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Biomedical subjects

A L Frank

Publications and source records attributed to A L Frank.

At least 19 recordsLinked to original sources

Passive dosimetry aboard the Mir Orbital Station: internal measurements.

Passive radiation dosimeters were exposed aboard the Mir Orbital Station over a substantial portion of the solar cycle in order to measure the change in dose and dose equivalent rates as a function of time. During solar minimum, simultaneous measurements of the radiation environment throughout the habitable volume of the Mir were made using passive dosimeters in order to investigate the effect of localized shielding on dose and dose equivalent. The passive dosimeters consisted of a combination of thermoluminescent detectors to measure absorbed dose and CR-39 PNTDs to measure the linear energy transfer (LET) spectrum from charged particles of LET infinity H2O > or = 5 keV/micrometers. Results from the two detector types were then combined to yield mean total dose rate, mean dose equivalent rate, and average quality factor. Contrary to expectations, both dose and dose equivalent rates measured during May-October 1991 near solar maximum were higher than similar measurements carried out in 1996-1997 during solar minimum. The elevated dose and dose equivalent rates measured in 1991 were probably due to a combination of intense solar activity, including a large solar particle event on 9 June 1991, and the temporary trapped radiation belt created in the slot region by the solar particle event and ensuing magnetic storm of 24 March 1991. During solar minimum, mean dose and dose equivalent rates were found to vary by factors of 1.55 and 1.37, respectively, between different locations through the interior of Mir. More heavily shielded locations tended to yield lower total dose and dose equivalent rates, but higher average quality factor than did more lightly shielding locations. However, other factors such as changes in the immediate shielding environment surrounding a given detector location, changes in the orientation of the Mir relative to its velocity vector, and changes in the altitude of the station also contributed to the variation. Proton and neutron-induced target fragment secondaries, not primary galactic cosmic rays, were found to dominate the LET spectrum above 100 keV/micrometers. This indicates that in low earth orbit, trapped protons in the South Atlantic Anomaly are responsible for the major fraction of the total dose equivalent.

Atlantic Ocean↗

Passive dosimetry aboard the Mir Orbital Station: external measurements.

This paper reports results from the first measurements made on the exterior of a LEO spacecraft of mean dose equivalent rate and average quality factor as functions of shielding depth for shielding less than 1 g/cm2 Al equivalent. Two sets of measurements were made on the outside of the Mir Orbital Station; one near solar maximum in June 1991 and one near solar minimum in 1997. Absorbed dose was measured using stacks of TLDs. LET spectrum from charged particles of LET infinity H2O > o r= 5keV/micrometers was measured using stacks of CR-39 PNTDs. Results from the TLD and PNTD measurements at a given shielding depth were combined to yield mean total dose rate, mean dose equivalent rate, and average quality factor. Measurements made near solar maximum tend to be greater than those made during solar minimum. Both mean dose rate and mean dose equivalent rate decrease by nearly four orders of magnitude within the first g/cm2 shielding illustrating the attenuation of both trapped electrons and low-energy trapped protons. In order to overcome problems with detector saturation after standard chemical processing, measurement of LET spectrum in the least shielded CR-39 PNTD layer (0.005 g/cm2 Al) was carried out using an atomic force microscope.

Atlantic Ocean↗

Dosimetric results from the Mir orbital station.

The Mir Orbital Station provided a unique platform on which to carry out a variety of space radiation dosimetry measurements. A number of experiments were conducted using a combination of passive detectors on the interior of the Mir during 1996-97. Thermoluminescent detectors were used to measure absorbed dose. CR-39 plastic nuclear track detectors were used to measure the LET spectra > or =5 keV.microm(-1). Results from TLDs and CR-39 PNTDs were combined to determine total dose and dose equivalent. Mean dose rate was found to decrease while mean dose equivalent rate and average quality factor increased with increasing shielding. Secondary particles from proton-induced target fragmentation interactions, not primary HZE particles, were found to be the largest contributor to the LET spectrum above 100 keV.microm(-1). During the 1997 measurements, mean quality factor was found to vary from 1.7 to 2.1 as a function of location within the Mir.

Aerospace Medicine↗

Ethical and practical aspects of human studies.

Increasingly, genetic information holds the promise of prevention, earlier detection, and better treatment for cancer and other genetically related diseases. Laboratory markers are giving insight into the role of measurable genetic changes; however, there is often difficulty in translating laboratory data into practical use in human populations. Human populations can be difficult to study, and, correctly, there are strict regulations regarding the use of humans as study subjects for many kinds of research activities. Various study designs have a differential ability to prove cause and effect relationships, and will similarly have a differential ability in validating the usefulness of genetic markers. Just as conducting bench research has a traditional set of problems, working with human populations has its own set of potential difficulties. In reality, workers and others are often exposed to carcinogenic substances, usually without their knowledge, and without their informed consent. As genetic information becomes more readily available, and in finer detail, there is a great risk of misuse by employers, insurance companies and others. Placing blame on someone's genetic make-up may once again put into vogue a "blame-the-victim" mentality instead of continuing efforts to clean up workplaces and the environment, or restricting the use of hazardous products. No genetic information should ever be used to deny employment or modify insurance rates. Individuals should be able to maintain personal control over their genetic information. Positive aspects of the use of genetic information can be used to decrease disease and make environments safer.

Confidentiality↗

Neutron dosimetry in low-earth orbit using passive detectors.

This paper summarizes neutron dosimetry measurements made by the USF Physics Research Laboratory aboard US and Russian LEO spacecraft over the past 20 years using two types of passive detector. Thermal/resonance neutron detectors exploiting the 6Li(n,T) alpha reaction were used to measure neutrons of energies <1 MeV. Fission foil neutron detectors were used to measure neutrons of energies above 1 MeV. While originally analysed in terms of dose equivalent using the NCRP-38 definition of quality factor, for the purposes of this paper the measured neutron data have been reanalyzed and are presented in terms of ambient dose equivalent. Dose equivalent rate for neutrons <1 MeV ranged from 0.80 microSv/d on the low altitude, low inclination STS-41B mission to 22.0 microSv/d measured in the Shuttle's cargo bay on the highly inclined STS-51F Spacelab-2 mission. In one particular instance a detector embedded within a large hydrogenous mass on STS-61 (in the ECT experiment) measured 34.6 microSv/d. Dose equivalent rate measurements of neutrons >1 MeV ranged from 4.5 microSv/d on the low altitude STS-3 mission to 172 microSv/d on the ~6 year LDEF mission. Thermal neutrons (<0.3 eV) were observed to make a negligible contribution to neutron dose equivalent in all cases. The major fraction of neutron dose equivalent was found to be from neutrons >1 MeV and, on LDEF, neutrons >1 MeV are responsible for over 98% of the total neutron dose equivalent. Estimates of the neutron contribution to the total dose equivalent are somewhat lower than model estimates, ranging from 5.7% at a location under low shielding on LDEF to 18.4% on the highly inclined (82.3 degrees) Biocosmos-2044 mission.

Fast Neutrons↗

Approach to the patient with an occupational or environmental illness.

This article reviews the importance of the occupational and environmental history, and the approach to a patient with a disease suspected to be of occupational or environmental origin. There is a detailed review of obtaining special aspects of the medical history related to work and environmental exposures as well as illustrative case studies. Sources of additional information are also cited.

Clinical Laboratory Techniques↗

Injuries related to shiftwork.

OBJECTIVE: The purpose of this study was to review the relationship of shiftwork to industrial injuries, and possible methods of injury control. METHOD: The primary method was a systematic review of the published literature. The Cochrane Collaboration protocol was used to conduct the literature search. SELECTION CRITERIA: Studies were included if they addressed the issue of industrial injuries related to shiftwork. RESULTS: No controlled interventions were found. All studies were observational, and most were retrospective. The studies were not comparable with one another since they refer to different industrial settings. CONCLUSIONS: Findings from the literature indicate that shiftwork should be avoided, but that if necessary, certain patterns and rest breaks appear to be associated with fewer injuries. More and better-focused research is needed in this field of study.

Accident Prevention↗

TLD efficiency of 7LiF for doses deposited by high-LET particles.

The efficiency of 7 LiF TLDs (TLD-700) in registering dose from high-LET (> or = 10 keV/micrometers) charged particles (relative to 137Cs gamma rays) has been measured for a number of accelerated heavy ions at various particle accelerator facilities. These measured efficiency values have been compared with similar results obtained from the open literature and a dose efficiency function has been fitted to the combined data set. While it was found that the dose efficiency is not only a function of LET, but also of the charge of the incident particle, the fitted function can be used to correct the undermeasured value of dose from exposures made in mixed radiation fields where LET information is available. This LET-dependent dose efficiency function is used in our laboratory in determining total absorbed dose and dose equivalent from combined TLD and CR-39 plastic nuclear track detector measurements.

Calibration↗

Ethical aspects of genetic testing.

No research study or significant medical treatment can be done involving patients without their informed consent. In workplaces and environmental settings, individuals are often exposed to mutagenic or carcinogenic substances, usually without their knowledge, and not with their informed consent. Such exposures can lead to evermore easily documentable genetic changes. As genetic testing becomes more widespread, there are significant ethical implications regarding employment, insurance coverage, and confidentiality regarding medical information. With an increased ability to detect genetic changes, or 'unfavorable' genetic polymorphisms, this information should not be used to deny employment or increase insurance rates. Rather, such information should be used to increasingly provide appropriately safe workplaces, and place workers in less hazardous settings.

Confidentiality↗

Community-acquired and clindamycin-susceptible methicillin-resistant Staphylococcus aureus in children.

BACKGROUND: Recognition of children with community-acquired (CA) infections caused by clindamycin-susceptible, methicillin-resistant Staphylococcus aureus (MRSA) prompted a retrospective study in two Chicago hospitals conducted from 1987 through 1997. METHODS: Laboratory records of MRSA isolates, antibiotic susceptibilities and information from patient medical records were reviewed. RESULTS: One hundred eleven MRSA isolates from 103 children were studied with 51 isolates CA and 77 susceptible to clindamycin. The CA infections were less frequently associated with prior surgery (P = 0.0039) or a foreign body (P = 0.0001), and clindamycin-susceptible MRSA infections were less frequently associated with a foreign body (P = 0.001) compared with nosocomially acquired or clindamycin-resistant MRSA infections. Clindamycin-susceptible MRSA sources were mostly skin, wound or abscess (69%). Soft tissue diagnoses predominated (70%), but 16% were serious invasive infections. Ninety percent of clindamycin-susceptible MRSA were susceptible to erythromycin and/or trimethoprim-sulfamethoxazole. Antibiotic undertreatment (45%) or overtreatment (17%) of children with the clindamycin-susceptible MRSA occurred, but clindamycin appeared to be effective when used. CONCLUSION: The impact of these organisms could be substantial if they become more frequent or widespread. S. aureus is a potential pathogen in large numbers of pediatric patients; microbiologic evaluation and both presumptive and definitive treatment of all these children may need to be changed.

Abscess↗

Environmental awareness among physicians: what are environmental health and environmental medicine?

Increased awareness of environmental health issues by the biomedical community and the general public places higher demands on all health and medical practitioners to understand the key terms and concepts related to environmental health and medicine. We all exist in 3 different environments (home, workplace, and community), each of which has its own array of hazards and means of exposure. Environmental medicine is a discipline that addresses preventive measures and provides assessment, diagnosis, and treatment of persons who experience adverse health effects of environmental exposures. In addition to basic clinical skills, environmental medicine uses specialized tools including biostatistics and epidemiologic studies, the science of toxicology and risk assessment, the discipline of industrial hygiene, and administrative and public policy skills. Examples of environmental issues that are faced by society today include asbestos exposure in public buildings as well as pesticide and other agricultural chemical residues present in various environmental media.

Attitude of Health Personnel↗

Carcinogenic implications of the lack of tremolite in UICC reference chrysotile.

Using light and electron microscopy analysis, as well as electron diffraction, and energy-dispersive x-ray analysis, an aliquot of UICC chrysotile B was analyzed with special attention given to any tremolite contamination. Polarized light microscopy, with its limit of detection of approximately 1 micron when using dispersion staining, revealed chrysotile as the only fibrous asbestos component. Analytical electron microscopy at 333,000x of more than 20,000 consecutive fibers showed only the tubular morphology characteristic of chrysotile. These findings highlight that when this sample was used for exposure disease induced in animal models correlates with chrysotile-induced pathology, and does not support an explanation based on the "amphibole hypothesis." Thus, chrysotile should be considered as having the biologic ability to produce cancers, including mesotheliomas, based on the extensive use of this material as a standard reference material.

Asbestos, Amphibole↗

Diagnosis and treatment of extracanal invasive resorption.

Extracanal invasive resorption is not a well-defined phenomenon. This article describes its clinical, radiographic, and histological characteristics. Treatment of affected teeth based on the location of the resorptive defect is also described.

Bicuspid↗

Tyler asbestos workers: mortality experience in a cohort exposed to amosite.

OBJECTIVES: To examine the causes of death among 1130 former workers of a plant in Tyler, Texas dedicated to the manufacture of asbestos pipe insulation materials. This cohort is important and unusual because it used amosite as the only asbestiform mineral in the production process. High level exposure of such a specific type was documented through industrial hygiene surveys in the plant. METHODS: Deaths were ascertained through various sources including data tapes from the Texas Department of Health and the national death index files. As many death certificates as possible were secured (304/315) and cause of death assigned. After select exclusions, 222 death certificates were used in the analysis. Causes of death were compared with age, race, and sex specific mortalities for the United States population with a commercial software package (OCMAP Version 2.0). RESULTS: There was an excess of deaths from respiratory cancer including the bronchus, trachea, and lung (standardised mortality ratio (SMR) 277 with 95% confidence interval (95% CI) 193 to 385). Four pleural mesotheliomas and two peritoneal mesotheliomas were identified. The analysis also showed an increasing risk of respiratory malignancy with increased duration of exposure including a significant excess of total deaths from respiratory cancer with less than six months of work at the plant (SMR 268 with 95% CI 172 to 399). CONCLUSIONS: The importance of the cohort lies with the pure amosite exposure which took place in the plant and the extended period of latency which has followed. The death certificate analysis indicates the pathogenicity of amosite, the predominant commercial amphibole used in the United States. These data confirm a link between amosite asbestos and respiratory malignancy as well as mesothelioma.

Adult↗

Pharmacokinetics of once-daily dosing of gentamicin in neonates.

In a prospective, randomized trial of once-daily versus twice-daily intravenous or intramuscular dosing with gentamicin, 11 neonates received 5.0 mg/kg once daily and 15 received 2.5 mg/kg twice daily for 2 ro 3 days. The once-daily intravenous dosing group and the twice-daily intravenous or intramuscular dosing group, respectively, had mean steady-state gentamicin peak concentrations of 10.7 versus 6.6 micrograms/ml (p < 0.05), 6-hour postdosing concentrations of 4.7 versus 2.8 micrograms/ml (p < 0.05), trough concentrations of 1.7 versus 1.7 micrograms/ml, elimination half-life of 8.8 versus 5.4 hours (p < 0.05), and volume of distribution at steady state of 0.67 versus 0.46 L/kg. No nephrotoxic effects were identified in any group. Once-daily gentamicin therapy with 5.0 mg/kg in neonates achieves peak serum levels that are more suitable for optimal bacterial killing than those which traditional regimens achieve. Similar trough levels suggest that even larger doses and longer dosing intervals may be ideal in term neonates.

Ampicillin↗