Biomedical subjects

Piotr Rapiejko

Publications and source records attributed to Piotr Rapiejko.

At least 19 recordsLinked to original sources

PubMed2006

[Application of microsurgery in diagnosis and treatment of larynx diseases].

THE AIM OF THE STUDY: was analyzing cases of laryngeal diseases and their location that required treatment by surgical procedure as well as analyzing complications resulting from microsurgery of the larynx and their location during surgical procedures and treatment performed in the Otolaryngology Clinic at Military Institute of the Health Services Central Military Hospital in Warsaw (years 1994-2003). MATERIAL AND METHODS: We analyzed 713 patients, of which 248 were women (34.8%) and 465 were men (65.2%) aged between 12 and 80 (the average age was 49.4 +/- 11.8), who were diagnosed as requiring microsurgery of the larynx using the Kleinsasser's set together with operating microscope and CO2 laser in selected cases. RESULTS: The total of 713 microsurgical operations was performed in the larynx area. The largest group were the patients who were diagnosed as having polyps (33.0%), chronic laryngitis (19.6%) and an established diagnosis of laryngeal carcinoma. Complications were observed in 416 patients (58.3%). CONCLUSIONS: Microsurgery of the larynx was the most often applied form of treatment of vocal fold polyps, chronic laryngitis and laryngeal carcinoma; pathological changes that require microsurgical treatment are mostly located in the epiglottis and the central part of the glottis whilst the major complications resulting from the microsurgery of the larynx are limited to superficial damage of the mucous membrane, mostly on the lips.

Adolescent↗

PubMed2006

[Laryngeal cancer risk factors].

Laryngeal cancer is the most common of head and neck cancers. Neoplasm used to develop basing on DNA mutation which leads to uncontrolled growth and cells' division. It is due to spontaneous mutations or influence of chemical, biological and physical factors. Laryngeal cancer generation is conditioned by many synergic factors. Some of them certainly participate in cancer genesis and this thesis is accepted by medical environment and other of them have been discussed giving different information. Definition of the risk factors role in laryngeal cancer etiology is very difficult especially regarding their contemporary occurrence in one person. Most common risk factors are environmental factors, gastroesophageal reflux, viral infections, diet, radiation, individual predisposition. Some of them, such as cigarette smoking and abuse alcohol are significantly oftener confirmed in patients with neoplasm diagnosis and others' role in developing of illness has been still researched. Thus the purpose of the study was to present so far achievements in laryngeal cancer etiology and to emphasize controversies relating to some factors' role in cancer genesis.

Alcohol Drinking↗

PubMed2005

Correlation between conjunctival provocation test results and conjunctival symptoms in pollinosis - preliminary report.

The aim of the study was to investigate the correlation between the level of reactivity in conjunctival provocation test and conjunctival symptoms that develop during the pollination season in grass allergic patients. Conjunctival provocation test with grass pollen allergens was performed in 22 patients suffering from pollinosis. During grass pollination season all patients monitored their symptoms with Symptoms Score Cards. A parallel measurement of the level of grass pollen count was carried out on a daily basis by volumetric method. The mean grass pollen count which triggered the reaction in individual patients depended on the results of conjunctival provocation test. The lowest pollen count level was observed in cases of patients with positive conjunctival provocation test at low allergen extract concentration of 160 and 500 BU/ml, whereas the highest count in cases of 1,600 BU/ml. The difference between the results was found to be statistically significant. A threshold grass pollen concentration for conjunctival symptoms was established at the level of 22 grains/m (3). We conclude that the patients with pollinosis and high reactivity in conjunctival provocation test develop conjunctival symptoms earlier during grass pollination season than the patients who are characterised by lower reactivity during conjunctival provocation test.

Adult↗

PubMed2005

[The usefulness of computer-aided navigation in endoscopic sinus and nasal surgery].

The usefulness of computer-aided navigation in endoscopic sinus and nasal surgery. Endoscopic surgeries of the sinuses are among the most difficult procedures in otolaryngology. The progress of endoscopic techniques led to reduction of invasiveness enabling the surgeon to perform precise procedures with minimal tissue traumatization. The systems for computer-aided endoscopic surgery combine preprocedural MRI or CT data with information regarding current location of the surgical tools. The aim of this study was to assess the usefulness of electromagnetic navigation system ENTrak 3500 in endoscopic nasal and sinus surgery. The study group consisted of 18 consecutive patients with maxillary or ethmoid sinusitis with concomitant nasal polyps, who were surgically treated in ENT Clinic Military Medical Institute in October 2003. In all patients the endoscopic nasal and sinus surgery with the use of computer-aided navigation was successful with complete removal of pathologic lesions within the cavities of the nose, maxillary and/or ethmoid sinuses.

Adult↗

PubMed2005

[Computer-navigated surgery].

Computer-navigated surgery Computer-navigated surgery has become very popular in the recent years. It provides "the third dimension" to CT scans and endoscopic images. This technique enables the surgeon to reach given structures in the operation field using instruments and to visualise their location on CT scans acquired earlier by the computer and presented on the screen. Computer-navigated surgery facilitates the visualisation of instruments position in relation to anatomical structures in three projections. Because of the simultaneous presentation of the scans and the endoscopic picture on one screen, enormous comfort is granted to both the surgeon and the patient who can feel safe. The analysis of images reveals further information, which enhance the safety and lead to more effective procedures with diminished complications. The surgeon's assurance that the instruments are in the desired position, even in the anatomically complex structures, is the most impressive advantage of this technique. Computer-navigated surgery can be of great benefit in endoscopic surgery teaching programs. However, it cannot become a substitute of an adequate knowledge or replace proper education about anatomy of operated organs. The authors present the review of systems for computer-navigated surgery. They also describe their own experience based on endoscopic surgery of ethmoid and maxillary sinuses carried out with the use of computer navigation.

Endoscopy↗

PubMed2005

[Assessment of nasal obstruction treatment with the rhinomanometric examination].

The aim of the present study was to assess of nasal obstruction treatment by means of rhinomanometry at patients with deviation of the nasal septum and with rhinitis allergic or vasomotor. The research encompassed 171 patients with nasal obstruction, medicated in Department ENT, who were assigned to 6 different groups according to nasal obstruction reason: group I--42 patients with deviation of the nasal septum, group II--32 patients and group III--34 patients deviation of the nasal septum and with allergic rhinitis, group IV--33 patients and group V--30 patients with deviation of the nasal septum and vasomotor rhinitis and 30 healthy subject forming control group. In groups I, II and IV patients performed plastic surgery of nasal septum and group II and IV performed inferior nasal concha surgery. Laboratory norms for rhinomanometry were fixed on the basis of healthy control group results analysis. After the surgical treatment normal results in rhinomanometry were found: in group I 81%, in group II 53%, in group III 62%, in group IV 51% and in group V 63% patients.

Adult↗

PubMed2005

[Aspects of biological activity of T and NK lymphocytes in children with adenoid hypertrophy and concomitant otitis media with effusion].

UNLABELLED: The aim of this study was to inquire whether it has got an influence on the number and activity of peripheral blood T and NK cells. MATERIAL AND METHODS: The examined group consisted of 51 children with adenoid hypertrophy. The first group consisted of 17 children with only one episode of otitis media with effusion (ome). The second group consisted of 14 children with more than 4 episodes of ome and the third group consisted of 20 children with adenoid hypertrophy without ome. Evaluation of percentage of CD4+, CD8+ and NK subsets with co-expression of CD69, HLA-DR molecules in peripheral blood was performed by flow cytometry method. In examined groups with ome the decrease of CD4 number was compensated by increase of the number of NK and CD19 cells. In these groups the increase of CD69 and HLA-DR expression on the examined subsets was observed. The results suggest that in recurrent otitis media with effusion may be one of the factors causing T lymphocytes deficiency. Obtained results might be one of the criteria of using adenoidectomy.

Adenoids↗

PubMed2005

[Assessment of the correlation between taste and smell functioning].

UNLABELLED: There are few studies examining relationship between taste and smell. However their clinical unity is more often indicated. Smell perception abnormalities cause modification in taste of food intensity, disabling perception of taste as a consequence of taste's sniffing failure. Thus disturbances of these senses, which often commonly coexist could cause great discomfort in patients, however taste sense is estimated as less important comparing to smell sense. The aim of that study was to compare the taste perception in patients with normal smell function and patients with hyposmia and anosmia. There was analyzed correlation between the patients' subjective estimation of smell and taste senses and results of gustometry and olfactometry examinations. MATERIAL AND METHOD: there were indicated three groups of patients based on smell examination with usage of Elsberga--Levy'ego olfactometr in Pruszewicz modification. The first group included patients with normosmia, the second--patients with hyposmia or anosmia related to every smell, the third--patients with hyposmia on few smells and normal smell feeling of others. The Bornstein's method gustometry modified by us was performed for all groups. Moreover patients presented their subjective estimation of smell and taste senses. All results were statistically analyzed, taking into consideration results with alpha < or = 0.05. RESULTS: All (100%) patients with normosmia correctly identified sour, bitter and salty tastes, while only 53% of patients with hyposmia and anosmia got similar results. However 76.5% of patients from the second group subjectively estimated their sense of taste as a normal perception. CONCLUSIONS: Patients with smell disturbances significantly more often have abnormalities in taste perception than patients with normosmia and their subjective estimation of taste and smell senses is much more different than gustometry and olfactometry results.

Adult↗

PubMed2005

[Detection of Helicobacter pylori in nasal polyps specimens using urease test GUT plus].

In patients with nasal polyps the colonisation of nasal polyps tissues by Helicobacter pylori was investigated using urease test (GUT plus). In this prospective clinical trials we enrolled 61 subjects who had undergone endoscopic nasal polyps surgery and 30 subjects who had undergone septoplasty (control group) were questioned and biopsy specimens of the removed polyps or the mucosal part of inferior turbinate were tested by the urease test GUT plus. In result Helicobacter pylori was not found in the nasal polyps and mucosal part of inferior turbinate tissue of any of patients including the 43 of 61 patients with nasal polyps and 7 of 30 patients with septum deviation who had symptoms of gastroesophageal reflux. In our study using the urease test GUT plus we were not able to confirm presence of Helicobacter pylori in the nasal polyps tissue. However, further epidemiologic studies using different diagnostic methods would be necessary to confirm presence of Helicobacter pylori as potential underlying pathogenetic mechanism of nasal polyposis.

Adult↗

PubMed2005

[Computerized image analysis in recognition and classification of aeroallergens].

UNLABELLED: In medical practice and research, it would be convenient to receive pollen identification and monitoring results in much shorter time than it comes from human identification. Image based analysis is one of the approaches to an automated identification scheme for pollens grain and pattern recognition on such images is widely used as a powerful tool. PURPOSE OF THE STUDY: The goal of such attempt is to provide accurate, fast recognition and classification and counting of pollen grains by computer system for monitoring. METHODS AND MATERIAL: The isolated pollen grain are objects extracted from microscopic image by CCD camera and PC computer under proper condition for further analysis. RESULTS: The algorithms are based on the knowledge from feature vector analysis of estimated parameters calculated from grain characteristics including morphological features, surface features and other applicable estimated characteristics. Segmentation algorithms specially tailored to pollen object characteristics provide exact descriptions of pollen characteristics (border and internal features) already used by human expert. The specific characteristics and its measures are statistically estimated for each object. Some low level statistics for estimated local and global measures of the features establish feature space. Some special care should be paid on choosing these feature and on constructing the feature space to optimize the number of subspaces for higher recognition rates in low-level classification for type differentiation of pollens grain. CONCLUSIONS: The results of estimated parameters of feature vector in low dimension space for some typical pollen types are presented as well as some effective and fast recognition results of performed experiments for different pollens. The findings show the evidence of using proper chosen estimators of tailored characteristics for good enough classification measures even for low dimensional classifiers for type differentiation of pollens grain.

Humans↗

PubMed2005

[Examination of upper airway function using the dew point hygrometer with semiconductor detector].

The nasal mucosa with blood capillary network has a remarkable role in respiration process. The most important nose functions are heating and humidifying to optimal level of reaching throat and lungs air and partly absorption of humidity and temperature from expired air. Variations of humidifying and heating processes can invoke some upper airways disorders. The paper presents dew point hygrometer which was specially design for laryngological purposes. The hygrometer can measure dynamic changes of humidity in upper airways. The device is fully automated, easy to operate and can communicate with external personal computer. Database application allows saving patient data with archive examination results and can display them easily. During ongoing clinical tests, still increasing amount of data will allow precisely investigate correlations between humidifying process and some diseases. The main advantage of the device is a short response time on humidity changing. The number of readings (detections) can reach 5 readings per second (slightly depending on humidity level) which is much faster than in available on the market hygrometers with sorption sensors. The paper also presents some results obtained in group of healthy volunteers and one patient with tracheostomy The tests figured out actual humidity in certain parts of upper airways: nose, throat, trachea in breathing cycles under various surrounding conditions. The constructed hygrometer can be used for air humidity measurement in upper airways during some diseases and for evaluation of an influence of some drugs and environmental conditions changing on air upper ways mucosa.

Adult↗

PubMed2005

[Examination of the temperature stabilization process in the upper airways using a miniaturized electronic thermometer].

Diagnostic and treatment procedures in laryngology demand the knowledge on physiological processes taking place in nasal cavities in the course of breathing. It is of special importance in treatment with pharmacologic agents exerting an influence on nasal blood vessels and in nasal structures operations. The paper presents electronic thermometer which was specially designed for measurements in human higher airways. The system is set of flexible measurement head with miniature thermistor and microprocessor system connected to the personal computer fit out database application for collect and visualization measurement data. The device is safe for medical doctor and patient as well. With patient point of view, the measurements can be done easily and comfortably. The system allows recording dynamic changes of air temperature in upper airways and recalculates average inspired and expired air temperatures. The paper presents also initial results obtained in group of 15 healthy volunteers and 3 with tracheotomy It was made an estimation nasal ability to heating inspired air in particular places of nasal cavity and determined air temperature in nasal cavity outlet.

Adult↗

PubMed2005

[Subjective and objective assessment of voice quality after surgical treatment of overgrowth changes in vocal folds].

OBJECTIVES: Complex estimation of results of treatment micro surgically of ill larynx with overgrowth changes of vocal folds and comparison of usefulness different methods of research phonation function of larynx, and also estimation of influence disturbances of voice on functional state, emotional and physical ill applying to Clinics. MATERIAL AND METHOD: With researches embraced group 40 ill with hoarseness, of which reason one was organic changes of vocal folds under form of polyps, of vocal nodes, of cyst and of swellings Reincke, attended operational (microsurgery with method Kleinsasser). Voice priced twice before intervention surgical and 3 months after operation. In researches used with scale GRBAS, with estimation laryngostroboscopy of function of vocal folds, analysis acoustic created of voice and Polish version of Voice Handicap Index (VHI). RESULTS: Values p = 0.001 for "G" and p = 0.002 for "B" testify about special usefulness these two values of scale GRBAS in estimation of efficiency used treatments. Value p = 0.0004 obtained in research VHI proves distinct statistical symptomatic between estimation one's own voice and his of influence on life ill before and after operation and about good result of treatment. Statistical analysis examined of acoustic parameters showed on indeed statistical symptomatic difference only in chance of variable RAP (p = 0.03). Greatly usefulness for estimations used treatments showed stroboscope research, where especially character close of glottis (p = 0.003) and changes of mucosal wave (p = 0.008) show distinct dependence statistical difference before and after operation. CONCLUSIONS: In complex estimation of voice ill after operation overgrowth changes of vocal folds greatest usefulness showed research of laryngostroboscopy, Voice Handicap Index (VHI) and qualification of grade-G and breathiness-B in scale GRBAS. Thanks used to method VHI ill oneself priced efficiency effect treatments, and doctor knowing answers of patient on each questions canned properly to steer further treatment.

Adult↗

PubMed2005

[Evaluation of polypectomy-related changes on olfactory function].

AIM: Aim of this study was to evaluate polypectomy-related changes of olfactory function in early postoperative period in comparison to the preoperative situation. MATERIAL AND METHODS: Olfactory function was assessed in 25 patients of Military Medical Institute using Elsberg-Levy method. Measurements were performed preoperatively and 1 month after polypectomy. RESULTS: Before the polypectomy measurements revealed higher odor thresholds in 18 patients. Postoperatively, decline of odor thresholds was observed in 14 hyposmic patients. CONCLUSION: Present data indicates that olfactory function is related to nasal obstruction resulting from nasal polyposis. The study showed that polypectomy can increase olfactory function in patients with nasal polyps. Olfactometry can help to estimate nasal polyps during and after treatment even in early stage.

Adult↗

PubMed2005

[Techniques of intranasal drug use].

The aim of the study was to assess the incidence of changes in nasal mucosa in patients treated with long term intranasal corticosteroids and to determinate reasonability of intranasal drops administration in symptomatic treatment of nasal catarrh. The study included the total of 1962 patients. Within this group, 612 patients treated with intranasal corticosteroids underwent full laryngological examination to evaluate the status of nasal mucosa. In the group of 1350 users of web-based Allergologic Courier, who had used intranasal drops because of "runny nose" within last 3 months before the examination, a questionnaire survey was performed. The study results reflect poor knowledge the methods of nasal drops administration among patients, as well as low effectiveness of educational initiatives led by physicians and pharmacists. In 25 persons from 367 examined (6.81%) who used steroid spray locally, and who showed up in laryngological outpatient clinic, nasal mucosal damage was diagnosed for the first time. Mucosal damage was most frequently located in the right nasal septal mucosa--in 21 patients (5.72% of total patients) that was connected with improper nasal inhaler positioning and right hand movements directing it towards septum in the right nasal meatus. Among patients, who have remained under regular laryngological care in outpatient clinic (all of them are instructed of drug administration technique), only 5 persons (2.04%) out from 245 in the study group presented changes in nasal mucosa. No differences between changes occurrence on each side of nasal septum were found. Without proper training, only 8.52% from 1350 examined persons had been taking nasal drops in a proper manner to achieve its effectiveness.

Administration, Intranasal↗

PubMed2005

Nasal provocative test in patients allergic to pollen.

Nasal provocative test (NPT) can be defined as a method for recreating upper respiratory tract response to natural allergens or irritants. It can be used in solving nasal patophisiology problems: establishing whether and how the patient's nose is sensitive to antigens or irritants; quantitative evaluation of sensitivity; establishing factors influencing sensitivity. This method is employed to confirm clinical diagnosis in cases where difficulties arise in interpretation of diagnostic tests. The study based on nasal provocative tests establish an allergy to pollen in cases of pollinosis, and select appropriate components for the desensitising vaccine. Sample group included 53 patients, 29 were females and 24 were males, aged 15-42 years, selected from 1,021 patients diagnosed between 1999-2002 in the Allergology Department of the ENT Department of the MMI. The sample patients were diagnosed based on additional tests with allergic inflammation of the nasal mucosa caused by allergy to pollen of such plants as birch, grass, rye, mugwort and plantain. Research methods included: subjective physical examination, prick tests, total and specific IgE levels in serum, nasal provocative tests and rhinomanometric examination. Allergen solution was administered onto the mucosa with a calibrated atomiser. NPT solutions containing pollen of birch, grass, rye, mugwort and plantain were used. Provocative test was considered positive if, following allergen provocation, rhinomanometric examination revealed an increase in respiratory resistance by at least 40 % in comparison with the control test. On the basis of the study, 2 conclusions were drawn: 1) Nasal provocative test is an essential element in diagnostics of allergic nasal obstruction. 2) Rhinomanometry, as an objective method of examining nasal patency, is crucial for evaluating the nasal provocative test.

Adolescent↗

PubMed2004

[Application of the fusafungine in perioperative period in patients after tonsillectomy].

The only treatment method in chronic palatine tonsillitis is the removal of tonsils (tonsillectomy). The study aimed at a clinical evaluation of postoperative fusafungine use in patients who underwent tonsillectomy. The study included 200 patients who underwent tonsillectomy for chronic palatine pyotonsillitis in the Otolaryngology Clinic of the Military Institute for the Health Services in Warsaw between 2000 and 2002. The patients were divided into two groups, each group including 100 patients: group I--patients who underwent tonsillectomy, including 67 females and 33 males, aged 16 to 52 (mean age 34.8), in whom fusafungine was used; group II--patients who underwent tonsillectomy, including 58 females and 42 males, aged 17 to 56 (mean age 36.1), who did not receive fusafungine. The subjects were observed during the first 14 days following the operation. The treatment was administered from the first day after the operation, by spraying 4 doses into the throat, 4 times a day, at 8.00 hrs, 12.00 hrs, 16.00 hrs and 20.00 hrs. The two groups were then compared in terms of: symptoms of sore throat, body temperature, swallowing difficulties, the course of healing, appearance of the pharyngeal mucosa, quality of life and general affection. Post-tonsillectomy fusafungine use was found to improve the patients' quality of life, appeases the sore throat and swallowing difficulties, decreases the need for general antibiotic therapy; the above results are statistically significant. Fusafungine was not found to influence body temperature, the appearance of the pharyngeal mucosa or the healing process.

Adolescent↗

PubMed2004

[The case of carcinoma adenoides cysticum of the tongue, the trachea and the thyroid gland].

We present a case of a 65-year-old female patient who was for the first time admitted to the clinic in 1997 due to a tuber of the tongue root. The removed tuber turned out to be histopatologically a polymorphic adenoma. The patient was re-admitted to the Clinic in 2001 due to a tuber of the tongue and of the oral cavity bottom. The tuber was removed entirely through a central incision, and an apart hypertrophic change has been found on the posterior pharynx wall and in the scar after the tracheostomy carried out during the previous surgery. In all cases carcinoma adenoides cysticum has been found, as well as metastasis into the thyroid gland and the lungs. The patient was qualified for chemotherapy in the Institute of Oncology, which she has been going through periodically every two weeks until now. In 2002 the patient was operated on a small tuber located hypodermically in the scar after the tracheotomy, which was removed. Carcinoma adenoides cysticum was found. In November 2002, during the surgery a tumorous infiltration of the thyroid gland was found comprehending trachea and reaching the mediastenum. In February 2003 the patient was re-admitted to the Clinic due to dyspnoea caused by a significant contraction of the trachea which occurred as a result of a focus of carcinoma adenoides cysticum and significantly enlarged lymph glands near the trachea. The patient was qualified for stent placement in the Institute of Pulmonary Disease and Tuberculosis (Instytut Chorób Płuc i Gruźlicy). The presented case describes an exceptionally aggressive and polyfocal regrowth and transformation of a polymorphic adenoma into cancer.

Bronchoscopy↗