Bleomycin-induced chromosome damage in lymphocytes indicates inefficient DNA repair capacity in breast cancer families

In vitro mutagen susceptibility has been observed as a predictor of cancer risk. To evaluate susceptibility to mutagen, we have studied the response to in vitro bleomycin (BLM) treatment in cultured peripheral blood lymphocytes (PBL) of 9 breast cancer families (BCFs). Eleven breast cancer patients (BCPs) and 36 healthy blood relatives (HBRs) from BCFs were included in the study. Data were compared with 22 healthy control women. The frequencies of chromosomal aberrations were evaluated after exposure to BLM in the last five hours. Mean frequency of BLM-induced chromosomal aberrations per cell (CA) observed among BCPs was significantly higher as compared to their HBRs as well as control subjects. Moreover, mean BLM-induced CA/cell value observed for HBRs was also significantly higher than that of control subjects. In comparison to controls, it was observed that there was four times more cancer risk in BCPs (OR=4.148, 95% CI=5.83-687.46) and 2.5 times more cancer risk in HBRs (OR=2.67, 95% CI=5.31-39.25). Lymphocytes from 90% of BCPs and 69% of HBRs were found to be sensitive to BLM (using a cutoff value = controls group mean + 1 SD). Thus, lymphocytes of BCPs and their HBRs were more sensitive to BLM exposure as compared to controls. Our finding indicated inefficient DNA repair capacity in BCFs. The HBRs in BCFs, having increased BLM-sensitivity, may be at higher risk to develop a similar cancer.     

Outbreak of surgical wound infections associated with total hip arthroplasty.

OBJECTIVES: Describe an outbreak of surgical wound infections associated with total hip arthroplasty; identify risk factors for surgical wound infection during the pre-outbreak and outbreak periods. SETTING: A 100-bed hospital. From May 1 to September 30, 1988, 7 of 15 patients who underwent total hip arthroplasty developed surgical wound infections from Staphylococcus aureus (5), Enterobacter cloacae (1), beta-hemolytic streptococci (1), enterococci (1), coagulase-negative staphylococci (1), and Escherichia coli (1) (attack rate = 46.7%). DESIGN: Retrospective cohort studies comparing surgical wound infection rates by patient- and procedure-related risk factors during the pre-outbreak and outbreak periods were conducted. Drop plate quantitative air culturing was conducted in 10 consecutive total hip arthroplasties in the subsequent 6 months. RESULTS: Rates of surgical wound infection were surgically higher for arthroplasties in which no intraoperative prophylactic antimicrobials were given (44% versus 8%, relative risk [RR] = 5.4, p = .01), or in which the posterior approach (20% versus 3%, RR = 6.7, p = .04) or a specific prosthesis (39% versus 5%, RR = 6.3, p = 0.01) was used. The surgical wound infection rate was highest when one circulating nurse, Nurse A, assisted (47% versus 4%, RR = 12.8, p less than .001). Logistic regression analysis identified use of the posterior approach (RR = 1.8, p = .04) and Nurse A's participation (RR = 5.0, p less than .001) as independent risk factors for surgical wound infection. Interviews of the nursing supervisor indicated that Nurse A had recurrent dermatitis on her hands. During 6 months following Nurse A's reassignment, the rate declined significantly (from 7/15 to 0/10, p = .01). Drop plate culturing yielded 2 to 10 colonies per plate of organisms that did not match outbreak organisms. CONCLUSIONS: Outbreaks associated with personnel generally involve only 1 species. In this outbreak, Nurse A (possibly because of her dermatitis), technique, the posterior approach, and/or other undetermined factors were the primary predictors of surgical wound infection.     

Voice disorders in teachers and the general population: effects on work performance, attendance, and future career choices.

To examine the frequency and adverse effects of voice disorders on job performance and attendance in teachers and the general population, 2,401 participants from Iowa and Utah (n1 = 1,243 teachers and n2 = 1,279 nonteachers) were randomly selected and were interviewed by telephone using a voice disorder questionnaire. Teachers were significantly more likely than nonteachers to have experienced multiple voice symptoms and signs including hoarseness, discomfort, and increased effort while using their voice, tiring or experiencing a change in voice quality after short use, difficulty projecting their voice, trouble speaking or singing softly, and a loss of their singing range (all odds ratios [ORs] p <.05). Furthermore, teachers consistently attributed these voice symptoms to their occupation and were significantly more likely to indicate that their voice limited their ability to perform certain tasks at work, and had reduced activities or interactions as a result. Teachers, as compared with nonteachers, had missed more workdays over the preceding year because of voice problems and were more likely to consider changing occupations because of their voice (all comparisons p <.05). These findings strongly suggest that occupationally related voice dysfunction in teachers can have significant adverse effects on job performance, attendance, and future career choices.     

Total gastric necrosis in a neonate.

Necrosis of the entire stomach is extremely rare in neonates. We report a case of total gastric necrosis in a full-term neonate. The possible pathophysiology, diagnostic features and therapeutic options for gastric necrosis in a newborn are discussed.     

Nonpharmacological treatment of reflex syncope

Clinical Autonomic Research - Reflex syncope is a common medical problem. Vasovagal reflex syncope is the most frequent form. Although the prognosis of the disorder is excellent, it may impose...     

Memory performance,self-reported memory loss and depressive symptoms in attenders at a GP-referral and a self-referral memory clinic

Reports of declining memory are common with increasing age. Sometimes these are corroborated by poor memory test performance, but often they appear to be more closely related to depressive symptomatology. As pharmacological treatments emerge for improving cognition in the elderly, understanding the aetiology of memory complaints will become increasingly important. This article compares memory performance, reports of memory loss and depressive symptoms in attenders at a GP-referral and a self-referral memory clinic, with age- and sex-matched community controls. The GP-referred patients were older, had lower MMSE scores and had levels of memory complaint and depression between the control and self-referred subjects. The self-referrers had cognitive test performance similar to community controls but complained more of memory loss, were more depressed and more frequently reported a past history of treated depression. Self-presentation of memory complaint appears to be more closely related to affective and possibly personality factors than memory test performance.     

Pallister-Killian syndrome: characterization of the isochromosome 12p by fluorescent in situ hybridization.

The isochromosome 12p (i(12p)) in fibroblasts of 3 patients with Pallister-Killian syndrome and one decreased prematurely born neonate, was characterized by fluorescent in situ hybridization (FISH) using chromosome 12-specific DNA probes. FISH is a useful technique for rapid and reliable detection and characterization of the i(12p) chromosome in Pallister-Killian patients. Detection was possible also in interphase cells. In addition, the in vitro selection against i(12p) cells at different passages in fibroblast cultures of two patients was monitored.     

Identification of a Homolog of CcpA Catabolite Repressor Protein in Streptococcus mutans

A locus containing a gene with homology to ccpA of other bacteria has been cloned from Streptococcus mutans LT11, sequenced, and named regM. Upstream of the regM gene, on the opposite strand, is a gene encoding an X-Pro dipeptidase, pepQ. A 14-bp palindromic sequence with homology to the consensus catabolite-responsive element sequence lay in the promoter region between the two genes. To study the function of regM, the gene was inactivated by insertion of an antibiotic resistance marker. Diauxic growth of S. mutans on a number of sugars in the presence of glucose was not affected by disruption of regM. The loss of RegM increased glucose repression of α-galactosidase, mannitol-1-P dehydrogenase, and P-β-galactosidase activities. These results suggest that while RegM can affect catabolite repression in S. mutans, it does not conform to the model proposed for CcpA in Bacillus subtilis.