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WOS: 000452510300005 PubMed: 30251732 Objectives: To evaluate the efficacy of the Breast lesion excision system (BLES) procedure as a primary excisional biopsy for the management of breast imaging-reporting and data system (BI-RADS) category 3, small, and solid breast lesions in women having severe breast cancer anxiety. Methods: A retospective study was conducted on 68 patients who underwent a BLES procedure. The study protocol was approved by the local ethical committee of Yeni Yuzyil University in Istanbul, Turkey. The study was carried out according to the principles of the Helsinki Declaration. Small breast lesions removed using a (12, 15 or 20 mm) wand from September 2011 to November 2014. These were category 3 lesions as determined by ultrasound (US) imaging according to BI-RADS. The radiological and pathological sizes of these lesions, the complete excision rates, the procedure durations, the pathological diagnosis, the complications, and the imaging findings before and after the procedure were all recorded. Results: All the patients had a benign pathology. The mean duration of procedure was 12 (range=8-22) minutes. There was no major complication during the procedure and in the following period. Only some small hematomas were determined in 3 (4.2%) patients, and no additional surgical intervention was performed. Conclusion: The BLES procedure is an optimal solution for the management of indeterminate BI-RADS category 3 breast lesions in women with severe anxiety.

Objective: Medications are generally administered by either the enteric or parenteral route. With parenteral administration, intramuscular (IM) is the preferred approach because it increases the bioavailability of the drug, acts more quickly than the enteric route. The aim of this study was to determine the rate of true dorsogluteal intramuscular drug injection and to determine the causes for application failures in practice by ultrasonography (US). Methods: The study was conducted from May 1 to May 30, 2017 in Giresun University Education and Research Hospital, Giresun, Turkey. We examined 60 patients who were administered dorsogluteal IM injection with a 38.1mm length needle. After the injection, localization of medications (whether intramuscular or subcutaneous adipose tissue [SAT]) was evaluated by Ultrasound. Results: Female/male ratio of the patients was 27/33, with a mean age of 39.78±2.16 years. Obese/normal weight ratio was 20/40. The mean dorsogluteal area SAT thickness of obese and normal weight patients were 32.34±2.17 mm and 20.85±1.20 mm, respectively. In 23 of the patients, IM injected drug was observed in the SAT, while it was observed in the IM area in 37 patients. Medication was observed in IM area in 37 of 50 patients who dorsogluteal region SAT thickness was appropriate (SAT thickness lower than 33.1mm) for IM injection while it was seen in SAT area in 13 patients. Conclusions: SAT thickness values are important if IM drug injection is to be administered correctly. Unsuccessful IM injections may be seen even in patients with appropriate SAT thicknesses. doi: https://doi.org/10.12669/pjms.35.4.313 How to cite this:Ozen O, Gunaydin M, Tosun A, Coskun ZU, Aytekin K, Takir S. Assessment rate of true dorsogluteal intramuscular drug injection using ultrasonography. Pak J Med Sci. 2019;35(4):1132-1137. doi: https://doi.org/10.12669/pjms.35.4.313 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

WOS: 000506033900007 PubMed: 31733365 Introduction: The injection amount of solutions differs in wide ranges, from 20 to 200 mu L in intraarticular injections experiments that was carried out with rats. The 10-fold difference between applied volumes is not acceptable since injection errors might affect the outcomes of the studies significantly. The excessive amount of solution that was injected into the knee joint of rats might end up with leakage of the solution from injection aperture, and damage the articular structures etc. In our preliminary experiments, we mentioned problems during the injection of excessive amount of solution into the rat knee joint. The main purpose of the present study, which was performed with rat knee joints, was to evaluate the applicability of different amounts of solutions used in experiments and to determine the optimal volume for intraarticular injection in rats. Methods: The volume of 100 mu L water-based stain was administered into knee joints of non-living rats. The legs were dissected to evaluate the possible presence of injected solution outside the knee joint. Then, the decreasing volumes (100 mu L, 50 mu L, 40 mu L and 30 mu L) of X-ray contrast solution (lobitridol) were applied into the knees of living rats to investigate whether systemic circulation acts on the leakage outside the joint. The X-ray images of all these joints were also taken to confirm the results. Results: In nonliving rats, the place where water-based strain overflow from the knee joint was pointed out. The place of leakage is where the tendo musculi extensor digitorum longus leaves outside the joint. In living rats, by using contrast solution, an overflow was noticed in the subdermal place with the intraarticular injection volumes of 100 mu L, 50 mu L, and 40 mu L. No overflow was observed with the intraarticular injection volumes of 30 mu L X-ray contrast solution. Discussion: In conclusion, the injection volume for the knee joints of rats should not exceed the 30 mu L for optimum efficiency.

Glomus tumors are usually presented with late diagnosis and treatment. This slow process may be caused due to the pain that only occur with provocative contact. In this case report, follow up of a patient is presented who has prolonged symptoms at a rare localisation of glomus tumor. After the glomus tumor of greater toe excised totally, the complaints of the patient were cut dramatically.

Objective: Breast pain is a very common condition among young women. The aim of this study is to provide supplementary and specific data especially in addition to available literature informa-tion about the ultrasonographic findings and breast cancer risk in women younger than 40 years who applied to the breast outpatient clinic with isolated mastalgia, and had no breast cancer risk factor.Method: Ultrasonograpic examination results of women between dates 01/01/2011 and 01/01/2015, and contribution of ultrasonography to diagnostic procedure of breast cancer were retrospectively evaluated.Results: A total of 1066 patients were included in the study. There were 555 (52%) women with focal and 511 (48%) women with diffuse mastalgia. US examination revealed only 7 suspicious cases, all of whom were over 30 years of age. Of women with suspicious masses, 6 had focal mastalgia, and invasive cancer was diagnosed in 3 of cases after core biopsy. In only one patient in the diffuse mastalgia group a suspect mass was detected which revealed to be a benign lesion on histopathological examination of core biopsy specimenConclusion: Careful clinical examination may be adequate especially in women younger than 30 years of age who have no breast cancer risk factor, and only diffuse mastalgia complaint. However, possibility of breast cancer should be considered in women older than 30 years even they have no breast cancer risk factor, and no complaint other than focal mastalgia. Amaç: Meme ağrısı genç kadınlar arasında çok yaygın bir durumdur. Bu çalışmanın amacı, meme hastalıkları polikliniğine izole mastalji ile başvuran ve meme kanseri risk faktörü olmayan 40 yaşından küçük kadınlarda özellikle ultrasonografik bulgular ve meme kanseri riski hakkında mevcut literatür bilgilerinin yanı sıra ek ve spesifik veriler sağlamaktır.Yöntem: 01/01/2011 ve 01/01/2015 tarihleri arasında kadınların ultrasonografik inceleme sonuç-ları ve meme kanseri tanısında ultrasonografinin katkısı retrospektif olarak değerlendirildi. Bulgular: Çalışmaya toplam 1.066 hasta dâhil edildi. Fokal mastaljisi olan 555 (%52) kadın ve yaygın mastaljisi olan 511 (%48) kadın vardı. Ultrasonogafi muayenesinde, her biri 30 yaşın üze-rinde olan yalnızca 7 şüpheli olgu ortaya çıktı. Şüpheli kitleleri olan kadınların 6’sında fokal mas-talji vardı ve kor biyopsiden sonra 3 olguya invaziv kanser teşhisi konuldu. Yaygın mastalji grubun-da yalnızca 1 hastada şüpheli kitle vardı ve kor biyopside benign bir lezyon saptandı.Sonuç: Özellikle meme kanseri risk faktörü olmayan ve yalnızca yaygın mastalji yakınması olan 30 yaşından küçük kadınlarda dikkatli klinik muayene yeterli olabilir. Bununla birlikte, meme kanseri risk faktörü olmayan ve fokal mastalji dışında hiçbir şikayeti olmayan 30 yaşından büyük kadın-larda meme kanseri olasılığı göz önünde bulundurulmalıdır.

4th Congress of European-ORL-HNS-Cornerstones in European ORL-HNS -- OCT 07-11, 2017 -- Barcelona, SPAIN Hizli, Omer/0000-0001-6822-2679; Yildirim, Guven/0000-0003-3864-3522 WOS: 000445362100002 PubMed: 29905906 Purpose We aimed to investigate the medial and inferior localization of orbit in patients with maxillary sinus hypoplasia using paranasal computerized tomography. Methods We included 76 patients who had a hypoplastic maxillary sinus at least on one side, and 76 patients with normal maxillary sinuses (control group). To assess the localization of orbit, we measured the distances from middle meatal antrostomy point to medial border of orbital medial wall and to the lower border of orbital floor in all patients. We performed statistical comparisons between the groups. Results Of 76 patients, 26 (34.2%) had unilateral and 50 (65.8%) had bilateral maxillary hypoplasia. Of 126 maxillary sinuses, 70 (55.6%) was type 1, 42 (33.3%) was type 2 and 14 (11.1%) was type 3 hypoplastic. The mean distance from antrostomy point to lamina papyracea was 4.36 +/- 2.62 mm in the hypoplasia group, and 1.08 +/- 1.7 mm in the control group. The mean distance from antrostomy point to orbital floor was 1.53 +/- 1.73 mm in the hypoplasia group, and 1.87 +/- 1.96 mm in the control group. Lamina papyracea showed a significant medial localization in the maxillary hypoplasia group as compared to the control group (p < 0.001). Conclusion The orbit has a medial localization in patients with maxillary sinus hypoplasia resulting in a higher complication risk during endoscopic sinus surgery.

Warfarin is an anticoagulant used in a variety of clinical indications and may rarely cause severe bleeding that can be life-threatening. Although intramuscular bleeding frequently occurs, secondary to trauma, it can be induced in cases with bleeding tendency. Hematoma is often treated with conventional methods. However, surgical decompression can also be applied. In this article, we report a case of gastrocnemius intramuscular hematoma, which was successfully treated with intracavitary tissue plasminogen activator that was recently used in the treatment of abdominal and pelvic abscess.

OBJECTIVES The objective of this study was to evaluate head and neck masses with real-time elastography to differentiate malignant masses. MATERIALS AND METHODS Between January 2011 and December 2012, a total of 51 patients with a palpable mass in the neck region were included in this study. Excisional histopathologic data were compared with elastographic results and Doppler ultrasonography. RESULTS The study group comprised 27 males (52.9%) and 24 females (47.1%) (mean [SD] age, 41.47 [19.59] y; range, 4-80 y). Fourteen masses were malignant (27.5%) and 37 were benign (72.5%). Comparing the elastographic results of benign and malignant masses, elastographic scores of the malignant masses were significantly higher than those of the benign masses (P < 0.005).The elastographic scores were divided into 2 groups: 34 (91.9%) patients with the diagnosis of benign mass had the score of 1 to 2, whereas 9 (64.3%) patients with the diagnosis of malignant cases had the score of 3 to 4. There was a significant difference between the groups (P < 0.005).However, 2 squamous cell carcinomas (28.6%) and 1 lymphoma (8.1%) were diagnosed with an elastographic score of 1 (Table 2). This showed that even an elastographic score of 1 was not enough to issue a diagnosis of benign masses. CONCLUSIONS With improvements in the device and increased experience, this modality can become a useful tool for the routine use. However, this modality cannot be used for screening to merely provide additional information about the nature of the masses.