RESUMO
Mini (15.2 cm) semipermeable membrane devices (SPMDs) were used successfully in 169 streams from six metropolitan areas of the US to sequester hydrophobic organic compounds (HOCs) that are indicative of urbanization. A microscale assay the P450RGS, which responds to compounds that bind to the aryl hydrocarbon receptor (AhR), and the Fluoroscan, a chemical screen for polycyclic aromatic hydrocarbons (PAHs), were performed on each mini SPMD extract. Results show both tests were sensitive enough to respond in streams with low urbanization and responded exponentially in a predictable way to a gradient of urbanization. Mini SPMDs had sufficient sampling rates to detect HOCs using gas chromatography with mass spectrometric detection (GC/MS) in streams with low levels of urbanization. The total number of HOCs in streams had a linear response to a gradient of urbanization, where 73 of 140 targeted compounds were detected. A diverse group of compounds was found in urban streams including, PAHs, insecticides, herbicides, musk fragrances, waste water treatment compounds and flame retardants. Pentachloroanisole (PCA), a breakdown product of pentachlorophenol (wood preservative), was the most ubiquitous HOC, and was detected in 71% of streams. An evaluation of mini SPMD performance showed they can detect concentrations in water below toxicity benchmarks for many HOCs with the exception of 2,3,7,8 tetrachlorodibenzo-p-dioxin. A comparison of mini SPMDs with full sized (91.4 cm) SPMDs showed they have several distinct advantages. The most notable advantages are their low cost, small size, and reduced chance of vandalism. The greatest limitation is the inability to detect compounds at low concentrations (pg/L). Mini SPMDs perform quite well in a wide array of environmental settings and applications and should be considered as an option in environmental studies.
RESUMO
OBJECTIVES: To describe clinical and neuroimaging manifestations of neurosarcoidosis in a cohort of 21 patients. PATIENTS AND METHODS: We reviewed records of 21 patients with sarcoidosis and central nervous system (CNS) manifestations referred to Cooper University Hospital, with emphasis on neuroimaging findings and associated clinical and laboratory evidence of sarcoidosis. Nineteen patients were categorized as having "definite," "probable," or "possible" neurosarcoidosis, while 1 had associated CNS vasculitis and another had Hodgkins lymphoma with cauda equina syndrome. RESULTS: The most common manifestations included myelopathy, cranial neuropathies, and encephalopathy. In 6 patients, CNS biopsy showed sterile, noncaseating granuloma (NCG), while in the remainder, the diagnosis was established through a combination of clinical, radiographic, and laboratory findings. Notably, 10 patients developed acute neurological emergencies, including seizures, spinal cord compression, and increased intracranial pressure. Findings on magnetic resonance imaging (MRI) included a variety of manifestations, including isolated mass lesion, diffuse intraparenchymal inflammatory lesions in the brain and spinal cord, leptomeningeal enhancement, hydrocephalus, and intracranial hemorrhage. CONCLUSIONS: Sarcoidosis is associated with diverse neurological manifestations and neuroimaging findings. The diagnosis of isolated CNS sarcoidosis requires a biopsy to document the presence of sterile NCG and to exclude neoplasms and other granulomatous diseases. When a biopsy of the CNS is not possible, a diagnosis of neurosarcoidosis can reasonably be supported in many patients by MRI findings and exclusion of other disorders. RELEVANCE: Optimum management of patients with neurosarcoidosis relies on the ability of clinicians to recognize the broad spectrum of clinical and neuroimaging manifestations of the disorder.
