Ultrasonografia w przewidywaniu rozległości nacieku trofoblastu w obręb ściany jajowodu w ciąży bańkowej

Objective: Predictive factors of damage to the Fallopian tube may guide the treatment for patients with tubal pregnancy. The purpose of this study was to evaluate the predictive value of ultrasonographic findings in patients affected by ampullary pregnancy for the determination of the depth of trophoblastic infiltration into the tubal wall on histological examination. Material and methods: 38 patients with ampullary pregnancy undergoing salpingectomy were enrolled into the study. The patients were divided into two subgroups depending on their transvaginal sonography (TVS) findings; either an ectopic gestational sac containing an embryo with cardiac activity or those with a tubal ring. The ampullary pregnancies were histologically classified according to the depth of infiltration of trophoblastic tissue into the tubal wall as follows: stage I: limited to mucosa; stage II: extension to the muscularis layer; stage III: complete infiltration of the tubal wall with or without rupture of the serosa. The association between findings on TVS and stage of trophoblastic invasion, serum beta-human chorionic gonodatropin (β-hCG) levels was evaluated. Results: Although there was no significant difference among two groups in terms of histological stage of trophoblastic infiltration (p=0.257), patients in whom an embryo with cardiac activity had been identified were found to have higher percentage of stage II (47.8%) or stage III (8.7%) invasion. However, there was a significant difference in serum β-hCG levels on the day of surgery among the two groups (p=0.028). Conclusions: Ultrasonographic aspect of ampullary pregnancy is associated with depth of trophoblastic infiltration into the tubal wall and serum β-hCG levels.Cel: Czynniki predykcyjne zniszczenia jajowodu mogą być pomocne w leczeniu pacjentek z ciążą jajowodową. Celem badania była ocena wartości prognostycznej badania ultrasonograficznego u pacjentek z ciążą bańkową dla określenia rozległości naciekania trofoblastu w obręb ściany jajowodu potwierdzonego w badaniu histopatologicznym. Materiał i metoda: Do badania włączono 38 pacjentek z ciążą bańkową, u których wykonano usunięcie jajowodu. Pacjentki podzielono na dwie podgrupy pod względem różnych obrazów ultrasonograficznych; jeden z widocznym pęcherzykiem ciążowym i z zarodkiem z czynnością serca, drugi z widocznym pierścieniem jajowodowym. Ciąże bańkowe podzielono na podstawie wyniku histopatologicznego, pod względem głębokości nacieku trofoblastu w ścianę jajowodu: stopień I: ograniczone do śluzówki, stopień II: przechodzące na mięśniówkę, stopień III: całkowite nacieczenie ściany jajowodu z /bez pęknięcia surowicówki. Oceniono związek pomiędzy obrazem ultrasonograficznym, stopniem nacieczenia ściany jajowodu oraz poziomem surowiczego beta hCG. Wyniki: Nie znaleziono istotnych różnic pomiędzy badanymi grupami pod względem histologicznie ocenionego nacieku trofoblastu (p=0,257). Jednak kobiety, u których stwierdzano żywy zarodek częściej miały stopień II (47,8%) lub III (8,7%) inwazji trofoblastu. Znaleziono również istotną różnicę poziomu beta-hCG w dniu operacji pomiędzy dwoma grupami (p=0,028). Wnioski: Pewne ultrasonograficzne aspekty ciąży bańkowej są związane z głębokością inwazji trofoblastu w ścianę jajowodu oraz surowiczym beta-hC

Targeting of temozolomide using magnetic nanobeads: an in vitro study

Temozolomide, a chemotherapeutic drug that is often administered for the treatment of brain cancer has severe side effects and a poor aqueous solubility. In order to decrease the detrimental effect of the drug over healthy cells, a novel drug delivery vehicle was developed where the therapeutic drug was encapsulated within the hydrophobic cavities of b-CD modified magnetite nanoparticles, which are embedded in chitosan nanobeads prepared by salt addition. In-vitro studies have shown that the magnetic properties of the novel delivery vehicle are adequate for targeted drug delivery applications under an external magnetic field. Additionally, an increase in the amount of chitosan was shown to exhibit a strong shielding effect over the magnetic properties of the delivery vehicle, which lead to deterioration of the amount of captured drug at the targeted area, suggesting a delicate balance between the amounts of constituents composing the drug delivery vehicle

İntratorasik ekstra abdominal agresif fibromatozis

Fibröz doku kaynaklı tümörler toraksta ve mediastinumda nadir olarak görülmekte ve rapor edilmektedirler. Biz burada, agresif fibromatozisin, toraks içi dokulardan kaynaklanan nadir bir formunu bildirmek istedik. Otuz altı yaşında bayan hasta hastanemize sol göğüs ağrısı ve sıkışma hissi ile başvurdu. Çekilen PA grafi ve toraks bilgisayarlı tomografisinde, sol toraks alt kısmını üçte iki oranında dolduran dev kitle görüldü. Bunun üzerine hastaya sol yedinci interkostal aralıktan yapılan torakotomi ile geniş rezeksiyon uygulandı. Tümör patolojisi 20x15x15 cm çapında agresif fibromatozis olarak geldi. Hasta 15 aydır takip altında ve kontrollerinde yineleme görülmedi.Tumors of fibrous tissue origin (fibromatosis) in chest and mediastinum have been rarely reported in the literature. Herein, we report a rare case of aggressive fibromatosis presenting as an intrathoracic tumor. A 36-year-old woman admitted to our hospital due to a feeling of oppression and pain in the left chest. A chest X-ray, thorax computed tomography revealed a large mass filling two thirds of lower left thorax. Widely surgical resection of the tumor was performed thoracotomy via seventh intercostal space. The tumor was 20x15x15 mm in size and diagnosed pathologically as aggressive fibromatosis. The patient has been well without recurrence for 15 months after surgery

FOXA1 is associated with high tumor grade, myometrial invasion and lymph node invasion in endometrial endometrioid carcinoma

Objectives: FOXA1 expression has been demonstrated in several hormone-dependent cancers. However, data are limited concerning the role of FOXA1 in endometrial cancers. The present study aimed to investigate FOXA1 expression via the microarray technique in benign hyperplasia, endometrial intraepithelial neoplasia, and endometrial endometrioid carcinoma. We also aimed to determine whether there were any associations between FOXA1 expression, tumor grade, myometrial invasion and lymphatic invasion.Material and methods: Paraffin-embedded sections prepared from samples obtained from 114 patients who underwent surgical hysterectomy or curettage were analyzed. Data were retrieved from digitally-stored medical records. Tissue microarrays were prepared from formalin-fixed, paraffin-embedded tissue blocks. Full tumor sections were used for immunohistochemical analysis performed.Results: Carcinomas with nuclear grade 3 had higher FOXA1 values than others, while grade 2 carcinomas also had higher FOXA1 values relative to grade 1 (p < 0.001). FOXA1 values of FIGO stage III carcinomas were significantly higher than others and stage II values were also significantly higher than stage I FOXA1 values (p < 0.001). Patients with myometrial and lymph node invasion had significantly higher FOXA1 values than others (p < 0.001 and p = 0.047, respectively). FOXA1 had 91.30% sensitivity, 63.60% specificity and 77.78% accuracy for predicting the presence of myometrial invasion with a cut-off value of 9.Conclusions: FOXA1 expression is higher in endometrial endometrioid carcinoma compared to benign endometrial hyperplasia or intraepithelial neoplasia. In patients with endometrial endometrioid carcinoma, high FOXA1 expression is associated with high tumor grade, myometrial and lymph node invasion. However, FOXA1 expression is not associated with lymphovascular or cervical invasion

Karaciğer kist hidatik olgularımız

Amaç: Kist hidatik hastalığı halen bölgemiz ve ülkemiz için yaygın bir sağlık sorunu olarak önemini korumaktadır. Bu klinik geriye dönük çalışmada intraperitoneal rüptür nedeniyle acil cerrahi uygulanan dört olgu ile birlikte aynı dönemde tedavi edilen tüm karaciğer kist hidatik olguları incelendi. Hastalar ve Yöntemler: Ocak 2004 ve Haziran 2007 tarihleri arasında kliniğimizde karaciğer kist hidatiği nedeniyle tedavi edilen toplam 44 hastanın (24 kadın, 20 erkek; ort. yaş 47.5; dağılım 16-83) tıbbi kayıtları geriye dönük olarak incelendi. Hastalar yaş, cinsiyet, kistin yerleşim yeri, uygulanan cerrahi yöntem, hastanede kalış süresi, meydana gelen ameliyat öncesi ve sonrası komplikasyonlar ve komplikasyonlara yönelik uygulanan tedavi yöntemleri açısından irdelendi. Bulgular: İntraperitoneal rüptür nedeniyle dört hasta (%9) acil olarak ameliyat edildi. Olguların 15’inde (%34) ameliyat sonrası dönemde kist poşuna safra kaçağı oluştu. Bu hastaların altısında (%40) kaçak herhangi bir müdahaleye gerek kalmadan kapandı, sekizinde (%53) ise 10 günden fazla sürdü ve günlük debi 100 cc’nin üzerinde idi. Bu olgulara endoskopik sfinkterotomi uygulandı. Mortalite oranı %4 (n=2) olarak tespit edildi. Sonuç: Hidatik kist rüptürü karaciğerde kistik kitlesi olan ve intraperitoneal serbest sıvısı bulunan travma hastalarında akılda bulundurulması gereken bir durumdur. Bu hastalarda anaflaktik reaksiyon riski olduğu göz önüne alınarak hızla müdahale edilmelidir. Karaciğer kist hidatik cerrahisi sonrasında safra fistülü gelişen hastalarda endoskopik sfinkterotomi etkin bir tedavi yöntemidir

Postmastectomy irradiation in breast in breast cancer patients with T1-2 and 1-3 positive axillary lymph nodes: Is there a role for radiation therapy?

<p>Abstract</p> <p>Background</p> <p>We aimed to evaluate retrospectively the correlation of loco-regional relapse (LRR) rate, distant metastasis (DM) rate, disease free survival (DFS) and overall survival (OS) in a group of breast cancer (BC) patients who are at intermediate risk for LRR (T1-2 tumor and 1-3 positive axillary nodes) treated with or without postmastectomy radiotherapy (PMRT) following modified radical mastectomy (MRM).</p> <p>Methods</p> <p>Ninety patients, with T1-T2 tumor, and 1-3 positive nodes who had undergone MRM received adjuvant systemic therapy with (n = 66) or without (n = 24) PMRT. Patient-related characteristics (age, menopausal status, pathological stage/tumor size, tumor location, histology, estrogen/progesterone receptor status, histological grade, nuclear grade, extracapsular extension, lymphatic, vascular and perineural invasion and ratio of involved nodes/dissected nodes) and treatment-related factors (PMRT, chemotherapy and hormonal therapy) were evaluated in terms of LRR and DM rate. The 5-year Kaplan-Meier DFS and OS rates were analysed.</p> <p>Results</p> <p>Differences between RT and no-RT groups were statistically significant for all comparisons in favor of RT group except OS: LRR rate (3%vs 17%, p = 0.038), DM rate (12% vs 42%, p = 0.004), 5 year DFS (82.4% vs 52.4%, p = 0.034), 5 year OS (90,2% vs 61,9%, p = 0.087). In multivariate analysis DM and lymphatic invasion were independent poor prognostic factors for OS.</p> <p>Conclusion</p> <p>PMRT for T1-2, N1-3 positive BC patients has to be reconsidered according to the prognostic factors and the decision has to be made individually with the consideration of long-term morbidity and with the patient approval.</p

Analysis of Serum Cytokine Levels in Larynx Squamous Cell Carcinoma and Dysplasia Patients

ABSTRACT Background: Although the imbalance of cytokines in Head and Neck Squamous Cell Carcinoma (HNSCC) is well known, there is scarce data regarding its occurrence during dysplasia, before the malignant transformation. Objective: To determine whether laryngeal dysplasia patients show a different cytokine profile than patients with cancer and healthy controls. Methods: Seventeen newly diagnosed, untreated larynx squamous cell carcinoma (SCC) and six laryngeal dysplasia patients as well as 22 healthy controls were analyzed for circulating cytokines. A flowcytometry Th1/Th2 cytokine array kit was used to quantitatively measure Interleukin-2 (IL-2), IL-4, IL-6, IL-10, Tumor Necrosis Factor-α (TNF-α) and Interferon-γ (IFN-γ) levels. Additionally, IL-8 levels were determined through ELISA. Results: IL-6, IL-8 and IL-10 were determined to be statistically increased in SCC patients (p&lt;0.05). IL-8 and IL-10 levels were also higher in SCC patients than dysplasia patients (p&lt;0.05). Additionally, IL-6 and IL-10 were all found to be markedly increased in dysplasia patients compared with controls (p&lt;0.05). Conclusion: Our results demonstrate an imbalance of IL-6 and IL-10 not only in HNSCC but also in laryngeal dysplasia

Safety and efficacy of Amplatzer duct occluder II and konar-MF™ VSD occluder in the closure of perimembranous ventricular septal defects in children weighing less than 10 kg

IntroductionDevice closure of perimembranous ventricular septal defects (pmVSD) is a successful off-label treatment alternative. We aim to report and compare the outcomes of pmVSD closure in children weighing less than 10 kg using Amplatzer Duct Occluder II (ADOII) and Konar-MF VSD Occluder (MFO) devices.MethodsRetrospective clinical data review of 52 children with hemodynamically significant pmVSD, and sent for transcatheter closure using ADOII and MFO, between January 2018 and January 2023. Baseline, procedural, and follow-up data were compared according to the implanted deviceResultsADOII devices were implanted in 22 children with a median age of 11 months (IQR, 4.1–14.7) and weight of 7.4 kg (IQR, 2.7–9.7). MFO devices were implanted in 30 children with a median age of 11 months (IQR, 4.8–16.6) and weight of 8 kg (IQR, 4.1–9.6). ADOII were implanted (retrograde, 68.1%) in defects with a median left ventricular diameter of 4.6 mm (IQR, 3.8–5.7) and right ventricular diameter of 3.5 mm (IQR, 3.1–4.9) while MFO were implanted (antegrade, 63.3%) in defects with a median left ventricular diameter of 7 mm (IQR, 5.2–11.3) (p &gt; 0.05) and right ventricular diameter of 5 mm (IQR, 2.0, 3.5–6.2) (p &lt; 0.05). The procedural and fluoroscopy times were shorter with the MFO device (p &lt; 0.05). On a median follow-up of 41.2 months (IQR, 19.7–49.3), valvular insufficiency was not observed. One 13-month-old child (6.3 kg) with ADOII developed a complete atrioventricular heart block (CAVB) six months postoperative and required pacemaker implantation. One 11-month-old child (5.9 kg) with MFO developed a CAVB 3 days postoperative and the device was removed. At 6 months post-procedure, only one child with MFO still experiences a minor residual shunt. There was one arterio-venous fistula that resolved spontaneously.ConclusionBoth the MFO and ADOII are effective closure devices in appropriately selected pmVSDs. CAVB can occur with both devices. The MFO is inherently advantageous for defects larger than 6 mm and subaortic rims smaller than 3 mm. In the literature, our series represents the first study comparing the mid-term outcomes of MFO and ADOII devices in children weighing less than 10 kg

The effect of students academic success, attitude and motivation on the utilization of learning management system in information technologies and software course

Yüksek Lisans TeziBu araştırmanın amacı bir öğretim- yönetim sistemi uygulaması olan Eğitim Bilişim Ağı (EBA) ders ortamının e- öğrenmeye yönelik tutuma, bilişim teknolojileri ve yazılım dersi eğitimine yönelik başarı ve öğrenci güdülenmesine etkisini belirlemektir. Araştırmada nicel; " Ön test- Son Test Kontrol Gruplu Yarı Deneysel Desen" , " Tek grup Ön test – Son Test Zayıf Deneysel Desen" ve nitel içerik analizi yöntemi kullanılmıştır. Deney, 2018- 2019 eğitim- öğretim yılında Konya Merkez Atatürk Ortaokulu 6. sınıfta öğrenim görmekte olan 47' si deney, 38' i kontrol grubu olmak üzere toplam 85 öğrenciyle yürütülerek deney ve kontrol gruplarına ön test ve son test uygulanmıştır. Veriler eşlenerek bağımsız t testiyle analiz edilmiştir. Nitel verilerin analiziyle kategoriler, temalar ve alt temalar oluşturulmuş, verilen yanıtlar sayısallaştırılarak alt problemlerden elde edilen verilere göre öğrencilerin doğrudan cevaplarına yer verilmiştir. Araştırma sonucunda akademik başarı yönünden deney grubu öğrencilerinin daha başarılı oldukları sonucuna ulaşılmıştır. Ayrıca yapılan akademik güdülenme ölçeği son test puanlarına göre anlamlı düzeyde farklılık göstermiştir. Deney grubu öğrencilerinin e- öğrenmeye yönelik tutumları bağımlı gruplar t testiyle analiz edildiğinde istatistiksel olarak anlamlılık düzeyinde farklılık bulunmamaktadır. Deney grubu öğrencilerinin EBA ders platformuna yönelik görüşleri analiz edildiğinde öğrenciler içeriklerin ilgi ve motivasyonu artırdığını, kalıcı öğrenmeler sağladığını, her zaman her yerde öğrenme imkânı sunduğunu; pekiştirme ve kavrama etkinliklerinin olduğunu ancak teknik olarak bazı sıkıntıların ve mobil girişte sorunların olduğunu, erişime yönelik alt yapıda ve yüz yüze iletişimde problemler olduğunu; anında dönütlerin yetersiz ve sosyalleşme imkânının az olduğunu belirtmişlerdir. Analizler sonucu ortaya çıkan bulgular, öğretim yönetim sistemleri ile derslerin daha iyi yapılandırılmasına öneri niteliğindedir.The aim of this study is to determine the effect of Education Information Network (EIN) course environment, which is a teaching-management system application, on the attitude towards e-learning, the success oriented to information technologies and software lesson education and the motivation of students. In the study, quantitative "Semi Experimental Pattern with Pretest - Final Test Control Group", "Single Group Pre-test - Final Test Poor Experimental Pattern" and qualitative content analysis methods were used. The experiment was carried out with a total of 85 students, 47 of them being experimental and 38 of them being control group, who are the students of Class 6 of Konya-Center Atatürk Secondary School in the 2018-2019 academic year and pre-test and post-test were applied to the experimental and control groups. Data were analyzed by independent t test by pairing. With the analysis of the qualitative data, categories, themes and sub-themes were created, and the responses were digitized and the direct answers of the students were included according to the data obtained from the sub-problems. As a result of the study, it was concluded that experimental group students were more successful in terms of academic achievement. In addition, the academic motivation scale differed significantly according to the final test scores. When experimental group students' attitudes towards e-learning were analyzed with dependent group t test, there was no significant difference in statistical significance level. When the experimental group students' opinions about the EIN course platform were analyzed, the students stated that the contents increased interest and motivation, provided permanent learning, offered learning opportunities anywhere at all times, had enhancement and comprehension activities, but there were some technical problems and mobile access problems and there are problems in face-to-face communication, insufficient feedback and low socialization. The findings come out as the result of analyzes are at the quality of a recommendation for better structuring of the courses with the teaching management systems