Multifocal and multicentric breast cancer: is breast conserving surgery acceptable?

PURPOSE: The purpose of our study was to evaluate the significance of multifocal (MF) and multicentric (MC) breast cancer in the diagnosis and treatment of this condition. METHODS: This retrospective study was a combination of clinical and laboratory data. The patient population consisted of 274 women operated on with Madden mastectomy for breast cancer. Assessed were the following parameters: age, menstrual status, histopathological parameters, HER-2 status, estrogen receptor (ER) and progesterone receptor (PR) status, disease stage, quadrant(s) in which breast cancer was detected and axillary lymph nodes status. RESULTS: Of 274 patients 206 (85%) has unifocal disease, 41 (15%) suffered of MF (n=27; 9.9%)/MC (n=14; 5.1%) disease. MC disease was associated with metastatic axillary lymph nodes in 92.9% of the cases. MF/MC cases were primarily dependent on histology. MF/MC cancer was best related to the lobular type (85.7% of the cases), while ductal histological type was characteristic of unifocal tumors. CONCLUSION: Quadrantectomy as a form of conservative breast surgery is acceptable in cases of MF tumors, because all tumor foci can be removed. We suggest radical surgical treatment in all cases of suspected MC tumors because they are most often associated with metastasis to the axillary lymph nodes. Lobular histology characterizes MC breast cancer.

Can leek interfere with bean plant-bean fly interaction? Test of ecological pest management in mixed cropping.

Effects of volatile odors from leek, Allium porum L., on the behavior of bean fly, Ophiomyia phaseoli (Tryon) (Diptera: Agromyzidae), were tested in laboratory olfactometer bioassays. Aqueous and solvent extracts (dichloromethane and methanol) of leek were repellent to adult flies. Whole leek plants were repellent and prevented attraction to the host plant, beans. Beans that had been exposed to volatiles from living leek plants for 7 d became repellent to the fly. Leek and several other crops were tested in field experiments to identify candidate crops for a mixed cropping system to minimize bean fly attack in beans, Phaseolus vulgaris L. In a wet season field experiment, mixed cropping of bean with leek or three other vegetable crops did not significantly reduce bean fly infestation or infection with Fusarium oxysporum Schltdl. compared with a mono crop, but significantly reduced plant death caused by both agents combined. In two dry season field experiments, mixed cropping of beans with leek significantly reduced adult bean fly settling, emergence, and death of bean plants compared with a mono crop. Bean yield per row was approximately 150% higher for the mixed crop, and economic returns were approximately Sri Lankan Rs. 180,000/ha, higher than for the mono crop. For the mono crop, the farmer had a monetary loss, which would become a small profit only if the costs of family labor are excluded. The study is an example of the first steps toward development of sustainable plant protection in a subsistence system.

Monitoring of serum concentrations of antibiotics by microbiological method: a one-year experience.

By monitoring serum concentrations of antibiotics one may have an opportunity to make optimal adjustment of dosing regime for each individual patient, resulting in therapeutic concentrations in tissues and avoiding their cumulation and thus side effects in the organism. Concentrations of gentamicin, amikacin, streptomycin, ceftriaxone, benzylpenicillin, clindamycin and lincomycin were measured in serum of 110 patients by microbiological agar cup method. The measurements were made only after establishment of steady-state. Current dosing regime of gentamicin gave systematically subtherapeutic serum concentrations, while usual doses of amikacin and streptomycin achieved serum concentrations slightly lower than minimal toxic concentrations. Three patients actually had toxic serum concentrations of amikacin. Current dosing regime of penicillin produces therapeutic serum concentrations. The results of our study recommend monitoring of serum concentrations of antibiotics by a microbiological method in patients not responding to antibiotic therapy or having insufficiency of excretory organs.