Amac: Koroner arterlerde gorulen Muskuler kopru (MK) iyi huylu bir durum olarak bilinmesine ragmen, bazi calismalarda olumsuz kardiyak olaylar ile iliskisinin oldugu belirtilmektedir. Bu olumsuz olaylarin meydana gelmesinde koroner iskemi gibi bazi durumlar suclansa da, miyokardiyal elektriksel iletimdeki olumsuzluklarin da buna katkida bulunacagi dusunulmektedir. Bu calisma da kalbin elektriksel aktivitesini gosteren elektrokardiyografi parametreleri ile muskuler kopru arasindaki iliski incelenmistir. Materyal ve Metod: Bu calismaya MK olan 36 hasta (26 erkek, yas ortalamasi 56 yil) ve normal koroner arteri olan MK olmayan 36 kisi (30 erkek, yas ortalamasi 51yil) kontrol grubu olarak kalinmistir. Istirahat halinde yatar pozisyonda 12 kanalli elektrokardiyografi (EKG) cekilerek QT intervali, QT corrected (QTc), Tp-Te intervali, Tp-Te/QT ve Tp-Te/QTc olcumleri yapilmistir. Bu parametreler, gruplar arasinda karsilastirildi. Bulgular: MK ve kontrol grubu arasinda klinik ve bazal demografik ozellikler acisindan anlamli farklilik saptanmadi. Ancak, MK grubunda QT intervali, QTc, Tp-Te intervali, Tp-Te/QT ve Tp-Te/QTc anlamli olarak yuksekti. (Sirasiyla 360±1.9’e karsin 355±2.3, p<0,001; 428.1±1,6‘e karsin. 417.3±1.4, p<0,001; 83.3±1.4‘e karsin 72.1±1.3, p<0,001; 0,24±0,005’e karsin0.2±0.004, p<0,001; 0,2±0,003’e karsin 0.17±0.003 p<0,001). Tp-e intervalinin bagimsiz prediktorlerini belirlemek amaciyla multivariate analiz yapildi. MB uzunlugu Tp-Te intervalinin bagimsiz ongordurucusu olarak saptandi. (β=0.530, p = 0.005) Sonuc: MK uzunlugu, Tp-Te intervalinin bagimsiz bir on gordurucusudur.

Colorectal cancer (CRC) is the third most frequent malignancy. Many factors such as NF-κB, matrix metalloproteinase-1 (MMP-1), p53, and Ki-67 are likely to be involved in its development and progression. Lymph node metastases indicate increased tumor burden and tumor cell heterogeneity and affect both the treatment strategies and the prognosis. In this study, expressions of NF-κB, MMP-1, p53, and Ki-67 were between the primary tumors and lymph node metastases in 110 Dukes' stage C, CRC cases by immunohistochemical methods, related to patients' clinical outcomes. NF-κB, p53, and Ki-67 expressions were significantly higher in the metastatic lymph nodes compared to the primary tumor tissues (P = 0.04, P = 0.04, and P = 0.01, resp.). In the metastatic lymph nodes NF-κB expression was correlated with both p53 (r = 0.546, P = 0.003) and Ki-67 (r = 0.586, P = 0.0001) expressions. The univariant and multivariant analyses showed that only “pT stage” preserved an independent prognostic significance for recurrence-free survival rates and 5-year overall survival rates (P < 0.001 for both). Metastatic cells can acquire different biological characteristics compared to their primaries. Elucidation of properties acquired by metastatic cells is important in order to better determine prognosis, reverse drug resistance, and discover new treatment alternatives.

Apocrine carcinoma of the breast is a relatively rare subgroup of breast tumors and comprises 1-4% of all breast carcinomas. The case is a 49 year-old postmenopausal woman. Two different lumps located near to each other at the left upper quadrant were both reported as invasive ductal carcinoma after core needle biopsy. The patient had undergone breast conserving surgery and sentinel lymph node biopsy of axilla with blue dye after wire localization of the masses. Since the lymph node biopsy was found to be metastatic, level I-II axillary dissection was performed on the patient. Pathology revealed apocrine carcinoma with 1 of 16 dissected lymph nodes and was evaluated as metastasis and the oncology department planned chemotherapy with 4 cycles Epirubicin-Cyclophosphamide protocol followed by radiotherapy.

The aim of this study was to evaluate the histologic diagnoses of the reduction mammaplasty specimens in two retrospective series of patients operated using superior and central pedicle mammaplasties. Between November 2000 and December 2011, 60 consecutive patients (120 breasts) underwent breast reduction using the superior pedicle technique with a vertical scar (Lejour's technique). These patients were compared with another series of 80 patients (150 breasts) who underwent breast reduction using a vertical scar mammaplasty with a central pedicle (Copcu's technique). The characteristics of the patients were statistically similar between the two groups. Therefore, 140 patients who had undergone reduction mammaplasty were analyzed with respect to their histologic diagnoses, age, and specimen's weight. In the superior pedicle technique, we found that 30% of these women had pathologic alterations in at least one of their breasts, whereas the pathologic changes in patients who underwent Copcu's technique were 35%. In terms of tumor diagnosis, the upper quadrant excision technique (e.g. Copcu's method) may be safer. If there is no other special condition, it is better to use the pedicle technique in which the upper lateral and upper medial pole is removed. Level of Evidence: Level I, therapeutic study.

Postmenopozal kanamasi olan 61 yasindaki hastanin endometrial biyopsisinde malignite saptanmasi uzerine evreleme cerrahisi yapildi. Frozen incelemede serozaya kadar ulasmis tumor, sarkom olarak bildirildi. Patolojik inceleme sonucunda mikst mulleriyan tumor (mikst mezodemal tumor, karsinosarkom) pelvik ve paraaortik lenf nodu tutulumu gozlendi. Hastaya adjuvan pelvik ve intrakaviter radyoterapi verildi. Ileri evre uterin karsinosarkomlarda 5 yillik sagkalim dusuktur. Hastanin 96 aylik izleminde hastaliksiz sagkalimi surmektedir. Bu sagkalim, cerrahi ve katkisi tartismali olmakla birlikte adjuvan radyoterapi ile saglanmistir.

Parathyroid carcinoma is a rare neoplasm, accounting for less than 1% of patients with primary hyperparathyroidism. Parathyroid carcinoma usually manifests during the fourth decade. A 77-year old female patient presented with weakness. The patient's laboratory results showed serum calcium (Ca) value of 13.6mq/dl (reference range:8.4-10.2 mg/dl), serum parathormone (PTH) value of 385pg/ml (15-65 pg/ml) and the patient's condition was concluded to be primary hyperparathyroidism. In parathyroid scintigraphy, the late images taken 2 hours after the injection of 25mCiTc-99m MIBI revealed focal sestamibi retention in the zone corresponding to the thyroid left lobe lower pole inferior (Figure 1). Considering parathyroid adenoma, parathyroidectomy was performed. The pathology result was parathyroid carcinoma. Although the disease is most common in the fourth decade, parathyroid carcinoma should be considered as a rare malignancy in the elderly.

Purpose. To describe the sonographic (US) features associated with ultrasonography BI-RADS category 4 lesions that have a benign histopathological outcome. Methods. One hundred seventy-two histopathologically proven benign lesions in 169 patients, which had been classified as BI-RADS category 4 with ultrasonography, were retrospectively evaluated. Ultrasonography and histopathology findings were analyzed. The frequency of sonographic findings according to the histopathological diagnosis was determined. Results. Among the 172 lesions, there were 66 (38%) fibroadenomas, 31 (18%) sclerosing adenoses, 24 (14%) fibrocystic changes, 16 (9%) mastitis/inflammations, 9 (5.5%) intraductal papillomas, 8 (5%) focal fibroses, 4 (2.5%) atypical ductal hyperplasias, 4 (2.5%) fat necroses, 2 (1%) phyllodes tumors, 1 (0.5%) tubular adenomas, 1 (0.5%) epidermal inclusion cysts, and 6 (3.5%) other benign lesions. The most frequent sonographic findings were heterogeneity, indistinct margin, microlobulation in fibroadenomas; heterogeneity, irregular-indefinite margin, and antiparallel orientation in sclerosing adenosis; heterogeneity, microlobulation, and acoustic shadowing in fibrocystic changes. Conclusions. BI-RADS category 4 lesions demonstrate more than one suspicious ultrasonography feature, and biopsy is necessary to diagnose malignancy captured in 33% of lesions in this study. At this time, any lesion with more than one suspicious BI-RADS US feature cannot avoid a diagnostic biopsy. (C) 2012 Wiley Periodicals, Inc. J Clin Ultrasound, 2012

PURPOSE:To examine the mammography and ultrasonography findings of patients who have a final histopathological diagnosis of sclerosing adenosis after breast biopsy, and to evaluate the follow-up results of patients who underwent core needle biopsies.MATERIALS AND METHODS:Seventy-six of the 723 patients who underwent breast biopsy in our institution were diagnosed with sclerosing adenosis on histopathological examination. Mammography and ultrasonography findings from these 76 lesions were analyzed retrospectively. Thirty-seven of these lesions were sampled by image-guided core needle biopsy; the remaining lesions were excised surgically. Mammograms and ultrasound images of the lesions were re-evaluated, and the post-biopsy medical records of these patients were evaluated.RESULTS:Sclerosing adenosis was the main diagnosis in 41 patients and the complementary diagnosis in 35 patients. Among the first 41 lesions in which sclerosing adenosis was the main diagnosis, there were 18 (44%) mass lesions, 16 (39%) microcalcification clusters, two (5%) lesions with asymmetrical opacity, three (7%) lesions with architectural distortion, and two (5%) lesions with focal acoustical shadowing that was only detected by ultrasonography. No alterations suggesting malignancy were noted during the follow-up examinations of 35 patients who underwent core needle biopsy.CONCLUSION:Sclerosing adenosis is a benign proliferative disease of the breast that can be confused with malignancy on clinical, radiological, and even histopathological examination. There is no typical radiological criterion for diagnosis. Core needle biopsy or excisional biopsy can be used, depending on the lesion's characteristics. Core needle biopsy can be the first step in the diagnosis of sclerosing adenosis.

Second primary cancers in patients with ovarian cancer can be observed. However, vaginal squamous cell cancer as a second primary cancer has not been reported in the literature. A postmenopausal, 51-year-old woman hypertensive and diabetic for ten years, admitted with bilateral adnexal masses. Serum CA- 125 value was found as 74.6 U/ml. Intra-operative frozen section reported that bilateral ovarian capsules were intact, but there were ovarian malignancies in some foci. Abdomen cytology was evaluated as negative. Six cycles of adjuvant carboplatin/paclitaxel treatment was given. Recurrence developed five years later and the same agents were again given. Second-look laparotomy was negative. Later, patient developed chronic renal failure, and dialysis was started. One year later, squamous cell carcinoma was detected at the anterior wall of the vagina, next to the vaginal cuff. Radiotherapy/carboplatin was given to the patient who declined surgical treatment. Patient’s metastatic lung lesion was detected in the ninth year of primary cancer diagnosis. Carboplatin/paclitaxel was restarted. In patients with gynecological cancer, increased risk of second primary cancers may be due to the common etiologic causes such as chemotherapies, prolonged survival, hereditary and systemic diseases. Careful follow-up is advised.

Objectives: To evaluate the incidence of breast lesions with a histopathological diagnosis of focal fibrosis based on imaging guided core biopsy, to review the radiologic findings and to assess the diagnostic reliability of 14 G core needle biopsy.Materials and methods: 723 patients, who had undergone 14 G core biopsy and/or surgical excisions, were retrospectively analyzed. Overall, 43 lesions were diagnosed as focal fibrosis. Physical examination, mammography, ultrasonography, and follow-up findings were all reviewed.Results: Radiological evaluation revealed that 35 (81%) lesions were solid masses. Of 35 mass lesions, 24 (69%) were well circumscribed, the remaining 11 (31%) lesions were ill defined on mammograms or sonograms. None of the lesions had pathological microcalcifications. Three lesions were surgically excised because of radio-pathological discordance after core needle biopsy.Conclusions: Focal fibrosis of the breast is a benign condition and reflects the ductal and lobular atrophy secondary to stromal proliferation. The radiological findings of this entity may vary and sometimes mimic those of malignant lesions. The incidence of focal fibrosis among our study population is 6% and a well-defined mass lesion is the most frequent finding. Core needle biopsy is a safe and reliable diagnostic procedure in the management of these cases. (C) 2010 Elsevier Ireland Ltd. All rights reserved.

Calcification of chronic subdural hematoma or cephalhematoma has been reported on several occasions in the literature. Nevertheless, ossified chronic subdural hematomas have been reported only rarely [2] [6] [7] [9] [15] [24]. In this report, we present a case of a 30-year-old woman with chronic subdural hematoma that was seen to be affected by a giant crust-like ossification, which was successfully excised.

Purpose: To evaluate the sonographic findings and histopathological diagnosis of complex breast cysts, and to assess the diagnostic reliability of a 14G core-needle biopsy.Patients and Methods: Sixty-one complex breast cysts that underwent a 14 G core-needle biopsy and/or surgical excisions were retrospectively analyzed. Cystic masses with thick wall- thick septation and with solid component were included. Mixed lesions with both cystic and solid appearance were excluded. Radiologic findings and histopathologic diagnosis of these lesions reviewed retrospectively.Results: Of 61 lesions, 39 (64%) were complex cysts with thick wall and/or thick septation and 22 (36%) were complex cysts with solid component. Forty- eight (79%) lesions were diagnosed as benign and 13 (21%) lesions were diagnosed as malignant. Of the 39 complex cysts with thick wall-thick septation, 31 (79%) lesions were diagnosed as benign and 8 (21%) lesions were malignant. Of the 22 complex cysts with solid component, 17 (77%) lesions were diagnosed as benign and 5 (23%) were malignant.Conclusion: Complex breast cysts have malignancy risk and usually require biopsy. Thirteen of 61 (21%) complex cysts proved malignant in our study. Core needle biopsy is a safe and reliable diagnostic procedure in the management of these cases. However, in cases of clinical/radiological/pathological discordance or the presence of atypical cells, a surgical excision should be performed.

The aim of this study was to investigate the efficacy of ibuprofen on the healing of esophagus and the prevention of stricture development after esophageal caustic injuries in rats.

Schwannomas arise from the neoplastic transformation of nerve sheath cells and are considered benign tumors. We report here on a 43-year-old patient seen for radiculopathic pain and loss of sphincter control. Magnetic resonance imaging of the spine revealed a giant intraspinal mass extending from L1 to L5. The patient underwent laminectomy for excision of the solitary mass and histological findings were consistent with schwannoma. Giant schwannoma of the cauda equina is a rare tumor, with variable manifestations.