[Neurologic aspects of vibration syndrome]. / Aspekty neurologiczne zespolu wibracyjnego.

The authors present divergent opinions on the pathogenesis of vibratory syndrome, and primarily on its angio-neurological form, i.e. vascular, neurogenic and immunological theory. In the light of these concepts the clinical manifestations of vibratory syndrome are discussed in view of both systemic and local developments. The issues concerning neurological diagnostics with reference to the usefulness of electrophysiological methods are thoroughly analysed. Difficulties in early diagnosis and identification of symptoms that distinguish vibratory syndrome from other syndromes with similar manifestations are highlighted.

[Changes in the nervous system due to occupational metallic mercury poisoning]. / Zmiany w ukladzie nerwowym w przewleklym zawodowym zatruciu rtecia metaliczna.

At the Institute of Occupational Medicine and Environmental Health, during 12 years, chronic mercury intoxication was diagnosed in 34 persons. There were male workers tending technological processes in which Hg was used as a catalyst (synthesis of acetic aldehyde and obtaining chlorine). The length of professional exposure was 13-34 years (mean 20.6). The patients were removed from the contact with Hg after Hg intoxication case was confirmed. During the following 11 years, 24 of them were reexamined in the clinical department 2-4 times. The clinical picture of the poisoning consisted mainly of neurasthenic, cerebellar (30 persons), psychoorganic symptoms (20 persons) and behavioural changes (irritability, aggressive states). Headaches, sleep and recent memory disturbances, progressive behavioral changes, dizziness, were the most frequent complaints. The authors stressed the irreversibility of central nervous disorders despite cessession of the exposure to Hg. The degree of cerebellar intensity changes did not handicap examined patients. This is especially important to show the difference between the above described clinical picture of Hg intoxication and multiple sclerosis.

[Examination of health effects from exposure to metallic mercury in workers employed in production of chlorine and aldehyde. II. Assessment of kidney lesions]. / Badania skutków zdrowotnych narazenia na pary rteeci metalicznej u pracowników zatrudnionych przy produkcji chloru i aldehydu octowego. II. Ocena uszkodzenia nerek.

A group under study embraced 73 workers involved in the production of acetic aldehyde, 74 workers of the department of chlorine and 13 retired workers with past poisoning by mercury. The control group consisted of 40 persons. Examinations performed in all subjects were designed mainly to assess the kidney lesions. The following results were obtained: Simple markers of kidney lesions (functions) such as urine standard examination, concentration of creatinine and glomerular filtration did not reveal clear-cut symptoms of metallic mercury nephrotoxic effect. In persons exposed to mercury an increased activity of lysosomal enzyme--beta-N-acetylglucosaminidase (beta-NAG) in urine was found. The activity of this enzyme showed correlation with actual mercury excretion in urine. A lack of correlation between beta-NAG activity and the index of cumulated urine excretion of mercury and the duration of exposure to mercury as well as low activity of this enzyme in the group of retired workers and pensioners with past poisoning by mercury suggest that the increase of beta-NAG activity is an reversible phenomenon. The value of determination of beta-2-microglobulin concentration in urine in persons currently exposed to mercury is doubtful because of the degradation of this protein resulting from urine acidification. The prolongation of secretory and excretory phase found in the renovasographic examination indicates the value of this method in the evaluation of kidney lesion in persons exposed to metallic mercury.

[Examination of health effects after exposure to metallic mercury vapors in workers engaged in production of chlorine and acetic aldehyde. I. Evaluation of general health status]. / Badania skutków zdrowotnych narazenia na pary rteci metalicznej u pracowników zatrudnionych przy produkcji chloru i aldehydu octowego. I. Ocena ogólnego stanu zdrowia.

Physical, neurological and psychological examinations as well as laboratory tests were performed in the group of 147 workers, engaged in the production of chlorine, acetic aldehyde and soda lye, exposed to metallic mercury vapours and in the control group (n = 49). In the evaluation of laboratory tests, morphology of peripheral blood, liver function tests and lipid balance were analysed in the first part of the work. Electroencephalography, electrocardiography and chest X-ray were also performed as auxiliary examinations. There was a certain percentage of cases with symptoms of organic damage of the brain mostly in the form of cerebellar syndrome. Psychological organic tests proved to be of little value in the evaluation of effects of exposure to mercury. The results suggest that occupational exposure to metallic mercury vapours can enhance the risk of hypertension and myocardial failure. Harmful effect of occupational exposure to metallic mercury vapour on the respiratory and haemopoietic systems as well as on the liver and lipid balance was not observed.

[Value of biochemical and immunological studies in the diagnosis of silicosis]. / Wartosc badan biochemicznych i immunologicznych w diagnostyce pylicy krzemowej.

A series of biochemical and immunological investigations was performed in a group of 33 silicosis patients and in 34 controls. The results obtained suggest future prospects of utilizing the following tests as silicotic-fibrosis markers: alpha 2-globulin and ceruloplasmin levels, activity of certain lysosomal enzymes (beta-galactosidase and beta-acetylglucosaminidase), IgM and IgG immunoglobulins, elastases, and the C4 component of the complement.

[Value of multimodal evoked potentials in the assessment of the neurotoxic effects of carbon disulphide]. / Przydatnosc badan multimodalnych potencjalów wywolanych w ocenie neurotoksycznego wplywu dwusiarczku wegla.

Central nervous system dysfunction among CS2-exposed workers was studied by measuring short latency SSEPs and VEPs. The examinations were done in 40 men. Chronic CS2 intoxication was diagnosed in 21 of them. Latency of N19, N11, N20 of somatosensory evoked potentials and latency of P100 wave of visual evoked potentials were statistically significant longer in CS2 exposed group in comparison with controls. The amplitude of N20 SSEPs was also significantly higher. Increase of N20 amplitude (33 persons) and elongation of its latency (25 persons) were frequent abnormalities of SSEps. In individual assessment of VEPs, most frequent were: abnormal difference in interocular latency of P100 (26 persons) and elongation of P100 latency (25 persons). In the analysed SSEPs and VEPs parameters there was no significant difference between two clinical groups. The authors conclude that the CS2--neurotoxic effect leads to impairment of the peripheral and central part of the somatosensory pathway, as well as to central dysfunction of the visual pathway.

[Value of electroencephalographic examination in the diagnosis of chronic carbon dioxide poisoning]. / Wartosc badan elektroencefalograficznych w rozpoznawaniu przewleklego zatrucia dwusiarczkiem wegla.

The aim of this study was to assess the value of EEG examination for the diagnosis of chronic CS2 intoxication in individual cases. 100 electroencephalograms obtained from a sample of 100 workers suspected of CS2 intoxication, treated in clinical department were analysed. The mean age of the group was 51, the mean duration of exposure was 24 years. Chronic CS2 intoxication was diagnosed in 49 persons, with prevalence of psycho-organic syndrome in 23 of them. Out of 100 EEG records, 35 were normal, 48 in normal limits, 12 within the border zone, 5 records were abnormal. In the group of 49 patients with chronic CS2 intoxication 3 records were abnormal, 6 were in the border zone. EEG disorders were found with the similar incidence in groups that differed as far as the clinical picture and the CS2 exposure period. In the authors opinion results of the EEG investigations cannot be considered as a reliable criterion in the diagnosis of chronic CS2 intoxication. The appearance of EEG abnormalities in workers exposed to CS2 should give rise to perform a more rigorous and extended neurological examination.

[Value of electroencephalographic studies for the evaluation of the neurotoxic effect of metallic mercury]. / Wartosc badan elektroencefalograficznych dla oceny neurotoksycznego wplywu rteci metalicznej.

The results of 373 EEG investigations were analysed. They were obtained in a period of 4 years in 222 workers with occupational exposure to metallic mercury in the synthesis of acetaldehyde and salt electrolysis. Abnormal or borderline abnormal results were found in 13% of them. Results were compared in groups differing in age, duration of occupation, working post and Hg excretion with urine. Significantly greater frequency of increased Hg absorption was found in the group with abnormal records. The authors stressed the following morphological features of EEG in those exposed to Hg: tendency for seizure activity, loss of ability of following of rhythmic flashes, unchanged frequency of background activity despite increasing degree of other abnormalities, absence of low-voltage tracings, persistence of abnormalities in the records after loss of contact with mercury.

[Cerebral bioelectric activity disorders in acute intoxication with hypoglycemic agents]. / Zaburzenia czynnosci bioelektrycznej mózgu w ostrych zatruciach srodkami hipoglikemizujacymi.

The authors present 10 acute suicidal poisonings with hypoglycaemic agents with particular reference to the course of disturbances of brain bioelectric activity. In most patients diffuse changes prevailed during the coma in the form of irregular, usually high-voltage slow activity. Normalization of EEG tracings was very slow, often it took several months, although the duration of hypoglycaemia was usually short (1--5 days). In patients with prolonged toxic coma profound structural lesions of the central nervous system developed with appearance of decortication (apallic syndrome). The authors think that the particular severity of central nervous system lesions in these intoxication and the persistence of changes point to the necessity of seeking more efficient measures of treating neuroglycopenia.

Complications of endotracheal intubation in patients treated for acute poisoning.

In a group of 141 patients treated for coma following poisoning, complications of endotracheal intubation were assessed. The results of this study indicate that prolonged intubation is not quite safe and that serious complications occur in several per cent of cases. Complications are more common when intubation is prolonged over 24 hours. It was observed that hypoxaemia and hypercapnia have an unfavourable effect on the incidence of complications.