[Evaluation of diagnostic accuracy of intraoperative cytology [touch imprint] in malignancy of breast masses]

Due to absence of frozen section in the majority of hospitals, malignant breast masses are being operated in two admissions first for biopsy and second for mastectomy. With simple and rapid technique of touch imprint [intraoperative cytology] we can do both operations in one time, if it be accurate. During 2003 to 2006 reports of touch imprints of 70 patients with breast masses compared with reports of permanent section. We had tow pathology teams in separate hospitals for cytology and permanent section. In 70 patients, 39 cases had malignant and 31 cases had benign masses. In 39 patients with malignant masses, 36 patients had malignant and 3 patients had benign cytologic reports. In 31 patients with benign masses 2 patients had malignant reports in cytology. Therefore sensitivity, specificity and accuracy of touch imprint in diagnosis of malignant breast masses are 92.3%, 93.5% and 92.9% respectively. Because of high specificity of touch imprint it seems this test can be done in centers that do not have frozen section for intraoperative diagnosis of malignant breast masses

[Incidental perforation of peptic ulcer after trans-urethral resection of bladder tumor: a case report]

Peptic ulcer is relatively common and in 2% of patients may present with sudden perforation without previous history of peptic ulcer disease. Early diagnosis and management can save the patient. A 79-year-old man was presented to emergency room with gross hematuria and clot uninary retention. A 3-4 cm vegetative mass was in left lateral wall of bladder in cystoscopy. Under spinal anesthesia, transurethral resection was performed without any complication. The day after surgery, patient had developed generalized abdominal pain and guarding and hematuria with urinary retention. Emergency abdominal sonography revealed free fluid in pelvis with possible bladder perforation. Laparotomy was performed and there was no bladder perforation except a little extra and intra peritoneal clear fluid. With a cystectomy tube and two intra and extra peritoneal drains laparotomy was closed. Two days after the second surgery, liquid diet was started for patient, but it was associated with fecal oderous leakage from the drains. After consultation with general surgeons with diagnosis of trauma to rectum or lieum again laparotomy was performed. In re-exploration there was a perforation in stomach [anterior aspect of pylores], so it was repaired and a few days later with normal general condition patient was discharged. Although peptic ulcer disease is relatively common. Its perforation with association of other surgeries in these patients is very rare and can mimic the complication of T.U.R.B.T. So close observation of patients and proper management can save the patients

[Effect of repairing and medication on treatment of perforation of peptic ulcer]

Background and Objective: Perforation of peptic ulcer is a common complication that its treatment needs several surgical methods [Repairing, vagotomy and anterectomy]. These methods in spite of technical difficulties and complications do not exclude the helicobacter pylori. This study was performed to evaluate the efficacy of simple repairing with anti-acid and anti-helicobacter agents in treatment of perforation of peptic ulcer

Case: This study was performed on 10 cases with perforated peptic ulcer. After simple closure of perforation, all patients were treated by metronidazole, amoxicillin, cimetidine, bismuth, omeprazole. After 6 weeks of treatment, an endoscopic examination was performed. All patients were treated completely by this method

Conclusion: According to the results, simple surgical repairing of perforation in addition to administration of anti-acid and anti-helicobacter treatment is sufficient for therapy of perforation of peptic ulcers