Grzegorz Namysłowski’s research while affiliated with Medical University of Silesia and other places

b> Introduction: Sleep is the physiological state of the body where proper morphology and duration are indispensable for human functions throughout both, physical and mental spheres. Disordered breathing during sleep impairs its morphology and results in major disorders in any age group. Adverse effects of Obstructive Sleep Apnea Syndrome in children and poor availability of centers offering children’s polysomnography call for a reliable and easily accessible screening method. Aim: The aim of the study were to evaluate the usefulness of pulse transit time in the diagnostics of disordered sleep breathing in children and to attempt to employ the parameter in screening tests. Pulse transit time is a physiological parameter determining the time needed for the pulse wave to travel between two measurement points. Material and methods: Enrolled in the retrospective study were 153 patients (100 boys and 53 girls) suspected of obstructive sleep apnea syndrome who underwent polysomnography at I. Mościcki ENT Hospital in Chorzów. Results: Statistically significant relations between apnea/hypopnea index and pulse transit time were observed in both, individual age groups and all of the patients. Pulse transit time results proved a negative correlation with apnea/hypopnea index values commonly accepted as a parameter concluding the polysomnography procedures. Conclusions: The results of the study indicate that pulse transit time measurements may find application in screening tests of sleep-disordered breathing in children.</br

The aim of this study was to evaluate a novel composite material for tracheal reconstruction in an ovine model. A polymer containing various forms of carbon fibers (roving, woven, and nonwoven fabric) impregnated with polysulfone (PSU) was used to create cylindrical tracheal implants, 3 cm in length and 2.5 cm in diameter. Each implant, reinforced with five rings made of PSU-impregnated carbon-fiber roving, had three external layers made of carbon-fiber woven fabric and the inner layer formed of carbon-fiber nonwoven fabric. The inner surface of five implants was additionally coated with polyurethane (PU), to promote migration of respiratory epithelium. The implants were used to repair tracheal defects (involving four tracheal rings) in 10 sheep (9-12 months of age; 40-50 kg body weight). Macroscopic and microscopic characteristics of the implants and tracheal anastomoses were examined 4 and 24 weeks after implantation. At the end of the follow-up period, outer surfaces of the implants were covered with the tissue which to various degree resembled histological structure of normal tracheal wall. In turn, inner surfaces of the prostheses were covered only with vascularized connective tissue. Inner polyurethane coating did not improve the outcomes of tracheal reconstruction and promoted excessive granulation, which contributed to moderate to severe stenosis at the tracheal anastomoses. The hereby presented preliminary findings constitute a valuable source of data for future research on a tracheal implant being optimally adjusted for medical needs.

Background: Otosclerosis is a cause of 5-9% of all hearing loss. The most effective treatment of otoslerosis is stapedotomy. Aim: The aim of this study was to evaluate the results of otosclerosis surgical treatment and to examine the impact of disease stage, time of the signs, age and sex on the results. Material and methods: 105 patients who underwent operation due to otosclerosis at the Department of Otolaryngology University Hospital in Zabrze at the age of 18-65 were analyzed. In 25 patients stapedotomy was bilateral. 130 cases of treated ears were included in the statistical analysis. The state of hearing after operation was evaluated with regard to guidance of Hearing and Balance Committee of American Academy of Otolaryngology - Head and Neck Surgery and with consideration of suggestions made by European Academy of Otolaryngology and Neurootology. Mean values of bone and air conduction, air bone gap before, one year after treatment, and at least 4 years after surgery were compared. The influence of stage of the disease in terms of Shambaugh index, lasting of signs, age and sex were evaluated with regard to change of mean hearing loss according to Bell Telephone Laboratories. Results: On the basis of hearing examination evaluating improvement in air and bone conduction and reduction of cochlear reserve, very good and good treatment results were obtained in over 90% of patients in short and long term observations. No influence of disease stage, time of signs lasting, age and sex on the results of treatment - with regard to change in mean hearing loss was shown.

The aim: of the study was to evaluate the oncological results of laryngeal cancer treatment performed in the Laryngology University Ward in Zabrze in the years 1990-2000, depending on the type of partial surgery applied. Materials and methods: Retrospective clinical material includes 209 patients in whom surgery was a primary treatment method. No distant metastases (M1) or another malignant cancer were found. In all 209 patients the squamous cell carcinoma of various degree of malignancy (G1-G3) was found. The most common operation in the analyzed group was a chordectomy - 83 surgeries (40%), next, vertical partial laryngectomies - 38 (18%), horizontal glottis surgeries - 28 (13%). In 79 patients (38%) partial laryngectomy was complemented with a nodal operation. The median of the observation period was 9 years. Local recurrence, nodal recurrence and distant metastasis are rated as treatment failure. Treatment effectiveness was evaluated with relation to overall survival, disease-free survival, cause specific survival and local control. All the above-mentioned parameters were analyzed with the updated percentages method. The level of statistical significance was assumed to be p≤0.05. Results: The best oncological results were observed after vertical operations. In the vertical operations group the most favourable oncological results were noted after chordectomy. 83% overall survivals, 82% disease-free survivals, 93% cause specific survivals and 96% local controls in the 5-year observation. On the other hand, the least favourable treatment results were observed after ¾ subtotal partial operation, after horizontal supraglottic operation and after reconstruction operation with CHP. Statistically significant differences in treatment results between the groups of patients after various types of partial operations were found in relation to local controls and disease-free survivals.

Background There is still controversy regarding the influence of aging on medial olivocochlear (MOC) system function. The main objective of this study is to measure age-related changes of MOC system function in people with normal hearing thresholds. Method Bilateral assessment of the MOC effect for click-evoked otoacoustic emissions (CEOAEs; at 70±3 dB peak sound pressure level [pSPL], click at 50/second, 260 repeats, 2.5–20 millisecond window) and for distortion product otoacoustic emissions (DPOAEs; with [frequencies] f2/f1=1.22, [levels of primary tones] L1=65 dB SPL and L2=55 dB SPL; DP-grams for 2f1–f2 were collected for the f1 frequencies varying from 977 Hz to 5,164 kHz, with the resolution of four points per octave) was performed in a group of 146 (n=292 ears) healthy, right-handed subjects aged from 10–60 years with a bilateral hearing threshold from 0.25–4.0 kHz, not exceeding 20 dB hearing level; normal tympanograms; and a threshold of the contralateral stapedial reflex for broadband noise (BBN) of 75 dB SPL or higher. The MOC inhibition was assessed on the basis of changes in OAE level during BBN contralateral stimulation at 50 dB sensation level (mean, 65±3 dB SPL). Results Comparative analysis of the MOC effect for CEOAE and DPOAE showed the weakest effect in the oldest age group (41–60 years) at almost all tested frequencies. Moreover, a weak, albeit significant, positive correlation between the level of OAE and the size of the MOC effect was documented. Conclusion On the basis of our study, we have found a decrease in the strength of the MOC system with increasing age in normally hearing subjects, as reflected by a decrease of the OAE suppression effects in older individuals and an increase of the number of CEOAE and DPOAE enhancements during contralateral acoustic stimulation in the elderly, especially in the high-frequency range.

Conclusion: The severity of laryngeal mucosal lesions in patients with gastroesophageal reflux disease (GERD) is significantly greater than in controls. A higher degree of laryngeal mucosal injury is documented in patients in whom GERD is associated with more advanced esophageal lesions. Objectives: (1) To confirm the presence of inflammatory lesions in the laryngopharynx of patients with GERD. (2) To analyze the relationship between the severity of laryngopharyngeal and esophageal lesions on the basis of the reflux finding score (RFS) and the Los Angeles (LA) scale of esophageal mucosal injury. Methods: The study included 92 subjects, among them 46 patients with GERD and 46 individuals without endoscopic evidence of esophageal lesions, qualified for routine endoscopy due to other indications. The endoscopic images of the inferior pharynx, larynx, and esophagus were analyzed during the video-endoscopic examination of the upper gastrointestinal tract. The laryngeal images were assessed according to RFS criteria and the numeric value of RFS was calculated. The degree of esophageal mucosal injury was described according to the LA scale. Results: Both global RFS score and the scores of all RFS parameters except the presence of granulomatous tissue were significantly higher in patients with GERD than in the controls. Patients in whom GERD was associated with more severe esophageal lesions (group B according to the LA scale) had significantly higher global RFS score and scores of all analyzed parameters of laryngeal injury except subglottic edema than individuals in whom the degree of esophageal involvement was classified as group A.

Background: Chronic nature of the nasal polyps, tendency to recurrence, and lack of satisfying treatment need the diagnostic's parameters which show early inflammatory state as ferritin and hs-CRP. The Aim of Study. Assessment of hs-CRP and ferritin blood levels in nasal polyps patients in evaluation of treatment efficacy. Methods: All 38 patients were divided into 2 groups. Group I included 19 patients with anti-inflammatory therapy 2 weeks after surgery. Group II included 19 patients without anti-inflammatory therapy 2 weeks after surgery. The levels of hs-CRP and ferritin have been assessed before and 2 and 6 weeks after surgical treatment. Results: Research showed statistically significant difference of ferritin's concentration between examined groups 6 weeks after surgery (P < 0.05) and statistically significant difference of hs-CRP concentration 2 and 6 weeks after surgery (P < 0.05). Conclusion: (1) The analysis of serum ferritin and hs-CRP concentrations can be useful in early postoperative detection of inflammatory state in patients with nasal polyps and for the effectiveness of therapy. (2) Lack of correlation between mean ferritin and hs-CRP serum levels, at each diagnostic and monitoring stage, shows that they are independent and cannot be determined interchangeably.

The bleeding and haemorrhage is strictly related with accidents and many medical procedures. In some conditions it leads to hypovolaemia and further to hypovolaemic shock. Under conditions of haemorrhagic shock, heart rate and blood pressure critically collapse. Reversing the sympathoinhibitory phase of hypovolaemia could be crucial for clinical management of injured patients after haemorrhage. Systemic administration of 5-HT1A agonists seams to produce resuscitating effects. The aim of this study was to investigate the participation of central serotonin and, in particular, 5-HT1A receptors in cardiovascular regulation in haemorrhagic shock in rats. Intracerebroventricular (i.c.v.) administration of serotonin (5-HT) increased the heart rate (HR), mean arterial pressure (MAP) and implicated that all haemorrhaged animals survived for the whole observation time (2 hours). Similar, although significantly more minor, effects were achieved after selective 5-HT1A activation. Moreover, the i.c.v. administration of selective 5-HT1A antagonist before i.c.v. 5-HT injection partially inhibited 5-HT induced changes. The results of the present work indicate that 5-HT plays an important role in the reversal of the haemorrhagic shock in rats. These effects are at least partially dependent on activation of 5-HT1A receptors.

INTRODUCTION: The aim of the study was to evaluate the results of radical surgery in group of 355 patients with advanced laryngeal cancer. MATERIAL AND METHOD: The paper presents results of treatment in group of 355 patients with advanced laryngeal cancer treated in the ENT Clinical Department in Zabrze in the following years 1998-2007. The advancement stage was defined as III in 147 patients (42%), as IV in 208 patients (58%). Group of 250 patients (70%) underwent total laryngectomy and group of 105 patients (30%) underwent pharyngolaryngectomy. In the group of 327 patients (92%) operation was performed microscopically radically. 298 patients (84%) underwent postoperative radiotherapy. Median follow-up period was 5 years. Local recurrence, nodal recurrence and distant metastasis were rated as treatment failure. Treatment effectiveness was evaluated in relation to overall survival, disease-free survival, local control, locoregional control and observation free from metastases. All of these parameters were analyzed with the method of updated percentages. RESULTS: During observation period 177 patients (50%) died. Local recurrence occurred in 47 patients (13%), nodal recurrence occurred in 19 patients (5%). Distant metastases occurred in 26 patients (7%). 5-year overall survival rate (OS) was 50%. 5-year disease-free survival rate (DFS) was 47%. 5-year local control rate (LC) was 81%. 5-year locoregional control rate (LRC) was 75%. The updated 5-year observation free from metastases rate (FFM) was 89% respectively. CONCLUSION: Radical surgery is the chance of 5-year survival of 50% of patients with advanced cancer of the larynx and of 5-year locoregional control of 75% patients.

IntroductionThe aim of the study was to evaluate the results of radical surgery in group of 355 patients with advanced laryngeal cancer.Material and methodThe paper presents results of treatment in group of 355 patients with advanced laryngeal cancer treated in the ENT Clinical Department in Zabrze in the following years 1998–2007. The advancement stage was defined as III in 147 patients (42%), as IV in 208 patients (58%). Group of 250 patients (70%) underwent total laryngectomy and group of 105 patients (30%) underwent pharyngolaryngectomy. In the group of 327 patients (92%) operation was performed microscopically radically. 298 patients (84%) underwent postoperative radiotherapy. Median follow-up period was 5 years. Local recurrence, nodal recurrence and distant metastasis were rated as treatment failure. Treatment effectiveness was evaluated in relation to overall survival, disease-free survival, local control, locoregional control and observation free from metastases. All of these parameters were analyzed with the method of updated percentages.ResultsDuring observation period 177 patients (50%) died. Local recurrence occurred in 47 patients (13%), nodal recurrence occurred in 19 patients (5%). Distant metastases occurred in 26 patients (7%). 5-year overall survival rate (OS) was 50%. 5-year disease-free survival rate (DFS) was 47%. 5-year local control rate (LC) was 81%. 5-year locoregional control rate (LRC) was 75%. The updated 5-year observation free from metastases rate (FFM) was 89% respectively.Conclusion Radical surgery is the chance of 5-year survival of 50% of patients with advanced cancer of the larynx and of 5-year locoregional control of 75% patients.