Preoperative sentinel lymph node localization in vulvar cancer: preliminary experience with inguinal intradermal contrast-enhanced ultrasound.

OBJECTIVE: To evaluate the feasibility and diagnostic performance of intradermal contrast-enhanced ultrasound (CEUS) sentinel lymph node (SLN) procedure in vulvar cancer. METHODS: Twelve consecutive patients with vulvar cancer underwent preoperatively inguinal CEUS SLN examination and guide wire marking of the enhanced lymph nodes. Altogether, 20 groins were examined with CEUS contrast agent injections including 8 bilateral groins due to midline tumours. One groin was excluded due to previous inguinal surgery. The results of the CEUS examinations were compared to conventional SLN biopsy using radiocolloid scintigraphy and/or methylene blue dye and final postoperative histopathology. RESULTS: The inguinal sentinel CEUS procedure had a technical success rate of 94.7% (18/19 injections) for identifying a potential inguinal SLN. Conventional SLN biopsy using lymphoscintigraphy and/or methylene blue dye was successfully performed in 16 groins. Compared to conventional SLN biopsy, the overall sensitivity was 81.2% (13/16 injections). Additionally, CEUS detected enhancing SLNs in two cases when traditional SLN procedure failed to do so. All metastatic SLNs (n = 5) were correctly identified by CEUS procedure. CONCLUSIONS: Intradermal CEUS SLN localization can be applied in the inguinal lymphatic region in patients with vulvar cancer. Further studies are needed to verify the clinical value of this method. KEY POINTS: • CEUS is a feasible method for inguinal SLN detection in vulvar cancer • All metastatic inguinal SLNs were identified by CEUS procedure • Further studies are needed to verify the clinical value of this method.

Treatment of delinquent youth in Finland.

Finnish law provides both protections and punishments for juvenile offenders, much of it dependent on the offender's age. A recently initiated mediation program is attempting to provide an alternative way to deal with crimes and conflicts, and to increase community understanding and tolerance.

Linkage map of birch, Betula pendula Roth, based on microsatellites and amplified fragment length polymorphisms.

The first genetic linkage map for silver birch, Betula pendula Roth, was constructed by using a pseudo-testcross mapping strategy and integration of linkage data from 3 unrelated 2-generation pedigrees. The map is based on the genetic inheritance and segregation of 82 amplified fragment length polyhmorphisms and 19 microsatellite markers, and was constructed by simultaneously comparing the performance of CRI-MAP and OUTMAP packages. The analysis revealed 16 linkage groups, and the total map coverage is 1561 cM (Kosambi units). Average map distance between adjacent markers is 15.5 cM. Linkage groups range between 6 and 18 loci and from 81.2 to 326.5 cM; the remaining 9 linkage groups consist of 2 or 3 loci ranging from 6.3 to 42.4 cM. The uncertainty of the map is illustrated with sensitivity analysis. This initial map can serve as a basis for developing a more detailed genetic map.