Effect of Fungicide on Pollen Foraging by Honeybees (Hymenoptera: Apidae) in Cranberry Differs by Fungicide Type.

Honeybees (Apis mellifera Linnaeus) (Hymenoptera: Apidae) play a major role in the pollination of cranberry (Vaccinium macrocarpon; Ericaceae). However, fungicide applications during cranberry bloom may affect bees foraging behavior. This research reports the amount of cranberry and noncranberry pollen brought back to hives immediately before and after two types of fungicide applications. The amount of cranberry pollen decreased while the amount of noncranberry pollen increased following a fungicide application. However, this relationship differed depending on the type of fungicide applied. Understanding how different fungicides specifically impact bee behavior is essential to minimizing bee exposure to potentially harmful chemicals.

Terrestrial Invertebrate Arsenic Accumulation Associated With an Arsenic Hyperaccumulating Fern, Pteris vittata (Polypodiales: Pteridaceae).

Arsenic (As) can play an important role in the contamination of soils, waters, and air. The toxicity of As to most organisms is well established, but little is known about the interactions between environmental As and terrestrial invertebrates and the fate of As through trophic levels. Pteris vittata L. (Polypodiales: Pteridaceae), a fern that hyperaccumulates arsenic, serves as a potential mechanism to facilitate interactions between environmental arsenic and other biota. We compared invertebrate arsenic concentrations (hereafter as [As]) and bioaccumulation factors associated with soil and fern [As] to elucidate relationships between invertebrate and environmental As exposure. We collected invertebrates in pitfall traps from field sites associated with P. vittata, and identified them to order for whole body arsenic analysis and subsequently family for classification into functional feeding groups. We found that overall [As] in invertebrates increased with soil [As], but not with fern [As]. The absence of a relationship between fern [As] and invertebrate [As] may indicate invertebrates are avoiding the fern. Individual taxonomic groups significantly differed in whole body [As], and individual taxa also varied in their relationship between whole body [As] relative to soil and fern [As]. Overall invertebrate abundance decreased as invertebrate [As] load increased but varied across taxa. One particular herbivore, Callopistria floridensis (Florida fern caterpillar), associated with relatively low environmental As exposure contained over 4,000 mg kg-1 As. Our results show that As bioaccumulates into higher trophic levels and invertebrate body [As] covary with exposure to naturally occurring environmental [As] associated with P. vittata.

Sirolimus-induced pneumonitis complicated by pentamidine-induced phospholipidosis in a renal transplant recipient: a case report.

The proliferation signal inhibitors (PSIs)-sirolimus, everolimus, and temsirolimus-have been associated with a noninfectious pneumonitis characterized by lymphocytic alveolitis and bronciolitis obliterans with organizing pneumonia (BOOP). This condition usually occurs within the first year. Herein we presented a case of a deceased donor renal transplant with interstitial pneumonitis developing 6 years after a switch from tacrolimus to sirolimus due to chronic graft dysfunction. After the addition of intravenous pentamidine due to the suspicion of Pneumocystis pneumonia, there was marked clinical deterioration requiring intubation. Open lung biopsy revealed sirolimus-induced pulmonary toxicity (BOOP) with the additional finding of a drug-induced phospholipidosis (DIPL) that we ascribe to pentamidine treatment. After cessation of both drugs and application of corticosteroid therapy, there was only partial improvement. Eight months later the residual interstitial fibrosis demands supplemental home oxygen. We review the literature on PSI-induced pneumonitis and discuss the pathophysiology of a potential interaction with pentamidine. We caution against its use in the setting of PSI-induced pneumonitis. It is currently unknown whether these concerns also apply to prescription of other more commonly used medications associated with DIPL, eg, amiodarone and aminoglycosides.

A targeted parathyroidectomy using guide wire technique in a pregnant patient with primary hyperparathyroidism.

Primary hyperparathyroidism may cause fetal demise in pregnant patients if prompt diagnosis and treatment is not initiated. The paper describes a novel guide wire technique for a targeted parathyroidectomy, which may reduce the risk to mother and fetus and be useful in other related circumstances.

NF-kappa B-mediated chemoresistance in breast cancer cells.

BACKGROUND: Nuclear factor-kappa B (NF-kappa B) is a known survival pathway, and it may explain differential sensitivity to tumor necrosis factor-alpha (TNF-alpha) and chemotherapeutic-induced apoptosis in apoptotically sensitive (APO+) and apoptotically resistant (APO-) Michigan Cancer Foundation-7 breast cancer cells. METHODS: Crystal violet viability and luciferase reporter gene assays were used to determine the inhibitory concentration of viability at 50% (IC(50)) and the inhibitory concentration of activity at 50% (EC(50)) values in APO- and APO+ cells with the selective NF-kappa B inhibitor, BAY 11-7082 (BAY). The apoptotic reporter assay was used to determine the effects of the transfection of the inhibitory kappa B-dominant negative (I kappa B-DN) construct in conjunction with TNF, paclitaxel, or doxorubicin treatments in these cells. RESULTS: The concentrations at which 50% of cell viability is inhibited (IC(50)) and at which 50% of NF-kappa B activity is inhibited (EC(50)) for BAY in APO- and APO+ cells were 95.24 micromol/L and 1.53 micromol/L, respectively, and 7.62 micromol/L and 2.64 micromol/L, respectively. The IC(50) and the EC(50) values were equivalent for the APO+ cells (P =.665), but not for the APO- cells (P =.025). I kappa B-DN--transfection alone, or with TNF, doxorubicin, or paclitaxel treatments resulted in cell death of both APO- and APO+ cells as compared with vector-control; however, greater cytotoxicity was seen in the APO+ cells. Direct comparison of the APO+ cells versus the APO- cells revealed that these differences were significant (P =.05). CONCLUSIONS: Pharmacologic or molecular inhibition of the NF-kappa B pathway blocked cell survival in MCF-7 APO+ cells, while only molecular inhibition induced cytotoxicity in the APO- cells. Selective manipulation of the NF-kappa B pathway in combination with standard chemotherapeutic agents may lead to an increased potency and efficacy of these agents.

Esophageal carcinosarcoma.

Carcinosarcoma is an uncommon malignancy of the esophagus that presents as a bulky intraluminal polypoid lesion of the esophagus. Histologically, both carcinomatous and sarcomatous components are seen. Because of accelerated intraluminal growth, esophageal carcinosarcoma often presents relatively early. This report describes a 64-year-old man with carcinosarcoma who was successfully treated with an esophagectomy. As in typical squamous cell carcinoma, early detection and treatment by surgical resection are needed to produce significant long-term survival.

Glutamine is essential for nitric oxide synthesis by murine macrophages.

BACKGROUND: Recent studies suggest an interaction between l-arginine (Arg) and l-glutamine (Gln) in the control of nitric oxide (NO) synthesis. Endotoxemia enhances Gln demand and NO production. This study was initiated to investigate the effects of altered Gln availability on the capacity of macrophages to produce NO and the interaction of Gln with l-citrulline (Cit) and Arg in the regulation of endotoxin-stimulated NO synthesis. METHODS: Cultures of RAW 264.7 macrophages in MEM containing Gln (0 to 100 mM) or Arg (0 or 0.6 mM) and supplemented or not with Cit (0.31 to 10 mM) were exposed to Escherichia coli lipopolysaccharide (LPS) at 0.001 and 1 microg/ml. After 24-h incubation, supernatants were evaluated for nitrite concentrations by Greiss reaction as a measure of NO synthesis. RESULTS: LPS stimulated nitrite synthesis in a dose-dependent fashion. Macrophages cultured in Gln-free medium containing Arg (0.6 mM) did not produce NO when stimulated with LPS. In contrast, in the presence of Arg and 0.001 microg/ml LPS, adding as little as 0.31 mM Gln resulted in a 23-fold increase in NO production (from 0.13 +/- 0. 02 to 2.92 +/- 0.06 nmol/ml) (P < 0.0001). Furthermore, a dose-dependent increase in LPS-stimulated nitrite release was observed with increasing amounts of Gln to as much as 1 mM. LPS-stimulated macrophages cultured in Arg-free medium containing Gln (0.31-10 mM) did not produce significant amounts of nitrite. However, in the absence of Arg, increasing extracellular Gln levels to 100 mM in the culture medium resulted in nitrite synthesis (2.39 +/- 0.11 nmol/ml). Detectable levels of nitrite (2.84 +/- 0.21 nmol/ml) were also documented when stimulated macrophages were incubated in culture medium lacking Arg but containing Cit (0.31 mM) and Gln (2 mM). Increasing Cit levels (0.63 to 10 mM) significantly augmented nitrite release (P < 0.05). Once again, no detectable levels of nitrite were observed when macrophages were cultured in Gln-free medium, even when Arg and Cit were present. CONCLUSION: These results suggest that Gln is an essential amino acid for NO synthesis by macrophages and raise the strong possibility that Gln acts with nitric oxide synthase to catalyze the conversion of Arg to NO. The consumption of Gln during sepsis may represent NO production.

Parathyroid preservation during thyroid surgery.

PURPOSE: Even though thyroid surgery is generally quite safe, permanent hypoparathyroidism is a very distressing complication. The incidence of hypoparathyroidism is directly proportional to the extent of thyroidectomy, and inversely proportional to the experience of the surgeon. It is also related to the extent of invasion of thyroid cancer and of the degree of dissection in the tracheo-esophageal groove. The incidence reported in the literature varies between 1% to 29%. Total thyroidectomy results in a higher incidence of hypoparathyroidism. MATERIALS AND METHODS: This report describes experiences with 600 thyroidectomies over a period of 11 years. The major indications for surgery included suspicion or proof of malignancy, compression symptoms, and substernal goiters. Twenty-six patients underwent surgery for Graves' disease. There were 221 men and 379 women, ranging in age from 16 to 89 years; 88% of the patients had benign disease, whereas 12% of the patients had malignant pathology. The surgical procedures included 62 total thyroidecotmies, 188 subtotal thyroidectomies, and lobectomy and isthmectomy in 350 patients. RESULTS: Meticulous tracheo-esophageal groove dissection, identification of parathyroids and their preservation, including the blood supply, was routine in each case. Even in patients undergoing unilateral lobectomy, every effort was made to preserve the parathyroids. If any of the parathyroids or its blood supply was injured, it was autotransplanted in the sternomastoid muscle. Only two patients developed temporary hypoparathyroidism. CONCLUSION: Parathyroid autotransplantation is performed whenever one or more of the parathyroids are damaged. Parathyroid preservation during thyroid surgery is crucial in the overall management of thyroid diseases.

Pancreatic polypeptide islet cell tumor: case report and review of the literature.

Pure pancreatic polypeptide-containing tumors (PPomas) are quite rare. Only 20 cases have been described. In this article we report a 75-year-old woman with such an endocrine islet cell tumor. The patient had no specific symptoms that could be ascribed to the tumor. An abdominal CT scan revealed a 3 cm soft tissue mass arising inferiorly from the tail of the pancreas. Local resection by way of a distal pancreatectomy was performed. A well-circumscribed hemorrhagic multiloculated mass, 3.7 cm in greatest dimension, was present in the tail of the pancreas. The patient has remained well and tumor free for the past 22 months. The endocrine characterization of the tumor was achieved by means of immunohistochemical analysis. Staining specific for insulin, glucagon, somatostatin, and gastrin was negative. In contrast, staining of the tumor for pancreatic polypeptide was strongly positive. A number of nonfunctioning islet cell tumors of the pancreas have been described. The lack of function has previously been suggested to indicate the lack of secretion of an endocrine product. This report documents that islet cell tumors may function by secreting pancreatic polypeptide but not cause symptoms.

Histopathologic changes in human small intestine during storage in Viaspan organ preservation solution.

OBJECTIVE: To evaluate the histopathologic changes that occur in human small intestine or time when preserved in Viaspan organ preservation solution. DESIGN: Short segments of human small intestine were placed in standard organ preservation solution (Viaspan) and stored in conditions that mimic the clinical situation associated with clinical organ procurement, preservation, and transplantation. The intestinal segments were removed at sequential time points and placed in 10% formalin. Specimens underwent histopathologic examination to determine time-related changes. SPECIMENS: Short intestinal segments were obtained from seven multiorgan cadaver donors. Specimens were obtained in a way that exactly mimicked small intestinal organ retrieval. RESULTS: Small intestinal histology remained normal for the first 6 hours. After 6 hours, vacuolar separation began to occur between the epithelium and the basement membrane in the upper half of the villi. After 9 hours of cold preservation, epithelial detachment extended deep into the crypts with occasional shedding of cells and villi. CONCLUSIONS: Currently used small intestinal preservation using Viaspan results in considerable histopathologic changes in human jejunum after 9 hours of cold storage. The histopathologic pattern appears normal for the first 6 hours and suggests that preservation times should be limited to this time period when possible.

Effects of luminal nutrients and small bowel transplants on congenital indirect hyperbilirubinemia.

The Gunn rat is an excellent model of Crigler-Najjar syndrome, type 1. In previous studies we demonstrated that heterotopic 15-20-cm jejunal transplants from Wistar rats lowered serum bilirubin levels by 40%, and the reduction was transient (6 weeks). In contrast, orthotopic transplants decreased bilirubin levels by 60% and the effect persisted throughout the 8-week study. This study was initiated to identify the luminal substance(s) which are responsible for the persistent bilirubin-lowering effect of jejunal transplants. Thirty-one Wistar to Gunn 15-20-cm jejunal transplants were randomized to receive daily Thiry-Vella graft irrigation with 5 ml of normal saline (n = 8); bile salts (cholate + deoxycholate, 40 mg/ml, n = 5; fats (Microlipid, 20 mg/ml, n = 5); proteins (Casec caseinate, 40 mg/ml, n = 5); and sugars (Moducal + Polycose, 40 mg/ml, n = 8). Bilirubin levels were measured spectrophotometrically at weekly intervals. At 4 and 8 weeks, enzyme-induced bilirubin conjugation activity was measured using added known amounts of added bilirubin. Irrigation of the transplants with saline, protein, and sugar resulted in moderate (40%) lowering of serum total and indirect bilirubin levels. Fat was significantly more effective, lowering mean total bilirubin levels from 9.6 +/- 0.4 to 1.6 +/- 0.2 mg/dl at 6 weeks. After this time, bilirubin levels increased slightly. Bile salts were slightly less effective, lowering bilirubin levels at 6 weeks by only 75%. However, this effect persisted and at 8 weeks levels averaged 2.4 +/- 0.2 mg/dl. Conjugating enzyme activity in the transplants increased from 1.4 +/- 0.3 to 2.5 +/- 0.5 mg bilirubin conjugated/mg tissue/hr. Luminal fats and bile salts appear to augment enzyme-induced bilirubin conjugation in heterotopic jejunal transplant recipients.

The use of jejunal transplants to treat a genetic enzyme deficiency.

INTRODUCTION: The Gunn rat is an excellent animal model of Crigler-Najjar syndrome, type 1. The liver and small intestine synthesize no functional bilirubin uridine diphosphoglucuronosyl transferase and, consequently, the animals cannot conjugate bilirubin. In prior studies, the authors have shown that 15- to 20-cm jejunal transplants from normal Wistar rats lowered but did not normalize serum bilirubin levels. Phenobarbital has been used to increase enzyme conjugation of bilirubin. HYPOTHESIS: Phenobarbital treatment of Gunn recipients of jejunal transplants from Wistar rats normalizes serum bilirubin levels. METHODS: Forty-three Gunn recipients of jejunal transplants from Wistar rats were divided into four groups: 1) heterotopically placed grafts (Thiry-Vella loops), saline-treated, n = 14; 2) heterotopically placed grafts, phenobarbital-treated (80 mg/kg/day), n = 17; 3) orthotopically placed (in intestinal continuity) grafts, saline-treated, n = 5; and 4) orthotopically placed grafts, phenobarbital-treated, n = 7. Serum was collected before operation and weekly for 8 weeks for measurement of serum total, indirect, and direct bilirubin levels. Animals received cyclosporine, 5 micrograms/kg, daily intramuscularly. RESULTS: Phenobarbital significantly augmented the bilirubin-lowering effect of heterotopic jejunal transplants (group 2). Mean total serum bilirubin fell from 9.14 +/- 0.01 to a nadir of 1.63 +/- 0.11 mg/dL at 6 weeks, after which time, levels began to rise toward baseline (as noted previously). Serum indirect bilirubin levels behaved in a similar fashion. Phenobarbital treatment "normalized" serum bilirubin levels in recipients of orthotopic Wistar jejunal grafts (group 4). Mean total serum bilirubin plummeted from 8.41 +/- 0.20 to 0.76 +/- 0.15 mg/dL at 1 week, and levels remained within the normal range for the entire 8-week study period. Identical changes were observed for serum indirect bilirubin levels. CONCLUSIONS: The combination of phenobarbital treatment and orthotopic small bowel transplantation may be an appropriate therapeutic alternative to liver transplantation in the management of Crigler-Najjar syndrome, type 1.

Localization and function of a 5-HT transporter in crypt epithelia of the gastrointestinal tract.

The peristaltic reflex can be evoked in the absence of input from the CNS because the responsible neural pathways are intrinsic to the intestine. Mucosal enterochromaffin cells have been postulated to be pressure transducers, which activate the intrinsic sensory neurons that initiate the reflex by secreting 5-HT. All of the criteria necessary to establish 5-HT as this transmitter have been fulfilled previously, except that no mucosal mechanism for 5-HT inactivation was known. In the current investigation, desensitization of 5-HT receptors was demonstrated to inhibit the peristaltic reflex in the guinea pig large intestine in vitro. At low concentration (1.0 nM), the 5-HT uptake inhibitor fluoxetine potentiated the reflex, but higher concentrations blocked it, suggesting that the peristaltic reflex depends on the 5-HT transporter-mediated inactivation of 5-HT. Specific (Na+ -dependent, fluoxetine-sensitive) uptake of 3H-5-HT by intestinal crypt epithelial cells was found by radioautography. mRNA encoding the neuronal 5-HT transporter was demonstrated in the intestinal mucosa by Northern analysis and located in crypt epithelial cells as well as in myenteric neurons by in situ hybridization. cDNA encoding the 5-HT transporter was cloned from the mucosa and completely sequenced. 5-HT transporter immunoreactivity was detected in crypt epithelial cells and enteric neurons. Mucosal epithelial cells thus express a plasmalemmal 5-HT transporter identical to that of serotonergic neurons. This molecule seems to play a critical role in the peristaltic reflex.

Bicycle helmets in Israel: observed change in usage following a nationwide campaign.

Bicycle-related head injuries are an important cause of injury and death among bicycle riders. The use of bicycle helmets could reduce the rate of serious head trauma among bicyclists involved in accidents. A nationwide survey was conducted in Israel to determine the usage of such helmets. This survey preceded a media campaign encouraging the use of bicycle helmets. A second survey compared the rates of helmet usage following the media campaign with those rates prior to the campaign. A modest but significant increase in the use of bicycle helmets was observed. In order to further increase this rate, additional educational campaigns are needed and possibly the enactment of legislation.