Archaeology and the alchemical laboratory: Exploring early modern chymical practices at colonial Jamestown (Virginia) and the Old Ashmolean Museum (Oxford)

The present PhD thesis focuses on the study of early modern laboratory apparatus, with the specific aim of adopting a material culture-approach to the history of science and technology. This is achieved through the scientific analysis of two assemblages of crucibles and other reaction vessels, namely that of Jamestown in Virginia (early 17th century) and that of the Ashmolean laboratory in Oxford (late 17th -early 18th century). For each of these case studies the high-temperature activities carried out were reconstructed and contextualised. The analysis of the residues left by the chemical reactions, through optical microscopy and SEM-EDS, allowed to determine what substances were manipulated and what technical processes were followed. While the vast majority of the crucibles from Jamestown were used for testing minerals in search of metals of interest to the settlers, the practitioners at the Ashmolean were found to diversify their work and experiment with technological innovation of the period. As no direct relation exists between the case studies, each of them stands on its own and each brings a novel contribution to its specific historical and archaeological context However, taken together the two case studies illustrate the wider scope of this thesis by indicating the potential of a new methodological approach to the study of laboratory remains, which combines the information of archaeological science with current narratives in the historiography of early modern science. The results are used to build a materials-based network, which tells the story of scientific developments from the bottom up and throws new light on the practical side of doing science. Ultimately, this thesis crosses old disciplinary boundaries and adds new layers of interpretation to both disciplines it engages with

Abandoning sentinel lymph node biopsy in early breast cancer? A new trial in progress at the European Institute of Oncology of Milan (SOUND: Sentinel node vs Observation after axillary UltraSouND)

Viewpoints and debates Sentinel lymph node biopsy (SLNB) is the standard approach for axillary staging in patients with early breast cancer. Recent data showed no outcome difference in patients with positive sentinel node between axillary dissection vs no further axillary surgery, raising doubts on the role of SLNB itself. Therefore, a new trial was designed comparing SLNB vs observation when axillary ultra-sound is negative in patients with small breast cancer candidates to breast conserving surgery

A New TNM Classification for Breast Cancer to Meet the Demands of the Present and the Challenges of the Future

In this article we will describe our proposed changes to the breast cancer tumour nodal metastasis (TNM) classification which, while retaining TNM structure to ensure compatibility is retained, will render it more useful and better able to accommodate future developments. We propose changing T to specify exact tumor size (a tumor of pathological diameter 1.7 cm would be pT1.7); changing N to specify the number of metastatic lymph nodes over the total number removed (e.g., pN5/21); adding suffixes to M to indicate metastatic site; removing in situ neoplasms from the classification, since they are not carcinomas and are incapable of metastasizing; and removing the terms 'infiltrating' and 'invasive' since they are redundant. Finally, we would include hormone receptor, HER2, and other biological indicators of prognosis, as they are verified, in a placeholder system appended to the TNM. These proposals shift the emphasis from the quantity of tumor present to the quality of the cancer

Improper use of "radioguided occult lesion localization" (ROLL) technique leads to misleading conclusions

No abstract availabl

Un modello evolutivo

L’ospedale oggi si deve confrontare con le grandi rivoluzioni epocali che stiamo vivendo, talvolta senza neppure rendercene conto, e che in estrema sintesi possiamo definire: – rivoluzione delle conoscenze medico-scientifiche, caratterizzata dalla post-genomica e dalla medicina molecolare e dei sistemi; – la rivoluzione delle tecnologie biomediche; – la rivoluzione della information e communication technology; – la rivoluzione etica e dell’umanizzazione. L’ospedale si deve adeguare alle richieste di cura di una società sempre più vitale e dinamica che, grazie agli straordinari traguardi raggiunti dalla medicina, non è disposta a farsi fermare nemmeno dalle malattie più gravi

positive axillary sentinel lymph node is axillary dissection always necessary

Summary There is considerable interest in foregoing axillary dissection (AD) when the sentinel node (SN) is positive in early breast cancer, particularly when axillary involvement is minimal (micrometastases or isolated tumor cells). In fact, clinical practice has run ahead of the evidence, since recent population-based data indicate that AD is 'underused' in breast cancer patients when the SN is positive. Several trials are addressing the problem (IBCSG 23-01, ASCOG Z0011, EORTC AMAROS). Only Z0011 has published interim results, finding, after a median follow-up of 6.3 years, no differences in locoregional recurrence or regional recurrence between patients, with a positive SN, who received AD vs. no further axillary treatment. Our own retrospective study evaluated patients with micrometastases or isolated tumor cells in the SN who received no further axillary treatment. We found high five-year survival and low cumulative incidence of axillary recurrence, supporting the findings of Z0011 and justifying the increasingly common practice of foregoing AD in women with minimal SN involvement. It is important to sound a note of caution however: If axillary dissection is not always necessary in women with a positive axilla, it seems important to be able to reliably identify the patients at high risk of developing overt axillary disease who should receive elective AD. Ancillary analyses of the IBCSG 23-01 and AMAROS trials, still in follow-up, may be able to do this

local therapy for breast cancer in malignant lymphoma survivors

Summary Aims: Breast cancer is the most frequent secondary tumor in young women previously treated with mantle radiation for Hodgkin's disease. Prior therapeutic radiation to the breast region is considered an absolute contraindication to breast conservative surgery, and mastectomy is considered the treatment of choice. We performed a retrospective review to assess the potential of performing breast conservative surgery and intraoperative radiotherapy with electrons (ELIOT), in these patients. Methods and results: Forty-three patients affected by early breast cancer, previously treated with mantle radiation for malignant lymphoma, who underwent breast conservative surgery and ELIOT, were identified in our institution. Median age at diagnosis of lymphoma was 26 years (49% were less than 25). Median interval between lymphoma and breast cancer occurrence was 19 years. A total dose of 21 Gy (prescribed at 90% isodose) in 39 patients (91%), of 17 Gy (prescribed at 100% isodose) in 1 patient and 18 Gy (prescribed at 90% isodose), was delivered. ELIOT was well tolerated in all patients without any unusual acute or late reactions. After a median follow-up of 52 months, local recurrence occurred in 9% of the patients and metastases in 7% patients. Conclusion: In patients previously treated for lymphoma, partial breast irradiation, and in particular ELIOT, permits breast conservative surgery without acute local complications, decreasing the number of avoidable mastectomies

breast conserving surgery in 201 very young patients 35 years

Abstract Introduction Surgical treatment of breast cancer in very young patients ( Patients and Methods We retrospectively evaluated outcome and prognostic factors of 201 consecutive patients treated with breast conservation followed by whole breast irradiation between 1997 and 2004 with special attention paid to local control. The average follow up was 72 months (range 13–133 months). Results The mean age was 32 years (Range 20–34). Invasive ductal carcinoma was found in 175 (87.1%) patients. Two (1%) patients had invasive lobular carcinoma. One-hundred and eighteen patients (58.7%) had tumors of 2 cm or smaller. Sentinel lymph node biopsy was performed in 105 (52.2%) patients. One-hundred and ten (54.7%) patients had node-negative disease, 68 (33.8%) patients had 1–3 positive nodes and 23 (11.4%) +4 positive nodes. Eighteen patients (9.0%) developed a local recurrence, 25 (12.5%) developed distant metastases and 23 patients (11.4%) died during follow up. The 5- and 10-year cumulative incidence of local events were 8.2% and 12,3% respectively. The univariate analysis did not identify any variables affecting local disease-free survival. Conclusions Breast conservation in very young patients achieves an acceptable local control rate. No prognostic factors were associated with local events

Testing the New World: early modern chemistry and mineral prospection at colonial Jamestown, 1607–1610

Abstract: The paper presents new research on an assemblage of metallurgical crucibles used in the assay of minerals at colonial Jamestown. The aim of the study is to explore the range of chemical operations carried out at the site of the first permanent British settlement in America, for which little is known in the documents. The results show that the colonists used high-quality Hessian crucibles to perform tests on different types of complex polymetallic sulphides. This was done to (1) prospect for potential silver and copper ores and (2) to find suitable sources of zinc and tin to be alloyed into brass and bronze through cementation with imported copper offcuts. This study makes a relevant contribution to the growing field of the archaeology of early chemistry and mineral prospection as well as the archaeology of early European colonies in the New World. In particular, material culture can shed fresh light on how European settlers reacted to the many challenges of a new and unfamiliar natural environment and how they tried to make sense and exploit it for financial profit

Intraoperative Radiation Therapy for Breast Cancer: Technical Notes

Abstract: Interest in intraoperative radiation therapy (IORT) for breast cancer is increasing as the possible benefits of this technique for the patient become apparent. The rationale for the use of this segmental radiation therapy in place of whole-breast irradiation is based on the finding that approximately 85% of breast relapses are confined to the same quadrant of the breast as the primary tumor. Phase I and II trials have demonstrated no increase in postsurgical complication rates following the use of single-dose IORT in localized breast cancers. Longer follow-up is needed to assess the cosmetic outcome. Clinical trials to evaluate the effectiveness of IORT in the treatment of breast cancer are currently under way at the European Institute of Oncology (EIO) at the University of Milan, Italy, and at Memorial Sloan-Kettering Cancer Center (MSKCC) in New York. Here we report the two different techniques in use in these trials