Preoperative axillary nodal staging of invasive lobular breast cancer with ultrasound guided fine needle aspiration in patients with suspicious ultrasound findings versus aspiration in all patients - A retrospective single institutional analysis.

INTRODUCTION: - At present, surgical strategies for breast cancer patients with >2 lymph nodes (LN) involved differ from those with no or lower degree of nodal involvement. Preoperative assessment of the axilla is less sensitive in patients with lobular carcinoma (ILC) than patients with other histological tumour types. MATERIALS AND METHODS: - A retrospective analysis of axillary staging by palpation, axillary ultrasound (AXUS) and AXUS-guided fine-needle aspiration cytology (FNAC) of 153 patients with ILC diagnosed and operated on between January 2013 and December 2020 was performed. Patients had either sentinel node biopsy or axillary lymph node dissection according to current practice. In period 1, patients had FNAC only when AXUS suggested nodal involvement (n = 106), and in period 2, all ILC patients had axillary FNAC (n = 47). RESULTS: - Of the factors associated with >2LNs involvement, logistic regression suggested only AXUS/FNAC based staging as independent variable for all patients. Patients with AXUS-guided FNAC had a significantly higher proportion of true negative and lower proportion of true positive cases in the P2 period (0 vs 55% and 72% vs 11% for >2 LNs involvement, respectively; both p < 0.0001). CONCLUSIONS: - AXUS-guided FNAC of all ILC patients did not result in improved preoperative identification of patients with >2 metastatic LNs but increased the false-negative rate of the assessment by producing false-negative results in patients who would not have undergone a biopsy due to negative AXUS findings.

Extension of the protocol of OECD guideline 407 (28-day repeated dose oral toxicity test in the rat) to detect potential immunotoxicity of chemicals.

To indicate the immunotoxic potential of chemicals the examinations prescribed by OECD Guideline 407 were extended by the following additional toxicological, haematological, histopathological, and immune function examinations: absolute and relative organ weight of spleen, thymus, popliteal lymph nodes, lung and brain; histopathology of thymus, mesenteric lymph nodes, popliteal lymph nodes, bone marrow (femur), Peyer's patches (ileum), lungs and colon; PFC assay (spleen), T cell proliferation and NK cell assay. Two well known immunosuppressants Azathioprine (AZA) and Cyclosporine A (CysA) were chosen as model compounds at a dose range which do not cause visible toxic signs on the animals during a 28 days treatment period. The results show that the applied experimental system is much more sensitive in detection of the immunotoxic potential of these two compounds in a low dose range than the examination required by OECD Guideline 407 are.

[Detection of Helicobacter pylori in biopsy specimens, methodical studies]. / Helicobacter pylori kimutatása biopsiás mintákból, metodikai vizsgálat.

Demonstration of Helicobacter pylori infection receives more and more importance in nowadays gastroenterological practice. The authors have compared culture and histology from 69 antral biopsy specimens for their ability to document Helicobacter pylori infection. Infection ratios in the context of clinical and histological diagnoses resulted in a distribution pattern similar to that described by others: 85-69% of duodenal ulcer patients, 67-67% of gastric ulcer patients, 62-54% of patients with gastritis and/or erosion(s) and 33-60% of endoscopically negative patients were found to be Helicobacter pylori positive with culture and histology respectively. Normal or atrophic mucosa showed no bacteria with either methods, but one must also consider the small number of such cases in this study. Chronic gastritis with no signs of activity proved to be infected only in a minority of cases, while chronic active gastritis cases were Helicobacter pylori positive in 72 and 61% histologically and with culture respectively. The modified Giemsa stain used in this study grave a relative specificity of 0.74 and sensitivity of 0.79 as compared with culture. There was a good association between the two methods tested, and this could be further improved by doing the two tests simultaneously. The association was weaker when the tests were done asynchronously, this is why it is not recommended to use such a diagnostic schedule. Comparison of the traditional haematoxylin-eosin stain with the modified Giemsa stain resulted in a very strong association between the two.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute and "long-term" genotoxic effects of CdCl2 on testes of mice.

The effects of Cd administered ip in a single carcinogenic dose (1 mg Cd/kg body weight) into male CFLP mice were investigated on the histological and cytogenetic status of the testes of the animals on d 3 and 6 mo after the Cd injection. There were some characteristic histological changes in the testes of the mice on d 3 after Cd treatment: the presence of interstitial hemorrhages, the death of Leydig cells, sterile necroses of tubular elements, and numerous atypical mitoses of the spermatocytes. A significant increase compared with the control was found only in the number of numerical chromosome aberrations in the Cd-treated group. Six months later, a significant difference compared with the control was found only in the relative weight of the testes in the treated group. There were soon no detectable effects of Cd on the histological picture of the testes and on the spermatocytes.

Inhibition of lung damage caused by paraquat with lymphokines or cytokines.

Gramoxone, containing paraquat as an active ingredient can cause severe lung injury in both humans and experimental animals. Biologically active fibroblast-stimulating factors produced by lymphocytes and macrophages may be of importance in the development of interstitial fibrosis. In our present study we have attempted to inhibit the process of paraquat induced lung fibrosis by lymphokine-enriched supernatants from concanavalin A stimulated spleen cell cultures. It was found that adequate supernatant treatment significantly reduced PQ-induced lung injury and its associated inflammatory response.

The effect of paraquat lung on mononuclear cells.

The mouse footpad swelling test was used to clarify the possibility of the induction of local cellular reaction with cell suspension of mouse lungs treated with paraquat in a syngeneous animal. Among the inbred strains used, the highest, statistically significant cellular reactivity was observed in C3H/He strain mice. These results suggest indirect evidence of macrophage activation in the lung toxicity of paraquat.

The preventive effect of prednisolone on the adrenal toxicity of cadmium.

The effects of a single dose of 3.3 mg/kg body weight i.p. or of a single dose of 0.2 mg/kg per os of cadmium and prednisolone on the adrenal weight and the thickness of the adrenal cortex were investigated in female mice. A significant increase was detected in the mean weight of the adrenals and the thickness of the adrenal cortex was significantly higher than the control value on days 1-3 following cadmium treatment. A dramatic decrease was observed in both adrenal weight and adrenal cortex thickness on day 4 following cadmium administration. No significant change occurred in the adrenals when prednisolone was given orally to mice following cadmium administration. This observation indicates a protective action of prednisolone on cadmium-induced adrenal toxicity.

[Thoracic and abdominal injuries caused by safety belts (author's transl)]. / Biztonsági öv által okozott mellkasi és hasi sérülések.

Based on experiences over half a year authors found that the introduction of safety belts, beside obvious advantages, resulted in new types of injuries. They describe own experiences and draw attention to heart contusions joining thoracic fractures, and to possible thoraco-abdominal organ injuries with characteristic symptom free or delayed appearance, caused by blount trauma.

[Primary spleen ruptures with problematic diagnosis (author's transl)]. / Nehezen diagnosztizálható primer léprupturák.

The clinical appearance of primary spleen rupture with latent bleeding is dealt with. Diagnostic difficulties, possible methods of examination and their evaluation are demonstrated. Selected characteristic cases from among their material are introduced.

The effect of diuretic drugs on lymph flow in experimental ascites.

The effect of several diuretic agents on thoracic duct and right lymph trunk lymph flow, and on some other parameters was examined in normal dogs and dogs with ascites produced by the constriction of inferior cava vein. In normal animals furosemide and etacrynic acid in diuretic doses did not influence thoracic duct lymph flow and reduced slightly arterial pressure and GFR (creatinine clearance). Hydrochlorothiazide increased slightly thoracic duct flow. Neither of the drugs had any significant influence on right trunk lymph flow. In dogs with ascites all drugs tested (furosemide, etacrynic acid and mercurophylline) reduced lymph flow in the thoracic duct but had no effect on the flow in the right trunk. The drugs reduced markedly arterial and inferior cava venous pressure. It is concluded that their effect on ascites is not based on enhanced lymphatic absorption and transport but mainly on the reduction of fluid and protein leakage from the liver sinusoids.

Cervical lymphato-venous shunt in treatment of ascites in caval-constricted dogs and in patients with hepatic cirrhosis. Experimental observations and 7 years clinical experience.

In experimental ascites produced by inferior vena caval constriction there is a pressure gradient at the thoracic duct-venous junction suggesting a functional obstacle to lymph flow. Abdominal fluid and protein are transported mainly by the right lymph trunk and not by the thoracic duct. External drainage of the thoracic duct or construction of a new, wider thoracic duct-venous anastomosis facilitates, however, transport of excess capillary filtrate formed in the liver and decreases fluid spillage into the peritoneal cavity. Construction of a cervical lymphato-venous anastomosis was attempted in 21 patients, 20 of whom had cirrhosis, and the operation was technically successful in 16 cases. Operation was helpful in cirrhotic patients with rapid ascites formation, who required less frequent abdominal paracenteses operation. The shunt was without benefit in prevention of oesophageal varix bleedings, and it should not be attempted in patients with icterus and severe deterioration of liver function.

Lymphatic drainage of the peritoneal cavity in experimental ascites.

Transport of labelled protein from the abdominal cavity by the thoracic duct and by the right lymph trunk was investigated in dogs with ascites due to inferior cava vein constriction and in control animals. The greater part of peritoneal fluid protein is transported in both ascites and under normal conditions by the lymphatics of the right side. The excess protein filtered from the liver sinusoids in venous stasis is transported by the thoracic duct. In this condition large amounts of fluid accumulate in the lymphatics in consequence of a relative obstacle to outflow at the veno-lymphatic junction. Thoracic duct drainage in experimental ascites leads to large fluid and protein losses and consequently to a reduction of inferior caval pressure and of capillary filtration in the liver. The intervention reduces ascites formation but does not influence the lymphatic absorption and transport of peritoneal fluid. Consequently, it is indicated only as a temporary measure, a preliminary to portocaval shunt operation, to reduce the increased sinusoidal and portal pressures. A cervical lympho-venous anastomosis reduces thoracic duct pressure by eliminating the obstacle to lymph flow. Accordingly, the intervention facilitates the return of excess lymph into the blood stream, and reduces fluid and protein leakage into the abdominal cavity from the liver.