Exposure to Cryogenic Temperature and Exercises and Changes in Blood Pressure.

BACKGROUND: Cryotherapy is one of the methods used in physical medicine to achieve analgesic, anti-inflammatory, antiedematous effects and to reduce muscle tension. OBJECTIVE: The aim of the study was to assess the impact of systemic cryotherapy combined with kinesitherapy on systolic and diastolic blood pressure. MATERIALS AND METHODS: A group of 215 individuals of both sexes was selected and submitted to a two-week cycle of the systemic cryotherapy treatment combined with kinesiotherapy. RESULTS: The decrease of average values was observed in systolic and diastolic blood pressure. In the case of systolic blood pressure there was a significant decrease of average value from 125 mm Hg on the first day to the value of 121.7 mmHg on 10th treatment day. In the case of diastolic blood pressure a significant decrease in the average blood pressure value of 80 mmHg to a value of 76.8 mmHg was observed in the further course of treatment. CONCLUSION: One cryostimulation treatment causes a decrease of the average values of the systolic blood pressure and diastolic blood pressure while the series of 10 treatments leads to stabilization of pressure. Stabilization of systolic blood pressure in men was significantly slower than in women, achieving statistically higher mean values. The women were more responsive to applied cryotherapy.

The infrequent simultaneous genetic alterations in glioblastoma multiforme (LOH 10, 17, 19q, TP53 mutation and EGFR amplification) with short clinical course.

We described the case of an unusual, complex genetic alteration in 57 year-old male patient with glioblastoma multiforme (GBM) with short survival (6 and half months). Alterations consisted of p53 mutation, LOH 10, LOH 17, LOH 19q and EGFR amplification. LOH1p, LOH 9 and LOH 13 were negative. Immunohistochemical study did not correlate with molecular results. The overexpression of TP53 protein and RB protein was detected only in small percentage of cells and interestingly the overexpression of EGFR was present only focally. Immnunostainings for PTEN, P16, PI3-K were negative. Additionally, we observed an overexpression of IGFB2 protein. This case indicates the accumulation of molecular changes in glioblastoma multiforme in patient with short survival.

The cause of 2S Diapason screw breakage after internal lumbar fixation: studies of the mechanical and material properties of the implant.

In the years 1994-99, unstable fractures of the lumbar spine were surgically treated with interbody fixation in the Department of Neurosurgery at the Nicholas Copernicus Voivodeship Specialized Hospital in Lódz, using stabilizers manufactured by various companies. Complications in the form of stabilizer breakage were observed in 1 case out of 22. The aim of the present study was to ascertain the reason why the Stryker 2S Diapason screws broke. Tests performed to measure the material and mechanical properties of the implant did not show any signs of material fatigue, nor were any material defects discovered. However, a scanning microscope investigation confirmed the hypothesis that the material had crumbled due to overload. This discovery led to the decision that screws would be mounted in the bodies of the vertebrae in a manner decreasing implant load.

Intraosseous orbital haemangioma.

We present a case of rare orbital roof haemangioma infiltrating the medial and lateral walls of the orbit, zygomatic bone and lesser and greater wings of the sphenoid. The tumour was totally excised by the frontolateral approach, followed by craniofacial and orbital roof reconstruction.

[Personal modification of the Codubix prosthesis in craniofacial plastic surgery]. / Wlasna modyfikacja protezy Codubix w plastyce ubytku twarzoczaszki.

Typical "Codubix" prosthesis usually applied to cover cranial defect was used in craniofacial reconstruction. In this case the defect resulted from total removal of cranial basis neoplasm infiltrating orbital roof and surrounding structures. The cranial defect included right frontal bone--superciliary arch, orbital roof and margin; zygomatic bone frontal part junction and the lesser and greater wings of the sphenoid. Cranial reconstruction in this spatially differentiated area is technically difficult. The authors discuss the way of standard prosthesis modification in order to apply it in craniofacial reconstruction. Follow-up radiological and aesthetic results are presented.

[Aneurysms causing symptoms of brain tumors treated with endovascular method in MDS system]. / Tetniaki powodujace objawy guza mózgu, leczone metoda wewnatrznaczyniowa, systemem MDS.

Basing on own material 25 patients with symptoms of intracranial structures pressed by aneurysm sack have been presented. The patients were treated with endovascular method in MDS system at the Department of Neurosurgery, Copernicus Hospital in Lódz. The aneurysms were diagnosed basing on neurological symptoms--cranial nerves damage, focal brain lesion and headaches. The aneurysms surgically difficult and were qualified for endovascular treatment. Ninety two per cent of aneurysms were big or giant; 92% with a wide neck. Total or almost total aneurysm closure was obtained in 59% of cases. The patients were observed 6 to 71 months. Follow up of 11 patients (50% observed group) revealed complete recovery in 8, neurological improvement in 3 cases.

[Cerebral arteriovenous malformation complicated by pulmonary embolism]. / Malformacja naczyniowa mózgu, powiklana zatorowoscia pluc.

Endovascular treatment of cerebral arteriovenous malformation (AVM) lies in selective catheterisation through feeder and AVM nidus. Sticking mixture is applied after proper verification of microcatheter location. Malformation embolisation is normal when the vessel net is of small diameter. In the presented case embolisation material penetrated cerebral vein system and then lungs, where numerous emboli developed. X-ray where confirmed pulmonary embolism resulted in severe respiratory insufficiency. Treatment of this rare complication as well as the cause of its occurrence have been presented. Prevention of such complications has been considered.

[Horner's syndrome induced by internal carotid artery aneurysm--diagnostics and therapy]. / Zespól hornera wywolany tetniakiem tetnicy szyjnej wewnetrznej--diagnostyka, leczenie.

Horner's syndrome is most frequently observed in the course of inflammatory, neoplastic and traumatic processes in the area of medulla oblongata, Gasserian ganglion and the lower part of brachial plexus. Horner's syndrome resulting from internal carotid artery aneurysm haemorrhage is very rare. A case of rapid appearance of Horner's syndrome initially treated as contrlateral exopthalmos has been presented. After several weeks headaches and neck pain accompanied Horner's syndrome on the same side. The CT-scan and cerebral angiography were normal. Repeated cerebral angiography with carotid arteries exhibition revealed an aneurysm on the extracranial part of the internal carotid artery. The aneurysm location was considered to be surgically difficult and thus endovascular treatment was applied (coiling). The regression of Horner's syndrome was observed 6 months after the treatment.

[Post-traumatic pulsating exophthalmus coexisting with congenital carotid-cavernous fistula]. / Pourazowy wytrzeszcz tetniacy na tle wrodzonej przetoki szyjno-jamistej.

Pulsating exophthalmus develops most frequently in the course of penetrating or bitemporal head trauma. Idiopathic form is even more rare. Orbit venous system over-loading with pathological arterial blood infiltration is the cause of pulsating exophthalmus. A patient with congenital carotid-cavernous fistula (right eyeball enlargement and noise), suffering from head trauma after road accident has been presented. Carotid-cavernous fistula was diagnosed and than treated casually by endovascular closure of the infiltration between internal carotid artery and cavernous sinus. After 5-month treatment regression of the noise and exophthalmus was observed.

The application of nanocrystaline diamond coatings in medicine.

The search for an endoprosthesis with the longest possible durability has been in progress for many years. In spite of three decades of intensive development of implant materials, contemporary endoprosthesis are still far from satisfactory. In an environment as corrosive as the human body, even the best metal alloys release ions: Co, Cr and Mo all dissolve at a rate of approximately 50 ng per year. The biocompatibility of an implants is directly by the extent of corrosion. Tests in vivo have shown that Ni, Co and Cr ions are bound to the body's own proteins, predominantly albumins, which can then transfer them to other ergans, thus disturbing their functions.
Facing this challenge, a new, entirely cementless endoprosthesis for the coxofemoral joint, comprised of a pin, a head and two bushings, has been constructed in a cooperative project involving three research centers: ECAM in Lyons, the Technical University of Bratislava, and the Thin Film Division of the Technical University of Lodz. Both the pin and the outer bushing are made of a titanium alloy, coated with a nanocrystalline diamond film. The heads is made of corundum ceramics, and the inner bushing is made if high molecular weight polyethylene. The shape of the pin has been designed in compliance with all biomechanical requirements.
As of this writing these endoprostheses have been implanted in test animals, and remain under continous biological monitoring. To this point all the test results have been postitive.

[Retrospective assessment of bilateral trigeminal neuralgia treatment]. / Retrospektywna ocena leczenia obustronnej neuralgii nerwu trójdzielnego.

Bilateral trigeminal neuralgia is a rarely observed suffering. It is usually localised on one half of the face and few years after therapy or idiopathic regression it appears on the other side. In exceptional cases trigeminal neuralgia appears on both sides at the same time. Neurovascular decompression or neurotomy in the pontocerebellar angle are the most effective therapy. In the last 25 years of 257 surgically treated patients with trigeminal neuralgia bilateral pain was found in 12 cases (5%). Retrospective assessment of the used method, in our department, in the treatment of trigeminal neuralgia demonstrated efficacy of this procedure.

Follow-up of a Patient Treated by the Mechanical Detachable System (MDS) of Tungsten Spirals. Our Experience.

SUMMARY: A case is presented of basilar artery aneurysm, to which endovascular treatment was applied, employing the mechanical detachable system (MDS) of tungsten spirals. The aim of the study was to demonstrate spiral disappearance in embolised aneurysm without recanalisation, following a long-term follow-up period - up to 42 months. During the years 1994 to 1999, about 100 intracranial aneurysms and carotidcavernous fistulas were embolised by the use of MDS spirals. In one case, spiral disappearance was noted, that event not, however, affecting the patient's state in any way and confirmed by clinical and radiological evaluations.

Experiences with the internal fixation of the cervical spine.

During the period 1994-1999, 141 surgeries were performed cervical vertebra in the Department of Neurosurgery at the Copernicus Hospital in Lódz; 62 of these were posttraumatic injuries. In cases of injury to the C1-C2 complex, anterior or posterior fixation was applied, ora a combination of both. In injuries involving the segment from C3 to Th1, fixation was done with the anterior approach, using autogenic or allogenic implants. We present here the treatment outcome for posttraumatic injuries treated surgically with the use of implants.

Instrumental fixation of the cervical spine with Ti-mesh prosthesis: a preliminary report.

This article describes the surgical treatment of the fractured body of a cervical vertebra, using the Codman Ti-mesh prosthesis according to the Harms method. This male patient had suffered a multiple fracture of the C6 cervical body; he required decompression of the nerve elements of the vertebral canal by C6 corporectomy and C5-C7 intervertebral fixation. A Ti-mesh prosthesis was filled with bone fragments from the fractured vertebra. A Caspar plate manufactured by Codman was used for C5-C7 intervertebral fixation. The chief advantages of the method applied here include shortening the duration of surgery and providing good, quick fixation.

Giant brain aneurysm--difficulties in diagnosis and treatment. Case report.

Aneurysms of diameter above 25 mm, determined as giant aneurysms, are thought to be surgically difficult. The most common symptom of the presence of aneurysm is subarachnoidal hemorrhage. Giant aneurysm may cause focal neurological symptoms, very rarely may show symptoms of intracranial hypertension. In the presented case a 47-year old woman after the first epilepsy attack the dominated symptoms were those of intracranial hypertension. CT suggested brain tumour of 70 mm diameter. Brain angiography revealed giant aneurysm of the left middle cerebral artery. After having considered differed method of therapeutic management, microsurgical operative technique was applied in general anesthesia with brain protection.

Metaplastic meningioma with lipomatous changes.

We report here relatively rare lipomatous metaplastic changes, probably related to a prolonged clinical course, in not otherwise specified transitional meningioma. This lesion appears to have evolved over 30 years, with the initial diagnosis of multiple sclerosis. Histologically, it was composed of clusters and whorls of polygonal and spindle cells characteristic for transitional meningioma, with large areas of cells with lipid cytoplasmic accumulation, closely resembling mature adipocytes. The lipidization of other brain tumors and the histogenesis of these lesions in meningiomas on the background of meningeal embryogenesis are also discussed.

Primitive neuroectodermal tumors: ultrastructural and immunohistochemical studies.

We report here ultrastructural and immunohistochemical studies of neuroblastic differentiation in the retrospective (n = 17) and prospective (n = 26) series of primitive neuroectodermal tumors (PNETs). By electron microscopy, neuritelike structures containing parallel-oriented microtubules, adhesive plaque junctions, and pleomorphic dense-core vesicles were found in the majority of tumor specimens while synaptic specializations were very rare. By immunohistochemistry, synaptophysin appeared to be the most reliable marker for neuroblastic differentiation present in the most reliable marker for neuroblastic differentiation present in the majority of tumors, while 200 kDa neurofilament protein was immunovisualized in a lower proportion of tumors. Glial fibrillary acidic protein (GFAP) was expressed in both reactive astrocytes and in a small proportion of otherwise typical neoplastic cells. We conclude that the majority of PNETs revealed diverse differentiation and that electron microscopy is still the most reliable tool for its detection followed by immunohistochemistry for synaptophysin.

Ultrastructure of the primitive neuroectodermal tumors (PNET).

We report a prospective series of consecutive cases of primitive neuroectodermal tumor (PNET) studied by electron microscopy. Virtually all specimens showed a differentiation along neuroblastic lines as evidenced by the presence of neurites, dense-cored vesicles, microtubules and adhesive plaque junctions. We observed also numerous intracytoplasmic cilia and autophagic vacuoles. Synaptic specializations were only rarely seen. We conclude that PNET is a tumor category which is not undifferentiated ("primitive") and clearly exhibits features of neuroblastic differentiation.