Cord serum IgE: an insensitive method for prediction of atopy

Cord total serum IgE has been advocated as a screening test to detect infants at high risk of allergy who would be suitable for preventive measures. In a population based prospective study to look at the predictive capacity of cord IgE and family history of atopy 1111 one-year-old infants were followed-up. Cord IgE was measured using the EIA ultra technique (Pharmacia, Uppsala, Sweden). Atopic symptoms developed in 255 (23%) at one year, 183 (16.5%) had probable atopy (clinical disorder but negative skin prick test (SPT)) and 72 (6.5%) had definite atopy (clinical disorder with positive SPT). There was no difference in the mean cord IgE levels in infants with or without atopic manifestations. The cut-off for IgE was taken at 0.6 ku/1. The specificity of the test was 92% but the sensitivity was only 8.5%. The positive and negative predictive values were 24% and 78% respectively. Family history of atopy is far more sensitive in detecting infants at risk of atopy and little is added by knowledge of cord IgE.     

Otorhinolaryngological training in Europe—a comparative study

Postgraduate training in the United Kingdom is undergoing radical changes following the `Calman Report'. Commissioned in response to a European Union (EU) Directive, this contained recommendations to allow reciprocal recognition of all EU trained specialists. We present the findings of a postal questionnaire sent to representatives of the European Federation of Oto-Rhino-Laryngological Societies and the otolaryngology professors of the UK and Ireland with a response rate of 62.7%. Aspects assessed included clinical and surgical experience, examinations, teaching, research, length, regulation and perception of training. The programmes share similar teaching and research experience but substantial differences exist in most other areas. The accredited UK trainee has a much wider clinical and surgical repertoire than those from the Continent. Greek trainees were trained to the lowest minimum standard. The requirements of a training system are largely determined by the level of clinical experience and surgical skill required by an independent specialist in a given country.     

Parental cigarette smoking and tonsillectomy in children

The deleterious effects of parental smoking on the upper respiratory tracts of children are becoming increasingly recognized. This study examines the effect of parental smoking on the frequency of tonsillitis and incidence of tonsillectomy in children. A group of children being admitted for tonsillectomy and a control group of children from an orthoptic clinic were studied. Details recorded about the children included a history of tonsillectomy and the number of courses of antibiotics taken for sore throats in the previous 12 months. Parents were questioned about their smoking habits. A marked and statistically significant association has been found between the incidence of tonsillectomy in children and parental smoking in the home environment. There was a higher frequency of attacks of tonsillitis requiring antibiotic treatment in those children whose parents smoked. This effect may be mediated by altered oropharyngeal flora, mucociliary dysfunction, increased cross infection or a combination of these. If parents are encouraged to stop smoking there will be a reduction in tobacco smoke levels in the home environment and this should lead to a fall in both the incidence of tonsillitis and the need for tonsillectomy in their children.     

COLON CANCER AND POLYPS IN ACROMEGALY: INCREASED RISK ASSOCIATED WITH FAMILY HISTORY OF COLON CANCER

A cohort of 52 subjects diagnosed with acromegaly in southeastern Michigan and northern Ohio between 1935 and 1985 were followed to determine the incidence of colon cancer and polyps. Medical records were reviewed, subjects or their next-of-kin were interviewed, and screening examinations of the colon were offered to the living patients who were located. Data on demographics, personal histories of cancer and colon polyps, family history of colon cancer, and cure from acromegaly were obtained for both living and deceased subjects. The risk for colon cancer compared to the general population was estimated using standardized incidence ratios (SIRs). The expected number of cases was determined utilizing age, sex and race-specific rates provided by the cancer registry in southeastern Michigan. Among the 52 subjects, one could not be located and nine were deceased, none from colon cancer, with one known to have a history of colon polyps. Of 13 (31%) who declined the screening physical, one had a history of polyps and none reported a history of colon cancer. Two of 29 screened patients were found to have right-sided adenocarcinoma of the colon. Of the entire cohort, eight people (including one deceased) had a current or previous diagnosis of polyps, with five known to be histologically adenomatous. The SIR for colon cancer was 4.7 (95% confidence interval 0.6-17.1). Seven subjects, including the two with detected adenocarcinoma and four of the six living subjects with polyps only, reported a family history of colon cancer. The SIR for the subset of subjects with a family history of colon cancer was 29.1 (95% confidence interval of 3.5-104.6).(ABSTRACT TRUNCATED AT 250 WORDS)     

Clinical and immunological characteristics of Brazil nut allergy

Twelve cases of allergy to Brazil nut have been recorded in the last 8 years. The reaction is usually IgE mediated and most patients have other atopic diseases. There appear to be several proteins with potent antigenic components in Brazil nut.     

CA19-9在膀胱癌中的表达及临床意义

目的:探讨糖类抗原CA19-9在膀胱癌中的表达及临床意义.方法:免疫组织化学法检测40例膀胱癌标本(实验组)中及5例正常膀胱组织(对照组)中CA19-9的表达水平,并分析其表达结果与肿瘤的临床及病理参数的关系.结果:40例膀胱癌组中的阳性表达率明显高于正常膀胱组(P<0.05);且CA19-9在浅表性、高分化组膀胱癌组织中表达明显高于其在浸润性,低分化组膀胱癌中的表达.浅表性膀胱癌病例(Tis,T0,T1)中CA19-9表达率高达95%.5例正常膀胱组织标本中CA19-9表达均为阴性.结论:糖类抗原CA19-9可作为膀胱TCC的肿瘤标志物尤其是在低分级,浅表性的膀胱癌病例.     

Asymmetric polyarthritis as an initial presentation of Rosai‐Dorfman disease

Rosai‐Dorfman disease (RDD) is a rare benign reactive lymphoproliferative disorder characterised by a histopathological pattern with sinus histiocytosis and hemophagocytosis. It usually presents with fever, elevated erythrocyte sedimentation rate, cervical lymphadenopathy, other lymph node and extra‐nodal site involvement. We present the case of a 25‐year‐old female patient with polyarthritis mimicking rheumatoid arthritis (RA). When the para‐aortic lymph node was biopsied, it showed extensive histiocytic proliferation; some clusters of plasma cells, lymphocytes and rare multinucleated cells were seen, suggesting a diagnosis of RDD. There is nothing in the literature regarding the polyarthritic presentation of the disease. To the best of our knowledge, our patient is the first case of RDD presenting with a clinical picture mimicking atypical seronegative RA.