A prospective study comparing endoscopic subcutaneous mastectomy plus immediate reconstruction with implants and breast conserving surgery for breast cancer.

BACKGROUND: Breast conserving surgery (BCS) has been the standard surgical procedure for the treatment of early breast cancer. Endoscopic subcutaneous mastectomy (ESM) plus immediate reconstruction with implants is an emerging procedure. The objective of this prospective study was to evaluate the clinical outcomes of these two surgical procedures in our clinical setting. METHODS: From March 2004 to October 2007, 43 patients with breast cancer underwent ESM plus axillary lymph node dissection and immediate reconstruction with implants, while 54 patients underwent BCS. The clinical and pathological characteristics, surgical safety, and therapeutic effects were compared between the two groups. RESULTS: There were no significant differences in the age, clinical stage, histopathologic type of tumor, operative blood loss, postoperative drainage time, and postoperative complications between the two groups (P > 0.05). The postoperative complications were partial necrosis of the nipple and superficial skin flap in the ESM patients, and hydrops in the axilla and residual cavity in the BCS patients. There was no significant difference in the rate of satisfactory postoperative cosmetic outcomes between the ESM (88.4%, 38/43) and BCS (92.6%, 50/54) patients (P > 0.05). During follow-up of 6 months to 4 years, all patients treated with ESM were disease-free, but 3 patients who underwent BCS had metastasis or recurrence -one of these patients died of multiple organ metastasis. CONCLUSIONS: After considering the wide indications for use, high surgical safety, and favorable cosmetic outcomes, we conclude that ESM plus axillary lymph node dissection and immediate reconstruction with implants - the new surgery of choice for breast cancer - warrants serious consideration as the prospective next standard surgical procedure.

Diffusion tensor tractography of the temporal stem on the inferior limiting sulcus.

OBJECT: The aim of this study was to use diffusion tensor tractography (DTT) to define the 3D relationships of the uncinate fasciculus, anterior commissure, inferior occipitofrontal fasciculus, inferior thalamic peduncle, and optic radiation and to determine the positioning landmarks of these white matter tracts. METHODS: The anatomy was studied in 10 adult human brain specimens. Brain DTT was performed in 10 healthy volunteers. Diffusion tensor tractography images of the white matter tracts in the temporal stem were obtained using the simple single region of interest (ROI) and multi-ROIs based on the anatomical knowledge. RESULTS: The posteroinferior insular point is the anterior extremity of intersection of the Heschl gyrus and the inferior limiting sulcus. On the inferior limiting sulcus, this point is the posterior limit of the optic radiation, and the temporal stem begins at the limen insulae and ends at the posteroinferior insular point. The distance from the limen insulae to the tip of the temporal horn is just one third the length of the temporal stem. The uncinate fasciculus comprises the core of the anterior temporal stem, behind which the anterior commissure and the inferior thalamic peduncle are located, and they occupy the anterior third of the temporal stem. The inferior occipitofrontal fasciculus passes through the entire temporal stem. The most anterior extent of the Meyer loop is located between the anterior tip of the temporal horn and the limen insulae. Most of the optic radiation crosses the postmedian two thirds of the temporal stem. CONCLUSIONS: On the inferior limiting sulcus, the posteroinferior insular point is a reliable landmark of the posterior limit of the optic radiations. The limen insulae, anterior tip of the temporal horn, and posteroinferior insular point may be used to localize the white matter fibers of the temporal stem in analyzing magnetic resonance imaging or during surgery.

[Regulatory effect of curcumin on p300 and HDAC1 in B-NHL cells].

The purpose of this study was to investigate the effect of curcumin on proliferation of B-NHL Raji cell line and explore the relationship between this effect and regulatory expression of p300 and HDAC1 transcription. The in vitro cultured Raji cells were treated with curcumin at various concentrations (6.25-50 micromol/L) and at different time points (0, 6, 12, 24 and 48 hours), the inhibitory ratio of cell growth was measured by MTT assay, the cell apoptosis rate was detected by flow cytometry with Annexin V-FITC/PI double staining, the changes of p300 and HDAC1 mRNA expression and protein level in Raji cells were determined by RT-PCR and Western blot. The results showed that the curcumin could inhibit Raji cell proliferation in significant time-and concentration-dependent manners, IC50 at 24 hours was 25 micromol/L; the curcumin could induce apoptosis of Raji cells in concentration-dependent manner, apoptosis rate was 14.38%-61.18%. The curcumin significantly inhibited activity and expression of p300 and HDAC1. At IC50 concentration, expression of p300 and HDAC1 mRNA and protein level decreased with time-dependent manner, difference between tested and control groups was significant (P < 0.05). It is concluded that the curcumin can inhibit proliferation of B-NHL Raji cells and promote apoptosis of those cells. Curcumin can inhibit the activity and expression of the transcriptional co-activator p300 and HDAC1, which may be involved in its pharmacological mechanisms on B lymphoma cells.

[Effect of curcumin on caspase 8- and caspase 9- induced apoptosis of lymphoma Raji cell].

Curcumin is a crucial component of curcuma. Recently more attention has been paid to the effect of curcumin on specific proliferative inhibition and inducing apoptosis of tumor cells. This study was aimed to investigate the anticancer activities of curcumin and its molecular mechanism. Raji cells (lymphoma cell line) were selected as studying targets, peripheral blood mononuclear cells (PBMNC) obtained from healthy donors were separated by Ficoll solution and suspended in RMPI 1640. The inhibition rates of Raji cells and PBMNC after treatment with curcumin at various concentrations and different times were determined by MTT method and were compared. The expressions of caspase 8 and caspase 9 in Raji cells after treatment with curcumin at 25 micromol/L (IC(50)) and for 24 hours were detected by Western blot. The results showed that curcumin could inhibit proliferation of Raji cells in dose-and time-dependent manner. Curcumin could remarkablely enhance the Raji cell apoptosis at 25 micromol/L and 24 hours (P < 0.01), and its effect was dose-dependent and time-selective. Curcumin had no remarkable effect on PBMNC at certain concentrations, which demonstrated that curcumin could selectively inhibit tumor cell proliferation. It is concluded that the expression of caspase 8 and caspase 9 plays an important role in the proliferation and apoptosis of Raji cells, so that curcumin showed inhibitive effect on Raji cells at various concentrations.