503
Childhood leukaemia and natural radiation SIR,-Henshaw et all have claimed that exposure to indoor radon responsible for a significant proportion of cases of
may be
Fig 2-FTIR spectra.
(a)lntestinal sample particles with two absorption bands corresponding to calcium oxalate (b) Lymph node sample particles with absorption bands corresponding to carbapatlte in sarcoid granulomas, in which crystals have been shown contain calcium oxalate and Schaumann bodies composed of a calcium-phosphate compound.’ The usual view is that these inclusions are a foreign substance (microbial protein or myelinoid membranes) impregnated with calcium oxalate or calcium phosphate.’ To the best of our knowledge such particles have not been reported in Crohn’s disease. Should our finding be confirmed by others it would be another histological finding common to sarcoidosis and Crohn’s disease. common
to
Adult Polyclinic and Histology, Biochemistry, and Analytical Chemistry Laboratories, Centre Hospitalo-Universtaire, 94270 Kremlin Bicêtre, France UER Sciences Tours
J. ROGE M. FABRE P. LEVILLAIN
Pharmaceutiques,
P. DUBOIS
1 Reid JD, Anderson ME Calcium oxalate m sarcoid granulomas with particular reference to the small ovoid body and a note on the finding of Dolomite. Am J Clin Pathol 1988, 90: 545-58 2 Kirkpatrick CJ, Curry, A, Bisset DL Light and electron microscopic studies on multinucleated giant cells in sarcoid granuloma: new aspects of asteroid and Schaumann bodies. Ultrastruct Pathol 1988, 12: 581-97.
Propofol
in
malignant hyperthermia
SIR,—In-vitro evidence suggests that propofol may be safe for individuals genetically susceptible to malignant hyperthermia (MH)1. In-vitro data support this belief and I now report clinical data from 19 patients susceptible to MH.2,3 Patients undergoing a biopsy of muscle for diagnostic in-vitro
testing (IVCT) for susceptibility to MH were anaesthetised according to a standard protocol, which included propofol for induction and maintenance of anaesthesia. Patients also received diazepam premedication, alfentanyl analgesia, atracurium neuromuscular block, endotracheal intubation and ventilation with N2O/O2 (FI02 03), and reversal of neuromuscular block with neostigmine and glycopyrrolate. Of 19 patients, 9 have satisfied IVCT criteria for MH susceptibility.4 Duration of anaesthesia ranged from 60 to 90 min. No patient showed signs of MH. These findings suggest that propofol is safe in those susceptible to MH. contracture
leukaemia. The claim was based largely on data for leukaemia incidence and national mean radon concentrations in fourteen countries. Variation between countries in the quality of the cancer and radon data makes interpretation very difficult.2 Also, even based on Henshaw’s cautiously high estimate of the dose to the red bone marrow, risk assessment suggests that radon exposure is responsible for only about 0-5% of childhood leukaemia in Britain.2 We report here a correlation study of childhood leukaemia and indoor radon concentrations (as well as indoor and outdoor gamma dose rates) in small areas throughout Britain. The Childhood Cancer Research Group has been assigning grid references and postcodes to addresses at diagnosis of childhood cancer cases diagnosed since the 1960s. The National Radiological Protection Board (NRPB) has collected data on outdoor and indoor gamma dose rates and on indoor radon concentrations.3,4 The data studied here consist of numbers of cases of leukaemia and non-Hodgkin lymphoma (NHL) and population sizes at ages less than 15 years during 1969-83 in 459 county districts in England and Wales and regional districts in Scotland ("districts"), and average indoor radon concentrations and gamma dose rates for the districts. The rates of leukaemia and NHL were analysed as linear functions of the natural radiation levels with Poisson regression methods.s The table shows the results from fitting categorised forms of all three radiation measures simultaneously; fitting terms one at a time gives similar results. With data aggregated into counties, the regression coefficient for radon is positive and that for indoor gamma is negative (both 0’05
Childhood leukaemia and natural radiation SIR,-Henshaw et all have claimed that exposure to indoor radon responsible for a significant proportion of cases of
may be
Fig 2-FTIR spectra.
(a)lntestinal sample particles with two absorption bands corresponding to calcium oxalate (b) Lymph node sample particles with absorption bands corresponding to carbapatlte in sarcoid granulomas, in which crystals have been shown contain calcium oxalate and Schaumann bodies composed of a calcium-phosphate compound.’ The usual view is that these inclusions are a foreign substance (microbial protein or myelinoid membranes) impregnated with calcium oxalate or calcium phosphate.’ To the best of our knowledge such particles have not been reported in Crohn’s disease. Should our finding be confirmed by others it would be another histological finding common to sarcoidosis and Crohn’s disease. common
to
Adult Polyclinic and Histology, Biochemistry, and Analytical Chemistry Laboratories, Centre Hospitalo-Universtaire, 94270 Kremlin Bicêtre, France UER Sciences Tours
J. ROGE M. FABRE P. LEVILLAIN
Pharmaceutiques,
P. DUBOIS
1 Reid JD, Anderson ME Calcium oxalate m sarcoid granulomas with particular reference to the small ovoid body and a note on the finding of Dolomite. Am J Clin Pathol 1988, 90: 545-58 2 Kirkpatrick CJ, Curry, A, Bisset DL Light and electron microscopic studies on multinucleated giant cells in sarcoid granuloma: new aspects of asteroid and Schaumann bodies. Ultrastruct Pathol 1988, 12: 581-97.
Propofol
in
malignant hyperthermia
SIR,—In-vitro evidence suggests that propofol may be safe for individuals genetically susceptible to malignant hyperthermia (MH)1. In-vitro data support this belief and I now report clinical data from 19 patients susceptible to MH.2,3 Patients undergoing a biopsy of muscle for diagnostic in-vitro
testing (IVCT) for susceptibility to MH were anaesthetised according to a standard protocol, which included propofol for induction and maintenance of anaesthesia. Patients also received diazepam premedication, alfentanyl analgesia, atracurium neuromuscular block, endotracheal intubation and ventilation with N2O/O2 (FI02 03), and reversal of neuromuscular block with neostigmine and glycopyrrolate. Of 19 patients, 9 have satisfied IVCT criteria for MH susceptibility.4 Duration of anaesthesia ranged from 60 to 90 min. No patient showed signs of MH. These findings suggest that propofol is safe in those susceptible to MH. contracture
leukaemia. The claim was based largely on data for leukaemia incidence and national mean radon concentrations in fourteen countries. Variation between countries in the quality of the cancer and radon data makes interpretation very difficult.2 Also, even based on Henshaw’s cautiously high estimate of the dose to the red bone marrow, risk assessment suggests that radon exposure is responsible for only about 0-5% of childhood leukaemia in Britain.2 We report here a correlation study of childhood leukaemia and indoor radon concentrations (as well as indoor and outdoor gamma dose rates) in small areas throughout Britain. The Childhood Cancer Research Group has been assigning grid references and postcodes to addresses at diagnosis of childhood cancer cases diagnosed since the 1960s. The National Radiological Protection Board (NRPB) has collected data on outdoor and indoor gamma dose rates and on indoor radon concentrations.3,4 The data studied here consist of numbers of cases of leukaemia and non-Hodgkin lymphoma (NHL) and population sizes at ages less than 15 years during 1969-83 in 459 county districts in England and Wales and regional districts in Scotland ("districts"), and average indoor radon concentrations and gamma dose rates for the districts. The rates of leukaemia and NHL were analysed as linear functions of the natural radiation levels with Poisson regression methods.s The table shows the results from fitting categorised forms of all three radiation measures simultaneously; fitting terms one at a time gives similar results. With data aggregated into counties, the regression coefficient for radon is positive and that for indoor gamma is negative (both 0’05
