Gierek T

Metal-proteinase ADAM12, kinesin 14 and checkpoint suppressor 1 as new molecular markers of laryngeal carcinoma

The assessment of gene expression profile in laryngeal cancer allows implementation of molecular biology methods in diagnostics, as well as in prognosticating the course of disease, thus allowing taking most optimal decisions as regards the method of treatment, scope of surgical procedure, or the necessity of adding complementary radiotherapy. The aim of the project was to analyze the gene expression profile in laryngeal cancer using oligonucleotide microarrays, having in mind searching new molecular markers for that carcinoma. The study comprised a group of 43 patients (38 males and 5 females) suffering from squamous cell laryngeal carcinoma, diagnosed and surgically treated in the years 2005–2007 in the ENT Department of the Silesian Medical University in Katowice, Poland. RNA was isolated from frozen tissue fragments, with the use of columns RNeasy Midi and Mini Kit (Qiagen). For the examination of gene expression profile, oligonucleotide microarrays of high density were used, provided by Affymetrix (U 133 2.0 PLUS) containing over 54,000 probes for over 47,000 transcripts. Four genes previously not examined in that respect in laryngeal carcinoma, occurred to be good markers of the neoplasm. They are: metal-proteinase ADAM12, cyclin-dependent kinase 2–CDK2, kinesin 14–KIF14, suppressor 1 of checkpoint–CHES1. The analysis of gene expression profile allows, in laryngeal carcinoma, to point out to new genes, which in future may become molecular markers of the carcinoma.

Intraorbital foreign bodies - 5 own cases and review of literature

Five patients were surgically treated for intraorbital foreign body: a 14-year-old girl had a door glass splinter, a 23-year-old man a metallic foreign body--gunshot pellet, a 55-year-old man a splinter from a metallic bar, a 48-year-old patient the splinters of circular saw and 61-year-old man with shot. Two foreign bodies were removed using the Krönlein-Reese-Berk lateral orbitotomy, two others by Sewell medial orbitotomy and one with superior orbitotomy of Dandy-Naffziger. Radiographs and CT scans were used to identify and localize intraorbital foreign bodies. In one case we found coexistence foreign body (shot) and tumor--inflammation pseudotumor of the orbita. It is possible, that in this case long-time occupy foreign body in the orbita was a cause of that tumor. All foreign bodies were successfully removed, and postoperative course was uneventful. The Krönlein-Reese-Berk orbitotomy provides a satisfactory access to the lateral and posterior orbit, which is of particular importance in the case of a deeply penetrating foreign body (metallic or glass). Surgical removal of intraorbital foreign bodies is a classic example of an interdisciplinary therapeutic approach. Best outcome is usually a result of a team of an ophtalmologist, ENT surgeon, maxillary surgeon and possibly also neurosurgeon performing the operation.

The assessment of hearing organ of school children in Upper Silesia region.

Because at present no estimated data is available concerning the frequency of hearing loss in the population of primary school children in Silesia, it has been assumed useful to carry out a research programme. An important advantage of this study is the assessment of hearing in children from Upper Silesian region, a top ranking region in Europe in industrialisation and environmental pollution. In the selected population of primary school children in the province of Silesia, hearing loss occurred in 6% of the examined pupils; in schools located in urban areas it was higher than in schools from rural areas. In the group of children aged 6-10 years conductive hearing loss occurred significantly more frequently, than main cause of that hearing loss was Eustachian tube dysfunction. The obtained results testify about the society being hardly aware of the problems related to hearing loss, which stresses the necessity of conducting screening examinations of hearing organ in children at school age, as well as improving the health care and prevention in that respect.

Analiza histokliniczna guzów ślinianek przyusznych u chorych operowanych w okresie 20 lat w Klinice Laryngologii ŚlAM w Katowicach

Summary Introduction Salivary gland neoplasms represent the diverse group of tumours encountered by the head and neck surgeons. Material and methods The study is analysis of 531 patients with parotid gland tumours in patients treated in ENT Department during 1986–2006. We analysed surgical treatment and intraoperative tumour stage. The results of histological diagnosis were presented. Results The frequency of incidence of benign neoplasm was 80%. The most frequent tumour was pleomorphic adenoma – 75% and adenolymphoma – 16%. Malignant tumours constituted 20% of all gland tumours. Mucoepidermoid (27%) and adenoid cyst (22%) carcinomas were the most common malignant tumour. Tumour stages T3–T4 was in 90%.INTRODUCTION Salivary gland neoplasms represent the diverse group of tumours encountered by the head and neck surgeons. MATERIAL AND METHODS The study is analysis of 531 patients with parotid gland tumours in patients treated in ENT Department during 1986-2006. We analysed surgical treatment and intraoperative tumour stage. The results of histological diagnosis were presented. RESULTS The frequency of incidence of benign neoplasm was 80%. The most frequent tumour was pleomorphic adenoma--75% and adenolymphoma--16%. Malignant tumours constituted 20% of all gland tumours. Mucoepidermoid (27%) and adenoid cyst (22%) carcinomas were the most common malignant tumour. Tumour stages T3-T4 was in 90%.

Assessment of vestibulocochlear organ function in patients meeting radiologic criteria of vascular compression syndrome of vestibulocochlear nerve – diagnosis of disabling positional vertigo

Summary Background This study sought to assess the vestibulocochlear organ in patients meeting radiologic criteria of vascular compression syndrome (VCS) of the eighth cranial nerve. Material/Methods The authors performed a retrospective analysis of 34 patients (18 women, 16 men; mean age, 49 years) treated in between 2000 and 2007, with VCS of the eighth cranial nerve by MRI. Contrasted magnetic resonance imaging identified an anterior inferior cerebellar artery vascular loop adhering to the vestibule-cochlear nerve in all 34 cases. All patients were given pure tone audiometry, distortion product otoacoustic emissions, auditory brainstem response, and electroneurographic examinations. Results Most-common symptoms were unilateral hearing loss (82%), unilateral tinnitus (80%), and dizziness (74%). Most-frequent abnormalities in performed examinations were specific auditory brainstem response changes (interpreted according to Möller’s criteria) in 86% of cases and sensorineural hearing loss in pure tone audiometry (82%). Abnormal changes in electronystagmography were found in the absence (12%) or weakness (35%) of a caloric response. No patients were surgically treated. Conclusions Significantly, there is no more weakness or absence of the caloric response of a vestibular organ in a patient with vascular compression of the vestibulocochlear nerve. Despite an absence of electrophysiologic testing of vestibular organ dysfunction, most examined patients (meeting the radiologic criteria of VCS of the eighth cranial nerve) had subjective symptoms like vertigo and dizziness. Disabling positional vertigo should be considered in the differential diagnosis of vertigo when accompanied by tinnitus or deafness.

Adenosine deaminase and purine phosphorylase activities in lymphocytes and red blood cells of patients with carcinoma of the larynx.

Lymphocytes from patients with cancer of the larynx have been characterized by the activity of two enzymes involved in purine metabolism--adenosine deaminase and purine nucleoside phosphorylase. It has been shown that purine nucleoside phosphorylase activity was 1.5-fold higher in lymphocytes of patients in comparison with a group of healthy individuals. Adenosine deaminase activity in lymphocytes was elevated three to four-fold. The authors suggest that especially the estimation of adenosine deaminase activity in lymphocytes would be a useful laboratory test in the study of immune responsiveness of patients with cancer of the larynx.

Enzymatic deficiencies of the immune system cells in patients with cancer of the larynx and other malignancies.

Activity of N-acetyl-beta-D-glucosaminidase, beta-glucuronidase, and acid phosphatase and myeloperoxidase was determined in neutrophils and lymphocytes of patients with cancer of the larynx and precancerous states of the larynx as well as--for comparative reasons--in patients with malignant tumors of female generation organs, breast carcinoma, cancer of the stomach and endometriosis. The main result of investigations performed was in fact that intracellular deficiency of beta-glucuronidase within the neutrophils characterizes patients with cancer and precancerous states of the larynx. Patients with cancer of the larynx show additionally a deficiency of neutrophil myeloperoxidase. Deficiency of N-acetyl-beta-D-glucosaminidase occurs, in contrast, in patients with malignancies of female generation organ. Activity of myeloperoxidase in neutrophils from patients with gastric carcinoma is slightly elevated.

Lymphocytes, neutrophils and serum immunoglobulins in patients with precancerous states of the larynx.

In 24 men aged 32 to 58 years with precancerous states of the larynx, i.e., leukoplakia, papillomas and pachydermia the peripheral blood lymphocytes were cytochemically stained for N-acetyl-beta-glucosaminidase, beta-glucuronidase, acid phosphatase and glycogen; and the neutrophils were stained for alkaline phosphatase, myeloperoxidase and lipids. The results were expressed in terms of the absolute counts of reaction-positive cells and of the activity index score. The serum immunoglobulins IgG, IgA and IgM were also determined by Mancinis method. The results obtained were compared with those in 20 healthy men aged 20 to 30 years. The patients exhibited elevated numbers of N-acetyl-beta-glucosaminidase and beta-glucuronidase-positive lymphocytes. A characteristic feature was an increase in the absolute counts of lymphocytes with diffuse and granular-diffuse types of cytochemical reaction for all enzymes studied. The number of cells with the granular type of enzymatic reaction (intact enzyme-positive lysosomes) was significantly diminished. These cytochemical alterations were accompanied by a significant increase in the serum IgA level. These results are discussed with reference to the lymphoid system response to tissues of precancerous lesions of the larynx. So far as the neutrophils are concerned the patients exhibited significant intracellular deficiency of beta-glucuronidase and decrease in the lipid content as well as an elevated alkaline phosphatase activity. The possible significance of the beta-glucuronidase deficiency in neutrophils for the diminished cytotoxic response of these cells against the tumor and precancerous lesion cells is discussed.

The intracellular enzymatic response of neutrophils and lymphocytes in patients with precancerous states and cancer of the larynx

In patients with precancerous states and cancer of the larynx prior to and after radiotherapy exhibit the decreased activity of neutrophil beta-glucuronidase. Moreover patients treated by radiotherapy before the age of 6 to 9 years demonstrate deficiency of N-acetyl-beta-glucosaminidase in the above cells. The main finding in lymphocytes of the patients studied was in the appearance by diffusion of the above enzymes and of acid phosphatase in the cytoplasm, reflecting their release from lysosomes and immunological mobilization of these cells. The authors discuss the possible role of neutrophil enzymatic deficiency in lowering the antitumour cytotoxic effect of these cells.

Gruźlica narządów głowy i szyi – wciąż aktualny problem w praktyce laryngologicznej ☆

Summary Introduction It is estimated that between XVI and XIX century one fourth of European population died of tuberculosis. Nowadays tuberculosis is still one of the most important infectious diseases. In 2009 estimately 9 million new cases were registered worldwide, mortality due tuberculosis reached 1.5 million. In Poland extrapulmonary tuberculosis is rare (7% of overall morbidity) and most commonly affects pleura, lymph nodes, bones, joints and genitourinary system. Head and neck tuberculosis is rare and causes many diagnostics problems. Methods Retrospective analysis of case histories of patients admitted to ENT Department of Silesian Medical University in Katowice. Results Between 1993 and 2010 four cases of head and neck tuberculosis were diagnosed in our Clinic. Two of patients were admitted to the hospital with symptoms of laryngeal tumor such as difficulty in swallowing. During direct laryngoscopy tissue specimens were taken. Examination of the third patient showed tumor located below left angle of mandibule. During superficial parotidectomy tumor was removed. In the fourth registered case tuberculosis manifested as tumor of nasopharynx. In every case which is mentioned above pathology reports revealed epithelioid cell granulomas with caseous necrosis typical for tuberculosis. Patients underwent tuberculostatic treatment. Conclusion Rare occurence and lack of characteristic symptoms of head and neck tuberculosis often lead to misdiagnosis. Histopathological examination is the most important diagnostic procedure. Microbiological examination is difficult in extrapulmonary tuberculosis, because of low concentration of pathogens in specimens. Tuberculostatic therapy is the leading method of treatment in every case of tuberculosis.