Management of the Nodal Basin

2019 ◽  
pp. 85-94
Author(s):  
Alfredo Guglielmi ◽  
Fabio Bagante ◽  
Andrea Ruzzenente ◽  
Tommaso Campagnaro ◽  
Simone Conci ◽  
...  
Keyword(s):  
2021 ◽  
Author(s):  
Lutz Kretschmer ◽  
Christina Mitteldorf ◽  
Simin Hellriegel ◽  
Andreas Leha ◽  
Alexander Fichtner ◽  
...  

AbstractSentinel lymph node (SN) tumor burden is becoming increasingly important and is likely to be included in future N classifications in melanoma. Our aim was to investigate the prognostic significance of melanoma infiltration of various anatomically defined lymph node substructures. This retrospective cohort study included 1250 consecutive patients with SN biopsy. The pathology protocol required description of metastatic infiltration of each of the following lymph node substructures: intracapsular lymph vessels, subcapsular and transverse sinuses, cortex, paracortex, medulla, and capsule. Within the SN with the highest tumor burden, the SN invasion level (SNIL) was defined as follows: SNIL 1 = melanoma cells confined to intracapsular lymph vessels, subcapsular or transverse sinuses; SNIL 2 = melanoma infiltrating the cortex or paracortex; SNIL 3 = melanoma infiltrating the medulla or capsule. We classified 338 SN-positive patients according to the non-metric SNIL. Using Kaplan–Meier estimates and Cox models, recurrence-free survival (RFS), melanoma-specific survival (MSS) and nodal basin recurrence rates were analyzed. The median follow-up time was 75 months. The SNIL divided the SN-positive population into three groups with significantly different RFS, MSS, and nodal basin recurrence probabilities. The MSS of patients with SNIL 1 was virtually identical to that of SN-negative patients, whereas outgrowth of the metastasis from the parenchyma into the fibrous capsule or the medulla of the lymph node indicated a very poor prognosis. Thus, the SNIL may help to better assess the benefit-risk ratio of adjuvant therapies in patients with different SN metastasis patterns.


2013 ◽  
Vol 21 (1) ◽  
pp. 300-305 ◽  
Author(s):  
Corrado Caracò ◽  
Ugo Marone ◽  
Gianluca Di Monta ◽  
Luigi Aloj ◽  
Corradina Caracò ◽  
...  

2021 ◽  
Vol 9 ◽  
Author(s):  
Jean-Charles Schaegis ◽  
Valentin Rime ◽  
Tesfaye Kidane ◽  
Jon Mosar ◽  
Ermias Filfilu Gebru ◽  
...  

Lake Afdera is a hypersaline endorheic lake situated at 112 m below sea-level in the Danakil Depression. The Danakil Depression is located in the northern part of the Ethiopian Afar and features an advanced stage of continental rifting. The remoteness and inhospitable environment explain the limited scientific research and knowledge about this lake. Bathymetric data were acquired during 2 weeks expeditions in January/February 2016 and 2017 using an easily deployable echosounder system mounted on an inflatable motorized boat. This study presents the first complete bathymetric map of the lake Afdera. Bathymetric results show that the lake has an average depth of 20.9 m and a total volume of 2.4 km3. The maximum measured depth is 80 m, making Lake Afdera the deepest known lake in Afar and the lowest elevation of the Danakil Depression. Comparison with historical reports shows that the lake level did not fluctuate significantly during the last 50 years. Two distinct tectonic basins to the north and the south are recognized. Faults of different orientations control the morphology of the northern basin. In contrast, the southern basin is affected by volcano-tectonic processes, unveiling a large submerged caldera. Comparison between the orientation of faults throughout the lake with the regional fault pattern indicates that the lake is part of two transfer zones: the major Alayta–Afdera Transfer Zone and the smaller Erta Ale–Tat’Ali Transfer Zone. The interaction between these Transfer Zones and the rift axis forms the equivalent of a developing nodal basin which explains the lake’s position as the deepest point of the depression. This study provides evidence for the development of an incipient transform fault on the floor of the Afar depression.


2016 ◽  
Vol 223 (1) ◽  
pp. 77-85.e1 ◽  
Author(s):  
Alexandra B. Gonzalez ◽  
James W. Jakub ◽  
William S. Harmsen ◽  
Vera J. Suman ◽  
Svetomir N. Markovic

2006 ◽  
Vol 24 (6) ◽  
pp. 878-883 ◽  
Author(s):  
Mark Redston ◽  
Carolyn C. Compton ◽  
Brent W. Miedema ◽  
Donna Niedzwiecki ◽  
Jeannette M. Dowell ◽  
...  

Purpose To determine whether sentinel lymph node (LN) sampling (SLNS) could reduce the number of nodes required to characterize micrometastatic disease (MMD) in patients with potentially curable colon cancer. Patients and Methods Cancer and Leukemia Group B 80001 was a study to determine whether SLNS could identify a subset of LNs that predicted the status of the nodal basin for resectable colon cancer and, therefore, could be extensively evaluated for the presence of micrometastases. Patients enrolled onto this study underwent SLNS after injection of 1% isosulfan blue, and both sentinel nodes (SNs) and non-SNs obtained during primary tumor resection were sectioned at multiple levels and stained using anti–carcinoembryonic antigen and anticytokeratin antibodies. Results Using standard histopathology, SNs failed to predict the presence of nodal disease in 13 (54%) of 24 node-positive patients. Immunostains were performed for patients whose LNs were negative by standard histopathology. Depending on the immunohistochemical criteria used to assign LN positivity, SN examination resulted in either an unacceptably high false-positive rate (20%) or a low sensitivity for detection of MMD (40%). Conclusion By examining both SNs and non-SNs, this multi-institutional study showed that SNs did not accurately predict the presence of either conventionally defined nodal metastases or MMD. As a result, SLNS is not a useful technique for the study of MMD in patients with colon cancer.


2009 ◽  
Vol 16 (5) ◽  
pp. 1176-1183 ◽  
Author(s):  
Troy F. Kimsey ◽  
T. Cohen ◽  
A. Patel ◽  
K. J. Busam ◽  
M. S. Brady

2020 ◽  
Author(s):  
Marcia Maia ◽  
Daniele Brunelli ◽  

<p>A strong edge effect is predicted at the intersections between long-offset transforms and mid ocean ridge segments. The Equatorial Atlantic hosts several megatransforms, where the connections of potentially low mantle temperatures due to the large lithospheric age contrast with melt production are poorly understood. The SMARTIES cruise focused on the Romanche transform that offsets the Mid Atlantic Ridge (MAR) laterally by 900 km with an age offset of 55 Ma. The eastern Ridge-Transform Intersection (RTI) markedly shows the effects of the lateral cooling of the ridge segment. To better understand the thermal regime at these complex domains, we acquired surface geophysical data and bathymetry of the area, and geological observations and sampling during 25 HOV Nautile dives. The integrated study of rock characteristics and of geophysical surveys allows tackling the connections between magmatism and tectonics. A network of 19 OBS was also deployed to study the seismic activity during the cruise in collaboration with the ILAB project.</p><p>There is a striking change in deformation patterns along the ridge axis moving away from the transform southwards. The bathymetry is extremely complex, with several structural directions, partly resulting from transtension. A low melt supply is focused at the ridge axis resulting in a long oblique axial domain, that forms a relay zone between the roughly north-south ridge axis in the south and the area close to the transform fault, while the transform fault domain is highly complex. Trends oblique to both the main spreading axis direction and the transform fault direction are widespread. A clear Principal Transform Displacement Zone (PTDZ) can be followed as a long, near continuous alignment, on the seafloor of the wide Romanche valley. However, the valley morphology suggests a migration of the PTDZ and intense deformation within the transform domain. The RTI is complex and the position of the spreading axis clearly evolved with time, through at least two and possibly three eastward ridge jumps.</p><p>Six Nautile dives explored the northern wall of the Romanche, the damaged zone of the transform fault, and the exceptionally deep nodal basin. The north wall exposes a very thick basalt unit covered with a thick layer of sediments. Eight dives explored the southern flank of the Romanche identifying fragments of old Oceanic Core Complexes (OCCs) formed by highly deformed peridotites, and a large OCC located at the RTI that exposes mylonitized peridotites and is dissected by several normal faults. The magmatic zones of the axial domain (nine dives) are formed by volcanic ridges affected by important tectonic activity. The dives show pillow and tube volcanic flows with intersecting faults. An oblique elongated faulted and sedimented ridge (2 dives) parallel to the oblique relay zone was shown to be of peridotitic nature Recent faults have been observed, as well as traces of high-T hydrothermal activity consistent with black-smoker type venting, recently overprinted by low temperature diffuse venting related to active faulting.</p>


Author(s):  
Vernon K. Sondak ◽  
Sandra L. Wong ◽  
Jeffrey E. Gershenwald ◽  
John F. Thompson

Sentinel lymph node biopsy (SLNB) was introduced in 1992 to allow histopathologic evaluation of the “sentinel” node, that is, the first node along the lymphatic drainage pathway from the primary melanoma. This procedure has less risk of complications than a complete lymphadenectomy, and if the sentinel node is uninvolved by tumor the likelihood a complete lymphadenectomy would find metastatic disease in that nodal basin is very low. SLNB is now widely used worldwide in the staging of melanoma as well as breast and Merkel cell carcinomas. SLNB provides safe, reliable staging for patients with clinically node-negative melanomas 1 mm or greater in thickness, with an acceptably low rate of failure in the sentinel node-negative basin. Evidence-based guidelines jointly produced by ASCO and the Society of Surgical Oncology (SSO) recommend SLNB for patients with intermediate-thickness melanomas and also state that SLNB may be recommended for patients with thick melanomas. Major remaining areas of uncertainty include the indications for SLNB in patients with thin melanomas, pediatric patients, and patients with atypical melanocytic neoplasms; the optimal radiotracers and dyes for lymphatic mapping; and the necessity of complete lymphadenectomy in all sentinel node-positive patients.


2014 ◽  
Vol 21 (13) ◽  
pp. 4324-4329 ◽  
Author(s):  
Laleh G. Melstrom ◽  
Eletha Taylor ◽  
Deborah Kuk ◽  
Timothy L. Frankel ◽  
Katherine Panageas ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document