Mastectomy versus radiotherapy as treatment for stage I-II breast cancer: A prospective randomized trial at the National Cancer Institute

In 1979, the National Cancer Institute in Bethesda, Maryland initiated a randomized, prospective trial to compare surgery versus radiation therapy in the treatment of stages I and II breast cancer. Surgical treatment consists of total mastectomy with axillary lymph node dissection (modified radical mastectomy) and breast reconstruction; radiation treatment consists of gross tumor excision, axillary lymph node dissection, and comprehensive irradiation including a boost dose to the tumor bed. All patients with pathologically positive axillary nodes receive 11 cycles of adjuvant Adriamycin ® /Cytoxan ® chemotherapy. As of December 1984, there have been 175 patients entered in the study. Twenty-three patients have developed disease recurrence (12 mastectomy, 11 radiation), but it is too early to obtain definitive treatment-related results. En 1979 l'Institut National du Cancer de Bethesda a lancé une étude prospective randomisée permettant de comparer les résultats respectifs de la chirurgie et de la radiothérapie en ce qui concerne les stades I et II du cancer du sein. Le traitement chirurgical consiste en la mastectomie totale complétée par le curage ganglionnaire axillaire (mastectomie totale modifiée); le traitement dit radiothérapique consiste en l'exérèse large de la tumeur associée au curage ganglionnaire axillaire et à l'administration d'une dose élevée de rayons au niveau du lit tumoral. Toutes les opérées dont les ganglions sont envahis reçoivent en outre 11 cycles d'une combinaison d'Adriamycine et Cytoxan. De 1979 à Décembre 1984, 175 malades ont fait l'objet de cette étude. Vingt-trois ont accusé une récidive (12 après mastectomie et 11 après traitement dit radiothérapique) mais il est encore trop tôt pour tirer des conclusions définitives de ces résultats. El Instituto Nacional de Cáncer de Bethesda inició en 1979 un ensayo prospectivo y aleatorio orientado a comparar el tratamiento quirúrgico versus radioterapia en el manejo del cáncer mamario en estados I y II. El tratamiento quirúrgico consistió de mastectomía total con disección ganglionar axilar (mastectomía radical modificada) y reconstrucción mamaria; el manejo radioterapéutico consistió de resección del tumor, disección de los ganglios linfáticos axilares e irradiación comprensiva incluyendo una dosis de refuerzo al lecho tumoral. Todos los pacientes con ganglios axilares histológicamente positivos recibieron 11 ciclos de quimioterapia adyuvante con Adriamicina/Citoxán. Hasta diciembre de 1984, 175 pacientes habían entrado al estudio. Veintitrés pacientes han desarrollado recurrencia de la enfermedad (12 mastectomía, 11 irradiación), pero es todavía muy temprano para derivar resultados definitivos.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/41319/1/268_2005_Article_BF01655179.pd

Isolation by distance among California sea lion populations in Mexico: redefining management stocks

Understanding a population’ spatial structure is critical for its effective assessment and management. Unfortunately, direct observation of spatial dynamics is generally difficult. California sea lions (Zalophus californianus) are polygynous pinnipeds distributed along the Pacific coast of North America. The species’ range has been subdivided into three management stocks based on differences in mitochondrial DNA, but to date no studies have considered nuclear genetic variation, and thus we lack an understanding of male gene flow patterns among sea lion colonies. In light of recent population declines in the Gulf of California, Mexico, it is critical to gain an inclusive understanding of spatial structure to determine if declining sea lion colonies are genetically isolated from others. To define population subdivision and identify sex biases in gene flow we analyzed a 355bp sequence of the mitochondrial DNA control region and 10 polymorphic microsatellite loci from 355 tissue samples collected from six colonies distributed along Mexican water. Using a novel approach to estimate sex biases in gene flow we found that male sea lions disperse on average 6.75 times as much as females. Analyses of population subdivision strongly suggested a pattern of isolation by distance among colonies and challenged current stock definitions. Therefore, we propose an alternative classification that identifies three Mexican management units: Upper Gulf of California, Southern Baja Peninsula, and Upper Pacific Coast of Baja. This revised classification should be considered in future assessment and management of California sea lion populations in Mexican waters

Improving Quality and Performance of Facility Management Using Building Information Modelling

Poor facility management has been attributed to lack of coordination and information during the maintenance process. The need for high quality applies not only to construction works and workmanship, but is also for its subsequent coordination and maintenance of a building. The paper aims to improve quality and performance of maintenance by integrating an advanced technology with a managerial approach, namely, building information modelling (BIM) and facility management. A BIM case study was investigated, which was located in Shanghai, China. Five significant areas were identified to improve the quality and performance of facility management, namely, centralized system, visualization, simplification, modifiable system, and smart emergency escape. The results highlight the benefits in applying the integrated system between BIM and facility management. It draws an insightful inference in enhancing quality services in facility management