Genetics and epidemiology of Wilms' tumor: The French Wilms' tumor study

A complete family history was obtained for 501 patients with Wilms' tumor, treated in departments of pediatric oncology in whole France. The information was collected by self-questionnaire and/or by interview of parents. The proportion of bilateral cases is 4.6% and there are 12 patients (2.4%) with a positive family history of Wilms' tumor. The affected relatives are most often distant and no first degree relative was affected. Apart from the well-known associations with aniridia, hemihypertrophy, genitourinary anomalies, Beckwith-Wiedeemann, and Drash syndromes, there is also a significant excess of congenital heart defects (P = .008) which remains to be explained. Several findings support the bimutational hypothesis such as earlier diagnosis and increased parental age in bilateral cases. No particular anomalies and no increased frequency of childhood cancer were found in patients' relatives. The frequency of Wilms' tumor in relatives was estimated to be less than 0.4% in sibs, 0.06% in unclesand aunts, and 0.04% in first cousins. These figures are very different from those found in retinoblastoma and suggest that the mechanism may be more complex in Wilms' tumor. This conclusion is in agreement with molecular biology studies in tumors and linkage analysis in multiple case families which suggest that more than one locus is involved. © 1992 Wiley-Liss, Inc.     

Illness-related behaviour and utilization of oral health services among adult city-dwellers in Burkina Faso: evidence from a household survey

Background  

In sub-Saharan Africa, the availability and accessibility of oral health services are seriously constrained and the provision of essential oral care is limited. Reports from the region show a very low utilization of oral health care services, and visits to dental-care facilities are mostly undertaken for symptomatic reasons. The objectives of the present study were to describe the prevalence of oral symptoms among adults in Ouagadougou, capital city of Burkina Faso and the use of oral health services and self-medication in response to these symptoms and to measure the associations between predisposing, enabling and needs factors and decisions to seek oral health care.     

Wash-out of the non-heart-beating donor liver: a comparison between ringer lactate, HTK, and polysol

The solution of choice for wash-out of non-heart-beating donor (NHBD) livers is histidine tryptophan ketoglutarate (HTK). This solution has a lower viscosity, due to absence of a colloid, and is less expensive as compared to the University of Wisconsin (UW) solution. A new preservation solution for machine perfusion was developed, named Polysol. In order to apply Polysol clinically in NHBD organ retrieval, the efficacy as a wash-out solution was investigated. METHODS: After a warm ischemic time of 30 minutes, the rat liver was washed out via the portal vein with 50 mL of either ringer lactate (RL), HTK or Polysol. After wash-out and harvesting, the liver was reperfused with Krebs-Henseleit buffer. Samples were taken to assess hepatocellular injury and liver function. RESULTS: Liver damage parameters were elevated in the RL group as compared to the HTK and Polysol groups. Liver/rat weight ratios were significantly lower after wash-out with Polysol. Overall, no differences were seen in ammonia clearance and bile production. In conclusion, wash-out of the NHBD liver with Polysol results in equal to improved reperfusion results as compared to HTK. Polysol is feasible as a wash-out solution in combination with machine perfusion using Polysol.     

Endoscopic ultrasound added to mediastinoscopy for preoperative staging of patients with lung cancer

Context  Up to 40% of thoracotomies performed for non–small cell lung cancer are unnecessary, predominantly due to inaccurate preoperative detection of lymph node metastases and mediastinal tumor invasion (T4). Mediastinoscopy and the novel, minimally invasive technique of transesophageal ultrasound–guided fine-needle aspiration (EUS-FNA) target different mediastinal lymph node stations. In addition, EUS can identify tumor invasion in neighboring organs if tumors are located adjacent to the esophagus. Objective  To investigate the additional value of EUS-FNA to mediastinoscopy in the preoperative staging of patients with non–small cell lung cancer. Design, Setting, and Patients  Prospective, nonrandomized multicenter trial performed in 1 referral and 5 general hospitals in the Netherlands. During a 3-year period (2000-2003), 107 consecutive patients with potential resectable non–small cell lung cancer underwent preoperative staging by both EUS-FNA and mediastinoscopy. Patients underwent thoracotomy with tumor resection if mediastinoscopy was negative. Surgical-pathological staging was compared with preoperative findings and the added benefit of the combined strategy was assessed. Intervention  The EUS-FNA examination was performed as an additional staging test to mediastinoscopy in all patients. Main Outcome Measure  Detection of mediastinal tumor invasion (T4) and lymph node metastases (N2/N3) comparing the combined staging by both EUS-FNA and mediastinoscopy with staging by mediastinoscopy alone. Results  The combination of EUS-FNA and mediastinoscopy identified more patients with tumor invasion or lymph node metastases (36%; 95% confidence interval [CI], 27%-46%) compared with either mediastinoscopy alone (20%; 95% CI, 13%-29%) or EUS-FNA (28%; 95% CI, 19%-38%) alone. This indicated that 16% of thoracotomies could have been avoided by using EUS-FNA in addition to mediastinoscopy. However, 2% of the EUS-FNA findings were false-positive. Conclusion  These preliminary findings suggest that EUS-FNA, when added to mediastinoscopy, improves the preoperative staging of lung cancer due to the complementary reach of EUS-FNA in detecting mediastinal lymph node metastases and the ability to assess mediastinal tumor invasion.      

Obesity induced during sexual maturation is linked to LDL-triacylglycerols in Yucatan miniature swine

The incidence of childhood obesity is rising dramatically throughout industrialised countries. To evaluate and study the impact of childhood obesity on lipoprotein metabolism, we developed a new animal model of premature obesity. Yucatan mini-pigs aged 4 months were studied over a 12-month period from childhood to adulthood. Animals were divided into two groups: the first group were overfed a Western misbalanced diet; the second group were normally fed a recommended human-type diet. Cholesterol and triacylglycerol concentrations in VLDL-, LDL- and HDL-lipoproteins were followed from baseline to adulthood by fast protein liquid chromatography. At 10 (the end of sexual maturation) and 16 months old (adulthood), liver, visceral and subcutaneous adipose tissues were sampled. Real-time RT-PCR was performed in order to compare apo AI, apo B, apo C-III, PPAR-alpha, insulin receptor and lipoprotein lipase gene expression between groups and ages. Differences between groups were observed only after sexual maturity. Adult overfed mini-pigs had a higher LDL-cholesterol:HDL-cholesterol ratio (P < 0.05; 0.55 (SE 0.06) for overfed v. 0.42 (SE 0.04) for normally fed pigs at the tenth month of the study). In both groups, VLDL-triacylglycerol decreased (P < 0.05). VLDL-triacylglycerol evolution in the overfed group was associated with an increase in LDL-triacylglycerol plasma concentrations (P < 0.05) after sexual maturation. LDL-triacylglycerol concentration in overfed mini-pigs went from an average of 0.28 mmol/l before sexual maturation to reach an average concentration of 0.56 mmol/l afterwards. This phenomenon has never been observed in similar studies when obesity is induced in adult mini-pigs and may represent a specific hallmark of an obesity induced during sexual maturity.     

Validation of the Reactions to Ageing Questionnaire: assessing similarities across several countries

With the increasing numbers of older adults, factors impacting the effectiveness of provision of health care must be addressed. The literature suggests attitudes, particularly those of nurses, impact health service provision. This article reports the outcome of a multicountry validation study of the Reactions to Ageing Questionnaire (RAQ). The RAQ measures attitudes toward personal aging and has been used in Australia for 5 years. This study was designed to determine whether the psychometric characteristics and norms of the RAQ identified for Australian nurses also apply to nursing samples in Sweden and the United Kingdom. Findings indicate the internal structure of the RAQ extends outside Australia, with similar factors appearing across the three countries. Ranges and standard deviations indicate the instrument is able to discriminate between respondents within each country. Cronbach's alpha coefficients were consistent across countries and fell in the moderately high range. The findings indicate the RAQ has many potential applications in attitude assessment and in providing direction for training designed to address attitudinal factors that may impact the effectiveness of nursing practice for older adults.     

Gnathostomiasis: clinicopathologic study

Gnathostomiasis is a systemic parasitic disease that is caused by the ingestion of contaminated raw fish, the intermediate host. Involvement of the skin is a common event, and when it does happen, it can produce a superficial or creeping eruption, pseudofurunculosis, and nodular migratory panniculitis. We carried out a retrospective study of 946 cases of gnathostomiasis; 66 of them had skin biopsies. The diagnosis was made based on clinical and epidemio-logic findings as well as the therapeutic response. The most common skin finding was nodular migratory panniculitis affecting the trunk. Most of the patients were males between 20 and 40 years of age. Histopathologically, we were able to see the larva and make a definitive diagnosis in 15 cases, and in 12 cases, the worm was retrieved during the surgical procedure. In remaining cases, despite of our inability to identify the larva, the histopathologic changes were quite characteristic and included: dermal and hypodermal edema with dense mixed infiltrates composed of eosinophils admixed with lymphocytes and neutrophils, eosinophilic vasculitis, flame figures, areas of necrosis, and hemorrhage. Thus, the presence of these histopathologic features in the context of a clinical picture suggestive of gnathostomiasis allows the pathologist to make the correct diagnosis.