PURPOSE: About 20% to 30% of patients with node-negative breast cancer die of systemic metastases in 10 years after surgery. This may be due to either early occult systemic spread before node metastasis or occult lymph node metastasis (OLNM) which is undectected by routine pathologic evaluation. The purpose of this study was to assess the incidence and its prognostic significance of OLNM in breast cancer. MATERIALS AND METHODS: Paraffin blocks of axillary lymph nodes from 50 patients with invasive breast carcinoma initially diagnosed as node-negative by routine histological examination were evaluated. All nodes were serially sectioned by 40 pm thickness interval, followed by hematoxylin-eosin (H-E) staining and cytokeratin immunohistochemical staining. RESULTS: OLNM were detected in 6 patients (12%) by immunohistochemical method; in 3 of these 6 patients, it were also detectable by serial sectioning and H-E staining. OLNM correlated with the primary tumor size (r=0.43, p <0.05). During mean follow- up of 57 months, there were 4 systemic recurrences and one death. Of 6 patients with OLNM, 2 had multiple systemic recurrences (33.3%). Of 44 patients without OLNM, in contrast, only 3 had systemic recurrences (6.8%). Five year disease-free survival rates of patients with and without OLNM were 66.7% and 93.0%, respectively (p=0.087). CONCLUSION: These results suggest that about 10% of patients with "node-negative" breast cancer have OLNM, and the presence of OLNM may have marginal prognostic significance. Serial sectioning and cytokeratin immunohistochemical staining of axillary lymph nodes should be considered as a part of the routine histologic examination especially in the patients with a large primary tumor.
Breast Neoplasms* ; Breast* ; Disease-Free Survival ; Humans ; Immunohistochemistry ; Incidence ; Keratins ; Lymph Nodes* ; Neoplasm Metastasis* ; Paraffin ; Recurrence

OBJECTIVETo evaluate the trabecular bone micro-structure from different sites of spine in adolescent idiopathic scoliosis patients. The target site consisted of the bilateral facet joints from apical vertebrae and from end vertebrae.

METHODSNine AIS patients with mean age 14.9 years (range 12-17 years) and mean Cobb angle 56 degrees (ranged 48 degrees-84 degrees) were recruited into this study. Corrective surgery was indicated to these patients, and facet joint biopsies were collected during decortications for spinal fusion. Biopsy consents were obtained from patients. Bone specimens were fixed with routine histology procedures and scanned by micro computer tomography (muCT40, Scanco Medical, Switzerland). Ten pairs of facet joint were harvested from apical vertebrae and 12 pairs from end vertebrae. Three-dimensional reconstructed images with the resolution of 20 microm were achieved for histomorphometric analysis.

RESULTSThe values of BV/TV (0.268 vs. 0.354, P < 0.05), TbTh (0.20 vs. 0.24, P < 0.05), TbSP (0.66 vs. 0.56, P < 0.05) and BS/BV (12.7 vs. 10.4, P < 0.05) between convex and concave side at the apex area were significantly different. No difference was found in any structural parameters between left and right side at end area, and upper thoracic (T5, 6) and thoracolumbar (T12, L1).

CONCLUSIONDue to asymmetric compression and tension shared between convex and concave side, more bone and thicker and more profound trabecular bones are observed in the concave side than in the convex side, which seems to resist the progression of spinal curvature. This finding suggests that the provocative factors which cause the progression of the curve in certain patients may not lie in the bone component of spine.

Adolescent ; Child ; Female ; Humans ; Scoliosis ; diagnostic imaging ; pathology ; physiopathology ; Tomography, X-Ray Computed ; Zygapophyseal Joint ; pathology ; physiopathology

OBJECTIVETo investigate whether the MTNR1A gene promotor polymorphism (rs2119882) are associated with the occurrence or curve severity of adolescent idiopathic scoliosis (AIS).

METHODS226 AIS patients and 277 normal controls were recruited. The maximum Cobb angles were recorded in AIS patients. PCR-RFLP was used for the genotyping.

RESULTSThe genotype and allele frequency distribution were comparable between AIS and normal control, the mean maximum Cobb angle of different genotypes of rs2119882 were similar with each other among AIS patients.

CONCLUSIONThe MTNR1A gene promoter polymorphism was neither associated with the occurrence nor the curve severity of AIS.

Adolescent ; Adult ; Child ; Female ; Gene Frequency ; Genetic Predisposition to Disease ; Genotype ; Humans ; Male ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Polymorphism, Restriction Fragment Length ; Receptor, Melatonin, MT1 ; genetics ; Scoliosis ; genetics

Adolescent ; Adult ; Cross-Sectional Studies ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Intensive Care Units ; statistics & numerical data ; Male ; Middle Aged ; Organ Transplantation ; psychology ; statistics & numerical data ; Surveys and Questionnaires ; Tissue and Organ Procurement ; statistics & numerical data ; Young Adult