David L Page

To assess the importance of various risk factors for breast cancer in women with benign proliferative breast lesions, we reevaluated 10,366 consecutive breast biopsies performed in women who had presented at three Nashville hospitals. The median duration of follow-up was 17 years for 3303 women, 1925 of whom had proliferative disease. This sample contained 84.4 per cent of the patients originally selected for follow-up. Women having proliferative disease without atypical hyperplasia had ...

BACKGROUND: Breast cancer originates in breast epithelium and is associated with progressive molecular and morphologic changes. Women with atypical breast ductal epithelial cells have an increased relative risk of breast cancer. In this study, ductal lavage, a new procedure for collecting ductal cells with a microcatheter, was compared with nipple aspiration with regard to safety, tolerability, and the ability to detect abnormal breast epithelial cells.

METHODS: Women at high risk for ...

BACKGROUND AND METHODS: In Paget's disease of the breast, the epidermis of the nipple is infiltrated by large neoplastic cells of glandular origin. It has been hypothesized that the spread of Paget cells through the nipple epidermis is induced by a motility factor that acts via the HER2/NEU receptor. To test this hypothesis, we characterized and purified a motility factor released by keratinocytes and identified its target receptors in specimens from patients with Paget's disease and in ...

Microglandular adenosis (MGA) is a well-recognized, if rare and incompletely characterized, entity in which carcinoma is rarely thought to develop. We report 17 cases in which patterns of adenoid cystic carcinoma (ACC) coexisted with MGA. Immunocharacterization with beta-catenin, E-cadherin, cytokeratins (AE1/AE3), epithelial membrane antigen, S-100 protein, smooth muscle actin, and vimentin was also performed. Most cases had areas of invasive ACC characterized by its defining dual-lumen ...

Apocrine ductal carcinoma in situ (ADCIS) has been called a special type of ductal carcinoma in situ (DCIS) because the histologic grading is considered difficult using the classification schemes that have been proposed for common DCIS. However, ADCIS encompasses a spectrum of lesions with different morphologic aspects ranging from minimally atypical to overtly malignant. To define a classification scheme for ADCIS, 35 cases (22 pure and 13 associated with invasive carcinoma) were ...

The staging and histologic cell type of patients in the Lung Cancer Study Group (LCSG) clinical trials program are reviewed and confirmed or resolved at the reference center for anatomic and pathologic classification of lung cancer. A high level of consistency in classification has been achieved through the use of criteria that minimize intraobserver variability. The data obtained from the review project have been used to characterize the relationship of disease extent and cell type to ...

Existing views on prorenin are conflicting and its physiological activation mechanism is not clear. In an attempt to obtain clearcut views on the molecular properties of prorenin in human plasma, the renin zymogen (prorenin) was separated from active renin by two steps of affinity chromatography and it was demonstrated that prorenin is a completely inactivate zymogen contrary to the existing information. Inactive prorenin has an apparent molecular of 56,000 contrary to 46,000-43,000 of ...

The amount of left ventricular myocardium destroyed by recent and old infarcts in patients with acute myocardial infarction with and without cardiogenic shock was compared in hearts obtained at autopsy. All 20 patients with, and only one of 14 without, shock had lost 40 per cent or more of the left ventricle. The remainder lost 35 per cent or less. These results indicate that cardiogenic shock is associated with extensive loss of left ventricular myocardium due to new and frequently old ...

Excessive accumulation of fat in the interatrial septum, termed lipomatous hypertrophy of the interatrial septum, was found at postmortem examination in ten elderly patients. All patients had atrial arrhythmias. Seven patients had unusual arrhythmias including multifocal atrial tachycardia, wandering atrial pacemaker, paroxysmal atrial tachycardia, and sinus arrest, all of which proved refractory to therapy. In five patients an unusual “dome and dip” P-wave configuration was noted in ...

The tubular adenomas, lactating adenomas, and ectopic lactation- or gestation-associated benign lesions of the breast diagnosed during a 22-year period are reported. Forty-two breast adenomas (in 28 patients) that demonstrated lactational changes are reviewed, with special attention to classification and clinical presentation. Five ectopic lactating adenomas--three axillary or in the chest wall and two vulvar, the latter occurring in the same patient--were identified in three patients. ...

IN CONTRAST to the X chromosome, little is known about the autosomal loci for various genetic traits. Recently Gerald et al1 and Bloom et al2 have presented suggestive evidence that the controlling formation of locus the α-chain of haptoglobin is situated on one end of a No. 13 chromosome. We have studied two patients with chromosome defects and dysgammaglobulinemia. One had a No. 18 ring chromosome, which is formed by breakage in both arms with reunion of the broken ends and loss of a ...

Since the recent acceptance of partial mastectomy (lumpectomy or segmentectomy) as equivalent to mastectomy for survival, design of the local management of breast cancers has centered around concerns of local recurrence. There has been wide acceptance of the tumorectomy or lumpectomy approach by most authors in North America, while in Italy, following the Milan trials, there has been a preference for a segmental or quadrantectomy approach. The latter preferentially includes more ductal ...

Interatrial fat deposits increase with advancing age.Atrial ectopic beats were present during life in a majority of patients with large amounts of fat in the interatrial septum. This atrial irritability may be the result of myocardial atrophy and fibrosis, which accompany the local deposition of large amounts of fat.

A 3-year-old child with severe acute self-limited enterocolitis was found on rectal biopsy to be infected with the protozoal parasite Cryptosporidium. This organism is known to infect a variety of vertebrates, but this is the first report of infection by Cryptosporidium in a human being. Both light and electron microscopic findings in the rectal biopsy are reported. It is suggested, on the basis of the severity of the clinical symptoms, and on the pathological changes in the rectum, that ...