[Adaptation of computed tomography and roentgenography to bone density measurements]. / Adaptacja tomografii komputerowej i rentgenografii do pomiarów densytometrycznych tkanki kostnej.

The increasing interest in issues connected with osteoporosis has recently caused the development of many new diagnostic methods which allow the measurement of bone density. The DEXA method, performed by specialised densitometers, is one of the most developed and reliable methods. However, the high cost od densitometers and DEXA investigation prevent this method from becoming easily accessible for everyday diagnosis. The adaptation of computerised tomography and rentgenography to densitometric measurements could be one of the methods by which the problem of densitometric diagnosis accessibility could be solved. Both methods are usually applied in the imaging of human tissues, working on the basis of differences in tissue X-ray absorption. X-ray absorption and density are related by linear function in the energy range used in rentgenography and tomography; therefore, quantitative information concerning density should be easily received. The procedure adapting computerised tomography and rentgenography to quantitative measurements of bone density in the lumbar spine is outlined in this work. The quantitative information is obtained from digitalised tomographic and rentgenographic images through use of a personal computer. Both methods were tested using a set of phantoms imitating the lumbar spine and the surrounding tissues. The precision and accuracy of both methods were assessed and compared to the precision and accuracy of the DEXA method. The outlined results confirm the usefulness of the described method in diagnosis.

[Congenital defects of the spinal cord and canal in neuroimaging]. / Wady rozwojowe kanalu i rdzenia kregowego w neuroobrazowaniu.

Authors present the clinical classification of spinal dysraphisms and discuss all imaging modalities useful in the diagnosis: conventional X-rays, myelography, computed tomography, myelo-CT and magnetic resonance imaging. They precise the place of ultrasound in the prenatal and postnatal imaging of spinal dysraphisms.

The results of the brain computer tomography and clinical picture in acute cholinesterase inhibitors poisoning.

The aim of this study was to evaluate a morphological and functional status of the CNS in acute cholinesterase inhibitors (ChI) poisonings using the brain computer tomography (CT) and complex psychiatric examination. Under examination there were 59 cholinesterase inhibitors orally poisoned patients, treated at the Department of Clinical Toxicology in years 1984-1997, aged from 14 to 68 (mean 34.7 +/- 12.8) years. The examined group comprised 9 women (15.3%) and 50 men (84.7%). Between the 3rd and 7th day of hospitalisation a complex psychiatric examination was performed. The CNS damage was diagnosed when the point score from complex psychiatric examination was minimum 5 points. CT was performed between the 3rd and 10th day after the intoxication. Incorrect CT scans were found in 78% of poisoned patients. The most common lesion was generalised cortex atrophy and subcortex atrophy of the brain (73.9%), followed by isolated cortex (17.4%) and subcortex atrophy with simultaneous areas of low density in the subcortical nuclei (8.7%). The frequency of incorrect CT scans was statistically higher (p < 0.01) in the group of organophosphorous compounds poisoned patients compared to those poisoned with carbamates. The complex psychiatric examination revealed in 24 patients (40.7%) the differently intensified alterations, but the point score was not higher than 4. Unquestionable damage of the CNS was recognised in 34 patients (57.6%) of the ChI poisoned patients. The frequency of CNS changes detected in complex psychiatric examination was statistically higher (p < 0.01) in the group of the severely poisoned patients. The significantly higher frequency of pathological changes revealed by the brain CT was found in the group of patients with higher than 5 point score obtained from the complex psychiatric evaluation compared to those with score lower than 5 (p < 0.001).

Progress in the CT evaluation of the cerebral atrophy in acute poisoning with carbon monoxide.

The aim of the study was to evaluate the frequency of occurrence and intensification of the cerebral atrophy changes taking into consideration the age of the examined, in the course of acute poisoning with carbon monoxide. A modified Messe's method was used to evaluate brain atrophy. 111 patients intoxicated with carbon monoxide were examined using CT of brain. In 75% of them cerebral atrophy was stated. To evaluate a dynamics of changes a control CT examination was performed in 72 patients after a year.

Combined treatment with antibiotic, heparin and streptokinase--a new approach to the therapy of bacterial osteomyelitis.

Combined treatment by continuous intravenous infusion of a selected antibiotic and heparin and/or streptokinase was elaborated as a method of causal, systemic treatment of bacterial osteomyelitis. The aim of the combined treatment was to overcome infection and disturbances in the coagulation and fibrinolysis system which lead to impairment of the bone blood supply and its subsequent necrosis as the main factor in the aetiopathology of osteomyelitis. Between 1969 and 1991, combined treatment was introduced in 63 patients with acute onset disease or with chronic osteomyelitis. Osteomyelitis was located in the mandible in 38 patients and in the long bones in 14 patients. Prior to combined treatment, moderate bone surgery was performed in 21 patients, while 31 patients were excluded from surgery. Combined treatment with an antibiotic and heparin (A+H) was performed in 43 patients, and the other 6 patients had infusion of an antibiotic, streptokinase and heparin (A+S+H). The authors' method of combined treatment offers a new approach and an alternative to routinely-ordered antibiotic therapy and radical surgery, which allow frequent recurrences of the disease, a long-lasting course and severe complications.

[Fate of patients after surgical treatment of premature closure of cranial sutures]. / Losy chorych po przebytym leczeniu operacyjnym z powodu przedwczesnego zarosniecia szwów czaszki.

From 1954 to 1971, 69 operations in patients with crs, resulting in relieving the intracranial hypertension symptoms, were performed. The patients were aged 1-34 years. In 1989, i.e. 20-29 years after the operation (mean 22.8 years), 14 patients were submitted again for a neurological, neuropsychological, EEG and brain CT check-up. The patients were divided into 3 groups: I gr. (3 patients)--with negligible disorders of attention and memory, without neurological changes in the EEG and CT--in a good social and occupational status. II gr. (4 patients)--with slight headaches, with discrete neurological and neuropsychological symptoms, slight generalized changes with the moderate burst activity in EEG, signs of hydrocephalus in CT scan. III. gr (7 patients)--with seizures, deficit symptoms, some with symptoms of mental impairment, generalized epileptic changes in EEG, signs of cortical and subcortical atrophy in CT scan. In this group some patients did not work and had no families. We have found that the frequency of epileptic seizures in the crs patients is higher, and their social and occupational status is worse.

[Toxic lesions to the central nervous system in acute poisoning with red lead]. / Toksyczne uszkodzenie osrodkowego ukladu nerwowego w przebiegu ostrego zatrucia minia.

Three cases of poisoning with oral red lead are presented. All 3 young persons ingested red lead for suicidal purposes. Six months prior to this poisoning all of the underwent detailed, medical examinations which did not reveal any pathologies. Toxicological analysis of the body fluids has shown the following results of urinalysis: lead (Pb) 2.41-9.29 mg/L; delta-aminolevulinic acid (ALA) 1.7-2.7 mg%; coproporphyrin-0.033-0.11 mg/L. Central nervous system activity has been assessed with the aid of a complex psychiatric examination, psychological tests, EEG, and CT-scans of the head. Organic lesions to CNS have been diagnosed in all poisoned patients. All of them were re-examined 4 months and 3 years after poisoning. This has enabled dynamic evaluation of remote CNS damage.

[Brain atrophy: radiological-neurological correlations]. / Zanik mózgu: korelacje radiologiczno-neurologiczne.

Computerized tomography of the head was done in 5021 patients aged 21 to 81 years from various neurological, neurosurgical and neurotraumatological indications. Brain atrophy as an only finding (primary) was noted in 11.5%- and in 5.4% of cases it was associated with other changes. The neurological-radiological correlations were established in 200 cases of primary strophy. History data included: headaches in 54.5%, dizziness in 15.0%, epilepsy in 24.5%. Objective examination showed: slight hemiparesis in 37.5%, spastic-atactic gait disturbances in 31.5%, isolated damage to the corticospinal tracts with signs limited to one side of the body was more frequent in cortical atrophy, and these signs associated with ataxia were more frequent in subcortional atrophy. The authors explain this as a loss of cortical cells or damage to the paraventricularly coursing nerve fibres. A probable aetiology of "primary" atrophy was established in 405% of cases (hypertension, atherosclerosis, minor craniocerebral trauma). No signs or neurological syndromes were observed which could be regarded as more or less characteristic of brain atrophy.

[Millard-Gubler syndrome in a young man after hemorrhage from arteriovenous hemangioma to the brain stem]. / Zespól Millarda-Gublera u mlodego mezczyzny w przebiegu krwotoku z naczyniaka tetniczo-zylnego do pnia mózgu.

A young man is described in whom in full health sudden violent headaches and loss of consciousness developed. After admission to hospital a complex of clinical signs was observed indicating brain stem lesion. Computerized tomography of the head and vertebral arteriography demonstrated arteriovenous haemangioma on the left side of the brain stem. The malformation was supplied by the anterior inferior cerebellar artery. The patient did not consent to operation, after several months of rehabilitation his clinical condition improved greatly.

[Topographical and radiological correlations in aneurysms of the middle cerebral artery]. / Korelacje topograficzno-radiologiczne tetniaków tetnicy mózgu srodkowej.

The authors demonstrated topographic-radiological correlations in cases of middle cerebral artery aneurysms verified surgically. In an own material of 91 cases treated in the Department of Neurosurgery, Medical Academy in Cracow in the years 1980-1983 the relationship of the aneurysm to the neighbouring vessels and the direction of the dome of the aneurysm were analysed. In the presented material aneurysms of the middle cerebral artery accounted for 18% of all intracranial aneurysms. Most frequently they were situated at the main bifurcation of the artery (86.8%). The dome of the aneurysms of the main bifurcation was lying usually in the line prolonging the main trunk of the artery cephalad and laterally. The results of surgical treatment are presented in 81 patients with aneurysms of the middle cerebral artery treated surgically.

[Radiograms of the paranasal sinuses as a principle of identifying catastrophe victims and unknown skeletons]. / Radiogramme der Stirnhöhlen als Grundlage für die Identifizierung von Katastrophenopfern und von unbekannten Skeletten.

The paper is devoted to the identification on the base of X-ray of frontal sinuses. These sinuses, developed in puberty doesn't change its shape during aging. Differentiation of the size and shape of sinuses is remarkable and probably is one of the individual features of the man. The system of classification of sinuses is proposed, basing on the area size, shape and symmetry. In the current everyday practice all X-ray radiograms are destroyed after five years of storage in Poland. For identification purpose all radiograms of sinuses and A-P punctures of skull should be stored in radiology departments, and arranged according to proposed classification system. The case is presented, in which the pictures of skull were the base of successful identification of skeleton.

Treatment of ischaemic stroke with prostacyclin.

Ten patients with ischaemic stroke were treated with prostacyclin (2.5-5.0 ng/kg/min i.v. in 6 h courses 4-10 times during 1-2.5 days). In all patients a dramatic regression of hemiplegia, or hemiparesis, or aphasia occurred in the first few hours of prostacyclin infusion. Four to eight weeks later 6 patients left the clinic without neurological deficit; 3 patients had minor residual hemiparesis in upper limbs. In one patient, the occlusion of the contralateral carotid artery led to his death. It is considered that an antagonism may exist between endogenous cerebral prostanoids and prostacyclin and may have been responsible for the beneficial effects of prostacyclin therapy.