Acute effects of hypertonic saline inhalation on nitric oxide pulmonary diffusing capacity in healthy adults.

We investigated acute effects of inhalation of hypertonic saline solution (HSS) and oxygen (O2, control exposure) on pulmonary diffusing capacity for nitric oxide (DLNO) and carbon monoxide (DLCO). In a randomized crossover study, 20 healthy, non-smoking subjects were allocated to short-term inhalation of HSS or O2. Spirometry [(forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC)] and combined single-breath DLNO-DLCO measurements were performed before and immediately after inhalation of either HSS or O2. Percent changes were presented as median values (interquartile range). After HSS inhalation, DLNO, FEV1 and FVC were decreased by -3.0% (-7.3, 0.5), -3.1% (-4.2, -1.6) and -1.2% (-3.3, 0.6), respectively (all P < 0.05), without significant effect on DLCO. No changes in spirometry and diffusing capacity were observed following O2 inhalation. Acute inhalation of HSS causes a slight decrease in membrane conductance, probably as a result of fluid imbalance at the alveolar surface and interstitial fluid accumulation, both of which could impair gas exchange.

Health effects of laser printer emissions: a controlled exposure study.

Ultrafine particles emitted from laser printers are suspected to elicit adverse health effects. We performed 75-minute exposures to emissions of laser printing devices (LPDs) in a standardized, randomized, cross-over manner in 23 healthy subjects, 14 mild, stable asthmatics, and 15 persons reporting symptoms associated with LPD emissions. Low-level exposures (LLE) ranged at the particle background (3000 cm-3 ) and high-level exposures (HLE) at 100 000 cm-3 . Examinations before and after exposures included spirometry, body plethysmography, transfer factors for CO and NO (TLCO, TLNO), bronchial and alveolar NO, cytokines in serum and nasal secretions (IL-1ß, IL-5, IL-6, IL-8, GM-CSF, IFNγ, TNFα), serum ECP, and IgE. Across all participants, no statistically significant changes occurred for lung mechanics and NO. There was a decrease in volume-related TLNO that was more pronounced in HLE, but the difference to LLE was not significant. ECP and IgE increased in the same way after exposures. Nasal IL-6 showed a higher increase after LLE. There was no coherent pattern regarding the responses in the participant subgroups or single sets of variables. In conclusion, the experimental acute responses to short but very high-level LPD exposures were small and did not indicate clinically relevant effects compared to low particle number concentrations.

Biological effects of inhaled nitrogen dioxide in healthy human subjects.

PURPOSE: Several epidemiological studies indicate that inhaled nitrogen dioxide (NO2) at low concentrations have been statistically associated with adverse health effects. However, these results are not reflected by exposure studies in humans. The aim of the study was to assess the acute functional and cellular responses to different NO2 concentrations in healthy human subjects with various techniques. METHODS: Twenty-five subjects were exposed for 3 h to NO2 concentrations 0, 0.1, 0.5, and 1.5 ppm in a randomized crossover study design during 4 consecutive weeks. In each subject, lung function, diffusion capacity and exhaled nitric oxide were measured and inflammation markers were assessed in blood, nasal secretions, induced sputum and exhaled breath condensate. RESULTS: From all lung function indices under consideration, only intrathoracic gas volume was borderline significantly increased after 0.5 ppm (p = 0.048) compared to 0.1 ppm NO2. Regarding the cellular effect parameters, the macrophage concentration in induced sputum decreased with increasing NO2 concentration, although these changes were only borderline significant (p = 0.05). CONCLUSION: These results do not suggest a considerable acute adverse response in human subjects after 3 h of exposure to NO2 in the NO2 concentration range investigated in this study.

Heart rate variability, hemostatic and acute inflammatory blood parameters in healthy adults after short-term exposure to welding fume.

The present study aimed to investigate, whether short-term experimental exposure to high levels of welding fumes would be capable of exerting acute effects in healthy subjects. Specifically, we assessed cardiovascular function in terms of heart rate variability (HRV) as well as the concentrations of inflammatory mediators and hemostatic proteins in blood as outcome measures. Twenty subjects without a history of airway and cardiovascular diseases were exposed to either control air or welding fume for 1 h on 2 separate days under standardized conditions. The median concentration of the alveolar particle fraction during welding was 3.5 mg/m(3 )(quartiles: 1.4-6.3 mg/m(3); range 1.0-25.3 mg/m(3)). Five hours later a panel of clinical assessments was performed, including HRV measurement and drawing of blood samples. There were no changes in symptom ratings or lung function after welding fume exposure. Exposures did also not differ regarding effects on time- and frequency-domain parameters of HRV. Similarly, blood leukocyte numbers, cell differentials and the blood levels of fibrinogen, C-reactive protein, antithrombin III, factor VIII, von Willebrand factor, ristocetin cofactor, sICAM-1, tumor necrosis factor alpha, interleukin 6, interleukin 8 and epithelial neutrophil activating peptide 78 were not altered by welding fume inhalation. However, there was a significant fall in the level of endothelin-1 (P < 0.01). In conclusion, the data did not indicate effects of clinical significance of a short-term high-level exposure to welding fumes on HRV or a set of blood hemostatic and acute inflammatory parameters in healthy subjects. The small but statistically significant effect on endothelin levels demonstrated that measurable effects could be elicited even in these individuals. Overall, welding fumes are not likely to exert acute cardiovascular effects in healthy individuals.

Lithium/aluminium alloys. A problem material for biological monitoring.

Investigations on aqueous and nonaqueous media have shown that the dust particles of lithium/aluminium alloy are readily soluble in blood serum. Concentration of 10 mg A1 and 3 mg Li in 1 l serum constitute the saturation values in human blood serum at 20 degrees C. Further observations are intended to clarify the danger at the workplace. With a short-term exposure, the change in concentration of Li and Al was followed in the working environment and in the staff. Both elements (Li and Al) were determined in the working air, in the urine, the blood serum and on human skin with electrothermal AAS. On human skin, microerosions arise owing to hydrolytic destruction of the epidermis after long-term contact. The intensive irritant action of Li/Al dust is most relevant for preventive measures. It must also be considered that the Al values in the blood serum are raised by up to 50% in the presence of Li. The resorption and/or the bioavailability of Al is altered by Li. In the presence of Li up to a Li content of 2.5% in Al dust, a MAK (biological tolerance value, threshold limit value) of 1 mg Al/m3 room air (for the total dust) is recommended.

[Megakaryocytic myelosis: clinical and morphological features (author's transl)]. / Megakaryozytäre Myelose Klinik und Morphologie

In general, megakaryocytic myelosis is nowadays considered to be a separate disease entity, one of the myeloproliferative syndromes. Morphologically there are localised or diffuse proliferations of usually large pleomorphic megakaryocytes and immature atypical megakaryocytes up to megakaryoblasts in the bone marrow, in the sense of a haemoblastosis. In the course of the disease megakaryocytic splenomegaly develops. A sarcomatous form (megakaryoblastoma, megakaryo-sarcoma) is rare. Megakaryocytic myelosis may arise from chronic meyloid leukaemia or polycythaemia vera, rarely as a transitional stage to an acute myeloblastic leukaemia or megakaryoblastic leukemia in the sense of a blast crisis. The mature form of the disease, which has an age peak at 59 years and is not sex-linked, often takes a course over years with increasing splenomegaly, anaemia, moderate leucocytosis and usually marked thrombocytosis (average value of 720 X 10(9)/1). Life threatening complications are haemorrhages, thromboembolism and increased frequency of infections due to antibody deficiency in the advanced stage.

[Megakaryocytic myelosis--cause of "idiopathic" thrombocythemia]. / Megakaryozytäre Myelose--Ursache der "idiopathischen" Thrombozythämie

Primary thrombocythaemia is to be distinguished from the secondary type by higher counts of megakaryocytes especially of atypic and gigantic forms of these cells, showing up in adequate histological preparations of bone marrow biopsies. From the analysis of those preparations the autonomous proliferation of the megakaryocytopoiesis clearly is to be understood as the reason of the socalled primary thrombocythaemia, occurring in the forms of isolated or mixtcellular megakaryocytic myelosis of the well differentiated type. Both of these forms can convert into thrombocytopenia when atypical and immature megakaryocytes start to overcrowd the picture or when myelofibrosis develops. The latter is to be considered in causal connections with the ineffective dislocated thrombopoiesis, a common finding among megakary-ocytic myelosis complicated with myelofibrosis. Megakaryocytic myelosis therefore is the clue of three different clinical syndromes, which are alternatively marked by the haemostaseologic or the histologic consequences of the overproduction of platelets, or by the proliferation of the megakaryocytes themselves.

[Histological examinations of late changes of bone marrow and bone following local fractionated gamma irradiation in patients with genital carcinoma (author's transl)]. / Histologische Spätveränderungen von Knochemark und Knochen nach fraktionierter Gamma-Bestrahlung bei Patientinnen mit Genitalcarcinom

In 25 patients iliac crest biopsies have been taken after radiation therapy of genital carcinoma. The radiation doses in the biopsied region ranged up to about 3,000 rads. The time interval from the end of radiation until the control biopsy was 2 months or longer, up to 25 years. The immediate consequences of the radiation, compared with the pretherapeutic picture, have been analyzed in an earlier study (Beil et al., 1974). By histomorphotometric analysis of the samples it can be shown that a more or less severe atrophy of the bone marrow is persisting in the irradiated area for years. The atrophy is accompanied either by normal or increased bony trabecularization, together with increased osteoblastic and -clastic activity. These disturbances are likely to depend of a chronic distortion of the marrow capillarization, which may be influenced by the individual RES activity; different types of the reticuloendothelial response can be demonstrated in our material. Whether this response has a bearing regarding the prognosis of the tumours condition itself remains a matter of speculation, to be proved by further investigations.

[Haematological and immunological findings in bone marrow aplasia (author's transl)]. / Hämatologische und immunologische Befunde bei Knochenmarkaplasie

The cellularity of the bone marrow, the number of blood cells and the immunoglobulins were investigated in 51 patients suffering from bone marrow aplasia. In this disease not only is a haematopoietic organ disturbed, but disorders of the lymphocyte and of the monocyte-systems can be detected too: the majority of patients show lymphocytopenia and monocytopenia. Immunologic reactions seem to be involved in the pathogenesis of bone marrow aplasia. The plasma cells of the bone marrow are elevated in nearly all of the patients, lymphocytes in every second case. One or several fractions of immunoglobulins are increased in about 50% and diminished in 25% of the patients.