[Validation of the sentinel lymph node biopsy in breast cancer]. / Validation de la technique de biopsie du ganglion sentinelle dans le cancer du sein.

PURPOSE: Assessment of our experience and validation of the sentinel lymph node biopsy technique in breast cancer stage T0-T2N0M0 surgery. METHODS: Identification and biopsy of the sentinel lymph node by the radio colloid method in a consecutive series of 205 patients undergoing surgery for breast cancer stage T0-T2N0M0 between October 1998 and January 2007, initially in association with a complete axillary lymph node dissection (learning curve), later in an elective way. Prospective recording of the data and analysis with an average follow-up of 50 months (3 to 102 months). RESULTS: Biopsy rate of the sentinel lymph node of 90%, false negative rate of the method 2.5%, axillary recurrence rate 0%. CONCLUSION: We confirm in this series that the sentinel lymph node biopsy technique is a reliable approach in our experience for the evaluation of the axillary lymph node status in breast cancer stage T0-T2N0M0.

Increased parasellar activity on gallium SPECT is not specific for active cluster headache.

We have performed Gallium SPECT head scans in 30 successive cluster headache (CH) patients and in 7 migraineurs without aura. Parasellar hyperactivity was judged as present in 81% of chronic CH patients, 54% of episodic CH patients in an active period, 56% of episodic CH patients in remission and 71% of migraineurs. No significant correlations were found between the SPECT images and the duration of the disease, of cluster periods or of remissions. Increased parasellar activity on Gallium SPECT is thus not specific for CH, nor for the active period of episodic CH. The method lacks reliability for investigation of putative cavernous sinus inflammation.

Immunoreactive prolactin like material in the urine of women.

Immunoreactive prolactin-like material (Ir Prl) was detected in urines of eugonadal women during the luteal phase and in urines of pregnant and lactating women. The levels of Ir Prl urinary excretion per 24 h and of elimination per 100 ml of glomerular filtrate were highest in lactating women as compared to pregnant women; levels in pregnant women were elevated as compared to eugonadal subjects. Iv injection of thyrotropin releasing hormone (TRH, 200 micrograms) caused increased levels of urinary Ir Prl. The physiochemical characteristics of urinary Ir Prl of lactating women were investigated by filtrating urine samples on Ultragel Aca 54 in presence or absence of Trasylol. Urines, supplemented with Trasylol and analyzed either immediately or after storage at room temperature for 24 h, contained in addition to the 23,000 Mr monomeric form (25.2 +/- 7.4%), two fractions of high (greater than or equal to 70,000) or low (less than 23,000) molecular weight, respectively. The latter material largely predominated (73.5 +/- 7.3%). Urines kept at room temperature for 24 h without Trasylol showed variable but significant decreases in the monomer form with a parallel increase in high MW and fragmented forms. The extent of degradation of the monomer was directly proportional to the proteolytic activity of the urines as estimated by the Azocoll breakdown test. Contrary to what was observed with the urinary endogenous monomeric Prl, human pituitary Prl remained unaltered upon incubation in Trasylol-free urines up to 45 h.(ABSTRACT TRUNCATED AT 250 WORDS)

[Clinical importance of the level of the free fraction of thyroid hormones]. / L'utilité clinique du dosage de la fraction libre des hormones thyroïdiennes.

The physiologic importance of the free fraction of thyroid hormones is well accepted for some time. The determination of free thyroid hormones plasma levels by column chromatography and radio-immunoassays has been tested in our laboratory since november 1980. Six hundred and ten patients have been submitted to a precise anamnesis, a clinical examination and a thyroid investigation by scintigraphy and echography. We have compared the following parameters: T4 and fT4, T3 and fT3, TSH, TBG in euthyroidism and in the pathologic status of hyperthyroidism, we have found an excellent correlation (r greater than 0,9) between the values of T4 and T3 and their free fraction. The determination of fT3 and fT4 seems to be specially interesting in comparison of the T4 and T3 because of the low incidence of false abnormal results in those patients regarding the other parameters. Hyperthyroidism is characterized by a lack of correlation between total and free hormones; the levels of the free fraction being widely increased. The determination of the free hormones levels improves the sensitivity and the accuracy of the diagnosis of hyperthyroidism. It permits an early diagnosis of the disease, an earlier detection of the recurrence and makes easier the follow-up of the treated patients. In hypothyroidism, there is a so light decrease in the value of fT3 and fT4 that the TSH estimation remains the method of choice to assure the diagnosis. Thus, we can conclude that the determination of fT3 and fT4 by column chromatography and radio-immunoassays is more discriminating in euthyroidism and hyperthyroidism. In hypothyroidism TSH and fT4 are the most sensitive parameters.