Kemik metastazı ile tanı konulmuş metastatik renal hücreli karsinom olgusu

Thirty-fifty percent of patients with renal cell carcinoma will evantuaily develop metastatic disease. In this case report, a male patient who initially presented with bone metastasis was then diagnosed with renal cell carcinoma after cytoreductive nephrectomy, is presented and relevant literature was reviewed. A 69 year old renal cell carcinoma male patient; presentation, diagnosis, relevant tests and management plan is presented. Cytoreductive nephrectomy in conjunction with cytokine therapy in the setting of metastatic disease in renal cell carcinoma may have a role in terms of survival.Renal hücreli karsinomlu hastaların %30-50'sinde zaman içerisinde metastaz ortaya çıkacaktır. Bu olgu sunumunda kemik metastazı ile tanı alan ve sitoredüktif nefrektomi uygulanan renal hücreli karsinom olgusu sunulmuş ve literatür gözden geçirilmiştir. 69 yaşındaki erkek renal hücreli kanser olgusu; kliniği, görüntüleme yöntemleri ve tedavisi ile birlikte sunulmuştur. Metastatik böbrek tümörlerinde radikal nefrektominin sitokin immünoterapisi ile kombinasyonun sağ kalıma olumlu etkisi olabileceği bildirilmekte­dir. Uygun hastalarda akıldan çıkarılmaması gereken bir tedavi modalitesidir

Comparative results of shockwave lithotripsy for renal calculi in upper, middle, and lower calices

WOS: 000250086200001PubMed ID: 17941767Background and Purpose: To assess the results of shockwave lithotripsy (SWL) for renal calculi in upper, middle, and lower calices according to the stone burden. Patient and Methods: A series of 52 female and 66 male patients with a mean age of 47.8 years and isolated single caliceal stones who underwent SWL monotherapy were enrolled. Stone burden, stone location, number of sessions/shockwaves, and auxiliary procedures were noted for each patient. Stones were located in the upper, middle, and lower calices of 35, 43, and 40, patients respectively, with mean stone burdens of 81.4 mm(2), 75.2 mm(2), and 96.3 mm(2), respectively. Patients were evaluated with intravenous urography, plain film, or ultrasonography. Success was determined 3 months after the last session. Re-treatment rates were calculated. The effect of anatomic factors on the success of treatment for lower-caliceal stones also was determined. Results: The mean stone burden, median number of treatment sessions, and mean number of shockwaves were 84.2 mm(2), 2, and 4344, respectively. The auxiliary procedure rate was 16.1%, and the re-treatment rate was 71.2%. Failure was noted in 26 patients (22%). The stone-free rates for stones in the upper, middle, and lower calices were 82.8%, 83.4%, and 67.5%, respectively (P = 0.14). The stone-free rates for stones <100 mm(2) and 100 to 200 mm(2) were 91.2% and 65.5%, respectively (P = 0.001). The efficiency quotient was 49.8, 44.8, and 32.5 for upper-, middle-, and lower-caliceal stones, respectively. Infundibular length (P = 0.006) and infundibular width (P = 0.036) were significant in determining the stone-free rate after treatment of lower-caliceal stones. Conclusions: We recommend SWL as the first choice for treatment of stones <200 mm(2) in the upper and middle calices. Extracorporeal lithotripsy is one of the options for lower-caliceal stones <200 mm(2) but has high re-treatment and auxiliary-procedure rates in these cases

The efficacy of shock wave lithotripsy for renal calculi in upper, middle and lower calices

WOS: 00023990620130

Effect of lisinopril on renal tissue damage in unilateral ureteral obstruction in rats

WOS: 000301778400003PubMed ID: 21667191In this study, it was aimed to investigate apoptosis in renal injury and the effect of lisinopril in rat model, which constitute unilateral ureteral obstruction. The retroperitoneal ureter was ligated with a 4.0 silk for the experimental model of ureteral obstruction in Wistar albino rats. Untreated group (n = 20) received no treatment. For the lisinopril-treated group (n = 20), 20 mg/kg/day of drug was given orally. Ultrastructural differences were analyzed using electron microscopic technique; apoptotic distribution was analyzed using the TUNEL method. After electron microscopic evaluation, on the 4th and 14th day in the untreated group, edema in the glomeruli, loss of microvillus and apoptotic cells in proximal tubule cells and sclerosis in the glomeruli were detected. On the 4th day in the lisinopril-treated group, the kidney was ultrastructurally normal and a less number of apoptotic cells were only observed on the 14th day. On light microscopic examination on the 4th and 14th day in the untreated group, while the glomeruli were normal in structure, the boundary of the proximal tubule was disrupted and some picnotic cells in both the proximal and collecting tubules were observed. In both 4th and 14th day of the lisinopril-treated group, kidney showed normal structure, although in some places picnotic cells in the collecting tubules were observed. In conclusion, lisinopril was effective and it may prevent early renal damage in the direct obstruction model