Correlation between immunohistochemically determined oestrogen receptor content, using monoclonal antibodies, and qualitative and quantitative tissue features in ductal breast cancer

Previous studies have shown that oestrogen receptor content in breast cancer was correlated with qualitative and also, more strongly, with quantitative nuclear features in tissue sections. However, even with the better reproducible quantitative microscopical assessments, the variance in the correlation with oestrogen receptor was considerable. This might be due to the implicit problems of oestrogen receptor determination with the biochemical assay. Therefore, receptor content was studied using monoclonal antibodies in 50 consecutive invasive ductal breast cancers. Oestrogen receptor status was compared with qualitative features and with the mean and standard deviation of the nuclear area, morphometrically evaluated on immunostained and adjacent haematoxylin and eosin stained sections. In agreement with earlier observations, nearly all tumours with prominent elastosis were oestrogen receptor positive; but a minority of negative cases also showed elastosis. The correlation between the other qualitative features and receptor status was weak. A significant inverse correlation (P less than 0.001) existed between the receptor status and the mean and standard deviation of the nuclear area. Even with the highly reproducible morphometrical analysis, correlation between nuclear oestrogen receptor content and quantitative nuclear features was relatively weak. This might indicate that receptor status and nuclear morphometric features reflect different biological characteristics of breast cancers.     

直肠癌全直肠系膜切除术后直肠阴道瘘原因与防治

本文通过分析近5年来我院18例女性直肠癌全直肠系膜切除术后直肠阴道痿的临床资料。发现直肠阴道痿多发生于中低位直肠癌行全直肠系膜切除保肛手术的患者。痿的发生与肿瘤的位置、肿瘤的分期、肿瘤距肛门口的距离．以及手术技巧、手术难度、引流方法有关。而与是否进行预防性造口，以及是否采用腹腔镜手术无关。预防上强调应重视术中直肠前壁的锐性分离、结肠直肠吻合以及术后盆腔的负压引流。治疗上应首先进行保守治疗，即肠内营养，阴道冲洗。早期配合肠外营养、及全身或局部抗炎治疗，大部分直肠阴道痿通过保守治疗可以治愈。保守治疗无效时考虑结肠或回肠末端造口。若长期不愈应考虑吻合口肿瘤复发的可能。     

艾滋病与千年发展目标

通过艾滋病的流行和传播与其他发展目标的相互影响,论证遏制并扭转艾滋病蔓延的紧迫性,同时采取多途径确保千年发展目标的最终实现。     

塞来昔布对大鼠化学性乳腺癌的抑制作用及机制

目的 观察环氧化酶-2(cyclooxygenase-2,COX-2)选择性抑制剂塞来昔布对化学致癌剂7,12-二甲基苯蒽(7,12-dimethybenz[a]anthracene,DMBA)化学诱发的大鼠乳腺癌的抑制作用并探讨其机制.方法 将DMBA油剂灌胃复制大鼠乳腺癌模型,大鼠分为对照组(24只)和实验组(25只),观察塞来昔布对大鼠乳腺癌的抑制作用,并采用基因芯片技术了解治疗后2组肿瘤的基因表达谱差异.结果 实验组塞来昔布处理后乳腺肿瘤的数目、直径、体积分别为(2.56±1.26)个、(1.162±0.355)cm、(1.967±1.725)cm.;明显小于实验前的(3.40±1.22)个、(1.948±0.481)cm、(8.794±6.389)cm3;明显小于对照组(3.88±1.73)个、(2.231±0.736)cm、(10.268±5.447)cm3,差异有显著性意义(均P＜0.01).对照组COX一2蛋白表达为62.5%(15/24),实验组COX-2蛋白表达为36.0%(9/25),差异有显著性意义(P＜O.05).基因表达谱显示两组之间表达丰度差异2倍及以上的基因共有243条,其中表达上调2倍或以上的基因片段124条,表达下调2倍或以上的基因片段119条,发现功能不明的新基因6条,其中表达上调的4条.结论 塞来昔布能抑制DMBA诱发的大鼠乳腺癌进展,其机制和多种基因改变有关.     

Aktuelle Indikationen zur pyloruserhaltenden Duodenopankreaskopfresektion beim Malignom

Zusammenfassung Die Pankreaskopfresektion in der Modifikation nach Traverso-Longmire, mit Erhaltung eines funktionierenden Pylorus, hat gegenüber der Kausch-Whipple-Operation die Vorteile, daß Anastomosenulzera vermieden werden und daß die Patienten postoperativ eine bessere und schnellere Gewichtszunahme haben. Indikationen waren bisher die Papillenkarzinome und periampulare Tumoren. Bei den Adenokarzinomen lassen sich mit der Pyloruserhaltung gleich gute Überlebensraten erzielen. Unsere Ergebnisse von 56 Pyloruserhaltungen, davon 32 beim duktalen Karzinom und 28 Kausch-Whipple-Operationen in den Jahren von 1985–1993, belegen gleiche Überlebensraten, wie dies bereits für das Papillenkarzinom gezeigt werden konnte. Die Überlebenskurven zeigen, daß die Radikalität nicht von der Magenteilentfernung, sondern von der Resektion an den posterioren und retroperitonealen Resektionsrändern abhängt.

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Current indications for pylorus preservation in duodenopancreatic head resection in malignancies

The Whipple procedure has been improved by preservation of a functioning pylorus. A functioning pylorus is important because marginal ulceration is avoided and, compared to the standard Whipple procedure with gastric resection, more patients can gain weight postoperatively. The most common indications are carcinomas of ampulla of Vater and periampullary tumors. In patients with pancreatic adenocarcinoma the pylorus-preserving variety results in equal or better survival rates. In 56 patients with pylorus preservation, 32 with ductal carcinoma, and 28 with Kausch-Whipple between 1985 and 1993, our results showed slightly better survival rates and better post-operative nutrition. The weakest aspect of the radical resection addresses the retroperitoneal margin of the pancreas head and not the gastric resection.

     

Left ventricle haemodynamics and vaso-active hormones during graded supine exercise in healthy male subjects

Left ventricle systolic and diastolic functional parameters were measured by gated equilibrium radionuclide cardiography in 12 healthy men (age 33–51 years) at rest and during graded supine exercise. The leftventricle end-diastolic volume showed an initial small (11%) increase during low submaximal exercise [from mean 163 (SD 40) at rest to mean 181 (SD 48) ml], while left ventricle end-systolic volume decreased successively [from mean 59 (SD 19) to mean 39 (SD 21) ml] with increasing exercise. Stroke volume was therefore elevated at all exercise levels compared with rest [mean 104 (SD 23) ml], and the peak value [mean 128 (SD 33) ml] was found at the lowest exercise level, contributing 40% to the initial increase in cardiac output. Cardiac output increased from mean 6.2 (SD 1.4) at rest to mean 20.2 (SD 5.0) 1 · min^–1 at maximum. Left ventricle peak ejection and peak filling rates increased from mean 449 (SD 89) and mean 442 (SD 85) ml · s^–1 at rest to mean 996 (SD 227) and mean 1255 (SD 333) ml · s^–1, respectively, at maximum. The myocardium oxygen consumption, assumed to be proportional to the sum of the stroke work and the potential energy, increased fourfold, but absolute values were twice as high as expected, indicating that extrapolation from data obtained in dog hearts (as we have done) cannot be directly applied to humans. Selected vaso-active hormones were measured at all exercise intensities. Noradrenaline (NA), adrenaline (A) and angiotensin II (AII) concentrations showed a very pronounced increase at maximal exercise compared with the preceding lower intensites, while atrial natriuretic factor (ANF) and cyclic guanosinemonophosphate (cGMP) concentrations showed a more continuous increase, and dopamine (DA) remained almost unchanged. This speaks in favour of a crucial role for NA, A and AII in preserving blood pressure at maximum exercise, while DA probably has no importance for the cardiovascular homeostasis during exercise. Increases in concentrations of ANF and cGMP were highly correlated (r = 0.86). Our data supported the opinion that there is a cardiac limitation to maximal performance connected to the cardiac pumping capacity.     

中西医结合治疗胫腓骨开放性骨折82例

对８２例胫腓骨开放性骨折，采用中西医结合治疗收到良好效果，治疗中主张在彻底清创的基础上使开放性骨折变为闭合性骨折，外固定时要求患者呈坐位，让伤肢自然下垂悬空，利用肢体的垂直重力作用使骨折正确复位，再根据具体情况进行有效的外固定。少用内固定，在用药方面，根据骨折治疗的不同时期采用中西药结合的辨证论治，同时强调早期进行功能锻炼。     

Testing for skin sensitization according to the notification procedure for new chemicals: the Magnusson and Kligman test

The notification procedure for new chemicals in the European Union (called the Chemicals Act in Germany) requires a skin sensitization test when the amount of a new chemical produced exceeds 100 kg/year. The preferred test is that of Magnusson and Kligman; more than 90% of the tests submitted are performed with it. Though the Magnusson and Kligman test is described in the literature, and in the test guidelines of the European Union and of the OECD, discrepancies do occur in the performance of the test between test laboratories. In this paper, recommendations are given for standardized performance of the Magnusson and Kligman test.     

EPIDEMIOLOGICAL CHARACTERISTICS OF PROSTATE CANCER IN GUNMA PREFECTURE, JAPAN

Background Prostate cancer is rare in Asia, but the number of patients is increasing in Japan. We conducted an epidemiological study of prostate cancer in Gunma Prefecture, Japan, to investigate the trends and characteristics of the disease.
Methods: The subjects were 1.411 prostate cancer patients newly diagnosed between 1985 and and 656 patients who died from prostate cancer between 1981 and 1992. The incidence and mortality rates were calculated by year, demographic region and age.
Results: The yearly incidence rate showed an increase but the mortality rate showed no marked fluctuations. There was no significant difference between urban and ruraI districts in either incidence or mortality rate. The incidence rate tended to be high in the northern part of the prefecture, but no marked variation in mortality rate was seen. The incidence and mortality rates in districts with a history of manganese mining were high compared to those in districts without mining. In contrast, the incidence and mortality rates in districts with a history of zinc mining were comparatively lower. Both incidence and mortality rates showed a marked increase with age. The age-specific incidence showed a double logarithmic relationship to age.
Conclusions: The increase of the yearly incidence rate might be due to changes in lifestyle and environmental factors, improved diagnostic techniques, and increased awareness among the general public regarding prostate disease. Further investigation is needed to clarify the pattern and the causes of regional differences in the incidence and mortality rates. The possibilities that manganese and zinc might be related to prostatic carcinogenesis are suggested. Int J Urol 1995:2:191–197