Reconstructing Contaminant Deposition in a San Francisco Bay Marina, California

Two sediment cores were collected from a marina in the San Francisco Bay to characterize historical sediment contamination resulting from the direct discharge of industrial wastewater from Naval Air Station Alameda. Depth profiles of trace metals, petroleum hydrocarbons, and radionuclides were determined with a 12-cm spacing down to a depth of 120 cm. The chronology of sediment accumulation is established by depth profiles of sedimentary time markers in conjunction with information on site history. The traditional approach of determining sediment accumulation rates by measuring atmospheric 210Pb deposition was obscured by a larger source of 210Pb in the sediments from the decay of anthropogenic 226Ra, likely from luminescent paints used at this facility and released to the marina. The sedimentation rates inferred from the data indicate that the greatest amount of contamination by trace metals and petroleum hydrocarbons took place between 1940 and 1960. In addition, anthropogenic 226Ra activities are positively correlated with some of the contaminants in the sediments, allowing the wastewater discharged from the facility to be distinguished from baywide contamination. In locations such as this, where there is a complex history of contaminant deposition, a source-specific tracer may be the only feasible method of attributing historical contamination to a point source.     

A history of neurological surgery at the University of California, San Francisco

Over a span of 80 years and four chairmanships, and now beginning the fifth chairmanship, the Department of Neurological Surgery at the University of California, San Francisco has held a position of renown among academic institutions serving neurological surgery. This article attributes this reputation to the qualities of the chairmen, an unforgettable group including Howard Naffziger, Edwin Boldrey, John Adams, and Charles Wilson. Some of their accomplishments are described.     

Hypoadrenal crisis caused by disseminated histoplasmosis

We report a case of disseminated histoplasmosis presenting with acute renal impairment due to adrenal insufficiency. The finding of bilateral adrenal gland enlargement on abdominal ultrasound examination led to a diagnostic CT-guided adrenal biopsy. Prolonged therapy with amphotericin and itraconazole resulted in a clinical cure, although the patient still requires adrenal replacement therapy.     

Carcinoma of the extrahepatic bile ducts. The University of California at San Francisco experience

OBJECTIVE: The authors investigated the combined experience of a single institution in treating bile duct carcinoma during the modern era. SUMMARY BACKGROUND DATA: Bile duct carcinomas are notoriously difficult to cure, with locoregional recurrence the rule, even after radical resection. Adjuvant efforts have included various radiation modalities, with limited success. Recently, charged-particle radiotherapy has also been used in these patients. METHODS: The authors performed a retrospective chart analysis of 129 patients with bile duct adenocarcinomas treated between 1977 and 1987 through the University of California at San Francisco, including 22 patients treated at Lawrence Berkeley Laboratory with the charged particles helium and neon. The minimum follow-up was 5 years. Survival, outcome, and complication results were analyzed. RESULTS: Sixty-two patients were treated with surgery alone (S), 45 patients received conventional adjuvant x-ray radiotherapy (S + X), and 22 were treated with charged particles (S + CP). The median survival times were 6.5, 11, and 14 months, respectively, for the entire group, and 16, 16, and 23 months in patients treated with curative intent. There was a survival difference in patients undergoing total resection compared with debulking (p = 0.05) and minor resections (p = 0.0001). Patients with microscopic residual disease had increased median survival times when they were treated with adjuvant irradiation, most markedly after CP (p = 0.0005) but also with conventional X (p = 0.0109). Patients with gross residual disease had a less marked but still statistically significant extended survival (p = 0.05 for S + X and p = 0.0423 for S + CP) after irradiatio CONCLUSIONS: The mainstay of bile duct carcinoma management was maximal surgical resection in these patients. Postoperative radiotherapy gave patients with positive microscopic margins a significant survival advantage and may be of value in selected patients with gross disease.     

The Women's Health Curriculum by a problem-based learning method for medical students at the University of California, San Francisco

OBJECTIVES: Our objectives were to (1) expand and strengthen the women's health curriculum at the University of California, San Francisco, and (2) evaluate the responses of both medical students and faculty to this curriculum. STUDY DESIGN: A written evaluation of the curriculum in women's health was completed by both students and faculty. Variables studied included mean scores of cases, the overall course score, and the preferences of medical students for faculty specialty in teaching the small groups. RESULTS: The overall course evaluation score was 7.81 (range 1 to 10). For those students who had both faculty from internal medicine or family medicine and obstetrics and gynecology, there was a strong preference that obstetrician-gynecologists teach the majority of the cases. CONCLUSIONS: The new case-based curriculum in women's health was enthusiastically received by both medical students and faculty.     

Proceedings of the Seventy-Sixth Annual Meeting of the American Psychological Association: August 30-September 3, 1968, San Francisco, California.

Comprises the Program for the Proceedings of the 76th Annual Meeting of the American Psychological Association. Information is provided for the following: Paper Sessions, Contributed Papers, Symposia, Roundtables, Panel Discussions, Tributes, Award Papers, Invited Reports, Invited Addresses, Commemorative Address, and Presidential Addresses. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prevalence, incidence, and correlates of syphilis seroreactivity in multiethnic San Francisco neighborhoods

To examine the extent of infection with syphilis in an inner-city community, we determined the prevalence, incidence, and correlates of syphilis seroreactivity in a representative sample of unmarried whites, African Americans, and Hispanics living in San Francisco during 1988 to 1989 and again 1 year later in 1989 to 1990. One thousand seven hundred seventy single men and women aged 20 to 44 were surveyed in a random household sample drawn from three neighborhoods of varying geographic and cultural characteristics. Syphilitic infection was determined by testing specimens with the microhemagglutination assay for antibodies to Treponema pallidum (MHA-TP). Of blood samples available from 1262 participants from the initial survey, 32 (2.5%) were MHA-TP reactive. After adjustment for age, a reactive syphilis serology was significantly predicted (P < 0.05) by African American race, homosexual activity (men), and less education. In homosexually active men, lifetime number of male sex partners and the presence of antibody to the human immunodeficiency virus (HIV) significantly predicted syphilis seroreactivity (P < 0.01). One year later, of 841 specimens available for testing, an additional 13 (1.5%) had become MHA-TP reactive. Eleven (85%) of the new cases were in heterosexual men and women. Although San Francisco citywide incidence data indicate that syphilis may be decreasing for the city as a whole, incidence data on a community level suggests that syphilitic infection is increasing in high-risk heterosexual communities. Thus, syphilis prevention programs should rely on serologic testing at the community level to plan effective intervention strategies.     

Three-Dimensional Salinity Simulations of South San Francisco Bay

A conservative transport method and a two-equation turbulence closure model are added to an established three-dimensional hydrodynamic model. The resulting model is applied to simulate the development of the salinity field in South San Francisco Bay. All model parameters in the salinity simulation are identical to those used in a model calibration in which the model is shown to reproduce current meter data accurately. The 64-day time period studied is characterized by low freshwater input. During this period, the observed salinity data is reproduced well by the model. Because no model parameters are adjusted, the salinity simulation is considered to be a verification of the model. Once the model is verified, it is used to explore the importance of stratification and baroclinic pressure gradients on long-term transport. It is concluded that, under conditions of moderate density gradients, the density-driven flow and mild periodic stratification that results have a significant effect on scalar transport.     

Disseminated histoplasmosis associated with disseminated tuberculosis: a case report

Disseminated histoplasmosis is reported in a 70-year-old White man. There was also evidence of a previous disseminated tuberculosis infection. This is the 9th reported case of disseminated histoplasmosis in the Republic of South Africa.     

A baseline assessment of cigarette sales to minors in San Diego, California

A community-wide survey of 302 parents of 2-year-old children and 90 private medical practitioners in a large midwestern city revealed low immunization rates (31%) and differences in parent and provider perceptions of barriers to preschool immunizations. Parents most frequently identified barriers of system factors such as cost, lack of insurance coverage, and long office waits. System barriers were reported across differing sources of immunizations (private physician as well as public clinics) and were pervasive across income groups. Providers were more likely to report barriers of parental difficulties with forgetting immunizations or not knowing when the immunizations were due. Even though providers identified parental shortcomings with scheduling as problematic, only one fifth employed tracking and reminder systems. Implications of findings for modifications of the delivery of immunization services and for parent education are discussed.     

Reactive hemophagocytic syndrome: a new presentation of disseminated histoplasmosis in patients with AIDS

We report the cases of six patients with AIDS in whom reactive hemophagocytic syndrome (RHPS) secondary to disseminated histoplasmosis was diagnosed. RHPS was diagnosed by established criteria, including fever (duration of > or = 7 days, with peak temperatures of > 38.5 degrees C), unexplained thrombocytopenia with anemia and/or neutropenia, and bone marrow biopsy findings of hemophagocytic histiocytosis. Disseminated Histoplasma capsulatum infection was diagnosed on the basis of the results of cultures of the bone marrow sample. The serum lactate dehydrogenase (LDH) level was elevated (> 1,000 IU/L) in all patients, and five of six patients had hyperferritinemia (range of ferritin level, 15,848-425,984 ng/mL). Five patients had features resembling severe sepsis with multiorgan dysfunction. Three patients recovered, and the findings of RHPS resolved following therapy with amphotericin B. In patients with AIDS, the combination of fever, cytopenia, elevated serum LDH level (> 1,000 IU/L), and/or hyperferritinemia (ferritin level of > 10,000 ng/mL) is a clue to the diagnosis of RHPS and disseminated histoplasmosis; bone marrow biopsy is valuable in establishing the diagnosis.     

The heroin epidemic in San Francisco: estimates of incidence and prevalence

Much attention has recently been focused on the question of the extent of heroin use in America. In a worthwhile effort to call public attention to the problem, many estimates of its size have evidenced a tendency toward exaggeration and aggrandizement. This paper presents methods of estimation of the extent of heroin addiction which, when carefully employed, should effectively correct such distorted estimates. Two general types of estimation are employed, incidence and prevalence. Incidence estimates are concerned with new cases of heroin addiction that occur in a specific population within a given amount of time. These estimates are based upon self-report data from addicts regarding date of first addiction. When corrected for the "lag phase" (that period of time between onset of first addiction and eventual visit to a treatment program), these data permit accurate retrospective charting of incidence trends. Prevalence estimates focus on all known cases of heroin addiction in a specific population within a given amount of time. Three separate types of prevalence estimates from three separate sources are outlined in this article: estimates based on overdose death data, estimates based on crime statistics, and estimates of "unknown" addicts. In outlining these methods, this article describes the fluctuations in heroin addiction in one major American city, San Francisco, California. After analyzing data gathered from a sample of 2,367 addicts contacted over a 3-year period, this study suggests that the incidence of heroin addiction seems to have declined after 1970. Possible factors underlying this apparent decline in heroin addiction are then discussed, including the post-1970 maturation of the "population at risk," the effectiveness of antidrug media messages, the changing drug fashions in the heroin subculture, and the gradual deterioration of the quality and potency of street heroin.     

AIDS in one city: An interview with Mervyn Silverman, Director of Health, San Francisco.

Summarizes the acquired immune deficiency syndrome (AIDS) programs and efforts in San Francisco and indicates that they are providing a continuum of care from information and education programs to counseling for those who already have AIDS. The mental health concerns include not only fear of death, but also ostracism, numerous reactions from peers (other gays), and the reaction of the general community. Understanding psychologists who comprehend the political and social ramifications and who understand the disease are needed. (0 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Suspension Cable Design of the New San Francisco–Oakland Bay Bridge

Various factors contribute to the difficulty in designing the main suspension cable for the new San Francisco–Oakland Bay Bridge Self-Anchored Suspension Span (or East Bay Bridge Suspension Span). The key factors are bridge design life, cable geometry, cable anchorage layout, cable construction method, and cable corrosion protection system. This paper describes the unique main suspension cable geometry layout for the East Bay Bridge Suspension Span, reviews the available technologies for each of the aforementioned design considerations, and presents the final cable design recommendations.