Male Lesions Research Articles

Aortic Aneurysm with and without Dissection and Concomitant Atherosclerosis-Differences in a Retrospective Study.

Thoracic aortic aneurysm is a latent disease with a high risk of death. Today, as data are accumulating, an estimation of the differences in thoracic aneurysm in men and women of different age groups is required. The present study evaluated the type of atherosclerotic aortic lesions in males and females at different ages regarding the presence or absence of aortic dissection. A retrospective analysis of clinical and morphological data of 43 patients with thoracic aortic aneurysm was carried out. Patients were divided into groups based on the presence or absence of thoracic aneurysm dissection. Our results of a comparative analysis of the age of study participants showed that patients with aneurysm dissection were younger than patients without dissection. In the subgroup of patients with aortic dissection, the mean age was 50.6 years old, and in patients without aortic dissection, the mean age was 55.0 years old. When conducting a frequency analysis using Fisher's exact test, it was found that in men and women aneurysm dissection was not associated with atherosclerotic lesions of the aorta. In women and men, aneurysm dissection was not associated with stage of atherosclerotic lesions of the aorta regardless of age; no statistically significant differences were found between the groups with and without aneurysm dissection (p > 0.05). Dissection of the thoracic aneurysm developed in the absence of severe atherosclerosis of the thoracic aorta. Only 18.6% men and women possessed atherosclerotic plaques of types IV and V.

Eyelid Tumors at Razi and Farabi Hospitals, Tehran, Iran

Background: Eyelid tumors are common in the daily practice of skin tumors and are composed of benign and malignant lesions. Methods: This retrospective case series study collected histopathologic reports of eyelid tumors of patients treated between 2022 and 2023 in Razi and Farabi hospitals (Tehran, Iran). Patient data, including patient age, sex, location of the lesion, and recurrence, were collected. Descriptive and inferential statistics were used to characterize the subgroups. Results: The sample was composed of 154 eyelid tumor specimens, including 72 (47%) malignant cases, 80 (52%) benign cases, and 2 (1%) premalignant cases. Malignant tumors included 81.9% basal cell carcinomas (BCC), 15.3% basosquamous cell carcinomas (BSC), and 1.4% squamous cell carcinoma (SCC). The benign eyelid lesions were comprised of 20% intradermal melanocytic nevus, 11.3% epidermal cyst, 7.6% dermoid cyst, 10% seborrheic keratosis, 6.3% xanthelasma, 2.5% wart, 3.8% compound nevus, 5% fibroconnective tissue, 3.8% squamous papilloma, 3.8% neurofibroma, 2.5% comedone,2.5% apocrine hidrocystoma, 2.5% foreign body type granuloma, and 1.3% of others (arteriovenous hemangioma, cavernous hemangioma, cutaneous horn, etc.) The premalignant lesions were 2 cases of actinic keratosis. Benign lesions had an equal frequency of occurrence in the upper and lower lids. Malignant lesions were seen more in the lower lid. Premalignant lesions were seen in the lower lid. The mean age at diagnosis was 45.8 ± 23.06 years for patients with benign lesions and 63.5 ± 16.7 years for patients with malignant lesions. The mean age for patients with premalignant lesions was 81.5 ± 9.19 years (P < 0.001). Conclusions: In our study, benign lesions were seen predominantly in young persons and malignant lesions were mostly seen in elderly persons. There is an equal occurrence of malignant lesions in males and females, and recurrence after excision was infrequent.

Relationship between sex and clinical and imaging features of early axial spondyloarthritis: results from a 48 month follow-up (Italian arm of the SPondyloArthritis Caught Early (SPACE) study)

Objectives To assess the association between sex and clinical and disease activity indices, and X-rays and magnetic resonance imaging (MRI) features, in early-stage axial spondyloarthritis (axSpA). Method Baseline data analysis was conducted on the Italian SPACE cohort, including patients with chronic back pain (duration ≥ 3 months and ≤ 2 years; onset < 45 years). Patients underwent MRI and X-rays of the sacroiliac joints (SIJs) to establish the diagnosis of axSpA, according to Assessment of SpondyloArthritis international Society criteria and physician’s judgement. Clinical features, disease activity and functional indices, and images were collected at baseline and yearly during 48 months. Spinal and SIJ X-rays and MRI images were scored by two readers following Spondyloarthritis Research Consortium of Canada (SPARCC), modified Stoke Ankylosing Spondylitis Spinal Score, and modified New York criteria. Characteristics of axSpA patients according to sex (male/female) were compared over time using descriptive statistics. Results Ninety-one patients had axSpA (83.5% non-radiographic; 16.5% radiographic); 47.3% were male. Males were younger, with shorter duration of axial symptoms, and more frequently had HLA-B27 positivity, radiographic sacroiliitis with a bilateral/symmetric pattern, and more signs of spondylitis. Females more frequently showed peripheral/entheseal involvement and the non-radiographic phenotype. Males showed increased pelvic/spinal radiographic progression and more often had active sacroiliitis on MRI. Although the frequency of inflammatory corner lesions did not differ between males and females, localization varied, with more cervical/thoracic MRI-spine lesions in females and more lumbar lesions in males. We observed a significant downward trend of SPARCC SIJ/spine scores in all patients, irrespective of sex. More fat lesions were observed on MRI-spine in females and on MRI-SIJ in males. Conclusion Sex was associated with distinct axSpA features: females showed low-grade radiographic sacroiliitis and spinal progression, and a higher prevalence of cervical and thoracic spine MRI signs.

PMON325 Rare Presentation of Precocious Puberty Secondary to LH-Secreting Adenoma

Abstract Background Normal male puberty begins after 9 years of age with a concurrent rise in luteinizing hormone (LH) and follicle-stimulating hormone (FSH). These play distinct roles, with LH acting on Leydig cells to stimulate testosterone and secondary sex characteristics, while FSH promotes testicular growth by stimulating the maturation of seminiferous tubules. Clinical Case An 8-year 9-month-old male TV presented with a 1.5 year history of facial hair and 9 months of phallic growth, body odor and acne. Physical exam revealed phallic enlargement, Tanner stage I pubic hair and firm, borderline pubertal testes (4 cc bilaterally). Bone age was 9 years at a chronological age of 8 years 6 months. Laboratory evaluation was inconsistent with typical puberty – LH (9 mIU/mL, RR 0.0-0.3 mIU/mL) and testosterone (519 ng/dL, RR 2-8 ng/dL) were elevated while FSH was pre-pubertal (&amp;lt;0.1 mIU/mL, RR 0.0-2.8 mIU/mL) and androgens were only mildly elevated (androstenedione 0.363 ng/mL, RR 0.03-0.3; 17-OHP 155 ng/dL, RR&amp;lt;63 ng/dL). Head MRI revealed an anterior pituitary adenoma measuring 8×12×10 mm. After failing to respond to leuprolide, TV was initiated on spironolactone and anastrozole to minimize pubertal progression prior to transsphenoidal adenomectomy. Surgical pathology was positive for steroidogenic factor 1 but negative for LH, FSH and thyroid-stimulating hormone immunoreactivity. However, he had post-operative reduction of LH (0.4 mIU/mL, RR 0.0-0.3 mIU/mL) and testosterone (16 ng/dL, RR 2-8 ng/dL). Conclusions Normal male puberty follows a predictable sequence, beginning with testicular enlargement followed by body odor, pubic hair growth, phallic enlargement, voice change, and increased growth velocity. In TV, hypersecretion of LH led to testosterone production, causing secondary sex characteristics. However, his pre-pubertal FSH did not stimulate the testicular growth that typically heralds the onset of puberty. Digression from typical pubertal sequence and isolated high LH raised concern for a pathologic cause. Central precocious puberty (CPP) is most often idiopathic in females, although more commonly associated with CNS lesions in males. Rarely, precocious puberty results from a functioning gonadotroph adenoma. Less than 1% of these are hormonally active. If active, these more often secrete FSH or co-secrete FSH and LH, and typically require surgical resection given limited success of medical therapies. This case illustrates the distinct roles of FSH and LH in pubertal development. Departures from the typical sequence of development should expand one's differential to include etiologies resulting in nonconcurrent secretion of gonadotropins. Presentation: Monday, June 13, 2022 12:30 p.m. - 2:30 p.m.

Gynécomastie : actualisation des données diagnostiques et thérapeutiques. À propos de 148 patients

Gynecomastia is the most frequently breast lesion in males. 148 patients (mean age 24,7 years) operated in our department were reviewed with a mean follow-up of five years. Gynecomastia occurred most frequently during puberty (77,7%), was bilateral (86,5%) and idiopathic (89,9%). The size of the enlargement was evaluated according to Simon's-classification based on breast-volume and skin-redundancy. 17 (11,5%) stage 1, 77 (52%) stage 2A, 32 (21,6%) stage 2B, 22 (14,9%) stage 3. Clinical examination and mammography determined the consistency of gynecomastia: adipose or firm. 4 different surgical managements were used: 17 (11,5%) subcutaneous mastectomies, 4 (2,7%) liposuctions, 110 (74,3%) liposuctions associated with subcutaneous mastectomy, 17 (11,5%) total mastectomy. All techniques gave good morphologic results. Nonetheless, the authors recommend the combination «liposuction and subcutaneous mastectomy», as this technique presents many advantages: small intraoperative blood loss, good skin redraping, short hospital stay, complete histologic examination of the material removed.

Causes of Mortality and Profile of Spontaneous Tumors in Young CD-1 Mice.

A retrospective study was performed to establish the causes of mortality and incidence patterns of tumors in young (<50 weeks) control CD-1® mice from Charles River Laboratories. Tumor incidences (fatal and nonfatal) and nonneoplastic causes of death observed during the first 50 weeks of the study were collected from 48 thirteen-week toxicity studies conducted between 2009 and 2018 and from 43 carcinogenicity studies conducted between 2005 and 2018. Thirteen-week studies had a mortality rate of 8/620 (1.3%) in males and 4/620 (0.65%) in females. The major factors contributing to death were integument lesions in males (3/8) and experimental procedure-related injuries in females (3/4). All tumors recorded were nonfatal. Bronchiolo-alveolar adenoma was the commonest tumor with the same incidence in both males and females (4/620, 0.65%); a single lymphoma (0.16%) and uterine leiomyosarcoma (1/620 0.16%) were reported in females. The mortality rates of males and females that died or were euthanized during the first 50 weeks in carcinogenicity studies were 192/2830 (6.8%) and 198/2830 (7%), respectively. The most common fatal tumor in this age group was lymphoma in both sexes, with an incidence of 18/192 (9.3%) and 41/198 (20.7%) in males and females, respectively. In males tumors were responsible for fewer deaths than in females (17% vs. 32.3%). The major nonneoplastic causes of death or moribundity were cutaneous lesions (44/192, 22.9%), and obstructive uropathy (39/192, 20.3%) in males, and chronic progressive nephropathy (40/198, 20.2%) in females. Only minor differences were evident compared to a similar study performed 15 years ago; these might reflect changes in terminology and diagnostic criteria, and stricter animal welfare endpoints.

Takayasu Arteritis: Pattern Of Clinical And Radiological Features, Experience From Pakistan.

Takayasu arteritis (TKA) is a rare large vessel vasculitis occurring in young adults of less than 50 year of age. We analyse the clinical, radiological features, and treatment regimens in Pakistani patients presenting to a tertiary care center. A retrospective cross-sectional analysis of TKA patients done at the Rheumatology department of Fatima Memorial Hospital. A comprehensive evaluation of clinical, laboratory, radiographic features and treatment regimens was carried out. A consecutive cohort of 18 patients, with 13 patients (72%) of female gender was studied. Mean age of the cohort was 35.94±2.7 years. A mean delay of 2.32±0.43 years between symptoms and final diagnosis was reported, attributed to alternate diagnosis in 57.1% and late presentation in 42.8% cases. Limb claudication (44.4%), absent pulses (38.9%), were the common initial manifestation. Hypertension (61.5%), blood pressure discrepancy between arms (88.9%) and bruit (72.2%) over major vessels were common systemic features. As per angiographic classification, Type V (44.4%), and Type I (33.3%), were most common pattern of disease in the cohort. Subclavian artery (72.2%), renal artery (33.3%), iliofemoral arteries (27.8%), and coronary artery involvement (16.7%) were the common lesions. Coronary artery lesion was higher in females (p=0.52) while renal artery lesion in males (p=0.27). There was no statistically significant difference in involvement of vessels according to gender (p >0.05). Type V and Type I are the common pattern of TKA. Limb claudication was the most common initial manifestation. Renal artery involvement was seen more commonly in males while coronary artery involvement more commonly in females.

Lupus mastitis in men

To analyze the pathophysiological aspects of lupus mastitis (LM), clinical presentation, epidemiology, radiological and histological findings, and treatment, to disseminate it to the academic community and draw attention to this pathology as one of the differential diagnoses in the management of breast lesions in males, especially in the case of breast cancer in men. A literature review was done by searching scientific studies in the PubMed / Medline, Scopus, Scielo, Embase, Web of Science, and Google Scholar databases. Relevant scientifically validated studies related to lupus mastitis in men were selected. The analysis, review and selection of articles carried out in pairs, blindly and separately, based on the reading of the title and abstract, with a third reviewer in case of disagreement. The LM should be suspect in patients known to have lupus erythematosus who present painful breast nodules associated with skin changes. However, LM can be the initial manifestation of lupus and mimic, both clinically and imaging, malignant neoplasms. The histopathological diagnostic criteria are well-established, finding mainly hyaline fat necrosis and lymphoplasmacytic infiltrate. Treatment must be drug-based as invasive procedures can exacerbate the injury. Due to physiological and anatomical aspects, this condition can appear and evolve differently in men. The knowledge of this pathology is necessary to carry out the correct approach since the non-identification of the disease and its erroneous management can lead to complications and irreversible sequelae to the patient.

Frequency Distribution of Prostatic Lesions in Males at Gadarif Advanced Medical Diagnostic Centre, Gadarif State Eastern Sudan

The prostate gland is a male reproductive organ, mostly affected by diseases. Prostate cancer is the most diagnosed cancer among men and causes mortality and morbidity in elderly males. The present study was carried out to determine the pattern of prostatic lesions in male patients at Gadarif Advanced Medical Diagnostic Centre, Gadarif State, Eastern Sudan from October 2017 to September 2019. For this retrospective descriptive investigation, the analysis of histopathological records of 167 cases of prostate lesions showed the mean age of 71±9.6 years; most of the patients being in the age group 61-70 years represented 67(40.1%) cases. The most common patterns of the prostatic lesions were benign prostatic hyperplasia accounted for 124 (74%) cases, 85(68.5 %) of them having chronic prostatitis on top of the benign prostatic hyperplasia, the second pattern was adenocarcinoma which accounted for 42 cases. 32(19.2) malignant cases showed PSA levels &gt;24 ng/ml, which revealed strong correlation between the increase in PSA levels and malignant lesions (p= 0.000). The most frequent Gleason scores were 7 and 9 and Gleason’s grade 3 was the most common histologic grade found in 16 (41%) cases. The present study revealed that benign prostatic hyperplasia was the most common lesion followed by adenocarcinoma and increased in elderly males. A strong correlation between increasing PSA levels and adenocarcinoma was established. Keywords: Prostatic gland, histopathology, benign prostatic hyperplasia, adenocarcinoma, PSA

Histopathological spectrum of neoplastic lesions: A two year study

Cancer is the second most common disease after cardiovascular disorders for maximum deaths in the world. The present research was undertaken to study the histopathological spectrum of neoplastic lesions in Rural Tertiary Care Hospital in Maharashtra. This retrospective study was carried out in the Department of Pathology at Shri Vasantrao Naik Government Medical College (VNGMC) Yavatmal, Maharashtra during October 2016 to November 2018. A detail history, diagnosis, primary site, morphology of neoplastic lesions and histopathological examination of all the specimens were done.Out of 3608 specimens examined, 724 cases had neoplastic lesions of which 499 cases were benign and 225 cases were malignant. The most commonly reported malignant tumors were those of oral cavity (47), breast (44), and gastrointestinal tract (22). Most commonly reported benign tumors in females were female genital tract lesions which constituted 170 cases followed by benign breast lesion (126) while in males, out of 123 cases, lipoma was diagnosed in 30 cases, followed by prostate hyperplasia (28) and other soft tissue tumor (28). In both the gender oral malignancies were commonest, while in males’ gastrointestinal tract malignancies and in females’ carcinoma of breast were the most frequent malignancies after oral malignancies. Commonest benign lesions in males were lipoma and while in female lesions of genital tract and breast were common.

Testosterone replacement therapy in male urolithiasis patients with metabolic syndrome

Urolithiasis is one of the most wide-spread kidney lesions in males and females all over the world. It is particularly important for males with hypogonadism and metabolic syndrome.&#x0D; The goal of the study is to assess the effectiveness and safety of Testosterone replacement therapy in males with hypogonadism and metabolic syndrome. Patients and methods. 465 male urolithiasis patients were studied. Mean age was 46 (38-54 years). All patients involved in the study had excessive body mass and obesity of various extent. Mean body mass was 92 (85-97 kg) and body mass index 40.5. More than 50% of the patients had Ischaemic Heart Disease, Cholelithiasis and Goiter. Essential Hypertension was present in 76.3% of cases. In more than 50% of the cases there was a combination of two or three nosological forms present. Depending on the replacement therapy used all patients were distributed into two groups: the main (300 patients) and the control one (165 patients).&#x0D; Results of the study. Testosterone replacement therapy proved to contribute to normalization of mineral and lipid metabolism as well as improvement of kidney function and restoration of normal bone tissue density. Analysis of 5-year relapse frequency demonstrated it to be considerably lower in the main group (10%) than in the control one (30%) which is astatistically valid difference (p &lt; 0.05).&#x0D; Conclusion. Testosterone replacement therapy is a highly effective and safe method for urolithiasis therapy in males with hypogonadism.

Qualitative evaluation of coronary atherosclerosis in a large cohort of young and middle-aged Dutch tissue donors implies that coronary thrombo-embolic manifestations are stochastic.

Background and aimsWith the intention to gain support for the hypothesis that incident ischemic complications of atherosclerotic disease involve a stochastic aspect, we performed a histological, qualitative evaluation of the epidemiology of coronary atherosclerotic disease in a cohort of aortic valve donors.Patients and methodsDonors (n = 695, median age 54, range 11–65 years) were dichotomized into a non-cardiovascular (non-CVD) and a cardiovascular disease death (CVD) group. Consecutive 5 mm proximal left coronary artery segments were Movat stained, and the atherosclerotic burden for each segment was graded (revised AHA-classification).ResultsNon-CVD and CVD groups showed steep increase of atherosclerosis severity beyond the age of 40, resulting in an endemic presence of advanced atherosclerosis in men over 40 and women over 50 years. In fact, only 19% of the non-CVD and 6% of the CVD donors over 40 years were classified with a normal LCA or a so called non-progressive lesion type. Fibrous calcified plaques (FCP), the consolidated remnants of earlier ruptured lesions, dominated in both non-CVD and CVD donors. Estimates of the atherosclerosis burden (i.e. average lesion grade, proportion of FCPs, and average number of FCPs per cross-section) were all higher in the CVD group (p<1.10−16, p<0.0001, and p<0.05, respectively).ConclusionsDominance of consolidated FCP lesions in males over 40 and females over 50 years, show that plaque ruptures in the left coronary artery are common. However, the majority of these ruptures remain asymptomatic. This implies that the atherosclerotic process is repetitive. A relative difference in disease burden between CVD and non-CVD donors supports the concept that complications of atherosclerotic disease involve a stochastic element.

An Analytical study on Male Mammography

Background: Mammography of male breast accounts for less than 1.5% of mammographic examinations done in breast imaging centers. In females the awareness of breast cancer is very high when compare to males. Females will undergo periodical screening very frequently through, mammography or clinical examination. The most common presenting symptoms and signs that led to a request for mammogram in these men include an enlargement of breast, a palpable lump, and breast tenderness (1). Aim and study: To know the breast lesions in males through mammography. Subjects and Methods: we have examined breast of 50 Males with the help of mammography. Results: Out of 50 patients. Gynaecomastia is seen in 18 patients. Breast cancer is seen in 4 patients. Conclusion: Routine mammography is very much useful in females for screening of breast cancer. In males also it is useful in ruling out different breast lesions like Gynaecomastia, breast cancer.

The local earth magnetic field changes impact on weekly hospitalization due to unstable angina pectoris

Objectives: Acute coronary syndrome as an acute oxygenated blood deprivation to the heart muscle due to atherosclerotic plaque rupture in the coronary artery followed by thrombosis is possibly associated with changes in the Earth’s local time varying magnetic field as they strongly influence hormonal and other regulatory systems’ activity. This study analyses the correlation between prevalence of the acute coronary syndrome and the changes in the local time varying aspects of the magnetic field. Methods: Seven-hundred patients admitted to Cardiology Department of Hospital of Lithuanian University of Health Sciences Kaunas Clinics within 2016 due to acute coronary syndrome were retrospectively included into the study. The number of cases per week was compared with the weekly changes of the local Earth magnetic field. The one-year period was divided into two periods: the first-half of the year (weeks 1 to 26) and the second-half of the year (weeks 27 to 52) and more detailed analyses were performed accordingly to the significance of the left main artery lesion. Mean power of local magnetic field fluctuations in Lithuania, measured in pT2 in five different frequency ranges where overlaps between the Schumann resonance and EEG frequency ranges (named as SDelta (0-3.5 Hz), STheta (3.5-7 Hz), SAlpha (7-15 Hz), SBeta (15-32 Hz) and SGamma (32-66 Hz) to distinguish them from the EEG bands). Results: Statistically significant weak and moderate correlations between weekly prevalence of acute coronary syndrome admissions and the magnetic field intensities changes were found. Higher intensities in the SBeta and SGamma ranges were associated with a higher number of admissions throughout the year in females and the SGamma range was associated with higher number of admission only during the second-half of the year in males. A higher intensity magnetic field in SDelta, STheta, SAlpha and SBeta ranges was associated with a higher admissions number due to left main artery lesions in males, while a higher intensity in the SGamma range was associated with higher number of admissions due to left main artery lesions in females through the year. Conclusion: Significant correlation between acute coronary syndrome and changes in the local Earth time varying magnetic field intensities was found. Some frequency ranges are associated with an episode of an acute coronary syndrome. Left main artery lesions significantly correlated with magnetic field changes in most of the frequency ranges in males while only one of the frequency ranges in females.

Tobacco Use, Oral Health, and Risk of Parkinson's Disease.

Few studies have investigated the associations between use of Swedish moist snuff (snus), associated poor oral health, and risk of Parkinson's disease (PD). We followed 20,175 participants who were free of PD in 1973-1974 in Uppsala, Sweden, until the end of 2012. We used Cox proportional hazards regression models to estimate hazard ratios and corresponding 95% confidence intervals for the associations between tobacco use, oral health indicators, and PD risk. We found that tobacco use was associated with a lower risk of PD in males. Compared with males who never used any tobacco daily, pure ever tobacco smokers, pure ever snus users, and combined users had adjusted hazard ratios of 0.68 (95% confidence interval (CI): 0.49, 0.93; n=83), 0.51 (95% CI: 0.27, 0.95; n=11), and 0.21 (95% CI: 0.07, 0.67; n=3), respectively. No association was observed for number of teeth, dental plaque, or detectable oral mucosal lesions and PD risk, although there was a suggestive association with Candida-related oral mucosal lesions in males (hazard ratio=1.56, 95% CI: 0.92, 2.65; P=0.098). Use of snus is associated with a lower risk of PD in males, while poor oral health seems not to be associated with PD occurrence.

Efficacy of esophageal cancer screening in high risk population: results of 105 561 subjects in Sichuan province

Objective: To analyze the efficacy of endoscopic screening for esophageal cancer in high risk population from high risk areas in order to provide scientific basis for evaluation of the results of early diagnosis and treatment of esophageal cancer. Methods: Ten high incidence cities and counties of esophageal cancer in Sichuan province were included in this study. Subjects aged 40-69 years were selected to participate in the endoscopic screening based on the cluster sampling, and the screening-positive subjects were further confirmed by pathological examination. Results: A total of 105 561 subjects were screened during 2006-2014 in 10 cities and counties in Sichuan Province. The detection rate of precancerous lesions was 5.53% (5 841/105 561), and the positive detection rate was 1.13% (1 193/105 561). The overall detection rates of low-grade hyperplasia, moderate hyperplasia, high-grade hyperplasia/carcinoma in situ, early esophageal cancer and invasive carcinoma were 3.87% (4 089/105 561), 1.66% (1 752/105 561), 0.77% (816/105 561), 0.08% (84/105 561) and 0.28% (293/105 561), respectively. The detection rates of all lesions in males were significantly higher than those in females (P<0.05), and were gradually increased with age (P<0.05). Conclusions: At these ten cities and counties in Sichuan Province with high incidence of esophageal cancer, the endoscopic screening has good effect. There are considerable numbers of patients aged 40-69 with precancerous lesions from the high risk areas. Improving the follow-up work of the population with precancerous lesions will achieve better results of early diagnosis and early treatment.

LEPTIN GENE EXPRESSION IN EPICARDIAL ADIPOSE TISSUE IN MALES WITH CORONARY HEART DISEASE

Objective . Evaluate leptin gene expression in epicardial adipose tissue in males with coronary heart disease (CHD). Design and methods. We enrolled 106 males: 57 males with CHD aged 61,3 ± 1,1 years old and 49 males without CHD aged 57,3 ± 1,3 years old (p > 0,05). Epicardial adipose tissue (EAT) specimens were obtained in 65 males (57 males with CHD and 8 males with valvular heart disease without CHD) undergoing cardiac surgery. Serum leptin was measured by immune enzyme assay (IEA). Leptin mRNA (messenger ribonucleic acid) level in EAT was assessed by real-time polymerase chain reaction. All patients underwent coronaroangiography and echocardiography. Results. Leptin mRNA level in EAT was significantly higher in males with CHD and atherosclerosis of main coronary arteries. Patients with multivessel (3 and more coronary arteries) atherosclerotic lesions showed higher leptin mRNA level in EAT than in subjects with lesions of 1–2 coronary artery and in patients without CHD: 2,84 ± 0,04 (RU), 1,91 ± 0,03 RU and 1,41 ± 0,02 RU, respectively (р < 0,05). Conclusions . Paracrine activity of epicardial adipose tissue plays a role in the pathogenesis of coronary atherosclerotic lesions in males

Role of Immunofluorescence in Adult Onset Nephrotic Syndrome-A Study in a Tertiary Care Centre of Western India.

Study of renal Immunofluorescence (IF) is an ancillary but essential technique in evaluation of renal biopsies in glomerulopathies and also it enlightens on the pathogenesis of nephrotic syndrome. To determine the role of IF in evaluating definite subtyping and diagnosis of adult onset nephrotic syndrome and attempting clinicopathological correlation. A total of 52 patients of adult onset nephrotic syndrome were evaluated clinically and with pertinent investigations; and subjected to USG guided percutaneous renal biopsy which was processed and stained for light microscopy and for immunofluorescence by direct method (DIF) using antibodies against IgG, IgM, IgA and C3. The predominant age group affected was 18-47 years (78.85%). Male:female ratio was 1:0.63. The most frequent glomerular lesion encountered was Focal Segmental Glomerulosclerosis (FSGS, 36.54%) followed by lupus nephritis (26.92%) and IgA nephropathy (9.62%). The most common glomerular lesion in males was FSGS and that in females was lupus nephritis. DIF was mainly coarsely granular whenever present. One case of lupus nephritis and diabetic nephropathy, showed non specific IF. It was negative in all cases of FSGS, Minimal Change Disease (MCD) and renal amyloidosis. The IF helped in differentiating eight cases that were normal on light microscopy as IgA nephropathy (n=5) and authentic MCD (n=3). It helped in endorsing 19 cases of FSGS to be a progression of MCD. It was also of help in sub-typing all cases of Membranoproliferative Glomerulonephritis (MPGN) (n=3) as MPGN-Type I. IF was of great help in diagnosing exact type of glomerulopathy in adult onset nephrotic syndrome and provided insight in its pathogenesis.

P1.08-023 Analysis of Prognostic Factors and Long-Term Results of Primary Pulmonary Pleomorphic Carcinoma

Pulmonary pleomorphic carcinoma (PPC) is a rare neoplasm and factors affecting survival after pulmonary resection, as well as its clinical and pathologic characteristics, are still unknown. For a better understanding we reviewed our large experience with these patients. Records of patients 134 patients (108 men, median age: 65 years) with diagnosis of PPC operated on between January 1999 and May 2015 were retrospectively analyzed from a prospective database; survival was calculated by using Kaplan-Meier method. 86 patients (64.1%) were smokers. Median tumor size was 4.8 cm (range, 0.6 to 23 cm). Initial histological diagnosis was NSCLC in 88 cases, adenocarcinoma in 21, pleomorphic tumor in 13, and no diagnosis in 12. 62 patients (46.0%) received a platinum based induction chemotherapy. Surgery included lobectomy in 87 patients (65%), pneumonectomy in 27 (20.1%), wedge resection in 12 (8.9%), and segmentectomy in 8 (6%). Four patients (3%) had an incomplete resection. Postoperative staging included 45 stage I (33.6%), 47 stage II (35.1%), and 42 stage III (31.3%). 64 patients (47.7%) received adjuvant treatment. Five-year overall survival and disease-free survival were 36.6% and 35.7%, respectively (median, 28 and 18 months, respectively). Recurrences occurred in 76 patients (56.7%) most of them at distant sites (47/76 [61.8%]). Factors associated with increased survival included no smoke habit (p=.02), no induction therapy (p=.04), right side disease (p=.01); pathological stage I (p=.001), no metastatic lymph nodes (p=.001), and adjuvant treatment (p=.003). At multivariate analysis, pN0, pstage I, and adjuvant treatment were independent prognostic factors (p=.002, 95%CI: 1.54-6.43; p=.003, 95%CI: 1.23-7.32, p=.001, 95%CI: 1.26-4.72, respectively). PPC are aggressive tumors usually presented as a large lesion in males. Preoperative diagnosis remains difficult. Prognosis is poor, and distant recurrence rate is high. Long-term survival can be achieved in early stage disease and by an appropriate adjuvant therapy.

Human Papillomavirus (Cervical Cancer) Vaccine Update

• There has been a paradigm shift in cervical cancer prevention strategies since the availability of the first cervical cancer vaccine, Gardasil.