Objective： The aim of our study was to investigate the feasibility and safety of thoracoscopic internal mammary lymphadenectomy as a method to refine and thereby improve nodal staging in breast cancer. Methods： Duri...Objective： The aim of our study was to investigate the feasibility and safety of thoracoscopic internal mammary lymphadenectomy as a method to refine and thereby improve nodal staging in breast cancer. Methods： During the period from June 2004 to May 2007, 50 patients with operable breast cancer underwent modified radical mastectomy （MRM） or breast conserving surgery （BCS）, followed by thoracoscopic internal mammary lymphadenectomy, using 3 ports through the skin incision of the MRM or the BCS. Metal clips were used to mark precise site of lymphadenectomy. Results： of total number of 50 patients, the mean age of patients was 44 years （range, 27-60 years）. 40 （80%） had medio-central tumor, 10 （20%） had lateral tumor. 35 （70%） had clinically involved axillary nodes. 16 out of 50 patients received neo-adjuvant CTH. 44 patients underwent MRM and 6 patients underwent BCS. No intra-operative complications occurred. Atelectasis was the only postoperative complication that was encountered, which occurred in 12 cases, and was treated conservatively. The average chest drainage period was 1.2 day （range, 1-2 days）. The total number of IMN metastasis was 18 patients （36%）. The risk of IMN metastasis was higher; in younger patients （P = 0.03）, in medio-central tumors （P = 0.03）, in bigger tumors （P = 0.05）, with heavier metastasis of axillary LNs （P = 0.001）. But a correlation with the histological pattern of the lry tumor didn＇t exist （P = 1）. Knowing the IMN status helped in proper staging of patients, 7 patients showed evident stage migration after adding the IMN analysis to that of primary tumor and axillary LN. During the follow up period （the median, 22 months; range, 7 to 42 months）, no patient had pleural dissemination or port-site metastasis. Conclusion： Thoracoscopic IMN lymphadenectomy is a safe procedure, which can be done serious additional complications or cosmetic compromise. And allow proper nodal staging, which allow proper treatment planning.展开更多
The main goal of this work was to quantify the detection of colistin at low levels in urine samples through the practical application of mixed surfactant micellar electrokinetic chromatography–laser-induced fluoresce...The main goal of this work was to quantify the detection of colistin at low levels in urine samples through the practical application of mixed surfactant micellar electrokinetic chromatography–laser-induced fluorescence (MEKC-LIF) analysis method using its advantage of sensitivity and to examine direct injection of biological samples. Colistin (po- lymyxin E) has neither strong UV chromophore nor fluorophore. So, its assay for metabolism, pharmacokinetics studies for bioavailability and bioequivalence are difficult because of poor detectability. Therefore an enhanced UV or fluores-cence detection by chemical derivatization is required. MEKC-LIF method was proposed for colistin with a 488/520 nm argon-ion laser using a pre-CE derivatization with fluorescein isothiocyanate (FITC). Borate buffer was used as background buffer (BGB). The different parameters affecting the proposed derivatization reaction including concentration of the derivatizing reagent, reaction time and temperature were studied and optimized. The derivative was stable for up to 3 days. Different micelles (TX-100 and SDS) were examined as BGB additives separately but negative-charged mixed micelles (SDS/TX-100) were shown to be the best additive to BGB for the analysis of colistin particularly in human urine as they enhance both selectivity and sensitivity of the proposed method. BGB was used with pH 9.5, 10 kV, 8 s inj time, capillary length 75 cm × 75 μm ID (66 cm effective length), detection was LIF Ex 488 nm;Em 520 nm. The method was applied to colistin analysis in human urine and the recovery was > 98% (n = 5). LOD and LOQ in urine after pre-column derivatization using FITC were 100 and 250 ng/ml, respectively. Urine samples were analysed by direct injection without sample pre-treatment. The mechanism of enhancement of fluorescence of the derivative by surfactant was proposed.展开更多
文摘Objective： The aim of our study was to investigate the feasibility and safety of thoracoscopic internal mammary lymphadenectomy as a method to refine and thereby improve nodal staging in breast cancer. Methods： During the period from June 2004 to May 2007, 50 patients with operable breast cancer underwent modified radical mastectomy （MRM） or breast conserving surgery （BCS）, followed by thoracoscopic internal mammary lymphadenectomy, using 3 ports through the skin incision of the MRM or the BCS. Metal clips were used to mark precise site of lymphadenectomy. Results： of total number of 50 patients, the mean age of patients was 44 years （range, 27-60 years）. 40 （80%） had medio-central tumor, 10 （20%） had lateral tumor. 35 （70%） had clinically involved axillary nodes. 16 out of 50 patients received neo-adjuvant CTH. 44 patients underwent MRM and 6 patients underwent BCS. No intra-operative complications occurred. Atelectasis was the only postoperative complication that was encountered, which occurred in 12 cases, and was treated conservatively. The average chest drainage period was 1.2 day （range, 1-2 days）. The total number of IMN metastasis was 18 patients （36%）. The risk of IMN metastasis was higher; in younger patients （P = 0.03）, in medio-central tumors （P = 0.03）, in bigger tumors （P = 0.05）, with heavier metastasis of axillary LNs （P = 0.001）. But a correlation with the histological pattern of the lry tumor didn＇t exist （P = 1）. Knowing the IMN status helped in proper staging of patients, 7 patients showed evident stage migration after adding the IMN analysis to that of primary tumor and axillary LN. During the follow up period （the median, 22 months; range, 7 to 42 months）, no patient had pleural dissemination or port-site metastasis. Conclusion： Thoracoscopic IMN lymphadenectomy is a safe procedure, which can be done serious additional complications or cosmetic compromise. And allow proper nodal staging, which allow proper treatment planning.
文摘The main goal of this work was to quantify the detection of colistin at low levels in urine samples through the practical application of mixed surfactant micellar electrokinetic chromatography–laser-induced fluorescence (MEKC-LIF) analysis method using its advantage of sensitivity and to examine direct injection of biological samples. Colistin (po- lymyxin E) has neither strong UV chromophore nor fluorophore. So, its assay for metabolism, pharmacokinetics studies for bioavailability and bioequivalence are difficult because of poor detectability. Therefore an enhanced UV or fluores-cence detection by chemical derivatization is required. MEKC-LIF method was proposed for colistin with a 488/520 nm argon-ion laser using a pre-CE derivatization with fluorescein isothiocyanate (FITC). Borate buffer was used as background buffer (BGB). The different parameters affecting the proposed derivatization reaction including concentration of the derivatizing reagent, reaction time and temperature were studied and optimized. The derivative was stable for up to 3 days. Different micelles (TX-100 and SDS) were examined as BGB additives separately but negative-charged mixed micelles (SDS/TX-100) were shown to be the best additive to BGB for the analysis of colistin particularly in human urine as they enhance both selectivity and sensitivity of the proposed method. BGB was used with pH 9.5, 10 kV, 8 s inj time, capillary length 75 cm × 75 μm ID (66 cm effective length), detection was LIF Ex 488 nm;Em 520 nm. The method was applied to colistin analysis in human urine and the recovery was > 98% (n = 5). LOD and LOQ in urine after pre-column derivatization using FITC were 100 and 250 ng/ml, respectively. Urine samples were analysed by direct injection without sample pre-treatment. The mechanism of enhancement of fluorescence of the derivative by surfactant was proposed.
