Follow-up care amongst long-term childhood cancer survivors: a report from the Swiss Childhood Cancer Survivor Study

In the Swiss Childhood Cancer Survivor Study, we aimed to assess the proportion of long-term survivors attending follow-up care, to characterise attendees and to describe the health professionals involved. We sent a questionnaire to 1252 patients, of whom 985 (79%) responded, aged in average 27 years (range 20-49). Overall, 183 (19%) reported regular, 405 (41%) irregular and 394 (40%) no follow-up. For 344, severity of late effects had been classified in a previous medical examination. Only 17% and 32% of survivors with moderate and severe late effects respectively had made regular visits a decade later. Female gender, after a shorter time since diagnosis, had radiotherapy, and having suffered a relapse predicted follow-up. In the past year, 8% had seen a general practitioner only, 10% a paediatric or adult oncologist and 16% other health specialists for a cancer related problem. These findings underline the necessity to implement tailored national follow-up programmes.

Tumor architecture exerts no bias on nuclear grading in breast cancer diagnosis

We recently reported that nuclear grading in prostate cancer is subject to a strong confirmation bias induced by the tumor architecture. We now wondered whether a similar bias governs nuclear grading in breast carcinoma. An unannounced test was performed at a pathology conference. Pathologists were asked to grade nuclei in a PowerPoint presentation. Circular high power fields of 27 invasive ductal carcinomas were shown, superimposed over low power background images of either tubule-rich or tubule-poor carcinomas. We found (a) that diagnostic reproducibility of nuclear grades was poor to moderate (weighed kappa values between 0.07 and 0.54, 27 cases, 44 graders), but (b) that nuclear grades were not affected by the tumor architecture. We speculate that the categorized grading in breast cancer, separating tubule formation, nuclear pleomorphism, and mitotic figure counts in a combined three tier score, prevents the bias that architecture exerts on nuclear grades in less well-controlled situations.

A 4-wk high-fructose diet alters lipid metabolism without affecting insulin sensitivity or ectopic lipids in healthy humans

BACKGROUND: High fructose consumption is suspected to be causally linked to the epidemics of obesity and metabolic disorders. In rodents, fructose leads to insulin resistance and ectopic lipid deposition. In humans, the effects of fructose on insulin sensitivity remain debated, whereas its effect on ectopic lipids has never been investigated. OBJECTIVE: We assessed the effect of moderate fructose supplementation on insulin sensitivity (IS) and ectopic lipids in healthy male volunteers (n = 7). DESIGN: IS, intrahepatocellular lipids (IHCL), and intramyocellular lipids (IMCL) were measured before and after 1 and 4 wk of a high-fructose diet containing 1.5 g fructose . kg body wt(-1) . d(-1). Adipose tissue IS was evaluated from nonesterified fatty acid suppression, hepatic IS from suppression of hepatic glucose output (6,6-2H2-glucose), and muscle IS from the whole-body glucose disposal rate during a 2-step hyperinsulinemic euglycemic clamp. IHCL and IMCL were measured by 1H magnetic resonance spectroscopy. RESULTS: Fructose caused significant (P < 0.05) increases in fasting plasma concentrations of triacylglycerol (36%), VLDL-triacylglycerol (72%), lactate (49%), glucose (5.5%), and leptin (48%) without any significant changes in body weight, IHCL, IMCL, or IS. IHCL were negatively correlated with triacylglycerol after 4 wk of the high-fructose diet (r = -0.78, P < 0.05). CONCLUSION: Moderate fructose supplementation over 4 wk increases plasma triacylglycerol and glucose concentrations without causing ectopic lipid deposition or insulin resistance in healthy humans.

Cathepsins: key modulators of cell death and inflammatory responses

Apoptosis is a key mechanism in the build up and maintenance of both innate and adaptive immunity as well as in the regulation of cellular homeostasis in almost every organ and tissue. Central to the apoptotic process is a family of intracellular cysteine proteases with aspartate-specificity, called caspases. Nevertheless, there is growing evidence that other non-caspase proteases, in particular lysosomal cathepsins, can play an important role in the regulation of apoptosis. In this review, the players and the molecular mechanisms involved in the lysosomal apoptotic pathways will be discussed as well as the importance of these pathways in the immune system and the pathogenesis of diseases.

Effect of segmented anodes on the performance and plume of a hall thruster

Development of alternative propellants for Hall thruster operation is an active area of research. Xenon is the current propellant of choice for Hall thrusters, but can be costly in large thrusters and for extended test periods. Condensible propellants may offer an alternative to xenon, as they will not require costly active pumping to remove from a test facility, and may be less expensive to purchase. A method has been developed which uses segmented electrodes in the discharge channel of a Hall thruster to divert discharge current to and from the main anode and thus control the anode temperature. By placing a propellant reservoir in the anode, the evaporation rate, and hence, mass flow of propellant can be controlled. Segmented electrodes for thermal control of a Hall thruster represent a unique strategy of thruster design, and thus the performance of the thruster must be measured to determine the effect the electrodes have on the thruster. Furthermore, the source of any changes in thruster performance due to the adjustment of discharge current between the shims and the main anode must be characterized. A Hall thruster was designed and constructed with segmented electrodes. It was then tested at anode voltages between 300 and 400 V and mass flows between 4 and 6 mg/s, as well as 100%, 75%, 50%, 25%, and <5% of the discharge current on the shim electrodes. The level of current on the shims was adjusted by changing the shim voltage. At each operating point, the thruster performance, plume divergence, ion energy, and multiply charged ion fraction were measured performance exhibited a small change with the level of discharge current on the shim electrodes. Thrust and specific impulse increased by as much as 6% and 7.7%, respectively, as discharge current was shifted from the main anode to the shims at constant anode voltage. Thruster efficiency did not change. Plume divergence was reduced by approximately 4 degrees of half-angle at high levels of current on the shims and at all combinations of mass flow and anode voltage. The fraction of singly charged xenon in the thruster plume varied between approximately 80% and 95% as the anode voltage and mass flow were changed, but did not show a significant change with shim current. Doubly and triply charged xenon made up the remainder of the ions detected. Ion energy exhibited a mixed behavior. The highest voltage present in the thruster largely dictated the most probable energy; either shim or anode voltage, depending on which was higher. The overall change in most probable ion energy was 20-30 eV, the majority of which took place while the shim voltage was higher than the anode voltage. The thrust, specific impulse, plume divergence, and ion energy all indicate that the thruster is capable of a higher performance output at high levels of discharge current on the shims. The lack of a change in efficiency and fraction of multiply charged ions indicate that the thruster can be operated at any level of current on the shims without detrimental effect, and thus a condensible propellant thruster can control the anode temperature without a decrease in efficiency or a change in the multiply charged ion fraction.

[Epidemiology of osteoporotic fractures in Switzerland]

Fractures occurring after 50 years of age are among the leading causes of hospitalizations in Switzerland. At the age of 50 years, in Switzerland, the remaining lifetime probability of suffering an osteoporotic fracture is 51% and 20% for women and men, respectively, i.e. every other woman and every fifth man. According to the demographic projection scenarios, the number of elderly aged 65 years or more will have doubled by year 2050. In the absence of targeted interventions, the considerable human, social, and economic burden represented by osteoporotic fractures should increase by the same order of magnitude. With FRAX (fracture risk assessment tool), validated for Switzerland in tight collaboration with the World Heath Organization, the individual probability of fracture during the next 10 years can be predicted.

A Mineral Dressing Study of the Benefication of Philipsburg Manganese Carbonate Ore

The beneficiation of rhodochrosite ore to the extent that it is suitable for nodulizing and subsequent use in the steel industry is intriguing. Such ores from certain mines is relatively easy to beneficiate, but the rhodo-chrosite ore from several deposits of the Philipsburg district has never been successfully up-graded by any of the several known beneficiating methods.

Surgical capping of superior semicircular canal dehiscence

Surgical plugging and resurfacing are well established treatments of superior semicircular canal dehiscence, while capping with hydroxyapatite cement has been little discussed in literature. The aim of this study was to prove the efficacy of the capping technique. Charts of patients diagnosed with superior semicircular canal dehiscence were reviewed retrospectively. All patients answered the dizziness handicap inventory, a survey analyzing the impact of their symptoms on their quality of life. Capping of the dehiscent canal was performed via the middle fossa approach in all cases. Ten out of 22 patients diagnosed with superior semicircular canal dehiscence were treated with surgical capping, nine of which were included in this study. No major perioperative complications occurred. In 8 out of 9 (89 %) patients, capping led to a satisfying reduction of the main symptoms. One patient underwent revision surgery 1 year after the initial intervention. Scores in the dizziness handicap inventory were lower in the surgically treated group than in the non-surgically treated group, but results were not statistically significant (P = 0.45). Overall, capping is a safe and efficient alternative to plugging and resurfacing of superior semicircular canal dehiscence.