The "agnosia" syndrome]

Studies have been made on the activity of glycosidases from eye tissues of developing chick embryos and adult hens. The enzymes of carbohydrates metabolism (hyaluronidase, beta-glycosidase and beta-galactosidase) from the sclera, cornea and ciliary body were examined. It was demonstrated that the distribution of glycosidases in different tissues of the eye is not identical. The activity of beta-glycosidase and beta-galactosidase in all the tissues of 14-day embryos is higher than in adult hens; sharp reduction of the activity was observed at the stage of eye opening. The activity of hyaluronidase in the sclera and cornea of chick embryos is maintained at a low level up to the stage of eye opening, being subjected to minor changes.     

The postcholecystectomy syndrome and its prevention]

The authors have made an analysis of results of clinical observations of 953 patients with gunshot wounds of soft tissues. It was found that primary surgical treatment (PST) of the gunshot wounds often proved to be not radical. Later it required reoperations in 30% of the wounded. To get more exact indications for a repeated surgical treatment it is necessary to make a careful revision of the gunshot wound within 3-5 days after getting the wound. The indications for reoperations are as follows: the development of secondary necrosis of the tissues necessary removal of the foreign body, opening of the pockets and leaks in order to provide valuable drainage as well as nonradical PST due to various causes. Reoperations performed according to the indications allowed to make the duration of treatment at an average 7 days shorter and the development of suppurations two times less frequent.     

Spontaneous intracranial hypotension syndrome]

Spontaneous intracranial hypotension is a rare but well known entity first described by the German neurosurgeon Schaltenbrand. We report the clinical and radiological findings of four patients (2 males, 2 females, mean age 55 years) presenting with this clinical entity and peculiar constant MRI findings. Intense postural headache was present in all patients together with a very low CSF pressure at lumbar tap although none of the patients had any history of recent lumbar puncture, spinal or cerebral surgery or cranio-cervical trauma. MRI revealed in all patients an intense meningeal enhancement and thickening which was most prominent on the dural side of the subdural space. The ventricular system was thin, presenting almost like slit ventricules. A downward shift of the cerebellar tonsils and hemorrhagic subdural collections were also observed in two patients. Biopsy of meninges performed in two patients showed fibrosis of the leptomeninges together with signs of old hemorrhage in one case. We postulate that histologic and radiologic changes are due to chronic subdural bleeding in relation with abnormal displacement of the nervous structures due to intracranial hypotension. The underlying cause of spontaneous intracranial hypotension is rarely established and the course of the disease is benign. Some authors have advocated to perform isotopic cysternography in search for a CSF leak, particularly in the spine, that could be surgically corrected. No such investigation has been conducted yet in our patients because the spontaneous evolution has been mostly favorable.     

The pathogenetic characteristics of the anemic syndrome in liver cirrhosis]

Currently a myriad of devices are available for immobilization of the injured or postsurgical upper extremity. Some of these devices are straightforward and easily used, but some are more complicated and require more familiarity for their successful application. However, even simple devices have the potential for misapplication and thus prevent their benefit to the patient. This article is the second in a 3-part series. The goals of the series are (1) to present and review several devices on the market used by shoulder surgeons to immobilize the upper extremity, and (2) to discuss proper application and precautions of their use. It is intended that this series will benefit nurses, therapists, and trainers involved in the use of these devices.     

Nipple dysplasia and androgen syndrome]

Among 1500 patients in the reproductive age of Clinical Department of Endocrinological Gynecology in State Hospital in Warszawa, Poland estimated the correlations between the onset of benign breast disease (BBD) and the incidence of androgenic syndrome. Symptoms of the androgenic syndrome stated in cases of 191 women; 51 of them had also benign lesions of the breasts. It makes 26.9 percent women with the symptoms of androgenicity. Clinical studies have correlated mean age patients with acne, hirsutism, menstrual cycle disturbances, gain of weight (androgenic syndrome) and mean age women who have suffered both androgenicity and BBD.     

alpha-thalassemia accompanied with Gilbert''s syndrome]

Reported frequencies of non-compliance in children with end-stage renal disease range from 8% to 70% with a mean around 40%. Sequelae amount to momentous emotional and financial burdens, including the loss of 7% of transplanted organs. Reasons for non-compliance have too often been attributed selectively to the patients (e.g., emotional, mental, social, or communication problems). Compared with general compliance research, this selective attribution appears to be too simplistic. Selective attribution neglects the patients' experiences within the context of disease and treatment and prevents open communication about non-compliance. Research on personal reasons for non-compliance is scarce. In psychological interviews, a third of our 85 patients with end-stage renal disease (34 boys, 51 girls, mean age 12.7 years, range 7.4-19.3 years) communicated psychologically meaningful reasons for non-compliance, frequently related to interrelational and systemic treatment conditions. Patients indirectly asked for more communication about their subjective reasons for non-compliance.