Jarosław Paluch

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.

Transforming growth factor β isoforms (TGF-β1, TGF-β2, TGF-β3) messenger RNA expression in laryngeal cancer

PURPOSE Cancerogenesis is a multistage process controlled by many cytokines, including growth factors. The aim of the study was the comparison of transcriptional activity of transforming growth factor beta (TGF-beta) genes in laryngeal squamous cell carcinomas and adjacent nonneoplastic tissues. MATERIALS AND METHODS Tissues samples were obtained from 32 patients with laryngeal squamous cell carcinoma in histologic grades G1 to G3 who underwent surgical treatment at the ENT Clinics of Medical University of Silesia in Katowice, Poland. Quantification of gene expression was performed by real-time quantitative reverse transcriptase polymerase chain reaction technique. RESULTS In tumor cells, expression of TGF-beta1 and TGF-beta2 isoforms (P < .001) was higher than in normal tissues. There was a positive correlation between the expression of TGF-beta1 and TGF-beta2 genes in tumors (R = 0.78, P = .0000) and adjacent normal tissues (R = 0.77, P = .0000). CONCLUSIONS The results suggest that TGF-beta1 and TGF-beta2 messenger RNAs may be useful as molecular markers in distinguishing cancer from nonneoplastic tissues in laryngeal area.

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.

The Influence of Ethanolic Extract of Brazilian Green Propolis Gel on Hygiene and Oral Microbiota in Patients after Mandible Fractures

Maintenance of proper oral hygiene by dental plaque elimination is one of the most important factors affecting the healing process in postoperative oral wounds. Propolis is a substance produced by bees. Ethanolic extract of propolis has bactericidal, fungicidal, anti-inflammatory, and antioxidative properties. Moreover, it can scavenge free radicals. The purpose of this paper is to demonstrate the efficacy of a gel containing 3% of ethanolic extract of Brazilian green propolis (EEP-B) when used for maintaining oral hygiene in patients with postoperative oral mucosal wounds. The hygiene was assessed using API, OHI, and SBI followed by microbiological examinations. The patients were divided into two groups. Group 1 consisted of those who used a gel containing EEP-B for oral hygiene, and group 2 consisted of those who used a gel without EEP-B. Although improved oral hygiene was noted in both groups, the improvement was markedly greater in the group using gel containing EEP-B. Summing up the results of microbiological examinations, EEP-B has beneficial effect on mouth microflora in postoperative period. Propolis preparations used for oral hygiene allow eliminating microorganisms of pathogenic character and physiological flora microorganisms considered as being opportunistic, with no harmful influence on physiological microflora in oral ecosystem.

Primary orbital tumors: A review of 122 cases during a 23-year period: A histo-clinical study in material from the ENT Department of the Medical University of Silesia

Background The aim of this study was to investigate the distribution of different types of primary orbital tumors, histopathological diagnosis, and postoperative complications. Material/Methods We analyzed 122 patients (68 women and 54 men) with orbital tumors, hospitalized in the ENT Department of the Medical University of Silesia in Katowice during 1990–2013. The patients were characterized in terms of anatomic, topographical, histopathological, and clinical parameters. The role of diagnostic imagining such as CT, NMR, and fine-needle aspiration (FNB) in preoperative diagnostics is discussed. Results of FNB, cytological, and histopathological examination of the postoperative specimens were compared. Results There were 56 (46%) patients with malignant tumors, 42 (34%) with benign tumors, 19 (16%) with inflammatory tumors, and 5 patients (4%) had other tumors. In cases of malignant tumors, local recurrence up to 5 years was found in 36 (64.3%) cases. In the other 20 (35.7%) cases of malignant tumors, the patients remained under close follow-up in the outpatient clinic, without signs of local recurrence (follow-up 1–17 years). According to histopathological examination, malignant tumors were detected in 45.9% of patients and non-malignant tumor in 34.4% of patients. In 19.7% of patients, inflammatory and other types of tumors were diagnosed. Conclusions We characterized the occurrence and pathological profiles of orbital tumors. The tumor location, histopathological diagnosis, and postoperative complications give us important information for the diagnosis of tumor prior to biopsy or tumor resection and for the determination of the treatment strategy and possible complications after surgery.

Ropowice głowy i szyi – diagnostyka i leczenie – obserwacje własne

Summary Introduction Head and neck phlegmons are rare diseases, however they are associated with high risk of mortality. They can derive from different structures of the described anatomical area. They are often odontogenic. Imaging studies, especially computerized tomography play the greatest role in diagnosis of phlegmons. The treatment is based on surgical incision and drainage as well as analgesia. Materials and methods A retrospective analysis was conducted on 11 patients from three different ENT centers: ENT Department of the Medical University of Silesia in Katowice, ENT Department of the Municipal Hospital in Sosnowiec and ENT Department of the Hospital No.1 in Bytom. Laboratory results, imaging results, treatment and other factors influencing the course of the disease were analyzed. Results Most patients were males and the average age was 50.8. In most cases the phlegmons were diffused and localized in different regions of head and neck. The phlegmons were mainly located in the carotid and parapharyngeal space. Streptococci and staphylococci were the most common pathogenes found in the examined material. Antibiotics and metronidasol were effective in all cases. Two types of surgical procedure were performed – either common abscess incision or broad incision along sternocleiodomastoid muscle. Conclusions Head and neck phlegmons are rare and they affect patients at any age. The dominating localization of the phlegmons depends mainly on the starting point. Computerized tomography plays the most important role in diagnosis. The treatment is based on surgical procedures and antibiotics.INTRODUCTION Head and neck phlegmons are rare diseases, however they are associated with high risk of mortality. They can derive from different structures of the described anatomical area. They are often odontogenic. Imaging studies, especially computerized tomography play the greatest role in diagnosis of phlegmons. The treatment is based on surgical incision and drainage as well as analgesia. MATERIALS AND METHODS A retrospective analysis was conducted on 11 patients from three different ENT centers: ENT Department of the Medical University of Silesia in Katowice, ENT Department of the Municipal Hospital in Sosnowiec and ENT Department of the Hospital No.1 in Bytom. Laboratory results, imaging results, treatment and other factors influencing the course of the disease were analyzed. RESULTS Most patients were males and the average age was 50.8. In most cases the phlegmons were diffused and localized in different regions of head and neck. The phlegmons were mainly located in the carotid and parapharyngeal space. Streptococci and staphylococci were the most common pathogenes found in the examined material. Antibiotics and metronidasol were effective in all cases. Two types of surgical procedure were performed - either common abscess incision or broad incision along sternocleiodomastoid muscle. CONCLUSIONS Head and neck phlegmons are rare and they affect patients at any age. The dominating localization of the phlegmons depends mainly on the starting point. Computerized tomography plays the most important role in diagnosis. The treatment is based on surgical procedures and antibiotics.

Chrzęstniakomięsaki krtani i zatoki szczękowej – przegląd literatury i opis trzech przypadków

Chondrosarcoma is a very rare neoplasm in the head and neck region. This region is associated with favourable prognosis. Only 340 cases of chondrosarcoma of the larynx and nearly 300 of sinus maxillaris have been reported in this localization. The most reasonable treatment is radical surgery. Radiotherapy and chemotherapy are of little value. Without metastasis the long term prognosis is excellent. Clinical, pathologic and radiologic characterities of these tumors are described and review of the literature is presented. The authors present two cases chondrosarcoma of the larynx and one case chondrosarcoma of sinus maxillaries.Summary Chondrosarcoma is a very rare neoplasm in the head and neck region. This region is associated with favourable prognosis. Only 340 cases of chondrosarcoma of the larynx and nearly 300 of sinus maxillaris have been reported in this localization. The most reasonable treatment is radical surgery. Radiotherapy and chemotherapy are of little value. Without metastasis the long term prognosis is excellent. Clinical, pathologic and radiologic characterities of these tumors are described and review of the literature is presented. The authors present two cases chondrosarcoma of the larynx and one case chondrosarcoma of sinus maxillaries.

Magnetic Resonance Tractography in Neuroradiological Diagnostic Aspects

: Diffusion tensor imaging is unique in its ability to non-invasively visualize white matter fiber tracts in the human brain in vivo. White matter fiber bundles of the human brain form a spatial defined by the anatomical and functional architecture. Determination of axonal pathways provides an invaluable means to study the connectivity of human brain and its functional network. Comparison of fiber tract properties across subjects requires comparison at corresponding anatomical locations. In this paper, we present application of white matter tractography method based on incoherent motion of water molecules in fiber tissue, mainly in central nervous system. This motion is itself dependent on the micro-structural environment that restricts the movement of the water molecules. In white matter fibers there is a pronounced directional dependence on diffusion. With white matter fiber tracking or tractography, projections among brain regions can be detected in the three-dimentional diffusion tensor dataset according to the directionality of the fibers. The authors indicate diagnostic possibilities of MR tractography in otolaryngology for imaging the nervous tracts of sense of hearing, smell and taste with particular consideration of otoneurological evaluation of patients with cochlear implants and bone anchored hearing aid (BAHA). White matter tracts can be evaluated independently by using diffusion tensor tractography, which appears to be a promising technique for determining changes in white matter in degenerative disease. The authors also indicate that method as a beneficial in the surgical planning for patients with intrinsic brain tumors.

The influence of environmental pollution on the amount of glycosoaminoglycans in the tissue of palatine tonsils.

In this study, we investigated persons exposed to high and low air pollution caused by metals. This investigation was done against the background of changes in the connective tissue of palatine tonsils. We evaluated the qualitative and quantitative composition of glycosoaminoglycans (GAG) isolated from palatine tonsils. GAGs were separated by column chromatography. We found that as the total amount of GAGs increased, the amount of heparin and chondroitin sulphate also increased, whereas the amount of hyaluronic acid, dermatane sulphate, heparane sulphate and keratane sulphate decreased. The changes observed in the amount of GAGs in the tissue of palatine tonsils can influence the incidence of infections of the upper airways.