Arrhythmogenic Right Ventricular Dysplasia ; diagnosis ; Humans ; Male

Purpose: To investigate the predictors of contralateral hypertrophy in patients treated with unilobar transarterial radioembolization (TARE) with yttrium-90-loaded resin microspheres due to unresectable right-liver tumors. Methods: Patients who underwent right unilobar TARE with resin microspheres between May 2019 and September 2021 were screened retrospectively. Contralateral hypertrophy was evaluated by calculating the kinetic growth rate (KGR) in 8–10 weeks after TARE. The predictors of increased KGR were determined with linear regression analysis. Results: A total of 24 patients (16 with primary and 8 with metastatic liver tumors) were included in the study. After right unilobar TARE, mean volume of the left lobe increased from 368.26 to 436.16 mL, while the mean volume of the right lobe decreased from 1576.22 to 1477.89 mL. The median KGR of the left lobe was 0.28% per week. The radiation dose absorbed by the healthy parenchyma of the right lobe was significantly higher in patients with increased KGR (31.62 vs. 18.78 Gy, p = 0.037). Linear regression analysis showed that the dose absorbed by healthy parenchyma was significantly associated with increased KGR (b = 0.014, p = 0.043). Conclusion Patients who received right unilobar TARE for liver malignancies could develop a substantial contralateral hypertrophy, and the radiation dose absorbed by the healthy parenchyma of the right lobe was significantly associated with increased KGR in the left lobe. TARE could have a role for inducing contralateral hypertrophy as it offers the advantage of concurrent local tumor control along with its hypertrophic effect.

PURPOSE: Surgical equipment used in breast cancer surgery that affects wound healing and minimizes complications seems to be a popular investigation topic. The aim of this study is to evaluate the effect of plasmakinetic cautery on wound healing in patients receiving mastectomy. METHODS: Forty-six consecutive breast cancer patients receiving modified radical mastectomy were evaluated prospectively. Plasmakinetic cautery was used in 24 operations and electrocautery was used in 22 operations in random order to manage skin flaps and excise breast tissue. In the postoperative period, vacuum drainage amount and duration time as well as the start time of arm exercises were recorded. Complications like seroma, surgical site infection, hematoma, and flap necrosis were determined. RESULTS: Age, body mass index, breast volume and flap area parameters were similar in each group. Mean drainage duration was found to be 5.5 days in the plasmacautery group and 7.9 days in the electrocautery group (p=0.020). In the plasmacautery and electrocautery groups, mean drainage volume was 707 and 1,093 mL, respectively (p=0.025). There was no statistical significance between the groups when operation duration, amount of blood loss, time to start arm exercises, seroma, hematoma, surgical site infection, and flap necrosis were considered. CONCLUSION: Plasmakinetic cautery is a promising new surgical instrument that provides atraumatic, scalpel-like cutting precision and electrosurgical-like hemostasis, resulting in minimal tissue injury. So, plasmacautery shortens the drainage amount and duration time compared to electrocautery without elongating operation duration or increasing the amount of blood loss.
Arm ; Body Mass Index ; Breast ; Breast Neoplasms ; Cautery ; Drainage ; Electrocoagulation ; Exercise ; Hematoma ; Hemostasis ; Humans ; Mastectomy ; Mastectomy, Modified Radical ; Necrosis ; Postoperative Period ; Prospective Studies ; Seroma ; Skin ; Surgical Equipment ; Surgical Instruments ; Vacuum ; Wound Healing

PURPOSE: The aim of this study is to determine and to compare the oncological outcomes of bilateral reduction mammoplasty to standard breast-conserving surgery for breast cancer. METHODS: One hundred sixty-two patients who received a quadrantectomy because of breast cancer (group 1) and 106 breast cancer patients with macromastia who underwent breast-conserving surgery via bilateral reduction mammoplasty (group 2) between 2003 and 2010 were enrolled in this study. RESULTS: The mean follow-up time was 37 months for group 1 and 33 months for group 2. Surgical margins were wider than 2 mm in 82.7% and 10 mm in 76.5% of the patients in group 1. Eleven percent of patients had positive surgical margins in this group. When compared to group 2, the rates were 89%, 84%, and 8.4%, respectively. Three patients (1.8%) in group 1 and one patient (0.9%) in group 2 had local recurrence of the disease and received a mastectomy. No statistical significances were noted for either local recurrence or overall survival between the two groups. CONCLUSION: Bilateral reduction mammoplasty has some advantages as compared to the standard conventional breast-conserving surgery techniques without having any unfavorable effects on surgical margin confidence, local recurrence, and survival rates.
Breast ; Breast Neoplasms ; Female ; Follow-Up Studies ; Humans ; Hypertrophy ; Mammaplasty ; Mastectomy ; Mastectomy, Segmental ; Recurrence ; Survival Rate

OBJECTIVE: The main causes of spinal cord ischemia are a variety of vascular pathologies causing acute arterial occlusions. We investigated neuroprotective effects of kefir on spinal cord ischemia injury in rats. METHODS: Rats were divided into three groups : 1) sham operated control rats; 2) spinal cord ischemia group fed on a standard diet without kefir pretreatment; and 3) spinal cord ischemia group fed on a standard diet plus kefir. Spinal cord ischemia was performed by the infrarenal aorta cross-clamping model. The spinal cord was removed after the procedure. The biochemical and histopathological changes were observed within the samples. Functional assessment was performed for neurological deficit scores. RESULTS: The kefir group was compared with the ischemia group, a significant decrease in malondialdehyde levels was observed (p<0.05). Catalase and superoxide dismutase levels of the kefir group were significantly higher than ischemia group (p<0.05). In histopathological samples, the kefir group is compared with ischemia group, there was a significant decrease in numbers of dead and degenerated neurons (p<0.05). In immunohistochemical staining, hipoxia-inducible factor-1alpha and caspase 3 immunopositive neurons were significantly decreased in kefir group compared with ischemia group (p<0.05). The neurological deficit scores of kefir group were significantly higher than ischemia group at 24 h (p<0.05). CONCLUSION: Our study revealed that kefir pretreatment in spinal cord ischemia/reperfusion reduced oxidative stress and neuronal degeneration as a neuroprotective agent. Ultrastructural studies are required in order for kefir to be developed as a promising therapeutic agent to be utilized for human spinal cord ischemia in the future.
Animals ; Aorta ; Caspase 3 ; Catalase ; Cultured Milk Products* ; Diet ; Humans ; Ischemia ; Malondialdehyde ; Neurons ; Neuroprotective Agents* ; Oxidative Stress ; Pathology ; Rats* ; Reperfusion Injury ; Spinal Cord Ischemia ; Spinal Cord* ; Superoxide Dismutase

A fibroadenoma was diagnosed in the left udder of a 3-month-old female Chios lamb. No recurrence was observed after surgery. Grossly, the tumor had a whitishgray lobular appearance, and the lobules were interlaced with thin septa. Microscopically, the tumor was composed of proliferating fibroepithelial tissue, including differentiated ducts lined by whorls and interlacing bundles of abundant loose fibrovascular stroma. Immunohistochemistry revealed the ductal epithelium to be positive for pancytokeratin (AE1/AE3) and loose fibrovascular stroma was positive for vimentin and basal cells covering the ductal epithelium of alpha-smooth-muscle actin. Immunostaining for the estrogen and progesterone receptors was negative. A diagnosis of mammary fibroadenoma was made based on the histological and immunohistochemical findings.
Animals ; Female ; Fibroadenoma/pathology/*veterinary ; Keratins/metabolism ; Mammary Glands, Animal/*pathology ; Mammary Neoplasms, Animal/*pathology ; Sheep ; Sheep Diseases/*pathology ; Vimentin/metabolism

OBJECTIVE: Bipolar disorder (BD) is associated with increased rates of cardiovascular diseases. There is growing evidence that blood viscosity may have a common role, correlated with well-known major risk factors that promote cardiovascular disease. In this study we aimed to investigate the whole blood viscosity (WBV) in different stages of BD. METHODS: A total of 121 bipolar patients and 41 age-gender matched healthy controls were included. Forty-four of bipolar patients were in manic, 35 were depressed and 42 were in euthymic state. WBV was calculated from hematocrit and total plasma protein according to Simone’s formula at low and high shear rates (LSR and HSR). RESULTS: WBV at HSR of manic group was 16.91±1.01, depressive group was 17.23±0.80, euthymic group was 17.63±0.95, and control group was 17.52±0.71 (p=0.001). WBV at LSR of manic depressive, euthymic and control group were 53.10±20.58, 60.30±17.02, 68.91±20.33, and 62.01±19.28, respectively (p=0.001). Both WBV at HSR and LSR of manic group was significantly lower than that of the euthymic and control groups (p=0.001 and 0.010 respectively for HSR, p=0.001 and 0.011 respectively for LSR). WBV was significantly positively correlated with lipid profile except high density lipoprotein (HDL). CONCLUSION: Our results demonstrate a decrement in blood viscosity in manic episode compared with euthymics and controls. Positive correlation of blood viscosity with lipid parameters (except HDL), and negative correlation with number of previous manic episodes suggest that manic episode has favorable effect on cardiovascular risk regarding to blood viscosity.
Bipolar Disorder* ; Blood Viscosity ; Cardiovascular Diseases ; Hematocrit ; Humans ; Lipoproteins ; Plasma ; Rheology* ; Risk Factors

BACKGROUND AND OBJECTIVES: Functional capacity varies significantly among patients with heart failure with reduced ejection fraction (HFrEF), and it remains unclear why functional capacity is severely compromised in some patients with HFrEF while it is preserved in others. In this study, we aimed to evaluate the role of pulmonary artery stiffness (PAS) in the functional status of patients with HFrEF. METHODS: A total of 46 heart failure (HF) patients without overt pulmonary hypertension or right HF and 52 controls were enrolled in the study. PAS was assessed on parasternal short-axis view using pulsed-wave Doppler recording of pulmonary flow one centimeter distal to the pulmonic valve annulus at a speed of 100 mm/sec. PAS was calculated according to the following formula: the ratio of maximum flow velocity shift of pulmonary flow to pulmonary acceleration time. RESULTS: PAS was significantly increased in the HFrEF group compared to the control group (10.53±2.40 vs. 7.41±1.32, p < 0.001). In sub-group analysis of patients with HFrEF, PAS was significantly associated with the functional class of the patients. HFrEF patients with poor New York Heart Association (NYHA) functional capacity had higher PAS compared those with good functional capacity. In multivariate regression analysis, NYHA class was independently correlated with PAS. CONCLUSION: PAS is associated with functional status and should be taken into consideration as an underlying pathophysiological mechanism of dyspnea in patients with HFrEF.
Acceleration ; Dyspnea ; Heart Failure* ; Heart* ; Humans ; Hypertension, Pulmonary ; Pulmonary Artery* ; Stroke Volume ; Vascular Stiffness

BACKGROUND AND OBJECTIVES: The etiopathogenesis of coronary artery ectasia (CAE) is not known completely. In most of the cases, CAE is associated with atherosclerosis; however, isolated CAE has a nonatherosclerotic mechanism. The association between atherosclerotic coronary artery disease and apelin has been examined in previous studies. However, the role of plasma apelin in isolated coronary artery ectasia has not been studied. In this study, we investigated the relationship between plasma apelin levels and isolated coronary artery ectasia. SUBJECTS AND METHODS: The study population included a total of 54 patients. Twenty-six patients had isolated CAE (53.6+/-8.1 years); 28 patients with normal coronary arteries (51.6+/-8.8 years) and with similar risk factors and demographic characteristics served as the control group. Apelin levels were measured using an enzyme-linked immunoassay kit. RESULTS: Apelin level in the CAE group was significantly lower (apelin=0.181+/-0.159 ng/mL) than that in the control group (apelin=0.646+/-0.578 ng/mL) (p=0.033). Glucose, creatinine, total cholesterol, triglyceride, low density lipoprotein cholesterol, and high density lipoprotein cholesterol levels were not significantly different between the two groups. CONCLUSION: In this study, we showed that patients with isolated CAE have decreased plasma apelin levels compared with the control group. Based on the data, a relationship between plasma apelin and isolated CAE was determined.
Atherosclerosis ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Coronary Artery Disease ; Coronary Vessels* ; Creatinine ; Dilatation, Pathologic* ; Glucose ; Humans ; Immunoassay ; Inflammation ; Plasma ; Risk Factors ; Triglycerides