Notes: [Auszug] The control of epidemic malaria is a priority for the international health community and specific targets for the early detection and effective control of epidemics have been agreed. Interannual climate variability is an important determinant of epidemics in parts of Africa where climate drives ...

Notes: Abstract BACKGROUND: Appendiceal tumors are rare and often unexpectedly discovered in an acute situation, in which decision-making is difficult. To help define the most appropriate management, a retrospective analysis was undertaken to describe the clinicopathologic behavior of appendiceal tumors, and the literature was reviewed of the management of the different types of appendiceal tumors. METHOD: From a single center, a histopathologic database of 7,970 appendectomies, all appendiceal tumors, were identified and case notes reviewed. Analysis of clinical presentation, histopathology, operation, and outcome is presented. RESULTS: During a 16-year period (7,970 appendectomies), 74 patients (0.9 percent) with appendiceal tumors were identified: 42 carcinoid, 12 benign, and 20 malignant. Acute appendicitis was the most common presentation (49 percent), and 9.5 percent were incidental findings. Primary malignant tumors of the appendix were found in 0.1 percent of all appendectomies. Secondary malignant disease was identified in the appendix of 11 patients, most commonly (55 percent) from patients with primary colorectal disease. There was a high incidence of synchronous and metachronous colorectal cancer in all appendiceal tumors: carcinoids, 10 percent; benign tumors, 33 percent; secondary malignancies, 55 percent; primary malignancies, 89 percent. CONCLUSION: Appendiceal tumors are uncommon and most often present as appendicitis. Most are benign and can be managed by appendectomy, except adenocarcinomas and carcinoids larger than 2 cm, which are most appropriately managed by right hemicolectomy. A suggested management algorithm is provided. Controversy exists over the management of carcinoids 1 to 2 cm in size and adenocarcinoids. All types of appendiceal tumors have a high incidence of synchronous and metachronous colorectal cancer.

Notes: Abstract Human milk and colostrum samples were collected from women living in the vicinity of Albany, Oswego, and Rochester, New York. Analysis by a highly sensitive method based on glass-capillary gas chromatography with electron-capture detection showed that mirex was present only at very low concentrations (generally less than 0.1 ng/g wet weight whole milk). Gas chromatographic/mass spectrometric analysis with both a quadrupole spectrometer and a double-focusing instrument confirmed the presence of mirex in three samples which had been shown by electron-capture analysis to contain more than 1 ng of mirex/g wet weight.

Notes: Abstract Corals were exposed to drilling mud for 24 hr and then allowed to recover for 48 hr in clean seawater. Depending on the concentration and the mud used, exposure produced either an increase or decrease in free amino acid (FAA) pool size. Aspartate was affected to a greater degree than other amino acids. No clear instance of recovery could be ascertained after 48 hr in clean seawater. In several cases, corals, apparently unaffected by a 24 hr exposure, nevertheless suffered significant changes in the FAA pool during the 48 hr recovery period. Thus, the degree of toxicity of the drilling mud could not be accurately predicted from the 24 hr exposure data. In many cases, the choice of a normalizing parameter determined whether two sets of data were significantly different or not. Accurate effects assessment depends on a comparison of several methods of normalization to confirm statistical results.

Notes: Abstract Forty human milk samples from women in an urban and a rural vicinity on Lake Ontario (Rochester and Oswego) and a mixed urban and rural location on the Hudson River (Albany), New York, were analyzed for 74 PCB congeners,p,p′-DDE, hexachlorobenzene, and mirex in order to determine the intake of breast-fed infants. All of the compounds were detected in the samples, but only eight PCB congeners andp,p′-DDE accounted for 88% of the chlorinated hydrocarbons detected.p,p′-DDE was the predominant pollutant (mean 78 ng/g wet weight), but the levels detected were low compared with the results from other parts of North America. Eight individual PCB congeners comprise 52% of the total PCB residue (mean 26.5 ng/g of whole milk); they ranged in mean concentration from 3.2 ng/g (2,4,5,2′,4′,5′-hexachlorobiphenyl) to 1 ng/g (2,3,4,3′,4′-pentachlorobiphenyl). Statistical correlation analysis among PCB congeners indicates a possible higher exposure to less chlorinated congeners at Oswego than at Albany.

Notes: Abstract Principal-components analysis (PCA) was used to compare concentrations of polychlorinated dibenzo-p-dioxin (PCDD) and polychlorinated dibenzofuran (PCDF) compounds in sediments collected from two interconnected lakes, Lake Champlain and Lake George, New York, USA. Two different PCDD/PCDF congener profiles were present in surface sediment samples from Lake George. Samples collected near residential areas and power-boat marinas had elevated hepta- and octa-CDDs (1±0.3 ng/g) and tetra-octa-CDFs compared with samples collected in other areas of the lake. The PCDD/PCDF pattern in the high-level samples was similar to the PCDD/PCDF pattern in sediments from Green Lake, NY, a small lake in which atmospheric deposition is the only route for PCDD/PCDF contamination, either from local sources or from long range transportation from multiple sources in the midwest. The samples containing the higher PCDD/PCDF concentrations also contained higher lead concentrations (173±33 μg/g) compared to the low-level PCDD/PCDF samples (52±25 μg/g). However, the increase in lead concentrations was accompanied by increased concentrations of other trace metals. Consequently, it can be concluded that emissions from power boats are not responsible for the PCDD/PCDF contamination in Lake George. Concentrations of PCDDs/PCDFs in the low-level samples were similar to PCDD/PCDF concentrations in sediments from remote midwestern lakes where long range atmospheric deposition was the only plausible route of entry for the PCDD/PCDF compounds. However, other studies have shown that offshore sediments in Lake George have lower concentrations of organic carbon than inshore samples and, therefore, the low-level PCDD/PCDF pattern may be an artifact related to a reduced PCDD/PCDF concentration in sediments with a low organic carbon content. Surface and core sediments from Lake Champlain also partitioned into two groups, which both had PCDD/PCDF patterns differing from the high-level surface sediments collected from Lake George. The largest group of samples was characterized by the presence of high octa-CDD concentrations (3.5–18 ng/g). The second group of samples was four sections from a single core sample collected near a bleached kraft pulp and paper mill, which closed in 1970. These samples had high concentrations of tetra-CDFs (0.5–1.4 ng/g), primarily 2,3,7,8-tetra-CDF, accompanied by comparable concentrations of octa-CDD (0.9–4.4 ng/g). The presence of 2,3,7,8-tetra-CDF is consistent with results from several studies where PCDDs/PCDFs were analyzed in samples taken from various stages of the bleached kraft process. These samples were grouped in the same quadrant on a PCA plot as coal soot and pulp and paper mill sludge. However, the grouping was not close, and the PCDD/PCDF contamination in these sediments cannot be associated with either source. Five sections of a core collected near a currently operating bleached kraft pulp and paper mill also had elevated 2,3,7,8-tetra-CDF concentrations (0.3±0.05 ng/g), but these 2,3,7,8-tetra-CDF concentrations were accompanied by considerably higher octa-CDD concentrations (7.5±0.5 ng/g). Therefore, they could not be distinguished by PCA from the majority of the Lake Champlain samples.

Notes: Abstract. We reviewed the diagnostic accuracy and complication rates of transthoracic needle biopsy (TNB) with an automated 18-gauge core biopsy needle and gun, using either fluoroscopic or CT guidance. One hundred six lesions were biopsied in 103 patients between 1992 and 1998. Hard-copy images, imaging reports, pathology reports and clinical notes were reviewed. In 3 patients it was not possible to establish the lesion as either malignant or benign from the available follow-up, so these were removed from the analysis of diagnostic accuracy. Adequate samples for histological diagnosis were obtained in 104 of 106 (98 %) biopsies. There were 75 of 85 (88 %) true-positive core biopsies for malignant lesions and a specific cell type was identified in 70 of 85 (82 %) cases. A specific histological diagnosis was obtained in 12 of 18 (66 %) biopsies. There was a 19 % rate of pneumothorax with only 2.4 % requiring drainage. Minor haemoptysis occurred in 3.8 % of procedures. The TNB technique with an automated core biopsy needle provides a high level of diagnostic accuracy, effectively distinguishes cell type in malignancy and provides a definite diagnosis in benign disease more frequently than fine needle aspiration (FNA). There is no increased complication rate compared with FNA.

Notes: Abstract. We present the clinical and magnetic resonance imaging findings of a patient who, following treatment for pancreatic non-Hodgkin's lymphoma (NHL), relapsed with apparently isolated involvement of the right masticator space and left psoas muscles. Non-Hodgkin's lymphoma arising from the masticator space muscles is very rare. In addition, simultaneous lymphomatous involvement of multiple discrete skeletal muscle sites, in the absence of disease elsewhere, has previously only been reported in the limb or limb girdle muscles. Lymphoma should be considered as a cause of isolated enlarged skeletal muscles, even when involving such distant sites.