Clinical optoacoustic imaging combined with ultrasound for coregistered functional and anatomical mapping of breast tumors.

Optoacoustic imaging, based on the differences in optical contrast of blood hemoglobin and oxyhemoglobin, is uniquely suited for the detection of breast vasculature and tumor microvasculature with the inherent capability to differentiate hypoxic from the normally oxygenated tissue. We describe technological details of the clinical ultrasound (US) system with optoacoustic (OA) imaging capabilities developed specifically for diagnostic imaging of breast cancer. The combined OA/US system provides co-registered and fused images of breast morphology based upon gray scale US with the functional parameters of total hemoglobin and blood oxygen saturation in the tumor angiogenesis related microvasculature based upon OA images. The system component that enabled clinical utility of functional OA imaging is the hand-held probe that utilizes a linear array of ultrasonic transducers sensitive within an ultrawide-band of acoustic frequencies from 0.1 MHz to 12 MHz when loaded to the high-impedance input of the low-noise analog preamplifier. The fiberoptic light delivery system integrated into a dual modality probe through a patented design allowed acquisition of OA images while minimizing typical artefacts associated with pulsed laser illumination of skin and the probe components in the US detection path. We report technical advances of the OA/US imaging system that enabled its demonstrated clinical viability. The prototype system performance was validated in well-defined tissue phantoms. Then a commercial prototype system named Imagio™ was produced and tested in a multicenter clinical trial termed PIONEER. We present examples of clinical images which demonstrate that the spatio-temporal co-registration of functional and anatomical images permit radiological assessment of the vascular pattern around tumors, microvascular density of tumors as well as the relative values of the total hemoglobin [tHb] and blood oxygen saturation [sO2] in tumors relative to adjacent normal breast tissues. The co-registration technology enables increased accuracy of radiologist assessment of malignancy by confirming, upgrading and/or downgrading US categorization of breast tumors according to Breast Imaging Reporting And Data System (BI-RADS). Microscopic histologic examinations on the biopsied tissue of the imaged tumors served as a gold standard in verifying the functional and anatomic interpretations of the OA/US image feature analysis.

Respiratory morbidities among working children of gem polishing industries, India.

There are millions of working children worldwide. In gem polishing industry, exposure to occupational hazards of dust and chemicals used in polishing of gemstone may result in respiratory symptoms and respiratory disorders. The present study included 586 exposed and 569 comparison group subjects. Data was collected through personal interview, clinical examination, and chest radiography. The respiratory morbidity was diagnosed on the basis of clinical signs and symptoms and chest radiography. The study variables included age, sex, daily working hours, and duration of exposure. The mean age of the child laborers was 11.31 +/- 5.34 years. Prevalence of respiratory morbidity was significantly high in the female child laborers. The other study variables namely age, duration of exposure, and daily working hours were found to be statistically non-significant. The prevalence of respiratory morbidity among child laborers of gem polishing industry in Jaipur was found to be 7%.

Acute and chronic health effects due to green tobacco exposure in agricultural workers.

BACKGROUND: An epidemiological study was undertaken in Gujarat, India to study the acute and chronic health effects of occupational exposure to green tobacco. METHODS: Non-Flue Cured Virginia (FCV) tobacco is the main crop in many districts of Central Gujarat. Three villages were selected from Anand district for the study and a random sample of 685 exposed workers were examined. Six hundred and fifty-five control workers with the same socio-economic status were examined from two villages where tobacco was not cultivated. RESULTS: The overall prevalence of green tobacco sickness (GTS) was 47.0% among tobacco workers. The prevalence in women workers was 55.7% while in men workers it was 42.66%. To detect the chronic health effects prevalence of hypertension, electrocardiogram (ECG) abnormalities, and eye problems in all the workers and reproductive abnormalities in women workers, all subjects received a medical examination. The data were compared in exposed and control group but they were non-significant statistically. No case of tobacco amblyopia was detected. CONCLUSION: The prevalence of GTS among non-FCV tobacco workers is high. However, from viewpoint of severity it can be considered as mild acute nicotine toxicity, which is relieved without medication. No significant difference is observed as regards to chronic health effects among tobacco workers and control workers.

Determination of nicotine and cotinine in tobacco harvesters' urine by solid-phase extraction and liquid chromatography.

A solid-phase extraction method using Drug Test-1 column containing chemically modified silica as a solid support for sample clean up and reversed phase ion-paired high-pressure liquid chromatography method have been developed for the simultaneous determination of nicotine and its metabolite cotinine from the urine samples. Mobile phase was consisted of acetate buffer (containing 0.03 M sodium acetate and 0.1 M acetic acid) pH 3.1 and acetonitrile (78:22% (v/v)) containing 0.02 M sodium octanosulfonate as an ion pair agent. pH of the mobile phase was adjusted to 3.6 with triethylamine for better resolution and to prevent peak tailing. The linearity was obtained in the range of 0.5-10 microg/ml concentrations of nicotine and cotinine standards. The correlation coefficients were 0.998 for cotinine and 0.999 for nicotine. The recoveries were obtained in the range of 79-97% with average value of 85% for nicotine and in the range of 82-98% with average value of 88% for cotinine. The limit of detection was 2 ng/ml for cotinine and 5 ng/ml for nicotine with 2 ml urine for extraction, calculated by taking signal to noise ratio 10:3. The intra-day co-efficient of variation (CV) were <4 and 7% and inter-day CV were <9 and 7% for nicotine and cotinine, respectively. The method was applied to the urine samples of tobacco harvesters, who suffer from green tobacco sickness (GTS) to check the absorption of nicotine through dermal route during the various processes of tobacco cultivation due to its good reproducibility and sensitivity.

Meningeal myelomatosis.

Many neoplasms disseminate along the pathway of the cerebrospinal fluid. Imaging in this setting is usually insensitive, but when there are findings, they have a characteristic appearance. The authors describe a 52-year-old woman with meningeal dissemination of myelomatosis and the classic myelographic appearance of leptomeningeal disease.

Unilateral megalencephaly in association with Dandy-Walker complex.

Unilateral megalencephaly is a rare congenital anomaly. The authors report a case of unilateral megalencephaly associated with Dandy-Walker complex. The embryonic pathogenesis of both entities is discussed. In the absence of magnetic resonance imaging, computed tomography can be used to document these abnormalities.

Acetazolamide-induced nephrocalcinosis.

Nephrocalcinosis has been reported in patients treated with acetazolamide and other agents, such as furosemide or bicarbonate. We present a case of nephrocalcinosis induced solely by acetazolamide and diagnosed radiographically. Possible mechanisms of pathogenesis are reviewed.

Charcot's arthropathy of the shoulder following intraarticular corticosteroid injections.

We describe a case of inflammatory and degenerative arthritis treated with intraarticular corticosteroid injections. This led to rapid subjective relief of symptoms, but inappropriate repeated injections led to the development of Charcot's arthropathy and rapid destruction of the shoulder joint.

Intervention studies against "green symptoms" among Indian tobacco harvesters.

The use of rubber gloves reduced nicotine and cotinine absorption among 29 tobacco harvesters, as evidenced by the urinary excretion rate of nicotine and cotinine. Approximately 20% (n = 6) of the subjects reported that symptoms disappeared when they used gloves, but the remaining 23 workers complained of an occasional headache even when using gloves. Wearing of boots and socks as well as gloves prevented the symptoms and significantly decreased nicotine and cotinine excretion. This suggests that nicotine is absorbed through the feet.

Post-manipulation CT of the knee joint: an aid in diagnosis of intraarticular loose bodies.

Static CT is of established value in evaluating the knee joint. The use of knee manipulation followed by repeat CT to establish a definitive diagnosis has not been previously described. An illustrative case is presented.

Acute and chronic changes in pulmonary functions among Indian textile workers.

An epidemiological study was carried out in three textile mills of Ahmedabad. A total of 214 cotton dust exposed and 184 control subjects were examined for pulmonary function tests. Pulmonary function tests included forced vital capacity and forced expiratory volume in one second. The pulmonary function tests were carried out before starting the shift and after 7 hours of exposure on a vitalograph spirometer. The study shows that among the cotton dust exposed workers byssinotics behave distinctly and show the maximum acute and chronic changes in pulmonary functions. It seems that the effect of cotton dust exposure on the byssinotic subjects is more predominant than the effect of smoking.

Prevalence of byssinosis in textile mills at Ahmedabad, India.

In an epidemiological study carried out in three textile mills at Ahmedabad, India, 929 workers were examined from the spinning departments. The mean prevalence of byssinosis in the blow section was 29.62%, whereas in the card section it was 37.83%. The concentrations of cotton dust (dust less fly) were high in the blow and card sections (4.00 mg/m3 in the blow and 3.06 mg/m3 in the card section). This study suggests that the prevalence of byssinosis is not low in the textile mills of India as reported in many earlier Indian studies.

Protection against "green symptoms" from tobacco in Indian harvesters: a preliminary intervention study.

Two types of gloves were provided to 85 non-Virginia tobacco harvesters who complained of having "green symptoms." Results show that the use of gloves causes a significant reduction in nicotine absorption as reflected by the nicotine and cotinine excretion rates and also the reduction in the prevalence of "green symptoms," since contact with the leaves and leaf-sap and the abrasions of the palms was avoided by their use. It was found that the use of rubber gloves afforded protection among 93% of the subjects, while with cotton gloves the proportion was somewhat less (78.5%). Cotton gloves were more comfortable but nondurable while the rubber ones were durable but not so comfortable.

Blood histamine levels in cotton-dust exposed workers in a textile mill of Ahmedabad.

Blood histamine levels were measured by the bioassay of histamine (on an isolated strip of guinea pig ileum) in workers exposed to cotton dust in a textile mill in Ahmedabad. Byssinotic subjects showed very high levels of blood histamine as compared to nonbyssinotic and control subjects. The blood histamine levels were not well correlated to the dust concentrations or duration of exposure but rather to the day of the week (ie, first, second, third, etc., after weekend break) on which the samples were collected. The blood histamine levels were high on the first day of the work week, when byssinotics complained most of their symptoms.

Occupational health problems among tobacco processing workers: a preliminary study.

Occupational health problems among 100 tobacco processing workers were investigated. Symptoms, including vomiting, giddiness, headache, etc. were found among 69 exposed subjects. It was also observed that the excretion rate of nicotine and cotinine increased among exposed subjects. Biochemical parameters were found to be within the normal range. Electrocardiographic findings were non-specific and clinically there was no evidence of hypertension or ischemic heart disease. Therefore, the symptoms in tobacco processing workers might possibly result from mild nicotine toxicity.