We aimed to evaluate the effectiveness of acoustic radiation force impulse (ARFI) elastography in differentiating between hepatic lesions. The prospective study included 117 patients with liver masses. Shear wave velocity (SWV) values for lesions were determined by ARFI imaging and compared statistically. The difference between SWV values for benign and malignant hepatic masses was significant (p < 0.01). The threshold SWV value for malignant hepatic lesions was established at 2.52 m/s, and the sensitivity and specificity of this cut-off value were 97% and 66%, respectively. We concluded that ARFI elastography provides supplementary data that aid in the differential diagnosis of liver masses.

Due to a lack of sufficient data, the treatment protocols for male breast cancer are usually the same as those used for female breast cancer. The aim of the current study was to present our clinical experience with male breast cancer. The records of 37 patients who were treated for male breast cancer in our hospital between 2004 and 2014 were reviewed retrospectively. The data of patients were recorded and analyzed. The mean age of the patients was 63.03±12.36 years. Thirty-three patients (89.2%) had invasive ductal carcinoma, two (5.4%) had ductal carcinoma in situ, and two had invasive lobular carcinoma (5.4%). The most common molecular subtype was luminal A (17 cases, 45.9%). Twenty-nine patients with male breast cancer underwent mastectomy and two underwent breast conserving surgery. Axillary lymph node dissection was performed in 25 patients. The most common surgical procedure was modified radical mastectomy. Distant metastases were present in 17 (45.9%) patients. Overall, the 5-year survival was 60%. The 5-year survival was 100% for those with stage 0–I disease, 87% for stage II, and 42% for stage III. The 3-year survival was 14% for stage IV. Patients with male breast cancer presented at an older age, a later stage, and with earlier metastasis. Early metastasis and death increases with increasing stage. Poor prognosis correlates with late admission. Data from different centers should be compiled and reviewed in order to determine a specific treatment protocol for male breast cancer; each paper published reveals new data.

There is growing evidence of a connection between inflammation and tumor development and NF-κB is an important transcription factor in the inflammation pathway. Genetic approaches have proven the role of NF-κB responsive genes in tumorigenesis. The NF-κB responsive genes products such as IL-8, VEGF and COX-2 are the key components of angiogenesis. MMP-2 and MMP-9 are playing important roles in the disruption of the extracellular matrix that may contribute to the metastasis of tumor cells. This study aimed to investigate gene expression levels of COX-2, IL-8, VEGF, MMP-2 and MMP-9 in colon tumors. A total of 34 fresh colon carcinoma specimens and paired normal adjacent tissues (NAT) were collected during the surgery and RNA isolations were carried out from specimens. Synthesis of cDNA was carried out from these RNAs with oligo dT18 primers. The transcribed cDNA was used for PCR amplification reactions for the investigated genes with β-actin being the internal reference via the semi-quantitative RT-PCR method. A statistically significant difference was observed for COX-2, IL-8 and VEGF which were all upregulated in colon tumors compared with adjacent normal tissues (p0.05). Upregulated expression levels of COX-2, IL-8 and VEGF might occur in the early stages of tumorigenesis and detection of these mRNA levels may be beneficial for early diagnosis and management of colon tumors.

Background/Aims: Levels of the hormones ghrelin and leptin in rat models of acute pancreatitis (AP) have been investigated in several experimental studies. However, there are very few clinical studies addressing the connection between hormone levels and AP. A few recent studies investigating the changes in ghrelin and leptin levels in patients with AP have been reported; however, our study is the first clinical study to investigate the change of nesfatin-1 levels in patients with gallstone-induced AP. Materials and Methods: Forty patients were enrolled in this study, eight of which presented with severe AP. Two blood samples were obtained from each study patient. The first blood samples were obtained at patient admission to the hospital and the second was obtained at patient discharge. All samples were collected after at least 6 h of fasting. Plasma nesfatin-1, leptin, and ghrelin levels were measured. Results: In all 40 patients, nesfatin-1 and leptin levels were higher at admission and had decreased at discharge. In contrast, the ghrelin levels at discharge were significantly higher than those at admission. Only the changes in these hormones in the mild AP group were significant. Conclusion: Levels of these hormones were altered during the course of gallstone-induced AP. These changes might be associated with the clinical outcomes of the disease. To clarify whether the magnitude of the change in hormone levels at AP onset can be used as a biomarkers to predict the severity of the disease requires further investigation.

Aims: Minimally invasive parathyroidectomy (MIP) has become the first line of treatment for primary hyperparathy- roidism caused by solitary parathyroid adenoma. In order to increase the sensitivity of high-resolution ultrasonography (hUS), surgeon performed ultrasonography (SUS) has been increasingly used preoperatively. However, a radiologist and surgeon performing ultrasonography (RSUS) has not been a usual practice. In this study, we aimed to evaluate the clinical contribution of RSUS on MIP. Material and methods: From 2012 to 2014, a total of 30 consecutive patients (4 male, 26 female, mean age 48.87±14.52 years) with solitary parathyroid adenoma, were included in the study. All patients underwent preoperative hUS and Technetium-99m sestamibi scintigraphy. In patients, demographic characteristics, diagnostic tools used, levels of bio- chemical parameters, duration of operation, and length of hospital stay were recorded. Results: Adenomas were successfully localized by US in all patients and the surgical approach was determined according to this localization. Parathyroidectomy with MIP was successfully performed under local anesthesia in all patients. Mean operation time was 19.87±3.35 min. Post- operative PTH and calcium values were significantly decreased. All patients were discharged from the hospital in the same day. None of the patients had complications such as recurrent laryngeal nerve injury, hematoma, or injury to nearby organs. None of the patients had drains placed. Conclusions: Adenoma is well localized by US and thus, MIP can be completed under local anesthesia. US provides a very important clinical contribution to the success of MIP. In addition to these, RSUS helps in determining the location of the incision and the shortest way to achieve the lesion; therefore, it provides a small incision and shortens duration of the operation with a minimal dissection.

The most common procedure to prevent seroma formation, a common complication after breast and axillary surgery, is to use prophylactic surgical drains. Ongoing discussions continue regarding the ideal time for removing drains after surgical procedures. In this study, we aimed to investigate factors that affect drain indwelling time (DIT). From 2014 to 2015, a total of 91 consecutive patients with breast cancer were included in the study. The demographic characteristics of the patients, treatment methods, histopathologic features of the tumor, size of removed breast tissue (BS), tumor size (TS), number of totally removed lymph nodes (TLN), and metastatic lymph nodes (MLN), whether they had neoadjuvant chemotherapy, and the DIT were retrospectively recorded from the hospital database. The mean age of the patients was 48.9 years, and the mean DIT was 4.8 days. The mean size of breast removed was 17.3 cm and tumor size was 4.7 cm, and the mean number of metastatic lymph nodes was 3.3, and mean total number of lymph nodes was 14.1. Patients who had neoadjuvant chemotherahpy had longer DIT. There was a positive correlation between the BS, TS, TLN, MLN, length of hospital stay, and DIT. Linear regresion analysis revealed that the BS, TLN, and history of neoadjuvant chemotherahpy were independent risk factors for DIT. DIT primarily depends on BS, TLN, and history of neoadjuvant chemotherahpy. A policy for the management of removing drains to prevent seroma formation should thus be individualized.