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Biomedical subjects

S Piotrowski

Publications and source records attributed to S Piotrowski.

At least 19 recordsLinked to original sources

[Laryngological aspects of treatment of male-female transsexuals].

The authors discuss laryngologist's participation in the adapting treatment of transsexuals of M/F type, including reduction of laryngeal prominence of thyroid cartilage, voice rehabilitation and nose operation. Literary reference is presented in the paper, as well as a case of a 27-year-old patient a transsexual of M/F type, in whom the prominence of thyroid cartilage was removed. Ethic and legal aspects of that management are also demonstrated.

Adult

[The evaluation of certain psychological indices concerning cognitive and emotional behaviors in patients after radical neck dissection].

Every disease and especially neoplasmatic disease is a source of deep mental experiences. The aim of this study was the establishment of some psychological behavioural parameters in 55 patients who underwent radical neck dissection and in 32 patients operated for other, non-neoplasmatic laryngologic diseases. In order to evaluate psychological state of the patients the following of States and Personality Traits (TISCO), 2. Feeling of Safety Question Sheet (KPB), 3. Profile of Mood States (POMS), 4. Scale of Hopelessness (HS-8). It was stated, that patients after radical neck dissection have deviations concerning indexes of cognitive and emotional behaviour and that there are differences between patients operated as the reason of neoplastic processes and other patients. These differences appear also among persons examined in the period shorter than 1 year from their surgery as opposed to patients operated earlier than 1 year before examinations. The fact of laryngectomy did not appear to have significant influence upon most of the evaluated indexes of cognitive and emotional behaviours.

Adult

[Rhinologic changes in cystic fibrosis and hypogammaglobulinemia].

Nasal and paranasal findings in cystic fibrosis and hypogammaglobulinaemia are presented. Two cases are discussed. Case one that is 20 year old man with oedemato-polypoid changes of nasal mucosa and diagnosis of cystic fibrosis was made during his staying in hospital. Case 2 that is 12 year old boy with previously diagnosed hypogammaglobulinaemia also presented oedemato-polypoid changes of nasal mucosa. Both pharmacological and surgical treatments were brought. Authors' observations are compared with the literature and necessity of detailed diagnosis of oedemato-polypoid changes of nasal and paranasal sinus' mucosa is stressed.

Adult

[Hyperbaric oxygen therapy in case of the neck diffuse phlegmon with very hard clinical course].

A case of 56 year old woman, diabetic (non-diagnosed before), suffering from diffuse phlegmon of the neck and acute submucosal laryngitis as a peritonsillar abscess complication is presented. Tracheotomy, abscess tonsillectomy with evacuation of peritonsillar abscess and extensive skin incisions of the neck with separation of tissue layers followed by drainage were performed at the beginning of hospitalization. This was regarded as responsible for stopping the violent development of the disease and saving the life of patient. Pathological bacteria were Streptococci (anaerobic and aerobic). Apart from the application of antibiotics (piperacyl, amikin, metronidazole) the patient was treated by hyperbaric oxygen (pressure 2,5 ata, one hour per day, on 6-9 day of treatment). Furthermore she was treated with oxygen applied through the tracheotomy tube during 5 days. In the authors' opinion the early performance of surgical procedure is necessary in the phlegmon of the neck as in the presented case. It is to be remembered, that these patients may suffer from other diseases like diabetes, non-diagnosed earlier. It has been noticed that significant improvement may be obtained by using the hyperbaric oxygen in the treatment of such cases.

Abscess

[Radical neck dissection and the possibility of complications: surgical technique].

Based on 15 pictures the technique of radical neck dissection is presented with particular attention to the topography of the neck. Steps by steps the possibility of complications is considered. During the operation the mandible branches of the facial nerve, vagus nerve, hypoglossal nerve, phrenic nerve, accessory nerve, shoulder plexus, cervical plexus, sympathetic trunk can be injured as well as the jugular vein, carotid artery, occipital artery, thoracic duct. The critical moments for generation of these complications are indicated.

Cranial Nerves

[Complications of the digestive tract in patients after laryngectomy].

The authors describe the case of six patients who after having undergone laryngectomy suffered from complications affecting digestive tract. One of the patients contracted aerophagy and in the case of five other patients occurred bleeding from the upper digestive tract. Four of the letter five patients had perforation of the gastric ulcer; three of them were treated surgically (in two cases by partial resection of the stomach, in one by ligation of the vessels in ulceration area) and in one case the conservative treatment was applied. All four above patients were completely cured of neoplasmatic illness such and the complications. In the fifth case developed a multiple ulceration of the esophageal wall and its perforation. The patient died as a result of massive and repeated bleeding, despite application of thoracosurgical treatment. In the sixth case, of the patient with aerophagy, the applied treatment was conservative.

Adult

[The usage of light density heparin (fraxiparin) in the treatment of orbital phlegmonous cellulitis with orbital veins and thrombophlebitis of the cavernous sinus].

A case of 72 years old man, diabetic, suffering from phlegmonous cellulitis with orbital veins and sinus cavernous thrombophlebitis as a nasal vestibule furuncle complication is presented. Apart from the application of antibiotics and surgical procedure, the patient was treated from beginning with thrombolytics specimen, fraxiparine. The methods of treatment of cavernous sinus thrombosis with thrombolytic specimens evoke in the literature controversial opinions. In the author's opinion the early application of fraxiparine in presented case could be regarded as responsible for stopping the process orbital veins and sinus cavernous thrombosis and even causing it to recess. The complete cure without complications (e.g. blindness) is attributed by the authors to the anticoagulation treatment. The authors also stress that fraxiparine may by used for treatment of cavernous sinus thrombophlebitis even when the surgical procedure is planned.

Aged

[Granular cell myoblastoma (Abrikossoff tumor) of the larynx].

Authors described a case of a 62 year old woman with non-typical laryngeal seat of granular-cell myoblastoma. In this case Abrikossoff tumor was located within the vestibular wall of the larynx (in the aryepiglottic and false folds). It was removed by laryngofissurae. During eight years of post-operative period no symptoms of recurrence were observed. While discussing literature of granular-cell myoblastoma the authors draw attention to histopathology, clinical course of this disease and stress the rarity of occurrence of Abrikossoff tumor in the larynx.

Female

[Adenoid cystic carcinoma of the larynx, trachea and thyroid].

The aim of this article was to describe rarely occurred carcinoma adenoides cysticum located in the larynx, trachea and thyroid. Epidemiology, clinical course and medical therapy was demonstrated. In reported case concerning 65-year old woman early bilateral paresis of vocal folds was observed as results of the perineural infiltration. That caused sudden laryngeal dyspnea. It is important to pay attention on local extensiveness of neoplasm. Besides changes in larynx, neoplastic infiltration was found in trachea, preesophageal tissues and right lobe of thyroid. For above reasons there is no possible to exclude thyroid as a primary tumor of carcinoma adenoides cysticum.

Aged

[Laryngeal edema after radiotherapy--radiation reaction or a property of the neoplasm (recurrence, residual neoplasm)].

The authors discuss occurrence of post-radiation laryngeal oedema in the cases of patients with laryngeal cancer. The examination was carried out in 69 cases of patients on whom laryngectomy had been performed after failure of radiotherapy. In 65 out of these cases patients suffered from oedema of larynx with 57 cases classified as persistent or progressive post-radiation oedema (lasting for over three months inspite of application of pharmacological treatment), and 8 cases identified as fluctuating (receding after application of treatment and periodically reoccuring). Analysing the microscopic material of the specimens of the post-radiation oedema, the authors differentiated the stasis, inflammatory oedema and that causes by the presence of cancer infiltration. Basing on their own research data and the contemporary literature, the authors conclude, that the occurrence of persistent post-radiation oedema of the larynx lasting for the three months without reaction to the applied pharmacotherapy should be regarded as an important symptom signalling the presence or the recurrence of tumour after radiotherapy.

Biopsy

[Regarding assessment of changes in the larynx after radiation according to RTOG/EORTC classification].

The authors discuss the classification of changes in reactions occurring during and after radiotherapy of the laryngeal cancer adopted in 1987 by Radiation Therapy Oncology Group and European Organisation for Research and Treatment of Cancer (RTOG/EORTC). The above classification is not based on uniform criteria. The authors express the opinion that is extremely difficult to distinguish between chondritis, chondronecrosis of high intensity and necrosis without microscopic examination and limiting oneselves to the subjective symptoms only. In they opinion the classification of the post-radiation reaction should take into account the clinical assessment of the state of the larynx as well as the subjective elements of the examination. The authors have their findings on their own clinical and microscopic research as well as on the date accessible in the relevant literature.

Humans

[Subjective evaluation of adaptation to life in patients after radical neck dissection].

Neoplastic disease is the reason for limitation in life activity and functioning. The aim of study was assessment of adaptation to life after radical neck dissection. 87 subjects were followed up: 55 patients (group A) after radical neck dissection and 32 operated on for non-neoplastic ORL diseases. Patients from group A almost in all estimated indices showed statistical significant differences in comparison with group B. Only some differences were noted between patients examined in the period shorter and longer than one year after operation. There were no differences between patients after total laryngectomy and these who were cured in other procedures.

Activities of Daily Living

[Bleeding from the esophagus in a patient after laryngectomy].

The report present a study of a case of a 38 year old man, suffering from massive haemorrhage from esophagus on the 21st day after performed laryngectomy. Serious difficulties occurred at first in specifying the exact sources of haemorrhage (cervical vessel, gastric ulcer?). The surgical assessment of the neck vessels and laparotomy were performed without finding any sources of bleeding. The haemorrhage was eventually stopped by the application of Sengstaken's tubene, but it reoccurred when a trial to remove was undertaken. Thoracotomy to assess the mediastinal vessels did not reveal the sources of bleeding. 22 units of blood were administered in transfusion. This patient died 10 days after the beginning of the haemorrhage. In autopsy the diffuse inflammatory process of the oesophageal wall, multiple corrosive points in the mucous and deep, large ulceration (2.5 x 1 cm in diameter) within posterior oesophageal wall located in the middle stenosis were found. Discussing the possible causes of the bleeding the authors point out to the fact that the presence of the naso-oesophageal catheter could have been one of them. The authors also express the opinion, that persisting hiccups can be regarded ad a characteristic symptom of developing oesophagitis which actually was observed in the presented case.

Adult

[Multiple lymphatic cervical cysts].

Authors described a case of 60 year old woman with multiple lateral neck cysts. Four cysts, 5 x 4 x 3 cm and 3 x 2 x 2 cm in diameter, were located in the supraclavicular region of lateral neck triangle. During histopathological studies of postoperative specimens a cystic hygroma diagnosis was established. The fact, that cystic lymphangioma occurred in an adult woman, was interesting. The authors stress the necessity of preoperative evaluation of tumor size in view of the possibility of its penetration into the thorax. The CT examination may be useful in these cases.

Cervical Vertebrae

[Cavernous sinus thrombosis--complication of nasal septum abscess in a child].

The authors present a case of nasal septum abscess, complicated with cavernous sinus thrombophlebitis in a four-year-old child. The importance is stressed of adequate treatment both local and systemic. Even the slightest complications of nasal cavity and nasal sinuses infections should be treated in hospital.

Abscess

[Clinical indications for laryngectomy in the patients with carcinoma of the larynx after failed radiotherapy].

The authors present 22 patients with carcinoma of the larynx after radiotherapy in which laryngectomy was performed basing on the clinical view, without repeated histological confirmation of the tumour. In this material there were 14 patients without any biopsies after radiotherapy, and 8, in whom biopsies were performed once or twice, but no evidence of tumour was found. During microscopic studies of postoperative specimens the tumour was found in 21 cases-in one case pre-operative changes were caused by postradition injuries (inflammation, necrosis). The authors discuss clinical signs, which can be helpful to recognize the presence of tumour with postradiation changes and which gives a reason for laryngectomy following radiotherapy. This signs were: persisting or progressive post-radiation oedema of the larynx, laryngeal wall swelling (especially dissimmetrical), vocal cord fixation after radiotherapy, mucosal ulceration of the laryngeal wall and lymph nodes palpability on the neck after radiotherapy.

Carcinoma

[Castleman's disease: an unusual neck neoplasm].

Castleman's tumour of unusual location on the neck of 12 years old girl has been described. From two forms of Castleman's disease which exist--the hyaline vascular kind of disease. The authors presented their opinion on the affection arising and differential diagnosis Castleman's tumour from tumours of thymus gland origin.

Castleman Disease