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OBJECTIVE: The aim of this study was to compare the cross-follow-up results in DDD or AAISafeR mode and to describe the safety and effectiveness of this pacing mode. METHODS: The Symphony 2450/2550 cardiac pacemakers were implanted in 30 patients with sick sinus syndrome between February 2006 and September 2006. They were randomized to the DDD mode or AAISafeR mode for 3 months and then crossed over to the alternate pacing modality for an additional 3 months. RESULTS: No AAISafeR-related adverse event was observed. All documented episodes of paroxysmal atrial ventricular block caused the immediate switch of the pacing mode from AAI to DDD. The cumulative percent ventricular pacing was significantly reduced in the AAISafeR mode compared with the DDD mode (0.9% [0%-3%] versus 51.3% [2%-91%] P = 0.001; 2.94% [0%-18%] versus 41.18% [0%-65%] P = 0.0001). After 3 months in DDD mode, left atrial diameter, left ventricular enddiastolic diameter, and left ventricular end-systolic diameter increased significantly and left ventricular ejection fraction decreased. However, no obvious changes appeared in 3 months of AAISafeR mode. Switches to DDD occurred during follow-up in 21 patients due to different-degree atrial ventricular block. CONCLUSION: The AAISafeR mode substantially reduces the amount of unnecessary right ventricular pacing in the bradycardia population and effectively prevents the deleterious effects on cardiac performance. An international randomized study will further ascertain the efficacy of this new pacing mode specifically in the prevention of heart failure hospitalization and atrial fibrillation.

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<p><b>OBJECTIVE</b>To evaluate the feasibility of lymphoscintigraphy in sentinel lymph node biopsy of breast cancer.</p><p><b>METHOD</b>Lymphoscintigraphy was performed after peritumoral or subdermal injection of radioactive colloid. Then, sentinel lymph node (SLN) biopsy guided by gamma detector probe was performed. Factors correlated with identification-detection rate were assessed.</p><p><b>RESULTS</b>Lymphatic drainage was present in preoperative lymphoscintigraphy in 88(93%) out of 95 patients, with 39 (44.3%) positive for lymphatic drainage other than in the axilla. A total of 91 (95.8%) patients had their SLN identified in the intraoperative procedure. The quality of lymphoscintigraphic image was closely related to SLN identification-detection rate in the intraoperative procedure (P = 0.025).</p><p><b>CONCLUSION</b>Sentinel lymph node outside the axilla can be detected by lymphoscintigraphy. The combination of lymphoscintigraphy and gamma detector probe for sentinel lymph node biopsy of breast cancer not only is acceptable but promising.</p>

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Purpose: To evaluate the clinical value of mammary sentinel lymphoscintigraphy in breast cancer. Methods: 91 patients with breast cancer in stage T1-2N0 were injected with 55. 5MBq/0. 5ml 99mTc- human serum albumin on the surface of the lesion subdermally or 92. 5MBq/4ml unfiltered 99mTc-sulfur colloid in four divided doses around the lesion. 63 patients underwent mammary lymphoscintigraphy and sentinel node biopsy using a hand-held r-ray detector probe were performed 2 - 16 hr postinjection in 70 patients during breast surgery . Results: The sentinel lymph node( s) (SLN) could quickly be shown by these two tracers in 81% (51/63) cases . A SLN with low activity could be seen in 13. 7% (7/5.1) cases , in which 85.7%(6/7) were proved to have a metastasis. Lymph drainage to the internal mammary nodes occurred in 38. 5% (5/13) of patients with an inner-lesion and in 26. 3% (10/38) of patients with an outer-lesion . The SLN was successfully identified in 95. 7% (67/70) of the patients and the number of the nodes ranged from 1 -5 with an average 1. 6 per person . The accuracy of the SLN with respect to the positive or negative status of the axillary nodes was 92.53% (62/67) . The sensitivity , specificity, PPV, NPV of the method was 82.75% (24/29), 100% (38/38), 100% (24/24) and 88. 37% (38/43), respectively . Conclusions: Mammary lymphoscintigraphy in breast cancer is helpful for localizing SLN correctly and identifying abnormal lymph drainage.

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ObjectiveTo assess the diagnostic value of preoperative lymphoscintigraphy for lateral lymph node metastasis in low rectal cancer. MethodsFrom May 1999 to March 2001, pelvic and lower abdominal lymphoscintigraphy with 99mTc sulfur colloid was performed on 32 patients with proven colorectal cancer one day prior to operation. Among these patients were 27 rectal cancers, 3 sigmoid cancers and 2 colon cancers. Fifteen cases of rectal cancer with the tumor located at or below the peritoneal reflection received extended lymphadenectomy with lateral dissection (D3 lymphadenectomy). The result of lymphoscintigrams was correlated with histologic lateral node examination. Results The image ratio of pararectal nodes, obturator nodes, and internal iliac aorti lymph trains was 69%, 91%, and 100% respectively. In 15 patients receiving D3 lymphadenectomy, 10 had negative lymphoscintigrams whereas 5 had positive image, and the lateral pathology positive rate was 13%(2/15). Analysis of these results revealed the sensitivity (100%), specificity (77%) and accuracy (80%) of this diagnostic method. ConclusionPelvic and lower abdominal lymphoscintigraphy with 99mTc sulfur colloid could demonstrate the lateral lymph node drainage of low rectal cancer, and the correlation with postoperative histologic lateral node examination was high enough to enable surgeons to adopt an individualized surgical approach.