Analysis of (estrogen receptors) ER in human breast cancer has shown two main clinical applicatio... more Analysis of (estrogen receptors) ER in human breast cancer has shown two main clinical applications: patient selection for endocrine therapy and prediction of the clinical course of the disease. Jensen and his colleagues [52] showed that breast cancer tissue possessed the same specific receptor mechanism for estrogen as did other estrogen target tissues. This work presented a working model of steroid action at the molecular level, applicable to female reproductive tissue including the breast. It was an extension of Folca\rss observation that breast cancer patients with a favorable response to adrenalectomy incorporated more radioactive hexestrol into their tumors in vivo than those who did not respond [30]. Such research contributed a mechanistic explanation for Beatson\rss observation [5] that oophorectomy caused tumor regression in two premenopausal patients with advanced breast cancer.
Summary The relationship to survival after first recurrence of oestrogen receptor (ER), nodal sta... more Summary The relationship to survival after first recurrence of oestrogen receptor (ER), nodal status and TNM stage at diagnosis, and treatment for advanced disease was studied in 457 females whose primary breast cancer was diagnosed in 1975 to 1981. Receptor concentration was the most important predictor of postrecurrence survival, with some additional information conveyed by nodal status. ER predicted survival after recurrence independently of nodal status, clinical stage or mode of therapy. Response to endocrine therapy is only a facet of the generally favourable prognosis of ER positive patients, rather than the sole explanation. The utility of oestrogen receptor (ER) measurement for predicting breast cancer survival has been extensively studied. The general consensus is that overall survival time, from initial diagnosis or primary treatment, is increased with tumours rated ER positive (ER +) by various definitions. The association between ER status and recurrence-free survival (...
PARTICIPATING SOCIETIES/SOCIETES PARTICIPANTES Canadian Neurosurgical Society Societe canadienne ... more PARTICIPATING SOCIETIES/SOCIETES PARTICIPANTES Canadian Neurosurgical Society Societe canadienne de neurochirurgie Canadian Neurological Society Societe canadienne de neurologie Canadian Society of Electroencephalographers, Electromyographers and Clinical Neurophysiologists Societe canadienne des electroencephalographistes, electromyographistes et neurophysiologistes cliniques Canadian Association of Neurological and Neurosurgical Nurses Association canadienne des infirmieres en neurologie et neurochirurge
The only significant advances in blood-taking in 25 years have been the disposable needle and eva... more The only significant advances in blood-taking in 25 years have been the disposable needle and evacuated blood-drawing tube. With the exception of a few isolated barcode experiments, most sample-tracking is performed through handwritten or computer-printed labels. Attempts to reduce the hazards of centrifugation have resulted in air-tight lids or chambers, the use of which is time-consuming and cumbersome. Most commonly used clinical analyzers require serum or plasma, distributed into specialized containers, unique to that analyzer. Aliquots for different tests are prepared by handpouring or pipetting. Moderate to large clinical laboratories perform so many different tests that even multi-analyzers performing multiple analyses on a single sample may account for only a portion of all tests ordered for a patient. Thus several aliquots of each specimen are usually required. We have developed a proprietary serial centrifuge and blood-collection tube suitable for incorporation into an aut...
The HER-2/neu proto-oncogene (also known as c-erb B-2) is homologous with, but distinct from, the... more The HER-2/neu proto-oncogene (also known as c-erb B-2) is homologous with, but distinct from, the epidermal growth factor receptor. Amplification of this gene in node-positive breast cancers has been shown to correlate with both earlier relapse and shorter overall survival. In node-negative breast cancer patients, the subgroup for which accurate prognostic data could make a significant contribution to treatment decisions, the prognostic utility of HER-2/neu amplification and/or overexpression has been controversial. The purpose of this report is to address the issues surrounding this controversy and to evaluate the prognostic utility of overexpression in a carefully followed group of patients using appropriately characterized reagents and methods. In this report we present data from a study of HER-2/neu expression designed specifically to test whether or not overexpression is associated with an increased risk of recurrence in node-negative breast cancers. From a cohort of 704 women ...
The independent prognostic effects of certain clinical and pathological variables measured at the... more The independent prognostic effects of certain clinical and pathological variables measured at the time of primary diagnosis were assessed with Cox multivariate regression analysis. The 859 patients with primary breast cancer, on which the proportional hazards model was based, had a median follow-up of 60 months. Axillary nodal status (categorized as N0, N1-3 or N4+) was the most significant and independent factor in overall survival, but inclusion of TNM stage, estrogen receptor (ER) concentration and tumor necrosis significantly improved survival predictions. Predictions made with the model showed striking subset survival differences within stage: 5-year survival from 36% (N4+, loge[ER] = 0, marked necrosis) to 96% (N0, loge[ER] = 6, no necrosis) in TNM I, and from 0 to 70% for the same categories in TNM IV. Results of the model were used to classify patients into four distinct risk groups according to a derived hazard index. An 8-fold variation in survival was seen with the highes...
... 1996 Apr;10(2):144-51. The implementation and use of automated group and screen procedures in... more ... 1996 Apr;10(2):144-51. The implementation and use of automated group and screen procedures in a hospital transfusion laboratory. Growe GH, Galenza J, Mah H, Whitehead R, Godolphin W. Vancouver Hospital and Health Sciences Centre, British Columbia, Canada. ...
Canadian Society of Forensic Science Journal, 1989
ABSTRACTVenous blood samples drawn from 14 drinking subjects were analyzed by a gas chromatograph... more ABSTRACTVenous blood samples drawn from 14 drinking subjects were analyzed by a gas chromatographic (GC) procedure and compared with serum samples analyzed by an automated alcohol dehydrogenase (ADH) based enzymatic assay using a DuPont ACA® Ill Discrete Clinical Analyzer. The conversion factor for serum to whole blood for alcohol was found to be 1.14 (range 1.12–1.18, s.d. 0.015).
Purpose – The purpose of this paper is to present a statement about the involvement of patients i... more Purpose – The purpose of this paper is to present a statement about the involvement of patients in the education of health and social care professionals developed at an international conference in November 2015. It aims to describe the current state and identify action items for the next five years. Design/methodology/approach – The paper describes how patient involvement in education has developed as a logical consequence of patient and public participation in health care and health research. It summarizes the current state of patient involvement across the continuum of education and training, including the benefits and barriers. It describes how the conference statement was developed and the outcome. Findings – The conference statement identifies nine priorities for action in the areas of policy, recognition and support, innovation, research and evaluation, and dissemination and knowledge exchange. Originality/value – The conference statement represents the first time that an inte...
A new column packing, SP-2510 DA (Supelco, Inc., Bellefonte, Pa. 16823), is an excellent stationa... more A new column packing, SP-2510 DA (Supelco, Inc., Bellefonte, Pa. 16823), is an excellent stationary phase for the determination of a wide variety of anticonvulsant drugs by gas--liquid chromatography without derivatization. However, when uncomplicated extraction procedures are used, serum cholesterol interferes with the determination of primidone. By the simple expedient of adding a short "pre-column" containing another phase (SP-2250 DA) the problem is overcome.
... cir-cumstances under which it is possible for a legitimate codeine user to be suspected of he... more ... cir-cumstances under which it is possible for a legitimate codeine user to be suspected of heroin abuse (1) and we now wish to describe a case in which the user of a relatively innocuous over-the-counter product, viz., Vick's Inhaler (Vick Chemical Co., Wilton, Conn.), was sus ...
Patients on long-term hemodialysis via arteriovenous fistula received heparin when the fistula ne... more Patients on long-term hemodialysis via arteriovenous fistula received heparin when the fistula needle was inserted, before a sample of blood was obtained for chemical analysis. The resultant release of lipoprotein lipase activity in vivo and continued lipolytic activity in vitro sometimes produced sufficient free fatty acid to precipitate calcium soaps. The consequent spurious hypocalcemia was most frequently observed when the patients had chylomicronemia. This cause of apparent hypocalcemia was eliminated either by immediate analyses of the blood samples or by obtaining samples before systemic heparinization.
Comparisons between oestrogen-receptor (RE)-positive or negative patients were made on a continuo... more Comparisons between oestrogen-receptor (RE)-positive or negative patients were made on a continuous series of 735 patients with primary breast tumours seen at the major treatment centre in British Columbia between 1975 and 1978. RE positivity was commoner in older patients, and was not associated with menopausal status independently of age. The concentration of receptor protein also increased with increasing age, but was not affected by menopausal status. Neither RE status nor quantity was associated with any of the epidemiological risk factors studied, which included parity, age at first birth, weight, family history and exposure to oestrogenic drugs and oral contraceptives. Patients with REtumours were more likely to present with symptoms other than a breast lump, pain or nipple inversion, and had less-differentiated tumours; they did not differ from RE+ patients in terms of stage, size of tumour, or interval from first symptom. These findings are discussed in terms of the biological origin and determinants of oestrogen receptors.
Analysis of (estrogen receptors) ER in human breast cancer has shown two main clinical applicatio... more Analysis of (estrogen receptors) ER in human breast cancer has shown two main clinical applications: patient selection for endocrine therapy and prediction of the clinical course of the disease. Jensen and his colleagues [52] showed that breast cancer tissue possessed the same specific receptor mechanism for estrogen as did other estrogen target tissues. This work presented a working model of steroid action at the molecular level, applicable to female reproductive tissue including the breast. It was an extension of Folca\rss observation that breast cancer patients with a favorable response to adrenalectomy incorporated more radioactive hexestrol into their tumors in vivo than those who did not respond [30]. Such research contributed a mechanistic explanation for Beatson\rss observation [5] that oophorectomy caused tumor regression in two premenopausal patients with advanced breast cancer.
Summary The relationship to survival after first recurrence of oestrogen receptor (ER), nodal sta... more Summary The relationship to survival after first recurrence of oestrogen receptor (ER), nodal status and TNM stage at diagnosis, and treatment for advanced disease was studied in 457 females whose primary breast cancer was diagnosed in 1975 to 1981. Receptor concentration was the most important predictor of postrecurrence survival, with some additional information conveyed by nodal status. ER predicted survival after recurrence independently of nodal status, clinical stage or mode of therapy. Response to endocrine therapy is only a facet of the generally favourable prognosis of ER positive patients, rather than the sole explanation. The utility of oestrogen receptor (ER) measurement for predicting breast cancer survival has been extensively studied. The general consensus is that overall survival time, from initial diagnosis or primary treatment, is increased with tumours rated ER positive (ER +) by various definitions. The association between ER status and recurrence-free survival (...
PARTICIPATING SOCIETIES/SOCIETES PARTICIPANTES Canadian Neurosurgical Society Societe canadienne ... more PARTICIPATING SOCIETIES/SOCIETES PARTICIPANTES Canadian Neurosurgical Society Societe canadienne de neurochirurgie Canadian Neurological Society Societe canadienne de neurologie Canadian Society of Electroencephalographers, Electromyographers and Clinical Neurophysiologists Societe canadienne des electroencephalographistes, electromyographistes et neurophysiologistes cliniques Canadian Association of Neurological and Neurosurgical Nurses Association canadienne des infirmieres en neurologie et neurochirurge
The only significant advances in blood-taking in 25 years have been the disposable needle and eva... more The only significant advances in blood-taking in 25 years have been the disposable needle and evacuated blood-drawing tube. With the exception of a few isolated barcode experiments, most sample-tracking is performed through handwritten or computer-printed labels. Attempts to reduce the hazards of centrifugation have resulted in air-tight lids or chambers, the use of which is time-consuming and cumbersome. Most commonly used clinical analyzers require serum or plasma, distributed into specialized containers, unique to that analyzer. Aliquots for different tests are prepared by handpouring or pipetting. Moderate to large clinical laboratories perform so many different tests that even multi-analyzers performing multiple analyses on a single sample may account for only a portion of all tests ordered for a patient. Thus several aliquots of each specimen are usually required. We have developed a proprietary serial centrifuge and blood-collection tube suitable for incorporation into an aut...
The HER-2/neu proto-oncogene (also known as c-erb B-2) is homologous with, but distinct from, the... more The HER-2/neu proto-oncogene (also known as c-erb B-2) is homologous with, but distinct from, the epidermal growth factor receptor. Amplification of this gene in node-positive breast cancers has been shown to correlate with both earlier relapse and shorter overall survival. In node-negative breast cancer patients, the subgroup for which accurate prognostic data could make a significant contribution to treatment decisions, the prognostic utility of HER-2/neu amplification and/or overexpression has been controversial. The purpose of this report is to address the issues surrounding this controversy and to evaluate the prognostic utility of overexpression in a carefully followed group of patients using appropriately characterized reagents and methods. In this report we present data from a study of HER-2/neu expression designed specifically to test whether or not overexpression is associated with an increased risk of recurrence in node-negative breast cancers. From a cohort of 704 women ...
The independent prognostic effects of certain clinical and pathological variables measured at the... more The independent prognostic effects of certain clinical and pathological variables measured at the time of primary diagnosis were assessed with Cox multivariate regression analysis. The 859 patients with primary breast cancer, on which the proportional hazards model was based, had a median follow-up of 60 months. Axillary nodal status (categorized as N0, N1-3 or N4+) was the most significant and independent factor in overall survival, but inclusion of TNM stage, estrogen receptor (ER) concentration and tumor necrosis significantly improved survival predictions. Predictions made with the model showed striking subset survival differences within stage: 5-year survival from 36% (N4+, loge[ER] = 0, marked necrosis) to 96% (N0, loge[ER] = 6, no necrosis) in TNM I, and from 0 to 70% for the same categories in TNM IV. Results of the model were used to classify patients into four distinct risk groups according to a derived hazard index. An 8-fold variation in survival was seen with the highes...
... 1996 Apr;10(2):144-51. The implementation and use of automated group and screen procedures in... more ... 1996 Apr;10(2):144-51. The implementation and use of automated group and screen procedures in a hospital transfusion laboratory. Growe GH, Galenza J, Mah H, Whitehead R, Godolphin W. Vancouver Hospital and Health Sciences Centre, British Columbia, Canada. ...
Canadian Society of Forensic Science Journal, 1989
ABSTRACTVenous blood samples drawn from 14 drinking subjects were analyzed by a gas chromatograph... more ABSTRACTVenous blood samples drawn from 14 drinking subjects were analyzed by a gas chromatographic (GC) procedure and compared with serum samples analyzed by an automated alcohol dehydrogenase (ADH) based enzymatic assay using a DuPont ACA® Ill Discrete Clinical Analyzer. The conversion factor for serum to whole blood for alcohol was found to be 1.14 (range 1.12–1.18, s.d. 0.015).
Purpose – The purpose of this paper is to present a statement about the involvement of patients i... more Purpose – The purpose of this paper is to present a statement about the involvement of patients in the education of health and social care professionals developed at an international conference in November 2015. It aims to describe the current state and identify action items for the next five years. Design/methodology/approach – The paper describes how patient involvement in education has developed as a logical consequence of patient and public participation in health care and health research. It summarizes the current state of patient involvement across the continuum of education and training, including the benefits and barriers. It describes how the conference statement was developed and the outcome. Findings – The conference statement identifies nine priorities for action in the areas of policy, recognition and support, innovation, research and evaluation, and dissemination and knowledge exchange. Originality/value – The conference statement represents the first time that an inte...
A new column packing, SP-2510 DA (Supelco, Inc., Bellefonte, Pa. 16823), is an excellent stationa... more A new column packing, SP-2510 DA (Supelco, Inc., Bellefonte, Pa. 16823), is an excellent stationary phase for the determination of a wide variety of anticonvulsant drugs by gas--liquid chromatography without derivatization. However, when uncomplicated extraction procedures are used, serum cholesterol interferes with the determination of primidone. By the simple expedient of adding a short "pre-column" containing another phase (SP-2250 DA) the problem is overcome.
... cir-cumstances under which it is possible for a legitimate codeine user to be suspected of he... more ... cir-cumstances under which it is possible for a legitimate codeine user to be suspected of heroin abuse (1) and we now wish to describe a case in which the user of a relatively innocuous over-the-counter product, viz., Vick's Inhaler (Vick Chemical Co., Wilton, Conn.), was sus ...
Patients on long-term hemodialysis via arteriovenous fistula received heparin when the fistula ne... more Patients on long-term hemodialysis via arteriovenous fistula received heparin when the fistula needle was inserted, before a sample of blood was obtained for chemical analysis. The resultant release of lipoprotein lipase activity in vivo and continued lipolytic activity in vitro sometimes produced sufficient free fatty acid to precipitate calcium soaps. The consequent spurious hypocalcemia was most frequently observed when the patients had chylomicronemia. This cause of apparent hypocalcemia was eliminated either by immediate analyses of the blood samples or by obtaining samples before systemic heparinization.
Comparisons between oestrogen-receptor (RE)-positive or negative patients were made on a continuo... more Comparisons between oestrogen-receptor (RE)-positive or negative patients were made on a continuous series of 735 patients with primary breast tumours seen at the major treatment centre in British Columbia between 1975 and 1978. RE positivity was commoner in older patients, and was not associated with menopausal status independently of age. The concentration of receptor protein also increased with increasing age, but was not affected by menopausal status. Neither RE status nor quantity was associated with any of the epidemiological risk factors studied, which included parity, age at first birth, weight, family history and exposure to oestrogenic drugs and oral contraceptives. Patients with REtumours were more likely to present with symptoms other than a breast lump, pain or nipple inversion, and had less-differentiated tumours; they did not differ from RE+ patients in terms of stage, size of tumour, or interval from first symptom. These findings are discussed in terms of the biological origin and determinants of oestrogen receptors.
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