Intravenous leiomyomatosis: Case series and review of the literature.

INTRODUCTION: Intravenous leiomyomatosis (ILV) is a rare pathology, part of leiomyoma beyond the uterus (LBU), characterized by benign smooth muscle cell tumor outside of the uterus and mainly affecting premenopausal woman with a medical history of leiomyoma or gynecologic surgical treatment. The treatment depends on the localization of the tumor, age of the patient, initial size, symptoms and the suitability for surgery but should always aims in toto surgical resection. CASE PRESENTATION: Retrospective case series and review of literature. CLINICAL DISCUSSION: Symptoms presented by the patient were aspecific and only localized in the pelvic area. All cases were fortuitous histopathological diagnosis. No relapse was. Two out of 5 patients have pulmonary nodules, only one was biopsied and diagnosed with PBML (pulmonary benign metastasizing leiomyoma). CONCLUSION: IVL and BML are rare disease that can co-exist. Because of tumoral hormonal receptors, hormonotherapy could be an optional treatment but to date no clear efficacy is demonstrated. In case of high recurrence risk such as voluminous initial mass, impairment of broad ligament, failure of total surgical resection, adjuvant hormonotherapy could be useful. Recurrence rate is about 16.6-30% and can occur even dozen years later and even after radical surgery, justifying a regular follow up.

Rare case of remission of a patient with small cell carcinoma of the ovary, hypercalcaemic type (SCCOHT) stage IV: Case report.

INTRODUCTION: Small cell carcinoma of the ovary (SCC) is a very rare (less than 1 % of ovarien neoplasia), highly undifferentiated, aggressive malignancy affecting young women and linked to a poor prognosis. Overall survive rate is very low (about 16 %). SCCOHT has recently been shown to be associated with SMARCA4 gene mutations and shows some genetic similarities to malignant rhabdoid tumors (MRT). PRESENTATION OF CASE: After a reminder of the clinical, histological description of the SCCOHT and concensus about the medical management, we describe the rare case of a 22 years old patient with complete remission after diagnosis of un undifferentiated SCCOHT stage IV treated by conservative surgery and high-doses chemotherapy, 30 months after diagnosis. DISCUSSION: Thus far, no standard therapy exists for SCCOHT. Treatment modalities are surgery, chemotherapy, radiotherapy and autologous stem cell transplant after high-dose chemotherapy. Research for new treatments includes target therapy. CONCLUSION: Autologous stem cell transplant after high-dose adjuvant chemotherapy seems to lead to the best survival rates. Invasiveness of the treatment depends on the stage of the disease, age of the patient and her fertility-sparing desire. An international collaboration will be needed to standardise practices due of the small number of patients.

Epidemiological survey of melanoma in the Auvergne region (France): is there an increased incidence in Auvergne?

To assess the efficiency of melanoma screening and prevention campaigns in the Auvergne region (France), cases of melanoma have been recorded since 1st June 1998. The epidemiological follow-up of melanoma was carried out using two sentinel networks; one involving the pathologists, and the other, the dermatologists of the region. Incidence was calculated using the capture-recapture method, by cross-matching the data supplied by both dermatologists and pathologists. Between June 1st 1998 and December 31st 2000, 363 cases of melanoma were recorded. The crude incidence rate of melanoma per 100,000 person-years was 17.1 for all melanomas and 14.6 for invasive melanomas. These rates of incidence were higher than the estimated national rate of France, and were close to incidences found in countries of Northern Europe. This might be explained by an increase in screening for melanoma, by more precise estimation of the incidence due to the capture-recapture method, or by geographic factors (mountainous area). An answer may be provided by following the variation in time of incidence and thickness of melanomas; the increase in the number of thin (low Breslow index) melanomas corresponding with increased screening.

Food and fluid intake of the SENECA population residing in Romans, France.

OBJECTIVES: to provide information and data on food and fluid intake of free-living elderly aged of 81-86 years old residing in the south of France. METHODS: using standardised methods data were collected from a random sample born between 1913 and 1918. The French study protocol again included data collection on dietary intake using a standardised modified dietary history consisting of a food frequency list and a 3-day estimated dietary record. RESULTS: Total dietary intake was generally low as compared to the recommended daily intake for elderly subjects. CONCLUSION: This descriptive part of the SENECA study gives the opportunity to have information on this growing segment of the population. These results should help to adapt the dietary guidelines for this category of the population.

Health effect of improved meal ambiance in a Dutch nursing home: a 1-year intervention study.

BACKGROUND: The aim of this study was to determine the effect of an improved ambiance of food consumption on health and nutritional status of Dutch nursing home elderly residents (n = 38) in a 1-year intervention study. METHODS: A parallel group intervention study was performed. Improvement of ambiance focused on three points: (1) physical environment and atmosphere of the dining room, (2) food service, (3) organization of the nursing staff assistance. Dietary intake, biochemical indicators of nutritional and health status and quality of life (Sickness Impact Profile and Philadelphia Geriatric Center Moral Scale) were assessed at baseline and after 1 year of intervention. Body weight, used as an indicator of compliance and nutritional status, was assessed every 4 months. RESULTS: Twenty-two subjects completed the 1-year intervention trial. Mean body weight significantly increased (+3.3 kg, P < 0.05) in the experimental group (n = 12), not in the control group (-0.4 kg, P = 0.78; n = 10). Health status biochemical indicators and the SIP score remained stable in the experimental group, indicating relatively stable health conditions. On the contrary, negative changes in the control group suggested a decline in health status. Dietary intake, which was insufficient at baseline, increased in both groups. CONCLUSIONS: This study showed that improving the ambiance of food consumption is a non-negligible issue for improving nutritional status and stabilizing health of nursing home residents.

Flavor enhancement of food improves dietary intake and nutritional status of elderly nursing home residents.

BACKGROUND: Taste and smell losses occur with aging. These changes may decrease the enjoyment of food and may subsequently reduce food consumption and negatively influence the nutritional status of elderly persons, especially those who are frail. The objective of this study was to determine if the addition of flavor enhancers to the cooked meals for elderly residents of a nursing home promotes food consumption and provides nutritional benefits. METHODS: We performed a 16-week parallel group intervention consisting of sprinkling flavor enhancers over the cooked meals of the "flavor" group (n = 36) and not over the meals of the control group (n = 31). Measurements of intake of the cooked meals were taken before and after 8 and 16 weeks of intervention. Appetite, daily dietary intake, and anthropometry were assessed before and after the intervention. RESULTS: On average, the body weight of the flavor group increased (+1.1 +/- 1.3 kg; p <.05) compared with that of the control group (-0.3 +/- 1.6 kg; p <.05). Daily dietary intake decreased in the control group (-485 +/- 1245 kJ; p <.05) but not in the flavor group (-208 +/- 1115 kJ; p =.28). Intake of the cooked meal increased in the flavor group (133 +/- 367 kJ; p <.05) but not in the control group (85 +/- 392 kJ). A similar trend was observed for hunger feelings, which increased only in the flavor group. CONCLUSION: Adding flavor enhancers to the cooked meals was an effective way to improve dietary intake and body weight in elderly nursing home residents.

Assessing appetite in Dutch elderly with the Appetite, Hunger and Sensory Perception (AHSP) questionnaire.

BACKGROUND: In investigating anorexia of ageing, attention is often given to physical and psychological determinants of appetite in the elderly but little has been done to provide information on self-assessment of appetite and sensory perceptions in the elderly. OBJECTIVES: to provide data and detect possible differences in self-assessment of appetite, hunger feelings and sensory perception in different health group of elderly using the Appetite, Hunger feelings and Sensory Perception (AHSP) questionnaire. METHODS: three health categories of elderly subjects were used for the present study: free-living with no help, free-living with help and nursing home elderly. For each group, collected data were general characteristics, anthropometry and answers to the AHSP. The AHSP questionnaire includes 29-items focusing on feelings of hunger and appetite as well as taste and smell perception addressing both the present situation and the period before retirement. RESULTS: Significant differences were observed between the 3 health groups for appetite, hunger feelings, present taste perception and present smell perception (P<0.05). Appetite and hunger were found to be related to body weight in the healthiest but not in the others. CONCLUSION: A decline in health status is paired with a decrease in appetite, hunger feelings and sensory perceptions of elderly subjects.

Short-term regulation of food intake in children, young adults and the elderly.

OBJECTIVE: The present study investigated the effects of consuming preloads with different macronutrient and energy contents on subsequent intake and subjective feelings of hunger and satiety in children, young adults and the elderly. SUBJECTS: 30 Children (4-6 y), 33 young adults (18-26 y) and 24 elderly (61-86 y). DESIGN: A 'preload test meal' design was applied. Subjects were given four different strawberry yoghurt preloads that varied in energy and macronutrient content, or no yoghurt. Children, young adults and elderly consumed 200, 340 and 300 g of the preload, respectively. One yoghurt was low-fat, low-carbohydrate and low in energy (the control; 0.7 MJ/500 g serving), one yoghurt was high-fat and medium in energy (71% of energy (en%) of fat; 2 MJ/500 g serving), one yoghurt was high-carbohydrate and medium in energy (87 en% of carbohydrate; 2 MJ/500 g serving) and the fourth yoghurt was high-fat and high-carbohydrate and high in energy (42 en% of fat and 53 en% of carbohydrate; 3 MJ/500 g serving). Ninety minutes after preload consumption, subjects had an attractive ad libitum lunch-buffet. Energy intake at lunch and subjective feelings of hunger and satiety were analysed. RESULTS: The ability to compensate at lunch did not differ among the three age groups. Compared to the no-preload condition, all children, young adults and elderly ate significantly less after the high-fat and high-carbohydrate yoghurt. The energy compensation observed in the children ranged between -21% and 34%, in the young adults between 15% and 44% and in the elderly between 17% and 23%. Hunger responses were clearly different between young adults and the elderly. Compared to the no-preload condition, the young adults showed larger differences in their appetite ratings than the elderly, indicating that the elderly were less sensitive to the energy content of the preload than the young adults. CONCLUSION: We conclude that the ability to regulate the food intake within a preload 90 min test meal paradigm did not differ among children, young adults and the elderly. SPONSORSHIP: This study was funded by the European Commission as part of project FAIR-CT95-0574.

Preparation and in vivo testing of porous alumina ceramics for cell carrier applications.

Microporous alumina was used to develop implantable cell carriers shaped as a hollow-sphere with a central opening to allow ingrowth of vascularised tissues. The carriers were produced by suspending the ceramic raw materials in water, homogenising and dropping the resulting slurry onto a heated plate (hot plate moulding, HPM). Morphological characteristics of the cell carriers were investigated by SEM and optical microscopy. Produced carriers had an average diameter of 4.9 mm. The material was highly porous (56 +/- 8%). For in vivo testing the cell carriers were implanted into abdominal wall of Zur: SIV rats for up to 50 weeks and investigated by light microscopy, SEM and TEM. The surface of the hollow carriers was in close contact with unirritated muscle tissue; no inflammation or capsule formation was observed. Loose connective tissue had grown into the hollow cell carrier, and after prolonged implantation >20 weeks adipocytes were observed. The absence of scar tissue formation around the implant and the vitality within the cavity of the hollow carriers indicate that porous alumina may be used for cell transplantation devices.

Tissue engineering scaffolds using superstructures.

Here, scaffolds as cell and tissue carriers are approached from an engineering point of view, emphasizing material superstructuring in the design of supports. Superstructure engineering provides optimal spatial and nutritional conditions for cell maintenance by the arrangement of structural elements (e.g. pores or fibres) so as to vary the order of cell to cell contact. This approach is illustrated in the design of several scaffolds: knitted fabrics as three-dimensional superstructures for optimized osteosynthesis implants, a new injectable open porous implant system, an angiopolar non-degradable ceramic cell carrier, and an injectable or microsurgically implantable entangled carrier system. The implications for tissue engineering are discussed.

["I protect others' and my life". Adolescents and their adaptation to the dangers of AIDS. A survey of trade school students]. / "Ich schütze anderes Leben und meins". Adoleszente und ihre Anpassung an die Gefährdung durch AIDS. Eine Befragung von Berufsschülern.

170 trade school students (main inquiry 142) between 18 and 21 in eight cantons were questioned via group discussions and questionnaire on their attitude to the STOP AIDS campaign, to the messages put across by the campaign and to the use of condoms. About half the trade school students recognise the personal appeal. 77% consider the recommended protection by using condoms personally acceptable and correct. However, the inquiry disclosed that this is only a relative acceptance. In practice, a considerable minority is developing individual behaviour concepts with a view to circumventing the recommended condom protection whenever possible. There is a lack of insight into the advantages of using condoms as standard practice in risk situations as a manifestation of the solidarity of all concerned to prevent AIDS from spreading further. The analysis of the results considers, inter alia, to what extent partner loyalty, confidence and abstinence are integrated in these behavioural concepts and attempts to assess their value with a view to reliable AIDS prevention. Prejudice against the condom and a gap in the STOP AIDS campaign reasoning are considered as possible grounds for the resistance to the recommended condom protection.

Effects of ambient noise on time estimation by humans.

10 male and 10 female undergraduates were asked to estimate 5-, 10-, 15-, and 30-sec. intervals under five intensities of ambient noise (50, 60, 70, 80, and 90 dB). Interval estimates became shorter as the intensity of noise increased from 50 to 80 dB but became longer at 90 dB. The effects of intensity of noise were most prominant in the two longest intervals. These results are interpreted in terms of CNS arousal theory.