Sentinel node biopsy in male breast cancer

OBJECTIVE: Male breast cancer is a rare disease and axillary status is the most important prognostic indicator. Lymphoscintigraphy associated with gamma-probe guided surgery has been proved to reliably detect sentinel nodes in female patients with breast cancer. This study evaluates the feasibility of the surgical identification of sentinel node by using lymphoscintigraphy and a gamma-detecting probe in male patients, in order to select subjects who would be suitable for complete axillary lymphadenectomy. METHODS: Colloid human albumin labelled with 99Tc was administered to 18 male patients with breast cancer and clinically negative axillary lymph nodes. Lymphoscintigraphy was performed the day before surgery. An intraoperative gamma-detecting probe was used to identify sentinel nodes during surgery. RESULTS: Lymphoscintigraphy and biopsy of the sentinel node were successful in all cases. A total of 20 sentinel nodes were removed. Pathological examinations showed 11 infiltrating ductal carcinomas, two intraductal carcinomas and five intracystic papillary carcinomas. Six patients (33%) had positive sentinel node (micrometastases were found in three patients). These patients underwent axillary dissection; in five of them (83%) the sentinel node was the only positive node. Twelve patients (67%) showed negative sentinel nodes; in all of them no further surgical treatments were planned. CONCLUSIONS: As in women, lymphoscintigraphy and sentinel node biopsy under the guidance of a gamma-detecting probe proved to be an easy method for the detection of sentinel nodes in male breast carcinoma. In male patients with early stage cancer, sentinel node biopsy might represent the standard surgical procedure in order to avoid unnecessary morbidity after surgery, preserving accurate staging of the disease in the axilla.     

The influence of occupants’ body mass on carbon dioxide mass flow rate inside a university classroom – case study

From 2014 to 2017, through the cold season, 37 experimental measurements of carbon dioxide (CO₂) concentration were done inside a selected university classroom, during the same type of activity, namely written examination. Based on the data obtained from the experimental measurements, the article sought to primarily establish a correlation between the body mass of the students and the intensity of carbon dioxide releases inside the experimental classroom. This relationship was determined by using statistical analysis (general least-square estimation of the regression line). The resulting equation may be used to determine in an easier way the required outdoor air volume flow rate inside a university classroom.     

Novel metrics for growth model selection

Background

Literature surrounding the statistical modeling of childhood growth data involves a diverse set of potential models from which investigators can choose. However, the lack of a comprehensive framework for comparing non-nested models leads to difficulty in assessing model performance. This paper proposes a framework for comparing non-nested growth models using novel metrics of predictive accuracy based on modifications of the mean squared error criteria.

Methods

Three metrics were created: normalized, age-adjusted, and weighted mean squared error (MSE). Predictive performance metrics were used to compare linear mixed effects models and functional regression models. Prediction accuracy was assessed by partitioning the observed data into training and test datasets. This partitioning was constructed to assess prediction accuracy for backward (i.e., early growth), forward (i.e., late growth), in-range, and on new-individuals. Analyses were done with height measurements from 215 Peruvian children with data spanning from near birth to 2 years of age.

Results

Functional models outperformed linear mixed effects models in all scenarios tested. In particular, prediction errors for functional concurrent regression (FCR) and functional principal component analysis models were approximately 6% lower when compared to linear mixed effects models. When we weighted subject-specific MSEs according to subject-specific growth rates during infancy, we found that FCR was the best performer in all scenarios.

Conclusion

With this novel approach, we can quantitatively compare non-nested models and weight subgroups of interest to select the best performing growth model for a particular application or problem at hand.

     

Relapse of cryoglobulinemic vasculitis with new-onset severe renal involvement in two patients following mRNA COVID-19 vaccination: A case report

Rationale:Since mass-scale severe acute respiratory syndrome coronavirus 2 vaccination, there have been case reports of several immune-mediated reactions, including new-onset and flares of glomerular disorders following immunization with mRNA coronavirus disease 2019 vaccines. Here, we report two cases, the first to our knowledge, of relapsing cryoglobulinemic vasculitis with new-onset severe renal involvement following mRNA coronavirus disease 2019 vaccination.Patient concerns:The relapse of the cutaneous and the new onset of severe renal involvement of cryoglobulinemic vasculitis occurred three weeks after the second dose of the mRNA Moderna coronavirus disease 2019 vaccination and two days after the first dose of mRNA Pfizer coronavirus disease 2019 vaccination in the first and second patient, respectively.Diagnosis:Kidney biopsies were performed. The first pacient''s kidney biopsy showed a membranoproliferative pattern of glomerular injury with extensive mesangial and endocapillary hypercellularity, while severe endothelial swelling, loss of fenestrations and widening of subendothelial space were identified by electron-microscopy. The second patient''s kidney biopsy was consistent with cryoglobulin associated membrano-proliferative pattern of glomerular injury.Interventions:Our patients were managed with a combination of immunosuppressants consisting of corticosteroids, Cyclophosphamide and Rituximab with a favourable outcome at the end of the induction period.Outcomes:Clinical and immunological response was achieved in both patients after four months of follow-up.Lessons:The temporal association of the relapse of the cryoglobulinemic vasculitis to mRNA coronavirus disease 2019 vaccination suggest that the vaccine might have been a trigger for the reactivation of the disease in our cases. This possible association should be acknowledged by physicians in order to provide optimal monitoring and treatment in case of reactivation of the disease post-immunization.     

New HfNbTaTiZr High-Entropy Alloy Coatings Produced by Electrospark Deposition with High Corrosion Resistance

The aim of the present paper is to investigate an innovative high corrosion resistance coating realized by electrospark deposition. The coating material was fabricated from HfNbTaTiZr high-entropy alloy. HEA was produced by the mechanical alloying of Hf, Nb, Ta, Ti, and Zr high-purity powders in a planetary ball mill, achieving a good homogenization and a high alloying degree, followed by spark plasma sintering consolidation. The electrodes for electrospark deposition were cut and machined from the bulk material. Stainless steel specimens were coated and electrochemically tested for corrosion resistance in a 3.5% NaCl saline solution.     

Removal of an intraperitoneal foreign body using a single port laparoscopic procedure

Background and Objectives:

To remove a foreign body from the peritoneal cavity in laparoscopic surgery, 2 or 3 ports are usually used. We have recently performed such a removal using a single 10-mm transumbilical port, a 0-degree laparoscope, a Farabeuf retractor, and a laparoscopic grasping forceps.

Methods:

Two patients with ventriculoperitoneal shunt catheter (V-P shunt) were admitted to our unit during the last year. They previously had a shunt catheter implanted for hydrocephalus of unknown cause. The complete migration of the ventriculoperitoneal shunt catheter into the peritoneal cavity was observed in these patients 12 and 7 years after the implantation. The laparoscopic removal of the migrated catheter was decided on. Its presence and location were confirmed by the use of a 0-degree laparoscope, through a 10-mm trocar port. The catheter was held and pulled out using a grasping forceps that was pushed in just beside the trocar port.

Conclusion:

The laparoscopic approach enables safe removal of a foreign body in the peritoneal cavity. The procedure can be performed using a single port.