Is SNOLL a good localization technique in early breast cancer treatment? A single center’s experience

AimThe aim of this study was to evaluate the method and present one center’s experience in applying the SNOLL technique to patients with non-palpable suspicious breast lesions.Materials and methods371 patients with suspected malignant lesions or diagnosed non-palpable breast cancer were subjected to a preoperative SNOLL procedure. The day before the surgery, they were administered two radiotracers to localize the tumor in the breast and the sentinel node. The following day, with the help of a handheld gamma probe the breast conserving surgery was performed.ResultsAll 371 patients (100%) had their suspected occult breast lesions resected. Histo-pathological examination revealed cancer in 339 patients all these patients had their sentinel nodes examined. The intraoperative tests showed the sentinel node to be metastatic in 35 patients, who were then given a simultaneous axillary lymphadenectomy. Another 7 patients were diagnosed with positive lymph nodes in the final pathology and had to undergo a second operation. Reoperations compelled by positive surgical margins were performed in 26 cases.ConclusionsSNOLL as a good technique of intraoperative localization, enables to remove a nonpalpable breast cancer together with sentinel lymph node in a single surgical procedure. It seems to be a optional method to be used in patients treated with breast conserving therapy.     

Diagnostic value of intraoperative histopathological examination of the sentinel nodes in breast cancer and skin melanoma—Preliminary results of single centre retrospective study

Objective

Intraoperative histopatological examination of the sentinel nodes enables selection of patients who need dissection of the regional lymphatic system during the same operation. The aim of this study is to evaluate the diagnostic value of intraoperative histopathological examination of the sentinel nodes in breast cancer and skin melanoma. Intraoperative histopathology of the sentinel nodes as a diagnostic method is used in patients with melanoma and breast cancer. Recent studies have proved it to be an effective method for evaluating the nodes in the final histopathology. Intraoperative histopathological examination of the sentinel nodes is not performed routinely and there is no clear position on this issue. In this paper we try to prove that intraoperative test gives patients the simultaneous benefits of removal of regional lymph nodes metastases and earlier initiation of adjuvant therapy.

Methods

The study comprises 137 patients with breast cancer and 35 patients with malignant skin melanoma. Sentinel nodes were intraoperatively sectioned and examined by means of the imprint method and frozen section evaluation. The patients with positive sentinel nodes underwent immediate dissection of regional lymph nodes. Those with negative sentinel nodes diagnosed in the intraoperative examination, but positive in final pathologic results, underwent subsequent dissection of regional lymph nodes.

Results

60 sentinel lymph nodes were found in 35 patients with skin melanoma. In 3 patients, 3 sentinel lymph nodes were false negative in the intraoperative histopathological examination. No false positive sentinel lymph nodes were found. 249 sentinel lymph nodes were found in the intraoperative histopathological examination in 137 patients with breast cancer. There were no false positive sentinel nodes, but there were 7 false negative sentinel nodes. In this study, only 5 (3.6%) patients with breast cancer and 3 (8.5%) patients with skin melanoma required another regional operation.

Conclusion

The method of intraoperative histopathological evaluation of the sentinel nodes enables identification of metastases in these lymph nodes and gives a possibility to carry out a one-step regional lymphadenectomy and start the adjuvant therapy earlier.     

Expression and localization of ionotropic glutamate receptor subunits in the goldfish retina—an in situ hybridization and immunocytochemical study

The expression and distribution of AMPA, kainate and NMDA glutamate receptor subunits was studied in the goldfish retina. For the immunocytochemical localization of the AMPA receptor antisera against GluR2, GluR2/3 and GluR4 were used, and for in situ hybridization rat specific probes for GluR1 and GluR2 and goldfish specific probes for GluR3 and GluR4 were used. The localization of the low affinity kainate receptor and NMDA receptor was studied using antisera against GluR5-7 and NR1. All AMPA receptor subtypes were demonstrated to be present in the goldfish retina both by immunocytochemistry and in situ hybridization. In situ hybridization revealed expression of all AMPA receptors subunit at the inner border of the INL. Only GluR3 was also strongly expressed in the outer border of the INL. Some of the ganglion cells displayed a strong signal for GluR1, GluR3 and GluR4. GluR1-immunoreactivity was present in subsets of bipolar, amacrine, and ganglion cells. GluR2 and GluR2/3-immunoreactivity was mainly localized in the outer plexiform layer. GluR2 and GluR2/3-immunoreactivity are associated with the photoreceptor synaptic terminals. GluR4-immunoreactivity is present on Müller cells in the inner retina and on dendrites of bipolar cells in the OPL, whereas GluR5-7-immunoreactivity was prominently present on horizontal cell axon terminals. Finally, NR1-immunoreactivity was confined to amacrine cells, the inner plexiform layer and ganglion cells. This study shows that there is a strong heterogeneity of glutamate receptor subunit expression in the various layers of the retina. Of the AMPA receptor subunits GluR3 seems to be expressed the most widely in all layers with strong glutamatergic synaptic interactions whereas all the other subunits seem to have a more restricted expressed pattern.     

Life-cycle-dependent changes of aspartate carbamoyltransferase localization in membranes ofSaccharomyces cerevisiae—Centrifugal elutriation and ultracytochemical study

Exponential culture of aSaccharomyces cerevisiae strain with overexpressed aspartate carbamoyltransferase activity (ACTase) was chilled in ice and fractionated by centrifugal elutriation to several cell populations of increasing cell mass. The enzyme activity which belongs to the pyrimidine biosynthesis pathway, was detectedin situ by a specific ultracytochemical reaction: the ACTase byproduct, monophosphate, was precipitated by cerium ions to cerium phosphate. During the outgrowth of nonbudding daughter cells (zero cells) the label appeared first in membranes of nuclear envelope and of mitochondria. In larger zero cells, this label appeared also in the endoplasmic reticulum, microvesicles and plasmalemma. In budding mother cells, the label was conspicuous in the whole cell-membrane complex. In most aged cells the ACTase activity was not detectable. The presence of ACTase activity in membranes of compartments conveying glycoproteinsvia the secretory pathway remains to be explained. To confirm thein situ detection of ACTase activity in membranes, we assayed the enzyme activity in both the 10 000g sediment and supernatant prepared from yeast homogenate precentrifuged at 3000g. From 23 to 43% of ACTase activity was detected in the sediments including membranes of wild-type and ACTase-overexpressing strains.     

Isodicentric X chromosome in a patient with Turner syndrome — implications for localization of the X-inactivation center

Summary Cytogenetic analyses have previously shown that the region Xq11.2–q21 is retained in all structurally abnormal X chromosomes. From these observations the conclusion has been drawn that this critical region on the proximal long arm of the X chromosome contains the locus controlling X-inactivation. Structurally abnormal X chromosomes without the X-inactivation center would allow nullisomy, disomy, or trisomy for genes on the X chromosome, and this condition is presumed nonviable. We studied a 28-year-old woman with primary amenorrhea and features of Turner syndrome who had an unusual isodicentric chromosome of the short arm of X. This patient provided us with the opportunity to more closely define the location of the X-inactivation center. High resolution chromosome analysis showed a 46,X,idic(X)(pterq13.2::q13.2pter) chromosome pattern in 94% of her cells and a 45,X complement in 6%. Replication studies showed this derivative X chromosome to be late-replicating (inactive) in all cells analyzed. DNA analysis confirmed the breakpoint of the isodicentric chromosome to be proximal to PGK1. Based on these results, the locus for the X-inactivation center can be refined to be within Xq11.2–q13.2.     

Ultrastructural localization of calcitonin in control and stimulated thyroid C cells of the rat using protein A — gold immunocytochemical technique

Summary Using anti-human calcitonin serum and a protein !-gold technique, calcitonin was localized at the ultrastructural level in control and calcium gluconate-stimulated thyroid C cells of the rat. In control rats calcitonin was dedected within a majority of the secretory granules while in experimental animals it was demonstrated also within prosecretory granules present in Golgi apparatus.The study was partially supported by a grant from the Committee of Cytobiology, Polish Academy of Sciences     

Institutional experience with a rotational total skin electron irradiation (RTSEI) technique—A three decade review (1981–2012)

Total skin electron irradiation (TSEI) for patients with cutaneous lymphomas is technically challenging, and numerous approaches have been developed to overcome the many field matching problems associated with such a large and complex treatment volume. Since 1981 we have delivered TSEI using a rotational total skin electron irradiation (RTSEI) technique in conjunction with patch, treat and boost fields in order to provide complete skin and dose coverage. Initially we used a 6 MeV electron beam at an extended source-skin distance (SSD) on a modified linear accelerator. More recently we began using a high dose rate electron mode on a commercially available linear accelerator. The RTSEI technique allows the delivery of a seamless surface dose to the majority of the patient''s skin surface in a single treatment. In this review paper we present our three-decade experience with the technical development, dosimetry, treatment delivery and clinical outcomes of our RTSEI technique.     

Autoradiographic study on the localization of estradiol-17β in neonatal mouse uterus and cervix

Summary The uptake of ³H-estradiol-17 in the neonatal mouse uterus and cervix has been studied by an autoradiographic method. When the radio-active hormone is administered in vivo and in vitro, grains are found to be concentrated above the nuclei both in the uterine and cervical epithelium and stroma. Grain counts revealed that the nuclear concentration of grains is higher at 4 h than at 2 h after isotope injection. The cervical epithelium has a higher nuclear concentration than the uterine epithelium both in vivo and in vitro. In the stroma, this situation is reversed except after in vitro treatment of the tissues.In the cervix, more of the hormone seems to be located within the nucleus while in the uterus a higher proportion of the grains are found in the vicinity of the nuclear periphery.Although the nuclear concentration of grains is higher at 4 h than at 2 h, the number of grains above the sections is lower at 4 h. Both in vivo and in vitro, the number of grains is higher above the stromal than above the epithelial compartments of the uterus and cervix.Five days old animals showed the same labeling pattern. The differences in uptake and distribution of ³H-estradiol are discussed in relation to other known differences in the hormone responsiveness in these tissues.We are greatly indebted to Professor W.E. Stumpf and the Laboratories for Reproductive Biology, University of North Carolina Medical School for the opportunity to study the method of dry mount autoradiography. The work has been supported by the Norwegian Research Council for Science and the Humanities and by the Norwegian Cancer Society (Landsforeningen mot Kreft)     

Cellular localization of estrogen receptor-alpha (ERα) and -beta (ERβ) mRNA in the boar testis

Boar testes synthesize high amounts of estrogens which are known to stimulate several male sexual functions in a variety of extragonadal target tissues. Possible effects within the testis depend on the existence of the estrogen receptor subtypes α and β (ERα, ERβ). The precise cellular localization of these subtypes within the testis was, so far, based mainly on protein expression studies using different antibodies in several species including boars shows contradictory results. Therefore, we investigated the ERα and ERβ gene expression using RT-PCR of testis homogenates and RT-PCR after UV-single cell microdissection combined with in-situ hybridization of four fertile boars with an average age of 32 weeks. Both ERα and ERβ mRNA were found in testis homogenates. Using in-situ hybridization and UV-single cell microdissection ERα mRNA was present in type A and type B spermatogonia up to mid-pachytene primary spermatocytes in stage V–VIII and stage I of the seminiferous epithelial cycle, but not in other cells. ERβ mRNA was found only in Sertoli cells. Interstitial Leydig cells revealed neither ERα nor ERβ mRNA. The data suggest a direct impact of estrogen in the boar on Sertoli cell function via ERβ and germ cell formation via ERα.     

Pyrimidine degradation in tomato cell suspension cultures and in Euglena gracilis—localization of enzymes

• 1.1. Subcellular location of dihydropyrimidinase and NCβA-amidohydrolase2 was studied in a cell suspension culture of tomato (Lycopersicon esculentum cv. Lukullus) and in Euglena gracilis.
• 2.2. By differential centrifugation, crude extracts were separated into ten fractions. Activities of both enzymes were found mainly in cytosolic fractions marked by EDH (tomato) and glu-6-P-DH (E. gracilis).
• 3.3. A cytosolic location was also found by a 20–60% and a 17.5–30% sucrose density gradients.
• 4.4. Using mitochondrial marker enzymes such as fumarase, SDH, CS and MDH, a mitochondrial occurrence of both enzymes or their release from mitochondria can be excluded by sucrose gradient centrifugations. This can also be achieved using purified mitochondria prepared from tomato cells by two subsequent sucrose gradients.
• 5.5. A possible vacuolar location of dihydropyrimidinase and NCβA-amidohydrolase was excluded by comparing their activities in isolated protoplasts and purified vacuoles which were characterized by their marker enzyme α-mannosidase.
• 6.6. A nuclear location of both enzymes and/or their release from the nucleus during procedures used cannot be excluded.
• 7.7. The results are discussed in relation to subcellular location to other pyrimidine-metabolizing enzymes in plant cells.

     

Is Stereotactic Body Radiotherapy (SBRT) in lymph node oligometastatic patients feasible and effective?

ObjectivesTo review the available data about stereotactic body-radiotherapy (SBRT) for oligometastatic lymph node cancer recurrence.MethodsThe inclusion criteria for this study were as follows: Medline search for the (1) English language (2) full paper (abstracts were excluded) on (3) adult oligometastatic solid cancer recurrence limited to lymph node that underwent SBRT (4) outcome data available and (5) published up to the 30th April 2014.Results38 papers fulfilling the inclusion criteria have been found: 7 review articles and 31 patient series (20 and 11 retrospective and prospective studies, respectively) including between 1 and 69 patients (636 lymph nodes). Twelve articles reported only lymph node SBRT while in 19 – all types of SBRT including lymph node SBRT were presented. Two-year local control, 4-year progression free survival and overall survival was of up to 100%, 30% and 50%, respectively. The progression was mainly out-field (10–30% of patients had a recurrence in another lymph node/nodes). The toxicity was low with mainly mild acute events and single grade 3–4 late events. When compared to SBRT for any oligometastatic cancer, SBRT for lymph node recurrence carried better prognosis and showed lower toxicity.ConclusionsSBRT is a feasible approach for oligometastatic lymph node recurrence, offering excellent in-field tumor control with low toxicity profile. The potential abscopal effect has been hypothesized as a basis of these findings. Future studies are warranted to identify the patients that benefit most from this treatment. The optimal combination with systemic treatment should also be defined.     

Immunochemical determination and immunocytological localization of brain-specific protein α-albumin (GFA) in isolated astrocytes

Astrocyte- and neuron-enriched fractions were isolated by preparative centrifugation from rat brain and human brain, obtained at autopsy. The brain-specific protein -albumin (GFA) was studied in these fractions by quantitative immunoradiochemical and by immunocytological methods. It is concluded that morphologically intact astrocytes can be isolated not only from rat, but also from human brain. In the rat, -albumin (GFA) is only found in the astrocyte-enriched fractions; this shows that determination of -albumin (GFA) is useful for the evaluation of cell separation methods for the brain. From the astrocyte-enriched fractions, four times more -albumin (GFA) can be extracted when detergent (0.1% SDS) is used, than when an aqueous extract is made. About ±0.15×10^–6 particles were extracted in 1 ml of either PBS or SDS/PBS. This suggests that -albumin (GFA) exists in at least two forms, one hydrosoluble, and one detergent soluble, possibly structurally bound, form.     

Cryptopolyploidy inBunias (Brassicaceae) revisited — A flow-cytometric and densitometric study

The concern of the present analysis is the hypothetical cryptopolyploidy, a concept basically of historical interest only, but discussed again by Battaglia (1996) in a recent treatment of the term and its historical background. Melinossi (1935), while reanalyzing erratic observations on the crucifersBunias erucago andB. orientalis by Jaretzky (1928a), found 2n = 14 in both species but twice the chromosome volume inB. erucago compared withB. orientalis. Melinossi considered cryptopolyploidy inB. erucago, i.e., she discussed pairwise fused chromosomes on a tetraploid basis or endoreduplicated (and thus binemic) chromosomes in this species. Cryptopolyploidy has also been claimed by Pannocchia-Laj (1938) inVinca difformis (Vincaceae). Battaglia (1996) criticized the term cryptopolyploidy because, in his opinion, the genuinely polyploid status of these plants is not hidden (crypto) but phenotypically (from herbarium specimens) recognizable. He coins the term phenopolyploidy, i.e., phenotypic polyploidy disagreeing with the karyotype numerically evalated. We measured genome size ofB. orientalis andB. erucago (both 2n = 14) by Feulgen densitometry and propidium iodide flow cytometry. Surprisingly,B. erucago (the annual species with 2.13 pg, 1 C) turned out to have only 0.81-fold the DNA amount ofB. orientalis (the perennial species with 2.64 pg, 1 C). Therefore, any kind of genetically polyploid status inB. erucago is out of the question. Only speculative significance can be ascribed to the terms cryptopolyploidy and phenopolyploidy.     

Appearence and localization of a β-glucosidase hydrolyzing coniferin in spruce (Picea abies) seedlings

-Glucosidase activity for coniferin (coniferyl alcohol -D-glucoside) is not present in spruce (Picea abies L. Karst.) seeds but appears in the young seedlings. Lignification starts at ca. day 9 of germination in the vascular bundles. An antiserum against glucosidase 1 isolated from spruce seedlings (Marcinowski and Grisebach, Eur J. Biochem. 1978) was employed for the localization of the enzyme in cross sections of hypocotyls using immunofluorescent technique. The results indicate that at this stage of development the glucosidase is localized at the inner layer of the secondary cell wall. Glucosidase activity was present in all cells of the investigated hypocotyl tissue.     

A study of the biochemistry and cytochemical localization of β-glycerophosphatase activity in root tips of maize and pea

Summary A critical study has been made of the standard lead phosphate precipitation technique for the localization of-glycerophosphatase activity in young root tips. The effects of fixatives on enzyme activity and on the loss of activity during fixation and incubation have been determined. Cytochemical studies showed that the most prominent sites of-glycerophosphatase activity were at particulate sites in the cytoplasm and in the nucleus. Good correlation was obtained between frozen section and electron microscope studies although a number of problems were encountered. These particularly concerned the penetration of the staining medium, the loss of activity during incubation and the use of the acetic acid rinse. Recommendations are made for the reliable localization of the enzyme. The use of controls in this method were studied and their validity discussed.The study was supported in part by a National Science Foundation Grant GB 12371 to Dr. J.Cronshaw.     

Traffic Deaths—A Preliminary Study of Urban and Rural Fatalities in California

An analysis by the California Department of Public Health of California Highway Patrol reports for 1961 showed that traffic accidents injured one and one-half times as many people per 1,000 population in rural California counties (under 50,000 people) as in urban counties (over 500,000 people), also persons injured in rural counties were almost four times as likely to die of their injuries as those injured in urban counties.A death certificate study was undertaken of 782 traffic deaths (excluding pedestrians) occurring in rural and urban California counties during 1961. Accidents occurring in rural counties tended to be single vehicle accidents which resulted in less severe injuries, while those in urban counties tended to be two vehicle and multiple vehicle accidents resulting in more serious injuries. The anatomic distribution of injuries was the same for both urban and rural accidents. However, people dying in rural accidents more frequently died at the scene of the accident, died sooner after injury, and died of less serious injuries than did those injured in urban accidents. For injuries where theoretically few lives should be salvaged by prompt emergency care, the time between injury and death was about the same in urban as in rural counties. Where such care should delay or prevent death because the injury was possibly or probably salvageable, those injured in rural counties died more quickly.Thirty-two per cent of fatalities in rural counties happened to urban and out-of-state residents, while only 12 per cent of fatalities in urban counties were to rural or out-of-state residents, suggesting that traffic accidents to non-residents may place an excessive load upon medical care resources in rural areas.     

Upper Lobe Lobectomy and Concomitant Thoracoplasty in Pulmonary Tuberculosis—A Preliminary Report

In this, a preliminary report, the advantages and disadvantages of upper lobe lobectomy and concomitant thoracoplasty in tuberculosis have been summarized. There has been no undue increase in the operative hazard, there have been no complications, and the immediate results have been entirely satisfactory.Twenty-six patients were subjected to a combined operation (17 upper lobectomy-thoracoplasty and nine pneumonectomy-thoracoplasty) with one postoperative death.Indications for primary lobectomy have been discussed.The technique of resection and concomitant thoracoplasty has been briefly described.     

Nitrogen-Vacancy color center in diamond — emerging nanoscale applications in bioimaging and biosensing

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