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Biomedical subjects

C R Zeiss

Publications and source records attributed to C R Zeiss.

122 records · Page 7Linked to original sources
PubMedDate not supplied

A twelve-year clinical and immunologic evaluation of workers involved in the manufacture of trimellitic anhydride (TMA).

The spectrum of immunologic lung disease occurring in a population of 196 workers involved in the manufacture of trimellitic anhydride (TMA) was assessed from January 1976 through December 1987. Workers were evaluated clinically by history, blood counts and chemistries, chest x-ray, and pulmonary function studies. Immunologic tests included skin testing with trimellityl-human serum albumin (TM-HSA) and assay of total antibody (TA) and of IgE antibody binding of 125I-TM-HSA. Seventeen workers had IgE-mediated asthma/rhinitis with a positive prick test to TM-HSA and IgE antibody of 0.8-57 ng of TM-HSA bound/ml. Seven workers had a late respiratory systemic syndrome with TA from 760-56,000 ng of TM-HSA bound/ml. Four had both syndromes. Three had late onset asthma with TA of 3,700-10,000 and trace levels of IgE to TM-HSA. One had marked arthralgia and myalgia occurring hours after TMA exposure, without respiratory symptoms, with an elevated TA level of 24,000. Of 46 workers reporting no symptoms, 8% had low TA levels, while 16% of 113 with irritant symptoms had low TA levels. There was a reduction in the number of workers exhibiting an immunologic syndrome during 1982-1987-8% (7 of 85) compared to 23% (26 of 111) during 1976-1981--in spite of increased TMA production. This paralleled environmental control and worker education efforts. Cooperative research by an academic Allergy-Immunology program and industry has defined TMA clinical syndromes and provided methods of immunologic monitoring, resulting in a reduction in new cases in spite of increased production of TMA.

Adult↗
PubMedDate not supplied

A clinical and immunologic study of employees in a facility manufacturing trimellitic anhydride.

We conducted a 1-year cross-sectional survey of 474 employees of a large chemical manufacturing complex to relate trimellitic anhydride (TMA) exposure to serologic and clinical outcomes. In 1988-1989, employees were evaluated by history and immunologic assay of total (T) and IgE antibody to trimellityl human serum albumin (TM-HSA). All employees were assigned to a TMA exposure class, from 1 (highest) to 5 (lowest), by an industrial hygienist, independent of the clinical and immunological data. Thirty-two (6.8%) of 474 employees had a TMA immunologic syndrome, 31.6% with an irritant response and 61.6% with no symptoms. Twelve had asthma/rhinitis, 10 had the late respiratory systemic syndrome (LRSS), four had late onset asthma, one had late onset arthralgia, and five had a distant history of LRSS. Included in this survey of the entire work force were 321 new enrollees, who had not joined the previous (1976 to 1988) voluntary surveillance program. Only four (1.3%) of the new enrollee group had a TMA immunologic syndrome. Among new enrollees, there were lower mean total and IgE serum antibody levels in lower exposure classes and a higher percentage with elevated antibody levels in high exposure classes (for T, x2 = 17.5, p = .0016; for IgE, x2 = 76.7, p less than .0001). In the new enrollee population, demographic variables of age, sex, date of hire, and smoking status were examined related to antibody levels. Only current or former smoking was related to elevated total antibody levels.

Antibodies↗
PubMedDate not supplied

Stevens-Johnson syndrome (SJS): effectiveness of corticosteroids in management and recurrent SJS.

To confirm that corticosteroids are beneficial in the treatment of Stevens-Johnson syndrome (SJS), 15 patients with the syndrome were evaluated by the same group of physicians over 2 years. All patients had cutaneous and most had mucosal lesions. Patients were treated with corticosteroids ranging from prednisone 40 mg daily to methylprednisolone 750 mg daily. The same group of physicians participated in the management of these patients until recovery. No deaths occurred among the 15 patients. Recovery was complete in all cases, and there was no residual skin, mucosal, or visceral damage except for minimal scarring in one patient. In some cases, reversal of disease after onset of corticosteroid therapy was sufficiently dramatic to demonstrate a benefit. The use of corticosteroids in the treatment of SJS remains controversial. We conclude that corticosteroids are beneficial in treatment of the syndrome. They may be lifesaving in some patients and should be the standard of therapy. SJS should be considered to be erythema multiforme with either bullous lesions or visceral involvement or both.

Adrenal Cortex Hormones↗
PubMedDate not supplied

ELISA screening tests for specific IgE and IgG antibody in employees exposed to trimellitic anhydride (TMA).

The objective of the study was to determine whether ELISA screening tests could be developed for specific IgE and IgG antibody in surveillance studies of employees exposed to trimellitic anhydride (TMA). Such tests would obviate the need for radiolabeling and disposal of radioactive wastes. The design of the study was a masked comparison of serologic results of ELISA screening tests with the criterion standard radioimmunoassay (RIA) currently used. The participants were 233 employees of a chemical plant that manufactures TMA. When the screening ELISA serologic results for IgG against TM-human serum albumin (TM-HSA) were compared with those of the RIA, the sensitivity was 92%, the specificity was 93%, the positive predictive value was 62%, and the negative predictive value was 99%. When the screening ELISA serologic results for IgE against TM-HSA were compared with those of the RIA, the sensitivity was 100%, the specificity was 91%, the positive predictive value was 31%, and the negative predictive value was 100%. We conclude that ELISA screening tests for antibody to TM-HSA have sufficient sensitivity, specificity, and predictive value to be useful in surveillance studies of employees exposed to TMA.

Chemical Industry↗
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Allergic rhinitis.

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Adolescent↗
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Atopic dermatitis.

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Adult↗
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Evolution of patient care, education, and research in asthma by one academic team of investigators over 35 years: the Northwestern University Medical School Division of Allergy-Immunology experience (Part Two).

This report reviews approximately 35 years of patient care, teaching, and research an asthma in one academic unit at Northwestern University Medical School. Historical perspectives are summarized on the delivery of care for asthma, therapeutic regimens for asthma we believed in (and were wrong), and diagnosis and management in the last decade of this century. Particular problems, such as potentially fatal asthma and assessment and management of such problems, are discussed. Finally, certain aspects of our basic research programs and their relevance to asthma are briefly reviewed. Part One of this article appeared in the May-June issue of this journal.

Adrenal Cortex Hormones↗
PubMedDate not supplied

Evolution of patient care, education, and research in asthma by one academic team of investigators over 35 years. The Northwestern University Medical School Division of Allergy-Immunology Experience: Part One.

This report reviews approximately 35 years of patient care, teaching, and research on asthma in one academic unit at Northwestern University Medical School. Historical perspectives are summarized on the delivery of care for asthma, therapeutic regimens for asthma we believed in (and were wrong), and diagnosis and management in the last decade of this century. Particular problems, such as potentially fatal asthma and assessment and management of such problems, are discussed. Finally, certain aspects of our basic research programs and their relevance to asthma are briefly reviewed. An outline of contents is shown in Table I.

Asthma↗
PubMedDate not supplied

Review of trimellitic anhydride (TMA) induced respiratory response.

Acid anhydrides such as trimellitic anhydride (TMA) are of interest due to their important industrial uses and to their adverse health effects in exposed populations. Important industrial uses of TMA include the production of epoxy and alkyd resins used to manufacture a variety of coating materials. The adverse health effects are a result of its direct irritant effects on mucosal surfaces in all exposed humans as well as its ability to cause immunologic sensitization in a small proportion of humans. In those individuals who are immunologically sensitized, reexposure to TMA can result in well described immunologic syndromes: asthma-rhinitis, late respiratory systemic syndrome (LRSS), and very rarely pulmonary disease anemia syndrome (PDA). In summary, adverse health effects of TMA are due to its effects as an irritant, an immunologic sensitizer, or a combination of both.

Allergens↗