Consequences of Disturbing Manganese Homeostasis

Manganese (Mn) is an essential trace element with unique functions in the body; it acts as a cofactor for many enzymes involved in energy metabolism, the endogenous antioxidant enzyme systems, neurotransmitter production, and the regulation of reproductive hormones. However, overexposure to Mn is toxic, particularly to the central nervous system (CNS) due to it causing the progressive destruction of nerve cells. Exposure to manganese is widespread and occurs by inhalation, ingestion, or dermal contact. Associations have been observed between Mn accumulation and neurodegenerative diseases such as manganism, Alzheimer's disease, Parkinson's disease, Huntington's disease, and amyotrophic lateral sclerosis. People with genetic diseases associated with a mutation in the gene associated with impaired Mn excretion, kidney disease, iron deficiency, or a vegetarian diet are at particular risk of excessive exposure to Mn. This review has collected data on the current knowledge of the source of Mn exposure, the experimental data supporting the dispersive accumulation of Mn in the brain, the controversies surrounding the reference values of biomarkers related to Mn status in different matrices, and the competitiveness of Mn with other metals, such as iron (Fe), magnesium (Mg), zinc (Zn), copper (Cu), lead (Pb), calcium (Ca). The disturbed homeostasis of Mn in the body has been connected with susceptibility to neurodegenerative diseases, fertility, and infectious diseases. The current evidence on the involvement of Mn in metabolic diseases, such as type 2 diabetes mellitus/insulin resistance, osteoporosis, obesity, atherosclerosis, and non-alcoholic fatty liver disease, was collected and discussed.

Polysaccharide Composite Films Utilising Wood Waste

This study aimed to investigate the effect of raw waste pine wood dust (Pinus sylvestris) from furniture production on polysaccharide biopolymer film properties. The obtained biocomposite films produced via the casting method were prepared with 20% glycerol and 0%, 5%, 10%, 15%, 20%, and 25% of added wood dust in relation to the dry starch matter. Wood dust composition and particle size distribution analysis were performed. In order to evaluate the material surface properties, tests were carried out using an atomic force microscope (AFM) and a contact angle goniometer. Utilising uniaxial tensile test methodology, the values for both tensile strength and Young's modulus were determined. In addition, the barrier properties, water solubility index, and colour were also investigated. The research showed that wood dust affected the functional parameters of the obtained biocomposites. A wood dust content increase causes the Young's modulus value to rise with a progressive decrease in the max. strain. The filler did not change the films' wetting properties, and each had a hydrophilic surface regardless of the additive amount. The bio-sourced composites obtained were non-toxic and environmentally neutral materials, suitable to be applied in the packaging industry as well as the agriculture sector.

Linking Metallic Micronutrients and Toxic Xenobiotics to Atherosclerosis and Fatty Liver Disease-Postmortem ICP-MS Analysis of Selected Human Tissues

Dyslipidaemia is a disorder of the lipid metabolism, caused mainly by poor eating habits. The most severe consequence of an inappropriate diet is the development of atherosclerosis and hepatic steatosis. It is generally believed that a change in nutrition, and increased physical activity can eliminate these health problems. The contemporary research and therapies used to treat dyslipidemia mainly focus on lowering the triglyceride and cholesterol levels. However, disturbances in trace element homeostasis or the accumulation of toxic elements can also affect physiological processes, and be involved in the development of metabolically mediated diseases. The present study aimed to determine the mineral profiles of liver and brain tissues collected at autopsy (n = 39) in groups of people with hepatic steatosis (n = 5), atherosclerosis (n = 9), hepatic steatosis, and atherosclerosis (n = 16), and others without the selected disorders (n = 9). Concentrations of 51 elements were analysed via inductively coupled plasma mass spectrometry (ICP-MS) after the initial wet mineralisation of the samples with nitric acid. The results obtained allow us to conclude that the hepatic steatosis group suffers from a deficiency of important trace elements, such as copper, zinc, and molybdenum (p < 0.05), whereas the group with atherosclerosis is characterised by elevated levels of cadmium in the liver tissue (p = 0.01). Analysing the mean values of the element concentrations measured in 11 brain areas, statistically significant higher levels of calcium and copper (p < 0.001) were found in the atherosclerosis group, compared to the hepatic steatosis group, confirming the involvement of these elements in the pathogenesis of atherosclerosis. In addition, an accumulation of cadmium, lead, titanium, and strontium in the brain tissue was observed in the atherosclerosis group. While the accumulation of individual elements differs in different parts of the brain, the differences in the cadmium content (p < 0.05) between the study groups apply to the whole brain, except for the nucleus accumbens septi area, where a statistically significant titanium accumulation occurs in the atherosclerosis and steatosis groups, compared to the others (p < 0.05). In addition, the disruption of elemental homeostasis in the brain of a single case with bipolar disorder, and a case with hip replacement was observed. Our results confirm the involvement of chemical elements in the pathogenesis of selected metabolic diseases, and the need for further studies in larger populations.

Assessment of the Concentration of 51 Elements in the Liver and in Various Parts of the Human Brain-Profiling of the Mineral Status

The anthropogenic environment and diet introduce many metals into the human body, both essential and toxic. Absorption leads to systemic exposure and accumulation in body fluids and tissues. Both excess and deficiency of trace elements are health hazards. The primary aim of the present study was to evaluate the concentration of 51 elements in liver samples and 11 selected brain regions obtained at post-mortem examination from a population of adults living in south-eastern Poland (n = 15). A total of 180 analyses were performed by inductively coupled plasma mass spectrometry in two independent replicates. The collected data show very high individual variability in the content of the investigated elements. Macroelements such as sodium, magnesium, phosphorus, potassium, calcium, iron, and zinc occurred in the highest concentrations and with the greatest statistically significant variations. Although the elemental content of the brain and liver differed significantly, the strongest positive correlation between liver and polus frontalis was observed for the essential element selenium (0.9338) and the strongest negative one for manganese (-0.4316) and lanthanum (-0.5110). The brain areas studied have different requirements for phosphorus, manganese, iron, and molybdenum. In addition, males had a significantly (p < 0.05) higher brain content of lanthanides and actinides than females. The results of this study show that the inhabitants of south-eastern Poland are exposed to a fairly uniform accumulation of aluminum and vanadium in the brain, which have the highest affinity to the thalamus dorsalis. This result proves that there is environmental exposure to these elements.

Fresh vegetables and fruit as a source of Salmonella bacteria

INTRODUCTION

Increased consumer awareness of the health aspects of the diet has influenced the increased consumption of fruit and vegetables. Due to the fact that these products are mainly consumed raw and are usually not subjected to processes that reduce their microbiological contamination, they become a source of infection and transmit pathogens causing food poisoning in humans. Salmonella bacteria are a serious treat to human health and remain a serious problem in many parts of the world.

OBJECTIVE

The aim of this study was to review the current state of knowledge regarding the prevalence of Salmonella bacteria on fresh fruit and vegetables. Attention is also given to the mechanisms by which these bacteria adapt to colonize plants. Methods that can prevent contamination of plant products by the bacteria are also analyzed.

REVIEW METHODS

The review was based on data obtained from scientific articles published in the Science Direct and Pub Med database between 2007 - 2022, found with the use of the following keywords: Salmonella, fruit, vegetables, food contamination.

BRIEF DESCRIPTION OF THE STATE OF KNOWLEDGE

Data from the literature report that fresh fruit and vegetables are a source of Salmonella contamination through contact with soil, manure, compost, water or staff.

SUMMARY

Actions targeting salmonellosis prevention should be undertaken by both the public and private sectors. Government regulations and stricter measures put in place can provide a framework that guides both domestic production and international imports. Periodic training of workers dealing with food is also important. Attention should be directed mainly to production control and less to the testing of final products. Education leading to increased awareness of salmonellosis should be indispensable.

Changes in Synthetic Soda Ash Production and Its Consequences for the Environment

This publication presents a series of data of one of the most difficult chemical processes to implement in industrial conditions. Obtaining soda using the Solvay technique is a process with a world volume of about 28 Tg per year. The process is extremely physico-chemically complex and environmentally burdensome. The paper presents information on a multi-component system containing three phases with a chemical reaction. Calculations for such systems and their engineering are very complicated, but the authors show how the results of this work can be applied. This paper also describes modifications of the soda process to minimize the environmental burden and minimize the production input of Na2CO3. The modifications were beneficial in reducing CO2 emissions and increased the efficiency of the soda process, resulting in a measurable financial benefit. At the scale of the plant where the experiment was carried out, this reduction in CO2 emissions amounts to 7.93 Gg per year.

Differences in microbiological quality of leafy green vegetables

OBJECTIVE

The aim of the study was to determine the presence and concentration of indicator microorganisms on leafy green vegetables available in Poland.

MATERIAL AND METHODS

Microbial analyses of 122 samples of leafy green vegetables: rocket, lamb's lettuce, iceberg lettuce, chive, spinach, celery, dill and parsley, sold in Polish supermarkets in 2018 and 2019, were conducted. The vegetables were analyzed for aerobic mesophilic bacteria, yeasts and moulds, Enterobacteriaceae, Enterococcus, coliforms and Escherichia coli number according to Polish standards.

RESULTS

The most microbiologically contaminated vegetables occurred to be parsley, rocket and spinach, and the least contaminated was iceberg lettuce. The presence of total mesophilic bacteria was found in all samples. The highest average number of mesophilic bacteria was found for lamb's lettuce, rocket, parsley and spinach. Numerous yeasts were presented in almost all leafy green samples while rocket and parsley were the most contaminated with moulds. Enterobacteriaceae were isolated from all samples of parsley. High populations of these bacteria were found in rocket and celery samples. Of the 122 vegetable samples, 95 (78%) were positive for coliforms, especially all samples of parsley were inhabited by these bacteria. 24% of all samples were contaminated by Enterococcus, mainly parsley, spinach and chive. The presence of E. coli was found in only one sample of spinach.

CONCLUSIONS

The levels of aerobic mesophilic bacteria, yeasts and moulds, Enterobacteriaceae, Enterococcus and coliforms in leafy green vegetables sold in Poland could be classified as moderate or low. The abundant presence of the studied microorganisms may pose a risk for some categories of people consuming leafy green vegetables, mostly immuno-compromised persons.

Influence of pipe material on biofilm microbial communities found in drinking water supply system

The biofilms and water samples from a model installation built of PVC-U, PE-HD and cast iron pipes were investigated using standard heterotrophic plate count and 16S rRNA Next Generation Sequencing. The results of the high throughput identification imply that the construction material strongly influences the microbiome composition. PVC-U and PE-HD pipes were dominated with Proteobacteria (54-60%) while the cast pipe was overgrown by Nitrospirae (64%). It was deduced that the plastic pipes create a more convenient environment for the potentially pathogenic taxa than the cast iron. The 7-year old biofilms were described as complex habitats with sharp oxidation-reduction gradients, where co-existence of methanogenic and methanotrophic microbiota takes place. Furthermore, it was found that the drinking water distribution systems (DWDS) are a useful tool for studying the ecology of rare bacterial phyla. New ecophysiological aspects were described for Aquihabitans, Thermogutta and Vampirovibrio. The discrepancy between identity of HPC-derived bacteria and NGS-revealed composition of biofilm and water microbiomes point to the need of introducing new diagnostical protocols to enable proper assessment of the drinking water safety, especially in DWDSs operating without disinfection.

Microbial quality of organic and conventional vegetables from Polish farms

Microbiological analyses of lettuce, radish, carrot and beetroot were conducted to determine the effect of production system (organic and conventional) on the microbial quality of vegetables in Poland. During 2010-2014 growing seasons, 600 organic and 372 conventional samples were collected from certified farms. The vegetables were analyzed for aerobic mesophilic bacteria, yeasts and molds, Enterobacteriaceae, coliforms and Escherichia coli according to Polish standards. The farmer's survey was conducted to collect information on farm management practices. The index (from 0 - no risk to 4 - high risk) of potential contamination of the produce by human pathogens, related to fertilization system was developed. The mesophilic bacteria, yeasts and molds, coliforms and Enterobacteriaceae numbers for the radish and carrot were similar for organic and conventional cultivation systems (mesophilic bacteria 7.0 log10 cfu g-1 and 6.6 log10 cfu g-1; yeasts and molds 5.1 and 4.8; coliforms 1.3 and 1.5; Enterobacteriaceae 2.1 and 2.3 for radish and carrot respectively). Organic lettuce harbored significantly more bacteria than conventional (mesophilic 6.7 log10 cfu g-1 and 6.4 log10 cfu g-1, coliforms 1.8 and 1.4; Enterobacteriaceae 2.5 and 1.9 for organic and conventional respectively). Organic beetroot contained higher number of yeasts and molds (5.1 log10 cfu g-1) and Enterobacteriaceae (2.9 log10 cfu g-1) than conventional (4.9 and 2.5 log10 cfu g-1). The vegetables from organic farms showed significantly higher load of E. coli (on average 0.42 log10 cfu g-1) than conventionally cultivated vegetables (in average 0.05 log10 cfu g-1). The index 0-4 of potential risk of produce contamination by human pathogens was created according to fertilization practices in both farm types. Its value increased with enhanced contribution of manures and other animal wastes. In organic production the main fertilization practice was application of animal manures, composted and not composted. A popular practice was also top dressing of growing plants with fermented plant extracts, sometimes enriched with dungwater. In conventional farming system mineral fertilization was the main source of the vegetable nutrition. Therefore, organic produce indicated higher index of contamination risk (2-4) than conventional vegetables (1-2). High indexes were positively associated with higher number of E. coli. It was found that fertilization system practiced in organic farms may deteriorate sanitary quality of the produce.

A neutral effect of testosterone therapy on macroprolactin content in men with macroprolactinemia and late-onset hypogonadism

BACKGROUND

In the light of recent studies, macroprolactinemia seems to occur much more frequently than previously thought. In women, oral contraceptive pills exhibit a stimulatory effect on macroprolactin production. No previous study has investigated macroprolactin levels in androgen-treated hypogonadal men.

METHODS

We studied 10 men with isolated macroprolactinemia and 14 men with normal prolactin levels who because of late-onset hypogonadism were treated with intramuscular testosterone enanthate. Serum prolactin, macroprolactin content, serum testosterone and gonadotropin levels were assessed at baseline and after 4 months of therapy.

RESULTS

Although baseline levels of testosterone and gonadotropins were similar in men with and without macroprolactinemia, clinical symptoms were more severe in patients with elevated big-big prolactin levels. As expected, testosterone treatment increased serum testosterone, slightly reduced serum gonadotropins, as well as improved clinical condition in both patients with and without macroprolactinemia, with no difference between the groups. However, testosterone therapy did not affect serum prolactin and macroprolactin content, even after replacing intramuscular testosterone enanthate with oral testosterone undecanoate.

CONCLUSIONS

Our results suggest a negligible effect of testosterone replacement on macroprolactin levels in macroprolactinemic men with late-onset hypogonadism.

The effect of oral contraception on macroprolactin levels in women with macroprolactinemia: A pilot study

BACKGROUND

Despite a high prevalence of macroprolactinemia in the population, the only drugs found to change macroprolactin (big-big prolactin) levels were dopamine receptor agonists.

METHODS

The aim of this study was to investigate the effect of oral contraceptive pills containing ethinyl estradiol and levonorgestrel on serum macroprolactin levels in patients with macroprolactinemia. The study population included 21 premenopausal women with isolated macroprolactinemia, 11 of whom were treated with oral contraceptive pills. Serum prolactin and macroprolactin levels were assessed at baseline and after 16 weeks of treatment.

RESULTS

Oral contraceptive pills administered for 16 weeks slightly increased pre-polyethylene glycol serum prolactin levels and macroprolactin levels and the effect of this treatment correlated with their baseline values.

CONCLUSIONS

Our results suggest that oral contraceptive pills containing ethinyl estradiol and levonorgestrel exhibit a stimulatory effect on macroprolactin production in women with basically high macroprolactin levels.

[Endocrine abnormalities in patients with chronic renal failure - part I]

The kidney plays an important role in synthesis, metabolism and elimination of a plethora of hormones. In subjects with chronic renal failure, particularly at its later stages, these adaptive responses are impaired and some of these alterations are of clinical relevance. Endocrine disturbances which are the most characteristic for chronic renal failure include: secondary and tertiary hyperparathyroidism, hypothalamic-pituitary-thyroid axis dysfunction and impaired growth. The pathogenesis of these complications is complex and multifactorial. This review discusses the most important changes in the function of the parathyroid glands, thyroid and the growth hormone-insulin-like growth factor 1 axis in the light of recent developments in this field. This article also tries to give insights into diagnosis and putative therapeutic strategies.

[Endocrine abnormalities in patients with chronic renal failure - part II]

The kidneys play a crucial role in maintaining homeostasis of fluids and electrolytes, acid-base balance, and volume regulation. In subjects with chronic renal failure, particularly at its later stages, these adaptive responses are impaired and some of these alterations are of clinical relevance. The ways in which chronic renal failure affects function of endocrine organs include impaired secretion of kidney-derived hormones, altered peripheral hormone metabolism, disturbed binding to carrier proteins, accumulation of hormone inhibitors, as well as abnormal target organ responsiveness. Apart from secondary hyperparathyroidism, thyroid dysfunction and impaired growth, reviewed in our previous study, endocrine disturbances that most frequently affect this group of patients include: abnormal functioning of the hypothalamic-pituitary-adrenal and hypothalamicpituitary- gonadal axes, bone loss and gynecomastia. The clinical picture and laboratory findings of these endocrine disturbances depend on the treatment strategy.

The effect of ezetimibe-statin combination on steroid hormone production in men with coronary artery disease and low cholesterol levels

BACKGROUND

Aggressive statin treatment was found to slightly reduce testosterone production. The aim of this study was to compare the effects of ezetimibe-statin combination and high-dose statin therapy on testicular and adrenal cortex function in men with LDL cholesterol levels below 70 mg/dL.

METHODS

The study included 26 adult men with coronary artery disease. Twelve of these patients did not tolerate high-dose statin therapy and were treated with lower doses of a statin plus ezetimibe. Fourteen patients tolerating high-dose simvastatin or rosuvastatin treatment continued high-dose statin therapy throughout the study period. Plasma lipids, glucose homeostasis markers and plasma levels of testosterone, cortisol, dehydroepiandrosterone sulphate, sex hormone-binding globulin, gonadotropins and ACTH, as well as urine free cortisol were assessed at baseline and after 16 weeks of treatment.

RESULTS

Replacing high-dose statin therapy with ezetimibe/statin combination therapy reduced plasma levels of LH by 32% (p=0.043), as well as increased plasma levels of testosterone by 20% (p=0.038). Ezetimibe/statin combination did not induce any significant changes in plasma levels or urine excretion of the remaining hormones. At the end of the study, plasma LH levels were higher, while plasma testosterone levels were lower in patients receiving the combination therapy than in those treated only with high-dose statin.

CONCLUSIONS

Our results indicate that ezetimibe combined with moderate statin dose exerts a less pronounced effect on testicular function in comparison with high-dose statin therapy.

Serum 25-Hydroxyvitamin D and Parathyroid Hormone Levels in Non-Lactating Women with Post-Partum Thyroiditis: The Effect of L-Thyroxine Treatment

Vitamin D deficiency seems to be implicated in the onset and progression of some autoimmune disorders. No previous study has investigated vitamin D homeostasis in post-partum thyroiditis. We compared 25-hydroxyvitamin D and parathyroid hormone (PTH) levels between four groups of non-lactating women who gave birth within 12 months before the beginning of the study: hypothyroid women with post-partum thyroiditis (group A; n = 14), euthyroid females with post-partum thyroiditis (group B; n = 14), women with non-autoimmune hypothyroidism (group C; n = 16) and healthy euthyroid females without thyroid autoimmunity (group D; n = 15). In the second part of the study, groups A and C were treated for 6 months with L-thyroxine. Serum levels of 25-hydroxyvitamin D were lower, while PTH higher in patients with post-partum thyroiditis than in patients without thyroid autoimmunity. They were also lower (25-hydroxyvitamin D) or higher (PTH) in group A than in group B, as well as in group C in comparison with group D. L-thyroxine treatment increased 25-hydroxyvitamin D and reduced PTH levels only in hypothyroid women with post-partum thyroiditis. Baseline levels of 25-hydroxyvitamin D correlated with thyroid antibody titres, thyroid function and circulating PTH levels, while the effect of L-thyroxine on serum levels of this vitamin correlated with the changes in thyroid antibody titres and PTH levels. The results of our study suggest the association of vitamin D status with post-partum thyroiditis and L-thyroxine treatment of this disorder.

[Precocious puberty in boys]

Precocious puberty in boys is defined as the onset of puberty before the age of 9 years. It is divided into two categories: central precocious puberty, characterized by the premature activation of the hypothalamic-pituitary-gonadal axis, and peripheral precocious puberty presents when premature sexual development is dependent on steroid production regardless of gonadotropin secretion. Although precocious puberty occurs more frequently in girls, in the case of boys it is more often associated with identifiable organic disorders of the central nervous system, adrenal glands or testes. The diagnosis should include detailed anamnesis and clinical examination, measurement of pituitary and sex hormones, assessment of bone age, and imaging of the hypothalamus, pituitary gland, adrenal glands and testes. Indications for treatment are based on the type of precocious puberty and its progression rate, advancement of bone age, predicted adult height and psychological evaluation. The purpose of this article was to discuss the etiopathogenesis of precocious puberty in boys and to provide the approach to its diagnosis, differentiation and treatment.

First report of Serratia plymuthica causing onion bulb rot in Poland

Specific bacterial disease symptoms were observed on onion bulbs in almost all regions in Poland. For the purpose of identification of agents causing disease, bacteria were isolated from the symptomatic plants. Their pathogenicity was confirmed by using pathogenicity test on onion scales. These bacteria were identified biochemically and molecularly as Serratia plymuthica.

[Case of typhoid fever in 43 old male]

The disease of 43 years old man, who was being taken in internal ward to diagnosis because of fever, was presented. In bacteriological culture Salmonella Typhi were kept. For reason the isolation was impossible on internal department, patient was conveyed to contagious department. As a result of carried out epidemiological inquiry, it turned out the man's infectious was coused by permanent carrier of typhoid fever.

[Effect of vitamin/mineral supplementation on calcium, magnesium and iron levels in amniotic fluid and serum taken from women during first half of pregnancy]

The levels of calcium, magnesium and iron in amniotic fluid and serum taken from women during first half of pregnancy were compared. The relationship between these levels and vitamin-mineral supplementation was also estimated. There was similar calcium and magnesium concentration in the serum and amniotic fluid. The concentration of iron in serum was four times as large as in amniotic fluid. Any influence of supplementation on concentration of studied minerals was noted.

[Effectiveness of elective neck dissection in patients with laryngeal carcinoma]

The authors presented material of 711 patients with laryngeal cancer treated in Department of Otolaryngology Medical University of Gdańsk in the years 1976-1995 estimating effectiveness of elective neck dissection. 402 patients (56.6%) had N0 stage and in 162 of them elective neck dissection was performed. Occult metastases were found in 21% of N0 patients. Comparing treatment results in this group to inoperated N0 patients the authors found higher percentage of survival and lower incidence of failure after elective neck dissection.

[Extracapsular spread of lymph nodes as a prognostic factor in laryngeal carcinoma]

The authors analysed clinical and morphological data of 105 patients with laryngeal carcinoma metastases in cervical lymph nodes treated in Department of Otolaryngology Medical University of Gdańsk in the years 1976-1985. The incidence of extracapsular spread and its relation to certain features of primary tumor and regional lymph nodes were estimated. The authors presented treatment results in two group of patients--with and without presence of extracapsular spread and stated prognostic value of extracapsular spread in patients with laryngeal carcinoma.

[Laryngeal carcinoma in brothers]

The most important etiologic factors of laryngeal carcinoma are tobacco smoking and heavy drinking as well as precancerous changes of laryngeal mucosa. The significance of genetic or family factor is still not explained. Two brothers, 45 and 48 years old, in which supraglottic carcinomas were diagnosed, are presented. The tumor localisation was the same in both brothers. In each of the patients supraglottic horizontal laryngectomy and neck dissection were performed. In one brother 5-year disease free survival was obtained, in second the distant and regional metastases were cause of death after two years.

[Bilateral neck dissections]

The structure of lymphatic system of the larynx causes that in some cases node metastases may occur bilaterally. In many patients bilateral neck dissection is indicated. In material of 252 patients with laryngeal carcinoma, treated in ENT Department in Gdańsk in 1976-1985, an assessment of frequency and indications to one-stage bilateral neck dissection was made. Among 252 patients, bilateral operations were performed in 50, i.e. 20%. We have found that in 29 patients of 50 were nodal metastases, in 12 unilateral and in 17 bilateral. The analysis of long-term results of treatment showed 23.5% of 5-year survivals in patients with bilateral metastases and 42.3% in patients with unilateral metastases. To base on these data we consider that bilateral one-stage neck dissection should be a standard treatment in many cases of laryngeal carcinoma.

[Long term result of treatment of laryngeal carcinoma (1981-1990)]

Long term results were evaluated on the basis of the epidemiological and clinical analysis of 386 patients treated surgically because of squamous cell carcinoma of the larynx in the ENT Department, Medical University of Gdańsk between 1981-1990. Full recovery was achieved in 52.3% of patients, failure was found in 26.9%. In the treatment evaluation the following factors were taken into account: the age of patients, T and N classification and clinical staging, primary location of the tumour. The treatment results, concerning the years 1981-1990 were compared to the ones obtained in our clinic in 1971-1980; it has been stated that the differences between the percentage of recoveries and the failures are statistically unimportant.

[Meningiomas of the nose and paranasal sinuses]

In material of ENT Department, Medical University of Gdańsk we have three cases of extracranial meningioma localized in the nose and sinuses. Two of them are presented in this paper. One case was 29 year woman with meningioma of the nose and ethmoid and maxillary sinuses; it was residual tumor after removal of intracranial meningioma 3 years earlier. Second case was 14 year boy with meningioma of the nose, ethmoid and maxillary sinuses and of the orbit. In both patients tumor was removed by rhinosurgical access (lateral rhinotomy). Late results of the operation were very good. Basing on clinical and radiological pictures of both cases, pathological characteristics of naso-sinusal meningioma was made.

[Evaluation of treatment and preventive care for recurrent urolithiasis in children]

Among 425 children with urolithiasis treated in the Paediatric Clinical Department of the National Research Institute of Mother and Child in Warsaw between 1976-1997, 50 of them i.e. 11.7% (26 boys and 24 girls) had recurrent urolithiasis. Patients' age was from 10 months to 16 years and 5 months. The number of recurrences of uroliothiasis before treatment in the Institute was from 1 to 8. Most of the children had numerous surgical operations, some of them excreted stones spontaneously. The etiology was determined in all cases. A metabolic cause of urolithiasis was found in 34 cases, i.e. 68% of the analysed group. They were as follows: idiopathic hypercalcuria--24 cases, uric acid urolithiasis--5 cases, cystynuria--4 cases, and incomplete distal renal tubular acidosis--1 case. Other reasons for urolithiasis were: infection--7 cases, idiopathic urolithiasis--8 cases, ren spongiosum--1 case. Prevention of recurrences depending on the etiology was successful. In 45 cases no recurrences were found. Recurrent urolithiasis was observed in 4 cases of cystynuria and in one case of incomplete tubular acidosis. The observation period was from 3-19 years.

[Pathological and clinical assessment of polypoid hypertrophy of the vocal cords]

Polypoid hypertrophy of mucosa of the vocal cord is the most common non-neoplastic disease of the larynx. This hypertrophy has a form of simple polyp of vocal cord or polypoid hypertrophy of the whole length of one or both vocal cords. In most cases a course of the disease is typical. In a few cases we can observe changes in polyp epithelium, i.e. hyperplasia or even dysplasia. Clinical and histological analysis of 809 patients treated because of laryngeal polyps (by Kleinsasser microsurgical procedure) within the period of 1981-1995 at ENT Clinic in Gdańsk was made. Sex and age of the patients, macroscopic picture of the disease as well as treatment and results were assessed. Special attention was paid to the problem of polyp epithelium rebuilding. In a few cases, polyp of the vocal cord should be assessed as praecancerous state.

[Ocular and orbital symptoms of Wegener's disease]

Wegener's granuloma occurs most commonly in upper respiratory tract, in lungs and in kidneys. In many cases ocular and orbital disturbances may be accompanied by changes in the nose and sinuses. These disturbances occur as: superior orbital fissure syndrome, orbital apex syndrome or ocular fascicle atrophy. The authors present the symptoms of these disturbances in 3 patients treated at Otolaryngological Clinic, Medical University of Gdańsk. On the bases of clinical symptoms and radiological results (CT and MRI) the assessment of pathogenesis of ocular and orbital symptoms was made in each of these cases, with special regard to the mode and result of the treatment.

[Extramedullary plasmacytomas of the larynx]

The authors present four cases of solitary extramedullary plasmocytoma of the larynx, a very rare laryngeal tumor, seen in ENT Department, Medical University of Gdańsk in years 1948-1994. They were 0.16% of all malignant laryngeal neoplasms and 23.5% of non-epithelial neoplasms of the larynx in this period. Characteristics for these tumors, epidemiological and clinical features were discussed.