Asbestos exposure among finnish lung cancer patients: Occupational history and fiber concentration in lung tissue

In a series of 65 surgically treated lung cancer patients, past exposure to asbestos was evaluated by personal interviews, and by scanning electron microscopy analyses of the mineral fibers in lung tissue. Lung tissue samples of 17 autopsied male office workers were analyzed as referents. According to occupational history, 37% of the lung cancer patients had definite or probable, 31% possible, and 32% unlikely exposure to asbestos. The fiber concentration in the lung tissue ranged from <0.1 to 65 million fibers per gram dry tissue in the lung cancer group, and from <0.1 to 0.8 million fibers per gram dry tissue in the reference group. In 26% of the lung cancer patients, but in none of the referents, the fiber concentration exceeded 1 million fibers per gram dry tissue. Most of the exposed patients had been employed in various construction jobs, and valuable information about the exposure levels could be obtained by the mineral fiber analyses. In general, there was a good accord between the exposure categorization and the fiber burden measured in the lung. © 1993 Wiley-Liss, Inc.     

Pregnancy outcome after previous induced abortion

The outcome of pregnancy was studied in 325 patients with an induced abortion in their previous pregnancy, together with 721 control patients. The patients were matched for age, parity and social class. Smoking and unplanned pregnancies were found to be more comon among abortion patients than among the control patients. As regards pregnancy complications, bleeding during pregnancy and placental retention were found to be significantly more common in the index group. No statistical differences were noticed in gestation length, birthweight, rate of spontaneous abortion and perinatal mortality in the pregnancy following induced abortion as compared with control patients.     

Lipid peroxidation in human milk and infant formula: effect of storage, tube feeding and exposure to phototherapy

Preformed lipid peroxidation products present in the feed may contribute to the total reactive oxygen radical load infants have to deal with and may play a role in the pathogenesis of necrotizing enterocolitis and bronchopulmonary dysplasia. In this study, the occurrence of lipid peroxidation in human milk and feeding formulas for preterm babies was evaluated in vitro. Free linoleic acid (18:2) and its hydroperoxide (18:2OOH) were measured by gas chromatography-mass spectrometry and the concentration of 18:2OOH and the 18:2OOH/18:2 ratio were used as indices of peroxidation. In all feeds peroxidation products were present, but the proportion of peroxidized 18:2 was greater in infant formula. Storage of human milk (+4°C for four days) increased lipid peroxidation. Exposure to light during tube feeding incrcased pcroxidation in infant formula but not in human milk. Different procedures for preparation, storage and feeding may decrease the concentration of these potentially toxic peroxidized lipids in human milk and infant formula.     

Congenitally corrected transposition in the adult: detection by radionuclide angiocardiography

Congenitally corrected transposition (CCT) of the great vessels is an uncommon anomaly usually detected in children because of associated severe cardiac malformations. When these are absent, patients may be hemodynamically normal, but associated cardiac abnormalities are usually present in CCT, leading to symptoms in adulthood. When CCT is suggested in an adult, diagnosis by means of ultrasound may be difficult. Radionuclide angiocardiography (RA) is a simple, noninvasive method by which to diagnose CCT. We found consistent morphologic scintigraphic results in 13 patients with proved CCT, leading to establishment of reliable diagnostic criteria. In all instances of situs solitus the aorta ascends and descends on the left with vertical orientation. In the case of situs inversus, the aorta ascends and descends on the right with vertical orientation. Our criteria are independent of the situs and cardiac position, unlike earlier reports by others. We believe images obtained in the anterior projection are sufficient for the study. The practical application of RA study in patient diagnosis is demonstrated, giving special attention to patients referred because of situs solitus and dextrocardia, in which CCT is known to be present in 50% of cases.     

Osteomalacia in institutionalized epileptic patients on long-term anticonvulsant therapy

The occurrence of anticonvulsant osteomalacia was studied in 31 epileptic inpatients, 16 women and 15 men.
Disturbances in biochemical parameters indicating osteomalacia were frequent. Thirty two per cent of the patients were hypocalcemic, 55% had an increase in S-ALP and 26% in U-HOP, and dU-Ca was decreased in 55%. The S-25OHD₃ concentrations were significantly lower in the patients compared with healthy controls. BMD was decreased in females but not in males compared with the controls. Histomorphometric analysis revealed an increase in the amount of osteoid, but the amount of trabecular bone was no lower than in the controls. The amount of resorption surfases was increased in the females, but not in the males. The patients who took less physical activity had a pronounced decrease in BMD.
The conclusion drawn was that osteomalacia is a frequent complication of long-term anticonvulsant medication, especially among institutionalized patients.     

Mitotic rate and S-phase fraction as prognostic factors in stage I cutaneous malignant melanoma.

Clinical data from 369 patients with clinical stage I cutaneous malignant melanoma treated in Kuopio University Hospital district between 1974 and 1989 with a mean follow-up of 6.4 years were analysed. Clinical parameters, histology, DNA index, S-phase fraction (SPF) and mitotic indices [mitotic activity index (MAI) and volume-corrected mitotic index (M/V index)] were correlated with the outcome of the disease to establish their value as predictors of stage I cutaneous malignant melanoma. In univariate survival analyses, bleeding, gender, tumour thickness, level of invasion according to Clark, TNM category, MAI, M/V index and SPF were the most significant predictors of recurrence-free (RFS) and overall survival. In Cox''s multivariate analysis, tumour thickness (P = 0.0021), bleeding (P = 0.0106) and M/V index (P = 0.0058) predicted poor RFS in the 259 patients available for the analysis. Poor overall survival was predicted by MAI (P = 0.0002), bleeding (P = 0.004), SPF (P = 0.009) and male gender (P = 0.034). The present results indicate that mitotic activity index (MAI), volume-corrected mitotic index (M/V index) and S-phase fraction (SPF) are important prognostic factors in addition to the well-established Breslow thickness in stage I cutaneous malignant melanoma.     

Prevention of early onset group B streptococcal sepsis in the newborn

: There is an urgent need for strategies to prevent early onset group B streptococcal sepsis in the newborn. The most effective mechanism is the identification of maternal carriers of the organism and interruption of transmission during labour. Vaginal culture is currently the most reliable method for the identification of carriers. Antibiotic prophylaxis for known carriers in labour has been demonstrated to be effective as standard management practice in a number of Australian institutions and is the best available strategy at this stage.