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BACKGROUND: Acceleromyography has been shown to be an appropriate method in the detection of residual paralysis. However, the clinical importance of an individual calibration of the device in the single patient to improve reliability in detecting residual paralysis remains unclear. METHODS: Observational study in 100 patients undergoing general anaesthesia with endotracheal intubation and a neuromuscular block with atracurium. In all patients, an individually calibrated acceleromyograph was used to estimate a possible residual block at the end of surgery. Immediately after finishing the calibrated measurements at the end of surgery, a non-calibrated measurement was performed. Agreements between the two measurements were tested using Cohen's κ and a Bland-Altman analysis. RESULTS: Data from 96 patients were analysed. At the end of surgery, a discordance in the calibrated and the non-calibrated train-of-four ratio was found in 88 patients. Bland-Altman analysis showed a mean (bias) of 0.01, with limits of agreement of 0.15/-0.15. κ was calculated with κ=0.84 for the absence or presence of a potential residual block if defined as a train-of-four ratio of 1.0 as a threshold. CONCLUSIONS: The results imply a good agreement in the detection of the presence or absence of a residual neuromuscular block between calibrated and non-calibrated acceleromyography if a train-of-four ratio of 1.0 has been chosen as the threshold. However, the estimated train-of-four values are not transferable between calibrated and non-calibrated measurements.

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120 adolescent girl suffered from acyclic pelvic pain and dysmenorrhoe (algomenorrhoee) was presented. They were treated with nonsteroidal anti-inflammatory drugs (NSAIDs) and oral contraceptive pills (OCPs) and underwent a laparoscopy to determine the etiology of pelvic pain. Endometriosis was classified according to American Fertility Society classification. Adolescent with pelvic pain not responding to therapy with NSAIDs and OCPs have different rate of endometriosis.

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The 15 years old adolescent with a rare mullerian anomaly, uterus unicornis with a rudimentary horn is presented. Patient was 15 years old girl suffered from pelvic pain. In this case we illustrate diagnosis, symptoms and therapy. Patient was submitted complex surgical treatment.

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An increasing number of deliveries in adolescents is a growing problem, not only obstetrical but also social in the whole world. Pregnancy is a physiological condition, although with girls under 18 needs a special care and treatment and is called as a high risk pregnancy. Especially girls with age under 16 appear to have high risk of pregnancy pathology as well as low-birthweight infants.

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The revised Regulation on the scope, organization and forms of prophylactic medical care of adolescents, issued by the Minister of Health and Social Welfare on 29 December 1995, has been in force since January 1996 (Journal of Laws, no. 4 entry 31). The Regulation commits doctors, authorized to carry out examinations of workers by virtue of other regulations, to perform prophylactic preplacement examinations among candidates applying for admission to secondary and basic vocational schools as well as of students attending these schools. In the Bydgoszcz voivodship (province) this principle was put into operation in 1993.

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The objective of this article is to describe main certification problems and difficulties that may concern physicians responsible for prophylactic care of adolescents. Certification concerning the replacement of candidates to technical schools is a very complex task and it requires from physicians to examine carefully the health condition of pupils and candidates and assess conditions of the work environment. The prereplacement medical examinations should facilitate the detection of any health defects that could disqualify a candidate.

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We present the case of a woman who had an Accufix atrial "J" pacemaker lead implanted in 1990. Subsequently, Telectronics Pacing Systems recalled two models of the atrial leads after problems with fracture and malfunction were reported. One of these models was used in our case. Fifty-two months after implantation, following recommended fluoroscopic screening, our patient was found to have a complete fracture of the "J" retention wire with one fragment protruding from the sheath in the right atrium and another fragment of the wire lodged in the right ventricle. The pacemaker had continued to function normally and there was no clinical evidence to suggest such a potentially disastrous fracture. Our report emphasizes the importance of fluoroscopic screening of all patients with atrial leads involved in the recall.

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The analysis covered 1615 teenagers, patients of Child's & Adolescents Gynaecology Clinic in Lódz in the years 1980-1990. 338 of them had troubles in the menstrual cycle. Majority of them (55.6%) claimed about algomenorrhoea, 17.6% had oligomenorrhoea and 10.5% had hypermenorrhoea. The examined teenagers were normally developed both in respect of age and gender. Age of menarche is relatively a little lower in Lódz, i.e. 12.4 years of age.

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Evaluation of vaginal discharge in children. Vulvovaginitis is one of the most common problems in clinical medicine and it is the cause cited most often for visits of children to gynecologists. The purpose of the study was to examine vaginal discharge and the sensitivity of there microorganisms to antibiotics. In this study the most (prevalent organism) was Escherichia coli (47.5%). We observed high sensitivity of Escherichia coli to examined antibiotics.

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The authors tried to find the correlation between the occurrence of genital tract candidiasis in adolescents and some subjective and objective examination parameters. The highest correlation rates were found for pudendal pruritus, lower abdominal pains and early applied antibiotic therapy material: 188 adolescent girls.

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Between 1980-1992, 41 teen-agers with ovarian tumors were operated. Adult teratoma and follicular cysts were most often encountered. adenocarcinoma and dysgerminoma were found at 6 cases. The way of operation was depended upon clinical course of stage and result of direct, histo-pathological examination.

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A 41-year-old white-skinned male admitted with 40 per cent total body surface area partial and full skin thickness burns developed septic pericarditis. He had a severe inhalation injury and subsequent pneumothorax. Multiple fibreoptic bronchoscopies were required. The septic pericarditis required pericardectomy which was carried out in two stages. The extensive burns required multiple operations. The patient eventually made a complete recovery.

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A case of documented severe idiopathic hypertrophic subaortic stenosis in which the Valsalva maneuver resulted in paradoxic attenuation of the systolic ejection murmur is presented. Such a response should not be considered incompatible with the diagnosis of this disease.

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The neurotransmitter catecholamines control metabolism 5-HT in pineal gland by stimulating pineal serotonin-N-acetyltransferase (EC 2.3.1.5) activity [1, 2]. To prove the influence of FP on the metabolism 5-HT provoked by norepinephrine was tested. Rat pineal gland were incubated in media containing 5-HT- 14C or 5-HT- 14C and FP (1-10(-6)-1-10(-4) M). Norepinephrine (1-10(-6)-1-10(-4)M) was added at the start of the experiment. The level of cyclic 3',5'-AMP, activity of HIOMT and metabolites of 5-HT-14C was examined. The results have suggested that the FP inhibit the provoked by norepinephrine metabolism of 5-HT in the rat pineal gland by decrease the formation of c-3',5'-AMP.

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