[Pain in the legs and progressive neurological deterioration: tethered cord syndrome in adults]. / Pijn in de benen en progressieve neurologische uitval: gekluisterd-ruggenmergsyndroom bij volwassenen.

In four patients, women aged 58, 63 and 42 years, and a man aged 25 years, tethered cord syndrome was diagnosed. These patients suffered from progressive neurological symptoms, notably radiating pain in the legs in the first three patients, and muscle weakness and atrophy in the lower legs in the fourth patient. All four were treated surgically. Nowadays, the phrase tethered (spinal) cord is used for both occult and open closure defects of the neural tube. New neurological symptoms and signs can develop not only in childhood, but also in adults. Neurosurgical release of the tethered cord prevents further deterioration and often leads to significant subjective improvement of symptoms.

Mutagen sensitivity in common cutaneous malignant melanoma and dysplastic naevus syndrome.

Sunlight (ultraviolet radiation) has been identified as the major environmental risk factor for the development of cutaneous malignant melanoma and dysplastic naevi. This is, however, not sufficient to explain all melanoma cases. In recent years much emphasis has been given to genetic susceptibility to melanoma. A biomarker of susceptibility to environmentally related cancer is mutagen sensitivity. This is measured as the number of chromatid breaks in lymphocytes which are exposed to bleomycin in the G2 phase of the cell cycle. It has been described that patients with common melanoma show an increased mutagen sensitivity compared with controls. In the present study mutagen sensitivity was measured in 10 dysplastic naevus syndrome patients and compared with that in 11 patients with common melanoma. We found similar results for common melanoma patients as have been reported earlier: a relatively high mean breaks per cell value (0.93 +/- 0.31). In contrast, melanoma patients with dysplastic naevi showed a significantly (P<0.01) lower mutagen sensitivity value (0.46 +/- 0.34). This phenomenon was even more pronounced when only hereditary dysplastic naevi patients (one or more family members with dysplastic naevi) were considered (n = 5; 0.24 +/- 0.05). These results suggest a difference in the initiation of the carcinogenic process in melanoma with a dysplastic naevus as a precursor and melanoma without dysplastic naevi.

Second moment method for evaluating human health risks from groundwater contaminated by trichloroethylene.

Pollutants in groundwater aquifers may constitute a significant human health risk. A large variation in response may result among human populations experiencing the same level and duration of exposure to pollutants. Variability in response, as a result of exposure to a carcinogenic contaminant such as trichloroethylene (TCE), can be represented by a distribution function of safe doses. Spatial variability in aquifer characteristics and contaminant transport parameters requires the use of stochastic transport models to quantify variability in exposure concentrations. A second moment method is used to evaluate the probability of exceeding safe dose levels for a contaminated aquifer. The name of this method stems from the fact that the formulation is based on the first and second moments of the random variables. With this method, the probability is a function of the variability of contaminant concentration (which incorporates variability in hydrogeologic parameters such as hydraulic conductivity) and the variability in response in the human population. In this manner, the severity of the health risk posed by a contaminated aquifer and the evaluation of appropriate strategies and technologies for aquifer remediation are a function of contaminant concentrations and human health risks. The applicability and limitations of this method are demonstrated with data on groundwater contaminated by TCE at Hill Air Force Base, Utah.