BACKGROUND & AIMS: BACKGROUND:A 79-year-old woman was referred for evaluation of her painful and swollen joints. She had a medical history of congestive heart failure, renal insufficiency and peptic ulcer disease. For the past 3 years she had experienced recurrent bouts of debilitating arthritis, lasting approximately 3-4 weeks at a time. The symptoms were most severe in the hands and knees, where the joints were warm, swollen and tender. During each flare-up, the patient was housebound and required therapeutic dosing of nonsteroidal anti-inflammatory drugs and codeine to control joint pain. INVESTIGATIONS:Physical examination, fine-detailed radiographs of the hands, standing radiographs of the knees, arthrocentesis including cell count and gram stain, compensated polarized light microscopy, alizarin-red staining, X-ray diffraction, scanning and transmission electron microscopy with energy dispersive spectrometry, electron microprobe analysis with energy dispersive spectrometry, Fourier transform infrared spectroscopy, and atomic force microscopy. DIAGNOSIS:Carbonated-substituted apatite arthropathy. MANAGEMENT:Both knees were aspirated and large volumes of a straw-colored synovial fluid was removed. The knees were injected with corticosteroid, resulting in excellent symptomatic response.

背景与目标： 背景：一名79岁的妇女被要求评估她的关节疼痛和肿胀。她有充血性心力衰竭，肾功能不全和消化性溃疡病的病史。在过去的三年中，她经历了反复发作的衰弱性关节炎发作，一次持续约3-4周。症状最严重的地方是手和膝盖，那里的关节温暖，肿胀和触痛。在每次发作期间，该患者待在屋内，需要非甾体抗炎药和可待因的治疗剂量以控制关节痛。
调查：体格检查，手部细微X线照片，膝盖站立X线照片，关节穿刺术（包括细胞计数和革兰氏染色），补偿偏振光显微镜，茜素红染色，X射线衍射，扫描和透射电子显微镜（能量分散）光谱分析，带能量色散光谱的电子显微探针分析，傅立叶变换红外光谱和原子力显微镜。
诊断：碳取代磷灰石关节炎。
处理：吸除两个膝盖，并去除大量稻草色滑液。膝关节注射皮质类固醇激素，可产生出色的症状反应。

BACKGROUND & AIMS: :Only 2 comprehensive surgical series, published in 1977 and 1983, have evaluated clinicopathologic features of the ascending aorta. Retrospective review of medical records and microscopic slides was performed on 513 consecutive patients with surgical resection of ascending aortic tissue (1985 to 1999). Patients were 2 to 89 years old (mean 59 y), and 303 (59%) were men. Aneurysm or dissection was the indication for surgery in 479. Aortic valves were also excised in 360. Systemic hypertension was present in 279, inherited connective tissue disease (ICTD) in 67, arteritis in 33, and acquired connective tissue disease in 16. Microscopy showed cystic medial degeneration (CMD) in 209, aortic dissection (AD) in 109 (with CMD in 56), normal media in 90, aortitis in 57 (with CMD in 14), and other findings in 48. The most significant, independent risk factor of CMD and AD was ICTD (confidence interval=7.61 and 2.26, respectively). Systemic hypertension was more common in patients with AD than without (P=0.0202). Normal media was the most common histologic finding associated with bicuspid aortic valve (P<0.0001). Among 57 patients with aortitis (giant cell in 39), ages ranged from 16 to 85 years (mean 64 y), and 42 (74%) were women; only 8 had Takayasu arteritis, and 11 had temporal or systemic arteritis. In surgically resected ascending aorta, the 3 most common histologic findings were CMD, AD, and normal media. ICTD, systemic hypertension, and bicuspid aortic valve were common comorbid findings. Giant cell aortitis occured predominantly in women, usually without systemic disease.

背景与目标： ：仅在1977年和1983年出版的2个综合外科手术系列中，评估了升主动脉的临床病理特征。回顾性审查了513例行升主动脉组织手术切除的患者（1985年至1999年）的病历和显微幻灯片。患者为2至89岁（平均59岁），其中303例（59％）为男性。 479例手术是动脉瘤或夹层手术的指征。360例也切除了主动脉瓣。279例出现系统性高血压，67例患遗传性结缔组织病（ICTD），33例患动脉炎，16例获得性结缔组织病。囊性内侧变性（CMD）209例，主动脉夹层（AD）109例（CMD 56例），正常介质90例，主动脉炎57例（CMD 14例），其他发现48例。 CMD和AD的因子为ICTD（置信区间分别为7.61和2.26）。 AD患者的全身性高血压比非AD患者更常见（P = 0.0202）。正常介质是与二尖瓣主动脉瓣相关的最常见的组织学发现（P <0.0001）。在57例主动脉炎患者中（39个巨大细胞），年龄在16至85岁之间（平均64岁），其中42例（74％）为女性。只有8例患有高津动脉炎，11例患有颞部或全身性动脉炎。在手术切除的升主动脉中，最常见的3种组织学发现是CMD，AD和正常介质。 ICTD，系统性高血压和双尖瓣主动脉瓣是常见的合并症。巨细胞主动脉炎主要发生于女性，通常无全身性疾病。

BACKGROUND & AIMS: The dose, efficacy, and side effects of continuous intravenous infusion (CIVI) of morphine were compared with continuous subcutaneous infusion (CSCI) of morphine in patients with chronic cancer pain. Eligible patients were referred to the Palliative Care Program and were receiving a stable dose of CIVI of morphine. The design was a within-patient, one-way crossover; in which each patient provided data before and after a switch from CIVI to CSCI of morphine. "Rescue" doses were 50% of the hourly dose given every 2 hours as needed. Morphine was infused intravenously (i.v.) and subcutaneously (s.c.) via a McGaw/AccuPro Volumetric Infusion Pump. After baseline data, including side effects and pain assessment, were obtained, patients were evaluated twice daily for toxicity and analgesic efficacy. Those who had a stable CIVI dose for 48 consecutive hr were crossed over to the CSCI at the same dose as the intravenous (i.v.) phase. A stable dose was defined as no dose change, four or less rescue doses in the previous 24 hr, and a pain rating of none or mild. CIVI was considered equal to CSCI if these criteria were maintained for 96 consecutive hr. Fifty-seven patients were entered, and 40 were evaluable (15 women and 25 men). The median age was 67 (range 30-83 years). All 40 participants, after maintaining a stable dose throughout the i.v. phase, crossed to the s.c. phase and remained on s.c. for at least 48 hr. Thirty-two patients maintained a stable dose throughout the i.v. and s.c. phases. The mean stable i.v. dose (day 2) was 5.05 mg/hr, and the mean stable s.c. dose (day 4) was 5.7 mg/hr (P = 0.01). The mean number of rescue doses on day 2 was 0.83 per 24 hr versus 0.80 per 24 hours on day 4 (P = 0.6). The mean categorical pain score on day 2 was 0.83, and on day 4, 0.85 (P = 0.7). The mean visual analogue scale (VAS) on day 2 was 22.9 mm versus 17.6 mm on day 4 (P = 0.1). The mean incidence of side effects on day 2 was 1.7, and on day 4, 2.0 (P = 0.2). No patient was withdrawn or had a dose reduction due to unacceptable toxicity. There were two reports of local toxicity (mild erythema) at the SC needle insertion point, which required a site change. All of our 40 patients had adequate pain control with CIVI and CSCI morphine. Of the eight participants who were not maintained on the same i.v. and s.c. dose, all had adequate pain control and a similar side-effect profile on a higher s.c. morphine dose. These data suggest that the i.v. and s.c. routes are equianalgesic for most patients when administered as a continuous infusion. Pain control and side-effect profiles are quite similar and acceptable. s.c. morphine is an excellent alternative to i.v. morphine in both inpatients and outpatients requiring parenteral morphine for pain.

背景与目标： 比较了慢性癌症疼痛患者中吗啡连续静脉输注（CIVI）与吗啡连续皮下输注（CSCI）的剂量，疗效和副作用。符合条件的患者被转到姑息治疗计划，并接受稳定剂量的吗啡CIVI。该设计是患者内部的单向交叉。其中每个患者提供了从吗啡从CIVI切换到CSCI之前和之后的数据。 “救援”剂量是根据需要每2小时给予的每小时剂量的50％。吗啡通过McGaw / AccuPro容量输注泵静脉内（i.v.）和皮下（s.c.）输注。获得包括副作用和疼痛评估在内的基线数据后，每天对患者进行两次毒性和止痛效果评估。连续48个小时具有稳定CIVI剂量的患者以与静脉内（i.v.）阶段相同的剂量转入CSCI。稳定剂量定义为无剂量变化，在过去24小时内有四个或更少的急救剂量，疼痛等级为无或轻度。如果连续96个小时保持这些标准，则认为CIVI等于CSCI。入组患者57例，其中40例可评估（女性15例，男性25例）。中位年龄为67岁（范围为30-83岁）。在整个静脉内维持稳定剂量后，所有40位参与者阶段，跨到南卡罗来纳州相并保持在s.c.至少持续48小时。在整个静脉内，有32名患者维持了稳定的剂量。和s.c.阶段。平均稳定i.v.剂量（第2天）为5.05 mg / hr，平均稳定s.c.剂量（第4天）为5.7 mg / hr（P = 0.01）。第2天的平均急救剂量为每24小时0.83，而第4天为每24小时0.80（P = 0.6）。第2天的平均类别疼痛评分为0.83，第4天的平均疼痛评分为0.85（P = 0.7）。第2天的平均视觉模拟量表（VAS）为22.9毫米，而第4天为17.6毫米（P = 0.1）。第2天的副作用的平均发生率为1.7，而第4天的平均发生率为2.0（P = 0.2）。没有患者因不可接受的毒性而退出或剂量减少。有两份关于SC针插入点的局部毒性（轻度红斑）的报道，需要进行部位改变。我们所有的40名患者均通过CIVI和CSCI吗啡可以很好地控制疼痛。在没有保持相同i.v.的八位参与者中和s.c.剂量较高时，所有患者均具有足够的疼痛控制能力，并且在较高的s.c.下具有相似的副作用。吗啡剂量。这些数据表明和s.c.当以连续输注方式给药时，对于大多数患者而言，这两种途径均具有镇痛作用。疼痛控制和副作用状况非常相似且可以接受。南卡罗来纳州吗啡是静脉注射的绝佳替代品。需要胃肠外吗啡治疗的住院患者和门诊患者中的吗啡疼痛。

BACKGROUND & AIMS: :In this review, we focused on our studies of cancer dormancy in a murine B cell lymphoma and human breast cancer. Lifelong dormancy was induced in syngeneic mice by prior immunization to the idiotype of the tumor cell (TC) Ig before TC challenge. The mice maintained approximately 10(6) lymphoma cells in their spleen throughout their lifetime despite replication of the TCs at a reduced rate. Recurrences occurred randomly. Because of the balance between replication and cell death, we hypothesized that a similar balance might occur in long-term survivors of breast cancer when the risk of recurrences is very low. We developed a sensitive assay for circulating tumor cells (CTCs) which none were found in normal age-matched women. One third of patients, 7-22 years after mastectomy and without any evidence of disease, had CTCs. The half-life of these CTCs could be deduced from other studies as probably 2-3 hours. Hence, there was a precise balance between replication of TCs (presumably from micrometastases) and cell death. Therefore, a major population of clinically cured breast cancer patients have a chronic disease controlled by their own physiological mechanisms. We speculate on underlying mechanisms based both on studies in experimental models and clinical trials.

背景与目标： ：在这篇综述中，我们集中于对小鼠B细胞淋巴瘤和人类乳腺癌的癌症休眠研究。通过在TC攻击之前先对肿瘤细胞（TC）Ig的独特型进行免疫，可以在同系小鼠中终生休眠。尽管TCs的复制率降低了，但小鼠的一生中仍在脾脏中维持着约10（6）个淋巴瘤细胞。复发随机发生。由于复制和细胞死亡之间的平衡，我们假设当复发风险非常低时，长期存活的乳腺癌患者可能会发生类似的平衡。我们开发了一种循环肿瘤细胞（CTC）的灵敏检测方法，在正常年龄的女性中均未发现。乳房切除术后7-22年且无任何疾病证据的三分之一患者患有CTC。这些CTC的半衰期可以从其他研究中推断出来，大概为2-3小时。因此，在TC的复制（可能来自微转移）和细胞死亡之间存在着精确的平衡。因此，大部分临床治愈的乳腺癌患者患有受其自身生理机制控制的慢性疾病。我们基于实验模型和临床试验研究潜在的机制。

BACKGROUND & AIMS: :The hypoxic environment in tumor is reported to play an important role in pancreatic cancer progression. The interaction between stromal and cancer cells also contributes to the malignant behavior of pancreatic cancer. In the present study, we investigated whether hypoxic stimulation affects stromal as well as pancreatic cancer cells. Our findings demonstrated that hypoxia remarkably elevated the HIF-1alpha expression in both pancreatic cancer (PK8) and fibroblast cells (MRC5). Hypoxic stimulation accelerated the invasive activity of PK8 cells, and invasiveness was thus further accelerated when the hypoxic PK8 cells were cultured with conditioned medium prepared from hypoxic MRC5 cells (hypoxic conditioned medium). MMP-2, MMP-7, MT1-MMP and c-Met expressions were increased in PK8 cells under hypoxia. Hypoxic stimulation also increased the hepatocyte growth factor (HGF) secretion from MRC5 cells, which led to an elevation of c-Met phosphorylation in PK8 cells. Conversely, the elevated cancer invasion, MMP activity and c-Met phosphorylation of PK8 cells were reduced by the removal of HGF from hypoxic conditioned medium. In immunohistochemical study, the HIF-1alpha expression was observed in surrounding stromal as well as pancreatic cancer cells, thus indicating hypoxia exists in both of cancer and stromal cells. Moreover, the stromal HGF expression was found to significantly correlate with not only the stromal HIF-1alpha expression but also the c-Met expression in cancer cells. These results indicate that the hypoxic environment within stromal as well as cancer cells activates the HGF/c-Met system, thereby contributing to the aggressive invasive features of pancreatic cancer.

背景与目标： ：据报道肿瘤中的低氧环境在胰腺癌的进展中起重要作用。基质细胞与癌细胞之间的相互作用也有助于胰腺癌的恶性行为。在本研究中，我们调查了低氧刺激是否影响基质和胰腺癌细胞。我们的研究结果表明，缺氧显着提高了胰腺癌（PK8）和成纤维细胞（MRC5）中HIF-1alpha的表达。低氧刺激加速了PK8细胞的侵袭活性，因此，当用由低氧MRC5细胞制备的条件培养基（低氧条件培养基）培养低氧PK8细胞时，侵袭性进一步加快。在缺氧条件下，PK8细胞中的MMP-2，MMP-7，MT1-MMP和c-Met表达增加。缺氧刺激还增加了MRC5细胞的肝细胞生长因子（HGF）分泌，这导致PK8细胞中c-Met磷酸化的升高。相反，通过从低氧条件培养基中除去HGF，可以降低PK8细胞的癌浸润，MMP活性和c-Met磷酸化升高。在免疫组织化学研究中，在周围的基质细胞和胰腺癌细胞中均观察到了HIF-1alpha的表达，因此表明在癌细胞和基质细胞中均存在缺氧。此外，发现基质HGF表达不仅与癌细胞中的基质HIF-1α表达而且与c-Met表达显着相关。这些结果表明基质以及癌细胞内的低氧环境激活了HGF / c-Met系统，从而促进了胰腺癌的侵袭性侵袭性特征。

BACKGROUND & AIMS: :Although the considerable progress against gastric cancer, it remains a complex lethal disease defined by peculiar histological and molecular features. The purpose of the present study was to investigate pRb2/p130, VEGF, EZH2, p53, p16(INK4A), p27(KIP1), p21(WAF1), Ki-67 expressions, and analyze their possible correlations with clinicopathological factors. The expression patterns were examined by immunohistochemistry in 47 patients, 27 evaluated of intestinal-type, and 20 of diffuse-type, with a mean follow up of 56 months and by Western blot in AGS, N87, KATO-III, and YCC-2, -3, -16 gastric cell lines. Overall, stomach cancer showed EZH2 correlated with high levels of p53, Ki-67, and cytoplasmic pRb2/p130 (P < 0.05, and P < 0.01, respectively). Increased expression of EZH2 was found in the intestinal-type and correlated with the risk of distant metastasis (P < 0.05 and P < 0.01, respectively), demonstrating that this protein may have a prognostic value in this type of cancer. Interestingly, a strong inverse correlation was observed between p27(KIP1) expression levels and the risk of advanced disease and metastasis (P < 0.05), and a positive correlation between the expression levels of p21(WAF1) and low-grade (G1) gastric tumors (P < 0.05), confirming the traditionally accepted role for these tumor-suppressor genes in gastric cancer. Finally, a direct correlation was found between the expression levels of nuclear pRb2/p130 and low-grade (G1) gastric tumors that was statistically significant (P < 0.05). Altogether, these data may help shed some additional light on the pathogenetic mechanisms related to the two main gastric cancer histotypes and their invasive potentials.

背景与目标： ：尽管在对抗胃癌方面取得了长足的进步，但它仍然是由特殊的组织学和分子学特征定义的复杂致死性疾病。本研究的目的是研究pRb2 / p130，VEGF，EZH2，p53，p16（INK4A），p27（KIP1），p21（WAF1），Ki-67的表达，并分析它们与临床病理因素的可能关系。通过免疫组织化学检查了47例患者的表达模式，其中27例为肠型，20例为弥散型，平均随访56个月，并通过Western blot检测AGS，N87，KATO-III和YCC-2 ，-3，-16个胃细胞系。总体而言，胃癌显示EZH2与高水平的p53，Ki-67和细胞质pRb2 / p130相关（分别为P <0.05和P <0.01）。在肠型中发现EZH2表达增加，并且与远处转移的风险相关（分别为P <0.05和P <0.01），表明该蛋白可能在这种类型的癌症中具有预后价值。有趣的是，观察到p27（KIP1）表达水平与晚期疾病和转移的风险之间存在强烈的负相关（P <0.05），而p21（WAF1）和低度胃癌（G1）的表达水平之间呈正相关。肿瘤（P <0.05），证实了这些肿瘤抑制基因在胃癌中的传统接受作用。最后，在核pRb2 / p130的表达水平与低度（G1）胃肿瘤的表达水平之间发现了直接相关性，具有统计学意义（P <0.05）。总之，这些数据可能有助于进一步阐明与两种主要胃癌组织学类型及其侵袭潜能有关的致病机制。

BACKGROUND & AIMS: :A retrospective study of male breast cancer was undertaken at Ouagadougou University Teaching Hospital over a 3 year period (1993-1996). Authors report 5 cases representing 4.16% of all breast cancers. The patients' mean age was 61 years. The average duration of signs and symptoms before the diagnosis was 13 months. Clinically all the 5 cases presented advanced cancers (4 T4N2M0, 1 T4N2M1 according to UICC TNM System) with size ranging from 5.5, to 11.5 cm. Histology found: 2 medullary infiltrating carcinoma, 1 canalar infiltrating carcinoma, 1 colloid mucous carcinoma and 1 lobular infiltrating carcinoma. All patients had mastectomy associated with axillary clearance in 4 cases. Radiotherapy, chemotherapy and hormonotherapy were not associated because unavailable in Burkina Faso. Three patients died: the first, 10 days after surgical treatment and the 2 others respectively after 14 and 17 months. We have lost sight 1 patients. The last one is still alive. Authors find that to get better prognosis, it is important to improve medical and technical means, to increase information and to promote early detection.

背景与目标： ：在瓦加杜古大学教学医院进行了为期3年（1993年至1996年）的男性乳腺癌回顾性研究。作者报告了5例病例，占所有乳腺癌的4.16％。患者的平均年龄为61岁。诊断前平均体征和症状持续时间为13个月。临床上，所有5例患者均出现晚期癌（根据UICC TNM System，4例T4N2M0、1例T4N2M1），大小在5.5至11.5厘米之间。组织学发现：2个髓样浸润癌，1个管状浸润癌，1个胶体粘​​液癌和1个小叶浸润癌。所有患者均进行了伴有腋窝清除术的乳房切除术4例。放疗，化学疗法和激素疗法没有联系，因为布基纳法索无法使用。 3例患者死亡：第一例，手术治疗10天后死亡，另外2例分别在14个月和17个月后死亡。我们失去了视力1例患者。最后一个还活着。作者发现，要获得更好的预后，重要的是改善医学和技术手段，增加信息并促进早期发现。

BACKGROUND & AIMS: :Several attempts to classify gastric cancer (GCA) have been made over the past decades. Most successful, and widely used, is the classification by Laurén, which distinguishes, by microscopical morphology alone, two main cancer pathogeneses, diffuse (DGCA) and intestinal (IGCA) subtypes, which appear clearly as dissimilar clinical and epidemiological entities. Here we review the main differences in epidemiology, histopathology, and molecular pathology of the two main subtypes of gastric carcinomas based on Laurén classification. In clinical practice, however, clinical staging, particularly in predicting the survival, still remains superior to all classifications of gastric cancer independent of cancer type. The existence of local precursor lesions or conditions of IGCA tumours, i.e. Helicobacter pylori gastritis, atrophic gastritis (AG), intestinal metaplasia (IM), adenoma, dysplasia, and intramucosal neoplasia, is firmly established. The links of DGCA with intestinal-type epithelium, AG or IM are poor, or do not exist. So far, H. pylori gastritis is the only universal precursor condition for DGCA. It implies that AG and achlorhydria are of minor significance and infrequent in the development of DGCA but are important steps in that of IGCA. Despite an increasing body of data, the overall view on molecular pathology of GCA remains fragmentary. No consistent differences in the molecular pathology of GCA subtypes to meet the Laurén classification have been established. With the exception of TP53, no gene mutation occurring regularly in both histological types of GCA has been reported. Chromosomal aberrations and loss of heterozygosity seem to be non-specific and do not follow any consistent route in the progression of GCA. Microsatellite instability is more commonly found in IGCA than in DGCA. The present epigenetic data suggest that most of the decrease (or loss) of gene expression may be explained by promoter hypermethylation which is more often found in IGCA. In DGCA specific genes such as CDH1 are more often hypermethylated. Compared with GCA, in premalignant condition lesions gene mutations and chromosomal aberrations are infrequent. Epigenetic dysregulation might also represent a major mechanism for altered gene expression in premalignant stages in gastric carcinogenesis.

背景与目标： ：在过去的几十年中，已经进行了多次尝试来对胃癌（GCA）进行分类。最成功且应用最广泛的是Laurén的分类法，该分类法仅通过显微镜形态就可以区分出两种主要的癌症病原体，即弥散（DGCA）和肠道（IGCA）亚型，它们明显表现为不同的临床和流行病学实体。在这里，我们基于Laurén分类，回顾了两种主要胃癌亚型的流行病学，组织病理学和分子病理学的主要差异。然而，在临床实践中，临床分期，尤其是在预测存活率方面，仍然优于胃癌的所有分类，而与癌症类型无关。牢固地确定了局部局部前体病变或IGCA肿瘤的状况，即幽门螺杆菌胃炎，萎缩性胃炎（AG），肠化生（IM），腺瘤，异型增生和粘膜内瘤变。 DGCA与肠型上皮，AG或IM的联系较差或不存在。到目前为止，幽门螺杆菌胃炎是DGCA的唯一通用先兆病状。这表明AG和胃酸缺乏症在DGCA的发展中意义不大，很少出现，但在IGCA中是重要的步骤。尽管有越来越多的数据，但关于GCA分子病理学的整体观点仍是零碎的。尚未建立符合劳伦分类的GCA亚型分子病理学方面的一致差异。除TP53外，在两种组织学类型的GCA中均没有定期发生基因突变的报道。染色体畸变和杂合性丧失似乎是非特异性的，并且在GCA的发展过程中未遵循任何一致的途径。在IGCA中比在DGCA中更常见微卫星不稳定性。目前的表观遗传学数据表明，基因表达的大多数减少（或丧失）可以通过在IGCA中更常见的启动子高甲基化来解释。在DGCA中，诸如CDH1之类的特定基因更经常被甲基化。与GCA相比，在癌变前病灶中，基因突变和染色体畸变很少见。表观遗传失调也可能代表了胃癌发生前癌变阶段基因表达改变的主要机制。

BACKGROUND & AIMS: BACKGROUND:We examined loss of heterozygosity (LOH) of the P53 gene in bladder cancer, and investigated the role of the P53 gene on malignant progression of papillary tumors. In addition, the clonality of recurrent bladder cancer was examined. METHODS:LOH of the P53 gene was analyzed in 67 bladder cancers from 47 patients. DNA was extracted from formalin-fixed, paraffin-embedded tissues, amplified by the polymerase chain reaction (PCR) at 3 polymorphic loci in the P53 gene, and analyzed with nonradioisotopic single-strand conformation polymorphism (Non-RI SSCP) analysis. RESULTS:Out of 40 informative samples, LOH was detected in 13 samples, containing 4 of 7 in grade 3 (57%), 9 of 23 in grade 2 (39%), and none of 10 in grade 1 (10%). Statistical significance was observed between the LOH in grades 1 and 2, and in grades 1 and 3. An analysis of 5 cases showing malignant progression revealed that 3 (60%) showed an LOH in the primary tumor, and 2 showed LOH in recurrent tumors, in contrast to LOH found in 3 cases of 19 (16%) not showing malignant progression. Four cases with metachronous recurrence exhibited LOH; 2 at recurrent tumors, 1 only at the initial tumor, and 1 at both tumors. CONCLUSIONS:The alterations of the P53 gene were considered to correlate with tumor grade, and contribute to the malignant progression of bladder cancer. LOH in the P53 gene may serve as a clinical indicator for prognosis in superficial bladder cancer.

背景与目标： 背景：我们检查了膀胱癌中P53基因的杂合性（LOH）缺失，并研究了P53基因在乳头状瘤恶性进展中的作用。另外，检查了复发性膀胱癌的克隆性。
方法：分析了47例患者的67例膀胱癌中P53基因的LOH。从福尔马林固定，石蜡包埋的组织中提取DNA，在P53基因的3个多态性位点处通过聚合酶链反应（PCR）进行扩增，并通过非放射性同位素单链构象多态性（Non-RI SSCP）分析。
结果：在40个信息量样本中，在13个样本中检测到LOH，其中3个7级中有4个（57％），2个23级中有9个（39％），1个10级中没有10个（10％）。在1级和2级以及1级和3级的LOH之间观察到统计学意义。对5例恶性进展的分析表明，3例（60％）在原发性肿瘤中显示LOH，2例在复发性肿瘤中显示LOH。 ，与LOH在19例（16％）的3例中未显示出恶性进展的情况相反。 4例异时复发表现为LOH。在复发性肿瘤中2个，仅在初始肿瘤中1个，在两个肿​​瘤中1个。
结论：P53基因的改变被认为与肿瘤的分级有关，并有助于膀胱癌的恶性进展。 P53基因中的LOH可作为浅表性膀胱癌预后的临床指标。

BACKGROUND & AIMS: :The course of untreated localized prostate cancer after 10 years of follow-up is at large unknown. As curative treatment is usually only offered patients with a life expectancy exceeding 10 Years, the expected course of the disease if left untreated is of the utmost interest. This paper aims to describe the outcome for patients who survive for more than 10 years when treated without curative intent. The results indicate that cancer specific mortality in patients with localized prostate cancer increases steadily over time and is approximately 50% after 15 years. This is a much higher figure than in reported series on radical prostatectomy. Even if many deaths occur at an old age, prostate cancer death is shown to be associated with a significant morbidity, need for palliative treatment, hospital care and cost. Preventing prostate cancer death is therefore not only a matter of saving year of life but also to prevent suffering caused by the disease. Modern diagnostic tools, such as prostate specific antigen, seem to detect clinically significant cancers in the vast majority of patients. Over diagnosis seems to be uncommon if diagnostic procedures are restricted to patients with a long life expectancy. Localized prostate cancer is a slow-growing but progressive neoplastic disease. When diagnosed in a man with a longer life expectancy it should be handled as such.

背景与目标： ：十年随访后未经治疗的局限性前列腺癌的病程目前还不得而知。由于通常仅为预期寿命超过10年的患者提供治愈性治疗，因此，如果不及时治疗，预期的病程将是最重要的。本文旨在描述未经治疗而存活超过10年的患者的预后。结果表明，局部前列腺癌患者的癌症特异性死亡率随时间稳定增加，并且在15年后约为50％。这是一个比已报道的前列腺癌根治术系列高得多的数字。即使许多死亡发生在老年，前列腺癌的死亡也被证明与明显的发病率，姑息治疗的需要，医院护理和费用有关。因此，预防前列腺癌的死亡不仅是挽救生命的一年，而且是预防由该疾病引起的痛苦的问题。现代诊断工具，例如前列腺特异性抗原，似乎可以在绝大多数患者中检测出具有临床意义的癌症。如果诊断程序仅限于预期寿命较长的患者，则过度诊断似乎不常见。局限性前列腺癌是一种生长缓慢但正在进行的肿瘤性疾病。当诊断为预期寿命较长的男性时，应照此处理。

BACKGROUND & AIMS: :In a previous large scale screen for differentially expressed genes in pancreatic cancer, we identified a gene highly overexpressed in cancer encoding a novel protein with four K-homologous (KH) domains. KH-domains are found in a subset of RNA-binding proteins, including pre-mRNA-binding (hnRNP) K protein and the fragile X mental retardation gene product (FMR1). By fluorescence in situ hybridization (FISH) the identified gene named koc (KH domain containing protein overexpressed in cancer) was assigned to chromosome 7p11.5. Two pseudogenes were localised on chromosome 6 and 11. The cloned koc cDNA has a 250 bp 5'-UTR, a 1740 bp ORF and a 2168 bp 3'-UTR. The AU-rich 3'-untranslated region of koc contains eight AUUUA and four AUUUUUA reiterated motifs. The deduced koc protein with 580 amino-acids has a relative molecular mass (Mr) of approximately 65,000 (65 K). The koc transcript is highly overexpressed in pancreatic cancer cell lines and in pancreatic cancer tissue as compared to both, normal pancreas and chronic pancreatitis tissue. High levels of expression were as well found in tissue samples of other human tumours. As the KH domain has been shown to be involved in the regulation of RNA synthesis and metabolism, we speculate that koc may assume a role in the regulation of tumour cell proliferation by interfering with transcriptional and or posttranscriptional processes. However, the precise role of koc in human tumour cells is unknown and remains to be elucidated.

背景与目标： ：在先前针对胰腺癌中差异表达基因的大规模筛选中，我们鉴定了在癌症中高度过表达的基因，该基因编码具有四个K同源（KH）域的新型蛋白质。 KH结构域存在于RNA结合蛋白的子集中，包括前mRNA结合（hnRNP）K蛋白和脆弱的X智力低下基因产物（FMR1）。通过荧光原位杂交（FISH），将鉴定出的名为koc（在癌症中过表达的KH域蛋白）的基因分配给7p11.5染色体。两个假基因位于6号和11号染色体上。克隆的koc cDNA具有250 bp的5'-UTR，1740 bp的ORF和2168 bp的3'-UTR。富含AU的3'非翻译区域的koc包含八个AUUUA和四个AUUUUUA重复的基序。推导的具有580个氨基酸的koc蛋白的相对分子质量（Mr）约为65,000（65 K）。与正常胰腺和慢性胰腺炎组织相比，koc转录本在胰腺癌细胞系和胰腺癌组织中高度过表达。在其他人类肿瘤的组织样本中也发现了高水平的表达。由于已经显示出KH结构域参与RNA合成和代谢的调节，我们推测koc可能通过干扰转录和/或转录后过程而在调节肿瘤细胞增殖中发挥作用。但是，koc在人肿瘤细胞中的确切作用尚不清楚，尚待阐明。

BACKGROUND & AIMS: :Surgery for thyroid disease requires skin incisions that can result in postsurgical problems such as prominent scars, adhesions, hypesthesia, and paresthesia in the neck. To overcome these problems we performed gasless endoscopic thyroidectomy via an axillary approach. Between May 2004 and April 2005, 30 patients underwent gasless endoscopic thyroidectomy via an axillary approach. The mean operating time was 126.8+/-32.4 minutes, and the mean length of hospital stay was 4.3+/-1.1 days. No cases required conversion to open surgery and none involved significant intraoperative complications. Three patients (10.0%) complained of slight hypesthesia or paresthesia in the anterior chest wall, and only 2 patients (6.7%) complained of discomfort while swallowing 4 months after surgery. All patients were satisfied with the cosmetic results. Gasless endoscopic thyroidectomy via an axillary approach is feasible and safe and provides excellent cosmetic results with a minimal degree of postoperative complaints.

背景与目标： ：甲状腺疾病的手术需要皮肤切口，这可能导致术后问题，例如明显的疤痕，粘连，感觉异常和颈部感觉异常。为了克服这些问题，我们通过腋窝入路进行了无气内镜甲状腺切除术。在2004年5月至2005年4月之间，有30例患者通过腋窝入路行无气内镜甲状腺切除术。平均手术时间为126.8 /-32.4分钟，平均住院时间为4.3 /-1.1天。没有病例需要转换为开放手术，也没有涉及重大的术中并发症。 3例患者（10.0％）抱怨前胸壁轻度感觉异常或感觉异常，而只有2例患者（6.7％）吞咽术后4个月吞咽不适。所有患者对美容效果均满意。通过腋窝入路的无气内镜甲状腺切除术是可行且安全的，并能以极少的术后不适程度提供出色的美容效果。

BACKGROUND & AIMS: :Malignant transformation of synovial chondromatosis into chondrosarcoma is unusual. Thirteen cases and one series have been reported; only four of them developed in the hip. The overall survival is about 50%, possibly because of the difficulty of arriving at a correct early diagnosis (radiographically and histologically) and subsequent adequate surgical therapy. We report two patients (ages 30 and 50 years) in whom synovial chondrosarcoma developed in previously excised synovial chondromatosis of the hip. The diagnosis was made with modern imaging techniques (computed tomography and magnetic resonance imaging) and verified by open biopsy. The early recognition allowed a wide limb-saving resection; both patients are disease free 3 and 2 years after surgery.

背景与目标： ：滑膜软骨瘤恶变为软骨肉瘤是罕见的。报告了13例和一系列病例；其中只有四个在臀部发育。总体存活率约为50％，这可能是由于难以进行正确的早期诊断（影像学和组织学）以及随后进行适当的手术治疗所致。我们报告了两名患者（年龄分别为30岁和50岁），其中滑膜软骨肉瘤在先前切除的髋关节滑膜软骨病中发展。诊断是使用现代成像技术（计算机断层扫描和磁共振成像）进行的，并通过开放式活检进行了验证。尽早发现，可以广泛地节省肢体。两名患者均在手术后3年和2年内无病。

BACKGROUND & AIMS: :A prospective collection of positive antimicrobial cultures was performed over 12 consecutive months in the medical intensive care unit of a cancer hospital. In all, 144 infections and 163 pathogens were documented during 87 of the 528 admissions. Lung, urinary, ENT (ear, nose and throat) infections and bacteraemia were the most frequently documented. Staphylococcus species, Streptococcus species, Escherichia coli, Klebsiella species and Pseudomonas species were the most common pathogens. Gram-positive strains were observed predominantly during monomicrobial bacteraemia (48.9%). Methicillin-resistant Staphylococcus aureus (MRSA) and Staphylococcus epidermidis (MRSE) were found in 58% and 92% of the isolated strains respectively. No particular outbreak was identified. A further prospective study will be necessary to evaluate the impact of the antibiotic use on the selection of resistant strains in our ICU.

背景与目标： ：在癌症医院的医疗重症监护室连续12个月进行了前瞻性抗菌药物阳性培养。在528例入院病例中，总共记录了144例感染和163种病原体。肺，尿，耳鼻喉（耳，鼻，喉）感染和菌血症的记录最频繁。葡萄球菌，链球菌，大肠杆菌，克雷伯菌和假单胞菌是最常见的病原体。革兰氏阳性菌株主要在单微生物菌血症期间观察到（48.9％）。分别在58％和92％的分离菌株中发现了耐甲氧西林的金黄色葡萄球菌（MRSA）和表皮葡萄球菌（MRSE）。没有发现特定的爆发。有必要进行进一步的前瞻性研究，以评估抗生素使用对我们ICU中耐药菌株选择的影响。

BACKGROUND & AIMS: OBJECTIVE:To examine the relationships between the expression of protein Nm23 and surgical stage, histologic grade, histopathologic findings, and survival in women with endometrial carcinoma. METHODS:19 patients with lymph node involvement were matched with 24 patients without lymph node involvement and the best paraffin-embedded blocks were selected for Nm23 immunohistochemical staining. The slides were evaluated semiquantitatively according to their degree of cytoplasmic staining. Statistical analysis was performed to determine whether there was a relationship between Nm23 expression and surgical stage, histologic grade, depth of myometrial invasion, lymph node metastasis, and/or lymphovascular space involvement. Survival analysis was also performed. RESULTS:Slides from 15 patients (79%) with lymph node involvement and 22 patients (88%) without lymph node involvement were found to be positive for Nm23 (P=0.01). No significant relations were observed between Nm23 expression and surgical stage, histologic grade, depth of myometrial invasion, or lymphovascular space involvement. Nm23 expression was found to be significantly related to lower rates of lymph node metastasis and longer survival (P=0.02). CONCLUSION:Elevated Nm23 expression is related to lower rates of lymph node metastasis and longer survival.

背景与目标： 目的：探讨Nm23蛋白的表达与子宫内膜癌女性手术分期，组织学分级，组织病理学发现及生存之间的关系。
方法：将19例淋巴结受累患者与24例无淋巴结受累患者进行配对，并选择最佳石蜡包埋块进行Nm23免疫组化染色。根据细胞质染色的程度对玻片进行半定量评估。进行统计分析以确定Nm23的表达与手术分期，组织学分级，肌层浸润深度，淋巴结转移和/或淋巴管间隙受累之间是否存在关系。还进行了生存分析。
结果：发现淋巴结受累的15例患者（79％）和未淋巴结受累的22例患者（88％）的玻片Nm23阳性（P = 0.01）。 Nm23表达与手术分期，组织学分级，肌层浸润深度或淋巴管间隙受累之间无显着相关性。发现Nm23表达与较低的淋巴结转移率和更长的存活率显着相关（P = 0.02）。
结论：Nm23表达升高与淋巴结转移率降低和生存期延长有关。