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PubMed1979

[Comparative evaluation of the functional state of the respiratory system in workers exposed to asbestos and cotton dust].

63 spinners exposed to cotton dust and 75 spinners exposed to asbestos dust were examined. In the women working in asbestos spinning room chronic nonspecific respiratory tract diseases prevalence was found to amount to 30% and in the cotton exposed group it was 15%. Mean values of lungs' vital capacity remained within the due values, although they were statistically significantly lower in asbestos exposed spinners (p less than 0,001). On the other hand, the percentage ratio of the forced expiratory capacity of 1 second was statistically significantly lower (0,001 less than p less than 0,01) in those exposed to cotton dust. The authors point to the occurrence of functional disturbances of the respiratory tract prior to radiological symptoms of lung asbestosis and their correlation with clinical symptoms.

Adult↗
PubMed1979

[Thoracoscopy in chronic pleural effusion (author's transl)].

123 patients with chronic pleurisy were investigated by thoracoscopy. The endoscopic biopsy is positive in 16 out of 17 cases of mesothelioma (96%), in 57 out of 72 cases of pleural metastasis (79%), and in 6 cases out of 7 pleural tuberculosis. Begnin pleural asbestosis was confirmed in 5. Endoscopic biopsy is thus more efficient than results obtained with pleural needle biopsy and exudative cytology. Thoracoscopy can be performed without any serious complications, this is not always true with open thoracotomy.

Anesthesia, General↗
PubMedDate not supplied

[Should the lung cancer of iron-miners in Lorraine be considered an occupational disease? (author's transl)].

The occupational group composed of the iron-miners working at the bottom of the mines in Lorraine makes up a high risk population for lung cancer (The carcinogenic index is 5 to 12 times as high as that of the population of non-miners). The authors report a new series of 270 cases in support of this assertion. The cancers have few particular characteristics. Their genesis appears to be related with the action of many co-factors: tobacco, various gases and noxious dust, iron particles. Our findings are similar to those of the Swedish, British and Russian authors. The occupation of iron-miner at the bottom of the mine appears then to favorize the manifestation of lung cancer. So it would be fair to consider this tumor an occupational disease, as with asbestosis.

Adult↗
PubMed1979

[Extrathoracic mesothelioma by inhalation of asbestos dust (author's transl)].

Report on 22 cases of malign peritoneal mesothelioma, their occupational, epidemiological, differentialdiagnostic, and oncologic aspects being discussed. For expert opinion the special criteria for acknowledging a peritoneal mesothelioma as an occupational disease are formulated (time and level to asbestos exposition, presence of pulmonary asbestosis and/or asbestos needles, latency time of about 20 years, and malignancy of the very often diffuse peritoneal mesothelioma).

Asbestos↗
PubMed1979

[Diffuse malignant mesothelioma of the pleura and peritoneum].

An analysis is presented of 14 cases of diffuse mesothelioma [one of them involving the peritoneum, the rest being of the pleural type] in postmortem material for a period of 18 years [1962--1978] with a view to the clinical course, macroscopic and microscopic pictures, diagnostic possibilities, and to the relationship to aetiological factors. With only one exception, no correlation to asbestosis was found in terms of either the patients' personal histories or morphology. A meticulously performed postmortem examination appears to be the most reliable diagnostic criterion.

Adult↗
PubMed1979

A study on acid glycosaminoglycans in pleural diseases.

1. Pleural fluid contained protein-bound hyaluronic acid, protein-bound chondroitin sulfate, hyaluronic acid, chondroitin sulfate, undersulfated chondroitin sulfate and dermatan sulfate. The composition of acid glycosaminoglycans in pleural fluid seems to reflect the rate of biosynthesis and degradation of these polysaccharides at some sites which are closely related to the pleural cavity. 2. A possibility was suggested that hyaluronic acid was synthesized in pleural tissue and was excreted shortly thereafter into the surroundings, as evidenced by experiments with rabbit pleural tissue. 3. In human, hyaluronic acid, chondroitin sulfate, dermatan sulfate and heparan sulfate were found in thickened pleurae caused by lung cancer, in those caused by asbestosis and also in tumor tissues of pleural mesothelioma. The molecular size of hyaluronic acid from pleural mesothelioma was found to be larger than that from human unbilical cord. 4. Quantification and histochemical study of acid glycosaminoglycans demonstrated that the quantity of hyaluronic acid in tissue specimens of mesothelioma by far exceeded that in non-mesothelioma cases (statistically significant). 5. Thus a possibility was suggested that histochemical investigation together with microquantitation of hyaluronic acid in pleural tissue may prove to be an efficient means of differential diagnosis of pleural mesothelioma. 6. Definite conclusion on the relationship between the fluctuation with time in quantity of acid glycosaminoglycans of the effusions and etiology of pleurisy awaits further investigations.

Adult↗
PubMed1982

[Characteristics, assay and semeiologic value of angiotensin converting enzyme (ACE)].

Serum angiotensin conversion enzyme (serum ACE) is a dipeptidylcarboxypeptidase which activates angiotensin I to angiotensin II and inactivates bradykinine. It is a glycoprotein with an MW of 126,000 to 480,000. It is produced by all endothelial cells, and is located on the cell membrane. It is inhibited by EDTA (chelator of Zn-- cofactor), teprotide (snake venom nonapeptide) and captopril. Estimation of ACE has greatly benefitted from the use of synthetic tripeptides. An example is the method of Cushman and Cheung using hippuryl histidyl leucine. A raised serum ACE level in sarcoidosis has been demonstrated by Liebermann in 1975. The diagnostic value is limited by the existence of high levels in other pulmonary diseases (asbestosis, silicosis). Serum ACE levels in sarcoidosis are all higher when the disease is diffuse from a pulmonary and extrapulmonary standpoint. They decrease when the disease regresses spontaneously and rise if it worsens. Radiological improvement in pulmonary sarcoid lesions under the influence of corticosteroid therapy is accompanied by a fall in serum ACE levels. Persistence of this normalization as the dose is decreased is a favourable sign, whilst the reappearance of a high serum level may either reflect simple and isolated biological "rebound" or may accompany a recurrence of signs of the disease. Serum ACE measurement is thus an important factor in the surveillance of cases of treated sarcoidosis when the dose of corticosteroids is to be reduced.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1983

Asbestos exposure enhances the release of fibroblast growth factor by sheep alveolar macrophages.

Interaction between free airway cells (FAC) and lung fibroblasts was studied in a sheep model of asbestosis. Three groups of six sheep each received, respectively, by repeated intratracheal instillations, saline (control), 328 mg (low dose), and 2282 mg (high dose) of UICC chrysotile B asbestos. Sixteen months after the first instillation, FAC obtained by segmental bronchoalveolar lavage (BAL) of sheep in each group were incubated for various intervals, and the effect of their culture supernatants (FAC-SN) on human embryonic lung fibroblast proliferation was determined. FAC-SN from control animals stimulated thymidine (3H-TdR) incorporation by lung fibroblasts two- to threefold compared to untreated cultures. Maximal stimulation was observed at 48 hr and was correlated with a significant increase of the fibroblast population at 72 hr. FAC population from control sheep consisted primarily of macrophages (79%) and lymphocytes (15%), and separation of these two cell populations indicated that only macrophages produced the fibroblast-stimulating activity. Production occurred within 1 hr of incubation and was maximal between 2 and 4 hr. This activity was nondialyzable and stable at 56 degrees C for 30 min, but was destroyed at 80 degrees C and low pH. Moreover, FAC-SN from sheep exposed to asbestos stimulated 3H-TdR incorporation by fibroblasts five- to sixfold compared to two- to threefold for control FAC-SN. This activity may modulate fibrogenesis and may be involved in the eventual fibrogenic response to asbestos.

Animals↗
PubMed1981

Significance of serum angiotensin converting enzyme and gallium scan in noninvasive diagnosis of sarcoidosis.

Serum angiotensin converting enzyme (SACE) assays, chest roentgenograms and gallium scans were obtained in 28 patients with active sarcoidosis, two patients with resolved sarcoidosis and 43 nonsarcoid patients. In patients with active sarcoidosis, 23 had elevated SACE activity and 26 had diffuse uptake of gallium in the lung parenchyma. Normal SACE and gallium scans were found in patients with resolved sarcoidosis. None of the nonsarcoid patients had a combination of elevated SACE activity and diffuse pulmonary parenchymal uptake of gallium, although some had elevated SACE activity and abnormal gallium scans. These results suggest that combination of elevated SACE activity and diffuse accumulation of gallium in the lung parenchyma are suggestive of sarcoidosis. However, in view of the reports of abnormal gallium accumulation, and occasional elevation of SACE activity in silicosis, asbestosis and miliary tuberculosis, it is still necessary to require histological evidence of noncaseating granuloma to confirm the diagnosis of sarcoidosis.

Clinical Enzyme Tests↗
PubMedDate not supplied

Port Allegany Asbestos Health Program: a community response to a public health problem.

The Port Allegany Asbestos Health Program (PAAHP) is a unique, community-run program that resulted from the successful cooperative efforts of a labor union, a corporation, community health care providers, and a medical school. PAAHP's goal is to develop a permanent community health organization that will use the most advanced existing knowledge to mitigate the adverse health effects anticipated as a result of the use of amosite asbestos in a Port Allegany, Pa. factory. All 1,188 persons employed by the factory during the years 1964-72 and the 3,000-4,000 persons in household contact with them are eligible for the program. PAAHP's major services are intensive medical surveillance, smoking cessation assistance, health education for participants, and continuing education for area physicians about asbestos-related diseases. One of the program's policies is not to disturb the usual patterns of medical care. If further testing or treatment is needed, patients are referred to their usual personal physicians. PAAHP does not provide ordinary medical care or medical insurance. Across the nation, the number of workers estimated to have been exposed to asbestos is more than 20 million, and their household contacts are estimated to be about three to four times that number. Adverse health effects resulting from asbestos exposure include elevated risk of lung cancer, mesothelioma, gastrointestinal tumors, and asbestosis. The problem requires the development of public health solutions. PAAHP has demonstrated the feasibility of a community-based model as one useful approach.

Asbestos↗
PubMed1984

Immunologic techniques utilized in the diagnosis of occupational lung disease.

Humoral and/or cell-mediated immune responses may contribute to the tissue injury in patients with certain types of occupational asthma, hypersensitivity pneumonitis, silicosis, and asbestosis. Numerous diagnostic modalities are available to the clinician investigating the etiology of these disorders. Among the current immunologic techniques discussed in this article are immunoassays for specific anti-IgE antibody, gel diffusion reactions, immunoelectrophoresis, ANA assays, complement studies, and immune complex assays.

Antibodies, Antinuclear↗
PubMedDate not supplied

[The age distribution of occupational disease (author's transl)].

The author analyses the incidence of occupational diseases in 1979 and their distribution according to age. Almost two thirds of all occupational diseases are detected in the latter half of life. The fact that noise-induced defective hearing, degenerative changes in the locomotor system, silicosis, asbestosis, and cancer of the airways due to occupational factors occur late in life cannot be primarily attributed to the physiological process of ageing. Rather, the reason for the late manifestation of these occupational diseases is the long time of exposure needed for symptoms to appear. Like other pathological forms of ageing, the consequences of exposure to occupational hazards must be distinguished from physiological processes of ageing. Normal ageing presupposes health-promoting working and living conditions.

Adolescent↗
PubMed1984

Malignant mesothelioma--clinical and epidemiological features. A report of 80 cases.

The clinical and epidemiological features of 80 cases of malignant mesothelioma (as proved by examination of biopsy specimens) referred to the clinic at the National Centre for Occupational Health between January 1977 and June 1983 are reviewed. There was a positive history of asbestos exposure in 89% of cases. The mean survival time from diagnosis to death was 8,6 months and from the onset of symptoms to death 13,6 months. Survival time was unaffected by stage of the tumour, treatment, histological features, smoking status, presenting symptoms, presence or absence of effusion and asbestosis, side of the lesion, source of exposure and lag period from first exposure to diagnosis. The duration of survival was significantly affected by age at diagnosis, duration of asbestos exposure and the number, rather than the type, of treatment regimens used. Caution is advocated in interpreting these data since the number of cases was small and the study design was retrospective. A reference group of 546 cases notified over the same period was drawn from the records of the South African Asbestos Tumour Reference Panel. The incompleteness of national mesothelioma incidence data was noted, and an incidence figure of 7,2 per million per year was calculated from the best-available data for South Africa. This figure is an underestimate because not all diagnosed cases are reflected and, more important, significant numbers of cases are never diagnosed. The extent to which the compensation machinery functions is mentioned.

Adult↗
PubMed1983

[Treatment possibilities and treatment results in pneumoconioses].

Some types of pneumoconiosis, such as asbestosis, are characterized by marked restrictive functional patterns. Treatment is begun when definite arterial hypoxemia appears, since the inhalation of oxygen clearly lowers pulmonary artery pressure. It is also important that the onset of concomitant airway obstruction is recognized promptly. From the sociomedical standpoint the most significant pneumoconiosis continues to be the miner's anthracosilicosis. The functional pattern of this pneumoconiosis is clearly airway obstruction, and such anthracosilicotic airway obstruction responds like all other forms of airway obstruction to antiobstructive therapy. The fundamentals of this therapy, which is based on the use of bronchodilators, adrenal cortical hormones and antibiotics, are described.

Airway Obstruction↗
PubMed1983

[Diagnostic problems in rare types of pneumoconiosis].

The problems encountered in diagnosing the rare types of pneumoconiosis ( silicatosis other than asbestosis, aluminosis and hard metals fibrosis), result from the difficulties in realising a good occupational anamnese and from the disease pattern by itself. The classical examinations, (X-rays of the thorax and lung function measurements), are not able to detect the cause of these diseases, which are fundamentally characterised by an absence of specificity. These last years, new methods of diagnoses (angiotensin converting enzyme, gallium scan, transbronchial biopsies, mineralogical, cytological and histological examinations of the lung tissues and of the bronchial alveolar lavage) were developed and progressively introduced in the daily practice in pneumology. Only the examination of lung biopsies and of the products of bronchial alveolar lavage, in particular the mineralogical examinations, may usefully orientate the diagnosis. The bronchial alveolar lavage has the advantage of an easy repetition and of a small invasive character. Moreover this technique is of a rather low financial cost. However the results of these examinations must be interpreted with the greatest caution, in function of the complete medical and occupational data. The experience following more than 500 BAL shows that the discovery of talc and kaolin is very significant for an exposition since these minerals were never observed among not exposed subjects. The evidence of these minerals argues also for the diagnosis of talcosis or kaolinosis if there are radiological lesions that are compatible with these diseases. On the other hand a recent study suggests that the identification of multinuclear macrophages and of tungsten and/of tantalum in the bronchial alveolar lavage is pathognomonic of the pathology of the hard metals.

Adult↗
PubMed1983

Urinary excretion of modified nucleosides in patients with malignant mesothelioma.

Transfer RNA is the most complex biomacromolecule in both structure and function. The complexity of its structure is caused by a large variety of enzymes which add modifying groups to the four bases after the primary synthesis. The most abundant of these enzymes are the transfer RNA methylases, which add methyl groups at various positions in the macromolecule. These methylating enzymes were found to be, without exception, aberrantly hyperactive in every malignant tumor examined. In turn, every malignant tumor contains a few transfer RNAs that are different in structure from the transfer RNAs in the normal tissue. Again, there is no exception. These are the first qualitatively different biochemical components of every malignant cell, not more or less but different transfer RNAs. The late Alexander Gutman observed that cancer patients excrete in their urine elevated levels of certain methylated bases. From the structure of these bases and our knowledge of their method of synthesis, it became apparent that most of them come from the breakdown of transfer RNA. Their elevation in the urine stems from an extraordinarily high rate of turnover of transfer RNAs in tumor tissue. Highly sophisticated, sensitive methods of analysis were developed for the determination of the modified nucleosides in the urine of cancer patients. When related to the creatinine level of the urine, some of the modified nucleosides and products derived from them were elevated in a large variety of tumors. Perhaps more importantly, it was found that these elevated levels return to normal after effective chemotherapy. Thus, these markers may also be useful in monitoring the effectiveness of therapy. We report here initial studies on the detection of cancer in asbestos workers and possible premalignant conditions in workers with asbestosis.

Adult↗
PubMed1983

Lung tumor-associated antigens: thin layer immunoassay.

Six hundred eighty-four rapid, sensitive thin layer immunoassays (TLI) were performed using an adapted visualization of condensation on plastic surface (VCS) method, for testing squamous cell and adenocarcinoma monospecific (TAA) and monoclonal antibody derived lung tumor-associated antigens (TAA epitopes) against small amounts of coded human test sera. The TAA epitopes selected for VCS-TLI were more specific, but both forms of TAA gave positive tests in 94% of lung cancer test sera of the appropriate histological types. The four antigens (adeno TAA and TAA epitope, squamous TAA and TAA epitope) did not react in VCS-TLI with coded sera from preselected normal individuals with known medical histories. With both TAA epitopes, 5% of non-lung cancer test sera were positive. There were indications that such tests may be useful in aiding pathological evaluations and in detecting precancerous conditions in patients with asbestosis. Cross-reacting (with other non-lung cancers) and specific peptide sequences of TAA were indicated in the comparative tests with the corresponding TAA epitopes, suggesting the tests for probing and analyzing portions of the antigens. Of immediate use is VCS-TLI for monitoring patients on specific active TAA immunotherapy.

Adult↗
PubMed1982

Proportional analysis of respiratory cells obtained by bronchoalveolar lavage.

Bronchoalveolar lavage was performed during fibreoptic bronchoscopy in 17 patients with biopsy-proven interstitial lung disease and in 12 control subjects who had focal lesions in the lung. The volume of fluid recovered was unrelated to disease activity or diagnosis. In the control subjects alveolar macrophages represented over 95% of the lavaged cells. The proportion of lymphocytes in the lavaged cells enabled a natural division of the diffuse interstitial lung diseases into two categories: active sarcoidosis, indicated by a large proportion of lymphocytes but a normal proportion of polymorphonuclear leukocytes; and idiopathic pulmonary fibrosis and asbestosis, indicated by a normal proportion of lymphocytes but a variable proportion of polymorphonuclear leukocytes. Bronchoalveolar lavage is a safe and well tolerated method for evaluating the role of alveolitis in diffuse interstitial lung disease through the sampling of respiratory alveolar cells.

Adult↗