[Breast complaints during the Dutch nationwide breast cancer screening program: increased risk of referral and of breast cancer]. / Borstklachten ten tijde van bevolkingsonderzoek naar borstkanker: grotere kans op verwijzing en op borstkanker.

OBJECTIVE: To determine the prevalence of breast complaints reported on a questionnaire among participants in the first round of the national breast cancer screening programme in the Netherlands, and to assess the relationship between these complaints and referral and diagnosis of breast cancer. DESIGN: Retrospective controlled study. METHOD: Women in the South screening region of the Dutch nation-wide breast cancer screening programme (Stichting Bevolkingsonderzoek Borstkander Zuid (BoBZ)) received a medical questionnaire together with the invitation for participation in the screening programme. This questionnaire was only reviewed by the radiologist if there were doubts concerning referral. The study assessed whether participants with these complaints had higher risks of referral and screen-detected breast cancer than those without these complaints. In this study two random and independent samples were drawn from the screening files: 1116 women who attended the first screening round and 1113 women who were referred for medical checkup in the same screening round. RESULTS: The prevalence of breast complaints reported in the first screening round was 5.1% (95% CI = 3.9-6.6). More than half of the complaints included pain not related to menses; nipple secretion; changes in skin (retraction or discolouration) or tumours. The referral risk for women with these complaints was more than twice that for women without complaints (adjusted odds ratio (OR) = 2.3; 95% CI = 1.4-3.8) and their risk of screen-detected breast cancer was more than three times as high (adjusted OR = 3.3; 95% CI = 1.4-3.8). Up to 5.8% of the screen-detected breast cancers could be attributed to the breast complaints. CONCLUSION: Breast complaints at the time of breast cancer screening increased the risk of breast cancer being detected, but it is not clear as yet whether the screening will benefit from the explicit incorporation of questions regarding complaints.

Picosecond intracavity optical parametric oscillator.

We present a novel technique to generate picosecond pulses at 1.57 microm with kilohertz repetition rates, using an intracavity optical parametric oscillator. With this device we were able to generate up to 120-mW average power at a repetition rate of 2.5 kHz.

Efficient continuous-wave TEM(00) operation of a transversely diode-pumped Nd:YAG laser.

A new, highly efficient, scalable technique for cw high-power diode-array side pumping of gain media has been eveloped. The use of simple all-reflective optics permits diode emission collection efficiencies of >95%. We have achieved a cw TEM(00) mode output (M(2) < 1.1) of 13.1 W at 1.06 microm from a Nd:YAG rod pumped with 60 W of laser-diode output (808 nm), representing 22% conversion efficiency (29% conversion of absorbed pump power). Numerical simulations and experimental results indicate that good thermal management results in thermally induced aberrations of

Thermal lens correction of a diode-pumped Nd:YAG laser of high TEM(00) power by an adjustable-curvature mirror.

Highly efficient TEM(00)-mode laser power of 11.5 W was obtained by the diode-array side pumping of a Nd:YAG rod. We maintained efficient laser operation at all pump powers by correcting for the changing thermal lens with an adjustable-curvature mirror.

Recurrent hyperparathyroidism after total parathyroidectomy and autotransplantation in patients with long-term hemodialysis.

From 1986 to 1990, we performed total parathyroidectomy with simultaneous autotransplantation (TPX with AT) of parathyroid tissue into the forearm in 13 patients on chronic maintenance hemodialysis with severe secondary hyperparathyroidism. The indications for surgery included persistent hypercalcemia, hyperphosphatemia, roentgenological signs of renal osteopathy, soft tissue calcifications and severe pruritus. The parathyroidectomy was performed by an experienced surgeon who removed all four parathyroid glands and transplanted 10 mm3 of parathyroid tissue into the brachioradialis muscle. After an average postoperative period of 33.5 months, 10 of 13 patients developed recurrent clinical and biochemical hyperparathyroidism requiring reoperation. Seven of these patients underwent removal of the autograft. In 5 patients, however, the success was minimal. Four of these patients had a second autograft resection, but only transient improvement resulted. Our recurrence rate after TPX with AT is very high. The histological aspect of the resected autograft is similar to tumor-like growth and this may account for the results. A therapeutic alternative to TPX with AT appears to be necessary.

Studies on health effects of automotive exhaust emissions. How dangerous are diesel emissions?

The following paper indicates that current results of research conducted on the effects of intentionally increased concentrations of diesel engine exhaust emissions, particularly the results of animal experiments, do not lead scientifically to final conclusions. According to the current level of knowledge, we must continue to assume that the risk of cancer, possibly due to diesel particles, is negligible, particularly under real environmental conditions. The preventive measures taken by governments are of course supported by the automotive industry, an additional research outlay, however, is necessary not only to clear up contradictions and answer new questions arising from current test results, but also to take positive, and not merely precautionary, action in the future. Due to its links to other influences on humans and plants, research conducted on the effects of motor vehicle emissions is a task that lies very much in the public interest. At the same time, the overview of concluded and ongoing research objectives presented in this paper indicates that the automotive industry is greatly committed to this issue and will meet well-justified expectations.

Comparison of adrenaline-induced hyper- and hypoglycaemia by histological and biochemical investigation.

Chronic treatment of rats by subcutaneously implanted A-depot capsules lead through a ca. 12 h hyperglycaemia to hypoglycaemia at 18 h p.o. SDH and G-6-Phase activities in the liver were compared during hyper- and hypoglycaemia using both histochemical and biochemical methods. The results show high triglyceride-contents, lack of glycogen and high G-6-Pase activities in the livers of animals during both hyper- and hypoglycaemia. Striking differences were found concerning SDH-activities: While biochemical measurements show enhanced activities during hyperglycaemia, hypoglycaemic values remain in the "normal" range. Nevertheless histochemical investigations show an amazing re-distribution of SDH-activities from the periportal areas towards the lobule centre. Therefore we think, that biochemical and histochemical methods should be combined to unveil such pseudonormalities. Further, this re-distribution shows the ability of the liver to cope with damage by shifting important processes away from fat-infiltrated areas.

[Serological and histological investigations as well as studies on changed food uptake during adrenaline application by intraperitoneal depot capsule]. / Serologische und histologische Untersuchungen sowie Studien über eine Anderung des Fressverhaltens während Adrenalin-Applikation durch eine intraperitoneale Vorratskapsel.

The authors have developed a method for long-term permanent application of water soluble substances by a intraperitoneal depot capsule [KLINGENBERG et al., Exp. Path. 13, 302-311 (1977)]. The present study deals with the effects on the liver and several metabolic processes induced by continuous long-term adrenaline application by means of such a depot capsule.

Salivary gland enlargement as a test for a new way of permanent isoproterenol application.

Low doses of isoproterenol, given permanently by a new application-method, show the same effects on salivary-gland enlargement of rats throughout approx. 6 days than 10fold higher concentrations given by previous workers as single daily injections.

[Adrenaline application by intraperitoneal depot capsule -- effects in the heart (author's transl)]. / Adrenalinapplikation durch eine intraperitoneale Depotkapsel -- Wirkungen auf das Herz.

An intraperitoneal depot capsule was developed to improve the hitherto used in vivo test methods for chronic action of water soluble substances (repeated injections or permanent infusion which immobilizes the experimental animals). The capsule allows free movement of the animal and guarantees long-term continuous output of the substance. The effectiveness of the capsule was examined using adrenaline as test substance. In these experiments the maximum period of effectiveness and the consequences of permanent occupation of the receptors due to continued supply of adrenaline were studied.

[Microscopical investigations on the 'vessel sealing' effect of calcium ions (author's transl)]. / Mikroskopische Untersuchungen zur "gefässabdichtenden" Wirkung der Kalziumionen

The effect of locally applied calcium on the vascular permeability is studied under the conditions of an acute inflammatory reaction. Using the Sephadex-inflammation, local elevated calcium concentration neither inhibited oedema formation, nor were reduction of inflammatory signs at all observed on the microscopical level.

[The influence of electrostatic fields on osmolality and concentrations of neutral fat and cholesterol (author's transl)]. / Der Einfluss elektrostatischer Felder auf Osmolalität, Neutralfett- und Cholesterinkonzentration

Rats were exposed to electrostatic fields of different intensities and exposure times, after which the osmolality of the serum and the concentration of neutral fat and cholesterol in the serum were measured. The triglyceride and cholesterol concentrations of the sera were independent of the strength of the electrostatic field and independent of the length of exposure of the animals in the constant field or Faraday cages. They always lay within normal limits, but moved according to the conditions of the constant field: the neurtal fat concentrations to the upper, and the cholesterol concentrations to the lower limit. The differences compared to the controls could be confirmed statistically.

[Metabolism of rat liver in the electrostatic field and in the faraday cage before and after hepatectomy (author's transl)]. / Stoffwechselaktivitäten der Rattenleber im elektrostatischen Feld und im Faraday-Käfig vor und nach Hepatektomie

Investigations were performed with the aim of establishing the influence of various environmental conditions (such as steady field conditions, climatized laboratories, Faraday's cage) on a number of enzymic activities in the rat (including glutamic oxaloacetic tic transaminase, glutamic pyruvic transaminase, lactic dehydrogenase, gamma-glutamyl transpeptidase, acid phosphatase), as well as the serum concentrations of triglycerides, the oxygen consumption of hepatic parenchyma cells, and the influence on the incorporation of 3H-thymidine (following partial hepatectomy). In the steady field, the activities of the cytoplasmic enzymes (GOT, GPT, LDH) were higher then under Faraday conditions. The same applies both to the hepatic oxygen consumption and to the neutral fat serum levels. The control values always remained within the range of the results obtained under steady field or Faraday conditions. In the structure-linked enzymes (gamma-glutamyl transpeptidase, acid phosphatase) the results were not uniform. Following partial hepatectomy, and under steady field conditions, the serum triglyceride concentrations showed a less pronounced drop than they did in the controls. Under selected environmental conditions, the results obtained lie within the physiological range. The present findings, therefore, do not permit definite conclusions to be drawn on favourable or unfavourable effects exerted by the different types of electroclimates.

[Sephadex induced inflammation in rats (author's transl)].

QUESTION: A single s.c. injection of Dextran is very suitable in producing an inflammatory response in the rat. The Dextran edema has become a standard method. It seems not uhlikely that Sephadex, the Dextran gel widely used in the gelchromatography may have a similar effect. Sephadex, because of its physiochemical properties, would offer some advantages in the studies of inflammatory reactions. But first of all the following questions have to be answered: 1. Does one single s.c. injection of Sephadex produce an inflammation at all and what are the characteristics on the microscopical level? 2 Does it make any difference if Sephadex of different types are injected? MATERIAL AND METHODS: Male and female Wistar rats (100-250 g) in groups of 5 animals each. Diet: Rat pellets "Tagger" and tap water ad libitum. Sephadex (Pharmacia Fine Chemicals) of the types G-25 m, G-50 m, G-100, and G-200 were soaked in 0.9% saline for the prescribed time and afterwards preserved until the Sephadex gel had settled on the bottom of the vessels. 1 ml of this Sephadex gel slurry each were subcutaneously injected to the shaved dorsal skin of the rats (right below). At different intervals (3, 6, 24 and 72 hours: 6, 14, 20 and 28 days) the Sephadex depot and the surrounding tissue were exstirpated and examined histologically. During all the procedures the animals were subjected to ether anesthesia. From the tissue samples frozen sections (Kryocut, -30 degrees C) were prepared and stained with hematoxylin and eosin or after van Gieson. Moreover, several preparations were stained after Pappenheim and Weigert (fibrin) or with PAS and toluidine blue. For recording of probable differences in the effect of the particular Sephadex types always 2 values were determined histometrically. The number of exudate cells emigrated between the Sephadex beads within the area of an ocular-net (edge length 1.66 mm) were counted at 500-fold magnification. Furthermore, the number of eosinophils was determined by the technique. However, because of poor occurrence the eosinophils were counted in 10 fields of view. Tests with Sephadex G-10 were omitted as preliminary tests had shown that it is not suitable for s.c. injections because of its gritty consistency (due to poor soaking properties). RESULTS: One single s.c. injection of Sephadex in the rat induces an acute inflammation. The exudative phase marked by a massive leucocytic infiltration (especially PMN leucocytes) is followed by the appearance of mononuclear leucocytes and fibroblasts after the 2nd day. The inflammation declines within approximately 3 weeks. Thereafter the Sephadex depot is encapsulated by a fibrous tissue. A chronic inflammation was never observed. In the microscopical aspect of the inflammation produced by the different types of Sephadex were detectable. The Sephadex lying in the tissue does not change its original shape, it is insoluble and is not disintegrated. The size of the particles prevents the transport into the blood or lymph vessels...

[Histological studies on the antiphlogistic effects caused by natural antiinflammatory factors (author's transl)]. / Histologische Untersuchungen der Wirkung natürlicher enzündungshemmender Stoffe

QUESTION: The dextran gel Sephadex causes a marked inflammatory response in rats when injected subcutaneously. This effect was used as a model of experimental inflammation. Sephadex and the resulting inflammatory exudate were gained and used again to study their antiphlogistic effects in the identical model. Histological reactions of the Sephadex induced acute inflammation were analyzed with and without presence of the exudate. MATERIAL AND METHODS: Male and female Wistar rats (100-250 g). Sephadex G-200 (Pharmacia Fine Chemicals). Sephadex B-200 (1 ml, swollen in 0.9% NaCl) was injected subcutaneously in the control group (C), whereas the experimental groups were injected with either untreated Sephadex taken from 1,3 and 5 days old inflammatory deposits (group A) or with Sephadex, extracted from those deposits but subsequently washed free by 0.9% NaCl (group B). Only the inner and not yet organized part of the Sephadex deposit was used in both experimental groups. In group A, B and C the histological effects were examined 24h after injection. The number of eosinophils amongst the exudate cells was counted. 100 mast cells of the perifocal region were examined in order to measure the percentage of degranulated cells. A smear differential count was performed using subepidermic parts of the Sephadex deposit. RESULTS: Sephadex injection caused a very marked inflammatory reaction which was studied extensively. Similar results were obtained either using fresh Sephadex or washed Sephadex from inflammatory deposits. However, Sephadex from inflammatory deposits without wash induced only mild inflammatory reactions. All signs of acute inflammation were less pronounced. Hence, the phlogistic efficacy of Sephadex is reduced by the simultaneous presence of exudate. The most significant antiphlogistic effects were seen when exudate containing Sephadex from 3 days old inflammatory deposits was used. The significance of soluble parts of the exudate in these antiphlogistic effects is discussed.