Does histology influence outcome in childhood Hodgkin's disease? Results from the United Kingdom Children's Cancer Study Group

PURPOSE: Histology has been identified as an important prognostic factor in Hodgkin's disease (HD) in adults. Information regarding the impact of histology on outcome in childhood HD is scarce. This study determines the effect of histology on the overall survival (OS) or progression-free survival (PFS) in a national series of children treated in a standardized manner. PATIENTS AND METHODS: The results of treatment of 331 assessable patients, treated between January 1, 1982 and June 30, 1992, in the United Kingdom Children's Cancer Study Group (UKCCSG) Hodgkin's study I were reviewed to evaluate OS, PFS, and deaths according to stage and histology. Treatment was either involved-field radiation alone (stage IA) or chlorambucil, vinblastine, procarbazine, and prednisolone (ChlVPP) chemotherapy with or without mediastinal radiation. All were clinically staged at diagnosis. RESULTS: Nodular sclerosing (NS) HD was the most common histologic subtype (155 of 331 patients [47%]) and was uniformly distributed through all stages. Lymphocyte-depletion (LD) HD was extremely uncommon (< 1%). Mixed-cellularity (MC) HD had the highest relapse rate, but this was only significant (P < .05) in stage I patients who received local irradiation alone. There was no other statistically significant difference in OS and PFS between the various histologic subtypes. Multivariate analysis for PFS and OS confirmed that stage was the most important prognostic factor and that histology did not have an effect after stratification by stage. CONCLUSION: This study demonstrates that with effective multiagent chemotherapy, histologic subtype does not influence outcome. The high relapse rates in stage I MC subtype indicates that MC HD is biologically aggressive and systemic treatment with or without local irradiation may be indicated. The high relapse rate in stage IV patients appeared to be independent of histology.     

Cardiovascular abnormalities associated with human and rodent obesity

Obesity is a major risk factor for cardiovascular disease. However, a direct link between these two states is difficult to establish, since obesity frequently occurs with other disease states such as diabetes, hypertension and atherosclerosis. Clinical studies have clearly shown that uncorrected obesity is associated with cardiac hypertrophy and compromised ventricular function. A number of rodent models of obesity have been studied in terms of cardiovascular adaptations. Cardiac function of the obese Zucker rat appears to be normal at a younger age. Only after several months is depression in cardiac function discernable. These animals are mildly hypertensive, but do not exhibit the characteristic increase in cardiac output associated with human obesity. A unique characteristic of JCR:LA-cp rat is that they develop atherosclerotic and myocardial lesions. Hearts from these animals will maintain normal function when perfused with physiological levels of calcium. At higher calcium concentrations, however, mechanical function becomes impaired. Dietary-induced obese rats exhibit many of the hemodynamic alterations associated with human obesity, but there is no evidence to-date that these animals will develop severe cardiac depression. Short-term weight reduction apparently has beneficial cardiovascular effects, but weight cycling may be harmful. Given the widespread occurrence of obesity, further studies are warranted to characterize the cardiac manifestations of this condition.     

Egg Thiamine Status of Lake Ontario Salmonines 1995–2004 with Emphasis on Lake Trout

Alewives (Alosa pseudoharengus), the major prey fish for Lake Ontario, contain thiaminase. They are associated with development of a thiamine deficiency in salmonines which greatly increases the potential for developing an early mortality syndrome (EMS). To assess the possible effects of thiamine deficiency on salmonine reproduction we measured egg thiamine concentrations for five species of Lake Ontario salmonines. From this we estimated the proportion of families susceptible to EMS based on whether they were below the ED20, the egg thiamine concentration associated with 20% mortality due to EMS. The ED20s were 1.52, 2.63, and 2.99 nmol/g egg for Chinook salmon (Oncorhynchus tshawytscha), lake trout (Salvelinus namaycush), and coho salmon (Oncorhynchus kisutch), respectively. Based on the proportion of fish having egg thiamine concentrations falling below the ED20, the risk of developing EMS in Lake Ontario was highest for lake trout, followed by coho (O. kisutch), and Chinook salmon, with the least risk for rainbow trout (O. mykiss). For lake trout from western Lake Ontario, mean egg thiamine concentration showed significant annual variability during 1994 to 2003, when the proportion of lake trout at risk of developing EMS based on ED20 ranged between 77 and 100%. Variation in the annual mean egg thiamine concentration for western Lake Ontario lake trout was positively related (p < 0.001, r² = 0.94) with indices of annual adult alewife biomass. While suggesting the possible involvement of density-dependent changes in alewives, the changes are small relative to egg thiamine concentrations when alewife are not part of the diet and are of insufficient magnitude to allow for natural reproduction by lake trout.     

Reduction of triceps muscle force after shortening of the distal humerus: a computational model

A retrospective case reference study examining the use of alcohol and tobacco in 303 women aged 40 or over suffering from oral or oropharyngeal cancer was conducted in the south-west Netherlands. Both alcohol and tobacco consumption are important in the development of oral and oropharyngeal cancer with increased consumption of both markedly increasing the risks of cancer, but alcohol having the greater effect.