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3862. Apomorphine test to predict dopaminergic responsiveness in parkinsonian syndromes.
To evaluate apomorphine as an indicator of dopaminergic responsiveness, responses to subcutaneous apomorphine, to a single levodopa challenge, and to prolonged levodopa therapy were studied in 100 patients with parkinsonian syndromes (65 with idiopathic Parkinson's disease, 35 with other parkinsonian syndromes). Excellent agreement was found between the initial challenges of apomorphine and levodopa. Apomorphine also accurately predicted the response to long-term levodopa in 90% of the patients. There were 8 false-negative results; 7 were in patients with mild deficits. The apomorphine test is a quick, safe, reliable indicator of dopaminergic responsiveness in parkinsonian syndromes. The test is especially helpful to reassess patients who seem to have become less responsive to levodopa and it also has some predictive value in the assessment of an untreated patient's likely response to dopaminergic therapy.
3866. Prognostic importance of occult axillary lymph node micrometastases from breast cancers. International (Ludwig) Breast Cancer Study Group.
来源: Lancet. 1990年335卷8705期1565-8页
Serial sectioning of ipsilateral axillary lymph nodes judged to be disease-free after routine histological examination revealed micrometastases in 83 (9%) of 921 breast cancer subjects. These patients had a poorer disease-free (p = 0.003) and overall (p = 0.002) survival after 5 years' median follow-up than did patients whose nodes remained negative on serial sectioning. The presence of axillary lymph node micrometastases correlated with the presence of vascular invasion and tumour size (p less than 0.0001 and p = 0.02, respectively). The presence of occult micrometastases remained statistically significant after adjusting for other prognostic factors. The detection of these micrometastases in lymph nodes may identify a high risk "node-negative" population and should be considered as part of the routine pathology examination.
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