In a study to investigate the incidence and significance of surgical glove perforation, bacterial contamination of surgeons' hands and gloves before and after operation was measured and the gloves tested for damage. Perforations were found in 74 of 582 gloves (12.7 per cent) and occurred in 34.5 per cent of operations. Glove perforation did not influence bacterial counts on the surgeons' hands or on the outside of their gloves. A separate clinical study of 100 adult hernia repairs gave no evidence that perforation increased wound sepsis. After standard pre-operative hand preparation, glove perforations are of no clinical significance to the patient, but their high incidence should alert surgeons to the need for protection against pathogens transmissible during surgery, such as hepatitis B and the human immunodeficiency virus. Protection of the surgeon is the main indication for preoperative change of damaged gloves.
Asbestos is interesting because it is known to be carcinogenic for man, is a relatively simple inorganic chemical substance, is very stable, and easily recognized under the polarizing microscope. Like other nonreactive foreign bodies, it excites macrophage reaction and giant cell formation in the tissues at sites of parenteral injection, and it is easy to study the stages of connective tissue reaction throughout the experimental period.In our line-bred White Leghorn fowls we have observed no spontaneous lung tumors, but we observed primary adenocarcinoma of the bronchus, as well as a range of other tumors, under repeated administration of 8-acetylaminofluorene (Peacock & Peacock, 1954 I . They a r e therefore suitable animals for the assay of suspected pulmonary carcinogens.The anatomy of birds differs from t h a t of mammals in t h a t there a r e multiple a i r sacs in direct communication with the lungs, with a system of primary and recurrent bronchi. Physiologically the respiratory cycle consists of inspiration through the primary bronchi directly into the a i r sacs followed by forcible expiration when the air sacs return the a i r through the recurrent bronchi which lead to the pulmonary alveoli where the respiratory exchange takes place.The axillary air sacs have a small subcutaneous area just below the shoulder joint and it is easy to inject aerosols or fluids into the respiratory system by this route. This technique was described in connection with cigarette smoking in birds (Peacock, 1955 ) . Attempts to puff asbestos dust into the air sacs were not very successful because the fibers adhere to the moist surface of the air sac immediately, and do not penetrate f a r into the lung. However, finely ground fibers suspended in tributyrin travel deeply into the respiratory system and reach the pulmonary alveoli, where they can be recognized histologically. I t is a fortunate provision of nature that asbestos fibers are birefringent and can thus be recognized down to the limits of optical resolution by the use of crossed polaroids.When injected cleanly into the lumen of the air sac the suspended fibers a r e spread over a considerable surface of mesothelium in the a i r sacs, and also penetrate by the recurrent bronchi to the alveoli of the lung.The immediate reaction to such injections is inflammatory, probably because of the sharpness of the fibers which readily penetrate epithelial cells. Of the wandering cells only the macrophages appear to engulf the 50 1
WE have previously reported the induction of squamous carcinoma of the crop in fowls foHowing injections into the lumen of the viscus of 2-acetylaminofluorene (2-AAF) dissolved in arachis oil (Peacock and Peacock, 1949). As the injections were made directly through the skin, subcutaneous tissues ancl wall of the crop, some of the inoculum might be retained in the tissues and in fact numerous smaR cysts in the track of the needle were found post-mortem in several birds. No sarcomata were found, however, and the local trauma to the squamous epithelium of the crop apparently favoured the local action of the oily solution of carcinogen.Further experiments designed to assess the possible action of 2-AAF in arachis oil eneysted in the submucous tissues of the crop have been in progress for about 4 years, so far with negative results. On the other hand, repeated injections of aqueous suspensions of 2-AAF directly into the lumen of the crop have yielded a variety of epithelial tuniours, now to be described.METHODS.An aqueous suspension of 2-AAF was prepared by adding 2 ml. of a 1-5 per cent solution of 2-AAF in absolute ethyl alcohol to 10 ml. of a 0-3 per cent solution of gelatin in distilled water. 10 ml. of this suspension containing 25 mg. of 2-AAF was injected repeatedly into the crop of each bird.Sixteen White Leghom cockerels of our inbred flock, aged 5 months at the start of the experiment were injected twice weekly for 4
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