Abortus imminens ve Missed Abortus'ta CA-125'in tanıdaki değeri

Bu tezin, veri tabanı üzerinden yayınlanma izni bulunmamaktadır. Yayınlanma izni olmayan tezlerin basılı kopyalarına Üniversite kütüphaneniz aracılığıyla (TÜBESS üzerinden) erişebilirsiniz.ÖZET Bu çalışmada Haziran 1990-Ekim 1991 tarihleri arasında Ege Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Anabilim Dalı' na başvuran abortus imminens ve missed abortus tanısı ile yatırılan gebelerin ve kontrol grubu olarak ise yasal kürtaj için başvuran 10 haftalıktan küçük gebelerin serum CA 125 değerlerine bırakıldı. Gebelere ultrasonografik inceleme yapıldı, kürtaj olanların histopatolojik sonuçlan değerlendirildi. Kontrol grubunda CA 125 ortalama 25.77 ± 3.33 U/ml, abortus imminens grubunda 30.14 ± 2.42 U/ml ve missed abortus grubunda 50.07 ± 9.08 U/ml bulundu. Missed abortus grubundaki değerlerin kontrol grubuna göre istatistiksel olarak anlamlı derecede yüksek olduğu belirlendi (p0.05). Abortus imminens grubunda anlamlı bir fark gözlenmedi. CA 125' in gebelikteki kaynağının desidua olduğu düşünüldü. 3

Analysis of cancer registration data in Ege University: Evaluation of 34134 cases [Ege Üniversitesi'nde kanser kayit analizleri: 34134 Olgunun degerlendirmesi]

Objectives: Ege University Cancer data is being collected by Ege University Cancer Fight against Cancer, Practice and Research Center within the "Izmir Cancer Incidence and Data Collection Project" which initiated in 1991. Gender, tumor type, stage and their relationship with residence place were analyzed in 34134 cases that was diagnosed cancer and treated in our hospital between 1992-2004. Methods: Of the patients, 56.6% were male and 43.4% were women. Stage distribution was as following: 31.6% local, 43% local advanced and 25.4% metastatic disease. Results: It was observed that men compared to women (p=0.00), patients who live outside Izmir compared to patients living in Izmir (p=0.00) presented to the hospital with more advanced disease. When residence area, stage and gender were evaluated together, it was determined that women (p=0.011) and men (p=0.04) who were living in Izmir have been diagnosed at early stage. According to tumor groups, while patients with larynx, prostate or breast cancer who were living in Izmir has been diagnosed at early stage (p=0.05, p=0.008, p=0.000, respectively), no significant correlation could be detected among patients with lung, colorectal, cervix and endometrial cancer. Conclusion: People who live in cities benefit from proximity to developed diagnose and medical centers and the effects of screening and training programmes are observed over women. Cancer training programmes should be enlarged for men besides rural areas

Palliative radiotherapy in bone metastases: Results of a randomized trial comparing three fractionation schedules

Purpose: To determine the efficacy of 3 different fractionation schedules of radiotherapy (8 Gy × 1, 4 Gy × 5, and 3 Gy × 10) in the management of painful bone metastases. Patients and methods: Between March 1994 and June 1995, 87 patients with a total of 109 solitary or multiple bone metastases from several primary tumors were randomized to receive 8 Gy × 1, 4 Gy × 5, and 3 Gy × 10 of Co-60 external beam radiotherapy with palliative intent. Palliation was evaluated by means of analgesic requirement scores and pain scores before and after radiotherapy. Results: The most common primary site was the breast (42.9%) and the most frequent site of metastases was the vertebral column (47.7%). Analgesic requirement scores decreased significantly after radiotherapy in each treatment group (p <0.001 for 8 Gy × 1; p=0.010 for 4 Gy × 5; and p <0.001 for 3 Gy × 10). There was a significant decrease in pain scores after radiotherapy in each treatment group (p <0.001 for 8 Gy × 1; p=0.031 for 4 Gy × 5; and p <0.022 for 3 Gy × 10). At the 10th day, evaluation of the palliation rate was in favor of the 3 Gy × 10 group (p=0.014 for 8 Gy × 1 versus 3 Gy × 10; p=0.046 for 4 Gy × 5 versus 3 Gy × 10; and p=0.538 for 8 Gy × 1 versus 4 Gy × 5). However, this significance disappeared at the first and third-month evaluations. Median duration of palliation for the whole group was 4 months (range 0-60 months). The duration of palliation was significantly longer in the 3 Gy × 10 group. Median survival duration for 8 Gy × 1, 4 Gy × 5 and 3 Gy × 10 was 3, 4 and 11 months, respectively (p=0.031). There was no statistically significant survival difference between 4 Gy × 5 versus 8 Gy × 1 (p=0.635), whereas survival was better in the 3 Gy × 10 group (8 Gy × 1 versus 3 Gy × 10, p=0.018; 4 Gy × 5 versus 3 Gy × 10, p=0.026). Conclusion: Radiotherapy schedules in the treatment of painful bone metastases should be individualized, based on the patient's condition, expected quality of life, radiation site and size of the field rather than the fractionation schedule. For the patient with advanced cancer and painful bone metastases the choice between a single fraction and a more protracted schedule is important. Patients with limited life expectancy should receive effective treatment over a time as short as possible. The use of a single fraction could be of benefit by reducing the treatment burden both for the patient and the department

Postoperative adjuvant radiotherapy in stage IB carcinomas of the uterine cervix

Between January 1987 and December 1992, amongst the cases who were evaluated and operated upon as clinical Stage IB carcinoma of the uterine cervix, 96 patients were treated with postoperative radiotherapy and the results were reviewed retrospectively in June 1996. Thirteen cases had undergone total abdominal hysterectomy and bilateral salpingoopherectomy, 41 had modified radical hysterectomy and 42 had radical hysterectomy. Postoperative radiotherapy was applied to cases with poor prognostic factors such as lymph node metastasis, deep stromal invasion and bulky tumour, or to cases with inadequate operation. External pelvic irradiation of 50.4-54 Gy without midline shielding and 20 Gy intracavitary (2 x 10 Gy of vaginal surface dose) irradiation were applied. Five-year overall and disease-free survival rates were 82.9% and 77.4%, respectively. There was no difference in survival rates due to the type of operation (P = 0.920). Factors that significantly affected the 5-year disease-free survivals by univariate analysis were lymph node metastasis (positive: 54.7%, negative: 84.8%; P 4 cm: 63.4%, < 4 cm: 83.5%, P = 0.004), surgical margins (positive: 62.1%, negative: 83.1%, P = 0.029), deep stromal invasion (positive: 71.1%, negative: 92.6%, P = 0.056) and histopathological type (P = 0.036). In multivariate analysis, lymph node metastasis was the only independent prognostic factor (P = 0.008). The complication rates of Grade II (7.4%) and Grade III (5.1%) indicates that postoperative radiotherapy was tolerated well by the patients. The efficiency of postoperative radiotherapy in clinically stage IB cervix carcinomas with inadequate surgery or with poor prognostic criteria was discussed and it was concluded that it might have a positive contribution to survival with an acceptable complication rate

Liposomal doxorubicin-related palmar-plantar erthrodysesthesia (hand-and foot syndrome): Report of a case [Li·pozomal doksorubi·si·n i·le i·li·şki· li· palmar-plantar eri·trodi·sestezi· (el-ayak sendromu): Olgu sunumu ve derleme]

Palmar-plantar erthrodyesthesia (PPE) (hand and foot syndrome) is a dermatological toxic reaction related to some chemotherapeutic agents. Liposomal doxorubicin is the long-acting formula of doxorubisin and it causes PPE in 50% of the patients when used with the dosage of 50 mg/m2. The disease causes burning sensation in the hands and feet and then shows progression by edema and erythema. After the disease is estbalished the treatment consists of lowering the drug dosage, prolonging the dose intervals or discontinuing the drug as well as using topical agents

Endoservikal mikroglandüler hiperplazi tedavisi

Twenty-seven patients who were diagnosed as endocervical microglanduler hyperplasia (EMH) after fractionated curettage were al;not;located to this study. 15 of them had undergone total abdominal hysterectomy, other 12 patients were invited for endocervical cu;not;rettage (ECC). After diagnosing initial EMH, we found EMH after ECC in 2 of 3 patients who used gestagen however 8 patients who didn't use gestagen after F.curettage showed no histopathologic findings of EMH. Among the hysterectomised 15 ^patients, EMH persisted tn 2 of 3 patients who used gestagen before hysterectomy but we noticed EMH only 2 of the 12 cases who didn't use gestagen before hysterectomy. Two of 27 patients were using oral contraceptives during the first F.curettage. The most common complaint was menometroragie and during the cervical examination we observed chronic cervtsitis (%59), erosion de cole (9622^, hypertrophy of cervix ;lt;9622J, hyperemic lesion (%22), and endocervical polyps CH;gt;7). This study revealed that endocervical curettage is sufficient for the treatment of EMH and may disappear spontaneously in approximately in a year.Şubat 1992-Mart 1995 tarihleri arasında yapılan fraksiyone kûretaj sonucu endoservikal mikroglandüler hiperplazi (EMH) tanısı al¬mış 27 olgunun 15'i histerektomt olmuştu, diğer 12 olguya ise kontrola çağırılıp endoservikal kûretaj yapıldı. EMH saptandıktan sonra gestagen kullanan 3 olgudan 2'sinde EMH devam ederken, kontrol kürtajına gelen 8 olgunun hiçbirinde EMH gözlenmedi. Gestagen uygulanmayan olgulardan 1 ay içinde histerektomt yapdan 12'sinin 2'sinde EMH devam ederken, ortalama 13 ay İçinde kontrol kûretajı yapılan 4 olgunun hiçbirinde EMH saptanmadı. Olguların 2'si Ük F.küretaj sırasında oral kontraseptif kullanmaktay¬dı. Hastaların en sık başvuru yakınması menometroraji idi, spekulum bakısında 9659 kronik servisti, 9622 servikal erezyon, 9622 servikal hipertrofi, 9622 hiperemik alan, 967 endoservikal polip mevcuttu. Bu çalışmada yalancı neoplasttk bir lezyon olan EMH' nin tedavisinde endoservikal kûretajm yeterli olacağı, ortalama 1 yıl içinde spontan gerileyebileceği, tedavinin EMH'nin beraberinde bu¬lunan servikal tntraepttelyal neoplazl (CİN), servikal polip, erezyon gibi diğer servikal lezyonlara yönelik olmasının yetedi olduğu so¬nucuna varılmıştır