Benthic macroinvertebrates as indicators of environmental deterioration in a large microtidal estuary.

This study tested the hypothesis that, during recent years, the benthic macroinvertebrate fauna of the large basin of the Swan-Canning Estuary has changed in ways consistent with deteriorating environmental conditions in that estuary. Between 1986/7 and 2003/4, the compositions of that fauna altered markedly at the species and even family levels. Thus, the densities and number of species of molluscs, and especially of crustaceans, which are particularly susceptible to environmental stress, declined, while those of the more tolerant polychaetes increased. However, taxonomic distinctness declined consistently only at one of the four widely-spaced sampling sites and the dispersion of samples did not differ markedly between periods, indicating that the benthic fauna has not undergone such extreme changes as in the nearby Peel-Harvey Estuary. It is thus proposed that benthic macroinvertebrates can act as important indicators of the severity of environmental degradation in microtidal estuaries in regions where such perturbations are increasing.

Changes in the benthic macroinvertebrate fauna of a large microtidal estuary following extreme modifications aimed at reducing eutrophication.

An artificial channel was opened in 1994 between the microtidal Peel-Harvey Estuary and the Indian Ocean to increase tidal exchange and thus ameliorate the problems of eutrophication. Although this greatly reduced macroalgal and cyanobacterial growths and the amount of particulate organic matter, our data indicate that, contrary to managerial expectations, the benthic environment has deteriorated. Thus, although macroinvertebrate density has declined as predicted, taxonomic distinctness (Delta( *)) has also declined and species composition has become more variable. Macroinvertebrate composition has also changed markedly at the species, family and even phylum levels. The Crustacea, the most sensitive of the major macrobenthic taxa to environmental stress, has become proportionally less abundant and speciose, whereas the Polychaeta, the least sensitive, was unique in showing the reverse trend. The benthos of the Peel-Harvey Estuary is thus apparently more stressed than previously, probably due to the multiple effects of a great increase in system use.

Interannual variability in fish biomarkers in a contaminated temperate urban estuary.

During the past decade the Swan-Canning estuary, Western Australia, has shown signs of stress which has been attributed to high nutrient inputs. There is little information on the effect of nonnutrient contaminants on biota inhabiting the estuary. A suite of biomarkers was measured on black bream (Acanthopagrus butcheri) to determine whether annual variations in fish biomarkers exist in the wet (winter) and dry (summer) seasons. Serum sorbitol dehydrogenase showed no significant differences between years, indicating that measured mixed-function oxygenase (MFO) enzyme activities were not affected by annual variations in hepatic tissue damage. Ethoxyresorufin-O-deethylase activity was lower in female black bream than in male fish while ethoxycoumarin-O-deethylase activity was not influenced by gender. Biomarker levels measured at various sites confirm that major roads and drains are significant contributors of MFO-inducing chemicals into the Swan-Canning estuary. No consistent upstream or downstream gradient in biomarker response was identified. The ratio of naphthalene-type to benzo(a)pyrene-type biliary metabolites was linked to runoff from urban areas into the estuary. There was high annual variability in all biomarkers in both seasons, suggesting that biannual monitoring is required to evaluate the effect of contaminants on the biota in the estuary.

Colonic carcinoma presenting as an appendiceal abscess in a young woman.

A 38-year-old woman with stage T4N0M0 adenocarcinoma of the cecum presented with what seemed to be an appendiceal abscess. She had a 10-month history of intermittent abdominal pain in the right lower quadrant. Initial laparotomy revealed an abscess in that quadrant. The abscess was drained. A mass in the cecum, associated with dense fibrous tissue and abscess formation, was found on subsequent surgical exploration. Pathological examination revealed a well-differentiated mucinous adenocarcinoma of the cecum with transmural invasion. The lesion had replaced most of the vermiform appendix and was associated with a periappendiceal abscess. Colonic carcinoma masquerading as acute appendicitis or an appendiceal abscess is a well-recognized entity in the elderly but may be overlooked in younger patients because malignant disease is not suspected.

A fatal pulmonary complication of lupus in pregnancy.

Pulmonary vasculitis is an uncommon complication of systemic lupus erythematosus (SLE), and has not been previously documented in pregnancy. This case report describes the rapidly fatal course of a pregnant SLE patient, whose terminal illness was manifested by severe pulmonary hypertension and unexpected autopsy findings of medium and large vessel vasculitis. The relationship of these unusual manifestations to other clinical and serologic features of SLE, as well as novel therapeutic options, are discussed.

Lupus pregnancy. A prospective study of placental changes.

Eleven patients with systemic lupus erythematosus (SLE) were monitored prospectively during pregnancy. Clinical and serologic features of disease activity were recorded, and after delivery, a careful search for pathologic changes in the placenta was carried out. Seven patients delivered live infants, and 4 patients had unsuccessful pregnancies, with fetal loss occurring between 12 and 27 weeks of gestation. One of these 4 patients had active SLE at delivery, and all had circulating lupus anticoagulant and thrombocytopenia. Other serologic abnormalities, including anticardiolipin and anti-Ro antibodies, were not associated with fetal loss. The overall placental size was reduced in SLE patients compared with that in healthy controls and in diabetic controls. A variety of pathologic changes were noted, including placental infarction, intraplacental hematoma, deposition of immunoglobulin and complement, and thickening of the trophoblast basement membrane. The reduction in placental size appeared to enhance the clinical significance of these pathologic changes.

Prenatal sonographic diagnosis of Pena-Shokeir syndrome type I, or fetal akinesia deformation sequence.

We report on a familial case of Pena-Shokeir syndrome type I (fetal akinesia deformation sequence) born to healthy parents. The antenatal ultrasound diagnosis was based on hydramnios, restricted limb movements, decreased fetal chest movements, small chest, arthrogryposis, clubfoot, fixed extension of knees, fixed flexion of elbows, camptodactyly, kyphosis of thoracic spine, cryptorchidism, and small muscle bulk. Thymic hyperplasia was noted at autopsy.

Review of causes of perinatal mortality in a regional perinatal center, 1980 to 1984.

During 1980 to 1984, 279 deaths occurred among 15,306 births in a regional perinatal unit. Survival to discharge corrected for lethal malformations was 81% or better in infants with a birth weight above 749 gm. Congenital malformations (23.2%), infections (21.3%), asphyxia (19.8%), and hyaline membrane disease (11%) caused most perinatal deaths.

Therapy-related leukemia and myelodysplasia in small-cell lung cancer. Report of a case and results of morphologic, cytogenetic, and bone marrow culture studies in long-term survivors.

The bone marrow of 11 patients with small-cell lung cancer, who survived more than two years following combined-modality therapy, was subjected to morphologic, cytogenetic, and bone marrow culture studies. One patient, after a prodrome of anemia and thrombocytopenia, developed acute leukemia 60 months after the start of chemotherapy. Four months before frank leukemia developed, bone marrow culture studies showed a marked inability to form colonies. Cytogenetic studies demonstrated an abnormal clone of cells that included the deletion of the long arm of chromosome 5. No morphologic abnormalities were noted in the bone marrow of any other long-term survivor; however, the mean corpuscular volume of peripheral red blood cells was greater than normal in three of four patients who remain alive and disease free. In one of these patients marrow culture studies also failed to grow colonies. The other patients showed a decreased ability to form multilineage colonies and colonies of the granulocyte-macrophage lineage in vitro compared with a control population. All patients showed some degree of aneuploidy on cytogenetic analysis; in two cases approximately 50% of cells were aneuploid. However, no clonal abnormality was detected in any patient. Follow-up for the development of secondary acute leukemia and other long-term complications continues in these patients.

Autosomal recessive pachyonychia congenita.

We report the second and third cases of pachyonychia congenita inherited as an autosomal recessive disorder. Our cases were unusual, with the fingernails showing a striking leukonychia and appearing clinically as Terry's nails. These patients were originally diagnosed as having epidermolysis bullosa simplex because of a history of a life-long blistering disorder. The clinical features and inheritance of pachyonychia congenita, as well as the reasons for the long delay in diagnosis of our cases, are discussed.

Fetal renal cystic disease: sonographic-pathologic correlation.

Renal cystic disease encompasses a complex group of pathologic and clinical entities, with varied yet distinctive sonographic features. An accurate assessment of the fetal genitourinary tract and the amniotic fluid volume by sonography can lead to a specific prenatal diagnosis in most cases. This article emphasizes the usefulness of sonographic-pathologic correlation in understanding renal cystic disease. The entities discussed are infantile polycystic kidney disease (Osathanondh and Potter type I), multi-cystic renal dysplasia (type II), adult polycystic kidney disease (type III) and renal cystic dysplasia associated with obstructive uropathy (type IV). Sonograms of six correctly diagnosed cases between November 1982 and November 1984 were retrospectively reviewed and correlated with their pathologic findings. The differential diagnosis and possible pitfalls are discussed. In addition, the impact on perinatal management and the role of genetic counselling will be emphasized.