Food cravings and aversions during pregnancy: relationships with nausea and vomiting

Food cravings and food aversions are common during pregnancy. A mechanism that may explain these changes in food preference is taste aversion learning. Accordingly, this study examined the temporal association between the first occurrences of nausea, vomiting, food cravings and food aversions during pregnancy. Ninety-nine women completed a questionnaire that asked about the occurrence, timing of first onset, duration, strength and targets of these symptoms. Nausea and vomiting were reported by 80% and 56% of the women, food cravings and aversions by 61% and 54% respectively. Although more women experienced both food cravings and aversions than either symptom alone, cravings and aversions were statistically unrelated. There was a significant positive correlation between week of onset of nausea and of aversions. In 60% of women reporting both nausea and food aversions, the first occurrence of each happened in the same week of pregnancy. No such association was found for cravings. These retrospective accounts provide good support for taste aversion learning as a mechanism for the development of some but not all food aversions during pregnancy. Prospective data are needed to confirm these temporal relationships and to assist understanding of the emergence of food cravings.     

Results of radiotherapy for primary subglottic squamous cell carcinoma

: To retrospectively evaluate the outcome after radical radiotherapy (RT) and surgical salvage and assess the risk of late toxicity for patients with primary subglottic squamous cell carcinoma treated at our center.

: Between 1971 and 1996, 43 patients with primary squamous cell carcinoma of the subglottis (35 men, 8 women) were treated with radical RT. All received megavoltage irradiation, most commonly to a dose of 50–52 Gy in 20 fractions during 4 weeks (39 patients). The median follow-up was 4.2 years.

: Local control was achieved with RT alone in 24 (56%) of the 43 patients: 7 of 11 with T1, 8 of 12 with T2, 4 of 8 with T3, and 5 of 12 with T4. The 5-year actuarial local relapse-free rate was 52%. Subsequent local control was achieved in 11 of the 13 patients with failed RT and attempted surgical salvage, for an ultimate local control rate of 81.4% (35 of 43). The 5-year overall and cause-specific actuarial survival rate was 50.3% and 66.9%, respectively. No patients developed Grade 3 or 4 late radiation morbidity.

: These data support the use of primary RT in the treatment of patients with primary squamous cell carcinoma of the subglottis as an appropriate treatment approach providing an option for laryngeal conservation.     

Osteoclast lineage commitment of bone marrow precursors through expression of membrane-bound TRANCE

Osteoclast formation from hemopoietic precursors is induced by TRANCE (also called RANKL, ODF, and OPGL), a membrane-bound ligand expressed by bone marrow stromal cells. Because soluble recombinant TRANCE is a suboptimal osteoclastogenic stimulus, and to eliminate the need for such dependence on stromal cells, membrane-bound TRANCE was expressed in hematopoietic precursors using retroviral gene transfer. Four TRANCE-expressing osteoclast cell lines were established that continuously generate large numbers of multinucleated cells and express tartrate-resistant acid phosphatase and calcitonin receptors. The multinuclear cells are long-lived and either fuse continuously with each other and with mononuclear cells to form enormous syncytia, or separate to form daughter multinuclear cells. When formed on bone, but not on plastic, the majority of multinuclear cells develop actin rings on bone, and resorb bone, suggesting that bone matrix may provide additional signals that facilitate osteoclastic functional maturation. Surprisingly, multinuclear cells originate from fusion of proliferating mononuclear cells that strongly express the mature macrophage markers F4/80 and Fc receptor, which are not expressed by osteoclasts. These results indicate that osteoclasts can be derived from F4/80-positive and Fc receptor-positive cells, and that TRANCE induces osteoclastic differentiation partly by suppressing the macrophage phenotype.     

Adhesiveness of human ligament fibroblasts to laminin

The adhesiveness of fibroblasts from the human anterior cruciate and medial collateral ligaments to the laminin molecule was studied, with particular emphasis on the intrinsic differences between fibroblasts from the two ligaments. Cellular adhesion strength, adhesion area, laminin concentration, and seeding time were examined. Cell adhesion to laminin anchored with poly-D-lysine to a cleaned cover glass was measured with a micropipette micromanipulation system after seeding. The adhesion strength of fibroblasts from the anterior cruciate ligament to laminin was greater than and significantly different from that of fibroblasts from the medial collateral ligament, depending on the laminin concentration. Fibroblasts from the anterior cruciate ligament also exhibited an increase in adhesion strength, dependent on laminin concentration of as much as 30 μg/ml, at which the laminin receptors were thought to be saturated. Fibroblasts from the medial collateral ligament did not show such an increase except at laminin concentrations of 5–10 μg/ml. There was no significant difference in adhesion area between fibroblasts from the two ligaments except after 45 minutes at a laminin concentration of 40 μg/ml. For both, the adhesion to laminin showed little correlation to seeding time during periods of as long as 60 minutes. Measurements of adhesion area also failed to show a significant correlation to seeding time for fibroblasts from either ligament at laminin concentrations of 20 and 40 μg/ml. Adhesion strength normalized by adhesion area had no correlation to seeding time. With all times taken into account, however, normalized adhesion strength for fibroblasts from the anterior cruciate ligament was approximately two times greater than and significantly different from that for fibroblasts from the medial collateral ligament at laminin concentrations of 20 and 40 μg/ml. Fibroblasts from the anterior cruciate ligament adhere more strongly to laminin than do those from the medial collateral ligament. This study may prove useful in the understanding of fibroblast adhesion to the basal lamina within the extracellular matrix and may provide insight into the natural healing processes of the anterior cruciate and medial collateral ligaments.     

Outcome analysis of patients with squamous cell carcinoma of the head and neck and hepatitis C virus

Objective/Hypothesis: Infection with the hepatitis C virus (HCV) is a global problem with over 170 million people infected. Recently, we have noticed that a large number of patients diagnosed with squamous cell carcinoma of the head and neck (SCCHN) have also been diagnosed with HCV. A review of the literature reveals little information concerning this patient population. The objective of this study was to compare the outcome of SCCHN patients who have been exposed to HCV with naïve SCCHN patients. Study Design: Retrospective chart review. Methods: A retrospective chart review from June 1991 through December 2002 was performed to identify patients diagnosed with SCCHN who were screened for HCV. Patients were stratified into two groups (HCV positive and HCV negative). Data were recorded on patients for status of disease at last clinic visit, pretreatment serum albumin and hematocrit levels, and RNA quantities of HCV. Statistical analysis was performed using paired t test to compare serum albumin and hematocrit levels. Kaplan‐Meier survival curves were used to compare outcomes. The log‐rank test was used to determine significance. Cox regression was used to examine the association of prognostic predictor variables with overall survival and disease‐free survival. Results: There was no difference noted in 5 year survival between hepatitis C positive and hepatitis C negative groups in overall outcomes (66.7% vs. 67.9%, P = 1.000) or 5 year disease‐free survival (90.5% vs. 80.8%, P = .514). The two groups, HCV positive versus HCV negative, also had similar serum albumin levels (3.62 g/dL vs. 3.72 g/dL, P = .37) as well as serum hematocrit levels (42.9% vs. 41.0%, P = .12). Serum levels of hepatitis C RNA were obtained in seven patients, with only one being undetectable. The only prognostic predictor variable that was significantly associated with overall survival was age. None of the predictor variables were significantly associated with disease‐free survival. Conclusion: Co‐infection with HCV, although prevalent in the Veterans Administration Hospital population, did not affect patient outcome as defined by disease‐free survival. Patients who were seropositive for HCV had comparable serum albumin levels as well as serum hematocrit when compared with HCV negative patients.