High-Resolution Computed Tomography and Pulmonary Function Findings of Occupational Arsenic Exposure in Workers.

BACKGROUND: The number of studies where non-malignant pulmonary diseases are evaluated after occupational arsenic exposure is very few. AIMS: To investigate the effects of occupational arsenic exposure on the lung by high-resolution computed tomography and pulmonary function tests. STUDY DESIGN: Retrospective cross-sectional study. METHODS: In this study, 256 workers with suspected respiratory occupational arsenic exposure were included, with an average age of 32.9±7.8 years and an average of 3.5±2.7 working years. Hair and urinary arsenic levels were analysed. High-resolution computed tomography and pulmonary function tests were done. RESULTS: In workers with occupational arsenic exposure, high-resolution computed tomography showed 18.8% pulmonary involvement. In pulmonary involvement, pulmonary nodule was the most frequently seen lesion (64.5%). The other findings of pulmonary involvement were 18.8% diffuse interstitial lung disease, 12.5% bronchiectasis, and 27.1% bullae-emphysema. The mean age of patients with pulmonary involvement was higher and as they smoked more. The pulmonary involvement was 5.2 times higher in patients with skin lesions because of arsenic. Diffusing capacity of lung for carbon monoxide was significantly lower in patients with pulmonary involvement. CONCLUSION: Besides lung cancer, chronic occupational inhalation of arsenic exposure may cause non-malignant pulmonary findings such as bronchiectasis, pulmonary nodules and diffuse interstitial lung disease. So, in order to detect pulmonary involvement in the early stages, workers who experience occupational arsenic exposure should be followed by diffusion test and high-resolution computed tomography.

Evaluation of dental technician's pneumoconiosis using chest X-rayand HRCT: correlation between radiological and functional findings.

BACKGROUND/AIM: This study aimed to compare high-resolution computed tomography (HRCT) findings with those of chest X-ray (CXR) and to evaluate the relationship of pulmonary function test (PFT) parameters with HRCT and CXR findings in cases of dental technician's pneumoconiosis. MATERIALS AND METHODS: CXR, PFT, and HRCT data of 89 dental technicians who were diagnosed with pneumoconiosis were retrospectively evaluated. RESULTS: The cases of 24 dental technicians (27%) classified as normal (Category 0) based on CXR were evaluated as Category 1 according to HRCT. There was an inverse correlation of PFT parameters with nodular profusion score in CXR and all HRCT parameters. In this participant sample, small opacities were predominant (70% of the individuals), and worsening of PFT parameters was associated with the prevalence of pulmonary parenchymal changes. CONCLUSION: In the present study, micronodules detected using HRCT had an effect on pulmonary function worsening, which has not been reported in previous studies.

The relation between the extent of radiological findings and respiratory functions in pneumoconiosis cases of dental technicians who are working in Ankara.

INTRODUCTION: In dental technicians, parenchymal changes caused by dust affect pulmonary functions. The evaluation of the relation between radiological scores (chest X-Ray/HRCT) indicating the extent of pulmonary involvement and the severity of functional findings in dental technicians. MATERIALS AND METHODS: 440 dental technicians were evaluated with chest X-Ray, pulmonary function tests (PFTs) and high resolution computed tomography (HRCT). The degree of pulmonary involvement in radiological images was categorized based upon emphysema, the profusion of opacities, ground-glass opacity, honey combing and extent of pleural abnormalities. RESULT: Mean age of the study population was 34.7 ± 8.5 and mean duration of work was 16.5 ± 7.9 years. The prevalance of Dental technicians' pneumoconiosis (DTP) was 11.1%. The most common opacity in HRCT was round opacity with a rate of 89.7%. The rate of large opacity was %14.3. There was positive correlation between ILO score and HRCT score. Negative correlation was found between ILO and HRCT scores and all pulmonary function tests (except for FEV1/FVC), while no relation was found with age, overall duration of exposure, smoking and the age ofwork onset. In Multiple regression analysis, the extent of pulmonary involvement (HRCT scores) was found to be an independent predictor of functional impairment. Functional parameter reflecting the extent of pulmonary involvement most accurately was (FEV1%). CONCLUSIONS: It is our suggestion that radiological measurement should be used along with functional measurements in the evaluation of functional impairment in mixed dust exposed dental technicians.

Farewell to an old friend: chest X-ray vs high-resolution computed tomography in welders' lung disease.

INTRODUCTION: Welder's lung disease originated from a mixed exposure to different kinds of metals and chemicals from welding fumes. Because of these various harmful effects, irreversible morphological changes may occur in all parts of the respiratory tract, airways and lung parenchyma. Parenchymal changes are the main lesions that define the severity of exposure. The grade of these lesions is the main criteria for compensation claims and the clinical threshold for the occupational health physician's decision making of work change in order to protect the worker's health. In this study, our aim was to compare the diagnostic performance of chest X-ray (CXR) and high-resolution computed tomography (HRCT) for welders' lung disease. OBJECTIVES: Seventy-four male welders aged between 25 and 55 years were enrolled to this study. METHODS: Clinical diagnoses were compared by CXR and HRCT. Same radiologists evaluated the scans without any knowledge about the medical history of the patient (double-blinded evaluation). The agreement between radiologists was compared with Cohen's kappa statistics. RESULTS: The mean age for 74 welders was 40.7 years. The mean duration of exposure was 18.9 years. Although all were found to be nonpathological on the CXR, 27 mild nodular and nine mild linear opacities, five emphysematous changes, three ground glass infiltrates and one pleural thickening were detected by HRCT. CONCLUSIONS: HRCT provides better diagnostic performance compared to CXR for the diagnosis of welders' lung disease.

Diagnosis and treatment of multiseptate gallbladder with recurrent abdominal pain.

Laparoscopic cholecystectomy is usually performed for gallstones or polyp of the gallbladder. Multiseptate gallbladder is a rare congenital malformation. Although several asymptomatic cases have been described, patient usually present with right upper abdominal pain. We present a 29-year-old female patient with multiseptate gallbladder, cholecystectomy was performed, and her abdominal pain and gastrointestinal complaints have resolved.

[Relationship between the mechanical and anatomic axis and orientation angles of the knee joint and functional capacity of patients with osteoarthritis]. / Osteoartritli hastalarda diz ekleminin mekanik ve anatomik akslarinin ve yönelim açilarinin fonksiyonel kapasiteyle iliskisi.

OBJECTIVES: We investigated the relationship between the mechanical-anatomic axes and angles of the knee joint and functional levels of patients with primary osteoarthritis. METHODS: A total of 35 patients (27 females, 8 males; mean age 58+/-9 years; range 42 to 77 years) with knee osteoarthritis were included. After physical examination, weight-bearing anteroposterior x-rays of the knees were obtained, on which measurements of the following were made: mechanical axis deviation (MAD), medial proximal tibial angle (MPTA), anatomic tibiofemoral angle (aTFA), mechanical lateral distal femoral angle (mLDFA), and joint line congruence angle (JLCA). Pain was evaluated by both the Western Ontario McMaster Osteoarthritis Index (WOMAC) and a visual analog scale (VAS). Functional capacity was assessed using the physical function and global indices of WOMAC. RESULTS: There was a moderate correlation between body mass index and the WOMAC global index (r=0.47, p<0.05). Radiographic evaluations revealed varus deformity in 28 patients. There was a correlation between aTFA and the physical function (r=0.47) and global (r=0.41) indices of WOMAC (p<0.05). Functional capacity and pain were not correlated with the other mechanical angles of the knee joint (p>0.05). CONCLUSION: In view of our results, aTFA may be considered one important criterion in designing treatment and planning surgery for patients with primary osteoarthritis.