Radionavigated detection of sentinel nodes in breast carcinoma--first experiences of our department.

INTRODUCTION: Biopsy and histological evaluation of sentinel lymphatic node limits the axillary node dissection only in cases of positive histological finding and decreases the occurrence of postoperative complications related to the axillary node dissection. METHODS: We used radiotracer SentiScint, Medi-Radiopharma Ltd, Hungary and preoperatively administered blue dye--Blue Patenté V, Guebert, Aulnay-Sous-Bios, France. 11 (18%) patients were subdued to deep peritimorous application of radiotracer, 10 (16.4%) to sub/intradermal application over the lesions and n 40 (65.6%) patients the application was sub/intradermal and periareolar. The patients underwent an operation protocol of corresponding quadrantectomy, radionavigated blue-dye sentinel node biopsy and axillary dissection. RESULTS AND CONCLUSIONS: From May 2006 to June 2008, we examined 61 patients with breast carcinoma. They underwent radionavigated and blue-dye sentinel node biopsy. We detected 57 (93.4%) sentinel nodes with preoperative scintigraphy, of which only 51 (83.6%) were detected peroperatively and underwent histological evaluation. In six (9.8%) cases, the "frozen cut" histology of the primary lesion had shown a benign lesion; hence no sentinel node biopsy or axillary disection was performed. 12 (19.7%) of 51 histologically evaluated sentinel nodes had metastatic invasion. We retrospectively compared the histological fund in sentinel and axillary nodes in patients with metastatic sentinel nodes. In 6 (16.6%) cases, the sentinel node was positive of metastatic invasion but axillary nodes were histologically negative, in 6 (16.6%) cases the sentinel node and axillary nodes were positive for metastatic invasion. We observed falsely negative findings in 3 (8.3%) patients with negative histological fund in the sentinel node, but positive axillary nodes (Tab. 3, Fig. 2, Ref. 11). Full Text (Free, PDF) www.bmj.sk.

[Response to a series of carbon dioxide baths]. / Reakcia organizmu na sériu uhlicitých kúpel'ov.

The authors investigated 28 patients, mean age 43.6 years, during their stay in spa Dudince. The patients had a daily carbon dioxide bath, thermally indifferent, for a period of 20 minutes. During the first, tenth and twentieth bath the humoral circulatory and renal response was assessed. During every bath a standard reaction developed (decline of plasma renin activity and of the aldosterone level, increased excretion of water and minerals, changes of the blood pressure and heart rate). The influence of the series of baths was manifested by a gradual increase of the diuresis, natriuresis, a more permanent drop of the blood pressure and at the end of the series also of the heart rate. The other investigated parameters did not change significantly during the series of baths, as compared with the reaction to a single bath. The attained results justify the conclusion that a series of carbon dioxide baths had a gradually improving effect which is favourable, in particular in the treatment of cardiovascular diseases.

Effects of sauna and glucose intake on TSH and thyroid hormone levels in plasma of euthyroid subjects.

The effect of sauna on thyroid function parameters and its modification by glucose was studied in young euthyroid male volunteers. A 30-minute stay in sauna resulted in an increase in plasma TSH; the response was exaggerated if glycemia had been increased by oral glucose intake at the beginning of the experiment. Plasma rT3 also increased in sauna, this response was, however, blunted by the higher glycemia. TSH response to sauna was definitely present in young men (aged 20 to 25) and absent in middle-aged ones (50 to 55). To explore the mechanism of the effect of increased glycemia, TRH tests were performed and dopamine infusions were administered with and without glucose pretreatment. Increased glycemia did not affect TSH and T3 response to TRH in young volunteers; however, 90 minutes after the administration, plasma rT3 levels were significantly lower in glucose pretreated subjects than in those receiving TRH injections after water pretreatment. Simultaneous infusion of glucose prevented the inhibitory effect of dopamine infusion on plasma TSH. It was concluded that glucose directly modulates the effect of sauna on plasma TSH at a suprapituitary level, while the inhibiting effect of glucose on plasma rT3 response to sauna and TRH is probably mediated by the insulin effect on thyroid hormone metabolism.

TSH response to 30 min stay in sauna in the morning and during evening hours.

The response of plasma TSH to 30 min stay in sauna was compared in the morning and in the evening. Both in the morning and in the evening plasma TSH was significantly elevated after sauna, with more prolonged response in the evening. This difference resembles the different reactivity of TSH to exogenous TRH administration in various times of day.