[US-guided localization of non-palpable breast cancer and sentinel node using 99mTechnetium-albumin colloid]. / Localización ecodirigida del cáncer de mama no palpable y del ganglio centinela con 99mtecnecio-coloide de albúmina.

OBJECTIVE: Surgery on non-palpable breast lesions is becoming increasingly common and new techniques for preoperative lesion localization have appeared. Radio-guided occult lesion localization (ROLL) enables malignant or probably malignant non-palpable breast lesions to be located and biopsy of the sentinel node to be performed (SNOLL: sentinel node and occult lesion localization). MATERIAL AND METHODS: Included were 118 patients with malignant or probably malignant non-palpable breast lesions visible on ultrasonography in whom radio-guided lesion resection and sentinel node biopsy were indicated. 99mTechnetium-albumin colloid was injected into the periphery of the lesion under ultrasonographic guidance and all patients underwent preoperative scintigraphy. RESULTS: From November 2001 to December 2004, 118 patients were included. All patients underwent conservative surgery, with the non-palpable lesion being located in all cases (100% lesion detection rate). The histological diagnoses were: 81 invasive ductal carcinomas (68.64%), 7 infiltrating lobular carcinomas (5.93%), 5 mixed-type carcinomas (4.24%), 17 carcinomas in situ (14.40%), and 8 other invasive carcinomas (6.78%). The sentinel node was detected in 98.41%. DISCUSSION AND CONCLUSIONS: Radio-guided ROLL surgery on non-palpable lesions located under ultrasonographic guidance is a simple, fast technique that enables the lesion to be safely excised. Both ROLL and SNOLL can be carried out in the same intervention with a single ultrasound-guided injection of 99mTechnetium-albumin colloid with satisfactory results.

Localización ecodirigida del cáncer de mama no palpable y del ganglio centinela con 99mtecnecio-coloide de albúmina / US-guided localization of non-palpable breast cancer and sentinel node using 99mtechnetium-albumin colloid

Objetivo. La cirugía de lesiones no palpables de mama va en aumento y han aparecido nuevas técnicas de localización preoperatoria. La técnica ecodirigida denominada ROLL (radioguided occult lesion localisation) permite localizar las lesiones de mama no palpables malignas o probablemente malignas y la biopsia del ganglio centinela (sentinel node and occult lesion localisation [SNOLL]).Material y métodos. Se incluyen 118 pacientes con lesiones de mama no palpables malignas o probablemente malignas visibles con ecografía, en las que está indicada la exéresis radioguiada de la lesión y la biopsia del ganglio centinela. Se inyecta con control ecográfico 99mtecnecio- coloide de albúmina en la periferia de la lesión y se realiza gammagrafía preoperatoria en todos los casos.Resultados. Desde noviembre del 2001 hasta diciembre del 2004 se incluyen 118 pacientes. En todas se realiza cirugía conservadora, localizando la lesión no palpable en todos los casos (tasa de detección de la lesión del 100%). El resultado anatomopatológico es: 81 carcinomas ductales infiltrantes (68,64%), 7 carcinomas lobulillares infiltrantes (5,93%), 5 carcinomas mixtos (4,24%), 17 carcinomas in situ (14,40%) y 8 otros carcinomas infiltrantes (6,78%). La detección del ganglio centinela es posible en un 98,41%.Discusión y conclusiones. La cirugía radioguiada ROLL de lesiones no palpables de mama localizadas con control ecográfico es una técnica sencilla y rápida que permite la exéresis de la lesión con seguridad. Se pueden realizar tanto ROLL como SNOLL en la misma intervención con una única inyección ecodirigida de 99mtecnecio-coloide de albúmina con resultados satisfactorios

Objective. Surgery on non-palpable breast lesions is becoming increasingly common and new techniques for preoperative lesion localization have appeared. Radio-guided occult lesion localization (ROLL) enables malignant or probably malignant non-palpable breast lesions to be located and biopsy of the sentinel node to be performed (SNOLL: sentinel node and occult lesion localization).Material and methods. Included were 118 patients with malignant or probably malignant non-palpable breast lesions visible on ultrasonography in whom radio-guided lesion resection and sentinel node biopsy were indicated. 99mTechnetium-albumin colloid was injected into the periphery of the lesion under ultrasonographic guidance and all patients underwent preoperative scintigraphy.Results. From November 2001 to December 2004, 118 patients were included. All patients underwent conservative surgery, with the non- lpable lesion being located in all cases (100% lesion detection rate). The histological diagnoses were: 81 invasive ductal carcinomas (68.64%), 7 infiltrating lobular carcinomas (5.93%), 5 mixed-type carcinomas (4.24%), 17 carcinomas in situ (14.40%), and 8 other invasive carcinomas (6.78%). The sentinel node was detected in 98.41%.Discussion and conclusions. Radio-guided ROLL surgery on nonpalpable lesions located under ultrasonographic guidance is a simple, fast technique that enables the lesion to be safely excised. Both ROLL and SNOLL can be carried out in the same intervention with a single ultrasound-guided injection of 99mTechnetium-albumin colloid with satisfactory results

[Infravesical obstructive uropathy secondary to extreme vulval atrophy]. / Uropatía obstructiva infravesical secundaria a atrofia vulvar extrema.

Lower urinary tract obstruction in women is an uncommon condition resulting from multiple either organic or functional disorders. This paper contributes one case of obstructive uropathy secondary to presence of almost complete vulvar synechia due to extreme genital atrophy, a rare entity that may appear in postmenopausal women. Partial and incomplete vulvar fusion usually occurs in significant postmenopausal atrophies, sometimes associated to urethral meatus stricture; this, however, has no significant repercussion on urination dynamics. No other comparable case was found in the reviewed literature.

Iron absorption by small intestine of chickens.

Iron (Fe) absorption by three segments (duodenum, jejunum, and ileum) of the small intestine of chickens was studied by a perfusion technique in vivo in closed circuit using 59Fe Cl3 and was related to the histological characteristics of each segment. The serosal transfers of Fe for the duodenum and jejunum were the same (14%/cm), but significantly different (p < 0.05) from those of the ileum (9%/cm), which may be explained by the morphological and histological properties of the gut of chickens. However, the presence of Fe in blood and in liver was significantly lower after perfusion of the jejunum and ileum than after perfusion of the duodenum. It is concluded that chickens show an early adaptation of small intestine to Fe absorption in response to the considerable loss of Fe suffered during the laying process.

Sexual and age variations of organ iron content in Shaver chickens.

1. Haematological values and iron content in liver, spleen, kidneys and intestine were determined in Shaver chickens of both sexes at 4, 8, 13 and 18 weeks and in females at 24 weeks (the beginning of the laying period). 2. The haematocrit decreased significantly in laying compared with non-laying females and the haemoglobin concentration was similar to that in the prelaying state. Plasma iron in laying females increased to four times the basal value at 13 weeks. 3. Females of 13 and 18 weeks (prelaying state) stored more iron than males at the same age. A simultaneous liver and spleen mobilisation of stored iron and increased intestinal iron accumulation took place in the laying process. The haematological variables examined were minimally altered. 4. The iron contents of both heart and kidneys were influenced by age and followed a linear trend, except that in the heart of females where a quadratic response was observed.

Organ iron content in New Hampshire chickens.

We have studied some hematological parameters and iron and ferritin iron contents in different organs of New Hampshire chickens at the ages of 4, 8, 13, and 18 wk for both sexes, as well as 24 wk for laying hens, in order to study the variations with age, the existence of sex differences, and the accommodations to laying. The hematocrit and hemoglobin levels did not show important variations, but plasma iron increased at laying. The iron and ferritin iron concentrations in liver and spleen increased more slowly during growth than the total iron and ferritin iron contents, and no significant decline was observed at laying. The iron concentration in the heart and pectoral muscle stayed constant throughout the period studied, and kidneys showed slight increase with age. However, the iron concentration in the intestine decreased from the proximal to the distal segments and also increased in the duodenum at laying. No differences caused by sex have been detected in the organs studied. The absence of differences caused by sex in the organ iron stores in favor of females, especially in liver, and the lack of influence of the laying process in iron stores could be a consequence of the low laying frequency of this strain.

Iron mobilization in three animal models of inflammation.

The effect of acute, subchronic, and chronic experimental models of inflammation upon hematocrit, hemoglobin, serum iron and ferritin iron and nonheme iron concentration in the liver and spleen has been studied in the rat. In the acute model (carrageenan oedema) no iron mobilization took place, whereas in the chronic models differences in iron mobilization were observed, related to their different chronicity and to the time elapsed from induction. The carrageenan-induced granuloma (from 12 h to 8 days) (subchronic model) was accompanied by a decrease of plasma iron (12 and 24 h), a later decrease of the hematocrit values (2 and 4 days) and high ferritin and nonheme iron concentrations in the liver and spleen for 4 days, followed by a tendency to return to the control values. The anemia in the adjuvant arthritis (from 1 to 4 weeks after induction) (chronic model) was observed at 7 days and is related to increased iron stores in the liver and spleen. However, the iron store levels in liver decreased and fell later below control values. The increase of ferritin and nonheme iron concentrations may be responsible for the reduced availability of iron release from tissue.

Body and egg iron content in shaver and New Hampshire chickens.

1. A comparative study on the iron content in internal organs (blood, liver, spleen, kidneys and heart), carcass and feathers, as well as on the whole iron content has been carried out at different ages (4, 8, 13, 18 and 24 weeks), on two chicken breeds (shaver and New Hampshire). 2. The iron content in internal organs in shaver was higher than in New Hampshire. 3. A tendency of the iron content in the carcass to decrease with age has been observed for both breeds; values were higher for laying shaver hens. 4. The egg-producing strain, shaver, showed a greater iron status with a stable body iron content from 13 weeks on (53-55 ppm), permitting a constant laying frequency (90%) during an 18-month period, with only a small reduction of egg iron content from 33.8 to 31 ppm. 5. The whole body iron decreased progressively with age in the New Hampshire broiler strain to 42-49 ppm iron, and the laying process sharpened this tendency. A drastic reduction in laying, accompanied by a lower egg iron content (28.9 ppm iron), was observed. 6. Iron data obtained in the present paper reflect the specific genetic adaptation to egg production of the shaver strain.

Intestinal iron absorption in chickens : I. Experimental conditions.

Intestinal iron absorption in chickens was studied in vivo, using an intestinal perfusion technique in closed circuit.The results obtained show that iron absorption, at 30 min intervals, is a linear function of test solution iron concentrations of up to 776 µg Fe/20 mL. At higher concentrations, iron saturation occurs. The mucosal epithelial cells seem to be less a limiting factor than in rats. However, in chickens, the binding capacity of plasma might play an important role in the regulation of iron absorption.Iron absorption versus time was analyzed in 15, 30, 60, and 120 min periods for the iron concentration of 14 µg Fe/20 mL. Intestinal iron absorption showed a linear relationship between these two parameters.A period of perfusion of either 30 or 60 min by a solution of 14 µg Fe/20 mL appears suitable since no interference by a saturation process can then occur.

Intestinal iron absorption in chickens : II. Effect of sex.

Sexual differences in intestinal iron absorption in Shaver and New Hampshire chickens strains was analyzed with an in vivo perfusion technique in closed circuit. In 6-week-old Shaver chickens, a significantly higher rate was found in females.A comparison of the absorption rates between adult males and laying and nonlaying hens from the New Hampshire strain, showed a significant increase of the net transfer during the laying period. However, we did not find any differences between males and nonlaying hens. From our data, a thicker intestinal wall seemed evident in the adult females, with highest values during laying.Estrogen administration in male chickens increased the plasma iron and produced a defensive reaction to iron absorption. However, during the laying stage, high plasma levels were found to be tied to higher absorption rates.Iron storage in females is higher in proportion to the increase of iron absorption, which is enhanced during the laying period. Estrogen appears to mediate this process, but from present data the point of action has not yet been identified.