The preoperative serum CA125 can predict the lymph node metastasis in endometrioid-type endometrial cancer

Objectives: To evaluate the predictive value of preoperative CA125 in extra-uterine disease and its association with poorprognostic factors in endometrioid-type endometrial cancer (EC).Material and methods: A total of 423 patients with pathologically proven endometrioid-type EC were included in thestudy. The association between preoperative CA125 level and surgical–pathological factors was evaluated. The conventional cut-off value was defined as 35 IU/mL.Results: A high CA125 level ( > 35 IU/mL) was significantly associated with all of the studied poor prognostic factors,except grade. The risk of lymph node metastasis (LNM) increased from 15.9% to 45.7% when CA125 level was > 35 IU/mL (p < 0.05). The optimal cut-off value for the prediction of LNM in patients aged > 50 years was determined to be 16 IU/mL (sensitivity, specificity, positive predictive value, and negative predictive value were 71%, 60%, 35%, and 87%, respectively.)Conclusions: Preoperative CA125 level was significantly related with the extent of the disease and LNM. The age-dependent cut-off level of CA125 can improve the prediction of LNM in endometrioid-type EC. For older patients, CA125 level of > 16 IU/ml could be used to predict LNM. However, further studies are needed to evaluate the appropriate cut-off level of CA125 for younger patients

Recurrence in Uterine Tumors with Ovarian Sex-Cord Tumor Resemblance: A Case Report and Systematic Review

Objective: The aim of this study was to evaluate the prognostic factors of recurrence in uterine tumors resembling ovarian sex-cord tumors (UTROSCT) and to determine clinical-pathological characteristics, treatment options and outcome. Material and Method: An electronic literature search was conducted from 1976 to 2018. After the comprehensive evaluation and conjunction with our case, the study included 79 cases. Results: The median age at initial diagnosis was 49 years (range; 16-86 years). The age was under 40 years in 21 (26.6%) patients. Whereas 68 patients underwent at least hysterectomy, 9 patients had organ sparing surgery. There was necrosis in 4 (5.1%) patients, atypia in 16 (20.3%) patients, and infiltrative tumor border in 34 (43%) patients. At least one mitosis per 10 high power fields was determined in 36 (45.5%) patients. The tumor involved at least part of the myometrium in 54 (68.3%) patients. Median follow-up time was 30 months (range; 3-296 months). Recurrence was determined in 5 (6.3%) patients. The disease free survival (DFS) was significantly related only to surgery type. None of the pathologic features were associated with DFS. The 5-year DFS was 86% and 96% in patients who underwent organ sparing surgery or not, respectively (p=0.038). Conclusion: The accurate pathologic diagnosis of UTROSCT has great value in shaping surgical management and management during the follow-up period. Organ sparing surgery was related to poor DFS. Although recurrence is rare, it should be kept in mind for patients with UTROSCT

Tig punta kaynağıyla birleştirilen az karbonlu çelik malzemelerin mekanik ve metalografik incelenmesi

Bu tez çalışmasında, özellikle TİG punta kaynağı ve sonra da karşılaştırmak açısından elektrik direnç punta kaynağı uygulamaları yapılmıştır. Tüm test numuneleri standartlara göre hazırlanmıştır. Deneylerde kullanılan TİG punta kaynak makinasının kapasitesi 300 amper olan doğru akım kaynak makinasıdır. Değişen kaynak parametreleri amper ve kaynak zamanıdır. TİG punta kaynak amperinin ve kaynak zamanının arttırılmasıyla, deney numunelerinin mekanik özellikleri ve mikro yapıları değişir. Bu çalışmada, farklı çekme deneyleri (çapraz çekme deneyi ve çekme-kesme deneyi) ve sertlik ölçümleri uygulanmıştır. Ana metal ve kaynak bölgesinin mikroyapı incelemesi mekanik sonuçlarla beraber değerlendirilmiştir. Sonuçta, TİG punta kaynağı elektrik direnç kaynağının yetersiz olduğu bir çok yerde kullanılabilir. SUMMARY In this thesis study, especially TIG spot welding and then electric resistance spot welding (for comparation) applications have been done. All test specimen are prepared according to test standarts. In used the tests, TIG spot welding machine capacity has 300 ampere was direct current welding machine. The changing welding parameters were ampere and welding time. Increasing TIG spot welding ampere and welding time, the test specimen mechanical properties and microstrueture changed. In this study, different tensile tests (transuerse tensile test and tensile-cut off test) and hardness test were applied. Microstructural examination of base metal and welding zone were evaluaded with mechanical results. Finally, TIG spot welding is used instead of electric resistance spot welding which is insufficient for a lot of applications

Tig punta kaynağıyla birleştirilen az karbonlu çelik malzemelerin mekanik ve metalografik incelenmesi

ÖZETBu tez çalışmasında, özellikle TİG punta kaynağı ve sonra da karşılaştırmak açısından elektrik direnç punta kaynağı uygulamaları yapılmıştır.Tüm test numuneleri standartlara göre hazırlanmıştır. Deneylerde kullanılan TİG punta kaynak makinasının kapasitesi 300 amper olan doğru akım kaynak makinasıdır. Değişen kaynak parametreleri amper ve kaynak zamanıdır.TİG punta kaynak amperinin ve kaynak zamanının arttırılmasıyla, deney numunelerinin mekanik özellikleri ve mikro yapıları değişir.Bu çalışmada, farklı çekme deneyleri (çapraz çekme deneyi ve çekme-kesme deneyi) ve sertlik ölçümleri uygulanmıştır.Ana metal ve kaynak bölgesinin mikroyapı incelemesi mekanik sonuçlarla beraber değerlendirilmiştir.Sonuçta, TİG punta kaynağı elektrik direnç kaynağının yetersiz olduğu bir çok yerde kullanılabilir.SUMMARY In this thesis study, especially TIG spot welding and then electric resistance spot welding (for comparation) applications have been done.All test specimen are prepared according to test standarts. In used the tests, TIG spot welding machine capacity has 300 ampere was direct current welding machine. The changing welding parameters were ampere and welding time.Increasing TIG spot welding ampere and welding time, the test specimen mechanical properties and microstrueture changed.In this study, different tensile tests (transuerse tensile test and tensile-cut off test) and hardness test were applied. Microstructural examination of base metal and welding zone were evaluaded with mechanical results.Finally, TIG spot welding is used instead of electric resistance spot welding which is insufficient for a lot of applications

The Second Incisional Site Metastasis in a Patient with Cervical Carcinoma: A Case Report

Cervical cancer is the third most commonly diagnosed cancer and the fourth leading cause of cancer deaths in females worldwide. Recurrence of carcinoma of the uterine cervix mainly occurs locally or regionally after treatment. Rarely (0.1-1.3%) metastatic recurrence of squamous cervical carcinoma could be identified in the abdominal wall especially in sites of incision. We present a case with a second incisional site metastasis of cervical cancer after seventy five months following first operation

Primary and bilateral tubal carcinoma is associated with long-standing granulomatous inflammation and primary infertility: A case report

We report a case of bilateral and primary tubal carcinoma associated with granulomatous inflammation and long-standing primary infertility. A 38-year-old woman with a 17-year history of primary infertility presented with lower abdominal pain and granulomatous inflammation in the endometrial biopsy. Bilateral adnexal masses measuring 4 and 6 cm in size were detected and the serum cancer antigen 125 level was 141 IU/ml. Laparoscopic surgical exploration and frozen section on the resected tubes revealed bilateral fallopian tube adenocarcinoma and then a staging laparotomy was performed. Histopathological examination showed a primary bilateral Grade 2 tubal serous adenocarcinoma of Stage 1b associated with granulomatous salpingitis. Primary fallopian tube carcinomas in young women are extremely rare gynecological tumors that are infrequently diagnosed prior to surgical exploration and their cause is unknown. A definitive diagnosis could be made on the histopathological examination in our case with the evidence of chronic pelvic inflammation. Our findings suggest that chronic pelvic inflammation may play a role in carcinogenesis in the tubes of infertile women

Case Report: Benign Multicystic Peritoneal Mesothelioma

Benign multicystic peritoneal mesothelioma (BMPM) is a rare tumor of unknown pathogenesis that occurs mainly in women in their reproductive ages and mostly diagnosed intraoperatively. In this paper, a case was summarized with pelvic mass which was handled as an ovarian cancer preoperatively. A 40 year old woman admitted to gynecologic oncology unit due to pelvic pain. On bimanual gynecologic examination a unilateral, semi-fixated pelvic mass in the right adnexial region was palpated. She had no medical history of malignancy. On pelvic ultrasound in the right adnexial region a multiseptated mass was reported. Ca-125 level was 178.2 IU/ml. On gross examination during operation, there was a thin walled multicystic pelvic mass adherent to posterior cul de sac, rectal serosa, and right pelvic wall. Pathologists’ first impression was that mass was not containing any malignant component on frozen sections. Carefull resection of pelvic mass, total abdominal hysterectomy, right salphingooophorectomy and appendectomy performed. The final pathologic diagnosis was BMPM with parafine blocks. In conclusion BPMP is a rare benign cystic tumor which can be easily misdiagnosed as an ovarian cancer preoperatively. Intraoperative findings and appearence of the mass may mimic malignancy. For that reason frozen section examination will prevent overtreatment

Bilateral Borderline Serous Ovarian Tumor Following Three Cycles of Clomiphene Treatment in 19 Years Old Subfertile Woman with Polycystic Ovaries: A Case Report

Clomiphene Citrate (CC) is one of the most comprehensively registered agent for ovulation induction in women with polycystic ovarian syndrome (PCOS). CC is regarded as safe and cost effective agent with very f ew complications. During the last 20 years, the potential association between the use of ovulation induction agents and the risk of ovarian neoplasm has become a topic of considerable scientific and public health interest. We report a woman who developed bilateral serous borderline ovarian tumor following three cycles of CC f rom normal appearing ovaries. The condition was diagnosed using baseline ultrasound of the aftercoming CC cycle and immediate diagnostic laparoscopy followed by a converting laparotomy for an accurate staging was performed. We also review published case reports of borderline ovarian tumors following ovulation induction to update the medical literature about this rare yet serious condition may be encountered by physicians providing infertility treatment. A borderline ovarian neoplasm in polycystic ovaries should be considered if a patient develops unforeseen ovarian mass (es) following ovulation induction

The Effects of Ankaferd Blood Stopper on the Recovery Process in an Experimental Oesophageal Perforation Model

Background: Oesophageal perforation is a life-threatening pathology that is generally treated conservatively; however, surgical procedures are frequently performed. A topical haemostatic agent, Ankaferd Blood Stopper (ABS), also has beneficial wound-healing effects. Aims: This study aimed to determine the effects of ABS following experimental oesophageal perforations. Study Design: Animal experiment. Methods: The experimental rats were classified into 6 groups (with 7 rats in each group). Pairs of groups (primary repair alone and primary repair + ABS) were terminated in the 1st, 2nd, and 3rd weeks following injury. The oesophageal perforations, which were 8-10 mm in length, were created using a nasogastric tube. The perforation sites were repaired with a 6-0 polyglactine thread in the primary repair groups. Additionally, ABS was sprayed over the perforation site in the treatment groups. Each oesophagus was evaluated histopathologically. Results: There were fewer microabscesses and areas of necrosis in the ABS groups compared with the primary repair groups. The histopathological evaluation revealed that the ABS groups had less inflammation and more re-epithelisation compared to the primary repair groups (p=0.002 and p=0.003, respectively). Fibrosis in the ABS groups was moderate in the 2nd week and mild in the 3rd week. Comparing the groups with respect to the time intervals, only the 1st week groups showed a significant difference in terms of re-epithelialisation (p=0.044). Conclusion: Topical ABS application on the repaired experimental oesophageal perforation regions led to positive wound-healing effects compared with the rats that were administered the primary repair alone

Is the Initial Treatment in Stage IB2 Cervical Carcinoma Neoadjuvant Chemothreapy or Primary Surgery?

OBJECTIVE: It is expected that neoadjuvant chemotherapy (NACT) decrease tumor size, increase the operability and improve surgical-pathologic risk factors so that improve the survival. In this study we evaluated the effect of NACT on surgical-pathologic risk factors and survival. STUDY DESIGN: Between 1993 and 2007, the data of patients with stage IB2 cervical cancer were reviewed. Twenty-four patients who were treated with NACT followed by radical surgery (RS) were compared with 15 patients underwent primary RS. After two or three courses of chemotherapy patients were reassessed and RS was performed to patients whose tumor size was less than 40mm. In both groups all patients underwent type III radical hysterectomy + bilateral salpingo-oophorectomy + systematic paraaortic and bilateral pelvic lymphadenectomy. RESULTS: The mean size of the tumor mass was 50.1mm. Nine patients were acccepted as responder (complete clinical response + partial clinical response) and 15 patients as unresponder (stabile disease) after NACT. The surgical-pathologic risk factors didn’t improve with NACT except for stromal invasion. The median follow-up was 48 months. Overall survival and disease free survival was 86.7% in RS group, this ratio was 80% in NACT unresponder group and 66.7% in NACT responder group (p=0.501). CONCLUSION: NACT didn’t improve either the surgical-pathologic risk factors expect for stromal invasion or survival in patients with stage IB2 cervical carcinoma. It appears that we have disappointment with this treatment modality