Clinical Evaluation of the Safety and Feasibility of Whole Autologous Cord Blood Transplant as a Source of Stem and Progenitor Cells for Extremely Premature Neonates: Preliminary Report

OBJECTIVES

This is a preliminary, single-center, prospective study in the field of autologous cord blood transplant. We investigated the feasibility, safety, and tolerability of autologous whole cord blood transplant in extremely premature infants as a potential therapeutic modality to prevent developing complications related to prematurity.

MATERIALS AND METHODS

This preliminary prospective study (ClinicalTrials.gov identifier NCT02050971) included preterm infants born at less than 32 weeks of gestational age who developed anemia because of prematurity. Infants were assigned to 2 groups: (1) those receiving an autologous cord blood transfusion within 5 days postpartum (n = 5) and (2) those who obtained only an allogeneic red blood cell transfusion when necessary (n = 9; control group). Vital measurements were performed during and after transfusion, and peripheral blood pH, hematocrit, glucose, and calcium and potassium ion levels were measured over the next 4 days.

RESULTS

Oxygen saturation was significantly increased throughout the cord blood transfusion and in the subsequent 48 hours. No significant differences were found in vital measurements, such as arterial blood pressure (mean, systolic, and diastolic) or heart rate over the first 48 hours posttransfusion. Similarly, no significant differences were found in biochemical analyses of blood with the exception of pH level. We found initial pH level to be significantly augmented in the cord blood recipient group by the first day after transplant, which remained significantly higher for next 24 hours compared with that shown in the control group.

CONCLUSIONS

Collection, preparation, and short-term storage of unfrozen cord blood are feasible for clinical use. Our results showed general safety and tolerability of the procedure of whole autologous cord blood transplant in recruited preterm newborns. However, because our study group was small, these results need to be confirmed in further investigations with a larger patient cohort.

A molecular switch based on the manipulation of 1,3-dichlorobenzene on Ge(001) between two adsorption sites by inelastic tunneling electrons

Meta-dichlorobenzene is adsorbed on Ge(001) and investigated by low temperature scanning tunneling microscopy. The molecule is altered between two adsorption sites by inelastic electron tunneling manipulation. These adsorption sites differ largely in conductivity. The necessary energy for switching the molecule between the sites and its polarity dependence indicate that the manipulation is initiated by the electronic excitation of the molecule.

Growth and evolution of nickel germanide nanostructures on Ge(001)

Nickel germanide is deemed an excellent material system for low resistance contact formation for future Ge device modules integrated into mainstream, Si-based integrated circuit technologies. In this study, we present a multi-technique experimental study on the formation processes of nickel germanides on Ge(001). We demonstrate that room temperature deposition of ∼1 nm of Ni on Ge(001) is realized in the Volmer-Weber growth mode. Subsequent thermal annealing results first in the formation of a continuous NixGey wetting layer featuring well-defined terrace morphology. Upon increasing the annealing temperature to 300 °C, we observed the onset of a de-wetting process, characterized by the appearance of voids on the NixGey terraces. Annealing above 300 °C enhances this de-wetting process and the surface evolves gradually towards the formation of well-ordered, rectangular NixGey 3D nanostructures. Annealing up to 500 °C induces an Ostwald ripening phenomenon, with smaller nanoislands disappearing and larger ones increasing their size. Subsequent annealing to higher temperatures drives the Ni-germanide diffusion into the bulk and the consequent formation of highly ordered, {111} faceted Ni-Ge nanocrystals featuring an epitaxial relationship with the substrate Ni-Ge (101); (010) || Ge(001); (110).

Ba termination of Ge(001) studied with STM

We use controlled annealing to tune the interfacial properties of a sub-monolayer and monolayer coverages of Ba atoms deposited on Ge(001), enabling the generation of either of two fundamentally distinct interfacial phases, as revealed by scanning tunneling microscopy. Firstly we identify the two key structural phases associated with this adsorption system, namely on-top adsorption and surface alloy formation, by performing a deposition and annealing experiment at a coverage low enough (∼0.15 ML) that isolated Ba-related features can be individually resolved. Subsequently we investigate the monolayer coverage case, of interest for passivation schemes of future Ge based devices, for which we find that the thermal evaporation of Ba onto a Ge(001) surface at room temperature results in on-top adsorption. This separation (lack of intermixing) between Ba and Ge layers is retained through successive annealing steps to temperatures of 470, 570, 670 and 770 K although a gradual ordering of the Ba layer is observed at 570 K and above, accompanied by a decrease in Ba layer density. Annealing above 770 K produces the 2D surface alloy phase accompanied by strain relief through monolayer height trench formation. An annealing temperature of 1070 K sees a further change in surface morphology but retention of the 2D surface alloy characteristic. These results are discussed in view of their possible implications for future semiconductor integrated circuit technology.

Mechanism of a molecular photo-switch adsorbed on Si(100)

We present a combined scanning tunneling microscopy and density functional theory study of a compact molecular photoswitch on a Si(100) surface.

Self-organisation of inorganic elements on Si(001) mediated by pre-adsorbed organic molecules

A combined theoretical and experimental study on the adsorption of an isolated benzonitrile molecule on the Si(001) surface, followed by the adsorption of Al (group III), Pb (carbon group) and Ag (transition metal) is presented.

Pregnancy delivery and puerperium in a patient with lysinuric protein intolerance--a case report

The paper presents the course of pregnancy delivery and early postpartum period in a 23-year-old woman with lysinuric protein intolerance (LPI). The pregnancy was uneventful and resulted in a caesarean birth to a healthy baby at 37 weeks gestation. Nevertheless, the course of pregnancy in women with LPI is associated with a significantly increased risk of serious complications, including acute hyperammonemia, preeclampsia and postpartum bleeding, as well as fetus intrauterine growth retardation. In many cases, intensive metabolic monitoring and a proper diet with protein limitation and appropriate amino acids supplementation may significantly reduce the risk for both the mother and the newborn.

Circulating hematopoietic stem cell count is a valuable predictor of prematurity complications in preterm newborns

BACKGROUND

The frequency of preterm labour has risen over the last few years. Hence, there is growing interest in the identification of markers that may facilitate prediction and prevention of premature birth complications. Here, we studied the association of the number of circulating stem cell populations with the incidence of complications typical of prematurity.

METHODS

The study groups consisted of 90 preterm (23-36 weeks of gestational age) and 52 full-term (37-41 weeks) infants. Non-hematopoietic stem cells (non-HSCs; CD45-lin-CD184+), enriched in very small embryonic-like stem cells (VSELs), expressing pluripotent (Oct-4, Nanog), early neural (β-III-tubulin), and oligodendrocyte lineage (Olig-1) genes as well as hematopoietic stem cells (HSCs; CD45+lin-CD184+), and circulating stem/progenitor cells (CSPCs; CD133+CD34+; CD133-CD34+) in association with characteristics of prematurity and preterm morbidity were analyzed in cord blood (CB) and peripheral blood (PB) until the sixth week after delivery. Phenotype analysis was performed using flow cytometry methods. Clonogenic assays suitable for detection of human hematopoietic progenitor cells were also applied. The quantitative parameters were compared between groups by the Mann-Whitney test and between time points by the Friedman test. Fisher's exact test was used for qualitative variables.

RESULTS

We found that the number of CB non-HSCs/VSELs is inversely associated with the birth weight of preterm infants. More notably, a high number of CB HSCs is strongly associated with a lower risk of prematurity complications including intraventricular hemorrhage, respiratory distress syndrome, infections, and anemia. The number of HSCs remains stable for the first six weeks of postnatal life. Besides, the number of CSPCs in CB is significantly higher in preterm infants than in full-term neonates (p < 0.0001) and extensively decreases in preterm babies during next six weeks after birth. Finally, the growth of burst-forming unit of erythrocytes (BFU-E) and colony-forming units of granulocyte-macrophage (CFU-GM) obtained from CB of premature neonates is higher than those obtained from CB of full-term infants and strongly correlates with the number of CB-derived CSPCs.

CONCLUSION

We conclude that CB HSCs are markedly associated with the development of premature birth complications. Thus, HSCs ought to be considered as the potential target for further research as they may be relevant for predicting and controlling the morbidity of premature infants. Moreover, the observed levels of non-HSCs/VSELs circulating in CB are inversely associated with the birth weight of preterm infants, suggesting non-HSCs/VSELs might be involved in the maturation of fetal organism.

Circulating endothelial progenitor cells in premature infants: is there an association with premature birth complications?

BACKGROUND

The most common morbidities in preterm infants are associated with vascular pathology. Endothelial progenitor cells (EPCs) have been implicated in repair of the vasculature, but their role in the pathogenesis of prematurity complications is not clear.

OBJECTIVES

We prospectively investigated an association between the number of EPCs circulating in blood during delivery as well as 2 and 6 weeks afterwards, the level of growth factors regulating their migration/homing, and the incidence of premature birth complications.

PATIENTS AND METHODS

The study groups consisted of 90 preterm and 52 full-term infants. Early-EPCs (CD133+CD34+CD144+) and late-EPCs (CD133-CD34+CD144+) were analysed in cord blood (CB) and peripheral blood (PB).

RESULTS

We found higher early- and late-EPC counts in the CB of premature infants compared with full-term babies. The number of circulating early- and late-EPCs was inversely associated with the Apgar score of preterm infants. A positive association between the early-EPC count and the risk of respiratory distress syndrome, retinopathy of prematurity, bronchopulmonary dysplasia, and infections was found. Nevertheless, multivariate analysis revealed that a higher number of EPCs was not an independent predictor of prematurity complications, which were directly related to lower gestational age. The EPC count in full-term infants maintained a constant, relatively low level over the 6-week follow-up, whereas the EPC population in preterm infants gradually decreased during this period. Furthermore, the number of CB late-EPCs in preterm infants positively correlated with VEGF concentration.

CONCLUSIONS

EPCs may play a considerable role in vascular development in preterm infants.

[The influence of patient-controlled epidural analgesia on labor progress and neonatal outcome]

AIM

The aim of the study was to check the influence of patient control epidural analgesia on labor progress and neonatal outcome.

MATERIAL AND METHODS

144 parturients were included into the clinical trial. In 73 cases patient control epidural analgesia was used and in 71 cases pethidine (meperidine) solution was given intravenously. Apgar score, umbilical artery pH, pain intensity the time of the first, second and third stage of labor the rate of episiotomy and uterine postpartum abrasions and the rate of caesarean sections and vaginal operative delivery were compared.

RESULTS

The time of the second stage of labor was significantly longer in the study group (40.99 vs 26.49 min, p- < 0.005), the neonatal outcome was comparable in both groups. There were no differences in the time of the first and the second stage of labor in primiparas and multiparas analyzed separately. Visual Analogue Score was lower in the study group (Ch(2)-12,48, p-0.25), especially in the subgroups of primiparas and multiparas.

CONCLUSIONS

Patient control epidural analgesia does not affect the time of the first and second stage of labor, oxytocin augmentation of labor may be the reason of that. This method is a more effective way of relieving labor pain. An increase of operative delivery is not observed after patient control epidural analgesia on condition that low doses and concentrations of analgesic drugs are used.

Uterine rupture in the second trimester of pregnancy as an iatrogenic complication of laparoscopic myomectomy

Uterine rupture is one of the most dangerous obstetric emergencies carrying a high risk for the mother and the fetus. Reports about uterine rupture in pregnancy following previous laparoscopic surgery have not been frequent; however, an increasing rate of the occurrence of this complication has been observed and reviewed in contemporary literature. We report a case of a spontaneous uterine rupture at 22 weeks of gestation in a 25-year old primigravida, who had had a laparoscopic removal of a small, peduncular, asymptomatic myoma located in the right uterine horn 20 months earlier. Ultrasound examination and subsequent urgent laparotomy confirmed a spontaneous uterine rupture with a nonviable fetus in the peritoneal cavity. Women planning to become pregnant should be qualified for laparoscopic myomectomy with special carefulness. Special attention must be paid to the potential solutions that limit the risk of postoperative uterine rupture, if the absolute necessity for the enucleation of myomas during the reproductive age occurs and a decision about laparoscopic intervention is made.

Maternal plasma lipopolysaccharide binding protein (LBP) concentrations in pregnancy complicated by preterm premature rupture of membranes

OBJECTIVES

To compare maternal plasma LBP concentrations in pregnancies complicated by preterm premature rupture of membranes (pPROM), and PROM at term, with their levels in uncomplicated pregnancy, and to determine whether LBP concentrations are of value in the diagnosis of subclinical intra-amniotic infection (IAI) in the prediction of the length of the pPROM-to-delivery interval, and in the prediction of neonatal congenital infection.

STUDY DESIGN

Thirty-one patients with pPROM, 35 with PROM at term, 33 healthy women at preterm gestation and 35 healthy women at term were included. In the pPROM group, analysis of maternal plasma LBP concentrations with reference to leukocytosis, C-reactive protein, vaginal fluid culture, neonatal infection and pPROM-to-delivery interval was carried out.

RESULTS

LBP concentrations in the four studied groups were comparable. Although in 58.1% of pPROM cases at least one laboratory parameter of infection was observed, the only difference concerned the subgroup with CRP above 10mg/L, in which LBP concentrations were higher. Comparison of LBP concentrations in patients delivered within 24 and 72h of pPROM and after these times showed no differences, or between patients who gave birth to newborns with and without congenital infection. The predictive values of these measurements were poor.

CONCLUSION

The predictive value of maternal LBP determinations in the diagnostics of pPROM cases suspected of IAI is unsatisfactory. LBP measurements performed shortly after pPROM, are not of value either in the prediction of newborn's infection, or in the prognosis of latency period duration.

[The role of circulating endothelial progenitor cells in the progression of retinopathy of prematurity--a prospective study]

PURPOSE

Retinopathy of prematurity (ROP) is the primary cause of visual impairment in preterm infants. There are available data confirming that circulating endothelial progenitor cells (EPCs) are involved in forming the growing network of blood vessels in the developing retina. In this study we sought to explore potential relationship between concentration of circulating bone marrow-derived EPCs and development of ROP in prospective study.

MATERIAL AND METHODS

The study groups consisted of 90 preterm (23-36 weeks of gestational age), and 52 full-term control infants. EPCs were analyzed in cord blood (CB) and subsequently in peripheral blood (PB) in second and sixth week since delivery. The incidence and stage of ROP was prospectively documented in the preterm infants.

RESULTS

EPC concentration in CB was considerably higher in the preterm infants developing ROP. In the preterm infants a noticeable decrease in PB EPC concentration within six weeks of the follow up was found, whereas in full-term infants EPC concentration was maintained at invariable level. Of note, in the sixth week since delivery, EPC concentration in preterm infants with ROP was lower compared to preterm infants without ROP.

CONCLUSIONS

Increase in CB EPC concentration in preterm infants, including those developing ROP, indicates that the circulating EPC cells contribute to the process of blood vessel formation, and their number in CB reflects the degree of prematurity. Impaired blood vessel formation within retina in the course of ROP may result from decrease in circulating EPC number observed at the sixth week since delivery.

Successful outcome of pregnancy complicated by Werner's syndrome

Werner's syndrome is an extremely rare genetic disorder of the autosomal recessive type, characterized by features suggesting premature aging in young adulthood. Because of the concomitant hypogonadism, pregnancy among patients with Werner's syndrome occurs extremely rarely. We present a case of a successful outcome of pregnancy complicated by Werner's syndrome in a 34-year-old primigravida. The reason for early delivery by caesarean section, at 34th week of pregnancy, was exacerbation of coronary symptoms, with early signs of cardiac insufficiency. A healthy female child was born in a good condition, with birth weight of 1950 g.

[Vaginal and cervical bacterial colonization in patients with threatening preterm labor]

OBJECTIVES

The aim of the following work was to evaluate vaginal and cervical colonization in patients with threatening preterm labor and comparing the frequency of colonization of the term and preterm labor groups.

MATERIAL AND METHODS

532 pregnant women with threatening preterm labor were included into the clinical trial. The frequency of colonization was established and the frequency of colonization depending on the duration of pregnancy was checked.

RESULTS

Positive vaginal cultures were found in 29.5% of patients. The most frequent were: Escherichia coli and Streptoccocus agalactiae. There was no relationship between the duration of pregnancy the frequency of colonization or the type of bacterial culture.

CONCLUSIONS

30% of positive vaginal and cervical cultures may indicate about the deficiency of the used method. The most frequent microorganisms remain to be Candida, Escherichia coli and GBS. However, the frequency of colonization with rare bacteria increases. Not only bacterial colonization but a group of different factors may be the reason of preterm labor.

Clinical Outcomes of High-risk Labours Monitored Using Fetal Electrocardiography

Objectives: The aim of the study was to review clinical and laboratory outcomes of a cohort of fetuses monitored during high-risk labours, simultaneously by fetal electrocardiography (FECG) and routine cardiotocography (CTG). Materials and Methods: Eighty-three parturients from the Department of Obstetrics and Gynecology of Medical University were included in the clinical study. Inclusive criteria to the study group were: (i) singleton pregnancy at term (between 37 and 42 weeks’ gestation), (ii) longitudinal fetal lying, (iii) more than 2500 g of estimated fetal weight, (iv) meconium-stained liquor, and (v) induction of labour due to fetal indications. Fetal outcome parameters analysed included Apgar scores at 1st, 5th and 10th minute after birth, cord artery acid-base assessment and lactate concentrations analysis. FECG was performed during labour, until the neonate was born, with the use of single spiral scalp electrode connected to the STAN S21 heart monitor. Immediately after delivery, arterial cord blood gas and venous cord blood lactate’s concentrations were analysed. Results: The sensitivity (100%), specificity (97%), negative predictive value (NPV) (100%) and positive predictive value (33%) were higher for FECG than for CTG. Moreover, several significant correlations between episodic/baseline T/QRS ratio rises and cord artery acid-base as well as lactate concentrations were demonstrated. Conclusions: Correlations between episodic/baseline T/QRS ratio rises and fetal outcome parameters indicate that observed changes in FECG reflect neonatal metabolic lactate acidosis. The high sensitivity, specificity and especially very high NPV are proof that FECG serves as a reliable method for electronic fetal monitoring during high-risk labours. Key words: Fetal asphyxia, STAN system

Clinical outcomes of high-risk labours monitored using fetal electrocardiography

OBJECTIVES

The aim of the study was to review clinical and laboratory outcomes of a cohort of fetuses monitored during high-risk labours, simultaneously by fetal electrocardiography (FECG) and routine cardiotocography (CTG).

MATERIALS AND METHODS

Eighty-three parturients from the Department of Obstetrics and Gynecology of Medical University were included in the clinical study. Inclusive criteria to the study group were: (i) singleton pregnancy at term (between 37 and 42 weeks' gestation), (ii) longitudinal fetal lying, (iii) more than 2500 g of estimated fetal weight, (iv) meconium-stained liquor, and (v) induction of labour due to fetal indications. Fetal outcome parameters analysed included Apgar scores at 1st, 5th and 10th minute after birth, cord artery acid-base assessment and lactate concentrations analysis. FECG was performed during labour, until the neonate was born, with the use of single spiral scalp electrode connected to the STAN S21 heart monitor. Immediately after delivery, arterial cord blood gas and venous cord blood lactate's concentrations were analysed.

RESULTS

The sensitivity (100%), specificity (97%), negative predictive value (NPV) (100%) and positive predictive value (33%) were higher for FECG than for CTG. Moreover, several significant correlations between episodic/baseline T/QRS ratio rises and cord artery acid-base as well as lactate concentrations were demonstrated.

CONCLUSIONS

Correlations between episodic/baseline T/QRS ratio rises and fetal outcome parameters indicate that observed changes in FECG reflect neonatal metabolic lactate acidosis. The high sensitivity, specificity and especially very high NPV are proof that FECG serves as a reliable method for electronic fetal monitoring during high-risk labours.

Isoprostanes 8-iPF2alpha-III: risk markers of premature rupture of fetal membranes?

AIMS

Isoprostanes may serve as sensitive and specific markers of in vivo oxidative stress intensity. We wanted to determine, whether or not isoprostane concentration may be considered as a risk marker of premature rupture of fetal membranes (PROM).

METHODS

On the basis of the presence of PROM and gestational maturity, a total of 128 patients were divided into: (1) preterm PROM (pPROM) group; (2) PROM at term group; (3) control preterm (C1) group and (4) control at term (C2) group. The concentrations of 8-iPF(2alpha)-III were determined using the enzyme-linked immunosorbent assay method.

RESULTS

The mean free isoprostane concentrations, examined in amniotic fluid and maternal plasma in the PROM at term patients were significantly higher than in C2 individuals (p < 0.01). The mean concentrations of free 8-iPF(2alpha)-III measured in blood plasma from women in the C1 group were significantly lower than in patients from the pPROM, PROM at term and C2 groups (p < 0.001, p < 0.00001 and p < 0.00001, respectively).

CONCLUSION

The measurement of free isoprostane concentration in maternal plasma and amniotic fluid may be considered as a laboratory marker of a PROM-risk pregnancy.

[Physiological and pathological consequences of a presence of germ line stem cells in adult tissues]

Various therapheutic strategies employing stem cells have been proposed as the alternative, effective methods for therapy of multitude diseases, difficult to treat using standard, well-established methods. Advancing regenerative medicine, which is becoming a novel branch of clinical medicine, has high hopes of stem cells which could be used in treatment of injuried organs such as myocardium after heart infarction, brain after stroke, spinal cord after mechanical injury as well as in treatment of diabetes and Parkinson disease. Application of embryonic stem cells, harvested from developing embryos, is highly controversial. Hence, the stem/primitive cells isolated from adult tissuses are considered to be an optimal source of cells for therapy. Recently our research team has isolated a population of very primitive stem cells from adult tissues (very small embryonic-like stem cells - VSELs) that show several embryonic-like features. These cells can become an alternative and more ethical source of the stem cells for therapy when compared to those isolated from the developing embryos.

[Rapid assessment of the IL-6 cervico-vaginal fluid level in threatening preterm labor]

OBJECTIVES

The aim of the study was to check the cervico-vaginal fluid IL-6 levels using rapid, quantitive test in patients with threatening preterm labor before and after tocolytic treatment.

MATERIAL AND METHODS

Sixty seven singular pregnant women, between 24 and 36 weeks of gestation, were included into the clinical trial. 35 women who were admitted to the Department due to clinical symptoms of threatened preterm labor formed the study group. 32 women between 24 and 36 gestational week, with uncomplicated pregnancy formed the control group. Levels of IL-6 were measured just after material collection, using fast, quantitative spectrofotometric test.

RESULTS

The cervico-vaginal IL-6 level was higher in the study group (458 pg/mL vs 123 pg/mL; p < 0.05). A significant reduction of cervico-vaginal IL-6 level was observed after two days of tocolytic treatment.

CONCLUSION

A bedside, quantitative spectrofotometric method allows for a quick and repeatable assessment of cervico-vaginal IL-6 levels to establish the risk of preterm labor as well as enables the monitoring of the effectiveness of tocolytic treatment.

[The assessment of neutrophil elastase measurements usefulness in pregnant women with premature rupture of fetal membranes and chorioamnionitis suspicion]

OBJECTIVES

The evaluation of neutrophil elastase (NE) levels and its usefulness in pregnant women with premature rupture of foetal membranes (PROM) and chorioamnionitis suspicion.

MATERIAL AND METHODS

We evaluated the relationship between maternal plasma and amniotic fluid NE levels with the presence of chorioamnion infection in sixty pregnant women, divided into two groups--with and without PROM. The diagnostic performance of NE evaluations in discrimination of suspected intraamniotic infection was calculated.

RESULTS

NE levels in PROM patients are significantly higher than in the control group (p < 0.000001). Significantly higher NE concentrations are also observed in the case of chorioamnionitis. Moreover, if at least two clinical markers of infection were present, the diagnostic value of amniotic fluid NE levels proved to be 100% sensitive and of 100% negative predictive value.

CONCLUSIONS

NE levels may be used as clinical markers which enable the obstetricians to exclude chorioamnionitis.

[Giant benign ovarian tumor coexisting with late pregnancy--a case report]

We have reported a rare case of a giant ovarian tumor which, due to the lack of proper health care on the side of the patient, had not been diagnosed until 27 weeks of pregnancy. The patient did not demonstrate any clinical symptoms till the moment of the diagnosis. Peripheral blood analysis showed severe anemia at the admission. The right adnex with the multilocular cystic tumor containing bloody fluid and measuring 40 cm in diameter, was removed in the course of the surgical procedure. The histological diagnosis of the tumor was: serous cyst. Surgical removal of the giant tumor allowed for further development of pregnancy and enabled vaginal delivery of healthy newborn at term.

The solid state reaction of Fe with the Si(111) vicinal surface: splitting of bunched steps

The solid state reaction of deposited Fe (four monolayers, ML) with vicinal Si(111) substrate induced by subsequent thermal treatment has been studied using scanning tunnelling microscopy. At the lower range of annealing temperatures up to 400 °C the bunched steps of bare substrate are reproduced by the surface of the covering iron silicide layer. At 400 °C the onset of three-dimensional growth of iron silicide islands is observed. In comparison to the samples covered with smaller amounts of Fe it appears at a lower annealing temperature. Above 500 °C the bunched steps split into lower ones but more densely distributed due to proceeding reactions between Fe-rich iron silicide and Si substrate. As a consequence, at 700 °C the well-developed three-dimensional nanocrystallites of iron silicide are randomly distributed on the Si surface. This observation is in contrast to the formation of a regular array of iron silicide crystallites upon deposition of 2 ML of Fe.

[Evaluation of neutrophile elastase and isoprostane 8epiPGF2alpha concentrations in maternal and umbilical cord blood serum and in amniotic fluid in pregnancies complicated by premature rupture of membranes]

OBJECTIVES

To evaluate the total isoprostane 8-epi-PGF2alpha and neutrophil elastase (NE) concentrations in pregnancies complicated by premature rupture of membranes (PROM).

MATERIAL AND METHODS

128 pregnant women were divided into four groups: pregnancies complicated by PROM between 24.-36.(PPBP-N) and between 38 a 41 weeks of gestation (PPBP-D), uncomplicated pregnancies between 24-36 gestation weeks (K1) and pregnancies delivered by cesarean section (before uterine contractions had started) after 38 weeks (K2). The concentrations of NE and isoprostane 8-epi-PGF2alpha were measured in maternal serum, cord blood serum and in the amniotic fluid.

RESULTS

The following study revealed higher concentrations of NE in maternal serum and in the amniotic fluid than in the umbilical cord blood in PROM cases, and lower amniotic fluid than maternal serum concentrations in the control groups. Also, the levels of isoprostane differentiated between compartments in particular groups. In both groups complicated with PROM, higher maternal serum and amniotic fluid NE concentrations than in controls were found. There were no differences in isoprostane levels between the groups.

CONCLUSIONS

1. Higher concentrations of NE in maternal blood serum and in the amniotic fluid than in the umbilical cord blood in PROM cases, as well as lower amniotic fluid than maternal serum concentrations in the controls, may be connected with pathogenesis of PROM. 2. Differentiated maternal serum, cord serum and amniotic fluid isoprostane concentrations may suggest various intensity of oxidative stress in particular compartments. 3. Lack of differences in maternal serum, cord serum and amniotic fluid isoprostane concentrations may suggest similar intensity of oxidative stress in cases with PROM and intact membranes.

Value of vaginal fluid proinflammatory cytokines for the prediction of early-onset neonatal infection in preterm premature rupture of the membranes

The usefulness of vaginal fluid proinflammatory cytokine assays in the prediction of neonatal congenital infection was evaluated. Sixty-two women between 24 and 34 weeks of pregnancy, complicated by premature rupture of the membranes, were divided into those who delivered newborns with (n = 21) and without (n = 41) signs of infection. Concentrations of all studied cytokines were higher in women who delivered babies with infection. The cutoff values of interleukin-1alpha (IL-1alpha) and IL-1beta > or = 400, IL-6 > or = 2000, and IL-8 > or = 2100 pg/mL predicted infection with a sensitivity of 57%, 57%, 33%, and 76%, a specificity of 73%, 73%, 93%, and 59%, a positive predictive value of 52%, 52%, 70%, and 48%, and a negative predictive value of 77%, 77%, 73%, and 83%, respectively. Receiver operating characteristic (ROC) curve analysis revealed that the predictive performance of the four studied cytokines was comparable. In conclusion, vaginal fluid cytokines after premature rupture of the membranes have moderately predictive value of whether or not a neonate will develop early sepsis.

Maternal serum proinflammatory cytokines in preterm labor with intact membranes: neonatal outcome and histological associations

Our aim was to compare maternal serum concentrations of interleukin(IL)-1alpha IL-1beta, IL-6 and IL-8 in pregnancies complicated by preterm labor (PTL), with the levels in healthy controls at comparable gestational age, and to determine if these assays have any value in the prediction of early-onset neonatal infection or histological chorioamnionitis. The study population consisted of 65 women with new-onset PTL, and 31 healthy controls. Maternal serum concentrations of IL-6 (8.40 versus 3.30 pg/mL; p = 0.002) and IL-1beta (2.20 versus 0.50 pg/mL; p = 0.003) were significantly higher in patients with PTL as compared to healthy pregnant women. The IL-1beta concentration (13.60 versus 1.20 pg/mL; p = 0.02) was significantly higher in the serum of mothers whose babies developed early-onset infections, than in mothers of newborns that were healthy. However, its predictive value, and the value of the other cytokines studied, was poor. In addition, IL-1beta levels (28.79 versus 5.19 pg/mL; p = 0.001) were significantly higher in patients with histological chorionamnionitis, than in those without the condition,. The cut-off value of >or= 14 pg/mL predicted inflammatory changes with a sensitivity of 80%, specificity of 86%, PPV of 80% and NPV of 86%. IL-1beta seems to be of moderate value in the prediction of histological chorioamnionitis.

Prematurity and protracted mechanical ventilation as risk factors for Pneumocystis jiroveci infection in HIV-negative neonates in an intensive care unit

This work was undertaken to elucidate some aspects of the epidemiology of Pneumocystis pneumonia (PP). We studied 42 mechanically ventilated, human immunodeficiency virus (HIV)-negative, severely ill neonates treated at an intensive care unit. The study group included 40 premature neonates and two mature neonates with lethal congenital defects. Progressive respiratory dysfunction in PP necessitated mechanical ventilation. Infection was usually noticeable on the 22nd day of life or after 12 days of ventilation. The usual manifestations included apnea, pallor, copious frothy sputum, seizures, and feeding difficulties. The diagnosis was established by detecting Pneumocystis jiroveci cysts in bronchial lavage fluid specimens (88.1% sensitivity). PP was managed with cotrimoxazole and pentamidine combination therapy administered over 14 days. No clinical improvement was noted in four neonates and three of them died during therapy. Prematurity and protracted mechanical ventilation are two risk factors for P. jiroveci infection in severely ill neonates in an intensive care unit.

Maternal venous procalcitonin levels do not correlate with umbilical cord blood and venous blood concentrations in the neonate

BACKGROUND

To compare procalcitonin (PCT) concentrations between maternal blood and levels in umbilical cord or venous blood of neonates who were born with or without infection.

METHODS

Forty-six women with singleton pregnancies, complicated by premature rupture of membranes, preterm delivery and/or chorioamnionitis, were enrolled in this study. The study group comprised 15 patients and their infected newborns. The control group consisted of 31 women and their healthy newborns. We compared PCT concentrations between maternal, umbilical cord and neonatal serum, in both study and control groups. Additionally, PCT levels were compared between the corresponding compartments.

RESULTS

PCT concentrations in the umbilical cord and venous blood in infected newborns, but not in non-infected neonates, were significantly higher than maternal serum PCT levels. PCT concentrations of mothers who delivered infected newborns were comparable to those in the controls. However, PCT concentrations in the umbilical cord and in the venous blood of the infected newborns were higher than in healthy newborns.

CONCLUSION

Measurement of maternal PCT concentration during labor does not contribute to early prediction of infection in the neonate. However, umbilical cord PCT concentrations, as well as its neonatal venous levels on the second day of life, seem to be related to intrauterine infection, and may be a useful tool in the diagnosis of early neonatal infection.

Morphological and molecular characterization of novel population of CXCR4+ SSEA-4+ Oct-4+ very small embryonic-like cells purified from human cord blood: preliminary report

Recently, we purified from adult murine bone marrow (BM) a population of CXCR4(+), Oct-4(+) SSEA-1(+), Sca-1(+) lin(-) CD45(-) very small embryonic-like (VSEL) stem cells and hypothesized that similar cells could be also present in human cord blood (CB). Here, we report that by employing a novel two-step isolation procedure -- removal of erythrocytes by hypotonic lysis combined with multiparameter sorting -- we could isolate from CB a population of human cells that are similar to murine BM-derived VSELs, described previously by us. These CB-isolated VSELs (CB-VSEL) are very small (3-5 micro m) and highly enriched in a population of CXCR4(+)AC133(+)CD34(+)lin(-) CD45(-) CB mononuclear cells, possess large nuclei containing unorganized euchromatin and express nuclear embryonic transcription factors Oct-4 and Nanog and surface embryonic antigen SSEA-4. Further studies are needed to see if human CB-isolated VSELs similar to their murine BM-derived counterparts are endowed with pluripotent stem cell properties.

Reliability of semiquantitative determination of procalcitonin serum concentrations in neonates

We studied the diagnostic usefulness of semiquantitative determination of procalcitonin (PCT) concentrations in neonatal serum by reference to a quantitative method. We compared 302 results of PCT measurements in 151 samples of venous blood collected during the 1st 7 days of life. The semiquantitative BRAHMS PCT-Q test and the quantitative immunoluminometric LUMItest were compared with Cohen's kappa as a measure of concordance. Concordance was revealed for 28.4% of samples, whereas 11.9% showed total disagreement. Concordance between both methods reached 88% when results from the next (lower or higher) category were included. The weighted kappa value was 0.235, indicative of satisfactory agreement between both methods. The semiquantitative BRAHMS PCT-Q test reveals satisfactory concordance with the quantitative method when results in the next category are included to account for readout error. The semiquantitative test is rapid, easy to use, and helpful as a supportive test when the quantitative assay is not available.

The activity of erythrocyte sodium-proton exchanger in women with pregnancy- induced hypertension

BACKGROUND

Hypertension that develops after 20 gestational weeks and is defined as pregnancy-induced hypertension (PIH). The main cause of PIH is vasoconstriction and the thickening of vascular media, which decreases vascular capacity and increases peripheral resistance. One of the theories postulated to explain this phenomenon is that a transmembrane sodium transport disorder causes an increase in intracellular sodium concentration. In the latest literature, special attention is paid to the role of the increased intracellular sodium concentration in the pathogenesis of essential hypertension (EH). One of the best documented phenotypes for EH is the increased activity of the sodium-proton exchanger (NHE). The aim of this study was to assess if increased NHE activity could be the mechanism responsible for the development of PIH.

SUBJECTS AND METHODS

The study included 30 women: 10 pregnant women with PIH after gestational week 30, 10 women with physiological pregnancy after 30 gestational weeks, and 10 healthy non-pregnant women. NHE activity was determined according to Orlov's method as amiloride-sensitive H(+) efflux from acid-loaded cells.

RESULTS

The NHE activity in the group of women with PIH was significantly higher than that in women with physiological pregnancy: 10.09 +/- 1.65 vs. 6.81 +/- 2.3 mmol/L RBC/h (p < 0.049) and in the group of non-pregnant women: 10.09 +/- 1.65 vs. 7.56 +/- 1.66 mmol/L RBC/h (p < 0.029). Erythrocyte NHE activity did not differ in the group of women with physiological pregnancy and in the group of non-pregnant women.

CONCLUSION

These results seem to suggest that erythrocyte NHE activity is elevated in PIH pregnancies.

[The detachment of retina as possible complication after BCG vaccination during HOP--description of case]

PURPOSE

The authors described the rare case of the progression of changes in the retina of child in course of retinopathy of prematurity. It happened after finished laser-treatment and full regression of changes of the retina. It seems that BCG vaccination done in 3-th month of life could reactivate the disease of the retina which caused total retina detachment of both eyes.

MATERIAL AND METHODS

The ophthalmologic examination included: indirect ophthalmoscopy using Fisson ophthalmoscope, slit-lamp examination and USG B-mode examination, using USG Echo Scan 3300 Oculus with the head 10 MHz--performed during all control visits.

RESULTS

The regular ophthalmologic examination enabled estimation of the dynamic of changes in the retina and correctness of treatment. In author's opinion, the secondary retina detachment in 3-th month of life could be associated with reaction post BCG vaccination.

CONCLUSIONS

Probably secondary inflammation after BCG vaccination could be the reason of reactivation of earlier treated with good results ROP Possible vision complications should incline to take special ophthalmologic care of premature infants from high risk group (very low mass of the body or fetal immaturity). Decision of changing time of BCG vaccination in such group should be made by attending physician.

Are vaginal fluid procalcitonin levels useful for the prediction of subclinial infection in patients with preterm premature rupture of membranes?

AIM

To compare vaginal fluid procalcitonin concentrations in cases of preterm premature rupture of membranes (pPROM) and premature rupture of membranes (PROM) at term, and to determine whether the procalcitonin concentrations are of value in the diagnosis of pPROM cases suspected of subclinical intrauterine infection or in the prediction of the pPROM-to-delivery interval.

METHODS

Forty-eight patients with pPROM and 30 with PROM at term were enrolled in this study. In pPROM group, analysis was conducted of procalcitonin concentrations with reference to serum leucocytosis, serum C-reactive protein levels and vaginal fluid culture, as well as to the presence/absence of neonatal congenital infection or histological chorioamnionitis. The outcomes of pPROM cases were also recorded with reference to pPROM-to-delivery interval.

RESULTS

Procalcitonin levels in the pPROM group were significantly higher than in cases of amniorrhexis at term (1.50 vs 0.83 ng/mL; P < 0.001). In the pPROM group procalcitonin concentrations between the patients with and without positive laboratory indices of infection were comparable. Also, no significant correlation was observed between procalcitonin and leucocytosis (r = -0.14; P = 0.33) or C-reactive protein (r = -0.17; P = 0.24). Procalcitonin concentrations of patients who gave birth to newborns with infection were comparable to those in women whose newborns were healthy. In patients with histological chorioamnionitis, procalcitonin concentrations were comparable to those without inflammatory changes.

CONCLUSION

These findings suggest that the value of vaginal fluid procalcitonin determinations is unsatisfactory in the diagnostics of pPROM cases suspected of subclinical intrauterine infection, as well as for the prediction of pPROM-to-delivery interval, newborn's congenital infection or histological chorioamnionitis.

Information support concerning care of a baby provided for lying-in women during their stay in maternity ward in rooming-in system

The aim of the study was to estimate the need for information support concerned with care of a baby and evaluation of lying-in women expectations referred to sources of support, methods and devices used during presentation. The research included 200 lying-in women hospitalized in Clinic of Obstetrics and Perinatology, Pomeranian Medical University in Szczecin; there were separated the study group which consisted of primiparas (n=100) and reference group - multiparas (n=100). The applied method was medical history of a patient, and a research tool was author's questionnaire. The results show that primiparas noticeably more often than multiparas need information support related to care of umbilical stump (p < 0.001), bathing (p < 0.001), care of skin and mucous membranes (p < 0.001), management of regurgitation, management of colic (p < 0.001), signs of neonatal transient states, and checking for concern-raising signs (p < 0.001). Lying-in women much more often indicate a nurse/midwife and a doctor working in maternity ward as a source of information support, and considerably more often expect information to be provided in the form of training and chatty lecture with the use of brochures.

CONCLUSIONS

(1) Primiparas require greater involvement of health professionals in providing information support and especially giving information on baby care. (2) A nurse/midwife and a doctor are these people in maternity ward who are particularly expected to provide information support for both primiparas and multiparas. (3) Different methods (training, chatty lecture) may be applied when information support is provided and the choice should correspond with patients' needs, goals and organizational possibilities. (4) Lying-in women expect various devices used for providing information support, but in most cases they are brochures with information on particular topics.

Influence of education at The Childbirth School on Breast Feeding

Breast feeding is the only proper way to feed a newborn and a baby during the first several months of his life. The most professional way of preparation for natural feeding is The Childbirth School. Education ought to be continued in maternity wards. The aim of this study is to prove that women who participated in The Childbirth Courses are better motivated and prepared for breast feeding. Material and methodology. The research comprised 294 lying-in women hospitalized in maternity ward in Clinic of Obstetrics and Perinatology, Pomeranian Medical University in Szczecin from June 2001 to December 2002. The examined women were divided into two groups: Group I--"study group"--comprised 129 lying-in women who attended the childbirth school courses during at least one pregnancy, but no earlier than 2 years ago. Group II--"control group" (reference group)--included 165 lying-in women who did not participate in any organized forms of prenatal education. Every woman who agreed to participate in the research was accepted. There was applied analysis of lying-in woman's documentation and author's questionnaire which was also used for further research. As a result of the research it was found that The Childbirth School increases motivation for natural feeding and prepares women for this activity. It also showed that more emphasis should be given to childbirth education for puerperal women in maternity wards; it refers in special to those women who did not attend The Childbirth School.

[Impact of delivery type on EGF and IGF-1 concentration in umbilical blood of newborns and their mothers' milk]

Peptide growth factors, including EGF and IGF-1, play a substantial role in child's growth and maturation processes. Growth factors found in mother's milk can modify development of the newborn and the infant, especially in the area of alimentary tract differentiation and maturation.

OBJECTIVES

Study was undertaken to evaluate impact of the delivery type on EGF and IGF-1 concentration in the umbilical blood of newborns and their mothers' milk.

MATERIAL AND METHODS

Sixty eight newborns and their mothers were examined. EGF and IGF-1 concentration was measured in serum of venous umbilical blood as well as in the mothers' milk collected on the first day of lactation. To measure EGF and IGF-1 concentration radioimmunoassay method (RIA) was applied.

RESULTS

No correlation was found between the concentration of the two growth factors in umbilical blood and the delivery type. Neither significant difference was found between EGF concentration in the milk of the mothers who had spontaneous labour and the factor concentration in the milk of the mothers who had a caesarean section. Contrary to EGF, IGF-1 concentration in the milk of the mothers who had a caesarean section was lower than in the milk of the mothers who had a spontaneous delivery. However, significant differences were observed only in a group of mothers of newborns born at term.

CONCLUSIONS

Caesarean section may disturb mechanisms of IGF-1 synthesis and release to mother's milk in the initial stage of lactation.

Maternal plasma procalcitonin concentrations in patients with preterm labor and intact membranes--prediction of preterm delivery and admission-to-delivery interval

The purpose of this study was to evaluate procalcitonin (PCT) plasma levels in pregnancy complicated by preterm labor and to determine their value in the prediction of preterm delivery and the length of the admission-to-delivery interval. The study population consisted of 53 patients with preterm labor and 31 healthy pregnants. The study patients were divided according to the delivery time and to the admission-to-delivery interval. Plasma PCT concentrations were higher in preterm labor than in healthy pregnants. Although at the onset of preterm labor plasma PCT concentrations in patients who delivered prematurely were higher than in patients who, after tocolytic treatment, delivered at term, the difference was not significant. Also in cases of preterm labor delivered within and after three and seven days of admission no differences were observed. The highest values in the prediction of preterm delivery and the length of admission-to-delivery interval corresponded to a PCT concentration of 1.7 ng/ml. These findings suggest that although preterm labor is associated with increased PCT concentrations in maternal plasma, there is no significant association either between plasma concentration of PCT at the moment of threat and preterm delivery, or the admission-to-delivery interval. The predictive value of plasma PCT determinations is unsatisfactory.

Procalcitonin in cervicovaginal secretion in pregnancies complicated by preterm labor--a preliminary report

OBJECTIVES

Although the usefulness of procalcitonin (PCT) in clinical practice is increasing, no data are available on procalcitonin during pregnancy. The purpose of this study was to investigate whether procalcitonin was present in the cervicovaginal secretion of pregnant women and, if so, to evaluate the practical value of determining the concentration.

STUDY DESIGN

A total of 53 patients in whom preterm labor (PTL) was expected and 31 healthy pregnant women were enrolled in this study. In the preterm labor group procalcitonin concentrations were analyzed with reference to laboratory indices suggestive of infection. The outcome of pregnancy was recorded in each case, with mention of the gestational age at delivery and of the time between admission to hospital and delivery.

RESULTS

Concentrations of procalcitonin in the preterm labor group were comparable to those in the healthy pregnant women. In the preterm labor group no significant correlations were observed between procalcitonin concentration and laboratory indices of infection. Nor were any correlations observed between procalcitonin concentration at the onset of preterm labor and gestational age either at the onset of labor or at delivery. However, procalcitonin concentrations at the onset of preterm labor were higher in patients who delivered prematurely than in those who delivered near term after treatment to delay labor. Procalcitonin concentrations in women whose babies were delivered within 3, 7 and 14 days of admission and in those whose babies were born at later times were comparable.

CONCLUSIONS

In this study, procalcitonin was determined in the cervicovaginal secretion of pregnant women for the first time. However, no association was observed either between procalcitonin concentration at the onset of preterm labor and laboratory signs of infection or between procalcitonin concentration and time between admission to hospital and delivery. Procalcitonin determination would be unsatisfactory as a prognostic indicator of the length of time between admission to hospital and delivery.

Proinflammatory cytokines and other indications of inflammation in cervico-vaginal secretions and preterm delivery

OBJECTIVES

To compare the usefulness of evaluating cervico-vaginal concentrations of proinflammatory cytokines (interleukin [IL]-1alpha, IL-1beta, IL-6 and IL-8) and procalcitonin (PCT), as well as serum levels of C-reactive protein (CRP), leucocytosis and band form granulocytes in the prediction of preterm delivery (PTD).

METHODS

A total of 65 pregnant women experiencing preterm labor (PTL) were enrolled in the study. Concentrations of the studied markers in women who delivered prematurely and in women who, after treatment, delivered at term were compared. Receiver operator characteristic (ROC) curve analysis was used for all study parameters.

RESULTS

Cervico-vaginal IL-6 and procalcitonin as well as serum CRP concentrations were higher in women who delivered prematurely than in those who delivered near term. A cervico-vaginal IL-6 level greater than 660 pg/ml was the best predictive value of preterm delivery (sensitivity, 50%; specificity 90%; positive predictive value [PPV], 85%; NPV, 62%; likelihood ratio, 5.17). Moreover, the area under the ROC curve of 0.75 for cervico-vaginal IL-6 was greater than for other markers.

CONCLUSION

Although cervico-vaginal concentrations of procalcitonin and serum concentration of CRP are higher in women who deliver prematurely, only cervico-vaginal concentration of IL-6 is a good predictor of preterm delivery.

A novel founder CHEK2 mutation is associated with increased prostate cancer risk

Variants in the CHEK2 have been found to be associated with prostate cancer risk in the United States and Finland. We sequenced CHEK2 gene in 140 Polish patients with prostate cancer and then genotyped the three detected variants in a larger series of prostate cancer cases and controls. CHEK2 truncating mutations (IVS2 + 1G>A or 1100delC) were identified in 9 of 1921 controls (0.5%) and in 11 of 690 (1.6%) unselected patients with prostate cancer [odds ratio (OR) = 3.4; P = 0.004]. These mutations were found in 4 of 98 familial prostate cases (OR = 9.0; P = 0.0002). The missense variant I157T was also more frequent in men with prostate cancer (7.8%) than in controls (4.8%), but the relative risk was more modest (OR = 1.7; P = 0.03). I157T was identified in 16% of men with familial prostate cancer (OR = 3.8; P = 0.00002). Loss of the wild-type CHEK2 allele was not observed in any of prostate cancers from five men who carried CHEK2-truncating mutations. Our results provide evidence that the two truncating mutations of CHEK2 confer a moderate risk of prostate cancer in Polish men and that the missense change appears to confer a modest risk.

[Clinical analysis of pregnancy complicated by hypertension in the material of the Department of Obstetrics and Perinatology of the Pomeranian Academy of Medicine]

OBJECTIVES

The aim of this study was retrospective analysis of arterial hypertension during pregnancy in the Department of Obstetrics and Perinatology of Pomeranian Academy of Medicine in Szczecin, and severe PIH intensive obstetrical care optimization.

DESIGN

The retrospective analysis of 81 pregnancies complicated by arterial hypertension in the years 1995-2000 was performed.

MATERIAL AND METHODS

The retrospective analysis of 81 pregnancies was performed. Patients were divided into two groups. In the first pregnancy was ended by caesarean section (n = 43), in the second by vaginal delivery. The mean gestational age, the way of delivery, accompanying diseases, uric acid levels, short term variability, Dawes - Reedman's criteria, presence of decelerations in CTG, Doppler PI, S/D, RI parameters in umbilical artery and cerebral arteries, presence of AEDVF and REDVF in umbilical artery were analyzed.

RESULTS

Caesarean section was performed in 53.1% of all cases, in 46.9% vaginal delivery took place. Absolute range of short-term variability was more often less than 6 ms in caesarean section group (41.9%). Uric acid level was also higher in caesarean section group (p = 0.000194)

CONCLUSIONS

1. The caesarean rate in pregnancies complicated by arterial hypertension is over 50% and during severe PIH is approximately 100%. 2. Caesarean section takes place before estimated delivery date and indications to it are in most cases connected with a main disease 3. Short-term variability is lower among patients from caesarean section group. 4. Uric acid level is a relevant parameter of a degree of arterial hypertension, and the level is higher in first group. 5. Doppler velocimetry of umbilical artery and middle cerebral artery are valid part of obstetrical care among patients with PIH.

The role of STAT5 proteins in the regulation of normal hematopoiesis in a cord blood model

The signal transducers and activators of transcription - STAT5A and STAT5B - are responsible for the control of proliferation, differentiation and apoptosis, via their effect on gene expression. They are activated by the binding of many cytokines, growth factors and hormones to their receptors on the cell surface. Many of these cytokines regulate hematopoietic cell development; therefore, STAT5 proteins are suggested to play an important role in hematopoiesis. There are numerous contradictory reports available in the literature on the role of STAT5 in normal hematopoietic cell development; hence, the question of the real function of STAT5 proteins clearly requires further studies. The aim of our study was to evaluate the role of STAT5 in normal hematopoiesis using oligodeoxynucleotide (ODN) strategy against STAT5 mRNA. We employed the RT-PCR method to study STAT5 mRNA expression in cells after their incubation with ODNs. We analyzed the effect of blocking STAT5 proteins on the viability and clonogenecity of the CFU-GM (Colony Forming Unit of Granulocyte-Macrophages) and the BFU-E (Burst Forming Unit of Erythrocytes) obtained from human cord blood (CB). The clonogenic growth of the cells was assessed in methylcellulose cultures according to the type of oligodeoxynucleotides. We also attempted to estimate the level of apoptosis induced in cord blood mononuclear and CD34+ cells by employing different assays: i) Annexin V staining using flow cytometry (FACSCalibur); ii) terminal deoxynucleotidyltransferase dUTP nick end labeling (TUNEL); iii) analysis of Bax and Bcl-X(L) gene expression by RT-PCR. Perturbation of STAT5 expression with antisense oligodeoxynucleotides had no impact on the viability, clonogenecity and apoptosis of CB hematopoietic cells. Our results showed that STAT5 proteins do not play a significant role in the regulation of proliferation of normal hematopoietic cells derived from cord blood.

[Assessment of social and professional support offered to patients during their stay in a rooming-in at a maternity ward]

The improvement of quality of care on maternity wards concerns not only the medical activities. Professional activities minimalizing the occurrence of difficult situations of woman in puerperal period are of great importance as well. The aims of the study were: 1) to evaluate the accessible social support and the need of professional support in women during their staying on maternity ward in rooming-in system; 2) to establish the correlation between accessible social support the need of professional one. Studies were conducted at one of maternity wards in Szczecin working in rooming-in system. Studied group were primiparas (n = 100), reference group consisted of multiparous females (n = 100). The following tools were introduced into the study: Modified Social Support Scale and Author's questionnaire on Demand for Support in maternity ward in rooming-in system. The results of investigations show, that the need of professional support was more often expressed in the study group (p < 0.001). It reached an average--high level. There was no significant difference concerning an accessible social support in both groups. No correlation was showed between accessible social and professional support.

CONCLUSIONS

1. Primiparas require special puerperal care and professional support as well. 2. High, accessible social support has no influence on need of professional support in women during their stay on maternity ward in rooming-in system.