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The current most important prognostic indicator in colorectal carcinoma is tumor stage at the moment of diagnosis. The role of NM23 gene as prognostic factor is controversial. The aim of this study was to investigate NM23 expression.The study population included 104 unselected patients who underwent surgery for colorectal carcinoma between 1992 and 1997. NM23 expression was quantified by estimating the percentage of tumor cells with unequivocal reactivity. The percentage was scored: 0 when no tumor cells showed immunoreactivity; 1 when less than 10% of cells showed immunoreactivity; 2 when 11-50% of cells were positive; 3 when more than 51% of cells were positive.Four cases belonged to group 0.21 to group 1.55 to group 2 and 24 to group 3.NM23 cannot be considered an independent prognostic variable.

We have performed a retrospective analysis of 53 cases of bronchial carcinoids using our own patient data from more than 4700 lung tumors and 1632 resections. The male/female ratio was 1:12 (28/25) and the age range 13 to 75 years (mean 52.2). Fifty-three tumors resections of varying extent were performed, including one radical pneumonectomy in a patient who had previously undergone a lobectomy, and one limited resection of the main left bronchus; there was no intraoperative mortality. After histological examination, 44 tumors (83%) were found to be typical carcinoids and nine (17%) atypical carcinoids. The median follow-up period was 4.56 years, with a range from 1 to 10 years. Only one patient with an atypical carcinoid tumor had a relapse and died three years after, while another patient underwent surgery of the contralateral lung for a second primary lung cancer (SPLC). On the basis of these observations we would like to underline the importance of an accurate histopathological classification for both therapeutic and prognostic purposes; given the higher aggressiveness of atypical carcinoids, these tumors would be eligible for a therapeutic approach analogous to that adopted for bronchogenic carcinoma.

New educational technologies might help to compensate for the decrease in time and emphasis dedicated to physical examination in medical training. This may, in particular, be applicable for improving the skills in auscultation of the chest. We investigated whether a multimedia presentation of acoustic and graphic characteristics of lung sounds could improve the learning of pulmonary auscultation by medical students, in comparison with conventional teaching methods. We studied 48 medical students without clinical experience, who had received conventional formal teaching on chest examination. Chest auscultation skills were evaluated using an inaccuracy score for the student's auscultation report on three patients, selected according to a standardized procedure. After a baseline evaluation, 27 students in groups of 5-10, participated in a multimedia seminar on lung sounds during which digitized lung sounds were played and the corresponding time-expanded waveform and frequency spectrum were commented on and displayed on a computer. The remaining 21 students received conventional bedside training, acting as control group. The following week, all the students underwent a second evaluation of chest auscultation skills. No differences in the inaccuracy score were observed between the two groups in the preliminary test. However, in the second postintervention assessment, the inaccuracy score of the students who had followed the seminar (11.2 +/- 1.3 points) was significantly lower than that of the controls (16.6 +/- 1.6 points). The answers to a feedback questionnaire confirmed that the great majority of the students found the association of the acoustic signals with their visual image to be useful for learning and understanding lung sounds.(ABSTRACT TRUNCATED AT 250 WORDS)