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The multidisciplinary management of a family with epithelial ovarian cancer (1992)

CRUICKSHANK, D. J. ; HAITES, N. ; ANDERSON, S. ; [et al.]

Oxford, UK : Blackwell Publishing Ltd

BJOG 99 (1992), S. 0

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ISSN: 1471-0528

Source: Blackwell Publishing Journal Backfiles 1879-2005

Topics: Medicine

Notes: Objective To describe the management of a family with an inherited predisposition to ovarian and breast cancer. Particular attention is paid to the problems of contraception, screening, prophylactic surgery and hormone replacement therapy.Setting The multidisciplinary Grampian Familial Epithelial Overian Cancer Study Group.Subjects 162 members of a family extending over five generations. In the third generation, five of the 10 women died with epithelial ovarian cancer. Three women in generation IV have developed premenopausal breast cancer. There are now 78 family members in the fifth generation aged between 2 and 22 years.Interventions Counselling of female family members is started at the age of 18 years. The combined oral contraceptive pill is advocated to suppress ovulation. Gynaecological follow-up after the age of 28 includes yearly pelvic examination, transvaginal ultrasonography and serum CA125 estimation. Laparoscopy with peritoneal cytology is indicated if any part of this yearly assessment is abnormal. Prophylactic oophorectomy is advised between the ages of 35 and 40 years after the family is complete. In generation IV, 20 of the 29 women have undergone prophylactic oophorectomy. Oestrogen hormone replacement therapy with a cyclical progestogen is recommended after prophylactic oophorectomy. Breast cancer screening starts at the age of 25 and involves annual clinical breast examination augmented by mammography and breast ultrasound.Conclusions Only by the careful questioning and recording of family history, including at least third degree relatives (cousins), will similar groups with familial ovarian/breast cancer be identified. When predisposing genes are characterized it will be possible to identify carriers within the family and concentrate clinical effort on them while offering appropriate reassurance to those with decreased risk.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1111/j.1471-0528.1992.tb14504.x

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Compensatory response of a legume root-nodule system to nodule herbivory by Sitona hispidulus (1992)

Quinn, M. A. ; Hall, M. H.

Springer

Entomologia experimentalis et applicata 64 (1992), S. 167-176

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ISSN: 1570-7458

Keywords: Curculionidae ; Sitona hispidulus ; Leguminosae ; nodule herbivory ; compensatory growth

Source: Springer Online Journal Archives 1860-2000

Topics: Biology

Notes: Abstract A laboratory study was conducted to examine the hypothesis that herbivory of nitrogen-fixing root nodules on legumes causes an exact compensatory response in nodule growth. Plants of Medicago sativa (L.) were grown hydroponically in clear plastic growth pouches so that the number and biomass of root nodules could be estimated nondestructively before, and 10 and 18 days after, partial denodulation. For treatments, plants were subjected to 23% denodulation by first-instar larvae of Sitona hispidulus (F.) (a common herbivore of Medicago and Trifolium) or 50% nodule pruning; additional plants were left untreated. Results indicated that nodule herbivory and nodule pruning caused an overcompensatory response in number of nodules. This was also true for number of nodule units (an indirect measure of nodule biomass) per plant at 10 days after denodulation but had changed to an exact compensatory response by day 18. An inverse relationship between change in number of nodule units and initial number of nodules indicated that compensatory nodulation was regulated by a feedback mechanism. Shoot and root biomasses were not affected by denodulation in this study.