Bioaccumulation and toxicity of four dissolved metals in Paracentrotus lividus sea-urchin embryo

The bioaccumulation of four metals (Cd, Cu, Pb, Zn) dissolved in water was assessed measuring the concentrations recorded within sea-urchin larvae (Paracentrotus lividus, Lmk.) after a 48-h exposure period. Concurrently, the frequencies of abnormalities were evaluated at the 48-h pluteus stage to check the actual toxicity of such contaminants with regards to larval development. Maximum metal concentrations in the larvae reached 43.8 +/- 6.7 micrograms Cd g-1 dry weight (d.w.), 1269 +/- 392 micrograms Cu g-1 d.w., 3106 +/- 679 micrograms Pb g-1 d.w., 534 +/- 62 micrograms Zn g-1 d.w. Bioconcentration factors (BCFs) reached very high values for Pb (maximum value: 16,282 +/- 973) and indicated that the concentrations of Pb and Cd were directly related to the water concentration at least in the range of concentrations tested. Zn appeared to be partially regulated above a certain threshold concentration (between 5 and 25 micrograms l-1). Cu was accumulated with an active uptake at least below lethal threshold level (100 micrograms l-1). Nevertheless, above these thresholds, high mortality of embryos prevent any interpretation of Zn and Cu bioconcentration factors. Concurrent studies carried out on embryotoxicity confirmed the high toxicity of Cu towards sea-urchin pluteus larvae and highlighted the different behaviour of Cd. The internal Cd concentrations were directly related to the external ones, comparable to other non-essential metals, but Cd had little toxic effect on the initial larval development.

Inhaled corticosteroids and Churg-Strauss syndrome: a report of five cases

Churg-Strauss syndrome is an eosinophil-associated, small vessel granulomatous vasculitis, characterized by late onset asthma, upper airways disease, eosinophilia, and clinical manifestations of systemic vasculitis. Several cases of Churg-Strauss syndrome have been recognized in patients treated with cysteinyl leukotriene-receptor antagonists and weaned off systemic corticosteroids. These cases have led to a general warning on the possible development of Churg-Strauss syndrome after taking cysteinyl leukotriene-receptor antagonists. The authors report five cases of Churg-Strauss syndrome in severe steroid dependent asthmatics in whom inhaled corticosteroids allowed systemic corticosteroid withdrawal. It is concluded that physicians should monitor patients carefully when severe asthma is controlled with any substance allowing withdrawal from (or even avoidance) of systemic corticosteroids. Case-control studies should identify more precisely the risk factors of Churg-Strauss syndrome.

Concentration and mobilization of Cd, Cu, Pb and Zn by meiofauna populations living in harbour sediment: their role in the heavy metal flux from sediment to food web

The bioavailability of Cd, Cu, Pb and Zn was assessed in different harbours of the Atlantic coast (France). The responses of the two dominant meiobenthic groups (nematodes and copepods) to a heavy metal contamination gradient measured in similar subtidal sediments were observed in field surveys. Heavy metal concentrations were measured in nematodes and copepods. Nematodes have higher Cd, Cu, Pb and Zn transfer factors than copepods or other benthic species. The flux of heavy metal through nematodes was estimated and appears to be important compared to plankton in the process of heavy metal transfer to benthic or pelagic food webs.

Six vs twelve cycles for complete responders to chemotherapy in small cell lung cancer: definitive results of a randomized clinical trial. The "Petites Cellules" Group

Of 320 patients with small cell lung cancer (SCLC) entered into a clinical trial of chemotherapy between January 1983 and September 1985, 106 patients achieved a complete response. The induction chemotherapy used was lomustine 60 mg.m-2 p.o., cyclophosphamide 1 g.m-2 i.v., doxorubicin 45 mg.m-2 i.v. and etoposide 150 mg.m-2 i.v., every four weeks. Lomustine was only given for the first three cycles. Seventy nine of the 106 patients still in complete response after six chemotherapy cycles were subsequently randomized to receive either six more cycles or no more treatment until relapse. In this group of 79 patients, a difference was shown from the time of inclusion between the 51 patients with limited disease and the 28 patients with disseminated disease, with overall median survivals of 395 and 165 days, respectively, (p = 0.0002). No difference was shown between the two treatment groups: the median survival was 332 days from the time of second randomization with a two year survival rate of 28% for the patients randomized to receive six more cycles and 246 days and 22% for those randomized to receive no more treatment (add 147 days to obtain overall median survival). Continuing chemotherapy for more than six cycles to patients in complete response did not improve survival.

Six vs twelve cycles for complete responders to chemotherapy in small cell lung cancer: definitive results of a randomized clinical trial. The "Petites Cellules" Group

Of 320 patients with small cell lung cancer (SCLC) entered into a clinical trial of chemotherapy between January 1983 and September 1985, 106 patients achieved a complete response. The induction chemotherapy used was lomustine 60 mg.m-2 p.o., cyclophosphamide 1 g.m-2 i.v., doxorubicin 45 mg.m-2 i.v. and etoposide 150 mg.m-2 i.v., every four weeks. Lomustine was only given for the first three cycles. Seventy nine of the 106 patients still in complete response after six chemotherapy cycles were subsequently randomized to receive either six more cycles or no more treatment until relapse. In this group of 79 patients, a difference was shown from the time of inclusion between the 51 patients with limited disease and the 28 patients with disseminated disease, with overall median survivals of 395 and 165 days, respectively, (p = 0.0002). No difference was shown between the two treatment groups: the median survival was 332 days from the time of second randomization with a two year survival rate of 28% for the patients randomized to receive six more cycles and 246 days and 22% for those randomized to receive no more treatment (add 147 days to obtain overall median survival). Continuing chemotherapy for more than six cycles to patients in complete response did not improve survival.

[Anemia caused by iron deficiency and pagophagia. Apropos of a case]

The authors report a case of a 17 year old young man, who entered our hospital for a severe iron lack anemia reported to ice cubes ingestion (Pagophagia). Such cases are reported in the literature. Usually, Pagophagia is a compulsive eating (Pica) caused by iron deficiency. Pagophagia could improve non hematologic symptoms of iron deficiency such as stomatitis and glossitis.

Adjuvant immunotherapy with nonviable Mycobacterium smegmatis in resected primary lung carcinoma. A randomized clinical trial of 219 patients

Two hundred and nineteen patients with resected lung carcinoma were randomized 3 weeks after surgery between two treatment arms: a control group (110 cases) and an immunotherapy group (109 cases). The immunostimulant was a nonviable saprophytic mycobacterium, M. smegmatis, given monthly by subcutaneous injection in four sites. The two groups were equivalent in terms of prognostic factors, including a nonsignificant difference favoring the control group based on the N (node) classification. This interim analysis was carried out on June 1, 1981. Treatment comparison by the log-rank test did not show any significant differences between these two groups in regards to disease-free interval and overall survival. There was no significant difference between the two groups after stratification of the comparison according to the N classification or adjustment with a subset of eight prognostic parameters through the Cox model. The initially expected difference (20% 1-year survival) will probably not be achieved, given these interim results, but patients will continue to be treated and followed-up according to the protocol as to allow further evaluation of this nonspecific immunotherapy.

[Double paraneoplastic syndrome and anaplastic carcinoma of the lung. ADH and ACTH levels in the tumoral tissue (author's transl)]

A double paraneoplasic syndrome with hypersecretion of ADH and ACTH revealed the presence of a small cell bronchial cancer in a man aged 62 years. Water and electrolyte anomalies due to the hypersecretions were of such a degree that an occlusive syndrome occurred. Very high levels of ADH and ACTH were found in the tumoral tissue. The measurement of these levels is rarely conducted at the present time but was able to define the mechanism of abnormal secretion of these two hormones in this case.

[Ocular metastasis demonstrated a carcinoma of the thyroid gland (author's transl)]

Report of a case of choroidal metastasis. Enucleation was performed because of the clinical aspect of a primitive tumor. Histopathologic stains revealed a vesicular adenocarcinoma, may be of the thyroid gland. Total thyroidectomy was performed and demonstrated a vesicular microcancer (1/10e mm diameter).

[Pleuro-pulmonary infections : importance of anaerobic bacteria and therapeutic consequences (author's transl)]

A prospective study of bacteriology and therapeutic outcome in 14 cases of pleuro-pulmonary infections is reported. Bacteriologic results are based on transtracheal aspirates and empyema fluid. Appropriate anaerobic bacteriologic methods were employed. Anaerobic bacteria were recovered from 11 patients, and were the only pathogens isolated in 6 patients. Patients were treated by penicillin G. This was judged satisfactory in all cases, although 1 patient died from pneumococcal septicemia few hours after his admission to the hospital. The results indicate that with reliable specimen (pleural fluidand transtracheal aspirates) and optimal anaerobic culture methods, bacteriologic diagnosis can be established. Since anaerobes play a key role in most cases of pleuro-pulmonary infections, penicillin G is the prefered initial drug.

The bacteriology of cavitating pulmonary infections and empysema. Studies of transtracheal aspirates and pleural fluid

A prospective study of bacteriology in 14 cases of cavitating pulmonary infections and empyema is reported. Bacteriologic results were based on transtracheal aspirates or pleural fluid. Appropriate anaerobic bacteriologic methods were employed. Anaerobic bacteria were recovered in 11 patients (79%); they were the only pathogens isolated in 6 patients. The predominant species were Fusobacterium nucleatum, Bacteroides melaninogenicus, Bacteroides fragilis and Peptostreptococcus. Aerobic bacteria were present in 7 patients. The results indicate that anaerobes play a key role in most cases of cavitating pulmonary infections and empyema, and that proper culture of adequat specimens will generally establish the bacteriological diagnosis.