[A monitoring program and intervention regimen based on biological exposure tests for ensuring individual health protection of workers exposed to lead]. / Ein Uberwachungsprogramm und Interventionsregime auf der Grundlage biologischer Expositionstests zur Gewährleistung des individuellen Gesundheitsschutzes bei bleiexponierten Werktätigen.

In Berlin a control and intervention regimen agreed upon by the Central Institute of Industrial Medicine of the GDR (ZAM) and the Industrial Hygiene Inspection of the Municipal Council has been applied in cooperation with the works health service for industrio-medical attendance of lead-exposed employees since 1984. The intervals for the check-ups by biological exposure tests are determined in higher-exposed employees resulting from blood concentration assays in addition to the legal regulations. The intervention regimen provides instructions for measures to the works doctor if the biological exposure tests indicate some high individual risk to health. The results of the application of this regimen are reported.

[The value of determining delta-aminolevulinic acid in urine (method II, East German occupational monitoring) as a screening procedure for the assessment of internal residues in occupational exposure to lead]. / Der Wert der Bestimmung von Delta-Aminolävulinsäure im Urin (Methode II, AB-DDR) als Screeningverfahren zur Einschätzung der inneren Belastung bei beruflicher Exposition gegenüber Blei.

For the purpose of supervising workers exposed to lead the ratio of blood lead is determined several times per year. The withdrawal of blood samples from the vein necessary for this purpose as well as the comparatively high analytic expense make it essential to revise, whether it is possible to give up the analysis of blood lead at least partially in favour of other diagnostic measures less affecting the worker. Our investigation gave evidence of the fact, that the validity of a screening test for evaluating the blood lead concentration on the basis of the determination of delta-aminolaevulinic acid in urine (method II, AB-DDR; 2 nd morning urine) is insufficient.

[Characterization of exposure to pollutants in spray painting industries using room air concentration values and an exposure test]. / Zur Charakterisierung der Schadstoffexposition in Spritzlackierereien unter Verwendung von Raumluftkonzentrationswerten und eines Expositionstests.

Occupational-hygienic measurements of the interior air concentration had been performed in a large number of spray painting plants. The analyses stated that with most of the cases the exposition risk on varnishers is characterized by aerosol concentration and the concentration of lead and chromate in it. The concentrations of vapours of solvent mixtures are of subordinate importance.

[Diagnostic bronchoalveolar lavage in comparison with gallium-67 scintigraphy in the diagnosis and treatment of lung sarcoidosis]. / Diagnostische bronchoalveoläre Lavage im Vergleich mit der Gallium-67-Szintigraphie in der Diagnostik und Behandlung der Lungensarkoidose.

The value of bronchoalveolar lavage (BAL) and Gallium-67-scintigraphy in the diagnosis of sarcoidosis is discussed. Both methods complete themselves and do not compete. Both are good indices for the activity of the disease and for corticoid treatment surveillance. There is not a direct correlation of SACE and Ga-67-scan in active disease. Ga-67-scan is the method preferred to establish the spread of granulomas. This radiological method allows the detection of invisible dissemination in the lungs and other organs. BAL allows a cell differentiation. With this method it is possible to survey the course of the disease and give further informations of the pathogenesis of sarcoidosis.

Detection of anti-contractile antibodies after cardiac surgery using ELISA assay.

Sera from 196 patients were collected before and after cardiac surgery to measure antibodies against heart tissue and against actin and myosin. In the post-operative period antibodies were found in 87 patients (44%) producing a cross-striated fluorescence pattern in heart tissue. Antibodies against the major contractile proteins were found in 91 patients (46%), anti-actin antibodies in 49 patients (25%) and anti-myosin antibodies in 65 patients (33%). We found a significant correlation (P less than 0.0001) between the antibodies producing a cross-striated fluorescence pattern and antibodies recognizing contractile proteins. These results suggest that contractile proteins evoke an immune response after cardiac surgery and that this response may compromise cardiac function.

Role of gallium 67 thoracic scintigraphy in the diagnosis and staging of patients suspected of bronchial carcinoma.

Gallium 67 (67Ga) lung scanning was performed in 100 consecutive cases in which because of the history, clinical data, or abnormal radiological findings, a bronchial carcinoma was suspected. This study allows the conclusion that a negative as well as a positive scan is an important element in the diagnosis of some cases of bronchial carcinoma. The method is most helpful in the preoperative diagnosis of circumscribed peripheral shadows and in the assessment of suspected hilar enlargement; it may even visualise hidden malignant tumours. Gallium 67 scanning is also valuable in the assessment of hilar and mediastinal involvement in the presence of a proven primary lung tumour. This study supports the view that in the presence of a negative mediastinal scan the patient may be spared mediastinoscopy and be referred directly for operation.

Non-invasive evaluation of cardiac function in professional cyclists.

Cardiac dimensions and left ventricular function were investigated at rest with non-invasive methods in 14 professional road race cyclists and in 11 age-matched sedentary control subjects. The electrocardiographic findings were in agreement with previous studies in endurance athletes and the vectocardiographic data showed anterior displacement of the electrical forces. Echocardiographic dimensions at end-diastole showed higher values in the cyclists for left ventricular internal diameter, left ventricular posterior wall thickness, and interventricular septal thickness. Derived values for left ventricular volume and left ventricular mass were also much larger in the cyclists and there was excellent agreement between total heart volume measured with radiology and total measured by echocardiography. There was a significant correlation between maximal oxygen consumption and end-diastolic left ventricular diameter.

The orthogonal Frank electrocardiogram in 257 nurse students.

It has clinically well been recognized that the vectorcardiogram in younger patients often shows characteristics that are largely different from the figures obtained in general adult populations. Well documented information on VCG parameters in younger subjects is scarce; the present paper deals with a report on 194 white females and 63 white males, aged 18-25 years. Data were analyzed using the Pipberger program 3.6, and also statistically compared to the classical Pipberger standards. Some parameters (e.g. QRS duration) show different values typically in females, as well in our group of young females as in the reference Pipberger group; other measurements (e.g. Q/Rz amplitude ratio) are specifically deviated in the young population and a pronounced anterior displacement of QRS is regularly observed here. It appears remarkable that QRS amplitude in the young age groups is significantly higher than in the general Pipberger groups only when examined in the inferior direction. The 96% range limits found in this study resp. in young males, and in young females, for the QRS spatial maximal vector (3.08 resp. 2.61 mV) and for RX + RZ (3.22 resp. 2.45 mV) can be taken into account for considering LVH in youngsters.

Is blood pressure variability related to activity of the sympathetic system?

1. In 70 patients with untreated essential hypertension, blood pressure variability was correlated to plasma catecholamines and to the response of blood pressure and peripheral flow to cold pressure and handgrip tests. 2. Supine blood pressure was recorded every 5 min, during 3 h. Variability was defined as the standard deviation of the mean of the readings in that period. 3. Blood pressure variability is positively and significantly correlated to the level of pressure and to age. 4. No significant correlation could be found with plasma catecholamines and sympathetic function tests. 5. It is concluded that blood pressure variability is related to the level of pressure but not to activity of the sympathetic nerves.