prospective study of the latero-central glandular pedicle technique as an oncoplastic procedure for medial quadrants breast masses:oncological safety and clinical outcomes

Background: breast cancer, according to national cancer institute, is the most common site of cancer in women in Egypt as it accounts for about 38.8% of total malignancies among Egyptian females; it is an important cause of mortality among women. For many women with stage 1 or 2 breast cancer, the combination of partial mastectomy and radiation therapy - together referred to as breast- conserving therapy is preferable to total mastectomy because breast conserving surgery survival rates is equivalent to those after mastectomy while preserving the breast

Aim of the work: this study aimed to focus on the latero-central glandular pedicle technique as an oncoplastic procedure for management of medial breast cancer and to assess the technique clinically regarding oncological safety, surgical outcomes and patient satisfaction

Methods: this was a prospective analytical study that included 15 patients aiming to clinically assess the centro-lateral oncoplastic technique for both inner quadrants of breast cancer regarding oncological safety and patient satisfaction. This study was conducted at Ain-Shams University Hospitals. Approval of the Ethical Committee and written informed consent from all participants was obtained

Results: in our study we were able to conduct an excellent cosmetic outcome for a relatively large tumor excisions with 66% of the cases [10 patients] falling in excellent and very good score groups with mean cosmetic outcome score 4.26. Another 20% [3 cases] which fall in good and fair score groups as those two patients noticed asymmetry of the two breasts in front of the mirror as they refused bilateral breast reduction mastopexy. None of our cases have had a poor or an ugly score

Conclusion: the combination of plastic surgery techniques with breast oncology surgery gives the surgeon a new tool for treatment of breast cancer. This approach has enabled us to increase the number and extend the indications of breast conserving surgery with wider margins offering safer oncologic control with more satisfactory cosmetic outcome

[HLA-DR /DQ antigens associations in recurrent abortions for women from Syrian population]

Many available references indicate to a role for HLA-antigens in recurrent abortions, during their function in self and non-self recognition. The embryo, being hemi-allograft, make it rational to search for some HLA-antigens more frequent in women suffering from recurrent abortions in Syrian population, especially HLA-II antigens HLA-II antigens. Searching also for combined haplotypes between these antigens. We did not found any like study in Syrian population. The Antigens types of HLA-DR and HLA-DQ of [14] fertile multifarious Syrian couples[controls] were defined by micro lymphocytotoxicity test[Terazaki method]. In the same time, antigen types of DR and DQ of [36] Healthy Syrian couples suffering from recurrent abortions were defined by the same technique. The results indicate different antigen pattern distribution between control and diseased groups. The frequencies in control group for DR types were as the following: DR4:29%, DR11:18%, DR15:14%, DR1: 7%, DR7: 7%, DR8: 7%, DR16: 7%, DR3: 4%, DR12: 4%, DR14: 4%. And in the diseased group were: DR4:18%, DR11:18%, DR7: 11%, DR1: 10%, DR14: 7%, DR17: 7%, DR13: 6%, DR15: 6%, DR8: 6%, DR3: 4%, DR12: 3%, DR9: 1%, DR10: 1%, DR16: 1%, DR18: 1%. The frequencies in control group for DQ types were: DQ3: 29%, DQ4: 25%, DQ5: 21% DQ2: 14%, DQ6: 11%. And in the diseased group were: DQ3: 28%, DQ5: 25%, DQ2: 18%, DQ4: 15%, DQ6: 14%. The obvious frequency changes for DR types were: DR1, DR7, DR4, D15, DR13, DR17, DR14 and for DQ types were: DQ2, DQ4, DQ5, DQ6. The differences of DR -DQ types distributions in the studied group of control [women and men] are similar to those in other studies in the Syrian population. This study suggest that having antigen types of DR-DQ in frequencies different from control observed in the whole population make them at risk to inconvenient immunological response to accept pregnancy the result of which is abortion.

[Immunological evalution of Syrien patients with recurrent abortion]

The prospective of this study is to define the percentages of white blood cells, lymphocytes cell lines, using [CD] markers for Syrian women [wives] suffering from recurrent abortions. We estimate that this will be useful tools to make unimmunological diagnostic screening, with other elements, offering convenient therapeutic protocols. White blood cells [WBC]s, T-Lymphocytes, Suppressors, Helpers, and Natural Killers [NK]B-Lymphocytes, from peripheral blood cells of Syrian normal Multiparus 25 Women and 102 Women with recurrent abortions were assessed by flow cytometry using: CD[+3], CD[+4], CD[+8], CD[+19], CD[+45], CD[+56], markers. The mean [WBC] count in the control group was 8072, 8453 in the patient group. The mean percentage of the total lymphocytes count was 33% in control group, it was 35% in patient group. The mean count of total Lymphocytes was 2635 in control group, it was 2913 in patient group. The mean count of T-Lymphocytes was 2036 in control group, 2223 in patient group. The B Lymphocytes count was 213 in control group, 263 in patient group. The mean count of natural killers [NK] was 285 in control group, 360 in patient group. The results indicate to increased values in patient group comparing with control group, it is probable that these changes would play a crucial role in recurrent abortion

Pars plana coreoplasty

The work was carried out on 18 eyes of fifteen patients with inadequate pupillary zone due to different causes. A completely occluded pupil was found in nine eyes [50%] while after cataract and retained lens matter was present in eight eyes [44.4%] and a seccluded pupil with a papillary membrane was the presenting sign in one eye [5.6%]. Preoperative ultrasonography [A and B mode] was carried out for 10 eyes [55.5%]. Pars plana coreoplasty with anterior vitrectomy was done for all the selected eyes. Anatomical success was achieved in all of the operated eyes [100] while visual success was achieved in 86.7% of the operated eyes. The complications and difficulties during and after the operation were recorded