ASO Visual Abstract: Limited Reporting of Histopathologic Details in a Multi-Institutional Academic Cohort of Phyllodes Tumors: Time for Standardization

Annals of Surgical Oncology -     

Bilateral mastectomy operations and the role for the cosurgeon technique: A Nationwide analysis of surgical practice patterns

Traditionally, bilateral mastectomy (BM) operations are performed by a single surgeon but a two‐attending co‐surgeon technique (CST) has been described. A questionnaire was sent to members of the American Society of Breast Surgeons to assess national BM practices and analyze utilization and perceived benefits of the CST. Among surgeons responding, most continue to use the single‐surgeon approach for BMs; however, 14.1% utilize the CST and up to 31% are interested in future CST use. Time savings, mentorship, cost savings, and opportunity to learn new techniques were identified as perceived CST advantages.     

Melanoma metastatic to breast

A patient presented with an unusual case of a breast mass. History and meticulous physical examination led to the diagnosis of metastatic melanoma, which was confirmed by biopsy. The differential diagnosis of metastasis to breast is discussed.     

Oral absorption of metronidazole in rabbits irradiated with cobalt-60 gamma radiation

The absorption of oral metronidazole in control rabbits and in rabbits irradiated with cobalt-60 gamma radiation was studied. It was observed that the bioavailability of metronidazole was significantly reduced in irradiated animals the reduction being dependent on the dose of radiation. The maximum decrease in absorption was seen 48 h post-irradiation.     

Role of L-lysine HCl in immunopotentiation towards development of suitable tuberculosis vaccination

L-Lysine HCl is being proposed to be a possible biocompatible adjuvant to enhance immune response by virtue of its probable non-specific bridging action and cellular proliferation properties. This proposal has been tried to be substantiated by carrying out experimentation where L-lysine HCl has been used as an adjuvant (various groups based on mode of application and frequency of booster dose were designed) in tuberculosis vaccination experiments with heat killed Mycobacterium tuberculosis (MTB) and Bacille Calmette Guerin (BCG). Antibody titre has been followed in all the experiments as a measure of immune response. Amongst the various groups designed, group 1A (L-lysine HCl was given at a separate site as that of the antigen; lysine booster was given to this group intermittently, i.e. lysine given on 0th, 7th, 14th, 21st days of immunization) came out as the stand-alone leader. This mode and frequency of application was then compared with a group which received a standard adjuvant, viz. alhydrogel. Results were obtained which showed the following order in terms of decreasing antibody titre: alhydrogel group > lysine group > control group. Considering the biocompatible nature of lysine in comparison with the reportedly hazardous nature of alum adjuvants, we propose L-lysine HCl as a probable adjuvant in vaccination.     

Impact of Residual Nodal Disease Burden on Technical Outcomes of Sentinel Lymph Node Biopsy for Node-Positive (cN1) Breast Cancer Patients Treated with Neoadjuvant Chemotherapy

Annals of Surgical Oncology - Recent trials have demonstrated the feasibility of sentinel lymph node biopsy (SLNB) for cN1 breast cancer patients after neoadjuvant chemotherapy (NAC). This study...     

Treatment of essential hypertension and non-insulin dependent diabetes mellitus with vitamin C

Inappropriate response of the carotid body region to encroachment of its perfusion results in essential hypertension (EH) and/or non-insulin dependent diabetes mellitus (NIDDM). This encroachment is caused by atherosclerosis. The carotid body perceives the encroachment on the lumen as a reduction in the availability of oxygen and glucose for the brain. Raising the perfusion pressure (thus, resulting in EH) and/ or inducing insulin resistance (causing NIDDM) are seen as compensatory mechanisms in response to the primary pathology, ie the encroachment of the lumen by atherosclerosis. Therefore, the reduction or reversal of the atherosclerosis process will help improve perfusion to the carotid bodies, which will in turn reduce or reverse the pathophysiological compensatory adjustments described above. A supplemental therapy, in addition to the standard treatment, with vitamin C is suggested here. The argument in favour of this suggestion is the basis of this paper. Vitamin C is a very important antioxidant. It is suggested to be used without any interference with the usual therapy prescribed for these two chronic diseases. It is recommended to be administered in small, frequent doses of 100mg every 2h, except during sleep. There is no need for compensation for the occasional missed dose. The safety of larger doses of vitamin C than the current recommendations, represents the beauty and is reassuring in recommending this approach.