'Wax bloom' on beeswax cultural heritage objects: Exploring the causes of the phenomenon.

The term 'wax bloom' is used to describe a thin whitish crystalline layer that develops on the surface of beeswax objects under specific conditions. This phenomenon is undesirable, especially in the cases of objects with aesthetic or informational value, such as wax sculptures or historical seals. A combination of solid-state NMR and FTIR measurements allowed to obtain fairly detailed insight into the problem and to suggest a probable mechanism of its development. Secondary crystallization of unsaturated hydrocarbons from beeswax was determined as a primary cause. After the macroscopic solidification of beeswax from the melt, these molecules remain for months in a highly mobile, liquid-like state. This facilitates their diffusion to the surface, where they eventually crystallize, forming the 'wax bloom' effect. Although these results are of particular interest with respect to the conservation of beeswax artifacts, they are relevant to this material in general and help with understanding its unique properties.

Pure red-cell aplasia as the presenting feature of the carcionoid tumor of the thymus: case report.

Acquired pure red-cell aplasia (PRCA) is an uncommon disorder of erythrocytopoiesis that can develop in association with thymic tumors. We present the very rare case of a severely anemic 62-year-old man with PRCA and a concurrent neuroendocrine carcinoid tumor of the thymus. The anterior mediastinal thymus tumor was completely excised, and following histological and immunohistochemical analyses (showing positive staining for cytokeratin, chromogranin A, synaptophysin, and neuron-specific enolase) the diagnosis of a (grade I; T(1)N(0)M(0)) typical carcinoid tumor of the thymus was made. Postoperatively the anemia persisted despite no signs of residual tumor on CT chest. A hematological work up found: normocellularity with <0.5% erythroblasts and preserved megakaryocytopoiesis and granulocytopoiesis in a trephine biopsy; reduced numbers of Colony Forming Unit Erythroid (CFU-E) and normal numbers of Burst-Forming Unit Erythroid (BFU-E) in bone marrow colony-forming assays; a markedly increased level of serum erythropoietin; normal T and B-cell numbers with a normal CD4/CD8 ratio; and no clonal T-cell receptor -gamma and -delta gene rearrangement) The patient responded favorably to a therapeutic trial of glucocorticoid immunosuppressive treatment (prednisone 1 mg/kg/day) with a normalization of the reticulocyte count and hematocrit, suggesting an immunologic mechanism for the PRCA. Though the exact mechanisms underlying the association between the PRCA and the carcinoid tumor of the thymus remain unknown.

[Physical therapy in the rehabilitation of patients with aerobic infections of the extremities]. / Vrijednost fizikalne terapije za rehabilitaciju osoba sa aerobnim infekcijama ekstremiteta.

OBJECTIVE: To evaluate how infection of extremity after war wound influenced the possibilities and immediate effects of a physical therapy. METHODS: The retrospective clinical investigation comparing two groups: group A (n = 86) with infection, group B (n = 87) without infection. Main indicators for possibilities of the physical therapy were the numbers and types of physical procedures used. For the estimation of immediate effects of physical therapy the muscle power and the range of motion were used. RESULTS: The number of daily physical procedures in the group with infection, compared to the group without infection, was significantly lesser ((A: 2.87 +/- 1.73; B: 4.02 +/- 1.73; p < 0.001). The patients with infection were significantly less frequently submitted to thermotherapy, hydrotherapy, interferent current and electrostimulation. Patients with infection, compared to patients without infection, had significantly poorer improvement of amplitude of analyzed movements at the end of treatment (A: 6.66 +/- 7.28 degrees; B: 16.66 +/- 14.79 degrees; p < 0.001). CONCLUSION: The infection of the extremities limited the possibilities and reduced the immediate effects of physical therapy.

Improvement of metastatic endocrine tumors of the pancreas by hepatic artery chemoembolization.

We report the results of transcatheter intraarterial perfusion of liver with the emulsion of iodized oil and cytostatics performed as palliative treatment in three patients with hepatic metastases of pancreatic endocrine tumors. Two patients had insulinoma and one patient had glucagonoma. They were also treated by medical therapy from the time the diagnosis was made. Intraarterial perfusion of the liver was achieved by Lipiodol emulsified with streptozotocin and 5-fluorouracil. Regarding these three patients therapeutic responses were different in duration of hormone secretion decrease. Relief of hypoglycemic attacks and a significant decrease of plasma immunoreactive insulin concentration within 12 months without any additional therapy was observed in the patient with insulinoma (case no. 2). This patient had slightly increased immunoreactive glucagon concentration from the time of diagnosis. A decrease of immunoreactive insulin levels in other patient with insulinoma and an increase in plasma glucose to the euglycemic range during two months allowed a reduction of doses of somatostatin analogue and diazoxide. Due to rapid progression of the disease, intraarterial perfusion of liver was repeated three months later with the same results. Remission of symptoms was partial in the case of glucagonoma. Immunoreactive glucagon levels were not changed and there was no significant benefit of the treatment. Intraarterial perfusion of liver with iodized oil and cytostatics could be an effective, safe and repeatable method of palliating symptoms of malignant pancreatic tumors, especially in inoperable but nonterminal cases. It could allow reduction of additional medical therapy, but success of the treatment is not predictable.

Gonadotrophin and free alpha-subunit secretion in patients with acromegaly and clinically non-functioning pituitary tumors: anterior pituitary function and the effect of thyrotrophin-releasing hormone.

The effect of the tumor size on the anterior pituitary hypofunction is analyzed in 29 patients with acromegaly and 34 patients with clinically non-functioning pituitary tumor (NFPA). Gonadotrophin and free alpha-subunit (SU) concentrations during daytime variations (samples were taken hourly for 24 h) and after stimulation with TRH were measured as well. Patients with NFPA had a higher prevalence of isolated secondary hypogonadism (20.6% vs 10.3%) and more severe pituitary failure (52.9% vs 6.9%) in comparison with acromegalic patients (p < 0.0001). However, there was no association between the tumor size and the anterior pituitary hypofunction (p = 0.1 and p = 0.9) in patients with NFPA and acromegaly respectively. In premenopausal women and in men with normal/low gonadotrophin levels, mean daytime levels of LH (0.75 +/- 0.6 vs 1.5 +/- 1.9 mlU/ml; p = 0.002) and FSH (2.1 +/- 2.7 vs 4.1 +/- 4.9 mlU/ml; p = 0.009) were higher in patients with acromegaly. There was no difference in the alpha-SU level (p = 0.9). Women with gonadotrophin levels compatible with menopause and men with elevated gonadotrophin levels had the same degree of gonadotrophin and alpha-SU elevation regardless of the tumor type. TRH induced significant rise of LH in 8 (23.5%), FSH in 5 (14.7%) and alpha-SU in 10 (29.4%) patients with NFPA. Among 29 patients with acromegaly LH rose in 6 (20.7%), FSH in 5 (17.2%) and alpha-SU in 3 (10.3%) patients. In conclusion, the anterior pituitary function is better preserved in patients with acromegaly than in patients with NFPA. It seems that the size of pituitary tumor is not the major factor in the pathogenesis of hypopituitarism in patients with macroadenomas. Gonadotrophin and possibly alpha-SU response to TRH exists not only in some patients with clinically non functioning pituitary tumors but also in some patients with acromegaly. Further investigations are need to explain if it represents a biochemical marker of a plurihormonal pituitary tumor in these patients.

Pituitary adenomas secreting large amounts of prolactin may give false low values in immunoradiometric assays. The hook effect.

Immunoradiometric assay (IRMA) for serum prolactin (PRL) measurement can give falsely low values, leading to unnecessary surgery in patients with prolactinomas. We studied clinical and biochemical features of patients with pituitary macroprolactinomas in whom plasma PRL levels had been underestimated due to the so-called "high dose PRL hook effect". This phenomenon was observed in four (14.2%) out of 28 patients with pituitary macroadenomas (13 macroadenomas) and 15 non-functioning macroadenomas) reffer during one-year period. Undiluted median (range) PRL levels were 11.3 (3.0-48.7), 983.9 (194.4-1959.4), and 96.9 (66.6-147.7) micrograms/l in patients with non-functioning macroadenomas, macroprolactinomas and the hook effect adenomas, respectively. In all patients assay was performed after serum dilution, and only in patients with the hook effect the median PRL levels increased significantly to 5795.0 (2097.2-12722.2) micrograms/l. The mean age at diagnosis was 38 +/- 6.5, 45 +/- 6, and 53 +/- 3 yr, for the patients with the hook effect, macroprolactinoma and non-functioning adenoma, respectively. Males were predominant (75%) in the hook effect adenoma group. Patients with the hook effect macroprolactinomas were all treated successfully with dopamine agonists, and all patients had significant shrinkage of the tumor mass (more than 50% shrinkage). In conclusion, this study suggests that patients with high dose PRL hook effect are generally younger, more frequently males with very large pituitary adenomas (grade III-IV according to Hardy). It is necessary, whenever performing IRMA for serum prolactin measurement, to dilute samples routinely (1:1 and 1:10 dilutions) in every patient with pituitary tumor.