Histopathological features of breast tumours in <Emphasis Type="Italic">BRCA1</Emphasis>, <Emphasis Type="Italic">BRCA2</Emphasis> and mutation-negative breast cancer families

Introduction

Histopathological features of BRCA1 and BRCA2 tumours have previously been characterised and compared with unselected breast tumours; however, familial non-BRCA1/2 tumours are less well known. The aim of this study was to characterise familial non-BRCA1/2 tumours and to evaluate routine immunohistochemical and pathological markers that could help us to further distinguish families carrying BRCA1/2 mutations from other breast cancer families.

Methods

Breast cancer tissue specimens (n = 262) from 25 BRCA1, 20 BRCA2 and 74 non-BRCA1/2 families were studied on a tumour tissue microarray. Immunohistochemical staining of oestrogen receptor (ER), progesterone receptor (PgR) and p53 as well as the histology and grade of these three groups were compared with each other and with the respective information on 862 unselected control patients from the archives of the Pathology Department of Helsinki University Central Hospital. Immunohistochemical staining of erbB2 was also performed among familial cases.

Results

BRCA1-associated cancers were diagnosed younger and were more ER-negative and PgR-negative, p53-positive and of higher grade than the other tumours. However, in multivariate analysis the independent factors compared with non-BRCA1/2 tumours were age, grade and PgR negativity. BRCA2 cases did not have such distinctive features compared with non-BRCA1/2 tumours or with unselected control tumours. Familial cases without BRCA1/2 mutations had tumours of lower grade than the other groups.

Conclusions

BRCA1 families differed from mutation-negative families by age, grade and PgR status, whereas ER status was not an independent marker.

     

Whole-brain CT perfusion measurement of perfused cerebral blood volume in acute ischemic stroke: probability curve for regional infarction

PURPOSE: To determine the probability curve for regional cerebral infarction as a function of percentage normalized perfused cerebral blood volume (pCBV) in patients with acute ischemic stroke. MATERIALS AND METHODS: The authors retrospectively analyzed whole-brain computed tomographic (CT) perfusion scans from 28 patients with acute stroke (<6 hours) due to major arterial occlusion, without intracranial hemorrhage. Each patient had a positive follow-up CT scan 1-4 days later, without interval thrombolysis. Normalized pCBV, expressed as a percentage of contralateral normal brain pCBV, was determined in the core infarction and in regions just inside and outside the boundary between infarcted and noninfarcted brain. These regions were dichotomized into infarcted (core and inner band) and noninfarcted (outer band) categories. Logistic regression analysis was then used to create a reference curve of probability of infarction as a function of percentage normalized pCBV. RESULTS: Normalized pCBV values in the core, inner band, and outer band were 24.5% +/- 2.3, 36.3% +/- 2.4, and 72.1% +/- 2.4, with corresponding probabilities of infarction of .99, .96, and .11. The normalized pCBV at which the probability of survival reached .5 was 58.0% +/- 0.5. Sensitivity, specificity, and accuracy of the reference probability curve were 90.5% (209 of 231), 89.5% (212 of 237), and 90.0% (421 of 468), respectively. Negative and positive predictive values were 90.6% (212 of 234) and 89.3% (209 of 234), respectively. R2 was 0.73, and differences in perfusion between core and inner and outer bands were highly significant (P <.0001). CONCLUSION: A probability of infarction curve can help predict the likelihood of infarction as a function of percentage normalized pCBV.     

Sound exposure among the Finnish National Opera personnel

The purpose of the study was to determine how and when the personnel of the Finnish National Opera are exposed to noise and whether exposure depends on musical selection of repertoire. Additionally, an evaluation of sound exposure level due to individual rehearsals was included. The measurements were done using individual noise dosimeters and fixed-point measurements. From the measurements, annual noise exposure in the Opera was evaluated. The conductors, dancers, and double bass players were exposed to levels below 85 decibels, A-weighted, dB(A), which is the national action level. The choir members were exposed to sound levels of 92 and 94 dB(A). Within the orchestra, the highest sound exposure levels were found among percussionists, 95 dB(A); flute/piccolo players, 95 dB(A); and brass players, 92-94 dB(A). Other sound exposure levels among orchestra members varied from 83 to 89 dB(A). Soloists and rehearsal pianists are likely to be exposed to sound levels exceeding the national action level. From an exposure perspective, the individual rehearsals, 79-100 dB(A), proved to be as important as performances and group rehearsals, 82-99 dB(A), among orchestra musicians and choir singers. The ambient sound level for the lighting crew was 76 +/- 4 dB(A). However, the measured sound levels at the ear varied from 77 to 92 dB(A) due to the communication via headphones that had individual volume control. For the majority of personnel of the Finnish National Opera, sound exposure level exceeded the national action level value of 85 dB(A). Artists exceeded the action level during both individual and group rehearsals, as well as during performances. Hearing protection has been designed for musicians. Education/reinforcement is required to ensure it is worn.     

Impaired spermatogenesis: an unrecognized feature of cartilage-hair hypoplasia

BACKGROUND: Cartilage-hair hypoplasia (CHH), an autosomal recessive chondrodysplasia, is characterized by severe growth failure, hypoplastic hair, impaired immunity, and deficient erythropoiesis. These features may result from a generalized defect in cell proliferation. AIM. In order to investigate whether an impairment of cell proliferation is present in spermatogenesis, we analysed fertility in a clinical and laboratory study of adult males with CHH. METHODS. Eleven adult males (median age 29 years, range 21-49 years) with CHH were included in the study. The patients were examined clinically for testicular volume and other clinical characteristics. Blood samples were collected to determine serum concentrations of sex hormones, sex hormone-binding globulin, inhibin B and gonadotrophins (basal and gonadotrophin-releasing hormone-stimulated). Semen samples were analysed for volume, sperm concentration, motility, morphology, and antibody status. RESULTS. The testicular size was subnormal in some patients, but the serum concentrations of testosterone, inhibin B and gonadotrophins were usually normal. The semen analyses were not within normal limits in any of the patients, as indicated by low sperm concentration, decreased motility and/or morphological changes. CONCLUSIONS. The defect in cell proliferation in men with CHH also involves the spermatogenic cells and is evident as an impairment of spermatogenesis.     

Mood improvement reduces memory complaints in depressed patients

Background The aim was to examine associations between memory complaints, cognitive performance and mood in 174 adult, clinically depressed, neurologically healthy patients at baseline and during six months of follow-up. Methods Subjective memory disturbance was assessed using the Memory Complaint Questionnaire (MCQ). Levels of cognitive function, including memory, were assessed using a battery of neuropsychological tests. Mood and personality traits were assessed using rating scales, including the Beck Depression Inventory (BDI), Hamilton Depression Rating Scale (HDRS) and the 90-item Symptom Check List (SCL-90). Results At baseline, patients complaining of memory disturbances had higher BDI and HDRS scores than patients not complaining of memory problems. They also did less well in objective memory performances but not in other cognitive functions. Complaints of memory problems decreased during the follow-up. This change was associated with mood improvement and with reductions in other mental symptoms but not with changes in cognitive performance. In logistic regression analysis factors independently associated with MCQ change were age (OR 0.96) and BDI change (OR 1.06). Conclusions Subjective memory problems usually decline if depression is alleviated. Received: 3 February 2000 / Accepted: 26 October 2000     

Effects of a community intervention to reduce the serving of alcohol to intoxicated patrons

Aims To assess the effects of an alcohol prevention programme to reduce the serving of alcoholic beverages to intoxicated clients on licensed premises. Research design A controlled pre‐ (2004) and post‐intervention study (2006) design. Intervention A community‐based programme combining law enforcement, responsible beverage service training, information campaigns and policy initiatives in one Finnish town (Jyväskylä). Participants and measurements A male actor pretended to be clearly under the influence of alcohol and tried to buy a pint of beer at licensed premises. For the baseline measurement, every bar and nightclub was visited in the intervention and the control areas (94 licensed premises in total). Post‐intervention data were gathered with the same principles (100 licensed premises in total). A researcher observed every visit and documented the results. Results In the post‐intervention study there was a statistically significant increase in refusals to serve denials alcohol to the actor in the intervention area (from 23% to 42% of the licensed premises) compared to refusals in the control area (from 36% to 27% of the licensed premises). Conclusion Previous research has documented that multi‐component community‐based interventions can have a significant impact on over‐serving of alcohol when training and house policies are combined with effective law enforcement. The present findings also demonstrate that comprehensive Responsible Beverage Service (RBS) interventions applied at a local community level can be effective in decreasing service to intoxicated clients in a Nordic context.     

Prevention of zoonotic animal diseases: a step towards co-operation among Nordic authorities?

Aim  

With globalisation, the spreading and consequences of serious animal diseases will become an increasingly realistic threat, also to Nordic countries, their food animals and consumers. It has already been suggested that it might be useful to establish an army to manage all co-operations among countries, for instance, for medical co-operation needs. In light of this, it might also be important to guarantee the security of animal products and to fight together against animal diseases, some of which are potentially dangerous for human beings. The aim of this study was to investigate how the laws concerning animal diseases construct the reality of co-operation among authorities in different Nordic countries.