Estrogen receptor beta protein in human breast cancer: correlation with clinical tumor parameters

The recent discovery of a second estrogen receptor (ER), designated ERbeta, raises pressing questions about its role in estrogen regulation of human breast cancer cells and its significance for the prediction of recurrence and treatment responses in clinical breast cancer. Most of what we know about ERbeta expression comes from studies examining a limited number of samples at the RNA level. We have now generated a monoclonal antibody useful for the detection of ERbeta at the protein level in archival, formalin-fixed breast tumors and have examined its expression using immunohistochemistry in a pilot series of 242 breast cancer patients. Coexpression of ERbeta and ERalpha was found in the majority of the tumors, with 76% of the tumors expressing ERbeta as determined by immunohistochemistry. ERalpha, but not ERbeta, was strongly associated with progesterone receptor expression, suggesting that ERalpha is the predominant regulator of this estrogen-induced gene in breast tumors. Although ERalpha expression was positively correlated with low tumor grade, diploidy, and low S-phase fraction, all biological parameters of a good prognostic profile, ERbeta trended toward an association only with aneuploidy; no association with tumor grade or S-phase fraction was seen for ERbeta. We found that ERbeta expression does cause false positive readings for ERalpha. These results suggest that ERbeta expression is not a surrogate for ERalpha in clinical breast tumors and, as such, could be a useful biomarker in its own right.     

Quality assurance in gynecologic cytology. The value of cytotechnologist-cytopathologist discrepancy logs

We describe a simple method for displaying and evaluating the concordance or discordance between cytotechnologists (CTs) and cytopathologists (CPs) on gynecologic cases. The provisional diagnoses made by the CTs and the final diagnoses of the CPs are captured by the laboratory information system; data generated for specified periods are displayed as a 10 x 10 matrix that classifies each possible diagnosis made by the CT and CP into 1 of 10 major categories. Matrices are generated for the entire laboratory and for individual CTs; individual CTs are evaluated based on their deviation from the laboratory average. Three statistical measures are generated: percentage of discordant diagnoses, a kappa statistic, and a weighted measure. During a 2.5-year period, approximately 4,200 cases were referred to a CP for review every 6 months. The median discordance in diagnoses increased during 2 years from 21% to 34%, and the kappa value fell from 0.69 to 0.38. This was attributed primarily to 1 CT, whose performance, as well as that of the entire laboratory, improved after remedial action. Measures of CT-CP diagnostic concordance are a useful and efficient measure of CT performance and can be incorporated into mandatory semiannual performance evaluations.     

Prognostic value of p53 for local failure in mastectomy-treated breast cancer patients.

PURPOSE: The loss of p53 function is a recognized adverse prognostic factor in invasive breast cancer. Several studies have shown a relationship between the nuclear accumulation of p53 protein (a surrogate marker of p53 inactivation) and poor disease-free and overall survival. In general, however, these studies did not report the prognostic value of p53 for local failure, which we have therefore assessed retrospectively here. MATERIALS AND METHODS: Accumulation of p53 protein was evaluated by immunohistochemistry in 1,530 mastectomy-treated breast cancer patients (259 radiation therapy [RT]- and 1,271 mastectomy only [No RT]-treated patients). Statistical comparisons were made between p53 protein accumulation, estrogen/progesterone receptors, nodal status, tumor size, and local failure rate (LFR). Local failure was defined as tumor recurrence involving the chest wall and/or the ipsilateral supraclavicular/axillary lymph nodes. The median follow-up period was 62 months. RESULTS: In the No RT group, the LFR was 9.1% and 16. 5% in p53-negative and p53-positive patients, respectively (P<.001). Multivariate analysis revealed that p53 protein accumulation was significantly associated with an increased risk of local relapse (relative risk [RR], 1.7; 95% confidence interval [CI], 1.2 to 2.4). Nodal status and tumor size were also significant factors. In the RT group, the LFR was 9.3% and 21.5% in p53-negative and p53-positive patients, respectively (P = .009). Multivariate analysis revealed that p53 protein accumulation was significantly associated with an increased risk of local relapse (RR, 2.5; 95% CI, 1.1 to 5.7), as was nodal status. CONCLUSION: Nuclear accumulation of p53 protein is independently associated with a significantly increased local failure rate in breast cancer patients treated with mastectomy, with or without radiation.     

Iopamidol arteriography: discomfort and pain

A double-blind, randomized study was performed to compare discomfort and pain associated with the use of iopamidol and Hypaque (diatrizoate sodium and diatrizoate meglumine) during iliofemoral runoff arteriography in 33 patients. Iopamidol caused substantially less discomfort and pain. The evaluation was helped by audiotaping the study and comparing patients' vocal responses to injections of these materials.     

Acute alloxan diabetes alters the activity but not the total quantity of acetyl CoA carboxylase in rat liver

Alloxan diabetes has repeatedly been shown to reduce lipogenesis in rat liver concomitant with decreased activity of acetyl CoA carboxylase. This and other observations led to the deduction that insulin is required for the synthesis of acetyl CoA carboxylase even though the actual amount of enzyme was not measured. We have developed methods to determine the quantity of acetyl CoA carboxylase in crude tissue extracts with which we have reexamined the role of insulin in regulating the amount of the enzyme in liver of acute (3-d) alloxan diabetic rats. The results show that although there was a decrease in the quantity of the active cytoplasmic form of acetyl CoA carboxylase in the liver of alloxan diabetic rats, there was a corresponding increase in the quantity of relatively inactive forms of the enzyme associated with mitochondria. Thus, the total amount of enzyme was minimally affected by the diabetic state. Instead, the results indicate that decreased acetyl CoA carboxylase activity in liver of the diabetic rats was attributable to a shift in the subcellular distribution of the enzyme from the active cytoplasmic to inactive mitochondrial forms. We have shown previously that subcellular distribution of the enzyme is dietary dependent. Results of this study implicate insulin in the mobilization and activation of mitochondrial acetyl CoA carboxylase.     

Executive Dysfunction Early Postnatal Biomarkers among Children Born Extremely Preterm

Journal of Neuroimmune Pharmacology - We evaluated the relationship between blood levels of inflammatory and neurotrophic proteins during the first postnatal month in 692 children born before the...     

The New Brunswick Health Council at a glance

This article presents an overview of the work of the New Brunswick Health Council (NBHC) since its creation by exploring its mandate and by presenting its different initiatives and publications as they relate to the NBHC's areas of work: population health, care experience, sustainability, and citizen engagement.     

爆裂性骨折所致眼球内陷的CT研究

目的:研究眼眶爆裂性骨折后,眼球内陷与眼眶容积扩大的关系并对眼球内陷进行早期预报。方法:28例单侧眼眶爆裂性骨折后1～350 d患者,分别测量双侧眼球位置和骨性眼眶容积值,计算患侧眼球内陷值(E)和骨性眼眶容积扩大值(V),应用pearson积矩法研究E、V相关性并建立直线回归方程。结果:28例患侧E、V呈正相关(r=0.88,P<0.001);15例≤24 d的患者直线回归方程为E=0.85 V-1.74(r=0.86,P<0.001),13例>24 d的患者直线回归方程为E=0.86 V-0.60(r=0.9,P<0.001)。结论:眼球内陷值与眼眶容积扩大值高度相关;1 mL眼眶容积的扩大,可引起大约0.9mm(0.85～0.86 mm)的眼球内陷。与伤后>24 d的相比,≤24 d的眼球有明显的抗拒内陷的趋势,>24 d之后,这种趋势逐渐消失,随之发生眼球内陷。     

无症状性脑梗塞的CT表现及病因分析

本文说明了无症状性脑梗塞的病灶大小、分布、特点及CT表现。主要病因是动脉粥样硬化、高血压、糖尿病。