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Ardahan, Turkey

Background: Urothelial carcinoma (UC) is a malignant neoplasm that most commonly occurs in the urinary bladder. The primary aim of this study was to evaluate the clinicopathologic features, recurrence and progression in patients with bladder urothelial cancer. Materials and Methods: The medical records of patients diagnosed with UC in the state pathology laboratory between January 2006 and July 2014 were retrospectively included. Carcinomas were categorized according to age, gender, histologic grade, tumor configuration, pathologic staging, recurrence status, and progression. Results: A total of 125 (113 men, 12 women) patients were examined. The mean age was 65.9 years and the male-to-female urothelial cancer incidence ratio was 9.4:1. Low-grade UCs were observed in 85 (68%) and high-grade in 40 (32%). A papillary tumor pattern was observed in 67.2% of the UCs. Cases were classified with the following pathological grades: 34 (27.2%) cases of pTa, 70 (56%) of pT1, and 21 (16.8%) of pT2. Recurrence occurred in 27 (21.6%) patients. Ten progressed to a higher stage (pT1 to pT2), and three cases to higher grade (low to high). We also analyzed the results separately for 70 (56%) patients 65 years of age and older. Conclusions: With early detection and diagnosis of precursor lesions in older patients, by methods such as standard urologic evaluation, urinary cytology, ultrasound scanning and contrast urography, and cystoscopy, in addition to coordinated efforts between pathologists and urologists, early diagnosis may reduce the morbidity and mortality of patients with urothelial carcinoma.

Elmas A.T.,Inonu University | Tabel Y.,Inonu University | Elmas O.N.,State Hospital
Pediatric Nephrology | Year: 2013

Background: We aimed to compare serum cystatin C levels (sCysC) in preterm neonates with respiratory distress syndrome (RDS) with a control group and to investigate whether it could be used as a predictor for acute kidney injury (AKI). Methods: sCysC was measured in 62 neonates with RDS (n = 28) and control neonates without RDS (n = 34), whose gestational ages (GA) were between 27 and 29 weeks (subgroup 1) and 30-32 weeks (subgroup 2). AKI was defined as oliguria and/or increase of serum creatinine. Blood samples were obtained on postnatal days (PND) 3 and 30. sCysC levels were determined by particle-enhanced nephelometric immunoassay. Results: There were six neonates with AKI (RDS-AKI subgroup) and 22 neonates without AKI (RDS-no AKI subgroup) during the first 7 days. Although sCysC levels were lower in neonates with RDS than controls on PND3 in both GA subgroups, the differences were not significant. However, in neonates with RDS and AKI, sCysC levels were significantly higher than neonates with RDS but no AKI and neonates in the control group on PND3. sCysC level was found to have a statistically significant association with AKI development in preterm neonates with RDS. Conclusions: sCysC is an independent predictor of AKI in preterm neonates with RDS. © 2012 IPNA.

Polat F.R.,State Hospital
Surgical Laparoscopy, Endoscopy and Percutaneous Techniques | Year: 2012

AIM:: The aim of this retrospective study was to evaluate the reliability and feasibility of the laparoscopic approach in hydatid cyst cystectomy. MATERIALS AND METHODS:: A retrospective review of the medical records of 21 patients diagnosed with hydatid cyst disease between July 1999 and January 2011 was conducted at Van State Hospital and Toyota Emergency Hospital. Two patients with calcified cysts were excluded. Hydatid cystectomy was performed by laparoscopy (LC) in 7 patients and by laparotomy (OC) in 12 patients. The preoperative and postoperative parameters were compared. RESULTS:: There were 11 female (52.3%) and 8 male (47.7%) patients with a mean age of 31.7 years (range, 14 to 50 y). The mean duration of hospitalization was 4.8 days (range, 2 to 15 d). Recurrence was not seen in any cases in both groups. The morbidity rates of LC and OC were 14.2% and 33.3%, respectively. The most frequent postoperative complications were wound infections (1 case in LC and 3 cases in OC), hemorrhage (1 patient in the OC group), and hernia (as the late complication in 2 patients in the OC group). The operation success was graded as excellent in 18 patients and good in 1 patient. CONCLUSIONS:: The laparoscopic technique is an easy-to-apply, safe, and effective method to conduct liver and spleen hydatid cyst surgery. This technique can be used in patients with unique, small-sized, superficially located cysts, and also has the advantages of other abdominal laparoscopic operations. Copyright © 2012 by Lippincott Williams & Wilkins.

Joks M.,Lords Transfiguration Hospital | Mysliwiec K.,State Hospital | Lewandowski K.,Poznan University of Medical Sciences
Archives of Medical Science | Year: 2011

Primary breast lymphoma (PBL) is a rare disease accounting for 0.4-0.5% of all breast malignancies. Diffuse large B-cell lymphoma (DLBCL) is the most common histological diagnosis. The clinical presentation of PBLs is usually no different from that of carcinoma. In this paper we review the literature on the clinical presentation, diagnosis, prognostic factors and treatment options of PBL. In the light of the information gained we discuss three patients with primary breast lymphoma (one with a central nervous system relapse) who were treated in our department in the years 2002-2007. In conclusion: there is no consensus on the question of how to best treat PBL: chemotherapy, radiotherapy or combined therapy. However, the last approach to be the most successful one. Due to high incidence of central nervous system (CNS) involvement in PBL patients, many authors strongly believe that patients with aggressive forms of PBL should receive CNS infiltration prophylaxis, even in the early stages, as this may improve the outcome and significantly reduce the risk of a CNS disease relapse. Copyright © 2011 Termedia & Banach.

Lymphedema can be defined as the abnormal accumulation of protein-rich interstitial fluid that occurs primarly as a consequence of malformation or acquired distruption of the lymphatic circulation. Upper extremity lymphedema can develop in a significant proportion of patients after mastectomy. Currently, complex decongestive physical therapy is accepted as international standard treatment approach for the treatment of lymphedema. Complex decongestive physical therapy includes skin care, manual lymphatic drainage, compression bandage, compression garments, exercise and sometimes addition of intermittent pneumatic compression pump. When conservative treatments is not sufficient surgical intervention is an alternative to the patients. In this review, current treatment approaches are discussed.

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