Mammary analogue secretory carcinoma: A rare salivary gland tumour.

Mammary analogue secretory carcinoma (MASC) is a rare and recently described tumour of the salivary glands. MASC has similar histomorphological and immunohistochemical features of secretory carcinoma of the breast. MASC can be mistaken for other salivary gland tumours, especially acinic cell carcinoma. A 28-year-old man was diagnosed with a rare salivary gland tumour in Pretoria, South Africa (SA). To our knowledge, a report of MASC in SA has not previously been published. The surgeons dealing with salivary gland tumours should be aware of the clinical presentation. Current treatment is similar to that of other salivary gland malignancies.

Contrasting patterns of population connectivity between regions in a commercially important mollusc Haliotis rubra: integrating population genetics, genomics and marine LiDAR data.

Estimating contemporary genetic structure and population connectivity in marine species is challenging, often compromised by genetic markers that lack adequate sensitivity, and unstructured sampling regimes. We show how these limitations can be overcome via the integration of modern genotyping methods and sampling designs guided by LiDAR and SONAR data sets. Here we explore patterns of gene flow and local genetic structure in a commercially harvested abalone species (Haliotis rubra) from southeastern Australia, where the viability of fishing stocks is believed to be dictated by recruitment from local sources. Using a panel of microsatellite and genomewide SNP markers, we compare allele frequencies across a replicated hierarchical sampling area guided by bathymetric LiDAR imagery. Results indicate high levels of gene flow and no significant genetic structure within or between benthic reef habitats across 1400 km of coastline. These findings differ to those reported for other regions of the fishery indicating that larval supply is likely to be spatially variable, with implications for management and long-term recovery from stock depletion. The study highlights the utility of suitably designed genetic markers and spatially informed sampling strategies for gaining insights into recruitment patterns in benthic marine species, assisting in conservation planning and sustainable management of fisheries.

Virtual environments for targeting cognitive processes: an overview of projects at the University of Southern California.

The Virtual Environments Laboratory at the University of Southern California (USC) has initiated a research program aimed at developing virtual reality (VR) technology applications for the study, assessment, and rehabilitation of cognitive processes. This technology is seen to offer many advantages for these aims. The status of two ongoing VR projects will be discussed in this article. The projects outlined are being conducted via cooperative efforts with both the Integrated Media Systems Center and the Information Sciences Institute at USC. These departments consist of a multidisciplinary group of scientists that represents engineering, computer science, communications, information technology, education, and psychology. This mix of expertise has served to facilitate the development of these projects via an integrated approach to VR application development. The first project involves the development of a series of ImmersaDesk-delivered visuospatial tests and training tools that leverage the interactive, dynamic, and 3D assets that are available with current VR technology. The second project involves a head mounted display (HMD) VR system for the study, assessment, and possible rehabilitation of attention disorders. It is believed that these projects target cognitive variables that are well matched to the current strengths and limitations that exist with presently available VR technology.

Gender issues in the use of virtual environments.

Gender differences in cognitive and behavioral performance have been reported throughout the psychological literature. Consequently, gender differences should be considered and controlled for when cognitive research is conducted in virtual environments (VEs). These variables may include gender-related differences in cognitive performance, susceptibility for cybersickness, and the impact of sex hormones on cognition. Such issues are addressed in the context of a recent VE study of the visuospatial ability referred to as mental rotation. The Mental Rotation Test (MRT), a paper and pencil measure, has been shown to produce one of the largest gender differences in the cognitive literature. The outcomes of the MRT are in favor of males. However, results reported from a Virtual Reality Spatial Rotation (VRSR) test demonstrate no gender differences when subjects were able to manually manipulate the stimuli in a VE. Further analysis uncovers gender differences in the patterns of associations between verbal and spatial tasks and performance on VRSR. Results are discussed in terms of dimensionality factors and hemispheric lateralization.

Systemic lupus erythematosus. I. Outcome and survival: Dutch experience with 110 patients studied prospectively.

This report presents an analysis of the cumulative survival in 110 well defined patients with systemic lupus erythematosus (SLE) who were followed up over a prolonged period of time. Special attention was paid to possible differences between patients who died and those who were still alive at the end of the study. Of the 110 patients with SLE, 96 (87%) were still alive after 10 years; the cumulative survival for men was 69% (11/16) and for women 90% (85/94). Patients who never developed a new exacerbation after the diagnosis for SLE had been established had a 10 year survival of 100%; for patients with one, two, or three exacerbations the 10 year survival was 91%, 69%, and 33% respectively. From these prospective studies it was found that the exacerbation frequency is most closely related to survival. Disease symptoms of renal involvement or neurological involvement, or both, present at the onset or at the moment the SLE diagnosis was established, were predominantly seen in patients who died during the follow up.

Systemic lupus erythematosus. II. Observations on the occurrence of exacerbations in the disease course: Dutch experience with 110 patients studied prospectively.

The incidence of exacerbations in the disease course was investigated in 110 patients with systemic lupus erythematosus (SLE) who were studied prospectively at our institute for lupus research. At the time of disease onset and diagnosis the male patients were much older than the female patients (about 10 years); exacerbation frequency during follow up was increased in the male patients. The follow up data showed that if a patient with SLE was prone to develop an exacerbation this mostly took place within the first five years of follow up. It could be calculated that after fulfilling the American Rheumatism Association criteria only 56% (62/110) of the patients developed a subsequent exacerbation. Features at the time of diagnosis, distinguishing those patients who developed a subsequent exacerbation from those who did not, were haemolytic anaemia, the presence of anti-Sm antibodies, and a falsely positive serological test for syphilis. At the time of diagnosis, however, the prevalences of these features were low; for haemolytic anaemia, anti-Sm antibodies, and a falsely positive serological test for syphilis they amounted to 40%, 5%, and 12% respectively.

Interleukin-6 (IL-6) and acute phase proteins in the disease course of patients with systemic lupus erythematosus.

One of the mediators responsible for the induction of the production of acute phase proteins by hepatocytes is interleukin-6 (IL-6), formally known as hybridoma growth factor (HGF). In a prospective study the biological significance of IL-6, but also the relationship with the acute phase response (C-reactive protein [CRP], alpha 1-antitrypsin and alpha 1-acid glycoprotein) during flare-ups in 12 systemic lupus erythematosus (SLE) patients was investigated. Only 2 SLE patients showed sustained elevated IL-6 levels, and in one of these patients a clear correlation was found between the increases in IL-6 and the acute phase response. In the other SLE patients hardly any response or change in the levels of IL-6, CRP, and/or alpha 1-antitrypsin was found. In contrast to the profiles of alpha 1-acid glycoprotein, in seven of the SLE patients a significant increase in the serum levels took place in the period preceding the exacerbation. This difference between the three acute phase proteins suggests that the regulatory mechanisms are different. Our results are in agreement with the findings that IL-6 might be responsible for the CRP response.

Complement (C3) metabolism in rheumatoid arthritis in relation to the disease course.

Metabolic turnover studies of the third component of complement, C3, were performed in 23 patients with rheumatoid arthritis (RA) to get a direct insight in the dynamics of complement synthesis and catabolism. Results of these turnover studies were related to the serum level of the total amount of C3 as well as to that of the activation product C3d. A hypercatabolism of C3 was observed in 12 of the 23 patients studied. Six of these 12 patients showed signs of extra-articular RA; only one patient with extra-articular manifestations had a normal catabolism of C3. Decreased serum levels of C3 were not found in any of the patients with a hypercatabolism of C3, indicating that the accelerated turnover was compensated by an increased synthesis. In RA patients levels of the activation product C3d could not correlate with the turnover of C3. However, in selected RA patients without signs of nodules or extra-articular manifestations, they could. Thus, our results indicate that serum levels of C3 and C3d do not reflect C3 metabolism in RA patients. Furthermore, the existence of extra-articular manifestations is accompanied by a more pronounced activation of the complement system.

Interleukin-6 (IL-6) in synovial fluid and serum of patients with rheumatic diseases.

Interleukin-6 (IL-6) is a monokine with a number of biological activities, which are intimately related to inflammatory responses. We have measured IL-6 levels in synovial fluid (SF) and serum (Se) of patients with rheumatic diseases. SF-IL-6 levels were a thousand-fold higher than corresponding Se levels and a positive correlation was found between SF and Se levels suggesting that Se-IL-6 is derived from IL-6 produced in the joint. Se levels of IL-6 were also positively correlated to C-reactive protein (CRP) levels, supporting the in vitro experiments showing that IL-6 stimulates hepatocytes to produce CRP. Finally we observed a positive correlation between SF-IL-6 levels and the local activity score.

An analysis of the levels of complement components in the synovial fluid in rheumatic diseases.

A linear relationship between the synovial fluid to serum concentration ratios and log molecular weight was found for six plasma proteins, which are largely synthesized by the liver. Production or utilization of a given protein in the joint can, therefore, be determined by its deviation from the calculated diffusion line. Based on this diffusion model the role of the complement system was investigated in the joint effusions of 48 patients with rheumatoid arthritis (RA), 6 patients with osteoarthritis (OA) and 7 patients with meniscus lesions (ML). Among these three groups quantitative differences were found in the metabolism or utilization of several complement components, based on the fact that the ratios were lower than expected for diffusion of proteins of similar molecular weight. The ratios for the RA group were the lowest. In the three patient groups, results showed increased consumption mainly of C3 and C4 locally in the joint. The existence of a real complement activation in the joints of the three different patient groups was further proved by the elevated levels of C3 breakdown products (C3d). Overall this kind of calculation provides us with a method for studying the role of other proteins which may be important in the inflammatory process of the joint.

Complement (C3) metabolism in systemic lupus erythematosus in relation to the disease course.

Metabolic turnover studies of complement components (C3) provide a direct insight into the dynamics of the complement regulation (synthesis and catabolism). To obtain information about the role of the complement system in relation to the disease course in patients with systemic lupus erythematosus (SLE), a prospective study was performed. The results of the C3 turnover studies were also correlated to the complement levels (C3) and to the presence of C3 conversion products (C3d) in circulation. In nearly all SLE patients (in 21 of the 26 metabolic turnover studies) a C3 hypercatabolism was found, with a quantitative difference depending on the disease phase. In the period preceding an exacerbation an impaired C3 synthesis was observed (in three of the four studies), in contrast to SLE patients in stable disease phase where in one case only a decrease C3 synthesis was calculated (1 out of 15 observations). A linear correlation was found between the serum C3-levels and the ratio of C3d/C3, suggesting that both serologic parameters are quantitatively indicative for C3 hypercatabolism. The study shows that in all SLE patients, irrespective of the disease stage, an increased C3 consumption is found, which supports the concept that a chronic inflammatory process is constantly present.

A clinical approach to urinary incontinence in the female.

Five hundred and twenty-eight female patients with urinary incontinence were studied and treated over a 10-year period. Details of management are given, including a description of a vaginal method of reconstruction of the anatomically incompetent bladder neck. The results of treatment of each group are discussed, and the importance of initial clinical recognition of the urinary outflow obstruction syndrome is stressed in order to institute correct treatment.

The effect of furosemide on serum prolactin levels in the postpartum period.

Furosemide, in combination with breast binding and milk fluid restriction, seems to inhibit postpartum lactation effectively, but has no effect in reducing serum prolactin levels. Inhibition of milk secretion must therefore be mediated by other mechanisms.

Pressure necrosis of a caesarean section scar with exteriorization of the gravid uterus. A case report.

A case of pressure necrosis of a caesarean section scar with protrusion of the gravid uterus through the wound is described. We can find no mention of a similar case in the literature. The management during the pregnancy presented some alarming problems, all of which were overcome, and the pregnancy was terminated by caesarean hysterectomy at 38 weeks. A healthy baby was delivered and the mother recovered.

Paget's disease of the vulva: a case report.

A patient with Paget's disease of the vulva is described. A brief review of some recent literature underlines the controversy regarding the histogenesis of the disease, and stresses the use of simple vulvectomy in its treatment. The importance of ruling out concomitant carcinoma is also stressed.

Suppression of postpartum lactation with furosemide.

A regimen of fursemide and moderate restriction of fluid intake was followed in 120 postpartum women to suppress lactation. The methods and results are presented, and possible mechanisms whereby furosemide may suppress lactation are discussed.