Biomedical subjects
Publications and source records attributed to J Kohout.
The article deals with the life and work of the eminent professor of internal medicine Josef Skoda, a native of Plzen, who especially deserved of the introduction of examination by percussion and auscultation. He supported materially his nephew Emil and so he contributed to the expansion of Skoda's factory in Plzen.
The authors administered to 36 workers exposed to lead, for four weeks the preparation Prolong which contains vitamin C, vitamin E, beta-carotene, selenium, zinc and chromium and investigated the effect on indicators of free radicals. A statistically significant increase of the following occurred: superoxide dismutase (p < 0.001), glutathione peroxidase (p < 0.01), an increase of the total antioxidant capacity (p < 0.01) and an increase of uricaemia (p < 0.05). Based on these results the authors consider supplementation with antioxidants indicated in workers exposed to lead.
In order to obtain objective information from estimations of trace elements (Al, As, Cd, Cr, Co, Cu, Pb, Li, Mn, Hg, Ni, Se, Zn) on deficiency or intake beyond the toxic limit it is necessary to pay attention among others also to preanalytical safeguarding, i.e. obtain all relevant information on the patient, ensure proper selection of material and sampling time, proper sampling and safeguarding the sample before the estimation proper. If the above rules and principles are respected, possible significant distortion on the results, which can be caused e.g. by contamination of the sample, can be prevented.
The authors examined indicators of the action of free radicals in 40 workers exposed to the risk of lead (work with lead containing glazing and prints). The lead concentration in the atmosphere did not exceed the highest permissible concentrations and the biological exposure tests as regards lead exposure did not exceed the highest permissible limits. In the examined subjects the authors found a significantly elevated level of superoxide dismutase activity (p < 0.05) which suggests long-term increased peroxide formation. The correlation of the selenium concentration in blood and the period of lead exposure was at the borderline of statistical significance (p = 0.1159). Further investigations will be focused on subjects with symptoms of increased exposure to lead and lead intoxication where the probability of pathological findings is greater.
The authors discuss the physiology and pathophysiology of zinc. They mention the main sources of exposure to zinc and its components. Zinc absorption in the digestive tract is regulated by cells of the intestinal mucosa, the main route of excretion is via faeces. Zinc is essential for the function of several enzymes, there are ample data on its participation in immune processes. The authors analyse the most commonly quoted causes of zinc deficiency and pathological conditions caused by acute exposure to zinc and its compounds. Chronic zinc intoxication was not described in human so far.
The human organism is exposed to mercury from the environment and working environment. In the diet the main source of mercury are marine fish. Amalgam fillings participate in the mercury load of the organism as was proved by investigations of the mercury content of the brain, kidneys and lenses. However, it was not confirmed that the mercury load from amalgam fillings caused intoxication.
To 30 workers exposed to the risk of styrene for a period of 30 days a mixture of antioxidants was administered: vitamin C 200 mg, vitamin E 300 mg, selenium 20 mg, troxerutin 600 mg and beta-carotene 6 mg. Before the onset of supplementation and immediately afterwards laboratory indicators of antioxidant protection and lipid peroxidation were investigated. Before treatment workers exposed to the risk of styrene had a significantly higher malondialdehyde concentration (p < 0.01) and antioxidant capacity (p < 0.01) as compared with the control group. Due to the established positive correlation between these parameters (r = 0.42, p < 0.05) the findings can be evaluated as the result of increased exposure to free radicals. After supplementation a marked decline of the malondialdehyde concentration occurred p < 0.001) and a further rise of the antioxidant capacity (p < 0.001). The selenium concentration increased also markedly, the rise being more marked in subjects who had originally a lower concentration. There was a significant rise of uric acid which has an antioxidant effect (p < 0.01). The antioxidant enzymes superoxide dismutase and gluathione peroxidase did not change significantly. The results indicate the favourable effect of antioxidant treatment in subjects exposed to the risk of styrene.
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Chromium holds a frequent and important place in toxicological literature. The large number of more or less important toxicological facts (e.g. allergic dermatoses, ulcer, perforations of the nasal septum, bronchitis, cancerogenity etc.) are the reason why chromium is conceived rather as a toxic element. On the other hand in the non-toxicological literature favourable actions of chromium are described (its relationship to carbohydrate utilization, the glucose tolerance factor, diabetes etc.) which may induce us to consider chromium an essential element. Is chromium toxic or essential? It is both. The concept of essential or toxic cannot be conceived statically, these terms are relative and depend on a number of other facts and data (dose, time, chemical form, individuality of the organism, interaction with other substances in the environment etc). This relative view has a more general validity not only for chromium but for trace elements in general and it is very important in particular with regard to prevention of health damage caused by deficiency or excess of a substance.
The authors examined indicators of the effect of free radicals (MDA, SOD, GSHPx, selenium) in 20 patients with notified simple silicosis or miner's pneumoconiosis, in 11 patients with complicated silicosis or miner's pneumoconiosis and in 10 patients exposed to fibrogenic dust without an X-ray finding of pneumoconiosis. No statistically significant differences between individual groups were found. Subsequent investigations should be focused on subjects with incipient pneumoconiosis who are not yet entitled to damages.
The authors examined indicators of the effect of free radicals (MDA, SOD, GSHPx, selenium) in 38 workers exposed to styrene. They revealed a statistically significant (p < 0.01) correlation of SOD activity and the period of exposure to styrene and also a statistically significant correlation (p < 0.05) between urinary selenium excretion and the period of exposure to styrene as well as a statistically significant correlation (p < 0.01) between the MDA serum concentration and urinary selenium excretion. There is no statistically significant difference between the MDA plasma concentration among smokers and non-smokers, the SOD activity is significantly higher in non-smokers (p < 0.05). Based on the revealed findings the authors assume that free radicals may also play a part in the action of styrene on the organism.
The authors review risk factors of prostate carcinoma. Generally accepted factors include advanced age; some work confirms a familial incidence of the condition. When the incidence is evaluated by race, the highest prevalence is described in American negroes and the lowest prevalence in the Japanese. The higher prevalence in northern areas and lower prevalence in southern areas is explained by the effect of ultraviolet radiation. It is generally accepted that prostate carcinoma depends on androgens; the dependence on sexual activity is evaluated in relation to the higher androgen concentration and the higher risk of infection. As to dietary factors the condition is promoted by fats; the higher prevalence in smokers can be explained by the cadmium and nickel content of cigarettes. With regard to occupation, brain workers are affected more frequently; as to occupational carcinogens cadmium and nickel are quoted most frequently.
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The authors discuss the relationship of serum concentrations of endothelin in patients with vascular disease due to vibration and the severity of the disease; the highest concentrations were found in the most advanced forms of disease. Combination of the vascular disease due to vibration with complicating cardiovascular diseases is also discussed. The authors prepared methodical norms for the elaboration and evaluation of the results of serum concentrations of endothelin. These norms are useful for comparing studies in various regions and for international cooperation. The paper presents preliminary results so far of small group of patients. The examination could be a useful additional method for the classification and assessment of severity and prognosis of the disease.
Vascular diseases caused by vibration are treated by different methods. We ourselves applied in our patients subcutaneous injections of hot-spring gas, per os prazosin (postsynaptic blocker of alpha-sympathetic receptors) which except for its vasodilatory effect improves the rheologic qualities of blood). Subcutaneous injections of hot-spring gas were administered to 31 males aged 32 to 67 years (average 50.58 years) for 15 days, Prazosin VUFB to 12 males aged 33 to 64 years (average 47.8 years) for 28 days and pentoxifylline (Agapurin SPOFA) to 20 males aged 29 to 69 years (average 46.35 years) for 28 days. Simultaneous nervous disease caused by vibration was present in 12 patients, articular affections caused by vibration in 10 patients, and disease of peripheral nerves and joints in 16 patients. The subjective complaints were influenced mostly by hotspring gas, the cold water test by prazosin, the skin temperature and plethysmogram by pentoxifylline. When evaluating the number of favourably influenced indicators pentoxifylline is the most successful. Tolerance of all three methods proved to be good.
1. Biochemical markers of kidney damage were examined in 14 male and 12 female workers highly exposed to soluble nickel compounds in a chemical plant. The results were compared to those obtained in 12 male and 12 female matched controls. 2. The concentration of nickel in urine of male and female workers averaged 5.0 and 10.3 micrograms g-1 creatinine, respectively. The mean duration of exposure in male and female workers was 25 and 15 years. 3. No difference was found in the mean urinary excretion of lactate dehydrogenase, albumin and transferrin in both sexes, total proteins, beta 2-microglobulin (beta 2-m) and retinol-binding protein (RBP) in males and lysozyme in females. Lysozyme and N-acetyl-beta-D-glucosaminidase (NAG) were increased in male and total proteins, beta 2-m, NAG and RBP in female exposed workers. Significant correlations between urinary concentrations of nickel on one side and that of beta 2-m in women (r = 0.462, P = 0.022) and men (r = 0.41, P = 0.018) and of NAG in men (r = 0.405, P = 0.019) on the other side were found in exposed subjects. 4. Results indicate adverse effects of soluble nickel compounds on the kidney tubular function. In agreement with literature data it seems that those effects occur only at high exposure levels.
The human stomach mucosa contains two main group of gastric proteinases. Both pepsinogen A (PGA) and pepsinogen C (PGC) consist of molecular variants, isozymogens, which can be separated electrophoretically, PGA was found to consist of five isozymogens (Pg1-Pg2), and PGC of two isozymogens (Pg6 and Pg7). Five hundred zymograms were examined and electrophoretic mobility of pepsinogens from patients with gastric cancer was found to be higher than from other gastric diseases. The ratio of isozymogens Pg3 to Pg5 differs in to great extent in various disease. Patients with ulcer disease have this value higher than 1, but patients with gastric cancer lower than 1. Patients with gastric ulcer have lower occurrence of Pg1 and SMP in antrum. In patients with gastric carcinoma lower concentration of PGA and also ratio PGA to PGC are observed.
From 614 patients with notified pneumoconiosis who died in 1964-1992 on necropsy carcinoma of the lungs was found in 87, i.e. 14.1% (in 48 it was the cause of death). The incidence in individual years did not differ significantly; on evaluation in relation to the diagnosis of pneumoconiosis an insignificantly more frequent incidence was found in complicated pneumoconiosis of miners. On evaluation by work places miners in black coal mines and workers in quarries were affected more frequently, the difference being at the borderline of statistical significance. As to the histological aspect, most frequently squamous cell carcinoma was involved, the site was most frequently in both upper lobes. The carcinoma was seven times associated with silicotic lesions, with anthracofibrotic lesions six times (a total of 14.9%). In lifetime carcinoma was detected in 55 of the patients who died, i.e. in 63.2%. As to aetiopathogenetic influences, the relationship with smoking is significant. The aetiopathogenesis of carcinoma of the lungs in patients with pneumoconiosis is most probably not uniform-the influence of smoking is beyond doubt, the carcinogenic effect of silica should be considered in patients with carcinoma in the scar. With regard to the repeatedly proved more frequent incidence of carcinoma of the lungs in patients with pneumoconiosis, frequent check-ups of patients with pneumoconiosis focused on possible detection of lung cancer are essential.