Qualitative and quantitative studies in electron microscopy on influence of experimental ischemia of the vertebral arteries on the outer hair cells function in guinea pigs.

Histological studies were performed in 20 guinea pigs, both sexes, weighing 250-300 g and divided into two groups: I--control (anaesthetized animals without surgery), II--examined (in anaesthetized animals through an incision of the skin and muscles of the neck), the left or right vertebral artery was exposed and a vascular clip was inserted into the foramen of the transverse process of the 2-nd cervical vertebra. 50 days after this procedure, the guinea pigs were again anaesthetized by intraperitoneal injection of 35% solution of chloral hydrate, then vascular and cochlear perfusion with 3.6% solution of glutaraldehyde was performed. Simultaneously, by means of micropreparation, samples of cochlea were made for electron studies by means of electron microscope (Philips EM 300). In qualitative histopathologic examinations in guinea pigs of II group, the ischemia changes of the outer hair cells were greater in the side of irritation of the vertebral artery than at the opposite side. At the receptor side of these cells, under the membrane, there are multilamellar outgrowths in the shape of cisterns, partly expanded. The relative volume of external compartment of mitochondria in control group is as follows respectively: 0.15 +/- 0.0% at the right side and 0.15 +/- 0.08% at the left side, and in II group, respectively: 0.22 +/- 0.06% at the side of irritation and 0.19 +/- 0.07% at the opposite side. The obtained data in electron microscopy, both qualitative and quantitative pointed at ischemia changes of outer hair cells in guinea pigs after prolonged irritation of periarterial plexus of vertebral artery.

[Pathophysiology and treatment of spinal cord medulla injuries]. / Patofizjologia i leczenie urazów rdzenia.

In view of the ever increasing incidence of spinal cord injuries and their very high socioeconomic costs studies are conducted for reduction of their consequences. In recent years considerable advances have been achieved in their treatment. The contribution of various mechanisms damaging spinal cord is known presently rather well, with isolation of two groups of causes: one is the primary spinal cord injury as a result of direct force acting on it during trauma, the other is secondary damage caused by vascular changes following trauma, free radicals, calcium distribution changes, participation of opioid receptors and inflammatory process. For counteracting these mechanisms in secondary cord damage treatment with drugs is justified. Among the drugs the main role is played by steroids--both glucocorticoids and non-glucocorticoids /lazaroids or aminosteroids/. Other drugs include calcium channel blockers, opioid receptor antagonists, serotonin antagonists, cyclo-oxygenase inhibitors, osmotically active drugs, antioxidants, NMDA receptor antagonists. Besides drugs hypervolaemia, haemodilution and hypothermia are tried. Proper diagnostic procedures and effective treatment of cord injury consequences depend on the knowledge of the mechanisms of later consequences of cord injury, this enables achieving of ever more effective treatment results.

[Correlation between results of transcranial doppler ultrasonography and SPECT in the brain of patients with ischemic cerebral stroke]. / Korelacja wyników badan przezczaszkowej ultrasonografii dopplerowskiej i SPECT-u mózgu u chorych z niedokrwiennym uszkodzeniem mózgu.

Single photon emission computerized tomography /SPECT/ and positron emission tomography /PET/ are used presently for the study of the cerebral blood flow /CBF/. The cost of these procedures limits the possibility of their use and makes them available mainly in large and rich clinical centres. Transcranial Doppler USG has no such drawbacks. The purpose of the present study was analysis of a possible correlation between marker cumulation /in SPECT/ in the vascularization area of the middle cerebral artery /MCA/ and the parameters Vs, Vm, Vd, PI, RI, R of the PUSG-G examination of these arteries in 50 patients aged 48-79 years treated for ischaemic cerebral episodes. Brain SPECT examination was done with Apex-SP-6-HR gamma camera assessing the distribution of 99mTc HMPAO marker in the vascularization area of both MCA. PUSG-D examination was done with Tc-2-64 unit. In both MCA the systolic Vs, the mean velocity Vm, the diastolic velocity Vd, the Gosling pulsation index PI, the Purcelot resistance index RI and the velocity amplitude R were measured. The following conclusions have been reached: 1/ in patients with ischaemic cerebral episodes a significant correlation was found between cerebral SPECT findings and the PUSG-D parameters; 2/ reduced perfusion of the cerebral tissue was correlated with lower values of Vs, Vm, Vd, and R and with higher values of PI and RI; 3/ slight disturbances of perfusion found in SPECT were not reflected in changed PUSG-D parameters; 4/ the results justify the use of PUSG-D for indirect assessment of blood flow in the MCA.

[Use of transcranial doppler ultrasonography in patients with vascular dementia]. / Zastosowanie przezczaszkowej ultrasonografii dopplerowskiej u chorych z otepieniem naczyniowym.

The aim of the study was the evaluation of the clinical usefulness of transcranial Doppler ultrasonography /TDU/ in patients with vascular dementia. The study was carried out in a group of 69 patients divided into two groups: group i of 32 patients aged 45-78 years, mean age 58.4 years with two or more ischaemic foci on TDU and dementia symptoms. The cases in this group fulfilled the criteria of dementia according to DSM-IV, ICD 10, MMS scale and Hachinski ischaemic scale. In TDU the following parameters were analysed: maximal velocity /Vmax/, minimal velocity /Vd/, mean velocity /Vmean/ of blood flow in the middle cerebral arteries, pulsation index /PI/ and resistance index /RI/. In group II the patients were divided into three subgroups according to ICD-10 criteria and localization of ischaemic foci: with cortical, subcortical and mixed lesions. The following conclusion have been drawn: 1/ the parameters of TDU could serve for differentiation of patients with vascular dementia; 2/ the PI and RI parameters in TDU are most valuable for diagnosis establishing; 3/ the transcranial Doppler ultrasonography is insufficient for differential diagnosis of dementia.

[Spasticity and physical methods for controlling it]. / Spastycznosc i metody fizykalne jej zwalczania.

Spasticity is one of the greatest difficulties in patients with central nervous system injuries and diseases. Severe spasticity makes treatment, rehabilitation and care of patient very difficult and sometimes even impossible. It has been sought for many years for an objective method to evaluate the degree of spasticity, necessary to establish the results of treatment and rehabilitation. In this study we present subjective and objective methods of evaluating the spasticity in order to classify every patient to adequate therapeutic group. The authors present physical methods that not only contribute to control of spasticity together with pharmacotherapy and surgical treatment, but can be used alone. The big advantage of this therapy is a low invasiveness and the very few side effects.

[Use of modified lateral nucleus pulposus herniation classification in low back pain]. / Zastosowanie zmodyfikowanej klasyfikacji przepuklin bocznych jadra miazdzystego krazka miedzykregowego w zespolach bólowych dolnego odcinka kregoslupa.

Nucleus pulposus herniation is one of frequent causes in spinal pains. The necessity of undertaking of appropriate treatment, often surgical, requires early establishing of precise diagnosis. The traditional classification of herniations into central, centrolateral and lateral seems to be insufficiently precise, especially from the surgical point of view. For that purpose, the authors, following the classification of Volle et al., applied in their analysis the new classification into central and lateral nucleus pulposus herniae and discerning among the latter ones four types with strictly defined localisation: mediolateral, lateral with recess involvement, intervertebral foramen hernia, outside intervertebral foramen hernia. Seventy-two cases were analysed. Hernia was diagnosed by means of CT. Particular attention was given to the most external hernias, that is into and outside the intervertebral foramen. The more accurate method for the assessment of hernias and bone changes was in CT the Reconstruction in sagittal and frontal planes and also in oblique projections. The authors believe that the diagnosis of lateral nucleus pulposus hernias in low spinal area, particularly those with herniation into and outside the intervertebral foramen should be based on CT in appropriate reconstructions.

[Correlation between electronystagmographic findings and results of transcranial Doppler ultrasonography of vertebrobasilar arterial system in patients with vertigo]. / Korelacje wyników badan elektronystagmograficznych i przezczaszkowej ultrasonografii dopplerowskiej tetnic ukladu kregowo-podstawnego u chorych z zawrotami glowy.

The purpose of the study was the determination of correlations between the results of electronystagmographic (ENG) investigations and the blood flow velocity in the vertebrobasilar arterial system measured by Doppler ultrasonography in patients with vertigo. The studied material comprised 68 patients (39 women and 29 men) aged 34-68 years (mean 52.4 years). ENG findings included unilateral hyporeflexia in 25 cases (37.7%), bilateral hyporeflexia in 15 (22.0%) and unilateral canal failure in 8 (11.9%). Doppler USG with neck rotation test showed normal flow velocity in 15 cases (22.0%) and pathological velocity in the remaining 53 cases (78.0%). These results showed that bilateral hyporeflexia is found usually in bilateral failure of vertebral arteries and unilateral hyporeflexia and unilateral canal failure were found with unilateral vertebral artery failure on the same side.

[The evaluation of the usefulness of electronystagmography studies in Doppler's intracranial ultrasonography and brain stem evoked potentials in patients with vertigo]. / Ocena przydatnosci badan elektronystagmograficznych przezczaszkowej ultrasonografii dopplerowskiej i sluchowych potencjalów wywolanych z pnia mózgu u chorych z zawrotami glowy.

The aim of the work was the evaluation of correlations between the electronystagmographic results examinations and Doppler's intracranial ultrasonography and brainstem auditory evoked potentials in patients with vertigo. The were 68 patients tested (39 women and 29 men) aged 34-68 years. The obtained results showed for the correlations between the electronystagmographic results examinations and Doppler's intracranial ultrasonography and brainstem auditory evoked potentials.

[Evaluation of the general condition and selected biochemical blood parameters in various types of retinal vein occlusion]. / Ocena stanu ogólnego i wybranych parametrów biochemicznych krwi w róznych typach zmian zakrzepowych zyl siatkówki.

UNLABELLED: The aim of the study was to evaluate the coagulant and fibrinolytic system, lipid economy and neurological condition in patients with various types of retinal vein occlusion. The material was 70 patients: 8 with diagnosed congestive venous retinopathy, 27 with ischaemic central retinal vein occlusion and 35 with central retinal vein branch occlusion. Apart from the neurological evaluation, every patient underwent determination of: hematocrit, number of blood platelets, total plasma protein with its electrophoretic division, plasma fibrinogen level, kaolin-cephalin and prothrombin coefficient, and the level of triglycerides, total cholesterol with its fractions LDL and HDL. RESULTS: Considerable percentage of patients with arterial hypertension and suffering from partial or multi-symptomatic hemiparesis associated with complication in plasma lipid content indicates significant atheromatous changes in vascular wall which promote occlusion formation. The role of rheological factors in pathogenesis of these changes seems to be secondary.