Evaluation of early results of triamcinolone acetonide treatment in the treatment of idiopathic granulomatous mastitis introduction

OBJECTIVE

Idiopathic granulomatous mastitis (IGM) is a rare, benign, chronic inflammatory breast disease with an unknown etiology. IGM patients may develop painful or painless masses, palpable lymph nodes, and skin findings that can mimic breast cancer, including retractions, skin edema, ulceration, and fistula formation. This presents a significant diagnostic challenge in clinical practice. The present study aimed to assess the early outcomes of triamcinolone acetonide treatment in patients with idiopathic granulomatous mastitis.

PATIENTS AND METHODS

After obtaining the necessary approvals from the ethics committee, patients who were admitted to the breast endocrine department of the general surgery clinic of our hospital between 2014 and 2022 with complaints of a mass, discharge, and fistula formation and who were histopathologically diagnosed with granulomatous mastitis after radiological examination by tru-cut biopsy were prospectively enrolled in the study.

RESULTS

Among the 136 patients with granulomatous mastitis, the mean age was 30.09±4.14 years, the symptom duration averaged 3 weeks (range: 1-5), the follow-up period extended for 20 weeks (range: 3-72), and the mean recurrence duration was 1.08±0.28 months. Complaints included discharge (52.2%), mass (51.5%), redness (45.6%), and pain (27.2%). Masses were predominantly on the left side (61.0%) compared to the right side (38.0%).

CONCLUSIONS

In conclusion, the heterogeneous phenotype of IGM and the lack of randomized controlled trials pose challenges. Long-acting triamcinolone acetonide proves effective in managing IGM by resolving the inflammatory process and the disease itself. Its low side effects and ease of use make it a valuable treatment modality.

From the knitting shop: the first physical and dynamic model of the taenioglossan radula (Mollusca: Gastropoda) aids in unravelling functional principles of the radular morphology

The radula is the structure used for food processing in Mollusca. It can consist of a membrane with stiffer teeth, which is, together with alary processus, muscles and odontophoral cartilages, part of the buccal mass. In malacology, it is common practice to infer potential tooth functions from morphology. Thus, past approaches to explain functional principles are mainly hypothesis driven. Therefore, there is an urgent need for a workflow testing hypotheses on the function of teeth and buccal mass components and interaction of structures, which can contribute to understanding the structure as a whole. Here, in a non-conventional approach, we introduce a physical and dynamic radular model, based on morphological data of Spekia zonata (Gastropoda, Paludomidae). Structures were documented, computer-modelled, three-dimensional-printed and assembled to gather a simplistic but realistic physical and dynamic radular model. Such a bioinspired design enabled studying of radular kinematics and interaction of parts when underlain supporting structures were manipulated in a similar manner as could result from muscle contractions. The presented work is a first step to provide a constructional manual, paving the way for even more realistic physical radular models, which could be used for understanding radular functional morphology and for the development of novel gripping devices.

Finite element analysis of individual taenioglossan radular teeth (Mollusca)

Molluscs are a highly successful group of invertebrates characterised by a specialised feeding organ called the radula. The diversity of this structure is associated with distinct feeding strategies and ecological niches. However, the precise function of the radula (each tooth type and their arrangement) remains poorly understood. Here for the first time, we use a quantitative approach, Finite-Element-Analysis (FEA), to test hypotheses regarding the function of particular taenioglossan tooth types. Taenioglossan radulae are of special interest, because they are comprised of multiple teeth that are regionally distinct in their morphology. For this study we choose the freshwater gastropod species Spekia zonata, endemic to Lake Tanganyika, inhabiting and feeding on algae attached to rocks. As a member of the African paludomid species flock, the enigmatic origin and evolutionary relationships of this species has received much attention. Its chitinous radula comprises several tooth types with distinctly different shapes. We characterise the tooth's position, material properties and attachment to the radular membrane and use this data to evaluate 18 possible FEA scenarios differing in the above parameters. Our estimations of stress and strain indicate different functional loads for different teeth. We posit that the central and lateral teeth are best suitable for scratching substrate loosening ingesta, whereas the marginals are best suited for gathering food particles. Our successful approach and workflow are readily applicable to other mollusc species.