentrations than the healthy subjects. The HDL cholesterol and omentin-1 levels were lower than in the controls. Leptin and adiponectin did not differ significantly between the groups. An analysis of the receiver operator curves (ROCs) showed that serum concentrations of chemerin ≥ 232.8 ng/mL had 30% sensitivity and 87% specificity when they were used to differentiate between children with IBS and healthy subjects. In the case of serum omentin-1 concentrations ≤ 279.4 ng/mL, the sensitivity and specificity were 60% and 80%, respectively.

CONCLUSIONS

The nutritional status of children with IBS did not differ from that of the healthy controls. We found significant differences in serum chemerin and omentin-1 concentrations between IBS patients and healthy children. These adipokines could be used as IBS biomarkers as they demonstrate good specificity and moderate sensitivity. The serum concentrations of chemerin and omentin-1 in IBS patients were related to nutritional status and insulin resistance.

Evaluation of the Frequency of ADIPOQ c.45 T>G and ADIPOQ c.276 G>T Polymorphisms in the Adiponectin Coding Gene in Girls with Anorexia Nervosa

INTRODUCTION

Anorexia nervosa (AN) is a serious chronic psychosomatic disorder, the essence of which are attempts to obtain a slim silhouette by deliberate weight loss (restrictive diet, strenuous physical exercise, provoking vomiting). The etiology of this disorder is multifactorial. Genetic factors which influence the predisposition to AN have been searched for. A broad meta-analysis points to a strong genetic correlation between AN and insulin resistance. Adiponectin (ADIPO) increases insulin sensitivity. In our pilot study we demonstrated that the TT genotype in loci ADIPOQ c.276 G>T of the ADIPO gene and a higher concentration of ADIPO in blood serum occurs significantly more frequently in 68 girls suffering from AN than in 38 healthy girls. The objective of this study is to evaluate the frequency of the occurrence of ADIPOQ c.45 T>G and ADIPOQ c.276 G>T in the ADIPO gene in a bigger cohort of girls with AN and healthy girls, as well as an analysis of correlations between variants of the aforementioned polymorphisms and the levels of ADIPO in blood serum.

MATERIALS AND METHODS

The study covered 472 girls (age: 11-19): 308 with the restrictive form of AN (AN), and 164 healthy girls (C). The level of ADIPO in blood serum was determined by means of the ELISA method on Bio-Vendor, LLC (Asheville, North Carolina, USA). The DNA isolation was carried out by means of Genomic Mini AX BLOOD (SPIN). The PCR reaction was carried out in the thermocycler ThermoCycle T100. 80-150 ng of the studied DNA and relevant starters F and R were added to the reaction mixture. The reaction products were subjected to digestion by restriction enzymes and separated on agarose gels (RFLP).

RESULTS

The distribution of genotypes in the polymorphic site ADP c.45 of the ADIPO gene and ADP c.276 was similar in both groups. In both groups the T allele was most frequent in loci ADIPOQ c.45 and the G allele in loci ADIPOQ c.276. In all the study subjects collectively (AN and C) a statistically significant negative correlation between the levels of ADIPO in blood serum on one hand and the body weight (r= -0.46; p< 0.0001) and BMI (r= -0.67; p< 0.0001) on the other was demonstrated. Exclusively in the AN group a significant correlation between the level of ADIPO in blood and the distribution of TG, TT, and GG alleles in loci ADIPOQ c.45 and ADIPOQ c.276 was demonstrated (p= 0.0052 and p< 0.0001; respectively).

CONCLUSIONS

The genotype in loci ADIPOQ c.45 and ADIPOQ c.276 of the ADIPO gene seems to have no effect on the predisposition to AN. Girls suffering from AN with the TT genotype in loci ADIPOQ c.45 and ADIPOQ c. 276 may demonstrate higher insulin sensitivity as they have significantly higher levels of ADIPO than girls suffering from AN with other genotypes. This may be suggestive of their better adaptation to the state of malnutrition, as well as it can have a potential effect on treatment effects.

Evaluation of the Frequency of RETN c.62G>A and RETN c.-180C>G Polymorphisms in the Resistin Coding Gene in Girls with Anorexia Nervosa

INTRODUCTION

Anorexia nervosa (AN) is a serious psychosomatic syndrome, classified as an eating disorder. AN patients strive to lose weight below normal limits defined for a specific age and height, achieving their goal even at the expense of extreme emaciation. AN has a multifactorial etiology. Genetic factors are believed to be significant in the predisposition to the development of AN. In girls suffering from AN significantly lower levels of resistin (RES) in blood serum are observed as compared to healthy girls. These differences may lead to a thesis that functional genetic polymorphisms in RES coding genes can be responsible for this phenomenon. In our pilot study we demonstrated significant differences in the distribution of genotypes in the loci RETN c.-180C>G of the RES gene in 67 girls with AN and 38 healthy girls. It seems reasonable to compare the frequency of polymorphisms of RETN c.62G>A and RETN c.-180C>G in the RES gene in girls with AN and in healthy subjects in a bigger cohort and to analyse correlations between individual variants of the polymorphisms referred to above and the RES levels in blood plasma.

MATERIAL AND METHODS

The study covered 308 girls with the restrictive form of AN (AN) and 164 healthy girls (C) (aged 11-19). The RES levels in blood serum were determined by means of the ELISA method on Bio-Vendor, LLC (Asheville, North Carolina, USA). The DNA isolation was carried out by means of Genomic Mini AX BLOOD (SPIN). The PCR reaction was carried out in the thermocycler ThermoCycle T100. 80-150 ng of the studied DNA and relevant starters F and R were added to the reaction mixture. The reaction products were subjected to digestion by restriction enzymes and separated on agarose gels (RFLP).

RESULTS

The average RES level in blood serum in the AN group was significantly lower (p< 0.0001) than in the C group. The distribution of genotypes in the loci RETN c.62 of the RES gene was similar in both groups. A significant difference was demonstrated in the distribution of genotypes in the polymorphic site RETN c.-180 of the RES gene between AN and C (p=0.0145) and in the distribution of the C and G alleles in the loci RETN c.-180 (p< 0.0001). The C allele occurred significantly more frequently than the G allele in the C group as compared to the AN group. In all the study subjects jointly (AN and C) a significant positive correlation between the blood RES levels on one hand and the body mass (r= 0.42; p< 0.0001) and BMI (r= 0.61; p< 0.0001) on the other hand was observed. There was no correlation between the concentration of RES in blood serum and the distribution of genotypes in the loci of the resistin gene referred to above.

CONCLUSIONS

The CG genotype in the loci RETN c.-180 C>G of the RES gene may constitute one of the factors predisposing to the development of AN in girls. The genotype in the loci RETN c.62 G>A and RETN c.-180 C>G of the resistin gene has no influence on the levels of this hormone in blood in AN patients.

Rare case of nephrocalcinosis in a 14-year-old girl: Questions

A 14-year-old Caucasian girl with a history of primary hypoparathyroidism and unstable calcium and phosphorus levels and on ongoing treatment was admitted to the Department of Pediatric Nephrology because of the onset of nephrocalcinosis and difficulties achieving normocalcemia. Coexistence of hypoparathyroidism, oral candidiasis, dental enamel hypoplasia, and subclinical Hashimoto's disease was strongly suggestive for autoimmune polyglandular syndrome (APS) type I. One of the clinical implications of this diagnosis is the high probability of future occurrence of adrenal insufficiency and hence the importance of maintaining a high level of suspicion in case of the onset of symptoms like weakness, fainting, hypotonia, or hyperkaliemia. Addison's disease would, in fact, be quite challenging for the future management of this patient.This clinical quiz highlighted the importance of careful evaluation of all multiorgan symptoms occurring in a patient to prevent further complications.

Evaluation of serum chemokine RANTES concentration as a biomarker in the diagnosis of early-onset severe infections in neonates

OBJECTIVE

Only a few studies on improving the early diagnosis of severe neonatal infections have focused on the role of serum RANTES concentration (sRC). The aim of the study was to establish sRC in neonates with early-onset infections, according to their gestational age, sex, birth asphyxia, mode of delivery and value of some biochemical and hematological parameters.

MATERIAL/METHODS

The analysis comprised 129 neonates, including 89 infected (52 preterm, 37 full-term; 43 with sepsis, 39 with congenital pneumonia, 7 with severe urinary tract infection) and 40 healthy (control group, 25 full-term, 15 preterm). The sRC in peripheral vein blood was measured by the ELISA method using Quantikine Set (R & D systems, USA).

RESULTS

The sRC in infected neonates ranged from 10.83 to 122.55 μg/ml, in full-term neonates from 18.28 to 122.55 μg/ml, and in preterm from 10.83 to 118.24 μg/ml. The mean sRCs in full-term septic neonates (73.95±25.99 μg/ml) and with organ infections (58.43±29.24 μg/ml) were significantly higher than healthy ones (28.25±14.06 μg/ml). The mean sRCs in septic preterm neonates (59.17±28.29 μg/ml) and those with organ infections (50.86±28.16) were significantly higher than in healthy preterm neonates (25.61±8.29 μg/ml). Positive correlations between sRC and CRP value (r=0.3014, p=0.004) and between sRC and band cell count (r=0.2489, p=0.019) were found in all infected neonates.

CONCLUSION

The significant increase of serum RANTES concentration in early-onset infections in neonates, regardless of their gestational age, sex and birth asphyxia, not only proves the presence of an active immunological process but also may be a useful biomarker for diagnosis of severe neonatal infections.

Chemerin serum levels in girls with anorexia nervosa

BACKGROUND

The regulatory function of chemerin (CHEM) in the process of adipogenesis and the metabolism of adipocytes has been confirmed. Data from several studies have shown higher serum CHEM in obesity. To date, there are no available studies on serum CHEM concentrations in patients with anorexia nervosa (AN), which is recognized as a good biological model of the chronic atrophy of adipose tissue and energy metabolism disorders in humans.

OBJECTIVES

The aim of the study was to assess serum CHEM concentrations in girls with AN in comparison to healthy and obese subjects and determine its relationship with body mass, BMI and insulin.

METHODS

CHEM serum concentrations were evaluated using commercially available ELISA kit in 65 Polish girls with restrictive AN, in 39 healthy controls (H) and 64 girls with simple obesity (OB).

RESULTS

The mean serum CHEM concentration in the AN group was significantly lower than in the H and OB groups. After adjusting for BMI, CHEM concentrations in the AN group were significantly lower than in the H group, but statistically higher than in the OB group. Significant correlations between serum CHEM and body mass (r=0.77), BMI (r=0.82), Cole index (r=0.81) and serum insulin (r=0.78) were observed.

Assessment of serum visfatin levels in girls with anorexia nervosa

OBJECTIVE

Visfatin (VISF) is a recently described peptide regulating the process of adipocyte differentiation. Only one pilot study of VISF expression in the fat tissue and its circulating concentrations in a small group of patients with anorexia nervosa (AN) have been published, yet.

DESIGN AND PATIENTS

Cross-sectional assessment of VISF serum concentrations in 195 girls aged 11-18·9 years with AN (n = 87), eating disorders not otherwise specified (NOS; n = 17), simple obesity (OB; n = 30), and healthy controls (H; n = 61).

MEASUREMENTS

Blood samples were collected during the fasting state between 7:00 am-8:30 am. VISF serum concentrations were determined using enzyme immunoassay. Comparisons of VISF levels between groups were performed.

RESULTS

Mean serum VISF concentrations in girls with AN and NOS were significantly lower than those in the H and OB groups. Serum VISF concentrations were higher in the OB than in the H groups. When were calculated per body mass index (BMI), VISF concentrations were significantly lower in the AN, NOS, and OB groups than in healthy controls. Among participants with a normal BMI, serum VISF concentrations correlated positively with BMI (r = 0·27; P < 0·05). In the OB group, a significant, negative correlation between BMI and VISF levels (r = -0·38; P = 0·04) was observed.

CONCLUSIONS

Compared with healthy girls, serum VISF concentrations are decreased in girls with AN. Conversely, obese girls have elevated VISF levels. When calculated per BMI (VISF/BMI), the results in AN and OB groups were lower than in healthy participants.

Assessment of serum levels resistin in girls with anorexia nervosa. Part II. Relationships between serum levels of resistin and thyroid, adrenal and gonadal hormones

OBJECTIVES

Thyroid, adrenal glands and gonadal hormones play a role in maintaining metabolic homeostasis of the body via the receptors located in the adipose tissue. The correlations between serum resistin (RES) and function of other hormonal axes in patients with AN have not been established, yet. Therefore, the aim of this study is: 1) assessment of concentrations of thyroid hormones (FT4, TSH), adrenal hormones (ACTH, cortisol), sex hormones (LH, FSH, estradiol, testosterone); 2) establishing their relationship with BMI and 3) analysis of correlations between examined hormones and RES serum concentrations in adolescent female patients with AN.

DESIGN AND SETTING

Serum RES (ELISA) and fT4, TSH, ACTH, LH, FSH, estradiol and testosterone (ECLIA) concentrations have been assayed in 195 adolescent girls: 87 with restrictive AN, 17 with not otherwise specified eating disorders (NOS), 30 with simple obesity (OB) and 61 healthy (H) subjects.

RESULTS

Mean serum FT4, LH and estradiol concentrations were significantly lower (p=0.015; p<0.0001; p<0.0001, respectively) in AN than in OB group, and cortisol increased (p<0.001) compared to OB and H subjects. In all examined subjects BMI correlated positively (p<0.0001) with LH (r=0.61) and estradiol (r=0.30), and negatively with cortisol (r=-0.35; p=0.008). Also the significant positive relationship between serum RES and FT4 (r=0.34), LH (r=0.57) as well as estradiol (r=0.28) was observed, whereas serum cortisol correlated negatively with RES (r=-0.40).

CONCLUSION

Changes in resistin serum concentrations in eating disorders may be involved in the altered regulation of hypothalamic-pituitary-adrenal, thyroid and gonadal axes.

Assessment of serum levels resistin in girls with anorexia nervosa. Part I. Relationship between resistin and body mass index

OBJECTIVES

There are only few studies available on blood resistin (RES) levels in patients with anorexia nervosa (AN), which revealed scarce results, however it has been demonstrated that RES mRNA expression in adipose tissue of these patients is increased. The aim of this study is: 1) the evaluation of serum resistin levels in girls with AN and determination a threshold value differentiating these patients from healthy subjects; 2) analysis of the relationship between serum resistin levels and BMI in examined subjects.

DESIGN AND SETTING

Serum RES concentration has been assayed using ELISA kit in 195 adolescent girls: 87 with restrictive AN (mean BMI-SDS: -2.65 ± 0.2), 17 with not otherwise specified eating disorders (NOS) (mean BMI-SDS: -1.4 ± 0.68), 30 with simple obesity (OB) (mean BMI-SDS: 6.91 ± 1.23) and 61 healthy (mean BMI-SDS: -0.18 ± 0.54).

RESULTS

Mean serum RES concentration in AN (2.8 ± 0.6 ng/ml) and NOS (3.1 ± 0.9 ng/ml) were significantly lower (p<0.0001) than in OB and H groups (4.8 ± 0.5 and 4.1 ± 0.4 ng/ml respectively). After corrected for BMI, RES values in AN were similar as in H subjects, but significantly higher (p<0.005) in comparison to OB group. ROC curve analysis revealed that 3.87 ng/ml is the threshold value of RES serum concentration differentiating AN from H girls (specificity 100%, sensitivity 80%). No significant correlations between BMI and serum resistin concentration are found in AN group, although a significant positive correlation has been established for all examined subjects.

CONCLUSION

Additional adaptive mechanisms may be involved in regulation of RES levels in adolescent girls with AN.

Assessment of serum apelin levels in girls with anorexia nervosa

CONTEXT

Pilot studies in rats have suggested that apelin (APE) is involved in the control of appetite and food intake. APE is secreted in the organs involved in the control of hunger and satiety: the stomach, hypothalamus, and fat tissue. Anorexia nervosa (AN) is an eating disorder that represents a good biological model of chronic fat tissue atrophy in humans. To date, there are no reports of APE expression in the fat tissue and its circulating concentrations in patients with AN.

OBJECTIVE

Our objective was to assess serum APE concentrations in girls with AN.

DESIGN, PARTICIPANTS, AND SETTING

APE-36 and APE-12 serum concentrations were evaluated in 87 Polish girls with restrictive AN, in 61 healthy (H) controls, 17 girls with no otherwise specified eating disorders (NOS), and 30 girls with simple obesity (OB).

RESULTS

Mean serum APE-36 and APE-12 concentrations in patients with AN and NOS were significantly lower than in the H and OB groups. However, no differences between AN, H, and NOS groups were observed when APE concentrations were calculated per body mass index (BMI). In participants with normal BMI, serum APE-36 (r = 0.35) and APE-12 (r = 0.37) concentrations correlated positively with BMI.

CONCLUSIONS

We conclude that compared with H controls, serum APE-36 and APE-12 concentrations decreased as a result of fat tissue depletion in patients with AN. Conversely, obese adolescents had elevated APE-36 and APE-12 due to excessive fat mass as well as increased APE production in adipose tissue.

An analysis of factors determining serum leptin concentration in healthy and infected newborns

OBJECTIVE

The effect leptin on fetal growth in healthy and infected newborns is not well known. This study is aimed at: 1) evaluating serum leptin concentration in full term and preterm, healthy and infected newborns, according to their gender, birth asphyxia, intrauterine and neonatal infections, and 2) assessing the correlation between serum leptin levels and anthropometric parameters among healthy and infected newborns.

MATERIALS AND METHODS

The study involved 146 newborns: 73 full-term and 73 preterm, 86 male and 60 female, 56 healthy and 90 infected, aged from 2nd to 4th day of life. Anthropometric parameters, including: birth weight, length, head and chest circumference, and serum leptin concentration were measured in all the subjects. Intrauterine and neonatal infections were diagnosed by the standard criteria.

RESULTS

In this study, it was found that both healthy and infected, but full-term newborns had significantly higher mean leptin concentration than the premature ones (p<0.05). Statistically significant (p<0.05), positive correlations were found between serum leptin level and gestational age, birth weight, head and chest circumference, both in healthy, and in infected newborns.

CONCLUSIONS

Findings of this study suggest that the serum leptin concentration in full term newborns is higher than in the preterm ones, and in females it is higher than in males, 2) among both healthy and infected newborns, there is a positive, linear correlation between the serum leptin concentration and anthropometric parameters, 3) intrauterine and neonatal infections do not have a significant influence on serum leptin concentration. The role of leptin in fetal growth deserves further research.

Effects of feminizing surgery for ambiguous genitalia - a novel scale for evaluation of cosmetic and anatomical results

INTRODUCTION

Ambiguous genitalia always present diagnostic and therapeutic problem. Long-term results of feminizing operations are unsatisfactory in some cases and reports from follow-up after feminizing genitoplasty are rare in the literature. Systematic studies are needed to evaluate ultimate function of all girls undergoing feminizing surgery. In our opinion, the lack of worldwide-accepted scale for the assessment of long-term effects of feminizing genitoplasty, enabling the possibility of comparing outcomes between institutions and countries, may contribute to this deficit of reliable data.

AIM

The aim of the study was the evaluation of the outcomes of surgical management of masculinization using a novel scale developed by the authors.

MATERIAL AND METHODS

We examined 43 patients aged 3-24 years (mean age 15,4 years) operated due to ambiguous genitalia. Most of the patients were females with congenital adrenal hyperplasia (CAH) diagnosed in 38 of subjects (88.4%).The patients were operated at the age from 10 months - 15 years (mean age 4,5 years). Five patients had to be reoperated. The effects of surgical management in ambiguous genitalia were assessed using our own scale. We evaluated five anatomical and cosmetic parameters (general appearance, size of pudendal labia, symmetry of pudendal labia symmetry, size and position of clitoris, size of introitus and position of urethra opening), each of them was scored 0-2 points.

RESULTS

In 36 of examined patients the result of the surgery was considered good, in 4 patients - satisfactory and in 3 - poor. The most common complication of feminizing genitoplasty in our patients was stenosed vagina (in 10 patients, 23.8%). Location of urinary coil in anterior wall of vagina was found in 6 patients (13.9%) and in 1 patient it was invisible (2.3%). Post-operational clitoral enlargement was found in 3 cases (6.9%).

CONCLUSION

Taking into consideration controversial data about the results of feminizing genitoplasty, a standarized, well-defined and commonly accepted scale enabling comparison between methods and institutions is necessary. In our opinion scoring scale makes the evaluation more precise and the results are more comparable.

Effect of intrauterine infection and perinatal risk factors on serum concentrations of insulin like growth factor (IGF-I) in full-term and preterm newborns

OBJECTIVES

IGF-I is believed to be a key factor in fetal growth dynamics It is widely known, that serious early-onset infection in the newborn is a risk factor for further developmental disturbances in a child. However, effect of congenital infection as well as an influence of infectious and non-infectious perinatal risk factors on circulating IGF-I concentrations in newborns has not been examined, yet.

DESIGN

Thus, the aim of this study was: 1) evaluation of IGF-I venous blood serum concentration in full-term and premature infants considering their sex, occurrence of intrauterine infection and perinatal risk factors; 2) establishing the relationship between IGF-I serum concentrations and chosen anthropometric parameters values in infected and healthy newborns.

SETTING

The study involved 112 newborns appropriate for gestational age. Taking into consideration occurrence of early onset infection and gestational age we divided examined children into 4 groups: I group--infected, full-term newborns; II group--infected premature newborns; III group--healthy full-term newborns; IV group--healthy premature newborns. In all infants immediately after birth anthropometric measurements were performed (birth weight, body length, circumference of head and circumference of chest) and serum IGF-I concentration was determined.

RESULTS

We demonstrated that full-term infants with intrauterine infection have statistically significantly higher concentration of IGF-I in blood serum than infected premature infants and healthy full-term infants. Analysis of correlation revealed a significant positive linear correlations between IGF-I serum concentration and gestational age and anthropometric parameters values.

CONCLUSIONS

We conclude that intrauterine infection increases serum IGF-I concentration in full-term infants, but not in preterm infants, that may be a result of immaturity. We suggest serum IGF-I concentration may be considered an additional element of developmental and nutritional state assessment in infected newborn.

Growth hormone therapy in boy with panhypopituitarism may induce pilomatricoma recurrence: case report

Pilomatricoma is usually a solitary subcutaneous nodule. Recurrence of the nodule after surgical excision is very rare. Pilomatricoma occurrence in patients with growth hormone (GH) deficiency has not been reported, yet. We report a 14-year-old boy with pilomatricoma and panhypopituitarism. After GH therapy had been started, we observed two relapses of previously completely excised pilomatricoma in the same location and a new pilomatricoma formation on the chin.

Effects of neuroendocrine changes on results of ambulatory blood pressure monitoring (ABPM) in adolescent girls with anorexia nervosa

OBJECTIVES

Anorexia nervosa (AN) is characterized by marked neuroendocrine and autonomic dysfunctions. In the recent studies using automatic blood pressure monitoring (ABPM), lower BP values and lack of circardian variation of BP in anorectic patients were demonstrated. Unfortunately effects of hormonal changes, that may explain BP abnormalities were not analysed together.

DESIGN

The aim of our study was the assessment of ABPM and hormonal status in anorectic girls.

SETTINGS

The study was performed on hospitalized 25 female anorectic adolescents aged 12-18 years. Control group was 17 age and height matched girls with normal weight and negative history for hypertension. ABPM was performed between 5 and 7 day of hospitalization, every 30 minutes during active period and every 60 minutes during sleep. Hormones (FSH, LH, estradiol, cortisol and fT4) serum concentrations were also evaluated.

RESULTS

Mean systolic BP values were significantly lower in patients with AN in comparison to controls. Maximal diastolic and mean arterial pressure values for the whole day and active period but not for sleep were lower in AN than in controls. Anorectic girls showed tendency to night-time bradycardia. Moreover, there were no physiological circadian variations of BP in AN.

CONCLUSIONS

We conclude that hormonal regulation of blood pressure and heart rate in anorectic patients is at least partially preserved. Lower blood pressure values, bradycardia and lack of physiological night fall of BP in anorectic patients may result from altered autonomic system function resulting from hormonal disturbances and other centrally mediated mechanisms.

[Anorexia nervosa in boys and men]

Anorexia nervosa (AN) is thought to appear predominantly in girls and young women. Twenty years ago the incidence of AN was considered as 1 boy to 10-15 girls. Recent data suggest that the girls to boys rate is 4:1. The most frequently AN in boys begins during puberty. Boys and young men reluctantly apply for help to medical professionals trying to hide their symptoms. The diagnosis of AN is established and the treatment is being performed only when they suffer from a marked loss of weight or a severe depression with suicidal thoughts. We report seven male patients with AN and review the differences in a course of this disease between male and female patients.

[Spirometric tests in school-age children with past bronchopulmonary dysplasia]

The aim of the paper was to estimate 9 spirometric parameters in 38 children aged 8-12, among them in16 with past bronchopulmonary dysplasia and in 22 healthy ones. Mean values of VC, FEV1, FVC Ex, PEF, MEF 75, MEF 50 and MEF 25 in children with past bronchopulmonary dysplasia were significantly lower than in healthy children. In children with past bronchopulmonary dysplasia VC was decreased comparing to normal values in 94% of cases, FVC Ex and MEF 50 in 75% and FEV1 in 63% of subjects. Tiffeneau coefficient and value of FEV1% FVC Ex were normal. Inhaled salbutamol increased significantly the mean values of VC and MEF 25 in children with dysplasia. The increase of FEV1 > 15% in 56% and VC > 15% only in 25% of these children was observed. It was found, that past bronchopulmonary dysplasia induces ventilatory disorders, mainly restriction changes with obstruction component in airways of school-age children.

[Quantitative changes of CD3+, CD4+, CD8+, HLA-DR+, T lymphocytes and CD25+ cells in eutrophic full-term neonates with staphylococcal septicemia]

OBJECTIVE

Influence of staphylococcal septicemia on changes of share and changes of amount of CD3+ lymphocytes and their subpopulation as well as CD25+ cells in eutrophic full-term neonates.

MATERIALS AND METHODS

In 52 full-term neonates, with birthweight ranged from 2900 to 4500 g, including 30 infants with staphylococcal septicemia caused by Staphylococcus epidermidis (19 cases), S. sciuri (2 cases) S. varneri, S. hominis, S. haemolyticus and S. aureus (6 cases) and 22 healthy neonates (control group) the subpopulation of CD3+, CD4+, CD8+, HLA-DR+ lymphocytes in venous blood was estimated using flow cytometer FACScan with monoclonal antibodies of Becton Dickinson.

RESULTS

Average percentage of CD3+ (69.2 +/- 5.9%), CD4+ (48.9 +/- 10.7%) and HLA-DR+ (1.8 +/- 0.9%) lymphocytes and average CD4+/CD8+ ratio (2.97 +/- 1.33) in neonates with septicemia did not significantly differ from average values of these parameters in healthy neonates that were: CD3+ (69.1 +/- 9.0%), CD4+ (47.4 +/- 10.6%), HLA-DR+ (1.5 +/- 0.5%) and CD4+/CD8+ (2.29 +/- 1.29). Likewise the average numbers of these lymphocytes were close to the values found in the control group. Whereas the average subpopulation of CD8+ (19.2 +/- 4.6%) lymphocytes in ill neonates was significantly lower (p = 0.007) than in healthy ones (23.6 +/- 6.6%), and the average number of CD25+ cells was essentially (p = 0.01) higher in septicemia neonates (8.5 +/- 2.5) compared to the control group (6.6 +/- 1.3%). Average numbers of these cells in ill neonates did not substantially differ from their average values in control group.

CONCLUSIONS

1. Staphylococcal septicemia significantly decreases the values of subpopulation of CD8+ lymphocytes and increases the number of CD25+ cells in eutrophic full-term neonates. 2. Estimation of lymphocytes, and their subpopulation and CD25+ cells in neonates with staphylococcal septicemia may be useful in assessment of immunological changes in severe infections.

[The influence of perinatal risk factors on the number of CD3+ lymphocytes and CD25+ cells in full-term neonates]

In 39 full-term neonates aged from 1 to 7 days of life, among them 24 with perinatal risk factors and 15 healthy as the control group, immunophenotyping of CD3+ and CD25+ cells using Becton Dickinson flow cytometer and monoclonal antibodies and CD3+ and CD25+ was performed. It was stated, that the mean relative and absolute number of CD3+ T lymphocytes in high risk neonates did not differ from the mean values in control group. The premature rupture of fetal membranes in mothers caused a significant increase of mean relative number of CD3+, whereas it did not influence on the absolute number of these cells. Significant increase of mean relative and absolute number of CD25+ cells in neonates with perinatal risk factors in comparison with the control group was noted. Mean relative and absolute number of CD25+ cells were significantly higher in neonates with non-infectious risk factors than in neonates with infectious risk factors. Authors emphasize that, evaluation of CD25+ cells is useful in the assessment of immunological changes in high risk neonates.

[The influence of severe infections on the natural killer cells in neonates with vary gestational age]

In 27 infected neonates (16 boys and 11 girls) with birth weight ranged from 1200 to 4500 g (mean 2670 +/- 827 g) and gestational age from 31 to 41 weeks (mean 36.7 +/- 4.1), among them 11 (41%) with birth asphyxia, between 1 and 7 day of life flow cytometric immunophenotyping of the relative sizes of natural killer cells (CD3-/CD16-56+) using monoclonal antibodies of Becton Dickinson were made. The following infections were diagnosed in the neonates: bacterial septicemia (gram-positive in 13 cases, gram-negative in 5 cases), pneumonia in 6 cases and purulent meningitis in 3 cases. Control group consisted of full-term, healthy, eutrophic neonates born in Military Medical Academy in Lódź between 1994-95 years, in which immunological studies were made with the same method and dr Banasik, agreed for using her results for statistical analysis. It was stated, that in infected full-term neonates the mean relative size of NK cells was 10.7 +/- 5.1% and in prematures 12.8 +/- 7.2% and did'n differ significantly from the control. Kind of infection had no significant influence on the mean relative size of these cells, because in septic neonates was 11.7 +/- 5.7% and in other infected babies 11.6 +/- 7.2%. It was found that infected neonates without respiratory insufficiency and shock had significantly higher (13.2 +/- 6.4%) relative size of NK cells than healthy. The lowest value (7.0 +/- 4.8%) of NK cells during infections in dead neonates were noted (4 cases, among them 2 septic with shock and 2 pneumonic prematures with intraventricular haemorrhages).

CONCLUSION

The severity and bad results of the treatment in neonatal infections may be due to deficit of NK cells.

[Acute lymphoblastic leukemia in children with Fanconi anemia]

Fanconi anaemia (FA) is a rare autosomal recessive disorder. Manifestation of the disease is pleomorphic and may include many congenital malformations and marrow aplasia. Congenital disorders include: skeletal abnormalities, hypo- or hyperpigmentation of the skin, renal or heart anomalies and many others. FA is an invariably fatal disease owing to progressive marrow aplasia or the development of acute leukaemia or squamous cell carcinoma. We present two children with Fanconi anaemia who developed acute lymphoblastic leukaemia in the 4 and 12 year of life.