Document xr8mowNw6kXjzw8OebV3waK6

550 INDUSTRIAL HYGIENE AND OCCUPATIONAL MEDICINE appraisal of symptoms were noted. Evidence of continuous ACTH stimulation of the adrenal glands was obtained by fasting eosinophil counts, made three, times weekly. For studies of respiratory function, the Collins respirometer was used. Each procedure consisted of at least three separate determinations, the patients lying in bed with their heads elevated on one or two pillows depending on their degree of dyspnea. The maximal deter mination of each procedure was selected for comparison. Arterial blood oxygen content and saturation were determined by Van Slyke manometric analysis or by the spectrophotometric technique of Hickam and Frayser.3 Studies were made of all patients before and during therapy and of three patients also at varying intervals following discontinuance of therapy. For the determinations of beryllium levels of 24-hour urinary specimens, we are indebted to Mr. A. Poritsky of the Lamp Department of the General Electric Company. The method 4 involved the use of large volumes (800 cc.) of urine. After wet ashing, the centrifuged precipitates were dissolved in nitric acid. The beryllium was further concentrated by precipitation and centrifuging. The precipitate, which was still fairly large, was acid-ashed to rid it of any remaining organic material and the beryllium precipitated for spectroscopic analysis. Determinations of the urinary levels of 17-ketosteroids were made for us by Dr. Ralph Dorfman. Table 1.--Initial Laboratory Studies (Control Period) Red blood cells per cu. mm....................................... Hemoglobin, Gm./lOO cc...................1......................... Hemoglobin, % .............i.............................................. Hematocrit reading, %................................................. White blood cells per cu. mm.................................... Differential percentages ............................................. Serum chloride, mEq.................................................... Serum sodium, mEq..................................................... Serum potassium, mEq............................................... Serum calcium, mg./lOO cc..................................... Serum phosphorus, mg.'/lOO cc.................................. Serum alkaline phosphatase, Bodansky units___ Total serum proteins, Gm./lOO cc............................ Serum albumin, Gm./lOO cc......................................... Serum globulin, Gm./lOO cc.............................. .......... Electrocardiogram ........................................................ Case 1 5,180,000. 15.1 97 50 6,100 Normal 141.2 4.22 10:2 4.1 6.9 8.2 4.7 3.5 Normal Basal metabolic rate, %................ Results of urinalysis..................... Vital capacity, cc............................ Pasting eosinophils per cu. mm. Control ...................................... 4 hours after 25 mg. ACTH. +8 Normal 2,387 310 86 Case 2 6,900,000 19.7 127 65 5,300 Normal 100 142 4.2 10.9 4.0 5.4 8.4 3.6 4.8 Enlarge- ment of right ventricle Normal 2,794 Case 3 6,090,000 15.9 102 54 12,100 Normal 10.8 4.1 6.7 7.5 4.4 3.1 Normal +14 Normal 2,618 255 158 92 52 Case 4 5,800,000 16.4 105 6,550 Normal Case 5 3,620,000 10.9 70 35 7,950 Normal 135.4 4.59 10.1 3.9 7.4 4.7 2.7 Right axis deviation Normal Normal 2,904 196 42 +27 Normal 1,650 REPORT OF CASES Case 1 (man, aged 36, University Hospitals no. 295-739).--Industrial HistoryJ---L. T. began working in a fluorescent lamp factory as a millwright on Nov. 17, 1939, continuing to Aug. 11, 1943, when he was inducted into the Army. Until Oct. 10, 1942 he was occasionally heavily exposed to beryllium-containing phosphors when it was necessary for him to clean the exhaust ducts that carried the effluent from the mixing room to the outside of the building. Other than this, his exposure was slight. He returned to employment on March 18, 1946 as. a-machinist, spending all of his time in the machine shop which was located in a separate room at a con siderable distance from any of the lamp-manufacturing operations. He has continued in this work to the present time with the exception of 15 months from June 1, 1948 to Sept. 26, 1949, when, owing to the progression of his disease, he was unable to work. Medical History.--He first reported to the company dispensary on June 15, 1948, stating that he had suffered from phlebitis in October 1947 and that this had been followed by weakness, 3. Hickam, J. B., and Frayser, R.: Spectrophotometric Determination of Blood Oxygen, J. Biol, Chem. 180:457 (Aug,) 1949. 4. Cholak, J., and Hubbard, D. M.: Spectrographic Determination of Beryllium in Bio logical Material and in Air, Analyt. Chem. 20:73 (Jan.) 1948.