Lymph node metastases displaying lower Ki-67 immunostaining activity than the primary breast cancer

The aim of the study was to verify by Ki-67 immunostaining if any difference exists in the cell proliferating fraction between primary breast tumors (PTs) and matching positive axillary lymph nodes (ALNs). PATIENTS AND METHODS: Immunohistochemistry with the monoclonal antibody against Ki-67 was performed in 160 node-positive breast carcinomas and in their respective lymph node metastases. RESULTS: An increase of Ki-67 immunoreactive cells in ALN compared with that of PTs was observed in 84% of cases (ALN: mean 17%, PTs: mean 8%; p < 0.001), whereas 16% of the cases showed Ki-67 value two to six times lower in the ALNs than in the corresponding PTs (ALN: mean 3.2%, PTs mean 12.5%; p < 0.005). The decrease of Ki-67 positive cells in the ALN was independent from the histotype and the histological grade of the tumor. CONCLUSION: A different cell proliferation fraction between PTs and matching positive ALNs was demonstrated and underlined that the existence of a group of patients with decreased number of Ki-67 immunoreactive cells in lymph node metastases compared with that of the primary tumors could be taken into account in the choice of therapeutic strategy

Teaching Experiences with E-Learning Network Infrastructures

Abstract. Computer-based learning environments provide the opportunity to promote students interactivity and meet their individual needs. Because of the advantages of such approach, the computer-based teaching is becoming very popular in universities and in other educational institutes. However, very often the solutions proposed to support the educational activities are not inter-operable and lack of a suitable network infrastructure. In this paper, we report the results of several teaching experiences gathered from more than one year of activities in various research projects. Our first step has been the development of a platform able to fully integrate the new powerful teaching tools, such as the virtual blackboard, and network transport services. From these experiences, we realized that the learning quality would be improved if students interactively participate to the learning process. Then, in a later experimentation, we proposed and validated a model of e-classroom, which would guarantee the mobility to students and preserve their identity. We show that this kind of mobile-learning is only possible whereas an advanced networking technology, such as Mobile IPv6, is enabled

Association of kidney disease measures with risk of renal function worsening in patients with type 1 diabetes

Background: Albuminuria has been classically considered a marker of kidney damage progression in diabetic patients and it is routinely assessed to monitor kidney function. However, the role of a mild GFR reduction on the development of stage 653 CKD has been less explored in type 1 diabetes mellitus (T1DM) patients. Aim of the present study was to evaluate the prognostic role of kidney disease measures, namely albuminuria and reduced GFR, on the development of stage 653 CKD in a large cohort of patients affected by T1DM. Methods: A total of 4284 patients affected by T1DM followed-up at 76 diabetes centers participating to the Italian Association of Clinical Diabetologists (Associazione Medici Diabetologi, AMD) initiative constitutes the study population. Urinary albumin excretion (ACR) and estimated GFR (eGFR) were retrieved and analyzed. The incidence of stage 653 CKD (eGFR &lt; 60 mL/min/1.73 m2) or eGFR reduction &gt; 30% from baseline was evaluated. Results: The mean estimated GFR was 98 \ub1 17 mL/min/1.73m2 and the proportion of patients with albuminuria was 15.3% (n = 654) at baseline. About 8% (n = 337) of patients developed one of the two renal endpoints during the 4-year follow-up period. Age, albuminuria (micro or macro) and baseline eGFR &lt; 90 ml/min/m2 were independent risk factors for stage 653 CKD and renal function worsening. When compared to patients with eGFR &gt; 90 ml/min/1.73m2 and normoalbuminuria, those with albuminuria at baseline had a 1.69 greater risk of reaching stage 3 CKD, while patients with mild eGFR reduction (i.e. eGFR between 90 and 60 mL/min/1.73 m2) show a 3.81 greater risk that rose to 8.24 for those patients with albuminuria and mild eGFR reduction at baseline. Conclusions: Albuminuria and eGFR reduction represent independent risk factors for incident stage 653 CKD in T1DM patients. The simultaneous occurrence of reduced eGFR and albuminuria have a synergistic effect on renal function worsening

Dynamic resource configuration in DiffServ network: control plane mechanisms and performance evaluation of a Traffic Control API

Voice, video and multimedia applications are sensitive to the QoS provided by the underlying IP network. The DiffServ architecture offers a set of QoS mechanisms for IP networks

Design and development of a DS-TE experimental testbed with P2MP LSP support

Nowadays, many IP backbone networks adopt separate control and forwarding planes for unicast and multicast traffic flows. Indeed, while MPLS (Multiprotocol Label Switching) is widely deployed for unicast trafile, IP multicast is the only available solution for the delivery of "one-to-many" traffic flows. With P2MP LSPs (Point-to-Multipoint Label Switched Paths) support, a unified control and forwading plane may be devised. Such a reduction in the number of protocols used in the core of the network as well as in the number of encapsulations in the data plane, results in simplified network operations. The paper discusses the design and the development of the control and data planes extensions needed to provide P2MP LSP support in an MPLS network. In particular, such signalling and forwarding mechanisms have been implemented in a network testbed based on open-source routers. Finally, tests have been performed to assess the new mechanisms from both an operational and performance point-of-view

Dynamic resource configuration in DiffServ networks: Control plane mechanisms and performance evaluation of a traffic control API

Voice, video and multimedia applications are sensitive to the QoS provided by the underlying IP network. The DiffServ architecture offers a set of QoS mechanisms for IP networks. The "binding" of the applications QoS needs with the QoS features offered by the DiffServ networks is still an open problem. The simplest approach is to have a static configuration of QoS and therefore no direct interaction in the control plane between applications and QoS. We consider the advanced scenario, where the QoS mechanisms can be dynamically configured to follow the applications' need. For this scenario, a set of control plane interfaces needed for a whole end-to-end QoS architecture is defined. At the lower level, an internal interface ("Application Programming Interface"-API) in the QoS router is considered. This interface provides access to the DiffServ QoS mechanism available in a router and is used by the control logic running in the router itself. Then a QoS signaling protocol is considered, that allows external QoS clients to dynamically access the QoS services provided by the network. Finally the interaction of a session level signaling protocol (i.e., the SIP for IP telephony) with the QoS protocol is defined. A testbed implementation of the proposed architecture and a set of performance tests on the internal QoS API are reported. (C) 2003 Elsevier B.V. All rights reserved

Experimental Validation of SLAs in Operational Networks through Hash-based Packet Sampling

In operational networks, services are delivered according to specific Service Level Agreements (SLAs). To ensure the SLAs stipulated with the users, providers make use of traffic monitoring and measurement tools controlling their highspeed IP networks. In order to improve the scalability of the measurement systems, techniques which allow to reduce the total amount of data to be collected and processed are currently being standardized in the IETF Packet Sampling (PSAMP) Working Group. Among packet sampling techniques, hash-based one is the only capable of providing a feasible framework to monitor One-Way Delays (OWDs). This paper is focused on the experimental validation of SLAs conformance in operational networks using hash-based packet sampling techniques. The results presented hereafter are obtained from the analysis of traffic traces collected at two different points of operational networks. Such results are fundamental to validate the whole hash-based packet sampling framework, because they complement the already available results on the uniformity of distribution, computation speed and statistical properties of the hash functions calculated by using single point traces

A soft real-time measurement system for Diffserv/MPLS edge routers

The paper presents the architecture of a measurement system designed to reside into DiffServ/MPLS Linux based routers. The goal of this research is to develop an open source software product to be used for management purposes and to be integrated in the network control plane in order to automate resource allocation, admission control and Traffic Engineering functionalities. The system is designed to be flexible, configurable and modular and each module has been implemented in order to minimize the impact of the system itself on the traffic dynamics. The output of the system is a sequence of measurements that report the amount of per-PHB and per-LSP traffic offered to the router over a configurable time window. The system allows to perform prediction on the future traffic activity as well as trigger asynchronous threshold crossing events. The system has proven to be reliable as it passed several functional tests. Preliminary experimental results have shown that the output of the system accurately captures the traffic patterns offered to the router