The association between exposure to environmental tobacco smoke and breast cancer: a review by the California Environmental Protection Agency

BACKGROUND: The California Environmental Protection Agency (Cal/EPA) recently completed a health effects assessment of exposure to environmental tobacco smoke (ETS) which resulted in California listing ETS as a Toxic Air Contaminant in January 2006. As part of the assessment, studies on the association between exposure to ETS and breast cancer were reviewed. METHODS: Twenty-six published reports (including 3 meta-analyses) evaluating the association between ETS exposure and breast cancer were reviewed. A weight-of-evidence approach was applied to evaluate the data and draw conclusions about the association between breast cancer and ETS exposure. RESULTS: The published data indicate an association between ETS and breast cancer in younger primarily premenopausal women. Thirteen of 14 studies (10 case-control and four cohort) that allowed analysis by menopausal status reported elevated risk estimates for breast cancer in premenopausal women, seven of which were statistically significant. Our meta-analyses indicated elevated summary relative risks ranging from OR 1.68 (95% C.I. 1.31, 2.15) for all 14 studies to 2.20 (95% C.I. 1.69, 2.87) for those with the best exposure assessment. CONCLUSIONS: Cal/EPA concluded that regular ETS exposure is causally related to breast cancer diagnosed in younger, primarily premenopausal women and that the association is not likely explained by bias or confounding.     

An auto-anti-B in an A1B person. Serological studies

Summary The serum of a patient (Mr. Lat) with the regular blood group A₁B contains an anti-B reacting with all cells having a B antigen except b_x and cis AB. The anti-B reacts at 4° C and occasionally at room temperature as shown by agglutination, absorption-elution and by thermo-dynamic assays. The antibody is regarded as an irregular autoantibody belonging to the group of the so called suppressed or latent antibodies.

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Zusammenfassung Das Serum eines Patienten (Mr. Lat) mit der normalen Blutgruppe A₁B enthält Anti-B, das mit allen Zellen reagiert, die ein B-Antigen aufweisen, ausgenommen B_x und cis AB. Das Anti-B reagiert bei 4° C und gelegentlich bei Zimmertemperatur, was durch Agglutination, Absorption-Elution und durch thermodynamische Unter-suchungen gezeigt wurde. Der Antikörper wird als irregulärer Autoantikörper angesehen, der zur Gruppe der supprimierten oder latenten Antikörper gehört.

     

IN VITRO SYNTHESIS AND SECRETION OF LYSOZYME BY MONONUCLEAR PHAGOCYTES

Pure cultures of three types of mononuclear phagocytes—mouse peritoneal macrophages, unstimulated or after thioglycollate stimulation, and human monocytes—synthesize and secrete large amounts of lysozyme in vitro. The macrophage lysozyme is indistinguishable from authentic lysozyme in its ability to lyse M. lysodeikticus, inhibition by specific antisera, a similar size of 14,000 and cationic charge. Lysozyme secretion in culture is characterized by a large net increase in total lysozyme, 4–20-fold in 3 h, 75–95% of which is in the medium, and its continued extracellular accumulation over at least 2 wk in culture. Lysozyme is the major ¹⁴C-labeled protein secreted into the medium by both unstimulated and thioglycollate-stimulated macrophages and the 0.75–1 µg produced per 1 x 10⁶ cells/day represents 0.5–2.5% of the total cell protein. Lysozyme is a cell-specific marker for mononuclear phagocytes and the PMN, which contains preformed enzyme, since it is absent in lymphoid cells and a variety of fibroblast and epithelioid cell lines. Lysozyme production is also a useful measure of mononuclear phagocyte cell number. The rate of lysozyme production and secretion is remarkably constant for all cell types under a variety of culture conditions. Production by the mouse macrophage increases threefold on the 2nd day in culture and then remains linear with time. Production is optimal at a relatively low serum concentration, but can be maintained, in the absence of serum, in lactalbumin hydrolysate or, at a reduced level in basal media. The production and secretion of lysozyme are independent of the production of macrophage acid hydrolases. Net increase and secretion of lysozyme occur under conditions where acid hydrolases like N-acetyl β-glucosaminidase, β-glucuronidase, β-galactosidase, and cathepsin D are neither accumulated nor secreted. Massive phagocytosis of latex particles has no effect on lysozyme production and secretion. Lysozyme production can be rapidly inhibited by treatment with cycloheximide (0.4 µg/ml) whereas inhibition of its production by colchicine (10^–6 M) occurs only after a lag period of more than 8 h, and is probably due to a secondary effect. These results show that mouse macrophages provide a simple in vitro system to measure lysozyme secretion and its control. These studies also indicate the possible importance of mononuclear phagocytes in the secretion of a variety of biologically active products and in the modification of their environment.     

Lack of transmission of neutrophil and platelet antibodies by intravenous immunoglobulin in bone marrow transplant patients

BACKGROUND: Several studies have demonstrated that the administration of intravenous immunoglobulin (IVIG) may be followed by the transient appearance of positive red cell antibody screens, positive direct antiglobulin tests, and, occasionally, frank hemolysis. However, little information is available regarding the possibility that IVIG could transmit neutrophil and/or platelet antibodies. STUDY DESIGN AND METHODS: Serum samples were obtained both immediately before and immediately after the administration of 12 separate lots of commercially available IVIG to bone marrow transplant patients. RESULTS: None of the patients were shown by standard granulocyte immunofluorescence testing to have acquired neutrophil antibodies. Four of the 12 postinfusion sera were positive for platelet antibodies in standard platelet suspension immunofluorescence testing, but in all four instances the corresponding preinfusion serum was positive as well. CONCLUSION: The risk of acquiring neutrophil and/or platelet antibodies after the administration of commercially available IVIG appears to be low.     

功能磁共振成像与弥散张量成像联合监测视觉通路异常在高压氧治疗前后的结构及功能变化

目的:联合应用血氧依赖功能磁共振成像(BOLD-fMRI)和弥散张量成像技术评价视觉通路异常高压氧患者在康复过程中脑功能和解剖结构的重组特点。方法:①临床资料:选择2006-01/2007-05解放军南京军区福州总医院收治的因视觉通路病变致单侧或双侧视觉障碍的16例患者为病变组,均接受2个标准大气压高压氧治疗3个疗程。以性别、年龄与病变组大致匹配的正常视力者12例作为正常对照组。②磁共振扫描及分析:两组以相同条件,采用黑白棋盘格变化刺激双眼,应用Signa xcite HD 1.5T双梯度16通道磁共振成像系统进行测试。BOLD-fMRI数据处理采用AFNI软件包进行,弥散张量成像应用日本东京大学影像计算和分析实验室开发的Volume-one 1.64下的dTV.II.R1软件进行数据处理。③观察指标:病变组高压氧干预前后BOLD-fMRI激活体数和弥散张量成像表现,并与正常对照组比较。结果:28例受试者均进入结果分析。①BOLD-fMRI激活体数值:病变组高压氧治疗前视皮质激活体数低于正常对照组(P<0.01),高压氧治疗后视皮质激活体数与正常对照组比较差异不显著(P>0.05),但高于高压氧治疗前(P<0.05)。②弥散张量成像示视放射部分各向异性值:病变组高压氧治疗前部分各向异性值低于正常对照组(P<0.05),高压氧治疗后与正常对照组比较差异不显著(P>0.05),且显著高于高压氧治疗前(P<0.05)。病变组中的6例视神经病变患者视放射显示完整,康复前后的视放射部分各向异性值与正常对照组比较无显著性差异(P>0.05),10例枕叶视中枢病变患者视放射纤维部分中断,视放射各向异性值低于视神经病变患者(P<0.05)。结论:BOLD-fMRI联合弥散张量成像能从功能和结构方面探讨视觉通路病变的发生、发展及康复过程,为脑功能的康复提供较为可靠的治疗依据。     

Changing patterns of self-poisoning in a UK health district

Details of admissions to a dedicated district poisons treatment unit in South Glamorgan were analysed to assess changes in self-poisoning patterns between 1987-1988 and 1992-1993. Self-poisoning rates increased in both men and women, with male rates showing a relatively larger increase, resulting in a fall in female to male ratio for person- based rates from 1.33:1 to 1.13:1. The highest age-specific rates in both period were found in 15-19-year-old females. Paracetamol was the most commonly ingested poison in 1992-1993, with 43.4% of episodes involving its use, compared with 31.3% of episodes in 1987-88. Antidepressant involvement in self-poisoning also increased from 11.3% of episodes in 1987-1988 to 17.6% of episodes in 1992-1993. Repetition of self-poisoning was relatively common, with 18% of admissions per year in 1992-1993 representing repeats. Although hospital admission increased in this health district over the study periods, this was not reflected in an increase in in-patient all-cause mortality, which was only 0.5% in 1987-1988 and 0.1% in 1992-1993.      

成人外周血单个核细胞体外培养过程中分化为早及晚期内皮祖细胞生物学表征

目的:观察成人外周血来源的单个核细胞在体外培养过程中形态、增殖能力和表面抗原的变化。方法:实验于2006-08/2007-02在广州南方医院完成。①实验材料:健康志愿者肘静脉血20份,年龄20～26岁,对本实验均知情同意。②实验方法:密度梯度离心健康成人肘静脉血得到单个核细胞,以(2～3)×106/cm2的密度接种于人纤维连接蛋白包被的6孔板,在含有人血管内皮细胞生长因子的M199培养基中进行培养,第4天首次换液,后每3d换液一次。③实验评估:第3天起观察细胞的形态及数量,分别对培养至第7,21天的贴壁细胞行流式细胞学分析及免疫组化染色检查。结果:①培养细胞的形态学观察:外周血来源单个核细胞接种后约有1/20贴壁,第4天左右可形成从中心向外放射的典型细胞集落,第7天有大量长梭形、双极针样细胞生长。培养第2周长梭形细胞开始凋亡,数量减少,同时出现大量椭圆形鹅卵石样细胞。至第3周鹅卵石样细胞已占据生长优势且增殖旺盛,长梭形细胞基本消失。②内皮祖细胞表面标志的变化:原代培养第7天,贴壁细胞表达与单核巨噬细胞系相关的表面抗原CD44(96.3%)、CD45(83.9%)、CD11c(63.7%)、CD14(11.9%),弱表达内皮细胞相关抗原flk-1(18.2%)、CD31(6.7%)、vWF(3.6%);第21天CD44表达下降至57.6%,而内皮细胞相关抗原CD31表达增加至67.2%,vWF增加至14.2%;造血干细胞相关抗原CD34始终呈阴性表达。免疫组化染色结果与流式细胞分析结果一致。结论:成人外周血中存在两种不同类型的血管内皮前体细胞,单个核细胞贴壁培养4～7d左右出现早期内皮祖细胞,2～3周时出现晚期内皮祖细胞。二者的外形、增殖潜能、表面抗原表达均不同。晚期内皮祖细胞是更好的种子细胞来源。     

异体肌腱移植重建伸肌腱止点治疗锤状指畸形

目的:观察异体肌腱移植重建伸肌腱止点治疗锤状指畸形的疗效。方法:选择于2003-01/2006-03在东南大学医学院附属徐州医院骨科采用改良伸肌腱止点重建术治疗的锤状指畸形患者15例,均自愿参加观察。开放损伤2例患者于急诊1期予以手术治疗,闭合损伤13例患者在1周内予以手术治疗。①手术方法:臂丛麻醉,于末节指骨基底以远4mm偏背侧的尺桡两边对向钻孔,形成骨隧道,采用修剪合适的异体肌腱穿过骨隧道,在远侧指间关节背侧交叉后分别与伸指肌腱的侧腱束吻合(吻合前选直径1.0mm克氏针将远侧指间关节固定过伸位10°￣15°),石膏托外固定,6周后拔除克氏针及拆除石膏进行末节屈伸功能锻炼。术后定期随访。②功能测评:测量手指最大伸直位掌指关节、近指间关节、远指间关节伸直受限角度的总和及手指屈曲位时指端与掌横纹之间的距离。优:伸指0°,屈指指端过掌横纹;良:伸指受限≤-15°,屈指指端达掌横纹。结果:15例患者全部进入结果分析,无脱落。术后随访2个月￣3年,平均19.5个月。所有患者伤口甲级愈合,无异物排斥反应。按Dargan功能评定标准,优12例(占80%),良2例(占13.3%),优良率达93.3%。1例因远侧指间关节僵硬而屈伸活动功能欠佳。结论:异体肌腱移植伸肌腱止点重建术是治疗锤状指畸形的有效方法。