[Micturition syncope: a peculiar cause of diagnostic doubt]. / Micturition syncope: szczególna przyczyna watpliwosci rozpoznawczych.

A 22-year old healthy man lost consciousness during urination in standing after night's sleep. He fell down to the floor without convulsions. A physician present by chance found on bradycardia. A 24-hours ECG monitoring disclosed an almost permanent sinus bradycardia (50-55 per minute). CT showed an arachnoid cyst at the base of the left temporal lobe without mass effect. In EEG only single slow waves above left temporal region were revealed. It seems, the cyst was found by chance and had no any pathogenetic relevance to the syncope. However, the presence of a structural change of the brain had not been described in micturition syncope till now and this makes careful differentiation from epileptic seizure essential. During the following 2 years the patient was well and the episode did not recur again. The control CT and EEG remained unchanged. Data from literature about syncope in association with micturition also in older persons, in majority women with chronic illnesses, are cited.

[Neurocysticercosis: benign natural course]. / Wagrzyca mózgu: lagodny przebieg naturalny.

In a waiter aged 51 without clinical symptoms, but with a history of sporadic epileptic seizures in young age, radiological examination demonstrated multiple calcifications in the brain corresponding to calcified cysticerci. Similar lesions were found in the muscles of the thighs and left lower leg. After another 18 years without cerebral symptoms these calcifications were demonstrated in CT. The case indicates that the natural course of cerebral cysticercosis may be asymptomatic or oligosymptomatic, and that it is useful to distinguish between active and inactive cysticercosis.

[Intramedullary metastasis of pulmonary carcinoma]. / Wewnatrzrdzeniowy przerzut raka pluc.

An autopsied case of intramedullary metastasis of microcellular pulmonary carcinoma is described. Data of the incidence and clinical course of intramedullary metastases are presented.

[Thoracic radiation myelopathy]. / Popromienna mielopatia piersiowa.

In a 62-year-old patient 8 month after radiotherapy for right pulmonary hilus carcinoma signs of thoracis cord involvement with ascending course from Th10 to Th7. Cerebrospinal fluid and myelogram were normal. The patient died after about 12 months. Radiation myelopathy was confirmed by neurohistological examination. The results of experimental studies are quoted which could predict the possibility of early diagnosis of radiation myelopathy by rising level of basic myelin protein in cerebrospinal fluid.

[Subacute sclerosing panencephalitis pregnancy]. / Podostre stwardniajace zapalenie mózgu (SSPE) w ciazy.

In a patient aged 16 behaviour at changes, followed by visual agnosia, aphasia, paraparesis and involuntary movements developed about the 24th week of pregnancy. The presence of measles virus antibodies in the cerebrospinal fluid and progressing course of the disease with fever suggested SSPE. Pregnancy was terminated by caesarean section in the 30th week of pregnancy, the male premature baby died after 4 days, his brain was not examined under microscope. The mother died 2 weeks after labour in decerebrate rigidity. In the brain numerous profuse infiltrations composed of lymphocytes and plasma cells were found around blood vessels, the glia was proliferated and hypertrophied, eosinophilic inclusions were demonstrated in the nucleic of cortical neurons. The authors review the very few case, reported as yet, of SSPE in pregnant women. During pregnancy natural immunosuppression occurs, which may lead to activation of dormant infection with measles virus mutant. However, the history of one of the published cases suggests the possibility of other pathogenetic factors active in such cases.

[Brain lesions after radiotherapy]. / Uszkodzenia mózgu po radioterapii.

On the basis of literature reports up to 1988 the incidence, clinical pattern and treatment of cerebral complications following radiotherapy administered to the organs and tissues of the head are discussed. Acute radiation-induced reaction and early delayed reaction in the form of e.g. the so called somnolence syndrome or rhombencephalopathy are rare and their prognosis is usually good. In 1 to 14% of the patients delayed reaction may develop corresponding to the late radiation necrosis, usually with progressive unfavourable course. A problem of practical importance is the impossibility of differentiating radiation-induced cerebral necrosis from recurrence, expansion of the primary tumour or metastatic tumour, even using CT and MNR. Only the poorly available positron emission tomography makes possible differential diagnosis. Sometimes, surgical or pharmacological treatment of cerebral necrosis is effective.

[Hoffmann's syndrome. The role of neurologists in the diagnosis of hypothyroidism]. / Zespól Hoffmanna. Udzial neurologa w wykrywaniu niedoczynnosci tarczycy.

In a mason aged 48 years gradually hardness, rigidity and painful muscle spasms, slowness of movements and awkwardness with progressing difficulties in walking developed. Only after several months of observation the finding of pseudo-myotonia suggested the diagnosis of Hoffmann's syndrome during hypothyroidism. In a number of neurological syndromes and in unclear muscular signs it is useful to consider hypothyroidism in the differential diagnosis.

On the mechanisms of ATP-induced and succinate-induced redistribution of cations in isolated rat liver cells.

1. The ability of external ATP to induce calcium uptake in isolated rat liver cells was further characterized. Stimulation of calcium uptake was specific for ATP, other nucleotides or ATP metabolites had no comparable effect. ATP was dephosphorylated while stimulating calcium uptake, but there was no stoichiometry between ATP hydrolysis and calcium uptake nor did dephosphorylation depend on calcium concentration. ATP acted from outside and was dephosphorylated by an ecto-ATPase of the cells. 2. In addition to its direct action, ATP enhanced succinate-dependent calcium uptake in a cooperative fashion. This is best explained by different sites of action. ATP increases cell membrane permeability while succinate stimulates uptake into mitochondria. 3. ATP was able to lower Na+ and K+ gradients and the pH gradient between cells and incubation medium. Increasing calcium concentration counteracted this effect though calcium uptake was then stimulated. 4. Succinate alone did not affect monovalent cation gradients but raised the pH gradient. It partially counteracted the ATP effects on these gradients. 5. Since catecholamine-like actions of ATP may be mediated by an increase in cytoplasmic calcium concentration, the action of extracellular ATP can be taken as a model to study the role of calcium as a transmitter of hormone actions. From interdependence between ATP-stimulated and succinate-stimulated calcium uptake, conclusions can be drawn on the resulting cytoplasmic calcium concentration and its effect on plasma membrane permeability.

[Many-year course of systemic lupus erythematosus with cerebral symptoms]. / Wieloletni przebieg tocznia trzewnego z objawami mózgowymi.

During 20 years of disease duration in the reported woman aged 47 years at the time of death articular involvement was followed by cardiac involvement and after labour renal signs appeared. Cerebral signs developed about 11 years before her death and manifested themselves as several typical strokes. The observed systemic affections, including the neurological signs, responded favourably to immunosuppression. Postmortem examination of the brain demonstrated numerous ischaemic foci, including a large cerebellar infarction, due to proliferative changes in the walls of cerebral and meningeal vessels.

[Ataxic form of Jakob-Creutzfeldt syndrome]. / Postac ataktyczna choroby Creutzfeldta-Jakoba.

The authors describe a man aged 43 years with a typical onset of the disease with cerebellar signs and progressive dementia prevailing during a 4 month course of the illness. Neuropathological examination demonstrated subacute spongiform encephalopathy with significant although not overwhelming damage to the cerebellar cortex. The case is an example of the ataxic form of this disease isolated in 1965. In the clinical diagnosis of Creutzfeldt-Jakob disease cerebellar signs may play a similarly important role as myoclonia and characteristic EEG curve.

[Compulsory sterilization in the Breslau district in 1934-1944]. / Przymusowe sterylizacje w rejencji wroclawskiej 1934-1944.

PIP: One of the earliest Nazi efforts to create a super race was the mass sterilization of German citizens through radiation or surgery. A law enacted on July 14, 1933 stated that all patients suffering from hereditary mental disorders, schizophrenia, manic-depressive psychosis, hereditary epilepsy, chorea, blindness, deafness, other serious hereditary defects or alcoholism must be sterilized. Special courts were created. Directors of psychiatric institutions, certain doctors, as well as the patients themselves were called before the court. All medical personnel including nurses and midwives were to report anyone in their care who should be sterilized. Patients had the alternation of willingly committing themselves for life into a "closed" institution, where they would have no opportunity for heterosexual actifity. On the whole, German society did not support this law, particularly relatives and family of patients. From the sketchy records available, it is clear that there were often casualties and that patients were hunted out and forced to submit to sterilization.^ieng

[Neurological syndromes in the course of systemic lupus erythematosus]. / Zespoly neurologiczne w przebiegu tocznia trzewnego.

Seven cases of SLE with concomitant neurological syndromes are reported. In 2 cases brain stroke with right-sided hemiplegia and aphasia developed, in the remaining cases brain-stem stroke with subarachnoid haemorrhage, progressive hemiparesis and signs of intracranial hypertension, chorea, status epilepticus in terminal uraemia were observed. In one case myasthenia coexisted. Severe neurological syndromes were preceded by signs of involvement of other organs and in most cases by low-grade signs of central nervous system involvement. Treatment with corticosteroids and immunosuppressants resulted in significant improvement without complete remission. A retrospective survey of clinical material showed that modern therapeutic methods have improved the prognosis in systemic lupus erythematosus independently of central nervous system involvement.