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Biomedical subjects

G Namysłowski

Publications and source records attributed to G Namysłowski.

At least 19 recordsLinked to original sources

Sleep study in patients with overweight and obesity.

Obstructive sleep apnea syndrome (OSAS) is a disorder characterized by repetitive collapse of the pharyngeal airway during sleep, which leads to oxygen desaturation, sleep fragmentation and daytime somnolence. Obesity is one of the most important risk factor for the development of OSAS. The exact mechanisms responsible for the relationship between obesity and OSAS are still unclear. The fat deposits in the pharynx region as well as the reduction in the lung volume have been considered as factors that might be responsible for the increase of the upper airway collapsibility. The aim of our study was to evaluate the correlation between the Body Mass Index (BMI) and sleep study parameters in overweight and obese patients suffering from breathing disturbances during sleep. We studied a group of 106 consecutive obese or overweight patients with a primary complaint of snoring or other breathing disturbances during sleep. In all cases, BMI and sleep studies (PolyMESAM) were examined. We evaluated relationship between the BMI and sleep study parameters such as Respiratory Disturbance Index (RDI), Apnea Index (AI), Desaturation Index (DI) and Average of Lowest Saturation (LSAT). The results showed the lack of significant statistical correlations between BMI and all the sleep parameters studied in the overweight patients and the statistical positive correlation between the BMI and RDI in the obese cases. We conclude that BMI determination may be considered as a simple, yet important predictor, of the OSAS in the group of obese patients.

Adult↗

The nasal airway evaluation in morbid obesity.

The aim of the present study was to evaluate objectively the nasal patency in the obese patients. A total of 18 morbidly obese patients were recruited for the study. All of them were surgically treated because of morbid obesity using Bilo-Pancreatic Diversion (BPD) or Laparoscopic Gastric Banding (LGB) methods. The patients were free of nasal abnormalities, such as septum deviation, polyps, nasal concha hypertrophy and paranasal sinus diseases. This group comprised 10 men and 8 women aged from 17 to 54. The mean Body Mass Index (BMI) was 51.6 kg/m(2), ranged from 34.7 to 61.8 kg/m(2). In all of the patients the nasal patency was examined by active anterior rhinomanometry according International Standardization Rhinomanometric Committee using air pressure 75, 100 and 150 dPa. The results were compared to the healthy control group. The correlation between BMI and nasal airflow pressure was also examined. We found that inspiration values for 75, 100 and 150 dPa as well as the expiration values for 100 and 150 dPa in standard method and expiration values for 100 and 150 dPa in Broms method using anterior rhinomanometry in morbidly obese patients were statistically significant higher in comparison with the healthy controls. No statistical significant correlation between BMI of obese patients and the airflow pressure values was found. We conclude that in the morbid obesity the nasal patency is reduced as compared to the healthy controls.

Adolescent↗

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.

Adult↗

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.

Acoustic Impedance Tests↗

[Deafness, as a complication of Pseudomonas aeruginosa septicemia in a 9-year old boy with acute lymphoblastic leukemia].

We described natural history of Pseudomonas aeruginosa septicemia in 9 year old boy, who was treated for acute lymphoblastic leukemia (ALL). After 14 day treatment of ALL the following signs and symptoms occurred: fever, earache with otorhoea, deafness, bilateral peripheral paralysis of n. VII, erythema, pneumonia, paralytic ileus. After 4 weeks of antimicrobial and supportive therapy, in the 10th week of chemotherapy, he achieved haematological remission. During continuation therapy, two-stage bilateral myringoplasty was performed. At present the maintenance therapy is continued, and in the future hearing aid and cochlear implant, will be applied.

Child↗

[Monitoring of neurophysiologic modalities during surgery for cerebellopontine angle tumors. Personal experiments].

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.

Adolescent↗

[A case of tongue neoplasm in a 15-year old patient treated with immunosuppressants for renal insufficiency].

The case of lingual cancer in the 25-years old man treated in 2nd ENT Department Silesian Medical Academy in Zabrze was presented in this paper. The patient has been treated from 1989 due to chronic pyelonephritis finished with the renal insufficiency. In 1991 the renal graft was performed and in 1993 graftectomy due to its rejection. In 1991-1993 the long-term immunosuppression was taking including medicines like Cyclosporin, Imuran, Azatioprin and Encorton. The aim of this study was to consider the influence of immunosuppression therapy on lingual cancer appearance in our patient.

Adult↗

[The analysis of the relationship between integrated grade of the gray and other karyometric parameters in the precancerous lesions and laryngeal cancer].

The authors assessed morphometrically the parameters describing nuclei of the normal epithelium (superficial and basal layers), precancerous lesions (dysplasia and keratosis) and laryngeal cancer in the postoperative samples of 12 patients treated in the II Laryngology Clinic Silesian Medical Academy in Zabrze. Then the relationship between the integrated grade of grey (the index of changes in DNA structure) and the others kariometric parameters was evaluated. The value of the integrated grade of grey was the smallest in the superficial layers nuclei and the biggest in the laryngeal cancer one. The evaluation of the relationship was made by using the Spearman Rang Test. The integrated grade of grey was correlated with others quantitative nuclear measurements, though the correlation power was differ in the individual morphometrical stages.

Adult↗

[Middle ear adenoma: a case report].

Middle ear adenoma (MEA) is a rare neoplasm with benign clinical behavior. The immunohistochemical and ultrastructural studies revealed the mixed, bidirectional mucinous and neuroendocrine character. These tumors have been known by many different names, reflecting the controversies relating to their histogenesis and differentiation. The term middle ear adenoma was proposed by Hyams and Michaels in 1976 and since this time over 100 cases were described in the literature. The most often symptoms of the MEA are the unilateral hearing loss and the tinnitus. MEA should be treated by surgery and very attentive postoperative follow-up. The prognosis of these tumors are good. The histological structure of middle ear adenoma, as well as symptomatology, treatment and clinical behavior are discussed on the basis of the literature. A case of histologically confirmed middle ear adenoma in a 34 year old women is presented.

Adenocarcinoma↗

[Laser assisted uvulopalatoplasty (LAUP) in the treatment of snoring and obstructive sleep apnea syndrome].

Laser Assisted Uvulopalatoplasty (LAUP) the surgical technique for the treatment of snoring and obstructive sleep apnea syndrome was first performed by Kamami in 1988. LAUP can reduce the airway obstruction in the oropharynx level. LAUP is the simple, reliable surgical procedure performed in an office setting under the local anesthesia, without hospitalization. From 1998 to 2000 37 patients underwent LAUP in our ENT Department in Zabrze. This group comprised of 19 OSA patients and 18 habitual snorers. In cases of nasal obstruction by turbinate hypertrophy or septal deviation we performed septoplasty or partial inferior turbinectomy by laser CO2. In some cases with palatin or lingual tonsils hypertrophy we also performed tonsillectomy or lingual tonsil laser ablation. In 5 patients LAUP was performed in several stages. Before and after the surgical treatment each patient were evaluated by PolyMESAM--the device belongs to the third diagnostic level. In all postoperative evaluated OSA patients the RDI decreased significantly. In 4 patients (50% of evaluated after LAUP patients) the RDI dropped to 10 or lower. Snoring was eliminated or significantly reduced in 83% of patients classified as the habitual snorers. No serious complications were observed. LAUP is a good alternative to UPPP in the surgical treatment of habitual snorers and some of the patients with OSA syndrome.

Adult↗

[Stapedectomy in the treatment of otosclerosis in children].

In the years 1994-2000 in the Laryngology Department Silesian Medical Academy in Zabrze 167 stapedectomy were performed in 143 patients with otosclerosis. In this group of patients 11 stapedectomies in 8 children aged from 9 to 17 years were performed. 5.6% of all the patients with otosclerosis treated in our Department were children. The purpose of this study was to analyze the audiologic results of stapedectomies in children. The postoperative evaluations were performed in the period from 6 months to 6 years after the surgical treatment. In the estimation of the hearing state we analyzed the change of the air-bone gap, an average air conduction hearing improvement, the rate of percentage hearing improvement and an average hearing loss by Bell Telephone Laboratories. In all the operated children we observed the decrease of the air conduction hearing level. Stapedectomy was successful (postoperative air bone gap within 10 dB of the preoperative bone conduction) in 63.6% of the patients. In 3 cases the air bone gap was lower than 20 dB (27.3%). In one case it was greater then 20 dB. The air bone gap closure was at the average of 5.75 dB level. The results were comparable with the other authors. Stapedectomy can be an effective procedure for correcting conducting hearing losses due to the otosclerosis in the pediatric patients.

Adolescent↗

[Rare case of multiple primary malignant neoplasm of the larynx: squamous carcinoma and fibrosarcoma].

The problem of primary mixed neoplasms has been recently a subject of numerous research works trying to find out their pathogenetic mechanisms, early detection, clinical course and treatment opportunities. The authors present a rare case (fibrosarcoma and squamous carcinoma) in a 73-year-old man. The patient had a surgery (total laryngectomy) and complementary irradiation at the Institute of Oncology.

Aged↗

[An influence of combined treatment of laryngeal cancer on thyroid gland activity].

The aim of the research work was to estimate the risk of functional complications arising within thyroid after radiotherapy, when thyroid of patients being ill with carcinoma of head and neck area skin was afflicted with radiation beam as well as to examine whether the circadian rhythmand concentration of hypophysis and thyroid hormones are dependent on combined treatment. The group contained 18 pilot patients treated with combined method, which were examined for concentration and circadian rhythm of TSH, T3, T4, fT3, fT4 three times: before commencement of treatment, one month and six months after completion of treatment. Results of circadian rhythm and concentration of thyroid hormones examinations proved that in case of all hormones the circadian rhythm exist which undergoes a dysrrythmia after one month and six months from completion of combined treatment.

Adult↗

[Esthesioneuroblastoma: staging system and methods of treatment].

A rare neoplasm of the nose and paranasal sinuses--esthesioneuroblastoma was characterised. New staging system, diagnostics and therapeutic methods were analyzed. Diagnostic difficulties in esthesioneuroblastoma recognition were emphasized. The interesting case report confirming this problem was shown. Value of the immunohistochemical examinations was emphasized.

Adult↗

[A case of laryngomucocele coexisted with pleomorphic adenoma of the larynx].

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.

Adenoma, Pleomorphic↗

[Reconstructive methods in the surgery of defects of the floor of the mouth and the tongue due to carcinoma].

A retrospective analysis of patients with tongue, floor of the mouth and tonsil carcinoma treated in II ENT Department University School of Medicine in Zabrze between 1994 and 1996 was undertaken. 32 male and 10 female underwent operation of the oropharynx. The visor flap, mandibulotomy or peroral approach was used. In 32 cases mandibulotomy, in 2 cases visor flap and in 3 cases peroral approach was performed. The usefulness of bone grafts from iliac ala, skin flaps and part of the tongue applied to replace the defect after extensive operation of the oropharynx was analysed and presented. In 2 patients partial mandibulectomy was performed. In 2 patients defect was replaced with iliac crest. Good graft's vitality, availability and function were emphasized.

Carcinoma, Squamous Cell↗

[The analysis of cellular nuclei of the normal epithelium, precancerous lesions and cancer of the larynx].

The aim of the study was to relationship analysis between the karyometrical parameters of the laryngeal mucosa and the morphometrical states as well as the morphometrical comparison among the normal epithelium, precancerous lesions and cancer of the larynx. The following nuclear parameters were assessed: area, equivalent diameter, length, width, perimeter, convex area and perimeter, roundness, elongation and fulfillment. The relationship between karyometrical parameters and morphometrical lesions were found to be statistically significant. In some cases of the measurements there was no significant difference between the mild dysplasia cells and the superficial layers of the normal epithelium.

Adult↗