Sentinel lymph node biopsy as guidance for radical trachelectomy in young patients with early stage cervical cancer

<p>Abstract</p> <p>Background</p> <p>The purpose of this study was to assess the feasibility and accuracy of sentinel lymph nodes (SLNs) detection using 99mTc phytate in predicting pelvic lymph nodes status for radical abdominal trachelectomy (RAT) in patients with early stage cervical cancer.</p> <p>Methods</p> <p>Sixty-eight women with stage IA2-IB1 cervical cancer and scheduled to undergo fertility-sparing surgery enrolled in this study. 99mTc-labeled phytate was injected before surgery. Intraoperatively, SLNs were identified, excised, and submitted to fast frozen section. Systematic bilateral pelvic lymphadenectomy and/or para-aortic lymph node dissection was performed. Then RAT was performed in patients with negative SLNs. All nodes were sent for routine pathological examination and immunostained with anti-cytokeratin antibody to detect micrometastases. Outcomes of follow up and fertility were observed.</p> <p>Results</p> <p>SLNs were identified in 64 of 68 patients (94.1%). Of these, SLNs of 8 patients (11.8%) were positive on frozen sections and proved to be metastasis by final pathologic examination. The sensitivity, accuracy, and false negative rates were 100%, 100%, and 0%, respectively. All 60 patients with negative SLN underwent RAT successfully. Two relapses occurred and no one died of tumor progression during follow-up. Five of the 15 patients with procreative desire conceived 8 pregnancies (3 term delivery, 2 premature birth, 1 spontaneous abortion, and 2 were still in the duration of pregnancy) after surgery.</p> <p>Conclusions</p> <p>The identification of SLN using 99mTc-labeled phytate is accurate and safe to assess pelvic nodes status in patients with early cervical cancer. SLNs biopsy guided RAT is feasible for patients who desire to have fertility preservation.</p

Intraoperative Multispectral Fluorescence Imaging for the Detection of the Sentinel Lymph Node in Cervical Cancer: A Novel Concept

PURPOSE: Real-time intraoperative near-infrared fluorescence (NIRF) imaging is a promising technique for lymphatic mapping and sentinel lymph node (SLN) detection. The purpose of this technical feasibility pilot study was to evaluate the applicability of NIRF imaging with indocyanin green (ICG) for the detection of the SLN in cervical cancer. PROCEDURES: In ten patients with early stage cervical cancer, a mixture of patent blue and ICG was injected into the cervix uteri during surgery. Real-time color and fluorescence videos and images were acquired using a custom-made multispectral fluorescence camera system. RESULTS: Real-time fluorescence lymphatic mapping was observed in vivo in six patients; a total of nine SLNs were detected, of which one (11%) contained metastases. Ex vivo fluorescence imaging revealed the remaining fluorescent signal in 11 of 197 non-sentinel LNs (5%), of which one contained metastatic tumor tissue. None of the non-fluorescent LNs contained metastases. CONCLUSIONS: We conclude that lymphatic mapping and detection of the SLN in cervical cancer using intraoperative NIRF imaging is technically feasible. However, the technique needs to be refined for full applicability in cervical cancer in terms of sensitivity and specificity

Structural, optical, thermal, mechanical, SHG and antibacterial properties of organic dyes doped glycine potassium dihydrogen orthophosphate single crystals

The advanced electro-optical materials are highly demanded because of their various uses in recent years. Glycine potassium dihydrogen orthophosphate single crystals are grown using a slow solvent evaporation technique in order to investigate the effects of the organic dyes crystal violet, malachite green, chrysoidine y, alizarin red, and victoria blue on the structural, optical, mechanical, thermal, SHG, and antibacterial properties. The powder XRD study validates the 14-2d space group tetragonal crystal structure. The higher optical bandgap energy and increased optical transparency of the crystal violet and victoria blue dye doped crystals indicate that there are less defects in their crystal lattice. The elemental analysis confirmed the presence of different organic dyes in the GKDP crystal lattice. The dye doping has enhanced the mechanical and optical characteristics of the formed crystals, and are categorised as soft materials. It is found that all dye-doped crystals have improved thermal stability. Malachite green and crystal violet doped GKDP crystals have higher SHG efficiency

Enterprise Risk Management Discloure, Komite Manajemen Risiko dan Nilai Perusahaan

Kepercayaan stakeholder terhadap informasi yang diberikan pada laporan keuangan semakin menurun. Saat ini, stakeholder lebih tertarik pada pengungkapan informasi mengenai risiko. Penelitian ini bertujuan untuk menguji apakah terdapat pengaruh pengungkapan enterprise risk management sebagai variabel moderasi terhadap komite manajemen risiko dan nilai Perusahaan. Penelitian ini menggunakan sampel pada 110 Perusahaan yang terdaftar di Bursa Efek Indonesia dengan kriteria Perusahaan pertambangan pada tahun 2016-2018 dan Perusahaan yang mengungkapkan enterprise risk management disclosure pada tahun 2016-2018. Berdasarkan pengukuran enterprise risk management disclosure menggunakan checklist yang dikembangkan berdasarkan ISO 31000: 2009, penelitian ini menemukan bahwa komite manajemen risiko berpengaruh positif signifikan terhadap nilai Perusahaan dan enterprise risk management disclosure memperkuat pengaruh komite manajemen risiko terhadap nilai Perusahaan. Komite manajemen risiko memberikan sinyal positif kepada stakeholder sehingga &nbsp;asimetri informasi tidak terjadi