Noninvasive, near infrared spectroscopic-measured muscle pH and PO2 indicate tissue perfusion for cardiac surgical patients undergoing cardiopulmonary bypass.

Objective: To determine whether near infrared spectroscopic measurement of tissue pH and Po2 has sufficient accuracy to assess variation in tissue perfusion resulting from changes in blood pressure and metabolic demand during cardiopulmonary bypass.

Design: Prospective clinical study.

Setting: Academic medical center.

Inhibition of alveolar neutrophil immigration in endotoxemia is macrophage inflammatory protein 2 independent.

Background: Altered transendothelial migration and delayed apoptosis of neutrophils (PMN) have been implicated as contributing to infection in patients with gram-negative sepsis. Macrophage inflammatory protein 2 (MIP-2) signals PMN immigration and may alter other PMN functions. We tested the hypothesis that sequential endotoxin challenge in vivo alters PMN apoptosis and chemotactic responses.

Inhibition of neutrophil apoptosis after severe trauma is NFkappabeta dependent.

Background: Systemic inflammation may inhibit neutrophil (PMN) apoptosis and promote multiple organ dysfunction syndrome. We hypothesize that severe trauma causes dysregulation of PMN apoptosis.

Methods: Neutrophils were isolated from trauma patients (24-72 hours after injury; n = 16) and controls (healthy volunteers) and incubated for 18 hours.

Mitogen-activated protein kinases signal inhibition of apoptosis in lipopolysaccharide-stimulated neutrophils.

Background: Neutrophil (PMN) apoptosis is critical to the resolution of infection and the limitation of inflammation. Bacterial endotoxin (lipopolysaccharide [LPS]) inhibits PMN apoptosis and activates the p38 mitogen-activated protein kinase (MAPK) signal cascade. The role of p38 and other MAPKs (ERK and SAPK/JNK) in regulating PMN apoptosis after LPS stimulation is unknown.

Seventeen-year evaluation of breast cancer screening: the DOM project, The Netherlands. Diagnostisch Onderzoek (investigation) Mammacarcinoom.

The DOM project is a non-randomized population-based breast cancer screening programme in Utrecht which started in 1974-75. The 17-year effect has been evaluated by a case-control study of breast cancer deaths during the period 1975-92 in women living in the city of Utrecht, born between 1911 and 1925, whose breast cancers were diagnosed after the initiation of the DOM project. Controls (three for each case) were defined as women having the same year of birth as the case, living in the city of Utrecht at the time the case died, and having had the opportunity of screening in the DOM project.

Urinary sex hormone excretions in premenopausal women and coronary heart disease risk: a nested case-referent study in the DOM-cohort.

The low incidence of coronary heart disease (CHD) in premenopausal women is partly ascribed to protection by endogenous estrogen production. As a consequence, we hypothesized that premenopausal women with low endogenous estrogen production or high androgen production might be at increased risk for CHD. We studied the relationship between urinary sex hormone excretions and CHD risk by means of a nested case-referent study within a cohort of premenopausal (ages 40-49 yrs) women (n = 11,284).

Estimation of reproducibility and relative validity of the questions included in the EPIC Physical Activity Questionnaire.

Background: The EPIC core questionnaire on lifestyle contains a number of questions on physical activity designed to rank subjects according to level of physical activity (short PA questionnaire). These questions are based on a more extensive questionnaire designed to measure absolute total energy expenditure (extensive PA questionnaire), that was validated in a pilot study preceding EPIC. Reproducibility and relative validity of the short PA questionnaire were estimated by selecting, from the pilot study data, the answers to a number of questions from the extensive questionnaire that resembled those actually included in the short version.

Prediction of peripheral fracture risk by quantitative microdensitometry.

Background: The purpose of the study was to investigate whether quantitative microdensitometry (QMD) could be used for screening purposes to identify a population with a high risk for peripheral osteoporotic fractures.

Methods: In 1984 bone mineral density (BMD) measurements were made on the index finger of 612 women. Repeated BMD measurements were obtained in 1989 in 440 women.

Relative validity and repeatability of a new questionnaire on physical activity.

Background: A physical activity questionnaire was developed with the aim to estimate usual individual daily energy expenditure. The questionnaire focused on the number of hours usually spent on various activities. In a pilot study it was tested for repeatability and validity in a population of 126 Dutch adults (64 men, 62 women).

Histopathology and growth rate of interval breast carcinoma. Characterization of different subgroups.

Background: Interval breast cancers are defined as carcinomas occurring within 2 years after a negative screening Distinction has to made between cancers existent at the time of screening but missed for some reason, and fast-growing incident cancers. This is important because the natural history and the implications for the treatment of the patient might differ.

Methods: Radiologic and histopathologic characteristics were assembled for 104 interval cancers diagnosed within the DOM project, the Utrecht program for the early detection of breast cancer.

Repeatability and relative validity of two physical activity questionnaires in elderly women.

In a population of 33 women aged 51-71 yr, two physical activity questionnaires (a modified Baecke questionnaire and the pre-EPIC questionnaire) were tested for repeatability (5 and 11 months). For assessment of relative validity, the questionnaires were compared with a physical activity diary (12 d) as the main reference method, a single 24-h Caltrac accelerometer score, and energy intake estimated from a 24-h dietary recall repeated 12 times. Repeatability of the questionnaires at 5 months was 0.

Age specific sensitivity and sojourn time in a breast cancer screening programme (DOM) in The Netherlands: a comparison of different methods.

Study Objective: To estimate age dependent sensitivity and sojourn time in a breast cancer screening programme by different methods.

Population And Methods: The study population comprised women participating in the DOM project--the Utrecht screening programme for the early detection of breast cancer. Breast cancer screening prevalence data and incidence rates after a negative screen were used to estimate age specific sensitivity and mean sojourn time by different methods.

Urinary excretions of high molecular weight beta-thromboglobulin and albumin are independently associated with coronary heart disease in women, a nested case-control study of middle-aged women in the Diagnostisch Onderzoek Mammacarcinoom (DOM) Cohort, Utrecht, Netherlands.

Increased plasma levels of beta-thromboglobulin, a platelet activation marker, are observed in coronary artery disease. Urinary albumin excretion, a marker of endothelial cell perturbation, is related to cardiovascular disease in diabetes. To test the value of these markers in predicting forthcoming coronary disease, the relations between urinary excretions of high molecular weight beta-thromboglobulin (HMW-beta TGf) and albumin and subsequent coronary disease in a cohort of 15,484 middle-aged women were investigated in a nested case-control study.

Survival in interval breast cancer in the DOM screening programme.

The study describes breast cancer survival of 75 interval cancer cases (cancer occurring within 2 years of a negative screen) detected in women who participated in the DOM screening programme. After mammographic revision, this group was divided into 17 so-called 'missed' cases and 58 'true' interval cases. Ten year survival of these 58 'true' interval cases was 58%, which was not significantly different from that of 219 cancers detected in a non-screened, control group of women, diagnosed with breast cancer before the start of screening (63%; log rank chi 2 test, P = 0.

Calcium and magnesium in human toenails do not reflect bone mineral density.

Nail mineral composition is influenced by several physiological and pathological processes. Potentially, nails could be used to monitor alterations in the level of incorporation of specific elements produced by nutritional abnormalities, disease states or chronic exposure to toxic agents. The purpose of this study was to investigate whether the calcium and magnesium content in nail clippings, as measured by instrumental neutron activation analysis (INAA), correlates with bone mineral density (BMD), as measured by quantitative microdensitometry (QMD), and therefore could be interesting as a screening instrument for osteoporosis.

Body fat distribution in relation to breast cancer in women participating in the DOM-project.

The association between body fat distribution and breast cancer risk was studied in 5923 pre- and 3568 post-menopausal women, participating in a breast cancer screening project (the DOM-project in Utrecht, the Netherlands). Cases were fifty six premenopausal women and thirty eight postmenopausal women with breast cancer detected at screening or afterwards. Controls were women participating in the breast cancer screening project without breast cancer.

Validity and repeatability of a modified Baecke questionnaire on physical activity.

Background: In a pilot study for the European Prospective Investigation into Cancer and Nutrition (EPIC) a modification of the Baecke questionnaire on physical activity was tested for repeatability and relative validity in a population of 134 men and women aged 20-70 years.

Methods: For the assessment of repeatability Pearson's correlation coefficients and percentages of agreement after classification in tertiles were computed between administrations of the questionnaire at baseline, and after 5 and 11 months. Relative validity was determined by comparing the questionnaire to a four times repeated 3-day activity diary.

Nation-wide breast cancer screening in The Netherlands: support for breast-cancer mortality reduction. National Evaluation Team for Breast Cancer Screening (NETB).

The nation-wide 2-yearly breast-cancer screening programme in The Netherlands, for women aged 50-69, started around 1988, and was predicted to result eventually in a 16% reduction in breast-cancer mortality in the total female population. We present the results of screening up to January 1, 1993, and compare these with the predicted results from the cost-effectiveness analysis, on which basis this mortality reduction has been calculated. At least 550,000 women aged 50-69 were invited to screening in 1990-1992, and 75% of these participated.

Effect on breast cancer screening response in The Netherlands of inviting women for an additional scientific investigation.

Study Objective: The study aimed to determine whether asking women to undertake an additional scientific study would deter them from attending screening for breast cancer.

Design: A randomised study was conducted in all women aged 50-70 years who were eligible for breast cancer screening and living in the city of Utrecht. A total of 1863 women were invited for mammography only and 1863 women were invited to participate in the European Prospective Investigation into Cancer and Nutrition (EPIC) in addition to the mammography.

A prospective study on obesity and subcutaneous fat patterning in relation to breast cancer in post-menopausal women participating in the DOM project.

The associations of body fat and body fat distribution with breast cancer risk were examined in a prospective study in 9,746 post-menopausal women with a natural menopause, aged 49-66 at intake, participating in a breast cancer screening project (the DOM project in Utrecht). During a follow-up period of 15 years (mean follow-up time 12.5 years) 260 women developed breast cancer.

The epidemiological profile of women with an interval cancer in the DOM screening programme.

Risk factors for breast cancer were compared in 107 women with interval breast cancer (cancers occurring within 2 years after a negative screen) and 258 women with breast cancer detected at 1st screening. All women (aged 40-67) were screened in the DOM project (the Utrecht programme for the early detection of breast cancer). Women with an interval cancer reported more often a history of benign breast disease (OR 4.

Cross-sectional and longitudinal study of age-related phalangeal bone loss in adult females.

To establish a comprehensive model for peripheral phalangeal bone loss, bone mass was studied in 1984 and 1989 using quantitative microdensitometry (QMD) in a total of 330 healthy women (age range 43-78.7 years). Bone mass and changes in bone mass were analyzed in relation to age and menopausal status.

Clinical heterogeneity of hereditary breast cancer and its impact on screening protocols: the Dutch experience on 24 families under surveillance.

We investigated 24 families who satisfied a set of criteria for hereditary breast cancer. Five families had only breast cancer, four a combination of breast and ovarian cancer and the remaining 15 had also a variety of other cancers. The families include 86 patients, 78 of which had a malignant tumour and the rest had a benign lesion in the breast.