Lifestyle determinants of serum insulin-like growth-factor-I (IGF-I), C-peptide and hormone binding protein levels in British women

Objective: This study aims to identify the lifestyle determinants of insulin-like growth factor-I (IGF-I) and its main binding proteins (IGFBPs), C-peptide, and sex hormone-binding globulin (SHBG) to help elucidate the mechanism through which lifestyle factors may affect cancer risk. Methods: This study is based on a sample of 292 British women, aged 20–70 years, whose lifestyle characteristics were assessed using a self-administered questionnaire and whose serum hormone concentrations were measured using immunoassays. Results: Age was a strong determinant of both IGF-I and IGFBP levels; women aged 65–70 years had significantly lower IGF-I and IGFBP-3 concentrations and significantly higher IGFBP-1 and IGFBP-2 concentrations than women aged 20–24 years. Body mass index (BMI) was not strongly associated with IGF-I, although women with a BMI of 26–27.9 kg/m² had a higher IGF-I concentration compared with both lean (BMI <20 kg/m²) and obese (BMI 30+ kg/m²) women. However, obese women had a significantly higher C-peptide and IGFBP-3 concentration and a significantly lower IGFBP-1, IGFBP-2, and SHBG concentration compared with lean women. Increasing vigorous exercise was associated with a significantly lower C-peptide concentration and increasing leisure-time activity was associated with a significantly higher IGFBP-1 concentration. Other lifestyle factors such as job activity, smoking, and reproductive factors were not associated with any hormone. Conclusions: Our data show that age is a major determinant of both IGF-I and its main binding proteins in women. BMI has strong effects on IGFBPs, C-peptide, and SHBG, but its effects on IGF-I remain unclear. The possible effect of physical activity on IGFBP-1 requires further investigation.     

The effect of diet on risk of cancer

Diet-related factors are thought to account for about 30% of cancers in developed countries. Obesity increases the risk of cancers in the oesophagus, colorectum, breast, endometrium, and kidney. Alcohol causes cancers of the oral cavity, pharynx, larynx, oesophagus, and liver, and causes a small increase in the risk of breast cancer. Adequate intakes of fruit and vegetables probably lower the risk for several types of cancer, especially cancers of the gastrointestinal tract. The importance of other factors, including meat, fibre, and vitamins, is not yet clear. Prudent advice is to eat a varied diet including plenty of fruit, vegetables, and cereals to maintain a healthy bodyweight with the help of regular physical activity and to restrict consumption of alcohol.     

Three-dimensional diffuse optical tomography of bones and joints

We present for the first time full three-dimensional (3D) volumetric reconstruction of absorption images of in vitro and in vivo bones and joints from near-infrared tomographic measurements. Imaging experiments were conducted on human finger and chicken bones embedded in cylindrical scattering media using a Clemson multichannel diffuse optical imager. The volumetric optical images were recovered with our 3D finite element based reconstruction algorithm. Our results show that 3D imaging methods can provide details of the joint structure/composition that would be impossible from two-dimensional imaging methods.     

Nosocomial infections in intensive care patients

Facilities must manage core system processes to minimize medication errors and other adverse outcomes, such as nosocomial infections. Characterization of specific risk factors for the development of nosocomial infections and efficacious evidence-based care interventions are expanding. Health care providers need to evaluate their patient populations and systems of care to minimize lack of knowledge, slips. and lapses in care and other system issues to assure that successful care practices are consistently used to minimize nosocomial infections.     

增殖细胞核抗原在上皮性卵巢肿瘤中的表达及其临床病理意义

应用免疫组织化学方法检测了５９例上皮性卵巢肿瘤中增殖细胞核抗原（ＰＣＮＡ）的表达，以探讨卵巢肿瘤中ＰＣＮＡ蛋白表达的临床病理意义。结果：ＰＣＮＡ在良、恶性上皮性卵巢瘤中均有表达，但卵巢癌中ＰＣＮＡ的阳性率（８０．９％）明显高于良性卵巢瘤中的阳性率（２５％，Ｐ＜０．０１）。卵巢癌中，高分化卵巢癌ＰＣＮＡ的阳性指数评分低于中、低分化卵巢癌（Ｐ＜０．００１），ＰＣＮＡ阳性指数评分与分化程度之间呈负相关，ｒｓ＝－０．５０（Ｐ＜０．０１）。Ⅰ／Ⅱ期卵巢癌ＰＣＮＡ指数阳性指数评分低于Ⅲ／Ⅳ期卵巢癌（Ｐ＜０．０５），ＰＣＮＡ阳性指数评分与临床期别之间呈正相关，ｒｓ＝０．４３（Ｐ＜０．０１）。结果提示，分化程度低、临床期别高的卵巢癌细胞增殖快，ＰＣＮＡ的检测有助于鉴别上皮性卵巢肿瘤的良、恶性，并有可能作为上皮性卵巢癌的预后指标。     

A prospective study of endogenous serum hormone concentrations and breast cancer risk in premenopausal women on the island of Guernsey.

The associations between serum concentrations of oestradiol, progesterone, testosterone and sex hormone-binding globulin (SHBG) and risk of breast cancer in premenopausal women were investigated in a prospective study of breast cancer on the island of Guernsey. Sixty-two women diagnosed with breast cancer an average of 8 years subsequent to blood collection were matched for day of menstrual cycle, age and year of blood collection with 182 control subjects. Cases had a 12% higher mean oestradiol concentration over the whole menstrual cycle (P = 0.17) with a large difference at mid-cycle (75% higher, P = 0.04). Differences between cases and control subjects in progesterone (luteal phase), testosterone and SHBG were small and not statistically significant: luteal phase progesterone 9% lower in cases, P = 0.64; testosterone 4% higher, P = 0.57; SHBG 8% higher, P = 0.24. The small difference in oestradiol concentration could be aetiologically important, but larger prospective studies are needed.     

HLA and Mooren's ulceration

BACKGROUND: Mooren's ulcer is a progressive intractable destructive peripheral ulceration of the cornea, probably of autoimmune aetiology. The disease is rare in the northern hemisphere but is more common in southern and central Africa and the Indian subcontinent. Although rare, its predominance in certain racial groups and their second generation migrants worldwide indicates a genetic as well as a geographic predisposition. The highly polymorphic human leucocyte antigens (HLA) confer genetic susceptibility to several autoimmune disorders. Therefore, a possible link between Mooren's ulcer and HLA type was investigated. METHODS: Patients (n=22) with non-infective destructive peripheral corneal inflammatory disease were recruited worldwide. Differential diagnosis confirmed Mooren's ulceration in 12 cases. HLA typing (HLA-A, B, C, DRB, DQB) was performed by serology and PCR using sequence specific primers. The patients came from varied ethnic backgrounds and their HLA typing results were compared with published data from ethnically matched control populations. RESULTS: Of the 12 patients with Mooren's ulcer, 10 (83%) were HLA-DR17(3) positive (including all nine patients of Asian, Indonesian, and black African origin), and 10 (83%) were HLA-DQ2 positive. The frequency of HLA-DR17(3) and DQ2 was higher in the Mooren's ulcer group compared to published data from ethnically matched control populations, where the expected antigen frequencies range between 5% and 40%. CONCLUSION: These results suggest a possible association between HLA-DR17(3) and/or DQ2 and susceptibility to Mooren's ulcer.     

Effects of neuroleptics on release of 3H-dopamine from slices of rat corpus striatum

Summary The characteristics of ³H-DA release from striatal slices by electrical stimulation were analyzed and the effects of a number of neuroleptics thereon were examined under different experimental conditions. The butyrophenones, haloperidol and spiroperidol, already at low concentrations (0.1–1 M) increased basal tritium efflux in a dose-dependent manner. The phenothiazines, chlorpromazine and fluphenazine, were much less effective in this respect.The butyrophenones strongly inhibited the electrically stimulated overflow of both ³H-DA and ¹⁴C-GABA, while the phenothiazines again had little effect. The action of 1 M haloperidol on ³H-DA release could be blocked by 10 M cocaine, but not with 1 M apomorphine. Apomorphine itself had no significant effect on ³H-DA release.Our data do not support the suggestion that presynaptic DA receptors on dopaminergic nerve terminals may modulate the release of newly taken-up ³H-DA. Some neuroleptics, particularly the butyrophenones may have presynaptic effects not related to interaction with DA receptors. It is suggested that different mechanisms may be involved in the local presynaptic receptor-mediated feedback regulation of transmitter release in noradrenergic and dopaminergic systems in the CNS.     

Unappreciated risk factors for transplant patients: HLA antibodies in blood components

One of the more aggressive approaches in renal transplantation is the use of plasmapheresis (PP) and intravenous immunoglobulin to eliminate donor-directed human leukocyte antigen (HLA) alloantibodies. A potential complication of a PP protocol is iatrogenic hypocoagulability resulting from the removal of coagulation factors. To prevent bleeding, hypocoagulable patients may require transfusions with fresh frozen plasma (FFP) and/or cryoprecipitate (Cryo). Although HLA alloantibodies in these components have been linked to complications, such as transfusion-related acute lung injury (TRALI), whether they cause complications following transfusion into allograft recipients is unknown. The incidence of complications would be dependent, in part, upon the frequency of HLA alloantibodies in the various blood components. In this study, segments from 77 units of FFP, 66 units of Cryo, 106 units of packed red blood cells (RBCs), and 59 units of apheresis platelets (Plts) were tested for antibodies to HLA class I and class II antigens using FlowPRA, an HLA antigen-specific flow cytometric assay. On average, 22% of blood components tested contained HLA alloantibodies, tenfold greater than previously reported. This unappreciated frequency of HLA alloantibodies in blood components may pose a risk to transplant patients requiring transfusions by promoting allograft dysfunction or loss.