[Urolithiasis in children: an analysis of clinical cases]. / Kamica ukladu moczowego u dzieci na podstawie analizy materialu klinicznego.

The authors on the basing on clinical observation of 116 children with urolithiasis, in aged between 3 and 17 years have concluded the following: among the patients of the pediatric ward urolithiasis amounts to 9% of patients. It has been concluded that to diagnose urolithiasis ultrasounds are necessary, but in treatment and prevention an assay of crystallization components is indispensable. In all cases of children with urolithiasis, besides an infection, one must look for coexisting defects in the urinary tract.

Middle superficial cerebral vein.

The microanatomical study present the anatomy of the middle cerebral vein. On the basis of the anatomical data we distinguished concentric and nonconcentric types of tributaries of the middle superficial cerebral vein. The nonconcentric type prevails.

[Contribution to the microanatomy of the proximal part of the arteria centralis longa (Heubner's artery)]. / Przyczynek do mikroanatomii poczatkowego odcinka tetnicy srodkowej dlugiej ("Heubner'a").

The anterior communicating artery complex is one of the most frequent intracranial aneurysm sites. Pterional craniotomy is the usual way to expose this region. While exposing of the aneurysmal dome, the posterior part of the gyrus rectus is frequently resected. In this stage of the procedure and later during clipping of the aneurysm, the surgeon's manipulation is closely related to the proximal part of the Heubner's artery. This vessel feeds important structures in the region of the basal ganglia. The anatomy of the Heubner's artery was described by many authors. However the intraoperative identification of this artery is still not clear. Therefore we performed detailed microanatomical investigation of the proximal part of the Heubner's artery in 40 brain hemispheres. It was found that during resection of the posterior part of the gyrus rectus two arteries are exposed. The recurrent Heubner's artery runs posteriorly to the gyrus rectus. The second artery runs on the medial and inferior surface of gyrus rectus supplying cerebral cortex. This artery frequently originates from the A1/A2 junction or the proximal part of the A2 segment of the anterior cerebral artery. Because of it, this cortical artery is difficult to distinguish from the recurrent Heubner's artery. This artery can branch out from the recurrent Heubner's artery or the frontopolar artery. In conclusion, the greatest probability of the injury to the recurrent Heubner's artery may occur during resection of the posterior part of the gyrus rectus.

Meningiomas and gliomas in juxtaposition: casual or causal coexistence? Report of two cases.

Two cases of meningioma and glioma established in biopsy material from one or more than one operation are reported. In these cases, an originally benign meningioma was followed by the development of anaplastic astrocytoma in close juxtaposition to the site of first operation. The close juxtaposition of two histologically different tumors suggested that one of them might lead to local proliferation and independent growth of the other.

[Evaluation of some hemodynamic indices in 15 to 18 year old boys with lipid risk factors for atherosclerosis]. / Ocena niektórych wskazników hemodynamicznych u chlopców w wieku 15 do 18 lat z lipidowymi czynnikami zagrozenia miazdzyca tetnic.

The aim of the work was an attempt at answering the question whether there is any correlation between the haemodynamic indices describing arterial elasticity assessed by physical analysis of the circulatory system and lipid risk factors for arterial atherosclerosis in boys aged 15 to 18 years. The studies included 45 boys with lipid risk factors for atherosclerosis. The control group included 53 boys without lipid risk factors. In boys aged 17-18 years with lipid risk factors for atherosclerosis as compared with their peers with normal serum lipid level, a statistically significant change of arterial elasticity was found. A positive correlation was also found between the increased serum cholesterol level and the values of air-chamber elasticity index and peripheral vascular resistance, and a negative correlation was demonstrated between the decreased serum HDL-cholesterol concentration and the increase of pulse wave velocity in the aorta, air-chamber elasticity index and peripheral vascular resistance.

[Neurotransplantation. III. Intracerebral grafting of fetal substantia nigra in Parkinson's disease]. / Neurotransplantacje. III. Domózgowe przeszczepy plodowej istoty czarnej w chorobie Parkinsona.

The paper reports the results of fetal substantia nigra transplantations into the brain of patients suffering from Parkinson's disease, performed in different neurosurgical centers in the world. Commonly accepted Ethical Guidelines for Fetal Tissue Transplantations are presented. The criteria regarding patients selection for therapeutic transplantation are also discussed. The results of studies concerning the problem of optimal fetal age for transplantations are presented. The optimal age seems to cover the period between the 7th gestational week when dopamine synthesis begins and the 11th week when protoplasmic processes start to grow intensively. The damage of these processes during transplantation procedure is thought to make the fetal cells survival difficult. The discussion concerning controversial problem of immunosuppression treatment after the neurotransplantation is also reported. The paper presents the principles of signs and symptoms assessment before and after operation including CAPIT system which emphasises the role of movement ability tests, PET-scanning with [18F]-6-L-fluorodopa and magnetic resonance imaging. The PET-scanning allows to follow up the changes in patient's brain resulting from the graft survival and its dopamine synthesis ability. The methods of donor woman examination to avoid the transmission of infections into the patient's brain are reviewed. The analysis of yet published results of about 100 operated on parkinsonian patients show marked improvement due to human fetal substantia nigra transplantation. The improvement lasts, at least 46 months postoperatively (the longest period of observation). Many of the grafted patients returned to normal self-dependent living activities and some of them resumed even their professional jobs. Most authors present the opinion that the therapeutic effects of fetal substantia nigra transplantations are more valuable and longer lasting than those after adrenal medulla autografts. However it should be borne in mind that both methods are yet only the experimental approach in Parkinson's disease therapy.

Microcystic meningioma--a rarely occurring morphological variant of meningioma.

Two cases of microcystic meningioma are reported. They were found by retrospective study of 124 human intracranial meningiomas. Both of the examined tumors were characterized histologically by a great number of cysts of various size intermixed with nests of neoplastic tissue of meningothelial meningioma type. Nevertheless, there were two kinds of cystic changes in these tumors. In the first case, numerous microcysts within the tumor were surrounded by stellate-shaped processes of meningioma's cells. The microcystic space were empty or rarely contained eosinophilic material. The latter tumor demonstrated small agglomerations of microcysts and many macrocystic changes, some of them filled with eosinophilic, PAS and mucicarmine negative material. Additionally, in focal areas of the tumor, single mitotic figures and giant cells with hyperchromasia were present. The authors discuss morphologic variability of the examined tumors and its possible clinical consequences. The pathogenesis of microcystic changes in meningioma is discussed with a brief review of the literature.

A long term follow-up of fetal dopaminergic neurons transplantation into the brain of three parkinsonian patients.

In three parkinsonian patients ages 48, 53, and 50, human fetal dopaminergic cells taken from the ventral part of mesencephalon of 11-12-week-old fetuses were implanted into the head of caudate nucleus. The operation was carried out with a specially designed device to enable safe and precise graft implantation. All patients had been suffering from severe Parkinson's disease for about 10-15 years (stage 4/5 according to Hoehn and Yahr scale) with bradykinesia, rigidity and tremor as the main symptoms. Long-lasting L-dopa therapy resulted in side effects with ON/OFF syndrome and dyskinesias. A detailed clinical examination was performed before and every 3 months after the operation according to the CAPIT battery of standarized tests. The patients were under post-operational observation lasting 30, 20 and 12 months, respectively. Improvement was observed in all patients starting between 3 and 6 months after operation and is still sustained. Significant increases in movement speed for repeated pronation-supination, finger dexterity and foot lifting tests were found. The speed of walking also increased with decreased rigidity. The OFF phase during the day is of shorter duration and less severe; dyskinesias are markedly reduced. Our results indicate that fetal grafting seems to be a valuable experimental approach towards the treatment of selected parkinsonian patients.

[Transplantation of fetal dopaminergic cells in Parkinson disease]. / Przeszczepianie plodowych komórek dopaminergicznych w chorobie Parkinsona.

Four patients with severe form of Parkinson's disease received transplantation of fetal dopaminergic cells into the caput of the caudate nucleus. The operation was done by an original method using a device designed specially for this purpose. In all cases the duration of the disease was 10 to 15 years, and the predominating signs were tremor, bradykinesia, and markedly pronounced side effects of the treatment (on-off syndrome and involuntary movements). One patients died 5 weeks after the operation. Autopsy demonstrated good survival of the transplanted cells with good integration with the brain of the recipient and traces of positive immunocytochemical reaction for tyrosine hydroxylase. In the other patients a significant clinical improvement was noted after the operation, with reduced intensity of parkinsonian symptomatology, shortening of the duration of the off phase, improved motor ability and reduced intensity of the involuntary movements. The longest follow-up was 24 months.

[Extensive bifocal location of ependymoma of the spinal cord]. / Rozlegle, dwuogniskowe umiejscowienie wysciólczaka rdzenia kregowego.

Spinal cord ependymomas belong to rare tumours of the central nervous system. Their malignancy is usually low although anaplastic forms are known also to occur. Surgical treatment is the method of choice supplemented often with radiotherapy. An exceptionally rare form of ependymoma with two foci of origin in the spinal cord is reported. The large extent of the tumour caused that laminectomy at 15 levels was necessary. The mechanism of ependymoma development at two levels is discussed.

[Methods of preventing atherosclerosis and ischemic heart disease in vocational school students]. / Metody prewencji miazdzycy i choroby wiencowej u uczniów szkól zawodowych.

The authors suggest that identification of high-risk individuals, modification of nutritional habit, preventing the smoking habit, increased physical activity, low salt intake, and early diagnosis and treatment of hypertension should be the most important methods used for atherosclerosis and IHD prevention in youths.

[Late growth of supratentorial meningioma after radiotherapy of cerebellar tumor]. / Odlegly wzrost oponiaka nadnamiotowego po radioterapii guza mózdzku.

The authors report a case of supratentorial meningioma of the brain developing after radiotherapy for cerebellar astrocytoma. On the basis of a survey of the literature and own speculations the authors try to demonstrate a cause-and-effect relationship between radiotherapy and meningioma development.

[Favorable outcome of decompression of the trigeminal nerve in a case of bilateral neuralgia]. / Pomyslny wynik odbarczenia nerwu trójdzielnego w przypadku obustronnego nerwobólu.

A case of the bilateral trigeminal neuralgia produced by compression of the V cranial nerve roots by the branch of the anterior lower cerebral artery and post-hemorrhagic aggregates is presented. Complete recovery was obtained in the result of 2-stage, intracranial relief of the right and left trigeminal nerve roots. Neurologists share the opinion that intracranial surgical relief of the V cranial nerve root produces favourable result in case of trigeminal neuralgia resistant to pharmacotherapy.