Problemy medycyny wieku rozwojowego最新文献

The author studied the mandibular osteogenesis process in Wistar rats during extrauterine development using macroscopic and microscopic investigations. Macroscopic investigations were carried out on rats aged 1, 5, 10, 20, 30 and 70 days, for establishing changes in the structure of the mandible and its elements, and autoradiographic determination of the sites of increased osteogenetic activity using Cr-51 chromium was obtained. Microscopic investigations were carried out in rats aged 1 and 5 days. The purpose of these investigations was a study of the morphological structure of the mandible, autoradiographic demonstration of the sites of increased cellular proliferation using 3H thymidine in rats aged 1 day, and osseous matrix formation in rats aged 1 and 5 days using 3H proline. The reported investigations showed that the periosteum and perichondrium were the source of mandibular bone formation. Proliferation of the cartilage of the condylar process and coronoid process occurs from the side of the perichondrium covering both these processes. This type of cartilage growth differs from the growth of the cartilage on the anterior part of mandibular corpus which showed additionally evidence of enchondral proliferation of cells. The process of osteogenesis was most active in the mandibular processes, anterior part of the mandibular corpus and the sites of attachments of muscles. This finding is explained as a result of function influence on the growing mandible. The results of macroscopic autoradiography performed with Cr-51 were confirmed by microscopic examinations.

In the years 1972-1979, 63 infants with spina bifida and myelomeningocele were under observation: in this group there were 29 boys and 34 girls, newborns and infants constituted 51% of this group. In 54 children spina bifida is observed in lumbar and/or lumborsacral segments of spine. In the roentgenographic evaluation the congenital malformations of urinary tract were present in 13% cases. Congenital skeletal malformations were coexistent in 9% children. In the first I.V.P. the roentgen appearance of hydronephrosis were manifested in 33%, in cystography abnormal picture was observed in 80% cases. The changes in neurogenic bladder were: trabeculated wall, obstructions of the flow of urine, residual urine and in 38% cases reflux into the kidney. Spontaneous flow of urine and normal micturition cystography is observed only in children, in which spina bifida was stated below second lumbar vertebral segment. No correlation exists between the level of spina bifida and radiological image of urinary tract.

The intravesical transurethal electrostimulation was introduced by F. Katona in order to create consciously controlled micturition in patients with neurogenic bladder lesions. The principle of therapy is based on the activation of the intramural receptors and vegetative pathways from the bladder with special exponential electric impulses. The electric stimulation should evoke the bladder sensation and finally the conscious urge to void might develop. Simultaneously the detrusor tonus should be normalised and evoked contractions become stronger and organised, to be able to empty bladder in stream. During the period from May 1977 to October 1980, 24 children with neurogenic urinary incontinence (aged 2-18 years), were treated in the Surgical Department of the Institute of Mother and Child. Most of them have been operated on for meningomyelocoele , 1--for spinal ependymoma, 1--suffered from extensive haemangioma of pelvic brim and spine, 1 child had no obvious signs of dysraphism. The therapeutic programme consisted of 2 series of 40 stimulations in each serie , applied every day. Each session lasted 90 minutes. The current parameters were: intensity of exponential waves, steadily increasing from 0,4 to 6 m A, frequency 70 Hz, impulse duration 5 msek . Before treatment the clinical, neurological and radiological evaluation were done. The extension of neurologic deficite and state of urinary tract were assessed. Every child had IVP and micturition cystourethrography. Since 1978 the urodynamic investigations were introduced. Cystometry was performed before and after each serie of stimulation. Since 1979 the measuring of urethral pressure profile was included, for more exact evaluation of the type of bladder lesion.(ABSTRACT TRUNCATED AT 250 WORDS)

The process of adaptation for extrauterine life can be easily disturbed by respiratory insufficiency. The surfactant deficiency as well as anatomical and physiological immaturity of a newborn can be considered as etiological factors in some diseases, such as respiratory distress syndrome (RDS), transient tachypnoea (TT) syndrome, segmental atelectasis or pneumonia complicated by atelectasis. The widespread used method of treatment is based on mechanical increase of difference between alveolar and atmospheric pressure. So-called constant distending pressure (CDP) increases functional residual capacity (FRC), keeps alveoli open and finally increases oxygenation of arterial blood. During 3 years period continuous positive airway pressure by nasal route (n-CPAP) was used as only one method in 26 newborns. The newborns were treated because of RDS (15 cases) and pneumonia with atelectasis (11 cases). n-CPAP was starting with pressure 8 cm H2O (0.8 kPa) and FIO2 0.5, if atelectasis with severe dyspnea, hypoxia and forced hyperventilation were found. This method was very well tolerated. 22 newborns treated for 2-7 days--survived, 4 small-for-date babies--died. The most common cause of death was septicaemia complicated by disseminated intravascular coagulation. The moderate hyperbilirubinemia, oliguria with tissue oedema was observed in many cases. The light nostril decubitus were only complications. No pneumothorax was detected. We found n-CPAP as a simple, safe method in treatment of atelectasis in newborns.

The urethral meatus caliber was evaluated in 368 boys from 0 to 14 years. The material was divided into 8 age groups. The length and circumference of penis, height and weight were also measured in each investigated patient. Arithmetic mean of urethral meatus caliber was calculated in two-years' age intervals. The relationship between the meatus caliber and other body parameters has been analysed. The equations of linear regression of meatal caliber according to the length and circumference of penis have been established. The urethral meatus caliber in investigated boys ranged from 8 to 23 Charr . This size was increasing gradually according to the age of patients. The highest correlation was found out between the meatus caliber and the length of penis.

In longitudinal complex auxological studies of healthy short stature children in the first decade of life the authors analyse the dynamics of height velocity and growth rate of 11 somatic patterns with skeletal maturation of the hand and wrist as well as the influence of some genetic, paragenetic and biological determinants (morbidity). They find that the degree of stature deficit is on the same level during the period of observation (5-10 years) with slow growth rate in some of the analysed anthropological parameters. The delay of skeletal maturation typical for children under study is coexistent with a number of minor anomalies of hands and wrists which are more frequent than in healthy normal children. These minor anomalies are more frequent in boys than in girls. The analysed paragenetic determinants seem not to be significant, however there exists a strong association between the short stature of mothers and children under study. Moreover a higher morbidity of respiratory tracts is observed in short stature children than in general population.

The authors have presented model of prophylaxis of female genital organ cancers introduced into the practice of obtained and gynaecological health service in Bia ł ystok macroregion . It was emphasized the significance of particular methods-components of mentioned above model to proper function of this model. The results were analysed and compared with the mortality rate trends.

Scientific interest in the placenta derives not only from its enormous diversity of form and function but also from the unique metabolic, endocrine and immunologic properties. The steady increase in size and weight of the placenta throughout pregnancy has been investigated in the large number of studies. The data obtained from weighing the placenta vary considerably, depending upon how the placenta is prepared. If membranes and mass of the cord are left attached and adherent maternal blood clot is not removed, the weight is increased by nearly 50 percent. In our study we tried to asses the value of the feto-placental ratio and to correlate the weight of placenta with the other data obtained during pregnancy and labour and with outcome of pregnancy. A group of 1010 patients was assessed. The data obtained these patients were correlated with the length of pregnancy, the body weight of the baby and the status of the newborn estimated by Apgar score in 1 and 5 min. The feto-placental ratio was significantly affected by the length of pregnancy and the status of the newborn. Another comparisons were made with the medical illnesses during pregnancy, i. g. H--Gestosis, renal diseases and the cholestasis of pregnancy.

On basis of the investigations authors found out that threat of cancerous process is related to increasingly growing disturbances in tissue trophics in disturbances in the process of growth and differentiation of glandular cells of mucosa of uterine corpus as well as increased capacity of cytoplasmic receptor to estrogen and elevated fibrinolytic activity of endometrium.

The aim of the work was an analysis of the causes of difficulties in the rehabilitation of children with profound hearing loss. A theoretical basis of this analysis is the assumption that rehabilitation effects are determined by factors related to the system of care of the deaf child, diagnostic possibilities, and psychophysical properties of the child. The reported analysis was carried out in a material of 232 children aged up to 3 years, treated at the Audiology Outpatient Clinic of the Institute. The following factors were found of great importance in the analysis of difficulties in rehabilitation: care-system applied to the child with a profound hearing loss, diagnosis of the hearing impairment, type of a central nervous system disfunctions .