In a population-based case-control study carried out in Sweden in 1982-1984, the authors examined the association of pancreatic cancer with several dietary factors, coffee, alcohol, and tobacco. Analyses were based on 99 cases, 138 population controls, and 163 hospital controls. The cases were persons aged 40-79 years diagnosed with cancer of the exocrine pancreas at three surgical departments in Stockholm and Uppsala. The risk increased with higher consumption frequency of fried and grilled meat in the comparison with each series of controls (e.g., relative risk (RR) = 1.7 (90% confidence interval (CI) = 1.1-2.7) for weekly intake and RR = 13.4 (90% CI = 2.4-74.7) for almost daily intake, in the comparison with population controls). Furthermore, associations were found with other fried or grilled foods, but not with meat other than fried or grilled. The risk also increased with the intake of margarine (e.g., RR = 9.7 (90% CI = 3.1-30.2) for 15+ g of margarine on a slice of bread, in the comparison with population controls). In contrast, no excess risk was associated with high intake of butter. A low risk was associated with frequent consumption of fruits and vegetables, particularly carrots (RR = 0.3 (90% CI = 0.2-0.7)) and citrus fruits (RR = 0.5 (90% CI = 0.3-0.9)) for almost daily intake. No consistent associations were found with coffee, artificial sweeteners or alcohol consumption, but a threefold increase in risk was associated with smoking at least one pack of cigarettes per day.

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The relation between occupational factors and pancreatic cancer has been studied by two different approaches: a population based case-control study with two series of controls and a retrospective cohort study based on register data. With both approaches, some support was found for an association with occupational exposure to petroleum products. Associations were also indicated with exposure to paint thinner (case-control study) and work in painting and in paint and varnish factories (cohort study), for exposure to detergents, floor cleaning agents, or polish (casecontrol study) and with floor polishing or window cleaning (cohort study), and for exposure to refuse (case-control study) and work in refuse disposal plants (cohort study).Little is known about the aetiology of pancreatic cancer, but possible associations with occupational In the present paper we present the findings from an investigation of occupational factors and pancreatic cancer in Sweden, using two different approaches: a population based case-control study and a retrospective cohort study. The purpose was to investigate possible associations between pancreatic cancer and occupational factors, including exposures related to wood and paper, metal, and petroleum products. Material and methodsThe case-control study included all incident (newly diagnosed) cases of cancer of the exocrine pancreas in subjects aged 40-79 at three surgical departments covering a geographically defined population in the Accepted 24 March 1986 Stockholm-Uppsala region. Hospital controls were a sample of patients of the same sex and in the same age range as the cases who had a diagnosis of inguinal hernia during the study period at the same surgical departments. Population controls were selected from population registers and matched to the cases by age, sex, and parish. Information on previous occupations and specific occupational exposures was obtained by questionnaire supplemented by telephone interviews. Each case and hospital control received a questionnaire at the time of clinical diagnosis. For each potential case (preliminary diagnosis of pancreatic cancer), a questionnaire was simultaneously sent to the corresponding population control. Subjects who did not return the questionnaire were reminded to do so first by letter and then by telephone. Those who returned a questionnaire were contacted by telephone by a trained interviewer to clarify or complete specific items whenever necessary. Table 1 shows the number of study subjects by case-control status. Of the 120 patients with a final diagnosis of pancreatic cancer, 21 were lost to the study leaving 99 cases (55 men, 44 women). For subjects who were severely ill, it was accepted that the questionnaire was completed by their spouse (see table 1, footnote). The cases were compared separately with each of the two series of controls. The data were stratified by sex, by age in two classes, and by hospital catchment area. The MantelHaenszel procedure was used to estimate the relative risks and 90% test based co...

Immunoreactive insulin has been assayed in portal and peripheral venous blood in fourteen patients with hepatic, pancreatic and gastric disease before and after tolbutamide administration. The difference between portal and peripheral insulin varied considerably in different patients. In some of the patients the portal insulin seemed to increase at a time when peripheral venous insulin had started to decrease. The implication of this finding is discussed.

A prospective series of 26 patients with portal hypertension and recent bleeding from esophageal varices was investigated with percutaneous transhepatic selective portography (PTP). PTP was performed immediately prior to and, in 23 patients, just after the initial endoscopic injection sclerotherapy (ST) session to study the acute effects of ST on the mediastinal portal-systemic collaterals. Late follow-up PTP was performed after a median of 8 months in 21 of 26 patients considered endoscopically to be free from esophageal varices after a median of 6 ST sessions. Five patients rebled from esophageal or gastric varices during the follow-up period of 15 months, but there were no fatalities due to variceal hemorrhage. In all patients, the initial PTP showed portal-systemic mediastinal collaterals. Immediately after ST, it was not possible to opacify esophageal varices at all (10 patients) or only partially (7 patients). Five patients died prior to late follow-up PTP. Endoscopic judgment of complete eradication of esophageal varices after repeated ST was in agreement with the late PTP results in 18 of 21 patients. In one patient, PTP showed residual esophageal varices subsequently confirmed by endoscopy. The results were uncertain in two patients for technical reasons. This study supports the opinion that submucosal esophageal varicose veins, as visualized by PTP, can be efficiently eradicated by serial ST, leaving the other mediastinal collaterals unaffected.

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