Genome-wide analysis of the role of the antibiotic biosynthesis regulator AbsA2 in Streptomyces coelicolor A3(2)

The AbsA1-AbsA2 two component signalling system of Streptomyces coelicolor has long been known to exert a powerful negative influence on the production of the antibiotics actinorhodin, undecylprodiginine and the Calcium-Dependent Antibiotic (CDA). Here we report the analysis of a ΔabsA2 deletion strain, which exhibits the classic precocious antibiotic hyper-production phenotype, and its complementation by an N-terminal triple-FLAG-tagged version of AbsA2. The complemented and non-complemented ΔabsA2 mutant strains were used in large-scale microarray-based time-course experiments to investigate the effect of deleting absA2 on gene expression and to identify the in vivo AbsA2 DNA-binding target sites using ChIP-on chip. We show that in addition to binding to the promoter regions of redZ and actII-orfIV AbsA2 binds to several previously unidentified sites within the cda biosynthetic gene cluster within and/or upstream of SCO3215—SCO3216, SCO3217, SCO3229—SCO3230, and SCO3226, and we relate the pattern of AbsA2 binding to the results of the transcriptomic study and antibiotic phenotypic assays. Interestingly, dual ‘biphasic’ ChIP peaks were observed with AbsA2 binding across the regulatory genes actII-orfIV and redZ and the absA2 gene itself, while more conventional single promoter-proximal peaks were seen at the CDA biosynthetic genes suggesting a different mechanism of regulation of the former loci. Taken together the results shed light on the complex mechanism of regulation of antibiotic biosynthesis in Streptomyces coelicolor and the important role of AbsA2 in controlling the expression of three antibiotic biosynthetic gene clusters.

Fine-mapping of prostate cancer susceptibility loci in a large meta-analysis identifies candidate causal variants

Prostate cancer is a polygenic disease with a large heritable component. A number of common, low-penetrance prostate cancer risk loci have been identified through GWAS. Here we apply the Bayesian multivariate variable selection algorithm JAM to fine-map 84 prostate cancer susceptibility loci, using summary data from a large European ancestry meta-analysis. We observe evidence for multiple independent signals at 12 regions and 99 risk signals overall. Only 15 original GWAS tag SNPs remain among the catalogue of candidate variants identified; the remainder are replaced by more likely candidates. Biological annotation of our credible set of variants indicates significant enrichment within promoter and enhancer elements, and transcription factor-binding sites, including AR, ERG and FOXA1. In 40 regions at least one variant is colocalised with an eQTL in prostate cancer tissue. The refined set of candidate variants substantially increase the proportion of familial relative risk explained by these known susceptibility regions, which highlights the importance of fine-mapping studies and has implications for clinical risk profiling.

Polygenic hazard score to guide screening for aggressive prostate cancer: development and validation in large scale cohorts

OBJECTIVES

To develop and validate a genetic tool to predict age of onset of aggressive prostate cancer (PCa) and to guide decisions of who to screen and at what age.

DESIGN

Analysis of genotype, PCa status, and age to select single nucleotide polymorphisms (SNPs) associated with diagnosis. These polymorphisms were incorporated into a survival analysis to estimate their effects on age at diagnosis of aggressive PCa (that is, not eligible for surveillance according to National Comprehensive Cancer Network guidelines; any of Gleason score ≥7, stage T3-T4, PSA (prostate specific antigen) concentration ≥10 ng/L, nodal metastasis, distant metastasis). The resulting polygenic hazard score is an assessment of individual genetic risk. The final model was applied to an independent dataset containing genotype and PSA screening data. The hazard score was calculated for these men to test prediction of survival free from PCa.

SETTING

Multiple institutions that were members of international PRACTICAL consortium.

PARTICIPANTS

All consortium participants of European ancestry with known age, PCa status, and quality assured custom (iCOGS) array genotype data. The development dataset comprised 31 747 men; the validation dataset comprised 6411 men.

MAIN OUTCOME MEASURES

Prediction with hazard score of age of onset of aggressive cancer in validation set.

RESULTS

In the independent validation set, the hazard score calculated from 54 single nucleotide polymorphisms was a highly significant predictor of age at diagnosis of aggressive cancer (z=11.2, P<10-16). When men in the validation set with high scores (>98th centile) were compared with those with average scores (30th-70th centile), the hazard ratio for aggressive cancer was 2.9 (95% confidence interval 2.4 to 3.4). Inclusion of family history in a combined model did not improve prediction of onset of aggressive PCa (P=0.59), and polygenic hazard score performance remained high when family history was accounted for. Additionally, the positive predictive value of PSA screening for aggressive PCa was increased with increasing polygenic hazard score.

CONCLUSIONS

Polygenic hazard scores can be used for personalised genetic risk estimates that can predict for age at onset of aggressive PCa.

Genome-Wide Meta-Analyses of Breast, Ovarian, and Prostate Cancer Association Studies Identify Multiple New Susceptibility Loci Shared by at Least Two Cancer Types

Breast, ovarian, and prostate cancers are hormone-related and may have a shared genetic basis, but this has not been investigated systematically by genome-wide association (GWA) studies. Meta-analyses combining the largest GWA meta-analysis data sets for these cancers totaling 112,349 cases and 116,421 controls of European ancestry, all together and in pairs, identified at P < 10(-8) seven new cross-cancer loci: three associated with susceptibility to all three cancers (rs17041869/2q13/BCL2L11; rs7937840/11q12/INCENP; rs1469713/19p13/GATAD2A), two breast and ovarian cancer risk loci (rs200182588/9q31/SMC2; rs8037137/15q26/RCCD1), and two breast and prostate cancer risk loci (rs5013329/1p34/NSUN4; rs9375701/6q23/L3MBTL3). Index variants in five additional regions previously associated with only one cancer also showed clear association with a second cancer type. Cell-type-specific expression quantitative trait locus and enhancer-gene interaction annotations suggested target genes with potential cross-cancer roles at the new loci. Pathway analysis revealed significant enrichment of death receptor signaling genes near loci with P < 10(-5) in the three-cancer meta-analysis.

SIGNIFICANCE

We demonstrate that combining large-scale GWA meta-analysis findings across cancer types can identify completely new risk loci common to breast, ovarian, and prostate cancers. We show that the identification of such cross-cancer risk loci has the potential to shed new light on the shared biology underlying these hormone-related cancers. Cancer Discov; 6(9); 1052-67. ©2016 AACR.This article is highlighted in the In This Issue feature, p. 932.

Atlas of prostate cancer heritability in European and African-American men pinpoints tissue-specific regulation

Although genome-wide association studies have identified over 100 risk loci that explain ∼33% of familial risk for prostate cancer (PrCa), their functional effects on risk remain largely unknown. Here we use genotype data from 59,089 men of European and African American ancestries combined with cell-type-specific epigenetic data to build a genomic atlas of single-nucleotide polymorphism (SNP) heritability in PrCa. We find significant differences in heritability between variants in prostate-relevant epigenetic marks defined in normal versus tumour tissue as well as between tissue and cell lines. The majority of SNP heritability lies in regions marked by H3k27 acetylation in prostate adenoc7arcinoma cell line (LNCaP) or by DNaseI hypersensitive sites in cancer cell lines. We find a high degree of similarity between European and African American ancestries suggesting a similar genetic architecture from common variation underlying PrCa risk. Our findings showcase the power of integrating functional annotation with genetic data to understand the genetic basis of PrCa.

Genome-wide association study of prostate cancer-specific survival

BACKGROUND

Unnecessary intervention and overtreatment of indolent disease are common challenges in clinical management of prostate cancer. Improved tools to distinguish lethal from indolent disease are critical.

METHODS

We performed a genome-wide survival analysis of cause-specific death in 24,023 prostate cancer patients (3,513 disease-specific deaths) from the PRACTICAL and BPC3 consortia. Top findings were assessed for replication in a Norwegian cohort (CONOR).

RESULTS

We observed no significant association between genetic variants and prostate cancer survival.

CONCLUSIONS

Common genetic variants with large impact on prostate cancer survival were not observed in this study.

IMPACT

Future studies should be designed for identification of rare variants with large effect sizes or common variants with small effect sizes.

Multiple novel prostate cancer susceptibility signals identified by fine-mapping of known risk loci among Europeans

Genome-wide association studies (GWAS) have identified numerous common prostate cancer (PrCa) susceptibility loci. We have fine-mapped 64 GWAS regions known at the conclusion of the iCOGS study using large-scale genotyping and imputation in 25 723 PrCa cases and 26 274 controls of European ancestry. We detected evidence for multiple independent signals at 16 regions, 12 of which contained additional newly identified significant associations. A single signal comprising a spectrum of correlated variation was observed at 39 regions; 35 of which are now described by a novel more significantly associated lead SNP, while the originally reported variant remained as the lead SNP only in 4 regions. We also confirmed two association signals in Europeans that had been previously reported only in East-Asian GWAS. Based on statistical evidence and linkage disequilibrium (LD) structure, we have curated and narrowed down the list of the most likely candidate causal variants for each region. Functional annotation using data from ENCODE filtered for PrCa cell lines and eQTL analysis demonstrated significant enrichment for overlap with bio-features within this set. By incorporating the novel risk variants identified here alongside the refined data for existing association signals, we estimate that these loci now explain ∼38.9% of the familial relative risk of PrCa, an 8.9% improvement over the previously reported GWAS tag SNPs. This suggests that a significant fraction of the heritability of PrCa may have been hidden during the discovery phase of GWAS, in particular due to the presence of multiple independent signals within the same region.

Prediction of individual genetic risk to prostate cancer using a polygenic score

BACKGROUND

Polygenic risk scores comprising established susceptibility variants have shown to be informative classifiers for several complex diseases including prostate cancer. For prostate cancer it is unknown if inclusion of genetic markers that have so far not been associated with prostate cancer risk at a genome-wide significant level will improve disease prediction.

METHODS

We built polygenic risk scores in a large training set comprising over 25,000 individuals. Initially 65 established prostate cancer susceptibility variants were selected. After LD pruning additional variants were prioritized based on their association with prostate cancer. Six-fold cross validation was performed to assess genetic risk scores and optimize the number of additional variants to be included. The final model was evaluated in an independent study population including 1,370 cases and 1,239 controls.

RESULTS

The polygenic risk score with 65 established susceptibility variants provided an area under the curve (AUC) of 0.67. Adding an additional 68 novel variants significantly increased the AUC to 0.68 (P = 0.0012) and the net reclassification index with 0.21 (P = 8.5E-08). All novel variants were located in genomic regions established as associated with prostate cancer risk.

CONCLUSIONS

Inclusion of additional genetic variants from established prostate cancer susceptibility regions improves disease prediction.

[The achievements of Therapeutic Institute of Eugenia Lewicka in Druskininkai]

The professional activity of Eugenia Lewicka (1896-1931), a Varsovian doctor, his thorough medical education in various European countries are presented first of all. Her significance for development of Main Institute of Physical Education in Warsaw is mentioned. She was a head of "Helio-, aero-, and kinesiotherapeutical infirmary" in Druskininkai. The achievements this well-known infirmary for development of Polish health resorts are recounted.

Achievements of Polish doctors in gastrodiaphanoscopy at the turn of the 19(th) and 20(th) centuries

Diaphanoscopy/transillumination, the method of shining a bright light through tissues, was devised in the mid-19(th) century and developed after the invention of the light bulb by T.A. Edison. Benjamin Milliot was the first to examine the stomach by means of an incandescent platinum wire. The experiments conducted by Max Einhorn using a device consisting of a Nelaton catheter with an inserted light bulb, were valuable. In Poland the method of gastrodiaphanoscopy was popularized by Teodor Heryng, Mikołaj Rejchman and by Warsaw doctors. They used a diaphanoscope consisting of a gutta-percha probe distally equipped with a metal attachment with a light bulb hidden in it and with a so-called cooling device. The examination would usually be conducted in the standing position after the stomach had been filled with water. Light patches corresponding to the stomach's lower and side boundaries would be obtained. Rejchman's observation, that such a contractile and flexible organ as the stomach, changing its volume and position, is bound to change its light image, was correct. Heryng's and Rejchman's research inspired the foreign researchers Renvier, Leopold Kuttner and John Jacobson. Extensive research was subsequently conducted by C.A. Meltzing and Wilhelm Schwartz. Diaphanoscopy would also be performed by Walery Jaworski, the pioneer of gastrology. He was particularly interested in transillumination of the stomach, peritoneum and omentum tumours. Eugeniusz Kozierowski, a practicing physician from Gorlice, diagnosed neoplastic pylorostenosisusing this method. Gastrodiaphanoscopy is a historical method, now of no value against gastroendoscopy and the state-of-the-art methods of image diagnostics.

The first Polish total laryngectomies

The total removal of the larynx (total laryngectomy), performed in 1872 by the well-known Viennese surgeon Christian A. Theodor Billroth (1829-1894), was an epoch-making event in the history of surgery and laryngology. This paper presents the first surgeons who performed this operation. The first Pole who performed a total laryngectomy (1877) was Julian Kosiński (1833-1914), head of the Surgical Clinic of Imperial University Warsaw. It was the 14(th) operation of this kind in the world. Several laryngectomies were carried out by Franciszek Ksawery Jawdyński (1851-1896), called the father of Polish head and neck surgery, who was the first Pole to excise a malignant neck cancer together with the lymph nodes. The next total laryngectomies were performed by the following Polish surgeons: Jan Mikulicz-Radecki (1850-1905), Władysław H.S. Krajewski (1855-1907), Alfred Obaliński (1843-1898). According to Jan Sędziak, by 1897 Poland with 16 laryngectomies (per 188 carried out) had occupied the fourth position in the world. The failures of the first laryngectomies were due to such factors as the ignorance of shock pathophysiology, the inability to ensure the patency of the airways during and after the operation, which would result in lung and mediastinum infections, massive haemorrhages and so on. But the primary cause was the lack of constructive collaboration between the laryngologists and the surgeons.

Professor Ludwik Hirszfeld in his relations with students and junior researchers

This paper presents a profile of Ludwik Hirszfeld (1874-1954) as an educator of medical personnel. Hirszfeld was an eminent immunologist, bacteriologist and seroanthropologist; the originator of the Polish school of immunology; a professor at Warsaw University, Maria Sklodowska-Curie University in Lublin and the University and Technical University in Wroclaw; and the founder of the Institute of Immunology and Experimental Therapy in Wroclaw. An account of his relations with university students and junior research personnel - relations based on respect, on multi-faceted assistance in everyday life, but above all on a love for science - is presented, depicting Hirszfeld as a teacher of scientific thinking.

[The development of treatment in a health resort in Niemirow until the end of the second republic]

The history ofNiemirów, a health resort on the south-eastern borderland of Poland is recounted in full particulars first of all. A mild climate, charming regions, natural stuffs (sulphuric-alkaline salt springs and therapeutic mud) formed the status of this health resort. The indications and contraindications in many diseases and effects of treatment in a health resort are described. The bats in Niemirów and fixtures are presented widely. The chances of recreation and attractions in this health resort are presented finally.

[The development of treatment in the Birstonas health resort up to 1939 and the physicians of Birstonas in the 19th and first half of the 20th century]

First of all, the history and development of Birstonas, a health resort by the river Neman, near Vilnius, first mentioned in 1382, are recounted in detail. The value of this health resort was determined by a mild climate and salt springs. Information on Birstonas by Władysław Syrokomla (1823-1862), the Polish poet, and Zygmunt Gloger (1845-1910), the Polish ethnographer, archaeologist and historian are well known. The indications and contraindications in many diseases, and the effects of treatment in this health resort are described. Finally, the opportunities for recreation and the attractions in this charming health resort are presented. Attention was paid to the leading role of Poles in the development of this health resort now in Lithuania. The biographies of several physicians practicing in Birstonas: Jan Sokołowski, Aleksander T.W. Korewa, Anicety Renier, Stanisław K. Wikszemski, Benedykt Bilifiski, Erminio Andriolli, Roman Przybylski and Paweł A. Sawicki are presented. Their biographies, professional achievements and work in Birstonas are depicted in detail.

Analysis of the influence of a metha-type metaphysical stem on biomechanical parameters

The full postoperative loading of the limb is possible if patients are properly selected and qualified for hip arthroplasty and the requirements as to the proper position of the metaphysial stem are met. The lack of precision, and patient qualification which does not satisfy the fixed criteria may result in stem setting inconsistent with the assumptions. An analysis based on the finite element method (FEM) will enable one to find out how to plan the magnitude of operated joint loading on the basis of the position of the stem in the postoperative radiograph. By analyzing the distribution of bone tissue deformations one can identify the zones where the spongy bone is overloaded and determine the strain level in comparison with the one determined for a model of the bone with the stem in proper position. On the basis of the results obtained one can estimate the range of loads for the operated limb, which will not result in the loss of the stem's primary stability prior to obtaining secondary stability through osteointegration. Moreover, an analysis of the formation of bone structures around the stem showed that the incorrect setting of a Metha-type stem may lead to the initiation of loosening.

[Anicety Renier (1804-1877) and his significance for development of Druskienkai]

The aim of his paper is to present the silhouette of Anicety Renier (1804-1877), an eminent physician, patriot, deportee. His professional achievements as a physician of health resort in Druskienkai are presented widely. He was the author of publications on this health resort.

[The past of Druskininkai (part I)]

The development of hydrotherapy in the first half of the XIX century is presented in short. The geographical, climatic and epidemiological situation of Druskininkai, a health resort founded in 1837 has been mentioned. The natural substances: salt springs and therapeutic muds are described sufficiently. The development of the health resort in the XIX and the first half of XX century has been recounted. The physicians Ksawery Wolfgang (?-1864), Ludwik Zembrzycki, Izydor Nahumowicz (1800-1842), Anicety Renier (1804-1877), Kazimierz Choiski (1814-1882), Jan Pilecki (1821-1878), Józef Markiewicz (1834-1923), Walery Bujakowski (1857-1919) and the others and local rich gentry played an important role in the development of Druskieniki. The physician was undoubtedly the most esteemed person-age of this health resort. Russification of this health resort on the turn of the XIX century is also presented. The role of Marshal J6zef Pitsudski in this development is pointed out. The comparison of the medical indications and contraindications in Druskininkai in the middle of the XIX century and in the thirties of the XX century are presented in more detail. The scale of medical indications was wide. Druskieniki was an important health resort in pre-war Poland.

[Jan Pilecki (1821-1878) and achievements his Druskieninkai]

The history of development of health resort Druskieniki basing on Adam Wrzosek, an eminent Polish historian of medicine pointed out. The beauty and advantages of this health resort is depicted widely. The living and professional achievements of Jan Pilecki (1821-1878), an eminent physician of health resort, his significance for development and of Druskieninkai are presented in more detail. The medical indications and contraindications in Druskieniki basing on his own experiences have been reported. Pilecki was a author of many medical publications in Polish medical magazines. His papers contained interested medical observations and description of social life and entertainments in this health resort.

[The priest Sebastian Kneipp and his outlook on otorhinolaryngology diseases]

The silhouettes of the Priest Sebastian Kneipp, one of the pioneers of world hydrotherapy are presented first of all. Impressions of Polish doctors Józef Surzycki and Władysław Jasiński from this hydrotherapeutic institution are outlined. The Kneipp's hydrotherapeutic achievements in treatment of illness of ears, common cold, angina, diphtheria, hoarseness, vocal insufficiency are described in more detail.

[The otorhinolaryngological achievements of Władysław Orłowski (1835-1889)]

The professional and scientific activities of Władysław Orłowski (1835-1889), an eminent Varsovian surgeon are presented widely. Orłowski was a versatile surgeon. Orłowski's successful surgical treatment of many otorhinolaryngological diseases (such as complications of the inflammation of the middle ear, carcinoma of face and nose, tumor of nose, tuberculosis of nose, abscess of cheek, probably actinomycosis of jaw, carcinomas of tongue and others) are described in some more detail. He was a good surgical therapist of many different otorhinolaryngological diseases.

[Deontologic aspects in publications of Bronisław Wilhelm Sawicki (1860-1931)]

Bronisław Wilhelm Sawicki (1860-1931), an eminent Warsaw surgeon who received an extensive education at foreign medical institutions, was an expert in various problems of hospital management. The complicated problems of education of physicians in the Russian sector of partitioned Poland (the Grand Duchy of Warsaw and the Congress Kingdom of Poland) formulated by Sawicki are presented in this work. Medical education in Western Europe especially in Germany, Austria and France, is described in detail. The problems of hospital assistants in the second part of the 19th and in the beginning of the 20th century are discussed.

ClgR regulation of chaperone and protease systems is essential for Mycobacterium tuberculosis parasitism of the macrophage

Chaperone and protease systems play essential roles in cellular homeostasis and have vital functions in controlling the abundance of specific cellular proteins involved in processes such as transcription, replication, metabolism and virulence. Bacteria have evolved accurate regulatory systems to control the expression and function of chaperones and potentially destructive proteases. Here, we have used a combination of transcriptomics, proteomics and targeted mutagenesis to reveal that the clp gene regulator (ClgR) of Mycobacterium tuberculosis activates the transcription of at least ten genes, including four that encode protease systems (ClpP1/C, ClpP2/C, PtrB and HtrA-like protease Rv1043c) and three that encode chaperones (Acr2, ClpB and the chaperonin Rv3269). Thus, M. tuberculosis ClgR controls a larger network of protein homeostatic and regulatory systems than ClgR in any other bacterium studied to date. We demonstrate that ClgR-regulated transcriptional activation of these systems is essential for M. tuberculosis to replicate in macrophages. Furthermore, we observe that this defect is manifest early in infection, as M. tuberculosis lacking ClgR is deficient in the ability to control phagosome pH 1 h post-phagocytosis.

[The surgical achievements of Jan Kwaśnicki (1838-1883) for Polish rhinolaryngology were important?]

The professional and scientific activities of Jan Kwaśnicki (1838-1883), a Varsovian surgeon, his medical education in various medical institutions is shortly outlined. He was the head of surgical ward at the Evangelical Hospital in Warsaw. He was an author of two-volume book "The operating surgery" (along with Władysław Stankiewicz and Józef Wszebor) (Warsaw 1868, 1874). Kwaśnicki's successful surgical treatment of rhinolaryngological diseases (such as perforation of hard palate, carcinomas of tongue and lower lip) are described in some more detail.

[The effectiveness of a comprehensive program of physiotherapy in shoulder pain syndromes]

INTRODUCTION

Periarthritis humeroscapularis (PHS) is a disease notable for serious therapeutic problems arising from lesions in various tissue structures. The shoulder is the most important biokinematic element in the upper extremity. For this reason, physiotherapy continues to search for an ideal form of rehabilitation. Treatment of PHS is long and difficult. The correct diagnosis combined with physiotherapy can reduce the suffering of the patient and shorten the duration of the disease. Thus, the restoration of physical activity can be expedited. We decided to assess the effectiveness of a comprehensive program of physiotherapy in shoulder pain syndromes. The study was done at the Rehabilitation Unit of the Stabłowice Clinic of the Wroclaw Health Center. We enrolled 30 patients aged 30 to 85 years (mean age: 60 +/- 14 years) with pain and limited mobility of the shoulder diagnosed as PHS.

MATERIAL AND METHODS

A questionnaire with 12 questions addressing the intensity and extent of shoulder pain was prepared. Shoulder joint mobility was determined with a goniometric method. In addition, an 11-grade Numerical Rating Scale (NRS), where 0 meant no pain and 10 the most severe pain, was adopted. All patients underwent a series of 10 physiotherapeutic procedures directed at the shoulder joint. Assessment was made before and after therapy.

RESULTS

A considerable reduction of pain was noted after physiotherapy and massage, while exercises significantly improved mobility, muscle status, and function of the upper extremity.

CONCLUSIONS

The present study has shown that the comprehensive program of physiotherapy carried out at the Rehabilitation Unit of the Stabłowice Clinic of the Wrocław Health Center is effective in treating patients with the shoulder pain syndrome.

[Contribution by Ksawery Wolfgang (-1864) to the development of Druskininkai]

We present the history of the spa of Druskininkai which was founded in 1837. The professional and scientific career of Ksawery Wolfgang (-1864), an eminent physician of this spa, is described in the context of his importance for the development of Druskininkai. Wolfgang was a respected person in Druskininkai. He was the editor-in-chief and publisher of the magazine "Ondyna Druskienickich Zródeł" ("Ondine of Druskininkai Springs") and the author of the book "On salt springs in Druskininkai" (Vilnius 1841), as well as of several other publications. The properties of Druskininkai salt springs and their therapeutic effects in many diseases are discussed. Wolfgang was able to establish indications and contraindications to treatment in Druskininkai. Mention is made of the book "Druskininkai. A literary and medical essay" by Józef Ignacy Kraszewski and Ksawery Wolfgang (Vilnius 1848).

[Izydor Nahumowicz (1800-1842) and his work on the salt springs of Druskininkai]

This article begins with a presentation of attractions of Druskininkai (formerly Druskieniki) in the first half of the 19th century. The life and scientific achievements of Izydor Nahumowicz (1800-1842), an eminent spa physician, are discussed. His treatise "Treatment with mineral waters in Druskininkai" (Grodno 1841) is presented in detail, as well as procedures preparing for treatment in Druskininkai with indications and contraindications for referring patients to this spa. Mention is made of the social life and entertainment in Druskininkai.

[Andrzej Franciszek Ksawery Dybek (1783-1826) and rhinolaryngology]

The professional and scientific activities of Andrzej Franciszek Ksawery Dybek (1783-1826), an eminent Varsovian physician, the military doctor, the professor of surgery of Warsaw Royal University, and the member of many scientific societies are presented with full particulars. The activity of Surgery Clinic of Warsaw Royal University is depicted widely. Dybek's successful treatment of rhinolaryngological diseases (such as traumas of cranium, syphilitic ulcerations of throat and face, polypus of nose, disease of maxillary sinus, cancer of lip) are presented in some more detail.

[Professor Wacław Kuśnierczyk (1908-1997)--Pro Memoria in the century of birthday]

Wacław Kuśnierczyk was born in 1908 in Sniatyń. He received the degree in medicine at Jan Kazimierz University in Lwów in 1932. He did his PhD degree under Professor Zaleski supervision in 1938 at Jan Kazimierz University. At that time he concentrated his scientific activity on research on tuberculosis. In 1953 he obtained the title of second degree specialist in ear, nose and throat diseases. He became a chief of Otolaryngology at Urban Hospital No 4 in Katowice in 1960. Since then this eminent physician was working on tumours located in upper respiratory tract and the possibility of its endoscopic diagnosis at Silesian Academy of Medicine in Katowice. As one of the first he pointed out the negative influence of smoking cigarettes on cancer of larynx. It was Wacław Kuśnierczyk who implemented new priorities for integrated programs in patient care, research, education and cancer prevention. He has published widely in peer reviewed journals and has edited or contributed to many books. He has given many major lectures and is the recipient of numerous prestigious awards for his scientific accomplishments. The achievement of Professor Kuśnierczyk were the valuable source of information for the physicians. In 1997, on the 31st of January he died in Katowice.

[The Józef Czekierski's (1777-1827) otorhinolaryngological connexions]

The professional and scientific activities of Józef Czekierski (1777-1827), an eminent Varsovian surgeon on the turn of the 18th century are described widely. He was the head of surgical and obstetricial departments in Warsaw. He was also the head of the first Surgical Clinic in Warsaw. In the four-part textbook "Surgery" published in 1817-1818 Czekierski presented surgical treatment of such otorhinolaryngoogical diseases as wounds of ear and tongue, traumas of nase, diseases of parotis, the foreign bodies at respiratory tract and at the upper part of alimentary canal with full particulars. He described such rhinolaryngological operations as plastic reconstruction of the nase, tracheotomy, conicotomy, oesophagotomy in some more detail.

[Julian Kosiński (1833-1914)--especially meritous surgeon for the development of otorynolaryngology. His achievements in therapy of diseases of larynx]

The achievements in surgical treatment of larynx diseases by Julian Kosiński (1833-1914), an eminent Warsaw surgeon, the head of Surgical Clinic in Main School and Warsaw Imperial University performed according to contemporary world-wide standards are presented in more detail. His successful surgical treatment such diseases as postinflammatory adhesions of larynx, diphtheria, syphilis of larynx, polyps of larynx and other are described in some more detail. The laryngectomy by Theodor Billroth in 1873 are described in short. The analysis the first laryngectomy in Polish territories performed by Julian Kosiński ("the tenth world laryngectomist") in 1877 is performed with full particulars. The surgical difficulties, the postoperating management are discussed. The reasons of failures of the laryngectomies in XIX century are analysed widely.

[The significance of Karol Gilewski (1832-1871) for the Polish laryngology]

The professional and scientific activities of Karol Gilewski (1832-1871), one of the famous Cracovian physicians, the professor of the Jagellonian University are described first of all. His treatise on laryngofissure and laryngeal polyps in 1865 is presented widely. This is a second scientific work in Polish medical literature on this subject. The cases of laryngeal scleroma and laryngeal and cutaneous syphilis are also described.

[Alfred Marcin Sokołowski and Władyslaw Matlakowski. Contribution to history of spa treatment of pulmonary tuberculosis]

The professional, scientific and didactic careers of Alfred Marcin Sokołowski (1849-1924) and Władysław Matlakowski (1851-1895) are presented at the beginning. Sokołowski was an assistant and afterwards a deputy of the head of hospital department Herman Brehmer in health resort in Goerbersdorf. In 1880 Sokołowski organized the internal diseases ward and rhinolaryngological outpatient clinic at St. Spirit Hospital in Warsaw. Sokołowski published "Clinical lectures of diseases of respiratory tract" (1902-1906) and many scientific papers. He was a pioneer of Polish pulmonology, rhinolaryngology and spa treatment of respiratory tract diseases. He was a well-known social worker. Matlakowski, who was a surgeon of Surgical Clinic of Warsaw Emperor University and an assistant of Julian Kosiński specialized in abdominal surgery and gynaecologic surgery. While suffering from pulmonary tuberculosis he moved to Zakopane, where he became famous as an ethnographer, an author of two books: "Country architecture of the Tatra Highlands" and "Decoration and equipment of Polish people of the Tatra Highlands". He translated Shakespearian "Hamlet" into Polish. He was also a well-known philosopher and an ornithologist. The meeting of Sokołowski and Matlakowski in Goerbersdorf, and also their further acquaintance and friendship are described widely by the author. Their work at "Gazeta Lekarska" ("Medical Magazine's") editorial office, which was well-known in three sectors of partitioned Poland is presented with more details by the author. Finally the epitome of spa treatment of pulmonary tuberculosis is presented. Sokołowski and Matlakowski were propagators of spa treatment of pulmonary tuberculosis; Sokołowski made Goerbersdorf famous, Matlakowski did the same for Zakopane.

[Przeglad Lekarski (Medial Review). The difficult years]

The progress of medical science with great difficulties in the Polish territories in the second half of 19th century is presented in short. The achievements of such Cracovian physicians as: Józef Dietl, Józef Oettinger, Antoni Bryk, Józef Majer, Fryderyk K. Skobel, Michał Zieleniewski is the creation of the Cracovian periodical "Przeglad Lekarski" ("Medical Review") is briefly pointed out. The critical observations of such Polish physicians as Józef C. Starkel, Józef Oettinger, Bolesław Placer, Adolf S. Friedberg in the 1860s of the 19th century were very helpful in the development of this medical magazine.

[Entertainment and social life in Druskienniki in the middle of the XIX century]

The geographical, climatic and epidemiological situation of Druskienniki, a health resort founded in 1837, has been mentioned at the beginning. The development of the health resort in the middle of the XIX century as well as a physician and chemist, Ignacy Fonberg's role (1801-1891), has been recounted. The physicians Ksawery Wolfgang (?-1864), Jan Pilecki (1821-1878) and Walery Bujakowski (1857-1919) and local rich gentry played an important role in the development of Druskienniki. The physician was the most esteemed personage of this health resort. The medical indications and contraindications in Druskienniki have been reported. Many diseases were treated in this health resort. The scale of medical indications was wide. The guests list in Druskienniki in 1845 is mentioned. The curative season persisted from May until October. "The letters from Druskieniki to friend" published in 1844-1845 in the magazine "Ondyna Druskienickich Zródeł" contained interested descriptions of social life and entertainments in this health resort. The balls, teas, theatrical spectacles, concerts and other attractions were analyzed widely. Theatrical spectacles with the participation of talented performers especially from Vilnius and Grodno were very attractive.

[Benni, Babiński, Bouchard, Charcot. Their contribution to the development of XIX-century Polish and French medical relations]

The professional and scientific achievements of four physicians: Józef F. Babiński (1857-1932), French clinician, neurologist of Polish origin, Karol Benni (1843-1916), one of the first Varsovian otiatrist and social activist, Charles Jacques Bouchard (1837-1915), French physician and bacteriologist and Jean Martin Charcot (1825-1893), one of the best XIX-century physicians have been presented in brief. Their personal, professional and scientific connections based on authority materials are presented in more detail. The letter from Charcot to Benni is presented.

[What Edmund Modrzejewski (1849-1893) contributed to the Polish otiatrics?]

The professional and scientific activities in the area of otiatrics of Edmund Modrzejewski (1849-1893) are presented. Modrzejewski's education in otology in Vienna and other places is strongly pointed out. His achievements in the treatment of many diseases of the ear are depicted. Modrzejewski is shown as a one of the pioneer of treatment of deaf-mutism in Polish territories. His publishing activity is also depicted.

[The otorhinolaryngological achievements of surgeon Hipolit Korzeniowski (1827-1897)]

The professional and scientific activities of Hipolit Korzeniowski (1827-1879), an eminent Varsovian surgeon, his thorough medical education in various European centries is shortly outlined. He was a head of the surgical ward especially at the Infant Jesus Hospital in Warsaw and at the medical schools in Warsaw. Korzeniowski's succesful surgical treatment of rhinolaryngological diseases, such as scarlet fever of ear, treatment of deaf-mutism, sinusitis paranasales, operations of jaws, plastic reconstruction of the palate, foreign bodies of larynx, tracheotomy in the tuberculosis of larynx, are described in some more detail.

[Postgraduate studies of Alfred Marcin Sokołowski (1849-1924) in Vienna and Heidelberg]

The professional, scientific and teaching career of Alfred M. Sokołowski (1849-1924) is presented. Alfred M. Sokołowski was a pioneer of Polish pulmonology and rhinolaryngology. His trips to Vienna and Heidelberg to study various fields of medicine are described. Emphasis is made on his training in rhinolaryngology under such masters as Leopold Schroetter and Karl Stoerck in Vienna and Antoni Jurasz Sr. in Heidelberg.

[The dilatation of auditive tube (Bougirage tubaire) by dilators in XIX century]

The treatment of auditiory tube chronic catarrh in XIX century by pharmagological drugs, by special apparatuses of surprising technical sophistication, by electrisation and faradisation is discussed first of all. The dilatation of auditory tube by dilators was the diagnostical and therapeutical methods, especially preferenced by Victor Urbantschitsch, Hermann Schwartze, Jean P. Bonnafonte, Albert Calmettes and Bronisław Taczanowski, Teodor Heiman and Samuel Meyerson. The dilators were building of celluloid, whale-bone, silver and were absorbed by argentum nitrate, vaseline. The technique, difficulties and effects of dilatation are described in more detail. The complications of this operation is presented finally.

[The hypertrophy of pharyngeal tonsill in the estimation of XIX-century physicians]

The role of such physicians as Rudolph A. Kolliker, Johann N. Czermak, Ludwig Tuerck, Friedrich E. Voltlini, Benjamin B. Loewenberg, Hubert v. Luschka in the building of the science on hypertrophy of pharyngeal tonsil are pointed out first of all. The specific significance of achievements of Wilhelm Meyer (1824-1895) of Copenhagen based on scrupulous examinations is described. In the Polish territories the innovatory were works of Teodor Heryng, Klemens Koehler, Władysław Wróblewski, Jan Sedziak, Teofil Zalewski. The epidemiology, etiology, pathogenesis, anatomo-patological examinations, the role of pharyngeal tonsil on immunity system are presented widely. The influence of hypertrophy of pharyngeal tonsil on general evolution of child, on his intellectual sphere, on speech disorders, on upper respiratory tract disorders, on auditory disorders, on the origination of deaf-mutism, on the origination of reflexogenous neuroses are described in more detail. An important role of anterior rhinoscopy, posterior rhinoscopy, and digital examination in the diagnosis of this illnes are also presented with full particulars.

[Galvanocautery in the 19th century otorhinolaryngology service]

The essence of galvanocautery, the such instruments as loops, cauteries and others are presented first of all. The achievements of such doctors as Albrecht Theodor Middeldorpf (1824-1868), Victor von Bruns (1812-1883), Friedrich Eduard Voltolini (1819-1889) and others in development of galvanocautery are depicted. The observations of such Polish physicians as Antoni Bryk (1820-1881), Jan Sedziak (1861-1932) and Zygmunt Srebrny (1860-1941) were very valuable. The good points and shortcomings of galvanocautery and principles of post-operational procedures are pointed out. The use of galvanocautery in otorhinolaryngology especially in strictures of external auditory meatus, aural polyps, aural granulations, in hypertrophy of nasal concha, nasal polyps, in atresia of nasal cavities, in hypertrophy of palatine tonsils, in tumors of naso-pharyngeal cavity, in tuberculosis laryngis are described with full particulars.

[The reception of Sebastian Kneipp's hydrotherapeutic method. Its significance in contemporary medicine]

The reports of Władysław Jasiński (1827-1903), Józef Surzycki (1855-1937) and Józef P. Drzewiecki (1860-1907), XIX century Polish physicians from the hydrotherapeutic infirmary in Worishofen are described with full particulars. The Kneipp's hydrotherapeutic methods are presented in more details. The Worishofen's physicians at that time are outlined. The critical view of therapeutic methods in Worishofen by Polish physicians is depicted. The importance of hydrotherapeutic methods for contemporary and present medicine is thoroughly described.

[Priest Sebastian Kneipp and his hydrotherapeutic method. Point of view after over one hundred years]

Vincenz Priestnitz (1799-1851) and Wilhelm Winternitz (1835-1905) were creators of world hydrotherapy. Sebastian Kneipp (1821-1893), the priest at Worishofen, the owner of the hydro-therapeutic infirmary where are found precursors of many hydro-therapeutic methods. He was the author of several popular books based on his experience. The book "My water treatment" is best known. He was also a builder of the curative houses, such as: Sebastianeum, Kneip pianeum, Kinder-Asyl. About 25 thousand people from far-away lands yearly were Kneipp's patients. Pourning, wrapings, compresses, rinsing off, total-baths and partial-baths were used often. The aim of this paper is to present Kneipp's silhouette and his sometimes uncritical hydro-therapeutic methods.

[The historical review of the adenotomy]

The opinions of famous foreign and also such Polish physicians as Jan Sedziak, Władysław Wr6blewski, Zdzisław Dmochowski on problem of removal of hypertrophic pharyngeal tonsil are presented first of all. An unsuccessful trials of conservative treatment are pointed out. Adenotomy was preformed in general anaesthesia, especially by chloroform, in "half-anaesthization", in local anaesthesia. The problems of anaesthesia are presented widely. The various method of removal of hypertrophic pharyngeal tonsils by forceps, by curettes, by loops, by nail are depicted with full particulars. The Loewenberg's forceps in various modifications, the Gottstein's curette and later the Beckmann's and La Force's adenotoms were best. The problem of rinsing of nose after the operation and influence of this rinsing on complications in auditory organ, the problem of postoperative relapses are discussed. The postoperative complications after adenotomy, bleeding and haemmorhage early and late, running of bits of tonsil into larynx, the inflammations of upper respiratory tract are also presented. The Jan Miodoński's and Jan Danielewicz's modern opinions at a performance of problem of adenotomy are depicted finally.

[The historical view of anterior rhinoscopy]

The discovery of laryngoscopy by Manuel Garcia (1805-1906) was very important for the development of rhinoscopic research. The discovery of nasal speculum by Ludovit Markuszovsky (1815-1893) is described. Markuszovsky and Johann N. Czermak (1828-1873) initiated the term "rhinoscopy". The achievements of Czermak for rhinoscopy are significant. The "conductor of light" by Phillip Bozzini (1773-1809) for the nasal research is presented. The nasal specula by Fraenkel, Duplay, Voltolini and others are depicted. The distinguished Polish rhinolaryngologist Antoni Jurasz sen. (1847-1923) was a creator of simple instrument for the anterior rhinoscopy. The discoveries and employments of cocaine, adrenaline and X rays were very useful for nasal examinations.