The use of pulse transit time in diagnostics of sleep-disordered breathing in children.

INTRODUCTION: Sleep is the physiological state of the body where proper morphology and duration are indispensable for human functions throughout both, physical and mental spheres. Disordered breathing during sleep impairs its morphology and results in major disorders in any age group. Adverse effects of Obstructive Sleep Apnea Syndrome in children and poor availability of centers offering children's polysomnography call for a reliable and easily accessible screening method. AIM: The aim of the study were to evaluate the usefulness of pulse transit time in the diagnostics of disordered sleep breathing in children and to attempt to employ the parameter in screening tests. Pulse transit time is a physiological parameter determining the time needed for the pulse wave to travel between two measurement points. MATERIAL AND METHODS: Enrolled in the retrospective study were 153 patients (100 boys and 53 girls) suspected of obstructive sleep apnea syndrome who underwent polysomnography at I. Moscicki ENT Hospital in Chorzów. RESULTS: Statistically significant relations between apnea/hypopnea index and pulse transit time were observed in both, individual age groups and all of the patients. Pulse transit time results proved a negative correlation with apnea/hypopnea index values commonly accepted as a parameter concluding the polysomnography procedures. CONCLUSIONS: The results of the study indicate that pulse transit time measurements may find application in screening tests of sleep-disordered breathing in children.

[Cochlea development in infants with central nervous system impairment occurring as an effect of perinatal asphyxia]. / Rozwój slimaka u niemowlat ze zmianami w obrebie osrodkowego ukladu nerwowego powstalymi w nastepstwie asfiksji okoloporodowej.

UNLABELLED: Asphyxia in neonates with inadequate blood-inner ear barrier function causes damage to the inner ear included the degeneration of outer hair cells of the organ of Corti and oedematous changes in stria vascularis. The major consequences in the central nervous system (CNS) are found to be hypoxic-ischemic encephalopathy (HIE) in term newborns, peri- (PVH) or intraventricular hemorrhages (IVH) and periventricular leucomalacia (PVL) in preterm neonates. THE AIM OF THE STUDY: was to carry out the objective assessment of the cochlea development using CEOAEs in infants with CNS impairment occurring as an effect of perinatal asphyxia, imaged during trans-fontanel ultrasonography. MATERIAL AND METHODS: To the investigation 36 infants with HIE, IVH or PVL were included, the control group encompassed 32 born at term, health children. In all children three times otoscopic examination and CEOAEs recordings were performed: after birth, in 3rd and in 6th month of life using Otodynamics Otoacoustic Analyser ILO-88 in Quick Screen version. Perinatal anamnesis, general pediatric status, results of trans-fontanel ultrasonography and biochemical test results were taken into account in statistical analyses. RESULTS: The mean amplitudes of CEOAEs in the first days of life were significantly reduced in InvG comparing to control babies. In half-octave frequency bandwidth analysis significant reduction of S/N Ratio at 1,5­4 kHz in InvG was observed. 3 and 6 months later the recorded responses significantly increased, they didn't reach values of CG but no statistical differences between groups were observed. CONCLUSION: In conclusion, the outer hair cells activity in first days of life is reduced in newborns with CNS impairment and perinatal asphyxia in anamnesis comparing to health children. The maturation of the cochlea is intensive during first 3 months of life, later only subtle changes in CEOAEs are observed.

[Long term results of partial laryngectomies in patients suffering from laryngeal cancer]. / Wyniki odlegle operacji czesciowych u chorych na raka krtani.

AIM: The aim of the study was to evaluate the results of partial laryngectomies in patients with laryngeal cancer treated in the 2(nd) Clinical Department of Laryngology SUM in Zabrze in the years 1990-2000. MATERIALS AND METHODS: Retrospective clinical material includes 209 patients in whom surgery was a primary treatment method. No distant metastases (M1) or another malignant cancer were found. The group consisted of 20 (10%) women and 189 (90%) men. The mean age was - 51.2 years. The stage of the neoplasm progression was defined as T1 in 91 patients (44%), T2 in 109 patients (52%). In other 9 patients (4%) the progression stage was T3 and T4. Clinical examination in 191 patients (91%) did not show enlarged lymph nodes in the area of head and neck (N0). In the group of remaining 18 patients (9%) the node progression was found to be N1-N3. In all 209 patients the squamous cell carcinoma of various stage of malignancy (G1-G3) was found in preoperative histopathological tests, out of which five cases were of papillary squamous cell carcinoma. The most common operation in the analyzed group was a chordectomy - 83 surgeries (40%), followed by 38 (18%) vertical partial laryngectomies, 28 (13%) horizontal glottis surgeries, 19 (9%) frontal-lateral and frontal-anterior operations, and supracricoid operations with a reconstruction of CHEP and CHP type, a total of 20 operations (9%). Other types of partial operations were performed less commonly. In 79 patients (38%) partial laryngectomy was complemented with a nodal operation, while cervical lymph nodes were not removed in 130 patients (62%). In 19 cases (9%) the metastases of squamous cell carcinoma to regional lymph nodes were confirmed in postoperative material. 82 patients of the study group (39%) underwent radiotherapy. The median of the observation period was 9 years. Local recurrence, nodal recurrence and distant metastasis are rated as treatment failure. Treatment effectiveness was evaluated with relation to local control, overall survival, disease-free survival and cause specific survival. All the aforementioned parameters were analyzed with the method of updated percentages. The level of statistical significance was assumed to be p ≤ 0.05. RESULTS: The updated 5-year and 10-year percentage of overall survivals was respectively 75% and 63%. The updated 5-year and 10-year percentage of cancer specific survivals was 85% and 79%, respectively. The updated 5-year and 10-year percentage of disease-free survivals was 72% and 56%, respectively. The percentage of 5-year and 10 year local controls was 86% and 79%, respectively.

An updated view on tuberculous lymphadenitis in the context of HIV epidemic as well as multidrug and extensively drug-resistant tuberculosis.

BACKGROUND: An updated view on tuberculous lymphadenitis was presented in this paper. OBJECTIVES: This article describes tuberculous lymphadenitis as the most common presentation of extrapulmonary tuberculosis and reviews its epidemiology, clinical aspects, diagnosis and treatment methods. The role of surgical procedures was also underlined. MATERIAL AND METHODS: Since the 1990's, the incidence and severity of tuberculosis - particularly the prevalence of extrapulmonary tuberculosis - are increasing internationally, mainly due to the HIV epidemic and the emergence of multidrug-resistant and extensively drug-resistant strains. Hence, tuberculosis is once again a serious global problem not only in the developing countries of Africa or South East Asia, but also in highly-developed communities. CONCLUSIONS: The latest data suggest that tuberculosis should be included in the list of differential diagnoses for all neck lymph node involvements, even in the absence of pulmonary involvement, in HIV-positive patients. If the otolaryngologist maintains a high index of suspicion, an early diagnosis can be made to contribute to more successful outcome of the disease.

[Usefulness of laser arytenoidectomy and laterofixation in treatment of bilateral vocal cord paralysis]. / Przydatnosc arytenoidektomii laserowej i laterofiksacji w leczeniu obustronnego porazenia faldów glosowych.

INTRODUCTION: Bilateral vocal cord paralysis is caused by the damage of both recurrent laryngeal nerves. Such a pathology is not commonplace in the ordinary medical practice. It most often occurs as a complication after the thyroid gland surgery or thyroid re-surgery. In the case of bilateral vocal cord paralysis the treatment of the patient includes performing immediate tracheotomy or one of the surgeries aiming at widening the glottis because of dyspnea caused by the upper respiratory tract obstruction on the glottis level. AIM: The comparison of efficacy and usefulness of two surgical techniques performed to widen the glottis ­ laser arytenoidectomy with posterior cordectomy and laterofixation. MATERIAL AND METHODS: The research was carried out on the group of 57 patients suffering from bilateral vocal cord paralysis who, in the period of 1997­2009, underwent treatment in ENT Department in Zabrze Medical University of Silesia in Katowice. The first group included 36 patients who underwent laser arytenoidectomy with posterior chordectomy. The second group included 21 patients who underwent laterofixation. All of the patients treated with the laser arytenoidectomy with posterior cordectomy and laterofixation were subjected to respiratory system ventilation examinations before the procedure of widening the glottis and after the healing, at least 4 months after the surgery. Making self-evaluation, each of the patients answered a question concerning the improvement of their breathing comfort after the surgery. The patients from both groups underwent the vocal apparatus examination which included: subjective perceptive voice analysis according to GRBAS scale, videolaryngostroboscopy, evaluation of the maximum phonation time, self-evaluation survey of the post-surgical voice quality. RESULTS: Among 57 patients suffering from bilateral vocal cord paralysis and operated by arytenoidectomy with posterior cordectomy (group I) and laterofixation (group II), a subjective improvement of the comfort of living was achieved which resulted in the possibility of making more physical activities. From the first group, 35 out of 36 patients were decannulated. In the second group, both patients who had previously undergone tracheotomy were successfully decannulated. There were no statistically significant differences in the increase of selected ventilation markers between the patients who underwent laser arytenoidectomy and those who underwent laterofixation. There were no substantial discrepancies in the perceptive voice analysis in GRBAS scale between the patients after laser arytenoidectomy and those treated with the technique of laterofixation. When asked about their post-surgical voice quality, the patients of the first and the second group rated their voice as worse than before the surgery. CONCLUSION: Both surgical techniques, laser arytenoidectomy with posterior cordectomy and laterofixation, are efficient and useful in widening the glottis in the case of bilateral vocal cord paralysis. The improvement of the ventilation markers allows the growth in the comfort of living, restoration of the physiological respiratory tract and decannulation of the patients who had undergone tracheotomy. The deterioration of the voice quality is characteristic of both surgical techniques.

[The quality of voice in coal-miners after burn/inhalation injury due to methane explosion]. / Jakosc glosu u górników po urazie inhalacyjnym górnych dróg oddechowych w wyniku wybuchu metanu.

The job as a coal-miner exposes to the greatest risk. One of the most dangerous health hazard is a burn/inhalation injury during the methane explosion. The victims undergo physical trauma, effect of high temperature and inhalation of toxic gases and products of incomplete combustion, As a result of inhalation injury both, upper and lower airways are affected. The aim of the study was to analyse the relationship between burn/inhalation injury and quality of voice in affected coal-miners. A group of 23 patients (men) in age from 28 to 59 (mean 38.5) 3 years after burn/inhalation injury participated in this study. The voice evaluation based on ENT examination, videlaryngostroboscopy, acoustic analysis, MPT parameter and GRBAS analysis was performed. The special control group of coal-miners served as a control. On the basis of the subjective evaluation and the objective acoustic analysis, aerodynamic parameter and videlaryngostroboscopy the worse quality of voice in the group of injured coalminers was shown in comparison to the control group. No substantial correlation between the acoustic parameters, MPT parameter and ventilating rates was found.

[Imaging and assessment of glomus jugulare in MRI and CT techniques]. / Rola tomografii komputerowej i rezonansu magnetycznego w obrazowaniu i ocenie zaawansowania klinicznego przyzwojaków opuszki zyly szyjnej.

INTRODUCTION: Paragangliomas are rare group of tumors originating from paraganglionic tissue. The most common site of occurrence of the head and neck paragangliomas are: carotid body, jugular foramen (glomus jugulare) and tympanic cavity (glomus tympanicum). Magnetic resonance (MR), computed tomography (CT) and angiography are the modalities of choice in detecting and characterizing paragangliomas. AIM: The aim of this study was to compare different imaging techniques of CT and MR in visualization, detecting and characterizing paragangliomas of the jugular foramen. METHODY: Usefulness of CT and MR techniques was analyzed on the basis of CT and MR examinations performed in the group of three patients with different clinical history. CONCLUSIONS: Multidetector CT scanning is especially useful to show subtle destruction of the temporal bone on early stage of disease. MR is the modality of choice in assessing middle ear, scull base or posterior fossa involvement and monitoring growth of paraganglioma. MR and CT angiography are both useful methods to identify arterial feeders of the paragangliomas, and in some cases due to better availability in clinical practice can be alternative to angiography. Angiography in combination with embolization will mainly be used prior to surgical resection.

Reconstruction of the larynx after a resection of a huge chondrosarcoma.

Chondrosarcoma of the larynx is a rare condition of still unknown pathogenesis. This tumor occurs usually between the sixth and seventh decade of life. Forty five years old patient was admitted to the ENT Department in Zabrze for a diagnosis of a slow growing tumor from about 3 years. The great unmovable tumor 2.5 cm/3 cm/3 cm was arising from the cricoid cartilage. The hist-pat result of the biopsy was cartilage. The patient did not agree on the proposed surgical treatment. After one year, in the MRI examination, the tumor sized 46 mm/37 mm/39 mm was found. The patient was again qualified for the operation and agreed for the proposed treatment. In general anesthesia, the tumor together with the part of trachea, cricoids and thyroid cartilages was resected. After excision the reconstruction was performed. During 10 months of the follow-up the patient remains free of the disease.

[Long-term results of airways' injury after a methane explosion]. / Odlegle skutki oparzenia dróg oddechowych w wyniku wybuchu metanu.

Injuries caused by thermal trauma more and more often affect people and they are an important problem of contemporary medicine. It is connected with the civilization development. Burn concerns not only the exterior integuments of the body but also airways, in those cases, the death rate among those who were injured with the thermal trauma increases. The treatment of both the burns and their complications is a long-lasting process, involving many specialists of various disciplines, and not always does it bring the wanted effects. The aim of the study was the assessment of the late morphological sequels inside the larynx and ventilation efficiency as a result of thermal inhalation trauma in the airways of the coal miners after the methane explosion. The methodology of examinations consisted of subjective evaluation of ventilation efficacy by MRC scale and ventilating rate measurement FEV1, FVC, FEV1%, PEF, MEF50, PIF, MIF 50, FIV. The morphological larynx evaluation was conducted based on videolaryngoscopy. 23 injured coal miners, who had been burnt at work in coal mines in 2003 in the methane explosion, were put under scrutiny. All the above mentioned examinations were done to the study group, but also to the specially selected control group, 23 coal miners. During the ventilating rates analysis in the study group, their lower values were noticed in comparison to the control group, however, the values were still within the clinical norms. Videolaryngoscopy showed hypertrophy of the laryngeal tissues.

Sarcoidosis and its otolaryngological implications.

Sarcoidosis and its aetiopathogenesis, epidemiology and diagnostic procedures (including the Kveim reaction) are presented in this paper. The clinical manifestations of this disease, especially in otolaryngological organs, including the larynx, salivary glands, nose and paranasal sinuses, are described. Treatment procedures, including surgical interventions and prognosis, are also discussed.

[Cartilage tissue reconstruction by the polymer biomaterials--early macroscopic and histological results]. / Rekonstrukcja tkanki chrzestnej biomaterialami polimerowymi--wczesne wyniki makroskopowe i histologiczne.

INTRODUCTION: The surgical treatment of large cartilage defects in the region of head and neck is often impossible because of the atrophy of surrounding tissues and lack of suitable material for reconstruction. In the surgical treatment many of methods and reconstructive materials have been used. For many years the suitable synthetic material for the cartilage defects reconstruction has been searched for. THE AIM OF THE STUDY: Was to evaluate two different biomaterials with proper mechanical and biological features for the cartilage replacement. MATERIAL AND METHODS: Two type of biomaterials in this study were used: resorbable polymer - poly(L-lactide-co-glycolide) (PLG) acting as a supportive matrix. A thin layer of sodium hyaluronate (Hyal) was also deposited on the surface as well in the pore walls of PLG scaffolds in order to provide biologically active molecules promoting differentiation and regeneration of the tissue. The studies were performed on the 50 animals--rabbits divided into 2 groups. The animals were operated in the general anaesthesia. The incision was done along the edge of the rabbit's auricle. Perichondrium and cartilage of the auricle on the surface 4 x 3 cm were prepared. Subperichondrically 1 x 1 cm fragment of the cartilage was removed by the scissors. This fragment was then replaced by the biomaterials: PLG in first group of 25 rabbits and PLG-Hyal in second group 25 rabbits. The tissues were sutured with polyglycolide Safil 3-0. The animals obtained Enrofloxacin for three days after the operation. Then 1, 4 and 12 weeks after the surgery the animals were painlessly euthanized by an overdose of Morbital. Implants and surrounding tissues were excised and observed macroscopically and using an optical microscope. RESULTS: In all the observation periods we observed proper macroscopic healing process of biomaterials. We didn't stated strong inflammatory process and necrosis around the implanted biomaterials. CONCLUSIONS: The histological and macroscopic examinations indicated that both materials developed in this study have properties similar to cartilaginous tissue and seem to be good for her restoration. Although the quickest tissue regeneration was found after implantation of PLG-Hyal.

[Extramedullary plasmacytoma of the neck--case report]. / Szpiczak plazmocytowy odosobniony pozakostny w obrebie szyi--opis przypadku.

Extramedullary plasmacytoma (EMP) is a rare neoplasm which belongs to non-Hodgkin's lymphomas, which is characterized by monoclonal, neoplastic proliferation of B-type lymphocytes in the soft tissues. The most common location for EMP to occur is the nasopharynx and paranasal sinuses. Treatment is efficacious with surgery, radiotherapy or combination these two methods. This report presents a case of EMP of the neck in 63-year-old patient, diagnosed and treated in ENT Department of Medical University of Silesia in Zabrze. On the basis of physical examination and radiologic studies the extensiveness of the tumour was determined and the surgical procedures were undertaken. Diagnosis was established on the basis of histopatological and immunohistochemical postoperative examinations as well as radiologic studies and trepanobiopsy. Surgery was followed by radiotherapy. 6 months later because of progression and dissemination of the disease chemotherapy and hematological treatment were performed. Patient remains in laryngological, oncological and transplantological follow-up.

[Assessment of retrocochlear hearing pathway activity in infants with central nervous system impairment occurring as an effect of perinatal asphyxia]. / Ocena funkcji pozaslimakowej czesci drogi sluchowej u niemowlat ze zmianami w obrebie osrodkowego ukladu nerwowego powstalymi na skutek asfiksji okoloporodowej.

INTRODUCTION: The most often changes in the central nervous system (CNS) occurring as an effect of perinatal asphyxia are found to be hypoxic-ischemic encephalopathy (HIE) in term newborns, peri- (PVH) or intraventricular hemorrhages (IVH) and periventricular leukomalacia (PVL) in preterm neonates. Chronic hypoxia is considered to affect the brainstem in infants, especially nuclei of the hearing pathway are vulnerable to low oxygen level. The aim of the study was to carry out the objective assessment of the retrocochlear hearing pathway activity using ABR in infants with CNS impairment occurring as an effect of perinatal asphyxia, imaged during trans-fontanel ultrasonography. MATERIAL AND METHODS: To the investigation 36 infants with HIE, IVH or PVL were included, the control group encompassed 32 born at term, health children. ABR recordings were performed in 3 months old children using Nicolet Spirit System for clicks of 85 and 80 dB nHL. RESULTS: No differences were found between latencies of waves I and II. ABR latencies of waves III, IV, V and interpeak latencies I-III, III-V, I-V were significantly delayed in InvG when compared to control patients. In conclusion, the brainstem activity in infants with CNS involvement as an effect of perinatal asphyxia is lower comparing to health children. Subclinical abnormalities as prolonged synaptic transmission of electric signal in retrocochlear auditory pathway were revealed.

[Treatment of invasive rhinosinusitis--the case report]. / Leczenie inwazyjnej grzybicy zatok przynosowych--opis przypadku.

The frequency of fungal etiology of sinusitis contains between 9 and 49 % according to different authors. Fungal rhinosinusitis has been divided into noninvasive and invasive forms. Noninvasive infections include fungus ball (mycetoma) and allergic fungal rhinosinusitis. Invasive infections include acute (or fulminates) fungal rhinosinusitis and invasive chronic rhinosinusitis. The case of chronic invasive rhinosinusitis was presented. Patient performed surgery--Functional Endoscopic Sinus Surgery and paranasal sinuses operation from subcranial approach. Surgery procedures were followed by antifungal pharmacotherapy (Orungal and Worykonazol). The presented case of fungal invasive chronic rhinosinusitis was treated according to recommended procedures with surgery followed by adequate antifungal farmacotherapy. In this case we have reached a successful outcome.

[Efferent suppression test--sensitivity and specificity]. / Test eferentny slimaka--czulosc i swoistosc metody.

INTRODUCTION: The amplitude of click evoked otoacoustic emissions can be suppressed (reduced) with contralateral acoustic stimulation (CAS). This is thought to be due to the inhibitory control that the medial efferent auditory nerve exerts on outer hair cell function. One commonly used test of medial olivocochlear (MOC) function in humans involves measuring the degree of suppression of ipsilateral otoacoustic emissions (OAEs) by CAS. This effect is called contralateral suppression, efferent effect or olivocochlear reflex. Aim of the study. The objective of this study was to measure cut-off level of contralateral suppression, sensitivity and specificity of the efferent test. MATERIAL AND METHODS: To evaluate the function of MOC system click evoked otoacoustic emissions (CEOAEs) with and without continuous contralateral broadband noise (BBN) stimulation were recorded in 14 patients with multiple sclerosis, 16 patients with unilateral cerebello-pontine angle tumor and control group matched for age and gender. BBN was presented at 50 dB SL and otoacoustic emissions were recorded in response to nonlinear clicks at 70 +/- 3 dB SPL. RESULTS: The cut-off level was established at -1.4 dB. For 1.4 dB cut-off level of contralateral suppression the sensitivity of the efferent test was 90% and specificity was 70%. CONCLUSIONS: To conclude, assessment of efferent suppression may be a useful addition to the battery test employed in the investigation of multiple sclerosis and cerebello-pontine angle tumors. The MOC suppression test may provide a tool for an early diagnosis of the brainstem pathology.

[Biodegradation of tracheal carbon implant in animal experiment]. / Biodegradacja weglowego implantu tchawicy w eksperymencie zwierzecym.

INTRODUCTION: The radical treatment of tracheal stenosis comprises segmental resection and its reconstruction. The most successful type of reconstruction is the "end to end" technique. In cases with large tracheal defects (over 6 cm) this kind of reconstruction is impossible. From many years the adequate biomaterial is searched for the tracheal reconstruction. Most of the implanted biomaterials undergo biodegradation process. AIM: The aim of the study was to analyze the biodegradation process in carbon fibers of prosthesis implanted in tracheal defects in animal experiment. MATERIAL AND METHODS: We studied the prosthesis implanted in tracheal defects in sheep. The prosthesis were built with composite biomaterial composed of carbon fibers and polisulfone. The observation period was 1, 2, 3, 4, 6, 8, 24 and 38 weeks. In the morphometric evaluations the breadth, curve width, fullness factor and mean grey level of carbon fibers were assessed. RESULTS: The results showed that carbon fibers undergo progressively degradation in animal environment. The width gradually decreased. The mean grey level in the first three weeks decreased, but in the next period it increased. Conclusion. The carbon fibers of segmental tracheal prosthesis undergo gradually degradation process in biological environment expressed by decreasing of their dimensions connected with the lost of irregularities and changes of structure density.

[Abscess of the parapharyngeal space]. / Ropowica przestrzeni przygardlowej.

The abscess of parapharyngeal space is very dangerous health condition graving numerous complications such as: jugular vein thrombosis, mediastinitis, arterial bleeding. This state originates most frequent during the acute pharyngitis, and especially acute tonsillitis. The aim of our study was to review the clinical sings, computed tomography scans and outcome of parapharyngeal space infection. 3 patients treatment in our Department were underwent surgical drainage and aggressive antibiotic therapy. One patient was treated solely with intravenous antibiotic therapy. The average time of hospitalization was 16 days. No one complication was observed.

[Prognostic molecular markers in oral and lip squamous cell carcinoma--evaluation of expression and its significance]. / Ekspresja niektórych molekularnych markerów immunohistochemicznych i ocena ich znaczenia prognostycznego w rakach plaskonablonkowych jamy ustnej i wargi.

INTRODUCTION: Head and neck cancer treatment optimization and individualization has become possible due to the implementation of the prognostic and predictive molecular markers in diagnostics. AIM: The aim of this study was an attempt to determine which of the investigated molecular markers may have prognostic and predictive value in head and neck cancers. MATERIALS AND METHODS: The paraffin blocks from 47 patients with oral and lip squamous cell carcinoma (SCC) after surgical treatment in the Institute of Oncology in Gliwice in the period of 1998-2002 were investigated. For immunohistochemical studies the DAKO monoclonal antibodies were used: p53, Ki67, Cyclin D1, Cathepsin B and Cox2-Cayman Chemical antibody. Staining reactions were evaluated at 400x magnification. The average percent of staining cells was estimated in every case in the groups of patients with (N+) and without (No) node metastases. The results were subsequently juxtaposed with selected clinical and histological parameters. Statistical analysis was performed with Mann-Whitney and Kruskal-Wallis tests and the log rank test with a significance level of 0.05 (p = 0,05). RESULTS: Significantly higher expression of Ki67 in N+ patients (p = 0,010) were recorded, although average staining in the group of treated and the group of unhealed patients was statistically insignificant. Cathepsin B expression (<20% and > 20%) was correlated with 3 year-long survival and a slight higher average staining (33,5%) in unhealed in comparison with treated patients (29,0%) was notified. Everage expression of p53 in unhealed patients (33,1%) was slightly higher than in treated ones (28,4%). Weaker Cyclin D1 expression (<10%) correlated with higher disease free survival. Average Cycline D1 staining in the groups of unhealed patients (19,6%) was higher than in the treated ones (12,0%). There were no significant differences in COX-2 staining in correlation with clinical and histological parameters. CONCLUSIONS: Lower expression of Cyclin D1 and Cathepsin B in neoplastic cells correlated with higher percentage of disease free survival what suggests the prognostic value of these markers. Higher proliferation activity of primary tumor neoplastic cells correlated with node metastases what may has the predictive value in the course of the disease.The different markers expressions observed in the different oral cavity localizations confirm the necessity to select patients for further investigations with respect to uniform disease changes topography.

Reconstruction of Ovine Trachea with a Biomimetic Composite Biomaterial.

The aim of this study was to evaluate a novel composite material for tracheal reconstruction in an ovine model. A polymer containing various forms of carbon fibers (roving, woven, and nonwoven fabric) impregnated with polysulfone (PSU) was used to create cylindrical tracheal implants, 3 cm in length and 2.5 cm in diameter. Each implant, reinforced with five rings made of PSU-impregnated carbon-fiber roving, had three external layers made of carbon-fiber woven fabric and the inner layer formed of carbon-fiber nonwoven fabric. The inner surface of five implants was additionally coated with polyurethane (PU), to promote migration of respiratory epithelium. The implants were used to repair tracheal defects (involving four tracheal rings) in 10 sheep (9-12 months of age; 40-50 kg body weight). Macroscopic and microscopic characteristics of the implants and tracheal anastomoses were examined 4 and 24 weeks after implantation. At the end of the follow-up period, outer surfaces of the implants were covered with the tissue which to various degree resembled histological structure of normal tracheal wall. In turn, inner surfaces of the prostheses were covered only with vascularized connective tissue. Inner polyurethane coating did not improve the outcomes of tracheal reconstruction and promoted excessive granulation, which contributed to moderate to severe stenosis at the tracheal anastomoses. The hereby presented preliminary findings constitute a valuable source of data for future research on a tracheal implant being optimally adjusted for medical needs.

[Influence of passive smoking on content of aluminium in pharyngeal tonsils from children living in Southern Poland]. / Wplyw biernego palenia na zawartosc glinu w migdalkach gardlowych dzieci zamieszkujacych rejony poludniowej Polski.

The characteristic of occurrence Al content in pharyngeal tonsils from girls and boys living in Southern Poland is presented in this article. Analysis of content of Al in pharyngeal tonsils was observed in four groups of children: girls exposed to tobacco smoke and unexposed to tobacco smoke, boys exposed to tobacco smoke and unexposed to tobacco smoke. Arithmetic mean of contents of aluminium in pharyngeal tonsils from exposed girls was 15.94+/-8.08 microg/g, in unexposed girls was 14.11+/-5.08 microg/g, in exposed to tobacco smoke boys--16.68+/-11.17 microg/g and unexposed boys 18.08+/-10.56 microg/g was observed. Differences between analysed groups of children were not statistically important. The cross-correlation analysis between content of Al and other metals Ba, Ca, Cr, Cu, Fe, Mg, Mn, Zn, K, Na showed repeating co-dependences between Al and Fe, Mg and Zn in pharyngeal tonsils from children exposed to tobacco smoke. In unexposed children was only one co-dependence between Al and Ca.