Serum CA125 elevation and risk of clinical detection of cancer in asymptomatic postmenopausal women.

Background: This study was undertaken to assess the correlation between CA125 elevation, a past history of cancer, and future risk of a diagnosis of cancer among asymptomatic postmenopausal women.

Methods: The subjects consisted of a study group of 771 women with elevated CA125 (> or =30 U/mL) and a control group of 771 women with CA125 <30 U/mL. They were selected from a prospective ovarian carcinoma screening trial of 22,000 postmenopausal women followed for a mean of 2269 days.

Screening for ovarian cancer: a pilot randomised controlled trial.

Background: The value of screening for ovarian cancer is uncertain. We did a pilot randomised trial to assess multimodal screening with sequential CA 125 antigen and ultrasonography.

Methods: Postmenopausal women aged 45 years or older were randomised to a control group (n=10,977) or screened group (n=10,958).

Differences between hereditary and sporadic ovarian cancer.

Approximately 5% of ovarian cancer cases can be attributed to an autosomal dominant inheritance factor. The majority of these cases are due to germline mutations in the BRCA1 or BRCA2 tumoursupressor genes. Patients with hereditary disease do not exhibit pathognomonic features that would allow distinction from non-hereditary (sporadic) cases of ovarian cancer.

A randomized controlled trial of buffered lidocaine for local anesthetic infiltration in children and adults with simple lacerations.

This study assessed the efficacy of buffered lidocaine in children and adults for the repair of simple lacerations. We compared plain lidocaine (PL) with buffered lidocaine (BL) in a prospective, randomized, double-blind, placebo controlled trial. Children had a 10-point pain score assessed by a nurse using predetermined behavior criteria, and a visual analog pain score (VAS) as perceived by the parent.

Physiological responses of exercised-fatigued individuals exposed to wet-cold conditions.

Thirteen healthy and fit men [age = 27 +/- 8 (SD) yr, height = 177 +/- 5 cm, mass = 75 +/- 7 kg, body fat = 14 +/- 5%, maximal O2 consumption = 51 +/- 4 ml. kg-1. min-1] participated in an experiment designed to test their thermoregulatory response to a challenging cold exposure after 5 h of demanding mixed exercise during which only water was consumed.

The Philadelphia story: the 22q11.2 deletion: report on 250 patients.

A submicroscopic deletion of chromosome 22q11.2 has been identified in the majority of patients with the DiGeorge, velocardiofacial, and conotruncal anomaly face syndromes, and in some patients with the Opitz G/BBB and Cayler cardiofacial syndromes. We have been involved in the analysis of DiGeorge syndrome and related diagnoses since 1982 and have evaluated a large number of patients with the deletion.

Combination of multiple serum markers using an artificial neural network to improve specificity in discriminating malignant from benign pelvic masses.

A panel of four selected tumor markers, CA 125 II, CA 72-4, CA 15-3, and lipid-associated sialic acid, was analyzed collectively using an artificial neural network (ANN) approach to differentiate malignant from benign pelvic masses. A dataset of 429 patients, 192 of whom had malignant histology, was retrospectively used in the study. A prototype ANN classifier was developed using a subset of the data which included 73 patients with malignant conditions and 101 patients with benign conditions.

Effects of UV on the migration and function of epidermal antigen presenting cells.

Depletion of epidermal Langerhans cells (LC) and the concomitant depression of the skin immune system after excessive exposure to ultraviolet B light (UVB) has been established in the international literature for some time. Our investigations were intended to determine whether or not these phenomena occurred as a direct result of increased LC migration being triggered by the UVB exposure. To test this hypothesis, a sheep model was established in which the lymphatic vessels draining a defined region of skin were cannulated and the cells migrating towards the regional lymph node continuously collected.

Screening for ovarian cancer.

Ovarian cancer is predominantly a disease of postmenopausal women which presents at a late stage and has an overall 5-year survival of less than 30%. If detected at stage I, survival is dramatically increased and this would suggest that screening for ovarian cancer may reduce mortality. However, the inaccessibility of the ovaries and the absence of a confirmed premalignant condition make screening for preclinical disease difficult.

Cold stress increases lipolysis, FFA Ra and TG/FFA cycling in humans.

Background: To characterize the important changes in the selection and mobilization of metabolic fuel during cold stress, six males rested for 3 h at 29 degrees C and at 5 degrees C dressed only in shorts while 2H5 glycerol, 1-13C palmitate and 6,6 2H2 glucose were continuously infused for 3 h in each condition to determine their rate of turnover (Ra).

Methods: Metabolic rate (M) as well as rates of carbohydrate (CHOox) and lipid oxidation (FATox) were assessed by indirect calorimetry whereas all isotopic enrichments were determined by mass spectrometry.

Results: Cold exposure decreased rectal and mean skin temperatures and increased M, FATox and CHOox compared with the same test at thermal neutrality (p<0.

Internal carotid artery narrowing in children with retropharyngeal lymphadenitis and abscess.

Background And Purpose: Our purpose was to describe the association between narrowing of the internal carotid artery (ICA) and retropharyngeal abscess in children.

Methods: Neck CT scans from 13 consecutive children with suppurative retropharyngeal lymphadenitis and abscess were evaluated retrospectively for asymmetric ICA diameters at the level of the abscess. Clinical status at the time of illness was established via a chart review.

Adrenal leiomyoma: a case report and review of the literature.

We describe a case of a 65-year-old Caucasian woman found to have an enlarging mass of the left adrenal gland. Laboratory examination revealed the mass to be nonfunctional. The patient underwent an uneventful left adrenalectomy.

p53 codon 72 polymorphism and risk of cervical cancer in UK.

Background: A polymorphism at codon 72 of the human tumour-suppressor gene, p53, results in translation to either arginine or proline. A recent report suggested that the risk of human-papillomavirus-associated cervical cancer in white women is higher for those homozygous for the arginine allele than for those who are heterozygous. We examined a similar number of cervical cancers and a larger control group for their p53 codon 72 polymorphism status to see if we could confirm this result.

Emergency department telephone advice.

Objective: To evaluate telephone advice given in an emergency department.

Design: Prospective, observational study.

Setting: A community-based emergency department in a semi-rural/outer metropolitan setting, between August and November 1995.

Ovarian cancer screening.

Despite advances in molecular biology, surgical oncology, and chemotherapy, the prognosis for ovarian cancer remains poor. The excellent survival rates for stage I disease provide the rationale for efforts to screen for early-stage ovarian cancer. However, there are doubts about the feasibility of screening related to the natural history of the disease, the performance of the available tests, and health economic considerations.

Effects of caffeine, ephedrine and their combination on time to exhaustion during high-intensity exercise.

This study investigated the effects of acute ingestion of caffeine (C), ephedrine (E) and their combination (C+E) on time to exhaustion during high-intensity exercise. Using a repeated-measures, double-blind design, eight male subjects exercised on a cycle ergometer at a power output that led to exhaustion after about 12.6 min during a placebo (P) control trial.

No evidence exists for methylation inactivation of the p16 tumor suppressor gene in ovarian carcinogenesis.

The p16ink4/CDKN2/MTS1 tumor suppressor gene encodes a cyclin-dependent kinase inhibitor which plays an important role in regulation of the G1/S phase cell cycle checkpoint. Loss of heterozygosity (LOH) at the p16 locus, 9p21, has been documented in a wide variety of tumors including ovarian carcinoma. However, inactivating mutations of the remaining allele and homozygous deletions are relatively infrequent events in primary tumors, even in cases where expression of p16 at the mRNA and protein level is clearly absent.

Tracheostomy decannulation in children: approaches and techniques.

Various approaches and techniques are used in discontinuing tracheostomy in children. The variability in the use of resources is considerable. The objective of this study was to assess decannulation in children attended in a university-affiliated children's hospital.

Management of nasopharyngeal and oropharyngeal stenosis in children.

Nasopharyngeal stenosis and oropharyngeal stenosis are rare and challenging problems in the pediatric population. The most common etiology is currently the surgical trauma associated with adenotonsillectomy. Stenosis can vary from a thin band to a complete obstructing cicatrix.

Effect of upper respiratory tract infection in patients with neuromuscular disease.

Respiratory muscle strength during acute upper respiratory tract infection (URI) was assessed in patients with various forms of neuromuscular disease. Vital capacity (VC), oxygen saturation, end-tidal PCO2, maximal inspiratory pressure (MIP), and maximal expiratory pressure (MEP) were determined in 25 stable patients with various forms of neuromuscular disease. Thirteen episodes of URI developed in 10 patients.

Pulmonary vascular complications of chronic airway obstruction in children.

Objective: To study the clinical presentation, treatment, and outcome of pulmonary artery hypertension (PAH) that develops in children with chronic airway obstruction.

Design: Case study.

Setting: Academic tertiary care children's hospital.