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Introduction: A minor percentage of bladder cancer cases in Denmark are caused by occupational exposure to carcinogens. The disease is therefore also present on the National Board of Industrial Injuries' list of occupational diseases, and reporting of these is compulsory for Danish physicians. In spite of this, only very few cases are reported annually. The aim of this study was to examine whether sufficiently detailed information on occupational exposure was obtained from the patient at the time of diagnosis, and if this presumed lack of information could be the reason for the possible low number of reporting., Material and Methods: We have examined 82 medical records from bladder cancer patients admitted or treated at Herlev University Hospital in the period from 01.01 2002 to 06.16 2004. General information, including information on occupation, was noted and examined., Results: 48 charts lacked occupational history or had an insufficient degree of information so that a possible occupational disease could not be excluded. In the remaining 34 medical records, there were four patients with a positive exposure history which should, therefore, have been reported. There was no information in the medical records as to whether this had been done., Conclusion: Medical records of many bladder cancer patients lack sufficient information on occupational exposure. The four cases that should have been reported furthermore suggest that the physicians need to be educated on the known exposures and on how to report a patient with a positive exposure history. This could be a considerable reason for the few annually reported cases.

Azathioprine/6MP (AZA/6MP) is effective in long-term treatment (> 3 months) of Crohn's disease and superior to other established medical treatments. The optimal dose remains to be defined. So far, effect has been demonstrated with 2-2.5 mg azathioprine/kg/day, but not with 1 mg/kg/day. A disease controlling effect has been demonstrated during up to four years of continuous treatment, after which data remains to be established. As part of remission-inducing combination therapy the effect of AZA/6MP can not be detected until two-three months after treatment start. High dose intravenous AZA/6MP administration does not shorten this interval. Reversible dose dependent side effects may require dose reduction or termination of treatment. Reversible dose independent side effects exclude further or repeated treatment. Some 10-15% stop treatment due to side effects. There is no increased death rate due to cancer in AZA/6MP treated Crohn patients. When giving the above full dose of AZA/6MP, monthly blood tests are recommended for the entire treatment period, more often during the first three months.

A 52 years old woman was hospitalized on suspicion of left femoral venous thrombosis. Within 24 hours she went into shock, and laparotomy was performed on suspicion of a ruptured abdominal aortic aneurysm. The operative finding was a ruptured iliac vein, which was repaired and anticoagulant treatment was started. Unfortunately the patient never stabilized and died from cardiovascular collapse within 12 hours.

The polypeptide growth factor transforming growth factor-beta (TGF-beta) is a multifunctional regulator of basic cellular functions: proliferation, differentiation, cell adhesion and interactions with the extracellular matrix. TGF-beta is part of a regulatory network of which our knowledge is still incomplete, together with other substances such as steroid hormones, oncogene products and integrins. Five isoforms for TGF-beta and five different TGF-beta receptors have been described. TGF-beta exhibits an antiproliferative effect in vitro and in vivo on many cells of epthelial, myeloid, lymphoid and mesenchymal origin together with a growth-stimulating effect on various cells like endothelial cells and epidermal keratinocytes. Production of TGF-beta and receptors for TGF-beta has been found in many cell types, both normal and malignant. Nevertheless the amount of in vivo data is too limited to identify possibilities for therapeutic intervention in the physiological and patophysiological functions of TGF-beta.

A case of the toxic shock syndrome (TSS) in a burnt (scalded) child is presented. TSS is a condition most frequently associated with menstruating women using tampons. In recent years, however, increased knowledge of the syndrome has led to an increase in the number of reported cases associated with other clinical situations. The non-menstrual cases are most frequently observed in young persons many of whom are children. TSS is due to infection with toxin-producing S. aureus. TSS-toxin-1 is apparently the most important among toxins. The fatality rate has been reported to be as high as 15%, so recognition of the syndrome and institution of the correct treatment are of utmost importance. By means of an easy and rapid test, it is possible to detect if the strain of S. aureus is TSST-1-producing. The test is now available and employs passive latex agglutination. The sensitivity and specificity are high and, if clinical signs of TSS are present, a positive test result will support the diagnosis in 94% of alle positive cases.

The leukotrienes constitute a group of 5-lipoxygenase catalyzed metabolites of arachidonic acid, the cellular effects of which may be divided into two broad categories. Leukotriene B4 is predominantly a leukocyte stimulant, and has recently been observed to represent the inflammatory cell component of a mutual activation mechanism between inflammatory cells and the immune system. It is thus anticipated that LTB4 acts as an inflammatory mediator and immune regulator in a variety of immune-mediated disorders. The presence of LTB4 in inflamed tissues from patients with psoriasis, rheumatoid arthritis and chronic inflammatory bowel disease renders it probable that the novel class of 5-lipoxygenase inhibitors and LTB4 antagonists will be capable of influencing the clinical course of these diseases. The other main group is comprised of leukotrienes C4, D4 and E4, collectively known as slow reacting substance of anaphylaxis leukotrienes, and has been identified primarily in immediate hypersensitivity conditions, e.g. bronchial asthma in which the smooth muscle contractile and permeability increasing properties of SRS-A appears to contribute to the early bronchoconstrictor phase. Leukotriene D4, however, may also be involved in the late reaction mediated by inflammatory cells, since it has the ability to immobilize neutrophils attracted by LTB4 to the inflammatory focus. The ultimate elucidation of the importance of leukotrienes in different diseases awaits the outcome of clinical trials with the newly developed highly potent and specific 5-lipoxygenase inhibitors and leukotriene antagonists.