Téléphone mobile, risque de tumeurs cérébrales et du nerf vestibuloacoustique: l'étude cas-témoins INTERPHONE en France

BACKGROUND

Use of cell phones has increased dramatically since 1992 when they were first introduced in France. Certain electromagnetic fields (at extremely low frequency) have been recognized as possibly carcinogenic by the International Agency for Research on Cancer. Given the use of radiofrequency technology in cell phones, the rapid increase in the number of cell phones has generated concerns about the existence of a potential health hazard. To evaluate the relationship between the use of cell phones and the development of tumors of the head, a multicentric international study (INTERPHONE), coordinated by the International Agency for Research on Cancer, was carried out in 13 countries. This publication reports the results of the French part of the INTERPHONE study.

METHODS

INTERPHONE is a case-control study focused on tumors of the brain and central nervous system: gliomas, meningiomas and neuromas of cranial nerves. Eligible cases were men and women, residents of Paris or Lyon, aged 30-59, newly diagnosed with a first primary tumor between February 2001 and August 2003. The diagnoses were all either histologically confirmed or based upon unequivocal radiological images. Controls were matched for gender, age (+/-5 years) and place of residence. They were randomly drawn from electoral rolls. Detailed information was collected for all subjects during a computer-assisted face-to-face interview. Conditional logistic regression was used to estimate the odds ratio (OR) for an association between the use of cell phones and risk of each type of cancer.

RESULTS

Regular cell phone use was not associated with an increased risk of neuroma (OR=0,92; 95% confidence interval=[0.53-1.59]), meningioma (OR=0,74; 95% confidence interval=[0.43-1.28]) or glioma (OR=1.15; 95% confidence interval=[0.65-2.05]). Although these results are not statistically significant, a general tendency was observed for an increased risk of glioma among the heaviest users: long-term users, heavy users, users with the largest numbers of telephones.

CONCLUSION

No significant increased risk for glioma, meningioma or neuroma was observed among cell phone users participating in Interphone. The statistical power of the study is limited, however. Our results, suggesting the possibility of an increased risk among the heaviest users, therefore need to be verified in the international INTERPHONE analyses.

The place of computed tomography as a guidance modality in percutaneous nephrostomy: analysis of a 10-year single-center experience

BACKGROUND

Percutaneous nephrostomy (PCN) has been established as an effective technique for urinary decompression or diversion. This procedure may be performed with the guidance of fluoroscopy, ultrasonography, a combination of fluoroscopy and ultrasonography, computed tomography (CT), or magnetic resonance imaging.

PURPOSE

To retrospectively review experience with CT-guided PCN over a 10-year period in a single center.

MATERIAL AND METHODS

All CT-guided PCN procedures performed in adults at our institution between 1995 and 2005 were evaluated. In 882 patients, 1113 nephrostomy catheters were inserted. Interventional radiologists or radiology residents under direct attending supervision inserted all catheters. During the PCN procedure, bleeding, sepsis, and injuries to adjacent organs were regarded as major complications. Clinical events requiring nominal therapy with no sequelae were regarded as minor complications.

RESULTS

PCN procedures were performed via 1-3 punctures in patients with grades 0-1 and 2 hydronephrosis, and via 1-2 punctures in patients with grade 3 hydronephrosis. They were carried out with a procedure time ranging from 9 to 26 min. All PCNs were considered as technically successful, and no major complications were observed. There were minor complications including transient macroscopic hematuria (28.6%, 19.9%, and 4.9% in patients with hydronephrosis grades 0-1, 2, and 3, respectively) and perirenal hematomas in a total of eight patients. No patient required additional intervention secondary to complications of the PCN procedure.

CONCLUSION

CT-guided PCN is an efficient and safe procedure with major and minor complication rates below the accepted thresholds. It can be used for the management of patients requiring nephrostomy insertion in inpatient settings, and might be a preferable procedure in patients with minimal or no dilatation of the renal pelvis.

Modulating interaction of glutathione-S-transferase polymorphisms with smoking in endometriosis

OBJECTIVE

To evaluate the interaction of glutathione-S-transferase (GST) gene polymorphisms and smoking as a risk factor for endometriosis.

STUDY DESIGN

The study group consisted of 150 women who were diagnosed by means of surgery and histopathology as having endometriosis. The control group consisted of 150 women who displayed no evidence of endometriosis during exploratory laparotomy or laparoscopy. We assessed the interaction of smoking and GSTM1 and GSTT1 polymorphisms in these patients.

RESULTS

Logistic regression analyses showed that the GSTM1-null allele was associated with a significantly increased risk of endometriosis and smoking with a decreased risk of endometriosis separately. There was no association between endometriosis and the GSTT1-null allele. The interaction of smoking and GST polymorphisms showed a joint effect. We found that the GSTM1-null allele was more prevalent in active smoking endometriosis patients (63.4%) than in the controls (35.0%), and the difference was statistically significant. A similar tendency was also observed in the GSTT1 allele distribution.

CONCLUSION

Genetic factors could modify the response to environmental pollutants in endometriosis.

The Association of Neurofibromatosis, Bilateral Pheochromocytoma and Primary Hyperparathyroidism

Neurofibromatosis (NF) is a hereditary disease and carries increased risk of both benign and malignant tumor development. Pheochromocytoma or hyperparathyroidism have been reported to be associated with NF type 1 (NF1). However, the coexistance of pheochromocytoma and parathyroid adenoma in a patient with NF1 is very rare. We report a case of a 37-year-old male with NF1, bilateral pheochromocytoma and parathyroid adenoma. This association sould be kept in mind in patients with NF1 in initial evaluation as well as during follow-up.

Determination of reference arterial blood pressure values by indirect methods for Kangal dogs

OBJECTIVES

To obtain reference arterial blood pressure values from Kangal dogs, a local giant breed found in Turkey.

METHODS

Arterial blood pressure measurements were obtained from 48 healthy Kangal dogs using oscillometric and Doppler techniques. The ages of the dogs ranged from two to 96 months, with a mean (sd) age of 36 (16) months.

RESULTS

The effect of age on systolic, diastolic and mean arterial pressures determined by the oscillometric technique and on systolic pressure determined by the Doppler technique was significant (P<0.001). Blood pressure was found to be higher in mature dogs compared with that in immature dogs. The effect of sex and the interaction between age and sex were not significant (P>0.05). There was a direct relationship between age and oscillometric systolic, diastolic and mean arterial pressures and Doppler systolic arterial blood pressure both in the whole group and the immature group (P<0.05). Correlation between age and systolic arterial blood pressure measured either by oscillometric or Doppler techniques was not significant in the mature group.

CLINICAL SIGNIFICANCE

The Kangal dog is bred in various countries including Turkey. It is known that giant breed dogs, such as the Kangal dog, are predisposed to cardiovascular disease. Canine arterial blood pressure values are highly breed and age dependent, so a reference value for any other breed is inappropriate for Kangal dogs. Therefore, it is important to measure arterial blood pressure of Kangal dogs.

Primary aortoduodenal fistula due to a swallowed sewing needle: a rare cause of gastrointestinal bleeding

A primary fistula between the abdominal aorta and the duodenum is rare and usually fatal. Atherosclerosis remains the most common etiologic factor, accounting for more than two-thirds of the cases reported. Other etiologies include carcinoma, ulcers, radiation, aortitis and foreign bodies including sewing needle, cocktail stick, open safety pin and fishbone. We report a case of a 17 year-old girl who underwent surgical treatment because of severe upper gastrointestinal bleeding which was related to an aortoduodenal fistula caused by a swallowed sewing needle. At operation, a chronic aortoduodenal fistula that contained the sewing needle was found and repaired. This is the fourth case in the literature in which a needle was found to be associated with the development of an aortoenteric fistula.

Myointimoma of the glans penis

Myointimoma is a recently described benign tumor, which is regarded as a rare type of mesenchymal tumor of the penis. The present patient was a 50-year-old man who had a nodule located in the glans penis. He had a 2 month history of a mass. An excisional biopsy was performed. The histological findings revealed a multinodular tumor that was characterized by spindle-shaped cells located in the intravascular area. This case, in addition to 11 cases reported in the literature, demonstrates that the myointimoma is frequently misdiagnosed on clinical and pathological grounds because of its rarity. Histological and immunohistochemical features are summarized on the basis of the present case and previously published reports.

Cumulative exposure to high estradiol levels during the follicular phase of IVF cycles negatively affects implantation

PURPOSE

To investigate the effect of the cumulative exposure to estradiol (E(2)) during the follicular phase on IVF outcome.

METHODS

Patients were stimulated with recombinant FSH after GnRH agonist suppression and had a day 3-embryo transfer. Estrogen exposure was determined as the area under the curve (AUC) for serum E(2) levels measured from the first day of stimulation through the day after hCG administration.

RESULTS

E(2) AUC thresholds for 10th and 90th percentiles were 4704 pg/ml and 16338 pg/ml, respectively. The pregnancy and implantation rates were highest in the 10th-90th percentile group, and were statistically higher in this group than in the >90th percentile group (54.6% vs. 33.3% and 24.8% and 12.9%, respectively, for pregnancy and implantation rates, P < 0.05). Recovered mature oocytes, fertilization, and number and mean score of transferred embryos were similar.

CONCLUSIONS

High cumulative E(2) exposure during the follicular phase of IVF cycles has detrimental effects on implantation.

Evaluation of Achilles tendon thickening in type 2 diabetes mellitus

AIM

To investigate the effect of diabetes mellitus on the Achilles tendon, which may contribute to the long-term complications in the foot-ankle complex and to investigate the factors relating to its thickening.

METHODS

The study group included 55 patients (26 female and 29 male) with type 2 DM, while the control group included 34 non-diabetic people (13 female and 21 male). We matched the female and male DM patients with their respective control groups in terms of age, BMI, height and body weight. Clinical and biochemical tests, as well as ultrasonographic evaluations of the internal carotid artery and the Achilles tendon, were carried out to evaluate the complications of diabetes mellitus, and to compare the Achilles tendon thickness (ATT) between the study and the control groups.

RESULTS

In the female groups the Achilles tendon was significantly thicker in the diabetic patients than in their healthy controls (p<0.001). However, no difference was found in the ATT between the male diabetic patients and their male controls (p=0.74). The ATT correlated with the body mass index (BMI) (r=0.47, p=0.015) and body weight in diabetic female group (r=0.56, p=0.003). We also observed that the ATT values were higher in male DM patients with retinopathy (p=0.034) or neuropathy (p=0.019) compared to the male DM patients without these complications.

CONCLUSIONS

The ATT in type 2 female diabetic patients was found to be higher than their non-diabetic controls, but no significant difference could be found between type 2 diabetic male patients and their non-diabetic controls by US. Our results might indicate a possible impact of diabetes on the ATT depending upon gender, but other mechanisms may also contribute to thickening of Achilles tendon.

Response to neoadjuvant chemotherapy in breast cancer could be predictable by measuring a novel serum apoptosis product, caspase-cleaved cytokeratin 18: a prospective pilot study

The M30-monoclonal antibody recognizes a neo-epitope of cytokeratin 18 which is formed after caspase-cleavage during apoptosis. Caspase-cleaved cytokeratin 18 is released from apoptotic cells into circulation. The aim of this study was to evaluate the relationship between M30-antigen level and chemotherapy response in neoadjuvant treatment of breast cancer. Forty-two patients with invasive breast carcinoma received 4 cycles of anthracycline based neoadjuvant chemotherapy. Serum samples were obtained for assessment of M30-antigen levels before the administration of first chemotherapy cycle (baseline), and then after 24 and 48 hours for determination of chemotherapy induced apoptosis. M30-antigen levels at 24 and 48 hours were found to be significantly higher than baseline (p < 0.001, p = 0.003, respectively). M30-antigen levels in responders showed statistically significant increases at 24 and 48 hours (p < 0.001; p = 0.004, respectively), while statistically significant increases were not observed in nonresponders. Percentage change of M30-antigen levels was significantly higher in responders than nonresponders at 24 hours (p = 0.020). In conclusion, our study revealed a significant relationship between increases of M30-antigen levels in serum and overall response to therapy.

Age and growth properties of brown trout (Salmo trutta L.) living in Kan Stream, upper Çoruh River, Turkey

Abstract

Age and growth were analyzed for brown trout from the Stream Kan, upper Çoruh River, from January 2001 to December 2001. Age varied between 0-7 years and the ratio of male to female was 1:1.05. Fork length and total weight for brown trout varied by 6.9-22.1 cm and 4.9-158.5 g for males, by 6.8-26.1 cm and 4.3-211.9 g for females, respectively. Fork length and total weight at the same age classes were not statistically significant between males and females. The highest specific growth rate occurred between age 1 and age 2 for both sexes. The von Bertalanffy equations were used to determine growth in length for both sexes and overall population separately. The growth parameters for males, females and overall population were estimated as L∞ = 32.5 cm, K = 0.169, t0 = −0.978, L∞ = 36.7 cm, K = 0.139, t0 = −1.065 and L∞ = 35.9 cm, K = 0.147, t0 = −1.002, respectively. Overall growth performance (ø) suggested that difference between the growth of brown trout from Kan stream and those from some other populations was found not statistically significant.