DNA-index and stereological estimation of nuclear volume in primary and metastatic malignant melanomas: a comparative study with analysis of heterogeneity.

The aim of this study was to investigate the relationship between physical nuclear volume and ploidy level in malignant melanomas, and to analyse the heterogeneity of these two parameters among primary and corresponding secondary tumours. Unbiased stereological estimates of nuclear volume can be obtained objectively by point-sampled intercepts. Using this approach, the volume-weighted mean nuclear volume, nuclear vv, was estimated in ordinary histological sections from 34 primary cutaneous malignant melanomas and their corresponding 62 metastatic lesions. For comparison, DNA-indices (DI) were determined by flow cytometry in adjacent sections from the same paraffin-embedded tumours. Only a poor correlation was found between nuclear vv and DI (Kendall's tau = +0.21). The variability of nuclear vv among metastatic lesions was increased as compared to primary melanomas, whereas averaged mean values of nuclear vv did not differ significantly between the two types of neoplasms. Aneuploidy was not significantly associated with increased nuclear vv. Pronounced intra-patient heterogeneity of nuclear vv was disclosed among metastases and between the primary melanoma and the metastatic lesions. Likewise, no significant association between DI of primary and metastatic melanomas was demonstrated. Heterogeneity of nuclear vv and DI in malignant melanomas is in agreement with the theory of polyclonality.

DNA level, tumor thickness, and stereological estimates of nuclear volume in stage I cutaneous malignant melanomas. A comparative study with analysis of prognostic impact.

The mutual relation and prognostic value of three quantitative variables were investigated in a retrospective series of 56 stage I cutaneous malignant melanomas. Unbiased stereological estimates of nuclear volume, nuclear nu v were obtained along with measurements of melanoma thickness. The DNA index (DI) was determined by flow cytometry in adjacent sections from the same paraffin-embedded specimens. The correlation between tumor thickness and nuclear nu v was only moderate (r = .60). Euploid lesions had a smaller nuclear nu v than aneuploid tumors (2p = .01), but with considerable overlap. No significant association between tumor thickness and DI could be demonstrated. Single-factor analysis showed prognostic value of nuclear nu v and tumor thickness (2p = .0007 and 2p = .03, respectively), whereas DI was without prognostic impact (2p = .54). When analyzing the three parameters in a Cox model, nuclear nu v was the only independent, prognostically significant variable. Physical, three-dimensional nuclear volume is not solely a reflection of nuclear DNA content, and may represent a valuable, quantitative prognostic indicator in cutaneous malignant melanomas.

Instability of trochanteric hip fractures following internal fixation. A radiographic comparison of the Richards sliding screw-plate and the McLaughlin nail-plate.

A comparison was made of the McLaughlin nail plate and the Richards sliding screw-plate techniques for fixation of trochanteric hip fractures. The series included 96 patients in each group. The fractures were followed radiographically for 3 months. Technical failures were encountered in 31 per cent of the McLaughlin fractures and in 8 per cent of the Richards fractures; reoperation was performed in 9 per cent in McLaughlin vs none in the Richards fractures. The main failure was varus displacement in both groups, always combined with lateral cutting of the screw in the Richards fractures, and often combined with failure of the nail-plate junction in McLaughlin fractures. Our study has shown that the sliding screw-plate is superior to the nail plate in both stable and unstable fractures.

Early rehabilitation following osteosynthesis with the sliding hip screw for trochanteric fractures.

A prospective study of 104 patients with throchanteric hip fractures was undertaken with particular regard to postoperative complications and rehabilitation at the follow-up 3 months later. The mortality was 20%, depended more on the social function prior to the fracture than on the patient's age. Osteosynthesis was performed with the Richards sliding screw-plate system. The most frequent clinical complications were of a cardiovascular and pulmonary nature. Technical failure was encountered in 10%. Hip function was excellent or good in 69%. In 40% the ability to walk remained unchanged after the operation. Seventy-five per cent of the patients returned to their own homes, although 51% were more dependent on the social welfare system than before the fracture. The social function prior to the fracture determined the social function after the fracture to a greater extent than did the patient's age.

Interpersonal violence: patterns in a Danish community.

We studied all cases of assault with violence (1,639) in a Danish population of 275,000 over a one-year period. Most victims were young men. The incidence rose during evenings, nights and weekends, and assaults were often seen in or around bars and restaurants. Women accounted for 64 per cent of all victims of assault in the home. Influence of alcohol was identified in 43 per cent of all cases. The fist was the most frequent agent of assault; use of firearms was a very rare act of violence but was associated with death in three out of five cases. There were 10 deaths in all.

Alcohol involvement in violence. A study from a Danish community.

All cases of assaults with violence (n = 1639) from a well defined area were registered for 1 year. A positive alcolmeter test (% greater than 0.2) was registered in 488 cases (29%). A further 216 patients (13%) were found under the influence of alcohol according to a simple clinical judgement. In nine of ten manslaughter and murder cases alcohol was involved. Young men, 19-29 years of age, comprised the majority of victims. Of the episodes of violence 66% took place during the weekend. In 250 cases the alcohol concentration surpassed 1.5%. Almost 50% of the violence episoded took place in or around restaurants. Blunt violence was concerned in 73% of the episodes. Gunshot was registered in five cases, stabbings in two cases.