Amputation of the penis and bilateral orchiectomy due to extensive debridement for Fournier's gangrene: case report and review of the literature.

Fournier's gangrene is a rare disease with rapidly progressive necrotising fasciitis of the genital, perineal and perianal regions and is known to have an impact in the morbidity and the mortality. Despite antibiotics and aggressive debridement, mortality rate is still high. We present a 79-year-old man who was admitted to School of Medicine, Harran University, Sanliurfa, Turkey, with painful swelling of penoscrotal region. Perineal examination revealed the entire perineal skin to be gangrenous, necrotic and foul smelling. Despite the aggressive drainage and broad-spectrum antibiotic therapy, the gangrene progressed rapidly in hours and the patient's general condition worsened. Secondary extensive debridement including bilateral orchiectomy and amputation of the penis was performed. This disease may result in loss of organ such as testes and penis even with sufficient therapy.

Giant rhinophyma in a bronchial asthma patient treated by excision and full thickness skin grafting.

A 72-year-old man presented with an unusually severe case of rhinophyma. The pedunculated mass was widely excised and a skin graft from the medial upper arm was applied. A very satisfactory cosmetic result was obtained.

Effects of maternal nicotine exposure during lactation on breast-fed rat pups.

BACKGROUND: Nicotine is known to be associated with adverse effects in infants and children. It is concentrated in breast milk and is absorbed by the infant. The aim of this study was to investigate the effects on breast-fed rat pups of maternal nicotine exposure during lactation. METHODS: In the experimental group (n = 6), nicotine was given to lactating dams (2 mg/kg/day) after delivery and continued for 10 days during lactation. Control animals (n = 4) received saline for the same duration. The suckling rats were weighed and killed on postnatal day 10, and samples were taken from the lung, liver, kidney, spleen and small intestine for histopathological examination. Superoxide dismutase (SOD), catalase (CAT) activities and malondialdehyde (MDA) levels were measured in the liver of the dam and the offspring. RESULTS: Histopathological changes in the liver of the nicotine-exposed group showed portal inflammatory infiltrate, ballooning degeneration of hepatocytes, and focal necrosis in the parenchyma. Thickening of alveolar walls because of interstitial inflammation was noted in the lungs. Histopathological examination of kidney, spleen and small intestine tissue did not reveal any abnormality. In the experimental group, SOD and CAT activities were significantly decreased (p <0.001) but MDA levels were significantly increased (p <0.001) compared with the control group. CONCLUSION: These results indicate that maternal nicotine exposure induces oxidative stress and causes detrimental histopathological changes in the lung and liver of lactating offspring.

TTF-1 and surfactant-B as co-adjuvants in the diagnosis of lung adenocarcinoma and pleural mesothelioma.

Primary lung adenocarcinomas and metastatic adenocarcinomas may show a great morphologic resemblance to malignant mesothelioma. There are numerous immunohistochemical markers being used, but none of them were proved to be effective enough to reach a certain diagnosis. The current study was performed to evaluate the utility of thyroid transcription factor-1 (TTF-1) and surfactant protein-B (SP-B) expression in the differential diagnosis between lung adenocarcinomas and pleural mesotheliomas. In this retrospective study, TTF-1 and SP-B were applied to 30 cases with adenocarcinoma and 15 cases with pleural mesothelioma, immunohistochemically, using an avidin-biotin detection system. Twenty percent of adenocarcinomas and 13.3% of pleural mesothelioma stained positive for SP-B. TTF-1 stained 24 of the 30 adenocarcinomas (80%) and none of the 15 mesotheliomas (0%). TTF-1 positivity in adenocarcinomas was found to be statistically significant, while SP-B had no important practical value either used alone or in combination with TTF-1. There was no statistically significant correlation between the differentiation level of adenocarcinomas and TTF-1 staining pattern. In conclusion, we believe that TTF-1 may be helpful in distinguishing lung adenocarcinoma from pleural mesothelioma.