Document k9zzQpzJw6yNxpQXJqw7nqJmn

FILE NAME: ZD^D/ DATE: DOC#: ^D/ DOCUMENT DESCRIPTION::ZZZ ^^Z^Z&tZZD "i ....-.,. s~, ' ~'~, bfto10gy and Bacteriol~gj J. 11c: Juur11a1 or __-.::.....-=:-"::::.,. #f otl The Official Journ~d of the Pathological Society of Great Britain and Ireland l!'.Dr!;;U ?Y A. E. RO\'\'DTT M. J. STE\L\ RT \\'. W.: C. ''J'<!PLEY ~r"" \; ~':1, .;,.. , :. ,,.. f")UJVnE}) l.Y ,'[r.. H; ::1:.1.'. .: SlJJS WOOL!!!E_f!J VCLUME THiflTYFOUfl-PAFIT I PAGES 1 400 f! ::.d 0 ~~} c;. ~;~..:_. ' i f'k :, Edinburgh 01i,er and Bovd London ; ,",'),...,,) P1' Lcrr"1- 0-~',1 c\, 1; y. l ( t'.1\\1 I9.~ 1 L <.._ ...:'l"I> I< The .Journal of 1~'.,pathology and Bacteriology Vol. XXXIV., No. 1 6r6.24--003.656.6:613.633 ASBESTOSIS BODIES IX THE ~::-PUTUl\I: OF SPECIME::c\~_, 'T(nI ~t STUDY .A l1''T Ao1B-:'11'vj,'t:1) ~.r")- ~, l-~u.l -L.I~ FIFTY "\YORKERS IX s:- F. \V. SL"L:)( :1~>: J\_. _l'lIEJ:L.AX_D STRACJLl:{. The De}'a,rtnienJt fra_l{1,l.'i:a ! /.\, ,~1,c, it,th.TerSluo_!uf1t,/n,t:s~htfur,riq'.. can Institute for r;>- s<!fi:m followiug ~:~fiutum of fifty cornr.1H1;:::li i, 1~ is uo.r:<x1 on thA examination nf tl:e ~'.~exposed l\'orkeu; ii: :en asLestos mill, to ashesto;;; J:_'t ~,, r_,1J1er occup some of "horn bail also ~::,::iJt~li.:hsettirn:igluliwshaslaartgetimcleijsecsots 0Ytr1:td:cal:i1~2t,aedncwe ith ation:>. dust lint Tl1e atmosphere it w?.sinrnm;siblc: .ooucentration of ~:~)t:;pulmona.ry dust it! 2. 'JlW ,,f the~ e 1'<::'11 iJf 1:5 or '.?,O feet- Since mafa factl,rs in the proJnction ;!:~Jtfon changes, under thr '-'":;~:>ing would be likely tu ocnn conditio~rn of the mill any ;:'-t.~ll~ititsheetglrefhatec:esturecxippoe~anurse:11Lc'Jl clfuusLrtyo-efcnm-ersn.npaiJdilny:.s; iTthies acmr.osensg tehxearnlai1t1tecdr The examinations 1rc;rc c:nTi'~ll 0ut Wt Medi.c,11 He<learch frJt11 i11:iteri~il s iu the Son tlt ~\Jrican Insti tntc, \.he urine wail seYernl Lunchul ;1IiL:.s npplied l1y l!r U. 1''. dista11t, SlllTi:uell~ S_i,11t.-. :.Ml a-; tiot :te<;ciYed until it was possiLle aftc1 . Li:"~" rA to t;en,.,1;':a'' 'SCH '!1J.:'ti11,es t\';n or tliree da"" Ju that t1w a&bc~stosis s1J:te 1_,; t Li-: intrnc.elltlla" in DraC'f.i oily in the cn1lec:t~u1; {;f b]le,;,i1 '" :r co1 \' 1.,1.se. 1~\1Ja ]1udic: weru .'1 dif!iGultv 11:1!' 1:uc .. :nte1"d C.oJlject.i.on ''') lll t1'1r~ 1 1110f1ll11,!..;: ii."" .. ,;,'';,(~l;, 1!,;,ivo'-3. l Jd(:.:t1 ti:Ll: fuJ' of the cililtrd e;1itlwii111 H:~.intory rlS CL l\'bU t (Jf U:t'. (;f_l'i1J;_,;lt LctJi.;J 1 t (l:c 1 rn1;cLi. 11111L'L~-. nom tl1c' ]u1w~r ju>1~'~u11:i~ ll~v L,r,: trJ1t lut.s }J,_1;11 ),:'"'::l1: lil'. lt"',_'ll1JJJ'IJ"1l1I l'i ,, \ JI-~'' In 1lu.c., 1111[('1,:: ii1:.'>t ( c!::. l;illl .... ~ ....., .la.:1L~ t..}:t~ htt1 \\'C''I~ ' ' __, < C'll<Jlll1iJ!l~ l '' ' ' (f ' 'i1e L 1 """r '';,' \ ~' tJ' J'.1 1 C;L-.; (Jl_ a~tJC0ld.; _ 1: ! J Jltl(',-~ '"''I " 1i1 <' ' ' ,I~,, :rJJ(~ ~!.:] ! '" L '' ' u far;~r-r.t -=..r p1e-ti1u:il1ly 1.,. , (:,ii\rC-\l - f;'1il1 111'~ lor!r \\ 1 'l:1rJ C! \ ,:'._;_;t;JJ j1,LJ1lc ... ..: tL1~ .1..nli- fC(-~pLu.::l\2::; \\L,.-:J i11 Il1i~ .qJu:~rc;1Ll:' 11 1 ti ~J:;,.~ l\U 110.\ ,, li.l.111~1.~~ 1 ~Le :--~i,rt11'11 JO~J~J<. OF 1,it the ,~'J1ft 1 , ,__, fl' ' ' n,11'' y-r, , ,c_, 1 G f,t'J t <. l _ - ',J-cl 1 ,r 1J J; l , ;:-, ' "- ii , ~ J.'J.l'U. Vt ., __ }.1 , ' , < L l l J i ..1 l .' ( ', _< , i;.,; J '.J d '~ '11 ::1 ':! i~ 1i\ :1:1 ,(ll ,111 :11 '1i\ 1 1::1 '2 F. W. SJMSON AND ''A. S. STRACHAN withwenasthpeosmsiobulethtoanddupnlaicsaotpehtahreysnex swamerpelelos,adaendd wa itshatdisufsatc. torFyorstpuencaimteelyn was obtained in all but two cases. we Teclinique. Two series of films were made from each sample. In the first and dried in a paraffin oven at thi::k 5-iC. films of These the mucoid portion were were fixed with saturated made mercuric chloride solution, one set being stained with The second series was hrematoxylin e acnendtreiofusigne, dthd(e)poostihtearftfeorrditguebsetirocnlewbiathciallni.tiformin, as recommended made from th hy Stewart (1929). found however that it was as easy to demonstrate lhc antiformin treated specimens, and asbestosis bodieetshoind thheadditrheect aiid.lvmasntua,sgein of showing both the cytology of the the former m specimerui and the intracellular development of the asbestosis bodies. Results of sputum ea:amination. Burtc,u Wood and Gloyne (1930) describe the sputum in pulmonary -frequently so thick as to resemble asbestosis as "thick and mucoid semi-coagulated egg albumen. In the latest stages small nummules of pus appear." In practically all om specimens there was a mucoid occasionally very thick. Pus cells element, mua.Uy were present in thin and watery, all specimens, but only a few contained obvious pus. The colour varied from grey to brown according to the amount of free The free dust sometimes separated asbestos and lode dust present. out as a deposit on standing. In all films asbestos fibres, small crystals of various types and colours, and amorpholLs debris both t, some of it intracellular. Pus cells, brownish and black were presen dust cells and epithelial squames were present in all specimens which contained bodies, out their proportions st C;ells. varied. Always the bodies Many of the asbestos masses were seen to present were be lying within du disiPtegrnting into their constituent Iib:es. Asbestosis br.diei3 were present in 48 of ths 50 cases examined. and shape. Some are long and thin, They show great variety in size much longer than the normal diameter of a dust cell, so that the ends are bent and tend to project on either side, where they are The extremities show a hu}bous covered by cytoplasmic prolongatic 1s. enlargement and commencing segmentation is often seen. Th.; colour is greenish- or golden-yellow. In t,he middle portion of tlie !llore the core is Yery thinly coated with slender bodies the fibre forming the golden-yellow material. .Many of the lrndics are sharply angled, suggestiug incipient fractme. SliuulLl GvH;i;lctc scp:.ir'.cti')l' t:i kP l'laee t\vo Lw,liuB of "crust~cean" 1ypc, with at this point it lrnlbous he:.1<ls, \vill give rise tu s0grncntcd bodies a:td tapming tiiils. Anal~1.sis qf cases. Tl1e age of the workers rang0cl frolll 17 to 50, two-1.hinl:-i uf them -]Jl'riod. All buL 10 li::.trl wo1k(;cl in Uie fallin: within the 30 to 45 age asLostus inill (or consecutively iu i11ill d,iJ1l 1ni111'.:) iu~ p~:rluds r~1 11 i 11 ~2 ~,,,.., PUL!lfONAR Y ASBESTOSIS 3 1 8 to 9 years. In the others the period of service ranged from ad also orked underground in the <-'7 months to 2 years. ,.,.~old mines. Cough 18 of them b was present in 11 every case, dyspnma in all but IO and 10ss of weight in all but 21. These :;yrnptoms close parallelism in naturally varied indfridual cases. in severity, but they showed fairl;v <:Examination of tho sputum for tubercle bacilli was negative in every ~ instance. ;.1 As already mentioned asbestosis bodies were present in 48 out of , . 'fine 50 cases examined. In 9 the antiformin method was negative result; in 11 the converse obtained. , hen dir e two ect cas sme es w a h r i s c g h ave lL gaYe J!ositi ne~ldt,i ve ve results with both :methods had been .ployed in the asbestf;S mill for ; months and 2 years respecti.reJy. by t,he appearance of the bodit:s shortest exposure to I.Jc five months, and ar:.other f9llowed ca:0 was positive after fonr months in the we aatnmdostphhreeericmcoonntdhisticmn.:sdeinrgtrhoeunmdi.ne are anroet isnufcohrmaesda,rhcolwikeevleyr,toth1L1et aocia.ted with asbm:tosis. or ~i. son (1929) has recon18d the prese,1ee c.s1x::stosis hcdies in .:. Sim '.-luunan lung from a cas? with a history of ouly nvo months' exposure ea-pigs after three to 'to dust, and Stewart (1930) ve months' exposure in cic1 in the h::.ugs cf guin asl>esto"' fa(~tory. The bodies ir:. Si!l!son's nt:cessa~y e were well former!.. a1irl e:.i m":'t it 12 0wwu~unl:llc,,asptp! e::a~:rL tl:at this. the time '. their developm t filr11~ Discu..ss1on. - It is obvious that t'...te presence of aslestosis bodies in the sputum istence of pulmonary fibrof'is, although snot necessarily ire.ply the ex ;:;~)vs are of the opinio11 :bt they indicata a reaction on the part of the t alveolar epithelium. HcCrae (1913) has shown that in silicosis mos acr, rhe ah-coli are of a size eompamLle owfitthhetihnahtaleorf[ poarrdtiincalersy 11dgJo1acitcth:o>1riefito. nn Inthethcoo1c0asoef othf easa:s,.b:setsotsu.s,islusbtodtihees more in length, anrl 1lbres which ultimatelr (Burton Wood rwd GJ.ci.,1w, 1930) may lN CO v. Gr enter the a'.YC(1li len;:.:tli1,i:::e. Herc tliC\" l1c:c1 c m e must therefore } 1h<1sroc:1icd hy Just eclls ('-limson, lW'.S) n11'1 \rn '1.re c,f thai 1];.-' (o:ph~i"nnigocns that it is in these r.r in ,;:rnLtl' 11lrngocyks cbcwhcrn 1::r: i' ihe boil1cs t:tke 11l:1ce. There ai.: r:;e,cru) which go to the f<,1m:niu11 u observations which sec in to fiUl1} "J:1, this vi ow. In utrefnl ly prq i.ned direet, ~~- ,~,r "<'l.nl' 't'._"._.J',_ n"-~',-',-' 1.,,.1,,,. '.J>i.L'-'-' 1 1 < <'-. '>1l1'"'l'<-"} '..'J i,._,t1"~rel>lt1lU1,1' "l..'~lll \\'"I._., lt\'C '' >J 11eL as stagL:s i:1 Llicir le10Iup- not\11l (J.Brprieealrlavnet;ohse~r\\>"h.i'eF;lfi' \\,) .:s fwollo1u1l1u~ inkrT1lir1 fiLn; lH:c:onH~H Ci>"t:1l with :L 1uent.. Thi.~ L:u~trnLC ux~n'rn1Li<:~:, j::tb greeuish.ydluw ui' ;.;uldc;11-yL:llu 1 , ;,Ulibla1w0 gin11.o.I ,ii': l,r;1-.,,1a11 i~ lrn~l.t1u.- r~ubr:_:ewe11t. blu0 reac:Liol!. 111ay 110 m1iioi'1'.1 except :tt che Th0 del"'.sitl'd llLtlerLtl iue,ea::.L'S Whc,re Llierc: a ~_mount i1wre~t.'0 ~Yjl; in and \Villi Llw beeu1t:nl<Ltiuu appeact> ni 1i,ust ol' lhc c,.i11p]1_L, I.;.;~l!r buuHs. :.lu;-; "''.C:iw1ilL1ii<:11 l,c,uiuu;, 1ln:-j1c;i, ,,L,; -;..,... t I 'I l lI ~lll""i ll ittl!l 'i 1 J, ~ Bi (';.! f1l~ 'Iii' 1ri 1 1 w1i t 1fl1il 1 ( 1 l .i )t"I ~ ' l~ ~. ~..: ,. l iitp1 -~( i f~!;JV ~ I f!lln ' ' ri;!d ; I :r111:1; . ,,,, l ):.,pl, 1 ,!!1,;;; 1' \: ~l 1"11 1ii:i' "'1:: !~Jdt;,:1! "' I ii1I: {J .j "i1'1111ii' 1 lt.! I 'l1il :l ~..\... 'i '"ll'l 1111!'; 1 ; :i1h;:i f I 1 1::1ri' ~~~ ~ !rtJH;;1 1 I ',L ~ '!!'1'1, .. :1''1I1 ...;' :!:/: . : HI 11j!'::!~! {-..,; 111.:1: il 1:1ii I i 11 I~~,'~! II '''1I~ ',:ii1' 1~1" l: ,pi ')-_ 1ll',1' ~ Hi~1 Mf ':1'g!. 1ir;;.: < :l '~: 1'i~: "'')Jii ~'._ l \ \./' ' \t].,r: 1. l ' !:1 --1, :1. I'" I ' ,,..[(I fracture of the fib~~ may occur with formation of the "crustacean" type of body.. The latter may continue developing, the tail again becoming slightly bulbous. We believe that the alveolar phagocyte and not merely the body fluid is the source of the material which goes to form the asbestosis body. Asbestos fibre is not the only inorganic substance which, in the luug, becomes coated with material giving the prussian blue reactfon. l\favrogordato (1922) has observed in the case of experimental quartzite inhalation that there may be associated with this substance intracellular yellow or red granules aml sometimes yellowish plates, some of which give the iron reaction. In some of the dust cells in specimens which we have examined, both in silicosis and in asbestosis, we have noted granules such as Mavrogordato has described. SimSO"l (1929) has observed, after 3 months, similar iron-reacting material around asbestos fibres injected subcl1taneously, and Stewart (1930) brrs been able to produce typical iron-reacting asbestosis bodies by the subcutaneous inoculation of a suspension of asbestos dust. Summary. The inhalation of asbestos dust in high concentrations leads to the appearance of asbestosis bodies in the sputum in a large percentage of the workers exposed thereto. They were present in 48 out of GO workers examined. Asbestosis bodies were as easily demonstrated by direct thick films as by the antiformin method. The sputum was always mucoid in character when there were no bronchial complications. It may resemble egg albumen. In none of the sputa were tubercle bacilli demonstrated. Study of the intracellular asbestosis bodies in these ca2es suggests that they are formed by the deposition on the aslJestos fibre of an iron-containing substance elaborated by the cell. v..re wish to tender our acknowledgments to Dr Slade for the opportunity of carrying out this work, for the collection of the material and for the clinical data which he supplied. 11cCaA.E, J. w. 1IAVROGORDATO, A. SIMSON, F. " STEWART, M. J .. ,, STEWART,M.J.,ANDHADDOW, w. A. C. Woon, Bm,ToN, AND GLoYNE, S. llooDHous~: REFERENCES. Publicnt1:ons of the South Africrin Institute for 1'ledical Research, 1913, i. 122. Ibid., 1922, xv. lGL Brit. JleJ, .Tourn., 1928, i. 883. A1mu11l Rcpurt of the South Afriran Institute for Jledical Resen:ch, Hl29, p. Gl. Brit. JieJ . .Journ., rn2ri, ii. 5'll. this .Toarnnl, W3<J, xxxiii. ::--ti. this Journa.l, Hl29, xxxii. 172. Lancet, Hl30, i. 4-15. ~ ~" 547. 912 +616-006+616-002. 4+616-004 EXPERIMENTAL LIVER :..-fECROSIS FROM SHALE OIL. CYRIL J. POLSON. .Department of Pathology and Bacteriology, University of Leecl.s. (PLATES I. AND II.) iN (1923, 1925) _observed that carcinogenic tar caused liver :*oin .rabbits. The carcinogenic action of shale oil and its ':es..is .widely recognised (Scott, 1923; 'Southam and \Vilson, it-eh, 1922; Twort, C. C. and J. :M:., 1929 and Roussy, 1929). &~that its action on the liver has hitherto escaped notice. No i!i"tins were observed in man (Scott, 1930). ~;.;-~t- Experimental Procedure. 11eoil uiied was shale oil No. 8(2), the carcinogenic action of which was -ed,.by C. C. and J. M. Twort in 1929. Dr C. C. Twort also s.:mt a sample ' -~cinogenic residue No. 8 (2) CHR5, an oily subst:E1ce having similar _,properties to the original oil. .> ,e preliminary experiment on llix rabbips, each animal received a daily _c.c. of undiluted oil per vaginam for tiiree days. within the week two ~bbits had died from acute liver necrosis: the remaindtr were killed at )ci a fortnight. . A fresh series of thirty-one rabbits was then used to te this liver damage. With one exception, each of the new rabbits the oil intra1)eritoneally. In the longer experiments, additional doses " ministered intrapleurally or subcutaneously. The dosage ranged from --to 10 c.c. and the experiments bsted from three days to several monthts. In er experiments the oil was diluted from 1/2to1/20 with liquid paraffin(B.P.). ..:;~~J~rder to exclude, as far as possible, Yitiation of the experiment~ by naturally ~(ocerirring disease twenty of the rabbits were subjected to laparotomy and biop;,y -_ of the liver at the commm'cc:.1ent or during the cour.:;e oi the treatment. Thill procedure was adopted both in the long experirneut.~ ancl in the controls. lu addition three rabbits were used to control the effects of laparotomy followed , bi the intraperitoneal administration of liquid paraffin alone. -. Twelve mice, four guinea-pigs and eight rats were also given oil. 1:he - "~-Dilution of the oil and the effeets of its sul1jedion to heating were also tested. non-carcinogenic residue of the oil was h-<lministcrc(l intraperitoneally in filnglc doses of 10 c.c. to ead1 of six rablJits and in 3 c.c. dosl:P. to c:ich of four rats. Twl!lve rabbits received an intmpc;ritoncal <lose of a IO pt:r Lent. solution of ~rlach It in oliYe oil, six had <loses of 10 c.c'. and ::,ix, of 5 c.1" :, - 1. Fiiulinys fo ralJ/.Jits. -,{~~One of the three control raLLits given lit1 li'l i1:tiJt:~i: .11 Li.11ar0torny ~Was killed three weeks later aml U1e uther twu ai_ t!1L :n:l uf tmve11 XXXIV. A2