Lewis antigens and argyrophilic nucleolar organizer regions staining for assessment of potential malignancy of adenomatous polyps of the gastrointestinal tract in children.

Adenomatous polyps (AP) of the gastrointestinal tract in children are very rare. Because of their potential malignancy, they are of great clinical importance. There is little experience in the management of children with AP. The immunohistochemical expression of the Lewis blood group antigens (BGA) (sialosyl-Le(a), Le(a), Leb, Le(x), and Le(y)) and the number of activated nucleoli with the silver staining method for nucleolar organizer regions (AgNORs) were studied in two children with AP. In a girl with isolated AP of the stomach and colon, it was found that antigens Le(b) and s-Le(a) were expressed extensively in the gastric adenoma, and sialosyl-Le(a) throughout the entire length of the rectal adenoma crypts, but in the AgNORs stain the number of nucleoli ranged from two to four, evidencing changes of a benign character. In the case of familial adenomatous polyposis diagnosed in a 9-year-old boy, in some colonic adenomas the number of activated nucleoli was greater than five, and the Le(b) antigen was expressed in superficial epithelial cells in one of the adenomas. Also, extensive expression of antigens Le(y) and s-Le(a) throughout the entire length of the crypt in another polyp removed was observed. We believe that immunohistochemical study of the intensity and extent of the expression of Lewis BGA in the polyp tissue simultaneously with the determination of the number of activated nucleoli by the AgNORs staining method can be helpful in better analysis of cytological risk factors of a malignant transformation.

[Achalasia of the esophagus]. / Achalazja przelyku.

In this review achalasia of the esophagus is presented. Attention is drawn to the prevalence, pathology, symptomatology, diagnostic procedures and several treatment options.

[Carcinoembryonic antigen and immunoglobulin IgE in duodenal ulcer disease in children]. / Antygen karcynoembrionalny oraz immunoglobulina IgE w chorobie wrzodowej dwunastnicy u dzieci.

The aim of this study was to monitor the behaviour of carcinoembryonic antigen (CEA) and immunoglobulin IgE level in children with duodenal ulcer disease. No sex-dependent differences were found in mean values of CEA, whereas the mean IgE level in boys was twice as high as in girls. No seasonal differences in CEA and IgE levels were found. The IgE concentration increased during exacerbations, and this difference was statistically significant. CEA levels changed according to a similar pattern during exacerbation and remission, but remained within normal limits.

[Achalasia--an uncommon cause of severe esophageal motor disorder in children. A case history]. / Achalazja--rzadka przyczyna powaznych zaburzen motoryki przelyku u dzieci. Opis dwóch przypadków.

Two girls, a 11- and 15-year-old are presented with a history of recurrent episodes of vomiting, failure to gain satisfactory weight and dysphagia secondary to an idiopathic achalasia of the esophagus. Attention is drawn to the functional pathology, symptoms, diagnostic procedures and several treatment options.

Carcionoembryonic antigen and immunoglobulin IgE in coeliac disease, food allergy and dudenal ulcer disease in children.

The aim of this study was to estimate the behaviour of carcinoembryonic antigen (CEA) and immunoglobulin IgE level in children with coeliac disease (CD), food allergy (FA) and duodenal ulcer disease (UD). In total, 390 determinations of CEA (201 for CD, 27 for FA and 162 for UD) and 558-IgE (238, 136 and 184, respectively) were carried out during disease aggravations and remissions. The analysis of CEA mean values with respect to sex revealed no differences while IgE level in boys with UD was twice as high as in girls. No differences in CEA or IgE levels were found with respect to the season of the year. The IgE concentration increased during aggravations, but only in the case of UD was the difference statistically significant. CEA behaviour was similar (statistically significant differences for CD and very significant for UD). Both values, however, were normal.

[Duphalac (lactulose) in the treatment of chronic constipation in children]. / Duphalac (laktuloza) w leczeniu przewleklych zaparc stolca u dzieci.

The aim of this study was to estimate the effectiveness of DUPHALAC preparation, produced by Solvay-Pharma, in treatment of functional chronic constipation. 112 children, aged 10 months-15.5 years were examined. DUPHALAC appeared to be very effective, were examined. Only two patients did not accept its taste. Rapidly (approximately after 2.5 weeks) improvement was achieved such as of restoration normal peristalsis and of previously disturbed defecation rhythm, softening of a stool, regression of pain and/or dyspeptic ailments, encopresis and improvement of appetite. In no case undesirable side effects were observed.

[Recurrent abdominal pain in children]. / Nawracajace bóle brzucha u dzieci.

The purpose of the work was an analysis of the causes of recurrent abdominal pain in children treated in the Paediatric Department, Province Hospital in Rzeszów in the years 1975-1991. The analysis included 3480 children (59.3% girls and 40.7% boys) aged 6-16 years. The causes of recurrent abdominal pain were gastrointestinal tract diseases (45.7%), urinary system diseases (36.8%), extra-abdominal diseases (6.4%), psychogenic background (11%).

Chronic constipation: a cause of recurrent urinary tract infections.

In this study children hospitalized for chronic constipation were investigated for urinary tract problems. The study group consisted of 180 children, 62 girls and 118 boys, suffering from recurrent urinary tract infections. In a number of the patients, radiological and ultrasonographic examinations revealed various urinary tract anomalies. When patient presents with a problem of the urinary tract, it is necessary to consider constipation as a possible cause. In many cases the treatment of chronic constipation may be the most important remedy for pyuria, bacteriuria and enuresis.

The significance of early panendoscopy in caustic ingestion in children.

Fourteen cases of esophageal and gastric burns following the accidental ingestion of a caustic substance are presented. Early fiberoptic endoscopy was necessary, for it made possible a precise assessment of the severity and extent of injury and the application of proper conservative therapy. Signs and symptoms of caustic burns in children are an unreliable guide to injury, therefore, panendoscopy should be performed as soon as possible. A delay in the performance of a fiberoptic examination could result in the perforation of the affected organs.

[Functional megacolon in children]. / Megacolon functionale u dzieci.

The author discusses a group of 21 children (15 boys and % girls aged between 4 and 16 years) with diagnosed syndrome of the functional megacolon. Possible causes of the chronic constipation which could lead to the functional megacolon have been analysed. The treatment--preceded by the detailed analysis of anamnesis and laboratory tests (rectoscopy and contrast medium enema)--included: enemas washing out the colon, emollient and laxative agents, fiber-rich diet, and instructions on the proper defecation. Excellent therapeutical results seem to result from the detailed explanation of causes of the functional megacolon. It has enabled to avoid surgical treatment which should be carried out in these cases in which long-term conservative treatment failed.