Localized vasculitis of the gastrointestinal tract: a case report and literature review.

Localized gastrointestinal vasculitis is a rare condition. It may be observed as an incidental unexpected pathologic finding at the time of biopsy of an abdominal mass or may present as unexplained abdominal pain with or without unexplained lower gastrointestinal bleeding. In this report we describe a new case of localized polyarteritis nodosa with involvement of peripancreatic middle-sized blood vessels. A literature review of cases of localized gastrointestinal vasculitis was also conducted. A major point of concern is whether a single organ vasculitis of the gastrointestinal tract is actually a localized gastrointestinal vasculitis or simply an initial manifestation of a more severe systemic vasculitis. Due to this, in cases of localized gastrointestinal vasculitis a complete evaluation of the patient to exclude the presence of a systemic a potentially threatening systemic vasculitis is required.

Reutilization of granite powder as an amendment and fertilizer for acid soils.

The properties of granite powders--a granite manufacturing waste product-were analyzed to assess their potential use as amendments and fertilizers on acid soils. Two types of powders were characterized: one produced during cutting of granite with a diamond-edged disc saw, comprising only rock powder, the other produced during cutting with a multi-blade bandsaw, containing calcium hydroxide and metal filings added during the cutting procedure. The acid neutralizing capacity of the granite powders was assessed in short- (2-3 h) and medium-term (1-30 d) experiments. The powders showed a buffering capacity at around pH 8, which corresponded to the rapid dissolution of basic cations, and another buffering effect at pH<4.5, attributable to the dissolution of Fe and Al. The acid neutralizing capacity (ANC) determined in the short-term experiments, to a final pH of 4.5, varied between 5 and 61 cmol H+kg(-1) powder. The ANC to pH 4.5 obtained in the medium-term experiments was much higher than that obtained in the short-term experiments, reaching a maximum ANC value of 200 cmol H+kg(-1) powder. There was no great difference in the neutralizing capacity determined at between 1 and 30 d. The most abundant elements in acid solutions obtained at the end of medium-term experiments were Mg and Ca for disc saw powders, whereas Ca and Fe (at pH<5) were the most soluble elements in the bandsaw powders. The rapid release of these cations suggests the possible effective use of the granite powders as a source of nutrients on being added to acid soils.

[Advanced gastric cancer: characteristics at presentation and therapeutic possibilities].

OBJECTIVE: To analyse the presentation forms and prognosis of patients with advanced gastric cancer at the time of diagnosis. DESIGN: Retrospective cohort study. PATIENTS AND METHODS: We studied all patients with gastric cancer (n=2,334) and synchronic metastases diagnosed in Lugo and A Coruña hospitals between 1975 and 1993. We estimated survival probability using the Kaplan-Meier method, and prognostic factors with Cox's regression models. RESULTS: Metastases were detected at the time of diagnosis in 585 (25.1%) patients, with the liver (346; 14.8%) and peritoneum (61; 6.9%) being the most frequently involved sites. The liver was exclusively affected in 213 (9.1%) cases, the peritoneum in 70 (3.3%), and another intraabdominal site in 121 (5.2%). Patients with peritoneal metastases were older (p=0.05), more commonly had a diffuse type of cancer according to Lauren's tumor classification (p<0.001), and underwent surgery more frequently (p=0.01). Curative resection was possible for only 11 (5.2%), 7 (10%), and 25 (20.7%) patients with metastases in only the liver, peritoneum, or another site, respectively, but in all cases survival probability was significantly enhanced. No surgery (HR=2.92), and simultaneous involvement of the liver and peritoneum (HR=1.62) were factors associated with a higher mortality rate. CONCLUSIONS: Patients with gastric cancer and metastases in only one intraabdominal organ show characteristic forms of presentation. Furthermore, in all cases candidacy for surgery should be carefully evaluated, as prognosis may improve in selected patients.

Atmospheric Pb deposition in Spain during the last 4600 years recorded by two ombrotrophic peat bogs and implications for the use of peat as archive.

Two ombrotrophic peat bogs in Northwestern Spain provided a history of 4600 years of Pb accumulation. Highest Pb concentrations (84-87 microg g(-1)) were found near the bogs' surface, but there were also other significant peaks (6-14 microg g(-1)), indicating pre-industrial atmospheric pollution. The enrichment factors (EFs) in both cores show a remarkably similar record. Atmospheric Pb pollution dates back to at least approximately 2500 years ago, reaching a first maximum during the Roman period. For the last 300 years, Pb EFs significantly increased due to industrial development, but the uppermost samples of the bogs show decreasing Pb EFs, probably due to the phasing out of leaded gasoline. These results are also supported by 206Pb/207Pb isotope ratios, as they continuously decrease from ca. 3000 BP until 2000 BP (from 1.275 at 4070 14C years BP to 1.182), indicating the growing importance of nonradiogenic Pb released from Iberian ores by ancient mining. Peat samples at a 3-5-cm depth are even less radiogenic (206Pb/107Pb = 1.157), indicating the strong influence of leaded gasoline. Despite the common history shared by the two bogs, striking differences were found for Pb enrichment, whether this was calculated by normalising to the Pb/Ti ratio of the upper continental crust or to the Pb/Ti ratios of peats from pre-anthropogenic times. This effect seems to be related to differences in Ti accumulation in both bogs, possibly due to physical fractionation of the airborne dust during wind transport. Enrichment has to be carefully considered when comparing the results obtained for different bogs, since our results suggest that normalising to crustal proportions is meaningless when the bulk of the deposition in an area is strongly influenced by short- and medium-range dust transport.

Análisis de la supervivencia del adenocarcinoma de colon y recto en pacientes menores de 40 años / Analysis of survival in colon and rectal adenocarcinomas in patients under 40 years of age

Introducción. El cáncer de colon y recto en pacientes menores de 40 años tiene un peor pronóstico que en el resto de la población debido al comportamiento agresivo de estos tumores, variando la supervivencia a los 5 años entre un 7 y un 59 por ciento. El objetivo de este estudio es analizar la supervivencia de dichos tumores en este grupo de edad. Pacientes y método. Entre enero de 1991 y diciembre de 1997, 20 pacientes menores de 40 años fueron diagnosticados de adenocarcinoma de colon o recto (el 2,6 por ciento del total de adenocarcinomas colorrectales diagnosticados en dicho período). El intervalo entre el inicio de los síntomas y el diagnóstico tuvo una media de 4 meses. Se realizó resección tumoral en todos los casos. Anatomopatológicamente, los tumores se clasificaron atendiendo al grado de diferenciación tumoral y según los estadios de Dukes. Resultados. La supervivencia actuarial a los 5 años fue del 45 por ciento (el 66 por ciento en los tumores de colon frente al 26 por ciento en los de recto [p = 0,43]; el 100 por ciento en los estadios A y B de Dukes frente al 25 por ciento en el estadio C y el 0 por ciento en el estadio D [p = 0,002]; el 5 por ciento en el grupo de tumores bien y moderadamente diferenciados frente al 0 por ciento en el de tumores mucinosos y mal diferenciados [p = 0,1]).Conclusiones. El cáncer de colon y recto en pacientes menores de 40 años tiene un mal pronóstico, que está influido por la localización tumoral, el estadio de Dukes y el tipo histológico (AU)

Mercury in a spanish peat bog: archive of climate change and atmospheric metal deposition

A peat core from a bog in northwest Spain provides a record of the net accumulation of atmospheric mercury since 4000 radiocarbon years before the present. It was found that cold climates promoted an enhanced accumulation and the preservation of mercury with low thermal stability, and warm climates were characterized by a lower accumulation and the predominance of mercury with moderate to high thermal stability. This record can be separated into natural and anthropogenic components. The substantial anthropogenic mercury component began approximately 2500 radiocarbon years before the present, which is near the time of the onset of mercury mining in Spain. Anthropogenic mercury has dominated the deposition record since the Islamic period (8th to 11th centuries A.D.). The results shown here have implications for the global mercury cycle and also imply that the thermal lability of the accumulated mercury can be used not only to quantify the effects of human activity, but also as a new tool for quantitative paleotemperature reconstruction.

Chemistry of soil solutions under different kinds of vegetation in the vicinity of a thermal power station.

The influence of atmospheric deposition on the chemical characteristics of soil solutions in a small catchment area in NW Spain was studied. The soils, developed from slates, were sampled from seven sites supporting different forms of vegetation (deciduous and pine forest and heath). Soil solutions were extracted, by the column displacement method, from soil samples collected monthly from March 1992 until November 1993. The solutions were acidic with a low content of basic cations. The most common ions in all horizons were Cl(-) and Na(+), due to marine influence. In the surface horizons (0-10 cm), relatively high concentrations of SO(2-)4 (150-380 micromol litre(-1)) and Zn (approximately 2 micromol litre(-1)) were obtained, with good correlation between the two ions. These results, along with the prevalence of inorganic forms of Al (50-90% of total Al), were related to the effects of acidic deposition in the catchment area. The more rapid breakdown of litter in the soils under deciduous forest explains the greater ionic concentrations obtained in these solutions.

Granular transformation of Sertoli cells in testicular disorders.

In order to study the granular transformation of Sertoli cells the following testicular specimens were reviewed: 58 postmortem biopsies from 21 children and 37 young adult males with normal histologic pattern; 165 biopsies from prepubertal cryptorchid testes; 38 biopsies and 18 surgical specimens from postpubertal-cryptorchid testes; bilateral biopsies from eight men with Del Castillo's syndrome, 14 men with retractile testes, and five men with obstructive azospermia; 17 bilateral and seven unilateral biopsies from 24 men with varicocele; seven unilateral biopsies plus five surgical specimens from 12 men with male pseudohermaphroditism; one biopsy and one surgical specimen from two men with macroorchidism; and the autopsy specimens from 28 adult men with acquired immunodeficiency syndrome (AIDS). Sertoli cells with eosinophilic granular cytoplasm were found in the testes of one prepubertal and four postpubertal cryptorchid males, two males with Del Castillo's syndrome, two males with retractile testes, four males with varicocele, two male pseudohermaphrodites, two males with macroorchidism, and one male with AIDS and interstitial orchitis. Histochemical and ultrastructural examination of granular Sertoli cells revealed that these cells accumulate secondary lysosomes and show scant cytoplasmic organelles. In the males with varicocele or retractile testes, these lysosomes were probably heterolysosomes that had degraded the germ cells and testicular fluid accumulated in the lumen of the ectatic seminiferous tubules of these testes. A similar mechanism is also probable in the male with interstitial orchitis that had caused germ cell destruction. In the other cases, in which the tubules showed reduced lumen and severe germ cell depletion, the abundant lysosomes are probably cytolysosomes. The development of these cytolysosomes might be related to the Sertoli cell dysgenesis present in these testes.