The role of sentinel node biopsy in ductal carcinoma in situ of the breast.

AIM: Sentinel node biopsy (SNB) is an accepted alternative to lymphadenectomy in the case of invasive breast carcinoma, although the sentinel node's role in ductal carcinoma in situ (DCIS) diagnosed on core needle biopsy has not been well defined nevertheless guidelines recommend this procedure. The purpose of this study was to determine the diagnostic value of sentinel nodes in female patients with primary DCIS using core needle stereotactic biopsy. MATERIAL AND METHODS: Between the years 2000 and 2005, 261 patients were diagnosed with DCIS by core needle biopsy. In this group, 183 patients underwent SNB to determine lymph node involvement. Those patients with metastases to the sentinel node underwent axillary lymphadenectomy. RESULTS: In the group of 183 patients that underwent SNB, 10 patients (5.5%) showed metastases to the sentinel lymph node. Histopathological studies of the primary lesions of these 10 patients revealed invasive ductal carcinoma in 6 cases (3.5%) and 1 case (0.5%) of invasive lobular carcinoma. Only 3 of the patients (1.5%) were given a final diagnosis of DCIS with metastases to sentinel lymph nodes, of which 2 cases were DCIS and 1 case was DCIS with microinvasion. Axillary lymphadenectomy performed on patients with abnormal SNB showed involvement of other axillary lymph nodes in 4 patients. CONCLUSIONS: SNB as a diagnostic tool in DCIS remains controversial as the number of cases of axillary lymph node metastases is minuscule. The biggest clinical challenge in this situation is a group of patients with primary diagnosis of DCIS in which invasive components are seen by mammotomic biopsy.

[A case of primary lymphangiomyomatosis in retroperitoneal space and lungs]. / Przypadek pierwotnego naczyniaka chlonnego (lymphangiomyomatosis primaria) przestrzeni zaotrzewnowej i pluc.

Authors present a rare case of primary lymphangiomyomatosis. Diagnosis was based on histopathological evaluation. Diagnostic difficulties were caused by lack of pathognomonic symptoms in clinical examination, ultrasonography and CT. The patient has been treated with hormonal medicines (Provera, Megace) since 1997. Now she is in a good condition, She hasn't got any symptoms of progression disease.

Arp2/3 complex and actin dynamics are required for actin-based mitochondrial motility in yeast.

The Arp2/3 complex is implicated in actin polymerization-driven movement of Listeria monocytogenes. Here, we find that Arp2p and Arc15p, two subunits of this complex, show tight, actin-independent association with isolated yeast mitochondria. Arp2p colocalizes with mitochondria. Consistent with this result, we detect Arp2p-dependent formation of actin clouds around mitochondria in intact yeast. Cells bearing mutations in ARP2 or ARC15 genes show decreased velocities of mitochondrial movement, loss of all directed movement and defects in mitochondrial morphology. Finally, we observe a decrease in the velocity and extent of mitochondrial movement in yeast in which actin dynamics are reduced but actin cytoskeletal structure is intact. These results support the idea that the movement of mitochondria in yeast is actin polymerization driven and that this movement requires Arp2/3 complex.

[Cases of carcinoid tumor in stomach and retroperitoneal space]. / Przypadki rakowiaka zoladka i przestrzeni zaotrzewnowej.

Authors present two cases of carcinoid localized in stomach and retroperitoneal space. Diagnosis was based on clinical examination, endoscopy, CT and histopathological evaluation. The case of gastric carcinoid was an early lesion (penetrated only mucose and submucose layer of gastric wall). In opposition, second patient had inoperable large tumor localized in retroperitoneal space with multiple metastases to the liver.

[Radiotherapy in the adjuvant therapy of rectal cancer: comparison of two treatment schedules]. / Radioterapia w leczeniu uzupelniajacym raka odbytnicy: porównanie dwóch schematów leczenia.

UNLABELLED: From 1988 to 1991 54 patient with carcinoma of the distal part of the rectum were cured in our Department. These patients were divided into two groups (similar with regard to sex, age and advance of disease). In group I (28 patients) abdomino-perineal resection was performed, accompanied (according to histo-pathological indications) by adjuvant radiotherapy to maximal dose 6000 cGy. In group II such procedure was preceded by "short" radiotherapy (4 x 500 cGy). Local recurrence rate was 17.8% in group I and 11.5% in group II. CONCLUSIONS: Preoperative radiotherapy (for example "short" schedule 4 x 500 cGy) may decrease number of local recurrences after abdomino-perineal resections in rectal cancer cases. This procedure effects no technical problems and complications during and after operations.

[The effect of regional lymphatic metastasis on the methods and results of treating stomach neoplasms]. / Wplyw zajecia regionalnych wezlów chlonnych na sposób i wyniki leczenia raka zoladka.

From I 1986 to I 1997 we have operated in our Department 333 patients with gastric cancer. Resection has been done in 204 cases (with total resection rate 97%). Mostly there were patients with advanced disease (totally 160 cases with III and IV stage according to UICC classification). Metastases to regional lymph nodes were confirmed at 186 patients (91%). In every resection for cure and in palliative operations, where it was possible, we have done lymphangiectomy contained D1 and D2 level of regional lymph nodes. We achieved 28.9% 5-year survival rate (according to Kaplan-Meier) with postoperative mortality 2% and low number of surgical complications. Total resection of the stomach with regional node dissection (levels D1 and D2) is good and safe procedure and should be performed in majority cases of gastric cancer particularly in early and middle stages of disease.

[Evaluation of the usefulness and technique of intraoperative large bowel lavage]. / Ocena przydatnosci i technika sródoperacyjnego plunkania jelita grubego.

The technique is presented of intraoperative large bowel lavage, making possible cleansing of the bowel in patients in whom this was impossible to perform in the preoperative period. This method in some patients enables abandoning of diverting fistula creation and thus avoiding of multistage treatment.

Immunostimulation by systemic administration of Propionibacterium granulosum in patients with primary or secondary lung tumours.

The effect of a cell suspension of Propionibacterium granulosum strain KP-45 given intravenously to patients with advanced primary or secondary lung carcinoma, and simultaneously treated with cytostatic drugs, was estimated. The control group consisted of patients treated with cytostatics only. The clinical state of patients treated with the KP-45 preparation and with this immunostimulant plus cytostatics, was compared by evaluation of tumour size by X-ray examination, peripheral blood picture, and biochemical and immunological parameters. Treatment with P. granulosum KP-45 did not cause any serious adverse reaction or complication. No evident inhibitory effect on primary or secondary lung tumour development was observed. However, injections of the KP-45 preparation in cytostatics-treated patients resulted in decreased adverse effect of these drugs on the haemopoietic system and absence of bacterial infections, in contrast to patients treated with cytostatics only.

Local immunotherapy of stomach and intestinal carcinoma by Propionibacterium granulosum.

The effect of cell suspension of Propionibacterium granulosum strain KP-45 injected intratumorally was estimated in patients with advanced malignant neoplastic disease of the upper and lower part of the digestive tract. These patients received no other anticancer treatment, and results of therapy with P. granulosum were compared with a control group of nontreated patients. In the course of immunotherapy, general clinical state, dynamics of tumor growth as judged by endoscopy and morphologic, biochemical and immunologic parameters of the peripheral blood, were evaluated. Treatment with KP-45 preparation usually resulted in partial regression of tumor growth, accompanied by improvement of the clinical state of these patients, as well as reappearance of normal values of blood picture and biochemical parameters. Enhancement of cellular immune response, evaluated by increased number of peripheral blood T lymphocytes and increased skin reactivity to PHA and PPD, was observed. No serious side effects or complications of local immunotherapy were noted. No patients who had immunotherapy suffered from bacterial infection; this was not the case in the control group.