Real-time elastography for differentiation of breast lesions

Backroung: To investigate the diagnostic performance of the elastography-based strain index ratio in the differential diagnosis of malignant and benign breast lesions. Material/Methods: Seventy-nine breast masses that were classified as BI-RADS category 3, 4, and 5 on B-mode ultrasonography (US) were further prospectively evaluated by real-time sonoelastography (RTE). To obtain an optimal cut-off value of the strain ratio for differentiating between malignant and benign breast lesions, RTE findings were compared with histopathology of core needle biopsy samples or with ultrasound follow-up data of the analyzed masses. Results: Seventy-nine breast lesions [BI-RADS category 3 (n=15), BI-RADS category 4 (n=34), and BI-RADS category 5 (n=30)] were classified as malignant (n=36) or benign (n=43). The mean strain index value was 6.59±3.44 (range 0.6-14) for malignant lesions and 2.79±2.16 (range 0.6-8.7) for benign lesions, respectively (p<0.05). As regards the detection of malignant lesions, US was characterized by sensitivity and specificity of 100% (CI 95%; 88-100) and 90% (CI 95%; 76-97), respectively. When an optimal value of the strain ratio (4.25) was obtained by ROC curve analysis, the sensitivity and specificity for diagnosing malignant lesions were 86% (CI 95%; 70-95) and 76% (CI 95%; 60-87), respectively. Conclusions: RTE can play an important role in the differentiation between malignant and benign breast masses, but it should be used in conjunction with ultrasonography

Original Article Long-term effects of forgotten biliary stents: a case series and literature review

Abstract: There are many studies about the biliary stents, however there is a little information about the long-term stayed forgotten biliary stents except a few case reports. We have reported the results of a number of cases with biliary stents that were forgotten or omitted by the patient and the endoscopist. During February 2010 to May 2013, five patients were referred to the general surgery clinic of Haydarpasa Numune Training and Research Hospital, Istanbul Turkey. Past history and medical documents submitted by the patient did not indicate a replacement of the biliary stent in 3 patients. Two patients knew that they had biliary stents. We also conducted a literature review via the PubMed and Google Scholar databases of English language studies published until March 2014 on forgotten biliary stent. There were 3 men and 2 women ranging in age from 22 to 68 years (mean age 41.6 years). Patients presented with pain in the upper abdomen, jaundice, fever, abnormal liver function tests or dilatation of the biliary tract alone or in combination. Patients&apos; demographic findings are presented i