Serum long chain n-3 fatty acids (EPA and DHA) in the pregnant mother are independent of risk of type 1 diabetes in the offspring.

BACKGROUND: This article aims to study whether higher proportions of the long chain n-3 fatty acids eicosapentaenoic acid (EPA) or docosahexaenoic acid (DHA) in the phospholipid fraction of serum samples in pregnancy were associated with a lower risk of childhood onset type 1 diabetes in the offspring. METHODS: In a prospective cohort of nearly 30 000 pregnant women who gave birth in Norway during 1992-1994, we analysed serum samples from 89 women whose child developed type 1 diabetes and was included in the nationwide Norwegian Childhood Diabetes Registry and 125 randomly selected women whose child did not develop type 1 diabetes before 15 years of age. Specific fatty acids were expressed as the proportion of total fatty acids (g/100 g) in the phospholipid fraction in serum analysed using solid phase extraction and gas chromatography with flame ionization detection. RESULTS: There was no significant association between EPA or DHA in maternal serum and risk of type 1 diabetes in the offspring. Odds ratio (OR) for upper versus lower quartile of EPA was 0.75 [95% confidence interval (CI) 0.34-1.65], test for trend p = 0.4, and for DHA OR = 0.71 (95% CI 0.33-1.53), test for trend p = 0.6. No significant association was found for the sum of n-3 fatty acids, or for n-6/n-3 ratio in the mother with risk of type 1 diabetes in the offspring. CONCLUSIONS: Our data did not support the hypothesis that higher proportions of maternal EPA or DHA during pregnancy are associated with a lower risk of type 1 diabetes in the offspring.

[Symptoms in women with Sjogren's syndrome]. / Symptomopplevelser hos kvinner med Sjögrens syndrom.

More knowledge about symptom experience is needed for diagnosing Sjögren's disease at an early stage of disease development. We have performed a qualitative study based on group interview with eight women with Sjögren's disease. The women presented with several different symptoms. They all described weariness, fatigue, sicca symptoms, various pains, hypersensitivity and organ manifestations in the same manner. Some of the symptoms had a dramatic impact on their life activities. The study revealed new descriptions of previously known symptoms and descriptions of previously unfamiliar symptoms. The results of the study may supplement the existing criteria of Sjögren's disease and provide new hypotheses about pathogenetic mechanisms related to chest pain, abdominal pain and facial pain in patients with Sjögren's disease.

[Survey of clinical diagnoses and autopsy findings. Autopsy findings and sensitivity, specificity and predictive values for clinical diagnosis during the periods 1 July 1980-30 June 1081 and 1 July 1990-30 June 1993]. / Undersøgelse af kliniske diagnoser og obduktionsfund. Obduktionsfund og sensitivitet, specificitet og proediktive voerdier for klinisk diagnostik i perioderne 1.7.1980-30.6.1981 og 1.7.1990-30.6.1993.

The sensitivity, specificity and clinical accuracy of clinical diagnoses were determined and compared for two periods of time: 1.7.1980-30.6.1981 and 1.7.1990-30.6.1993 based on the analysis of 286 and 138 autopsies respectively. The autopsy rate decreased from 82.7% in the first period to 11.2% in the second. The first period shows a generally higher sensitivity and accuracy for positive diagnosis. Both periods reveal the lowest sensitivity for pulmonary embolism and the lowest accuracy for positive clinical diagnosis of pneumonia/bronchopneumonia. For malignancies and arteriosclerotic heart diseases significant discrepancy between the periods was demonstrated using the chi 2-test. The results are influenced by low autopsy rates causing fewer true-positive diagnoses and a declining sensitivity. This type of study is a useful tool for demonstrating changes in the diagnostic procedure. The present investigation demonstrates a need for further analysis of malignancies to explain the simultaneous decrease in sensitivity, specificity and accuracy in spite of an increasing number of malignancies in autopsy findings.

[Niels Finsen's treatment of tuberculosis of the skin]. / Niels Finsens behandling af hudtuberkulose.

By his contemporaries Niels Ryberg Finsen (1860-1904) has been described as a highly dynamic personality and characterised as a sympathetic, kind, confidence-inspiring, conscientious, reliable, intellectual, mysterious and genious doctor, who took care of his patients' illness as well as their social and economic conditions. But he was known too as sharp, critical and able to defend his scientific viewpoints with a deep commitment. Niels Finsen introduced the universal light bath, but his great achievement was the local light treatment of lupus vulgaris for which he got the Nobel Prize in 1903. In the article the history of lupus vulgaris, its treatment and its social consequenses for the patients as individuals are described as an introduction to an analysis of Niels Finsen's scientific methods, his treatment and results and the reactions from the contemporary medical authorities, the public represented by the press and the patients themselves. Finally the discussions after Niels Finsen's death are researched.

[Importance of the autopsy rate. A comparison between clinical assessment and findings at autopsies during the periods: 1 July 1908--30 June 1981 and 1 July 1990--30 June 1991]. / Obduktionsfrekvensens betydning. Sammenligning mellem klinisk vurdering og obduktionsfund i perioderne 1.7.1980-30.6.1981 og 1.7.1990-30.6.1991.

On the 1.7.1990 a new law was introduced in Denmark whereby specific consent had to be obtained from the deceased's relatives before autopsy could be performed. Autopsy records from two periods before and after this date, namely from 1.7.1980 to 1.7.1981 and from 1.7.1990 to 30.6.1991, are examined here with respect to autopsy rate and agreement/disagreement between clinical assessment as to cause of death and findings on autopsy. With an autopsy rate of 82.7% before and 10.3% after the new law we found that there was significantly more disagreement between the clinical assessment and the autopsy findings in the 1990/1991 period, presumably because of a selection bias towards difficult cases. The autopsy material from 1990/1991 could only be used for statistics in a limited fashion. A very low autopsy rate of about 10% implies that 25-30% of all death certificates from hospitals must be assumed to be incorrect as concerning serious diseases. The study shows that there is a considerable need for the performance of autopsies for the sake of medical statistics.

Ductal adenoma of the breast: the cytological features of six cases.

Ductal adenoma of the breast may simulate malignancy by both clinical, histological, and cytological examination. Fine-needle aspirations from breast lesions are now daily routine and preoperative recognition of this benign lesion is desirable. This study describes the cytologic features of six additional cases of ductal adenoma. The smears from all the lesions were highly cellular with epithelial cells in sheets. Numerous large fragments of purple stroma in tight connection with epithelial cells often making finger-like hyaline structures or globules between cells were seen. Naked oval nuclei in the background were observed in all cases indicating benignancy. We find the cytologic picture in fine-needle aspirations from ductal adenomas sufficiently characteristic for preoperative diagnosis. The differential diagnoses toward other benign and malignant conditions are discussed.

Primary malignant fibrous histiocytoma of the breast. A report of four cases and review of the literature.

Clinical, light microscopic and immunohistochemical features of four cases of primary malignant fibrous histiocytoma (MFH) of the breast are presented. Twenty-eight cases have been reported previously. We found that the prognosis of primary MFH located in the parenchyma of the breast is comparable to the prognosis of other MFH located superficial to the fascial level. We therefore conclude that simple mastectomy is adequate surgical therapy for MFH located in the breast. The possible beneficial effects of adjuvant therapy need further investigation.

The presence of HPV types 6/11, 13, 16 and 33 in bowenoid papulosis in an HIV-positive male, demonstrated by DNA in situ hybridization.

A perianal bowenoid papulosis was examined for the presence of HPV types 2, 6, 11, 13, 16, 18, 32 and 33 by DNA in situ hybridization. Positive signals were seen for HPV types 6/11, 13, 16 and 33. HPV type 13 is strongly related to oral focal epithelial hyperplasia and has not been reported outside the oral cavity before.

Verrucous carcinoma of the female genital tract: report of a case and review of the literature.

Verrucous carcinoma (VC) of the female genital tract is a rare lesion, primarily affecting postmenopausal women. A case of VC of the vulva is reported, bringing the total number of VC of the female genital tract to 89. VC is a slowly growing, locally "pushing" tumor with a rather benign histologic appearance, and the clinical and histologic characteristics are described on the basis of the present report and a review of the literature. The treatment of VC is still a matter of discussion. It seems logical to treat the tumor by wide local excision, taking the lack of proof of spontaneous metastasis into consideration. Radiation therapy should be contraindicated, and local application of podophyllin, bleomycin therapy, and cryosurgery are ineffective methods in the treatment of VC.

Adenomyoepithelial adenosis and low-grade malignant adenomyoepithelioma of the breast.

Adenomyoepithelial adenosis of the breast is a form of adenosis not previously described. It is similar in several ways to microglandular adenosis, but one significant difference is the presence of myoepithelial cells. The present case originated as adenomyoepithelial adenosis in a 46-year-old woman. In the course of 18 years it proliferated and changed into a low-grade malignant adenomyoepithelioma. Electron microscopy confirmed the presence of myoepithelial cells in the adenosis, and immuno-histochemical study demonstrated cells containing actin (representing myoepithelial cells) in the adenosis as well as in the adenomyoepithelioma.

Pulmonary histiocytomas.

Five cases of pulmonary histiocytomas are presented (four "endobronchial" and one "pulmonary"). They occurred in two children, and three adults over a five year period. Our center has a catchment of 1 million inhabitants. The possible nature and diagnostic possibilities are discussed. The prognosis is good in young people with this disease, which, in principle, does not differ from the same proliferating histiocytic and fibroblastic disorder arising elsewhere. The histological diagnosis was based upon characteristic and consistent morphological features, common to all cases.