1369

Prince Charles Merthyr Tydfil (M. Maguire, G. Hams); Princess Alexandra Harlow (B. Patel, E. Seth); Princess Ann Southampton (M. Hall, S. Smith); Pnncess Margaret Swmdon (J. King, J. Smith); Pnncess Mary Maternity Newcastle (E. Hey, S Fritz, S. Cook); Queen Elizabeth King’s Lynn (J. Dossetor, K. Pandey); Queen Elizabeth Gateshead (J. Beesley, H. Bagley); Queens Park Blackburn (J. Benson, J Bloor); Royal Alexandra Paisley (E. Byme, K. Cowan); Royal Berkshire Reading (A. Boon, M. Muncaster); Royal Buckinghamshire Aylesbury (R. Brown, T. Nuttall); Royal Free London (V. Van Someren, D. Isaacs); Royal Gwent Newport (S Ferguson, M. Evans), Royal Inftrmary Huddersfield (M. Miller, G. Potts); Royal Lancaster (M. Placzek, K. Swaùe);Royal Shrewsbury Maternity (J. Bnce, S. Elhs); Royal United Bath (P. Rudd, J. Jackson); Rush Green Romford (G. Cheriyan, M O’Donnell); Rutherglen Maternity Glasgow (P Galea, J. Ross); Sharoe Green Preston (A. Campbell, S. Parkmson); Shotley Bndge General Consett (B. Thalayasingham, S. Richardson); Solihull (M. Watkinson, J. Hall); South Cleveland Middlesbrough (S. Smha, A Lampson, D. Greensett); South Shields General (M. Taylor, L. Malcolm); Southern General Glasgow (A. Sutton, A. Glen), Southmead Bristol (B. Speidel, G. Rothwell); St James’s University Leeds (P. Dear, C. Murray); St John’s Chelmsford (A. Lipscomb, J. Layzell); St Mary’s Isle of Wight (A. Watson, C. Stone); St Paul’s Cheltenham (A. Day, M. Jones); Sunderland District General (S. Richmond, G. Shilling, J. Martin); Tameside General (M. Purcell, J.

Bury), University Hospital Nottingham (D. Curnock, J. Masterson); Univeristy Hospital of Wales Cardiff (M. Drayton, W. Huxton); Walsgrave Coventry (A. Coe, B. Marshall); Waveney, Ballymena (J. Jenkms, S. Bonar); West Cumberland (P. Carter, H Tedford); West Dorset Dorchester (P. Johnson, R. Murton); West Middlesex University (A. Habel, M. Orishaguna); Westminster Childrens, London (J. M. O’Donohoe); Wexham Park Slough (J. Pearce, S Singam); Withington, Manchester (S. Roberts, K. Hicklm); Wrexham Maelor General Clywd (H. Williams, M. Williams); Wycombe General (H. Fleet, J. Macdonald); Wythenshawe Manchester (S. Roberts, M. Roberts); York District (D. Beverley, V. Wilson).

(A. Merritt*) University of Califorrua Davis Medical Center Sacramento (A. Merritt, R. White, A.

USA

Maynard)

Steering Committee S. Arkle, R. Cooke, D. Elbourne (trial coordinator). A. Grant (trial coordinator), B. Hallsworth, M. Weindling, A. Wilkinson. Data Monitoring Committee R. Doll (Chairman), D. Altman, J. Lloyd, R. Soll. OSIRIS Trial Office C. Harris (data manager), J. Krog (programmer), E. Lukes, J. Metcalf (data entry), L. Morgan-Mireh (administrator), R. Seifas, R. Waller, J. Warde (secretary).

REFERENCES 1. Soll RF, McQueen MC. Respiratory distress syndrome. In: Sinclair JC, Bracken MB, eds. Effective care of the newborn infant. Oxford: Oxford University Press, 1992: 325-58. 2. Halliday HL. Other acute lung disorders. In: Sinclair JC, Bracken MB, eds. Effective care of the newborn infant. Oxford: Oxford University Press, 1992: 359-84.

3. Gilbert R, Keighley GF. The arterial/alveolar oxygen tension ratio: an index of gas exchange applicable to varying inspired oxygen concentrations. Am Rev Resp Dis 1974; 109: 142-45. 4. Hey EN, Lloyd DJ, Wigglesworth JS. Classifying perinatal death: fetal and neonatal factors. Br J Obstet Gynaecol 1986; 93: 1212-23. 5. Soll RF. Prophylactic surfactant vs treatment with surfactant. In: Chalmers I, ed. Oxford database of perinatal trials. Version 1.2. Disk issue 8, Autumn 1992, record 5675. 6. Kendig JW, Notter RH, Cox C, et al. A comparison of surfactant as immediate prophylaxis and as rescue therapy in newborns of less than 30 weeks’ gestation. N Engl J Med 1991; 324: 865-71. 7. Dunn MS, Shennan AT, Zayack D, Possmayer F. Bovine surfactant replacement therapy in neonates of less than 30 weeks’ gestation: a randomized controlled trial of prophylaxis versus treatment. Pediatrics

1991; 87: 377-86. 8. Merritt TA, Hallman M, Berry C, et al. Randomized placebo-controlled trial of human surfactant given at birth versus rescue administration in very low birth weight infants with lung immaturity. J Pediatr 1991; 118: 581-94. 9. Egberts J. Prophylactic and therapeutic application of surfactant (Curosurf) in preterm infants: a randomised trial. Oxford database of perinatal trials. Version 1.2. Disk issue 8, Autumn 1992, record 7277. 10. Konishi M, Fujiwara T, Chida S, et al. A prospective randomised trial of early versus late administration of a single dose of surfactant-TA. Proceedings of Ross Laboratories Special Conference, Hot Topics ’90 in neonatology, Washington, DC, 1990: 233-50. 11. Enhorning G. The bubble surfactometer. J Appl Physiol 1977; 43: 198-203. 12. European Exosurf Study Group. Early versus selective surfactant (colfosceril palmite, EXOSURF) at 26-29 weeks gestation: a European double-blind trial with sequential analysis. Online J Curr Clin Trials 1992 Nov 10, Doc no 28. 13. Long W, Thompson T, Sundell H, et al. Effects of two rescue doses of a synthetic surfactant on mortality rate and survival without bronchopulmonary dysplasia in 700- to 1350-gram infants with respiratory distress syndrome. J Pediatr 1991; 118: 595-605. 14. Long W, Corbet A, Cotton R, et al. A controlled trial of synthetic surfactant in infants weighing 1250g or more with respiratory distress syndrome. N Engl J Med 1991; 325: 1696-703. 15. Pramanik AK, Dhanireddy R, Hallman M, et al. Randomized comparison of 2 vs 4 doses of synthetic surfactant in 548 infants with RDS weighing ≥ 1250 grams. Pediatr Res 1992; 31, no 4, part 2. 16. Cummings JJ, Holm BA, Hudak ML, et al. A controlled clinical comparison of four different surfactant preparations in surfactantdeficient preterm lambs. Am Rev Resp Dis 1992; 145: 999-1004.

Prognostic significance of cytoplasmic p53 oncoprotein in colorectal adenocarcinoma

Mutation of p53, a tumour-suppressor protein, leads to overexpression of the protein and loss of its

tumour-suppressive properties. In some tumours (eg, breast) p53 expression is related to well-known prognostic factors, but findings in colorectal tumours are equivocal. We have used the polyclonal antibody CM1 to investigate nuclear and cytoplasmic p53 expression in colorectal tumours and to assess their relations with prognosis. Of 293 colorectal adenocarcinomas, 71 (24%) showed p53 expression in the nucleus alone, 30 (10%) showed p53 in the cytoplasm alone, and 43 (15%) showed both nuclear and cytoplasmic expression. Nuclear p53 expression showed no relation with survival

Dukes’ stage of the tumour. the However, frequency of cytoplasmic expression increased with advancing Dukes’ stage (&khgr;2 for trend 11·18, 1 df, p = 0·0008) and cytoplasmic expression was associated with poor survival (rate ratio 2·3 or

[95% Cl 1·6-3·3], p

Prognostic significance of cytoplasmic p53 oncoprotein in colorectal adenocarcinoma.

Mutation of p53, a tumour-suppressor protein, leads to overexpression of the protein and loss of its tumour-suppressive properties. In some tumours (e...
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