Modification of skin incision for Baha Attract System Implantations.

<b><br>Introduction:</b> In an era of wide accessibility to various systems for hearing impairment prosthetics, there exists a broad spectrum of surgical techniques facilitating system implantation.</br> <b><br>Aim:</b> The aim of the study is to present the technique of vertical incision in the implantation of the Baha Attract magnetic system as an alternative incision, maintaining a compromise between optimizing the surgical procedure and preserving the functionality and quality of life of the patient.</br> <b><br>Materials and methods:</b> The vertical incision technique is presented based on 5 patients treated between December 2022 and March 2023 diagnosed with conductive or mixed hearing loss.</br> <b><br>Results:</b> There were no adverse consequences or complications resulting from the performed surgical incision. All patients experienced uncomplicated healing. Patients are using sound processor magnets ranging from 4-5 in strength and Baha 6 Max sound processors weighing 11.5 g.</br> <b><br>Conclusions:</b> The vertical incision technique serves as an alternative to the C-shaped perimeter incision, allowing for the optimization and standardization of the surgical procedure, resulting in a smooth scar formation and maintaining good audiological and aesthetic outcomes.</br>.

Pediatric unmanipulated haploidentical hematopoietic stem cell transplantation with post-transplant cyclophosphamide and reduced intensity, TBI-free conditioning regimens in salvage transplantations.

BACKGROUND: Unmanipulated haploidentical stem cell transplantation (haploSCT) with post-transplant cyclophosphamide is an option for patients with advanced hematologic malignancies. It offers a platform both for non-major histocompatibility complex-restricted alloimmunity due to killer-like immunoglobulin receptor (KIR)-mediated mechanisms of natural killer lymphocyte regulation and for classical T-cell mediated antileukemic effects. OBJECTIVES: The devastating long-term sequelae after total body irradiation (TBI) in children are encouraging omission of irradiation techniques in pediatric stem cell transplantations (SCT). MATERIAL AND METHODS: Five children, 4 with acute leukemia and 1 with hemophagocytic lymphohistiocytosis, aged from 1 to 10 years, underwent haploSCT with post-transplantation cyclophosphamide. In all children, the conditioning regimen consisted of chemotherapy without TBI. The graft material was bone marrow (BM) in 4 cases and peripheral blood stem cells in 1 case. Three out of 5 leukemic patients showed better KIR haplotype associated with augmented alloreactivity. RESULTS: Engraftment with complete donor chimerism was achieved in 4 patients, and 1 recipient died before leukocyte recovery. Three patients developed skin acute graft-versus-host-disease (aGvHD), 1 gut aGvHD and 1 liver aGvHD. In 2 recipients, chronic graft-versus-host-disease (cGvHD) was observed (1 limited and 1 extensive). The 4 engrafted patients were alive and in complete remission 3, 9, 32, and 36 months after transplantation. A T-cell count of 200 cells/uL was reached 90 days after haploSCT in all patients. CONCLUSIONS: HaploSCT with TBI-free protocols can be a viable option for heavily pretreated patients with advanced malignancies.

Feasibility and Safety of Treosulfan, Melphalan, and Thiotepa-Based Megachemotherapy with Autologous or Allogeneic Stem Cell Transplantation in Heavily Pretreated Children with Relapsed or Refractory Neuroblastoma.

The prognosis of resistant or relapsing children with neuroblastoma remains very poor, and the search for new therapies is ongoing. In this analysis, we assessed the toxicity of a treosulfan, melphalan, and thiotepa (TMT) regimen in 17 children with recurrent or refractory neuroblastoma who underwent stem cell transplantation (SCT). For allogeneic SCT, fludarabine and antithymocyte globulin were added. The stem cell source was autologous in 8 patients, haploidentical in 8 patients, and a matched unrelated donor in 1 patient. The reported nonhematologic toxicities included grade 3 mucositis, grade 1 to 3 hypertransaminasemia, and in 3 patients, veno-occlusive disease. No neurologic, cardiac, or dermatologic toxicities were observed. The probability of overall survival (OS) in patients with primary resistance was superior to that in patients with relapsed disease (100% versus 22.6%; P = .046). Post-transplantation dinutuximab beta immunotherapy was associated with superior 5-year OS (66.7% versus 11.4%; P = .0007). The use of an allogeneic donor, previous autologous SCT with busulfan and melphalan, and pretreatment with high-dose metaiodobenzylguanidine therapy demonstrated no effect on outcomes. In 4 patients, TMT megatherapy alone was enough to achieve complete remission. The TMT conditioning regimen was well tolerated in heavily pretreated patients with neuroblastoma. The manageable toxicity and addition of new anticancer drugs with optional post-SCT immunotherapy or chemotherapy support further trials with the TMT regimen in patients with neuroblastoma.

[The impact of VDR gene polymorphisms on obesity, metabolic changes, bone mass disorders and neoplastic processes]. / Wplyw polimorfizmów genu VDR na otylosc, zmiany metaboliczne, zaburzenia masy kostnej i procesy nowotworowe.

Vitamin D activity is controlled by its receptor (VDR) located in many cells of the body. The presence of VDR in numerous cellular pathways suggests its important role in the etiology and development of many diseases. Increased risk of obesity, metabolic disturbances, bone mass disturbances and neoplasia among certain VDR alleles has been proven. The importance of VDR in the etiopathology of obesity is associated with the occurrence of polymorphisms: Fok1, Bsm1, Apa1, Taq1. VDR expression in adipocytes plays a role in the regulation of energy metabolism and the induction of obesity. Vitamin D and VDR polymorphisms can participate in the development of many metabolic disorders. The VDR gene is one of the better researched genes among patients with type 1 diabetes. The action of vitamin D affects the proper functioning and development of the skeletal system. Vitamin D has an effect on bone remodeling through its receptor and its polymorphisms: Apa1, Bsm1, Taq1, Fok1 and Cdx2. The identification and diagnosis of VDR varieties gives the possibility of early detection of the risk of osteoporosis or individual predisposition to its development. There is a high variability in the results of individual VDR polymorphisms in relation to the occurrence of osteoporosis among various ethnic groups. The polymorphisms important in the neoplastic process include, among others, the polymorphism of Fok1, Bsm1, and Taq1. The association of VDR gene polymorphisms with the risk of breast cancer (Bsm1, Fok1), prostate cancer (Fok1) and malignant melanoma (Fok1) is indicated. The greatest importance in the prognosis is observed in patients with prostate cancer (F1), breast cancer (Bsm1, Taq1), malignant melanoma (Bsm1) and renal cell carcinoma (Taq1). It is important to identify, describe and correlate the occurrence of genetic polymorphisms of the VDR, which will allow early diagnosis or prevention of correlative entities correlated with them.

Results of cystadenolymphoma treatment of superficial parotid gland.

Introduction Warthin's tumor is a non-malignant tumor that occurs in major salivary glands. Diagnostics include an interview and physical examination as well as additional tests - ultrasonography, magnetic resonance tomography, fine-needle aspiration biopsy. Surgical tumor resection remains the method of treatment, the scope of which includes techniques from extracapsular tumor resection to a full range of parotidectomy. Material and methods A retrospective analysis was conducted for available medical records of 53 patients treated surgically at the Department of Otolaryngology and Laryngological Oncology at the Collegium Medicum of the Nicolaus Copernicus University in Torun in 2009-2016. Each patient underwent an interview, physical examination and a routine ultrasound examination. Results of treatment of 57 tumors were analyzed. Results The study showed that in the case of extracapsular tumor excision in 57 patients in the treatment of Warthin's tumors of the lower pole of the parotid lobe, there were no complications in the form of: permanent paralysis or facial nerve palsy, mucocele, symptoms of Frey's syndrome or cosmetic facial defect. Ultrasound examination in 8 (14%) patients revealed changes requiring further diagnostics or periodic ultrasound monitoring. Conclusions 1. Extracapsular tumor excision appears to be an accurate surgical technique in Warthin's tumor of the lower pole of the parotid gland's superficial lobe. 2. After removal of a cancerous lesion of the parotid gland, every patient requires periodic laryngological monitoring.

[Effects of oncological therapy on bone disorders]. / Wplyw terapii onkologicznej na zaburzenia w ukladzie kostnym.

Due to increasing incidence of cancer disease and the searching for new, aggressive methods of therapy, more attention is focusing on applied treatment consequences. The specificity of oncological drugs allows to destroy cancer cells, simultaneously destroying and disrupting the functioning of healthy tissues. Side effects concern infertility, urolotoxicity, nephrotoxicity, neurotoxicity or bone marrow suppression. Chemotherapy can also be affected on physiological function of movement system and the skeleton construction. Mineral status disorders and skeletal changes lead to secondary forms of osteopenia and osteoporosis and refer oncological patients of any age. The main cause of these conditions is an imbalance between osteoclast and osteoblast activity, occurring as a result of drug interactions, parathyroid hormone-like proteins or interleukins. In addition to the direct effect on bone tissue, disorders in its construction and metabolism are also manifested as a consequence of hypogonadism. The sexual hormones at normal level can inhibit process of bone destruction, increase parathormone level, stimulate active vitamin D3 formation and intestinal calcium absorption. The deficiency of estrogens and androgens indirectly leads to disorder of bone metabolism and homeostasis. Symptoms such as musculoskeletal pain and fractures appear in the late stage of degeneration. Moreover, the appropriate selection of therapy and dosage, compatible with the patient's age and condition are crucial for treatment. Early bone loss should be prevented by supplementing with calcium, vitamin D3, hormone replacement therapy or bisphosphonates. The physical activity and proper diet are important as well. The aim of the study was to characterize the most common oncological treatment regimens, considering the long-term side effect of applied therapy and its influence on the skeletal mineralization and trace element profile. Based on the mechanism of drug action, the disorders observed after pharmacotherapy were described. The processes leading to bone's composition changes were discussed and prevention of their occurrence were estimated.

CONDITIONS OF PROOXIDANT ACTIVITY OF CISTUS AND POMEGRANATE POLYPHENOLS IN V79 CELL CULTURES.

Polyphenol rich extracts obtained from cistus herb (Cistus incanus L.) and pomegranate peels (Punica granatunm L.) added at high concentrations (25-100 pg/mL) to V79 (Chinese hamster lung fibroblast) cell cultures, markedly increased intracellular level of ROS (reactive oxygen species). Also in cells exposed to the exogenous oxidant - H202, [100 µM, 30 min., 37'C] intracellular ROS level was augmented, although to a lower extent than in resting cells not exposed to H202. Additionally, cistus and pomegranate extracts at high concentration (25-100 µg/mL) inhibited the P-gp protein efflux function in V79 cell cultures. Both pro-oxidant activity of polyphenols at high concentrations and their ability to decrease efflux function of P-gp (cellular multidrug resistance protein) could be exploited for improving anticancer adjuvant therapy.

ANTIOXIDANT AND CANCER CHEMOPREVENTIVE ACTIVITIES OF CISTUS AND POMEGRANATE POLYPHENOLS.

Polyphenol rich extracts obtained from cistus herb (Cistus incanus L.) and pomegranate peel (Punica granatum L.) exhibited significant antioxidant activity in V79 cell culture (Chinese hamster lung fibroblasts) -cistus extract reduced intracellular content of reactive oxygen species (ROS) by 30-40% and pomegranate extract by 29-36%. In human breast (MCF-7) and colon (LOVO) cancer cell lines cistus and pomegranate extracts decreased cancer cell growth both in drug-sensitive cells by 15-30% and in drug resistant (doxorubicin-resistant; DX) sublines by 5-20%. However, the extracts did not influence on cell growth%f normal hamster fibroblast cultures (V79). The extracts induced apoptosis in the tested cancer cell lines. Significantly higher proapoptotic impact of the extracts was observed in drug-sensitive than in drug-resistant sublines. The results suggest potential usefulness of the tested polyphenol rich extracts in people exposed to oxidative stress. Their potential use as adjuvant therapy of human cancers needs further studies.