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The purpose of this study was to investigate whether the metabolic suppression of hippuric acid (HA) occurs in field workers coexposed to toluene, xylene and ethyl benzene. Eleven male spray painters were recruited into this study and monitored for 2 weeks using a repeated-measures study design. The sampling was conducted for 3 consecutive working days each week. Toluene, ethyl benzene, and xylene in the air were collected using 3M 3500 organic vapor monitors. Urine samples were collected before and after work shift, and urinary HA, methyl hippuric acid, mandelic acid, and phenylgloxylic acid concentrations were determined. In the first week, toluene concentrations were 2.66 +/- 0.95 (mean +/- SE) ppm, whereas ethyl benzene and xylene concentrations were 27.84 +/- 3.61 and 72.63 +/- 13.37 ppm, respectively, for all subjects. Pre-work shift HA concentrations were 230.23 +/- 37.31 mg/g creatinine, whereas pre-work shift HA concentrations were 137.81 +/- 14.15 mg/g creatinine. Mean urinary HA concentration was significantly greater in the pre-work shift samples than in the pre-work shift samples (p = 0.043). In the second week, toluene concentrations were much lower (0.28 ppm), whereas ethyl benzene and xylene were 47.12 +/- 8.98 and 23.88 +/- 4.09 ppm, respectively, for all subjects. Pre-work shift HA concentrations were 351.98 +/- 116.23 mg/g creatinine, whereas pre-work shift HA concentrations were 951.82 +/- 116.23 mg/g creatinine. Mean urinary HA concentration was significantly greater in the pre-work shift samples than in the pre-work shift samples (p <0.01); a significant correlation (r = 0.565; p = 0.002) was found between pre-work shift urinary HA levels and ethyl benzene exposure. This study showed that urinary HA peak was delayed to next morning for workers coexposed to toluene, ethyl benzene, and xylene; xylene and ethyl benzene probably played competitive inhibitors for metabolism of toluene. The study also presumed that urinary HA became the major metabolite of ethyl benzene at the end of work shift, when the exposure concentrations of ethyl benzene were 2.0 times those of xylene.

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OBJECTIVES: To determine the effectiveness of protective suits and gloves by biomonitoring. METHODS: Fifteen male spray painters at a ship coating factory were studied for two weeks. Workers wore no protective clothing during the first week and wore protective suits and gloves during the second week. Sampling was conducted on four consecutive working days each week. Ethyl benzene and xylene in the air were collected by using 3M 3500 organic vapour monitors. Urine was collected before and after each work shift. RESULTS: Urinary mandelic acid (MA) and methyl hippuric acid (MHA) levels were divided by the personal exposure concentrations of ethyl benzene and xylene, respectively. Mean (SE) corrected MA and MHA concentrations in the first week were 1.07 (0.18) and 2.66 (0.68) (mg/g creatinine)/(mg/m3), and concentrations in the second week were 0.50 (0.12) and 1.76 (0.35) (mg/g creatinine)/(mg/m3) in the second week, respectively. Both MA and MHA concentrations in the second week (when spray painters wore protective suits and gloves) were lower than in the first week, respectively (p<0.001, p = 0.011). Mean decrease in MA and MHA biomarkers were 69% and 49%, respectively. CONCLUSION: This study successfully evaluated the effectiveness of chemical protective suits and gloves by using biomarkers as urinary MA and MHA. This method is feasible for determining the performance of workers wearing personal protective equipment. Moreover, the experimental results suggest that dermal exposure may be the major contributor to total body burden of solvents in spray painters without protective suits and gloves.

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We describe an operating theater blood transaction system (OTBTS) that is a novel computer software system incorporating electronic crossmatch and the concept of a "self-service" blood banking system in the operating theater. Through this system, the surgeons and the anesthetists can issue blood units for intraoperative transfusion for the patients with a negative antibody screen without the need for a porter service or pneumatic tube system. Since implementation of the OTBTS, the time for obtaining compatible blood for intraoperative transfusion has been reduced from 20 to 30 minutes to around 1 minute. Furthermore, the crossmatch-transfusion ratio was reduced to 1.05. The 23% of patients who required extra blood units (i.e., more than originally anticipated) during surgery further benefited from the system. The blood stock reserved for patients undergoing surgery was reduced by 20%. Therefore, the OTBTS is a system that can greatly enhance the efficiency and safety of intraoperative transfusion and can also save workforce resources.

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An investigation was performed to study the mechanical performance of fiber-reinforced composite hip prostheses in a femur. The main objective of the study was to evaluate the effect of fiber orientation of a composite femoral implant on the response of the surrounding femoral bone. A three-dimensional finite element analysis was developed for analyzing a composite implant in the femur. A three-dimensional composite element was proposed to take into account ply drop-off due to a change of cross-section of the composite implant. The element could accommodate multidirectional layers and tapered composites. The material properties of the composite were treated as anisotropic and inhomogeneous while the properties of femoral bone were treated as anisotropic and homogenous. All the materials were assumed to behave linear-elastically. The thermoplastic graphite/PEEK material system was selected for the study. In this presentation, as the first part of the study, the development of the finite element analysis will be described. Numerical calculations were generated and compared with existing data and numerical results available from studies related to metal hip prostheses in the literature. Experiments on the composite hip implants were also conducted for further verification of the analysis and the computer simulations. In Part II, using the finite element code, an extensive study was performed to evaluate the stress/strain distributions, micromotions, and strain-energy density of the surrounding femoral bone, which have been related to initial fixation and long-term stability of the prosthesis in a femoral bone. Numerous fiber orientations were studied, and results of the calculations were compared with those generated by the prosthesis made of cobalt alloy and titanium alloy.

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An investigation was performed to study the mechanical performance of fiber-reinforced composite hip prostheses. In Part I of the study, a three-dimensional finite element code was developed for analyzing a composite hip prosthesis in a femur. The material properties of the composite were treated as anisotropic and inhomogeneous while the properties of the femoral bone were treated as anisotropic and homogeneous. All the materials were assumed to behave linear-elastically. Thermoplastic graphite/PEEK material was selected for the study. No slippage was assumed at the interface between the implant and the surrounding femoral bone. In Part II, numerical simulations were performed using the code to study the performance of a composite prosthesis in the femur. The stress/strain distributions, micromotions, and strain energy density of the surrounding femoral bone were evaluated and found to be related to initial fixation and long-term stability of the prosthesis in the femur. Numerous fiber orientations were studied, and the results of the calculations were compared with those generated from a prosthesis made of cobalt chrome and Ti-6Al-4V titanium alloys. Based on the analysis, it was shown that compared to conventional metallic implants more favorable stresses and deformations could be generated in the femur using composite implants. In addition, by changing fiber orientations according to femoral loads, a composite implant could be designed specifically for the left or the right femur.

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This work is concerned with the design of hip prostheses using advanced fiber reinforced composite materials. The major focus of the study is to evaluate how the stiffness and strength of composite hip prostheses can be affected by variations in ply orientation and stacking sequence for a selected manufacturing method. This investigation involved both analytical and experimental work. An analytical model was developed which consists of a stress analysis and a failure analysis. A finite element program was developed during the course of the investigation for analyzing stresses, strains, and deformations of composite stems with a simplified configuration. Failure and mode of failure were predicted by appropriately selected failure criteria. Experiments were also performed on T300/976 graphite/epoxy composites to verify the analysis and the computer calculations. Both testing and analysis accounted for the various combinations of in-plane and out-of-plane (torsion) loading that can act on the prosthetic hip. Simplified composite stems with a 120 layer thickness were fabricated and tested. An excellent agreement was found between the measured strain data and the numerical calculations. Using the program, parametric studies were performed. It was found that an optimal design of hip stems can be achieved by using advanced fiber-reinforced composite materials, but great care must be taken when selecting the appropriate ply orientation and stacking sequence for a chosen fabrication method.

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A case of malignant lymphoma primarily involving the heart is reported for the first time in which the tumor per se and its accompanying hemodynamic abnormalities were demonstrated by radionuclide angiography (RNA). The patient had severe and progressive failure of the right side of the heart of obscure origin. The tumor was pathologically proven to have involvement of the pericardium, right atrium, and right ventricle, causing significant tricuspid and pulmonic obstruction.

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A case of the left superior vena cava draining to the coronary sinus without associated intracardiac shunt was initially demonstrated by first pass radionuclide angiography. The patient had atypical chest pain for 8 years, and had sick sinus syndrome with a long cardiac pause. Cardiac catheterization confirmed this diagnosis, and a transvenous pacemaker was successfully implanted through the left superior vena cava.

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