Reliable PCR quantitation of estrogen, progesterone and ERBB2 receptor mRNA from formalin-fixed, paraffin-embedded tissue is independent of prior macro-dissection

Gene expression analysis on messenger RNA (mRNA) purified from formalin-fixed, paraffin-embedded tissue is increasingly used for research purposes. Tissue heterogeneity may question specificity and interpretation of results from mRNA isolated from a whole slide section, and thresholds for minimal tumor content in the paraffin block or macrodissection are used to avoid contamination from non-neoplastic tissue. The aim was to test if mRNA from tissue surrounding breast cancer affected quantification of estrogen receptor α (ESR1), progesterone receptor (PGR) and human epidermal growth factor receptor 2 (ERBB2), by comparing gene expression from whole slide and tumor-enriched sections, and correlating gene expression from whole slide sections with corresponding immunohistochemistry. Gene expression, based on mRNA extracted from a training set (36 paraffin blocks) and two validation sets (133 + 1,083 blocks), were determined by quantitative reverse transcription polymerase chain reaction for all samples, as well as by microarray for 133 validation samples. In the training set, agreement between high vs. low mRNA expression from whole slide and tumor-enriched sections was absolute for ESR1 and ERBB2, and 83 % for PGR. Overall agreements, when comparing mRNA expression to immunohistochemistry, were 100 % (ERBB2), 89 % (ESR1) and 83 % (PGR), which was confirmed in the validation sets. Percentage of tumor in the sections did not influence the results. In conclusion, reliable quantification of ESR1, PGR and ERBB2 mRNA expression can be obtained from a whole slide section, and correlates well with immunohistochemistry. Prior removal of surrounding tissue was found to be unnecessary even with minimal tumor content in the section

The impact of stapling technique and surgeon specialism on anastomotic failure after right-sided colorectal resection:an international multicentre, prospective audit

AIM: There is little evidence to support choice of technique and configuration for stapled anastomoses after right hemicolectomy and ileocaecal resection. This study aimed to determine the relationship between stapling technique and anastomotic failure.METHOD: Any unit performing gastrointestinal surgery was invited to contribute data on consecutive adult patients undergoing right hemicolectomy or ileocolic resection to this prospective, observational, international, multicentre study. Patients undergoing stapled, side-to-side ileocolic anastomoses were identified and multilevel, multivariable logistic regression analyses were performed to explore factors associated with anastomotic leak.RESULTS: One thousand three hundred and forty-seven patients were included from 200 centres in 32 countries. The overall anastomotic leak rate was 8.3%. Upon multivariate analysis there was no difference in leak rate with use of a cutting stapler for apical closure compared with a noncutting stapler (8.4% vs 8.0%, OR 0.91, 95% CI 0.54-1.53, P = 0.72). Oversewing of the apical staple line, whether in the cutting group (7.9% vs 9.7%, OR 0.87, 95% CI 0.52-1.46, P = 0.60) or noncutting group (8.9% vs 5.7%, OR 1.40, 95% CI 0.46-4.23, P = 0.55) also conferred no benefit in terms of reducing leak rates. Surgeons reporting to be general surgeons had a significantly higher leak rate than those reporting to be colorectal surgeons (12.1% vs 7.3%, OR 1.65, 95% CI 1.04-2.64, P = 0.04).CONCLUSION: This study did not identify any difference in anastomotic leak rates according to the type of stapling device used to close the apical aspect. In addition, oversewing of the anastomotic staple lines appears to confer no benefit in terms of reducing leak rates. Although general surgeons operated on patients with more high-risk characteristics than colorectal surgeons, a higher leak rate for general surgeons which remained after risk adjustment needs further exploration.</p

Virkninger af Trafikpolitiske Tiltag – På landet og i byerne

I afgangsprojektet: ”Virkninger af Trafikpolitiske Tiltag – Set i et fordelingsmæssigt perspektiv” udarbejdet ved civilingeniøruddannelsen i trafikplanlægning på Aalborg Universitet er der foretaget en analyse af virkningen af forskellige trafikpolitiske tiltag og herunder først og fremmest forskellige former for afgiftspålæggelser. Formålet med projektet er at identificere de mulige negative effekter knyttet til yderligere afgiftspålæggelser på persontransporten i bil med hensyn til mobilitet, nuværende aktivitetsniveau og –mønster, opsparing samt øvrigt forbrug. Analysen er gennemført i et fordelingsmæssigt perspektiv med henblik på først og fremmest at undersøge, hvorvidt yderligere afgiftspålæggelser; · vil ramme hårdere blandt lavindkomsthusstande (det indkomstmæssige fordelingsaspekt). · vil ramme hårdere på landet end i byerne (det geografisk fordelingsaspekt). Analysen af disse to fordelingsmæssige aspekter er gennemført på baggrund af en større empirisk undersøgelse. I dette paper gives en præsentation af hovedresultaterne fra analysen af det geografiske fordelingsaspekt

Identifikation af uheldsbelastede lokaliteter: Antal eller alvorlighedsgrad?

Med Færdselssikkerhedskommissionens seneste handlingsplan for trafiksikkerhedsarbejdet i Danmark er der sket et strategiske skifte i dette arbejde, idet indsatsen fremover i højere grad skal fokuseres mod at nedbringe antallet af alvorlige trafikulykker.I dette perspektiv synes der at foreligge et behov for en revision af de danske metoder til identifikation af sorte pletter, således at sortpletudpegningen ikke alene sker på baggrund af antallet af uheld, men også tager hensyn til uheldens alvorlighedsgrad.Analyserne præsenteret i dette paper viser, at en uheldsstedet og uheldstypen, det vil sige kombinationen af uheldssituation og implicerede parter, har væsentlig indflydelse på ulykkers alvorlighedsgrad. På det grundlag synes det specifikt hensigtsmæssig, at sortpletudpegningen sker på basis af uheldstypen og ikke blot antallet af ulykker. I paperet præsenteres to mulige modeller til revision af de danske sortpletmetoder