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Exposures to polyvinyl chloride, methyl ketone and other chemicals. The pulmonary and non-pulmonary effect.

As part of the continuing assessment of the health impact of exposures in the emerging industries of Nigeria, a study was conducted to determine the relative impact of exposures encountered in four operations of a shoe factory. The health impact assessment consisted of spirometric lung function evaluations and environmental measurement for polyvinyl chloride (1.6 +/- 5 ppm). The study showed that there were differences among exposure subgroups with respect to pulmonary, neurological and dermal toxicities and that these differences were dictated by the types of exposure encountered. Pulmonary toxicity was most severe in the vinyl chloride-exposed subgroup. Neurological impact was most severe in the leather and methylethyl ketone-exposed subgroup and dermal toxicity most severe in the subgroup exposed to plasticizers and stabilizers. There existed substantial deficits in lung function (forced expiratory volume, forced vital capacity FEV1, FVC) among the subgroups relative to normal, non-industrially exposed Nigerians of similar age and height. The deficits in lung function, particularly in FVC, paralleled the variations in the prevalence of restrictive lung disease, which for the whole study group was 56.5 cases per 1000 person-years. The vinyl chloride-exposed subgroup had the highest prevalence of restrictive lung disease, 92.6 cases per 100 person-years. Step-wise multiple regression suggested that 27% of the deficit in FEV1 was explainable by the number of exposures. The use of person-years as a denominator gives a better estimate of risk than the total number of subjects as it incorporates both the number exposed and the total exposure experience.(ABSTRACT TRUNCATED AT 250 WORDS)

Air Pollutants, Occupational↗

Embolization of intracranial arteriovenous malformations and fistulas with polyvinyl alcohol particles and platinum fibre coils.

In order to reduce the recanalization rate of arteriovenous malformations and multiple dural arteriovenous fistulas, embolization was carried out with polyvinyl alcohol (PVA) particles combined with platinum fibre coils in 20 patients. The malformation was occluded more effectively than by PVA alone. Distal deposition of the emboli was obtained by improved steerable catheters (Tracker-18-unibody) and guidewires. The complication rate was lower than usually reported from studies using glue as embolic agent. It was concluded that the combination of PVA and fibre coils enhances the safety and effectiveness of embolization therapy and reduces the frequency of recanalization of intracranial AVMs.

Adult↗

Evaluation of polyvinyl alcohol hydrogel as a soft contact lens material.

We prepared a transparent polyvinyl alcohol (PVA) hydrogel from a PVA solution in a mixed solvent consisting of water and a water-miscible organic solvent by cooling. The physical properties of the hydrogel were evaluated in various mixed solvents and compared with those of commercially available soft contact lens materials, such as polyhydroxyethyl methacrylate (PHEMA) and copolymers of methylmethycrylate (MMA) and N-vinyl pyrrolidone (N-VP). The PVA hydrogel showed higher tensile strength and elongation before breaking than did the other materials. Also, the PVA hydrogel was comparable in its high water content and its oxygen permeability with the MMA/VP copolymers. The protein adsorption of the PVA hydrogel was much lower than that of the other materials. Soft contact lenses of PVA hydrogel were applied to rabbit eyes for 12 weeks. The effects of the lenses on the cornea were studied by biomicroscopy, ultrasonic pachymetry, and histopathologic examination. No abnormal findings were noted, suggesting that the PVA hydrogel may be promising as a new material for use in soft contact lenses.

Animals↗

Synthesis of tolerogenic monomethoxypolyethylene glycol and polyvinyl alcohol conjugates of peptides.

Recent studies from this laboratory showed that tolerogenic peptide conjugates are very effective reagents for obtaining epitope-specific immunosuppression of antibody responses to immunopathogenic sites on multideterminant complex protein antigens. This paper describes the procedure for synthesis of well-defined conjugates of peptides to monomethoxypolyethylene glycol (mPEG) or to polyvinyl alcohol (PVA). The first step involves succinylation of the hydroxyl groups on the polymers by reaction with succinic anhydride. The polymer is then coupled via the carboxyl of the succinyl group to the alpha-NH2 of the completed peptide on the synthetic resin, while maintaining intact all the side-chain protecting groups on the peptide. The mPEG or PVA-peptide conjugates are cleaved from the resin and purified by standard procedures. This method results in the preparation of conjugates in which one molecule of tolerogenic polymer is coupled to the N-terminal of an otherwise unaltered peptide molecule.

Amino Acid Sequence↗

XRCC1, CYP2E1 and ALDH2 genetic polymorphisms and sister chromatid exchange frequency alterations amongst vinyl chloride monomer-exposed polyvinyl chloride workers.

Vinyl chloride monomer (VCM) is a known human carcinogen, which may be metabolized by cytochrome P450 2E1 (CYP2E1), aldehyde dehydrogenase 2 (ALDH2), and glutathione S-transferase T1 (GSTT1). A DNA-repair gene, X-ray repair cross-complementing group 1 ( XRCC1, exon 10), may also be implicated in the process of VCM-related carcinogenesis. Thus, VCM-exposed workers with inherited susceptible metabolic and DNA-repair genotypes may experience an increased risk of genotoxiciy. This study was designed to investigate whether metabolic and DNA-repair genotypes affected sister chromatid exchange (SCE) frequency in occupationally VCM-exposed workers from polyvinyl chloride (PVC) manufacturing plants. Study subjects comprised 61 male workers having experienced VCM exposure, and 29 male controls. Questionnaires were administered to obtain detailed histories of cigarette-smoking habits, alcohol consumption behavior, and occupation. The frequency of SCE in peripheral lymphocytes was determined using a standardized method, and genotypes of CYP2E1, ALDH2, GSTT1 and XRCC1 were identified by the polymerase chain reaction (PCR) procedure. Our results demonstrated that smoking, age and VCM exposure and XRCC1 ( P=0.03), CYP2E1 ( P=0.04), and ALDH2 ( P=0.08) were significantly associated with an increased SCE frequency. Further analysis of gene combinations, including CYP2E1, ALDH2 and XRCC1, revealed an increased trend for these genotypes to influence SCE frequencies for the low VCM-exposure group ( P<0.01), but not so for the high VCM-exposure group ( P=0.29) or for controls ( P=0.49). These results suggest that workers with susceptible metabolic and DNA-repair genotypes, may experience an increased risk of DNA damage elicited by VCM exposure.

Adult↗

Preclinical testing of a new clot-retrieving wire device using polyvinyl alcohol hydrogel vascular models.

INTRODUCTION: Cerebral embolism is the principal cause of cerebral infarction. Recently, mechanical embolectomy has been proposed as an effective method. We performed a preclinical evaluation of a new mechanical clot-retrieving wire. METHODS: This clot-retrieving wire consisted of three nitinol loops at the tip of a microguidewire. These three loops could be collapsed into a 0.018-inch wire compatible microcatheter. Each loop was 8 mm long and 3.5 mm wide. For simulation, polyvinyl alcohol (PVA) vascular anatomical models of the human carotid (eight models) and vertebrobasilar (three models) circulation were constructed. A pulsatile flow circulation system was used. Embolic clots were produced using pig blood plasma. The microcatheter and the microguidewire were advanced beyond the clot. The wire was then exchanged for the retrieving wire. The microcatheter was then pulled slightly back to open the loops. The clot was then caught by withdrawal of the system. Once caught, the clot was retrieved to the guiding catheter tip. We investigated the following points: ease of device deployment, clot capture ability, clot removal against blood flow and removal of the clot out of the introducer system. RESULTS: A total of 104 procedures were performed in 11 PVA models and evaluated. The drop rate was 19%. We succeeded in partial and total recanalization in 51.0% of the procedures (53/104) within 30 minutes. CONCLUSION: This new clot-retrieving wire could be useful for mechanical clot extraction in stroke.

Embolectomy↗

Biodegradation of dichloromethane by the polyvinyl alcohol-immobilized methylotrophic bacterium Ralstonia metallidurans PD11.

A dichloromethane (DCM)-degrading bacterium, Ralstonia metallidurans PD11 NBRC 101272, was immobilized in a polyvinyl alcohol (PVA) gel to use in a bioreactor for DCM treatment. After 4-month incubation of PVA gel beads with R. metallidurans PD11 and DCM in a mineral salt medium, the cells were tightly packed in the mesh of the gel. Forty beads of the gel in 10 ml of a batch system model showed effective activity degrading 500 and 1,000 mg l(-1) DCM within 2 and 3 h, respectively. Although reduction of pH due to accumulation of chloride ion liberated from DCM decreased the activity, it was recovered by adjustment to neutral pH. The activity of the immobilized cells was not affected by addition of nutrients which were preferentially utilized by R. metallidurans PD11, unlike the activity of the free-living cells. A continuous flow system with a column was more effective for rapid degradation of DCM. Thus, the PVA gel-immobilized cell of R. metallidurans PD11 is thought to be a prospective candidate to develop the bioreactor.

Biodegradation, Environmental↗

Comparison of pain after uterine artery embolization using tris-acryl gelatin microspheres versus polyvinyl alcohol particles.

When compared in a uterine artery embolization (UAE) animal model, Embospheres (ES) (Biosphere Medical, Rockland, MA) were found to induce less uterine ischemia than polyvinyl alcohol (PVA) particles. Given this finding, we aimed to test the hypothesis that ES is associated with less pain after UAE than PVA in human patients. We performed retrospective analysis on data from 72 consecutive UAE patients, collected from a prospectively acquired database. Patient-controlled analgesia (PCA) pump-delivered morphine sulfate (MS) dosages were compared between patients who received ES versus PVA. Subjective pain scores (SPS) were also compared between the two groups. Secondary outcome measures, including embolic volume and clinical outcome data, were also collected. Linear regression and t-test statistical analyses were performed. Null hypotheses were rejected at the p < 0.05 level. Mean follow-up period in the PVA population was 178 days (range 28-426), versus 96 days (range 24-197) in the ES population. The mean MS doses used by ES and PVA patients were 37.2 (s.d. 23.5) versus 47.1 (s.d. 26.8), respectively. This difference was not significant (p > 0.15). Utilizing a standard 0-10 pain scale, the mean peak SPS for the ES and PVA groups were 5.58 (s.d. 2.77) and 5.07 (s.d. 2.99), respectively. The difference was not significant. The mean amount of embolic material used in each ES and PVA patient was 4.86 cc (s.d. 3.01) and 3.52 cc (s.d. 1.63), respectively. The difference revealed a strong trend toward statistical significance (p = 0.05). There was one treatment failure in each group of patients. Within both patient samples, no significant correlation was found when comparing the volume of embolic used and subsequent MS dose. Despite a strong trend toward a significantly higher volume of ES used per patient, there is no subjective or objective difference in pain after UAE with ES when compared to PVA.

Adult↗

Trisacryl gelatin microspheres versus polyvinyl alcohol particles in the preoperative embolization of bone neoplasms.

The aim of this study was to compare the efficacy of trisacryl gelatin microspheres versus polyvinyl alcohol particles (PVA) in the preoperative embolization of bone neoplasms, on the basis of intraoperative blood loss quantified by the differences in preoperative and postoperative hematic levels of hemoglobin, hematocrit and erythrocytes count. From January 1997 to December 2002, preoperative embolization of bone tumors (either primary or secondary) was carried out in 49 patients (age range 12/78), 20 of whom were treated with trysacril gelatin microspheres (group A) and 29 with PVA particles (group B). The delay between embolization and surgery ranged from 1 to 13 days in group A and 1 to 4 days in group B. As used in international protocols, we considered hematic levels of hemoglobin, hematocrit and erythrocytes count for the measurement of intraoperative blood loss then the differences in pre- and postoperative levels were used as statistical comparative parameters. We compared the values of patients treated with embospheres (n = 10) and PVA (n = 18) alone, and patients treated with (group A = 10; group B = 11) versus patients treated without other additional embolic materials in each group (group A = 10; group B = 18). According to the Student's t-test ( p < 0.05), the difference of hematic parameters between patients treated by embospheres and PVA alone were significant; otherwise there was no significant difference between patients treated with only one embolic material (embospheres and PVA) versus those treated with other additional embolic agents in each group. The patients treated with microspheres had a minor quantification of intraoperative blood loss compared to those who received PVA particles. Furthermore, they had a minor increase of bleeding related to the delay time between embolization and surgery. The use of additional embolic material did not improve the efficacy of the procedure in either group of patients.

Acrylic Resins↗

Pregnancy following uterine artery embolization with polyvinyl alcohol particles for patients with uterine fibroid or adenomyosis.

PURPOSE: To determine whether uterine fibroid embolization (UFE) with polyvinyl alcohol (PVA) particles affects fertility in women desiring future pregnancy. METHODS: Of 288 patients managed with UFE with PVA particles for uterine myoma or adenomyosis between 1998 and 2001, 94 patients were enrolled in this study. The age range of participants was 20-40 years. The data were collected through review of medical records and telephone interviews. Mean duration of follow-up duration was 35 months (range 22-60 months). Patients using contraception and single women were excluded, and the chance of infertility caused by possible spousal infertility or other factors was disregarded. Contrast-enhanced magnetic resonance imaging was performed in all patients before and after UFE, and the size of PVA particles used was 255-700 mum. RESULTS: Among 94 patients who underwent UFE with PVA, 74 were on contraceptives, 6 had been single until the point of interview, and 8 were lost to follow-up. Of the remaining 6 patients who desired future pregnancy, 5 (83%) succeeded in becoming pregnant (1 patient became pregnant twice). Of a total of 8 pregnancies, 6 were planned pregnancies and 2 occurred after contraception failed. Five deliveries were vaginal, and 2 were by elective cesarean. Artificial abortion was performed in 1 case of unplanned pregnancy. There was 1 case of premature rupture of membrane (PROM) followed by preterm labor and delivery of an infant who was small-for-gestational-age. After UFE, mean volume reduction rates of the uterus and fibroid were 36.6% (range 0 to 62.6%) and 69.3% (range 36.3% to 93.3%), respectively. CONCLUSION: Although the absolute number of cases was small, UFE with PVA particles ultimately did not affect fertility in the women who underwent the procedure.

Adult↗

Massive lower gastrointestinal hemorrhage from the surgical anastomosis in patients with multiorgan trauma: treatment by subselective embolization with polyvinyl alcohol particles.

PURPOSE: To evaluate the efficacy and safety of subselective arterial embolization with polyvinyl alcohol (PVA) particles with or without microcoil augmentation to control postoperative lower gastrointestinal (GI) bleeding. METHODS: Ten patients with clinical, scintigraphic, and angiographic evidence of postoperative lower GI bleeding were considered for subselective embolization. Subselective embolizations were performed through coaxial microcatheters with 355-500 micron PVA particles with or without additional coil embolization. RESULTS: Embolization was technically successful in 9 of 10 (90%) patients. In one patient, subselective embolization was not possible; consequently no embolization was performed. Clinical success was achieved after a single embolization in 6 of 10 (60%) patients and after a second embolization in an additional 3 of the 10 (30%) patients. While there was no rebleeding in patients with normal coagulation parameters, all three patients (100%) with coagulopathy rebled, two of them from another source. Although no acute ischemic effects developed, no long-term sequela such as ischemic stricture were specifically looked for. Seven patients developed abdominal discomfort and/or fever within 24-48 hr. Four of 10 patients died of complications other than hemorrhage or ischemia. CONCLUSION: Subselective PVA embolization with or without a microcoil embolization is an effective and safe means of managing postoperative lower GI hemorrhage in patients with multiorgan trauma.

Adult↗

Repeated-batch xylitol bioproduction using yeast cells entrapped in polyvinyl alcohol-hydrogel.

Xylose-to-xylitol conversion was investigated in a bench-scale bioreactor using Candida guilliermondii cells entrapped within polyvinyl alcohol-hydrogel beads in a system operated in repeated-batch mode with cell recycling. Yeast-viable cells were immobilized in the support using the freezing-thawing method. Bioconversion assays were performed in a stirred tank reactor operated at 400-rpm agitation speed, 30 degrees C temperature, and 1.04-vvm air flow rate. The system was explored during six successive cycles, and a small decrease in the conversion performance in the fifth cycle was observed, but the biocatalytic activity of the microorganism was recovered in the sixth cycle after washing the particles. During the process, the hydrogel beads maintained their shape and size without appreciable deterioration. Xylitol production, yield factor, and volumetric productivity increased with progressive recycling of cells and achieved their maximum values (P(F) = 39.7 g l(-1); Y(P/S) = 0.77 g g(-1); Q(P) = 0.53 g l(-1) h(-1), respectively) after the third cell recycling, probably because of cells' adaptation to the medium.

Biotechnology↗

Lost bits: particle shedding with polyvinyl chloride intravenous administration sets.

Silicone particles have been demonstrated in the effluent from silicone intravenous (IV) tubing. It has been widely suspected that polyvinyl chloride (PVC) particles are also lost. We sought to clarify the situation in a carefully controlled laboratory setting using the apparatus and flow rates common in a paediatric setting, using scanning electron microscope techniques (SEM), we found that particles were indeed shed from IV tubing during use, but they were not PVC.

Equipment Contamination↗

Percutaneous right portal vein embolization with polyvinyl alcohol particles in gastric cancer metastasis: report of a case.

Polyvinyl alcohol (PVA) particles are used for the embolization of various vascular tumors. They are also used before hepatic resection to embolize the ipsilateral portal vein, causing hypertrophy of the remaining liver. We report our first experience with portal vein embolization (PVE) with PVA particles to treat gastric cancer metastasis to the liver. PVE with PVA is a safe interventional radiologic procedure, which does not cause problems during surgery and can improve the outcome of hepatic resection.

Embolization, Therapeutic↗

Evaluation of endocrine disrupting activity of plasticizers in polyvinyl chloride tubes by estrogen receptor alpha binding assay.

Polyvinyl chloride (PVC) tubing is an indispensable medical material for extracorporeal circulation therapy. However, di(2-ethylhexyl)phthalate (DEHP), a suspected endocrine disruptor, can be eluted from PVC, suggesting that an alternative material that does not contain DEHP is needed for clinical applications. First, we evaluated the endocrine disrupting risks of the plasticizers contained in PVC tubes by investigating their binding affinities for the human estrogen receptor alpha (ERalpha). Our results revealed that, while DEHP has some binding affinity for ERalpha, neither epoxidized soybean oil nor tris(2-ethylhexyl)trimellitate (an alternative to DEHP) has any affinity for ERalpha. Second, we evaluated the endocrine disrupting risks of a tube made of newly developed plasticizer-free (PF) materials. We confirmed the presence of DEHP and detected several unidentified substances in plasma stored within the PVC tube. This plasma's competitive binding affinity for ERalpha was significantly higher than that of control plasma (P < 0.01). In contrast, the profile of plasma stored in the PF tube was similar to that of the control, both in terms of high-performance liquid chromatography chromatograms and competitive binding capacity for ERalpha, suggesting that the PF tube is biocompatible and is useful for reducing the elution of substances capable of binding to ERalpha.

Chromatography, High Pressure Liquid↗

Degradation of polyvinyl alcohol by Sphingomonas sp. SA3 and its symbiote.

A total of 800 samples was taken from Taegu province, Korea, where many textile factories provide a source of polyvinyl alcohol (PVA) waste. These samples were screened for PVA-degrading bacteria. A new strain, SA3, was discovered which formed yellow colonies and used PVA as the sole carbon and energy source. Strain SA3 was identified as a Sphingomonas sp., based on the partial nucleotide sequence analysis of 16S ribosomal RNA, the presence of 2-hydroxymyristic acid (14:O 2-OH) and sphingolipids with d-17:0, d-18:0, d-19:1, and d-20:1 as the main dihydrosphingosines. This genus has not previously been reported as a PVA-degrading bacterium. Sphingomonas sp. SA3 needs a symbiote strain, SA2, for PVA degradation as a growth factor producer. In mixed cultures of these strains, the optimum temperature for PVA biodegradation ranged from 30 degrees C to 35 degrees C. The optimum pH was 8.0 and the most effective nitrogen source was NH(4)(+).

Biodegradation, Environmental↗

Ammonia removal from livestock wastewater by ammonia-assimilating microorganisms immobilized in polyvinyl alcohol.

We isolated ammonia-assimilating microorganisms from the livestock manure treatment systems and evaluated their ammonia-assimilating ability. Many isolates utilized ammonia at high rates when they were purely cultivated in a nitrogen-limited medium to which sterilized lagoon extract had been added. Some isolates that were immobilized in polyvinyl alcohol (PVA) utilized ammonia present in the media containing viable lagoon microorganisms. Staining with 4',6'-diamidino-2-phenylindole (DAPI) indicated that the immobilized high ammonia-assimilating isolates grew dominantly within the PVA beads. High ammonia-assimilating isolates in the mixed culture containing viable lagoon microorganisms were identified as Pseudomonas spp. and member of Rhizobiaceae species by partial sequencing of the 16S ribosomal DNA.

Ammonia↗

Preparation, characterization and microhardness study of semi interpenetrating polymer networks of polyvinyl alcohol and crosslinked polyacrylamide.

Semi-IPNs based on polyvinyl alcohol (PVA) and crosslinked polyacrylamide (PAM) were prepared and characterized. Various compositions of semi-interpenetrating polymer networks (semi-IPNs) were prepared by varying concentrations of PVA, acrylamide (AM) and crosslinker N,N'-methylene bis acrylamide (MBA) in the feed mixtures and polymerized using a suitable redox system comprising of potassium persulphate and metabisulphite. The prepared semi-IPNs were characterized by fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM) and X-ray diffraction (XRD) methods. The prepared semi-IPNs were also investigated for microhardness measurements.

Acrylamides↗