External Oblique Intercostal Block for Living Kidney Donor Open Nephrectomy: A Case Series

The external oblique intercostal (EOI) block is a novel regional technique that provides analgesia for upper abdominal incisions. We performed single-injection and continuous EOI blocks in living kidney donors who underwent open nephrectomy. In this case series, we report our experience with pain management using this technique in five patients at our centre. EOI block resulted in good pain relief in our patients. The median (IQR) numerical rating scale score was 3 (1-6) at rest immediately after the end of the surgery, predominantly visceral. We want to highlight the benefits regarding pain management of the association of EOI block with conventional therapy.

A case of self-improving collodion ichthyosis associated with a rare variant of the ALOX12B gene

Collodion baby is usually a manifestation of autosomal recessive congenital ichthyosis, a heterogeneous group of congenital hyperkeratotic genodermatoses with highly variable severity and genetic background. Herein, we report a case of self-improving collodion ichthyosis, a rare subtype of autosomal recessive congenital ichthyosis, characterized by an almost-complete spontaneous resolution of symptoms.

Familial multiple basaloid follicular hamartoma

Basaloid follicular hamartoma (BFH) is a rare follicular hamartoma of benign nature, which should be part of the differential diagnoses of basal cell carcinoma. Familial multiple BFH (FMBFH) is a hereditary subtype which typically presents early in life with multiple small, skin-colored papules primarily on the central face. Although these lesions are usually asymptomatic, they can be cosmetically disfiguring. Treatment options include surgery, cryotherapy, CO2 laser and imiquimod; no standard of care has been determined. We present a case of FMBFH presenting in adulthood, which was treated with CO2 laser with satisfactory results.

Postpartum lumbosacral radiculopathy: a neuraxial anaesthesia complication or an intrinsic obstetric palsy?

Postpartum peripheral nerve disorders are an uncommon obstetrical complication, with most cases resulting from intrinsic obstetric palsies. We present the case of a full-term nulliparous pregnant 33-year-old woman with a vacuum-assisted vaginal delivery due to a prolonged second stage of labour and occipitoposterior position of the fetal head. For analgesia, a combined spinal-epidural technique was used. Four hours after delivery, the patient experienced a painless asymmetric motor deficit and hypoesthesia in the lower limbs, followed by sphincter disturbance. Emergent MRI was unremarkable. Electromyography showed signs of a bilateral lumbosacral radiculopathy. The patient experienced a gradual recovery over the following 2 months. Although a definitive aetiological diagnosis could not be confirmed, a lumbosacral polyradiculopathy due to intrinsic obstetric complication was considered. The patient presented several risk factors known to be associated with intrinsic obstetric palsies. Obstetricians and anaesthesiologists have an important role in preventing and diagnosing postpartum peripheral nerve disorders.

Implications of violence experience in postpartum depression

Introduction

The violence against women is an exacerbating factor in public health that affects a third of the world's female population, and the intimate partner is the main perpetrator. Researches show the impact of violence in the victims' health, such as: postpartum depression (PPD). In this context, considering the importance and magnitude of the experience of violence and its impact on health, as well as depression negatively impacted on the health of the mother and baby, justify it to carry out this study.

Objective

To identify the prevalence of symptoms of PPD among puerperal women and to examine the association with violence experience.

Methods

This is a cross-sectional study, performed with 330 puerperal women admitted to a municipal maternity hospital in Cariacica - State of Espírito Santo, Brazil. Data collection was conducted by duly trained interviewers, using a form containing data on socioeconomic, behavioral and clinical characterization. In order to track violence acts, in life and in pregnancy, practiced by the intimate partner, we applied the World Health Organization instrument, which enables the identification of psychological, physical and sexual violence acts. The identification of the outcome under study, postpartum depression, was obtained by means of the Edinburgh Postnatal Depression Scale. The data collected were analyzed through the Stata 13.0 program, where the following tests were performed: Pearson chi-squared test and Poisson regression.

Results

a rate of 36.7% of participants (95% CI: 31.6-42.0) showed symptoms of postpartum depression. Women who experienced violence from their partners throughout their lives had 1.9 times more prevalence of symptoms of depression. Those who experienced aggression during pregnancy showed an increase of 38.0% of this illness (p = 0.037).

Conclusions

The data presented reveal the high prevalence of women with symptoms of PPD and that violence experience was associated with higher frequencies of this event.

Key messages

Women who experienced violence from their partners throughout their lives had 1.9 times more prevalence of symptoms of depression. The data presented reveal the high prevalence of women with symptoms of postpartum depression and that violence experience was associated with higher frequencies of this event.

The experiences of maternity in front of hospitalization in high risk pregnances

Introduction

The pregnancy-puerperal cycle is defined as a moment that involves physical, psychological and social changes. There are pregnancies that require specialized care and attention due to the presence of risk factors that may be prior to pregnancy and / or that may be associated with the pregnancy condition itself, which characterize them as high-risk pregnancies. Currently, prenatal care with risk stratification is the main care strategy for pregnant women, once the risk classification is identified, it is possible to promote interventions according to the health needs of each pregnant woman. For this, the risk assessment is carried out at each prenatal consultation, so that, depending on the course of pregnancy, hospitalization becomes necessary. The diagnosis of high-risk pregnancies accompanied by hospitalization has impacts on the woman's life, such as loss of autonomy, a sense of failure and the incidence of greater care and interventions by the health team and the family that can configure practices to control their bodies.

Objective

This work aims to identify the hospitalization process during high-risk pregnancy as a space for the production of projects, resistance and protagonism through the protocols and regulations that configure the hospital context.

Methodology

This is an exploratory analysis of a qualitative approach in public health. A reference maternity hospital in high-risk pregnancy located in a teaching hospital in Greater Vitória was chosen. It will be used to define sampling for convenience. The data will be collected through semi-structured interviews and on-site observations by the researcher. The data analysis methodology used will be content analysis.

Expected Results

It is expected to understand the various practices of protagonism and resistance that permeate the care of hospitalized pregnant women.

Key messages

This work has an impact on the improvement of the maternal and child care network of the public health system in Brazil. This work allows to evaluate the quality of the assistance provided in the public maternity.

Aberrant Trajectory Of A Central Venous Catheter

During placement of a central venous catheter into the right subclavian vein it was found to be impossible to extract the guidewire. An Angio-Computed Tomography was performed, showing an aberrant guidewire path, as the image shows. An urgent mini-sternotomy was performed to extract both catheter and guidewire under direct visualization.

[The multidisciplinary challenge of anesthesia for ex utero intrapartum treatment: a case report]

The Ex- Utero Intrapartum Treatment (EXIT) is a surgical procedure performed in cases of expected postpartum fetal airway obstruction, allowing the establishment of patent airway while maintaining placental circulation. Anesthesia for EXIT procedure has several specific features such as adequate uterine relaxation, maintenance of maternal blood pressure fetal anesthesia and fetal airway establishment. The anesthesiologist should be aware of these particularities in order to contribute to a favorable outcome. This is a case report of an EXIT procedure performed on a fetus with a cervical lymphangioma with prenatal evidence of partial obstruction of the trachea and risk of post-delivery airway compromise.

How vision governs the collective behaviour of dense cycling pelotons

In densely packed groups demonstrating collective behaviour, such as bird flocks, fish schools or packs of bicycle racers (cycling pelotons), information propagates over a network, with individuals sensing and reacting to stimuli over relatively short space and time scales. What remains elusive is a robust, mechanistic understanding of how sensory system properties affect interactions, information propagation and emergent behaviour. Here, we show through direct observation how the spatio-temporal limits of the human visual sensory system govern local interactions and set the network structure in large, dense collections of cyclists. We found that cyclists align in patterns within a ± 30° arc corresponding to the human near-peripheral visual field, in order to safely accommodate motion perturbations. Furthermore, the group structure changes near the end of the race, suggesting a narrowing of the used field of vision. This change is consistent with established theory in psychology linking increased physical exertion to the decreased field of perception. Our results show how vision, modulated by arousal-dependent neurological effects, sets the local arrangement of cyclists, the mechanisms of interaction and the implicit communication across the group. We furthermore describe information propagation phenomena with an analogous elastic solid mechanics model. We anticipate our mechanistic description will enable a more detailed understanding of the interaction principles for collective behaviour in a variety of animals.

Progression of rabbit haemorrhagic disease virus 2 upon vaccination in an industrial rabbitry: a laboratorial approach

<p>Rabbit haemorrhagic disease virus 2 (RHDV2) emerged recently in several European countries, leading to extensive economic losses in the industry. In response to this new infection, specific inactivated vaccines were developed in Europe and full and rapid setup of protective immunity induced by vaccination was reported. However, data on the efficacy of these vaccines in an ongoing-infection scenario is unavailable. In this study we investigated an infected RHDV2 indoor industrial meat rabbitry, where fatalities continued to occur after the implementation of the RHDV2 vaccination, introduced to control the disease. The aim of this study was to understand if these mortalities were RHDV2-related, to discover if the dead animals showed any common features such as age or time distance from vaccination, and to identify the source of the outbreak. Anatomo-pathological analysis of vaccinated animals with the virus showed lesions compatible with systemic haemorrhagic disease and RHDV2-RNA was detected in 85.7% of the animals tested. Sequencing of the <em>vp60</em> gene amplified from liver samples led to the recognition of RHDV2 field strains demonstrating that after the implementation of vaccination, RHDV2 continued to circulate in the premises and to cause sporadic deaths. A nearby, semi-intensive, RHDV2 infected farm belonging to the same owner was identified as the most probable source of the virus. The main risk factors for virus introduction in these two industries were identified. Despite the virus being able to infect a few of the vaccinated rabbits, the significant decrease in mortality rate observed in vaccinated adult rabbits clearly reflects the efficacy of the vaccination. Nonetheless, the time taken to control the infection also highlights the importance of RHDV2 vaccination prior to the first contact with the virus, highly recommendable in endemic areas, to mitigate the infection’s impact on the industry.</p>

Genetic variation in the HLA region is associated with susceptibility to herpes zoster

Herpes zoster, commonly referred to as shingles, is caused by the varicella zoster virus (VZV). VZV initially manifests as chicken pox, most commonly in childhood, can remain asymptomatically latent in nerve tissues for many years and often re-emerges as shingles. Although reactivation may be related to immune suppression, aging and female sex, most inter-individual variability in re-emergence risk has not been explained to date. We performed a genome-wide association analyses in 22 981 participants (2280 shingles cases) from the electronic Medical Records and Genomics Network. Using Cox survival and logistic regression, we identified a genomic region in the combined and European ancestry groups that has an age of onset effect reaching genome-wide significance (P>1.0 × 10⁻⁸). This region tags the non-coding gene HCP5 (HLA Complex P5) in the major histocompatibility complex. This gene is an endogenous retrovirus and likely influences viral activity through regulatory functions. Variants in this genetic region are known to be associated with delay in development of AIDS in people infected by HIV. Our study provides further suggestion that this region may have a critical role in viral suppression and could potentially harbor a clinically actionable variant for the shingles vaccine.

Complete genome sequence of the Radiation-Resistant bacterium Rubrobacter radiotolerans RSPS-4

Rubrobacter radiotolerans strain RSPS-4 is a slightly thermophilic member of the phylum “Actinobacteria” isolated from a hot spring in São Pedro do Sul, Portugal. This aerobic and halotolerant bacterium is also extremely resistant to gamma and UV radiation, which are the main reasons for the interest in sequencing its genome. Here, we present the complete genome sequence of strain RSPS-4 as well as its assembly and annotation. We also compare the gene sequence of this organism with that of the type strain of the species R. radiotolerans isolated from a hot spring in Japan. The genome of strain RSPS-4 comprises one circular chromosome of 2,875,491 bp with a G+C content of 66.91%, and 3 circular plasmids of 190,889 bp, 149,806 bp and 51,047 bp, harboring 3,214 predicted protein coding genes, 46 tRNA genes and a single rRNA operon.

Differences in lipid profiles in two Hispanic ischemic stroke populations

BACKGROUND AND PURPOSE

The study aims to compare lipid profiles among ischemic stroke patients in a predominantly Caribbean-Hispanic population in Miami and a Mestizo Hispanic population in Mexico City.

METHODS

We analyzed ischemic stroke Hispanic patients with complete baseline fasting lipid profile enrolled contemporaneously in the prospective registries of two tertiary care teaching hospitals in Mexico City and Miami. Demographic characteristics, risk factors, medications, ischemic stroke subtype, and first fasting lipid profile were compared. Vascular risk factor definitions were standardized. Multiple linear regression analysis was performed to compare lipid fractions.

RESULTS

A total of 324 patients from Mexico and 236 from Miami were analyzed. Mexicans were significantly younger (58 · 1 vs. 67 · 4 years), had a lower frequency of hypertension (53 · 4% vs. 79 · 7%), and lower body mass index (27 vs. 28 · 5). There was a trend toward greater prevalence of diabetes in Mexicans (31 · 5 vs. 24 · 6%, P = 0 · 07). Statin use at the time of ischemic stroke was more common in Miami Hispanics (18 · 6 vs. 9 · 4%). Mexicans had lower total cholesterol levels (169 · 9 ± 46 · 1 vs. 179 · 9 ± 48 · 4 mg/dl), lower low-density lipoprotein (92 · 3 ± 37 · 1 vs. 108 · 2 ± 40 · 8 mg/dl), and higher triglyceride levels (166 · 9 ± 123 · 9 vs. 149 · 2 ± 115 · 2 mg/dl). These differences remained significant after adjusting for age, gender, hypertension, diabetes, body mass index, smoking, ischemic stroke subtype, and statin use.

CONCLUSION

We found significant differences in lipid fractions in Hispanic ischemic stroke patients, with lower total cholesterol and low-density lipoprotein, and higher triglyceride levels in Mexicans. These findings highlight the heterogeneity of dyslipidemia among the Hispanic race-ethnic group and may lead to different secondary prevention strategies.

Intracerebroventricular delivery of glucocerebrosidase reduces substrates and increases lifespan in a mouse model of neuronopathic Gaucher disease

Gaucher disease is caused by a deficit in the enzyme glucocerebrosidase. As a consequence, degradation of the glycolipids glucosylceramide (GluCer) and glucosylsphingosine (GluSph) is impaired, and their subsequent buildup can lead to significant pathology and early death. Type 1 Gaucher patients can be treated successfully with intravenous replacement enzyme, but this enzyme does not reach the CNS and thus does not ameliorate the neurological involvement in types 2 and 3 Gaucher disease. As one potential approach to treating these latter patients, we have evaluated intracerebroventricular (ICV) administration of recombinant human glucocerebrosidase (rhGC) in a mouse model of neuronopathic Gaucher disease. ICV administration resulted in enzyme distribution throughout the brain and alleviated neuropathology in multiple brain regions of this mouse model. Treatment also resulted in dose-dependent decreases in GluCer and GluSph and significantly extended survival. To evaluate the potential of continuous enzyme delivery, a group of animals was treated ICV with an adeno-associated viral vector encoding hGC and resulted in a further extension of survival. These data suggest that ICV administration of rhGC may represent a potential therapeutic approach for type 2/3 Gaucher patients. Preclinical evaluation in larger animals will be needed to ascertain the translatability of this approach to the clinic.

Prefrontal morphology, 5-HTTLPR polymorphism and biased attention for emotional stimuli

Biased attention for emotional stimuli has been associated with vulnerability to psychopathology. This study examines the neural substrates of biased attention. Twenty-three adult women completed high-resolution structural imaging followed by a standard behavioral measure of biased attention (i.e. spatial cueing task). Participants were also genotyped for the serotonin transporter-linked promoter region (5-HTTLPR) gene. Results indicated that lateral prefrontal cortex (lPFC) morphology was inversely associated with maintained attention for positive and negative stimuli, but only among short 5-HTTLPR allele carriers. No such associations were observed for the medial prefrontal cortex (mPFC) or the amygdala. Results from this study suggest that brain regions involved in cognitive control of emotion are also associated with attentional biases for emotion stimuli among short 5-HTTLPR allele carriers.

Detection of cortical thickness correlates of cognitive performance: Reliability across MRI scan sessions, scanners, and field strengths

In normal humans, relationships between cognitive test performance and cortical structure have received little study, in part, because of the paucity of tools for measuring cortical structure. Computational morphometric methods have recently been developed that enable the measurement of cortical thickness from MRI data, but little data exist on their reliability. We undertook this study to evaluate the reliability of an automated cortical thickness measurement method to detect correlates of interest between thickness and cognitive task performance. Fifteen healthy older participants were scanned four times at 2-week intervals on three different scanner platforms. The four MRI data sets were initially treated independently to investigate the reliability of the spatial localization of findings from exploratory whole-cortex analyses of cortical thickness-cognitive performance correlates. Next, the first data set was used to define cortical ROIs based on the exploratory results that were then applied to the remaining three data sets to determine whether the relationships between cognitive performance and regional cortical thickness were comparable across different scanner platforms and field strengths. Verbal memory performance was associated with medial temporal cortical thickness, while visuomotor speed/set shifting was associated with lateral parietal cortical thickness. These effects were highly reliable - in terms of both spatial localization and magnitude of absolute cortical thickness measurements - across the four scan sessions. Brain-behavior relationships between regional cortical thickness and cognitive task performance can be reliably identified using an automated data analysis system, suggesting that these measures may be useful as imaging biomarkers of disease or performance ability in multicenter studies in which MRI data are pooled.

Comparison of urine contamination rates using three different methods of collection: clean-catch, cotton wool pad and urine bag

Collecting uncontaminated urine specimens from infants is difficult. Commonly, an adhesive urinecollecting bag is used, which is uncomfortable. This study determined bacterial contamination rates using three methods of urine collection sequentially on the same infant (without known urinary tract infection)-clean-catch, cotton wool (sanitary) pad and urine bag. The study was undertaken in children under 3 years of age in the Institute of Maternal and Child Health of Pernambuco (IMIP), Recife, Brazil. Urine samples were analysed using phase contrast microscopy and routine culture. Culture of bacteria at any level was interpreted as a contaminated urine specimen. Cultures with > 10(5) colony-forming units/ml of one species by all three collection methods were regarded as true urinary tract infection and these children were excluded. Altogether, 534 urine samples from 191 patients were analysed. Median age was 2 months (1 day-36 months) and 124 (65%) were boys. Twelve children (6.3%) were considered to have true urinary tract infection, three were indeterminate and in 16 one or more samples were missing and all were excluded from analysis. There were more missing samples using the clean-catch method (12%) than when using the bag (4%) or pad (4%). Seventy-six of 160 (47.5%) children had evidence of bacterial contamination. Clean-catch specimens showed the least contamination (14.7%) and rates were similar between pads (29%) and bags (26.6%) (kappa = 0.40). Urine contamination rates were similar for sanitary pads and urine bags and significantly higher than for clean-catch (p<0.01). However, pads were a simple, non-invasive and comfortable alternative to bags.

A novel index for predicting intraocular pressure reduction following cataract surgery

AIM

The results of a study designed to investigate the predictive value of preoperative anterior chamber depth (ACD) and intraocular pressure (IOP) are reported. The relation between these factors and their effect on the reduction in IOP following phacoemulsification cataract surgery was also studied.

METHODS

The ACD and IOP were prospectively measured in 103 non-glaucomatous eyes of 103 patients who underwent uneventful phacoemulsification and posterior chamber intraocular lens (PCIOL) implantation. Other data which were recorded included best corrected visual acuity, axial length, lens thickness, and severity of lens opacity.

RESULTS

The ACD increased by a mean (SD) of 1.10 (0.44) mm (p<0.00001) and this increase was significantly and inversely related to preoperative ACD (r(2) = 68%; p<0.01). IOP dropped by a mean of 2.55 (1.78) mm Hg following cataract surgery (p<0.0001), and this reduction was significantly and positively related to preoperative IOP (r(2) = 56%; p<0.01), and significantly and inversely related to preoperative ACD (r(2) = 21%; p<0.01). A novel ratio, the pressure to depth (PD) ratio (preoperative IOP/preoperative ACD), was found to be significantly and positively related to the surgically induced reduction in IOP (r(2) = 73%; p<0.01), and IOP was reduced by > or =4 mm Hg in all patients with a PD ratio >7.

CONCLUSION

The reduction in IOP following cataract surgery was found to be positively related to preoperative IOP, and inversely related to preoperative ACD. Furthermore, these results indicate that a novel index, the PD ratio, is strongly predictive for IOP reduction following cataract extraction, and may prove useful in surgical decision making.

Mild hypercholesterolemia is an early risk factor for the development of Alzheimer amyloid pathology

BACKGROUND

Epidemiologic and experimental data suggest that cholesterol may play a role in the pathogenesis of AD. Modulation of cholesterolemia in transgenic animal models of AD strongly alters amyloid pathology.

OBJECTIVE

To determine whether a relationship exists between amyloid deposition and total cholesterolemia (TC) in the human brain.

METHODS

The authors reviewed autopsy cases of patients older than 40 years and correlated cholesterolemia and presence or absence of amyloid deposition (amyloid positive vs amyloid negative subjects) and cholesterolemia and amyloid load. Amyloid load in human brains was measured by immunohistochemistry and image analysis. To remove the effect of apoE isoforms on cholesterol levels, cases were genotyped and duplicate analyses were performed on apoE3/3 subjects.

RESULTS

Cholesterolemia correlates with presence of amyloid deposition in the youngest subjects (40 to 55 years) with early amyloid deposition (diffuse type of senile plaques) (p = 0.000 for all apoE isoforms; p = 0.009 for apoE3/3 subjects). In this group, increases in cholesterolemia from 181 to 200 almost tripled the odds for developing amyloid, independent of apoE isoform. A logistic regression model showed consistent results (McFadden rho2 = 0.445). The difference in mean TC between subjects with and without amyloid disappeared as the age of the sample increased (>55 years: p = 0.491), possibly reflecting the effect of cardiovascular deaths among other possibilities. TC and amyloid load were not linearly correlated, indicating that there are additional factors involved in amyloid accumulation.

CONCLUSIONS

Serum hypercholesterolemia may be an early risk factor for the development of AD amyloid pathology.

Power propagation in homogeneous isotropic frequency-dispersive left-handed media

We study transmission at a boundary between a right-handed medium (RHM: epsilon>0, mu>0) and a frequency dispersive left-handed medium [LHM: epsilon(omega)<0, mu(omega)<0 for some omega], both homogeneous and isotropic. In order to account for the dispersion, two types of signal spectra are considered. The first consists of two discrete frequencies, while the second is Gaussian. Explicit expressions for the time-domain fields are obtained, from which the time-averaged Poynting vectors and hence power flow vectors are calculated. In both cases, we find that waves refract at negative angles at a RHM-LHM interface.

[Bluetongue: isolation and characterization of the virus and identification of vectors in northeastern Argentina]

To establish if BTV was circulating in Argentina, 94 bovines from the Santo Tomé and Ituzaingó Departments of Corrientes Province were sampled every 30-60 days during 14 months. Red blood cells from those animals that showed seroconvertion with a c-ELISA were processed for virus isolation by inoculation in embryonated chicken eggs and cell cultures. Cells with CPE were positive by direct and indirect immunofluorescence with BTV specific reagents. These samples examined by electron microscopy showed virus particles with BTV morphological characteristics. Blood samples and tissue culture supernantants were positive by RT-PCR technique with primers corresponding to the segment 3 of the BTV genome. Haematophagous insects were captured in one farm using light traps and Culicoides insignis Lutz was the predominant species detected. This is the first isolation of BTV in Argentina from northeastern bovines without any disease symptom.

Reactions of O*- with methyl benzoate: a negative ion chemical ionization and Fourier transform ion cyclotron resonance study

The reactions of O*- with methyl benzoate have been examined by the measurement of negative ion chemical ionization (NICI) mass spectra using a CI source, with confirmatory studies carried out on a Fourier transform ion cyclotron resonance mass spectrometer. Reaction mechanisms have been elucidated using isotopically labeled esters. Nucleophilic attack at the carbonyl carbon and the aromatic ring were important reaction pathways. Nucleophilic attack at the carbonyl carbon was followed by the production of products (C6HsCO2- and CH3OCO2-) characteristic of radical, beta-fragmentation. Using 18O-labeled methyl benzoate, the SN2 reaction was found to account for a smaller percentage, 21(+/-1)%, of the benzoate product. Aromatic ring attack resulted in formation of [M + O - H]- and [M - 2H]*- ions. Although aryl hydrogens accounted for most H2*+ abstracted by O*-, evidence for abstraction of HarylH*+alkyl and HalkylH*+alkyl was also found. Although present at much lower abundance, dehydrobenzoate, dehydrophenoxy, and C7H6*- ([M - 2H - CO2]*-) radical anions were also observed. An Haryl/Halkyl exchange associated with formation of the benzoate anion was attributed to an Halkyl abstraction that occurred within the methanol/dehydrobenzoate ion-dipole complex. The [M - 2H]*-, dehydrobenzoate, dehydrophenoxy, and [M - 2H - CO2]*- ion signals were quenched by reaction with O2. Conditions required for production of O*- spectra under NICI conditions were also examined.

MUC4 (sialomucin complex) expression in salivary gland tumors and squamous cell carcinoma of the upper aerodigestive tract

OBJECTIVES

This study investigates MUC4 expression in normal squamous epithelia and squamous cell carcinoma (SCC) of the upper aerodigestive tract (UADT), and in salivary gland neoplasms.

STUDY DESIGN

MUC4 antigens in tumor and adjacent normal tissue are localized by immunocytochemical studies. Fresh frozen tissues from surgical resection specimens are further analyzed by Western blot.

RESULTS

MUC4 is identified by immunocytochemical staining throughout the normal UADT mucosa, in 34 of 40 primary UADT SCC, and in 11 of 12 metastatic cervical lymph nodes. A trend toward decreased MUC4 staining in moderately and poorly differentiated tumors is noted. Immunoblots show MUC4 in 4 of 5 SCC analyzed. Immunocytochemical staining of MUC4 in 13 major and minor salivary gland neoplasms reveal variable staining of normal and neoplastic tissue. MUC4 is demonstrated in immunoblots of normal parotid tissue and in the single parotid malignancy analyzed, but is not demonstrated in one minor salivary gland malignancy. These findings characterize normal UADT mucosal and salivary MUC4 expression, and MUC4 expression in SCC of the UADT and in salivary gland tumors.

SIGNIFICANCE

Correlation of MUC4 expression with clinical outcomes may establish MUC4 as a potential molecular prognostic marker for these tumors.

Botulism outbreak associated with poultry litter consumption in three Brazilian cattle herds

One hundred fifty-five of 201 cattle from 3 different farms showed clinical signs and died of botulism after eating the same batch of poultry litter contaminated with poultry and rodent carcasses. The cattle had access to poultry litter for only 1 d; afterwards it was removed from the diet. Death occurred over a period of 17 d after the poultry litter intake. The peak mortality was on day 4; 20 animals died within 10 d of the ingestion. The greater the intake of poultry litter, the higher the cattle mortality. Three steers which died on the first day had peracute effects while the remaining cattle showed classical signs. Twenty-five of the 46 surviving cattle had mild clinical signs, but recovered in a few days. Type C Clostridium botulinum toxin was found in extracts of the poultry litter, carcasses and cattle intestinal contents. Nutrient composition of the poultry litter was normal but pH was lower (6.9) than usual (7.5 to 9.3).

Manual and pump methods of expression of breast milk

This study was designed to compare two methods of breast milk expression, namely, the manual and the pumping method using a hand-held cylindric pump. The parameters evaluated were (i) the output of breast milk during milk expression sessions of 15 minutes' duration, and, (ii) the subjective preference of the method by the mothers. In the first phase, 22 mothers whose infants were on gavage feeding in the nursery, had 3 sittings each by the two methods on 4th and 5th postnatal days (66 expression). It was seen that the use of breast pump (Medela) was associated with significantly higher volume of breast milk expressed per session (41.57 +/- 16.05 ml vs. 21.7 +/- 10.5 ml, P < 0.001). In the second phase, 14 mothers had such sessions (42 each) not only on the 4th and 5th postnatal days, but lso on days 8 and 9. It was again seen that, the volume of breast milk expressed was greater by the pump method than the manual expression (on day 5 and 6 (46.8 +/- 26.3 ml vs 31.2 +/- 15.5 ml, P < 0.01) as well as on day 8 and 9 (50.40 +/- 11.2 ml vs 38.49 +/- 13.4 ml, P < 0.01). Subjectively, the pump expression was preferred by the mothers on day 4 & 5, while the manual expression was the preference on days 8 & 9. The use of breast pump is more efficient than the manual system of expression of breast milk among mothers whose infants are not directly breast-fed. It is recommended that in case the mothers prefer to use the manual method, let them express as much milk as possible by this method initially, and then follow it up with a short period of pumping to ensure complete evacuation of breasts.

Potentiation of the immobility response elicited by bandaging and clamping in mesencephalic rats

In earlier work, we showed that adult rats exhibit immobility response (IR) if a clamp is fastened to the skin of the nape of the neck, but not at other areas of the body, and not by bandaging. The present study characterizes IR in adult rats with complete mesencephalic transections. In the mesencephalic rats, the duration of the IR not only increased, but the stimuli capable of eliciting it were more diverse. All head and body areas clamped or bandaged were capable of inducing a profound IR. In contrast, the IR in intact rats was of shorter duration, and was only induced by clamping the neck, or by bandaging the upper or the lower torso. Furthermore, unlike the mesencephalic rats the ability of the bandaging to induce IR is reduced after the first trial and finally disappears. Only clamping the neck was able to persistently induce IR in intact rats. These data support the hypothesis that the IR control system is in the midbrain, hindbrain or spinal cord, and that systems above the mesencephalon modulate the IR. Such modulation appears to involve the ability to discriminate amongst tactile stimuli, and to integrate previous experience.

Metastatic colon carcinoma to oral soft tissues

Metastatic tumors to the oral cavity are uncommon. Most of these cases involve the mandible or the maxilla. Rarely, metastasis occurs to the oral soft tissues from a distant primary tumor. The lung and breast are the most common primary sites. It is extremely rare to have an oral soft-tissue metastasis from a carcinoma of the colon. A case of primary adenocarcinoma of the colon with metastasis to the soft tissues of the mouth is described. Three similar case reports are reviewed. A metastatic lesion to the oral cavity could be the first indication of the presence of a primary tumor.