A 27-year-old woman with a history of intravenous drug abuse presented with a stage IE, diffuse, large cell lymphoma of the right maxillary sinus. A test for antibodies to the human immunodeficiency virus was positive. The patient was treated with systemic chemotherapy and local maxillary sinus irradiation which resulted in complete regression of the disease. Therapy was complicated by mucositis, neutropenia, and opportunistic infections. This is the first case report to discuss the presentation and treatment of acquired immunodeficiency syndrome (AIDS)-related lymphoma of the maxillary sinus.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

[The use of the Epidemiology Cancer registry Baden-Württemberg in the follow-up of the EPIC cohort].

The European Prospective Investigation into Cancer and Nutrition (EPIC) is a prospective multicentre study that has been implemented to further the understanding of the association between diet and chronic diseases with emphasis on cancer. In Heidelberg from June 1994 until October 1998 about 25,500 subjects aged 35 to 65 years in women and 40 to 65 years in men were recruited. Apart from extensive questions about food intake, the participants were also asked to provide detailed information about their smoking habits, physical activity, subjective well-being, medical history and use of medications. As well as completing the questionnaire and a personal interview, the participants also gave blood samples and anthropometiric measures and the blood pressure were taken in standardized manner. The analyses of the EPIC study will depend on achieving a comprehensive record of all new cancer cases, and all deaths, together with the corresponding cause of death, within the study population. To date all self-reported incident cancer cases are verified by comparing them with pathology reports and hospital records. They are then coded according to the coding list for the International Classification of Diseases (ICD-O2) issued by the World Health Organisation (WHO). Since at begin of the investigation in the study region no cancer registration existed, the participants are followed -up by interval questioning ('active follow-up'). In order to integrate increasingly the data of the Cancer registry Baden-Württemberg (EKR-BW) attempts were made to explore record linkage systems. For this purpose, in the years 2000, 2002, 2003 record linkages between EPIC-Heidelberg and EKR-BW were performed. Procedures were evaluated for performing an anonymous linkage of the EPIC data with the data of the EKR-BW. After a pilot project on the feasibility of the linkage the program was evaluated on the EPIC data, record linkages are performed regularly. Different coding systems were applied. Simultaneously, the EPIC data about on cancer cases among the Heidelberg study participants are passed on to the Cancer Registry, thus contributing to improve completeness of the registry. So far the active follow-up can not be replaced by passive follow-up through record linkage with the cancer registry, but in the long-term it may be possible. Since the technical requirements are complied with, attempts should be made to improve the completeness of the epidemiological cancer registry Baden- Württemberg.

Adult↗

PubMedDate not supplied

Geographical clusters and common patterns in cancer mortality of the Federal Republic of Germany.

This paper quantitatively analyzes the maps of the Cancer Atlas of the Federal Republic of Germany with respect to regional clustering in the patterns of rates and relations between the patterns for different localizations. Indices of clustering and association are introduced and compared with those values resulting from computer simulations assuming random distributions. For most localizations, the clusterings could not be considered random, even though they were more or less marked, a finding which, in some cases, is neither evident nor generally known. The clusterings and correlations found offer a wealth of material for generating etiological hypotheses.

Epidemiologic Methods↗

PubMedDate not supplied

Cumulative damage models in cancer epidemiology: application to human incidence and mortality data.

Cumulative damage models are a special class of mathematical models within reliability theory that describe the probability of failure of a given system under the impact of a damaging environment. Though originally introduced to handle wear and tear processes, their concepts can easily be interpreted in terms of the epidemiologic aspects of human carcinogenesis. This paper introduces the new approach and demonstrates its applicability to human cancer incidence and mortality data from Denmark and the Federal Republic of Germany. A slight simplification of the originally stochastic model provides an explicit formula for the relative risk between different populations, which predicts that this basic measure used in cancer epidemiology may have to be considered age-dependent in contrast to a widely used practice which, for convenience, postulates age-independent relative risks. A comparison with empirical data reveals that the concept of age-dependent relative risks is not inconsistent with real world examples of cancer incidence. Thus, some basic assumptions and concepts of epidemiology concerning carcinogenesis and strategies for data analysis may require reconsideration.

Cohort Studies↗

PubMedDate not supplied

Cumulative damage models of additional exposures and host factors.

Cumulative damage models represent a mathematically accurate conceptualized approach for the consideration of various problems of descriptive and analytical epidemiology. This study demonstrates the application of these models to situations where additional exposures, e.g., occupational exposures or smoking, overlay an always existing background exposure. Moreover, a way to incorporate host responses into the model is outlined, which is straightforward within this new approach, but has not been achieved by existing models to date. Based on empirical data, it is shown that some effects, which arise from additional exposures, can be understood as a kind of host response. This result contrasts with interpretations given by existing models and promises to open interesting discussion regarding which biological processes can be observed by epidemiological data.

Carcinogens↗

PubMedDate not supplied

Frequency of common colds and serum levels of sICAM-1 (CD54), sLFA-3 (CD58) and sIL-2R (CD25).

Epidemiologic case-control studies have suggested an inverse relationship between past medical history of frequency of common colds and subsequent cancer risk for various sites. One hypothetical explanation for this finding may be that there are unknown differences in immune responsiveness between patients developing cancer and healthy individuals. The present study examines the relationship between the frequency of common colds and a) plasma levels of sICAM-1/CD54, sLFA-3/CD58 and sIL-2R/CD25 which are believed to modulate activation of immune responses, and b) cell-mediated immunity in vivo as determined by Multitest Mérieux. The investigation was conducted as a correlation study amongst a healthy group of individuals from the general population in Germany. We found a statistically significant inverse relationship between frequency of common colds and levels of sCD58 and, partially, sCD54. No association was found between levels of sCD25 and results of Multitest Mérieux.

Aged↗

PubMedDate not supplied

Level of injection in spinal anesthesia: effect on sensory anesthetic level.

BACKGROUND AND OBJECTIVES: A prospective, randomized study was performed to investigate the influence of the level of injection on sensory anesthesia when bupivacaine 0.5% adjusted to 37.0 C was used. METHODS: Three milliliters of plain bupivacaine 0.5% were injected at either the L2-3 interspace or the L4-5 interspace. There were 10 patients in each group. The patients were kept sitting for 2 minutes after injection. RESULTS: No significant difference in maximal level of sensory anesthesia was found (p = 0.123). CONCLUSION: These preliminary results indicate that if a higher level of injection is more suitable for anatomic reasons, it can safely be used without the risk of a much higher level of sensory blockade.

Aged↗