[The role of thoracoscopy in traumatic diaphragmatic rupture]. / Wartosc torakoskopii w diagnostyce urazowego uszkodzenia przepony.

The aim of this study was assess the role of thoracoscopy in the diagnosis of diaphragmatic rupture. Eight patients: six male and two female with blunt thoracic trauma underwent thoracoscopy. The chest X-ray and CT findings, pleural ultrasound indicated a diaphragmatic rupture only in three cases. Five of eight diaphragmatic injuries were confirmed by thoracoscopy. Authors suggests that thoracoscopy is a safe, accurate method for the diagnosis of diaphragmatic rupture.

[Metachronic lung cancer]. / Metachroniczny rak pluca.

Authors describe a rare case of metachronic lung cancer treated surgically. The time from the diagnosis of the first adenocarcinoma to the appearance of the second carcinoma planoepitheliale was 6 years. The successful of surgical treatment was due to systematic, long postoperatively control.

Decreased selenium concentration and glutathione peroxidase activity in blood and increase of these parameters in malignant tissue of lung cancer patients.

We studied the selenium (Se) concentration in whole blood and plasma, glutathione peroxidase (GSH-Px) activity in red blood cells and plasma, as well as both of these parameters in cancerous and tumor-free lung tissue of lung cancer patients. Blood samples were taken from 84 cancer patients and 61 healthy controls. Normal and neoplastic lung tissues were obtained from 57 patients at the time of surgery. Se concentrations in whole blood and plasma were lower by 23% (p < 0.001) in patients compared with controls. GSH-Px activity in red cells was lower by 20.2% (p < 0.004) and in plasma by 11.7% (p < 0.05) in patients than in the control group. On the other hand, the tumor Se level was higher by 66.6% (p < 0.0001) and GSH Px activity by 49.5% (p < 0.0001) than in adjacent tumor-free tissue. No differences in Se concentrations and GSH-Px activities were found between squamous cell carcinoma and adenocarcinoma nor among the clinical stages of the disease. In the whole blood and plasma of cancer patients significantly lower Se concentrations were found in smokers than in nonsmokers. Significantly lower Se concentrations were also found among cancer patients who were smokers compared with controls. These findings show that in the blood of cancer the antioxidant ability, as measured by Se and GSH-Px, is reduced significantly. The cause of increased Se and GSH-Px in the malignant part of the lung is not understood and requires further studies.

[Results of treating patients with pleural empyema in relation to time of diagnosis]. / Wyniki leczenia chorych z ropniakiem oplucnej w zaleznosci od czasu rozpoznania.

Results of surgical treatment of 182 patients with pleural empyema were assessed. Patients were divided into 2 groups according to the length of time between the beginning of illness and the start of treatment at the thoracosurgical department. The first group consisted of 36 patients in whom the draining of empyema's chamber was applied no later than 7 days after the onset of illness. This treatment was effective in 31 (86%) of patients. The remaining, 14% of patients required operative treatment. The second group consisted of 146 patients who were admitted to surgical department later than 7 days from the beginning of disease. 33% of them required operative treatment. The results achieved in both groups of patients proved that the time lapse between, the beginning of disease and the confirmation of suppurative character of exudation, had a decisive influence on the surgical procedure and the final results of treatment.

[Boerhaavea syndrome--diagnostic difficulties]. / Zespól Boerhaavea--trudnosci rozpoznawcze.

Two cases are presented in whom a spontaneous tearing of the esophagus was diagnosed. Both were initially treated for pleural empyema and pneumothorax. Late correct diagnosis was the cause of treatment failure.