Document jgzORrmRQEE6Zzbggja8doqQk

R&S 109331 gl'O-HSeiCAL RESEARCH DOCUKEKT DZSCPIPTIOH PORH 63 68 69 76 -- Duplicate in all cards:-- year as-1961- 0^320 Pile number [Right justify [Hureric only] Author(s), as Last Name PS (Ho Punctuation) and coder for journal as JAHA preceeded -by. ore blank space 1 20 -21 '' )a.r* / r_m //-K-. 1 - JoluTSoKn ) am; Ka^;( ec.,- 1 ll'he-tsilnp JLJ=______!_______L_____ 40 41 1 1 1 77' 78 Sub-Inder: Code 60 61 62 11 12 13 Title of R.enort: end with space-hyphen-hyphanyspace. Pollov with Index "errs, separated roa each other with -coma-space. Avoid other punctuation; ' do 'not abbreviate. 12 ` . 61 62 l....- 'i-0 ` ' (?c^so'ill^r y /j6nc/v^i'r//is ` //i 22 22 CJ'] Cj)o/c/^e./^.S ~--" t r^ 23 24 Source (Journal, Vol., Humber, Pages, Date) 12 ..........: ;* | A 1 C-^-o CL I K_c.uJ nj-1 O I\ ` -2. /p/p . 1 j trtTu -J2 3y 7 y-tp^ZCn^_ 61 62.31 32 brief Summary' 61 62 61 62 63 64 Reprinted from: MICROCIRCULATION, VOL. 2 (1976) Edited by John Grayson and Walter Zingg Book available from: Plenum Publishing Corporation 227 West 17th Street, New York, New York 10011 p -j uo o U ^ndodOUn Q TRAUMA AND INFLAMMATION 235 ----------------- ;----------------------- ;---- ---------- 6.6. In Vivo Skin Capillary Abnormalities in Vinyl Chloride Workers H. R. MARICQ, M. N. JOHNSON, C. L. WHETSTONE, and E. C. LeROY Some workers exposed to vinyl chloride (VC) have been found to have clinically detectable proliferative and fibrotic lesions of the periphery (acroosteolysis, Raynaud's phenomenon, and sclerodermalike skin pla ques) and the viscera (angiosarcoma and hepatic fibrosis, Band type) (Harris and Adams, 1967; Wilson el al., 1967; Dinman el al., 1971; Jiihe and Lange, 1972, Falk el al,, 1974; Lange el al., 1974; Marstellar el al., 1975; Thomas et al., 1975). Techniques of wide-field capillary microscopy have shown distincdvely abnormal patterns in pauents with spontaneous Raynaud's syn drome and scleroderma, as well as a strong posiuve correlation between severity of capillary pattern abnormality and visceral involvement (Maricq and LeRoy, 1973; Maricq et al., 1974). Therefore, these techniques were used to examine 152 VC workers (44 selected, 108 unselected) and 50 control manual workers not exposed to VC. In 44 VC workers selected for known disease (angiosarcoma, hepatic fibrosis, acroosteolysis, Raynaud's phenomenon, and skin lesions), 39% had capillary abnormalities, of which 16% were sclerodermalike patterns and 23% were isolated, discrete capillary lesions. The possibility that trauma and not VC was the cause of capillary abnormalities in VC workers, many of whom had been reactor cleaners, was studied by comparing 108 VC workers and 50 manual workers outside the VC industry. The results showed (Table I) that capillary abnormalities were significantly more common in the VC-exposed, group than in non-VC manual workers (x2 = I&.50, df = 2,p < 0.001). More of the selected VC workers with VC-specific lesions (angiosarcoma, hepatic fibrosis, severe acroosteolysis, and fibrotic skin changes) had capillary abnormalities than did VC workers with inactive, stable, or nonspecific lesions (healed acroosteolysis, nonspecific skin rashes, and Raynaud's phenomenon alone) (X2 = 13.85, df = 1, p < 0.001). Among the 108 VC employees, no correlation was found between capillary abnormalities and length of employment or length of reactor-cleaning assignment. H. R. MARICQ Medical University of South Carolina, Charleston, South Carolina 29-101. M. N. JOHNSON - 15, F. Goodrich, Akron, Ohio -11300. C. l,, WHET STONE and E. C. LeROY - Conoco, Inc., Ponca City, Oklahoma 74601. R&S 109333 S> 236 TRAUMA AND INFLAMMATION TABLE I. Comparison of Capillary Observations between Employees of VC Industry and Manual Workers Not Exposed to VC Capillary observations Definitely SD-like capillary pattern Abnormal capillaries present, but few in number No capillary abnormalities seen Employees of VC industry Manual workers not exposed to VC X2 p 11 . 27 0 15.50 < 0.001 3 70 47 These data suggest that 10% or more of the VC workers (unselected or selected) have capillary abnormalities which are not found in non-VC manual workers. These capillary changes are present in VC workers in higher proportion than are clinically overt lesions (Wilson el al., 1967; Dinman et al., 1971). Further studies are needed to compare these capillary changes with those seen in blood vessels and endothclia in animals exposed to VC (Maltoni and Lefemine, 1975). Capillary micros copy could then be used as a reproducible, noninvasive technique to monitor VC workers and identify VC-related vascular diseases in "suscep tible" individuals at an early and possibly preventable stage. References Dinman, B. D., Cook, W. A., Whitehouse. \V. M., Magnuson, H. J., and Ditchcck. T.. 1971, Occupational acroosteolysis. 1. An epidemiological study, Arch. Environ. Health 22:61. Falk, H., Creech, J. L., Heath, C. W., Johnson, M. N., and Key, M. M.. 197-1. Hepatic disease among workers at a vinyl chloride polymerization plant, J. Am. Med. Awk. 230:59. Harris, D. K.. and Adams, W. G. F., 1967, Acro-osteolysis occurring in men engaged in the polymerization of vinyl chloride, Br. Med. J. 3:712. ` Jflhe, S., and Lange, C. E., 1972, Sklcrodermieartige Hautveranderungen. RaynaudSyndrom und Akroosteolysen bei Arbeitern der PVC-herstellenden Industrie, Dveh. Med. Wochenschr. 97:1922. Lange, C. E., Juhc, S., Stein, G., and Veltman, G., 197-1, Die sogenanme Vinylchlorid* Krankheit--Einc berufsbedingte Systemsklerose? lot. Arch. Arbeitsmed. 32:1. Maltoni, C., and Lefemine, G., 1975, Carcinogenicity bioassays of vinyl chloride: Current results, Ann. N.Y. Acad, Sci. 246:195. Maricq, H. R., and LeRoy, E. C., 1973, Patterns of finger capillary abnormalities in connective tissue diseases by wide-ftcld microscopy, Arthritis Rheum. 16:619. Maricq, H. R-, Spencer-Green, G., and LeRoy, E. C., 1974, Abnormal capillary pattern* TRAUMA ystcni eiue for th M.u stellar. H.J, galic liver ( (mlyv/riil cl Ilimiias. L. B., induced liv angiosarcoti UiNon, R. H., 5 acroosteolvi 2Mi?Slre! 6 TRAUMA AND INFLAMMATION 237 and systemic disease in scleroderma. Proceedings of the Eighth European Confer ence tor the Microcirculation, Le Touquet. Marstellar, H. J., Lelbadt. \V. K,, Muller. R,, and Gedigk, P,, 1975, Unusual splenomegalic liver disease as evidenced by peritoneoscopy and guided User biopsy among polyvinyl chloride production workers, Ann. ,V.Y. Acad. Set. 246:95. Thomas, L. B., Popper, H., Berh. P. D., Selikoff, I,, and Falk, H.. 1975, Vinvl-chloride induced liver disease: From idiopathic portal hypertension (Band's syndrome) to angiosarcomas, N. Engl. J. Med. 292:17. Wilson, R. H., McCormick, W. E., Tatum, C. F., and Creech, J. L,, 1967, Occupational acroosteolysis./. Am. Med. Assoc. 201:577,