PubMed Health⌕ Search

Biomedical subjects

W B Panko

Publications and source records attributed to W B Panko.

41 records · Page 3Linked to original sources
PubMedDate not supplied

Clinical care and the factory floor.

The purpose of this article is to provide the author's perspective on whether it is likely or feasible that those working in the health care domain will adapt and use lessons learned by those in the industrial domain. This article provides some historical perspective on the changes brought about in the industrial domain through the introduction of new technologies, including information technologies. The author discusses how industrialization catalyzed changes in health care delivery that paralleled but lagged behind those of the broader U.S. economy. The article concludes that there is ample reason for those interested in improving the quality and effectiveness of health informatics to systematically evaluate information technology strategies used in the industrial domain. Finally, it outlines some challenges for health informaticians and a number of factors that should be considered in adapting lessons from industry to the health care domain.

Computers↗
PubMedDate not supplied

Qualitative differences in estrogenic/antiestrogenic effects of clomiphene and zuclomiphene.

Depending upon the rat assay end point, the estrogenic or antiestrogenic activity of clomiphene (CC) or its isomer, zuclomiphene (Zu), varies considerably. For uterine/body weight ratio, Zu = estradiol greater than CC; for the estrogenic effect on uterine epithelium, Zu greater than estradiol = CC; higher CC doses were antiestrogenic. For endometrial stroma, Zu = estradiol much greater than CC. In the effect of estrogen receptor, low-dose CC = estradiol; high-dose CC was antiestrogenic. For Zu, both doses were about equal and highly antiestrogenic. Essentially the same was seen with progesterone receptor. For plasma LH suppression, Zu much greater than CC much greater than estradiol; but for plasma FSH, estradiol much greater than CC = Zu. The intrinsic estrogenicity of these compounds was made more apparent by the castrate status of the rats. This spectrum of activities may make it possible to select estrogenic or antiestrogenic activities for clinical purposes, depending upon the end-organ effect desired.

Animals↗
PubMedDate not supplied

Hormone receptors and disease-free survival in breast cancer: impact of increasing threshold levels.

Laboratory data from Milan and Houston were evaluated to determine the extent to which the distribution of estrogen receptor (ER) and progesterone receptor (PgR) has changed with time. Results from over 11,500 ER and over 8,200 PgR determinations (6,194 ER and 3,127 PgR from Milan) were analyzed. All assays in Milan were performed by a dextran-coated charcoal method and in Houston by a sucrose density-gradient method. The data demonstrate a time-dependent, upward drift in the amount of ER and PgR detected, with the effect most pronounced at the lower end of the distribution curves. We attribute this change to optimization of all facets of the receptor assay procedures (tissue harvesting and storage) as well as to a change in breast cancer biology. These results suggest that studies correlating certain biological parameters with receptor status (whether using qualitative or quantitative scales) need to be re-examined. For example, a population of 349 node-negative patients who did not receive any adjuvant treatment was studied in Milan to determine any association between disease-free survival (DFS) and receptor status. If the "historical" threshold values (10 fmol/mg protein) were used to determine receptor status, no significant difference in DFS at 5 years was detected. Even the combination of ER and PgR did not improve the predictive power of receptor status. In the premenopausal subgroup, ER status did predict the 5-year DFS. However, if the threshold value for PgR was adjusted to 25 fmol/mg protein, patients with ER-positive, PgR-positive tumors had significantly better 5-year DFS than patients with ER-negative, PgR-negative tumors. In addition, PgR status alone was associated with significantly improved 3-year DFS if the subgroups of PgR less than 5 fmol/mg protein and PgR greater than 100 fmol/mg protein were compared. We conclude from these data that: 1) historical threshold values for receptor positivity should be re-examined in all laboratories; 2) studies involving receptor results determined over an extended period of time should attempt to "normalize" these results; and 3) the quantitative assessment of receptor status should be used whenever possible.

Biomarkers, Tumor↗