The efficacy of lower axillary sampling in obtaining lymph node status in breast cancer: a controlled randomized trial

Four hundred and seventeen patients with operable breast cancer treated by simple mastectomy were randomly allocated to have node sampling or total axillary clearance. There was no significant difference in the incidence of node positivity. One hundred and thirty-five patients had node sampling and were randomized at the completion of this procedure to have axillary clearance or to have no further surgery. All node positive patients who went on to have a clearance had positive samples, confirming the accuracy of the sampling technique.     

Posterior corneal folds and endothelial cell damage in human donor eyes.

Posterior folds in human donor corneas stored as whole eyes in moist chambers, or isolated in McCarey-Kaufman medium at 4 degrees C, have been studied by light and scanning electron microscopy to determine whether or not endothelial cells on the folds are damaged. Extensive, often irreversible cell damage was found associated with most of the folds. Hence posterior folds in donor corneas are of importance in that they indirectly reduce the quality of the donor cornea for transplantation.     

Monocular pattern discrimination learning after unilateral lesions of anteromedial cortex in rat

Monocularly patched rats were trained on a series of visual tilt discriminations ordered from simple to difficult to measure the angular difference threshold of each eye. Preoperatively there was no difference between discrimination performance for either eye. Unilateral lesions of anteromedial cortex did not alter the monocular angular difference threshold. However, there was a reduction in discrimination performance for all angular difference comparisons. Animals showed a visual neglect for stimuli in the field contralateral to the lesion. The neglect was independent of the eye used for the discrimination.     

A simple method for the solubilisation of reduced NBT, and its use as a colorimetric assay for activation of human macrophages by gamma-interferon

We describe a simple method by which the insoluble blue formazan dye produced by the reduction of nitro blue tetrazolium can be dissolved without heating using potassium hydroxide and dimethyl sulphoxide. This modification enhances the sensitivity and increases the applications of tests performed using the microELISA method and removes variations caused by uneven cell monolayers. It also allows quantification of NBT reduced by cells adherent to coverslips or in larger wells or Petri dishes, and can be used as a sensitive assay for macrophage activation by gamma-interferon.     

IgM natural autoantibodies against bromelain-treated mouse red blood cells recognise carbonic anhydrase.

Carbonic anhydrase (CA) from mouse erythrocyte membranes is recognised as an autoantigen in Western blotting experiments with FUB 1, a murine IgM monoclonal antibody that binds both phosphatidylcholine and bromelain-treated mouse red blood cells (BrMRBC). Serum from mice stimulated with lipopolysaccharide (LPS-serum) also recognises CA. From SDS-PAGE, and blotting experiments with whole mouse erythrocytes, we found two closely spaced glycoprotein bands in the 30 kD region that reacted with both FUB 1 and LPS-serum. One of the molecular weight markers, bovine carbonic anhydrase which is of a molecular weight of about 30 kD, electrophoresed in the same 30 kD region also reacted with these antibodies. Carbonic anhydrases from a range of mammalian species were found to be crossreactive with FUB 1 and LPS-serum by Western blotting, whereas human glycophorin A and human asialoglycophorin were not recognised by the antibodies. FUB 1 specifically recognises both native and denatured bovine carbonic anhydrase in ELISA assays. The serological identity of the determinants of CA and BrMRBC was confirmed by specific absorption of both FUB 1 and LPS-serum with BrMRBC and normal mouse erythrocytes. We propose that a native autoantigenic epitope on erythrocytes may be revealed by the proteolytic action of bromelain and that this determinant is associated, at least in part, with carbonic anhydrase.     

Controversies in the management of non-small cell lung cancer: the results of an expert surrogate study

Four hundred and sixty-one doctors who treat lung cancer in Canada and the United States answered a questionnaire in which they were asked how they would wish to be managed if they developed non-small cell lung cancer (NSCLC). There was no evidence of a consensus as to preferred treatment in either of two clinical situations described. Personal treatment preferences were significantly influenced by specialist training and each discipline showed a preference for its own modality of treatment. The personal treatment preferences of American and Canadian doctors differed significantly. In the United States, the role of surgery in NSCLC with extensive mediastinal disease was controversial, whereas in Canada, the major controversy was whether any active treatment was desirable in this situation if symptoms were absent. The role of chemotherapy in the treatment of NSCLC with painful bone metastases was controversial in the United States, but the vast majority of Canadian doctors would not wish any form of chemotherapy in this situation. Respondents were also asked what treatment they usually recommended for patients with NSCLC in the two situations described. Almost all these doctors recommended for their patients exactly the same treatment which they would choose for themselves. It was concluded that the personal treatment preferences of doctors are an important factor in determining how patients with NSCLC are treated. Doctors were also asked (a) if they would be willing to participate as patient-subjects in a number of clinical trials for which they would be eligible if they developed NSCLC, and (b) if they would be willing to ask their patients to participate in the same trials. There were significant differences in the perceived acceptability of the trials studied, but in each case a higher proportion of doctors would be willing to ask their patients to participate than would be prepared to consent themselves.     

Angioimmunoblastic lymphadenopathy, sulphasalazine exposure and villous atrophy

A woman with inflammatory lesions in the terminal ileum was treated with sulphasalazine. Nine months later she developed angioimmunoblastic lymphadenopathy and was found to have intestinal villous atrophy. Her systemic illness partially responded to oral steroids but a gluten free diet restored clinical and biochemical well being coincident with a return of her villous pattern.