The competitive and predatory impacts of the nonindigenous crab Carcinus maenas (L.) on early benthic phase Dungeness crab Cancer magister Dana.

We evaluate the potential competitive and predatory impacts of nonindigenous European green crab Carcinus maenas on native Dungeness crab Cancer magister in the northeast Pacific. The coastal estuaries of Washington State, USA, provide appropriate habitat for recently introduced green crab, yet these areas are important nursery grounds for Dungeness crab and contribute greatly to the coastal crab fishery. Juvenile Dungeness crabs are dependent on limited intertidal epibenthic shell for refuge habitat during early benthic life and experience increased mortality on open sand and mud as a result of predation by fish and birds. Early juveniles throughout the subtidal are similarly at risk due to predation by fish and especially adult conspecifics. Laboratory experiments and infrared video observations revealed that juvenile green crab displace Dungeness crab of equal size from shelters during one-on-one competition. Green crab also consistently win nocturnal foraging trials in which the species compete for fresh, damaged clams. Field and laboratory enclosure experiments show that juvenile Dungeness crab emigrate from oyster shell habitat as a result of competition and predation by adult green crab. Depending on the extent to which the two species overlap, interactions with the dominant nonindigenous species could have a negative influence on juvenile Dungeness crab survival and could conceivably impact recruitment to the fishery. However, current evidence indicates that the distribution of green crab in Washington State is far removed from nursery areas of Dungeness crab.

Monoclonal gammopathy of the immunoglobulin A class in a two-year-old girl with ataxia telangiectasia.

Ataxia telangiectasia is an autosomal recessive neurologic disorder which is frequently associated with a deficiency of IgA immunoglobulin. We report an unusual case of monoclonal gammopathy of the IgA kappa type in a 2-year-old female patient newly diagnosed with ataxia telangiectasia. Quantitative analysis of the patient's immunoglobulins revealed a marked elevation in the IgA fraction with a value of 672 mg/dL (normal 14-123 mg/dL). The IgG and IgM fractions were normal. Serum protein electrophoresis showed a band of restricted mobility present in the gamma region, which was identified as a monoclonal IgA kappa immunoglobulin on immunofixation electrophoresis. This is the first case report of a patient with ataxia telangiectasia associated with an IgA monoclonal gammopathy.

The heartsink patient: a preliminary study.

Eight GPs identified 78 heartsink patients; in an open-ended interview they were asked to explain why they regarded them in this way. A GP's definition of a heartsink patient was influenced by GP sex, practice location, and time of surgery, although the number of participating GPs was too low to make any definite assertions. Practitioners' anticipations of heartsink consultations were generally over-exaggerated, with most of the encounters going better than expected. GPs expressed the view that these patients raised serious professional issues for them, whilst there was also a dislike for these patients' personalities and behaviour. Two levels of the heartsink state are hypothesized: one, a state of inertia, is when the heartsink patient has been a chronic high user of the primary health care system, and a GP has exhausted all avenues. The other is an acute situation with those heartsink patients who have been low users of the system in the past. Recent, new events in these patients' lives have raised an issue that is just as much to do with patient and doctor reaction to these events, as it is about finding a diagnosis or solution to the problem. We present the results and hypotheses to provoke further discussion and research.

Retinol and retinol-binding protein in lung cancer screening.

Human epidemiology studies demonstrate an inverse correlation between serum levels of vitamin A and the incidence of lung cancer. While such studies suggest that vitamin A may have a role in cancer prevention, the intent of this study was to investigate the use of vitamin A status parameters as markers for detection of occult lung cancer. In the first of two phases of this study, we established criteria for a prospective screening study. Serum levels of retinol-binding protein (RBP), zinc, retinol, and beta-carotene in lung cancer patients were compared to levels in controls. For the second phase, a prospective screening study, 100 ambulatory male cigarette smokers over the age of 45 were enrolled. Subjects were excluded if they had a known diagnosis of cancer, recent weight loss, or serum albumin less than 3.5 g/dl. Subjects with RBP less than 4.2 mg/dl and retinol less than 42 micrograms/dl were classified as high-risk; those remaining were classified as controls. A chest X-ray (CXR) was obtained on all 17 high-risk subjects and on 26 of the 83 controls. CXR was read and follow-up was performed by physicians without knowledge of this study. Lung cancer was detected in 24% (4/17) of the high-risk subset, and 4% (1/26) of the controls. These data suggest that retinol and RBP may be useful in lung cancer screening for selecting a high-risk population that warrants further examination.

Colonic impaction in guinea pigs fed a chemically defined diet: a case report.

Pathogen-free female Hartley guinea pigs were divided into four diet groups to determine optimal nitrogen requirements for growth, pregnancy and lactation. Three chemically defined test diets varying in total nitrogen were compared with commercial guinea pig feed. Within 13 days, 24 of 78 animals from the three test diet groups died or required euthanasia. Affected guinea pigs were depressed, lost weight and had distended abdomens. Distension, impaction and, in most cases, rupture of the spiral of the ascending colon and subsequent peritonitis were observed at necropsy. Husbandry changes which resulted in a decreased incidence of impactions included increased acclimatization time on commercial feed post-shipping, decreased animal density per cage and cessation of water medication with oxytetracycline.