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PubMed1979

Electron microscopic identity of talc in the liver of a narcotic addict.

In this report we identify the ultrastructural correlate of birefringent crystals that we found in biopsy specimens from an intravenous drug addict and that were presumed to be talc. By electron microscopy the crystals were electron dense and elongated with sharp edges and had an apparent lamination. The crystals were found within portal or granuloma macrophages and were often displaced or associated with section tears and knife marks. Weak electron diffraction patterns were obtained that were consistent with talc.

Adult↗
PubMed1976

Characterization of talc and associated minerals.

The unequivocal identification of mineral impurities in talc requires definitive analytical techniques due to the very similar structure of many naturally occurring silicates and the small quantities of associated minerals frequently found. The instrumental methods and techniques extant for this purpose are reviewed. Light microscopy, x-ray diffractometry, and differential thermal analysis have been found to be particularly useful, complementary, and practical for both exploratory and routine determinations of mineral impurities in the talc matrix. When necessary, transmission electron microscopy is recommended for the analysis of mineral components present at sub-trace levels.

Chemical Phenomena↗
PubMedDate not supplied

Exposure to asbestiform minerals and radiographic chest abnormalities in a talc mining region of upstate New York.

A radiologist in New York reported a high prevalence of pulmonary fibrosis in St. Lawrence and Jefferson counties. The New York State Department of Health responded by conducting a case history study of radiographic abnormalities found in the lung parenchyma and pleura of residents in Lawrence and Jefferson counties, where tremolitic talc has been mined for many years. During a 1-y period, all radiographs from 6 hospitals in the region were reviewed. A B-reader confirmed that 355 of 9,442 patients who were at least 40 y of age (3.8%) had a relevant abnormality; 60% of them reported occupational exposure to asbestiform minerals, and another 15% had a chest condition or injury that could have accounted for the abnormal radiograph. The results should be interpreted cautiously, but there was no evidence of widespread radiographic abnormalities resulting from ambient dust exposure. The data, however, support earlier studies that indicate that talc miners and millers experience excess parenchymal fibrosis and pleural changes. The data also suggest that individuals in the paper industry and construction trades may be at risk.

Adult↗
PubMed2000

Video-assisted thoracoscopic introduction of talc in the treatment of recurrent spontaneous pneumothorax.

OBJECTIVE: To present our experience of using a video-assisted thoracic surgical (VATS) technique to treat spontaneous pneumothorax. DESIGN: Retrospective study. SETTING: Teaching hospital, The Netherlands. SUBJECT: 34 patients with recurrent spontaneous pneumothoraces. INTERVENTION: Combined bullectomy, parietal pleural abrasion, and spraying with talc using the Tissuecol (Immuno) spray device using a VATS technique. Measurement of pain by visual analogue scale (VAS) and analgesic requirements. MAIN OUTCOME MEASURES: Duration of drainage and hospital stay, pain, and morbidity. RESULTS: Patients were followed up after 4 weeks and 1 year. Median drainage time postoperatively was 2 days (range 1-3) and duration of hospital stay 3 days (range 2-5). One pneumothorax recurred and one wound became infected. Patients scored a median of 4 (range 1-9) on the VAS for pain at 4 weeks, and 2 (range 0-6) at 1 year. CONCLUSION: Bullectomy combined with pleural abrasion and the introduction of talc using a VATS technique is safe and effective, and requires only a short hospital stay.

Adolescent↗
PubMed1987

Electron microscopic analyses of dust from the lungs and the lymph nodes of talc-mine employees.

The primary purpose of the present study was to obtain microscopic analyses of the lung and lymph-node dust samples from 12 deceased Austrian workers who had been exposed occupationally to dust of talc and other mineral impurities in a talc deposit for many years. The results of the analyses of both fibers and particles are presented. A second goal of the study was to search for a relationship between different grades of pneumoconiotic effects and the concentration, size distribution and the chemical composition of the retained particles. Automatic analysis of approximately regularly shaped particles with a computer-controlled scanning electron microscope (CCSEM) was used for this purpose, while the fiber content was determined manually on the SEM-screen. The SEM examination of real and irregularly shaped fibers at a magnification of 6000x resulted in an average concentration that was increased slightly in comparison to that found in so-called normal lungs. Fibers were rather short with a mean length of 3 microns; 95% of the fibers had a length less than 10 microns. There was reasonable agreement between medical findings and mineralogical analyses concerning the grade of pneumoconiosis in most of the cases.

Aged↗
PubMed1982

Systemic visceral talc granulomatosis associated with miliary tuberculosis in a drug addict.

Light and scanning electron microscopic study of tissues obtained at biopsy and at autopsy from a 64-year-old male drug addict revealed the presence of foreign body granulomas associated with birefringent crystals in the lungs, liver, bone marrow, spleen, and lymph nodes. Caseating granulomas associated with Mycobacteriaceae tuberculosis were also present. Energy dispersive X-ray analysis identified the crystals as talc. Minute talc crystals were also visualized in urine sediment, by scanning electron microscopy and identified by energy dispersive X-ray analysis.

Granuloma↗
PubMed2000

Exposure to nitrosamines, carbon black, asbestos, and talc and mortality from stomach, lung, and laryngeal cancer in a cohort of rubber workers.

There is sufficient evidence for an excess occurrence of stomach and lung cancer among rubber workers. However, evidence for causal associations with specific exposures is still limited. A cohort of 8,933 male German rubber workers was followed for mortality from January 1, 1981 through December 31, 1991. Work histories were reconstructed using routinely documented cost center codes. For each cost center code, calendar time-and plant-specific levels of exposure to nitrosamines, asbestos, talc (low, medium (m), and high (h)), and carbon black (two levels) were estimated by industrial hygienists. Rate ratios (RR) and 95% confidence intervals (CI) were calculated using Cox proportional hazards models, with the lowest exposure level used as the reference category. Exposure was lagged 10 years to account for latency. Exposure-response relations between exposure to asbestos and lung cancer mortality (RRm = 1.3, 95% CI: 0.9, 1.9; RRh = 2.0, 95% CI: 0.9, 4.1) and between exposure to dust (talc and asbestos combined) and stomach cancer mortality (RRm = 1.8, 95% CI: 0.9, 3.8; RRh = 2.7, 95% CI: 1.0, 7.1) were observed. Exposure to nitrosamines was not associated with mortality from stomach or lung cancer. These results suggest that the increased mortality from lung and stomach cancer among rubber workers is associated with exposure to asbestos and dust, respectively.

Aged↗
PubMed2002

Mortality among workers at a talc mining and milling facility.

BACKGROUND: This study evaluated mortality among workers at a talc mining and milling facility. METHODS: Subjects were white men actively employed between 1948 and 1989 and known to have been alive in or after 1950. Analyses assessed cancer mortality during the period 1950-89 (809 subjects) and non-cancer mortality during 1960-89 (782 subjects). RESULTS: Comparisons with regional general population death rates for 1960-89 indicated that the workers had more than expected deaths from all causes combined [209 observed/160 expected, standardized mortality ratio (SMR) = 131, 95% confidence interval (CI) = 114-150], due mainly to increased mortality from lung cancer (31/13, SMR = 232, CI = 157-329) and non-malignant respiratory disease (NMRD) (28/13, SMR = 221, CI = 147-320). The lung cancer excess was concentrated in miners (18/4.6, SMR = 394, CI = 233-622); millers had only a small increase (7/5.5, SMR = 128, CI = 51-263). An excess of NMRD occurred both in miners (10/4.2, SMR = 241, CI = 116-444) and in millers (11/4.8, SMR = 227, CI = 113-407). The median estimated exposure to respirable dust was 511 mg/m(3)-days for all exposed employees, 739 mg/m(3)-days for mine workers and 683 mg/m(3)-days for mill workers. Employees with high, compared with low, estimated exposure to dust had a rate ratio of 0.5 (CI = 0.2-1.3) for lung cancer and of 11.8 (CI = 3.1-44.9) for pulmonary fibrosis. CONCLUSIONS: Exposure to talc ore dust may not have been responsible for the lung cancer excess among these workers but probably contributed to the elevated rate of NMRD, particularly pulmonary fibrosis.

Dust↗
PubMed1989

A case-control study of borderline ovarian tumors: the influence of perineal exposure to talc.

The authors interviewed 116 female residents of western Washington State with serous and mucinous borderline ovarian tumors diagnosed between 1980 and 1985 and questioned them on their use of hygienic powders. A sample of 158 control women from the same counties were identified through random digit dialing and were interviewed as well. Neither the perineal application of baby powder nor the perineal application of cornstarch was associated with an appreciably altered risk of borderline ovarian tumors. However, women who used deodorizing powders alone or in combination with other talc-containing powders had 2.8 times the risk (95% confidence interval 1.1-11.7) of women who had not had perineal exposure to powder. These results suggest that future studies of ovarian tumors in relation to the application of talc-containing powders should consider ascertaining the specific type(s) of powder used.

Adult↗
PubMed1998

Treatment of large, persistent lymphocoeles using an argon beam coagulator and talc.

BACKGROUND: Lymphocoele formation can be a troublesome surgical complication after lymph node dissection and mobilization of large skin flaps. Occasionally, lymphocoeles persist for prolonged periods despite repeated aspiration. Treatment by sclerotherapy has been recommended, but this requires a prolonged treatment time and often causes intense pain. METHODS: The technique used to treat large, persistent lymphocoeles involved 'painting' the lymphocoele wall with an argon beam coagulator after evacuating its contents. Sterile talc was then distributed liberally through the cavity, a closed suction drain placed and the wound closed. RESULTS: The procedure was completely successful in each of the four patients treated. After a mean follow-up period of 11 months (range 6-15 months) no lymphocoele recurrence has occurred. CONCLUSIONS: Use of an argon beam coagulator and talc reliably achieves rapid, definitive obliteration of large, persistent lymphocoeles.

Aged↗
PubMed2006

Foreign body post-varicella granulomas due to talc.

Foreign body granulomas in the skin have been described frequently and may have various causes. Diagnosis is relatively easy in most cases, as most are related to foreign material penetrating into the skin due to different kinds of traumas. We present the case of a boy with multiple facial granulomas, persisting more than 6 months and related to the use of topical anti-pruriginous talc powder applied to papuloexudative lesions caused by varicella. Data gathered in the anamnesis, examination with polarized light and images seen through the electron microscope enabled us to identify the causal agent talc as the inducer of the granulomatous lesions that the patient presented, discarding other types of foreign body granulomas of exogenous origin.

Administration, Topical↗
PubMed1997

Disordered biopyriboles, amphibole, and talc in the Allende meteorite: products of nebular or parent body aqueous alteration?

Transmission electron microscope observations of the Allende carbonaceous chondrite provided evidence of widespread hydrous phases replacing enstatite in chondrules. Calcic amphibole and talc occur in thin (less than 0.3 micrometer) crosscutting veins and as alteration products of primary chondrule glass in contraction cracks within the enstatite. In addition, talc and disordered biopyriboles were found replacing enstatite grains along cracks and fractures. Although rare hydrous phases have been reported in calcium- and aluminum-rich inclusions in the Allende meteorite, these observations suggest that aqueous fluids played a much more significant role in the mineralogical and geochemical evolution of Allende than has previously been thought.

Aluminum↗
PubMed1999

Malignant pleural effusions: treatment with small-bore-catheter thoracostomy and talc pleurodesis.

Thirty-two patients with a known primary malignancy and a symptomatic malignant pleural effusion underwent small-bore-catheter thoracostomy and talc pleurodesis. Twenty-three patients (72%) had a complete response; four (12%), a partial response; and five (16%), no response. Symptoms in all those who responded were clinically improved. Complications included fever in 13 patients (41%) and moderate shortness of breath, chest pain, or both in six (19%). Small-bore-catheter thoracostomy and talc pleurodesis was successful in treating malignant pleural effusions.

Adult↗
PubMed2006

Prognostic value of pleural fluid pH in malignant epithelial mesothelioma after talc poudrage.

BACKGROUND: Current staging schemes for malignant mesothelioma are inadequate. The most accurate staging may require pneumonectomy - a procedure associated with many complications. The pH of pleural fluid (ppH) predicts survival in non-mesotheliomatous malignant pleural effusions, suggesting that this noninvasive test might be useful for prognostication in malignant mesothelioma. OBJECTIVE: It was the aim of this study to determine whether baseline ppH correlates with survival in malignant epithelial pleural mesothelioma. METHODS: We reviewed survival data in patients treated with thoracoscopic talc pleurodesis whose final diagnosis was epithelial malignant pleural mesothelioma and whose chart recorded a ppH determination performed just before thoracoscopy. We monitored 26 patients until April 2002 (25 of these patients died), identifying cutoff ppH values that discriminate best for survival; Cox proportional hazards models were recursively run by increasing the ppH cutoff value by 0.02 each time. RESULTS: The mean follow-up time was 19+/-14 months. Mean ppH was 7.30+/-0.09, and median ppH was 7.32. Several cutoff points correlated with a statistically significant difference in survival, but ppH 7.32 was associated with the greatest value for the area under the curve. Patients with ppH>.32 lived a median of 21.2 months (95% confidence interval 16.5-30.0 months) after diagnosis compared with patients who had ppH <or=7.32 and lived a median of 13.4 months (95% confidence interval 4.5-16.2 months; p=0.0194). CONCLUSIONS: Baseline ppH correlates with survival in epithelial mesothelioma patients treated palliatively with pleurodesis by thoracoscopic talc poudrage. This noninvasive test - ppH - should be included when staging patients with malignant mesothelioma.

Female↗
PubMed1981

Angiotensin converting enzyme concentrations in rabbits with talc-induced pulmonary granulomas.

Pulmonary foreign body granulomas were induced in rabbits by intravenous injection of a talc suspension, and serum angiotensin converting enzyme (ACE) concentrations were monitored for 50 days. One of 3 treated rabbits responded with a slight elevation of serum ACE in the third week after the first injection and for the remainder of the experimental period. Two treated rabbits and 2 control rabbits maintained serum ACE concentrations close to the starting values throughout the observation period of 50 days. We concluded that pulmonary talc granulomas and probably other foreign body granulomas do not elicit a major elevation of serum ACE in rabbits.

Animals↗
PubMed1996

Atypical mycobacteriosis as a complication of talc pneumoconiosis.

A 57 year old man, receiving compensation for talc pneumoconiosis since 1977, was admitted to hospital for the first time in 1987, with symptoms of weight loss, fever, dyspnoea and productive cough. A chest roentgenogram showed bilateral cavitation. Two years later, Mycobacterium xenopi was found in sputum cultures. Despite specific oral antibiotherapy, the patient's health deteriorated and he died in 1990. To the best of our knowledge, this is the first reported case of an association of talcosis with a M. xenopi pneumonia. The relative timing of the two diseases suggests that talc pneumoconiosis predisposed to the infection by M. xenopi.

Diagnosis, Differential↗
PubMed2007

A spray catheter technique for pleural anesthesia: a novel method for pain control before talc poudrage.

BACKGROUND: Chemical pleurodesis causes severe pain, prompting physicians to perform thoracoscopic talc poudrage under general or neuroleptanalgesia. We describe a novel method for pain control in five patients with pneumothoraces and severe chronic obstructive pulmonary disease. METHODS: Patients were premedicated with IM pethidine and IV midazolam. The pleural space was examined with the flex-rigid pleuroscope. Before talc poudrage, 250 mg lidocaine was administered via spray catheter, and pain scores measured immediately after the procedure and on postoperative days 1 and 2 were 3, 2, and 2, respectively. RESULTS: No complications were noted, and 30-day mortality was 0%. CONCLUSION: Lidocaine via spray catheter is effective for pain control before pleurodesis.

Aged↗