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Identification of dyes on ancient Chinese paper samples using the subtracted shifted Raman spectroscopy method.

The Stein Collection in the British Library contains the Diamond Sutra, the world's oldest, dated, printed document. The paper of the Diamond Sutra and other documents from the Stein collection is believed to be dyed yellow by a natural extract, called huangbo, from the bark of Phellodendron amurense, which contains three major yellow chromophores: berberine, palmatine, and jatrorrhizine. Conservation of these documents requires definite information on the chemical composition of the dyes but no suitable, completely noninvasive analytical method is known. Here we report resonance Raman studies of a series of pure dyes, of plant materials and extracts, and of dyed ancient and modern paper samples. Resonance Raman spectroscopy is used to enhance the spectra of the dyes over the signals from the paper matrixes in which they are held. The samples all give resonance Raman spectra which are dominated by intense fluorescence, but by using SSRS (subtracted shifted Raman spectroscopy) we have obtained reliable spectra of the pure dyes, native bark from the Phellodendron amurense, modern paper dyed with huangbo extracted from this bark, and ancient paper samples. For both ancient paper samples whose pigment bands were detected, the relative intensities of the bands due to berberine and palmatine suggest that the ancient paper is richer in berberine than its modern counterpart. This is the first nondestructive in situ method for detection of these pigments in manuscripts, and as such has considerable potential benefit for the treatment of irreplaceable documents that are believed to be dyed with huangbo but documents on which conservation work cannot proceed without definite identification of the chemical compounds that they contain.

Luminescent Measurements↗

Occupational allergic contact dermatitis caused by diethylenetriamine in carbonless copy paper.

Carbonless copy paper, or 'no carbon required' (NCR) paper, has often been implicated as the cause of skin, respiratory, or general symptoms, but allergy has been verified in only a few cases. A 43-year-old machinist whose work involved the manufacture of NCR paper developed occupational dermatitis on the hands. On patch testing, both the NCR paper and 1 of the chemicals used to produce the microcapsules of the NCR paper, namely diethylenetriamine (DETA), provoked an allergic reaction. Analysis of the paper showed that it contained enough DETA to induce allergic contact dermatitis. People who handle NCR paper and develop symptoms of contact dermatitis should be patch tested with DETA.

Adult↗

Protein recovery from several paper types used to collect gingival crevicular fluid.

The purpose of this study was to compare the efficiency of protein elution from several types of gingival crevicular fluid (GCF) collection papers when the volume of the inoculated protein and the elution methods were constant. Various concentrations of bovine serum albumin (BSA) and 14C-BSA were placed onto strips of Whatman #1 [W1], Whatman 3 MM chromatographic [W3], Periopaper (ProFlow) [P] and Periopaper (Harco) [H], and recovered proteins measured following a non-optimized centrifugal elution technique. There were significant differences in % recovery of BSA and 14C-BSA from the papers, which was dependent on both the type of paper and the concentration of the inoculated protein; that is, proteins at the lowest concentrations were less efficiently eluted from GCF collection papers than those at higher concentrations. Equations for regression lines of elution efficiency were quadratic. Thus, our data suggest significant differences in the efficiency for elution of BSA from absorbent papers when the volume of the inoculated fluid and the elution technique were constant. Previous variable or conflicting experimental data between research groups may have resulted from incomplete elution of proteins from GCF collection papers, possibly due to entrapment within, or binding of GCF proteins to the paper.

Absorption↗

Novel screening method for urine cultures using a filter paper dilution system.

We have developed a novel method for urine culture for office practice based on the use of filter paper as a solid-phase dilution device. Filtration dilutes and spreads the inoculum onto a solid culture surface. Experiments were conducted to determine the optimum inoculum size, microbial permeability through filter papers, and ability to exclude vaginal epithelial cells. The filter paper dilution system was compared to the standard streak method to detect bacteriuria in specimens submitted to the diagnostic laboratory. The sensitivity and specificity of the filter paper dilution system for detection of high-count (>/=10(4) CFU/ml) gram-negative bacteriuria in 487 urine specimens were 98.2 and 97.4%, respectively. The sensitivity and specificity for gram-positive bacteriuria in 404 urine specimens were 91.2 and 99.2%, respectively. Low-count gram-negative bacteriuria (<10(4) CFU/ml) was detected by the filter paper dilution system in five of nine specimens (55.6%). In addition, the filter paper dilution system was able to detect gram-negative bacteria in 12 of 41 (29.3%) mixed cultures. Lactobacillus and Gardnerella organisms in urine specimens were excluded by the filter paper dilution system. Only three of eight Candida sp. isolates were detected at counts of >/=10(4) CFU/ml. The system has good storage properties and can be inoculated at the point of source without the need for refrigeration or preservatives. It should be a useful screening method for office practice, where members of the family Enterobacteriaceae and staphylococci cause most infections. Standard culture methods are preferred for hospital diagnostic microbiology laboratories, where there is a need to detect yeasts and fastidious microorganisms and to isolate individual colonies from mixed cultures.

Bacteriuria↗

Mortality from non-malignant diseases in a cohort of female pulp and paper workers in Norway.

OBJECTIVES: The objective of the present study was to investigate the risk of death from non-malignant diseases in female pulp and paper workers in Norway. METHODS: A total of 3143 women first employed between 1920-93 were included in the study cohort. Information about each cohort member was obtained from personnel record files in the mills in order to identify employment periods and job categories. Data on cause and date of death were added by linkage to the Cause of Death Register using unique personal identification numbers. The follow up period was 1951-2000. Standardised mortality ratios (SMRs) with 95% confidence intervals (95% CIs) were calculated using the national female mortality rates as reference. Poisson regression analysis was used to examine internal relations between the duration of employment in paper departments and the risk of death from selected causes. Relative risks (RRs) and 95% CIs were calculated. RESULTS: The study showed a significantly increased risk for total non-malignant mortality (SMR = 1.14, 95% CI 1.05 to 1.24), mainly due to increased mortality from ischaemic heart disease (SMR = 1.22, 95% CI 1.03 to 1.43) and cerebrovascular diseases (SMR = 1.16, 95% CI 0.94 to 1.42). Analysis by department showed the highest risk of death in paper department workers with short term employment. Internal analyses showed a 5% and 9% increase in risk of dying from ischaemic heart disease and respiratory diseases, respectively, among paper department workers exposed to paper dust. The risk decreased with increasing duration of employment. CONCLUSION: The increased risk of ischaemic heart diseases and respiratory diseases seen among employees of paper departments may be related to exposure to paper dust.

Adult↗

Risk of cancer among paper recycling workers.

OBJECTIVES: Studies in traditional paper mills have indicated an excess cancer risk, and mutagenic compounds have been identified in the industry. No studies have reported on risk of cancer in paper recycling. Therefore the cancer incidence in Danish paper recycling mills was investigated. METHODS: 5377 employees in five paper recycling plants were included in a historical cohort study. The workers had been employed in paper recycling in 1965-90, and the cohort was followed up until 31 December 1993. The expected number of cancer cases was calculated from national rates. RESULTS: There was significantly more pharyngeal cancer among male workers (seven observed (standardised incidence ratio (SIR) 3.33, 95% confidence interval (95% CI) 1.34 to 6.87)). There was slightly more lung cancer among male workers in production (39 observed, SIR 1.21, 95% CI 0.86 to 1.65). Risk of Hodgkin's disease was doubled in male production worker (four observed, SIR 1.90, 95% CI 0.51 to 4.85). CONCLUSIONS: The increased risk of pharyngeal cancer found in this study is interesting but may be influenced by confounders such as smoking and alcohol intake. This study also indicates an excess risk of Hodgkin's disease, which is in accordance with some studies in the traditional paper mills. As this is the first report on risk of cancer in paper recycling, further studies are needed.

Cohort Studies↗

Enzyme-linked immunoassay for dengue virus IgM and IgG antibodies in serum and filter paper blood.

BACKGROUND: The reproducibilty of dengue IgM and IgG ELISA was studied in serum and filter paper blood spots from Vietnamese febrile patients. METHODS: 781 pairs of acute (t0) and convalescent sera, obtained after three weeks (t3) and 161 corresponding pairs of filter paper blood spots were tested with ELISA for dengue IgG and IgM. 74 serum pairs were tested again in another laboratory with similar methods, after a mean of 252 days. RESULTS: Cases were classified as no dengue (10 %), past dengue (55%) acute primary (7%) or secondary (28%) dengue. Significant differences between the two laboratories' results were found leading to different diagnostic classification (kappa 0.46, p < 0.001). Filter paper results correlated poorly to serum values, being more variable and lower with a mean (95% CI) difference of 0.82 (0.36 to 1.28) for IgMt3, 0.94 (0.51 to 1.37) for IgGt0 and 0.26 (-0.20 to 0.71) for IgGt3. This also led to differences in diagnostic classification (kappa value 0.44, p < 0.001) The duration of storage of frozen serum and dried filter papers, sealed in nylon bags in an air-conditioned room, had no significant effect on the ELISA results. CONCLUSION: Dengue virus IgG antibodies in serum and filter papers was not affected by duration of storage, but was subject to inter-laboratory variability. Dengue virus IgM antibodies measured in serum reconstituted from blood spots on filter papers were lower than in serum, in particular in the acute phase of disease. Therefore this method limits its value for diagnostic confirmation of individual patients with dengue virus infections. However the detection of dengue virus IgG antibodies eluted from filter paper can be used for sero-prevalence cross sectional studies.

Antibodies, Viral↗

Is pH paper an acceptable, low-cost alternative to the blood gas analyzer for determining pleural fluid pH?

BACKGROUND: Our laboratory uses pH paper rather than a blood gas analyzer to measure pleural fluid pH to decrease cost and avoid analyzer malfunction due to viscous fluids. METHODS: To compare these two methods of determining pleural fluid pH, 42 patients undergoing diagnostic or therapeutic thoracentesis had two 1-mL aliquots of pleural fluid anaerobically collected in a heparinized syringe and placed on ice. pH measurements were made using litmus paper (pHydron Vivid 6-8 brand litmus paper; MicroEssential Labs; Brooklyn, NY) and the model 995-Hb blood gas analyzer (AVL Instruments; Roswell, GA) within 1 h of collection. Agreement analysis was performed in three ways: on the entire group; in subcategories of complicated or uncomplicated parapneumonic effusions (<7.1, 7.1 to 7.3, >7.3); and in subcategories of poor prognosis or better prognosis malignant effusions(<7.3, >7.3). RESULTS: pH measured with pH paper was significantly more variable (SD=0.55, coefficient of variation [CV]=7.5%) than was pH measured with the blood gas analyzer (SD=0.11, CV=1.5%). There was no significant correlation between values obtained with the two techniques (r=-0.26, SD of the differences=0.59). Using the pH subcategories, there was 72% discordance in classification between litmus paper and arterial blood gas (ABG) determinations for patients with parapneumonic effusions. In patients with malignant effusions, there was 30% discordance. The pH values obtained by the ABG analyzer predicted tube thoracostomy 72% of the time, whereas the pH values obtained using pH paper were consistent only 36% of the time. CONCLUSION: Determination of pleural fluid pH using pH paper is unreliable and should not be considered an acceptable alternative to the blood gas analyzer. There is no need to determine pH on purulent samples. Hospital laboratories will be more likely to allow the use of the ABG analyzer on fluids other than blood if clinicians keep this in mind.

Blood Gas Analysis↗

Capillary blood on filter paper for determination of HbA1c by ion exchange chromatography.

OBJECTIVE: To facilitate HbA1c determination, we evaluated an HbA1c filter paper system enabling capillary blood sampling at home by the patients. RESEARCH DESIGN AND METHODS: Capillary blood (two drops) was applied to a filter paper (HbA1c Via Post) and sent to the laboratory where a small disc was punched out on the filter paper. Hemoglobin was eluted from the disc in a buffer containing cysteine to eliminate the interfering glutathione adduct (HbA3) formed during storage. Analysis was performed by ion-exchange chromatography (Mono S, high-performance liquid chromatography), and the eluate was compared with hemolysate of venous blood from 41 patients. The stability of blood impregnated on filter paper was checked at different temperatures over different periods of time. RESULTS: There was an excellent agreement (r = 0.99) between HbA1c values from capillary blood on filter paper and HbA1c values from venous blood. HbA1c values were constant when stored on filter paper for 5-7 days at 20-21 degrees C (room temperature) or at 4-6 degrees C (refrigerator) for 10 days as well as at -70 degrees C for several months after blood sampling. A new chromatographic-interfering hemoglobin fraction both from venous and capillary samples was identified as free alpha-chain of hemoglobin. CONCLUSIONS: The HbA1c filter paper system enables capillary blood sampling at home, eliminates the need of vein puncture in children and adults, and provides the diabetologist with an HbA1c value when the patient visits the clinic without a need for a previsit phlebotomy.

Blood Specimen Collection↗

Gliomas among men employed in the Swedish pulp and paper industry.

OBJECTIVES: This study investigated whether previous findings of an increased risk of gliomas among workers in some pulp and paper mills could be confirmed for all Swedish pulp and paper mill workers and whether the increase could be attributed to certain occupational groups. METHODS: The study was based on the Swedish Cancer Environment Register, which links the incidence of cancer from 1971 to 1990 and the 1960 and 1970 census data on codes of occupation and industry for the whole population. Standardized incidence ratios (SIR) were used to estimate the risks for men in different occupations in pulp (N = 28,142) and paper (N = 39,169) mills in 1960, 1970 or both years as compared with those of all gainfully employed men in Sweden. RESULTS: Maintenance workers employed in pulp or paper mills in 1960, 1970 or both years, as well aspulp workers, showed an increased incidence of gliomas in 1971-1990 [SIR 1.5, 95% confidence interval (95% CI) 1.1-2.1 and SIR 1.5,95% CI 1.0-2.2, respectively], whereas the incidence among process workers in paper mills was lower than expected (SIR 0.6, 95% CI 0.3-0.9). Taken together, all employed men in the pulp mill industry had an increased incidence of gliomas (SIR 1.3, 95% CI 1.0-1.7). CONCLUSIONS: Pulp mill workers, but not paper mill workers, were found to have more gliomas in 1971-1990 than expected. There was an increased risk of gliomas among maintenance workers in both pulp and paper mills. Few risk factors for brain tumors are recognized, and the causes of the increase are not obvious.

Aged↗

Use of FTA gene guard filter paper for the storage and transportation of tumor cells for molecular testing.

CONTEXT: Efficient methods of storing tumor specimens for molecular testing are needed in the modern surgical pathology laboratory. The FTA Gene Guard system is a novel method for the collection and room temperature storage of blood samples for DNA testing. The method uses index card-sized filter papers that provide an ideal medium on which to store tumor specimens for DNA testing. OBJECTIVE: To determine whether FTA filter paper can be used in the surgical pathology laboratory to store tumor cells for DNA testing. DESIGN: Cell suspensions were prepared from 60 surgical specimens, and DNA was extracted either immediately or after storage on FTA paper. The DNA extracted by each method was tested by polymerase chain reaction (PCR) for the beta-globin and interferon gamma genes, and the results were compared. Fifteen lymph node specimens stored on FTA paper were then tested for immunoglobulin heavy chain (IgH) gene rearrangement by PCR, and these results were compared with those obtained for immediately extracted DNA. SETTING: University medical center. RESULTS: The DNA extracted from cells stored on FTA paper performed as well in the PCR as the freshly extracted DNA in nearly all cases (>95%). The results of tests for IgH gene rearrangements showed 100% concordance between the 2 methods of DNA extraction.Conclusion.-Cells from surgical specimens can be stored on FTA paper for extended lengths of time, and DNA can be extracted from these cells for PCR-based testing. FTA filter paper is a reliable medium for the storage and/or transport of tumor cells for PCR-based DNA analysis.

Cytodiagnosis↗

Use of filter paper disks for hepatitis A surveillance.

BACKGROUND: Venous blood collection is a cumbersome and uncomfortable procedure during hepatitis A surveillance. Collection of capillary blood by finger prick is an alternative method. AIM: To evaluate the reactivity of capillary blood/anti-hepatitis A virus (HAV) IgG stored on filter paper disks for detection of anti-HAV antibody. METHODS: Venous blood specimens were collected from healthy individuals. Simultaneous capillary blood specimens obtained by finger prick were stored on filter paper disks. A reference standard of anti-HAV IgG in known concentrations was spotted on filter paper disks. The reactivities of anti-HAV IgG and capillary blood specimens eluted from filter paper disks were tested by blocking ELISA for detection of anti-HAV antibody. The results were evaluated by comparing optical density (OD) and neutralization values with those obtained for WHO anti-HAV IgG stored in liquid phase and homologous venous blood specimens, respectively. RESULTS: Among both venous and capillary-blood specimens stored for 10 days, percent neutralization shown by the same 46 specimens was > 50 and that of the same 3 specimens was < 50, indicating anti-HAV positivity and negativity, respectively. There was significant correlation between the OD values displayed by anti-HAV IgG from liquid phase and that eluted from filter paper disk (p < 0.01). Sixteen serum specimens stored for a period of 2 months showed results similar to those of the corresponding filter paper disk elutes. CONCLUSION: Use of filter paper disks could be a suitable choice for pre- and post-immunization collection of blood specimens during hepatitis A surveillance.

Bacteriological Techniques↗

Storage stability of dengue IgM and IgG antibodies in whole blood and serum dried on filter paper strips detected by ELISA.

Blood specimens from 133 patients clinically diagnosed as dengue virus infection by physicians in Nakhon Phanom Hospital, Thailand, were examined to detect anti-dengue IgM and IgG antibodies by antibody capture ELISA. The blood specimens were divided into 3 types of storage; (1) frozen serum aliquots, (2) whole blood dried on filter paper strips, and (3) sera dried on filter paper strips. These specimens were stored for the periods of 1, 3, 4, and 5 months, at -20 degrees C in the case of frozen serum aliquots, or at room temperature in the case of specimens dried on filter paper strips, before examined in paralleled by the ELISA. Anti-dengue IgG antibodies were stable for at least 5 months of storage as dried whole blood or serum on filter paper strips. So were the anti-dengue IgM antibodies in the dried whole blood from secondary dengue cases. Anti-dengue IgM antibodies from primary dengue cases declined slowly in whole blood and more rapidly in serum, both dried on filter paper strips. In the serum dried on filter paper strips, even anti-dengue IgM antibodies from secondary cases decreased significantly on storage. We suggest that diagnosis on dengue infections by IgM-capture ELISA should be performed within 1 month after the test specimens are collected as whole blood, not as serum, when the filter paper method is used for sample collection.

Antibodies, Viral↗

[Risk of death from malignant neoplasms among paper mill workers].

A cohort study was designed to evaluate the risk of death from malignant neoplasms among pulp and paper workers. This paper presents the evaluation of death risk among workers engaged only in the production of paper, paperboard and paper products. The cohort study covered 1,322 males and 1,914 females employed for, at least, one year in a big pulp and paper mill during the period 1968-90. The study of exposure to harmful factors revealed that concentrations of paper and paperboard dusts in this mill exceeded hygienic standards. The analysis of death risk by causes and gender of those under study was based on standardized mortality rate (SMR) calculated using the method of person-year observation. The general population of Poland was used as reference. The results do not confirm excess mortality from lung, stomach and hematopoietic cancers in paper mill workers reported by other authors. However, an elevated risk of bladder cancer in males (SMR = 491, two deaths) and brain cancer in females (SMR = 353, two deaths) was observed. Both SMR values were not statistically significant. Because of small number of deaths, risk according to exposure and latency was not evaluated.

Adult↗

[Anal hygiene in perianal skin diseases--compatibility of water moist and dry toilet paper].

The most common morphological changes in 485 of our ambulatory patients were found on external examination of the anal region (46%). These changes included erosions, fissur and eczema. Regarding the symptoms the predominant complaints were itching and burning in 42.1%. Anal hygiene after defaecation was most commonly done with dry toilet-paper (55%). A change in anal hygiene after defaecation relieves symptoms: By changing from water to moist toilet paper in 9%, from dry toilet paper to moist toilet paper in 30%, from moist toilet paper to water in 32%, an from dry toilet paper to water in 60%. These results confirm known facts regarding the influences of conserving agents an printing materials in dry (often recycled) and moist toilet papers on the skin. These side-effects to be even more pronounced in the compromised skin and suggest that anal hygiene should be done with water only.

Adult↗

[Respiratory function and allergic reactions in paper recycling workers].

Respiratory function and allergic reactions were studied in 101 male workers in paper recycling and in 87 nonexposed male control workers. Ventilatory capacity was measured by recording maximum expiratory flow-volume (MEFV) curves with readings on forced vital capacity (FVC), one-second forced expiratory volume (FEV1), and maximum expiratory flows at 50% and the last 25% (FEF50 and FEF25, respectively). Skin prick test with paper dust allergens, some nonoccupational allergens, and total immunoglobulin IgE analysis were used to assess immunological status. Significantly higher prevalences of all chronic respiratory symptoms were recorded in the exposed workers than in controls. The highest prevalence was recorded for chronic cough (36.6%), followed by chronic phlegm (34.7%), chronic bronchitis (33.7%), sinusitis (31.7%), nasal catarrh (29.7%), and dyspnea (16.8%). Occupational asthma was diagnosed in four paper recycling workers only (4.0%). Values of FEF50 and FEF25 were significantly lower than predicted, indicating obstructive changes located mostly in the smaller airways. Skin tests to paper allergens were found positive in 16 (15.8%) paper recycling workers and none in controls. An increase in total immunoglobulin IgE was found in 21 of 101 paper recycling workers and in two of 37 of controls (P < 0.05). Our data indicate that exposure to air pollutants in paper recycling industry may lead to the development of respiratory symptoms accompanied by lung function and immunological impairment.

Adult↗

Expanded paper towel test: an objective test of urine loss for stress incontinence.

AIM: To investigate the repeatability of a short stress test of coughing and jumping (the expanded Paper Towel Test (PTT)) to quantify urine loss in stress incontinent adult women. MATERIALS AND METHODS: In the laboratory, the reliability of two methods of measuring the size of the wet area, produced by a typical volume of water titrated onto paper towel was investigated and some absorbency properties of the brand of towel used were quantified. Thirty one women performed a provocative coughing and jumping test on consecutive days using a "perineal pad" of paper towel. The repeatability coefficient was calculated. RESULTS: The provocative test was repeatable to within 2.8 ml of urine loss, but with the exclusion of one anomalous result, the repeatability improved to lie within 1 ml. The coefficient of variation (CV) for the between-method differences (computer scanning and graph paper) was 1.27%. A volume of 1 ml of water produced a wet area of 25.7 cm2. The range of measurable areas corresponded to volumes of 0.005-8 ml. Standardization of method is required because the size of the wet area differed by manufacturer of paper towel (P < 0.01, two products compared) and with time elapsed since titration (P < 0.01). CONCLUSIONS: The "expanded PTT" is a simple tool for quantification of urine loss (0.005-8 ml) in women to 72 years with stress incontinence. With a suggested modification, it should prove reliable for detection of between-visit differences of 1 ml. The reliability of the test is dependent upon the use of standard protocol and paper towel with known volume-area ratio. To improve clinical diagnosis, it can also be used with any brand of paper towel to confirm the sign of stress incontinence on exertion.

Absorption↗

Anaplasmosis in Uganda. I. Use of dried blood on filter papers and serum samples for serodiagnosis of anaplasmosis--a comparative study.

The suitability of blood collected on filter papers in comparison with corresponding conventional serum samples in the diagnosis of bovine anaplasmosis was studied using the complement fixation test, DOT-ELISA, Western immunoblot and rapid card agglutination test. Dried blood on Whatman filter paper no. 1 was eluted in PBS 0.05% Tween 20 giving an initial dilution of 1:10. The reactivity of the eluted samples in both DOT-ELISA and Western immunoblotting were similar to those obtained with the corresponding straight serum sample dilutions. Filter paper samples gave lower reactivity in the remaining tests when compared with corresponding serum samples. There was no significant difference in the reactivity between the eluates from filter papers stored at temperatures ranging between 15.5 and 24 degrees C and those kept refrigerated. Storage at 15.5 to 24 degrees C did not significantly affect reactivity for up to six months. Eluates from filter papers stored for six months at 15.5 to 24 degrees C continued to give similar reactivity as those from freshly prepared filter papers in both DOT-ELISA and Western blot, and in the rapid card agglutination test. It is concluded that collecting blood on filter papers is a suitable technique for large scale seroepidemiological studies on anaplasmosis and offers many advantages in developing countries where transport and cold chain facilities are a major constraint.

Agglutination Tests↗