[Low-intensity laser radiation applied in occupational pathology].

The authors present results of treatment including laser radiation in patients with various occupational diseases. Evidence is that low-intensity laser radiation appears effective in occupational pathology. The treatment is based on blood circulation improvement.

A case of occupational bile duct carcinoma following exposure to a chlorinated organic solvent in the printing industry that was recognized as a work-related accident.

A man in his 40s presented with liver dysfunction on a screening examination. He was working in the printing industry and had been exposed to a chlorinated organic solvent for 12 years from the age of 20. Detailed examination revealed hilar bile duct cancer; proton radiotherapy was initiated. About three years after completing the proton radiotherapy, recurrence was suspected in hepatic hilar lymph nodes on radiological examination, and he was referred to our hospital. Endoscopic ultrasound-guided fine-needle aspiration of hepatic hilar lymph nodes revealed adenocarcinoma, and systemic chemotherapy was started. Two years later, the lymph nodes showed tumor regrowth, and surgical lymph node resection was performed. To date, 20 months after resection, no recurrence has been identified. We report a case of bile duct carcinoma that was recognized as a work-related accident in an individual working in the printing industry.

[Opportunity to use the low-level laser therapy in the treatment of the occupational peripheral nervous system diseases (review of literature)].

Occupational diseases of the peripheral nervous system are a wide and heterogeneous group. Until now, the researchers still look for new treatment techniques, because complaints, clinical, instrumental and laboratory findings persist for years even after discontinued occupational exposure to the factors that induced these diseases. The aim of this article is a review of low-intensity laser therapy methods which are used in treatment of various diseases including peripheral nervous system diseases.

[The use of magnetic-laser therapy in the combined treatment of osteoarthrosis in workers exposed to inorganic fluoride compounds].

The present study included 67 patients who had been exposed to the impact of inorganic fluoride compounds. It demonstrated beneficial effect of magnetolaser therapy in combination with whole body iodine-bromide-sodium chlorine baths, physical exercises, and massage on clinical manifestations of the primary disease and concomitant pathologies. Simultaneously, metabolic processes in the articular cartilage and bone tissue were normalized, lipid peroxidation was improved and optimization of antioxidative protection achieved. These changes are indicative of high therapeutic efficiency of the combined treatment employed in this study and its favourable influence on the quality of life of the patients.

[Expert assessment of adenocarcinomas of the nasal cavity and the paranasal sinuses caused by wood dust]. / Aktualisierung der Hinweise zur Begutachtung holzstaubassoziierter sinunasaler Adenokarzinome (BK 4203)1.

BACKGROUND: Adenocarcinomas of the nasal cavity and the paranasal sinuses after occupational exposure to sawdust from oak and beech have been listed as occupational diseases in Germany since 1988. Given that modes of treatment have changed, we analyzed the guidelines based on the recommendations of Hartung et al. for developing an expert assessment on reduced earning capacity. MATERIALS AND METHODS: A retrospective analysis of 43 cases which had been evaluated between March 1994 and February 2007 for an occupational disease #4203, in the Ear-Nose-Throat clinic of the Münster University Hospital, Germany. RESULTS: Following the guidelines of Hartung et al., it was impossible to formally classify 21 of 43 cases (48.8 %) in an unambiguous manner. This was primarily due to the assessment of the results of radiotherapy, either adjuvant or therapeutic, as well as the grading of postoperative dysfunction in the area of the sinuses operated on (Rhinitis, Ozaena). Suggestions for a revision of the classification system include a modified assessment of radiotherapy as well as evidence for grading post-therapeutic inflammations of the sinus operated on based on the need for further care. These changes enable all cases in question to be classified unambiguously. CONCLUSIONS: The use of the revised guidelines is recommended for expert assessment of adenocarcinomas of the nasal cavity and the paranasal sinuses caused by wood dust.

Is surgical debridement and topical 5 fluorouracil the optimum treatment for woodworkers' adenocarcinoma of the ethmoid sinuses? A case-controlled study of a 20-year experience.

OBJECTIVES: Woodworkers' adenocarcinoma of the ethmoid sinuses is an extremely rare occupational malignancy with a locally aggressive course. Treatment with surgical exenteration and topical 5 fluorouracil (5FU) packs has become standard treatment over the last 10 years in this ENT unit. This study presents level 2 evidence that 5FU provides improved survival over previous management with primary radiotherapy and salvage craniofacial resection. DESIGN: Retrospective case series with historical control group. SETTING: District General Hospital. PARTICIPANTS: The records of 31 consecutive patients with the disease were analysed. Five patients died prior to treatment. One patient was treated with surgery alone and therefore excluded. Twenty-five patients were included in the analysis. Fourteen were treated with primary radiotherapy and 11 with surgery and topical 5FU. OUTCOME MEASURES: Disease free survival was measured using Kaplan-Meier survival analysis. RESULTS: Five-year disease free survival improved from 50% with primary radiotherapy to 86% with surgery and 5FU. This improvement is statistically significant (P = 0.03). CONCLUSION: Topical 5FU treatment improves survival of Woodworker's adenocarcinoma of the ethmoid sinuses. This finding may be useful in the treatment of other locally aggressive sinonasal malignancies.

[Effect of infrared laser irradiation on the arterial blood pressure in liquidators of the accident at the Chernobyl power plant]. / Vplyv infrachervonoho lazernoho oprominiuvannia na riven' arterial'noho tysku u likvidatoriv avariï na ChAES.

Liquidators of Tchernobyl accident with discirculatory post-irradiation encephalopathy were treated with infra-red lazer irradiation together with a half doze of pharmacological agents usually used. Infra-red lazer irradiation has been shown to result in a significant reduce in the arterial pressure level, so it can be effective in correcting the disturbances in haemodynamics.

Invading basal cell carcinoma of the jaw: an under-evaluated complex entity.

Basal cell carcinoma (BCC) is a locally invasive neoplasm, rarely metastatic, yet capable of significant local destruction and disfigurement. Invasion into the bone is uncommon and only a few cases of invasion into facial bones, but never to the mandible or maxilla, have been described. We report three patients with BCC lesions invading their jaws, as a consequence of which either their mandible or maxilla had to be partially resected. This resulted in facial mutilation which required comprehensive multi-disciplinary therapy to restore function and esthetics. Such therapy requires a combination of modalities offered by both plastic and maxillofacial surgeons, as well as oral and dental rehabilitators.

Ethmoidal sinus adenocarcinoma with orbital invasion.

PURPOSE: To report a rare case of massive ethmoidal adenocarcinoma with orbital invasion but minimal ophthalmic symptoms on presentation. METHODS: Case report of a 69-year-old, otherwise healthy, retired carpenter who was referred for treatment of bilateral senile cataract. RESULTS: A relative afferent pupillary defect and sectorial disc atrophy on ophthalmic examination led to further investigation and identification of an extensive ethmoidal neoplasm with orbital invasion. An incisional biopsy was performed and histopathologic examination revealed an adenocarcinoma of low-grade malignancy. CONCLUSION: Ethmoidal adenocarcinomas with orbital involvement may occasionally be relatively asymptomatic and masked by coexisting ocular disease.

Excision and low-dose radiotherapy for refractory laryngeal granuloma.

Laryngeal granulomas are uncommon lesions of an inflammatory origin. They are conventionally managed by simple excision with the occasional use of adjuvant treatment depending on the aetiological factors. Unfortunately, recurrences can occur, requiring repeated excision. Some lesions are refractory to this approach and alternative management approaches include excision and immediate adjuvant radiotherapy. The use of radiotherapy in the management of benign disease can be limited by the risk of induction of late malignancy and informed consent of a patient must include an assessment of this risk. We describe a case of refractory laryngeal granuloma successfully treated by excision and immediate radiotherapy in a patient occupationally dependent upon his voice.

[Effects of laser therapy on psychophysiological parameters and arterial blood pressure in drivers with hypertension]. / Vliianie lazeroterapii na psikhofiziologicheskie pokazateli i arterial'noe davlenie u voditelei s gipertonicheskoi bolezn'iu.

The study covered possibility to use laser therapy for correction of arterial hypertension in car and track drivers suffering from high blood pressure. Laser irradiation of infrared waves with wavelength of 0.89 micrometers appeared to have positive influence on the drivers facing arterial hypertension.

Successful management of female office workers with "repetitive stress injury" or "carpal tunnel syndrome" by a new treatment modality--application of low level laser.

Female office workers with desk jobs who are incapacitated by pain and tingling in the hands and fingers are often diagnosed by physicians as "repetitive stress injury" (RSI) or "carpal tunnel syndrome" (CTS). These patients usually have poor posture with their head and neck stooped forward and shoulders rounded; upon palpation, they have pain and tenderness at the spinous processes C5-T1 and the medial angle of the scapula. In 35 such patients we focused the treatment primarily at the posterior neck area and not the wrists and hands. A low level laser (100 mW) was used and directed at the tips of the spinous processes C5-T1. The laser rapidly alleviated the pain and tingling in the arms, hands and fingers, and diminished tenderness at the involved spinous processes. Thereby, it has become apparent that many patients labelled as having RSI or CTS have predominantly cervical radicular dysfunction resulting in pain to the upper extremities which can be managed by low level laser. Successful long-term management involves treating the soft tissue lesions in the neck combined with correcting the abnormal head, neck and shoulder posture by taping, cervical collars, and clavicle harnesses as well as improved work ergonomics.

The carcinogenic risk of exposure to sulphuric acid fumes from lead acid batteries.

Prolonged exposure to sulphuric acid fumes is associated with an increased risk of developing laryngeal carcinoma. Lead acid batteries are a potential source of these fumes. We present a case of an electric fork lift truck driver who developed laryngeal carcinoma as a result of such exposure.

[Role of neuropeptides in the pathogenesis of pain syndrome in autonomic and sensory polyneuropathy of occupational etiology and their role in the therapeutic action of laser acupuncture]. / Rol neiropeptidov v geneze bolevogo syndroma pri vegetosensornoi polinevropatii professionalnoi étiologii i ikh uchastie v mekha- nizme terapevticheskogo deistviia lazernoi akupunktury.

Biochemical studies of opiate system in patients with occupational diseases showed the role of the central pain regulating system inducing the pain syndrome in autonomic and sensory polyneuropathy caused by occupational factors. Increased production of the pain-reducing endogenic neuropeptides such as endorphin and leucine enkephalin was found one of the He-Ne laser acting principles which restore the pain adaptation in human. A repeated course of laser therapy would normalize the content of both neuropeptides. Blood levels of neuropeptides may serve for evaluating the pain syndrome and estimating of laser therapy effects.

[Laser therapy in dust bronchitis]. / Lazeroterapiia pri pylevom bronkhite.

Laser therapies of 43 dust bronchitis patients (4 cases in 1st stage and 39 cases in 2nd stage) were performed in comparison with routine therapeutic procedures of 28 patients (6 cases in 1st stage and 22 cases in 2nd stage). 14 acupuncture points were selected. A good therapeutic effect was attained in 16.3% sample group and 7.1% control group patients, satisfactory results--in respectively 58% and 42.9% cases, insignificant results--in 25.6% and 50% cases. Along with the favourable therapeutic effect, a positive influence of laser therapy on the immune system was established, particularly on the immunity T-system, in dust bronchitis cases. Laser therapy was recommended as part of complex treatment procedures for dust bronchitis patients.

Adenocarcinoma of the ethmoid sinuses. A review of 28 cases with special reference to wood dust exposure.

Adenocarcinoma makes up only a small percent of all nasal and paranasal sinus carcinomas, and is most often found in the ethmoid sinuses. Adenocarcinoma of the ethmoid sinuses is known to be associated with exposure to wood dust. Twenty-eight patients with ethmoid adenocarcinomas were collected, mainly during the last decade from a region with approximately 900,000 inhabitants and with a large amount of furniture industries. There were 4 women and 24 men in the study. Twenty of the men were exposed to dust from hardwood for 20 to 55 years (mean, 40 years) which is in accord with other reports and supports data on the increased risk for workers of developing adenocarcinoma of the ethmoid sinuses when exposed to dust from hardwood. Radiologic diagnosis is necessary to delineate the extent of these tumours, and computerized tomography (CT) especially furnishes important information. Most patients received preoperative radiotherapy followed by surgery, 50% of them survived 5 years, which is in accord with other reports.

Radiation-induced carcinoma of the lung--the St. Lawrence tragedy.

This paper reviews the problem of radiation-induced carcinoma of the lung in the fluorspar mines of Newfoundland. Seventy-eight workers have died from this disease since commercial operation commenced in 1933. In 1959 the source of the radiation was identified as radon, and its daughter nucleotides present as contaminants in water seeping into the mines. Heavy smoking is probably a synergistic cocarcinogen. The histology in this group of patients with radiation-induced lung cancers is unusual, since squamous cell carcinoma accounts for 90 percent of all cases. There have been four patients with second primary lung cancers. Radical radiotherapy has been the primary mode of treatment based on the reluctance of the miners to undergo operation. Surprisingly good results have been obtained, with an average survival time of 34 months after treatment. Institution of improved ventilation has reduced radiation to safe levels, but an estimated 120 miners from the pre-1960 era are still at risk.