The assessment of multiple variables on breast carcinoma fine needle aspiration (FNA) cytology specimens: method, preliminary results and prognostic associations

The assessment of multiple variables on breast carcinoma fine needle aspiration (FNA) cytology specimens: method, preliminary results and prognostic associations
We have assessed multiple biological variables on breast carcinoma FNA specimens using a Cytoblock technique. The growth fraction (MIBI), oestrogen receptor (ER), progesterone receptor (PR), p53 mutant protein, c-erbB-2, epidermal growth factor receptor (EGFR), NCRCl Vepithelial membrane antigen (EMA) and DNA plopidy were examined. Objective quantification using image analysis (CAS 200) was applied as appropriate. Fifty cases were examined in this preliminary study. Excellent correlation between the Cytoblock preparations and parallel tissue sections was seen. Of the cancers, 81% were aneuploid with only 19% diploid in character, but 67% of the carcinomas were of histological grade 3. The mean nuclear area staining with MIBl was 31.3% and with ER was 26.7%. Twenty-four percent (24.1%) of the nuclear area showed immunoreactivity with PR. Significant immunostaining was seen in 38%, 46%, 38% and 95% of carcinomas with c-erbB-2, p53, EGFR and EMA, respectively. A significant association between histological grade of the resected tumours and both MIBl (P=0.04) and EGFR (P=0.02) expression in the Cytoblock samples was seen. p53 (P = 0.03) and EGFR (P=0.01) immunoreactivity showed an association with tumour size. EGFR (P=0.04) immunostaining also showed a relationship with the lymph node status of the patient. The technique is, we believe, a useful one for the assessment of multiple variables on breast cytology specimens; these preliminary data suggest that some of these may be useful in predicting prognosis in breast cancer patients.     

Crania sedgwickii revised as a hyolith operculum

Originally described as an inarticulate brachiopod, and later even queried as a possible coral, the unique specimen of Crania sedgwickii Davidson, 1848, from the Much Wenlock Limestone Formation (Silurian) of England is now recognised as an operculum belonging to the Hyolitha. In detail its affinities remain unclear, since it cannot be matched with any known hyolith, and it probably represents a new genus. Its morphology incorporates a combination of features suggestive of both the Order Hyolithida and the Orthothecida, but its closest relationships appear to be with the latter group. Records of C. sedgwickii from Gotland, Sweden, probably refer to true craniacean brachiopods and thus bear no relationship to the English specimen.     

Lifestyle modifications to prevent and control hypertension. 1. Methods and an overview of the Canadian recommendations. Canadian Hypertension Society,Canadian Coalition for High Blood Pressure Prevention and Control,Laboratory Centre for Disease Control at Health Canada,Heart and Stroke Foundation of Canada

OBJECTIVE: To provide updated, evidence-based recommendations for health care professionals on lifestyle changes to prevent and control hypertension in otherwise healthy adults (except pregnant women). OPTIONS: For people at risk for hypertension, there are a number of lifestyle options that may avert the condition--maintaining a healthy body weight, moderating consumption of alcohol, exercising, reducing sodium intake, altering intake of calcium, magnesium and potassium, and reducing stress. Following these options will maintain or reduce the risk of hypertension. For people who already have hypertension, the options for controlling the condition are lifestyle modification, antihypertensive medications or a combination of these options; with no treatment, these people remain at risk for the complications of hypertension. OUTCOMES: The health outcomes considered were changes in blood pressure and in morbidity and mortality rates. Because of insufficient evidence, no economic outcomes were considered. EVIDENCE: A MEDLINE search was conducted for the period January 1996 to September 1996 for each of the interventions studied. Reference lists were scanned, experts were polled, and the personal files of the authors were used to identify other studies. All relevant articles were reviewed, classified according to study design and graded according to level of evidence. VALUES: A high value was placed on the avoidance of cardiovascular morbidity and premature death caused by untreated hypertension. BENEFITS, HARMS AND COSTS: Lifestyle modification by means of weight loss (or maintenance of healthy body weight), regular exercise and low alcohol consumption will reduce the blood pressure of appropriately selected normotensive and hypertensive people. Sodium restriction and stress management will reduce the blood pressure of appropriately selected hypertensive patients. The side effects of these therapies are few, and the indirect benefits are well known. There are certainly costs associated with lifestyle modification, but they were not measured in the studies reviewed. Supplementing the diet with potassium, calcium and magnesium has not been associated with a clinically important reduction in blood pressure in people consuming a healthy diet. RECOMMENDATIONS: (1) It is recommended that health care professionals determine the body mass index (weight in kilograms/[height in metres]2) and alcohol consumption of all adult patients and assess sodium consumption and stress levels in all hypertensive patients. (2) To reduce blood pressure in the population at large, it is recommended that Canadians attain and maintain a healthy body mass index. For those who choose to drink alcohol intake should be limited to 2 or fewer standard drinks per day (maximum of 14/week for men and 9/week for women). Adults should exercise regularly. (3) To reduce blood pressure in hypertensive patients, individualized therapy is recommended. This therapy should emphasize weight loss for overweight patients, abstinence from or moderation in alcohol intake, regular exercise, restriction of sodium intake and, in appropriate circumstances, individualized cognitive behaviour modification to reduce the negative effects of stress. VALIDATION: The recommendations were reviewed by all of the sponsoring organizations and by participants in a satellite symposium of the fourth international Conference on Preventive Cardiology. They are similar to those of the World Hypertension League and the Joint National committee, with the exception of the recommendations on stress management, which are based on new information. They have not been clinically tested. SPONSORS: The Canadian Hypertension Society, the Canadian Coalition for High Blood Pressure Prevention and Control, the Laboratory Centre for Disease Control at health Canada, and the Heart and Stroke Foundation of Canada.     

Surgical repair of corneal injury

Operations on the cornea relating to trauma are discussed, and included are tangential flaps, corneal injuries, old adherent leukoma, and optical iridectomy. Variations from the usual technique and the immediate surgical closure of corneal wounds are emphasized.     

Anthropogenic changes to the landscape resulted in colonization of koalas in north‐east New South Wales,Australia

Significant changes in the distribution and persistence of species have been driven by Pleistocene cyclical climate changes and, more recently, by human modification of the environment. In eastern Australia, Pleistocene cyclical patterns in temperature and aridity led to the expansion and retraction of rainforest and likely affected the distribution of the koala (Phascolarctos cinereus, family Phascolarctidae), a species preferring dry or open woodland. More recently, anthropogenic landscape modification has led to a large‐scale change in distribution of the koala following the destruction of approx. 75 000 ha of subtropical rainforest in north‐east New South Wales termed the ‘Big Scrub’. Sharing of the control region haplotypes to the north and south of this region indicate historical connectivity of coastal koala populations. However, the majority (110/115) of sampled koalas from this region shared a single mitochondrial control region haplotype, suggesting that koalas did not persist in multiple refugial pockets within a heterogenous rainforest but expanded into the region following deforestation. Bayesian cluster analysis of microsatellite data consistently identified two clusters of koalas. One cluster, in the north of the area, had high microsatellite diversity (10 alleles per locus, He = 0.79) and clustered with koalas further to the north, thus suggesting a southerly expansion into the cleared area. To the south was a cluster with significantly lower diversity (six alleles per locus, He = 0.59, P < 0.001). It is possible there has been restricted or filtered movement of koalas between these clusters, which coincides with a cleared river valley and associated roads or immigration from populations both to the north and to the south. This study gives an insight into the timescale of changes in species distribution following rapid alterations to suitable habitat.     

A Model of the Effect of Temperature and Moisture on Pollen Longevity in Air-dry Storage Environments

Data on the survival of pollen ofTypha latifoliaL. stored forup to 261 d over seven different saturated salt solutions (providing0.5 to 66% relative humidity) and six different constant temperatures(from -5 to +45 °C) were analysed to quantify the effectof air-dry storage environment on pollen longevity. Pollen survivalcurves conformed much more closely to negative cumulative normaldistributions than to negative exponential relations. Estimatesofp₅₀(storage period required to reduce pollen viability to50%), provided by negative cumulative normal distributions,were available from 37 different storage environments in whichpollen viability was reduced below 50%. Once observations at0.5% and 5.5% relative humidity were excluded from analysis,there was a negative logarithmic relation between these estimatesof longevity and pollen moisture content (%, wet basis) anda curvilinear semi-logarithmic relation between longevity andtemperature. When the negative logarithmic relation betweenlongevity and moisture content was replaced by a negative semi-logarithmicrelation between longevity and the relative humidity of thestorage environment the resultant model was less satisfactory,principally because pollen longevity over saturated solutionsof calcium nitrate (43–62% relative humidity) and sodiumnitrite (60–66% relative humidity) were consistently greaterand smaller, respectively, than fitted values. Notwithstandingthese errors, comparison between the fitted relations and observationsat the two lowest relative humidities provided estimates ofthe lower-relative-humidity limits to these relations. Theseprovisional estimates varied with storage temperature beinglowest at 25 °C (<5.5% relative humidity). However, therewas no linear trend to that variation (P>0.25): the meanestimate was 11.9 (s.e.=1.4)%. The considerable similaritiesamong models of pollen longevity in air-dry storage, and theirestimated lower limits, and those developed previously for orthodoxseeds and spores are discussed.Copyright 1999 Annals of BotanyCompany. Typha latifoliaL., pollen, storage, survival, longevity, relative humidity, moisture content, temperature.     

Disease spread of non-specialised fungal pathogens from inoculated point sources in intraspecific mixed stands of cereal cultivars

Spread of Septoria nodorum from inoculated point sources was examined in pure stands and mixtures of two spring wheat cultivars Kolibri and Maris Butler. Gradients in disease were observed soon after inoculation; the presence of the more resistant cultivar (Maris Butler) in the mixtures retarded the outward spread of disease compared with the susceptible pure stand (Kolibri). Regression analysis suggested that gradients in incidence were influenced by nearness to the source whereas gradients in severity were not. Spread of disease was also examined in pure stands and mixtures for the host/pathogen combinations, winter wheat (cvs Maris Huntsman and Maris Ranger)/S. nodorum and winter barley (cvs Maris Otter and Hoppel)/Rhynchosporium secalis. In contrast to the spring wheat experiment, no gradients were observed; explanations for the uniform distribution of disease were (a) extensive spread prior to the period of assessment, (b) no physical barrier to dispersal due to the juvenile growth stage of the crop and (c) exhaustion of the point-source.