The EXIT (ex-utero intrapartum treatment) procedure - from the paediatric ENT perspective.

The main principle of the EXIT procedure is to maintain uteroplacental circulation with neonatal anaesthesia by controlled uterine hypotonia. This enables securing the foetal airways and decompress or resect large neck and mediastinal foetal masses. The authors present their experience with use of the EXIT procedure in 7 foetuses in whom evaluation and management of the airways were performed. In 4 patients, the neck mass was surgically removed in the neonatal period, in 1 the propranolol treatment was introduced. Two newborns died shortly after the EXIT procedure. The EXIT procedure allows the paediatric otolaryngologist to provide airway patency of newborns during delivery. Both ultrasound and MR imaging are crucial in the prenatal assessment of foetal head and neck masses. Their application in the evaluation of any foetal anomaly is essential for proper prognosis and treatment. Maternal monitoring for complications such as polyhydramnios and preterm labour are important in planning and desirability of the EXIT procedure.

The effect of mechanical vibration and industrial noise on the behaviour of blood serum immunoglobulins and on the lymphocyte blastic transformation.

The investigations have been undertaken to determine the effect of mechanical vibration on the behaviour of blood serum immunoglobulins and on the lymphocyte blastic transformation. The concentrations of IgA, IgG, IgM have been determined with 174 workers of metallurgical plants who were exposed to both vibration and noise, and with 50 workers exposed to noise only. The lymphocyte blastic transformation has been determined with 70 workers exposed to both vibration and noise. The investigations revealed that mechanical vibrations cause the concentration of IgA and IgG to increase, and that of IgM - to decrease; they also stimulate the lymphocyte blastic transformation. The noise itself causes the level of the examined immunoglobulins to lower.

[Blood viscosity and the pressure limit of whole blood in patients with a vascular form of vibration disease]. / Lepkosc i naprezenie graniczne krwi u chorych na naczyniowa postac choroby wibracyjnej.

Eighty-two men suffering from the vascular form to the vibration disease have been divided into two groups pursuant to advancement of the disease: group I consisting of 42 persons (average age 40 +/- 7.5 years) representing an early stage of the disease, and group II consisting of 40 persons (average age 49,7 +/- 5,6 years)--at an advanced stage of the disease. In both groups the variation of apparent viscosity with shear rate (rheological equations), plastic viscosity and yield stress of the whole blood have been determined. The control group consisted of 100 healthy men (average age 41.3 +/- 8.4 years), classified as medium-hard working (group III). Those afflicted with the vascular form of the vibration disease have been found to exhibit viscosity and yield stress of the whole blood, the increase varying with advancement of the disease.

[Erythrocyte aggregation indicator, hematocrit and plasma viscosity in patients with a vascular form of vibration disease]. / Wskaznik agregacji krwinek czerwonych, hematokryt i lepkosc osocza krwi u chorych na naczyniowa postac choroby wibracyjnej.

In 82 men suffering from the vascular form of the vibration disease divided by its advancement into two groups: group I of 42 persons (aged, on average, 40 +/- 7.5) at an early stage of the disease and group II consisting of 40 persons (aged, on average, 49.7 +/- 5.6) at an advanced stage of the disease--haematocrit, plasma viscosity and red-cell aggregation indices were determined. The control group (III) was composed of 100 healthy, average--hard working, men (aged, on average, 41.3 +/- 8.4). In those suffering from the vibration disease the red-cell aggregation and plasma viscosity were found to increase, the rise being more intense in group II.

[Evaluation of the immune system in workers engaged in the production of coal derivatives]. / Ocena ukladu odpornosciowego u osób pracujacych przy produkcji substancji weglopochodnych.

The study involved 361 people, 161 of whom were workers of coke plants and the remaining 200 constituted the control group. The coke plant workers were divided into the exposed and non-exposed groups. All of them were subject to the following tests: rosette test, determination of B lymphocytes, determination of the concentration of IgG, IgA, IgM immunoglobulins, and NBT granulocyte reduction test only were found in group I. Subgroups Ia, IIa, IIIa were established, in which subpopulations of T, TH-helper, TS-suppressor, TH and NK (Natural Killer) lymphocytes were discovered in group Ia. The above observations can probably be associated with exposure to tar substances which contain pyrenes.

[Effect of working in a coke plant on levels of carbon monoxide hemoglobin in employed workers]. / Wplyw pracy w zakladach koksochemicznych na zachowanie sie hemoglobiny tlenkoweglowej u zatrudnionych pracowników.

Concentrations of carbon monoxide hemoglobin in blood of 48 furnace-room, and of 31 carbon derivatives department workers for many years exposed to carbon monoxide (divided into smokers and non-smokers) were assessed by spectrophotometry. CO levels were within the values provided in the corresponding standards for the occupational exposure, there was, however, the risk of periodically exceeding the MAC values. It has been found that HbCO levels in the workers of the furnace room and of the carbon derivatives department were much significantly higher than in the controls, both in the smoker and in the non-smoker group.

[Effect of simultaneous exposure to fluorine and manganese on health status of workers]. / Wplyw jednoczesnego narazenia na fluor i mangan na stan zdrowia narazonych pracowników.

The effect of fluorine and manganese on the health of workers continually exposed to these elements was studied. The concentration of the chemicals did not significantly exceed maximum allowable concentrations only during three hours of work daily. Thirty-six workers directly exposed to fluorine and manganese were examined and compared with the controls. The authors demonstrated that exceeding permissible norms did not cause evident intoxication symptoms even though working in exposure had lasted for many years. However, some changes in the activity of liver indicatory enzymes may be one of the first symptoms of this organ's damage. Frequently occurring ++periodontosis and leukoplakia of the mucous membrane needed careful stomatological prophylaxis .

[Myocardiopathy and arterial hypertension in coal miners in the Rybnik region]. / Schorzenia miesnia serca i nadcisnienie tetnicze u górników Rybnickiego Okregu Weglowego.

Examinations were carried out on the frequency of the occurrence of myocardiopathy and arterial hypertension in 492 miners and 175 manual workers employed on mines surface. Physical symptoms of cardiac muscle degeneration were found in 7,3%, electrocardiographical symptoms in 11,1%, whereas in 9,9% miners hypertension was found. No significant difference between the frequency of these diseases in pit miners, as compared with those manual workers working on the surface of the mines, was found.

[Frequency of chromosome aberration in workers of a coke derivative distillation plant]. / Czestosc aberracji chromosomalnych u pracowników wydzialu weglopochodnych koksowni.

The effect of occupational exposure on frequency of chromosomal aberrations in workers of coke by-product department was estimated. Fourty seven persons employed in that plant, exposed to tar substances, BaP and dust and 77 non-exposed controls were examined. Concentrations of tar substances, BaP and dust exceeded MAC 13.9, 10 and 1.5 times, respectively. The structural chromosomal aberrations were evaluated in peripheral blood lymphocytes after 72h cultivation, according to a modified Moorhead method. The findings did not revealed any significant differences in the frequency of chromosomal aberrations between the compared groups. These results seem to be produced by a relatively low level of exposure.

[Blood serum viscosity in patients with advanced vascular forms of vibration disease]. / Lepkosc surowicy krwi u osób z zaawansowana postacia naczyniowa choroby wibracyjnej.

In 35 persons afflicted by advanced angioneurotic vibration syndrome, with no contact with mechanical vibrations for the past several years and recognized invalidity due to vibration disease, specific and reduced blood serum viscosity have been determined, as well as total protein concentration and albumin to globulin concentrations ratio. Control groups were composed of 32 healthy subjects, with no contact with vibration or any other environmental hazards, as well as of 57 professionally active subjects, afflicted by angioneurotic vibration syndrome. A significant increase in specific and reduced viscosity in the group with advanced angioneurotic vibration syndrome, as compared to both the remaining groups, was found. At the same time, the albumin-globulin concentrations ratio was found to be decreased, the total protein concentration remaining unaltered.

[Effect of vibration and noise on the fat balance in exposed workers]. / Wplyw drgan mechanicznych i halasu na gospodarke tluszczów u pracowników narazonych.

In 265 workers exposed to local vibration of low and medium frequencies and to industrial noise, the level of total lipids, phospholipids, beta lipoproteins and total cholesterol in the blood serum was examined. The level of all those substances, except cholesterol, was found to be increased. Based on the discussion, the possibility is assumed of the influence of the neurohormonal system upon the disturbances in lipometabolism.

[Effect of vibration and noise on glycosaminoglycan (mucopolysaccharide) and hydroxyproline excretion]. / Wplyw drgan mechanicznych i halasu na wydalanie glikozoaminoglikanów (mukopolisacharydów) i hydroksyproliny.

In 126 humans occupationally exposed to local vibration and in 50 humans exposed to general vibration, glycosaminoglycanuria (GAG) and hydroxyprolinuria (HP) were examined. In addition, all subjects were exposed to industrial noise. An increased GAG excretion in those exposed to the vibration of low and medium frequencies was found, which is indicative of a damage to the basic substance of the connective tissue. The exposure to the lowest frequencies increases the HP excretion, thus indicating a damage to the collagen fibers.

[Effect of vibration and noise on various morphotic elements in the peripheral blood of exposed workers]. / Wplyw drgan mechanicznych i halasu na niektóre elementy morfotyczne krwi obwodowej narazonych pracowników.

The authors examined blood cell count in 198 males and 53 females occupationally exposed to vibration and noise surpassing allowable standards. In addition, in some subjects cytochemical examinations of leukocytes were performed. Decreased amounts of erythrocytes and hemoglobin content were found. Cytochemical examinations showed an increased activity of non-specific esterase, increase PAS reaction, decreased activity of acid phosphatase, and the tendency to decrease the activity of base phosphatase.

[Evaluation of the nervous system in workers in the furnace and coal divisions of the coke-producing plants]. / Ocena ukladu nerwowego u pracowników piecowni i weglowni zakladów koksochemicznych.

240 workers of coking plant exposed to noxious chemical compounds released at coke production and control group consisting of 76 persons including 48 workers without direct contact with coke production process and 28 randomly selected healthy subjects were examined. No characteristic syndrome of subjective changes was found in workers of productive sphere. However, defective neurological symptoms were more prevalent in this group as compared to the controls. The workers from the group exposed developed neurotic syndromes with vegetative disregulation symptoms two times more frequently than the controls. The changes in EEG were significantly more prevalent in the workers occupationally exposed. The prevalence of diffuse changes in EEG depended on the level of exposure to BaP.

[Various plasma components and whole blood viscosity in patients with the vascular form of vibration disease]. / Niektóre skladniki osocza a lepkosc pelnej krwi u chorych na naczyniowa postac choroby wibracyjnej.

In 82 men suffering from vascular form of the vibration disease, divided by the degree of its advancement into two groups: I--consisting of 42 persons (average age 40 +/- 7,5 years) at an early stage of the disease and II--consisting of 40 persons (average age 49.7 +/- 5.6 years) with an advanced stage of the disease--the whole blood and plasma viscosity, the plasma fibrinogen level, the total protein level and its fractions and the total cholesterol level were determined. The control group (III) consisted of 100 men in good health (average age 41.3 +/- 8.4 years). The studies showed in both groups with the disease a significant growth of alpha 1, gamma globulins and fibrinogen. It was demonstrated that the increased blood viscosity is--among other things--a consequence of increased plasma viscosity and proteins disturbances.

[C14-aminopyrine breath test and enzymatic liver tests in workers employed by the coke tar distillation department]. / Test oddechowy z C14-aminopiryna i klasyczne enzymatyczne testy watrobowe u pracowników zatrudnionych w wydziale weglopochodnych zakladów koksochemicznych.

A group of 400 subjects divided into three sub-groups was examined. Group I consisted of 130 persons employed at the coke tar distillation department. Group II (controls) consisted of 70 persons also employed at the coke plant but free from occupational exposure. Group III was composed of 200 workers employed at the Building Factory. C14-aminopyrine breath test (ABT) was performed in 30 subjects randomly assigned from each group. A standard enzymatic liver test was assessed in all subjects examined. The range of tests performed did not permit to indicate the toxic effect of occupational environment on the liver tissue. Abnormal enzymatic liver test found in all groups could results, among others, from alcohol abuse among those tested. However, it was revealed that aromatic hydrocarbons to which workers of the coke tar distillation department were exposed to, stimulated the activity of the liver microsomal oxygenase assessed by ABT.

[Effect of working conditions in the coke-processing department on the secretory function of the adrenal cortex]. / Wplyw warunków pracy w wydziale weglopochodnych koksowni na wydzielanie kory nadnerczy.

In 85 randomly chosen employees of the coal tar distillation department working at least 5 years, exposed to toxic substances not exceeding MAC except tar substances and benzo(a)pyrene, whose concentrations were high, blood level of cortisol and 17 OHCS and 17 KS excretion in urine were examined. In the most exposed group cortisol level decreased and the 17 OHCS excretion augmented.

[Effect of occupational exposure in coke production on various parameters of the hematopoietic system]. / Wplyw narazenia zawodowego przy produkcji koksu na niektóre parametry ukladu krwiotwórczego.

The basic parameters of the erythrocytes, white blood cell and coagulation were determined in 201 workers exposed occupationally to organic substances containing benzene and its homologues. Occupational exposure to many factors during coke production, especially to high concentrations of BaP, did not cause perceptible changes in the erythrocytes. Moreover, total number of the lymphocytes was increased in the peripheral blood of exposed workers. That maybe considered as a nonspecific exposure test for the influence of the aromatic hydrocarbons. In haemostasis system the thrombocytopenia and the abnormalities of the plasma coagulation factors were revealed.

[Spectrum character of vibration and clinical form of vibration disease]. / Charakter widma predkosci drgan mechanicznych a postac kliniczna choroby wibracyjnej.

300 workers of metalurgical plant exposed to vibrations were divided according to the chief work tool into the three groups: 1) moulder, 2) mould cleaner and 3) ironworker--grinder. The velocity of vibration was measured and the spectrum of vibrations examined. The product of vibration velocity excesses was evaluated within the following three bands of frequency: 16--63 Hz, 125--250 Hz, 500--2000 Hz and the frequency of occurrence of the two main forms of vibration disease, i.e. angioneurosis and osteoarthrosis was calculated. The osteoarthretic form of vibration disease was significantly more frequent when the multiplicity of surpassing the velocity of vibration occurred with low frequencies (moulders), and angioneurotic form was more frequent at high and very high frequencies. It seems, that "the safe limit" of vibration frequency should be transferred to frequencies higher than 500 Hz.

[Characteristics of coke plants. Health and ergonomic conditions]. / Charakterystyka zakladów koksochemicznych. Warunki higieniczne i ergonomiczne.

1300 workers were employed in that plant; 632 in production out of which 308, most exposed, worked in the baking ovens department. The hygienic examinations revealed a very high concentration of benzo(a)piren and crude tar in the air of in the baking ovens department the MAC from several to 600 times. Other harmful substances and dust, as well as the industrial noise exceeded the MAC only incidentally. The ergonomic examinations revealed the exceeding of the energetic expenditory only in the door operators of cooking ovens. The results of medical examination will be presented in subsequent papers.