Complex Scalp and Calvarium Defects After Giant Basal Cell Carcinoma Excision: Management, Challanges, Outcomes.

Giant basal cell carcinoma (GBCC) is defined as a tumor ≥5 cm in diameter. GBCC of scalp usually requires extended resection of soft tissues, calvarium, and dura. In this study, we present 5 patients with GBCC of head, who underwent a single-stage combined scalp, calvarium, and dural reconstruction. Herein, we aim to discuss reconstruction methods, cerebrospinal fluid (CSF) leakage, duration of hospital stay, and tumor recurrency. Peroperative and postoperative follow-ups, defect areas, and performed calvarium reconstruction methods of 5 patients, who underwent complex scalp and calvarium reconstruction after GBCC between year 2010 and 2017, were retrospectively maintained. We studied reconstruction methods, CSF leakage, duration of hospital stay, and tumor recurrency. All patients undergone single-stage reconstruction. Avarge duration of hospital stay was 15 days. Titanium mesh was used in 3 patients and methyl methacrylate was used in 2 patients for calvarium reconstruction. CSF leakage was seen in patients who underwent calvarium reconstruction with titanium mesh. Tumor recurrence occured next to calvarium in 1 patient who undergone calvarium reconstruction with methyl methacrylate. CSF leakage and duration of hospital stay may induce morbidity of this oncoplastic procedure. The fact of longer hospital stay of patients reconstructed with titanium mesh might be a new data presented in this study. These parameters can be related with the method of calvarium reconstruction.

The Effects of Total Abdominal Hysterectomy on Ovarian Function - Serial Changes in Serum Anti-Müllerian Hormone, FSH and Estradiol Levels.

OBJECTIVES: The aim of this study was to evaluate ovarian function with longitudinal changes in serum levels of anti-mullerian hormone (AMH), follicle stimulating hormone (FSH) and estradiol (E2) after total abdominal hysterectomy (TAH) with ovarian conservation. MATERIAL AND METHODS: In this prospective longitudinal study, a total of 29 women, aged 39 to 48 years, suffering from uterine pathologies underwent TAH with ovarian conservation. Their serum AMH, FSH and E2 levels were measured at baseline, at the first month and the third month after TAH. RESULTS: There was a statistically significant decrease in AMH serum levels between the baseline and the first postoperative month; the values were 0.22 (0.16-1.49) ng/mL and 0.18 (0.04-0.52) ng/mL, respectively. However, significant differences were not seen for serum levels of FSH and E2 when baseline and one-month values were compared. In addition, no statistically significant differences were detected between the baseline and third-month serum AMH, FSH and E2 levels. CONCLUSIONS: The study demonstrated that TAH affects ovarian function temporarily.

Expression of intercellular adhesion molecule-1 in umbilical and placental vascular tissue of gestational diabetic and normal pregnancies.

OBJECTIVE: Expression of intercellular adhesion molecule-1 (ICAM-1), a marker of endothelial dysfunction leading to damaging vascular disorders, in umbilical and placental vascular tissue of gestational pregnancies was compared to non-diabetic controls. METHODS: We included 32 pregnant women with gestational diabetes mellitus (GDM) and 28 women with normal ongoing pregnancies were taken as the control group. Pregnant women with GDM were selected from the ones who had glycosylated haemoglobin (HbA(1c)) values lower from 6%. CD54/ICAM-1 expression profile was evaluated by immunohistochemistry, and cellular localization was determined under light microscopy. The immunoreactivity was assessed using a four-tiered scale: 0-5% (0), 6-20% (+1), 21-50% (+2), 51-100% (+3). RESULTS: In gestational diabetic patient's umbilical artery, +1 immunostaining group was observed (62.5%), and in their placenta, the highest percentage was seen in the 0 immunostaining group (43.8%). Diabetic patient's umbilical vein has the highest percentage in the +1 immunostaining group. In the control group, in both umbilical artery and vein, the highest percentage was seen in the +2 immunostaining group (46.4%) and their placenta has the +3 immunostaining group with the highest percentage (57.1%). CONCLUSION: The main outcome of our study was that, although underlying diabetes does have some effects on the pregnant mother, fears of endothelial dysfunction leading to damaging vascular disorders are probably unfounded in well-controlled GDM women.