Unusual complications of thyroid carcinoma.

Thyroid carcinomas are the most frequent endocrine malignancies. Complications may arise from an established malignancy and these may lead to the initial clinical presentation or cause subsequent problems. In this case report two elderly patients with differentiated and undifferentiated thyroid carcinomas who suffered unusual medical complications are described. The incidence and treatment of thyroid carcinoma is discussed and the importance of fine needle aspiration of thyroid nodules and the recognition of iodine containing radiographic contrast media in the causation of iodine induced thyrotoxicosis is highlighted.

Monitoring the hydraulic performance of a containment system with significant barometric pressure effects.

Under certain circumstances, wells in unconfined aquifers can display significant water level fluctuations in response to changes in barometric pressure. This is illustrated by Hare and Morse (1997) at a site where a portion of the unconfined aquifer is isolated by a soil-bentonite cutoff wall and clay cap. A relief well located within the containment system displays water level fluctuations that mirror barometric pressure changes. Water levels fluctuated 0.37 m in response to barometric pressure changes of 2.87 centimeters mercury (cm-Hg), representing a barometric efficiency of 93.6%. As described in this paper, the short-term variability in water level elevations inside the containment system had to be considered to develop a reliable post-enhancement performance monitoring program. The approach that was ultimately selected involves correcting the water level elevations obtained in the relief well within the containment system for the effects of barometric pressure changes prior to comparison with the water level elevations in an observation well in the aquifer outside the system. The reliability of the post-enhancement performance monitoring program is improved further by simply requiring that any decision to enhance the containment system be based on the water level measurements obtained during two consecutive months. Using this approach, the probability that the containment system's performance will erroneously be deemed unacceptable is low. The post-enhancement performance monitoring program also requires no extra field work and does not involve any specialized equipment, which helps to keep operation and maintenance costs to a minimum.

Mobility after proximal femoral fracture: the relevance of leg extensor power, postural sway and other factors.

We studied 40 previously healthy women (median age 83 years 90% central range 77-90) 1 week after surgical fixation of their proximal femoral fracture to establish the significance of leg extensor power, postural sway, age, pre-injury mobility and fracture type in recovery of walking and stair-climbing ability. Subjects demonstrated a range of walking and stair-climbing abilities. Those not mobile all had sway greater than 40.9 cm/1 min and were more likely to have suffered a trochanteric fracture (p < 0.05). These subjects were not the oldest or those with the worst pre-injury mobility, but did report much greater pain (p < 0.05). Multiple linear regression revealed leg extensor power in the fractured leg (LEPf) to be the most important determinant of walking speed (R2 0.40, p < 0.001) and stair climbing time (R2 0.33, p < 0.002). LEPf was less than in the uninjured leg (p < 0.001), and accounted for only 30% of the total power output. LEPf was determined by pain, and not pre-injury mobility or fracture pattern. These findings have implications for the development of rehabilitation programmes.

Aflatoxin production by a variant of Aspergillus oryzae (NRRL strain 1988) on cowpeas (Vigna sinensis).

Aflatoxin B1, B2, G1, and G2 are produced when a variant of Aspergillus oryzae (NRRL strain 1988) is grown on cowpeas or rice. The present study indicates that a strain of Aspergillus oryzae approved for use in food processing is variable and the resulting variant, unlike the parent strain, has a propensity to produce aflatoxin.