MR imaging properties of breast cancer molecular subtypes.

OBJECTIVE: In this study, we aim at investigating the magnetic resonance (MR) imaging features of molecular subtypes, according to the BIRADS Atlas. PATIENTS AND METHODS: The preoperative MRI examinations of 104 breast cancer patients were reviewed retrospectively using the 5th Edition Breast Imaging-Reporting and Data System (BI-RADS) Atlas. According to BI-RADS, cases were classified as mass or non-mass enhancement. Background parenchymal enhancements of the cases were evaluated. The population was examined for shape, contour, enhancement characteristics of masses, distribution and internal enhancement patterns of non-mass enhancements, background parenchymal enhancement, multifocal/multicentric (MFMS) status, presence of axillary LAP, ADC values, and kinetic aspects. The Kruskal-Wallis and Chi-square tests were used to explore the connection between molecular subtypes and MR data. RESULTS: The link between molecular subtypes and mass/non-mass enhancement was discovered to be statistically significant (p=0.007). The shape (p=0.001) and contour (p=0.001) properties of the masses were observed to differ depending on the molecular subtypes. The Luminal types were usually irregularly shaped with irregular/spiculated contours, whereas the HER-2 (+) and Triple (-) subtypes were mostly oval/round with smooth contours. The subtype with the highest non-mass enhancement rate (70%) was HER-2 (+). Axillary lymphadenopathy was most common (64.3%) in the Triple (-) subtype (p=0.033). CONCLUSIONS: According to the BIRADS Atlas, molecular subtypes exhibit a wide range of imaging properties in MR in our study.

Association between male accesory gland infections and prostate cancer in Turkish men: A case-control study.

It is well known that chronic inflammation contributes to several forms of human cancer. Although several studies have investigated the association between prostatitis and prostate cancer, there is a lack of specifically designed study about male accessory gland infections (MAGI) and prostate cancer co-occurrence. We aimed to investigate this association with a case-control study in Turkish men. A total of 155 patients were enrolled to the study. After the pathological examination of the transrectal ultrasound-guided prostate biopsy specimens, patients were divided the two groups as control and prostate cancer and the presence of MAGI was determined. Of 155 patients, 145 met inclusion criteria. In the prostate cancer group, MAGI diagnose was determined in 18 of 31 patients (58.06%), while it was determined in 25 of 114 (21.93%) patients in the control group (p = .001). A significant correlation between MAGI and pathological Gleason score also revealed (p = .0001). We demonstrated that men with MAGI have increased risk for the development of prostate cancer. Moreover, in this population, most of the prostate cancers tend to be clinically significant or high grade.

Mucosal cuff length to penile length ratio may affect the risk of premature ejaculation in circumcised males.

Data regarding the relation between premature ejaculation (PE) and post-circumcision mucosal cuff length are controversial. The aim of this study is to analyze the relation between post-circumcision mucosal cuff length/penile length ratio (MCR) and PE. After exclusion of patients with erectile dysfunction, penile deformity, history of penile surgery and severe lower urinary tract symptoms, 49 circumcised men with PE were included. The control group is constituted of 50 healthy volunteers with normal ejaculatory function. Self-estimated intravaginal ejaculation latency time (IELT) and premature ejaculation profile (PEP) measures of all subjects were recorded, and the MCRs of patients and controls were compared. The mean age of PE patients and controls was 35.82 ± 7.73 (range 23-54) and 38.78 ± 13.42 (range 19-71) years, respectively (P=0.183). Although mucosal cuff length was not associated with either self-estimated IELT (r=-0.185, P=0.067) or PEP (r=-0.098, P=0.336), there was a negative correlation between MCR and self-estimated IELT (r=-0.205, P=0.0001) and PEP measures (r=-0.308, P=0.002). The length of the mucosal cuff after circumcision may have an impact on ejaculatory function. Surgeons should avoid leaving excessive amount of mucosa during circumcision.

The effects of four different suture materials on penile tissue of rats.

Several types of suture materials are being used for the correction of penile curvature and this study was designed to compare histopathological changes on penile tissue among different suture materials. A total of 30 male Sprague-Dawley rats were divided into five groups and right cavernosal body was sutured with 5/0 sutures (ETB: polyethylene terephthalate; PRL: polypropylene; VCR: polyglactine; and PDS: polydioxanone). An identical needle (3/8-13 mm cutting) was passed through the cavernosal bodies in the sham group (SHAM). After 3 weeks, all rats were killed and penile tissues were examined to assess the level (0-3) of inflammation, granuloma formation and fibrosis. There was a statistically significant difference among five groups regarding inflammation, granuloma formation and fibrosis levels (P<0.01 for all). The histological changes in the PRL group were not different from the SHAM group. Although the levels of granulation and fibrosis in the PDS group were also similar to the SHAM group, inflammation level was significantly higher. The inflammation, granulation and fibrosis levels were the highest in the ETB group. VCR caused similar levels of granulation and fibrosis to ETB. In conclusion, PRL suture is associated with the least histopathological change in the penile tissue. PDS can theoretically be a reasonable alternative to PRL as it causes similar levels of granulation and fibrosis.

Surgical outcomes of a civil war in a neighbouring country.

OBJECTIVES: The civil war in Syria began on 15 March 2011, and many of the injured were treated in the neighbouring country of Turkey. This study reports the surgical outcomes of this war, in a tertiary centre in Turkey. METHODS: 159 patients with civilian war injuries in Syria who were admitted to the General Surgery Department in the Research and Training Hospital of the Medical School of Mustafa Kemal University, Hatay, Turkey, between 2011 and 2012 were analysed regarding the age, sex, injury type, history of previous surgery for the injury, types of abdominal injuries (solid or luminal organ), the status of isolated abdominal injuries or multiple injuries, mortality, length of hospital stay and injury severity scoring. RESULTS: The median age of the patients was 30.05 (18-66 years) years. Most of the injuries were gunshot wounds (99 of 116 patients, 85.3%). Primary and previously operated patients were transferred to our clinic in a median time of 6.28±4.44 h and 58.11±44.08 h, respectively. Most of the patients had intestinal injuries; although a limited number of patients with colorectal injuries were treated with primary repair, stoma was the major surgical option due to the gross peritoneal contamination secondary to prolonged transport time. Two women and 21 men died. The major cause of death was multiorgan failure secondary to sepsis (18 patients). CONCLUSIONS: In the case of civil war in the bordering countries, it is recommended that precautions are taken, such as transformation of nearby civilian hospitals into military ones and employment of experienced trauma surgeons in these hospitals to provide effective medical care. Damage control procedures can avoid fatalities especially before the lethal triad of physiological demise occurs. Rapid transport of the wounded to the nearest medical centre is the key point in countries neighbouring a civil war.

The relationship between mortality and inflammation in patients with gastrointestinal bleeding.

The objective of this study was to investigate the association between mortality and inflammation in patients who were admitted to the emergency room with gastrointestinal bleeding. Patients (n = 96) managed at two medical centres were included in the study. Initial levels of serum C-reactive protein (CRP), haemoglobin and albumin, and leucocyte and thrombocyte counts for 28 patients who died were compared with those for the 68 patients who survived and were successfully discharged. The data were analysed using the chi(2)-test. Serum levels of CRP and leucocyte counts were significantly higher, and albumin and haemoglobin were significantly lower in patients who died compared with patients who survived. The increased levels of serum CRP and leucocyte counts, and decreased levels of albumin and haemoglobin were found to be independent risk factors for mortality. It is concluded that increased serum CRP levels and leucocyte counts combined with decreased albumin and haemoglobin levels on admission to the emergency room may be used as predictive factors of mortality in patients with gastrointestinal bleeding.

A rare and frequently unrecognised pathology in children: femoral hernia.

A femoral hernia is the protrusion of the abdominal contents through the femoral canal. It accounts for less than 1% of all groin hernias in children and is often confused with inguinal hernia or other inguinal pathologies. Preoperative misdiagnosis has been reported to be between 40 and 75%. We believe that misdiagnosis and mistreatment usually occur due to insufficient physical examination, knowledge and experience about childhood femoral hernias. Here, we report and discuss the clinical appearance and treatment approach of three patients operated with the diagnosis of femoral hernias.

Role of the antiangiogenetic drug paclitaxel on healing of intestinal anastomosis: an experimental study.

BACKGROUND: The aim of intraperitoneal administration of antineoplastic agents is the prevention of the implantation of tumoral cells after surgical intervention or the treatment of peritoneal carcinomatosis. The efficiency of intraperitoneal administration of paclitaxel, which is also an antiangiogenetic agent, has been investigated recently. The aim of this experimental study was to evaluate, taking into consideration its antiangiogenetic properties, the effects of intraperitoneal paclitaxel on healing of end to end colonic anastomosis. METHODS: 42 rats were allocated to 2 main groups (n = 21 for each group) to be evaluated on postperative day 3 (group A) and postoperative day 7 (group B). Each of the two main groups was divided into 3 subgroups (7 rats each). These subgroups were determined as control and two treatment groups administered paclitaxel in a dose of 2.5 mg/kg and 3.5 mg/kg intraperitoneally. Anastomosed segments of colon were harvested on postoperative day 3 or 7 and evaluated to determine bursting pressure of anastomoses, hydroxyproline levels and neovascularization with CD-31. RESULTS: In both groups, there were no significant differences between control and paclitaxel-treated groups with respect to bursting pressure. The level of hydroxyproline showed a significant decrease in all paclitaxel-treated groups compared with control groups (p = 0.001). Neovascularization was found to be decreased significantly on day 3 in the doses of paclitaxel 2.5 mg/kg (6.4 +/- 1.63) and 3.5 mg/kg (5.89 +/- 1.01) compared with control (8.02 +/- 0.88) (p = 0.029 and p = 0.005, respectively). There were no significant differences in neovascularization in either groups on postoperative day 7. CONCLUSION: We suggest that intraperitoneal administration of paclitaxel during surgical procedure decreases the hydroxyproline content and neovessel formation that are necessary for healing of intestinal anastomosis.