Outcomes of patients with advanced stage ovarian cancer with intestinal metastasis

Objectives: The aim of this study is to evaluate the results of advanced stage (stage IIIB-IVB) ovarian cancer (OC) patients with intestinal metastasis, and to investigate the factors that affect survival. Material and methods: Patients who underwent cytoreductive surgery (CS) for FIGO stage IIIB-IVB OC with metastasis in the intestinal system, at Tepecik Research and Treatment Hospital between 2008–2014, were analyzed retrospectively. Patients with borderline ovarian tumor; those who had previously undergone radiation therapy and/or hysterectomy and patients having secondary or tertiary cytoreduction were excluded and 49 patients were included and analyzed in this study. Hysterectomy, bilateral salpingo-oopherectomy, pelvic and para-aortic lymph node sampling, resection of bulky lymph nodes and omentectomy were performed. Optimal cytoreduction was accepted as that which left residual tumor ≤ one cm maximum size. Results: The risk factors affecting OS interval were investigated according to Cox’ regression analysis. Optimality of the primary CS (P = 0.008 and HR = 5.202) and cancer stage (P = 0.016 and HR = 6.083) were found to be statistically significant factors. Conclusions: Achieving optimal CS is the most important aim for the general surgeon carrying out an intestinal resection procedure. Although resection procedures are superior in providing the desired optimal results when compared to excision surgery, their higher complication rates and subsequent lower quality of life must be taken into consideration when choosing either resection or excision methods; surgical intervention should always be kept to the minimum possible

Isolated pulmonary metastases in patients with cervical cancer and the factors affecting survival after recurrence

Objectives: The aim of this study was to assess the treatment options and survival of uterine cervical cancer (UCC) patients who develop isolated pulmonary metastases (IPM) and to establish risk factors for IPM.Material and Methods: Data from patients diagnosed with UCC between June 1991 and January 2017 at the Gynecological Oncology Department, Tepecik Training and Research Hospital, were investigated. In total, 43 cases with IPM were evaluated retrospectively. Additionally, 172 control patients diagnosed with UCC without recurrence were matched according to the International Federation of Gynecology and Obstetrics (FIGO) 2009 stage when the tumor was diagnosed. They wereselected using a dependent random sampling method.Results: Of the 890 patients with UCC, 43 (4.8%) had IPM. The presence of lymphovascular space invasion (LVSI) anda mid-corpuscular volume (MCV) < 80 fL were statistically significant prognostic factors for IPM development in UCC patientsaccording to univariate regression analyses, and the presence of LVSI, a hemoglobin level < 12 g/dL, and an MCV < 80 fLwere statistically significant according to the multivariate regression analyses. We were unable to assess the role of lymph node status (involvement or reactive) as a prognostic factor in the development of IPM, because only seven patients (16.2%) in the case group underwent lymph node dissection.Conclusions: IPM typically develops within the first 3 years after the diagnosis of UCC, and survival is generally poor. AnMCV < 80 fL and the presence of LVSI are significant risk factors for IPM development

Stage IB1 cervical cancer treated with modified radical or radical hysterectomy: does size determine risk factors?

Objectives: This study was performed to investigate prognostic factors status at smaller tumors in patients with stageIB1 cervical cancer (CC) who underwent modified radical or radical hysterectomy.Matherial and metods: Data from patients diagnosed with CC between January 1995 and January 2017 at the GynecologicalOncology Department, Tepecik Training and Research Hospital and Bakirkoy Dr. Sadi Konuk Training and Research Hospital,Istanbul, Turkey, were investigated. A total of 182 stage IB1 CC cases were evaluated retrospectively.Results: Patients were divided into two groups according to tumor size (< 2 cm and ≥ 2 cm). There were no complicationsassociated with the operation in patients with a tumor size < 2 cm. Among patients with a tumor size ≥ 2 cm, however, 0.9% (n = 1) developed bladder laceration, 0.9% (n = 1) rectum laceration, and 0.9% (n = 1) pulmonary emboli (P = 0.583). The rates of intermediate risk factors (depth of stromal invasion and lymphovascular space invasion) were significantly higher and lymph node involvement significantly more frequent in patients with a tumor size ≥ 2 cm. However, there were no significant differences in parametrial invasion or vaginal margin involvement between the two groups.Conclusions: Intermediate risk factors and lymph node metastasis were significantly less frequent in patients with smalltumors measuring < 2 cm. However, although parametrial involvement and vaginal margin involvement were less common in patients with small tumors compared with large tumors (≥ 2 cm), the differences were not significant

Use Of Geosynthetics On Highway Structures: Examples In Turkey

Tez (Yüksek Lisans) -- İstanbul Teknik Üniversitesi, Fen Bilimleri Enstitüsü, 2011Thesis (M.Sc.) -- İstanbul Technical University, Institute of Science and Technology, 2011Geosentetik malzemeler son yıllarda, bütün dünyada mühendislik uygulamalarında hem faydalı hem de alternatif çözümler sağladıklarından hızla yaygınlaşmaktadır. Tezin ilk bölümlerinde, geosentetik malzemeler genel olarak tanıtılmış ve mekanik, hidrolik, dayanım ve bozulma özelliklerinden bahsedilmiştir. Sonraki bölümlerde geosentetik malzemelerin test yöntemleri ile farklı geosentetik malzemelerin fonksiyonları, kullanım alanları ve üretim yöntemleri ile birlikte ham madde türleri anlatılmıştır. Tezin takibeden diğer bölümlerinde de karayolu yapılarında çeşitli geosentetiklerin farklı kullanım alanları, kullanım amaçları ile sağladığı faydalardan söz edilmiştir. Geosentetiklerin karayolu ulaştırma yapılarında kullanılmasında dikkate alınan tasarım ilkeleri ana hatlarıyla belirtilmiştir. Son yıllarda yaygınlaşmaya başlayan geoköpük (geofoam) malzemesinin karayolu yapılarında kullanım alanları üzerinde durulmuştur. Türkiye’deki bazı ulaştırma yapılarında uygulanan farklı geosentetik malzemelerle meydana getirilen çözümler anlatılmıştır. Karayolu ulaştırma yapılarında kullanılmaları durumunda maliyete etkileri de ayrı bir başlık altında irdelenmiştir. İstanbul Hasdal Kavşağı TEM Geçiş Tüneli Çıkış Portalı’nda yapılan geogrid donatılı istinat duvarı maliyeti ile yerine betonarme istinat duvarı yapılması durumunda oluşacak maliyet analiz edilmiş ve önemli oranda ekonomi sağladığı görülmüştür.Geosynthetic materials are enjoying a widespread use in recent years as they provide both useful and alternative solutions for engineering applications all over the world. In first parts of the thesis, we give an overview of geosynthetic materials, discussing their mechanical, hydraulic, strength and decomposition characteristics. In the following parts, we discuss testing methods used for geosynthetic materials as well as functions, areas of application and production methods of different geosynthetic materials, along with varieties of raw materials. In other parts of the thesis, we discuss different areas of application of various geosynthetics on highway structures, as well as their application purposes and benefits. Principles of design considered while using geosynthetics on highway transportation structures are also outlined. We also discuss geofoam, a material which is getting widespread use in recent years, as regards its application on highway structures. We also shed some light on solutions created by different geosynthetic materials applied in certain transportation structures in Turkey. We discuss, under a separate caption, their potential cost effects when used on highway transportation structures. We analyzed the cost of building a geogrid-supported retaining-wall at Istanbul Hasdal Crossroads TEM Pass-over Tunnel and the cost of bulding a retaining-wall of reinforced concrete, and found out that it provides a significant economy.Yüksek LisansM.Sc

Importance hydropower resources of Turkey

Hydroelectric power has an important role to play in the future and provides considerable benefits to an integrated electric system. Hydropower (HP) provides more than 97% of all electricity generated by renewable sources. The social, economic, and environmental impacts of large hydropower, however, highlight the serious limitations of large hydropower in sustainable energy development. HP is a clean energy source. It prevents the burning of 22 billion gallons of oil or 120 million tons of coal each year. HP does not produce greenhouse gasses or other air pollution. HP leaves behind no waste

Active management of the third stage of labor: A brief overview of key issues

WOS: 000443619200011PubMed ID: 30202630Postpartum hemorrhage is a potentially life-threatening, albeit preventable, condition that persists as a leading cause of maternal death. It occurs mostly during the third stage of labor, and active management of the third stage of labor (AMTSL) can prevent its occurrence. AMTSL is a recommended series of steps, including the provision of uterotonic drugs immediately upon fetal delivery, controlled cord traction, and massage of the uterine fundus, as developed by the World Health Organization. Here, we present current opinion and protocols for AMTSL

Postoperative nomogram for the prediction of disease-free survival in lymph node-negative stage I?IIA cervical cancer patients treated with radical hysterectomy

The purpose of this study was to develop and validate a nomogram for individual prediction of recurrence and disease-free survival (DFS) among lymph node (LN)-negative early-stage (I?IIA) cervical cancer (CC) patients treated with Type B or Type C2 hysterectomy. Data were collected from patients diagnosed with CC between 1995 and 2017 at the Gynecological Oncology Department, Tepecik Training and Research Hospital. A total of 194 cases with stage IA2?IIA CC were evaluated retrospectively. Patients with stage IA2?IIA CC who underwent radical (Type C2) or modified radical (Type B) hysterectomy and pelvic???paraaortic LN dissection with LN negativity were included in the study. The relationships between prognostic factors such as stage, tumour size, parametrial involvement, vaginal cuff margin, endomyometrial infiltration, and lymphovascular space invasion status and DFS were compared using a univariable Cox regression model. When the nomogram was prepared, the scores of the risk factors were collected, and we observed that scores were at least 0 to a maximum of 414 points. The concordance-index for the nomogram was 0.895 (95% confidence interval, 0.79?0.99). The nomogram based on the indicated prognostic factors yielded excellent results in predicting recurrence in early-stage CC patients without LN metastasis who underwent radical hysterectomy.Impact statement What is already known on this subject? Pathology of radical hysterectomy specimens in patients with early-stage cervical cancer provides information that has predictive prognostic potential. In addition to FIGO stage, other important prognostic factors are lymph node status, tumour size, parametrial involvement, vaginal cuff margin status, endomyometrial infiltration, histological type, patient age, lymphovascular space invasion, histological grade, and depth of cervical stromal invasion. What do the results of this study add? In this study, patients with early-stage cervical cancer who underwent radical and modified radical hysterectomy without retroperitoneal lymph node involvement were evaluated, and recurrence development and factors affecting disease-free survival were investigated. A nomogram consisting of factors influencing disease-free survival was constructed. The total score was determined according to the status of all risk factors. This allowed clear definition of the risk for each patient. A nomogram predicting recurrence in patients with stages IA2?IIA cervical cancer with radical hysterectomy without lymph node involvement has not previously been published

Do estrogen, progesterone, P53 and Ki67 receptor ratios determined from curettage materials in endometrioid-type endometrial carcinoma predict lymph node metastasis?

Aim: Estrogen receptor (ER), progesterone receptor (PR), and Ki-67 and P53 receptor levels in endometrial curettage material were investigated for their ability to predict lymph node (LN) involvement in patients with endometrioid-type endometrial cancer (EEC)

Is the measurement of the size of uterine lesions with positron emission tomography consistent in pre- and postmenopausal periods in endometrioid-type endometrial cancer?

Objective: We aimed to investigate the correlation of the size and volume of uterine tumors obtained using positron emission tomography/computed tomography (PET/CT) and pathology specimens in patients with endometrioid-type endometrial cancer (EEC) in the premenopausal period, and to compare the results with those of postmenopausal women. In the premenopausal period, the endometrium uses more glucose than in the postmenopausal period. Therefore, the measurement of uterine tumor size using PET/CT in the premenopausal period may normally be different