Oral Cavity Cancer Tissues Differ in Isotopic Composition Depending on Location and Staging.

The aim of this paper was to characterise the isotopic composition of oral squamous cell carcinoma (OSCC) specimens of different areas of the oral cavity. Secondly, we assessed whether there was a correlation between clinical stages of OSCC and isotopic abundance. The IRMS procedure was performed on 124 samples derived from 31 patients with OSCC of 15 N and 13 C to assess the isotopic composition. From each individual, four samples from the tumour, two from the margins, and two samples of healthy oral mucous membranes were derived. The two samples from the tumour and two samples from the margin were additionally subjected to histopathological assessment. Then, statistical analysis was conducted. Tumour infiltration tissues of the lower lip were characterised by higher mean δ13C values compared to samples derived from cancers of the other oral cavity regions (-23.82 ± 1.21 vs. -22.67 ± 1.35); (p = 0.04). The mean percentage of nitrogen content in tumour tissues was statistically higher in patients with the most advanced cancers (11.89 ± 0.03%) versus the group of patients with II and III stage cancers (11.12 ± 0.02%); (p = 0.04). In patients at stage IV, the mean δ13C value in the cancer samples equalled -22.69 ± 1.42 and was lower than that in patients at less severe clinical stages (p = 0.04). Lower lip cancer tissues differed in the isotopic abundance of carbon in comparison with tissues derived from the group of combined samples from other locations. Values of δ13C observed in specimens derived from lower lip cancers were similar to those observed in healthy oral mucous membranes. Cancer tissues obtained from patients in the last stage of OSCC had a different isotopic composition in comparison with those obtained from earlier stages. To confirm these observations, further research on larger groups of patients is needed.

Characteristic of Oral Squamous Cell Carcinoma Tissues Using Isotope Ratio Mass Spectrometry.

Overall prognosis for patients with oral squamous cell carcinomas (OSSC) is still unfavourable. However, there is a hope that a novel diagnostic method may establish better cancer biology characteristics. The aim of this study was to evaluate the isotope ratio of nitrogen and carbon in OSSC as compared to margin and healthy tissue. A total of 18 patients with OSSC were included in the study. Specimens collected covered: four tumour, four margin and two healthy oral mucosa samples. The samples underwent further procedures: lyophilization and isotope ratio mass spectrometry. Measurements of the ratio of stable isotopes of nitrogen 15N/14N and carbon 13C/12C were performed. It is noticeable that the highest average nitrogen concentration was observed in tumour 12 ± 0.4% and the lowest in healthy tissues 8 ± 0.9% (p < 0.00001). The highest average carbon content was observed in healthy tissues 57 ± 2.2% and the lowest in tumour 46 ± 1.3% (p < 0.00001). Moreover, values of 15N/14N expressed in delta notation were the highest in healthy tissues 9.84 ± 0.61 and the lowest in tumour 8.92 ± 0.58. Values of 13C/12C tended to be higher in tumour -22.2 ± 0.89 and the lowest in healthy tissues -23.7 ± 1.2. Tumour tissues differ in isotopic composition from tissues taken from margin and healthy tissues taken from distant oral mucosa.

Screening test for extracranial carotid lesions' detection in patients of an outpatient vascular clinic.

Purpose The objective of the study was to evaluate the frequency and severity of atherosclerotic lesions in extracranial sections of carotid arteries and to determine the level of the correlation between these lesions and symptoms of cerebral ischemia. Secondly, to identify the most common risk factors of ischaemic stroke occurrence in population of patients of vascular outpatient clinic. Material and Methods Prospective study was conducted on a group of 1,000 people (217 women and 783 men), aged 50 to 86 years, the average age was 62 years (± 9.95). Results Atherosclerotic lesions of carotid arteries were observed in 670 examined people (67%). In 63 cases (6.3%) carotid artery occlusion was revealed. Patients with symptomatic carotid artery stenosis more frequently were addicted to cigarettes and suffered from hypertension in comparison to asymptomatic group. A statistically significant correlation between the TIA or ischemic stroke and smoking were noticed, as well as between TIA/ischemic stroke and hypertension Conclusions Among patients with atherosclerosis of peripheral arteries atherosclerotic lesions in the extracranial carotid sections occur with a high frequency. Statistically significant differences in the incidence and severity of atherosclerotic lesions in the carotid arteries were observed in this group. A statistically significant correlation was revealed between the prevalence and severity of atherosclerosis in the carotid arteries in symptomatic patients and smoking and hypertension. Performing screening in patients with atherosclerosis of the abdominal aorta and/or lower limb arteries may detect significant carotid artery stenosis, requiring surgical intervention.

Characteristics and risk factors of bike-related accidents: Preliminary analysis.

BACKGROUND: The growing popularity of cycling not only enhances self-efficacy, physical well-being and improves quality of life, but it also leads to the increasing number of bike-related injuries. OBJECTIVES: The aim of this study was to characterize the population of cyclists in Poland, assess the occurrence of safety behaviors among them and to precise the risk factors for bike accidents. Additionally, we analyzed bike-related injuries. MATERIAL AND METHODS: The survey was based on a 39-item questionnaire created for this study. We collected data concerning the demographical status of respondents, their cycling preferences, attitude toward safety behaviors during cycling, and the characteristics of bike-related injuries. Our research covered 729 people who declared themselves as cyclists (302 women - average age: 31.5 ±10.3 years; 427 men - average age: 32.6 ±10.7 years). RESULTS: In the study, 71.3% of the interviewees declared that they did not always wear helmets. Women more often than men claimed that they did not always use head protection (p < 0.001). Among 729 people, 277 suffered from bike-related injuries. In this group, we noted 870 accidents that resulted in 1,671 different injuries. In our study, wearing helmets did not influence the region of trauma nor its type (p < 0.05). We noted 811 injuries of the upper extremities and 541 of the lower extremities. CONCLUSIONS: Young men constitute the main group of cyclists in Poland. The risk factors for bike-related accidents in our study proved to be: educational level (secondary education and incomplete higher education), number of children (having at least 3 children), frequency of using a bike (the more often, the more injuries), type of bike used (mountain bikes and fold-up bikes), and frequency of using a helmet (using helmets was correlated with a higher rate of injuries). The upper and lower extremities were the most common location of injuries.

Gender-related risk factors for perioperative stroke after carotid endarterectomy in symptomatic patients.

BACKGROUND: Carotid endarterectomy (CEA) is a surgical procedure used in ischemic brain stroke prevention in patients with symptomatic and asymptomatic severe carotid artery stenosis. OBJECTIVES: This study compares perioperative stroke or death rate after carotid endarterectomy (CEA) in male and female patients, and determines risk factors for perioperative incidents in women and men. MATERIAL AND METHODS: The outcome of surgical treatment of 269 consecutive symptomatic patients (181 men and 88 women) treated from January 2004 to August 2008 in the Department of Vascular, General and Oncologic Surgery was analyzed. RESULTS: Perioperative stroke-death rate (within 30 days after the surgery) in women was 6.8% (6/88) and 3.3% (6/181) in men (p > 0.05). In the female group, none of the analyzed risk factors were associated with a higher risk of periprocedural incident, while in men, only hypercholesterolemia was a significant predictor of perioperative stroke (TC > 240 vs 240 vs 200-240: OR = 6.59; 95% CI: 1.12-38.97; p = 0.0375). CONCLUSIONS: In men, hypercholesterolemia significantly increased the risk of perioperative stroke or death, while in females, none of the analyzed factors were determined as the predictors of the incident. The fact that plaque type VI by AHA was significantly more frequent in women and men more frequently were suffering from ischemic heart disease and peripheral artery occlusive disease appeared not to influence the outcome of CEA.

Are animal-related injuries in rural areas a social problem? A survey from Poland.

OBJECTIVE: The aim of this study was to analyze the mechanisms of animal-related injuries in Polish rural areas, and to evaluate the effects of such injuries on subjects' health and social life. MATERIAL AND METHODS: Data concerning animal-related injuries were collected from 102 patients (45 females and 57 males, mean age 45.01±11.4 years) on the basis of a questionnaire. The study was conducted in the rural area of central Poland. Moreover, to assess the severity of injuries to the head and neck region, the Facial Injury Severity Scale (FISS) was applied. RESULTS: The most commonly affected body areas are the upper and lower limbs, which explains the fact that most subjects do not recognize the injury-related deformity as an aesthetic defect.Statistical correlations were observed in several aspects, amongst others: - women were significantly more likely than men to consider undergoing surgical procedures to eliminate/reduce post-traumatic deformities and scars (p<0.05); - injury-related deterioration in appearance resulted in limitations of patients' social life (p<0.0001).

Goldenhar syndrome: current perspectives.

BACKGROUND: Progress in medical branches that has taken place since the first child with Goldenhare syndrome (GS) had been described in 1952 by Maurice Goldenhar, facilitated better understanding of this congenital defect. It also gave new perspectives and the opportunity to achieve satisfactory treatment results, mainly due to development of surgical techniques. DATA SOURCES: Based on the literature and own experience, we discussed the phenotype of presentation of GS, ethiopathogenesis, genetic counselling and treatment with particular emphasis on surgery correction of hemifacial microsomia. RESULTS: The spectrum of GS abnormalities ranges from mild to severe ones and include patients with barely noticeable facial asymmetry to very pronounced facial defect with more or less severe abnormalities of internal organs and/or skeleton. It is characterized most commonly by impaired development of eyes, ears, lips, tongue, palate, mandible, maxilla, zygomatic and orbital structures and deformations of the teeth structures. Ethiopathogenesis is multifactorial and dependent on genetic and environmental factors but there are still many unknowns about the syndrome which should be revealed. CONCLUSIONS: Patients with GS due to a large variety of abnormalities and different severity of symptoms pose a challenge for clinicians. All of this necessitate an individual approach to each single patient and involvement a team of specialists in treatment planning. It is a complex, long-lasting, multidisciplinary process and should be divided into stages, according to patient's age, as well as the extent and severity of observed abnormalities. Neonatologists and pediatricians are involved in care of these patients from the onset.

Penetrating trauma of the face and facial skeleton - a case series of six patients.

Penetrating traumas of the facial skeleton are relatively rare; however, they can be dangerous and even life-threatening. The epidemiology of facial skeleton trauma is diverse and depends on the affected region, age, and the kind of foreign body that caused the injury. In Poland, the most common cause of penetrating traumas are accidents and assaults, and only rarely accidents are related to improper use of firecrackers or fireworks. The aim of this study is to present a literature review and our own experience with penetrating traumas of the face and the facial part of the cranium. Six cases with severe wounds and fractures of the facial skeleton were treated between the years 2000 and 2012 in our department. The applied treatment methods depended mainly on the general condition of the patients. In all cases, we achieved acceptable functional and aesthetic outcomes.

Penetrating trauma to the facial skeleton by pickaxe - case report.

Number of deaths related with injuries suffered as a result of experienced traumas is increasing. Penetrating traumas of the facial skeleton occur relatively rarely and much more often concern rather children than adults. Epidemiology relating this kind of trauma differs depending on the region of the world. In Poland, gunshot injuries as well as traumas caused by explosions of firecrackers or fireworks amount only to a slight percentage among all facial skeleton traumas, and the most common reason for penetrating traumas lies in accidents or assault with the use of sharp, narrow and long objects that easily enter bones of the facial skeleton. The present study reported the case of 50-year-old man who suffered from trauma of the facial skeleton, which resulted from foreign body (pickaxe) penetration into the subtemporal area, zygomatic arch and the right orbital cavity. The surgical treatment method and final outcome was presented and discussed.

Short Text Messages (SMS) as an Additional Tool for Notifying Medical Staff in Case of a Hospital Mass Casualty Incident.

OBJECTIVE: The aim of the study was to verify the effectiveness of short text messages (short message service, or SMS) as an additional notification tool in case of fire or a mass casualty incident in a hospital. METHODS: A total of 2242 SMS text messages were sent to 59 hospital workers divided into 3 groups (n=21, n=19, n=19). Messages were sent from a Samsung GT-S8500 Wave cell phone and Orange Poland was chosen as the telecommunication provider. During a 3-month trial period, messages were sent between 3:35 PM and midnight with no regular pattern. Employees were asked to respond by telling how much time it would take them to reach the hospital in case of a mass casualty incident. RESULTS: The mean reaction time (SMS reply) was 36.41 minutes. The mean declared time of arrival to the hospital was 100.5 minutes. After excluding 10% of extreme values for declared arrival time, the mean arrival time was estimated as 38.35 minutes. CONCLUSIONS: Short text messages (SMS) can be considered an additional tool for notifying medical staff in case of a mass casualty incident.

How Do Patients Assess Outcomes Of Treatment Of Prognathism?

UNLABELLED: The aim of the study was to analyze the results of patients' subjective self-assessment of surgical treatment of prognathism. MATERIALS AND METHODS: The study included 35 patients who underwent extraoral vertical ramus osteotomy. Each patient responded to 12 questions contained in the questionnaire created by the authors. RESULTS: All respondents positively assessed their appearance after surgery. In most cases they pointed out the positive impact of treatment on their self-confidence (82.9% of responses). The vast majority of respondents felt improvement in biting off food (91.4%). CONCLUSIONS: Patients positively evaluate the outcome of surgical treatment with extraoral vertical ramus osteotomy. The subjective improvement of the facial appearance, as well as chewing and articulation functions took place after the treatment.

Analysis of complications after blood components' transfusions.

UNLABELLED: Complications after blood components still constitute an important clinical problem and serve as limitation of liberal-transfusion strategy. The aim of the study was to present the 5-year incidence of early blood transfusions complications and to assess their relation to the type of the transfused blood components. MATERIAL AND METHODS: 58,505 transfusions of blood components performed in the years 2006-2010 were retrospectively analyzed. Data concerning the amount of the transfused blood components and the numbers of adverse transfusion reactions reported to the Regional Blood Donation and Treatment Center (RBDTC) was collected. RESULTS: 95 adverse transfusion reactions were reportedto RBDTC 0.16% of alldonations (95/58 505) - 58 after PRBC transfusions, 28 after platelet concentrate transfusions and 9 after FFP transfusion. Febrile nonhemolytic and allergic reactions constitute respectively 36.8% and 30.5% of all complications. CONCLUSION: Nonhemolyticand allergic reactions are the most common complications of blood components transfusion and they are more common after platelet concentrate transfusions in comparison to PRBC and FFP donations.

Servicios médicos en helicópteros de emergencias para pacientes con ictus cerebral / Helicopter emergency medical services for patients with cerebral stroke

Objetivo: El objetivo de este estudio transversal es analizar los transportes en helicóptero de pacientes con ictus isquémico en Polonia durante los años 2011-12. Se procuró evaluar el papel del servicio médico de helicópteros en reducir tiempos prehospitalarios y analizar la evolución de los pacientes durante el transporte. Método: Estudio retrospectivo de todas las atenciones realizadas por el servicio polaco de helicópteros medicalizados durante un periodo de dos años. Los datos recogidos de cada atención y paciente incluyeron el tiempo desde la activación hasta la llegada al lugar de atención, tiempo en el lugar de la atención, tiempo de transporte, escala del National Advisory Committee for Aeronautics (NACA), ETR (Escala de Trauma Revisada) y ECG (Escala de Coma de Glasgow) en el lugar de atención y en el momento de transferencia del paciente a los servicios de emergencias o al hospital. Resultados: Se analizaron 1.191 atenciones. Los valores medios de las escalas ETR y ECG en el lugar de atención eran 11,1 (DE 1,36) y de 11,8 (DE 3,39). Después del transporte en helicóptero medicalizado, los valores medios eran: 11,0 (1,5) y 11,7 (3,5), respectivamente. Se observó que el tiempo de transporte no influyó en el estado del paciente, mientras que más tiempo en el lugar de atención produce una disminución estadísticamente significativa en los valores medios de las escalas. Conclusiones: El helicóptero es un modo seguro de transporte para pacientes con ictus y asegura su transferencia al hospital/ambulancia más cercano en el tiempo apropiado para la iniciación de tratamiento. La atención en el lugar de atención en caso de ictus debería ser tan corta como sea posible (AU)

Objective: The aim of this cross-sectional study was to analyze transport by helicopter emergency medical services (HEMS) in cases of ischemic cerebral stroke in Poland in 2011 and 2012. We assessed the role of the HEMS in reducing prehospital times and analyzed changes in patients’ status during transport. Methods: Retrospective study of all missions flown by the Polish HEMS to attend stroke patients over the 2-year period. The following data were collected for each mission and patient: time from activation of the HEMS until arrival at the scene, time spent at the scene; and scores on the National Advisory Committee for Aeronautics scale, the Revised Trauma Scale (ETR), and the Glasgow Coma Scale (ECG) at the scene and on transfer of the patient to the hospital or ambulance. Results: A total of 1191 patients were analyzed. The mean (SD) ETR and ECG scores on the scene were 11.1 (1.36) and 11.8 (3.39), respectively. After HEMS transport the means were 11.0 (1.5) and 11.7 (3.5). In-flight transport did not affect the patient’s condition, but more time spent at the scene was associated with significantly lower scores on the scales. Conclusions: Helicopter transport of these patients is safe and ensures their transfer to the nearest hospital or ambulance within the treatment time window. Time spent on care at the scene of the emergency should probably be as short as posible (AU)

[Helicopter emergency medical services for patients with cerebral stroke]. / Servicios médicos en helicópteros de emergencias para pacientes con ictus cerebral.

OBJECTIVES: The aim of this cross-sectional study was to analyze transport by helicopter emergency medical services (HEMS) in cases of ischemic cerebral stroke in Poland in 2011 and 2012. We assessed the role of the HEMS in reducing prehospital times and analyzed changes in patients' status during transport. MATERIAL AND METHODS: Retrospective study of all missions flown by the Polish HEMS to attend stroke patients over the 2-year period. The following data were collected for each mission and patient: time from activation of the HEMS until arrival at the scene, time spent at the scene; and scores on the National Advisory Committee for Aeronautics scale, the Revised Trauma Scale (ETR), and the Glasgow Coma Scale (ECG) at the scene and on transfer of the patient to the hospital or ambulance. RESULTS: A total of 1191 patients were analyzed. The mean (SD) ETR and ECG scores on the scene were 11.1 (1.36) and 11.8 (3.39), respectively. After HEMS transport the means were 11.0 (1.5) and 11.7 (3.5). In-flight transport did not affect the patient's condition, but more time spent at the scene was associated with significantly lower scores on the scales. CONCLUSION: Helicopter transport of these patients is safe and ensures their transfer to the nearest hospital or ambulance within the treatment time window. Time spent on care at the scene of the emergency should probably be as short as possible.

OBJETIVO: El objetivo de este estudio transversal es analizar los transportes en helicóptero de pacientes con ictus isquémico en Polonia durante los años 2011-12. Se procuró evaluar el papel del servicio médico de helicópteros en reducir tiempos prehospitalarios y analizar la evolución de los pacientes durante el transporte. METODO: Estudio retrospectivo de todas las atenciones realizadas por el servicio polaco de helicópteros medicalizados durante un periodo de dos años. Los datos recogidos de cada atención y paciente incluyeron el tiempo desde la activación hasta la llegada al lugar de atención, tiempo en el lugar de la atención, tiempo de transporte, escala del National Advisory Committee for Aeronautics (NACA), ETR (Escala de Trauma Revisada) y ECG (Escala de Coma de Glasgow) en el lugar de atención y en el momento de transferencia del paciente a los servicios de emergencias o al hospital. RESULTADOS: Se analizaron 1.191 atenciones. Los valores medios de las escalas ETR y ECG en el lugar de atención eran 11,1 (DE 1,36) y de 11,8 (DE 3,39). Después del transporte en helicóptero medicalizado, los valores medios eran: 11,0 (1,5) y 11,7 (3,5), respectivamente. Se observó que el tiempo de transporte no influyó en el estado del paciente, mientras que más tiempo en el lugar de atención produce una disminución estadísticamente significativa en los valores medios de las escalas. CONCLUSIONES: El helicóptero es un modo seguro de transporte para pacientes con ictus y asegura su transferencia al hospital/ambulancia más cercano en el tiempo apropiado para la iniciación de tratamiento. La atención en el lugar de atención en caso de ictus debería ser tan corta como sea posible.

The role of human papillomavirus infection in the head and neck region and methods for its detection.

Human papillomaviruses (HPV) are the etiological factors of many benign and malignant lesions localized in the skin and mucous membranes in the region of the urogenital organs and head and neck. Currently, most assays for the detection of HPV are based on detecting the presence of viral nucleic acids, mostly viral DNA. These molecular techniques can be divided into: 1) methods based on a targeted, selective amplification of nucleic acids, 2) signal amplification methods, 3) nucleic acid hybridization assays. This paper presents and explains a number of different HPV detection methods and provides examples of some commonly available commercial tests.

Treatment strategy in Goldenhar syndrome.

Goldenhar syndrome is a rare congenital defect characterized by ocular symptoms including (epibulbar dermoids, microphthalmia, anophthalmia, eyes asymmetry/dysmorphy, cleft eyelid, exophthalmia, strabismus), auricular symptoms (dacryocystitis), preauricular appendages, preauricular fistulas, ear asymmetry, microtia, atresia of the external auditory canal), craniofacial deformities (cleft face, cleft lip, cleft palate, macrostomia, bifid tongue, hypoplasia of the mandible, hypoplasia of the maxilla, asymmetry of the mandible and maxilla, malocclusion, tooth discrepancies, agenesis of third molars and second premolars, supernumerary teeth, enamel and dentin malformations, delay in tooth development), and skeletal abnormalities (cleft spine, microcephaly, dolichocephaly, plagiocephaly, vertebral defects) or abnormalities of internal organs. The degree of abnormalities vary from severe to mild. In this article, we present a long-term observation of a patient with Goldenhar syndrome. During the patient's life, the intensification of anomalies varied. We describe preoperative and postoperative orthodontic treatment and surgical correction procedures of maxillofacial deformation.

Neurologic and functional long-term outcome after carotid endarterectomy.

BACKGROUND: The aim of this research was to assess the neurologic status of patients a year after endarterectomy with the use of National Institutes of Health Stroke Scale (NIHSS) and the degree of disability using the modified Rankin Scale (mRS) and to examine the patients' subjective evaluation of their health. METHODS: One hundred two patients with symptomatic internal carotid artery stenosis who underwent endarterectomy and attended a 1-year follow-up examination were enrolled in the study. The material comprised 72 (70.6%) men and 30 (29.4%) women. Before the surgery, the patients' neurologic status was assessed according to the NIHSS, and their functional status was rated with the mRS. Additionally, the patients were asked to assess their life quality on a 10-point Likert scale. RESULTS: The mean NIHSS score before the operation was 2.76 points (SD 2.47), whereas a year after it was 2.05 points (SD 1.84) (P < .0001). The NIHSS scores that improved significantly a year after endarterectomy were level of consciousness-questions and commands, motor leg, and sensory (P < .05). CONCLUSIONS: The patients' neurologic status assessed with the NIHSS improved significantly 1 year after carotid endarterectomy mostly because of the improvement in their verbal and motor communication ability, physical condition and agility, and reduction in sensory disturbances. The observed changes in the neurologic status were reflected in the functional status and subjective life quality assessment, which appeared to be significantly better a year after the surgical treatment.

Influence of internal carotid endarterectomy on patients' life quality.

UNLABELLED: Appropriate treatment of symptomatic carotid artery stenosis can reduce ischemic cerebral strokes' risk and in some cases eliminate neurological symptoms. Endarterectomy is the most common surgical treatment. The aim of the study was to examine the influence of carotid endarterectomy on neurological symptoms and patients' life quality. MATERIAL AND METHODS: The material comprised of 102 patients who underwent endarterectomy. All of the patients were given a questionnaire with a list of neurological symptoms (vertigos, headaches, left hemiparesis, right hemiparesis, numbness, acroparaesthesia, single syncope, recurrent syncopies, diplopia, tinnitus, concentration disturbances and aphasia) and with a numerical life quality scale to fill in before and a year after the surgery. RESULTS: Vertigo, headache, single and recurrent syncopies and aphasia as well as cerebral stroke and amaurosis fugax were significantly more rarely observed after endarterectomy. The mean value of patients' life quality evaluated on a 10-point Likert scale after the surgery increased (3.9 vs 6.3). CONCLUSIONS: A year after carotid endarterectomy patients' life quality improves which is connected with neurological symptoms' regression and no further symptoms' occurrence due to a preventive role of the surgery.

Characteristics and epidemiology of zygomaticomaxillary complex fractures.

OBJECTIVES: The aim of this study was to analyze the characteristics, namely, cause, type, site of fracture, and epidemiology data, of zygomaticomaxillary complex (ZMC) fractures. MATERIALS AND METHODS: Hospital records and computed tomographic scans of 468 patients, treated for ZMC fractures at the Department of Craniomaxillofacial and Oncological Surgery between January 1990 and December 1995 and between January 2000 and December 2007, were selected and analyzed according to several factors including age, sex, cause, type, site of fracture, alcohol use before injury treatment modalities, complications, and mean treatment delay. RESULTS: A total of 468 patients (400 males and 68 females; male to-female ratio, 5.88:1) were included in this study. Their ages ranged from 15 to 85 years (mean T SD age, 37.1 T 14.83 y). Type B, by Zingg classification, was the most common type of ZMC fractures and accounted for 73.1% of cases. Assaults (64.5%), traffic accidents (13.9%), falls (13.0%), sports accidents (5.8%), and work accidents (2.8%) were noted. More than one-third of all the patients experienced injury after alcohol consumption. Of these patients, 96.6% were treated surgically. The most favored technique was miniplate osteosynthesis. The complication rate associated with the inaccurate reduction of the fractures was the most common. In this group of complications, minor asymmetry was the most common and occurred in 35 patients. Mean treatment delay was 42.7 hours. It ranged from 0.25 to 1080 hours, and the lowest value was observed in work accidents (2.7 hours). CONCLUSIONS: Facial trauma can result in fractures limited to 1 component of the tetrapod structure but more commonly results in a tetrapod fracture involving all 4 buttresses. Males are the most common victims of ZMC fractures, and assault remains the major cause of ZMC injuries in Poland, like in most developed countries. Alcohol involvement among trauma patients is high, especially in case of assaults and falls. Each patient with ZMC fracture should be evaluated individually.

Intracranial occlusions and internal carotid artery stenoses: clinical implications.

BACKGROUND: The aim of this research was to investigate the influence of intracranial stenoses or occlusions on the outcome of carotid endarterectomy (CEA) in patients with internal carotid artery stenosis. The authors also searched for internal carotid artery plaque's morphology influence on the atherosclerotic process in intracranial arteries. METHODS: The study included 154 patients who underwent angiography and CEA. Intracranial lesions (stenosis or occlusion) were stated in 28 (18.2%) patients. RESULTS: Perioperative stroke - death rate was 3.9%. Statistical analysis revealed that perioperative stroke after CEA appeared significantly more often in patients with intracranial stenoses or occlusions (p = 0.0104). Late death-stroke rate was 13.6%. Log-rank test revealed that after a 1-year follow-up period, there were significantly more survivals in patients without intracranial lesions than in those with intracranial lesions (p = 0.048). CONCLUSIONS: Intracranial stenosis or occlusion predicts poor perioperative neurological outcome. Patients with intracranial lesions benefit less from endarterectomy in a 1-year follow-up period. On the basis of internal carotid artery plaque's morphology, no conclusions on advancement of intracranial arteries' atherosclerosis can be made.