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Biomedical subjects

D Rees

Publications and source records attributed to D Rees.

At least 73 records · Page 4Linked to original sources

Solvent exposure, alcohol consumption and liver injury in workers manufacturing paint.

Liver enzyme activity was examined in 89 South African paint makers currently exposed to a mixture of organic solvents at fairly low levels. However, the duration of exposure was substantial for many. Fifty-eight workers (65%) had at least one enzyme value above the upper reference limit. Gamma glutamyl transferase (gamma GT) activity was elevated in 46% of the workers and aspartate aminotransferase (ASAT) in 52%. In a comparison between workers with high and low solvent exposure, the gamma GT and ASAT values were higher in the most exposed group (eg, gamma GT mean 108 versus 69 U.l-1, P > 0.05). Adjustment for confounding by alcohol consumption and body mass index eliminated the differences due to exposure. It was concluded that the measures of liver injury used did not demonstrate solvent-induced hepatic damage but that excessive alcohol consumption was an important factor.

Adult↗

A survey of a small group of workers exposed to toluene di-isocyanate.

All 20 workers exposed to toluene di-isocyanate (TDI) in a chemical processing and packing factory were tested for TDI-induced asthma. The assessment included a respiratory symptom questionnaire, spirometry, skin prick tests for common allergens and assessment of total and TDI-specific immunoglobulin E (IgE) levels by radio-allergosorbent tests. Six workers had symptoms suggestive of TDI-related asthma. Three of these 6 workers had a significant cross-shift decline in forced expiratory volume in 1 second (FEV1) (10% or greater). Two of the 6 had high levels of TDI-specific IgE. Of the 14 workers without work-related symptoms, 1 had a significant cross-shift decline in FEV1. There was no significant association between the levels of exposure to TDI and symptoms, lung function parameters or immunological findings. This study demonstrates the difficulties in correlating immunological status with clinical and lung function findings in workers exposed to TDI. Recommendations include a stepwise approach to diagnosing TDI-induced asthma in exposed workers.

Asthma↗

Triglyceride metabolism in 3T3-L1 cells. An in vivo 13C NMR study.

13C nuclear magnetic resonance spectroscopy has been used to study triglyceride metabolism in 3T3-L1 cells incubated with [1-13/14C] acetate, myristate, palmitate, stearate, or oleate. Labeled cells embedded in agarose filaments were perfused in a specially fitted NMR tube within the spectrometer magnet. Incubation of 3T3-L1 cells with a specific fatty acid enriched the cellular triglycerides with that fatty acid; the NMR signal observed in the carbonyl region of the cell spectrum was due in large part to that fatty acid. NMR data demonstrated that cellular enzymes preferentially esterified saturated fatty acids at the glyceride sn-1,3 position and unsaturated fatty acids at the sn-2 position. cellular triglyceride hydrolysis by hormone-sensitive lipase was monitored by measuring the decrease in the integrated intensities of resonances arising from fatty acyl carbonyls esterified at glycerol carbons sn-1,3 and sn-2. Under basal conditions, the time courses were first-order, and the average rates were 0.14% of signal/min at both carbonyl positions. Under isoproterenol stimulated conditions, these rates were still first-order and increased 6.4-fold at the sn-1,3 position and 2.4-fold at the sn-2 position. The observation that the hydrolysis time courses were first-order suggested that only a small amount of cellular triglyceride was available to hormone-sensitive lipase, supporting the view that lipolytic enzymes operate at lipid surfaces where only small amounts of neutral lipid may be soluble. Attempts to correlate the measured rates with the rates of hydrolysis at the sn-1,3 and sn-2 positions were hindered by the fact that the chemical shifts of the carbonyl carbons of the diglyceride hydrolysis product did not overlie those of the triglyceride. Analysis of hydrolysis kinetics revealed that hormone-sensitive lipase exhibited little preference for a particular esterified fatty acid under basal conditions; however, under stimulated conditions, the enzyme exhibited a preference for certain triglyceride species.

3T3 Cells↗

Dust exposure and pneumoconiosis in a South African pottery. 1. Study objectives and dust exposure.

Dust exposure and pneumoconiosis were investigated in a South African pottery that manufactured wall tiles and bathroom fittings. This paper describes the objectives of the investigation and presents dust measurement data. x Ray diffraction showed that the clays used by the pottery had a high quartz content (range 58%-23%, mean 38%). Exposure to respirable dust was measured for 43 workers and was highest (6.6 mg/m3) in a bathroom fitting fettler. Quartz concentrations in excess of 0.1 mg/m3 were found in all sections of the manufacturing process from slip production to biscuit firing and sorting. The proportion of quartz in the respirable dust of these sections was 24% to 33%. This is higher than is usually reported in English potteries. Four hundred and six (80%) of the 509 workers employed at the pottery were potentially at risk of occupational lung disease. The finding of large numbers of pottery workers exposed to unacceptable dust concentrations is not surprising as poor dust control was found in all six wall tile and sanitary ware factories surveyed by the National Centre for Occupational Health between 1973 and 1989. Dust related occupational disease can be expected in potters for many years to come.

Air↗

Dust exposure and pneumoconiosis in a South African pottery. 2. Pneumoconiosis and factors influencing reading of radiological opacities.

A cross sectional radiological survey of workers exposed to pottery dust during the manufacture of wall tiles and bathroom fittings was conducted in a South African factory. Roughly one third of workers with 15 or more years of service in high dust sections of the factory had pneumoconiosis. Previously undiagnosed advanced cases, including two with progressive massive fibrosis, were working in dusty occupations. A firm diagnosis of potters' pneumoconiosis was made in 11 of the 358 workers radiographed; all had served more than 10 years suggesting that radiography of workers with more than 10 years service would be a successful case finding strategy in South Africa. A combination of rounded and irregular opacities was the most common radiological finding in the workers with pneumoconiosis (55%). Three readers reported on the chest radiographs, and all found an association between small radiological opacities, which were usually irregular or a combination of irregular and rounded, and exposure to pottery dust. The occurrence of irregular radiological opacities in workers exposed to pottery dust deserves further study. The least experienced reader significantly associated age with small opacities when duration of service (years) was used to measure exposure to dust. Sex was not an important predictor of radiological changes consistent with pneumoconiosis. Breast shadows were not an important cause of false positive readings and participating women did not develop pneumoconiosis after less exposure than men.

Humans↗

Betamethasone-induced resistance to neuromuscular blockade: a comparison of atracurium and vecuronium in vitro.

Steroids induce resistance to neuromuscular blocking drugs. Betamethasone-induced resistance to vecuronium has been demonstrated in vitro, and a presynaptic site of interaction has been suggested. This study investigated whether atracurium is similarly affected. Rat phrenic nerve-hemidiaphragm preparations were bathed in a physiologic solution, and one-half were exposed to betamethasone (1 mumol/L). Dose responses were recorded for atracurium (8-13 mumol/L) and vecuronium (2-12 mumol/L) for control and betamethasone-treated preparations. In comparison to control, the betamethasone groups had significantly less depression of muscle contraction force at all concentrations of atracurium (P = 0.0004) and vecuronium (P = 0.002). The calculated ED50 (50% depression of muscle contraction force, expressed as mean +/- SEM) for atracurium was 8.83 +/- 0.62 mumol/L for controls and 11.19 +/- 0.54 mumol/L for betamethasone-treated preparations. The calculated ED50 for vecuronium was 4.72 +/- 0.41 mumol/L for controls and 6.84 +/- 0.66 mumol/L for betamethasone-treated preparations. Betamethasone therefore increased the ED50 for atracurium by 27% and vecuronium by 45%; however, the magnitudes of these differences were not significant (P = 0.74) between the neuromuscular blocking agents. These results indicate that betamethasone-induced resistance to nondepolarizing neuromuscular blockade affects both atracurium and vecuronium to similar degrees in vitro.

Animals↗

Control of the light-harvesting function of chloroplast membranes by aggregation of the LHCII chlorophyll-protein complex.

A new hypothesis is presented to explain the major molecular process that regulates the efficiency of light harvesting by chloroplast membranes. It is proposed that in excess light the decrease in the thylakoid lumen pH causes an increase in aggregation of the light harvesting complexes of photosystem II resulting in formation of an efficient pathway for non-radiative dissipation of excitation energy. The aggregation is potentiated by the conversion of violaxanthin to zeaxanthin. This hypothesis is based upon (i) similarity between the spectroscopic changes associated with energy dissipation and those observed upon aggregation of isolated light harvesting complex; and (ii) the link between changes in light scattering and increased energy dissipation.

Chlorophyll↗

Interaction between betamethasone and vecuronium.

A possible interaction between betamethasone and vecuronium was examined in 20 rat phrenic nerve-hemidiaphragm preparations. Ten preparations were bathed in a physiological solution with betamethasone 1 mumol litre-1 added and, after a 30-min period were exposed to vecuronium at concentrations of 4, 6, 8 and 10 mumol litre-1 with vecuronium free washings between each exposure. Ten control experiments were performed also using a betamethasone-free bathing solution. In comparison with control, the betamethasone group had significantly (P = 0.0008) less depression of muscle contraction (twitch) force at all concentrations of vecuronium. The calculated ED50 (50% depression of muscle contraction force) was 5.65 mumol litre-1 for controls and 7.39 mumol litre-1 for betamethasone-pretreated preparations. This study confirms our previous clinical observations that an interaction occurs between vecuronium and betamethasone which is characterized by resistance to neuromuscular block.

Animals↗

Fluoride in workplace air and in urine of workers concentrating fluorspar.

The urinary fluoride concentrations of workers exposed to calcium fluoride (CaF2) during fluorspar processing were measured. Personal dust measurement showed that the mean occupational exposure to fluoride for 12 workers in the most dusty environment was 24.3 mg/m3, which is 9.7 times the threshold limit value (TLV) of 2.5 mg/m3. Exposure was below the TLV for the remaining 23 workers. Urinary fluoride concentrations were measured pre- and postshift. The heavily exposed workers had a mean preshift concentration of 3.3 mg/liter (range 1.4-8.5 mg/liter), only slightly higher than the mean of 2.8 mg/liter (range 1.3-4.2 mg/liter) in the workers with fluoride exposure below the TLV. Four of the preshift concentrations exceeded the recommended upper limit of 4 mg/liter. The mean postshift concentration for workers exposed above the TLV was 4.4 mg/liter (range 2.4-7.1 mg/liter) and the difference between pre- and postshift concentrations was significant (p less than 0.05). Only one urinary concentration exceeded the recommended upper limit of 7 mg/liter. There was poor correlation between intensity of environmental exposure to fluorspar and postshift fluoride concentration in the urine. Eighteen workers provided a urine sample 7-14 hr after the end of a shift. The mean fluoride concentration was 4.7 mg/liter (range 2.4-11.7 mg/liter), which exceeded their postshift concentration by 0.2 mg/liter. These results indicate that the low aqueous solubility of fluorspar reduced the biologic availability of the fluoride ion but that this did not prevent excessive fluoride absorption in some workers.

Air Pollutants, Occupational↗

In vivo functioning of creatine phosphokinase in human forearm muscle, studied by 31P NMR saturation transfer.

31P nuclear magnetic resonance (NMR) saturation transfer has been used to measure enzymatic flux through the creatine phosphokinase reaction in the direction of ATP synthesis in the human forearm muscle flexor digitorum superficialis. Modification of the ratio method for measurement of spin-lattice relaxation (R. Freeman, H.D.W. Hill, and R. Kaptein, J. Magn. Reson. 7, 82(1972]was tested and used to appreciably shorten the duration of the measurement. Under conditions of steady state work intracellular pH decreased slightly by 0.06 units and the spin-lattice relaxation time of phosphocreatine in muscle was unchanged, while flux from phosphocreatine to ATP was 64 +/- 10% of the resting value. This is contrary to the increase in flux of 155% predicted from previous saturation transfer studies carried out in vitro on rabbit skeletal muscle creatine phosphokinase using metabolite concentrations to mimic those in vivo (E.A. Shoubridge, J.L. Bland, and G.K. Radda, Biochim. Biophys. Acta 805, 72 (1984]. This discrepancy could be accounted for by an underestimation of the ADP concentrations to which the enzyme is exposed due to inaccurate assumptions about the total metabolite concentrations, or possibly by compartmentation of creatine phosphokinase and its reactants.

Adenosine Diphosphate↗

Scoliosis surgery in the Prader-Willi syndrome.

There is a high incidence of spinal deformity in children with the Prader-Willi syndrome. We have encountered major complications following spinal surgery in this condition. We report our experience and conclude that spinal surgery is a formidable undertaking and the risks should be appreciated by the surgeon and the parents.

Child↗

Silicosis in non-mining industry on the Witwatersrand.

Silicosis outside the mines in South Africa has received little legislative or public attention. Between 1972 and 1986 217 such cases were seen at the National Centre for Occupational Health clinic, including 46 cases of progressive massive fibrosis. The relatively high proportion of cases of progressive massive fibrosis (21%), of patients less than or equal to 40 years at diagnosis (21% of blacks) and with exposures of less than or equal to 10 years (18%) indicate high silica exposures in industry. Four industries accounted for 83% of the cases--foundries, ceramics factories, refractories, and ore and stone crushing. Radiologically, readings of a mixture of rounded and irregular opacities were not uncommon (14%). Lymphadenopathy was very uncommon (less than 1%), while pleural thickening other than loss of the costophrenic angle was absent. Prevalences of symptoms, signs and lung function abnormality were high, probably owing to a range of factors other than silicosis. Cases of progressive massive fibrosis had significantly higher prevalences of these clinical abnormalities. When two separate lung function prediction equations were applied to the observed values in these cases, the number that met criteria for 'abnormality' differed. This finding has important implications for compensation. Recommendations include control of silica-using industries and careful occupational history-taking by clinicians.

Adult↗