Assessment of personal protective equipment use among Midwestern farmers

BACKGROUND: Personal protective equipment (PPE) is readily available and widely recommended, yet usage among agricultural workers is largely unknown. METHODS: A mail survey of 2,483 farmers in six Midwestern states with telephone follow-up addressed PPE usage related to sun exposure, noise abatement, chain saw usage, welding and metal work, handling of large animals in and out of confinement facilities, feed handling, manure storage facilities, and mixing and applying chemicals. Summary statistics of survey responses were compiled. RESULTS: With the exception of welding masks, PPE usage was low. Farmers were satisfied with availability of PPE through local hardware and farm cooperatives, but the decision to use PPE was personal and influenced little by outside parties. CONCLUSION: PPE usage rates by farmers on Midwestern farms need to be increased. The desire of the individual farmer to reduce risk of personal injury or exposure should be targeted. The most effective venue will be local agricultural extension services.     

Increased level of polymerase Ⅲ transcribed Alu RNA in hepatocellular carcinoma tissue

There have been extensive observations that RNA containing repetitive elements accumulates in transformed cells and tumor tissues. In the present study, we first obtained result consistent with previous observations by in situ hybridization.     

Seizures in children with low-grade tumors： outcome after tumor resection and risk factors for uncontrolled seizures

OBJECT： The goals of this study were to define the incidence of seizures in children with low-grade tumors, study seizure outcome after lesionectomy in these children, and identify risk factors for poor seizure outcome, METHODS： The authors performed a retrospective chart review of children who harbored low-grade brain tumors, experienced seizures, and were treated in a single institution, Statistical analyses included step-wise as well as single-variable binary logistic regression analyses.     

Pediatric central corneal thickness variation among major ethnic populations.

PURPOSE: To investigate differences in central corneal thickness (CCT) among African-American, Caucasian, and Hispanic pediatric populations with respect to race, age, and gender. SUBJECTS AND METHODS: Ultrasound pachymetry measurements were obtained on 208 eyes of 106 patients. Measurements from left eyes were used in data analysis. Analysis of variance (ANOVA) and two-tailed t-test were performed to determine the effect of race, age, and gender on CCT variation. RESULTS: Mean central corneal thickness of left eyes in each ethnic group was African-Americans, 523 +/- 40 microm; Caucasians, 563 +/- 36 microm; and Hispanics, 568 +/- 44 microm. ANOVA performed on pachymetry values showed a significant effect of race on CCT (P = 0.00002). Mean Hispanic CCT was greater than mean African-American CCT (P = 0.0003), but was not significantly different from Caucasian CCT (P = 0.56). Mean Caucasian CCT was also greater than mean African-American CCT (P = 0.0001). The difference between mean male CCT (548 +/- 41 microm) and mean female CCT (563 +/- 44 microm) did not reach statistical significance (P = 0.07). When patients were stratified into age groups (<2 years, 2 to 4 years, 5 to 9 years, 10 to 18 years), CCT did not vary with age (P = 0.16). CONCLUSIONS: Our study suggests there may be differences in CCT among different ethnic groups in the pediatric population, with African-Americans having thinner corneas than Caucasians and Hispanics.     

Treatment utilization by patients with personality disorders

OBJECTIVE: Utilization of mental health treatment was compared in patients with personality disorders and patients with major depressive disorder without personality disorder. METHOD: Semistructured interviews were used to assess diagnosis and treatment history of 664 patients in four representative personality disorder groups-schizotypal, borderline, avoidant, and obsessive-compulsive-and in a comparison group of patients with major depressive disorder. RESULTS: Patients with personality disorders had more extensive histories of psychiatric outpatient, inpatient, and psychopharmacologic treatment than patients with major depressive disorder. Compared to the depression group, patients with borderline personality disorder were significantly more likely to have received every type of psychosocial treatment except self-help groups, and patients with obsessive-compulsive personality disorder reported greater utilization of individual psychotherapy. Patients with borderline personality disorder were also more likely to have used antianxiety, antidepressant, and mood stabilizer medications, and those with borderline or schizotypal personality disorder had a greater likelihood of having received antipsychotic medications. Patients with borderline personality disorder had received greater amounts of treatment, except for family/couples therapy and self-help, than the depressed patients and patients with other personality disorders. CONCLUSIONS: These results underscore the importance of considering personality disorders in diagnosis and treatment of psychiatric patients. Borderline and schizotypal personality disorder are associated with extensive use of mental health resources, and other, less severe personality disorders may not be addressed sufficiently in treatment planning. More work is needed to determine whether patients with personality disorders are receiving adequate and appropriate mental health treatments.     

The normal development of tibial torsion

Objective: Pathological rotation of the leg is a well-known problem in paediatric orthopaedics. In this study the normal development of tibial torsion during growth was evaluated by computed tomography (CT). Design: Seventy-eight normal individuals (52 children, 26 adults) aged 3–51 years were examined with CT. In axial scans the angle between a line tangential to the posterior part of the femoral condyles and the intermalleolar line, a line through the centre of the lateral and medial malleolus, was measured. The radiation exposure was evaluated and accepted by The National Department for Radiation and the Regional Committee for Ethics in Science. Results: CT showed that the average lateral torsion of the leg at the age of 4 years was 28° with an individual variation of 20°–37°. Later the increase in tibial torsion was on average 1°/year until 10 years of age and, thereafter, 4° until maturity when the mean lateral torsion was 38° (18°–47°). Conclusion: Tibial torsion in children mainly develops during the first 4 years of life. After this the increase was of less clinical significance. Received: 13 November 2000 Revision requested: 26 February 2001 Revision received: 19 March 2001 Accepted: 18 April 2001     

Ki-ras mutations are an early event and correlate with tumor stage in transplacentally-induced murine lung tumors

A previous study from this laboratory demonstrated that treatment of pregnant mice with 3-methylcholanthrene (MC) caused lung tumors in the offspring at 1 year after birth, the incidence of which correlated with fetal inducibility of Cyp1a1. Analysis by PCR amplification and allele- specific hybridization (ASO) of paraffin-embedded tumors generated from that study revealed the presence of point mutations in exon 1 of the Ki- ras gene. This work has now been expanded by PCR amplification and ASO analysis of 31 additional lesions. Point mutations were found in 37 of the 47 (79%) lesions analyzed in this and the previous study, the majority of which were G-->T transversions in the first or second base of codon 12. The mutational spectrum appeared to be dependent on the relative stage of differentiation of the lesion, as both the incidence of mutation and type of mutation produced correlated with malignant progression. Mutations occurred in 60% of the hyperplasias, 80% of the adenomas and 100% of the adenocarcinomas. In the lesions with mutations, GLY12-->CYS12 transversions occurred in 100% of the hyperplasias, 42% of the adenomas and 14% of the adenocarcinomas. The GLY12-->VAL12 transversions occurred in none of the hyperplasias, 42% of the adenomas and 57% of the adenocarcinomas. The remaining mutations, which consisted of ASP12 transitions and ARG13 transversions, occurred only in adenomas (17%) and adenocarcinomas (29%). Between this study and our previous analyses, the identity of the mutations obtained by ASO were confirmed by sequence analysis of eight of the 37 lesions that harbored mutations at the Ki-ras gene locus. There were no differences in the type or incidence of mutations relative to the metabolic phenotype or sex of the mice. These data suggest that mutational activation of the Ki-ras gene locus is an early event in transplacental lung tumorigenesis, and that the type of mutations produced by exposure to chemical carcinogens can influence the carcinogenic potential of the tumor. This may have prognostic significance in determining the malignant progression of the neoplasm.      

Early pregnancy complications: endovaginal sonographic findings correlated with human chorionic gonadotropin levels

Endovaginal sonography results were compared with quantitatively determined human chorionic gonadotropin (hCG) levels in 84 women referred for early pregnancy complications. Of the 27 with normal intrauterine pregnancies, an intrauterine gestational sac was prospectively identified in one of five cases (20%) in which hCG levels were below 500 IU/L (Second International Standard), four of five (80%) with hCG levels of 500-1,000 IU/L, and all 17 with hCG levels above 1,000 IU/L. In comparison, 17 of the 26 women with ectopic pregnancies (65%) had hCG levels greater than 1,000 IU/L, and none of the 26 had an intrauterine gestational sac. Endovaginal sonography demonstrated an adnexal mass and/or a gestational sac-like structure in 16 of the 17 cases (94%) in which hCG levels were above 1,000 IU/L, compared with only three of the nine (33%) with lower hCG levels (P less than .01). These findings indicate that an intrauterine gestational sac should be normally visualized with endovaginal sonography when the hCG level exceeds 1,000 IU/L, and that visualization of an extrauterine gestational sac and/or adnexal mass is significantly more likely in ectopic pregnancies when the hCG level exceeds 1,000 IU/L.     

Extra-hepatic biliary tract metastases from breast cancer

A retrospective review was conducted of 49 breast cancer patients who were seen at the Massachusetts General Hospital from 1962 to 1978 and who developed biliary tract metastases. Although these findings were incidental at autopsy in 21 patients, clinical evidence of extra-hepatic biliary involvement developed in 28. This was documented radiographically, surgically, and/or confirmed at autopsy. Although most patients had previous or concurrent nonbiliary tract metastases, in 6 patients the initial site of failure was in the extra-hepatic biliary system. Analysis of the 28 patients in the clinical group revealed that initial management with radiation therapy alone produced a response in 3 of 6 patients. However, when radiation was coupled with bypass surgery and/or adjuvant chemotherapy, a response occurred in 3 of 3; the total radiation therapy response rate was 6/9. Chemotherapy given either alone or in combination with surgery produced a response in only one of 7 patients. All 4 irradiated patients who were treated with a time-dose-fractionation (TDF) > 40 had a complete response compared to a complete response in only 2 of 8 with a TDF ≤ 40. The median survival of the irradiated group was 6 months compared to 3.3 months in the treated-unirradiated patients and 0.7 months in the untreated patients. The onset of jaundice in a breast cancer patient does not necessarily indicate progressive hepatic involvement. Patients with extrahepatic metastatic obstruction are being recognized increasingly and should be treated vigorously, especially since such patients with no liver parenchymal involvement have a greater survival (median 6 months) than those with liver involvement (median 1.8 months).