ABSTRACT Emerging data indicate a link between genetic instability and up-regulation of cyclooxyg... more ABSTRACT Emerging data indicate a link between genetic instability and up-regulation of cyclooxygenase-2 (COX-2). To see if individuals at high risk of oral cancer are candidates for treatment with selective COX-2 inhibitors (coxibs), levels of COX-2 expression in healthy, premalignant and cancerous oral mucosa were compared with the occurrence of DNA ploidy status as a genetic risk marker of oral cancer. COX-2 gene product was evaluated immunohistochemically in 30 healthy persons, in 22 patients with dysplastic lesions without previous or concomitant carcinomas, and in 29 patients with oral carcinomas. The immunohistochemical findings were verified by western blotting. COX-2 expression was correlated to DNA content as a genetic risk marker of oral cancer. COX-2 was up-regulated from healthy to premalignant to cancerous oral mucosa. Thus, COX-2 expression was found in 1 case of healthy oral mucosa (3%). All specimens from healthy mucosa had a normal DNA content. In patients with premalignancies. In 29 patients with oral carcinomas, cyclooxygenase-2 expression was observed in 26 (88%), and aneuploidy was observed in 25 cases (94%, P=0.04). Notably, of 22 patients with dysplastic lesions, COX-2 was exclusively expressed in a subgroup of nine patients (41%) identified to be at high risk of cancer by the aberrant DNA content of their lesions. Seven of these patients were followed for 5 years or more. An oral carcinoma developed in six of them (85%; P=0.02). These findings emphasize the need to determine whether coxibs can reduce the risk of oral cancer in patients with high-risk precancerous lesions.
The records of 214 consecutively registered, previously untreated patients with squamous cell car... more The records of 214 consecutively registered, previously untreated patients with squamous cell carcinoma of the head and neck region were reviewed. Among the 157 patients considered "free of disease" following the primary treatment 54 developed recurrences - all but three within three years. Only in patients with carcinoma of the larynx treated with radiation alone did follow-up disclose recurrences for which further treatment resulted in a significant number of cures. For these patients the cure rate was one in 79 routine appointments compared to only one cure in 325 appointments for patients with carcinoma in other localizations. It seems that our routine follow-up procedure for most types of carcinoma is too extensive and that follow-up beyond three years mainly will be of value for the possible detection of second primary malignancies.
Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række, Jan 30, 2001
The craniofacial approach has greatly facilitated resections of tumours involving the base of the... more The craniofacial approach has greatly facilitated resections of tumours involving the base of the anterior cranial fossa when compared to either the transcranial or transfacial approach alone. This approach was used in 11 patients with malignant tumours localized to the ethmoid sinus, orbit and bone or soft tissue of the base of the anterior part of the skull. By combining a low frontal or frontolateral craniotomy with resection of the facial skull, en bloc resections were accomplished. A frontogaleal periostal flap or a muscle flap from the temporal muscle was used to replace resected bone and to seal the skull base. There were no peri- or postoperative deaths. One patient died due to local recurrence, one patient is alive with residual tumour six years after surgery, and one is reoperated due to local recurrence. In addition one patient developed recurrence of a previously treated tumour of the maxillary sinus. Two patients developed meningitis and one pneumocephalus postoperative...
Biopsies of nasal epithelium consisting of metaplasia (stratified cuboid epithelium, mixed strati... more Biopsies of nasal epithelium consisting of metaplasia (stratified cuboid epithelium, mixed stratified cuboid/stratified squamous epithelium and squamous epithelium), dysplasia and carcinoma, were the subjects of morphometric analysis using semithin sections of plastic embedded material. Use of a semiautomatic device for image analysis (MOP, AMO3, Kontron) facilitated the workload considerably but not at the expense of reliability. The measurements were restricted to the basal layer. The preliminary study consists of scanning and transmission electron microscopy besides morphometry. The most interesting electron microscopic finding was a significant reduction in foldings of the surface of the plasma membrane in dysplasia with a nearly complete loss in carcinoma and an increase of desmosomes in dysplasia. The most conspicuous light microscopic finding was an increase in the cell size with largest values in dysplasia (162 +/- 16 micrometer 2) and an unchanged nuclear/cytoplasmic ratio for the different types of metaplasia of 0.28 in contrast to dysplasia and carcinoma of 0.31 and 0.51 respectively. Alterations of the karyoplasm consisted of a conspicuous, gradual increase in the percentage of nuclei containing nucleoli, which was nearly 100% in carcinoma. The nucleoli fraction per nuclei was 7.6% in dysplasia, which was a 2 or 1.5 times increase compared to stratified cuboid epithelium or carcinoma respectively. This increase was mainly the consequence of an enlargement of the average nucleoli size which was 2 or 3 times higher in atypia (9.3 +/- 1.4 micrometer 2) than in stratified cuboid epithelium and carcinoma respectively. Further work is in progress to enlarge the number of analyzed cases and especially to quantify the ultrastructural alterations.
Modem stereologic techniques enable unbiased, objective and reproducible assessment of histologic... more Modem stereologic techniques enable unbiased, objective and reproducible assessment of histologic parameters. The purpose of this study was to investigate the prognostic impact of the volume-weighted mean volume of tumor nuclei (nuclear (V) over bar v) in 62 patients with adenoid cystic carcinoma (ACC) and to correlate nuclear (V) over bar v and some traditional prognostic parameters with treatment failures. The observation time of the patients ranged from 2 to 11 years. Disregarding the well known histopathological subtypes of ACC and using random sampling it was found that treatment failures, i.e. inability to eradicate the disease and recurrences, were more often seen in specimens with small nuclear (V) over bar v when-compared to non-failures. Using a cut-off point of 250 mu m(3) the prognostic significance of nuclear (V) over bar v was 0.0177 by log rank analysis. For tumor stage vs. treatment failures/nonfailures log rank analysis revealed p=0.0147. Cox regression analysis left only the nuclear (V) over bar v (p=0.0234) as a prognostic factor. Estimations of nuclear (V) over bar v appears to be a reliable indicator of short term treatment failures in ACC.
A retrospective analysis of the CT examinations of 45 patients with squamous cell carcinomas of t... more A retrospective analysis of the CT examinations of 45 patients with squamous cell carcinomas of the tongue, floor of the mouth and tongue base with long-term follow-up is presented. The aim of the study was to determine whether differences in tumor contrast enhancement and tumor demarcation at contrast-enhanced CT were correlated to prognosis in terms of posttreatment residual tumor or local recurrence. Ill-defined tumor margins were by means of multiple regression analysis significantly correlated to local failures (p = 0.043). This feature was, however, not associated with a significant decreased survival. The degree of tumor contrast enhancement did not parallel variations in the histopathologic composition of the tumors.
PURPOSE: The aim of this study was to define the scales and test the validity, reliability, and s... more PURPOSE: The aim of this study was to define the scales and test the validity, reliability, and sensitivity of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ)-H&N35, a questionnaire designed to assess the quality of life of head and neck (H&N) cancer patients in conjunction with the general cancer-specific EORTC QLQ-C30. PATIENTS AND METHODS: Questionnaires were given to 500 H&N cancer patients from Norway, Sweden, and the Netherlands as part of two prospective studies. The patients completed the questionnaires before, during (Norway and Sweden only), and after treatment, yielding a total of 2070 completed questionnaires. RESULTS: The compliance rate was high, and the questionnaires were well accepted by the patients. Seven scales were constructed (pain, swallowing, senses, speech, social eating, social contact, sexuality). Scales and single items were sensitive to differences between patient subgroups with relation to site, stage, or performance status. Most scales and single items were sensitive to changes, with differences of various magnitudes according to the site in question. The internal consistency, as assessed by Cronbach's alpha coefficient, varied according to assessment point and within subsamples of patients. A low overall alpha value was found for the speech and the senses scales, but values were higher in assessments of patients with laryngeal cancer and in patients with nose, sinus, and salivary gland tumors. Scales and single items in the QLQ-H&N35 seem to be more sensitive to differences between groups and changes over time than do the scales and single items in the core questionnaire. CONCLUSION: The QLQ-H&N35, in conjunction with the QLQ-C30, provides a valuable tool for the assessment of health-related quality of life in clinical studies of H&N cancer patients before, during, and after treatment with radiotherapy, surgery, or chemotherapy.
A retrospective analysis of 137 patients treated with reconstruction of defects following head an... more A retrospective analysis of 137 patients treated with reconstruction of defects following head and neck cancer surgery is presented. From 1976 through 1984, 151 regional flaps were used: 43 pectoralis myocutaneous, 29 deltopectoral, 19 forehead, 17 nasolabial, 14 combinations of the aforementioned and 15 other types. The minimum follow-up was two years. Of 62 patients (51 stage III and IV) operated as part of the primary treatment, 20 (32%) died due to relapse, of which 14 (23%) occurred within the region reconstructed. The corresponding figures for 64 patients receiving salvage surgery for recurrences were 53% and 39% respectively. Eleven patients had repair of wounds following surgery or irradiation. Major flap necrosis necessitating reoperation occurred in 11%. The average duration of hospitalization was 35 days. We feel that these results justify these resource-demanding operations.
Since 1989, 40 free-tissue grafts were used in 39 patients to repair defects following major head... more Since 1989, 40 free-tissue grafts were used in 39 patients to repair defects following major head and neck ablative surgery (n = 32) and for reconstruction of the mandible because of osteoradionecrosis or trauma (n = 7). The radial forearm flap was used in 17 patients (five including a segment of radius), the lateral arm flap in seven, fibula in five and a segment of ileum for restoration of the hypopharynx in 11 cases. Three radial forearm flaps and the bone in one lateral arm flap failed. Better functional and cosmetic results seem to be obtained with free flaps than with other reconstructive techniques.
We evaluate 41 patients treated for cervical lymph node metastases from occult primary carcinomas... more We evaluate 41 patients treated for cervical lymph node metastases from occult primary carcinomas. Minimum follow-up was two years. 18 patients had metastases from squamous cell carcinoma, 12 from undifferentiated and 11 from adenocarcinoma. The survival rate was best for patients treated with surgery and radiation. The survival rate was 66% for patients with squamous cell and undifferentiated carcinoma, compared with 20% for patients with adenocarcinoma. The survival rate was 85% for patients with N1 and N2A metastases (UICC 1987) from squamous cell and undifferentiated carcinoma, compared with 45% for patients with metastases classified as N2B-N3. The prognosis was better for patients with tumors in the upper 2/3 of the neck than for patients with metastases in the lower 1/3 of the neck. We emphasize the significance of fine-needle aspiration biopsy as a highly accurate, safe and valuable technique in diagnosing malignant tumors of the head and neck.
Objective: To investigate whether the quantitation of p53 protein reactivity in nasal biopsies co... more Objective: To investigate whether the quantitation of p53 protein reactivity in nasal biopsies could be related to nickel exposure by comparing nickel workers with various control groups. Study design: Nasal biopsies taken from nickel workers (n = 93) were compared immunohistochemically to various controls, including office staff members (n = 34) and hospital attendants (n = 6). The material was studied immunohistochemically with p53 antibody DO-1. p53 Protein-positive cells were counted at 400x magnification. Results: p53 Protein reactivity was found in 54% (49/93) of nickel workers, 50% (17/34) of office staff members, 67% (4/6) of hospital attendants. No differences were seen between roasting/smelting, electrolysis and other workers in the refinery. The positive cells were present predominantly in the basal layer of the epithelium. The number of positive nasal cells per field in the hospital attendants on the average was half of that in the workers and the office staff in the refinery. In no case in the control group were more than 10 cells per field seen. No significant differences in p53 protein positivity were observed between the three nickel worker groups and between production workers and office staff members. Conclusion: Accumulation of p53 protein in nickel workers seems not to be attributable to nickel exposure. The lack of p53 protein positivity in fetal tissues shows that the accumulation of p53 protein is an event taking place after birth. Stimuli in the natural environment during life may explain p53 protein positivity.
It is generally accepted that some 5% of all human cancer results from occupational exposure to c... more It is generally accepted that some 5% of all human cancer results from occupational exposure to carcinogens. An increased incidence of respiratory tract cancer has been reported from nickel refineries in Wales, Russia, Canada and Norway1. Epidemiological studies from a Norwegian nickel refinery2 show that workers exposed to various nickel compounds for more than 3 years have a ratio of observed versus expected respiratory tract cancer of 13.9. Chromosome studies of humans exposed to nickel have not previously been reported.
After completed radiotherapy, 24 in-patients and 25 out-patients enrolled at the Department of Ot... more After completed radiotherapy, 24 in-patients and 25 out-patients enrolled at the Department of Otolaryngology, National Hospital, were randomised to either tailored dietary information and instruction by a clinical nutritionist or regular dietary information from a nurse. At the six weeks follow-up examination the incidence of malnutrition, as evaluated by anthropometry and routine blood analyses, was lower among the patients who had been given intensive information than those who had received regular information (p < 0.05). Out-patients lost more weight than in-patients did (p < 0.05). The in-patients randomised to intensive dietary information were the only ones who did not lose weight. This study indicates a beneficial effect of intensive dietary advice in order to improve nutritional status after radiation treatment.
ABSTRACT Emerging data indicate a link between genetic instability and up-regulation of cyclooxyg... more ABSTRACT Emerging data indicate a link between genetic instability and up-regulation of cyclooxygenase-2 (COX-2). To see if individuals at high risk of oral cancer are candidates for treatment with selective COX-2 inhibitors (coxibs), levels of COX-2 expression in healthy, premalignant and cancerous oral mucosa were compared with the occurrence of DNA ploidy status as a genetic risk marker of oral cancer. COX-2 gene product was evaluated immunohistochemically in 30 healthy persons, in 22 patients with dysplastic lesions without previous or concomitant carcinomas, and in 29 patients with oral carcinomas. The immunohistochemical findings were verified by western blotting. COX-2 expression was correlated to DNA content as a genetic risk marker of oral cancer. COX-2 was up-regulated from healthy to premalignant to cancerous oral mucosa. Thus, COX-2 expression was found in 1 case of healthy oral mucosa (3%). All specimens from healthy mucosa had a normal DNA content. In patients with premalignancies. In 29 patients with oral carcinomas, cyclooxygenase-2 expression was observed in 26 (88%), and aneuploidy was observed in 25 cases (94%, P=0.04). Notably, of 22 patients with dysplastic lesions, COX-2 was exclusively expressed in a subgroup of nine patients (41%) identified to be at high risk of cancer by the aberrant DNA content of their lesions. Seven of these patients were followed for 5 years or more. An oral carcinoma developed in six of them (85%; P=0.02). These findings emphasize the need to determine whether coxibs can reduce the risk of oral cancer in patients with high-risk precancerous lesions.
The records of 214 consecutively registered, previously untreated patients with squamous cell car... more The records of 214 consecutively registered, previously untreated patients with squamous cell carcinoma of the head and neck region were reviewed. Among the 157 patients considered "free of disease" following the primary treatment 54 developed recurrences - all but three within three years. Only in patients with carcinoma of the larynx treated with radiation alone did follow-up disclose recurrences for which further treatment resulted in a significant number of cures. For these patients the cure rate was one in 79 routine appointments compared to only one cure in 325 appointments for patients with carcinoma in other localizations. It seems that our routine follow-up procedure for most types of carcinoma is too extensive and that follow-up beyond three years mainly will be of value for the possible detection of second primary malignancies.
Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række, Jan 30, 2001
The craniofacial approach has greatly facilitated resections of tumours involving the base of the... more The craniofacial approach has greatly facilitated resections of tumours involving the base of the anterior cranial fossa when compared to either the transcranial or transfacial approach alone. This approach was used in 11 patients with malignant tumours localized to the ethmoid sinus, orbit and bone or soft tissue of the base of the anterior part of the skull. By combining a low frontal or frontolateral craniotomy with resection of the facial skull, en bloc resections were accomplished. A frontogaleal periostal flap or a muscle flap from the temporal muscle was used to replace resected bone and to seal the skull base. There were no peri- or postoperative deaths. One patient died due to local recurrence, one patient is alive with residual tumour six years after surgery, and one is reoperated due to local recurrence. In addition one patient developed recurrence of a previously treated tumour of the maxillary sinus. Two patients developed meningitis and one pneumocephalus postoperative...
Biopsies of nasal epithelium consisting of metaplasia (stratified cuboid epithelium, mixed strati... more Biopsies of nasal epithelium consisting of metaplasia (stratified cuboid epithelium, mixed stratified cuboid/stratified squamous epithelium and squamous epithelium), dysplasia and carcinoma, were the subjects of morphometric analysis using semithin sections of plastic embedded material. Use of a semiautomatic device for image analysis (MOP, AMO3, Kontron) facilitated the workload considerably but not at the expense of reliability. The measurements were restricted to the basal layer. The preliminary study consists of scanning and transmission electron microscopy besides morphometry. The most interesting electron microscopic finding was a significant reduction in foldings of the surface of the plasma membrane in dysplasia with a nearly complete loss in carcinoma and an increase of desmosomes in dysplasia. The most conspicuous light microscopic finding was an increase in the cell size with largest values in dysplasia (162 +/- 16 micrometer 2) and an unchanged nuclear/cytoplasmic ratio for the different types of metaplasia of 0.28 in contrast to dysplasia and carcinoma of 0.31 and 0.51 respectively. Alterations of the karyoplasm consisted of a conspicuous, gradual increase in the percentage of nuclei containing nucleoli, which was nearly 100% in carcinoma. The nucleoli fraction per nuclei was 7.6% in dysplasia, which was a 2 or 1.5 times increase compared to stratified cuboid epithelium or carcinoma respectively. This increase was mainly the consequence of an enlargement of the average nucleoli size which was 2 or 3 times higher in atypia (9.3 +/- 1.4 micrometer 2) than in stratified cuboid epithelium and carcinoma respectively. Further work is in progress to enlarge the number of analyzed cases and especially to quantify the ultrastructural alterations.
Modem stereologic techniques enable unbiased, objective and reproducible assessment of histologic... more Modem stereologic techniques enable unbiased, objective and reproducible assessment of histologic parameters. The purpose of this study was to investigate the prognostic impact of the volume-weighted mean volume of tumor nuclei (nuclear (V) over bar v) in 62 patients with adenoid cystic carcinoma (ACC) and to correlate nuclear (V) over bar v and some traditional prognostic parameters with treatment failures. The observation time of the patients ranged from 2 to 11 years. Disregarding the well known histopathological subtypes of ACC and using random sampling it was found that treatment failures, i.e. inability to eradicate the disease and recurrences, were more often seen in specimens with small nuclear (V) over bar v when-compared to non-failures. Using a cut-off point of 250 mu m(3) the prognostic significance of nuclear (V) over bar v was 0.0177 by log rank analysis. For tumor stage vs. treatment failures/nonfailures log rank analysis revealed p=0.0147. Cox regression analysis left only the nuclear (V) over bar v (p=0.0234) as a prognostic factor. Estimations of nuclear (V) over bar v appears to be a reliable indicator of short term treatment failures in ACC.
A retrospective analysis of the CT examinations of 45 patients with squamous cell carcinomas of t... more A retrospective analysis of the CT examinations of 45 patients with squamous cell carcinomas of the tongue, floor of the mouth and tongue base with long-term follow-up is presented. The aim of the study was to determine whether differences in tumor contrast enhancement and tumor demarcation at contrast-enhanced CT were correlated to prognosis in terms of posttreatment residual tumor or local recurrence. Ill-defined tumor margins were by means of multiple regression analysis significantly correlated to local failures (p = 0.043). This feature was, however, not associated with a significant decreased survival. The degree of tumor contrast enhancement did not parallel variations in the histopathologic composition of the tumors.
PURPOSE: The aim of this study was to define the scales and test the validity, reliability, and s... more PURPOSE: The aim of this study was to define the scales and test the validity, reliability, and sensitivity of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ)-H&amp;N35, a questionnaire designed to assess the quality of life of head and neck (H&amp;N) cancer patients in conjunction with the general cancer-specific EORTC QLQ-C30. PATIENTS AND METHODS: Questionnaires were given to 500 H&amp;N cancer patients from Norway, Sweden, and the Netherlands as part of two prospective studies. The patients completed the questionnaires before, during (Norway and Sweden only), and after treatment, yielding a total of 2070 completed questionnaires. RESULTS: The compliance rate was high, and the questionnaires were well accepted by the patients. Seven scales were constructed (pain, swallowing, senses, speech, social eating, social contact, sexuality). Scales and single items were sensitive to differences between patient subgroups with relation to site, stage, or performance status. Most scales and single items were sensitive to changes, with differences of various magnitudes according to the site in question. The internal consistency, as assessed by Cronbach's alpha coefficient, varied according to assessment point and within subsamples of patients. A low overall alpha value was found for the speech and the senses scales, but values were higher in assessments of patients with laryngeal cancer and in patients with nose, sinus, and salivary gland tumors. Scales and single items in the QLQ-H&amp;N35 seem to be more sensitive to differences between groups and changes over time than do the scales and single items in the core questionnaire. CONCLUSION: The QLQ-H&amp;N35, in conjunction with the QLQ-C30, provides a valuable tool for the assessment of health-related quality of life in clinical studies of H&amp;N cancer patients before, during, and after treatment with radiotherapy, surgery, or chemotherapy.
A retrospective analysis of 137 patients treated with reconstruction of defects following head an... more A retrospective analysis of 137 patients treated with reconstruction of defects following head and neck cancer surgery is presented. From 1976 through 1984, 151 regional flaps were used: 43 pectoralis myocutaneous, 29 deltopectoral, 19 forehead, 17 nasolabial, 14 combinations of the aforementioned and 15 other types. The minimum follow-up was two years. Of 62 patients (51 stage III and IV) operated as part of the primary treatment, 20 (32%) died due to relapse, of which 14 (23%) occurred within the region reconstructed. The corresponding figures for 64 patients receiving salvage surgery for recurrences were 53% and 39% respectively. Eleven patients had repair of wounds following surgery or irradiation. Major flap necrosis necessitating reoperation occurred in 11%. The average duration of hospitalization was 35 days. We feel that these results justify these resource-demanding operations.
Since 1989, 40 free-tissue grafts were used in 39 patients to repair defects following major head... more Since 1989, 40 free-tissue grafts were used in 39 patients to repair defects following major head and neck ablative surgery (n = 32) and for reconstruction of the mandible because of osteoradionecrosis or trauma (n = 7). The radial forearm flap was used in 17 patients (five including a segment of radius), the lateral arm flap in seven, fibula in five and a segment of ileum for restoration of the hypopharynx in 11 cases. Three radial forearm flaps and the bone in one lateral arm flap failed. Better functional and cosmetic results seem to be obtained with free flaps than with other reconstructive techniques.
We evaluate 41 patients treated for cervical lymph node metastases from occult primary carcinomas... more We evaluate 41 patients treated for cervical lymph node metastases from occult primary carcinomas. Minimum follow-up was two years. 18 patients had metastases from squamous cell carcinoma, 12 from undifferentiated and 11 from adenocarcinoma. The survival rate was best for patients treated with surgery and radiation. The survival rate was 66% for patients with squamous cell and undifferentiated carcinoma, compared with 20% for patients with adenocarcinoma. The survival rate was 85% for patients with N1 and N2A metastases (UICC 1987) from squamous cell and undifferentiated carcinoma, compared with 45% for patients with metastases classified as N2B-N3. The prognosis was better for patients with tumors in the upper 2/3 of the neck than for patients with metastases in the lower 1/3 of the neck. We emphasize the significance of fine-needle aspiration biopsy as a highly accurate, safe and valuable technique in diagnosing malignant tumors of the head and neck.
Objective: To investigate whether the quantitation of p53 protein reactivity in nasal biopsies co... more Objective: To investigate whether the quantitation of p53 protein reactivity in nasal biopsies could be related to nickel exposure by comparing nickel workers with various control groups. Study design: Nasal biopsies taken from nickel workers (n = 93) were compared immunohistochemically to various controls, including office staff members (n = 34) and hospital attendants (n = 6). The material was studied immunohistochemically with p53 antibody DO-1. p53 Protein-positive cells were counted at 400x magnification. Results: p53 Protein reactivity was found in 54% (49/93) of nickel workers, 50% (17/34) of office staff members, 67% (4/6) of hospital attendants. No differences were seen between roasting/smelting, electrolysis and other workers in the refinery. The positive cells were present predominantly in the basal layer of the epithelium. The number of positive nasal cells per field in the hospital attendants on the average was half of that in the workers and the office staff in the refinery. In no case in the control group were more than 10 cells per field seen. No significant differences in p53 protein positivity were observed between the three nickel worker groups and between production workers and office staff members. Conclusion: Accumulation of p53 protein in nickel workers seems not to be attributable to nickel exposure. The lack of p53 protein positivity in fetal tissues shows that the accumulation of p53 protein is an event taking place after birth. Stimuli in the natural environment during life may explain p53 protein positivity.
It is generally accepted that some 5% of all human cancer results from occupational exposure to c... more It is generally accepted that some 5% of all human cancer results from occupational exposure to carcinogens. An increased incidence of respiratory tract cancer has been reported from nickel refineries in Wales, Russia, Canada and Norway1. Epidemiological studies from a Norwegian nickel refinery2 show that workers exposed to various nickel compounds for more than 3 years have a ratio of observed versus expected respiratory tract cancer of 13.9. Chromosome studies of humans exposed to nickel have not previously been reported.
After completed radiotherapy, 24 in-patients and 25 out-patients enrolled at the Department of Ot... more After completed radiotherapy, 24 in-patients and 25 out-patients enrolled at the Department of Otolaryngology, National Hospital, were randomised to either tailored dietary information and instruction by a clinical nutritionist or regular dietary information from a nurse. At the six weeks follow-up examination the incidence of malnutrition, as evaluated by anthropometry and routine blood analyses, was lower among the patients who had been given intensive information than those who had received regular information (p < 0.05). Out-patients lost more weight than in-patients did (p < 0.05). The in-patients randomised to intensive dietary information were the only ones who did not lose weight. This study indicates a beneficial effect of intensive dietary advice in order to improve nutritional status after radiation treatment.
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