An efficient method for isolation of representative and contamination-free population of blood platelets for proteomic studies.

To date, there has been no ideal method for blood platelet isolation which allows one to obtain a preparation devoid of contaminations, reflecting the activation status and morphological features of circulating platelets. To address these requirements, we have developed a method which combines the continuous density gradient centrifugation with washing from PGI2-supplemented platelet-rich plasma (PRP). We have assessed the degree of erythrocyte and leukocyte contamination, recovery of platelets, morphological features, activation status, and reactivity of isolated platelets. Using our protocol, we were able to get a preparation free from contaminations, representing well the platelet population prior to the isolation in terms of size and activity. Besides this, we have obtained approximately 2 times more platelets from the same volume of blood compared to the most widely used method. From 10 ml of whole citrated blood we were able to get on average 2.7 mg of platelet-derived protein. The method of platelet isolation presented in this paper can be successfully applied to tests requiring very pure platelets, reflecting the circulating platelet state, from a small volume of blood.

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.

CD117 (c-kit) expression on CD34+ cells participates in the cytogenetic response to imatinib in patients with chronic myeloid leukemia in the first chronic phase.

BACKGROUND: Chronic myeloid leukemia (CML) biology seemed to be perfectly explored especially at the beginning of the tyrosine kinase inhibitors era. Later years with imatinib and second-generation tyrosine kinase inhibitors showed a variety of resistance mechanisms and it became obvious that the bcr-abl chimeric gene is not the only enemy to fight. Some studies assumed the decreased rate of programmed cell death (apoptotic) to be the primary mechanism by which BCR-ABL affects expansion of the leukemic clone in CML. Therefore, the aim of this study was to investigate the role of c-kit inhibition in treatment response. METHODS: Cytogenetic analysis, real-time quantitative reverse-transcriptase polymerase chain reaction, flow-cytometric analysis and imatinib serum level quantification were applied. RESULTS: The percentage of CD34+ cells expressing c-kit (CD117) isolated from bone marrow samples of 54 CML patients treated with standard-dose imatinib was significantly lower among imatinib responders. The fraction of apoptotic CD34+CD117+ cells in this patient group was significantly higher than in nonresponders. CONCLUSION: To achieve optimal treatment response in CML patients, the elimination of CD34+CD117+ may be necessary through an apoptotic pathway.

Assessment of Preferences in Taking Painkillers among Students of Medicine, Dentistry, and Pharmacy: A Pilot Study.

Students of pharmacy, medicine, and dentistry are important for shaping drug policy. The aim of this study is to assess and compare students preferences in taking painkillers. The study group consists of 382 students of pharmacy (28.8%), medicine (40.0%), and dentistry (30.1%). An anonymous questionnaire consisting of 17 questions was prepared using the Google Forms platform and distributed through social media. Ibuprofen was the most frequently preferred, regardless of the study major (57.8%). Pharmacy students expressed the least concern about the possible side effects of analgesics (17.5%). The fast onset of painkillers was more important for dental students (59.1%) and pharmacy students (44.7%), compared to medical students (39.22%). Medicine and pharmacy students indicated their studies to be their main source of information about painkillers compared to dentistry students (p = 0.001). There are no differences in pain severity regarding which analgesics are used among student groups (p = 0.547). Dental students experienced odontogenic pain less frequently (57.3%) than medical (79.7%) and pharmacy students (79.8%), (p = 0.000). Ketoprofen was the most frequently chosen prescription painkiller for odontogenic pain in all groups (49.4%). Gastrointestinal complaints were the most often reported side effects, regardless of the study major (87.1%). Choice of studies, gender, and year of study were the most important determinants of the choice of painkillers.

Biodegradability Study of Modified Chitosan Films with Cinnamic Acid and Ellagic Acid in Soil.

Currently, natural polymer materials with bactericidal properties are extremely popular. Unfortunately, although the biopolymer material itself is biodegradable, its enrichment with bactericidal compounds may affect the efficiency of biodegradation by natural soil microflora. Therefore, the primary objective of this study was to evaluate the utility of fungi belonging to the genus Trichoderma in facilitating the degradation of chitosan film modified with cinnamic acid and ellagic acid in the soil environment. Only two strains (T.07 and T.14) used chitosan films as a source of carbon and nitrogen. However, their respiratory activity decreased with the addition of tested phenolic acids, especially cinnamic acid. Addition of Trichoderma isolates to the soil increased oxygen consumption during the biodegradation process compared with native microorganisms, especially after application of the T.07 and T.14 consortium. Isolates T.07 and T.14 showed high lipolytic (55.78 U/h and 62.21 U/h) and chitinase (43.03 U/h and 41.27 U/h) activities. Chitinase activity after incorporation of the materials into the soil was higher for samples enriched with T.07, T.14 and the consortium. The isolates were classified as Trichoderma sp. and Trichoderma koningii. Considering the outcomes derived from our findings, it is our contention that the application of Trichoderma isolates holds promise for expediting the degradation process of chitosan materials containing bactericidal compounds.

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.

[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.

[The analysis of mean arterial pressure and heart rate in patients treated with laryngological surgery within pre- and peri- and postoperative periods]. / Analiza sredniego cisnienia tetniczego krwi i czestosci akcji serca u chorych operowanych z powodów laryngologicznych w okresie przedoperacyjnym oraz sródoperacyjnym i pooperacyjnym.

INTRODUCTION: This work aimed to analyse the mean arterial blood pressure (MBP) and heart rate (HR) in patients who underwent laryngological surgery within the preoperative, perioperative and postoperative periods. MATERIAL AND METHODS: The study covered 502 patients, including 209 women and 293 men, aged 18-85, who were divided into 6 groups according to the type of surgery: I - FESS (Functional Endoscopic Sinus Surgery), II - septoplasty, III - endoscopic re-operation of the paranasal sinuses, IV - microlaryngoscopy, V - tonsillectomy, VI - middle ear surgery. Only the patients with BP below 140/90 mmHg and maximum class 2 in the ASA scale were qualified for the surgical procedure. On admission, the arterial blood pressure was measured and diagnostic investigations like FBC, blood grouping determination, coagulogram, ESR, CRP and imaging studies were performed in each patient. Every operation was conducted under TIVA. BT and HR were monitored during an operation as well as through the four following hours in a recovery room. RESULTS: The youngest group of patients with chronic palatine tonsillitis showed the lowest pressure values while the oldest studied group consisted of patients who were operated due to chronic otitis media and this group demonstrated the highest BP values. The patients with treated or untreated hypertension should be pharmacologically normalised by an anaesthesiologist. However, considerable lowering of BP can often be not possible, contrary to the patients with normal BP. CONCLUSIONS: The own experience indicates that perioperative lowering of BP, including hypotension, ought to be avoided in cardiology patients. The postoperative BP raise, usually accompanied by pain, was noticed in the own studies. Therefore, effective analgesic treatment should be implemented in a recovery room.

Matrix Metalloproteinase-2 Inhibition in Acute Ischemia-Reperfusion Heart Injury-Cardioprotective Properties of Carvedilol.

Matrix metalloproteinase 2 (MMP-2) is activated in hearts upon ischemia-reperfusion (IR) injury and cleaves sarcomeric proteins. It was shown that carvedilol and nebivolol reduced the activity of different MMPs. Hence, we hypothesized that they could reduce MMPs activation in myocytes, and therefore, protect against cardiac contractile dysfunction related with IR injury. Isolated rat hearts were subjected to either control aerobic perfusion or IR injury: 25 min of aerobic perfusion, followed by 20 min global, no-flow ischemia, and reperfusion for 30 min. The effects of carvedilol, nebivolol, or metoprolol were evaluated in hearts subjected to IR injury. Cardiac mechanical function and MMP-2 activity in the heart homogenates and coronary effluent were assessed along with troponin I content in the former. Only carvedilol improved the recovery of mechanical function at the end of reperfusion compared to IR injury hearts. IR injury induced the activation and release of MMP-2 into the coronary effluent during reperfusion. MMP-2 activity in the coronary effluent increased in the IR injury group and this was prevented by carvedilol. Troponin I levels decreased by 73% in IR hearts and this was abolished by carvedilol. Conclusions: These data suggest that the cardioprotective effect of carvedilol in myocardial IR injury may be mediated by inhibiting MMP-2 activation.

Evaluation of selected parameters of the coagulation system during the perioperative period in patients undergoing endoscopic surgery of the paranasal sinuses.

INTRODUCTION: The aim of the study was to evaluate selected parameters of the coagulation system during the perioperative period in patients undergoing endoscopic sinus surgery. MATERIAL AND METHODS: The study involved 121 patients: group I - 42 patients who did not receive anticoagulatory or antiplatelet medications, qualified for endoscopic sinus surgery under total intravenous anaesthesia (TIVA); group II - 40 patients who received in the perioperative period low-molecular-weight heparins, qualified for endoscopic sinus surgery under TIVA; group III - 39 patients diagnosed according to a schedule, due to vertigo or loss of hearing. All the patients received a full laryngological examination and detailed audiological and otoneurological diagnostics, and examination of selected haemostatic parameters before the surgery/diagnostics. RESULTS: The analysis of concentrations of coagulation parameters in groups I and II revealed a statistically significantly higher international normalized ratio value before surgery (I - 1.11; II - 1.08) and 48 h following surgery (I - 1.15; II - 1.10) in group I. The concentration of coagulation factor VII in the study patients was considerably higher in group I for all three measurements (481.93; 443.13; 486.02). The concentration of fibrinogen (coagulation factor I) was significantly lower in group I before surgery (3.2) and at 6 h after surgery (2.84). A significantly lower level of von Willebrand factor was found in group I before surgery (2.94). Comparing test results of groups I and III, who did not receive antiaggregants, statistically significant differences were observed in both tests for factors VII and VIII. CONCLUSIONS: Concentrations of von Willebrand factor and prothrombin revealed statistically significant differences in between groups.

MMP-2, MMP-9, and TIMP-4 and Response to Aspirin in Diabetic and Nondiabetic Patients with Stable Coronary Artery Disease: A Pilot Study.

BACKGROUND: High on-aspirin treatment platelets reactivity (HPR) is a significant problem in long-term secondary prevention of cardiovascular events. We hypothesize that imbalance between platelets MMPs/TIMPs results in cardiovascular disorders. We also explored whether chronically elevated blood glucose affects MMP-2/TIMP-4 release from platelets. MATERIALS AND METHODS: Seventy patients with stable coronary artery disease, supplemented with aspirin, participated in this pilot study. The presence of HPR and/or diabetes mellitus was considered as the differentiating factor. Light aggregometry, impedance aggregometry, and ELISA tests for TXB2, MMP-2, MMP-9, and TIMP-4 were performed in serum, plasma, platelet-rich plasma, and platelets-poor plasma, as appropriate. RESULTS: Aspirin-HPR did not affect plasma MMP-2, MMP-9, and TIMP-4. Arachidonic acid-induced aggregation of platelets from aspirin-HPR patients did not lead to increased release of MMP-2, MMP-9, and TIMP-4. Studying patients at the lowest TXB2 serum concentration quartile revealed that high concentration of plasma TIMP-4 and TIMP-4 negatively correlated with TXB2 and platelet aggregation. Diabetics showed an increased plasma MMP-2 as well as an increased MMP-2 in supernatants after platelet aggregation. However, diabetes mellitus did not affect MMP-9 and TIMP-4. CONCLUSION: Aspirin-HPR did not affect the translocation and release of MMPs and TIMP-4 from platelets. TIMP-4 may serve as a marker of TXA2-mediated platelet aggregation. Chronically elevated plasma glucose increases plasma MMP-2, and HPR potentiates this phenomenon.

Two mutations in the tetracycline repressor change the inducer anhydrotetracycline to a corepressor.

We report for the first time the in vitro characterization of a reverse tetracycline repressor (revTetR). The dimeric wild-type repressor (TetR) binds to tet operator tetO in the absence of the inducer anhydrotetracycline (atc) to confer tight repression. We have isolated the revTetR G96E L205S mutant, which, contrary to TetR, binds tetO only in the presence of atc. This reverse acting mutant was overproduced and purified. Effector and DNA binding properties were analyzed by EMSA and quantified by fluorescence titration and surface plasmon resonance. The association constant K(A) of revTetR for binding of [atcMg](+) is approximately 10(8) M(-1), four orders of magnitude lower than that of TetR. The affinity of TetR for tetO is 5.6 +/- 2 x 10(9) M(-1) and that for revTetR in the presence of atc is 1 +/- 0.2 x 10(8) M(-1). Both induced forms, the atc-bound TetR and the free revTetR, have the same low affinity of 4 +/- 1 x 10(5) M(-1) for DNA. Therefore, atc does not act as a dimerization agent for revTetR. We discuss the structural differences between TetR and revTetR potentially underlying this reversal of activity.

[Mycophenolic acid concentration profiles may select recipients with high-risk of acute rejection in renal transplant recipients]. / Przydatnosc pomiarów stezenia kwasu mykofenolowego w osoczu w okresleniu zagrozenia wystapieniem ostrego odrzucania u biorców przeszczepu nerki.

UNLABELLED: The aim of the study was to assess relationship between the pharmacokinetics of mycophenolic acid (MPA) and the risk of developing acute rejection within 6 months after renal transplantation. MATERIAL AND METHODS: MPA concentrations were measured using validated HPLC. Venous blood samples for assay of MPA plasma concentrations were evaluated before (trough level; C) and 40 minutes, 1, 2 and 4 hours after mycophenolate mofetil (MMF) oral administration. The study included adult kidney cadaveric graft recipients: 26 patients treated with CsA, MMF and prednisone. MPA AUC was determined using the linear trapezoidal rule. Statistical significance was assessed using ANOVA Statistica. RESULTS: A total of 13 patients experienced biopsy proven rejection. Patients with acute rejection had lower GFR, lower serum albumin and were younger. There was statistically significant difference for MPA AUC(0-4), C40, C(max) between patients with acute rejection and patients with uneventful outcomes: mean MPA AUC(0-4): 11,4 +/- 7,23 microg x h/ml versus 34,0 26,8 microgxh/ml (p 0,01). Recipients with MPA AUC(0-4) <20 g x h/ml had a greater risk of acute rejection. CONCLUSIONS: MPA AUC(0-4) was a useful predictor of outcome in renal recipients within first 6 months after renal transplantation.

The influence of the body mass index (BMI) on selected parameters of the coagulation system in patients with disorders of the balance system taking oral contraceptives.

INTRODUCTION: The objective of the paper is to evaluate the influence of the body mass index (BMI) on selected parameters of the coagulation system in patients with disorders of the balance system taking oral contraceptives. MATERIAL AND METHODS: 105 young women participated in the study who were divided into 2 groups. Group I: 52 women disorders of the balance system taking hormonal contraceptives for at least 2 months, between the age of 20-49; Group II: 53 women with no disorders of the balance system taking hormonal contraceptives for at least 2 months, between the age of 18-40. Patients entering the study underwent full otoneurological examination, detailed laryngological assessment and the examination of selected parameters of the hemostasis system, including the evaluation of fibrinogen and D-dimer levels, APTT and PT, estradiol and progesterone concentrations in the blood serum and evaluation of the body mass index (BMI). RESULTS: Central vertigo was the most common type of vertigo in the study group (59,6% of cases). Other vertigo types in this group included compensated vertigo of mixed origin (36,6% of cases) and peripheral vertigo (only 3,8% of cases), which indicates that 40.4% of the cases suffer from damage to the labyrinth. The analysis of the concentration of estradiol in the blood serum revealed, after consideration of a menstrual cycle phase, that estradiol concentration exceeded normative values significantly more often in the study group than in the control group and that estradiol concentration was significantly less frequently below the norm in the study group; the difference was statistically significant (p=0,048). The body mass index (BMI) of women participating in the study significantly correlated with the concentration of D-dimers only in the study group (p=0,35 vs p=0,012). CONCLUSIONS: Evaluating the body mass index before administering hormonal contraception can be useful to eliminate other risk factors for thromboembolism. In order to prevent potential thromboembolism episodes, administering hormonal contraception only after lowering the body mass index may also be worth considering.

The influence of the body mass index (BMI) on selected parameters of the coagulation system in patients with disorders of the balance system taking oral contraceptives.

INTRODUCTION: The objective of the paper is to evaluate the influence of the body mass index (BMI) on selected parameters of the coagulation system in patients with disorders of the balance system taking oral contraceptives. MATERIAL AND METHODS: 105 young women participated in the study who were divided into 2 groups. Group I: 52 women disorders of the balance system taking hormonal contraceptives for at least 2 months, between the age of 20-49; Group II: 53 women with no disorders of the balance system taking hormonal contraceptives for at least 2 months, between the age of 18-40. Patients entering the study underwent full otoneurological examination, detailed laryngological assessment and the examination of selected parameters of the hemostasis system, including the evaluation of fibrinogen and D-dimer levels, APTT and PT, estradiol and progesterone concentrations in the blood serum and evaluation of the body mass index (BMI). RESULTS: Central vertigo was the most common type of vertigo in the study group (59,6% of cases). Other vertigo types in this group included compensated vertigo of mixed origin (36,6% of cases) and peripheral vertigo (only 3,8% of cases), which indicates that 40.4% of the cases suffer from damage to the labyrinth. The analysis of the concentration of estradiol in the blood serum revealed, after consideration of a menstrual cycle phase, that estradiol concentration exceeded normative values significantly more often in the study group than in the control group and that estradiol concentration was significantly less frequently below the norm in the study group; the difference was statistically significant (p=0,048). The body mass index (BMI) of women participating in the study significantly correlated with the concentration of D-dimers only in the study group (p=0,35 vs p=0,012). CONCLUSIONS: Evaluating the body mass index before administering hormonal contraception can be useful to eliminate other risk factors for thromboembolism. In order to prevent potential thromboembolism episodes, administering hormonal contraception only after lowering the body mass index may also be worth considering.

Evaluation of risk factors for oral cavity and oropharynx cancers in patients under the week activity program of head and neck cancers prevention in Lodz.

INTRODUCTION: The aim of the study was to evaluate risk factors for oral cavity and oropharynx cancers in patients under the week activity program of head and neck cancers prevention in Lodz. MATERIAL AND METHODS: 104 people reported to preventive examinations under the week activity program of head and neck cancers prevention in Lodz (25-th of September, 2015): 33 women aged 21-68 and 38 men aged 23-71. Before ENT examination, subjects completed the questionnaire, which concerned: the degree of education, source of information about preventive examinations, symptoms, smoking, number of smoked cigarettes, alcohol, number of life sexual partners, number of oral sex partners and family history of head and neck cancers. RESULTS AND CONCLUSIONS: The analysis showed that people who reported to preventive examination were mostly in the age group of 51-60 and over 60, respectively 71,2% of women and 57,9% of men. Patients were at the age, that predispose to oral cavity and oropharynx cancers. In our own material, 15,9% of women and 23,6% of men have smoked. Most of them have smoked 10-20 cigarettes daily. On the other hand, 40,9% of women and 10,5% of men didn't consume alcohol. In our study, both women and men had, at life, 1-3 sexual partners the most often, respectively 78,9% and 60,5%. The oral sex was cultivated by 45,5% of women and 60,5% of men, the most often with 1-3 partners, respectively 95,8% and 70,0%. Based on complete ENT examination and the presence of risk factors for oral cavity and oropharynx cancers, 14,4% of patients were qualified to further oncological examinations including: videolaryngostroboscopy, neck ultrasound with fine-needle biopsy, neck CT and HPV test.

Unilateral pathological lesions of paranasal sinuses removed by endoscopic surgery.

INTRODUCTION: The aim of this study was to analyze the incidence and nature of unilateral pathological lesions of paranasal sinuses in patients who had endoscopic sinus surgery performed in ENT. MATERIALS AND METHODS: In the years 2006-2011 endoscopic sinus surgery for unilateral pathological lesions of paranasal sinuses was performed in 1847 patients (838 women and 1009 men). The enrollment of patients was based on the findings of otolaryngological clinical and subjective examinations, assessment of the paranasal sinuses on three-dimensional CT scans, and laboratory examinations. Based on the analysis of medical history data, including gender, age, the type of surgical procedure performed, and histopathological findings the cases were finally analyzed. RESULTS: Pathological lesions of the paranasal sinuses were localized on the left side in 132 (57%) patients, and on the right side in 100 (43%) patients. Of the 232 patients with unilateral pathological changes, 41.8% subjects underwent endoscopic sinus surgery for polypotic changes in the ethmoid and maxillary sinuses; 28.4% for the maxillary sinus; 10.8% for the ethmoid, maxillary and frontal sinuses; and 8.6% patients for all paranasal sinuses on one side. The number of operations of only one sinus was considerably lower: sphenoid sinus, 4.7%; ethmoid sinus, 2.2%; and frontal sinus, 1.7% patients. The histopathological analysis of unilateral pathological lesions removed by endoscopic surgery showed chronic paranasal sinusitis with polyps in 56.5% patients; chronic paranasal sinusitis in 22.8% patients; and maxillary sinus cyst was confirmed in 11.6% patients. In 5.1% patients inverted papilloma was diagnosed and in 2.2% patients the presence of osteoma was found. CONCLUSIONS: Unilateral paranasal pathological lesions, leaving aside rather typical maxillary sinus cysts, require a particularly thorough pre-operative diagnosis and a precise histopathological assessment.

[Neoplastic tumors in patients with unilateral inflammations qualified for endoscopic surgery]. / Guzy nowotworowe u chorych z jednostronnymi zmianami zapalnymi zakwalifikowanymi do operacji endoskopowych.

INTRODUCTION: The aim of this work was to analyze the occurrence and type of neoplasm in unilateral pathological lesions within the nose and paranasal sinuses in patients who underwent endoscopic surgery, in own material. MATERIAL AND METHODS: Between 2006 and 2012 2295 patients, including 1006 women aged 15-84 and 1289 men aged 17-87, were operated on due to diseases of paranasal sinuses in the Department of Otolaryngology and Laryngological Oncology. The patients underwent surgery after a medical interview, physical examination, 3D CT of paranasal sinuses and laboratory tests. The removed lesions were histopathologically investigated. The studied group included the patients with only unilateral lesions and histopathologically recognized neoplastic lesion. RESULTS: In the studied material, neoplastic lesions occurred in 9.8% cases, out of which 5.4% were inverted papillomas, 3.1% osteomas, and 1.5% malignant tumors. However, in the patients who were operated due to hypertrophic changes within paranasal sinuses, neoplasm was found in 1.3% cases, while inverted papilloma in 0.7%, osteoma in 0.4% and malignant tumors in 0.1%, which altogether amounts to 8 times higher occurrence of neoplastic lesions in unilateral changes. RESULTS: Unilateral changes within paranasal sinuses require highly inquisitive pre-operative diagnostics, peri-operative analysis and histopathological evaluation.

[Inverted papilloma of the nose and paranasal sinuses in own material]. / Brodawczaki odwrócone nosa i zatok przynosowych w materiale wlasnym.

INTRODUCTION: The aim of this work was to analyze the occurrence of inverted papilloma within the nose and paranasal sinuses, the extent of lesions and the clinical course in the patients who underwent endoscopic surgery. MATERIALS AND METHODS: Between the years of 2006-2012, at the Department of Otolaryngology and Laryngological Oncology, 2295 patients were subjected to surgery due to paranasal sinus diseases. The material was based on their past medical histories. The analysis includes the age and gender of the patients, the type of surgery, and results of histopathological examinations. A surgical procedure covered the paranasal sinuses with lesions diagnosed in CT. The qualified patients had inverted papilloma in histopathological results. RESULTS: Among 2295 patients who were operated because of chronic inflammatory changes, inverted papilloma was histopathologically diagnosed in 49 cases. In 16 patients with inverted papilloma, inflammatory changes were present on one side only, while in 33 cases inverted papilloma was confirmed histopathologically on one side. The analysis of age and gender of the study group showed that the highest occurrence of inverted papilloma was in patients over 50 years of age. In the majority of the studied cases, inverted papilloma spread in the middle nasal concha and the maxillary or ethmoid sinus. CONCLUSIONS: In surgery, the endoscopic technique allows for an effective removal of inverted papilloma from the nose and paranasal sinuses. According to the authors, endoscopy is the most valuable method for post-operative monitoring of recurrent inverted papilloma.

Inflammation of the frontal intersinus septal air cell as a cause of headaches.

INTRODUCTION: The aim of this paper is to present a rare case of frontal intersinus septal air cell inflammation as a cause of headaches. PRESENTATION OF CASE: A 23-year-old patient was admitted to the Department of Otolaryngology and Laryngological Oncology for severe headaches during an upper respiratory tract infection. After neurological consultation including brain MRI and CT scanning of the paranasal sinuses, the inflammation of the frontal intersinus septal air cell was diagnosed. After examination, the patient was qualified for external osteoplasty. Under general endotracheal anaesthesia, the frontal intersinus septal air cell was intraoperatively opened from the side of the right frontal sinus, the mucoid content was aspirated and a plate of bone was removed. The patient reported complete relief from headaches on the second day after surgery. DISCUSSION: According to the previous studies, the frontal intersinus septal cell is more frequent in patients with frontal sinus inflammation than in the patients without inflammatory changes. Further, the conducted research indicates that its occurrence does not result in significant disorders in the drainage and ventilation of the frontal sinuses, and as such is not likely to be the cause of inflammation. CONCLUSION: In the case of inflammatory changes in the frontal intersinus septal air cell without concomitant frontal or ethmoid sinusitis, surgery via the external approach appears to be an effective method for the radical removal of pathological changes.