Stage I non-small cell lung cancer: a pragmatic approach to prognosis after complete resection

BACKGROUND: Long-term results of the surgical treatment of stage I non-small cell lung cancer (NSCLC) are disappointing. METHODS: Univariate and multivariate analyses were conducted on 515 consecutive lung resections for stage I NSCLC performed from 1990 to 1999 and identified by reviewing a database into which data were entered prospectively. Tumors were staged as stages IA (n = 147) and IB (n = 348) according to the 1997 UICC (Union Internationale Contre le Cancer) pTNM classification. RESULTS: Operative mortality rates were 6.2%, 5.3%, 2.3%, and 0% for pneumonectomy, bilobectomy, lobectomy, and lesser resections, respectively. Overall survival rate was 61.1% (55.8% to 66.5%) at 5 years. Univariate analysis identified three significant adverse prognosticators: arteriosclerosis as comorbidity, pathologic T2 status, and blood vessel invasion. Male sex (p = 0.056) and performance of pneumonectomy (p = 0.057) were at the threshold of statistical significance. At multivariate analysis, three independent prognosticators entered the model: arteriosclerosis, blood vessels invasion, and performance of pneumonectomy. CONCLUSIONS: Long-term survival of patients with completely resected stage I NSCLC was adversely influenced in a relatively balanced way by factors related to the clinical status of the patient, to the tumor, and to the treatment.     

Neuroepithelial origin of the insular and endopiriform parts of the claustrum

The lateral and ventral pallia have been proposed as the source of neurons for the insular and endopiriform claustra, respectively. However, this correlation is controversial. Here, we analysed this relationship by labelling radial glia in coronal slices of the telencephalon of paraformaldehyde-fixed rabbit embryos (E18-E28) and newborn rabbits with an anti-vimentin antibody or with the fluorescent dye DiI. The radial glia that crossed the claustrum was anchored to the neuroepithelium of the lateral ventricular angle (LVA) at all ages studied. The LVA was deep at E18, but it subsequently become shallower, because of the apposition of the portion of its walls proximal to the vertex of the LVA. At E18, the radial glia that crossed most of the insular claustrum extended from the lateral wall of the LVA (presumptive lateral pallium), and the radial glia that crossed either the most ventral part of the insular claustrum or the endopiriform claustrum proceeded from the medial wall of the LVA (presumptive ventral pallium). These results suggest that although the endopiriform claustrum originates from the ventral pallium, the insular claustrum originates from both the lateral and the ventral pallial portions.     

The role of discriminant analysis in the refinement of customer satisfaction assessment

OBJECTIVE: To test discriminant analysis as a method of turning the information of a routine customer satisfaction survey (CSS) into a more accurate decision-making tool. METHODS: A 7-question, 10-multiple choice, self-applied questionnaire was used to study a sample of patients seen in two outpatient care units in Valparaíso, Chile, one of primary care (n=100) and the other of secondary care (n=249). Two cutting points were considered in the dependent variable (final satisfaction score): satisfied versus unsatisfied, and very satisfied versus all others. Results were compared with empirical measures (proportion of satisfied individuals, proportion of unsatisfied individuals and size of the median). RESULTS: The response rate was very high, over 97.0% in both units. A new variable, medical attention, was revealed, as explaining satisfaction at the primary care unit. The proportion of the total variability explained by the model was very high (over 99.4%) in both units, when comparing satisfied with unsatisfied customers. In the analysis of very satisfied versus all other customers, significant relationship was identified only in the case of the primary care unit, which explained a small proportion of the variability (41.9%). CONCLUSIONS: Discriminant analysis identified relationships not revealed by the previous analysis. It provided information about the proportion of the variability explained by the model. It identified non-significant relationships suggested by empirical analysis (e.g. the case of the relation very satisfied versus others in the secondary care unit). It measured the contribution of each independent variable to the explanation of the variation of the dependent one.     

Phenotypic variability in the Baller-Gerold syndrome: Report of a mildly affected patient and review of the literature

We report a patient with a mild form of the Baller-Gerold syndrome (craniosynostosis-radial aplasia syndrome). The patient, a 3-year 3 month-old boy, has trigonocephaly with bilateral absent radii and thumbs. His growth parameters and psychomotor development have been normal. No visceral anomalies were found. This patient represents a new case of the rare mild form of the syndrome.