Moulds in housing: visual inspection and spore counts comparison--implications for future strategies in the public health setting

OBJECTIVES: Among the problems of health related to living conditions presented to a public consulting centre for environmental medicine in Vienna, the main point at issue was damp housing and mould growth. On answering this demand indoor exposure to fungal spores was identified by visual semi-quantitative assessment of fungal growth on the one hand and quantitative measurement of viable spores on the other hand. The validity and practicability of this approach was investigated. METHOD: We applied these two simple methods in a standardised form and compared the results in a field study, which has been conducted between 1995 and 1999. In 197 rooms in Viennese flats (183 of which were claimed to be "mouldy") fungal spore concentrations were measured by RCS-impactor and Rose-Bengal-agar. Outdoor measurements were taken simultaneously outside the buildings and were used for reference. RESULTS: Independent classification of visible growth of mould in flats correlated significantly (r = 0.635; p < 0.0001) with the ratio of indoor/ outdoor concentration of fungal spores. CONCLUSIONS: It is usually possible to classify the severity of the problem just by local inspection. Visible plaques should always be an indication for sanitary measures. However, spore counting is indicated for quantifying health relevant exposures, for scientific comparisons and in documentation and follow up such as for litigation purposes. Quantitative data bear more credibility and so help to prove the need of sanitation.     

Phenotypic variation and detection of carrier status in the partial androgen insensitivity syndrome

The partial androgen insensitivity syndrome occurs in 46,XY subjects with phenotypes ranging from perineoscrotal hypospadias with cryptorchidism and micropenis (mild undervirilisation) to clitoromegaly and partial labial fusion (marked undervirilisation). Within an affected family, wide variation in the degree of genital ambiguity between individuals can be seen. Two cousins of a previously reported subject who had severe genital ambiguity and partial androgen insensitivity were investigated. Neither of the cousins had genital abnormalities as marked as the index case, who also had qualitatively abnormal androgen binding and two mutations of the androgen receptor gene. Despite marked phenotypic differences between the index case and his cousins, similar androgen binding and the same androgen receptor mutations were shown in the cousins. Furthermore, one of the androgen receptor gene mutations has been shown in the mother and sister of one of the boys indicating that they are carriers. Thus phenotypic variation in families affected by partial androgen insensitivity is dependent on factors other than abnormalities of the androgen receptor gene alone. Although carrier status in partial androgen insensitivity can be determined, the severity of genital abnormalities in an affected offspring cannot be reliably predicted.     

巫山淫羊藿的化学研究

从小檗科Berberidaceae淫羊藿属Epimedium植物巫山淫羊藿Epimedium wushanense T.S.Ying的地上部分中分得两种黄酮甙单体,经理化性质鉴定及紫外、红外、质谱、氢谱、碳谱等光谱分析,确定甙Ⅰ是新化合物,命名为巫山淫羊藿甙(wushanicariin)。甙Ⅱ是已知化合物淫羊藿甙(icariin),系首次从该种植物中分离。     

An enzyme-linked immunosorbent assay for detection of antibodies against halothane-altered hepatocyte antigens

Patients with massive liver cell necrosis that may follow halothane anaesthesia have a high incidence of circulating antibodies against halothane-induced hepatocyte antigens. In order to provide an objective and quantitative method for the detection of these antibodies, an enzyme-linked immunosorbent assay has been developed. Sera, after absorption with normal rabbit liver microsomal fraction, are tested for binding to microsomal fractions from control and halothane-pretreated rabbits. Those containing antibodies against halothane-induced determinants give significantly enhanced binding to halothane-altered fractions; this specificity was verified by absorption experiments. Using this method, halothane-related antibodies were detected in sera from 16/24 patients with halothane-associated liver failure, at titres ranging from 1:100 to 1:25600. Such antibodies were not detectable in sera from 26 normal blood donors, 5 healthy anaesthetists, 12 patients who had received multiple halothane anaesthetics but had normal liver function tests and 32 patients with a variety of other liver diseases. This rapid and reproducible assay should be of value for the detection of antibodies and for detailed investigation of patient antibody responses, and also for characterization of the route of production and metabolism of the antigen.     

Major motor atrophic patterns in the face and neck: CT evaluation

Cranial nerve deficits from various pathologic processes of the head and neck may result in characteristic patterns of denervation muscular atrophy. Such atrophic patterns may be clues to the location and extent of the lesion, particularly when cranial nerves are involved early in the course of the disease process. Thirty-six patients with computed tomographic (CT) evidence of muscular atrophy secondary to pathologic conditions involving the motor division of cranial nerves were examined. Five characteristic denervation muscular atrophy patterns seen on CT scans were identified. In several patients, identification of the muscular atrophy pattern was the only clue to the presence of a pathologic condition. Recognition of these atrophic patterns can prevent misinterpretation of their CT appearance and direct the CT examination to the course of the compromised cranial nerve from the brainstem to its peripheral innervation.     

Lung cancer and dust exposure: results of a prospective cohort study following 3260 workers for 50 years

Aims: To study the lasting health impact of occupational dust exposure on life expectancy and specific causes of death.

Methods: Male Viennese workers, selected at age 40 (mean 54) years during preventive check-ups between 1950 and 1960, were followed prospectively until death. Half of them (1630) were exposed at work to (non-fibrous) particulates, while the non-exposed workers were matched for year, age, and smoking status at the start of observation.

Results: Average life expectancy of those exposed was 1.6 years less than that of those non-exposed. Only a small part of this decrease in life expectancy (hazards ratios in brackets) was related to acknowledged occupational diseases such as silicosis and silicotuberculosis (67.12). Chronic obstructive lung disease (1.82) and cancer of the lung (1.42) and stomach (1.77) were found more frequently among those exposed.

Conclusions: Results support the hypothesis that high exposure to insoluble particulates such as silica in the metal, glass, ceramics, and stone industries promotes bronchial cancer and chronic obstructive pulmonary disease. The finding of an increased incidence of stomach cancer might be related to particles swallowed after clearance from the airways.

     

Nicotine and surface of particulates as indicators of exposure to environmental tobacco smoke in public places in Austria

As part of a Europe-wide project the amount of exposure to environmental tobacco smoke (ETS) in public places like schools, restaurants, and public transport facilities was investigated. Three methods were applied: nicotine passive samplers (with a filter treated with sodium bisulphate), the same filters with an active sampling device, and the measurement of fine particles' active surface by unipolar diffusion charging. Settings were selected where either high or low ETS concentrations were expected and where non-smokers would have to stay or at least to pass by. Highest ETS concentrations were found in discos (mean nicotine concentration 154.4 maximum 487.1 microg/m3) and intermediate concentrations in restaurants with no significant difference between smoking (21.3 +/- 6.1 microg/m3) and non-smoking areas (23.3 +/- 15.9 microg/m3) but on average higher values in restaurants with no separation between smoking and non-smoking areas (38.0 +/- 60.6 microg/m3). Concentrations usually below 10 microg/m3 were found in transport facilities (8.9 +/- 8.0 microg/m3, maximum 20.6 in the restaurant section of a railway station's waiting room) and in schools (3.0 +/- 4.6 microg/m3). In hospitals "problem spots" were sought and so concentrations from very low to as high as 45.1 microg/m3 next to a smoking area with no physical barrier or separation and 47.7 microg/m3 inside a smoking room could be documented (21.4 +/- 39.3 microg/m3). The fine particle's surface correlated well with the nicotine concentration (r = 0.8; p < 0.001). Only in one instance (in a pizza restaurant on a busy road with heavy duty diesel traffic and the sampling spot next to the pizza stove) high concentration of fine particles was detected without high nicotine. Tobacco smoke is a key source of indoor fine particles. Health policy must intervene to change the situation found at present in many public places in Austria.     

By-products of immunoglobulin somatic hypermutation

The antigen receptor loci are the only loci in humans to undergo programmed somatic gene modification. Although aberrant V(D)J integration and class switch recombination can both give rise to chromosomal translocations, a role for somatic hypermutation in such genomic rearrangements has been suggested but is less clearly established. To characterize the types of by-products of somatic hypermutation, we analyzed aberrant rearrangements involving the immunoglobulin loci in a human B-cell line (Ramos) that performs Ig V gene hypermutation constitutively during culture. Single-nucleotide substitutions account for 95% of the mutational events in the VH gene, with small deletions and duplications accounting for most of the remaining mutations. However, larger genetic alterations can be detected at low frequency, accounting for 0.5% of VH-inactivating mutations. Examples include a large (13 kb) deletion, which entirely removes the expressed VH gene; a 3-kb deletion extending from the functional VHDJH into an upstream VH (generating a hybrid VHDJH gene reminiscent of VH replacement); and an ectopic insertion into the VH from chromosome 1. The results support the proposal that aberrant antibody hypermutation can lead to gross genomic alterations but indicate that such events are rare.