Attitudes to the use of animals in biomedical research: Effects of stigma and selected research project summaries

Three groups of participants (largely recruited from the UK) completed a survey to examine attitudes to the use of animals in biomedical research, after reading the lay (N = 182) or technical (N = 201) summary of a research project, or no summary (N = 215). They then completed a survey comprising the animal attitude (AAS), animal purpose (APQ), belief in animal mind (BAM) and empathy quotient (EQ) scales. The APQ was adapted to assess attitudes towards the use of animals for research into disorders selected to be perceived as controllable and so 'blameworthy' and potentially stigmatised (addiction and obesity) and 'psychological' (schizophrenia and addiction) versus 'physical' (cardiovascular disease and obesity), across selected species (rats, mice, fish pigs and monkeys). Thus, the APQ was used to examine how the effects of perceived controllability and the nature of the disorder affected attitudes to animal use, in different species and in the three summary groups. As expected, attitudes to animal use as measured by the AAS and the APQ (total) correlated positively with BAM and EQ scores, consistent with the assumption that the scales all measured pro-welfare attitudes. Participants in the two research summary groups did not differentiate the use of rats, mice and fish (or fish and pigs in the technical summary group), whereas all species were differentiated in the no summary group. Participants given the lay summary were as concerned about the use of animals for schizophrenia as for addiction research. APQ ratings otherwise indicated more concern for animals used for addiction research (and for obesity compared to cardiovascular disease in all summary groups). Therefore, the information provided by a research project summary influenced attitudes to use of animals in biomedical research. However, there was no overall increase in agreement with animal use in either of the summary groups.

Development of 'gastrostomy tube - is it for me?', a web-based patient decision aid for people living with motor neurone disease considering having a gastrostomy tube placed

Objective: To develop and pilot a web-based patient decision aid (PDA) to support people living with motor neurone disease (plwMND) considering having a gastrostomy tube placed. Methods: In Phase 1, content and design were informed by semi-structured interviews, literature reviews and a prioritization survey. In Phase 2, the prototype PDA was tested with users and developed iteratively with feedback from surveys and 'think-aloud' interviews. Phase 1 and 2 participants were plwMND, carers and healthcare professionals (HCPs). In Phase 3, the PDA was evaluated by plwMND using validated questionnaires and HCPs provided feedback in focus groups. Results: Sixteen plwMND, 16 carers and 25 HCPs took part in Phases 1 and 2. Interviews and the literature review informed a prioritization survey with 82 content items. Seventy-seven per cent (63/82) of the content of the PDA was retained. A prototype PDA, which conforms to international standards, was produced and improved during Phase 2. In Phase 3, 17 plwMND completed questionnaires after using the PDA. Most plwMND (94%) found the PDA completely acceptable and would recommend it to others in their position, 88% had no decisional conflict, 82% were well prepared and 100% were satisfied with their decision-making. Seventeen HCPs provided positive feedback and suggestions for use in clinical practice. Conclusion: Gastrostomy Tube: Is it for me? was co-produced with stakeholders and found to be acceptable, practical and useful. Freely available from the MND Association website, the PDA is a valuable tool to support the shared decision-making process for gastrostomy tube placement.

From safety to frustration: The neural substrates of inhibitory learning in aversive and appetitive conditioning procedures

Inhibitory associative learning counters the effects of excitatory learning, whether appetitively or aversively motivated. Moreover, the affective responses accompanying the inhibitory associations are of opponent valence to the excitatory conditioned responses. Inhibitors for negative aversive outcomes (e.g. shock) signal safety, while inhibitors for appetitive outcomes (e.g. food reward) elicit frustration and/or disappointment. This raises the question as to whether studies using appetitive and aversive conditioning procedures should demonstrate the same neural substrates for inhibitory learning. We review the neural substrates of appetitive and aversive inhibitory learning as measured in different procedural variants and in the context of the underpinning excitatory conditioning on which it depends. The mesocorticolimbic dopamine pathways, retrosplenial cortex and hippocampus are consistently implicated in inhibitory learning. Further neural substrates identified in some procedural variants may be related to the specific motivation of the learning task and modalities of the learning cues. Finally, we consider the translational implications of our understanding of the neural substrates of inhibitory learning, for obesity and addictions as well as for anxiety disorders.

Timed exercise stabilizes behavioral rhythms but not molecular programs in the brain's suprachiasmatic clock

Timed daily access to a running-wheel (scheduled voluntary exercise; SVE) synchronizes rodent circadian rhythms and promotes stable, 24h rhythms in animals with genetically targeted impairment of neuropeptide signaling (Vipr2 ^-/- mice). Here we used RNA-seq and/or qRT-PCR to assess how this neuropeptide signaling impairment as well as SVE shapes molecular programs in the brain clock (suprachiasmatic nuclei; SCN) and peripheral tissues (liver and lung). Compared to Vipr2 ^+/+ animals, the SCN transcriptome of Vipr2 ^-/- mice showed extensive dysregulation which included core clock components, transcription factors, and neurochemicals. Furthermore, although SVE stabilized behavioral rhythms in these animals, the SCN transcriptome remained dysregulated. The molecular programs in the lung and liver of Vipr2 ^-/- mice were partially intact, although their response to SVE differed to that of these peripheral tissues in the Vipr2 ^+/+ mice. These findings highlight that SVE can correct behavioral abnormalities in circadian rhythms without causing large scale alterations to the SCN transcriptome.

Loss of Function of the Neural Cell Adhesion Molecule NrCAM Regulates Differentiation, Proliferation and Neurogenesis in Early Postnatal Hypothalamic Tanycytes

Hypothalamic tanycytes are neural stem and progenitor cells, but little is known of how they are regulated. Here we provide evidence that the cell adhesion molecule, NrCAM, regulates tanycytes in the adult niche. NrCAM is strongly expressed in adult mouse tanycytes. Immunohistochemical and in situ hybridization analysis revealed that NrCAM loss of function leads to both a reduced number of tanycytes and reduced expression of tanycyte-specific cell markers, along with a small reduction in tyrosine hydroxylase-positive arcuate neurons. Similar analyses of NrCAM mutants at E16 identify few changes in gene expression or cell composition, indicating that NrCAM regulates tanycytes, rather than early embryonic hypothalamic development. Neurosphere and organotypic assays support the idea that NrCAM governs cellular homeostasis. Single-cell RNA sequencing (scRNA-Seq) shows that tanycyte-specific genes, including a number that are implicated in thyroid hormone metabolism, show reduced expression in the mutant mouse. However, the mild tanycyte depletion and loss of markers observed in NrCAM-deficient mice were associated with only a subtle metabolic phenotype.

Clinical Features, Imaging Characteristics, and Long-term Outcome of Dogs with Cranial Meningocele or Meningoencephalocele

Background

The term meningoencephalocele (MEC) describes a herniation of cerebral tissue and meninges through a defect in the cranium, whereas a meningocele (MC) is a herniation of the meninges alone.

Hypothesis/Objectives

To describe the clinical features, magnetic resonance imaging (MRI) characteristics, and outcomes of dogs with cranial MC and MEC.

Animals

Twenty‐two client‐owned dogs diagnosed with cranial MC or MEC.

Methods

Multicentric retrospective descriptive study. Clinical records of 13 institutions were reviewed. Signalment, clinical history, neurologic findings and MRI characteristics as well as treatment and outcome were recorded and evaluated.

Results

Most affected dogs were presented at a young age (median, 6.5 months; range, 1 month – 8 years). The most common presenting complaints were seizures and behavioral abnormalities. Intranasal MEC was more common than parietal MC. Magnetic resonance imaging identified meningeal enhancement of the protruded tissue in 77% of the cases. Porencephaly was seen in all cases with parietal MC. Cerebrospinal fluid (CSF) analysis identified mild abnormalities in 4 of 11 cases. Surgery was not performed in any affected dog. Seventeen patients were treated medically, and seizures were adequately controlled with anti‐epileptic drugs in 10 dogs. Dogs with intranasal MEC and mild neurologic signs had a fair prognosis with medical treatment.

Conclusion and clinical importance

Although uncommon, MC and MEC should be considered as a differential diagnosis in young dogs presenting with seizures or alterations in behavior. Medical treatment is a valid option with a fair prognosis when the neurologic signs are mild.

A pulse-front-tilt-compensated streaked optical spectrometer with high throughput and picosecond time resolution

A high-throughput, broadband optical spectrometer coupled to the Rochester optical streak system equipped with a Photonis P820 streak tube was designed to record time-resolved spectra with 1-ps time resolution. Spectral resolution of 0.8 nm is achieved over a wavelength coverage range of 480 to 580 nm, using a 300-groove/mm diffraction grating in conjunction with a pair of 225-mm-focal-length doublets operating at an f/2.9 aperture. Overall pulse-front tilt across the beam diameter generated by the diffraction grating is reduced by preferentially delaying discrete segments of the collimated input beam using a 34-element reflective echelon optic. The introduced delay temporally aligns the beam segments and the net pulse-front tilt is limited to the accumulation across an individual sub-element. The resulting spectrometer design balances resolving power and pulse-front tilt while maintaining high throughput.

The Physical Properties of a Hyaluronic Acid Based Bioresorbable Membrane for the Prevention of postsurgical Adhesions

We have evaluated the physical properties and animal efficacy of a hyaluronic acid (HA) based bioresorbable membrane for the prevention of post-surgical adhesions. Test methods were developed to measure the dry and wet tensile properties and ia Xilm tissue adhesiveness of the membranes. The thin membranes were found to have sufficient strength and flexibility in the dry state for surgical handling. When hydrated in buffered saline, the membranes became weaker and more elastic. The membranes exhibited a high degree of tissue adhesiveness and significantly reduced adhesion formation in a rat cecal abrasion model.

Genetic population structure of an anchialine shrimp, Metabetaeus lohena (Crustacea: Alpheidae), in the Hawaiian Islands

Anchialine habitats in the Hawaiian Islands, characterized as coastal bodies of land-locked salt or brackish water that fluctuate with the tides due to subterranean connections, are the only ecosystems of this type found within the United States. These habitats are currently subject to anthropogenic impacts that threaten their future existence. Previous research has shown strong genetic population structure of an endemic atyid shrimp, Halocaridina rubra, in these habitats. The native alpheid shrimp, Metabetaeus lohena, whose known range entirely overlaps that of H. rubra, has feeding and reproductive behaviors that are biologically distinct from H. rubra. Its historic scarcity and status as a candidate for the US Fish and Wildlife Department's Endangered Species List, make M. lohena an ideal species to compare against the known genetic structure of H. rubra. We investigated the population structure of this native anchialine shrimp to test the hypothesis that genetic population structure differs between the two shrimp species and that M. lohena is genetically unstructured across its range. A survey of 605 bp of the mitochondrial cytochrome c oxidase subunit I (COI) gene from 127 individuals collected at 7 sites spanning the islands of O'ahu, Maui and Hawaii revealed 43 haplotypes. The most common haplotype was represented in similar proportions from all sites sampled, accounting for 44% of the surveyed sequences. Analyses of molecular variation (AMOVA), pairwise PhiST values, Bayesian estimates of migration (M), Mantel tests and Nested Clade Analyses (NCAs) all failed to reveal evidence of major barriers to gene flow among most populations separated by inter-island channels. This lack of genetic structure in M. lohena is found to be in stark contrast with the highly structured population of H. rubra, and may be attributed to oceanic dispersal strategies and/or a recent introduction to the Hawaiian Islands.

Conservation implications of hybridization in Hawaiian picture-winged Drosophila

In this review, we discuss the importance of hybridization among species for the conservation of Hawaiian picture-winged Drosophila. Hybridization can be a positive evolutionary process that creates new species and increases the adaptation of populations and species through the spread of adaptive alleles and traits. Conversely, hybridization can disrupt the genetic integrity of species or populations and this may be most detrimental among taxa that are recently hybridizing due to recent ecological changes. The loss of biodiversity in Hawaiian Drosophila through hybridization may be facilitated by habitat alteration and introduced species that reduce population sizes and alter geographic distributions of native species. We briefly review the evidence for hybridization in the genus Drosophila and then focus on hybridization in the Hawaiian picture-winged Drosophila. We examine three general approaches for identifying hybrids and for assessing the factors that appear to contribute to hybridization and the potential ecological and evolutionary outcomes of hybrids in natural populations. Overall, the potential for hybridization among species will likely increase the risk of extinction for Hawaiian picture-winged Drosophila species. Thus, it is important to consider the potential for hybridization among species when developing plans for the conservation of Hawaiian Drosophila.

Involvement of noradrenergic and corticoid receptors in the consolidation of the lasting anxiogenic effects of predator stress

The roles of beta-NER (beta-noradrenergic receptor), GR (glucocorticoid) and mineral corticoid receptors (MR) in the consolidation of anxiogenic effects of predator stress were studied. One minute after predator stress, different groups of rats were injected (ip) with vehicle, propranolol (beta-NER blocker, 5 and 10 mg/kg), mifepristone (RU486, GR blocker, 20 mg/kg), spironolactone (MR blocker, 50 mg/kg), propranolol (5 mg/kg) plus RU486 (20 mg/kg) or the anxiolytic, chloradiazepoxide (CPZ, 10 mg/kg). One week later, rodent anxiety was assessed in elevated plus maze, hole board, light/dark box, social interaction and acoustic startle. Considering all tests except startle, propranolol dose dependently blocked consolidation of lasting anxiogenic effects of predator stress in all tests. GR receptor block alone was ineffective. However, GR block in combination with an ineffective dose of propranolol did blocked consolidation of predator stress effects in all tests, suggesting a synergism between beta-NER and GR. Surprisingly, MR block prevented consolidation of anxiogenic effects in all tests except the light/dark box. CPZ post stress was ineffective against the anxiogenic impact of predator stress. Study of startle was complicated by the fact that anxiogenic effects of stress on startle amplitude manifested as both an increase and a decrease in startle amplitude. Suppression of startle occurred in stressed plus vehicle injected groups handled three times prior to predator stress. In contrast, stressed plus vehicle rats handled five times prior to predator stress showed increases in startle, as did all predator stressed only groups. Mechanisms of consolidation of the different startle responses appear to differ. CPZ post stress blocked startle suppression but not enhancement of startle. Propranolol post stress had no effect on either suppression or enhancement of startle. GR block alone post stress prevented suppression of startle, but not enhancement. In contrast blocking GR and beta-NER together prevented startle enhancement. MR block also prevented startle enhancement. Effects of MR block on startle suppression were not tested. Delay of habituation to startle was found in all stressed rats. Consolidation of delay of habituation was blocked or attenuated by post stress MR block, GR plus beta-NER block and CPZ but not by post stress GR or beta-NER block alone. Taken together, present findings suggest consolidation of lasting anxiogenic effects of predator stress may share some of the same neurochemical mechanisms implicated in some forms of fear memory consolidation. Implications of these findings for the study of stress-induced changes in affect including posttraumatic stress disorder (PTSD) are discussed.

Enzymeimmunoassay of oestradiol, testosterone and progesterone in urine samples from female mice before and after insemination

ELISA measurements of 17beta-oestradiol, testosterone and progesterone were determined for urine samples collected non-invasively from female mice. Initial samples were collected during 5 successive days while mature female mice were isolated and cyclic. Subsequently, female mice were inseminated and additional urine samples were collected during days 2-6 after observation of copulatory plugs. Measurements of oestradiol and testosterone showed variance over days within individuals and did not significantly differ in measurements taken before or after insemination. Progesterone concentrations were significantly higher after insemination compared with before mating. In a second sample of inseminated females, urinary progesterone was measured during days 2-18 of pregnancy. Most females showed high urinary progesterone up to day 10 of pregnancy and lower concentrations during the remainder of gestation. These results indicate that urinary progesterone reflects established systemic increases of this hormone during pregnancy.

Enzymeimmunoassay of oestradiol, testosterone and progesterone in urine samples from female mice before and after insemination

ELISA measurements of 17beta-oestradiol, testosterone and progesterone were determined for urine samples collected non-invasively from female mice. Initial samples were collected during 5 successive days while mature female mice were isolated and cyclic. Subsequently, female mice were inseminated and additional urine samples were collected during days 2-6 after observation of copulatory plugs. Measurements of oestradiol and testosterone showed variance over days within individuals and did not significantly differ in measurements taken before or after insemination. Progesterone concentrations were significantly higher after insemination compared with before mating. In a second sample of inseminated females, urinary progesterone was measured during days 2-18 of pregnancy. Most females showed high urinary progesterone up to day 10 of pregnancy and lower concentrations during the remainder of gestation. These results indicate that urinary progesterone reflects established systemic increases of this hormone during pregnancy.

Enzyme immunoassay of 17 beta-estradiol, estrone conjugates, and testosterone in urinary and fecal samples from male and female mice

ELISA measures of 17 beta-estradiol, estrone conjugates, and testosterone were adapted for fecal and urinary samples from laboratory mice. We will report on validations of these assays and data from interacting males and females. Unconjugated gonadal steroids were consistently measurable in urine and feces of both males and females. Females that were parturient following insemination excreted relatively low levels of urinary testosterone compared to non-parturient females. The results are consistent with evidence that elevated androgens and estrogens are incompatible with intrauterine implantation of fertilized ova, and suggest that steroids in male urine could contribute to pheromonal action. These methods permit repeated noninvasive measurement of steroid activity in this species.

Maximizing the benefit--minimizing the risk: the developing role of radiographers in performing intravenous injections

Performance of intravenous (iv) injections as part of radiographer role development has become fundamental to the operational management of diagnostic imaging departments in the UK. Through discussion of appropriate areas, this review aims to highlight current issues pertaining to iv injection. More importantly, the framework described could be transposed to other existing or future areas of role development. Within a validated system of delegation, utilization of radiographers' skills in an expanded role improves allocation of resources and may increase radiographer motivation and provide career enhancement. Professional body accreditation as well as civil and employment law provide clear guidelines on medicolegal implications, valid consent and accountability. Implementation of an iv administration policy, based on Royal College of Radiologists guidelines, includes proper delegation of duties and safe administration of substances. This should help ensure acceptance of vicarious liability by an employer. Failure to adhere to these established guidelines could leave employers and radiographers vulnerable to medicolegal action. Furthermore, evaluation of radiographer performance, facilitated by clinical governance and departmental audits, should ensure effective and safe practice whilst minimizing associated risks. Evidence-based radiography will provide the necessary drive for future changes in practice as well as further expansion of the radiographer's role.

Concurrent paclitaxel and radiation in the treatment of locally advanced head and neck cancer

PURPOSE

To determine the feasibility of an organ preservation regimen consisting of infusional paclitaxel administered concurrently with radiotherapy to patients with locally advanced head and neck squamous cell carcinoma (HNSCC).

PATIENTS AND METHODS

Thirty-three previously untreated patients with stage III or IV tumors were enrolled onto the study. Paclitaxel was administered as a 120-hour continuous infusion every 3 weeks during the course of radiation therapy. Sixteen patients received a paclitaxel dose of 105 mg/m(2), and 17 patients received 120 mg/m(2). Radiation was delivered in a standard format at 1.8 Gy/d to a total dose of 70.2 to 72 Gy.

RESULTS

Three months after therapy, a 76% complete response (CR) at the primary site and a 70% overall CR was achieved. At 36 months, locoregional control was 55.7%, overall survival was 57.8%, and disease-free survival was 51.1%. The median survival duration for all 33 patients was greater than 50 months at the time of this report. Local toxicities including mucositis, dysphagia, and skin reactions were severe but tolerable. All patients retained functional speech, and all but four patients were swallowing food 3 months after treatment. Steady-state plasma concentrations for paclitaxel were not achieved during a 120-hour infusion, suggesting a nonlinear process. Tumor volume quantified by pretreatment computerized tomography imaging was associated with likelihood of response and survival.

CONCLUSION

Paclitaxel administered as a 120-hour continuous infusion in combination with radiotherapy is a feasible and promising treatment for patients with advanced HNSCC.

NCCN Practice Guidelines for Cancer Pain

The overall approach to pain management encompassed in these guidelines is comprehensive. It is based on objective pain assessments, utilizes both pharmacologic and nonpharmacologic interventions, and requires continual reevaluation of the patient. The NCCN Cancer Pain Practice Guidelines Panel believes that cancer pain can be well controlled in the vast majority of patients if the algorithms presented are systematically applied, carefully monitored, and tailored to the needs of the individual patient.

Novel male mice disrupt pregnancy despite removal of vesicular-coagulating and preputial glands

Exposure to novel males can disrupt intrauterine implantation of fertilized ova in inseminated female mice, an effect established to involve androgen-dependent male excretions. These experiments were designed to examine potential roles of vesicular and coagulating glands, independently or in conjunction with preputial glands. Inseminated females were randomly assigned to conditions of housing below (1) no males; (2) males with vesicular-coagulating gland removal; (3) males with preputial, vesicular, and coagulating gland removal; or (4) males subjected to sham surgery. Males with accessory glands removed disrupted pregnancy to the same extent as did sham-operated males. Long-term testosterone replacement permitted pregnancy disruption in castrated males with vesicular-coagulating and preputial glands removed. Fertility was not disrupted by preputialectomy, but half of the males without vesicular-coagulating glands could not inseminate females. We suggest that males' capacity to disrupt pregnancy could derive from androgen metabolism that is independent of actions on major accessory glands.

Pheromones and novel male-induced pregnancy disruptions in mice: exposure to conspecifics is necessary for urine alone to induce an effect

Previous research indicates a role of pheromones in novel male-induced early pregnancy disruptions. Although some reports suggest that urine alone is sufficient to produce this effect, others raise procedural concerns and fail to replicate such effects. On Days 1 to 5 after insemination, female CF-1 mice had their nasal regions repeatedly painted with water, urine from males housed in isolation, or urine from males housed in proximity to females. Almost all (87.5%) of the control females delivered litters. There was a small nonsignificant reduction in proportion parturient (78.5%) among females exposed to urine of males housed without social contact. The proportion of females parturient (57.1%) after treatment with urine from males housed in proximity to females was significantly different from controls. The magnitude of the effect of socially stimulated male urine is substantially less than that recorded when males are housed directly above inseminated females separated by a wire-mesh grid. These data suggest that production of pregnancy-disrupting male pheromones is stimulated by contact with conspecifics.

A novel nanospray capillary zone electrophoresis/mass spectrometry interface

The high resolution of capillary zone electrophoresis/mass spectrometry (CZE/MS) offers a promising technique to characterize biomolecules in pharmaceutical and biotechnology industries. A novel capillary zone electrophoresis/electrospray ionization time-of-flight mass spectrometry (CZE/ESI-TOFMS) interface was designed in this study to successfully integrate ESI-TOFMS, nanospray, and CZE for biomolecular identification. The interface offers a novel way to take advantage of the high resolution separation achieved during CZE and the detection sensitivity of nanospray ESI-MS. The results showed mixtures of peptides were highly resolved within a few minutes (each CZE electropherogram of a peptide is 2-3 seconds). The novel CZE/ESI-TOFMS interface may simultaneously provide sensitivity, data acquisition speed, mass range, and mass resolution while maintaining resolution of the CZE separation.

Differential sexual activity of isolated and group-housed male mice: lack of substantial influence of acute or chronic naloxone administration

Influences of naloxone upon male sexual behavior were examined using two different baseline activity levels: individually and group-housed mice. In Experiment 1, single injections of 0,12.5, or 50 micrograms per animal were administered before testing. Isolated mice showed more sexual activity than did grouped mice; naloxone failed to alter those differences. In Experiment 2, a similar result was obtained despite administration of 50 or 150 micrograms per animal of naloxone. In Experiment 3,0 or 50 micrograms of naloxone was administered to isolated or grouped males daily on the 5 days before testing. Isolated mice showed performance superior to that of grouped mice, but there was no effect of the drug. In Experiment 4, doses of 0. 12.5, or 50 micrograms of naloxone were given to isolated or grouped males twice daily for 7 days prior to testing, producing little effect. These results suggest that the influences of prior social condition on male sexual activity are robust in the face of naloxone administration.

Cancer in older persons in Scotland

BACKGROUND

The average age in many populations in increasing. As the risk of most epithelial cancers increases with age, numbers of people with cancer can also be expected to grow.

METHODS

Incidence data from the Scottish Cancer Registry for the period 1981-1990 were used to examine the size of the cancer burden in those aged 75 years and over. The future burden of cancer in Scotland was estimated by applying current age specific rates to population projections. Cancer survival in older cancer patients in Scotland was examined and comparisons made with other selected countries. The place of treatment of people under and over 75 in Scotland was investigated.

RESULTS

Approximately 30% of the total cancer burden in Scotland and other countries occurs in the elderly. The total number of incident cases in Scotland in those aged 75 and over is estimated to rise by approximately 60% in males and 20% in females by 2029. A decline in survival is seen with increasing age. Older people with cancer in Scotland are less likely to be treated outwit their area of residence and are more likely to be admitted to institutions which admit small numbers of patients.

CONCLUSIONS

Cancer in older persons contributes a significant proportion of the overall cancer burden. The burden of cancer in the elderly is likely to grow. More work needs to be done characterising cancer and its treatment in older persons.

Disruption of early pregnancy by direct and indirect exposure to novel males in mice: comparison of influences of preputialectomized and intact males

Inseminated female CF-1 mice (Mus musculus) were exposed on days 1 to 5 of pregnancy to unfamiliar outbred males. In the first experiment, inseminated females were each housed directly with the sire, a preputialectomized male, or an intact male. Both types of novel male attempted to mate with the female during this period, unlike the sire. Reinsemination occurred in a significant proportion of the females that were exposed to novel males; this effect was equivalent for preputialectomized and intact males. In two subsequent experiments, we refined a paradigm of indirect exposure to novel males through a wire-mesh grid, which prevents mating and reinsemination. Two or three males housed directly above each female through a grid disrupt pregnancy in most cases, but housing the males below the females is much less likely to do so. In a final experiment, each inseminated female was housed below two males that were either preputialectomized or sham-preputialectomized. Whereas 29 of 33 undisturbed controls were parturient, only eight of 32 females exposed to sham-preputialectomized males and six of 32 exposed to preputialectomized males were parturient. These results suggest that nonvolatile pheromones are involved in novel-male-induced pregnancy disruptions, but that preputial gland emissions are not necessary for such disruptions.

Identification and expression cloning of a leptin receptor, OB-R

The ob gene product, leptin, is an important circulating signal for the regulation of body weight. To identify high affinity leptin-binding sites, we generated a series of leptin-alkaline phosphatase (AP) fusion proteins as well as [125I]leptin. After a binding survey of cell lines and tissues, we identified leptin-binding sites in the mouse choroid plexus. A cDNA expression library was prepared from mouse choroid plexus and screened with a leptin-AP fusion protein to identify a leptin receptor (OB-R). OB-R is a single membrane-spanning receptor most related to the gp130 signal-transducing component of the IL-6 receptor, the G-CSF receptor, and the LIF receptor. OB-R mRNA is expressed not only in choroid plexus, but also in several other tissues, including hypothalamus. Genetic mapping of the gene encoding OB-R shows that it is within the 5.1 cM interval of mouse chromosome 4 that contains the db locus.

Estimating avoidable causes of cancer

Evidence that much cancer is preventable derives from observations of time trends and geographic patterns of cancer, birth cohort changes, high risks in groups with well-defined exposures, and experimental studies. In an effort to identify additional opportunities for reducing the impact of cancer on society, this conference assessed avoidable causes of cancer. The magnitude and extent of preventable causes of cancer are subjects of intense debate, with discrepancies often related to the use of different time frames and different weights for epidemiologic and toxicologic evidence. There is much agreement, however, about the exposures that increase risk, notably tobacco, alcohol, diet, radiation, medications, occupational exposures, general environmental exposures, and infectious agents. Interactions between carcinogenic exposures and genetic susceptibility are also important. Concerted efforts are needed to identify avoidable causes of cancer and to apply knowledge already obtained to reduce the cancer burden.

Registration of non-melanoma skin cancers in Scotland--how accurate are site and morphology codes?

Although under-reporting of non-melanoma skin cancers to cancer registries is widely acknowledged, less is known about the accuracy of information held about registered cases. In 1993, the accuracy of a random sample of cancer registrations in Scotland attributed to the year 1990 was assessed by reference to relevant medical records. The sample contained 290 registrations of non-melanoma skin cancers, 251 (90%) of which had records available for scrutiny. Here we report the results of a detailed analysis of the accuracy of site and morphology coding of non-melanoma skin cancers. Following reabstraction of details from available medical records, only three cases (1.2%) did not retain the same first three digit ICD-9 site code (173.--), although a further three cases were judged to have been registered in error. There were 56 (21.5%) discrepancies in morphology coding, but 21 of these arose through inferences about morphology in the absence of microscopic confirmation, and most of the remainder were of a relatively minor nature. In summary, it does seem possible to collect data about non-melanoma skin cancers to a reasonably high standard of accuracy. This provides some justification to those who advocate an increased effort directed towards improving levels of completeness of case ascertainment.

Strange-male-induced pregnancy disruption in mice: potentiation by administration of 17 beta-estradiol to castrated males

Previous evidence suggests that androgen activity is necessary for strange males to disrupt early pregnancy in mice. Inseminated females were housed below castrated males, separated by a wire-mesh grid. Castrated males did not disrupt pregnancy, whereas those given daily injections of 27 or 81 micrograms of 17 beta-estradiol did so. In conjunction with previous evidence, these data suggest a similarity between the hormones involved in the capacity of males to disrupt pregnancy and the hormones directly implicated in the females' vulnerability to pregnancy disruption.

Strange-male-induced pregnancy disruption in mice: reduction of vulnerability by 17 beta-estradiol antibodies

It is well-established that novel males can disrupt early pregnancy in house mice. Inseminated female C57BL mice were either left undisturbed or each exposed indirectly to a novel HS male through a wire-mesh grid during days 1-6 of pregnancy. Varied dosages of antibodies to 17 beta-estradiol were administered to females exposed to males. Vehicle-treated females exposed to novel males showed fewer litters than did nonexposed controls. Male-exposed females given 1 ml daily of the antibody showed rates of pregnancy comparable to those observed in controls. These data suggest that estrogen levels might play a role in strange-male-induced pregnancy disruptions, converging with evidence implicating estrogens in stress-induced pregnancy blocks.

Registration of lung cancer in Scotland: an assessment of data accuracy based on review of medical records

Lung cancer represents a major public health problem in Scotland. Cancer registration data permit the approximate incidence of this disease to be measured directly and the projected incidence to be modelled. Thus, in addition to epidemiologic studies and survival analyses, cancer registration data may be used for planning and monitoring relevant health services. Since the value of the data depends on their quality, we undertook a large-scale study of the accuracy of cancer registration data in Scotland. The medical records of a random sample of cancer registrations attributed to the year 1990 were sought. The sample contained 340 registrations of lung cancer, 309 (91 percent) of which had relevant medical records available for scrutiny. Registration details were reabstracted from available records and compared with data in the registry. Results revealed 19 discrepancies in identifying items of data (surname, forename, gender, and date of birth) involving 16 (5.2 percent) patients. Most were trivial and would not disturb record linkage. Discrepancy rates were found to be: 7.8 percent in postcode of residence at the time of diagnosis, 10 percent in 'anniversary date' (excluding differences of six weeks or less), 12.5 percent in histologic verification status; 4.2 percent in ICD-9 site code (the first three digits), and 15.5 percent in four digit ICD-O morphology code (excluding 'inferred' morphology codes). This relatively high level of accuracy gives weight to routinely published incidence figures and supports the use of these data for exploratory epidemiologic studies, assessment of health care needs, and calculation of survival.

Registration of colorectal cancer in Scotland: an assessment of data accuracy based on review of medical records

Colorectal cancer accounts for a substantial burden of morbidity and mortality in the population. While the need for reliable incidence data may be self-evident, the quality of cancer registration data has rarely been assessed. In Scotland during 1993, the medical records of a random sample of cancer registrations attributed to the year 1990 were sought. The sample contained 238 registrations of colorectal cancer, 217 (91%) of which had relevant medical records available for review. Registration details were reabstracted from available records and compared with data in the registry. Discrepancies in identifying items of data (surname, forename, sex and date of birth) were recorded in eight cases (3.7%, 95% confidence intervals 1.2-6.2%). None would have disturbed record linkage. Discrepancy rates of 3.7% (1.2-6.3%) in postcode of residence at the time of diagnosis (excluding differences arising through boundary changes), 8.3% (4.6-12.0%) in 'anniversary date' (excluding differences of 30 days or less), 2.8% (0.6-5.0%) in histological verification status and 13.5% (8.9-18.1%) in morphology code (excluding 'inferred' morphology codes) were recorded. Twelve cases (5.5%, 2.5-8.6%) were deemed not to warrant site codes for cancer of the colon (ICD-9 153) or rectum (ICD-9 154). In many respects, therefore, the data held about registrations of colorectal cancer in Scotland appear to show a high level of accuracy. Completeness of case ascertainment has still to be formally assessed.

Cancer. Introduction

This supplement presents the study of various histologic types of cancers diagnosed in the populations covered by the Surveillance, Epidemiology, and End Results (SEER) Program. It describes the SEER program and the coding of histologic type by the International Classification of Diseases for Oncology. Each of the 19 articles deals with the histologic types of cancer found in major sites or with specific histologic types, such as lymphomas or melanomas. Histologic types have been grouped based on those developed by Dr. John Berg. Data presented in this supplement are based on more than one million microscopically proven invasive cancers and 98,000 in situ cancers diagnosed during the period 1973-1987 in areas covered by the SEER Program.

Cancer of unknown primary site

BACKGROUND

About 2% of more than 1 million cases of cancer diagnosed in residents of SEER areas for the 15-year period 1973-1987 were designated as being cancers of unknown primary site.

METHODS

The 26,050 histologically diagnosed cancers of unknown primary site were studied. The small groups of other and ill-defined sites within the respiratory and intrathoracic systems and other ill-defined sites (546 total) were included in this total.

RESULTS

Over the 15-year period, there has been a decrease in the number of these cancers for each race-sex group. There has been very little change over time in the distribution by histologic type. The most frequent diagnosis was adenocarcinoma (around 55%), with approximately equal numbers of epidermoid carcinoma and carcinoma, not otherwise specified (about 14%). Changes in the frequency of mucinous, small cell, and large cell carcinoma have been observed. Carcinoid tumors of unknown primary site increased substantially.

CONCLUSION

The decline in the numbers of cancers assigned to unknown primary site is to be welcomed.

Upper aerodigestive tract cancers

BACKGROUND

Cancers of the upper aerodigestive tract constitute approximately 4% of all malignancies. These include cancer of the lip, tongue, major salivary glands, gums and adjacent oral cavity tissues, floor of the mouth, tonsils, oropharynx, nasopharynx, hypopharynx and other oral regions, nasal cavity, accessory sinuses, middle ear, and larynx.

METHODS

The histologically diagnosed cancers of the upper aerodigestive tract reported to the Surveillance, Epidemiology, and End Results program of the National Cancer Institute in 1973-1987 were tabulated by histologic type, sex, age, and racial group, and according to quinquennium (1973-1977, 1978-1982, 1983-1987). Frequencies, age-specific incidence rates, median age, and extent of spread at diagnosis, stage, and survival were examined.

RESULTS

Cancer of the upper aerodigestive tract represented 3.5% of all microscopically proven malignant neoplasms. Except for salivary glands, gums, nasopharynx, and nasal cavity and accessory sinuses, epidermoid carcinomas accounted for greater than 95% of the cancers. For all aerodigestive sites combined, there was a 2-to-1 male-to-female ratio (greater for laryngeal cancer, which was approximately 5 to 1). Incidence in black males was often twice the levels recorded in white males, whereas rates for black and white females tended to be close. The 5-year relative survival was approximately 50% (90% for lip and 65% for larynx), was somewhat better for whites than for blacks, and did not improve significantly over the 15 years studied. Salivary gland adenocarcinoma carried a survival of approximately 80%.

CONCLUSIONS

Because many of the cancers of the upper aerodigestive tract are caused by alcohol and tobacco use, the potential for prevention is considerable.

Pharmacokinetics and pharmacodynamics of tizanidine

The relationship among tizanidine dose, plasma concentration, and antispastic action is linear in nature. Response to a given dose of this agent varies among patients, and determining the appropriate clinical dose requires individual titration.

Correlations between dose, plasma concentrations, and antispastic action of tizanidine (Sirdalud)

In a double blind, placebo controlled, cross over study the correlations between single doses (2, 4, and 8 mg), plasma concentrations, and antispastic action of tizanidine were investigated in 16 patients with extensor spasticity of the legs due to multiple sclerosis. An electrogoniometer was used to assess muscle tone at knee extensors, applying Wartenberg's pendulum test. Blood samples, a clinical assessment of muscle tone by the Ashworth scale, and muscle strength by the British Medical Research Council scale were obtained concomitantly. Confirmatory analysis using the change in the relaxation index (R2 value) 1.5 hours after each treatment, showed a statistically significant (p = 0.0123) linear dose-response relation between single doses and antispastic action of tizanidine. Further statistical analysis showed a strong within patient linear correlation between plasma concentrations and antispastic action at 4 and 8 mg doses (p = 0.014 and 0.004 respectively), but only weak between patient correlations. The analysis of the dose-plasma concentration relation showed results consistent with linear pharmacokinetics. The comparison of changes in the R2 ratio with concomitant Ashworth scores showed a significant correlation between the two. It is concluded that there are linear correlations between single doses, plasma concentrations, and antispastic action of tizanidine. Because of the strong within patient but weak between patient correlation between plasma concentrations and antispastic action of tizanidine the effective doses should be determined individually.

How accurate are Scottish cancer registration data?

In order to assess the accuracy of Scottish cancer registration data, a random sample of 2,200 registrations, attributed to the year 1990, was generated. Relevant medical records were available for review in 2,021 (92%) cases. Registration details were reabstracted from available records and compared with data in the registry. Discrepancies in identifying items of data (surname, forename, sex and date of birth) were found in 3.5% of cases. Most were trivial and would not disturb record linkage. Discrepancy rates of 7.1% in post code of residence at the time of diagnosis (excluding differences arising through boundary changes), 11.0% in anniversary date (excluding differences of 6 weeks or less), 7.7% in histological verification status, 5.4% in ICD-9 site codes (the first three digits) and 14.5% in ICD-O morphology codes (excluding 'inferred' morphology codes) were recorded. Overall, serious discrepancies were judged to have occurred in 2.8% of cases. In many respects, therefore, Scottish cancer registration data show a high level of accuracy that compares favourably to the reported accuracy of the few other cancer registries undertaking such analyses.

Fluoxetine ingestion: a one year retrospective study

Fluoxetine (PROZAC) is a recently marketed straight chain antidepressant unrelated to the cyclic anti-depressants. There is only limited information on fluoxetine and a single case report on overdose (benign outcome) in the literature. In response to this we performed a 1y retrospective chart review at 2 AAPCC certified poison centers. Forty-four exposures to fluoxetine were reviewed from 1988; 31 cases were treated in a HCF, 2 cases were followed at home by phone and 11 cases were lost to follow up. Thirteen cases with follow up (FU) reported no coingestants; 3 cases reported increased anxiety without cardiovascular (CV) changes, 2 cases presented confused with out CV changes, and 8 cases were asymptomatic. Eight cases with FU had ETOH and/or benzodiazepines as a coingestant and experienced only a decreased level of consciousness that could be explained by the coingestant. Five cases remained asymptomatic with reported coingestants of APAP #3, lorazepam, haloperidol, molindone, alprazolam, propranolol, phenobarbital (level 18.2). Four cases were excluded from the evaluation due to the coingestants involved. No seizures were recorded in this series. Three possible drug reactions occurred; 2 cases had reactions with tranylcypromine (PARNATE), and 1 case with a diagnosis of septicemia had a severe hyperthermic reaction with therapeutic coingestants of mephytoin, verapamil, digoxin and indocin. We believe overdose with fluoxetine present minimal risk of serious cardiovascular or neurological complications.

The international comparability of cancer mortality data. Results of an international death certificate study

In preparation for the 10th revision of the International Classification of Diseases (ICD-10), a two-part study was undertaken to assess the international comparability of the coding, by the 9th revision (ICD-9), of death certificates mentioning cancer, to see whether there had been improvement since the 8th revision (ICD-8). Part I repeated a 1978 study in which nine countries coded the same 1,234 United States death certificates mentioning cancer by ICD-9. The proportion of disagreements in coding the underlying cause of death fell about 35% between 1978 and the present study. This reduction was probably due to the new more detailed rules for coding cancer death certificates given in ICD-9. To combat the criticism of the possible bias associated with using United States death certificates only, in Part II of the study, each of seven countries submitted about 100 certificates translated into English which had posed problems in coding cancer. Discrepancies in assigning the underlying cause of death were found for 54% of these problem certificates. The major types of problems identified were coding when multiple cancer sites were mentioned on the death certificate, whether to select heart disease or cancer as the underlying cause of death, and the interpretation of the coding rules. Better rules for ICD-10 must be provided for both physicians and coders if international comparability of cancer mortality data is to be achieved.