Differential diagnosis of frontal syndrome in patients with closed-head injuries

Background. A common sequela of head injury is "frontal syndrome", consisting in characteristic neurobehavioral disturbances. However, there is no ecologically valid research tool that would clearly indicate the presence of this syndrome. The goal of this article is to evaluate the authorized the Polish version of the Frontal Behavioral Inventory (FBInv), used to differentiate fronto-temporal dementia (FTD) from other dementias. Material and methods. The research involved 95 patients treated at the centers represented by the authors, divided into 3 groups: CHI, consisting of 39 patients with traumatic frontal lobe injuries; FTD, consisting of 28 patients with fronto-temporal dementia; and a control group of persons with post-traumatic depression without injury to the frontal lobes. The results were based on data obtained from caregivers in 24 categories of patient behavior covered by the FBInv. Results. We found important differences in total scores between patients with frontal syndrome from groups CHI and FTD, as against patients with post-traumatic depression. There are also noticeable differences between patients in group FTD and group CHI in terms of scores on particular test items. Conclusions. The FBInv in the authorized Polish version is both sensitive and specific in measuring neurobehavioral disturbances occurring in patients with post-traumatic damage to the changes in the behavioral and personality of these patients with the passage of time since injury or onset should be the topic of further research.     

Treatment of intraocular metastatic tumors

PURPOSE: Analysis of the clinical picture of intraocular metastatic tumors and the results of the treatment with various methods. MATERIAL AND METHODS: Between 1994-1997 intraocular metastatic tumors were diagnosed in 14 patients (19 eyes). There were 13 females and 1 male, aged 28 to 69 years (average 50). The primary tumor in 8 patients developed in the breast, in 4 cases in the lungs, 1 in the brain, and 1 in the kidney. In all patients the primary tumor was excised, then chemotherapy was applied in 9 cases, radiotherapy in 3 cases, and hormonal treatment in 2 cases. In 7 patients the metastatic process concerned also other organs: bones, liver, lungs, hypophysis, and lymphatic glands. Metastases developed in 10 months to 11 years since the diagnosis and treatment of the primary tumor. Intraocular tumors were the most often located near the optic disc (8 cases), or near the macula (4 cases). There were usually flat tumors (in 12 cases < 5 mm in thickness), creamy white, sometimes with pigment clamping. In order, to confirm the diagnosis of the tumor, USG was always performed and in 8 cases fluorescein angiography. In all cases topical treatment was applied, which consisted of irradiation with ruthenium (106Ru) in 6 eyes (in 1 case two times), laser coagulation in 3 eyes, and thermotherapy (TTT) with diode laser in 4 eyes, combined treatment (106Ru + TTT) in 2 eyes, 106Ru and 125I brachytherapy in one eye. The dose of radiation for the apex of the tumor was 60-90 Gy (av. 65). The eyeball was enucleated in 3 patients, 4 patients received chemotherapy. 2 patients received hormonal therapy, applied together with the topical treatment. RESULTS: In the majority of cases (14 eyes), a flat scar or the significant decrease of the volume of the tumor was obtained. 8 patients died, two are currently observed, the remaining 4 do not come to the control examination, and there is no information as to their fate. CONCLUSIONS: Good results of the treatment encourage further application of brachy and thermotherapy in the treatment of intraocular metastatic tumors. It allows for the conservative treatment of the eyeball, and also useful visual acuity is retained often.     

Retrospective evaluation of eyes with high progressive myopia in children and youth ten years after Snyder and Thompson's scleroplasty

PURPOSE: Of the study was, to assess the safety and efficiency of scleral reinforcement after Snyder and Thompson surgery. MATERIAL AND METHODS: The scleroplasty was performed on 129 eyes of 75 children with progressive myopia from 6 to 10 years of age. The control study group included 40 eyes of 25 children with similar age, mean eyeball axial length and refraction. In the control study group scleroplasty was not performed. The main indication criteria for surgery included: severe myopia more than -6.0 D, and the increase in refraction error more than -1.0 D per year. We evaluated the eyeball axial length in all subjects, before time of surgery and ten years after surgery, using Ultrasound Alcon Imaging System. The visual acuity, tonometry, visual field were evaluated as well. RESULTS: In the study group the mean eyeball axial length measured before surgery was 25.95 mm +/- 0.62 mm. Ten years after surgery the length of the eyeball was 26.97 mm +/- 0.64 mm. The average increase was 1.03 mm +/- 0.29 mm. In the control group, at the time when study group children were operated, the mean eyeball axial length was 25.91 mm +/- 0.48 mm, and ten years later it was 28.06 mm +/- 0.59 mm. The average increase in the eyeball length was 2.13 mm +/- 0.3 mm. There was statistically significant difference between the eyeball axial length progression in the study group and the control group, where surgery was not performed. In the study group no serious complications after surgery were reported. CONCLUSIONS: Scleral reinforcement is an effective and safe surgery, that can stabilize the progression of severe myopia in children.     

Reduction of genotoxic effects of the carcinogen N-methyl-N'-nitro-N-nitrosoguanidine by dietary lignin in mammalian cells cultured in vitro

In the present study the protective effect of several lignin polymers against the genotoxic effect of N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) was tested in hamster lung V79 cells and human colon Caco-2 cells. Preculturing of cells with sublethal, nongenotoxic concentrations of the lignins A, B, and C (50 microg/ml) was found to decrease significantly the level of DNA strand breaks in both hamster and human cells treated with MNNG. Lignin A also reduced MNNG-induced gene mutations in V79 cells. As in addition to alkyl lesions MNNG gives rise to hydroxyl free radicals (OH) and nitrogen-centered free radicals (NR), we tried to determine whether antimutagenicity of lignin A was connected only with the well-known ability of lignin to bind MNNG molecules or also with its antioxidative effects. The use of the modified comet assay technique proved that preculturing of hamster V79 cells with lignin A resulted in a significant decrease of the level of DNA strand breaks originating from oxidized DNA bases. Therefore, we suggest that the antimutagenic effect of lignin A against MNNG is associated with both adsorptive and antioxidative action. This study also showed that the presence of lignin A neither helped to renew DNA replication nor influenced the kinetics of DNA rejoining in MNNG-treated V79 cells.     

Immunoglobulins and rules of passive-active prophylaxis

This review deals with the safety uses and mechanisms of action intravenous immunoglobulin preparations (IVIG) in prophylaxis and treatment of viruses and bacterial infection and also about the role of immunoglobulins in autoimmune disorders. The second part contains suggested intervals between immunoglobulin administration and measles immunization.     

Evaluation of energy and nutritive value of meals for nursery school children

The energy value and content of nutritive components in nursery school meals have been evaluated by analytical method and calculated by Nutritionist IV computer program with Polish data base. A significant correlation between analysed and calculated values has been observed. An average nursery school meal covered recommended intake of iron, calcium, zinc, vit. B1 and % of energy from proteins, fats and carbohydrates. An average nursery school meal covered above recommended intake of total energy and % of energy from saturated fatty acids, proteins, fats, cholesterol, carbohydrates, fiber, magnesium, potassium, phosphorus, copper and vitamins A, E, C, B2 i B6. Only the average content of vit. PP and % of energy from mono- and polyunsaturated fatty acids in analysed nursery school meals has been below the recommended intake. The results indicate that there is a tendency to supply energy and some of nutritive components in nursery school meals above the recommended intake.     

Hydrogen-1 MR spectroscopy of the peritumoral zone in patients with cerebral glioma: assessment of the value of the method

RATIONALE AND OBJECTIVES: The determination of tumor boundaries, especially in high-grade glioma, is critically important for the proper planning of treatment, but the standard diagnostic imaging methods do not enable precise delimitation of the extent of tumor cell infiltration into the surrounding tissue. The objective of this study was to assess the usefulness of hydrogen-1 (H-1) magnetic resonance (MR) spectroscopy for determining the extent of gliomatous infiltrate in the "uncertain zone'--the peritumoral area that appears unchanged on standard diagnostic MR images. MATERIALS AND METHODS: The study group consisted of 64 patients with cerebral glioma scheduled for tumor resection and subsequent radiation therapy. All patients were examined prior to resection with MR imaging and MR spectroscopy. MR spectra were obtained from examination of the solid part of the tumor and from two peritumoral volumes of interest located approximately along the axis of surgical access to the tumor. MR spectra obtained from a group of 32 healthy volunteers were used as control data. RESULTS: Analysis of the consequent voxels in the peritumoral zone revealed statistically significant differences in lipid/creatine and lactate/creatine metabolite ratios between patient subgroups with recurrent malignant lesions and without recurrent lesions. Significant differences also were found between the patient group and the control group in most metabolite ratios assessed. CONCLUSION: H-1 MR spectroscopic demonstration of metabolic changes in the peritumoral zone can guide treatment for cerebral glioma, enabling the physician to identify patients who have a high risk of recurrence.     

Phenoxodiol--an isoflavone analog--induces apoptosis in chemoresistant ovarian cancer cells

Interference with the innate apoptotic activity is a hallmark of neoplastic transformation and tumor formation. In this study we characterize the cytotoxic effect of phenoxodiol, a synthetic anticancer drug analog of genestein, and demonstrate the mechanism of action by which phenoxodiol affects the components of the Fas apoptotic pathway on ovarian cancer cells. Primary ovarian cancer cells, isolated from ascitic fluids of ovarian cancer patients, resistant to conventional chemotherapy, undergo apoptosis following phenoxodiol treatment. This effect is dependent upon the activation of the caspase system, inhibiting XIAP, an inhibitor of apoptosis, and disrupting FLICE inhibitory protein (FLIP) expression through the Akt signal transduction pathway. We suggest that phenoxodiol is an efficient inducer of cell death in ovarian cancer cells and sensitizes the cancer cells to Fas-mediated apoptosis. We identified FLIP and XIAP signalling pathways as key factors regulating the survival of ovarian cancer cells. These findings demonstrate a novel nontoxic drug that controls FLIP/XIAP function and has the potential to eliminate tumor cells through Fas-mediated apoptosis.