Dendritic polyelectrolytes as seen by the Poisson-Boltzmann-Flory theory.

G3-G9 dendritic polyelectrolytes accompanied by counterions are investigated using the Poisson-Boltzmann-Flory theory. Within this approach we solve numerically the Poisson-Boltzmann equation for the mean electrostatic potential and minimize the Poisson-Boltzmann-Flory free energy with respect to the size of the molecules. Such a scheme enables us to inspect the conformational and electrostatic properties of the dendrimers in equilibrium based on their response to varying the dendrimer generation. The calculations indicate that the G3-G6 dendrimers exist in the polyelectrolyte regime where absorption of counterions into the volume of the molecules is minor. Trapping of ions in the interior region becomes significant for the G7-G9 dendrimers and signals the emergence of the osmotic regime. We find that the behavior of the dendritic polyelectrolytes corresponds with the degree of ion trapping. In particular, in both regimes the polyelectrolytes are swollen as compared to their neutral counterparts and the expansion factor is maximal at the crossover generation G7.

Diffuse nodular lymphoid hyperplasia of the gastrointestinal tract in patient with selective immunoglobulin A deficiency and sarcoid-like syndrome--case report.

Nodular lymphoid hyperplasia is uncommon in adult patients. Associated diseases are common variable immunodeficiency (CVI) and lymphoid tissue malignancies. In this case report we focus on clinical presentation and differential diagnosis of diffuse nodular lymphoid hyperplasia of the gastrointestinal tract coexisting with selective immunoglobulin A deficiency and sarcoid-like syndrome.

Magnification chromoendoscopy in comparison to standard chromoendoscopy for detection of intestinal metaplasia in renal transplant recipients.

PURPOSE: Renal transplantation is associated with frequent gastrointestinal complications. Intestinal metaplasia is a feature of atrophic gastritis whereas the diagnosis of Barrett's esophagus is based on histological demonstration of specialized metaplasia. Both conditions are associated with increased risk of adenocarcinoma. The aim of the present study was to assess whether magnification endoscopy improves the diagnostic accuracy of intestinal metaplasia in stomach and in esophagus. MATERIAL AND METHODS: In this non-randomized, feasibility study thirty one (12 women and 19 men) renal transplant recipients, with a mean age of 44.0 years were evaluated for the presence of intestinal metaplasia. Standard esophagogastroscopy with methylene blue staining was followed by magnification endoscopy. The presence of gastritis and intestinal metaplasia was classified according to modified updated Sydney classification. RESULTS: Of 31 patients, 16 patients had endoscopic and histopathological evidence of gastric intestinal metaplasia, and standard endoscopy with methylene blue staining was sufficient for diagnosis (15 from 16). Magnification endoscopy allowed identification of 6 patients with specialized intestinal metaplasia in Barrett's esophagus, which would be otherwise missed. CONCLUSIONS: In this study diagnostic accuracy of standard endoscopy for identification of intestinal metaplasia in the stomach was not improved by the use of magnification endoscopy, but the latter was an accurate method of predicting specialized intestinal metaplasia in Barrett's esophagus. The use of magnification endoscopy in the clinical setting of renal transplantation needs further studies.

[Surgical tactics in treatment of duodenal injuries after endoscopic sphincterotomy]. / Taktyka chirurgiczna w leczeniu uszkodzen dwunastnicy po endoskopowej sfinkterotomii.

The procedure in case of injury of the duodenum as a complication of endoscopic sphincterotomy remains controversial. We have studied all the cases of duodenal injury after endoscopic sphincterotomy during last 5 years to indicate the best strategy of surgical treatment. We observed 10 cases of duodenal perforations following 464 endoscopic sphincterotomies. Other 4 patients came from different hospitals. Six patients were managed with nonoperative treatment (group I), four patients were operated on right after the diagnosis (group II), and other four patients were initially managed with nonoperative treatment and then were operated at least 3 days after the complications occurred (group III). All the patients treated nonsurgically recovered. All the patients from group III and one from group II died, as a result of duodenal fistula and sepsis. Spontaneous recovery was observed in those cases in which gradual improvement appeared during first 24 hours. Operation should be undertaken when the symptoms are quickly increasing and primary nonsurgical treatment is not satisfied. The operations delayed for more than 3 days give poor results.

[Diagnostic difficulties in the evaluation of diving accidents]. / Trudnosci diagnostyczne w ocenie wypadków nurkowych.

The aim of the paper was to present the difficulties in diagnostics of diver diseases and accidents and the leading role of the otolaryngologist in this aspect. These problems have been illustrated with two unusual diver accidents (the bilateral barotrauma of the inner ear and subcutaneous emphysema of the eye socket in the course of the osteoma of ethmoidal sinuses.

[Enalapril in patients with diabetes mellitus type I with microalbuminuria without hypertension]. / Enalapryl u chorych na cukrzyce typu I z mikroalbuminuria bez nadcisnienia tetniczego.

The studies included 18 normotensive patients with diabetes mellitus type I (mean age 29 years) and constant microalbuminuria (UAE-30 - 300 mg/24 hours). Group A consisted of 10 patients treated with enalapril, and group B--10 patients given placebo. Glomerular filtration rate, ERPF, and UAE were measured before and after 6 months of therapy. UAE decreased significantly in patients of group A (p = 0.02) after 6 months while evident proteinuria was seen in two patients of group B. Arterial blood pressure dropped in patients of group A (131/84 vs 122/78 mm Hg), and increased significantly in patients of group B (126 +/- 8 vs 136 +/- 15 mm Hg; p < 0.05). Blood flow through kidneys improved (p = 0.02) and renal vascular resistance decreased (p = 0.02) in patients of group A. The obtained results suggest that enalapril may prevent diabetic nephropathy in diabetics with constant microalbuminuria.

[Blood pressure and blood lipids in normotensive patients with diabetes mellitus type I with microalbuminuria]. / Cisnienie tetnicze i lipidy krwi u normotensyjnych chorych na cukrzyce typu I z mikroalbuminuria.

The study involved 50 normotensive men (means age = 34 years) with diabetes mellitus type I (mean duration of the disease 14 years). Group I included 29 patients with normal albumin excretion with the urine (UAE below 30 mg daily), and group II-21 patients with microalbuminuria (UAE 30-300 mg daily). Both groups were similar in relation to the age and duration of diabetes mellitus. Blood cholesterol was significantly higher in patients of group II than in patients of group I (p = 0.02) similarly to blood triglycerides levels (p = 0.01). Mean arterial pressure was lower in patients of group I than that in patients of group II (94.3 +/- 7.0 vs 99.1 +/- 6.0 mm Hg; p = 0.01). HbA1c was positively correlated with blood cholesterol (p = 0.01) and blood triglycerides levels (p = 0.05).

[Bladder-uterine fistulas]. / Przetoki pecherzowo-maciczne.

Three cases of the bladder-uterine fistulas treated within the last three years (1982-1984) have been presented. All patients underwent cesarean sections (two patients once, and the third - thrice). The patients were treated surgically. Each one has undergone hysterectomy, and the opening of the fistula into the bladder has been operated by incision of the bladder in two cases and through extracystic approach in one case. Mechanism of development, symptoms, various types, diagnosis, and therapy of the bladder-uterine fistulas have been discussed.

Calicocystostomy in the treatment of giant hydronephrosis.

Calicocystostomy or calicopyelocystostomy was performed for the treatment of hydronephrosis of ectopic or transplanted kidney into the region of the iliac fossa. To the best of our knowledge there is no description of this treatment modality for hydronephrosis in a normally situated kidney. This prompted us to present 2 such cases observed in our clinic.