Annual committed effective dosage from natural radionuclides by ingestion of local food growing in mineral mining area, Sri Lanka

Sri Lanka's largest mineral sand deposit occurs in Pulmoddai, and the surrounding area of the mineral sand deposit has been identified as a high natural background radiation area. The food crops grown in the area are used for human consumption. However, the long-term consumption of high radioactive foodstuff may cause health defects. The objective of the present study was to assess the radiological impact on individuals due to ingestion of foodstuffs grown in Pulmoddai area. Seasonal food crops growing in the area, including cereals, vegetables, nuts, fruits and yams were collected and used to prepare common meal plans consumed by the residents. Samples were analyzed with high-purity germanium gamma spectrometer for activity concentrations. Activity concentration of ⁴⁰K was observed in higher amounts in every food sample. Trace amounts of ¹³⁷Cs ²³²Th and ⁷Be were also identified. The total committed effective dosage to an adult from gamma-emitting radionuclides from cooked meals was 0.1482 mSv year^-1, and raw foodstuff was 0.0667 mSv year^-1, which are far below than the harmful levels declared by International Atomic Energy Agency. Results concluded that foodstuff and cooked meals consumed by the people who live in Pulmoddai, Sri Lanka, are radiologically safe.

The effect of universal maternal antenatal iron supplementation on neurodevelopment in offspring: a systematic review and meta-analysis

BACKGROUND

Although antenatal iron supplementation is beneficial to mothers, its impact on the neurodevelopment of offspring is controversial. A systematic review and meta-analysis was undertaken to assess whether routine maternal antenatal iron supplementation confers later neurodevelopmental benefit to offspring.

METHODS

Electronic databases were searched using MESH terms or key words and identified papers were reviewed by two independent reviewers. The study quality was assessed using the Cochrane risk of bias assessment tool. The review was registered in the PROSPERO CRD data base.

RESULTS

Seven publications were identified, based on four randomised trials published between 2006 and 2016. Three of the trials were in the Asian sub-continent. A range of tools were used to evaluate neurodevelopment. Meta-analysis of outcomes from the three RCTs meeting our inclusion criteria showed minimal effect of antenatal iron supplementation on the neurodevelopment of offspring, which was not statistically significant: weighted mean difference of 0.54 (95% CI: -0.67 to 1.75); test for overall effect Z = 0.87; p = 0.38; and heterogeneity 48%. Meta-analysis of outcomes of these RCTs at later stages of development produced similar results.

CONCLUSIONS

The benefit of routine antenatal iron supplementation on neurodevelopment in offspring was not statistically significant in this relatively limited set of trials, and some benefit cannot be excluded in areas with a high prevalence of maternal anaemia. A large randomized controlled trial showing significant benefit would be required to modify our conclusions.

Renal cell carcinoma with Xp11.2 translocation in a 7-year-old boy

BACKGROUND

More than 90% of pediatric renal tumors are nephroblastomas while renal cell carcinomas (RCC) are rare in children (< 5%).

PATIENT

According to the clinical diagnoses of a nephroblastoma stage IV a 7-year-old boy with a kidney tumor and peripheral pulmonary lesion was preoperatively treated for 8 weeks with Vincristine, Actinomycin D and Adriamycin. The resected kidney displayed a RCC with Xp11.2 translocation. There was no tumor regression and the pulmonary lesion was no longer detectable. Hence chemotherapy was put to a halt.

CONCLUSION

Fine needle aspiration biopsy (FNA) would have allowed to adjust the tumor subtype. Prognosis of pediatric RCC with translocation seems more favourable than without translocation though definitive evidence will only be possible by documentation in a clinical diagnose-related register.

Endothelial VEGFR-3 expression in colorectal carcinomas is associated with hematogenous metastasis

Vascular endothelial growth factor receptor 3 (VEGFR-3) is a major inducer of lymphangiogenic signalling and seems to be involved also in angiogenesis. Since both processes are closely linked with tumor metastasis this study investigated the expression of VEGFR-3 in tumor-associated vessels in colorectal carcinomas and evaluated its relevance for lymphogenous and hematogenous metastasis. In a comparative study between microvascular endothelial cells isolated from the tumor (HCTEC) and the corresponding non-neoplastic tissue (HCMEC) from five patients with colorectal cancer VEGFR-3 expression was measured using a specific ELISA. The expression pattern was individually different, with cases showing reduced, elevated and unchanged protein levels. Under hypoxic culture conditions (3% O2 for 24 h), which are more realistic for the tumor situation, the levels remained unchanged. In contrast, hypoxia exposure of macrovascular human umbilical vein endothelial cells (HUVEC) led to a consistent downregulation of VEGFR-3 protein. These data indicate a 'hypoxia-resistant' behaviour of VEGFR-3 in colonic microvasculature. Using immunohistochemistry the endothelial expression pattern of VEGFR-3 in 74 non-metastatic, lymphogenously-metastatic and hematogenously-metastatic colorectal carcinoma specimens was assessed. Positive VEGFR-3 expression was highly significantly associated with those cases showing distant metastasis (p=0.0003). In contrast, significant differences in the expression of VEGFR-3 between non-metastatic tumors and carcinomas with lymph node metastasis were not found. The majority of the detectable intratumoral VEGFR-3-positive vessels were of blood vascular origin (CD31 positive, D2-40 negative). Whereas intratumoral lymphatic vessels were collapsed, VEGFR-3 positive peritumoral lymphatic vessels had mostly open lumina. These morphological observations provide evidence for a predominant significance of VEGFR-3-positive, possibly angiogenesis-mediated, tumor-associated blood vessels in hematogenous metastasis of colorectal cancer. In addition, due to their patency VEGFR-3-positive peritumoral, but not intratumoral lymphatics could be the vascular substrate functionally mediating lymphogenous metastasis.

Desorption kinetics of oxygen in plasma treated SWNTs by in situ thermoelectric power measurements

The functionalization and defect formation of SWNTs caused by isotropic plasma treatments were studied using oxygen desorption/adsorption kinetics by measuring the time dependence of the in situ thermoelectric power (TEP). It is shown that the plasma treatments result in the formation of low binding energy sites for oxygen adsorption. Raman and x-ray photoelectron spectroscopy (XPS) data are in good agreement with the results.

Effect of pro-inflammatory stimuli on tumor cell-mediated induction of endothelial cell adhesion molecules in vitro

The object of our study was the question about the relevance of the tumor surrounding inflammatory cells with respect to the metastatic potential of the tumor cells. To imitate the role of inflammatory cells, three colon carcinoma (HT-29, HRT-18, and SW-620), one breast carcinoma (MCF-7), and one melanoma (ST-ML-12) cell lines were treated with pro-inflammatory stimuli, LPS, TNF-alpha, or IL-1beta. HUVEC monolayers were then stimulated by the collected supernatants (SN) of the tumor cells, following washing out of the applied stimuli. Analysis of CAM expression on HUVEC was performed using cell enzyme immunoassay. E-selectin, VCAM-1, and, in part, ICAM-1 were significantly up-regulated on HUVEC by exposure to SN of all LPS-stimulated tumor cells. This was especially the case for the colon carcinoma cell lines. A minimal increase of expression of VCAM-1 was observed after exposure to SN from TNF-alpha-stimulated HT-29 and MCF-7 cells. IL-1beta stimulation had no effect on endothelial CAM expression. These observations indicate that LPS could play a crucial role in tumor metastasis by inducing the release of soluble factors from different tumor cell lines capable of up-regulating CAM expression. This might be of special significance in colon carcinomas, where a large source of bacterial LPS is available in the intestinal lumen.

Pain management in the critically ill obstetric patient

Safe and successful pain management in pregnant women requires an understanding of the normal physiologic changes of pregnancy. Some hemodynamic changes of labor and delivery are attenuated by effective epidural analgesia. The ideal analgesic agent for laboring parturients should produce a rapid onset of analgesia that lasts throughout labor without any adverse effect on the mother or fetus. There is no ideal analgesic for pain relief in labor. The physiologic changes of labor and delivery are reviewed, together with commonly used analgesic techniques. Special emphasis is placed on critically ill obstetric patients with concomitant cardiac disease.