The influence of occupational chronic lead exposure on the levels of selected pro-inflammatory cytokines and angiogenic factors.

The aim of the study was to determine the effect of occupational exposure to lead on the blood levels of pro-inflammatory cytokines and selected factors that influence angiogenesis. The study population was divided into two groups. The first group consisted of 56 male workers chronically exposed to lead. The second group (control) was comprised of 24 male administrative workers. The serum levels of interleukin 1ß (IL-1ß), interleukin 6 (IL-6), and tumor necrosis factor α (TNF-α) were significantly higher in the group of workers chronically exposed to lead compared to control values by 38%, 68%, and 57%, respectively. Similarly, the values of soluble vascular endothelial growth factor receptor-1 (sVEGFR-1) and fibroblast growth factor-basic (FGF-basic) were higher by 19% and 63%, respectively. In the group of workers chronically exposed to lead, there were positive correlations between the levels of pro-inflammatory cytokines (IL-1ß, IL-6, and TNF-α) and angiogenic factors (VEGF, FGF-basic, sVEGFR-1, and soluble angiopoietin receptor). In the control group, there were no correlations between the levels of the abovementioned parameters. Results of the present study indicate that chronic occupational lead exposure promotes inflammatory processes via induction of pro-inflammatory cytokines, modulates angiogenesis, and elicits interdependencies between the immune response and angiogenic factors.

Early identification of hearing impairment in patients with type 1 diabetes mellitus.

OBJECTIVE: The aim of this study was to evaluate the cochlear micromechanics and central auditory function in patients with type I diabetes mellitus and to identify the site of possible dysfunction. METHODS: Cochlear activity was evaluated by recording distortion product otoacoustic emissions (DPOAEs). DPOAEs were performed using an ILO 92 Otodynamics Analyser. Functional changes in the retrocochlear auditory pathway were evaluated by auditory brainstem responses (ABRs). DPOAEs and ABRs were measured in 42 normally hearing patients with type 1 diabetes mellitus aged 21 to 42 years, and 33 age- and sex-matched nondiabetic control subjects. RESULTS: Both of the groups (diabetic and control) had normal and undifferentiated results in tonal and impedance audiometry. ABR peripheral transmission time (wave I) and central transmission time (interpeak latencies I-V) were significantly delayed in the diabetic compared with normal subjects, and the mean amplitudes of various DPOAEs were significantly reduced in the diabetic patients compared with the control subjects. CONCLUSIONS: Combined use of different procedures for monitoring central and peripheral portions of the auditory pathway in diabetic patients showed alterations in cochlear micromechanics and the retrocochlear auditory pathway. Hearing impairment in diabetic patients is usually mild and subclinical, and can be detected early by accurate and objective audiometric methods.

[Monitoring of neurophysiologic modalities during surgery for cerebellopontine angle tumors. Personal experiments]. / Monitorowanie neurofizjologicznych modalnosci w trakcie zabiegów operacyjnych guzów kata mostowo-mózdzkowego. Doswiadczenia wlasne.

The purpose of intraoperative monitoring of many modalities is to save some structures of the nervous system being at risk of damaging during surgical procedures. In cerebellopontine angle (cpa) tumour cases these nervous system structures can include cranial nerves (trigeminal, facial, cochlear, accessory), motor and sensory tracts localised within brainstem, and other. Continuous registration of somatosensory and auditory evoked potentials as well as electromyography of masseter muscle, orbicular muscle of eye and trapezius muscle during procedure is the method of brainstem, cochlear tract and cranial nerves status evaluation. Direct stimulation of cranial nerves within posterior fossa using bipolar electrode is the method of facial, trigeminal and accessory nerves localisation, especially in patients with large tumours. In Department of Neurosurgery Silesian University School of Medicine for intraoperative monitoring of many modalities in cpa lesion cases Nocolet Viking IV D unit with special IOM software is employed. Authors presented own experience in such method and effect in treatment of group of 15 patients operated with electrophysiological intraoperative monitoring.

Assessment of the medial olivocochlear efferent system in children. pure tone 1.0 kHz and 2.0 kHz suppressive effects on transient evoked otoacoustic emission.

The role of medial efferent system in regulating outer hair cell function has been studied by many investigators. Usually narrow band noise or white noise as contralateral stimulation (CS) suppressors have been used and changes in OAE amplitudes estimated. Thirty children aged 6-15 years (mean 12.5 +/- 4.7), without any changes in tonal and impedance audiometry and with negative history regarding otiatric diseases were examined. Transient evoked otoacoustic emissions (TEOAE) were recorded using ILO 92 Otodynamics Analyser. CS was performed using 1.0 kHz and 2.0 kHz continuous pure tones of 30 dB SL or 50 dB SL. Effects of CS on TEOAE evoked by click of 80, 70 and 60 dB SPL were investigated. TEOAE analysis included assessment of TEOAE amplitude of half octave frequency bandwidth (HOFBW-1.0; HOFBW-1.5; HOFBW-2.0; HOFBW-3.0 and HOFBW-4.0 kHz) and 0.8 kHz frequency bandwidth (0.8-FBW) amplitudes centred at 1.0; 2.0; 3.0; 4.0 and 5.0 kHz. TEOAE amplitude recorded for stimuli 80, 70 and 60 dB SPL without CS decreased: mean values respectively 6.1 +/- 4.2; 5.4 +/- 4.5 and 3.3 dB SPL +/- 4.3. CS effect on TEOAE was observed for all CS options, however, larger suppressive effect was recorded on TEOAE elicited by 70 dB SPL stimulus using 1 kHz/50 dB SL tone as a suppressor and on TEOAE elicited by 60 dB SPL stimulus using 2 kHz/50 dB SL tone as a suppressor. HOFBW and 0.8-FBW analyses showed the association between the frequency/intensity of the suppressors and decreasing of amplitudes of adequate frequency bands. It is concluded that the described method of investigating of the medial olivocochlear efferent system seems to be sensitive and confirms frequency-dependent suppressive effect on OAE.

Latencies of the 2f1-f2 distortion product otoacoustic emissions measured using a phase-gradient method in young people, in the elderly and in people exposed to noise.

Distortion product otoacoustic emissions (DPOAE) are generally accepted as a good tool for investigating the micromechanics of the cochlea. The 2f1-f2 DPOAE latencies provide significant data regarding travelling waves. In this study the 2f1-f2 DPOAE latencies were measured using a phase-gradient method, with a swept-f2 procedure, for three groups: Group I comprised 60 healthy young people, aged 17-32 years; Group II comprised elderly patients, aged 56-72 years, with presbyacusis; and Group III consisted of 74 miners, aged 19-35 years, who had been exposed to noise for 2-15 years. Measurements were performed for frequencies between 1.0 and 6.0 kHz. In all groups the latencies were fitted using a non-linear regression model. The aim of the study was to compare the latency and amplitude of 2f1-f2 DPOAE in different inner ear pathologies. The highest DPOAE amplitudes were recorded in Group I and in miners with 2-4 years noise exposure (Group IIIa), and the latencies showed a similar pattern. The lowest DPOAE amplitudes were recorded in the elderly and in miners with 8-15 years noise exposure (Group IIIc), but in contrast the longest latencies were measured in miners and the shortest in the elderly. The latency analysis significantly reinforces opinions on the micromechanics of the cochlea, mostly in terms of the cochlear functioning as a filter and amplifier and with regard to the elasticity of the basilar membrane.

Contralateral suppression of TEOAE in diabetic children. Effects of 1.0 kHz and 2.0 kHz pure tone stimulation--preliminary study.

The medial efferent system and its regulating outer hair cell function have not been previously studied in diabetic children. In this study, the group comprised 32 diabetic children, aged 6.0-16.0 years, with diabetes lasting 2.0-9.0 years, with normal tonal and impedance audiometry. A control group consisted of 30 healthy children with similar age and sex distribution. Contralateral stimulation (CS) was performed using 1.0 and 2.0 kHz pure tones on the level of 30 and 50 dB SL. Effects of CS on transient evoked otoacoustic emissions (TEOAE) elicited by click of a level equal to 70 and 60 dB SPL were investigated. Analysis included assessment of TEOAE amplitude and 0.8 kHz frequency bandwidth (0.8-FBW) amplitudes (signal/noise) centred at 1.0; 2.0; 3.0; 4.0; 5.0 kHz. TEOAE-RA recorded for stimulus 80, 70 and 60 dB SPL without CS were decreasing: average values respectively 7.3, 4.7 and 3.9 dB SPL. In the group of diabetic children TEOAE amplitudes, recorded for different click levels without CS, were similar to these recorded in healthy children. It suggested that normal function of the cochlea was preserved, mostly outer hair cells. However, the obtained effects of CS, in comparison with healthy children, were weaker and not so regular. Statistical analysis revealed that the reduction of TEOAE amplitudes for adequate 0.8-FBW in the control group was significantly higher, for both 1.0 kHz and 2.0 kHz CPTs of 30 dB SL and 50dB SL, in comparison with diabetic children. It is concluded that the suppressive effect on OAE in diabetic children is rather weak and seems to be associated with pathological changes in medial olivo-cochlear myelinated fibres.

Cochlear dysfunction and diabetic microangiopathy.

The aim of this study was to evaluate the cochlear micromechanics in type 1 diabetic patients and to compare these findings with diabetic microvascular complications (retinopathy and nephropathy). Cochlear activity was evaluated by recording 2f1-f2 DPOAE. DPOAEs were performed using an ILO92 Otodynamics Ltd Analyser. DPOAEs were measured in 42 normally hearing IDDM patients aged between 21 and 42 years, and 33 age-and sex-matched non-diabetic control subjects. IDDM patients were divided into two groups: 17 patients without microangiopathy and 25 with microangiopathy. Microangiopathy was evaluated with ophthalmoscopy and 24-hour albumin excretion rate into urine. Both groups (diabetic and control) had normal and undifferentiated results in tonal and impedance audiometry. The mean amplitudes of various DPOAEs were significantly reduced in the diabetic groups (with and without microangiopathy) compared with control subjects. No correlation was found between diabetic microvascular complications and DPOAE amplitudes reduction. Our results indicate the existence of an alteration in cochlear micromechanics in diabetic patients with microangiopathy as well as in patients without microangiopathy. The lack of significant correlation between the degree of microvascular complications in the retina or kidneys and DPOAEs amplitude reduction suggest that the impaired functional properties of the outer hair cells are probably caused by early metabolic complications in diabetes (among other things non-enzymatic glycation related to hyperactivity of free oxygen radicals) and not directly by diabetic microangiopathy.

The hearing system in newborns from the Upper Silesia. Assessment of TEOAE depending on selected parameters of delivery disorders.

Transient evoked otoacoustic emission (TEOAE) is an accepted test for screening of the cochlea function in newborns. In this study 300 newborns was tested using TEOAE, as well as analysing such parameters as birth weight, Apgar scale, bilirubinaemia. The study indicated the tendency of TEOAE to decrease in newborns with low birth weight and low Apgar scores. Hyperbilirubinaemia seems to have an influence on cochlea function monitored by TEOAE, especially if there were simultaneously low Apgar scores. A similar tendency, although slightly stronger, was observed in the preterm newborn group. TEOAE seems to be a good method of recording the negative influence on the cochlea activity such factors as low birth weight and asphyxia. Hyperbilirubinaemia with asphyxia acts upon the cochlea similarly. All these tendencies were observed more strongly in the preterm newborn group. It is concluded that TEOAE analysis demonstrated its utility as a screening test assessing the hearing state in newborns, additionally the associations of cochlea activity was found with a few parameters of delivery disorders.

[The 2f1-f2 DPOAE amplitudes and latencies in the groups of older people with presbyacusis and young people with normal hearing]. / Ocena amplitud i latencji 2f1-f2 DPOAE w grupie osób starszych z presbyacusis oraz osób mlodych z prawidlowym sluchem.

Otoacoustic emissions have been shown to be useful as indicators of the cochlear function. One of the most valuable techniques is distortion product otoacoustic emission recording (DPOAE), mostly 2f1-f2 distortion, which is described as being present regularly and indicating the strongest connection with hearing level. DPOAE amplitudes are analysed as relating to the frequency (DP-gram) or to the signal levels (input-output function). Another feature of DPOAE providing many details with regard to cochlear mechanics seems to be the assessment of 2f1-f2 DPOAE latencies. In the present study 2f1-f2 DPOAE amplitudes and latencies were analysed and compared in two groups: the elderly with presbyacousis and the young with normal hearing level. All measurements were taken using Otodynamics ILO 92 system. DPOAE latencies were recorded by phase gradient method with fixed-f1 and swept-f2 signal. The following signal parameters were used: f2 ranging from 732 to 6396 Hz, signal levels L1 = L2 = 70 dB SPL, f2/f1 ratio ranging from 1.18 to 1.25. According to the mathematical formula y = 1.412 + exp(7.685-0.7698*ln(f2)) 2f1-f2 DPOAE latencies were calculated in the group of young people at f2 = 1.0 kHz; 2.0 kHz; 3.0 kHz; 4.0 kHz; 5.0 kHz; 6.0 kHz as follows: 12.08 ms; 7.67 ms; 5.99 ms; 5.08 ms; 4.50 ms; 4.10 ms. The analogous analysis revealed the following results in the group of the elderly: y = 2.402 + exp(9.293-1.019*ln(f2)) and calculated latencies--11.9 ms; 7.09 ms; 5.50 ms; 4.71 ms; 4.24 ms; 3.93 ms. The greater differentiation of the latencies measured in low frequency band was observed in the elderly while in the young subjects in mid and high frequency bands. The 2f1-f2 DPOAE amplitudes recorded for the whole frequency band were significantly higher in the young people than in the elderly. No correlation was observed between latencies and amplitudes in both investigated groups.

[A case of laryngomucocele coexisted with pleomorphic adenoma of the larynx]. / Rzadki przypadek laryngomucocele z jednoczesnym wystapieniem gruczolaka wielopostaciowego krtani.

Benign pleomorphic adenomas of the larynx are very rare. Review of the literature showed about 20 cases of this tumours. We present a case of benign mixed tumor located in the false vocal cord and coexisted with laryngomucocele. The tumor was removed by endoscopic laser resection. To our knowledge it is the second published in literature case of benign plemorphic adenoma of the larynx in which treatment was performed by using CO2 laser surgery.

[Assessment of utility of nm 23 antigen as a metastatic potential marker in laryngeal cancers: preliminary study]. / Ocena przydatnosci oznaczania antygenu nm 23 jako markera potencjalu przerzutowego raków krtani--doniesienie wstepne.

The aim of the study was the analysis of the utility of nm 23 protein in prediction of cervical lymph node metastases in patients with laryngeal cancer. A preliminary study was performed in 35 patients with laryngeal cancer with cervical lymph node metastases, which were confirmed by histopathologist. The control group consisted of 30 patients with laryngeal cancer without cervical lymph node metastases. In statistical analysis T and N were taken into account. In the investigated group with metastases the presence of positive immunostaining was found in 11% of cases while in the control group in 20%. The analysis of the presence of nm 23 protein revealed a weak usefulness of this marker as a factor which predicts the presence of the cervical metastases.

[Preliminary assessment of transient evoked acoustic emissions (TEOAE) in newborns depending on selected parameters of delivery complications with particular analysis of newborns with hypotrophy]. / Wstepna ocena emisji otoakustycznej wywolanej trzaskiem (TEOAE) u noworodków w zaleznosci od wybranych parametrów zaburzen okoloporodowych ze szczególnym uwzglednieniem noworodków z cechami hipotrofii wewnatrzmacicznej.

OBJECTIVES: Transient evoked otoacoustic emission (TEOAE) is accepted as a good and universal test for screening of the cochlea function in newborns. This method is particularly useful in the newborn group with risk-factors of hearing losses. Early identification of the cochlear pathology gives possibility of supplying with hearing aid instrument and rehabilitation. MATERIAL AND METHODS: In this study 300 newborns was tested with TEOAE, besides such parameters as birth mass, Apgar scale, bilirubinemy were analysed. Then the same results of the newborns with hypotrophy consisted of 40 subjects were analysed. RESULTS: The study did not indicate any tendency of changing TEOAE in particular parts within the cochlea in newborns with hypotrophy. Hypotrophy does not seem to influence the cochlea function monitored by TEOAE half-octave band analysis.