Is intraoperative touch imprint cytology indicated in the surgical treatment of early breast cancers?

INTRODUCTION: Intraoperative touch imprint cytology (TIC) of the sentinel lymph node(s) (SLN(s)) in the treatment of breast cancer has significantly reduced the number of axillary block dissections (ABD) required during second surgeries. Based on recent studies, ABD was not considered necessary if the presence of tumor cells/micrometastasis was confirmed in the SLN(s) or in the case of macrometastases in a patient group meeting the inclusion criteria for the ACOSOG Z0011 study. Our aim was to determine the sensitivity and usefulness of TIC with regard to these results. METHODS: TICs of the SLN(s) were examined in 1168 patients operated on for breast cancer. The method was also analyzed retrospectively based on the guidelines for the Z0011 study. During TIC, new samples were cut every 250 µm; impression smears were evaluated after being stained with hematoxylin eosin. RESULTS: TIC confirmed metastasis in 202 cases (202/1168, 17.29%). Metastasis was confirmed in SLN(s) in 149 additional cases during a final histological examination. The sensitivity of TIC was found to be 57.18%, and its specificity was 99.63%. An analysis was then performed except for cases that met the inclusion criteria for the Z0011 study and with metastasis smaller than 2 mm (micrometastasis/isolated tumor cells) considered to be positive during intraoperative cytology. The sensitivity of the method decreased to 34.23%, while its specificity was still high at 99.76%. CONCLUSIONS: Based on the new guidelines for ABD, imprint cytology cannot be considered a beneficial and cost-effective intervention in the surgical treatment of early breast cancer.

Seasonal and diurnal variability in sap flow intensity of mature sessile oak (Quercus petraea (Matt.) Liebl.) trees in relation to microclimatic conditions.

In this study sap flow dynamics of mature sessile oak trees (Quercus petraea) in a marginal sessile oak-turkey oak forest was investigated in 2009. That year spring was dry without significant rain in April and May and the driest month was August. Due to the extreme weather conditions the volumetric soil water content (SWC) of upper 30 cm was low on experimental days in May (0.13-0.14 cm3 cm-3) but it reached the lowest value in August (0.08 cm3 cm-3). Sap flow was measured in a dominant and a co-dominant tree by heat dissipation method from 26 March till 30 October. In the present paper several three-day long periods of the continuous seasonal recordings were chosen to represent the effects of typical weather conditions and different stages of canopy development on sap flow dynamics. The daily maximum sap flow density values of dominant and co-dominant trees were similar (0.30-0.32 cm3 cm-2 min-1) in moist period (July). Rains and transient increase of SWC after proceeding drought resulted in change of diurnal course of sap flow in experimental days of July. In this period dominant trees also showed considerable sap flow (0.19 cm3 cm-2 min-1) during night hours and short sap flow peaks in early morning (6:00 to 8:00 a.m.) indicating the refilling of desiccated tissues. After the progressive drought in August the daily maximum sap flow density decreased to 0.07 cm3 cm-2 min-1 in dominant tree and to 0.12 cm3 cm-2 min-1 in the co-dominant. Both trees exhibited gradual stomatal closure from morning hours.

Seasonal variation of leaf ecophysiological traits within the canopy of Quercus petraea (Matt.) Liebl. trees.

Facing contrasting light regimes during a vegetation season and depending on canopy position, physiological plasticity of leaves is vital for tree species to sustain the optimal ratio between the benefit of carbon assimilation and the costs of photoprotection in a given leaf. We tested the seasonal adjustment of sun and shade leaf photochemistry of sessile oak (Quercus petraea (Matt.) Liebl.) to changing light environments by parallel investigation of the meteorological conditions, photosynthetic pigment content, PSII quantum efficiency and excitation energy quenching. Sun and shade leaves got adapted to their prevailing light regimes till mid of May. High LMA was a favourable trait in avoiding water loss and decreasing photoinhibition in both flushing and sun leaves, while low LMA optimized the light absorbing leaf surface in the lower canopy layer. Partitioning of excitation energy dissipation pathyways that is PSII photochemistry-Y(II), regulated-Y(NPQ) and non-regulated-Y(NO) quenching changed significantly during leaf ontogeny and with the position of leaves in the canopy. At 800 µmol m(-2) s(-1)Y(II) < Y (NO) < Y (NPQ) was characteristic to early developmental stage of leaves from both canopy layers and to mature shade leaves, and Y(NO) < Y (II) < Y (NPQ) to mature sun leaves but the magnitude of Y(NPQ) and violaxanthin cycle activity differed in different canopy positions.

[Determination of urinary NAG to detect renal ischemia-reperfusion injury and the protective effect of Allopurinol]. / Ischaemia-reperfusiós vesekárosodás és az Allopurinol védo hatásának kimutatása vizelet NAG követésével.

We analysed the effect of ischemia-reperfusion injury to renal parenchyma after unilateral renal artery clamping using urinary N-acetyl-beta-D-glucosaminidase (NAG) that is a sensitive parameter of early renal tubular injury. In the study 60 mongrel dogs were divided into 3 groups: in the 1st group the left renal artery was clamped for 45 minutes, in the 2nd group Allopurinol was administered before the clamping, the 3rd was the control group, where only laparotomy and closure of the abdomen was performed. Urinary NAG activity referring to urinary creatinine (NAG index) was determined before the operation, at the beginning of the reperfusion, in the 60th and 120th minute of the reperfusion then 1, 2, 3 and 5 days after the operation. The highest NAG indices relating to injury of the proximal tubuli were found at the beginning of the reperfusion, in the 60th and 120th minutes of the reperfusion, then NAG returned to preoperative level in each group. Significantly higher NAG indices were found in the ischemia-reperfusion group compared to the group with Allopurinol pretreatment. Renal ischemia-reperfusion injury and the protective effect of Allopurinol could be detected by lysosomal NAG enzyme. The injury of the tubular function was reversible so it could be a change in tubular function.

Urinary N-acetyl-beta-D-glucosaminidase activity in leukaemic children during high-dose methotrexate therapy.

Urinary N-acetyl-beta-D-glucosaminidase (NAG-ase) activity is a very sensitive parameter of kidney proximal tubular damage. Using urinary NAG-ase activity/urinary creatinine as the NAG index, the serum methotrexate (MTX) level and urinary pH were investigated simultaneously. These parameters were measured in 17 leukaemic children. During MTX treatment, NAG indices were normal in 5 children and only slightly elevated occasionally in 9 patients. Among them, transiently high serum MTX levels (Patient A) or low urinary pH (Patient B) were accompanied by high NAG indices. MTX toxicity has been diagnosed in 3 cases, when permanently high NAG indices were in accordance with other clinical signs.

Assay of N-acetyl-beta-D-glucosaminidase in urine from neonates: comparison of two new colorimetric methods using MNP-GlcNAc and VRA-GlcNAc as substrates.

The NAG activity present in urine from newborn babies was assayed using two colorimetric procedures with either MNP-GlcNAc or VRA-GlcNAc as substrate and compared with data obtained with the well established PNP-GlcNAc procedure. Both new assays were easy to perform and reproducible. The MNP-GlcNAc method has the advantage that it is now available as a kit; however, the VRA-GlcNAc procedure is more sensitive. NAG activity, creatinine concentration and NAG-index values were determined in normal neonates and within-run imprecision calculated. Excellent correlations were found between MNP-GlcNAc-ase and VRA-GlcNAc-ase indices (r = 0.984) and between PNP-GlcNAc-ase and VRA-GlcNAc-ase indices (r = 0.952). When low molecular weight urinary components were removed by gel filtration no significant change in VRA-GlcNAc-ase activity was observed.

Erythrocyte damage in newborn babies caused by hyperbilirubinaemia and hypoxia.

Erythrocyte damage of newborn babies suffering from hyperbilirubinaemia and hypoxia was compared with a control group. In the cases of serum bilirubin level higher than physiological icterus lipid peroxidation of erythrocytes decreased probably due to the antioxidant effect of bilirubin. Moreover, an increase in potassium and protein outflow from patients' red blood cells was observed indicating a membrane damage both in hyperbilirubinaemic and hypoxic groups. Superoxide dismutase activity of serum and erythrocytes did not show significant difference in patients compared with healthy newborns. However, the low serum coeruloplasmin level in the hypoxic group and the low serum transferrin level of babies both with hypoxia and hyperbilirubinaemia suggest an insufficient antioxidant defence against free radicals.

Serum antioxidant activity in premature babies.

Autooxidation of bovine-brain homogenate proved to be a good model to determine the antioxidant capacity of sera. It was measured in parallel with the level of ceruloplasmin and apotransferrin in sera of 35 healthy children and 20 premature babies (gestational age 28-33 weeks). Antioxidant capacity was very low in premature babies with a nadir on the 4th postnatal day. Lipid-peroxidation of bovine-brain homogenate could be inhibited in vitro by the addition of exogen antioxidant. In this assay MTDQ-DS, Cavinton, DPA-HC1, vitamin E, A, C showed different antioxidant activity.

An in vitro study of the hydroxyl scavenger effect of Cavinton.

The hydroxyl radical scavenging capability of vinpocetine was studied in vitro by aromatic hydroxylation and deoxyribose degradation methods. Hydroxyl radicals were generated by the Fenton reaction. The effect of vinpocetine was compared to other antioxidants, to mannitol, vitamin E and dimethyl sulfoxide. The antioxidant capacity of vinpocetine is near to vitamin E, and higher than that of mannitol.