Sample records for ii axillary lymph

  1. Short-term morbidity of the upper limb after sentinel lymph node biopsy or axillary lymph node dissection for Stage I or II breast carcinoma

    Microsoft Academic Search

    Johan S. Rietman; Pieter U. Dijkstra; Jan H. B. Geertzen; Peter Baas; Jaap de Vries; Wil Dolsma; Johan W. Groothoff; Willem H. Eisma; Harald J. Hoekstra

    2003-01-01

    BACKGROUND. The goals of sentinel lymph node biopsy (SLNB) are to improve axillary staging and reduce unnecessary axillary lymph node dissections (ALND), thereby reducing treatment-related upper-limb morbidity. In the current prospec- tive study, short-term upper-limb morbidity was assessed after SLNB and\\/or ALND. METHODS. The study comprised 204 patients with Stage I\\/II breast carcinoma. Mean patient age was 55.6 years (standard

  2. A Longitudinal Comparison of Arm Morbidity in Stage I–II Breast Cancer Patients Treated with Sentinel Lymph Node Biopsy, Sentinel Lymph Node Biopsy Followed by Completion Lymph Node Dissection, or Axillary Lymph Node Dissection

    Microsoft Academic Search

    Jan J. Kootstra; Josette E. H. M. Hoekstra-Weebers; Johan S. Rietman; Jakob de Vries; Peter C. Baas; Jan H. B. Geertzen; Harald J. Hoekstra

    2010-01-01

    Background  Long-term shoulder and arm function following sentinel lymph node biopsy (SLNB) may surpass that following complete axillary\\u000a lymph node dissection (CLND) or axillary lymph node dissection (ALND). We objectively examined the morbidity and compared\\u000a outcomes after SLNB, SLNB + CLND, and ALND in stage I\\/II breast cancer patients.\\u000a \\u000a \\u000a \\u000a \\u000a Materials and Methods  Breast cancer patients who had SLNB (n = 51), SLNB + CLND (n = 55), and ALND (n = 65)

  3. Sentinel lymph node biopsy is associated with improved survival compared to level I & II axillary lymph node dissection in node negative breast cancer patients

    Microsoft Academic Search

    I. Langer; U. Guller; S. F. Hsu-Schmitz; A. Ladewig; C. T. Viehl; H. Moch; E. Wight; F. Harder; D. Oertli; M. Zuber

    2009-01-01

    ObjectiveThe few long-term follow-up data for sentinel lymph node (SLN) negative breast cancer patients demonstrate a 5-year disease-free survival of 96–98%. It remains to be elucidated whether the more accurate SLN staging defines a more selective node negative patient group and whether this is associated with better overall and disease-free survival compared with level I & II axillary lymph node

  4. Treatment-Related Upper Limb Morbidity 1 Year after Sentinel Lymph Node Biopsy or Axillary Lymph Node Dissection for Stage I or II Breast Cancer

    Microsoft Academic Search

    J. S. Rietman; P. U. Dijkstra; J. H. B. Geertzen; P. Baas; J. de Vries; W. V. Dolsma; J. W. Groothoff; W. H. Eisma; H. J. Hoekstra

    2004-01-01

    Background: In a prospective study, upper limb morbidity and perceived disability\\/activities of daily life (ADLs) were assessed before and 1 year after sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND).Methods: A total of 204 patients with stage I\\/II breast cancer (mean age, 55.6 years; SD, 11.6 years) entered the study, and 189 patients (93%) could be evaluated

  5. Axillary lymph node ratio and total number of removed lymph nodes: predictors of survival in stage I and II breast cancer

    Microsoft Academic Search

    B. C. H van der Wal; R. M. J. M Butzelaar; S van der Meij; M. A Boermeester

    2002-01-01

    Aims: Presence of axillary lymph node metastases is considered the most important prognostic factor for breast cancer survival. In a period of increasing popularity for the sentinel node procedure, clarity about the possible relation between axillary dissection and survival is essential. This study investigated whether the total number of removed lymph nodes and the ratio of invaded\\/removed lymph nodes (lymph

  6. Quality of Life After Sentinel Lymph Node Biopsy or Axillary Lymph Node Dissection in Stage I\\/II Breast Cancer Patients: A Prospective Longitudinal Study

    Microsoft Academic Search

    Jan Kootstra; Josette E. H. M. Hoekstra-Weebers; Hans Rietman; Jaap de Vries; Peter Baas; Jan H. B. Geertzen; Harald J. Hoekstra

    2008-01-01

    Background  Breast cancer patients’ quality of life (QoL) after surgery has been reported to improve significantly over time. Little is\\u000a known about QoL recovery after sentinel lymph node biopsy (SLNB) in comparison to axillary lymph node dissection (ALND).\\u000a \\u000a \\u000a \\u000a Methods  175 of 195 stage I\\/II breast cancer patients completed the EORTC QLQ-C30: one day before surgery (T0) and after 6 (T1), 26\\u000a (T2),

  7. Axillary lymph node dose with tangential breast irradiation

    SciTech Connect

    Reed, Daniel R. [Radiation Oncology, University of Washington Medical Center, Seattle, WA (United States)]. E-mail: drreed@u.washington.edu; Lindsley, Skyler Karen [Radiation Oncology, University of Washington Medical Center, Seattle, WA (United States); Mann, Gary N. [Department of Surgery, University of Washington Medical Center, Seattle, WA (United States); Austin-Seymour, Mary [Radiation Oncology, University of Washington Medical Center, Seattle, WA (United States); Korssjoen, Tammy [Radiation Oncology, University of Washington Medical Center, Seattle, WA (United States); Anderson, Benjamin O. [Department of Surgery, University of Washington Medical Center, Seattle, WA (United States); Moe, Roger [Department of Surgery, University of Washington Medical Center, Seattle, WA (United States)

    2005-02-01

    Purpose: The advent of sentinel lymph node mapping and biopsy in the staging of breast cancer has resulted in a significant decrease in the extent of axillary nodal surgery. As the extent of axillary surgery decreases, the radiation dose and distribution within the axilla becomes increasingly important for current therapy planning and future analysis of results. This analysis examined the radiation dose distribution delivered to the anatomically defined axillary level I and II lymph node volume and surgically placed axillary clips with conventional tangential breast fields and CT-based three-dimensional (3D) planning. Methods and materials: Fifty consecutive patients with early-stage breast cancer undergoing breast conservation therapy were evaluated. All patients underwent 3D CT-based planning with conventional breast tangential fields designed to encompass the entire breast parenchyma. Using CT-based 3D planning, the dose distribution of the standard tangential breast irradiation fields was examined in relationship to the axillary level I and II lymph node volumes. Axillary level I and II lymph node anatomic volumes were defined by CT and surgical clips placed during complete level I-II lymph node dissection. Axillary level I-II lymph node volume doses were examined on the basis of the prescribed breast radiation dose and 3D dose distribution. Results: All defined breast volumes received {>=}95% of the prescribed dose. By contrast, the 95% isodose line encompassed only an average of 55% (range, 23-87%) of the axillary level I-II lymph node anatomic volume. No patient had complete coverage of the axillary level I-II lymph node region by the 95% isodose line. The mean anatomic axillary level I-II volume was 146.3 cm{sup 3} (range, 83.1-313.0 cm{sup 3}). The mean anatomic axillary level I-II volume encompassed by the 95% isodose line was 84.9 cm{sup 3} (range, 25.1-219.0 cm{sup 3}). The mean 95% isodose coverage of the surgical clip volume was 80%, and the median value was 81% (range, 58-98%). The mean volume deficit between the axillary level I-II volume and the surgical clip volume was 41.7 cm{sup 3} (median, 30.0 cc). Conclusion: In this study, standard tangential breast radiation fields failed to deliver a therapeutic dose adequately to the axillary level I-II lymph node anatomic volume. No patient received complete coverage of the axillary level I-II lymph node volume. Surgically placed axillary clips also failed to delineate the level I-II axilla adequately. Definitive irradiation of the level I and II axillary lymph node region requires significant modification of standard tangential fields, best accomplished with 3D treatment planning, with specific targeting of anatomically defined axillary lymph node volumes as described, in addition to the breast parenchymal volumes.

  8. Axillary reverse mapping for preventing lymphedema in axillary lymph node dissection and\\/or sentinel lymph node biopsy

    Microsoft Academic Search

    Masakuni Noguchi

    2010-01-01

    The Japanese Breast Cancer Society 2009 Axillary lymph node dissection (ALND) is a standard surgical treatment in patients with involved axillary lymph nodes. Unfortunately, arm lymphedema develops in 2.7– 5.0% of patients treated by partial ALND (level I and II), in 3.1–9.6% of those undergoing total ALND, and in 26– 38% of patients treated with ALND and radiotherapy [1]. The

  9. Minimal risk of macrometastases in the non-sentinel axillary lymph nodes in breast cancer patients with micrometastatic sentinel lymph nodes and preoperatively ultrasonically uninvolved axillary lymph nodes

    Microsoft Academic Search

    Janez Zgajnar; Nikola Besic; Maja Podkrajsek; Kristijana Hertl; Snjezana Frkovic-Grazio; Marko Hocevar

    2005-01-01

    Micrometastases in the sentinel lymph node (SLN) carry a considerable risk of macrometastases in the non-sentinel lymph nodes (NSLN), resulting in axillary lymph node dissection (ALND). Preoperative ultrasound (US) examination of the axillary lymph nodes combined with a fine-needle aspiration biopsy (FNAB) has been proved to discover metastases in the axillary lymph nodes. The aim of our study was to

  10. Axillary lymph node metastasis in lung cancer

    Microsoft Academic Search

    Hiroaki Satoh; Hiroichi Ishikawa; Katsunori Kagohashi; Koichi Kurishima; Kiyohisa Sekizawa

    2009-01-01

    Study objectives Axillary lymph node metastasis (ALNM) from lung cancer is rare. Its prognosis and effective treatments remain unknown. To\\u000a evaluate clinicopatholgical characteristics of such lung cancer patients, we performed a retrospective study of them, who\\u000a had ALNM at the time of initial presentation or developed ALNM in their clinical courses. Methods We reviewed the medical records and pathological reports

  11. Determinants of axillary recurrence after axillary lymph node dissection for invasive breast cancer

    Microsoft Academic Search

    A. C. Voogd; R. de Boer; M. J. C. van der Sangen; R. M. H. Roumen; H. J. T. Rutten; J. W. W. Coebergh

    2001-01-01

    Aim This study was undertaken to gain insight into the risk factors for axillary recurrence among patients with invasive breast cancer who underwent breast-conserving treatment or mastectomy and axillary lymph node dissection. Methods In a matched case–control design, 59 patients with axillary recurrence and 295 randomly selected control patients without axillary recurrence were compared. Matching factors included age, year of

  12. 200 Sentinel lymph node biopsies without axillary lymph node dissection – no axillary recurrences after a 3-year follow-up

    Microsoft Academic Search

    R Reitsamer; F Peintinger; E Prokop; L Rettenbacher; C Menzel

    2004-01-01

    The aim of this study is to evaluate the rate of axillary recurrences in sentinel lymph node (SLN)-negative breast cancer patients after sentinel lymph node biopsy (SLNB) alone without further axillary lymph node dissection (ALND). Between May 1999 and February 2002, 333 consecutive patients with primary invasive breast cancer up to 4 cm and clinically negative axillae were entered into

  13. Six Cases of Chylous Leakage after Axillary Lymph Node Dissection

    Microsoft Academic Search

    Ming-hua Cong; Qi Liu; Wen-hong Zhou; Jian Zhu; Chen-xin Song; Xing-song Tian

    2008-01-01

    Summary Background: Chylous leakage has been described after several surgical procedures, especially in the region of the neck and thorax. However, it has rarely been reported after axillary lymph node dissection. Patients and Methods: We encountered 6 cases of chylous leakage after axillary lymph node dissection out of a total of 882 breast cancer patients between July 2005 and June

  14. Sentinel lymph node biopsy alone without axillary lymph node dissection – follow up of sentinel lymph node negative breast cancer patients

    Microsoft Academic Search

    R Reitsamer; F Peintinger; E Prokop; C Menzel; W Cimpoca; L Rettenbacher

    2003-01-01

    Aims: To evaluate the rate of axillary recurrences in sentinel lymph node (SLN) negative breast cancer patients after sentinel lymph node biopsy (SLNB) alone without further axillary lymph node dissection (ALND).Methods: Between May 1999 and February 2001 all patients who had primary invasive breast cancer and were SLN negative were eligible for this prospective study. SLNB was performed by using

  15. Sentinel lymph-node biopsy compared to axillary lymph-node dissection for axillary staging in breast cancer patients

    Microsoft Academic Search

    P Schrenk; A Shamiyeh; W Wayand

    2001-01-01

    Aims The purpose of this study was to evaluate the feasibility of sentinel lymph-node biopsy in breast cancer patients at our institution and to compare the results of sentinel node (SN) biopsy to standard axillary lymph-node dissection (ALND). Methods In a retrospective study the percentage of lymph-node positive patients and the number of micrometastases in 165 breast cancer patients following

  16. Sentinel lymph-node biopsy compared to axillary lymph-node dissection for axillary staging in breast cancer patients

    Microsoft Academic Search

    P. Schrenk; A. Shamiyeh; W. Wayand

    Aims: The purpose of this study was to evaluate the feasibility of sentinel lymph-node biopsy in breast cancer patients at our institution and to compare the results of sentinel node (SN) biopsy to standard axillary lymph-node dissection (ALND). Methods: In a retrospective study the percentage of lymph-node positive patients and the number of micrometastases in 165 breast cancer patients following

  17. A calibration phantom for direct, in vivo measurement of 241Am in the axillary lymph nodes.

    PubMed

    Zeman, Rachel; Lobaugh, Megan; Spitz, Henry; Glover, Samuel; Hickman, David

    2009-09-01

    A calibration phantom was developed at the University of Cincinnati (UC) to determine detection efficiency and estimate the quantity of activity deposited in the axillary lymph nodes of a worker who had unknowingly sustained a wound contaminated with 241Am at some distant time in the past. This paper describes how the Livermore Torso Phantom was modified for calibrating direct, in vivo measurements of 241Am deposited in the axillary lymph nodes. Modifications involved milling a pair of parallel, flat bottom, cylindrical holes into the left and right shoulders (below the humeral head) of the Livermore Torso Phantom in which solid, 1.40-cm-diameter cylindrical rods were inserted. Each rod was fabricated using a muscle tissue substitute. One end of each rod contained a precisely known quantity of Am sealed in a 1-cm-diameter, 2.54-cm-deep well to simulate the axillary lymph nodes when inserted into the modified Livermore Torso Phantom. The fixed locations for the axillary lymph nodes in the phantom were determined according to the position of the Level I and the combined Level II + III axillary lymph nodes reported in the literature. Discrete calibration measurements for 241Am in the simulated axillary lymph nodes located in the right and left sides of the thorax were performed using pairs of high-resolution germanium detectors at UC and Lawrence Livermore National Laboratory. The percent efficiency for measuring the 59.5 keV photon from Am deposited in the right and left axillary lymph nodes using a pair of 3,000 mm2 detectors is 2.60 +/- 0.03 counts gamma-1 and 5.45 +/- 0.07 counts gamma-1, respectively. Activity deposited in the right and left axillary lymph nodes was found to contribute 12.5% and 19.7%, respectively, to a lung measurement and 1.2% and 0.2%, respectively, to a liver measurement. Thus, radioactive material mobilized from a wound in a finger or hand and deposited in the axillary lymph nodes has been shown to confound results of a direct, in vivo measurement of the lungs. PMID:19667805

  18. Sentinel Lymph Node Biopsy in Patients with Previous Ipsilateral Complete Axillary Lymph Node Dissection

    Microsoft Academic Search

    Paramjeet Kaur; John V. Kiluk; Tammi Meade; Daniel Ramos; William Koeppel; Julia Jara; Jeff King; Charles E. Cox

    2011-01-01

    Background  Prior ipsilateral completion axillary lymph node dissection (CALND) may be considered a contraindication to performing a sentinel\\u000a lymph node (SLN) mapping in a patient with recurrent breast carcinoma. However, reoperative SLN biopsy following axillary\\u000a dissection would determine if alternative lymphatic drainage pathways exist. If nodes were found to contain metastatic disease,\\u000a staging and locoregional control of the disease could be

  19. Morbidity of Sentinel Lymph Node Biopsy (SLN) Alone Versus SLN and Completion Axillary Lymph Node Dissection After Breast Cancer Surgery A Prospective Swiss Multicenter Study on 659 Patients

    Microsoft Academic Search

    Igor Langer; Ulrich Guller; Gilles Berclaz; Ossi R. Koechli; Gabriel Schaer; Mathias K. Fehr; Thomas Hess; Daniel Oertli; Lucio Bronz; Beate Schnarwyler; Edward Wight; Urs Uehlinger; Eduard Infanger; Daniel Burger; Markus Zuber

    Objective: To assess the morbidity after sentinel lymph node (SLN) biopsy compared with SLN and completion level I and II axillary lymph node dissection (ALND) in a prospective multicenter study. Summary Background Data: ALND after breast cancer surgery is associated with considerable morbidity. We hypothesized: 1) that the morbidity in patients undergoing SLN biopsy only is signifi- cantly lower compared

  20. The role of axillary lymph node dissection in breast cancer patients with sentinel lymph node micrometastases

    Microsoft Academic Search

    M. Gipponi; G. Canavese; R. Lionetto; A. Catturich; C. Vecchio; A. Sapino; D. Friedman; F. Cafiero

    2006-01-01

    AimTo identify by means of clinical and histopathological features a subset of breast cancer patients with sentinel lymph-node (sN) micrometastases and metastatic disease confined only to the sN in order to spare them an unnecessary axillary lymph node dissection (ALND).

  1. Axillary lymph node dissection in early-stage invasive breast cancer: is it still standard today?

    Microsoft Academic Search

    Bernd Gerber; Kristin Heintze; Johannes Stubert; Max Dieterich; Steffi Hartmann; Angrit Stachs; Toralf Reimer

    2011-01-01

    Evaluation of axillary lymph node status by sentinel lymph node biopsy (SLNB) and complete axillary lymph node dissection\\u000a (ALND) are an inherent part of breast cancer treatment. Increased understanding of tumor biology has changed the prognostic\\u000a and therapeutic impact of lymph node status. Non-invasive imaging techniques like axillary ultrasound, FDG-PET, or MRI revealed\\u000a moderate sensitivity and high specificity in evaluation

  2. Endoscopic axillary lymph node dissection: an experimental study in human cadavers

    Microsoft Academic Search

    L. Michael Brunt; Daniel B. Jones; Justin S. Wu; Elizabeth M. Brunt; Diane M. Radford

    1998-01-01

    Background: The role of axillary lymph node dissection in the staging of patients with breast carcinoma is currently under evaluation. As a result of recent advances in minimally invasive techniques, an endoscopic approach to axillary lymph node dissection may be an attractive alternative to lymphadenectomy performed via a standard “open” axillary incision. The purpose of the present study was to

  3. A standardized surgical technique for mastoscopic axillary lymph node dissection.

    PubMed

    Chengyu, Luo; Yongqiao, Zhou; Hua, Lin; Xiaoxin, Ji; Chen, Guan; Jing, Li; Jian, Zhang

    2005-06-01

    To standardize the surgical technique for mastoscopic axillary lymph node dissection (MALND). Mastoscopic lymph node dissection was performed consistently by a group of surgeons in 316 cases of breast cancer. The mean operation time was 46.7 minutes with minimal bleeding, and the median number of lymph nodes dissected at each operation was 17.0. There were no operative complications in any case, nor did trocar implantation or tumor diffusion occurring during the mean follow-up time of 15.1 months. MALND is distinctive and practicable in operative anatomy as well as safe and convenient. The location of critical anatomy such as the intercostobrachial nerve, lateral thoracic artery, medial thoracic nerve, and thoracoepigastric vein should be clearly identified to avoid damage to them, so that is the great advantage of MALND. PMID:15956900

  4. Pathology Case Study: Enlarged Right Axillary Lymph Node

    NSDL National Science Digital Library

    Fung, Mark

    This is a case study presented by the University of Pittsburgh Department of Pathology in which a 40-year-old man was found to have an enlarged right axillary lymph node. Visitors are given the patient history, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in pathology and clinical immunology.

  5. A mathematical model of axillary lymph node involvement considering lymph node size in patients with breast cancer

    Microsoft Academic Search

    Takaomi Suzuma; Takeo Sakurai; Goro Yoshimura; Teiji Umemura; Takeshi Tamaki; Yasuaki Naito

    2001-01-01

    Background  Surgical sampling for assessing axillary status has not been considered as a well defined surgical procedure. We have reported\\u000a that MRI is a good instrument for assessing lymph node size and identifying lymph node position. We also developed a mathematical\\u000a model that takes into consideration the size of axillary lymph nodes, and retrospectively determined the number and size of\\u000a the

  6. Quantitative evaluation of metastases in axillary lymph nodes of breast cancer

    Microsoft Academic Search

    M Inokuchi; I Ninomiya; K Tsugawa; I Terada; K Miwa

    2003-01-01

    We have established a highly sensitive and quantitative reverse transcriptase–polymerase chain reaction (RT–PCR) method to detect axillary lymph node metastases of breast cancer. Amplifying cytokeratin 19 (CK19) mRNA transcripts using real-time TaqMan PCR made it possible to quantify axillary metastatic burden. Metastases in 358 axillary lymph nodes obtained from 23 breast cancers of 22 patients were investigated by conventional haematoxylin

  7. Predictors of Completion Axillary Lymph Node Dissection in Patients with Positive Sentinel Lymph Nodes

    Microsoft Academic Search

    Amer K. Karam; Meier Hsu; Sujata Patil; Michelle Stempel; Tiffany A. Traina; Alice Y. Ho; Hiram S. Cody; Elisa R. Port; Monica Morrow; Mary L. Gemignani

    2009-01-01

    Background  Completion axillary lymph node dissection (CALND) is routinely performed in breast cancer patients with positive sentinel\\u000a lymph nodes (SLN). We sought to determine the sociodemographic, pathologic, and therapeutic variables that were associated\\u000a with CALND.\\u000a \\u000a \\u000a \\u000a Methods  From 7\\/1997 to 7\\/2003, 1,470 patients with invasive breast cancer were SLN positive by intraoperative frozen section or final\\u000a pathologic exam by hematoxylin–eosin and\\/or immunohistochemistry (IHC).

  8. Comparison of side effects between sentinel lymph node and axillary lymph node dissection for breast cancer

    Microsoft Academic Search

    Karen K. Swenson; Mary J. Nissen; Carolyn Ceronsky; Lindsey Swenson; Martin W. Lee; Todd M. Tuttle

    2002-01-01

    Background  Axillary lymph node dissection (ALND) is often associated with permanent arm side effects. Side effects after sentinel lymph\\u000a node dissection (SLND) should be less common, because the surgery is less extensive.\\u000a \\u000a \\u000a \\u000a Methods  The study compared side effects and interference with daily life between 169 women who underwent an SLND and 78 who underwent\\u000a an ALND for breast cancer. Patients rated symptom

  9. Management strategy of early-stage breast cancer patients with a positive sentinel lymph node: With or without axillary lymph node dissection

    Microsoft Academic Search

    Jia-Jian Chen; Jiong Wu

    2011-01-01

    Sentinel lymph node biopsy (SLNB) has been generally adopted as an alternative procedure to axillary lymph node dissection (ALND) for node staging. ALND remains the standard management of the axilla when a tumor-positive sentinel lymph node (SLN) is identified. However, further analysis has demonstrated that in 40–70% of cases with metastasis to the axillary lymph nodes, the SLN is the

  10. Isolated retromammary lymph node metastasis of breast cancer without axillary lymph node involvement: a case report with a false-negative sentinel lymph node biopsy

    Microsoft Academic Search

    Nana Rokutanda; Jun Horiguchi; Yukio Koibuchi; Rin Nagaoka; Ayako Sato; Hiroki Odawara; Hideaki Tokiniwa; Yuichi Iino; Junko Hirato; Izumi Takeyoshi

    2009-01-01

    A 54-year-old woman visited our hospital with a palpable tumor in her left breast, which was diagnosed as invasive ductal\\u000a carcinoma. Breast-conserving surgery was performed, in association with a sentinel lymph node (SLN) biopsy and back-up dissection\\u000a of the axillary lymph nodes. One dyed axillary lymph node with high radioactivity was defined as an SLN, and intraoperative\\u000a frozen-section analysis of

  11. Comparative efficacy of positron emission tomography and ultrasonography in preoperative evaluation of axillary lymph node metastases in breast cancer

    Microsoft Academic Search

    Masatoshi Ohta; Yutaka Tokuda; Yuki Saitoh; Yasuhiro Suzuki; Akira Okumura; Mitsuhiro Kubota; Hiroyasu Makuuchi; Tomoo Tajima; Seiei Yasuda; Akira Shohtsu

    2000-01-01

    Purpose  In primary breast cancer, axillary nodal status is the most powerful predictive factor of recurrence. However, axillary lymph\\u000a node dissection may cause surgical complications. If preoperative evaluation of axillary lymph node metastases is possible,\\u000a unnecessary axillary lymph node dissections can be avoided. The purpose of this study was to evaluate the efficacy of positron\\u000a emission tomography (PET) on detection of

  12. Sentinel lymph node biopsy results in less postoperative morbidity compared with axillary lymph node dissection for breast cancer

    Microsoft Academic Search

    William E Burak; Scott T Hollenbeck; Emmanuel E Zervos; Karen L Hock; Lisa C Kemp; Donn C Young

    2002-01-01

    Background: This study was designed to compare the postoperative morbidity and socioeconomic impact of sentinel lymph node biopsy (SLNB) with axillary lymph node dissection (ALND) in patients with early stage breast cancer.Methods: A prospective, nonrandomized, controlled study was designed to include patients who underwent breast conservation surgery and SLNB ± ALND. Group A consisted of patients who had a negative

  13. Intraoperative Pathologic Evaluation of a Breast Cancer Sentinel Lymph Node Biopsy as a Determinant for Synchronous Axillary Lymph Node Dissection

    Microsoft Academic Search

    John M. Kane III; Stephen B. Edge; Janet S. Winston; Nancy Watroba; Thelma C. Hurd

    2001-01-01

    Background: Intraoperative pathologic evaluation of a breast cancer sentinel lymph node (SLN) biopsy permits synchronous axillary lymph node dissection (ALND), but frozen section is time consuming and potentially inaccurate. This study evaluated intraoperative gross examination and touch prep analysis (TPA) of a breast cancer SLN biopsy as determinants for synchronous ALND. Methods: Intraoperative gross examination\\/TPA were performed on the SLN

  14. Can Axillary Lymph Node Dissection Be Safely Omitted for Early-Stage Breast Cancer Patients with Sentinel Lymph Node Micrometastasis?

    Microsoft Academic Search

    Sameer Damle; Christine B. Teal

    2009-01-01

    This study presents data that we have been anxiously awaiting. It adds to a slowly growing body of evidence that axillary lymph node dissection (ALND) may be omitted in select groups of node-positive patients. Many of us prefer not to perform ALND when only micrometastases are identified in sentinel lymph nodes (SLNs), especially when it often involves returning to the

  15. Can Axillary Lymph Node Dissection Be Safely Omitted for Early-Stage Breast Cancer Patients with Sentinel Lymph Node Micrometastasis?

    Microsoft Academic Search

    Sameer Damle; Christine B. Teal

    2010-01-01

    This study presents data that we have been anxiously awaiting. It adds to a slowly growing body of evidence that axillary lymph node dissection (ALND) may be omitted in select groups of node-positive patients. Many of us prefer not to perform ALND when only micrometastases are identified in sentinel lymph nodes (SLNs), especially when it often involves returning to the

  16. Predictors of positive axillary lymph nodes in breast cancer patients with metastatic sentinel lymph node

    Microsoft Academic Search

    Isabel Peixoto Callejo; José Américo Brito; José Wheinholtz Bivar; Fernando Jesus Fernandes; João Leal Faria; María Saudade André; Carlos Santos Costa; M. Odette Almelda; J. Menesese Sousa

    2005-01-01

    Introduction  Breast cancer with metastatic sentinel lymph nodes (SLN) may have clinico-pathologic factors associated with the presence\\u000a of positive nonsentinel axillary nodes (NSLN). The aim of the present study was to determine factors that predict in-volvement\\u000a of NSLN in breast cancer patients with positive SLN.\\u000a \\u000a \\u000a \\u000a Material and methods  A prospective database search identified 80 patients who underwent SLN biopsy for invasive breast

  17. S-Classification of Sentinel Lymph Node Predicts Axillary Nonsentinel Lymph Node Status in Patients with Breast Cancer

    Microsoft Academic Search

    Astrid Maria Fink; Harald Lass; Helmut Hartleb; Wolfgang Jurecka; Heinrich Salzer; Andreas Steiner

    2008-01-01

    Background  One-half of breast cancer patients with positive sentinel lymph node (SN) have no further metastases in the axillary lymph\\u000a node basin. The aim of the present study was to identify patients with positive SN who are unlikely to have further metastases\\u000a in the axillary lymph node basin, using a new classification of SN, namely the S-classification.\\u000a \\u000a \\u000a \\u000a Methods  Specimens of positive SN

  18. Toward nodal staging of axillary lymph node basins through intradermal administration of fluorescent imaging agents

    PubMed Central

    Meric-Bernstam, Funda; Rasmussen, John C.; Krishnamurthy, Savitri; Tan, I-Chih; Zhu, Banghe; Wagner, Jamie L.; Babiera, Gildy V.; Mittendorf, Elizabeth A.; Sevick-Muraca, Eva M.

    2013-01-01

    As part of a proof-of-concept study for future delivery of targeted near-infrared fluorescent (NIRF) tracers, we sought to assess the delivery of micrograms of indocyanine green to all the axillary lymph nodes following intraparenchymal breast injections and intradermal arm injections in 20 subjects with advanced breast carcinoma and undergoing complete axillary lymph node dissection. Lymphatic vessels and nodes were assessed in vivo. Ex vivo images demonstrated that 87% of excised lymph nodes, including 81% of tumor-positive lymph nodes, were fluorescent. Future clinical studies using microdose amounts of tumor-targeting NIRF contrast agents may demonstrate improved surgical intervention with reduced morbidity. PMID:24466486

  19. Five cases of axillary lymph node metastatic breast cancer on contrast-enhanced sonography.

    PubMed

    Ohta, Tomoyuki; Nishioka, Makiko; Nakata, Norio; Fukuda, Kunihiko; Kato, Kumiko

    2015-06-01

    This study was performed to determine the importance of contrast-enhanced sonography for axillary lymph node metastatic breast cancer. Contrast-enhanced sonographic findings in 5 patients with breast cancer and axillary lymph node metastasis are discussed, and imaging-pathologic correlations are also presented in 3 cases. In all 5 cases, lymph nodes showed a perfusion defect in the late phase. Rapid arterial enhancement and wash-out were observed in 2 cases in which we performed second injections. Contrast-enhanced sonography may be effective for identifying metastatic lesions in lymph nodes, especially in the early stages. PMID:26014334

  20. Reoperative sentinel lymph node biopsy for ipsilateral breast tumor recurrence after previous axillary lymph node dissection: Report of a case

    Microsoft Academic Search

    Masaya Hattori; Seiichiro Nishimura; Keiichiro Tada; Masamichi Koyama; Futoshi Akiyama; Yoshinori Ito; Takuji Iwase

    2011-01-01

    Sentinel lymph node biopsy has become a standard component of the evaluation of early-stage breast cancer, with a gradually\\u000a increasing number of indications in this patient population. This report presents the case of a patient who underwent reoperative\\u000a sentinel lymph node biopsy as part of an evaluation of ipsilateral breast tumor recurrence; she had previously undergone axillary\\u000a lymph node dissection.

  1. Sentinel lymph node biopsy compared with axillary lymph node dissection in early breast cancer: a meta-analysis

    Microsoft Academic Search

    Zhen Wang; Liu-Cheng Wu; Jun-Qiang Chen

    Sentinel lymph node biopsy (SLNB) has been recommended as the standard performance for negative sentinel lymph node (SLN)\\u000a patients without axillary lymph node dissection (ALND) in the surgical management of early breast cancer; however, the efficiency\\u000a of SLNB for patients with positive SLNs is still unclear. We performed this meta-analysis to compare the effectiveness and\\u000a safety of SLNB with ALND.

  2. Breast Cancer Regional Radiation Fields for Supraclavicular and Axillary Lymph Node Treatment: Is a Posterior Axillary Boost Field Technique Optimal?

    SciTech Connect

    Wang Xiaochun [Department of Radiation Physics, University of Texas, M. D. Anderson Cancer Center, Houston, TX (United States)], E-mail: xiaochunw@mdanderson.org; Yu, T.K. [Department of Radiation Oncology, University of Texas, M. D. Anderson Cancer Center, Houston, TX (United States); Salehpour, Mohammad; Zhang, Sean X.; Sun, T.L. [Department of Radiation Physics, University of Texas, M. D. Anderson Cancer Center, Houston, TX (United States); Buchholz, Thomas A. [Department of Radiation Oncology, University of Texas, M. D. Anderson Cancer Center, Houston, TX (United States)

    2009-05-01

    Purpose: To assess whether using an anterior oblique supraclavicular (SCV) field with a posterior axillary boost (PAB) field is an optimal technique for targeting axillary (AX) lymph nodes compared with two computed tomography (CT)-based techniques: (1) an SCV field with an anterior boost field and (2) intensity-modulated radiotherapy (IMRT). Methods and Materials: Ten patients with CT simulation data treated with postmastectomy radiation that included an SCV field were selected for the study. Supraclavicular nodes and AX Level I-III nodes within the SCV field were contoured and defined as the treatment target. Plans using the three techniques were generated and evaluated for each patient. Results: The anterior axillary boost field and IMRT resulted in superior dose coverage compared with PAB. Namely, treatment volumes that received 105%, 80%, and 30% of prescribed dose for IMRT plans were significantly less than those for the anterior axillary boost plans, which were significantly less than PAB. For PAB and anterior axillary boost plans, there was a linear correlation between treatment volume receiving 105% of prescribed dose and maximum target depth. Furthermore, the IMRT technique resulted in better lung sparing and dose conformity to the target than anterior axillary boost, which again was significantly better than PAB. The maximum cord dose for IMRT was small, but higher than for the other two techniques. More monitor units were required to deliver the IMRT plan than the PAB plan, which was more than the anterior axillary boost plan. Conclusions: The PAB technique is not optimal for treatment of AX lymph nodes in an SCV field. We conclude that CT treatment planning with dose optimization around delineated target volumes should become standard for radiation treatments of supraclavicular and AX lymph nodes.

  3. Contribution of Kinetic Characteristics of Axillary Lymph Nodes to the Diagnosis in Breast Magnetic Resonance Imaging

    PubMed Central

    Örgüç, ?ebnem; Ba?ara, I??l; Pekindil, Gökhan; Co?kun, Teoman

    2012-01-01

    Objective: To assess the contribution of kinetic characteristics in the discrimination of malignant-benign axillary lymph nodes. Material and Methods: One hundred fifty-five female patients were included in the study. Following magnetic resonance imaging (MRI) examinations postprocessing applications were applied, dynamic curves were obtained from subtracted images. Types of dynamic curves were correlated with histopathological results in malignant cases or final clinical results in patients with no evidence of malignancy. Sensitivity, specificity, positive likehood ratio (+LHR), negative (?LHR) of dynamic curves characterizing the axillary lymph nodes were calculated. Results: A total of 178 lymph nodes greater than 8 mm were evaluated in 113 patients. Forty-six lymph nodes in 24 cases had malignant axillary involvement. 132 lymph nodes in 89 patients with benign diagnosis were included in the study. The sensitivity of type 3 curve as an indicator of malignancy was calculated as 89%. However the specificity, +LHR, ?LHR were calculated as 14%, 1.04, 0.76 respectively. Conclusion: Since kinetic analysis of both benign and malignant axillary lymph nodes, rapid enhancement and washout (type 3) they cannot be used as a discriminator, unlike breast lesions. MRI, depending on the kinetic features of the axillary lymph nodes, is not high enough to be used in the clinical management of breast cancer patients. PMID:25207016

  4. In vitro diagnosis of axillary lymph node metastases in breast cancer by spectrum analysis of radio frequency echo signals

    Microsoft Academic Search

    Tsutomu Tateishi; Junji Machi; Ernest J. Feleppa; Robert Oishi; Jerry Jucha; Eugene Yanagihara; Laurence J. McCarthy; Tomoaki Noritomi; Kazuo Shirouzu

    1998-01-01

    Axillary lymph node status is of particular importance for staging and managing breast cancer. Currently, axillary lymph node dissection is performed routinely in cases of invasive breast cancer because of the lack of accurate noninvasive methods for diagnosing lymph node metastasis. We investigated the diagnostic ability of ultrasonic tissue characterization based on spectrum analysis of backscattered echo signals to detect

  5. Axillary sparganosis which was misunderstood lymph node metastasis during neoadjuvant chemotheraphy in a breast cancer patient.

    PubMed

    Lee, Eun Kyoung; Yoo, Young Bum

    2014-12-01

    Sparganosis of the breast is an uncommon disease, but should be considered in the differential diagnosis of unusual and suspicious breast masses. A history of ingesting contaminated water and direct ingestion of snakes and frogs may help in differential diagnosis of the mass. Complete surgical removal is the treatment of choice and provides a definite diagnosis. We report a case of multiple axillary lymph node sparganosis. It was first considered as an axillary metastasis of breast cancer because a newly axillary mass appeared in follow-up radiologic study after neoadjuvant chemotherapy. We performed curative breast cancer surgery and sparganosis was confirmed by extracting the worm during axillary dissection. PMID:25485243

  6. FDG-PET for axillary lymph node staging in primary breast cancer

    Microsoft Academic Search

    Flavio Crippa; Alberto Gerali; Alessandra Alessi; Roberto Agresti; Emilio Bombardieri

    2004-01-01

    Management of the axilla in patients with operable breast cancer is still one of the most controversial areas in clinical oncology. The best procedure to examine the lymph nodes is still standard axillary lymph node dissection; nevertheless, the morbidity associated with this procedure is well known. Based on these considerations, it is important for progress in the treatment of operable

  7. Quantum dots in axillary lymph node mapping: Biodistribution study in healthy mice

    Microsoft Academic Search

    Anne Robe; Emilie Pic; Henri-Pierre Lassalle; Lina Bezdetnaya; François Guillemin; Frédéric Marchal

    2008-01-01

    BACKGROUND: Breast cancer is the first cause of cancer death among women and its incidence doubled in the last two decades. Several approaches for the treatment of these cancers have been developed. The axillary lymph node dissection (ALND) leads to numerous morbidity complications and is now advantageously replaced by the dissection and the biopsy of the sentinel lymph node. Although

  8. Intercostobrachial Nerves as a Novel Anatomic Landmark for Dividing the Axillary Space in Lymph Node Dissection

    PubMed Central

    Li, Jianyi; Zhang, Yang; Zhang, Wenhai; Jia, Shi; Gu, Xi; Ma, Yan; Li, Dan

    2013-01-01

    Purpose. Our aim was to assess the feasibility of using the intercostobrachial nerves (ICBNs) as a possible new anatomic landmark for axillaries lymph node dissection in breast cancer patients. Background Data Summary. The preservation of ICBN is now an accepted procedure in this type of dissection; however, it could be improved further to reduce the number of postoperative complications. The axillary space is divided into lower and upper parts by the ICBN—a thorough investigation of the metastasis patterns in lymph nodes found in this area could supply new information leading to such improvements. Methods. Seventy-two breast cancer patients, all about to undergo lymph node dissection and with sentinel lymph nodes identified, were included in this trial. The lymph nodes were collected in two groups, from lower and upper axillary spaces, relative to the intercostobrachial nerves. The first group was further subdivided into sentinel (SLN) and nonsentinel (non-SLN) nodes. All lymph nodes were tested to detect macro- and micrometastasis. Results. All the sentinel lymph nodes were found under the intercostobrachial nerves; more than 10 lymph nodes were located in that space. Moreover, when lymph nodes macrometastasize or micrometastasize above the intercostobrachial nerves, we also observe metastasis-positive nodes under the nerves; when the lower group nodes show no metastasis, the upper group is also metastasis free. Conclusions. Our results show that the intercostobrachial nerves are good candidates for a new anatomic landmark to be used in lymph node dissection procedure. PMID:23401796

  9. Solitary positive sentinel lymph node accompanied by negative sentinel lymph node(s) is predictive of a negative completion axillary lymph node dissection

    Microsoft Academic Search

    Weesam Alkhatib; Carol Connor; Fan Fang

    2007-01-01

    BackgroundMany patients with a positive sentinel lymph node (SLN) have a negative axillary lymph node dissection (ALND). We hypothesized that a solitary positive SLN associated with at least 1 negative SLN is predictive of a negative completion ALND. Omission of ALND may be possible in these patients.

  10. Intradermal administration of fluorescent contrast agents for delivery to axillary lymph nodes

    NASA Astrophysics Data System (ADS)

    Rasmussen, John C.; Meric-Berstam, Funda; Krishnamurthy, Savitri; Tan, I.-Chih; Zhu, Banghe; Wagner, Jamie L.; Babiera, Gildy V.; Mittendorf, Elizabeth A.; Sevick-Muraca, Eva M.

    2014-05-01

    In this proof-of-concept study we seek to demonstrate the delivery of fluorescent contrast agent to the tumor-draining lymph node basin following intraparenchymal breast injections and intradermal arm injection of micrograms of indocyanine green in 20 breast cancer patients undergoing complete axillary lymph node dissection. Individual lymph nodes were assessed ex vivo for presence of fluorescent signal. In all, 88% of tumor-negative lymph nodes and 81% of tumor-positive lymph nodes were fluorescent. These results indicate that future studies utilizing targeted fluorescent contrast agents may demonstrate improved surgical and therapeutic intervention.

  11. A Prospective Evaluation of Positron Emission Tomography Scanning, Sentinel Lymph Node Biopsy, and Standard Axillary Dissection for Axillary Staging in Patients with Early Stage Breast Cancer

    Microsoft Academic Search

    Peter J. Lovrics; Vicky Chen; Geoff Coates; Sylvie D. Cornacchi; Charlie H. Goldsmith; Calvin Law; Mark N. Levine; Ken Sanders; Ved R. Tandan

    2004-01-01

    Background: Positron emission tomography (PET) is a noninvasive imaging modality that can detect malignant lymph nodes. This study determined the sensitivity, specificity, predictive values, and likelihood ratios of PET scanning compared with standard axillary lymph node dissection (ALND) and sentinel lymph node biopsy (SLNB) in staging the axilla in women with early stage breast cancer.Methods: Women with clinical stage I

  12. Regional radiotherapy versus an axillary lymph node dissection after lumpectomy: a safe alternative for an axillary lymph node dissection in a clinically uninvolved axilla in breast cancer. A case control study with 10 years follow up

    Microsoft Academic Search

    Patty H Spruit; Sabine Siesling; Marloes AG Elferink; Ernest JA Vonk; Carel JM Hoekstra

    2007-01-01

    BACKGROUND: The standard treatment of the axilla in breast cancer used to be an axillary lymph node dissection. An axillary lymph node dissection is known to give substantial risks of morbidity. In recent years the sentinel node biopsy has become common practice. Future randomized study results will determine whether the expected decrease in morbidity can be proven. METHODS: Before the

  13. The evolving role of axillary lymph node dissection in the modern era of breast cancer management

    Microsoft Academic Search

    J. M. Barry; W. P. Weber; V. Sacchini

    The standard of practice in breast cancer surgery is that all patients with a positive sentinel node mandate an axillary lymph node dissection (ALND). Recently, this dogma has been challenged by a trial from ACOSOG (American College Of Surgeons Oncology Group) (Trial Z0011) which demonstrated that patients (without clinically\\/radiologically apparent axillary metastases) undergoing breast conserving surgery (i.e lumpectomy followed by

  14. Role of axillary lymph node dissection after tumor downstaging with induction chemotherapy for locally advanced breast cancer

    Microsoft Academic Search

    Henry M. Kuerer; Lisa A. Newman; Bruno D. Fornage; Kapil Dhingra; Kelly K. Hunt; Aman U. Buzdar; Fred C. Ames; Merrick I. Ross; Barry W. Feig; Gabriel N. Hortobagyi; S. Eva Singletary

    1998-01-01

    Background: Induction chemotherapy has become the standard of care for patients with locally advanced breast cancer (LABC) and currently is being evaluated in prospective clinical trials in patients with earlier-stage disease. To better gauge the role of axillary lymph node dissection in patients with LABC this study was performed to assess initial axillary status on physical and ultrasound examination, axillary

  15. Efficiency of a Preoperative Axillary Ultrasound and Fine-Needle Aspiration Cytology to Detect Patients with Extensive Axillary Lymph Node Involvement

    PubMed Central

    Castellano, Isabella; Deambrogio, Cristina; Muscarà, Francesca; Chiusa, Luigi; Mariscotti, Giovanna; Bussone, Riccardo; Gazzetta, Guglielmo; Macrì, Luigia; Cassoni, Paola; Sapino, Anna

    2014-01-01

    Background Recent studies have demonstrated that axillary lymph node dissection (ALND) does not affect patient survival, even in those with one or two positive sentinel lymph nodes (SLNs). On the other hand, patients with 3 or more metastatic lymph nodes are eligible for chemotherapy. Therefore, it is crucial to identify a priori patients at risk of having a high number of metastatic axillary lymph nodes for their surgical and/or clinical management. Ultrasound (US) guided Fine-Needle Aspiration (FNA) has been proven to be a useful and highly specific method for detecting metastatic axillary lymph nodes. However, only one recent study has evaluated the efficiency of this method in identifying patients with high metastatic nodal involvement. Our aim was to validate US-guided FNA as a reliable method to discriminate a priori patients with >3 metastatic lymph nodes. Methods A retrospective series of 1287 breast cancer patients who underwent a simultaneous preoperative breast and axillary US to stage their axilla was collected. A total of 365 patients, with either positive SLNs (278) or positive axillary lymph nodes detected via US-guided FNA (87), underwent ALND. In these two subgroups, we compared the number of metastatic lymph nodes in the axilla. Results The number of metastatic axillary lymph nodes in patients who underwent US-guided FNA was significantly higher (63% had >3 metastatic lymph nodes) than that in patients with SLNs positive for micro- or macrometastases (3% and 27%, respectively) (P<0.001, ?2?=?117.897). Conclusions Preoperative axillary US-guided FNA could act as a reliable tool in identifying breast cancer patients with extensive nodal involvement. PMID:25207643

  16. Touch Imprint Cytology of the Sentinel Lymph Nodes Might Not Be Indicated in Early Breast Cancer Patients with Ultrasonically Uninvolved Axillary Lymph Nodes

    Microsoft Academic Search

    Andraž Perhavec; Nikola Besi?; Marko Ho?evar; Janez Žgajnar

    2008-01-01

    Background  Touch imprint cytology (TIC) is a fast, cheap and specific intraoperative examination of the sentinel lymph nodes (SLNs) in\\u000a early breast cancer patients. The results of TIC in patients with ultrasonically (US) uninvolved axillary lymph nodes are\\u000a not known. The objective of our study was to compare the results of TIC in the patients with US uninvolved axillary lymph\\u000a nodes

  17. Does Fibrin Glue Improve Drainage after Axillary Lymph Node Dissection? Prospective and Randomized Study in Humans

    Microsoft Academic Search

    F. Vaxman; A. Kolbe; F. Stricher; D. Zund; P. Volkmar; D. Gros; J. F. Grenier

    1995-01-01

    The aim of this prospective and randomized study was to establish whether the use of fibrin glue was beneficial after axillary lymph node dissection. From January 1990 to January 1991, 40 women were randomized before surgery for breast cancer: 20 patients (group A) underwent vaporization of fibrin glue (Tissucol®, 5 ml of 500 IU thrombin) only in the area of

  18. Completion axillary lymph node dissection minimizes the likelihood of false negatives for patients with invasive breast carcinoma and cytokeratin positive only sentinel lymph nodes

    Microsoft Academic Search

    James W Jakub; Nils M Diaz; Mark D Ebert; Alan Cantor; Douglas S Reintgen; Elisabeth L Dupont; Alan R Shons; Charles E Cox

    2002-01-01

    Objective: To document the incidence of metastatic disease in complete axillary lymph node dissections (CALND) of patients with invasive carcinoma after a sentinel lymph node (SLN) biopsy, positive only by immunohistochemical staining for cytokeratin (CK-IHC).Methods: Sections of all SLNs, negative by routine histology, were immunostained and examined for cytokeratin positive cells. Sections of lymph nodes from CALND specimens were interpreted

  19. Predictors of Completion Axillary Lymph Node Dissection in Patients With Immunohistochemical Metastases to the Sentinel Lymph Node in Breast Cancer

    Microsoft Academic Search

    Matthew S. Pugliese; Amer K. Karam; Meier Hsu; Michelle M. Stempel; Sujata M. Patil; Alice Y. Ho; Tiffany A. Traina; Kimberly J. Van Zee; Hiram S. Cody III; Monica Morrow; Mary L. Gemignani

    2010-01-01

    Background  Axillary lymph node dissection (ALND) in patients with immunohistochemistry (IHC)-determined metastases to the sentinel lymph\\u000a node (SLN) is controversial. The goal of this study was to examine factors associated with ALND in IHC-only patients.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Retrospective review of an institutional SLN database from July 1997 to July 2003 was performed. We compared sociodemographic,\\u000a pathologic, and therapeutic variables between IHC-only patients who

  20. Eighteen Sensations After Breast Cancer Surgery: A 5Year Comparison of Sentinel Lymph Node Biopsy and Axillary Lymph Node Dissection

    Microsoft Academic Search

    Roberta H. Baron; Jane V. Fey; Patrick I. Borgen; Michelle M. Stempel; Kathleen R. Hardick; Kimberly J. Van Zee

    2007-01-01

    Background  The aim of this study is to evaluate prevalence, severity, and level of distress of 18 sensations at baseline (3–15 days)\\u000a and 5 years after breast cancer surgery, and compare sensations after sentinel lymph node biopsy (SLNB) with those after SLNB\\u000a plus immediate or delayed axillary lymph node dissection (ALND).\\u000a \\u000a \\u000a \\u000a Methods  A total of 187 patients with breast cancer completed the

  1. The prognostic significance of total lymph node number in patients with axillary lymph node-negative breast cancer

    Microsoft Academic Search

    H Mersin; E Y?ld?r?m; H Bulut; U Berbero?lu

    2003-01-01

    Aim: In node-negative breast cancer patients, several factors for survival have been evaluated and currently, some of them are accepted for their prognostic and\\/or predictive values after validation in the separate data sets. The prognostic significance of increases in the number of pathologically detectable axillary lymph nodes in the node-negative patients could not been established clearly. To address this question,

  2. Axillary Lymph Node Echo-Guided Fine-Needle Aspiration Cytology Enables Breast Cancer Patients to Avoid a Sentinel Lymph Node Biopsy. Preliminary Experience and a Review of the Literature

    Microsoft Academic Search

    Vittorio Altomare; Gabriella Guerriero; Rita Carino; Cleonice Battista; Angelo Primavera; Annamaria Altomare; Donata Vaccaro; Alessandro Esposito; Anna Maria Ferri; Carla Rabitti

    2007-01-01

    Purpose  For many years, the status of the axillary lymph nodes has been determined by an axillary lymphadenectomy. However, a sentinel\\u000a lymph node biopsy has been shown to effectively replace the need for an axillary lymphadenectomy in order to determine the\\u000a axillary staging. This study presents the preliminary results regarding the efficacy of fine-needle aspiration cytology (FNAC)\\u000a to identify metastatic axillary

  3. Morbidity comparison of sentinel lymph node biopsy versus conventional axillary lymph node dissection for breast cancer patients: Results of the sentinella–GIVOM Italian randomised clinical trial

    Microsoft Academic Search

    P. Del Bianco; G. Zavagno; P. Burelli; G. Scalco; L. Barutta; P. Carraro; P. Pietrarota; G. Meneghini; T. Morbin; G. Tacchetti; P. Pecoraro; V. Belardinelli; G. L. De Salvo

    2008-01-01

    AimsTo compare physical morbidity and health-related quality of life (HRQOL) in breast cancer patients who received standard axillary dissection (ALND) or sentinel lymph node biopsy (SLNB), followed by axillary dissection only in the case of sentinel-node positivity, within a randomised clinical trial.

  4. Patients with Breast Cancer and Negative Sentinel Lymph Node Biopsy without Additional Axillary Lymph Node Dissection: A Follow-Up Study of up to 5 Years

    Microsoft Academic Search

    Anna Domènech; Ana Benitez; María Teresa Bajén; María Jesús Pla; Miguel Gil; Josep Martín-Comín

    2007-01-01

    Objective: To analyze the rate of axillary recurrences and survival in patients operated on for breast cancer who had not undergone an axillary lymph node dissection (ALND) because of a negative sentinel node biopsy. Methods: The study includes 97 patients operated on for breast cancer and selective node biopsy from June 2000 to December 2001 who had a negative sentinel

  5. Subareolar blue dye only injection sentinel lymph node biopsy could reduce the numbers of standard axillary lymph node dissection in environments without access to nuclear medicine

    Microsoft Academic Search

    Andreas Kavallaris; Oumar Camara; Ingo B. Runnebaum

    2008-01-01

    Purpose  The gold standard of axillary sentinel lymph node biopsy (SLNB) in breast cancer is the combination of radioactive colloid\\u000a and blue dye injection. Worldwide, numerous hospitals without access to radioactive tracers still perform a routine complete\\u000a axillary lymph node dissection (ALND). We retrospectively analyzed the false negative rate and identification rate of SLNB\\u000a with injection of blue dye in the

  6. Predicting axillary lymph node metastasis from kinetic statistics of DCE-MRI breast images

    NASA Astrophysics Data System (ADS)

    Ashraf, Ahmed B.; Lin, Lilie; Gavenonis, Sara C.; Mies, Carolyn; Xanthopoulos, Eric; Kontos, Despina

    2012-03-01

    The presence of axillary lymph node metastases is the most important prognostic factor in breast cancer and can influence the selection of adjuvant therapy, both chemotherapy and radiotherapy. In this work we present a set of kinetic statistics derived from DCE-MRI for predicting axillary node status. Breast DCE-MRI images from 69 women with known nodal status were analyzed retrospectively under HIPAA and IRB approval. Axillary lymph nodes were positive in 12 patients while 57 patients had no axillary lymph node involvement. Kinetic curves for each pixel were computed and a pixel-wise map of time-to-peak (TTP) was obtained. Pixels were first partitioned according to the similarity of their kinetic behavior, based on TTP values. For every kinetic curve, the following pixel-wise features were computed: peak enhancement (PE), wash-in-slope (WIS), wash-out-slope (WOS). Partition-wise statistics for every feature map were calculated, resulting in a total of 21 kinetic statistic features. ANOVA analysis was done to select features that differ significantly between node positive and node negative women. Using the computed kinetic statistic features a leave-one-out SVM classifier was learned that performs with AUC=0.77 under the ROC curve, outperforming the conventional kinetic measures, including maximum peak enhancement (MPE) and signal enhancement ratio (SER), (AUCs of 0.61 and 0.57 respectively). These findings suggest that our DCE-MRI kinetic statistic features can be used to improve the prediction of axillary node status in breast cancer patients. Such features could ultimately be used as imaging biomarkers to guide personalized treatment choices for women diagnosed with breast cancer.

  7. 18F-FDG PET complemented with sentinel lymph node biopsy in the detection of axillary involvement in breast cancer

    Microsoft Academic Search

    G. Zornoza; M. J. Garcia-Velloso; J. Sola; F. M. Regueira; L. Pina; C. Beorlegui

    2004-01-01

    Aim. The presence of axillary involvement is the most important prognostic factor in breast cancer. This study analysis the value of 18F-FDG PET in the detection of the lymph node status.Methods. This study includes 200 breast cancer patients. The PET scans were obtained after the injection of 370MBq of 18F-FDG; the breast areas, axillary, supraclavicular and internal mammary lymph node

  8. Epitrochlear and axillary lymph node visualization on FDG-PET\\/CT imaging in a patient with rheumatoid arthritis

    Microsoft Academic Search

    P. Ozcan Kara; B. Kaya; G. Kara Gedik; O. Sari

    2011-01-01

    An 38 year-old female with oral tongue cancer was referred for FDG-PET\\/CT scan for evaluating axillary lymph nodes and restaging malignancy. Bilateral uptake of axillary and epitrochlear lymph nodes were observed on PET\\/CT imaging. The uptake pattern was unexpected for the patient with this malignancy and she had a history of rheumatoid arthritis. Additionally, the wrists were included in the

  9. Variability of the depth of supraclavicular and axillary lymph nodes in patients with breast cancer: is a posterior axillary boost field necessary?

    Microsoft Academic Search

    Gunilla C Bentel; Lawrence B Marks; Patricia H Hardenbergh; Leonard R Prosnitz

    2000-01-01

    Purpose: To determine the variability of the depth of supraclavicular (SC) and axillary (AX) lymph nodes in patients undergoing radiation therapy for breast cancer and to relate this variability with the patient’s anterior\\/posterior (A\\/P) diameter. The dosimetric consequences of the variability in depth are explored and related to the need for a posterior axillary boost field.Method and Materials: In 49

  10. Interoperative detection of cancer metastasis to the axillary lymph nodes

    NASA Astrophysics Data System (ADS)

    Derakhshan, Jamal

    2002-03-01

    Sentinel lymph node biopsy utilizing Technetium-99m-labeled sulfur colloid is becoming a standard part of the surgical treatment of breast cancer. However, the non-tumor-specific nature of colloids necessitates removal of the node(s) for analysis. Tumor-specific radiotracers, such as positron-emitting Fluorine-18-labeled Fluorodeoxyglucose (FDG), are used with positron emission tomography (PET) to successfully stage breast cancer. Thus, the use of FDG with a handheld probe optimized for detection of beta particles could perhaps identify cancer-infiltrated nodes. In this study the ability of a new solid-state beta-sensitive probe to identify tumor-infiltrated lymph nodes was investigated in a phantom study. A PET image of the phantom was also acquired. The results demonstrated that the probe was capable of identifying nodes containing as little as 10ml of tumor, an amount too small to be detected by the PET scanner. This method, therefore, may be useful in intraoperatively identifying some tumor-infiltrated lymph nodes not detected with PET.

  11. Breast Cancer Metastasis Alters Acetylcholinesterase Activity and the Composition of Enzyme Forms in Axillary Lymph Nodes

    Microsoft Academic Search

    Francisco Ruiz-Espejo; Juan Cabezas-Herrera; Julián Illana; Francisco J. Campoy; Encarnación Muñoz-Delgado; Cecilio J. Vidal

    2003-01-01

    Because of the probable involvement of cholinesterases (ChEs) in tumorigenesis, this research was addressed to ascertaining whether breast cancer metastasis alters the content of acetylcholinesterase (AChE) and\\/or butyrylcholinesterase (BuChE) in axillary lymph nodes (LN). ChE activity was assayed in nine normal (NLN) and seven metastasis-bearing nodes (MLN) from women. AChE and BuChE forms were characterised by sedimentation analyses, hydrophobic chromatography

  12. Locoregional failure of postmastectomy patients with 1–3 positive axillary lymph nodes without adjuvant radiotherapy

    Microsoft Academic Search

    Jason Chia-Hsien Cheng; Chii-Ming Chen; Mei-Ching Liu; Mei-Hua Tsou; Po-Sheng Yang; James Jer-Min Jian; Skye Hongiun Cheng; Stella Y. Tsai; Szu-Yun Leu; Andrew T. Huang

    2002-01-01

    Purpose: To analyze the incidence and risk factors for locoregional recurrence (LRR) in patients with breast cancer who had T1 or T2 primary tumor and 1–3 histologically involved axillary lymph nodes treated with modified radical mastectomy without adjuvant radiotherapy (RT).Methods and Materials: Between April 1991 and December 1998, 125 patients with invasive breast cancer were treated with modified radical mastectomy

  13. Sentinel lymph node biopsy (SLNB) vs. axillary lymph node dissection (ALND) in the current surgical treatment of early stage breast cancer

    PubMed Central

    Gherghe, M; Bordea, C; Blidaru, A

    2015-01-01

    The identification and biopsy of the sentinel lymph node has become a standard method of treatment for stage I and II breast cancer in the last decades, taking into account the fact that the management of the axilla in patients with breast cancer has evolved from the routine lymphadenectomy to a selective attitude, based on the histopathological evaluation of the sentinel lymph node, as well as on the tumor and on the patients’ characteristics. Since the introduction of the method into clinical practice, in 1994, different methods of identification have been used (radioisotope injection, vital blue dye, or, more recently, lipophilic contrast agent for ultrasound visualization or paramagnetic nanoparticles (NPs) or the method of indocyanine green fluorescence), each presenting certain limits, but the radioisotopic method proving the most accurate. Moreover, during the development of the method, beside the standard indications specific for T1 or T2 breast tumor, without clinical or imagistic axillary adenopathies, their extension to a series of other particular situations such as the following, has been tried: ductal carcinoma in situ, multicentre tumors, after excisional biopsy or tumors preoperatively treated by neoadjuvant chemotherapy. The aim of the paper is to present the progress made regarding the current stage in the use of sentinel lymph node technique in breast cancer, while mentioning the established indications, as well as the ones that are still debating and need further studies. Likewise, the cases in which the axillary lymph node dissection remains the major indication for treatment of the axilla, in patients with early stage breast cancer, will be discussed. PMID:25866575

  14. Sentinel lymph node biopsy (SLNB) vs. axillary lymph node dissection (ALND) in the current surgical treatment of early stage breast cancer.

    PubMed

    Gherghe, M; Bordea, C; Blidaru, A

    2015-01-01

    The identification and biopsy of the sentinel lymph node has become a standard method of treatment for stage I and II breast cancer in the last decades, taking into account the fact that the management of the axilla in patients with breast cancer has evolved from the routine lymphadenectomy to a selective attitude, based on the histopathological evaluation of the sentinel lymph node, as well as on the tumor and on the patients' characteristics. Since the introduction of the method into clinical practice, in 1994, different methods of identification have been used (radioisotope injection, vital blue dye, or, more recently, lipophilic contrast agent for ultrasound visualization or paramagnetic nanoparticles (NPs) or the method of indocyanine green fluorescence), each presenting certain limits, but the radioisotopic method proving the most accurate. Moreover, during the development of the method, beside the standard indications specific for T1 or T2 breast tumor, without clinical or imagistic axillary adenopathies, their extension to a series of other particular situations such as the following, has been tried: ductal carcinoma in situ, multicentre tumors, after excisional biopsy or tumors preoperatively treated by neoadjuvant chemotherapy. The aim of the paper is to present the progress made regarding the current stage in the use of sentinel lymph node technique in breast cancer, while mentioning the established indications, as well as the ones that are still debating and need further studies. Likewise, the cases in which the axillary lymph node dissection remains the major indication for treatment of the axilla, in patients with early stage breast cancer, will be discussed. PMID:25866575

  15. Epitrochlear and axillary lymph node visualization on FDG-PET/CT imaging in a patient with rheumatoid arthritis.

    PubMed

    Ozcan Kara, P; Kaya, B; Kara Gedik, G; Sari, O

    2011-01-01

    An 38 year-old female with oral tongue cancer was referred for FDG-PET/CT scan for evaluating axillary lymph nodes and restaging malignancy. Bilateral uptake of axillary and epitrochlear lymph nodes were observed on PET/CT imaging. The uptake pattern was unexpected for the patient with this malignancy and she had a history of rheumatoid arthritis. Additionally, the wrists were included in the field of view and showed elevated FDG uptake. In this case report, we report benign axillary and epitrochlear tracer uptake on FDG-PET/CT scan in a patient with a history of rheumatoid arthritis. PMID:20570414

  16. [Statistical distribution of involved axillary lymph nodes in breast cancer].

    PubMed

    Guern, Anne-Sophie; Vinh-Hung, Vincent

    2008-04-01

    Our aim is to characterize the statistical distribution of the number of involved lymph nodes in breast cancer. The material uses a sample of 109618 women from the US SEER (Surveillance, Epidemiology, and End Results). In a first analysis, we observed a log-concave distribution with overdispersion which excluded a Poisson stochastic process. A Negative Binomial (NB) provided an acceptable fit. Overdispersion implies that there are patients who are more at risk than expected, and/or cascade processes in which the variability increases when there are more involved lymph nodes. In a second series of analyses, we applied predictive models taking into account or not the NB. Logistic models, commonly used, allow only the prediction of nodal status, and we found a poor predictive value. A NB generalized linear regression (NBGLR) allowed us to model the number of involved nodes. We argued that the approach of modeling the number of nodes, and not merely the nodal status, allows a grading of nodal involvement risk and might identify patients for whom neoadjuvant treatment would be justified. Incidentally, the NBGLR found in our sample a seasonal factor affecting the numbers of nodes, suggesting the variability of medical practice, which might warrant further investigation. PMID:18495575

  17. Impact of Omission of Axillary Lymph Node Dissection After Negative Sentinel Lymph Node Biopsy: 70Month Follow-up

    Microsoft Academic Search

    Hee Jeong Kim; Byung Ho Son; Woo Sung Lim; Jin Yong Seo; Beom Seok Koh; Jong Won Lee; Gyung Yup Gong; Sei Hyun Ahn

    2010-01-01

    Background  The objective of this study is to assess the oncologic safety of sentinel lymph node biopsy (SLNB), especially with regard\\u000a to the axillary recurrence (AR) rate, and to determine the risk factors for AR and disease-free survival (DFS) and overall\\u000a survival (OS) after negative SLNB.\\u000a \\u000a \\u000a \\u000a \\u000a Materials and Methods  Between 2003 and 2006, a total of 1626 patients with invasive breast cancer

  18. Discordance of Intraoperative Frozen Section Analysis with Definitive Histology of Sentinel Lymph Nodes in Breast Cancer Surgery: Complementary Axillary Lymph Node Dissection is Irrelevant for Subsequent Systemic Therapy

    Microsoft Academic Search

    D. Geertsema; P. D. Gobardhan; E. V. E. Madsen; M. Albregts; J. van Gorp; P. de Hooge; Th. van Dalen

    2010-01-01

    Background  In breast cancer surgery, intraoperative frozen section (FS) analysis of sentinel lymph nodes (SLNs) enables axillary lymph\\u000a node dissection (ALND) during the same operative procedure. In case of discordance between a “negative” FS analysis and definitive\\u000a histology, an ALND as a second operation is advocated since additional lymph node metastases may be present. The clinical\\u000a implications of the subsequent ALND

  19. Diagnostic value of full-dose FDG PET\\/CT for axillary lymph node staging in breast cancer patients

    Microsoft Academic Search

    Till A. Heusner; Sherko Kuemmel; Steffen Hahn; Angela Koeninger; Friedrich Otterbach; Monia E. Hamami; Klaus R. Kimmig; Michael Forsting; Andreas Bockisch; Gerald Antoch; Alexander Stahl

    2009-01-01

    Purpose  The aims of this study were (1) to evaluate FDG PET\\/CT and CT for the detection of axillary lymph node metastases in breast\\u000a cancer (BC) patients and (2) to evaluate FDG PET\\/CT as a pre-test for the triage to sentinel lymph node biopsy (SLNB) versus\\u000a axillary lymph node dissection (ALND).\\u000a \\u000a \\u000a \\u000a Methods  The sensitivity, specificity, positive and negative predictive value (PPV, NPV),

  20. [Loss of appetite, night sweats, eczema, and axillary and inguinal lymph node swelling in a 28-year-old man].

    PubMed

    Wahl, U; Stranzenbach, R; Tischoff, I; Tannapfel, A; Stadler, R; Ernst, F

    2014-03-01

    A 28-year-old man presented with loss of appetite, night sweats, eczema, and axillary and inguinal lymph node swelling. The tentative diagnosis of malignant lymphoma was made. To confirm the diagnosis, extirpation of a lymph node and a skin biopsy were performed. Systemic treatment with methylprednisolone resulted in an improvement of eczema and lymph node swelling. Because of the histological findings and clinical course, we diagnosed dermatopathic lymphadenopathy, also known as Pautrier-Woringer syndrome. PMID:24522559

  1. Herpes Zoster Mimicking Breast Cancer With Axillary Lymph Node Metastasis on PET/CT.

    PubMed

    Choi, Eun Kyoung; Oh, Jin Kyoung; Chung, Yong-An

    2015-07-01

    Herpes zoster is a reactivated varicella-zoster virus infection and demonstrates typical dermatomal distribution. We herein describe a case of a 41-year-old woman with a history of ovarian cancer. Intense hot uptake in the left breast and enlarged ipsilateral axillary lymph nodes were noted on F-FDG PET/CT for adjuvant chemotherapy response evaluation. Blinded to the patient's clinical information, these lesions were interpreted as incidental breast cancer with axillary nodal metastasis. However, clinically she presented with vesicles along the T4 dermatome and palpable enlarged nodes in the left axilla. On 3-month follow-up PET/CT after antiviral treatment, these intense hot uptake areas were no longer visualized. PMID:26018707

  2. Immunohistochemical detection of axillary lymph node micrometastases in node negative breast cancer patients using cytokeratin and epithelial membrane antigen

    PubMed Central

    Choudhury, Monisha; Agrawal, Sapna; Pujani, Mukta; Thomas, Shaji; Pujani, Meenu

    2015-01-01

    Background and Objective: The study was conducted to detect occult metastases in lymph node negative breast cancer patients using cytokeratin (CK) and epithelial membrane antigen (EMA) immunohistochemistry (IHC) and correlate this with primary tumor size and grade. Materials and Methods: A total of 32 cases including 12 prospective and 20 retrospective cases of axillary lymph node negative breast cancer were studied. CK and EMA IHC were performed to detect micrometastases. Results: Axillary lymph node metastases were detected in 18.75% of previously node negative cases using CK and EMA IHC. CK was found to be more sensitive for detection of metastases compared to EMA. A highly significant correlation was observed between tumor grade and axillary lymph node metastases detected by CK and EMA. However, no significant correlation was found between tumor size and axillary lymph node metastases detected by IHC. Conclusion: In the present study, there was an increase of 18.75% in the occult metastases detection rate using CK and EMA. To conclude, IHC detection of occult metastases should be done using CK in all axillary node negative cases, especially in T1 and T2 stage tumors. PMID:25839017

  3. Probability of axillary lymph node metastasis when sentinel lymph node biopsy is negative in women with clinically node negative breast cancer: a bayesian approach

    Microsoft Academic Search

    Takahiro Okamoto; Kiyomi Yamazaki; Masako Kanbe; Hitomi Kodama; Yoko Omi; Akiko Kawamata; Rumi Suzuki; Yuka Igari; Reiko Tanaka; Masatoshi lihara; Yukio Ito; Tatsuo Sawada; Toshio Nishikawa; Masako Maki; Kiyoko Kusakabe; Norio Mitsuhashi; Takao Obara

    2005-01-01

    Background  Although sentinel lymph node biopsy (SLNB) is highly accurate in predicting axillary nodal status in patients with breast\\u000a cancer, it has been shown that the procedure is associated with a few false negative results. The risk of leaving metastatic\\u000a nodes behind in the axillary basin when SLNB is negative should be estimated for an individual patient if SLNB is performed

  4. A rare case of secretory breast carcinoma in a male adult with axillary lymph node metastasis

    PubMed Central

    Ding, Jinhua; Jiang, Li; Gan, Yongli; Wu, Weizhu

    2015-01-01

    Secretory breast carcinoma is a rare tumor originally described in children but occurring equally in adult population, especially in women. This unusual subtype has a generally favorable prognosis, although several cases have been described in adults with increased aggressiveness and a risk of metastases even death. So far, merely ten cases of secretory breast carcinoma with metastatic axillary lymph node in male were reported. Here, we describe the eleventh case, a 24-years-old male who presented with a painless mass in the right breast was diagnosed to be “secretary breast carcinoma”, and subsequently underwent modified radical mastectomy and adjuvant chemotherapy. PMID:26045861

  5. Tattoo pigment in axillary lymph node mimicking calcification of breast cancer.

    PubMed

    Matsika, Admire; Srinivasan, Bhuvana; Gray, Janet Meryl; Galbraith, Christine Ruth

    2013-01-01

    A tattoo is defined as the intentional or accidental deposit of pigment into the skin. The phenomenon of skin tattooing is on the rise worldwide and complications of tattooing are increasingly being recognised in diagnostic and clinical medicine. We describe a case of calcification-like changes on mammography resembling that of breast malignancy as a result of tattoo pigment deposition in an axillary lymph node. Recognition of such changes in routine breast screening is crucial to avoid further unnecessary invasive investigations and surgery in such patients. PMID:23929611

  6. Factors associated with involvement of four or more axillary nodes for sentinel lymph node-positive patients

    SciTech Connect

    Katz, Angela [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States)]. E-mail: abkatz@partners.org; Niemierko, Andrzej [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States); Gage, Irene [Breast Cancer Treatment Group, Sibley Memorial Hospital, Washington, DC (United States); Evans, Sheila [Breast Cancer Treatment Group, Sibley Memorial Hospital, Washington, DC (United States); Shaffer, Margaret [Breast Cancer Treatment Group, Sibley Memorial Hospital, Washington, DC (United States); Smith, Frederick P. [Breast Cancer Treatment Group, Sibley Memorial Hospital, Washington, DC (United States); Taghian, Alphonse [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States); Magnant, Colette [Breast Cancer Treatment Group, Sibley Memorial Hospital, Washington, DC (United States)

    2006-05-01

    Purpose: Sentinel lymph node-positive (SLN+) patients who are unlikely to have 4 or more involved axillary nodes might be treated with less extensive regional nodal radiation. The purpose of this study was to define possible predictors of having 4 or more involved axillary nodes. Methods and Materials: The records of 224 patients with breast cancer and 1 to 3 involved SLNs, who underwent completion axillary dissection without neoadjuvant chemotherapy or hormonal therapy were reviewed. Factors associated with the presence of 4 or more involved axillary nodes (SLNs plus non-SLNs) were evaluated by Pearson chi-square test of association and by simple and multiple logistic-regression analysis. Results: Of 224 patients, 42 had involvement of 4 or more axillary nodes. On univariate analysis, the presence of 4 or more involved axillary nodes was positively associated with increased tumor size, lobular histology, lymphovascular space invasion (LVSI), increased number of involved SLNs, decreased number of uninvolved SLNs, and increased size of SLN metastasis. On multivariate analysis, the presence of 4 or more involved axillary nodes was associated with LVSI, increased number of involved SLNs, increased size of SLN metastasis, and lobular histology. Conclusions: Patients with 1 or more involved SLN, LVSI, or SLN macrometastasis should be treated to the supraclavicular fossa/axillary apex if they do not undergo completion axillary dissection. Other SLN+ patients might be adequately treated with less extensive radiation fields.

  7. Axillary and internal mammary sentinel lymph node biopsy in male breast cancer patients: case series and review

    PubMed Central

    Cao, Xiaoshan; Wang, Chunjian; Liu, Yanbing; Qiu, Pengfei; Cong, Binbin; Wang, Yongsheng

    2015-01-01

    Male breast cancer (MBC) is considered as a rare disease that accounts for less than 1% of all breast cancers, and its treatment has been based on the evidence available from female breast cancer. Axillary sentinel lymph node biopsy (SLNB) is now regarded as the standard of care for both female and male patients without clinical and imaging evidence of axillary lymph node metastases, while internal mammary SLNB has rarely been performed. Internal mammary chain metastasis is an independent prognostic predictor. Internal mammary SLNB should be performed to complete nodal staging and guide adjuvant therapy in MBC patients with preoperative lymphoscintigraphic internal mammary chain drainage. We report both axillary and internal mammary SLNB in two cases with MBC. Internal mammary sentinel lymph node did contain metastasis in one case. PMID:26124669

  8. Predictors of positive axillary lymph nodes after sentinel lymph node biopsy in breast cancer

    Microsoft Academic Search

    Shahab F Abdessalam; Emmanuel E Zervos; Manju Prasad; William B Farrar; Lisa D Yee; Michael J Walker; William B Carson; William E Burak

    2001-01-01

    Objective: The purpose of this study was to determine the factors that predict the presence of metastasis in nonsentinel lymph nodes (SLN) when the SLN is positive.Methods: A prospective database was analyzed and included patients who underwent SLN biopsy for invasive breast cancer from July 1997 to August 2000 (n = 442). One hundred (22.6%) patients had one or more

  9. Arm morbidity following sentinel lymph node biopsy or axillary lymph node dissection: A study from the Danish Breast Cancer Cooperative Group

    Microsoft Academic Search

    Anders Husted Madsen; Karen Haugaard; Jan Soerensen; Susanne Bokmand; Esbern Friis; Helle Holtveg; Jens Peter Garne; John Horby; Peer Christiansen

    2008-01-01

    BackgroundSentinel lymph node biopsy was implemented in the treatment of early breast cancer with the aim of reducing shoulder and arm morbidity. Relatively few prospective studies have been published where the morbidity was assessed by clinical examination. Very few studies have examined the impact on shoulder mobility of node positive patients having a secondary axillary dissection because of the findings

  10. Axillary lymph node dissection for sentinel lymph node micrometastases may be safely omitted in early-stage breast cancer patients: long-term outcomes of a prospective study

    Microsoft Academic Search

    Igor Langer; Ulrich Guller; Carsten T. Viehl; Holger Moch; Edward Wight; Felix Harder; Daniel Oertli; Markus Zuber

    2010-01-01

    Objectives  To evaluate the long-term disease-free and overall survival of patients with sentinel lymph node (SLN) micrometastases, in\\u000a whom a completion axillary lymph node dissection (ALND) was systematically omitted.\\u000a \\u000a \\u000a \\u000a \\u000a Background  The use of step sectioning and immunohistochemistry for SLN analysis results in a more accurate histopathologic examination\\u000a and a higher detection rate of micrometastases. However, the clinical relevance and therapeutic implications of

  11. Axillary Lymph Node Dissection for Sentinel Lymph Node Micrometastases May Be Safely Omitted in Early-Stage Breast Cancer Patients: Long-Term Outcomes of a Prospective Study

    Microsoft Academic Search

    Igor Langer; Ulrich Guller; Carsten T. Viehl; Holger Moch; Edward Wight; Felix Harder; Daniel Oertli; Markus Zuber

    2009-01-01

    Objectives  To evaluate the long-term disease-free and overall survival of patients with sentinel lymph node (SLN) micrometastases, in\\u000a whom a completion axillary lymph node dissection (ALND) was systematically omitted.\\u000a \\u000a \\u000a \\u000a \\u000a Background  The use of step sectioning and immunohistochemistry for SLN analysis results in a more accurate histopathologic examination\\u000a and a higher detection rate of micrometastases. However, the clinical relevance and therapeutic implications of

  12. Axillary lymph node dissection can be avoided in women with breast cancer with intraoperative, false-negative sentinel lymph node biopsies

    Microsoft Academic Search

    Hiroyuki Takei; Masafumi Kurosumi; Takashi Yoshida; Yuko Ishikawa; Yuji Hayashi; Jun Ninomiya; Katsunori Tozuka; Hanako Oba; Kenichi Inoue; Shigenori Nagai; Yoshihiro Saito; Tomoko Kazumoto; Jun-ichi Saitoh; Toshio Tabei

    2010-01-01

    Background  It is currently unclear which patients with breast cancer with sentinel lymph node (SLN) metastases do not need axillary lymph\\u000a node dissection (ALND).\\u000a \\u000a \\u000a \\u000a Patients and methods  A cohort of 1,132 women who had unilateral invasive breast cancer with clinically negative nodes or nodes suspicious for metastasis,\\u000a were intraoperatively diagnosed as having negative SLNs, and did not undergo an immediate ALND. Our

  13. Comparison of quality of life and arm complaints after axillary lymph node dissection vs sentinel lymph node biopsy in breast cancer patients

    Microsoft Academic Search

    F Peintinger; R Reitsamer; H Stranzl; G Ralph

    2003-01-01

    The sentinel lymph node biopsy (SLNB) represents a minimal invasive surgical method for axillary staging in patients with primary breast cancer. In a prospective study, evaluation of quality of life (QOL) and arm morbidity was performed before surgery on a total of 56 breast cancer patients. The EORTC QLQ-C30 and EORTC QLQ-BR23 questionnaires were used for QOL assessment. Assessment of

  14. Volume-controlled vs no\\/short-term drainage after axillary lymph node dissection in breast cancer surgery: A meta-analysis

    Microsoft Academic Search

    R. A. Droeser; D. M. Frey; D. Oertli; D. Kopelman; M. J. Baas-Vrancken Peeters; A. E. Giuliano; K. Dalberg; R. Kallam; A. Nordmann

    2009-01-01

    It is unknown whether there are any clinically relevant differences between volume-controlled (<30–50ml\\/24h across trials) vs no\\/short-term drainage after axillary lymph node dissection in breast cancer surgery on outcomes such as seroma formation, wound infection or length of hospital stay.Randomised controlled trials comparing volume-controlled drainage vs no or short-term drainage after axillary lymph node dissection in breast cancer surgery were

  15. Use of tomographic nuclear medicine procedures, SPECT and pinhole SPECT, with cationic lipophilic radiotracers for the evaluation of axillary lymph node status in breast cancer patients

    Microsoft Academic Search

    Giuseppe Madeddu; Angela Spanu

    2004-01-01

    Scintimammography with the cationic lipophilic 99mTc-tetrofosmin and 99mTc-methoxyisobutylisonitrile (MIBI) is one of the most widely available non-invasive imaging methods employed in the preoperative evaluation of breast cancer axillary lymph node status, for which, at present, axillary lymph node dissection (ALND) is still considered the method of choice. Comparative studies have demonstrated that single-photon emission computed tomography (SPECT) acquisition significantly improves

  16. Spontaneous regression of breast cancer with axillary lymph node metastasis: a case report and review of literature.

    PubMed

    Tokunaga, Eriko; Okano, Shinji; Nakashima, Yuichiro; Yamashita, Nami; Tanaka, Kimihiro; Akiyoshi, Sauri; Taketani, Kenji; Shirouzu, Mitsunori; Yamamoto, Hidetaka; Morita, Masaru; Maehara, Yoshihiko

    2014-01-01

    Spontaneous regression (SR) of cancer is a rare but well-documented biological phenomenon. However, the mechanism remains to be elucidated. We herein report a case of the SR of breast cancer at both the primary site and metastatic axillary lymph node with spontaneously-induced T cell-mediated immunological responses. A 52-year-old female with a lump in the left axilla was diagnosed to have a small breast carcinoma with a distinct axillary lymph node metastasis. During the preoperative systemic examination, she was diagnosed to have severe type 2 diabetes mellitus, was treated with insulin, and the hyperglycemia was normalized after one month. Surgery for left breast cancer was then performed. The postoperative histopathological examination revealed the SR of breast cancer at both the primary site and metastatic axillary lymph node. Immunohistochemical studies revealed that estrogen receptor positive, AE1/AE3-positive ductal carcinoma completely underwent necrosis associated with extensive infiltration of CD3-positive T cells in the tumor nodule in the lymph node. In addition, primary ductal carcinoma cells also underwent single cell necrosis with infiltration of T cells with lymph follicle-like organization of B cells in the mammary gland. The features were suggestive that the tumor eradication in the metastatic lymph node and regression of the primary ductal carcinoma could be due to host T cell response to the ductal carcinoma. As far as we know it is the first report that shows the spontaneous regression of breast cancer, probably due to the spontaneously-induced T cell response. PMID:25120822

  17. The use of Raman spectroscopy for the intra-operative assessment of axillary lymph nodes in breast cancer

    NASA Astrophysics Data System (ADS)

    Horsnell, Jonathan

    Breast cancer remains a significant cause of morbidity and mortality. Assessment of the axillary lymph nodes is part of the staging of the disease. Advances in surgical management of breast cancer have seen a move towards intra-operative lymph node assessment that facilitates an immediate axillary clearance if it is indicated. Raman spectroscopy, a technique based on the inelastic scattering of light, has previously been shown to be capable of differentiating between normal and malignant tissue. These results, based on the biochemical composition of the tissue, potentially allow for this technique to be utilised in this clinical context. The aim of this study was to evaluate the facility of Raman spectroscopy to both assess axillary lymph node tissue within the theatre setting and to achieve results that were comparable to other intra-operative techniques within a clinically relevant time frame. Initial experiments demonstrated that these aims were feasible within the context of both the theatre environment and current surgical techniques. A laboratory based feasibility study involving 17 patients and 38 lymph node samples achieved sensivities and specificities of >90% in unsupervised testing. 339 lymph node samples from 66 patients were subsequently assessed within the theatre environment. Chemometric analysis of this data demonstrated sensitivities of up to 94% and specificities of up to 99% in unsupervised testing. The best results were achieved when comparing negative nodes from N0 patients and nodes containing macrometastases. Spectral analysis revealed increased levels of lipid in the negative nodes and increased DNA and protein levels in the positive nodes. Further studies highlighted the reproducibility of these results using different equipment, users and time from excision. This study uses Raman spectroscopy for the first time in an operating theatre and demonstrates that the results obtained, in real-time, are comparable, if not superior, to current intra-operative techniques of lymph nodes assessment.

  18. Optical characterization of ex-vivo axillary lymph nodes of breast-cancer patients using a custom-built spectrophotometer

    NASA Astrophysics Data System (ADS)

    Sampathkumar, Ashwin; Saegusa-Beecroft, Emi; Mamou, Jonathan; Chitnis, Parag V.; Machi, Junji; Feleppa, Ernest J.

    2014-03-01

    Quantitative photoacoustics is emerging as a new hybrid modality to investigate diseases and cells in human pathology and cytology studies. Optical absorption of light is the predominant mechanism behind the photoacoustic effect. Therefore, a need exits to characterize the optical properties of specimens and to identify the relevant operating wavelengths for photoacoustic imaging. We have developed a custom low-cost spectrophotometer to measure the optical properties of human axillary lymph nodes dissected for breast-cancer staging. Optical extinction curves of positive and negative nodes were determined in the spectral range of 400 to 1000 nm. We have developed a model to estimate tissue optical properties, taking into account the role of fat and saline. Our results enabled us to select the optimal optical wavelengths for maximizing the imaging contrast between metastatic and noncancerous tissue in axillary lymph nodes.

  19. Sentinel lymph node biopsy as an indicator for axillary dissection in early breast cancer

    Microsoft Academic Search

    U Veronesi; V Galimberti; S Zurrida; F Pigatto; P Veronesi; C Robertson; G Paganelli; V Sciascia; G Viale

    2001-01-01

    Sentinel node biopsy (SNB) is a new component of the surgical treatment of breast cancer that accurately predicts axillary status. Although the procedure is still mainly investigational, many patients are requesting SNB to avoid axillary dissection if the sentinel node (SN) is negative. From March 1996 to December 1999, 373 patients with breast carcinoma and clinically negative axillary nodes underwent

  20. The detection of axillary lymph node metastases from breast cancer by radiolabelled monoclonal antibodies: a prospective study.

    PubMed

    Tjandra, J J; Sacks, N P; Thompson, C H; Leyden, M J; Stacker, S A; Lichtenstein, M; Russell, I S; Collins, J P; Andrews, J T; Pietersz, G A

    1989-02-01

    In a prospective study to assess the accuracy of monoclonal immunoscintigraphy for the detection of axillary lymph node metastases in breast cancer, two murine monoclonal antibodies that react with human breast cancer (3E1.2 and RCC-1) were labelled with 131iodine, and the radiolabelled antibody was injected subcutaneously into the interdigital spaces of both hands of 40 patients, 36 of whom had breast cancer and the remaining four of whom had fibroadenoma (the normal, contralateral axilla was used as a control). Of the patients with breast cancer, the findings from the scintigraphy images were correlated with histopathology or cytology of the axillary lymph nodes; images were regarded as positive and hence indicative of lymph node metastases if the amount of background-subtracted radioactive count in axilla on the side of breast cancer exceeded the contralateral normal side by a ratio greater than or equal to 1.5:1.0 as assessed by computer analysis. Using this method, immunoscintigraphy had an overall sensitivity of 33% (23% with 131I-3E1.2 and 50% with 131I-RCC-1) for the detection of lymph node metastases and a specificity of 63% (67% with 131I-3E1.2 and 60% with 131I-RCC-1) with problems of non-specific uptake by presumably normal lymph nodes. The results of immunoscintigraphy obtained with 131I-RCC-1 (IgG) were superior to 131I-3E1.2 (IgM) although the accuracy of immunoscintigraphy using 131I-RCC-1 (56%) was not much better than preoperative clinical assessment (50%). However, there were cases when immunoscintigraphy using radiolabelled antibody (IgM or IgG) detected axillary lymph node metastases not suspected by clinical examination. Thus it appears that while immunoscintigraphy may be a useful adjunct to preoperative clinical assessment and is simple and safe, a major improvement in its accuracy is needed before it can replace axillary dissection and histological examination in the accurate staging of axilla in breast cancer. PMID:2930695

  1. Collision metastasis of breast and ovarian adenocarcinoma in axillary lymph nodes: a case report and review of the literature.

    PubMed

    Sughayer, Maher A; Zakarneh, Lama; Abu-Shakra, Raffat

    2009-09-01

    Despite their accepted clinical and genetic association, the incidence of synchronous breast and ovarian carcinoma is rare. Moreover, collision metastasis from both breast and ovarian carcinomas to the same lymph node, to our knowledge has never been reported. Review of the literature revealed eleven cases of metastatic malignant tumors colliding in the same lymph node, none of which had both ovarian and breast carcinoma. Our case was that of a 63 year old woman presenting with a breast lump that was diagnosed as infiltrating ductal carcinoma after a needle biopsy. One month later the patient was found to have malignant ascites, omental carcinomatosis and an ovarian mass. Histology and immunohistochemistry revealed high grade serous papillary adenocarcinoma. When surgery was done to treat the breast tumor some of the axillary lymph nodes revealed metastases from the breast primary, others metastases from the ovarian primary and one had both tumors in a collision phenomenon. Immunohistochemistry was used to confirm this finding. PMID:19067238

  2. Implications of a Postoperative Rehabilitation Program on Quality of Life in Women with Primary Breast Cancer Treated with Sentinel Lymph Node Biopsy or Complete Axillary Lymph Node Dissection

    Microsoft Academic Search

    Marcela Ponzio Pinto e Silva; Luis Otávio Sarian; Sirlei Siani Morais; Maria Teresa Pace do Amaral; Mariana Maia Freire de Oliveira; Sophie Derchain

    2008-01-01

    Background  The aim of this clinical study was to evaluate quality of life (QoL) in early-stage breast cancer patients and to investigate\\u000a the effects of a comprehensive rehabilitation program comparing women undergoing sentinel node biopsy (SNB) versus complete\\u000a axillary lymph node dissection (ALND). QoL was assessed with the Functional Assessment of Cancer Therapy—General and Functional\\u000a Assessment of Cancer Therapy—Breast (FACT-B) questionnaire.

  3. Evaluation of Fluorodeoxyglucose Positron Emission Tomography in the Detection of Axillary Lymph Node Metastases in Patients With Early-Stage Breast Cancer

    Microsoft Academic Search

    Emmanuel Barranger; Dany Grahek; Martine Antoine; Françoise Montravers; Jean-Noel Talbot; Serge Uzan

    2003-01-01

    Background: The aim of this study was to assess the capacity of positron emission tomography (PET) with fluorodeoxyglucose (FDG) to determine\\u000a axillary lymph node status in patients with breast cancer undergoing sentinel node (SN) biopsy.\\u000a \\u000a \\u000a Methods: Thirty-two patients with breast cancer and clinically negative axillary nodes were recruited. All patients underwent FDG-PET\\u000a before SN biopsy. After SN biopsy, all patients

  4. Optimization of a gamma imaging probe for axillary sentinel lymph mapping

    NASA Astrophysics Data System (ADS)

    Georgiou, M.; Loudos, G.; Stratos, D.; Papadimitroulas, P.; Liakou, P.; Georgoulias, P.

    2012-09-01

    Sentinel lymph node (SLN) mapping is a technique for assessing whether early-stage invasive breast cancer has metastasized, thus determining prognosis and treatment options. SLN identification is achieved using the blue-dye and radioactive colloids techniques, which are sometimes combined with lymphoscintigraphy. Furthermore, intra-operative gamma acoustic probes, as well as gamma imaging probes are used during surgery. The purpose of this study is the construction of a gamma probe for sentinel lymph node imaging and its optimization in terms of sensitivity with respect to spatial resolution. The reference probe has small field of view (2.5 × 2.5 cm2) and is based on a position sensitive photomultiplier tube (PSPMT) coupled to a pixellated CsI(Tl) scintillator. Following experimental validation, we simulated the system using the GATE Monte Carlo toolkit (GATE v6.1) and modeled various collimator geometries, in order to evaluate their performance and propose the optimal configuration. The constraints of the proposed gamma imaging probe are i) sensitivity close to 2 cps/kBq and ii) spatial resolution equal to 6 mm at 2 cm source-to-collimator distance and ~ 10 mm at 5 cm. An integrated structure that achieves those requirements is a tungsten collimator with 2 × 2 mm2square holes, 16 mm thickness, 0.15 mm septa, where each CsI(Tl) 2 × 2 × 5 mm3 crystal pixel is placed inside the collimator.

  5. Immunohistochemical detection and significance of axillary lymph node micrometastases in breast carcinoma. A study of 97 cases.

    PubMed

    Elson, C E; Kufe, D; Johnston, W W

    1993-06-01

    Paraffin blocks of all axillary lymph nodes from 97 patients with an initial histologic diagnosis of infiltrating ductal carcinoma and negative axillary nodes were recut and stained with two monoclonal antibodies, AE/AE3 (antikeratin) and DF3 (developed against breast cancer cells and reactive with a glycoprotein tumor-associated antigen). Immunohistochemical staining detected occult micrometastases in 20 patients (20.6%). No patient had more than three lymph nodes involved by tumor. Review of the original hematoxylin and eosin-stained sections revealed that foci of tumor were initially overlooked in nine of these cases (9.3%). In the remaining 11 cases (11.3%) the metastatic foci were encountered in the process of recutting the paraffin blocks for immunohistochemical studies. AE1/AE3 proved to be the more effective of the two antibodies in staining micrometastases. After a mean follow-up period of 5.7 years, no significant decrease in survival or increase in tumor recurrence was detected for patients with occult micrometastases as compared to those patients without micrometastases. PMID:7688511

  6. Predictors of tumour involvement in remaining axillary lymph nodes of breast cancer patients with positive sentinel lymph node

    Microsoft Academic Search

    N. Wada; S. Imoto; C. Yamauchi; T. Hasebe; A. Ochiai

    2006-01-01

    AimsTo characterize the various clinicopathologic features in cases of breast cancer with positive sentinel lymph nodes (SLNs), in order to determine factors that might help in predicting the involvement of the non-SLNs.

  7. Trends in and Outcomes from Sentinel Lymph Node Biopsy (SLNB) Alone vs. SLNB with Axillary Lymph Node Dissection for Node-Positive Breast Cancer Patients: Experience from the SEER Database

    Microsoft Academic Search

    Min Yi; Sharon Hermes Giordano; Funda Meric-Bernstam; Elizabeth A. Mittendorf; Henry M. Kuerer; Rosa F. Hwang; Isabelle Bedrosian; Loren Rourke; Kelly K. Hunt

    2010-01-01

    Background  Complete axillary lymph node dissection (ALND) after a positive sentinel lymph node biopsy (SLNB) remains the standard practice.\\u000a As nodal surgery has long been considered a staging procedure without a clear survival benefit, the need for ALND in all patients\\u000a is debatable. The purpose of this study was to examine differences in survival for patients undergoing SLNB alone versus SLNB

  8. The Role of FDG-PET for Axillary Lymph Node Staging in Primary Breast Cancer

    Microsoft Academic Search

    Flavio Crippa; Alberto Gerali; Alessandra Alessi; Roberto Agresti; Emilio Bombardieri

    PET and PET\\/CT have revealed a good diagnostic accuracy in visualizing both primary cancer and metastatic lesions, and many\\u000a clinical studies demonstrate that they can compete with the morphological conventional diagnostic modalities mainly in staging,\\u000a detecting tumor relapses, evaluating tumor response to therapy and giving useful prognostic indications. Data about the usefulness\\u000a of PET to stage axillary nodes in breast

  9. Sentinel Lymph Node Metastases Detected by Immunohistochemistry Only Do Not Mandate Complete Axillary Lymph Node Dissection in Breast Cancer

    Microsoft Academic Search

    Richard J. Gray; Barbara A. Pockaj; Christopher R. Conley

    2004-01-01

    Background: The significance of breast cancer sentinel lymph node (SLN) metastases detected only by immunohistochemistry staining (IHC)\\u000a remains poorly understood. This study attempted to quantify the risk of non-SLN metastases.\\u000a \\u000a \\u000a Methods: A prospectively collected database of 750 consecutive SLN biopsy procedures in breast cancer patients was reviewed. Medical\\u000a records were reviewed to supplement the database.\\u000a \\u000a \\u000a \\u000a \\u000a Results: SLNs were identified in

  10. Recurrence after sentinel lymph node biopsy with or without axillary lymph node dissection in patients with breast cancer

    Microsoft Academic Search

    Hiroyuki Takei; Kimito Suemasu; Masafumi Kurosumi; Yoshio Horii; Takashi Yoshida; Jun Ninomiya; Miho Yoshida; Yasutaka Hagiwara; Mari Kamimura; Yuji Hayashi; Kenichi Inoue; Toshio Tabei

    2007-01-01

    Background  A regional nodal recurrence is a major concern after a sentinel lymph node biopsy (SLNB) alone in patients with breast cancer.\\u000a In this study we investigated patterns and risk factors of regional nodal recurrence after SLNB alone.\\u000a \\u000a \\u000a \\u000a Patients and Methods  Between January 1999 and March 2005, a series of 1,704 consecutive breast cancer cases in 1,670 patients (34 bilateral breast\\u000a cancer

  11. Efficiency of Ultrasound and Ultrasound-Guided Fine Needle Aspiration Cytology in Preoperative Assessment of Axillary Lymph Node Metastases in Breast Cancer

    PubMed Central

    Demirkazik, Figen Basaran; Akpinar, Meltem Gulsun; Soygur, Is?l; Baykal, Atac; Onder, Sevgen Celik; Uner, Aysegul

    2012-01-01

    Purpose We performed this study to detect preoperative axillary metastases with ultrasound (US)-guided fine needle aspiration biopsy (FNAB), to eliminate the need for time-consuming and costly sentinel lymph node (SLN) scintigraphy and biopsy steps in the treatment of breast cancer patients, and in that of with suspicious US findings, and to evaluate the accuracy of preoperative US-guided FNAB for patients with suspicious lymph node metastases on US. Methods Patients with a suspicious breast lump or histopathologically proven breast cancer underwent breast-axillary US. Increase in lymph node size, cortical thickening, non-hilar cortical flow, and hilar changes were evaluated with gray scale-color Doppler US. FNAB was performed if US results were suspicious for malignancy. Results Thirty-eight axillary lymph nodes (ALN) underwent FNAB. ALN dissection, SLN scintigraphy, and biopsy steps were bypassed in 23 axillas with positive ALN FNAB (60.5%). The sensitivity of ALN FNAB was 88.46%; specificity and positive predictive value were 100%; and negative predictive value was 66.6% (inadequate cytology included; 76.7%, 100%, 100%, 53.3%, respectively). Asymmetrical cortical thickening, non-hilar cortical flow, and increase in hypoechogenity were only detected in metastatic nodes. Cortical thickening, and lymph node and breast mass size was higher in the metastatic group. Conclusion By performing FNAB on suspicious lymph nodes, the routine, high-cost SLN scintigraphy and intraoperative gamma probe steps may be skipped, and axilla dissection can be performed directly. This leads to the elimination of the need for SLN investigation in more than half of the patients. The assessment of ALN metastases with preoperative US-guided FNAB is a cost-effective method with high specificity, that eliminates the need for costly and time-consuming SLN scintigraphy and biopsy steps, and helps in preoperative staging. PMID:22807939

  12. Feasibility of FDG PET\\/CT to monitor the response of axillary lymph node metastases to neoadjuvant chemotherapy in breast cancer patients

    Microsoft Academic Search

    Marieke E. Straver; Tjeerd S. Aukema; Renato A. Valdes Olmos; Emiel J. T. Rutgers; Kenneth G. A. Gilhuijs; Margaret E. Schot; Wouter V. Vogel; Marie-Jeanne T. F. D. Vrancken Peeters

    2010-01-01

    Purpose  The aim of this study was to assess the accuracy of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)\\/CT to visualize lymph node metastases before the start of neoadjuvant\\u000a chemotherapy and to determine how often the visualization is sufficiently prominent to allow monitoring of the axillary response.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Thirty-eight patients with invasive breast cancer of >3 cm and\\/or lymph node metastasis underwent FDG PET\\/CT

  13. Assessment of Axillary Lymph Node Involvement in Breast Cancer Patients With Positron Emission Tomography Using Radiolabeled 2-(Fluorine18)- fluoro-2-deoxy-D-glucose

    Microsoft Academic Search

    Norbert Avril; Jorg Dose; Fritz Jdnicke; Sibylle Ziegler; Wolfgang Romer; Wolfgang Weber; Michael Herz; Walter Nathrath; Henner Graejf; Markus Schwaiger

    Background: The presence of metastatic tumor cells in the axillary lymph nodes is an important factor when deciding whether or not to treat breast cancer patients with adjuvant therapy. Positron emission tomography (PET) imaging with the radiolabeled glucose analogue 2-(fluorine-18)-fluoro-2- deoxy-D-glucose (F-18 FDG) has been used to visualize primary breast tumors as well as bone and soft-tissue metas- tases. Purpose:

  14. Multi-modality computer-aided diagnosis system for axillary lymph node (ALN) staging: segmentation of ALN on ultrasound images

    NASA Astrophysics Data System (ADS)

    Arbash Meinel, Lina; Bergtholdt, Martin; Abe, Hiroyuki; Huo, D.; Buelow, Thomas; Carlsen, Ingwer; Newstead, Gillian

    2009-02-01

    Our goal was to develop and evaluate a reliable segmentation method to delineate axillary lymph node (ALN) from surrounding tissues on US images as the first step of building a multi-modality CADx system for staging ALN. Ultrasound images of 24 ALN from 18 breast cancer patients were used. An elliptical model algorithm was used to fit ALNs boundaries using the following steps: reduce image noise, extract image edges using the Canny edge detector, select edge pixels and fit an ellipse by minimizing the quadratic error, Find the best fitting ellipse based on RANSAC. The segmentation was qualitatively evaluated by 3 expert readers using 4 aspects: Orientation of long axis (OLA): within +- 45 degrees, or off by +-45 degrees, overlap (OV): the fitted ellipse completely included ALN, partially included ALN, or missed the ALN, size (SZ): too small, good within 20% error margin, or too large, and aspect ratio (AR): correct or wrong. Nightly six % of ALNs were correctly evaluated by all readers in terms of OLA and AR, 90.2% in terms of OV and 86.11 in terms of SZ. Readers agreed that the segmentation was correct in 70% of the cases in all aspects. Due to small sample size and small variation among readers, we don't have power to show the accuracy of them is different.

  15. In-vivo detection of tumor-infiltrated axillary lymph nodes with a handheld beta-sensitive probe: a phantom study

    NASA Astrophysics Data System (ADS)

    Raylman, Raymond R.; Derakhshan, Jamal

    2001-05-01

    Sentinel node biopsy utilizing Technetium-99m-labeled sulfur colloid is rapidly becoming a standard part of the surgical treatment of breast cancer. Although this method is effective in identifying sentinel lymph node(s) in the axilla, the non-tumor-specific nature of colloids necessitates removal of the node(s) for subsequent analysis. Tumor-specific radiotracers, such as positron-emitting Fluorine-18-labeled Fluorodeoxyglucose (FDG), have been used with positron emission tomography (PET) to successfully stage breast cancer. Thus, the use of FDG with a handheld probe optimized for detection of beta particles could perhaps help identify cancer-infiltrated nodes during axillary dissection. In this study the ability of a new solid-state beta-sensitive probe to identify tumor- infiltrated lymph nodes was investigated in a phantom study. The axilla and tumor-infiltrated lymph nodes were simulated with gelatin phantoms containing FDG concentrations commonly reported from PET studies. FDG uptake in the organs of a patient was simulated with an anthropomorphic torso phantom. Following examination by the handheld probe, a PET image of the phantom was acquired. The results demonstrated that the probe was capable of identifying lymph nodes containing as little as 10 (mu) l of tumor. This amount of simulated tumor was too small to be detected by the PET scanner. This method, therefore, may be useful in intraoperatively identifying some tumor-infiltrated axillary lymph nodes not detected with PET; potentially increasing the efficiency of axillary dissection. Future clinical trials must be performed to assess the utility of this new technique.

  16. Comparison of Mastoscopic and Conventional Axillary Lymph Node Dissection in Breast Cancer: Long-term Results From a Randomized, Multicenter Trial

    PubMed Central

    Luo, Chengyu; Guo, Wenbin; Yang, Jie; Sun, Qiuru; Wei, Wei; Wu, Suhua; Fang, Shubing; Zeng, Qingliang; Zhao, Zhensheng; Meng, Fanjie; Huang, Xuandong; Zhang, Xianlan; Li, Ruihua; Ma, Xiufeng; Luo, Chaoying; Yang, Yun

    2012-01-01

    Objective To compare the long-term results of mastoscopic axillary lymph node dissection (MALND) and conventional axillary lymph node dissection (CALND). Patients and Methods From January 1, 2003, through December 31, 2005, a group of 1027 consecutive patients with operable breast cancer were randomly assigned to 1 of 2 study groups: MALND and CALND. The median follow-up was 63 months. The primary end points of the study were operative outcomes, complication reduction, function conservation, and cosmetics. The secondary end points were disease-free and overall survival. Results The mean operative blood loss in the MALND group was less than in the CALND group (P<.001). The patients who underwent MALND had less axillary pain, numbness or paresthesias, and arm swelling (P<.001). The aesthetic appearance of the axilla in the MALND group was much better than that in the CALND group (P=.001 at 6 months and P=.002 at 24 months). A significant difference was found between the 2 groups in distant metastasis (P=.04). The disease-free survival rate was 64.5% in the MALND group and 60.8% in the CALND group (P=.88). The overall survival rate was 81.7% in the MALND group and 78.6% in the CALND group (P=.95). Conclusion Compared with CALND, MALND has advantages in operative outcomes, complication reduction, function conservation, and cosmetics. PMID:23146657

  17. Development of Web tools to predict axillary lymph node metastasis and pathological response to neoadjuvant chemotherapy in breast cancer patients.

    PubMed

    Sugimoto, Masahiro; Takada, Masahiro; Toi, Masakazu

    2014-01-01

    Nomograms are a standard computational tool to predict the likelihood of an outcome using multiple available patient features. We have developed a more powerful data mining methodology, to predict axillary lymph node (AxLN) metastasis and response to neoadjuvant chemotherapy (NAC) in primary breast cancer patients. We developed websites to use these tools. The tools calculate the probability of AxLN metastasis (AxLN model) and pathological complete response to NAC (NAC model). As a calculation algorithm, we employed a decision tree-based prediction model known as the alternative decision tree (ADTree), which is an analog development of if-then type decision trees. An ensemble technique was used to combine multiple ADTree predictions, resulting in higher generalization abilities and robustness against missing values. The AxLN model was developed with training datasets (n=148) and test datasets (n=143), and validated using an independent cohort (n=174), yielding an area under the receiver operating characteristic curve (AUC) of 0.768. The NAC model was developed and validated with n=150 and n=173 datasets from a randomized controlled trial, yielding an AUC of 0.787. AxLN and NAC models require users to input up to 17 and 16 variables, respectively. These include pathological features, including human epidermal growth factor receptor 2 (HER2) status and imaging findings. Each input variable has an option of "unknown," to facilitate prediction for cases with missing values. The websites developed facilitate the use of these tools, and serve as a database for accumulating new datasets. PMID:25096734

  18. Diagnostic performance of fluorodeoxyglucose-positron emission tomography\\/computed tomography of breast cancer in detecting axillary lymph node metastasis: comparison with ultrasonography and contrast-enhanced CT

    Microsoft Academic Search

    Shuichi Monzawa; Shuji Adachi; Kayo Suzuki; Koichi Hirokaga; Shintaro Takao; Toshiko Sakuma; Keisuke Hanioka

    2009-01-01

    Purpose  The purpose of this retrospective study was to evaluate the diagnostic performance of positron emission tomography\\/computed\\u000a tomography (PET\\/CT) with fluorine-18–labeled 2-fluoro-2-deoxy-d-glucose (FDG) in comparison with that of ultrasonography and contrast-enhanced computed tomography (CT) in detecting axillary\\u000a lymph node metastasis in patients with breast cancer.\\u000a \\u000a \\u000a \\u000a Materials and methods  Fifty patients with invasive breast cancer were recruited. They had received no neoadjuvant chemotherapy

  19. Breast imaging. Preoperative breast cancer staging: comparison of USPIO-enhanced MR imaging and 18F-fluorodeoxyglucose (FDC) positron emission tomography (PET) imaging for axillary lymph node staging—initial findings

    Microsoft Academic Search

    Tadeusz W. Stadnik; Hendrik Everaert; Smitha Makkat; Robert Sacré; Jan Lamote; Claire Bourgain

    2006-01-01

    Magnetic resonance (MR) imaging after ultra-small super paramagnetic iron oxide (USPIO) injection and 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) for preoperative axillary lymph node staging in patients with breast cancer were evaluated using histopathologic findings as the reference standard. USPIO-enhanced MR and FDG-PET were performed in ten patients with breast cancer who were scheduled for surgery and axillary node resection. T2-weighted

  20. Molecular Detection of Micrometastatic Breast Cancer in Histopathology—Negative Axillary Lymph Nodes Fails to Predict Breast Cancer Recurrence: A Final Analysis of a Prospective Multi-Institutional Cohort Study

    Microsoft Academic Search

    Carla Suzanne Fisher; David J. Cole; Michael Mitas; Elizabeth Garrett-Meyer; John S. Metcalf; William E. Gillanders; Kaidi Mikhitarian; Marshall M. Urist; G. Bruce Mann; Gerard Doherty; Virginia M. Herrmann; Arnold D. Hill; Oleg Eremin; Mohamed El-Sheemy; Richard K. Orr; Alvaro A. Valle; Michael A. Henderson; Robert L. Dewitty; Sonia L. Sugg; Eric Frykberg; Karen Yeh; Richard M. Bell; Megan K. Baker

    2010-01-01

    Background  To address the clinical relevance of molecular detection of occult breast cancer in sentinel lymph nodes and nonsentinel axillary\\u000a lymph nodes (ALN), we initiated the Minimally Invasive Molecular Staging of Breast Cancer (MIMS) trial, a multi-institutional\\u000a prospective cohort study. This trial represents the first prospective cohort study in which a multimarker, real-time reverse\\u000a transcription polymerase chain reaction (RT-PCR) analysis was

  1. Axillary and Extra-axillary Lymph Node Recurrences after a Tumor-Negative Sentinel Node Biopsy for Breast Cancer Using Intralesional Tracer Administration

    Microsoft Academic Search

    Iris M. C. van der Ploeg; Bin B. R. Kroon; Ninja Antonini; Renato A. Valdés Olmos; Emiel J. T. Rutgers; Omgo E. Nieweg

    2008-01-01

    Background  At our institution, tracer fluids are administered in the primary breast cancer and, in addition to the ones in the axilla,\\u000a sentinel nodes outside the axilla are rigorously pursued. The objective of the present study of sentinel node-negative breast\\u000a cancer patients was to determine the lymph node recurrence rates in the axilla and elsewhere, the false-negative rates, and\\u000a the survival.

  2. A false-positive finding in therapeutic evaluation: hypermetabolic axillary lymph node in a lymphoma patient following FDG extravasation.

    PubMed

    Wagner, Thomas; Brucher, Nicolas; Julian, Anne; Hitzel, Anne

    2011-01-01

    We report a case of a false-positive finding in FDG PET/CT following radiotracer extravasation. A 15-year-old male patient was referred for therapeutic evaluation status post-chemotherapy for a lymphoblastic lymphoma. FDG PET/CT showed discordant findings with a marked decrease in a liver/hepatic hilum uptake, disappearance of a subcutaneous left supraclavicular uptake, and appearance of intense right axillary nodal uptake. Extravasation in the right superior limb was noted. Comparison with the previous scan showed that the axillary nodes were present, measured less than 1 cm in their short axis, had not increased in size, and had a fatty hilum. We concluded that FDG uptake was caused by a migration in lymphatic vessels. PMID:22219152

  3. Collision Metastasis of Breast and Ovarian Adenocarcinoma in Axillary Lymph Nodes: A Case Report and Review of the Literature

    Microsoft Academic Search

    Maher A. Sughayer; Lama Zakarneh; Raffat Abu-Shakra

    2009-01-01

    Despite their accepted clinical and genetic association, the incidence of synchronous breast and ovarian carcinoma is rare.\\u000a Moreover, collision metastasis from both breast and ovarian carcinomas to the same lymph node, to our knowledge has never\\u000a been reported. Review of the literature revealed eleven cases of metastatic malignant tumors colliding in the same lymph node,\\u000a none of which had both

  4. Risk of node metastasis of sentinel lymph nodes detected in level II/III of the axilla by single-photon emission computed tomography/computed tomography

    PubMed Central

    SHIMA, HIROAKI; KUTOMI, GORO; SATOMI, FUKINO; MAEDA, HIDEKI; TAKAMARU, TOMOKO; KAMESHIMA, HIDEKAZU; OMURA, TOSEI; MORI, MITSURU; HATAKENAKA, MASAMITSU; HASEGAWA, TADASHI; HIRATA, KOICHI

    2014-01-01

    In breast cancer, single-photon emission computed tomography/computed tomography (SPECT/CT) shows the exact anatomical location of sentinel nodes (SN). SPECT/CT mainly exposes axilla and partly exposes atypical sites of extra-axillary lymphatic drainage. The mechanism of how the atypical hot nodes are involved in lymphatic metastasis was retrospectively investigated in the present study, particularly at the level II/III region. SPECT/CT was performed in 92 clinical stage 0-IIA breast cancer patients. Sentinel lymph nodes are depicted as hot nodes in SPECT/CT. Patients were divided into two groups: With or without hot node in level II/III on SPECT/CT. The existence of metastasis in level II/III was investigated and the risk factors were identified. A total of 12 patients were sentinel lymph node biopsy metastasis positive and axillary lymph node dissection (ALND) was performed. These patients were divided into two groups: With and without SN in level II/III, and nodes in level II/III were pathologically proven. In 11 of the 92 patients, hot nodes were detected in level II/III. There was a significant difference in node metastasis depending on whether there were hot nodes in level II/III (P=0.0319). Multivariate analysis indicated that the hot nodes in level II/III and lymphatic invasion were independent factors associated with node metastasis. There were 12 SN-positive patients followed by ALND. In four of the 12 patients, hot nodes were observed in level II/III. Two of the four patients with hot nodes depicted by SPECT/CT and metastatic nodes were pathologically evident in the same lesion. Therefore, the present study indicated that the hot node in level II/III as depicted by SPECT/CT may be a risk of SN metastasis, including deeper nodes. PMID:25289038

  5. Primary Tumor Response to Induction Chemotherapy as a Predictor of Histological Status of Axillary Nodes in Operable Breast Cancer Patients

    Microsoft Academic Search

    Jeffrey T. Lenert; Georges Vlastos; Nadem Q. Mirza; David J. Winchester; Susanne M. Binkley; Fred C. Ames; Merrick I. Ross; Barry W. Feig; Kelly K. Hunt; Eric Strom; Aman U. Buzdar; Gabriel N. Hortobagyi; S. Eva Singletary

    1999-01-01

    Background: Routine use of axillary lymph node dissection is being questioned, especially in clinically N0 patients. The goal of this study was to determine whether primary tumor response to induction chemotherapy (IC) can predict the histological volume of residual axillary disease in patients who were candidates for breast conservation surgery after IC.Methods: Forty-seven patients with stage II or IIIA breast

  6. Fine-Needle Aspirate CYFRA 21-1, an Innovative New Marker for Diagnosis of Axillary Lymph Node Metastasis in Breast Cancer Patients.

    PubMed

    Choi, Ji Soo; Han, Kyung Hwa; Kim, Eun-Kyung; Moon, Hee Jung; Yoon, Jung Hyun; Kim, Min Jung

    2015-05-01

    To compare the value of cytokeratin fragment 21-1 (CYFRA 21-1) concentration in the fine-needle biopsy aspirates (fine needle aspirate [FNA] CYFRA 21-1) with cytopathology of fine-needle aspiration biopsy (FNA cytology) and to assess whether CYFRA 21-1 concentrations from ultrasound-guided fine-needle aspiration biopsy (US-FNAB) specimens (FNA CYFRA 21-1) is not inferior to FNA cytology in the diagnosis of axillary lymph node (ALN) metastasis of breast cancer patients.This study received institutional review board approval, and written informed consent was obtained from all patients. US-FNAB was performed in 373 ALNs from 358 patients with invasive breast cancer. Concentrations of CYFRA 21-1 were measured from washouts of the syringe used during US-FNAB (FNA CYFRA 21-1), and ALN metastasis was determined using a cutoff value of 1.93?ng/mL. FNA cytology, intraoperative sentinel lymph node biopsy, and surgical pathology results were reviewed and analyzed. The noninferiority margin for the difference in accuracies between FNA cytology and FNA CYFRA 21-1 was set as 5%.Among 373 ALNs, 136 (36.5%) were benign, and 237 (63.5%) were metastatic. The mean FNA CYFRA 21-1 was significantly higher in metastatic ALNs compared to that in benign ALNs (P?=?0.001). For the diagnosis of ALN metastasis, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of FNA CYFRA 21-1 (cutoff value 1.93?ng/mL) were not significantly different from those of FNA cytology (P?>?0.05). FNA CYFRA 21-1 reached statistical noninferiority to FNA cytology in terms of diagnostic accuracy for ALN metastasis. Of the 20 ALNs (8 metastasis, 12 benign) that showed insufficient results on FNA cytology, FNA CYFRA 21-1 accurately diagnosed 15 ALNs (4 metastasis, 11 benign).The diagnostic performance of FNA CYFRA 21-1 is comparable with that of FNA cytology for breast cancer ALN metastasis. Our results indicate that FNA CYFRA 21-1, using an US-FNAB specimen, can be a useful method equal to FNA cytology in terms of diagnostic accuracy. PMID:25984666

  7. Axillary Lymph Node-to-Primary Tumor Standard Uptake Value Ratio on Preoperative 18F-FDG PET/CT: A Prognostic Factor for Invasive Ductal Breast Cancer

    PubMed Central

    Kim, Young Hwan; Yoon, Hai-Jeon; Kim, Yemi

    2015-01-01

    Purpose This study assessed the axillary lymph node (ALN)-to-primary tumor maximum standard uptake value (SUVmax) ratio (ALN/T SUV ratio) in invasive ductal breast cancer (IDC) on preoperative 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) to determine the effectiveness in predicting recurrence-free survival (RFS). Methods One hundred nineteen IDC patients (mean age, 50.5±10.5 years) with pathologically proven ALN involvement without distant metastasis and preoperative FDG PET/CT were enrolled in the study. SUVmax values of the ALN and primary tumor were obtained on FDG PET/CT, and ALN/T SUV ratio was calculated. Several factors were evaluated for their effectiveness in predicting RFS. These included several parameters on FDG PET/CT as well as several clinicopathological parameters: pathologic tumor/node stage; nuclear and histological grade; hormonal state; status with respect to human epidermal growth factor receptor 2, mindbomb E3 ubiquitin protein ligase 1 (MIB-1), and p53; primary tumor size; and ALN size. Results Among 119 patients with breast cancer, 17 patients (14.3%) experienced relapse during follow-up (mean follow-up, 28.4 months). The ALN/T SUV ratio of the group with disease recurrence was higher than that of the group without recurrence (0.97±1.60 and 0.45±0.40, respectively, p=0.005). Univariate analysis showed that the primary tumor SUVmax, ALN SUVmax, ALN/T SUV ratio, ALN status, nuclear and histological grade, estrogen receptor (ER) status, and MIB-1 status were predictors for RFS. Among these variables, ALN/T SUV ratio with hazard ratio of 4.20 (95% confidence interval [CI], 1.74-10.13) and ER status with hazard ratio of 4.33 (95% CI, 1.06-17.71) were predictors for RFS according to multivariate analysis (p=0.002 and p=0.042, respectively). Conclusion Our study demonstrated that ALN/T SUV ratio together with ER status was an independent factor for predicting relapse in IDC with metastatic ALN. ALN/T SUV ratio on preoperative FDG PET/CT may be a useful marker for selecting IDC patients that need adjunct treatment to prevent recurrence. PMID:26155294

  8. Axillary reverse mapping for breast cancer

    Microsoft Academic Search

    Masakuni Noguchi

    2010-01-01

    The axillary reverse mapping (ARM) technique has been developed to map and preserve arm lymphatic drainage during axillary\\u000a lymph node dissection (ALND) and\\/or sentinel lymph node (SLN) biopsy, thereby minimizing arm lymphedema. However, several\\u000a problems remain to be resolved in the practical application of this technique. This article presents a review of current knowledge\\u000a regarding ARM and discusses the practical

  9. Cranial location of level II lymph nodes in laryngeal cancer: Implications for elective nodal target volume delineation

    Microsoft Academic Search

    Petra M.. Braam; Cornelis P. J. Raaijmakers; Chris H. J. Terhaard

    2007-01-01

    Purpose: To analyze the cranial distribution of level II lymph nodes in patients with laryngeal cancer to optimize the elective radiation nodal target volume delineation. Methods and Materials: The most cranially located metastatic lymph node was delineated in 67 diagnostic CT data sets. The minimum distance from the base of the skull (BOS) to the lymph node was determined. Results:

  10. Epitrochlear Lymph Node Dissection

    Microsoft Academic Search

    Steven N. Hochwald; Nicole Kissane; Stephen R. Grobmyer; James Lopes

    2011-01-01

    Epitrochlear node involvement occurs in a small minority of patients with forearm or hand melanoma. Although in-transit sentinel\\u000a lymph nodes are identified infrequently, they contain metastatic disease at nearly the same frequency as sentinel lymph nodes\\u000a in cervical, axillary, and inguinal nodal basins. Positive in-transit sentinel lymph nodes are likely to be the only site\\u000a of nodal metastasis. Therefore, detailed

  11. [Prophylactic axillary radiotherapy for breast cancer].

    PubMed

    Rivera, S; Louvel, G; Rivin Del Campo, E; Boros, A; Oueslati, H; Deutsch, É

    2015-06-01

    Adjuvant radiotherapy, after breast conserving surgery or mastectomy for breast cancer, improves overall survival while decreasing the risk of recurrence. However, prophylactic postoperative radiotherapy of locoregional lymph nodes for breast cancer, particularly of the axillary region, is still controversial since the benefits and the risks due to axillary irradiation have not been well defined. To begin with, when performing conformal radiotherapy, volume definition is crucial for the analysis of the risk-benefit balance of any radiation treatment. Definition and contouring of the axillary lymph node region is discussed in this work, as per the recommendations of the European Society for Radiotherapy and Oncology (ESTRO). Axillary recurrences are rare, and the recent trend leads toward less aggressive surgery with regard to the axilla. In this literature review we present the data that lead us to avoid adjuvant axillary radiotherapy in pN0, pN0i+ and pN1mi patients even without axillary clearance and to perform it in some other situations. Finally, we propose an update about the potential toxicity of adjuvant axillary irradiation, which is essential for therapeutic decision-making based on current evidence, and to guide us in the evolution of our techniques and indications of axillary radiotherapy. PMID:26044178

  12. Individual Surgeon, Pathologist, and Other Factors Affecting Lymph Node Harvest in Stage II Colon Carcinoma. Is a Minimum of 12 Examined Lymph Nodes Sufficient?

    Microsoft Academic Search

    Luca Stocchi; Victor W. Fazio; Ian Lavery; Jeff Hammel

    2011-01-01

    Background  Insufficient lymph node harvest in presumed stage II colon carcinomas can result in understaging and worsened cancer outcomes.\\u000a The purpose of this study was to evaluate factors affecting the number of lymph node examined, their corresponding impact\\u000a on cancer outcomes, and the optimal number of examined nodes with reference to the standard of 12.\\u000a \\u000a \\u000a \\u000a \\u000a Materials and Methods  We evaluated all patients

  13. Postmastectomy irradiation in breast in breast cancer patients with T1-2 and 1-3 positive axillary lymph nodes: Is there a role for radiation therapy?

    PubMed Central

    2011-01-01

    Background We aimed to evaluate retrospectively the correlation of loco-regional relapse (LRR) rate, distant metastasis (DM) rate, disease free survival (DFS) and overall survival (OS) in a group of breast cancer (BC) patients who are at intermediate risk for LRR (T1-2 tumor and 1-3 positive axillary nodes) treated with or without postmastectomy radiotherapy (PMRT) following modified radical mastectomy (MRM). Methods Ninety patients, with T1-T2 tumor, and 1-3 positive nodes who had undergone MRM received adjuvant systemic therapy with (n = 66) or without (n = 24) PMRT. Patient-related characteristics (age, menopausal status, pathological stage/tumor size, tumor location, histology, estrogen/progesterone receptor status, histological grade, nuclear grade, extracapsular extension, lymphatic, vascular and perineural invasion and ratio of involved nodes/dissected nodes) and treatment-related factors (PMRT, chemotherapy and hormonal therapy) were evaluated in terms of LRR and DM rate. The 5-year Kaplan-Meier DFS and OS rates were analysed. Results Differences between RT and no-RT groups were statistically significant for all comparisons in favor of RT group except OS: LRR rate (3%vs 17%, p = 0.038), DM rate (12% vs 42%, p = 0.004), 5 year DFS (82.4% vs 52.4%, p = 0.034), 5 year OS (90,2% vs 61,9%, p = 0.087). In multivariate analysis DM and lymphatic invasion were independent poor prognostic factors for OS. Conclusion PMRT for T1-2, N1-3 positive BC patients has to be reconsidered according to the prognostic factors and the decision has to be made individually with the consideration of long-term morbidity and with the patient approval. PMID:21450076

  14. Axillary lymphadenectomy for breast cancer – the influence of shoulder mobilisation on lymphatic drainage

    Microsoft Academic Search

    M. Christodoulakis; E. Sanidas; E. de Bree; J. Michalakis; E. Volakakis; D. Tsiftsis

    2003-01-01

    Aim: The purpose of the present study was to study the influence of external axillary compression dressing with immobilisation of the ipsilateral shoulder after axillary lymph node dissection (ALND) on postoperative axillary drainage.Methods: One hundred consecutive women with breast cancer undergoing ALND were enrolled in this study. They were allowed free shoulder movement and were compared with a matched historical

  15. Sentinel lymph node detection ex vivo using

    E-print Network

    Wang, Lihong

    - tinel lymph nodes in breast cancer staging in vivo. © 2008 Society of Photo-Optical Instrumentation biopsy; breast cancer; axillary lymph node dissection; speckle contrast; acoustic bursts. Paper 07492LRSentinel lymph node detection ex vivo using ultrasound-modulated optical tomography Chulhong Kim

  16. Prognostic, predictive abilities and concordance of BCL2 and TP53 protein expression in primary breast cancers and axillary lymph-nodes: a retrospective analysis of the Belgian three arm study evaluating anthracycline vs CMF adjuvant chemotherapy.

    PubMed

    Bozovic-Spasojevic, Ivana; Ameye, Lieveke; Paesmans, Marianne; Larsimont, Denis; Di Leo, Angelo; Dolci, Stella; Piccart, Martine; de Azambuja, Evandro; Loi, Sherene

    2014-08-01

    Given recent data on genetic heterogeneity within and individual's tumor, we investigated if there were differences in the prognostic and predictive abilities of BCL2 and TP53 protein expression in primary breast cancer (TU) and corresponding axillary lymph-nodes (LN). We used patient samples from the adjuvant Belgian three-arm study which randomized between anthracycline containing regimens and traditional CMF. The endpoints analyzed were overall survival (OS), event-free survival (EFS) and interactions between chemotherapy regimens. At a median follow-up of 15.6 years, BCL2 and TP53 (in both TU and LN) were significantly associated with OS but only in the first 5 years. Likewise, BCL2 and TP53 (in both TU and LN) were associated with EFS in the first 2 years after randomization, with no association after 2 years. BCL2 and TP53 remained statistically significant after adjustment for the standard clinical-pathological characteristics in regard to OS and EFS in the respective first years after randomization, (p value < 0.001 for both markers). Furthermore, an interaction was found between high BCL2 expression in the TU (but not in LN) and benefit to CMF over anthracycline-based chemotherapy (interaction p value EFS: 0.042; OS = 0.01). No interaction was found for TP53 expression neither in TU nor in LN. We conclude that BCL2 and TP53 were predictive biomarkers for better and worse survival respectively, but only in the first two to five years after diagnosis. BCL2 expression in the TU but not in the LN was predictive of increased benefit to CMF vs anthracycline-based chemotherapy. PMID:24768477

  17. Cranial location of level II lymph nodes in laryngeal cancer: Implications for elective nodal target volume delineation

    SciTech Connect

    Braam, Petra M. [Department of Radiotherapy, University Medical Center Utrecht, Utrecht (Netherlands)]. E-mail: P.M.Braam@umcutrecht.nl; Raaijmakers, Cornelis P.J. [Department of Radiotherapy, University Medical Center Utrecht, Utrecht (Netherlands); Terhaard, Chris [Department of Radiotherapy, University Medical Center Utrecht, Utrecht (Netherlands)

    2007-02-01

    Purpose: To analyze the cranial distribution of level II lymph nodes in patients with laryngeal cancer to optimize the elective radiation nodal target volume delineation. Methods and Materials: The most cranially located metastatic lymph node was delineated in 67 diagnostic CT data sets. The minimum distance from the base of the skull (BOS) to the lymph node was determined. Results: A total of 98 lymph nodes were delineated including 62 ipsilateral and 36 contralateral lymph nodes. The mean ipsilateral and contralateral distance from the top of the most cranial metastatic lymph node to the BOS was 36 mm (range, -9-120; standard deviation [SD], 17.9) and 35 mm (range, 14-78; SD 15.0), respectively. Only 5% and 12% of the ipsilateral and 3% and 9% of the contralateral metastatic lymph nodes were located within 15 mm and 20 mm below the BOS, respectively. No significant differences were found between patients with only ipsilateral metastatic lymph nodes and patients with bilateral metastatic lymph nodes. Between tumors that do cross the midline and those that do not, no significant difference was found in the distance of the most cranial lymph node to the BOS and the occurrence ipsilateral or contralateral. Conclusions: Setting the cranial border of the nodal target volume 1.5 cm below the base of the skull covers 95% of the lymph nodes and should be considered in elective nodal irradiation for laryngeal cancer. Bilateral neck irradiation is mandatory, including patients with unilateral laryngeal cancer, when elective irradiation is advised.

  18. Impact of breast MRI on surgical treatment, axillary approach, and systemic therapy for breast cancer.

    PubMed

    Mameri, Claudia S; Kemp, Claudio; Goldman, Suzan M; Sobral, Luiz A; Ajzen, Sergio

    2008-01-01

    The purpose of this study is to determine how often breast magnetic resonance imaging (MRI) brings additional information that influences management of patients with breast cancer concerning surgical treatment, axillary lymph node approach, and systemic therapy. From July 2004 to July 2005, 99 patients recently diagnosed with breast cancer in clinical stages 0, I, and II were prospectively evaluated about their therapeutic plans, at first based on usual protocol (physical examination, mammography and ultrasound) and next going through bilateral breast MR. Examinations were carried out at 1.5 T on five sequences of FSPGR 3D for 90 seconds (four post-gadolinium diethylenetriaminepenta acetic acid 0.16 mM/Kg). Parameters analyzed on MRI were extension of primary lesion; detection of multifocality, multicentricity, or contra lateral lesion; muscular or skin involvement; and presence of lymph node involvement. Pathologic confirmation of additional lesions was achieved by core or excisional biopsy. MRI made 69 additional findings in 53 patients. Fifty-one findings were true-positives (51/69 = 73.9%) including 16 larger single lesions; 18 cases of multifocality; 7 cases of multicentricity; 3 cases of contra lateral lesion; 5 cases of lymph node involvement (one of them involved medial thoracic chain); 1 with muscular involvement; 1 with skin involvement. MRI has changed previous management plans in 44.4% of 99 patients. We observed increase in mastectomies (26.8%) on axillary lymph node dissection (25%) and changes on systemic therapy (20.2%), all because of additional MRI true-positive findings. Breast MRI alters significantly the rate of mastectomy, the approach of axillary chain for staging, and the use of systemic therapy because of its accuracy in evaluating breast cancer local extent. PMID:18476882

  19. Pathology Case Study: Enlarged Axillary Lymph Node

    NSDL National Science Digital Library

    Contis, Lydia C.

    This is a case study presented by the University of Pittsburgh Department of Pathology, which describes a 73 year old female who had a history of thyroidectomy for benign nodules who presented with a lump in her thyroidectomy scar. Visitors are given a patient history, microscopic description, and immunohistochemistry, including images. They are also given an opportunity to diagnose the patient before clicking on the "Final Diagnosis" section, which provides a discussion of the findings as well as references. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in hematopatholgy.

  20. Treatment and prognosis for retrograde cervical lymph node metastases in breast cancer

    PubMed Central

    Qin, Rong; Zhang, Qiaoyu; Weng, Jianfeng; Liu, Weiping; Zhang, Bo; Lv, Gang; Wang, Yi; Wu, Youjun

    2015-01-01

    Metastasis in axillary and supraclavicular lymph nodes has been frequently observed in patients with breast cancer. The clinical staging and therapeutic principle determined according to the situation of lymph node metastasis are clear. One patient with infiltrating ductal carcinoma of the left breast was reported to undergo modified radical mastectomy. One and a half years later, lymphadenectasis was observed in area II, III, IV, V and VI of the left neck; therefore, cervical lymphadenectomy was performed under cervical plexus anesthesia, indicating lymph node metastatic adenocarcinoma (21/26). The patient took 10 mg tamoxifen twice per day for five years after lymphadenectomy and the review showed negative results in liver, lungs, mediastinum, neck and contralateral breast. This suggested that although breast cancer complicated with retrograde cervical lymph node metastases is rare, timely surgery is required even if the patient is in a good general condition, to avoid „delayed therapy” due to misjudgment of illness simply according to disease staging. PMID:26034395

  1. Epitrochlear sentinel lymph nodes in melanoma: interval or independent?

    PubMed

    Kidner, Travis B; Yoon, Jeong L; Faries, Mark B; Morton, Donald L

    2012-06-01

    Most primary melanomas on the distal upper extremity metastasize to a sentinel lymph node (SLN) in the axillary basin, but occasionally a primary melanoma will drain to the epitrochlear basin. The relationship between tumor-draining axillary and epitrochlear SLNs is unclear. We hypothesize that the epitrochlear SLN functions in an interval manner with the axillary lymph node basin. We queried our melanoma database to identify patients who underwent SLN biopsy for a distal upper-extremity melanoma. Patient demographics, tumor characteristics, patterns of nodal drainage, and incidence of SLN metastasis were analyzed. Of 255 patients identified, 38 (14.9%) had an epitrochlear SLN. Mean Breslow thickness was 2.26 mm. All patients with epitrochlear drainage had concurrent axillary drainage and underwent axillary and epitrochlear SLN biopsies. Of these 38 patients, two (5.2%) had epitrochlear and axillary SLN metastasis, four (10.5%) had epitrochlear metastasis only, four (10.5%) had axillary metastasis only, and the remaining 28 (73.7%) had tumor-free SLNs. The invariable association of epitrochlear and axillary drainage in this study suggests that epitrochlear nodes function in an interval role with the axillary lymph node basin. Therefore we recommend that all patients with a positive epitrochlear SLN undergo completion axillary dissection. PMID:22643268

  2. Epitrochlear Sentinel Lymph Nodes in Melanoma: Interval or Independent?

    PubMed Central

    Kidner, Travis; Yoon, Jeong; Faries, Mark; Morton, Donald

    2012-01-01

    Most primary melanomas on the distal upper extremity metastasize to a sentinel lymph node (SLN) in the axillary basin, but occasionally a primary melanoma will drain to the epitrochlear basin. The relationship between tumor-draining axillary and epitrochlear SLNs is unclear. We hypothesize that the epitrochlear SLN functions in an interval manner with the axillary lymph node basin. We queried our melanoma database to identify patients who underwent SLN biopsy for a distal upper-extremity melanoma. Patient demographics, tumor characteristics, patterns of nodal drainage and incidence of SLN metastasis were analyzed. Of 255 patients identified, 38 (14.9%) had an epitrochlear SLN. Mean Breslow thickness was 2.26 mm. All patients with epitrochlear drainage had concurrent axillary drainage and underwent axillary and epitrochlear SLN biopsies. Of these 38 patients, two (5.2%) had epitrochlear and axillary SLN metastasis, four (10.5%) had epitrochlear metastasis only, four (10.5%) had axillary metastasis only, and the remaining 28 (73.7%) had tumor-free SLNs. The invariable association of epitrochlear and axillary drainage in this study suggests that epitrochlear nodes function in an interval role with the axillary lymph node basin. Therefore we recommend that all patients with a positive epitrochlear SLN undergo completion axillary dissection. PMID:22643268

  3. Axillary lump: an unusual presentation of fat necrosis in the breast.

    PubMed

    Donuru, A; Obaid, H; Al Attar, M; Kandula, V; Purnell, D

    2007-10-01

    The clinical presentation of an axillary lump, in majority of cases, raises suspicion of an enlarged lymph node due to malignant causes. In this case report, we established a diagnosis of an axillary lump caused by fat necrosis. We present this case report with review of the literature to familiarize clinicians with this condition. PMID:17875154

  4. Intramammary lymph nodes and breast cancer: a marker for disease severity, or just another lymph node?

    Microsoft Academic Search

    Amber A. Guth; Cecilia Mercado; Daniel F. Roses; Karen Hiotis; Kristin Skinner; Thomas Diflo; Joan Cangiarella

    2006-01-01

    BackgroundAxillary lymph node status is still considered the most significant prognostic factor for breast cancer outcome, and treatment decisions are based on the presence or absence of nodal disease. Intramammary lymph nodes (IMLNs) can be a site of regional spread. Is this a marker for more aggressive disease?

  5. Non-sentinel lymph node metastases associated with isolated breast cancer cells in the sentinel node

    Microsoft Academic Search

    Carolien H. M. van Deurzen; M. de Boer; E. M. Monninkhof; P. Bult; E. van der Wall; V. C. Tjan-Heijnen; P. J. van Diest

    2008-01-01

    There are many reports on the frequency of non-sentinel lymph node involvement when isolated tumor cells are found in the sentinel node, but results and recommendations for the use of an axillary lymph node dissection differ among studies. This systematic review was conducted to give an overview of this issue and to provide recommendations for the use of an axillary

  6. Sentinel lymphadenectomy in breast cancer: identification of sentinel lymph node and detection of metastases

    Microsoft Academic Search

    Masakuni Noguchi; Koichiro Tsugawa; Etsuro Bando; Futoshi Kawahara; Koichi Miwa; Kunihiko Yokoyama; Ken-ichi Nakajima; Norihisa Tonami

    1999-01-01

    Sentinel lymphadenectomy is a useful way of assessing axillary status and obviating axillary dissection in patients with node-negative breast cancer. However, controversies remain concerning the optimal method to identify the sentinel lymph node (SLN) and detect micrometastases in this lymph node. We reviewed the literature concerning sentinel lymphadenectomy in breast cancer and reached the following conclusions: (a) A combination of

  7. Handheld array-based photoacoustic probe for guiding needle biopsy of sentinel lymph nodes

    E-print Network

    Wang, Lihong

    lymph nodes for cancer staging and metastasis detection in humans. © 2010 Society of Photo cancer, replacing axillary lymph node dissection. Biopsy of the lymph nodes directly draining the tumorHandheld array-based photoacoustic probe for guiding needle biopsy of sentinel lymph nodes Chulhong

  8. Tattoo Pigment Mimics Positive Sentinel Lymph Node in Melanoma

    Microsoft Academic Search

    M. Moehrle; H. J. Blaheta; P. Ruck

    2001-01-01

    A 42-year-old man with metastasizing melanoma from an unknown primary is presented. Initially a subcutaneous metastasis in the scapular region and a single lung metastasis were resected. Thorough examinations did not show any evidence of a primary tumour. From the site of the metastasis on the right scapular region, lymphoscintigraphy with axillary sentinel lymph node biopsy was performed. One axillary

  9. Consensus on the regional lymph nodes irradiation in breast cancer.

    PubMed

    Bayo, E; Herruzo, I; Arenas, M; Algara, M

    2013-10-01

    Standard locoregional treatment of early-stage breast cancer currently consists of the conservative surgery and sentinel lymph node biopsy. In the event of positive sentinel node biopsy, an axillary level I-II lymphadenectomy should be carried out. However, recent publications have increasingly supported a tendency not to apply the surgical lymphadenectomy, but simultaneously, it has been developed a new role of regional radiotherapy, even if there is only 1-3 axillary lymph nodes involved. Given these new trends, radiation oncologists are facing the dilemma with regard to deciding about regional irradiation of breast cancer. For such purpose, The Spanish Group of Breast Cancer Radiation Oncology (GEORM as per its Spanish acronym) decided to reach a consensus to issue the respective guidelines for such types of cases. GEORM Managing Commission, gathering 13 members of different Spanish regional communities, issued a questionnaire including different clinical situations. These questions were set as key questions seeking responses, which were answered by 66 % out of the 75 members of the group. Following the response, the guidelines were drafted based on the replies to the mentioned questionnaire. All the respective issues were discussed by means of a virtual platform. In this article, we show the levels of consensus for different clinical situations, depending on the number of nodes involved and the type of surgical procedure performed on the axillary lymph nodes. The ongoing evolution of the oncological treatments obliges the radiation oncologists to take decisions without any existing clarifying evidence, and therefore, the consensus is necessary, which can assist in the decision-making process by the practitioners in such kinds of clinical situations. PMID:23519538

  10. Radioguided lymph node biopsy of a chemoresistant lymph node detected on interim FDG PET-CT in Hodgkin lymphoma

    Microsoft Academic Search

    Tamás Györke; Attila Kollár; Gyula Bottlik; Ágota Szepesi; Imre Bodó; Tamás Masszi; Viktor Bérczi; Ildikó Garai

    2011-01-01

    A 32-year-old male patient was diagnosed with nodular lymphocyte-predominant Hodgkin lymphoma. Staging FDG PET-CT detected\\u000a a large right axillary lymph node conglomerate and splenic manifestation. Interim PET-CT following two cycles of ABVD chemotherapy\\u000a revealed good metabolic response with the exception of a single axillary lymph node. A second “interim” PET-CT after two further\\u000a cycles showed a similar result. A biopsy

  11. Combined ipsilateral neck and axillary lymphadenectomy for metastatic skin cancers: a case series and surgical tips.

    PubMed

    Goodenough, J; Martin, H; Shaaban, H

    2013-08-01

    In the absence of distant disease simultaneous skin cancer metastasis to neck and axillary lymph nodes necessitates both an axillary and neck en block lymphadenectomy. A combined ipsilateral neck and axillary lymph node dissection should involve an in-continuity dissection through the cervicoaxillary canal for optimal lymphatic and oncological clearance. Review of the literature reveals little published instruction on the procedure since the radical surgery performed by Bowden over 50 years ago. We present 4 cases where ipsilateral axillary and neck lymph node dissections were performed for metastatic melanoma and a case of apical axillary node dissection via a neck incision approach. Our surgical tips include performing apical axillary node dissection via the neck incision and consideration of clavicular osteotomy or clavicular excision. A transclavicular approach was taken in one patient who had an excellent functional outcome after a plate and screw fixation. One elderly patient required a middle third claviculectomy which reduced shoulder elevation but was not associated with functional impairment. We conclude the surgery is safe and associated with the usual morbidity ascribed with either an axillary or neck dissection undertaken in isolation. However, patients have a significant risk of disease relapse as would be expected due to the duel metastatic sites, multiple lymph node and neck involvement which are known to be independent poor prognostic factors on melanoma survival and relapse. PMID:23664381

  12. Some Women May Not Need More Extensive Lymph Node Surgery for Breast Cancer

    Cancer.gov

    Results from a randomized clinical trial published February 9, 2011, in the Journal of the American Medical Association demonstrate that axillary lymph node dissection provided no additional survival benefit when compared with sentinel lymph node biopsy in women with small breast tumors and minimal lymph node metastasis who were treated with lumpectomy, whole-breast radiotherapy, and adjuvant systemic therapy.

  13. Elastic scattering spectroscopy for intraoperative determination of sentinel lymph node status in the breast

    E-print Network

    Bigio, Irving J.

    depends on establishing whether or not the cancer has spread to the lymph nodes under the arm incidence of up to 1 in 8 women. The presence or absence of metastatic cancer in the axillary lymph nodesElastic scattering spectroscopy for intraoperative determination of sentinel lymph node status

  14. Volume-Based Parameters of {sup 18}F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Improve Disease Recurrence Prediction in Postmastectomy Breast Cancer Patients With 1 to 3 Positive Axillary Lymph Nodes

    SciTech Connect

    Nakajima, Naomi, E-mail: haruhi0321@gmail.com [Department of Radiation Oncology, National Hospital Organization Shikoku Cancer Center, Ehime (Japan); Department of Radiology, Ehime University, Ehime (Japan); Kataoka, Masaaki [Department of Radiation Oncology, National Hospital Organization Shikoku Cancer Center, Ehime (Japan); Sugawara, Yoshifumi [Department of Diagnostic Radiology, National Hospital Organization Shikoku Cancer Center, Ehime (Japan); Ochi, Takashi [Department of Radiology, Ehime University, Ehime (Japan); Kiyoto, Sachiko; Ohsumi, Shozo [Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, Ehime (Japan); Mochizuki, Teruhito [Department of Radiology, Ehime University, Ehime (Japan)

    2013-11-15

    Purpose: To determine whether volume-based parameters on pretreatment {sup 18}F-fluorodeoxyglucose positron emission tomography/computed tomography in breast cancer patients treated with mastectomy without adjuvant radiation therapy are predictive of recurrence. Methods and Materials: We retrospectively analyzed 93 patients with 1 to 3 positive axillary nodes after surgery, who were studied with {sup 18}F-fluorodeoxyglucose positron emission tomography/computed tomography for initial staging. We evaluated the relationship between positron emission tomography parameters, including the maximum standardized uptake value, metabolic tumor volume (MTV), and total lesion glycolysis (TLG), and clinical outcomes. Results: The median follow-up duration was 45 months. Recurrence was observed in 11 patients. Metabolic tumor volume and TLG were significantly related to tumor size, number of involved nodes, nodal ratio, nuclear grade, estrogen receptor (ER) status, and triple negativity (TN) (all P values were <.05). In receiver operating characteristic curve analysis, MTV and TLG showed better predictive performance than tumor size, ER status, or TN (area under the curve: 0.85, 0.86, 0.79, 0.74, and 0.74, respectively). On multivariate analysis, MTV was an independent prognostic factor of locoregional recurrence-free survival (hazard ratio 34.42, 95% confidence interval 3.94-882.71, P=.0008) and disease-free survival (DFS) (hazard ratio 13.92, 95% confidence interval 2.65-103.78, P=.0018). The 3-year DFS rate was 93.8% for the lower MTV group (<53.1; n=85) and 25.0% for the higher MTV group (?53.1; n=8; P<.0001, log–rank test). The 3-year DFS rate for patients with both ER-positive status and MTV <53.1 was 98.2%; and for those with ER-negative status and MTV ?53.1 it was 25.0% (P<.0001). Conclusions: Volume-based parameters improve recurrence prediction in postmastectomy breast cancer patients with 1 to 3 positive nodes. The addition of MTV to ER status or TN has potential benefits to identify a subgroup at higher risk for recurrence.

  15. [Breast cancer and axillary area: state of the art and perspectives].

    PubMed

    Houvenaeghel, Gilles; Cohen, Monique; Chereau Ewald, Elisabeth; Bannier, Marie; Buttarelli, Max; Jauffret, Camille; Lambaudie, Eric

    2013-12-01

    A therapeutic surgical de-escalation has been observed since many years with an actual prolongation for axillary lymph node area treatment. Axillary lymph node dissection (ALND) omission has been studied before and after validation of sentinel node (SN) biopsy procedure. A non-inferiority of ALND omission has been reported in case of non-involved SN. ALND omission has been studied in case of SN involvement without consensus in relation with scientific level of proof and with selective indications. The purpose of this work is to make a synthesis of the experiences on this subject then to envisage the current and future perspectives. PMID:24316763

  16. Automatic detection of axillary lymphadenopathy on CT scans of untreated chronic lymphocytic leukemia patients

    NASA Astrophysics Data System (ADS)

    Liu, Jiamin; Hua, Jeremy; Chellappa, Vivek; Petrick, Nicholas; Sahiner, Berkman; Farooqui, Mohammed; Marti, Gerald; Wiestner, Adrian; Summers, Ronald M.

    2012-03-01

    Patients with chronic lymphocytic leukemia (CLL) have an increased frequency of axillary lymphadenopathy. Pretreatment CT scans can be used to upstage patients at the time of presentation and post-treatment CT scans can reduce the number of complete responses. In the current clinical workflow, the detection and diagnosis of lymph nodes is usually performed manually by examining all slices of CT images, which can be time consuming and highly dependent on the observer's experience. A system for automatic lymph node detection and measurement is desired. We propose a computer aided detection (CAD) system for axillary lymph nodes on CT scans in CLL patients. The lung is first automatically segmented and the patient's body in lung region is extracted to set the search region for lymph nodes. Multi-scale Hessian based blob detection is then applied to detect potential lymph nodes within the search region. Next, the detected potential candidates are segmented by fast level set method. Finally, features are calculated from the segmented candidates and support vector machine (SVM) classification is utilized for false positive reduction. Two blobness features, Frangi's and Li's, are tested and their free-response receiver operating characteristic (FROC) curves are generated to assess system performance. We applied our detection system to 12 patients with 168 axillary lymph nodes measuring greater than 10 mm. All lymph nodes are manually labeled as ground truth. The system achieved sensitivities of 81% and 85% at 2 false positives per patient for Frangi's and Li's blobness, respectively.

  17. A Phase I/II Trial of 125I Methylene Blue for One-Stage Sentinel Lymph Node Biopsy

    PubMed Central

    Cundiff, Jason David; Wang, Yi-Zarn; Espenan, Gregory; Maloney, Thomas; Camp, Arthur; Lazarus, Laura; Stolier, Alan; Brooks, Randy; Torrance, Bruce; Stafford, Shawn; O'Leary, James P.; Woltering, Eugene A.

    2007-01-01

    Background: Sentinel lymph node biopsy can be associated with delays in operating room schedule and with significant pain during the preoperative 99mTc colloid injection. To avoid these problems, we developed a novel radiolabeled blue dye that can be injected intraoperatively. Methods: We performed a phase I/II trial (IND#70627) of sterile pyrogen-free 125I-methylene blue to identify sentinel nodes in patients with breast cancer. Twelve women were studied. Two women each were given peritumoral or circumareolar injections of 100, 200, 300, 400, 500, or 1000 ?Ci of 125I methylene blue. Results: Sentinel nodes were detected in 11 of 12 patients, with a low-dose 200 ?Ci patient being the single exception. The number of sentinel nodes detected per patient ranged from 0 to 3 (mean = 1.66 nodes/case). Radioactivity at the tumor injection site [counts per second (cps) averaged over 10 seconds] ranged from 3346 to 47,300 cps and was highly dose-dependent (r = 0.90, P = 0.0002). In contrast, the in vivo node counts ranged from 0 to 1228 cps, while ex vivo counts ranged from 0 to 1516 cps. The in vivo nodal counts were dose-dependent (r = 0.67, and P = 0.0231). Radiation was carefully monitored inside the operating room and in pathology. Even with the 1-mCi dose, the radioactive blue dye produced significantly lower personnel exposure than historically seen with 99mTc. Conclusions: This method eliminates the painful preoperative injections of 99mTc colloid, is performed by the surgeon in the operating room, is associated with lower radiation exposures for personnel, and avoids the delays caused by nonoperating room personnel. These observations warrant a more extensive trial of this method using the 1000-?Ci dose of 125I methylene blue dye for sentinel lymph node biopsies. PMID:17245184

  18. Radiation Therapy Field Extent for Adjuvant Treatment of Axillary Metastases From Malignant Melanoma

    SciTech Connect

    Beadle, Beth M. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Guadagnolo, B. Ashleigh [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)], E-mail: aguadagn@mdanderson.org; Ballo, Matthew T. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Lee, Jeffrey E.; Gershenwald, Jeffrey E.; Cormier, Janice N.; Mansfield, Paul F.; Ross, Merrick I. [Department of Surgical Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Zagars, Gunar K. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)

    2009-04-01

    Purpose: To compare treatment-related outcomes and toxicity for patients with axillary lymph node metastases from malignant melanoma treated with postoperative radiation therapy (RT) to either the axilla only or both the axilla and supraclavicular fossa (extended field [EF]). Methods and Materials: The medical records of 200 consecutive patients treated with postoperative RT for axillary lymph node metastases from malignant melanoma were retrospectively reviewed. All patients received postoperative hypofractionated RT for high-risk features; 95 patients (48%) received RT to the axilla only and 105 patients (52%) to the EF. Results: At a median follow-up of 59 months, 111 patients (56%) had sustained relapse, and 99 patients (50%) had died. The 5-year overall survival, disease-free survival, and distant metastasis-free survival rates were 51%, 43%, and 46%, respectively. The 5-year axillary control rate was 88%. There was no difference in axillary control rates on the basis of the treated field (89% for axilla only vs. 86% for EF; p = 0.4). Forty-seven patients (24%) developed treatment-related complications. On both univariate and multivariate analyses, only treatment with EF irradiation was significantly associated with increased treatment-related complications. Conclusions: Adjuvant hypofractionated RT to the axilla only for metastatic malignant melanoma with high-risk features is an effective method to control axillary disease. Limiting the radiation field to the axilla only produced equivalent axillary control rates to EF and resulted in lower treatment-related complication rates.

  19. [Management of axillary hyperhidrosis].

    PubMed

    Pomarède, N

    2009-05-01

    Hyperhidrosis is considered as an handicap which affects around of 2.8% of the population. It is linked to an extreme, permanent and symetric production of sweating because of an hyperactivity of sweat glands independant of thermo regulation process. The treatment by botulinum toxin has completely changed the treatment of axillary hyperhidrosis. It is an easy, quick, efficient treatment which improved quality of life of these patients. This treatment can also be used for palmar and plantar hyperhidrosis but it requires regional anesthetic technics, so it is done to the hospital. PMID:19576478

  20. [Lymph mobilization].

    PubMed

    Froneberg, W; Fabian, G

    1989-07-01

    Following a review of the literature lymph mobilization is described. Function and causalities of lymph mobilization and their interactions are explained giving examples and an evaluation of the experience available up to date. In many cases, manual neurotherapy may result in coordination and normalization of disorders which do not respond to other forms of therapy. PMID:2672664

  1. Coexistent Isolated Tumor Cell Clusters of Infiltrating Lobular Carcinoma and Benign Glandular Inclusions of Müllerian (Endosalpingiosis) Type in an Axillary Sentinel Node: Case Report and Review of the Literature.

    PubMed

    Groth, John V; Prabhu, Sanjiv; Wiley, Elizabeth

    2014-09-01

    The presence of benign epithelial inclusions in axillary lymph nodes coexistant with breast disease is a rare event; however, their presence makes the assessment of nodal disease diagnostically challenging. Broadly, these inclusions can be classified as glandular (müllerian type or nonmüllerian type), mixed glandular-squamous, and squamous. Among these the presence of benign müllerian-type glandular inclusions with concurrent breast parenchymal disease is an exceedingly rare event, with 10 previous cases reported in the literature, 2 coexisting with infiltrating ductal-type mammary carcinoma in axillary lymph nodes. Here, we report the first case of coexistent invasive lobular carcinoma and endosalpingiosis in an axillary lymph node. PMID:25203429

  2. Sentinel lymph node biopsy in early-stage breast cancer

    Microsoft Academic Search

    Amit Goyal; Robert E. Mansel

    Sentinel lymph node biopsy (SLNB) is the current standard of care for nodal staging in early-stage breast cancer patients\\u000a who are clinically nodenegative. Data from three randomised controlled trials conclusively demonstrates that SLNB is associated\\u000a with less arm morbidity and better quality of life than axillary lymph node dissection (ALND). Large observational studies\\u000a have shown that SLNB is associated with

  3. Near infrared photoacoustic detection of sentinel lymph nodes with gold nanobeacons

    Microsoft Academic Search

    Dipanjan Pan; Manojit Pramanik; Angana Senpan; Soumojit Ghosh; Samuel A. Wickline; Lihong V. Wang; Gregory M. Lanza

    2010-01-01

    Detection of sentinel lymph node (SLN) using photoacoustic imaging is an emerging technique for noninvasive axillary staging of breast cancer. Due to the absence of intrinsic contrast inside the lymph nodes, exogenous contrast agents are used for photoacoustic detection. In this work, we have demonstrated near infrared detection of SLN with gold nanobeacons (GNBs) providing the photoacoustic contrast in a

  4. Impact of Clinicopathological Factors on Sensitivity of Axillary Ultrasonography in the Detection of Axillary Nodal Metastases in Patients With Breast Cancer

    Microsoft Academic Search

    Isabelle Bedrosian; Deepak Bedi; Henry M. Kuerer; Bruno D. Fornage; Lori Harker; Merrick I. Ross; Frederick C. Ames; Savitri Krishnamurthy; Beth S. Edeiken-Monroe; Funda Meric; Barry W. Feig; Jeri Akins; S. Eva Singletary; Nadeem Q. Mirza; Kelly K. Hunt

    2003-01-01

    Background: Ultrasonography and fine-needle aspiration (FNA) are used to evaluate the breast and regional nodes in breast cancer patients.\\u000a We sought to identify factors influencing the sensitivity of ultrasonography for detection of nodal metastasis.\\u000a \\u000a \\u000a Methods: Patients with a clinically negative axilla who underwent axillary ultrasonography and sentinel lymph node biopsy were included.\\u000a \\u000a \\u000a \\u000a \\u000a Results: Of 208 patients, axillary ultrasonography was negative

  5. Handheld array-based photoacoustic probe for guiding needle biopsy of sentinel lymph nodes

    NASA Astrophysics Data System (ADS)

    Kim, Chulhong; Erpelding, Todd N.; Maslov, Konstantin; Jankovic, Ladislav; Akers, Walter J.; Song, Liang; Achilefu, Samuel; Margenthaler, Julie A.; Pashley, Michael D.; Wang, Lihong V.

    2010-07-01

    By modifying a clinical ultrasound array system, we develop a novel handheld photoacoustic probe for image-guided needle biopsy. The integration of optical fiber bundles for pulsed laser light delivery enables photoacoustic image-guided insertion of a needle into rat axillary lymph nodes with accumulated indocyanine green (ICG). Strong photoacoustic contrast of the needle is achieved. After subcutaneous injection of the dye in the left forepaw, sentinel lymph nodes are easily detected, in vivo and in real time, beneath 2-cm-thick chicken breast overlaying the axillary region. ICG uptake in axillary lymph nodes is confirmed with fluorescence imaging both in vivo and ex vivo. These results demonstrate the clinical potential of this handheld photoacoustic system for facile identification and needle biopsy of sentinel lymph nodes for cancer staging and metastasis detection in humans.

  6. Radiotherapy for Stage II and Stage III Breast Cancer Patients With Negative Lymph Nodes After Preoperative Chemotherapy and Mastectomy

    SciTech Connect

    Le Scodan, Romuald, E-mail: lescodan@crh1.org [Department of Radiation Oncology, Institut Curie-Hopital Rene Huguenin, Saint-Cloud (France); Selz, Jessica [Department of Radiation Oncology, Institut Curie-Hopital Rene Huguenin, Saint-Cloud (France); Stevens, Denise [Department of Biostatistics, Institut Curie-Hopital Rene Huguenin, Saint-Cloud (France); Bollet, Marc A.; Lande, Brigitte de la; Daveau, Caroline [Department of Radiation Oncology, Institut Curie-Hopital Rene Huguenin, Saint-Cloud (France); Lerebours, Florence [Department of Medical Oncology, Institut Curie-Hopital Rene Huguenin, Saint-Cloud (France); Labib, Alain [Department of Radiation Oncology, Institut Curie-Hopital Rene Huguenin, Saint-Cloud (France); Bruant, Sarah [Department of Biostatistics, Institut Curie-Hopital Rene Huguenin, Saint-Cloud (France)

    2012-01-01

    Purpose: To evaluate the effect of postmastectomy radiotherapy (PMRT) in Stage II-III breast cancer patients with negative lymph nodes (pN0) after neoadjuvant chemotherapy (NAC). Patients and Materials: Of 1,054 breast cancer patients treated with NAC at our institution between 1990 and 2004, 134 had pN0 status after NAC and mastectomy. The demographic data, tumor characteristics, metastatic sites, and treatments were prospectively recorded. The effect of PMRT on locoregional recurrence-free survival and overall survival (OS) was evaluated by multivariate analysis, including known prognostic factors. Results: Of the 134 eligible patients, 78 (58.2%) received PMRT and 56 (41.8%) did not. At a median follow-up time of 91.4 months, the 5-year locoregional recurrence-free survival and OS rate was 96.2% and 88.3% with PMRT and 92.5% and 94.3% without PMRT, respectively (p = NS). The corresponding values at 10 years were 96.2% and 77.2% with PMRT and 86.8% and 87.7% without PMRT (p = NS). On multivariate analysis, PMRT had no effect on either locoregional recurrence-free survival (hazard ratio, 0.37; 95% confidence interval, 0.09-1.61; p = .18) or OS (hazard ratio, 2.06; 95% confidence interval, 0.71-6; p = .18). This remained true in the subgroups of patients with clinical Stage II or Stage III disease at diagnosis. A trend was seen toward poorer OS among patients who had not had a pathologic complete in-breast tumor response after NAC (hazard ratio, 6.65; 95% confidence interval, 0.82-54.12; p = .076). Conclusions: The results from the present retrospective study showed no increase in the risk of distant metastasis, locoregional recurrence, or death when PMRT was omitted in breast cancer patients with pN0 status after NAC and mastectomy. Whether the omission of PMRT is acceptable for these patients should be addressed prospectively.

  7. Optical Coherence uring breast-conserving surgeries, axillary lymph

    E-print Network

    Boppart, Stephen

    to lung cancer) has started to decrease over the last few years, largely attributed to the effectiveness-node involvement and cancer metastasis. The management and treatment of breast cancer has continued to improve-time microscopic optical-imaging technique previously used to image breast cancer tumor margins intraoperatively

  8. Docetaxel, cisplatin and 5-fluorouracil adjuvant chemotherapy following three-field lymph node dissection for stage II/III N1, 2 esophageal cancer

    PubMed Central

    HASHIGUCHI, TADASUKE; NASU, MOTOMI; HASHIMOTO, TAKASHI; KUNIYASU, TETSUJI; INOUE, HIROHUMI; SAKAI, NORITAKA; OUCHI, KAZUTOMO; AMANO, TAKAYUKI; ISAYAMA, FUYUMI; TOMITA, NATSUMI; IWANUMA, YOSHIMI; TSURUMARU, MASAHIKO; KAJIYAMA, YOSHIAKI

    2014-01-01

    To determine the efficacy of postoperative adjuvant chemotherapy with docetaxel + cisplatin + 5-fluorouracil (DCF) in lymph node metastasis-positive esophageal cancer, we retrospectively analyzed 139 patients with stage II/III (non-T4) esophageal cancer with lymph node metastasis (1–6 nodes), who did not receive preoperative treatment and underwent three-field lymph node dissection in the Juntendo University Hospital between December, 2004 and December, 2009. The tumors were histologically diagnossed as squamous cell carcinoma. The patients were divided into two groups, a surgery alone group (S group, 88 patients) and a group that received postoperative DCF therapy (DCF group, 51 patients). The disease-free and overall survival were compared between the groups and a multivariate analysis of prognostic factors was performed. The same analysis was performed for cases classified as N1 and N2, according to the TNM classification. There were no significant differences between the S and DCF groups regarding clinicopathological factors other than intramural metastasis and main tumor location. The presence of intramural metastasis, blood vessel invasion and the number of lymph nodes were identified as prognostic factors. The 5-year disease-free and overall survival were 55.8 and 57.3%, respectively, in the S group and 52.8 and 63.0%, respectively, in the DCF group. These differences were not considered to be statistically significant (P=0.789 and 0.479 for disease-free and overall survival, respectively). Although there were no significant differences in disease-free and overall survival between the S and DCF groups in N1 cases, both disease-free and overall survival were found to be better in the DCF group (54.2 and 61.4%, respectively) compared to the S group (29.6 and 28.8%, respectively) in N2 cases (P=0.029 and 0.020 for disease-free and overall survival, respectively). Therefore, postoperative adjuvant chemotherapy with DCF was shown to improve disease-free and overall survival in moderate lymph node metastasis-positive cases (N2), suggesting that the DCF regimen may be effective as postoperative adjuvant chemotherapy for patients with lymph node metastasis from esophageal cancer. PMID:25054036

  9. [A new approach to the axilla: functional axillary lymphadenectomy and padding].

    PubMed

    Garnier, J M; Hamy, A; Classe, J M; Laborde, O; Sagot, P; Lopes, P; Boog, G; Drianno, J C; Guillard, Y

    1993-01-01

    Axillary lymph node dissection, which is now mandatory in the conservative breast cancer surgery and classically involves Berg's two lower levels, is burdened with numerous complications. In 1988 and 1989, two technical modifications were introduced and are described here: padding of the axilla as preventive treatment of postoperative lymphocele and, more recently, functional axillary lymphadenectomy (FAL) in which the medial cutaneous nerve of the arm, the two perforating intercostal nerves and above all the lateral thoracic pedicle (external mammary artery and vein) are spared. These two technical innovations, more respectful of anatomy, are aimed at reducing the morbidity of conservative breast cancer at a time when detection enables breast cancers to be treated at an increasingly early stage, which results in a increase of negative axillary dissections. The postoperative period is simplified (no drainage, immediate mobilization), and the hospital stay is reduced to 2 days. Complementary treatments can thus be started early on, without any functional or cosmetic damage while the number of lymph nodes removes remains the same as in the conventional axillary dissection technique. The authors describe the operative procedures and analyse the 100 cases of conservative breast cancer they have treated with padding and FAL. These two technical modifications are now systematically used by them in the management of breast cancers. PMID:8345145

  10. New models and online calculator for predicting non-sentinel lymph node status in sentinel lymph node positive breast cancer patients

    Microsoft Academic Search

    Holbrook E Kohrt; Richard A Olshen; Honnie R Bermas; William H Goodson; Douglas J Wood; Solomon Henry; Robert V Rouse; Lisa Bailey; Vicki J Philben; Frederick M Dirbas; Jocelyn J Dunn; Denise L Johnson; Irene L Wapnir; Robert W Carlson; Frank E Stockdale; Nora M Hansen; Stefanie S Jeffrey

    2008-01-01

    BACKGROUND: Current practice is to perform a completion axillary lymph node dissection (ALND) for breast cancer patients with tumor-involved sentinel lymph nodes (SLNs), although fewer than half will have non-sentinel node (NSLN) metastasis. Our goal was to develop new models to quantify the risk of NSLN metastasis in SLN-positive patients and to compare predictive capabilities to another widely used model.

  11. Axillary and rectal temperature measurements in infants

    Microsoft Academic Search

    C J Morley; P H Hewson; A J Thornton; T J Cole

    1992-01-01

    Rectal and axillary temperatures were measured during the daytime in 281 infants seen randomly at home and 656 at hospital under 6 months old, using mercury-in-glass thermometers. The normal temperature range derived from the babies at home was 36.7-37.9 degrees C for rectal temperature and 35.6-37.2 degrees C for axillary temperature. Rectal temperature was higher than axillary in 98% of

  12. Dissemination in cutaneous leishmaniasis. 3. Lymph node involvement.

    PubMed

    al-Gindan, Y; Kubba, R; el-Hassan, A M; Omer, A H; Kutty, M K; Saeed, M B

    1989-05-01

    In a study of zoonotic cutaneous leishmaniasis (CL) due to leishmania major in an endemic focus in Saudi Arabia, lymph node enlargement was observed in 66 of 643 patients (10.26%). The epitrochlear lymph nodes were most commonly involved (68%), but cervical (11%), axillary (15%), and inguinal (18%) lymph nodes were also involved. In eight patients (12%), two lymph node areas were involved. The affected lymph nodes were typically solitary, firm, mobile, nontender, only moderately enlarged, and appeared to persist beyond the clinical healing of the associated skin lesions. The results of pathologic and immunopathologic studies carried out on eight lymph nodes obtained from this group of patients supported the leishmanial etiology. Although amastigotes were only demonstrated in two lymph nodes, the leishmanial antigen was found in all eight specimens. The lymph node involvement is another manifestation of dissemination in infection with a dermotropic leishmania. It appears that in some cases, instead of the parasite, it may be the leishmanial antigen that disseminates and produces lymphadenitis. PMID:2722339

  13. Unilateral Axillary Arch and Variations in the Axillary Vein and Intercostal Nerves: A Case Report

    PubMed Central

    Ramanadham, Sharada; Kalthur, Sneha Guruprasad; Pai, Shakunthala R

    2011-01-01

    Knowledge of muscular, vascular, and neural variations in the axilla is of great clinical importance, especially in mastectomies, breast reconstruction, and axillary bypass operations. In the present paper, we report unilateral variations observed in the axillary region of a male cadaver. A fibromuscular axillary arch was observed on the right side. On the same side, there was a bifurcated axillary vein; a medial cutaneous nerve of the arm passed through and later ran beneath this axillary vein. In addition, the intercostobrachial nerve was absent on the right side. The clinical significance of the variations observed and their embryological basis are discussed in this paper. PMID:22135576

  14. Multifocality and multicentricity are not contraindications for sentinel lymph node biopsy in breast cancer surgery

    Microsoft Academic Search

    Alberta Ferrari; Paolo Dionigi; Francesca Rovera; Luigi Boni; Giorgio Limonta; Silvana Garancini; Diego De Palma; Gianlorenzo Dionigi; Cristiana Vanoli; Mario Diurni; Giulio Carcano; Renzo Dionigi

    2006-01-01

    BACKGROUND: After the availability of the results of validation studies, the sentinel lymph node biopsy (SLNB) has replaced routine axillary dissection (AD) as the new standard of care in early unifocal breast cancers. Multifocal (MF) and multicentric (MC) tumors have been considered a contraindication for this technique due to the possible incidence of a higher false-negative rate. This prospective study

  15. Diagnostic value of peripheral lymph node biopsy in sarcoidosis: a report of 67 cases.

    PubMed

    Yanardag, Halil; Caner, Metin; Papila, Irfan; Uygun, Sedat; Demirci, Sabriye; Karayel, Tuncer

    2007-01-01

    A peripheral lymph node (PLN) 1 cm or greater was found in 79 of 546 sarcoidosis patients (14.5%) between 1972 and 2005. Seventy-two of the 79 sarcoidosis patients had a lymph node biopsy performed. Sixty-seven of these biopsy specimens were histologically diagnosed as sarcoidosis, whereas five patients had a reactive adenopathy. For patients with histological diagnosis of sarcoidosis, localizations of the biopsies were as follows: cervical (n=21), supraclavicular (n=20), inguinal (n=11), axillary (n=8), epitrochlear (n=5) and submandibular (n=2). At the time of biopsy, 12 patients had stage 0 disease, 37 patients had stage I disease, 14 patients had stage II disease and four patients had stage III disease. Skin involvement (16.4%) was the most frequently observed type of organ involvement in patients who had enlarged PLNs due to sarcoidosis. In the presence of an enlarged PLN in sarcoidosis, biopsy had a greater diagnostic value compared with other methods, as well as having a relatively low cost (approximately US$120) in Turkey. No procedure-related complications were observed. In conclusion, it is recommended that PLNs be thoroughly examined when sarcoidosis is suspected. If an enlarged PLN is found, biopsy should be routinely performed because it is an easy, convenient and practical method, with a low complication risk and a high sensitivity. PMID:17551595

  16. Diagnostic value of peripheral lymph node biopsy in sarcoidosis: A report of 67 cases

    PubMed Central

    Yanardag, Halil; Caner, Metin; Papila, Irfan; Uygun, Sedat; Demirci, Sabriye; Karayel, Tuncer

    2007-01-01

    A peripheral lymph node (PLN) 1 cm or greater was found in 79 of 546 sarcoidosis patients (14.5%) between 1972 and 2005. Seventy-two of the 79 sarcoidosis patients had a lymph node biopsy performed. Sixty-seven of these biopsy specimens were histologically diagnosed as sarcoidosis, whereas five patients had a reactive adenopathy. For patients with histological diagnosis of sarcoidosis, localizations of the biopsies were as follows: cervical (n=21), supra-clavicular (n=20), inguinal (n=11), axillary (n=8), epitrochlear (n=5) and submandibular (n=2). At the time of biopsy, 12 patients had stage 0 disease, 37 patients had stage I disease, 14 patients had stage II disease and four patients had stage III disease. Skin involvement (16.4%) was the most frequently observed type of organ involvement in patients who had enlarged PLNs due to sarcoidosis. In the presence of an enlarged PLN in sarcoidosis, biopsy had a greater diagnostic value compared with other methods, as well as having a relatively low cost (approximately US$120) in Turkey. No procedure-related complications were observed. In conclusion, it is recommended that PLNs be thoroughly examined when sarcoidosis is suspected. If an enlarged PLN is found, biopsy should be routinely performed because it is an easy, convenient and practical method, with a low complication risk and a high sensitivity. PMID:17551595

  17. [Examining the lymph nodes].

    PubMed

    Buis, Jaap; de Jongh, Tjeerd O H

    2011-01-01

    Enlarged lymph nodes occur frequently and imply a benign or systematic disorder. In primary care, only 1% of patients with an unexplained lymphadenopathy have a malignancy. In the case of unexplained lymphadenopathy the most important diagnostic dilemma is whether biopsy should be applied. In young patients the necessity of lymph node biopsy can be accurately predicted using the following parameters: abnormal chest X-ray; lymph node > 2 cm and ear, nose and throat symptoms. In adults the necessity of biopsy may be reliably predicted using the following parameters: age; lymph node tenderness; lymph node size; consistency, presence of supraclavicular lymph nodes and generalised pruritus. PMID:21262028

  18. Double-injection perivascular ultrasound-guided axillary brachial plexus block according to needle positioning: 12 versus 6 o'clock position of the axillary artery

    PubMed Central

    Cho, Sooyoung; Kim, Jong-Hak; Baik, Hee-Jung

    2014-01-01

    Background We conducted prospective, randomized, observer-blinded trial to compare two double-injection perivascular (PV) ultrasound-guided techniques of axillary brachial plexus block (BPB). Methods American Society of Anesthesiologists physical status I-II, 50 patients undergoing surgery of the forearm, wrist or hand were randomly allocated to two groups. For PV12 group, injection was carried out at the 12 o'clock position using 24 ml of 2% lidocaine. Patients of PV6 group got their injection of 24 ml of 2% lidocaine at direction of 6 o'clock of axillary artery. For all 2 groups, the musculocutaneous nerve was identified and 5 ml of 2% lidocaine was deposited around the nerve. The performance time and the onset time were recorded. The induction time (sum of performance and onset time), the success rate of the block, the need rate of rescue block, and incidence of adverse events was compared. Results The success rate was same (84%) in two groups. The performance time, onset time, and induction time showed no differences between two groups. There were no differences in vessel puncture, paresthesia, and numbness. Conclusions Double-injection perivascular ultrasound-guided axillary BPB can be performed at 12 o'clock or 6 o'clock position of axillary artery, and performer may choose needle targeting position by considering surgery site. Thus perivascular double-injection technique may be an alternative method for axillary BPB and useful in case of difficult block. PMID:24624268

  19. Unusual lymph node metastases of prostate cancer detected by 18F-fluorocholine PET/CT.

    PubMed

    Pinaquy, J B; Allard, J B; Cornelis, F; Pasticier, G; De Clermont, H

    2015-04-01

    A 65-year-old patient with prostate adenocarcinoma was explored by 18F-fluorocholine (FCH) PET/CT for pretreatment staging because of a high risk of prostate cancer. Images showed multiple foci with increased uptake of 18F-FCH within some pelvic and retroperitoneal lymph nodes, osseous foci (iliac bones and sacrum), and much more unusual, increased uptake foci within some left supraclavicular and left axillary lymph nodes. Owing to the rarity of spread to supraclavicular lymph nodes, surgical removal was performed and revealed prostate cancer metastases. PMID:25674860

  20. Axillary lipogranuloma mimicking carcinoma metastasis after silicone breast implant rupture: a case report.

    PubMed

    Gundeslioglu, A Ozlem; Hakverdi, Sibel; Erdem, Ozlem; Ozen, E Cigdem; Inan, Irfan; Emlik, Dilek

    2013-03-01

    Silicone-gel-filled breast implants have been widely used for breast augmentation and reconstruction after mastectomy. However, silicone implants have some well-known complications, such as implant rupture, which requires surgical intervention. Dissemination of silicone particles out of the implant causes a granulomatous reaction, a phenomenon known as silicone granuloma, in breast parenchyma as well as axillary, breast and chest wall lymph nodes, which mimics breast cancer metastasis. However, lipogranuloma after silicone breast implant rupture has not been reported in the literature, although it is a common complication after mineral oil or liquid silicone injection. We present a case report of an axillary lymphadenopathy resulting from lipogranuloma after silicone-gel-filled implant rupture. Review of the literature suggests that this is the first report of a lipogranuloma resulting from implant rupture. PMID:23245917

  1. A comparison of axillary node status between cancers detected at the prevalence and first incidence breast screening rounds.

    PubMed Central

    Holland, P. A.; Walls, J.; Boggis, C. R.; Knox, F.; Baildam, A. D.; Bundred, N. J.

    1996-01-01

    Screen-detected breast cancers are smaller than those detected in symptomatic populations and, for any given size, they are associated with fewer lymph node metastases. The management of axillary lymph nodes in patients with screen-detected breast cancer remains controversial. We have previously reported that prevalence (initial screen)-detected cancers are associated with nodal metastases in 17.4% of cases overall. Cancers < or = 10 mm, of any grade, are associated with metastases in only 5% of cases, and grade I cancers <30 mm are not associated with metastases. This led to our recommendation that axillary surgery is unnecessary for these groups of women. The present study compared the nodal status of cancers detected at the prevalence and first incidence (second) screens in order to determine whether our recommendation is appropriate for cancers detected at the first incidence screen. Overall, 30.1% of cancers detected in the first incidence screen presented axillary nodal metastases. At all size ranges, cancers detected at the first incidence screen were associated with significantly more lymph node metastases than prevalence-detected cancers. In particular, cancers < or = 10 mm were associated with metastases in 14.3% of cases. With the possible exception of grade I cancers, we believe that surgical staging of the axilla is essential for cancers detected at the first incidence screen, irrespective of size. PMID:8932348

  2. Intramammary lymph node metastasis in a patient with ovarian carcinoma and a brief review of the literature

    PubMed Central

    Erten, Cigdem; Yigit, Seyran Ceri; Can, Alper; Dirican, Ahmet; Bayoglu, Vedat; Kucukzeybek, Yuksel; Somali, Isil; Tarhan, M Oktay

    2012-01-01

    Metastasis from serous carcinoma of the ovary usually occurs in the subdiaphragmatic region. Metastasis to the breast and/or axillary-intramammary lymph node is very rare. It usually occurs in advanced disease, and it is important to distinguish a primary breast cancer from an ovarian cancer metastasis since the management of these two entities is totally different. Here we present a patient with metastasis to the breast and intramammary lymph nodes from ovarian serous carcinoma 25 months after diagnosis. PMID:23788864

  3. The risk of nodal metastases in breast cancer patients with clinically negative lymph nodes: a population-based analysis

    Microsoft Academic Search

    Adri C. Voogd; Jan-Willem W. Coebergh; Ocker J. Repelaer van Driel; Rudi M. H. Roumen; Mike W. P. M. van Beek; Art Vreugdenhil; Mariad A. Crommelin

    2000-01-01

    A population-based study was performed to assess the likelihood of axillary lymph node metastases in patients with clinically negative lymph nodes, according to patient age, tumor size and site, estrogen receptor status, histologic type and mode of detection. Data were obtained from the population-based Eindhoven Cancer Registry. During the period 1984–1997, 7680 patients with invasive breast cancer were documented, 6663

  4. Clinico-pathological study of lymph node involvement in leprosy.

    PubMed

    Kar, H K; Mohanty, H C; Mohanty, G N; Nayak, U P

    1983-10-01

    One hundred and five leprosy patients including 37 cases of LL and LI, 22 cases of BL, 3 cases of BB, 17 cases of BT, 23 cases of TT and 3 cases of indeterminate type during the period of 1980-81 have been examined clinically. All the patients of LL, LI, BL and BB types, 94% of BT, 70% of TT and 66.6% of indeterminate type have showed clinical enlargement of lymph nodes. In order of frequency the enlarged nodes are inguinal (76.2%) cervical (69.5%), axillary (69.5%), epitrochlear (64.7%) and lastly pre-auricular (9.5%). Although both regional and distant groups of lymph node enlargement have been observed in all cases of LL, LI and BL, in majority of the non-lepromatous cases there is only involvement of regional lymph nodes. Biopsies of lymph nodes are made from 51 leprosy patients, 22 from LL and LI cases, 11 from BL cases, 2 from BB cases, 8 from BT cases, 6 from TT cases and 2 from indeterminate leprosy cases. Major histopathological changes have been studied in different types of leprosy. The humoral antibody response and the cellular immune response are well reflected on the histopathological finding of the lymph nodes belonging to different immunological spectrum of leprosy patients. The examination of lymph nodes is recommended as a useful adjunct for the diagnosis and classification of leprosy. PMID:6668933

  5. Axillary dissection in primary breast cancer: variations of the surgical technique and influence on morbidity.

    PubMed

    Wojcinski, Sebastian; Nuengsri, Sirin; Hillemanns, Peter; Schmidt, Werner; Deryal, Mustafa; Ertan, Kubilay; Degenhardt, Friedrich

    2012-01-01

    Lymphedema of the arm is the most common and impairing complication after breast cancer surgery with axillary lymph node dissection (ALND). Our prospective study evaluated the effect of two different surgical techniques for ALND on postoperative morbidity. Patients were scheduled to undergo ALND. Patients in group 1 (n = 17) underwent the most common and standard technique of ALND, which uses sharp dissection of the tissue and subsequent electro-coagulation of bleedings. Patients in group 2 (n = 17) underwent a modified standard technique of ALND with clamping and ligatures of all resection margins. Postoperative wound secretion was quantified and patients were followed up for 6 months to assess long-term morbidity. The variations in surgical technique had no significant influence on the outcome variables. However, patients in group 2 showed a tendency to less wound secretion (713 versus 802 mL; P = nonsignificant), a decreased rate of immediate postoperative seromas (11.8 versus 23.5%; P = nonsignificant) and less lymphedema after 3 months (29.4 versus 41.2%; P = nonsignificant). Moreover, the number of resected lymph nodes correlated with the total amount of drained fluid (P = 0.006), the duration of the drain (P = 0.015), and the risk for the development of lymphedema after 3 months (P = 0.016). The described variations in surgical technique had no influence on the outcomes of the patients. The number of resected axillary lymph nodes remains the most important risk factor for treatment-related morbidity. Therefore, a well-balanced choice of the extent of the axillary dissection should be the surgeon's main concern. PMID:22570566

  6. Diffusion MRI on lymph node staging of gastric adenocarcinoma

    PubMed Central

    Akcakaya, Adem; Memmi, Naim; Turkmen, Ihsan; Cipe, Gokhan; Yildiz, Pelin; Arici, Dilek Sema; Muslumanoglu, Mahmut

    2015-01-01

    Objective The purpose of this study was to evaluate the accuracy of diffusion weighted magnetic resonance imaging (MRI) in preoperative assessment of metastatic lymph nodes of gastric cancer. Methods A total of 23 gastric cancer patients with a mean age of 59.4±10.9 years were analyzed. Lymph nodes were grouped as perigastric lesser curvature (Group Ia), perigastric greater curvature (Group Ib), D1+/D2 lymph nodes (Group II). Identification of histologically metastatic lymph nodes by diffusion weighted MRI was regarded as the main outcome. Results A total of 1,056 lymph nodes including 180 histologically proven metastatic lymph nodes were dissected. Although diffusion weighted MRI could identify the metastatic lymph nodes in 18 out of 23 patients (77.8%), only 69 of total 1,056 nodes (6.53%), either metastatic or non-metastatic, could be detected. There was no correlation between histopathology and diffusion weighted MRI with regard to lymph node groups (P>0.05 for all). Overall accuracy was calculated as 69.56, 65.21 and 52.17 for Groups II, Ib and Ia lymph nodes, respectively. Apparent diffusion coefficient (ADC) values could not be helpful to differentiate metastatic lymph nodes (P=0.673). Conclusions Diffusion weighted MRI has low accuracy to detect or to differentiate metastatic and non-metastatic lymph nodes based on their ADC values in gastric cancer.

  7. Tangential Radiotherapy Without Axillary Surgery in Early-Stage Breast Cancer: Results of a Prospective Trial

    SciTech Connect

    Wong, Julia S. [Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA (United States)], E-mail: jwong@lroc.harvard.edu; Taghian, Alphonse G. [Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (United States); Bellon, Jennifer R. [Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA (United States); Keshaviah, Aparna [Department of Biostatistics and Computational Biology, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA (United States); Smith, Barbara L. [Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA (United States); Winer, Eric P. [Department of Medical Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA (United States); Silver, Barbara; Harris, Jay R. [Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA (United States)

    2008-11-01

    Purpose: To determine the risk of regional-nodal recurrence in patients with early-stage, invasive breast cancer, with clinically negative axillary nodes, who were treated with breast-conserving surgery, 'high tangential' breast radiotherapy, and hormonal therapy, without axillary surgery or the use of a separate nodal radiation field. Methods and Materials: Between September 1998 and November 2003, 74 patients who were {>=}55 years of age with Stage I-II clinically node-negative, hormone-receptor-positive breast cancer underwent tumor excision to negative margins without axillary surgery as a part of a multi-institutional prospective study. Postoperatively, all underwent high-tangential, whole-breast radiotherapy with a boost to the tumor bed, followed by 5 years of hormonal therapy. Results: For the 74 patients enrolled, the median age was 74.5 years, and the median pathologic tumor size was 1.2 cm. Lymphatic vessel invasion was present in 5 patients (7%). At a median follow-up of 52 months, no regional-nodal failures or ipsilateral breast recurrences had been identified (95% confidence interval, 0-4%). Eight patients died, one of metastatic disease and seven of other causes. Conclusion: In this select group of mainly older patients with early-stage hormone-responsive breast cancer and clinically negative axillary nodes, treatment with high-tangential breast radiotherapy and hormonal therapy, without axillary surgery, yielded a low regional recurrence rate. Such patients might be spared more extensive axillary treatment (axillary surgery, including sentinel node biopsy, or a separate nodal radiation field), with its associated time, expense, and morbidity.

  8. Clinical significance of aromatase protein expression in axillary node negative breast cancer

    Microsoft Academic Search

    Jingsong Lu; Hecheng Li; Daocheng Cao; Genhong Di; Jiong Wu; Kunwei Sheng; Qixia Han; Zhenzhou Shen; Zhiming Shao

    2007-01-01

    Purpose  Aromatase catalyzes the conversion of androgens to estrogens; its high expression in breast cancers may be responsible for\\u000a the local high levels of estrogen and may promote tumor growth and progression; however, the clinical importance of aromatase\\u000a remains unclear and needs to be further researched.\\u000a \\u000a \\u000a \\u000a Methods  By immunochemistry, we detected aromatase, MMP2 and MMP9 immunoreactivity in 244 axillary lymph node negative

  9. Midterm Experience of Ipsilateral Axillary-Axillary Arteriovenous Loop Graft as Tertiary Access for Haemodialysis

    PubMed Central

    Hunter, J. P.; Nicholson, M. L.

    2014-01-01

    Objectives. To present a series of ipsilateral axillary artery to axillary vein loop arm grafts as an alternative vascular access procedure for haemodialysis in patients with difficult access. Design. Retrospective case series. Methods. Patients who underwent an axillary loop arteriovenous graft from September 2009 to September 2012 were included. Preoperative venous imaging to exclude central venous stenosis and to image arm/axillary veins was performed. A cuffed PTFE graft was anastomosed to the distal axillary artery and axillary vein and looped on the arm. Results. 25 procedures were performed on 22 patients. Median age was 51 years, with 9 males and 13 females. Median number of previous access procedures was 3 (range 0–7). Median followup was 16.4 months (range 1–35). At 3 months and 1 year, the primary and secondary patency rates were 70% and 72% and 36% and 37%, respectively. There were 11 radiological interventions in 6 grafts including 5 angioplasties and 6 thrombectomies. There were 19 surgical procedures in 10 grafts, including thrombectomy, revision, repair for bleeding, and excision. Conclusions. Our series demonstrates that the axillary loop arm graft yields acceptable early patency rates in a complex group of patients but to maintain graft patency required high rates of surgical and radiological intervention, in particular graft thrombectomy. PMID:24778864

  10. Axillary pilonidal sinus: A case report

    PubMed Central

    Sengul, Ilker; Sengul, Demet; Mocan, Gamze

    2009-01-01

    Context: Pilonidal sinus is a disease which is very common, especially in men and usually located in sacrococcygeal area. However, the disease can be also seen in rare localizations such as umblicus, forehead, scalp, clitoris, interdigital area and axilla. In the etiology of pilonidal sinus, acquired theory is accepted by most of surgeons instead of the congenital one. Case report: In the present study, we purposed to report our case of hirsute Turkish women aged 25 having axillary pilonidal sinus. After application of total surgical excision with eliptical skin incision, histopathological evaluations confirmed the prediagnosis of axillary pilonidal sinus. The patient was lost to follow-up and neither recurrens nor distance metastasis has been detected during 36 months. Conclusions: In our opinion; surgical therapy of axillary pilonidal sinus, allows to complete resection in addition to absolute histopathological diagnoses and it may be an appropriate choice of treatment especially for the disease having one or two sinuses. PMID:22666715

  11. Axillary artery cannulation for cardiopulmonary bypass reduces cerebral microemboli

    Microsoft Academic Search

    Nasim Hedayati; J. Timothy Sherwood; Steve J. Schomisch; Joseph L. Carino; Alan H. Markowitz

    2010-01-01

    Background: Aortic cannulation for cardiopulmonary bypass (CPB) is linked to cerebral microemboli emanating from the ascending aorta. Aortic calcification or disease requiring replacement precludes aortic cannulation. Clinical experience with axillary artery cannulation led to the hypothesis that axillary cannulation may be cerebroprotective. Methods: Five mongrel dogs underwent a median sternotomy and isolation of the right axillary artery. The canine bicarotid

  12. Axillary Schwannoma with Extensive Cystic Degeneration

    PubMed Central

    Jadhav, Chaithra R; Angeline, N R; Kumar, Bipin; Bhat, Ramachandra V; Balachandran, G

    2013-01-01

    Schwannoma affect mainly head, neck, and flexor aspect of the limbs. Neurogenic tumors arising from the brachial plexus are rare and axillary schwannoma is extremely uncommon. Cystic degeneration is common in longstanding cases and which when aspirated may yield only macrophages or lymphocytes leading to false diagnosis of the case in spite of strong clinical suspicion. We report one such rare case of a solitary axillary schwannoma with extensive cystic degeneration, which was misdiagnosed on fine needle aspiration cytology and subsequently confirmed by the histopathological examination and immunohistochemistry. PMID:24014973

  13. Axillary Lymphadenopathy: An Outstanding Presentation for Breast Implant-Associated ALK-Negative Anaplastic Large Cell Lymphoma.

    PubMed

    Tardío, Juan C; Granados, Rosario

    2015-08-01

    Till date, there is only one reported case of breast implant-associated ALK-negative anaplastic large cell lymphoma (ALCL) with an axillary presentation that followed an aggressive behavior. We report the case of a 50-year-old female presenting with an axillary lymphadenopathy 8 years after breast prostheses implantation. Clinical examination, ultrasound, and magnetic resonance imaging detected no mammary lesions. The lymph node showed intrasinusoidal infiltration by large pleomorphic cells expressing CD30 and lacking ALK-immunoreactivity. Tumor staging was negative. Cells with identical features were found in the ipsilateral periprosthetic capsule. The patient was treated with CHOP and radiotherapy, and she is alive without evidence of disease after a 30-month follow-up. The diagnosis of an ALK-negative ALCL in an axillary lymph node of a patient with ipsilateral breast prosthesis and negative staging should prompt removal of the implant with capsulectomy, since the pathological study of this specimen allows the correct diagnosis with important prognostic implications. PMID:25829459

  14. Evaluation of a Single-Isocenter Technique for Axillary Radiotherapy in Breast Cancer

    SciTech Connect

    Beek, Suzanne van [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Radiation Oncology, Amsterdam (Netherlands)], E-mail: s.v.beek@nki.nl; Jaeger, Katrien de [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Radiation Oncology, Amsterdam (Netherlands); Mijnheer, Ben [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Radiation Oncology, Amsterdam (Netherlands)]|[INHOLLAND University of Professional Training, Haarlem (Netherlands); Vliet-Vroegindeweij, Corine van [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Radiation Oncology, Amsterdam (Netherlands)

    2008-10-01

    The aim of this study was to develop a technique for axillary radiotherapy that minimizes the risk of radiation-induced damage to the surrounding normal tissue (i.e., arm, shoulder, lung, esophagus, and spinal cord) while keeping the risk of a nodal recurrence to a minimum. A planning study was performed in 20 breast cancer patients. The target volume of the axillary treatment encompassed the periclavicular and axillary lymph node areas. The 3-dimensional (3D) computed tomography (CT) information in this study was used to outline the lymph node areas and the organs at risk (i.e., the esophagus, spinal cord, brachial plexus, and lung). A conventional AP-PA technique (with a transmission plate placed in the AP beam) was evaluated. In addition, a new single-isocenter technique consisting of AP/PA fields using a gantry rotation of {+-}20 deg. and a medial AP segment was developed. Both techniques were compared by evaluation of the calculated dose distributions and the dose-volume histograms of the target volume and surrounding organs at risk. The field borders and humeral shielding were redefined based on the 3D anatomical references. Adapting the humeral shielding reduced the irradiated volume by 19% and might contribute to a reduction of the incidence of arm edema and impairment of shoulder function. The maximum radiation dose in the esophagus and spinal cord was reduced by more than 50% using the single-isocenter technique. The difference between both techniques with respect to the mean doses in the target volume and lung, and the maximum dose in brachial plexus, was not statistically significant. Moreover, the single-isocenter technique allowed a fast and easy treatment preparation and reduced the execution time considerably (with approximately 10 minutes per fraction)

  15. The axillopectoral muscle (Langer's axillary arch): a cause of axillary vein obstruction.

    PubMed

    Sachatello, C R

    1977-05-01

    The second patient recognized to have high grade intermittent obstruction of the axillary vein due to an anomalous axillopectoral muscle is reported. This relatively common anomalous muscle extends from the latissimus dorsi to the insertion of the pectoralis major and overlies the neurovascular bundle in the axilla. Preoperative recognition of this anomaly appears possible by phlebography, a history of intermittent axillary vein obstruction, loss of the normal axillary concavity, and a market disparity between obvious visual fullness in the axilla and the great difficulty encountered in palpating an axillary mass. Although a correct preoperative diagnosis of the presence of this anomaly has not been made yet, awareness of this entity is important because simple excision of this muscle is curative. PMID:850878

  16. Axillary skin malignancy: a rare breast cancer presentation.

    PubMed

    Miranda, Benjamin H; Malahias, Marco; El-Said, Tarek F A; Fahmy, Fahmy S

    2014-05-01

    A rise in incidence and decrease in mortality rates from breast cancer have lead to an increase in prevalence within developed countries. Presentation is classically with a palpable breast tissue mass that may metastasize to bone, lung, liver, brain, lymph nodes, and skin. We describe a delayed diagnosis, in an 80-year-old female patient, where, on 2 occasions, the primary initial presentation was with a cutaneous squamous cell carcinoma in the right axilla. It was not until the third referral, with an ipsilateral breast lump, that breast cancer was clinically diagnosed. This was histologically identified as the primary malignancy, most likely in-keeping with squamous cell carcinoma of the breast. This unique atypical presentation represents a diagnostic challenge and highlights a clinically relevant learning point that may avoid subsequent diagnostic delay. Cutaneous axillary lesions should be treated with a high index of suspicion, necessitating the requirement for chest examination because of the possible presence of an associated primary breast carcinoma. PMID:23241794

  17. Which prediction models best identify additional axillary disease after a positive sentinel node biopsy for breast cancer?

    PubMed

    Berrang, Tanya S; Lesperance, Mary; Truong, Pauline T; Walter, Caroline; Hayashi, Allen H; Olivotto, Ivo A

    2012-06-01

    To determine which web-based model best identifies women at low risk of further axillary disease after a positive sentinel lymph node (SLN+) biopsy. 673 women with T1-2cN0M0 SNB+ breast cancer who underwent completion axillary dissection (AxD) were identified. A subgroup not eligible to avoid AxD as part of the Z0011 study was defined (Z0011 exclusion group). Predicted risk of further axillary disease was generated using seven web-based models. "Low risk" was defined as a ?10% risk of further axillary disease. False negative ("low risk" prediction but AxD+) rates (FNRs), area under the receiver operating characteristic curve (AUC), and Brier score were determined for each model. 6 of 7 models identified "low risk" patients but FNRs ranged from 14 to 30%. The Stanford and Memorial Sloan-Kettering (MSKCC) models had the best FNRs. FNRs were lower with SLN micrometastasis (7-15%) and higher in the Z0011 exclusion group (21-41%). All models under-predicted further nodal disease in low risk patients and over-predicted in higher-risk patients. The Stanford and MSKCC models were able to identify women with SLN micrometastasis with a ?10% FNR. Models were not able to accurately identify low risk women from a cohort that would have been excluded from Z0011. PMID:22367621

  18. Photoacoustic image-guided needle biopsy of sentinel lymph nodes

    NASA Astrophysics Data System (ADS)

    Kim, Chulhong; Erpelding, Todd N.; Akers, Walter J.; Maslov, Konstantin; Song, Liang; Jankovic, Ladislav; Margenthaler, Julie A.; Achilefu, Samuel; Wang, Lihong V.

    2011-03-01

    We have implemented a hand-held photoacoustic and ultrasound probe for image-guided needle biopsy using a modified clinical ultrasound array system. Pulsed laser light was delivered via bifurcated optical fiber bundles integrated with the hand-held ultrasound probe. We photoacoustically guided needle insertion into rat sentinel lymph nodes (SLNs) following accumulation of indocyanine green (ICG). Strong photoacoustic image contrast of the needle was achieved. After intradermal injection of ICG in the left forepaw, deeply positioned SLNs (beneath 2-cm thick chicken breast) were easily indentified in vivo and in real time. Further, we confirmed ICG uptake in axillary lymph nodes with in vivo and ex vivo fluorescence imaging. These results demonstrate the clinical potential of this hand-held photoacoustic system for facile identification and needle biopsy of SLNs for cancer staging and metastasis detection in humans.

  19. Sentinel lymph node biopsy following prior augmentation mammaplasty and implant rupture.

    PubMed

    Warbrick-Smith, J; Cawthorn, S J

    2012-12-01

    We report the case of a 44 year old lady with bilateral cosmetic silicone breast implants who had previously undergone a change of her right implant following extracapsular rupture. She presented 4 years later with a new lump in her right breast and underwent subcutaneous mastectomy for a grade 3 invasive ductal carcinoma. Sentinel lymph node biopsy demonstrated axillary silicone lymphadenopathy but nil evidence of metastatic disease. We present this as the first described case of successful sentinel lymph node biopsy in the context of prior augmentation mammaplasty and ipsilateral implant rupture with silicone lymphadenopathy. PMID:23047180

  20. Subareolar injection of 99m Tc facilitates sentinel lymph node identification

    Microsoft Academic Search

    Todd M. Tuttle; Marybeth Colbert; Robert Christensen; Kevin J. Ose; Thomas Jones; Robert Wetherille; Joel Friedman; Karen Swenson; Kelly M. McMasters

    2002-01-01

    Background: Sentinel lymph node (SLN) biopsy with the standard intraparenchymal injection has been accepted as an alternative to routine\\u000a axillary dissection for patients with breast cancer. However, the identification and false-negative rates with this method\\u000a can vary widely from surgeon to surgeon. The subareolar location contains a rich lymphatic network and represents a potential\\u000a site of injection for SLN identification.

  1. Isolation and characterization of high endothelial cell lines derived from mouse lymph nodes

    Microsoft Academic Search

    Joan M. Cook-Milis; Joan S. Gallagher; Thomas L. Feldbush

    1996-01-01

    Summary  Two long-term cultured cell lines were established from BALB\\/c mouse axillary and cervical lymph nodes that exhibited a combination\\u000a of functional, morphological, and phenotypic characteristics consistent only with high endothelial venule cells. Spleen lymphocytes\\u000a selectively bound and migrated across the cell lines. On Matrigel, these cell lines formed tubules with lumens, a characteristic\\u000a unique to endothelial cells. Morphologically the cells

  2. Photothermal therapy of tumors in lymph nodes using gold nanorods and near-infrared laser light.

    PubMed

    Okuno, Tatsuki; Kato, Shigeki; Hatakeyama, Yuriko; Okajima, Junnosuke; Maruyama, Shigenao; Sakamoto, Maya; Mori, Shiro; Kodama, Tetsuya

    2013-12-28

    Lymph node dissection for regional nodal metastasis is a primary option, but is invasive and associated with adverse effects. The development of non-invasive therapeutic methods in preclinical experiments using mice has been restricted by the small lymph node size and the limited techniques available for non-invasive monitoring of lymph node metastasis. Here, we show that photothermal therapy (PTT) using gold nanorods (GNRs) and near-infrared (NIR) laser light shows potential as a non-invasive treatment for tumors in the proper axillary lymph nodes (proper-ALNs) of MXH10/Mo-lpr/lpr mice, which develop systemic swelling of lymph nodes (up to 13mm in diameter, similar in size to human lymph nodes). Tumor cells were inoculated into the proper-ALNs to develop a model of metastatic lesions, and any anti-tumor effects of therapy were assessed. We found that GNRs accumulated in the tumor in the proper-ALNs 24h after tail vein injection, and that irradiation with NIR laser light elevated tumor temperature. Furthermore, combining local or systemic delivery of GNRs with NIR irradiation suppressed tumor growth more than irradiation alone. We propose that PTT with GNRs and NIR laser light can serve as a new therapeutic method for lymph node metastasis, as an alternative to lymph node dissection. PMID:24144919

  3. Follicular lymphoma mimicking marginal zone lymphoma in lymph node: a case report

    PubMed Central

    Matsuda, Ikuo; Shimizu, Yoshifumi; Okamoto, Takahiro; Hirota, Seiichi

    2014-01-01

    Nodal follicular lymphoma (FL) is typically composed of follicular or nodular proliferation of small cleaved lymphoid cells, presumably derived from germinal center (GC) B cells. The hallmark of FL is t(14;18)(q32;q21) chromosomal translocation, which juxtaposes anti-apoptotic gene BCL2 to immunoglobulin heavy chain (IGH) promoter. Reflecting this background, FL cells are immunohistochemically positive for BCL2 as well as GC B cell markers CD10 and BCL6. It is known that low grade B-cell lymphomas, including FL, chronic lymphocytic leukemia/small lymphocytic lymphoma, and marginal zone lymphoma, are sometimes associated with marginal zone differentiation or plasmacytic differentiation. The marginal zone differentiation obscures the morphological differences among these, providing diagnostic challenges for histopathologists. In this paper, we present a case of FL, originally mimicking marginal zone lymphoma in the axillary lymph node. Subsequent bone marrow biopsy showed paratrabecular infiltration of small to medium-sized lymphoid cells. Immunohistochemical analysis of the bone marrow biopsy together with histopathology and flow cytometry of the axillary lymph node led to a final diagnosis of FL with marginal zone differentiation in the axillary lymph node and its bone marrow infiltration. Our case illustrates and reconfirms the importance of clinicopathological correlation which leads to a correct diagnosis. PMID:25400800

  4. Sentinel Lymph Node Biopsy for Breast Cancer: Impact of the Number of Sentinel Nodes Removed on the False-Negative Rate

    Microsoft Academic Search

    Sandra L Wong; Michael J Edwards; Celia Chao; Todd M Tuttle; R Dirk Noyes; David J Carlson; Patricia B Cerrito; Kelly M McMasters

    BACKGROUND: Numerous studies have demonstrated that sentinel lymph node (SLN) biopsy can accurately determine axillary nodal status for breast cancer, but unacceptably high false negative rates have also been reported. Attention has been focused on factors associated with improved accuracy. We have previously shown that injection of blue dye in combination with radioactive colloid reduces the false negative rate compared

  5. Is Regional Lymph Node Irradiation Necessary in Stage II to III Breast Cancer Patients With Negative Pathologic Node Status After Neoadjuvant Chemotherapy?

    SciTech Connect

    Daveau, Caroline [Department of Radiation Oncology, Centre Rene Huguenin, Saint-Cloud (France); Stevens, Denise [Department of Biostatistics, Centre Rene Huguenin, Saint-Cloud (France); Brain, Etienne [Department of Medical Oncology, Centre Rene Huguenin, Saint-Cloud (France)

    2010-10-01

    Purpose: Neoadjuvant chemotherapy (NAC) generally induces significant changes in the pathologic extent of disease. This potential down-staging challenges the standard indications of adjuvant radiation therapy. We assessed the utility of lymph node irradiation (LNI) in breast cancer (BC) patients with pathologic N0 status (pN0) after NAC and breast-conserving surgery (BCS). Methods and Materials: Among 1,054 BC patients treated with NAC in our institution between 1990 and 2004, 248 patients with clinical N0 or N1 to N2 lymph node status at diagnosis had pN0 status after NAC and BCS. Cox regression analysis was used to identify factors influencing locoregional recurrence-free survival (LRR-FS), disease-free survival (DFS), and overall survival (OS). Results: All 248 patients underwent breast irradiation, and 158 patients (63.7%) also received LNI. With a median follow-up of 88 months, the 5-year LRR-FS and OS rates were respectively 89.4% and 88.7% with LNI and 86.2% and 92% without LNI (no significant difference). Survival was poorer among patients who did not have a pathologic complete primary tumor response (hazard ratio, 3.05; 95% confidence interval, 1.17-7.99) and in patients with N1 to N2 clinical status at diagnosis (hazard ratio = 2.24; 95% confidence interval, 1.15-4.36). LNI did not significantly affect survival. Conclusions: Relative to combined breast and local lymph node irradiation, isolated breast irradiation does not appear to be associated with a higher risk of locoregional relapse or death among cN0 to cN2 breast cancer patients with pN0 status after NAC. These results need to be confirmed in a prospective study.

  6. Properties of lymph-borne (veiled) dendritic cells in culture. II. Expression of the IL-2 receptor: role of GM-CSF.

    PubMed Central

    MacPherson, G G; Fossum, S; Harrison, B

    1989-01-01

    Fresh lymph-borne (veiled) dendritic cells (L-DC) in the rat are almost totally negative for the interleukin-2 (IL-2) receptor detected by the monoclonal antibody (mAb) MRC OX39. After 16 hr culture more than 90% of L-DC are OX39 positive, and increased levels of expression can be seen within 5 hr culture. In cultures of L-DC and allogeneic lymphocytes. L-DC appear to express the IL-2 receptor more rapidly than lymphocytes. The intensity of labelling of L-DC is variable but maximal levels are similar to those seen on lymphoblasts. Culture in the presence of concanavalin A (Con A)-stimulated spleen cell supernatants or recombinant granulocyte-macrophage colony-stimulating factor (GM-CSF) results in a more rapid and intense expression of the IL-2 receptor by L-DC. L-DC cultured following rigorous T-cell depletion, or derived from athymic rats also express the IL-2 receptor after culture with GM-CSF. Cultured, but not fresh, L-DC bind iodinated recombinant IL-2 in a dose-dependent manner and binding is inhibited by excess unlabelled ligand. The amount of IL-2 bound varies but maximal amounts are similar to those bound by lymphoblasts. Following intravenous endotoxin injection, a large proportion of freshly collected L-DC express the IL-2 receptor and the number of L-DC released into the lymph is increased. An antibody to the IL-2 receptor which blocks an allogeneic MLR has no effect on a xenogeneic MLR using rat L-DC as stimulators and mouse lymphocytes as responders. Images Figure 1 Figure 4 Figure 5 PMID:2680907

  7. Observational study of axilla treatment for breast cancer patients with 1-3 positive micrometastases or macrometastases in sentinel lymph nodes.

    PubMed

    Oba, Mari S; Imoto, Shigeru; Toh, Uhi; Wada, Noriaki; Kawada, Masaya; Kitada, Masahiro; Masuda, Norikazu; Taguchi, Tetsuya; Minami, Shigeki; Jinno, Hiromitsu; Sakamoto, Junichi; Morita, Satoshi

    2014-09-01

    Sentinel node biopsy is a standard procedure in clinically node-negative breast cancer patients. It has eliminated unnecessary axillary lymph node dissection in more than half of the early breast cancers. However, one of the unresolved issues in sentinel node biopsy is how to manage axilla surgery for sentinel node-positive patients and clinically node-negative patients. To evaluate the outcome of no axillary lymph node dissection in sentinel node-positive breast cancer, a prospective cohort study registering early breast cancer patients with positive sentinel nodes has been conducted (UMIN 000011782). Patients with 1-3 positive micrometastases or macrometastases in sentinel lymph nodes are eligible for the study. The primary endpoint is the recurrence rate of regional lymph nodes in patients treated with sentinel node biopsy. Patients treated with sentinel node biopsy followed by axillary lymph node dissection are also registered simultaneously to compare the prognosis. The propensity score matching is used to make the distributions of baseline risk factors comparable. PMID:25030214

  8. Axillary Metastasis from an Occult Tubal Serous Carcinoma in a Patient with Ipsilateral Breast Carcinoma: A Potential Diagnostic Pitfall

    PubMed Central

    Altinel, Gulbeyaz; Arseneau, Jocelyne; Omeroglu, Atilla

    2014-01-01

    Axillary nodal metastasis from a nonmammary neoplasia is much rarer than diseases associated with a primary breast carcinoma. However, this has to be considered in the differential diagnosis of nodal disease in patients with a history of breast cancer. Here, we report the case of a 73-year-old female with a past medical history of breast cancer, presenting with an ipsilateral axillary metastatic carcinoma. The immunohistochemical profile of the metastatic lesion was consistent with a high grade serous carcinoma. After undergoing a total abdominal hysterectomy and salpingo-oophorectomy, thorough pathological examination revealed two microscopic foci of serous carcinoma in the right fallopian tube, not detectable by preoperative magnetic resonance imaging. In this context, the poorly differentiated appearance of the metastatic tumor and positive staining for estrogen receptor, might lead to a misdiagnosis of metastatic breast carcinoma. As the therapeutic implications differ, it is important for the pathologist to critically assess axillary lymph node metastases, even in patients with a past history of ipsilateral breast carcinoma and no other known primary tumors. PMID:25110596

  9. Comparison methods for branching and axillary flowering sequences

    Microsoft Academic Search

    Y. Guédon; P. Heuret; E. Costes

    2003-01-01

    Comparing branching and axillary flowering patterns accurately is a major issue both in botany and in various agronomic contexts. Data take the form of sequences which naturally represent the underlying structural information of branching and axillary flowering patterns. Various comparison methods are proposed based either on sequence alignment or on the computation of dissimilarity measures between (hidden) Markovian models built

  10. Original article Axillary bud proliferation of 2 North American

    E-print Network

    Paris-Sud XI, Université de

    Original article Axillary bud proliferation of 2 North American oak species: Quercus alba rubra, northern red oak, were selected to devel- op in vitro plantlet regeneration methods from bud and embryo explants. Various hormonal combina- tions were applied to explants to induce axillary bud

  11. Axillary artery cannulation for cardiopulmonary bypass reduces cerebral microemboli

    Microsoft Academic Search

    Nasim Hedayati; J. Timothy Sherwood; Steve J. Schomisch; Joseph L. Carino; Alan H. Markowitz

    2004-01-01

    BackgroundAortic cannulation for cardiopulmonary bypass (CPB) is linked to cerebral microemboli emanating from the ascending aorta. Aortic calcification or disease requiring replacement precludes aortic cannulation. Clinical experience with axillary artery cannulation led to the hypothesis that axillary cannulation may be cerebroprotective.

  12. Evaluation of Breast Sentinel Lymph Node Coverage by Standard Radiation Therapy Fields

    SciTech Connect

    Rabinovitch, Rachel [Department of Radiation Oncology, University of Colorado Cancer Center, Aurora, CO (United States)], E-mail: Rachel.rabinovitch@uchsc.edu; Ballonoff, Ari; Newman, Francis M.S. [Department of Radiation Oncology, University of Colorado Cancer Center, Aurora, CO (United States); Finlayson, Christina [Department of GI, Tumor, and Endocrine Surgery, University of Colorado Cancer Center, Aurora, CO (United States)

    2008-04-01

    Background: Biopsy of the breast sentinel lymph node (SLN) is now a standard staging procedure for early-stage invasive breast cancer. The anatomic location of the breast SLN and its relationship to standard radiation fields has not been described. Methods and Materials: A retrospective review of radiotherapy treatment planning data sets was performed in patients with breast cancer who had undergone SLN biopsy, and those with a surgical clip at the SLN biopsy site were identified. The location of the clip was evaluated relative to vertebral body level on an anterior-posterior digitally reconstructed radiograph, treated whole-breast tangential radiation fields, and standard axillary fields in 106 data sets meeting these criteria. Results: The breast SLN varied in vertebral body level position, ranging from T2 to T7 but most commonly opposite T4. The SLN clip was located below the base of the clavicle in 90%, and hence would be excluded from standard axillary radiotherapy fields where the inferior border is placed at this level. The clip was within the irradiated whole-breast tangent fields in 78%, beneath the superior-posterior corner multileaf collimators in 12%, and outside the tangent field borders in 10%. Conclusions: Standard axillary fields do not encompass the lymph nodes at highest risk of containing tumor in breast cancer patients. Elimination of the superior-posterior corner MLCs from the tangent field design would result in inclusion of the breast SLN in 90% of patients treated with standard whole-breast irradiation.

  13. In vivo photoacoustic and ultrasonic mapping of rat sentinel lymph nodes with a modified commercial ultrasound imaging system

    NASA Astrophysics Data System (ADS)

    Erpelding, Todd N.; Kim, Chulhong; Pramanik, Manojit; Guo, Zijian; Dean, John; Jankovic, Ladislav; Maslov, Konstantin; Wang, Lihong V.

    2010-02-01

    Sentinel lymph node biopsy (SLNB) has become the standard method for axillary staging in breast cancer patients, relying on invasive identification of sentinel lymph nodes (SLNs) following injection of blue dye and radioactive tracers. While SLNB achieves a low false negative rate (5-10%), it is an invasive procedure requiring ionizing radiation. As an alternative to SLNB, ultrasound-guided fine needle aspiration biopsy has been tested clinically. However, ultrasound alone is unable to accurately identify which lymph nodes are sentinel. Therefore, a non-ionizing and noninvasive detection method for accurate SLN mapping is needed. In this study, we successfully imaged methylene blue dye accumulation in vivo in rat axillary lymph nodes using a Phillips iU22 ultrasound imaging system adapted for photoacoustic imaging with an Nd:YAG pumped, tunable dye laser. Photoacoustic images of rat SLNs clearly identify methylene blue dye accumulation within minutes following intradermal dye injection and co-registered photoacoustic/ultrasound images illustrate lymph node position relative to surrounding anatomy. To investigate clinical translation, the imaging depth was extended up to 2.5 cm by adding chicken breast tissue on top of the rat skin surface. These results raise confidence that photoacoustic imaging can be used clinically for accurate, noninvasive SLN mapping.

  14. Pathological lymph node involvement at surgery is a significant predictive factor of recurrence in locally advanced breast cancer treated with concomitant epirubicin–docetaxel neoadjuvant chemotherapy: a cohort study

    Microsoft Academic Search

    Kazuharu Kai; Nobuyuki Arima; Haruhiko Miyayama; Yutaka Yamamoto; Hirotaka Iwase; Reiki Nishimura

    2009-01-01

    Background  Neoadjuvant chemotherapy (NAC) is the standard therapy for locally advanced breast cancer. Recently, several studies have\\u000a revealed that clearance of axillary lymph node involvement is an independent factor for survival irrespective of the response\\u000a of the primary lesion. However, in daily practice, it is difficult to fully examine every lymph node that has been surgically\\u000a sampled, in view of pathology

  15. Sentinel Node Biopsy Before Neoadjuvant Chemotherapy Spares Breast Cancer Patients Axillary Lymph Node Dissection

    Microsoft Academic Search

    Maartje C. van Rijk; Omgo E. Nieweg; Emiel J. T. Rutgers; Hester S. A. Oldenburg; Renato Valdés Olmos; Cornelis A. Hoefnagel; Bin B. R. Kroon

    2006-01-01

    Background  Neoadjuvant chemotherapy in breast cancer patients is a valuable method to determine the efficacy of chemotherapy and potentially\\u000a downsize the primary tumor, which facilitates breast-conserving therapy. In 18 studies published about sentinel node biopsy\\u000a after neoadjuvant chemotherapy, the sentinel node was identified in on average 89%, and the false-negative rate was on average\\u000a 10%. Because of these mediocre results, no

  16. Women with Breast Cancer Micrometastases in Their Sentinel Lymph Nodes May Not Need Axillary Dissection

    MedlinePLUS

    ... doctors,” said Jo Anne Zujewski, MD, head of breast cancer therapeutics at NCI. “Some patients, especially those for whom radiation therapy plus chemotherapy and/or hormonal therapy is planned, ...

  17. Effect of shaving on axillary stratum corneum.

    PubMed

    Marti, V P J; Lee, R S; Moore, A E; Paterson, S E; Watkinson, A; Rawlings, A V

    2003-08-01

    Removal of underarm hair is an intrinsic part of the care regimen for the majority of female consumers, with most using a wet shave with a disposable razor. However, little is known of the impact of shaving on axillary skin, and it is a particularly neglected area of research. To investigate this, we have studied the acute and chronic effects of shaving ultrastructurally, biochemically and functionally. A forearm patch test protocol was devised for antiperspirant (AP) product screening, which involved a pre-shave of the test site with a dry razor just prior to patching. Comparison of the irritation caused by a series of AP products confirmed that shaving leads to increased irritation consistent with enhanced sensitivity. The effect of regular shaving in the axilla was assessed in a 4-week in-use study with shaving either once a week or once a day, both combined with the application of an AP. Expert visual assessment of skin condition showed that more frequent shaving promoted a higher level of visible irritation. However, indirect measurement using corneosurfametry indicated no significant changes to the lipid barrier over the study period irrespective of shaving frequency. Nevertheless, digital images of the axillary skin after dry shaving show distinct opaque lines because of uplifting skin flakes with a corresponding increase in scaliness parameter. Moreover, histamine iontophoresis to assess skin sensitivity demonstrated a significant enhancement of histamine-induced itch and neurogenic flare. PMID:18494901

  18. Effects of Adding Dexmedetomidine to Levobupivacaine in Axillary Brachial Plexus Block

    PubMed Central

    Kaygusuz, Kenan; Kol, Iclal Ozdemir; Duger, Cevdet; Gursoy, Sinan; Ozturk, Hayati; Kayacan, Ulku; Aydin, Rukiye; Mimaroglu, Caner

    2012-01-01

    Background Although several studies have described effects of dexmedetomidine on peripheral nerve blocks, to date there is limited knowledge available on the impact of dexmedetomidine adjunct to levobupivacaine in axillary brachial plexus block. Objective In this study, we aimed to investigate the effects of adding dexmedetomidine to levobupivacaine for an axillary brachial plexus block. Methods A total of 64 patients of American Society of Anesthesiologists physical status I/II scheduled to undergo forearm and hand surgery, in which an axillary block was used, were enrolled. The patients were randomly divided into 2 groups: in group L patients (n = 32), an axillary block was performed with 39 mL levobupivacaine 5% plus 1 mL of isotonic sodium chloride. In group D patients (n = 32), an axillary block was performed with 39 mL levobupivacaine 5% and 1 mL dexmedetomidine 1 ?g/kg?1 plus isotonic sodium chloride. Demographic data, mean arterial pressure (MAP), heart rate (HR), peripheral oxygen saturation (Spo2), sensory and motor block onset times and block durations, time to first analgesic use, total analgesic need, intraoperative verbal analog scale, postoperative visual analog scale (VAS) data, and side effects were recorded for each patient. Results There were no significant differences in patient and surgery characteristics between the 2 groups. Sensory block onset time was shorter in group D (P < 0.05). Sensory and motor block duration and time to first analgesic use were significantly longer in group D (P < 0.05), and the total need for analgesics was lower in group D (P < 0.05). Intraoperative 5- and 10-minute verbal analog scale values and postoperative VAS value at 12 hours were significantly lower in group D (P < 0.05). Intraoperative MAP and HR values, except at 5 minutes and postoperatively at 10 and 30 minutes and 1 and 2 hours, were significantly lower in group D (P < 0.01). Bradycardia, hypotension, hypoxemia, nausea, vomiting, and any other side effects were not seen in any patients. Conclusions It was concluded in our study that adding dexmedetomidine to axillary brachial plexus block shortens sensory block onset time, increases the sensory and motor block duration and time to first analgesic use, and decreases total analgesic use with no side effects. ClinicalTrials.gov identifier ISRCTN67622282. PMID:24648597

  19. Design and development of a dedicated mammary and axillary region positron emission tomography system

    NASA Astrophysics Data System (ADS)

    Doshi, Niraj Kumar

    Breast cancer is the second leading cause of cancer death in women. Currently, mammography and physical breast examination, both non-invasive techniques, provide the two most effective methods available for screening potential breast cancer patients. During the management of patients, however, several invasive techniques such as axillary lymph node dissection, core biopsies and lumpectomies, are utilized to determine the stage or malignancy of the disease with significant cost and morbidity associated with them. Positron Emission Tomography (PET), using [F-18] fluorodeoxyglucose (FDG) tracer is a sensitive and non-invasive imaging modality that may be a cost-effective alternative to certain invasive procedures. In this project we have developed a low cost, high performance, dedicated PET camera (maxPET) for mammary and axillary region imaging. The system consists of two 15x15 cm2 planar scintillation detector arrays composed of modular detectors operating in coincidence. The modular detectors are comprised of a 9x9 array of 3x3x20 mm3 lutetiurn oxyorthosilicate (LSO) detector elements, read out by a 5x5 array of position- sensitive photomultiplier tubes. The average measured intrinsic spatial resolution of a detector module is 2.26 mm with a sensitivity of up to 40% for a central point source. The measured coincidence timing resolution for two modules is 2.4 ns. The average energy resolution measured across the entire two detector plates is 21.6%. The coincidence timing resolution for the entire system is 8.1 ns. A line bar phantom was imaged and images were reconstructed using the focal plane tomography algorithm. A 4 mm projection image resolution was measured based on profiles taken through the line bar phantom images. The goal of the maxPET system will be to aid in breast cancer patient management by assisting in imaging women with dense, fibro-glandular breasts, detecting axillary lymph node metastases without surgery, monitoring chemotherapy effectiveness and assisting in visualization of recurrence and tumoral boundaries.

  20. Mid-arm lymph nodes dissection for melanoma.

    PubMed

    Fujiwara, Masao; Suzuki, Ayano; Mizukami, Takahide; Nagata, Takeshi; Ito, Taisuke; Fukamizu, Hidekazu

    2010-09-01

    An interval node in the upper limb termed the mid-arm node was recently identified. However, its surgical anatomy remains unclear. We report a patient with metastatic melanoma of the mid-arm node and the epitrochlear node at 10 years after removal of the primary tumour from the forearm and therapeutic axillary lymph node dissection. The mid-arm node is located halfway up the upper arm on the medial intermuscular septum, at the site where the brachial vessels, the median nerve and the ulnar nerve run adjacent to each other. The mid-arm node lies adjacent to the basilic vein where lymphatic vessels ascend and converge. This is the first report regarding the surgical anatomy of the mid-arm node. PMID:20227935

  1. Clinicopathologic subtypes and compromise of lymph nodes in patients with breast cancer

    PubMed Central

    Jaime Jans, B; Nicolás Escudero, M; Dahiana Pulgar, B; Francisco Acevedo, C; César Sánchez, R; Camus, A Mauricio

    2014-01-01

    Breast cancer (BC) is currently a heterogeneous disease with variations in clinical behaviour. Classification according to subtypes has allowed progress in the individualisation of treatment. The objective of this study is to evaluate the risk of axillary node compromise in patients with BC, according to clinicopathologic subtypes. Materials and methods are a retrospective, descriptive-analytical study. All patients that had undergone surgery for invasive BC were included, with the study of sentinel lymph nodes (SLNs) at Hospital Clínico de la Pontificia Universidad Católica, between May 1999 and December 2012. The results showed 632 patients fulfilled the inclusion criteria, with the median age being 55 years (range: 28–95), and 559 (88.4%) patients presented with estrogen receptor and/or progesterone receptor positive tumours. Luminal A: 246 patients (38.9%), luminal B: 243 (38.4%), luminal not otherwise specified: 70 (11.1%) triple negative (TN): 60 (9.5%) and over expression of epidermal growth factor type 2 receptor (HER2 positive): 13 (2.1%). Luminal tumours displayed a greater risk of metastasis in the SLNs, but this difference was not statistically significant (p = 0.67). TN and HER2 positive tumours presented the greatest proportion of metastatic compromise in non-sentinel lymph nodes (non-SLNs) (57.1% and 50%, respectively). The presence of macrometastasis (MAM) in the SLN was associated with a greater risk of compromise of the non-SLN. Conclusions: Luminal tumours are the most frequent and present a greater proportion of axillary lymph node compromise, without being statistically significant. TN and HER2 positive tumours tend to have a higher axillary compromise; however, this was not statistically significant in either. Only the presence of MAM in SLNs displayed a statistically significantly association in the compromise of non-SLNs. PMID:25114720

  2. Sentinel lymph node biopsy in selected cases of ductal carcinoma in situ

    Microsoft Academic Search

    María Vicenta Collado; Jaime Ruiz-Tovar; Augusto García-Villanueva; Roberto Rojo; Lucía Latorre; María Eugenia Rioja; Fernando González-Palacios

    2010-01-01

    Introduction  Axillary lymphadenectomy is nowadays not recommended to treat ductal carcinoma in situ (DCIS), but there is controversy surrounding\\u000a the indication for sentinel lymph node biopsy (SLNB).\\u000a \\u000a \\u000a \\u000a \\u000a Materials and methods  A prospective study of a selected group of patients diagnosed preoperatively with DCIS was performed between 2004 and 2009.\\u000a Indications for SLNB were histologically determined high-grade tumours, tumour size >2 cm and

  3. Tortuous axillary artery aneurysm causing median nerve compression.

    PubMed

    Ortiz-Pomales, Yan; Smith, Jennifer; Weiss, Jeffrey; Casey, Kevin

    2014-01-01

    Axillary artery aneurysms are rare entities that warrant surgical intervention. Reported complications include thrombosis, distal embolization, and debilitating neurologic symptoms caused by median nerve compression. Common etiologies include trauma or repetition injuries. Less recognized associations include atherosclerotic, connective tissue, or mycotic processes. We report a case of a rare tortuous axillary artery aneurysm causing neurologic symptoms in a woman with an unused arteriovenous fistula. PMID:24189011

  4. Axillary and Rectal Temperature Measurements Poorly Agree in Newborn Infants

    Microsoft Academic Search

    P. C. E. Hissink Muller; L. H. van Berkel; A. J. de Beaufort

    2008-01-01

    Aim: Evaluation of the agreement between axillary temperature measurements and rectal temperature measurements in neonates. Methods: Rectal and axillary body temperatures were simultaneously measured for 3 min in 33 neonates (gestational age 25–42 weeks, weight 840–4,005 g). Two investigators performed paired measurements, one in each neonate. A single type of thermometer was used in this study: one thermometer for each

  5. [Lung cancer and lymph drainage].

    PubMed

    Riquet, M

    2007-01-01

    Lung cancer is lymphophile and may involve lymph nodes (LN) belonging to lung lymph drainage. LN metastases are figured within stations numbered 1 to 14. These stations are located along lymph vessels. The lymph vessels and the LN are forming together anatomical chains. Lymph vessels are valved and pulsatile and travel to the cervical venous confluence where they pour the lung lymph into the blood circulation. They may be totally or partly nodeless along their travel, anastomose with each other around the trachea, and connect with the thoracic duct within the mediastinum. Within the anatomical LN chains, LN are variable in number and in size from one individual to another. They may be absent from one or several stations of the international mapping. Stations are located along the anatomical chains: pulmonary ligament (9), tracheal bifurcation(8 and 7), right paratracheal (4R, 2R and 1), preaortic (5 and 6), left paratracheal (4L, 2L and 1). Station 3 is located on 2 differents chains (phrenic and right esophagotracheal). Station 10 are located at the beginning of the mediastinal lymph nodes chains. Each chain connects with the blood circulation, anastomoses with he neighbouring chains and behave as an own entity whatever the number of its LN. International station mapping misknowns this anatomy and occults the true pronostic value of lung lymph drainage. PMID:16928459

  6. Risk Factors for Regional Nodal Relapse in Breast Cancer Patients With One to Three Positive Axillary Nodes

    SciTech Connect

    Yates, Lucy, E-mail: lucy.yates@gstt.nhs.uk [Guy's, King's, St Thomas' Cancer Centre, Guy's Hospital, London (United Kingdom); Kirby, Anna [Guy's, King's, St Thomas' Cancer Centre, Guy's Hospital, London (United Kingdom); Department of Clinical Oncology, Royal Marsden Hospital, Sutton (United Kingdom); Crichton, Siobhan [Department of Statistics, Kings College London (United Kingdom); Gillett, Cheryl [Breast Pathology, Kings College London (United Kingdom); Cane, Paul [Department of Histopathology, Guy's and St Thomas' Foundation Trust, London (United Kingdom); Fentiman, Ian; Sawyer, Elinor [Guy's, King's, St Thomas' Cancer Centre, Guy's Hospital, London (United Kingdom)

    2012-04-01

    Purpose: In many centers, supraclavicular fossa radiotherapy (SCF RT) is not routinely offered to breast cancer patients with one to three positive lymph nodes. We aimed to identify a subgroup of these patients who are at high risk of supra or infraclavicular fossa relapse (SCFR) such that they can be offered SCFRT at the time of diagnosis to improve long term locoregional control. Methods and Materials: We performed a retrospective analysis of the pathological features of 1,065 cases of invasive breast cancer with one to three positive axillary lymph nodes. Patients underwent radical breast conserving surgery or mastectomy. A total of 45% of patients received adjuvant chest wall/breast RT. No patients received adjuvant SCFRT. The primary outcome was SCFR. Secondary outcomes were chest wall/breast recurrence, distant metastasis, all death, and breast-cancer specific death. Kaplan-Meier estimates were used to calculate actuarial event rates and survival functions compared using log-rank tests. Multivariate analyses (MVA) of factors associated with outcome were conducted using Cox proportional hazards models. Results: Median follow-up was 9.7 years. SCFR rate was 9.2%. Median time from primary diagnosis to SCFR was 3.4 years (range, 0.7-14.4 years). SCFR was associated with significantly lower 10-year survival (18% vs. 65%; p < 0.001). Higher grade and number of positive lymph nodes were the most significant predictors of SCFR on MVA (p < 0.001). 10 year SCFR rates were less than 1% in all patients with Grade 1 cancers compared with 30% in those having Grade 3 cancers with three positive lymph nodes. Additional factors associated with SCFR on univariate analysis but not on MVA included larger nodal deposits (p = 0.002) and proportion of positive nodes (p = 0.003). Conclusions: Breast cancer patients with one to three positive lymph nodes have a heterogenous risk of SCFR. Patients with two to three positive axillary nodes and/or high-grade disease may warrant consideration of SCFRT.

  7. MRI of axillary brachial plexus blocks

    PubMed Central

    Kjelstrup, Trygve; Hol, Per K.; Courivaud, Frédéric; Smith, Hans-Jørgen; Røkkum, Magne; Klaastad, Øivind

    2014-01-01

    BACKGROUND Axillary plexus blocks are usually guided by ultrasound, but alternative methods may be used when ultrasound equipment is lacking. For a nonultrasound-guided axillary block, the need for three injections has been questioned. OBJECTIVES Could differences in block success between single, double and triple deposits methods be explained by differences in local anaesthetic distribution as observed by MRI? DESIGN A blinded and randomised controlled study. SETTING Conducted at Oslo University Hospital, Rikshospitalet, Norway from 2009 to 2011. PATIENTS Forty-five ASA 1 to 2 patients scheduled for surgery were randomised to three equally sized groups. All patients completed the study. INTERVENTIONS Patients in the single-deposit group had an injection through a catheter parallel to the median nerve. In the double-deposit group the patients received a transarterial block. In the triple-deposit group the injections of the two other groups were combined. Upon completion of local anaesthetic injection the patients were scanned by MRI, before clinical block assessment. The distribution of local anaesthetic was scored by its closeness to terminal nerves and cords of the brachial plexus, as seen by MRI. The clinical effect was scored by the degree of sensory block in terminal nerve innervation areas. MAIN OUTCOME MEASURES Sensory block effect and MRI distribution pattern. RESULTS The triple-deposit method had a higher success rate (100%) than the single-deposit method (67%) and the double-deposit method (67%) in blocking all cutaneous nerves distal to the elbow (P?=?0.04). The patients in the triple-deposit group most often had the best MRI scores. For any nerve or cord, at least one of the single-deposit or double-deposit groups had a similarly high MRI score as the triple-deposit group. CONCLUSION Distal to the elbow, the triple-deposit method had the highest sensory block success rate. This could be explained to some extent by analysis of the magnetic resonance images. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT01033006. PMID:25051144

  8. Lymph pathways of the medial retropharyngeal lymph node in dogs.

    PubMed Central

    Belz, G T; Heath, T J

    1995-01-01

    In dogs, lymph drains from tissues throughout the head, including the tonsils, along lymphatic vessels to the facial, parotid, lateral retropharyngeal and mandibular lymph nodes. From the mandibular lymph nodes, lymph may flow to the ipsilateral medial retropharyngeal lymph nodes, or along anastomotic connections to the contralateral node. Afferent lymphatics convey lymph from these nodes to defined areas in the medial retropharyngeal nodes. They divide over the surface of the node, and within trabeculae. Terminal afferent lymphatics are connected to the subcapsular and trabecular sinuses either through circular or oval holes in the vessel wall, or terminate at the sinus where the vessel contains a valve adjacent to the point of entry. The subcapsular sinus surrounds the entire node, and is continuous with an interconnecting network of trabecular and cortical sinuses which convey lymph through the cortex. Connective tissue septa extend through the sinuses and lymph flows freely between adjacent sinuses through holes in the septal walls. Initial efferent lymphatic vessels, which arise from the medullary sinuses between medullary cords, converge towards and unite within the network of medullary trabeculae. Other vessels, which contain valve-like flaps, drain lymph from the subcapsular sinus. Efferent vessels emerge along the hilus and coalesce to form the tracheal trunk. The tracheal trunk has several layers of smooth muscle cells, well developed elastic laminae and connective tissue, surrounding the lymphatic endothelium. Images Fig. 3 Fig. 4 Fig. 5 Fig. 6 Fig. 7 Fig. 8 Fig. 9 Fig. 10 Fig. 11 Fig. 12 Fig. 13 Fig. 14 Fig. 15 Fig. 16 Fig. 17 Fig. 18 PMID:7559125

  9. Secretory breast carcinoma in a 6-year-old girl: mastectomy with sentinel lymph node dissection.

    PubMed

    Soyer, Tutku; Yaman Bajin, ?nci; Orhan, Diclehan; Yalçin, Bilgehan; Özgen Kiratli, Pinar; O?uz, Berna; Karnak, ?brahim

    2015-07-01

    Secretory breast carcinoma (SBC) is a rare type of breast neoplasia that was originally described in children. SBC is an indolent breast tumor with good clinical outcome and rare systemic involvement. Since, majority of studies concerning pediatric SBC have been case reports, it has been difficult to clearly elucidate the characteristics and optimal treatment strategies for SBC in children. Although treatment recommendations vary, surgical excision is the primary mode of treatment. Also, necessity of axillary and/or sentinel lymph node dissection is another matter of discussion in children. We report a 6-year-old girl who was diagnosed as SBC was reported to discuss the use of mastectomy with sentinel lymph node dissection in the treatment of this rare tumor in children. PMID:25994562

  10. Sentinel Lymph Node Biopsy in Colon Cancer

    PubMed Central

    Bembenek, Andreas E.; Rosenberg, Robert; Wagler, Elke; Gretschel, Stephan; Sendler, Andreas; Siewert, Joerg-Ruediger; Nährig, Jörg; Witzigmann, Helmut; Hauss, Johann; Knorr, Christian; Dimmler, Arno; Gröne, Jörn; Buhr, Heinz-Johannes; Haier, Jörg; Herbst, Hermann; Tepel, Juergen; Siphos, Bence; Kleespies, Axel; Koenigsrainer, Alfred; Stoecklein, Nikolas H.; Horstmann, Olaf; Grützmann, Robert; Imdahl, Andreas; Svoboda, Daniel; Wittekind, Christian; Schneider, Wolfgang; Wernecke, Klaus-Dieter; Schlag, Peter M.

    2007-01-01

    Introduction: The clinical impact of sentinel lymph node biopsy (SLNB) in colon cancer is still controversial. The purpose of this prospective multicenter trial was to evaluate its clinical value to predict the nodal status and identify factors that influence these results. Methods: Colon cancer patients without prior colorectal surgery or irradiation were eligible. The sentinel lymph node (SLN) was identified intraoperatively by subserosal blue dye injection around the tumor. The SLN underwent step sections and immunohistochemistry (IHC), if classified free of metastases after routine hematoxylin and eosin examination. Results: At least one SLN (median, n = 2) was identified in 268 of 315 enrolled patients (detection rate, 85%). Center experience, lymphovascular invasion, body mass index (BMI), and learning curve were positively associated with the detection rate. The false-negative rate to identify pN+ patients by SLNB was 46% (38 of 82). BMI showed a significant association to the false-negative rate (P < 0.0001), the number of tumor-involved lymph nodes was inversely associated. If only slim patients (BMI ?24) were investigated in experienced centers (>22 patients enrolled), the sensitivity increased to 88% (14 of 16). Moreover, 21% (30 of 141) of the patients, classified as pN0 by routine histopathology, revealed micrometastases or isolated tumor cells (MM/ITC) in the SLN. Conclusions: The contribution of SLNB to conventional nodal staging of colon cancer patients is still unspecified. Technical problems have to be resolved before a definite conclusion can be drawn in this regard. However, SLNB identifies about one fourth of stage II patients to reveal MM/ITC in lymph nodes. Further studies must clarify the clinical impact of these findings in terms of prognosis and the indication of adjuvant therapy. PMID:17522509

  11. Predictive factors of non-sentinel lymph node involvement in patients with invasive breast cancer and sentinel node micrometastases.

    PubMed

    Friedman, Daniele; Gipponi, Marco; Murelli, Federica; Meszaros, Paolo; Solari, Nicola; Massa, Michela; Depaoli, Francesca; Baccini, Paola; Carli, Franca; Gallo, Maurizio; Cafiero, Ferdinando

    2013-10-01

    Patient-related, tumor-related, and sentinel node (SN)-related factors have been identified with the aim of predicting non-SN status in patients with SN micrometastases. According to our previous experience, primary tumor size (p=0.005) and the presence of lymphovascular invasion (LVI) (p=0.000) significantly predicted non-SN status in patients with SN micrometastasis; moreover, non-SN metastases were never detected in patients with pT1a-1b, G1, and no LVI. A prospective assessment was undertaken in a validation set of 126 patients to confirm these findings. Univariate analysis indicated that primary tumor size (p=0.05), Scarff-Bloom-Richardson (SBR) grade (p=0.008), LVI (p=0.001), and the number of mitoses/mm(2) (p=0.01) were significant predictors of non-SN status. By logistic regression analysis, tumor size (p=0.03), LVI (p=0.001), grade (p=0.003) and the number of mitoses/mm(2) (p=0.01) were the only variables remaining in the model. Three subsets of patients were identified: i) 18.3% of patients (pT1, G1, and no LVI) had tumor-negative non-SN (no risk group); ii) 37.3% of patients (number of mitoses/mm(2) <10, SBR grade II-III) had a rate of tumor-positive non-SN <15% (intermediate risk); iii) 44.4% of patients had a mean rate of non-SN involvement of 46% (high risk). By these parameters, more than 50% of patients could be selectively spared unnecessary axillary lymph node dissection without staging or therapeutic benefit, especially in patients with well-differentiated pT1 tumors without LVI. PMID:24123023

  12. New treatment techniques for axillary hyperhidrosis.

    PubMed

    Mordon, Serge R; Trelles, Mario A; Leclere, Franck Marie; Betrouni, Nacim

    2014-10-01

    Hyperhidrosis is a medical problem defined as perspiration in excess of what is normally needed to cool the body. The excessive production of sweat by the sudoriferous glands is independent of the process of thermoregulation. Techniques have recently appeared that make use of energy sources, in particular microwave devices and light (pulsed flashlamp or laser). The aim is to obtain very long-lasting efficacy without notable side effects. Thermal Nd:YAG lasers used with an interstitial fiber, microwave devices, and photodynamic therapy appear to offer new treatment options for axillary hyperhidrosis. However, insertion of a laser fiber into tissue by means of a cannula may lead to complications if the procedure is not well mastered, as has been shown by numerous studies on laser lipolysis. The only microwave device available on the market is certainly interesting. Photodynamic therapy using eosin gel is an attractive technique. The energy source is a pulsed flashlamp, which many physicians have. Eosin gel is relatively easy to produce and these gels are already marketed in several countries. However, further clinical studies of larger series of patients and with longer follow-up are still needed to reach a definitive conclusion as to the value of this approach. PMID:25065458

  13. Micropropagation of Helleborus through axillary budding.

    PubMed

    Beruto, Margherita; Viglione, Serena; Bisignano, Alessandro

    2013-01-01

    Helleborus genus, belonging to the Ranunculaceae family, has 20 species of herbaceous perennial flowering plants. The commercial exploitation of this plant is dependent on the selection and propagation of appropriate lines. High propagation rate could be accomplished by using a suitable tissue culture method enabling the rapid introduction of valuable selections in the market. However, in vitro cultivation of Helleborus is still very difficult. Thereby the development of reliable in vitro propagation procedures is crucial for future production systems. Axillary buds cultured on agar-solidified Murashige and Skoog medium supplemented with 1 mg/L benzyladenine, 0.1 mg/L ?-naphthoxyacetic acid, and 2 mg/L isopentenyl adenine develop shoots after 16 weeks of culture under 16 h light regime, 50-60 ?mol/s/m(2), and 19 ± 1°C. The multiplication rate ranges from 1.4 to 2.1. However, the genotype and the number of subcultures affect the efficiency of the micropropagation process. The rooting of shoots is about 80% in solidified MS medium containing 1 mg/L 1-naphthaleneacetic acid and 3 mg/L indole-3-butyric acid. The described protocol provides information which can contribute to the commercial production of Helleborus plants. PMID:23179705

  14. Phase II study of concurrent selective lymph node late course accelerated hyper-fractionated radiotherapy and pemetrexed and cisplatin for locally advanced oesophageal squamous cell carcinoma

    PubMed Central

    Fu, C; Guo, L; Li, H; Huang, W; Gong, H; Sun, M; Wang, Z; Zhou, T; Liu, C

    2014-01-01

    Objective: To determine the clinical efficacy and toxicity of pemetrexed combined with low-dose cisplatin (CDDP) concurrent with late-course accelerated hyperfractionated (LCAF) intensity-modulated radiation therapy (IMRT) in patients with inoperable locally advanced oesophageal squamous cell carcinoma (ESCC). Methods: Patients with locally advanced ESCC (less than or equal to 75 years of age, clinical stages IIB–IVA and Karnofsky performance status ?70) were enrolled into the study. A target group size of 22 was projected based on the estimation that 2-year overall survival (OS) would increase from 20% to 40%. Patients were treated with pemetrexed, low-dose CDDP and LCAF IMRT concurrently. The main objective of the study was for a 2-year OS, and the secondary objectives were progression-free survival (PFS), objective response, locoregional failure rate, and acute and late toxicities. Results: 25 patients were recruited from October 2008 to July 2011. The median OS was 21 months, with 2- and 5-year OS rates of 44% and 44%, respectively. The median PFS was 18.2 months. The objective response rate was 96% (24/25), with 11 complete responses and 13 partial responses. The locoregional failure rate was 16%. Grades 4 and 5 acute toxicity rates were 8% and 4%, respectively, while no Grade 3 or greater late toxicity was observed. Conclusion: The findings of this Phase II study indicated that the therapeutic regimen appears to achieve an excellent response rate and favourable survival for locally advanced ESCC. However, the severe acute side effects should be considered cautiously in further studies. Advances in knowledge: To our knowledge, this is the first study that introduced pemetrexed and low-dose CDDP combined with LCAF IMRT to treat locally advanced ESCC. The 5-year OS rate was as high as 44%, which was more favourable than other studies. PMID:24666012

  15. Sentinel lymph node detection by intranipple injection of patent blue dye in breast cancer: a preliminary report of a feasibility study.

    PubMed

    Zervoudis, S; Iatrakis, G; Paschopoulos, M; Dousias, V; Geahchan, N; Stefos, T; Pechlivani, F; Navrozoglou, I

    2012-01-01

    Sentinel lymph node (SLN) biopsy is a well established option for assessing axillary lymph node status in breast cancer. Several techniques have been applied so far (superficial or deeper ones). Based on anatomical features of the lymphatic drainage in the breast, we assessed the feasibility of an intranipple approach for SLN mapping. Our data support the feasibility of SLN detection by our technique, with a high rate of SLN identification, which could be used in clinical practice as an alternative to the peri-areolar approach. PMID:22873105

  16. A prospective study of the significance of gene and chromosome alterations as prognostic indicators of breast cancer patients with lymph node metastases

    Microsoft Academic Search

    Hitoshi Tsuda; Chinami Sakamaki; Shoichiro Tsugane; Takashi Fukutomi; Setsuo Hirohashi

    1998-01-01

    In 150 surgically resected primary breast carcinomas that had axillary lymph-node metastases, we examined the incidence of loss of heterozygosity on chromosomes 16p, 16q, 17p, 17q, and 18q, point mutation of the p53 tumor-suppressor gene, nuclear immunoreaction of p53 protein, and amplifications of the c-erbB-2 and int-2 oncogenes by Southern blotting, single-strand conformation polymorphism analysis, and immunohistochemistry. We analyzed the

  17. Epitrochlear lymph nodes as marker of HIV disease in sub-Saharan Africa.

    PubMed

    Malin, A; Ternouth, I; Sarbah, S

    1994-12-10

    Because serological testing for HIV infection is expensive and hard to obtain in Africa, diagnosis often depends upon clinical evaluation. A study was undertaken, therefore, to determine whether the rate of occurrence of enlarged lymph nodes and variations in their size and distribution could provide useful diagnostic markers. Of 260 eligible adult patients admitted to a hospital in Zimbabwe, 259 agreed to take part in the study. 146 (56%) were diagnosed with HIV using serological tests. A doctor who was blinded to these results scored lymph node size in the epitrochlear, submandibular, and axillary regions. Enlargement of axillary and submandibular lymph nodes by or= 1 cm gave positive predictive values of 91 and 89%, respectively, and specificities of 95 and 96%, respectively, but the negative predictive values and sensitivities were all 60%. Thus, the presence of enlarged lymph nodes was a strong marker of HIV disease, but their absence was unhelpful, and they were only occasionally present (in 24 and 12% of patients, respectively). When the criterion for enlargement was or= 0.5 cm, the number of patients with palpable nodes increased, but positive prediction and specificity were poor. Enlargement of the epitrochlear nodes by or= 0.5 cm resulted in a positive predictive value of 85%, a specificity of 81%, and a sensitivity of 84%. Also, these nodes were palpable in 47% of patients. Larger epitrochlear nodes (or= 1 cm) improved specificity to 90% but reduced positive prediction and sensitivity dramatically. A combination of the 2 regions improved positive predictive value to 90% but caused a noticeable fall in sensitivity. These predictive values must not be extrapolated beyond the setting in which they were derived (one of high prevalence). The predictive value of epitrochlear nodes in other clinical settings remains to be determined, but the clinical importance of these nodes deserves attention. PMID:7819896

  18. Methylation signature of lymph node metastases in breast cancer patients

    PubMed Central

    2012-01-01

    Background Invasion and metastasis are two important hallmarks of malignant tumors caused by complex genetic and epigenetic alterations. The present study investigated the contribution of aberrant methylation profiles of cancer related genes, APC, BIN1, BMP6, BRCA1, CST6, ESR-b, GSTP1, P14 (ARF), P16 (CDKN2A), P21 (CDKN1A), PTEN, and TIMP3, in the matched axillary lymph node metastasis in comparison to the primary tumor tissue and the adjacent normal tissue from the same breast cancer patients to identify the potential of candidate genes methylation as metastatic markers. Methods The quantitative methylation analysis was performed using the SEQUENOM’s EpiTYPER™ assay which relies on matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). Results The quantitative DNA methylation analysis of the candidate genes showed higher methylation proportion in the primary tumor tissue than that of the matched normal tissue and the differences were significant for the APC, BIN1, BMP6, BRCA1, CST6, ESR-b, P16, PTEN and TIMP3 promoter regions (P<0.05). Among those candidate methylated genes, APC, BMP6, BRCA1 and P16 displayed higher methylation proportion in the matched lymph node metastasis than that found in the normal tissue (P<0.05). The pathway analysis revealed that BMP6, BRCA1 and P16 have a role in prevention of neoplasm metastasis. Conclusions The results of the present study showed methylation heterogeneity between primary tumors and metastatic lesion. The contribution of aberrant methylation alterations of BMP6, BRCA1 and P16 genes in lymph node metastasis might provide a further clue to establish useful biomarkers for screening metastasis. PMID:22695536

  19. Surgical Resection for Bulky or Recurrent Axillary Metastatic Melanoma

    PubMed Central

    Shada, Amber L.; Walters, Dustin M.; Tierney, Shannon N.; Slingluff, Craig L.

    2015-01-01

    Introduction Metastatic melanoma has few FDA approved treatments, and aggressive surgical resection has to be considered for management of bulky axillary metastases. We hypothesized that axillary resection in this setting is well tolerated and improves symptoms in the majority of patients. Methods We reviewed a prospectively collected database and identified 47 stage IIIC and IV patients with axillary nodal disease greater than 5 cm (68%), recurrent disease (36%), or disease adherent to axillary neurovascular structures (45%). Paresthesias, pain, and bleeding were present in 40% of patients, and were stable or improved after surgery in 75%. Most patients were asymptomatic prior to resection, and underwent resection for prevention of potential symptoms. Results Most patients underwent outpatient surgery. Postoperative complications included lymphedema (34%), range of motion limitation (23%), wound infection (17%), and neuropathic pain (17%). Among symptomatic patients, average time to progression was 3 months, compared to 9.5 months in asymptomatic patients (P = 0.08). Five-year survival was lower (16%) in symptomatic patients than in asymptomatic patients (35%, P = 0.001). Discussion Surgery for bulky axillary melanoma metastases is well tolerated, and should be considered in the management of Stage III or IV melanoma. Resection prior to symptoms may improve quality of life and is associated with longer survival. PMID:21826672

  20. Asteroid bodies in lymph node cytology: infrequently seen and still mysterious.

    PubMed

    Jorns, Julie M; Knoepp, Stewart M

    2011-01-01

    Granulomatous inflammation is a relatively common finding in routine aspiration cytology of lymph nodes. However, asteroid bodies are very rarely encountered in cytologic preparations, and most morphologic descriptions result from observations made in histologic tissue sections. This brief report describes the cytologic findings in paratracheal aspirate smears from a 74-year-old Caucasian woman with the history of squamous-cell carcinoma of the right ankle metastatic to a right groin lymph node. At the time of removal of the metastatic tumor, the patient was noted to have multiple small, mildly FDG-avid lymph nodes in the supraclavicular, paratracheal, precarinal, pulmonic hilar, and axillary regions. A transbronchial fine-needle aspiration biopsy (FNAB) of a paratracheal lymph node showed granulomatous inflammation and numerous multinucleated giant cells containing asteroid bodies. No evidence of malignancy was present in any of the smears. Additional patient history elicited at the time of FNAB revealed a diagnosis 6 years previously of disseminated histoplasmosis infection. A concomitant workup for sarcoidosis was negative. PMID:20049975

  1. Spectral imaging as a potential tool for optical sentinel lymph node biopsies

    NASA Astrophysics Data System (ADS)

    O'Sullivan, Jack D.; Hoy, Paul R.; Rutt, Harvey N.

    2011-07-01

    Sentinel Lymph Node Biopsy (SLNB) is an increasingly standard procedure to help oncologists accurately stage cancers. It is performed as an alternative to full axillary lymph node dissection in breast cancer patients, reducing the risk of longterm health problems associated with lymph node removal. Intraoperative analysis is currently performed using touchprint cytology, which can introduce significant delay into the procedure. Spectral imaging is forming a multi-plane image where reflected intensities from a number of spectral bands are recorded at each pixel in the spatial plane. We investigate the possibility of using spectral imaging to assess sentinel lymph nodes of breast cancer patients with a view to eventually developing an optical technique that could significantly reduce the time required to perform this procedure. We investigate previously reported spectra of normal and metastatic tissue in the visible and near infrared region, using them as the basis of dummy spectral images. We analyse these images using the spectral angle map (SAM), a tool routinely used in other fields where spectral imaging is prevalent. We simulate random noise in these images in order to determine whether the SAM can discriminate between normal and metastatic pixels as the quality of the images deteriorates. We show that even in cases where noise levels are up to 20% of the maximum signal, the spectral angle map can distinguish healthy pixels from metastatic. We believe that this makes spectral imaging a good candidate for further study in the development of an optical SLNB.

  2. Sentinel lymph nodes detection with an imaging system using Patent Blue V dye as fluorescent tracer

    NASA Astrophysics Data System (ADS)

    Tellier, F.; Steibel, J.; Chabrier, R.; Rodier, J. F.; Pourroy, G.; Poulet, P.

    2013-03-01

    Sentinel lymph node biopsy is the gold standard to detect metastatic invasion from primary breast cancer. This method can help patients avoid full axillary chain dissection, thereby decreasing the risk of morbidity. We propose an alternative to the traditional isotopic method, to detect and map the sentinel lymph nodes. Indeed, Patent Blue V is the most widely used dye in clinical routine for the visual detection of sentinel lymph nodes. A Recent study has shown the possibility of increasing the fluorescence quantum yield of Patent Blue V, when it is bound to human serum albumin. In this study we present a preclinical fluorescence imaging system to detect sentinel lymph nodes labeled with this fluorescent tracer. The setup is composed of a black and white CCD camera and two laser sources. One excitation source with a laser emitting at 635 nm and a second laser at 785 nm to illuminate the region of interest. The prototype is operated via a laptop. Preliminary experiments permitted to determine the device sensitivity in the ?mol.L-1 range as regards the detection of PBV fluorescence signals. We also present a preclinical evaluation performed on Lewis rats, during which the fluorescence imaging setup detected the accumulation and fixation of the fluorescent dye on different nodes through the skin.

  3. Thyroid Gland Removal With or Without Central Lymph Node Dissection in Treating Patients With Node Negative Thyroid Cancer | Division of Cancer Prevention

    Cancer.gov

    This randomized phase II trial studies how well thyroid gland removal with or without central lymph node dissection works in treating patients with thyroid cancer or suspected thyroid cancer that has not spread to the lymph nodes. Currently, the standard treatment for thyroid cancer is total thyroidectomy, or complete removal of the thyroid. Sometimes, the lymph nodes in the central part of the neck may also be surgically removed, called central lymph node dissection.

  4. Axillary vein thrombosis in a female backpacker: Paget-Schroetter syndrome.

    PubMed

    Kolodinsky, S D; Brandschwei, F H

    1989-08-01

    In 1875 Sir James Paget reported the first case of primary axillary vein thrombosis. Since then numerous reports of axillary vein thrombosis have appeared citing various initiating events and possible causes. We report here a patient with axillary vein thrombosis. The thrombosis appears to have been provoked by carrying a backpack. PMID:2766025

  5. Artificial sweat composition to grow and sustain a mixed human axillary microbiome.

    PubMed

    Callewaert, Chris; Buysschaert, Benjamin; Vossen, Els; Fievez, Veerle; Van de Wiele, Tom; Boon, Nico

    2014-08-01

    A novel artificial sweat composition, Skin Community Interaction simulation, designed to mimic the human axillary sweat, was compared to other artificial sweat compositions. Axillary microbiota grown in the novel composition closely resembled the original community. Volatile organic compound analysis showed good correlations with in vivo axillary (mal)odor components. PMID:24858451

  6. The Microbiology of the Human Axilla and Its Relationship to Axillary Odor

    Microsoft Academic Search

    James J. Leyden; Kenneth J. McGinley; Erhard Hölzle; John N. Labows; Albert M. Kligman

    1981-01-01

    The axillary microflora of 229 subjects was characterized quantitatively and the results correlated with whether the odor was pungent body odor or instead a faint “acid odor.” The axillary flora was found to be a stable mixture of Micrococcaceac, aerobic diphtheroids and Propionibacteria. Significantly higher numbers of bacteria were recovered from the axillae of those with pungent axillary odor than

  7. Large-sized bilateral axillary artery aneurysms in a patient with marfan syndrome: a case report.

    PubMed

    Jun, Feng; Shun, Zhang Yu; Min, Liu Ya; Xue, Qu Gen; Yan, Tian Hong; Hao, Qin; Li, Xiao Xin

    2010-08-01

    A 46-year-old man presented with large bilateral aneurysm of the axillary arteries combined with Marfan syndrome. Treatment consisted of axillary aneurysm resection and vessel replacement. Postoperative computed tomographic angiography confirmed good flow in the bilateral axillary artery, and the patient recovered without complication. PMID:20719737

  8. Ultrasound guidance improves success rate of axillary brachial plexus block

    Microsoft Academic Search

    Vincent W. S. Chan; Anahi Perlas; Colin J. L. McCartney; Richard Brull; Daquan Xu; Sherif Abbas

    2007-01-01

    Purpose  The purpose of this study is to determine if real time ultrasound guidance improves the success rate of axillary brachial\\u000a plexus blockade.\\u000a \\u000a \\u000a \\u000a Methods  Patients undergoing elective hand surgery were randomly assigned to one of three groups. Axillary blocks were performed using\\u000a three motor response endpoints in the nerve stimulator (NS) Group, real-time ultrasound guidance in the ultrasound (US) Group\\u000a and combined

  9. Anthracycline-based induction chemotherapy followed by concurrent cyclophosphamide, methotrexate and 5-fluorouracil and radiation therapy in surgically resected axillary node-positive breast cancer.

    PubMed

    Recchia, Francesco; Candeloro, Giampiero; Cesta, Alisia; DI Staso, Mario; Bonfili, Pierluigi; Gravina, Giovanni Luca; DI Cesare, Ernesto; Necozione, Stefano; Rea, Silvio

    2014-05-01

    The present study aimed to determine the toxicity and efficacy of 4 courses of anthracyclines-taxane (AT) chemotherapy followed by radiation therapy (XRT) concurrent with cyclophosphamide, methotrexate and 5-fluorouracil (CMF) in surgically resected axillary node-positive (N+) breast cancer. A total of 200 women with N+ breast cancer were treated with adriamycin and docetaxel followed by XRT concurrent with six courses of CMF. Two courses of dose-dense chemotherapy with ifosfamide, carboplatin and etoposide, supported by pegfilgrastim, were administered to patients with >5 histologically confirmed axillary lymph node metastases and patients with triple-negative disease. Additional treatments included 1 year of trastuzumab in human epidermal growth factor receptor 2-positive patients, 5 years of a luteinizing hormone-releasing hormone analogue in premenopausal women and 5 years of an aromatase inhibitor (AI) in estrogen receptor-positive (ER+) patients. The mean number of positive axillary lymph nodes was 4.4 (range, 2-37), 52% of the patients were premenopausal, 74% were ER+ and 26% had triple-negative disease. After a median follow-up of 73 months, grade 2 and 3 hematological toxicity was observed in 20% of the patients. The 10-year disease-free survival (DFS) and overall survival (OS) rates were 73 and 77%, respectively. There was no significant difference in DFS between ER+ and estrogen receptor-negative (ER-) patients (P>0.05), whereas the OS was better in ER+ vs. ER- patients (P<0.05) and in premenopausal vs. postmenopausal patients (P<0.005). In conclusion, induction AT concurrent CMF and XRT and dose-dense chemotherapy followed by AI in N+ high-risk breast cancer was associated with a low level of systemic and late cardiac toxicity and excellent local control, DFS and OS. PMID:24772320

  10. Anthracycline-based induction chemotherapy followed by concurrent cyclophosphamide, methotrexate and 5-fluorouracil and radiation therapy in surgically resected axillary node-positive breast cancer

    PubMed Central

    RECCHIA, FRANCESCO; CANDELORO, GIAMPIERO; CESTA, ALISIA; DI STASO, MARIO; BONFILI, PIERLUIGI; GRAVINA, GIOVANNI LUCA; DI CESARE, ERNESTO; NECOZIONE, STEFANO; REA, SILVIO

    2014-01-01

    The present study aimed to determine the toxicity and efficacy of 4 courses of anthracyclines-taxane (AT) chemotherapy followed by radiation therapy (XRT) concurrent with cyclophosphamide, methotrexate and 5-fluorouracil (CMF) in surgically resected axillary node-positive (N+) breast cancer. A total of 200 women with N+ breast cancer were treated with adriamycin and docetaxel followed by XRT concurrent with six courses of CMF. Two courses of dose-dense chemotherapy with ifosfamide, carboplatin and etoposide, supported by pegfilgrastim, were administered to patients with >5 histologically confirmed axillary lymph node metastases and patients with triple-negative disease. Additional treatments included 1 year of trastuzumab in human epidermal growth factor receptor 2-positive patients, 5 years of a luteinizing hormone-releasing hormone analogue in premenopausal women and 5 years of an aromatase inhibitor (AI) in estrogen receptor-positive (ER+) patients. The mean number of positive axillary lymph nodes was 4.4 (range, 2–37), 52% of the patients were premenopausal, 74% were ER+ and 26% had triple-negative disease. After a median follow-up of 73 months, grade 2 and 3 hematological toxicity was observed in 20% of the patients. The 10-year disease-free survival (DFS) and overall survival (OS) rates were 73 and 77%, respectively. There was no significant difference in DFS between ER+ and estrogen receptor-negative (ER?) patients (P>0.05), whereas the OS was better in ER+ vs. ER? patients (P<0.05) and in premenopausal vs. postmenopausal patients (P<0.005). In conclusion, induction AT concurrent CMF and XRT and dose-dense chemotherapy followed by AI in N+ high-risk breast cancer was associated with a low level of systemic and late cardiac toxicity and excellent local control, DFS and OS. PMID:24772320

  11. Does the Addition of Tramadol and Ketamine to Ropivacaine Prolong the Axillary Brachial Plexus Block?

    PubMed Central

    Senel, Ahmet Can; Ukinc, Ozlem; Timurkaynak, Alper

    2014-01-01

    Background and Objectives. A prospective, randomized, controlled, double-blind clinical trial to assess the effect of tramadol and ketamine, 50?mg, added to ropivacaine in brachial plexus anesthesia. Methods. Thirty-six ASA physical statuses I and II patients, between 18 and 60 years of age, scheduled for forearm and hand surgery under axillary brachial plexus block, were allocated to 3 groups. Group R received 0.375% ropivacaine in 40?mL, group RT received 0.375% ropivacaine in 40?mL with 50?mg tramadol, and group RK received 0.375% ropivacaine in 40?mL with 50?mg ketamine for axillary brachial plexus block. The onset times and the duration of sensory and motor blocks, duration of analgesia, hemodynamic parameters, and adverse events (nausea, vomiting, and feeling uncomfortable) were recorded. Results. The onset time of sensorial block was the fastest in ropivacaine + tramadol group. Duration of sensorial and motor block was the shortest in the ropivacaine + tramadol group. Duration of analgesia was significantly longer in ropivacaine + tramadol group. Conclusion. We conclude that when added to brachial plexus analgesia at a dose of 50?mg, tramadol extends the onset and duration time of the block and improves the quality of postoperative analgesia without any side effects. PMID:24883319

  12. Pattern Analysis in Branching and Axillary Flowering Sequences

    Microsoft Academic Search

    Y GUÉDON; D BARTHÉLÉMY; Y. Caraglio; E. Costes

    2001-01-01

    In the architectural approach to the study of plants, a major issue is to analyse branching and axillary flowering patterns. Due to the structured expression of the branching process and the noisy character of the observed patterns, we propose an analysis framework which is both structural and probabilistic. Data take the form of sequences which naturally represent the underlying structural

  13. Comparison of two neurostimulation techniques for axillary brachial plexus blockade

    Microsoft Academic Search

    D. M. Coventry; K. F. Barker; M. Thomson

    2001-01-01

    This prospective, randomized, double-blind study compared two techniques of axillary brachial plexus block using a peripheral nerve stimulator. Both groups received initial musculo- cutaneous nerve block followed by either a single injection on median nerve stimulation (group 1) or a double injection divided between median and radial nerves (group 2). All 60 patients received a total of 30 ml of

  14. Sentinel node biopsy in breast cancer: early results in 953 patients with negative sentinel node biopsy and no axillary dissection

    Microsoft Academic Search

    Umberto Veronesi; Viviana Galimberti; Luigi Mariani; Giovanna Gatti; Giovanni Paganelli; Giuseppe Viale; Stefano Zurrida; Paolo Veronesi; Mattia Intra; Roberto Gennari; Anna Rita Vento; Alberto Luini; Marco Tullii; Guillermo Bassani; Nicole Rotmensz

    2005-01-01

    Sentinel node biopsy in patients with breast carcinoma accurately predicts the axillary nodal status. However, in some 6% of patients with negative sentinel nodes the remaining axillary nodes harbour metastases. Our purpose was to observe a large number of patients who did not undergo an axillary dissection after a negative sentinel node biopsy for the appearance of overt axillary metastases.

  15. Liberal use of axillary artery cannulation for aortic and complex cardiac surgery

    PubMed Central

    Fong, Laura S.; Bassin, Levi; Mathur, Manu N.

    2013-01-01

    OBJECTIVES Axillary artery cannulation for cardiopulmonary bypass has been described previously as a safe and reliable technique, with a low risk of atheroemboli, avoidance of malperfusion in aortic dissection and facilitation of selective antegrade cerebral perfusion during hypothermic circulatory arrest. The aim of this study was to document the broad applicability of axillary cannulation and its associated morbidity and identify where it was not possible to use planned axillary cannulation. METHODS A retrospective review of a single surgeon's 10-year experience of axillary cannulation using the side-graft technique in 184 consecutive patients (age 22–92 years) in aortic and complex cardiac surgery from July 2002 to June 2012. RESULTS There were no intraoperative deaths and no major complications related to axillary artery use. There were six postoperative deaths unrelated to axillary artery cannulation. Six patients (3.3%) had minor complications as a direct result of axillary cannulation including seroma, haematoma, chronic pain and pectoralis major muscle atrophy. There were 10 cases where planned axillary cannulation was abandoned, due to inadequate size of the axillary artery in 8 patients and axillary artery dissection and morbid obesity in 1 patient each. CONCLUSIONS Axillary artery cannulation is an ideal arterial inflow site in cases where the ascending aorta is unsuitable as it is safe, reliable and reduces the risks of atheroembolization and malperfusion. Major complications are rare with this meticulous technique and it is our standard practice in complex cardiac and aortic surgery. PMID:23456684

  16. Lymph node dissection – understanding the immunological function of lymph nodes

    PubMed Central

    Buettner, M; Bode, U

    2012-01-01

    Lymph nodes (LN) are one of the important sites in the body where immune responses to pathogenic antigens are initiated. This immunological function induced by cells within the LN is an extensive area of research. To clarify the general function of LN, to identify cell populations within the lymphatic system and to describe the regeneration of the lymph vessels, the experimental surgical technique of LN dissection has been established in various animal models. In this review different research areas in which LN dissection is used as an experimental tool will be highlighted. These include regeneration studies, immunological analysis and studies with clinical questions. LN were dissected in order to analyse the different cell subsets of the incoming lymph in detail. Furthermore, LN were identified as the place where the induction of an antigen-specific response occurs and, more significantly, where this immune response is regulated. During bacterial infection LN, as a filter of the lymph system, play a life-saving role. In addition, LN are essential for the induction of tolerance against harmless antigens, because tolerance could not be induced in LN-resected animals. Thus, the technique of LN dissection is an excellent and simple method to identify the important role of LN in immune responses, tolerance and infection. PMID:22861359

  17. Appropriate lymph node dissection for early gastric cancer based on lymph node metastases

    Microsoft Academic Search

    Chikara Kunisaki; Hiroshi Shimada; Masato Nomura; Hirotoshi Akiyama

    2001-01-01

    Background. Lymph node dissection in patients with early gastric cancer is controversial because lymph node metastases are much less common than in advanced cancer. Therefore, routine extensive lymph node dissection with wide resection of the stomach may be excessive, and an appropriate lymph node dissection procedure in patients with early gastric cancer should be established. Methods. Retrospectively, 588 consecutive patients

  18. Noninvasive Photoacoustic and Fluorescence Sentinel Lymph Node

    E-print Network

    Wang, Lihong

    nodes and the blood- stream, leading to a wider spread of the cancer. The closest lymph node that drainsNoninvasive Photoacoustic and Fluorescence Sentinel Lymph Node Identification using Dye the lymphatic system. Cancer cells that migrate from the primary tumor may become lodged in the first lymph

  19. Nodal lymph flow quantified with afferent vessel input function allows differentiation between normal and cancer-bearing nodes.

    PubMed

    DSouza, Alisha V; Elliott, Jonathan T; Gunn, Jason R; Barth, Richard J; Samkoe, Kimberley S; Tichauer, Kenneth M; Pogue, Brian W

    2015-04-01

    Morbidity and complexity involved in lymph node staging via surgical resection and biopsy could ideally be improved using node assay techniques that are non-invasive. While visible blue dyes are often used to locate the sentinel lymph nodes from draining lymphatic vessels near a tumor, they do not provide an in situ metric to evaluate presence of cancer. In this study, the transport kinetics of methylene blue were analyzed to determine the potential for better in situ information about metastatic involvement in the nodes. A rat model with cancer cells in the axillary lymph nodes was used, with methylene blue injection to image the fluorescence kinetics. The lymphatic flow from injection sites to nodes was imaged and the relative kinetics from feeding lymphatic ducts relative to lymph nodes was quantified. Large variability existed in raw fluorescence and transport patterns within each cohort resulting in no systematic difference between average nodal uptake in normal, sham control and cancer-bearing nodes. However, when the signal from the afferent lymph vessel fluorescence was used to normalize the signal of the lymph nodes, the high signal heterogeneity was reduced. Using a model, the lymph flow through the nodes [Formula: see text] was estimated to be 1.49 ± 0.64 ml/g/min in normal nodes, 1.53 ± 0.45 ml/g/min in sham control nodes, and reduced to 0.50 ± 0.24 ml/g/min in cancer-cell injected nodes. This summarizes the significant difference (p = 0.0002) between cancer-free and cancer-bearing nodes in normalized flow. This process of normalized flow imaging could be used as an in situ tool to detect metastatic involvement in nodes. PMID:25909014

  20. Nodal lymph flow quantified with afferent vessel input function allows differentiation between normal and cancer-bearing nodes

    PubMed Central

    DSouza, Alisha V.; Elliott, Jonathan T.; Gunn, Jason R.; Barth, Richard J.; Samkoe, Kimberley S.; Tichauer, Kenneth M.; Pogue, Brian W.

    2015-01-01

    Morbidity and complexity involved in lymph node staging via surgical resection and biopsy could ideally be improved using node assay techniques that are non-invasive. While visible blue dyes are often used to locate the sentinel lymph nodes from draining lymphatic vessels near a tumor, they do not provide an in situ metric to evaluate presence of cancer. In this study, the transport kinetics of methylene blue were analyzed to determine the potential for better in situ information about metastatic involvement in the nodes. A rat model with cancer cells in the axillary lymph nodes was used, with methylene blue injection to image the fluorescence kinetics. The lymphatic flow from injection sites to nodes was imaged and the relative kinetics from feeding lymphatic ducts relative to lymph nodes was quantified. Large variability existed in raw fluorescence and transport patterns within each cohort resulting in no systematic difference between average nodal uptake in normal, sham control and cancer-bearing nodes. However, when the signal from the afferent lymph vessel fluorescence was used to normalize the signal of the lymph nodes, the high signal heterogeneity was reduced. Using a model, the lymph flow through the nodes (FLN) was estimated to be 1.49 ± 0.64 ml/g/min in normal nodes, 1.53 ± 0.45 ml/g/min in sham control nodes, and reduced to 0.50 ± 0.24 ml/g/min in cancer-cell injected nodes. This summarizes the significant difference (p = 0.0002) between cancer-free and cancer-bearing nodes in normalized flow. This process of normalized flow imaging could be used as an in situ tool to detect metastatic involvement in nodes. PMID:25909014

  1. Twice-daily fractionation of external irradiation with brachytherapy and chemotherapy in carcinoma of the cervix with positive para-aortic lymph nodes: phase II study of the radiation therapy oncology group 92-10

    Microsoft Academic Search

    Perry W Grigsby; J. D Lu; David G Mutch; Robert Y Kim; Patricia J Eifel

    1998-01-01

    Purpose: The purpose of this study was to evaluate the toxicity and efficacy of twice-daily external irradiation to the pelvis and para-aortics with brachytherapy and concurrent chemotherapy for carcinoma of the cervix with positive para-aortic lymph nodes.Methods and Materials: This study was designed to administer twice-daily radiation doses of 1.2 Gy to the pelvis and para-aortics at 4- to 6-h

  2. Isolated regional lymph node dissection: morbidity, mortality and economic considerations.

    PubMed Central

    Bland, K I; Klamer, T W; Polk, H C; Knutson, C O

    1981-01-01

    Between 1971-1979, 330 consecutive isolated regional lymph node dissections (RLNDs) were performed as therapeutic procedures for metastatic disease, at the University of Louisville Affiliated Hospitals and the Ellis-Fischel State Cancer Hospital in Columbia, Missouri. This retrospective analysis includes 133 radical neck RLNDs, 87 axillary RLNDs, and 110 superficial groin RLNDs. All accessioned cases were elective and were performed as isolated procedures, discrete from resection of contiguous or remote organs. No patients received preoperative irradiation, chemotherapy or immunotherapy. Forty-eight per cent of the 330 RLND procedures resulted in some form of postoperative complication. However, 91% of the incurred morbidity was localized to the operative site and was related to serum collection and/or flap necrosis. The occurrence of postoperative complications for each RLND site resulted in a prolongation of the patients' hospital stays by a mean of 9 days, and was most extended for the superficial groin RLND by a mean of 11 days. Nine patients (3%) died. These data for morbidity and mortality rates, as well as the implicit economic impact, represent substantial factors in the utilization of elective RLND. PMID:7212799

  3. Visualising lymph movement in anuran amphibians with computed tomography.

    PubMed

    Hedrick, Michael S; Hansen, Kasper; Wang, Tobias; Lauridsen, Henrik; Thygesen, Jesper; Pedersen, Michael

    2014-09-01

    Lymph flux rates in anuran amphibians are high relative to those of other vertebrates owing to 'leaky' capillaries and a high interstitial compliance. Lymph movement is accomplished primarily by specialised lymph muscles and lung ventilation that move lymph through highly compartmentalised lymph sacs to the dorsally located lymph hearts, which are responsible for pumping lymph into the circulatory system; however, it is unclear how lymph reaches the lymph hearts. We used computed tomography (CT) to visualise an iodinated contrast agent, injected into various lymph sacs, through the lymph system in cane toads (Rhinella marina). We observed vertical movement of contrast agent from lymph sacs as predicted, but the precise pathways were sometimes unexpected. These visual results confirm predictions regarding lymph movement, but also provide some novel findings regarding the pathways for lymph movement and establish CT as a useful technique for visualising lymph movement in amphibians. PMID:25165132

  4. Lymph node staging in prostate cancer.

    PubMed

    Sankineni, Sandeep; Brown, Anna M; Fascelli, Michele; Law, Yan Mee; Pinto, Peter A; Choyke, Peter L; Turkbey, Baris

    2015-05-01

    Nodal staging is important in prostate cancer treatment. While surgical lymph node dissection is the classic method of determining whether lymph nodes harbor malignancy, this is a very invasive technique. Current noninvasive approaches to identifying malignant lymph nodes are limited. Conventional imaging methods rely on size and morphology of lymph nodes and have notoriously low sensitivity for detecting malignant nodes. New imaging techniques such as targeted positron emission tomography (PET) imaging and magnetic resonance lymphography (MRL) with iron oxide particles are promising for nodal staging of prostate cancer. In this review, the strengths and limitations of imaging techniques for lymph node staging of prostate cancer are discussed. PMID:25773350

  5. Lymph Node Recovery from Colorectal Tumor Specimens:Recommendation for a Minimum Number of Lymph Nodes to be Examined

    Microsoft Academic Search

    Fabio Cianchi; Annarita Palomba; Vieri Boddi; Luca Messerini; Filippo Pucciani; Giuliano Perigli; Paolo Bechi; Camillo Cortesini

    2002-01-01

      Lymph node involvement is the mostimportant prognostic factor for patients who have undergone radicalsurgery for colorectal\\u000a carcinoma. An accurate examination of thesurgical specimens is mandatory for the correct assessment of the lymphnode status\\u000a of the tumor. The risk of understaging is particularly highfor patients with tumors classified as Dukes B (TNM stage II).\\u000a The aimof this study was to determine

  6. DEC-205 expression on migrating dendritic cells in afferent lymph.

    PubMed

    Gliddon, Daniel R; Hope, Jayne C; Brooke, Gareth P; Howard, Christopher J

    2004-03-01

    Previous studies have identified a 210 000-molecular weight molecule expressed at a high level on the surface of dendritic cells (DCs) in afferent lymph of cattle and evident on cells with the morphology of DCs in lymphoid tissues. Expression is either absent from other immune cells or is present at a lower level. The molecular weight and cellular distribution suggested that the molecule, called bovine WC6 antigen (workshop cluster), might be an orthologue of human DEC-205 (CD205). To establish whether this was the case, the open reading frame of bovine DEC-205 was amplified, by polymerase chain reaction, from thymic cDNA (accession no. AY264845). The cDNA sequence of bovine DEC-205 had 86% and 78% nucleic acid identity with human and mouse molecules, respectively. COS-7 cells transfected with a plasmid containing the cattle DEC-205 coding region expressed a molecule that stained with WC6-specific monoclonal antibody, showing that ruminant WC6 is an orthologue of DEC-205. Two-colour flow cytometry of mononuclear cells from afferent lymph draining cattle skin, and from blood, confirmed the high level of expression on large cells in lymph that were uniformly DC-LAMP positive and major histocompatibility complex class II positive. Within this DEC-205+ DC-LAMP+ population were subpopulations of cells that expressed the mannose receptor or SIRPalpha. The observations imply that DCs in afferent lymph are all DEC-205high, but not a uniform population of homogeneous mature DCs. PMID:15009426

  7. Muscular Variations During Axillary Dissection: A Clinical Study in Fifty Patients

    PubMed Central

    Upasna; Kumar, Ashwani; Singh, Bimaljot; Kaushal, Subhash

    2015-01-01

    Aim: The present study was conducted to detect the musculature variations during axillary dissection for breast cancer surgery. Methods: The anatomy of axilla regarding muscular variations was studied in 50 patients who had an axillary dissection for the staging and treatment of invasive primary breast cancer over one year. Results: In a period of one year, two patients (4%) with axillary arch and one patient (2%) with absent pectoralis major and minor muscles among fifty patients undergoing axillary surgery for breast cancer were identified. Conclusions: Axillary arch when present should always be identified and formally divided to allow adequate exposure of axillary contents, in order to achieve a complete lymphatic dissection. Complete absence of pectoralis major and minor muscles precludes the insertion of breast implants and worsens the prognosis of breast cancer. PMID:25838770

  8. Sentinel lymph node biopsy in a patient with ruptured poly implant prothese (PIP) implants: A case report

    PubMed Central

    Tafazal, H.; Basu, N.N.; Jewkes, A.

    2014-01-01

    Introduction Around 400,000 silicone gel breast implants produced by the French company poly implant prothese (PIP) were used worldwide. Following revelations that the company were using non- medical grade silicone for the production of their implants there has been growing concern over the increased rupture rate of these implants and the implications this may have on patients. Presentation of Case We report the case of a 57-year old lady with ruptured bilateral cosmetic PIP breast implants in whom a right breast lesion was detected on screening mammograms. Biopsies demonstrated a grade 1 tubular carcinoma. Histology from the sentinel lymph node biopsy showed axillary silicone granulomas but no evidence of metastatic disease. Discussion To our knowledge, this is the first reported case to describe SLNB in the presence of ruptured PIP implants, although SLNB in ruptured non-PIP implants has been previously described. Conclusion We conclude that SLNB can be utilised even in the context of concurrent PIP implant rupture and the presence of silicone granulomas in the axillary lymph nodes. PMID:25460455

  9. Histopathology of the Lymph Nodes

    PubMed Central

    Elmore, Susan A.

    2007-01-01

    Lymph nodes function as filters of tissues and tissue fluids and are sites of origin and production of lymphocytes for normal physiological functions. As part of this normal function, they react to both endogenous and exogenous substances with a variety of specific morphological and functional responses. Lesions can be both proliferative and nonproliferative, and can be treatment-related or not. The histological evaluation of lymph nodes is necessary in order to understand the immunotoxic effects of chemicals with the resulting data providing an important component of human risk assessment. It is the challenge of the toxicologic pathologist to interpret the pathology data within the complete clinical evaluation of the entire animal. Daily insults, ageing and toxins can alter the normal histology and primary function of lymph nodes. Therefore it is important to distinguish and differentiate lesions that occur naturally during normal development and ageing from those that are induced by xenobiotics. To achieve this goal, comparison with strain- age- and sex-matched controls is crucial. PMID:17067938

  10. A unique branching pattern of the axillary artery in a South Indian male cadaver.

    PubMed

    Bhat, Kumar M R; Gowda, Siddaraju; Potu, Bhagath Kumar; Rao, Muddanna S

    2008-01-01

    Axillary artery divides into 3 parts by pectoralis minor muscle and classically each part has its own branches. There are many reports to show different variations in the branching pattern of the axillary artery. However, here we have shown an unreported unique branching pattern of axillary artery, where most of the branches of the axillary artery are arising from one common trunk from its 2nd part. Further, with relevant literature review we have also discussed their developmental and clinical importance (Fig. 1, Ref. 16). Full Text (Free, PDF) www.bmj.sk. PMID:19348386

  11. Breast cancer with cartilaginous and/or osseous metaplasia diagnosed by lymph nodal metastasis: a case report.

    PubMed

    Tsukuda, Kazunori; Tsuji, Hisashi; Kunitomo, Tadayoshi; Aokage, Keiju; Miyake, Takayoshi; Nakahara, Saki; Masuda, Hiroko

    2009-12-01

    Breast cancer with cartilaginous and/or osseous metaplasia is a type of metaplastic carcinomas and is a rare disease. We report the case of a 49 year-old female who underwent right mastectomy for a large breast tumor. Histological examinations revealed a mixed tumor with both stromal and epithelial elements;the stroma showed poor differentiated spindle-shape and multiform cells with a massive osseous matrix, and atypical epithelial cells, which mainly existed on the surface of the cysts, showed nucleic atypia. The tumor was diagnosed as a malignant phyllodes tumor with osteosarcomatous differentiation;it was not identified as a metaplastic carcinoma because of the lack of proof of a cancerous component. Two years after a mastectomy, swelling of the axillary lymph nodes was found and a biopsy was performed. Histological findings for the lymph node indicated a metastasis of the invasive ductal carcinoma. The primary tumor was re-examined and was considered to be the origin of the lymph nodal metastasis. Lymph nodal metastasis of cancer proved that the primary tumor had cancerous potential, and the pathological diagnosis was altered to a breast cancer with cartilaginous and/or osseous metaplasia. PMID:20035293

  12. Randomized Controlled Trial to Reduce Bacterial Colonization of Surgical Drains After Breast and Axillary Operations

    PubMed Central

    Degnim, Amy C.; Scow, Jeffrey S.; Hoskin, Tanya L.; Miller, Joyce P.; Loprinzi, Margie; Boughey, Judy C.; Jakub, James W.; Throckmorton, Alyssa; Patel, Robin; Baddour, Larry M.

    2014-01-01

    Objective To determine if bacterial colonization of drains can be reduced by local antiseptic interventions. Summary Background Drains are a potential source of bacterial entry into surgical wounds and may contribute to surgical site infection (SSI) after breast surgery. Methods Following IRB approval, patients undergoing total mastectomy and/or axillary lymph node dissection were randomized to standard drain care (control) or drain antisepsis (treated). Standard drain care comprised twice daily cleansing with alcohol swabs. Antisepsis drain care included 1) a chlorhexidine disc at the drain exit site and 2) irrigation of the drain bulb twice daily with dilute sodium hypochlorite (Dakin’s) solution. Cultures results of drain fluid and tubing were compared between control and antisepsis groups. Results Overall, 100 patients with 125 drains completed the study with 48 patients (58 drains) in the control group and 52 patients (67 drains) in the antisepsis group. Cultures of drain bulb fluid at one week were positive (1+ or greater growth) in 66% (38/58) of control drains compared to 21% of antisepsis drains (14/67), (p=0.0001). Drain tubing cultures demonstrated >50 CFU in 19% (8/43) of control drains versus 0% (0/53) of treated drains (p=0.004). SSI was diagnosed in 6 patients (6%) - 5 patients in the control group and 1 patient in the antisepsis group (p=0.06). Conclusions Simple and inexpensive local antiseptic interventions with a chlorhexidine disc and hypochlorite solution reduce bacterial colonization of drains. Based on these data, further study of drain antisepsis and its potential impact on SSI rate is warranted. PMID:23518704

  13. Whole Genome Sequence Analysis Suggests Intratumoral Heterogeneity in Dissemination of Breast Cancer to Lymph Nodes

    PubMed Central

    Blighe, Kevin; Kenny, Laura; Patel, Naina; Guttery, David S.; Page, Karen; Gronau, Julian H.; Golshani, Cyrus; Stebbing, Justin; Coombes, R. Charles; Shaw, Jacqueline A.

    2014-01-01

    Background Intratumoral heterogeneity may help drive resistance to targeted therapies in cancer. In breast cancer, the presence of nodal metastases is a key indicator of poorer overall survival. The aim of this study was to identify somatic genetic alterations in early dissemination of breast cancer by whole genome next generation sequencing (NGS) of a primary breast tumor, a matched locally-involved axillary lymph node and healthy normal DNA from blood. Methods Whole genome NGS was performed on 12 µg (range 11.1–13.3 µg) of DNA isolated from fresh-frozen primary breast tumor, axillary lymph node and peripheral blood following the DNA nanoball sequencing protocol. Single nucleotide variants, insertions, deletions, and substitutions were identified through a bioinformatic pipeline and compared to CIN25, a key set of genes associated with tumor metastasis. Results Whole genome sequencing revealed overlapping variants between the tumor and node, but also variants that were unique to each. Novel mutations unique to the node included those found in two CIN25 targets, TGIF2 and CCNB2, which are related to transcription cyclin activity and chromosomal stability, respectively, and a unique frameshift in PDS5B, which is required for accurate sister chromatid segregation during cell division. We also identified dominant clonal variants that progressed from tumor to node, including SNVs in TP53 and ARAP3, which mediates rearrangements to the cytoskeleton and cell shape, and an insertion in TOP2A, the expression of which is significantly associated with tumor proliferation and can segregate breast cancers by outcome. Conclusion This case study provides preliminary evidence that primary tumor and early nodal metastasis have largely overlapping somatic genetic alterations. There were very few mutations unique to the involved node. However, significant conclusions regarding early dissemination needs analysis of a larger number of patient samples. PMID:25546409

  14. Prognostic significance of morphology of tumor and retroperitoneal lymph nodes in epithelial carcinoma of the ovary. I. Correlation with lymph node metastasis.

    PubMed

    Chen, S S; Lee, L

    1984-05-01

    The prognostic indices based on a morphologic study of tumor and retroperitoneal lymph nodes in 63 patients with epithelial carcinoma of the ovary are reported. The purpose of the study was to identify those variables most frequently related to nodal involvement. The cases in the series consisted of 11 Stage I, 10 Stage II, 34 Stage III, and 8 Stage IV. Histologic distribution was 60.4% serous type, 11.1% mucinous, 6.3% endometrioid, 6.3% clear cell, and 15.9% unclassified. All patients had maximal surgery and selective biopsy of para-aortic and pelvic lymph nodes. The results showed statistically significant variables associated with nodal metastasis in both primary tumor and regional lymph nodes. The indices in primary tumor were grade of tumor, vascular invasion, lymphocytic infiltration, and stromal fibrosis; those in lymph node were type of lymph node reaction, sinus histiocytosis, and fibroblastic proliferation. The nodes with lymphocyte depletion were associated with nodal spread in 81.3% of cases. It is concluded that morphologic study of tumor and lymph node could identify prognostic factors predicting regional nodal metastasis in ovarian carcinoma. PMID:6714809

  15. A Long-Term Study of Radiation Therapy in T1-2 Node-Negative Breast Cancer Patients in Relation to the Number of Axillary Nodes Examined

    SciTech Connect

    Tai, Patricia [Department of Oncology, Allan Blair Cancer Center, University of Saskatchewan (Canada)], E-mail: ptai2@yahoo.com; Yu, Edward [Radiation Oncology Division, Department of Oncology, University of Western Ontario (Canada); Sadikov, Evgeny [Department of Oncology, Allan Blair Cancer Center, University of Saskatchewan (Canada); Joseph, Kurian [Department of Radiation Oncology, Cross Cancer Institute, University of Alberta (Canada)

    2009-06-01

    Purpose: The optimal number of axillary nodes to be resected is controversial. This large series investigated the effect of surgery with or without adjuvant radiotherapy among node-negative breast cancer patients in relation to the number of nodes examined. Methods and Materials: Node-negative patients from the Saskatchewan registry of 1981-1995 were studied. Because nodal status may be more reliable with more number of nodes examined, we analyzed T1-2 age < 90 patients with < 10 nodes examined treated with surgery alone (Group A{sub S}, n = 509) vs. surgery and adjuvant radiotherapy (Group A{sub S}+R, n = 342); and T1-2 age < 90 patients with {>=} 10 nodes examined treated with surgery alone (Group B{sub S}, n = 902) vs. surgery and adjuvant radiotherapy (Group B{sub S}+R, n = 596). Results: For the two radiotherapy groups, patients with < 10 nodes (Group A{sub S}+R) vs. {>=} 10 nodes (Group B{sub S}+R), there was no difference in overall survival (p = 0.14). In the two nonradiotherapy groups (A{sub S} and B{sub S}), there is a statistically significant decrease in overall survival for patients with < 10 nodes removed (p < 0.001, log-rank test). The optimal number of axillary nodes examined could be 8 nodes with adjuvant radiotherapy (p = 0.05, logrank test) and 12 nodes without adjuvant radiotherapy (p = 0.02, log-rank test). Conclusions: The poorer prognosis of a lesser number of nodes resected was overcome partly by the use of radiotherapy, raising the possibility of micrometastases in lymph nodes not removed. The optimal number of axillary nodes examined could be 8 nodes with adjuvant radiotherapy and 12 nodes without adjuvant radiotherapy.

  16. Comparison of Ultrasound-Guided Axillary Brachial Plexus Block Techniques: Perineural Injection versus Single or Double Perivascular Infiltration

    PubMed Central

    Cho, Sooyoung; Baik, Hee Jung; Kim, Jong Hak; Woo, Jae Hee

    2015-01-01

    Purpose We compared three methods of ultrasound-guided axillary brachial plexus block, which were single, and double perivascular (PV) infiltration techniques, and a perineural (PN) injection technique. Materials and Methods 78 patients of American Society of Anesthesiologists physical status I-II undergoing surgery of the forearm, wrist, or hand were randomly allocated to three groups. 2% lidocaine with epinephrine 5 µg/mL was used. The PN group (n=26) received injections at the median, ulnar, and radial nerve with 8 mL for each nerve. The PV1 group (n=26) received a single injection of 24 mL at 12-o'clock position of the axillary artery. The PV2 group (n=26) received two injections of 12 mL each at 12-o'clock and 6-o'clock position. For all groups, musculocutaneous nerve was blocked separately. Results The PN group (391.2±171.6 sec) had the longest anesthetic procedure duration than PV1 (192.8±59.0 sec) and PV2 (211.4±58.6 sec). There were no differences in onset time. The average induction time was longer in PN group (673.4±149.6 sec) than PV1 (557.6±194.9 sec) and PV2 (561.5±129.8 sec). There were no differences in the success rate (89.7% vs. 86.2% vs. 89.7%). Conclusion The PV injection technique consisting of a single injection in 12-o'clock position above the axillary artery in addition to a musculocutaneous nerve block is equally effective and less time consuming than the PN technique. Therefore, the PV technique is an alternative method that may be used in busy clinics or for difficult cases. PMID:25837194

  17. Predictive Factors for Non-Sentinel Lymph Node Metastasis in the Case of Positive Sentinel Lymph Node Metastasis in Two or Fewer Nodes in Breast Cancer

    PubMed Central

    Toshikawa, Chie; Koyama, Yu; Nagahashi, Masayuki; Tatsuda, Kumiko; Moro, Kazuki; Tsuchida, Junko; Hasegawa, Miki; Niwano, Toshiyuki; Manba, Naoko; Ikarashi, Mayuko; Kameyama, Hitoshi; Kobayashi, Takashi; Kosugi, Shin-ichi; Wakai, Toshifumi

    2015-01-01

    Background In breast cancer, recent clinical trials have shown that sentinel lymph node biopsy (SLNB) alone without axillary lymph node dissection results in excellent prognosis if there is sentinel lymph node (SLN) metastasis in two or fewer nodes. The aim of the present study was to investigate the association between non-SLN metastasis and clinicopathological factors in case of SLN metastasis in two or fewer nodes in breast cancer. Methods Patients who underwent SLNB for invasive breast cancer and were found to have positive SLN in two or fewer nodes were evaluated. The associations between non-SLN metastasis and clinicopahological factors were examined. Statistical analyses were performed using the Mann-Whitney and Chi-square tests, with statistical significance set at P < 0.05. Results A total of 358 patients were enrolled during the study period and all of these patients were female and 54 patients had SLN metastasis (15%). Positive SLN in two or fewer nodes was identified in 44 patients (81.5%). Among these patients, 17 (38.6%) were found to have non-SLN metastasis. Non-SLN metastasis was associated with invasive tumor size (P = 0.015) and lymphatic involvement (P = 0.035). Multivariate analysis showed that tumor size (P = 0.011) and lymphatic involvement (P = 0.019) remained significant independent predictors of non-SLN metastasis, and that an invasive tumor size cut-off point of 28 mm was useful for dividing patients with positive SLN in two or fewer nodes into non-SLN-positive and non-SLN-negative groups. Conclusions Non-SLN metastasis was found in more than 30% of patients with SLN metastasis present in two or fewer nodes. Large tumor size and the presence of lymphatic involvement were significantly associated with non-SLN metastasis.

  18. Superficial brachioradial artery (radial artery originating from the axillary artery): a case report and embryological background

    Microsoft Academic Search

    Folia Morphol; M. Konarik; J. Knize; V. Baca; D. Kachlik

    A case of anomalous terminal branching of the axillary artery, concerning the variant called superficial brachioradial artery (arteria brachioradialis superfi- cialis) was described, with special regard to its embryological origin. The left upper limb of a male cadaver was dissected in successive steps from the axillary fossa distally to the palmar region. A variant artery, stemming from the end of

  19. Tramadol Added to Mepivacaine Prolongs the Duration of an Axillary Brachial Plexus Blockade

    Microsoft Academic Search

    Stephan Kapral; Gabriele Gollmann; Barbara Waltl; Rudolf Likar; Robert N. Sladen; Christian Weinstabl; Franz Lehofer

    1999-01-01

    Tramadol is an analgesic drug that is antagonized by a2-adrenoceptor antagonists, as well as opioid antago- nists. We hypothesized that tramadol might produce effects on an axillary brachial plexus blockade similar to those of clonidine. We designed a prospective, con- trolled, double-blinded study to assess the impact of tramadol added to mepivacaine on the duration of an axillary brachial plexus

  20. Ultrastructural examination of the axillary skin biopsy in the diagnosis of metabolic diseases

    Microsoft Academic Search

    Caroline M Abramovich; Richard A Prayson; James T McMahon; Bruce H Cohen

    2001-01-01

    There is little information in the literature regarding the usefulness of ultrastructural examination of axillary skin biopsies in the evaluation of metabolic diseases. This is a retrospective clinicopathologic review of 143 patients who underwent axillary skin biopsies as part of evaluations for metabolic disease. Twenty-three (16%) had abnormalities, classified as follows: mitochondrial (n = 12), lysosomal (n = 6), increased

  1. Lymph Node Tumor Volumes in Patients Undergoing Sentinel Lymph Node Biopsy for Cutaneous Melanoma

    Microsoft Academic Search

    Jeffrey D. Wagner; Darrell Davidson; John J. Coleman III; Gary Hutchins; Donald Schauwecker; Hee-Myung Park; Robert J. Havlik

    1999-01-01

    Background: Regional lymph node tumor volumes in patients undergoing sentinel lymph node (SN) biopsy (SNB) for treatment of cutaneous melanoma have not been described. The objectives of this study were to describe the lymph node tumor volumes typically seen in this population and to correlate tumor volumes with tumor thickness and positive SN characteristics. Methods: Review of a consecutive series

  2. Death from axillary haemorrhage during haemodialysis in a patient with a history of microscopic polyangiitis.

    PubMed

    Unuma, Kana; Uozaki, Hiroshi; Kuroda, Ryouhei; Uemura, Koichi; Yoshida, Ken-ichi

    2012-01-01

    An older female with a history of microscopic polyangiitis underwent haemodialysis through an end-to-side anastomosis between the left basilica vein and brachial artery. During the last haemodialysis session, repeated punctures induced haemorrhage that required brachial compression. Twenty min posthaemodialysis, haemorrhage had expanded from the axilla to the left lateral thorax. Autopsy disclosed axillary haematoma. The haemorrhage was not derived from punctured vessels or the left axillary artery. Although neither an alveolar nor a glomerular microscopic polyangiitis lesion was detected, fragility of the axillary small vessels due to microscopic polyangiitis, ageing, atherosclerosis and steroid therapy were underlying factors in the haematoma. Aspirin and heparin may have promoted haemorrhage, while shunt vessel stenosis with disturbed flow may have increased the axillary vessel pressure when the shunt vessels were compressed for haemostasis. This is the first report of a death due to haemorrhage from ruptured axillary vessels related to haemodialysis or microscopic polyangiitis. PMID:22665880

  3. Death from axillary haemorrhage during haemodialysis in a patient with a history of microscopic polyangiitis

    PubMed Central

    Unuma, Kana; Uozaki, Hiroshi; Kuroda, Ryouhei; Uemura, Koichi; Yoshida, Ken-ichi

    2012-01-01

    An older female with a history of microscopic polyangiitis underwent haemodialysis through an end-to-side anastomosis between the left basilica vein and brachial artery. During the last haemodialysis session, repeated punctures induced haemorrhage that required brachial compression. Twenty min posthaemodialysis, haemorrhage had expanded from the axilla to the left lateral thorax. Autopsy disclosed axillary haematoma. The haemorrhage was not derived from punctured vessels or the left axillary artery. Although neither an alveolar nor a glomerular microscopic polyangiitis lesion was detected, fragility of the axillary small vessels due to microscopic polyangiitis, ageing, atherosclerosis and steroid therapy were underlying factors in the haematoma. Aspirin and heparin may have promoted haemorrhage, while shunt vessel stenosis with disturbed flow may have increased the axillary vessel pressure when the shunt vessels were compressed for haemostasis. This is the first report of a death due to haemorrhage from ruptured axillary vessels related to haemodialysis or microscopic polyangiitis. PMID:22665880

  4. Duration of 18 F-FDG avidity in lymph nodes after pandemic H1N1v and seasonal influenza vaccination

    Microsoft Academic Search

    Anders Thomassen; Anne Lerberg Nielsen; Oke Gerke; Allan Johansen; Henrik Petersen

    2011-01-01

    Purpose  The aim of our study was to investigate the occurrence of fluorodeoxyglucose (FDG) avidity in draining axillary lymph nodes\\u000a after vaccination against influenza (H1N1v pandemic and seasonal) and to determine the period of increased FDG uptake.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  During December 2009, patients referred for 18F-FDG positron emission tomography (PET)\\/CT scans (n?=?293) filled in a questionnaire concerning vaccination type (seasonal and\\/or H1N1v), time

  5. Three-dimensional quantitative ultrasound for detecting lymph node metastases

    E-print Network

    Illinois at Urbana-Champaign, University of

    -frequency ultrasound Lymph node metastases Lymph node micrometastases Breast cancer Colorectal cancer Gastric cancerThree-dimensional quantitative ultrasound for detecting lymph node metastases Emi Saegusa nodes (LNs) is critical for cancer management. Conventional histological methods may miss metastatic

  6. Colorectal Surgical Specimen Lymph Node Harvest: Improvement of Lymph Node Yield with a Pathology Assistant

    Microsoft Academic Search

    Jeffery A. Reese; Christopher Hall; Kelly Bowles; Robert C. Moesinger

    2009-01-01

    Introduction  Adequate lymph node harvest from colorectal cancer specimens has become a standard of care, influencing both staging and survival.\\u000a To improve lymph node harvests at our hospital, a pathology assistant was trained to meticulously harvest lymph nodes from\\u000a colorectal cancer specimens. An analysis of trends in lymph node harvests over time is presented.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  The number of harvested lymph nodes from

  7. Fetal axillary cystic hygroma: a case report and review

    PubMed Central

    Temizkan, Osman; Abike, Faruk; Ayvaci, Habibe; Demirag, Ersan; Görücü, Yasin; Isik, Ecmel

    2011-01-01

    Cystic hygroma (CH) is a lymphatic malformation occurring different parts of fetal body, typically in the region of the fetal neck and axillary, abdominal wall, mediastinal, inguinal and retroperitoneal areas. CH has been associated with fetal aneuploidy, hydrops fetalis, structural malformations and intrauterine fetal death. A 24-year-old gravida 1, para 1 was admitted to our hospital at 28 weeks of gestation. Ultrasonographic examination determined 28 weeks of gestation, singleton, alive fetus who had a mass derived from the right axillary region which was extending to the anterior and posterior thoracic wall with fluid-filled cavities about 12 cm in size. There was no evidence of intrathorasic or intraabdominal extension of mass. Cordocentesis was performed and karyotype examination was normal 46 XY. The fetal demise was found after the first visit. The patient was delivered vaginally after labor induction with oxytocin infusion. The fetal autopsy confirmed the diagnosis of CH. The fetal CH carries high risk of aneuploidy and fetal malformations. Patients that have been diagnosed with CH in antenatal follow-ups should be assessed in terms of other anomalies. Fetal karyotyping should be done and the patient should be monitored for fetal hydrops. The birth should be planned in a multidisciplinary hospital and as neonatal resuscitation could be needed, pediatricians should be consulted. PMID:22355494

  8. Traumatic Pseudoaneurysm of Axillary Artery Combined with Brachial Plexus Injury

    PubMed Central

    Chen, Lin; Peng, Feng; Wang, Tao; Chen, Desong; Yang, Jianyun

    2014-01-01

    Traumatic pseudoaneurysm of the axillary artery combined with brachial plexus injury is extremely rare. The factors that influence the symptoms and functional recovery related to this condition are unclear. Nine patients who had sustained this trauma were surgically treated at our unit between June 1999 and November 2010. The cause of trauma, symptoms, signs and examinations of neurological and vascular deficits, and the surgical findings of the involved nerves and vessels were recorded in detail. The functional recovery of vessels and nerves, as well as the extent of pain, were evaluated, respectively. The average length of patient follow-up was 4.5 years (range, 24 months to 11.3 years). After vessel repair, whether by endovascular or operative treatment, the distending, constant, and pulsating pain was relieved in all patients. Furthermore, examination of the radial artery pulse on the repaired side appeared normal at last follow-up. All patients showed satisfactory sensory recovery, with motor recovery rated as good in five patients and fair in four patients. The symptom characteristics varied with the location of the damage to the axillary artery. Ultrasound examination and computed tomography angiography are useful to evaluate vascular injury and provide valuable information for operative planning. Surgical exploration is an effective therapy with results related to the nerve injury condition of the brachial plexus. PMID:25412426

  9. Sentinel Lymph Node in Nonmelanoma Skin Cancer

    Microsoft Academic Search

    I. Salguero-Fernández; L. Rios-Buceta; P. Jaén-Olasolo

    Sentinel lymph node biopsy is performed routinely in melanoma because lymph node progression has been shown to be the strongest predictor of survival. Given the proven relevance of biopsy findings in this type of skin cancer, the procedure has been extended to other skin tumors. Experience in nonmelanoma cancer is much more limited and the prognostic usefulness of biopsy results

  10. Treatment Outcome of Breast Cancer with Pathologically Proven Synchronous Ipsilateral Supraclavicular Lymph Node Metastases

    PubMed Central

    Jung, Jinhong; Ahn, Seung Do; Lee, Sang-wook; Ahn, Sei-Hyun; Son, Byung Ho; Lee, Jong Won; Choi, Eun Kyung

    2015-01-01

    Purpose The aim of this study was to investigate the prognosis, patterns of failure, and prognostic factors for breast cancer patients with pathologically proven synchronous ipsilateral supraclavicular lymph node (ISCLN) metastases. Methods We reviewed the records of breast cancer patients with pathologically proven ISCLN metastases. Local aggressive treatment was defined as treatment including surgery, axillary lymph node dissection (ALND), ISCLN excision, radiotherapy (RT), and chemotherapy. Results A total of 111 patients were included. The 5-year overall survival (OS) and disease-free survival (DFS) rates were 64.2% and 56.2%, respectively. On univariate analysis, RT, ALND, trastuzumab treatment, hormone receptor (HR) status, and local aggressive treatment were identified as significant factors for OS. The 5-year OS for 73 patients who received local aggressive treatment was superior to that of 38 patients who received nonaggressive treatment (70.9% vs. 49.3%, p=0.036). Multivariate analysis showed that RT, HR status, and trastuzumab were significant variables for the 5-year OS and DFS. Conclusion Multimodality treatment with surgery, taxane-based chemotherapy, hormone therapy, and RT is strongly recommended for breast cancer patients with synchronous ISCLN metastases.

  11. Epitrochlear lymph nodes: Anatomy, clinical aspects, and sonography features. Pictorial essay().

    PubMed

    Catalano, O; Nunziata, A; Saturnino, P P; Siani, A

    2010-12-01

    The normal and abnormal aspects of the epitrochlear lymphatic station are not well known, mainly because the axillary basin is commonly regarded as the primary lymphatic target of all upper limb disorders. The purpose of this paper is to illustrate, through a review of specific cases, the normal and abnormal findings that can emerge during ultrasonographic (US) and color-Doppler US exploration of the epitrochlear region. We illustrate the normal anatomy and variations of the epitrochlear lymph nodes and highlight the functional role of this lymphatic station. Subsequently we describe the US and color-Doppler US findings. A number of different abnormalities are reviewed, including metastases (mainly from upper limb cutaneous melanomas), Hodgkin disease, and non-Hodgkin lymphoma, lymphadenitis (cat-scratch disease, foreign bodies, and IV drug abuse). Measures are suggested to avoid interpretative pitfalls and to carry out an effective differential diagnosis of elbow masses. This article represents a pictorial essay of the US and color-Doppler US features of various epitrochlear lymph node abnormalities that clinicians may not be familiar with. PMID:23397026

  12. Epitrochlear lymph nodes: Anatomy, clinical aspects, and sonography features. Pictorial essay?

    PubMed Central

    Catalano, O.; Nunziata, A.; Saturnino, P.P.; Siani, A.

    2010-01-01

    The normal and abnormal aspects of the epitrochlear lymphatic station are not well known, mainly because the axillary basin is commonly regarded as the primary lymphatic target of all upper limb disorders. The purpose of this paper is to illustrate, through a review of specific cases, the normal and abnormal findings that can emerge during ultrasonographic (US) and color-Doppler US exploration of the epitrochlear region. We illustrate the normal anatomy and variations of the epitrochlear lymph nodes and highlight the functional role of this lymphatic station. Subsequently we describe the US and color-Doppler US findings. A number of different abnormalities are reviewed, including metastases (mainly from upper limb cutaneous melanomas), Hodgkin disease, and non-Hodgkin lymphoma, lymphadenitis (cat-scratch disease, foreign bodies, and IV drug abuse). Measures are suggested to avoid interpretative pitfalls and to carry out an effective differential diagnosis of elbow masses. This article represents a pictorial essay of the US and color-Doppler US features of various epitrochlear lymph node abnormalities that clinicians may not be familiar with. PMID:23397026

  13. Long-term outcomes in breast cancer patients with ten or more positive axillary nodes treated with combined-modality therapy: The importance of radiation field selection

    SciTech Connect

    Chang, Daniel T. [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL (United States); Feigenberg, Steven J. [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States); Indelicato, Daniel J. [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL (United States); Morris, Christopher G. [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL (United States); Lightsey, Judith [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL (United States); Grobmyer, Stephen R. [Department of Surgery, University of Florida College of Medicine, Gainesville, FL (United States); Copeland, Edward M. [Department of Surgery, University of Florida College of Medicine, Gainesville, FL (United States); Mendenhall, Nancy P. [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL (United States)]. E-mail: mendenan@shands.ufl.edu

    2007-03-15

    Purpose: To determine the long-term outcome of a consistent treatment approach with electron beam postmastectomy radiation therapy (PMRT) in breast cancer patients with {>=}10 positive nodes treated with combined-modality therapy. Methods and Materials: TSixty-three breast cancer patients with {>=}10 positive lymph nodes were treated with combined-modality therapy using an electron beam en face technique for PMRT at University of Florida. Patterns of recurrence were studied for correlation with radiation fields. Potential clinical and treatment variables were tested for possible association with local-regional control (LRC), disease-free survival (DFS), and overall survival (OS). Results: TAt 5, 10, and 15 years, OS rates were 57%, 36%, and 27%, respectively; DFS rates were 46%, 37%, and 34%; and LRC rates were 87%, 87%, and 87%. No clinical or treatment variables were associated with OS or DFS. The use of supplemental axillary radiation (SART) (p = 0.012) and pathologic N stage (p = 0.053) were associated with improved LRC. Patients who received SART had a higher rate of LRC than those who did not. Moderate to severe arm edema developed in 17% of patients receiving SART compared with 7% in patients not treated with SART (p = 0.28). Conclusions: TA substantial percentage of patients with {>=}10 positive lymph nodes survive breast cancer. The 10-year overall survival in these patients was 36%. The addition of SART was associated with better LRC.

  14. Cytokine transcription in lymph nodes of cattle in different stages of bovine leukemia virus infection

    Microsoft Academic Search

    Robert G. Keefe; David A. Ferrick; Jeffrey L. Stott

    1997-01-01

    Bovine leukemia virus (BLV) is a transforming oncovirus that contains no oncogenes or preferred site of proviral integration. The role of cytokines in the disease process of BLV is potentially important due to the similarity of BLV with other retroviruses in which cytokines play a role, such as HTLV-I and -II. Mesenteric and supra-mammary lymph nodes were obtained from a

  15. Evolution of sentinel lymph node biopsy in breast cancer, in and out of vogue?

    PubMed

    Jaffer, Shabnam; Bleiweiss, Ira J

    2014-11-01

    Sentinel lymph node biopsy (SLNB) was introduced 2 decades ago and thereafter validated for routine surgical management of breast cancer, including cases treated with neoadjuvant chemotherapy. As the number of lymph nodes for staging has decreased, pathologists have scrutinized SLN with a combination of standard hematoxylin and eosin, levels, immunohistochemistry (IHC), and molecular methods. An epidemic of small-volume metastases thereby arose, leading to modifications in the American Joint Committee on Cancer staging to accommodate findings such as isolated tumor cells (ITC) and micrometastases. With the goal of determining the significance of these findings, retrospective followed by prospective trials were performed, showing mixed results. The ACOSOG Z10 and NSABP B-32 trials both independently showed that ITC and micrometastases were not significant and thus discouraged the use of levels and IHC for detecting them. However, the Surveillance Epidemiology and End Results database showed that patients with micrometastases had an overall decreased survival. In addition, the MIRROR (Micrometastases and ITC: Relevant and Robust or Rubbish?) trial, showed that patients with ITC and micrometastases treated with adjuvant therapy had lower hazard ratios compared with untreated patients. Subsequently, the ACOSOG Z0011 trial randomized patients with up to 2 positive SLN to axillary lymph node dissection (ALND) or not, all treated with radiation and chemotherapy, showing no difference in survival or recurrence rates between the 2 groups and causing a shift from ALND. As the rate of ALND has declined, the necessity of performing levels, IHC, frozen section, and molecular studies on SLN needs to be revisited. PMID:25299312

  16. Fluorescence tomographic imaging of sentinel lymph node using near-infrared emitting bioreducible dextran nanogels

    PubMed Central

    Li, Jiejing; Jiang, Beiqi; Lin, Chao; Zhuang, Zhigang

    2014-01-01

    Sentinel lymph node (SLN) mapping is a critical procedure for SLN biopsy and its diagnosis as tumor metastasis in clinical practice. However, SLN mapping agents used in the clinic frequently cause side effects and complications in the patients. Here, we report the development of a near-infrared (NIR) emitting polymeric nanogel with hydrodynamic diameter of ~28 nm – which is the optimal size for SLN uptake – for noninvasive fluorescence mapping of SLN in a mouse. This polymeric nanogel was obtained by coupling Cy7, an NIR dye, to the self-assembled nanogel from disulfide-linked dextran-deoxycholic acid conjugate with the dextran of 10 kDa, denoted as Dex–Cy7. Fluorescence imaging analysis showed that Dex–Cy7 nanogels had an enhanced photostability when compared to Cy7 alone. After intradermal injection of Dex–Cy7 nanogel into the front paw of a mouse, the nanogels were able to migrate into the mouse’s axillary lymph node, exhibiting longer retention time and higher fluorescence intensity in the node when compared to Cy7 alone. An immunohistofluorescence assay revealed that the nanogels were localized in the central region of lymph node and that the uptake was largely by the macrophages. In vitro and in vivo toxicity results indicated that the dextran-based nanogels were of low cytotoxicity at a polymer concentration up to 1,000 ?g/mL and harmless to normal liver and kidney organs in mice at an intravenous dose of 1.25 mg/kg. The results of this study suggest that NIR-emitting polymeric nanogels based on bioreducible dextran-deoxycholic acid conjugates show high potential as fluorescence nanoprobes for safe and noninvasive SLN mapping. PMID:25506217

  17. Value of systematic mediastinal lymph node dissection during pulmonary metastasectomy

    Microsoft Academic Search

    Florian Loehe; Sonja Kobinger; Rudolf A Hatz; Thomas Helmberger; Udo Loehrs; Heinrich Fuerst

    2001-01-01

    Background. Systematic mediastinal lymph node dissection is the accepted standard when curative resection of bronchial carcinoma is performed. However, mediastinal lymph node dissection is not routinely performed with pulmonary metastasectomy, in which only enlarged or suspicious lymph nodes are removed. The incidence of malignant infiltration of mediastinal lymph nodes in patients with pulmonary metastases is not known.Methods. Sixty-three patients who

  18. Molecular analysis of sarcoidosis lymph nodes for microorganisms: a case–control study with clinical correlates

    PubMed Central

    Robinson, Lary A; Smith, Prudence; SenGupta, Dhruba J; Prentice, Jennifer L; Sandin, Ramon L

    2013-01-01

    Introduction Sarcoidosis is an incurable, chronic granulomatous disease primarily involving the lungs and lymph nodes of unknown aetiology, treated with non-specific anti-inflammatory/immunosuppressive drugs. Persistently symptomatic patients worsen with a disabling, potentially fatal clinical course. To determine a possible infectious cause, we correlated in a case-control study the clinical information with the presence of bacterial DNA in sarcoidosis mediastinal lymph nodes compared with control lymph nodes resected during cancer surgery. Methods We retrospectively studied formalin-fixed, paraffin-embedded, mediastinal lymph nodes from 30 patients with sarcoidosis and 30 control patients with lung cancer. Nucleic acids were extracted from nodes, evaluated by ribosomal RNA PCR for bacterial 16S ribosomal DNA and the results were sequenced and compared with a bacterial sequence library. Clinical information was correlated. Results 11/30 (36.7%) of lymph nodes from patients with sarcoidosis had detectable bacterial DNA, significantly more than control patient lymph nodes (2/30, 6.7%), p=0.00516. At presentation, 19/30 (63.3%) patients with sarcoidosis were symptomatic including all patients with detectable bacterial DNA. Radiographically, there were 18 stage I and 12 stage II patients. All stage II patients were symptomatic and 75% had PCR-detectable bacteria. After a mean follow-up of 52.8±32.8?months, all patients with PCR-detectable bacteria in this series were persistently symptomatic requiring treatment. Discussion 36.6% of patients with sarcoidosis had detectable bacterial DNA on presentation, all of these patients were quite symptomatic and most were radiographically advanced stage II. These findings suggest that bacterial DNA-positive, symptomatic patients have more aggressive sarcoidosis that persists long term and might benefit from antimicrobial treatment directed against this presumed chronic granulomatous infection. PMID:24366580

  19. Familial Blood and Lymph Node Cancers Study

    Cancer.gov

    A study of a group of familial blood and lymph node cancers (also called "lymphoproliferative disorders"), including: chronic lymphocytic leukemia, Hodgkin lymphoma, non-Hodgkin lymphoma, Waldenström's macroglobulinemia, and multiple myeloma

  20. Endovascular Repair of a Traumatic Axillary Pseudoaneurysm Following Anterior Shoulder Dislocation

    SciTech Connect

    Stahnke, Michaela; Duddy, Martin J. [Selly Oak Hospital, University Hospital Birmingham Foundation Trust, Department of Radiology (United Kingdom)], E-mail: martin.duddy@uhb.nhs.uk

    2006-04-15

    Pseudoaneurysms due to musculoskeletal trauma are rare and comprise less than 2% of all pseudoaneurysms. We report a case of axillary pseudoaneurysm following anterior dislocation of the shoulder. The patient was successfully treated by endovascular intervention.

  1. Sentinel lymph node mapping with GI cancer

    Microsoft Academic Search

    Takashi Aikou; Yuko Kitagawa; Masaki Kitajima; Yoshikazu Uenosono; Anton J. Bilchik; Steve R. Martinez; Sukamal Saha

    2006-01-01

    Precise evaluation of lymph node status is one of the most important factors in determining clinical outcome in treating gastro-intestinal\\u000a (GI) cancer. Sentinel lymph node (SLN) mapping clearly has become highly feasible and accurate in staging GI cancer. The lunchtime\\u000a symposium focused on the present status of SLN mapping for GI cancer. Dr. Kitigawa proposed a new strategy using sentinel

  2. Primary Neuroendocrine Carcinoma of Inguinal Lymph Node

    Microsoft Academic Search

    H. Biering; J. Bauditz; N. Brenner; H. Stein; H. Lochs; C. J. Strasburger

    2005-01-01

    Ninety-seven percent of neuroendocrine carcinomas are located in the gastrointestinal tract or in the bronchopulmonary tree. Inguinal lymph nodes as the primary tumor site for neuroendocrine carcinoma represent a very unusual location, and have only been described in 2 patient series in the literature. A 64-year-old, previously healthy, Caucasian female presented with a 2-month history of an enlarged inguinal lymph

  3. Cervical lymph node diseases in children

    PubMed Central

    Lang, Stephan; Kansy, Benjamin

    2014-01-01

    The lymph nodes are an essential part of the body’s immune system and as such are affected in many infectious, autoimmune, metabolic and malignant diseases. The cervical lymph nodes are particularly important because they are the first drainage stations for key points of contact with the outside world (mouth/throat/nose/eyes/ears/respiratory system) – a critical aspect especially among children – and can represent an early clinical sign in their exposed position on a child’s slim neck. Involvement of the lymph nodes in multiple conditions is accompanied by a correspondingly large number of available diagnostic procedures. In the interests of time, patient wellbeing and cost, a careful choice of these must be made to permit appropriate treatment. The basis of diagnostic decisions is a detailed anamnesis and clinical examination. Sonography also plays an important role in differential diagnosis of lymph node swelling in children and is useful in answering one of the critical diagnostic questions: is there a suspicion of malignancy? If so, full dissection of the most conspicuous lymph node may be necessary to obtain histological confirmation. Diagnosis and treatment of childhood cervical lymph node disorders present the attending pediatric and ENT physicians with some particular challenges. The spectrum of differential diagnoses and the varying degrees of clinical relevance – from banal infections to malignant diseases – demand a clear and considered approach to the child’s individual clinical presentation. Such an approach is described in the following paper. PMID:25587368

  4. Axillary sampling in the definitive treatment of breast cancer by radiation therapy and lumpectomy

    Microsoft Academic Search

    C. M. Rose; L. E. Botnick; M. Weinstein; J. R. Harris; C. Koufman; W. Silen; S. Hellman

    1983-01-01

    Between January, 1967 and July, 1980, 176 women who were referred to the Joint Center for Radiation Therapy (JCRT) for definitive breast irradiation underwent low axillary dissection. A typical operative technique is described. The dissection stops short of the axillary vein although the vein is usually visualized. One hundred thirty-two axillae were thought to be Nâ or N\\/sub 1a\\/. Forty-six

  5. Axillary bud banks of two semiarid perennial grasses: occurrence, longevity, and contribution to population persistence

    Microsoft Academic Search

    J. R. Hendrickson; D. D. Briske

    1997-01-01

    The occurrence, longevity, and contribution of axillary bud banks to population maintenance were investigated in a late-seral\\u000a perennial grass, Bouteloua curtipendula, and a mid-seral perennial grass, Hilaria belangeri, in a semiarid oak-juniper savanna. Axillary buds of both species were evaluated over a 2-year period in communities with\\u000a contrasting histories of grazing by domestic herbivores. A double staining procedure utilizing triphenyl

  6. Cryopreservation of dried axillary buds from plantlets of Asparagus officinalis L. grown in vitro

    Microsoft Academic Search

    A. Uragami; A. Sakai; M. Nagai

    1990-01-01

    Dried axillary buds from plantlets of Asparagus lofficinalis L. grown in vitro were successfully cryopreserved. Single node segments (5mm in length) with axillary bud were taken from mature in vitro plantlets. The segments were precultured on solidfied Murashige-Skoog medium (1962) containing 0.7M sucrose at 25 °C in light for 2 days. Thereafter, these precultured segments were subjected to dehydration with

  7. FhSPECT-US guided needle biopsy of sentinel lymph nodes in the axilla: is it feasible?

    PubMed

    Okur, Asl?; Hennersperger, Christoph; Runyan, Brent; Gardiazaball, José; Keicher, Matthias; Paepke, Stefan; Wendler, Thomas; Navab, Nassir

    2014-01-01

    Until now, core needle biopsy of the axillary sentinel lymph nodes in early stage breast cancer patients is not possible, due to the lack of a proper combination of functional and anatomical information. In this work we present the first fully 3D freehand SPECT--ultrasound fusion, combining the advantages of both modalities. By using spatial positioning either with optical or with electromagnetic tracking for the ultrasound probe, and a mini gamma camera as radiation detector for freehand SPECT reconstructions, we investigate the capability of the introduced multi-model imaging system, where we compare both 3D freehand SPECT and 3D ultrasound to ground truth for a realistic breast mimicking phantom and further analyze the effect of tissue deformation by ultrasound. Finally, we also show its application in a real clinical setting. PMID:25333165

  8. Interspecific comparisons of lymph volume and lymphatic fluxes: do lymph reserves and lymph mobilization capacities vary in anurans from different environments?

    PubMed

    Hillman, Stanley S; Drewes, Robert C; Hedrick, Michael S; Withers, Philip C

    2011-01-01

    The femoral lymph sac volumes and lymph mobilization capacity were compared in three anuran species that span a range of environments, dehydration tolerance, ability to maintain blood volume with dehydration, and degrees of development of skeletal muscles putatively involved in moving lymph vertically to the posterior lymph hearts. The femoral lymph sac volume determined by Evans blue injection and dilution in the femoral lymph sac varied interspecifically. The semiaquatic species, Lithobates catesbeianus, had the greatest apparent lymph volume expressed either as 18.7 mL kg body mass?¹ or 94 mL kg thigh mass?¹, compared with both the terrestrial and aquatic species, Rhinella marina (7.3 mL kg body mass?¹ and 57 mL kg thigh mass?¹) and Xenopus laevis (6.5 mL kg body mass?¹ and 40 mL kg thigh mass?¹, respectively. Injections of Evans blue into the subvertebral lymph sac, which communicates with both pairs of lymph hearts, yielded the highest rates of lymph return to the circulation in all three species. The most terrestrial species had a greater rate of lymphatic return from the subvertebral lymph sac, compared with the other two species. The rate of lymph flux from the femoral sac varied interspecifically and was correlated with the number and development of skeletal muscles involved in lymph movement. The results indicated that the three species differ in both the volume of lymph present and the capacity to return lymph. Lymph flux was correlated with habitat and the ability to maintain blood volume when challenged by dehydration or hemorrhage, whereas femoral lymph volume was not correlated with these factors. PMID:21527817

  9. The effect of preoperative chemoradiotherapy on lymph nodes harvested in TME for rectal cancer

    PubMed Central

    2013-01-01

    Background Adequate lymph nodes resection in rectal cancer is important for staging and local control. This retrospective analysis single center study evaluated the effect of neoadjuvant chemoradiation on the number of lymph nodes in rectal carcinoma, considering some clinicopathological parameters. Methods A total of 111 patients undergone total mesorectal excision for rectal adenocarcinoma from July 2005 to May 2012 in our center were included. No patient underwent any prior pelvic surgery or radiotherapy. Chemoradiotherapy was indicated in patients with rectal cancer stage II or III before chemoradiation. Results One-hundred and eleven patients were considered. The mean age was 67.6 yrs (range 36 – 84, SD 10.8). Fifty (45.0%) received neoadjuvant therapy before resection. The mean number of removed lymph nodes was 13.6 (range 0–39, SD 7.3). In the patients who received neoadjuvant therapy the number of nodes detected was lower (11.5, SD 6.5 vs. 15.3, SD 7.5, p?=?0.006). 37.4% of patients with preoperative chemoradiotherapy had 12 or more lymph nodes in the specimen compared to the 63.6% of those who had surgery at the first step (p: 0.006). Other factors associated in univariate analysis with lower lymph nodes yield included stage (p 0.005) and grade (p 0.0003) of the tumour. Age, sex, tumor site, type of operation, surgeons and pathologists did not weight upon the number of the removed lymph nodes. Conclusion In TME surgery for rectal cancer, preoperative CRT results into a reduction of lymph nodes yield in univariate analisys and linear regression. PMID:24246069

  10. Bacteriologic studies of skin, tissue fluid, lymph, and lymph nodes in patients with filarial lymphedema.

    PubMed

    Olszewski, W L; Jamal, S; Manokaran, G; Pani, S; Kumaraswami, V; Kubicka, U; Lukomska, B; Dworczynski, A; Swoboda, E; Meisel-Mikolajczyk, F

    1997-07-01

    Filarial lymphedema is complicated by frequent episodes of dermatolymphangioadenitis (DLA). It is not certain whether DLA is of filarial or bacterial etiology. The frequency of episodic DLA does not depend on the presence or absence of microfilariae. Antibiotic therapy is effective in prevention and treatment of DLA. These observations point to the bacterial rather than filarial etiology of DLA. Skin and lymph node biopsies, tissue fluid, lymph, and blood from patients with chronic filarial lymphedema, and during acute episodes of DLA, were cultured for detection of bacteria. A high prevalence of bacterial isolates from the tissue fluid (64%), lymph (75%), and inguinal lymph nodes (66%) of limbs with filarial lymphedema was found. Bacillus cereus, Staphylococcus epidermidis, S. hominis, S. capitis, S. xylosus, and Micrococcus spp. were the most common isolates. Bacteria were also isolated from the blood of patients with recent episodes of DLA, with strains of the same phenotype and antibiotic sensitivity in all specimens from patients with DLA. Bacterial strains of the same phenotype and antibiotic sensitivity were documented on the toe web surface and in tissue fluid (25%), lymph (26%), or lymph nodes (41%). Increasing prevalence of bacterial isolates in tissue fluid, lymph, and lymph nodes was observed in advanced stages of lymphedema. Bacilli and cocci were sensitive to gentamicin, tetracyline, rifampicin, vancomycin, kanamycin and cotrimoxazole, and least sensitive to penicillin. Blood cultures of patients in the periods between DLA attacks were negative. In healthy controls without edema and episodes of DLA, tissue fluid did not contain bacteria. In lymph, only single colonies of Micrococcus and Acinetobacter were cultured in 12% of the cases. Impaired lymph drainage and lack of elimination of penetrating bacteria may be responsible for progression of lymphedema and recurrent attacks of DLA. PMID:9242310

  11. Characterization of MORE AXILLARY GROWTH Genes in Populus

    PubMed Central

    Czarnecki, Olaf; Yang, Jun; Wang, Xiaoping; Wang, Shucai; Muchero, Wellington; Tuskan, Gerald A.; Chen, Jin-Gui

    2014-01-01

    Background Strigolactones are a new class of plant hormones that play a key role in regulating shoot branching. Studies of branching mutants in Arabidopsis, pea, rice and petunia have identified several key genes involved in strigolactone biosynthesis or signaling pathway. In the model plant Arabidopsis, MORE AXILLARY GROWTH1 (MAX1), MAX2, MAX3 and MAX4 are four founding members of strigolactone pathway genes. However, little is known about the strigolactone pathway genes in the woody perennial plants. Methodology/Principal Finding Here we report the identification of MAX homologues in the woody model plant Populus trichocarpa. We identified the sequence homologues for each MAX protein in P. trichocarpa. Gene expression analysis revealed that Populus MAX paralogous genes are differentially expressed across various tissues and organs. Furthermore, we showed that Populus MAX genes could complement or partially complement the shoot branching phenotypes of the corresponding Arabidopsis max mutants. Conclusion/Significance This study provides genetic evidence that strigolactone pathway genes are likely conserved in the woody perennial plants and lays a foundation for further characterization of strigolactone pathway and its functions in the woody perennial plants. PMID:25036388

  12. Aortic flow patterns resulting from right axillary artery cannulation.

    PubMed

    Demertzis, Stefanos; Tevaearai, Hendrik; Carrel, Thierry; Vandenberghe, Stijn

    2011-06-01

    Right axillary artery (RAA) cannulation is increasingly used in cardiac surgery. Little is known about resulting flow patterns in the aorta. Therefore, flow was visualized and analyzed. A mock circulatory circuit was assembled based on a compliant transparent anatomical silicon aortic model. A RAA cannula was connected to a continuous flow rotary blood pump (RBP), pulsatile heart action was provided by a pneumatic ventricular assist device (PVAD). Peripheral vascular resistance, regional flow and vascular compliance were adjusted to obtain physiological flow and pressure waveforms. Colorants were injected automatically for flow visualization. Five flow distributions with a total flow of 4 l/min were tested (%PVAD:%RBP): 100:0, 75:25, 50:50, 25:75, 0:100. Colorant distribution was assessed using quantitative 2D image processing. Continuous flow from the RAA divided in a retrograde and an antegrade portion. Retro- to antegrade flow ratio increased with increasing RAA-flow. At full RBP support flow was stagnant in the ascending aorta. There were distinct flow patterns between the right- and left-sided supra-aortic branches. At full RBP support retrograde flow was demonstrated in the right carotid and right vertebral arteries. Further studies are needed to confirm and evaluate the described flow patterns. PMID:21398649

  13. How many cases are enough for accreditation in sentinel lymph node biopsy in breast cancer?

    Microsoft Academic Search

    Elias E Sanidas; Eelco de Bree; Dimitris D Tsiftsis

    2003-01-01

    BackgroundThere is considerable argument concerning the number of sentinel node biopsy cases with axillary dissection that surgeons should perform before they are eligible on abandoning axillary dissection in negative sentinel node patients.

  14. Pathologic examination of sentinel lymph nodes in breast cancer.

    PubMed

    Ku, N N

    1999-07-01

    Lymphatic mapping with selective sentinel lymphadenectomy allows accurate pathologic examination of the nodes most likely to contain macro- or micrometastastic disease for staging and proper adjuvant chemotherapy. The hypothesis of SLN biopsies was histopathologically validated by Turner et al that if the node is tumor free by H&E and immunohistochemistry, the probability of non-SLN involvement is less than 0.1%. Giuliano et al and Veronesi et al reported that detection of metastases in SLNs by frozen section technique is 89% and 64%, respectively. At MCC, frozen section evaluation of SLN is not performed because of its potential loss of micrometastasis in the cryostat, freezing artifacts, sampling error, and perhaps radioactive contamination. Intraoperative detection of macro- or micrometastasis is critical because it enables conversion of patients with positive SLN to CLND in one surgical setting more cost-effectively. IIC of the lymph nodes has been used routinely in the diagnosis of hematologic malignancies and also in breast cancer as a useful method in many series. In the author's experience, IIC by Diff-Quik stain converted 100% of grossly positive and suspicious SLNs and 22% of grossly negative SLNs. The significance of detecting micrometastases in axillary lymph nodes using immunohistochemical techniques has been reported in many series. At the MCC, routine use of CKI on paraffin sections of grossly negative SLNs enabled the upstaging of 10.6% of patients from N0 to N1. Recent addition of intraoperative rapid CKI as an adjunct to complement Diff-Quik stain has proven to be more sensitive in detecting micrometastases than using Diff-Quik stain alone. IIC technique using either Diff-Quik stain or CKI requires intensive training and experience to avoid potential pitfalls and errors in interpretation. Evaluation of SLN should use methods that enhance the ability to detect micrometastasis, however, in a cost-effective manner. The cost-effectiveness of IIC by Diff-Quik stain is incomparable with frozen section evaluation. The added cost of routine immunohistochemical stain and perhaps multiple levels of H&E stain should be offset by the decreased costs of IIC and clinically by treating most patients in the outpatient settings. In summary, IIC by Diff-Quik stain is simple, rapid, and has excellent diagnostic accuracy in grossly positive and suspicious SLNs allowing cost-effective, immediate CLND. IIC by CKI is an extremely useful ancillary technique that complements Diff-Quik stain in detecting micrometastases particularly in low grade ductal or lobular carcinoma and low tumor cell volume. Appropriate combined use of both stains may lead to intraoperative nodal staging and cost-effective CLND. SLN mapping technology at MCC using IIC in conjunction with serial sections, entire tissue submission, routine use of CKI, and multiple levels of the SLN have led us to uncover micrometastasis in high-risk, traditionally node-negative patients. These results have encouraged investigators to pursue even more sensitive techniques to detect micrometastases, including molecular biology techniques such as RT-PCR. Experienced cytopathologists and active cytopathology services are required to avoid potential pitfalls in performing and interpreting IIC. More long-term follow-up and prospective trials are needed to determine the prognostic significance of upstaging by ancillary techniques, which may lead to a revision of the current TNM staging system. PMID:10448690

  15. Extended Lymph Node Dissection for Rectal Cancer with Radiologically Diagnosed Extramesenteric Lymph Node Metastasis

    Microsoft Academic Search

    Byung Soh Min; Jin Soo Kim; Nam Kyu Kim; Joon-Seok Lim; Kang Young Lee; Chang Hwan Cho; Seung Kook Sohn

    2009-01-01

    Background  The purpose of this study is to review the clinical outcomes of patients who received extended lymph node dissection for radiologically\\u000a diagnosed extramesenteric lymph node metastasis.\\u000a \\u000a \\u000a \\u000a \\u000a Patients and Methods  The authors reviewed clinical characteristics, short-term operative outcomes, and long-term oncologic outcomes of 151 patients\\u000a who had received total mesorectal excision plus extended lymph node dissection for the treatment of radiologically diagnosed

  16. Bronchogenic carcinoma: incidence of metastases to normal sized lymph nodes

    Microsoft Academic Search

    T Arita; T Kuramitsu; M Kawamura; T Matsumoto; N Matsunaga; K Sugi; K Esato

    1995-01-01

    BACKGROUND--The incidence of metastases to mediastinal lymph nodes was evaluated in patients with normal sized mediastinal nodes on the computed tomographic (CT) scan who underwent thoracotomy. The use of hilar lymph nodes in predicting mediastinal lymph node metastases was also assessed. METHODS--Ninety patients with non-small cell lung cancer who later underwent thoracotomy wer prospectively examined by CT scanning. Lymph nodes

  17. A Model to Estimate the Risk of Breast Cancer-Related Lymphedema: Combinations of Treatment-Related Factors of the Number of Dissected Axillary Nodes, Adjuvant Chemotherapy, and Radiation Therapy

    SciTech Connect

    Kim, Myungsoo; Kim, Seok Won; Lee, Sung Uk; Lee, Nam Kwon; Jung, So-Youn; Kim, Tae Hyun; Lee, Eun Sook; Kang, Han-Sung [Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of)] [Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of); Shin, Kyung Hwan, E-mail: shin.kyunghwan@gmail.com [Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of)

    2013-07-01

    Purpose: The development of breast cancer-related lymphedema (LE) is closely related to the number of dissected axillary lymph nodes (N-ALNs), chemotherapy, and radiation therapy. In this study, we attempted to estimate the risk of LE based on combinations of these treatment-related factors. Methods and Materials: A total of 772 patients with breast cancer, who underwent primary surgery with axillary lymph node dissection from 2004 to 2009, were retrospectively analyzed. Adjuvant chemotherapy (ACT) was performed in 677 patients (88%). Among patients who received radiation therapy (n=675), 274 (35%) received supraclavicular radiation therapy (SCRT). Results: At a median follow-up of 5.1 years (range, 3.0-8.3 years), 127 patients had developed LE. The overall 5-year cumulative incidence of LE was 17%. Among the 127 affected patients, LE occurred within 2 years after surgery in 97 (76%) and within 3 years in 115 (91%) patients. Multivariate analysis showed that N-ALN (hazard ratio [HR], 2.81; P<.001), ACT (HR, 4.14; P=.048), and SCRT (HR, 3.24; P<.001) were independent risk factors for LE. The total number of risk factors correlated well with the incidence of LE. Patients with no risk or 1 risk factor showed a significantly lower 5-year probability of LE (3%) than patients with 2 (19%) or 3 risk factors (38%) (P<.001). Conclusions: The risk factors associated with LE were N-ALN, ACT, and SCRT. A simple model using combinations of these factors may help clinicians predict the risk of LE.

  18. Is the Lateral Lymph Node Compartment Relevant?

    Microsoft Academic Search

    Moritz Koch; Peter Kienle; Dalibor Antolovic; Markus W. Büchler; Jürgen Weitz

    Lateral pelvic lymphadenectomy is routinely performed in advanced lower rectal cancers by Japanese surgeons, whereas in the western world it has not progressed to a frequently performed technique. Claimed benefit for this extensive surgery is an improved locoregional control; on the other hand, low positive lateral lymph node yields, questionable prognostic significance, and high morbidity (urinary and sexual dysfunction) are

  19. Detection of isolated ipsilateral regional lymph node recurrences by F18-fluorodeoxyglucose positron emission tomography-CT in follow-up of postoperative breast cancer patients.

    PubMed

    Ohsumi, Shozo; Inoue, Takeshi; Kiyoto, Sachiko; Hara, Fumikata; Takahashi, Mina; Takabatake, Daisuke; Takashima, Seiki; Aogi, Kenjiro; Takashima, Shigemitsu

    2011-11-01

    Imaging diagnostic methods except for mammograms are not recommended for follow-up of postoperative breast cancer patients in order to detect small recurrences because of the poor survival improvement in earlier randomized trials. However, the use of new imaging modalities may improve survival by detection of small isolated regional lymph node recurrences which are potentially curable. Between April 2006 and December 2008, we used PET-CT to find small recurrences in follow-up of 1,907 postoperative breast cancer patients. A total of 3,280 PET-CT imagings were performed. The median age at PET-CT imaging was 58 years, with a median 48-month interval from definitive surgery to the PET-CT imaging. Twenty-two patients were found to have isolated ipsilateral regional recurrences only by PET-CT (axillary node recurrences in 6, infraclavicular node recurrences in 5, supraclavicular node recurrences in 6, and parasternal node recurrences in 5). All of those recurrences were missed by palpation or were nonpalpable. The pathological lymph node status at the definitive surgery for the primary breast cancer of 22 patients with the isolated ipsilateral regional lymph node recurrences was positive in 17 patients. If patients are limited to those who had pathologically positive node(s) at definitive surgery, the incidence of patients with isolated regional lymph node recurrences found only by PET-CT would be 2.6% (17/663 patients). Seventeen other asymptomatic cancers including contralateral breast cancers were found only by PET-CT. Early detection of isolated loco-regional recurrences of breast cancer is suggested to result in improved survival. Therefore, the use of PET-CT in follow-up of postoperative node-positive breast cancer patients may improve their survival because of early detection of isolated regional lymph node recurrences which are still potentially curable, and screening of other asymptomatic cancers. PMID:21590272

  20. Plant growth regulator and graft control of axillary bud formation and development in the TO2 mutant tomato

    Microsoft Academic Search

    S. Mapelli; J. M. Kinet

    1992-01-01

    The torosa-2 tomato mutant is characterized by a strong inhibition of release of axillary shoots, that is not under the control of the main apex and IAA. Microscopic examination indicated that about 70% of leaf axils do not have axillary buds. Of the growth regulators tested, gibberellic acid and cytokinins were able to modify the to-2 phenotype: increasing bud number

  1. Effect of plant growth substances on the growth of axillary buds in cultured stem segments of Phaseolus vulgaris L

    Microsoft Academic Search

    Imre A. Tamas; Janet L. Schlossberg-Jacobs; Robert Lim; Leslie B. Friedman; Charles C. Barone

    1989-01-01

    The hormonal control of axillary bud growth was investigated in cultured stem segments of Phaseolus vulgaris L. When the stem explants were excised and implanted with their apical end in a solid nutrient medium, outgrowth of the axillary buds-located at the midline of the segment-was induced. However, if indoleacetic acid (IAA) or naphthaleneacetic acid (NAA) was included in the medium,

  2. Comparison of axillary and rectal temperatures for healthy Beagles in a temperature- and humidity-controlled environment.

    PubMed

    Mathis, Justin C; Campbell, Vicki L

    2015-07-01

    OBJECTIVE To compare axillary and rectal temperature measurements obtained with a digital thermometer for Beagles in a temperature- and humidity-controlled environment. ANIMALS 26 healthy Beagles (17 sexually intact males and 9 sexually intact females). PROCEDURES Dogs were maintained in a temperature- and humidity-controlled environment for 56 days before rectal and axillary temperatures were measured. Axillary and rectal temperatures were obtained in triplicate for each dog by use of a single commercially available manufacturer-calibrated digital thermometer. RESULTS Mean rectal and axillary temperatures of Beagles maintained in a temperature- and humidity-controlled environment were significantly different, with a median ± SD difference of 1.4° ± 0.15°C (range, 0.7° to 2.1°C). Mean rectal and axillary temperatures were 38.7°C (range, 37.6° to 39.5°C) and 37.2°C (range, 36.6° to 38.3°C), respectively. CONCLUSIONS AND CLINICAL RELEVANCE Results of this study indicated that the historical reference of a 0.55°C gradient between rectal and axillary temperatures that has been clinically used for veterinary patients was inaccurate for healthy Beagles in a temperature- and humidity-controlled environment. Rectal and axillary temperatures can be measured in veterinary patients. Reliable interpretation of axillary temperatures may accommodate patient comfort and reduce patient anxiety when serial measurement of temperatures is necessary. Further clinical studies will be needed. PMID:26111093

  3. Lymphotrophic nanoparticle enhanced MR imaging (LNMRI) for lymph node imaging

    Microsoft Academic Search

    Anuradha Saokar; Marta Braschi; Mukesh G. Harisinghani

    The accurate staging of lymph nodes in various primary tumors continues to pose a major diagnostic challenge. Following the detection of lymph nodes, the next arduous task is the characterization of nodes into benign and malignant categories. Cross-sectional modalities like CT and MRI rely on nodal size as the primary yardstick for differentiating benign from malignant lymph nodes. Other parameters

  4. Sentinel lymph node biopsy progress in surgical treatment of cancer

    Microsoft Academic Search

    T. Schulze; A. Bembenek; P. M. Schlag

    2004-01-01

    Background Forty-three years after the first description of the sentinel lymph node technique in malignant tumours of the parotid by Gould, sentinel lymph node biopsy (SNLB) has become a precious tool in the treatment of solid tumours. Methods In the following review we give a synopsis of the fundamentals of the sentinel lymph node concept and then proceed to an

  5. Salmonella in lymph nodes of cattle presented for harvest

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This study was undertaken to determine the prevalence of Salmonella in the subiliac lymph nodes (LN) of cattle. Lymph node samples were obtained from carcasses of cull and feedlot cattle at commercial packing plants. Lymph nodes were trimmed of all fat, surface sterilized by submersion in boiling ...

  6. Introduction About 6070% of patients with lymph-node-negative

    E-print Network

    Tian, Qi

    Articles Introduction About 60­70% of patients with lymph-node-negative breast cancer are cured predictions on disease outcome for patients with lymph-node-negative breast cancer. Methods Patients' samples samples from patients with lymph-node- negative breast cancer who were treated during 1980­95, but who did

  7. Metastasis of Right Upper Para-Esophageal Lymph Nodes in Central Compartment Lymph Node Dissection of Papillary Thyroid Cancer

    Microsoft Academic Search

    Byung-Joo Lee; Jin-Choon Lee; Soo-Geun Wang; Yong-Ki Kim; In-Ju Kim; Seok-Man Son

    2009-01-01

    Background  Although some lymph nodes (upper para-esophageal lymph nodes) that exist between the right recurrent laryngeal nerve and the\\u000a esophagus should be involved in central-compartment lymph node dissection (CLND) in patients with papillary thyroid cancer,\\u000a the procedure can cause some injury to the nerve. We set out to assess the incidence of right upper para-esophageal lymph\\u000a node metastasis after routine CLND.

  8. Lymph nodes tuberculosis: a retrospective study on clinical and therapeutic features

    PubMed Central

    Benjelloun, Amine; Darouassi, Youssef; Zakaria, Yasser; Bouchentouf, Rachid; Errami, Noureddine

    2015-01-01

    Lymph nodes tuberculosis represents 30 percent of extra pulmonary tuberculosis in Morocco. We report here the experience of the pulmonology unit of the Avicenne Military Hospital in Marrakech for a period of 4 years. Our study interested 30 patients (15 males and 15 females) with an average age of 29 years old (10 to 62 years old). Tuberculosis has interested a single site in 28 patients, the other two patients had multiple but unilateral involvement. For the single sites, locations were jugulo-carotidian (20 patients), supra-calvicular (2 patients), axillary (2 patients), sub-mandibular (2 patients), spinal (2 patients) and mediastinal (2 patients). For the multiple locations, the involvement was jugulo-carotidian, sub-mandibular, spinal and sub-clavicular for one patient; and jugulo-carotidian and sub-clavicular for the other. Diagnosis was made by surgical biopsy and histology for all the patients. A six-month anti-tuberculous treatment was given afterward, with relapses in two patients. PMID:26090023

  9. Surgical treatment of axillary hyperhidrosis by suction-curettage of sweat glands*

    PubMed Central

    de Rezende, Rebeca Maffra; Luz, Flávio Barbosa

    2014-01-01

    Suction curettage is a dermatologic surgery technique for the treatment of axillary hyperhidrosis, which is becoming more popular. Objective: The purpose of this study is to describe the current technique of removal of axillary sweat glands, and evaluate its efficacy and safety. Conclusion: Suction-curettage of sweat glands is a minimally invasive surgical technique that is easy to perform, safe, has high rates of success and relatively few side-effects. It is generally well tolerated by patients and requires shorter time away from daily activities, when compared with other surgical modalities. PMID:25387499

  10. Magnetic resonance imaging of retropharyngeal lymph node metastasis in nasopharyngeal carcinoma: Patterns of spread

    SciTech Connect

    Liu Lizhi [Imaging Diagnosis and Interventional Center, State Key Laboratory of Oncology in Southern China, Cancer Center, Sun Yat-sen University, Guangzhou (China); Zhang Guoyi [Department of Radiation Oncology, State Key Laboratory of Oncology in Southern China, Cancer Center, Sun Yat-sen University, Guangzhou (China); Xie Chuangmiao [Imaging Diagnosis and Interventional Center, State Key Laboratory of Oncology in Southern China, Cancer Center, Sun Yat-sen University, Guangzhou (China); Liu Xuewen [Imaging Diagnosis and Interventional Center, State Key Laboratory of Oncology in Southern China, Cancer Center, Sun Yat-sen University, Guangzhou (China); Cui Chunyan [Imaging Diagnosis and Interventional Center, State Key Laboratory of Oncology in Southern China, Cancer Center, Sun Yat-sen University, Guangzhou (China); Li Li [Imaging Diagnosis and Interventional Center, State Key Laboratory of Oncology in Southern China, Cancer Center, Sun Yat-sen University, Guangzhou (China)]. E-mail: lililixj@hotmail.com

    2006-11-01

    Purpose: To investigate the incidence, distribution, and spread pattern of retropharyngeal lymph node (RLN) involvement in patients with nasopharyngeal carcinoma (NPC) by using magnetic resonance imaging (MRI). Methods and Materials: The MR images of 275 patients with newly diagnosed NPC were reviewed retrospectively. Nodes were classified as metastatic based on size criteria, the presence of nodal necrosis, and extracapsular spread. Results: Retropharyngeal lymph node involvement was detected in 175 (63.6%) patients. Metastatic RLNs were seen at the following levels: occipital bone, 24 (9.6%) nodes; C1, 157 (62.5%) nodes; C1/2, 40 (15.9%) nodes; C2, 27 (10.8%) nodes; C2/3, 1 (0.4%) node; and C3, 2 (0.8%) nodes. The incidence of RLN involvement was equal to the incidence of cervical lymph node involvement (81.4% vs. 81.4%) in 215 patients with nodal metastases. A significantly higher incidence of metastatic RLNs was observed in the presence of oropharynx, prestyloid parapharyngeal space, post-styloid parapharyngeal space, longus colli muscle, medial pterygoid muscle, levator muscle of velum palatini, tensor muscle of velum palatini, Level II node, Level III node, and Level V node involvement. A significantly lower incidence of metastatic RLNs was found in T1, N0, and Stage I disease. Conversely, no significant difference in the incidence of metastatic RLNs was observed between T1, 2, and, 3; N2 and N3; or Stage II, III, and IV disease. Conclusions: There is an orderly decrease in the incidence of metastatic lateral RLNs from the C1 to C3 level. Metastatic RLNs associate well with involvement of certain structures in early stage primary tumors and lymph node metastases of the upper jugular chain (Level II, Level III nodes) and the posterior triangle (Level V nodes). Both RLNs and cervical Level II nodes appear to be the first-echelon nodes in NPC.

  11. Lymph flow and contractile activity of mesenteric lymph nodes in rats with toxic hepatitis effects of antioxidants.

    PubMed

    Abdreshov, S N; Bulekbayeva, L E; Demshenko, G A

    2013-05-01

    We studied contractile function of isolated mesenteric lymph nodes in rats with toxic hepatitis. We observed suppression of spontaneous and stimulated contractile activity of mesenteric lymph nodes and changes in biochemical composition of the lymph. We propose a method of correction of these dysfunctions with antioxidant ?-tocopherol and Selen-Active. PMID:23667863

  12. Sentinel lymph node biopsy in breast cancer: an analysis of the maximum number of nodes requiring excision.

    PubMed

    Gill, Jasper; Lovegrove, Richard; Naessens, Katrien; Pursell, Roslyn; Cominos, Timothy; McCormick, Colin; Umeh, Hilary; Courtney, Stephen; Smith, Brendan

    2011-01-01

    Sentinel lymph node biopsy (SNB) is now the standard of care in assessment of patients with clinically staged T1-2, N0 breast cancers. This study investigates whether there is a maximum number of sentinel lymph nodes (SLN) that need to be excised without compromising the false-negative (FN) rate of this procedure. Data were prospectively collected for 319 patients undergoing SNB between February 2001 and December 2006 at our institution. This data were analysed, both in terms of the order of SLN retrieval and relative isotope counts of the SLNs, in order to determine the maximum number of SLNs that need to be retrieved without increasing the FN rate. Furthermore, we investigated the relationship between SLN blue dye concentration and the presence of SLN metastases. The SLN identification rate was 97% with no false-negative cases amongst patients undergoing simultaneous axillary clearance historically during technique validation. In patients with SLN metastases, excision of the first 4 SLNs encountered results in the identification of a metastatic SLN in all cases. Although the majority (86%) of SNB metastases are in the hottest node, the SLN containing the metastasis is in the first 4 hottest nodes in 99% of patients with nodal metastases. The remaining 1% of SLN metastases were identified by blue dye. There was no statistically significant association between the SLN blue dye concentration and the presence of SLN metastases. A policy to remove a maximum of four blue and/or hot SLNs along with any palpably abnormal lymph nodes does not result in an increased false-negative rate of detection of SLN metastases. PMID:21129088

  13. The Lymph Self-Antigen Repertoire

    PubMed Central

    Clement, Cristina C.; Santambrogio, Laura

    2013-01-01

    The lymphatic fluid originates from the interstitial fluid which bathes every parenchymal organ and reflects the “omic” composition of the tissue from which it originates in its physiological or pathological signature. Several recent proteomic analyses have mapped the proteome-degradome and peptidome of this immunologically relevant fluid pointing to the lymph as an important source of tissue-derived self-antigens. A vast array of lymph-circulating peptides have been mapped deriving from a variety of processing pathways including caspases, cathepsins, MMPs, ADAMs, kallikreins, calpains, and granzymes, among others. These self peptides can be directly loaded on circulatory dendritic cells and expand the self-antigenic repertoire available for central and peripheral tolerance. PMID:24379811

  14. Lymphoscintigraphy and Radioguided Biopsy of the Sentinel Axillary Node in Breast Cancer

    Microsoft Academic Search

    Concetta De Cicco; Marta Cremonesi; Alberto Luini; Mirco Bartolomei; Chiara Grana; Gennaro Prisco; Viviana Galimberti; Paolo Calza; Giuseppe Viale; Umberto Veronesi; Giovanni Paganelli

    Lymphoscintigraphy associated with radioguided biopsy of the sentinel node (SN) is well established in clinical practice for mela noma. In breast cancer, the SN concept is similarly valid, and lymphoscintigraphy is a useful method for localizing the axillary SN. The aim of this study was to optimize the lymphoscintigraphy technique in association with a gamma ray detecting probe (GDP) for

  15. A Randomized Comparison of Sentinel-Node Biopsy with Routine Axillary Dissection in Breast Cancer

    Microsoft Academic Search

    Umberto Veronesi; Giovanni Paganelli; Giuseppe Viale; Alberto Luini; Stefano Zurrida; Viviana Galimberti; Mattia Intra; Paolo Veronesi; Chris Robertson; Patrick Maisonneuve; Giuseppe Renne; Concetta De Cicco; Francesca De Lucia; Roberto Gennari

    2010-01-01

    background Although numerous studies have shown that the status of the sentinel node is an accu- rate predictor of the status of the axillary nodes in breast cancer, the efficacy and safety of sentinel-node biopsy require validation. methods From March 1998 to December 1999, we randomly assigned 516 patients with primary breast cancer in whom the tumor was less than

  16. Axillary artery thrombosis in a major league baseball pitcher: a case report and rehabilitation guide.

    PubMed

    Zajac, John M; Angeline, Michael E; Bohon, Tiffany M; Loftus, Michael; Potter, Hollis G; Weiland, Andrew J; Thompson, Robert W; Coleman, Struan H; Altchek, David W

    2013-09-01

    This case study describes a Major League Baseball player who was diagnosed with an axillary artery thrombosis due to arterial compression from throwing. The purpose of this article is to create awareness as to the signs and symptoms associated with arterial positional compression and the rehabilitative implications to surgical intervention. PMID:24427409

  17. Axillary Metastases With DCIS: Is the Glass Half Empty or Half Full?

    Microsoft Academic Search

    Benjamin O. Anderson

    2000-01-01

    Traditionally, ductal carcinoma-in-situ (DCIS) has been thought to be an indolent localized disease lacking metastatic potential by itself. Axillary dissection for DCIS was abandoned because the rate of nodal metastases with this noninvasive disease was believed to be a trivial 1% to 2%, based on data from the era prior to sentinel node mapping. However, the article in this issue

  18. [Lymph node dissection: what for? From esophagus to rectum: surgical and lymph node related prognostic factors].

    PubMed

    Alline, Mathias; Bertrand, Martin Marie; Colombo, Pierre Emmanuel; Mourregot, Anne; Rouanet, Philippe

    2014-04-01

    Surgery has still a key role in curative treatment of digestive carcinomas, and for almost all localisations, lymph node status is a major prognostic factor. As far as oesophageal and gastric cancer are concerned, there is not yet any internationally standardized approach. Occidental guidelines recommend more limited lymph node dissections than Asiatic ones. Lymph node numbers requested during surgery of such cancers remain high, at least 23 lymph nodes for oesophageal cancer, and 25 for a D2 or D1.5 lymphadenectomy for gastric cancer. Generalisation of neo-adjuvant and adjuvant treatments has not yet modified these standards. On the other hand, rectal cancer surgery is well standardized since the global adoption of Total Mesorectal Excision (TME) for the late eighties. Development of mini-invasive techniques (laparoscopy and robot-assisted surgery) enabled an important decrease of surgery related morbidity as well as an enhanced post-operative recovery. However, rectal cancer surgery still has an important morbidity. Development of neo-adjuvant chemo-radiotherapy as well as in-depth knowledge of risk factor of lymph node invasion opened up the path for transanal full thickness resection without lymphadenectomy. The goal of such an approach is to avoid TME's morbidity without risking local recurrence rate increase. As a consequence, this technique might need to be completed with a TME case histological factors are not favorable. PMID:24793629

  19. New models and online calculator for predicting non-sentinel lymph node status in sentinel lymph node positive breast cancer patients

    PubMed Central

    Kohrt, Holbrook E; Olshen, Richard A; Bermas, Honnie R; Goodson, William H; Wood, Douglas J; Henry, Solomon; Rouse, Robert V; Bailey, Lisa; Philben, Vicki J; Dirbas, Frederick M; Dunn, Jocelyn J; Johnson, Denise L; Wapnir, Irene L; Carlson, Robert W; Stockdale, Frank E; Hansen, Nora M; Jeffrey, Stefanie S

    2008-01-01

    Background Current practice is to perform a completion axillary lymph node dissection (ALND) for breast cancer patients with tumor-involved sentinel lymph nodes (SLNs), although fewer than half will have non-sentinel node (NSLN) metastasis. Our goal was to develop new models to quantify the risk of NSLN metastasis in SLN-positive patients and to compare predictive capabilities to another widely used model. Methods We constructed three models to predict NSLN status: recursive partitioning with receiver operating characteristic curves (RP-ROC), boosted Classification and Regression Trees (CART), and multivariate logistic regression (MLR) informed by CART. Data were compiled from a multicenter Northern California and Oregon database of 784 patients who prospectively underwent SLN biopsy and completion ALND. We compared the predictive abilities of our best model and the Memorial Sloan-Kettering Breast Cancer Nomogram (Nomogram) in our dataset and an independent dataset from Northwestern University. Results 285 patients had positive SLNs, of which 213 had known angiolymphatic invasion status and 171 had complete pathologic data including hormone receptor status. 264 (93%) patients had limited SLN disease (micrometastasis, 70%, or isolated tumor cells, 23%). 101 (35%) of all SLN-positive patients had tumor-involved NSLNs. Three variables (tumor size, angiolymphatic invasion, and SLN metastasis size) predicted risk in all our models. RP-ROC and boosted CART stratified patients into four risk levels. MLR informed by CART was most accurate. Using two composite predictors calculated from three variables, MLR informed by CART was more accurate than the Nomogram computed using eight predictors. In our dataset, area under ROC curve (AUC) was 0.83/0.85 for MLR (n = 213/n = 171) and 0.77 for Nomogram (n = 171). When applied to an independent dataset (n = 77), AUC was 0.74 for our model and 0.62 for Nomogram. The composite predictors in our model were the product of angiolymphatic invasion and size of SLN metastasis, and the product of tumor size and square of SLN metastasis size. Conclusion We present a new model developed from a community-based SLN database that uses only three rather than eight variables to achieve higher accuracy than the Nomogram for predicting NSLN status in two different datasets. PMID:18315887

  20. Self-illuminating quantum dots for highly sensitive in vivo real-time luminescent mapping of sentinel lymph nodes.

    PubMed

    Wu, Qiang; Chu, Maoquan

    2012-01-01

    Quantum dots (QDs) show promise as novel nanomaterials for sentinel lymph node (SLN) mapping through their use in noninvasive in vivo fluorescence imaging, and they have provided remarkable results. However, in vivo fluorescence imaging has limitations mainly reflected in the strong autofluorescence and low deepness of tissue penetration associated with this technique. Here, we report on the use of self-illuminating 3-mercaptopropionic acid-capped CdTe/CdS QDs for mouse axillary SLN mapping by bioluminescence resonance energy transfer, which was found to overcome these limitations [corrected]. We used CdTe/CdS QDs synthesized in aqueous solution to conjugate a mutant of the bioluminescent protein, Renilla reniformis luciferase. The nanobioconjugates obtained had an average hydrodynamic diameter of 19 nm, and their luminescence catalyzed by the substrate (coelenterazine) could penetrate into at least 20 mm of hairless pigskin, which could be observed using an in vivo imaging system equipped with a 700 nm emission filter. Conversely, the fluorescence of the nanobioconjugates penetrated no more than 10 mm of pigskin and was observed with a strong background. When 80 ?L of the nanobioconjugates (containing about 0.5 ?mol/L of QDs) and 5 ?L of coelenterazine (1 ?g/?L) were intradermally injected into a mouse paw, the axillary SLN could be imaged in real time without external excitation, and little background interference was detected. Furthermore, the decayed luminescence of QD-Luc8 in SLNs could be recovered after being intradermally reinjected with the coelenterazine. Our data showed that using self-illuminating QDs, as opposed to fluorescence QDs, has greatly enhanced sensitivity in SLN mapping, and that the SLN could be identified synchronously by the luminescence and fluorescence of the self-illuminating QDs. PMID:22848169

  1. Immunohistochemical study of dendritic cells in foetal skin and lymph-nodes supporting the hypothesis for the neural crest origin of Langerhans cells.

    PubMed

    Muretto, Pietro

    2008-01-01

    An immunohistochemical study on foetal skin and lymph-nodes was undertaken in 35 foetuses with the aim to obtain some evidence supporting the hypothesis for the neural crest origin of the Langerhans cells (LCs).Specimens from the axillary and inguinal areas including the skin, subcutaneous tissues and lymph-nodes have been examined. For immunohistochemistry a panel of antibodies were used such as CD1, Langerin, Melan A, HMB45, S100 protein, CD21, subsets for B and T lymphocytes, CD68, Myeloperoxidase, CD31 and CD34. Immunohistochemistry using Melan-A or HMB45 resulted on the detection of melanocytes in the basal layers of epidermis during the first months of gestation. At the same time CD1 allowed the identification of LCs as scattered starry cells in the basal and supra-basal of epidermis layers. Similarly, in the subcutaneous lymph-nodes, LCs could be demonstrated already from the 4th month of foetal life, likely in relation to their known migratory and circulating ability (veiled cells). Immunohistochemical results demonstrated that LCs are intimately correlated to melanocytes during the foetal life, they and both become apparent in the same gestational time and similarly increase in number during the last months of foetal life. The neural crest origin for melanocytes has been universally accepted; the same site origin for Langerhans cells and their biological meaning are discussed. Probably LCs, which can be observed in embryonic tissues of ovary teratomas, in the epidermis of foetal skin and lymph-nodes, and from literature reported in the epidermis of all living beings, represent ancestral cells related to the T lymphocyte compartment acting as a primary defence mechanism against invading micro-organisms of the natural outer habitat. PMID:19507464

  2. Agrobacterium-mediated genetic transformation and development of herbicide-resistant sugarcane (Saccharum species hybrids) using axillary buds.

    PubMed

    Manickavasagam, M; Ganapathi, A; Anbazhagan, V R; Sudhakar, B; Selvaraj, N; Vasudevan, A; Kasthurirengan, S

    2004-09-01

    Direct regeneration from explants without an intervening callus phase has several advantages, including production of true type progenies. Axillary bud explants from 6-month-old sugarcane cultivars Co92061 and Co671 were co-cultivated with Agrobacterium strains LBA4404 and EHA105 that harboured a binary vector pGA492 carrying neomycin phosphotransferase II, phosphinothricin acetyltransferase (bar) and an intron containing beta-glucuronidase (gus-intron) genes in the T-DNA region. A comparison of kanamycin, geneticin and phosphinothricin (PPT) selection showed that PPT (5.0 mg l(-1)) was the most effective selection agent for axillary bud transformation. Repeated proliferation of shoots in the selection medium eliminated chimeric transformants. Transgenic plants were generated in three different steps: (1) production of putative primary transgenic shoots in Murashige-Skoog (MS) liquid medium with 3.0 mg l(-1) 6-benzyladenine (BA) and 5.0 mg l(-1) PPT, (2) production of secondary transgenic shoots from the primary transgenic shoots by growing them in MS liquid medium with 2.0 mg l(-1) BA, 1.0 mg l(-1) kinetin (Kin), 0.5 mg l(-1) alpha-napthaleneacetic acid (NAA) and 5.0 mg l(-1) PPT for 3 weeks, followed by five more cycles of shoot proliferation and selection under same conditions, and (3) rooting of transgenic shoots on half-strength MS liquid medium with 0.5 mg l(-1) NAA and 5.0 mg l(-1) PPT. About 90% of the regenerated shoots rooted and 80% of them survived during acclimatisation in greenhouse. Transformation was confirmed by a histochemical beta-glucuronidase (GUS) assay and PCR amplification of the bar gene. Southern blot analysis indicated integration of the bar gene in two genomic locations in the majority of transformants. Transformation efficiency was influenced by the co-cultivation period, addition of the phenolic compound acetosyringone and the Agrobacterium strain. A 3-day co-cultivation with 50 micro M acetosyringone considerably increased the transformation efficiency. Agrobacterium strain EHA105 was more effective, producing twice the number of transgenic shoots than strain LBA4404 in both Co92061 and Co671 cultivars. Depending on the variety, 50-60% of the transgenic plants sprayed with BASTA (60 g l(-1) glufosinate) grew without any herbicide damage under greenhouse conditions. These results show that, with this protocol, generation and multiplication of transgenic shoots can be achieved in about 5 months with transformation efficiencies as high as 50%. PMID:15133712

  3. Morphological characteristics of lateral pelvic lymph nodes in rectal carcinoma

    Microsoft Academic Search

    Hiroyoshi Matsuoka; Tadahiko Masaki; Masanori Sugiyama; Yutaka Atomi; Yasuo Ohkura; Atsuhiko Sakamoto

    2007-01-01

    Aim  Macroscopic and imaging indicators for lymph node metastasis have been documented not in lateral pelvic lymph nodes but in\\u000a mesorectal lymph nodes in patients with rectal carcinoma. We conducted this study to uncover morphological characteristics\\u000a of lateral pelvic lymph nodes in patients with rectal carcinoma.\\u000a \\u000a \\u000a \\u000a Materials and methods  Fifty-eight patients with locally advanced rectal carcinoma who had total mesorectal excision and

  4. Lymph node size does not correlate with the presence of prostate cancer metastasis

    Microsoft Academic Search

    Rabi Tiguert; Edward L Gheiler; Marcos V Tefilli; Peter Oskanian; Mousumi Banerjee; David J Grignon; Wael Sakr; J. Edson Pontes; David P Wood

    1999-01-01

    Objectives. To determine whether lymph node size is a surrogate marker for lymph node metastasis.Methods. We reviewed 980 patients who underwent radical retropubic prostatectomy with bilateral pelvic lymph node dissection for clinically localized prostate cancer, of whom 63 had lymph node metastases. A comparable group of patients with prostate cancer undergoing radical prostatectomy who did not have lymph node involvement

  5. Black sentinel lymph node and 'scary stickers'.

    PubMed

    Yang, Arthur S; Creagh, Terrence A

    2013-04-01

    An unusual case is presented of a young adult patient with two black-stained, radio-nucleotide tracer-active sentinel lymph nodes biopsied following her primary cutaneous melanoma treatment. This was subsequently confirmed to be secondary to cutaneous tattoos, averting the need of an elective regional node dissection. History of tattooing and tattoo removal should therefore be obtained as a routine in all melanoma patients considered for sentinel node biopsy (SLN). SLN biopsy and any subsequent completion node dissection should be strictly staged so that proper histologic diagnosis of the sentinel node is available for correct decision making and treatment. PMID:23010587

  6. A Minimum Dose of Clonidine Added to Mepivacaine Prolongs the Duration of Anesthesia and Analgesia After Axillary Brachial Plexus Block

    Microsoft Academic Search

    FRANCOIS J. SINGELYN; JEAN-MARIE GOUVERNEUR; ANNIE ROBERT; John M. Gibbs

    1997-01-01

    This study assessed the minimum dose of clonidine re- quired to prolong the duration of both anesthesia and an- algesia after axillary bra&al plexus blockade. Eighty pa- tients scheduled for elective hand surgery were divided into eight groups in a randomized, double-blind fashion. An axillary bra&al plexus block was performed with 40 mL 1% mepivacaine plus 1:200,000 epinephrine. The control

  7. Cytokeratin Deposits in Lymph Nodes Show Distinct Clinical Significance from Lymph Node Micrometastasis in Human Esophageal Cancers

    Microsoft Academic Search

    Yuichiro Doki; Osamu Ishikawa; Masayuki Mano; Masahiro Hiratsuka; Yo Sasaki; Masao Kameyama; Hiroaki Ohigashi; Kohei Murata; Terumasa Yamada; Isao Miyashiro; Shigekazu Yokoyama; Shingo Ishiguro; Shingi Imaoka

    2002-01-01

    Background. Cytokeratin immunostaining is the most common method used to identify micrometastatic cancer cells from the lymph nodes. However, contamination with hyalinized cytokeratin particles, frequently observed in the lymph nodes of esophageal cancer patients, can lead to misinterpretation of cytokeratin immunostaining.Materials and methods. Cytokeratin immunostaining (AE1\\/AE3) of surgically removed lymph nodes was performed for 41 cases of node-negative, but locally

  8. The impact of lymph node metastases on the survival of breast cancer patients with ten or more positive lymph nodes

    Microsoft Academic Search

    Atsuo Tsuchiya; Masahiko Kanno; Rikiya Abe

    1997-01-01

    To investigate the impact of the number of involved lymph nodes on survival, we retrospectively reviewed the data for 37 patients\\u000a with breast cancer and metastases of ten or more lymph nodes who underwent treatment between 1987 and 1995. Based on the number\\u000a of positive lymph nodes, the patients were allocated to one of three groups. The 5-year disease-free and

  9. Macroscopic lymph-node involvement and neck dissection predict lymph-node recurrence in papillary thyroid carcinoma

    Microsoft Academic Search

    Stephane Bardet; Elodie Malville; Jean-Pierre Rame; Emmanuel Babin; Guy Samama; Dominique De Raucourt; Jean-Jacques Michels; Yves Reznik; Michel Henry-Amar

    2008-01-01

    Objective: Whether lymph-node dissection (LND) influences the lymph-node recurrence (LNR) risk in patients with papillary thyroid cancer remains controversial. The prognostic impact of macroscopic and microscopic lymph-node involvement at diagnosis is also an unresolved issue. A retrospective study was conducted to assess the influence of various LND procedures and to search for LNR risk factors. Methods: Overall 545 patients without

  10. Regional lymph node radiotherapy in breast cancer: single anterior supraclavicular field vs. two anterior and posterior opposed supraclavicular fields

    PubMed Central

    Houshyari, Mohammad; Kashi, Amir Shahram Yousefi; Varaki, Sakineh Soleimani; Rakhsha, Afshin; Blookat, Eftekhar Rajab

    2015-01-01

    Background: The treatment of lymph nodes engaged in breast cancer with radiotherapy leads to improved locoregional control and enhanced survival rates in patients after surgery. The aim of this study was to compare two treatment techniques, namely single anterior posterior (AP) supraclavicular field with plan depth and two anterior and posterior opposed (AP/PA) supraclavicular fields. In the study, we also examined the relationships between the depth of supraclavicular lymph nodes (SCLNs) and the diameter of the wall of the chest and body mass index (BMI). Methods: Forty patients with breast cancer were analyzed using computed tomography (CT) scans. In planning target volume (PTV), the SCLNs and axillary lymph nodes (AXLNs) were contoured, and, with the attention to PTV, supraclavicular (SC) depth was measured. The dosage that reached the aforementioned lymph nodes and the level of hot spots were investigated using two treatment methods, i.e., 1) AP/PA and 2) AP with three-dimensional (3D) planning. Each of these methods was analyzed using the program Isogray for the 6 MV compact accelerator, and the diameter of the wall of the chest was measured using the CT scan at the center of the SC field. Results: Placing the plan such that 95% of the target volume with 95% or greater of the prescribed dose of 50 Gy (V95) had ?95% concordance in both treatment techniques. According to the PTV, the depth of SCLNs and the diameter of the wall of the chest were 3–7 and 12–21cm, respectively. Regression analysis showed that the mean SC depth (the mean Plan depth) and the mean diameter of the wall of the chest were related directly to BMI (p<0.0001, adjusted R2=0.67) and (p<0.0001, adjusted R2=0.71), respectively. Conclusion: The AP/PA treatment technique was a more suitable choice of treatment than the AP field, especially for overweight and obese breast cancer patients. However, in the AP/PA technique, the use of a single-photon, low energy (6 MV) caused more hot spots than usual. PMID:26120411

  11. Aortobilateral axillary bypass to treat severe cerebral ischemia due to Takayasu's arteritis.

    PubMed

    Zhang, Bin; Wang, Zhong-gao; Huang, Ying; Gu, Yong-quan; Yu, Heng-xi; Chen, Bing; Zhang, Jian

    2009-01-01

    Cerebral ischemia resulting from four cervical arterial occlusions due to Takayasu's arteritis is a rare condition. Ascending aortounilateral/-bilateral internal carotid arterial bypass is a means for relieving it. However, postoperative reperfusion syndrome remains an unsolved severe, even fatal complication. The following case report reveals new findings. The patient presented massive cerebral infarction in the left cerebral hemisphere, four cervical arterial lesions, and bilateral subclavian steal syndrome. An ascending aorta to bilateral axillary bypass resumed the vertebral blood flow, and as a result the patient had a marvelous improvement. Unlike ascending aorta-carotid bypass, which directly increases brain perfusion, our procedure does so indirectly via axillary arteries. Therefore, there is strong reason to recommend ascending aorta to biaxillary bypass for patients with cerebral ischemia due to four cervical arterial lesions accompanying a bilateral subclavian steal phenomenon that has reversed vertebral flow. PMID:19747616

  12. Gastric Metastasis of Ectopic Breast Cancer Mimicking Axillary Metastasis of Primary Gastric Cancer

    PubMed Central

    Kay?l?o?lu, Selami Ilgaz; Akyol, Cihangir; Esen, Ebru; Cans?z-Ersöz, Cevriye; Kocaay, Ak?n F?rat; Genç, Volkan; Kepenekçi, ?lknur; Demirer, Seher

    2014-01-01

    Ectopic breast tissue has the ability to undergo all the pathological changes of the normal breast, including breast cancer. Gastrointestinal metastasis of breast cancer is rarely observed and it is very difficult to differentiate gastric metastases from primary gastric cancer. We present a case of 52-year-old female, who suffered from abdominal pain. Physical examination showed a palpable mass in the left anterior axilla and computerized tomography revealed gastric wall thickening with linitis plastica. When gastroscopic biopsy showed no signs of malignancy, excisional biopsy was performed in the left axilla. Histological examination revealed invasive lobular carcinoma of the breast, consistent with ectopic breast cancer. Further gastroscopic submucosal biopsies and immunohistochemical studies revealed gastric metastases of invasive lobular carcinoma. Axillary ectopic breast tissue carcinomas can mimic axillary lymphadenopathies. Additionally, gastric metastasis of breast cancer is an uncommon but possible condition. To the best of our knowledge, this is the first report of ectopic breast cancer with gastric metastasis. PMID:25574403

  13. Axillary vein thrombosis induced by an increasingly popular oscillating dumbbell exercise device: a case report.

    PubMed

    Shennib, Hani; Hickle, Kelli; Bowles, Bradley

    2015-01-01

    A 53 year-old male presented with a one-day history of a swollen arm and dull, aching pain in the right upper extremity. The patient reported commencing exercising daily over the prior week with a modified, oscillating dumbbell; commonly referred to as a Shake Weight. Imaging revealed an occlusive thrombus in the right axillary, proximal brachial and basilic veins. The patient was treated with a 24-hour tPA infusion followed by mechanical thrombectomy, balloon angioplasty, and stent placement for a residual thrombus and stenosis. The patient was discharged the following day on warfarin and aspirin. This is the first report of effort-induced thrombosis of the upper extremity following the use of a modified, oscillating dumbbell. Due to the growing popularity of modified dumbbells and the possible risk for axillary vein thrombosis, consideration should be made to caution consumers of this potential complication. PMID:25986625

  14. Through-and-through wire technique for endovascular damage control in traumatic proximal axillary artery transection.

    PubMed

    Rohlffs, Fiona; Larena-Avellaneda, Axel Antonio; Petersen, Jan Philipp; Debus, Eike Sebastian; Kölbel, Tilo

    2015-02-01

    Repair of blunt shoulder trauma with transection of the subclavian or proximal axillary artery poses a surgical challenge, especially in instable patients. Endovascular treatment for initial damage control in arterial transection has evolved as a promising technique to improve outcome, but technical success can be limited in cases of complete transection as the lesion cannot be passed by a guidewire. This report describes an endovascular approach using a through-and-through brachial-femoral wire to control complete traumatic transection of the proximal axillary artery in a hemodynamically unstable patient. Endovascular therapy is used as a bridging method for open surgical repair three days later under optimized conditions with an interdisciplinary team. The brachial-femoral guidewire technique helps to overcome limitations in endovascular therapy in patients with blunt traumatic transection of thoracic outlet arteries. PMID:24729014

  15. Ultrasound of malignant cervical lymph nodes

    PubMed Central

    Ying, M.; Ho, S.Y.; Antonio, G.; Lee, Y.P.; King, A.D.; Wong, K.T.

    2008-01-01

    Abstract Malignant lymph nodes in the neck include metastases and lymphoma. Cervical nodal metastases are common in patients with head and neck cancers, and their assessment is important as it affects treatment planning and prognosis. Neck nodes are also a common site of lymphomatous involvement and an accurate diagnosis is essential as its treatment differs from other causes of neck lymphadenopathy. On ultrasound, grey scale sonography helps to evaluate nodal morphology, whilst power Doppler sonography is used to assess the vascular pattern. Grey scale sonographic features that help to identify metastatic and lymphomatous lymph nodes include size, shape and internal architecture (loss of hilar architecture, presence of intranodal necrosis and calcification). Soft tissue oedema and nodal matting are additional grey scale features seen in tuberculous nodes or in nodes that have been previously irradiated. Power Doppler sonography evaluates the vascular pattern of nodes and helps to identify the malignant nodes. In addition, serial monitoring of nodal size and vascularity are useful features in the assessment of treatment response. PMID:18390388

  16. The local lymph node assay (LLNA).

    PubMed

    Rovida, Costanza; Ryan, Cindy; Cinelli, Serena; Basketter, David; Dearman, Rebecca; Kimber, Ian

    2012-02-01

    The murine local lymph node assay (LLNA) is a widely accepted method for assessing the skin sensitization potential of chemicals. Compared with other in vivo methods in guinea pig, the LLNA offers important advantages with respect to animal welfare, including a requirement for reduced animal numbers as well as reduced pain and trauma. In addition to hazard identification, the LLNA is used for determining the relative skin sensitizing potency of contact allergens as a pivotal contribution to the risk assessment process. The LLNA is the only in vivo method that has been subjected to a formal validation process. The original LLNA protocol is based on measurement of the proliferative activity of draining lymph node cells (LNC), as determined by incorporation of radiolabeled thymidine. Several variants to the original LLNA have been developed to eliminate the use of radioactive materials. One such alternative is considered here: the LLNA:BrdU-ELISA method, which uses 5-bromo-2-deoxyuridine (BrdU) in place of radiolabeled thymidine to measure LNC proliferation in draining nodes. PMID:22511117

  17. Curative Chemoradiotherapy in Patients With Stage IVB Cervical Cancer Presenting With Paraortic and Left Supraclavicular Lymph Node Metastases

    SciTech Connect

    Kim, Ji-Yoon [Department of Radiation Oncology, Catholic University of Korea, College of Medicine, Seoul (Korea, Republic of)] [Department of Radiation Oncology, Catholic University of Korea, College of Medicine, Seoul (Korea, Republic of); Kim, Joo-Young [Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of)] [Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of); Kim, Jin Hee [Department of Radiation Oncology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu (Korea, Republic of)] [Department of Radiation Oncology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu (Korea, Republic of); Yoon, Mee Sun [Department of Radiation Oncology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Jeollanam-do (Korea, Republic of)] [Department of Radiation Oncology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Jeollanam-do (Korea, Republic of); Kim, Juree [Department of Radiation Oncology, Cheil General Hospital and Women's Healthcare Center, Kwandong University, College of Medicine, Seoul (Korea, Republic of)] [Department of Radiation Oncology, Cheil General Hospital and Women's Healthcare Center, Kwandong University, College of Medicine, Seoul (Korea, Republic of); Kim, Young Seok, E-mail: ysk@amc.seoul.kr [Department of Radiation Oncology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul (Korea, Republic of)

    2012-11-01

    Purpose: To evaluate the efficacy and toxicity of concurrent chemoradiotherapy (CCRT) with curative intent in patients with stage IVB cervical cancer initially presenting with paraortic and left supraclavicular lymph node metastases. Methods and Materials: The medical records of 25 patients with both paraortic and left supraclavicular lymph nodal metastases (group I) were reviewed and compared with those of 101 women with paraortic lymph node metastases alone (group II). Group I received a mean 59.4 Gy to the paraortic and left supraclavicular areas and 50.4 Gy to the pelvis, followed by 30 Gy of high-dose-rate brachytherapy in 6 fractions. Group II received the same dose to the paraortic area and pelvis followed by intracavitary brachytherapy. All patients received platinum-based chemotherapy simultaneously. Results: Of the 25 patients in group I, 16 (64%) experienced acute grade 3-4 hematologic toxicities, and 1 had a late grade 3 genitourinary toxicity. Complete responses, including the primary mass and pelvic, paraortic, and left supraclavicular lymph nodes, were observed in 13 patients (52%). At a median follow-up of 32 months for surviving patients, 3 experienced in-field failure, 6 showed distant failure, and 9 showed both. The 3-year overall and disease-free survival rates were 49% and 33%, respectively. In comparison, of the 101 patients in group II, 16 showed in-field failure, 14 experienced distant failure, and 11 showed both. The 3-year overall and disease-free survival rates were 69% and 57%, respectively. Conclusions: Curative CCRT is feasible in patients with stage IVB cervical cancer presenting with paraortic and left supraclavicular lymph nodal metastases, with acceptable late toxicity and high response rates, despite high rates of acute hematologic toxicity.

  18. Treatment of chronic obstruction of the axillary, subclavian, and innominate veins

    Microsoft Academic Search

    J. E. Molina

    1999-01-01

    Of 79 patients seen at the University of Minnesota with symptomatic chronic obstruction of the axillary subclavian or innominate vein, 65 were considered surgical candidates. Etiology of the obstruction was as follows: Group A (n=45), previous subclavian effort thrombosis; Group B (n=14), stenosis caused by occupation or sport activities; and Group C (n=6), long segments (4–7.2 cm) of obstruction caused

  19. Axillary plexus block using a peripheral nerve stimulator: single or multiple injections

    Microsoft Academic Search

    J. Lavoie; R. Martin; J.-P. Tétrault; D. J. Côté; M. J. Colas

    1992-01-01

    This prospective, randomized, double-blind study was undertaken to evaluate the success rates of axillary brachial plexus\\u000a block performed with the help of a peripheral nerve stimulator when either one, two or four of the major nerves of the brachial\\u000a plexus were located. Seventy-five patients undergoing upper limb surgery were randomly allocated to one of the following five\\u000a groups according to

  20. Comparison of two techniques for ultrasound-guided axillary brachial plexus blockade in cats.

    PubMed

    Ansón, Agustina; Laredo, Francisco G; Gil, Francisco; Soler, Marta; Belda, Eliseo; Ayala, Maria D; Agut, Amalia

    2015-06-01

    Axillary blockade of the brachial plexus (BP) is advocated in humans and dogs for surgical procedures carried out on the foot, carpus and elbow as it provides complete analgesia distally from above the elbow joint. The aim of this study was to develop an ultrasound (US)-guided approach to block the BP in cats. Two groups of 12 feline cadavers each were used to compare two different techniques to block the BP at the axillary level. The reliability of the techniques was assessed by anatomical and computed tomography (CT) studies. Cadavers of the first group were positioned in dorsal recumbency with the forelimb to be blocked adducted (thoracic limbs flexed and orientated caudally) (FAD technique). The second group was positioned in dorsal recumbency with the forelimb abducted 90° (FAB technique). The accuracy of the techniques was determined by US after injecting 1 ml blue ink along the BP nerves, and by CT after injecting 1 ml of an iodinated contrast medium. The anatomical and CT studies confirmed the accuracy of the US location of the BP nerves. Staining of the axillaris, musculocutaneous, radialis, medianus and ulnaris nerves was observed in 100% of cats using the FAB technique and in 66% of the cats using the FAD technique. Rate of complications was higher in the FAD technique. In conclusion, a US-guided axillary approach to the BP by the use of a FAB technique is a safe and feasible procedure to block the BP in the cat. Further studies are needed to ascertain whether the technique can be applied in a clinical setting. PMID:25193280

  1. Chemoendocrine Therapy for Premenopausal Women With Axillary Lymph Node-Positive, Steroid Hormone Receptor-Positive Breast Cancer: Results From INT 0101 (E5188)

    Microsoft Academic Search

    Nancy E. Davidson; Anne M. O'Neill; Allen M. Vukov; C. Kent Osborne; Silvana Martino; Douglas R. White; Martin D. Abeloff

    Purpose Chemotherapy, tamoxifen, and ovarian ablation\\/suppression (OA\\/OS) are effective adjuvant approaches for premenopausal, steroid hormone receptor-positive breast cancer. The value of combined therapy has not been clearly established.

  2. Correction of axillary burn scar contracture with the thoracodorsal perforator-based cutaneous island flap.

    PubMed

    Kim, D Y; Cho, S Y; Kim, K S; Lee, S Y; Cho, B H

    2000-02-01

    Axillary scar contracture is observed frequently after severe burn insult and is usually accompanied by injuries to the adjacent area. Although many therapeutic methods, including skin grafting, Z-plasties, local flaps, island flaps, and free flaps, have been established, each technique has its own advantages and disadvantages in specific situations. The decision regarding which technique to use can only be made after consideration is given to the merits of the individual case. We applied thoracodorsal perforator-based cutaneous flaps to 5 patients with axillary burn scar contractures and damaged adjacent tissues. In 1 patient both axillae were involved. Elevated flaps as large as 11 x 27 cm in size were used. All flaps survived completely even when raised in scar tissue. The donor sites were closed primarily except one, which needed a skin graft. Three patients obtained satisfactory release with more than 160 deg shoulder abduction. In 2 patients, release was incomplete with only 110 deg shoulder abduction, but neither one required a second release. The range of motion in terms of shoulder abduction was improved preoperatively (30-90 deg) to postoperatively (110-170 deg). The thoracodorsal perforator-based cutaneous flap presents a very useful reconstructive method for the treatment of axillary defects. PMID:10696046

  3. [Growth of axillary buds of Salix babylonica L. and activity of phenylalanine ammonia-lyase].

    PubMed

    Letouzé, R

    1975-01-01

    In-vitro study of the growth of the axillary bud of a decapitated willow cutting gave the following results: 1. The intact and the decapitated willow cutting show a gradient of PAL (phenylalanine ammonia-lyase EC. 4.3.1.5) activity, which decreases from the apical part down to the base. 2. After decapitation of the cutting, a shift of PAL activity takes place 36 hr later at the section level. 3. A correlation between the growth of the axillary bud of the decapitated willow cutting and the PAL activity at the same level, within the stem as well as the leaf, has been demonstrated. In continuous red light (660 nm) apical dominance is lost after decapitation of the cutting.The highest leaf bud starts growing and replaces the cut-out apical bud. The PAL activity at that level first increases, then becomes stable.In continuous blue light (440 nm), apical dominance is maintained in spite of decapitation.The growth of the axillary bud is negligible and the PAL activity at that same level rapidly tends to zero. PMID:24435082

  4. Safety and Efficacy of Micro-focused Ultrasound Plus Visualization for the Treatment of Axillary Hyperhidrosis

    PubMed Central

    Park, Hyunhee

    2014-01-01

    Objectives: To evaluate the safety, efficacy, and durability of treating axillary hyperhidrosis with high-intensity micro-focused ultrasound plus visualization. Design: Two randomized double-blind, sham-controlled pilot studies. Measurements: For Study 1, the primary endpoint was response defined as ?50-percent reduction in baseline sweat production as measured gravimetrically. For Study 2, the primary endpoint was response defined as a reduction of Hyperhidrosis Disease Severity Scale scores from 3 or 4 to 1 or 2. Secondary endpoints included changes in gravimetric and starch-iodine testing and patient satisfaction. Results: In Study 1, ?50 percent of patients achieved a positive treatment response. In Study 2, the response rate at post-treatment Day 60 for micro-focused ultrasound plus visualization- (N=12) and sham-treated (N=8) patients was 67 and zero percent, respectively (p=0.005). Patients evaluated 12 months after treatment (N=11) demonstrated the long-lasting effectiveness of micro-focused ultrasound plus visualization for treating axillary hyperhidrosis. All but one patient in the micro-focused ultrasound plus visualization group were satisfied with their results while all sham group patients were dissatisfied (p=0.0001). Subjective reports of greatest improvement were sweat production (92%) and social embarrassment (83%). Adverse events were found to be mild and were resolved within a short timeframe. Conclusion: Micro-focused ultrasound plus visualization appears to be safe, effective, well-tolerated, and a long-lasting means for treating axillary hyperhidrosis. PMID:24765226

  5. Salmonella in lymph nodes of cattle presented for harvest

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Introduction: Salmonella can invade and survive within host immune cells. Once internalized, these pathogens have the potential to disseminate throughout the lymphatic system and reside within lymph nodes. If so, because some lymph nodes are located within muscle and fat tissues, Salmonella-positiv...

  6. Radioguided Sentinel Lymph Node Biopsy in Breast Cancer Surgery

    Microsoft Academic Search

    Giuliano Mariani; Luciano Moresco; Giuseppe Viale; Giuseppe Villa; Marcello Bagnasco; Giuseppe Canavese; John Buscombe; H. William Strauss; Giovanni Paganelli

    The concept of sentinel lymph node biopsy in breast cancer surgery relates to the fact that the tumor drains in a logical way through the lymphatic system, from the first to upper levels. Therefore, the first lymph node met (the sentinel node) will most likely be the first to be affected by metastasis, and a negative sentinel node makes it

  7. Significance of Lymph Node Micrometastasis in Pancreatic Cancer Patients

    Microsoft Academic Search

    J. Bober

    2012-01-01

    Background \\/Aims: The present study deals with the significance of lymph node micrometastasis in the survival rate for pancreatic cancer patients. Methods: Between January 2006 and December 2010 at the First Department of Surgery in Košice, a prospective trial was done in which we investigated the survival rate after radical pancreatic resection. All negative lymph nodes removed during standard radical

  8. Tumour–induced immune modulation of sentinel lymph nodes

    Microsoft Academic Search

    Rong-Rong Huang; Jonathan Lee; Eijun Itakura; Stanley P. L. Leong; Richard Essner; Alistair J. Cochran

    2006-01-01

    Sentinel lymph nodes (SLNs), being the first nodes to receive lymph from a primary tumour and the preferential site of initial tumour metastases, are intensively exposed to the bioactive products of tumour cells and other associated cells. This makes them ideal for studies of the factors that determine selective tissue susceptibility to metastases. We postulate that tumour-induced immune modulation of

  9. THE ORIGIN AND SIGNIFICANCE OF MACROPHAGES IN THORACIC DUCT LYMPH

    Microsoft Academic Search

    Bruce J Roser

    1976-01-01

    Efferent lymph collected from a thoracic duct fistula initially contains no macrophages. However, the surgical procedures used to insert plastic cannulae into efferent lymphatics incite a vigorous foreign body reaction leading to the contamination of collected lymph with significant numbers of these cells. A sensitive and specific assay for the presence of macrophages in lymphocyte populations was used to quantitate

  10. Current status of sentinel lymph node biopsy in solid malignancies

    Microsoft Academic Search

    Amit Goyal; Robert E Mansel

    2004-01-01

    Lymphatic mapping and sentinel lymph node biopsy were first reported in 1977 by Cabanas for penile cancer. Since that time, the technique has become rapidly assimilated into clinical practice. The sentinel node concept has been validated in cutaneous melanoma and breast cancer. However, follow-up data of patients from randomised trials is needed to establish the clinical significance of sentinel lymph

  11. Genetic diagnosis of lymph-node metastasis in colorectal cancer

    Microsoft Academic Search

    N. Hayashi; I. Ito; Y. Nakamura; A. Yanagisawa; Y. Kato; S. Nakamori; S. Imaoka; H. Watanabe; M. Ogawa

    1995-01-01

    If a regional lymph node taken during surgery for colorectal cancer is found to be free of tumour on histological examination this is taken to be a good sign. However, conventional staining may not be sensitive enough. Mutant-allele-specific amplification (MASA) is a technique that can detect, at the level of an individual cell, micrometastases to lymph nodes that are histologically

  12. Variable course of primary simian immunodeficiency virus infection in lymph nodes: relation to disease progression.

    PubMed Central

    Chakrabarti, L; Cumont, M C; Montagnier, L; Hurtrel, B

    1994-01-01

    To investigate the dynamics of spread of simian immunodeficiency virus (SIV) in the lymphoid organs, we sequentially analyzed the viral burden in lymph nodes (LN) of eight rhesus macaques inoculated intravenously with a high or low dose of the pathogenic SIVmac 251 isolate. For each animal, four axillary or inguinal LN were collected during the first weeks of infection and a fifth LN was taken 6 or 8 months later to estimate disease progression. Measurement of SIV RNA by in situ hybridization showed that all of the macaques studied had a phase of acute viral replication in LN between 7 and 14 days postinoculation which paralleled that observed in the blood. In a second phase, productive infection was controlled and viral particles were trapped in the germinal centers that developed in LN. While the peaks of productive infection were similar for the eight animals, marked differences in the numbers of productively infected cells that persisted in LN after primary infection were seen. Differences were less pronounced in the blood, where productive infection was efficiently controlled in all cases. The persistence of productively infected cells in LN after primary infection was found to be associated with more rapid disease progression, as measured by the decrease of the T4/T8 ratio and the occurrence of clinical signs. However, the persistence of a significant level of viral particles in germinal centers was observed even in animals that remained healthy over a 1- to 2-year observation period. This study indicates that the course of primary SIV infection in LN is variable, and it suggests that the initial capacity of the host to control productive infection in LN may determine the rate of disease progression. Images PMID:7916061

  13. Lymph node dissection for lung cancer: past, present, and future.

    PubMed

    Watanabe, Shun-ichi

    2014-07-01

    In 1978, Naruke et al. proposed an anatomical map that included numbered lymph node stations, which then became widely used for nodal dissection. In 1997, Mountain and Dresler published a new map, which is now favored by the American Thoracic Society and the European Respiratory Society. Using these maps, regional nodal dissection has been universally performed in lung cancer surgery. Clear evidence regarding the survival benefit of lymph node dissection for lung cancer is lacking. However, lobectomy with lymph node dissection continues to be a standard surgical procedure for lung cancer because lymph node dissection is an important investigative process in staging patients. Over the last decade, the extent of nodal dissection for lung cancer has changed due to the increasing number of early detected lung cancers made possible by the recent development of the CT scanner. This manuscript describes the history, present strategy, and future perspectives of lymph node dissection for lung cancer. PMID:24823489

  14. Factors affecting sentinel lymph node identification rate after neoadjuvant chemotherapy for breast cancer patients enrolled in ACOSOG Z1071 (Alliance)

    PubMed Central

    Boughey, Judy C.; Suman, Vera J.; Mittendorf, Elizabeth A.; Ahrendt, Gretchen M.; Wilke, Lee G.; Taback, Bret; Leitch, A. Marilyn; Flippo-Morton, Teresa S.; Kuerer, Henry M.; Bowling, Monet; Hunt, Kelly K.

    2014-01-01

    Objective To evaluate factors affecting sentinel lymph node (SLN) identification after neoadjuvant chemotherapy (NAC) in patients with initial node-positive breast cancer. Summary Background Data SLN surgery is increasingly used for nodal staging after NAC and optimal technique for SLN identification is important. Methods The American College of Surgeons Oncology Group Z1071 prospective trial enrolled clinical T0-4,N1-2,M0 breast cancer patients. Following NAC, SLN surgery and axillary lymph node dissection (ALND) were planned. Multivariate logistic regression modeling assessing factors influencing SLN identification was performed. Results Of 756 patients enrolled, 34 women withdrew, 21 were ineligible, 12 underwent ALND only, and 689 had SLN surgery attempted. At least one SLN was identified in 639 patients (92.7%: 95%CI: 90.5–94.6%). Among factors evaluated, mapping technique was the only factor found to impact SLN identification; with use of blue dye alone increasing the likelihood of failure to identify the SLN relative to using radiolabelled colloid +/? blue dye (p=0.006; OR=3.82 95%CI: 1.47-9.92). The SLN identification rate was 78.6% with blue dye alone; 91.4% with radiolabelled colloid and 93.8% with dual mapping agents. Patient factors (age, BMI), tumor factors (clinical T or N stage), pathologic nodal response to chemotherapy, site of tracer injection and length of chemotherapy treatment did not significantly affect the SLN identification rate. Conclusions The SLN identification rate after NAC was higher when mapping was performed using radiolabelled colloid alone or with blue dye compared to blue dye alone. Optimal tracer use is important to ensure successful identification of SLN(s) after NAC. PMID:25664534

  15. Male axillary extracts modify the affinity of the platelet serotonin transporter and impulsiveness in women.

    PubMed

    Marazziti, Donatella; Masala, Irene; Baroni, Stefano; Polini, Margherita; Massimetti, Gabriele; Giannaccini, Gino; Betti, Laura; Italiani, Paola; Fabbrini, Laura; Caglieresi, Carolina; Moschini, Cecilia; Canale, Domenico; Lucacchini, Antonio; Mauri, Mauro

    2010-06-16

    The presence of functional pheromones in axillary extracts in humans is still matter of debate. Scattered data suggest that unidentified human axillary compounds with pheromonal activity may influence mood and this may occur, perhaps, through the modulation of the serotonin (5-HT) system that has been linked to mood by several findings. Therefore, the aim of this study was to assess the possible changes of a peripheral marker of the 5-HT system, i.e., the platelet 5HT transporter, and of some psychological tests, in a group of women who were exposed to male axillary extracts (group 1). A matched group of women who underwent an exposure to a neutral solution, were used as control subjects (group 2). The 5-HT transporter was evaluated by means of the specific binding of (3)H-paroxetine ((3)H-Par) to platelet membranes, as well as by means of (3)H-5-HT reuptake in whole platelets, at baseline (T0) and 1h after the stimulation (T1). The following tests were used: the "Experiences in Close Relationships" questionnaire (ECR), the latest version of the Barratt Impulsiveness Scale (BIS-11) and the Structured Clinical Interview for Mood Spectrum, self-reported version. The dissociation constant (Kd) of (3)H-Par binding showed a significant decrease at T1 only in the women exposed to male axillary extracts, as compared with baseline values, while the Bmax and (3)H-5-HT reuptake parameters did not show any change in both groups. The correlation analyses showed that at T0, the Kd values correlated significantly and positively with the factor of motor impulsiveness in all subjects. Two factors of the BIS-11, in particular, the attentional and the motor impulsiveness were significantly lower at T1 in the group 1. Further, at T1 and still in the group 1, a significant and positive correlation was measured between the Kd values and two ECR attachment styles, the secure and preoccupied, as well as with the ECR anxiety scale. Taken together, these findings suggest that the application of male axillary extracts to women may modify the affinity of their platelet 5-HT transporter, as well as of some impulsiveness and romantic attachment characteristics. The substances responsible for this effect remain to be identified. PMID:20347855

  16. Block copolymer carrier systems for translymphatic chemotherapy of lymph node metastases.

    PubMed

    Dünne, Anja A; Boerner, Hans G; Kukula, Hildegard; Schlaad, Helmut; Wiegand, Susanne; Werner, Jochen A; Antonietti, Markus

    2007-01-01

    The presence of lymph node metastases relevantly and significantly impairs disease-specific survival in patients suffering from squamous cell carcinoma of the upper aerodigestive tract. In a VX2 animal tumor model, we present an interstitial translymphatic therapeutic approach using cis-diaminedichloro-platinum(II) (CDDP) conjugated to a poly(ethylene oxide)-block-poly(lysine) (PEO-b-PLys) block copolymer tracking systems for the successful treatment of lymph node metastases. Most effective was the application of a high cargo-load CDDP tracking system (48 wt. % CDDP) curing 90% of the animals and causing only minor local side-effects. Systems containing 1 or 10 wt. % of CDDP were less effective but still cured 50% of the animals. Moreover, the administration of 1 or 10 wt. % of CDDP consistently limited tumor growth to the draining lymph nodes (50%) and prevented systemic distribution of the metastasis even'with 1 wt. % CDDP load. The systems contained 0.25-0.003 mg/kg per body weight CDDP compared to 1 ml/kg per body weight as usually used for intravenous administration. This approach encourages further and more detailed research of a CDDP-based interstitial translymphatic administration of chemotherapy for lymphogenic metastasizing carcinomas in different body regions. PMID:18225553

  17. Dose-dense paclitaxel versus docetaxel following FEC as adjuvant chemotherapy in axillary node-positive early breast cancer: a multicenter randomized study of the Hellenic Oncology Research Group (HORG).

    PubMed

    Saloustros, Emmanouil; Malamos, Nikolaos; Boukovinas, Ioannis; Kakolyris, Stylianos; Kouroussis, Charalampos; Athanasiadis, Athanasios; Ziras, Nikolaos; Kentepozidis, Nikolaos; Makrantonakis, Parisis; Polyzos, Aristidis; Christophyllakis, Charalampos; Georgoulias, Vassilios; Mavroudis, Dimitrios

    2014-12-01

    Adding a taxane to anthracycline-based adjuvant chemotherapy prolongs survival in node-positive early breast cancer. However, which is the preferable taxane in a dose-dense regimen remains unknown. We conducted a randomized study to compare the efficacy of dose-dense paclitaxel versus docetaxel following 5-fluorouracil, epirubicin, and cyclophosphamide (FEC) as adjuvant chemotherapy in women with node-positive early breast cancer. Following surgery women with HER2-negative breast cancer and at least one infiltrated axillary lymph node were randomized to receive four cycles of FEC (700/75/700 mg/m(2)) followed by four cycles of either paclitaxel (175 mg/m(2)) or docetaxel (75 mg/m(2)). All cycles were administered every 14 days with G-CSF support. The primary endpoint was disease-free survival (DFS) at 3 years. Between 2004 and 2007, 481 women were randomized to paclitaxel (n = 241) and docetaxel (n = 240). After a median follow-up of 6 years, 51 (21%) and 48 (20%) women experienced disease relapse (p = 0.753) and there was no significant difference in DFS between the paclitaxel- and docetaxel-treated groups (3-year DFS 87.4 vs. 88.3%, respectively; median DFS not reached; p = 0.633). Toxicities were manageable, with grade 2-4 neutropenia in 21 versus 31% (p = 0.01), thrombocytopenia 0.8 versus 3.4% (p = 0.06), any grade neurotoxicity 17 versus 7.5% (p = 0.35) and onycholysis 4.9 versus 12.1% (p = 0.03) for patients receiving paclitaxel and docetaxel, respectively. There were no toxic deaths. Dose-dense paclitaxel versus docetaxel after FEC as adjuvant chemotherapy results in a similar 3-year DFS rate in women with axillary node-positive early breast cancer. Due to its more favorable toxicity profile, paclitaxel is the taxane of choice in this setting. PMID:25399229

  18. Detection of Lymph Node Micrometastases and Isolated Tumor Cells in Sentinel and Nonsentinel Lymph Nodes of Colon Cancer Patients

    Microsoft Academic Search

    Andreas Bembenek; Ulrike Schneider; Stephan Gretschel; Joerg Fischer; Peter M. Schlag

    2005-01-01

    About 20% to 30% of colon cancer patients classified as node negative by routine hematoxylin-eosin (H&E) staining are found to have micrometastases (MM) or isolated tumor cells (ITC) in sentinel lymph nodes (SLNs) if analyzed by step sections and immunohistochemistry (IHC). Whether SLNs are in this respect representative for all lymph nodes was addressed in this study. SLNs were identified

  19. Effectiveness of benzoporphyrin derivative monoacid (BPD-MA) and fiberoptic sensor in detecting metastatic neoplasm in lymph nodes in rats

    NASA Astrophysics Data System (ADS)

    Vari, Sandor G.; Pergadia, Vani R.; Wolfson, David; Thomas, Reem; Stavridi, Marigo; Snyder, Wendy J.; Fishbein, Michael C.; Papaioannou, Thanassis; Shapiro, L.; Grundfest, Warren S.

    1994-01-01

    An intensity ration of the photosensitizing agent to the natural fluorescence was used to determine the condition of lymph nodes (normal, inflammatory, or with metastases). Eighty- one Lobund Wistar rats were inoculated with Pollard rat adenocarcinoma cells. After 40 days the rats were injected with 0.75 mg/kg BPD-MA. A helium-cadmium lasers (442 nm) was used for both light delivery ad fluorescence acquisition. Fluorescence spectra were acquired and analyzed by an optical multichannel analyzer 9 EG&G, OMA III). Unbalanced repeated measures analysis of variance (ANOVA) was done on the mean intensity ratio according to location. Several locations recorded for each rat were modeled as the repeated variable. The fluorescence signal obtained from lymph nodes with metastases indicated high drug amounts, greater than in the skin, tumors, and all other tissues. The lowest fluorescence intensity ratios were observed in the skin. This leads us to the conclusion that the amount of Photofrin porfimer sodium and BPD-MA which localized in the metastatic lymph nodes is higher than in tumor and all other healthy tissues. Among normal lymph nodes there were significant differences according to the site of the node, with the left iliac lymph nodes having higher IR values than either the mesenteric (MC I or MC II) nodes. The geometric means of IR are consistently higher in normal as compared to inflammatory nodes for each location. The optical biopsy needle with laser-induced fluorescence detection and exogenic fluorochrome is a sensitive, novel techniques to localize small boundaries of metastatic neoplasm in lymph nodes.

  20. Vaccination with liposomal poly(I:C) induces discordant maturation of migratory dendritic cell subsets and anti-viral gene signatures in afferent lymph cells.

    PubMed

    Neeland, Melanie R; Elhay, Martin J; Meeusen, Els N T; de Veer, Michael J

    2014-10-29

    Vaccine formulations administered in the periphery must activate naive immune cells within the lymph node. In this study, we have directly cannulated the ovine lymphatic vessels to investigate the cellular and molecular mechanisms that transfer information from the periphery into the local draining lymph node via the afferent lymph. Inclusion of poly(I:C) into a liposomal vaccine formulation enhances the neutrophil-associated inflammatory immune response in afferent lymph and increases antigen uptake by migratory dendritic cells (DCs). Interestingly, antigen positive migratory DCs undergo discordant maturation, with peak expression of CD86 at 4 h and CD80 at 48-72 h post vaccination. Afferent lymph monocytes up-regulate expression of genes related to inflammatory and anti-viral immune phenotypes following vaccination however show no differentiation into APCs prior to their migration to the local lymph node as measured by surface MHC II expression. Finally, this study reveals the addition of poly(I:C) increases systemic antigen-specific humoral immunity. These findings provide a detailed understanding of the real time in vivo immune response induced by liposomes incorporating the innate immune agonist poly(I:C) utilising a vaccination setting comparable to that administered in humans. PMID:25280435

  1. Immunohistology of ectopic secondary lymph follicles in subcutaneous nodules from patients with hyperreactive onchocerciasis (sowda)

    PubMed Central

    Tenner-Racz, Klara; Korten, Simone; Hoerauf, Achim; Büttner, Dietrich W.

    2010-01-01

    Ectopic secondary lymph follicles emerge in patients with autoimmune or infectious diseases, e.g. in the synovium in rheumatoid arthritis or the skin in Borrelia burgdorferi infection, but ectopic localisations in the skin are rarely described for helminth infections. We investigated the cellular composition of secondary lymph follicles in subcutaneous nodules from eight patients with hyperreactive onchocerciasis (synonymous “localised” form or sowda) using immunohistology. CD3- and CD45RO-positive T cells and CD20-positive B cells were present in the mantle zone. The germinal centre was characterised by many B cells and CD35-positive follicular dendritic cells, which formed a network of attached IgE- and CD23-positive cells with the low-affinity IgE (epsilon) receptor. Few of the B cells were labelled for IgG1, IgG2 and IgG4, whereas in other zones of the nodule IgG1 was expressed by plasma cells and IgG1-coated dead microfilariae. B cells and few macrophages expressed the MHC class II molecule HLA-DR. Mature CD68-positive tingible body macrophages with phagocytosed leukocytes and CD57-positive lymphocytes occurred in the germinal centre. Macrophages in the germinal centre only weakly expressed alpha1-antichymotrypsin in contrast to macrophages in other zones of the onchocercoma. Furthermore, the multifunctional cytokine TGF-beta was only weakly expressed by macrophages and lymphocytes in the secondary follicles. Only few tryptase-positive mast cells, calprotectin-positive young macrophages, eosinophils and neutrophils occurred in the secondary follicles, although these cells were abundant in the onchocercomas. In conclusion, the ectopic secondary lymph follicles in onchocercomas and lymph nodes from hyperreactive onchocerciasis patients are equally composed. Electronic supplementary material The online version of this article (doi:10.1007/s00436-010-1912-0) contains supplementary material, which is available to authorized users. PMID:20524133

  2. Non-invasive mapping of deep-tissue lymph nodes in live animals using a multimodal PET/MRI nanoparticle

    NASA Astrophysics Data System (ADS)

    Thorek, Daniel L. J.; Ulmert, David; Diop, Ndeye-Fatou M.; Lupu, Mihaela E.; Doran, Michael G.; Huang, Ruimin; Abou, Diane S.; Larson, Steven M.; Grimm, Jan

    2014-01-01

    The invasion status of tumour-draining lymph nodes (LNs) is a critical indicator of cancer stage and is important for treatment planning. Clinicians currently use planar scintigraphy and single-photon emission computed tomography (SPECT) with 99mTc-radiocolloid to guide biopsy and resection of LNs. However, emerging multimodality approaches such as positron emission tomography combined with magnetic resonance imaging (PET/MRI) detect sites of disease with higher sensitivity and accuracy. Here we present a multimodal nanoparticle, 89Zr-ferumoxytol, for the enhanced detection of LNs with PET/MRI. For genuine translational potential, we leverage a clinical iron oxide formulation, altered with minimal modification for radiolabelling. Axillary drainage in naive mice and from healthy and tumour-bearing prostates was investigated. We demonstrate that 89Zr-ferumoxytol can be used for high-resolution tomographic studies of lymphatic drainage in preclinical disease models. This nanoparticle platform has significant translational potential to improve preoperative planning for nodal resection and tumour staging.

  3. Whole Proteome Analysis of Mouse Lymph Nodes in Cutaneous Anthrax

    PubMed Central

    Zhou, Weidong; Mueller, Claudius; Liotta, Lance; Popov, Serguei G.

    2014-01-01

    This study aimed to characterize a soluble proteome of popliteal lymph nodes during lymphadenitis induced by intradermal injection of Bacillus anthracis Sterne spores in mice using tandem LC-MS/MS and reverse-phase protein microarray with antibodies specific to epitopes of phosphorylated proteins. More than 380 proteins were detected in the normal intra-nodal lymph, while the infectious process resulted in the profound changes in the protein abundances and appearance of 297 unique proteins. These proteins belong to an array of processes reflecting response to wounding, inflammation and perturbations of hemostasis, innate immune response, coagulation and fibrinolysis, regulation of body fluid levels and vascular disturbance among others. Comparison of lymph and serum revealed 83 common proteins. Also, using 71 antibodies specific to total and phosphorylated forms of proteins we carried initial characterization of circulating lymph phosphoproteome which brought additional information regarding signaling pathways operating in the lymphatics. The results demonstrate that the proteome of intra-nodal lymph serves as a sensitive sentinel of the processes occurring within the lymph nodes during infection. The acute innate response of the lymph nodes to anthrax is accompanied by cellular damage and inflammation with a large number of up- and down-regulated proteins many of which are distinct from those detected in serum. MS data are available via ProteomeXchange with identifier PXD001342. PMID:25329596

  4. Plasmacytoid dendritic cells migrate in afferent skin lymph.

    PubMed

    Pascale, Florentina; Pascale, Florentia; Contreras, Vanessa; Bonneau, Michel; Courbet, Alexandre; Chilmonczyk, Stefan; Bevilacqua, Claudia; Epardaud, Mathieu; Eparaud, Mathieu; Niborski, Violeta; Riffault, Sabine; Balazuc, Anne-Marie; Foulon, Eliane; Guzylack-Piriou, Laurence; Riteau, Beatrice; Hope, Jayne; Bertho, Nicolas; Charley, Bernard; Schwartz-Cornil, Isabelle

    2008-05-01

    Conventional dendritic cells enter lymph nodes by migrating from peripheral tissues via the lymphatic route, whereas plasmacytoid dendritic cells (pDC), also called IFN-producing cells (IPC), are described to gain nodes from blood via the high endothelial venules. We demonstrate here that IPC/pDC migrate in the afferent lymph of two large mammals. In sheep, injection of type A CpG oligodinucleotide (ODN) induced lymph cells to produce type I IFN. Furthermore, low-density lymph cells collected at steady state produced type I IFN after stimulation with type A CpG ODN and enveloped viruses. Sheep lymph IPC were found within a minor B(neg)CD11c(neg) subset expressing CD45RB. They presented a plasmacytoid morphology, expressed high levels of TLR-7, TLR-9, and IFN regulatory factor 7 mRNA, induced IFN-gamma production in allogeneic CD4(pos) T cells, and differentiated into dendritic cell-like cells under viral stimulation, thus fulfilling criteria of bona fide pDC. In mini-pig, a CD4(pos)SIRP(pos) subset in afferent lymph cells, corresponding to pDC homologs, produced type I IFN after type A CpG-ODN triggering. Thus, pDC can link innate and acquired immunity by migrating from tissue to draining node via lymph, similarly to conventional dendritic cells. PMID:18424716

  5. Treatment of various secondary lymphedemas by microsurgical lymph vessel transplantation.

    PubMed

    Felmerer, Gunther; Sattler, Thorsten; Lohrmann, Christian; Tobbia, Dalia

    2012-03-01

    Chronic lymphedema is a debilitating complication of cancer diagnosis and therapy and poses many challenges for health care professionals. It remains a poorly understood condition that has the potential to occur after any intervention affecting lymph node drainage mechanism. Microsurgical lymph vessel transplantation is increasingly recognized as a promising method for bypassing the obstructed lymph pathways and promoting long-term reduction of edema in the affected limb. A detailed review of 14 patients with postoperative lymphedema treated with autologous lymph vessel transplantation between October 2005 and November 2009 was performed. In this report, the authors gave an account of their experience in utilizing this operative method to alleviate secondary lymphedema including upper limb, lower limb, genital, and facial edemas. Lymph vessel transplantation enhanced lymphatic drainage in patients with secondary lymphedema. In the upper and lower extremities, three patients had completed symptomatic recovery and another nine patients achieved reasonable reduction of lymphedema, four of these needed no further lymph drainage or compression garments and the remaining maintained their improvement with further decongestive therapy with or without compression garments. The patients with facial and genital edemas also experienced significant symptomatic improvement. The authors were able to establish long-term patency of the lymph vessel anastomosis by magnetic resonance lymphangiography. PMID:22113994

  6. Auxin Depletion from the Leaf Axil Conditions Competence for Axillary Meristem Formation in Arabidopsis and Tomato[W][OPEN

    PubMed Central

    Wang, Quan; Kohlen, Wouter; Rossmann, Susanne; Vernoux, Teva; Theres, Klaus

    2014-01-01

    The enormous variation in architecture of flowering plants is based to a large extent on their ability to form new axes of growth throughout their life span. Secondary growth is initiated from groups of pluripotent cells, called meristems, which are established in the axils of leaves. Such meristems form lateral organs and develop into a side shoot or a flower, depending on the developmental status of the plant and environmental conditions. The phytohormone auxin is well known to play an important role in inhibiting the outgrowth of axillary buds, a phenomenon known as apical dominance. However, the role of auxin in the process of axillary meristem formation is largely unknown. In this study, we show in the model species Arabidopsis thaliana and tomato (Solanum lycopersicum) that auxin is depleted from leaf axils during vegetative development. Disruption of polar auxin transport compromises auxin depletion from the leaf axil and axillary meristem initiation. Ectopic auxin biosynthesis in leaf axils interferes with axillary meristem formation, whereas repression of auxin signaling in polar auxin transport mutants can largely rescue their branching defects. These results strongly suggest that depletion of auxin from leaf axils is a prerequisite for axillary meristem formation during vegetative development. PMID:24850851

  7. Clinical stage B non-seminomatous germ cell testis cancer: The Indiana University experience (1965–1989) using routine primary retroperitoneal lymph node dissection

    Microsoft Academic Search

    J. P. Donohue; J. A. Thornhill; R. S. Foster; R. G. Rowland; R. Bihrle

    1995-01-01

    Between 1965 and 1989, 1180 patients at Indiana University, U.S.A., underwent retroperitoneal lymph node dissection (RPLND) for non-seminomatous germ cell (NSGC) testis cancer of whom 638 cases had primary RPLND. A subset of 174 cases were considered clinical stage B (or II) before surgery (retroperitoneal nodal metastases by clinical staging). Surgery revealed that 23% (n = 41) had pathological stage

  8. Current status of sentinel lymph node biopsy in solid malignancies

    PubMed Central

    Goyal, Amit; Mansel, Robert E

    2004-01-01

    Lymphatic mapping and sentinel lymph node biopsy were first reported in 1977 by Cabanas for penile cancer. Since that time, the technique has become rapidly assimilated into clinical practice. The sentinel node concept has been validated in cutaneous melanoma and breast cancer. However, follow-up data of patients from randomised trials is needed to establish the clinical significance of sentinel lymph node biopsy before accepting the procedure as a standard of care. This technique has the potential to be utilised in all solid tumours like colon, gastric, oesophageal, lung, gynaecologic, and head and neck cancer. This paper reviews the current status of sentinel lymph node biopsy in solid tumours. PMID:15107132

  9. Synergistic Effect of Adjustments of Elastic Stockings to Maintain Reduction in Leg Volume after Mechanical Lymph Drainage

    PubMed Central

    de Godoy, José Maria Pereira; Lopes Pinto, Renata; Pereira de Godoy, Ana Carolina; de Fátima Guerreiro Godoy, Maria

    2014-01-01

    The objective of the present study was to evaluate the effect of elastic compression stockings on volumetric variations of lymphedematous limbs between mechanical lymph drainage sessions. Eleven patients with Grade II leg lymphedema, regardless of etiology, were evaluated in a randomized clinical trial. The ages ranged from 47 to 83 years old with a mean of 62.4 years. Participants were submitted to mechanical lymph drainage (RAGodoy) associated with adjusted and unadjusted knee-high elastic compression stockings (20/30 Venosan). The effect of these stockings on the maintenance of volumetric reductions between sessions of lymph drainage was assessed. In all, 33 evaluations were carried out, 18 of patients using well-adjusted stockings and 15 with badly-adjusted stockings. The differences in volumes were significant (unpaired t-test; P-value?lymph drainage. PMID:25328707

  10. Helical Tomotherapy Planning for Left-Sided Breast Cancer Patients With Positive Lymph Nodes: Comparison to Conventional Multiport Breast Technique

    SciTech Connect

    Goddu, S. Murty [Washington University School of Medicine, St. Louis, MO (United States)], E-mail: sgoddu@radonc.wustl.edu; Chaudhari, Summer; Mamalui-Hunter, Maria; Pechenaya, Olga L.; Pratt, David; Mutic, Sasa; Zoberi, Imran [Washington University School of Medicine, St. Louis, MO (United States); Jeswani, Sam [Tomotherapy Inc., Madison, WI (United States); Powell, Simon N. [Washington University School of Medicine, St. Louis, MO (United States); Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Low, Daniel A. [Washington University School of Medicine, St. Louis, MO (United States)

    2009-03-15

    Purpose: To evaluate the feasibility of using helical tomotherapy for locally advanced left-sided breast cancer. Methods and Materials: Treatment plans were generated for 10 left-sided breast cancer patients with positive lymph nodes comparing a multiport breast (three-dimensional) technique with the tomotherapy treatment planning system. The planning target volumes, including the chest wall/breast, supraclavicular, axillary, and internal mammary lymph nodes, were contoured. The treatment plans were generated on the tomotherapy treatment planning system to deliver 50.4 Gy to the planning target volume. To spare the contralateral tissues, directional blocking was applied to the right breast and right lung. The optimization goals were to protect the lungs, heart, and right breast. Results: The tomotherapy plans increased the minimal dose to the planning target volume (minimal dose received by 99% of target volume = 46.2 {+-} 1.3 Gy vs. 27.9 {+-} 17.1 Gy) while improving the dose homogeneity (dose difference between the minimal dose received by 5% and 95% of the planning target volume = 7.5 {+-} 1.8 Gy vs. 37.5 {+-} 26.9 Gy). The mean percentage of the left lung volume receiving {>=}20 Gy in the tomotherapy plans decreased from 32.6% {+-} 4.1% to 17.6% {+-} 3.5%, while restricting the right-lung mean dose to <5 Gy. However, the mean percentage of volume receiving {>=}5 Gy for the total lung increased from 25.2% {+-} 4.2% for the three-dimensional technique to 46.9% {+-} 8.4% for the tomotherapy plan. The mean volume receiving {>=}35 Gy for the heart decreased from 5.6% {+-} 4.8% to 2.2% {+-} 1.5% in the tomotherapy plans. However, the mean heart dose for tomotherapy delivery increased from 7.5 {+-} 3.4 Gy to 12.2 {+-} 1.8 Gy. Conclusion: The tomotherapy plans provided better dose conformity and homogeneity than did the three-dimensional plans for treatment of left-sided breast tumors with regional lymph node involvement, while allowing greater sparing of the heart and left lung from doses associated with increased complications.

  11. Incidence of para-aortic and pelvic lymph node metastases in epithelial carcinoma of the ovary.

    PubMed

    Chen, S S; Lee, L

    1983-08-01

    In patients with ovarian carcinoma, the presence of metastatic disease in a retroperitoneal lymph node is indicative of a poor prognosis. Although a "staging laparotomy" is required for proper treatment, definitive information concerning para-aortic and pelvic lymph node metastasis often is not available. To determine the incidence of retroperitoneal lymph node metastases in untreated cases of ovarian carcinoma, a prospective study by selective nodal biopsy was undertaken in 61 unselected patients with the following distribution: Stage I, 11; Stage II, 10; Stage III, 31; and Stage IV, 9. The incidence of para-aortic node metastasis overall was 37.7% and of pelvic node metastasis, 14.8%. Of 23 patients with positive para-aortic nodes, 30.4% had no concomitant pelvic node involvement. Direct relationships between nodal metastasis and clinical stage, tumor grade, and histologic type of tumor were demonstrated. The incidence of positive para-aortic nodes in Stage I disease was 18.2%; in Stage II, 20.0%; in Stage III, 41.9%; and in Stage IV, 66.7%. The corresponding incidence of pelvic node metastasis was 9.1% in Stage I, 10.0% in Stage II, 12.9% in Stage III, and 33.3% in Stage IV. Grade 3 tumors were associated most frequently with nodal involvement, with an incidence of positive para-aortic nodes of 52.5% and of positive pelvic nodes of 15.5%. In patients with a serous type of malignancy, the frequencies of positive para-aortic/pelvic nodes were 44.4%/16.7%, respectively; in the undifferentiated type, 50.0%/10.0%; in the clear cell type, 25.0%/25.0%; and in the mucinous type, 14.3%/14.3%. In this small series, 32 patients (52.5%) had positive retroperitoneal nodal involvement. It is concluded that selective biopsies of the para-aortic and pelvic lymph nodes should be part of any "staging laparotomy" for ovarian carcinoma, and that the true incidence of nodal involvement in these patients awaits further investigation. PMID:6884834

  12. The Effect of Magnesium Sulfate on Motor and Sensory Axillary Plexus Blockade

    PubMed Central

    Haghighi, Mohammad; Soleymanha, Mehran; Sedighinejad, Abbas; Mirbolook, Ahmadreza; Naderi Nabi, Bahram; Rahmati, Mehdi; Ashoori Saheli, Nasim

    2015-01-01

    Background: Magnesium is a physiologic cation that blocks neuromuscular transmission and does not allow the nerve to be stimulated. Objectives: This study investigates the effect of adding magnesium sulfate to lidocaine to extend the duration of sensory and motor blocks of the axillary plexus in orthopedic surgeries of the upper extremities. Patients and Methods: This controlled randomized double-blind study was performed on patients who were candidates for orthopedic surgery of the upper extremities. A total of 60 patients between 18–60 years with ASA Class 1 or 2 participated in the study. One group received lidocaine (5 mg/kg) with magnesium sulfate 20% (3 mL) as the case group, while the second group received lidocaine (5 mg/kg) with normal saline (3 mL) as a placebo to block the axillary plexus using the trans-arterial technique. The duration of the sensory and motor block of the axillary plexus was monitored and evaluated using the pinprick and modified Bromage scale. Results: A total of 60 patients were included in the study with 30 patients having received lidocaine plus magnesium and the other 30 patients having received lidocaine plus normal saline. The mean sensory block duration in the case group was 248.83 ± 18.36 and in control group was 204.67 ± 22.62. The mean motor block duration in the case group was 207.0 ± 16.64 and in control group was 147.33 ± 21.52 (both P < 0.0001). The mean onset of sensory block in case group was 15.5 ± 3.79 and the onset block in control group was 10.33 ± 4.13 (P < 0.0001). The mean onset of motor block in case group was 20.66 ± 4.09 and the onset block in control group was 19.73 ± 26.18 (P < 0.848). Conclusions: The addition of magnesium sulfate to lidocaine increased the duration of motor and sensory axillary block in the upper extremities during surgeries when compared to the use of lidocaine alone. PMID:25830117

  13. Anatomy of Axillary Nerve and Its Clinical Importance: A Cadaveric Study

    PubMed Central

    Kuppasad, Saniya

    2015-01-01

    Introduction: Axillary nerve is one of the terminal branches of posterior cord of brachial plexus, which is most commonly injured during numerous orthopaedic surgeries, during shoulder dislocation & rotator cuff tear. All these possible iatrogenic injuries are because of lack of awareness of anatomical variations of the nerve. Therefore, it is very much necessary to explore its possible variations and guide the surgeons to enhance the better clinical outcome by reducing the risk and complications. Materials and Methods: Twenty five cadavers (20 Males & 05 Females) making 50 specimens including both right and left sides were dissected as per standard dissection methods to find the origin, course, branches, distribution & exact location of the nerve beneath the deltoid muscle from important landmarks like: posterolateral aspect of acromion process, anteromedial aspect of tip of coracoid process, midpoint of deltoid muscle insertion (deltoid tuberosity of humerus) and from the midpoint of vertical length of deltoid muscle. The measurements were recorded and tabulated. Statistical Analysis: The measurements were entered in Microsoft excel and mean, proportion, standard deviation were calculated by using SPSS 16th version. Results: The axillary nerve was found to take origin from the posterior cord of brachial plexus (100%) dividing into anterior & posterior branches in Quadrangular space (88%) and supply deltoid muscle mainly. It also gave branches to teres minor muscle, shoulder joint capsule & superolateral brachial cutaneous nerve (100%). This study concluded that the mean distance of axillary nerve from the – anteromedial aspect of tip of coracoid process, posterolateral aspect of acromion process, midpoint of deltoid insertion & from the midpoint of vertical length of deltoid muscle measured to be (in cm) as 3.56±0.51, 7.4±0.99, 6.7±0.47 & 2.45±0.48 respectively. The mean vertical distance of entering point of axillary nerve from the anterior upper, mid middle upper & posterior upper deltoid border found to be (in cm): 4.94±0.86, 5.14±0.90 & 5.44±0.95 respectively and the horizontal anterior & horizontal posterior mean distance being 4.54±0.65 & 3.22±0.53 respectively. The mean height, mean width & mean depth of Quadrangular space measured to be (in cm): 2.23±0.40, 2.19±0.22 & 1.25±0.14 respectively. Conclusion: The findings were found to be highly significant when males were compared with females but not significant when sides (right & left) were compared. PMID:25954611

  14. Ultrasound elastography for evaluation of cervical lymph nodes

    PubMed Central

    Choi, Young Jun; Lee, Jeong Hyun; Baek, Jung Hwan

    2015-01-01

    Ultrasound (US) elastography has been introduced as a noninvasive imaging technique for evaluating cervical lymph nodes. US elastography techniques include strain elastography and shear wave-based elastography. The application of this technique is based on the fact that stiff tissues tend to deform less and show less strain than compliant tissues when the same force is applied. In general, metastatic lymph nodes demonstrate higher stiffness than benign lymph nodes. Overall, preliminary studies suggest that US elastography may be useful in differentiating benign and malignant cervical lymph nodes, thereby informing decisions to perform a biopsy and facilitating follow-up. For US elastography to be accepted into clinical practice, however, its techniques, associated diagnostic criteria, and reliability need to be further refined. PMID:25827473

  15. Sentinel lymph node biopsy in Japan.

    PubMed

    Uhara, Hisashi; Takata, Minoru; Saida, Toshiaki

    2009-12-01

    Similar to the practice in Western countries, intraoperative lymphatic mapping and selected lymphadenectomy (SLNB) have been validated and are widely performed for the staging of melanoma in Japan. Recent studies have shown that approximately 90% (73/81) of university hospitals and several cancer hospitals routinely perform SLNB, and half of all melanoma patients receive this examination. SLNB is performed according to a variation of the standard procedure described by Morton and Cochran. The most frequently used tracers are Tc(99m)-tin colloid or Tc(99m)-phytate for scintigraphy and patent blue violet or indigo carmine as a blue dye. Some institutions use indocyanine green, which is fluorescent and can be used to visualize sentinel lymph node(s) (SLNs) under an infrared camera. The recent detection rate of SLNs has increased to more than 95% with the method using blue dye, lymphoscintigraphy, and a handheld gamma probe. In a multicenter study, the rates of metastasis in SLN were as follows: pTis, 0% (0/36); pT1, 10.7% (6/56); pT2, 21.0% (13/63); pT3, 34.0% (35/103); and pT4, 62.4% (63/101). The metastasis rate was also significantly related to ulceration of the primary tumor. Here, we discuss data from Japanese patients and the present status of SLNB in Japan. PMID:19967483

  16. Apelin promotes lymphangiogenesis and lymph node metastasis.

    PubMed

    Berta, Judit; Hoda, Mir Alireza; Laszlo, Viktoria; Rozsas, Anita; Garay, Tamas; Torok, Szilvia; Grusch, Michael; Berger, Walter; Paku, Sandor; Renyi-Vamos, Ferenc; Masri, Bernard; Tovari, Jozsef; Groger, Marion; Klepetko, Walter; Hegedus, Balazs; Dome, Balazs

    2014-06-30

    Whereas the role of the G-protein-coupled APJ receptor and its ligand, apelin, in angiogenesis has been well documented, the ability of the apelin/APJ system to induce lymphangiogenesis and lymphatic metastasis has been largely unexplored. To this end, we first show that APJ is expressed in lymphatic endothelial cells (LECs) and, moreover, that it responds to apelin by activating the apelinergic signaling cascade. We find that although apelin treatment does not influence the proliferation of LECs in vitro, it enhances their migration, protects them against UV irradiation-induced apoptosis, increases their spheroid numbers in 3D culture, stimulates their in vitro capillary-like tube formation and, furthermore, promotes the invasive growth of lymphatic microvessels in vivo in the matrigel plug assay. We also demonstrate that apelin overexpression in malignant cells is associated with accelerated in vivo tumor growth and with increased intratumoral lymphangiogenesis and lymph node metastasis. These results indicate that apelin induces lymphangiogenesis and, accordingly, plays an important role in lymphatic tumor progression. Our study does not only reveal apelin as a novel lymphangiogenic factor but might also open the door for the development of novel anticancer therapies targeting lymphangiogenesis. PMID:24962866

  17. Apelin promotes lymphangiogenesis and lymph node metastasis

    PubMed Central

    Laszlo, Viktoria; Rozsas, Anita; Garay, Tamas; Torok, Szilvia; Grusch, Michael; Berger, Walter; Paku, Sandor; Renyi-Vamos, Ferenc; Masri, Bernard; Tovari, Jozsef; Groger, Marion; Klepetko, Walter; Hegedus, Balazs; Dome, Balazs

    2014-01-01

    Whereas the role of the G-protein-coupled APJ receptor and its ligand, apelin, in angiogenesis has been well documented, the ability of the apelin/APJ system to induce lymphangiogenesis and lymphatic metastasis has been largely unexplored. To this end, we first show that APJ is expressed in lymphatic endothelial cells (LECs) and, moreover, that it responds to apelin by activating the apelinergic signaling cascade. We find that although apelin treatment does not influence the proliferation of LECs in vitro, it enhances their migration, protects them against UV irradiation-induced apoptosis, increases their spheroid numbers in 3D culture, stimulates their in vitro capillary-like tube formation and, furthermore, promotes the invasive growth of lymphatic microvessels in vivo in the matrigel plug assay. We also demonstrate that apelin overexpression in malignant cells is associated with accelerated in vivo tumor growth and with increased intratumoral lymphangiogenesis and lymph node metastasis. These results indicate that apelin induces lymphangiogenesis and, accordingly, plays an important role in lymphatic tumor progression. Our study does not only reveal apelin as a novel lymphangiogenic factor but might also open the door for the development of novel anticancer therapies targeting lymphangiogenesis. PMID:24962866

  18. Epitrochlear lymph node metastases from invasive ductal breast cancer.

    PubMed

    Kumar, Pavan; Singh, Shalini; Datta, N R; Tandon, Ashwani

    2009-01-01

    Metastasis to an epitrochlear lymph node from a primary invasive breast cancer has not been reported earlier. We report a case of epitrochlear lymph node metastasis that presented 10 years after the primary breast malignancy had been treated with radiotherapy, chemotherapy, and hormonal therapy. The patient was successfully treated and continues to remain asymptomatic more than 2 years after she presented with the metastasis. PMID:19841563

  19. Quality enhancement with adaptive edge preservation for lymph nodal images

    NASA Astrophysics Data System (ADS)

    Tian, Haiying; Cai, Hongmin; Cui, Chunyan; Li, Li

    2011-06-01

    Morphological information of lymph nodal metastasis is a critical prognostic factor in patients with cancer. However, the raw images of lymph node obtained by CT equipments are usually corrupted by noises. In this paper, we are proposing to use a revised nonlinear diffusion techniques to remove the noises while preserving edge information. Experiments on real data show that the method can be used to obtain accurate edge information and thus facilitate nodal morphological analysis.

  20. Sarcoid Reactions in Regional Lymph Nodes of Primary Lung Cancer

    Microsoft Academic Search

    Kenji Sugio; Takashi Inoue; Hideki Yokoyama; Teruyoshi Ishida; Shuji Nakano; Keizo Sugimachi

    1993-01-01

    A 66-year-old woman diagnosed as having primary lung cancer with an enlargement of the mediastinal, subcarinal and bilateral hilar lymph nodes underwent a thoracotomy after preoperative chemotherapy. The histological examination showed a moderately differentiated papillary adenocarcinoma in the left upper lobe without any metastases to the regional lymph nodes; however, non-caseous epithelioid granulomas without necrosis were observed in the nodes.

  1. Sentinel lymph node biopsy in endometrial cancer: description of the technique and preliminary results

    PubMed Central

    Kuru, O?uzhan; Topuz, Samet; ?en, Serhat; ?yibozkurt, Cem; Berkman, Sinan

    2011-01-01

    Objective To measure the feasibility of sentinel lymph node technique in endometrial cancer. Material and Methods The study was designed as a prospective non-randomized case-control trial. Between 2010–2011, in Istanbul University, Istanbul Medical Faculty, Gynecologic Oncology department, 26 patients who were preoperatively evaluated as endometrial cancer enrolled in the study. Patients’ detailed informed consent and ethics committee approval were obtained. Sentinel lymph node (SLN) detection rate was determined as the primary outcome. Sensitivity, specificity, positive and negative predictive values and particularly false negative results were determined as secondary outcomes. As a technique of SLN, injection of methylene blue to the subserosal myometrium of the uterine fundus via 5 cc syringe following peritoneal aspiration cytology procedure was obtained. Surgery was made after injection for an average of 5 minutes due to the physiological spread of the blue dye. Then, the standard protocol of hysterectomy was performed and the retroperitoneum was opened to perform lymphadenectomy. The presence of lymph node regions, and presence of a sentinel node was recorded on the trial record form. Positive staining nodes were sent separately for pathological examination. In the course of the study due to insufficient rate of staining, the technique has been changed to cervical and multiple uterine injections. Results As the primary outcome, an SLN positivity rate of 23% in 6 patients with a total of 8 lymph nodes were found. The remarkable finding was that in the first technique, the rate was 1/16 (6%), while the second technique, 5/10 (50%), respectively. The difference is statistically significant (p=0.001). In endometrial cancer stage I and II, secondary outcomes for sensitivity, specificity, positive predictive value, negative predictive value were 23%, 0%, 100%, 43%, respectively. Because there were no metastatic lymph nodes found, false negative rate was 0%. Conclusion SLN approach is not valuable enough to eliminate the need for lymphadenectomy. On the other hand, it facilitates scanning micrometastases and ultrastaging, while its clinical value has not yet been established. However, according to the recent pilot studies, it provides a means for assessing micrometastases for the medium-risk group for local recurrence. PMID:24591995

  2. BRANCHED1 Promotes Axillary Bud Dormancy in Response to Shade in Arabidopsis[C][W

    PubMed Central

    González-Grandío, Eduardo; Poza-Carrión, César; Sorzano, Carlos Oscar S.; Cubas, Pilar

    2013-01-01

    Plants interpret a decrease in the red to far-red light ratio (R:FR) as a sign of impending shading by neighboring vegetation. This triggers a set of developmental responses known as shade avoidance syndrome. One of these responses is reduced branching through suppression of axillary bud outgrowth. The Arabidopsis thaliana gene BRANCHED1 (BRC1), expressed in axillary buds, is required for branch suppression in response to shade. Unlike wild-type plants, brc1 mutants develop several branches after a shade treatment. BRC1 transcription is positively regulated 4 h after exposure to low R:FR. Consistently, BRC1 is negatively regulated by phytochrome B. Transcriptional profiling of wild-type and brc1 buds of plants treated with simulated shade has revealed groups of genes whose mRNA levels are dependent on BRC1, among them a set of upregulated abscisic acid response genes and two networks of cell cycle– and ribosome-related downregulated genes. The downregulated genes have promoters enriched in TEOSINTE BRANCHED1, CYCLOIDEA, and PCF (TCP) binding sites, suggesting that they could be transcriptionally regulated by TCP factors. Some of these genes respond to BRC1 in seedlings and buds, supporting their close relationship with BRC1 activity. This response may allow the rapid adaptation of plants to fluctuations in the ratio of R:FR light. PMID:23524661

  3. Mastectomy With Immediate Expander-Implant Reconstruction, Adjuvant Chemotherapy, and Radiation for Stage II-III Breast Cancer: Treatment Intervals and Clinical Outcomes

    SciTech Connect

    Wright, Jean L. [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Cordeiro, Peter G. [Department of Surgery, Plastic and Reconstructive Service, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Ben-Porat, Leah [Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Van Zee, Kimberly J. [Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Hudis, Clifford [Department of Medicine, Solid Tumor Division, Breast Cancer Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Beal, Kathryn [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); McCormick, Beryl [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)], E-mail: mccormib@mskcc.org

    2008-01-01

    Purpose: To determine intervals between surgery and adjuvant chemotherapy and radiation in patients treated with mastectomy with immediate expander-implant reconstruction, and to evaluate locoregional and distant control and overall survival in these patients. Methods and Materials: Between May 1996 and March 2004, 104 patients with Stage II-III breast cancer were routinely treated at our institution under the following algorithm: (1) definitive mastectomy with axillary lymph node dissection and immediate tissue expander placement, (2) tissue expansion during chemotherapy, (3) exchange of tissue expander for permanent implant, (4) radiation. Patient, disease, and treatment characteristics and clinical outcomes were retrospectively evaluated. Results: Median age was 45 years. Twenty-six percent of patients were Stage II and 74% Stage III. All received adjuvant chemotherapy. Estrogen receptor staining was positive in 77%, and 78% received hormone therapy. Radiation was delivered to the chest wall with daily 0.5-cm bolus and to the supraclavicular fossa. Median dose was 5040 cGy. Median interval from surgery to chemotherapy was 5 weeks, from completion of chemotherapy to exchange 4 weeks, and from exchange to radiation 4 weeks. Median interval from completion of chemotherapy to start of radiation was 8 weeks. Median follow-up was 64 months from date of mastectomy. The 5-year rate for locoregional disease control was 100%, for distant metastasis-free survival 90%, and for overall survival 96%. Conclusions: Mastectomy with immediate expander-implant reconstruction, adjuvant chemotherapy, and radiation results in a median interval of 8 weeks from completion of chemotherapy to initiation of radiation and seems to be associated with acceptable 5-year locoregional control, distant metastasis-free survival, and overall survival.

  4. CYTOPATHOLOGY Computer-Derived Nuclear Features Compared

    E-print Network

    Street, Nick

    172 CANCER CYTOPATHOLOGY Computer-Derived Nuclear Features Compared with Axillary Lymph Node Status of axillary lymph nodes and may obviate the need for routine axillary lymph node dissection. Cancer (Cancer for Breast Carcinoma Prognosis BACKGROUND. Both axillary lymph node involvement and tumor anaplasia, as

  5. The influence of sentinel lymph node tumour burden on additional lymph node involvement and disease-free survival in cutaneous melanoma – a retrospective analysis of 392 cases

    Microsoft Academic Search

    M Guggenheim; R Dummer; F J Jung; D Mihic-Probst; H Steinert; V Rousson; L E French; P Giovanoli

    2008-01-01

    Twenty per cent of sentinel lymph node (SLN)-positive melanoma patients have positive non-SLN lymph nodes in completion lymph node dissection (CLND). We investigated SLN tumour load, non-sentinel positivity and disease-free survival (DFS) to assess whether certain patients could be spared CLND. Sentinel lymph node biopsy was performed on 392 patients between 1999 and 2005. Median observation period was 38.8 months.

  6. Pattern of lymph node involvement and prognosis in pancreatic adenocarcinoma: direct lymph node invasion has similar survival to node-negative disease.

    PubMed

    Pai, Rish K; Beck, Andrew H; Mitchem, Jonathan; Linehan, David C; Chang, Daniel T; Norton, Jeffrey A; Pai, Reetesh K

    2011-02-01

    Lymph node status is one of the most important predictors of survival in pancreatic ductal adenocarcinoma. Surgically resected pancreatic adenocarcinoma is often locally invasive and may invade directly into peripancreatic lymph nodes. The significance of direct invasion into lymph nodes in the absence of true lymphatic metastases is unclear. The purpose of this study was to retrospectively compare clinical outcome in patients with pancreatic ductal adenocarcinoma with direct invasion into peripancreatic lymph nodes with patients with node-negative adenocarcinomas and patients with true lymphatic lymph node metastasis. A total of 380 patients with invasive pancreatic ductal adenocarcinoma classified as pT3, were evaluated: ductal adenocarcinoma with true lymphatic metastasis to regional lymph nodes (248 cases), ductal adenocarcinoma without lymph node involvement (97 cases), and ductal adenocarcinoma with regional lymph nodes involved only by direct invasion from the main tumor mass (35 cases). Isolated lymph node involvement by direct invasion occurred in 35 of 380 (9%) patients. Overall survival for patients with direct invasion of lymph nodes (median survival, 21 mo; 5-year overall survival, 36%) was not statistically different from patients with node-negative adenocarcinomas (median survival, 30 mo; 5-year overall survival, 31%) (P=0.609). Patients with node-negative adenocarcinomas had an improved survival compared with patients with lymph node involvement by true lymphatic metastasis (median survival, 15 mo; 5-year overall survival, 8%) (P<0.001) regardless of the number of lymph nodes involved by adenocarcinoma. There was a trend toward decreased overall survival for patients with 1 or 2 lymph nodes involved by true lymphatic metastasis compared with patients with direct invasion of tumor into lymph nodes (P=0.056). However, this did not reach statistical significance. Our results indicate that patients with isolated direct lymph node invasion have a comparable overall survival with patients with node-negative adenocarcinomas as opposed to true lymphatic lymph node metastasis. PMID:21263243

  7. Axillary polymastia

    Microsoft Academic Search

    Anne E. Burdick; Kavita A. Thomas; Esperanza Welsh; Jodeen Powell; George W. Elgart

    2003-01-01

    “Polymastia” is a term used to describe the presence of more than 2 breasts in human beings. It is synonymous with supernumerary or accessory breast tissue. Accessory breast tissue has the potential to undergo the same benign and malignant changes as normal pectoral breast tissue.

  8. Axillary polymastia.

    PubMed

    Burdick, Anne E; Thomas, Kavita A; Welsh, Esperanza; Powell, Jodeen; Elgart, George W

    2003-12-01

    "Polymastia" is a term used to describe the presence of more than 2 breasts in human beings. It is synonymous with supernumerary or accessory breast tissue. Accessory breast tissue has the potential to undergo the same benign and malignant changes as normal pectoral breast tissue. PMID:14639406

  9. The Utility of Sentinel Lymph Node Biopsy in Papillary Thyroid Carcinoma with Occult Lymph Nodes

    PubMed Central

    Yan, Xingqiang; Zeng, Ruichao; Ma, Zhaosheng; Chen, Chengze; Chen, Endong; Zhang, Xiaohua; Cao, Feilin

    2015-01-01

    Background The sentinel lymph node (SLN) is defined as the first draining node from the primary lesion, and it has proven to be a good indicator of the metastatic status of regional lymph nodes in solid tumors. The aim of this study was to evaluate the clinical application of SLN biopsy (SLNB) in papillary thyroid carcinoma (PTC) with occult lymph nodes. Methods From April 2006 to October 2012, 212 consecutive PTC patients were treated with SLNB using carbon nanoparticle suspension (CNS). Then, the stained nodes defined as SLN were collected, and prophylactic central compartment neck dissection (CCND) followed by total thyroidectomy or subtotal thyroidectomy were performed. All the samples were sent for pathological examination. Results There were 78 (36.8%) SLN metastasis (SLNM)-positive cases and 134 (63.2%) SLNM-negative cases. The sensitivity, specificity, positive and negative predictive values, and false-positive and false-negative rates of SLNB were 78.8%, 100%, 100%, 84.3%, 0%, and 21.2%, respectively. The PTC patients with SLNM were more likely to be male (48.2% vs. 32.7%, p = 0.039) and exhibited multifocality (52.6% vs. 33.3%, p = 0.025) and extrathyroidal extension (56.7% vs. 33.5%, p = 0.015). A greater incidence of non-SLN metastases in the central compartment was found in patients with SLNM (41/78, 52.6%) than in those without SLNM (21/134, 15.7%; p < 0.05). However, the SLNM-negative PTC patients with non-SLN metastases were more likely to be male (37.9% vs. 9.5%, p < 0.05). Conclusions The application of SLNB using CNS is technically feasible, safe, and useful, especially for male patients with co-existing multifocality and extrathyroidal extension. However, the sensitivity of SLNB must be improved and its false-negative rate reduced before it can be a routine procedure and replace prophylactic CCND. More attention should be paid to PTC patients (especially males) without SLNM for signs of non-SLN metastases. PMID:26046782

  10. Bending of apricot tree branches under the weight of axillary growth: test of a mechanical model with experimental data

    Microsoft Academic Search

    Tancrède Alméras; Joseph Gril; Evelyne Costes

    2002-01-01

    Stem orientation is an important factor for fruit tree growth and branching habit since it influences fruit production as well as training practices. A mechanical model of the bending of a stem under axillary load was written and evaluated using experimental data on apricot trees (Prunus armeniaca L.). A set of 15 1-year-old stems of various shapes was observed during

  11. Local expression of the ipt gene in transgenic tobacco (Nicotiana tabacum L. cv. SR1) axillary buds establishes a role for cytokinins in tuberization and sink formation.

    PubMed

    Guivarc'h, Anne; Rembur, Jacques; Goetz, Marc; Roitsch, Thomas; Noin, Michèle; Schmülling, Thomas; Chriqui, Dominique

    2002-04-01

    The developmental characteristics of a transgenic tobacco line (BIK62) expressing the ipt cytokinin-biosynthetic gene under the control of a tagged promoter were analysed. In situ hybridization and cytokinin immunocytochemistry revealed that the ipt gene was mainly expressed in the axillary buds after the floral transition. The ipt-expressing axillary buds presented morphological alterations such as short and narrow scale-leaflets, and swollen internodes filled with starch grains, giving rise to short and tuberized lateral branches. In addition, the modification of the endogenous cytokinin balance in the axillary meristems resulted in a fast rate of leaf initiation and cytokinins accumulated mostly in the lateral zones of the reactivated axillary meristems, suggesting a role in leaf organogenesis. Cell cycle analysis revealed that the reactivated axillary meristems were characterized by predominant S+G2 nuclei. Terminal internodes displayed low levels of hexose and sucrose concomitant with starch accumulation. Extracellular invertases (EC 3.1.26) were also present in higher amounts in the tuberizing internodes compared to the axillary buds of wild-type tobacco. These results underline the role of cytokinins in cell cycle regulation and in the creation of a sink--source effect. They also provide new information about cytokinin involvement in the process of tuberization and their overproduction in axillary buds giving rise to tuberized lateral branches in a naturally non-tuberizing species. PMID:11886881

  12. Deodorant effects of a sage extract stick: Antibacterial activity and sensory evaluation of axillary deodorancy

    PubMed Central

    Shahtalebi, Mohammad Ali; Ghanadian, Mustafa; Farzan, Ali; Shiri, Niloufar; Shokri, Dariush; Fatemi, Syed Ali

    2013-01-01

    Background: Deodorant products prevent the growth and activity of the degrading apocrine gland bacteria living in the armpit. Common antibacterial agents in the market like triclosan and aluminum salts, in spite of their suitable antibacterial effects, increase the risk of Alzheimer's disease, breast and prostate cancers or induce contact dermatitis. Therefore, plant extracts possessing antibacterial effects are of interest. The aim of the present study was to verify the in vitro antimicrobial effects of different sage extracts against two major bacteria responsible for axillary odor, and to evaluate the deodorant effect of a silicon-based stick containing sage extracts in different densities in humans. Materials and Methods: Different fractions of methanolic extract of Salvia officinalis (sage) were evaluated on a culture of armpit skin surface of volunteers through agar microdilution antimicrobial assay. Then, randomized, double-blind placebo-controlled clinical trial with the best antibacterial fraction was conducted on 45 female healthy volunteers. Participants were treated with a single dose in four groups, each containing 15 individuals: Group 1 (200 ?g/mL), 2 (400 ?g/mL), 3 (600 ?g/mL) of dichloromethane sage extract, and placebo (without extract). A standard sensory evaluation method for the evaluation of deodorant efficacy was used before, and two hours, four hours, and eight hours after single application of a deodorant or placebo (ASTM method E 1207-87 Standard Practice for the Sensory Evaluation of Axillary Deodorancy). Results: The data were analyzed with two factors relating to densities and time. In 45 participants with a mean [± standard deviation (SD)] age of 61.5±11.8 years, statistically significant within-group differences were observed before and two, four, and eight hours after deodorant treatment for groups 1, 2, and 3. Groups 1, 2, and 3 had a significantly smaller odor score than placebo after two, four, and eight hours (P < 0.001). In a comparison of different deodorant densities, the interaction effect was not significant between deodorant 200 and 400 ?g/mL, but was significant between 200 and 600 and between 400 and 600 ?g/mL sage extract sticks (P < 0.001). Before running the sensory evaluation of the deodorant sticks on the subjects, a rabbit skin patch test was used to demonstrate that the formulation had no irritants. Conclusion: A single treatment with a stick deodorant containing dichloromethane sage extract of 200, 400, or 600 ?g/mL concentrations was effective in reducing the axillary malodor level compared with the control, in healthy subjects. PMID:24497852

  13. Biomechanical Contributions of Posterior Deltoid and Teres Minor in the Context of Axillary Nerve Injury: A Computational Study

    PubMed Central

    Crouch, Dustin L.; Plate, Johannes F.; Li, Zhongyu; Saul, Katherine R.

    2013-01-01

    Purpose To determine if transfer to only the anterior branch of the axillary nerve will restore useful function following axillary nerve injury with persistent posterior deltoid and teres minor paralysis. Methods We used a computational musculoskeletal model of the upper limb to determine the relative contributions of posterior deltoid and teres minor to maximum joint moment generated during a simulated static strength assessment and to joint moments during 3 sub-maximal shoulder movements. Movement simulations were performed with and without simulated posterior deltoid and teres minor paralysis to identify muscles which may compensate for their paralysis. Results In the unimpaired limb model, teres minor and posterior deltoid accounted for 16% and 14% of the total isometric shoulder extension and external rotation joint moments, respectively. During the 3 movement simulations, posterior deltoid produced as much as 20% of the mean shoulder extension moment, while teres minor accounted for less than 5% of the mean joint moment in all directions of movement. When posterior deltoid and teres minor were paralyzed, the mean extension moments generated by the supraspinatus, long head of triceps, latissimus dorsi, and middle deltoid increased to compensate. Compensatory muscles were not fully activated during movement simulations when posterior deltoid and teres minor were paralyzed. Conclusions Reconstruction of the anterior branch of the axillary nerve only is an appropriate technique for restoring shoulder abduction strength following isolated axillary nerve injury. When shoulder extension strength is compromised by extensive neuromuscular shoulder injury, reconstruction of both the anterior and posterior branches of the axillary nerve should be considered. Clinical Relevance By quantifying the biomechanical role of muscles during sub-maximal movement, in addition to quantifying muscle contributions to maximal shoulder strength, we can inform pre-operative planning and permit more accurate predictions of functional outcomes. PMID:23294649

  14. Aggressive Digital Papillary Adenocarcinoma: Case Report of a Positive Sentinel Lymph Node and Discussion of Utility of Sentinel Lymph Node Biopsy.

    PubMed

    Kempton, Steve J; Navarrete, Andrew D; Salyapongse, A Neil

    2015-07-01

    Aggressive digital papillary adenocarcinoma (ADPA) is an uncommon eccrine sweat gland tumor of the distal extremities that is associated with a high rate of local recurrence and distant metastasis. Current opinion suggests that sentinel lymph node evaluation should be done for high-risk tumors where lymph node spread is a concern. Despite documented spread to regional lymph nodes, information on sentinel lymph node status in ADPA is reported infrequently, with only 1 documented case of positive findings. We report on a case of ADPA of the right long finger where sentinel lymph node biopsy was done and positive for metastases in the axilla, resulting in a subsequent completion lymphadenectomy. To determine the benefit of sentinel lymph node biopsy in ADPA, there is a need for more cases of sentinel lymph node evaluation along with data on local recurrence and distant metastasis in those with positive and negative findings. PMID:25954845

  15. Beyond conventional pathology: towards preoperative and intraoperative lymph node staging.

    PubMed

    Winter, Marnie; Gibson, Rachel; Ruszkiewicz, Andrew; Thompson, Sarah K; Thierry, Benjamin

    2015-02-15

    Accurate detection of lymph node metastases is critical for many solid tumours to guide treatment strategies and determine prognostic outcomes. The gold standard for detection of metastasis is by histological analysis of formalin-fixed paraffin-embedded (FFPE) sections of removed lymph nodes; this analysis method has remained largely unchanged for decades. Recent studies have highlighted limitations in the sensitivity of this approach, at least in its current clinical use, to detect very small metastatic deposits. Importantly, the poor prognostic outcomes associated with the presence of such small tumour deposits are now well established in a number of cancers. In addition, histological analysis of FFPE sections cannot be used practically for intraoperative node assessment. Novel lymph node staging technologies are therefore actively being developed. This review critically presents the main advances in this field and discusses why these technologies have not been able to provide a better alternative to the current gold standard diagnostic technique. PMID:24469881

  16. A case of idiopathic lymph leakage in the neck.

    PubMed

    Suzuki, Masanobu; Morita, Shinya; Iizuka, Keiji

    2010-08-01

    A 48-year-old female patient was seen in our institution complaining of sudden onset of swelling and tenderness in the left side of her neck. Computed tomography and magnetic resonance imaging revealed abundant effusions in this area. Since these narrowed the patient's airway, we performed incisional drainage and intra-operatively we observed a transparent, colorless lymph fluid that oozed from the operative field, which was mainly a fatty layer at the supraclavicular area. Dilated lymphatic ducts were seen along the carotid artery and internal jugular vein, but damaged lymphatic ducts and obvious causative disease structures like tumorous lesions were not seen. Idiopathic lymph leakage was diagnosed due to the serous discharge from the left side of the neck and no apparent causative disease. The patient was successfully treated with incisional drainage and dietary restriction. Lymph leakage in the neck is more common after trauma or surgery. To our knowledge, no similar cases have ever been reported. PMID:20031353

  17. Characteristics of magnetic probes for identifying sentinel lymph nodes.

    PubMed

    Ookubo, Tetsu; Inoue, Yusuke; Kim, Dongmin; Ohsaki, Hiroyuki; Mashiko, Yusuke; Kusakabe, Moriaki; Sekino, Masaki

    2013-01-01

    The identification of the sentinel lymph nodes that cause tumor metastasis is important in breast cancer therapy. The detection of magnetic fluid accumulating in the lymph nodes using a magnetic probe allows surgeons to identify the lymph nodes. In this study, we carried out numerical simulations and experiments to investigate the sensitivity and basic characteristics of a magnetic probe consisting of a permanent magnet and a small magnetic sensor. The measured magnetic flux density arising from the magnetic fluid agreed well with the numerical results. In addition, the results helped realize an appropriate probe configuration for achieving high sensitivity to magnetic fluid. A prototype probe detected magnetic fluid located 30 mm from the probe head. PMID:24110978

  18. Serious axillary nerve injury caused by subscapular artery compression resulting from use of backpacks.

    PubMed

    Haninec, Pavel; Mencl, Libor; Ba?inský, Peter; Kaiser, Radek

    2013-12-01

    A palsy of the brachial plexus elements caused by carrying a heavy backpack is a very rare injury usually occurring in soldiers or hikers, and recovery is usually spontaneous. We describe here the case of male civilian presenting with an isolated serious axillary nerve palsy associated with chronic backpack use. During the surgery, a dumbbell-shaped neuroma-in-continuity was found which was caused by direct pressure from the subscapular artery. After resection of the neuroma, a nerve graft from the sural nerve was used to reconstruct the nerve. Reinnervation was successful and the patient was able to abduct his arm to its full range, with full muscle strength, within 24 months. PMID:23696291

  19. Directional atherectomy of a heavy calcified axillary artery stenosis inducing critical hand ischemia.

    PubMed

    Anzuini, Angelo; Palloshi, Altin; Aprigliano, Gianfranco; Ielasi, Alfonso

    2013-07-01

    The presence of a severe calcified peripheral artery lesion is responsible for a poor response to balloon dilation, due to significant acute vessel recoil and frequent flow-limiting dissections requiring stent implantation. This possibility could be associated with very high compression and/or fracture rates particularly in cases of lesion located at the mobile joints. In this setting directional atherectomy offers the theoretical advantages of eliminating stretch injury on arterial walls and reducing the restenosis rate by direct plaque excision. In this report, we present a case of critical hand ischemia due to a heavily calcified axillary artery lesion managed by directional atherectomy and balloon angioplasty followed by immediate angiographic success and sustained clinical benefit up to 3 years of follow-up. PMID:23371036

  20. Robot-assisted resection of multiple schwannomas of the neck and mediastinum through an axillary approach.

    PubMed

    Ishikawa, Norihiko; Kawaguchi, Masahiko; Moriyama, Hideki; Oda, Makoto; Watanabe, Go

    2012-07-01

    A 49-year-old woman was referred to our department for increased schwannoma of the right neck and mediastinum. We chose a robot-assisted endoscopic approach to minimize the operative trauma. After exposure of the thyroid through the right axilla, the neck tumor was resected using the da Vinci Surgical System. A mini-thoracotomy was then made in the left third intercostal space through the axillary incision, robotic instruments were introduced across the thoracic cavity, and the tumor was excised circumferentially using the robot. Histopathological examination of both specimens revealed schwannomas. This procedure has benefited the patient with good cosmetic results and allowed her to rapidly resume her daily activities. PMID:22309604

  1. Closure of Alternative Vascular Sites, Including Axillary, Brachial, Popliteal, and Surgical Grafts.

    PubMed

    Sheth, Rahul A; Ganguli, Suvranu

    2015-06-01

    Although common femoral arterial access remains the cornerstone for endovascular interventions, alternative arterial access sites such as the brachial, axillary, and popliteal arteries as well as surgical bypass grafts offer additional options when the conventional approach is unavailable or impractical. Each of these alternative access sites features a unique blend of risks and benefits, and the interventionalist should be well versed not only in how to safely enter the arterial system at these locations but also in how to safely exit. Manual compression represents the gold standard method for hemostasis at all vascular access sites, though variations and modifications in the technique exist based on anatomical factors in different arteries. Vascular closure devices widely used for common femoral arteriotomy closure have also been applied in "off-label" settings for multiple additional arteries. In this article, we discuss the pertinent anatomy as well as summarize the literature and anecdotal experience regarding methods for achieving hemostasis at multiple alternative arterial access sites. PMID:26070623

  2. Propagation of Casuarina equisetifolia through axillary buds of immature female inflorescences cultured in vitro.

    PubMed

    Duhoux, E; Sougoufara, B; Dommergues, Y

    1986-06-01

    The study of the actinorhizal symbiosis in Casuarina equisetifolia requires an homogenous plant material. Consequently, we devised a method of micropropagation based on the use of immature female inflorescences (IFI) as explants. IFI excised from an adult tree formed multiple buds after 4-week incubation on Murashige and Skoog medium with 0.05 ?mol 1(-1) NAA and 11.1 ?mol 1(-1) BAP. The axillary buds evolved into 5-6 cm long shoots 5 weeks after the transfer of IFI on a similar medium except for the addition of activated charcoal. Rooting of the shoots was obtained on a third medium, without BAP or charcoal, but with 1 ?mol 1(-1) NAA. The plantlets were transferred into soil. Their growth was satisfactory and no plagiotropic tendency was observed. PMID:24248122

  3. Antioxidant defenses in rat intestine and mesenteric lymph.

    PubMed

    Mohr, D; Umeda, Y; Redgrave, T G; Stocker, R

    1999-01-01

    Dietary oxysterols can reach the circulation and this may contribute to atherosclerosis, where lipid oxidation is thought to be important. There is also evidence that, in rats, peroxidized lipids are absorbed and transported into lymph [Aw TY, Williams MW, Gray L. Absorption and lymphatic transport of peroxidized lipids by rat small intestine in vivo: role of mucosal GSH. Am J Physiol 1992; 262: G99-G106], although the method used to detect lipid peroxides lacked specificity. We tested whether intragastric administration of vegetable oils containing triglyceride hydroperoxides (TG-OOH) to rats resulted in detectable lipid hydroperoxides in mesenteric lymph. Using sensitive HPLC with postcolumn chemiluminescence detection, we were unable to detect hydroperoxides of triglycerides, cholesterylesters or phospholipids during the course of lipid absorption, and lymph levels of ascorbate, urate, alpha-tocopherol and ubiquinol-9 did not change significantly. By contrast, we observed a striking reducing activity judged by the efficient reduction of administered ubiquinones-9 and -10 to the corresponding ubiquinols. Exposure of rat lymph and isolated chylomicrons to aqueous peroxyl radicals revealed patterns of antioxidant consumption and lipid hydroperoxide formation similar to those described previously for human extravascular fluids and isolated lipoproteins, respectively. In particular, rates of TG-OOH formation in lymph and chylomicrons were very low to undetectable as long as ascorbate and/or ubiquinols were present, but subsequently proceeded in a chain reaction despite the presence of alpha-tocopherol. These studies demonstrate that rat intestine and mesenteric lymph possess efficient antioxidant defenses against preformed lipid hydroperoxides and (peroxyl) radical mediated lipid oxidation. We conclude that dietary lipid hydroperoxides or postprandial oxidation of lipids are not likely to contribute to these particular forms of oxidized lipids in circulation and aortic tissue. PMID:10496410

  4. Robust automated lymph node segmentation with random forests

    NASA Astrophysics Data System (ADS)

    Allen, David; Lu, Le; Yao, Jianhua; Liu, Jiamin; Turkbey, Evrim; Summers, Ronald M.

    2014-03-01

    Enlarged lymph nodes may indicate the presence of illness. Therefore, identification and measurement of lymph nodes provide essential biomarkers for diagnosing disease. Accurate automatic detection and measurement of lymph nodes can assist radiologists for better repeatability and quality assurance, but is challenging as well because lymph nodes are often very small and have a highly variable shape. In this paper, we propose to tackle this problem via supervised statistical learning-based robust voxel labeling, specifically the random forest algorithm. Random forest employs an ensemble of decision trees that are trained on labeled multi-class data to recognize the data features and is adopted to handle lowlevel image features sampled and extracted from 3D medical scans. Here we exploit three types of image features (intensity, order-1 contrast and order-2 contrast) and evaluate their effectiveness in random forest feature selection setting. The trained forest can then be applied to unseen data by voxel scanning via sliding windows (11×11×11), to assign the class label and class-conditional probability to each unlabeled voxel at the center of window. Voxels from the manually annotated lymph nodes in a CT volume are treated as positive class; background non-lymph node voxels as negatives. We show that the random forest algorithm can be adapted and perform the voxel labeling task accurately and efficiently. The experimental results are very promising, with AUCs (area under curve) of the training and validation ROC (receiver operating characteristic) of 0.972 and 0.959, respectively. The visualized voxel labeling results also confirm the validity.

  5. Specific Migratory Dendritic Cells Rapidly Transport Antigen from the Airways to the Thoracic Lymph Nodes

    PubMed Central

    Vermaelen, Karim Y.; Carro-Muino, Ines; Lambrecht, Bart N.; Pauwels, Romain A.

    2001-01-01

    Antigen transport from the airway mucosa to the thoracic lymph nodes (TLNs) was studied in vivo by intratracheal instillation of fluorescein isothiocyanate (FITC)-conjugated macromolecules. After instillation, FITC+ cells with stellate morphology were found deep in the TLN T cell area. Using flow cytometry, an FITC signal was exclusively detected in CD11cmed-hi/major histocompatibility complex class II (MHCII)hi cells, representing migratory airway-derived lymph node dendritic cells (AW-LNDCs). No FITC signal accumulated in lymphocytes and in a CD11chiMHCIImed DC group containing a CD8?hi subset (non–airway-derived [NAW]-LNDCs). Sorted AW-LNDCs showed long MHCIIbright cytoplasmic processes and intracytoplasmatic FITC+ granules. The fraction of FITC+ AW-LNDCs peaked after 24 h and had reached baseline by day 7. AW-LNDCs were depleted by 7 d of ganciclovir treatment in thymidine kinase transgenic mice, resulting in a strong reduction of FITC-macromolecule transport into the TLNs. Compared with intrapulmonary DCs, AW-LNDCs had a mature phenotype and upregulated levels of MHCII, B7-2, CD40, and intracellular adhesion molecule (ICAM)-1. In addition, sorted AW-LNDCs from FITC-ovalbumin (OVA)–instilled animals strongly presented OVA to OVA-TCR transgenic T cells. These results validate the unique sentinel role of airway DCs, picking up antigen in the airways and delivering it in an immunogenic form to the T cells in the TLNs. PMID:11136820

  6. Right axillary and femoral artery perfusion with mild hypothermia for aortic arch replacement

    PubMed Central

    2014-01-01

    Objectives Aortic arch replacement is associated with increased mortality and morbidity especially in acute type-A aortic dissection. Although hypothermic circulatory arrest with selective antegrade cerebral perfusion has been widely used because of its excellent cerebral protection, its optimal perfusion characteristics are unknown. The present study investigates clinical results obtained after perfusion method modification and temperature management during cardiopulmonary bypass (CPB). Methods Between July 2010 and August 2012, 16 consecutive adult patients (mean age 50.0 yr?±?14.1 yr, range 25 yr to 73 yr, 12 males, 4 females) who presented with acute Stanford type-A aortic dissection underwent aortic arch replacement (total arch, n?=?11; hemiarch, n?=?5) under mild hypothermia (31.1°C?±?1.5°C) with right axillary and femoral artery perfusion. Results The mean CPB time was 201 min?±?53 min, and the mean myocardial ischemic time was 140 min?±?42 min. The mean selective cerebral perfusion time was 80 min?±?16 min, and the mean lower-body circulatory arrest time was 20 min?±?13 min. No patient death occurred within 30 post-operative days. The following details were observed: new post-operative permanent neurologic deficit in 1 patient (6.3%), temporary neurologic deficit in 2 patients (12.5%), acute renal dysfunction (creatinine level?>?230 umol/L) in 3 patients (18.8%) and mechanical ventilation?>?72 h in 5 patients (31.2%). Conclusions Aortic arch replacement for acute type-A aortic dissection under mild hypothermia with right axillary and femoral artery perfusion could be safely performed in the patient cohort. PMID:24885031

  7. Primary subclavian-axillary vein thrombosis: the relative roles of thrombolysis, percutaneous angioplasty, stents, and surgery.

    PubMed

    Rutherford, R B

    1998-06-01

    This article is based on a review of the literature and a survey of vascular surgeons augmented by more recent reports of new therapeutic approaches. Primary subclavian-axillary vein thrombosis (SAVT) occurs mostly (approximately 70%) in the dominant upper extremity of active healthy patients after a period of unusual exercise or arm positioning. In such patients, most experience severe symptoms, and this outlook is not modified by anticoagulant therapy. These patients should be considered for interventional therapy, beginning with catheter-directed thrombolysis. Although it is clear that the initial management of primary SAVT, by catheter-directed thrombolysis, followed by surgical relief of phlebographically demonstrated extrinsic thoracic outlet compression, is well accepted, the preferred method of dealing with residual intrinsic stenoses and occlusions is still controversial. The durability of percutaneous transluminal angioplasty (PTA) or stents still needs to be defined by long-term follow-up, but kinking or compression of the stent has lead to failure when performed without concomitant thoracic outlet (TO) decompression. Thus, in addition to thrombolysis and TO decompression, residual intrinsic stenoses can be treated either by stenting or by surgical reconstruction, the latter preferably through an extended incision that avoids claviculectomy. Surgical reconstructions are favored only for short, proximal occlusions or for residual stenoses, when performed at the same time as thoracic outlet decompression. First rib removal has lost its popularity in the treatment of postthrombotic occlusion of the subclavian-axillary venous segment and should not be used alone in this setting in the absence of objective proof of positional collateral obstruction. PMID:9671238

  8. Multiple shoot induction from axillary bud cultures of the medicinal orchid, Dendrobium longicornu

    PubMed Central

    Dohling, Stadwelson; Kumaria, Suman; Tandon, Pramod

    2012-01-01

    Background and aims Dendrobium longicornu, commonly known as the ‘Long-horned Dendrobium’, is an endangered and medicinally important epiphytic orchid. Over-exploitation and habitat destruction seriously threaten this orchid in Northeast India. Our objective was to develop an efficient protocol for the mass propagation of D. longicornu using axillary bud segments. Methodology and principal results Axillary buds cultured in Murashige and Skoog semi-solid medium supplemented with ?-naphthalene acetic acid (NAA), 2,4-dichlorophenoxy acetic acid (2,4-D) and 6-benzylaminopurine (BAP) readily developed into plantlets. These formed either directly from shoot buds or from intermediary protocorm-like bodies (PLBs). The maximum explant response (86.6 %) was obtained in medium supplemented with NAA at 30 µM, while the maximum number of shoots (4.42) and maximum bud-forming capacity (3.51) were observed in medium containing 15 µM BAP and 5 µM NAA in combination. Protocorm-like bodies were obtained when the medium contained 2,4-D. The maximum number of explants forming PLBs (41.48 %) was obtained in medium containing 15 µM BAP and 15 µM 2,4-D. Well-developed plantlets obtained after 20–25 weeks of culture were acclimatized and eventually transferred to the greenhouse. Over 60 % of these survived to form plants ?3–4 cm tall after 90 days in glasshouse conditions using a substrate of crushed brick and charcoal, shredded bark and moss. Conclusions The method described can readily be used for the rapid and large-scale regeneration of D. longicornu. Its commercial adoption would reduce the collection of this medicinally important and increasingly rare orchid from the wild. PMID:23136638

  9. Surgical treatment of lymph node metastases from hepatocellular carcinoma

    Microsoft Academic Search

    Shin Kobayashi; Shinichiro Takahashi; Yuichiro Kato; Naoto Gotohda; Toshio Nakagohri; Masaru Konishi; Taira Kinoshita

    2011-01-01

    Background  No consensus has been reached on the feasibility and efficacy of surgery for lymph node metastases (LNM) from hepatocellular\\u000a carcinoma (HCC).\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Of 2189 patients with HCC treated at our hospital between July 1992 and March 2008, we retrospectively reviewed the medical\\u000a dossiers of the 18 patients (0.8%) who underwent lymph node resection and were pathologically diagnosed to have LNM from

  10. Cytokines in mammary lymph and milk during endotoxin-induced bovine mastitis

    Microsoft Academic Search

    K. Persson Waller; I. G. Colditz; S. Lun; K. Östensson

    2003-01-01

    Cytokine kinetics were examined in milk and in afferent and efferent lymph of the supramammary lymph node after intramammary infusion of endotoxin from Escherichia coli. Cows were sampled 0, 2 and 4h after infusion (p.i.). Neutrophils appeared in afferent lymph 2h p.i., and in efferent lymph and milk 4h p.i. The milk contained high concentrations of interleukin-8 (IL-8) at 2

  11. Neurocristic Hamartoma With Lymph Node Involvement: A Diagnostic Dilemma.

    PubMed

    Goyal, Surbhi; Arora, Vinod K; Gupta, Lipy; Singal, Archana; Kaur, Navneet

    2015-07-01

    Neurocristic hamartoma (NH) is a rare dermal melanocytic lesion that is formed due to the aberrant development of neural crest-derived melanocytes during their course of migration through the dermis at the time of embryogenesis. Here, we describe a case of NH in a 6-year-old boy who clinically presented with diffuse plaque-type blue nevus on his scalp with a contiguous extension into the cervical region and lymph node involvement. A subcutaneous nodule displaying a marked histological heterogeneity with lymph node involvement is a very unusual and diagnostically challenging presentation of NH. The importance of an accurate diagnosis of NH lies in the fact that malignant transformation can rarely occur within these lesions over an unpredictable time course and remain undetected, rendering clinical management difficult. Although our child had a benign course after a follow-up of 5 years despite lymph node involvement, the possible risk of development of malignant melanoma in such a lesion warrants long-term surveillance. This case report highlights the unusual clinical presentation and histopathological features of this rare entity along with a relevant review of the literature. The present case also underscores the concept that sentinel lymph node involvement in certain melanocytic lesions in children must not be mistaken for malignant melanoma. PMID:26091517

  12. Adhesive mechanisms governing interferon- producing cell recruitment into lymph nodes

    Microsoft Academic Search

    Thomas G. Diacovo; Amanda L. Blasius; Tak W. Mak; Marina Cella; Marco Colonna

    Natural interferon-producing cells (IPCs) are found in peripheral lymph nodes (PLNs), where they support NK cell, T cell, and B cell responses to pathogens. However, their route of entry and the adhesive mechanisms used to gain access to PLNs remain poorly defined. We report that IPCs can enter PLNs via a hematogenous route, which involves a multistep adhesive process, and

  13. Staging lymph node metastases from lung cancer in the mediastinum

    PubMed Central

    Terán, Mario D.

    2014-01-01

    Background The presence of tumor metastases in the mediastinum is one of the most important elements in determining the optimal treatment strategy in patients with non-small cell lung cancer. This review is aimed at examining the current strategies for investigating lymph node metastases corresponding to an “N2” classification delineated by The International Staging Committee of the International Association for the Study of Lung Cancer (IASLC). Methods Extensive review of the existing scientific literature related to the investigation of mediastinal lymph node metastases was undertaken in order to summarize and report current best practices. Conclusions N2 disease is very heterogeneous requiring multiple modalities for thorough investigation. New research is now focusing on better identifying, defining, and classifying lymph node metastases in the mediastinum. Molecular staging and sub-classifying mediastinal lymph node metastases are being actively researched in order to provide better prognostic value and to optimize treatment strategies. Non-invasive imaging, such as PET/CT and minimally invasive techniques such as endobronchial and endoscopic ultrasound guided biopsy, are now the lead investigative methods in evaluating the mediastinum for metastatic presence. PMID:24624287

  14. Increased concentrations of lysophosphatidylcholine in cardiac lymph from ischemic zones

    SciTech Connect

    Corr, P.B.; Akita, H.; Creer, M.H.; Yamada, K.A.; Sobel, B.E.

    1986-03-01

    The authors have previously shown that lysophosphatidylcholine (LPC) elicits electrophysiological derangements in normoxic cells exposed to low concentrations of LPC with or without albumin in the extracellular fluid. To determine whether such exposure occurs in vivo, concentrations of phospholipids in cardiac lymph were assessed in 7 dogs subjected to myocardial ischemia. In each animal, a cannula was inserted into the supracardiac lymph vessel identified with Evans Blue dye injected into the left ventricular apex. Less than 4% of /sup 14/C-PC (phosphatidyl choline) or /sup 14/C-LPC incubated in cardiac lymph for 30 min at 4/sup 0/C or 90 min at 37/sup 0/C was catabolized (n = 5). Lymph was collected on ice at 15 min intervals throughout 2 hr of ischemia induced by LAD coronary ligation, extracted in CHCl/sub 3/:CH/sub 3/OH (2:1) and phospholipids separated by HPLC. Prior to ischemia, PC constituted the major phospholipid (79 +/- 2%). Substantial quantities of sphinogomeylin (11 +/- 2%) and LPC (6 +/- 1%) were present. With ischemia, LPC concentration increased 134% from 84 +/- 5 to 197 +/- 34 ..mu..M (n = 7, p < .01) judging from the measured concentration and dilution determined with constant infusion of dye into the LV apex. In contrast, PC concentration and efflux did not change. Thus with ischemia LPC increases in interstitial fluid to levels sufficient to induce electrophysiologic derangements in normoxic cells.

  15. Local lymph node assay — validation, conduct and use in practice

    Microsoft Academic Search

    D. A. Basketter; P. Evans; R. J. Fielder; G. F. Gerberick; R. J. Dearman; I. Kimber

    2002-01-01

    The validation of alternative methods is a relatively new activity in toxicology. The local lymph node assay (LLNA), a novel method for the identification of chemicals that have the potential to cause skin sensitization, was the first test to pass through the formal regulatory validation process established in the USA under the auspices of ICCVAM, the Interagency Coordinating Committee on

  16. Local lymph node assay: Validation assessment for regulatory purposes

    Microsoft Academic Search

    G. Frank Gerberick; Cindy A. Ryan; Ian Kimber; Rebecca J. Dearman; Linda J. Lea; David A. Basketter

    2000-01-01

    For the prediction of skin sensitization potential of substances, the murine local lymph node assay (LLNA) is an alternative to the widely used guinea pig tests. For more than 10 years, this method has undergone extensive development, evaluation, and validation. In this review, the validation status of the LLNA is considered, specifically with regard to its use for regulatory identification

  17. [Lymph node metastasis in superficial squamous carcinoma of the esophagus].

    PubMed

    Takubo, K; Makuuchi, H; Arima, M; Aida, J; Arai, T; Vieth, M

    2013-03-01

    The definition of early carcinoma of the esophagus has changed with time on the basis of new data. As from 2007 an early carcinoma is defined as an intramucosal carcinoma with or without metastasis. In the subclassification based on invasion depth, m1 and m2 squamous cell carcinomas have no metastasis and are considered curable by endoscopic resection alone, whereas less than 10% of m3 carcinomas and some 20% of sm1 squamous cell carcinomas have lymph node metastasis. In this article the relationship between various histopathological findings and the incidence of lymph node metastasis is reviewed. The m3 and sm1 superficial squamous cell carcinomas showing 0-I and 0-III types, large tumors over 50 mm in size or those showing vessel permeation have higher incidences of lymph node metastasis. In the field of gastrointestinal surgical pathology pathologists are now expected to not only diagnose the presence or absence of malignancy but also to investigate in detail many of the histological factors related to the prevalence of lymph node metastasis. PMID:23420516

  18. Prostanoid induces premetastatic niche in regional lymph nodes.

    PubMed

    Ogawa, Fumihiro; Amano, Hideki; Eshima, Koji; Ito, Yoshiya; Matsui, Yoshio; Hosono, Kanako; Kitasato, Hidero; Iyoda, Akira; Iwabuchi, Kazuya; Kumagai, Yuji; Satoh, Yukitoshi; Narumiya, Shuh; Majima, Masataka

    2014-11-01

    The lymphatic system is an important route for cancer dissemination, and lymph node metastasis (LNM) serves as a critical prognostic determinant in cancer patients. We investigated the contribution of COX-2-derived prostaglandin E2 (PGE2) in the formation of a premetastatic niche and LNM. A murine model of Lewis lung carcinoma (LLC) cell metastasis revealed that COX-2 is expressed in DCs from the early stage in the lymph node subcapsular regions, and COX-2 inhibition markedly suppressed mediastinal LNM. Stromal cell-derived factor-1 (SDF-1) was elevated in DCs before LLC cell infiltration to the lymph nodes, and a COX-2 inhibitor, an SDF-1 antagonist, and a CXCR4 neutralizing antibody all reduced LNM. Moreover, LNM was reduced in mice lacking the PGE2 receptor EP3, and stimulation of cultured DCs with an EP3 agonist increased SDF-1 production. Compared with WT CD11c+ DCs, injection of EP3-deficient CD11c+ DCs dramatically reduced accumulation of SDF-1+CD11c+ DCs in regional LNs and LNM in LLC-injected mice. Accumulation of Tregs and lymph node lymphangiogenesis, which may influence the fate of metastasized tumor cells, was also COX-2/EP3-dependent. These results indicate that DCs induce a premetastatic niche during LNM via COX-2/EP3-dependent induction of SDF-1 and suggest that inhibition of this signaling axis may be an effective strategy to suppress premetastatic niche formation and LNM. PMID:25271626

  19. Cervical Lymph Node Metastasis Model of Pyriform Sinus Carcinoma

    Microsoft Academic Search

    Na Shen; Haitao Wu; Xiuyin Xu; Jianzhong Wang; Matthew R. Hoffman; Adam L. Rieves; Liang Zhou

    2009-01-01

    Objective: To establish a cervical lymph node metastasis model of pyriform sinus VX2 carcinoma and investigate its metastatic features. Methods: VX2 tumor tissue suspension was transplanted into the pyriform sinus submucosa of 15 rabbits under direct laryngoscopy. Rabbits were randomly placed into 1 of 3 groups, each comprised of 5 rabbits. Health evaluation and histopathological analysis were performed on days

  20. Stimulation of axillary shoot development and concentration of fruit set in cucumber, Cucumis sativus L., as a result of chemical inactivation of the apical meristem 

    E-print Network

    Campbell, Gary Davis

    1969-01-01

    Two saturated fatty acid derivatives, methyl de- canoate and decyl alcohol, were compared for stimula- tion of axillary shoot development in the pickling cucumber MSU-35-G, a gynoecious breeding line. Both chemicals stimulated increased axillary... shoot develop- ment within certain concentration ranges, but decyl alcohol had a wider effective concentration range. The effect of decyl alcohol on once-over harvest fruit yield was evaluated, with appLications made at 3 different leaf stages. Both...

  1. Breakdown of self-incompatibility in a natural population of Petunia axillaris (Solanaceae) in Uruguay containing both self-incompatible and self-compatible plants

    Microsoft Academic Search

    Tatsuya Tsukamoto; T. Ando; Hisashi Kokubun; Hitoshi Watanabe; Masahiro Masada; X. Zhu; Eduardo Marchesi; T. Kao

    1999-01-01

    Many members of the Solanaceae display a type of gametophytic self-incompatibility which is controlled by a single multiallelic\\u000a locus, called the S-locus. From our previous survey of more than 100 natural populations of Petunia axillaris (a solanaceous species) in Uruguay, we had found that the majority of the populations of subspecies axillaris were comprised of virtually all self-incompatible individuals. The

  2. Pharmacokinetics and efficacy of 40 ml ropivacaine 7.5 mg\\/ml (300 mg), for axillary brachial plexus block — an open pilot study

    Microsoft Academic Search

    W. Wank; J. Büttner; K. Rissler Maier; B.-M. Emanuelson; D. Selander

    2002-01-01

    Summary  In this study, the pharmacokinetics, tolerability and efficacy of 40 ml of ropivacaine 7.5 mg\\/ml (300 mg) for axillary brachial\\u000a plexus block were investigated. With institutional review board approval, 10 patients presenting for surgery of the upper\\u000a limb were enrolled in this open study. The axillary plexus was identified with a nerve stimulator and the study drug was injected\\u000a into

  3. Prevalence and Characterization of Salmonella in Bovine Lymph Nodes Potentially Destined for Use in Ground Beef

    Technology Transfer Automated Retrieval System (TEKTRAN)

    A potential source of pathogenic bacteria in ground beef is the lymphatic system, specifically the lymph nodes. There are several reports of bacteria isolated from the lymph nodes of cattle at slaughter; however, most of the studies have dealt with mesenteric lymph nodes that are not normally incor...

  4. Omission of Mediastinal Lymph Node Dissection in Lung Cancer: Its Techniques and Diagnostic Procedures

    Microsoft Academic Search

    Hiroaki Nomori; Kazunori Iwatani; Hironori Kobayashi; Atsushi Mori; Shouichi Yoshioka

    To reduce or omit a mediastinal lymph node dissection in the patients with clinical stage I non-small cell lung cancer (NSCLC), several authors examined the prevalence of metastatic sites of lymph nodes. Because lymphatic drainage usually heads for the upper mediastinum in upper lobe cancer and for the lower mediastinum in lower lobe cancer, upper and lower mediastinal lymph node

  5. Head and Neck Lymph Node Region Delineation with 3-D CT Image Registration

    E-print Network

    Shapiro, Linda

    Head and Neck Lymph Node Region Delineation with 3-D CT Image Registration Chia-Chi Teng , Mary M for automatically selecting and adapting standardized regions of tumor spread based on the location of lymph nodes the GTV plus the lymph node regions around it. Microscopic disease cannot currently be im- aged by any

  6. The Role of Interval Nodes in Sentinel Lymph Node Mapping and Dissection for Melanoma Patients

    Microsoft Academic Search

    Maurice Matter; Marie Nicod Lalonde; Mohamed Allaoua; Ariane Boubaker; Danielle Li ´ enard; Oliver Gugerli; Jean-Philippe Cerottini; Hanifa Bouzourene; Angelika Bischof Delaloye; Ferdinand Lejeune

    In sentinel node (SN) biopsy, an interval SN is defined as a lymph node or group of lymph nodes located between the primary melanoma and an anatomically well-defined lymph node group directly draining the skin. As shown in previous reports, these interval SNs seem to be at the same metastatic risk as are SNs in the usual, classic areas. This

  7. Prognostic significance of lymph node ratio in patients with Merkel cell carcinoma.

    PubMed

    Fochtmann, Alexandra; Haymerle, Georg; Kunstfeld, Rainer; Pammer, Johannes; Grasl, Matthaeus Ch; Erovic, Boban M

    2015-07-01

    Merkel cell carcinoma is a rare and aggressive metastasizing tumor of the skin. Lymph node metastasis is a significant clinical prognostic factor for overall and disease-free survival in patients with Merkel cell carcinoma. A retrospective medical chart review of 12 Merkel cell carcinoma patients was performed. All patients received treatment at the Medical University of Vienna and underwent lymph node dissection between 1994 and 2013. The lymph node ratio was determined by dividing the total number of positive lymph nodes by the entire number of dissected lymph nodes. A positive lymph node ratio was defined as a number >0 and the negative lymph node ratio was defined by zero. The median follow-up was 44 months (range 4-92). A positive lymph node ratio (range 1.00-0.04) was found in 7 (58 %) out of 12 patients of whom 5 (71 %) died of disease. A negative lymph node ratio was found in 5 (42 %) out of 12 patients of whom 2 (40 %) patients died of disease. The disease-specific death rate was higher in patients diagnosed with a positive lymph node ratio compared to patients diagnosed with a negative lymph node ratio. Based on these preliminary findings, there might be a prognostic impact of lymph node ratio in patients suffering from Merkel cell carcinoma. PMID:24906842

  8. Rationale for Central and Bilateral Lymph Node Dissection in Sporadic and Hereditary Medullary Thyroid Cancer

    Microsoft Academic Search

    CLAUDIA SCOLLO; ERIC BAUDIN; JEAN-PAUL TRAVAGLI; BERNARD CAILLOU; NICOLAS BELLON; SOPHIE LEBOULLEUX; MARTIN SCHLUMBERGER

    A retrospective study was performed on 101 consecutive med- ullary thyroid cancer (MTC) patients who underwent at In- stitut Gustave-Roussy (IGR) total thyroidectomy with central and bilateral lymph node dissection. At histology, lymph node metastases were found in 55% of patients. In sporadic MTC, lymph node metastases were observed in the central compart- ment in 50% of patients, in the

  9. Three-dimensional quantitative ultrasound to guide pathologists towards metastatic foci in lymph nodes

    E-print Network

    Illinois at Urbana-Champaign, University of

    -excised lymph nodes from cancer patients during lymphadenectomy is critically important for cancer staging-excised lymph nodes from cancer patients undergoing a lymphadenectomy. Our group previously described the basis of our innovative 3D QUS methods to characterize lymph-node tissues from cancer patients [4]. Our methods

  10. Investigating mediastinal lymph node stations segmentation on thoracic CT following experts

    E-print Network

    Paris-Sud XI, Université de

    Introduction Mediastinal and hilar lymph node involvement often occurs in lung cancer. A reference definition of lymph node station anatomy was recently updated by the IASLC Lung Cancer Staging Project cancer on CT images. This atlas has been superseded by the new IASLC lymph node. Lynch et al [9] have

  11. In Vitro Investigation of Lymph Node Metastasis of Colorectal Cancer Using Ultrasonic Spectral Parameters

    Microsoft Academic Search

    Tomoaki Noritomi; Junji Machi; Ernest J Feleppa; Eugene Yanagihara; Kazuo Shirouzu

    1998-01-01

    Lymph node involvement is one of the major factors affecting the prognosis of colorectal cancer. Various imaging methods, including ultrasound and computed tomography, are not sufficiently sensitive or specific for reliably determining lymph node involvement. We investigated the feasibility of using ultrasonic tissue characterization (UTC) based on spectrum analysis of backscattered echo signals for diagnosing lymph node metastasis of colorectal

  12. Salvage Pelvic Lymph Node Dissection after Radical Prostatectomy for Biochemical and Lymph Node Recurrence.

    PubMed

    Peeters, Charlotte; Ponette, Diederik; van Poppel, Hendrik

    2014-09-01

    Prostate cancer is the most common male malignancy. Radiation therapy and radical prostatectomy are the main curative treatment options for organ confined disease. Despite the good long-term oncologic outcomes, roughly 40% of patients undergoing surgery develop biochemical recurrence, manifested as a rising prostate-specific antigen (PSA). Those patients are at higher risk of developing a local or distant recurrence. The diagnosis of a nodal recurrence is challenging. This report is about a 66-year-old male, who had a radical prostatectomy in 2006. Postoperatively, the PSA was never undetectable. Radiotherapy was delivered in 2007, but the PSA rose again. Anti-androgen therapy was started, but he developed painful mastodynia. A ((11)C) choline PET-CT showed an enlarged suspicious lymph node at the left common iliac and a salvage pelvic lymphadenectomy was performed. Postoperatively, the PSA remained undetectable for the last 5 years. The use of lesion - targeted therapy for oligometastatic disease is a new concept in urology, aiming at reducing the tumor burden. Therefore, even though this surgical approach might not be associated with a durable response over time, the tumor load is decreased and further cancer progression might be delayed, allowing to postpone the delivery of hormone therapy. © 2014 S. Karger AG, Basel. PMID:25228162

  13. Expression of aquaporin 5 in primary carcinoma and lymph node metastatic carcinoma of non-small cell lung cancer

    PubMed Central

    SONG, TIANHE; YANG, HONG; HO, JAMES CHUNG MAN; TANG, SYDNEY CHI WAI; SZE, STEPHEN CHO WING; LAO, LIXING; WANG, YING; ZHANG, KALIN YANBO

    2015-01-01

    Aquaporin 5 (AQP5), a water channel protein, is highly expressed in non-small cell lung cancer (NSCLC) tissues compared with adjacent normal tissues. AQP5 expression in lung cancer tissues is associated with a poor prognosis. The present study aimed to analyze the expression of AQP5 and investigate its role in primary and lymph node metastatic NSCLCs. An immunohistochemical labeled streptavidin-biotin method was used to determine the expression of AQP5 in 94 cases of NSCLC primary carcinoma, which included 51 cases accompanied by lymph node metastasis. The results revealed that the expression of AQP5 was significantly higher in adenocarcinomas compared with squamous cell carcinomas (P=0.002). In addition, the percentage of AQP5 expression in the primary carcinomas with lymph node metastasis was significantly higher compared with those without lymph node metastasis (P=0.024). However, no statistically significant difference in the percentage of AQP5 expression was observed between the metastatic and the primary carcinomas (P=0.377). The expression of AQP5 exhibited a correlation with the tumor-node-metastasis staging of NSCLC (P=0.027). The percentage of AQP5 expression in stage III and IV tumors was higher than that in stage I and II tumors. In addition, AQP5 expression was correlated with the survival rate of NSCLC patients (P=0.051). In conclusion, the results of the present study provide evidence for the AQP5-facilitated incidence, progression and metastasis of NSCLC. Therefore, AQP5 may be used as a potential target to investigate the incidence, progression and metastasis of NSCLC. PMID:26137150

  14. Proteomic biomarkers predicting lymph node involvement in serum of cervical cancer patients. Limitations of SELDI-TOF MS

    PubMed Central

    2012-01-01

    Background Lymph node status is not part of the staging system for cervical cancer, but provides important information for prognosis and treatment. We investigated whether lymph node status can be predicted with proteomic profiling. Material & methods Serum samples of 60 cervical cancer patients (FIGO I/II) were obtained before primary treatment. Samples were run through a HPLC depletion column, eliminating the 14 most abundant proteins ubiquitously present in serum. Unbound fractions were concentrated with spin filters. Fractions were spotted onto CM10 and IMAC30 surfaces and analyzed with surface-enhanced laser desorption time of flight (SELDI-TOF) mass spectrometry (MS). Unsupervised peak detection and peak clustering was performed using MASDA software. Leave-one-out (LOO) validation for weighted Least Squares Support Vector Machines (LSSVM) was used for prediction of lymph node involvement. Other outcomes were histological type, lymphvascular space involvement (LVSI) and recurrent disease. Results LSSVM models were able to determine LN status with a LOO area under the receiver operating characteristics curve (AUC) of 0.95, based on peaks with m/z values 2,698.9, 3,953.2, and 15,254.8. Furthermore, we were able to predict LVSI (AUC 0.81), to predict recurrence (AUC 0.92), and to differentiate between squamous carcinomas and adenocarcinomas (AUC 0.88), between squamous and adenosquamous carcinomas (AUC 0.85), and between adenocarcinomas and adenosquamous carcinomas (AUC 0.94). Conclusions Potential markers related with lymph node involvement were detected, and protein/peptide profiling support differentiation between various subtypes of cervical cancer. However, identification of the potential biomarkers was hampered by the technical limitations of SELDI-TOF MS. PMID:22694804

  15. GELSOLIN IS DEPLETED IN POST-SHOCK MESENTERIC LYMPH

    PubMed Central

    Jordan, Janeen R.; Moore, Ernest E.; Damle, Sagar S.; Eckels, Phillip; Johnson, Jeffrey L.; Roach, Jonathan P.; Redzic, Jasmina S.; Hansen, Kirk C.; Banerjee, Anirban

    2009-01-01

    Background Gelsolin is a plasma protein that functions to depolymerize actin filaments preventing capillary plug formation following tissue injury. It also functions to mediate the inflammatory response by binding proinflammatory lipids such as lysophosphatidic acid, sphingosine-1-phosphate and phosphoinositides. Clinically, reduced gelsolin concentrations have been associated with increased mortality in critically ill, trauma and burn patients. We have previously shown that following hemorrhagic shock with splanchnic hypoperfusion, mesenteric lymph contains lipid components that cause neutrophil and EC activation and that protein concentrations are severely diluted due to resuscitation. We hypothesized that lipid binding proteins such as gelsolin may be depleted after trauma/hemorrhagic shock leading to increased lipid bioactivity. Methods Shock was induced in SD rats by controlled hemorrhage and the mesenteric duct cannulated for lymph collection. Resuscitation was performed by infusing 2x SB volume in NS over 30min, followed by ½ SB volume over 30min, then 2x SB volume in NS over 60min. Pre and post-shock lymph was loaded at equal protein concentrations on 2D-gels, followed by trypsin digestion and identification with mass spectrometry (MS-MS). Proteomics data was confirmed with Western blotting then quantitated by densitometry. ANOVA was used evaluate statistical data. Results Gelsolin decreased in mesenteric lymph following hemorrhagic shock. Conclusion Gelsolin is found at high levels (comparable to plasma) in mesenteric lymph. Following hemorrhagic shock, gelsolin levels decrease significantly possibly due to consumption by the actin scavenging system. The magnitude of this change in concentration could release lipid bioactivity and predispose the lung and other organs to capillary injury. PMID:17950082

  16. Treatment factors affecting breast cancer-related lymphedema after systemic chemotherapy and radiotherapy in stage II/III breast cancer patients.

    PubMed

    Jung, So-Youn; Shin, Kyung Hwan; Kim, Myungsoo; Chung, Seung Hyun; Lee, Seeyoun; Kang, Han-Sung; Lee, Eun Sook; Kwon, Youngmee; Lee, Keun Seok; Park, In Hae; Ro, Jungsil

    2014-11-01

    We evaluated whether the sequence or regimen of systemic chemotherapy could be a risk factor for breast cancer-related lymphedema (LE). We retrospectively analyzed 848 patients with stage II/III breast cancer who underwent curative surgery with adequate systemic therapy from 2004 to 2009. Adjuvant chemotherapy (ACT) was performed in 552 patients (65.1 %) and neoadjuvant chemotherapy (NAC) in 296 (34.9 %). We evaluated the incidence of LE based on clinicopathological factors and treatments. At a median follow-up of 5.1 years, 358 patients (42.2 %) had experienced LE and 243 (28.7 %) had retained (persistent LE) [120/552 (21.7 %) with ACT vs. 123/296 (41.6 %) with NAC; P < 0.001]. The incidence of LE in patients with taxane was greater than in those without taxane [233/704 (33.1 %) vs. 10/144 (6.9 %); P < 0.001]. Multivariate analysis showed that NAC [hazard ratio (HR), 1.63 in LE event; P < 0.001; HR, 1.39 in persistent LE; P = 0.02] and RT including supraclavicular area (SCRT) (HR 1.55; P = 0.02; HR 1.93; P = 0.006), number of dissected axillary lymph nodes (N-ALNs) >10 (HR, 1.37; P = 0.01; HR, 1.71; P = 0.001), advanced stage (HR, 1.31; P = 0.03; HR, 1.60; P = 0.002), and taxane (HR, 1.69; P = 0.03; HR, 2.07; P = 0.04) were independent risk factors for the LE occurrence. In addition to advanced stage, N-ALNs and SCRT, NAC, and taxane were shown to increase the risk of LE, which could help clinicians identify patients at risk for LE. PMID:25253173

  17. Curative use of forequarter amputation for recurrent breast cancer over an axillary area: a case report and literature review.

    PubMed

    Tsai, Chun-Hao; Tzeng, Huey-En; Juang, Wei-Kae; Chu, Pei-Guo; Fann, Patricia; Fong, Yi-Chin; Hsu, Horng-Chaung; Yen, Yun

    2014-01-01

    Axillary recurrence of breast cancer that involves the brachial neurovascular bundle is uncommon. However, for many patients with such recurrence, forequarter amputation can play a palliative role in relieving excruciating pain and paralysis of the upper limb. Further, for those patients who do not have distant metastasis or other local-regional recurrence, forequarter amputation provides a chance for a cure. Only a few case reports of curative amputations for recurrent breast cancer are present in the literature. Here, we report a case of forequarter amputation for curative treatment of axillary recurrent breast cancer, together with a literature review. To date, we have followed the patient for three years after amputation, during which there has been no evidence of recurrence or metastasis. Although radical resection is feasible, it can be accompanied by surgical wound complications and psychosocial stress. Therefore, an organized multidisciplinary approach is needed to ensure the success of radical resection. PMID:25407045

  18. Cooling by frozen gel pack as pain relief during treatment of axillary hyperhidrosis with botulinum toxin a injections.

    PubMed

    Skiveren, Jette; Kjaerby, Emmy; Nordahl Larsen, Heidi

    2008-01-01

    Botulinum toxin A injection is a well-described efficacious treatment for axillary hyperhidrosis. Although considered a safe treatment, many patients experience pain during injections. The purpose of the present study was to examine whether cooling by frozen gel packs applied in the axilla for 5 min before treatment could reduce pain. Thirty-six patients with axillary hyperhidrosis were included in this randomized, open-label prospective study, in which patients were their own controls. Pain was assessed before, during (four times), and immediately after treatment, using a numeric rating scale. The patients experienced statistically significant pain reduction, of 14-19%, in areas cooled by frozen gel pack (p<0.01). However, the clinical relevance of this relatively small pain reduction is questionable. PMID:18709307

  19. Combination of Ex Vivo Sentinel Lymph Node Mapping and Methylene Blue-Assisted Lymph Node Dissection in Gastric Cancer: A Prospective and Randomized Study

    Microsoft Academic Search

    Bruno Märkl; Alexandra I. Moldovan; Hendrik Jähnig; Claudio Cacchi; Hanno Spatz; Matthias Anthuber; Daniel V. Oruzio; Hallie Kretsinger; Hans M. Arnholdt

    2011-01-01

    Background  Exact lymph node (LN) staging is crucial for prognosis estimation and treatment stratification in gastric cancer. Recently,\\u000a a new concept for improving LN harvest and the accuracy of LN staging was introduced. It combines methylene blue-assisted\\u000a lymph node dissection (MBLND) with a new ex vivo sentinel lymph node (evSLN) mapping technique. The purpose of this study\\u000a was to investigate these

  20. Immunomorphologic study of regional lymph nodes in cancer: Response of regional lymph node cells from gastric and colorectal cancer to PHA stimulation

    Microsoft Academic Search

    Osamu Kojima; Yoshihiro Fujita; Akimune Oh; Masakazu Sakita; Bunzo Nishioka; Susumu Majima

    1980-01-01

    To obtain information regarding the immunologic capacity of uninvolved regional lymph nodes (RLNs) draining tumor, the in\\u000a vitro response of regional lymph node cells (RLNCs) to PHA was investigated in lymph nodes from 55 patients with gastric or\\u000a colorectal cancer, and gastric ulcer. Evaluation of data relative to cancer progress demonstrated that, in gastric cancer\\u000a patients, the response of stimulated

  1. Cryopreservation of in vitro-grown axillary shoot-tip meristems of mint ( Mentha spicata L.) by encapsulation vitrification

    Microsoft Academic Search

    D. Hirai; A. Sakai

    1999-01-01

    Alginate-coated meristems from in vitro-grown axillary buds of mint (Mentha spicata L.) were successfully cryopreserved by vitrification. Excised meristems from nodal segments cold hardened at 4??°C for 3\\u000a weeks were encapsulated and osmoprotected by a mixture of 2?M glycerol plus 0.4?M sucrose. These meristems were dehydrated with a highly concentrated vitrification solution (PVS2 solution) for 3?h at 0??°C\\u000a prior to

  2. Topographic pattern of the brachial plexus at the axillary fossa through real-time ultrasonography in Koreans

    PubMed Central

    Han, Jin Hye; Kim, Jong Hak; Kim, Dong Yeon; Lee, Guie Yong; Kim, Chi Hyo

    2014-01-01

    Background The ability to explore the anatomy has improved our appreciation of the brachial anatomy and the quality of regional anesthesia. Using real-time ultrasonography, we investigated the cross-sectional anatomy of the brachial plexus and of vessels at the axillary fossa in Koreans. Methods One hundred and thirty-one patients scheduled to undergo surgery in the region below the elbow were enrolled after giving their informed written consent. Using the 5-12 MHz linear probe of an ultrasound system, we examined cross-sectional images of the brachial plexus in the supine position with the arm abducted by 90°, the shoulder externally rotated, and the forearm flexed by 90° at the axillary fossa. The results of the nerve positions were expressed on a 12-section pie chart and the numbers of arteries and veins were reported. Results Applying gentle pressure to prevent vein collapse, the positions of the nerves changed easily and showed a clockwise order around the axillary artery (AA). The most frequent positions were observed in the 10-11 section (79.2%) for the median, 1-2 section (79.3%) for the ulnar, 3-5 section (78.4%) for the radial, and 8-9 section (86.9%) for the musculocutaneous nerve. We also noted anatomical variations consisting of double arteries (9.2%) and multiple axillary veins (87%). Conclusions Using real-time ultrasonography, we found that the anatomical pattern of the major nerves in Koreans was about 80% of the frequent position of individual nerves, 90.8% of the single AA, and 87% of multiple veins around the AA. PMID:25473459

  3. In Vitro Propagation of Jojoba (Simmondsia chinensis L.) through Alginate-encapsulated Shoot Apical and Axillary Buds

    Microsoft Academic Search

    NOAMAN SHAWKY HASSAN

    Regrowth of apical and axillary buds of jojoba after encapsulation in calcium alginate matrix was evaluated. These buds were derived from in vitro cultured shoots. Encapsulation was performed with 6% sodium alginate and 100 mM CaCl2. Morphogenic response and percentage of conversion into plantlets of encapsulated buds on various planting media was described. Encapsulated buds exhibited the best shoot development

  4. Effects of thidiazuron and benzyladenine on axillary shoot proliferation of three green ash (Fraxinus pennsylvanica Marsh.) clones

    Microsoft Academic Search

    Mee-Sook Kim; Carol M. Schumann; Ned B. Klopfenstein

    1997-01-01

    Mature seeds of three green ash (Fraxinus pennsylvanica Marsh.) clones, SD1009 (South Dakota origin), SD2002 (South Dakota origin), and KA2018 (Kansas origin) were cut to remove the apical portion and germinated on Murashige and Skoog (1962) salts with B5 vitamins (Gamborg et al., 1968) (MSB5) medium without plant growth regulators. Stable axillary shoot establishment was achieved for all three clones

  5. Lymph node staging of oral and maxillofacial neoplasms in 31 dogs and cats.

    PubMed

    Herring, Erin S; Smith, Mark M; Robertson, John L

    2002-09-01

    A retrospective study was performed to report the histologic examination results of regional lymph nodes of dogs and cats with oral or maxillofacial neoplasms. Twenty-eight dogs and 3 cats were evaluated. Histologic examination results of standard and serial tissue sectioning of regional lymph nodes were recorded. When available, other clinical parameters including mandibular lymph node palpation, thoracic radiographs, and pre- and postoperative fine needle aspiration of lymph nodes were compared with the histologic results. Squamous cell carcinoma, fibrosarcoma, and melanoma were the most common neoplasms diagnosed in dogs. Squamous cell carcinoma and fibrosarcoma were diagnosed in cats. Of the palpably enlarged mandibular lymph nodes, 17.0% had metastatic disease histologically. Radiographically evident thoracic metastatic disease was present in 7.4% of cases. Preoperative cytologic evaluation of the mandibular lymph node based on fine needle aspiration concurred with the histologic results in 90.5% of lymph nodes examined. Postoperative cytologic evaluation of fine needle aspirates of regional lymph nodes concurred with the histologic results in 80.6% of lymph nodes examined. Only 54.5% of cases with metastatic disease to regional lymph nodes had metastasis that included the mandibular lymph node. Serial lymph node sectioning provided additional information or metastasis detection. Cytologic evaluation of the mandibular lymph node correlates positively with histology, however results may fail to indicate the presence of regional metastasis. Assessment of all regional lymph nodes in dogs and cats with oral or maxillofacial neoplasms will detect more metastatic disease than assessing the mandibular lymph node only. PMID:12382529

  6. In vivo quantification of lymph viscosity and pressure in lymphatic vessels and draining lymph nodes of arthritic joints in mice

    PubMed Central

    Bouta, Echoe M; Wood, Ronald W; Brown, Edward B; Rahimi, Homaira; Ritchlin, Christopher T; Schwarz, Edward M

    2014-01-01

    Rheumatoid arthritis (RA) is a chronic inflammatory joint disease with episodic flares. In TNF-Tg mice, a model of inflammatory–erosive arthritis, the popliteal lymph node (PLN) enlarges during the pre-arthritic ‘expanding’ phase, and then ‘collapses’ with adjacent knee flare associated with the loss of the intrinsic lymphatic pulse. As the mechanisms responsible are unknown, we developed in vivo methods to quantify lymph viscosity and pressure in mice with wild-type (WT), expanding and collapsed PLN. While no differences in viscosity were detected via multiphoton fluorescence recovery after photobleaching (MP-FRAP) of injected FITC-BSA, a 32.6% decrease in lymph speed was observed in vessels afferent to collapsed PLN (P?lymph node pressure (LNP) demonstrated a decrease in expanding PLN versus WT pressure (3.41?±?0.43 vs. 6.86?±?0.56?cmH2O; P?lymph viscosity and lymphatic pressure, and provide evidence to support the hypothesis that lymphangiogenesis and lymphatic transport are compensatory mechanisms to prevent synovitis via increased drainage of inflamed joints. Furthermore, the decrease in lymphatic flow and loss of LPP during PLN collapse are consistent with decreased drainage from the joint during arthritic flare, and validate these biomarkers of RA progression and possibly other chronic inflammatory conditions. PMID:24421350

  7. Extended lymph node dissection in robot-assisted radical prostatectomy: lymph node yield and distribution of metastases

    PubMed Central

    Kim, Kwang Hyun; Lim, Sey Kiat; Koo, Kyo Chul; Han, Woong Kyu; Hong, Sung Joon; Rha, Koon Ho

    2014-01-01

    In this study, we reported our experience performing robotic extended lymph node dissection (eLND) in patients with prostate cancer. A total of 147 patients with intermediate and high-risk prostate cancer who underwent robotic eLND from May 2008 to December 2011 were included in this analysis. The dissection template extended to the ureter crossing the iliac vessels. We assessed lymph node yield, lymph node positivity, and perioperative outcomes. Lymph node positivity was also evaluated according to the number of lymph nodes (LNs) removed (<22 vs ?22). The median number of LNs removed was 22 (11–51), and 97 positive LNs were found in 24 patients (16.3%). While the obturator fossa was the most common site for LN metastases (42.3%, 41/97), the internal iliac area was the most common area for a single positive LN packet (20.8%, 5/24). Eight patients (33.3%, 8/24) had positive LNs at the common iliac area. The incidence of positive LNs did not differ according to the number of LNs removed. Complications associated with eLND occurred in 21 patients (14.3%) and symptomatic lymphocele was found in five patients (3.4%). In conclusion, robotic eLND can be performed with minimal morbidity. Furthermore, LN yield and the node positive rate achieved using this robotic technique are comparable to those of open series. In addition, the extent of dissection is more important than the absolute number of LNs removed in eLND, and the robotic technique is not a prohibitive factor for performing eLND. PMID:25038184

  8. Comparison of axillary bud growth and patatin accumulation in potato leaf cuttings as assays for tuber induction

    NASA Technical Reports Server (NTRS)

    Wheeler, R. M.; Hannapel, D. J.; Tibbitts, T. W.

    1988-01-01

    Single-node leaf cuttings from potatoes (Solanum tuberosum L.) cvs. Norland, Superior, Norchip, and Kennebec, were used to assess tuber induction in plants grown under 12, 16, and 20 h daily irradiation (400 micromol s-1 m-2 PPF). Leaf cuttings were taken from plants at four, six and 15 weeks after planting and cultured for 14 d in sand trays in humid environments. Tuber induction was determined by visually rating the type of growth at the attached axillary bud, and by measuring the accumulation of the major tuber protein, patatin, in the base of the petioles. Axillary buds from leaf cuttings of plants grown under the 12 h photoperiod consistently formed round, sessile tubers at the axils for all four cultivars at all harvests. Buds from cuttings of plants grown under the 16 and 20 h photoperiods exhibited mixed tuber, stolon, and leafy shoot growth. Patatin accumulation was highest in petioles of cuttings taken from 12 h plants for all cultivars at all harvests, with levels in 16 and 20 h cuttings approx. one-half that of the 12 h cuttings. Trends, both in visual ratings of axillary buds and in petiole patatin accumulation, followed the harvest index (ratio of tuber to total plant dry matter), suggesting that either method is an acceptable assay for tuber induction in the potato.

  9. SUPPRESSOR OF MORE AXILLARY GROWTH2 1 controls seed germination and seedling development in Arabidopsis.

    PubMed

    Stanga, John P; Smith, Steven M; Briggs, Winslow R; Nelson, David C

    2013-09-01

    Abiotic chemical signals discovered in smoke that are known as karrikins (KARs) and the endogenous hormone strigolactone (SL) control plant growth through a shared MORE AXILLARY GROWTH2 (MAX2)-dependent pathway. A SL biosynthetic pathway and candidate KAR/SL receptors have been characterized, but signaling downstream of MAX2 is poorly defined. A screen for genetic suppressors of the enhanced seed dormancy phenotype of max2 in Arabidopsis (Arabidopsis thaliana) led to identification of a suppressor of max2 1 (smax1) mutant. smax1 restores the seed germination and seedling photomorphogenesis phenotypes of max2 but does not affect the lateral root formation, axillary shoot growth, or senescence phenotypes of max2. Expression of three transcriptional markers of KAR/SL signaling, D14-LIKE2, KAR-UP F-BOX1, and INDOLE-3-ACETIC ACID INDUCIBLE1, is rescued in smax1 max2 seedlings. SMAX1 is a member of an eight-gene family in Arabidopsis that has weak similarity to HEAT SHOCK PROTEIN 101, which encodes a caseinolytic peptidase B chaperonin required for thermotolerance. SMAX1 and the SMAX1-like (SMXL) homologs are differentially expressed in Arabidopsis tissues. SMAX1 transcripts are most abundant in dry seed, consistent with its function in seed germination control. Several SMXL genes are up-regulated in seedlings treated with the synthetic SL GR24. SMAX1 and SMXL2 transcripts are reduced in max2 seedlings, which could indicate negative feedback regulation by KAR/SL signaling. smax1 seed and seedling growth mimics the wild type treated with KAR/SL, but smax1 seedlings are still responsive to 2H-furo[2,3-c]pyran-2-one (KAR2) or GR24. We conclude that SMAX1 is an important component of KAR/SL signaling during seed germination and seedling growth but is not necessary for all MAX2-dependent responses. We hypothesize that one or more SMXL proteins may also act downstream of MAX2 to control the diverse developmental responses to KARs and SLs. PMID:23893171

  10. Current Status and Scope of Lymph Node Micrometastasis in Gastric Cancer

    PubMed Central

    Lee, Chang Min; Park, Sung-Soo

    2015-01-01

    Recently, lymph node micrometastasis has been evaluated for its prognostic value in gastric cancer. Lymph node micrometastasis cannot be detected via a usual pathologic examination, but it can be detected by using some other techniques including immunohistochemistry and reverse transcription-polymerase chain reaction assay. With the development of such diagnostic techniques, the detection rate of lymph node micrometastasis is constantly increasing. Although the prognostic value of lymph node micrometastasis remains debatable, its clinical impact is apparently remarkable in both early and advanced gastric cancer. At present, studies on the prognostic value of lymph node micrometastasis are evolving to overcome its current limitations and extend the scope of its application. PMID:25861517

  11. Molecular and Functional Imaging for Detection of Lymph Node Metastases in Prostate Cancer

    PubMed Central

    Fortuin, Ansje; de Rooij, Maarten; Zamecnik, Patrik; Haberkorn, Uwe; Barentsz, Jelle

    2013-01-01

    Knowledge on lymph node metastases is crucial for the prognosis and treatment of prostate cancer patients. Conventional anatomic imaging often fails to differentiate benign from metastatic lymph nodes. Pelvic lymph node dissection is an invasive technique and underestimates the extent of lymph node metastases. Therefore, there is a need for more accurate non-invasive diagnostic techniques. Molecular and functional imaging has been subject of research for the last decades, in this respect. Therefore, in this article the value of imaging techniques to detect lymph node metastases is reviewed. These techniques include scintigraphy, sentinel node imaging, positron emission tomography/computed tomography (PET/CT), diffusion weighted magnetic resonance imaging (DWI MRI) and magnetic resonance lymphography (MRL). Knowledge on pathway and size of lymph node metastases has increased with molecular and functional imaging. Furthermore, improved detection and localization of lymph node metastases will enable (focal) treatment of the positive nodes only. PMID:23823804

  12. Development of the axillary bud complex in Echinocystis lobata (Cucurbitaceae): interpreting the cucurbitaceous tendril.

    PubMed

    Gerrath, Jean M; Guthrie, Theodore B; Zitnak, Tim A; Posluszny, Usher

    2008-07-01

    In the Cucurbitaceae, the tendrils, coiling organs used for climbing and mechanical support, are part of an axillary bud complex (ABC). Although the morphological nature of tendrils and the branching pattern of the ABC in the Cucurbitaceae have been much studied, their homology remains unresolved, with hypothesized candidates being the leaf, flower, stem, or stem-leaf combination. We used Echinocystis lobata as a model to study the early ontogeny of the ABC with epi-illumination microscopy and serial resin sections. The ABC produces four structures (proximal to distal, relative to the subtending leaf) as the result of two successive subdivisions: an inflorescence of staminate flowers, a solitary pistillate flower, a lateral bud, and a tendril. The first separates the tendril primordium from the continuation of the ABC, and the second separates the staminate inflorescence and the ABC. The pistillate flower apparently forms between the staminate inflorescence and the lateral bud. Because there is no subtending leaf during these subdivisions and the first lateral appendages in the resulting primordia arise in the same plane, we conclude that the tendril and other organs formed by the ABC are lateral branches of equal morphological value. This study is the basis for continuing comparative and functional morphological studies. PMID:21632403

  13. An ultrasound-guided technique for axillary brachial plexus nerve block in rabbits.

    PubMed

    Fonseca, Carla; Server, Anna; Esteves, Marielle; Barastegui, David; Rosal, Marta; Fontecha, Cesar G; Soldado, Francisco

    2015-04-21

    Regional anesthesia techniques, such as nerve blocks, are routinely used in humans and can contribute to multimodal approaches to pain management in research animals. Ultrasound guidance is an emerging aspect of regional anesthesia that has the potential to optimize local delivery and distribution of anesthetic agents, thereby reducing the amounts of these agents that must be administered. The authors developed an ultrasound-guided technique for effective block of the axillary brachial plexus in rabbits. They used this technique to carry out nerve block in 14 rabbits. The procedure was accomplished in a relatively short amount of time and achieved successful nerve block in all rabbits with no adverse effects. Sonographic visualization of the distribution of the local anesthetic ropivacaine led to administration of smaller anesthetic doses in eight of the rabbits without affecting the duration of nerve block. The authors conclude that their technique is feasible and safe and provides effective analgesia of the thoracic limb in rabbits. They recommend that this technique be integrated into multimodal approaches to pain management in rabbits undergoing thoracic limb surgery. PMID:25897939

  14. Peritoneal malignant mesothelioma metastatic to supraclavicular lymph nodes.

    PubMed

    Zannella, Stefano; Testi, Maria Adele; Cattoretti, Giorgio; Pelosi, Giuseppe; Zucchini, Nicola

    2014-09-01

    Distinguishing between malignant mesothelioma and reactive mesothelial hyperplasia is often inestimable, but may be a challenging gauntlet for pathologists. A 62-year-old man underwent appendectomy after the identification of a peritoneal mass and the histological examination showed mesothelial proliferation along the appendix surface with no clear images of infiltration. After a few months the patient developed mediastinal and supraclavicular lymphadenopathies, and a nodal biopsy showed mesothelial cell proliferation invading lymphatic sinuses, consistent with the cells seen in the abdominal cavity. Since overt morphologic criteria for malignancy were lacking and reactive mesothelial cell deposits have been documented in lymph nodes, a molecular investigation of the CDKN2A (henceforth simply p16) gene status via fluorescence in situ hybridization was performed, which showed homozygous deletion in 100% tumor cells. These data ruled out the hypothesis of reactive mesothelial cells inclusion in lymph nodes, thus confirming the diagnosis of epithelioid malignant mesothelioma. PMID:24474244

  15. The local lymph node assay and skin sensitization testing.

    PubMed

    Kimber, Ian; Dearman, Rebecca J

    2010-01-01

    The mouse local lymph node assay (LLNA) is a method for the identification and characterization of skin sensitization hazards. In this context the method can be used both to identify contact allergens, and also determine the relative skin sensitizing potency as a basis for derivation of effective risk assessments.The assay is based on measurement of proliferative responses by draining lymph node cells induced following topical exposure of mice to test chemicals. Such responses are known to be causally and quantitatively associated with the acquisition of skin sensitization and therefore provide a relevant marker for characterization of contact allergic potential.The LLNA has been the subject of exhaustive evaluation and validation exercises and has been assigned Organization for Economic Cooperation and Development (OECD) test guideline 429. Herein we describe the conduct and interpretation of the LLNA. PMID:19967517

  16. What next? Managing lymph nodes in men with penile cancer

    PubMed Central

    Leveridge, Michael; Siemens, D. Robert; Morash, Christopher

    2008-01-01

    The management of patients with squamous cell carcinoma of the penis is often daunting given its rarity and subsequent lack of high-level evidence to support our decision-making. This culminates in the complex surgical issues involving the management of the regional lymph nodes, which is of critical importance to both quantity and quality of life for these patients. This review aims to highlight the decisive issues surrounding the management of the pelvic and inguinal lymph nodes in the setting of squamous cell carcinoma of the penis, and to spotlight recently published information that adds credence to accepted management strategies of both the clinically positive and negative groin after successful management of the primary lesion. PMID:18953451

  17. Animal model of para-aortic lymph node metastasis

    Microsoft Academic Search

    Souichi Tsutsumi; Hiroyuki Kuwano; Nobuhiro Morinaga; Tatsuo Shimura; Takayuki Asao

    2001-01-01

    The purpose of this study was to establish a model of experimental lymph node metastasis by intra-rectal implantation of human cancer cells in nude mice. Four types of human cancer cell lines (TE-1, MKN-45, HT-29, and MIAPaca-2) were investigated. Tumor cells suspended in MatrigelTM were injected into the submucosal layer of the rectum. All cancer cell lines produced locally aggressive

  18. Factors influencing lymph node harvest in colorectal surgery

    Microsoft Academic Search

    M. Gelos; J. Gelhaus; P. Mehnert; G. Bonhag; M. Sand; S. Philippou; B. Mann

    2008-01-01

    Background and aims  Lymphadenectomy in colorectal cancer is a critical component concerning prognosis and survival of patients. Several variables\\u000a influence the number of harvested lymph nodes (LN). However, results of studies are contradictory, and influencing factors\\u000a remain to be identified. The aim of the present study was to identify factors that have a significant influence on the number\\u000a of assessed LN

  19. Epitrochlear lymph nodes as a site of melanoma metastasis

    Microsoft Academic Search

    Jeremy A. Hunt; John F. Thompson; Roger F. Uren; Robert Howman-Giles; C. Richard Harman

    1998-01-01

    Background: The incidence of epitrochlear lymph node metastasis for patients with melanomas on the hand or forearm is disputed, and management guidelines for these nodes are unclear.\\u000aMethods: The records of 13,139 consecutive melanoma patients were reviewed to document the incidence of metastatic disease in epitrochlear nodes. The frequency of direct lymphatic drainage to epitrochlear nodes was determined for 109

  20. Lymph Node Metastasis In Small Peripheral Adenocarcinoma Of The Lung

    Microsoft Academic Search

    Tsuneyo Takizawa; Masanori Terashima; Teruaki Koike; Takehiro Watanabe; Yuzo Kurita; Akira Yokoyama; Keiichi Honma

    1998-01-01

    Objective: Our aim in this study is to clarify the clinical and pathologic features of small peripheral adenocarcinoma of the lung with special emphasis on intraoperative identification of lymph node metastasis. Patients and methods: Between 1980 and 1996, 157 patients underwent lobectomy and complete hilar\\/mediastinal lymphadenectomy for small (1.1 to 2.0 cm in diameter) peripheral adenocarcinoma of the lung. The

  1. High definition infrared spectroscopic imaging for lymph node histopathology.

    PubMed

    Leslie, L Suzanne; Wrobel, Tomasz P; Mayerich, David; Bindra, Snehal; Emmadi, Rajyasree; Bhargava, Rohit

    2015-01-01

    Chemical imaging is a rapidly emerging field in which molecular information within samples can be used to predict biological function and recognize disease without the use of stains or manual identification. In Fourier transform infrared (FT-IR) spectroscopic imaging, molecular absorption contrast provides a large signal relative to noise. Due to the long mid-IR wavelengths and sub-optimal instrument design, however, pixel sizes have historically been much larger than cells. This limits both the accuracy of the technique in identifying small regions, as well as the ability to visualize single cells. Here we obtain data with micron-sized sampling using a tabletop FT-IR instrument, and demonstrate that the high-definition (HD) data lead to accurate identification of multiple cells in lymph nodes that was not previously possible. Highly accurate recognition of eight distinct classes - naïve and memory B cells, T cells, erythrocytes, connective tissue, fibrovascular network, smooth muscle, and light and dark zone activated B cells was achieved in healthy, reactive, and malignant lymph node biopsies using a random forest classifier. The results demonstrate that cells currently identifiable only through immunohistochemical stains and cumbersome manual recognition of optical microscopy images can now be distinguished to a similar level through a single IR spectroscopic image from a lymph node biopsy. PMID:26039216

  2. High Definition Infrared Spectroscopic Imaging for Lymph Node Histopathology

    PubMed Central

    Leslie, L. Suzanne; Wrobel, Tomasz P.; Mayerich, David; Bindra, Snehal; Emmadi, Rajyasree; Bhargava, Rohit

    2015-01-01

    Chemical imaging is a rapidly emerging field in which molecular information within samples can be used to predict biological function and recognize disease without the use of stains or manual identification. In Fourier transform infrared (FT-IR) spectroscopic imaging, molecular absorption contrast provides a large signal relative to noise. Due to the long mid-IR wavelengths and sub-optimal instrument design, however, pixel sizes have historically been much larger than cells. This limits both the accuracy of the technique in identifying small regions, as well as the ability to visualize single cells. Here we obtain data with micron-sized sampling using a tabletop FT-IR instrument, and demonstrate that the high-definition (HD) data lead to accurate identification of multiple cells in lymph nodes that was not previously possible. Highly accurate recognition of eight distinct classes - naïve and memory B cells, T cells, erythrocytes, connective tissue, fibrovascular network, smooth muscle, and light and dark zone activated B cells was achieved in healthy, reactive, and malignant lymph node biopsies using a random forest classifier. The results demonstrate that cells currently identifiable only through immunohistochemical stains and cumbersome manual recognition of optical microscopy images can now be distinguished to a similar level through a single IR spectroscopic image from a lymph node biopsy. PMID:26039216

  3. Immunoscintigraphic evaluation of lymph node involvement in prostatic carcinoma

    SciTech Connect

    Vihko, P.; Kontturi, M.; Lukkarinen, O.; Martikainen, P.; Pelliniemi, L.; Heikkilae, J.V.; Vihko, R.

    1987-01-01

    Five patients who were candidates for radical prostatectomy were investigated. One milligram of diethylene triamine pentaacetic acid derivatives of purified F(ab')2 fragments of monoclonal antibodies against prostatic acid phosphatase, labeled with /sup 99m/Tc, were bilaterally injected into the periprostatic space. The amount of radioactivity injected varied between 3 and 7 mCi. Imaging took place dynamically for the first hour following injection, then at 6 and 24 hr. In one patient, lymph node metastases were detected in the left paraaortic, iliac, and obturator lymph nodes by this technique. The lesions incorporating radioactivity were confirmed to be metastases of prostatic cancer following staging pelvic lymphadenectomy. Immunolabeling electron microscopy studies revealed internalized antibody in prostatic cancer cells. In the four other patients, radioimaging did not show any lymph node metastases, and this negative finding was confirmed at surgery. These early data indicate the possibility of preoperative staging of prostatic cancer using radiolabeled derivatives of monoclonal antibodies raised against prostatic acid phosphatase and injected into the periprostatic area.

  4. Popliteal lymph node dissection for metastases of cutaneous malignant melanoma

    PubMed Central

    2014-01-01

    Popliteal lymph node dissection is performed when grossly metastatic nodal disease is encountered in the popliteal fossa or after microscopic metastasis is found in interval sentinel nodes during clinical staging of cutaneous malignant melanoma. Initially, an S-shaped incision is made to gain access to the popliteal fossa. A careful en bloc removal of fat tissue and lymph nodes is made to preserve and avoid the injury of peroneal and tibial nerves as well as popliteal vessels, following the previous recommendations. This rare surgical procedure was successfully employed in a patient with cutaneous malignant melanoma and nodal metastases at the popliteal fossa. The technique described by Karakousis was reproduced in a step-by-step fashion to allow anatomical identification of the neurovascular structures and radical resection with no post-operative morbidity and prompt recovery. Popliteal lymph node dissection is a rarely performed operative procedure. Following a lymphoscintigraphic examination of the popliteal nodal station, surgeons can be asked to explore the popliteal fossa. Detailed familiarity of the operative procedure is necessary, however, to avoid complications. PMID:24886058

  5. The Influence of Serial Sections, Immunohistochemistry, and Extension of Pelvic Lymph Node Dissection on the Lymph Node Status in Clinically Localized Prostate Cancer

    Microsoft Academic Search

    Friedhelm Wawroschek; Theodor Wagner; Michael Hamm; Dorothea Weckermann; Harry Vogt; Bruno Märkl; Ronald Gordijn; Rolf Harzmann

    2003-01-01

    Objectives: Pelvic lymph node metastases indicate a poor prognosis for patients with clinically localized prostate cancer. The aim of the study was to investigate the value of extended histopathological techniques considering the extent of pelvic lymphadenectomy and preoperative risk factors.Methods: Total of 194 patients with prostate cancer were examined. At first all patients had a sampling of the sentinel lymph

  6. Real-time rapid reverse transcriptase-polymerase chain reaction for intraoperative diagnosis of lymph node micrometastasis: Clinical application for cervical lymph node dissection in esophageal cancers

    Microsoft Academic Search

    Setsuko Yoshioka; Yoshiyuki Fujiwara; Yurika Sugita; Yoshihiro Okada; Masahiko Yano; Shigeyuki Tamura; Takushi Yasuda; Shuji Takiguchi; Hitoshi Shiozaki; Morito Monden

    2002-01-01

    Background. New molecular techniques have been designed to detect cancer micrometastases that are otherwise missed by conventional histologic examination. The aim of this study was to establish a sensitive and rapid genetic assay to detect lymph node micrometastasis and to assess its usefulness clinically for cervical lymphadenectomy in esophageal cancer. We have recently shown that metastasis in the lymph node

  7. Assessment of the performance of the Stanford Online Calculator for the prediction of nonsentinel lymph node metastasis in sentinel lymph node-positive breast cancer patients

    Microsoft Academic Search

    Jeffrey S. Scow; Amy C. Degnim; Tanya L. Hoskin; Carol Reynolds; Judy C. Boughey

    2009-01-01

    BACKGROUND: Several models for the prediction of nonsentinel lymph node (NSLN) metastasis in sentinel lymph node (SLN)-positive breast cancer patients have been proposed. In this study, the authors evaluate the Stanford Online Calculator (SOC), which was designed to predict the likelihood of NSLN metastasis using only 3 variables: primary tumor size, SLN metastasis size, and angiolymphatic invasion status. They compared

  8. In-vitro Strain and Modulus Measurements in Porcine Cervical Lymph Nodes

    PubMed Central

    Wing-Han Yuen, Queeny; Zheng, Yong-Ping; Huang, Yan-Ping; He, Jun-Feng; Chung-Wai Cheung, James; Ying, Michael

    2011-01-01

    Cervical lymph nodes are common sites of metastatic involvement in head and neck cancers. These lymph nodes are superficially located and palpation is a common practice for assessing nodal hardness and staging cancer which is, however, too subjective and with limited accuracy. In this study, the mechanical properties of pig lymph node tissues were investigated using ultrasound elastography and indentation test. Lymph nodes were excised from fresh pork pieces and embedded in an agar-gelatin phantom for strain imaging by elastography. A strain ratio reflecting the strain contrast of lymph node over agar-gelatin phantom was used to assess the elasticity of the lymph node. A cutting device was then custom-designed to slice the phantom into uniform slices for indentation test. The measurements revealed that there were significant differences in both the strain ratio and Young’s modulus between the peripheral and middle regions of the lymph nodes (both p < 0.05); however, the results appeared contradictory. Correlation between the results of the two measurements (modulus ratio vs. inversed strain ratio) showed their association was moderate for both the peripheral and middle regions (R2 = 0.437 and 0.424 respectively). As the tests were only performed on normal lymph nodes, comparison in stiffness between healthy and abnormal lymph nodes could not be made. Future studies should be conducted to quantify the stiffness change in abnormal lymph nodes. PMID:21643424

  9. The local lymph node assay: an interlaboratory evaluation of interleukin 6 (IL-6) production by draining lymph node cells.

    PubMed

    Dearman, R J; Scholes, E W; Ramdin, L S; Basketter, D A; Kimber, I

    1994-01-01

    The murine local lymph node assay is a predictive method for the identification of skin-sensitizing chemicals in which activity is measured as a function of proliferative activity induced in lymph nodes draining the site of exposure. In the present study, the induction by topically applied chemicals of draining lymph node cell (LNC) production of the cytokine interleukin 6 (IL-6) has been evaluated as an alternative endpoint for the local lymph node assay. In addition, results derived from studies of IL-6 production by LNC performed independently in two separate collaborating laboratories have been compared. Of the nine skin sensitizing chemicals examined, six provoked detectable levels (> 150 pg ml-1) of IL-6 production by draining LNCs (as measured by enzyme-linked immunosorbent assay) following exposure of mice to at least one test concentration of the material in both of the laboratories. Three other sensitizing chemicals failed to induce measurable IL-6 production at any test concentration in either one or both of the participating laboratories. Both of the non-sensitizing chemicals evaluated (sodium lauryl sulphate and methyl salicylate) also failed to result in detectable IL-6 synthesis. There was a high level of agreement between the two laboratories. The rank order of chemicals with respect to IL-6 production by LNCs was identical in both cases, as was the dose-response relationship observed with each test material. These data reveal that, although inducible IL-6 production by draining LNCs provides a robust approach to the measurement of strong sensitizing activity, as performed here the method is of insufficient sensitivity for the routine identification of skin allergens. PMID:7963242

  10. Feasibility of an endoscopic approach to the axillary nerve and the nerve to the long head of the triceps brachii with the help of the Da Vinci Robot.

    PubMed

    Porto de Melo, P M; Garcia, J C; Montero, E F de Souza; Atik, T; Robert, E-G; Facca, S; Liverneaux, P-A

    2013-09-01

    Surgery to transfer the axillary nerve and the nerve of the long head of the triceps presents two obstacles: 1) the access portals are not standardized and 2) the nerves are for their larger part approached through large incisions. The goal of this study was to explore the feasibility of an endoscopic microsurgical approach. The posterior aspect of a cadaver shoulder was approached through three communicating mini-incisions. The Da Vinci robot camera was installed on a central trocart, and the instrument arms on the adjacent trocarts. A gas insufflation distended the soft tissues up to the lateral axillary space. The branches of the axillary nerve and the nerve to the long head of the triceps brachii muscle were identified. The dissection of the axillary nerve trunk and its branches was easy. The posterior humeral circumflex veins and artery were dissected as well without any difficulty. Finding the nerve to the long head of the triceps brachii was found to be more challenging because of its deeper location. Robots properties allow performing conventional microsurgery: elimination of the physiologic tremor and multiplication of the movements. They also facilitate the endoscopic approach of the peripheral nerves, as seen in our results on the terminal branches of the axillary nerve and the nerve to the long head of the triceps brachii. PMID:23867724

  11. Topical niacinamide 4% and desonide 0.05% for treatment of axillary hyperpigmentation: a randomized, double-blind, placebo-controlled study

    PubMed Central

    Castanedo-Cazares, Juan Pablo; Lárraga-Piñones, Gabryela; Ehnis-Pérez, Adriana; Fuentes-Ahumada, Cornelia; Oros-Ovalle, Cuauhtemoc; Smoller, Bruce R; Torres-Álvarez, Bertha

    2013-01-01

    Background Axillary hyperpigmentation is a frequent cause of cosmetic consultations in dark-skinned women from tropical areas, including Latin America. Currently, there is no widely accepted treatment for the disorder, but it is usually treated with bleaching agents because it is considered a variant of inflammatory hyperpigmentation. The purpose of this study was to assess the efficacy of niacinamide 4% and desonide 0.05% emulsions compared with placebo in the treatment of axillary hyperpigmentation. Methods Twenty-four women aged 19–27 years with hyperpigmented axillae (phototype III–V) were randomly assigned to receive the study treatments in the axillary region. Improvement was assessed at baseline, then clinically and by colorimetry 9 weeks later. Quantitative evaluation including melanin, inflammatory infiltrates, NKI/Beteb, CD1a, CD68, and collagen type IV content was performed by histochemistry and immunohistochemistry, assisted by computerized morphometric analysis. Results Both niacinamide and desonide induced significant colorimetric improvement compared with placebo; however, desonide showed a better depigmenting effect than niacinamide. A good to excellent response was achieved in 24% of cases for niacinamide, 30% for desonide, and 6% for placebo. We observed a marked disruption of the basal membrane in axillary hyperpigmentation and an inflammatory infiltrate that improved after treatment. Decreased pigmentation in the desonide-treated axillae was associated with recovery of disruption at the basal membrane. Conclusion Niacinamide and desonide showed depigmenting properties in women with axillary hyperpigmentation. These findings may be explained by their antimelanogenic and anti-inflammatory properties, respectively. PMID:23355788

  12. Functions for rice RFL in vegetative axillary meristem specification and outgrowth.

    PubMed

    Deshpande, Gauravi M; Ramakrishna, Kavitha; Chongloi, Grace L; Vijayraghavan, Usha

    2015-05-01

    Axillary meristems (AMs) are secondary shoot meristems whose outgrowth determines plant architecture. In rice, AMs form tillers, and tillering mutants reveal an interplay between transcription factors and the phytohormones auxin and strigolactone as some factors that underpin this developmental process. Previous studies showed that knockdown of the transcription factor gene RFL reduced tillering and caused a very large decrease in panicle branching. Here, the relationship between RFL, AM initiation, and outgrowth was examined. We show that RFL promotes AM specification through its effects on LAX1 and CUC genes, as their expression was modulated on RFL knockdown, on induction of RFL:GR fusion protein, and by a repressive RFL-EAR fusion protein. Further, we report reduced expression of auxin transporter genes OsPIN1 and OsPIN3 in the culm of RFL knockdown transgenic plants. Additionally, subtle change in the spatial pattern of IR4 DR5:GFP auxin reporter was observed, which hints at compromised auxin transport on RFL knockdown. The relationship between RFL, strigolactone signalling, and bud outgrowth was studied by transcript analyses and by the tillering phenotype of transgenic plants knocked down for both RFL and D3. These data suggest indirect RFL-strigolactone links that may affect tillering. Further, we show expression modulation of the auxin transporter gene OsPIN3 upon RFL:GR protein induction and by the repressive RFL-EAR protein. These modified forms of RFL had only indirect effects on OsPIN1. Together, we have found that RFL regulates the LAX1 and CUC genes during AM specification, and positively influences the outgrowth of AMs though its effects on auxin transport. PMID:25788736

  13. Primary axillary-subclavian venous thrombosis: is aggressive surgical intervention justified?

    PubMed

    Schmacht, D C; Back, M R; Novotney, M L; Johnson, B L; Bandyk, D F

    2001-01-01

    Multimodal (thrombolysis, surgical decompression, venous reconstruction, oral anticoagulation) treatment of primary axillary-subclavian venous thrombosis was reviewed to assess the impact of venous patency on functional outcome. Since 1996, 7 patients (6 men, 1 woman) of ages 16-53 years (mean 33 years) presented with symptomatic acute axillosubclavian venous thrombosis as a result of a recent athletic or strenuous arm activity. Five patients had undergone previous (>2 weeks) catheter-directed thrombolysis and venous angioplasty. Diagnostic contrast venography followed by repeat catheter-directed thrombolysis demonstrated abnormal (residual stenosis [n=6] or occlusion [n=1]) axillosubclavian venous segments in all patients. Surgical intervention was performed at a mean interval of 7 days (range 1-19 days) after thrombolysis and consisted of thoracic outlet decompression with scalenectomy and 1st rib resection via a paraclavicular (n=4) or supraclavicular (n=3) approach. Medial claviculectomy or cervical rib resection was performed in 2 patients. Concomitant venous surgery was performed in all patients to restore normal venous patency by circumferential venolysis (n=7) and balloon catheter thrombectomy (n=3), or vein-patch angioplasty (n=2), or endovenectomy (n=5), or internal jugular transposition (n=2). Postoperative venous duplex testing beyond 1 month identified recurrent thrombosis in 4 patients despite therapeutic oral anticoagulation. Subsequent venous recanalization was documented in 3 patients. Poor functional outcome was associated with an occluded venous repair and extensive venous thrombosis on initial presentation. A patent or recanalized venous repair present in 6 of 7 patients was associated with good functional outcome and may justify multimodal intervention in patients with primary axillosubclavian effort thrombosis presenting with recurrent thrombosis and significant residual disease after thrombolysis. PMID:11565039

  14. [Changes of dynamics of the lymph production after the cannulation of the thoracic duct].

    PubMed

    Rozhkov, A G; Karandin, V I; Perekhodov, S N; Tsarev, M I; Nagaev, R M

    2010-06-01

    An adequate cannulation of the thoracic duct is always accompanied with appropriate dynamics of the lymph production. As a result, the daily output of lymph increases from 2.0 to 2.2 times during 4-5 days. To find out the reasons of the lymph production changes were examined 57 patients with acute purulent inflammatory diseases of abdominal and thoracic organs. It was determined that the lymph production change is conditioned by 2 factors: the first is the stopping of the flow into venous vessels via lympho-venous anastomosies of the thoracic duct, lymphatic trunks and large lymphatic vessels. It leads to a mobilization of the greater part of lymph in lymphatic vessels. The second is the speeding-up of lymph production. PMID:20731090

  15. Duodenal gangliocytic paraganglioma with regional lymph node metastasis and a glandular component.

    PubMed

    Ogata, Sho; Horio, Takuya; Sugiura, Yoshiaki; Aiko, Satoshi; Aida, Shinsuke

    2011-02-01

    Gangliocytic paraganglioma (GP) is generally considered to be a benign periampullary lesion, although it is unclear whether it should be classified as a hamartoma or as a neoplasm. Here, we present a GP case with lymph node metastasis. A 16-year-old boy complained of exertional dyspnea. Upper endoscopy and imaging studies revealed a polypoid ampullary tumor. Pancreaticoduodenectomy with lymph node dissection was performed due to swelling of peripancreatic lymph nodes. Histologically, the tumor consisted of three cell types: epithelioid; spindle; and ganglion cells. In addition to these typical components of GP, a distinct glandular component was also present. There was substantial invasion of tumor cells into the lymphovascular vessels, associated with lymph node metastases. These lymph node metastases were histologically similar to the primary tumor. To judge from these findings GP may be a true neoplasm with metastatic capacity. Pre- and intraoperative investigations for lymph node or distant metastases are required for adequate resection of this kind of tumor. PMID:21255188

  16. The Effect of Thoracoscopic Sympathicotomy at the Fourth Rib (R4) for the Treatment of Palmar and Axillary Hyperhidrosis

    PubMed Central

    Kim, Jae-Bum; Kum, Dong-Yoon

    2011-01-01

    Background Video-assisted thoracic sympathicotomy plays an important for the treatment of essential hyperhidrosis. Patients are usually satisfied with the surgical outcome at the early post-operative period, but suffer recurrence and compensatory sweating in the late post-operative period. There are many sympathicotomy methods to minimize recurrence and compensatory sweating. We compared the outcome of sympathicotomy methods above the third rib (R3) and the fourth rib (R4) with regards to symptoms, satisfaction, recurrence, and compensatory palmar and axillary hyperhydrosis. Materials and Methods From January 1999 to April 2009, 39 cases of thoracoscopic sympathicotomy at the third rib (R3), and 94 cases of thoracoscopic sympathicotomy at the fourth rib (R4) for palmar and axillary hyperhidrosis were compared for early and late post-operative satisfaction, compensatory sweating and recurrence. Results There was no sex or age difference between groups. Early satisfaction was 94.9% and 98.9% in the R3 group and R4 group, respectively. There was no difference in early satisfaction (94.9% in R3 and 98.9% in R4), late satisfaction (84.6% in R3 and 89.4% in R4), or recurrence (17.9% in R3 and 17.0% in R4) between groups. There was significant difference in compensatory sweating (71.8% in R3 and 33% in R4, p=0.002). Conclusion R4 sympathicotomy demonstrated superior efficacy in the treatment of compensatory sweating compared to R3 in palmar and/or axillary hyperhidrosis. PMID:22263143

  17. Lymph Node Micrometastases in Early Gastric Cancer and Their Impact on Prognosis

    Microsoft Academic Search

    Paolo Morgagni; Luca Saragoni; Emanuela Scarpi; Pier Sante Zattini; Alberto Zaccaroni; Diana Morgagni; Francesca Bazzocchi

    2003-01-01

      Abstract\\u000a \\u000a While the presence of lymph node metastases in early gastric cancer (EGC) is the most significant prognostic factor, the relevance\\u000a of lymph node micrometastases remains uncertain. The authors studied 5400 lymph nodes dissected from 300 patients treated\\u000a surgically for EGC between 1976 and 1999, all of whom were histologically pN0. Micrometastases were defined as single or small\\u000a clusters of

  18. A preliminary study on sentinel lymph node biopsy: feasibility and predictive ability in oral cavity cancer

    Microsoft Academic Search

    Kazuaki Chikamatsu; Hideo Kamada; Hiroshi Ninomiya; Katsumasa Takahashi; Tsutomu Sakurai; Noboru Oriuchi; Nobuhiko Furuya

    2004-01-01

    The main factor that affects the prognosis of patients with head and neck cancer (HNC) is regional lymph node metastases.\\u000a For this reason, the accurate evaluation of neck metastases is required for neck management. This study investigates the sentinel\\u000a lymph node identification and the accuracy of the histopathology of the sentinel lymph node in patients with HNC. Eleven patients\\u000a with

  19. A clinicopathological study of mediastinal lymph node metastasis of lung cancer

    Microsoft Academic Search

    Jin-liang Xu; Qing-kai Yu; Sen Wu; Zong-ren Gao; Zhi-qiang Long; Si-jie Qiao

    2000-01-01

    Objective: To investigate pathologically the characteristics of lung cancer metastasis by mediastinal lymph node ways (N2). Methods: Of 398 lung cancer patients who underwent radical pulmonectomy and extensive lymph node dissection, 160 patients\\u000a were diagnosed as with N2 metastasis, their 352 groups of mediastinal lymph nodes invaded were subject to the pathological\\u000a study. Results: Evidences showed that the N2 metastasis

  20. Sensitization to 2,4-dinitrochlorobenzene: influence of vehicle on absorption and lymph node activation

    Microsoft Academic Search

    J. R. Heylings; H. M. Clowes; M. Cumberbatch; R. J. Dearman; I. Fielding; J. Hilton; I. Kimber

    1996-01-01

    Effective skin sensitization is dependent upon immune activation of lymph nodes draining the site of exposure. The influence of vehicle formulation on the vigour of lymph node cell proliferative responses to 2,4-dinitrochlorobenzene (DNCB) has been examined. Mice (BALB\\/c strain) were exposed topically to 0.5% DNCB dissolved in either acetone or propylene glycol (PG). A significantly greater lymph node cell proliferative