Histologic types of lung carcinoma and age at onset

BACKGROUND

Previous research has demonstrated that adenocarcinoma is the leading cell type among patients with early age onset lung carcinoma. An increase in adenocarcinoma at the expense of squamous cell carcinoma in general was observed in recent years and may be due to the smoking of filtered cigarettes.

METHODS

To rule out whether shifts in smoking patterns or other etiologic factors are responsible for the high rates of adenocarcinoma in young patients, personal interviews regarding smoking, occupation, and family history of cancer were conducted in 251 young patients (age < or =45 years) and 2009 older patients (ages 55-69 years) with histologically confirmed lung carcinoma from selected study clinics in Germany between 1990 and 1996.

RESULTS

Young male patients were found to have significantly more adenocarcinomas (41%) than older male patients (28%), whereas adenocarcinomas were dominant in young and older women (43% and 47%, respectively). Because smoking patterns were different between young and older patients, the authors stratified for comparable levels of smoking exposure. Histology did not differ in never smokers (dominance of adenocarcinomas in both age groups) and in male heavy smokers (dominance of squamous cell carcinomas in both age groups), whereas young male low dose smokers showed significantly more cases of adenocarcinoma than older low dose smokers. A family history of lung carcinoma was significantly higher in young patients compared with older patients, but no association with histologic type was observed.

CONCLUSIONS

The results of the current study show that differences in the histologic type of lung carcinoma based on age at onset can be explained in part by differences in smoking patterns. However, there still are unknown factors that appear to favor the development of adenocarcinoma in the young.

Cigar and pipe smoking and lung cancer risk: a multicenter study from Europe

BACKGROUND

Because limited information is available on the quantitative association between consumption of tobacco products other than cigarettes and lung cancer risk, we undertook a case-control study of this relationship.

METHODS

We investigated lung cancer risk among smokers of cigars and/or cigarillos only and of pipes only and compared these risks with the risk of smokers of cigarettes only in a case-control study conducted in seven European areas. Our study population consisted of 5621 male case patients with lung cancer and 7255 male control subjects. Each subject or his proxy was interviewed with respect to the subject's smoking history and other risk factors for lung cancer.

RESULTS

The odds ratio (OR) for smoking cigars and cigarillos only was 9.0 (95% confidence interval [CI] = 5.8-14.1), based on 43 exposed case patients and 77 exposed control subjects, and the OR for smoking a pipe only was 7.9 (95% CI = 5.3-11.8), representing 61 case patients and 129 control subjects. The OR for smoking cigarettes only was 14.9 (95% CI = 12.3-18.1), based on 4204 case patients and 3930 control subjects. A dose-response relationship was present for duration of use and cumulative consumption both for cigars and cigarillos and for pipe tobacco. An effect was also suggested for inhalation of cigar and cigarillo smoke. The dose-response relationships between lung cancer risk and either duration of smoking or average and cumulative consumption were similar for cigar and cigarillo smoking, pipe smoking, and cigarette smoking.

CONCLUSION

Our results suggest that smoking of European cigars, cigarillos, and pipe tobacco might exert a carcinogenic effect on the lung comparable to that of cigarettes.

Methane suppression by coconut oil and associated effects on nutrient and energy balance in sheep

Three different diets with increasing proportions of coconut oil (0, 3.5 and 7%) were fed to six sheep in an incomplete Latin square experiment with four replicates per diet. The diets were composed of hay and concentrates either without or with coconut oil. Concentrate comprised 28.8 and 54.6% of the diet DM in the treatments containing 3.5 and 7% coconut oil, respectively. Wethers on all treatments were fed at 1.2 × maintenance. Gaseous exchange was measured in respiratory chambers. Protozoa counts were reduced (P < 0.05) by 88 and 97% when diets contained 3.5 and 7% coconut oil, respectively, whereas bacteria counts increased (P < 0.05). Supplementation of coconut oil at proportions of 3.5 and 7% suppressed (P < 0.001) methane production by 28 and 73%, respectively, as related to the unsupplemented diet. This proportionately reduced (P < 0.001) the amount of gross energy lost through methane from 7.5 to 5.7 and 2.5%, in diets containing 0, 3.5 and 7% coconut oil, respectively. Assuming a linear suppressive effect of coconut oil, about half of the additional methane reduction with the 7% coconut oil diet as compared with the 3.5% diet was attributed to the substitution of concentrate for hay. Digestibility of cell wall constituents was numerically decreased by coconut oil. Apart from this and its effect on methane emissions coconut oil had no major influence on digestion or on energy and nitrogen balance. Key words: Coconut oil, methane, energy balance, sheep, ruminants

Multicenter case-control study of exposure to environmental tobacco smoke and lung cancer in Europe

BACKGROUND

An association between exposure to environmental tobacco smoke (ETS) and lung cancer risk has been suggested. To evaluate this possible association better, researchers need more precise estimates of risk, the relative contribution of different sources of ETS, and the effect of ETS exposure on different histologic types of lung cancer. To address these issues, we have conducted a case-control study of lung cancer and exposure to ETS in 12 centers from seven European countries.

METHODS

A total of 650 patients with lung cancer and 1542 control subjects up to 74 years of age were interviewed about exposure to ETS. Neither case subjects nor control subjects had smoked more than 400 cigarettes in their lifetime.

RESULTS

ETS exposure during childhood was not associated with an increased risk of lung cancer (odds ratio [OR] for ever exposure = 0.78; 95% confidence interval [CI] = 0.64-0.96). The OR for ever exposure to spousal ETS was 1.16 (95% CI = 0.93-1.44). No clear dose-response relationship could be demonstrated for cumulative spousal ETS exposure. The OR for ever exposure to workplace ETS was 1.17 (95% CI = 0.94-1.45), with possible evidence of increasing risk for increasing duration of exposure. No increase in risk was detected in subjects whose exposure to spousal or workplace ETS ended more than 15 years earlier. Ever exposure to ETS from other sources was not associated with lung cancer risk. Risks from combined exposure to spousal and workplace ETS were higher for squamous cell carcinoma and small-cell carcinoma than for adenocarcinoma, but the differences were not statistically significant.

CONCLUSIONS

Our results indicate no association between childhood exposure to ETS and lung cancer risk. We did find weak evidence of a dose-response relationship between risk of lung cancer and exposure to spousal and workplace ETS. There was no detectable risk after cessation of exposure.

Risk factors for lung cancer in young adults

Risk factors for early onset of lung cancer are relatively unknown. In a case-control study, carried out in Germany between 1990 and 1996, the effects of smoking and familial aggregation of cancer were compared in 251 young cases and 280 young controls (< or = 45 years) and in 2,009 older cases and 2,039 older controls (55-69 years). The male/female ratio was 2.6/1 in young patients and 5.6/1 in older patients. Adenocarcinomas were more frequent in young men than in older men (41 % vs. 28%). Duration of smoking and amount smoked showed significantly increased odds ratios for lung cancer in both age groups. Lung cancer in a first degree relative was associated with a 2.6-fold (95% confidence interval (CI) 1.1-6.0) increase in the risk of lung cancer in the young age group, but no elevated risk was seen in the older group (OR = 1.2, 95% CI 0.9-1.6). Smoking-related cancer in relatives with the age at diagnosis under 46 years was associated with an increased risk of lung cancer in the young group (OR = 5.6, 95% CI 0.7-46.9) but not in the older group (OR = 0.7, 95% CI 0.3-1.5). Results indicated that lung cancer risk in young and older age groups shows remarkable differences with respect to sex, histologic type, and genetic predisposition.

Spreading the message: the significance of CE-marking

Considerable time and resources have been invested in developing the Medical Device Directive. This article outlines some initiatives to publicize the meaning and importance of the CE mark to clinicians, users and patients, which have been developed by the United Kingdom Medical Devices Agency and industry.

Available iron and zinc in major lean meat cuts and their contribution to the recommended trace element supply in Switzerland

The objective of the present study was to analyze iron and zinc in major lean meat cuts in order to estimate the contribution of the average lean meat consumption in Switzerland (1995) for these trace elements. Iron, heme iron and zinc contents were analyzed in following muscles: pork (longissimus dorsi muscle and shoulder), beef (longissimus dorsi muscle and shoulder), veal (longissimus dorsi muscle) and chicken (breast and thigh). Beef and pork shoulder were the best sources of iron, heme iron and zinc. Pork and veal longissimus dorsi muscle and chicken were relatively poor in these trace elements. With an average daily lean meat consumption of 105 g, iron and zinc intake were about 1.1 mg/d and 3.8 mg/d, respectively. Recommendations for daily iron intake were met to 11% (men) and 7% (women) and for zinc to 25% (men) and 32% (women). Applying a modified Monsen model, the requirements for absorbed iron were met in the range of 10-30% and 7-20% for men and women, respectively. Taking into account a zinc absorption rate from meat of about 20-36%, the daily requirements for absorbed zinc were covered to 32-56%. In conclusion, the average amount of lean meat as consumed in Switzerland was high enough to be an important source of available iron and zinc, particularly for people with low iron and zinc status.

Characterisation of the acute phase response of heifers to a prolonged low dose infusion of lipopolysaccharide

The effect of a prolonged low dose infusion of bacterial lipopolysaccharide (LPS) on acute phase-like reactions was examined in heifers. LPS (2 micrograms kg-1 dissolved in 100 ml water), or saline was infused (at 1 ml min-1) intravenously for 100 minutes and blood samples were taken at various times before, during and after the infusion. The serum concentrations of tumour necrosis factor-alpha (TNF alpha), interleukin-1 beta (IL-1 beta), interleukin-6 (IL-6) and serum amyloid A (SAA) and the rectal temperature increased in response to the LPS infusion. Serum TNF alpha increased before the increases in IL-1 beta and IL-6 and remained high from 20 minutes after the onset of the infusion until the end of the sampling period (six hours). The LPS-induced increases in serum IL-1 beta and IL-6 were biphasic. Plasma cortisol and lactate concentrations also increased, and plasma glucose and beta-hydroxybutyrate concentrations decreased in response to the LPS infusion. The similarity of these reactions to changes observed in response to bacterial infections shows that the prolonged infusion of low doses of LPS is a good model for studying the acute phase response to Gram-negative bacterial infection in heifers.

Response of renal orotic acid and creatinine to treatments affecting metabolic protein supply of ruminants

90 urine samples obtained in three lamb trials and one experiment using adult wethers were analyzed for their contents of orotic acid and creatinine. The average daily excretion of orotic acid accounted for 0.5 mg to 1.5 mg (35 micrograms to 130 micrograms/W0.75) with a high individual variation. Correlation coefficients between orotic acid and other urinary constituents were low indicating an entirely different response to metabolic variations. There was only a weak relationship to live weight, protein retention and rumen fluid traits. Defaunation reduced the orotic acid excretion (significant in the adult wethers) whereas the addition of rumen-protected lysine as well as the use of different dietary carbohydrate sources were without effect. The urinary excretion of creatinine increased with live weight and age from 0.4 g/d in the 20 kg lambs to 1.7 g/d in the adult 53 kg wethers. The correlations with live weight were close whereas the apparently negative correlation with protein retention was not real as could be evaluated by calculation of the partial correlations. There was a close correlation of creatinine with total N, urea and allantoin. Neither defaunation nor rumen-protected lysine and the kind of carbohydrate source had significant effects on creatinine. The use of orotic acid and creatinine as indicators of metabolic disorders were discussed. Easy application in practical diagnosis without quantitative urine collection might be possible by the determination of orotic acid in the milk of cows and of the creatinine/N ratio in urine.

Interactions of cobalt and iron in absorption and retention

The effects of supplementary oral cobalt and iron, as well as the interaction between both at the absorption site, fecal and urinary excretion as well as the retention of these trace elements were determined by using four diets containing either 9 or 63 micrograms/kg of Co and 48 or 446 mg/kg of Fe over a period of 19 days in a total of 24 rats. Retention was calculated by the balance technique and by the comparative slaughter technique. After one day, fecal as well as urinary excretion of both elements had already responded to the dietary treatments, with constant values being reached after approximately three days. Cobalt excretion was enhanced by supplementary cobalt; fecal excretion, too, was increased by supplementary iron; whereas urinary excretion was decreased in both cases. Additional iron significantly inhibited the absorption of cobalt in both dietary cobalt treatments. The lower rate of absorption in the groups receiving 446 mg Fe instead of 48 mg of Fe per kg diet resulted in a decreased renal excretion of cobalt. Consequently, the effect of iron on the retention of cobalt was lower than on absorption. This suggests that interactions between the two elements only take place at the site of absorption. Because of the low dietary cobalt concentration as compared to the iron contents of the diets, no effect of cobalt on iron absorption and excretion occurred. Differences in iron balance were only observed between both dietary concentrations, showing a higher absolute but a lower relative absorption as well as retention in the groups fed further Fe.(ABSTRACT TRUNCATED AT 250 WORDS)

[Age and sex dependent variation in the content of Fe, Zn, Cu and Mn in different body parts and their retention in fattening pigs]

The concentrations of Fe, Zn, Cu and Mn were determined in meat, inner organs, blood and residual carcass in a total of 24 barrows and gilts of 60 kg and 100 kg of live weight, respectively. the finisher diet contained 192 ppm Fe, 113 ppm Zn, 18 ppm Cu and 65 ppm Mn with, as calculated, a great proportion originating from the mineral supplement. During growth, the contents of Fe, Cu and Mn were significantly reduced. No sex differences occurred. In the lean meat of the 100 kg pigs, common values accounting for 1.1 mg Fe, 2.8 mg Zn and 0.05 mg Cu per 100 g were analyzed. The manganese concentration of 0.01 mg per 100 g, however, was considerably lower as the corresponding figure from nutrient tables. In the finishing period, the animals retained per animal and day about 18 mg Fe, 15 mg Zn and 0.2 mg Cu. Mn retention was not significantly different from zero. The low utilization rates calculated from these data can be partly explained by the moderately excessive supply in this fattening period. In order to reduce the trace element load of the soils, a considerably lower tolerance of excessive trace element contents in finisher diets has to be developed.

Endogenous excretion and true absorption of cobalt as affected by the oral supply of cobalt

At the end of a 49-d experiment with 32 growing male rats, a period of 8 d was used to determine endogenous excretion and true absorption as well as apparent absorption and retention of cobalt with the aid of the isotope dilution technique. For this purpose, a single im dose of 58Co was applied at d 35 of the experiment. After that, urine and feces were collected separately from d 8 to 15 after injection of the isotope. The specific cobalt activity of the liver was used as an endogenous reference source. The basal diet provided 5.9 ppb cobalt, the different treatment groups were obtained by supplementing the diet with 0, 10, 50, 250, or 1250 ppb cobalt. The different diets were offered from the beginning of the experiment. In the balance period, apparent and true absorption as well as fecal excretion behaved similar to cobalt intake, whereas urinary excretion increased more rapidly with increasing cobalt supply. Endogenous fecal excretion accounted for 3.5 ng Co/d in the groups fed the diets without and with 10 ppb cobalt. An increase was not observed until supplementing the diet with 50 ppb cobalt. This increase between 250 and 1250 ppb cobalt was higher than the corresponding increase in the dietary cobalt supply. This indicates that endogenous fecal excretion might be more important for homeostatic regulation at a higher dietary cobalt concentration. Endogenous renal excretion as calculated from the results of the isotope dilution technique showed a similar kind of response to increasing cobalt supply as endogenous fecal loss. Nevertheless, the elimination of excessive cobalt mainly took place by adjusting urinary excretion, whereas the variations in true absorption and endogenous fecal excretion had no quantitative importance. Apparent and true absorption were on average 28.0 and 29.8%, respectively, of the cobalt intake. In the case of retention, a marked decline was observed from 19% in the depletion group to 3% with 1250 ppb cobalt, again demonstrating the importance of urinary excretion for controlling the cobalt content of the organism.

Cellulose fermentation capacity of the hindgut and nitrogen turnover in the hindgut of sows as evaluated by oral and intracecal supply of purified cellulose

Adult sows fed a constant amount of a basal diet received purified cellulose either orally at levels of 0 and 475 g/animal.d (Experiment 1) or intracecally at levels of 0, 285, 570 and 855 g/animal.d (Experiment 2). Each experiment consisted of subsequent periods of faeces and urine collection with the animals re-allocated to the treatments each time. With that, a total of 36 observations on each parameter was achieved. The faecal samples were analyzed for the contents of organic matter, cell wall carbohydrates and various nitrogen fractions such as bacterial N and undigested dietary N. Furthermore, N balance, urinary allantoin excretion and plasma urea concentrations were determined. In a preliminary study, the effects of freeze-drying and of shaking of the faecal samples as suspensions with water (in order to release bacteria from fibre) on content and composition of faecal nitrogen had turned out to be reproducible. Cellulose significantly enhanced faecal nitrogen loss whereas N retention was not affected due to the counteraction of urinary N loss. Plasma urea concentration reflected the situation with urinary N. The proportion of undigested dietary N and of water-soluble protein in total faecal N was somewhat increased by cellulose at cost of the bacterial N proportion which accounted for about 72% of total N on average. Urinary allantoin did not respond to the higher bacterial activity in the hindgut in the presence of supplementary cellulose. Cellulose significantly decreased the apparent N digestibility by on average about 3 percentage units per 100 g of supplementary cellulose. True N digestibility was also reduced by cellulose but did not go below 95%. The supplementary cellulose was fermented in the hindgut at similar rates of on average about 60% regardless of the route of administration. The almost 100 g of native cellulose incorporated in the basal diets were lignified by about 20%, and that is why they were fermented at a rate of only about 30%. The rate of fermentation was only slightly decreasing with increasing amounts of supplementary cellulose, and a daily quantity of 564 g (11 g/W0.75) cellulose was fermented on average if the highest level of cellulose was provided. This was within a range exclusively reported for easily-fermentable carbohydrates but was achieved in the case of cellulose only at a consistently higher level of supply. The true efficiency of bacterial protein synthesis was 5.2 g bacterial protein/100 g supplementary cellulose on average. The apparent efficiency was 60% higher averaging 8.4 g bacterial protein/100 g further apparently fermented organic matter.

Endogenous iron excretion. A quantitative means to control iron metabolism?

The effects of supplemental oral (0, 40, and 400 ppm) and parenteral iron (0 and 2.72 mg Fe iv given initially as a single dose) on iron absorption, excretion, and retention were determined in 30 rats. Endogenous fecal iron excretion was determined by the radioisotope dilution technique after im injection of 80 kBq Fe-59, using blood and certain body tissues as reference sources for the estimation of the specific activity (Bq Fe-59/micrograms Fe) of endogenous iron. The basal diet contained 3.6 ppm Fe. Fe(III)-hydroxide-polymaltose was used as the sole iron source in oral, iv, and im iron treatments. Iron balance as determined from day 14 to 20 of the experiment was not significantly affected by iv iron administration. Nevertheless, a temporarily reduced retention should have occurred, since differences in final body iron contents were lower than 2.72 mg, as compared to the respective untreated groups. Apparent iron absorption and iron retention increased with surplus oral iron, and the efficiency rates were highest with adequate iron supply (40 ppm). True absorption rates of iron were similar without any, and with 40 ppm Fe amounting 40 to 50% of the intake. In the iron deficient rats, half of the actually absorbed iron (about 16 micrograms/d) was lost by endogenous fecal re-excretion, and another 3 micrograms/d by the urinary route. Endogenous loss with feces and with urine increased with further oral iron supply, but at a considerably lower rate as total fecal excretion. Parenterally administered iron did not affect endogenous loss at all. The results indicate that endogenous excretion cannot be regarded as a means to eliminate excessive iron, and might actually be an inevitable loss.