[Intractable epistaxis in a 3,5-year-old child]. / Nawracajace krwawienie z nosa u 3,5-letniego dziecka.

Intractable epistaxis can be a serious problem in children. The authors present the case of a 3,5 year old child with a history of nasal bleeding lasting 3 years which was successfully managed by superselective embolisation of the internal maxillary artery.

[The evolution of epidemiology and clinical characteristics of laryngeal and hypopharyngeal carcinoma in Poland from 1991 to 2001]. / Ewolucja obrazu epidemiologicznego i klinicznego raka krtani i krtaniowej czesci gardla w Polsce w latach 1991-2001.

On the base of retrospective analysis of 12,888 cases of carcinoma of larynx and hypopharynx, diagnosed in 19 ENT Departments in Poland from 1991 to 2001, the assessment of basic epidemiological data, including the localization of tumor and stage of local and clinical advancement of the disease at the time of diagnosis has been conducted. In analyzed period of 11 years the trends to change of the mentioned above parameters has been examined. The significant increase of female patients in this period was observed, with average proportion M:F = 8:1. The glottis localization of carcinoma dominated (47.6%), followed by supraglottis (40.8%) and pyriform fossa (7.8%), with significant increase of pyriform fossa tumors in the analyzed period of 11 years. In the majority of cases the carcinoma of larynx and hypopharynx was diagnosed in the advanced stage (T3 + T4) of local disease, with the highest percentage in localization within the pyriform fossa (81.0%), and the lowest percentage in glottis tumors (45.6%). The regional lymph nodes metastases has been diagnosed in 46.7% of the analyzed group, with the highest percentage in tumors localized in pyriform fossa (82.9%), and the lowest percentage in tumors of glottis localization (33.1%). In the 11 years time the significant drop down of N0 cases and tendency to increase of N2 and N3 in the supraglottis localization of tumor. The distant metastases in the analyzed group at the time of diagnosis has been registered in 2.0%, with the highest percentage in posterior pharyngeal wall (7.6%) and pyriform fossa (7.4%). The authors postulate the renewal of prospective study on epidemiology, clinical characteristics and treatment results of larynx and hypopharynx carcinoma in Poland.

[Antieosinophil action of IL-12 in human polyp culture]. / Przeciweozynofilowe dzialanie IL-12 w hodowanej tkance ludzkiego polipa nosa.

RATIONALE: Tissue eosinophilia is an important pathophysiological issue in bronchial asthma and nasal polyps. Its magnitude is regulated by several mechanisms, including selective migration of eosinophils to peripheral tissues and prolongation of survival. A key role in this processes is assigned to Th2 originating cytokines: IL-3, IL-5, GM-CSF. It has been previously demonstrated that IL-12 diminishes tissue eosinophilia in an animal model, and Hofstra showed that IL-12 together with IL-18 prevents allergen-induced increase bronchial hyperresponsiveness, BAL eosinophilia and the development of allergen-specific Th2 cells. METHODS: Nasal polyps were obtained during routine surgery and were cultured in fragments of approximately 30 mg for 2, 6, and 15 days in RPMI 1640 in the absence or presence of IL-12. Afterwards a dose-dependency was tested at day 2 of culture. Polyp tissue from cultures was than processed to slides, stained with Giemsa and cells were counted in light microscopy (400x). RESULTS: Eosinophils represented 62.8+/-21.3% of residing cells in nasal polyps at the day 0. IL-12 (1 microg/ml) caused a significant time-dependent decrease in the percentage of Eos after 2 and 6 days. The effect of IL-12 at day 2 was concentration-dependent: control, 28.2+/-2.9; at 10 ng/ml, 13.9+/-6.4 (n=4, p<0.05); at 100 ng/ml, 11.6+/-2.1 (p<0.01); at 1 microg/ml, 7.5+/-1.5 (p<0.005). CONCLUSION: IL-12 acts as potent topical antieosinophilic agent. Its action can be seen in a cultured polyp environment. It is visible already after two days and is concentration-dependent. Further study is needed to elucidate tissue mechanisms of this action.

Time-dependent observations of secretion marker levels in nasal secretion after histamine and methacholine provocations.

Nasal provocation tests with histamine and methacholine were carried out on 25 healthy men in an effort to assess the dynamic changes of albumin, total IgA, secretory IgA and lactoferrin concentrations in the nasal secretion. The trials were performed with 0.5, 1, and 4 mg of histamine and 8, 16, and 32 mg of methacholine. Each dose of histamine or methacholine was sprayed into the nose every 2nd day, with two days' interval between the two provoking agents. Nasal secretions were collected after saline spraying only, forming the baseline group, after 3, 10 and 15 min of administration of the challenge agent. The baseline levels presented the following values: for albumin 257 +/- 230 microg/ml, secretory IgA 608 +/- 379 microg/ml, total IgA 1025 +/- 423 micog/ml, and lactoferrin 213 +/- 156 microg/ml. The increase in albumin level after nasal provocation, particularly significant after histamine administration (to 3713 +/- 2311 microg/ml), indicates incessant protein plasma leakage from the blood circulation to the nasal secretion. After administration of both provocating agents, there was a significant gradual decrease in secretory IgA level, even below the baseline value. After the 2nd and 3rd doses of methacholine and histamine spray, the concentration of secretory IgA decreased by 2-3 times and was found to be 200-300 microg/ml, respectively. Also, lactoferrin concentration values decreased gradually after the 2nd and 3rd doses of methacholine and histamine to levels close the baseline value. These observations suggest a time- and dose-dependent, non-specific dysfunction of local immunity response after nasal provocations.

Activity of cysteine proteases and their inhibitors in the lymph nodes of larynx cancer patients.

BACKGROUND: Cysteine endopeptidases and their inhibitors play an important role in the process of carcinogenesis. Positive correlation has been found between tumor invasiveness, its metastatic potential and the secretion of cysteine endopeptidases. Cysteine protease inhibitory activity is also altered in malignant tumors and various body fluids of patients with cancer. MATERIAL/METHODS: Total cysteine endopeptidase activity and cysteine proteinase inhibitory activity were measured in homogenates of cervical lymph node tissue surgically obtained from the larynx of cancer patients. The tissue samples were histologically examined, and each was divided into two parts: positive (PCN), with mostly cancer cells, and negative (NCN), with no cancer cells. RESULTS: In the PCNs, the levels of the assayed enzymes and their inhibitors were significantly higher than in the NCNs. The mean values of cysteine protease activity were 2.70I2.29 and 1.59I1.28 for PCNs and NCNs, respectively (p<0.005). The mean values of cysteine protease inhibitors were 9.1I8.6 and 6.1I6.3 for PCNs and NCNs, respectively (p<0.02). An altered protease-inhibitor activity ratio was also found in PCN samples compared to NCNs. CONCLUSIONS: These data suggest increased activity of cysteine peptidases and their inhibitors in the case of secondary tumor tissue. The cancer cells metastasized to lymph node tissue produce some alteration in balance between cysteine protease activity and the endogenous inhibitors of the proteases.