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Biomedical subjects

M Szymczak

Publications and source records attributed to M Szymczak.

At least 19 recordsLinked to original sources
PubMed1999

Treatment of progressive familial intrahepatic cholestasis: liver transplantation or partial external biliary diversion.

Progressive intrahepatic familial cholestasis (PFIC), previously called Byler's disease, is a syndrome in which children develop severe cholestasis progressing to biliary cirrhosis and chronic liver failure, usually during the first decade of life. Clinical features include jaundice, hepatomegaly, splenomegaly, growth retardation and severe pruritus. Laboratory tests demonstrate elevated bilirubin and bile acids, without an increase in serum gamma-glutamyl-transpeptidase or cholesterol. This study was performed to evaluate our experience with medical therapy as well as two types of surgical treatment used in children with PFIC, particularly partial external biliary diversion (PEBD) as an alternative method of therapy to liver transplantation (OLTx). Between 1979 and 1998 we have treated 46 children with PFIC (27 boys and 19 girls), aged 10 months to 19 yr (at the time of this study). Medical treatment with ursodeoxycholic (UDCA) was used in 39 patients for the period between 6 and 82 months. PEBD (cholecysto-jejuno-cutaneostomy) was performed in 16 patients, OLTx in eight children (including one after unsuccessful PEBD). Retrospective analysis of the clinical course and selected laboratory tests (bilirubin, ASPAT, ALAT, bile acids), and histopathological examinations were performed. Results of treatment were assessed by means of influence of the type of treatment on clinical symptoms, laboratory tests, progress of liver cirrhosis and hepatic failure, as well as physical development and survival. Medical therapy was effective in the long term in four (10%) of the patients resulting in clinical and biochemical normalization. Both surgical methods of therapy of PFIC, PEBD and OLTx, resulted in an 80% success rate and therefore should be used as complementary therapies. In patients before established liver cirrhosis, PEBD should be the first choice of treatment. Patients presenting with cirrhosis or after ineffective PEBD should qualify for OLTx. With this strategy most children with PIFC can be cured.

Adolescent↗
PubMed1999

Behavioral effects of occupational exposure to organophosphorous pesticides in female greenhouse planting workers.

51 women employed in gardening enterprises were studied. Of these, 26 performed planting jobs in greenhouses and were occupationally exposed to several organophosphates. The comparison group consisted of 25 women not exposed to neurotoxic chemicals. The groups were similar in terms of age, education, place of habitation, and intake of stimulants and drugs. Exposure determinations were performed during the period when pesticides were intensively used in the greenhouses (March-June). Exposure measurements included air pollution, contamination of skin and clothes, and work timing. The level of total exposure in the planting worker group was low. Psychological examinations were conducted twice: before and after the spraying season, and the Neurobehavioral Core Test Battery recommended by the WHO was administered to all subjects. The results of the psychological tests did not reveal effects of exposure after a single spraying season. Analysis of the results, however, indicated differences between the exposed and control groups on both occasions. The exposed female workers were characterized by longer reaction times and reduced motor steadiness compared to the unexposed workers. In addition, increased tension, greater depression and fatigue, more frequent symptoms of CNS disturbances were observed in the exposed women compared to the controls.

Adult↗
PubMed1997

Primary vascular thrombosis after renal transplantation in children.

The aim of the study was to assess the incidence, causes, diagnostic and treatment modalities, and outcome of vascular thrombosis after kidney transplantation in children. Between 1984 and 1995 we performed 176 kidney transplants in pediatric recipients aged 1 to 18 years. Vascular thrombosis followed 7 transplants, 4 were renal vein and 3 arterial thromboses. Venous thromboses occurred 2 to 12 days after transplantation. All of the patients with a renal vein thrombosis lost their grafts. Arterial thrombosis developed in 2 cases of double renal arteries which were separately anastomosed into the recipient vessels. One graft was lost, but the other was saved by thrombolytic therapy (streptokinase). One child experienced intrarenal segmental artery thrombosis during acute vascular rejection, which resolved following combined anti-rejection and thrombolytic (intra-arterial streptokinase) treatment with full recovery of graft function. In all, vascular thrombosis complicated 7 out of 176 transplants (4.0%), and was the cause of 5 graft losses (2.8%). The incidence of vascular thrombosis was not increased in grafts with vascular anomalies (3/34 v. 4/142; p>0.05, chi sq.). We conclude that acute tubular necrosis, rejection and unstable volemia may predispose to vascular thrombosis. In selected cases, early diagnosis of vascular thrombosis may enable graft salvage by surgical or thrombolytic treatment.

Adolescent↗
PubMed1997

Rhythm patterns of basic brain bioelectric activity in workers chronically exposed to carbon disulfide.

The work aimed at defining the pattern and frequency of rhythm disturbances in basic brain bioelectric activity in EEG recordings, routinely regarded as normal, in workers exposed to chronic carbon disulfide (CS2) poisoning, without detected symptoms of organic lesions in the nervous system. The study covered 188 viscose spinners occupationally exposed to changing concentrations of CS2 vapours whose mean annual results of measurements ranged between 10 and 35 mg/m3, and the mean individual exposure fell within the range of 9.9-41.6 mg/m3 (mean--25.8 mg/m3). The frequency of alpha rhythm was analysed in EEG recordings with exclusive or nearly exclusive alpha rhythm in two groups studied. The presence or absence of subjective symptoms was taken as a criterion for the selection of subjects. Group I was composed of 116 subjects with subjective symptoms. Group II consisted of 72 workers with neither subjective nor objective symptoms. The age in group I ranged from 26 to 65 years (mean, 48.7 years), and the duration of employed from 5 to 39 years (mean, 23.3 years). The complaints reported were of neurasthenic and polyneuropathic type. The age in group II ranged from 28 to 63 years (mean, 49.4 years), the duration of occupational exposure accounted for 8-43 years (mean, 25.6 years). The control group included 194 persons with EEG routinely regarded as normal, matched by gender, age and work shift distribution. The subjects in Group I reported most frequently the following complaints: headache (72.4%), vertigo (48.3%), increased emotional irritability (42.2%), dysmnesia (36.2%), sleep disorders (27.6%), concentration difficulties (25.9%), limb pains (36.2%) and paraesthesia (27.6%). In the groups of subjects chronically exposed to CS2, both with subjective neurological symptoms, and without subjective or objective neurological symptoms, EEG recordings, routinely regarded as normal, did not reveal constant and symmetrical frequency of alpha rhythm waves. EEC recordings in the CS2 exposed workers with subjective neurological symptoms revealed almost constant frequency (12.9%) or slightly fluctuating frequency (41.4%) in 54.3% of subjects. In 45.7% of subjects considerable fluctuation of alpha rhythm frequency at the range of 3-4 Hz was found. Frequency disturbances applied to both sides, however, they were more pronounced in the leftside leads. Statistical analysis showed, neither in Group I nor in Group II, significant relationship between the pattern of alpha rhythm frequency fluctuations, the duration of CS2 exposure and the cumulative exposure index. Substantial and asymmetric fluctuations of alpha rhythm frequency found in the exposed group of subjects with subjective symptoms were considered as subclinical disturbances in the function of the central nervous system.

Adult↗
PubMed1996

Neurological and neurophysiological examinations of workers occupationally exposed to organic solvent mixtures used in the paint and varnish production.

The aim of this work was to examine the nervous system of workers chronically exposed to mixtures of organic solvent at concentrations within or slightly exceeding the MAC values, used in the manufacture of paints and lacquers. The tests were performed on a group of 175 people, 107 men aged 22-59 (x = 41.25), and 68 women aged 20-55 (x = 38.62). The period of employment was x = 17.34 years and cumulative dose index 16.97 for males; for females, the corresponding values were x = 14.75 and x = 11.42, respectively. The control group included 175 people (107 men and 68 women) not exposed to chemicals matched according to sex, age, and work shift distribution. The neurological examinations included subjective and objective examinations of the nervous system, electroencephalographic (EEG) and visual evoked potential (VEP) evaluations. The assessment of organic solvent exposure was performed according to the method described in PN89/Z-04008/07, and the solvent mixtures were shown to contain xylenes, ethyltoluenes, trimethylbenzenes, propylbenzene, ethylbenzene, toluene, aliphatic hydrocarbons and the components of painter's naphtha. The most frequent complaints among the exposed males included headache, vertigo, concentration difficulties, sleep disorders, sleepiness during the day, increased emotional irritability, mood swings with a tendency to anxiety. The objective neurological examinations did not reveal organic lesions in the central or peripheral nervous systems. Generalised and paroxysmal changes were most common recordings in the abnormal EEG. VEP examinations revealed abnormalities, primarily in the latency of the response evoked. The results of this study suggest that exposures to concentrations within MAC values, or below 1.5 of the MAC values of organic solvents mixtures used in the manufacture of paints and lacquers produce subclinical health effect in the nervous system.

Adult↗
PubMed1996

Diagnosis and monitoring of cytomegalovirus infection after liver transplantation in children.

Cytomegalovirus infection (CMV) complicated the posttransplant course in 9 of 24 children after liver transplantation. We found specific antibodies (IgG and IgM) to be of very low value in diagnosis and monitoring of CMV infection after liver transplantation. Detection of CMV-DNA by PCR method in the blood or urine was very useful for diagnosis, but less for monitoring of the course of disease and its treatment. Measurements of early immediate CMV antigen (IEA), in peripheral blood leucocytes allowed for very early diagnosis of CMV infection and correlated well with the course of disease and response to treatment of the patient.

Antibodies, Viral↗