Epithelial atypia in biopsies performed for microcalcifications. Practical considerations about 2,833 serially sectioned surgical biopsies with a long follow-up

This study analyzes the occurrence of epithelial atypia in 2,833 serially sectioned surgical breast biopsies (SB) performed for microcalcifications (median number of blocks per SB:26) and the occurrence of subsequent cancer after an initial diagnosis of epithelial atypia (median follow-up 160 months). Epithelial atypia (flat epithelial atypia, atypical ductal hyperplasia, and lobular neoplasia) were found in 971 SB, with and without a concomitant cancer in 301 (31%) and 670 (69%) SB, respectively. Thus, isolated epithelial atypia were found in 670 out of the 2,833 SB (23%). Concomitant cancers corresponded to ductal carcinomas in situ and micro-invasive (77%), invasive ductal carcinomas not otherwise specified (15%), invasive lobular carcinomas (4%), and tubular carcinomas (4%). Fifteen out of the 443 patients with isolated epithelial atypia developed a subsequent ipsilateral (n = 14) and contralateral (n = 1) invasive cancer. The high slide rating might explain the high percentages of epithelial atypia and concomitant cancers and the low percentage of subsequent cancer after a diagnosis of epithelial atypia as a single lesion. Epithelial atypia could be more a risk marker of concomitant than subsequent cancer

Clinical aspects of sentinel node biopsy

Sentinel lymph node (SLN) biopsy requires validation by a backup axillary dissection in a defined series of cases before becoming standard practice, to establish individual and institutional success rates and the frequency of false negative results. At least 90% success in finding the SLN with no more than 5-10% false negative results is a reasonable goal for surgeons and institutions learning the technique. A combination of isotope and dye to map the SLN is probably superior to either method used alone, yet a wide variety of technical variations in the procedure have produced a striking similarity of results. Most breast cancer patients are suitable for SLN biopsy, and the large majority reported to date has had clinical stage T1-2N0 invasive breast cancers. SLN biopsy will play a growing role in patients having prophylactic mastectomy, and in those with 'high-risk' duct carcinoma in situ, microinvasive cancers, T3 disease, and neoadjuvant chemotherapy. SLN biopsy for the first time makes enhanced pathologic analysis of lymph nodes logistically feasible, at once allowing greater staging accuracy and less morbidity than standard methods. Retrospective data suggest that micrometastases identified in this way are prognostically significant, and prospective clinical trials now accruing promise a definitive answer to this issue

Joint practice guidelines for radionuclide lymphoscintigraphy for sentinel node localization in oral/oropharyngeal squamous cell carcinoma

Involvement of the cervical lymph nodes is the most important prognostic factor for patients with oral/oropharyngeal squamous cell carcinoma (OSCC), and the decision whether to electively treat patients with clinically negative necks remains a controversial topic. Sentinel node biopsy (SNB) provides a minimally invasive method of determining the disease status of the cervical node basin, without the need for a formal neck dissection. This technique potentially improves the accuracy of histological nodal staging and avoids over-treating three-quarters of this patient population, minimizing associated morbidity. The technique has been validated for patients with OSCC, and larger-scale studies are in progress to determine its exact role in the management of this patient population. This article was designed to outline the current best practice guidelines for the provision of SNB in patients with early-stage OSCC, and to provide a framework for the currently evolving recommendations for its use. These guidelines were prepared by a multidisciplinary surgical/nuclear medicine/pathology expert panel under the joint auspices of the European Association of Nuclear Medicine (EANM) Oncology Committee and the Sentinel European Node Trial Committee

Joint Practice Guidelines for Radionuclide Lymphoscintigraphy for Sentinel Node Localization in Oral/Oropharyngeal Squamous Cell Carcinoma

Involvement of the cervical lymph nodes is the most important prognostic factor for patients with oral/oropharyngeal squamous cell carcinoma (OSCC), and the decision of whether to electively treat patients with clinically negative necks remains a controversial topic. Sentinel node biopsy (SNB) provides a minimally invasive method for determining the disease status of the cervical node basin, without the need for a formal neck dissection. This technique potentially improves the accuracy of histologic nodal staging and avoids overtreating three-quarters of this patient population, minimizing associated morbidity. The technique has been validated for patients with OSCC, and larger-scale studies are in progress to determine its exact role in the management of this patient population. This document is designed to outline the current best practice guidelines for the provision of SNB in patients with early-stage OSCC, and to provide a framework for the currently evolving recommendations for its use. Preparation of this guideline was carried out by a multidisciplinary surgical/nuclear medicine/pathology expert panel under the joint auspices of the European Association of Nuclear Medicine (EANM) Oncology Committee and the Sentinel European Node Trial (SENT) Committee

A comprehensive overview of radioguided surgery using gamma detection probe technology

The concept of radioguided surgery, which was first developed some 60 years ago, involves the use of a radiation detection probe system for the intraoperative detection of radionuclides. The use of gamma detection probe technology in radioguided surgery has tremendously expanded and has evolved into what is now considered an established discipline within the practice of surgery, revolutionizing the surgical management of many malignancies, including breast cancer, melanoma, and colorectal cancer, as well as the surgical management of parathyroid disease. The impact of radioguided surgery on the surgical management of cancer patients includes providing vital and real-time information to the surgeon regarding the location and extent of disease, as well as regarding the assessment of surgical resection margins. Additionally, it has allowed the surgeon to minimize the surgical invasiveness of many diagnostic and therapeutic procedures, while still maintaining maximum benefit to the cancer patient. In the current review, we have attempted to comprehensively evaluate the history, technical aspects, and clinical applications of radioguided surgery using gamma detection probe technology

Multiple dimensions of biodiversity drive human interest in tide pool communities

Abstract Activities involving observation of wild organisms (e.g. wildlife watching, tidepooling) can provide recreational and learning opportunities, with biologically diverse animal assemblages expected to be more stimulating to humans. In turn, more diverse communities may enhance human interest and facilitate provisioning of cultural services. However, no experimental tests of this biodiversity-interest hypothesis exist to date. We therefore investigated the effects of different dimensions of animal biodiversity (species richness, phyletic richness and functional diversity) on self-reported interest using tide pools as a model system. We performed two experiments by manipulating: (1) the richness of lower (species) and higher taxonomic levels (phyla) in an image based, online survey, and (2) the richness of the higher taxonomic level (phyla) in live public exhibits. In both experiments, we further quantified functional diversity, which varied freely, and within the online experiment we also included the hue diversity and colourfulness arising from the combination of organisms and the background scenes. Interest was increased by phyletic richness (both studies), animal species richness (online study) and functional diversity (online study). A structural equation model revealed that functional diversity and colourfulness (of the whole scene) also partially mediated the effects of phyletic richness on interest in the online study. In both studies, the presence of three of four phyla additively increased interest, supporting the importance of multiple, diverse phyla rather than a single particularly interesting phylum. These results provide novel experimental evidence that multiple dimensions of biodiversity enhance human interest and suggest that conservation initiatives that maintain or restore biodiversity will help stimulate interest in ecosystems, facilitating educational and recreational benefits

Geochemistry and spatial distribution of heavy metals in Oxisols in a mineralized region of the Brazilian Central Plateau

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)The majority of the soils of the Central Plateau of Brazil are product of long time development over stable surfaces, usually associated with erosion and re-deposition cycles. In this context, to successfully study the geochemistry and spatial distribution of heavy metals, it is essential to understand the geology as well as the geomorphology of the landscape and the properties of the metals related to their mobility. The main objective of this work was to evaluate contents of naturally occurring heavy metals (Co, Cu, Mn, Ni, Pb and Zn) in some highly weathered tropical soils as related to their geochemistry, geology and geomorphology. Additionally, it was aimed to interpret the spatial distribution patterns of these metals and of major elements (Al, Fe, Ti and Mg), evaluating the association and taking the influence of the geology and geomorphology into consideration. In geo-referenced sites, ranging from 480 to 1040 m in altitude, samples were collected at two depths (0-20 and 60-80 cm), ground, sieved, and prepared for analysis. Heavy metals and major element contents were determined by extraction with aqua regia. Descriptive statistics, Pearson correlation coefficients, Principal Components Analysis (PCA) and spatial variability analyses were conducted and soil metal concentrations for the whole area were predicted by kriging (interpolation). A close association between Pb, Zn, and Mn was observed using PCA and Pearson's correlation. Highest concentrations of Pb, Zn, and Mn were determined in soils between 650 and 550 m altitude surrounding the dolomite massif hills and Ambrosia and Fagundes mineral deposits. Copper and Fe were found to be geochemically associated with highest concentrations observed in soils formed from carbonaceous phyllite with quartzite layers. Cobalt and Ni concentrations were associated with areas characterized geomorphologically as alluvial-colluvial deposits at the lowest altitudes within the region. Although there is a marked dispersive action of tropical weathering on metal distribution in the region, Cu, Pb, and Zn were found spatially associated with their geological source. This probably happens because of greater affinity of those metals to Fe and Mn oxides formed predominantly under tropical conditions and present in higher concentrations near to the sources of these heavy metals. On the other hand, both the low affinity of Ni and Co for these oxide minerals and the region's geomorphology allowed for their migration towards the drainage network to the regions of sediment accumulation at lower altitudes during the landscape's evolution. (C) 2010 Elsevier B.V. All rights reserved.1602131142Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)project EMBRAPA Cerrados/IRD [0203205]Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)CNPq [475623/2003-7]CAPES [514-05]project EMBRAPA Cerrados/IRD [0203205

Soil quality index for extensive pastures in hilly landforms region of highly weathered soils in an Atlantic forest biome, Brazil

Extensive pasture systems established in highly weathered tropical soils on steep slopes are vulnerable to soil degradation. Soil degradation can be monitored using an soil quality index (SQI). The SQI can assess both environmental aspects and indices related to pasture productivity within specific environments. A framework to evaluate and map a soil quality index for Ferralsols was developed in this study, emphasising pasture quality and seasonal variations, as well as geologic–geomorphological influences. Ground cover was determined in pasture areas with different levels of degradation. A minimum data set associated with pasture quality and productivity was selected by partial least squares regression to generate the SQI. The SQI is controlled by geomorphology and geology. In highlands, Ferralsols that develop in the oldest surfaces show strong leaching of basic cations and have higher acidity and, although components of organic matter increase, they are less important to pasture quality. In lowlands, landscape dissection exposes less weathered saprolite, forming Ferralsols with good chemical properties. This favours sustainability in pasture systems and reduces soil degradation in vulnerable environments. Soil quality indices were able to better evaluate pasture quality when established in summer. Keywords: multivariate analysis; pasture management; soil degradation; soil fertility; soil organic matter; soil variabilit

Baseline skills—scaffolding soft skills development within the curriculum

To enable Computer Science students to develop employability and ‘work-ready’ skills it is important to consider both the technical skills aligned to their discipline and the soft skills desired by employers. Research has identified that students in Computer Science would benefit from further support to develop the latter. This chapter considers how these skills can be developed through a variety of work experience opportunities including work-based learning and work-related learning; in class activities and alternative teaching approaches such as project, inquiry and problem-based learning; and through scaffolding both soft skills development and reflective practice, how students can become more confident in articulating these skills when applying for graduate work