Temporary remission of an alveolar rhabdomyosarcoma diagnosed and treated as acute leukemia

A 29-year-old man with alveolar rhabdomyosarcoma was considered to be suffering from acute leukemia. A bone marrow aspirate had revealed extensive infiltration by atypical blast-like cells which were interpreted as acute lymphoblastic leukemia. Although there was no confirmation of this diagnosis by immunophenotyping chemotherapy with a protocol suited for the treatment of acute lymphoblastic leukemia was started prior to histological analysis and resulted in a complete temporary remission after the first cycle. Histological analysis of a bone marrow biopsy revealed an alveolar rhabdomyosarcoma, as further confirmed by molecular genetic analysis. Two months after the end of chemotherapy, there was an extensive recurrence and the patient died one year after initial diagnosis with chemotherapy refractory disease. In conclusion, rhabdomyosarcoma should always be included in the differential diagnosis of systemic diseases with extensive bone marrow infiltration by tumor cells which could otherwise be misinterpreted as a haematological malignancy.     

Manpower Studies for the United States: Part II Demand for Eye Care A Public Opinion Poll Based upon a Gallup Poll Survey

This is the second in the series of Ophthalmology Manpower Studies. Part I presented estimates of disease prevalence and incidence, the average amount of time required to care for such conditions, and based on that information, the total hours of ophthalmological services required to care for all the projected need in the population. Using different estimates of the average number of hours worked per year per ophthalmologist (based on a 35, 40 and 48 hours/week in patient care), estimates of the total number of ophthalmologists required were calculated. This method is basically similar to the method later adopted by the Graduate Medical Education National Advisory Committee (GMENAC) to arrive at estimates of hours of ophthalmological services required for 1990. However, instead of using all the need present in the population, the GMENAC panel chose to use an "adjustedneeds based" model as a compromise between total need and actual utilization, the former being an overestimation and the latter being an underestimation since it is in part a function of the barriers to medical care.Since some of these barriers to medical care include informational factors, as well as availability and accessability, this study was undertaken to assess the utilization of these services and the adequacy of present ophthalmological manpower in the opinion of the consumer. Also, since the consumer's choice or behavior depends on being informed about the differences between optometrists and ophthalmologists, such knowledge was assessed and the responses further evaluated after explanatory statements were made to the responders.     

The implications of copper fungicide usage in vineyards for earthworm activity and resulting sustainable soil quality

To investigate the impact of copper-containing fungicides (copper oxychloride) on earthworms in South African vineyards, field inventories of earthworms in and between vine rows were carried out and compared to directly adjacent grassland. Also copper content, pH, organic matter content, and soil porosity were determined in these soils. This was combined with laboratory experiments to study the impact of vineyard soil characteristics on the burrowing and dispersal behavior of earthworms. Moreover, the direct toxic action of copper oxychloride on different endpoints of the earthworms (survival and growth) was studied. Copper oxychloride had a negative impact on these endpoints (decreased growth and survival related to increased copper body content) as well as on the behavioral aspect (decreased burrowing rate and avoidance of copper-containing soil). Moreover, there was an inverse relation between burrowing activity and soil bulk density that could also be related to the copper content. This may lead to a decrease in sustainable soil quality in vineyards.