Review of George Eliot and Schiller: Intertextuality and Cross-Culural Discourse, Dutch Readings of George Eliot

In their very different ways these two studies contribute significantly to our understanding of George Eliot\u27s place in the wider context of European literary culture. Diederik van Werven examines the nineteenth-century reception of her novels in the Netherlands, thus filling in what is, for most of the English-speaking world, a blank space in the map of her contemporary reputation; while Deborah Guth reads her work through the lens provided by the well-known but relatively neglected Schiller, who was the fust German writer to arouse her enthusiasm, but who was later supplanted, both in her own life and in subsequent critical commentary, by his contemporary Goethe. Van Werven\u27s survey of Dutch reviews makes clear George Eliot\u27s popularity in the Netherlands during her lifetime, with Adam Bede, the original Dutch translation of which went through ten editions, proving her most successful work. The reasons for her popularity seem to lie in the way that the ethical concerns of her fiction were particularly congenial to the Dutch Protestant sensibility; and many of those who wrote about her were indeed, as van Werven points out, Protestant ministers of the church. The three figures that are his principal focus, Allard Pierson, lohannes van Vloten, and Conrad Busken Huet, also shared a common intellectual heritage with the novelist, and two of them left the church in the 1860s for reasons that were similar to hers twenty years earlier. Van Werven briefly traces the intellectual development of these three men, summarizes what they wrote about George Eliot, and discusses the importance to them of the thinkers that they had read and she had translated: Strauss, Feuerbach, Spinoza, and Vinet. George Eliot is not always kept in the foreground in all this, and some of the connections that are made between the reviewers and the reviewed seem a little strained. For instance, Van Vloten\u27s interest in Spinoza is not shown to inform his own reading of Felix Holt, but is used, rather, as a cue for van Werven\u27s view that Esther \u27s development can be understood as an advance through Spinoza\u27s different kinds of knowledge as set out in the Ethics; and the chapter concludes with the disarming question of whether van Vloten himself ever made the connection between Spinoza and George Eliot

A Decade of Change: An Institutional Experience with Breast Surgery in 1995 and 2005

Introduction: With the adoption of routine screening mammography, breast cancers are being diagnosed at earlier stages, with DCIS now accouting for 22.5% of all newly diagnosed breast cancers. This has been attributed to both increased breast cancer awareness and improvements in breast imaging techniques. How have these changes, including the increased use of image-guided sampling techniques, influenced the clinical practice of breast surgery?Methods: The institutional pathology database was queried for all breast surgeries, including breast reconstruction, performed in 1995 and 2005. Cosmetic procedures were excluded. The results were analysed utilizing the Chi-square test.Results: Surgical indications changed during 10-year study period, with an increase in preoperatively diagnosed cancers undergoing definitive surgical management. ADH, and to a lesser extent, ALH, became indications for surgical excision. Fewer surgical biopsies were performed for indeterminate abnormalities on breast imaging, due to the introduction of stereotactic large core biopsy. While the rate of benign breast biopsies remained constant, there was a higher percentage of precancerous and DCIS cases in 2005. The overall rate of mastectomy decreased from 36.8% in 1995 to 14.5% in 2005. With the increase in sentinel node procedures, the rate of ALND dropped from 18.3% to 13.7%. Accompanying the increased recognition of early-stage cancers, the rate of positive ALND also decreased, from 43.3% to 25.0%.Conclusions: While the rate of benign breast biopsies has remained constant over a recent 10-year period, fewer diagnostic surgical image-guided biopsies were performed in 2005. A greater percentage of patients with breast cancer or preinvasive disease have these diagnoses determined before surgery. More preinvasive and Stage 0 cancers are undergoing surgical management. Earlier stage invasive cancers are being detected, reflected by the lower incidence of axillary nodal metastases

Pro-oncogenic cytokines and growth factors are differentially expressed in the post-surgical wound fluid from malignant compared to benign breast lesions

PURPOSE: The accumulation of wound fluid known as seroma in the chest cavity following breast surgery is a common occurrence that can persist for many weeks. While the pro-inflammatory composition of seroma is well established, there has been remarkably little research to determine whether seroma contains pro-oncogenic factors, and whether this is influenced by previous malignant disease. METHODS: We developed a clinical trial in which we obtained post-surgical seroma fluids from women with benign or malignant disease 1 or 2 weeks following lumpectomy or mastectomy. We conducted an analysis of more than 80 different cytokines, chemokines and growth factors. RESULTS: We found that surgical cavity seroma from breast cancer patients has a higher expression of key tumor-promoting cytokines and lower expression of important tumor-inhibiting factors when compared to benign lesions from non-cancer patients. Patients with high body mass index also had higher levels of leptin regardless of malignancy. CONCLUSIONS: We conclude that the breast post-surgical tumor cavity contains factors that are pro-inflammatory regardless of malignant or benign disease, but in malignant disease there is significant enrichment of additional pro-oncogenic chemokines, cytokines and growth factors, and reduction in tumor-inhibiting factors. These results are consistent with tumor conditioning of surrounding normal stromal tissue and creation of a pro-oncogenic environment that persists long after surgical removal of the tumor. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s40064-015-1260-8) contains supplementary material, which is available to authorized users

Clinical Characteristics in Patients with Triple Negative Breast Cancer

Purpose. The purpose of this study was to compare and contrast the clinical characteristics of the triple negative breast cancer (TNBC) and non-TNBC patients, with a particular focus on genetic susceptibility and risk factors prior to diagnosis. Methods. Our institutional database was queried for all patients diagnosed with invasive breast cancer between January 2010 and May 2016. Results. Out of a total of 1964 patients, 190 (10%) patients had TNBC. The median age for both TNBC and non-TNBC was 59 years. There was a significantly higher proportion of African American and Asian patients with TNBC (p=0.0003) compared to patients with non-TNBC. BRCA1 and BRCA2 were significantly associated with TNBC (p<0.0001, p=0.0007). A prior history of breast cancer was significantly associated with TNBC (p=0.0003). There was no relationship observed between TNBC and a history of chemoprevention or patients who had a history of AH or LCIS. Conclusions. We found that having Asian ancestry, a prior history of breast cancer, and a BRCA1 or BRCA2 mutation all appear to be positively associated with TNBC. In order to develop more effective treatments, better surveillance, and improved prevention strategies, it is necessary to improve our understanding of the population at risk for TNBC