The influence of radioisotope vehicle on breast sentinel node detection.

AIM: To assess the relationship between carrier molecule size and time elapsing between marker injection and sentinel node(s) biopsy in patients with breast cancer. MATERIAL: The study performed on 122 women, in whom the sentinel node(s) was identified according to the procedure described below. In Group I (n=72 patients), SN identification was done with radioisotope marker of 400-3000 nm molecule size (tin colloid). In Group II (n=50 patients) radioisotope marker of <100 nm molecule size (colloidal albumin) was used. METHODS: All the patients of both groups received the markers with a single-point, intradermal, periareolar injection. Four hours after the injection (Group I - surgery in the next day) or immediately before the surgery (in this same day) (Group II), stationary lymphoscintigraphy was performed. RESULTS: Mean numbers of sentinel nodes identified with the radioisotope method in Groups I and II were 1.22 and 1.48, respectively. The difference was statistically significant (p<0.01). CONCLUSIONS: There is a relationship between the radioisotope marker molecule size and the injection-to-intra-operative evaluation time. Administration of small molecule size radioisotope marker several hours prior to the planned surgery appears to be the optimum procedure in this method of SN identification in patients with breast cancer.

Blue-dye intraoperative sentinel lymph node mapping in early non-small cell lung cancer.

AIMS: The blue-dye staining method of sentinel lymph node identification in lung cancer patients has been scarcely reported. The study was designed to assess the sensitivity, accuracy and negative predictive value (NPV) of intraoperative sentinel lymph node mapping in patients with non-small cell lung cancer by means of staining with colloid or water solution of blue dye. PATIENTS AND METHODS: One hundred and ten patients with clinically confirmed NO non-small cell lung cancer were enrolled into prospective study of intraoperative sentinel node identification. Four quadrants of the peritumoral tissue were injected with 4 ml of blue dye. After complete lymphadenectomy, all resected lymph nodes were examined with conventional hematoxylin-eosine staining. All negative sentinel nodes were searched for metastatic deposits with both serial sections and immunohistochemistry for cytokeratines. RESULTS: The blue-dye technique was characterized by unacceptably low sentinel node identification rate (IR) and low sensitivity (27% and 67% respectively). No significant differences were found in either the sensitivity or NPV among the colloid or water solutions of the blue dye applied. Although patent blue (colloid) was superior to water solution of methylene blue in identifying sentinel lymph node (identification rate 36% and 22% respectively) the sensitivity and NPV were lower (63% and 80% for patent blue and 75% and 92% for methylene blue respectively). CONCLUSION: The blue-dye staining method of sentinel node identification in non-small cell lung cancer patients is inadequate and should not be recommended for clinical use.

[Chylothorax and chyloperitoneum]. / Chylothorax i chyloperitoneum.

We report three cases of chylous leakage. Chylothorax and chyloperitoneum following radical esophagectomy are described in one patient. Chylothorax in the course of lymphoma malignum, and chylothorax due to traffic accident are described in two other patients. All three patients undergone surgical intervention to repair leaking lymphatics. In two patients with chylothorax this kind of treatment was successful, however in patient with lymphoma malignum success was temporary only.

[Varices of the spermatic cord and endo-sonographic changes of urogenital organs in men with decreased values of certain sperm parameters]. / Zylaki powrózka nasiennego i endosonograficzne zmiany narzadów moczowo-plciowych mezczyzn z obnizona wartoscia niektórych cech nasienia.

A comparative analysis was carried out of sperm cell density, proportion of mobility and viability, and the proportion of morphologically abnormal sperm cells in 80 (74.6%) men with varices of the spermatic cord and 88 (52.4%) men without the varices. A significant shortening was observed of the viability time od the sperm cells, measured by the ability to maintain motion, in 57.5% of sperm samples from men with varices of the spermatic cord and in 39.8% of sperm samples from men without the varices. The shorter viability time was correlated with lower sperm cell density (20 million/ml) in the sperm samples. In endosonographic examinations performed at the same time, a coexistence was observed of varices and endosonographic changes in the prostate, seminal vesicles, and in a small proportion in the testicles. The coexistence of endosonographic changes and the varices was more frequently associated with decreased sperm cell density. The usefulness was demonstrated of sonographic examinations in the diagnosis and treatment of impaired fertility in men.