How do long-term development and periodical changes of river-floodplain systems affect the fate of contaminants? Results from European rivers.

In many densely populated areas, riverine floodplains have been strongly impacted and degraded by river channelization and flood protection dikes. Floodplains act as buffers for flood water and as filters for nutrients and pollutants carried with river water and sediment from upstream source areas. Based on results of the EU-funded "AquaTerra" project (2004-2009), we analyze changes in the dynamics of European river-floodplain systems over different temporal scales and assess their effects on contaminant behaviour and ecosystem functioning. We find that human-induced changes in the hydrologic regime of rivers have direct and severe consequences on nutrient cycling and contaminant retention in adjacent floodplains. We point out the complex interactions of contaminants with nutrient availability and other physico-chemical characteristics (pH, organic matter) in determining ecotoxicity and habitat quality, and draw conclusions for improved floodplain management.

Distribution of cadmium among geochemical fractions in floodplain soils of progressing development.

Initial soil development in river floodplains influences soil properties and processes. In this study, suites of young floodplain soils sampled at three European rivers (Danube/Austria, Ebro/Spain and Elbe/Germany) were used to link soil development to the soils' retention capacity for cadmium. Geochemical fractionation of original and metal-spiked soils was conducted. Cadmium remained in weakly bound fractions in both original and spiked soils, representing an entirely different behaviour than observed for copper in an earlier study. The tendency of incorporation into more stable forms over time was only slightly expressed. Correlation analysis revealed the involvement of different sorption surfaces in soil, with no single soil constituent determining cadmium retention behaviour. Nevertheless, in the calcareous soils of the Danube floodplain, we found increased cadmium retention and decreased portions of desorbable cadmium with progressing soil development.

Geochemical fractions of copper in soil chronosequences of selected European floodplains.

The influence of soil formation on copper sorption is documented based on chronosequences of soils from three river floodplains in Europe (Danube, Ebro and Elbe). Sequential extraction was used to fractionate copper in original and spiked soils in order to study the long-term and short-term behaviour of copper retention. Copper partitioning among defined geochemical fractions was mainly determined by soil pH and the contents of carbonates, organic matter and Fe-/Mn-oxides and hydroxides. Copper extracted with NH(2)OH.HCl correlated well with the contents of crystalline Fe-oxides and hydroxides, demonstrating increasing retention capacity with progressing soil development. Copper retained in original soils was found in more strongly bound fractions, whereas sorption of freshly added copper was primarily influenced by the presence of carbonates. Beyond the effect of progressing soil formation, variations in organic carbon contents due to different land use history affected the copper retention capacity of the investigated soils.

Primary cutaneous B-cell lymphomas of the lower limbs: a study of integrin expression in 11 cases.

Primary cutaneous B-cell lymphoma is a rare disease. Among the cutaneous B lymphomas, B-cell lymphomas of the lower limbs appear as a special subgroup with a prognosis that is possibly worse than that of primary cutaneous B-cell lymphomas located on the trunk, arms or head, with more frequent relapses. In addition, some recent studies indicate that the level of expression of integrins on tumour cells could be related to the clinical course of the disease. This study reports on 14 cases of primary cutaneous B-cell lymphomas of the lower limbs and their clinical course. A study of integrin expression by tumour cells was performed in 11 of these cases. With a mean follow-up of 31 months, the study confirmed the worse prognosis of lymphomas with a predominance of centroblasts and immunoblasts (3 deaths) compared with lymphomas with a predominance of centrocytes, as well as their higher rate of recurrence (7/11). A correlation was confirmed between the course of the disease and the level of expression of lymphocyte function-associated antigen-1, intercellular adhesion molecule-1 and very late antigen-4 by tumour cells.

[Langerhans histiocytosis in adults: cutaneous and mucous lesion regression after treatment with thalidomide]. / Histiocytose langerhansienne de l'adulte: localisations cutanéomuqueuses régressives après traitement par thalidomide.

BACKGROUND: Langerhans cell histiocytosis is a rare disorder with a wide spectrum of diseases and various clinical behaviours. The prognosis depends on the patient's age at onset and the extension of the disease. Treatment is function of evolution and extension of the disease. CASE REPORT: We report one case of Langerhans cell histiocytosis in a 33-year-old woman with resistant vulvar involvement whose cutaneous lesions improved with thalidomide. Complete healing of the genital lesions occurred within 1 month, but the patient discontinued her treatment after 3 months because of somnolence. Recurrence of the symptoms was observed within 2 weeks without treatment, but complete control was obtained with reintroduction of thalidomide. No severe adverse effect was detected at electrophysiological and clinical examinations. CONCLUSION: The simplicity and the rapid effect of thalidomide on cutaneous lesions suggest that new clinical evaluation of this old drug that can also be used in some systemic disease might be of the value.

[Coronary involvement in systemic lupus erythematosus]. / Atteinte coronarienne au cours du lupus Erythémateux systeémique.

BACKGROUND: Coronary artery disease is an uncommon event in lupus erythematosus. The mechanisms responsible for coronary occlusion are probably complex and intermixed. We report three patients with lupus erythematosus and antiphospholipid antibodies who had coronary artery disease diagnosed with coronary angiogram. OBSERVATION: Coronary artery disease occurred in three young patients aged from 21 to 35 years 3 to 11 years after the onset of lupus. They all had antiphospholipid antibodies. They had been treated with corticosteroids for 6 to 36 months. Two of them were smokers. Angiograms showed coronary occlusion two patients while the third one had probable myocardial microvasculopathy. The lupus was quiescent in all cases when coronary artery disease occurred. DISCUSSION: Antiphospholipid antibodies associated with smoking may be involved in the pathogenesis of coronary artery disease in these 3 patients.

[Red fingers syndrome in the course of HIV infection. A new case]. / Syndrome des doigts rouges au cours de l'infection par le VIH. Une nouvelle observation.

Human immunodeficiency virus can be associated with vascular manifestations such as arteritis mainly with cerebrovascular localization, arterial aneurysms or accelerated formation of atherosclerosis lesions. Red fingers syndrome has been recently described in i.v.-drug patients with HIV and hepatitis C infection. We report a new case in a 36-year old woman, and suggest that this syndrome must be considered as a new microcirculatory manifestation of HIV infection. Red fingers syndrome in patients with HIV is likely secondary to co-infection with hepatitis C or immunological disturbances-associated such as cryoglobulinemia.

[Generalized pseudoxanthoma elasticum combined with vitamin K dependent clotting factors deficiency]. / Pseudoxanthome élastique généralisé associé à un déficit en facteurs vitamine-K dépendants.

INTRODUCTION: Pseudoxanthoma elasticum is a connective tissue disease currently classed in 4 forms. Two forms are inherited via dominant autosomal transmission and the other two via recessive autosomal transmission. The generalized form of pseudoxanthoma elasticum is the most uncommon form and corresponds to recessive type II. Clinical manifestations include the typical generalized "peau d'orange" skin associated with hyperlaxity of the skin. Usually, there is no systemic manifestation. CASE REPORT: We report a case of a patient with generalized pseudoxanthoma elasticum associated with deficiency of vitamin-K dependent factors II, VII, IX, and X. A search for other causes of vitamin-K dependent factor deficiency was negative. DISCUSSION: The association of generalized pseudoxanthoma elasticum with deficiency of vitamin-K dependent clotting factors has been reported previously in very rare cases and is probably not fortuitous. It could led to the definition of a sub-group of recessive autosomal pseudoxanthoma elasticum.

[Protein S deficiency in necrotizing cellulitis of the penis]. / Déficit en protéine S au cours d'une cellulite nécrosante de la verge.

INTRODUCTION: The pathogenesis of necrotizing cellulitis remains uncertain. Factors that enhance clot formation may contribute to tissue necrosis. CASE REPORT: A case of necrotizing cellulitis of the penis in a patient with a transient protein S deficiency, is reported. CONCLUSION: The responsibility of this transient hypercoagulable state in the occurrence of tissue necrosis in this patient is discussed.

Antiarrhythmic effects of timolol in patientes with ventricular arrhythmais

O objetivo desse estudo foi avaliar os efeitos anti-arrítmicos do maleato de timolol, em portadores de extra-sístoles ventriculares prematuras freqüentes e multifocais (DVP), surto bigeminado e episódio de taquicardia ventricular (TV. Foi administrado maleato de timolol nas doses de 10 a 30 mg duas vezes ao dia a 31 pacientes, em estudo multiclínico duplo cego, cruzado e controlado por placebo. A avaliaçäo do grau de controle das arritmias ventriculares utilizou o eletrocardiograma dinâmico de 24 horas enquanto que o grau de beta-bloqueio foi determinado pela reduçäo da freqüência cardíaca máxima em exercício. A administraçäo do maleato de timolol causou decréscimo de: 36% na freqüência cardíaca em exercício, 39% na DVP/24 horas (de 383 ñ 80 a 232 ñ 63, p..<.05), 81% nos surtos bigeminados (de 239 ñ 84 a 44 ñ 17, p < 0,05) e 83% na incidência de mais de um episódio de taquicardia ventricular (TV) durante as 24 horas de monitorizaçäo (de 46% a 8%, p<0,01). Portanto o maleato de timolol, administrado em doses que produzam beta-bloqueio, é um agente promissor para o tratamento das DVP freqüentes e multifocais, surtos bigeminados e episódios eventuais de taquicardia ventricular

Hemodynamic and metabolic evaluation of an acute left ventricular failure model induced by coronary artery embolization

Existe uma necessidade de um modelo experimental reproduzível e estável da insuficiência cardíaca aguda. Neste estudo, realizado em 56 cäes, avaliamos os efeitos hemodinâmicos e metabólicos da insuficiência ventricular esquerda, produzidos por embolia via artéria coronária principal esquerda com microsferas plásticas de 50 micrometros. Foram excluídos 15 cäes que apresentaram tanto arritmias como hemodinâmica instável. Nos 41 cäes restantes, a embolia causou aumento gradativo da pressäo endodiastólica final do ventrículo esquerdo de 5,6 ñ 0,3 (média ñ EPM) para 14,8 ñ 0,4 mmHg, diminuiçäo da dP/dt max ventricular esquerda de 2627 ñ 81 para 1812 ñ 46 mmHg/s, reduçäo do débito cardíaco (28%), queda da pressäo sistêmica arterial (9%) e aumento da resistência vascular periférica total (31%) (todos p < 0,01, n = 41). O consumo de oxigênio do miocárdio foi reduzido em 36% (p < 0,01, n = 41), o lactato do miocárdio declinou de 43,1 ñ 5,3 para 8,4 ñ 5,3 micromol/1 e a absorçäo dos ácidos graxos no miocárdio foi reduzida em 42% p < 0,01, n = 22). O total da necrose ventricular esquerda foi estimado após 24 horas, atraves de uma técnica que emprega o corante trifenil terazólio. Neste grupo, 41% ñ 3 do ventrículo esquerdo estavam necrosados, existindo boa correlaçäo entre a extensäo da necrose e a pressäo endodiastólica final do ventrículo esquerdo (r = 0,75, n = 12, p < 0,01). Concluindo, a embolia via artéria coronária principal esquerda provocou um modelo reproduzível e estável da insuficiência ventricular esquerda, em cäes. A pressäo endodiastólica final do ventrículo esquerdo parece refletir a extensäo da necrose miocárdica neste modelo

Beneficial effects of timolol in digitalized patients with atrial fibrillation and a rapid ventricular response

Quarenta e dois pacientes com fibrilaçäo atrial crônica e em uso de digitálico foram tratados com timolol. A reduçäo da freqüência ventricular foi avaliada através do teste de esforço e de monitorizaçäo contínua pelo sistema Holter. O estudo teve duraçäo de 10 semanas e foi duplamente cego, aleatório, com um grupo placebo e um grupo tratado com timolol. A administraçäo de timolol, na dose média de 10mg, duas vezes por dia, produziu uma diminuiçäo de 31% na freqüência cardíaca (de 164 + ou - 5 para 113 + ou - 4 bpm, p < 0,01) e na pressäo arterial média (de 88 + ou - 1,5 para 81 + ou - 1,9 mmHg) durante o teste na esteira rolante. O duplo-produto reduziu-se de 27,396 + ou - 1080 para 16,080 + ou - 786 (p < 0,01). A freqüência cardíaca determinada diminuiu de 90 + ou - 3 para 69 + ou - 2 bpm (p < 0,01). Sete pacientes tratados com timolol e um paciente tratado com placebo foram retirados do estudo em virtude dos efeitos colaterais (fadiga, tonteira e dispnéia). Conclui que a administraçäo de timolol é eficaz e segura em pacientes com fibrilaçäo atrial crônica e uso concomitante de digitálico