Barriers to widespread use of hormonal emergency contraceptives (EC), such as lack of knowledge and prejudices held by health-care providers, still exist today. This study was initiated to evaluate the knowledge, attitudes and prejudices of family-planning (FP) providers.This survey was conducted in FP units of primary-health-care centers in Istanbul. A total of 180 providers were interviewed in 80 units to whom a questionnaire was administered by face-to-face technique.One-hundred and fifty-two of the providers stated that they had heard of EC. The correct timing and dose interval of EC were known by 50% of them. The participants held the belief that EC caused abortion (39.4%), and that it was harmful for the fetus (31.1%). Other prejudices were the possibility of increased unprotected sexual intercourse (78.9%) and a tendency for men to give up condom use (75%); female providers were more prejudiced concerning these statements. The providers' tendency towards the provision of counseling was significantly related to their prejudices (p = 0.011, p = 0.033) and to the application rate (p = 0.000). Conclusion Providers need more detailed information about EC. During FP training courses, the providers should be encouraged towards counseling EC which would increase the application rate of the users and decrease their own prejudices.
Coronary arterial stenoses impose a constraint on the delivery of cold cardioplegic solutions conventionally perfused via the aortic root, resulting in uneven myocardial cooling and protection. Therefore the hearts undergoing coronary bypass operations show impaired cooling of the post-occlusive myocardial regions, and temperature gradients among different myocardial fields are registered after cold cardioplegic perfusion. We applied retrograde coronary sinus perfusion of cold cardioplegic solution in canine hearts with occluded multiple left coronary arterial branches to overcome the above-mentioned drawbacks, and a uniform left ventricular cooling was demonstrated by this technique.
Fallopian tube carcinoma is a rare gynecological tumor and simultaneous pericardial and breast metastasis of this cancer is an extremely exceptional event.A 46-year-old woman with FIGO Stage IIIc, grade 3 adenocarcinoma of the fallopian tube received cyclophosphamide and carboplatin subsequent to surgery. The disease had been completely silent for 41 months and then it relapsed with pericardial and breast metastasis consecutively. She expired one year after the relapse.Although clinical and biological behavior and response to the treatment of fallopian tube carcinoma is quite similar to epithelial ovarian carcinoma, breast and pericardium are unusual sites of metastasis for each malignancy. As survival is prolonged with new chemotherapeutics these atypical cancer metastases will be observed more frequently.
The aim of this study is to observe the relationship between the expression of vascular endothelial growth factor (VEGF), microvascular density (MVD) and the pathological characteristics of gastric carcinoma.A total of 87 cases of gastric carcinomas were examined by immunohistochemical staining, using anti-VEGF and anti-CD34 antibodies.VEGF positive staining was obtained in 62 out of 87 cases (71.2%). The MVD was 64.00 +/- 15.51 (mean +/- SE) in VEGF-positive group and 48.33 +/- 12.71 in VEGF-negative group.The expression of VEGF is correlated with tumor angiogenesis, and VEGF plays an important role in new blood vessels formation. The expression of VEGF and MVD wereclosely correlated with the degree of differentiation and lymphatic metastasis, but not related to depth of cancer invasion, size of tumor, age or sex.
To evaluate the adequacy of intraoperative assessment of depth of myometrial invasion in patients with endometrial adenocarcinoma.Of the 58 evaluable cases, depth of myometrial invasion was estimated by gross examination of fresh tissue by an experienced surgeon and a pathologist and on the frozen section by the same pathologist. This was compared with the depth of invasion on the final microscopic examination performed by another pathologist.The depth of invasion was accurately predicted by the surgeon in 89.7% of the patients, while the pathologist's accurate prediction rates on fresh tissue and frozen section were 86.2% and 91.4%, respectively. The accurate prediction rate gradually diminished for both the surgeon and the pathologist as the histologic grade increased. Frozen section examination was reliable in grade I cancer (100%), while gross examination of the surgeon and the pathologist had a significant error rate in predicting accurate depth of invasion (7.6%-33%).If frozen section shows that myometrial invasion in patients with grade 1 endometrial carcinoma is less than 1/3, lymphadenectomy may be omitted. In all other cases radical surgery and surgical staging is mandatory to avoid undertreatment.
