Group-specific component, alpha1-antitrypsin and esterase D in Canadian Eskimos.

Three genetic markers - group-specific component (Gc), alpha1-antitrypsin, and esterase D - were examined in a population of Eskimos from Igloolik in the eastern Canadian Arctic. Gc and esterase D were found to be polymorphic. In addition to the common Gc types, an anodal variant called Gc Igloolik was found, probably identical to previously reported Gc Eskimo. Gene frequencies were Gc1: 0.6524, Gc2: 0.3373, GcIgl: 0.0104, for 338 Eskimos. Genetic types of alpha1-antitrypsin (Pi types) were mostly M, with two MS sibs who were half Caucasian, in 170 Eskimos. Frequencies of the esterase D allele in 336 Eskimos were EsD1: 0.7083, EsD2: 0.2917. The frequencies of Gc2 and EsD2 are both higher than are found in Caucasian populations.     

The genetic structure of populations of Chuckotka Peninsula Eskimos and Chuckchi based on study of 13 loci of serum and erythrocyte proteins and enzymes

The Eskimos and Chuckchi of the Chuckotka Peninsula were studied at 13 loci of serum and erythrocyte proteins and enzymes by electrophoresis. Six loci-including albumin, transferrin, carbonic anhydrase I and II, monoamine oxidase, and superoxide dismutase-were monomorphic in the studied populations. The mean frequencies of alleles in nine polymorphic loci of Chuckotka Eskimos and Chuckchi, Eskimos of Alaska, Canada, and Greenland, some Mongoloid populations of Siberia, American Indians, and Lapps of circumpolar areas of Western Europe were obtained. The genetic distances between these populations were calculated. The Eskimos of Chuckotka were closest to the Alaskan Eskimos. The relative heterozygosity of Chuckotka Eskimos was calculated and was the highest in Chuckchi. The average heterozygosity in Eskimo populations increased in the following order, from least to greatest: Chuckotka Eskimos, St. Lawrence Island Eskimos, Alaskan Eskimos, Greenland Eskimos, and Canadian Eskimos. The average heterozygosity of the Chuckchi was similar to that of Western Hemisphere Eskimos.     

Pre- and Post-natal Growth Acceleration and Increased Sugar Consumption in Canadian Eskimos

A striking increase in birth weights and height measurements in children of Canadian Eskimos was observed in recent years.The growth acceleration seen to varying degrees in different Eskimo groups appears most closely to parallel the increase in the per capita annual sugar consumption which has more than quadrupled during the last decade in some trading areas of the Canadian Central and Eastern Arctic, while the per capita consumption of protein derived from animal sources shows a reverse relationship.Canadian Eskimos do, therefore, contrary to what is stated in earlier publications, conform to the general secular growth acceleration patterns observed in all populations coming under the influence of modern civilization. They do not, however, conform to the commonly held explanation for this acceleration, namely increased consumption of high-quality proteins, since their traditionally extremely high consumption of meat and fish decreased markedly during the same period.Our observations confirm the relation of growth acceleration and consumption of sugar first established by the Swiss pediatrician, Eugen Ziegler. A hypothesis first advanced by Ziegler is elaborated to link this growth acceleration, in particular the extraordinary increase in birth weight, to “pseudo-diabetic” oral glucose tolerance patterns described previously by the author in a large proportion of Eskimos.     

Frontal sinus size in Eskimo populations

The frontal sinuses of 143 Eskimo skulls from two sites in the Hudson Bay region of Canada were examined radiographically. No between-site or sex differences were noted in the size of the sinuses. On average, the sinuses are small and often bilaterally absent. The Canadian samples have smaller sinuses than reported for Alaskan Eskimos or American Indian groups.     

Diverticules acquis de l'appendice

During a recent ophthalmic survey of 780 Eskimos in the Canadian Eastern Arctic, 217 were found to have stigmata of phlyctenular keratoconjunctivitis, 198 of these being inactive and 19 active. Attention is drawn to the high incidence of pediculosis capitis in the Eskimos of this region, and it is suggested that there may be a relationship between this infestation and phlyctenulosis.     

Genetic variation in the Aleuts of the Pribilof Islands and the Eskimos of Kodiak Island

A sample of Aleuts residing in the Pribilof Islands of St. Paul (N = 163) and St. George (N = 62) and Eskimo residents of Kodiak Island (N = 294) have been typed for genetic variation at 31 discrete genetic markers. Of these, 16 were polymorphic and 15 were monomorphic. Several private polymorphisms previously reported in Eskimo or Alaskan Amerindian populations were absent in both the Aleuts and Kodiak Island Eskimos. Genetic distance analysis shows considerable genetic differentiation between Aleuts and Kodiak Island Eskimos.     

The St. Lawrence Island Eskimos: genetic variation and genetic distance

The Eskimos of St. Lawrence Island have been typed for genetic variation at 44 discrete genetic loci. Three private polymorphisms, at the 2,3-diphosphoglycerate mutase, peptidase B, and purine nucleoside phosphorylase loci, have been observed, which may be useful in future studies of genetic relationships between Eskimos and other circumpolar populations. Genetic distance analysis reveals a close relationship between the St. Lawrence Island Eskimos and other Eskimo populations and that the Eskimo populations form a distinct cluster from Amerindian populations. The St. Lawrence Island Eskimos appear to be more similar to Asiatic Eskimos than to other groups. Caucasian admixture in this population is estimated to be between 2 and 7%.     

Risk of malignant neoplasms among Polish population in 1986

An analysis of the mortality for malignant tumors in Poland in 1986 is provided. The most frequent neoplasms noted in Poland were in 1986: in men cancer of the lungs (33.5% of all malignancies), cancer of the stomach (13.4%), prostate (4.8%), and pancreas (4.2%). In women the most frequent were: breast cancer (13.1%), cancer of the stomach (9.6%), lungs (7.8%), and cervix (6.7%). In 1986, significant difference in mortality rate was seen between men and women (prevalence of death in men) and between urban and rural areas (prevalence in urban areas). Moreover, persisting higher mortality rate for malignancies was noted in the western and central regions in comparison to eastern Poland. Mortality rate for malignancies in both men and women is higher in Poland than the average mortality rate in Europe.     

Metabolic syndrome in Yup'ik Eskimos: the Center for Alaska Native Health Research (CANHR) Study

Objective: This study investigated the prevalence of metabolic syndrome and its defining components among Yup'ik Eskimos. Research Methods and Procedures: A cross‐sectional study design that included 710 adult Yup'ik Eskimos ≥18 years of age residing in 8 communities in Southwest Alaska. The prevalence of metabolic syndrome was determined using the recently updated Adult Treatment Panel III criteria. Results: The prevalence of metabolic syndrome in this study cohort was 14.7%, and varied by sex with 8.6% of the men and 19.8% of the women having metabolic syndrome. This is lower than the prevalence of 23.9% in the general U.S. adult population. The most common metabolic syndrome components/risk factors were increased waist circumference and elevated blood glucose. High‐density lipoprotein (HDL) cholesterol levels in Yup'ik Eskimos were significantly higher, and triglycerides lower than levels reported in National Health and Nutritional Examination III. Discussion: Compared with other populations, metabolic syndrome is relatively uncommon in Yup'ik Eskimos. The higher prevalence among Yup'ik women is primarily explained by their large waist circumference, suggesting central body fat accumulation. Further increases in metabolic syndrome risk factors among Yup'ik Eskimos could lead to increases in the prevalence of type 2 diabetes and cardiovascular disease, once rare in this population.     

Second malignant neoplasms after cancer in childhood or adolescence. Nordic Society of Paediatric Haematology and Oncology Association of the Nordic Cancer Registries.

OBJECTIVE--To assess the relative risk of developing a second malignant neoplasm in people with a diagnosis of cancer in childhood and adolescence. DESIGN--Register based follow up study. SETTING--Populations of Nordic countries. SUBJECTS--30,880 people under the age of 20 with a first malignant neoplasm diagnosed during the period 1943-87. MAIN OUTCOME MEASURES--Relative and attributable risks of second malignant neoplasms by type of first cancer, age at first diagnosis, calendar period, sex, and country. Expected figures were based on the appropriate national incidence rates for cancer. RESULTS--247 cases of second malignant neoplasms were observed in 238 patients, yielding a relative risk for cancer of 3.6 (95% confidence interval 3.1 to 4.1). The risk changed significantly from 2.6 in people first diagnosed during the 1940s and 1950s to 6.9 among cohort members included in the late 1970s and 1980s. Increases were observed for most types of cancer. Highest levels of the relative risk were seen during the 10 years immediately after first malignant diagnosis. The incidence of second malignant neoplasms attributable to the first cancer and associated treatments, however, showed a consistent rise throughout the 45 years of follow up. CONCLUSION--The estimated risks for a second malignant neoplasm were significantly lower than those found in most large hospital based studies but compatible with the results from a similar population based study in the United Kingdom. Extent of risk and cancer pattern were similar among the Nordic countries and are believed to be representative for a large part of the European population.     

Cancer patterns in Canada.

Cancer is diagnosed in about 70 000 Canadians each year and is the leading cause of the loss of potential years of life before age 75 among women. Life-threatening forms of cancer will develop in at least one of every three Canadian newborns during their lifetimes if current cancer risks are not reduced. Lung and breast cancers are, respectively, the leading causes of premature death due to cancer among men and women. Compared with other countries Canada has low death rates for stomach cancer but high rates for certain smoking-related cancers (those of the lung and of the mouth and throat), leukemia and cancers of the colon, breast and lymphatic tissues. Newfoundland has the highest rates of death from stomach cancer and the lowest rates of death from prostatic cancer, whereas the western provinces have the opposite pattern. The rates of death from lung cancer among men are highest in Quebec, the province with the highest prevalence of smoking. In Canada the overall rates of death from cancer increased by 32% among men from 1951 to 1983. However, among women they declined by 12% from 1951 to 1976 and increased from 1976 to 1983, particularly among those aged 55 to 74. The rising rates of death due to lung cancer were primarily responsible for these increases. Lung cancer will likely displace breast cancer as the leading cancer killer of Canadian women by 1990. Given the relatively low survival rates for cancers caused by smoking and the lack of substantial improvement in rates for the most frequent types of cancer, preventive strategies that include effective measures to reduce tobacco consumption are urgently required.     

Dental chipping in Aleuts, Eskimos and Indians

Analysis of dentitions belonging to 324 prehistoric and protohistoric Aleuts, Eskimos and northern Indians, all of whom were regularly meat-eaters, reveals a significant difference between Eskimos and Aleut-Indians for a little known type of tooth wear. This wear is characterized by severe crushing and/or flaking of the crown surface of one or more teeth (termed “pressure-chipping”). It occurs chiefly in dentitions of high arctic Eskimos of Alaska, Canada, and Greenland, and significantly less often in the teeth of Kodiak Island Eskimos, Aleuts and northern Indians. Sex differences do not exist but pressure-chipping occurs significantly more often in adult (21–x years) than in non-adult (0–20 years) Eskimos. The exact mechanism(s) responsible for pressure-chipping is unknown, although ethnographic accounts of Eskimo eating habits suggest that crushing of hard substances such as bone was involved. The severity of this wear could have contributed to the selection for, or preservation of, large and complex crowns in high arctic Eskimos. Pressure-chipping is offered as evidence favoring the view that tooth size (longevity) may have had in the past some adaptive value.     

Morphologic characteristics of the Alaskan Eskimo dentition. II. Carabelli's cusp

A study of coastal and inland Alaskan Eskimos revealed that a faintly developed Carabelli's cusp was present in 42.7%. No sex difference in the occurrence of Carabelli's cusp was evident and no family showed any difference in the distribution of the frequencies when each family was compared to the rest of the population. A general tendency toward a higher prevalence of Carabelli's cusp in the coastal Eskimos may be due to more admixture with white people along the coast. Alaskan Eskimos have a significantly higher frequency of Carabelli's cusp than do Aleuts. Statistical evaluation revealed that in the Alaskan Eskimo dentition the formation of Carabelli's cusp is independent of the size of the molars and the suppression of the third molars.     

mtDNA variation among Greenland Eskimos: the edge of the Beringian expansion

The Eskimo-Aleut language phylum is distributed from coastal Siberia across Alaska and Canada to Greenland and is well distinguished from the neighboring Na Dene languages. Genetically, however, the distinction between Na Dene and Eskimo-Aleut speakers is less clear. In order to improve the genetic characterization of Eskimos in general and Greenlanders in particular, we have sequenced hypervariable segment I (HVS-I) of the mitochondrial DNA (mtDNA) control region and typed relevant RFLP sites in the mtDNA of 82 Eskimos from Greenland. A comparison of our data with published sequences demonstrates major mtDNA types shared between Na Dene and Eskimo, indicating a common Beringian history within the Holocene. We further confirm the presence of an Eskimo-specific mtDNA subgroup characterized by nucleotide position 16265G within mtDNA group A2. This subgroup is found in all Eskimo groups analyzed so far and is estimated to have originated <3,000 years ago. A founder analysis of all Eskimo and Chukchi A2 types indicates that the Siberian and Greenland ancestral mtDNA pools separated around the time when the Neo-Eskimo culture emerged. The Greenland mtDNA types are a subset of the Alaskan mtDNA variation: they lack the groups D2 and D3 found in Siberia and Alaska and are exclusively A2 but at the same time lack the A2 root type. The data are in agreement with the view that the present Greenland Eskimos essentially descend from Alaskan Neo-Eskimos. European mtDNA types are absent in our Eskimo sample.     

Long bone growth in western Eskimo and Aleut skeletons

The pattern of long bone growth in Eskimo and Aleut juvenile skeletons reflects that in living Eskimos and Aleuts. There is a pre-adolescent growth spurt which is particularly intense in females. After age 14 male long bones supercede those of females in length. The characteristic Eskimo and Aleut adult body proportion is established early in childhood. Eskimos and Aleuts have shorter bones than whites at all ages. The difference in length of the forearm and lower leg in comparison with whites appears to increase especially at adolescence.     

An update on the current epidemiological status of metastatic neoplasms to the thyroid

Secondary tumours to the thyroid gland are uncommon with an overall prevalence of 5.9% in autopsy studies. In recent clinical series, secondary thyroid cancer is seen in only 1.9% of malignant thyroids. There is no gender predominance both overall (female to male 1.07:1) and when stratified by common histological subtypes (renal cell carcinoma, lung adenocarcinoma and colorectal adenocarcinoma). The median age of patients diagnosed with metastatic thyroid tumours in major studies ranges from 54 to 68 years. Metastases are more frequent in patients with pre-existing or concurrent thyroid pathology. In autopsy studies, the most common primary sites are breast carcinoma and lung carcinoma. Renal cell carcinoma, lung carcinoma and breast carcinoma predominate in clinical series. Upper aerodigestive tract primaries often directly infiltrate the thyroid gland. The underlying frequency of a histological subtype, geographic prevalence and aggressiveness of primary cancer likely contributes to the incidence of metastasis in the thyroid gland. This is seen in case series from Asia where gastric and oesophageal primary cancers predominate. Secondary thyroid cancer can present metachronously (60%), synchronously (34%), or as the first presentation of the underlying cancer (6%). Late metastases and first clinical presentations of disease often originate from renal cell carcinomas while synchronous cases tend to originate from the lungs. Other common primary sites for first presentation of secondary thyroid cancer include the lung and oesophagus. Although rare, secondary thyroid cancer should be considered as a differential particularly in patients with previous malignancy, such as from the kidney, lung, or breast.     

Prostate‐specific membrane antigen expression in the vasculature of primary lung carcinomas associates with faster metastatic dissemination to the brain

Glioblastomas and brain metastases (BM) of solid tumours are the most common central nervous system neoplasms associated with very unfavourable prognosis. In this study, we report the association of prostate‐specific membrane antigen (PSMA) with various clinical parameters in a large cohort of primary and secondary brain tumours. A tissue microarray containing 371 cases of ascending grades of gliomas pertaining to astrocytic origin and samples of 52 cases of primary lung carcinomas with matching BM with follow‐up time accounting to 10.4 years was evaluated for PSMA expression using immunohistochemistry. In addition, PSMA expression was studied in BM arising from melanomas and breast carcinomas. Neovascular expression of PSMA was evident alongside with high expression in the proliferating microvasculature of glioblastomas when compared to the tumour cell expression. This result correlated with the results obtained from the in silico (cancer genome databases) analyses. In gliomas, only the vascular expression of PSMA associated with poor overall survival but not the tumour cell expression. In the matched primary lung cancers and their BM (n = 52), vascular PSMA expression in primary tumours associated with significantly accelerated metastatic dissemination to the brain with a tendency towards poor overall survival. Taken together, we report that the vascular expression of PSMA in the primary and secondary brain tumours globally associates with the malignant progression and poor outcome of the patients.     

Cells of squamous cell carcinoma in pleural, peritoneal and pericardial fluids. Origin and morphology

The records of two cytopathology laboratories, covering an aggregate of 33 years, were searched for pleural, peritoneal and pericardial fluids reported as containing cells of squamous cell carcinoma (SCC). This search embraced 9,297 serous fluids from 7,389 patients. Cells of SCCs were found in the fluids from only 46 patients, illustrating the infrequency of such a finding, with most of the SCC cells originating in primary neoplasms of the lung (16), female genital tract (8) or larynx (6). All of the recognized types of SCC cells were found in these fluids. Even so, SCC cells may be mistaken for cells of other neoplasms, such as adenocarcinoma and malignant mesothelioma. SCC cells in serous fluids should be identifiable if careful attention is paid to the morphologic features characteristic of SCC.     

Gender Differences in Survival and the Use of Primary Care Prior to Diagnosis of Three Cancers: An Analysis of Routinely Collected UK General Practice Data

Objective

To explore whether there are gender differences in the number of GP recorded cases, the probability of survival and consulting pattern prior to diagnosis amongst patients with three non-sex-specific cancers.

Design

Cross sectional study.

Setting

UK primary care.

Subjects

12,189 patients aged 16 years or over diagnosed with colorectal cancer (CRC), 11,081 patients with lung cancer and 4,352 patients with malignant melanoma, with first record of cancer diagnosis during 1997–2006.

Main outcome measures

Cancer cases recorded in primary care; probability of survival following diagnosis; and number of GP contacts within the 24 months preceding diagnosis.

Results

From 1997–2006, overall rates of GP recorded CRC and lung cancer cases recorded were higher in men than in women, but rates of malignant melanoma were higher in women than in men. Gender differences in survival were small; 49% of men and 53% of women survived at least 5 years following CRC diagnosis; 9% of men and 12% of women with lung cancer, and 77% of men and 86% of women with malignant melanoma. The adjusted male to female relative hazard ratio of death in all patients was 1.20 (95%CI 1.13–1.30), 1.24 (95%CI 1.16–1.33) and 1.73 (95%CI 1.51–2.00) for CRC, lung cancer and malignant melanoma respectively. However, gender differences in the relative risk were much smaller amongst those who died during follow-up. For each cancer, there was little evidence of gender difference in the percentage who consulted and the number of GP contacts made within 24 months prior to diagnosis.

Conclusions

This study found that patterns of consulting prior to cancer diagnosis differed little between two genders, providing no support for the hypothesis that gender differences in survival are explained by gender differences in consultation for more serious illness, and suggests the need for a more critical view of gender and consultation.