Mammographic and Ultrasonographic Findings of Different Breast Adenosis Lesions.

Aim: To describe imaging features of different breast adenosis lesions. Materials and methods: Mammographic and ultrasonographic findings of patients with different types of adenosis were reviewed retrospectively Tissue samples were obtained either with US-guided core needle biopsy or localization with needle-wire system and surgical excision. Results: Forty-three adenosis lesions were diagnosed in 41 patients: 27 sclerosing adenosis, 13 blunt duct adenosis and 3 microglandular adenosis. Most frequent abnormal findings of sclerosing adenosis were masses with non-circumscribed margins and focal acoustic shadowing without mass configuration (54%) on ultrasonography. Mammography was normal in 54% of sclerosing adenosis, the most common abnormality was architectural distortion (21%). In blunt duct adenosis, usually circumscribed masses (46%) were detected on ultrasonography, clustered punctate microcalcifications (23%) and circumscribed masses (23%) were observed on mammography. All microglandular adenosis lesions were non-circumscribed masses. Premalignant components were detected only with surgical excisional biopsy in three patients that showed suspicious radiological findings and benign pathological result on core biopsy. Conclusion: The adenosis lesions have no pathognomonic characteristics on mammography and ultrasound. Total excision may be considered when suspicious radiological findings are present although core needle biopsy results are benign.

Radiologic findings and percutaneous treatment of a rare giant soft tissue hydatid cyst.

The aim of this report is to present the radiologic findings and discuss the percutaneous treatment of an extremely rare giant soft tissue hydatid cyst located in the left thigh in a 44-year-old woman. Ultrasound showed a well circumscribed giant soft tissue cyst, and computed tomography revealed a well defined unilocular hypodense cystic mass originating from the adductor muscles and extending through the subcutaneous tissue without bony relations. On magnetic resonance imaging, the cystic mass was hypointense on T1 and hyperintense on T2-weighted images. Percutaneous treatment was performed successfully by catheterization technique with hypertonic saline and alcohol. No complications and recurrence were observed during the procedure, in the postprocedure or in the follow up period.

The association of intramammarian arterial calcifications detected on mammography with coronary artery disease and its risk factors.

AIM OF THE STUDY: To evaluate the association of intramammarian arterial calcifications seen on mammography with coronary artery disease and its risk factors and to discuss intramammarian arterial calcifications value as a predictor of coronary artery disease. MATERIAL AND METHODS: Mammography was performed on 55 women over 40 years of age who have undergone coronary angiography and have not had a mammography in the past year. Coronary angiography results, coronary artery disease risk factors and intramammarian arterial calcifications are evaluated. RESULTS: The prevalance of intramammarian arterial calcifications was 41.8%. A significant relationship between intramammarian arterial calcifications and coronary artery disease was indicated (OR 10,8, 95% Cl 3,02-38,59). The positive predictive value and negative predictive value of intramammarian arterial calcifications for coronary artery disease was 78.3% and 75% respectively. Also advancing age was found relevant with these calcifications (OR 1,15, 95% Cl 1,05-1,25). CONCLUSION: The results support the present literature and suggest that mammography, already widely in use as a screening tool among women over 40, may be used simultaneously in coronary artery disease risk assessment. These results should be confirmed by further larger group controlled studies.

Pathologic assessment of non-palpable probably benign breast masses at sonography: can instant intervention be avoided and is follow-up adequate?

AIM OF THE STUDY: To evaluate the pathologic results, determine the negative predictive value of non-palpable probably benign lesions at ultrasound and asses whether follow-up is adequate and immediate biopsy can be avoided. MATERIALS AND METHODS: Four hundred and eight cases which were referred to our breast imaging unit between 2004 and 2008 for biopsy evaluation were enrolled into the study. Two hundred and thirteen probably benign solid masses are classified as BI-RADS 3 in 205 of the enrollees. All masses were sonographically detectable and were classified through the guidelines of BI-RADS lexicon for sonography before the final pathological examination. All pathologic results were evaluated and the negative predictive value, false negativity rate and 95% confidence interval were calculated. RESULTS: Of the 213 masses, fine needle aspiration cytology was performed in 120. US-guided wire localization and eventual surgery were carried out in the remaining 93 masses. Finally, 211 of the punctured lesions turned out to be benign and only two malignant lesions were detected. The resulting negative predictive value was found to be 99.1% while the false negative rate value was 0.9%. CONCLUSION: With the results provided, we think that in the patients with sonographically detected probably benign breast lesions, short-term follow-up seems to be a strong alternative to immediate biopsy with its reliable high negative predictivity as well as low false negativity.

Intravascular papillary endothelial hyperplasia (Masson's hemangioma) presenting as a lateral neck mass.

Intravascular papillary endothelial hyperplasia (Masson's hemangioma) is a benign disease of vascular origin characterized by exuberant endothelial proliferation in normal blood vessels.The most important feature of the disease is its resemblance to hemangiosarcoma and the resulting possible radiologic misinterpretation. We present the radiologic findings in a 45-year-old woman presenting a neck mass extending to the thoracic cavity.

Percutaneous treatment of giant abdominal hydatid cysts: long-term results.

BACKGROUND: This study aimed to evaluate the efficacy of percutaneous treatment of giant abdominal hydatid cysts. METHODS: In this study, 15 abdominal giant hydatid cysts were treated with the catheterization technique, which included puncture of the cyst, aspiration of fluid, instillation and respiration of hypertonic saline solution, and catheterization and sclerosant therapy with absolute ethanol followed by free drainage of the cavity. The catheter was removed when the daily drainage was less than 10 ml. RESULTS: The goals, including inactivation of the parasite and elimination of the mass effect, were achieved in all patients. Catheterization required a mean of 32 days (range, 14-52 days) and hospitalization a mean of 8.73 days (range, 2-30 days). No evidence for recurrence was observed in any patient during a mean follow-up period of 52.8 months (range, 36-72 months). CONCLUSION: Percutaneous treatment of giant hydatid cysts is effective because it eliminates both the mass effect and the parasite and alleviates the symptoms. Although the long catheterization time associated with the procedure is unfavorable, it is tolerated by the patients.

Extramuscular myofascial force transmission: experiments and finite element modeling.

The specific purpose of the present study was to show that extramuscular myofascial force transmission exclusively has substantial effects on muscular mechanics. Muscle forces exerted at proximal and distal tendons of the rat extensor digitorium longus (EDL) were measured simultaneously, in two conditions (1) with intact extramuscular connections (2) after dissecting the muscles' extramuscular connections to a maximum extent without endangering circulation and innervation (as in most in situ muscle experiments). A finite element model of EDL including the muscles' extramuscular connections was used to assess the effects of extramuscular myofascial force transmission on muscular mechanics, primarily to test if such effects lead to distribution of length of sarcomeres within muscle fibers. In condition (1), EDL isometric forces measured at the distal and proximal tendons were significantly different (F(dist) > F(prox), DeltaF approximates maximally 40% of the proximal force). The model results show that extramuscular myofascial force transmission causes distributions of strain in the fiber direction (shortening in the proximal, lengthening in the distal ends of fibers) at higher lengths. This indicates significant length distributions of sarcomeres arranged in series within muscle fibers. Stress distributions found are in agreement with the higher distal force measured, meaning that the muscle fiber is no longer the unit exerting equal forces at both ends. Experimental results obtained in condition (2) showed no significant changes in the length-force characteristics (i.e., proximo-distal force differences were maintained). This shows that a muscle in situ has to be distinguished from a muscle that is truly isolated in which case the force difference has to be zero. We conclude that extramuscular myofascial force transmission has major effects on muscle functioning.

The mechanical properties of intact and traumatized epidural catheters.

UNLABELLED: Comparative data on the mechanical properties of epidural catheters used clinically are not available. We performed a controlled laboratory investigation to assess the mechanical performance of three different intact or traumatized catheter types (Polyurethane, clear nylon, and radiopaque nylon catheters, designed for 18-gauge Tuohy needles). We studied a control (intact) and two trauma groups (needle bevel and surgical blade). Catheters were loaded to their breaking points by using a Lloyd LS500 material testing machine (Lloyd, Southampton, UK). Maximal load and extension values before breakage were measured, and modulus of elasticity and toughness values were calculated. Intact polyurethane catheters did not break within the limits of the experimental study (extension up to 3 times the original length of a specimen). The toughness values obtained from polyurethane and clear nylon catheters were significantly higher than those for the radiopaque catheters in intact specimens (P < 0.05). In the traumatized groups, polyurethane catheters had the highest toughness values (P < 0.05). Modulus of elasticity values were higher in both control and trauma groups of the radiopaque catheters when compared with the polyurethane and clear nylon catheters, which indicates a higher stiffness to elastic deformation (P < 0.05). In conclusion, polyurethane catheters are the most durable catheter type to tensile loading, either intact or traumatized. Mechanical properties can be used to predict complications related to the clinical use of these catheters. IMPLICATIONS: Using a computer-assisted material testing machine, we studied the mechanical properties of three different types of epidural catheters, either intact or traumatized, in a blinded, controlled study. This information may be vital to clinicians who implant epidural catheters by helping them choose a catheter that has the lowest probability of failure.

Simultaneous determination of pseudoephedrine sulfate, dexbrompheniramine maleate and loratadine in pharmaceutical preparations using derivative spectrophotometry and ratio spectra derivative spectrophotometry.

Two new spectrophotometric methods are described for the simultaneous analysis of pseudoephedrine sulfate-dexbrompheniramine maleate (DBP) and pseudoephedrine sulfate-loratadine combinations. In the first, derivative spectrophotometry, dA/dlambda values were read at zero-crossing points. In the second, ratio spectra derivative spectrophotometry, analytical signals were measured at the wavelengths corresponding to either maxima or minima for these drugs in the first derivative spectra of their ratio spectra. The procedures do not require any separation step. Mean recoveries were found to be >99% in the methods for these compounds in their synthetic mixtures. All the spectrophotometric methods proposed were compared with each other and HPLC which was also developed by us and applied to the pharmaceutical preparations selected.

Intraaortic growth of hydatid cysts causing occlusion of the aorta and of both iliac arteries: case report.

A woman who had been operated on previously for a paraspinal hydatid cyst presented with claudication of the lower limbs. Computed tomographic and magnetic resonance images showed multiple cysts in the soft tissues of the back, retroperitoneum, and lumen of the aorta and iliac arteries. Occlusion of the aorta and iliac arteries by recurrent hydatid cysts after previous surgery was confirmed with angiography and subsequent surgical exploration. The authors present the imaging findings of this unusual manifestation of cystic echinococcosis.

In vitro effects of various metals on natural killer cell activity in cultured human lymphocytes.

Heavy metals have been shown to have a differential effects on various aspects of immune response. Recently natural killer cells have been widely investigated due to their purported role in immune surveillance. To ascertain the immunotoxic effects of lead, cadmium, nickel and chromium on natural killer (NK) cell activity in vitro, peripheral blood lymphocytes from normal donors were examined in the presence of different concentrations (10(-5)-10(-8) M) of four selected metal salts (cadmium sulphate, lead nitrate, chromium nitrate and nickel sulphate). NK cell activity was evaluated in a 4-h chromium release assay against K562 target cells. All of the metal salts were found to exert no effect on NK cell function in the human concentration range.

Percutaneous treatment of hepatic hydatid cysts: an alternative to surgery.

OBJECTIVE: Percutaneous treatment of hydatid cysts is relatively new, and the data related to it are limited. The purpose of this study was to provide additional data to strengthen the proof of its effectiveness. SUBJECTS AND METHODS: One hundred sixty-eight hepatic cysts in 111 patients were treated using a percutaneous approach under sonographic and fluoroscopic guidance. Cysts smaller than 5 cm in diameter were treated with a one-stage procedure that consisted of puncture of the cyst, aspiration of fluid, and injection and reaspiration of hypertonic saline solution. Larger cysts were treated with a two-stage procedure that consisted of the one-stage procedure followed by catheterization and sclerotherapy with alcohol. RESULTS: The mean observation time was 19 months (range, 1-48 months). Follow-up examinations showed progressive shrinkage and solidification of the cysts. Early complications occurred in 32 (28.8%) of the 111 patients, including fatal anaphylaxis in one patient, biliary fistula in seven, infection of the cyst in four, persistent serous drainage from the cyst in two, intraperitoneal leakage of cyst fluid in two, urticaria in seven, fever without evidence of infection in seven, and pleural effusion in two. Late complications occurred in four (3.8%) of the 104 patients who underwent follow-up examinations, including local recurrence in three patients and intrabiliary rupture of a cyst in one patient. CONCLUSION: Our experience indicates that percutaneous treatment is efficient in the management of hepatic hydatid cysts and that this technique should be considered an alternative to surgery.