Giant cell tumor-like lesion of the urinary bladder: a report of two cases and literature review; giant cell tumor or undifferentiated carcinoma?

<p>Summary</p> <p>Giant cell tumor, excluding its prototype in bone, is usually a benign but local aggressive neoplasm originating from tendon sheath or soft tissue. Malignant behavior is uncommon. Visceral organ involvement including urinary bladder is rare. Giant cell tumors in visceral organs usually accompany epithelial tumors and the clinical behavior of giant cell tumor in urinary bladder is similar to its bone counterpart. Here, we report two cases of giant cell tumor located in urinary bladder in comparison with nine reported cases in the English literature. Concurrent noninvasive urothelial carcinoma was also described in all these previous reports and only one patient with follow-up died of disease. One of the two cases we present had no concurrent urothelial tumor at the time of diagnosis but had a history of a low grade noninvasive urothelial carcinoma with three recurrences. The histology of these two cases was similar to the giant cell tumor of bone and composed of oval to spindle mononuclear cells with evenly spaced osteoclast-like giant cells. Immunohistochemically, the giant cells showed staining with osteoclastic markers including CD68, TRAP, and LCA. Immunohistochemical expression of vimentin, CD68, LCA, and smooth muscle actin in mononuclear cells supported a mesenchymal origin with histiocytic lineage. The histologic and immunohistochemical properties in our cases as well as their clinical courses were consistent with a giant cell tumor. Consequently, tumors in urinary bladder showing features of giant cell tumor of bone may also be considered and termed "giant cell tumor".</p

An Inlet Patch Case with Difficulty Swallowing

Heterotopic Gastric Mucosa (inlet patch) is a clinical entity, described firstly by Schmit as a congenital anomaly, char-acterized by settling of gastric mucosa in any part of the gastrointestinal mucosa. It causes various clinical symp-toms due to acid secretion. Our case is oberved rarelly in case of inlet patch

Outcomes of high-risk breast lesions diagnosed using image-guided core needle biopsy: results from a multicenter retrospective study

PURPOSEThe clinical management of high-risk lesions using image-guided biopsy is challenging. This study aimed to evaluate the rates at which such lesions were upgraded to malignancy and identify possible predictive factors for upgrading high-risk lesions.METHODSThis retrospective multicenter analysis included 1.343 patients diagnosed with high-risk lesions using an image-guided core needle or vacuum-assisted biopsy (VAB). Only patients managed using an excisional biopsy or with at least one year of documented radiological follow-up were included. For each, the Breast Imaging Reporting and Data System (BI-RADS) category, number of samples, needle thickness, and lesion size were correlated with malignancy upgrade rates in different histologic subtypes. Pearson’s chi-squared test, the Fisher–Freeman–Halton test, and Fisher’s exact test were used for the statistical analyses.RESULTSThe overall upgrade rate was 20.6%, with the highest rates in the subtypes of intraductal papilloma (IP) with atypia (44.7%; 55/123), followed by atypical ductal hyperplasia (ADH) (38.4%; 144/375), lobular neoplasia (LN) (12.7%; 7/55), papilloma without atypia (9.4%; 58/611), flat epithelial atypia (FEA) (8.7%; 10/114), and radial scars (RSs) (4.6%; 3/65). There was a significant relationship between the upgrade rate and BI-RADS category, number of samples, and lesion size Lesion size was the most predictive factor for an upgrade in all subtypes.CONCLUSIONADH and atypical IP showed considerable upgrade rates to malignancy, requiring surgical excision. The LN, IP without atypia, pure FEA, and RS subtypes showed lower malignancy rates when the BI-RADS category was lower and in smaller lesions that had been adequately sampled using VAB. After being discussed in a multidisciplinary meeting, these cases could be managed with follow-up instead of excision

Investigating the effect of the concentration of Fluoride on the reproduction of S. Mutans

The bacterium S. Mutans is known as the bacterium which is one of the reasons of the cavities in humans mouth. It basically combines with sugar and this makes the bacterium to adhere onto the teeth and after this the cavities begin to occur. To prevent the cavities, there is a substance called fluoride. Almost every toothpaste includes this substance and it fights against the S. Mutans by combining the inhibitor part to the bacterium. Some experiments have been done showing the effect of the concentration of the fluoride on S. Mutans. However there isn’t enough experiment which shows the exact effect of the concentration of the fluoride on the reproduction of S. Mutans. As a result the research question of this study is; how does the amount of fluoride effect the reproduction of S. Mutans on the teeth surface? Throughout the experiment it was found that when the concentration of the fluoride was increased the concentration of the bacteria was decreased. The greatest concentration of the bacteria was observed when there is no fluoride concentration in petri dishes, it was 0,527 od±0,005. In addition to that the lowest concentration of S. Mutans was observed when the fluoride concentration was the greatest (2000±0,5 ppm), the mean concentration of the bacteria was 0,173 od±0,005 which is the lowest concentration in the experiment. In addition to that a decrease was observed in the concentration of the bacteria when the fluoride concentration was increased, which shows the experiment is suitable with the hypothesis. On the other hand the results of the annova test also shows that the experiment is meaningfull with a p value which is smaller that 0.05. The result of the experiment shows that the fluoride has an effect on the reproduction of the bacteria and the regression in the decrease of the bacteria is directly proportional with the concentration of the fluoride

Obstetrik hastalarda bölgesel anestezi tercihini etkileyen faktörler: Anket çalışması

Objective: Most patients in Turkey still prefer general anaesthesia (GA) and are somehow afraid of regional blocks. Receiving adequate information is likely to increase patients' awareness about regional anaesthesia (RA). We aimed to determine the current preferences of parturients, the reasons for refusal of RA techniques, and how detailed information about the type of anaesthesia affect a patient's preference for anaesthesia among obstetric cases. Methods: One hundred fifty patients, scheduled for elective caesarean section (C/S), were surveyed before and after the C/S. The survey included three parts: the first part involved demographic features, anaesthesia preferences, prior opinions and experiences related to RA, and assessment of preoperative fears and reasons, and the second part involved persuasion of patients after reading the information sheet about RA. The final part was composed of postoperative satisfaction and complications related to the RA or GA depending on the patients' preferences. Complications were recorded on the anaesthesia chart. Results: Of all patients, 42.7% (n=64) approved and 48% (n=72) refused RA at the first preoperative anaesthesia visit. The remaining patients (n=14) had no idea of which anaesthesia type to choose. After being informed about RA in detail, 48 (66.6%) of the patients who previously refused RA and all patients who had no idea approved the procedure, and all of them were satisfied with the anaesthesia following the procedure. Conclusion: Our study revealed exactly that particularly obstetric anaesthetists should inform their patients about the advantages and disadvantages of all alternative types of anaesthesia. Effective and correct information is the major point.Amaç: Obstetrik hastalarda herhangi bir kontrendikasyonu yoksa, bölgesel anestezi ilk tercih edilmesi gereken ve en güveniliryöntemdir. Bu anket çalışmamızda obstetrik hastalarda bölgeselanesteziyi reddetme nedenlerini, iyi bir bilgilendirme sonrasındakigörüş değişikliklerini ve ameliyat sonrasındaki memnuniyet düzeylerini ölçmeyi amaçladık.Yöntemler: Etik kurul onayıyla preoperatif değerlendirme sırasında anestezi polikliniğine gelen gebelerden iki aşamalı bir anketformu doldurmaları istendi. Anketin ilk bölümünde anestezi tercihleri ve bölgesel anesteziyi reddetme nedenleri sorgulandıktansonra hastalara standart bir bilgilendirme broşürü okutuldu. Bilgilendirme sonrası anketin ikinci aşamasına geçilerek seçim değişiklikleri ve nedenleri sorgulandı. Girişim sonrasında tüm hastalarınanestezi seçimleriyle ilgili memnuniyetleri ve komplikasyonlarkaydedildi.Bulgular: Doğum öncesi anestezi polikliniğinde değerlendirilen150 ASA I veya II gebe verilen anket formunu doldurdu. Altmışdört gebe (%42,7) herhangi bir ön bilgilendirme yapmadan bölgesel anesteziyi tercih etti. Yetmiş iki gebe (%48) bölgesel anesteziyi reddetti. Bu gebelerin 16’sı (%11,1) daha önceki bölgeselanestezi deneyimlerinde yaşadıkları komplikasyonları neden olarak gösterdiler. Tüm gebeler standart bilgilendirilmeye tabi tutulduktan sonra 48 (%66,6) gebe bölgesel anesteziyi kabul etti ve buhastaların tamamının ameliyat sonrası memnuniyet değerlendirmesi ‘çok iyi’ şeklindeydi.Sonuç: Bu anket çalışması; etkin ve doğru bir bilgilendirmeylehastaların yöntem seçimlerini değiştirebileceklerini göstermiştir.Sonuçta hastaların ameliyat öncesi anestezistler tarafından bilgilendirmesinin önemi bir kez daha ortaya çıkmıştır

A viable childbirth after correction of spontaneous uterine dehiscence

We report a case of uterine dehiscence during pregnancy. Uterine dehiscence and rupture are serious complications of pregnancy. This situation takes place especially in women that prior uterine operation(s). We represent a 30-year-old woman diagnosed uterine dehiscence at 22nd gestation week. Uterine dehiscence treated surgically and then medical treatment was given to prevent preterm labour. At 34th gestation week, the patient was operated because of preterm labour and an alive foetus was born. The result of the pathologic examination of the placenta: Placental adhesion failure was detected. In conclusion women with prior caesarean delivery (one or more), ultrasound measurement should be recommended for measuring the lower uterine segment thickness in order to predict the possibility of uterine dehiscence and rupture

Examining 12-14 Age Secondary School Students’ Tendency to Violence doing Active Sport or not

The aim of this study was to investigate secondary school students’ tendency to violence, doing active sport or not. The sampling group of the study was consisted of 101 girls and 99 boys in the total 200 secondary school students in Kütahya city center of whose ages differs between of 12-14. In the study tendency to violence scale, developed by Göka and colleagues, was used as data gathering tool. In the evaluation of the data SPSS package program for Windows was used and after reliability of the scale was assessed One Sample Kolmogorov-Smirnov test was applied for if the obtained data was showing normal distribution and also as hypotheses tests Independent Samples t Test was applied for pairwise comparisons and One Way ANOVA test was applied for triple or more comparisons. As a result of the study there were no significant differences between students’ tendency to violence according to their ages and sport participation situations, on the other hand there were significant differences according to their class and perceived success in class. This study showed that class and perceived success in class are predictors of tendency to violence