Populations in Southern China (Bai-yue) and Borneo (Bidayuh) with high incidence of nasopharyngeal cancer(NPC) share similar mitochondrial DNA signatures, supporting the hypothesis that these two populations may share the same genetic predisposition for NPC, which may have first appeared in a common ancestral reference population before the sea levels rose after the last ice age.
Borneo ; epidemiology ; Carcinoma ; China ; epidemiology ; DNA, Mitochondrial ; genetics ; Ethnic Groups ; genetics ; Genetic Predisposition to Disease ; Humans ; Incidence ; Nasopharyngeal Neoplasms ; epidemiology ; ethnology ; genetics

Current proposed mechanisms implicate both early and latent Epstein–Barr virus (EBV) infection in the carcinogenic cascade, whereas epidemiological studies have always associated nasopharyngeal carcinoma (NPC) with early child-hood EBV infection and with chronic ear, nose, and sinus conditions. Moreover, most patients with NPC present with IgA antibody titers to EBV capsid antigen (VCA-IgA), which can precede actual tumor presentation by several years. If early childhood EBV infection indeed constitutes a key event in NPC carcinogenesis, one would have to explain the inability to detect the virus in normal nasopharyngeal epithelium of patients at a high risk for EBV infection. It is perhaps possible that EBV resides within the salivary glands, instead of the epithelium, during latency. This claim is indirectly supported by observations that the East Asian phenotype shares the characteristics of an increased sus-ceptibility to NPC and immature salivary gland morphogenesis, the latter of which is inlfuenced by the association of salivary gland morphogenesis with an evolutionary variant of the human ectodysplasin receptor gene (EDAR), EDARV370A. Whether the immature salivary gland represents a more favorable nidus for EBV is uncertain, but in patients with infectious mononucleosis, EBV has been isolated in this anatomical organ. The presence of EBV-induced lymphoepitheliomas in the salivary glands and lungs further addresses the possibility of submucosal spread of the virus. Adding to the fact that the fossa of Rosen Müller contains a transformative zone active only in the ifrst decade of life, one might be tempted to speculate the possibility of an alternative carcinogenic cascade for NPC that is perhaps not dissimilar to the model of human papillomavirus and cervical cancer.

Antineoplastic Agents ; therapeutic use ; Chemotherapy, Adjuvant ; Clinical Trials as Topic ; Humans ; Nasopharyngeal Neoplasms ; drug therapy ; mortality ; radiotherapy ; therapy ; Radiotherapy, Intensity-Modulated ; Research Design ; Singapore

INTRODUCTIONHealth-related quality of life is an important aspect of health outcome. The assessment of it must be done by validated instruments. There is no published data on the validity, reliability and sensitiveness to change of the official Chinese translation of the Functional Assessment of Cancer Therapy-General (version 4; FACT-G).

MATERIALS AND METHODSA Chinese questionnaire package comprising the FACT-G and Functional Living Index-Cancer (FLIC, which was translated, modified and validated in Singapore) was filled in by 165 ethnic Chinese patients recruited from the National Cancer Centre, Singapore. Four weeks later, the patients were assessed again by a postal questionnaire survey.

RESULTSThe FACT-G and FLIC total scores were strongly correlated (r = 0.85). The Physical, Social/Family, Emotional and Functional Well-being scales of the FACT-G converged to and diverged from FLIC components as conceptually expected. The FACT-G and its 4 scales also demonstrated known-groups validity in differentiating patients with different performance status (each P <0.001). Their internal consistency ranged from 0.81 to 0.93 and test-retest reliability ranged from 0.74 to 0.85. The FACT-G and its Physical, Emotional and Functional Well-being scales showed trends of change in relation to change in performance status. The Social/Family Well-being scale was sensitive to decline but not improvement in performance status.

CONCLUSIONSThe Chinese version of the FACT-G can be used to assess overall level and some specific aspects of health-related quality of life. However, researchers should be cautious in using this instrument to specifically investigate the social aspect of quality of life.

China ; ethnology ; Female ; Humans ; Language ; Male ; Middle Aged ; Neoplasms ; therapy ; Outcome Assessment (Health Care) ; Quality of Life ; Sensitivity and Specificity ; Singapore ; Surveys and Questionnaires

Background: Nasopharyngeal carcinoma (NPC) is a commonly diagnosed cancer in Southeast Asia. Many stud-ies have examined the risk factors for NPC, yet the roles of some risk factors remain inconclusive. The purpose of this study was to examine associations between modifiable lifestyle factors and the risk of NPC in the Singaporean population. Methods: We conducted a case–control study in Singapore with 300 patients and 310 controls who were recruited between 2008 and 2012. Each control was selected and individually matched to each patient based on sex, ethnicity, and age (±5 years). A total of 290 pairs of cases and controls were matched successfully. We examined lifestyle factorssuch as tobacco smoking, alcohol drinking, various salted and preserved food consumption, and weaning practices. Results: After adjusting for covariates, multivariate analysis showed that those participants who were current smok-ers and had ever smoked tobacco had a higher risk of NPC than participants who had never smoked, with odds ratios (ORs) of 4.50 (95% confidence interval [CI] 2.58–7.86; P < 0.001) and 2.52 (95% CI 1.54–4.12; P < 0.001), respectively. Those who consumed salted vegetables at least once a week also showed a significantly increased risk of NPC than those who never or rarely consumed salted vegetables, with an OR of 4.18 (95% CI 1.69–10.38; P = 0.002). Conclusion: Smoking (currently and ever-smoked) and consuming salted vegetables once a week or more were lifestyle risk factors for NPC, and changes of these factors for the better may reduce the risk of NPC.

Nasopharyngeal cancer (NPC) is endemic in Southern China, with Guandong province and Hong Kong reporting some of the highest incidences in the world. The journal Science has called it a "Cantonese cancer". We propose that in fact NPC is a cancer that originated in the Bai Yue ("proto Tai Kadai" or "proto Austronesian" or "proto Zhuang") peoples and was transmitted to the Han Chinese in southern China through intermarriage. However, the work by John Ho raised the profile of NPC, and because of the high incidence of NPC in Hong Kong and Guangzhou, NPC became known as a Cantonese cancer. We searched historical articles, articles cited in PubMed, Google, monographs, books and Internet articles relating to genetics of the peoples with high populations of NPC. The migration history of these various peoples was extensively researched, and where possible, their genetic fingerprint identified to corroborate with historical accounts. Genetic and anthropological evidence suggest there are a lot of similarities between the Bai Yue and the aboriginal peoples of Borneo and Northeast India; between Inuit of Greenland, Austronesian Mayalo Polynesians of Southeast Asia and Polynesians of Oceania, suggesting some common ancestry. Genetic studies also suggest the present Cantonese, Minnans and Hakkas are probably an admixture of northern Han and southern Bai Yue. All these populations have a high incidence of NPC. Very early contact between southern Chinese and peoples of East Africa and Arabia can also account for the intermediate incidence of NPC in these regions.
Asia, Southeastern ; epidemiology ; Asian Continental Ancestry Group ; genetics ; history ; Borneo ; epidemiology ; China ; epidemiology ; Emigration and Immigration ; history ; Ethnic Groups ; genetics ; history ; Female ; Genetic Predisposition to Disease ; epidemiology ; ethnology ; genetics ; Genetics, Population ; Greenland ; epidemiology ; History, Ancient ; Hong Kong ; epidemiology ; Humans ; Incidence ; India ; epidemiology ; Inuits ; genetics ; Male ; Nasopharyngeal Neoplasms ; epidemiology ; ethnology ; genetics ; mortality ; Oceania ; epidemiology

Adult ; Age Factors ; Aged ; Aged, 80 and over ; Antineoplastic Agents ; therapeutic use ; Carcinoma ; epidemiology ; pathology ; radiotherapy ; Disease-Free Survival ; Female ; Humans ; Hypopharyngeal Neoplasms ; epidemiology ; pathology ; radiotherapy ; Hypopharynx ; surgery ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Proportional Hazards Models ; Radiotherapy, Adjuvant ; Radiotherapy, Intensity-Modulated ; Retrospective Studies ; Sex Factors ; Smoking ; epidemiology ; Tumor Burden

We report a case of group O losing anti-B selectively. A 25-year-old male donated blood; on the donor test an ABO discrepancy was noted, and a further evaluation study was performed. ABO genotyping with an allele specific polymerase chain reaction assay revealed O/O and DNA sequencing of exons 6 and 7 of the ABO gene showed O01/O02. The serum gammaglobulin level was decreased and only 0.2% CD19 pan-B positive lymphocytes were present in a subset of lymphocytes. In a previous donor study, anti-B of the patient was lost from a third donor study and was still not detected.
Adult ; Agammaglobulinemia ; Alleles ; Exons ; Humans ; Lymphocytes ; Male ; Polymerase Chain Reaction ; Sequence Analysis, DNA ; Tissue Donors

BACKGROUND: The AutoVue Innova (Ortho Clinical Diagnostic, Raritan, NJ, USA) is an automatic instrument for blood bank tests, and it has recently been introduced in Korea for the first time at our hospital. This instrument employs column agglutination technology and it performs blood bank tests automatically. We evaluated this instrument and we report on the results. METHODS: We performed ABO/RhD typing and antibody screening for 250 randomly selected samples, and crossmatching for 261 samples with using the AutoVue Innova in parallel with the conventional manual methods. For a sensitivity test, we added 3 samples of A(2)B(3) and 2 samples of weak-D and serially diluted reagent antisera to the test pool and we measured turnaround time (TAT) for the antibody screening test. RESULTS: The concordance rates between AutoVue Innova and the manual methods for ABO/RhD blood typing, antibody screening and crossmatching tests were 99.6%, 100% and 98.9%, respectively. The overall retest rate was 0.5% and the main cause of the discrepancy was revealed to be hemolysis or an inadequate amount of the samples. The overall sensitivity of AutoVue Innova seems to be same as or better than the manual methods. The TAT for the antibody screening test was significantly shorter for the AutoVue Innova (64+/-43 min, n=512) than for the tube method (89+/-57 min, n=99) (P<0.001). CONCLUSION: The test results of AutoVue Innova were accurate and sensitive for the ABO/RhD typing, crossmatching and antibody screening tests. The TAT for the antibody screening test was remarkably shortened up to five times more samples could be tested without an increase of manpower.
Agglutination ; Blood Banks ; Blood Grouping and Crossmatching ; Hemolysis ; Immune Sera ; Korea ; Mass Screening

INTRODUCTIONThe aim of this study was to evaluate the health-related quality of life (HRQoL) of Malaysian patients with type 2 diabetes mellitus (T2DM) who have cardiovascular disease (CVD), as well as identify the determinants of HRQoL among this cohort of patients.

METHODSThis study was an analytical cross-sectional study involving 313 patients aged 30-78 years (150 men, 163 women; mean age 55.7 ± 9.2 years) who were diagnosed with T2DM (mean duration of T2DM 10.1 ± 8.1 years) at two tertiary Malaysian government hospitals. The patients' sociodemographic, lifestyle, clinical and laboratory data were collected prospectively from medical records and via face-to-face interviews. HRQoL was assessed using the 15D instrument - a generic, 15-dimensional and standardised measure of HRQoL that can be used as both a profile and a single index score measure.

RESULTST2DM patients with CVD were found to have significantly lower 15D HRQoL scores than their nonCVD counterparts (p < 0.001). The HRQoL of T2DM patients with CVD was significantly lower than those without CVD (p < 0.05) in all of the 15 dimensions of the 15D instrument. Multinomial logistic regression analysis using backward stepwise method revealed a significant association between CVD and impaired HRQoL (odds ratio [OR] 11.746, 95% confidence interval [CI] 4.898-28.167). Age (OR 1.095, 95% CI 1.054-1.137), duration of T2DM (OR 1.085, 95% CI 1.032-1.140), ethnicity (OR 0.411, 95% CI 0.187-0.903), body mass index (OR 1.074, 95% CI 1.006-1.148), and physical activity level (OR 3.506, 95% CI 1.415-8.689) were also significant predictors of HRQoL.

CONCLUSIONIn T2DM patients, the presence of CVD was significantly associated with a lower HRQoL. Therefore, the importance of tertiary prevention to minimise the potential deterioration of the HRQoL of T2DM patients with CVD should be highly emphasised.

Adult ; Aged ; Cardiovascular Diseases ; complications ; psychology ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2 ; complications ; psychology ; Female ; Humans ; Malaysia ; Male ; Middle Aged ; Quality of Life ; Social Class ; Surveys and Questionnaires ; Tertiary Care Centers