Notes on the Occurrence of Oligonychus milleri (McGregor) and Oligonychus ununguis (Jacobi) (Acari: Tetranychidae) in Brazil.

We verified infestation of Oligonychus milleri (McGregor) on plantations of Pinus caribaea (Pinaceae) and of Oligonychus ununguis (Jacobi) on plantations of Eucalyptus urophylla x Eucalyptus grandis (Myrtaceae) in State of Rondônia, Northern region of Brazil. This represents the first record of O. milleri in Brazil. Oligonychus ununguis was recorded previously, on cypress. The damage caused by these two spider mites in the plantations is described herein.

Population fluctuation and damage caused by phytophagous mites on three rubber tree clones.

Our aim was to investigate the population fluctuation and the damage caused by the phytophagous mites Calacarus heveae Feres, Tenuipalpus heveae Baker, and Eutetranychus banksi (McGregor) on clones FX 2784, FX 3864, and MDF 180 in rubber tree crops from southeastern Bahia, Brazil. Moreover, we tested for the influence of climatic variables on occurrence patterns of these species throughout weekly samples performed from October to April. The infestation peaks was between mid-January and late February. The clones FX 2784 and FX 3864 had the highest infestations and more severe damage possibly caused by C. heveae, which was the most frequent and abundant species in all clones. We found that sunlight duration and rainfall were the most important factors for C. heveae while T. heveae was affected by rainfall and temperature. Eutetranychus banksi was only affected by sunlight duration. However, the best models had low goodness of fit. We concluded that the clones FX 2784 and FX 3864 had a higher susceptibility to mite attack, and the association between climatic variables and favorable physiological conditions were determinant for the population increase of the species from January to April.

Concentric retinitis pigmentosa: clinicopathologic correlations.

Progressive concentric (centripetal) loss of vision is one pattern of visual field loss in retinitis pigmentosa. This study provides the first clinicopathologic correlations for this form of retinitis pigmentosa. A family with autosomal dominant concentric retinitis pigmentosa was examined clinically and with visual function tests. A post-mortem eye of an affected 94 year old family member was processed for histopathology and immunocytochemistry with retinal cell specific antibodies. Unrelated simplex/multiplex patients with concentric retinitis pigmentosa were also examined. Affected family members of the eye donor and patients from the other families had prominent peripheral pigmentary retinopathy with more normal appearing central retina, good visual acuity, concentric field loss, normal or near normal rod and cone sensitivity within the preserved visual field, and reduced rod and cone electroretinograms. The eye donor, at age 90, had good acuity and function in a central island. Grossly, the central region of the donor retina appeared thinned but otherwise normal, while the far periphery contained heavy bone spicule pigment. Microscopically the central retina showed photoreceptor outer segment shortening and some photoreceptor cell loss. The mid periphery had a sharp line of demarcation where more central photoreceptors were near normal except for very short outer segments and peripheral photoreceptors were absent. Rods and cones showed abrupt loss of outer segments and cell death at this interface. It is concluded that concentric retinitis pigmentosa is a rare but recognizable phenotype with slowly progressive photoreceptor death from the far periphery toward the central retina. The disease is retina-wide but shows regional variation in severity of degeneration; photoreceptor death is severe in the peripheral retina with an abrupt edge between viable and degenerate photoreceptors. Peripheral to central gradients of unknown retinal molecule(s) may be defective or modify photoreceptor degeneration in concentric retinitis pigmentosa.

Benign solitary lung lesions in patients with cancer.

The appearance of a lung opacity on a chest film of a patient with known cancer may present a diagnostic dilemma. From 1940 through 1975, over 800 patients with this problem underwent thoracotomy for confirmation of diagnosis. In some 500 of these patients, the lesion proved to be primary cancer of the lung; in 196 they were solitary metastases and in 11 patients the lesions were benign. There were six additional patients in whom multiple opacities were found which proved to be benign conditions. An approach to the investigation, diagnosis, and surgical management of such solitary pulmonary lesions is presented. It is emphasized that the appearance of a solitary pulmonary shadow in a patient with a history of cancer should not be assumed to be a metastasis. Appropriate investigations should be performed without delay in an effort to define the nature of the lesion by microscopic analysis permitting definitive therapy to be administered and a more accurate prognosis provided.

Separate primary carcinomas of the esophagus and head and neck region in the same patient.

From 1949 to 1972 at Memorial Sloan-Kettering Cancer Center, 60 patients with primary cancers of both the oral cavity, pharynx, larynx (OPL) and esophagus were studied. In 15, the cancers occurred synchronously, and in 68% they occurred within 2 years of each other, the longest interval being 27 years. The tongue and extrinsic larynx were the most common sites of origin together with the middle third of the esophagus. During the same period, over 7000 patients with OPL and over 1000 patients with esophageal cancers were seen at this institution. The majority of patients had a history of excessive smoking and alcohol intake. Four out of nine who had previous radiation therapy for their OPL cancer developed esophageal cancer within the therapeutic field (three after 16, 25, and 27 years). Thirty percent (18/60) had three primary cancers; one had four, of which two were in the head and neck region. Two patients survived more than 5 years; both also had a third primary cancer of the lung. There are broader implications in this study: multiple primary cancers in general, and this group in particular, give us especially valuable clues as to the oncogenic influence of environmental factors as well as cellular, organ, and also systemic susceptibility. With one cancer, one can anticipate formation in other related organs. This provides an opportunity for early diagnosis, more effective management, and improved survival. The cause and effect relationship of tobacco and alcohol must be emphasized at every opportunity and most particularly to those who have developed one cancer in the oropharyngeal-laryngeal region.

Surgical treatment of 297 soft tissue sarcomas of the lower extremity.

The results of surgical treatment of 297 soft tissue sarcomas arising in the lower extremity were critically examined. En bloc wide soft part resection (158 cases) yielded five and ten year survival rates of 63% and 50%. Amputation or major disarticulation (139 cases) gave corresponding survival rates of 45% and 29%. The most frequent cause of treatment failure was distant metastases, commonly in the lungs. The tissue type of sarcoma, histologic grade of malignancy, and tumor size appear to be important determinants of survival irrespective of the type of surgical treatment. Local recurrence of sarcoma occurred in 18% of the cases, more commonly after soft part resections than amputations. The proximity of a sarcoma to major vessels, bone or joint tends to compromise the margins of a wide soft part resection, thus increasing the risk of local recurrence. In appropriate cases, the scope of soft part resection can be extended by en bloc excision of the femoral vessels, with the hope of improving local control of sarcoma. Amputation should br resorted to if an adequate margin of resection cannot otherwise be obtained. This decision must be weighted against the high frequency of distant metastases in this disease. Postoperative adjuvant chemotherapy and immunotherapy offer prospects of prevention of this tragic outcome.

Significance of a solitary lung shadow in patients with breast cancer.

From 1949 through 1972 at Memorial Sloan-Kettering Cancer Institute, 72 breast cancer patients developed a synchronous or metachronous solitary lung shadow. Forty-three had separate primary lung cancers; 23 had breast carcinoma metastases and six had benign lung lesions. Of these, 47% were asymptomatic and the lesions were discovered by routine chest roentgenograms. Among 49 patients who underwent pulmonary procedures, secondary involvement of regional lymphatics was noted in 22, nine of which were daughter metastases secondary to the breast deposit. In such a setting, a radical lobectomy (or pneumonectomy) would seem the operation of choice. Four patients who had primary lung cancer and five patients with pulmonary breast metastases survived five years after the thoracic procedure. Prolonged survival in these patients bore no relationship to age, sex, state of axillary lymph nodes or length of interlude between the breast and the lung cancer. Early diagnosis, the extent of the cancer and adequate excision seem to influence end results. When other primary cancers were present, in addition to those of breast and lung, these did not seem to diminish the chance for survival provided they were treated as if they existed alone. The need for strict periodic and continual followup examinations, not only in breast, but also for all cancer patients is essential for early detection of metastases or new primaries. Chest roentgenograms are an integral part of such a plan. The ambiguity of a solitary lung shadow (or at the most two or three opacities) with a known primary breast cancer requires clarification without delay as to its histologic nature so that proper treatment can be instituted and an accurate prognosis given.

Major hepatic resection using vascular isolation and hypothermic perfusion.

The technique and results of 29 major hepatic resections using the method of complete vascular isolation and hypothermic perfusion of the liver are reported. The method enables the surgeon to perform otherwise difficult or impossible resections through chilled bloodless hepatic parenchyma. Major intrahepatic vascular structures can thus be recognized and controlled readily under clear vision. Direct neoplastic involvement of, or tumor thrombi in the portal vein, hepatic vein or vena cava, can be successfully dealt with by appropriate surgical measures. The operative mortality was 10.3% for this series which included many tumors previously deemed unresectable. The technical detail and intraoperative physiologic monitoring crucial to success in the use of the method are described. It is hoped that with the widened scope of resectability afforded by this technique, and the use of adjuvant chemotherapy, the currently experienced low cure rates for hepatic cancer can be improved.