About 70% of early breast cancer cases axillary lymph nodes are intact and surgical axillary intervention is unnecessary. There is an ongoing search for non-invasive methods to evaluate the status of axillary lymph nodes in order to prevent Axillary Lymph Node Dissection (ALND) or Sentinel Lymph Node Biopsy (SLNB). Patients with normal axillary physical exam and ultrasound rarely harbor a large nodal disease burden (pN2). There are studies suggesting that the Preoperative Axillary Ultrasound (PAUS) can replace SLNB when the axillary surgery is no longer curative and only biomarkers are important for adjuvant chemotherapy. The purpose of this study was to determine the accuracy and reliability of the ultrasound examination in detecting more than three metastatic axillary lymph nodes (pN2) and to assess the clinicopathological factors that lead to the truenegative and false-negative results of the ultrasound study. All patients underwent the PAUS as part of their staging. The nodal status assessed by PAUS was compared with histological findings. Determining pN2, the accuracy of PAUS was 91.2% and the NPV -96.5%. False-negative results of PAUS were 18.7 %. On bivariate analysis, primary Tumor Size (T), the tumor spreading in blood and Lymphatic Vessels (LV), Tumor Grade (G) and patient age were found to be significantly different between true-and false-negative PAUS. We found that PAUS is sufficiently accurate to detect a heavy nodal disease burden and in most cases an additional axillary surgery can be avoided. PAUS findings may be less accurate in young age and in patients with T2, G3 and LV1.

Background: Chronic Kidney Disease (CKD) is a worldwide health threat. The Pyramids of Egypt are one of the world's most amazing achievements. Thereby, the present study aims to investigate the ameliorative efficacy of housing Unilateral Nephrectomized (UNx) rats inside model of the great Egyptian pyramid.Results: Housing UNx rats for 24 and 48h inside the Egyptian pyramid model induced significant increase in the weight of the right kidney, serum sodium and calcium levels and potassium ions excretion in urine. Creatinine clearance increased significantly after housing UNx rats inside the Egyptian pyramid model following 48 h. However, housing of rats inside the Egyptian pyramids for 24 and 48h ameliorate kidney function markers (proteinuria, urea and uric acid) and restore their levels towards the control values. In addition, levels of the reinin, angiotensin and aldosterone hormones significantly increased after housing UNx rats inside the Egyptian pyramid for 24 and 48h. Conclusion:The present study showed that housing nephrectomized rats inside model of the Egyptian pyramid may be a potential new strategy prevents CKD following renal tumour resection. Also, the current study suggested that pyramid environment plays an important role in ameliorating the serious effects of nephrectomy by enhancing kidney function.