[Malonic dialdehyde concentration in cerebrospinal fluid as an indicator of the intensity of lipid peroxidation processes in intracranial hypertension]. / Stezenie dialdehydehydu malonowego w plynie mózgowo-rdzeniowym jako wskaznik natezenia procesów peroksydacji lipidów w stanach nadcisnienia sródczaszkowego u niemowlat.

The authors of the study correlate malonic dialdehyde (MDA) concentration in the cerebrospinal fluid of infants with hydrocephalus with the values of intracranial pressure. The purpose of the study was verification of the usefulness of MDA concentration determination as an indicator of the processes of lipid peroxidation in CNS tissues in hydrocephalic children. The obtained results point out that the isolated MDA concentration is not a sufficiently precise marker of intracranial hypertension.

[Assessment of anaerobic metabolism in central nervous system tissues in infants with intractable hypertension]. / Ocena przemian beztlenowych w tkankach osrodkowego ukladu nerwowego u niemowlat z nadcisnieniem sródczaszkowym.

Analogously to the blood lactate levels in conditions caused by impairment of peripheral circulation the authors sought a correlation between the concentrations of lactate, glucose and lactate dehydrogenase in the cerebrospinal fluid in children with hydrocephalus and the values of intracranial pressure as an important factor impairing oxygen supply to central nervous system tissues.

[Intraoperative complications in neurosurgical patients operated on in a seated position (personal observations)]. / Powiklania sródoperacyjne u chorych neurochirurgicznych operowanych w pozycji siedzacej (na podstawie przypadków wlasnych).

Specific intraoperative complications are described which occur as a result of sitting position of the patients: herniation of the cerebellar tonsils into the great occipital foramen in a case of tumour in cerebellar hemisphere and venous air embolism in another case of tumour in the cervical part of the vertebral canal. Attention is called to certain methods of prevention and diagnosis.

[Spinal reflexes in the determination of brain death]. / Odruchy rdzeniowe w przypadkach z rozpoznana smiercia mózgu.

The authors present the results of spinal cord function evaluation in organ donors by examination of reflexes. The knee reflex and ankle jerk, as well as abdominal reflex and foot withdrawal reaction were tested in 31 donors. At least one of the above was seen in 25 individuals. It is suggested on the basis of data obtained not to hamper the transplant procedure in cases of tested reflex persistency when brain death is revealed on relevant examination.

[Etiologic bacterial factors of infections in patients treated at the clinical anesthesiology ward and with intensive therapy]. / Bakteryjne czynniki etiologiczne zakazen u chorych leczonych w Klinicznym Oddziale Anestezjologii i intensywnej Terapii.

Bacteriological investigations were carried on 264 patients treated in 1988-1990. 1736 samples of biological materials were taken and it amounts to 6-7 samples from each patient. Most frequently isolated microorganisms were: Pseudomonas aeruginosa (15%), Proteus mirabilis (13%), Klebsiella pneumoniae (10%) and Staphylococcus aureus (10%). Serological typing of Pseudomonas aeruginosa was performed according to Habs and domination of immunotype P16 (30%) was detected. Majority of isolated Klebsiella pneumoniae were not typable with basic and broadened phage set. One strain was susceptible to phages KI12 and KI27. This phage type was not isolated in Poland before. Staphylococci were most frequently susceptible to group II phages (29%), additional phages (19%) and 15% were not typable with the phage set used. Isolated bacteria were in majority resistant to numerous antibiotics.

[An attempt at optimization of diagnosis for patients in puerperium treated due to eclampsia and systemic complications in the Department of Anesthesiology and Intensive Therapy in the Silesian Medical Academy in Katowice]. / Próba optymalizacji diagnostyki poloznic leczonych z powodu rzucawki i powiklan narzadowych w Klinice Anestezjologii i Intensywnej Terapii Sl. AM w Katowicach.

Conditions under which episodes of eclampsia occurred in puerperal, who were than admitted to the Intensive Care Units for treatment are presentation the paper. Multidirectional diagnostic procedures introduced in those 30 patients are discussed. In the analysed group of patients various types of organ complications were diagnosed. The paper underlines value and benefits of the interdisciplinary consultation in diagnostic procedure in cases of dramatic and rapidly occurring complications overlapping existing puerperal status.

[Complex therapy of obstetric patients hospitalized for eclampsia and systemic complications in the Department of Anesthesiology and Intensive Therapy in the Silesian Medical Academy in Katowice]. / Kompleksowe leczenie poloznic hospitalizowanych z powodu rzucawki i powiklan narzadowych w Klinice Anestezjologii i Intensywnej Terapii Sl AM w Katowicach.

The paper reviews the treatment introduced to control cerebral oedema in 30 puerperal women with eclampsia, tonic-clonic seizures and symptoms of increased JcP. Methods of hypotensive treatment, introduced in 23 of 30 patients are presented. Other elements of the therapeutical management aimed at the maintenance of homeostasis, normothermia, normotension and normoglycaemia are also discussed in the paper. Patients required not only complex pharmacological therapy but also mechanical ventilation by means of respirator, often with use of special techniques.

[Intensive therapy of puerperal disorders with a life-threatening state caused by sepsis]. / Intensywna terapia poloznic w stanie zagrozenia zycia z powodu posocznicy.

The paper reviews intensive, complex therapeutical procedure introduced in 19 critically ill puerperal women due to severe sepsis. In 6 cases only the generative organ was the primary source of infection. It is underlined that sepsis can predispose to various complications and multiorgan failure.

[Analysis of therapeutic methods used in puerperium complicated by hemorrhagic shock]. / Analiza metod leczenia poloznic w stanie wstrzasu krwotocznego.

Methods of intensive treatment of puerperium with severe haemorrhagic shock of a dramatic course are analysed in the paper. In 20% of patients shock occurred due to non-obstetric reasons. It is stated, that haemorrhagic shock predisposes to various complications, which in turn require multidirectional treatment. It is stressed, that monitored therapy by means of adequately selected fluids should be supplemented by immediate and appropriate oxygen therapy.

[A case of multiple congenital anomalies of the central nervous system with neural infection and respiratory disturbances]. / Przypadek mnogich wad wrodzonych osrodkowego ukladu nerwowego z neuroinfekcja i zaburzeniami oddychania.

The authors describe a case of an infant with hydrocephalus in whom respiratory disturbances occurred which were directly life-threatening. They present the differential diagnosis of this condition and put forward suggestions on aetiology and pathogenesis, based on the latest literature data.

[Surgical removal of a giant intracranial tumor (medulloblastoma) in a child--patient's chances and surgical problems]. / Operacja usuniecia olbrzymiego guza wewnatrzczaszkowego (Medulloblastoma) u dziecka--szanse chorego oraz problemy zespolu operacyjnego.

A case is presented of an 8-year-old child reoperated on for recurrence of intracranial expansive lesion. Intraoperative cardiac arrest occurred and resuscitation was unsuccessful. The authors analysed the supposed causes of failures and laid stress on problems which may be encountered by the anaesthesiology-neurosurgical team. A number of physiopathological processes occurring here are presented in mathematical form.

[Rare complication of decompression laminectomy in a patient with cervical intramedullary tumor]. / Rzadkie powiklanie laminektomii dekompresyjnej u chorej z wewnatrzrdzeniowym guzem w odcinku szyjnym.

The authors describe a 28-year-old patient with cervical intraspinal tumour in whom permanent apnoea developed after decompression laminectomy and plastic operation of the dura. The patient was artificially ventilated and received intensive therapy but died 2 months after the operation for septic complications.

[Intraoperative intracranial hypotension syndrome]. / Niezamierzony sródoperacyjny zespól podcisnienia wewnatrzczaszkowego.

A case is described of intracranial hypotension after surgical removal of chronic subdural haematoma and hygroma resulting in apnoea lasting several hours. Fully effective anaesthesiological management of this complication is reported.

[Project of the organization of cardiopulmonary resuscitation in the multidisciplinary hospital]. / Projekt organizacji resuscytacji krazeniowo-oddechowej w szpitalu wieloprofilowym.

The new standards of cardiopulmonary resuscitation (CPR), being the result of the World Health Organisation and the European Resuscitation Council studies, should be introduced to the hospital practice everywhere. The aim of this study is to create the project of organisation of the effective CPR system in the big, multidisciplinary hospital--Central Teaching Hospital of the Silesian University of Medicine in Katowice. We propose to establish the interdisciplinary Hospital Resuscitation Council (HRC) consisted of competent representatives of doctors and nurses from all departments with the head of department of anaesthesiology and intensive therapy as a leader of this group. The HRC will be responsible for introducing the effective teaching program of cardiac arrest assessment and basic life support for the whole hospital staff including physicians, nurses, nursing students and lay people. Clear rules of CPR-Alarm, call-system and "do not resuscitate" patients should be established and introduced. There is a need of elaboration of the uniform documentation system and continuous analysis of the effects of CPR activity in the hospital. Anticipated costs of this project are high but the safety of our patients and quality of medical service in the hospital will improve significantly.

[Adrenal gland diseases--results of surgical treatment]. / Choroby nadnerczy--wyniki leczenia chirurgicznego.

The aim of the study is presentation of own remarks, related to surgical treatment of 183 patients with adrenal glands pathology in the years 1976-1996. The diagnosis was based on typical clinical symptoms and hormonal studies. The localisation of lesion was determined initially by X-ray examinations, mostly arteriography, later by ultra-sound and computer tomography, recently also by nuclear magnetic resonance and scintigraphy. The paper discusses methods of preparing the patients for surgery, tactics of surgical treatment, intra- and postoperative complications (8.2%), problem of incidentalomas.

[Evaluation of the usefulness of the laryngeal mask for general anesthesia in eye microsurgery--preliminary results]. / Ocena przydatnosci maski krtaniowej do znieczulenia ogólnego w mikrochirurgii oka--doniesienie wstepne.

PURPOSE: This prospective study was designed to compare intraocular pressure changes and haemodynamic response to insertion of either a laryngeal mask or an orotracheal tube during general anaesthesia for cataract surgery. MATERIAL AND METHODS: The effect of techniques (tracheal tube-TT, laryngeal mask airway-LMA) securing a clear upper airway on the heart rate changes (HR), arterial pressure (SAP, DAP), oxygen saturation (SpO2), end-tidal carbon-dioxide pressure (Et-CO2), intraocular pressure (IOP) and the incidence of coughing, stridor and sore throat was analysed in 60 patients undergoing cataract surgery during general anaesthesia. RESULTS: The mean values for HR, SAP, DAP and IOP measured before and after induction of anaesthesia were not different in both groups. After securing a clear airway, mean HR increased in TT group to 95.5/min and decreased to 75.7/min in LMA group. SAP increased in TT group to 131 mmHg, DAP to 82.6 mmHg, whilst in LMA group both values decreased to 98.6 mmHG and 66.3 mmHg, respectively. The significant difference in IOP values was observed after intubation or using laryngeal mask. In TT group, intraocular pressure increased to 15 mmHg in healthy eye and to 13.6 mmHg in ill eye whilst there was a decrease in LMA group to 5.5 and 7.43 mmHg, respectively. Furthermore, a greater incidence of such complications as coughing, stridor and sore throat in TT group was observed. CONCLUSION: The results show that using LMA in microsurgery during general anaesthesia is more advantageous and safer for patients in comparison with tracheal intubation.