VIDEO-ASSISTED EXTIRPATION OF BREAST FIBROADENOMA WITH IMMEDIATE BILATERAL BREAST AUGMENTATION – A CASE REPORT

Pozadina: Od sredine 1990-ih godina razvila se videoasistirana kirurgija dojke (VABS) za liječenje dobroćudnih i zloćudnih bolesti dojke. Prema studijama koje su provedene uglavnom u Japanu, ova je tehnika sigurna i lako se uči, a njezina je glavna prednost izvrstan kozmetski rezultat poslijeoperacijskog izgleda dojki koji se ne može postići standardnim kirurškim tehnikama. Cilj: Prikazati prvi slučaj videoasistirane kirurgije dojke u Hrvatskoj primijenjene u liječenju fibroadenoma dojke uz neposredno obostrano povećanje dojki. Prikaz bolesnice: Bolesnica u dobi od 39 godina primljena je u našu bolnicu radi elektivnog zahvata povećanja obiju dojki. Tom je prilikom upotrijebljena metoda videoasistirane ekstirpacije fibroadenoma kroz inframamarnu inciziju neposredno nakon koje je učinjeno obostrano povećanje dojki. Zaključak: VABS je izvediva uz očit kozmetski učinak i zbog tog postaje metoda izbora u kirurgiji dojke. Međutim, potrebno je steći daljnja iskustva u ovom području kako bismo adekvatnije mogli procijeniti ovu tehniku.Background: Since mid 1990s video-assisted breast surgery (VABS) has been developed in the treatment of benign and malignant breast diseases. According to studies that are conducted mainly in Japan, this tehnique is safe, easy to learn and his main advantage is excellent cosmetic results on postoperative appearance of breasts that cannot be achived with standard surgical procedures. Objective: To present a first case of video assisted breast surgery in Croatia applied to treatment of breast fibroadenoma and immediate bilateral breast augmentation. Case report: A 39 year old female patient was admitted to our hospital for elective procedure of breast augmentation. On this occasion video assisted extirpation of fibroadenoma was performed through inframammary incision and followed by immediate bilateral breast augmentation. Conclusion: VABS is feasible, cosmetic effects are evident and the VABS deserves attention as a possible surgical option in breast surgery. However further experience on this field must be gained and it remains to evaluate this tehnique on the additional studies

VIDEO-ASSISTED EXTIRPATION OF BREAST FIBROADENOMA WITH IMMEDIATE BILATERAL BREAST AUGMENTATION – A CASE REPORT

Pozadina: Od sredine 1990-ih godina razvila se videoasistirana kirurgija dojke (VABS) za liječenje dobroćudnih i zloćudnih bolesti dojke. Prema studijama koje su provedene uglavnom u Japanu, ova je tehnika sigurna i lako se uči, a njezina je glavna prednost izvrstan kozmetski rezultat poslijeoperacijskog izgleda dojki koji se ne može postići standardnim kirurškim tehnikama. Cilj: Prikazati prvi slučaj videoasistirane kirurgije dojke u Hrvatskoj primijenjene u liječenju fibroadenoma dojke uz neposredno obostrano povećanje dojki. Prikaz bolesnice: Bolesnica u dobi od 39 godina primljena je u našu bolnicu radi elektivnog zahvata povećanja obiju dojki. Tom je prilikom upotrijebljena metoda videoasistirane ekstirpacije fibroadenoma kroz inframamarnu inciziju neposredno nakon koje je učinjeno obostrano povećanje dojki. Zaključak: VABS je izvediva uz očit kozmetski učinak i zbog tog postaje metoda izbora u kirurgiji dojke. Međutim, potrebno je steći daljnja iskustva u ovom području kako bismo adekvatnije mogli procijeniti ovu tehniku.Background: Since mid 1990s video-assisted breast surgery (VABS) has been developed in the treatment of benign and malignant breast diseases. According to studies that are conducted mainly in Japan, this tehnique is safe, easy to learn and his main advantage is excellent cosmetic results on postoperative appearance of breasts that cannot be achived with standard surgical procedures. Objective: To present a first case of video assisted breast surgery in Croatia applied to treatment of breast fibroadenoma and immediate bilateral breast augmentation. Case report: A 39 year old female patient was admitted to our hospital for elective procedure of breast augmentation. On this occasion video assisted extirpation of fibroadenoma was performed through inframammary incision and followed by immediate bilateral breast augmentation. Conclusion: VABS is feasible, cosmetic effects are evident and the VABS deserves attention as a possible surgical option in breast surgery. However further experience on this field must be gained and it remains to evaluate this tehnique on the additional studies

Sexual Dimorphism of the Extraorbital Lacrimal Glands in Sf-1 Knockout Mice

Spolni dimorfizam (SD) kao razlika u karakteristikama mužjaka i ženki iste vrste poznat je i u suznoj žlijezdi, a postoje i podaci o utjecaju testosterona na SD. U nokaut-miševima za steroidogeni faktor 1 (Sf-1 KO) ne razvijaju se gonade. Cilj doktorskog rada bio je istražiti pojavu spolnog dimorfizma žlijezde Sf-1 KO mužjaka i ženki miševa te suzne žlijezde Sf-1 KO mužjaka koji su dobivali nadomjesnu testosteronsku terapiju (TP). Provedena je detaljna histološka analiza i imunohistokemijska analiza izražaja androgenih receptora (AR) uz stereološku kvantifikaciju i statističku analizu rezultata. Nije bilo statistički značajne razlike u srednjem volumenu acinusa, vezivnog tkiva ni duljine odvodnih kanala između mužjaka, ženki kao ni mužjaka na nadomjesnoj terapiji testosteronom. Stanice acinusa mužjaka koji su dobivali TP bile su pozitivne na androgene receptore, a u mužjaka bez primjene TP signal je bio negativan. Davanje TP je induciralo pojavu AR, ali nije dokazan utjecaj na morfologiju. Može se zaključiti da spolni dimorfizam suzne žlijezde Sf-1 KO miševa različitog genetskog spola nije prisutan, pa spolni hormoni imaju presudnu ulogu u razvoju spolnog dimorfizma suzne žlijezde.Sexual dimorphism (SD), a difference in the characteristics of males and females of the same species was found in lacrimal glands together with data on the influence of testosterone. Knockout mice for steroidogenic factor 1 (Sf-1 KO) do not develop gonads. We aimed to investigate the lacrimal gland sexual dimorphism in male and female Sf-1 KO mice and the lacrimal glands of Sf-1 KO males receiving replacement testosterone therapy (TP). Detailed histological analysis and immunohistochemical analysis of androgen receptor expression (AR) were carried out with stereological quantification and statistical analysis of the results. There was no statistically significant difference in the mean volume of acini, connective tissue or ductal system length between males and females nor males on testosterone replacement therapy. TP induced androgen receptor in male acini-cells, and in males without TP administration, the signal was negative. Administering TP induces the occurrence of AR, but no impact on morphology has been demonstrated. It can be concluded that the sexual dimorphism of the lacrimal gland in Sf-1 KO mice of different genetic sex is not present, so sex hormones play a crucial role in the development of sexual dimorphism in the lacrimal glands

Foetal Leydig cells and the neuroendocrine system

It has been shown that adult human Leydig cells express a number of neuroendocrine markers, and, therefore, could be considered as a part of the neuroendocrine system in the adult. A limited number of studies have dealt with the dynamics of development of human foetal Leydig cells, whereas studies on their neuroendocrine nature are still extremely rare. Therefore, the aim of our study was to investigate the development of human foetal Leydig cells in different weeks of gestation (wg) and to check if these cells express certain markers characteristic of the diffuse neuroendocrine system (DNS). Qualitative, quantitative histological studies and immunohistochemical analyses of human foetal testicular tissue have been performed. According to our data, Leydig cells formed a dynamic population of cells within the interstitum of testes in the period between 15 and 36 wg. The total number of Leydig cells of human foetal testes changed through different stages of gestation by means of 'pulsatile' dynamics (most likely, by following the variable level of gonadotropins). At early stages of development (15-17 wg) immunohistochemical reactions for the expression of neuron specific enolase (NSE) were positive within sex cords and between them, in the interstitum. Pro-spermatogonia in the sex cords were positive, as well as elongated spindle-shaped cells of the interstitum (very likely, precursors of Leydig cells). During the later stages of development (28-36 wg), excluding the pro-spermatogonia, the interstitial Leydig cells were also positive. The results of the immunohistochemical analyses (the expression of NSE) confirmed the hypothesis that human foetal Leydig cells were of neuroendocrine nature

Sexual dimorphism of the extraorbital lacrimal glands in SF-1 knockout mice

Sexual dimorphism (SD) represents all the differences between males and females of the same species. SD of the murine lacrimal gland and the major effect of testosterone on its formation are well documented. Steroidogenic factor-1 (SF-1, NR5a1) is a nuclear receptor essential for the fetal development of steroid hormones producing organs and SF-1 knockout mice (Sf-1 KO) are therefore born without gonads and adrenal glands. The aim of this study was to investigate whether SD in lacrimal glands is present in the absence of exposure to sex hormones during development. Lacrimal glands from adult Sf-1 KO male and female mice without hormonal exposure, and from males that were treated with testosterone propionate (TP) prior to sacrifice, were examined. After sacrifice, glandular tissue was processed using standard histological procedures. Paraffin sections were analysed by stereology and immunostained against the androgen receptor (AR). Our results showed that there were no statistically significant differences in the mean volumes of acini, connective tissue or ductal system between males, females, and males on TP. The same pertains to the mean length of the ducts in all three groups. In the absence of sex hormones, sex chromosomes proved to be insufficient in inducing sexual dimorphism in LG. However, nuclei of the acinar cells in males on TP were positive for AR, whereas in males without TP no expression of AR was detected. Administration of TP induced the expression of AR in the nuclei of acinar cells of males but did not affect the morphology of LG. We conclude that SD in the lacrimal gland is not present in Sf-1 KO mice and this suggests that sex hormones have a major role in the development of SD in the lacrimal gland