Chemical and biological characterization of volatile components of environmental samples after fractionation by vacuum line cryogenic distillation

Volatile components from diesel exhaust particles and coal gasifier process gas condensate were vacuum fractionated by cryogenic distillation and identified by infrared spectroscopy and gas chromatography/mass spectrometry. The vacuum distillation line consisted of a sample flask and nine traps cooled from 0°C to ?196°C in approximately 20°C steps. The pressure in the vacuum line of about 10^?2 Torr was maintained with a vacuum pump. Separated compounds were identified by comparison to reference infrared spectra and confirmed by comparison with standards when practical. Volatile compounds identified from the diesel exhaust particle sample included NO_x, carbon dioxide, sulfur dioxide, alkanes, aldehydes, and one and two ring aromatic hydrocarbons. Volatile compounds identified in process gas condensate from a coal gasifier were ammonia, carbonyl sulfide, carbon dioxide, C₃-C₇ hydrocarbons, one and two ring aromatic hydrocarbons, and phenols. Volatile components collected at either 0° or ?24°C were evaluated to determine their genotoxicity using the Chinese hamster ovary/hypoxanthine-guanine phosphoribosyltransferase (CHO/HGPRT) assay. Neither the gasifier condensate nor diesel particle samples produced mutations at the HGPRT locus. The diesel samples were not cytotoxic at the concentrations tested (100 μg/ml) but the gasifier samples resulted in 50% cell killing at concentrations between 25 and 100 μg/ml depending on the temperature of collection and the test conditions. Vacuum desorption with cryogenic distillation has provided a means to separate the volatile components in complex environmental samples to allow chemical and biological characterization of these components.     

Negotiation of self and setting to advantage: an interactionist consideration of nursing home data

This paper examines the dynamics of the process of negotiation in a nursing home by focusing on the process of gaining advantage. The concepts of primary and secondary advantage are introduced in order to allow comparison and organization of the data. In the course of examining what rewards are possible and how they are achieved, we are able to see that the impetus to treat and the control of treatment action often lies with the staff of the home rather than the physician, that officially imposed definitions may be unfavourable to the persons they are imposed upon and that the process of deciding on everyday activities is often complex.     

1040 Prophylactic infusions with an unmodified intravenous immunoglobulin product causing few side-effects in patients with antibody deficiency syndromes

Summary Thirty-two patients with common variable immunodeficiency (CVID) and two patients with IgA and IgG subclass deficiency received a total of 1,040 intravenous (i.v.) infusions during 60 patient years with 7,575 g of a new immunoglobulin (Ig) preparation. The content of prekallikrein activators and the anti-complementary activity in the tested Ig preparation was low and, in comparison to seven other commercial i.v. Igs, so was the proportion of IgG polymers and fragments. The IgA content was always 0.02 g/l, often <0.004 g/l, and it was possible to continuously give the Ig prophylactically to four patients with anti-IgA antibodies, i.e. three with CVID and one with combined IgA-IgG2 deficiency. Adverse reactions were only noted in 4.7% of the 1,040 infusions and in 12 out of the 34 patients. None of the reactions were of the anaphylactic type, but two patients had moderate reactions and one had anuria, probably not caused by the Ig. A simultaneous infection seemed to increase the risk of phlogistic reactions, as five out of six patients who reacted with temperature rise and chills had a simultaneous upper respiratory tract infection. A substudy of various dosage schedules was performed with 11 patients receiving 203 infusions over 10.8 patient years. On 25 mg/kg/week of Ig given i.v. every five weeks, a mean increase in the preinfusion serum IgG level of 0.3 g/l was observed, as compared to earlier i.m. prophylaxis with the same dose. Only 1/4 of the patients on 25 mg/kg/week every five or three weeks reached a preinfusion IgG level 3 g/l. On 50 mg/kg/week every two weeks, 4/4 CVID patients had preinfusion levels above 3 g/l with a mean preinfusion increase of 1.5 g/l over the start level. Finally, 100 mg/kg/week every three weeks gave 5/5 patients a preinfusion serum IgG level of >4 g/l with a mean rise of 3.6 g/l, as compared with the levels before the study. An association between decreasing preinfusion IgG serum levels and the presence of infection was noted on 13/17 occasions, while increasing IgG was seen in healthy periods on 14/14 observations.

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1040 Infusionen mit einem nicht modifizierten Immunglobulin-Produkt, das bei Patienten mit Antikörpermangelsyndrom wenig Nebenwirkungen hervorruft

Zusammenfassung 32 Patienten mit gewöhnlichem variablen Immunglobulinmangel (CVID) und zwei Patienten mit fehlenden IgA- und IgG-Subklassen erhielten zusammen 1040 intravenöse (i.v.) Infusionen innerhalb von 60 Patientenjahren mit 7575 g einer neuen Immunglobulinpräparation (Ig). Der Gehalt an Prä-Kallikrein-Aktivatoren und die anti-komplementäre Aktivität in der getesteten Ig-Präparation war gering, verglichen mit sieben anderen kommerziell erhältlichen i.v. Immunglobulinen. Dasselbe gilt für den Anteil an IgG-Polymeren und -Fragmenten. Der IgA-Gehalt betrug immer 0,02 g/l, oft 0,004 g/l. Das Ig konnte vier Patienten mit IgA-Antikörpern, d. h. drei mit CVID und einem mit kombiniertem IgA-IgG-Mangel kontinuierlich verabreicht werden. Nur bei 4,7% der 1040 Infusionen und bei 12 der 34 Patienten wurden Nebenwirkungen beobachtet. Keine der Nebenwirkungen war vom anaphylaktischen Typ, aber zwei Patienten hatten mittelschwere Nebenwirkungen und einer eine Anurie, die wahrscheinlich nicht durch das Ig verursacht war. Das Risiko für phlogistische Reaktionen schien durch gleichzeitige Infektionen erhöht zu werden. Dies wurde bei fünf von sechs Patienten beobachtet, die bei Infektion der oberen Atemwege auf die Infusion mit Temperaturanstieg und Schüttelfrost reagierten. Bei 11 Patienten, die über 10,8 Patientenjahre 203 Infusionen erhielten, wurde eine Sonderstudie zu verschiedenen Dosierungen durchgeführt. Bei Infusion von 25 mg/kg/Woche i.v. alle fünf Wochen wurde ein mittlerer Anstieg der Serumspiegel vor Infusion gemessen, der um 0,3 g/l höher war als bei früherer i.m. Prophylaxe mit derselben Dosis. Nur bei 1/4 Patienten, die alle fünf oder drei Wochen 25 mg/kg/Woche erhielten, wurde ein IgG-Spiegel vor Infusion von 3 g/l erreicht. Bei Gabe von 50 mg/kg/Woche alle zwei Wochen hatten 4/4 CVID-Patienten vor Infusion Spiegel über 3 g/l, dabei stiegen die Spiegel vor Infusion um 1,5 g/l höher an als vor Therapiebeginn. Bei 100 mg/kg/Woche alle drei Wochen wiesen 5/5 Patienten ein Serum IgG von >4 g/l auf; der mittlere Anstieg gegenüber den Werten vor Studienbeginn betrug 3,6 g/l. Bei 13/17 Fällen wurde eine Assoziation von abnehmenden IgG-Serumspiegeln vor Infusion mit einer Infektion beobachtet; in gesunden Phasen waren bei 14/14 Beobachtungen Anstiege der IgG-Spiegel zu beobachten.

     

Endemic Lassa fever in Liberia. VI. Village serological surveys for evidence of Lassa virus activity in Lofa County, Liberia

Six villages in Lofa County, north-west Liberia, and one near the coast were surveyed for the presence of indirect fluorescent antibodies (IFA) to Lassa virus (LV). Prevalences were similar among males and females, and among various age groups. The prevalence of IFA positive sera, 6.4%, in two roadside villages was significantly higher than in two matched villages "in the bush", 1.9%. It was also higher in Gbanwei, a roadside village which did not maintain traditional sanitary measures, than in Zuwulo, similarly located but with maintenance of clean-swept areas without shrubbery or rubble between the houses. In another pair of villages, the one adjacent to a Mission Clinic with a very high prevalence of IFA positive staff members had significantly higher prevalence, 14.1%, than did the other, a roadside village with 5.1% seropositives. LV antibodies were also found in 4.3% of the inhabitants of a small coastal village near Robertsfield International Airport. Though LV infections are more common in villages in which traditional practices have been modified, they are present even in villages which are relatively unchanged. In the former they appear to be continuous while sporadic in the latter. The prevalences of IFA in the villages with the highest rates are about one third of what is found in personnel of hospitals near them, suggesting that hospital staff members acquire infections from patients as well as from the communities in which they live.     

Risk factors for psychiatric inpatient assaults on staff

The risk of psychiatric patient assaults on staff members is increasing yearly, with resultant increases in employee victim suffering, medical expense, and lost productivity. Traditionally considered a clinician responsibility, the management of patient violence also has important administrative implications. This article presents a review of the risk factors associated with violence that includes the characteristics of patients who assault but adds the characteristics of employee victims of such assaults as well as contextual variables. Additional data from a two-year study of a peer-help crisis intervention program for employee victims of patient assaults are included. The mental health administrative implications of this approach are outlined.     

Contractile effect of big endothelin-1 and its conversion to endothelin-1 in rabbit cerebral arteries

The effect of big endothelin-1 (big ET-1) and its conversion to endothelin-1 (ET-1) in rabbit cerebral arteries were examined. Big ET-1 and ET-1 induced concentration-dependent contractions in the basilar artery; ET-1 was approximately 8 times more potent than big ET-1. The metalloprotease inhibitor phosphoramidon (30 ol/1) almost abolished the contractile response to big ET-1, whereas the ET-1-induced contraction was unaffected. Removal of the endothelium did not attenuate the big ET-1-induced contraction. ET-1 was approximately 14 times more potent than endothelin-3 (ET-3) to elicit contraction. The contractions induced by big ET-1, ET-1 and ET-3 were all inhibited by the ET_A receptor antagonist BQ 123 (3 mol/l). The ET_B receptor antagonist IRL 1038 (3 mol/l) had no effect on the contractile responses to big ET-1 and ET 1, but produced a small inhibition of the ET-3-induced contraction. Formation of ET-1 was demonstrated in membrane fractions of cerebral arteries incubated with big ET-1 as measured by high pressure liquid chromatography followed by radioimmunoassay. These results suggest that externally applied big ET-1 is converted to ET-1 by a phosphoramidon-sensitive endothelin converting enzyme present in the vascular smooth muscle cells. The ET-1 formed subsequently mediates the big ET-1-induced contraction by activation of mainly ETA receptors, although a small contribution of ETB receptors cannot be excluded.     

Importance of participation rate in sampling of data in population based studies, with special reference to bone mass in Sweden.

OBJECTIVE: To study the effects of participation rate in sampling on "normative" bone mass data. DESIGN: This was a comparison between two randomly selected samples from the same population. The participation rates in the two samples were 61.9% and 83.6%. Measurements were made of bone mass at different skeletal sites and of muscle strength, as well as an assessment of physical activity. SETTING: Malmö, Sweden. SUBJECTS: There were 230 subjects (117 men, 113 women), aged 21 to 42 years. RESULTS: Many subjects participated in both studies (163). Those who took part only in the study with the higher participation rate (67) almost invariably had higher values for bone mass density at the sites measured (up to 7.6% for men) than participants in the study with the lower participation rate. No differences in muscle strength were recorded. CONCLUSION: A high degree of compliance is important to achieve a reliable result in determining normal values in population based studies.     

Respiratory function changes after asbestos pleurisy.

Six patients with radiographic evidence of diffuse pleural thickening after industrial asbestos exposure are described. Five had computed tomography of the thorax. All the scans showed marked circumferential pleural thickening often with calcification, and four showed no significant evidence of intrapulmonary fibrosis (asbestosis). Lung function testing showed reduction of the inspiratory capacity and the single-breath carbon monoxide transfer factor (TLCO). The transfer coefficient, calculated as the TLCO divided by the alveolar volume determined by helium dilution during the measurement of TLCO, was increased. Pseudo-static compliance curves showed markedly more negative intrapleural pressures at all lung volumes than found in normal people. These results suggest that the circumferential pleural thickening was preventing normal lung expansion despite abnormally great distending pressures. The pattern of lung function tests is sufficiently distinctive for it to be recognised in clinical practice, and suggests that the lungs are held rigidly within an abnormal pleura. The pleural thickening in our patients may have been related to the condition described as "benign asbestos pleurisy" rather than the interstitial fibrosis of asbestosis.