Free transplantation of venous network pattern skin flap: an experimental study in rabbits

Free skin flaps using rabbit ear to replace rabbit scalp have been accomplished using only arteriovenous and venous-venous anastomosis, without arterio-arterial anastomosis. The technique produced excellent graft survival in 30 of 33 rabbits. Without the vascular anastomosis control grafts did poorly. The mechanism of flow reversed revascularization is discussed.     

Antifungal activities and action mechanisms of compounds from Tribulus terrestris L.

Antifungal activity of natural products is being studied widely. Saponins are known to be antifungal and antibacterial. We used bioassay-guided fractionation to have isolated eight steroid saponins from Tribulus terrestris L. , which were identified as hecogenin-3-O-beta-D-glucopyranosyl （ 1→4 ）-beta-D-galactopyranoside （ TTS-8）, tigogenin-3-O-beta-D-glucopyranosyl （ 1 →4 ）-beta-D-galactopyranoside （ TTS-9 ）, hecogenin-3-O-beta-D-glucopyranosyl （ 1 → 2 ）-beta-D-glucopyranosyl （ 1 4 ）-beta-D-galactopyranoside （ TTS-10 ）, hecogenin-3-O-beta-D-xylopyranosyl （ 1→3 ）-beta-D-glucopyranosyl （ 1→ 4 ）-beta-D-galactopyranoside （ TTS-11 ）, tigogenin-3-O-beta-D-xylopyranosyl （ 1→ 2 ）-[- beta-D-xylopyranosyl （ 1 → 3 ） ]-beta-D-glucopyranosyl （1→4）-[alpha-L-rhamnopyranosyl （1→2）]-beta-D-galactopyranoside （TTS-12）, 3-O-Ebeta-D-xylopyranosyl （1→2）-[beta-D- xylopyranosyl （1→3）]-beta-D-glucopyranosyl （ 1→4）-[alpha-L-rhamnopyranosyl （ 1→2 ）]-beta-D-galactopyranosy13-26-O-beta- D-glucopyranosyl-22-methoxy-（3beta, 5alpha, 25R）-furostan-3,26-diol （TTS-13）, hecogenin-3-O-beta-D-glucopyranosyl （ 1→ 2）-[beta-D-xylopyranosyl （ 1→ 3 ）]-beta-D-glucopyranosyl （ 1 → 4 ）-beta-D-galactopyranoside （ TTS-14 ）, tigogenin-3-O-beta-D- glucopyranosyl （ 1→ 2 ）-[ beta-D-xylopyranosyl （ 1 → 3 ）]-beta-D-glucopyranosyl （ 1 → 4 ）-beta-D-galaetopyranoside （ TTS-15 ）. The in vitro antifungal activities of the eight saponins against five yeasts, Candida albicans, Candida glabrata, Candida parapsilosis, Candida tropicalis and Cryptococcus neoformans were studied using microbroth dilution assay. In vivo activity of TTS-12 in a Candida albicans vaginal infection model was studied in particular. The results showed that TTS-12 and TTS-15 were very effective against several pathogenic candidal species and Cryptococcus neoformans in vitro. It is noteworthy that TTS-12 and TTS-15 were very active against Candida albicans （MIC50 = 10 and 2.3 microg/ml） and Cryptococcus neoformans （MIC50 = 1.7 and 6. 7 microg/ml）.     

Carrier solutions for low-level intravenous insulin infusion.

In the use of low-level intravenous insulin infusion for treating diabetic hyperglycaemia and ketoacidosis adsorption of insulin to containers or plastic infusion apparatus results in significant losses of 60-80% of insulin in dilute physiological saline solution (40 U/l). It is therefore necessary to add protein to the carrier solution to minimize losses and maintain a constant delivery rate. Recovery studies showed that 3.5% w/v polygeline solution (polymer of degraded gelatin) was a suitable medium for this purpose, offering some advantages over human serum albumin. A minimum concentration of 0.5% polygeline was required to ensure adequate delivery of insulin to the patient.     

Long-term survival of patients with supraclavicular metastases at diagnosis of breast cancer.

BACKGROUND: Patients with supraclavicular metastases at diagnosis of breast cancer were classified between 1987 and 2002 as having stage M(1) breast cancer according to the tumor-node-metastasis (TNM) system. The 2003 edition of the TNM staging guidelines has classified such patients as having stage IIIC disease. To determine relative prognosis, we compared long-term survival in a population-based cohort of patients with isolated supraclavicular metastases (nodal-M(1)) to outcomes of patients with stage IIIB or M(1) (other) disease at presentation. MATERIALS AND METHODS: Among patients with breast cancer and known tumor stage referred to the British Columbia Cancer Agency from 1976 to 1985, 336 IIIB, 233 M(1), and 51 nodal-M(1) patients were identified. Actuarial overall and breast cancer-specific survival rates were determined to 20 years. RESULTS: Overall survival at 20 years was 13.2% for nodal-M(1) cases (95% confidence interval [CI], 5% to 26%), 9.4% for IIIB cases (95% CI, 6% to 14%), and 1.3% for M(1) (other) cases (95% CI, 0.4% to 3.5%; log-rank P <.0005). Overall survival was similar between nodal-M(1) and IIIB cases (P =.27). Breast cancer-specific survival at 20 years was 24.1% for nodal-M(1) cases (95% CI, 13% to 37%), 30.2% for IIIB cases (95% CI, 23% to 38%), and 3.9% for M(1) (other) cases (95% CI, 2% to 8%; log-rank P <.0005). Breast cancer-specific survival was significantly different for nodal-M(1) cases compared with either IIIB or M(1) (other) cases (P =.008 for both). CONCLUSION: Patients with supraclavicular metastases at diagnosis have significantly better outcomes than patients with M(1) (other) disease and overall survival similar to patients with IIIB disease. Reclassification as stage IIIC is appropriate for patients with breast cancer who present with supraclavicular nodal metastases alone.     

Fine needle aspiration biopsy in the diagnosis and management of fibroadenoma of the breast

Cytological and histological biopsies were obtained on 75 breast lumps clinically diagnosed as fibroadenomas. Of these, 95 per cent of lesions were benign. In 51 (68 per cent) confirmed as fibroadenomas histologically, cytology was benign in 78 per cent, but inadequate for diagnosis in 16 per cent. The remaining 24 lesions included three breast cancers and one lymph node with Hodgkin's disease. In this group cytology was inadequate for diagnosis in 54 per cent, including one breast cancer. No lesion with benign cytology was subsequently shown to be malignant. The study supports the view that clinical diagnosis and cytology are accurate in the diagnosis of benign breast disease of this type. Breast cancer may rarely present with the clinical features of a fibroadenoma and too few lesions have been studied to assess fully the performance of cytological biopsy in detecting these small mobile lesions. A non-excisional policy should therefore include prolonged follow-up and repeat biopsy.