Influence of anti-inflammatory diet and smoking on mortality and survival in men and women: two prospective cohort studies.

BACKGROUND: The associations between an anti-inflammatory diet and both all-cause and cause-specific mortality have been studied previously; however, the influence of an anti-inflammatory diet on survival time has not been investigated. Moreover, the potential modification of these associations by smoking status remains unclear. OBJECTIVE: The aims of this study were to examine the associations between an anti-inflammatory diet index (AIDI) and all-cause and cause-specific mortality, to determine the association between the AIDI and differences in survival time and to assess effect modification by smoking status. METHODS: The study population included 68 273 Swedish men and women (aged 45-83 years) at baseline. The anti-inflammatory potential of the diet was estimated using the validated AIDI, which includes 11 potential anti-inflammatory and five potential pro-inflammatory foods. Cox proportional hazards and Laplace regression were used to estimate hazard ratios and differences in survival time. RESULTS: During 16 years of follow-up (1 057 959 person-years), 16 088 deaths [5980 due to cardiovascular disease (CVD) and 5252 due to cancer] were recorded. Participants in the highest versus lowest quartile of the AIDI had lower risks of all-cause (18% reduction, 95% CI: 14-22%), CVD (20%, 95% CI: 14-26%) and cancer (13%, 95% CI: 5-20%) mortality. The strongest inverse associations between the highest and lowest quartiles of AIDI and risk of mortality were observed in current smokers: 31%, 36% and 22% lower risks of all-cause, CVD and cancer mortality, respectively. The difference in survival time between current smokers in the lowest AIDI quartile and never smokers in the highest quartile was 4.6 years. CONCLUSION: Adherence to a diet with high anti-inflammatory potential may reduce all-cause, CVD and cancer mortality and prolong survival time especially amongst smokers.

Combined impact of healthy lifestyle factors on lifespan: two prospective cohorts.

BACKGROUND: The impact of multiple healthy lifestyle factors on survival time is unclear. OBJECTIVE: The aim of this study was to examine differences in survival time associated with a healthy lifestyle versus a less healthy lifestyle. METHODS: This study consisted of 33 454 men (Cohort of Swedish Men) and 30 639 women (Swedish Mammography Cohort) aged 45-83 years and free of cancer and cardiovascular disease at baseline. The healthy lifestyle factors included the following: (i) nonsmoking; (ii) physical activity at least 150 min per week; (iii) alcohol consumption of 0-14 drinks per week; (iv) and healthy diet defined as a modified Dietary Approaches to Stop Hypertension Diet score above the median. Cox proportional hazards regression models and Laplace regression were used to estimate, respectively, hazard ratios of all-cause mortality and differences in survival time. RESULTS: During follow-up from 1998 through 2014, 8630 deaths amongst men and 6730 deaths amongst women were ascertained through linkage to the Swedish Cause of Death Register. Each of the four healthy lifestyle factors was inversely associated with all-cause mortality and increased survival time. Compared with individuals with no or one healthy lifestyle factor, the multivariable hazard ratios of all-cause mortality for individuals with all four health behaviours were 0.47 (95% 95% confidence interval [CI]: 0.44-0.51) in men and 0.39 (95% CI: 0.35-0.44) in women. This corresponded to a difference in survival time of 4.1 (95% CI: 3.6-4.6) years in men and 4.9 (95% CI: 4.3-5.6) years in women. CONCLUSION: Adopting healthy lifestyle behaviours may markedly increase lifespan.

Diet quality and mortality: a population-based prospective study of men.

BACKGROUND/OBJECTIVES: To study quality of diet in relation to all-cause mortality, cardiovascular disease (CVD) and cancer mortality. SUBJECTS/METHODS: The population-based prospective Cohort of Swedish Men (COSM) included 40 837 men, 45-79 years of age, who filled in a FFQ (96 food items) and were CVD- and cancer-free at baseline. Quality of diet was assessed by Recommended Food Score (RFS) based on 36 items and Non-Recommended Food Score (Non-RFS) based on 16 items. Cox's proportional hazards regression models were used to estimate the hazard ratios (HRs) of mortality and 95% confidence intervals (CIs). Multivariate HRs for RFS and Non-RFS were adjusted for age, education, physical activity, martial status, self-perceived health status, smoking status, dietary supplements use, WHR, alcohol use, intake of energy and mutually adjusted. RESULTS: Between 1998 and 2005, 4501 deaths from all-causes were registered. Between 1998 and 2003, there were 1394 CVD and 759 cancer deaths. High RFS (> or =28) compared with low (< or =20) was associated with lower risk of all-cause mortality (HR: 0.81; 95% CI: 0.71-0.91; P-value for trend<0.0001) and CVD mortality (HR: 0.71; 95% CI: 0.54-0.93; P-value for trend=0.003). In contrast, men with high Non-RFS (> or =5) had higher risk of all-cause (HR: 1.21; 95% CI: 1.09-1.34; P-value for trend=0.001) and CVD mortality (HR: 1.27; 95% CI: 1.05-1.54; P-value for trend=0.07) compared to those with low Non-RFS (< or =2 items). No significant associations with cancer mortality were observed. CONCLUSIONS: Both measures of diet quality, RFS and Non-RFS, showed statistically significant associations with all-cause and CVD mortality (recommended foods inversely while nonrecommended foods positively), but not with cancer mortality.

[Iron, zinc and copper status in the elderly living in Warsaw district determined by hair analysis]. / Ocena stanu odzywienia zelazem, cynkiem i miedzia osób starszych zamieszkalych w rejonie warszawskim na podstawie analizy wlosów.

The aim of this study was to assess the iron, zinc and copper status of elderly people using hair trace element levels determined by using atomic absorption spectrophotometry (AAS). The samples of hair were taken in May-June 1999 from 73 people aged 75-80 years (50 men and 23 women) living in Warsaw district. The mean content of iron was 17.32 +/- 12.38 micrograms/g dry weight, zinc 176.44 +/- 64.33 micrograms/g d.w. and copper 11.25 +/- 6.32 micrograms/g d.w. Although these values were in range of reference intervals almost 40% of population had iron and zinc level below them, and for copper the result was even worse (50% of the elderly people). No significant differences between trace element content in hair of male and female have been observed. However it has revealed a trend that female hair contained less iron and more zinc than male hair. The mean copper level was similar for both sexes. It has been found that subject who had not excluded any food products from their diets had higher hair iron contents than those with some dietetic restrictions.

Immunohistochemical investigations of excitotoxicity in experimental spinal cord trauma.

The concept of "excitotoxicity" assumes that high concentration of glutamate (main excitatory neuromediator) acting through specific receptors leads to damage of cells due to an influx of calcium ions. Proteins called "excitatory amino acid transporters" (EAATs), present in astroglia, play important role in the removal of glutamate. We investigated the expression of GluR2 (glutamate receptor), EAAT1, and EAAT2 by immunohistochemistry in formalin-fixed, paraffin-embedded rat spinal cords, previously subjected to experimental mechanical trauma. In the injured spinal cords, an elevated immunoreactivity of GluR2 was noted even 10 min after trauma and was still observed 2 days after injury. Strong immunoreactivity was observed not only in many cells in gray matter but also in some cells in white matter (probably glial cells). In the injured spinal cords, we observed stronger (as compared with controls) expression of EAATs in the white matter, especially 6 hours after injury. The results support the role of excitotoxicity in mechanical trauma of spinal cord suggesting a possibility of long lasting elevated expression of glutamate receptor. It may help to understand and to explain beneficial action of "anti-glutamate" drugs, reported by other investigators.

[Brain stereotactic procedures in the Department of Neurotraumatology CM UJ in Cracow]. / Operacje stereotaktyczne guzów mózgu w materiale Kliniki Neurotraumatologii CM UJ w Krakowie.

Stereotactic procedures using Leksell frame have been performed in that Department since 1995, and as jet 199 such operations were carried out. The most frequent complication after stereotaxic biopsies was intracerebral haemorrhage occurring in 0.6 to 7.2% of cases, according to various authors. In the presented material it occurred in 1.3% of biopsies. Besides biopsy, the stereotactic procedures (105 cases) were applied for reducing the size or removal of tumours, including multiple tumours in one or both hemispheres, in one-step operations. The histological diagnoses were based on the examination of HE-stained smears, immunocytochemical reactions and electron microscopic studies. The effectiveness of the operations was assessed in control examinations (CT). The greatest group of cases undergoing stereotaxic surgery were metastatic tumours (47 cases, 61.3%), primary brain tumours were treated in 22 cases (28.57%), meningiomas in 4 (5.19%), abscesses in 3 cases (3.89%). In patients with metastatic tumours improvement was obtained in 97% of cases. One patient died from disseminated malignancies with cardiorespiratory failure. In the remaining patients no worsening of the objective status was noted after stereotaxic surgery.

Progressive multifocal leukoencephalopathy (PML) in a patient with silicosis treated previously with steroids. A report of a case with JC virus infection confirmed immunohistochemically and by electron microscopy.

We present a case of progressive multifocal leukoencephalopathy (PML) diagnosed at autopsy, in which JC virus infection of the central nervous system was confirmed by means of electron microscopy and immunohistochemistry. The patient had been receiving steroid hormones due to suspected sarcoidosis or pneumoconiosis. Diffuse silicosis in lungs and in hilar and mediastinal lymph nodes was diagnosed at autopsy. Intranuclear inclusions, ultrastructurally typical of JC virus were found in some oligodendrocytes in the white matter. However the strongest immunopositive viral deposits were found in the cerebellar cortex, also within Purkinje cells. Numerous apparently apoptotic cells seen in white matter suggest that this mechanism of cell elimination plays an important role in PML pathogenesis and hence anti-apoptotic treatment may alleviate the symptoms and prolong survival.

Responsiveness of olfactory neurons to distinct aliphatic aldehydes.

The responsiveness of isolated olfactory sensory neurons to stimulation with aliphatic aldehydes of varying chain length (5-10 hydrogenated carbon atoms) was investigated by means of Ca(2+ )imaging. More than half the cells examined were responsive to aliphatic aldehydes. Individual cells did not react or reacted to one or multiple aldehydes; in the latter case, cells only reacted to aldehydes of consecutive carbon chain lengths. The largest proportion of cells responded to octanal. It was also demonstrated that a structural difference as small as one hydrogenated carbon atom was detectable by the olfactory neurons. Neurons were increasingly able to discriminate between two aldehydes as the difference in chain length between the two increased. Discrimination between aldehydes with longer carbon chains was reduced. Although the odorants examined belong to a distinct chemical class and differ only slightly in structure, individual olfactory sensory neurons showed quite different receptive properties.

The distinct morphological and biological features of primary brain tumors and their influence upon prognosis and treatment.

Primary tumors of the central nervous system apart from features common with tumors of other organs and tissues in man show some different and distinct features which give significant meaning for prognosis and treatment. One of the most important features which characterizes their distinctness is the relation of the tumor to its surroundings. Macroscopic and microscopic evaluation of this relation decides of possibilities of an early diagnosis and totality of removal. Basing on comparison with tumors of other organs e.g. lung, stomach and liver the difficult task of differentiation of the infiltration zone with the use of morphological criteria only in glial tumors is discussed. Notice has been taken of elements which determine the limitation of totality of removal and factors conditioning the recurrences. Attention was directed on discrepancy between morphological criteria and biological activity of the tumors, specially of those which in agreement with cytogenetic classification are included to the group of tumors of astrocytic origin. Additionally, the dependency of prognosis and treatment on age and localization of the primary brain tumors have been taken into consideration.

CT-guided stereotactic biopsy of brain. Three years of experience.

In our center from 1995 up to now (08.06.99) we have performed 78 CT-guided stereotactic biopsies (SB) of brain. In all cases the stereotactic biopsy was performed as the first surgical, diagnostic procedure. Indications for SB were as follows (in brackets, the number of SBs): diffuse, inoperable tumor (43), tumor of central region of brain (19), multiple tumors (7), a change of the obscure nature in CT/NMR scan (15), stereotactic assistance of the "classic: craniotomy and surgery of tumor (4). Among 78 SBs in 49 cases the primary and in 13 cases--secondary (metastatic) brain tumors were diagnosed. In the remaining 16 cases nonspecific changes like gliosis or necrosis were found. Of 49 primary tumors 40 were gliomas. Different pathomorphological methods, including especially immunohistochemistry with GFAP, vimentin, p53, Ki-67, and topoisomerase II alpha if applied together, may at least partially help to overcome the problems of the differentiation of reactive and neoplastic gliosis. We found a grading system of gliomas according to Daumas-Duport very useful in interpretation of SB material. Our preliminary observations suggest that immunolabelling of the biopsy material by means of topoisomerase II alpha antibody may be very useful in SB since it gives technically very good results on smears and because on the grounds of what is known on this enzyme it is the "target" of many antineoplastic drugs and hence may indicate the potential sensitivity to drugs.

Secretory meningioma of the brain. Report of two cases.

Two cases of cerebral secretory meningioma, occurring in 57 and 33-year-old females are reported. The tumors were located in the tentorial and frontotemporal region, respectively. The general histologic appearance of the tumors was of meningothelial meningioma (case 1) and meningioma with microcystic and angiomatous features (case 2). The most striking histological finding in both tumors were numerous pseudopsammoma bodies, localized chiefly around blood vessels. The inclusions were slightly eosinophilic, stained strongly with PAS method and were differing in size from 3 to 30 microns. Tumor cells containing or surrounding pseudopsammomas were immunopositive for cytokeratin and epithelial membrane antigen. In the first case, individual pseudopsammomas were strongly positive for carcinoembryonic antigen. Some diagnostic aspects of this antigen and problems regarding differential diagnosis in secretory meningioma are briefly discussed.

Primary malignant lymphoma of brain. A review of four cases diagnosed by means of CT-guided stereotactic biopsy.

In a series of 66 CT-guided stereotactic biopsies (SB) of the brain performed in 1995-1998, four were found to be the primary non-Hodgkin's lymphomas (PCNSL). All cases were studied with immunohistochemistry (broad panel of antibodies; reactions performed mainly on cytological smears) and with the use of an electron microscopy. In an immunophenotyping all cases were positive for leukocyte common antigen (LCA) and 3/4 showed B-cell phenotype. Since the PCNSL are typically located in central, periventricular region of brain and the surgical removal does not bring any benefit, the stereotactic biopsy is a method of choice to make a definite diagnosis that opens the chances for implementation of chemo- and radiotherapy. The diagnostic difficulties that are derivatives of an extremely small amount of the available biopsy material were discussed and the role of the immunophenotyping and of the electron microscopy for avoiding the possible diagnostic mistakes was stressed. Cytological smears stained with H&E and the smears and histological slides with immunohistochemical reaction against glial fibrillary acidic protein (GFAP) showing sometimes extremely dense network of astrocytes mingled with neoplastic lymphoma cells are especially interesting and seem to suggest the involvement of astroglia in the pathogenesis of PCNSL.

Vascular endothelial growth factor and its receptor, KDR, in human brain tissue after ischemic stroke.

Ischemic stroke results from a reduction in cerebral blood flow to a focal region of the brain after the occlusion of an artery, causing damage to nervous tissue. There is a region of cerebral ischemic tissue (penumbra) surrounding an acute cerebral infarct that is dysfunctional but potentially viable. Restoration of perfusion in the penumbra may ameliorate the tissue damage. The identity and the role of growth factors that control the extent of tissue damage and its repair are poorly understood. Angiogenesis has been demonstrated to occur in brain tissues of patients surviving an acute ischemic stroke. In this paper we have investigated the status of a potent angiogenesis factor, vascular endothelial growth factor (VEGF), in patients after acute ischemic brain stroke. Western blotting and immunohistochemistry were used to determine protein expression, and in situ hybridization was used to quantify and localize mRNA synthesis. The expression of VEGF protein was increased in the penumbra compared with infarcted brain and contralateral hemisphere. Neurones, endothelial cells, and astrocytes in the penumbra in all patients studied had significant up-regulation of both VEGF165 and VEGF189 mRNA (p < 0.01, Wilcoxon Matched-Pairs Signed-Ranks Test) compared with infarcted tissue and the normal looking contralateral hemisphere that was used as a control. Immunohistochemistry demonstrated that kinase insert domain receptor was present in blood vessels within the infarct/penumbra and absent from the normal contralateral hemisphere. VEGF, which is important in angiogenesis, may also influence long term neuronal survival, and possibly its modulation may prove to be of therapeutic value for patients with ischemic stroke.

[Central nervous system and organ infiltration in the chronic phase of chronic myelogenous leukemia: a case report]. / Nacieki narzadowe i centralnego systemu nerwowego w fazie chronicznej przewleklej bialaczki szpikowej--opis przypadku.

The case report presents a 35-year-old patient with neurological disorders caused by a solid tumour of the spinal cord and organ infiltration during the chronic phase of CML (chronic myelogenous leukemia). In spite of combined chemo- and radiotherapy, disease progression was only halted for a short time. Patient death occurred 5 months after disease diagnosis. Taking into consideration the non-typical disease course and few described case reports available in literature concerning solid tumours located in the CNS (central nervous system) with organ infiltration it appears noteworthy to discuss thoroughly the above case report.

Variability of localization and intensity of damage of the white matter of the brain and cerebellum in genetically conditioned diseases.

The investigations were based on 3 cases with Leigh, 5 cases with Krabbe's, 4 cases of Alpers, 2 cases with Sandhoff, 1 case with Alexander's disease and 1 case with metachromatic leukodystrophy. In 1 case included into the study we have diagnosed nonketotic hyperglycinemia II. All the diseases under examination are recognized as genetically conditioned or are supposed to be of genetic origin. Damage of the white matter in a more delineated form in certain regions was found in Leigh disease. The changes demonstrated a variable degree of intensity from demyelination to necrosis. More extensive lesions of white matter in gyri and semivoal centrum were found in diseases with simultaneously damaged gray matter e.g. in Alpers and Sandhoff disease. The most extensive changes of diffuse demyelination were found in Krabbe's and Alexander's disease. In these diseases demyelination was accompanied with specific morphological structures e.g. globoidal cells (Krabbe's disease) and Rosenthal fibers (Alexander's disease). The peculiar type of demyelination was characteristic for nonketotic hyperglycinemia of type II. It was expressed by demyelination with vacuolization.

Recurrent ossifying fibromyxoid tumour of soft parts. Immunohistochemical profile and ultrastructure.

Growing bulk of evidence supports a view that ossifying fibromyxoid (OFMT) tumor histogenetically belongs to tumors derived from peripheral nerve sheath. Its precise cellular ancestor is disputable nevertheless the Schwann cell should be considered as a first candidate. Clinical behavior of this rare and usually benign neoplasm can probably vary from benign to even truly malignant, though the latter possibility is extremely rare. We present a case of recurrent OFMT located subcutaneously in the medial aspect of the knee in 66-year-old male. Macroscopically, microscopically, and immunohistochemically both primary and recurrent tumors were almost identical. Tumors were entirely negative for S-100 protein and strongly positive for neuron specific enolase. However, electron microscopy did not reveal any traces of basal lamina. Apparent lack of vascularization of tumor tissue may play an important role in the morphogenesis of OFMT.