Biomedical subjects
Publications and source records attributed to J Bolewski.
The authors analysed differences between two types of clinical diseases based on 161 cases of brain metastases. The first type (A) is, when symptoms of brain metastasis appear in different time of recognized malignant disease. In type B brain metastasis is the first symptom of neoplastic disease.
On the basis of 149 CT examinations of cases of brain metastases the neurological symptoms and signs were analysed in relation to the character of the metastasis and the extent of oedema. Stroke beginning of clinical manifestations, loss of consciousness, seizures and neurological syndromes were evaluated.
The diagnosis of metastases of malignant tumours to the brain possess still considerable clinical problems, especially if the metastasis is the first sign of malignancy. As yet no uniform opinion on the methods of successful treatment has been accepted. The reported analysis includes 139 patients with brain metastases of the lungs, breast and kidney cancer and malignant melanoma, with surgical intervention in 62 cases. A comparison of the location, clinical status and therapeutic results in single metastases showed a superiority of the surgical treatment over conservative methods. Twice as many patients survived one year after the operation as after conservative treatment, and 85-90% of all patients survived 9-12 months after the beginning of the treatment. In cases of multiple metastases the prognosis is poor and the possibilities of treatment are small, with somewhat better results obtained after radiotherapy combined with chemotherapy.
Explore the source record for details and available documents.
A variety of symptoms makes difficult the diagnosis and causes therapeutic problems after blunt limb trauma, particularly after long time from the immediate treatment. Three cases of sympathetic reflex dystrophy of the ulnar nerve as a late consequence of blunt upper limb traumas are presented. Long-term medical and surgical treatment produced temporary remission only. Full efficiency of the limb and remission were achieved only when anterior transposition of the nerve was done.
Severe head traumas cause high mortality. It was the reason to analyze such a group of patients, treated in the Neurosurgical Department of the CCH MMA in the years 1980-1990. All cases of mirror injuries were divided into three groups. The lesions of frontal and temporal lobes present brain-stem lesion like syndromes. Personality disorders were associated with lesions of both frontal lobes. The third syndrome is caused by focal lesions according to their location. The authors discuss medical and surgical treatment and stress the importance of early brain protection.
This report details the management of a patient with a primary pituitary abscess with secondary amenorrhea, mimicking pituitary adenoma. The preoperative diagnosis of intra- and suprasellar pituitary abscess was established by X-ray examination of the skull, CT-scans and anamnesis. After transsphenoidal removal of the abscess with accompanying antibiotic therapy the patient had a progressive and nearly complete recovery with normalization of menstruation.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The authors describe the method of non-operative treatment of widely occurring low back pain syndromes diagnosed as due to isolated degeneration of the nucleus pulposus. In this phase of degenerative spinal disease pain is not due to nucleus pulposus prolapse. The patients are dissatisfied with the results of physiotherapy and rehabilitation, and surgical treatment brings no satisfactory results. The method of dissolving of nucleus pulposus, widely used in the USA, Australia and West European countries, has been used in Poland only in the clinical centre of the authors. The clinical experience gathered during these years made possible delineation of the syndrome of isolated nucleus pulposus degeneration and strict qualification for chemonucleolysis which gives success in about 90% of cases.
A case of conus medullaris tumour (ependymoma) is reported in which the presenting symptom was subarachnoid haemorrhage, which has left bladder dysfunction. 70-year-old patient was admitted to the Department of Neurology due to symptoms of conus medullaris lesion with retention of urine and diminished pain sensitivity in perianal zona. He had been hospitalized 30 years ago due to vomiting, headache and pain in lumbar region. The cerebrospinal fluid examination confirmed the diagnosis of subarachnoid haemorrhage. Cerebral angiography failed to show the source of bleeding. Myelography and spinal arteriography showed nor tumour neither vascular malformation. Only MRI examination performed after 30 years following the first symptoms of tumour made possible the correct diagnosis--tumour in vertebral canal at L1-L2 level compressing conus medullaris. Surgical procedure confirmed the diagnosis. Histopathological examination--ependymoma myxopapillare.