Sentinel Node Procedure for Breast Cancer: training, safety, reliability and follow-up aspects

In the recent years the surgical treatment of breast cancer has changed towards a less invasive and less mutilating procedure. Breast conserving therapy and the introduction of the sentinel node (SN) procedure are the two most important changes. The introduction of a new technique is a time consuming procedure. First it should be developed and evaluated in a local situation. If the new technique is believed to be better than the standard treatment, the technique should be come available if possible after a randomised controlled trial for all patients concerned. In CHAPTER 2 the introduction of the SN procedure in three participating hospitals (a large teaching hospital, a cancer centre and a university hospital) is described. Special attention was made on the role of a co-ordinator to assure standardisation and quality control in this multicenter study. The role of the co-ordinator was two folded; firstly the supervision of the implementation in the several involved departments and secondly to refine the procedure upon the collected data. During our study we adjusted several aspects of the procedure: the concentration of the colloid in the radioactive solution, the injection of the blue dye intracutaneously after disappointing results of the peritumoral injection and, in cases of a preceding lumpectomy, a cranial injection to the scar because of failure of the caudal injections. With these corrections the results became excellent. In the end the results of the procedure (sensitivity and false negativity) were the same for the three participating hospitals

Efficient library synthesis of imidazoles using a multicomponent reaction and microwave irradiation

Optimization of Radziszewski's four-component reaction employing a microwave-assisted protocol, led to a small library of 48 imidazoles with a success rate of 65% (conversion >45%). All three diversity points of the four-component reaction were varied. Aromatic and aliphatic inputs were successfully implemented and mono-, di-, tri- and tetrasubstituted imidazoles with various substitution patterns were synthesized. Furthermore, unsymmetrical diketones could successfully be used which improved the intrinsic diversity of the method significantly. If the unsymmetrical diketone 1,2-phenylpropanedione (