Treatment of hepatic epithelioid hemangioendothelioma with liver transplantation

Ten patients received liver transplants for unresectable epithelioid hemangioendothelioma (EHE). At the time of transplantation, four patients had microscopic metastases to the hilar lymph nodes, and one of the four also had metastases to a rib. The fifth patient had metastases to the lung, pleura, and diaphragm. The remaining five patients were believed to be free of metastatic disease. Two of these five patients died of metastatic disease at 3 and 16 months, respectively, after transplantation. Interestingly, all five patients with metastatic involvement are currently alive 40.6 ± 22 months (mean ± standard error of mean [SEM]) after transplantation, although one of these patients currently has metastatic disease to the lungs and mediastinum. Thus, the projected 5‐year actuarial survival rate is 76%, with two patients at risk after the third year. In conclusion, liver transplantation is a reasonable procedure for bulky, otherwise unresectable, EHE even in the presence of metastatic disease. Copyright © 1988 American Cancer Societ

Energy-resolved neutron imaging for reconstruction of strain introduced by cold working

Energy-resolved neutron transmission imaging is used to reconstruct maps of residual strains in drilled and cold-expanded holes in 5-mm and 6.4-mm-thick aluminum plates. The possibility of measuring the positions of Bragg edges in the transmission spectrum in each 55 × 55 µm2 pixel is utilized in the reconstruction of the strain distribution within the entire imaged area of the sample, all from a single measurement. Although the reconstructed strain is averaged through the sample thickness, this technique reveals strain asymmetries within the sample and thus provides information complementary to other well-established non-destructive testing methods

Paediatric anaemia at Kamuzu Central Hospital

This retrospective study assessed the outcome of children admitted during a six week period to Kamuzu Central Hospital (KCH) with anaemia. 19% of admissions had a primary discharge diagnosis of anaemia and there was a 12% mortality. Children who died were more likely than those who did not to have other diagnoses that may have contributed to mortality. 72% had a diagnosis that included both anaemia and malaria, but malaria was only documented in 36%. Malaria may be oveJlodiagnosed in that 57% of cases with a diagnosis that included malaria had negative blood smears for malaria. More data is required to determine whether delays in obtaining blood for transfusion influence mortality

Variation in suicide rates between Health Board areas

This paper examines variations in suicide in the eight Health Boards of the Republic of Ireland for the years 1976 to 1995. It is found that while all have experienced a rise in male suicide, it has been much less pronounced in the Eastern Health Board which is somewhat surprising when one considers Dublin’s much-publicised problems with homelessness and hard drug misuse. Since the mid-eighties, female rates have been somewhat higher in the southern half of the country, comprising the Southern, Mid-Western and South-Eastern Health Boards. This variation may reflect a difficulty with contacting services for psychological distress in rural areas, either because of stigma or simple practical problems associated with transport. The development of appropriate services, especially in rural areas, should be at the top of the agenda of any Resource Officer to be appointed subsequent to the Final Report of the Task Force

Antinuclear antibodies (ANA) in chronic hepatitis C virus infection: correlates of positivity and clinical relevance.

We examined correlates of antinuclear antibody (ANA) positivity (ANA+) in individuals with chronic hepatitis C virus (HCV) infection and the effect of positivity on clinical outcome of HCV. Pretreatment sera from 645 patients from three centres in Sweden (n = 225), the UK (n = 207) and Italy (n = 213) were evaluated by indirect immunofluorescence on Hep-2 cells for ANA pattern and titre by a single laboratory. Liver biopsies were all scored by one pathologist. A total of 258 patients were subsequently treated with interferon monotherapy. There was a significant difference in the prevalence of ANA (1:40) by geographic location: Lund 4.4%, London 8.7%, Padova 10.3% [odds ratio (OR) = 0.66; 95% CI: 0.46-0.94; P = 0.023]. Duration of HCV infection, age at infection, current age, route of infection, viral genotype, alcohol consumption, fibrosis stage and inflammatory score were not correlated with ANA+ or ANA pattern. Female gender was correlated with ANA+ and this association persisted in multivariable analyses (OR = 3.0; P = 0.002). Increased plasma cells were observed in the liver biopsies of ANA-positive individuals compared with ANA-negative individuals, while a trend towards decreased lymphoid aggregates was observed [hazard ratio (HR) = 9.0, P = 0.037; HR = 0.291, P = 0.118, respectively]. No correlations were observed between ANA positivity and nonresponse to therapy (OR = 1.4; P = 0.513), although ANA+ was correlated with faster rates of liver fibrosis, this was not statistically significant (OR = 1.8; P = 0.1452). Low titre ANA+ should not be a contraindication for interferon treatment. Our observation of increased plasma cells in ANA+ biopsies might suggest B-cell polyclonal activity with a secondary clinical manifestation of increased serum immunoglobulins

CV10_28 Irish Sea cruise report

Cruise CV10_28 mobilized and demobilized from Howth, Co. Dublin, on the 2nd and 7th June 2010 respectively, and totalled over 112 operational hours. The objectives of this cruise were primarily to investigate and sample previously identified methane-related seepage structures in the Irish Designated Seabed Zone (IDSZ) of the Irish Sea, to carry out sampling grids of Dublin Bay and of the region of the IDSZ from Dublin Bay to Dundalk Bay for multidisciplinary geochemical and microbiological studies, and also to sample the water column for dissolved organic matter studies. A total of 113 sampling stations were successfully sampled: 46 grabs; 55 boxcores (0.25m2); 5 gravity cores (1m); and 7 vibrocores (3m). Gas-related seepage features successfully investigated were methane-derived authigenic carbonates (MDAC) in the Codling Fault Zone (CFZ), the Lambay Deep mud diapir, and also a shallow pockmark in the northen mudbelt region. Four videolines with over six hours of video footage were acquired in the MDAC target sites. Video footage and image stills of clusters of MDAC slabs, nodules and outcroppings, as well as indications enhanced anaerobic oxidation of methane (AOM) were successfully obtained. These features were subsequently successfully ground-truthed, sampled and preliminary geochemical analysis was carried out, thereby proving MDAC mounds in the CFZ are distinct features caused by active sub-surface seepage of methane. The Lambay Deep mud diapir was investigated by videoline deployment, whereby no distinct differences in seabed structure or biodiversity were observed. Fine sandy muds with relatively high macrofaunal biodiversity characterized seabed both inside and outside of Lambay Deep. The feature and surrounding seabed was ground-truthed by vibrocore and boxcore, and results supported the videoline findings. Sub-surface sediment (0-3m) was characterized by homogenous well-sorted fine sandy mud, with low infauna and shell presence, and little or no evidence of sub-surface anoxia. The mudbelt pockmark was investigated by videoline deployment and also subsequently ground-truthed by gravity core and boxcore. Videoline and sampling evidence suggests that the pockmark and reference samples from the surrounding seabed is uniform, and characterized by very fine mud with little sub-surface zonation. Previous sub-bottom profiling of the feature suggests no evidence of gas seepage or accumulations in the vicinity of the pockmark. The weather and sampling conditions were overall favourable throughout the cruise but the lack of dynamic positioning aboard the Celtic Voyager and also the restriction on the vibrocore to slack water and day-time use resulted in some sampling limitations and incomplete secondary objectives. Overall CV10_28 achieved the vast majority of its objectives, and a comprehensive foundation for numerous studies and peer-reviewed publications has been established