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Authors have presented a very rare case of young woman favourable surgically treated for morphologically correct breast tissue in the unilateral axilla. They have paid the peculiar attention to possibility of ectopically placed breast tissue malignancy of every that case.
The F-wave conduction velocity (FWCV) in the central segment (axilla to spinal cord) of the median and ulnar nerves was compared to the motor nerve conduction velocity (MNCV) in the more distal segments in nine patients with mild cases of the Guillain-Barré syndrome. In four patients, FWCV was slow despite normal or borderline MNCV. In four others, both FWCV and MNCV were abnormal. One patient showed slow MNCV with normal FWCV. The average FWCV was significantly decreased (40.9 +/- 12.0 meters/sec for median and 42.9 +/- 8.3 meters/sec for ulnar nerves) when compared to the corresponding normal values (64.3 +/- 6.4 meters/sec and 63.1 +/- 5.9 meters/sec). These data support the hypothesis that the central segment of a nerve is predominantly involved in some patients with Guillain-Barré syndrome.
The purpose of this study was to evaluate the ability of MRI to identify a primary site of malignancy in the breast of patients who present clinically with ipsilateral lymph nodes containing metastatic carcinoma but whose physical and mammographic examination are negative. MRI of the breast was performed on four patients using a variety of imaging parameters, all with and without gadolinium contrast. All patients had biopsy-proven adenocarcinoma of the ipsilateral axilla, with negative physical and mammographic examinations. Foci of enhancement assessed visually on precontrast and postcontrast scans (n = 1) and on subtraction studies (n = 3) were considered suspicious under the clinical circumstances defined for this study. Lesions identified on MRI were re-identified on ultrasound examination and either preoperative localization for excisional biopsy or tissue sampling was performed. Surgery was performed and histopathologic correlation was obtained in all cases. Primary sites of breast carcinoma were identified in all four patients, with multiple sites of malignancy identified in three of four patients. Breast conservation therapy was made possible for three of four patients based on the results of the MRI study showing sites of malignancy and no features of cancer elsewhere in the breast. Follow-up data of 1, 2, and 5 years of these patients show no evidence of recurrent disease. MRI of the breast is a useful technique for identifying primary sites of malignancy in patients presenting with ipsilateral lymph nodes positive for metastatic adenocarcinoma when the physical and mammographic examinations are negative.
Twenty-one median and 22 ulnar nerves were tested in 12 patients for motor nerve conduction velocity (MNCV) and motor nerve conduction time (MNCT) in the segments from Erb's point (N) to axilla (A) bilaterally. It was found that on this segment for both nerves, MNCV values equal to or smaller than 51 m/s or conduction times equal to or longer than 4 ms are to be considered abnormal. For comparative studies and for checking the normality of the tested nerves in their entire length, the more distally located segments in the same nerve were also tested. For diagnostic purposes, the differences between right and left MNCV or MNCT values determined in the same person on N-A segments of homologous nerves were analysed. Motor nerve conduction velocity or MNCT determinations on the N-A nerve segment are expected to replace MNCV determinations on the longer N-AE (AE=100 mm above elbow) nerve segment, which is now in use, for diagnosis of the thoracic outlet syndrome.
The aim of the work was the evaluation of the dose delivered to the axilla during endocurietherapy for carcinoma of the breast using Iridium 192. The position of the radioactive material with respect to the axillary zone differing with the patient seated or lying, the authors carried out an vivo dosimetric study using Lithium fluoride. They refer to the chief properties of Lithium fluoride which render it the dosimetric agent of choice for clinical work and give details of their experimental conditions, stressing the problems encountered in practice (response in relation to dose, mass of thermoluminescent powder to use, fading, regeneration etc.). They then describe the technique used for placing the thermoluminescent dosimeter in the axillary zone adjacent to the target volume irradiated. Results concerning 43 patients made possible the establishment of a significant correlation between the dose delivered to the axillary region and the site of implantation of the radioactive material in the breast, and show that, with identical tumour doses, this dose is little dependent upon the structure of the radioactive implant itself. They conclude that the dose delivered to the axillary region is of the order of 25% of the tumour dose if the radioactive implant is localised in the axillary tail, 10% if it is in the upper outer quadrant and negligeable if it is elsewhere.
We presented a case of use a dacron prosthesis, bonded with collagen and impregnated with salts of silver in the treatment of extraanatomical axilla-femoral by-pass infection, by-pass was made at 78-years-old patient cause of an acute ischaemia of the lower extremity caused by an inoperative inflammatory aneurysm of abdominal aorta and iliac arteries. Firstly intentional antibiotics were administered. The patient was again admitted to hospital and operated on after an ineffective preventive treatment. The infected prosthesis was replaced by a new, salts of silver impregnated dacron one with increased infection resistance. The clinical effect was successful.
A 36-year-old woman presented with persistent skin-coloured papules in the axillae after waxing, caused by reactive perifollicular fibrosis.
The study was carried out to identify the group of patients with early breast cancer [stage I and II] after surgery in which chest wall irradiation alone was given without lymphatic irradiation thus reducing morbidity and also creating room for more patients on the available limited treatment facility. 92 patients with histologically confirmed early breast cancer that attended Radiotherapy clinic between June 1995 and May 1998 that satisfied selection criteria were studied. They all received External Radiotherapy to the chest wall, meadiasternum inclusive and breast if still in-situ. All also received cytotoxic chemotherapy. Majority of the patients 67 [84.8%] were recurrence free in 2 years while 12 [15.2%] had recurrent disease, the recurrent sites were axilla 4 [5.06%], chest wall 3 [3.80%] and supraclavicular 2 [2.52%]. Average time to recurrence was 3-12 months. In view of majority being recurrence free, chest wall irradiation alone in early breast cancer [stage I and II] could be encouraged, thus creating access to treatment for more patients in centers like ours with limited therapy facilities.
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