Biomedical subjects
Publications and source records attributed to D Marx.
A review of significant administrative and judicial rulings in antitrust law during 1993 shows that the antitrust laws should not impede innovative, cost-cutting cooperative arrangements among providers, so long as their actual or potential procompetitive benefits are not outweighed by their anticompetitive effects.
The authors report a retrospective series of 22 cases of bronchogenic cysts in children. The development of antenatal ultrasonography allowed the diagnosis in 3 cases. When the diagnosis is suggested for the time first postnatally, chest x-ray and oesophagography remain the essential initial investigations. Thoracic ultrasonography needs to be developed, as in some cases it can reveal the cystic nature of the tumour. In difficult cases, the work-up should be completed by CT scan, while keeping in mind that not all bronchogenic cysts present in the form of low-density images. A detailed review of the literature shows that mediastino-pulmonary opacities are more frequent than exclusively pulmonary images in the form of hyperlucent, fluid level or solid opacity images.
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Concentrations of a fragment of the c-erbB-2 translational product (p185 fragment) were measured in serum of 70 breast cancer patients, 19 healthy blood donors, and 18 pregnant women using a heterogenic enzyme immunoassay. The serum concentrations of blood donors and pregnant women were below 30 kU/l. Breast cancer patients showed serum concentrations up to 578 kU/l. All 9/70 patients with serum concentrations higher than 30 kU/l had clinical evidence of metastatic disease and the serum levels of all 35/70 patients without metastasis lay within the normal range. From 9/37 patients with p185 overexpression of the primary tumor in immunohistochemical analysis 3/9 patients with metastatic disease had elevated serum levels higher than 30 kU/l. In all, 6/9 patients without metastasis serum levels were below 30 kU/l. The data of the present study suggest that determination of serum p185 fragment concentrations may be useful as a diagnostic tool in postoperative follow-up of breast cancer patients with c-erbB-2 overexpression of the primary tumor.
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DNA amplification, RNA overexpression and p185 protein expression of the c-erbB2 oncogene were investigated in 109 cases of breast cancer with the aim of evaluating any correlation between the different methods. A correlation between Southern blotting and immunohistochemical analysis of paraffin-embedded material was found. Thus, amplification of the c-erbB2 oncogene leads to overexpression of the p185 protein. By contrast, no statistical correlation could be shown between RNA overexpression, measured by Northern blotting, and immunohistochemical p185 membrane stainings. It is of special interest that most of the cases that are positive for Northern blotting and negative for immunochemistry are negative for Southern blotting as well. Contradictory findings between RNA overexpression and lack of immunohistochemical staining of p185 give rise to the assumption that a defective protein is encoded, which cannot be incorporated into the substructures of the tumour cell membrane. When screening for point mutations in the transmembrane domain of the c-erbB2 oncogene, no point mutation could be detected, either by using the endonuclease FokI, which cuts at position 2012 (the point mutation in the neu gene of the rat), or by direct sequencing.
In 1983, The German Breast Cancer Study Group, sponsored by the Federal Ministry of Research and Technology, started a prospective multicenter trial on the treatment of early breast cancer pT1 pN0 M0. Treatment consisted of initial tumorectomy with microscopically free margins and lower axillary dissection. After conformation of a pT1 pN0-stage, additional treatment was either mastectomy or adjuvant radiotherapy (50 Gy in 25 fractions to the entire breast plus 12 Gy electron boost). In medially located tumors, the parasternal and supraclavicular area was also irradiated with 50 Gy. A randomization between both treatment modalities was initially planned but was not feasible and abandoned. Nearly all patients were treated according to their own choice. From November 1983 through December 1989, 1119 patients were recruited. Eighty-three were excluded from the protocol. Out of the remaining 1036 patients, 733 (71%) underwent breast preservation and 303 (29%) mastectomy. A detailed pathohistological examination of all tumorectomy specimens was performed in a pathologic reference center. Oncogen overexpression was evaluated by immunohistological detection of the transmembrane protein p-185 (corresponding to c-erb-B2) in 425 cases. After a median follow-up of 48 months, the frequency of local recurrences (4.7%), regional recurrences (1%), and distant metastases (5.4%) was the same in the breast preservation group and the mastectomy group. The 3-year disease-free survival was 90% after breast preservation and 88% after mastectomy (p = 0.21). In the breast preserving group, 24 patients with microscopically involved margins had a poorer disease-free survival than the study group (75% vs 90% after 3 years). The width of the margins had no impact on prognosis. Other prognostic factors in an univariate and multivariate analysis were tumor size and tumor grade. Age, menopausal status, hormone receptor status, histological tumor type, and treatment (mastectomy vs breast preservation) were not significant. P-185-expression was dependent on tumor grade and was the strongest prognostic factor in an univariate and multivariate analysis (p less than 0.001). The results emphasize the central role of tumor grade for prognosis and suggest the independent prognostic significance of the c-erb-B2 oncogen (corresponding to p-185) in pN0-patients.
In ovarian cancers, no valuable prognostic factors are available so far for predicting biological behaviour and clinical outcome. During the last years, overexpression of c-erbB-2-oncogene has been reported to be a prognostic factor in various human carcinomas. Its prognostic value in ovarian cancer is still a matter of controversy. The records and histological specimens of 243 patients with primary ovarian cancer were reviewed. Overexpression of c-erbB-2-oncogene encoded transmembrane protein p185 was determined immunohistochemically using polyclonal and monoclonal antibodies. Of 243 investigated tumours, 45 (19%) were positive. We examined the relationship between p185 and clinical stage, histological type, grading and prognosis. p185 overexpression differs within the histological subtypes of tumours. No correlation was found between p185 overexpression and stage or histological grade. The follow-up data demonstrate that patients with positive staining for p185 have a significantly worse prognosis (p = 0.001) than those with negative staining. These results suggest that overexpression of c-erbB-2 oncogene is associated with higher biological aggressiveness and unfavourable course of disease.
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The hormonally induced changes in the breast during pregnancy make the diagnosis of breast cancer difficult. Furthermore, examinations during pregnancy tend to concentrate only on the pregnancy itself. In this report the clinical, pathological and immunohistochemical results from 7 patients with breast cancer during pregnancy are presented. All women first noticed the tumor by self-examination. The time periods between discovery of the tumor and medical treatment were between 4 and 22 weeks. An overexpression of c-erbB-2-oncogene coded transmembrane protein p185 could be demonstrated in 4 cases. Of the seven patients, 5 have already passed away. Three of the deceased had p185-positive tumors, and died 4, 8 and 21 months after diagnosis. The two p185-negative patients lived 34 and 65 months post diagnosis. Despite the small amount of cases presented, a trend can be seen that p185 may be an additional prognostic factor for breast cancer in pregnancy.
Female pigs aged between one day (body weight 1.39 +/- 0.20 kg) and 1123 days (b. w. 233 +/- 32 kg) were allotted to 10 groups of various age and analyses of the concentration of DNA, RNA and protein in 9 different tissues were performed. The wet weight: DNA-, the protein: DNA- and the RNA: DNA-ratio were determined. With the exception of the liver the content in DNA, RNA and protein increased to the age of 1123 days. The highest fresh weight: DNA ratio of 2041 was reached on the 1123rd day in the M.longissimus; the smallest (111) existed at this time in the spleen. In the liver the highest content in fresh weight, in DNA and RNA was found on the 180th day. The smallest increases in the content of DNA and RNA in the mentioned period were in the brain, the highest in the spleen, the liver and the M.longissimus dorsi. The values can be used as a basis for studies on the influence of feeding and of diseases (infections) on growth.
The authors describe three cases of scopolamine intoxication which was added to nasal drops instead of Mucoseptonex. An account is given of the characteristics of scopolamine intoxication and of possible therapy.
In 1983, the German Breast Cancer Study Group (GBSG), sponsored by the Federal Ministry of Research and Technology, started a prospective multicenter trial on the treatment of early breast cancer (pT1 pN0 M0). This was preceded by a three-year reviewing period because of some novelties of medical, juristical and ethical problems in the FRG. University and, in the majority, community hospitals participated, combining all together 69 different institutions. From 11/1983 to 12/1989, 1112 patients were recruited. From 1036 patients, 733 underwent breast preservation (71%) and 303 mastectomy (29%). The randomization rate was only 6%. In 268 patients (26%) the tumor size was less than or equal to 10 mm, in 765 patients (74%) 11 to 22 mm. In 129 cases, we subdivided the tumor grading II[3] into IIa and IIb. Moreover, the immunohistochemical detection of the transmembrane proteins EGFR, p-185 and p-148 by oncogene overexpression and c-myc oncogene were undertaken in 425 breast cancers. After tumorectomy (or wide excision) and a lower axillary dissection (at least eight lymph nodes) the breast was irradiated up to 50 Gy in 25 fractions. A boost of 12 Gy was given to the tumor bed. The medial located lymph nodes were also irradiated in case of medially or centrally tumors. Quality control was performed by pathological, radiotherapeutic and methodical reference centers. Significant correlations could be demonstrated between receptor status and tumor grading, patient age and grading, and tumor size and grading. The results emphasize the central role of tumor grading among the prognostic factors. Especially the differentiation of the Bloom and Richardson score II into IIa and IIb seems to play an important role. After a median follow-up of 41 months, the frequency of local recurrences (4.4%), regional recurrences (1%) and distant metastases (4.6%) was exactly the same in both treatment groups. In multivariate analysis, only tumor size and tumor grading had a significant impact on disease-free survival. 23 patients with tumor-involved margins had a higher recurrence rate (DFS 62% versus 85% after five years). Without any impact on DFS were the other conventionally evaluated prognostic factors: age, menopausal status, hormone receptor status, histological tumor type, tumor localisation, degree of differentiation, pleomorphism, mitotic index and degree of dissociation. Among the transmembrane proteins EGFR, p-185, p-148 and c-myc, only the impact of p-185 and EGRF positivity on DSF is significant.(ABSTRACT TRUNCATED AT 400 WORDS)
After introducing remarks on the meaning of the ethology of farm animals about the evaluation of housing systems the own examinations about piglets in the rearing period and about housing systems of rabbits held in groups respectively will be demonstrated. By these examinations choice experiments have proved true. For estimating and evaluating the ethological experimental results the concept of the meeting of requirements and avoidance of damage is an important point. The animals requirement can be found out in reference systems. Those investigated results are used as guiding-line for the evaluation of the dates found under practical conditions. The merits of Tschanz concerning the ethology of farm animals will be appreciated.
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