Peliosis hepatis following treatment with androgen-steroids in patients with bone marrow failure syndromes

Androgens widely used in the treatment of bone marrow failure syndromes can in rare cases cause hepatic peliosis, a pathological entity characterized by multiple blood-filled cavities in the liver parenchyma. Bone marrow failure syndromes per se are associated with a low coagulation status, which is further magnified by bone marrow transplantation for aplastic anaemia due to deep thrombocytopenia. Both these conditions can cause bleeding; their combination is especially dangerous. We describe two cases of aplastic anaemia due to paroxysmal nocturnal hemoglobinuria and Fanconi syndrome, in which patients developed peliosis hepatis after prolonged treatment with androgens. One patient developed severe subcapsular bleeding, successfully treated with catheterization of the right hepatic artery and embolization of the bleeding site. The second patient bridged over deep post-transplant aplasia with high frequency platelet transfusions, and demonstrated an uncomplicated post-BMT course. We suggest avoiding or interrupting treatment with androgens in patients preparing for BMT.

A novel dispersion method comprising a nucleating agent solubilized in a microemulsion, in polymeric matrix

This second part of our paper focuses on structural characterization of the microemulsion for increasing the crystallization rate of polypropylene (PP) through the entrapment of nucleating agent (nucleator) HPN-68, serving as a transport vehicle. Our concept is based on creating an advantage in dispersion capability of the nucleator that is dissolved in a nanoreactor vehicle, compared with its conventional loading as a crystalline powder. The advantage was achieved by solubilizing the HPN-68 in a microemulsion to decrease its size from micro- to nanoscale. The microemulsions were introduced to the target PP using a mixer. By the end of the mixing, when the water phase had evaporated, only the nucleator and the surfactant remained in the matrix. DSC results showed a 24% improvement in nucleation efficiency of PP by this novel method. It was shown that solubilization of the nucleator depends on the water activity in the microemulsion, and the presence of the nucleator opposes formation of the W/O phase. Light scattering, SD-NMR, and SAXS results showed that HPN-68 is accommodated in the water phase and at the interface, and significantly reduces the level of order in the microemulsion. In intermediate water content, a worm-like structure was proposed instead of the classical bicontinuous one. The structure was confirmed by SAXS and SD-NMR analysis. Viscosity measurements revealed structural transitions in the microemulsions.

A novel dispersion method comprising a nucleating agent solubilized in a microemulsion, in polymeric matrix

This is the first of a two-part study focusing on a novel dispersion method which enables increasing the crystallization rate of polypropylene (PP) through the incorporation of nucleating agent HPN-68 into the molten polymer using a microemulsion as a nanovehicle. The cycle time for processing the PP is significantly reduced and thus the effectiveness of its production is increased. Our concept is based on creating an advantage in dispersion capability of the nucleator that is dissolved in a nanoreactor vehicle in comparison with its conventional introduction as a crystalline powder. The microemulsions were introduced to the target PP using a mixer. By the end of the mixing, when the water phase had evaporated, only the nucleator and the surfactant remained in the matrix. The microemulsion components that solubilized the HPN-68 were mineral oil, alcohol, surfactant, and water. DSC results showed a 24% improvement in nucleation efficiency of PP by this method. WAXS results showed that HPN-68 is a gamma-nucleator. It causes polymorphism by significantly raising the gamma-phase concentration in the PP. SEM results showed a four-fold decrease in the PP spherulite size due to the improved dispersion of HPN-68 within the matrix via microemulsion compared to conventional nucleator incorporation.

[Physiological aspects of women in combat]

Since military service is physically demanding, soldiers must maintain high levels of physical fitness for optimal performance of their duties. Women are at a physiological disadvantage when competing against men: they have a smaller muscle mass, more body fat, lower red blood cell counts, lower hemoglobin levels and smaller cardiac outputs. Women are slower and weaker than men and more prone to exercise-induced skeletal injuries. Fewer women than men meet the standards of physically demanding jobs. Therefore integrating women into physically demanding military-oriented jobs requires redesigning or modifying the tasks (different pace, mechanical aids, teamwork). While physical training can increase the physical capacity of women, training cannot completely eliminate gender differences. Thus the data presented do not imply that women cannot be integrated into combat units, but highlight gender-related differences which might have an effect on the ability of women to compete equally with men at the same task.

Differences in rhodamine-123 efflux in B-type chronic lymphocytic leukemia suggest possible gender and stage variations in drug-resistance gene activity

Peripheral blood samples from 61 patients (36 male, 25 female) with all stages of B-type chronic lymphocytic leukemia (CLL) were studied for MDR1 phenotype using monoclonal antibodies and rhodamine-123 dye exclusion, a functional assay of MDR1 expression. The duration of the disease varied from 1 month to 22 years at the time of initial study. Overall, 74% of the patients were positive for rhodamine-123 exclusion. When analyzed by gender, significantly more men than women were positive (89% versus 48%, p<0.001). There were more positive men than women for every stage of the disease. Female patients were found to be either MDR1 phenotype positive or negative at any stage of the disease. In contrast, all male patients with early (stages 0-II) disease were MDR1 phenotype positive. One early-stage (stage II) male patient converted from rhodamine-efflux positive to rhodamine-efflux negative as he progressed from stage-II to stage-IV disease. We suggest that some of the differences in disease biology of male versus female CLL patients (women having a more benign course) may be due to gender-dependent differences in drug-resistance gene activity, including MDR1. Our results also emphasize the need to take into account gender in evaluating the clinical course of patients with CLL.