Mortality and cancer incidence among marine engineers and machinists in Iceland

A retrospective cohort study of mortality and cancer morbidity was carried out among 295 marine engineers and 182 machinists with special regard to cancer of the lung. The cohort was defined as all graduates from engineering and machinists school in Iceland during 1936-1955. During vocational training, as well as in their professional lives, marine engineers and machinists are exposed to asbestos, different kinds of mineral oils, and exhaust gases with marked individual variation as regards mode and magnitude of exposure. For deaths occurring between 1951 and 1982 information was obtained from the Statistical Bureau of Iceland. Significantly increased standardized mortality ratios were determined for cancer of the trachea, bronchus, and lung for the entire cohort. Record linkage with the Cancer Register revealed 36 cancers in the period 1955-1982. No statistically significant excess was found for the overall cancer incidence or for the incidence of cancer at any particular site. A special survey of smoking status showed that cigarette smoking was not as common among the subjects of the cohort as among the general male population in Reykjavik. These results support the suggestion that the increased mortality of lung cancer in the study group had a causal relationship to occupational exposure, particularly to asbestos exposure.     

Success and complications of pneumatic retinopexy

Fifty-eight consecutive patients with rhegmatogenous retinal detachment were treated by pneumatic retinopexy using intravitreal perfluoropropane gas. Reattachment was achieved in 29 of 35 eyes (83%) having single retinal breaks (up to 45 degrees in extent), including dialyses (up to 60 degrees), and groups of breaks within one clock hour. The cumulative reattachment rate was 37 of 58 eyes (64%), including eyes with detachments with multiple breaks 30 to 120 degrees apart and vitreous hemorrhage as well as aphakic and pseudophakic eyes. Pneumatic retinopexy was successful in 18 of 22 (82%) myopic eyes (-3 to -11 diopters). Virtually all complications developed in the inferior retinal quadrants, and included preretinal vitreous condensations or membranes in 27 of 58 eyes (47%), new retinal breaks in seven eyes (12%), and rhegmatogenous or tractional detachments in previously attached areas in 14 eyes (24%). Postoperative proliferative vitreoretinopathy occurred in six eyes (10%) and macular pucker in two (3%).     

Changes in snoring characteristics after 30 days of nasal continuous positive airway pressure in patients with non-apnoeic snoring: a controlled trial.

BACKGROUND--A study was performed to evaluate the effect of discontinuation of nasal continuous positive airway pressure (NCPAP) treatment on snoring characteristics. METHODS--Eighteen non-apnoeic snoring subjects were randomly allocated to either a no treatment control group or an NCPAP treatment group. The control group was studied twice (baseline and day 30 of follow up). In the NCPAP group the level of NCPAP that abolished snoring was determined and part abolished snoring was determined and patients were placed on NCPAP every night for one month. A sleep study was performed on the first night without NCPAP after completing 30 days of treatment (follow up 1). A fourth polysomnographic study was performed 8-10 days after NCPAP was stopped (follow up 2) in six subjects. RESULTS--In both groups total sleep time (TST) and sleep architecture remained unchanged at the different visits. Baseline snoring characteristics in the two groups were similar. In the control group the mean (SE) number of snoring episodes/hour of sleep (snoring index) and the percentage of TST > 60 decibels (dB) were 380 (36)/h and 11.1 (2.0)% TST respectively at baseline, and was unchanged at follow up. In the NCPAP group the snoring index decreased from 387 (50)/h to 320 (57)/h after NCPAP therapy, but the % TSTS > 60 dB decreased from 10.3 (1.8)% to 7.4 (1.5)%. The snoring index and intensity returned to baseline values at follow up 2 (374 (74)/h, 9.8 (2.1)% TST). Changes in snoring characteristics could not be explained by changes in body position between the different sleep studies. CONCLUSIONS--NCPAP improves snoring but this effect is lost soon after stopping treatment.     

Acute pericarditis as the initial manifestation in Still's disease in an adult

Almost 90% of primary acute pericarditis are idiopathic. Between specifics forms, a very low percentage of cases are due to chronic rheumatic diseases. A case of adult Still's disease (juvenile chronic rheumatoid arthritis) with acute pericarditis being the first clinical manifestation (besides fever and general syndrome) is presented. Therapy with oral prednisone was rapidly effective, and pericardial effusion resolved after 3 weeks of treatment, as echocardiography showed.     

Hand rejuvenescence by fat filling.

The advantages of fat filling for hand rejuvenescence are discussed. Seventy-two patients treated by this method are presented, including their follow-up, complication rate, and details of combined operations. Preference is given to local anesthesia when no other major surgeries are associated with the method. A highly satisfactory rate was obtained (98.62%) with a low complication rate (4.15%).     

Porphyria cutanea tarda associated with autoimmune hypothyroidism, vitiligo and alopecia universalis.

The aetiology of porphyria cutanea tarda (PCT) has not been elucidated, but the possibility of an autoimmune mechanism has been proposed. We report a case of an unknown clinical combination of PCT with autoimmune hypothyroidism, alopecia universalis and vitiligo with thyroid and parietal cell circulating antibodies. This is highly suggestive of underlying autoimmune damage in this patient.     

The cardioprotective action of nifedipine during short-term transient ischemia

To determine the therapeutic activity on regional myocardial function of nifedipine intravenous administration (0.16 mg/kg) during short term myocardial induced ischemia, we used 6 mongrel dogs anesthetized and intubated those who we have implanted 3 pairs of ultrasonic crystals in the subendocardial layer. Utilizing an open chest canine model we performed total 1 minute and partial 2 minutes 30 seconds alternative obstructions, controlled with electromagnetic flowmeters in the anterior descending (AD) and circumflex (Cx) coronary arteries before and after drug administration. During the 70-80% obstructions we have shown a significant improvement in segment shortening, reduced by ischemia, in the ischemic and peri-ischemic zone. The ischemic markers, per cent increment of end diastolic length (% IEDL) and per cent increment of end systolic length (% IESL), have shown significant improvement during partial obstructions in the ischemic and peri-ischemic zone. After total obstructions the improvement on regional myocardial function is less marked and limited to ischemic zone.