[The quality of voice in coal-miners after burn/inhalation injury due to methane explosion]. / Jakosc glosu u górników po urazie inhalacyjnym górnych dróg oddechowych w wyniku wybuchu metanu.

The job as a coal-miner exposes to the greatest risk. One of the most dangerous health hazard is a burn/inhalation injury during the methane explosion. The victims undergo physical trauma, effect of high temperature and inhalation of toxic gases and products of incomplete combustion, As a result of inhalation injury both, upper and lower airways are affected. The aim of the study was to analyse the relationship between burn/inhalation injury and quality of voice in affected coal-miners. A group of 23 patients (men) in age from 28 to 59 (mean 38.5) 3 years after burn/inhalation injury participated in this study. The voice evaluation based on ENT examination, videlaryngostroboscopy, acoustic analysis, MPT parameter and GRBAS analysis was performed. The special control group of coal-miners served as a control. On the basis of the subjective evaluation and the objective acoustic analysis, aerodynamic parameter and videlaryngostroboscopy the worse quality of voice in the group of injured coalminers was shown in comparison to the control group. No substantial correlation between the acoustic parameters, MPT parameter and ventilating rates was found.

[Long-term results of airways' injury after a methane explosion]. / Odlegle skutki oparzenia dróg oddechowych w wyniku wybuchu metanu.

Injuries caused by thermal trauma more and more often affect people and they are an important problem of contemporary medicine. It is connected with the civilization development. Burn concerns not only the exterior integuments of the body but also airways, in those cases, the death rate among those who were injured with the thermal trauma increases. The treatment of both the burns and their complications is a long-lasting process, involving many specialists of various disciplines, and not always does it bring the wanted effects. The aim of the study was the assessment of the late morphological sequels inside the larynx and ventilation efficiency as a result of thermal inhalation trauma in the airways of the coal miners after the methane explosion. The methodology of examinations consisted of subjective evaluation of ventilation efficacy by MRC scale and ventilating rate measurement FEV1, FVC, FEV1%, PEF, MEF50, PIF, MIF 50, FIV. The morphological larynx evaluation was conducted based on videolaryngoscopy. 23 injured coal miners, who had been burnt at work in coal mines in 2003 in the methane explosion, were put under scrutiny. All the above mentioned examinations were done to the study group, but also to the specially selected control group, 23 coal miners. During the ventilating rates analysis in the study group, their lower values were noticed in comparison to the control group, however, the values were still within the clinical norms. Videolaryngoscopy showed hypertrophy of the laryngeal tissues.

[Peritoneal tuberculosis mimicking ovarian cancer--diagnostic difficulties. Two cases reports]. / Gruzlica otrzewnej czy rak jajnika--trudnosci diagnostyczne. Opisy dwóch przypadków.

Tuberculosis, and specially its extrapulmonary location still causes diagnostic difficulties. In 2007, in Poland 7.3% of newly registered cases of tuberculosis in Poland were located extrapulmonary. Peritoneal tuberculosis is often wrongly diagnosed as an ovarian cancer, it is due to similar symptoms like abdominal pain, abdominopelvic masses, ascites and elevated serum CA-125. Two patients who were admitted to our department with suspicion of ovarian cancer are presented. Subjective symptoms suggested the ovarian cancer, elevated levels of CA-125, chest x-rays without abnormal findings or with minimal fibrotic changes and uncharacteristic results of additional investigations were disclosed. A diagnostic laparoscopy was made to establish the diagnosis. Because of clinical and operative picture suggesting ovarian cancer in both cases resections were performed. The procedure consisted of total abdominal hysterectomy and bilateral salpingo-oophorectomy. Biopsy specimens were taken up and verified histopathologically. The peritoneal tuberculosis was recognized in both cases.

Citric acid cough threshold in patients with gastroesophageal reflux disease rises after laparoscopic fundoplication.

BACKGROUND: It has been reported that antireflux surgery can diminish chronic cough due to gastroesophageal reflux disease (GERD) that is resistant to pharmacologic therapy. The aim of this study was the assessment of citric acid cough threshold (CACT) in patients with chronic cough due to GERD before and 3 months after laparoscopic Toupet fundoplication. METHODS: Thirty subjects (20 women and 10 men; median age, 45.3 years) with chronic cough due to GERD and 15 healthy volunteers underwent cough challenge with doubling concentrations of citric acid. Twenty subjects with GERD, a group of 14 women and 6 men (mean age, 45.5 years), underwent the same protocol 3 months after laparoscopic fundoplication. Daytime and nighttime cough score questionnaires (verbal category descriptive score) were completed in all groups. RESULTS: The geometric mean of CACT was significantly lower in GERD patients (9.62 mg/mL) than in healthy volunteers (50.8 mg/mL, p < 0.001). The results of cough score measurement significantly improved within 2 weeks after laparoscopic surgery. In 13 weeks of postoperative follow-up, cough disappeared or was greatly improved in 14 of the 20 patients (70%); in 3 other patients, cough resolved partially. In three patients. there was no improvement in cough. Cough challenge after surgery revealed a significant increase in mean cough threshold, from 8.28 to 19.03 mg/mL (p < 0.05). CONCLUSIONS: The results suggest that GERD influences CACT, which was significantly lower in GERD patients compared to healthy subjects. A significant correlation was found between subjective and objective measurements of cough in GERD patients. We found laparoscopic fundoplication to be objectively beneficial in GERD-induced chronic cough, as it reduced the CACT.

[Lung function and exercise tolerance after treatment with salmeterol or ipratropium bromide in chronic obstructive pulmonary disease]. / Czynnosc pluc i tolerancja wysilku u chorych na przewlekla obturacyjna chorobe pluc leczonych bromkiem ipratropium lub salmeterolem.

The aim of this study was to compare the effects of 6 months therapy with salmeterol or ipratropium bromide on lung function (resting and dynamic parameters), exercise tolerance in patients with chronic obstructive pulmonary disease (COPD). In open, randomised study patients at visit 1 were included into trial, at visit 2 and, after 6 months therapy, at visit 3 lung function measured by a pressure body plethysmography, exercise tolerance was investigated by 6 minute walking test and dyspnoea was analysed by the means of Borg scale. We studied 24 patients (18 males, 6 females, range age 45-76 yrs, mean: 60.2+/-10.46) with stable COPD. 13 subjects (mean FEV1 = 63.61% predicted, SD = 15.66%) received salmeterol (2 x 50 microg/day) and 11 subjects (mean FEV1 = 62.52% predicted, SD = 12.39%) received ipratropium bromide (4 x 40 microg/day). There were no significant changes in lung function parameters (FEV1, VC, Rtot, TLC, RV and RV%TLC) after 6 months therapy with both drugs, but the treatment with salmeterol significantly improves exercise tolerance in 6 minute walking test (p=0.048) and Borg dyspnea ratings (p=0.008).

[Two cases of bronchial tuberculosis--diagnostic difficulties]. / Dwa przypadki gruzlicy oskrzeli--trudnosci rozpoznawcze.

We present two cases of bronchial tuberculosis. The first one, man aged 45, showed diffuse necrotic changes in bronchoscopic picture described histologically as coagulative necrosis. AFB were not found in sputum smear but only in the cultures. The second patient--19-year old female presented the features of right lung bronchopneumonia. Bronchoscopic examinations showed diffused necrotic infiltration. Tuberculosis etiology was confirmed by positive results of examined brosage, concomitantly with negative Mantoux reaction.

[Chronic obstructive pulmonary disease in inhabitants of Zabrze]. / Przewlekla obturacyjna choroba pluc u mieszkanców miasta Zabrza.

In 2001 a modified MRC questionnaire and spirometry were performed in the inhabitants of Zabrze (Poland). Two hundred and thirty-nine men and 320 women aged 19-69 years were studied. Forty percent of men and 23% of women were smokers. In men but not in women a decline in smoking habit was observed as compared with previous studies in Zabrze carried out in the eighties. More men (32%) than women (19%) gave up smoking. The prevalence of chronic productive cough was closely related to smoking habit. Dyspnea and wheezing were also related to smoking but less strongly than productive cough. The prevalence of COPD (diagnosed according to GOLD criteria) was 10.2%. COPD was more common in smokers than in non-smokers, especially among men (19% and 2% respectively). Persistent productive cough, wheezing and advanced dyspnoea as well as intensive smoking (more than 40 pack years) were strongly connected with the prevalence of COPD. COPD was previously diagnosed in more than 50% of subjects identified as having COPD in this study. Almost 80% of subjects with COPD were not given any treatment in the past year.

[Transbronchial needle aspiration biopsy in the diagnosis of peripheral lung lesions]. / Przezoskrzelowa aspiracyjna biopsja igla Wanga w diagnostyce zmian obwodowych w plucach.

In 1996-2000 in 55 patients (16 females, 39 males) admitted to Department of Phtisiopneumonology in Zabrze because of peripheral lung lesions (diameter 2.5-9.5 cm mean 4.5 cm). The transbronchial aspiration needle biopsy (TANB) was performed as diagnostic procedure during fiberoptic bronchoscopy. Subjects classified to TANB showed no pathologic changes in the bronchial tree during fiberoptic bronchoscopy. In all subjects the TANB was performed using special Wang's needles and always under fluoroscopy supervision. Based on pathologic examination of specimens obtained by Wang's needle the diagnosis was established in 29 (52.7%) cases. The most frequent diagnosis was non small cell carcinoma--in 22 (40%) of examined patients. The small cell carcinoma was confirmed only in 1 patient. In 3 (5.5%) patients tuberculosis was diagnosed. TANB was good tolerated by almost all patients, only in 1 patient small pneumothorax was recorded and in 6 cases small bleeding occurred. We conclude that transbronchial aspiration needle biopsy is safe and efficient method in diagnosis of peripheral lung tumors.