[Assessment of p53 dependent apoptosis in glia-derived tumors of the brain]. / Ocena zjawiska apoptozy w glejopochodnych guzach mózgu w oparciu o badanie antyonkogenu p53.

There are conflicting reports in connection with the association of the p53 tumour suppressor gene mutation with the clinical and histopathological progression of gliomas. Glia-derived neoplasms frequently show mutational changes in the p53 gene which result in enhancement of tumorigenesis. The aim of the paper was an assessment of the frequency of mutations in the exon 8 of this gene. The specimens from 14 patients operated for glial tumors were investigated by polymerase chain reaction-assisted--single strand conformation polymorphism (PCR-SSCP). We found aberrant bands in 64.3% of specimens. The percentage of mutations was similar in patients with benign and malignant tumours. There was no correlation between the alteration of the gene and intensity of necrosis in histological examination in patients with glioblastoma. Changes in activity of the p53 gene were more frequent in younger patients and in males when compared to women.

[Expression of bcl-2 gene in glia-derived tumors of the brain]. / Ekspresja genu bcl-2 w glejopochodnych guzach mózgu.

Bcl-2 gene is an important factor in regulation of apoptosis as an inhibitor of this process. Its increased expression is observed in numerous neoplasms, what points out on importance of this gene in the process of oncogenesis. The aim of this paper was to assess the expression of bcl-2 gene in the cells of the glia-derived tumours of the brain. The method of Chomczynski and Sacchi with guanidine tiocyanate was applied to isolate a whole cellular RNA. Expression of bcl-2 gene was measured with a reverse transcription method by a synthesis of cDNA and amplification of gene fragment with specific oligonucleotides in polymerase chain reaction (RT-PCR). The expression of bcl-2 gene was found in cells of all examined glial tumours at the level of transcript. We carried out the discussion of the results and an attempt to explain the importance of bcl-2 gene expression of these neoplasms.

[The application and evaluation of TachoComb in repair of lacerations of dural sac]. / Zastosowanie i ocena przydatnosci Tachocombu w operacyjnym zaopatrywaniu uszkodzen worka oponowego.

The opening of dural sac (deliberate or accidental) during operation of the spine should be watertightly closed because of the risk of cerebro-spinal fluid leakage and infectious complications. Suturing the dural sac is sometimes difficult and time-consuming in cases of dural sac lacerations in a narrow confined space or in the proximity of radices. This occurs particularly in the case of reoperation in presence of scar involving the dural sac, that increases the risk of laceration. The aim of this paper is to asses the usefulness of a new sealing and haemostatic material--TachoComb in a watertight closure of the dural sac during spinal operation. We compared the frequency of complications related to closing of the dural sac in patients operated before and after introduction of TachoComb. The results indicate that the rate of liquorrhoea and infections is lower in the postoperative period with addition of TachoComb. Addition of TachoComb allows to shorten the time of operation, while its application is relatively easy.

[Direct effects of the intrathecal administration of normal saline for the brain expansion after the removal of subdural hematoma]. / Bezposrednie skutki dokanalowego podawania fizjologicznego roztworu soli w celu rozprezenia mózgu po usunieciu krwiaka podtwardówkowego.

In a group of 360 patients the effects were studied of various management methods in case of lacking expansion of the brain after removal of chronic subdural haematoma on the therapeutic results. It was found that intrathecal infusion of normal saline was an effective procedure, with small frequency of transient complications, and was followed by a considerably lower number of re-operations than after external or internal drainage of haematoma cavity.

[The early results of surgical treatment of chronic subdural hematomas in computerized tomography imaging]. / Wczesne wyniki leczenia operacyjnego przewleklych krwiaków podtwardówkowych w obrazie tomografii komputerowej.

Since the introduction of computerized tomography (CT) it has been possible to trace the image of the brain after removal of subdural haematoma. Postoperative studies demonstrated often presence of residual haematoma. This raises the problem of establishing indication to reoperation, especially of patients with good clinical condition. The clinical condition and CT images before and after operation were assessed in 20 patients treated surgically for chronic subdural haematoma. A statistically significant correlation was found between the magnitude of the effect of the space occupying lesion in CT image and the severity of the clinical condition. A high-grade mass effect with major ventricular system shifting was more often connected with presence of partly haemolysed haematoma in CT. Subdural haematoma thickness exceeding 20 mm correlated with serious clinical condition of the patient, and increased the likelihood of hemiparesis persisting after the operation. Finding of residual haematoma in postoperative CT should not be an indication to reoperation, if not associated with high-grade mass effect and if the clinical condition is good. In our material out of 15 patients with good clinical condition postoperatively residual haematoma was detected by CT in 12 cases, but only one had to be reoperated because of persistent high-grade mass effect.

[Early results of surgical treatment of chronic subdural hematoma in CT images]. / Wczesne wyniki leczenia operacyjnego przewleklych krwiaków podtwardówkowych w obrazie tomografii komputerowej.

Since the introduction of CT it has become possible to trace the pattern of brain changes after removal of subdural haematoma. Postoperative studies show frequently presence of haematoma residues, and this is connected with the problem of deciding about establishing of indications to reoperation, especially difficult if the patient is in a good clinical condition. The clinical status was compared with CT findings preoperatively and postoperatively in 20 patients subjected to operations for chronic subdural haematomas. A statistically significant correlation was found between the size of the mass effect in CT before and after the operation and the severity of the clinical condition. Major mass effect with high-grade ventricular shifting is more frequently connected with partially haemolysed haematoma in CT. The thickness of subdural haematoma exceeding 20 mm correlated with severe clinical condition, and increased the probability of hemiparesis persistence after the operation. Finding of residual haematoma in CT imaging after the operation, especially when not associated with high-grade mass effect, and with good clinical condition should not be accepted as an indication to repeated operation. In the presented material out of 15 patients with good clinical condition 12 had CT evidence of residual haematoma, and only one had reoperation in view of persisting evident mass effect.

[Factors affecting the quality of life of patients treated by a combined method for poorly differentiated supratentorial glioma]. / Czynniki wplywajace na zmiany jakosci zycia chorych leczonych w sposób skojarzony z powodu niskozróznicowanych, nadnamiotowych glejaków mózgu.

The quality of life of patients treated for brain tumours and the length of survival are important factors making possible the evaluation of treatment effectiveness. Changes of life quality evaluated by the Karnofsky scale were analysed in a group of 56 patients who have received combined treatment for poorly differentiated supratentorial gliomas. Life quality changes were evaluated after completion of surgical and radiological treatment in relation to preoperative status. The influence of various clinical factors on life quality changes was evaluated. Surgical treatment and tumour site had a significant effect on the stabilization or slight improvement of life quality. The direction and extent of life quality changes were related to surgery, with further change after radiotherapy.