Relationship of Estrogen and Progesterone Receptor Protein Levels in Carcinomatous and Adjacent Non-Neoplastic Epithelium of the Breast: A Histopathologic and Image Cytometric Study

Background. Results of a previous study demonstrating a correlation between steroid hormone receptor concentrations in benign and tumor tissue in patients with breast carcinoma suggest that receptor levels in breast epithelium undergoing malignant transformation may play a role in determining the receptor levels in the resulting carcinoma. Data used in that study were derived from ligand binding assays and may reflect shortcomings inherent in this methodology, particularly the dilution of receptor proteins from benign and malignant epithelial cells by stromal components. Methods. We performed a correlation study of steroid hormone receptor expression in benign and malignant breast epithelial cells using computerized image cytometry and histologic sections stained for estrogen (ER) and progesterone receptor (PR), avoiding the problems of contribution of stromal cells to the measurements and uncertainty about the histologic composition of the sample. Sections which contained both tumor and non-neoplastic breast elements were obtained from surgical specimens from 50 patients with breast carcinoma. Results. Positive area (PA) scores for ER in benign and malignant epithelium showed direct correlation that was significant (r=0.46, p<0.001), whereas those for PR, although trended in the same direction, did not (r=0.17, p>0.2). PA levels for both receptor proteins were higher in benign breast epithelium with proliferative features, compared to non-proliferative benign epithelium, and in tumors when the associated benign tissue had proliferative changes, but neither of these differences were statistically significant, suggesting that the correlation of ER levels in benign and malignant epithelium was not simply a function of proliferative change. Conclusion. Our results provide support for the concept that ER expression in breast carcinoma depends partially on epithelial cell receptor levels in the breast in which it arises, but not for the analogous hypothesis for PR. When costs and benefits of tamoxifen chemoprevention are weighed for a patient at risk for breast carcinoma, and when cyto- or histopathologic breast tissue specimens are available, it may be reasonable to include breast epithelial ER levels among the factors considered in making the treatment decision.     

Presentation of striatal hyperintensity on T1-weighted MRI in patients with hemiballism-hemichorea caused by non-ketotic hyperglycemia: report of seven new cases and a review of literature

Recent studies have shown unique clinicoradiologic characteristics in patients with hemiballism-hemichorea (HB-HC) caused by non-ketotic hyperglycemia; however, there is still a limited number of patients being reported. We report 7 patients (3 males and 4 females) with this type of dyskinesia, whose ages ranged from 60 to 84 years. Brain CT of these patients showed hyperdensity in the contralateral striatum, corresponding with MRI studies that showed an increased signal intensity on T1-weighted images and a decreased signal on T2-weighted images. After metabolic control had been achieved, the hyperkinetic state of these patients abruptly ceased. Follow-up neuroimaging studies in 2 patients documentied complete resolution of the striatal hyperintensity on brain CT and MRI after 3 months and 6 months, respectively. A review of patients with HB-HC caused by non-ketotic hyperglycemia reported formerly and in the present study shows that the dyskinesia tends to occur in aged diabetic patients. The age of patients with dyskinesia secondary to cerebral infarction is generelly much lower. We also found that 86 % (30 out of 35 cases) patients reported with HB-HC caused by non-ketotic hyperglycemia were Asians. The prognosis of the dyskinesia was excellent, and the radiological abnormalities are completely reversible. Received: 2 November 2000 / Received in revised form: 1 February 2001 / Accepted: 3 March 2001     

How complete and accurate are cancer registrations notified by the National Health Service Central Register for England and Wales?

STUDY OBJECTIVE: To assess the completeness and accuracy of notification of cancers by the National Health Service Central Register (NHSCR) for England and Wales. DESIGN: Comparison of 720 cancer registrations ascertained from NHSCR up to May 1999 with those ascertained for the same cohort from six other sources and a pathology review of the NHSCR cancer registrations. PARTICIPANTS: People born in Cumbria, north west England, 1950-89, and diagnosed with cancer throughout the UK, 1971-1989. MAIN RESULTS: Cancer diagnoses notified by NHSCR differed substantially from those determined by this pathology review for 47 of the 688 notified cases reviewed (7%; 95% CI 5%, 9%). Over one third of these discrepancies were attributable to failures in data capture or coding by the cancer registration system and almost half to changes in diagnosis; 26 of the 47 discrepant cases were reclassified as non-malignant and 21 as malignancies but with a substantially different diagnosis. The 694 confirmed malignancies represented 94% (95%CI 92%, 95%) of the 740 cancers ascertained from all sources. CONCLUSIONS: It is estimated that the cancer registration system missed at least 10% (95%CI 6%, 15%) of all incident cases of malignant disease. Without additional ascertainment from multiple sources and diagnostic review, it would be incautious to use NHSCR cancer registrations as the sole basis of an epidemiological study.     

Reliability and reproducibility of brain tissue volumetry from segmented MR scans

Reliable measurement of different tissue volumes in the living brain is of great importance for human brain research. In this article, we report on the inter- and intraoperator reliability and scan-rescan reproducibility of segmented intracranial tissue volumes from MR images using the image analysis software suite BRAINS. The absolute data of tissue volume measurements are also presented. The reliability and consistency of the measurements of the segmented volumes were excellent. The segmentation is robust and rapid and the volume measurements are plausible and suitable for quantitative studies in clinical brain research. Received: 24 April 2001 / Accepted: 24 September 2001     

改善门诊流程 促进医患和谐

改善门诊流程就是以病人为中心，在现有就诊流程的基础上，充分利用信息技术手段，对门诊的作业流程进行重新思考和重新设计，以求得医院门诊在成本、质量、服务和速度等方面获得进一步的改善，从而减缓医护人员与病人之间可能出现的矛盾。从几个方面探讨了改善门诊流程的途径和方法，经多家医院实施和验证，在医护人员工作效率、病人满意度、医院效益等指标上都有了显著提高，和谐的医患关系得到加强。     

医院品牌形象传播的策略与实践

医院品牌形象传播要求以传播品牌核心价值为主旋律,以形象识别系统为载体,以整合传播为手段.在品牌形象传播过程中,烟台毓璜顶医院坚持对内传播和对外推广并重,新闻策略、广告策略、公关策略、事件行销策略并举,实现了品牌传播的效益扩大功能.     

基于区域生长分割的三维心腔重建

阐述了在心内导管手术前．利用胸腔的CT序列断层图像．经一系列处理后．重建心腔三维模型的过程。首先对序列胸腔的CT图像进行降噪和增强等预处理：然后将其堆砌成体数据．根据血液的灰度特性．将其作为三维区域生长的判断准则提取心腔的数据：最后．通过表面重建的方法重建三维心腔模型。     

高度散光患者虹膜定位波前引导的LASIK与常规LASIK手术疗效的比较

目的:比较高度散光患者虹膜定位波前引导的LASIK(IR-LASIK)手术与常规LASIK手术的临床效果。方法:≥2.0DC的高度散光患者分别使用VISXS4-IR准分子激光机进行IR-LASIK手术(204例338眼)和常规LASIK手术(180例335眼),对术后裸眼视力和残留散光度数进行比较,IR手术组检查了眼球旋转的角度。结果:IR-LASIK手术组术后2d裸眼视力(≥1.0者89.1%)明显优于常规LASIK手术组(≥1.0者83.6%,P<0.05),术后残留散光度数也明显小于常规LASIK手术组(0.56DCvs1.15DC,P<0.01)。IR-LASIK手术组波前像差检查的散光度数和轴位均与显然验光结果有一定的差别,所有患眼手术时均发生了眼球旋转。这可能是IR手术后疗效较好的重要原因。结论:IR-LASIK手术能够明显改善高度散光患者术后裸眼视力,减轻术后的散光残留。     

Completeness in an African cancer registry

Objective: A high level of completeness of case-finding is essential if data from cancer registries are to be useful for comparative studies. A large case series, collected independently of the cancer registry case-finding mechanisms, as part of a study of the influence of HIV infection on cancer risk, was used to evaluate the completeness of the registry in Kampala, Uganda, for the years 1994–1996. Results: For adults aged 15 or more, the completeness of registration of diagnosed cancer cases was 89.6% (95% CI 87.0–91.7) overall. It varied with age (better ascertainment of younger cases, aged under 30) and cancer site (with Kaposi sarcoma cases significantly better identified), and cases with a histology report were more likely to be registered than those without (though the difference was not significant). Completeness declined with time, as in most registries, which continue to identify late cases some time after the initial diagnosis. Conclusion: This is the first objective measurement of completeness of cancer registration in Africa, and it gives reassurance that published incidence rates are reasonably accurate (provided that there is not an insistence on the very latest results).