Golestan Province in northern Iran is a very high-incidence area for oesophageal squamous cell carcinoma (OSCC), while tobacco and alcohol use, the major risk factors of OSCC in the Western countries, are not common habits there. As an attempt to indentify the risk factors of OSCC in Golestan, the following studies were conducted in the context of this thesis: a meta-analysis on Helicobacter pylori and risk of OSCC; a cross-sectional study on patterns of food and nutrient intake among 131 healthy individuals; a case-control study with 300 cases/571 controls on the association of socioeconomic status and tea drinking habits with OSCC; a cross-sectional study on patterns of exposure to polycyclic aromatic hydrocarbons (PAHs) among 110 healthy individuals. -- In the meta-analysis, there was no significant association between H. pylori and risk of OSCC, but there was substantial heterogeneity among studies. A large proportion of Golestan inhabitants drink hot tea. Our results showed a two-fold and 8-fold increase in risk of OSCC associated with drinking hot and very hot tea, respectively. Several indicators of SES, including formal education, being married, and high wealth were inversely associated with risk of OSCC. We found severe nutrient deficiencies among rural dwellers and women and a high exposure of the general population to PAHs in Golestan. Only kerosene and gas were used for heating, which was not associated with exposure to PAHs. Red meat intake, passive smoking, and certain genetic polymorphisms showed associations with PAH metabolites in urine. Meat frying intensity had significant associations with bulky DNA adduct levels. -- Interactions among several factors, e.g. hot tea drinking and intra-luminal PAHs, with the background of poor socioeconomic status and deficient nutrient intake, may be responsible for the high incidence of OSCC in Golestan.
Golestan Province in northern Iran is a very high-incidence area for oesophageal squamous cell carcinoma (OSCC), while tobacco and alcohol use, the major risk factors of OSCC in the Western countries, are not common habits there.
A young Irish gentleman of the numerous clan O'Donnells, and a Patrick, hardly a distinction of him until we know him, had bound himself, by purchase of a railway-ticket, to travel direct to the borders of North Wales, on a visit to a notable landowner of those marches, the Squire Adister, whose family-seat was where the hills begin to lift and spy into the heart of black mountains. Examining his ticket with an apparent curiosity, the son of a greener island debated whether it would not be better for him to follow his inclinations, now that he had gone so far as to pay for the journey, and stay. But his inclinations were also subject to question, upon his considering that he had expended pounds English for the privilege of making the journey in this very train. He asked himself earnestly what was the nature of the power which forced him to do it—a bad genius or a good: and it seemed to him a sort of answer, inasmuch as it silenced the contending parties, that he had been the victim of an impetus. True; still his present position involved a certain outlay of money simply, not at all his bondage to the instrument it had procured for him, and that was true; nevertheless, to buy a ticket to shy it away is an incident so uncommon, that if we can but pause to dwell on the singularity of the act, we are unlikely to abjure our fellowship with them who would not be guilty of it; and therefore, by the aid of his reflections and a remainder of the impetus, Mr. Patrick O'Donnell stepped into a carriage of the train like any ordinary English traveller, between whom and his destination there is an agreement to meet if they can. It is an experience of hesitating minds, be they Saxon or others, that when we have submitted our persons to the charge of public companies, immediately, as if the renouncing of our independence into their hands had given us a taste of a will of our own, we are eager for the performance of their contract to do what we are only half inclined to; the train cannot go fast enough to please us, though we could excuse it for breaking down; stoppages at stations are impertinences, and the delivery of us at last on the platform is an astonishment, for it is not we who have done it—we have not even desired it. To be imperfectly in accord with the velocity precipitating us upon a certain point, is to be going without our heads, which have so much the habit of supposing it must be whither we intend, when we go in a determined manner, that a doubt of it distracts the understanding—decapitates us; suddenly to alight, moreover, and find ourselves dropped at the heels of flying Time, like an unconsidered bundle, is anything but a reconstruction of the edifice. The natural revelry of the blood in speed suffers a violent shock, not to speak of our notion of being left behind, quite isolated and unsound. Or, if you insist, the condition shall be said to belong exclusively to Celtic nature, seeing that it had been drawn directly from a scion of one of those tribes.
A young Irish gentleman of the numerous clan O'Donnells, and a Patrick, hardly a distinction of him until we know him, had bound himself, by purchase of a railway-ticket, to travel direct to the borders of North Wales, on a visit to a ...
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