OBJECTIVES: To compare the concentrations of inorganic fibres in the lungs in cases of mesothelioma and controls: to determine whether concentrations of retained asbestos fibres differ with the different exposures identified from interview; and to investigate the existence of a cut off point in concentrations of asbestos fibres that indicates occupational exposure. METHODS: Case-control study; 147 confirmed cases of mesothelioma and 122 controls identified from deaths occurring in four districts of Yorkshire between 1979 and 1991. Surviving relatives were interviewed to determine lifetime exposure history to asbestos. Mineral fibre analysis was carried out on lung tissue from postmortem examinations. RESULTS: Odds on high concentrations of retained asbestos fibres were greater in cases than controls. After excluding subjects with occupational and paraoccupational exposure, the odds on high concentrations were still greater in cases than controls, but only significantly so for amphiboles. There was only a weak relation between probability of occupational exposure to asbestos and concentrations of retained asbestos fibres, and no significant difference in fibre concentrations was found between subjects who had been exposed to asbestos through different routes: these comparisons were only based on small groups. There was considerable overlap in concentrations of retained asbestos fibres between cases and controls with and without histories of occupational exposure. CONCLUSIONS: The study has confirmed previous results of higher concentrations of asbestos fibres in cases than controls, and has shown that this is still found in subjects with little evidence of occupational and para-occupational exposure. The overlap in concentrations of retained asbestos for different groups of subjects did not suggest a clear cut of value.
Saliva secretory IgA (sIgA), secretory component (SC); serum immunoglobulins (IgG, IgA, IgM), complement (C3, C4), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were performed in 32 patients with ankylosing spondylitis and 29 normal controls. They were investigated for carriage in the faeces of Klebsiella spp. on 3 occasions over the previous months. Throat swabs and urine were cultured at the same time as immunological estimations were done. 24-hour urine sIgA specimens were studied in 13 patients and 12 normal controls. Significantly raised mean values of saliva sIgA and serum IgG, IgA, C3, and C4 were found in patients with raised values of serum ESR and CRP levels when correlated with controls. Raised values of sIgA in saliva, which is an important factor of the local immune defence mechanism of mucosal surfaces, suggests the presence of an antigenic stimulus from the gastrointestinal system in ankylosing spondylitis during activity of disease.
In medico-legal work the identification of skin, hair or secretions can be very important. Here an adaptation of the mixed agglutination technique suitable for determining the major blood group of skin is described as a step towards this goal and a foundation for further work. The advantages of the newer immunological methods lie particularly in the very minute amount of material needed and the direct significance of the result, in contrast with older methods which depended on the indirect inhibition of the agglutinating power of a serum, or a precipitin reaction with much-altered and processed material.
Understanding of the significance of congenital malformations advances only slowly.One of the most difficult to explain is acephalia-complete absence of the head-of which an example is described here.True acephaly where the whole head is missing from an otherwise well-developed foetus must be distinguished from anencephaly, of which the features are well known, and the acephalic acardiac variety of reduced twin (Willis, 1962).Here, though no head may be visible, some of the organs and a brain in much reduced form may be buried in the amorphous body.Case Report (Case I in Table )-The mother, aged 24, has given birth to three infants.The first, a girl, born 1961, weighed 1871 g. (4 lb. 2 oz.).The third, a boy, weighing 2919 g. (6 lb.7 oz.) was born in 1964.Both were entirely normal.Her second pregnancy in 1963 was also uneventful, until she was admitted in the second stage of labour at approximately 33 weeks' gestation.One hour later a slightly macerated headless male foetus was delivered by breech extraction.Because of a retained placenta the uterus was explored under general anaesthetic and the placenta was removed manually.At the same time a search was made for the missing head, but no trace was found.The puerperium was without complication.The foetus (Fig. 1 and 2) weighed 750 g. Between the shoulders, the neck formed a conical stump sur- mounted by a leaf-shaped dark bluish-red shiny area.Maceration was moderately advanced and sheets of epidermis were separating from the limbs, abdomen, and perineum.Loose epidermis formed a 'collar' about
David Gentilcore: Food and Health in Early Modern Europe. Diet, Medicine and Society, 1450–1800: Bloomsbury Academic, 2016: 250 pp., paperback, £19.99.
AN association of pigmented naevi and dermal bony nodules has rarely been reported.Heidingsfeld (1908) described a congenital pigmented hairy mole occurring on the left side of the chin in a man
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