Correction: Synthesis and characterisation of brannerite compositions (U0.9Ce0.1)1−xMxTi2O6 (M = Gd3+, Ca2+) for the immobilisation of MOX residues

Correction for ‘Synthesis and characterisation of brannerite compositions (U_0.9Ce_0.1)_1−xM_xTi₂O₆ (M = Gd³⁺, Ca²⁺) for the immobilisation of MOX residues’ by D. J. Bailey et al., RSC Adv., 2018, 8, 2092–2099. DOI: 10.1039/C7RA11742F.

Synthesis and characterization of iodovanadinite using PdI2, an iodine source for the immobilisation of radioiodine

The synthesis of a palladium-containing iodovanadinite derivative, hypothetically “PdPb₉(VO₄)₆I₂”, was attempted using PdI₂ as a source of iodine in searching for a novel waste form for radioiodine. Stoichiometric amounts of Pb₃(VO₄)₂ and PdI₂ were batched and reacted at elevated temperatures in sealed vessels. Batched material was also subjected to high-energy ball-milling (HEBM) in order to reduce reaction time and the potential for iodine volatilization during subsequent reaction at 200–500 °C. The resulting products were characterized using X-ray diffraction, scanning electron microscopy, energy-dispersive X-ray analysis, IR spectroscopy, thermal analysis and Pd K XANES. Results showed that PdI₂ can function as a sacrificial iodine source for the formation of iodovanadinite, prototypically Pb₁₀(VO₄)₆I₂, however, the incorporation of Pd into this phase was not definitively observed. The sacrificial reaction mechanism involved the decomposition of PdI₂ to Pd metal and nascent I₂, with the latter incorporated into the iodovanadinite Pb₁₀(VO₄)₆I₂ phase. In comparison to processing using standard solid state reaction techniques, the use of HEBM prior to high temperature reaction generates a more homogeneous end-product with better iodine retention for this system. Overall, the key novelty and importance of this work is in demonstrating a method for direct immobilisation of undissolved PdI₂ from nuclear fuel reprocessing, in a composite wasteform in which I-129 is immobilised within a durable iodovandinite ceramic, encapsulating Pd metal.

The synthesis and characterisation of a composite wasteform, comprising iodovanadinite Pb₁₀(VO₄)₆I₂ and Pd metal, is reported, for immobilisation of radioiodine PdI₂; the formation of Pd incorporated iodovanadinite “PdPb₉(VO₄)₆I₂” was not observed.

A synchrotron X-ray spectroscopy study of titanium co-ordination in explosive melt glass derived from the trinity nuclear test

The speciation of Ti in trinitite, the explosive melt glass derived from the Trinity Test of 16^th of July 1945, was investigated by X-ray absorption spectroscopy (XAS). Ti K-edge XANES showed that Ti was present in the Ti(iv) oxidation state for all samples. Fitting of pre-edge features by Gaussian functions and comparison with standards of known Ti coordination revealed significant variation in Ti coordination environment between samples. The variation of Ti coordination may be attributed to several factors including specific local chemistry and thermal histories of samples, in keeping with the highly heterogeneous microstructure of trinitite and the arkosic sand source material.

Synthesis and characterisation of brannerite compositions (U0.9Ce0.1)1−xMxTi2O6 (M = Gd3+, Ca2+) for the immobilisation of MOX residues

This work presents the synthesis and characterisation of novel brannerite ceramics designed for the disposal of mixed oxide fuel residues.

On the existence of AgM9(VO4)6I (M = Ba, Pb)

Attempts to synthesize “AgM₉(VO₄)₆I” (M = Ba, Pb), potential waste form materials for radioiodine, were unsuccessful, demonstrating that AgI incorporation into an iodine-deficient apatite phase is not feasible under the reported conditions.

Percolation-based risk index for pathogen invasion: application to soilborne disease in propagation systems

Propagation systems for seedling growth play a major role in agriculture, and in notable cases (such as organic systems), are under constant threat from soil and seedborne fungal plant pathogens such as Rhizoctonia solani or Pythium spp. Yet, to date little is known that links the risk of disease invasion to the host density, which is an agronomic characteristic that can be readily controlled. We introduce here, for the first time in an agronomic system, a percolation framework to analyze the link. We set up an experiment to study the spread of the ubiquitous fungus R. solani in replicated propagation systems with different planting densities, and fit a percolation-based epidemiological model to the data using Bayesian inference methods. The estimated probability of pathogen transmission between infected and susceptible plants is used to calculate the risk of invasion. By comparing the transmission probability and the risk values obtained for different planting densities, we are able to give evidence of a nonlinear relationship between disease invasion and the inter-plant spacing, hence to demonstrate the existence of a spatial threshold for epidemic invasion. The implications and potential use of our methods for the evaluation of disease control strategies are discussed.

With a little help from my friends: androgens tap BDNF signaling pathways to alter neural circuits

Gonadal androgens are critical for the development and maintenance of sexually dimorphic regions of the male nervous system, which is critical for male-specific behavior and physiological functioning. In rodents, the motoneurons of the spinal nucleus of the bulbocavernosus (SNB) provide a useful example of a neural system dependent on androgen. Unless rescued by perinatal androgens, the SNB motoneurons will undergo apoptotic cell death. In adulthood, SNB motoneurons remain dependent on androgen, as castration leads to somal atrophy and dendritic retraction. In a second vertebrate model, the zebra finch, androgens are critical for the development of several brain nuclei involved in song production in males. Androgen deprivation during a critical period during postnatal development disrupts song acquisition and dimorphic size-associated nuclei. Mechanisms by which androgens exert masculinizing effects in each model system remain elusive. Recent studies suggest that brain-derived neurotrophic factor (BDNF) may play a role in androgen-dependent masculinization and maintenance of both SNB motoneurons and song nuclei of birds. This review aims to summarize studies demonstrating that BDNF signaling via its tyrosine receptor kinase (TrkB) receptor may work cooperatively with androgens to maintain somal and dendritic morphology of SNB motoneurons. We further describe studies that suggest the cellular origin of BDNF is of particular importance in androgen-dependent regulation of SNB motoneurons. We review evidence that androgens and BDNF may synergistically influence song development and plasticity in bird species. Finally, we provide hypothetical models of mechanisms that may underlie androgen- and BDNF-dependent signaling pathways.

Periodicity in host availability does not account for evolutionary branching as observed in many plant pathogens: an application to Gaeumannomyces graminis var. tritici

Periodicity in host availability is common in agricultural systems. Although it is known to have profound effects on plant pathogen abundance, the evolutionary consequences of periodicity for the pathogen population have not previously been analyzed. An epidemiological model incorporating periodic absence of the host crop is combined with the theory of adaptive dynamics to determine whether or not seasonality in host presence plays a role in the occurrence of evolutionary branching, leading to coexisting yet genetically distinct pathogen phenotypes. The study is motivated and illustrated by the specific example of take-all disease of wheat, caused by the pathogen Gaeumannomyces graminis var. tritici, for which two coexisting but genetically distinct types and a trade-off related to seasonality in host presence have been identified. Numerical simulations are used to show that a trade-off between the pathogen transmission rate and the survival of the pathogen between cropping seasons cannot account for the evolutionary branching observed in many pathogens. Model elaborations show that this conclusion holds for a broad range of putative mechanisms. Although the analysis is motivated and illustrated by the specific example of take-all of wheat, the results apply to a broad range of pathogens.

Epidemiological analysis of take-all decline in winter wheat

Take-all dynamics within crops differing in cropping history (the number of previous consecutive wheat crops) were analyzed using an epidemiological model to determine the processes affected during take-all decline. The model includes terms for primary infection, secondary infection, inoculum decay, and root growth. The average rates of root production did not vary with cropping history. The force of primary infection increased from a low level in 1st wheat crops, to a maximum in 2nd to 4th wheat crops, and then to intermediate levels thereafter. The force of secondary infection was low but increased steadily during the season in first wheat crops, was delayed but rose and fell sharply in 2nd to 4th wheat crops, and for 5th and 7th wheat crops returned to similar dynamics as that for 1st wheat crops. Chemical seed treatment with silthiofam had no consistent effect on the take-all decline process. We conjecture that these results are consistent with (i) low levels of particulate inoculum prior to the first wheat crop leading to low levels of primary infection, low levels of secondary infection, and little disease suppression; (ii) net amplification of inoculum during the first wheat crop and intercrop period; (iii) increased levels of primary and secondary infection in subsequent crops, but higher levels of disease suppression; and (iv) an equilibrium between the pathogen and antagonist populations by the 5th wheat, reflected by lower overall rates of primary infection, secondary infection, disease suppression and hence, disease severity.

Reversed halo sign in lymphomatoid granulomatosis

Lymphomatoid granulomatosis is a rare lymphoproliferative disorder which affects extranodal sites, most commonly lung. Radiologically, it typically presents with multiple nodular opacities that may wax and wane. The reversed halo sign has previously been reported in cryptogenic organizing pneumonia and more recently in South American blastomycosis. We describe a case of histologically proven lymphomatoid granulomatosis in a patient who presented initially with the more typical nodular opacities, which subsequently progressed into the reversed halo sign. To the best of our knowledge, this association has not been previously described.

A Comparative Study of the Enantiomeric Separation of Labeled Amino Acids with Cyclodextrins and Mixed Micelles in Capillary Electrophoresis

Enantiomeric separations of fluorescently labeled amino acids are studied by capillary electrophoresis (CE) under a novel variety of experimental conditions. Three different labels are evaluated using two different additives: cyclodextrins (beta- and gamma-) and a dual surfactant system of sodium dodecyl sulfate and sodium taurodeoxycholate. Fluorescein-5-isothiocyanate is the best label to use in this cyclodextrin-based system, and dansyl chloride is the best label to use in this dual surfactant system. Possible limitations for separation of the enantiomers using the mixed micelle system include the fact that there is little interaction of the solute with the surfactants, the negative charge of the solute is limiting the separation window of the system, and the amount of the chiral phase available for partitioning is limited. The separations using cyclodextrins as a chiral selector show that the label affects migration order of the enantiomers, and the cyclodextrins are very effective in separating numerous enantiomers. Overall, cyclodextrins are the better buffer additive for CE use, and the dual surfactant systems, including sodium taurodeoxycholate, offer future promise.

An Epidemiological Analysis of the Role of Disease-Induced Root Growth in the Differential Response of Two Cultivars of Winter Wheat to Infection by Gaeumannomyces graminis var. tritici

ABSTRACT Epidemiological modeling combined with parameter estimation of experimental data was used to examine differences in the contribution of disease-induced root production to the spread of take-all on plants of two representative yet contrasting cultivars of winter wheat, Ghengis and Savannah. A mechanistic model, including terms for primary infection, secondary infection, inoculum decay, and intrinsic and disease-induced root growth, was fitted to data describing changes in the numbers of infected and susceptible roots over time at a low or high density of inoculum. Disease progress curves were characterized by consecutive phases of primary and secondary infection. No differences in root growth were detected between cultivars in the absence of disease and root production continued for the duration of the experiment. However, significant differences in disease-induced root production were detected between Savannah and Genghis. In the presence of disease, root production for both cultivars was characterized by stimulation when few roots were infected and inhibition when many roots were infected. At low inoculum density, the transition from stimulation to inhibition occurred when an average of 5.0 and 9.0 roots were infected for Genghis and Savannah, respectively. At high inoculum density, the transition from stimulation to inhibition occurred when an average of 4.5 and 6.7 roots were infected for Genghis and Savannah, respectively. Differences in the rates of primary and secondary infection between Savannah and Genghis also were detected. At a low inoculum density, Genghis was marginally more resistant to secondary infection whereas, at a high density of inoculum, Savannah was marginally more resistant to primary infection. The combined effects of differences in disease-induced root growth and differences in the rates of primary and secondary infection meant that the period of stimulated root production was extended by 7 and 15 days for Savannah at a low and high inoculum density, respectively. The contribution of this form of epidemiological modeling to the better management of take-all is discussed.

Epidemiology and chemical control of take-all on seminal and adventitious roots of wheat

ABSTRACT Epidemiological modeling is used to examine the effect of silthiofam seed treatment on field epidemics of take-all in winter wheat. A simple compartmental model, including terms for primary infection, secondary infection, root production, and decay of inoculum, was fitted to data describing change in the number of diseased and susceptible roots per plant over thermal time obtained from replicated field trials. This produced a composite curve describing change in the proportion of diseased roots over time that increased monotonically to an initial plateau and then increased exponentially thereafter. The shape of this curve was consistent with consecutive phases of primary and secondary infection. The seed treatment reduced the proportion of diseased roots throughout both phases of the epidemic. However, analysis with the model detected a significant reduction in the rate of primary, but not secondary, infection. The potential for silthiofam to affect secondary infection from diseased seminal or adventitious roots was examined in further detail by extending the compartmental model and fitting to change in the number of diseased and susceptible seminal or adventitious roots. Rates of secondary infection from either source of infected roots were not affected. Seed treatment controlled primary infection of seminal roots from particulate inoculum but not secondary infection from either seminal or adventitious roots. The reduction in disease for silthiofam-treated plants observed following the secondary infection phase of the epidemic was not due to long-term activity of the chemical but to the manifestation of disease control early in the epidemic.

Modeling and analysis of disease-induced host growth in the epidemiology of take-all

ABSTRACT Epidemiological modeling, together with parameter estimation to experimental data, was used to examine the contribution of disease-induced root growth to the spread of take-all in wheat. Production of roots from plants grown in the absence of disease was compared with production of those grown in the presence of disease and the precise form of diseaseinduced growth was examined by fitting a mechanistic model to data describing change in the number of infected and susceptible roots over time from a low and a high density of inoculum. During the early phase of the epidemic, diseased plants produced more roots than their noninfected counterparts. However, as the epidemic progressed, the rate of root production for infected plants slowed so that by the end of the epidemic, and depending on inoculum density, infected plants had fewer roots than uninfected plants. The dynamical change in the numbers of infected and susceptible roots over time could only be explained by the mechanistic model when allowance was made for disease-induced root growth. Analysis of the effect of disease-induced root production on the spread of disease using the model suggests that additional roots produced early in the epidemic serve only to reduce the proportion of diseased roots. However, as the epidemic switches from primary to secondary infection, these roots perform an active role in the transmission of disease. Some consequence of disease-induced root growth for field epidemics is discussed.

Epidemiological dynamics and the efficiency of biological control of soil-borne disease during consecutive epidemics in a controlled environment

•  A combination of experimentation and modelling is used to examine the role of epidemiological dynamics on the production and infectivity of inoculum and the efficiency of biocontrol by Trichoderma viride during consecutive epidemics of damping-off disease caused by the pathogen Rhizoctonia solani in crops of radish. •  Changes in the net infectivity of inoculum at the beginning of first and second crops caused a switch in epidemiological dynamics. Epidemics of first crops were dominated by secondary infection leading to amplification of inoculum so that epidemics of second crops were overwhelmingly determined by primary infection. •  The biocontrol agent reduced primary infection and hence parasitic amplification of inoculum in both first and second crops but the efficiency of control dropped from 91.7% in first crops to 64.8% in second crops, with sudden outbreaks of disease in second crops which had previously been disease-free. •  We conclude that parasitic amplification can cause a rapid build-up of disease and inoculum over consecutive crops, leading to loss in the efficiency of biocontrol. This form of inoculum production is supplemented by saprotrophic infestation which can result in sudden outbreaks of disease in protected crops where control of disease had previously been fully successful.

Linear solvation energy relationships of mixed micelles of sodium dodecyl sulfate and decanol: towards a better model of octanol/water partitioning

We show that we can alter the mechanism of micelle/water partitioning by the addition of decanol as a co-surfactant to an SDS micellar solution. Linear solvation energy relationship (LSER) studies indicate that as we increase the amount of decanol added to sodium dodecyl sulfate solution, the hydrogen bond donating ability of the aqueous phase increases and the cavity term of the micellar phase increases. We obtain a better correlation with octanol/water partitioning using the mixed micelle system compared to normal micelle solution. Choosing the appropriate micelle marker is very important. Significant changes in the LSER equations can occur if a different compound is used as the micelle marker.

pH effects on micelle-water partitioning determined by micellar electrokinetic chromatography

In many biological and environmental situations, the pH of aqueous media varies and differences in solute partitioning may result. However, the majority of biopartitioning and hydrophobicity studies conducted have been at pH 7. Using migration factors measured by micellar electrokinetic chromatography, we have determined pH effects on micelle-water partitioning for 19 compounds. We develop an improvement to the migration factor equation and the corrected migration factor for aniline shows a definite increase as pH decreases. The corrected migration factor was constant for the rest of the compounds over the pH ranged studied. We also investigated five micelle markers and determined that decanophenone is the best micelle marker to date. Decanophenone has a strong chromophore, detectable at all pH levels, and is easy to dissolve in the mobile phase.

Acquisition of fear conditioning in rats requires the synthesis of mRNA in the amygdala

In this study, the role of mRNA synthesis in the amygdala was studied during the acquisition of conditional fear. Rats with cannulas placed in the basolateral region of the amygdala were trained with a series of noise-shock pairings in a distinctive observation chamber. One half of the rats were pretreated with the mRNA synthesis inhibitor actinomycin-D (act-D). Responding to the training context and the auditory stimulus in a novel context measured by defensive freezing was assessed. Pretreatment with act-D significantly attenuated fear responses to both stimuli. Animals receiving act-D injections exhibited normal reactions to the conditioned stimulus-unconditioned stimulus pairings in the initial training session and displayed normal learning when retrained 7 days after injections. These results indicate that the transcription of new mRNA and subsequent protein synthesis in the amygdala may be essential for neural plasticity during this form of associative learning.

Acquisition of fear conditioning in rats requires the synthesis of mRNA in the amygdala

In this study, the role of mRNA synthesis in the amygdala was studied during the acquisition of conditional fear. Rats with cannulas placed in the basolateral region of the amygdala were trained with a series of noise-shock pairings in a distinctive observation chamber. One half of the rats were pretreated with the mRNA synthesis inhibitor actinomycin-D (act-D). Responding to the training context and the auditory stimulus in a novel context measured by defensive freezing was assessed. Pretreatment with act-D significantly attenuated fear responses to both stimuli. Animals receiving act-D injections exhibited normal reactions to the conditioned stimulus-unconditioned stimulus pairings in the initial training session and displayed normal learning when retrained 7 days after injections. These results indicate that the transcription of new mRNA and subsequent protein synthesis in the amygdala may be essential for neural plasticity during this form of associative learning.

Adenovector-mediated gene delivery of interleukin-2 in metastatic breast cancer and melanoma: results of a phase 1 clinical trial

We conducted a phase 1 trial of direct injection of an E1, E3-deleted adenovirus encoding interleukin-2 (AdCAIL-2) into subcutaneous deposits of melanoma or breast cancer. Twenty-three patients were injected at seven dose levels (10(7)-10(10) p.f.u). Local inflammation was observed at the site of injection in 60% of patients, but side-effects were otherwise minor. Incomplete local tumor regression occurred at the site of injection in 24% of patients, but no conventional clinical responses were seen. Circulating CD4 and CD8 counts fell significantly 24 h after injection. Post-injection biopsies demonstrated tumor necrosis and lymphocytic infiltration with the predominant tumor-infiltrating cells both CD3- and CD8-positive. Vector-derived sequences were detected in 14 of 18 biopsies examined 7 days after injection and vector-derived hIL-2 mRNA was detected in 80% of 7-day biopsies processed after injection of 10(8) p.f.u. of AdCAIL-2 or higher. While IL-2 was detectable by ELISA in tumor biopsies at 48 h, no protein was detectable in injected tumors after 7 days and no circulating IL-2 was detectable at any time-point. No Ad5E1 sequences were detected either before or after injection indicating absence of replication-competent virus or endogenous E1-like sequence; furthermore, only rare vector shedding was detected. Anti-adenovirus and neutralizing antibody titers were elevated 1 month after injection in all patients. This trial therefore confirms the safety of use of adenoviral vectors for gene delivery in humans and demonstrates successful transgene expression even in the face of pre-existing immunity to adenovirus.

Dynamics of primary and secondary infection in take-all epidemics

ABSTRACT Using a combination of experimentation and mathematical modeling, the effects of initial (particulate) inoculum density on the dynamics of disease resulting from primary and secondary infection of wheat by the take-all fungus, Gaeumannomyces graminis var. tritici, were tested. A relatively high inoculum density generated a disease progress curve that rose monotonically toward an asymptote. Reducing the initial inoculum density resulted in a curve that initially was monotonic, rising to a plateau, but which increased sigmoidally to an asymptotic level of disease thereafter. Changes in the infectivity of particulate inoculum over time were examined in a separate experiment. Using a model that incorporated terms for primary and secondary infection, inoculum decay, and host growth, we showed that both disease progress curves were consistent with consecutive phases dominated, respectively, by primary and secondary infection. We examined the spread of disease from a low particulate inoculum density on seminal and adventitious root systems separately. Although seminal roots were affected by consecutive phases of primary and secondary infection, adventitious roots were affected only by secondary infection. We showed that the characteristic features of disease progress in controlled experiments were consistent with field data from crops of winter wheat. We concluded that there is an initial phase of primary infection by G. graminis var. tritici on winter wheat as seminal roots grow through the soil and encounter inoculum, but the rate of primary infection slows progressively as inoculum decays. After the initial phase, there is an acceleration in the rate of secondary infection on both seminal and adventitious roots that is stimulated by the increase in the availability of infected tissue as a source of inoculum and the availability of susceptible tissue for infection.

Chewing gum bezoars of the gastrointestinal tract

Children have chewed gum since the Stone Age. Black lumps of prehistoric tar with human tooth impressions have been found in Northern Europe dating from approximately 7000 BC (Middle Stone Age) to 2000 BC (Bronze Age). The bite impressions suggest that most chewers were between 6 and 15 years of age. The Greeks chewed resin from the mastic tree (mastic gum). North American Indians chewed spruce gum. The first manufacturing patent for chewing gum was issued in 1869 for a natural gum, chicle, derived from the Sopadilla tree, indigenous to Central America. Chewing gum sold today is a mixture of natural and synthetic gums and resins, with added color and flavor sweetened with corn syrup and sugar. Chewing gum is big business. A significant amount of the $21 billion US candy industry sales is from chewing gums, many of which appeal almost exclusively to children. Despite the history and prevalence of gum chewing, the medical literature contains very little information about the adverse effects of chewing gum. In the present report, we briefly review gum-chewing complications and describe three children who developed intestinal tract and esophageal obstruction as a consequence of swallowing gum.

Establishing guidelines for the role of minor salivary gland biopsy in clinical practice for Sjögren's syndrome

OBJECTIVE

To evaluate the predictive value of clinical variables for the finding of a positive minor salivary gland biopsy (focus score > or = 2) in patients investigated for Sjögren's syndrome (SS).

METHODS

One hundred twenty-one patients with sicca symptoms were referred to a multidisciplinary SS clinic in a tertiary hospital. Each patient was evaluated on protocol and labial salivary gland (LSG) biopsy was obtained. Using the San Diego criteria as a model, patient data were subjected to a cross sectional analysis on an algorithm to determine when the LSG biopsy would be most useful for determining the diagnosis of SS in clinical practice.

RESULTS

Eighty-four patients had sufficient data to be included in the study. Forty patients had LSG biopsy with focus score < 2 and 44 had focus score > or = 2. Twenty-three patients had objective evidence of sicca and positive serology according to criteria standards. Eighteen of these had a positive biopsy (78%). The remaining 5 patients had many extraglandular features suggestive of SS, and the biopsies appeared to add little practical information. Patients with incomplete criteria for sicca could be diagnosed as possible SS (3 of 4 criteria) with a positive biopsy in 14 of 18 cases. The finding of anti-Ro or anti-La positivity in patients with incomplete criteria for sicca predicted a positive LSG biopsy in 85.7% of such cases. Patients with incomplete sicca and negative anti-Ro and anti-La had a negative LSG biopsy in 82% of cases.

CONCLUSION

The LSG biopsy is most necessary in patients who have partial San Diego criteria for sicca and positive anti-Ro or anti-La antibody. Where SS is not reasonably suspected, or where the diagnosis is clinically obvious, the LSG biopsy adds little useful clinical information.

Testicular plasmacytoma following chemical orchiectomy: potential role of hypogonadism in myeloma proliferation

We present a case of a 55 year old man with multiple myeloma who underwent autologous stem cell transplantation and subsequently developed testicular myeloma. Testicular enlargement was observed only after treatment of an incidental prostatic adenocarcinoma with chemical orchidectomy at a time when myeloma was controlled systemically. A subsequent bilateral surgical orchiectomy revealed plasmacytoma in both testis. Enhanced production of B-lymphocytes after castration has been reported and implicates testosterone as a possible negative regulator of B-cell production. We propose that the androgen deficient state may have contributed to the development of plasmacytoma of the testes in our patient. The regulatory role of sex steroids in B-cell development is discussed.

Bilateral primary breast lymphoma in pregnancy: a case report and literature review

Primary lymphoma of the breast is an uncommon malignant breast tumour, which is seldom distinguished preoperatively from other more common forms of breast cancer. The management differs from the more typical adenocarcinoma of breast in that the emphasis is on systemic chemotherapy. A young white woman presented during the 3rd trimester with bilateral breast enlargement, which failed to involute post partum. Subsequent biopsy revealed primary breast lymphoma of the large cell immunoblastic type. She received systemic chemotherapy and was alive and well with no evidence of recurrence 28 months later.

In situ hybridization for the Y chromosome reveals a donor origin for a posttransplant lymphoproliferative disorder in a sex-mismatched hepatic allograft

We report a case of posttransplant lymphoproliferative disorder diagnosed within 4 weeks of orthotopic liver transplantation from a male donor to a female recipient. To determine whether the posttransplant lymphoproliferative disorder was of donor or recipient origin, nonisotopic in situ hybridization for the human Y chromosome was performed on formalin-fixed, paraffin-embedded sections of the donor liver using a digoxigenin-labeled probe. The lymphoid cells hybridized with the Y chromosome probe, indicative of a male genotype consistent with posttransplant lymphoproliferative disorder of donor origin. This case illustrates that nonisotopic in situ hybridization for the Y chromosome can discriminate between donor and recipient cells in sex-mismatched organ transplants.

Local anesthesia in blepharoplasty: a new look?

Forty volunteers were asked to compare pain from injection of buffered versus unbuffered local anesthetics given for upper lid and lower lid blepharoplasty. The concentration of the solution was 1 part 8.4% sodium bicarbonate to 5 parts local anesthetic. The surgeons performing the operations were asked to identify any difference in onset of action, hemostasis, or duration of action. Thirty-five of the 40 patients found the buffered anesthetic to be less painful and better tolerated. No difference in hemostasis or duration of action was noted between the buffered or unbuffered solutions, but the buffered solution produced faster onset of action.

Local anesthesia in rhinoplasty: a new twist?

Twenty volunteers were asked to compare pain upon injection during septorhinoplasty using buffered versus unbuffered local anesthetics. The concentration of the buffer was one part sodium bicarbonate to five parts local. The surgeons performing the operation were asked to identify any difference in hemostasis or duration of anesthesia. Eighteen of twenty patients found the buffered anesthetic to be less painful and better tolerated. No difference in hemostasis or duration of action was noted between the buffered or unbuffered solution, however, faster onset of action was noted with the buffered solution. The addition of sodium bicarbonate as a buffering agent to the local anesthetics lidocaine and bupivacaine can significantly reduce pain upon injection. A solution of 5cc 2% lidocaine with 1:100,000 epinephrine, 5cc 0.25% bupivacaine with 1:200,000 epinephrine, and 2cc of 7.5% sodium bicarbonate mixed just prior to injection is a safe, effective, less painful local anesthetic with rapid onset of action and full efficacy.

Evidence for increased liver glycogen in patients with noninsulin-dependent diabetes mellitus after a 3-day fast

In order to assess hepatic glycogen stores in patients with noninsulin dependent diabetes mellitus (NIDDM) after a 3-day fast, the incremental glucose response to 1.0 mg iv glucagon (glucose area under the curve, glucoseAUC) was assessed in 19 obese diabetic subjects after an overnight (14 h) fast and again after a 3-day (64 h) fast. Results were compared to those of lean (n = 6) and obese (n = 15) nondiabetic subjects. During the fast, plasma glucose fell significantly in the lean (4.9 +/- 0.2 to 3.9 +/- 0.2 mmol/L), obese (5.1 +/- 0.1 to 4.2 +/- 0.2 mmol/L), and diabetic (14.7 +/- 0.7 to 10.3 +/- 1.0 mmol/L) subjects. However, in contrast to the fall in glucoseAUC observed in the lean (92.4 +/- 15.4 to 39.9 +/- 8.1 mmol min-1 L-1, P less than 0.02) and obese (64.4 +/- 11.1 to 48.4 +/- 9.4 mmol min-1 L-1) subjects, the glucoseAUC increased in diabetic subjects from 81.6 +/- 8.6 to 103.9 +/- 8.8 mmol min-1 L-1 during the fast, and was significantly greater than that of either the lean (P less than 0.001) or obese (P less than 0.001) nondiabetic subjects after the 64-h fast. Evidence that the glucose response to glucagon after a 64-h fast represents glycogenolysis and not gluconeogenesis was provided by studies in 10 additional subjects (5 obese nondiabetic subjects and 5 patients with NIDDM). Overall hepatic glucose output calculated from glucose kinetic data [( 3-3H]glucose) increased in diabetic and nondiabetic subjects during the first 30 min after glucagon administration and fell progressively thereafter. However, no increase in alanine gluconeogenesis (14C-alanine incorporation into glucose) was observed after glucagon administration in either subject group. The paradoxical accumulation of glycogen in the patients with NIDDM during the fast occurred despite basal rates of hepatic glucose output on the third day of the fast which were greater than those of obese nondiabetic subjects (9.0 +/- 1.2 vs. 5.6 +/- 0.5 mumol kg-1 min-1, P less than 0.05). A glycogen sparing action of increased gluconeogenesis is proposed as the explanation for the preservation of liver glycogen in patients with NIDDM.

Growth of enteric neurones from isolated myenteric ganglia in dissociated cell culture

Ganglia of the myenteric plexus from the newborn guinea-pig, isolated by microdissection, were dissociated by a combination of enzymatic and mechanical methods. The neurones and glial cells in the resulting cell suspension were cultured for up to 21 days in vitro. The growth of the enteric ganglion cells in serum-free, hormone-supplemented (N1) medium and in serum-supplemented medium containing a mitotic inhibitor was compared over a period of 14 days in vitro. Enteric neurones were outnumbered by glia in both culture media, although glial cell proliferation was inhibited in both media compared with that in serum-supplemented medium without mitotic inhibitors. Glial cell numbers appeared to decline in serum-free medium after the first week in vitro. Neurites tended to be more varicose in the serum-free medium, and the morphology of the enteric glial cells also differed markedly in the two media. This is the first report of the dissociation and subsequent culture of myenteric ganglia that had previously been completely isolated from the remainder of the gut wall.

Autoradiographic visualization of muscarinic receptors on rat paratracheal neurons in dissociated cell culture

An autoradiographic method was used to determine the distribution of muscarinic receptors on cells cultured from the trachealis muscle of 12-13-day-old rats. Cells identified in these culture preparations included neurones, fibroblasts, smooth muscle, and glial and epithelial cells. The cultured cells were incubated with the specific, irreversible ligand [3H]propylbenzylylcholine mustard, and the autoradiographs generated showed that most, if not all, of the paratracheal neurones observed in these cultures were specifically labelled. Both the neuronal cell body and associated neurites were evenly labelled over their entire surface. Neither the pattern nor the density of neuronal labelling appeared to be influenced by close association with other cultured cell types. Autoradiographic grains for muscarinic receptors also appeared to be uniformly distributed over smooth muscle cells and epithelial cell groups in culture. In contrast, no specific labelling was associated with cultured fibroblasts, glial cells and other non-neuronal supporting cells. The precise localization of muscarinic receptors on different cell types in culture may prove to be useful knowledge in the design of an effective and specific antimuscarinic bronchodilator.

HIV infection and South-West general practitioners

General practitioners in the Severn Faculty of the Royal College of General Practitioners were asked about their knowledge and practice in dealing with HIV infected patients. 62% responded to our anonymous questionnaire. Overall, four-fifths of the doctors expressed confidence in their ability to advise HIV antibody positive patients on sexual activity, drug abuse and domestic activities. Only 61% were confident of their ability to advise such patients on pregnancy. Differences in screening policy and measures of awareness were related to location of practice by county within the Region and to the presence of HIV infected patients on individual lists. The findings are discussed in relation to previous surveys of general practitioners in the UK.

Nuclear antigens in neoplastic lymphocytes of B cell and T cell non-Hodgkin's lymphomas

Gross nuclear morphology is a major diagnostic feature in the identification of subtypes of non-Hodgkin's lymphoma (NHL). The authors have shown that the size, shape, and chromatin distribution of the lymphocyte nuclei vary extensively both within and between samples of a subtype, and have proposed that the variations may reflect qualitative and quantitative differences in extrachromatinic components. To test this hypothesis, the organization of individual nuclear antigens in NHL and in reactive hyperplasia biopsies was examined by immunofluorescence labeling of frozen sections with previously characterized monoclonal antibodies. The results have been correlated with observations of the staining patterns produced by the antibodies in mitogenically stimulated human peripheral blood lymphocytes. Labeling pattern and intensity with each antibody were consistent between preparations of blood lymphocytes, and all four antibodies labeled all blood lymphocyte samples tested. In contrast, only 15% of the 53 biopsies were labeled by all four antibodies, although all were stained by anti-peripherin, nearly 80% by I1, and almost 60% by PI1. Antibody PI2 labeling was detected in only 20% of the samples. Variation in labeling intensity was equally extensive both within and between biopsy samples. In general, there was little homogeneity between samples of an NHL subtype as to which antigens were detected, their labeling intensity, or their pattern of intranuclear distribution. These observations are consistent with earlier reports of significant diversity in the morphology of nonchromatin components in such samples. The data support the proposition that the heterogeneity of gross nuclear morphology in nuclei of NHL biopsies may be due in part to disordered expression or abnormal organization of nuclear proteins.

Primary thyroid thymoma: a distinct clinicopathologic entity

A 51-year-old man presented with a paratracheal tumor. He had undergone resection of a thyroid tumor 15 years previously; at that time, the histologic diagnosis had been anaplastic carcinoma. When the tumor recurred, the presumptive clinical diagnosis was medullary thyroid carcinoma. Histologic examination revealed a poorly differentiated epithelial tumor with immunoreactivity for keratins, carcinoembryonic antigen, and, focally, S-100 protein. The tumor was negative for calcitonin and thyroglobulin. There were scattered lymphocytes and plasma cells. Ultrastructural examination showed elongated epithelial cells with prominent desmosomes and bundles of cytoplasmic tonofilaments but no secretory granules; amyloid was not present ultrastructurally or histochemically. The characteristic ultrastructural and immunocytochemical features and the clinical behavior of this tumor verify the existence of primary thyroid thymoma. This new primary thyroid neoplasm is of clinical importance, considering the more benign behavior of primary thyroid thymoma than of other tumors in the differential diagnosis of this lesion.

Ventricular and atrial myocytes of newborn rats synthesise and secrete atrial natriuretic peptide in culture: light- and electron-microscopical localisation and chromatographic examination of stored and secreted molecular forms

We have demonstrated that atrial natriuretic peptide-like immunoreactivity is stored and secreted by ventricular and atrial myocytes in dissociated cell culture preparations from the heart of newborn rat. Culture preparations were maintained in either foetal calf serum-supplemented medium 199 or in hormone-supplemented, serum-free medium 199. The presence of atrial natriuretic peptide-like immunoreactivity in the cultured myocytes was demonstrated at both light- and electron-microscopical levels. Release of atrial natriuretic peptide-like immunoreactivity into the culture medium was measured by radioimmunoassay; molecular forms of the stored and secreted peptide were determined by gel column chromatography. The atrial natriuretic peptide-like immunoreactivity of cultured atrial and ventricular myocytes was concentrated in the perinuclear cytoplasm and was localised to electron-dense secretory granules. The number of immunoreactive ventricular myocytes and the intensity of their immunofluorescence changed with time in culture and was higher in cultures in foetal calf serum-supplemented medium than in serum-free medium. Gamma-atrial natriuretic peptide was stored and released by cultured atrial and ventricular myocytes, but was broken down to alpha-atrial natriuretic peptide in the growth medium. This process was foetal calf serum-independent, since it occurred in both the media used, indicating that cardiac myocytes in culture may release a factor that cleaves gamma-atrial natriuretic peptide to form alpha-atrial natriuretic peptide.

Cecal polyp and appendiceal intussusception in a child with recurrent abdominal pain: diagnosis by colonoscopy

A 7-year-old boy developed recurrent abdominal pain. He was eventually discovered to have an inverted appendix via colonoscopy. At surgery, a polyploid intracecal mass was palpated at the base of the partially invaginated appendix. Resection of the cecal mass (histologically, a juvenile polyp) and appendix was easily accomplished. The types of clinical presentation and treatment of children with appendiceal intussusception are discussed.

Lack of efficacy of thickened feeding as treatment for gastroesophageal reflux

The efficacy of thickened feedings for the treatment of gastroesophageal reflux in infancy was evaluated. Fifty-two infants were examined with prolonged pH monitoring of the distal esophagus after feedings of apple juice or apple juice thickened with rice cereal. All infants had a minimum of three feedings of both thickened and unthickened juice. The recordings of distal esophageal pH were analyzed for the percent of time the pH was less than 4 in the first 2 hours after each feeding. The infants were maintained in the following positions after feeding: prone (n = 29), prone-board with the head elevated 30 degrees from horizontal (n = 29), supine (n = 7), and unrestricted (n = 21). We found no significant difference in the percent of time with reflux with thickened versus unthickened feedings except in those infants maintained in the 30-degree prone position. In the first 2 hours after eating thickened juice, infants maintained in this position had increased esophageal reflux time (P less than 0.006). Further analysis revealed that 33% of the infants had a greater than 30% increase in esophageal reflux time after thickened feedings. Our study suggests that the immediate effect of thickened feedings on gastroesophageal reflux in infants is unpredictable.

Role of gonadal and adrenal steroids in the impairment of the male rat's sexual behaviour by hyperprolactinaemia

The sexual behaviour of male rats, castrated and testosterone-implanted, declined following induction of hyperprolactinaemia by domperidone. Treatment with oestradiol benzoate did not reverse this effect, and may have accentuated it. Oestradiol also amplified domperidone-induced hyperprolactinaemia. Testosterone or dihydrotestosterone (DHT) apparently delayed, but did not prevent, the gradual deterioration in sexual behaviour (prolonged ejaculation latencies) induced by domperidone, but this effect was not confirmed statistically. Adrenalectomy, followed by cortisol replacement, failed to prevent the behavioural effects of hyperprolactinaemia. No consistent changes in serum progesterone or corticosterone could be found in hyperprolactinaemic rats in which the adrenals had not been removed. In vitro formation of DHT from precursor testosterone was reduced in the amygdalae of hyperprolactinaemic rats, but not in the hypothalamus or caudal spinal cord. Oestradiol cytosol binding was unchanged in all brain areas, except for a small but significant increase in the anterior hypothalamus. These results do not support a role for altered adrenal activity in determining the effects of high levels of prolactin on sexual behaviour. There is evidence for an impaired formation of DHT in the brain, but this may account for only part of the behavioural changes observed. It is possible that the major effect of prolactin lies in neural systems directly responsive to it, rather than in altered steroid secretion or metabolism.