Incidence,mortality and survival patterns of prostate cancer among residents in Singapore from 1968 to 2002

Background  

From 1968 to 2002, Singapore experienced an almost four-fold increase in prostate cancer incidence. This paper examines the incidence, mortality and survival patterns for prostate cancer among all residents in Singapore from 1968 to 2002.     

Immunity to hepatitis B, poliomyelitis and measles in fully vaccinated Aboriginal and Torres Strait Island children

Objective: To determine the immunity to hepatitis B, poliomyelitis and measles in fully vaccinated Aboriginal and Torres Strait Island children in north Queensland.
Methodology: A cross-sectional survey of immunity in a sample of children; 101 fully vaccinated Aboriginal and Torres Strait Island children, with a median age of 24.5 months, from 10 communities in North Queensland participated in this study. The main outcome measures were the prevalence of adequate antibody levels against hepatitis B, poliomyelitis and measles.
Results: Only 54% (95% Cl 44–63%) of the children had adequate immunity (10 m iu/mL) to hepatitis B, and one child had been infected despite vaccination. Although all the children (95% Cl 96–100%) had adequate immunity (i.e. neutralizing antibodies at a dilution of 1:8) to poliovirus 2, only 93% (95% Cl 86–96%) and 60% (95% Cl 50–69%) had adequate immunity to polioviruses 1 and 3, respectively. Nearly all (96%; 95% Cl 90–98%) of the children had adequate immunity (i.e. detectable IgG antibody) to measles.
Conclusions: Although a relatively low proportion of the children had adequate antibody levels against hepatitis B the clinical significance of this observation is uncertain. Further studies are needed to determine whether fully vaccinated Torres Strait Island children have been adequately protected and whether they require a booster dose of hepatitis B vaccine. A substantial proportion of fully vaccinated Aboriginal and Torres Strait Island children are inadequately protected against poliomyelitis, and therefore any such child with acute flaccid paralysis should be investigated fully for poliomyelitis. Vaccinated Aboriginal and Torres Strait Island children are well protected against measles, as are other Australian children.     

New treatment strategies for malignant gliomas

Malignant gliomas are the most prevalent type of primary brain tumor in adults. Despite progress in brain tumor therapy, the prognosis of malignant glioma patients remains dismal. The median survival of patients with glioblastoma muhiforme, the most common grade of malignant glioma, is 10-12 months. Conventional therapy of surgery, radiation and chemotherapy is largely palliative. Essentially, tumor recurrence is inevitable. Salvage treatments upon recurrence are palliative at best and rarely provide significant survival benefit. Therapies targeting the underlying molecular pathogenesis of brain tumors are urgently required. Common genetic abnormalities in malignant glioma specimens are associated with aberrant activation or suppression of cellular signal transduction pathways and resistance to radiation and chemotherapy.     

Development of a microchamber which spontaneously selects high-quality sperm for use in in vitro fertilization or micromanipulation

Background: A microchamber has been developed which allows motile sperm to swim from a central loading site to peripheral sidewells. The sidewells are designed such that oocytes may be placed within them for in vitro fertilization (IVF) or sperm may be harvested from them for use in standard IVF or micromanipulation. Because only motile sperm can reach the sidewells, the microchamber can select relatively high-quality sperm from a crude preparation. Moreover the steep walls of the sidewells create the potential to trap sperm. Objective: The present study was under taken to compare sperm in the sidewells to those found in randomly sampled regions of microchamber after various periods of incubation. Results: We find that the sidewells concentrate motile sperm and that a higher percentage of sperm removed from side-wells is acrosome reacted. Motile sperm from oligospermic patients can be harvested from microchamber sidewells for use in micromanipulation after loading the microchamber with unprocessed specimens. Results suggest that this microchamber could be used to enhance sperm:egg interaction in IVF or to harvest sperm for micromanipulation.     

Ambulatory blood pressure monitoring

Ambulatory blood pressure monitoring (ABPM) in adults is proving to be useful. The aim of this study was to determine if ABPM is accurate in the lower blood pressure range encountered in children and, equally important, whether it is acceptable to children. Thirty one children, between the ages of 6 and 18 years, were assessed using an ambulatory blood pressure monitor that uses an auscultatory method. Blood pressure was measured in the contralateral arm with a mercury sphygmomanometer and an oscillometric device at the beginning and end of the study for comparison. Over a blood pressure range of 90-130 mm Hg systolic and 40-80 mm Hg diastolic, a close agreement was found with the sphygmomanometer; the limits of agreement (+/- 2 SD) were 11.6 mm Hg for systolic blood pressure and 13.6 mm Hg for diastolic blood pressure. The bias was less than 1.0 mm Hg. The ambulatory device was worn by all patients for at least 16 hours with an average of 52 recordings per patient. The majority found the device comfortable to wear and were not woken from sleep.     

High-risk mild head injury

The generally accepted definition of mild head injury is a Glasgow Coma Scale (GCS) score of 13-15. However, many studies have already shown that there is a heterogeneity in pathophysiology among patients with GCS scores ranging from 13-15. Patients with GCS score 13 or 14 tended to have more serious injury. There is a statistically significant trend across GCS scores in terms of percentage of patients with positive acute radiographic findings, percentage of patients with neurosurgical interventions, and percentage of patients with poorer outcome. Patients with the so-called "mild" head injury may have serious long-term sequelae. The current definition of mild head injury is misleading because the sequelae of the injury may not be mild. A more precise classification of head injury is necessary. An ideal classification of head injury is one that can accurately predict the outcome of the injury. Based on the results of our earlier study [Hsiang et al. High-risk mild head injury. J Neurosurg 1997; 87:234-238], the head injury patients with GCS 13-15 should be further subdivided into "mild head injury" or "high-risk mild head injury." Mild head injury is defined as GCS 15 without any acute positive radiographic findings, whereas high-risk mild head injury is defined as GCS 13 or 14, or GCS 15 with acute positive radiographic findings. Using this more precise classification, the truly mild head injury patients can be safely discharged from the emergency department, and the high-risk mild head injury patients can either be admitted or be warned about the expected sequelae. The addition of the subgroup "high-risk mild head injury" may help to avoid the confusion caused by the current classification of mild head injury.     

Spatial variations in optical and physiological properties of healthy breast tissue

Near-infrared (NIR) diffuse optical spectroscopy (DOS) and diffuse optical imaging (DOI) show promise as noninvasive clinical techniques for breast cancer screening and diagnosis. Since NIR methods are based on optical contrast between healthy and diseased tissue, it is essential to characterize the sources of endogenous contrast in normal subjects. We report intra- and inter-subject variation and bilateral asymmetry of the optical and physiological parameters of 31 women using a seven-wavelength NIR frequency-domain photon migration (FDPM) instrument. Wavelength-dependent absorption and reduced scattering parameters (micro(a) and micro(s'), respectively) were measured in four major quadrants and the areolar regions of left and right breasts. These values were used to determine tissue concentrations of oxy-(HbO(2)) and deoxy-(Hb-R) hemoglobin, lipid content, water concentration, and tissue "scatter power." Mean total hemoglobin for premenopausal (PRE) women (20 to 30 microM) is approximately two-fold higher than for postmenopausal (POST) subjects at all positions. POST women have approximately 50% higher lipid content (50 to 60%) than PRE at all positions. Water concentration on average is 1.8-fold higher for PRE subjects (30 to 40%) than POST. These differences are most pronounced when comparing the areolar complex to the other regions of the breast. In premenopausal women, the areolar regions have 40 to 45% increased total hemoglobin concentration (THC), 20 to 25% lower lipid content, and 30 to 60% higher scatter power versus the quadrants. Small-scale (3 cm) changes in optical properties are negligible compared to large-scale variations over all quadrants, where the intrinsic spatial heterogeneity of healthy breast tissue is 20 to 40% for micro(a) and 5 to 12% for micro(s'). Although no consistent right-left differences are observed in the study population, relative differences between symmetric positions ranged from 18 to 30% for THC, 10 to 40% for adipose, 10 to 25% for water, and 4 to 9% for scattering (674 nm) within an individual.