A cohort study of toner-handling workers on inflammatory, allergic, and oxidative stress markers: cross-sectional and longitudinal analyses from 2003 to 2008.

OBJECTIVES: This study examines the relationship between toner exposure and its health effects in terms of biomarkers which are known to assess the damages to humans caused by toxic material exposure. METHODS: The subjects were 1504 male workers aged below 50 in 2003 in a Japanese toner and photocopier manufacturing company. Personal exposure measurements, pulmonary function tests, chest X-ray examinations, biomarker measurement, and a questionnaire about respiratory symptoms were conducted. We will report about biomarker measurement in this study. Cross-sectional survey studies and a longitudinal study from 2003 to 2008 were conducted. RESULTS: Few significant findings were associated with the toner exposure in both the cross-sectional and the longitudinal studies. The higher toner exposure concentrations did not induce effects on increasing biomarkers. CONCLUSION: There was no evidence of excessive inflammatory, allergic, or oxidative stress reaction in toner-handling workers as compared to non-handling workers, despite some sporadically significant findings. There are no other reports of a longitudinal epidemiological study with regard to toner exposure; this report significantly contributes to toner exposure literature. Although in the current well-controlled working environment, the toner exposure concentrations are quite low; further studies are needed to completely understand the health effects toner may have, however small they may be.

A cohort study using pulmonary function tests and x-ray examination in toner-handling workers: cross-sectional and longitudinal analyses from 2003 to 2008.

OBJECTIVES: This study uses pulmonary function tests and chest x-ray examinations to examine the relationship between toner-handling work and its health effects. METHODS: The subjects were 1504 male workers in a Japanese toner and photocopier manufacturing company, in the age range from 19 to 50 years in 2003. Personal exposure measurements, pulmonary function tests, chest x-ray examinations, biomarker measurements, and a questionnaire about respiratory symptoms were conducted. The present study reports the results of pulmonary function tests and chest x-ray examinations conducted in the subjects, which includes a cross-sectional study on the toner handling and non-handling workers and a longitudinal study from 2003 to 2008. RESULTS: Few significant findings were suspected to be caused by toner exposure found in pulmonary function indices in both the cross-sectional and longitudinal studies. Any obvious fibrotic findings in chest x-ray findings related to the toner exposure could not be found out. CONCLUSION: No evidence of adverse effects on pulmonary function indices and chest x-rays was present in the toner-handling workers as compared to the nonspecifically exposed workers. Although the toner exposure concentration is quite low in the current well-controlled working environment, even among the toner-handling workers, we would like to continue this study in the future to verify the toner exposure health effects.

Alterations in electrical and mechanical activity in Langendorff-perfused guinea pig hearts exposed to decreased external sodium concentration with or without hypotonic insult.

In order to examine electrical and mechanical effects of hyponatremia and hypotonicity, relevant to those in patients with 'water intoxication' syndrome, Langendorff-perfused guinea pig hearts were exposed to reduced NaCl concentrations (hypotonic [NaCl](0)-reduction) under the monitoring of left ventricular developed pressure (LVDP) and epicardial ECG. In some hearts, hyponatremia (from 140 to 80 mEq/l) was compensated for by adding mannitol to maintain osmolarity at a constant level (isotonic [NaCl](0)-reduction) or tetraethylammonium chloride to maintain both osmolarity and chloride concentrations at a constant level (isotonic [Na(+)](0)-reduction). Progressive isotonic [NaCl](0)-reduction increased LVDP, which was abolished in the presence of KB-R7943, a novel inhibitor of Na(+)/Ca(2+)-exchange. LVDP was reduced in hypotonic [NaCl](0)-reduction in which myocardial water content was increased. PQ interval and QRS duration were prolonged with both hypotonic and isotonic [NaCl](0)-reduction and these changes tended to be more pronounced with hypotonic than with isotonic [NaCl](0)-reduction. Similar ECG changes were also evident with isotonic [Na(+)](0)-reduction. Gd(3+) (1-5 µM), a blocker of stretch-activated nonspecific cation channels, had no substantial effects on the electrical or mechanical changes seen with hypotonic [NaCl](0)-reduction. In conclusion, isotonic [NaCl](0)-reduction produced a positive inotropism by modulating Na(+)/Ca(2+)-exchange, whereas hypotonic [NaCl](0)-reduction led to negative inotropism, due in part to hypotonic myocardial swelling. In addition, [Na(+)](0)-reduction, irrespective of the concomitant [Cl(-)](0) or osmotic changes, depressed atrioventricular as well as intraventricular conduction.

Radiofrequency catheter ablation of idiopathic right ventricular tachycardia near the His bundle.

There are only a few reports on successful radiofrequency catheter ablation of idiopathic right ventricular tachycardia (VT) originating from other sites than right ventricular outflow tract. We report here a case of VT which exhibited an inferior-axis and a left bundle branch block pattern and originated near the His bundle. Using the temperature-controlled ablation catheter, prudent observation of the fluoroscopy and intracardiac electrograms during pacemapping, we successfully ablated the origin of the VT without any conduction disturbance. However, further study is required to determine the effectiveness of catheter ablation and the long term prognosis for this type of VT.

Electrical and mechanical abnormalities in the heart of a schizophrenic patient with hyponatremia derived from water intoxication.

Electrical and mechanical abnormalities were studied in the heart of a schizophrenic male patient with severe hyponatremia and concomitant low plasma osmolarity induced by excessive water intake (so-called "water intoxication syndrome") by recording electrocardiography and echocardiography. There was a significant positive correlation between the plasma osmolarity and serum sodium concentration. The QRS duration of electrocardiography, an index of the ventricular electrical conduction velocity, tended to be prolonged and the left ventricular ejection fraction calculated by echocardiography decreased in proportion to the reduction of the serum sodium concentration. Lowering extracellular sodium concentration theoretically slows electrical conduction velocity, and was observed in this patient. On the other hand, low external sodium concentration should increase cardiac contractility via suppression of the forward mode operation of the sodium-calcium exchange mechanism, thereby increasing the intracellular free calcium concentration. However, this was not the case in our patient, because ejection fraction was not increased but rather significantly decreased with the lowering of serum sodium concentration. We speculate that in patients with water intoxication, the negative inotropism of the heart caused by low plasma osmolarity prevails over the positive inotropism caused by low serum sodium concentration.

Radiofrequency catheter ablation of left ventricular outflow tract tachycardia: report of two cases.

Idiopathic ventricular tachycardia (VT) originating from the left ventricular outflow tract (LVOT) is rare. We report two patients whose QRS configuration during VT commonly showed an inferior axis and monophasic R waves in all the precordial leads. The mechanism of these VTs appeared to be triggered activity. From mapping and ablation, the origin of these VTs was determined to be in the most posterior LVOT, corresponding to the aortomitral continuity (left fibrous trigone).

[Primary cutaneous lymphoma--mycosis fungoides].

Malignant lymphoma of the skin is a type of extranodal lymphoma with a benign prognosis, in which the main organ involved is the skin. Some 80-90% of the cases in Japan show a T-cell phenotype. Mycosis fungoides and Sézary syndrome are common T-cell lymphomas of the skin. The tumor cells of mycosis fungoides, small and medium-sized cells with cerebriform nuclei, are detected in an epidermo-dermo junction. The tumor cells show CD3, CD4 and CLA, (cutaneous lymphocyte associated antigen) positivity. Various forms of topical therapy, such as topical steroid, photochemotherapy (PUVA), and interferons, have been indicated for the good-risk group (stages I A, I B and II A). Electron-beam irradiation, various chemotherapy, such as low-dose etoposide, low-dose MTX and CPT-11 and deoxy coformycin (DCF) plus IFNs, have been indicated for intermediate-risk group (stage II B, III and IV A). BRMs plus low-dose etoposide, electron-beam irradiation and a multiagent combination chemotherapy, such as MACOP-B, M-BACOD or ProMACE-CytaBOM, have been indicated for the high-risk group (stages IV A and IV B). Cutaneous B cell lymphoma (CBCL) can be diagnosed using a molecular biological assay. The tumor cells of CBCL do not express T-cell antigens such as CD2, CD3 and CD43 and show B-cell antigens such as sIg, CD19, CD20 and CD22. Electron-beam irradiation has been indicated for early-stage CBCL (stages I and II). An effective multiagent combination chemotherapy, such as MACOP-B, M-BACOD or ProMACE-CytaBOM, is required for patients with advanced stage CBCL (stages III and IV).

[Factors predictive of early mortality after acute myocardial infarction].

OBJECTIVES: (1) To define the clinical and laboratory findings predictive of early mortality after myocardial infarction (AMI), 100 consecutive patients were studied. (2) To elucidate the serum potassium (K) concentration and its clinical significance after AMI, 38 patients were studied. RESULTS: (1) The 30-day mortality was greater for women than for men, for patients with diabetes mellitus than for those without, and for patients with previous MI than for those without. Clinical and laboratory findings predictive of early mortality were cardiogenic shock, congestive heart failure, perforation or rupture of the ventricle, and presence of bundle branch block and extensive anterior AMI on electrocardiogram. The presence of bradyarrhythmia, ventricular tachyarrhythmias, and high blood levels of peak creatinine phosphokinase (CPK) or myosin or atrial natriuretic peptide (ANP) were not independent predictors of early mortality. Patients complicated with congestive heart failure showed higher levels of peak CPK and ANP and patients with cardiogenic shock showed higher levels of ANP. (2) Serum K concentration was lower on admission than the following days, and it showed a negative correlation with plasma epinephrine. The lower serum K was accompanied with more severe ventricular arrhythmias on 24-hour electrocardiogram. CONCLUSION: (1) Early mortality after AMI is related to left ventricular function rather than to arrhythmias. (2) Serum K is lower in the early phase of AMI and is related with plasma catecholamines and severe ventricular arrhythmias.