Seeding from hepatocellular carcinoma after percutaneous ablation: color Doppler ultrasound findings.

BACKGROUND: We describe the clinical and color Doppler ultrasound findings in a series of cases of seeding from hepatocellular carcinoma (HCC) observed in patients treated with percutaneous ablation therapy (PAT) over a 15-year period. METHODS: We reviewed the clinical and imaging records of 12 patients with cirrhosis (nine men and three women, age range 51-82 years, mean age 63 years) that showed neoplastic seeding from HCC occurring after one or more PAT procedures. Five of 12 cases of seeding were observed as a complication of 1080 PAT procedures (0.46%) performed in 545 patients (0.96%) by two of the authors (L.T., G.F.) over a long period (15 years) at different institutions. The other seven patients had been treated with PAT procedures at other institutions and had come to our attention during post-treatment follow-up. RESULTS: The 12 patients who had seeding nodules had undergone the following PAT procedures: multisession conventional percutaneous ethanol injection (PEI) without anesthesia (four patients), single-session PEI with general anesthesia (three patients), single-session PEI with general anesthesia plus multisession conventional PEI (four patients), and single-session PEI plus radiofrequency ablation (one patient). Seeding nodules ranged from 0.9 to 6.0 cm (mean 1.7 cm). Eleven of 12 seeding nodules appeared as hypervascular hypoechoic nodules with smooth and regular margins and multiple intralesional vascular signals. CONCLUSIONS: Clinical and imaging findings of seeding from HCC should be recognized by physicians who perform follow-up ultrasound examinations of patients who are treated with PAT. Early diagnosis of seeding can be reliably made by scanning the abdominal wall with small probes in the area where the previous PAT has been performed. Hypoechoic hypervascular pattern of the seeding nodule allows definitive diagnosis.

[Core biopsy in the preoperative diagnosis of breast carcinoma]. / La "core biopsy" nella diagnostica preoperatoria del carcinoma mammario.

BACKGROUND: In spite of the widespread use of cytological smears for the diagnosis of breast cancer lesions, many surgeons are still reluctant to accept the cytological report as the only criterion for performing definitive surgery. Modern surgical strategy requires a preoperative planning of the surgical treatment which is possible with the use of core biopsy (CB) or FNB (fine needle biopsy) for the diagnosis of tissue specimens. METHODS: The authors report their five-year experience with this technique and evaluate its diagnostic usefulness and substitution of interoperative biopsy. The histological examination of 92 palpable breast lesions, clinically and mammographically detected, was performed with CB, and diagnosis was confirmed with the surgical sample in 80 cases. RESULTS: A definitive histological diagnosis was obtained with CB in 90% of cases. Only nine cases required confirmation with frozen section diagnosis at the time of definitive surgery. The sensibility of CB was 93%, specificity and predictive value of a positive result were 100%, and diagnostic efficiency was 95%. CONCLUSIONS: This study confirms the usefulness of the systematic use of CB for accurate preoperative diagnosis of breast cancer, and the simplicity, safety and accuracy of this method also make ultrasound-guided CB applicable to non-palpable lesions.

Core Biopsy as Alternative to Fine-Needle Aspiration Biopsy in Diagnosis of Breast Tumors.

In spite of the widespread use of cytological smears for diagnosis of breast cancer lesions, many surgeons are still reluctant to accept the cytological report as the only criterion for performing definitive surgery. Modern surgical strategy requires a preoperative planning of the surgical treatment, possible through the use of core biopsy, which provides a diagnosis based on tissue specimens, thus permitting the study of both the architectural and cytological patterns. The authors report their five-year experience with this technique and evaluate its diagnostic usefulness and ability to reduce intraoperative biopsy procedures. The histological examination of 92 palpable breast lesions, clinically and mammographically detected, was performed with core biopsy, and diagnosis was confirmed with the surgical sample in 80 cases. A definitive histological diagnosis was obtained with core biopsy in 90% of cases. Only nine cases required confirmation with frozen section diagnosis at the time of definitive surgery. The sensibility of core biopsy was 92%, specificity and predictive value of positive result were 100%, and diagnostic efficiency was 86%. This study confirms the usefulness of systematic use of core biopsy for definitive preoperative diagnosis of breast cancer; the simplicity, safety and low cost of this method also make ultrasound-guided core biopsy applicable to nonpalpable lesions.

Opiate receptor function may be modulated through an oxidation-reduction mechanism.

Cupric ion, a thiol oxidant, caused naloxone-reversible analgesia when injected intracerebroventricularly in mice; its potency was close to that of morphine. Dithiothreitol, a thiol reductant, reversed the analgesia induced by cupric ion and antagonized analgesia induced by morphine. Oxidized dithiothreitol had no effect. These findings, together with evidence for redox modification of opiate receptor binding in vitro, suggest that a mechanism of oxidation-reduction of thiols may modulate opiate receptor function.

An endogenous inhibitor of N-methyltransferase activity and opiate receptor binding in rabbit tissue.

We have characterized and purified a peptide extracted from newborn rabbit brain, lung and liver. This peptide has a molecular weight of 1500 and has the ability to inhibit adult rabbit lung N-methyltransferase activity in vitro and can also bind to opiate receptor in rat brain homogenate.