[Show abstract][Hide abstract] ABSTRACT: In this study, the long-term effects of mesh and its localisation (i.e. anterior or posterior) on testicular perfusion and testicular function were evaluated in groin hernia patients. Testicular function has been evaluated with spermiogram and testicular perfusion with colour Doppler ultrasonography. Group I: consisted of 30 posterior preperitoneal mesh repair patients Group II: consisted of 30 anterior tension-free repair patients. The operation types were randomised with a systematic sampling method. There was no statistically significant difference between pre-operative and postoperative spermiogram results for both groups. No statistically significant difference was found between the two groups in terms of Doppler flow parameters (PSV, EDV, RI and PI) for pre-operative, early and late postoperative periods. When Doppler flow parameters were compared for group I, statistically significant differences were found between pre-operative and early postoperative values. No statistically significant difference was found between pre-operative and late postoperative values. This is also true for early postoperative values versus late postoperative values. When Doppler flow parameters were compared for group II, statistically significant differences were found between pre-operative and early postoperative values. No statistically difference was found between pre-operative and late postoperative values. This is also true for early postoperative values versus late postoperative values. These results support the idea that inguinal mesh application is still a safe procedure in patients with no children or who are undergoing infertility treatment, where testicular function is important.
No preview · Article · Dec 2003 · Acta chirurgica Belgica
[Show abstract][Hide abstract] ABSTRACT: Keratotic basal cell carcinoma may not only clinically but also histologically share more or less the same features with giant solitary trichoepithelioma. It can be difficult to distinguish these two entities from each other, even for an experienced dermatopathologist. We present an unusual case of inguinal keratotic basal cell carcinoma mimicking giant solitary trichoepithelioma in a 56-year-old woman with a finger-like tumor of 20 years duration. The patient presented with an asymptomatic, skin colored, firm, nonulcerative, nodular lesion. Scanty mitotic activity and apoptotic cells were the histopathologic findings against basal cell carcinoma, whereas absence of papillary mesenchymal bodies, presence of peritumoral lacunae detected only around the solid areas, and accumulation of amyloid-like hyalinized material were the findings in favor of basal cell carcinoma. This case illustrates that keratotic basal cell carcinoma must be taken into account in the differential diagnosis of inguinally located solitary, polypoid masses, especially giant solitary trichoepithelioma.
No preview · Article · Jun 2003 · The Journal of Dermatology
[Show abstract][Hide abstract] ABSTRACT: Involvement of the costovertebral (CV) and costotransverse (CT) as well as the sacroiliac (SI) joints is known to occur in patients with ankylosing spondylitis (AS). The functional significance of these changes is not clear. We have performed clinical and radiological evaluations and assessed the effect of joint involvement on pulmonary function. We detected radiologic evidence of involvement of the CV joint in 80% of patients and of the CT joint in 60 %. We found a direct relation between the severity of CV, CT and SI joint affliction, and the severity of CV and SI joints were related to time of evolution of the disease. Pulmonary function tests revealed neither restrictive nor obstructive defects. No relation was found between pulmonary function and CV and CT joint affliction. Patients with stiffer spines had a tendency to have pulmonary function tests within the lower limit of the normal range. In patients with AS diaphragmatic breathing might compensate the chest respiration to some extent.
No preview · Article · Sep 2002 · Clinical Rheumatology
[Show abstract][Hide abstract] ABSTRACT: Fibroadenomas comprise most of the benign breast lumps among young females and present as well circumscribed masses in the breast. Multiple fibroadenomas are not uncommon. But the presence of more than four fibroadenomas in one breast with recurrences at different time periods is rare. A case of multiple, bilateral and recurrent fibroadenomas (12 previously excised lesions, 17 gradually formed fibroadenomas during follow-up) in a 22-year-old nulliparous female who is still on clinical follow-up is presented. This unusual case is helpful to enlighten the difficulty which may take place in the management of such kind of recurrent multiple fibroadenomas of the breast in the adolescent nulliparous female.
[Show abstract][Hide abstract] ABSTRACT: Blue naevus is an acquired benign melanocytic naevus. It is a firm, sharply defined dark blue to grey-black papule or nodule, which is likely to arise from the arrested dermal melanocytes in the dermis. In the last few years, blue naevus has attracted much attention due to the recognition of new entities and to its confusion with malignant melanoma. We report a 69-year-old man who developed a blue-black nodular lesion with satellitosis on his scalp. Although clinically it was thought to be a malignant melanoma, histopathological investigation and conservative methods such as dermatoscopy and power Doppler ultrasonography did not confirm this diagnosis. Histopathological examination excluded malignant melanoma, as there were no cellular atypia and mitotic activity in either the nodular lesion or the satellitosis. Doppler ultrasonography confirmed the benign nature of the lesion. Dermatoscopic examination showed homogeneous steel-blue pigmentation with individual blue globules, dots and some brown veils, and confirmed the histopathological diagnosis. To the best of our knowledge, our case is the third reported case of a blue naevus with satellitosis mimicking malignant melanoma.
No preview · Article · Dec 2001 · Journal of the European Academy of Dermatology and Venereology
[Show abstract][Hide abstract] ABSTRACT: Bacground/aims: Magnetic resonance cholangiopancreaticography is a noninvasive technique in examination of the biliopancreatic tract which requires less experience than endoscopic retrograde cholangiopancreaticography. The aim of this study was to evaluate the diagnostic value of magnetic resonance cholangiopancreaticography compared to endoscopic retrograde cholangiopancreaticography for common bile duct stones. Methods: The study included 27 patients (16 male, 11 female), with a median age of 59.2±8.1 years (range 24 to 76 years) who underwent magnetic resonance cholangiopancreaticography and then endoscopic retrograde cholangiopancreaticography and in whom the results of both techniques were compared. The time interval between each technique was no longer than 12 hours. Results: False negative results with magnetic resonance cholangiopancreaticography occurred in two cases with stones less than 3 mm in diameter. No false positivity was seen. Magnetic resonance cholangiopancreaticography was unsuccessful in detecting a stone in the common bile duct of a patient with massive ascites, while it had a sensitivity and specificity of 88.8% and 100% respectively. Conclusion: Magnetic resonance cholangiopancreaticography has very high sensitivity and specificity in the evaluation of the common bile duct and can avoid to perform purely diagnostic than endoscopic retrograde cholangiopancreaticography.
[Show abstract][Hide abstract] ABSTRACT: Schwannomas are neurogenic tumors that can arise from different organs and tissues. They are rarely seen within the gastrointestinal tract, but when they do occur, the most common site is stomach. Two cases encountered in a 4.5 year period are presented here. These tumors are usually asymptomatic at the beginning, but may rarely cause hemorrhage due to ulceration of the overlying mucosa. They sometimes present as mass lesions. When hemorrhage is the first symptom, upper endoscopy is important in the initial evaluation. But when it is asymptomatic, barium meal or computerized tomography can be useful. Histopathologic diagnosis is based on features of palisading nuclei with spindle-cell morphology and hyalinized vessels. Immunohistochemical stains, especially for S-100 protein, CD34, desmin and actin must be done for the differentiation from the other stromal tumors of the stomach such as leiomyomas. Although the recurrence rate is too small, complete excision of the tumor with free margins including local resection or enucleation is necessary for the adequate treatment. Prognosis after treatment is good.
[Show abstract][Hide abstract] ABSTRACT: Purpose: To evaluate the efficacy and accuracy of endorectal ultrasonography (EUS) in detecting preoperatively rectal wall invasion and nodal involvement in patients with rectal carcinoma. Materials and methods: EUS was applied to 27 patients prediagnosed as having rectal carcinoma by using a 7.5 MHz endorectal transducers with water bag. Sonographic evaluation consisted of estimation of tumour invasion into the rectal wall and adjacent lymph node involvement. All of the patients were operated on with curative intend and the sonographic stage was compared with the postoperative pathologic stage. Results: The accuracy rates of EUS compared with the postoperative pathologic staging were 81%, 70.3% and 59.3% in determining wall invasion, nodal involvement and overall tumour stage, respectively. The most frequent factor leading to false-positive results was the abnormally reactive-hyperplastic lymph nodes which were hypoechoic and larger than 5 mm in diameter. Conclusion: It is concluded that EUS is a moderately reliable imaging method for local tumour staging, mainly due to its relatively high rate of nodal imaging failure.