Familial risks of squamous cell carcinoma of the head and neck: retrospective case-control study.

OBJECTIVE: To determine the contribution of inheritance to the incidence of squamous cell carcinoma of the head and neck. DESIGN: Historical cohort study. First degree relatives of cases with squamous cell carcinoma of the head and neck made up the exposed cohort and first degree relatives of spouses of cases made up the comparison unexposed cohort. SETTING: Ear, nose, and throat clinic in a large metropolitan teaching hospital. SUBJECTS: 1429 first degree relatives of 242 index cases of squamous cell carcinoma of the head and neck; as controls, 934 first degree relatives of the spouses of 156 index cases. MAIN OUTCOME MEASURES: Relative risk of developing squamous cell carcinoma in first degree relatives of cases compared with risk in first degree relatives of spouses. RESULTS: The adjusted relative risk for developing head and neck cancer if the index case had squamous cell carcinoma of the head and neck was 3.79 (95% confidence interval 1.11 to 13.0). There were no significantly increased risks associated with a family history of cancer at other sites. The adjusted relative risk for squamous cell carcinoma of the head and neck was 7.89 (1.50 to 41.6) in first degree relatives of patients with multiple primary head and neck tumours. CONCLUSIONS: These data suggest that genetic factors are important in the aetiology of head and neck cancer, in particular for patients with multiple primary cancers. Given the prolonged exposure of these subjects to carcinogens, these genetic factors may have a role in modifying carcinogen activity or in host resistance to carcinogens. Inherited factors may be important in persons with environmentally induced cancers.     

Dispersions in hydrocarbon fermentation. A retrospective study

A nondimensionalized plot, obtained by normalizing the drop-size distribution in the hydrocarbon phase using the Sauter mean diameter, shows a tendency towards self-preservation of the distribution. Changes of distribution in time during the course of fermentation, initial dispersed phase fraction, speed of rotation, and reactor size were taken into account. Using this self-preserving property, an empirical (single parameter) equation has been proposed for drop-size distribution. Data, available from the literature, are presented for non-biological and biological systems (gas-oil, n-hexadecane, and n-hexadecane dissolved in dewaxed gas oil as dispersed phases). The parameter, Sauter mean diameter, has been correlated with the operating conditions, and a critical review presented. Cell density was found to have significant effect on Sauter mean diameter. This effect has also been empirically explained. The possibilities of using generalized distribution in predicting the performance of fermenters is outlined.     

Nosocomial infection in a children's hospital. A retrospective study

The investigations the frequency of the occurrences of hospital infections were carried in a General Pediatric Ward. Most of the infections (77 per cent) appeared in children up to one year of age. The hospital infections mostly affected children residing in rural areas. The etiological agent was E. coli (36 per cent), Proteus (22.7 per cent) Klebsiella and Staphylococcus. The infections caused by E. coli mainly appeared in girls, others- in boys. The frequency of the occurrences of hospital infections was also analysed with respect to the primary disease of a child. In most cases of additional infections were found in children with upper respiratory tract infections, pneumonia and bronchitis. The above differences are statistically valid.     

Candidemia in AIDS. A retrospective study of nine cases

Prevalence of candidemia has increased during the last decade, numerous predisposing factors are invoked, like parenteral drug abuse in the case of brown heroin syndrome, neutropenia, prolonged antibiotic therapeutics and immunosupression. Only a few articles are published about candidemia. Candidemia in AIDS patients seems very low; its incidence is estimated approximately one candidemia per 120 patients.     

A modified human head model for the study of impact head injury

A recently published finite element (FE) head model is modified to consider the viscoelasticity of the meninges, the spongy and compact bone in the skull. The cerebrospinal fluid (CSF) is simulated explicitly as a hydrostatic fluid by using a surface-based fluid modelling method, which allows fluid and structure interaction. It is found that the modified model yields smoother pressure responses in a head impact simulation. The baseline model underestimated the peak von Mises stress in the brain by 15% and the peak principal stress in the skull by 33%. The increase in the maximum principal stress in the skull is mainly caused by the updation of the material's viscoelasticity, and the change in the maximum von Mises stress in the brain is mainly caused by the improvement of the CSF simulation. The study shows that the viscoelasticity of the head tissue should be considered, and that the CSF should be modelled as a fluid, when using FE analysis to study head injury due to impact.     

Fine needle aspiration cytology of the pancreas. A retrospective study of 73 cases

Retrospective review of pancreatic fine needle aspiration (FNA) biopsy specimens collected with computed tomographic guidance from 73 patients between 1980 and 1985 at the Medical Center of Delaware was performed to determine the accuracy of the procedure in our hands and to identify possible problem areas for cytologic diagnosis. When compared with clinical data or tissue diagnosis, FNA had a sensitivity for the detection of pancreatic carcinoma of 67.7%. The predictive value of a negative result was only 23.1%. When compared to the cytologic diagnosis made at the time of review, FNA had a sensitivity of 100%, but a single false-positive case was identified. In addition to the majority of probable pancreatic ductal carcinomas, a hepatoma and a lymphoma were detected. Cases of primary pancreatic carcinoma were classified by cytologic features, but all groups had dismal three-to-six-month median survivals, regardless of the degree of tumor differentiation. Survival times were similarly low for patients with negative pancreatic FNAs. The low patient survival times, regardless of FNA diagnosis, support the value of avoiding laparotomy in these patients and confirm the high false-negative rate of the procedure.     

The positive pleural effusion. A retrospective study of cytopathologic diagnoses with autopsy confirmation.

We performed an investigation focusing on the distribution of tumor types responsible for positive pleural effusions in 143 patients who died of malignancy and underwent autopsy. The principal malignant tumors were lung carcinoma (41 cases, 51.2%) and pleural mesothelioma (23 cases, 28.7%) in males and breast carcinoma (24 cases, 38.2%) and lung carcinoma (13 cases, 20.6%) in females. Histologically, most of the cases belonged to the adenocarcinoma category. The first morphologic diagnosis was a cytologic one in 86 cases (60.1%), especially regarding lung cancer. In breast cancer a positive pleural effusion always preceded recurrent disease with a rapidly progressive course, even a long time after the initial surgery. The results of this study, based on both cytomorphologic features and postmortem data on the tumor sites, may be a useful working framework for the cytologist dealing with a positive pleural effusion.     

Population-based retrospective study to investigate preexisting and new depression diagnosis among head and neck cancer patients

This study aimed to estimate the pre-cancer prevalence and post-cancer incidence of depression in older adult head and neck cancer patients. Using SEER-Medicare files, cancer was identified from SEER data and depression diagnosis was identified using Medicare claims. Of 3533 head and neck cancer patients, 10.6% were diagnosed with depression during the two years prior to cancer diagnosis, and an additional 8.9% developed depression in the year following cancer diagnosis. This study supports the critical need of screening for depression throughout cancer diagnosis and treatment, as well as a preventative approach in depression development in the older head and neck cancer patient population.     

Exfoliative cytology of microinvasive squamous-cell carcinoma of the uterine cervix. A retrospective study of 42 cases

The cervical scraping smears from 42 cases of microinvasive squamous-cell carcinoma of the uterine cervix with stromal invasion less than 3 mm were reviewed. Microinvasion could be suggested in approximately 60% of the cases by examination of the smears. The cytologic prediction of microinvasion was 14% in cases having stromal invasion less than 1 mm; it increased to 72.7% and 88.2% when stromal invasions were 1.1 to 2 mm and 2.1 to 3 mm in depth, respectively.