Clinicopathologic features of incidental prostatic adenocarcinoma in radical cystoprostatectomy specimens

<p>Abstract</p> <p>Background</p> <p>The aim of this study is to review all features of incidentally discovered prostate adenocarcinoma in patients undergoing radical cystoprostatectomy for bladder cancer.</p> <p>Methods</p> <p>The medical charts of 300 male patients who underwent radical cystoprostatectomy for bladder cancer between 1997 and 2005 were retrospectively reviewed. The mean age of the patients was 62 (range 51-75) years.</p> <p>Results</p> <p>Prostate adenocarcinoma was present in 60 (20%) of 300 specimens. All were acinar adenocarcinoma. Of these, 40 (66.7%) were located in peripheral zone, 20 (33.3%) had pT2a tumor, 12 (20%) had pT2b tumor, 22(36.7%) had pT2c and, 6 (10%) had pT3a tumor. Gleason score was 6 or less in 48 (80%) patients. Surgical margins were negative in 54 (90%) patients, and tumor volume was less than 0.5 cc in 23 (38.3%) patients. Of the 60 incidentally detected cases of prostate adenocarcinoma 40 (66.7%) were considered clinically significant.</p> <p>Conclusion</p> <p>Incidentally detected prostate adenocarcinoma is frequently observed in radical cystoprostatectomy specimens. The majority are clinically significant.</p

The effects of tadalafil on renal ischemia reperfusion injury: an experimental study

Many pharmacological agents were investigated for the prevention of renal ischemic reperfusion (I/R) injury as well as the phosphodiesterase (PDE) inhibitors. The aim of the study was to examine the possible renoprotective effect of a member in this family, tadalafil (Td) on I/R injury. Thirty-six Spraque Dawley rats were allocated to six groups as; control, sham, ischemia (I), ischemia/reperfusion (I/R), Td pretreatment ischemia (Td/I) and Td pretreatment ischemia/reperfusion (Td/IR) groups. Right nephrectomy was performed in all groups. Td was dissolved in saline solution and given as a single dose (1mg/kg) through an orogastrictube 60 min before the operation in the Td pretreatment groups. In ischemia group the left renal pedicle was occluded for 45 minutes and after than underwent left nephrectomy. In I/R group left renal pedicle was occluded for 45 minutes, reperfused for 1 hour and after then underwent nephrectomy. The left kidneys were evaluated after standard laboratory procedures with regard to tubular morphology, and leukocyte infiltration. The data were analyzed by using Kruskal–Wallis test to determine differences among the groups. A p value of < 0.05 was considered significant. Renal tubular damage was significant increased in the ischemia and I/R group (Groups III and IV) when compared to those in the sham group (Group II), (p = 0.004, 0.004, respectively). Tubular damage, in the Td pretreatment ischemia (Td/I) (Group V) and Td pretreatment ischemia/reperfusion (Td/IR) (Group VI) were less than that in the ischemia group (Group III) (p= 0.010, p= 0.025, respectively). Td administration prior to the renal I/R injury attenuated these morphological disarrangements, which were observed in renal I/R. Tubular necrosis, which may be considered as an important issue of the developing renal injury, was also completely prevented with Td administration

Touch imprint cytology of prostate core needle biopsy specimens: A useful method for immediate reporting of prostate cancer

Background: Cytology plays an important role in the preoperative assessment of many cancers. It is used as a first-line pathological investigation in both screening and diagnostic purposes. Aims: To determine the diagnostic value and accuracy of touch imprint cytology (TIC) smear of prostate core needle biopsy (CNB) specimens in the diagnosis of prostate carcinoma. Materials and Methods: One hundred and twenty-one patients had ultrasound-guided transrectal prostate CNB. A total of 1210 TIC smears were prepared from all CNB specimens. Results: Diagnoses of 1210 TIC smears were compared with the histopathological findings of the CNB specimens. One hundred and seventy (14%) TIC smears were found positive for malignancy, 35 (2.9%) were diagnosed as suspicious for malignancy and 1005 (83.1%) were found negative for malignancy. Twenty-five of 35 suspicious imprints and 150 of 170 malignant smears were confirmed to be malignant on histopathological evaluation. Although 20 malignant TIC smears were defined as benign in standard histological preparations, 10 of them had definitive diagnosis of malignancy following extensive serial sectioning. Last of all, there were 10 false-positive cytology results. Moreover, 10 of the 35 suspected TIC smears were false negative when compared with the histopathological diagnosis. The sensitivity, specificity, positive predictive value and negative predictive value of touch imprint smear results were 100%, 98%, 90.2% and 100%, respectively. Conclusions: TIC smears can provide an immediate and reliable cytological diagnosis of prostate carcinoma. It may clearly help the rapid detection of carcinoma, particularly in highly suspected cases that had negative routine biopsy results for malignancy with abnormal serum prostate specific antigen (PSA) levels and atypical digital rectal examination

Better outcomes with desmopressin melt than enuretic alarm therapy in children with nocturnal enuresis during coronavirus disease 2019 (COVID-19)

Abstract. Objectives:. This study aimed to investigate the effect of the coronavirus disease 2019 (COVID-19) pandemic on the treatment of children with primary monosymptomatic nocturnal enuresis (MNE) with desmopressin melt versus an enuresis alarm. Materials and methods:. This study included 56 children with primary MNE who were taking desmopressin melt or using an alarm. Their anxiety levels were evaluated using the Social Anxiety Scale for Children-Revised. For both treatment methods, data from a 3-month bedwetting diary between the third and sixth months of the pre-pandemic treatment were compared with those assessed during the same period during the pandemic. Results:. Prior to the COVID-19 pandemic, the median 3-month mean frequency of MNE was 1 (0–7.67) in children using desmopressin melt versus 1.33 (0–6) in those using alarm treatment (p = 0.095). During the COVID-19 pandemic period, the median monthly mean frequency of MNE was 1.33 (0–7.33) in children using desmopressin melt versus 6 (1.33–13) in those using alarm treatment (p < 0.001). Conclusions:. The COVID-19 pandemic and its accompanying psychological effects did not affect the treatment efficacy of desmopressin melt in children with primary MNE but did adversely affect that of enuresis alarms

Experience and learning curve of retroperitoneal laparoscopic ureterolithotomy

This study was conducted to evaluate clinical experience and learning curve associated with laparoscopic ureterolithotomy performed for upper ureteral stones. The medical data of 50 patients who had undergone retroperitoneal laparoscopic ureterolithotomy between June 2010 and March 2013 were retrospectively analyzed. To assess the learning curve, patients were divided into two groups: Group A (the first 25 cases) and Group B (the last 25 cases). In Group A, double J stents were placed in 17 patients, whereas in Group B 15 patients received double J stents. In Group A, three ports were placed in nine patients and four ports in 16 patients. In Group B, three ports were placed in 20 patients and five patients had four ports. The patients were compared according to demographics, operative time, stone size, complications, hospital stay, and transfusion. The mean age for Group A was 47.8 ± 14.13 (21–72) years and that for Group B was 44.2 ± 14.98 (22–78) years. Mean operative times were 106.4 ± 38 (55–210) minutes and 70.76 ± 30.4 (30–180) minutes for Groups A and B, respectively (p 0.05). In our study, as staff experience (in performing laparoscopic retroperitoneal ureterolithotomy) increased, operative time, length of hospital stay, and complication rates have correspondingly declined

Laparoscopic Extraperitoneal Simple Prostatectomyfor Benign Prostate Hyperplasia:A Two-Year Experience

PURPOSE: To evaluate the feasibility of laparoscopic simple prostatectomyfor large volume prostates.MATERIALS AND METHODS: Between October 2007 and July 2009, laparoscopicsimple prostatectomy was performed on 16 patients with the prostates over 80mL. All the patients were operated with transvesical method. Peri-operativeand 3rd postoperative month data were recorded and evaluated.RESULTS: The mean prostate volume was 147 mL (range, 80 to 200 mL). Themean operation time, blood loss, duration of hospitalization, and duration ofdrain placement was 133 minutes (range, 75 to 210 minutes), 134 cc (range,50 to 300 cc), 3.9 days (range, 2 to 7 days), and 2.1 days (range, 2 to 3 days),respectively. Only one patient required blood transfusion due to postoperativebleeding and clot obstruction in the catheter lumen. Postoperative infectionwas not seen and recatheterization was not needed in any of the patients.All the patients’ pathology reports were noted as benign. Pre-operative andpostoperative International Prostate Symptom Score were 9.2 and 25.4,respectively. Maximum urinary flow rate was 4.0 mL/sec pre-operatively,but 24.7 mL/sec postoperatively.CONCLUSION: Laparoscopic simple prostatectomy is a feasible method withlow morbidity and improved postoperative outcomes

Scrotal Agressive Angiomyxoma

Aggressive angiomyxoma is often a rare benign tumor, arising in the pelvic soft tissues and perineum. Aggressive angiomyxoma was described by Steper and Rosai first time in 1983. The main treatment method is wide-local excision. There is a high recurrence rate. In this case report, we aimed to present a case of scrotal agresif angiomyxoma in a 32-year-old man with literature. [Cukurova Med J 2014; 39(2.000): 357-361

Total Bilirubin Levels Predict Subclinical Atherosclerosis in Patients With Prediabetes

Vuruskan, Ertan/0000-0001-6820-3582; Durakoglugil, Emre/0000-0001-5268-4262; duman, hakan/0000-0002-1441-7320WOS: 000386036600005PubMed: 26921264Bilirubin may have important antiatherosclerotic effects. Prediabetes (PD), the intermediate stage before diabetes mellitus, is associated with increased cardiovascular morbidity and mortality. We evaluated the relationship between serum bilirubin levels and carotid intima-media thickness (cIMT), as a surrogate marker of subclinical atherosclerosis, in patients with PD. We enrolled 170 consecutive patients with PD. the patients underwent ultrasonography to evaluate cIMT. the patients were divided into groups according to cIMT values (<0.9 vs 0.9 mm). the patients with cIMT 0.9 mm had significantly higher diastolic blood pressure, neutrophil-lymphocyte ratio (NLR), and glycated hemoglobin values compared with patients having cIMT < 0.9 mm, whereas total and direct bilirubin values were significantly lower in this group. Multivariate regression analyses revealed NLR and total bilirubin as the independent predictors of subclinical atherosclerosis. the present study demonstrated that NLR and lower total bilirubin levels were independent predictors of subclinical atherosclerosis in patients with PD. Simple measures such as NRL and total bilirubin may provide predictive information regarding the risk of cardiovascular disease in patients with PD

Determinants of Chronic Total Occlusion in Patients With Peripheral Arterial Occlusive Disease

Vuruskan, Ertan/0000-0001-6820-3582; duman, hakan/0000-0002-1441-7320; Buyuklu, Mutlu/0000-0002-4513-2483WOS: 000391460300009PubMed: 27059289Chronic total occlusion (CTO) is a common finding in 40% of the patients with peripheral arterial disease (PAD). the aim of this study was to investigate the determinants of CTO in patients with PAD. the study included a total of 211 nonanemic patients with PAD. All patients were categorized according to the Fontaine classification. in lower extremity angiography cohorts, CTO- patients were designated as group 1 and CTO+ patients were designated as group 2. Patients with CTO had significantly higher red cell distribution width (RDW), neutrophil-lymphocyte ratio, uric acid, and high-sensitivity C-reactive protein compared to patients without CTO (P .001, P = .036, P .001, and P = .015, respectively). Albumin, total bilirubin, and direct bilirubin were significantly lower in the patients with CTO compared to patients without CTO (P = .023, P .001, and P = .049, respectively). Multivariate logistic regression analysis showed that RDW, uric acid, and total bilirubin were independent predictors of CTO in patients with PAD. We demonstrated that increased RDW and uric acid levels and lower total bilirubin values were independently associated with CTO in patients with PAD