Metastatic prostate cancer masquerading clinically and radiologically as a primary caecal carcinoma

BACKGROUND: Prostatic carcinoma is the second most common cause of cancer-related deaths in males in the West. Approximately 20% of patients present with metastatic disease. We describe the case of a patient with metastatic prostate cancer to the bowel presenting clinically and radiologically as a primary caecal cancer. CASE PRESENTATION: A 72 year-old man presented with abdominal discomfort and a clinically palpable caecal mass and a firm nodule on his thigh, the latter behaving clinically and radiologically as a lipoma. Computed tomographic (CT) scan showed a luminally protuberant caecal mass with regional nodal involvement. The patient was being treated (Zoladex(®)) for prostatic cancer diagnosed 6 years previously and was known to have bony metastases. On admission his PSA was 245.4 nmol/ml. The patient underwent a right hemicolectomy. Histology showed a poorly differentiated adenocarcinoma which was PSA positive, confirming metastatic prostatic adenocarcinoma to the caecum. The patient underwent adjuvant chemotherapy and is free from recurrence a year later. CONCLUSION: Metastasis of prostatic carcinoma to the bowel is a very rare occurrence and presents a challenging diagnosis. The diagnosis is supported by immunohistochemistry for PSA. The treatment for metastatic prostate cancer is mainly palliative

Geology of Caphouse Colliery, Wakefield, Yorkshire, UK

The National Coal Mining Museum in West Yorkshire affords a rare opportunity for the public to visit a former colliery (Caphouse) and experience at first hand the geology of a mine. The geology at the museum can be seen via the public tour, limited surface outcrop and an inclined ventilation drift, which provides the best geological exposure and information. The strata encountered at the site are c. 100 m thick and are of latest Langsettian (Pennsylvanian) age. The ventilation drift intersects several coal seams (Flockton Thick, Flockton Thin, Old Hards, Green Lane and New Hards) and their associated roof rocks and seatearths. In addition to exposures of bedrock, recent mineral precipitates of calcium carbonates, manganese carbonates and oxides, and iron oxyhydroxides can be observed along the drift, and there is a surface exposure of Flockton Thick Coal and overlying roof strata. The coals and interbedded strata were deposited in the Pennine Basin in a fluvio-lacustrine setting in an embayment distant from the open ocean with limited marine influence. A lacustrine origin for mudstone roof rocks of several of the seams is supported by the incidence of non-marine bivalves and fossilized fish remains whilst the upper part of the Flockton Thick Coal consists of subaqueously deposited cannel coal. The mudstones overlying the Flockton Thick containing abundant non-marine bivalves are of great lateral extent, indicating a basin-wide rise of base level following coal deposition that may be compared with a non-marine flooding surface

Mental health selection : common mental disorder and migration between multiple states of deprivation in a UK cohort

Funding Funding for this work was received from Public Health Wales NHS Trust as part of a report on migration and health. Support for the report was also received from the National Centre for Population Health and Wellbeing Research (NCPHWR). The eCATALYsT multiagency dataset and the baseline survey was supported by the Wales Office of Research and Development (SCC99/1/105 and R00/1/017). The follow-up survey was supported by a Welsh Assembly Government/Medical Research Council Health Research Partnership Award (H07-3-030), and the electronic cohort is supported by a National Institute for Social Care and Health Research Welsh Assembly Government Translational Health Research Platform Award (TPR08-020). Data availability statement Data may be obtained from a third party and are not publicly available. The electronic cohort is securely stored and maintained on the Secure Anonymised Information Linkage (SAIL) databank at Swansea University Medical School. The authors welcome general enquiries and ideas for new collaborations. Readers with an interest in further details should contact Professor Shantini Paranjothy, Principal Investigator.Peer reviewedPublisher PD

Continuous-wave highly-efficient low-divergence terahertz wire lasers.

Terahertz (THz) quantum cascade lasers (QCLs) have undergone rapid development since their demonstration, showing high power, broad-tunability, quantum-limited linewidth, and ultra-broadband gain. Typically, to address applications needs, continuous-wave (CW) operation, low-divergent beam profiles and fine spectral control of the emitted radiation, are required. This, however, is very difficult to achieve in practice. Lithographic patterning has been extensively used to this purpose (via distributed feedback (DFB), photonic crystals or microcavities), to optimize either the beam divergence or the emission frequency, or, both of them simultaneously, in third-order DFBs, via a demanding fabrication procedure that precisely constrains the mode index to 3. Here, we demonstrate wire DFB THz QCLs, in which feedback is provided by a sinusoidal corrugation of the cavity, defining the frequency, while light extraction is ensured by an array of surface holes. This new architecture, extendable to a broad range of far-infrared frequencies, has led to the achievement of low-divergent beams (10°), single-mode emission, high slope efficiencies (250 mW/A), and stable CW operation

Perinatal outcomes by mode of assisted conception and sub-fertility in an Australian data linkage cohort

BACKGROUND: Fertility treatment is associated with increased risk of major birth defects, which varies between in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI), and is significantly reduced by embryo freezing. We therefore examined a range of additional perinatal outcomes for these exposures. METHODS: All patients in South Australia receiving assisted conception between Jan 1986-Dec 2002 were linked to the state-wide perinatal collection (all births/stillbirths ≥20 weeks gestation or 400 g birth weight, n = 306 995). We examined stillbirth, mean birth weight, low birth weight (90th percentile), preterm birth (32-<37 weeks, <32 weeks gestation), postterm birth (≥41 weeks gestation), Apgar <7 at 5 minutes and neonatal death. RESULTS: Relative to spontaneous conceptions, singletons from assisted conception were more likely to be stillborn (OR = 1.82, 95% Confidence Interval (CI) 1.34-2.48), while survivors as a group were comprehensively disadvantaged at birth, including lower birth weight (-109 g, CI -129--89), very low birth weight (OR = 2.74, CI 2.19-3.43), very preterm birth (OR = 2.30, CI 1.82-2.90) and neonatal death (OR = 2.04, CI 1.27-3.26). Outcomes varied by type of assisted conception. Very low and low birth weight, very preterm and preterm birth, and neonatal death were markedly more common in singleton births from IVF and to a lesser degree, in births from ICSI. Using frozen-embryos eliminated all significant adverse outcomes associated with ICSI but not with IVF. However, frozen-embryo cycles were also associated with increased risk of macrosomia for IVF and ICSI singletons (OR = 1.36, CI 1.02-1.82; OR = 1.55, CI 1.05-2.28). Infertility status without treatment was also associated with adverse outcomes. CONCLUSIONS: Births after assisted conception show an extensive range of compromised outcomes that vary by treatment modality, that are substantially reduced after embryo freezing, but which co-occur with an increased risk of macrosomia.Jennifer L. Marino, Vivienne M. Moore, Kristyn J. Willson, Alice Rumbold, Melissa J. Whitrow, Lynne C. Giles, Michael J. Davie

IL-10 differentially controls the infiltration of inflammatory macrophages and antigen-presenting cells during inflammation

The inflammatory activation and recruitment of defined myeloid populations is essential for controlling the bridge between innate and adaptive immunity and shaping the immune response to microbial challenge. However, these cells exhibit significant functional heterogeneity and the inflammatory signals that differentially influence their effector characteristics are poorly characterized. In this study, we defined the phenotype of discrete subsets of effective antigen-presenting cells (APCs) in the peritoneal cavity during peritonitis. When the functional properties of these cells were compared to inflammatory monocyte-derived macrophages we noted differential responses to the immune-modulatory cytokine IL-10. In contrast to the suppressive actions of IL-10 on inflammatory macrophages, the recruitment of APCs was relatively refractory and we found no evidence for selective inhibition of APC differentiation. This differential response of myeloid cell subsets to IL-10 may thus have limited impact on development of potentially tissue-damaging adaptive immune responses, whilst restricting the magnitude of the inflammatory response. These findings may have clinical relevance in the context of peritoneal dialysis patients, where recurrent infections are associated with immune-mediated membrane dysfunction, treatment failure and increased morbidity