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Introduction: Patients who underwent laryngectomy due to larynx cancer have a possibility to regain ability to speak with the use of silicone voice prosthesis. However, the lifetime of the device is limited, and last for approximately 3-6 months, mainly due to bacterial and fungal biofilm formation, that subsequently causes deterioration of the prosthesis and malfunction of the valve mechanisms. Moreover, the biofilm can be reservoir for chronic and systemic infections., Aim: The aim of the following study was to investigate Candida biofilm formation on silicone voice prosthesis., Material and Methods: Experiments were performed using C. albicans and C. krusei fungal strains with Provox 2 and Provox Acti Valve voice prosthesis. Fungal biofilms were examined under various magnifications using SEM technique., Results: Scanning electron microscopy revealed that Candida biofilms formed on voice prosthesis had highly heterogeneous structure and were composed of blastospores, pseudohyphae, hyphae and ,,germ tubes" encased in an extracellular material. Noticeable differences in biofilms structure depended on Candida species and type of voice prosthesis., Conclusions: Presented data throws light on problems concerned fungal colonization on indwelled medical devices.

In mycoses congenital--nonspecific innate as well as acquired immunity (involving neutrophiles, monocytes, macrophages, dendritic cells and lymphocytes) both play important roles in host defence. Th1 lymphocytes release cytokines (IL-2, IL-12, IFN gamma) and stimulate cytotoxic cells and neutrophiles to destroy fungal cells. Th2 lymphocytes, on the other hand, suppress cellular immunity by releasing the cytokines IL-4, IL-6 and IL-10 which counter regulate the secretion of IL-2, IL-12, IFN gamma and depress the activity of macrophages. Cellular mechanisms play essential roles in host responses to fungal infections. Dysfunction of T lymphocytes and a reduction in their number are typically observed in patients with mycotic diseases. There occurs a reduction of both T lymphocyte populations and the T-helper to T-suppressor cell number ratio, and these are of critical importance in explaining the diminished IgA production and enhanced adhesion of fungal cells to the surface of host cells as well as in facilitating the intrusion of fungi throughout the skin and mucous membranes. The specific immunological reaction, associated with the synthesis of antibodies against fungal cell wall or cytoplasmic antigens, is of little significance in protective immunity, but nevertheless has a rather important role to play in diagnosis as well as in supporting phagocytosis by inhibition of fungal cell adherence. In patients with mycoses, typically low blood serum level of the immunoglobulin class G and A and low sIgA in saliva are observed. A detailed understanding the nature and function of the immune system in mycoses is necessary to enable improvements in pharmacotherapy with antifungal antibiotics and chemotherapeutics, as well as to treatments based on immunotherapy and vaccination.

Formation of fungal biofilms in patients with implanted biomedical prosthesis constitutes very serious clinical problems. The biofilm can lead to dysfunction of implanted material and can be a reservoir for chronic and systemic infections. Numerous investigations demonstrated differences in quantity and structure of biofilms that had been formed by various species of fungi belonged to Candida genus. Stages of biofilm formations had been examined carefully in in vitro conditions. Biofilm formation begin with adhesion of fungi to the surface, microcolonies are formed subsequently. At the end of the process, extracellular material is excreted, and its formula, that is various in different fungi Candida species, contribute to its resistance to antifungal drugs. Farnesol and tyrosol are two quorum-sensing molecules. They are acting inversely, regulating formation of "germ tubes" and influencing morphogenetic conversion between yeast and filamentous forms, which plays a very important role in pathogenicity and formation of biofilm. Drug resistance of fungi from Candida has been shown to create a very important clinical problem. Many experiments in vitro confirm significantly lower activity of antifungal drugs toward Candida biofilm than toward Candida, in the form of planctonic cells. Surprisingly, some non-steroidal anti-inflammatory drugs can inhibit biofilm formation.

The systemic fungal invasions are recognized with increasing frequency and constitute a primary cause of morbidity and mortality, especially in immunocompromised patients. Early diagnosis improves prognosis, but remains a problem because there is lack of sensitive tests to aid in the diagnosis of systemic mycoses on the one hand, and on the other the patients only present unspecific signs and symptoms, thus delaying early diagnosis. The diagnosis depends upon a combination of clinical observation and laboratory investigation. The successful laboratory diagnosis of fungal infection depends in major part on the collection of appropriate clinical specimens for investigations and on the selection of appropriate microbiological test procedures. So these problems (collection of specimens, direct techniques, staining methods, cultures on different media and non-culture-based methods) are presented in article.

Fungi, in comparison with other pathogenic factors, have high pathogenicity. The number of fungal species which are able to infect people is over 500. The upper respiratory tract and ear have permanent contact with external environment which makes their ontocenoses open to continuous exchange of microorganisms of which they consist. In etiology of inflammatory processes 21 species which belonging to 3 genera (Zygomycota, Ascomycota, Basidiomycota) of fungi play important role. Administration of antifungal drugs can be: prophylactic, empiric preemptive and therapeutic. Physicians may prescribe antibiotics (mainly pollens: amphotericin B, natamycin and nystatin) and chemiotherapeutics (mainly azoles and fluorpirymidins, pigments, chlorhexidine and chlorquinaldol). In ENT practice topical and systemic drugs can be administrated. Topical lozenges include amphotericin B, clotrimazole, chlorhexidine or chlorquinaldol and oral gels: nystatin and miconazole. Some of drugs are in the form of suspension/solution, which can be used for inhalation, into the sinus, for swabbing or for lavage: amphotericin B, natamycin, nystatin, clotrimazol, flucytosine, miconazole, fluconazole, vorykonazole, caspofungin. It should be underlined that only a few of dugs can be absorbed from the digestive tract: flucytosine, fluconazole, itraconazole, ketoconazole, miconazole, vorykonazole.

The occurrence of potentially pathogenic fungal strains in the Charzykowskie Lake and runnels flowing into and out of it was investigated. The study material was obtained in 2005 and in 2006, in the periods of spring intermix and summer stagnation, and in 2005 in the period of autumn intermix. The fungi found in the Charzykowski Lake belonged to 5 genera: Rhodotorula (R. minuta, R. rubra and R. glutinis), Cryptoccocus (C. neoformans, C. laurentii, C. terreus and C. laurentii), Candida (C. inconspicua, C. lusitaniae, C. tropicalis, C. pelliculosa, C. kefir, C. glabrata, C. inconspicua, C. parapsilosis, C. ciferrii and C. colliculosa), Trichosporon (T. cutaneum) and Klockera (K. apiculata). The fungi found in runnels flowing into and out of the Charzykowskie Lake belonged to 4 genera: Rhodotorula (R. rubra and R. glutinis), Cryptoccocus (C. laurentii, C. neoformans, C. albidus and C. terreus), Candida (C. colliculosa, C. lusitaniae, C. tropicalis, C. pelliculosa, C. cifferii, C. glabrata) and Trichosporon (T. cutaneum).

Introduction: Over the last years, systemic fungal infections have dramatically increased in hospitalized patients. The Candida is the main pathogen caused nosocomial fungal infections., The Aim of the Study: The aim was to analyze frequency of occurrence of the yeast-like fungi in different biological materials isolated from the patients of an Intensive Care Unit of the University Hospital of Lodz in the period of 2000-2003., Material and Methods: 123 strains of fungi were analyzed with the use of API 20 C AUX test (bioMarieux)., Results: Among all the investigated Candida strains C. albicans accounted for 52.0%. Samples from respiratory system and urine most often contained the strains of C. albicans (56.3 and 60.5%, respectively); blood samples contained C. parapsilosis (44.8%). In patients who were untreated by bacterial antibiotics C. albicans was the most frequent species, whereas in patients who were ordered bacterial antibiotics it was C. parapsilosis that dominated., Conclusions: (1) Candida is the most frequent cause of fungal infections in patients hospitalized in an intensive care unit. (2) C. parapsilosis is the main pathogen caused bloodstream infections. This species is also more frequent in patients who were ordered antibacterial antibiotics over five days. (3). Species other than C. albicans become more and more frequent and dangerous.

For the past twenty years, invasive fungal infections have dramatically increased resulting in the high morbidity and mortality. The main reason of these infections is the development of invasive diagnostic and therapeutic technologies. Immunosuppression, neutropenia, broad-spectrum antibacterial agents, corticosteroids, chemotherapy, central intravascular catheter, total parenteral nutrition are the major risk factors of the invasive fungal infections. Most of these factors are very common for hospitalized patients. For example, patients with fungemia are more likely to die during hospitalization then those with bloodstream infection caused by nonfungal pathogens. Unfortunately, diagnosis and diagnostic methods of fungal infection are still difficult.

Some aspects of multifocal and disseminated mycosis are discussed. Special attention is devoted to factors, which play a significant role in the development of fungal infections. Host criteria and microbiological as well as a clinical criteria are discussed. A special attention is given to nosocomial invasions and post-transplantation mycosis.

The aim of the study was to analyze the frequency of occurrence of Trichomonas tenax in patients with periodontitis and also to check the relationship between the occurrence of the protozoan and the indices of oral hygiene, and to evaluate periodontal treatment needs. The study involved 91 individuals aged 23-79 years (52 women and 39 men). 34 of them were infected with Trichomonas tenax. The study revealed dependence between the frequency of occurrence of Trichomonas tenax and the state of periodontium and the hygiene of the oral cavity.

We have investigated the hydrolytic activity of 21 species of yeast-like fungi from Candida genus and 1 species of yeast S. cerevisiae isolated from Sulej6w Reservoir water. The activity of hydrolytic enzymes of the studied fungi was different than that of standard strains and also of fungi isolated from patients. This difference demonstrates the capability of the studied fungi to adapt to various environmental conditions.

Candida glabrata is very important pathogen which is resistant to some imidazoles (fluconazole). The aim of study was to compare a susceptibility of Candida albicans and Candida glabrata - strains isolated from patietnts treated in Centre for Treatment of Parasitic Diseases and Mycoses - to miconazole using MIC. 96.5% of strains were sensitive to miconazole; values of MIC for C. albicans were lower than for C. glabrata.

We have evalueated the activity of acidous asparagine protease in 48 strains of Candida isolated from homogenates of palatine tonsils from 116 patients after tonsilectomy. Strains most frequently isolated were C. albicans (66.7 +/- 6.8%) and C. tropicalis (14.6 +/- 5.09%). The range of proteolysis zone for Candida strains was 4.6 to 12.5 mm. Over 60% of the studied strains showed high and very high proteolytic activity (>6.6 mm) and the remaining strains showed moderate activity (4.6-6.5). There were no strains with low medium activity (to 4.5 mm zone). The range of the number of rosettes E formed by lymphocytes obtained from the studied tonsils was 0-268.3. Lymphocytes isolated from 70 % of tonsils infected with Candida formed only 0-130 rosettes E; in the remaining cases the number ranged between 131 and 220. The number of lymphocytes T forming rosettes E isolated from palatine tonsils from patients not infected with fungi was 2.5 times higher. There was no correlation between the size of proteolysis zone and the number of rosettes E.

All over the world an increase in the number of subjects addicted to various chemical substances has been observed. The studies of their toxic effect on the hearing have been so far most frequently limited to acute intoxication or direct effect: there are no data concerning distant and persistent effects. The aim of the study was to determine the type of hearing loss in drug addicts and individuals drinking non-consumable alcohols, examined during the period of abstinence. A group of 210 subjects addicted to various substances was examined using acumetry test and tuning forks, as well as threshold, suprathreshold and speech audiometry. Taking into consideration the threshold results for particular subjects, the percentage of hearing loss for both ears was calculated using CPT index. Most frequent complaints connected with the organ of hearing, such as tinnitus and hearing impairment were reported by alcoholics and opioid addicts. In the age adjusted threshold audiometry, perceptive hearing loss was diagnosed in nearly 50% of the subjects. The percentage of hearing loss calculated for both ears, using CPT index, demonstrated the highest values in the group of subjects drinking non-consumable alcohols and addicted to volatile organic substances.

Protozoa and fungi of the oral cavity, although frequently occuring and connected with considerable clinical adverse effects, are as yet insufficiently known. The aims of the study were to estimate the prevalence of common invasions of Trichomonas tenax and fungi, to associate the symptoms with the diagnosis of trichomonosis complicated by mycosis and to determine trichomonacidal properties of ornidazole, tinidazole and metronidazole. 936 dentist patients with different diagnoses were included into the study. The collected material consisted of rinsings, with simultaneous application of selective media, different for protozoa and for fungi 6ultures. Among the examined patients T. tenax was found in 90 cases including 85 cases where it occurred together with fungi (11 species), on the basis of which the diagnosis of trichomonosomycosis of the oral cavity was established. It was the most often in patients with leukoplakia and Lichen Wilsoni. We received a statistically significant association (0.001

Every disease and especially neoplasmatic disease is a source of deep mental experiences. The aim of this study was the establishment of some psychological behavioural parameters in 55 patients who underwent radical neck dissection and in 32 patients operated for other, non-neoplasmatic laryngologic diseases. In order to evaluate psychological state of the patients the following of States and Personality Traits (TISCO), 2. Feeling of Safety Question Sheet (KPB), 3. Profile of Mood States (POMS), 4. Scale of Hopelessness (HS-8). It was stated, that patients after radical neck dissection have deviations concerning indexes of cognitive and emotional behaviour and that there are differences between patients operated as the reason of neoplastic processes and other patients. These differences appear also among persons examined in the period shorter than 1 year from their surgery as opposed to patients operated earlier than 1 year before examinations. The fact of laryngectomy did not appear to have significant influence upon most of the evaluated indexes of cognitive and emotional behaviours.

Based on 15 pictures the technique of radical neck dissection is presented with particular attention to the topography of the neck. Steps by steps the possibility of complications is considered. During the operation the mandible branches of the facial nerve, vagus nerve, hypoglossal nerve, phrenic nerve, accessory nerve, shoulder plexus, cervical plexus, sympathetic trunk can be injured as well as the jugular vein, carotid artery, occipital artery, thoracic duct. The critical moments for generation of these complications are indicated.

Neoplastic disease is the reason for limitation in life activity and functioning. The aim of study was assessment of adaptation to life after radical neck dissection. 87 subjects were followed up: 55 patients (group A) after radical neck dissection and 32 operated on for non-neoplastic ORL diseases. Patients from group A almost in all estimated indices showed statistical significant differences in comparison with group B. Only some differences were noted between patients examined in the period shorter and longer than one year after operation. There were no differences between patients after total laryngectomy and these who were cured in other procedures.

The results are reported of studies for the assessment of the efficiency of vestibular organ in 113 drug-dependent individuals at the time of abstinence, and in 50 healthy controls. In 82.3% of drug-dependent persons vestibular damage was found, with the character of the observed abnormalities suggesting their central origin in 3/4 cases.

There isn't data concerning changes which occur to vestibular system as a result of chronic addiction. The aim of this study was to determine if the changes are dependent on the time of addiction or the time of abstinence. 113 persons, who were treated in Monar houses were divided into 3 subgroups (U 1-3) according to the time of addiction and into 4 subgroups (A 1-4) according to the time of abstinence. Symptoms, results of otoneurological examinations and answers from vestibular organs after provocation and after kinetic and caloric stimulations were taken under consideration. It was proved that there exists the relevant correlation between the whole number of symptoms and the dependence lasting over a year and it was also noticed that the greatest number of important symptoms occurs during the first two months of abstinence.

Opioids, barbiturates and volatile organic substances are the most common drugs used in Poland by addicts. In the literature there are no data concerning efficiency of vestibular organs of addicted persons examined during abstinence period. 74 drug addicts and 50 healthy persons were subjected to ENG examinations (spontaneous nystagmus, positional ny gaze ny, eye-tracking test, optokinetic test, rotatory test and caloric test were evaluated). ENG showed abnormal records in all tests performed in the addicted persons. This study has revealed that addicts have insufficiency of vestibular organs, which is probably a result of central lesions.