Document ym6zBaK15eQ2NwragR7y80KJX

May 1 , 1948 Department of Pathology, Cincinnati General Hospital. Subject: Analysis of Tissues 1 enclose herewith two copies of a report of our analyses of the tissues of one Oliver Smith. One copy of this, presumably, should be forwarded for inclusion In the hospital record of this case. Ary examination of the data shows clearly that this man absorbed abnormal quantities of lead in significant amounts, during some considerable period prior to the date of his death. The evidence for this may be found principally In the high concentration of lead in the rib. It is quite unusual to find concentrations in excess of 2 mgs., or at most 3 mgs. per hundred grams of fresh bone in any part o f 'the skeleton of Individuals who have not been exposed to unusual quantities of lead. The lead concentration here, therefore, is at least twice that ordinarily found. The lead concentration of the liver is also high but not remarkably so, in relation to the lead content of the bone. The concentration of lead in the skeleton is often found to be several times that found in this case, among persons with comparable histories of occupational exposure. There fore, it may be assumed, as the history indicates, that this man lost rather sizable quantities of lead from his body following the termination of his occupational lead exposure in 194J. Me have never seen lead Intoxication in an individual whose period of lead exposure had been terminated some months before, and therefore I cannot credit this man's lead absorption, as demonstrated at necropsy, as having any important significance in relation to his terminal illness. One might feel, perhaps, that there might be a stronger case for some contributory effect of lead in this illness, If the lead concentrations in the soft tissues had been found to be higher. Actually these concentrations are in keeping with the moderate increase in the lead concentration in the skeleton over that normally found. - Cordially yours, KAK ef Enc. Robert A. Kehoe, M. D. Material: Source: History: Diagnosis : Submitted: Required: Tissues Worked with lead for 15 years. Employed bv Eagle-Picher Lead Company until August, 1940 Had lead colic attack 10 years ago. Had . abdominal cramps and headache about 6 months ago. Malignant hypertension; arteriosclerotic and hypertensive cardiovascular disease; acute pulmonary edema 2-26-1+8 by the Department of Pathology, Medical College. University of Cincinnati, Hospital #255394* Necropsy #N-ij.8-llij. Lead Determinations Analysis Number I+Sa --187I4 48A-1875 [.81-1876 14,3a -1877 I4.8A-1878 [{.8-1879 J4.8A-1880 I4.8A-1881 I4BA-1882 I4.8A-1883 1|.8A-I88i4. 4.8A-1885 Description Lungs Heart Liver Spleen Kidneys Stomach Small Intestine Prostate Large Intestine Adrenals Muscle Rih Bone Grams Sample 22.0 52.0 26.5 60.5 52.2 1)1.0 18.5 10.0 5M 9.2 36.5 26.5 Mg.Pb Pound in Sample 0.011 0.023+ O.165 0.09+ O.O57 0 .01)1 0.028+ 0.01 .0.70 0.00$ 0.012+ 1.85 Mg. Pb in 100 g. Sample 0,05 O.OI4.5 0.66 0.15 0.09 0.10 0.16 0.10 1.30 0.055 0.035 7.00 Reported: 1j.-27-1).8 INFORMATION REQUIRED ON: CASES FROM WHICH TISSUES ARE OBTAINED AT NECROPSY FOR KETTERING LABORATORY OF APPLIED PHYSIOLOGY Name Necropsy number Hospital number Age-// Sex/^Nutrition/ Clinical Diagnosis Date of Necropsy -LS-V-tf Date of Death Length of Body /<7 Approximate Duration of Illness Anatomical Diagnosis Lc^eJUi-a~Z<_^ " (s ' Previous Medical History in Brief . Pt- . /'iAt'.-J. M&SL / ~4". *~7f/ 5v~e >aSf~L' @ aat P&odL* (Ls&^Ls ,, tHCf^- Occupti^onsa*hT&j(iL>sjt2oLr4dyL '*Y7- c rJ V History or Evidence of Exposure to Lead, Arsenic, Mercury f>LC-.' - Pertinent Remarks I> TISSUES DESIRED (Please obtain such of these as circumstances will permit, giving weights of entire organs when available. Weight of sample provided will be determined in Kettering Laboratory.) Organ _________ Total Weight of Weight Sample Lungs Heart Liver /3>o %** ^ ?0V ^ /i s ^ Spleen Kidneys 2-3>.o0 Suprarenals ' Stomach and: K? Intestines vy Prostate r Thyroid L.tNt'FCt s v_- Organ _____ Total Weight of .Height Sample Brain Spinal Cord -S-tp-ia&ed Muscle Adipose tissue Long Bone Rib ^ Testicle Skin r /\ rt? S\ f+ /> H ! I! Additional Information Obtained.' from .hospital his tony.. ' ; . . `i`his pl-year-old colored male was admitted 1'eb. 25,,19^8 and died the same day. Oh admission he- complained of having had a sudden attack of dizziness followed, by vomiting' and ' nausea while at work, 5 days previously. At that time he left work and went home, That evening he had cramping pain over entire abdomen, most marked over lower abdomen. His nausea and cramps continued until the day of admission. The day before admission the patient, while in bed, had a. . . sudden attack of shortness of breath, accompanied by a cough producing frothy blood-stained sputum. Patient was employed by the Eagle Picher Lead Company for 15 years until August 19-4-7 * Erom then until 5 days before admission he was employed by the Lackner Sign company. He suffered an attack of abdominal cramps and vomiting 10 years ago which was diagnosed as lead Intoxication, ns was seen o months ago, by Dr. f$atuska, because he complained of neaaache and abdominal cramps. He was told that his blood pressure was elevated _ 10 years ago after an Army examination and again in April I94.7 when he was examined following an attack of flu. During his final year he lost 25 lb. in weight (155-130)* lie nad been short of breath on exertion for 6 months. He had nad no edema or palpitation. He was orthopneic only t during his final week. The positive findings on Physical Examination were: T 98.6, P 112, R 50, BP 270/160 well developed, fairly well nourished dyspneic, orthopneic,, coughing. . . . skin warm, moist _ -h mucous membranes pale ^ : discs blurred, arteriolar spasm (?) of retinal vessels no lead line ' ' " ' ." . venous pressure slightly raised clinically moist rales over entire chest . g ; ,.:.h heart enlarged to left. Sinus rhythm. Aa tympanitic . ;;... .ana greater than Ps Ho murmurs. > Abdomen noth tender; no rigidity. pieen. and liver not felt, Small: umbilical hernia. : . ' IS7441.03 no edema neurological normal rPV> negative. 'v0 oth.r laboratory work wasJ,c"oam'phlte*teKda.hn .T,as. iie was given AmmoDhylin^f^^I lastec^about 3 hour this also pdervnieionodd..r o dKhoi nrpecoo-rr>d iwa/ sl mad-e o,'f the rveesuLlltt.TM n^e 6wasUrinS Five minutes a f t t h U Pj f . 1/ 150 by hypo. a cardiac death. 3^ Catln -Datlent died, apparently are as they'ao" ar""" theatln V ? f " hospltEa history two house officers Sho h z j " formation sheet. The apparently felt chat lead i n t o x i r a t i o ^ a ^ ln- t1 oilart elenllesi!" " ** TM I quote; . this picture *buteidSiib t ^ i t TM 1318" "ay b pla^'ln2 a Part in contributing* to " ** . , , p l u m b l s m l i k e l y present but not Dr. Ian Maclachlan