BACKGROUND: Cervical lymph node metastasis has a major influence on survival in oral cancer. However, the factors influencing its occurrence are uncertain. Our aim was to improve the prognostic efficiency of the histologic assessment of the primary tumor in predicting metastasis in an individual patient. METHODS: The relationship between selected clinical and histologic features of the primary tumor of tongue/floor of the mouth and the actual metastatic status was investigated in 45 patients. Invasive cell grading was supplemented by histologic measurements of tumor size and assessments of vascular and perineural invasion. RESULTS: Ten histologic features showed significant differences in relation to metastasis. A logistic regression model with two predictor variables (total histologic malignancy score and vascular invasion) classified correctly 39 (87%) of the 45 cases. CONCLUSIONS: Histologic assessment of tumor size and malignancy grade are useful in predicting metastasis. Vascular and perineural invasion are important predictors and should be included in multifactorial malignancy grading schemes. Application of the prognostic index to the biopsy specimen would aid in treatment planning.

Adult↗

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Measurements of x-ray induced mutational damage in stage-14 oocytes of Drosophila.

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Animals↗

PubMedDate not supplied

Malaria: review of features pertinent to the emergency physician.

Malaria is a health problem of growing concern to the emergency physician. Plasmodium vivax, P ovale, and P malaria infections are relatively benign and can be treated in an outpatient setting with oral chloroquine or amodiaquine. In contrast, P falciparum can present fulminantly, often resulting in death with multiple organ system failure. Although quinine historically has been the mainstay of therapy for severe falciparum malaria in the United States, and still is outside the U.S., quinidine gluconate as a continuous infusion is currently recommended as the agent of choice for severe P falciparum infection. In addition to the rapid administration of appropriate chemotherapeutic agents and the institution of aggressive supportive care, exchange transfusion may be utilized as a means of rapidly reducing the parasitemia and consequently, the mortality.

Adult↗

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Variation of apolipoprotein-B gene is associated with obesity, high blood cholesterol levels, and increased risk of coronary heart disease.

A random sample of 290 white men was examined for association between restriction fragment length polymorphism (RFLP) haplotypes (closely linked RFLPs on a single chromosome) of the apolipoprotein-B gene and serum levels of cholesterol, triglyceride, and high-density lipoprotein, obesity, smoking, alcohol consumption, and coronary heart disease. Haplotype or single RFLP frequencies differed significantly for obesity (p less than 0.005), serum cholesterol (p less than 0.005), and coronary heart disease (p less than 0.05), but for no other variable. Obesity was associated with haplotypes involving minimum PvuII and XbaI RFLPs are likely to be in linkage disequilibrium with nearby functional variation predisposing to obesity. Significant variation in serum cholesterol levels was associated with three functional alleles defined by MspI and EcoRI RFLP pairs (p less than 0.03). These RFLPs correspond to charged aminoacid variants at positions 3611 (arginine to glutamine) and 4154 (glutamic acid to lysine), which lie near the low-density-lipoprotein (LDL) receptor binding region of apolipoprotein-B. The three alleles showed stratification of serum cholesterol between low, normal, and high levels. Coronary heart disease was associated with minimum haplotypes involving XbaI and MspI RFLPs. Together these results suggest that inherited variations of the apolipoprotein-B gene, probably in the form of charged aminoacid substitutions, influence circulating cholesterol concentration, and that these and other functional variants of the apolipoprotein-B gene affect susceptibility to coronary heart disease and obesity.

Aged↗

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A benefit-cost analysis of two-dose measles immunization in Canada.

In 1992, because of the limitations of the one-dose measles immunization program, the National Advisory Committee on Immunization (NACI) recommended a two-dose measles immunization program to eliminate measles. More recently, NACI recommended also a special catch-up program to prevent predicted measles outbreaks and to achieve an earlier elimination of measles. The objective of this study was to complete a benefit-cost analysis of a two-dose immunization program with and without a mass catch-up compaign compared with the current one-dose program. The resulting benefit: cost ratios vary between 2.61:1 and 4.31:1 depending on the strategy used and the age of the children targeted. Given the parameters established for this analysis, the benefits of a second-dose vaccination program against measles far outweight the costs of such a program under all scenarios.

Adolescent↗

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Managing anxiety and depression in alcohol and drug dependence.

Previous research has highlighted the high prevalence (30-60%) of comorbid anxiety and mood disorders in clients with substance misuse disorders and, equivalently, a third of those with affective disorder report a history of substance use disorder (Kessler et al., 1994; Regier et al., 1990; Robins & Regier, 1991). This article reviews the management of such cases and identifies key issues in the assessment process, as well as potential avenues for treatment. Other articles have highlighted the increased service utilisation and the cost of care and treatment of comorbidity. This article will primarily focus on the management of individual cases and will briefly refer to issues of service organisation. Although antidepressant or anxiolytic pharmacotherapy may have a role in the treatment of severe disorders, the benefits of using these medications must be balanced against the increased risk of side-effects or adverse reactions in individuals who continue to engage in substance misuse or who have medical complications associated with drug or alcohol dependency. Effective psychosocial approaches largely focus on brief, empirically tested manualised therapies such as cognitive therapy (Carroll, 1998a). However, modifications are required to such approaches to ensure that the interventions are tailored to the needs of clients exhibiting comorbidity. The data available demonstrate some evidence for the benefits of structured psychological approaches, but more sophisticated randomized controlled trials are required to evaluate the efficacy of both psychological and pharmacological approaches.

Alcohol-Related Disorders↗

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Sequence of a cDNA clone encoding human preproinsulin-like growth factor II.

The insulin-like growth factors (IGF) I and II are single-chain serum proteins of 70 and 67 amino acids, respectively, which are synthesized by the liver and possibly other tissues. They are probably required for normal fetal and postnatal growth and development. They also stimulate the growth of cultured cells, possibly by controlling the progression through the G1 phase of the cell cycle. In contrast to IGF-II whose concentration does not vary during postnatal development, the serum levels of IGF-I increase several-fold to adult levels during puberty. The serum concentration of IGF-I is a sensitive monitor of growth hormone levels and is decreased in individuals with growth hormone deficiency and elevated in those with growth hormone-secreting tumours. As a first step in studying the biosynthesis of these proteins and elucidating their role(s) in normal development and in tumorigenesis, we have isolated and sequenced cDNAs prepared from adult human liver mRNA which encode the precursors to IGF-I and -II. We report here the sequence of a cDNA encoding a 180-amino acid protein which is the precursor to IGF-II.

Amino Acid Sequence↗

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Localization of insulin-like growth factor genes to human chromosomes 11 and 12.

The insulin-like growth factors IGF-I and IGF-II are required for growth and development. Both are single-chain proteins (of 70 and 67 amino acids respectively) derived from precursors by proteolytic processing. IGF-I may be particularly important in promoting normal stature and IGF-II may be a fetal growth hormone. The IGF proteins are probably synthesized by many normal tissues and by some tumours. The secretion of growth factors by tumours and tumour-derived cell lines suggests that they may act as autocrine regulators of cell proliferation. Because of the possible role of these proteins in growth disorders and cancer, and their sequence homology with insulin, we have determined their chromosomal localization. Using somatic cell hybrids and cloned cDNA probes for these proteins, we have assigned the genes for IGF-I and IGF-II to human chromosomes 12 and 11, respectively. We present evidence that the IGF-II gene is located on the short arm of chromosome 11 with a ras proto-oncogene and the insulin structural gene, and also suggest the existence of a fragment length polymorphism using the IGF-I probe.

Animals↗

PubMedDate not supplied

Mouse prepro-epidermal growth factor synthesis by the kidney and other tissues.

Epidermal growth factor (EGF), a protein comprising 53 amino acids, is derived from a precursor of 1,217 amino acids that includes at least seven EGF-like sequences. EGF has diverse biological activities: it is a potent mitogen for many tissue culture cells, inhibits gastric acid secretion from the intestinal mucosa and promotes healing of the corneal epithelium. EGF given to fetal animals accelerates several developmental processes including palate formation, incisor eruption, eyelid opening and lung maturation. However, the physiological roles of EGF in vivo are unknown. The presence of high-affinity receptors in many fetal and adult tissues suggests that EGF is involved in normal cellular functions. Immunocytochemical studies have revealed the presence of EGF in mouse and human submaxillary glands, rat brain and human intestine. The low levels of EGF in extracts from many tissues may reflect sequestration rather than synthesis of the polypeptide. We show here that several mouse tissues contain preproEGF mRNA and that it is synthesized mainly in the distal tubules of the kidney. PreproEGF does not seem to be processed to EGF or other peptides in this tissue.

Animals↗