Relation between mood, social support and the quality of life in patients with laryngectomies

Two hundred laryngectomized members of the Norwegian Society of Laryngectomies (NSL), a subsidiary of the Norwegian Cancer Society, were invited to answer the EORTC QLQ-C30 (version 3.0) and QLQ-H&N35 QOL questionnaires to assess their quality of life (QOL). The Beck Depression Inventory (BDI) scores, their levels of social support and their marital and educational statuses were also determined. In addition, the activity levels of each patient within the NSL were assessed. The questionnaires were returned anonymously by 104 patients. The results of this sample were compared with the responses to the EORTC QLQ C30/H&N35 by all of the survivors of treatment for head and neck squamous cell carcinoma (HNSCC) in western Norway between 1992 and 1997. This sample included 96 of 106 eligible patients. The QLQ-C30 symptom scores include, e.g., dyspnea, smell and taste. However, neither the QLQ-C30 functional scores nor the disease-specific scores of the people with laryngectomies differed from the general HNSCC-treated population. The level of social support by family, friends and neighbors was not associated with the QOL, whereas high BDI scores were associated with reduced QOL by most measured indexes. Furthermore, a positive association was determined between the level of activity within the NSL and QOL. This relation was to some extent secondary to differential BDI scores. In conclusion, the QOL of people with laryngectomies is relatively similar to a general population of patients treated because of HNSCC, is related to the activity level within a patient interest organization and is associated with a lower mood level.     

Heterogeneity of squamous cell carcinomas of the oral cavity studied by flow cytometry

The DNA pattern was determined by flow cytometry in 76 samples from 16 squamous cell carcinomas of the oral cavity to assess intratumour DNA heterogeneity. Heterogeneous DNA content was found in 2 tumours (12%); both containing DNA diploid and DNA aneuploid cell clones. The remaining 14 tumours showed a homogeneous DNA distribution in the different specimens; 9 (56%) were diploid, 3 (19%) aneuploid and 2 (12%) were polyploid. The DNA non-diploid tumours were clinically more advanced than the DNA diploid ones (p less than 0.05). The tumour proliferation rate (fraction of cells in S-phase) was higher in aneuploid tumours than in diploid ones (p less than 0.01).     

Gender differences in patients treated for critical limb ischemia.

OBJECTIVE: To investigate, in patients treated for critical limb ischemia, how pre-operative conditions, localisation of lesions and outcome varied according to gender. DESIGN: Retrospective cohort study. METHODS: Medical records were analysed for all patients treated with vascular reconstruction or PTA for critical limb ischemia 1993-1994 (119 women, 115 men) at the Karolinska Hospital. All events such as secondary intervention, amputation and death occurring until 2003 were included in the analysis. RESULTS: The preoperative conditions were similar between women and men apart from higher mean age (74 years in women vs 69 in men, p=0.0002), fewer subjects with a smoking history (63 vs 82%, p=0-005) and diabetic disease (22 vs 43%, p=0.0004) among females. More interventions were performed suprainguinally in women (44% in women vs 19% in men). Amputation and survival rates were similar in women and men, even after matching for age and diabetes. CONCLUSION: Women were older, had a lower frequency of diabetes, smoked less and had more proximal lesions than treated men. Outcome was identical for both genders. Biological and anatomical differences could possibly explain several of the found gender differences. Gender differences in risk factors and possibly in the selection process also may have contributed to our findings.     

Identification of an N-linked glycan in the V1-loop of HIV-1 gp120 influencing neutralization by anti-V3 antibodies and soluble CD4

Summary Glycosylation is necessary for HIV-1 gp120 to attain a functional conformation, and individual N-linked glycans of gp120 are important, but not essential, for replication of HIV-1 in cell culture. We have constructed a mutant HIV-1 infectious clone lacking a signal for N-linked glycosylation in the V1-loop of HIV-1 gp120. Lack of an N-linked glycan was verified by a mobility enhancement of mutant gp120 in SDS-gel electrophoresis. The mutated virus showed no differences in either gp120 content per infectious unit or infectivity, indicating that the N-linked glycan was neither essential nor affecting viral infectivity in cell culture. We found that the mutated virus lacking an N-linked glycan in the V1-loop of gp120 was more resistant to neutralization by monoclonal antibodies to the V3-loop and neutralization by soluble recombinant CD4 (sCD4). Both viruses were equally well neutralized by ConA and a conformation dependent human antibody IAM-2G12. This suggests that the N-linked glycan in the V1-loop modulates the three-dimensional conformation of gp120, without changing the overall functional integrity of the molecule.     

Serum prealbumin and retinol-binding protein in the prealbumin-related senile and familial forms of systemic amyloidosis

In a series of 13 elderly patients with proven prealbumin-related senile systemic amyloidosis (SSA), depressed serum prealbumin values (110.7 +/- 14.1 micrograms/ml) were found as compared to an age-matched control group (175.1 +/- 20.3 micrograms/ml). As expected, there was a significant correlation between serum prealbumin and serum retinol-binding proteins in both groups of patients. Patients with reactive amyloid protein AA amyloidosis had slightly depressed serum prealbumin concentrations, whereas patients with prealbumin-related familial amyloidosis of Swedish type had prealbumin values within normal limits. Since the serum levels of the acute phase reactants, haptoglobin and amyloid-related serum protein AA, were higher in the group of patients with reactive amyloidosis than in patients with SSA, the depression of the prealbumin levels in SSA is not a result of inflammation. Since SSA is known to contain prealbumin, it is possible that a disturbed prealbumin metabolism in old age results in low prealbumin serum values and deposition of amyloid.     

Histogenesis and ultrastructure of pancreatic islet graft microvasculature. Evidence for graft revascularization by endothelial cells of host origin.

In previous studies we have demonstrated that syngeneic and xenogeneic pancreatic islet grafts are revascularized within a 10 to 14-day period after transplantation. With the combined use of intravital and electron microscopy, as well as immunohistochemistry using a set of species-specific or -crossreacting antibodies to endothelial cell antigens, we investigated 1) the origin of the endothelium of the newly formed capillaries in free pancreatic islet isografts (hamster-->hamster) and xenografts (rat-->hamster), and 2) the ultrastructural characteristics of these microvessels. Intravital microscopy demonstrated that newly formed microvessels grow from the vascular bed of the host muscle tissue into the islet grafts. Immunohistochemical analysis of host tissue and transplanted islets with antibodies against factor VIII (recognizing both hamster and rat factor VIII), bovine PECAM-1 (CD31; endoCAM, crossreacting with hamster but not rat PECAM-1), and rat ICAM-1 (CD54, non-crossreacting with hamster ICAM-1) showed that the transplanted rat islets were revascularized by endothelium of hamster (host) origin. At an ultrastructural level, the endothelial lining of the newly formed microvessels showed diaphragmatic fenestration, a characteristic feature of endothelial cells of pancreatic islets in situ. On the basis of these findings we suggest that pancreatic islet transplantation may take a unique position in the field of organ transplantation, since the generally proposed mechanisms of endothelial cell-dependent antigen recognition as a trigger of graft rejection may not be transferred to islet grafts, containing microvessels lined by endothelial cells of host origin.     

Isodicentric 7p, idic(7)(q11.2), in acute myeloid leukemia associated with older age and favorable response to induction chemotherapy: a new clinical entity?

Three adult de novo acute myeloid leukemias (AML M1, M2, and M4) with an isochromosome 7p are presented. No additional abnormalities were detected by G-band and multicolor, using combined binary ratio labeling, fluorescence in situ hybridization (FISH) analyses, indicating that the i(7p) was the sole, i.e., the primary, chromosomal aberration. Although the patients were elderly--68, 72, and 78 years old--they all responded very well to chemotherapy, achieving complete remission lasting more than a year. Further FISH analyses, using painting, centromeric, as well as 7q11.2-specific YAC probes, revealed that the i(7p) contained two centromeres and that the breakpoints were located in 7q11.2. Thus, the abnormality should formally be designated idic(7)(q11.2). The detailed mapping disclosed a breakpoint heterogeneity, with the breaks in 7q11.2 varying among the cases, being at least 1,310 kb apart. Furthermore, the breakpoints also differed within one of the cases, being located on both the proximal and the distal side of the most centromeric probe used. Based on our three patients, as well as on a previously reported 82-year-old patient with AML M2 and idic(7)(q11) as the only chromosomal change, we suggest that this abnormality, as the sole anomaly, is associated with AML in elderly patients who display a good response to induction chemotherapy and, hence, have a favorable prognosis. Furthermore, the heterogeneous breakpoints in 7q11.2 suggest that the important functional outcome of the idic(7)(q11.2) is the genomic imbalance incurred, i.e., gain of 7p and loss of 7q material, rather than a rearrangement of a specific gene.     

Is prevention of suicide worth less? A comparison of the value per statistical life

The European Journal of Health Economics - This paper compares the value per statistical life (VSL) in the context of suicide prevention to that of prevention of traffic fatalities. We conducted...