Bladder Cancer and Arsenic Exposure： Differences in the Two Populations Enrolled in A Study in Southwest Taiwan

Objective Analyses of bladder cancer mortality in the Black Foot Disease (BFD) endemic area of southwest Taiwan conducted by Morales et al. showed a discontinuity in risk at 400 μg/L arsenic in the drinking water in a stratified analysis and no discontinuity in a continuous analysis.     

The relationship context of contraceptive use at first intercourse

CONTEXT: Despite widespread efforts to increase contraceptive use to prevent both pregnancy and sexually transmitted diseases among sexually active adolescents, most prior work examining adolescent contraceptive use does not explicitly recognize that sexual decision-making inherently involves both partners in a couple. METHODS: An analytic sample of 1,593 females who first had intercourse during adolescence (prior to age 18) was drawn from the 1995 National Survey of Family Growth. Logistic regression and multinomial logistic regression techniques were used to model the effects of sexual partners' characteristics and relationship type on contraceptive use at first intercourse and contraceptive method selected at first intercourse. RESULTS: Approximately 31% of respondents used no contraceptive method at first intercourse. Roughly half (52%) of adolescents who had just met their sexual partner used no method, compared with 24% of those who were going steady. Whereas 75% of teenagers who practiced contraception at first intercourse used a condom, 17% relied on the pill. In multivariate models, net of other variables, adolescents who had just met their partner had 66% lower odds than those who were going steady of practicing contraception at first intercourse. Individual-level factors that influenced contraceptive use at first intercourse were age at first intercourse, race or ethnicity family type, parents' education, grades in school and receipt of birth control education prior to first intercourse. Differences between respondents and their partner in age and race or ethnicity mostly were not significantly related to method use at first intercourse. One exception was that adolescents who first had sex with a man six or more years older had reduced odds of practicing contraception. Type of relationship was significantly associated with method selection only among adolescents who were just friends with their first partner, who had higher odds of using "other" methods rather than the condom. Variables associated with pill use rather than condom use were age at first sex, race, family type, mother's education and school grades. CONCLUSIONS: Further efforts to understand contraceptive choice among adolescents should focus on relationship features. Research on the decision-making process surrounding contraceptive use may benefit from treating this as a partner decision and not just as a decision made by one member of the couple. Further research examining the qualities of the relationship may provide important clues for understanding adolescent contraceptive choice.     

Total but not resting energy expenditure is increased in infants with ventricular septal defects

OBJECTIVE: The purpose of this study was to determine the effect of left-to-right shunting on the resting energy expenditure (REE), total energy expenditure (TEE), and energy intake in a group of 3- to 5-month-old infants with moderate to large unrepaired ventricular septal defects (VSDs) compared with age-matched, healthy infants. METHODS: Eight infants with VSDs and 10 healthy controls between 3 to 5 months of age participated in the study. Indirect calorimetry was used to measure REE and the doubly-labeled water method was used to measure TEE and energy intake. An echocardiogram and anthropometric measurements were performed on all study participants. Daily urine samples were collected at home for 7 days. Samples were analyzed by isotope ratio mass spectrometry. Data were compared using analysis of variance. RESULTS: No significant differences were found in REE (VSD, 42.2 +/- 8.7 kcal/kg/d; control, 43.9 +/- 14.1 kcal/kg/d) or energy intake (VSD, 90.8 +/- 19.9 kcal/kg/d; control, 87.1 +/- 11.7 kcal/kg/d) between the groups. The percent total body water was significantly higher in the VSD infants and the percent fat mass was significantly lower. TEE was 40% higher in the VSD group (VSD, 87.6 +/- 10.8 kcal/kg/d; control, 61.9 +/- 10.3 kcal/kg/d). The difference between TEE and REE, reflecting the energy of activity, was 2.5 times greater in the VSD group. CONCLUSIONS: REE and energy intake are virtually identical between the two groups. Despite this, infants with VSDs have substantially higher TEE than age-matched healthy infants. The large difference between TEE and REE in VSD infants suggests a substantially elevated energy cost of physical activity in these infants. These results demonstrate that, although infants with VSDs may match the energy intake of healthy infants, they are unable to meet their increased energy demands, resulting in growth retardation.     

Isolation and characterization of propagable cell lines (HUNC) from the androgen-sensitive Dunning R3327H rat prostatic adenocarcinoma

The Dunning H rat prostate tumor (R3327H) is a widely used experimental model of human prostatic adenocarcinoma (CaP). The Dunning H tumor has been characterized as androgen-sensitive, androgen-receptor (AR) positive, prostate-specific antigen and prostatic acid phosphatase (PAP) positive. To date, the tumor has been maintained by serial passage in vivo because of the lack of an in vitro cell line that retains the characteristics of the in vivo tumor. The objective of the present study was to establish a propagable cell line from R3327H adenocarcinoma that maintained androgen sensitivity and expression of AR, PSA and PAP. Tissue harvested from an in vivo R3327H tumor was dissociated with collagenase and placed into Richter's improved media (with supplements). A cytokeratin-positive epithelial cell line (HUNC- E) and a vimentin-positive stromal cell line (HUNC-S) were generated from the primary culture, subcultured continuously for >300 days, and passaged >50 times. Survival of the HUNC-E cell line in vitro depended on several media supplements, including nicotinamide, insulin, transferrin, selenium and epidermal growth factor (EGF). HUNC-E cells expressed AR and produced PSA and PAP throughout the culture period, as confirmed by immunocytochemistry and Western blot analyses. Addition of 14 nM testosterone (T) or dihydrotestosterone (DHT) to HUNC-E cells, stimulated DNA synthesis as well as anchorage-independent growth and PSA production, which demonstrated the androgen-sensitive nature of the cells in vitro. When HUNC-E and HUNC-S cells were combined in a 3:1 ratio and introduced subcutaneously into syngeneic male hosts, tumors formed in 2/3 animals with an average latency of 7 months. RT-PCR and immunocytochemical characterization of the HUNC cell lines revealed that the cells expressed several growth factors and their cognate receptors, including HGF, TGF-alpha and the TGF-betas, indicating the establishment of potential autocrine loops in the neoplastic cells. The HUNC-E and HUNC-S CaP cell lines, which retain the characteristics of the epithelial and stromal components of the in vivo R3327H tumor, will allow a more thorough and informative molecular and biological analysis of prostatic adenocarcinoma.      

Oestrogen-regulated genes in breast cancer: association of pLIV1 with response to endocrine therapy.

Northern hybridization analyses of the oestrogen-inducible mRNAs pLIV1 and pS2 were compared with oestrogen receptor (ER) immunocytochemistry assessments in 40 untreated primary or early recurrent breast tumours. Significant associations were observed between pLIV1/ER (P < 0.03), pS2/ER (P < 0.001) and pLIV1/pS2 (P < 0.04) status. After disease recurrence, patients were treated with assessable courses of endocrine therapies. Positive pLIV1, pS2 and ER statuses in primary disease were consequently found to be predictive of endocrine responsiveness in the secondary lesions (P < 0.03, P < 0.02, P < 0.005 respectively). However, despite these associations, a number of pLIV1- and/or pS2-positive tumours failed to respond to therapy.     

Presumed consent in emergency neonatal research

Current methods of obtaining consent for emergency neonatal research are flawed. They risk aggravating the distress of parents of preterm and other sick neonates. This distress, and the inevitable time constraints, compromise understanding and voluntariness, essential components of adequately informed consent. Current practice may be unjust in over-representing babies of more vulnerable and deprived parents. The research findings may thus not be generalisable. Informing parents antenatally about the possible need for emergency neonatal research, with presumed consent and scope for opting out, would address these problems. It would spare parents of sick neonates, already terrified by their baby's illness, further distress. Experience with opting out suggests that recruitment might increase, thus generating earlier results, without compromising parental understanding of the nature and purpose of the research.     

STRESS FRACTURES: EFFECT OF PRIOR PHYSICAL ACTIVITY,SPORTS PARTICIPATION AND MILITARY TRAINING

A study was carried out to find out the effects of prior physical activity, sports participation and prior military training on the incidence of stress fractures among Gentlemen Cadets (GC''s) undergoing military training at Indian Military Academy (IMA). One thousand and fourteen GC''s were followed up for a period of 12 weeks. Thirty-seven GC''s developed stress fractures during the study period. The incidence of stress fractures was significantly higher in GC''s without any prior military training (p=0.0009). They were compared with 100 healthy controls drawn from the study population to study the influence of the other mentioned factors. There was no significant association between prior physical activity and stress fractures (OR=0.74, 95% CL=0.26 to 2.05, p=0.688). There was also no significant relationship between sports participation and stress fractures (OR=0.79. 95% CCL=0.35 to 1.81, p=0.684).KEY WORDS: Risk factors, Stress fractures     

Ultrasound evaluation of the multifetal gestation

With the increasing incidence of multifetal gestations, it is essential for the clinician to appreciate the benefit of ultrasound evaluation in these pregnancies. Multifetal gestation pregnancies are at increased risk for a range of both antepartum and intrapartum complications, such as intrauterine growth restriction, premature delivery, congenital anomalies, cord accidents, malpresentations, placenta previa, and abruptio placentae. First-trimester ultrasonic evaluation, amniotic fluid assessment, monitoring of fetal growth, diagnosing the twin-to-twin transfusion syndrome, and assessment of fetal anomalies will be reviewed. An early and accurate assessment of amnionicity and chorionicity are paramount in these gestations. The impact of chorionicity, in particular, can have profound consequences in the management of multifetal gestations. The determination of chorionicity onultrasonic evaluation in a multifetal gestations. The determination of chorionicity on ultrasonic evaluation in a multifetal pregnancy should be determined in a systematic way between 10-14 weeks' gestation. The amniotic fluid volume should be routinely assessed when performing an ultrasonic evaluation in a multifetal pregnancy. Amniotic fluid changes may serve as the only useful indicator to a potential pathological condition. In addition, evaluation of fetal growth in twins is essential, because these pregnancies are at increased risk for growth restriction and increased perinatal mortality rates compared to singletons. Finally, a careful anatomical evaluation in mulitifetal gestation is important because twin pregnancies have higher rates of anomalies than their singleton counterparts.