Persistent trigeminal artery as a rare cause of vertebrobasilar insufficiency.

The persistent trigeminal artery (PTA) is the most common foetal carotid-basilar anastomosis which may persist into adult life. In the literature there are numerous papers referring to the anatomical characteristics of this anomalous vessel. In the majority of cases PTA is an incidental finding and its clinical significance has been debated. Some authors describe the coincidence of PTA with various clinical syndromes. However, there are few reports linking PTA with the symptoms of vertebrobasilar insufficiency. We present a patient with a 3-year history of recurrent dizziness and impaired vision, precipitated by physical activity, in whom neuroimaging techniques revealed a left PTA. In our case the occurrence of PTA might have been related to the clinical manifestation and the potential mechanism will be discussed.

Temporal order of DNA replication in the H-2 major histocompatibility complex of the mouse.

As an approach to mapping replicons in an extended chromosomal region, the temporal order of DNA replication was analyzed in the murine major histocompatibility gene complex (MHC). Replicating DNA from T-lymphoma and myelomonocyte cell lines was density labeled with bromodeoxyuridine and extracted from cells which had been fractionated into different stages of S phase by centrifugal elutriation. The replicating DNA from each fraction of S phase was separated from nonreplicating DNA on density gradients, blotted, and hybridized with 34 specific MHC probes. The earliest replication occurred in the vicinity of transcribed genes K, HAM1 and HAM2, RD, B144, D, L, T18, and T3. The temporal order of replication of groups of DNA segments suggests the location of five or six replicons within the H-2 complex, some of which appear to be either unidirectional or markedly asymmetric. The rates of replication through each of these apparent replicons appear to be similar. The TL region of the S49.1 T-lymphoma cells, which contains at least three transcribed genes, replicates earlier than the inactive TL region of WEHI-3 myelomonocytic cells. These results provide further evidence of a relationship between transcription and the initiation of DNA replication in mammalian cells. The mouse MHC examined in this study is the largest chromosomal region (> 2,000 kb) measured for timing of replication to date.

HLA antigens and susceptibility to myasthenia gravis.

HLA-A, -B, -C and -DR antigen frequencies determined in a group of 73 myasthenia gravis (MG) patients were compared with those of a control group of 205 subjects. The strongest positive association with MG was found antigens B8 and DR3 (relative risks 9.56 and 8.84 respectively). Analysis of our data indicates that both antigens, independently from their linkage disequilibrium, are involved in susceptibility to MG. No relationship between HLA antigens on thymic pathology was observed in our material. In male MG patients the association with DR3 was weaker than in female patients. The difference in DR3 frequency between male and female patients was statistically significant; no significant difference was found for antigen B8. It appears that DR3 contributes to development of MG only in females. In male patients aged more than 30 years at the onset of disease, MG was not associated with B8 or DR3. In contrast, in female patients aged more than 30 years at the onset of disease there was a strong association of B8 and DR3 with the disease.

[Hemorrhagic lesion of the sciatic nerve caused by chronic infection and iatrogenic factors]. / Krwotoczne uszkodzenie nerwu kulszowego wywolane przewleklym zakazeniem i jatrogennymi czynnikami.

The author reports a 50-year-old woman with haemorrhagic lesion to the sciatic nerve during a chronic infectious process and treatment with chemotherapeutic agents. The nerve was damaged by pressure exerted by extravasated blood or haemorrhage from vasa nervorum.

[Familial form of myasthenia]. / Przypadek rodzinnego wystepowania miastenii.

In 2 daughters of healthy parents severe myasthenia with involvement of the eye muscles, bulbar muscles and extremities developed at the age of 20 and 28 years. In both patients persistent thymus was demonstrated. The authors suggest that familial occurrence of myasthenia does not seem to be coincidental; there may be a relationship with genetically determined HL-A system.

[Thrombo-obliterative changes in blood vessels of oculo-cerebral location]. / Zmiany zakrzepowo-zarostowe naczyn o lokalizacji oczno-mózgowej.

The authors report a 46-year-old woman with discrete signs of central nervous system lesions and thrombo-obliterative changes in retinal vessels. There were no circulatory changes in the extremities. The type of vascular retinal changes, maintained patency of ocular and cerebral arteries and slow course suggested the diagnosis of oculo-cerebral form of thrombo-obliterative changes in blood vessels with involvement of the end portions of these arteries.

[Extensive intracerebral calcinosis in postoperative hypoparathyroidism]. / Rozlegle zwapnienia sródmózgowe w przebiegu pooperacyjnej niedoczynnosci przytarczyc.

A case is described of extensive calcifications of basal nuclei and cerebellar nuclei with abundant clinical and radiological findings. The slowly progressive hyperkinetic syndrome and pyramidal damage signs were related to hypoparathyroidism developing after two operations for goitre.

[Multiple intracranial meningiomas in a patient with asymptomatic syringomyelia]. / Mnogie oponiaki sródczaszkowe u chorej z bezobjawowa jamistoscia rdzenia kregowego.

A rare coexistence of multiple intracranial neoplasms of mesodermal origin with asymptomatic syringomyelia is reported. The clinical findings were documented by NMR and CT results. The histological examination of the tumours removed surgically is included.

[Dysembryoplastic neuroepithelial tumor (DNT)--case report and literature review]. / Dysembrioplastyczny nowotwór neuroepitelialny (DNT)--opis przypadku i przeglad pismiennictwa.

Neuroepithelial dysembryoplastic tumour was first described by Daumas-Duport in 1988 and in WHO classification was included into the group of neuronal and mixed neuroglial tumours. This is a benign and very rare tumor with a good prognosis occurring in children and young adults. The tumour caused characteristic clinical symptoms: epileptic fits, supratentorial, intracortical localisation, most often in temporal lobe and specific nodular architecture with heterogenic cell composition. Oligodendrocyte-like cells, glial and neuronal elements are usually found. The authors present a case of a 24-years old female with partial epileptic sensorial symptomatology. CT examination revealed a tumour in the left parietal lobe. Histological findings showed a typical texture of DNT. The tumour has no tendency for recurrence even in case of incomplete removal and does not require chemotherapy nor radiotherapy which is significantly important for accurate diagnosis, in order to avoid an aggressive therapy in young patients.

[Various lipid components in the serum of alcoholics]. / Zachowanie sie niektórych skladników lipidowych w surowicy krwi u osób naduzywajacych alkoholu.

In a group of 57 alcoholics, patients of disaccustoming ward, and a group of 61 controls the level of adipose bodies in blood serum was determined. The comparison showed a significantly higher level of cholesterol and triglycerides in alcoholics than in controls. Other lipid components, beta lpoproteides, total lipids and fatty acids exhibited similar values in both groups. The authors analyse, basing on a survey of literature, the expected mechanism of changes responsible for disturbed metabolism of fats in chronic alcoholism.

[The comparison of the effectiveness of treatment of multiple sclerosis relapse with high doses of methylprednisolone, alpha-24 corticotropin and cyclophosphamide]. / Porównanie skutecznosci leczenia rzutu stwardnienia rozsianego duzymi dawkami metyloprednizolonu, alpha-24 kortykotropina i cyklofosfamidem.

The effectiveness of treatment was compared in groups of patients with definite multiple sclerosis (MS) given respectively: methylprednisolone, alpha-24 corticotropine and cyclophosphamide combined with corticotropine. Clinical improvement was assessed by means of the expanded disability status scale (EDSS). The significant results were noted in patients treated with methylprednisolon and corticotropine combined with cyclophosphamide (1.5 in EDSS) for the first time, when compared to subsequent treatment. Within the patients in a more advanced stage of the disease, undergoing subsequent treatment, those given corticotropine displayed the best improvement (1.5 in EDSS), but without statistical significance. The authors suggest methylprednisolone or corticotropine combined with cyclophosphamide are the most effective immunosuppressive treatment in the initial phase of MS.

[Chronic demyelinative polyneuropathy Guillain-Barré type in the course of systemic lupus erythematosus ]. / Przewlekla polineuropatia demielinizacyjna Guillaina-Barrégo w przebiegu tocznia ukladowego.

The authors presented a rare case of chronic demyelinative polyneuropathy Guillain-Barré type in 49-year old woman with systemic lupus erythematosus. The diagnostic was based on electroneurographic examination and immunodiffusion of cerebrospinal fluid proteins. The authors indicated to the high effectiveness of high doses of immunoglobulins administrated intravenously after 3 months of the beginning of peripheral symptoms. At the onset of the disease the immunosuppression by use of prednisolone and cyclophosphamide was ineffective.

[Evaluation of cardiovascular and sudomotor functions in Alzheimer's disease]. / Ocena czynnosci ukladu sercowo-naczyniowego i potowydzielniczego u chorych na chorobe Alzheimera.

The assessment of some aspects of cardiovascular and sudomotor system was performed in the group of patients with Alzheimer's disease. No one of patients complained of disturbances arising from these two parts of the vegetative system. The autonomic functions were evaluated by means of: clinical examination, heart rate variability tests at rest, measures of blood pressure and heart rate in supine and standing position and skin sympathetic response. At rest heart rate and its variability as well as blood pressure in the patients did not differ significantly from the results obtained in the healthy controls. On standing, changes in systolic blood pressure and heart rate were recorded in the controls, but not found in the patients. The majority of patients presented with abnormalities in skin sympathetic response: lack of response or prolongation of its latency. The results of motor and sensory nerve conduction studies excluded neuropathic changes in the patients. We conclude that autonomic disturbances accompanied Alzheimer's disease and were probably caused by damaged control mechanisms within the central vegetative system.

[Apolipoprotein E(ApoE)and tau protein in Alzheimer type dementia]. / Apolipoproteina (ApoE) i bialko tau w otepieniu typu Alzheimera.

In 45 patients meeting NINCDS-ARDRA criteria for probably diagnosis of Alzheimer disease (AD), ApoE genotype and tau protein level in cerebro-spinal fluid (CSF) were determined. Frequency of e4 allele occurrence in group of AD patients was 73.3% and showed high statistic significance in comparison with control group. Increase of tau protein level in CSF was also statistically significant. No correlation in ApoE allele and tau protein level in CSF was revealed. The authors emphasize the usefulness of tau protein level measurement and determination of ApoE allele in diagnosis of Alzheimer disease.

[Multimodal evoked potentials in malabsorption syndrome]. / Multimodalne potencjaly wywolane w zespolach zlego wchlaniania.

The multimodal evoked potentials (visual, somatosensory and auditory brainstem) in 23 patients with malabsorption syndrome of different origin were investigated. The diagnosis of the disease was confirmed on the basis of histological examination and result of D-ksyloza test. The control group consisted of 30 healthy persons. Examination of visual evoked potentials revealed significant prolongation of latency of P 100 component in examined group in comparison with controls. Latency of N13 and N20 of somatosensory evoked potentials in patients with malabsorption syndrome were also significantly prolonged when compared to controls, otherwise transit time to cortex (TTC) was merely prolonged. Auditory brainstem potentials were also abnormal. Changes involved prolongation of latency of I, III and V responses and prolongation of interpeak latencies of I-III, III-V, I-V as well. The amplitudes of the examined evoked potentials between patients and controls did not differ significantly. On the basis of obtained results in was pointed out that different specific afferent systems are affected in patients with malabsorption syndrome what seems to be connected with vitamin's deficiency, especially B12 and E. Authors conclude that multimodal evoked potentials examinations are useful in the diagnosis and monitoring of the disease, specially in subclinical cases.