Pulmonary function and respiratory symptoms of Portland cement workers in southern Taiwan

In Australia, planning to give birth at home was unusual in the middle to late 1980s, a choice made by only about 0.5 percent of women. This study investigated the personal beliefs and circumstances of 552 women who planned to give birth at home. Results showed that these women came from diverse backgrounds and beliefs, although in general they were of higher than average educational and occupational status, and less likely to hold Christian beliefs relative to the Australian community in general. Their lives and experiences reflected both unconventional and more traditional choices, and the view that women who give birth at home characteristically belong to the counterculture could not be justified. The findings of this study suggest that stereotypes of women who give birth at home do not apply to the circumstances of substantial numbers of women.     

Pulmonary manifestations in cerebrotendinous xanthomatosis

We investigated five cases with cerebrotendinous xanthomatosis (CTX) with particular reference to biochemical and pathological pulmonary disorders. To date, few reports discuss the pathophysiology of pulmonary disorders of CTX patients. This study is the first investigation of such pulmonary disorders. All 5 patients had no pulmonary symptoms and no disturbances on radiological studies and pulmonary function tests. However, in bronchoalveolar lavage (BAL) fluids, many cells with cruciform reflexes, which is characteristic of intracellular sterol accumulation, were found under phase contrast microscopy. Biochemically, cholestanol was found to be increased in the BAL fluid as well as in serum. Pathological findings of transbronchial lung biopsy (TBLB) samples disclosed foamy macrophages and small granulomas in alveolar septa. In conclusion, the lung was apparently involved in CTX, and the lesions were characterized with the accumulation of foamy and giant cells with a high concentration of cholestanol, which likely results in the formation of foreign body granulomas.     

Pulmonary function in perlite workers

Pulmonary function was studied in 117 men employed in three plants engaged in the mining and processing of perlite. Of these, 38 had been employed for ten years or more; 18 for 15 years or more and four men for 20 years or more. Review of chest films confirmed previous studies which showed no changes indicative of pneumoconiosis. Measurement of forced vital capacity (FVC) by Jones Pulmonor and by Collins 9-liter spirometer did not show reductions correlated with length of exposure, after effects of cigarette smoking had been taken into account. There was instead a slight increase in FVC associated with years in the perlite industry. The distribution of individuals with FVC below 80% of predicted also showed no association with duration of perlite exposure. Although there were slight reductions in forced expiratory volume in one second (FEV1) and in FEV1/FVC% which were associated with years in the perlite industry and which could not be explained by cigarette smoking, these reductions were not statistically significant. In summary, the population of men available for study in the major perlite-producing area of the United States, who have worked for periods up to 23 years, showed no evidence of pneumoconiosis by chest radiography or by measurement of forced vital capacity. Nevertheless, continued control of dust to ensure exposures below nuisance dust levels is essential. Medical surveillance should also continue with records being retained for periodic reevaluation.     

Pulmonary manifestations of rheumatoid arthritis

Rheumatoid arthritis (RA) is the most common of the classic connective tissue diseases. Its manifestations in the chest are varied as the pleura, lung parenchyma, airways, and pulmonary vasculature can all be involved. The approach to a patient with RA and respiratory complaints, radiographic findings, or physiologic abnormalities requires a broad understanding of these manifestations. Moreover, the potential for therapy-related toxicity adds further complexity to the pulmonary evaluation of these patients.     

Pulmonary manifestations of systemic lupus erythematosus

Systemic lupus erythematosus (SLE) is an autoimmune disease that primarily affects young women. The respiratory system is more commonly involved in SLE than in any other collagen vascular disease. SLE may affect virtually all components of the respiratory system, including the upper airway, lung parenchyma, pulmonary vasculature, pleura, and respiratory muscles. Respiratory system involvement ranges from symptomatic to fulminant and life threatening. This article reviews the pulmonary manifestations of SLE, including drug-induced SLE.     

Pulmonary manifestations of Sj?gren''s syndrome

The viro-static drugs IDU and tromantadin were tested in view of their influence on epithelial regeneration. IDU slows down the speed of epithelisation only slightly, and produces no irreversible damage in the corneal stroma, Descemet's membrane and endothelium of the rabbit eye. Tromantadin, however, slows down the speed of epithelisation quite a lot, even if the dosis is relatively small. We also found substantial changes in corneal stroma and Descemet's membrane, which have been partly recognized histologically as fibrous tissue. Application of these medicaments is recommended only if the relation between side effects and viro-static potency has been carefully rated.     

Pulmonary manifestations of Sj?gren's syndrome

Sj?gren's syndrome is one of the most common systemic rheumatic diseases. Pulmonary disease is prevalent in Sj?gren's syndrome; respiratory manifestations include chronic cough, obstructive airways disease, pulmonary lymphoma, and interstitial lung disease that may progress to severe pulmonary fibrosis.     

Pulmonary changes as primary manifestations in Waldenstr?m macroglobulinemia]

We describe a patient with a 19-year history of lymphocytic lung infiltrations. A diagnosis of lymphocytic interstitial pneumonitis was made in 1982 after an open lung biopsy, but in 1995 a comprehensive re-evaluation led to the diagnosis of Waldenstr?m's macroglobulinaemia with primary bronchopulmonary involvement. It could also be demonstrated by polymerase chain reaction and immunological techniques that this disease had been present since before 1982. In 1995 it was still difficult to demonstrate bone marrow involvement, even with new and sensitive methods. We discuss some diagnostic problems of organ manifestations of uncommon systemic diseases. Pulmonary manifestations of Waldenstr?m's macroglobulinaemia or other diseases of the immune system should be considered in patients with atypical lung disorders.     

Pulmonary manifestations in adult T-cell leukemia at the time of diagnosis

The results of clinical use of an extracorporeal shock wave lithotripter (Biolithos MARK III) are presented. From May 1991 through February 1992, a total of 50 sessions were carried out on 33 patients with upper urinary tract stones. Treatments were performed on an outpatient basis, and none of the patients needed anesthesia or analgesia. One month after the last session, 18 patients (54.5%) were free from stone fragments and 6 (18.2%) had stone fragments equal to or smaller than 4 mm. The over-all successful rate obtained by these categories was 72.7%. After treatment no serious complications were observed. Although gross hematuria appeared in almost all patients, pain was noted in only 5 patients. Laboratory data after treatments showed slight and transient changes. It is concluded that Biolithos MARK III is useful and safe in the management of upper urinary tract stones on an outpatient basis.     

Epidemiology of chronic, precancerous and oncologic diseases in workers of asbestos and cement industry

Hygienic, clinical and epidemiologic screening was performed in staff of asbestos and cement goods production enterprise. Various dystrophic processes of pharynx and nasal cavity appeared to prevail among upper respiratory tract diseases. Average exposure to dust during 22 years at the stated production can lead to asbestosis 0-I stage, average exposure during 20.5 years can result in dust bronchitis and occupational allergic dermatosis can result from average exposure to dust during 21 years. Retrospective cohort study of mortality within 1949-1988 failed to find oncologic risk in workers engaged into asbestos and cement goods production higher than in general population.     

Pulmonary cytopathology of former asbestos workers. Report of the first year

Five hundred fifty-four workers, 84% of whom are chronic cigarette smokers, have been examined during the past year with emphasis on the role of sputum cytopathology in the early detection and diagnosis of lung cancer. Of the 554, 232 (42%) have shown squamous metaplasia, 44 (8%), mild to moderate atypias, 18 (3.2%), severe atypias, and two (0.4%), squamous carcinoma. Both of the carcinomas were in x-ray negative, cytopathology-positive elderly cigarette smokers. Ferruginous bodies have been found in the sputa of 187 (33%) workers. Ferruginous bodies in the sputum do not appear to be a marker for severe atypias; rather, their presence correlates best with duration and extent of industrial exposure to asbestos.     

Pulmonary parenchymal manifestations surrounding small peripheral masses: pathologic correlation with chest radiographs and diagnostic value

The corrosion of aluminium (Al) in several brands of soft drinks (cola- and citrate-based drinks) has been studied, using an electrochemical method, namely potentiodynamic polarization. The results show that the corrosion of Al in soft drinks is a very slow, time-dependent and complex process, strongly influenced by the passivation, complexation and adsorption processes. The corrosion of Al in these drinks occurs principally due to the presence of acids: citric acid in citrate-based drinks and orthophosphoric acid in cola-based drinks. The corrosion rate of Al rose with an increase in the acidity of soft drinks, i.e. with increase of the content of total acids. The corrosion rates are much higher in the cola-based drinks than those in citrate-based drinks, due to the facts that: (1) orthophosphoric acid is more corrosive to Al than is citric acid, (2) a quite different passive oxide layer (with different properties) is formed on Al, depending on whether the drink is cola or citrate based. The method of potentiodynamic polarization was shown as being very suitable for the study of corrosion of Al in soft drinks, especially if it is combined with some non-electrochemical method, e.g. graphite furnace atomic absorption spectrometry (GFAAS).     

AIDS manifestations in otorhinolaryngology

The otorhinolaryngological signs of AIDS are reviewed (both analysis and synthesis) following the chronological order of the literature. The earliest clinical pictures, their frequency and time of onset, are described by the authors studied. In 1986 the ENT signs of this disease were well known, and in our region the same multiple, polyfacetic aspects are seen. Personal experience of this is described, emphasizing how seldom the diagnosis has been made, except early on. Usually the cases seen and diagnosed by the Department of Infectious Diseases were referred for specialist opinion. The commonest findings were, amongst the opportunist infections: oropharyngeal and oesophageal candidiasis, and tuberculous adenopathies. Classical ENT pathology was represented by sinusitis and to a lesser extent by otitis and tonsillitis. The tumours seen were non-Hodgkin lymphomas, but no Hodgkin's or Burkitt's lymphomas. There was an unusual case of 'high grade centroblastic lymphoma', localized to the tonsil and presenting as necrotic tonsillitis and peritonsillar abscess. Recently a patient with a large pharyngeal tumour (still being investigated) has been provisionally diagnosed as having a cavernous angioma. Both these patients were diagnosed by us, since we saw the first sign of the disease. We have seen few Kaposi's sarcomas, since cutaneous and oral lesions are not usually referred to us.     

Renal manifestations in sarcoidosis

Clinically distinct renal disease is said to be rare in sarcoidosis, but autopsy reveals an incidence of renal involvement is 23 or 26% in Japanese studies. There are three categories of renal disease in sarcoidosis: 1) renal changes by abnormal calcium metabolism, 2) interstitial nephritis or granulomatous nephritis and 3) glomerulonephritis. Some investigators add renal angiitis to the three categories. In some patients without clinical renal disorders, renal involvement is discovered by chance at the time of autopsy or renal biopsy. Renal disease may develop during the course of sarcoidosis, preceding the diagnosis of sarcoidosis, or may be found simultaneously with extrarenal involvements at the time of diagnosis. Renal involvement should always be considered for exact diagnosis and appropriate treatment.     

Perspectives on neurosurgical practice: neurosurgery in Jordan

Neurosurgery as a specialty medical field is new in Jordan. This article documents the history, current status, and projected future of neurosurgery in Jordan. Resident training is also highlighted, and challenges for the future of the profession are presented.     

Viral gastroenteritis among young children in northern Jordan

Perforating and penetrating globe injuries secondary to peribulbar and retrobulbar anaesthesia are often complicated by vitreous haemorrhage and retinal detachment. We describe the effectiveness of primary silicone oil tamponade in the repair of three perforated globes secondary to local anaesthesia for ophthalmic surgery. Three patients with axial myopia had peribulbar and retrobulbar anaesthesia for extracapsular cataract extraction (two patients) and cryotherapy (one patient). All eyes sustained a vitreous haemorrhage obscuring the view to the fundus. Retinal detachments were detected by B-scan ultrasound. In all eyes, scleral buckling, pars plana vitrectomy and silicone oil tamponade were performed as a primary surgical procedure. All the patients had complete anatomic reposition. In two patients, after two years follow-up, visual acuity was between 6/12 to 6/36 with the retina attached and no proliferative vitreoretinopathy (PVR). The third patient had blind painful eye and enucleation was performed. Primary use of silicone oil tamponade, in the management of perforated globe with retinal detachment due to local anaesthesia injection, is recommended.     

Epidemiology of primary cutaneous malignant melanoma in Jordan

Juvenile xanthogranuloma of parotid gland is reported in a 9-year-old boy. This kind of tumor is thought to be very rare in salivary glands. Histological, immunohistochemical and ultrastructural data showed characteristic features and excluded a Langerhans cell histiocytosis. Follow-up was uneventful after 18 months.