Variation in fibre and dust counts in an asbestos mine and mill.
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Biomedical subjects
Publications and source records attributed to H W Edstrom.
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We describe a case of endobronchial polyp associated with a foreign body. To our knowledge, this is the first report of such an occurrence. The polyp was successfully treated with steroids. This is only the third report of steroid treatment of endobronchial polyps.
Enterobronchial fistula is a rare condition. The authors describe a 47-year-old man who had a fistula between the small bowel and tracheobronchial tree, 8 years after resection of an adrenal carcinoma. The report illustrates the difficulties in diagnosis and the surgical treatment. In particular, the use of hyperosmolar, water-soluble contrast medium in radiologic investigations is to be avoided and the use of a double-lumen endotracheal tube is mandatory if a general anesthetic must be given. Despite its rarity, enterobronchial fistula can be diagnosed through a carefully taken history, confirmed safely by roentgenography and cured surgically.
Forty-eight workers involved for various periods from 1962 in mining and milling iron-containing rock in the Carol Lake area of western Labrador were found in late 1974 and early 1975 to have pneumoconiosis. Their annual chest roentgenograms demonstrated irregular nodular densities, and several revealed mild hilar lymphadenopathy or pleural thickening. All 48 workers were asymptomatic and had normal pulmonary function; their average age was 38 years. At work they had been exposed to high levels of dust containing iron, silica and anthophyllite, a type of asbestos. Lung biopsy specimens from 13 of them showed widespread focal fibrosis, large amounts of hemosiderin and silica and many ferruginous bodies; one ferruginous body was identified as having a core of anthophyllite. A granulomatous reaction was seen in two biopsy specimens and typical silicotic nodules were found in two others. The relatively brief exposure, especially in ones case (11 months), and the short latent interval before the development of the pneumoconiosis are reasons for concern for the health of iron ore workers.
A 30-year-old man with recurrent sinopulmonary infections, eventually fatal, was found to have common variable immunodeficiency. In addition to low serum immunoglobulin concentrations he also had lymphopenia and cell-mediated immunodeficiency as shown by cutaneous anergy and a poor lymphocyte response to phytohemagglutinin (PHA) in vitro. However, intradermal injection of PHA produced a vigorous cutaneous response, showing that some cell-mediated responsiveness remained. The responsiveness of his lymphocytes to PHA was restored towards normal (confirmed by chromosome studies) by the addition of a small number of normal leukocytes to cultures; thus a reversible functional defect in his T-lymphocytes was revealed. Experiments indicated that the defect was cellular and not due to serum factors and it was concluded that normal leukocytes restored a missing factor to the patient's T-lymphocytes. Although counts of macrophage precursor cells in the bloodstream were low, thus contributing to the immunodeficiency, this could not have caused the reduced PHA response. Several relatives of this patient had lymphoma; two cousins had common variable immunodeficiency.