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Patients with Ki-67 LI >5% had a reduced survival (P< 0.0001) -none survived beyond 86 weeks following diagnosis, whilst 63% of patients with < 5% positive cells were still alive at 100 weeks. The univariate analysis showed that in astrocytomas expression of p53 mutants, EGFR protein, and Ki-67> 5% are associated with malignant progression and poor prognosis. The multivariate analysis revealed that only tumour grade and Ki-67LI were independent prognostic factors for survival.

Campylobacter incidence in England and Wales between 1990 and 1999 was examined in conjunction with weather conditions. Over the 10-year interval, the average annual rate was determined to be 78.4 ؎ 15.0 cases per 100,000, with an upward trend. Rates were higher in males than in females, regardless of age, and highest in children less than 5 years old. Major regional differences were detected, with the highest rates in Wales and the southwest and the lowest in the southeast. The disease displayed a seasonal pattern, and increased campylobacter rates were found to be correlated with temperature. The most marked seasonal effect was observed for children under the age of 5. The seasonal pattern of campylobacter infections indicated a linkage with environmental factors rather than food sources. Therefore, public health interventions should not be restricted to food-borne approaches, and the epidemiology of the seasonal peak in human campylobacter infections may best be understood through studies in young children.Nearly 30 years ago, campylobacter infection emerged as a leading bacterial cause of gastroenteritis in developed countries (47). Two species, Campylobacter jejuni and Campylobacter coli, are responsible for over 99% of human campylobacter infections (6, 23). Major infection sources include undercooked poultry, contaminated milk, untreated water, and animal contact (24). The public health consequences of human campylobacter infection are large, in part because of its high incidence (61). In developed countries, campylobacter causes more illnesses than Shigella spp. and Salmonella spp. combined (55). Only a fraction of cases are reported (25), and some estimates suggest as much as 1% of the population in the United States and Europe is affected by campylobacter each year (57). The annual cost in the United States in 1996 alone was estimated at US$4.3 billion (5), and £69.6 million was the estimated cost in the United Kingdom in 1994 (43). In addition to acute gastroenteritis, campylobacter infections may be complicated by neurological (35, 53), rheumatological (26, 34), and renal (10) problems. Effective prevention and control strategies to reduce the population burden of campylobacter infections require a robust understanding of the epidemiology of this disease. Case-control studies to investigate the origins of human infection showed that the majority of cases of campylobacter infection were not explained by the commonly recognized risk factors (1,13,14,30,37,44). For example, despite public health interventions focused on reducing food-borne transmission (16, 17), campylobacter incidence remains high (15). A striking phenomenon is the remarkably pronounced and consistent seasonal pattern, for which the explanation is unclear (29,38,41). This study investigated the relationship between seasonal variation in human campylobacter infection in England and Wales and environmental conditions to obtain new insights with respect to disease transmission. MATERIALS AND METHODSEpidemiological data. Campylobacter data...

was supplied with fresh chicken by a single wholesaler (wholesaler A), who obtained all of the chicken that it distributed from a single farm. This farm and its immediate surroundings were investigated to determine the source(s) of the organisms colonizing the chickens. Evidence was obtained that poultry from the farm caused sporadic human campylobacteriosis in the population served by the farm for at least 18 months after the recognition of the catering college outbreak. A report on this investigation is being prepared for publication elsewhere.

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