Prognostic significance of surgical margin status and gleason grade at the positive surgical margin in predicting biochemical recurrence after radical prostatectomy in a turkish patient cohort

Objective: To investigate the prognostic role of positive surgical margin (PSM) features in addition to well-defined risk factors in predicting biochemical recurrence (BCR) after radical prostatectomy. Materials and Methods: This study used the prostate cancer database from the Urooncology Association in Turkey. Clinical, surgical, pathological and follow-up data were recorded from the database. PSM features, including number, location, linear length and Gleason grade (GG) were also recorded. Kaplan-Meier survival analyses were performed to assess differences in BCR-free survival (BCR-FS). In order to identify prognostic factors affecting BCR-FS, univariate and multivariate Cox regression analyses were performed. Results: The study included 984 patients who met the eligibility criteria. The median follow-up time was 29 (minimum: 6, maximum: 210) months, and BCR was detected in 178 (18.1%) patients. BCR-FS was found to be significantly lower in patients with higher total prostate-specific antigen, higher International Society of Urological Pathology (ISUP) grade, extraprostatic extension (EPE), seminal vesicle invasion, lymphovascular invasion, lymph node involvement, PSM and GG at PSM (PSMGG) >= 4 (log-rank p<0.001, p<0.001, p<0.001, p<0.001, p<0.001, p<0.001, p<0.001 and p=0.005). ISUP grade, EPE and PSM were identified as independent prognostic factors in predicting BCR-FS [Hazard ratio (HR): 1.89, p=0.035 and HR: 4.65, p<0.001, HR: 1.82, p=0.030, HR: 1.77, p=0.042, respectively]. Unlike the univariate analysis, in multivariate analysis, PSMGG did not prove to be an independent prognostic factor in predicting BCR-FS. Conclusion: PSM GG >= 4 was found to be significantly associated with shorter BCR-FS. There is a need for large, randomised prospective studies to clarify the role of PSMGG to be used in nomograms as an independent predictor to determine patients who would benefit from adjuvant radiation therapy

Ege Bölgesinde Organik Zeytin Yetiştiriciliği

Bu çalışmada, insan beslenmesi ve sağlığı açısından çok önemli bir ürün olan zeytinin yetiştirilmesinde, konvansiyonel yöntemlere alternatif olarak organik tarım yöntemlerinin uygulanabilirliğinin belirlenmesi, fenolojik, pomolojik ve ekonomik farklılıkların ortaya konması amaçlanmıştır. Çalışma Güney Ege Bölgesinin en önemli yağlık çeşidi olan Memecik zeytin çeşidinde Zeytincilik Araştırma Enstitüsünün Kemalpaşa üretim alanında 2004-2007 yılları arasında yürütülmüştür. Çalışmada organik parsellerde toprak verimliliğini artırmak amacıyla yeşil gübreleme, organik gübre, organik tarım yönetmeliğinde izin verilen mineral maddeler, konvansiyonel parsellerde ise kimyasal gübreler uygulanmıştır. Zeytin sineği popülasyon takibi Mc phail ve sarı yapışkan tuzaklar, zeytin güvesi ise delta tipi feremon tuzaklar ile yapılmıştır. Organik parsellerde zeytin sineği mücadelesinde Ecotrap, neemazal ve kaolin uygulamaları yapılmıştır. Konvansiyonel parsellerde mücadele Fenthion ile yapılmıştır. Her iki parseldeki ağaçlarda sürgün boyu, somak ve çiçek adeti, meyvelerde ise tane adedi ve ağırlığı, eni, boyu, et/çekirdek oranları, ürün miktarları tespit edilmiştir. Elde edilen zeytinyağlarında ise yağ asitleri bileşimleri ve zeytinyağı kalite parametreleri değerlendirilmiştir. Ayrıca yaprak ve toprak analizleri ile bitki besin maddelerinin değişimleri incelenmiş, parsellerden elde edilen meyvelerde kalıntı analizleri yapılmıştır. Meyve örneklerinde yapılan analizlerde organik fosforlu nitrojenli ve sülfürlü pestisitlere rastlanmamıştır. Her iki grupta da ürün miktarı, yağ kalite parametreleri ve yağ asitleri bileşiminde önemli bir farklılık bulunmamıştır. Yapılan organik tarım uygulamalarıyla, konvansiyonel yöntemler uygulanarak sağlanan verim ve kalitede ürün elde edilmiştir

Two Cases of Bladder Adenocarcinoma After Augmentation Cystoplasty

To draw attention to the disregarded malignancy risk after ileocystoplasty, we present two cases of adenocarcinoma. The first case was metastatic at initial diagnosis. Despite chemotherapy, the condition progressed and the patient died at the 9th month. The second patient has received cystectomy followed by chemotherapy and radiotherapy. Although the second patient was an immunosuppressed renal transplant, she was disease-free at the 27th month. As the malignancy risk after bladder augmentation is a proven fact, until the discovery of a proper diagnostic method, we recommend doing routine annual cystoscopic biopsy starting after the 10th year of ileocystoplasty

Endovascular management of renal angiomyolipomas: Do coils have a benefit in terms of clinical success rates?

PURPOSEThis study evaluated single center results of endovascular treatment in renal angiomyolipoma (AML) to determine whether there is clinical relevance of adding proximal coil embolization to distal particle embolization in terms of safety, efficacy and retreatment rates.METHODSA retrospective analysis was performed to evaluate patients undergoing transarterial embolization for renal AMLs from January 2007 to October 2020. Parameters regarding patient and tumor characteristics, embolization technique, treatment outcome and complications were recorded. Patients were divided into two groups as A (only particle group) and B (particle + coil group) based on the type of embolic agent used for treatment. Comparative analysis was performed between the two groups in terms of tumor size reduction, retreatment and complication rates.RESULTForty-two patients (37 (88.1%) female, 5 (11.9%) male) harboring 48 AMLs were included in the study. The mean age was 43.46 (range 20 to 78). The technical success rate was 95.8% (46 of 48 procedures). The mean size reduction was 1.94±1 cm (p < 0.001) after treatments however, no significant difference was seen between groups in terms of tumor size reduction. Retreatment rates were 3.1% (1 of 32 cases) in group A and 14.3% (2 of 14 cases) in group B (p = 0.21). No significant difference was found between groups in terms of bleeding and complication rates during the perioperative period. Mean follow-up duration was 26.48±25.71 (range from 2 to 102) months. CONCLUSIONIn this study, no clear supplementary benefit was observed in terms of safety, and efficacy with the adjunction of coils to distal particle embolization in the management of AMLs

Real-world efficacy and safety of Ledipasvir plus Sofosbuvir and Ombitasvir/Paritaprevir/Ritonavir +/- Dasabuvir combination therapies for chronic hepatitis C: A Turkish experience

Background/Aims: This study aimed to evaluate the real-life efficacy and tolerability of direct-acting antiviral treatments for patients with chronic hepatitis C (CHC) with/without cirrhosis in the Turkish population.Material and Methods: A total of 4,352 patients with CHC from 36 different institutions in Turkey were enrolled. They received ledipasvir (LDV) and sofosbuvir (SOF)+/- ribavirin (RBV) ombitasvir/paritaprevir/ritonavir +/- dasabuvir (PrOD)+/- RBV for 12 or 24 weeks. Sustained virologic response (SVR) rates, factors affecting SVR, safety profile, and hepatocellular cancer (HCC) occurrence were analyzed.Results: SVR12 was achieved in 92.8% of the patients (4,040/4,352) according to intention-to-treat and in 98.3% of the patients (4,040/4,108) according to per-protocol analysis. The SVR12 rates were similar between the treatment regimens (97.2%-100%) and genotypes (95.6%-100%). Patients achieving SVR showed a significant decrease in the mean serum alanine transaminase (ALT) levels (50.90 +/- 54.60 U/L to 17.00 +/- 14.50 U/L) and model for end-stage liver disease (MELD) scores (7.51 +/- 4.54 to 7.32 +/- 3.40) (p<0.05). Of the patients, 2 were diagnosed with HCC during the treatment and 14 were diagnosed with HCC 37.0 +/- 16.0 weeks post-treatment. Higher initial MELD score (odds ratio [OR]: 1.92, 95% confidence interval [CI]: 1.22-2.38; p=0.023]), higher hepatitis C virus (HCV) RNA levels (OR: 1.44, 95% CI: 1.31-2.28; p=0.038), and higher serum ALT levels (OR: 1.38, 95% CI: 1.21-1.83; p=0.042) were associated with poor SVR12. The most common adverse events were fatigue (12.6%), pruritis (7.3%), increased serum ALT (4.7%) and bilirubin (3.8%) levels, and anemia (3.1%).Conclusion: LDV/SOF or PrOD +/- RBV were effective and tolerable treatments for patients with CHC and with or without advanced liver disease before and after liver transplantation. Although HCV eradication improves the liver function, there is a risk of developing HCC.Turkish Association for the Study of The Liver (TASL

Describing normal variations of head and face by using standard measurement and craniofacial variability index (CVI) in seven-year-old normal children

To define the line separating normal from abnormal craniofacial appearance is complex and difficult because there are many craniofacial measurement parameters, and there are also many factors that influence the craniofacial morphology, such as genetics and environmental influence. The aim of this study is to define the range of normal distribution of craniofacial morphology by using different numerical methods in seven-year-old students in Denizli, Turkey. For this purpose, height, weight and 20 defined craniofacial parameters (including face height, face width, face depth, eyes, nose, ear, mouth and head) of 61 female and 58 male (119 total) normal cases were measured. Every measurement was taken twice by the same investigator and the standard anthropometric methods of measurements were used. All data were recorded by computer and analyzed statistically. At the end, craniofacial variability index (CVI) was found 0.874 ± 0.338 in female, 0.824 ± 0.333 in male. Furthermore, the female results were compared to the male results. Parameters were correlated with each other. Seven years old is the beginning age for primary school in Turkey. So, it is an important year for initial diagnostic screening in children with facial syndromes, and it is also important for pre-and postsurgical assessments of children with craniofacial anomalies. ©2007Muntaz B. Habal, MD

Excisional tapering and ureteroneocystostomy in primary obstructive megaureter: Case report

Çocuklarda normal üreter çapı nadiren 5 mm’den büyüktür ve çapı 7 mm’yi aşan üreterler megaüreter (MGÜ) olarak adlandırılır. Megaüreterler, reflülü, obstrükte, reflülü obstrükte ve reflülüsüz non-obstrükte olmak üzere dört gruba ayrılmaktadır. Primer obstrüktif megaüreter (POMÜ) distal üreterin, fonksiyonel obstrüksiyonuna bağlı olarak gelişen nonherediter konjenital dilatasyonudur. Distal segmentteki fonksiyonel obstrüksiyon sebebiyle üreteral peristaltizmin normal distal yayılımı kaybolmuştur. Hastaların en çok başvuru nedeni sık gelişen üriner enfeksiyonlar ve karın ağrısıdır. Bu makalede, karın ağrısı ve sık tekrarlayan üriner enfeksiyon yakınmasıyla başvuran 7 yaşındaki POMÜ’li kız çocuğunda uygulamış olduğumuz Hendren tipi üreteral remodeling ve üreteroneosistostomi yöntemleriinin tanımlanması ve uzun dönem sonuçları ile birlikte sunulması amaçlanmıştır.In children the normal ureter diameter is rarely bigger than 5 mm and if the ureters which have diameter greater than 7 mm, are called as megaureter (MGU). Megaureters are classified under four groups, as refluxing, obstructive, refluxing-obstructive and non-refluxing, non-obstructive. Primary obstructive megaureter (POMU) is a nonhereditary congenital dilatation that grow up by the obstruction of the distal ureter. The normal ureteral peristhaltism is lost because of the functional obstruction of the distal segment. Patients usually present with urinary infection. Herein, a case of POMU who underwent Cohen type ureteroneocistostomy and Hendren type ureteral remodeling at our institution is presented