Chromosomal instability and double minute chromosomes in a breast cancer patient.

Cytogenetic analysis was performed in peripheral blood lymphocytes (PBL) of a woman with ductal breast carcinoma, who as a hospital employee was exposed professionally for 15 years to low doses of ionizing radiation. The most important finding after the chemotherapy in combination with radiotherapy was the presence of double minutes (DM) chromosomes, in combination with other chromosomal abnormalities (on 200 scored metaphases were found 2 chromatid breaks, 10 dicentrics, 11 acentric fragments, 2 gaps, and 3 double min chromosomes). In a repeated analysis (after 6 months), DM chromosomes were still present. To rule out the possibility that the patient was overexposed to ionizing radiation at work, her blood test was compared with a group of coworkers as well as with a group of professionally unexposed people. The data rejected this possibility, but the retroactive analysis showed that the patient even at the time of employment had a moderately increased number of chromosomal aberrations (3.5%) consisting of 3 isochromatids and 4 gaps, suggesting that her initial genomic instability enhanced the later development. The finding of a continuous presence of rare DM chromosomes in her PBL (4 and 10 months after radiochemotherapy) was considered as an indicator of additional risk, which might have some prognostic significance.</p

Knowledge management measurement in South African organisations

This article explores the status of knowledge management (KM) measurement in South African organisations. KM has been advocated by some observers as the only way of maintaining a competitive advantage in today's global economy, but if KM is not to fade away as yet another `management fad', it needs practical implementation models and measures to determine if it adds value. Considerable international research into KM models and measures exists, and several projects are afoot to derive KM standards, but there has been very little research in South Africa in this regard. This article investigates whether organisations in South Africa are using KM measurement models and measures, and if so, which ones. In particular, the authors wanted to establish if the measures used conform to one of the published approaches, namely that of the British Standards Institute (BSI). A descriptive quantitative research methodology was employed, using a semi-structured questionnaire e-mailed to a target population derived from non-probability purposive sampling. In the sample of eighteen organisations 94 per cent were found to be using KM measurement models, albeit from a much wider range than has been recorded elsewhere. In terms of measures, 89 per cent of the sample were found to be using measures, and all of these were using at least some of those recommended by the BSI

T1 bladder carcinoma with variant histology: pathological features and clinical significance

none7siThe aim of the study was to stratify high-grade T1 (HGT1) bladder urothelial carcinoma into risk categories based on the presence of variant histology when compared to conventional urothelial carcinoma. The clinicopathological features of 104 HGT1 cases of urothelial carcinoma of the bladder with variant histology present in 34 (37%) were assessed. The endpoint of the study was disease-free survival and cancer-specific survival. Overall, variant histology was identified as a significant predictor of disease-free survival (P = 0.035). The presence of any specific variant histology (squamous, glandular, micropapillary, nested, microcystic, inverted growth, villous-like, basaloid, and lymphoepithelioma-like) was identified as a significant predictor of disease-free survival (P = 0.008) and cancer-specific survival (P = 0.0001) in HGT1 bladder cancer. Therefore, our results support including micropapillary HGT1 urothelial carcinoma within the aggressive high-risk category, as suggested by some recent clinical guidelines, but also favor nested, glandular, and basaloid to be placed in the high-risk category due to their potential of aggressive, life-threatening behavior and their limited response to bacillus Calmette-Guerin therapy. Conversely, the low-risk category would include urothelial carcinomas with squamous, inverted growth, or microcystic morphology, all with limited life-threatening potential and good response to current therapy. A very low-risk category would finally include patients whose tumors present villous-like or lymphoepithelioma-like morphology. In conclusion, our findings support the value of reporting the variant histology as a feature of variable aggressiveness in HGT1 urothelial carcinoma of the bladder.noneLopez-Beltran A.; Blanca A.; Cimadamore A.; Montironi R.; Luque R.J.; Volavsek M.; Cheng L.Lopez-Beltran, A.; Blanca, A.; Cimadamore, A.; Montironi, R.; Luque, R. J.; Volavsek, M.; Cheng, L