Leiomyosarcoma of the esophagus: results of surgical treatment

BACKGROUND: This study examined the results of surgical treatment of leiomyosarcoma of the esophagus. METHODS: Between January 1920 and December 1996, 17 patients (9 men and 8 women) with leiomyosarcoma of the esophagus were treated surgically at the Mayo Clinic. Median age was 58 years and ranged from 26 to 76 years. Symptoms included dysphagia in 11 patients (64.7%) and odynophagia in 6 (35.3%). The tumor was located in the middle third of the esophagus in 10 patients (58.8%) and in the cervical esophagus in 7 (41.2%). Procedures performed included esophagogastrectomy in 9 patients (Ivor Lewis in 5, left thoracoabdominal in 3, and transhiatal in 1), enucleation in 3, transgastric excision in 1, and exploration without resection in 4. RESULTS: The procedure was considered curative in 11 patients (64.7%). There was one operative death (mortality, 5.9%). Complications occurred in 3 patients (17.6%) and included anastomotic leak in 2 and bleeding requiring reoperation in 1. Growth pattern was infiltrating in 7, polypoid in 5, and intramural in 5. Histologically, the tumor was grade 1 in 6 patients, grade 2 in 2, grade 3 in 7, and grade 4 in 2. The tumor was postsurgically classified as stage I in 2 patients, stage IIA in 7, stage IIB in 1, stage IIIA in 5, stage IV in 1, and unknown in 1. Six patients (35.3%) received adjuvant treatment. Follow-up was complete in 16 patients (94.1%) and ranged from 1 to 182 months (median, 48 months). Five- and 10-year actuarial survivals were 47.0% and 31.0%, respectively. Seven patients (41.2%) are currently alive (median survival, 72 months); all underwent curative resection. Factors affecting survival included completeness of resection, growth pattern, postsurgical stage, tumor grade, and tumor location (p < 0.05). CONCLUSIONS: We conclude that leiomyosarcoma of the esophagus is rare. Complete resection provides long-term survival.     

Prevalence and role of anticardiolipin antibodies in Crohn disease

OBJECTIVES: Anticardiolipin antibodies belong to the group of antiphospholid antibodies, and may be seen in association with endothelial damage and recurrent vascular thrombosis. The aim of our study was to determine in patients with Crohn's disease the frequency of anticardiolipin antibodies, and to correlate their presence with clinical activity and treatment of the disease. METHODS: One hundred and thirty-eight sera from patients with Crohn's disease and 118 from age-matched controls were tested for IgG anticardiolipin antibodies. In the Crohn's disease group, we determined whether the patients had a past history of vascular thrombosis, a clinically active intestinal disease, or a current immunosuppressive therapy (steroids or azathioprine). RESULTS: Anticardiolipin antibodies were found significantly more often in patients with Crohn's disease than in controls: 11.0% versus 2.5%, P < 0.02. Three patients with Crohn's disease had a past history of vascular thrombosis, but none of them had anticardiolipin antibodies. The presence of anticardiolipin antibodies was not correlated with the fact that patients had a clinically active disease (P = 0.77), or a current immunosuppressive therapy at the time of the serological test (P = 0.95). CONCLUSIONS: There is a significantly high prevalence of patients with anticardiolipin antibodies during Crohn's disease. The positivity of the test does not seem to be correlated to the existence of a past history of vascular thrombosis, nor to the clinical activity of the disease.     

What defense doesSchouwia purpurea (Cruciferae) have against the desert locust?

A field study of the food eaten by solitary desert locusts was carried out in a winter breeding area in Mauritania. The food eaten, determined by the plant epidermis found in fecal pellets, was compared to the plant's availability in the habitat.Schouwia purpurea, well represented in the diets, was dominant at the study site. Adults had a preference forTribulus terrester. Growth and feeding on these two plants were compared. The high water content ofS. purpurea leaves limited the dry matter eaten and slowed down growth. Glucosinolates were separated and quantified by gas chromatography. There are 132mol/g dry matter in green leaves. In multiple choice tests, with paper disks, glucosinolate extracts were phagostimulant at a low concentration (21mol/g dry matter) and repulsive at a higher one (214mol/ g dry matter). Biting behavior onS. purpurea was recorded and analyzed on video. The importance ofSchouwia purpurea in desert locust habitats and its defenses is discussed.     

In situ evaluation of dynamic precipitation during plastic straining of an Al-Zn-Mg-Cu alloy

The coupling between precipitation and plasticity has been systematically investigated in an Al-Zn-Mg-Cu alloy using in situ small-angle X-ray scattering measurements during thermomechanical tests. Material pre-aged to two different initial precipitate conditions has been examined. Each pre-aged condition has been strained at 160 °C and we show that the plasticity induces an accelerated coarsening kinetics, which we characterize in terms of the evolution of the precipitate size. This acceleration is correlated with the degree of plastic strain, but does not depend markedly on strain rate. The experimental data strongly suggests that the accelerated kinetics is mainly linked with the accumulation of a supersaturation of vacancies during plastic flow that increases the effective diffusion constant.     

Two-port isotropic radiator for unpolarized waves

The possibility of radiating an equal amount of power in all directions and all polarizations, using a two-port antenna excited by two independent noise sources, is considered.     

Relationship between blood pressure and weight characteristics in childhood and adolescence. II.--Blood pressure, fatness, lean body mass and non lean body mass (author's transl)

The relationship between adiposity and blood pressure has been studied among 17,067 healthy children aged 4 to 18 years old. The correlation of blood pressure with fatness, expressed as non lean body mass, is smaller than the correlation with lean body mass, especially in boys. Blood pressure association with lean body mass strongly increases during puberty growth in boys. These data suggest that during adolescence blood pressure association with weight is mainly due to growth and physical-maturation and that fatness has less influence. A careful analysis of somatic features of adolescents with high blood pressure seems necessary before advocating and improved system of weight control. Preference of blood pressure reference to height is again strengthened.     

Photodegradation of RDX in aqueous solution: a mechanistic probe for biodegradation with Rhodococcus sp

Recently we demonstrated that Rhodococcus sp. strain DN22 degraded hexahydro-1,3,5-trinitro-1,3,5-triazine (RDX) (1) aerobically via initial denitration followed by ring cleavage. Using UL 14C-[RDX] and ring labeled 15N-[RDX] approximately 30% of the energetic chemical mineralized (one C atom) and 64% converted to a dead end product that was tentatively identified as 4-nitro-2,4-diaza-butanal (OHCHNCH2NHNO2). To have further insight into the role of initial denitration on RDX decomposition, we photolyzed the energetic chemical at 350 nm and pH 5.5 and monitored the reaction using a combination of analytical techniques. GC/ MS-PCI showed a product with a [M+H] at 176 Da matching a molecular formula of C3H5N5O4 that was tentatively identified as the initially denitrated RDX product pentahydro-3,5-dinitro-1,3,5-triazacyclohex-1-ene (II). LC/MS (ES-) showed that the removal of RDX was accompanied by the formation of two other key products, each showing the same [M-H] at 192 Da matching a molecular formula of C3H7N5O5. The two products were tentatively identified as the carbinol (III) of the enamine (II) and its ring cleavage product O2NNHCH2NNO2CH2NHCHO (IV). Interestingly, the removal of III and IV was accompanied by the formation and accumulation of OHCHNCH2NHNO2 that we detected with strain DN22. At the end of the experiment, which lasted 16 h, we detected the following products HCHO, HCOOH, NH2CHO, N2O, NO2-, and NO3-. Most were also detected during RDX incubation with strain DN22. Finally, we were unable to detect any of RDX nitroso products during both photolysis and incubation with the aerobic bacteria, emphasizing that initial denitration in both cases was responsible for ring cleavage and subsequent decomposition in water.