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From lynching to gay bashing: the elusive connection between economic conditions and hate crime.

Trends in bigoted violence are often explained by reference to frustrations arising from macroeconomic downturns. Historical and recent time-series studies have turned up significant links between economic conditions and lynchings of Blacks in the pre-Depression South (e.g., Hepworth & West, 1988; Hovland & Sears, 1940). However, replicating the time-series analyses of lynching, extending them through the Great Depression, and applying similar techniques to contemporary data fail to provide robust evidence of a link between economic performance and intolerant behavior directed against minorities. The authors speculate that the predictive force of macroeconomic fluctuation is undermined by the rapid rate of decay in the frustration-bred aggressive impulse and the absence of prominent political actors affixing economic blame on target groups.

Adult↗

No thanks, I'm good. Any more and I'll be sick: comment on Lynch and Carroll (2001).

W. J. Lynch and M. E. Carroll's (2001) excellent analyses of drug intake from a regulation perspective are formalized in terms of control systems. Satiation corresponds to the set point, deviations below which are called hunger or craving, deviations above which are called surfeit. Although simple, the model provides a unifying framework for many of the phenomena Lynch and Carroll describe.

Humans↗

B-Lynch Brace Suturing in primary post-partum hemorrhage during cesarean section.

Primary atonic post-partum hemorrhage during lower segment cesarean section, which was not controlled by ecbolics--oxytocin, methylergometrine, 15-methyl-prostaglandinF2alpha--was managed by applying a B-Lynch Brace Suture. The test of potential efficacy was the control of hemorrhage by bimanual uterine compression. Six primigravida patients at their term gestation, who underwent emergency cesarean section, all except one under spinal anesthesia, received this type of suture. Interestingly, in every case hemorrhage was controlled successfully with the compression suture. None of them received blood or blood products transfusions or developed disseminated intravascular coagulopathy. Postoperative recovery was good and all patients are in follow-up to assess their future reproductive activity. B-Lynch Brace Suturing is an invaluable procedure for the control of atonic primary post-partum hemorrhage following cesarean delivery.

Adult↗

Tumour spectrum of non-polyposis colorectal cancer (Lynch syndrome) on the island of Tenerife and influence of insularity on the clinical manifestations.

Colorectal cancer is a complex disease from a genetic point of view because both genetic and environmental factors interact in its development. Only familial adenomatous polyposis (FAP) follows mendelian genetics, in that mutations of the APC gene lead to development of the tumours. Lynch syndrome is the most frequent form of hereditary colorectal cancer and appears to be associated with other types of extracolonic cancers. The genetic basis has been established as a defect in DNA mismatch repair genes, and there is genetic heterogeneity due to the involvement of several genes in this system. Germinal mutations in these genes predispose to appearance of the syndrome. The aim of this study is to describe the tumoral spectrum of 10 families, comprising a total of 488 individuals, from the island of Tenerife (Canary Islands) and to assess whether the geographical isolation of this population has changed any features of the tumoral spectrum of the syndrome in comparison with studies that cover larger geographical areas with more genetic exchange. From our results we can conclude that the genetic drift and consanguinity in this population with a demographic history of isolation did not significantly alter the tumoral spectrum of the syndrome. Our data confirm that families affected by Lynch syndrome are a high-risk population and should be closely monitored, since their careful supervision has been shown to be useful in preventing cancer. We also emphasize the importance of developing a complete family history that permits these families to be identified together with a mutational screening of DNA mismatch repair genes (mainly MLH1 and MSH2 genes) with the aim of a possible identification of members of a family that should be carefully monitored (the carriers of germline mutations in these genes), whereas the remaining members, originally, are no more at risk than the general population.

Age Distribution↗

Successful term pregnancy after B-Lynch compression suture in a previous pregnancy on account of massive primary postpartum hemorrhage.

A case is presented of a successful term pregnancy in a 28-year-old secundipara after previous Misgav-Ladach cesarean section and B-Lynch compression suture on account of massive postpartal hemorrhage caused by uterine atony. On account of dystocia and relative cephalopelvic disproportion, secondary repeated cesarean section was performed; she gave birth to a live child 3,900 g/52 cm, Apgar score 9/10, with a regular neonatal course. During the repeated cesarean section, thin laces of connective tissue were found along the sutures placed on the uterus during the previous B-Lynch operation. Pelvic and intrauterine adhesions were not found.

Adult↗

Lymphocyte subpopulations in Lynch syndrome II: an immunocytochemical study on gastrointestinal biopsies. Preliminary report.

Gastrointestinal biopsies from 18 members of a family with Lynch Syndrome II were evaluated and immunocytochemical studies were made to characterize the phenotypic expression of the tissue's immune populations. The intestinal findings suggest polyclonal B-cell activation related to the T-helper distribution. Our evaluation provides no specific information so far on the management of patients with Lynch Syndrome II.

Biomarkers, Tumor↗

Modified Lynch procedure for chronic frontal sinus diseases: rationale, technique, and long-term results.

The modified Lynch operation (Neel-Lake) differs in several ways from the operation described by Lynch. The operation begins with an intranasal anterior ethmoidectomy. The agger nasi cells are removed by curetting forward between the frontal process of the maxilla and the septum. The middle turbinate, normal-appearing mucosa of the frontal-ethmoid complex, and frontal process of the superior maxilla are preserved. Bone removal is limited in most cases to the anterior floor of the frontal sinus, a portion of the lacrimal bone, and the bone over the anterior ethmoid cells. Another important difference is the use of soft, nonreactive material (thin Silastic sheeting) to stent the nasal-frontal passageway. Removal of all the mucosa of the frontal-ethmoid-sphenoid complex is unnecessary for a good postoperative result, and the remaining normal mucosa hastens the process of reepithelialization of the nasal-frontal duct. The patients in our original study group have been observed for a period of 5 to 20 years (mean, 13.5 years) after the surgical procedure. This is the longest period of follow-up for any group of patients reported in the literature. The incidence of failures increased from 7% (one duct) to 20% (3 of 15 ducts) after an additional 7 years of follow-up.

Adolescent↗

The use of microsatellite instability, immunohistochemistry and other variables in determining the clinical significance of MLH1 and MSH2 unclassified variants in Lynch syndrome.

Missense changes constitute approximately 1/3 and 1/5 of all rare sequence constitutional variations identified in the MLH1 and MSH2 genes by mutation screening. They represent a challenge for the clinician and for the genetic counselor, who often cannot use them for the management of Lynch syndrome families. Several parameters can be evaluated to gain insight into the significance of such unclassified variants (UVs). These include analysis of microsatellite instability (MSI), immunohistochemistry of mismatch repair (MMR) proteins, segregation data, frequency of the variants in control samples, presence of other pathogenic mutations, and functional and mRNA analyses. While none of these variables can be used alone to predict the significance of UVs in a single case, combined evaluation can lead to clinically useful conclusions. This review reports available information on a sample of MLH1 and MSH2 missense UVs, for which MSI and immunohistochemical data could be retrieved from the literature. Currently, since MSI analysis is routinely performed as a diagnostic test for Lynch syndrome, tumor MSI status represents the most important factor for determining the pathogenicity of UVs in MMR genes.

Adaptor Proteins, Signal Transducing↗

Lynch syndrome: implications for the surgeon.

Hereditary nonpolyposis colorectal cancer (HNPCC), or Lynch syndrome, is an autosomal dominant syndrome characterized by onset of colorectal cancer (CRC) at an early age, right-sided predominance, excess synchronous and metachronous colorectal neoplasms, and extracolonic neoplasms. It is the most common of the hereditary CRCs, so the practicing surgeon should expect to encounter patients with this disease. The diagnosis of HNPCC, which begins with a complete family history and a high index of suspicion by the clinician, has important implications in the management and surveillance of not only the affected individual but also for the individual's family. In this article, the diagnosis and management of Lynch syndrome will be reviewed, with emphasis on the implications for the surgeon.

Colectomy↗

[Familial colonic cancer (Lynch's syndrome) and bile duct cancer. Study of 2 cases].

The authors describe two cases of bile duct carcinoma affecting two patients with hereditary non polyposis colorectal carcinoma (Lynch's syndrome). These two cases were observed in 14 families composed of 283 persons, 58 of whom were affected by hereditary non polyposis colorectal cancer and 15 by gynecological carcinomas. Bile duct carcinoma can therefore be associated with Lynch's syndrome but seems less frequent than observed in familial polyposis or Gardner's syndrome.

Adult↗

[Hereditary nonpolyposis colorectal cancer. Lynch syndrome].

BACKGROUND: Hereditary non-polyposis colorectal cancer represent 5% of the colorectal cancer population. It's characterized by an autosomal dominant inheritance; there are two variants: Lynch syndrome I is characterized by predisposition to early onset colorectal cancer, with predominance for proximal location to the splenic flexure and synchronous and/or metachronous colorectal cancers. Lynch syndrome II shares the same features, but shows association with extracolonic cancers, particularly carcinomas of endometrium, ovary and stomach. However, this syndrome is not easily recognized, due to the lack of phenotypical expression as familiar adenomatous polyposis. OBJECTIVE: The purpose of this report is to review the natural history, diagnosis, treatment, surveillance of the probands and their families, and to update recent research on the genotypic risk biomarkers located in chromosomes 2, 3 and 7. METHODS: We analyzed the available literature to discuss the clinical characteristics, pathology, genetics, management, and surveillance of hereditary non-polyposis colorectal cancer. CONCLUSIONS: The diagnosis of hereditary non-polyposis colorectal carcinoma is not a rare event. It requires the demonstration of vertical transmission, therefore, the past history of colorectal cancer in the proband and his family should be carefully taken; including the anatomic site, histology and age at diagnosis.

Adult↗

[Lynch syndrome. (Hereditary colonic carcinoma without polyposis)].

Colonic carcinoma is a well-defined tumor with a low frequency among young people. We report the case of a 34 year old patient having two synchronous colorectal carcinomas of the right colon, who also had a family history of colonic and extracolonic neoplasms. We performed an extended right colectomy without chemotherapy. Fourteen months after surgery he had tumor recurrence and liver metastases. We reviewed then the clinical features, inclusion criteria, screening and the discussed treatment of the hereditary non-poliposis colorectal cancer or Lynch Syndrome, limited to the colon or associated to extracolonic carcinoma (Lynch I and II). A clear and detailed familial history is the only definite criteria for the diagnosis. We recommend early colonoscopy follow-up on first degree relatives considered as a high risk population.

Adult↗

A family of five first degree relatives affected by Lynch II syndrome.

Hereditary non-polyposis colorectal cancer (Lynch syndromes) has been reported in the international literature over the last decade. We now present a case of a family with Lynch II syndrome, in which five first-degree relatives were affected by colorectal cancer; in addition, the two female patients had ovarian or breast cancer.

Adult↗

Genetic diagnosis of Lynch syndrome II in an extended colorectal cancer-prone family.

Knowledge of colon cancer genetics, with particular attention to precision in hereditary cancer syndrome diagnosis, can often enable highly targeted surveillance and management strategies for patients at high genetic risk. Unfortunately, the patient's family history of cancer is often given minimal attention, and knowledge of hereditary cancer syndromes is frequently limited. Indeed, many physicians still consider familial adenomatous polyposis (FAP) as the only genetic risk factor for colorectal cancer. This concern with FAP was noted in a colorectal cancer-prone kindred which for decades had been thought to manifest that syndrome. However, after meticulous genetic, medical, and pathologic studies, the cardinal phenotypic characteristics of Lynch syndrome II were observed. The potential for cancer control in current and future generations of families like this one clearly mandates the need for computerized registries which could transmit current information about hereditary colon cancer syndrome diagnosis, surveillance, and management.

Adolescent↗

Genetic predictability and minimal cancer clues in Lynch syndrome II.

Increasing attention has been given to hereditary nonpolyposis colorectal cancer (HNPCC), a disorder which occurs four or five times more frequently than its hereditary counterpart, familial multiple adenomatous polyposis coli (FPC). Because of the lack of premonitory physical signs in HNPCC, its diagnosis must encompass pertinent family cancer history. This report describes a kindred with a subtype of HNPCC, the cancer family syndrome also referred to as Lynch syndrome II. Emphasis has been given to the temporal evolution of this disorder and the manner in which minimal clinical-genetic clues might best be employed for its diagnosis.

Colonic Polyps↗

The Lynch Syndrome: Melding Natural History and Molecular Genetics to Genetic Counseling and Cancer Control.

Hereditary nonpolyposis colorectal cancer (HNPCC), also referred to as Lynch syndromes I and II, is an autosomal, dominantly inherited disorder that accounts for approximately 5% of all colorectal cancers. While colorectal cancer is the most frequently occurring malignancy in HNPCC, other types of cancer occur with increased statistical significance. A better understanding of its natural history, particularly early age of onset and the pattern of multiple primary cancer excess, is essential for the diagnosis and management of HNPCC.

Journal Article↗

Lynch syndrome: genetics, natural history, genetic counseling, and prevention.

Lynch syndrome is the most common hereditary form of colorectal cancer (CRC). Its natural history has been investigated extensively, so that highly targeted surveillance and management strategies, melded to its natural history, have proven effective in cancer control. Most important is the early age of onset of cancer (approximately 44 years), involving CRC and the several extracolonic cancers that are integral to the syndrome. With respect to CRC, approximately 70% of cases occur proximal to the splenic flexure. Synchronous and metachronous CRCs are extremely common. Full colonoscopy should be initiated when the patient is between the ages of 20 and 25, and because of the accelerated carcinogenesis of CRC, it should be performed every 1 to 2 years. The presence of initial CRC requires subtotal colectomy, given the mentioned increased frequency of metachronous cancer. Options available for germ-line mutation carriers, in addition to cancer screening, include prophylactic colectomy as well as prophylactic total abdominal hysterectomy and bilateral salpingo-oophorectomy. The discovery of mismatch repair germ-line mutations (most commonly MSH2 or MLH1) has added significantly to the recognition of this disease as well as to the search for high-risk individuals throughout families who, with genetic counseling, may become candidates for germ-line mutation testing. Clearly, hereditary nonpolyposis colorectal cancer provides an excellent opportunity for learning about the etio-pathogenesis of cancer at the molecular and clinical levels and how this knowledge might ultimately be exploited for cancer control. A search for chemoprevention agents, such as cyclo-oxygenase 2 inhibitors, as well as for putative environmental effects and how they may interact with the genetic component in CRC etiology should abet this entire cancer control process.

Awards and Prizes↗

New phenotypic aspects in a family with Lynch syndrome II.

Increasing attention has been given to hereditary nonpolyposis colorectal cancer (HNPCC). This report provides medical genetic/pathologic findings on an HNPCC kindred from southern Italy that shows criteria consistent with Lynch syndrome II. An international collaborative effort led to extension of this kindred with disclosure of a potentially new spectrum of phenotypic findings: an excess of gastric carcinoma; complete intestinal metaplasia and chronic atrophic gastritis restricted to the antrum; an apparent excess of colonic mucosal macrophagia, which by special stain appeared to be positive for mucin, with a constant content of both sialo and sulfomucin, a lack of iron, and an inconstant positivity for lysozyme obtained by immunoperoxidase technique; and findings of crypt atrophy of the colonic mucosa. During the relatively short period of investigation of this family, an intensive educational and surveillance program has been mounted in the interest of improving cancer control through direct application of knowledge of natural history and the risk factor evidence through pedigree assessment.

Adult↗