Clinically Significant Envenomation From Postmortem Copperhead (Agkistrodon contortrix).

Over 14,000 copperhead (Agkistrodon contortrix) bites were reported to United States poison centers between 1983 and 2008, and 1809 cases were reported to poison centers in 2014. The copperhead is primarily found in the southeastern United States and belongs to the pit viper subfamily Crotalinae, which also includes the water moccasin (Agkistrodon piscivorus) and rattlesnakes (Crotalus and Sistrurus genera). Postmortem rattlesnakes have been reported to cause clinically significant envenomation; we report a case of a postmortem copperhead causing clinically significant envenomation after inadvertent puncture with the deceased copperhead fang. The copperhead was transected twice, leaving the snake in 3 separate pieces. While handling the snake head, an inadvertent puncture occurred on the right index finger followed by pain and swelling in the affected extremity necessitating antivenom administration. Care should be taken when handling deceased pit vipers due to the continued risk of envenomation.

Gas chromatography with pulsed flame photometric detection multiresidue method for organophosphate pesticide and metabolite residues at the parts-per-billion level in representatives commodities of fruits and vegetable crop groups.

A gas chromatographic method with a pulsed flame photometric detector (P-FPD) is presented for the analysis of 28 parent organophosphate (OP) pesticides and their OP metabolites. A total of 57 organophosphates were analyzed in 10 representative fruit and vegetable crop groups. The method is based on a judicious selection of known procedures from FDA sources such as the Pesticide Analytical Manual and Laboratory Information Bulletins, combined in a manner to recover the OPs and their metabolite(s) at the part-per-billion (ppb) level. The method uses an acetone extraction with either miniaturized Hydromatrix column partitioning or alternately a miniaturized methylene dichloride liquid-liquid partitioning, followed by solid-phase extraction (SPE) cleanup with graphitized carbon black (GCB) and PSA cartridges. Determination of residues is by programmed temperature capillary column gas chromatography fitted with a P-FPD set in the phosphorus mode. The method is designed so that a set of samples can be prepared in 1 working day for overnight instrumental analysis. The recovery data indicates that a daily column-cutting procedure used in combination with the SPE extract cleanup effectively reduces matrix enhancement at the ppb level for many organophosphates. The OPs most susceptible to elevated recoveries around or greater than 150%, based on peak area calculations, were trichlorfon, phosmet, and the metabolites of dimethoate, fenamiphos, fenthion, and phorate.

Acute toxicity, genotoxicity, and dermal carcinogenicity assessment of isooctyl acrylate.

Isooctyl acrylate (IOA) monomer is a complex mixture comprised predominantly of isomeric, eight-carbon alkyl esters of acrylic acid. Limited evidence from animal studies suggests that certain acrylate esters may be carcinogenic by the dermal route of exposure. The following studies were performed with IOA monomer: acute oral toxicity limit test in rats, primary dermal and ocular irritancy in rabbits, Ames Salmonella microsome assay, Saccharomyces cerevisiae D3 recombinogenicity assay, L5178Y TK +/- mouse lymphoma cell assay, and C3H/10T1/2 mouse embryo cell transformation assay. Finally, a limited dermal carcinogenicity bioassay was performed in which aliquots (25 microliters) of IOA monomer (5% v/v in acetone), IOA polymer (19% w/v in 70:30 acetone/heptane), or acetone (vehicle control) were applied to the shaved backs of male C3H/HeJ mice three times per week for the animals' lifetimes. IOA monomer had an acute oral LD50 in rats greater than 5000 mg/kg, was slightly irritating to the eyes and skin of rabbits on single exposures, and exhibited no genotoxic or cell-transforming potential. In the dermal carcinogenicity bioassay, no significant difference in mean survival times was observed between either treatment group and the control group. Animals treated with IOA monomer exhibited moderate dermatitis, surface crusting, hyperkeratosis, epidermal hyperplasia, diffuse melanosis, and one benign melanoma at the treatment size. Animals treated with IOA polymer exhibited varying degrees of dermatitis, surface crusting, and hyperkeratosis. Neither IOA monomer nor IOA polymer was carcinogenic under the conditions of the study.

The promise of international eye banking.

According to the World Health Organization, world blindness has been put between 28 to 42 million. Of this number, well over 10 million are corneally blind. Tissue Banks International, TBI, through its international division known as the International Federation of Eye Banks, IFEB, is assisting in establishing regional eye banks on a global basis. The experiences of TBI in the United States have provided a model system of eye banking and, as an outgrowth of this system, an international network may be established. It is hoped that this international network of eye banks will generate eye tissue which can be shared with those parts of the world where no eye banking system currently exists.

Trial of an intervention to reduce passive smoking in infancy.

We tested a health education intervention program to reduce passive smoking in infancy. The aim was to develop an instrument for study of tobacco smoke exposure and childhood respiratory illness. One hundred and eighty-four women who had smoked during pregnancy were allocated by month of delivery to an intervention group, to a minimal contact group, or to a follow-up only comparison group. Exposure to smoke was assessed 3 months later by questionnaire and by measurement of cotinine in samples of maternal and infant urine. There was a reduction in maternal smoking associated with contact with research staff, but this was not statistically significant. There were no differences between the groups in the exposure of infants to tobacco smoke. Reasons for this finding may include the timing of the intervention, the heterogeneity of the target group, and the manner in which information was presented on health risks caused by parental smoking.

Long-term adult use of ambulatory services provided by physicians in a Canadian medical care plan.

Utilization of physician services by initial subscribers to a Canadian consumer-sponsored medical care plan was examined for the period 1965-1979. After stratification by sex and age, 1,046 individuals aged 18-44 years were sampled and their records abstracted to yield the annual number of in-plan physician visits. The most frequently attending 10% of patients generated almost 30% of all visits. Moreover, those who initially made most frequent use of physician services persisted in doing so over the 15-year period. Utilization patterns differed between the sexes. Women, with a median of 40 visits, made more frequent use of services than men, with a median of 27 visits. Among men, the group that was oldest at enrollment utilized services more heavily than their younger counterparts, and this increased relative utilization became more pronounced with time. Corresponding effects were not seen in women, even after adjustment for prenatal visits. Adjustment for prenatal visits also had only a minimal effect on the frequency and duration of nonattendance. Ascertainment of out-of-plan utilization indicated that for the most recent year of follow-up, 20% of the patients made at least one out-of-plan visit. Although this had little effect on patients' relative utilization status, it had a substantial effect on the identification of nonattenders.

Pulmonary response and transmigration of inorganic fibers by inhalation exposure.

Rats, hamsters, and guinea pigs were exposed by inhalation to different concentrations of potassium octatitanate fibers. Following 3 months of exposure, the animals were sacrificed between the 15th and 24th month. The exposed animals showed dose-related dust deposition and pulmonary fibrosis mainly in the respiratory bronchiolar region. Most short fibers (less than 5 micrograms) were phagocytized by alveolar macrophages, but long fibers (greater than 10 micrograms) were phagocytized by foreign body giant cells. Dust-laden macrophages (dust cells) entered into the lumen of bronchial lymphatic or pulmonary blood vessels. Numerous dust cells were transported from the lung to the tracheobronchial and mediastinal lymph nodes where some dust cells penetrated into the blood or lymphatic circulation. Massive direct cell migration of the mediastinal adipose tissue from the lymph nodes occurred occasionally. Dust-laden giant cells were found only occasionally in the liver, and there was widespread migration of the fibers into other vital organs and tissues without any significant responses.

Animal toxicity studies with ammonium perfluorooctanoate.

These studies were conducted to evaluate the potential toxicity of ammonium perfluorooctanoate, a commercial surfactant. They include acute and subchronic feeding studies with rabbits, mice, rats and monkeys as well as in vitro mutagenicity assays with Salmonella typhimurium and Saccharomyces cerevisiae. The compound was non-irritating to the skin and moderately irritating to the eyes of rabbits. The rat oral LD50 was 540 mg/kg; no deaths resulted from a one hour rat inhalation exposure at a nominal concentration of 18.6 mg/L. All in vitro assays were negative. The liver was the target organ in rodents in both the 28 day and 90 day feeding studies with males showing a greater response than females. Serum and liver concentrations of organic fluorine were greater in male than in female rats. In a 90 day oral study in rhesus monkeys the gastrointestinal tract and the reticuloendothelial system were the sites of toxic effects. The gastrointestinal effects were attributed to the potent surface activity of the compound. Histopathological effects wer noted in the spleen, lymph nodes and bone marrow. Unlike the rats, sex related differences were not evident in the monkeys. Toxicological evaluations of ammonium perfluorooctanoate are continuing.

Adaptation of the enzyme-multiplied immunoassay for methotrexate to the centrifugal analyzer.

We adapted the homogeneous enzyme-multiplied immunoassay for methotrexate to the centrifugal analyzer. The sensitivity of the assay has been extended from 200 nmol/L down to 12.5 nmol/L. Several protocols may be followed, depending on whether the samples to be tested are from patients on low- or high-dose methotrexate regimens. Precision, accuracy, and sensitivity were satisfactory. Comparison with the enzymic-inhibition method (x) gave the following least-squares regression: y = 1.002 x - 0.013 mumol/L; r2 = 0.9721; Sy/x = 0.014 mumol/L.

Immunochemical determination of human immunoglobulins: use of kinetic turbidimetry and a 36-place centrifugal analyzer.

We describe the measurement of human immunoglobulins IgG, IgA, and IgM in diluted sera, with diluted commercial monospecific antisera, with use of a 36-place centrifugal analyzer (RotoChem IIa; American Instrument Co., Silver Spring, MD 20920). The assay involves a two-point kinetic turbidimetric technique. The changes in absorbance at 340 nm between 10 and 255 s are taken for standard curve construction with use of a computer-generated cubic least-squares fit. Patients' samples are quickly calculated from the stored curve. Multiple time-interval readings are taken to observe the reaction kinetics. The lowest detectable concentrations are: IgG, 5 mg/L; IgA, 20 mg/L; and IgM, 20 mg/L. Correlation with radial immunodiffusion was excellent. Precision, accuracy, linearity, and sensitivity were very acceptable. Antigen or antibody excess can be easily detected. The accuracy of the proposed method when measuring idiotypic monoclonal proteins is greater than radial immunodiffusion. Up to 30 patients' samples can be analyzed at one time, and calculation of test results by use of the computer program is efficient and rapid.

Pulmonary response to glass fiber by inhalation exposure.

Rats, hamsters, and guinea pigs were exposed to airborne glass fiber at a gravimetric concentration of 0.42 mg. per liter for 6 hours per day, 5 days per week for 90 days. The number of dust particles greater than 5 micron. in length was 0.73 x 10(6) per liter with an average diameter of approximately 1.2 micron. Most particles were less than 2 micron. in size and only 15% of the dust particles had a fibrous shape. Few fibers were longer than 10 micron. The pulmonary response was characterized by macrophage reaction with alveolar proteinosis at 90 days of inhalation. The light and ultrastructural alterations were similar to the other experimental or human alveolar proteinosis. The alveolar proteinosis disappeared at 1-year postexposure, but focal dust cell accumulation with proliferating granular pneumocytes persisted throughout the 2-year recovery period. No significant fibrosis or stromal changes were found in the dust-deposited areas. In hamsters and guinea pigs, most ferruginous bodies were developed from fibrous fibers but not from tiny dust particles. The tracheobronchial lymph nodes were markedly swollen and laden with dust cells.

Toxicological evaluations of some brominated biphenyls.

Extensive toxicological studies were carried out to define the probable hazard of octabromobiphenyl (OBB) to workers, users, and the environment. OBB had low acute toxicity in mammals and birds by various routes of administration. It was essentially non-irritating to rabbit eyes, non-irritating to human skin and caused only mild skin irritation and no sensitization in the guinea pig. OBB caused equivocal effects in the rat fetus. OBB was stored in the body fat of rats and caused liver enlargement at high single doses or low repeated doses. The studies indicate probable low safety factors in application and use and probable bioaccumulation. Hexabromobiphenyl (HBB) was more acutely toxic than OBB by skin absorption in the rabbit and caused liver enlargement at lower single doses.