Intrathecal baclofen in severe spasticity due to multiple sclerosis

Intrathecal administration of baclofen via programmable pump is a highly effective treatment method in severe spasticity resistant to oral medications. The authors describe a case of severe spasticity with tetraplegia and painful (> 10 a day) muscle spasms in the upper and lower limbs and paraspinal muscles, in a patient with clinically definite diagnosis of multiple sclerosis (MS). The 34-year-old female patient with a 15-year history of MS, suffering from lower limb spasticity with pes equinovarus since 1995, was treated with very good results with botulinum toxin injections of calf muscles (14 sessions of Dysport 1500iu till 2002). In the early 2002 she developed tetraplegia with severe, generalized and intractable spasticity. After 4 months of ineffective polytherapy (with high doses of oral baclofen, tizanidine, gabapentine, clonidine, diazepam) and the patient's enormous sufferings (she could neither sit up nor voluntarily change her position in bed), a programmable baclofen pump (Medtronic) was implanted. As soon as a few days after the surgery she could stand, sit and move voluntarily, her painful spasms disappeared, and her bladder catheter was removed. At a 6-month follow-up the effect was stable--she was able to walk a long distance outdoors with the aid of a crutch. The daily dose of the drug is 500 micrograms. No side effects of complications were noted.     

The frequency of diagnosis of catatonic schizophrenia in hospitals in Lubliniec (1894-1932, 1934-1936, 1970-1999) and Boleslawiec (1958-1999)

AIM: The analysis of the data from the psychiatric hospitals in Lubliniec (1894-1932, 1934-1936, 1970-1999) and Boles?awiec (1958-1999) proved a decrease in frequency of diagnosis of catatonic schizophrenia, what could testify to a decrease in morbidity with this form of schizophrenia. METHOD AND RESULTS: Basing on the facts from scientific literature there was ascertained that the decrease in frequency of diagnosis of catatonic schizophrenia is connected with following causes: firstly, with the changes in nozology, secondly, with the introduction of a new form of therapy and finally, with the fact that here psychological and sociological factors exist which eliminate catatonia as the most expressive form of schizophrenia.     

Coexistence of diffuse large B-cell lymphoma within pontocerebellar angle schwannoma

We present an unusual case of diffuse large B-cell lymphoma within pontocerebellar angle schwannoma in 62-year-old woman. The patient suffered for 5 months with V, VII and VIII nerves paresis and with cerebellar ataxia. CT scan demonstrated large hyperdensive mass in cerebellopontine angle translocating cerebellar hemisphere and cerebral trunk. The patient was subjected to surgery and the tumour was removed totally by suboccipital retromastoidal right craniectomy approach. Histopathological examination revealed schwannoma infiltrated with high grade B-cell lymphoma. The patient did well following surgery without any other lymphoma manifestations, and she died from a heart attack 20 months later. Solitary lymphoma of pontocerebellar angle coexisting with schwannoma is an unusual finding, thus our case is the first report.     

Cystic meningioma: report of three cases

Meningioma with cystic component is not a commonly encountered tumor. We report three patients with cystic meningioma histologically confirmed. Tomographic images of these tumours resembled those of a glial or metastatic origin with cystic or necrotic changes and were easily confused. In a 2-year period (1997-1999) in our Department we had three patients with cystic meningioma who account for 5.4% of all patients with meningiomas we have.     

Lack of association between 141C Ins/Del promoter polymorphism of DRD2 gene and schizophrenia

Results of family studies show the importance of genetic factors in etiopathogenesis of schizophrenia. Susceptibility to the disease is probably due to an interaction of many genes. This association study was conducted to investigate frequencies of alleles and genotypes in a group of patients with schizophrenia and in healthy controls. We examined DRD2 gene promoter polymorphism--insertion or deletion of the cytosine in the position -141 of 5'-flanking region of this gene. No relationship between the polymorphism under study and schizophrenia has been found.     

Lack of association between VNTR polymorphism of DAT gene and schizophrenia

The substantial importance of genetic factors in the etiology of schizophrenia was demonstrated in many studies. The complex model of disease inheritance seems to be the most probable, involving epistatic interaction of many genes. Association studies are based on the analysis of the so-called candidate genes, which are coding for neurotransmitter receptors, neurotransmitter transporters and enzymes involved in their metabolism. In the present work the results of an association study of VNTR polymorphism of dopamine transporter gene (DAT) in schizophrenia are presented. This polymorphism is characterised by a different number of tandem repeats (VNTR) within the 3'-untranslated region of gene. In Caucasians the 40 base pair motif has 3 to 11 repeats, the most common (about 90%) are alleles containing 9 and 10 repeats. In the present study no association between the polymorphism studied and schizophrenia was found.     

Molecular methods and techniques used in diagnosis and epidemiology of infections caused by pathogenic fungi

In this paper we reviewed the latest literature on molecular techniques used in diagnosis and epidemiology of infections caused by pathogenic fungi. Traditional methods used for the identification and typing of medically relevant fungi include morphological and biochemical analysis. These methods are time-consuming and base on phenotypic features what makes them unreliable. We described the usefulness in mycological studies of fast and very sensitive molecular methods which rely on PCR and hybridization techniques.     

Evaluation of the usefulness of SIS and MS/MS mode for the determination of persistent organochlorine compounds and polychlorinated biphenyls in human specimens

This study aimed of examining of the applicability of the SIS (Selected Ion Storage) and the MS/ MS (Tandem Mass Spectrometry) methods for analyzing organochlorine pesticide (OCs) residues and PCBs in human specimens. The samples of human abdominal adipose tissue, women's breast adipose tissue, and human milk were used as study material. The samples were analyzed using the gas chromatography method with EC and MS detectors. MS/MS and SIS mode allow to eliminate system-based (e.g., column, septum) ions and the biological samples extract impurities' ions from the background to achieve the analytical system sensitive enough for trace analysis of organochlorine compounds in human specimens.     

The evolution of epidemiology and clinical characteristics of laryngeal and hypopharyngeal carcinoma in Poland from 1991 to 2001

On the base of retrospective analysis of 12,888 cases of carcinoma of larynx and hypopharynx, diagnosed in 19 ENT Departments in Poland from 1991 to 2001, the assessment of basic epidemiological data, including the localization of tumor and stage of local and clinical advancement of the disease at the time of diagnosis has been conducted. In analyzed period of 11 years the trends to change of the mentioned above parameters has been examined. The significant increase of female patients in this period was observed, with average proportion M:F = 8:1. The glottis localization of carcinoma dominated (47.6%), followed by supraglottis (40.8%) and pyriform fossa (7.8%), with significant increase of pyriform fossa tumors in the analyzed period of 11 years. In the majority of cases the carcinoma of larynx and hypopharynx was diagnosed in the advanced stage (T3 + T4) of local disease, with the highest percentage in localization within the pyriform fossa (81.0%), and the lowest percentage in glottis tumors (45.6%). The regional lymph nodes metastases has been diagnosed in 46.7% of the analyzed group, with the highest percentage in tumors localized in pyriform fossa (82.9%), and the lowest percentage in tumors of glottis localization (33.1%). In the 11 years time the significant drop down of N0 cases and tendency to increase of N2 and N3 in the supraglottis localization of tumor. The distant metastases in the analyzed group at the time of diagnosis has been registered in 2.0%, with the highest percentage in posterior pharyngeal wall (7.6%) and pyriform fossa (7.4%). The authors postulate the renewal of prospective study on epidemiology, clinical characteristics and treatment results of larynx and hypopharynx carcinoma in Poland.