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Background and Purpose: The purpose of this study is to present the results of deep cerebellar stimulation in spasticity as a main symptom of cerebral palsy (CP)., Material and Methods: Thirteen patients suffering from CP were surgically treated with deep cerebellar stimulation of the superior cerebellar peduncle region between April 2003 and April 2007. Outcome was evaluated in 11 out of 13 patients (two patients had their stimulators removed due to infections). The study group comprised 7 women and 4 men (age range: 16-27). Muscle tone was assessed with the 5-point Ashworth scale. Psychomotor status was evaluated with the questionnaire form prepared specially for this study. Each patient was evaluated four times: before surgery, as well as 6, 12, and 24 months after surgery., Results: A great reduction of muscle tone was observed, mostly in the first six months. An improvement in psychomotor status during 2-year follow-up was also noted. One patient (9.1%) started walking, and speech improved in 7 cases (63.6%). Among patients with epileptic attacks, we found a decrease in frequency and intensity of attacks. Reduction of pain associated with muscle tone and improvement of mood were noted in all patients. Inflammatory complications occurred in 3 out of 13 cases (23.1%) and led to removal of the stimulating systems. In one case the stimulator was re-implanted successfully and the patient was evaluated in the active group. Two other patients (15.4%) were excluded from the active group due to inflammatory complications., Conclusions: Deep cerebellar stimulation in patients suffering from spasticity in CP is an effective way of treatment; it reduces signs of illness and permits effective rehabilitation, as well as significantly improving the quality of life of these patients. As a non-ablative and reversible procedure it seems to be a safe method of treatment. The most serious complication of the procedure is infection within the operation site.

Unlabelled: Discopathy of lumbar spine inevitably leads to decreased quality of life in patients. Decrease of the backbone dysfunction at the degree which makes leading a life close to the normal style of family, social and professional life impossible, is the key therapeutic task. Evaluation of the functional disability can be the objective method of evaluation of the treatment efficacy. The purpose of this study was to analyze of the functional state in patients with lumbar discopathy receiving either conservative therapy only or surgical treatment., Material and Methods: 665 patients aged between 16 and 76 years with discopathy at L4-L5, L5-S1 levels have been enrolled into the study. In analyzed group 348 patients received only a conservative therapy whereas 317 patients underwent an operative procedure. Analysis has been performed based on four rating scores for evaluation of the functional status: Low Back Pain Rating Scale, Functional-Economic Outcome Rating Scale of Prolo, Oswestry Low Back Pain Disability Questionnaire, Low-Back Outcome Score., Results: In preliminary examination approx. 40% decrease in parameters of evaluation of the functional status has been found in the group of patients receiving conservative therapy. Functional status of the patients within more than 10-year period of treatment was sufficiently stable and tended to progression in distant study. Ability to perform daily life activities was the strongest determined by backbone and limb pains as well as by the level of neurological deficits. In preliminary examination approx. 45% decrease in parameters of evaluation of the functional status has been found in the group of operated patients. Functional status significantly improved within immediate period post surgery., Conclusions: 1. Functional status in patients with discopathy of the lumbar spine in basic degree is determined by neurological status and intensification of the pain afflictions. 2. The operative intervention brings essential improvement of the patients' functional status. 3. Functional status deteriorates within subsequent years of the treatment; it is determined in greater degree by the age of patients than by treatment method.

Background: Pancreatic surgery has developed over the last 60 years. A pancreaticoduodenectomy of the pancreatic head and duodenal papilla is the most common procedure. The most popular pancreatic cross-section site of a pancreaticoduodenectomy is the isthmus of the gland. The pancreatic isthmus anatomical configuration is still being considered., Study Design: The authors propose a new parametric descriptive system of pancreatic cross-section based on an elliptical model., Results: The pancreatic cross-section was evaluated as a geometric ellipse and the location of the pancreatic duct was based on coordinates. When analyzing the cross-section plane of the pancreatic isthmus, the mean size of the pancreatic isthmus cross-section was 10.46+/-2.34 mm in width (mean+/-SD) and 25.55+/-4.56 mm in length. The mean vertical/horizontal distance ratio was 0.42+/-0.12. The mean size of the main pancreatic duct was 1.02x2.46 mm. The mean distribution coordinates of the main pancreatic duct were: X 51.23; Y 50.60., Conclusions: A proportional model of pancreatic isthmus cross-section analysis is easy and effective, and could become a valuable tool in future anatomical studies. The system described allows us to analyze data acquired from several investigators.

Unlabelled: Neurological examination is one of basic assessment methods of the patients with discopathy of the lumbar spine. Neurological status of the patients can significantly change depending on progression of the disease of the intervertebral disc. It often determines a selection of the treatment method; it is also important criterion for assessment of efficacy of the accepted procedure. The aim of this study was to retrospectively evaluate neurological status in the patients with lumbar discopathy receiving only conservative therapy as well as undergoing surgical procedures., Material and Methods: 665 patients aged between 16 and 76 years with discopathy at L4-L5 and L5-S1 levels have been enrolled to the study. In estimated group 348 patients received only a conservative therapy whereas 317 patients undergone an operative procedure. Study included hospitalization period and more than ten year period after discharge from the Clinic. Collected material has been analyzed in tree age groups: young persons (up to 30), mid age persons (31-50 years) and older persons (at the age of above 50). Neurological examination included analysis of the following parameters: cough symptom, Laségue's sign, stretch reflexes (patellar, ankle), superficial perception and vibration, function of sphincters, muscular power)., Results: No significant progression of the neurological symptoms up to the fifth year of treatment has been seen in group of patients receiving conservative therapy. In group of operated patients starting the second year after surgical procedure, number of diagnosed pathological neurological symptoms systematically was increasing. Patients at the age above 50 presented significantly higher level of neurological disturbances than young and patients in mid age. In the baseline study, level of diagnosed neurological disturbances in group of patients referred to surgical procedure was significantly higher than in group of patients receiving only conservative therapy., Conclusions: Conservative treatment and operative procedure yield improvement of the neurological status of the patients. Improvement ratio, within immediate period following operative therapy, takes higher values than in analogous period of the conservative therapy. In distant investigation, the average quantity of neurological pathological symptom is higher in the group of patients treated surgically. Individualized plan of treatment within patients with lumbar discopathy is needed in every example.

Unlabelled: Pain syndromes of the lower spine are considered as a serious economical problem throughout the world. They are one of the main reasons of limitation or total disability to work. Social expenses connected with treatment costs are accompanied by deterioration of the patient's financial situation and his family. Evaluation of the professional activity can be a valuable index of treatment efficiency evaluation. The purpose of this study was to comparably evaluate of the professional activity of the patients with lumbar discopathy receiving only conservative treatment as well as operated patients., Material and Methods: 619 patients aged between 18 and 65 years with discopathy at L4-L5, L5-S 1 levels have been enrolled into the study. In analyzed group 327 patients received only a conservative therapy whereas 292 patients undergone an operative procedure. Evaluation of the degree of the disability to professional activity caused by the disease of the intervertebral disc of the lumbar backbone has been performed based on the following scales: Low-Back Outcome Score (L-BOS) and Functional-Economic Outcome Rating Scale (F-EORS)., Results: Ability to work of the patients receiving conservative therapy was approx. 3.1 (according to F-EORS) what can be defined as ,,work in older profession within limited range". Level of ability to work within subsequent evaluated periods did not tend to change significantly. Ability to hire the operated patients was approx. 2.8 what means "able to work but not in previous profession". In both analyzed groups the highest hiring level (approx. 63%) referred to young patients and it was significantly higher than in patient at the mid age (approx. 47%) and in older patients (approx. 33%)., Conclusions: Disease of the intervertebral disc of the lumbar spine significantly reduced ability to professional work. Hiring ratio shows the strongest correlation with functional status, level of the payment satisfaction and level of the patients' depression. Ratio of return to the professional work is connected with patient's age. Patients at the age below 40 show the highest professional activity. Treatment method does not exert significant influence on the level of the patients' professional activity.

Background: The beneficial effect of physical exercise in the treatment of patients with intervertebral lumbar discopathy is generally known. Regular exercise has a beneficial effect on motor performance of the spine, increasing the degree of active stabilization. Exercise also improves posture control, coordination and precision of movement, preventing spinal fatigue and micro injuries. The purpose of our study was to evaluate the popularity of physical exercise in lumbar discopathy patients., Material and Methods: 665 patients, 16 76 years of age, with L4-L5 or L5- with discopathy, were enrolled in the study.348 patients received only conservative therapy, while 317 had undergone surgery., Results: 55.6% of the conservatively managed patients and 57.4% of the surgically managed patients reported regular physical exercise. Patients receiving conservative therapy exercised for approx. 1 hour a week. Older patients exercised for a shorter period than young and middle-aged patients. In long-term follow-up, 2.2% more patients performed spinal exercises. Surgical patients devoted the most time to spinal exercise during the first 3 years after surgery. In long-term follow-up, the percentage of regularly exercising patients decreased by 3.9%. On average, 16.8% of conservatively managed patients and 21.5% of surgically managed patients exercised for more than 2 hours per week. Only approx. 20% of patients regularly engaged in spinal exercises for ca. 30 minutes daily., Conclusions: There is insufficient use of physical exercise of the spine for the prevention and treatment of lumbar discopathy.

Unlabelled: Pain afflictions are the basic problems in patients with discopathy of the lumbar backbone. Pain control is the key therapeutic task in patients with a disease of the intervertebral disc. Degree of reduction of the pain sensations is one of the most important criteria in assessment of the treatment efficacy., The Aim: of this study was to evaluate the pain afflictions in patients with lumbar discopathy treated with conservative and operative therapies., Material and Methods: 665 patients aged between 16 and 76 years with discopathy at L4-L5 and L5-S1 levels have been enrolled to the study. In estimated group 348 patients received only a conservative therapy whereas 317 patients undergone an operative procedure. Analysis has been performed based on pain rating scores: Low Back Pain Rating Scale (LBPRS), Japanese Orthopedic Association Low Back Pain Score (JOA-LBPS), Domial's pain rating score., Results: Results of performed studies show that conservative and operative treatment significantly alleviate pain affliction in patients with lumbar discopathy. Complete abatement of pain afflictions more frequent refers to operated patients than those only receiving conservative therapy. Alleviation of pain afflictions within a period of three years following operating procedure is significantly higher than within analogous period of conservative treatment. Reduction of pain obtained as a result of surgical procedure in higher degree refers to limb than backbone. Treatment method does not exert an influence on nature of pain afflictions within distant period., Conclusions: Alleviation of pain afflictions within a period of three years following operating procedure is significantly higher than within analogous period of conservative treatment. Treatment method does not exert an influence on nature of pain afflictions within distant period. Patients at the age of above 50 notify the higher level of intensity of pain ailments than young patients and patients in mid age.