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Bartonella infections including cat scratch disease (CSD) is a group of infectious diseases which are diagnosed sporadically. Because of this fact the number of CSD cases in Poland is underestimated and their incidence is markedly lower in comparison to other European countries. The aim of our report is to present various diagnostic methods and possibilities on the basis of two cases with symptoms of CSD. The efficiency of specific Bartonella antibiotic therapy is also discussed.

Tumors of paranasal sinuses present a small percent of tumors detected in the region of head and neck 3-4% and they present a fraction of a percent of tumors in general /0.16%/., Material: In the years 2004 and 2005, the National Register of Neoplasms recorded 120 and 132 cases of malignant tumors of paranasal sinuses, respectively. Between 2006-2007 we treated 15 patients with tumors of paranasal sinuses underwent treatment at the ENT department of the MiEdzyleski Szpital Specjalistyczny in Warsaw. The following were analyzed: the advancement stage of the tumor, symptoms, the time that has elapsed from the first appearance until the admission for treatment at the department, the methods of treatment, and the histological differentiation of neoplasms., The Results: We detected the following:--benign neoplasms: 2 cases of angiofibroma, 3 cases of inverted papilloma;--malignant tumors: 4 cases of Ca planoepitheliale, 1 instance of adenocarcinoma, 1 instance of Ca anaplasticum, 1--melanoma, 1--esthesioneuroblastoma, 1--lymphoma malignum, 1--metastatic tumor., The Conclusions: at the moment of the admission for treatment at the ENT department, the advancement stage of tumor T3/T4, from the first signs until the proper diagnosis was that marked with the passage of eight months. Ca planoepitheliale is the most common type of malignant tumors of paranasal sinuses. It is only good cooperation between the surgeon and the pathologist which makes it possible to put the proper diagnosis.

Background: Vagal nerve stimulation (VNS) is a new non-pharmacological method of pharmacoresistant epilepsy treatment. The aim of this paper was to present effects of treatment in 23 patients with drug-resistant epilepsy with a different etiology., Material and Methods: Implantation and treatment was performed in two centers in 1998-2002. The effect of treatment was presented as a reduction of seizures during therapy., Results: The lack of group homogeneity and a small number of patients (especially a small number of patients with a long follow-up period) did not allow a more detailed analysis to be made, although there seems to be a clear tendency to obtain better effects of treatment over follow-up time (at 24 month more than 50% seizure reduction or cease of seizures was observed in 80% of patients). The possibility to turn on the device "on demand" is an important advantage of this method. This raises the effectiveness of treatment in more than 80% of patients, and in more than 20% it stops the seizure. There were two groups of undesired side effects: frequent specific effects caused by local irritation of the vagal nerve in the cervical part of the neck and rare transient general effects. Both groups of effects rarely caused any treatment complications., Conclusions: VNS is an effective method of treatment, complementary to other epilepsy treatment methods and should be used in patients with drug-resistant epilepsy as an alternative to neurosurgical treatment. VNS improves the quality of life in treated patients.

A rare case of a embryonal germ cell tumor of the mediastinum is presented in a 22 year old male. A radical excision of the tumor was performed, followed by chemotherapy. A five year survival was observed without evidence of a recurrence.

Inquiry investigations were carried out covering 657 individuals from two counties: Plock and Nowy Targ. The inquiry contained 21 questions concerning the knowledge of epilepsy and the attitudes of those questioned to epileptics. The responses were correlated with the sex, age, educational level and occupation of the questioned. Statistical significance was assessed at the confidence level 0.05. The fear of epilepsy was in the 5th place after neoplasms, tuberculosis, cardiac diseases and mental diseases. As the most shameful diseases were regarded venereal diseases, tuberculosis and epilepsy ex aequo with mental diseases. About 1/3 of the respondents answered that epilepsy is a hereditary disease; nearly half of them considered that epileptics may marry and have children. 60% of those questioned regard that they would let their children play with epileptic children, they were usually respondents with medium and higher educational level and representatives of non-agricultural workers. Most respondents stressed the significance of sudden fright in the aetiology of epilepsy and thought that observation of an epileptic seizure may cause epilepsy; the observing subject, especially a child, may be frightened. About 50% of respondents knew nothing of the causes of epilepsy. Over 1/3 of respondents regarded that epileptic children can attend normal schools. Nearly 60% of respondents regard that epileptics can work in certain occupations. The latter view is expressed by younger people below 40 years with high school and college education and representatives of non-agricultural occupations.

The effects of DPH on internal organs of cats were investigated. The drug (Hydantoinal POLFA) was administered orally in doses 8 to 20 mg/kg daily during from 27 to 560 days. The initial dose was 1.5 mg/kg and it was increased gradually. Consistently occurring changes were found in the liver, kidneys, salivary glands and spleen. In the liver and kidneys the character of changes was mainly degenerative (fatty infiltration of hepatocytes and renal tubular epithelial cells). In the salivary gland the number of mucus-producing cells was increased, in the spleen proliferation of connective tissue and congestion were present.

The importance of various morphotic elements of EEG tracings in the diagnosis of seizures in children is discussed with particular reference to seizures connected with fever. The common neurophysiological mechanism of epileptic discharges in various epileptic seizures in children and adults is stressed calling attention to the fact that EEG investigation in only one of the elements on which the diagnostic process should be based. Attention is called also to the prognostic significance of duration of post-seizure slowing down of the background activity and occurrence of focal spike discharges at the site of greatest slowing of the activity - the greater is this slowing (above one week) the worse is the prognosis. In view of a considerable range of the concept of electroencephalographic normality in children it is stressed that EEG investigations should be repeated after the seizure to study the dynamics of bioelectric changes: the duration and type of EEG abnormalities.

A group of 20 patients (average age 55.5 yrs) with advanced arterioscleorosis obliterans and cerebral thrombosis were treated with pyridinolcarbamate. Anginin was given for 6 months, 1,5--2 g. per day. Observation period before, during and after the treatment lasted 2 yrs. Medical and psychological examinations were performed; laboratory test included: sphigmooscylography, photoplethysmography, EKG, EEG, cholesterol, triglyceridis and other routine biochemical blood tests. All data are statistically evaluated. Results. During Anginin treatment clinical improvement was noted in 8 cases, in 9 there was no change in neurological examination; 3 cases--deteriorated. Control examination 6 to 12 months after discontinuation of the treatment revealed no changes in 13 patients; 1 patient deteriorated and 6--died. There was improvement in blood circulation as shown by plethysmography and sphigmooscylography in patients with less advanced vascular changes and no change in cases with more advanced disease. In 75% of the patients there was statistically significant (p less than 0.001) decrease of cholesterol and in 50% of triglicerids (not statistically significant). In patients with advanced disease there was no clinical and EEG improvement, on the contrary 1/3 of them deteriorated clinically and in EEG. In cases with less advanced disease clinical improvement was recorded. Anginin seems to be a good drug for patients with moderately advanced combined peripheral and central arteriosclerosis.

The effect of Anginin was assessed in 10 patients with cerebrovascular diseases. Anginin was administered in daily doses of 1.5 g. during a mean time of 5.25 months. The duration of follow-up before, during and after treatment was 2 years. A favourable effect of Anginin was observed on such symptoms as dizziness, disturbances of recent memory, mental fatiguability, difficulties in concentration and irritability. EEG investigations demonstrated a rise in the index of alpha waves, increased frequency and amplitude of alpha waves, and normalization of tracings in cases with pathological abnormalities. The basic laboratory investigations failed to reveal any significant changes. Side effects included transient dyspeptic symptoms were in 5 patients.

The purpose of this work was to assess the effects of DPH on a developed epileptogenic focus in cats with split cerebral hemispheres. The investigations were carried out on 12 cats with a chronic epileptogenic focus produced by means of aluminum method in the right motor area. In all cats the epileptogenic focus was found in EEG. All animals received DPH in daily doses of 8-15 mg/kg. In 2 cats they appeared before beginning of treatment. One of these cats died after 3 days from status epilepticus, the other survived status epilepticus and died after 42 days of DPH administration with signs of intoxication. In 3 cats clinical seizures developed during DPH treatment after 30.84 and 210 days. DPH was given during from 171 to 314 days. Clinical seizures appeared in these cats only sporadically and the animals were sacrificed after completion of investigations. In 7 out of 12 cats clinical seizures failed to develop despite presence of bioelectrically active epileptogenic seizures in the right motor area. Administration of DPH in cats with developed epileptogenic focus failed to prevent clinical seizures. In cats with seizures their control was limited by drug toxicity. In all animals toxic effects were observed although the serum DPH level was in the range 8-20 mug/ml.

On the basis of personal investigations including 1) electrophysiological methods (EEG, averaged evoked potentials), 2) behavior methods, 3) destruction of various parts of the brain (mesencephalic reticular formation, auditory pathways) and 4) pharmacological methods, conducted in the years 1953-1974 the author put forward a concept of sensory organization of reticular formation postulating existence of special systems in the reticular formation differing in their relative physiological and chemical specificity. This relative specificity is, in this concept, the ability of the so-called non-specific neurons in the reticular formation to be included under certain experimental conditions into specific functional systems. The author suggests the term "paraspecific systems" for designating these relatively specific systems. It seems that these systems determine the integrative role of reticular formation in the process of learning. In contrast to this important role the reticular formation is without any greater importance for the process of memory storage. The dynamic and relatively specific functional organization of reticular formation provides potential possibilities of its utilization in the processes of reeducation or rehabilitation in central nervous system damage and in pharmacological treatment of psychic disturbances.

Unlabelled: The action of the new antiepileptic preparation Didepil which is a combination of the anticholinergic agent procyclidine (dl-1-cyclohexyl-1-phenyl-3-pyrolidinopropane-1-ol hydrochloride) with phenobarbitone was evaluated in a group of 20 patients of either sex, mean age 28.5 years. These patients had mostly (14 cases) two types of seizures occurring up to several times daily. The mean duration of epilepsy was 12.5 years, the aetiology of the disease was different, and the patients were usually refractory to previously used drugs. Didepil was administered during 3 months, on the average, in doses of 3--4 tablets daily as the only antiepileptic drug or in combination with other anticonvulsants. The duration of follow-up of the patients before, during and after treatment was from 6 to 15 months. In each repeated EEG investigations, biochemical investigation of the blood, liver function tests, and urine analysis were performed., Results: improvement was observed in cases of grand mal as well as temporal lobe seizures in 70% of patients, EEG improvement was found in 50% of patients. Side effects including oral dryness, accomodation disturbances developed in 17 patients but were usually slight and transient, in only 4 cases they were sufficiently severe as to justify reduction of dosage. Improvement of mood and contact with surroundings was noted in 60% of cases., Conclusions: Didepil seems to be an effective antiepileptic agent in maximal generalized seizures as well as in temporal lobe seizures.

The period of the so-called "maturation" of the epileptogenic focus creates a potential field for pharmacological prevention of further development of the disease. The author analysed the experimental investigations carried our by himself on the effects of epileptogenic foci and/or diphenylhydantoin on the process of learning, EEG tracings, and histological findings in the brain and internal organs, and believes that prophylactic administration of diphenylhydantoin in moderate therapeutic doses (20 mg daily) and for a relatively short time period (1 year) is associated with a much lower possibility of side effects than the risk of development of post-traumatic epilepsy. A condition of successful prophylaxis is the administration of the drug immediately after trauma since the experimental investigations of the author indicate that starting treatment at the time of epileptogenic focus development in the EEG, even before the appearance of clinical seizures is too late for complete prophylactic or even therapeutic success.

In 103 patients with strokes without associated infections the prophylactic usefulness of antibiotics was assessed clinically. In 30 patients (group I) and 27 patients (group II) ampicillin was used in daily doses of 2-4 g or penicillin (Polfa) was given 2.4-4.8 million i.u. during 10 days. In the remaining 46 cases (group III) no antibiotics were given and these patients served as controls. During the first 10 days after stroke onset infectious complications developed significantly less frequently in controls (in 15 cases, i.e. 33%) than in those receiving antibiotic phophylaxis (40 cases i.e. 70%). The difference between the groups was statistically significant (p less than 0.001). In the second ten-day period no clinical evidence of new infection was observed in any group. It may be supposed in the light of these diseases that administration of penicillin G or ampicillin to patients with strokes without carrying out antibiotic sensitivity tests is unnecessary. Nearly exclusively pneumonia and urinary tract infection appear in the first ten days after stroke onset which may suggest acute and gradually levelling-off of the neuroregulation of immunological defense mechanisms.

Investigations were performed on 13 cats with epileptogenic focus developed after sectioning the optic chiasm and corpus callosum. Learning was begun 3 months after producing the epileptogenic focus by the aluminium method when it was bioelectrically active. Additionally in 6 cats DPH in daily doses of 10--15 mg/kg was given 3 months after development of the focus. Learning of these animals was begun 1--2 months after the beginning of DPH administration which was continued throughout the whole period of learning during a 3-month pause in learning, as well as at the time of memory testing. In all animals the time of conditioned reflex development and differentiation was delayed. Learning was more difficult in animals with epileptogenic focus receiving DPH than in the animals with the epileptogenic focus not receiving DPH. Learning was slightly worse in the hemisphere with the focus than in that without the focus. Presence of clinical epileptic seizures was without any significant effect on the time of learning with the exception of days on which clinical seizures occurred (the percent of responses was then lower). Disturbances of memory of acquired conditioned reflexes were found only in animals with clinical seizures.