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Biomedical subjects

M Silverstein

Publications and source records attributed to M Silverstein.

At least 55 records · Page 3Linked to original sources

Mortality among workers exposed to coal tar pitch volatiles and welding emissions: an exercise in epidemiologic triage.

The United Automobile Workers International Union has established a system of epidemiologic triage to evaluate patterns of mortality among groups of union members. In response to worker concerns, the Union examined mortality at a metal stamping plant, using a method which linked pension records with the State of Michigan computerized death registry. The observed proportion of malignant neoplasms was nearly twice that expected (95% Confidence Limits 1.36, 2.62). Two- to five-fold excess proportional mortality from cancer of the digestive organs, lung cancer, and leukemia accounted for most of the overall excess. Strong associations were found between lung and digestive organ cancer and employment as maintenance welders or millwrights in the plant (odds ratios greater than 10). High levels of six polycyclic aromatic hydrocarbons with mutagenic and carcinogenic properties were found during hot coal tar application to wood block floors, work conducted by the high-risk groups. These levels were substantially reduced following the purchase of new tar pots. The example demonstrates that epidemiologic tools can play a valuable role in occupational health decision making, but care must be taken to avoid mechanical reliance on quantitative testing and to acknowledge the important role of social and political value judgments in the establishment of responsible public policy.

Adult↗

Disordered thinking.

To evaluate formulations that thought disorder at the posthospital phase identifies a subgroup of nuclear schizophrenics with poor outcomes, 77 patients from a longitudinal project were followed up on major dimensions of psychopathology linked to nuclear schizophrenia. The data indicate that (1) schizophrenics were more thought disordered than were nonschizophrenics at the posthospital phase; (2) thought-disordered schizophrenics had only slightly poorer scores on classic prognostic indicators associated with poor outcomes; (3) a subgroup of early chronic schizophrenics were not severely thought disordered; (4) almost all severely thought-disordered schizophrenics demonstrated clear evidence of delusional activity at follow-up; and (5) thought-disordered schizophrenics had poorer outcomes. The overall results fit in with formulations that a severe thought disorder is one of several major features of schizophrenia. The data suggest that posthospital thought disorder identifies a subgroup of poor-outcome schizophrenics, although some non-thought-disordered schizophrenics also show poor outcomes.

Adult↗

Mortality among workers in a die-casting and electroplating plant.

A proportional mortality and case-referent analysis of 238 deaths among hourly employees in an automobile hardware manufacturing plant was conducted. The major operations of the plant were zinc die casting and electroplating. Chemical exposure included die-casting emissions and mists from chrome and nickel plating. The chief proportional mortality finding was a significant excess of lung cancer among both white men and women. A case-referent analysis indicated a possible association between lung cancer and work in certain departments. The findings support the hypothesis of a work-related carcinogenic risk. Follow-up recommendations have been made.

Adult↗

Nodular mixed lymphocytic-histiocytic lymphoma (NM): response and survival. Eastern Cooperative Oncology Group.

Eighty patients with nodular mixed lymphocytic-histiocytic lymphoma (NM) entered on four different Eastern Cooperative Oncology Group chemotherapy studies were analyzed for response and survival. They were compared with 249 patients with nodular lymphocytic poorly differentiated lymphoma (NLPD), who were treated similarly. The response rates in NM were: CR 45%, PR 30%, NC-PD 25%. In NLPD the quality of response had little effect on survival (CR 91%, PR 90%, NC-PD 76%), whereas in NM the two year survivorship of 85% for CR dropped drastically to 33% for the partial responders (P less than 0.01). Ninety percent of the previously untreated NLPD, but only 59% of the comparable group of NM, survived 2 years. In 23 patients with NM in which the pattern was reported as both nodular and diffuse (ND-M), the 2-year survival of 35% was markedly inferior to a 66% 2-year survivorship observed in 57 patients with the pure nodular pattern (P less than 0.05). It appears that NM is a less favorable lymphoma type than NLPD. In NM achievement of a CR affects survival favorably; consequently, the use of aggressive chemotherapy regimens in an attempt to achieve high rates of CR are recommended. In NLPD, on the other hand, since survival curves of partial and complete responders are almost identical, suboptimal treatments may be justified.

Antineoplastic Agents↗

Effects of asbestos on epithelioid cell lines.

The in vitro effects of asbestos fibers on the growth and viability of CHO cells, an epithelioid cell line derived from Chinese hamster ovary, and on K-22 cells, an epithelial cell line derived from rat liver, have been studied. Relatively low concentrations of asbestos (10 micrograms/ml) were quite cytotoxic to both cell types. A sample of chrysotile asbestos was more toxic than samples of crocidolite or amosite. The toxic factor could not be extracted from the asbestos and toxicity occurred only if there was physical contact between the fibers and the cells. Although the phorbol ester class of tumor promoters induces the synthesis of plasminogen activator in various cell cultures, asbestos did not induce this protease in epithelioid or fibroblast cell cultures. The results obtained are compared to previous in vitro results obtained with fibroblast or macrophage cultures and are discussed in terms of their possible relevance to asbestos-induced fibrosis and tumorigenesis.

Animals↗

Comparison of intensive versus moderate chemotherapy of lymphocytic lymphomas: a progress report.

In an Easter Cooperative Oncology Group trial, Cytoxan-prednisone (CP) Induction was compared to BCNU-prednisone (BP) in 273 patients with lymphocytic lymphoma. Response rates were comparable, with 21% achieving complete response and 40%, partial response. Patients with a nodular pattern responded better. Maintenance phase comparing cyclic intensive therapy (BCVP) with intermittent chlorambucil revealed the superiority of BCVP as demonstrated by improvement of the quality of response and somewhat longer remissions. The value of the Rappaport classification in the evaluation of lymphoma chemotherapy results is discussed. It is suggested tha NHL be separated into "favorable" and "unfavorable" groups, based on the presence or absence of nodularity and treatment schedules devised accordingly.

Adult↗

Successful transurethral intralesional BCG therapy of a bladder melanoma.

An isolated metastasis of malignant melanoma to the urinary bladder of a patient was sucessfully eradicated by transurethral intralesional injection of BCG. Total destruction of the tumor was confirmed by subsequent excision. Lymphocyte blastogenesis studies revealed no significant alteration in immunocompetence secondary to the therapy, except for an increased responsiveness to PPD. There was no evidence of presence of blocking factors following therapy; cytotoxicity against MLA-14 melanoma cells sharply increased after the intralesional injection. Humoral antimelanoma antibody levels, determined by complement fixation, were decreased before the intralesional therapy, but increased markedly immediately following the transurethral BCG injection.

Antibodies, Neoplasm↗