Synergistic effect of fennel essential oil and hydrogen peroxide on bacterial biofilm.

INTRODUCTION: Staphylococcal biofilm formation significantly challenges wound management. The causes of difficult-to-treat wounds are not only methicillin-resistant staphylococci, but also methicillin-sensitive strains with different patterns of resistance. Bacterial biofilm significantly limits the access and activity of antimicrobials used in dermatological infections. AIM: To evaluate the synergistic effect of fennel essential oil (FEO) and H2O2 on biofilm formation by Staphylococcus aureus (MSSA and MRSA) reference strains. MATERIAL AND METHODS: Minimum inhibitory concentration (MIC) values were determined for FEO and H2O2 against S. aureus reference strains by the broth microdilution method. The combined effects of the FEO and H2O2 were calculated and expressed in terms of a fractional inhibitory concentration index (FICI) using the checkerboard method. The FEO composition was analyzed by the GC-MS method. The data were analysed by one-way ANOVA. RESULTS: Decreased MIC values for FEO combined with H2O2 were observed in comparison to FEO itself. The combinations of FEO and H2O2 determined synergistic effects on all S. aureus reference strains. Subinhibitory concentration of FEO alone and in combination with 0.5 MIC of H2O2 significantly decreased the production of biofilm biomass in S. aureus strains and reduced the metabolic activity of attached cells. CONCLUSIONS: Combination of fennel essential oil containing nearly 80% trans-anethole and H2O2 represents a potential for further basic and applied research on wound management.

The effect of fennel essential oil and trans-anethole on antibacterial activity of mupirocin against Staphylococcus aureus isolated from asymptomatic carriers.

INTRODUCTION: Staphylococcus aureus constitutes the most pathogenic species within the staphylococcal genus. Humans remain the major reservoirs of this pathogen which colonizes mostly anterior nares of healthy individuals. AIM: To investigate the effect of fennel essential oil (FEO) and trans-anethole (tA) on antibacterial activity of mupirocin (MUP) against S. aureus strains isolated from asymptomatic carriers. MATERIAL AND METHODS: The content of the FEO was analysed with use of the GC-MS method. The research done on 43 S. aureus isolates with different resistance patterns, obtained from nasal vestibule. Antibacterial activity of MUP in combination with FEO or tA was examined using the agar dilution method and E-test method. The data analysis was done with the Pearson's χ2 test. RESULTS: The chemical composition of FEO was consistent with the European Pharmacopoeia (EP) for the main constituent - tA (77.9%) according to the EP recommendations. Macrolide-lincosamide-streptogramin B resistance phenotype was prevalent among 39.5% of S. aureus isolates. FEO concentrations of 2.0% and 2.5% revealed antibacterial activity against 76.7% of isolates, whereas tA inhibited S. aureus growth at concentrations > 4.0%. The MIC values for MUP combined with FEO as well as for MUP combined with tA were < 0.064 µg/ml for 79.1% and 86.0% of S. aureus isolates, respectively. CONCLUSIONS: Our experiment revealed FEO and tA influence on MUP effectiveness. The combination of MUP with FEO as well as MUP with tA are worth considering to implement in S. aureus eradication procedures. These findings will be useful in designing efficient antistaphylococcal agents which can limit the emergence of antibiotic resistance.

[Narrow-band imaging endoscopy for diagnosis of adult laryngeal papillomatosis - case raports].

The laryngeal papillomas belong to the group of non-malignant tumours. The risk of getting sick increases with the number of contingent sexual contacts, smoking, alcohol abuse and untreated gastro-oesophageal reflux. This paper describes five cases presenting different levels of exposure to the risk factors and variable course of adult laryngeal papillomatosis. These people, in addition to routine diagnostics, were examined using endoscopy with the use of narrow beam of light, which turns out to be a useful diagnostic tool in the case of laryngeal papillomatosis.

The effect of metallothionein 2A core promoter region single-nucleotide polymorphism on accumulation of toxic metals in sinonasal inverted papilloma tissues.

Metallothioneins (MTs) are intracellular thiol-rich heavy metal-binding proteins which join trace metal ions protecting cells against heavy metal toxicity and regulate metal distribution and donation to various enzymes and transcription factors. The goal of this study was to identify the -5 A/G (rs28366003) single-nucleotide polymorphism (SNP) in the core promoter region of the MT2A gene, and to investigate its effect on allele-specific gene expression and Cd, Zn, Cu and Ni content in sinonasal inverted papilloma tissue (IP), with non-cancerous sinonasal mucosa (NCM) as a control. The MT2A promoter region -5 A/G SNP was identified by restriction fragment length polymorphism using 117 IP and 132 NCM. MT2A gene analysis was performed by quantitative real-time PCR. Metal levels were analyzed by flame atomic absorption spectrometry. The frequency of A allele carriage was 99.2% and 100% in IP and NCM, respectively. The G allele carriage was detected in 23.9% of IP and in 12.1% of the NCM samples. As a result, a significant association of -5 A/G SNP in MT2A gene with mRNA expression in both groups was determined. A significant association was identified between the -5 A/G SNP in the MT2A gene with mRNA expression in both groups. A highly significant association was detected between the rs28366003 genotype and Cd and Zn content in IP. Furthermore, significant differences were identified between A/A and A/G genotype with regard to the type of metal contaminant. The Spearman rank correlation results showed the MT2A gene expression and both Cd and Cu levels were negatively correlated. The results obtained in this study suggest that the -5 A/G SNP in the MT2A gene may have an effect on allele-specific gene expression and toxic metal accumulation in sinonasal inverted papilloma.

Metallothionein 2A core promoter region genetic polymorphism and its impact on the risk, tumor behavior, and recurrences of sinonasal inverted papilloma (Schneiderian papilloma).

Inverted papillomas are a unique group of locally aggressive benign epithelial neoplasms in the nasal cavity and paranasal sinuses arising from the Schneiderian mucosa. Metallothioneins are sulfhydryl-rich heavy metal-binding proteins required for metal toxicity protection and regulation of biological mechanisms including proliferation and invasion. The goal of this study was to identify three SNPs at loci -5 A/G (rs28366003) and -209 A/G (rs1610216) in the core promoter region and at locus +838 C/G (rs10636) in 3'UTR region of the MT2A gene with IP risk and with tumor invasiveness according to Krouse staging. Genotyping was performed using the PCR restriction fragment length polymorphism technique in 130 genetically unrelated IP individuals, and 418 randomly selected healthy volunteers. The presence of the rs28366003 SNP was significantly related to the risk of IP within the present population-based case-control study. Compared to homozygous common allele carriers, heterozygosity and homozygosity for the G variant had a significantly increased risk of IP (adjusted odds ratio [OR] = 7.71, 95% confidence interval [CI]: 4.01-14.91, p(dominant) < 0.001). Moreover, risk allele carriers demonstrated higher Krouse stage (pT1 vs. pT2-4) (OR = 19.32; 95% CI, 2.30-173.53; p < 0.0001), diffuse tumor growth (OR = 4.58; 95% CI, 1.70-12.11; p = 0.0008), bone destruction (OR = 4.13; 95% CI, 1.50-11.60; p = 0.003), and higher incidence of tumor recurrences (OR = 5.11; 95% CI, 1.68-15.20; p = 0.001). The findings suggest that MT2A gene variation rs28366003 may be implicated in the etiology of sinonasal inverted papilloma in a Polish population.

Effects of oral contraceptives on selected parameters of the homeostatic control system in young women having a sudden disorder of the auditory and/or balance system.

The purpose of the paper was to assess the effects of oral contraceptives on selected parameters of the homeostatic control system in women having a sudden disorder of the auditory and/or balance system. The study included 105 young women divided into two groups: Group I--52 women with the disorder of the auditory and/or balance system using hormonal contraceptives for at least 2 months, aged 20-49; and Group II--53 women without any disorder of the auditory and/or balance system using hormonal contraceptives for at least 2 months, aged 18-40. The patients included in the study underwent a full otoneurological evaluation, detailed laryngological diagnostics and an evaluation of selected parameters of the homeostatic control system--fibrinogen level, D-dimer level, evaluation of APTT and PT indicator, plasma estradiol and progesterone with the Roche Cobas analyser by means of chemiluminescence. The vertigo occurring in the study group was most often central (59.6% of cases), mixed with compensation in 36.6% of cases, and peripheral only in 3.8% of cases, indicating labyrinth damage in 40.4% of cases. An analysis of the progesterone level, considering the menstrual cycle phase in the group, showed that its value was abnormal in 51.0% of women in the study group and 47.1% in the control group. In their own studies, the authors observed that the estradiol level in the plasma, considering the menstrual cycle phase in the study group, was abnormal in 41.2% of women and that the differences in its concentration were statistically significant in the study and control groups (p = 0.005), which may have a negative impact on the possibility of a thromboembolic episode.

Significance of CYCLOOXYGENASE-2(COX-2), PERIOSTIN (POSTN) and INTERLEUKIN-4(IL-4) gene expression in the pathogenesis of chronic rhinosinusitis with nasal polyps.

The purpose of this paper was to evaluate the level of Cyclooxygenase-2 (COX-2), Periostin (POSTN) and Interleukin-4(IL-4) gene expression in patients with chronic rhinosinusitis with nasal polyps, without polyps and with a nasal septum deviation. The tests were performed on 63 patients (24 women and 39 men) with chronic rhinosinusitis and polyps (CRSwP-study group I), with determination of the COX-2, POSTN and IL-4 gene expression; an allergy was diagnosed in 38 cases. The reference groups were patients with chronic rhinosinusitis without polyps--CRS (n = 23, including 14 women and 9 men) and patients with nasal septum deviation--DSN (n = 18, including 9 women and 9 men). The expression level was determined in the polyp tissue and the mucosa of paranasal sinus collected during an FESS. The expression level of studied genes was also evaluated in the material. Immediately after being collected, the tissue fragments were placed in test tubes with 1 ml of RNAlater (Qiagen, Hilden, Germany) preventing the degradation of RNA and frozen at -70 °C. The studies revealed an increased level of POSTN, IL-4 gene expression and a decreased level of COX-2 gene expression that may be associated with the development of chronic rhinosinusitis with nasal polyps. An analysis of the expression level indicates the participation of POSTN and IL-4 in the development of chronic rhinosinusitis with nasal polyps in patients with atopy.

The -5 A/G single-nucleotide polymorphism in the core promoter region of MT2A and its effect on allele-specific gene expression and Cd, Zn and Cu levels in laryngeal cancer.

Metallothioneins (MTs) are low molecular weight, cysteine-rich heavy metal-binding proteins which participate in the mechanisms of Zn homeostasis, and protect against toxic metals. MTs contain metal-thiolate cluster groups and suppress metal toxicity by binding to them. The aim of this study was to determine the -5 A/G (rs28366003) single-nucleotide polymorphism (SNP) in the core promoter region of the MT2A gene and to investigate its effect on allele-specific gene expression and Cd, Zn and Cu content in squamous cell laryngeal cancer (SCC) and non-cancerous laryngeal mucosa (NCM) as a control. The MT2A promoter region -5 A/G SNP was determined by restriction fragment length polymorphism using 323 SCC and 116 NCM. MT2A gene analysis was performed by quantitative real-time PCR. The frequency of A allele carriage was 94.2% and 91.8% in SCC and NCM, respectively, while G allele carriage was detected in 5.8% and 8.2% of SCC and NCM samples, respectively. As a result, a significant association was identified between the -5 A/G SNP in the MT2A gene with mRNA expression in both groups. Metal levels were analyzed by flame atomic absorption spectrometry. The significant differences were identified between A/A and both the A/G and G/G genotypes, with regard to the concentration of the contaminating metal. The Spearman rank correlation results showed that the MT2A expression and Cd, Zn, Cu levels were negatively correlated. Results obtained in this study suggest that -5 A/G SNP in MT2A gene may have an effect on allele-specific gene expression and accumulation of metal levels in laryngeal cancer.

Association of IL1ß and IL4 gene polymorphisms with nasal polyps in a Polish population.

Imbalance between proinflammatory and anti-inflammatory cytokines may regulate the inflammatory reaction in the nasal polyps. Polymorphisms in the regulatory regions of the cytokines genes may influence their expression. The aim of this study was to investigate the relationship between an IL-1ß and IL-4 promoter polymorphisms and nasal polyps. The C-511T promoter polymorphism of the IL-1ß gene and C-590T promoter polymorphism of the IL-4 gene were genotyped by polymerase chain reaction-restriction fragment length polymorphism analysis in 208 Polish patients with nasal polyps and 200 healthy Polish subjects. The risk of susceptibility to NP was significantly higher in patients with NP who had -511 T/T genotype of IL1ß than in controls (OR 3.07; 95 % CI 1.18-7.99). No statistically significant differences were found between NP patients and the control group with regard to genotype distribution and allele frequencies of C/T polymorphism of IL4 gene. Our study demonstrated that the TT genotype for C-511T mutation associated with the risk of developing NP in a Polish population.

Direct current stimulation of the ear in tinnitus treatment: a double-blind placebo-controlled study.

The objectives of the study are assessment of the influence of direct current electrical stimulations of the ear in tinnitus treatment, comparison of the results with placebo group and evaluation of hearing after electrical stimulations. The study comprised 120 tinnitus and sensorineural hearing loss patients (n = 184 tinnitus ears). In group one (n = 119 tinnitus ears) the authors applied a non-invasive hydrotransmissive electrical stimulation (15) of the ear, in group two (n = 65 tinnitus ears)--placebo electrical stimulation. Direct rectangular, positive polarization current was used. The frequency of stimulation was adjusted according to tinnitus frequency. In group two, the authors used similar procedure, but no current was delivered through the active electrode. Evaluation of tinnitus and hearing was conducted. In groups one and two, directly after the treatment, the number of ears with permanent tinnitus decreased considerably. In group one in 40 ears (33.6%) tinnitus disappeared; in group two, tinnitus disappeared in four ears (6.1%). After 30 days, statistically significant changes were observed in group one (p < 0.05), which were comparable with results returned 90 days later (p > 0.05). Changes in group two (after 30 and 90 days) were not significant (p > 0.05). The authors recognized audiometric improvement of hearing (in pure tone audiometry). The application of direct current electrical stimulation of the hearing organ, with current frequencies similar to tinnitus frequencies (selective electrical stimulation), was an efficient method in severe tinnitus treatment. We did not observe a harmful effect of direct current on hearing organ.

Delayed perforation of posterior pharyngeal wall caused by dislodged bioresorbable interbody cage. Case report.

A 48-year-old man was admitted for the management of congenital anomalies: Arnold-Chiari type I malformation combined with odontoid upward migration. He also had degenerative stenosis of the spinal canal by spurs at C2/C3 and C3/C4 levels. Osseous deformities caused ischaemic changes of the brainstem as well as spinal cord compression. Authors used the Biocage - interbody cage covered by bioresorbable layer to fill the surgically created gap after removal of the right part of C3 vertebral body. Twenty-seven months after implantation, the implant was extruded through posterior pharyngeal wall. Authors describe this unusual case and discuss possible causes of Biocage extrusion.

Electrical safety assessment of a prototype device for electromagnetic stimulation of the ear in patients with tinnitus.

<b><br>Aim:</b> The aim of the study was to evaluate the results of electrical safety results of a prototype electromagnetic ear stimulation device in patients with tinnitus.</br> <b><br>Material and methods:</b> The electrical safety tests of the prototype device for electro- and magnetostimulation of the hearing organ were carried out at the Center for Attestation and Certification Tests in Gliwice. The tests concerned selected parameters including the PN-EN standard.</br> <b><br>Results:</b> Safety studies of the prototype electrical stimulation device for the ear in patients with tinnitus were necessary to perform the planned further preclinical studies. Obtained results regarding: identification and labeling of the device; protection against electric shock; checking protective earthing, functional earthing and potential equalization; checking the leakage current and auxiliary currents of the patient; checking the distances through the solid insulation and the use of thin insulating spacers; checking the electrical strength of the device insulation; checking protection against mechanical hazards of the device; checking the risk associated with surfaces, corners and edges, and checking the protection against excessive temperatures and other threats comply with the standard PN-EN.</br> <b><br>Conclusions:</b> No risk to the patient and medical staff. Tests of protection against mechanical hazards of the device have shown that the only movable part whose contact with the patient could cause an unacceptable risk is the fan installed inside the housing.</br>.

Effects of three different types of anaesthesia on perioperative bleeding control in functional endoscopic sinus surgery.

The aim of the study was to assess the effect of three different types of anaesthesia on perioperative bleeding control and to analyse the mean arterial blood pressure and heart rate in patients undergoing endoscopic paranasal sinus surgery. Ninety patients (30 women and 60 men, aged 18-85 years) scheduled to undergo functional endoscopic sinus surgery in the years 2008-2010 were identified as candidates for inclusion in the study. Patients were randomly assigned to one of three groups (30 patients each) according to the type of general anaesthesia to be administered. Groups I and II both received inhalation anaesthesia (sevoflurane for sedation) and intravenous anaesthesia (fentanyl in group I, remifentanil in group II). Anaesthesia was delivered solely via intravenous route (TIVA) in group III, with propofol used for sedation and remifentanil for analgesia. Blood pressure and heart rate were monitored during surgery and post-surgically for 4 h. Mean anaesthesia duration in groups I, II and III was 108.7 ± 20.8, 112.6 ± 22.2 and 103.7 ± 17.5 min and the surgery duration was 71.3 ± 16.7, 78.8 ± 24.2 and 66.5 ± 15.5 min, respectively. Mean blood loss during surgery was 365.0 ± 176.2, 340.0 ± 150.5 and 225.0 ± 91.7 ml, with a mean blood loss rate of 5.1 ± 2.4, 4.5 ± 2.2 and 3.4 ± 1.1 ml/min in groups I, II and III, respectively. Technologically advanced control of the drug dose with the TIVA technique allows for better control of perioperative bleeding.

Evaluation the results of electromagnetic compatibility of a prototype device for ear stimulation in patients with tinnitus.

<b><br>Aim:</b> The aim of the study was to evaluate the results of electromagnetic compatibility of a prototype device for ear stimulation in patients with tinnitus.</br> <b><br>Material and methods:</b> The electromagnetic compatibility tests of the prototype device for electro- and magnetostimulation of the hearing organ were carried out at the Center for Attestation and Certification Tests OBAC Sp. z o. o. in Gliwice in 2020. The following product standards were used: PN-EN 60601-1-2:2015-11 - medical electrical equipment (general requirements for basic safety and essential functioning; PN-EN 55011:2012 - industrial, scientific and medical equipment [characteristics of radio frequency disturbances] ) PN-EN 61000-3-2:2014-10 - electromagnetic compatibility (EMC), permissible levels of harmonic current emissions (phase load current ≤ 16 A).</br> <b><br>Results:</b> The level of expanded uncertainty in the measurement of conducted disturbances in the range of 0.150-30MHz does not exceed the level specified in the PN-EN-55016-4-2:2011 standard. In the study of the emission of radiated disturbances up to 1GHz in the frequency range of 30-1000MHz (PN-EN 55011:2012 standard), it was found that the setting of the EUT during the tests was in accordance with the requirements of the standard. The level of expanded uncertainty in the measurement of radiated disturbances in the 30-1000MHz range does not exceed the level specified in the PN-EN 55016-4-2:2011 standard. The measured current harmonic levels (phase power supply current ≤16A) with a frequency range of 50Hz-2kHz do not exceed the permissible levels specified in the PN-EN 61000-3-2:2014-10 standard. The test of resistance to the magnetic field at the frequency of the power grid (PN-EN 61000-4-8: 2010 standard also showed that the setting of the EUT during the tests was in accordance with the requirements of the standard and the result was positive.</br> <b><br>Conclusions:</b> Testing of immunity to radiated radio frequency electromagnetic field (PN-EN 61000-4-3:2007 +A1:2008+A2:2011 standard) and testing of resistance to magnetic field at power frequency (PN-EN 61000-4-8 standard :2010) did not exceed the level specified in the standard and showed a positive result. The measured harmonic levels of the network current (phase supply current ≤16A) with the frequency range 50Hz-2kHz do not exceed the permissible levels specified in the PN-EN 61000- 3-2:2014-10 standard for a class A device.</br>.

The analysis of etiology and treatment of chronic rhinosinusitis in our own material.

<b>Introduction and aim:</b> The aim of the study was the analysis of etiology and treatment of chronic rhinosinusitis in our own material.</br></br> <b>Material and methods:</b> The study was performed on 520 women aged 18-87 and 789 men aged 19-85, diagnosed and treated for chronic rhinosinusitis between 2016 and 2020. The analysis was based on the medical records, taking into account: gender; age; type of symptoms; allergy tests; probable cause of inflammation; type of anatomical anomalies; assessment of the stage based on the Lund-Mackay score for CT scans; number of operations; pathology report; postoperative complications.</br></br> <b>Results:</b> The study showed that the hospitalized patients were most often aged 41-50, 51-60, and 31-40 for women and 51-60, 41-50, and 31-40 for men, respectively. The results of allergy tests in chronic rhinosinusitis patients showed that women were most often allergic to Pyralgin + Ketonal + paracetamol + ibuprofen in 4.50%, to penicillins in 1.07%, and to house dust mites in 0.92%, while in men positive reactions were found in 3.36% for Pyralgin + Ketonal + paracetamol + ibuprofen, 0.99% for house dust mites and 0.92% for cat and dog hair, respectively. Absence of anatomical anomalies was found in 20.75% of women and 26.36% of men, but most often they occurred in the form of deviated nasal septum and enlarged middle nasal concha. The pathology reports revealed the following: chronic rhinosinusitis, chronic polypoid rhinosinusitis, chronic cystic rhinosinusitis, and chronic allergic rhinosinusitis.</br></br> <b>Conclusions:</b> The main symptoms in patients with chronic rhinosinusitis included: nasal congestion + rhinorrhea, nasal congestion + nasal discharge + olfactory impairment, and nasal congestion + nasal discharge + headache. The most common probable causes of chronic rhinosinusitis in the studied patients included: anatomical anomalies, allergies, and irritants including tobacco smoke. Depending on the assessment of the stage based on the Lund-Mackay score for CT scans, it appears that moderate to severe inflammation prevailed in the studied patients.

The analysis of reason for the presence and treatment of chronic inflammation of the paranasal sinuses in own material.

SummaryIntroduction. . The aim of the study was the analysis of reasons for the occurrence and treatment results of chronic inflammation of the paranasal sinuses in own materail. MATERIAL AND METHODS: The study was performed on 520 women aged 18 - 87 and 789 men aged 19-85, diagnosed and treated for the chronic inflammation of the paranasal sinuses in 2016 - 2020. The analysis was based on disease medical history, taking into account: gender; age of patients; type of symptoms; allergy diagnosis; probable cause of inflammation; type of anatomical anomalies; assessment of the advancement of lesions based on CT images in the Lund- Mackay scale; number of operations; histopathological result of the removed lesions; complications that occured after surgical treatment.ResultsThe study showed that the hospitalized patients were most often aged 41-50, 51-60 and 31-40 among women and men aged 51-60, 41-50 and 31- 40 . The results of allergological diagnostics among patients with chronic inflammation of the paranasal sinuses showed that women were most often allergic to pyralgin + ketonal + paracetamol + ibuprofen in 4.50 % , to penicillins in 1.07 % and to house dust saprophytes in 0.92%, while among men, positive reactions were found in 3.36 % for pyralgin + ketonal + paracetamol + ibuprofen, 0.99% for house dust saprophytes and 0.92% for cats and dogs fur. Absence of anatomical anomalies was found among 20.75 % of woman and 26.36 % of men, but most often they occurred in the form of nasal septal curvature and excessively dilated middle nasal turbinate. In the histopathological examination of the lesions from the paranasal sinuses, the following were found: chronicinflammation of mucous membrane, chronic polypoid inflammation, chronic cystic inflammation and chronic allergic inflammation. CONCLUSIONS: The main symptoms among patients with chronic inflammation of paranasal sinuses were: nasal congestion + rhinorrhea, nasal congestion + rhinorrhea + smell impairment and nasal congestion + rhinorrhea+ headache. The most common probable causes for chronic inflammation of nasal sinuses among the examined patients were: anatomical anomalies, allergies, irritant factors, including tobacco smoke. Depending on the assessment of the severity of changes in the paranasal sinuses according to the Lund- Mackay scale, it appears that medium and large inflammatory lesions prevailed in the examined patients. KEY WORDS: reason/cause, occurrence, treatment results, chronic inflammation of the paranasal sinuses.

Association of the -33C/G OSF-2 and the 140A/G LF gene polymorphisms with the risk of chronic rhinosinusitis with nasal polyps in a Polish population.

Nasal polyps are strongly associated with a risk of chronic rhinosinusitis development as well as other obstruction including asthma and allergy. The following study tested the association of the 140A/G polymorphism of lactoferine (LF) encoding gene and the -33C/G polymorphism of osteoblast-specific factor-2 (OSF-2) encoding gene with a risk of chronic rhinosinusitis with nasal polyps in a Polish population. One hundred ninety five patients of chronic rhinosinusitis with nasal polyps as well as 200 sex, age and ethnicity matched control subjects without chronic sinusitis and nasal polyps were enrolled in this study. Among the group of patients 63 subjects were diagnosed with allergy and 65 subjects with asthma, respectively. DNA was isolated from peripheral blood lymphocytes of patients as well as controls and gene polymorphisms were analyzed by restriction fragments length polymorphism polymerase chain reaction (RFLP-PCR). We reported that the 140A/G LF (OR 4.78; 95% CI 3.07-7.24), the -33C/G OSF-2 OR 3.48; 95% CI 2.19-5.52) and the -33G/G OSF-2 (OR 16.45; 95% CI 6.71-40.30) genotypes were associated with an increased risk of chronic rhinosinusitis with nasal polyps among analyzed group of patients. Moreover, the group of patients without allergy or asthma indicated the association of the -33C/G (OR 3.72; 95% CI 2.24-6.19 and OR 15.11; 95% CI 5.91-38.6) and -33G/G (OR 3.73; 95% CI 2.24-6.19 and OR 14.07; 95% CI 5.47-36.16) genotypes of the OSF-2 as wells as 140A/G (OR 3.89; 95% CI 2.40-6.31 and OR 3.62; 95% CI 2.45-5.34) genotype of OSF-2 with an increased risk of chronic rhinosinusitis with nasal polyps. Finally, it was also found that the selected group of patients with allergy or asthma indicated a very strong association of the -33C/G (OR 2.40; 95% CI 1.23-4.69 and OR 2.40; 95% CI 1.23-4.69, respectively) and -33G/G (OR 16.01; 95% CI 5.77-44.41 and OR 17.90; 95% CI 6.53-49.05, respectively) genotypes of the OSF-2 as wells as 140A/G (OR 3.22; 95% CI 1.74-6.11 and OR 3.25; 95% CI 1.75-6.04, respectively) genotypes with an increased risk of chronic rhinosinusitis with nasal polyps. Thus, our results suggest that LF and OSF-2 gene polymorphisms may have deep impact on the risk of rhinosinusitis nasal polyps' formation which may also depend on asthma or allergy. Our results showed that the 140A/G polymorphism of LF gene and the -33C/G polymorphism of the OSF-2 gene may be associated with the risk of chronic rhinosinusitis with nasal polyps in a Polish population.

[The comparison of the influence of various types of anaesthesia on perioperative bleeding control in endoscopic paranasal sinus surgery]. / Porównanie wplywu róznych rodzajów znieczulenia na kontrole krwawienia sródoperacyjnego w operacjach endoskopowych zatok przynosowych.

INTRODUCTION: The study aimed at evaluating the influence of targeted hypotension with three types of anaesthetics on the amount of blood loss in extensive endoscopic operations of polyps of the nose and paranasal sinuses. MATERIAL AND METHODS: Ninety patients, including 30 women aged 31-73 and 60 men aged 21-79, who were operated within the period of 2008-2010 at Department of Otolaryngology and Laryngological Oncology Military Medical Academy University Clinical Hospital in Lodz, were qualified for the study. The bilateral removal of nasal polyps, bilateral ethmoidectomy, and surgery or revision of the maxillary, sphenoid and temporal sinuses in endoscopy were conducted in each patient. Due to the type of general anaesthesia the patients were divided into three groups, 30 patients each: I ­ sevoflurane inhalation (sedation) and fentanyl I.V., II ­ sevoflurane inhalation (sedation) and remifentanil I.V. (analgesia), III ­ TIVA, propofol sedation and remifentanil analgesia. The drugs were administered via the infusion pomp TCI. RESULTS: In group I the mean anaesthesia time was 108.67±20.80 min., group II ­ 112.63±22.17 min., group III ­ 103.67±17.47 min. The surgery time in the studied groups was as follows: I ­ 71.33±16.71 min, II ­ 78.83±24.24 min, III ­ 66.5±15.49 min. During the operation the mean blood loss was: group I ­ 365±176.2 ml, group II ­ 340±150.5 ml, group III ­ 225±91.7 ml. During the operation the mean rate of blood loss was: group I ­ 5.118±2.38 ml/min, II ­ 4.507±2.215 ml/min, group III ­ 3.416±1.059 ml/min. CONCLUSIONS: In TIVA the advanced technologically control of a drug dose allows for a better control of hypotension, which, finally, results in lower haemorrhage within the operation area, a favourable condition for both a patient and a physician. Perioperative bleeding was independent on sex in every type of anaesthesia.

[Role of the -765 G/C polymorphism of COX-2 gene in pathogenesis of chronic rhinosinusitis with nose polyps in a Polish population]. / Znaczenie polimorfizmu -765G/C genu COX-2 dla patogenezy przewleklego zapalenia zatok przynosowych z polipami nosa w populacji polskiej.

INTRODUCTION: It is believed that local factors within the nasal cavities contribute to the formation of nasal polyps. The disruption of local homeostasis mechanisms in a chronic inflammatory process is one of those factors. Cyclooxygenase (COX)-2 expression is activated in the course of the immune response to extracellular and intracellular stimuli. Also, an increase of the gene expression can be associated with the development of nasal polyps in patients with chronic sinusitis. THE AIM OF THE STUDY: The aim of this study was an evaluation of the role of the -765G/C COX-2 polymorphism in sinusitis pathogenesis in patients with nasal polyps. MATERIALS AND METHODS: The study group consisted of 100 patients, aged 35-65, with chronic sinusitis and nasal polyps and 150 people in the age, sex-, age- and ethnicity-matched control group. The study material included DNA isolated from peripheral blood lymphocytes of the patients and the controls. PCR-RFLP method was used in genotyping polymorphic variants of COX-2. RESULTS: In comparison to the control group, the group of the patients with chronic sinusitis and nasal polyps showed a statistically significant increase in the occurrence frequency of the -765G/C polymorphic variant of COX-2 gene (OR 4.04; 95% CI 2.32-7.03; p > 0.001) and C allele (OR 3.68; 95% CI 2.38-5.68; p < 0.001). CONCLUSIONS: The -765G/C genotype of COX-2 can be associated with an increased risk of the occurrence of chronic sinusitis with nasal polyps in the Polish population.

[Early complications of Griggs percutaneous tracheotomy in own material]. / Wczesne powiklania tracheotomii przezskórnej metoda Griggsa w materiale wlasnym.

INTRODUCTION: The aim of the work was to assess early complications of Griggs percutaneous tracheotomy in the own material. MATERIAL AND METHODS: The study covered 155 patients aged 17-88, including 36 women and 119 men. The patients were treated at the Department of Anaesthesiology and Intensive Therapy between 2006-2010. They underwent Griggs percutaneous tracheostomy by a laryngologist or a trained anaesthesiologist. Each surgical procedure was conducted with the use of Portex Blue Line Ultra Percutaneous Tracheotomy Kit (Smiths Medical Co., USA), the trachea was intubated while the patient was under general anaesthesia with propofol, fentanyl and relaxation with atracurium. RESULTS: The studied material revealed Griggs percutaneous tracheotomy complications in 26 patients (16.8%), in which 11 patients (7.1%) presented complications within the perioperative period while 15 patients (9.7%) reported early complications. Haemorrhage, usually not very profuse, occurred 7 times (4.6%), mainly in tracheopunction, and was the most often perioperative complication. Moreover, in the perioperative period, 3 patients (1.9%) had trachea identifications difficulties, which required tracheopunction many a time, and 1 patient (0.65%) encountered sudden circulatory arrest with asystolia and effective CPR. In the early postoperative period after Griggs percutaneous tracheotomy, the most common complication was haemorrhage in the operative twenty-four hours, which was noted in 10 patients (6.5%). Among other adverse complications were found: infection of the tissues near the tracheostomal region in 3 patients (1.9%), subcutaneous oedema in 1 patient (0.65%), accidental removing the tube from an unformed tracheostoma in 1 patient (0.65%). CONCLUSIONS: In the studied material, complications after Griggs percutaneous tracheotomy amounted to 16.8%, of which 7.1% occurred in the perioperative period while 9.7% were early complications, mainly light bleeding. This may prove good preparation of the surgical team for the surgical procedures.