Our Surgical Approach and Management Results in Renal Tumors

Objective:Surgery is the gold standard therapy method in renal tumors. Renal tumor surgery can be performed as open radical nephrectomy, open partial nephrectomy, laparoscopic radical nephrectomy or laparoscopic partial nephrectomy.Each technique has its own advantages and disadvantages. In this research, it was aimed to evaluate the renal tumor surgery techniques in our clinic and the oncologic data obtained from the patients.Material and Method:A total of 92 patients with a radiologically proven renal mass were underwent surgery between July 2011 and January 2018. The clinical, oncological and pathological results of these patients are evaluated according to their surgical approach retrospectively. The obtained data were evaluated according to the surgical technique.Results:The patients who have renal mass underwent partial nephrectomy (n:39), radical nephrectomy (n:38), laparoscopic radical nephrectomy (n:14) and laparoscopic partial nephrectomy( n:1). The most common pathologic tumor type is clear cell carcinoma (n: 56), the most common T stage is T1b (n: 39) and the most common tumor grade is Fuhrman grade 2 (n:34). Average tumor mass size of open partial nephrectomy patients are 3,3±1,8 cm, significantly smaller than the radical surgeries (p0,05).Conclusion:Surgery is still the best type of oncological treatment in renal tumors. Partial and laparoscopic radical nephrectomy has similar oncologic results with open radical nephrectomy in selected cases. Kidney tumor surgery results in our clinic have similar characteristics with the literature

The Results of Urodynamics and Pressure Flow Study of Patients with Neurological Disease in a Single Center for 12 Years: Neurogenic Bladder Etiology

Aim:Generally, urodynamic-pressure flow study (U-PFS) is performed on patients with lower urinary tract symptoms (LUTS) for verifying the diagnosis and evaluating the rate of response for treatment. The aim of the study was to assess the results of the U-PFS of patients according to the etiology of neurological disorders.Materials and Methods:The data of 2,489 patients who underwent U-PFS in our clinic between 2010-2022 were analyzed retrospectively. A total of 535 patients with LUTS and neurogenic disorder were included in the study. Patients were divided into subgroups according to their diagnosis. The patient’s age, gender, and U-PFS data (sensation of first urine, maximum cystometric capacity (MSC), maximum detrusor pressures in the filling phase, presence of urgency, and bladder compliance status) were evaluated and compared according to neurological disorders.Results:Cervical and lumbar disc disorder was found in 204 (38.1%) patients, multiple sclerosis (MS) in 103 (19.2%), and cerebrovascular incidents in 74 (13.8%) patients (SVI), spinal cord injury in 48 (8.9%), polyneuropathy in 43 (8.0%), Parkinson’s disease (PD) in 30 (5.6%), diabetic neuropathy in 18 (3.4%), and operated spine bifida (oSB) in 15 (2.8%) was detected. Detrusor pressures in the filling phase were compared according to neurological disorders, and detrusor pressures were statistically significantly higher in patients with oSB and PD (52.66±40.78 mmHg; 45.30±34.43 mmHg, respectively; p<0.001). When the MSCs were compared, it was observed that the bladder capacity was significantly lower in PD and ASD patients, whereas bladder capacity was relatively increased in lomber and servical disc disorder, spinal cord injury and polyneuropathy patients (respectively 308.71±190.25 mL, 264.81±140.25 mL, 491.90±167.49, 474.52±182.92, 447.67±168.03, p<0.001).Conclusion:These specific patient groups (oSB and spinal cord injury) are hazardous groups for the development of end-stage kidney failure. Clinicians should take into consideration that patients and their relatives have to be informed about possible long-term complications

Biyodizel Pilot Püskürtmeli Doğalgaz Yakıtıyla Çalışan Bir Dizel Motorda Silindir Basıncı Değişiminin Stokastik Reaktör Model Kullanılarak İncelenmesi

Denizcilik sektöründe enerjinin ekonomik ve ekolojik özelliklerini dikkate alan gemi makinelerinin üretilmesi için yapılan çalışmalardan birisi de çift yakıtlı motorlardır. Çift yakıtlı motorlarda, yanma odasındaki gaz yakıthava karışımı pilot yakıtla tutuşturulur. Bu motorlar çoğunlukla dizel motorların dönüştürülmesiyle üretilirler. Yanma karakteristikleri; genellikle basınç, ısı salınım oranı ve tutuşma gecikmesini kapsamaktadır. Bu karakteristikler, deneysel ölçümlerle ve teorik yaklaşımlarla elde edilmektedir. Kullanılan teorik yaklaşımlardan birisi de 0-boyutlu Stokastik Reaktör Model yaklaşımıdır. Bu yaklaşım, olasılık yoğunluk fonksiyonuyla sıkıştırma, yanma ve genişleme işlemlerini analiz eder. Bu yaklaşıma dayalı bir motor simülasyon yazılımı geliştirilmiştir ve yakıtların detaylı ve indirgenmiş kimyasal kinetik mekanizmalarıyla çalışmaktadır. Bu çalışmada, biyodizel pilot yakıtı ve doğalgaz gaz yakıtıyla çalışan çift yakıtlı motor en uygun iki pilot püskürtme parametresi ve farklı stokastik parçacık sayılarında simüle edilmiştir. Modelin geçerliliğini göstermek için bu motor üzerinde yapılan çalışmadan yararlanılmıştır. En uygun pilot püskürtme parametrelerinde simülasyon ve deneysel basınç değerlerinin belirli hata oranlarında uyumlu olduğu gözlemlenmiştir

The shrinkage effect of formalin on renal cell carcinoma: Does it change the stages?

Objective: To determine the shrinkage effect of formalin on renal cell carcinoma. Method: The retrospective study was conducted from October to November 2020 at Tekirdag Namil kemal University, Turkey and comprised all radical and partial nephrectomy cases performed by a single surgeon in a single clinic between January 2014 and August 2020. Preoperative images and postoperative pathology were reviewed by the same clinician. Preoperative longest tumour diameter of radiological images and pathological specimens measured after formalin fixation shrinkage were compared, and the effect of the difference between the two measurements on the circumference of the tumour was examined. The formalin related shrinkage rates of renal tumours according to the tumour size and the tumour types were also analysed. Data was analysed using SPSS 20. Results: Of the 101 cases, 58(57.4%) were of radical and 43(42.6%) of partial nephrectomy. Also, there were 77(76.2%) renal cell carcinoma cases, 22(21.8%) benign renal tumours and 2(1.9%) had other malignant tumours. There were 59(58.4%) males and 42(41.6%) females with an overall mean age of 58.1±12,2 years (range: 30-82 years). The mean radiological size of the renal tumours was 55.3±30.4mm and it was 52.9±31.6mm at pathological examination (p>0.05). Conclusion: Formalin fixation of tissues post-surgery caused a difference between the radiological and pathological dimensions. Though the difference was no significant, under-staging due to the shrinkage post-surgery should be considered. Key Words: Renal tumours, Tissue shrinkage, Formalin, radiological dimension, Pathological dimension. ---Continu