Oesophageal and other cancer patterns in four selected districts of Transkei,Southern Africa: 1985-1990

New data regarding the incidence of oesophageal and other cancers during the period 1985-1990 are reported for all clinics and hospitals in four selected districts of Transkei, Southern Africa i.e Kentani, Butterworth, Lusikisiki and Bizana. Active and passive methods were used to obtain the hospital-based cancer registry data. The mean annual number of cancer cases recorded for the period 1985-1990 was 292. Age-standardized incidence rates (ASIIR, African Standard) for all recorded cancers were 81.4 and 52.6/100,000 for males and females, respectively. Histopathogical examination of 52.6% of recorded tumours revealed that 67.3% were squamous carcinomas, 21.7% adenocarcinomas and the remainder non-epithelial neoplasms. Cancer of the oesophagus (EC) was the most frequently recorded cancer and accounted for 46.5% of the cases with mean ASIR of 46.7 and 19.2/100,000 for males and females, respectively. The male/female ratio was 2:4:1. The highest mean ASIR per annum for OC in males (55.6/100,000) occurred in Kentani and in females (22.3/100,000) in Lusikisiki, whereas the lowest rates in both sexes (37.0 and 11.7/100,000 respectively) occurred in Bizana. Comparison of the OC rates in the four districts of Transkei during 1985-1990 with previously reported trends, confirms a consistently high rate in the south-western district of Kentani during the past 35 years and progressively increasing rates in the north-eastern districts of Bizana and Lusikisiki. These results have profound implications for further epidemiological and aetiological studies on OC in Transkei, but need to be corroborated by data from other sources such as statistics on histologically diagnosed cancer in Transkei by district in the South African National Cancer Registry. The second most frequently recorded cancer among males was liver cancer with a mean annual ASIR of 6.0/100,0000 and a male: female ratio of 3:1. The most frequently recorded cancer with a mean annual AISR of 20.9/100,000 followed by OC (19.2/100,000) and breast cancer (5.8/100,000).     

(n-3) fatty acid supplementation in moderately hypertriglyceridemic adults changes postprandial lipid and apolipoprotein B responses to a standardized test meal.

The effects of (n-3) fatty acids on the postprandial state were investigated by monitoring the alimentary responses to identical test meals fed to adults [n = 11; fasting triacylglycerol (TG) 2.55 +/- 0.24 mmol/L; mean +/- SEM] after a self-selected diet baseline period (BLP) and then after a 6-wk (n-3) fatty acid period (FOP) [ approximately 5.2 g (n-3) fatty acids] and a 6-wk control oil period (COP) administered in random order. Samples were drawn immediately prior to the test meal (time 0) and then hourly from 2 to 6 h postmeal. Postprandial plasma triacylglycerol (TG) and TG-rich lipoprotein (TRL) TG apo B48, and B100 absolute concentrations were significantly lower after FOP than after COP or BLP, while plasma cholesterol was unchanged. Normalizing the results as increments over time 0 eliminated the diet effect on all but plasma TG. Time remained a significant effect for plasma TG, TRL TG, and TRL TC. Finally, only absolute TRL B48 and absolute and incremental plasma TG concentrations displayed significant time-diet interactions. These results suggest that postprandial TRL apo B reductions are likely caused by (n-3) fatty acid suppression of both hepatic and intestinal apoB secretion/synthesis. Altered TRL metabolism, i.e. changes in postprandial TG, cholesterol, apo B48, and increase in LDL particle size, may represent an additional mechanism for the reduced heart disease risk associated with fish [(n-3) fatty acid] consumption.     

Digital X-rays are here; why aren't you using them?

Digital imaging is here. It is cost-effective and helps dentists glean more useful information to make treatment decisions. Many more choices of digital systems are available for dentists to adopt than when the technology was introduced. The hardware is less costly than it was even one year ago, and image storage is now very inexpensive. Technical time is reduced, and no special training is required if the dentist or auxiliary has used a paralleling system. Insurance companies are gearing up to accept image files attached to claims. Why, then, are dentists not buying these systems as fast as manufacturer's can build them? This article explores that question and discusses the false assumptions behind perceived obstacles.     

alpha 1-tubulin expression in proximally axotomized mouse cortical neurons

This paper further characterizes the response to axotomy of mouse transcallosal cortical neurons, a population of neurons that seems to be particularly refractory to regeneration. Mouse transcallosal cortical neurons did not upregulate mRNA for the growth-associated protein alpha 1-tubulin following axotomy, even when the axonal distance from injury to cell body was only 100-300 microns. Previous experiments had found no upregulation of another growth-associated protein, GAP-43, by transcallosal neurons following axotomy 1-2 mm from the cell body. These latest results establish that this population of neurons fails to respond to axotomy even when it is extremely proximal and that this failure is not a peculiarity specific to one growth-associated protein but is indicative of a generally poor regenerative response.     

Fatal injury: characteristics and prevention of deaths at the scene

BACKGROUND: Almost half of all trauma deaths occur at the scene. It is important to determine if these deaths can be prevented. METHODS: Penetrating or blunt force trauma deaths were identified through the Office of the Medical Examiner during a 2-year period. Data were also obtained through review of these records. RESULTS: There were 312 deaths at the scene that received no medical care. Almost 60% were firearm-related. About 80% of the victims were men, and 55% of these deaths occurred in people between 20 and 49 years old. Suicide accounted for nearly half of these deaths. Eighty percent of these injured people had Abbreviated Injury Scale scores of 5 or 6. CONCLUSION: Almost 60% of deaths at the scene occurred at the same time as injury and reflect severe injury to vital regions of the body. These findings suggest that primary prevention of the initial event causing injury may be more important than definitive prehospital emergency medical care to prevent these deaths.     

Long-term results of silicone expander for moderate and severe Brown syndrome (Brown syndrome “plus”)

Background: The treatment of Brown syndrome has been undergoing an evolution toward more effective procedures with fewer operative interventions. Dr Kenneth Wright has introduced a procedure of superior oblique muscle tenotomy with a silicone expander to reduce the incidence of overcorrection. Methods: There was a retrospective study of 20 eyes of 19 consecutive patients with moderate or severe Brown syndrome (Brown syndrome “plus”). Follow-up ranged from 12 to 72 months. The expander, which varies 6 to 10 mm in length, was placed in all patients in the tenotomized superior oblique muscle tendon 5 mm nasal to the nasal border of the superior rectus muscle using 7-0 or 8-0 Prolene suture without violating the inner layer of the intermuscular septum. The intermuscular septum was closed over the silicone expander. Results: One hundred percent of patients had resolution of the down shoot in adduction and some or full ability to elevate the eye in adduction. Twenty percent of patients required reoperation (12.5% using 5-8 mm expanders) for overcorrection. Restriction of downgaze was not seen postoperatively. Patients often show an undercorrection 1 to 6 months postoperatively and improve or occasionally overcorrect at 1 to 2 years postoperatively. One patient with a 10-mm expander extruded the implant. Discussion: Placement of a 5- to 8-mm silicone expander in the tenotomized superior oblique muscle tendon is an effective means of correcting Brown syndrome with a low rate of reoperation. Initial undercorrection should not discourage the surgeon because improvement may continue for up to 3 years. The goal of treatment should be to convert a moderate or severe Brown syndrome (Brown syndrome plus) to a mild Brown syndrome (“true” Brown syndrome). Conclusion: This technique reduces the need for either simultaneous or subsequent inferior oblique muscle weakening and represents an advance in the treatment of Brown syndrome. (J AAPOS 1999;3:328-32)