Vertical distribution of organochlorine pesticides in humus along Alpine altitudinal profiles in relation to ambiental parameters.

In forest soils along vertical profiles located in different parts of the Alps, concentrations of persistent organic pollutants (POPs), namely organochlorine pesticides (OCPs) like dichlorodiphenyltrichloroethanes (DDTs), hexachlorobenzene (HCB), hexachlorocyclohexanes (HCH), heptachlor, aldrin, dieldrin and mirex, were measured. Though local characteristics of the sites are influenced by numerous factors like orographic and meteorological parameters, forest stand characteristics and humus parameters, we ascertained a marked vertical increase of concentrations of some organochlorine compounds in the soil. On the basis of climatological values of each site, we found that the contamination increase with altitude can be ascribed to a certain 'cold condensation effect'. In addition, the perennial atmospheric deposition of POPs is controlled by precipitation. Other key parameters explaining the accumulation of POPs are the soil organic carbon stocks, the turnover times, the re-volatilisation and degradation processes, which vary with altitude.

Monitoring of PCDD/Fs in a mountain forest by means of active and passive sampling.

Polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/F) are sampled and investigated in a forested area in Middle-Europe. The campaigns, consisting in active and passive samplings, were conducted in the Bavarian and Bohemian Forest at four sites chosen for their similar soil and forest stand characteristics. Passive sampling was conducted using both semi-permeable membrane devices (SPMDs) and needles of well-exposed dominant spruce trees. Active air sampling was also performed at one site with a low volume air sampler. Correlations were performed to identify relationships and trends of PCDD/F. Lower chlorinated PCDD/F are accumulated in SPMDs, needles collected all compounds among homologues and their PCDD/F pattern is close to that of active sampling. Results of the analysed compounds obtained with the different sampling methods served as a basis for the establishment of advantages and disadvantages of the sampling tools applied and their possible optimisation.

Practice guideline on prophylactic cranial irradiation in small-cell lung cancer.

PURPOSE: To develop an evidence-based clinical practice guideline that would address the following questions: (a) What is the role of prophylactic cranial irradiation (PCI) in patients with limited or extensive stage small-cell lung cancer (SCLC) who have achieved complete remission in response to induction therapy (chemotherapy or chemoradiotherapy)? (b) What dose and fractionation schedules of PCI are optimal? (c) Does the use of PCI in patients with SCLC in complete remission affect quality of life? Survival, disease-free survival, quality of life, and adverse effects were the outcomes of interest. METHODS AND MATERIALS: A systematic review of the published literature was undertaken to provide the data for an evidence-based practice guideline. RESULTS: Six randomized controlled trials and one fully published individual patient data meta-analysis were included in the systematic review of the evidence. For patients who have achieved complete response after induction therapy, there is evidence of a disease-free survival benefit (4 of 6 trials) and an overall survival benefit (meta-analysis). There is insufficient evidence to make a definitive recommendation with respect to dose. There is some indication that 30-36 Gy in 2-3 Gy per fraction, or a biologically equivalent dose, may produce a better outcome than a lower dose or less aggressive fractionation regimen. The schedule commonly used in Canada is 25 Gy in 10 fractions over 2 weeks. Data from further research, including a trial currently ongoing that compares 25 Gy in 10 fractions with 36 Gy in 18 fractions, will be required to determine optimal dose of PCI. There is insufficient evidence to make recommendations concerning the optimal timing of PCI in relation to the administration of chemotherapy. Lung DSG members generally felt that it should be given as soon as possible after completion of chemotherapy. There is evidence from trials with data for up to 2 years of follow-up that prophylactic cranial irradiation does not produce significant late neurotoxicity. There is evidence from one trial that prophylactic cranial irradiation does not have a detrimental effect on quality of life in the first 12 months following the completion of therapy. There is insufficient evidence to comment on the long-term effects of prophylactic cranial irradiation on quality of life. CONCLUSION: For adult patients with limited or extensive SCLC who achieve a complete remission with induction therapy, PCI is recommended.

Chromatographic properties of the ion-exclusion column IonPac ICE-AS6 and its application in environmental analysis, Part II: application in environmental analysis

Biological processes, geochemical reactions, anthropogenic emissions, and transformation reactions of xenobiotics are responsible for the widespread occurrence of aliphatic carboxylic acids in the environment. To study the performance of the ion-exclusion chromatography column IonPac ICE-AS6 in the analysis of environmental and environmental-technical samples, organic acids are investigated in composting seepage, silage effluents, aqueous extracts of sewage sludge, molasses hydrolysate, and alkaline cellulose hydrolysates. With respect to the diverse sample matrix and composition, different chromatographic conditions are applied. It is possible to determine various volatile fatty acids, dicarboxylic acids, (poly)hydroxy acids, and keto acids as main and trace components in samples with very high and low dissolved organic carbon content. Low baseline noise allows the determination of malic and succinic acid in the concentration range of approximately 1 microM/L in the presence of higher concentrations of fully ionized compounds. The applicability of the column in environmental analysis may be limited by the poor retardation of strong organic acids, insufficient separation of some relevant substance combinations (i.e., citric and isocitric acid), and very strong hydrophobic interactions with straight-chain monocarboxylic acids containing four or more carbon atoms.

The creation of a database for cancer screening: is the consent of clients required?

Professional caregivers have an obligation to maintain the privacy and confidentiality of all personal information given to them by their patients or clients. Such information is to be released to a party who is not participating in the care of the patient only with the express consent of the patient. The question is whether or not the express consent of a client of an organized cancer screening program is ethically required before the client's personal information is entered into a centralized database. The arguments in favour of express consent are grounded largely in a desire to respect clients' privacy and autonomy fully. The arguments for the reliance on nonexpress, implied or tacit consent are based chiefly on the desire to provide clients with the full benefits of screening. It is suggested here that neither extreme position is satisfactory. A novel, balanced approach that would be sensitive to both electronic data storage and a preventive care situation is needed. Progress on this issue requires focused empirical research, a debate in both professional and public forums, and further critical analysis.

Chromatographic properties of the ion-exclusion column IonPac ICE-AS6 and application in environmental analysis. Part I: Chromatographic properties.

The chromatographic performance of the Dionex IonPac ICE-AS6 ion exclusion column is investigated. Therefore, capacity factors, efficiency, peak symmetry, resolution, and selectivity are determined for various mono- and polyfunctional aliphatic carboxylic acids under selected chromatographic conditions. Except for the stronger acids (pKa1 < 3.75), the highest chromatographic efficiency is achieved at a column temperature of 40 or 50 degrees C, and peak shape is found to be optimal at approximately 60 degrees C. The separation of the stronger acids is favored by an eluent pH below 3.0 and column temperatures below 40 degrees C. The maximal effective plate numbers range between 126 (tartronic acid) and 6380 (4-oxovaleric acid). Hydroxy-substituted acids are less retained and less influenced by temperature changes than the unsubstituted compounds. It is estimated that size exclusion effects take part in the separation of aldonic acids. The addition of 1% isopropanol to the acidic eluent increases the chromatographic efficiency generally, whereas higher concentrations reduce the retention of several acids drastically.

Variations in the management and outcome of non-small cell lung cancer in Ontario.

Prospectively gathered information in the Ontario Cancer Foundation's computerized clinical database was analysed to provide a description of the management of 12,399 patients with unresected non-small cell lung cancer (NSCLC) registered at seven regional cancer centres in Ontario between 1982 and 1991. Overall, 44% received initial thoracic radiotherapy, 19% received initial radiotherapy to metastatic sites, and 36% received no immediate radiotherapy. Of those who received thoracic radiation 41% received doses > or = 40 Gy and 59% received doses < 40 Gy. Among the seven centres, the proportion of patients receiving initial thoracic radiotherapy ranged from 41% to 56% (p < 0.001), and the proportion of those receiving doses > or = 40 Gy ranged from 30% to 68% (p < 0.001). Between 1982 and 1991, the overall proportion of patients who received initial thoracic radiotherapy decreased from 48% to 38%, the proportion of those receiving high dose treatment decreased from 55% to 28%, and the mean number of fractions given to the chest decreased from 17 to 10. Only 10% received chemotherapy at any time, and that proportion ranged from 3% to 21% (p < 0.001) among the seven centres. Between 1982 and 1991 the proportion of patients receiving chemotherapy decreased significantly from 15% to 8% (p < 0.001) across the Cancer Foundation as a whole. These wide variations in management policies were not associated with any significant differences in survival, which was similar at all seven centres, and remained constant between 1982 and 1991.