汞对大鼠周围神经影响的形态学研究

目的观察氯化汞(HgCl2)对胫神经的影响。方法SD大鼠30只,雌雄各半,体重160～200g。随机分为3组,每组10只。大剂量染汞组按17mg/kg(1/4 LD50);小剂量染汞组按8.5mg/kg(1/8 LD50),经口灌胃HgCl2溶液,每天1次。对照组经口灌胃生理盐水2ml/次,每天1次,三组均连续灌胃(20±2)d。染汞组制成亚急性汞中毒模型后,用二巯丙磺钠(DMPS)驱汞2个疗程(14d)。分别于驱汞前和驱汞后分批处死大鼠,取其胫神经并用透射电镜观察超微结构的变化。结果大剂量染汞组中有7只出现汞中毒,其中1只雄鼠出现疼痛表现。小剂量组中有6只出现汞中毒,均无疼痛表现。电镜放大4000至20000倍见:汞中毒大鼠胫神经出现脱髓鞘和轴索病变,DMPS驱汞2个疗程未能阻止周围神经病变。结论亚急性HgCl2中毒可导致SD大鼠胫神经损伤。     

汞中毒大鼠脊髓及背根神经节降钙素基因相关肽的表达

目的 观察氯化汞及药物对大鼠脊髓和背根神经节(DRG)降钙素基因相关肽(CGRP)的影响.方法 40只雄性SD大鼠分为7组.对照组(10只)经口灌胃生理盐水(NS)2 ml/次,每天1次;高Hg、高Hg+二巯丙磺钠注射液(DMPS)、高Hg+DMPS+卡马西平组(各5只)按17 mg/kg经口灌胃HgCl2溶液;低Hg、低Hg+DMPS、低Hg+NS组(各5只)按8.5mg/kg经口灌胃HgCl2溶液,每天1次.7组均连续灌胃18～22d.汞染毒组动物出现汞中毒症状后,处死高Hg和低Hg组大鼠和对照组5只大鼠.随后高Hg+DMPS和低Hg+DMPS组用DMPS按28 mg/kg腹腔注射驱汞2个疗程(驱汞3 d,休息4d为一疗程);高Hg+DMPS+卡马西平组用DMPS+卡马西平(按16.82mg/kg 经口灌胃,每天1次,共14d);低Hg+NS组腹腔注射NS 1 ml/次,方法同DMPS.实验结束后处死全部动物,灌注,固定,取出脊髓L5-6节及L5、L6两侧DRG并制成病理切片.用免疫组化SABC法测定DRG和脊髓CGRP表达水平.结果 汞染毒组大鼠DRG和脊髓CGRP平均灰度均显著低于对照组;阳性反应物平均面积均显著高于对照组(P＜0.05);高Hg+DMPS和低Hg+DMPS组用DMPS驱汞两疗程及低Hg+NS组腹腔注射NS两周期后均未见CGRP表达显著减弱,驱汞后,高Hg+DMPS+卡马西平组与高Hg+DMPS组比较,DRG和脊髓CGRP平均灰度显著提高,平均面积减少(P＜0.05).结论 亚急性HgCl2中毒大鼠DRG和脊髓CGRP表达显著增强,卡马西平联合DMPS能够有效抑制CGRP表达.     

氯化汞亚急性染毒对大鼠脊髓及脊神经节星形胶质细胞的影响

目的观察氯化汞(HgCl2)对大鼠脊髓及脊神经节星形胶质细胞的影响。方法SD大鼠30只,雌雄各半,体重160～200g。随机分为3组,每组10只。高、低剂量染汞组分别按17.0、8.5mg/kg经口灌胃HgCl2溶液,对照组经口灌胃生理氯化钠溶液2ml/次,均每天1次。3组连续灌胃(20±2)d。染汞组制成亚急性汞中毒模型后,各组均处死5只大鼠,留5只作药物干预实验。两组均用二巯丙磺钠(DMPS)注射液按28mg/kg腹腔注射驱汞2个疗程(驱汞3d,休4d为1个疗程),高剂量组加用己酮可可碱(POF,29.22mg/kg经口灌胃qd×14d)。实验结束后处死全部动物,灌注固定取出脊髓L5-6节及两侧L5、L6脊神经节,制成病理切片,用免疫组化SABC法测定脊髓和脊神经节胶质纤维酸性蛋白(GFAP)。结果高、低剂量染汞组脊髓及脊神经节GFAP平均灰度均显著低于对照组;阳性细胞率均显著高于对照组(P<0.05)。DMPS POF显著降低GFAP阳性细胞率,提高平均灰度值(P<0.05),单纯应用DMPS无此作用。结论亚急性HgCl中毒大鼠脊髓及脊神经节GFAP表达上调,DMPS联合POF可以显著抑制星形胶质细胞激活。     

HgCl2中毒大鼠脊髓胶质纤维酸性蛋白表达上调

目的 观察HgCl2对大鼠脊髓星形胶质细胞的影响.方法 SD大鼠30只,雌雄各半,体重160～200 g.随机分为3组,每组10只(5♀,5 ♂).①大剂量组,按17 mg/kg(1/4LD50)经口灌胃HgCl2溶液,每天1次.②小剂量组,按85 mg/kg(1/8LD50)经口灌胃HgCl2溶液,每天1次.③对照组,经口灌胃生理盐水2ml,每天1次.三组均连续灌胃(20±2)d,染汞组制成亚急性汞中毒模型后,各组均处死5只雄鼠,留5只雌鼠作药物干预实验.用二巯丙磺钠(DMPS)按28 mg/kg腹腔注射驱汞2疗程,在此基础上,大剂量组加用己酮可可碱(POF),小剂量组仅用DMPS.实验结束后处死全部动物,灌注固定取出脊髓L5-6节并制成病理切片.用免疫组化SABC法测定脊髓胶质纤维酸性蛋白(GFAP).结果 两染汞组GFAP平均灰度均显著低于对照组,阳性细胞率均显著高于对照组.DMPS+POF显著降低GFAP阳性细胞率,提高平均灰度值,单纯应用DMPS无此作用.结论 亚急性HgCl2中毒大鼠脊髓GFAP表达上调,POF能够有效抑制脊髓星形胶质细胞激活.     

汞中毒大鼠脊髓GFAP表达与药物干预研究

目的观察HgCl2对大鼠脊髓星形胶质细胞的影响。方法SD大鼠30只,雌雄各半,体重160~200 g。随机分为3组,每组10只。大剂量组按17 mg/kg（1/4 LD50）经口灌胃HgCl2溶液,1次/d。小剂量组按8.5 mg/kg（1/8 LD50）经口灌胃HgCl2溶液,1次/d。对照组经口灌胃生理盐水2 ml,1次/d,3组均连续灌胃（20±2）d。染汞组建成亚急性汞中毒模型后,各组均处死5只雄鼠,留5只雌鼠作药物干预试验。染汞组用二巯丙磺钠注射液（DMPS）按28 mg/kg腹腔注射驱汞2个疗程,小剂量组仅用DMPS,大剂量组在用DMPS的期间内,按29.22/（kg.d）经口灌胃己酮可可碱（POF）溶液14 d。实验结束后处死全部动物,灌注固定取出脊髓L5-6节并制成病理切片。用免疫组化链酶亲和素-生物素-过氧化物酶聚合物（SABC）法测定脊髓胶质纤维酸性蛋白（GFAP）。结果大、小剂量组GFAP平均灰度均显著低于对照组,阳性细胞率均显著高于对照组。DMPS＋POF显著降低GFAP阳性细胞率,提高平均灰度值,单纯应用DMPS无此作用。结论亚急性HgCl2中毒大鼠脊髓GFAP表达上调,POF能够有效抑制星形胶质细胞激活。     

亚急性汞中毒大鼠脊髓及背根神经节TNF-α表达与药物干预研究

目的观察亚急性汞中毒大鼠脊髓和背根神经节(DRG)肿瘤坏死因子-α(TNF-α)的表达。方法雄性SD大鼠40只,体重180～220g,分为7组;对照组(10只)经口灌胃生理盐水(NS),2ml/次,1次/d;A、B、C、D、E、F组(各5只)经口灌胃HgCl2溶液,1次/d。A、B、C组为17mg/kg,D、E、F组为8.5mg/kg。7组均连续灌胃18～22d。染汞组动物出现汞中毒症状后,处死A、D组和对照组各5只大鼠。随后B、E组用二巯丙磺钠注射液(DMPS)按28mg/kg腹腔注射驱汞2个疗程(驱汞3d,休息4d为1个疗程);C组用DMPS+己酮可可碱(按29.22mg/kg经口灌胃,1次/d,共14d);F组腹腔注射NS1ml/次,方法同DMPS。实验结束后处死全部动物,灌注固定后,取出脊髓L5-6节及L5、L6两侧DRG并制成病理切片。用免疫组化SABC法测定DRG和脊髓TNF-α表达水平。结果染毒组大鼠脊髓和DRG内TNF-α平均灰度均显著低于对照组;阳性反应物平均面积均显著高于对照组(P0.05);B、E组用DMPS驱汞2个疗程及F组腹腔注射NS2个周期后均未见TNF-α表达显著减弱,C组(DMPS+已酮可可碱)脊髓和DRG内TNF-α平均灰度显著提高,平均面积减少(P0.05)。结论亚急性HgCl2中毒大鼠脊髓和DRG内TNF-α表达显著增强,SMPS联合已酮可可碱能够有效抵制TNF-α表达。     

几种物质对汞致大鼠肾脏氧化损伤的影响

目的探讨1次染汞致大鼠肾脏氧化损伤作用并观察2-氨基4-(S-丁基磺酰亚氨)丁酸(BSO)、还原型谷胱甘肽(GSH)、维生素C(Vit C)和二巯丙磺钠(DMPS)预处理对汞致肾脏氧化损伤的影响. 方法 Wistar大鼠64只,随机分成8组:对照组1组,染汞组3组,分别皮下注射0.75、1.5或2.5 mg/kg的氯化汞溶液,预处理干预组4组.BSO预处理组先腹腔注射BSO 0.5 mmol/kg体重,4 h后皮下注射0.75 mg/kg HgCl2溶液.其他3个预处理组中,先分别腹腔注射GSH 3 mmol/kg,Vit C 4 mmol/kg或DMPS 200 μmol/kg体重,2 h后皮下注射2.5 mg/kg HgCl2溶液.测定肝脏、肾皮质和尿汞含量以及肾皮质中GSH、丙二醛(MDA)、蛋白含量和谷胱甘肽过氧化物酶(GSH-Px)活性. 结果染汞后肝、肾皮质和尿汞含量随染汞剂量加大而增加.BSO预处理组肾皮质MDA含量和GSH-Px活性显著高于对照组和0.75 mg/kg HgCl2组,而GSH含量则与此相反.GSH、Vit C和DMPS预处理组肾皮质中:MDA含量均显著低于2.5 mg/kg HgCl2组;GSH含量均高于对照组;GSH-Px活性显著高于对照组和2.5 mg/kg HgCl2组.Vit C和DMPS预处理组肾皮质GSH含量也显著高于2.5 mg/kg HgCl2组. 结论肝脏、肾皮质和尿汞含量随染汞剂量而增加.BSO预处理可增强汞致肾脏氧化损伤作用,而GSH、Vit C和DMPS预处理则对汞致肾脏氧化损伤具有一定的拮抗作用.     

两种药物对氯化汞染毒大鼠脊髓及背根神经节P物质的影响

目的观察两种药物对氯化汞染毒大鼠脊髓和背根神经节（DRG）P物质（SP）的影响。方法雄性sD大鼠40只，分为7组。对照组（10只）经口灌胃生理盐水（NS）2ml／次，每天1次；A、B、C组（各5只）按17mg／kg；D、E、F组（各5只）按8．5mg／kg经口灌胃HgCl2溶液，每天1次。7组均连续灌胃（20＋2）d。处死A、D组大鼠和对照组5只大鼠，随后B、E组用二巯丙磺钠注射液（DMPS）按28mg／kg腹腔注射驱汞两疗程；C组用DMPS（28mg／kg）＋卡马西平（按16．82mg／kg经口灌胃qd×14d）；F组腹腔注射NS1ml／次。实验结束后处死全部动物，灌注固定取出脊髓L5-6节及L5、L6两侧DRG并制成病理切片。用免疫组化SABC法测定DRG和脊髓SP表达水平。结果染汞组大鼠DRG和脊髓SP平均灰度均显著低于对照组；平均面积均显著高于对照组（P〈0．05）；B、E组用DMPS驱汞两疗程及F组腹腔注射NS两周期后均未见SP表达显著减弱，C组用DMPS＋卡马西平显著降低DRG和脊髓SP平均面积，提高平均灰度（P〈0．05）。结论亚急性氯化汞染毒大鼠DRG和脊髓SP水平显著增高，卡马西平联合DMPS能够有效抑制SP表达。     

竹荪多糖早期和晚期干预对砷中毒大鼠肝功能的影响

目的探讨砷致肝损伤大鼠体内砷含量和肝功能受竹荪多糖干预的影响。方法 108只成年清洁级SD大鼠随机分为正常对照组(24只,以普通饲料喂饲)、砷+竹荪同时干预组[(简称同时干预组),24只,10 mg/ml的竹荪多糖每日20ml/kg灌胃,且饲料中砷含量为50 mg/kg]、砷染毒组(60只,喂饲砷含量50 mg/kg的饲料),均雌雄各半。采用喂饲法进行染毒3个月后,以HE、Masson染色观察肝损伤情况。继续将砷染毒组随机均分为砷染毒组、砷+二巯基丙磺酸钠(DMPS)组[(简称DMPS组),每天以5 mg/kg二巯基丙磺酸钠腹腔注射,连续3 d,间隔4 d为一个周期]、砷+竹荪后干预组[(简称竹荪后干预组),10 mg/ml竹荪多糖每日20 ml/kg灌胃],每组18只,雌雄各半,三组均以砷含量为50 mg/kg的饲料喂饲,各组再处理3个月,观察大鼠体内砷含量和肝功能的变化情况。结果肝脏HE、Masson染色显示,与正常对照组比较,同时干预组、砷染毒组光镜下肝组织均有不同程度肝损伤出现。与正常对照组相比,各处理组大鼠血清ALT和AST的活力升高,且随着染毒时间的增加,各组大鼠血清ALT和AST的活力呈上升趋势。与正常对照组相比,各处理组大鼠血、尿、肝脏砷含量均增高(P0.05)。与砷染毒组相比,同时干预组、DMPS组、竹荪后干预组肝砷降低,血砷和尿砷升高(P0.05)。与DMPS组相比,同时干预组肝砷先降低后升高,尿砷先升高后减低,血砷先升高后减低再升高(P0.05)。与同时干预组相比,竹荪后干预组肝砷升高,血砷、尿砷降低(P0.05)。与竹荪后干预组相比,DMPS组肝砷降低,尿砷升高,血砷先升高后降低(P0.05)。结论竹荪多糖早期干预能减轻砷中毒大鼠肝损伤程度,且竹荪在砷中毒早期干预对肝损伤的减轻效果优于砷中毒后再干预,但竹荪多糖对砷中毒大鼠体内驱砷效果仍不及二巯基丙磺酸钠。     

慢性砷中毒对小鼠齿状回caspase-3表达的影响

目的 观察慢性砷中毒对成年小鼠齿状回神经元的形态学影响,探讨慢性砷中毒对成年小鼠脑部的神经毒性机制.方法 选取健康成年昆明小鼠80只,雌雄各半,分为对照组、高、中、低剂量砷染毒组,每组20只,高、中、低剂量砷染毒组分别以As03的1/5、1/10、1/40 LD50(9、4.5、1.1 mg/kg)灌胃染毒,对照组以蒸...     

The human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

Worker education in the primary prevention of occupational dermatoses

This paper reports the evaluation of a skin care education programmeconducted on a fine chemicals manufacturing site where over1,000 employees are located. Approximately 60% are involvedin chemical manufacture. Over a 12 month period production staffreceived training in prevention of occupational dermatoses linkedto a site-wide poster initiative. The incidence of new casesof occupational dermatoses fell from 0.055 (70 cases in 1,277employees) to 0.021 (27 cases in 1,277 employees) before andafter the intervention respectively (p<0.0001). After otherfactors such as chemicals handled, observer bias and changesin reporting related to socioeconomic climate were taken intoaccount it is concluded that this study demonstrates the importanceof worker education as a tool for primary prevention of disease.Training materials such as video and poster presentations maybe effectively used in the chemical manufacturing industry asan adjunct to prevention and control of exposure to substanceshazardous to the skin. Such methods may also be used in otherindustries where there are significant risks of dermatoses.     

Regional Variation in Travel-related Illness acquired in Africa,March 1997–May 2011

To understand geographic variation in travel-related illness acquired in distinct African regions, we used the GeoSentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported gastrointestinal illnesses and dog bites. Febrile illnesses were more common in travelers returning from sub-Saharan countries. Eleven travelers died, 9 of malaria; these deaths occurred mainly among male business travelers to sub-Saharan Africa. The profile of illness varied substantially by region: malaria predominated in travelers returning from Central and Western Africa; schistosomiasis, strongyloidiasis, and dengue from Eastern and Western Africa; and loaisis from Central Africa. There were few reports of vaccine-preventable infections, HIV infection, and tuberculosis. Geographic profiling of illness acquired during travel to Africa guides targeted pretravel advice, expedites diagnosis in ill returning travelers, and may influence destination choices in tourism.     

The design of hazard risk assessment matrices for ranking occupational health risks and their application in mining and minerals processing

Two hazard risk assessment matrices for the ranking of occupational health risks are described. The qualitative matrix uses qualitative measures of probability and consequence to determine risk assessment codes for hazard-disease combinations. A walk-through survey of an underground metalliferous mine and concentrator is used to demonstrate how the qualitative matrix can be applied to determine priorities for the control of occupational health hazards. The semi-quantitative matrix uses attributable risk as a quantitative measure of probability and uses qualitative measures of consequence. A practical application of this matrix is the determination of occupational health priorities using existing epidemiological studies. Calculated attributable risks from epidemiological studies of hazard-disease combinations in mining and minerals processing are used as examples. These historic response data do not reflect the risks associated with current exposures. A method using current exposure data, known exposure-response relationships and the semi-quantitative matrix is proposed for more accurate and current risk rankings.     

Psychopathological features of a patient population of targets of workplace bullying

BACKGROUND: A strong association between workplace bullying and subsequent anxiety and depression, indicated by empirical research, suggests that bullying is an aetiological factor for mental health problems. AIMS: To evaluate levels of stress and anxiety-depression disorder developed by targets of workplace bullying together with outcome at 12 months and to characterize this population in terms of psychopathology and sociodemographic features. METHODS: Forty-eight patients (36 women and 12 men) meeting Leymann Inventory of Psychological Terror criteria for bullying were included in a prospective study. Evaluations were performed at first consultation and at 12 months using a standard clinical interview, a visual analogue scale of stress, the Hospital Anxiety and Depression (HAD) scale, the Beech scale of stress in the workplace and a projective test (Picture-Frustration Study). RESULTS: At first consultation, 81% of patients showed high levels of perceived stress at work and 83 and 52% presented with anxiety or depression, respectively. At 12 months, only 19% of working patients expressed a feeling of stress at work. There was a significant change in symptoms of anxiety while there was no change in symptoms of depression. Stress at work and depression influenced significatively capacity to go back to work. At 12-month assessments, workers showed a significantly better score on the HAD scale than non-workers. Over half the targets presented a neuroticism-related predominant personality trait. CONCLUSION: Workplace bullying can have severe mental health repercussions, triggering serious and persistent underlying disorders.     

The rise and fall in incidence of malignant mesothelioma from a British Naval Dockyard, 1979-1999

BACKGROUND: The incidence of malignant mesothelioma in Britain is predicted to rise over the next 15-25 years because of past failure to protect the workforce against inhalation of asbestos. In British Naval dockyards, alternative insulation materials and respiratory protection were introduced from the mid-1960s. Aims This study was carried out to investigate the effects of these control measures on mesothelioma deaths in dockyard workers. METHODS: Cases of mesothelioma of the pleura and peritoneum between 1979 and 1999 in workers from the Devonport Naval Dockyard, south-west England, were sought from coroners' and medico-legal records. RESULTS: Three hundred and one cases were identified, 7% peritoneal. The peak incidence occurred in 1991 with 25 cases per annum (quadratic model fit R(2) = 74.2%, P < 0.001) and we predict that by 2003 the incidence will fall to fewer than five cases per annum. The mean time between first exposure and presentation was 48.5 years [95% confidence interval (CI) = 47.3-49.8], but this was significantly shorter in the more heavily exposed trades, when compared with the less heavily exposed (42 years, 95% CI = 39.0-45.0, versus 49.5 years, 95% CI = 48.2-50.9). Those with higher exposure were also at significantly greater risk of peritoneal disease (P < 0.023, Fisher's exact test). CONCLUSION: The reduction in incidence of mesothelioma is greater than can be accounted for by reduction in numbers of dockyard workers over the last 50 years. Changes in insulation materials and improved industrial hygiene measures introduced into the Devonport Dockyard from the mid-1960s have resulted in an earlier decline in the incidence of malignant mesothelioma than that predicted for the British workforce as a whole.     

Organophosphate toxicity and occupational exposure

The ubiquitous organophosphates present a continuing health hazard in agriculture, public health eradication programmes and as chemical warfare agents. Despite significant progress in understanding the potential mechanisms of toxicity far beyond the commonly accepted mechanism of cholinesterase inhibition in intentional exposures, the precise health effects following occupational exposures are yet to be completely defined. A much greater understanding exists of the clinical features of organophosphate poisoning. These are characterized by a triphasic response involving an initial acute cholinergic phase, an intermediate syndrome (both associated with high mortality) and a disabling but non-lethal delayed polyneuropathy. The delayed polyneuropathy may occur in the absence of the cholinergic or intermediate phases. However, progress is still required in order to improve the quantification and assessment of occupational exposures and the implementation of appropriate preventive measures. Finally, evidence-based guidelines for appropriate or optimal therapeutic interventions following poisoning are required urgently and collaborative work with colleagues in developing countries, where the occurrence of organophosphate exposures is more frequent, may provide the answers.     

Die sogenannte Vinylchlorid-Krankheit—eine berufsbedingte Systemsklerose?

Zusammenfassung Es wurden 13 Arbeiter untersucht, die zwischen 1 3/4 und 18 Jahren in einem PVC-herstellenden Betrieb beschäftigt waren. 8 von ihnen wiesen sklerodermieartige Hautveränderungen (Abb. 2) auf, die histologisch charakterisiert sind durch Verbreiterung und Homogenisierung der kollagenen Faserbündel (Abb. 3 u. 4) sowie Fragmentation und Rarefizierung der elastischen Fasern (Abb. 5). Bei 7 Patienten bestanden trommelschlegelartige Auftreibungen einzelner Fingerendphalangen (Abb. 1). 11 Patienten zeigten Durchblutungsstörungen der Extremitäten (4 von diesen ein Raynaud-Syndrom) und 6 Patienten Acroosteolysen einzelner Fingerendphalangen (Abb. 6, Tabellen 1–3).Darüber hinaus bestand bei allen Patienten eine Thrombocytopenie, bei 12 Patienten eine Splenomegalie, bei 11 Patienten eine Einschränkung der Leberfunktion (erhöhte BSP-Retention). An der Leber ließ sich histologisch bei den 5 laparoskopierten Patienten eine deutliche Fibrosierung der Portalfelder nachweisen. Bei 4 Patienten bestanden Oesophagusvaricen (Tabellen 4 u. 5). 8 Patienten zeigten eine Partialinsuffizienz mit Hinweisen für vorwiegend restriktive Veränderungen.Die hier beschriebenen Veränderungen gehen weit über das bisher bekannte Acroosteolysesyndrom hinaus. Es wird der dringende Verdacht geäußert, daß langfristige Vinylchlorid-Exposition dieses komplexe Krankheitsbild verursacht. Daher wird für diese systemische Krankheit die Bezeichnung Vinylchlorid-Krankheit vorgeschlagen.Wir danken Frau E. Voigtländer für die Herstellung der klinischen und histologischen Abbildungen.     

Miliaria rubra of the lower limbs in underground miners

This report documents a case series of miliaria rubra of the lower limbs in miners at a deep underground metalliferous mine in tropical arid Australia. During the summer months of February and March 1999, all cases of miliaria rubra of the lower limbs in underground miners seen at the mine's medical centre were clinically examined and administered a questionnaire. Twenty-five patients were seen, an incidence of 56.4 cases per million man-hours. Miliaria rubra was most often located between the ankle and knee (88% of cases). Twenty-four percent had concurrent folliculitis and 20% had concurrent tinea. Thirty-two percent had a personal history of asthma. Walking through ground-water and splashing of the legs was common. Three to 4 weeks of sedentary duties in air conditioning was generally required to achieve resolution of miliaria rubra. The incidence of miliaria rubra of the lower limbs is 38% of the incidence of heat exhaustion at the same mine. The length of disablement is greater, however. Atopics may be at increased risk of miliaria rubra. Control measures are discussed.     

Planning research

The starting point for any research project should be a question.Once this has been defined and the relevant scientific literaturereviewed, a protocol should be drawn up. This will be used notonly as a guide to the conduct of the study and in the preparationof the final report, but also in seeking any financial supportand approvals that are required for the investigation. A protocolis normally arranged in sections covering the background tothe study, the question(s) that it will address, the methodsthat will be used for the collection and analysis of data, thestatistical power of the investigation (where relevant), anyethical considerations, and the financial input that will beneeded. A pilot study is often helpful where aspects of thestudy method are untried or of uncertainvalidity.