Facilitating [2+2] Photocycloadditions by Promoting Oxygen Tolerance and Substrate Activation in Water.

Micellar photocatalysis has been used to overcome oxygen quenching and enable a [2+2] photocycloaddition through triplet-energy transfer in water under aerobic conditions. The cheap and commercially available self-assembling sodium dodecyl sulfate (SDS) micelles were found to increase the oxygen tolerance of a typically oxygen-sensitive reaction. Furthermore, the use of the micellar solution was found to activate α,ß-unsaturated carbonyl compounds to energy transfer and allow [2+2] photocycloadditions to take place. Our preliminary studies of micellar effects on energy-transfer-based reactions demonstrate the reaction between α,ß-unsaturated carbonyl compounds and activated alkenes in a mixture of SDS, water and [Ru(bpy)3 ](PF6 )2 .

Parental ancestry and risk of early pregnancy loss at high altitude.

High altitude pregnancy is associated with increased frequency of low birth weight infants and neonatal complications, the risks of which are higher in women of low-altitude ancestry. Does ancestry also influence the risk of miscarriage (pregnancy loss <20 weeks) in high-altitude pregnancy? To answer this, 5386 women from La Paz, Bolivia (3300-4150 m) with ≥1 live-born infant were identified. Data were extracted from medical records including maternal and paternal ancestry, demographic factors, and reproductive history. The risk of miscarriage by ancestry was assessed using multivariate logistic regression, adjusting for parity, and maternal age. Andean women experienced first live-births younger than Mestizo or European women (21.7 ± 4.6 vs 23.4 ± 8.0 vs 24.1 ± 5.1, P < .001). Andeans experienced more pregnancies per year of reproductive life (P < .001) and had significantly higher ratios of live-births to miscarriages than women of Mestizo or European ancestry (P < .001). Andean women were 24% less likely to have ever experienced a miscarriage compared to European women (OR:0.76; CI:0.62-0.90, P < .001). The woman's partner's ancestry wasn't a significant independent predictor of miscarriage. In conclusion, the risk of miscarriage at high altitude is lower in Andean women. The lack of a paternal ancestry effect suggests underlying mechanisms relate more to differential maternal adaptation in early pregnancy than fetal genetics.

Biochemical and toxicological profiles of venoms from an adult female South American bushmaster (Lachesis muta rhombeata) and her offspring.

In this work, we compared the biochemical and toxicological profiles of venoms from an adult female specimen of Lachesis muta rhombeata (South American bushmaster) and her seven offspring born in captivity, based on SDS-PAGE, RP-HPLC, enzymatic, coagulant, and hemorrhagic assays. Although adult and juvenile venoms showed comparable SDS-PAGE profiles, juveniles lacked some chromatographic peaks compared with adult venom. Adult venom had higher proteolytic (caseinolytic) activity than juvenile venoms (p < 0.05), but there were no significant inter-venom variations in the esterase, PLA2, phosphodiesterase and L-amino acid oxidase (LAAO) activities, although the latter activity was highly variable among the venoms. Juveniles displayed higher coagulant activity on human plasma, with a minimum coagulant dose ∼42% lower than the adult venom (p < 0.05), but there were no age-related differences in thrombin-like activity. Adult venom was more fibrinogenolytic (based on the rate of fibrinogen chain degradation) and hemorrhagic than juvenile venoms (p < 0.05). The effective dose of Bothrops/Lachesis antivenom (produced by the Instituto Butantan) needed to neutralize the coagulant activity was ∼57% greater for juvenile venoms (p < 0.05), whereas antivenom did not attenuate the thrombin-like activity of juvenile and adult venoms. Antivenom significantly reduced the hemorrhagic activity of adult venom (400 µg/kg, i. d.), but not that of juvenile venoms. Overall, these data indicate a compositional and functional ontogenetic shift in L. m. rhombeata venom.

New specimens of Baurutitan britoi and a taxonomic reassessment of the titanosaur dinosaur fauna (Sauropoda) from the Serra da Galga Formation (Late Cretaceous) of Brazil.

The description of new titanosaur specimens unearthed from deposits of the Serra da Galga Formation (Bauru Group, Late Cretaceous) at the BR-262 site, near Peirópolis (Uberaba, Minas Gerais State, Brazil), sheds light on the taxonomy of two taxa previously known from the same area and geological unit: Baurutitan britoi and Trigonosaurus pricei. A comparative revision indicates that T. pricei represents a junior synonym of Ba. britoi, and that the BR-262 specimens belong to that latter species. The information provided by the new specimens also revealed that the paratype of T. pricei (MCT 1719-R), a caudal vertebral series, actually represents a new taxon, named here as Caieiria allocaudata gen. et sp. nov.

First titanosaur dinosaur nesting site from the Late Cretaceous of Brazil.

Titanosaurs were successful herbivorous dinosaurs widely distributed in all continents during the Cretaceous, with the major diversity in South America. The success of titanosaurs was probably due to several physiological and ecological factors, in addition to a series of morphological traits they achieved during their evolutionary history. However, the generalist nesting behaviour using different palaeoenvironments and strategies was key to accomplish that success. Titanosaur nesting sites have been found extensively around the world, with notable records in Spain, France, Romania, India, and, especially, Argentina. Here, we describe the first titanosaur nesting site from the Late Cretaceous of Brazil that represents the most boreal nesting site for South America. Several egg-clutches, partially preserved, isolated eggs and many eggshell fragments were discovered in an Inceptisol palaeosol profile of the mining Lafarge Quarry, at the Ponte Alta District (Uberaba Municipality, Minas Gerais State), corresponding to the Serra da Galga Formation (Bauru Group, Bauru Basin). Although classical mechanical preparation and CT scans have not revealed embryonic remains in ovo, the eggs and eggshell features match those eggs containing titanosaurian embryos found worldwide. The morphology of the egg-clutches and observations of the sedimentary characteristics bolster the hypothesis that these sauropods were burrow-nester dinosaurs, as was already suggested for the group based on other nesting sites. The egg-clutches distributed in two levels along the Lafarge outcrops, together with the geopalaeontological data collected, provide clear evidence for the first colonial nesting and breeding area of titanosaur dinosaurs in Brazil.

Osteology and systematics of Uberabatitan ribeiroi (Dinosauria; Sauropoda): a Late Cretaceous titanosaur from Minas Gerais, Brazil.

Uberabatitan ribeiroi is a Late Cretaceous titanosaur (Dinosauria, Sauropoda) from southeastern Brazil. Here we provide a detailed revision of all its available specimens, including new elements from the type-locality. One new autopomorphy is added to diagnosis of the taxon: astragalus with a well-developed anteroposterior crest that mediodistally delimits the tibial articulation. Linear regressions were conducted in an attempt to circumscribe specimens within the type-series, revealing that it is composed of several individuals, with inferred total body lengths varying from 7 to 26 meters. Phylogenetic analyses including U. ribeiroi show that the Brazilian taxon corresponds to a non-saltasaurid lithostrotian titanosaur.

Cushing's syndrome with small cell carcinoma of the uterine cervix.

A 28 year old white women was found to have a cervical tumor in the 25th week of pregnancy. Pathologic examination revealed a nonkeratinizing small cell carcinoma. After delivery by cesarean section, pelvic lymph node exploration was carried out, and all 15 nodes were free of tumor. Her condition was staged as II-A, and she was treated with local radiation. Metastatic disease became manifest almost a year later and was histologically similar to her primary disease. A Cushingoid appearance was noticed and plasma cortisol levels were elevated. Twenty-four hour urinary 17-hydroxycorticosteroid (17-OHCS) and 17-ketosteroid (17-KS) levels were elevated and failed to suppress with dexamethasone. Plasma adrenocorticotropin (ACTH) level was elevated. Electron microscopic examination of the tumor tissue revealed neurosecretory granules. Immunoperoxidase stains for ACTH were positive. The patient's course was one of progressive decline and eventual death. A literature review revealed two other cases in which carcinoma of the uterine cervix was considered to be the source of ectopic ACTH. Some small cell carcinomas of the cervix may arise from cells of the APUD series. Small cell carcinoma of the uterine cervix may behave differently from the more commonly encountered keratinizing and large cell nonkeratinizing carcinomas of the cervix and may not respond as well to standard therapy. Ectopic hormone production, production of abnormal peptides or of vasoactive amines may be more common in small cell carcinoma of the cervix than is currently recognized, and these products may be clinically useful as tumor markers.

Invasive vulvar Paget's disease.

Seven cases of invasive vulvar Paget's disease are presented. These are compared with 10 cases of intraepithelial vulvar Paget's disease. On the basis of both clinical and histopathologic observations, the concept of intraepithelial vulvar Paget's disease is supported, and this entity is distinguished from the invasive form. Therapy for the latter is discussed.

Radioactive phosphorus and external radiation as an adjuvant to surgery for ovarian carcinoma.

At the Johns Hopkins Hospital between the years 1967 and 1973, 40 patients with primary ovarian carcinoma were treated with radioactive phosphorus. Of these, 19 were treated with external radiation in addition. The morbidity from the radioactive phosphorus alone was negligible. Dosages of less than 5000 rads to the pelvis were usually well tolerated even when given in combination with the isotope. Pathologic changes in the bowel are discussed.

Bleomycin, vinblastine, and cis-platinum in the treatment of advanced endodermal sinus tumor.

The endodermal sinus tumor has traditionally been associated with an exceedingly poor prognosis. Three women with advanced pure endodermal sinus tumors were treated with a combination of bleomycin, vinblastine, and cis-platinum (VBC). Serum alpha-fetoprotein levels were monitored for all patients during and after therapy, and in each case the alpha-fetoprotein returned to normal range, correlating with complete clinical remission. Second-look laparotomy was negative for tumor in each case. Two patients have had no overt sign of recurrence 12 months after cessation of therapy. The third patient had post-treatment elevation of alpha-fetoprotein levels, and eventually was found to have recurrent tumor 6 months after chemotherapy was stopped. The VBC combination, previously found effective in testicular germ cell tumors, is also effective in ovarian germ cell tumors.

Advanced ovarian cancer: brief intensive combination chemotherapy and second-look operation.

The effects of brief intensive combination chemotherapy have been evaluated in 59 patients with advanced epithelial ovarian cancer. Following surgery and before chemotherapy, 16 patients had limited residual cancer (tumor nodules 3 cm or less in diameter) and 43 had bulky disease (tumor nodules greater than 3 cm). Chemotherapy with hexamethylmelamine, cyclophosphamide or 5-fluorouracil, doxorubicin, and cisplatin was given intensively. Myelo-suppression was the most serious side effect, although gastrointestinal, neurologic, and renal toxicity was also observed. Fifty-five of the 58 (95%) evaluable patients had either a partial clinical response or no clinically detectable tumor following therapy. Forty-five of these 55 patients underwent a second-look surgical evaluation at 6 months; 17 of 45 patients (14 of 16 patients with limited residual disease and 3 of 29 with bulky disease) had no evidence of residual cancer, and 9 patients had all known cancer resected. Sixteen of 17 patients who attained a complete response as judged by laparotomy remain in remission; median follow-up has been 19 months (range, 9 to 30 months) following chemotherapy. This combination chemotherapy produces marked tumor regression as judged by second-look evaluation, and most patients who had limited residual disease have all evidence of cancer eradicated. Longer observations is required to determine how many of these patients will remain continuously free of ovarian cancer.

Dogger Bank Itch and cyclosporin.

Two cases of Dogger Bank Itch responding to oral cyclosporin (Neoral) are reported. The first, a 42-year-old shell-fisherman, presented with eczema on his face, forearms and hands. Oral prednisolone was ineffective and in subsequent years systemic steroids and topical clobetasol propionate allowed him to continue his work. In the shellfishing season of 1996, cyclosporin (Neoral) was introduced and the eczema was subsequently satisfactorily controlled. The second fisherman, aged 46, presented with an irritant eczema of the hands and forearms. Initial treatment with emollients and potent topical steroids had little effect. A subsequent course of cyclosporin provided good control of the eczema.

Spontaneous regression in gynecologic neoplasia.

As I have tried to tabulate and evaluate the cases of spontaneous regression of gynecologic malignancy, several facts stand out: 1) They were infrequent. 2) The tumors most commonly undergoing spontaneous regression were the germinal epithelial tumors of the ovary; there was not any case of spontaneous regression of any other variety of ovarian neoplasm. 3) There was not one legitimate case of spontaneous regression of an invasive epidermoid carcinoma of the vulva, vagina, or uterus.

Dermatology in general practice.

A significant percentage of the workload of a general practitioner is dermatological. This study has analysed the cases seen by one partner in a semirural practice over a 5-year period. Of a total of 11,191 patients seen, 2386 had a dermatological diagnosis (21%). There was a preponderance of females (1604, 67%) and the most common skin diseases seen were viral warts, eczema and benign tumours. Surgical intervention was carried out in 707 cases, an atypical situation for most general practitioners. It was only because of additional training as a hospital practitioner in dermatology that the partner treated both benign and malignant tumours where she felt confident to do so. The incidence of skin cancer was 3% and 22 patients were referred to a dermatology outpatient department.