Metabonomic analysis of serum of workers occupationally exposed to arsenic, cadmium and lead for biomarker research: a preliminary study.

Environmental metabonomics is the application of metabonomics to characterize the interactions of organisms with their environment. Metabolic profiling is an exciting addition to the armory of the epidemiologist for the discovery of new disease risk biomarkers and diagnostics. This work is a continuation of research searching for preclinical serum markers in a group of 389 healthy smelter workers exposed to lead, cadmium and arsenic. Changes in the metabolic profiles were studied using Proton Nuclear Magnetic Resonance Spectroscopy on pooled serum samples from both the metal exposed and control groups. These multivariate metabonomic datasets were analyzed with Principal Component Analysis and Partial Least Squares Discriminant Analysis. Analysis of metabolic profiles of people exposed to heavy metals suggests energy metabolism disturbance induced by heavy metals. Changes in lipid fraction (very-low-density lipoprotein - VLDL, low-density lipoprotein - LDL), unsaturated lipids and in the level of amino acids suggest perturbation of the metabolism of lipids and amino acids. This study illustrated the high reliability of NMR-based metabonomic profiling on the study of the biochemical effects induced by the mixture of heavy metals. This approach is capable of identifying intermediate biomarkers of response to toxicants at environmental/occupational concentrations, paving the way to its use in a monitoring of smelter workers exposed to low doses of lead, cadmium and arsenic.

The influence of the intensity of smoking and years of work in the metallurgy on pro-oxidant/antioxidant balance in the blood of smelters.

The aim of this study was to investigate the effect of cigarette smoking and occupational exposure to heavy metals on the degree of pro-oxidant/antioxidant imbalance in smelters. The investigations were performed on the blood and urine of 400 subjects: 300 male copper smelters and 100 nonexposed male subjects. Biological material was divided into three groups: nonsmokers, those who smoked less than 20 cigarettes a day and those who smoked more than 20 cigarettes a day. The results showed a significant increase in the concentration of lead, cadmium and arsenic in the blood and urine of smelters, while smoking more than 20 cigarettes a day caused a further increase in the concentration of these metals. The level of malondialdehyde was approximately twofold higher in the plasma of the smelters compared to the control group. We have observed a disturbance in the level of antioxidants in erythrocyte lysate manifested by an increase in metallothionein and glutathione concentrations as well as superoxide dismutase and glutathione peroxidase activities and the decrease in glutathione S-transferase activity. Cigarette smoking, years of work in metallurgy and age of smelters were additional factors significantly affecting the pro-oxidant/antioxidant balance.

Effect of the intravascular low energy laser illumination during percutaneous coronary intervention on the inflammatory process in vascular wall.

The angioplasty procedure is associated with a release of numerous factors triggering the local inflammatory reaction in vascular wall and leading thus to the restenosis. In this study, we hypothesize that the low-energy laser irradiation may exert beneficial effect by limiting this process. A group of 101 subjects (75 men and 26 women, mean age: 59.1 ± 10.3) treated with percutaneous coronary intervention (PCI), were recruited to this study. While 52 patients (40 men and 12 women) were subjected to the intravascular low-energy laser irradiation (λ=808 nm) of dilated lesion during the PCI, the remaining patients (35 men and 14 women) constituted the control group. The levels of interleukin 1ß, 6 and 10 (IL 1ß, IL 6 and IL 10) were measured immediately before the procedure, and then at the 6th, 12th hour as well as after 1 month following the PCI. Significantly lower levels of IL 1ß and IL 6 in the irradiated group during each analysis after the procedure were observed. Moreover, significantly lower IL 10 level in irradiated group within 6 and 12 hours after PCI was observed. Irradiation of the lesion with low-energy laser radiation during the PCI procedure results in a decrease in the levels of pro-inflammatory IL 1ß and IL 6 as well as in an increase in the levels of anti-inflammatory IL 10, which may result in decreased risk for restenosis.

Environmental and occupational exposure to lead as a potential risk factor for cardiovascular disease.

We have evaluated current knowledge on relations between environmental and occupational exposure to lead with a strong emphasis on cardiovascular disease risk factors, such as the influence of lead compounds on lipid disturbances and arterial blood pressure. In addition, "novel" biochemical and vascular risk factors for cardiovascular diseases were discussed, as well as the combination of lead exposure and genetic predisposition to cardiovascular diseases. Occupationally and educationally, awareness of the unfavourable effects of lead on cardiovascular diseases risk factors should be emphasised. Indeed, accurate identification of the various mechanisms that might account for the effects of lead on the cardiovascular system should be of the highest priority in this field of research.

Relationship between occupational exposure to lead and local arterial stiffness and left ventricular diastolic function in individuals with arterial hypertension.

Relationship between occupational exposure to lead and frequency of complications in persons with arterial hypertension has been poorly investigated. This study aimed at evaluation of the relationship between occupational exposure to lead and manifestation of an increased local arterial stiffness and left ventricular diastolic dysfunction. The studies included 105 men (mean age: 44.47±9.12years) with arterial hypertension, treated with hypotensive drugs: group I - men occupationally exposed to lead (n=53), and group II - men not exposed to lead (n=52). In echocardiographic examination, the left ventricular diastolic dysfunction was diagnosed significantly more frequently in group I than in group II. In eTracking examination mean values of stiffness parameter (ß), augmentation index (AI) and one-point pulse wave velocity (PWV-ß) were significantly higher and mean values of arterial compliance (AC) were significantly lower in group I than in group II. The logistic regression showed that in the group of persons with arterial hypertension occupationally exposed to lead a more advanced age, higher blood lead concentration and higher mean values of augmentation index represent independent risk factors of left ventricular diastolic dysfunction. The multifactorial regression showed that amongst persons with arterial hypertension occupationally exposed to lead higher blood zinc protoporphyrin concentration, a more advanced age and higher value of body mass index (BMI) represent independent risk factors of an increased local arterial stiffness. In summary, we should note that in the group of persons with arterial hypertension occupationally exposed to lead the study has demonstrated a significantly more frequent manifestation of left ventricular diastolic dysfunction and an increase in local arterial stiffness.

Relation between occupational exposure to lead, cadmium, arsenic and concentration of cystatin C.

UNLABELLED: Lead, cadmium and arsenic represent well recognized toxic agents which in a specific manner disturb function of cardiovascular system. Cystatin C has been accepted to be a significant prognostic factor for cardiovascular diseases. The study aimed at defining relationship between occupational exposure to lead, cadmium and arsenic on one hand and concentration of cystatin C on the other. The studies were performed on 282 men occupationally exposed to lead, cadmium and arsenic. Among the tested individuals several groups of persons were distinguished: exposed exclusively to lead (Pb group), cadmium (Cd group), arsenic (As group), to lead and cadmium (Pb/Cd group), to lead and arsenic (Pb/As group) or to cadmium and arsenic (Cd/As group). In all the individuals serum concentration of cystatin C was estimated. Concentration of cystatin C was found to be significantly higher in Pb group than in Cd and As groups, also in Pb/Cd group higher than in Cd group and in Pb/As group than in As group. Positive linear correlations were established between Pb concentration in blood (Pb-B) and serum concentration of cystatin C (r=0.59; p<0.05) as well as between urinary concentration of As (As-U) and serum concentration of cystatin C (r=0.41; p<0.05). Regression analysis demonstrated that higher blood level of lead, higher urinary level of arsenic, more advanced age and higher body mass index represented independent risk factors of an increased serum concentration of cystatin C in the group of persons exposed to lead, cadmium and arsenic. CONCLUSIONS: Higher blood level of lead and higher urinary level of arsenic represented independent risk factors of an increased serum concentration of cystatin C in the group of persons occupationally exposed to lead, cadmium and arsenic. Concentration of lead in blood was significantly influencing serum concentration of cystatin C. The highest mean serum concentration of cystatin C was detected in the group of foundry workers exposed simultaneously to lead and arsenic.

Cutaneous angiogenesis in patient with intravascular lymphoma (IVL): A case report.

We present a case of widespread cutaneous telangiectasias in a patient with a B-cell intravascular lymphoma most likely representing tumor-induced angiogenesis. The patient presented with a rapid onset of large cutaneous telangiectasias and skin edema, followed by the development of multiorgan failure. We describe difficulties with the ante-mortem diagnosis in the patient with predominant, clinically observed, skin lesions. The patient had disseminated disease involving many organs with a rapidly fatal outcome. The final diagnosis of intravascular malignant lymphoma (IVL) was established post-mortem after morphological and immunohistochemical studies of the autopsy material.

Proteomic analysis of serum of workers occupationally exposed to arsenic, cadmium, and lead for biomarker research: a preliminary study.

The main factor of environmental contamination is the presence of the heavy metals lead, cadmium, and arsenic. The aim of serum protein profile analysis of people chronically exposed to heavy metals is to find protein markers of early pathological changes. The study was conducted in a group of 389 healthy men working in copper foundry and 45 age-matched non-exposed healthy men. Toxicological test samples included whole blood, serum, and urine. Thirty-seven clinical parameters were measured. Based on the parameters values of the healthy volunteers, the centroid in 37-dimensional space was calculated. The individuals in the metal-exposed and control groups were ordered based on the Euclidean distance from the centroid defined by the first component according to Principal Component Analysis (PCA). Serum samples of two individuals, one from the control and one from the metal-exposed group, were chosen for proteomic analysis. In optimized conditions of two-dimensional gel electrophoresis (2-DE), two protein maps were obtained representing both groups. Twenty-eight corresponding protein spots from both protein maps were chosen and identified based on PDQuest analysis and the SWISS-2DPAGE database. From a panel of six proteins with differences in expression greater than a factor of two, three potential markers with the highest differences were selected: hemoglobin-spot 26 (pI 7.05, Mw 10.53), unidentified protein-spot 27 (pI 6.73, Mw 10.17), and unidentified protein-spot 25 (pI 5.75, Mw 12.07). Further studies are required to prove so far obtained results. Identified proteins could serve as potential markers of preclinical changes and could be in the future included in biomonitoring of people exposed to heavy metals.

The relationship between occupational exposure to lead and manifestation of cardiovascular complications in persons with arterial hypertension.

The chronic exposure to lead represents a risk factor of arterial hypertension development. Ambulatory blood pressure monitoring is the most prognostically reliable method of measuring of arterial blood pressure. The study is aimed at evaluating the relationship between occupational exposure to lead and manifestation of cardiovascular complications in patients with arterial hypertension. The studies included 73 men (mean age, 54.26±8.17 years) with arterial hypertension, treated with hypotensive drugs: group I-persons occupationally exposed to lead (n=35) and group II-individuals not exposed to lead (n=38). An analysis of results obtained during ambulatory blood pressure monitoring disclosed significantly higher values of mean systolic blood pressure, mean blood pressure, pulse pressure, and variability of systolic blood pressure in the group of hypertensive patients occupationally exposed to lead as compared to patients with arterial hypertension but not exposed to lead. The logistic regression showed that a more advanced age, higher concentration of blood zinc protoporphyrin, and a higher mean value of pulse pressure represented independent risk factors of left ventricular hypertrophy in the group of persons with arterial hypertension and chronically exposed to lead (OR(age)=1.11; OR(ZnPP)=1.32; OR(PP)=1,43; p<0.05). In view of the above data demonstration that occupational exposure to lead represents an independent risk factor of increased pulse pressure may be of key importance in the process of shaping general social awareness as to harmful effects of lead compounds on human health.

[Relationship between chronic exposure to lead, cadmium and manganese, blood pressure values and incidence of arterial hypertension]. / Zwiazek miedzy przewleklym narazeniem na olów, kadm i mangan a wartoscia cisnienia tetniczego oraz wystepowaniem nadcisnienia tetniczego.

BACKGROUND: Chronic exposure to heavy metals may cause the increase in blood pressure (BP). The aim of the study was to determine the relationship between chronic exposure to lead, cadmium and manganese, BP values and the incidence of arterial hypertension (AT). MATERIAL AND METHODS: The study group consisted of 171 men occupationally and chronically exposed to heavy metals (group I), and 19 healthy men included into the control group (group II). Concentrations of lead and cadmium in blood, manganese in serum, free protoporphyrins in erytrocytes, and delta aminolevulinic acid in urine as well as blood pressure were measured. Six subgroups of the exposed individuals were chosen: those exposed to lead (subgroup A), to cadmium--(subgroup B), to manganese (subgroup C), to lead and cadmium (subgroup D), to lead and manganese (subgroup E), and to cadmium and manganese (subgroup F). RESULTS: In group I, the values of systolic blood pressure and mean blood pressure were statistically significantly higher than in group II. Moreover, systolic blood pressure was significantly higher in subgroups A, B, D and E in comparison with group II. Diastolic pressure was significantly lower in group II than in subgroups A and D, and mean blood pressure was significantly higher in subgroups A, D and E in comparison with group II. The incidence of arterial hypertension was significantly higher in subgroups A and D than in group II. The independent risk factors for the incidence of arterial hypertension in the study group were higher blood concentrations of lead and, cadmium. CONCLUSIONS: In men occupationally exposed to heavy metals there is a tendency to higher levels of BP. Higher blood concentrations of lead and cadmium were found to be the independent risk factors for the incidence of arterial hypertension in subjects chronically exposed to heavy metals.

Physical and psychological impairments of women with upper limb lymphedema following breast cancer treatment.

OBJECTIVE: The aim of the study was to identify factors associated with worse physical and emotional functioning of breast cancer survivors with upper extremity lymphedema. METHODS: 1250 sets of questionnaires consisting of WHO-DAS II, EORTC QLQ-C30, EORTC QLQ-BR23 and GHQ-30 were mailed to women who underwent a breast cancer surgery at the Lower Silesian Oncology Center in Poland between January 1998 and December 2005. RESULTS AND CONCLUSIONS: The response rate was 33.47%. 117 women were included into a lymphedema group and 211 into a group without this complication. Women with lymphedema were more disabled (overall disability (DAS) score 39.78 versus 34.67; p<0.001), reported symptoms from the upper extremity (shoulder or arm pain and difficulties in arm movement) and from the operated breast (pain and swelling) 2-3 times more often, experienced poorer quality of life (global quality of life (QOL) score 0.50 versus 0.57; p=0.005) and higher psychological distress (GHQ score 10.61 versus 8.01; p=0.007) in comparison to breast cancer survivors without lymphedema. The factors associated with higher DAS score, higher GHQ score and lower QOL score in women with lymphedema were as following: pain in the upper limb (mainly shoulder and arm), pain in operated breast, difficulties with arm movement, localization of lymphedema within the hand or in operated breast, a history of dermatolymphangitis and of receiving chemotherapy. Severity of lymphedema, younger age, BMI and localization of lymphedema within the dominant limb were not considerably related to worse outcomes in these women.

[Renal hypertension. A case report - therapeutic dilemmas]. / Nadcisnienie tetnicze nerkopochodne. Dylematy terapeutyczne - opis przypadku.

Hypertension associated with fibromuscular dysplasia of renal artery is the most common form of secondary hypertension among young patients. In this article we present a case of a 27-year-old patient, with drug-resistant hypertension. Stenosis of right renal artery and small right kidney were found on ultrasonography, angio-CT and angiography. There was no sign of renal atrophy therefore we performed percutaneous transluminal angioplasty. After the procedure we observed a decrease in blood pressure and no need to use hypertensive medication. Diagnosis and treatment of this condition are discussed.

Asymmetric dimethylarginine in hematological malignancies: a preliminary study.

Asymmetric dimethylarginine (ADMA) is a product of protein hydrolysis and an endogenous competitive inhibitor of nitric oxide synthase. It is considered a new independent risk factor for endothelial dysfunction and cardiovascular diseases. Increased protein turnover, oxidative stress and impaired dimethylarginine dimethylaminohydrolase activity occurring in hematological malignancies may lead to increased dimethylarginines production. We have measured ADMA, symmetric dimethylarginine (SDMA) and L-arginine plasma levels in 43 patients with different types of hematological malignancies and in control group of 43 healthy volunteers. Mean ADMA and L-arginine plasma levels were higher in hematological group than in control group (1.59 vs 0.64; p<0.001 and 34.84 vs 28.35; p=0.044 respectively). Mean plasma levels of SDMA were not significantly different between the groups. Elevated ADMA plasma levels in patients with hematological malignancies interfere with nitric oxide metabolism and may influence their prognosis. Further prognostic studies are postulated to assess this phenomenon.

Life style and cardiovascular risk factors among students of Wroclaw postgraduate schools.

INTRODUCTION: Cardiovascular risk factors include independent factors such as advanced age, male gender, family history and modifiable risk factors including cigarette smoking, arterial hypertension, lipid disturbances, diabetes mellitus, obesity, dietary habits and stress. In contrast, fruit and vegetables consumption, moderate alcohol consumption and physical activity are cardioprotective factors. OBJECTIVES: The aim of the study was to analyze the lifestyle of students from universities of the city of Wroclaw in the aspect of cardiovascular risk factors. PATIENTS AND METHODS: The studies were performed in 240 students of nature faculties from four public universities and one nonpublic postgraduate school. Mean age of participants was 21.5 +/- 1.5 years. A special questionnaire prepared by the authors was used during the study, and the participants filled it anonymously. RESULTS: Among the participants 17.4% claimed to use a special diet. Overweight or obesity were declared by 10.3% of the students but it was proved only in 7.7%. Smoking habit was reported by 23.9% of the participants. Students gave the correct answers to questions on diet in 47.7% of cases. CONCLUSIONS: Life style and diet habits of the students from Wroclaw universities do not basically differ from the pattern presented by a statistical Pole and it should be modified. In order to improve the present epidemiological situation it is necessary to include problems of preventive medicine in teaching programs in all Polish universities.

[Influence of tobacco smoking on amylase activity in serum persons occupational exposed to heavy metals]. / Wplyw palenia papierosów na aktywnosc amylazy w surowicy osób narazonych zawodowo na metale ciezkie.

The newest conducted investigations showed the significant role of tobacco smoking in inducing pathological changes in pancreas. Additionally exposure to heavy metals presents on polluted environment influences on function this organ. However, the mechanism of development of these changes has not been fully recognised. The aim of this study is to prove the influence of tobacco smoking on total amylase and termolabile amylase activity in serum of smoking and nonsmoking healthy persons and workers at cooper foundry in Legnica occupationally exposed to heavy metals: cadmium, arsenic, lead. Blood has been collected from 28 healthy persons and 60 founders. The enzyme total activity has been determined using the colorimetric method with substrate 1,2-odilauryl-rac-glycero-3-glutaric acid-(6-methylresorufin) ester. The thermolability activity has been determined using the thermolability test. It has been noted significant higher total amylase and thermolabile amylase activity in serum of smoking healthy persons (p < 0.0002; p < 0.002) and of non-smoking (p < 0.001; p < 0.01) and smoking founders (p < 0.0004; p < 0.001) comparison with non-smoking healthy persons. It hasn't been found significant differences in total and thermolabile amylase activity in smoking founders and non-smoking founders. The fact that there are significant differences in serum amylase activity in serum of smoking and nonsmoking founders in comparison with nonsmoking healthy persons prove a significant influence of exposure to heavy metals on exocrine function of pancreas.

[Urinary N-acetyl-beta-D-glucosaminidase and its isoenzymes in smoking and non-smoking workers at copper foundry occupational co-exposed to arsenic cadmium and lead]. / Aktywnosc N-acetylo-beta-D-glukozaminidazy i jej izoform w moczu palacych i niepalacych pracowników huty narazonych zawodowo na arsen, kadm i olów.

The kidneys are the critical organs in the case of a long-term occupational or environmental exposure to heavy metals and tobacco smoke. In diagnostics of renal damage useful are the methods which determine the activity of renal enzymes, quantify in urine (e.g. beta-glucuronidase, N-acetyl-beta-D-glucosaminidase). N-acetyl-beta-D-glucosaminidase (NAG) is one of the most often determined factors of tubular damage, since its activity increases in early stages of renal injury, ahead of appearance of excretory dysfunction. The aim of this research was to assess the influence of occupational exposure of copper-foundry workers to heavy metals (arsenic, cadmium, lead) on total activity of N-acetyl-beta-D-glucosaminidase and its molecular forms in urine. The investigated group was made up of 95 founders (smokers n = 51, non-smokers n = 44) and 43 people in control group (smokers n = 16, non-smokers n = 27). The concentrations of arsenic (As) and cadmium (Cd) were determined in urine, whilst the level of lead (Pb) was determined in whole blood. The activities of NAG and its isoforms were determined in urine. Smoking and non-smoking founders' urine demonstrated 14 times higher concentrations of arsenic levels in comparison with smoking and nonsmoking control group. Cadmium concentrations were 3.5 times higher in urine of smoking founders in comparison with smoking control group and about 3 times higher in case of nonsmoking founders in comparison with non-smoking control group. 7 times increase of lead concentration was observed in the whole blood within the smoking founders group in comparison with the smoking control group. In the blood of non-smoking founders was demonstrated about 10 times increase of lead concentration in comparison with the non-smoking control group. About 3-times increase of total NAG's activity was observed in urine of smoking founders and 4-times increase of non-smoking founders in comparison with smoking and non-smoking control group. The highest activity of NAG-B was observed in urine of smoking founders (11.35 +/- 7.85 U/g creatinine), then non-smoking founders (9.7 +/- 8.75 U/ g creatinine). It was confirmed, that the activity of N-acetyl-beta-D-glucosaminidase is a good factor in the assessment of occupational exposure to heavy metals like arsenic, cadmium and lead.

Levels of hemoglobin and lipid peroxidation metabolites in blood, catalase activity in erythrocytes and peak expiratory flow rate in subjects with passive exposure to tobacco smoke.

INTRODUCTION: Exposure to tobacco smoke is an extremely important risk factor determining the development of respiratory diseases, cardiovascular diseases and cancer. Passive exposure is common and often not realized by the exposed subjects. Markers of tobacco smoke exposure are nicotine metabolites, i.e. cotinine and trans-3'-hydroxycotinine. OBJECTIVES: The objective of the study was to assess the level of passive exposure to tobacco smoke among students and the exposure impact on the blood hemoglobin level, peak expiratory flow (PEF), lipid peroxidation level and antioxidant enzyme activity. PATIENTS AND METHODS: A total of 104 subjects were enrolled in the study. The subjects were categorized in 3 subgroups depending on nicotine metabolite levels in blood (subgroup I with metabolite level > 100 ng/ml (high exposure); subgroup II with the metabolite level of 10-100 ng/ml; subgroup III with metabolite level <10 ng/ml). The blood hemoglobin level, PEF, levels of lipid peroxidation metabolites--malondialdehyde and 4-hydroxynonenal (MDA + 4-HNE) and catalase (CAT) activity were determined in all the subjects. RESULTS: The study showed statistically significant differences in levels of lipid peroxidation metabolites and CAT activity. Levels of MDA + 4-HNE were higher in subgroup I than in subgroup II or III (I: 3.84 +/- 1.64 mmol/l; II: 2.25 +/- 0.94 mmol/l; III: 1.90 +/- 0.82 mmol/l; pI-II < 0.01; pI-III <0.001). CAT activity was statistically significantly lower in subgroup I than in subgroup III (I: 0.38 +/- 0.01 x 10(6) IU/g hemoglobin [Hb]; II: 0.38 +/- 0.03 x 10(6) IU/g Hb; III: 0.41 +/- 0.04 x 10(6) IU/g Hb; pI-III <0.05). CONCLUSIONS: Passive exposure to tobacco smoke in the study population of students is common. The observed effects of passive exposure to tobacco smoke are similar to those of active smoking. It is postulated to undertake actions aiming at limiting passive exposure to tobacco smoke.

The concentration of selected cancer markers (TPA, TPS, CYFRA 21-1, CEA) in workers occupationally exposed to arsenic (As) and some heavy metals (Pb, Cd) during a two-year observation study.

OBJECTIVE: Molecular epidemiology studies have lately been focused on occupational cancer associated with exposure to chemical carcinogens in work environment. Measuring serum levels of tumour markers ie. the substances produced in transformed cells, is a modern method used in the prevention or early detection of cancer. A two-year observation study was constructed to investigate the relationship between arsenic, lead, and cadmium concentrations and the levels of cancer markers: TPA (tissue polipeptide antigen), TPS (tissue polipeptide specific antigen), and CYFRA 21-1 in 69 male workers occupationally exposed to As and Pb, and environmentally exposed to Cd via tobacco smoking. RESULTS: Significant correlations were found between CEA and blood Cd concentrations or between CEA and period of work under exposure. Multiple regression tests revealed also relationships between some cancer markers and the work period, and thereby the lifetime exposure to heavy metals. Duration of work under exposure significantly influenced TPA and TPS concentrations in these models. All the metals examined were found to have influence on the concentration of cancer markers, except for CYFRA 21-1, but the direction of this influence varied. Lead (especially FEP level) and cadmium were also among the metals affecting TPA concentration profile, although the multiple regression ratio for Cd-TPA correlation was negative. CONCLUSIONS: The strong positive correlation between blood concentrations of Cd and CEA, the marker of abnormal cellular differentiation, may reflect neoplastic transformation of normal cells stimulated by some carcinogens (e.g. cadmium). All the examined carcinogenic, or potentially carcinogenic metals (As, Cd, Pb) belong to the group of factors having impact on serum TPS and/or TPA concentrations in exposed workers. No correlation was found between CYFRA 21-1 and any metal studied but it is plausible that changes in the concentration level of this marker might be revealed after a longer observation period.

[Giant coronary artery aneurysm successfully treated with surgery--a case report]. / Znacznych rozmiarów tetniak naczynia wiencowego skutecznie leczony kardiochirurgicznie. Opis przypadku wraz z omówieniem etiologii, diagnostyki i leczenia.

We report a case of a 54-year-old woman presenting with nonspecific chest pain and clinical symptoms of heart failure. Various diagnostic tools, including both noninvasive methods and coronary angiography, revealed the presence of a giant aneurysm of the right coronary artery. The aneurysm formed a mediastinal mass of a huge size, with blood flow in it, and caused cardiac displacement within the thorax cavity. Surgical management of this anomaly was effective. Aetiology, clinical symptoms, diagnostic tools and treatment options of coronary artery aneurysms are discussed.

[Trials of casual treatment of silicosis]. / Próby leczenia przyczynowego pylicy krzemowej.

Silica-induced lung injury and the development of silicosis is one of the major occupational diseases. Accumulation and deposition of respirable dust containing silica mineral particles in the lung produces chronic lung disease characterized by granulomatous and fibrotic lesions. Knowledge of precise mechanisms, which induce this process is still limited, hence problems faced in the treatment of silicosis, especially the casual one. This article describes various trials of casual silicosis treatment with tetrandrine (Tet), isolated from the root of Stephania tetrandra, tumor necrosis factor (TNF) antagonists, polyvinyl-pyridine-N-oxide (PVNO), aluminum compounds, corticosteroids or bronchoalveolar lavage (BAL). The existing methods are not sufficient, which warrants further investigations. At present, prevention of the disease and treatment of its complications are most important.