[Hypertension of adrenal origin. Clinical experience].
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Biomedical subjects
Publications and source records attributed to G C Botta.
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A new case of rare-earth (RE) pneumoconiosis is described. The subject had worked as a photoengraver for 13 years and had not been exposed for 17 years. Chest X-ray showed a diffuse nodular pattern (q 2/3-ILO/1980). The patient was asymptomatic despite a restrictive spirometric impairment. The diagnosis derived from the finding, in the bronchoalveolar lavage fluid, of abnormal levels of La, Ce, Nd, Sm, Tb, Yb, and Lu. The presence of these elements was demonstrated by two methods: the neutron activation analysis and (as regards Ce alone) the X-ray energy spectrometry of mineral particles observed with electron microscope. Abnormal levels of rare earths were demonstrated also in the nails, suggesting an absorption of the RE from the lung.
The authors present their experience of endoscopic sclerosis of esophageal varices in 56 patients in a period of about two and half year (February '83-July '85). 46% of the patients were of the group C according to Child's criteria and 48.2% showed a fourth degree varices according to Paquet's criteria. Twenty-nine patients (51.7%) were submitted to the sclerosis as emergency treatment, 17 patients (30.3%) had an elective procedure and 10 (17.8%) were treated by a prophylactic sclerosis. The hemorrhage was stopped in 25 cases (86%) among emergency treated patients. However a new hemorrhage was observed before the end of the cycle of treatment in 48%. On the contrary 17% of patients complained recurrent hemorrhage after completing the treatment. Thirty-five per cent of patients electively treated showed recurrent hemorrhage while 40% bled after prophylactic treatment. Thirty-eight patients had a follow up of one year with results very similar to these reported in the literature. As a conclusion, on the bases of the reported results the authors suggest to submit to this treatment all the patients with recent hemorrhage or in emergency. The sclerosis should be reserved as elective procedure only to the patients of the class C; class A should be reserved to surgery while patients of the class B are matter of debate. Moreover prophylactic treatment, theoretically very attractive, needs further evaluation, at least in their hand.
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Twenty-six workers in a hard metal manufacturing plant were monitored by cobalt urinary and ambient air measurements during the first month after summer holidays. Cobalt determinations were performed utilizing AAS, with a preliminary chelation and extraction procedure for urinary samples. Almost all personal ambient air samples turned out to be under the cobalt dust TLV of 0.1 mg/m3. When restarting work after the holidays, urinary values did not differ from the control group. At the end of the first working week, urinary cobalt had increased four fold, then decreased to the original values on the following Monday before restarting work. Thereafter, the weekend was no longer sufficient to reduce the levels to normal urinary cobalt values. The values rose to the same level observed before the holidays, and dit not substantially decrease even after the weekend. End-shift urinary cobalt values showed a good relationship with present as well as with mean past exposure on the first and the fifth weekday, but the third day did not. The correlation was better with present exposure on Monday and with mean past exposure on Friday. The observed differences may be explained by the minor influence of recent exposure on present exposure on Monday. The highest values were found on Wednesday. We suggest the utilization of end-shift urinary cobalt determination as a measure of the present exposure on Monday, and of mean recent or preceding exposure on Friday.
Intrasplenic hepatocytes transplantation was carried out in Wistar-Lewis strain inbred rats, after inducing acute hepatic failure by intravenous injection of Dimethylnitrosamine (DMNA) (30 mg/kg). Iso-, allo-(CDF-Fisher strain) and xenogeneic (New Zealand White rabbit) grafts were performed. Liver cells suspension was obtained by mechanical separation. The results demonstrated the efficacy of iso- and allotransplants, but not of xenogeneic hepatocytes, in improving significantly the survival rate compared to the control group. It is concluded that immunogenicity of liver cells is a factor which must be taken into consideration in hepatocyte transplantation. Moreover the absence of liver cells into the spleen at one week after the transplant seems to suggest that an intact liver cell is not necessary to improve survival.
Following a rapid review of equipment available for the depolluting of operating theatres, new equipment which does not interfere with anaesthesia circuit pressures is presented; experimental data obtained during use of this equipment are also reported and compared with standard data.
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Later on detection of several cases of acute myelotoxic intoxications the use of benzene as a solvent has been banned in Italy since 1963 (Law n. 245). Its consumption has therefore been confined to synthesys processes in petrolchemical industry. The hazards arising from the operations performed in an open air chemical plant which produces alkylbenzene were monitored by the AA. The synthesis occurs in a closed system which provides opportunities for benzene exposure during filling, control and maintenance operations. Nine environmental samples out of 10 showed benzene concentrations above 10 ppm with peaks up to 110 ppm. Long term air sampling showed values ranging from 12 to 75 ppm. Urinary phenol elimination has been measured showing values above 50 mg/1 for approximately 20% of workmen. The difficulties pertaining to an adequate control of benzene exposure in chemical plants are discussed. Being skin contact a mode of entry of apreciable concern, the AA. stress out that priority in exposure monitoring should be given to biological tests such as urinary phenol level and benzene concentration in expired air measurements.
A physiopathological interpretation is offered of the possibilities given by recent selective or portally regulated reduction of pressure in achieving a balance between reduction of pressure and diversion. Classic demonstrations, in fact, prove effective in the prevention of haemorrhage due to rupture of oesophageal varices. On the other hand, by over-diversion of the portal flow from the liver, they may cause a further deterioration in liver performance and more imposing the greater the flow of portal blood through the liver preoperatively. Procedures aimed at de-tension of the portal system, particularly the gastro-oesophageal segment, and at ensuring an intrahepatic venous flow sufficient to obviate steal syndrome damage, are described. Some of these procedures are still at the experimental stage. The techniques involved are explained, along with the underlying principles achieved by or prospected for each of them.
Tissue reactions to polyglycol acid and plain catgut threads were compared. The second part of the paper deals with changes in the mechanical properties of the polymer. Their reduction after insertion in tissues was proportionally equal for threads of different sizes. This finding is explicable histologically, since it can be shown that cell and humoral attack of the single filaments is homogenous throughout the entire cross-section of the thread.
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