Hypothalamic amenorrhea in a Camurati-Engelmann disease--a case report.

OBJECTIVE: A case report of a patient diagnosed with Camurati-Engelmann Disease (CED) in association with the functional hypothalamic amenorrhea disturbances. CED is a very rare genetically determined disorder classified as a type of bone dysplasia. DESIGN: Case report. SETTING: Department of Gynecological Endocrinology, 3rd grade Medical University Hospital. PATIENT: Twenty-one years old female patient with CED admitted to the hospital because of primary amenorrhea. Her history revealed skeletal deformities and hearing impairment. METHODS: Clinical examination, ultrasound, laboratory evaluations (including serum gonadotropins (FSH, LH) at basal state and after stimulation with gonadotropin-releasing hormone, serum basal estradiol) radiological studies (X-ray of the head, the lumbar spine and lower extremities; a computed tomography of the head), G-banding karyotype, polymerase chain reaction and DNA sequencing. Hormonal serum evaluations were made using an enzyme-linked immunosorbent assay. The exon 4 of the transforming growth factor beta 1 gene was amplified by a polymerase chain reaction and the product was directly sequenced. RESULTS: The hormonal analysis was characteristic for the hypogonadotropic hypogonadism. Radiological and molecular analyses confirmed CED diagnosis. CONCLUSIONS: The hypothalamic amenorrhea in a patient with CED may be explained as a consequence of fat hypotrophy and very low body mass index. Therefore, impairment within hypothalamic-pituitary axis in patients with CED should be treated with special attention.

[Endovascular and surgical associated treatment of post-traumatic epistaxis]. / Skojarzone leczenie endowaskularne i chirurgiczne pourazowych krwawien z nosa.

We report on two cases of patients, in whom endovascular embolization of the maxillary artery and next surgical ligation of the anterior ethmoidal artery was performed due to posttraumatic intracrable epistaxis. In those patients, conservative treatment failed, hence endovascular embolization was made. Due to persisted bleeding, right anterior ethmoidal artery were surgically ligated in both patients. After the procedures, bleeding completely stopped.

[An unusual location of a foreign body in the posterior hypopharynx--case report]. / Cialo obce tylnej sciany gardla dolnego zagrazajace tetnicy kregowej--opis przypadku.

The foreign bodies ingestion are common among the patients admitting to the ENT Emergency Unit. Usually the treatment does not cause too much trouble, however, the symptoms and possible complications might be potentially life threatening. The 64 years old female suffering from severe pain in the hypopharynx and dysphagia was introduced to the ENT Emergency Unit of the F. Raszeja City Hospital in Poznan. The laryngological examination showed the piece of the needle protruding from the back wall of the hypopharynx. The CT scans indicated the tip of the needle, touching the transverse processes of the C3 and C4 vertebrae. Unfortunately the analysis of the CT scans could not clearly exclude the injury of the vertebral artery.

[Identification of human papilloma viruses (HPV) in inflammatory states and ear neoplasms]. / Identyfikacja wirusów ludzkich brodawczaków (HPV) w stanach zapalnych i nowotworach uszu.

INTRODUCTION: Human Papilloma Virus has a strong relation to oropharyngeal mucosa and is considered to be responsible for a wide range of upper respiratory tract pathologies, like laryngeal papilloma. There's a hypothesis, that it plays a significant role in middle ear chronic inflammations and neoplasm's. MATERIAL AND METHODIC. The examination was carried on a group of 53 patients, 39 of which was suffering from granulation tissue chronic otitis media, 7-cholesteatomatous otitis media, 6--middle ear malignant neoplasm, and 1 middle and/or external ear benign neoplasm. The control group consisted of 5 patients operated on: otosclerosis--4 cases and post-traumatic tympanic membrane perforation--1 case. The material was postoperative tissue, like polyps, inflammatory granulation tissue, cholesteatoma masses and malignant neoplasm's tissue. RESULTS: In the whole group of 53 examined cases, HPV DNA was confirmed in 22 cases (41.5%), in that group oncogenic types 16 or 18 in 12 cases (22.6%), and in 14 cases (26.4%) types 6 or 11. In a group of chronic granulomatous otitis media DNA characteristic for Papilloma was identified in 12 cases (25.6%), in it in 9 cases DNA HPV type 6 or 11 was confirmed, and in 7 cases type 16 or 18. Among cholesteatomatous chronic otitis media HPV DNA types 6 or 11 was identified in 70%. In every case of middle ear malignant neoplasm a presence of high-risk DNA Papilloma types 16 or 18 was confirmed. In any case of control group HPV DNA was detected. CONCLUSIONS: The results has been compared with other authors examinations and it is claimed that they confirm the observation, that Human Papilloma Viruses may be a factor, that might play an important role in pathology of chronic otitis media and ear neoplasm's. It is concluded, that differences in percentages of HPV presence in chronic inflammations (70%) and ear neoplasm's may be explained by viral co-infection during bacterial c. o. m. Viral infection probably evolves carcinogenesis, which leads to a neoplastic growth.

[Smell and taste in drug addicts]. / Zachowanie sie wechu i smaku u osób uzaleznionych od narkotyków.

The main objective of this study was to establish the degree of influence of various illicit drugs, taken into the body in different ways, on the senses of smell and taste. Other possible factors, that might have caused disturbances in normal functioning of both senses, were outlined. The studied group consisted of 48 drug addicts, between the age of 16 and 48 years, addicted to various illicit drugs for several years. Olfactory testing included two methods. First quantitative method described by Elsberg and Levy, modified by Pruszewicz, was used to establish the smell detection threshold. Then the University of Pennsylvania Smell Identification Test was used as a method for odor identification. The sense of taste was tested with the use of method described by Krarup and modified by Pruszewicz. The results showed disturbances in olfactory performance (combined in both method) in 52.1% of all drug abusers, and 16.7% of them were diagnosed with ageusia when the sense of taste was tested. The route of administration of illicit drugs proved to be a statistically significant factor that might have caused disturbances of smell perception and identification in the study group. Drug abusers who were taking drugs intravenously and those who smoked and inhaled various drugs had the most significant olfactory problems. Both means for assessing smell function were statistically compared and the results showed that approximately 75% of drug users with olfactory disturbances had olfactory problems in both tests.

[Osteosarcoma of the larynx]. / Osteosarcoma krtani.

The authors present a case of rare laryngeal neoplasm--osteosarcoma, which generated many diagnostic and treatment difficulties. Its main cause was nonspecific symptoms and laryngoscopic view, positive tuberculous history and positive tuberculosis tests. The first histopathological examination was "angioleiomyoma exulcerans, chronic inflammation and granulation." No cancer nor tuberculosis was found". After the physiologic consultations and with positive tuberculin test the tuberculocidal treatment was applied, but it bought no success. The larynx was split then, intraoperative histopathological examination gave the result: "Cellulae carcinomatosae". The total laryngectomy was performed. Postoperative immunohistochemical examination was "Osteosarcoma of larynx". The patient was not evaluated for radio- or chemotherapy. Admitted to the hospital after 5 months with neck tumor and reactional lymph nodes by the right side of the neck. Crile's operation was performed. During the postoperative course some metastatic lymph nodes on the left side of the neck and in lungs were detected. Patient noted to chemotherapy.

[Influence of tonsillectomy in adults on the concentration and glycosylation profile of acute phase proteins]. / Wplyw tonsilektomii u osób doroslych na stezenia i profile glikozylacji wybranych bialek ostrej fazy.

Chronic tonsillitis (ch.t.) in adults can have the effect on immunological system and its function. The aims of this study were: 1. the estimation of concentration and glycosylation of acute-phase serum protein (a.ph.s.p.)--C-reactive protein (CRP), alpha 1-acid glycoprotein (AGP), alpha 1-antichymotrypsin (ACT), transferrin (Tf) and the concentration of immunoglobulins (Ig) and alpha 2-macroglobulin (alpha 2-M) in adults with ch.t. 2. the influence of tonsillectomy on the concentration and glycosylation a.ph.s.p. in I week and 6-8 months after surgery and determination of normalization estimated parameters. 116 patients with ch.t. and 15 healthy persons were evaluated. In all patients with ch.t. the concentration of acute-phase serum protein, alpha 2-M and immunoglobulins were determined before, in I-II day, VII day and 6-8 months after surgery. In patients with ch.t. were observed the significantly higher the concentration of CRP, AGP, ACT, IgG and the significantly decreased the concentration of serum transferrin before tonsillectomy, as an effects of immunological response on chronic inflammation. Tonsillectomy induced further increases the concentration of a.ph.s.p. and the highest value attained the CRP level. The change of glycosylation of AGP and ACT were results of chronic inflammatory process and analysis the glycosylation of these proteins can be useful in the estimation of activity of inflammatory process. The normalization of the concentration of acute-phase serum protein were observed in 6-8 months after tonsillectomy and confirmed the withdrawal of inflammatory process.

[Iatrogenic foreign bodies found in the middle ear as a result of prosthetic management]. / Jatrogenne ciala obce ucha srodkowego w wyniku postepowania protetycznego.

In the past few months two patients were admitted and operated on for liquid silicone that hardened to form a sponge-like mass after it was accidentally poured into the tympanic cavity during an impression taking procedure. In on case an atrophic eardrum was torn open and in the other the accident was the result of a misdiagnosed chronic otitis. In both cases a tympanoplasty was performed to remove the sponge from the tympanic cavity and to restore the conductive structures in the middle ear. Both cases demonstrate the importance of following the rules of conduct precisely, in taking the prosthetic impressions and the obvious necessity for a thorough primary examination of patients by experienced otologists with a use of a microscope.

[A comparison of water and air stimulated bithermal-caloric test and the usefulness of both methods in otologic surgery]. / Porównanie przydatnosci wodnej i powietrznej próby dwukalorycznej w praktyce otochirurgicznej.

The most commonly used method of testing the responses of the labyrinths is Water Stimulated Bithermal-Caloric Test of Fitzgerald-Hallpike. Before planning an otiatric surgery it is necessary to support by documentary evidence the responses of the vestibular organ in the ear planned to be operated on, however, irrigation with water may cause damage to structures of the ear and may intensify symptoms of the diseases and eventually make the treatment more difficult. In some centers where Water Stimulated Bithermal-Caloric Test were used alone, or a combination of air and water stimulated caloric test were performed, it seemed to be difficult to compare the results of both tests. In this study I tried to establish parameters of stimuli obtained in the Air Stimulated Bithermal-Calorics test that evoked nystagmus, similar to those obtained in the Fitzgerald-Hallpike water stimulated test. It was determined that the duration of nystagmus in both water and air stimulated bithermal-caloric tests were identical when the temperature of "cold" air wave was 26 degrees C, whereas "warm" air wave had the temperature of 48 degrees C and the time of stimulation for both tests was 80 seconds.

[Cat scratch disease--diagnostic problems]. / Choroba kociego pazura--trudnosci diagnostyczne.

Etiology, epidemiology and clinical symptoms of Mollaret's disease, also known as Cat-scratch disease, were described. Four cases of treated patients were presented. One patient with a history of type I Diabetes mellitus presented clinical symptoms of Mollaret's disease, however, after investigation he was finally diagnosed with malignant lymphoma and was given chemotherapy. In other cases some symptoms were also doubtful, but the final diagnoses were made upon positive results of serological reactions and all patients recovered completely after a few week antibiotic treatment. All patients had frequent contacts with cats. A significant divergence between the results of histopathological, serological and ultrasonographic findings lead to a conclusion that a certain diagnosis of Cat-scratch disease can only be made with the use of positive results of serological reactions.