Professor Witold Zahorski (1909-1995).
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History, 20th Century↗
Biomedical subjects
K Marek
Publications and source records attributed to K Marek.
Mortality among coal miners with pneumoconiosis in Poland.
A mortality cohort study was carried out on 7,065 coal miners with pneumoconiosis first diagnosed during the years of 1970-85. The cohort was selected from among subjects entered into the National Register of Occupational Diseases and followed up through to the end of 1991. The general male population of Poland was considered as a reference group. The PYRS-3 programme was used to identify, by means of standardized mortality ratios (SMRs), total and selected cause-specific mortality. An analysis revealed significantly elevated total mortality (SMR = 105; 95% confidence interval (CI): 100-110) in the whole cohort of coal miners. The risk of selected cause-specific mortality was significantly enhanced due to diseases of the respiratory system among which pneumoconiosis predominated (SMR = 383; 95% CI: 345-424). While mortality from all diseases of the circulatory system (SmR = 89; CI: 82-96), arterial hypertension (SMR = 63; 95% CI: 38-98), cerebrovascular diseases (SMR = 79; 95% CI: 62-99), atherosclerosis (SMR = 79; 95% CI: 66-93), and injury in poisoning (SMR = 50; 95% CI: 38-64) was significantly lower. The risk of death from malignant neoplasm of lung in the whole study population as well as in individual groups and categories of coal miners with pneumoconiosis, which varied in the risk of pneumoconiosis and the level of exposure to ionizing radiation, was not increased.
Adult↗
[Examination of health effects from exposure to metallic mercury in workers employed in production of chlorine and aldehyde. II. Assessment of kidney lesions].
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.
Acetylglucosaminidase↗
[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].
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.
Adult↗
Mortality pattern in men with pneumoconiosis in Poland.
Mortality study was carried out on the cohort of 11,224 men with coal workers' pneumoconiosis or silicosis diagnosed during the period 1970-1985. The cohort was selected from the register of occupational diseases and was traced up to the end of 1991. The general male population of Poland was a reference group. The study showed small but significant excess of total mortality (SMR = 115; p < 0.01). The analysis of death causes revealed an elevated mortality from infectious diseases, among which tuberculosis was most prevalent (SMR = 212; p < 0.01) and from pneumoconioses predominant in diseases of the respiratory system, (SMR = 426; p < 0.01) and lung cancer (SMR = 116; p < 0.01). The comparison of the prevalence of smoking in the population under study with that in the reference general male population of Poland indicated that this habit is mostly responsible for the excess of lung cancer deaths. This finding contradicts the hypothesis that there is a causal relationship between exposure to dusts containing crystalline silica, pneumoconiosis and lung cancer.
Aged↗
[Professor Dr Hab. Med. Witold Zahorski, co-author and nestor of Polish Occupational Medicine].
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History, 20th Century↗
[Evaluation of exposure to metallic mercury following the measurement of mercury vapor concentration in air of the working zone where acetic aldehyde and chlorine are produced].
The analysis of mercury vapour concentrations in the working zone indicated considerable variations in full shift measurements--from 1/10 MAC to over 3 MAC at the acetic aldehyde production and 40 MAC at the chlorine electrolysis. Individual dosimeters were used in the sample collection and an absorptive ASA atomic spectometry with cool vapour attachment was applied for qualitative determination. The results obtained correspond, to greater extent, with observed high level of mercury excreted with urine than with data of stationary measurements taken in the period of even higher production.
Air Pollutants, Occupational↗
[Nephrotoxicity of metallic mercury in conditions of occupational exposure].
The authors discuss the nephrotoxic effect of metallic mercury vapour in conditions of occupational exposure on the basis of literature available. They present the current knowledge on the ways of absorption, distribution and effect of mercury on the human body. Then they focus on biochemical enzymatic and immunological indices used in the assessment of early stage of kidney damage. They also present results of epidemiological survey in workers occupationally exposed to vapour of metallic mercury.
Humans↗
Pneumoconioses in Poland.
This article deals with the analysis of the epidemiological situation in Poland in the purview of the incidence of pneumoconioses in the past 32 years. During that period pneumoconioses (mainly in coal workers and arc welders) made 17% of all occupational diseases and proved to be the most common pathology among occupational diseases of the respiratory system. The average age of the majority of persons who developed pneumoconioses was over 40 years and duration of exposure--20 years. Almost a half of them was granted disability pensions and average health impairment was assessed at 41%.
Adult↗
[Beta-n-acetylglucosaminidase in urine as a sign of kidney damage in workers exposed to metallic mercury].
The activity of beta-N-acetylglucosaminidase (beta-NAG) was determined in 41 workers of a chemical plant, exposed to metallic mercury, and in 10 controls. In addition, a routine urine examination was performed and the level of creatinine was measured in serum. The mercury excretion in urine in the exposed workers exceeded admissible biological concentrations three times, on average. In the group exposed to mercury the beta-NAG activity in urine was significantly higher than in the a control group. Several cases of trace proteinuria and microscopic haematuria were found in the exposed group. A mean beta-NAG activity in urine was significantly higher in those cases than in other persons. The study proved the usefulness of determinations of the beta-NAG activity in urine in assessing nephrotoxicity in workers exposed to metallic mercury.
Acetylglucosaminidase↗
Severe disturbances in speech, swallowing, and gait following stereotactic infrathalamic lesions in Gilles de la Tourette's syndrome.
A 40-year-old man with severe Gilles de la Tourette's syndrome characterized by forceful self-injurious motor tics, coprolalia, and obsessive-compulsive disorder had bilateral anterior cingulotomies and bilateral infrathalamic lesions placed stereotactically during two neurosurgical procedures. During the second procedure, the patient acutely developed a marked dysarthria. Postoperatively, he manifested a severe gait disturbance with postural instability, bradykinesia, axial rigidity, micrographia, and a profound swallowing disorder. MRI showed asymmetric (left > right) low-density areas in an infrathalamic region as well as low-density areas bilaterally in the anterior cingulate gyri. Although the patient's tic and obsessive-compulsive symptoms improved, the self-injurious motor tics along with other motor and phonic tics have recurred. The patient's speech remains largely unintelligible 8 months following the last surgical procedure, and the other neurologic deficits remain unchanged.
Adult↗
[Lead hazards in Polish industry].
The author presented information of 1988 on occupational exposure to lead in the Polish industry and discussed more thoroughly current data applying to the Katowice voivodship. The incidence of lead poisoning in various branches of the national economy in recent ten years was also discussed. A decreasing tendency in the frequency of this disease has been observed. Amendments to principles of diagnosis and prevention of lead poisoning were proposed as well as classification of health effects of exposure to lead and medical certification.
Adult↗
[Interpretation of early radiological changes in the diagnosis of pneumoconiosis among coal miners].
Apart from certain changes which are typical for pneumoconiosis, the radiological picture of the lungs of sigma coal miners does frequently show some irregular small opacities of s, t and u types. The role and specificity of these changes in the early diagnosis of pneumoconiosis has not been too well defined by now. A 10-year study (conducted at 2 or 3 year intervals) was carried out among 150 miners from 2 mines characterized by different dust loading. Some irregular changes in the miners' lungs were observed. The control group derived from the same mines comprised 115 miners with no radiological changes found in their lungs. The evolution of radiological changes took place in 55.3% of the miners and was more intensive in the heavily dusted mine. Radiological changes were revealed in 38.3% of the controls. It was indicated that pneumoconiosis results much more frequently (38.6%) from the evolution of the irregular changes rather than directly from the proper radiological picture of the lungs (5.3%). In 44.7% of the subjects the changes of s, t and u type did not undergo any evolution, which may be due to their non-specific characteristics. The evolution of irregular opacities is dominating in the patients with bronchitis and emphysema. No significant correlation between smoking and the progress of irregular opacities was found. The observation of the further exposure to the dusts did not produce any clear results. The progress of the changes of s, t and u type was observed more frequently in those still working under ground, but more cases of pneumoconiosis were found in the miners who stopped working. This fact indicates that the further exposure affects the s, t and u type changes and confirms the observations by other authors concerning the manifestation of pneumoconiosis after the break of exposure. The results of the 10-year study prove that the miners with this sort of changes are exposed to a higher risk of pneumoconiosis, although the answer concerning specificity of irregular changes in the radiological picture has not yet been found.
Adult↗
[Analysis of the incidence of pneumoconiosis among coal miners].
Basing on the prevention system for pneumoconiosis in ++coal mining, an analysis of the disease incidence in the workers of a selected ++coal mine was performed. The subjects were 2.495 miners with the work period longer than 8 years and a group of 822 retired miners. In the former group 16 cases (0.64%) of pneumoconiosis were diagnosed, whereas in the latter as many as 89 cases (10.8%) were found which would indicate a necessity for more detailed examinations in ex-miners of this ++coal mine. The pneumoconiosis changes were detected in the early period of their development. The highest risk was found to refer to longwall and blasting miners and cutter-loadermen. The correlation between radiological changes of the s, t, and u type and the duration of work as well as the high frequency of these changes at highly polluted workplaces seem to point to their relation to dust exposure.
Adult↗
[Chronic bronchitis and respiratory capacity of the lungs in miners from a specific coal mine].
In the group of 3317 miners of one coal mine, who were employed for over 8 years, the prevalence of chronic bronchitis (ch.b.) and lung ventilation disorders was analysed. The frequency of ch.b. in the subjects under study was almost twice as high as in the general male population in Poland and significantly more frequent in miners with pneumoconiosis than in those without pneumoconiosis. Simple pneumoconiosis and ch.b. contributed to decreased ventilatory capacity of the lung.
Adult↗
[Causes of mortality among workers exposed to inorganic dust containing crystalline silica].
The authors briefly comment on the characteristics and results of recent epidemiological studies devoted to the reasons of mortality in persons exposed to dusts containing crystalline silica. The most important data concerning these studies are presented in the table accompanied by an author commentary which discusses results obtained by various authors and justification behind this subject in Poland.
Adult↗
Nifedipine in the prophylaxis of classic migraine: a crossover, double-masked, placebo-controlled study of headache frequency and side effects.
Twenty-four patients with classic migraine attacks were treated with either nifedipine or placebo for up to 12 weeks. No significant differences were observed between the nifedipine (2.1 +/- 0.2) and placebo (2.3 +/- 0.2) treatment groups in the monthly frequency of headaches. However, the incidence of side effects was significantly greater (p less than 0.001) in the nifedipine (54% of patients) than in the placebo (8% of patients) treatment groups.
Clinical Trials as Topic↗
[3 cases of Alport's syndrome with different clinical and morphologic manifestations].
Of 350 renal biopsies referred to the Pathologic Anatomy Department Academy of Medicine in Lódź between 1982 and 1986 the authors recognized three cases of Alport's syndrome. The diagnosis was made on the basis of light microscopy (HE, PTAH, silver staining according to Jones, PAS with alcian blue) and immunofluorescence reactions with the sera against IgA, IgG, IgM and fraction C3 of the complement. In two cases electron microscopy was performed additionally. In two patients clinical data pointed to the diagnosis of Alport's syndrome (hematuria, partial deafness, mental retardation, progressive nephropathy). In the third patient Alport's syndrome was not suspected clinically and the diagnosis was established only on the basis of electron microscopic studies. Light microscopy detected cellular proliferation and increase of the mesangium matrix as well as foci of foamy cells in the renal stroma in one case. Immunofluorescence studies were not significant for the diagnosis whereas electron microscopy examinations were decisive. We found characteristic diffused or focal widening of basal membranes of the glomerular vascular loops with the dense lamina splitting, as well as focal thinning of the basal membranes. The intensity and extent of submicroscopic changes varied in the cases described.
Adolescent↗