[Smoking and breast cancer]. / Rygning og mammacancer.

Two hypotheses have been suggested concerning the relationship between smoking and breast cancer: 1) smoking has a protective effect on the development of breast cancer because of an anti-oestrogenic effect; 2) smoking increases the risk of breast cancer because of a direct carcinogenic effect. The present study examined the relationship between smoking and breast cancer in 3240 women who were referred for mammography. There was no support for the first hypothesis. In contrast, women had an increased risk of developing breast cancer after 30 years of smoking with a relative risk of 1.6, and smokers with breast cancer were eight years younger than non-smokers with breast cancer.

Aggression and personality: association with amino acids and monoamine metabolites.

Associations in 52 normal individuals were examined between plasma and cerebrospinal fluid (CSF) concentrations of tryptophan (Trp) and tyrosine, and concentrations of monoamine metabolites in the CSF, and scores on an aggression questionnaire, the Kinsey Institute Reaction List II, and the Eysenck Personality Questionnaire. There was a significantly positive correlation between CSF 5-hydroxyindoleacetic acid (5-HIAA) levels and extroverted aggression scores, and a significantly negative correlation between CSF 5-HIAA levels and introverted aggression scores. Males showed higher plasma Trp concentrations than females, and significantly positive correlations between plasma Trp concentrations and scores on extroverted aggression and the Eysenck E scale. Males, furthermore, showed a significantly negative correlation between CSF Trp levels and scores on the Eysenck P scale, and a significantly positive correlation between concentrations of 3-methoxy-4-hydroxy-phenylglycol in CSF and scores on moral aggression. These results suggest that central serotonin influences aggression in normal individuals through effects on personality.

Cigarette smoking and breast cancer.

OBJECTIVE: To investigate cigarette smoking in relation to the risk of breast cancer. DESIGN: Interviews with women referred for mammography. SETTING: Hjørring District Hospital, a public, population based hospital in Denmark. SUBJECTS: 3240 women aged 15-92 years referred for mammography during 1 June 1989 to 1 November 1991. MAIN OUTCOME MEASURES: Smoking, parity, age, reason for referral, breast cancer. RESULTS: In a multiple logistic regression analysis adjusted for six variables a pronounced increased risk of breast cancer was found in women who had smoked for over 20 years, and this was significant in women who had smoked for over 30 years (odds ratio 1.6, 95% confidence interval 1.1 to 2.3). The median age of women with breast cancer was 59 (range 31-81) years for smokers and 67 (38-92) years for nonsmokers. The difference of eight years between the median ages was significant (P < 0.01). CONCLUSION: Smoking may increase the risk of breast cancer after 30 years of smoking.

Observer variation in the Lauge-Hansen classification of ankle fractures. Precision improved by instruction.

We investigated whether instruction can decrease the variation in the classification of ankle fractures. The radiographs of 100 consecutive ankle fractures were twice assessed by 8 observers, using the Lauge-Hansen classification system. 1 group of 4 observers was given special instruction between 2 assessments. Without instruction the interobserver variation was identical at the first and second assessments. After instruction, the agreement increased from 0.66 to 0.75. These results show that the variation in the Lauge-Hansen classification system can be reduced by instruction.

Bricker's ileal conduit urinary diversion with a simple non-refluxing uretero ileal anastomosis.

Fifty consecutive patients had ileal conduits constructed with a technically and quick simple antireflux ureteroileal anastomosis. Complications related to the ureteral implantation were studied retrospectively, and at follow-up (8 months-12 years later, median 3 years) conduit dysfunction and ureteral reflux were assessed in 18 patients out of the 25 patients who were still alive. Early complications and signs of late upper urinary tract deterioration were similar to those found after other operative techniques had been used. One patient had a postoperative urinary leak from the uretero ileal anastomosis. which was treated successfully by two weeks drainage. Hydronephrosis deteriorated in 18 (26%) of the renal units, remained unchanged in 39 (57%) and improved in 11 (16%). Increases in plasma creatinine concentrations up to 200 mumol/l were found in eight patients, and in one patient it increased from 300 to 420 mumol/l. Partial ureteral reflux was present in three (2 patients) of 33 ureters studied and minimal conduit dysfunction was found in 8 patients. In conclusion we find this method of urinary diversion to be quick, easy, and safe.

[Air cysts of the colon]. / Luftcyster i colon.

Air cysts in the colon may cause problems in differential diagnosis. This is illustrated by a case report. The etiology and diagnosis are briefly discussed.

[Results and complications of balloon dilatation of renal artery stenosis in patients with renovascular hypertension]. / Resultater og komplikationer ved ballondilatation af nyrearteriestenoser hos patienter med renovaskulaer hypertension.

During the years 1981 to 1987, 32 patients with renovascular hypertension due to renal artery stenosis were submitted to percutaneous transluminal renal angioplastic (PTRA) in four hospitals in Copenhagen. Nineteen of the interventions were technically successful and six of these patients (32%) no longer required medicine, eight (42%) were able to manage on reduced medication while the circumstances where five were concerned (26%) remained unchanged. Serious complications occurred in 16% and the mortality was 6%. The results of this treatment correspond to those reported elsewhere but the frequency of complications is high. It is concluded that the procedure should be centralized, possibly as a national function.