Analysis of intratumoral heterogeneity and amplification status in breast carcinomas with equivocal (2+) HER-2 immunostaining

Fluorescence in situ hybridization (FISH) and immunohistochemical analysis for assessment of HER-2 status in breast carcinomas are discordant in a significant proportion of cases with equivocal (2+) immunostaining. To evaluate the role of intratumoral heterogeneity and degree of amplification, we performed additional HER-2 immunostains and FISH on tumor-bearing blocks from 20 invasive breast carcinomas with immunohistochemical scores of 2+ with gene amplification and in 18 cases without amplification. Of the amplified cases, 11 (55%) had a 3+ immunohistochemical score on at least 1 additional slide, 8 (40%) remained 2+, and 1 (5%) had a slide scored 1+. All cases rescored 3+ showed high-level amplification in original and repeated FISH; cases remaining 2+ had a heterogeneous FISH profile (low-level amplification or a mosaic mixture of high-level amplified and nonamplified cells) in original and repeated FISH. Of nonamplified cases, 13 (72%) had a 1+ score on at least 1 additional slide, 4 (22%) remained 2+, and 1 (6%) had 1 slide scored 3+. In the nonamplified cases, 17 (94%) showed no amplification in repeated FISH. Significant intratumoral heterogeneity and minimal (low-level) HER-2 amplification account for many breast cancers with 2+ HER-2 protein expression.     

Administration of recombinant human granulocyte-macrophage colony- stimulating factor after chemotherapy regulates the expression and secretion of monocyte tumor necrosis factor (TNF) and TNF receptors p55 and p75

Monocyte expression and secretion of tumor necrosis factor (TNF) and TNF receptors (TNF-R) p55 and p75 was studied in patients receiving granulocyte-macrophage colony-stimulating factor (GM-CSF) after intensive chemotherapy. TNF expression and secretion of biologically active TNF was increased at regeneration compared with that of patients who had received chemotherapy alone. This effect persisted for several weeks after cessation of growth factor therapy. GM-CSF restored the responsiveness of monocytes to bacterial lipopolysaccharide (LPS), which appeared to be diminished after chemotherapy alone. Expression and secretion of TNF-R p55 and p75 by monocytes was augmented by GM-CSF therapy in association with the increase in TNF protein. We propose that GM-CSF administration after chemotherapy restores the normal responsiveness of monocytes to a secondary stimulus such as LPS and primes monocytes to respond to LPS with increased expression and secretion of TNF and TNF-R.     

Reliability and validity of the sideways step test and its correlation with motor function after stroke

[Purpose] This study investigated the intra-rater, inter-rater and test-retest reliability of the sideways step test (SST), its correlation with other indicators of stroke-specific impairment, and the cut-off count best discriminating subjects with stroke from their healthy counterparts. [Subjects and Methods] Forty-three subjects with chronic stroke and 41 healthy subjects older than 50 years participated in this study. The SST was administered along with the Fugl-Meyer motor assessment for the lower extremities (FMA-LE), the five-times sit to stand (5TSTS) test, the Berg Balance Scale (BBS), the movement velocity (MVL) by the limits of stability (LOS) test, the ten-metre walk (10mW) test, the timed “Up and Go” (TUG) test and the Activities-specific Balance Confidence (ABC) scale. [Results] The SST showed good to excellent intra-rater, inter-rater and test-retest reliability. The SST counts correlated with 5TSTS times, 10mW times, TUG times, and the FMA-LE and BBS scores. SST counts of 11 for the paretic leg and 14 for the non-paretic leg were found to distinguish the healthy adults from subjects with stroke. [Conclusion] The sideways step test is a reliable clinical test, which correlates with the functional strength, gait speed, and functional balance of people with chronic stroke.Key words: Balance, Stroke, Rehabilitation     

颈动脉内中膜厚度与初诊2型糖尿病视网膜病变的关系

目的:研究发现,糖尿病视网膜病变和动脉粥样硬化终点事件相关。试验拟验证颈动脉内中膜厚度与初诊汉族2型糖尿病患者糖尿病视网膜病变相关危险因素的关系。方法:①试验对象:选择2006-06/2007-06本院住院的初诊2型糖尿病患者187例,男114例,女73例;平均年龄(51±14)岁;平均体质量指数(24.7±4.7)kg/m2。均符合1997年美国糖尿病协会的2型糖尿病诊断标准,排除既往已存在心血管疾病者。患者对治疗及试验均知情同意。根据眼底照相检查结果,将所有受检者分为糖尿病视网膜病变组及非糖尿病视网膜病变组进行统计分析。②试验方法及评估:所有患者询问一般情况,测量颈动脉内中膜厚度以及相关生化指标,对糖尿病视网膜病变相关因素进行单因素及多因素Logistic回归分析。结果:纳入2型糖尿病患者187例,均进入结果分析。单因素Logistic回归分析显示,高血压、糖尿病家族史、颈动脉内中膜厚度、尿白蛋白、低密度脂蛋白胆固醇与糖尿病视网膜病变发生呈显著正相关,多因素Logistic回归分析未见显效因素。结论:单因素回归分析中颈动脉内中膜厚度及其他4项指标与糖尿病视网膜病变相关,而多因素回归分析这些因素未进入主效基因模型。     

上海市0～6岁小儿佝偻病的现状调查

目的:了解上海市小儿佝偻病的现状及影响因素。方法:2005年春季以整群和分层随机抽样法抽取上海市部分城区0～6岁小儿821名,采取问卷调查方法了解小儿的生活环境、饮食习惯、户外活动、营养状况、既往疾病史及母亲的妊娠情况等。佝偻病的诊断以1996年国家卫生部颁布的"婴幼儿佝偻病防治方案"为诊断标准。结果:取得完整有效资料769名,其中男童396名,女童373名;集居儿童456名,散居儿童313名。①小儿佝偻病患病率为17.3%(133/769),其中男童患病率为17.4%、女童为17.2%。②佝偻病与喂养方式(母乳喂养的患病率为13.0%、混合喂养的患病率为17.5%、人工喂养的患病率为25.2%)、鱼肝油添加(按时添加维生素D的患病率为13.5%、偶加或未加维生素D的患病率为32.5%)、居住环境(居住在市区的患病率为23.6%、居住在郊区的患病率为10.6%;集居儿童患病率为13.8%、散居儿童患病率为22.4%)、户外活动时间(经常户外活动的患病率为12.9%、偶尔户外活动的患病率为31.8%)、反复呼吸道感染(小儿有反复呼吸道感染的患病率为26.9%、无反复呼吸道感染的患病率为12.9%)、母孕期缺钙(母孕期有缺钙的患病率为33.2%、无缺钙的患病率为12.0%)等因素有关(P<0.01)。结论:上海市小儿佝偻病患病率有上升趋势。影响因素与城市环境污染、母乳喂养减少、年轻父母科学育儿知识缺乏等有关。     

健康人群隐神经传导中远端和近端方法的比较

隐神经传导对隐、股神经损伤,腰丛病变和L3、L4神经根损伤具有诊断价值.在通过表面电极评估隐神经逆向传导中,有远端和近端两种方法.[收稿日期 2005-09-20     

The PB3300 intraarterial blood gas monitoring system

Continuous intraarterial blood gas (IABG) monitoring is in clinical use both in the operating room and intensive care unit. This technology uses miniature, optically-based sensors that can be placed into a patient's artery. The arterial blood gas values are transduced into an optical signal that is measured by a bedside monitor on which the values are displayed. In this paper, we describe the operating principles of the PB3300 Intra-Arterial Blood Gas Monitoring System (Puritan-Bennett Corporation, FOxS Division, Carlsbad, CA). Topics include the principles of fluorescent determinations of pH,PCo ₂, andPO ₂; the optical path of the PB3300; system calibration; dye layer geometry; and clinical operation. The accuracy, precision, and drift of the system measuring tonometered aqueous standards are reported. The following values were noted for eight sensors sending data to eight monitors: system bias and precisions of 0.00±0.02 pH at a pH of 7.40, –2.5±1.5 mm HgPCo ₂ at aPCo ₂ of 40 mm Hg, and 3.3±1.3 mm HgPO ₂ at aPO ₂ of 80 mm Hg.

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Abstrakt Die kontinuierliche intraarterielle Blutgasüberwachung (IABG) wird klinisch sowohl im OP als auch auf der Intensivstation eingesetzt. Hierbei werden miniaturisierte, optische Sensoren angewandt, die sich direkt in der Arterie des Patienten plazieren lassen. Die Blutgaswerte werden in optische Signale umgesetzt und von einem bettseitigen Monitor gemessen und angezeigt. In dieser Arbeit beschreiben wir das Funktionsprinzip des Intra-Arteriellen Blutgasanalysesystems PB3300 (Puritan-Bennett Corporation, FOxS Division, Carlsbad, CA). Themen sind die Grundlagen der Bestimmung von pH, PCO2 und PO2 mittels Fluoreszenz; die optische Übertragung des PB3300; die Kalibrierung des Systems; die Geometrie der Farbschichten und der Einsatz in der Klinik. Die Genauigkeit, Auflösung und Drift des Systems bei der Messung von tonometrischen wässrigen Standards wird beschrieben. Die folgenden Werte ergaben sich aus einer Meßreihe mit 8 Sensoren, die an 8 Monitore angeschlossen waren (jeweils Bias, Streuung und Sollwert): 0.00±0.02 pH bei 7.40 pH, –2.5±1.5 mmHg PCO2 bei 40 mmHg PCO2 und 3.3±1.3 mmHg PO2 bei 80 mmHg PO2.

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Resumen La monitorizaciòn continua de gases intraarteriales tiene uso clinico, tanto en el pabellòn de operaciones como en la unidad de cuidados intensivos. Esta tecnologia utiliza sensores miniatura de tipo òptico que pueden ser introducidos en una arteria del paciente. Los valores de gases arteriales son transducidos en forma de señal òptica que es medida al lado de la cama del paciente por un monitor que presenta los valores numéricos. En este trabajo, describimos los principios de operaciòn del PB3300 Intra-Arterial Blood Gas Monitoring System (Puritan-Bennett Corporation, FOxS Division, Carlsbad, CA). Los temas incluyen los principios de determinaciones fluorescentes de pH, PCO₂, and PO₂; la via òptica del PB3300; calibraciòn del sistema; geometria de la capa de colorante; y la operaciòn clinica. Se presentan la exactitud, precisiòn, y deriva (drift) del sistema, midiendo soluciones acuosas de tonometrìa estàndar. Los siguientes valores fueron registrados para ocho sensores enviando informaciòn a ocho monitores: los sesgos del sistema y las precisiones fueron de 0.00±0.02 pH a pH 7.40, –2.5±1.5 mmHg PCO₂ a PCO₂ 40 mmHg, y 3.3±1.3 mmHg PO₂ a PO₂ 80 mmHg.