Pesticide exposures to migrant farmworkers in Eastern NC: detection of metabolites in farmworker urine associated with housing violations and camp characteristics.

BACKGROUND: The purpose of this paper is to present and evaluate descriptively bivariate associations between urinary metabolites of pesticides and herbicides and migrant camp conditions, violations, and personal worker behaviors at home for farmworkers who do not apply pesticides. METHODS: We studied 183 migrant farmworker camps in eastern North Carolina in 2010. Data and urine samples were collected from 371 men. Predictor measures included violations in six domains of housing regulations and nonviolation characteristics and personal behaviors that might impact urinary metabolites. RESULTS: Cockroaches and bathroom violations were predictive of increased exposure to pyrethroids and cyfluthrin/chlorpyrifos, respectively. Changing and storing clothing and shoes in sleeping rooms increased the number of detects for the diazinon metabolite. CONCLUSIONS: Farmworkers had exposures to multiple chemicals. No single housing domain was identified as critical to mitigating housing-related exposure; specific attention should be paid to changing and storing soiled clothing in sleeping rooms, and insect infestations.

Quantification of 2,4-D on solid-phase exposure sampling media by LC-MS-MS.

Three types of solid-phase chemical exposure sampling media: cellulose, polyurethane foam, and XAD-2, were analyzed for 2,4-dichlorophenoxyacetic acid (2,4-D) and the amine salts of 2,4-D. Individual samples were extracted into acidified methanol, and the extracts were analyzed via liquid chromatography-tandem mass spectrometry using electrospray ionization and a C(8) reversed-phase LC column. (13)C 2,4-D and a labeled benzoic acid (13)C or d5) were employed as the surrogate and internal standard, respectively. Over a three-year study of pesticide exposure among agricultural workers involving a high volume of analyses, values of average % recovery for (13)C 2,4-D on personal exposure samples ranged from 87 to 98 with a % relative standard deviation ranging from 7 to 12. The performance of the method compares favorably with that of the current National Institute for Occupational Safety and Health-recommended approach for the analysis of 2,4-D on these types of exposure sampling matrices.

Stereotactic core-needle breast biopsy: a multi-institutional prospective trial.

PURPOSE: To assess the accuracy of stereotactic core-needle biopsy (CNB) of nonpalpable breast lesions within the context of clinically important parameters of anticipated tissue-sampling error and concordance with mammographic findings. MATERIALS AND METHODS: CNB was performed in 1,003 patients, with results validated at surgery or clinical and mammographic follow-up. Mammographic findings were scored according to the American College of Radiology Breast Imaging Reporting and Data System with a similar correlative scale for histopathologic samples obtained at either CNB or surgery. Agreement of CNB findings with surgical findings or evidence of no change during clinical and mammographic follow-up (median, 24 months) for benign lesions was used to determine results. Three forms of diagnostic discrimination measures (strict, working [strict conditioned by tissue sampling error], applied [working conditioned by concordance of imaging and CNB findings) were used to evaluate the correlation of CNB, surgical, and follow-up results. RESULTS: Strict, working, and applied sensitivities were 91% +/- 1.9; 92% +/- 1.8, and 98% +/- 0.9, respectively; strict, working, and applied specificities were 100%, 98% +/- 0.8, and 73% +/- 0.9; strict, working, and applied accuracies were 97%, 96%, and 79%. CONCLUSION: Percutaneous stereotactic CNB is an accurate method to establish a histopathologic diagnosis of nonpalpable breast lesions. Accuracy increases when additional surgery is performed for lesions with anticipated sampling error or when CNB findings are discordant with mammographic findings. An understanding of the interrelationship among these parameters is necessary to properly assess results.

Influenza immunization and mortality among diabetic Medicare beneficiaries in West Virginia.

This study estimated the increased risk of death among Medicare beneficiaries with diabetes in West Virginia who do not receive influenza beneficiaries with diabetes. Medicare beneficiaries with diabetes who did not have claims for influenza vaccination had approximately a 1.7-fold risk of death during a subsequent influenza season, compared with those with a vaccination. This risk was observed in all age and sex subgroups, and was changed very little by adjustment for comorbidity. The adjusted odds ratio for death in the vaccinated group (compared with the unvaccinated group) during the 1996-97 influenza season was 0.639 (95% confidence interval 0.565-0.722); in 1997-98 it was 0.601 (95% confidence interval 0.527-0.687). West Virginia Medicare beneficiaries with diabetes are at a significantly increased risk of death during an influenza season if they do not have prior claims for influenza vaccination.

Breast calcification and mass detection with mammographic anode-filter combinations of molybdenum, tungsten, and rhodium.

PURPOSE: To determine whether contrast loss on mammograms obtained with tungsten (W)-molybdenum (Mo), rhodium (Rh)-Rh, and W-Rh anode-filter units affects calcification and mass detection relative to that on mammograms obtained with Mo-Mo anode-filter units. MATERIALS AND METHODS: Three unfixed cadaveric breasts of 4.0-, 5.5-, or 7.0-cm thickness were imaged with three mammographic units with Mo-Mo, W-Mo, Rh-Rh, and W-Rh anode-filter combinations. Calcification clusters (<300 microm in diameter) and masses (0.5-1.2 cm) placed on the cadaveric breasts simulated abnormal mammograms. Thirty-five images without and 57 images with added calcifications and masses were acquired with a 180-speed screen-film system and interpreted by four mammographic specialists. With a 150-speed screen-film system, 10 normal images and 30 abnormal images with added calcifications were obtained with Mo-Mo and Rh-Rh equipment and read by three of the four radiologists. RESULTS: For the 180-speed system, there were statistically significant differences (P < .05) in detection of calcifications on Mo-Mo images compared with W-Mo, Rh-Rh, and W-Rh images. These differences disappeared with the 150-speed system. For mass detection with the 180-speed system, W-Rh was significantly better than Mo-Mo (P = .02). CONCLUSION: Dose savings and increased penetration with Rh-Rh and W-Rh anode-filter combinations may decrease calcification detection if fast screen-film systems are used, but mass detection may be improved.

An update on core needle biopsy for radiologically detected breast lesions.

BACKGROUND: Traditionally, radiologically detected lesions of the breast have been evaluated by open surgical biopsy with wire localization. Recently, core needle biopsy has been introduced as an alternative to open surgical biopsy. The authors evaluated their own results with long term follow-up after core needle biopsy and reviewed the experience of other physicians with this new technique. METHODS: Four hundred thirty-one core needle biopsies performed at UCLA were analyzed. The outcome of these cases was determined by either surgery or long term follow-up. Statistical analysis was performed to determine the accuracy of the method. RESULTS: Definitive outcome was obtained in 96% of the core needle biopsy cases, with a median follow-up time of 18 months (range, 6-38 months). The authors achieved a sensitivity of 99% and a specificity of 100%. The false-negative rate was 1.7%. There were no complications in this series. CONCLUSIONS: Core needle biopsy is a highly accurate and safe method for the diagnosis of radiologically detected lesions of the breast.

Using tissue texture surrounding calcification clusters to predict benign vs malignant outcomes.

The positive predictive value of mammography is between 20% and 25% for clustered microcalcifications. For very early cancers there is often a lack of concordance between mammographic signs and pathology. This study examines the usefulness of computer texture analysis to improve the accuracy of malignant diagnosis. Texture analysis of the breast tissue surrounding microcalcifications on digitally acquired images during stereotactic biopsy is used in this study to predict malignant vs benign outcomes. 54 biopsy proven cases (36 benign, 18 malignant) are used. The texture analysis calculates statistical features from gray level co-occurrence matrices and fractal geometry for equal probability and linear quantizations of the image data. Discriminant models are generated using linear discriminant analysis and logistic discriminant analysis. Results do not differ significantly by method of quantization or discriminant analysis. Jackknife results misclassify 2 of 18 malignant cases (sensitivity 89%) and 6 of 36 benign cases (specificity 83%) for logistic discriminant analysis. From this preliminary study, texture analysis appears to show significant discriminatory power between benign and malignant tissue, which may be useful in resolving problems of discordance between pathological and mammographic findings, and may ultimately reduce the number of benign biopsies.

Mammography fixed grid versus reciprocating grid: evaluation using cadaveric breasts as test objects.

In this study we use unfixed cadaveric breasts to obtain mammography images with fixed and reciprocating grids. Sheets of acrylic, containing one or more clusters of simulated calcifications and masses, were superimposed on two fresh cadaveric breasts (3.4 and 6.5 cm thick), and were imaged with a fixed grid and a reciprocating grid. Six radiologists, working independently, attempted to identify the number of clusters and/or masses in 114 images containing 139 clusters of simulated calcifications and 42 simulated masses. Thirty-four of these images were normal, containing no lesions. For the thinner breast, no statistically significant difference was found in the detection of clusters of calcifications in the images produced with the fixed grid compared to those produced with the reciprocating grid. However, for the detection of calcifications in images of the thicker breast, sensitivity of 74% for detection of calcifications when a fixed grid was used was significantly less than sensitivity of 86% when a reciprocating grid was used (P = 0.006). The mass detection sensitivity was 91% for images made with a fixed grid compared to 96% for images made with a reciprocating grid, but the difference was not statistically significant (P = 0.346). The use of cadaveric breasts as test objects was well accepted by radiologists. Only for the thick cadaveric breast were differences between the two grids significant, and these differences were restricted to the task of finding calcifications.

US-guided core biopsy of the breast with a coaxial system.

From July 1993 through June 1994, the authors performed 42 ultrasound (US)-guided core biopsies with use of a coaxial technique in which a 14- or 15-gauge core biopsy needle was passed through a 12-gauge introducer needle. This technique proved to be effective in all 42 biopsies. Use of the coaxial technique decreased the procedure time necessary for US-guided core biopsy and may be less traumatic than the standard core biopsy technique.

Silicone breast implant ruptures in an animal model: comparison of mammography, MR imaging, US, and CT.

PURPOSE: To determine the most accurate imaging modality for detection of silicone implant ruptures. MATERIALS AND METHODS: Forty single-lumen silicone implants were surgically placed in 20 rabbits. Each rabbit received one intact and one ruptured implant and was examined with mammography, magnetic resonance (MR) imaging, ultrasound (US), and computed tomography (CT). Five radiologists reviewed all images in a random fashion and graded each for rupture. The radiologist who performed US also graded her impression during examination with US. Receiver operating characteristic (ROC) analysis was performed. RESULTS: MR imaging and CT were the most accurate modalities in detection of implant ruptures, with areas under the ROC curves (Az) of .95 and .91. Mammography and US were statistically significantly inferior, with Az of .77 for each (P < .05). CONCLUSION: MR imaging and CT are statistically more accurate than US and mammography for detection of intracapsular silicone implant ruptures when only the images are reviewed.

Biochemical studies on human ceruloplasmin.

Ceruloplasmin from nephrotic urine, ascites fluid and plasma has been partially characterized. All ceruloplasmin preparations were found to be comprised of two light and two heavy polypeptide subunits. Characterization of the purified subunits indicated that the alpha chain had a mol. wt. of 16000 and had N-terminal valine while the beta chain had a mol. wt. of 59000 and had N-terminal lysine. All carbohydrate resided in the beta subunit. Incomplete cleavage of the 5-methionine residues of the alpha chain enabled a preliminary ordering of the CNBr fragments. Automated sequence analysis of the alpha chain was carried out and the sequence determined was Val-Phe-Asx-Pro-Arg-Arg-Lys-Leu-Glx-Phe-Ala-Leu-Leu-Phe-Leu-Val-Phe-Asx-Glx-Asx-Glx.

Cystic fibrosis: characterization of the inhibitor to ciliary action in oyster gills.

The inhibitor to oyster ciliary activity was isolated from serumof cystic fibrosis patients and heterozygotes. The inhibitinig protein fraction wast a cation as judged by electrophoresis; it had a molecuer weight of 125,000 to 200,000 as judged by gel filtration; antd oil diethylaminoethyl-cellulose chromatography it eluted with the immunoglobulin G fraction. The analogous fraction in normal individuals did not inhibit oyster cillary activity.

Oyster ciliary inhibition by cystic fibrosis factor.

Ciliary inhibition in oysters serves as an assay in identifying a serum factor in cystic fibrosis patients and heterozygotes. Seriums from 47 patients With cystic fibrosis antd 19 heterozygotes caused ciliary cessation within 35 minutes, whereas serums from only 2 of 64 individuals without cystic fibrosis inhibited ciliary activity within this time.