Measurement of atmospheric concentrations of common household pesticides: A pilot study

Air concentrations of 28 of the most commonly used household pesticides were measured inside nine homes in Jacksonville, Florida, and compared with corresponding outdoor levels. The households selected were sorted into three categories according to the degree of pesticide indoor usage. Personal air monitoring was also performed on one resident of each household by means of a portable sampler, which was kept with the person at all times. Five of the pesticides were found in the air inside of the majority of the homes at concentrations as high as 15 μgm(-3) (average concentrations, 12 ngm(-3) to 2.4 μgm(-3)). Indoor levels were generally one to two ordrrs of magnitude higher than surrounding outdoor air levels and personal air measurements were within ± 50% of corresponding indoor values. All samples were collected over 24-hr periods on polyurethane foam and analyzed by capillary colum gas chromatography with mass spectrometric and/or electron capture detection.

Subcapsular orchiectomy using the CO2 laser: a new technique

We report a technique for performing subcapsular orchiectomy using the CO2 laser. The procedure was simple and safe and was completed within 30-45 minutes in the 13 patients in whom it was carried out. Postoperative pain and swelling were minimal, and compression dressings were unnecessary. Postoperatively, the mean serum testosterone value was of castrate level. We conclude that CO2 subcapsular orchiectomy is a worthwhile addition to our surgical armory.

Pulmonary and systemic vascular effects of serotonin in conscious newborn lambs

There is evidence that serotonin (5-hydroxytryptamine) may be released from pulmonary neuroendocrine cells during hypoxia in animals. Because there are few data regarding serotonin's effect on the immature pulmonary circulation, we studied the direct pulmonary (and systemic) vascular effects of this amine in awake lambs. As has been observed in mature animals, we found that serotonin is a powerful pulmonary and systemic vasoconstrictor, with a threshold of 3 micrograms/kg in immature lambs. However, unlike in mature animals, phenoxybenzamine, 2 mg/kg, prevented both the pulmonary (and systemic) vasoconstriction seen with serotonin. Serotonin is a powerful pulmonary vasoconstrictor in immature lambs, which is consistent with the idea that release of serotonin from pulmonary neuroendocrine cells may play a role in the hypoxic pulmonary vasoconstrictor response.

Denudation of the entire mucosa of the canine urinary bladder using the neodymium:YAG laser with the MTR 1.5 contact probe

Although the procedure of mucosal stripping or denudation of the urinary bladder was developed over 25 years ago to treat the potentially neoplastic mucosa in patients with low-grade superficial transitional cell carcinoma of the bladder, the procedure was abandoned because of serious complications, including short-term bladder hemorrhage and urinary extravasation and long-term severe bladder contracture, ureteral reflux, and hydronephrosis. In this study, we used the neodymium:YAG laser with the MTR 1.5 contact probe to denude the entire mucosa of the canine urinary bladder. Evaluation of our results showed that mucosal denudation by this technique can be performed simply and safely without complications. Specifically, we encountered no significant bladder hemorrhage, urinary extravasation, bladder contracture, ureteral reflux, or hydronephrosis. We believe that the denudation procedure may be useful as a surgical means of treating the entire bladder mucosa in patients with proliferative epithelial lesions of the bladder including multifocal carcinoma in situ.

Effective outpatient treatment of Kaposi's sarcoma of the urethral meatus using the neodymium:YAG laser

An unusual presentation of acquired immunodeficiency syndrome (AIDS)--a case of Kaposi's sarcoma involving the glans penis and fossa navicularis--was treated palliatively with neodymium:YAG (Nd:YAG) laser photoablation. A single outpatient treatment removed the two lesions and restored the patient's ability to void normally. The Nd:YAG laser proved extremely useful, providing effective outpatient therapy with minimal morbidity and excellent local results.

Comparison of gated cardiac magnetic resonance imaging and two-dimensional echocardiography for the evaluation of right ventricular thrombi: a case report with autopsy correlation

In a patient who died of complications of severe pulmonary hypertension, right ventricular failure, and sepsis, antemortem two-dimensional (2-D) echocardiography and magnetic resonance imaging (MRI) studies demonstrated a right ventricular mass which at autopsy proved to be thrombus. The diagnostic features of this mass as imaged by these two methods are compared. This case was complicated in that the patient had a history of right atrial myxoma that had been successfully removed three years previously, and a history of several prior pulmonary emboli. Gated MRI depicted the size, shape, and surface characteristics of the mass more clearly than 2-D echocardiography because MRI provided better contrast and spatial resolution. Both techniques were useful in localizing the mass and showing if it was fixed or mobile. Depiction of tumor attachment was unclear with echocardiography but very clear with MRI. MRI also showed a left pulmonary artery thrombus that was not visualized by 2-D echocardiography. Both techniques provided chamber dimension measurements showing enlargement of the right atrium and ventricle. This case demonstrates that gated MRI provides high-quality images of cardiac anatomy and masses. Gated cardiac MRI should be considered at least complementary and potentially superior to two-dimensional echocardiography in the evaluation of intracardiac masses in certain patients.

Residual effects of limestone on pasture yields, soil pH and soil aluminium in a krasnozem in north-western Tasmania

Residual effects of 15 t/ha of surface applied limestone were evaluated at Elliott in northwestern Tasmania on a clover-based, perennial dryland pasture that was well fertilised and sufficient in molybdenum. The soil was a krasnozem (Gn 4.11) with a mean pH of 5.5. Annual pasture DM increases of 0.5-1.7 t/ha persisted for at least 9 years after the final application of limestone. The largest seasonal DM increases of 0.4-0.7t/ha were recorded in autumn. No decline in the pH of the surface 75 mm of the unlimed plots was detected. However, the pH of the surface 75 mm of the limed plots declined by 0.09 pH units per year from pH 7.0. The decline in surface pH was due to the movement of the zone of maximum limestone effect on pH from the 25-50 mm depth to the 100-125 mm depth, a distance of 75 mm in 8 years. Average soil pH profiles, CaCl2-extractable aluminium and root DM distribution in the surface 300 mm did not indicate that aluminium toxicity was restricting pasture DM production on the unlimed plots. However, toxic concentrations of exchangeable aluminium (extracted with BaCl2) were recorded below 100 mm in the unlimed plots.

Partial nephrectomy using the Nd:YAG laser: a comparison of the 1.06 mu and 1.32 mu lasers employing different delivery systems

A comparative study of the 1.06 mu and the 1.32 mu Nd:YAG laser using a variety of delivery systems (focusing handpiece, freehand GI quartz fiber, or frosted laser scalpel) was undertaken to determine the usefulness of these modalities in performing partial nephrectomies in dogs. Variables evaluated included total operative time, total joules expended, estimated amount of blood loss, and extent of renal tissue damage. The contact laser scalpel provided the greatest precision and speed, but no hemostasis, and is therefore inappropriate for parenchymal renal surgery. Evaluation of the other delivery systems showed no discernible differences in the extent of renal damage that could be attributed to either wavelength or wattage used. The usual depth of acute renal damage ranged from 1.0 mm to 1.8 mm when the tissue was fixed immediately after completing the polar nephrectomy, but the damage had extended to 3.0 mm when tissue was examined after 6 weeks. No consistent differences in extent of cellular damage could be demonstrated between the renal cortex and medulla. The lens system inherent in the focusing handpiece limited the total power (60 watts) that could be employed and surgery proceeded at a slower pace and required a greater expenditure of energy. Likewise, the maximal power that could be applied using the 1.32 mu laser was 25 watts and surgery also proceeded at a slower pace.(ABSTRACT TRUNCATED AT 250 WORDS)

Effective outpatient use of polyethylene glycol-electrolyte bowel preparation for radical cystectomy and ileal conduit urinary diversion

In this prospective study we examined the oral electrolyte-overload method of bowel preparation for patients who were to undergo radical cystectomy and ileal conduit urinary diversion. We found it to be a safe and effective mechanical bowel preparation that can be used by outpatients. It was well tolerated and resulted in adequate bowel cleansing and a low incidence of postoperative wound infections and pyelonephritis. A major advantage of this method is that it reduced the period of preoperative hospitalization.

Changes in bombesin, calcitonin, and serotonin immunoreactive pulmonary neuroendocrine cells in cystic fibrosis and after prolonged mechanical ventilation

Increases in bombesin, calcitonin, and serotonin immunoreactive pulmonary neuroendocrine cells have been documented in infants with bronchopulmonary dysplasia. As some of the secretory products of these postulated airway chemoreceptors are known to adversely affect pulmonary vasomotor and bronchomotor tone, the present study was undertaken to determine if similar changes occur in the lungs of older pediatric patients with chronic respiratory disease. Immunoreactive cells were identified using the antibody-peroxidase-antiperoxidase technique and expressed as immunoreactive bronchioles/cm2 of lung tissue. In subjects dying an accidental or noncardiopulmonary death (control group: n = 48, zero to 24 yr of age), the total number of bombesin, calcitonin, and serotonin immunoreactive bronchioles/cm2 was greatest at birth, then decreased rapidly to extremely low levels after the first year of life. In the cystic fibrosis (n = 55, 3 days to 29 yr of age) and prolonged ventilation (n = 24, 4 months to 18 yr of age) groups, there was a significant increase (p less than 0.035) in bombesin, calcitonin, and serotonin immunoreactive bronchioles/cm2 from 1 to 11 yr of age. In the cystic fibrosis group, there was a sixfold increase in the number of serotonin immunoreactive bronchioles/cm2 lung tissue (p less than 0.015) compared with that in the other 2 groups during the first decade of life, suggesting a response to specific factors present only in the lungs of patients with this disease. In all 3 groups, immunoreactive cells were infrequently identified after 11 yr, implying a fundamental change in neuroendocrine cell biology coincident with the termination of lung growth and/or the onset of puberty.(ABSTRACT TRUNCATED AT 250 WORDS)

A prospective study of dengue infections in Bangkok

Dengue infections were prospectively studied among 4- to 16-year-old students at a Bangkok school. Blood samples were obtained from 1,757 students in June 1980, before the dengue season, and in January 1981, after the season, and tested for dengue antibodies by the hemagglutination inhibition method. Classrooms were monitored daily for school absences. Fifty percent of the children had antibodies to, and were presumably immune to, at least 1 dengue serotype by the age of 7 years. Most (90/103, 87%) students who became infected by dengue viruses during the study period were either asymptomatic or minimally symptomatic (absent only 1 day). Most (7/13, 53%) of the symptomatic dengue infections (absent with fever for greater than or equal to 2 days) were clinically recognized as cases of dengue hemorrhagic fever which required hospitalization. None of 47 primary dengue infections required hospitalization, whereas 7 of 56 secondary infections did (P = 0.012). Preexistent dengue immunity, as detected by conventional serologic techniques, was a significant (odds ratio greater than or equal to 6.5) risk factor for development of dengue hemorrhagic fever.

Calcitonin gene-related peptide immunoreactivity in airway epithelial cells of the human fetus and infant

Calcitonin gene-related peptide-immunoreactive cells were identified within the epithelium of distal conducting airways in the human fetus and infant. Several peptides and amines, including calcitonin, have been identified previously within a specific population of airway epithelial cells. These cells, referred to as pulmonary neuroendocrine cells, are postulated to be airway chemoreceptors responsible for changes in ventilation and perfusion in response to changes in airway gas composition. Calcitonin gene-related peptide immunoreactive cells could be identified throughout the period of development studies (20 weeks gestation to 3 months of age), but were present in only limited numbers in less than 50% of individuals (n = 23). In contrast, large numbers of calcitonin gene-related peptide immunoreactive cells were identified in 100% of infants (1-3 months, n = 5) with bronchopulmonary dysplasia. The differential processing of mRNA transcribed from the calcitonin gene in neural and non-neural tissue suggests that calcitonin, rather than calcitonin gene-related peptide, is the primary product of translation in pulmonary neuroendocrine cells. However, considering the potent vasodilatory and bronchoconstrictive effects of calcitonin gene-related peptide, its presence in pulmonary neuroendocrine cells, even in small amounts, may be important in controlling pulmonary vaso- and/or bronchomotor tone. The presence of large numbers of calcitonin gene-related peptide immunoreactive cells in infants with bronchopulmonary dysplasia suggests that calcitonin gene-related peptide may be one further agent contributing to the pulmonary pathophysiology seen in this disease.

Small cell carcinoma of the kidney. A clinicopathologic, immunohistochemical, and ultrastructural study

Three cases of primary small cell carcinoma of the kidney with light microscopic, immunohistochemical, and electron microscopic findings are reported. Two patients died of disseminated disease 8 months and 1 year, respectively, after the diagnosis and the third was free of tumor after 18 months. Immunohistochemical studies revealed keratin immunostaining of tumor cells in two cases and staining for neuron-specific enolase in the third. The third case also showed a few dense neurosecretory granules at the ultrastructural level. Although no strong conclusions regarding histogenesis can be drawn, this study indicates that small cell carcinoma of the kidney exists and does not necessarily exhibit a neuroendocrine differentiation. Small cell carcinoma of the kidney must be considered in the differential diagnosis of malignant renal tumor, especially in cases in which a large necrotic tumor is present. Based on the few cases presented in this study and on the one previously reported case, small cell carcinoma of the kidney appears to be an aggressive tumor.

Stage C adenocarcinoma of the prostate. An analysis of 551 patients treated with external beam radiation

We retrospectively reviewed records of 551 patients with clinical Stage C prostatic adenocarcinoma treated with 60 to 70 Gy external beam radiation. Elective pelvic node irradiation was given to 247 patients (45%). Follow-up for all surviving patients ranged from 16 to 201 months (median, 6.5 years; mean, 7 years). The 5-, 10-, and 15-year uncorrected actuarial survival rates were 72%, 47%, and 27%, respectively. Disease-free survival rates were 59%, 46%, and 40% at the corresponding times. Actuarial local control rates were 88%, 81%, and 75% at 5, 10, and 15 years, respectively. Disease-free survival was adversely affected by high pathologic grade, disease fixed to the pelvic sidewall, invasion of the bladder, prior transurethral resection, hydronephrosis, and elevated serum levels of prostatic acid phosphatase and creatinine. Elective pelvic node irradiation did not improve the outcome. Complications of treatment were acceptable: minor anorectal and/or urinary symptoms, 11%; mild to moderate complications, 19%; serious problems requiring surgery, 3%. It is concluded that localized, high-energy external beam irradiation provides excellent local control of disease, low morbidity, and 5-, 10-, and 15-year survival rates that have not been rivaled by other treatment.

Adenocarcinoma of the urethra in women. A clinicopathologic study

Twenty-two cases of adenocarcinoma of the urethra in women were studied. Nine were classified histologically as clear cell adenocarcinoma and 13 were classified as columnar/mucinous adenocarcinoma. Thirteen patients (59%) were black. The average patient age was 61 years (range, 27 to 76 years). Follow-up ranged from 6 to 194 months, (average, 40 months). At presentation, most patients (82%) had extension of tumor into adjacent structures or metastases to regional lymph nodes. Eighty-six percent received radiation therapy and 41% underwent an anterior exenteration or cystectomy. Eight of 22 patients (36%) had no evidence of disease 21 to 194 months after diagnosis (average, 83 months). Fourteen (64%) were dead of disease 6 to 23 months after diagnosis (average, 15 months). In general, the extent of tumor correlated best with survival time. Forty-four percent of patients with clear cell adenocarcinoma were dead of disease within 24 months of diagnosis, in contrast to 77% of those with columnar/mucinous adenocarcinoma, suggesting that patients with clear cell adenocarcinoma may have a better prognosis than those with columnar/mucinous adenocarcinoma. However, the difference in survival probability between the two groups was not found to be statistically significant. Recognition of the two histologic types of urethral adenocarcinoma is important to prevent misdiagnosis of such tumors as metastases (or direct extension) of nonurethral neoplasms having a similar histologic appearance. A possible predilection of the disease for black women has not been previously described.

Uropathogenicity in rats and mice of Providencia stuartii from long-term catheterized patients

Providencia stuartii, a frequent and persistent isolate from the urinary tract of chronically catheterized elderly patients, is multiply antibiotic resistant and may cause fatal bacteremia in those patients. We studied P. stuartii strains in rats and mice to determine differences in uropathogenicity. Strains studied varied in expression of factors which contribute to pathogenicity of other bacterial species. Urinary tract responses following challenge with P. stuartii strain HO (factors expressed) were similar to responses reported for uropathogenic E. coli strains both in bacterial persistence and histologic change. In animals similarly challenged with P. stuartii strain RO (factors not expressed), responses were similar to those reported for non-uropathogenic E. coli strains. Results indicate that: a) animal model studies may be useful in differentiating P. stuartii strains based on uropathogenicity, b) P. stuartii uropathogenicity may be related to identifiable factors associated with virulence in other species, and c) the CBA mouse model appears to be the most suitable for studies of P. stuartii uropathogenicity.

Effects of prepartum protein nutrition and birth weight on basal metabolism in bovine neonates

Recipient beef heifers, pregnant with single demi-embryos, were paired to according to identical twin or full-sib embryo. Within pair, recipient heifers were assigned to one of two isocaloric diets containing a control or restricted level of protein (91 vs 55% of National Research Council recommendations) on d 190 of gestation. Following parturition, calves were weighed, fed 1 liter of colostrum, dried and placed in a metabolic chamber at 5 h of age for an 8-h determination of heat production (HP). Maternal body weight gains (P less than .001) during the last trimester and body condition scores at parturition (P less than .05) were reduced in heifers fed the protein-restricted diet. Calves born to heifers fed the protein-restricted diet had 11.4% lower (P less than .05) HP than calves born to control heifers (43.7 vs 49.3 kcal.kg-1.d-1). Birth weights, respiratory quotients and rectal temperatures of newborn calves were not significantly affected by prepartum protein restriction. Within treatment groups, the relationship between HP and weight was described by the equation: HP (kcal/d) = 2.30 wt1.86. The allometric exponent of 1.86 +/- .26 implied that weight-specific metabolic rate was higher rather than lower in larger weight calves. We concluded that the thermogenic ability of neonatal calves may be compromised by prepartum protein restriction and(or) small birth weights.

Subfertility: an etiologic factor in development of testicular cancer?

Gonadal dysfunction with resultant subfertility has been implicated as a possible etiologic factor in testicular cancer. A survey of 57 men who had been married before testicular cancer developed revealed that only four marriages (9%) had problems with fertility. Our findings fail to support a premise that testicular carcinoma is associated with prior male infertility.

Localization of quantitative changes in pulmonary beta-receptors in ovalbumin-sensitized guinea pigs

Impaired beta-receptor function has been postulated as one factor contributing to airway hyperreactivity in asthmatic patients. Although numerous indirect studies have cast doubt on this theory, none of these previous investigations has been able to directly measure changes in beta-receptor number on intrapulmonary structures capable of affecting the physiologic changes seen in this disease state. To help clarify the intrapulmonary location of such changes, a model of allergic bronchoconstriction was prepared by sensitizing guinea pigs to ovalbumin intraperitoneally (ip) 2 wk prior to testing (Group S). A second group of animals was sensitized to ovalbumin, then 2 wk later partially desensitized (Group D) during a 4- to 6-wk period by repeated exposure to increasing doses of nebulized ovalbumin with epinephrine rescue. Control animals received ip administered and nebulized normal saline alone. Pulmonary function assessed by plethysmography revealed an increase in airway resistance to 294 +/- 42% (SE) of control in Group S (p less than 0.005) and a decrease in dynamic compliance to 76 +/- 8% of control in Group D and 39 +/- 10% of control in Group S (p less than 0.002) after exposure to nebulized ovalbumin. Using L-[3H] dihydroalprenolol ([3H] DHA), beta-receptors were autoradiographically localized and quantitated in lung sections from all 3 groups. Significant decreases (p less than 0.02) in 3H-DHA binding were noted in alveolar and conducting airway epithelium, and bronchiolar and vascular smooth muscle in ovalbumin-exposed animals.(ABSTRACT TRUNCATED AT 250 WORDS)

Primary chemotherapy for clinical stage II nonseminomatous germ cell tumors of the testis: a follow-up of 50 patients

Fifty patients with clinical stage II nonseminomatous germ cell tumor of the testis (NSGCTT) were treated with primary chemotherapy followed by a retroperitoneal lymph node dissection (RPLND) in selected patients. The study population included 34 patients with retroperitoneal masses and elevated levels of serum biomarkers (alpha-fetoprotein [AFP] and beta-human chorionic gonadotropin [BHCG] ), five with needle aspiration biopsy-proven retroperitoneal metastases but normal levels of biomarkers, and 11 in whom there were rising levels of serum biomarkers but no radiographic evidence of retroperitoneal metastases. Forty-eight patients (96%) achieved a complete response (CR), with a mean disease-free survival of 132 weeks (range, 55 to 273 weeks). Two patients developed recurrent disease. One died and one achieved a second CR with further therapy (48 + weeks). Postchemotherapy RPLND was required in 11 patients (22%). Patients with embryonal carcinoma had a lower frequency of RPLND (8%) than patients with teratomatous elements in their primary tumor [36%, P = .014]. To reduce the frequency of double therapy (surgery +/- chemotherapy), we propose individualized therapy. Patients presenting with clinical stage II embryonal carcinoma of the testis should receive primary chemotherapy. Patients with clinical stage II NSGCTT and teratomatous elements in their primary tumor continue to require an RPLND. Those patients with intermediate volume disease (greater than 2 cm less than or equal to 5 cm in maximum diameter) may be treated with an RPLND only. Patients with higher volume teratomatous elements (greater than 5 cm less than or equal to 10 cm in maximum diameter) are likely to require the combination of chemotherapy and surgery.

Establishment of a human B-cell tumor in athymic mice

Human B-cell tumors have been established in athymic, BALB/c mice using the EBV-positive Burkitt lymphoma cell line Namalwa. One-hundred-one of 104 animals (97%) developed tumors 10-14 days following s.c. injection of a mixture of 20 x 10(6) Namalwa and 5 X 10(6) irradiated human fibrosarcoma (HT-1080) cells. Tumors developed at the site of injection and reached approximately 300 mm2 (product of cross-sectional diameters) after 21 days; no metastases were found. Histological analysis showed that tumors consisted solely of lymphoid cells. Immunofluorescence assays demonstrated that while 85% of the tumor cells retained reactivity with the monoclonal B-cell antibody BA-1, 96% retained reactivity with antibody BA-2 and 43% with BA-3. A similar reactivity profile was observed with cultured Namalwa cells. Tumors were passaged serially 10 times without significant change in BA-1, BA-2, or BA-3 reactivity. Indirect immunofluorescence demonstrated that antibody BA-2 reached tumor cells within 2 h following i.p. injection; antigen modulation was not observed. These results demonstrate the suitability of this B-cell model for testing the in vivo efficacy and stability of anti-B-cell immunoconjugates.