Whether cycling around the city is in fact healthy in the light of air quality - Results of black carbon.

Studying the air quality and exposure of the inhabitants of urban agglomerations to pollution is the basis for the creation and development of more sustainable cities. Although research on black carbon (BC) has not yet reached the official acceptable levels and guidelines, the World Health Organization clearly indicates the need to measure and control the level of this pollutant. In Poland, monitoring of the level of BC concentration is not included in the air quality monitoring network. To estimate the extent of this pollutant to which pedestrians and cyclists are exposed, mobile measurements were carried out on over 26 km of bicycle paths in Wroclaw. The obtained results indicate the influence of urban greenery next to the bicycle path (especially if the cyclist is separated from the street lane by hedges or other tall plants) and the 'breathability' (i.e., associated with surrounding infrastructure) of the area on the obtained concentrations; the average concentration of BC in such places ranged from 1.3 to 2.2 µg/m3, whereas a cyclist riding directly on bike paths adjacent to the main roads in the city center is exposed to concentrations in the range of 2.3-14 µg/m3. The results of the measurements, also related to stationary measurements made at a selected point of one of the routes, clearly indicate the importance of the infrastructure surrounding the bicycle paths, their location, and the impact of urban traffic on the obtained BC concentrations. The results presented in our study are based only on short-term-field campaigns preliminary studies. To determine the quantitative impact of the characteristics of the bicycle route on the concentration of pollutants, and thus the exposure of users, the systematized research should cover a greater part of the city and be representative in terms of various hours of the day.

Anatomical variation of the vertebral artery clinically mimicking myasthenia gravis.

Cranial nerve palsy, most commonly trigeminal, abducens, or facial, caused by compression of an ectatic or elongated intracranial artery is a well-known phenomenon. Symptoms of brain stem compression by an abnormal artery have rarely been reported (Tomasello et al. Neurosurgery 56(suppl 1):117-124, 2005). The authors present a 59-year-old woman with intermittent ptosis of the right eye, diplopia and swallowing disturbances, enhanced after physical effort, implying myasthenia gravis. Typical diagnostic procedures, e.g. repetitive nerve stimulation tests, acetylcholine receptor antibodies level were within normal limit. Neurogenic changes from the orbicularis oculi muscle were found in EMG. MRI and angio-CT revealed anatomical variation of the vertebral artery (elongated and arcuate route), causing intermittent signs of brain stem lesion. We point out the similarity of the clinical symptoms of myasthenia gravis and vascular brain stem compression by abnormal vertebral artery. The two diseases require completely different therapeutic proceedings.

Computerized tomography evaluation of cortical bone properties in the tibia.

BACKGROUND: Tibia shaft fractures are among the most common fractures. However, the incidence of tibia fractures does not increase in the elderly. Osteoporotic bone resorption is possibly compensated for by periosteal apposition, which improves the mechanical properties of the bone. The purpose of this study was to identify a correlation between geometric indices of transverse bone scans and radiologic bone density based in CT studies. MATERIAL AND METHODS: 12 human cadaver tibiae were CT examined. Radiological density in Hounsfield units was evaluated in transverse bone scans taken at the junction of the distal and middle third of the tibial shaft. The average and maximum radiological density and area of cortical bone were evaluated. RESULTS: Average radiological bone density decreased with age. This was not accompanied by a corresponding increase in cortical bone area. CONCLUSION: The study did not provide direct confirmation that age-related osteoporotic bone resorption is compensated for by periosteal apposition.

Cerebral venous thrombosis as a first presentation of diabetes.

This report presents a case of cerebral venous thrombosis and venous infarction in a diabetic patient, the third in the world literature (the second in a child). An 8-year-old male was admitted to the hospital due to abdominal pain, vomiting, polydypsia, and polyuria, lasting for 4 days. Laboratory studies revealed marked hyperglycemia and ketoacidosis. Two hours after admission the child lost consciousness. Emergency computed tomography performed 3 hours after admission (4 days after the onset of symptoms) revealed hyperdensity in the vein of Galen and superior sagittal sinus, consistent with thrombosis, accompanied by bilateral venous infarction. Follow-up computed tomography performed 6 days after admission (10 days after the onset of symptoms) documented evolution of thrombosis. Magnetic resonance imaging and magnetic resonance venography performed 22 days after admission (26 days after the onset of symptoms) confirmed venous infarction and thrombosis. This report discusses possible mechanisms of cerebral venous thrombosis in diabetic hyperglycemia and stresses the importance of imaging studies despite the extreme rarity of such cases.

[Diagnostic problems in case of primary central nervous system lymphoma]. / Trudnosci diagnostyczne w przypadku pierwotnego chloniaka mózgu.

The authors described a case of young patient with primary central nervous system lymphoma (PCNSL). Unspecific initial symptoms and clinical course, as well as neuroimaging findings caused many diagnostic difficulties. The diagnosis of PCNSL was finally established on the basis of stereotactic brain biopsy, after 18 months of follow-up.

[Cortico-basal degeneration: the rare form of tau protein disease]. / Zwyrodnienie korowo-podstawne--rzadki rodzaj tauopatii.

Cortico-basal degeneration is a rare degenerative disease connected with Tau protein pathology. Epidemiology of cortico-basal degeneration is unknown. The authors present a case of 59 years old woman with suspicion of cortico-basal degeneration. The extrapyramidal symptoms mainly on the right side with "alien limb phenomenon" and dystonia of lower limb is observed in our patient. Cortico-subcortical brain atrophy was present in MRI scans. EEG was asymmetrical. No improvement was noticed after L-Dopa. Treatment of amantidine caused the transient improvement.

Efficiency of CT-angiography in the diagnosis of intracranial aneurysms.

BACKGROUND: CT-angiography is a non-invasive method, alternative to cerebral angiography in the diagnosis of intracranial aneurysms. The aim of the study was the assessment of the efficiency of CT-angiography in a large material, which has been mostly verified with angiography and/or surgery. MATERIAL/METHODS: CT-angiography was performed in 196 patients with intracranial bleeding. Seventy-three (73) patients underwent also cerebral angiography (CA), 121 were operated on, 74 of them solely on the basis of CT-angiography. A spiral CT scanning (2 mm slices, 1-1.5 pitch, 1 mm-gap reconstruction) combined with an injection of 120 mL of contrast medium (5 mL/sec) was used. Subsequently three-dimensional MIP reconstructions were received, supplemented in some cases with SSD, VRT and MPR. RESULTS: CT-angiography revealed 128 aneurysms in 106 patients, located mostly in anterior communicating, middle cerebral and internal carotid arteries. The size of most aneurysms was 6-10 mm, but nearly one-third of them did not exceed 5 mm. In the group of patients who underwent CA, there was only 1 false negative CT-angiography result, while in 7 patients CT-angiography allowed for the diagnosis of small aneurysms which were not clearly visible on CA. CT-angiography was superior to CA in assessment of aneurysm morphology by 3 independent radiologists in 17 out of 22 cases. CT-angiography findings were confirmed during surgery in all 74 patients. CONCLUSIONS: CT-angiography is highly effective in the diagnosis of intracranial aneurysms and the evaluation of their morphology. In our opinion, in most cases, CT-angiography is precise enough to plan a surgical or endovascular procedure.