Stage C3 Research Articles

Time in residence affects escape and agonistic behavior in adult male american lobsters.

Acquisition and retention of a shelter by a lobster are two of the variables that play a role in lobster agonistic interactions. Since shelter procurement and retention are important for lobster survival, behaviors related to this activity frequently outrank other daily behaviors (e.g., searching for food). Here, we examine the effects of time in residence on the parameters of the escape response of the American lobster, Homarus americanus. Adult male intermolt lobsters (Stage C4) were placed in an experimental tank for three different time periods (one hour, 24 hours, and 48 hours). The probability of eliciting an escape response was inversely related to the time spent in the tank. Eighty percent of the animals in residence for 1 h tailflipped in response to a threat, whereas only 14% of the animals in residence for 48 h tailflipped. There were also significant changes in some of the parameters of the escape response among animals in residence for 24 h compared to those in residence for 1 h. The number of tailflips and the distance traveled were reduced, although frequency, velocity, acceleration, force, and work factors were not significantly different. Furthermore, with increased time in residence, lobsters switched from an avoidance or escape-prone behavior to an aggressive-prone behavior. Most of the animals in residence for 48 h approached and attacked a threat-stimulus rather than fleeing from it. On an empirically defined "index of aggressiveness," in which various behaviors were numerically ranked from least aggressive (0) to most aggressive (6), animals residing in the tank for 1 h had an average index value of 0.1 compared to a value of 5.0 for animals in residence for 48 h. These findings are consonant with the suggestion that lobsters that have occupied a given space for an extended period of time take possession of the site and defend it instead of fleeing when threatened with a threat-inducing stimulus; it supports the idea that shelter retention increases aggressiveness and diminishes avoidance behaviors.

Die Pseudomonas-Pneumonie – eine wichtige Differentialdiagnose pulmonaler Infiltrate bei Aids

Bacterial pneumonias are the most common pulmonary complication in HIV-infected patients. Up to now, H. influenzae and S. pneumoniae have been described as the most important germs. Within a period of 4 years we diagnosed 15 cases of pneumonia caused by P. aeruginosa. All patients were in HIV stage C3; 3F, 12M; median age 34 (24-54) years; median CD4 count 10 (0-130) microliters. Except for 3 nosocomial pneumonias, all others were community-acquired. Only 3 patients had neutropenia < 1000/microliter; 7 were intravenous drug abusers. Morphologically there were 6 cases of abscess pneumonia, in 3 of which pleural drainage was necessary because of pyopneumothorax. 4 patients showed bilateral infiltrates that could not be differentiated from those of P. carinii pneumonia. Our diagnosis was based on quantitative cultures of broncho-alveolar lavage fluid (9 cases, two of them with concurrent positive blood cultures/positive cultures of the pleural fluid), pleural puncture (one case), sputum in pneumonias responding only to antipseudomonas therapy (3 cases), and autopsy (2 cases). 8 patients died of pseudomonas pneumonia within 1-3 months despite therapy. 7 patients received pseudomonas-specific combination therapy, but all died after median 9 (4-15) months of the underlying illness. In 3 cases recurrent pseudomonas pneumonia could be documented bacteriologically. We conclude that in HIV-infected patients pneumonia caused by P. aeruginosa is a significant and severe pulmonary complication.

Eyelid molluscum contagiosum in patients with human immunodeficiency virus infection

PURPOSE . Molluscum contagiosum (MC) is a common viral infection in patients with human immunodeficiency virus (HIV) infection. This study aimed to describe the relationship between the presentation of MC and the stage of HIV infection as measured by T-cell subsets. METHODS . A retrospective study is presented of 11 patients with MC of the eyelids and HIV infection in whom their CD4+ T lymphocytes were determined. RESULTS . Ten patients were in stage C3. The overall mean CD4+ count, CD4+ percentage and CD4+/CD8+ ratio were 71.63, 4.37%, and 0.085, respectively. Seven patients have died of AIDS-related conditions; the mean survival time was 12 months and the median 9 months from the diagnosis of MC. CONCLUSIONS . MC of the eyelids appears in advanced HIV infection when the CD4+ counts are less than 80 cells/µl.

Adjunctive daunorubicin in the treatment of proliferative vitreoretinopathy: results of a multicenter clinical trial

PURPOSE: To assess the efficacy and safety of adjunctive daunorubicin during vitrectomy surgery in eyes with idiopathic proliferative vitreoretinopathy (PVR). METHODS: Two hundred eighty-six eyes (286 patients) with stage C2 (Retina Society Classification, 1983) or more advanced preoperative PVR in which surgery with silicone oil was planned were enrolled in a multicenter, prospective, randomized, controlled clinical trial. Standardized surgery plus adjunctive daunorubicin perfusion was compared with surgery alone. Outcomes assessed were retinal attachment without additional vitreoretinal surgery 6 months after standardized surgery, number of and time until vitreoretinal reoperations within 1 year of standardized surgery, and change in visual acuity 1 year after standardized surgery, evaluated by photodocumentation, number of reoperations, and measurement of best-corrected visual function. Outcomes were determined 6 months after operation and reevaluated after 1 year of follow-up. RESULTS: Six months after standardized surgery, complete retinal reattachment without additional vitreoretinal surgery was achieved in 62.7% (89/142) of eyes in the daunorubicin group vs 54.1% (73/135) in the control group ( P = .07, one-sided). However, in the daunorubicin group, significantly fewer vitreoretinal reoperations were performed within 1 year postoperatively ( P = .005, one-sided) to achieve the same overall 1-year retinal reattachment rate (80.2% [105/131] vs 81.8% [103/126]). The rate of patients with no vitreoretinal reoperations was 65.5% (95/145) in the daunorubicin group vs 53.9% (76/141) in the control group. There was no difference in the best-corrected visual acuity. No severe adverse effect related to daunorubicin was identified. CONCLUSIONS: Although the rate of anatomic success after 6 months failed to show significance, some benefit of the adjunctive treatment exists, especially a tendency toward increased rate of reattachment and a significant reduction in the number of reoperations. This shows that human PVR is amenable to pharmacologic treatment.

Protease inhibitors in antiviral therapy of paediatric HIV disease

In order to evaluate clinical efficacy and safety of combination antiretroviral therapy with protease inhibitors in children with congenital HIV disease a pilot study was performed at our department. After informed consent was obtained from parents seven children aged 8-13 y (five at disease stage A2 and two at stage C3) were treated with indinavir (four cases) at 1600-2000 mg/m2/d in three daily doses or with ritonavir (three patients) at 800-1000 mg/ m2/d in two daily doses in association with one or two reverse transcriptase inhibitors (zidovudine didanosine and zalcitabine in three cases each and zidovudine plus zalcitabine in the remaining patient). After 2-4 months stavudine plus lamivudine was introduced in all children instead of previously administered reverse transcriptase inhibitors since our patients have been receiving zidovudine and/or didanosine and/or zalcitabine for > 15 months. (excerpt)

Radical Prostatectomy and Postoperative Irradiation in Patients With Pathological Stage C (T3) Carcinoma of the Prostate

Purpose: Adenocarcinoma of the prostate is the most common human cancer of internal organs. Radical surgery is regarded by many to be the treatment of choice for capsule confined disease. Since accurate preoperative assessment of tumor stage is difficult to define, many patients are subsequently found to have pathological stage C (T3) disease. These patients should be considered for adjuvant radiotherapy. Methods and Materials: A group of 201 PS C (T3) unselected patients, treated with radical prostatectomy and limited pelvic lymphadenectomy, received postoperative irradiation to the prostate bed. This radiotherapy was given between 42–90 days after surgery and consisted of a median dose of 48 Gy. Patient survival, disease free survival, time to clinical and chemical relapse and the incidence of local and systemic relapse were analyzed. The influence of multiple parameters on the treatment outcome including patient age, treatment period, clinical stage, pathological stage, Gleason’s score, prostate specific antigen (PSA), radiotherapy techniques and radiation dose were examined using univariate and multivariate analysis. Follow-up ranged from 3 to 15 years, with a median of 5 years. Results: The overall 5- and 10-year actuarial survival was 92% and 83% (median > 10 years), respectively and the 5- and 10-year disease-free survival (clinical and PSA) was 67% and 53% (median > 10 years), respectively. A total of 61 (30%) patients had a recurrence, including 23 (11%) patients who had clinical and 38 (19%) who had PSA recurrence. Of the 23 patients with clinical recurrence, 10 (5%) had local recurrence, including two patients who had local and systemic recurrence. Pathological stage and Gleason’s score were independently predictive of recurrence (each with p < 0.001 after controlling for the other). Patients in the worst prognostic category with pathological stage C3 and Gleason’s score 8–10 were predicted to be at 7.2 times the risk of recurrence, compared to stage C1 or C2 and Gleason’s score 2–7 patients. Preoperative PSA level (> 25 ng/ml) was also an important independent factor predicting tumor recurrence, p = 0.05. All other investigated parameters were not significant in predicting tumor recurrence. This treatment program was very well tolerated by the study patients, with seven (3.5%) recorded with major and 18 (9%) with minor surgical complications, while 65% of patients had minor and clinically insignificant radiation complications. Conclusion: Surgery followed by moderate dose radiotherapy in patients with PS C (T3) prostatic carcinoma was well tolerated and resulted in excellent overall and disease free survival, with a low incidence of local recurrence. New treatment strategies need to be developed for patients with C3 tumors and those with high (8–10) Gleason’s score and those with high (> 25 ng/ml) PSA level at diagnosis.

Changes in the male voice at puberty

The changes in the male voice in relation to the biological characteristics of puberty were assessed longitudinally in 26 boys. Speaking and singing fundamental frequencies were analysed in relation to...

Fifteen-year survival and recurrence rates after radiotherapy for localized prostate cancer.

To determine 15-year survival and recurrence rates after radiotherapy for localized prostate cancer. One hundred thirty-six patients with clinically localized prostate cancer treated from 1966 to 1974 with interstitial gold seed and external-beam irradiation were evaluated to determine the probability of recurrence and survival > or = 15 years after therapy. All patients were surgically staged with pelvic lymphadenectomy and none received hormonal therapy before relapse. Overall, 60 patients (44%) have never recurred, although 57% (34 of 60) of these same patients have died of causes other than prostate cancer. Local progression developed in 39% of patients and distant metastases in 42%. At 15 years, the probability of dying of prostate cancer was 33%+/-8% (% +/- 2SE) and of all causes was 72%+/-8%. In clinical stage A2 and B, 29%+/-9% of patients died of their cancer within 15 years, compared with 57%+/-21% in stage C1, while only 18%+/-8% with clinical stage A2 and B and negative lymph nodes died of cancer within this period. In contrast, the prostate cancer mortality rate at 15 years was high for patients with positive nodes regardless of the stage of the primary tumor (73% for A2 and B; 71% for C1). Patients with nodal metastases, poorly differentiated tumors, and advanced local disease all had a significantly (P < .0001) increased risk of cancer death. The cancer-specific mortality rate for patients with stage A2 and B tumors and negative nodes compares favorably with other series of patients treated with radiation therapy and > or = 15 years' follow-up evaluation. While local progression rates are high and associated with a substantial risk of prostate cancer death, many patients live with the disease and ultimately die of causes other than prostate cancer.

Structure and grazing impact of the mesozooplankton community during late summer 1994 near South Georgia, Antarctica

Mesozooplankton abundance, community structure and grazing impact were determined during late austral summer (February/March) 1994 at eight oceanic stations near South Georgia using samples collected with a Bongo and WP-2 nets in the upper 200-m and 100-m layer, respectively. The zooplankton abundance was generally dominated by copepodite stages C3–C5 of six copepod species: Rhincalanus gigas, Calanus simillimus, Calanoides acutus, Metridia spp., Clausocalanus laticeps and Ctenocalanus vanus. Most copepods had large lipid sacs. All copepods accounted for 41–98% of total zooplankton abundance. Juvenile euphausiids were the second most important component contributing between 1 and 20% of total abundance. Pteropods, mainly Limacina inflata, were important members of the pelagic community at two sites, accounting for 44 and 53% of total abundance. Average mesozooplankton biomass in the upper 200 m was 8.0 g dry weight m−2, ranging from 4.3 to 11.5 g dry weight m−2. With the exception of Calanussimillimus, gut pigment contents and feeding activity of copepod species were low, suggesting that some species, after having stored large lipid reserves, had probably started undergoing developmental arrest. Daily mesozooplankton grazing impact, measured using in situ gut fluorescence techniques and in vitro incubations, varied widely from <1 to 8% (mean 3.5%) of phytoplankton standing stock, and from 5 to 102% (mean 36%) of primary production. The highest grazing impact was found northeast of the island co-incident with the lowest phytoplankton biomass and primary production levels.

Selective serotonin reuptake inhibitor treatment of depression in symptomatic HIV infection and AIDS: Improvements in affective and somatic symptoms

Somatic symptoms often complicate the diagnosis and psychopharmacological treatment of depression in HIV illness. We treated 33 depressed HIV-positive men and women with medically symptomatic HIV or AIDS (CDC stages 2B, 2C, 3B, or 3C) in a 6 week open-label trial with sertraline, paroxetine, or fluoxetine, to assess their effectiveness and tolerability. We further assessed whether treatment of depression resulted in a reduction in both affective and somatic symptoms in this medically ill population. Twenty-four subjects (73%) completed the trial (7 on sertraline, 7 on paroxetine, 10 on fluoxetine), 20 (83%) of whom were clinical responders. Nine dropped out within 1–3 weeks of treatment because of adverse effects, mostly agitation, anxiety, and insomnia. Subjects who completed 6 weeks of SSRI treatment experienced significant reductions in both affective and somatic symptoms, many of the latter having been attributed to HIV rather than depression. These results suggest that, even in later stages of HIV illness, the contribution of depression to perceived somatic symptoms may be significant, and that these symptoms may improve with antidepressant treatment.

Preoperative radiotherapy (RT) for rectal cancer: Predictive factors of tumor downstaging and residual tumor cell density (RTCD): Prognostic implications

Purpose : To determine predictive factors and prognostic value of tumor downstaging and tumor sterilization after preoperative RT for rectal cancer. Methods and Materials : Between 1977 and 1994, 167 patients with a histologically proven adenocarcinoma (70 T2, 65 T3, 29 T4, and 3 local recurrences) underwent preoperative RT. Median dose was 44 Gy (5–73 Gy). Surgery was performed in a mean time of 5 weeks after RT. Pathologic specimens have been reviewed by the same pathologist in order to specify the modified Astler Coller classification (MAC), and to quantify the residual tumor cell density (RTCD). Results : According to the MAC, there was 9 stage 0 (5%), 10 stage A (6%), 103 stage B1–B3 (62%), and 45 stage C1–C3 (27%) tumors. Seventeen percent and 56% of the patients who received a dose ≥44 Gy had respectively a 0-A and a B tumor, compared to 4 and 69% in those who received a dose <55 Gy ( p = 0.04). Tumor differentiation and a longer interval before surgery were significantly associated with a more frequent downstaging, and preoperative staging correlated well to the postoperative pathological findings. According to the RTCD, 62 tumors (37%) showed no or only rare foci of residual tumor cells (Group 1); 62 (37%) showed an intermediate RTCD (Group 2); and 43 (26%) a high RTCD (Group 3). No predictive factor of RTCD was statistically significant. In univariate analysis, postoperative staging was a significant prognostic factor, with corresponding 5-year overall survival rates in 0-A, b, and C stages of 92, 67, and 25% ( p < 0.01). RTCD was nota prognostic factor. However, ovrall and disease-free survival rates for patients with complete pathologic response of 83% at 2 and 5 years suggested a better outcome in this subgroup of patients. Conclusion : The favorable influence of higher doses of preoperative RT on pathologic stage has been observed. Tumor differentiation, preoperative classification and time before surgery were the other predictive factors of tumor downstaging. Howwever, there was no predictive factor of complete pathologic response. Even after preoperative RT, postoperative staging remained a prognostic factor.

Serum and Secretory IgA from HIV-Infected Individuals Mediate Antibody-Dependent Cellular Cytotoxicity

The potential function of IgA anti-HIV antibodies in mediation of antibody-dependent cellular cytotoxicity (ADCC) was investigated in this study. Serum IgA isolated from HIV-seropositive subjects in stage B3 or C3 and from healthy seronegative individuals was compared to IgG and whole serum for the ability to mediate ADCC. Peripheral blood mononuclear cells isolated from uninfected donors were used as effectors against CEM-NKrcells chronically infected with the HTLV-IIIBstrain of HIV-1. Whole sera, isolated IgA, and IgG from both groups of seropositive individuals were capable of significant ADCC lysis against infected CEM-NKrcells compared to identical preparations from seronegative individuals. In comparing ADCC activity between the two seropositive groups, IgG mediated higher mean ADCC levels in the C3 group at the two highest concentrations of antibody assayed (P< 0.03), whereas IgA mediated the highest mean ADCC levels in the B3 group at all concentrations. Secretory IgA (S-IgA) isolated from colostrum of HIV-infected women was also examined for ADCC capabilities against infected CEM-NKrcells. Significant differences were observed between ADCC mediated by S-IgA from seropositive mothers compared to seronegative mothers (P< 0.04), but the amount of lysis detected was not as great as that seen with serum IgA. The presence of IgG, serum IgA, and secretory IgA antibodies capable of mediating ADCC may be critical in maintaining a functional immune response in all stages of HIV infection.

Postoperative radiotherapy for locally advanced colon cancer.

The role of adjuvant postoperative radiotherapy for locally advanced colon cancer is not well documented. Seventy-eight patients who underwent a complete resection of B2-C colon cancer received postoperative radiotherapy. Twenty-eight patients received < or = 45 Gy; 50 patients received 50-55 Gy. Twenty-seven patients received adjuvant fluorouracil-based chemotherapy. All patients were followed for a minimum of 3 years; no patients were lost to follow-up. The overall local control rate was 88%. The 5-year actuarial rate of local control was 96% after 50-55 Gy postoperative radiotherapy compared with 76% after < 50 Gy (p = 0.0095). Multivariate analysis of local control showed that only radiotherapy dose significantly influenced this end point. Cause-specific survival rates at 5 years were B2, 67%; B3, 90%; C1, 100%; C2, 61%; C3, 36%; and overall, 63%. Multivariate analysis of cause-specific survival showed that only stage significantly influenced this end point. Bowel obstruction caused by adhesions developed in three patients and required a laparotomy; radiation-induced sarcoma developed in one additional patient. Postoperative radiotherapy appears to reduce the risk of local recurrence in patients with locally advanced colon cancer. The optimal dose is probably 50-55 Gy at 1.8 Gy per fraction. Postoperative radiotherapy may improve cause-specific survival for patients with stages B3 and C2 cancers.

Renal invasive aspergilloma: Unusual infection in AIDS

Invasive aspergillosis is a devastating infection that mainly affects immunocompromised hosts. Nevertheless it is not a common infection in AIDS probably due to specific immune aspects. Even more rare in this group of patients is infection limited to the kidney without dissemination as occurred in our case reported here. He had heroin addiction, AIDS in advanced stage C3, neutropenia and received antifungal prophyllaxis as predisposing factors to aspergillosis. Despite correct therapy with Amphotericine B and drainage of one of the abscesses, he died due to antibiotic side-effects and persistence of not-drained contralateral abscess. Our experience supports the fact that we should have a high index of suspicion for fungal aetiology in kidney infection in AIDS patients with predisposing factors discussed in the text, in order to make early diagnosis and to establish prompt aggressive antifungal therapy supported by drainage of fungus collections, or even nephrectomy if required.

In vivo muscle protein synthesis rates in the American lobster Homarus americanus during the moult cycle and in response to 20-hydroxyecdysone

Simultaneous measurements of in vivo rates of protein synthesis (Ks) in claw, leg and abdominal muscles were made in the American lobster Homarus americanus at three stages of the moult cycle. Ks values are significantly elevated during the premoult (stage D2-D3) and fall during the intermoult (stage C4) periods in all three muscles. Postmoult (stage A/B) levels are not significantly elevated above intermoult levels. Intermoult levels are between 0.3 and 0.4 % protein synthesized per day. In the premoult animals, the ribosomal activity (milligrams protein synthesized per microgram RNA per day) of the claw, abdominal and leg muscles is elevated three- to fivefold. The claw muscle maintains an elevated ribosomal activity into the postmoult stage whereas, by this stage, that of the other muscle tissues has fallen to intermoult levels. The RNA/protein ratios of the three muscle groups from intermoult, premoult and postmoult animals do not show any significant differences. 18S ribosomal RNA levels fluctuate slightly, with no consistent pattern over the moult cycle. In vivo injection of premoult concentrations of 20-hydroxyecdysone (20-HE) into intermoult lobsters results in elevated Ks values and ribosomal activity for the muscles after 3 days. RNA/protein ratios remain constant in the muscles in response to injections of 20-HE in vivo. In vitro preparations of leg muscle treated with 20-HE did not show similar elevated rates of protein synthesis.

Mortality estimation for planktonic copepods: Pseudocalanus newmani in a temperate fjord

The population surface method for estimating mortality was modified to incorporate diapause of copepodid stage 5 and missing naupliar stages and applied to a 2‐yr time series of the planktonic copepod Pseudocalanus newmani in a temperate fjord. The fitted model captures nearly all of the observed dynamics of the population and yields age‐, stage‐, and time‐specific measures of mortality along with confidence limits. Average mortality rates for eggs and adult females were quite similar, as would be expected for species that carry eggs until hatching. Instantaneous mortality rates of adult males were on average 11–12 times higher than those for adult females. Average mortality rates were high for copepodid 1 (C1), declined in stages C2 through C4, and increased again at C5. This bimodal pattern of mortality with developmental stage probably results from changing susceptibility to different guilds of predators with ontogeny. Mortality rates for C5 and adult females were not significantly different between the overwintering period and the active growth season. Mortality rates of adult female P. newmani varied in a nonlinear manner with the abundance of predators as a result of predator avoidance behavior, underscoring the importance of zooplankton behavior in interpreting population dynamics.

Spatial and seasonal patterns in abundance and age-composition of Calanus finmarchicus in the Gulf of Maine and on Georges Bank: 1977–1987

The mean seasonal cycle and distribution of various life history stages of C. finmarchicus throughout the Georges Bank (GB)-Gulf of Maine (GOM) region were characterized based on 5966 MARMAP zooplankton samples collected during 106 surveys over a 10-year period (autumn 1977–autumn 1987). A high degree of seasonal and spatial variability in C. finmarchicus abundance throughout the region was evident in contoured portrayals of data, grouped into standard stations and 2-month “seasons”.Eight subareas of the Gulf of Maine-Georges Bank region were identified through cluster analysis of standard stations having similar seasonal patterns in mean abundance of C. finmarchicus stages C3, C4, C5 and adults. These were the northern Gulf of Maine (Northern GOM); southern Gulf of Maine (Southern GOM); Scotian Shelf-coastal Gulf of Maine (Scotian-Coastal GOM); Mass Bay; tidally mixed Georges Bank (Mixed GB); tidal front on the Bank separating mixed from seasonally stratified water (Tidal Front GB); seasonally stratified water on the Bank (Stratified GB) and the Continental Slope adjacent to Georges Bank (SLOPE).A distinct seasonal abundance cycle was present in all subareas, but, the magnitude and timing of annual maxima varied greatly among subareas. Peak abundance was reached early (March–April) in Mixed GB, Tidal Front GB and Mass Bay, and late (July–August) in Northern GOM and Scotian-Coastal GOM. Remaining subareas had maxima in May–June. Abundance increased 10-fold from January–February to March–April and decreased sharply from July–August to September–October in all areas except southern GOM and northern GOM. The amplitude of the annual cycle was weakest in northern GOM and southern GOM, where high concentrations of C. finmarchicus persisted year-round, and strongest in the tidally mixed shallow water on GB, where the sparsest densities of C. finmarchicus occurred most of the year. Abundance curves for the various areas converged in March–April, when C. finmarchicus was ubiquitously very abundant (> 104/10 m2), and diverged from September to December.C. finmarchicus stage distribution in the GB-GOM area was highly negatively correlated with mean water column temperature during the stratified season. This seemed more related to the hydrography of the region, which isolates warmer well mixed Georges Bank from the Gulf of Maine and the stratified areas on the Bank, than to temperature, because Calanus abundances decline on the Bank before water temperatures exceed their preferences.A large part of the spatial and seasonal variation in C. finmarchicus abundance and age structure appears to be tightly coupled to major hydrographic regimes and to major circulation patterns in the region. There was a sharp ecotone between well-mixed Georges Bank and the Gulf of Maine as defined by C. finmarchicus abundance patterns and life history distributions. The ecotone is present year-round but is most apparent during the stratified season (May–October), when thermohaline density gradients and the near-surface current jet along the northern flank are generally strongest. The Gulf of Maine had the highest abundances of C. finmarchicus, and lowest spatial and seasonal variation in the region, while tidally mixed Georges Banks displayed the opposite pattern. This indication of stable population centers in the Gulf of Maine would make it a major source of Calanus in the region, particularly during March–April. Distributional patterns also suggest a strong Calanus influence from Scotian Shelf water in northern Gulf of Maine and on the southern flank of Georges Bank.

Dysregulation of the polymorphonuclear leukocyte--Candida spp. interaction in HIV-positive patients.

In HIV-infected patients there is an increased frequency of fungal infections. Dysregulation of the response of phagocytic cells to fungal pathogens may be involved. Phagocytosis of Candida spp., consecutive intracellular production of reactive oxygen species, and candicidal activity were analysed in polymorphonuclear leukocytes (PML) from HIV-1-infected patients, who were at stage C3 of the 1993 revised Centers for Disease Control and Prevention classification system, by means of flow cytometry. Phagocytic ability was assessed by measuring uptake of fluorescein isothiocyanate-labelled Candida albicans, C. krusei and C. glabrata. Reactive oxygen intermediate production was estimated by the quantity of dihydrorhodamine-123 converted to rhodamine-123 intracellularly. The candicidal effect was assessed by the propidium iodide uptake of killed yeast cells. As compared to PML of healthy, HIV-negative controls, PML of AIDS patients exhibited an increased phagocytic activity and a similar ability to generate reactive oxygen products. In contrast, PML of AIDS patients displayed a decreased candicidal activity (P < 0.05 compared to controls). These results suggest that in patients with advanced HIV-1 infection the impairment of non-oxidative killing mechanisms of phagocytic cells may contribute to the high incidence of fungal infections.

Detection of microsporidia (Enterocytozoon bieneusi) in intestinal biopsy specimens from human immunodeficiency virus-infected patients by PCR.

Intestinal microsporidiosis has been implicated as a major cause of chronic diarrhea in human immunodeficiency virus (HIV)-infected patients. So far diagnosis depends on direct visualization of the parasites by light and transmission electron microscopy. We evaluated the diagnostic value of microsporidian DNA amplification by PCR on duodenal biopsy specimens obtained from patients with and without intestinal microsporidiosis caused by Enterocytozoon bieneusi. Thirteen HIV-infected patients (all CDC stage C3) were studied. Eight patients had intestinal microsporidiosis caused by E. bieneusi (n = 6), Septata intestinalis (n = 1), and Encephalitozoon cuniculi (n = 1); microsporidioses were diagnosed by light microscopy of stool samples and confirmed by light and electron microscopy of intestinal biopsy specimens. Five patients had no microsporidia in their stool samples or in their intestinal biopsy specimens, as examined by light and electron microscopy. Additionally, DNA prepared from Toxoplasma gondii derived from mouse ascites was used as a further control. A 353-bp DNA fragment of the small-subunit rRNA gene could be amplified from all six biopsy specimens infected with E. bieneusi, and the nature of the PCR products was confirmed by Southern blot hybridization. No amplification of DNA fragments was seen by using DNA extracted from biopsy specimens with S. intestinalis or E. cuniculi infection or without microsporidian infection and with template DNA extracted from T. gondii. The results suggest that PCR testing of intestinal biopsy specimens may be a useful approach to diagnosing microsporidiosis in HIV-infected patients.

Adjuvant postoperative radiotherapy for adenocarcinoma of the rectum and rectosigmoid. A retrospective analysis of locoregional control, survival, and prognostic factors on 178 patients.

Results are presented of a retrospective study on 178 patients receiving adjuvant postoperative radiotherapy after curative surgery for adenocarcinoma of the rectum and rectosigmoid. Tumorstages according to Gunderson-Sosin were B2: 67, B3: 5, C1: 9, C2: 94, and C3: 3. Median total dosage was 50 Gy (range: 10-66 Gy), with a median dose per fraction of 2.0 Gy, 5 fractions per week. The censored overall 5-year survival rate was 42%, and 5-year disease-free survival rate was 37%. The respective rates for stage B2 patients (n = 67) were 59% and 53%, and for stage C2 patients (n = 94), 25% and 25%. Recurrences occurred in 89% within 3 years, 8% in the fourth, and 1% in the fifth year of follow-up. Five-year local relapse rates were 27% for the stage B2 tumors and 40% for the stage C2 tumors. For survival, stage (P = .006), grade (P = .02), fixation at surgery (P = .03), and gender (P = .03) were independent prognostic factors. With local relapse-free probability (LRFP) as endpoint, grade (P < .02) was an independent prognostic factor. Dose of radiation was not of prognostic significance, neither for survival (P = .63) nor for LRFP (P = .61). Since improvement should be made in locoregional control, initiatives are taken to start preoperative radiotherapy; furthermore, the key role of surgery is emphasized.