Biomedical subjects

Witold Szyfter

Publications and source records attributed to Witold Szyfter.

At least 19 recordsLinked to original sources

PubMed2006

Immunohistochemical analysis of growth mechanisms in juvenile nasopharyngeal angiofibroma.

Angiogenic factors are discussed to participate in growth and promotion of juvenile nasopharyngeal angiofibroma (JNA). However, only few data are available and mechanisms remain unclear. In the presented study we analysed the expression and subcellular distribution of several angiogenic growth factors and receptors potentially involved in JNA-growth and -vascularisation. In a retrospective, descriptive, multicenter-study, we analysed 13 formalin-fixed, paraffin-embedded or cryopreserved JNA-tumors (eleven primary tumors and two recurrent ones) after immunohistochemical staining. We used monoclonal antibodies specific for transforming growth factor beta 1 (TGF-beta(1)), basic fibroblast growth factor (bFGF), the VEGF-receptors 1 and -2 (FLT-1 and FLK-1), and the hypoxia inducible factor (Hif-1alpha). Data were compared to the vessel density. Quantitative analysis of staining intensities was performed by a computer assisted quantification technique. Endothelial and stromal compartments of the samples were analysed separately. Data were compared to vessel densities and patients data. The VEGF-Receptor-2 (FLK) was frequently unregulated in the stroma and endothelium of those samples with high vessel densities. Similarly, we observed high bFGF- and TGF-beta(1) levels in the stroma of strong vascularised samples. No correlations of expression levels to patients' data were found. The reported data support the concept of JNA-growth and -vascularisation driven by factors released from stromal fibroblasts. Therefore, inhibition of these factors might be beneficial for the therapy of inoperable JNA.

Adolescent↗

PubMed2006

Does loss of heterozygosity in critical genome regions predict a local relapse in patients after laryngectomy?

BACKGROUND: Patients, who had an upper aerodigestive tract malignancy, have a high incidence of succeeding tumor development. This has been attributed to the role of "field cancerization" in carcinogenesis. The aim of this study was analysis of loss of heterozygosity (LOH) in the regions frequently lost during the course of head and neck squamous cell carcinomas (HNSCC), especially at early stages, which could answer the clinicians' question, if LOH analysis has any "predictive" value in relation to tumor occurrence. MATERIAL AND METHODS: Sixty-five larynx cancer patients were examined for loss of heterozygosity on 3p, 7q, 8p, 9p and 18q chromosomal arms with the use of 12 microsatellite markers. The material from a single patient consisted of blood, tumor, safe margin and one or two clinically unchanged mucosal samples. During follow up, the material from brush specimens (14 patients) as well as laryngeal swabs (4 patients) was also examined. RESULTS: The highest frequency of LOH was detected for marker D3S1234 in tumor tissues (29%). Analysis of margin samples (b) revealed low LOH frequencies (2-5%) and complete retention of heterozygosity for markers: D3S1234, D7S486, D8S261, D8S264, D9S171 and D18S46. Similarly, for normal appearing mucosa from upper part of larynx (c) frequencies of LOH were low (2-6%), with the complete retention of heterozygosity for markers: D3S1284, D3S1304, D3S1234, D8S264 and D9S1870. We did not detect any LOH in the material of normal appearing mucosa from tracheostoma region (d). During follow up, LOH was detected for eight markers, with the highest incidence for markers D18S46 (six cases), D7S486 (four cases) and D3S1300 (three cases). CONCLUSIONS: The data, obtained during this investigation, did not reveal the predictive value of LOH with respect to local relapse occurrence in laryngeal cancer patients. However, time of follow up did not reach 5 years, so that further clinical monitoring should be conducted.

Carcinoma, Squamous Cell↗

PubMed2006

Toll-like receptors 2, 3 and 4 (TLR-2, TLR-3 and TLR-4) are expressed in the microenvironment of human acquired cholesteatoma.

Human toll-like receptors (TLR 1-10) are crucial in the induction and activation of innate immunity in the course of an infection. They are expressed mainly on the cells of the immune system, and also on some epithelia and endothelia. Their ligands so called pathogen associated molecular patterns are abundant on invading microbes. TLR-ligand binding results in cell signal transduction and subsequent production of various proinflammatory cytokines such as IL-1 and TNF-alpha. Acquired cholesteatoma is formed during chronic otitis media in the proportion of cases. It has adverse effects on ear structures, resulting in osteolysis and bone resorption. Its formation and pathogenesis are not fully understood. The current study attempted to search the possible role of TLRs in this somewhat awkward pathological condition. Surgical specimens of human acquired cholesteatoma (n=15) and normal external auditory canal skin (n=5, control tissues) were tested by immunohistochemistry for the presence of TLRs. Three TLRs were examined: TLR-2, TLR-3 and TLR-4. All TLRs tested were demonstrated in matrix (layer of keratinizing epithelium) and perimatrix (granulation tissue) of this inflammatory tumour. Expression of particular TLRs within the keratinizing epithelium was distinct and uneven. In the perimatrix, numerous T (CD3+) cells were seen and relatively few macrophages (CD11c+, HLA-DR+). There was a weak expression of all TLRs on normal (non-inflammatory) skin. Expression of TLR-3 both on the epithelium and some cells within the perimatrix and the presence of T cells may suggest that apart from innate immune responses, mechanisms of adaptive immunity also operate in cholesteatoma. Weak expression of these receptors on normal skin may also suggest the important role of TLRs in the etiopathogenesis of cholesteatoma.

Adolescent↗

PubMed2006

[Rare case of xanthoma disseminatum with severe dyspnoea].

The unique case of xantoma disseminatum with laryngological symptoms is presented. The 64 year old female patient was admitted to ENT Department University of Medical Sciences in Poznan, Poland, because of severe dyspnoe. Xantoma progressed for five years, affectin both the skin and laryngo-pharyngeal mucosa. Numerous skin lesions, yellowish and brown spots in the nuchal region and nosolabial area have been observed for 4 years. As well, patient was under control for moderate anemia. In the ENT examination subglottic stenosis was stated in indirect and direct laryngoscopy. The mucosal scars in the mesopharynx were observed with no impairment of swallowing. The general status improved after conservative, pharmacological treatment (Encorton, Amlopin). The patient is still under control, the laryngeal stenosis is stable.

Dermatitis↗

PubMed2006

[Tumors infiltrating carotid artery--diagnostic and principles of treatment].

The involvement of internal or common carotid artery by neoplasmatic process usually indicates advanced stage of a disease and is always a serious problem for surgical treatment. The high risk of surgical and neurological complications, frequent local reappearance, distant metastases and significant loss of quality of life should have influence on mode of scheduled treatment. Current options of diagnosis and treatment with special focus on surgical carotid artery reconstruction are presented based on the review of the articles related to this problem. Our 3-years experience with this group of patients is presented.

Adult↗

PubMed2006

[Stomal recurrence after total laryngectomy].

UNLABELLED: Stomal recurrence after total laryngectomy is a very serious complication, in general with dismal prognosis. There are only a few possibilities of treatment, so stress should be put on prevention. MATERIAL: In the ENT Department Poznań University of Medical Sciences between 1997-2004 829 total laryngectomy were performed, because of advanced laryngeal cancer (T3, T4). In this group until may 2005 37 cases of stomal recurrence were found. AIM: The aim of this study was to analyse the group of patients stomal recurrence. RESULTS: Stomal reccurence developed in 35 men and 2 women. The age of patients was 43-79 years (mean 59 years). The time of lasting the symptoms before laryngectomy was 6-12 months (mean 8 months). The emergency tracheotomy was performed in 16 patients (43%). The time between tracheotomy and laryngectomy was 2 days to 3 weeks (mean 6 days). The subglottic extension was observed in 24 patients (65%). 19 patients (51%) was classified as T3, 18 (49%) as T4. 12 patients (32%) was classified as N0, 5 (14%) as N1, 16 (43%) as N2 and 4 (11%) as N3. 4 patients were earlier treated because of larynx cancer (2 of them has laser chordectomy and 2 fronto-lateral laryngectomy). The time between laryngectomy and radiotehrapy was 4-15 weeks (mean 7 weeks). 22 patients (59%) were classified (due Sisson at al) as type I, 12 (32%) type II, 2 (6%) type III and 1 (3%) type IV. The treatment of stomal recurrences consisted of surgical resection of tumor, chemiotherapy, radiotherapy, brachytherapy or palliative treatment. 34 patients died, 2 are presently treated and 1 is near 5 years free of disease after surgical treatment. CONCLUSIONS: Patients with stomal recurrences begun primary treatment in locally and regionally advanced disease. In more that 60% of patients subglottic extension was observed. Emergency tracheotomy may predispose to stomal recurrence. Limited possibilities of treatment of stomal recurrences are the reason of very poor prognosis in this group of patients. During total laryngectomy paratracheal lymphatic nodes should be looked for and dissect.

Adult↗

PubMed2006

[Glomus caroticum, jugulare and vagale--problems in diagnosis and treatment].

INTRODUCTION: The paraganglia tissue in 80% is located in suprarenal glands. The rest (20%) are with close association with autonomic nerves and some cranial nerves. Paraganglioma, being tumors arising from the paraganglion cells of the parasympathetic system, were first reported in man in 1935. Although histologically these tumors have been shown to contain neurosecretory granules, they are rarely functional. There are four kinds of paragangliomas: deriving from carotid artery baroreceptors (glomus caroticum), internal jugular vein (glomus jugulare); placed along vagal nerve (glomus vagale) and paragangliomas of tympanic cavity (glomus tympanicum). The first three of them are clinically recognized as tumor of the neck. MATERIAL AND METHODS: Authors present group of 7 patients with paragangliomas treated in ENT Department in Poznań in the years 1994-2004. There were treated 4 patients with glomus caroticum, two with glomus vagale and one patient with glomus jugulare. RESULTS: All patients were treated surgically. In one case in group with glomus caroticum in histological examination tendency to infiltration of internal carotid artery was stated (chemodectoma malignum). The tumor was removed totally with partial excision of communis, external and internal carotid artery. The internal carotid artery was closed by the tumor. CONCLUSION: Authors underline three aspects of process of treatment in whole group of patients: diagnostic problems, way of treatment and long term results.

Adult↗

PubMed2006

[Deep lobe of parotid gland tumors].

INTRODUCTION: Surgery of the parotid gland tumors can be difficult because of the presence of the facial nerve branches in the parotid tissue. The aim of the surgical treatment is complete removal of the tumor without damaging the facial nerve. There are several surgical techniques to expose the main trunk and the branches of the facial nerve. On the other hand during the surgery the nerve function is continuously observed by using facial nerve monitor. MATERIAL AND METHODS: In the years of 2002-2004 208 patients with the parotid gland tumors were treated. There were 177 benign and 31 malignant tumors. 159 tumors were located in the superficial lobe of the parotid gland, 35 in the superficial and the deep lobe, and 14 only in the deep lobe. All patients were treated surgically. RESULTS: In cases concerning the operations of the tumors located in the deep lobe, the facial nerve branches had to be exposed with help of the microscopic operating techniques. All tumors were removed totally. A paralysis of the facial nerve was observed in two cases of the pleomorhic adenoma with a diameter over 6 cm, and in 9 cases of malignant tumors of the superficial and the deep lobe, where the main trunk or the branches of the facial nerve were integrated with the tumor mass. CONCLUSION: Surgical treatment of the parotid gland tumors presented in our study demonstrates good results. The risk of facial nerve paresis is higher in malignant tumors and big pleomorphic adenomas.

Adult↗

PubMed2006

[Deep neck infections].

Deep neck infection is relatively rare but potentially life threatening complication of common oropharyngeal infections. This retrospective study was aimed at analyzing the occurrence of complications, diagnostic methods and proper management of deep neck infection. A review was conducted in 32 cases who were diagnosed as having deep neck infection from 1995 to 2005. The causes of deep neck infections were tonsillitis (16 cases), tooth diseases (6 cases), paratonsillar abscess (4 cases), parotitis (1 case), pussy lymphonodes after tonsillectomy (2 cases), pussy congenital neck cyst (1 case), chronic otitis media (1 case), parotitis (1 case), foreign body of the esophagus (1 case). All the puss bacterial cultivation were positive. All the patients were treated by different ways of chirurgical drainage and use of large dosage of antibiotics. Deep neck infection should be suspected in patients with long lasting fever and painful swelling of the neck and treatment should begin quick as possible.

Adolescent↗

PubMed2006

[The assessment of intravital staining of parotic gland using methylene blue in the surgery of benign gland tumors--preliminary report].

INTRODUCTION: The operation of parotic gland tumors are challenge for the surgeon. The main aim of these operations is tumor removal and facial nerve preservation. Despite of imaging examinations, showing the localization of the tumor, it's important for surgeon to have the opportunity to discriminate between tumor and normal parotic gland tissue during the operation, e.g. in color difference. Methylene blue (MB) has been used in intravital staining of various tissues for a long time. MATERIAL AND METHODS: The aim of the study was an attempt of intravital staining of parotic gland, using MB during the surgery of five benign gland tumors. RESULTS: In all cases parenchyma of the parotic gland was dark-blue stained and in all cases, while the tumor didn't show any staining. CONCLUSIONS: Using of MB may be useful in the surgery of parotic gland.

Adult↗

PubMed2006

[Rare case of schwannoma of the sinonasal tract].

Schwannomas of the sinonasal tract are extremely uncommon lesions. An interesting case of this tumour in young 19-year old woman involved in nasal cavity, the maxillary, ethmoid and sphenoid sinus is presented. A long, above 2-year history of symptoms was emphasized. The magnetic resonance findings and metod of treatment modo Denker was described.

Adult↗

PubMed2005

The impact of genetic factors on the incidence of multiple primary tumors (MPT) of the head and neck.

One of the most troublesome failures in head and neck tumors treatment is the incidence of multiple primary tumors (MPT). The aim of the study was to identity the genetic factors associated with the predisposition of second cancer occurrence. The polymorphisms of genes involved in carcinogen metabolic activation (CYP1A1, CYP2E1), detoxication (GSTM1, GSTT1, GSTM3, NAT2,) and DNA repair (XPD /A35931C-exon 23 and C22541A-exon 6/, XRCC1 /G28152A-exon 10 and C26304T-exon 6/, XRCC3/C18067T/) were studied by PCR-based techniques to analyze genotypes and allele distribution in 84 patients with MPT correlated with 182 subjects with a single tumor of head and neck and 143 cancer-free male volunteers recruited from healthy smokers. Out of 11 polymorphisms examined significant differences between studied groups in CYP1A1, GSTM1, NAT2 genes, but not at the CYP2E1, GSTT1, GSTM3, XPD (exon 23 and 6), XRCC1 (exon 10 and 6) and XRCC3 were established. Further, the coexistence of some genotypes/alleles associated with a higher cancer risk, so called 'risk genotypes' was established as an added genetic factor to MPT development. The interpretation of our data indicates that the same group of low-penetration genes is involved in the development of single and multiple primary head and neck cancer but their association with MPT is significantly stronger.

Aged↗

PubMed2005

CYP1A1, CYP2D6, CYP2E1, NAT2, GSTM1 and GSTT1 polymorphisms or their combinations are associated with the increased risk of the laryngeal squamous cell carcinoma.

Polymorphisms in the selected genes controlling carcinogen metabolism (CYP1A1, CYP2D6, CYP2E1, NAT2, GSTM1, GSTT1) considered separately or in different combinations, were investigated for an association with tobacco smoke-associated squamous cell carcinoma (SCC) of the larynx. The case-control study was performed in 289 patients with laryngeal SCC and in 316 cancer-free controls; all were Caucasian males from the same region of Poland and current tobacco smokers. The DNA samples were genotyped using PCR-RFLP and multiplex PCR. The variants' frequencies in both groups were compared; odds ratios and their 95% confidence intervals were calculated by logistic regression analyses. The CYP1A1*1/*4, CYP2D6*4/*4, NAT2*4/*6A genotypes, as well as the CYP1A1*4, CYP2D6*4 and NAT2*4 alleles, were found at significantly higher frequencies in cases than in controls indicating their role as "risk-elevating" factors in laryngeal SCC. Combined genotypes, characterized by the presence of the "risk-elevating" variants at more than one locus, often occurred together with the null variant of the GSTM1 gene and homozygous XPD A/A (Lys751Gln, A35931C) genotype. Furthermore, we identified some "protective" variants, found more frequently in controls than in cases, i.e. the NAT2*6A/*6A and NAT2*5B/*6A genotypes. A distribution of "risk" or "protection" genotypes/alleles seems to be connected with age as an occurrence or risk genes was more frequent in the group of "young" cases (< or = 49 years). Accumulation of certain alleles or genotypes of the CYP1A1, NAT2, GSTM1 and XPD seems to be associated with either increased or decreased risk to develop laryngeal SCC. Therefore, polymorphisms in these genes may play a role in the laryngeal cancer etiology.

Adult↗

PubMed2005

Stent-graft treatment of extracranial internal carotid artery aneurysm.

Extracranial internal carotid artery aneurysm is not a frequent finding. Although there are a number of methods used for the treatment of this kind of pathology, every approach should be tailored to the patient. The authors describe the case of a patient with a large extracranial internal carotid artery aneurysm presenting as a tumor of the parapharyngeal space, treated with a stent-graft. The patient remains asymptomatic at the 2-year follow-up. To our knowledge, this type of successful treatment of a carotid aneurysm has been reported only once so far.

Adult↗

PubMed2005

Reduced DNA repair capacity in laryngeal cancer subjects. A comparison of phenotypic and genotypic results.

The impact of genetic factors on laryngeal cancer risk was studied in relation to DNA repair capacity on the phenotypic and genotypic level. DNA lesions induced by bleomycin or S9-activated benzo[a]pyrene were determined in blood lymphocytes using the alkaline comet assay. Laryngeal cancer subjects (n = 52) were shown to have higher levels of spontaneous and mutagen-induced DNA damage as compared to healthy controls (n = 56). A level of spontaneous DNA damage tended to increase with tumour grading. A percentage of individuals with an efficient DNA repair was higher in controls than in cancer subjects for both used mutagens. The distribution of polymorphic variants of XPD, XRCC1 and XRCC3 DNA repair genes in the group of laryngeal cancer subjects (n = 293), subjects with second primary tumours (n = 84) and in the matched controls (n = 322) was estimated by PCR-based genotyping. Five polymorphisms were studied in 3 DNA repair genes. There were found only 2 XPD alleles significantly overrepresented in laryngeal cancer that could be interpreted as an increase in genetic risk. There were no significant differences in distribution of 'risk' and 'protective' genotypes between single primary and second primary tumours. Altogether, the established phenotypic deficit of DNA repair in laryngeal cancer subjects was only partly confirmed by overrepresentation of 'risk' genotypes of the studied DNA repair genes.

Adult↗

PubMed2005

[Functional endoscopic sinus surgery assisted by navigation system--own experience].

Functional endoscopic sinus surgery is nowadays a gold standard in case of chronic sinusitis. Microscopes and endoscopes are routinely used and the plan of the operation is based on physical examination and high resolution computed tomography of paranasal sinuses done in the bone frame. In the last few years trials were done with intraoperative navigation systems. This kind of system was tested in the ENT department of Karol Marcinkowski University in Poznań. Surgery was performed using electromagnetic and optical one. Thirteen patients with chronic sinusitis underwent surgery. A high resolution computed tomography was done in three planes. Then the data were transferred to the computer system. Those data were used to plan the surgery (determination of the "safe corridor") and in the intraoperative monitoring of the position of surgical instruments. We can state an improvement of the comfort for the surgeon and safety for the patient. We did not state disturbances in system work due to patient displacement during surgery. Accuracy and rapidity of the computer system allowed to perform safe surgery. Authors accentuate the usability of this system in case of reoperation, extensive pathological changes and in congenital malformations.

Chronic Disease↗

PubMed2005

[Three kinds of chemodectoma in one patient--a rare case].

Tumors arising from paraganglioma tissue are properly called paragangliomas. Preferentially these tumors are named for their site of origin. In the head and neck they are most commonly found arising from the carotid body (glomus caroticum), the jugular bulb (glomus jugulare), the tympanic cavity (glomus tympanicum) and the vagal ganglia (glomus vagale). Mutiple paragangliomas may occur in 2-10%. The purpose of this study was to present the rare case of patient with three kinds of chemodectoma: glomus tympanicum, jugulare i vagale.

Carotid Body Tumor↗

PubMed2005

[Sphenoid sinus surgery].

Sphenoid sinus surgery due to specific localization is placed in otolaryngologists and neurosurgeons field of interest. Surgery of this area, from one side, causes number of problems, which usually arise due to close neighbourhood of important structures, but on the other, serves as alternative approach, eliminating necessity of extended operations with craniotomies. The article summarizes results of sphenoid sinus surgery at ENT Department, University of Medical Sciences in Poznan between 1990 and 2003, as well as points out characteristic features of the surgery in this specific localization.

Female↗