Following the suggestion that lead derivatives might cause cancer in man, the causes of death among workers known to have been exposed to lead were studied. A group of companies made available the records of their pension fund, and an accumulator factory provided details of men who had died whilst in their employ. Details of each man's exposure to lead were supplied.There were 425 pensioners, of whom 184 had died; 153 deaths occurred among an unknown number of employed men who had not yet reached pensionable age. Expected deaths were calculated from the appropriate rates for all males in England and Wales.It was concluded that there was no evidence to suggest that malignant disease was related to lead absorption. There was, however, evidence that heavy exposure to lead was associated with an increased incidence of deaths from cerebrovascular catastrophies.
The records of 100 consecutive patients undergoing transantral ligation of the internal maxillary artery (IMA) for epistaxis, including 15 patients who developed postoperative bleeding, were reviewed. Preoperative parameters predictive of surgical failure were advanced age, anemia, and a history of hypertension. The causes of postoperative epistaxis, as determined by surgical reexploration or angiography in 12 cases, included failure to identify the IMA in the pterygomaxillary space (6 cases), blood flow through partially closed clips on the IMA (2 cases), bleeding from posterior ethmoid arteries (2 cases), and revascularization of the nasal blood supply (2 cases). The incidence of surgical failure may be reduced by proper techniques of IMA identification and ligation.
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