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Biomedical subjects

W H Hartmann

Publications and source records attributed to W H Hartmann.

At least 37 records · Page 2Linked to original sources
PubMed1984

Receptor heterogeneity of human breast cancer as measured by multiple intratumoral assays of estrogen and progesterone receptor.

Multiple intratumoral tissue samples from the primary mass of 30 consecutive invasive breast cancer patients were assayed for estrogen receptor (ER) and progesterone receptor (PR) by the dextran-coated charcoal method following frozen section histopathological examination. Steroid receptor status of each sample was classified as positive (R+) or negative (R-), based only upon quantitative guide lines from the ER/PR results. Four out of 32 (12.5%) of the invasive cancers had an intratumoral sample classified as R+ and one sample as R-. R+ invasive ductal carcinomas has a highly significant degree of tubule formation (P = 0.005) when compared with R- invasive ductal cancers. While the quantitative ER content (r = 0.18) and the degree of quantitative variation in ER content (P = 0.04) did not correlate with the tumor cellularity of the individual samples, tumor cellularity (P = 0.005) and ER content (P = 0.005) were lower in the samples from the tumor border than from the central tumor samples. Variations in ER and PR content may be found on a regional basis within a breast tumor mass resulting from heterogeneity of tumor subpopulations and/or differences in tumor cellularity.

Adult↗
PubMed1984

[Intratumoral regional differences in hormone receptor status of breast cancer].

Biopsy specimens of tissue were taken from 32 invasive carcinomas of the breast, in each case from the centre of the tumour, the tumour margin and the surrounding mammary gland tissue. After preparation of a frozen section for tissue identification, the concentration of oestrogen and progesteron receptors (ER and PR, respectively) was determined in each specimen by means of the dextrane-coated charcoal method. On the basis of these measured values, the receptor status of each specimen was classified either as positive (R+), borderline value (BL) or as negative (R-). Various morphological parameters were compared with the measured data. 9 (28%) of the 32 carcinomas demonstrated such high intratumoural differences in receptor concentration that the receptor status was classified quite differently in each of them. Formation of tubuli of the invasive ductal carcinomas was more marked with the R+ tumours (p = 0.005) than with the R- tumours. The quantitative ER content did not correlate with the abundance of the tissue specimen (r = 0.182). The regional differences in receptor status could not be explained, neither by the abundance in cells nor by morphological peculiarities of the tumour. - It follows from the results of this study that intratumoural regional variations in ER and PR concentrations can occur in carcinoma of the breast, and that such variations can have clinical significance.

Breast Neoplasms↗
PubMed1984

Graduate medical education: what will happen under DRGs?

Changing methods of reimbursement could cause the number of Graduate Medical Education programs to fall, the author says. Here, he explores how this will affect competition in and funding of the programs, and the programs themselves.

Costs and Cost Analysis↗
PubMed1980

Pathology in the Soviet Union.

Five pathologists from the United States visited the Soviet Union for three weeks in April 1978 to learn of the training in and the practice of pathology in that country. The major observations of the Americans were that (1) pathology is a medical specialty in the Soviet Union, with practice limited to anatomic pathology; (2) exfoliative cytology and clinical pathology are not part of pathology; (3) interest, both clinical and experimental, in occupational, environmental, and geographic pathology is conspicuous; (4) an autopsy rate of 90% to 95% is customary; and (5) there is an organized and hierarchical framework for practice, with career patterns established early and change infrequent.

Autopsy↗
PubMed1980

Molecular and morphological evidence for type B retrovirus (oncornavirus) expression in human mammary carcinoma. An overview using scanning electron microscopy, immunoperoxidase staining, and transmission electron microscopy.

Approximately 45% of human mammary carcinoma cases express an antigen which cross reacts in formalin fixed tissues with antiserum prepared against the purified 52,000 molecular weight structural glycoprotein (gp52) of mouse mammary tumor virus (MMTV). Breast carcinoma immunoperoxidase marking is abolished by antiserum adsorption with MMTV. Adsorption with murine leukemia virus failed to block immunoperoxidase marking. No correlation was seen in the cases analyzed between gp52-like antigen expression and family history of mammary carcinoma, age, or pathological classification. The evidence linking an oncornaviral agent in human mammary carcinoma is reviewed with respect to the structure and biology of a known etiological agent, MMTV, in murine mammary cancer. The potential role of SEM in amplifying the surface area available for analysis in malignant and premalignant human breast epithelia is considered.

Antigens, Neoplasm↗
PubMed1979

Prognostic factors in adrenal cortical tumors. A mathematical analysis of clinical and morphologic data.

Forty-one patients with adrenal cortical tumors were evaluated retrospectively for the presence of histologic and non-histologic features associated with malignant behavior. The patients who survived operation were followed at least five years. The association of these features with subsequent metastasis was examined by both parametric and nonparametric statistical methods. Twelve criteria were statistically significant in predicting subsequent metastasis. The most significant of these were: clinical evidence of weight loss, broad fibrous bands traversing the tumor, a diffuse growth pattern, vascular invasion, tumor cell necrosis, and tumor mass. The tendency toward metastasis for each tumor was expressed in indices that correlated well with diagnoses made by conventional histologic means, but were more accurate in predicting subsequent clinical behavior than nonquantitative methods of evaluation.

Adolescent↗
PubMed1978

Relation between component parts of fibrocystic disease complex and breast cancer.

Specimens of benign breast disease obtained from biopsies performed at Vanderbilt Hospital (Nashville, Tenn.) between 1952 and 1959 were histologically reviewed and characterized as to individual component types of fibrocystic disease. Follow-up for information regarding breast cancer development was 94% successful. Carcinoma developed more often when epithelial proliferative lesions were present. Atypical lobular hyperplasia had a greater predictive value than other epithelial lesions and was associated with an elevated risk six times that expected prior to the age of 45 years and a tripling of risk after the age of 45 years. Various ductal hyperplastic lesions are associated with approximately a doubly increased risk that is present only if the lesions are identified at biopsy after the age of 45 years. Women with cysts, sclerosing adenosis, fibrosis, and other nonhyperplastic changes were at no greater risk for subsequent carcinoma than women in the general population.

Adenofibroma↗
PubMed1976

Adenocarcinoma of the colon and rectum in young adults.

A retrospective analysis was made in 47 young adults (20 to 40 years of age) with adenocarcinoma of the colon and rectum. Rectal bleeding was the most frequent presenting symptom. Tumor grade had no correlation with survivial. Smaller tumors were associated with better prognosis. Depth of invasion was a most important prognostic factor. There was no operative mortality. The five-year survival rate in these young adults compares favourably with the overall survival statistics for colorectal carcinoma.

Adenocarcinoma↗
PubMed1975

Breast cancer report.

The recent increased public awareness of the necessity for early diagnosis of breast cancer has been accentuated by an intense exposure by the news media centering about the disease. This publicity includes the unfortunate but timely clinical sources of the wives of the President and the Vice President of the United States, Mrs. G.F. Ford and Mrs. N.A. Rockefeller. This paper attempts to quantitate in a subjective manner the impact of the events on the American public by comparing the incidence of operative procedures in similar populations in the Nashville community during October through December, 1973, and October through December, 1974, the latter period following the operative procedures upon Mrs. Ford and Mrs. Rockefeller. A statistically significant increase was noted in patients seen, biopsies performed, and cancers detected.

Attitude to Health↗
PubMed1975

Salivary gland carcinoma of the palate.

Results of a detailed study of the clinical features, histology, management, and prognosis of palatal carcinoma of salivary origin in 30 patients are presented. These were compared to a larger series of salivary carcinoma at other sites, and to the known behavior of epidermoid carcinoma of the palate. The prognosis was significantly better for lesions of the palate. Results of treatment were also much better for these salivary gland lesions than for epidermoid carcinoma of the palate. The frequent occurrence and seemingly greater malignancy of adenoid cystic carcinoma at this anatomic site are stressed. Several patients with primary bone involvement survived, but local recurrence in the maxilla carried a graver prognosis. There was no definite indication that radiotherapy altered the course of the disease, and nothing to suggest that prophylactic neck dissection is of value. On the basis of the evidence presented, there is little to justify more radical excision than the clinical extent of the lesion would indicate, with the probable exception of adenoid cystic carcinoma, where a more aggressive approach may well prevent death from cancer.

Adult↗