The breast lesion excision system procedure: An optimal solution for the management of indeterminate BI-RADS category 3 breast lesions in women with severe anxiety.

OBJECTIVES: To evaluate the efficacy of the Breast lesion excision system (BLES) procedure as a primary excisional biopsy for the management of breast imaging-reporting and data system (BI-RADS) category 3, small, and solid breast lesions in women having severe breast cancer anxiety. METHODS: A retospective study was conducted on 68 patients who underwent a BLES procedure. The study protocol was approved by the local ethical committee of Yeni Yuzyil University in Istanbul, Turkey. The study was carried out according to the principles of the Helsinki Declaration. Small breast lesions removed using a (12, 15 or 20 mm) wand from September 2011 to November 2014. These were category 3 lesions as determined by ultrasound (US) imaging according to BI-RADS. The radiological and pathological sizes of these lesions, the complete excision rates, the procedure durations, the pathological diagnosis, the complications, and the imaging findings before and after the procedure were all recorded. RESULTS: All the patients had a benign pathology. The mean duration of procedure was 12 (range=8-22) minutes. There was no major complication during the procedure and in the following period. Only some small hematomas were determined in 3 (4.2%) patients, and no additional surgical intervention was performed. Conclusion: The BLES procedure is an optimal solution for the management of indeterminate BI-RADS category 3 breast lesions in women with severe anxiety.

Effects of enteral and parenteral glutamine on intestinal mucosa and on levels of blood glutamine, tumor necrosis factor-alpha, and interleukin-10 in an experimental sepsis model.

OBJECTIVE: To investigate the effects of enteral and parenteral glutamine (Gln) usage on rats in sepsis. METHODS: This study was conducted in Istanbul University Experimental Medical Research Institution (DETAE) laboratory, Istanbul University, Istanbul, Turkey between June and September 2009. The levels of blood Gln, tumor necrosis-alpha (TNF-alpha) and interleukin (IL)-10 was measured. Samples of tissue were obtained from the mesenteric lymph nodes, liver, and lower lobe of the right lung to evaluate the reproduction of bacteria, and samples of tissue were also obtained from the small intestine to evaluate blood and villus atrophy. RESULTS: Bacteremia of Group EP (combined group) were found lower than Group C (control) (p=0.007). Villous atrophy rates of all groups were lower than Group C: between Group E (enteral) and C (p=0.003); between Group P (parenteral alanine) and C (p=0.019); and between Group EP and C (p=0.001). The values of serum TNF-alpha and IL-10 of Group EP and P were lower than the other groups at the 24th and 96th hours (p=0.000). CONCLUSION: In this study we found that the most efficient Gln administration technique in sepsis was enteral administration together with parenteral administration due to trophic effect on the intestinal mucosa, decrease of reproduction in tissue and blood cultures, immunomodulator effect, and approximately the same cost as parenteral application.

Effects of intra-abdominal pressure increase on intestinal ischemia and bacterial translocation in experimental sepsis model.

OBJECTIVE: To investigate the safety of laparoscopic intervention for diagnosis and treatment at 8 mm Hg pressure in one-hour period on acute peritonitis related intra-abdominal sepsis model. METHODS: In this study, we included 32 female Wistar-Albino rats, weighing 250 +/- 20 g, and divided them into 4 groups. This study was conducted in Istanbul University Experimental Medical Research Institution (DETAE) laboratory from April to May 2009. Intra-abdominal sepsis was created with intraperitoneal (i.p.) one mL (109 CFU/mL) Escherichia coli (E. coli) injection, and pneumoperitoneum was formed with CO2 insufflation at 8 mm Hg pressure for one hour i.p. The rats were administered with: Group 1 - one mL i.p. isotonic saline; Group 2 - one mL i.p. isotonic saline + pneumoperitoneum; Group 3 - i.p E. coli; and Group 4 - i.p. E.coli + pneumoperitoneum. Data were analyzed using the Statistical Package for Social Sciences version 15 for Windows (SPSS Inc, Chicago, IL, USA). RESULTS: Fever and leukocyte values were considered high in Groups 3 and 4 compared with Groups 1 and 2 (p=0.001). The administered reproduction ratio of the E. coli strain was determined as 0% in Groups 1 and 2, and 100% in Groups 3 and 4. CONCLUSION: In this study, as pneumoperitoneum was formed for one hour at 8 mm Hg pressure, in case of intra-abdominal derived sepsis where emergency intervention is needed, we consider that laparoscopic approaches with low pressure may be used safely for diagnosis and treatment.