Biomedical subjects
Publications and source records attributed to J Kulczycki.
The authors report a case of Jakob-Creutzfeldt disease diagnosed at autopsy. In the discussion attention is called to characteristic clinical manifestations and possibilities of intravital diagnosis of the disease.
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Seven patients with SSPE aged from 10 to 19 years received beta interferon intrathecally one million units every second day during one month (in all, 15 million units for one course of treatment. During the treatment signs were observed of irritation of the meninges which regressed after treatment completion. The neurological status of the patients was not significantly changed during the treatment. Control investigations carried out 3 to 10 months after the treatment demonstrated worsening with progression to a further phase of SSPE in 4 cases, and evidence of disease progression within the previous phase in 3 cases.
Changes were observed in the cerebrospinal fluid in SSPE cases during administration of beta-interferon 1 million units in 3.3 ml of normal saline intrathecally every second day for one month. During and after the treatment the cell count rose to a mean value of 277/mm3, with prevalence of monocytes initially and then lymphocytes. The total protein level increased by a mean threefold value, with a particular increase in the gamma-globulin and IgG fractions. In control investigations 3-10 months after completion of treatment the cell count became normal and the total protein level was slightly above the normal one, while the electrophoretically demonstrated changes regressed. The changes in the cerebrospinal fluid during intrathecal administration of beta-interferon are due probably to a non-specific irritative action of the drug on the reticulo-histiocytic system of the leptomeninx and the effect of interferon on the immune system.
The technique and results of surgical reconstruction of different extent of the extratemporal part of the facial nerve after oncological operations and after accidental injuries are reported. Return of facial nerve function was observed in 15 out of 17 cases (87%) with follow-up over 1 year. An own modification of nerve suture is described. Attention is called to the possibility of perineural and endoneural spread of parotid malignant neoplasms.
On the basis of experimental investigations the authors describe the causes of certain complications after extracorporeal circulation. The experiments were carried out in 11 sheep. The duration of extracorporeal circulation was from 1 to 2 hours. It was found that the intracranial pressure, which is an indicator of intracranial expansion, increased with increasing time of cannule introduction into the heart and veins, with the volume of perfusing fluid given during the procedure, with falling value of the arterial blood pressure and impairment of venous return. The intracranial pressure increased also with the duration of extracorporeal circulation. Falls of the arterial blood pressure and venous return occurred simultaneously with impairment of the cerebral blood flow causing cerebral hypoxia. The results of histological examinations of brain tissue were consistent with central nervous system hypoxia, and showed also that these changes developed within the first hour of extracorporeal circulation. The complications arising after extracorporeal circulation may be due to brain oedema. Thus it would be recommendable to pay attention during preoperative management of the patients to the possibility of brain oedema as a complication of the procedure.
Investigations of calcium-phosphate metabolism were carried out in a group of 11 children and adults with intracerebral calcifications. It was possible to isolate three different pathogenetic types of calcifications in the striatum and dentate nuclei in the cerebellum. The authors suggest restriction of the term "Fahr's syndrome" to cases without true of false hypoparathyroidism. The assessment of the calcium-phosphate metabolism, and particularly, the test with parathyroid hormone, seem to be an indispensable element in the differential diagnosis of this type of intracerebral calcifications.
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