Learning curve for the detection of axillary sentinel lymph node in breast cancer.

AIM: Sentinel axillary lymph node (SALN) detection is a new technique. Surgeons must progress up a learning curve in order to guarantee quality and safety equivalent to axillary lymphadenectomy. To ensure accurate staging of patients this learning curve must include SALN detection and an axillary lymphadenectomy. The aim of our work was to validate the principles and evaluate the consequences of learning curve for SALN detection from a prospective series of 200 consecutive patients. METHOD: Prospective assessment was made of the detection and false negative rates, post operative morbidity as abcess and seroma, and length of hospital stay. RESULTS: We evaluated the performance from the first to the hundredth case for each surgeon. Detection rate improved to 85% after patient number 10. False negative rate was less than 6%. Post operative axillary morbidity included 11% of seromas and 2% of abcess. Mean hospital stay was 2.8 days. CONCLUSION: Multidisciplinary validation of the learning period contributes to an accurate and safe SALN.

A 356-Kb sequence of the subtelomeric part of the MHC Class I region.

The subtelomeric part of the MHC Class I region contains 11 of the 21 genes described on chromosome 6 at position 6p21.3. The general organization of those and other genes resident in the region was revealed by determining a 356,376 bp sequence. Potential exons for new genes were identified by computer analysis and a large number of ESTs were selected by testing the sequence by the BLAST algorithm against the GenBank nonredundant and EST databases. Most of the ESTs are clustered in two regions. In contrast, the whole HLA-gene region is crammed with LINE and SINE repeats, fragments of genes and microsatellites, which tends to hinder the identification of new genes.

[Accuracy of conservative treatment for infiltrating lobular breast cancer: a retrospective study of 217 infiltrating lobular carcinomas and 2155 infiltrating ductal carcinomas]. / Evaluation de la validité du traitement conservateur dans le carcinome lobulaire infiltrant du sein: à propos d'une étude rétrospective portant sur 217 carcinomes lobulaires infiltrants et 2155 carcinomes canalaires infiltrants.

OBJECTIVES: Prognosis factors used for the management of infiltrative lobular carcinoma (ILC) are not different from those for infiltrative cuctal carcinoma (IDC). The aim of our work was to evaluate indications for conservative treatment for patients with ILC and to compare the results to those of patients with IDC. MATERIAL AND METHODS. Between 1985 and 1999 we retrospectively compared cases of 217 ILC with cases of 2155 IDC treated in Centre Rene Gauducheau, Nantes. RESULTS: Clinical size of tumors was not different between ILC and IDC but pathological size>30 mm was more frequent for IDC. Good prognosis factors as pathological SBR classification I or II, positive hormone receptor, and the lack of axillary lymph node involvement, were more frequent for ILC. Clinical examination underestimated tumor size more frequently of ILC than IDC (p=0.02). Secondary mastectomy for involved margin was more frequent for ILC than IDC (p=0.001). For tumor with good prognosis factors, such as T<20mm, lack of lymph node involvement and SBR I or II with conservative treatment, 5 years local relapse were less frequent for ILC than IDC (p=0.025). CONCLUSION: Parameters to validate conservative or radical treatment are the same for ILC and IDC. Diagnosis of ILC should not influence decisions regarding surgical treatment.

[Characterization of secondary vitellin in the crustacean Brachyura Carcinus maenas]. / Caractérisation de la vitelline secondaire chez le Crustacé Brachyoure Carcinus maenas.

The secondary vitellin was chromatographically purified and characterized in the crab, Carcinus maenas. It was a lipoglycoprotein of molecular weight 500,000. After dissociation, we observed two major sub units (82,000 and 72,000, respectively), and many lighter minor fractions. These results are compared with those described for some other Crustacea.

[Preliminary results on the ultrastructure of the molting gland (Y organ) of normal and Sacculina carcini parasitized crabs]. / Données préliminaires sur l'ultrastructure de la glande de mue (organe Y) chez le Crabe Carcinus mediterraneus sain en parasité par Sacculina carcini

The Y organ of Carcinus mediterraneus parasitized by Sacculina carcini and of normal Crabs at the C4 stage of the intermolt cycle have the same ultrastructure. At this stage the secretory activity of the Y organ appears to be reduced.

[Protein composition of hemolymph from the crabs Carcinus mediterraneus Czerniavsky, healthy or parasitized by Sacculina carcini Thompson]. / Composition protéique de l'hémolymphe des crabes Carcinus mediterraneus Czerniavsky, sains ou parasités par Sacculina carcini Thompson

The proteic composition of haemolymph from C. mediterraneus varies during the intermoult cycle. Some proteic fractions are occasionally absent in post-ecdysis. At each intermoult stage, parasitized Crabs have generally the same protein pattern as healthy ones, but the presence of the observed fractions is not constant. Compared healthy Crabs, the sacculinized animals show a surnumerary proteic fraction. With very short delay, the injection of ecdysterone puts the proteic composition of haemolymph from sacculinized Crabs in order, this composition becomes comparable to that from healthy individuals.

[Determination of the ecdysone level in the molting cycle of the crab, Carcinus moenas: comparison between healthy individuals and those parasitized by Sacculina carcini]. / Détermination du taux d'ecdysone au cours du cycle d'intermue chez le crabe Carcinus moenas; comparaison entre individus sains et parasités par Sacculina carcini

Radioimmunoassay is performed for a quantitative study of ecdysone in Carcinus moenas. Two periods can be determined in the moulting cycle. In haemolymph from ecdysis until beginning D0 stage, the moulting hormone content is not very high; from D0 stage until D4 stage, the hormone titer rises considerably. We can observe a similar rise in hormone content in both haemolymph and Y organ during the premolt stages. In sacculinized Crabs, the determined values of ecdysone in haemolymph and in Y organ are lower than those determined in healthy animals at the same stage.

[The relationship between host and parasite in the Crustacean Carcinus parasitized by Sacculina carcini: effect of crude extracts of Sacculina and haemolymph of parasitized Crab upon the proteinogramm of experimented healthy crabs (author's transl)]. / Relations hote-parasite entre les crustacés Carcinus et Sacculina carcini: effet d'extraits de parasite et de l'hémolymphe de crabe infesté sur le protéinogramme de crabes sains.

The injection of crude extracts of Sacculina to healthy crabs induces, after a variable lapse of time, qualitative and quantitative changes in their proteinogramm and a delay in their moulting cycle. These changes are the same as those observed in infested specimens. The injection of haemolymph from parasitized crabs gives similar effects. So, the Sacculina could be able to produce effect from afar upon organs not invaded by the roots of the parasite.

Systematic sequencing of the human HLA-A/HLA-F region: establishment of a cosmid contig and identification of a new gene cluster within 37 kb of sequence.

The class I region of the human histocompatibility complex is characterized by a high density of genes and pseudogenes and a complex structural organization. To elucidate the complete structure of the HLA-A/HLA-F region with a view to defining its contents in genes and pseudogenes, we developed a strategy of systematic sequencing. This report describes the establishment of a cosmid contig spanning most of the region and the analysis of a 37-kb sequence from one of the cosmids. Four new genes, organized with the HCG-V gene in a clustered structure, have been identified. Two of these contain a zinc finger motif characteristic of DNA-binding proteins. The former, a member of the C3HC4 protein family, is highly expressed in prostate and contains a B30-2-like sequence identified in several genes mapped within the class I region. The latter, which is ubiquitously expressed, is the human equivalent of the yeast polymerase IA12.2 subunit and of the murine tctex6 gene. Of the two other genes, one remains an anonymous gene with no particular feature, while the fourth, specifically expressed in testis, is the human equivalent of the murine tctex4 gene. This cluster, located in a region corresponding to a syntenic unit between mouse and human, appears to be highly conserved.

A 1200-kilobase transcription map encompassing the D6S105 locus at 6p21.3.

The gene content of the MHC class I telomerically adjacent region, in linkage disequilibrium with hereditary hemochromatosis, has not been well characterized yet. In the present work, we established three bacterial clone contigs, including mainly P1-derived artificial chromosomes. These contigs cover 89% of the 1.2-Mb 6p-subtelomeric region encompassing locus D6S105. Terminal exon trapping was applied to selected clones from these contigs. Forty-six independent terminal exons were identified and mapped within the region, 2 of which matched perfectly to expressed sequence tags. These 3' exons are all expressed in human fetal brain but differentially expressed in four tissues and two cell lines. The high number of exons identified indicates that the high gene density observed in the MHC class I region extends to this telomerically adjacent region.