Biomedical subjects
Publications and source records attributed to J Hugh.
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A nested case-control study was conducted to identify risk factors for benign breast biopsies in 382 cases (women with a benign biopsy result) and 399 controls (women who had not undergone a biopsy) who were sampled from the Alberta breast cancer screening program. The breast biopsy specimens of the cases were reviewed by a panel of pathologists, and percent fibroglandular tissue density was assessed. The multivariable odds ratios for the risk of open benign breast biopsy associated with current cigarette smoking was 2.04 (95% CI 1.32-3.13), for ever regular smoking was 1.61 (1.20-2.16), and for passive smoking was 1.41 (0.99-2.02). A risk reduction was found for ever alcohol consumption (0.61 [0.44-0.85]). Some risk reductions were found when the highest and the lowest quintiles of total aerobic recreational activity were compared (0.71 [0.42-1.20]), stair climbing (0.61 [0.37-1.01]) and walking pace (0.13 [0.02-0.741). Lifestyle risk factors may be implicated in the continuum between detection of an abnormality on a screening mammogram and a breast biopsy specimen. By considering these risk factors, breast screening programs may be better able to identify those women who require a breast biopsy and reduce the number of benign breast biopsies.
BACKGROUND: As part of a nested case-control study of benign proliferative breast disease (BPBD) conducted within the cohort of women participating in the Alberta breast screening programme, an analysis of all women who had a benign breast biopsy between 1990 and 1995 was undertaken to identify the epidemiological risk factors for BPBD. METHODS: The breast biopsies of all eligible women were re-reviewed by a panel of four pathologists using Page's classification for benign breast disease. Cases were 165 women whose biopsies, upon review, showed benign breast tissue changes ranging from sclerosing adenosis to atypical ductal hyperplasia. Controls were 217 women whose biopsies showed no evidence of any proliferative or neoplastic changes. In-person interviews were conducted with all study subjects. RESULTS: Women with >/=25% fibroglandular breast tissue density, as compared to women with <25% density, experienced nearly a doubling in risk of BPBD (OR = 1.91, 95% CI : 1.24-2.94). All other possible risk factors examined were not associated with BPBD. CONCLUSION: This study suggests that fibroglandular tissue density may be a risk factor, or marker, for increased risk of BPBD.
Haemorrhagic myocarditis is a rare but important complication of cyclophosphamide therapy. Echocardiographic identification of the disorder can be made. We believe that the ultrasound features of this disorder have not been previously reported.
In contrast to previous decades, the 1990s have witnessed an increase of new agents with significant activity in breast cancer, including chemotherapy, hormone therapy, and, more recently, biologic modifiers. All information appears to confirm that such a trend will persist and even accelerate in the coming decades. Unless clear strategies of development for new drugs are strictly followed, it will become difficult to adequately assess the many new agents with potentially important activity against breast cancer, and patient access may become a limiting key factor. The academic, global virtual concept is calling for the definition of a new relationship between the pharmaceutical industry and clinical researchers. The main aspect is related to the creation of partnerships with an academically controlled global strategy of development for promising new agents, in which the quality and independence of processes (adjuvant setting, for example) are critical. The means are based on the globalization of patient access (worldwide network) and the virtuality of the approach (modern means of communication as well as access to subgroups of patients). The Breast Cancer International Research Group is the first academic global virtual cooperative group in breast cancer and is making contributions in the development of new drugs, such as taxanes, new antiestrogens, and new cytokines.
PURPOSE: We assessed the prognostic impact of genitourinary small cell carcinoma tumor and patient characteristics, and therapy. MATERIALS AND METHODS: We retrospectively reviewed the records of 180 patients with genitourinary small cell carcinoma in which patient and tumor characteristics, therapy, followup duration and survival status had been documented. Patient age, sex, primary site, histological features, tumor size, stage, locoregional therapy, systemic chemotherapy and hormonal manipulations were analyzed for association with survival. RESULTS: There were 106 cases of bladder, 60 prostatic, 8 renal and 6 ureteral small cell carcinoma. Median survival was 10.5 months overall, and 7 and 13 months for prostatic and bladder small cell carcinoma, respectively (p <0.0001 log rank analysis). In all cases metastatic disease at presentation (p <0.008, risk ratio 1.9) predicted poor survival on multivariate analysis. Radical surgery (p <0.0001, risk ratio 0.34) and cisplatin chemotherapy (p <0.0001, risk ratio 0.20) were the only factors that predicted improved survival on multivariate analysis. For prostatic small cell carcinoma primary surgical therapy (p <0.012, risk ratio 0.46) was the only parameter that predicted survival on univariate analysis. For bladder small cell carcinoma only cisplatin chemotherapy (p <0.0001, risk ratio 0.15) predicted survival on multivariate analysis. CONCLUSIONS: Genitourinary small cell carcinoma has a poor prognosis, which is worse in prostatic than bladder disease. Patient and tumor characteristics were not determinants of survival when prostatic and bladder small cell carcinoma were analyzed individually. For prostatic disease only primary surgical therapy was associated with prolonged survival, while for bladder disease cisplatin chemotherapy was associated with a favorable prognosis. We recommend considering primary surgical therapy for prostatic and cisplatin based chemotherapy for bladder small cell carcinoma.
TRAF-4 was discovered because of its expression in breast cancers and is a member of the tumor necrosis factor (TNF) receptor-associated factor (TRAF) family of putative signal-transducing proteins. In vitro binding assays demonstrated that TRAF-4 interacts with the cytosolic domain of the lymphotoxin-beta receptor (LT beta R) and weakly with the p75 nerve growth factor receptor (NGFR) but not with TNFR1, TNFR2, Fas, or CD40. Immunofluorescence analysis of TRAF-4 in transfected cells demonstrated localization to cytosol but not nucleus. Immunohistochemical assays of normal human adult tissues revealed prominent cytosolic immunostaining in thymic epithelial cells and lymph node dendritic cells but not in lymphocytes or thymocytes, paralleling the reported patterns of LT beta R expression. The basal cell layer of most epithelia in the body was very strongly TRAF-4 immunopositive, including epidermis, nasopharynx, respiratory tract, salivary gland, and esophagus. Similar findings were obtained in 12- to 18-week human fetal tissue, indicating a highly restricted pattern of expression even during development in the mammary gland, epithelial cells of the terminal ducts were strongly TRAF-4 immunopositive whereas myoepithelial cells and most of the mammary epithelial cells lining the extralobular ducts were TRAF-4 immunonegative. Of 84 primary breast cancers evaluated, only 7 expressed TRAF-4. Ductal carcinoma in situ (DCIS) lesions were uniformly TRAF-4 immunonegative (n = 21). In the prostate, the basal cells were strongly immunostained for TRAF-4, whereas the secretory epithelial cells were TRAF-4 negative. Basal cells in prostate hypertrophy (n = 6) and prostatic intraepithelial neoplasia (PIN; n = 6) were strongly TRAF-4 positive, but none of the 32 primary and 16 metastatic prostate cancer specimens examined contained TRAF-4-positive malignant cells. Although also expressed in some types of mesenchymal cells, these findings suggest that TRAF-4 is a marker of normal epithelial stem cells, the expression of which often ceases on differentiation and malignant transformation.
A 32-year-old female presented with a right ovarian mass, and the unilateral oophorectomy specimen revealed adenocarcinoma with signet-ring cells histology consistent with a Krukenberg tumor. The high-grade gastric primary adenocarcinoma was later identified, but by this time a viable 7-week fetus and left ovarian Krukenberg tumor were present. Second trimester palliative oophorectomy and partial gastrectomy were performed. The patient delivered a healthy infant by cesarean section and is now 36 months after the initial diagnosis of metastatic gastric carcinoma and remains asymptomatic and free of disease. The unexpectedly favorable clinical outcome suggests that a patient may benefit from resection of gastric adenocarcinoma metastatic to ovary when other sites of metastatic disease are not evident.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Esthesioneuroblastoma or olfactory neuroblastoma, is a rare tumour. It was first described by Berger et al. in 1924. Since then, approximately 250 cases have been reported. These neuroendocrine neoplasms are rarely associated with hormone excess syndromes. We report a case of olfactory neuroblastoma initially manifested with a syndrome of inappropriate secretion of antidiuretic hormone (SIADH) in a 27-year-old man. A literature review is briefly presented.
Direct involvement of the brain by chronic lymphocytic leukemia (CLL) is extremely rare. This is the second documented case. A 63 year-old-man presented with motor deficits. Conventional radiographic imaging showed no abnormalities but an MRI scan of the head showed a high signal intensity lesion in the left cerebellum. Biopsy of this area showed a perivascular infiltrate of small B lymphocytes consistent with CLL involvement. The patient was treated with radiotherapy and had some improvement in symptoms. Three years later he remains alive with some neurologic deficit. This case confirms that CLL can be complicated by direct brain involvement.
BACKGROUND: Amplification of the c-erbB-2 protooncogene and DNA aneuploidy have been reported to correlate with poor patient prognosis in human breast cancer. Several studies have investigated the prognostic value of these two factors in heterogeneous populations of patients with node-positive and node-negative disease. This study evaluated, on a series of patients with node-negative disease, whether c-erbB-2 proto-oncogene amplification and cellular DNA content could identify a subset of patients who, without adjuvant therapy, are destined to experience a relapse. METHODS: Paraffin-embedded tissues of 78 patients were evaluated for cellular DNA content using flow cytometric analysis. Amplification of c-erbB-2 was determined on the same group of patients using slot-blot hybridization. The majority of patients were matched with control subjects for the following five clinicopathologic criteria: size of primary tumor, menopausal status, estrogen receptor, anniversary year of initial treatment, and age at treatment. Long-term follow-up (5-16 years) was available for each patient, none of whom received any form of adjuvant therapy. RESULTS: The presence of an abnormal DNA stemline was found in 47% (37 of 78) of the tissue specimens, whereas only 10% (8 of 78) of the tumors expressed from 3-fold to 22-fold c-erbB-2 amplification. Combined c-erbB-2 amplification and DNA aneuploidy occurred in a small group of patients (n = 4), all of whom experienced relapse. The four remaining tumors having excessive gene copy numbers had a diploid DNA distribution. CONCLUSIONS: The results indicate that tumors that overexpress the c-erbB-2 proto-oncogene have variable amounts of DNA and that c-erbB-2 amplification and DNA ploidy analysis provide limited predictive information of relapse in patients with node-negative breast cancer. Although the combination of c-erbB-2 amplification and DNA aneuploidy may be a predictor of poor prognosis in a small number of patients, neither measurement alone is effective in identifying patients at increased risk of recurrence of disease.