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Biomedical subjects

W Lebkowski

Publications and source records attributed to W Lebkowski.

10 recordsLinked to original sources

MIB-I as a proliferative activity marker of the multiform glioblastomas.

MIB-I is a proliferative activity marker of multiform glioblastomas which are the most frequent tumors of the central nervous system. They are characterizad by differential rate and prognosis. The aim of the study was to determine the proliferative activity of multiform glioblastomas and estimation of the correlation between tumors' proliferative activity and tumors' localization, size, patients' age and sex. 24 patients (18 females and 6 males) with multiform glioblastomas were analyzed. The mean patients' age was 52.1. The proliferative activity was calculated as a proliferation index: IP for MIB-I. Cells with positive reaction were determined by MIB-I which was compared to all neoplastic cells. The most frequent localization of the tumors were frontal and temporal lobes of the brain. The size of the tumors ranged from 2.5 to 5.3 cm (mean 3.9). Mean IP was 43.2 (SD+/-17.4). We found no correlation between IP MIB-I and localization of the tumor, patients' age and sex. There was a marginal statistically significant correlation between IP MIB-I and size of the tumor (p=0.005).

Antigens, Nuclear↗

No specific brain protection against thermal stress in fever.

Knowledge about human brain temperature is still very limited, despite evidence demonstrating the critical influence of mild increases in temperature on the ischaemic brain. It has been suggested that in passive and exercise hyperthermia the brain may be protected against thermal damage by a mechanism of selective brain cooling (SBC). It is said to bring about suppression of the temperature of the brain, rendering it significantly lower than trunk and arterial blood temperature. Yet very little is known about the possible role of this mechanism in fever, a condition fundamentally different from "physiological" hyperthermia, especially when it occurs in brain-damaged patients. In our investigation we retrospectively analysed the results of direct recordings of cerebral temperature within the subdural space (Tsd) and within the brain parenchyma (Tbr-16 cases) in 63 unanaesthetized patients following neurosurgical procedures, including 23 with fever > 38 degrees C. The difference between trunk temperature, measured in the rectum (Tre) or in the oesophagus (Tes), and the intracranial temperature, were calculated in all subjects. A statistically significant reduction of these differences, in step with increasing fever, would be compatible with demonstrating a process of selective brain cooling. The offsets Tre-Tsd, Tre-Tbr, and Tes-Tsd were plotted against Tre over a wide range of body temperature and near zero correlation was found. This finding suggests that brain temperature in fever was not selectively suppressed by any specific thermolytic mechanism and that dissipation of the main bulk of cerebral metabolic heat both in normothermia and in fever depends on heat uptake by arterial blood. The results suggest that the brain in fever can be seriously jeopardized by heat stress and no specific cooling mechanism exists, to reduce it below body temperature in feverish neurosurgical patients. Tbr and/or Tsd remained the highest body temperature in 14 out of the 23 patients during fever.

Aged↗

[Brain temperature during craniotomy in general anesthesia].

Mild hypothermia may occur spontaneously or, because of its putative neuroprotective effect, may be induced purposefully during neurosurgical procedures. Though the brain is the organ targeted for the purpose of neuroprotection, little is known about its temperature during general anaesthesia and craniotomy. The purpose of this study was to define the relations between core, skin and brain temperature during craniotomy and to compare two modes of inducing thermal insulation in patients during operative procedures. To achieve this we recorded core: rectal (Tre), oesophageal (Tes) and tympanic (Try) temperature, brain temperature in the subdural space (Tsd), and skin temperature on the thigh (Tfe), forehead (Tfr) and sternum (Tst) in 15 patients undergoing standard procedure for aneurysm clipping. In 13 patients the core temperature decreased, whereas skin temperature increased, after induction of general anaesthesia with isofluran. Nevertheless the mean body temperature remained unchanged, thus supporting the view that the cause of the resultant core hypothermia was heat redistribution between the thermal core and the periphery. Special thermofoil proved to be only as effective as a plain cotton blanket in preventing further heat loss during the later phases of the operation. Brain temperature was found to be the lowest core temperature throughout the procedure. It differed by as much as 0.1-1.2 degrees C from rectal temperature (mean 0.75 +/- 0.41 degree C) and reached the level of mild hypothermia (below 35 degrees C) even in those patients in whom rectal temperature indicated the state of normothermia. Furthermore tympanic and oesophageal temperature was on average 0.5 degree C higher than brain temperature. In conclusion, temperature measurements obtained in standard sites do not reflect brain temperature reliably during craniotomy and general anaesthesia. This indicates that the direct measurement of intracranial temperature is necessary for correct estimation of brain hypothermia.

Anesthesia, General↗

[Internal ophthalmoplegia as a direct consequence of head injury. Report on 2 cases].

The authors describe two cases admitted following head injury and presenting with a dilated, stiff pupil. CT scan of the head revealed no intracranial mass lesion. The symptoms persisted over a year in one case, whereas in the other one they faded away within a few weeks. The symptoms are believed to arise due to a downward shift of the brainstem which is known to occur at the moment of head injury. The oculomotor nerve is ++over-stretched and is supposed to be partially damaged at the posterior petroclinoid ligament. The roots of the pupillomotor fibers may also be supposedly torn at the site where they leave the brainstem.

Adult↗

[A case of blast injury of the brain].

Cases of craniocerebral injuries associated with foreign body penetration into the cranial cavity are not frequent in peacetime. The reported case was that of shot wound of the head caused by a steel pin used in construction works. The foreign body penetrated into the cranial cavity through the right eyeball and across the brain to the occipital lobe. The foreign body was not removed, and after 34 days in hospital the patient was discharged home with only a slight neurological deficit, i.e. low-grade paresis of his left foot. No remote complications were observed during 4 years of follow-up.

Accidents, Occupational↗

[Clinico-radiological analysis of surgically treated sciatica cases].

An analysis included 187 patients treated surgically for sciatica due to vertebral disk pathologies. Nerve roots compression was noted in all examined patients, including 54% of left-sided compression, 43% of right-sided, and 3% of bilateral compression. Majority of cases involved nerve roots in L5 (51%) and L4 (36%) segments of the spine. Intra-operationally 139 (87%) out of 160 abnormal radiculographies have been confirmed. Disk disease was diagnosed in 11 patients despite the lack of changes in radiculography. It may be explained by the extremely lateral prolapse of the vertebral disk. Long term course of the disease and clinical picture decide on surgery in such cases.

Adolescent↗