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INTRODUCTION: Patients with chronic renal failure exhibit abnormalities of thyroid function. Reports regarding thyroid function in kidney transplant recipients (TX) are rare, particularly those individuals on long-term immunosuppression. The aim of this study was to investigate correlations between FT3, FT4, TSH concentrations, thyroid volume, and graft function. MATERIAL AND METHODS: The study enrolled 46 kidney allograft recipients (aged 27-67 years,) engrafted between years 1994 and 2000 and clinically stable. The mean time after TX was 45.3 +/- 37.4 months. Transplanted patients received prednisone, cyclosporine, and azathioprine. The control group included 22 patients with normal renal function. In addition to serum creatinine, TSH, FT3, and FT4 concentrations, thyroid examinations were performed with a 7.5-MHz linear probe to calculated the thyroid volume. RESULTS: Thyroid volume in TX patients was 25.3 +/- 13.3 mL. A positive correlation existed between thyroid volume and serum creatinine (P <.05), and a negative one between thyroid volume and TSH (P <.05). No correlation was observed between TSH, FT4, and serum creatinine. The time after TX was negatively related to TSH (P <.05). A negative correlation existed also between FT3 and creatinine in TX patients (P <.05). In the control group the concentrations of TSH and FT3 were within normal ranges. CONCLUSION: The FT3 concentration correlates with function of the renal graft. In TX patients the supplementary thyroid hormone therapy should be considered.

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BACKGROUND: Infections remain among the most common morbid events and are an important cause of death in end stage renal disease. They have reduced immune response and increased hazard of infections due to repeated puncture of an arterio-venous fistula, formation of haematoma at the site of cannulation and central vein catheterisation. CASE REPORT: We report a case of brain abscess in chronically haemodialysed patient admitted to our department due to haedache, vomiting, accelerated hypertension and fever. The clinical examination revealed narroving of the right palpebral slit, weeping and right oral angle hanging loose. He had mild microcytic anaemia and high level of g-globulin. Ophtalmologic examination showed normal oculi fundi. The computed tomography revealed heterogenous mass marginally enhanced with contrast agent in the right frontal cerebral lobe. The right fronto-temporal craniotomy was performed and the right frontal lobe abscess was found and totally excised. The postoperative course was uneventful besides of seizures which were effectively treated with carbamazepine. After bilateral nephrectomy the patient undervent succesfull kidney transplantation and is in good condition without any neurological defect. A probable cause of his brain abscess was peridontal abscess recognized 3 month earlier or bilateral vesicoureteral refluxes. CONCLUSIONS: 1. Uremic patients have a reduced immunocapacity and are a high risk group for infections of various etiology. 2. Prompt eradication of all sources of infection is essential in hemodialysed patients.

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Primary intracranial malignant fibrous histiocytoma (MFH) is an extremely rare occurrence, however this kind of neoplasm is observed among the sarcomas. The aim of this report is to present a case of malignant fibrous histiocytoma in a 22 years-old woman. The control examination performed five years after operation revealed only mild exophthalmus and visual disturbances as presented before surgery.

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The aim of the study was to estimate the activity of glutathione peroxydase, glutathione reductase and superoxide dysmutase in the brain tumours. The activity of GSH-Px was evaluated with the use of spectrophotometry, GSSG-R was evaluated based on the Mize and Langdon method, and SOD-1 with Sykes et al. method. The 55 specimens (45 specimens of neoplasm and 10 specimens of healthy brain tissue) were studied. The statistical analysis revealed significant increase of enzymes within the brain tumours in comparison to the healthy brain tissue.

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In some patients with lumbar disc herniation pain of various character and intensity is observed. Besides the pain a number of patients present burning or cold sensations. The superficial temperature of the lower extremities was evaluated in 39 patients with ischialgia, classified for surgical treatment. The differences of skin temperature, however not statistically significant, between the affected and non-affected limbs were found.

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The authors present long-term results (10.2 years post-op) of surgical treatment of lumbar disc herniation in 1003 patients operated at the Department of Neurosurgery by the University of Medical Sciences in Bialystok. The operated group comprised 33.1% women (mean age--55.6 years) and 68.7% men (mean age 57.3 years). Ten years post-op 15.9% women and 5.8% men kept the recommended diet, 14% women and 7.0% men continued muscle strengthening exercise. Ten years post-op excellent and good results were noted in respectively 42.4% and 46.5% women and 45.4% and 46.6% men.

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The authors present a rare case of the total intradural sequester from a prolapsed lumbar disc at the L4 level. This kind of hernations comprise 0.3% of all disc hernations. Surgical treatment resulted in a good outcome.

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The aim of the study was to evaluate the concentration of glutathione (GSH), ascorbic acid (Vit C), and thiobarbiturate acid reacting components (MDA) in brain neoplasms in specimens from normal brain tissue. The group of 72 individuals treated surgically for brain neoplasm in Department of Neurosurgery Medical Academy of Bialystok (Poland) in the period from 1996 to 1999 was included into the study. The GSH concentration was estimated with GSH-400 method, ascorbic acid by the use of Kyaw method, and MDA by Salaris and Babs method. The statistical analysis revealed diminished concentration of GSH and Vit. C (p < 0.001), and analogous increase of MDA concentration (p < 0.001) in the investigated specimens compared to the mentioned above substances concentration in the specimens obtained from normal brain tissue.

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The cranio-cerebral injury could result in cerebro-spinal fluid fistula with serious consequences in form of meningitis. In a number of cases a surgical procedure is needed, however in spite of established standards the controversies are still present concerning approach and reconstruction technique. The author presents his own experience in duroplastic operations with intradural use of pedunculated periostal allograft flaps.

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Dermoid cysts are common benign tumours mainly observed in the hairy skin of head. We present the case of cyst with untypical course of disease, diagnosed and treated in our hospital. The initial diagnosis with use of computed tomography (CT) scanner suggested a neoplasm of the skull.

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In general tumours of lipoid origin are benign. A high proportion of cases are mesenchymal neoplasms localised in subcutaneous tissue. Neurological signs related to compression of neural structures by fat within the vertebral canal were first presented in 1975. The lipogenic neoplasms represent 1-4% of spinal tumours, and generally are associated with congenital disorders of the spine. These fatty swellings are usually benign, but penetrating deeply into the spine, and connecting with spinal cord, cauda equina or filium terminale, they produce deficits. The deficits may be present at birth but they may also occur in the middle age. These events are classified as epidural lipomatosis (mostly observed in patients on chronic steroid treatment) or as lipoma, common in spinal disraphism. Intracranial tumours of lipoid origin are very rare (0.06-0.5% of brain tumours), and are probably congenital. They occur anywhere within the cranium, however a high proportion of cases tend to be located around the midline, and approximately 50% of tumours are found in the corpus callosum. Usually they are asymptomatic, and when the symptoms occur, they are frequently a result of general clinical condition. The authors present three cases of lipomatous tumours; one intracranial and two of spinal location.

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UNLABELLED: We describe a case of 48 year old male patient treated in the Department of Parasitic Diseases and Neuroinfections AMB with suspected neuroborreliosis. CLINICAL SYMPTOMS: lymphocytic meningitis with cranial neuropathies n. VII palsy and radiculitis after numerous tick bites in endemic area--indicated neuroborreliosis. Because there was no effect of antibiotic therapy and lack antibodies against B-burgdorferi in serum and CSF we excluded neuroborreliosis. Developing neuropathies III-XII, increasing cytosis and protein concentration, radiculalgia and difficulties in walking, cachexia made us think of tbc etiology. Patient failed to improve after anti-tbc treatment. CT and MR showed presence of neoplasmatic masses in spinal canal. In cytologic examination "neoplasma malignum male differentiatum probabiliter metastaticum" was found. Primary focus of neoplasmatic process was not found.

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The studies aimed to estimate an incidence of the low back pain (LBP) in the youngsters and teenagers and correlating it with risk factors. A groups of 2,346 secondary school pupils (1,704 girls and 642 boys) of a mean age 17 +/- 1 yrs, and 970 high-school students (532 women and 438 men) of a mean age 24 +/- 2 yrs have been examined. Low back pain has been seen in 1,416 out of 2,346 secondary school pupils (60%), and in 32% of the examined students. Statistical analysis with chi 2 test has confirmed a correlation between LBP and such risk factors as the incorrect sedentary position (p < .001 for pupils, and p < .02 for students), and smoking (p < .001 for students and p < .02 for pupils).

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A case of dens fracture with severe dislocation not accompanied by spinal cord injury is presented. Cranial traction has been employed, reduction followed. Orthopedic neck brace has been used for further four weeks. Bony union has been achieved.

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Radiculographic assessment and intraoperative findings in patients with single level lumbar disc nucleus pulposus herniation have been compared with each another. Radiculography has been confirmed in 81 per cent of cases.

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The purpose of this investigation was to evaluate the effectiveness of hyperalimentary therapy on the outcome in patients after severe head injuries. The observations were carried out in patients admitted within 24 hours after injury and divided into various alimentary groups (hyperalimentation, parenteral nutrition and enteral nutrition). The follow-up examination of patients' reactivity according to the Glasgow Coma Scale (GCS) performed 8-10 days after admission revealed improvement 1.2 +/- 0.9 pts in hyperalimentary subjects, while in the groups fed enterally or parenterally only 0.6 +/- 0.6 pts and 0.7 +/- 0.9 pts, respectively. In patients with severe head trauma and GCS score level lower than 5 the prognosis is unfavourable, irrespective of the treatment method.

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Several hundreds of thousands of operations on the lumbosacral spine are carried out annually for decompression of nerve roots and disc removal. It is the opinion that serious intraoperative complications developed in 2.5 to 13.7% of cases. In the few literature reports cases have been described of dural sac rupture, injury to large retroperitoneal vessels, intestinal perforation and complete severing of ureters.

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