Lung function in patients operated for chronic pleural empyema.

OBJECTIVES: To evaluate lung function after lung decortication in patients operated for chronic pleural empyema. METHODS AND MATERIALS: To determine the lung function after lung decortication in 20 men (71.4%) and 8 women (28.6%) a prospective evaluation of blood gases, spirometry, lung perfusion, ventilation, and alveolar permeability were performed 28 weeks (15-60 weeks) after the operation. RESULTS: Median lung perfusion on the affected side was 45.2% (26.1-55.3%) in 13 right and 36% (13.8-47.2%) in 15 left empyemas, and was within normal limits in 4/28 cases. The mean lung ventilation was 44.4% (21.5-54%) and 37% (18.9-50.6%) in patients affected on the right or left side, respectively. Ventilation perfusion inequality occurred in 22 patients (78.6%). Dynamic ventilation scintigraphy revealed impairment of epithelial integrity in 10 cases (35.7%). Individual analysis revealed that 15 patients (53.6%) showed a severe reduction in one of the examinations and 8 (28.6%) in more than one. CONCLUSIONS: Although the separate analysis of the different functional parameters revealed a mild reduction of lung function after decortication, in the majority of patients the impairment was more severe due to multilevel functional lung damage.

[Difficulties in diagnosis and therapy in a case of brain inflammatory process in patient with Hodgkin's disease]. / Trudnosci diagnostyczne i terapeutyczne w przypadku zapalenia mózgu w przebiegu ziarnicy zlosliwej.

A rare case of cerebral probable viral inflammatory process in a patient with the Hodgkin's disease has been presented. The diagnosis of the neurological disorder was based on the clinical course of the disease, the dynamics of the process observed in CT and MRI examinations. The pathogen was not identified in bacteriological and viral tests. Hodgkin's disease restricted to the spleen was diagnosed in postmortem examination. The presented case demonstrates variability of the clinical picture and difficulties in diagnosing viral encephalitis.

[Tc-99m-MIBI and Tc-99m-HMPAO accumulation in primary and metastatic brain tumors assessed by brain SPECT]. / Akumulacja Tc-99m-MIBI i Tc-99m-HMPAO w pierwotnych i przerzutowych guzach mózgu ocenione tomografia emisyjna SPECT.

Imaging of intracranial lesions is frequently difficult in CT/MRI diagnosis. The introduction of the encephalic tracer MIBI seemed to be a promising alternative. We tried to compare the accumulation of Tc-99m-MIBI and HMPAO CT/MRI interpretationeally difficult intracranial lesions. We did SPECT scanning with single-head and triple-head gammacamera after i.v. administration of Tc-99m-HMPAO/MIBI. We performed HMPAO scanning in 34 patients, MIBI scanning in 41 pts. CT and MRI scanning was performed simultaneously. Histological diagnosis was done intra- and/or postoperatively. Increased accumulation of Tc-99m-MIBI was seen in 7/7 meningiomas (100%), 7/9 gliomas (77%), 10/15 brain metastases (66%), 2/4 unverified. In 5 cases with finally non-neoplastic diagnosis (stroke, a-v malformation) no MIBI accumulation was seen. Increased accumulation of HMPAO was seen in 3/11 gliomas, 2/7 meningiomas, 2/8 metastases and 2/4 unverified. In 4 cases non-neoplastic diagnosis was established. Our results seem to be less promising, than reported so far, particularly for heterogeneous accumulation of MIBI in metastatic tumours. The coupled Tc-99m-MIBI/HMPAO scanning may be useful in primary tumour diagnosis, particularly in meningiomas.

[Arterial hypertension caused by abnormality and translocation of the kidney]. / Nadcisnienie tetnicze w wyniku zaburzen rozwoju i przemieszczenia nerki.

The authors described developmental anomaly of the right kidney associated with hypertension and pyonephrosis in a 37 years old male. The authors reported the diagnostic problems in this kind of hypertension. After nephrectomy had been performed the elevated blood pressure returned to normal values without any additional pharmacological treatment.

[A giant perineural root cyst in the sacral part of the spinal vertebrae]. / Olbrzymia torbiel korzeniowa (perineuralna) w odcinku krzyzowym kanalu kregowego.

In a 30-year-old female patient the cause of pain in lower extremities lasting for many years was a giant perineural cyst in the sacral part of the vertebral canal. After radical removal the cyst pain disappeared completely.