1/13. Fatal and non-fatal injuries from vessels under air pressure in construction.Using a surveillance system that captures data on construction workers treated in an urban emergency department, we identified a series of injuries caused by vessels and tools under air pressure. We describe those six cases, as well as similar cases found in the Census of Fatal occupational injuries; we also review data from the National Surveillance for Traumatic Occupational Fatalities database and data from the Bureau of Labor statistics. Among the injuries and deaths for which we had good case descriptions, the majority would have been prevented by adherence to existing Occupational safety and health Administration standards in the construction industry.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/13. carbon disulfide vasculopathy: a small vessel disease.We present the clinical manifestations of 4 male patients with acute stroke-like symptoms and polyneuropathy after long-term exposure to carbon disulfide (CS2) in a viscose rayon plant. The ages of onset of polyneuropathy ranged from 42 to 45 years with a duration of CS2 exposure between 6 and 21 years. The ages of onset of stroke were from 42 to 48 years. The risk factors for stroke including heart disease and diabetes were denied, except for smoking in 4, hyperlipidemia in 2 and hypertension in 1. At the initial visit in 1992, only 2 patients developed sudden onset of hemiparesis suggesting a lacunar stroke before the diagnosis of CS2 intoxication. brain computed tomography (CT) scans showed low-density lesions in the basal ganglia in 2 patients, cortical atrophy in 1 and normal in 1. brain magnetic resonance image (MRI) study disclosed multiple lesions in the corona radiata and basal ganglia on T(2)-weighted images in 3 patients and cortical atrophy in 1. After the diagnosis, they left their jobs for a CS2-free environment, and improvement of the working conditions was noted. During 5 years follow-up period, another 2 patients also developed an acute episode of stroke with hemiparesis. brain CT and/or MRI follow-up studies in these 2 patients revealed new lesions in the basal ganglia and corona radiata. Intriguingly, a patient with previous stroke also developed new lesions in the bilateral thalami and brainstem. Carotid Doppler scan, transcranial Doppler scan and/or cerebral angiography did not show any prominent stenosis or occlusion in the major intracranial large arteries. We conclude that encephalopathy may occur in patients after long-term CS2 exposure, probably due to impaired cerebral perfusion. The lesions tend to occur in the basal ganglia, corona radiata and even brainstem, particularly involving the small-sized vessels. In addition, the cerebral lesions may progress even after cessation of CS2 exposure. Therefore, we suggest that CS2 exposure may be a risk factor for stroke.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/13. Silica exposure and systemic vasculitis.Work in Department of Energy (DOE) facilities has exposed workers to multiple toxic agents leading to acute and chronic diseases. Many exposures were common to numerous work sites. Exposure to crystalline silica was primarily restricted to a few facilities. I present the case of a 63-year-old male who worked in DOE facilities for 30 years as a weapons testing technician. In addition to silica, other workplace exposures included beryllium, various solvents and heavy metals, depleted uranium, and ionizing radiation. In 1989 a painful macular skin lesion was biopsied and diagnosed as leukocytoclastic vasculitis. By 1992 he developed gross hematuria and dyspnea. Blood laboratory results revealed a serum creatinine concentration of 2.1 mg/dL, ethrythrocyte sedimentation rate of 61 mm/hr, negative cANCA (antineutrophil cytoplasmic antibody cytoplasmic pattern), positive pANCA (ANCA perinuclear pattern), and antiglomerular basement membrane negative. Renal biopsy showed proliferative (crescentric) and necrotizing glomerulonephritis. The patient's diagnoses included microscopic polyangiitis, systemic necrotizing vasculitis, leukocytoclastic vasculitis, and glomerulonephritis. Environmental triggers are thought to play a role in the development of an idiopathic expression of systemic autoimmune disease. Crystalline silica exposure has been linked to rheumatoid arthritis, scleroderma, systemic lupus erythematosus, rapidly progressive glomerulonephritis and some of the small vessel vasculitides. DOE workers are currently able to apply for compensation under the federal Energy Employees Occupational Illness Compensation Program (EEOICP). However, the only diseases covered by EEOICP are cancers related to radiation exposure, chronic beryllium disease, and chronic silicosis.- - - - - - - - - - ranking = 0.2keywords = vessel (Clic here for more details about this article) |
4/13. Fatal streptococcus suis septicemia in an abattoir worker.A 51-year-old abattoir worker became ill with high fever and was admitted to hospital late in the evening, where he died 4 h later. Smears of peripheral blood taken 7 h after death showed numerous cocci. Cultures of the blood grew beta-hemolytic streptococci exhibiting the biochemical properties of streptococcus suis II. A complete autopsy with extensive microscopical studies showed numerous bacteria in small vessels of several organs, but no bacterial colonisation of tissues, meningitis, or other relevant lesions were found. The group R antigen of the bacteria could be demonstrated by immunofluorescence in paraffin sections of the kidney and the adrenal gland. Two similar cases of fulminant fatal streptococcus suis II septicemia have been reported from denmark. This appears to be the first case observed in the Federal Republic of germany.- - - - - - - - - - ranking = 0.2keywords = vessel (Clic here for more details about this article) |
5/13. Varix of the vocal cord in the professional voice user.Singers and actors who abuse their voices may develop either polyps, nodules, contact ulcers, and/or contact granuloma. Rarely a vascular lesion consisting of a hypertrophic vessel projecting above the medial or superior mucosal surface of the vocal cord is encountered that may contain a small knucklelike deformity. Clinically this is not dissimilar in appearance to a vessel found on the anterior nasal septum that is responsible for epistaxis. When the voice is strained, these vessels can rupture, causing recurrent submucosal hemorrhages in the professional voice user. The case described is that of a well-known actress in whom vocal abuse did not produce a submucosal hemorrhage from the varix but rather an edematous change and symptoms identical to those of a soft, early vocal cord nodule.- - - - - - - - - - ranking = 0.6keywords = vessel (Clic here for more details about this article) |
6/13. A report of occupational deaths attributed to fluorocarbon-113.This study reports two occupational deaths resulting from exposure to fluorocarbon-113 (1,1,2-trichloro-1,2,2-trifluoroethane; FC-113) in enclosed and confined spaces. One incident involved a worker who was exposed to FC-113 after entering a small degreasing tank to clean it. The second case involved a significant spill of FC-113 onboard a marine vessel. The incidents are compared to other fatal exposures.- - - - - - - - - - ranking = 0.2keywords = vessel (Clic here for more details about this article) |
7/13. Digital ischemia: angiographic differentiation of embolism from primary arterial disease.Embolic disease is often overlooked as a cause of digital ischemia. Unilateral symptoms, in particular, should suggest the possibility of emboli arising from the subclavian or more distal upper extremity vessels. Emboli may originate in the subclavian artery as the result of atherosclerosis at its origin or arterial injury secondary to thoracic outlet compression. Arteriography can be useful in the identification of upper extremity emboli and their source, and should include studies of the aortic arch, proximal subclavian artery, and digital arteries. Retrograde subclavian injections may be required to adequately demonstrate the origin of the subclavian artery. Magnification technique is often essential in differentiating small digital artery emboli from primary arterial diseases, such as Buerger disease or scleroderma.- - - - - - - - - - ranking = 0.2keywords = vessel (Clic here for more details about this article) |
8/13. Clearance of asbestos bodies from the lung: a personal view.In histological sections asbestos bodies in human lungs may be either transparent, yellow, strongly Perls-positive structures as described in published reports, or opaque, black structures, the ferroprotein coating having been converted into haemosiderin. The transparent asbestos bodies fragment into segments; the black asbestos bodies disintegrate into a mass of haemosiderin granules that accumulate as dense deposits, particularly near to blood vessels. The presence of haemosiderin granules indicates that asbestos bodies have broken down. When a patient has died with a mesothelioma there is little evidence of phagocytic activity in many areas of the lung. When exposure to asbestos ceased many years before a mesothelioma developed there may be few recognisable asbestos bodies remaining in the lung.- - - - - - - - - - ranking = 0.2keywords = vessel (Clic here for more details about this article) |
9/13. The differential diagnosis of hard metal lung disease.Hard metal lung disease is usually easy to diagnose, on the basis of occupational history, chest X-ray appearance of interstitial lung disease and, if necessary, by bronchoalveolar lavage (BAL). However, other interstitial lung diseases may affect patients with an occupational history of exposure to cobalt. In hard metal disease, the hylar lymphnodes may enlarge due to high draining of hard metals from the lung tissue via lymphatic vessels. Also, the presence of giant cells (even if Langhan's type) in the BAL fluid of sarcoid patients may be high. We present four patients with a history of exposure to hard metals and whose chest x-rays suggest sarcoidosis, stage II; in each, a pulmonary biopsy was necessary to confirm the diagnosis. Final diagnosis was sarcoidosis in one (showing typical granulomata in the lung tissue), and hard metal disease in three: two of these had foreign body-type granulomata in the lung tissue. neutron activation analysis (NAA) study was carried out on these four patients using specimens of BAL fluid, blood, urine, toenails, pubic hair and sperm. In the light of available data, the concentration of elements may not be useful in differentiating between sarcoidosis and hard metal pneumoconiosis. However, NAA on BAL fluid or other specimens may be helpful in confirming the presence of the offending agent in suspected cases when the occupational history is not clear.- - - - - - - - - - ranking = 0.2keywords = vessel (Clic here for more details about this article) |
10/13. The acute pathologic changes of paint-injection injury and correlation to surgical treatment: a report of two cases.The early histologic changes of digital tissues after paint-injection injury support the urgent need to remove all contaminated tissue. paint causes immediate tissue necrosis on contact and then incites an immediate necrotizing inflammatory reaction that persists if the tissues are not completely debrided. Early histopathologic changes include vessel thrombosis, tissue necrosis, and acute necrotizing inflammatory infiltrate, all occurring only hours after injection injury. In light of these histologic changes, if paint cannot be completely removed from digital arteries in an attempt to salvage the finger, then the wound should be left open and the finger monitored for further necrosis in response to the retained paint.- - - - - - - - - - ranking = 0.2keywords = vessel (Clic here for more details about this article) |
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