Lithium/aluminium alloys. A problem material for biological monitoring.

Investigations on aqueous and nonaqueous media have shown that the dust particles of lithium/aluminium alloy are readily soluble in blood serum. Concentration of 10 mg A1 and 3 mg Li in 1 l serum constitute the saturation values in human blood serum at 20 degrees C. Further observations are intended to clarify the danger at the workplace. With a short-term exposure, the change in concentration of Li and Al was followed in the working environment and in the staff. Both elements (Li and Al) were determined in the working air, in the urine, the blood serum and on human skin with electrothermal AAS. On human skin, microerosions arise owing to hydrolytic destruction of the epidermis after long-term contact. The intensive irritant action of Li/Al dust is most relevant for preventive measures. It must also be considered that the Al values in the blood serum are raised by up to 50% in the presence of Li. The resorption and/or the bioavailability of Al is altered by Li. In the presence of Li up to a Li content of 2.5% in Al dust, a MAK (biological tolerance value, threshold limit value) of 1 mg Al/m3 room air (for the total dust) is recommended.

Magnetic resonance imaging of the brain and spinal cord in cerebrotendinous xanthomatosis.

This reports a 40 year old man with cerebrotendinous xanthomatosis who had bilateral cataracts, enlarged Achilles tendons, progressive dementia, gait disturbance and peripheral neuropathy. Electroencephalography, electromyography, and magnetic resonance imaging (MRI) of the brain and spine were performed. Magnetic resonance imaging revealed cerebral, cerebellar and cervical cord atrophy and white matter involvement in the cerebrum and cerebellum correlating well with the clinical findings. To date there has been one previous report of MRI of the brain in cerebrotendinous xanthomatosis and none of the spinal cord.

A mouse model for the study of blood-brain barrier permeability.

This article describes a C57BL/6 mouse model for the investigation of blood-brain barrier (BBB) alteration. Osmotic modification of BBB was achieved by infusion of 1.6 M arabinose solution into the internal carotid artery with or without occlusion of the external carotid artery. BBB alteration was measured by infusing 2% Evans blue dye. Only 1.6 M arabinose-treated animals but not 0.9% NaCl controls displayed prominent ipsilateral staining of frontal and temporal lobes. Light blue staining occurred in animals sacrificed within 10 min after injection. Prominent staining occurred in animals sacrificed 1-6 hours later. Identically treated animals were maintained for up to 6 months without signs of systemic or neurological dysfunction. This model may permit study of the effects of biological response modifiers (BRMs) upon the central nervous system (CNS) in healthy and diseased mice.

[The cadmium content of human tissues from biopsies]. / Der Cadmiumgehalt bioptisch gewonnener menschlicher Gewebe.

The level of cadmium (cd) concentration was determined in organs of 130 men and women. This study was conducted on living human beings who, in their occupation, haven't had extraordinary cd-exposure. Samples of tissues taken during operation were evaluated as well as urine samples (24 hours specimen), blood, an extended patient history including occupation and the postoperative diagnosis. The average cd-concentration was means = 27.3 +/- 29.7 micrograms/g wet weight in kidney cortex, 9.3 +/- 11.7 micrograms/g in kidney medulla, 1.1 +/- 0.5 micrograms/g in liver, 2.9 +/- 2.5 micrograms/l in blood and 2.6 +/- 2.9 micrograms/l in urine. Concentrations in 7 other tissues were measured. The critical cd-level for liver and kidney was not reached in any case. Cd-concentration is related to age and cigarette smoking, not to the sex of the person. It is quite impossible to make a precise estimation on the kidney load from blood or urine level of an individual patient. Differences in cd-load between patients with cancer and those without are discussed. A synopsis of international studies shows that results achieved through various methods, radiological cd-measurement, autopsies and our biopsies were comparatively the same.

Reflex absence epilepsy.

Epilepsy can be triggered by many unusual mechanisms. Some are exceedingly rare and bizarre, seemingly confined to one patient. This article reports the case of a 20-year-old woman who has had absence epilepsy for 11 years that is evoked by thinking or talking about driving an automobile. This stimulus consistently precipitated absence seizures, as defined by clinical and electroencephalographic criteria. An emotionally traumatic early childhood event may play a role in the triggering mechanism. A similar case has not been reported.

Pulmonary involvement in zinc fume fever.

A patient with the clinical history of recurring zinc fume fever underwent an experimental welding exposure; this resulted in a systemic reaction and a distinct self-limiting response in the periphery of the lung, demonstrated by pulmonary function tests and bronchoalveolar lavage. These pulmonary changes observed for the first time in man were reproducible.

Study of familial alpha-1-proteinase inhibitor deficiency including a rare proteinase inhibitor phenotype (IZ). I. Alpha-1-phenotyping and clinical investigations.

Proteinase inhibitor (PI) phenotyping and clinical investigations were performed on 20 persons in three generations of a family with alpha 1-antitrypsin deficiency. Two persons were homozygotes and 9 were heterozygotes for the Z allele; one is the first reported IZ phenotype; 11 were common M-types. Both homozygotes and 5 of the heterozygotes, including the IZ individual, had suffered from recurring or chronic respiratory diseases. However, only mild to moderate impairment in lung function tests was observed in some of these patients (DLCO steady state, 3 subjects; FEV1, 3 subjects; FEF25-75, 2 subject; elevation of RV, 2 subjects). The rare IZ type, a 35-year-old female, smoker, showed normal lung function except for an elevated RV. Our results indicate that PI deficiency is not necessarily associated with severe lung destruction if noxious inhalants are absent.

Data on the clinical aspects and therapy of primary gastrointestinal lymphomas.

Fifteen cases of primary gastrointestinal lymphoma diagnosed over 8 years are reviewed. In the period 1980 to 1982 there was a cumulative appearance of GI lymphomas, nine out of 15 cases were diagnosed in that period. According to its localization, lymphoma occurred in 12 cases in the stomach, and in 3 in the small intestines and the colon. One case of gastric lymphoma was Hodgkin type, the others were non-Hodgkin types. The clinical symptoms were not characteristic of lymphoma. The age of the patients was, on the average, ten years lower than the mean age of carcinoma patients. Preoperative diagnosis by gastric biopsy was successful in four cases. In patients with lymphoma of the colon not subjects to surgery, colonoscopy verified the origin of lymphoma. Exact clinical classification in the majority of cases was made intraoperatively. In the non-operated cases, sonography and lymphography were performed. In general, operation was attempted, but patients in stage II, in very poor condition, were possibly not operated. The possibility and indications of the "second look" operation are discussed. Histological typing was made according to the Kiel classification. In the literature, in the most controversial question of therapy, individual consideration of the cases is recommended. Based on our experience, in devising therapy or therapeutic strategy as well as concerning prognosis, the degree of malignancy according to histological type, clinical stage and anatomical localization seem to be the most decisive factors. In exceptionally malignant cases a protocol with doxorubicine + bleomycin + teniposide and prednisolone was applied.

[Chronic thallium poisoning. Study of criminal poisoning]. / Chronische Thalliumintoxikation. Beobachtung einer kriminellen Vergiftung.

In a 42-year-old man with abdominal symptoms, loss of hair and increasing distal polyneuropathy in both legs, the clinical suspicion of thallium poisoning was confirmed by urinary and blood analysis. Hair analysis provided a pointer to the time of poisoning. In addition to symptomatic measures, treatment consisted of administration of potassium-iron (III) hexacyanoferrate (II) (Berlin blue), combined with forced diuresis. Despite the overall favourable course, residual symptoms of distal polyneuropathy were still present 6 months after discharge from hospital.

Clinical symptoms and results of skin test, RAST and bronchial provocation test in thirty-three papain workers: evidence for strong immunogenic potency and clinically relevant 'proteolytic effects of airborne papain'.

Seventeen out of thirty-three workers who have been exposed to airborne papain at their place of work regularly developed asthmatic symptoms such as shortness of breath, wheezing, coughing, sneezing, rhinorrhea and conjunctival irritation upon contact with this proteolytic enzyme. Investigations by RAST, skin test and bronchial provocation test proved IgE-mediated hypersensitivity to papain in fourteen symptomatic workers. Ten of these were in a screening investigation involving twenty-nine of the thirty-three workers; i.e. the incidence of IgE-mediated sensitization was 34.5% of this group. Bronchial provocation of as little as 0.001--0.5 mg of papain was shown to elicit immediate or dual asthmatic reactions in all eight tested workers with RAST values greater than 3 u/ml. On the other hand, inhalation of 0.5 mg of papain did not cause any remarkable change in non-exposed asthmatics. Occupation-related blood-stained nasal secretions and/or cutaneous flare reactions in all four heavily-exposed papain workers, of whom three had negative skin test and RAST results, suggest a direct effect of the proteolytically active enzyme on human tissue. There was a significant elevation (P less than 0.001) of serum trypsin inhibitory capacity in papain workers which seems to depend on the degree of exposure. No significant differences between symptomatic and asymptomatic workers in alpha 1-antitrypsin (Pi) phenotype subtypes were found.

Alpha 1-antitrypsin: the PiMM subtypes. Do they play a role in development of chronic obstructive pulmonary diseases?

In a comparative study, we examined 324 sera of the PiMM phenotype by isoelectric focusing. Sera were obtained from 254 healthy individuals, and from 70 patients suffering from chronic obstructive pulmonary disease (COPD). All individuals were examined, a detailed history and chest x-ray films were taken, and lung function tests were performed. The classification into PiMM subtypes according to a modified method, originally described by Genz et al, showed a significantly higher number of subtypes, containing more slowly migrating protein fractions (M2) in the group of patients. Since the prevalence of bronchitic symptoms is unusually common in industry, in workers who are exposed to dust and smoke tobacco, these findings are important, especially in regard to prophylactic measures in industry.

[Mercury concentrations in the air, in the blood and urine of dentists in dental clinics and free practice]. / Untersuchungen über die Quecksilber-Konzentrationen in der Raumluft, im Blut und im Urin bei zahnärztlicher Tätigkeit in Klinik und freier Praxis.

The concentration of mercury in the air was measured for 12 assistants and students, 27 dentists, and 42 dental assistants. The total concentration of mercury in the blood and the urine was also determined and compared with a control group. The results were as follows: 1. The highest concentration of mercury in the air (3--12 microgram Hg/m3) appeared only briefly. 2. The mercury concentration in the spontaneous urine of the dentists and dental assistants (6 microgram/l) was only slightly higher than that for the nonexposed control group (4 microgram/l). 3. The mercury concentration in the whole blood of the students (22 microgram/l) was the highest; that of the dentists and dental assistants (with several years exposure to mercury vapor, 7.0 and/or 6.5 microgram/l) was only slightly higher than that of the nonexposed control group (5 microgram Hg/l).

[Fast alpha 1-antitrypsin phenotyping for the differentiation of PiMM-sub-types (author's transl)]. / Schnelle Phänotypisierung des alpha 1-antitrypsins zur Bestimmung der Subtypen des Phänotyps MM.

The polyacrylamide gel slabs for isoelectric focussing were adapted for 20 microliter samples by adding a certain quantity of urea, and by letting it run idle before adding the sample. A better separation of protein fractions was obtained, and the distance of the M2- and M8-bands was increased to more than 20 mm in a total migration length of 120 mm. A M1M3 standard serum was introduced and the M8 band was included to differentiate PiMM sub-types. The clinical use of the method is demonstrated with the results of a recently published clinical study by Bencze, K. et al. ((1979), Chest 76, in press).

[About mass-spectroscopy of aflatoxines (author's transl)]. / Zur Massenspektroskopie der Aflatoxine

The mass-spectroscopical identification of aflatoxines in the eluant after thin-layer-chromatographical seperation represents a problem at amounts of less than 50 ng normally found in foods. Therefore it was necessary to investigate the factors influencing the identification. Among others, influences of plate material and the eluant were found. Based on the results with pure aflatoxines ideas were developed on their possible reactions.

[Investigations on the influence of insecticides on autoxidation processes. X. Formation of peroxides from octadecenic acid methylester in the presence of water and chlorinated hydrocarbon insecticides (author's transl)]. / Untersuchungen und Betrachtungen zum Insecticideinfluss auf Autoxydationsprozesse. X. Peroxidbildung aus Octadecensäuremethylester in Gegenwart von Wasser und insecticiden Chlorkohlenwasserstoffen

According to the range DDT less than DDE less than heptachlor less than heptachlorepoxide, chlorinated hydrocarbon insecticides promote the formation of peroxides from cis- and trans-9-octadecenic acid methylesters within the lipid and the water phase of the investigated model system. Compared with DDT and heptachlor the metabolites DDE and heptachlorepoxide proof as more efficient prooxidants; this may be explained by their higher reactivity. According with these observations the amount of insecticides, especially of heptachlor and heptachlorepoxide, that can be extracted from the model system with petroleumether after 72 hrs of autoxidation is markedly diminished. From that it is concluded, that in the investigated lipid-water-system the insecticides not only have a catalytic effect, but also are in part immediately involved in the formation of peroxides from 9-octadecenic acid methyl ester.