Asbestosis: clinical spectrum and pathogenic mechanisms.

Asbestosis is a diffuse pulmonary fibrotic process caused by the inhalation of asbestos fibers. Despite extensive investigations, the precise mechanisms regulating asbestos-induced lung damage are not fully understood. This review summarizes the important clinical manifestations and pathogenic mechanisms of asbestosis.

Foot infections in diabetic patients: the role of anaerobes.

The prevalence of anaerobic bacteria in cultures of specimens from foot infections in diabetic patients is dependent upon the method of obtaining the specimen, the care with which it is transported anaerobically, and the sophistication of the laboratory methods. The rate at which anaerobes are isolated with use of the best methods ranges from 74% to 95% of patients, but it is only 41% to 53% in clinical studies of patients with limb-threatening infection. The mean number of bacterial isolates from an infected foot ranges from 4.

Localization of inhaled trimellitic anhydride to lung with a respiratory lymph node antibody secreting cell response.

Male Sprague-Dawley rats were exposed to trimellitic anhydride (TMA) by inhalation (500 micrograms/m3), 4 hours a day, for 1 to 10 days. TMA was localized to lung cells by immunoelectron microscopy. Enzyme-linked immunosorbent assay (ELISA) and Western blot analysis were used in an attempt to localize TMA to lung lavage proteins.

A clinical and immunologic study of employees in a facility manufacturing trimellitic anhydride.

We conducted a 1-year cross-sectional survey of 474 employees of a large chemical manufacturing complex to relate trimellitic anhydride (TMA) exposure to serologic and clinical outcomes. In 1988-1989, employees were evaluated by history and immunologic assay of total (T) and IgE antibody to trimellityl human serum albumin (TM-HSA). All employees were assigned to a TMA exposure class, from 1 (highest) to 5 (lowest), by an industrial hygienist, independent of the clinical and immunological data.

Interpretation of hypercalcemia in a patient with end-stage renal disease.

Patients with both end-stage renal disease and multiple myeloma are prone to changes in ionized calcium homeostasis that may have grave consequences. However, only total calcium level is reported in most routine laboratory testing, with various algorithms used to derive the physiologically important ionized or free calcium level to guide treatment. We studied a patient with multiple myeloma undergoing long-term hemodialysis who presented with a markedly elevated total calcium level but with only minimal elevation in the ionized calcium level.