Tissue microarrays for rapid linking of molecular changes to clinical endpoints.

Advances in genomics and proteomics are dramatically increasing the need to evaluate large numbers of molecular targets for their diagnostic, predictive or prognostic value in clinical oncology. Conventional molecular pathology techniques are often tedious, time-consuming, and require a lot of tissue, thereby limiting both the number of tissues and the number of targets that can be evaluated. Here, we demonstrate the power of our recently described tissue microarray (TMA) technology in analyzing prognostic markers in a series of 553 breast carcinomas. Four independent TMAs were constructed by acquiring 0.6 mm biopsies from one central and from three peripheral regions of each of the formalin-fixed paraffin embedded tumors. Immunostaining of TMA sections and conventional "large" sections were performed for two well- established prognostic markers, estrogen receptor (ER) and progesterone receptor (PR), as well as for p53, another frequently examined protein for which the data on prognostic utility in breast cancer are less unequivocal. Compared with conventional large section analysis, a single sample from each tumor identified about 95% of the information for ER, 75 to 81% for PR, and 70 to 74% for p53. However, all 12 TMA analyses (three antibodies on four different arrays) yielded as significant or more significant associations with tumor-specific survival than large section analyses (p < 0.0015 for each of the 12 comparisons). A single sample from each tumor was sufficient to identify associations between molecular alterations and clinical outcome. It is concluded that, contrary to expectations, tissue heterogeneity did not negatively influence the predictive power of the TMA results. TMA technology will be of substantial value in rapidly translating genomic and proteomics information to clinical applications.

[Telemetric monitoring of delivery when inducing labour by prostaglandin E2 tablets (author's transl)]. / Telemetrische Geburtsüberwachung bei Einleitung mit Prostaglandin-E2-Tabletten.

The article reports on 75 patients in whom labour had been introduced by means of oral administration of prostaglandin E2 tablets (35 patients were controlled at the bedside and 40 patients were monitored telemetrically.) Telemetric monitoring is preferable in oral application of ecbolics, since this entails a saving in ecbolics (4.7 as against 5.4 tablets), regular labour is induced more rapidly (after 57 as against 72 minutes) and total delivery time is shortened (4 hours 24 minutes as against 5 hours 15 minutes). There were no serious side effects neither in the mother nor in the neonate. 6 of the 75 patients complained of slight gastrointestinal side effects. The Apgar scores and pH levels of the children were in the normal range. The post-partum period was identical in both groups, namely, 11 minutes.

PIP: This article reports on 75 patients in whom labor was induced by means of oral administration of prostaglandin E2 (PGE2) tablets; 35 patients were controls at bedside and 40 patients were monitored telemetrically. Telemetric monitoring is preferrable in oral application of ecbolics, since this entails a saving in ecbolics (4.7 vs 5.4 tablets), regular labor is induced more rapidly (after 57 vs 72 minutes), and total delivery time is shortened (4 hours 24 minutes vs 5 hours 15 minutes. There were no serious side effects in either the mother or the neonate. 6 of 75 patients complained of slight gastrointestinal side effects. Apgar scores and pH levels of the children were in the normal range. The postpartum period of 11 minutes was identical in both groups. (author's)

[Programmed labor: methods, results, guidelines (author's transl)]. / Die progrmmierte Geburt. Methodik, Ergbnisse, Richtlnien.

The programming of labor (setting the best possbile time under optimal conditions) was carried out in the University Women's Hospital, Freiburg i. Br. between 1970 and 1975 in 1121 cases. No perinatal mortality was reported. The secondary frequency of cesarean section for this primarily uncomplicated labor was 3.21% (general hospital statistics for this time period: 6.29%). The most important factors for the strict standardized method of induction is the observation of the pelvic score (desired: greater than 6) and a moderate dose of oxytocin or prostaglandin based on the essential amniotomy. In a statistical comparison of three groups of patients (n = 786): programmed labor (n = 427), induction via the same type of method where transference was suspected (n = 158), and uncomplicated spontaneous labor (n=183), the results with induced labor were better than those with spontaneous labor. In addition for the fact that the course of labor could be preplanned and the period of labor shortened intrauterine and partal complications occurred less frequently with programmed labor than with spontaneous labor. Placental complications and the tendency toward postpartum atony must be discussed. Minor complications decreased as the weight, length and gestation period of the newborn increased. Individual palpation until the physiological maturity for birth is reached would, therefore, seem to be required. Observe the conditions and increase antepartal controls. Only by setting the exact time for labor with modern methods of supervision is it theoretically possible to eliminate the danger of active management. The organizational problem involved with a general programming of labor poses the major problem at present.

[Quantitative and virus specific serum IgM detection in newborns (author's transl)]. / Quantitativer und virusspezifischer Serum-IgM-Nachweis bei Neugeborenen

Serum IgM concentration was determined in umbilical cord blood samples from 1000 newborns. 34 cases presenting elevated IgM values (greater than or equal to 30 mg%) were tested for virus specific IgM antibodies. We could demonstrate such virus specific IgM antibodies against Cytomegalovirus (4), against Rubella, Influenza A and Influenza B (2 each) and against Coxsackie virus (1). The quantitation of IgM in blood samples of child bearing women showed no elevated values compared to those of non-pregnant women of similar age groups.