Prognosis based on primary breast carcinoma instead of pathological nodal status.

In breast cancer patients, prognostic information required to plan post-surgical therapy is obtained mainly through axillary dissection. This study was designed to establish a new prognostic score based solely on parameters of the primary tumour as an alternative to axillary surgery in assessing prognosis. Eight different prognostic factors, including menopausal status, tumour size, grading, lymphatic invasion, desmoplasia, necrosis, c-erbB-2 and laminin receptor expression, were evaluated retrospectively on a large series of primary breast carcinoma patients. From multivariate analysis, four independent parameters were selected and examined, alone and in combination, for their prognostic potential. These parameters were used to generate a prognostic score that was analysed retrospectively in 467 N0-N1a patients to determine its predictive value for survival. The score, which includes variables such as tumour size, grading, laminin receptor and c-erbB-2 overexpression, was established based on the number of negative prognostic factors: score 1 refers to cases in which all four parameters reflect a good prognosis, scores 2 and 3 refer to tumours in which, respectively, one or two of the four parameters reflect a poor prognosis, whereas score 4 refers to tumours with three or four poor prognosis factors. Analysis of the overall survival of the four score groups shows that patients with score 1 tumours (22% of the total) had the best prognosis with a 15 year survival of 82%, patients with score 2 and 3 had an intermediate prognosis, whereas score 4 patients had the poorest prognosis with a 15 year survival of only 38%. Moreover, survival in the N+ score 1 cases was found to be longer than that in the total N- patients. Our data suggest that the primary tumour score provides more reliable prognostic information than pathological nodal status, and that axillary dissection can be avoided in a large number of patients

The body in the library: adventures in realism

This essay looks at two aspects of the virtual ‘material world’ of realist fiction: objects encountered by the protagonist and the latter’s body. Taking from Sartre two angles on the realist pact by which readers agree to lend their bodies, feelings, and experiences to the otherwise ‘languishing signs’ of the text, it goes on to examine two sets of first-person fictions published between 1902 and 1956 — first, four modernist texts in which banal objects defy and then gratify the protagonist, who ends up ready and almost able to write; and, second, three novels in which the body of the protagonist is indeterminate in its sex, gender, or sexuality. In each of these cases, how do we as readers make texts work for us as ‘an adventure of the body’

Effect of pectin and soybean meal addition on the apparent digestibility of nutrients, in horses

O trabalho foi conduzido com o objetivo de avaliar a influência da adição de pectina e farelo de soja sobre a digestibilidade aparente de nutrientes, em eqüinos. Foi utilizado um delineamento inteiramente casualizado em esquema fatorial 4x2, sendo qautro níveis de pectina (0, 1, 2 e 3% da MS do feno de coastcross consumido) e a adição ou não de farelo de soja, totalizando oito tratamentos, com quatro repetições. As variáveis estudadas foram os coeficientes de digestibilidade aparente da matéria seca (CDAMS), proteína bruta (CDAPB), fibra em detergente neutro (CDAFDN), fibra em detergente ácido (CDAFDA), hemicelulose (CDAHEM), energia bruta (CDAEB) e a energia digestível (ED). A adição de pectina não afetou o CDAMS, CDAFDN, CDAFDA, CDAEB e nem a ED; porém melhorou o CDAPB, no nível de 1,25%, e o CDAHEM, em todos os níveis utilizados. Concluiu-se que a adição de 1,25% de pectina à dieta melhorou a digestibilidade aparente da PB e a adição de 3% de pectina proporcionou a melhor digestibilidade aparente da hemicelulose. A adição de farelo de soja à dieta, com o intuito de aumentar o aproveitamento da fibra bruta dos alimentos como fonte de energia, não é aconselhavel, uma vez que não houve melhora da digestibilidade aparente da FDN e da FDA.The work was carried out at the Equine Production Sector of the Department of Animal Science of the Federal University of Lavras - UFLA, in Lavras - MG, Brazil, with the objective of evaluating the effect of pectin and soybean meal addition on the apparent digestibility of nutrients in horses. The experimental design was completely randomized in a 4x2 factorial arrangement, with four pectin levels (0, 1, 2 and 3% of the DM of the hay of coastcross consumed) and addition or not of soybean meal amounting to eight treatments with four replications. Variables were the coefficients of apparent digestibility of dry matter (CADDM), crude protein (CADCP), neutral detergent fiber (CADNDF), acid detergent fiber (CADADF), hemicellulose (CADHEM), gross energy (CADGE) and of digestible energy (DE). Pectin addition did not affect the CADDM, CADNDF, CADADF, CADGE and nor DE; it improved CADCP, when at the level of 1.25% and CADHEM at all the used levels. It follows that the addition of 1.25% of pectin to the diet improved the apparent digestibility of CP and addition of 3% pectin provided the best apparent digestibility of hemicellulose. The addition of soybean meal to the diet with the purpose of increasing the utilization of crude fiber of feed as an energy source is not advisable, since there was no improvement of apparent digestibility of the NDF and ADF

Cellular and complement-dependent cytotoxicity of Ep-CAM-specific monoclonal antibody MT201 against breast cancer cell lines

MT201 is a fully human monoclonal IgG1 antibody with moderate affinity for epithelial cell adhesion molecule (Ep-CAM) being clinically developed for the treatment of carcinomas. Like many other clinically validated IgG1 monoclonal antibodies, MT201 primarily acts by antibody-dependent cellular cytotoxicity (ADCC) and complement-dependent cytotoxicity (CDC). Here, we analysed ADCC and CDC induced by MT201 and, as reference, trastuzumab against a panel of nine human breast cancer cell lines expressing distinct surface levels of Ep-CAM and human epithelial growth factor receptor type 2 antigen. Maximal cell lysis by ADCC by MT201 and trastuzumab in the presence of peripheral mononuclear cells did not significantly differ when averaged over the nine cell lines, but showed marked differences with respect to individual cell lines. The extent of cell lysis at intermediate surface target density was highly variable, suggesting a dominant influence of other susceptibility factors. Only one breast cancer cell line was eliminated via CDC, but only by MT201. Resistance to CDC appeared to correlate with high expression levels of complement resistance factors. Our present data as well as recent data on the prevalence and prognostic relevance of Ep-CAM expression in metastatic breast cancer suggest that Ep-CAM-specific monoclonal IgG1 antibodies may have a significant therapeutic potential in the treatment of breast cancer