Altered dopamine signalling in chronic epigastric pain syndrome.

Chronic epigastric pain syndrome (CEPS) is an important diagnostic problem, especially in patients without macroscopic and microscopic changes in gastric mucosa. The cause of this ailment is unclear. The aim of this study was the assessment of coexistence between symptoms of this syndrome and secretion level of dopamine (DA), as well as the efficacy of peripheral and central D2 receptors antagonist. Sixty depressive patients with CEPS occurring independently of the diet and with no Helicobacter pylori infection and 30 healthy subjects were enrolled in this study. Plasma DA and urinary homovanilic acid (HVA) concentration were measured by ELISA, and the mRNA expression of dopa decarboxylase (DDC) in gastric mucosa was evaluated by RT-PCR in 30 patients with CEPS and 30 controls. Severity of epigastric pain before and after 12 weeks 2 x 50 mg itopride or sulpiride treatment was evaluated using the modified 10-point Visual Analogue Scale. Higher average levels of plasma DA and urinary HVA levels in CEPS patients than controls 129.5 ± 22.0 versus 109.1 ± 18.4 pg/ml (p < 0.001) and 6.82 ± 1.55 versus 5.39 ± 1.04 mg/24 h, respectively were obtained. Moreover, the expression of DDC in gastric mucosa of CEPS patients was higher than in healthy subjects (p < 0.01). Sulpiride subsided epigastric pain in 73.3%, but itopride reduced it only in 6.6% of CEPS patients. We concluded that altered dopamine signalling may affect locally-and-centrally mediated chronic epigastric pain.

HIV-1 Gag specifically restricts PI(4,5)P2 and cholesterol mobility in living cells creating a nanodomain platform for virus assembly.

HIV-1 Gag protein assembles at the plasma membrane of infected cells for viral particle formation. Gag targets lipids, mainly PI(4,5)P2, at the inner leaflet of this membrane. Here, we address the question whether Gag is able to trap specifically PI(4,5)P2 or other lipids during HIV-1 assembly in the host CD4+ T lymphocytes. Lipid dynamics within and away from HIV-1 assembly sites were determined using super-resolution microscopy coupled with scanning fluorescence correlation spectroscopy in living cells. Analysis of HIV-1-infected cells revealed that, upon assembly, HIV-1 is able to specifically trap PI(4,5)P2 and cholesterol, but not phosphatidylethanolamine or sphingomyelin. Furthermore, our data showed that Gag is the main driving force to restrict the mobility of PI(4,5)P2 and cholesterol at the cell plasma membrane. This is the first direct evidence highlighting that HIV-1 creates its own specific lipid environment by selectively recruiting PI(4,5)P2 and cholesterol as a membrane nanoplatform for virus assembly.

The effect of long-term melatonin supplementation on psychosomatic disorders in postmenopausal women.

Different psychosomatic disorders are observed in postmenopausal women. The decrease of estrogen production is believed to be the main cause of their severity. It is nowadays evident that the decreased melatonin release in women at this age who suffer from postmenopausal disorders might also contribute to the severity of the symptoms. The aim of the study was to evaluate the effect of melatonin supplementation on female hormones release and the alteration in climacteric symptoms. The study included 60 postmenopausal women, aged 51 - 64 years, who were randomly allotted into two equal groups. Group I was recommended placebo (2 x 1 tablet) and Group II - melatonin (3 mg in the morning and 5 mg at bedtime) for 12 months. Serum levels of 17ß-estradiol, follicle-stimulating hormone (FSH), melatonin and urinary 6-sulfatoxymelatonin (aMT6s) excretion as well as Kupperman Index (KI) and body mass index (BMI) were determined before the start and at 12 months after placebo or melatonin administration. In Group I only the value of KI slightly decreased (28.4 ± 2.9 versus 25.6 ± 3.8 points, P = 0,0619). In Group II - KI decreased from 29.1 ± 2.9 to 19.7 ± 3.1 points (P < 0.001) and BMI from 30.9 ± 2.9 to 28.1 ± 2.3 kg/m2 (P < 0.05). Melatonin supplementation failed to change significantly the serum concentration of female reproductive hormones 17ß-estradiol and FSH. We conclude that melatonin supplementation therapy exerts a positive effect on psychosomatic symptoms in postmenopausal women and can be recommended as the useful adjuvant therapeutic option in treatment of these disorders.

Predictors and prognostic implications of clinical decisions in patients with primary high-risk non-muscle-invasive bladder cancer - results of a cross country retrospective study.

Adjuvant diagnostic and therapeutic procedures are available to reduce the risk of recurrence or progression in patients with high-risk non-muscle-invasive bladder cancer (NMIBC). However, their indications and efficacy remain a matter of debate. The aim of this study was to analyze therapeutic decisions in patients with primary high-risk NMIBC and to analyze the adherence to clinical guidelines in this field.545 consecutive patients, aged a median of 70.3 years, diagnosed with primary high-risk NMIBC in thirteen urological institutions, were enrolled into this retrospective study. Diagnostic and therapeutic decisions after transurethral resection (TUR) were recorded, and predictive factors were analyzed.Restaging TUR was offered to 260 patients (47.7%), up-front intravesical Bacillus Calmette-Guerin (BCG) therapy to 74 patients (13.6%), immediate radical cystectomy to 38 patients (7.0%), and intravesical chemotherapy with the maintenance therapy to 12 patients (2.2%). No additional procedure was performed in 161 patients (29.5%). The strongest predictive factor for restaging TUR was G3 or high-grade cancer (RR 1.68, p<0.01), for upfront BCG therapy it was carcinoma in situ (RR 3.20, p=0.01), for immediate cystectomy it was stage T1 tumor (RR 3.71, p<0.01), for no additional procedures it was G2 or low-grade cancer (RR 2.18, p<0.01).Clinical management of patients with high-risk NMIBC is suboptimal and not standardized. As this can directly influence patients' survival, urgent improvement of urological care in this field should be considered.

Stage of bladder cancer in Central Europe - Polish perspective.

Mortality rate from bladder cancer in Europe is the highest in its Central Region. This study is an attempt to find underlying factors by proper characterisation of large cohort of Polish patients with bladder cancer.This is a multicentre study enrolling 1360 consecutive patients diagnosed with primary urothelial carcinoma of the bladder in years 2012-2013 in Poland. All patients underwent transurethral resection of the bladder tumor. Data on staging and grading of all cancers were collected, as well as several demographic and clinical factors were tested for the association with muscle invasiveness of the cancer.Mean age of the cohort was 69.6 years, male to female ratio was 3:1. Bladder cancer stage Ta, T1 and muscle-invasive (MIBC) was diagnosed in 533 (39.2%), 516 (37.9%) and 296 (21.8%) patients, respectively. Patients with MIBC were older (73 vs. 68 years, p<0.05), had lower body mass index (25.4 vs. 26.5 kg/m2, p<0.05), lower haemoglobin concentration (12.2 vs. 13.4 mg/l, p<0.05), longer history of haematuria (86.2 vs. 74.4 days) and longer time interval from first symptom to diagnosis (118.0 vs. 88.2 days), compared to patients with Ta and T1 tumors.High mortality rate from bladder cancer in Central Europe can result from very high incidence of high-risk T1 tumors and high prevalence of prognostic factors of poor survival.

Effects of fluoxetine and melatonin on mood, sleep quality and body mass index in postmenopausal women.

Frequent mood and sleep disorders and increased appetite leading to obesity are observed in postmenopausal women. Due to the limitations of hormone replacement therapy the researchers look for other treatment regimes. The aim of the study was to evaluate the efficacy of fluoxetine and melatonin in the treatment of these disorders. The study included 64 overweight postmenopausal women, aged 54 - 65 years, with increased appetite. They were randomly assigned in 2 groups. In group I (n = 30) fluoxetine (20 mg in the morning) and placebo (in the evening) were administered for 24 weeks. Group II (n = 34) received fluoxetine (20 mg in the morning) and melatonin (5 mg in the evening) in the same period of time. Hamilton anxiety rating scale (HARS), Beck depression scale (BDI), the insomnia severity index (ISI) and body mass index (BMI) were used to assess the health status and the treatment efficacy. After 24 weeks, comparable and statistically significant reduction in the level of anxiety and depression was obtained in both groups. In group I, the ISI decreased from 14.9 ± 2.5 points to 10.9 ± 1.9 points (P < 0.05) and in group II from 15.8 ± 2.4 points to 7.7 ± 1.5 points (P < 0.001). In group I no reduction in BMI was achieved whereas in group II this index decreased from 30.9 ± 3.1 to 26.3 ± 3.2 (P < 0.05). We conclude that combined administration of fluoxetine and melatonin was useful option to treat mood, sleep and appetite disorders in postmenopausal women.

Influence of tianeptine on melatonin homeostasis and psychosomatic symptoms in patients with irritable bowel syndrome.

UNLABELLED: Selective serotonin reuptake inhibitors (SSRIs) exert beneficial effect on gastrointestinal tract (GIT), but its mechanism has not been recognized. One of the hypothesis assumes, that fluoxetine increases indirectly melatonin production. For this reason it can be hypothesized, that administration of drugs of opposite effect, for example tianepine (selective serotonin reuptake enhancer (SSRE), can reduce melatonin production resulting in harmful effects as regards GIT. The aim of the study was to confirm or reject this hypothesis. The study included 100 patients, aged 21-58 years, with irritable bowel syndrome (IBS). Basing on the Rome III Criteria patients with constipation-predominant (IBS-C, n=50) and with diarrhoea-predominant (IBS-D, n=50) and 25 health volunteers (control group C) were distinguished. Visual Analog Scale (VAS) and Hamilton Depression Rating Scale (HDRS) were used to determine the severity of somatic and psychic symptoms. The concentration of 6-sultatoxymelatonin (6-HMS) in the urine was measured by ELISA method. In both groups the patients were administrated tianeptine 12.5 mg three times daily or placebo for 8 weeks. After 8 weeks of tianeptine therapy no significant changes were found in urinary 6-HMS excretion both in IBS-C group (9.9±3.2 versus 11.5±3.5 µg/24 h) and in IBS-D group (11.8±3.3 versus 12.2±3.5 µg/24 h). Eight-week tianeptine therapy resulted in significant decrease of somatic and psychic symptoms in both investigated groups. The improvement in the quality of life indices was obtained in 76.5% of IBS-C and in 63.3% of IBS-D patients. CONCLUSIONS: tianeptine does not impair melatonin homeostasis in patients with IB, diminishes IBS symptoms and improves the patients' quality of life.

Serum and ascitic fluid serotonin levels and 5-hydroxyindoleacetic acid urine excretion in the liver of cirrhotic patients with encephalopathy.

PURPOSE: The excess and deficit of serotonin can be the cause of somatic and mental disorders. The aim of this study was to evaluate serotonin levels in blood and ascitic fluid as well as excretion of 5-hydroxyindoleacetic acid (5-HIAA) in urine in patients with hepatic encephalopathy (HE). MATERIAL AND METHODS: The study included 75 alcoholic cirrhotic patients divided into 3 groups (HE1, HE2, HE3), 25 patients each, with grade 1, 2 and 3 of hepatic encephalopathy according to West-Haven classification. The control group (C) included 25 clinically healthy volunteers. Venous blood and ascitic fluid were collected in fasting. On the same day a 24-hour urine collection was performed. Immunoenzymatic method was used to determine the serotonin level in serum and ascitic fluid, and 5-HIAA in urine (IBL-RE-59121, RE-59131). RESULTS: In the control group, mean serum serotonin level (ng/ml) was 155.5 ± 38.1 and in the 3 study groups: HE1 - 175.2 ± 32.4 (NS), HE2 - 137.2 ± 28.6 (NS), HE3 - 108.3 ± 46.3 (p<0.001). Serotonin concentration in ascitic fluid was on the average about 25% of its level in serum. The excretion of 5-HIAA in urine (mg/24h) in all groups, was: C - 5.9 ± 2.1, HE1 - 5.8 ± 1.8 (NS), HE2 - 4.8 ± 1.2(NS), HE3 - 4.3 ± 1.3 (p<0.05). CONCLUSION: The results of our study indicate that serum and ascitic fluid level of serotonin and urine excretion of 5-HIAA depends on the grade of hepatic encephalopathy. In patients with severe hepatic encephalopathy serotonin concentration in blood is decreased which can affect some clinical manifestation of this disease.

The conversion of multinuclear µ-oxo titanium(IV) species in the reaction of Ti(O(i)Bu)4 with branched organic acids; results of structural and spectroscopic studies.

Crystalline materials have been synthesized in reactions of titanium(iv) tetraisobutoxide with branched organic acids (HOOCR', R' = CMe(2)Et, (t)Bu, CH(2)(t)Bu) in the molar ratio 1:1 at room temperature under Ar atmosphere. Particular attention has been paid to the structural and spectral characterization of metastable intermediate complexes of general formula [Ti(7)O(9)(O(i)Bu)(4)(HO(i)Bu)(OOCCMe(2)Et)(6)](2) (1) and [Ti(6)O(5)(O(i)Bu)(6)(OOC(t)Bu)(8)] (3), and their conversion towards more structurally stable compounds [Ti(6)O(6)(O(i)Bu)(6)(OOCC(Me)(2)Et)(6)] (2) and [Ti(6)O(6)(H(2)O)(2)(O(i)Bu)(6)(OOC(t)Bu)(6)] (4). The hexanuclear structure of (5) ([Ti(6)O(6)(O(i)Bu)(6)(OOCCH(2)(t)Bu)(6)]) has been postulated on the basis of IR and (13)C NMR spectroscopic data analysis. The possible reaction pathways which may occur during the formation of the above mentioned compounds are also discussed.

Evaluation of melatonin effectiveness in the adjuvant treatment of ulcerative colitis.

Ulcerative colitis (UC) is a chronic disease characterized by the variable clinical picture with the inflammatory changes which can involve the whole colon or its distal part. The current treatments for UC are mostly nonspecific, not always effective, and often accompanied by serious side effects. Therefore, there is a considerable interest in finding alternative and more tolerable treatments for this serious disease. Several lines of experimental studies have shown that melatonin (MEL) regulates the extensive gut immune system and exerts antiinflammatory and immunomodulatory effects suggesting its beneficial action in UC by reducing and controlling inflammation. The study aimed at evaluating the effect of MEL on the activity of inflammatory process and sustaining the remission in patients with UC. It comprised 60 patients with left-sided UC, divided in two equal groups of 30 patients each (38 women and 22 men, aged 26-49 years), similar in both groups, who were in clinical remission for the last 12 months. Patients, during a next period of 12 months, were given mesalazine in daily doses 2 x 1.0 g and melatonin 5 mg daily at bedtime (group I) or placebo (group II). All the patients on MEL adjuvant treatment remained in remission during 12 months of observation with The Mayo Clinic Disease Activity Index (MCDAI) values 1.50±0.51 at the beginning and 2.75±1.86 points after 12 months. In the placebo group significantly higher MCDAI values were observed than in patients on MEL after 6, 9 and 12 months. At the inclusion MCDAI was 1.61±0.68 points and at the end of observation it reached the value of 5.10±2.22 points. In MEL group CRP level remained within the normal range during the course of the study (from 3.49±1.40 to 4.17±2.10 mg/dl). Whereas in the placebo group from the end of the third month the steady rise in CRP blood concentration was noted from 3.85±1.29 to 13.13±6.08 mg/dl. Parallelly to CRP rise a significant decrease in hemoglobin concentration in blood from 12.05±0.69 to 10.93±0.81 g/dl was observed in patients receiving placebo and the values significantly differed between the groups after 3 (p<0.05), 6, 9 and 12 months (p<0.01). The level of anxiety and the intensity of depression in patients on adjuvant MEL decreased during the study but there were no statistical differences noted between the groups. The results of the study allowed drawing the conclusion that adjuvant melatonin therapy may help in sustaining remission in patients with UC.

Evaluation of urinary 6-hydroxymelatonin sulphate excretion in women at different age with irritable bowel syndrome.

Melatonin (MT) exerts a beneficial action in the treatment of many diseases, among them also in irritable bowel syndrome (IBS). Its secretion decreases with age, particularly, in the postmenopausal period in women. It has not been determined whether these changes can have an impact on the clinical picture of IBS. The study aimed at evaluating the urinary excretion of the main MT metabolite - 6-hydroxymelatonin sulphate (6-HMS) in women at different age with IBS. The investigations were carried out in five groups of 30 women each. Group Ia (the controls) - premenopausal healthy women (20-39 years), group Ib (the controls) - postmenopausal healthy women (46-66 years), group II - women with constipation predominant IBS (IBS-C; 19-42 years), group III - women with diarrhoea predominant IBS (IBS-D; 20-39 years), group IV - women with IBS-C (49-68 years), group V - women with IBS-D (48-69 years). The diagnosis of IBS was based on the Rome III Criteria after excluding other diseases. On the day of the study the patients remained on the same liquid diet (Nutridrink - 3x400 ml) and 1500 ml of still mineral water. 6-HMS concentration in urine was measured by ELISA method applying IBL antibodies (RE-54031, Immunological Laboratories). The results showed that 24-hour urinary 6-HMS excretion in the studied premenopausal women were as follows: group Ia - 15.13+/-5.83 microg/24 h, group II - 28.85+/-12.59 microg/24 h (p<0,01), group III - 26.10+/-11.76 microg/24 h (p<0,01) and in the postmenopausal subjects they were: group Ib - 10.66+/-3.23 microg/24 h, group IV - 13.73+/-5.09 microg/24 h ((p=0,02), group V - 21.39+/-10.88 microg/24 h (p<0,01). In women with IBS-C the obtained results of 24-hour 6-HMS urinary excretion were independent on the intensity of clinical symptoms. On the other hand, in women with IBS-D, both in the group III and V, higher intensity of ailments was accompanied by significantly increased 6-HMS urinary excretion. The results of the study allowed drawing the following conclusions: (1). 24-hour 6-HMS urinary excretion in women with the constipation-predominant (IBS-C) as well as the diarrhoea-predominant IBS (IBS-D) is higher than in healthy persons both in the premenopausal and postmenopausal period. (2). Relatively high 6-HMS urinary excretion in postmenopausal women with IBS-D indicates an adaptive increase in MT secretion from EC in the gut.

Influence of cigarette smoking on the level of mRNA of somatostatin receptor 3 (SSTR3) in the gastric mucosa of patients with functional dyspepsia.

PURPOSE: Helicobacter pylori (H. pylori) infection and smoking of cigarettes increase individual risk to gastric carcinoma. In stomach tumors, an expression of somatostatin receptor 3 (SSTR3) is diminished or completely lost. The purpose of these studies was to determine the influence of smoking cigarettes and H. pylori infection on the expression of SSTR3 in patients with functional dyspepsia. MATERIALS AND METHODS: The study comprised 109 patients with functional dyspepsia in the age range 28-61 years. The total 218 biopsies used for analysis were divided into two groups: group I - 176 biopsies from non-smokers (72 from H. pylori positive ones), and group II - 42 biopsies from cigarette smokers (28 from H. pylori positive patients). The SSTR3 mRNA amount in the gastric mucosa (1 biopsy from the antrum and 1 biopsy from the corpus) was determined by real time RT-PCR. The presence of H. pylori colonization in the stomach tissue was evaluated by multiplex PCR. RESULTS: In the H. pylori negative samples the amount of the SSTR3 mRNA was significantly lower for smokers than for non-smokers (by 40%, p < 0.010). Infection with H. pylori caused reduction of the level of SSTR3 mRNA in non-smoking patients by ca. 30% (p < 0.01), while in samples from smokers the SSTR3 mRNA level was similar regardless of H. pylori infection. CONCLUSIONS: The cigarettes smoking and H. pylori infection are independent factors leading to decreasing of the SSTR3 mRNA level in gastric mucosa of patients with functional dyspepsia.

No association between the Arg194Trp and Arg399Gln polymorphisms of the XRCC1 gene and colorectal cancer risk and progression in a Polish population.

BACKGROUND: The risk of sporadic colorectal cancer can be associated with environmental and lifestyle factors that may be sources of physical and chemical carcinogens, modulated by products of many low penetrance genes. Polymorphisms of DNA repair genes may influence variation in individual DNA repair capacity, which is crucial for preventing genomic instability, which, in turn, may be associated with risk of cancer. XRCC1 is an essential protein for the base excision repair pathway which primarily deals with DNA base modifications, arisen spontaneously or as a consequence of the action of environmental factors. AIM: To perform a case-control study and test the association between two polymorphisms in the XRCC1 gene: Arg194Trp and Arg399Gln and colorectal cancer risk and progression. METHODS: Genotypes were determined in DNA from peripheral blood lymphocytes of 100 colorectal cancer patients and 100 age, sex and ethnic-matched cancer-free controls by PCR RFLP. RESULTS: We found that both polymorphisms of the XRCC1 gene were not associated with risk and progession of colorectal cancer in a Polish population. Moreover, there was not such association form the Arg194Trp/Arg399Gln haplotypes. CONCLUSION: The Arg194Trp and Arg399Gln polymorphisms of the XRCC1 gene may not be associated with colorectal cancer in Polish population.

Nocturnal secretion of melatonin in patients with upper digestive tract disorders.

Recently, the results of many experimental investigations have shown that melatonin possesses gastroprotective properties. On the other hand its role in pathogenesis of upper digestive tract diseases in man still remains unclear. The aim of the study was to investigate nocturnal secretion of melatonin in patients with functional and organic diseases of the upper part of digestive tract. The investigations were carried out in 149 persons, aged 21-51 years, including healthy subjects (group I, n=30), and patients with non-erosive gastroduodenal reflux (NERD, group II, n=24), with gastroesophageal reflux disease (GERD, group III, n=25), with functional dyspepsia (FD, according to the Rome III Criteria, group IV, n=36) and with recurrent duodenal ulcer (DUD, group V, n=34). Diagnoses were established on the basis of endoscopic imaging and histological examination, 24-hour pH-metry and laboratory tests. Melatonin serum concentration was measured with ELISA method. Blood samples were taken for examination in red-lighted room at 10 p.m. and on the following day at 2 and 6 a.m. The highest concentration of melatonin in all examined groups was determined at 2 a.m. The average melatonin concentration in healthy subjects was 34,7 +/- 4,8 pg/ml. In patients with GERD and DUD melatonin concentration was lower than in healthy subjects - 27,2 +/- 8,5 pg/ml and 25,5 +/- 6,2 pg/ml respectively (p < 0,05; p < 0,01). The highest concentration of melatonin was found in patients with NERD and FD - 43,2 +/- 10,8 pg/ml and 42,4 +/- 10,1 pg/ml (p < 0,01; p < 0,05). The findings of this study support the notion that melatonin exerts beneficial influences on the upper digestive tract. It is likely that high or relatively correct secretion of melatonin is sufficient to prevent peptic changes in esophageal and duodenal mucosa.

A hydrophobic domain in the large envelope protein is essential for fusion of duck hepatitis B virus at the late endosome.

The duck hepatitis B virus (DHBV) envelope is comprised of two transmembrane (TM) proteins, the large (L) and the small (S), that assemble into virions and subviral particles. Secondary-structure predictions indicate that L and S have three alpha-helical, membrane-spanning domains, with TM1 predicted to act as the fusion peptide following endocytosis of DHBV into the hepatocyte. We used bafilomycin A1 during infection of primary duck hepatocytes to show that DHBV must be trafficked from the early to the late endosome for fusion to occur. Alanine substitution mutations in TM1 of L and S, which lowered TM1 hydrophobicity, were used to examine the role of TM1 in infectivity. The high hydrophobicity of the TM1 domain of L, but not of S, was shown to be essential for virus infection at a step downstream of receptor binding and virus internalization. Using wild-type and mutant synthetic peptides, we demonstrate that the hydrophobicity of this domain is required for the aggregation and the lipid mixing of phospholipid vesicles, supporting the role of TM1 as the fusion peptide. While lipid mixing occurred at pH 7, the kinetics of insertion of the fusion peptide was increased at pH 5, consistent with the location of DHBV in the late-endosome compartment and previous studies of the nonessential role of low pH for infectivity. Exchange of the TM1 of DHBV with that of hepatitis B virus yielded functional, infectious DHBV particles, suggesting that TM1 of all of the hepadnaviruses act similarly in the fusion mechanism.

[Laryngeal mask of gastroesophageal reflux disease]. / Maska laryngologiczna choroby refluksowej przelyku.

Gastroesophageal reflux disease has become a serious problem not only for general practitioners but for other specialists as well. It is caused by the fact that its clinical picture and symptomatology are very rich. Beside characteristic symptoms such as: heartburn, eructation, gastric contents reflux, epigastric burning or dysphagia, there may appear extroesophageal symptoms (frequently as single or leading ones). It is generally though that the above symptoms result from the direct effect of gastric contents on throat and larynx and/or through vagus nerve. Direct effect of hydrochloric acid and other gastric juice components on larynx may be the cause of subglottic laryngostenosis, neoplastic transformation and development of squamous cell carcinoma. This, it may be concluded that gastroesophageal reflux disease should be in the sphere of interest of laryngologists as well as gastroenterologists. Cooperation of these specialists is particularly useful as it quickens the choice of proper diagnostic procedure and an introduction of an appropriate therapeutic treatment.

[The advanced stomach cancer]. / Zaawansowany rak zoladka.

In the years 1993 to 1997, 106 patients with gastric carcinoma were treated. The age of patients ranged from 24 to 90 years. There were 73 males and 33 females. Variant advancement of gastric carcinoma was diagnosed in the patients: 29 had III grade and 77 IV grade according to TNM. The following resections of the stomach were performed: total in 38 (46%), subtotal or partial 45 (54%). While the remaining 23 patients had other operative procedures. The resection rate increased from 13% to 54%. Chemotherapy was also used. 53 patients died. The authors conclude that the increase in surgical radicalness and application of aggressive chemotherapy are the methods improving the results in gastric carcinoma.

[Effect of prokinetic drugs inhibiting dopaminergic system on gallbladder motility in subjects with duodenal ulcer]. / Wplyw leków prokinetycznych hamujacych uklad dopaminergiczny na czynnosc ruchowa pecherzyka zólciowego u osób z choroba wrzodowa dwunastnicy.

The purpose of this study was to determine the effect prokinetic drugs inhibiting dopaminergic receptors on gallbladder volume in normal conditions. The study comprised 90 males, aged 20-26 years with duodenal ulcer disease in remission alloted into 3 groups, 30 subject each. The gallbladder volume was determined in group I after placebo or 10 and 20 mg or metoclopramide administration; in group II: placebo or 10 and 20 mg of domperidone and in group III after placebo or 50 and 100 mg of sulphiride administration. Gallbladder motility was assessed ultrasonographically from 15 minutes to 2 hours since placebo or drug administration. The effect of the studied prokinetic drugs in fasting on gallbladder motility was differentiated after metoclopramide no significant changes in gallbladder volume were observed; after domperidone in the dose of 20 mg a slight decrease of gallbladder volume was found, whereas after sulphiryde statistically significant decrease was detected.

Effect of the H2 histamine receptor antagonist on oxygen metabolism in some morphotic blood elements in patients with ulcer disease.

BACKGROUND/AIMS: Our investigations was carried out in order to examine the effect of cimetidine, ranitidine and famotidine on the generation of free radicals, lipid peroxidation and enzymatic antioxidative defense in the blood of patients with peptic ulcer disease, clinically diagnosed as gastric or duodenal ulcer. METHODOLOGY: 124 non-smoking males (aged 20-51 years), were randomly divided into 4 groups: 28 patients received intravenously 200 mg of cimetidine; 26 patients intravenously 50 mg comprised of ranitidine; 25 patients received intravenously 20 mg of famotidine; and 45 healthy men served as the control group. Superoxide dismutase activity, malonyldialdehyde concentration in blood platelets and superoxide anion generation in granulocytes were determined in all examined men. An assay of superoxide dismutase activity and malonyldialdehyde concentration were performed before drug administration and after 2 and 72 hours. Superoxide anion generation was estimated before drug administration and after 2 hours. RESULTS: Our data indicate that all examined H2 receptor antagonists stimulate superoxide dismutase activity, but after 72 hours a distinct increase was observed, in addition to a decrease of malonyldialdehyde concentration. No differences have been observed in superoxide anion generation in patients with ulcer disease or in healthy subjects before and after ranitidine and famotidine administration. Only after 2 hours of cimetidine administration was a significant increase in superoxide anion generation observed. CONCLUSION: We concluded that H2 receptor antagonists have a beneficial effect on antioxidative processes.