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.

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

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

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

This analytical cross-sectional study examined the nutrient intakes, dietary compliance, dietary supplementation and traditional remedy usage in type 2 diabetes mellitus (T2DM) patients from selected tertiary hospitals in multi-racial Malaysia. We compared the different characteristics of T2DM patients with and without cardiovascular disease (CVD). Socio-demographic status, dietary intakes, dietary supplementation, traditional remedy use, medical history, anthropometric measurements and clinical characteristics were obtained from face-to-face interviews. A total of 313 patients who were treated for T2DM participated in this study, in which 36.1% of them had CVD. The mean age of study subjects was 55.7 +/- 9.2 years; mean diabetes duration was 10.1 +/- 8.1 years; 52.1% were females; and 47.0% were Malays. The mean total energy intake of the subjects was 1674 +/- 694 kcal/day, and patients with CVD consumed higher total calories (p = 0.001). Likewise, the mean carbohydrate, protein and total fat intake of CVD patients were significantly higher than non-CVD patients (p < 0.05), while mean intakes of cholesterol, fibre, minerals and all vitamins were comparable between CVD and non-CVD patients. Regardless of CVD status, a notably high proportion of the subjects did not meet the recommendations of the Medical Nutrition Therapy Guidelines for Type 2 Diabetes for total energy, carbohydrate, protein, total fat, and fibre intakes. Meanwhile, 52.4% used at least one dietary supplement and 12.1% took single traditional remedy or in various combinations. Traditional remedies and supplement intake did not differ between CVD and non-CVD subjects. It is suggested that T2DM patients should be educated based on their personalized dietary intake, dietary supplementation and traditional remedy usage. The recommendations for T2DM patients shall be met to achieve the optimal metabolic goals and minimize the potential diabetic complications.
Cardiovascular Diseases* ; Cholesterol ; Compliance* ; Cross-Sectional Studies ; Diabetes Complications ; Diabetes Mellitus, Type 2 ; Dietary Supplements* ; Energy Intake ; Female ; Humans ; Malaysia ; Minerals ; Nutrition Therapy ; Tertiary Care Centers ; Vitamins

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