Dam-Breach hydrology of the Johnstown flood of 1889-challenging the findings of the 1891 investigation report.

In 1891 a report was published by an ASCE committee to investigate the cause of the Johnstown flood of 1889. They concluded that changes made to the dam by the South Fork Fishing and Hunting Club did not cause the disaster because the embankment would have been overflowed and breached if the changes were not made. We dispute that conclusion based on hydraulic analyses of the dam as originally built, estimates of the time of concentration and time to peak for the South Fork drainage basin, and reported conditions at the dam and in the watershed. We present a LiDAR-based volume of Lake Conemaugh at the time of dam failure (1.455 × 10(7) m(3)) and hydrographs of flood discharge and lake stage decline. Our analytical approach incorporates the complex shape of this dam breach. More than 65 min would have been needed to drain most of the lake, not the 45 min cited by most sources. Peak flood discharges were likely in the range 7200 to 8970 m(3) s(-1). The original dam design, with a crest ∼0.9 m higher and the added capacity of an auxiliary spillway and five discharge pipes, had a discharge capacity at overtopping more than twice that of the reconstructed dam. A properly rebuilt dam would not have overtopped and would likely have survived the runoff event, thereby saving thousands of lives. We believe the ASCE report represented state-of-the-art for 1891. However, the report contains discrepancies and lapses in key observations, and relied on excessive reservoir inflow estimates. The confidence they expressed that dam failure was inevitable was inconsistent with information available to the committee. Hydrodynamic erosion was a likely culprit in the 1862 dam failure that seriously damaged the embankment. The Club's substandard repair of this earlier breach sowed the seeds of its eventual destruction.

Estimated lag time in global carbon emissions and CO2 concentrations produced by commercial nuclear power through 2009 with projections through 2030.

This study examines the past and future impact of nuclear reactors on anthropogenic carbon emissions to the atmosphere. If nuclear power had never been commercially developed, what additional global carbon emissions would have occurred? More than 44 y of global nuclear power have caused a lag time of at least 1.2 y in carbon emissions and CO2 concentrations through the end of 2009. This lag time incorporates the contribution of life cycle carbon emissions due to the construction and operation of nuclear plants. Cumulative global carbon emissions would have been about 13 Gt greater through 2009, and the mean annual CO2 concentration at Mauna Loa would have been ~2.7 ppm greater than without nuclear power. This study finds that an additional 14­17 Gt of atmospheric carbon emissions could be averted by the global use of nuclear power through 2030, for a cumulative total of 27­30 Gt averted during the period 1965­2030. This result is based on International Atomic Energy Agency projections of future growth in nuclear power from 2009­2030, modified by the recent loss or permanent shutdown of 14 reactors in Japan and Germany

COL1A1:PDGFB chimeric transcripts are not present in indeterminate fibrohistiocytic lesions of the skin.

Indeterminate fibrohistiocytic lesions of the skin share histological and immunohistochemical features of both benign fibrous histiocytoma/dermatofibroma and dermatofibrosarcoma protuberans (DFSP). Unlike dermatofibroma, DFSP harbors recurrent genetic aberrations resulting in the fusion of COL1A1 on chromosome 17 and PDGFB on chromosome 22. Because indeterminate fibrohistiocytic lesions share some features with DFSP, they were evaluated for the possible presence of COL1A1-PDGFB chimeric transcripts. Twelve formalin-fixed paraffin-embedded cases were examined for COL1A1-PDGFB chimeric transcripts using a previously validated sensitive multiplex reverse transcriptase-polymerase chain reaction assay. The median patient age was 52.5 years (33-70 years) with 9 females and 3 males. The most common site was the extremities (n = 8) followed by the trunk (n = 2) and the head and neck region (n = 2). All demonstrated the expected reactivity for both CD34 and factor XIIIa, and the majority focally infiltrated into subcutaneous fat. Of the 6 patients with follow-up, 2 had residual tumor excised, but no patient developed a recurrence. None of the tumors harbored COL1A1-PDGFB fusion transcripts identified by reverse transcriptase-polymerase chain reaction. Although indeterminate fibrohistiocytic lesions share some features with DFSP, the lack of COL1A1-PDGFB chimeric transcripts suggests that they are distinct entities.

Balloon tamponade of hemorrhage after uterine curettage for gestational trophoblastic disease.

BACKGROUND: Uterine bleeding frequently complicates gestational trophoblastic disease, particularly after uterine evacuation. Hysterectomy and other procedures used to control this bleeding incur significant risk and can limit fertility. CASE: We present a case of massive hemorrhage complicating uterine curettage performed for metastatic gestational trophoblastic disease. The patient's bleeding was controlled successfully by intrauterine tamponade performed using a balloon catheter. After catheter removal, she achieved complete disease remission. CONCLUSION: Intrauterine balloon catheterization appears to be a promising alternative to control uterine hemorrhage and preserve fertility for young women undergoing treatment for gestational trophoblastic disease. Its use may help avoid invasive interventions, such as hysterectomy and embolization, currently used to control hemorrhage after uterine evacuation.

Axillary syringomas.

Syringomas are common benign neoplasms encountered mostly around the eyes. However, as described herein, these tumors can occur in atypical locations such as the axilla. The differential diagnosis revolves around those entities more likely seen in this anatomical location (such as Fox-Fordyce, Hailey-Hailey and Darier diseases). Various ablative modalities are curative.

Differential cellular expression of LIGHT and its receptors in early gestation human placentas.

LIGHT (homologous to lymphotoxins, exhibits inducible expression, competes with herpes simplex virus glycoprotein D for HVEM, a receptor expressed by T lymphocytes) is an apoptosis-inducing member of the tumor necrosis factor family of ligands. Messenger RNAs encoding LIGHT and its receptors, lymphotoxin-beta receptor (LTbetaR), decoy receptor-3 (DcR3) and herpes virus entry mediator (HVEM), are present in first trimester and term placentas. Proteins have been localized to specific cells in term but not earlier gestation placentas. Here, we have studied LIGHT and its receptors in early (6-7 weeks) and early-to-middle (8-13 weeks) gestation using immunohistology. Notable cell-specific, gestation-related features were identified. LIGHT and two of its receptors, a membrane-bound receptor that mediates apoptosis (LTbetaR) and a soluble receptor that interferes with LIGHT signaling (DcR3), were present in syncytiotrophoblast and cytotrophoblast cells in all samples but were detected in placental stromal cells only at week 8 and thereafter. HVEM, a membrane-bound receptor that protects against apoptosis, was expressed only on syncytiotrophoblast. These observations suggest that the LIGHT system may regulate early to middle stages of placental development via cell-specific, temporally programmed expression of the ligand and its receptors, and may also assist in preserving placental immune privilege.

Primary neuroendocrine carcinoma of the vagina with Merkel cell carcinoma phenotype.

We describe a case of primary neuroendocrine carcinoma arising from the anterior vaginal wall of a 67-year-old woman. Primary neuroendocrine carcinoma of the vagina is a rare entity with only 25 previously reported cases in the literature. In previous reports, these tumors have not been distinguished from primary neuroendocrine carcinoma of the skin (Merkel cell carcinoma). The tumor was composed of cells that showed neuroendocrine-type nuclear features with hyperchromasia, nuclear molding, occasional small nucleoli, and a chromatin pattern that was finely granular. The tumor cells were positive for cytokeratin 20 (CK20), neuron specific enolase, pancytokeratin, epithelial membrane antigen, and chromogranin A expression. Ki-67, a marker of proliferation, was also positive in>90% of cells. The tumor cells showed intense expression of Bcl-2 oncoprotein and mild to moderate expression of c-KIT. Synaptophysin, neurofilament, CD45, CD56, CD10, S-100, HMB-45, cytokeratin 7, and thyroid transcription factor 1 were negative. This pattern of staining is consistent with a Merkel cell carcinoma. This is the first report of a primary neuroendocrine carcinoma of the vagina with a Merkel cell phenotype. Previous studies have not distinguished primary neuroendocrine carcinoma of the vagina from Merkel cell carcinoma of the skin. Positive expression of CK20 in primary small cell carcinoma of the vagina might represent a Merkel cell carcinoma subtype of this tumor.