Cancer of the male breast: The Turkish experience

Twenty-six patients with male breast cancer who were admitted to the Center of Oncology and Nuclear Medicine, Istanbul, Turkey, between 1980 and 1988, were analyzed retrospectively. Median age was 60 years. Most lesions were infiltrating ductal carcinomas (92%). Of 26 lesions, 9 were staged as stage II (35%), 14 as stage III (54%), and 3 as stage IV (11%). All but five patients underwent unilateral mastectomy (81%). Postoperative treatment consisted of radiation therapy combined with chemotherapy in 11 patients (42%), chemotherapy with or without hormonal therapy in 4 (15%), radiation therapy alone in 10 (38%). Radiation therapy was delivered for a mean total radiation dose of 52 ± 2 Gy (range 30–60 Gy). Chemotherapy consisted of cyclophosphamide, methotrexate and 5-fluorouracil (CMF) in most patients (60%). FAC regimen (5-fluorouracil, Adriamycin, and cyclophosphamide) was given to 6 patients (40%). Six patients were known to have died of breast cancer during follow-up (23%). Fourteen patients were NED (no evidence of disease) at last follow-up (54%). Overall actuarial 5-year survival was calculated to be 37%, and median actuarial survival was 46.6 months. Actuarial 5-year disease-free survival was 27%, and median actuarial disease-free survival was 47.1 months. Only one patient had a local recurrence, and eight patients had 13 distant metastases (31%). Age (P = 0.023), tumor stage (P = 0.055) and nodal status (P = 0.013) were the most significant prognostic factors correlated with the overall survival. © 1993 Wiley-Liss, Inc.     

Side-to-side choledochoduodenostomy in the management of choledocholithiasis

Sixty patients with choledocholithiasis (either single or multiple stones of the biliary tree) were treated with lateral choledochoduodenostomy. Of these cases 83.3% were followed up for from 1 to 7 years. Only 1 patient developed cholangitis, which responded well to conservative treatment. The other cases have been asymptomatic following surgery. The diameter of the common bile duct is not an important problem in constructing a functional anastomosis.     

The effects of mitomycin C and 5-fluorouracil/triamcinolone on fibrosis/scar tissue formation secondary to subglottic trauma (experimental study)

PURPOSE: The aim of the study was to compare the effects of mitomycin-C (MMC) and 5-fluorouracil/triamcinolone acetonide (5-FU/TA) on the development of fibrosis/scar tissue formation of rabbit subglottic area, which is injured acutely. MATERIALS AND METHODS: After standardized trauma to subglottic area the rabbits were divided into those that received treatment and those that did not (controls). The subjects were treated with either topical 0.4 mg/mL MMC or 5 mg 5-FU/TA injection. Those groups were further divided into subgroups depending on the time of examination: at 2 or 6 weeks. Each subgroup had 4 rabbits. The specimens were examined histopathologically and the measurements were performed using a software. RESULTS: The fibrosis indices (FIs) of the treated subgroups were significantly less than the FIs of their corresponding control subgroups (P<.05). The difference in FIs of the MMC-treated and 5-FU/TA-treated groups was not statistically significant (P>.05). MMC and 5-FU/TA did not interfere with regeneration of the epithelium although in 2 cases treated with 5-FU/TA the regenerated epithelium showed squamous metaplasia. CONCLUSIONS: Both MMC and 5-FU/TA decrease fibrosis/scar tissue formation secondary to experimentally induced acute subglottic trauma. There is no significant difference between the effects of the 2 drugs.     

Interleukin-1alpha, interleukin-1beta, and interleukin-1Ra polymorphisms in febrile seizures

Febrile seizures are the most common form of childhood seizures. The exact mechanism promoting convulsions during a common febrile illness remains unknown, but it is accepted that genetic influences are likely to account for at least some of the cases. Previous studies reported high interleukin-1beta levels in the cerebrospinal fluid of patients with febrile seizures. Recently, an association between a regulatory polymorphism in the genes encoding interleukin-1beta and interleukin-1Ra and febrile seizures was reported. In this study, we attempted to confirm these findings. We analyzed the cytokine gene polymorphisms of interleukin-1beta, interleukin-1alpha, and interleukin-1Ra of 73 children with febrile seizure and 152 healthy controls. The distribution of interleukin-1beta -511, interleukin-1alpha -889, and interleukin-1Ra genotypes and alleles did not differ significantly between cases and controls. Our data suggest that the studied gene polymorphisms of interleukin-1beta, interleukin-1alpha, and interleukin-1Ra do not have a significant role in the pathogenesis of febrile seizures.     

Spinal granulocytic sarcoma (chloroma) presenting as acute cord compression in a nonleukemic patient

The case of a previously healthy 24-year-old man diagnosed with extradural thoracic granulocytic sarcoma with no evidence of bone marrow or other hematological involvement is described. The tumor was removed totally by microsurgery. The histopathological examination was consistent with granulocytic sarcoma. Granulocytic sarcomas are most commonly found in the context of an acute myelogenous leukemia or in chronic myelogenous leukemia. They rarely have been reported in otherwise healthy patients without any evidence of systemic disease. A review of the literature revealed only 14 more nonleukaemic cases with granulocytic sarcoma causing thoracic spinal cord compression.     

Large animal-related abdominal injuries

BACKGROUND: This study investigated injuries to the abdominal area of the body caused by large animals, as well as the management of this problem. METHODS: All the patients with large animal-related abdominal injuries over a 10-year period were identified retrospectively through the general surgery registrations. RESULTS: Overall, 113 patients were hospitalized after large animal encounters during the 10-year study period, 33 (30%) of which had large animal-related abdominal injuries. These patients comprised 10 women (30%) and 23 men (70%) with a mean age of 56 +/- 14 years. Of the 33 patients, 31 (93.9%) sustained blunt injuries and 2 (6.1%) experienced penetrating abdominal trauma. The mean Injury Severity Score was 12.7 +/- 4.0, and the mean Acute Physiology and Chronic Health Evaluation II (APACHE II) score was 10.6 +/- 3.2. The mean intensive care unit stay was 0.8 +/- 2.2 days, and the total hospital length of stay was 7.3 +/- 5.6 days. Whereas 12 patients (36.4%) were managed nonoperatively, 21 patients (63.6%) required surgery. Laparotomy showed injuries to the jejunum in three patients (9.1%), to the ileum in 13 patients (39.4%), to the ileal mesenterium in 1 patient (3%), to the liver in 4 patients (12.1%), and to the spleen in 2 patients (6.1%). One patient died of myocardial infarction on the second day after admission. CONCLUSIONS: Large animal-related injuries to the abdominal area can be serious. Immediate transportation and early diagnosis of abdominal insults are important because of the frequencies of small bowel and mesenteric injuries, which are difficult to diagnose using currently available diagnostic tools.