Franciszek Burdan

Incidence of spinal perineurial (Tarlov) cysts among East-European patients.

The spinal perineurial cyst (Tarlov) is a dilatation between the perineurium and endoneurium of spinal nerve roots, located at level of the spinal ganglion and filled with cerebrospinal fluid but without communication with the perineurial subarachnoid space. The aim of the study was to evaluate it incidence among East-European patients. The retrospective data collected during various magnetic resonance spinal examinations and stored on the picture archiving and communication system was analyzed for an incidence of perineurial cysts. From among 842 patients that underwent examination, 75 cases perineurial cysts were revealed. In 22 cases single anomalies were found. In remaining 53 cases, multiple uni- or less frequently bilateral changes were noted. The most common position was the sacral canal, particularly the level of S2 and S3. Occasionally, cysts were also visible on the cervical, thoracic and lumbar level. Incidence of sacral perineurial cysts was significantly higher in females than in males. Similar data was found for single and multiple changes despite of their localization. Insignificant changes were seen for patient age and cyst size. Perineurial spinal cysts were the most frequently observed on the sacral level and such changes were more common in females.

Anatomical classification of the shape and topography of the stomach

The aim of the study was to present the classification of anatomical variations of the stomach, based on the radiological and historical data. In years 2006–2010, 2,034 examinations of the upper digestive tract were performed. Normal stomach anatomy or different variations of the organ shape and/or topography without any organic radiologically detectable gastric lesions were revealed in 568 and 821 cases, respectively. Five primary groups were established: abnormal position along longitudinal (I) and horizontal axis (II), as well as abnormal shape (III) and stomach connections (IV) or mixed forms (V). The first group contains abnormalities most commonly observed among examined patients such as stomach rotation and translocation to the chest cavity, including sliding, paraesophageal, mixed-form and upside-down hiatal diaphragmatic hernias, as well as short esophagus, and the other diaphragmatic hernias, that were not found in the evaluated population. The second group includes the stomach cascade. The third and fourth groups comprise developmental variations and organ malformations that were not observed in evaluated patients. The last group (V) encloses mixed forms that connect two or more previous variations.

Prenatal tolerability of acetaminophen and other over-the-counter non-selective cyclooxygenase inhibitors

Over-the-counter cyclooxygenase inhibitors are used to relief fever and various types of acute pain like headache, toothache, earache, sore throat, as well as postoperative and menstrual ones. They are also major ingredients in cold and flu mixtures. Unlike well-known organ toxicological profile, their prenatal toxicity was not fully established. For a long time, acetaminophen was considered as a relatively safe antipyretic and analgesic drug during pregnancy. However, a new data indicate that it may increase the risk of cryptorchidism and asthma during childhood as well as preeclampsia, preterm birth, maternal phlebothrombosis and pulmonary embolism. Contrary to acetaminophen, non-selective cyclooxygenase inhibitors (non-steroidal anti-inflammatory drugs - NSAID; i.e., diclofenac, ibuprofen, naproxen) may induce intrauterine growth retardation, ductus arteriosus constriction with secondary persistent pulmonary hypertension, reduced fetal renal perfusion that led to oligohydramion, prolonged pregnancy as well as increase prevalence of intracranial bleeding in newborns. Furthermore, a higher risk of miscarriage, stillbirth and some congenital malformations (cardiac and diaphragmatic defects, celosomy - gastroschisis and umbilical hernia) was reported for non-selective inhibitors, in particular high doses of acetylsalicylic acid (aspirin).

Developmental outcome after exposure to cyclooxygenase inhibitors during pregnancy and lactation

The developmental toxicity of non-selective (ibuprofen, piroxicam, tolmetin) and selective cyclooxygenase-2 inhibitors (DFU) was evaluated in rats. Compounds were administered separately from the eighth gestational to the seventh lactational day. After spontaneous delivery, the weight, length and number of fetuses were determined. The digital radiography and double-staining were used to evaluate the skeleton morphology and mineralization in 7-day-old pups. Maternal toxicity was also assessed. Although decrease in pup weight and length was found, no teratogenic effects were revealed. Decrease in the absolute bone optical density was noted in the groups exposed to the middle and highest doses of tolmetin and ibuprofen, respectively. Increase of the absolute bone density was observed in the groups treated with the middle and the lowest doses of piroxicam, as well as in pups born after the expected day. Non-selective cyclooxygenase inhibitors (non-steroidal anti-inflammatory drugs--NSAID) affected pups growth and influenced mineralization of the lumbar vertebrae.

Pharmacology of Caffeine: The Main Active Compound of Coffee

Caffeine (1,3,7-trimethylxanthine), the main active ingredient of coffee, is a natural methylxanthine derivative that acts as an antagonist of adenosine A1, A2A, and A2B receptors. Unlike metabolism, caffeine absorption, distribution, and excretion are similar in humans and most laboratory animals. Because of rapid absorption, slight binding with protein, the alkaloid crosses intercellular barriers and is well distributed in tissues and organs. Caffeine is metabolized mainly in the liver and the crucial step (i.e., demethylation) is catalyzed by CYP1A2. The compound is eliminated by kidney excretion. In addition to number of positive clinical effects, the alkaloid administration is complicated by number of adverse effects that depend on the ingested dose, age, hormonal status, health status, and concomitantly consumed food and xenobiotics.Abstract Caffeine (1,3,7-trimethylxanthine), the main active ingredient of coffee, is a natural methylxanthine derivative that acts as an antagonist of adenosine A1, A2A, and A2B receptors. Unlike metabolism, caffeine absorption, distribution, and excretion are similar in humans and most laboratory animals. Because of rapid absorption, slight binding with protein, the alkaloid crosses intercellular barriers and is well distributed in tissues and organs. Caffeine is metabolized mainly in the liver and the crucial step (i.e., demethylation) is catalyzed by CYP1A2. The compound is eliminated by kidney excretion. In addition to number of positive clinical effects, the alkaloid administration is complicated by number of adverse effects that depend on the ingested dose, age, hormonal status, health status, and concomitantly consumed food and xenobiotics.

Urinary bladder diverticulum as an unusual content of the inguinal canal

The inguinal urinary bladder hernia is a rare pathology observed mostly in males. A new case of asymptomatic reducible acquired inguinal hernia was revealed in a 54-year-old male during computed tomography (CT) undertaken for oncological follow-up. The right nephrectomy was previously performed due to clear cell carcinoma. The hernia was not visible on the CT 6 months before and on ultrasound performed after voiding. Slight herniation with a wide invagination of transversalis fascia but with empty bladder was seen on CT 4 months after the initial detection of hernia.

Alobar holoprosencephaly with cyclopia – Autopsy-based observations from one medical center

Holoprosencephaly, a major congenital malformation of the brain, consists in a complete or partial failure of the prosencephalon to divide into separate hemispheres. Alobar holoprosencephaly with cyclopia was analyzed on the basis of autopsy reports performed for hospitals admitting patients from the Lublin Region in Eastern Poland in the period of 20 years (1981-2000). The malformation was found in seven newborns - five girls, one boy and one child with sex not established due to agenesia of the genital organs, all autopsied in the years 1990-1999. According to clinical data, none of the mothers (age 24-39 years) was exposed to any prescribed or over-the-counter (OTC) drugs during pregnancy, but one was exposed to paints in early pregnancy. The proboscis was present in four of seven cases. Six of seven children displayed additional congenital malformations. In two cases intrapancreatic accessory spleen suggesting trisomy 13 was found. Alobar holoprosencephaly with cyclopia is a rare lethal congenital anomaly frequently accompanied by other malformations and characterized by large variations in incidence.