Early operative mortality after surgical treatment of bronchogenic carcinoma

Background A retrospective analysis of the results of pulmonary resection over a 7 years period for bronchogenic carcinoma was performed. Methods Three hundred and eleven patients with primary bronchogenic carcinoma were operated upon at Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, between January 1996 to June 2002. There were 62 pneumonectomies (19.93%), 174 lobectomies (55.94%) and 75 lesser resections (24.11%). Results The overall operative mortality was 4.82%. The mortality rate for pneumonectomy, lobectomy and lesser resections were 9.6%, 4.5% and 1.3% respectively. There was no significant difference in operative mortality between pneumonectomy and lobectomy, and between lobectomy and lesser resections. Post operative mortality rate increased as the age of patient increased. Mortality was 2.3;2.9;5.0;7.41; and 14.2 in the age groups of <50 years, 50–59 years, 60–69 years, 70–79 years and 80 years and above respectively. Pneumonia and respiratory failure caused most deaths (46.66%). Conclusions Pulmonary resections can be performed with satisfactory mortality and morbidity in bronchogenic carcinoma.     

Serum selenium and subsequent risk of prostate cancer.

It is suspected that selenium is protective against prostate cancer. To test this hypothesis, we conducted a nested case-control study in a cohort of 9345 Japanese-American men examined between 1971 and 1977. At the time of examination, a blood specimen was obtained, and the serum was frozen. After a surveillance period of more than 20 years, 249 tissue-confirmed incident cases of prostate cancer were identified. Their stored sera and those of 249 matched controls were measured for selenium levels. Odds ratios for prostate cancer, based on quartiles of serum selenium levels, were determined using the General Estimating Equations approach. The multivariate odds ratio for the highest quartile was 0.5 (95% confidence interval, 0.3-0.9) with a two-sided P for trend of 0.02. The inverse association was more notable for cases with advanced disease and for cases diagnosed 5-15 years after phlebotomy. However, the association was mainly present in current or past cigarette smokers rather than nonsmokers, which leads to caution in the interpretation of the results.     

Diagnosis and management of benign fibro‐osseous lesions of the jaws: a current review for the dental clinician

Benign fibro‐osseous lesions of the maxillofacial skeleton constitute a heterogeneous group of disorders that includes developmental, reactive (dysplastic) and neoplastic lesions. Although their classification has been reviewed multiple times in the past, the most common benign fibro‐osseous lesions are fibrous dysplasia, osseous dysplasia and ossifying fibroma. For the dental clinician, the challenges involve diagnosis and treatment (or lack thereof). A careful correlation of all clinical, radiologic and microscopic features is essential to establish a proper diagnosis and a clear treatment plan. This article aimed to review the clinical, radiologic and histopathologic characteristics of benign fibro‐osseous lesions of the jaws, with emphasis on their differential diagnoses. With a deeper understanding of benign fibro‐osseous lesions, clinicians will be better prepared to manage these lesions in their practice.     

Influence of facial skin attributes on the perceived age of Caucasian women

Background and objective The facial appearance of a person does not always reflect the chronological age; some people look younger or older than they really are. Many studies have described the changes in skin properties (colour, wrinkles, sagging, micro relief, etc.) with age, but few of them have analysed their influence on the perceived age. The primary objective of this study was to assess the contribution of individual skin attributes of the face on the perceived age of Caucasian women. Secondary objectives were to assess the influence of age and gender of graders with regard to the age perception. Subjects and method A random sample of 173 subjects of 20 to 74 years of age was taken from a database of more than 5000 healthy Caucasian women. A trained grader performed visual assessment of facial skin attributes (using a visual analogue scale), and a front face photograph was taken from each subject. Photographs were shown to 48 graders (20 men and 28 women, aged 22–64 years) who were asked to estimate the age of the subjects. Graders were classified as young (less than 35 years), middle age (35–50 years) and seniors (older than 50 years). Partial Least Square regression models were built to predict the chronological and the perceived age from the measured facial individual attributes. The contribution of each attribute within the regression model enabled to measure the relevance of this attribute with regards to age prediction. Results The eye area and the skin colour uniformity were the main attributes related to perceived age. For age prediction, older graders’ estimations were more driven by lips border definition shape and eyes opening, whereas younger graders’ (older than 50 years) estimations were more driven by dark circles, nasolabial fold and brown spots. There were statistically significant differences in graders’ age perception between gender and among age ranges. Our findings suggest that female graders are more accurate than male, and younger graders (under 35 years) are more accurate than older (over 50 years) to predict Caucasian women age from facial photographs. Conclusions Different skin attributes influence the estimation of age. These attributes have a different weight in the evaluation of the perceived age, depending on the age and of the observer. The most important attributes to estimate age are eyes, lips and skin colour uniformity.     

Are aortic aneurysms caused by atherosclerosis?

BACKGROUND. The emerging controversy concerning the causal role of atherosclerosis in the development of aortic aneurysms was examined using the accumulated clinical and autopsy data obtained during a 20-year follow-up of a cohort of more than 8,000 men of Japanese ancestry in Hawaii. METHODS AND RESULTS. Analyses of 174 clinical incident events indicated that there were two types of aneurysmal disease, 151 aortic aneurysms and 23 aortic dissections. The baseline risk factors that predicted the clinical aortic aneurysms were the same factors that predicted aortic atherosclerosis in the same cohort, namely, high blood pressure, high serum cholesterol, and cigarette smoking. These same risk factors were also significantly associated with the occurrence of 27 aortic aneurysms among 293 autopsied men. The less common aortic dissections had an age-specific incidence pattern indicative of an innate susceptibility precipitated by an exposure to another factor. This pattern was consistent with the findings that the incidence of aortic dissections was predicted mainly by baseline high blood pressure. CONCLUSIONS. From the perspective of prevention, it appears that the risk factors for aortic atherosclerosis and probably atherosclerosis itself are necessary elements in the causal pathway for the great majority of aortic aneurysms in this cohort.