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Læknablaðið - 01.10.1966, Qupperneq 52

Læknablaðið - 01.10.1966, Qupperneq 52
218 LÆKNABLAÐIÐ of confusion. On admission, clinical examination revealed crepitations over both lungfields and enlarged liver. He was found uraemic, hyper- kaliaemic, hyponatriaemic, hypochloroaemic and with lowered bicar- bonate in plasma. Roentgen examination showed infiltrations in both lungs. Electrocardiogrammes are shown and explained in figs. 3 and 4. During the first day the pt. was anuric. He was then cautiously infused and afterwards quit some urine. However, during the 3rd day the pt. suffered increasingly from dyspnoe and died. The post mortem ex- amination showed massive lung oedema, fluid in pericardium, pleura and peritoneum, necrosis and haemorrhages in liver and parenchym- atous degeneration of kidneys (cf. fig. 5). Table 3 shows the amounts of tetrachloromethan, trichloroethylene and tetrachloroethylene sold during the years 1952—1964. The figures indicate that trichloroethylene was sold in amounts approximateiy five times greater than those of tetrachloromethan, whereas tetrachloro- ethylene was sold in negligible amounts. From this and the obser- vations mentioned above, it was concluded that the incidence of acute, serious poisonings with tetrachloromethan had been absolutely greater during the years 1945—1964 than that of serious poisonings d.ue to trichloroethylene. It was likewise concluded that tetrachloromethan must be definitely more dangerous than trichloroethylene. Emphasis was therefore given to the rigorous restriction on the sale of tetrachloro- methan stipulated in a newly drafted bill on toxic and dangerous sub- stances. It was also suggested that methylchloroform, being less dang- erous than tetrachloromethan and trichloroethylene, should be substi- tuted, as far as is possible, for these substances for domestical and industrial usage. (Our gratitude is due to professor Sigurður Samúelsson and as- sociate professor Theodór Skúlason, Department of Intsrnal Medicine, Landspítalinn (The University Hospital), Reykjavík, and to physician in chief Óskar Þórðarson, Department of Internal Medicine, Borgar- spítalinn (The Municipal Hospital), Reykjavík, for giving us access to the case reports of the patients treated in their departments and per- mission to use the information contained therein for this publication.) Heimildir. Abrahamsen, A. M.: Quantitative estimation of trichloroacetic acid in urine and serum in trichloroethylene poisoning. Acta pharmacol. et toxicol. 1960, 17, 288—294. Alha, A.: Carbon tetrachloride mass poisoning. Ann. MecL. Intern. Fenn. 1950, 39 (suppl. 8), 3—32. Bartonícek, V.: MetaboJism and excretion of trichloroethylene after inhalation by human subjects. Brit. J. lndustr. Med. 1962, 19, 134—141. Dvorácková, I.: Ein fall von tödlicher oraler Tetrachlorokohlenstoff- vergiftung. Arch. f. Toxikologie 1963, 20, 72—78. Fassett, D. W.: Toxicology of organic compounds: A review of current problems, Ann. Rev. Pharmacol. 1963, 3, 267—292.
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