[Sentinel node biopsy in breast cancer--a minimally invasive procedure for staging of the axilla]. / Die Sentinel Node Biopsy beim Mammakarzinom--ein minimal invasives Verfahren zum exakten Staging der Axilla.

Clinical examinations and imaging methods are not sufficiently reliable for an exact staging of axillary nodes in breast cancer. The sentinel node biopsy concept is a minimally invasive procedure to locate and remove the first and important nodes responsible for draining a tumor. Histologic examinations using immunohistochemical methods permit more accurate staging than hematoxylin and eosin staining alone. Between 4/1997 and 9/1998 a total of 62 patients with 65 breast cancers underwent surgery. The sentinel node procedure with radio tracers and/or blue dye was performed in patients with clinically negative or unclear positive findings in the axilla, with a primary tumor size less than 5 cm; 11 patients had received preoperative chemotherapy. The sentinel node biopsy was followed by axillary dissection in 44 cases. In 58 (89%) cases we found one or more (on an average 1.4) sentinel nodes with radio tracers (in 73%) and/or the blue dye method (in 85%). Axillary nodal status was correctly predicted in 43 of 44 (97.7%) cases; only in one patient was the sentinel node false negative. After preoperative chemotherapy sentinel nodes were found in 9 cases; all of these were predictive. Micrometastases were found in two patients only after cytokeratine staining. Our results concur with the experience of other study groups in regard of sentinel node biopsy. The sentinel node concept is a fascinating method; its importance in breast cancer treatment appears to be comparable with introduction of breast saving surgery in the 1980's.

[Diagnosis of radionuclide uptake using samples and excretion measurements]. / Diagnose der Inkorporation durch Proben und Ausscheidungsmessungen.

Diagnosis of internal contamination with radionuclides can be achieved by body or organ counting and by analysis of samples of intake or excretion. Sample counting from air, drinking water, food etc. is preferred in environmental contamination and may be used to estimate average body burden and internal dose. For complete monitoring of intake numerous samples have to be measured. Unknown internal contamination with alpha and low energy beta emitters is detected by excretion analysis. For determination of body or organ burden, based on standard man models, time and frequency of intake, physical, chemical and biological behaviour of radionuclides have to be taken into account. Sample sources are mainly urine, feces, exhaled air and in special cases sweat, blood and hair. The collection of excreta needs the cooperation of the contaminated individuals. The results of analysis is usually delayed because of time consuming radiochemical procedures. Repetition of measurement is necessary to increase precision of dose estimate and for detection of single, recurrent or continuous uptake.

[The supply of iodine in the province of Vorarlberg]. / Die Jodversorgung im Bundesland Vorarlberg.

For evaluation of iodine supply in Vorarlberg, Austria, iodine urine excretion was measured in 299 patients. The Mean was 74,3 +/- 53,6 micrograms J/g Cr, the Median 61 micrograms J/g Cr. 79% of the patients showed an iodine deficiency I according to WHO classification and 41% an iodine deficiency II. In this patient group were included 44 subjects with no thyroid disease who showed an iodine excretion of 70.8 +/- 56,5 micrograms J/g Cr and a Median of 50,5 micrograms J/g Cr. There was no statistical difference to the values of the patient group. Regional evaluation of iodine supply showed an iodine deficiency I in 78% and an iodine deficiency II in 38% in the industrial region of the Rheintal. In the region Walgau with mixed industrial-rural population an iodine deficiency I was found in 81% and an iodine deficiency II in 45%. In the rural areas of Bregenzerwald and deep valleys an iodine deficiency I could be demonstrated in 81% and 83% respectively and an iodine deficiency II in 47 and 57% respectively. This moderate but statistically not significant differences show the minor influence of alimentation in iodine supply. Assuming a constant table salt consumption the results support the common belief that iodine supply in iodine deficient areas is strongly connected to incorporation of iodinated table salt. Therefore an increase of the iodination of table salt in Austria seems to be necessary to guarantee sufficient iodine supply.