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Biomedical subjects

Witold Szyfter

Publications and source records attributed to Witold Szyfter.

At least 37 records · Page 2Linked to original sources
PubMed2005

[Localisation and direction of spread in oral and oropharyngeal cancer in the material of Head and Neck Oncological Surgery Department, University of Medical Sciences in Poznań].

UNLABELLED: The directions of tumor spread are determined by the anatomy of the affected organ. The vessel, nerve anatomy and presence of structures, that may potentially constitute a barrier for spread out of the tumor are of crucial importance. The aim of this paper was to presentation of the spreading directions of oral cavity and oropharyngeal squamous cell cancer based on the own experience. Material include 163 patients surgically treated between 2003-2003 in Department of ENT, Head and Neck Oncological Surgery Department in Poznań. The examination was conducted on the base of retrospective analysis of ambulatory charts and the hospital files. RESULTS: 163 (90%) patients were operated for primary oral and oropharyngeal cancer. The primary localization included in the palatine tonsil (82 patients), trunk of the tongue (48 patients) and floor of the mouth (20 patients) were predominated. The spread directions included: floor of the mouth (36) soft palate (35), base of tongue (33), hypopharynx (20) and trunk of tongue (16). The 31 crossed the midline, 27 infiltrated the tonsillopalatine angle, 9 retromolar area and 3 the mucosa of the cheek. Knowledge of anatomy facility in clinical evaluation of spreading malignancy. It helps in proper qualification to surgery or radiotherapy.

Adult↗
PubMed2005

[Infrahyoid musculo-cutaneous flap in head and neck reconstructions].

INTRODUCTION: Background reconstructive surgery with infrahyoid musculo-cutaneous flap is the procedure used in head and neck cancer from the 80 years XX century. Technique of that operation was designed and described by Wang in 1979. Nowadays it is used in reconstructions after resection of the tongue and floor of the mouth. The flap is formed by infrahyoid muscles and skin island. It's pedicled on the superior thyroid vessels and superior root of ansa cervicalis. The most important contraindication is multiple metastases on the side of the neck unilateral to the designed flap. The relative contraindication is previous radiotherapy. AIM: The introduction of this method to the practice and assessment of the early results. MATERIAL AND METHOD: 5 patients underwent the treatment (floor of the mouth, tongue, oropharynx resection because of malignancy). In 1 patient the flap was used in esophageal reconstruction after iatrogenic rupture. Reconstruction technique according to Wang was performed. Clinical observation of the patients to asses the early results has been conducted. RESULTS: Preliminary results of treatment among 6 patients are as follows: necrosis was found in 2 patients (total necrosis of flap in 1 case, partial in 1 case). Speech and swallowing restoration was satisfactory in four patients. CONCLUSION: The procedure using the infrahyoid flap provide the satisfactory reconstruction of the anterior part of the oral cavity and oropharynx. The technique is simple and not time consuming. The infrahyoid flap can be recommended in elderly or in poor general condition patients descending the surgery time as short as possible.

Adult↗
PubMed2005

[Cochlear implantation in visually impaired patients--long-term rehabilitation results].

UNLABELLED: The aim of the study was to assess the rehabilitation results in visually impaired patients with cochlear implants. Material consisted of 9 patients (2 with prelingual deafness, 3 with perilingual deafness, 4 with postlingual deafness) from 244 implanted persons in Poznań. METHODS: In all the patients the rehabilitation results were evaluated using Test of Auditory Perception of Speech (TAPS) and screening test. RESULTS: In the group of patients with pre- and perilingual deafness a little bit slower progress of rehabilitation was found, according to 117 persons with prelingual deafness and 34 persons with perilingual deafness without vision disorders. Within the group of patients with postlingual deafness important progress of rehabilitation was observed. Two brothers with Usher syndrome 1-2 months after speech processor switch-on reached the highest level of test, they could communicate with family. One person after 5 months of rehabilitation could talk by phone without any problems. In all implanted visually impaired patients improvement of auditory perception of speech was observed.

Adolescent↗
PubMed2005

[Evaluation of phonemic hearing development in CI-patients].

Phonemic hearing it is a typical interdisciplinary problem. Many specialists like pedagogues, psychologists, phoniatricians and speech therapists are interested in this field. So, we may find many definitions describing this kind of hearing. The speech perception and acquisition of speech is a difficult process profoundly hearing impaired children. With the development of the cochlear implant, acoustic input can be provide to these children. Studies documenting the postoperative performance of children with implants have generally shown significant improvements in speech perception and production. On the opposite side--in the group of postlingually deafened adult the speech rehabilitation is quite short. Only a few specialists described their observation about phonemic hearing development in CI-patients. How do it differ from hearing development in healthy population? The aim of this study was to describe the phonemic hearing development in CI-patients. In the ENT Dept. of University of Medical Sciences in Poznań 280 cochlear implantation were performed. They were observe in three groups: pre-, peri- and postlingually deafened ones. We concluded the same order of phonemic hearing development in every group. The time of acquisition differed, and depended of oral language development before implantation. At first they start to distinct voiced and unvoiced phones, than oral-nasal and sharp-soft ones. The most difficult for them was to discriminate fricative and plosive sounds.

Adolescent↗
PubMed2005

[Use of the lymphoscintigraphy in detection of sentinel lymph nodes of the neck].

Technique of the application of radioactive tracer to the primary tumor and lymphoscintigraphy with use of the stationary and handheld gamma probe was presented. Various types of the used radioactive tracers were characterized. Scintigraphical criteria for sentinel nodes recognition were discussed. Advantages and limitations of the use of lymphoscintigraphy for sentinel nodes detection were described. Necessity of further study to determine feasibility of sentinel nodes radiolocalization in stage N0 in head and neck cancer was pointed out.

Humans↗
PubMed2005

[The sentinel node in cancer of the oral cavity, pharynx and larynx].

AIM OF THE STUDY: The evaluation of the importance of the prognostic of sentinel node biopsy in head and neck cancer with N0 neck. MATERIAL AND METHODS: Prospective study included 19 patients with squamous cell carcinoma of the oral cavity, pharynx and larynx without enlarged lymph nodes in ultrasound examination (N0). The study was carried out in ENT Department of Medical University in Poznań between 2001-2004. Each patient underwent lymphoscintigraphy after administration of radionuclide Technetium 99m (Nanocol). In case of detection of sentinel node, blue dye was injected into the tumour bed and dyed lymph nodes were removed. The specimens were evaluated histologically and immunohistochemically. The patients are still followed up. RESULTS: So far 19 patients were included in our study. The tumours were classified from T1 to T4. In each case sentinel nodes were located. Metastases in removed lymphnodes were found in 5 patients. In one of them regional recidive was observed after 5 month. In the other patients no changes were found in follow up examination. In 14 cases in histological examination no metastases were found in sentinel nodes. In this group in one case local recurrence was observed and in another two lymph nodes metastases were confirmed. In patients with positive sentinel node elective neck dissection was performed. So far immunohistochemical examination has not provided us with any vital information. In no case with negative sentinel node we found micrometastases with the use of cytokeratin. CONCLUSIONS: Based on our preliminary observation of the patients we have found that there is certain correlation confirming the fact that sentinel node may be reliable for the whole neck lymphatic system. Further clinical observation are needed based on a larger number of patients and longer observation period.

Aged↗
PubMed2005

[Fatal necrotizing mediastinitis as a complication of peritonsillar abscess].

In the paper showed the case of fatal necrotizing phlegmon of the neck and descending mediastinitis in 48 year old male patient with primary peritonsillar abscess. On the base of literature it was showed the etiology, pathomechanism of the evolution of this heavy complication and surgical and pharmacological methods of its treatment. In spite of prompt wide incision and drainage of phlegmon of the neck and mediastinum and intensive treatment in intensive care unit conditions patient died in the image of septic shock and pus changes in the mediastinum, heart and lungs, what was showed on the base of post-mortum examination.

Drainage↗
PubMed2005

[Median rhomboid glossitis--change of inflammation origin or developmental anomaly?].

The etiology and pathogenesis of median rhomboid glossitis have been subjects of controversial discussion for a long time. In the past it was thought to be a developmental defect involving the tongue. This condition was believed to have been caused by the failure of the embriologic tuberculum impair to be covered by the lateral processes of the tongue. In the recent years the possible role of Candida albicans has been stressed. It is proposed that Actinomyces like Candida induces pseudoepitheliomatous hyperplasia of the mucosa of the tongue and inflammatory hyperplasia of the underlying connecting tissue, resulting in the characteristic elevated lesion. In the paper we present a case of 63 years old female with median rhomboid glossitis and methods of its treatment. The importance of tobacco smoking and denture wearing in the etiology of median rhomboid glossitis has been evaluated.

Diagnosis, Differential↗
PubMed2005

[Wide esophageal wall rupture as iatrogenic complication of anterior cervical spine surgery].

The case of 19-year old men with iatrogenic esophageal wall perforation is presented. The patient underwent anterior cervical stabilization using plate and screw for fracture of the C4 and C5 vertebra followed by an abscess of prevertebral space with discharging pus and food from the wound. The general condition was poor. Symptoms included: pneumonia, pleuritis with effusion, septicemia with mediastinitis, fever up to 40 and quadriplegia on neurological examination. During surgical procedure the implant loose but was still fixed into the esophagus causing a large defect in the posterior wall of the hypopharynx and cervical part of esophagus was found. The patient undergone three step surgery with wide drainage of prevertebral abscess, removing of osteosynthetic plate removal and formation of pedicle flap with sterno-cleido-mastoideus muscule. The finnal fourth procedure with using of pediculed infrahyoid flap gave an excellent result. During 160 days hospitalization the pus culture showed growth of the 11 bacterials species (like Pseudomonas aeruginosa, Staphylococcus aureus, Enterococcus faecalis) and 2 species of fungus. He was treated 13 types of antybiotics. This special case we present because of live threatening complication (mediastinitis) and complicated clinical course as well as because of unique technique of the defect closure, i.e. the infrahyoid flap occurred to be successful.

Adult↗
PubMed2004

Loss of heterozygosity on chromosome arm 13q in larynx cancer patients: analysis of tumor, margin and clinically unchanged mucosa.

BACKGROUND: Loss of heterozygosity, frequently observed during the development of many tumor types, also occurs in larynx cancer. This disease has a very complex genetic background, with numerous alterations involving oncogenes and tumor suppressor genes. The upper parts of the respiratory-digestive tract are exposed to many carcinogens, which can result in the appearance of multiple tumors or primary tumor relapses. The examination of normal-appearing tissues makes it possible to recognize genetic events occurring at early stages. MATERIAL/METHODS: 65 larynx cancer patients were examined for loss of heterozygosity (LOH) on the 13q chromosomal arm, with the application of three microsatellite markers. The material from each patient consisted of blood, tumor, safe margin, and 1-2 clinically unchanged mucosal samples. RESULTS: High frequencies of LOH in tumor tissues (49-64%) were observed in both studied chromosomal regions (13q14 and 13q34). The frequency of LOH in safe margin ranged from 12 to 31%. In normal-appearing mucosa, LOH was observed less frequently: 6-26% of informative cases. CONCLUSIONS: The data obtained from this investigation suggest that losses in the region of the 13q arm occur frequently during larynx cancer development. Moreover, they were observed not only in tumor tissues, but also in clinically unchanged mucosa. This could be a highly reliable predictor of the occurrence of relapse or second primary tumor in this anatomical site.

Adult↗
PubMed2004

Vessel density, proliferation, and immunolocalization of vascular endothelial growth factor in juvenile nasopharyngeal angiofibromas.

BACKGROUND: Juvenile nasopharyngeal angiofibroma (JNA) is a rare, highly vascularized neoplasm of the nasopharynx that affects boys and young men. The underlying dysregulated molecular mechanisms remain unclear. The participation of angiogenic growth factors has been suggested, but few studies have been published. OBJECTIVES: To evaluate the expression and localization of vascular endothelial growth factor (VEGF), proliferating cells, and vessel density in JNA. STUDY DESIGN: Immunohistochemical examination of 10 consecutive JNAs (8 primary tumors and 2 recurrent tumors). METHODS: Paraffin-embedded and cryopreserved JNA samples were included. VEGF-, CD31-, and Ki67-specific antibodies were applied and visualized using light microscopy. Vascularization was determined by counting CD31-positive vessels. Proliferating and VEGF-expressing vessels as well as stromal cells were quantified by the same method. Patients' age at the time of surgery and tumor stage were correlated with the immunohistochemical data. RESULTS: All tumors were heavily vascularized, but major differences were noted between the samples. About half of the vessels were proliferating (Ki67 positive) and half of the Ki67-positive cells were also VEGF positive. The tumor stroma was VEGF positive in 8 of 10 samples and proliferating in 5 of these 8. The 5 samples with both VEGF- and Ki67-positive stroma showed high vessel densities. No correlation was observed between age or tumor stage and vessel density, VEGF expression, or Ki67 expression. CONCLUSIONS: In JNA, VEGF is frequently expressed by stromal cells and vessels and is associated with proliferation and increased vessel density. We suggest the promotion of vascularization by VEGF, but the involvement of androgens in JNA angiogenesis still needs to be analyzed.

Adolescent↗
PubMed2004

[Poznań's program of cochlear implantation: 10 years experience].

The first cochlear implant in the ENT Department in Poznań was introduced in adult patient in January 1994. One year later the first deaf child was implanted. During 10 years over 200 deaf people were operated on. Modifications of diagnostics, surgery and rehabilitation were presented. Lowering the age of the implantation, changes of audiological criteria, genetic diagnostic and possibility of implantation in multi-handicapped patients were emphasized. Almost all surgeries were performed through the posterior tympanotomy and in one cases through the middle fossa approach. In one child with total ossification in CT scans Nucleus Double Array was used. Speech rehabilitation bases on auditory-verbal therapy. Rehabilitation consists of individual sessions with speech therapist and group therapy. Logorytmics exercises were introduced.

Catchment Area, Health↗
PubMed2004

Non-random distribution of chromatid breaks in lymphocytes of laryngeal squamous cell carcinoma patients.

The frequency and localization of mutagen-induced chromatid breaks in peripheral blood lymphocytes (PBLs) were investigated for association with squamous cell carcinoma (SCC) of the larynx. The case-control study was performed in 52 patients with laryngeal SCC and in 47 cancer-free controls. The analyses were based on the bleomycin sensitivity assay. The differences between cases and controls were estimated using Mann-Whitney U test and unconditional logistic regression. The total number of chromatid breaks in PBLs of patients was significantly higher compared with healthy controls (p<0.0001); the increase was observed in almost all chromosomal arms. In a number of chromosomal regions, the relative frequency of breaks was higher in patients; this increase was statistically significant for 1p22, 5q31, 6q23 and 10q24. The majority of sites with the increased proportion of breaks in patients were identified as regions containing loci involved in DNA repair, cell cycle regulation, suppressor genes and oncogenes. Revealing non-random distribution of chromatid breaks specifically associated with laryngeal SSC may be instrumental for defining regions involved in the etiology of this disease.

Carcinoma, Squamous Cell↗
PubMed2004

[Changes in interpersonal communication in pre- and perilingually deafened children after cochlear implantation].

People with deep prelingual deafness cannot fluently use oral language as a basic mode of communication. Hearing impaired subjects elaborated their own mode of communication. Cochlear implants as a surgical mode of deafness treatment may create a new chance for prelingually deaf children to develop vocal speech. The aim of this study was to assess changes in interpersonal mode of communication in pre- and perilingually deaf children after cochlear implantation. It was observed, that cochlear implantation stimulates development of oral language. The possibility of hearing perception of oral language it is a chance for a child for fully participation in life of hearing societies.

Adolescent↗
PubMed2004

[The dynamics of habituation of perception and reaction in tinnitus patients treated with TRT].

In this paper the authors present the dynamics of habituation of reaction and perception in tinnitus patients. All patient with subjective chronic tinnitus were diagnosed and treated using TRT method according to Jastreboff's neurophysiological model. 110 patients was estimated during last 4 years treated in ENT Rehabilitation Center in Poznań. The authors present the most frequently troubles in every day life caused by tinnitus and also the dynamics regression of complaints during period of treatment. Speed of disappearance of suffering is very important for all patients already in the beginning of cure.

Acoustic Stimulation↗
PubMed2004

[Mutagen sensitivity in patients with multiple primary tumors (MPT) of the head and neck region--quantitative and qualitative assessment based on bleomycin assay].

The occurrence of second primary tumors after curative treatment or simultaneous multiple malignancies are current problem in head and neck cancer. The mutagen sensitivity is well known marker to predict patient proneness to develop the second tumor. The frequency and localization of spontaneous and mutagen induced chromatid breaks in peripheral blood lymphocytes (PBLs) in patients with multiple primary tumors (MPT) may help in defining regions involved in cancerogenesis process. The case control study using the bleomycin sensitivity assay (number of chromatid breaks per cell (b/c) was performed in 36 patients with MPT and two control groups: 52 patients with one malignancy and 47 healthy individuals. The differences between examined patients and control groups were estimated using U Mann-Whitney test. The b/c level in PBLs of patients with MPT ranged from 0.26 to 4.12 (mean 1.53) and was significantly higher (p<0.000006) both compared with patients with one malignancy (b/c ranged from 0.02 to 3.08; mean 0.74) and healthy controls (b/c ranged from 0.04 to 1.14; mean 0.41). An increase of b/c index was observed in almost all chromosomal arms. The majority of chromosomal locations with the increased proportion of breaks in the group of patients with multiple tumors were identified as regions where loci involved in DNA repair, cell cycle regulation suppressor genes and oncogenes were found. Statistically higher induced individual susceptibility in MPT patients compared with single tumor and healthy controls was confirmed. Comparable induced mean b/c was found in patients with two smoking-related cancers as well as with not smoking related tumors.

Antibiotics, Antineoplastic↗