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Littoral-cell angioma LCA ; is a primary splenic vascular tumor that arises from the normal littoral cells lining the sinus channels of the splenic red pulp. We report a case of LCA of the spleen, which has been infrequently communicated in the literature. A 76-year-old man with a 2-wk history of weight loss, abdominal pain and changes in bowel habits was admitted to our hospital. Imaging studies CT and MRI ; showed multiple lesions in the spleen. Splenectomy was performed. Lining cells were positive for CD31 CD68 markers. Our case was associated with a serrated colonic adenoma. LCA is a benign vascular tumor of the spleen that needs to be included in the differential diagnosis of multiple splenic nodules.
What, for you, were the most interesting findings brought to light by the DOK trial? Ruedi Frey: The trial gave us scientific proof that organic farming methods have a rational basis. I find this extremely gratifying. I learn a great deal from my exchanges with the researchers and I glad that my suggestions and experiences are received so openly. An impressive result for me was how the potassium supply is depleted if the compost is not covered with fleece. Of course, there is not need for a long-term trial to prove that, but the DOK trial has shown up the changes over the years very well. Rainer Sax: The DOK trial has given us organic farmers self-confidence that we are on the right track. As a biodynamic farmer, it has always fascinated me how much goes on out of sight in the soil at the same time as above-ground, visible production. In this sense the scientific studies on soil processes are the most interesting for me. David Dubois: From the researcher's point of view, having had this systemic research recognized on a scientific basis through the publication in 'Science' is certainly a high point. Beyond that, I think the DOK trial is a model for exchange between farmers and scientists, between pure and applied research. The DOK trial makes it possible to describe and compare organic and.
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AstraZeneca R&D, Molndal, Sweden A.E., S.B. and School of Pharmacy and Pharmaceutical Sciences, University of Manchester, Manchester, United Kingdom A.E., B.H. ; Received December 04, 2002; accepted January 10, 2003.
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Table 2 displays the clinical and endocrine-metabolic indexes before treatment, after 6 months of metformin treatment, and after 3 months off metformin. The sequential on and off treatment effects on major variables are highlighted in Fig. 1. Metformin treatment was associated with a striking decrease in hirsutism and the free androgen index, and in circulating total testosterone, androstenedione, and DHEAS; regular cycles were reported by all girls within 4 months. Metformin treatment was also accompanied by a reduction in the hyperresponses of LH, 17-OHP, androstenedione, and DHEA to GnRH agonist; serum triglycerides, total cholesterol, and LDL cholesterol levels dropped, whereas those of HDL cholesterol rose. Upon withdrawal of metformin treatment, all of the aforementioned variables consistently returned toward pretreatment levels within 3 months; menstrual cyclicity was lost. Metformin treatment or withdrawal did not detectably affect BMI or basal serum concentrations of LH, FSH, or estradiol. At start of metformin treatment, glucose tolerance was normal in all girls 42 ; , and it remained so throughout the study. Metformin treatment and withdrawal had no detect8 ; with precocious pubarche before puberty and with ovarian and dolasetron.
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Kelli D. Herd When thinking of someone who embodies the spirit of volunteerism, one must think of Kris DiPietro. Since 2003, Kris has been a member of the Hazelwood Initiative. She has been chair of the Membership Recruitment and Development Committee since 2003. Before her involvement with HI, Kris had volunteered with various organizations throughout Hazelwood and the Pittsburgh area. In addition to HI, she continues to volunteer with Meals on Wheels and to lend her support and services to others. Kris believes that her spirit to volunteer stems from the example set by her parents. Kris' mother worked for forty years as editor of the Hazelwood Envoy, a local newspaper that stopped publishing around 1964. Her father was the first fire captain at the fire house on Flowers Avenue. Kris says her mother instilled in her the idea that living in a community doesn't just mean taking care of your yard. "You need to be an active part of the community to help it grow and to make change, " she adds. Born and raised in Hazelwood, Kris attended St. Stephen High School where she met husband of 40 years, Carl DiPietro. She and Carl have lived in Hazelwood since they married, raising their five children and now helping to raise six grand children. Kris has seen Hazelwood through its good and bad times. She remembers the racial riots when Martin Luther King Jr. was shot in 1968. Kris believes that the Hazelwood community remains scarred from those incidents. Racism was already festering throughout the community, she says. The racial tension exploded with the assassination of MLK Jr. Old feelings die hard and Kris believes that the memories of such an explosive time are passed down from generations. "The scars run deep and the community has a difficult time dealing with the racism that continues to exist in Hazelwood, " laments Kris. With organizations like HI, however, she believes things can change. The first step is seeing the organization increase its diversity to include full participation from the community. Kris believes there is a negative perception of Hazelwood that permeates throughout Pittsburgh. Some of the negativity we must own, she
22. McHorney CA, Ware JE, Lu R, Sherbourne CD. The MOS 36item short-form health survey SF-36 ; : III Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Med Care 1994; 32: 4066. Ejaz FK, Noelker LS, Schur D, Whitlatch CJ, Looman WJ. Family satisfaction with nursing home care for relatives with dementia. J Applied Geron 2002; 21: 368384. Davis MA, Sebastian JG, Tschetter J. Measuring quality of nursing home service: residents' perspective. Psychol Reports 1997; 81: 531542. Applebaum RA, Straker JK, Geron SM. Assessing Satisfaction in Health and Long-term Care: Practical Approaches to Hearing the Voices of Consumers. New York: Springer, 2000. 26. Krowinski WJ, Steiber SR. Measuring and Managing Patient Satisfaction. Chicago, IL: American Hospital Association, 1996 and doral.
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Phlebology 1994; 9: 130. CD11b CD18 in experimental venous hypertension. DA Shields, S Andaz, CA Timothy-Antoine, JB Porter, JH Scurr and PD Coleridge Smith. Phlebology 1994; 9: 130-131. Does duplex scanning assess venous valvular function. K Sommerville, J Farrah, S Sarin, JH Scurr and PD Coleridge Smith. Phlebology 1994; 9: 131-132. Leg elevation increases blood cell velocity in chronic venous insufficiency. A Abu-Own, SK Shami, JH Scurr and PD Coleridge Smith. Phlebology 1994; 9: 133. Role of low molecular weight heparins in the prevention and treatment of venous thromboembolism after surgery. S Andaz, DA Shields, JH Scurr and PD Coleridge Smith. Phlebology 1994; 9: 2-7. Plasma lactoferrin as a marker of white cell degranulation in venous disease. DA Shields, S Andaz, RD Abeysinghe, JB Porter, JH Scurr and PD Coleridge Smith. Phlebology 1994; 9: 55-58. Treatment of the critically ischaemic lower limb. DA Shield and JH Scurr. Postgrad-Med-J. 1994 Jan; 70 819 ; : 5-9. Does venous function deteriorate in patients waiting for varicose vein surgery? S Sarin, DA Sheilds, J Farrah, JH Scurr and PD Coleridge Smith. J R Soc Med 1994; 86: 21-3. Saphenous vein reflux without incompetence at the saphenofemoral junction. A Abu-Own, JH Scurr and PD Coleridge Smith. Br-J-Surg. 1994 Oct; 81 10 ; : 1452-4. Stripping of the long saphenous vein in the treatment of primary varicose veins. S Sarin, JH Scurr and PD Coleridge Smith. Br-J-Surg. 1994 Oct; 81 10 ; : 1455-8. Plasma elastase in venous disease. DA Shields, SK Andaz, S Sarin, JH Scurr and PD Coleridge Smith. Br-J-Surg. 1994 Oct; 81 10 ; : 1496-9. Neutrophil activation in experimental venous hypertension. DA Shields, S Andaz, RD Abeysinghe, JB Porter, JH Scurr and PD Coleridge Smith. Phlebology 1994; 9: 119-124. The role of inflammation in venous disease. PD Coleridge Smith, CM Butler and JH Scurr. Medicographia 1994; 16 2 ; : 23-27.
23. Ascioglu S, Rex JH, de Pauw B, et al. Defining opportunistic invasive fungal infections in immunocompromised patients with cancer and hematopoietic stem cell transplants: an international consensus. Clin Infect Dis. 2002; 34: 7-14 and dovonex.
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TO THE EDITOR: In his letter, Dr. Grucza underlines the importance of appreciating that the relationship of anxiety symptoms and panic disorder to suicide attempts may differ between community samples and inpatient groups. We agree, but with an important caveat. Such comparisons should take into account other clinical factors thought to convey risk for suicidal behavior. One of the major limitations of the studies reviewed in the article by Johnson et al. 1990 ; was the fact that axis II comorbidity and the aggression impulsivity dimension were not considered in the evaluation of suicidal status. Both cluster B personality disorder and aggression impulsivity have been found to be highly associated with suicidal acts 1 ; . A high rate of cluster B personality disorders or aggressive-impulsive traits among the subjects with comorbid depression and panic could bias the studies. We stressed this limitation in the work of Johnson et al. 2 ; . Thus, the assessment of axis I and II disorders and their comorbidity, as well as aggression impulsivity traits, should be considered when evaluating suicidal risk. Dr. Grucza inquires about the details of the multivariate and logistic regressions that were performed in order to establish the direction of the association between the anxiety variables and the status of being a suicide attempter. In the interest of conciseness, we did not publish the quantitative details of the multivariate and logistic regressions. However, all of the anxiety variables reported in Table 2 and Table 3 were included in the analyses. Dr. Grucza inquires about the exclusion of the Beck Depression Inventory score from the multivariate analysis. We did not include any self-report measures in the multivariate analysis in order to maintain uniformity of the assessment perspective. Also, since all of the subjects were depressed, we had already controlled for the relationship of depression to the status of attempter, and the hypothesis tested addressed the relationship of anxiety to suicide attempts, not to subjective depression. Suicidal behavior is determined by multiple factors, and it is critical to assess all of the major factors in individual studies to avoid gathering misleading results for individual putative correlates or risk factors. Finally, we agree that longitudinal, prospective studies are needed to test the potential predictors of suicidal behavior, including anxiety disorders and symptoms and doxil.
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THE RE-EMERGENCE OF SYPHILIS AMONG HOMOSEXUALLY ACTIVE MEN IN MELBOURNE Lee D M1, 2, Chen M Y1, Fairley C K1, 2 Melbourne Sexual Health Centre, Carlton, VIC, Australia; 2 School of Population Health, The University of Melbourne, VIC, Australia Syphilis has re-emerged as a problem among homosexually active men internationally. At the Melbourne Sexual Health Centre, an increase in early syphilis among homosexual men attending the service has also occurred. From July 2002 to December 2004, 40 homosexual men with early syphilis primary, secondary, or early latent ; attended the Centre, representing 54% of syphilis notifications in Victoria over this period. The characteristics of these men were compared with those of 76 randomly selected homosexual men who did not have early syphilis. The mean age of syphilis-infected men was 35 years range 26 to 48 ; Men with syphilis were more likely to be HIV positive OR 5.9, 95%CI: 1.8-19.0, p 0.001 ; and to have had sex with a partner from overseas in the previous 12 months OR 2.8, 95%CI: 1.2-6.9, p 0.03 ; . Sixteen 40% ; of the syphilisinfected men were HIV positive. Fourteen 35% ; men with syphilis reported no anal intercourse within the previous 12 months. This is consistent with oral sex being a significant route of syphilis transmission between men, as reported overseas. Motile spirochetes were seen with dark ground microscopy in 13 of the 21 men who had specimens collected from genital ulcers. Eight of the ten specimens tested for Treponema pallidum using polymerase chain reaction were positive. Clinicians managing homosexually active men including those who are HIV positive need to be vigilant for syphilis. The frequency of asymptomatic syphilis supports annual serological screening of men in this group. HIV POST EXPOSURE PROPHYLAXIS PEP ; COMPLETION AND ASSOCIATED SEXUALLY TRANSMITTED INFECTION STI ; CARE AT A SEXUAL HEALTH CLINIC Francia R1, Bourne C1, 2 1 Sydney Sexual Health Centre, Sydney, NSW, Australia; 2 School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia Objectives: To determine if patients prescribed HIV PEP obtained the complete 28-day course from the hospital pharmacy and the proportion of patients attending for HIV PEP that attended for an HIV test at or after 3 months and were screened for syphilis, gonorrhoea and chlamydia. Method: The Sydney Sexual Health Centre SSHC ; database was searched for HIV PEP presentations and cross-referenced with the Hospital Pharmacy records for the period March 1999 and December 2003. Results: There were 140 presentations for HIV PEP from135 patient 4 twice and one thrice ; . 97 patients were prescribed HIV PEP and 62 97 64% ; collected the 28-day supply from the pharmacy. At or after 3 months, only 30 62 48% ; of those completing dispensing and 8 35 23% ; of those who did not complete dispensing had returned for HIV testing. All tested HIV negative. 44 62 70% ; of those completing dispensing were screened for bacterial STIs detecting one case each of early latent syphilis, rectal Chlamydia and rectal gonorrhoea. Conclusion: Attendance for follow-up HIV testing postHIVPEP was sub-optimal, so a recall system is being considered at SSHC. Of those patients completing dispensing HIV PEP, 7% tested for STIs had a concurrent bacterial STI, supporting the need for STI screening at the time of HIV PEP assessment. SEXUAL HEALTH CONFERENCE: PROFFERED PAPER SESSION: MEDICAL WEDNEDSAY 24 AUGUST 2005: 9.00 10.30 AM and doxorubicin.
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FIGURE 4. Oligomerization is required for Dok to inhibit CD2-induced ERK1 2 activation. A, Jurkat J77.6 cells or cells overexpressing HA-Dok-1 WT, Y146F, and R207-208A or HA-Dok-2 WT, Y139F, and R200-201A were left unstimulated ; or were stimulated with an anti-CD2 mAb pair for the indicated amounts of time. Postnuclear lysates were immunoblotted with anti-phospho ERK1 2 Abs, and equivalent levels of ERK1 2 protein in each lane were evaluated by probing the membranes with anti-total ERK1 2 Abs in parallel Western blots. This experiment was performed at least five times on at least two independent transfectants for each of the Dok constructs. All clones selected for our experiments expressed similar amounts of transfected Dok. WB, Western blot. B, Jurkat J77.6 cells or cells overexpressing HA-Dok-1 or HA-Dok-2 were transfected with NFAT luciferase reporter plasmid and TK-Renilla luciferase constructs. After 24 h, cells were left unstimulated ; or were stimulated with anti-CD2 mAbs CD2 ; or anti-CD3 mAbs CD3 ; . Cells were harvested after 6 h, and luciferase activity was measured. The results were expressed as a percentage of the fold induction relative to maximal luciferase induction induced by treatment with PMA and ionomycin. This experiment was repeated in triplicate in three independent experiments with similar results and dronabinol.
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