Histološka i imunohistokemijska svojstva metastatskog karcinosarkoma mliječne žlijezde u kuje - prikaz slučaja

A carcinosarcoma is a tumor composed of cells morphologically resembling both malignant epithelial and mesenchymal components. An 11-year-old, female, mixed-breed terrier was referred to the clinic with complaints of anorexia, vomiting and exercise intolerance. Clinically, tumoral masses were seen in the mammary glands. During necropsy, multilobulated calcified masses were observed in several visceral organs (the liver, kidneys, lungs, small intestines, lymph nodes and thyroid) and both right and left (3rd and 4th) mammary glands. Immunohistochemically, Thyroglobulin, SMA, TTF-1, S100, CD34, and p53 were negative in both epithelial and mesenchymal areas, however, Ki-67 showed high proliferation, especially in the mesenchymal areas. While the positivity of vimentin expression was high in the mesenchymal component of the tumor, the positivity of cytokeratin (CK7 and CK19) expressions was high in the epithelial component of the tumor. In the case of a carcinosarcoma, there is a probability that not only the carcinomatous part, but also the sarcomatous part will metastasize. Despite being uncommon, canine carcinosarcomas should always be considered in the differential diagnosis of mixed mammary tumors, if they include both components. There have not been many previous studies dealing with the metastasis of a mammary carcinosarcoma in dogs as an aggressive tumor. Therefore, we consider this report a worthy contribution and have defined the multiple organ metastasis of a mammary carcinosarcoma.Karcinosarkom je tumor sastavljen od stanica koje morfološki nalikuju i na maligne epitelne i na mezenhimne komponente. Ženka stara 11 godina, mješanka u tipu terijera, primljena je na pregled zbog anoreksije, povraćanja i nepodnošenja tjelesnog napora. Klinički, uočena je tumorska masa u mliječnim žlijezdama. Pri obdukciji su uočene multilobulirane kalcificirane tvrobe u nekoliko visceralnih organa (jetra, bubreg, pluća, tanko crijevo, limfni čvorovi, štitnjača) te u desnoj i lijevoj (trećoj i četvrtoj) mliječnoj žlijezdi. Imunohistokemijski su tireoglobulin, SMA, TTF-1, S100, CD34 i p53 bili negativni i u epitelnim i mezenhimnim tkivima, međutim Ki-67 pokazao je visoku proliferaciju, osobito u mezenhimnom području. Dok je pozitivnost ekspresije vimentina bila visoka u mezenhimnoj komponenti tumora, pozitivnost ekspresije citokeratina (CK7 i CK19) bila je visoka u epitelnoj komponenti tumora. U slučaju karcinosarkoma moguće je da ne metastaziraju samo karcinomatozni dijelovi nego također i sarkomatozni. Premda je neuobičajen, pseći karcinosarkom trebalo bi uzeti u obzir kao diferencijalnu dijagnozu kod miješanih tumora mliječne žlijezde, ako sadržavaju obje komponente. U dosadašnjim istraživanjima nema mnogo radova o metastazama karcinosarkoma mliječne žlijezde kuja, posebno u slučajevima gdje je to agresivan tumor. Stoga smatramo da je ovaj prikaz slučaja vrijedan doprinos kojim su utvrđene višestruke metastaze karcinosarkoma mliječne žlijezde na različitim organima

Evaluation of vision development attitude in health care services management

14.07.2018 tarihine kadar kullanımı yazar tarafından kısıtlanmıştır.İstanbul Bilim Üniversitesi, Sağlık Bilimleri Enstitüsü, Hemşirelik Yüksek Lisans ProgramıBu araştırma sağlık bakım hizmetleri yöneticilerinin vizyon geliştirme tutumlarını değerlendirmek amacıyla tanımlayıcı olarak planlanmıştır. Araştırmanın evrenini, İstanbul İli Avrupa Yakasında bulunan beş ayrı özel hastanede çalışan yönetici hemşireler alınmış, örneklem grubunu araştırmaya katılmayı kabul eden 67 servis sorumlu hemşiresi oluşturmuştur. Veriler araştırmacı tarafından literatür doğrultusunda hazırlanan ‘Tanıtıcı Bilgi Formu’ ve ‘Vizyon Geliştirme Tutum Ölçeği’ kullanılarak toplandı. Vizyon Geliştirme alt boyutlarında ‘Yaratıcılık ve Gelişmeye İnanç’ Faktöründe iç tutarlılık (Cronbach Alpha:0,800) yüksekti. ‘Hedeflere Ulaşma İnancı ve Kararlılığı’ Faktörü sorularında iç tutarlılık (Cronbach Alpha:0,587) yüksekti. Etme ve Yön Gösterme’ Faktörü sorularında iç tutarlılık (Cronbach Alpha: 0,781) yüksekti. Verilerin analizinde SPSS 22.0 programı kullanılmıştır. Verilerin tanımlayıcı istatistiksel değerlendirilmelerinde ortalama, standart sapma, oran ve frekans değerleri kullanılmıştır. Değişkenlerin dağılımı Kolmogorov Simirnov testi ile kontrol edildi. Niteliksel verilerin analizinde Kruskal-Wallis, Mann-Whitney U test kullanıldı. Faktörlerin iç tutarlılığı Cronbach Alpha değeri ile ölçüldü. Korelasyon analizinde Spearman korelasyon analizi kullanıldı. Araştırma sonucunda; servis sorumlu hemşirelerinin vizyon geliştirme tutum ölçeğinden ortalama ort±ss.:51,42±5,26 puan aldığı bulundu. Yöneticilerin yönetim eğitimi alanların vizyon geliştirme tutumu ve alt boyutları yönetim eğitimi almayanlara göre anlamlı olarak daha yüksekti. Toplam kalite yönetimi veya stratejik planlama konularında görev alanların ‘Öncülük Etme ve Yön Gösterme’ puanı görev almayanlara göre anlamlı olarak yüksek bulundu. Herhangi bir sağlık kurumunun kuruluşunda veya organizasyonunda görev alanların ‘Vizyon Geliştirme Tutum’ puanı, 'Öncülük Etme ve Yön Gösterme’, ‘Hedeflere Ulaşma İnancı ve Kararlılığı’ alt faktör puanları, görev almayanlara göre anlamlı olarak daha yüksek bulundu. Çalışma sonuçlarına göre yönetici hemşirelerin yönetim konularındaki eğitim ihtiyaçlarının belirlenmesi ve periyodik eğitim programlarının oluşturulması önerilmiştir.This study has been designed as a descriptive study with an eye to evaluate the vision development attitudes of health care services managers. The population of the research consisted of manager nurses working in five separate private hospitals in the European Side of Istanbul province while the sample group consisted of 67 nurses in charge of service who agreed to participate in the study. Data was collected by using the “Introductory Information Form” and “Vision Development Attitude Scale” prepared by the researcher in accordance with literature. Internal consistency in “Faith in Creativity and Development” factor in sub-dimensions of Vision Development) was higher (Cronbach's alpha: 0,800). Internal consistency was higher in “Faith and Determination in Achieving Targets” factor questions (Cronbach's alpha: 0.587). Internal consistency was higher in “Leading and Guiding” factor questions (Cronbach's alpha: 0.781) were higher. SPSS 22.0 program was used to analyze the data. Average, standard deviation, rate and frequency values were used in descriptive statistics of the data. Distribution of variables was checked by Kolmogorov–Smirnov test. Kruskal-Wallis Test and Mann-Whitney U test were employed in the analysis of qualitative data. Internal consistencies of the factors were measured by Cronbach's alpha value. Spearman correlation was used in correlation analysis. As a result of the study it was found that the nurses in charge of services received avr.±ss.:51,42±5,26 points from vision development attitude scale in average. Vision development attitude and sub-dimensions of managers who received management training were found significantly higher than those who did not receive management training. “Leading and Guiding” scores of those working in total quality management or strategic planning were found significantly higher than those who did not work in total quality management or strategic planning. “Vision Development Attitude” scores, “Leading and Guiding” and “Faith and Determination in Achieving Targets” sub-factor scores of those working in any health institution, establishment or organization were found significantly higher than those who did not work in any health institution, establishment or organization. Determination of the educational needs of nurse managers on management issues according to the results of the study and the creation of periodic training programs have been proposed

Primary leiomyosarcoma in left ventricle: A rare case presenataion Sol ventrikül yerleşimli primer leiomyosarkom: Nadir bir olgunun sunumu

Primary cardiac leiomyosarcoma is one of the rare primary malign cardiac tumors and it has a poor prognosis. In this report we present a case who had an operation for left ventricle leiomyosarcoma and a review of literature and principles of treatment

Knowledge of medical doctors in Turkey about the relationship between periodontal disease and systemic health

Understanding the relationship between periodontal disease (PD) and systemic health (SH) is necessary for the accurate diagnosis and treatment of both. The aim of this study was to evaluate the knowledge of medical doctors in Turkey with regard to the association between PD and SH. This study was carried out using self-reported questionnaires that were sent to medical doctors who work at various universities and public and private hospitals in different cities in Turkey. The questionnaires consisted of questions about the demographic information of the medical doctors, as well as the knowledge of those doctors about the relationship between PD and SH. In total, 1,766 responses were received and 90.8% of the participants agreed that there was a relationship between PD and SH. Diabetes mellitus was the most frequent systemic disease (66.8%) known to be related to PD. Of the participants, 56.5% of the medical doctors referred their patients to periodontists for different reasons. Gingival bleeding was the most frequent reason for patient referrals, with 44% of doctors giving such referrals. Doctors who worked in basic medical sciences were significantly less aware of the relationship between PD and SH than the doctors in other specialties. Although the vast majority of the medical doctors reported that they knew the relationship between PD and SH, the findings of this study showed that this awareness was not supported by precise knowledge, and often failed to translate into appropriate clinical practice

Effects of Ozone Therapy on the Early Healing Period of Deepithelialized Gingival Grafts: A Randomized Placebo-Controlled Clinical Trial

Background: This study evaluates the effects of ozone therapy (OT) on the early healing period of deepithelialized gingival grafts (DGG) placed for non-root coverage gingival augmentation by laser Doppler flowmetry (LDF)

Meckel Gruber Syndrome: Correlation Between Prenatal Diagnosis and Autopsy Findings

OBJECTIVE: To analyze prenatal sonographic anomalies detected in fetuses with Meckel Gruber syndrome (MGS), and to correlate these anomalies with autopsy findings. STUDY DESIGN: In a 4-year long prospective study, ultrasound findings were compared with fetal autopsy findings in eight fetuses with MGS out of 107 second-trimester termination of pregnancy (TOP) cases due to fetal malformation diagnosed by second trimester-ultrasound examination at a tertiary referral center. RESULTS: Eight prenatally diagnosed fetuses with MGS were analyzed. Seven cases had classical clinic triad. One case had only polycystic kidneys and polydactyly. Fetal autopsy confirmed all prenatally diagnosed findings associated with MGS; fetal examination added polydactyly in two prenatally undiagnosed cases. Hepatic lesions were found in four cases which were determined during the histologic examination. CONCLUSION: Ultrasonographic findings of MGS allow for diagnosis of the most cases. However autopsy may be valuable for confirmation of the diagnosis and to evaluate the recurrence risk in future pregnancies

A comparative study on the some haematological parameters of Sakız, Karayaka and crosbred of Sakız X Karayaka G1 sheep

Bu araştırma, Sakız erkek ve Karayaka dişi ile Sakız X Karayaka melezi erkek ve dişi G1 koyunlarının hematolojik değerlerini karşılaştırmak amacı ile yapılmıştır. Çalışmada, ergin ve sağlıklı 7 Sakız erkek, 9 Karayaka dişi ile 15'i dişi ve 7'si erkek olan 22 Sakız X Karayaka melezi G1 koyunlardan alınan toplam 38 kan örneğinde alyuvar (RBC) ve akyuvar (WBC) sayısı, hemoglobin miktarı (Hb) ve hematokrit (Htc) değer, sedimentasyon hızı ile nötrofil, lenfosit, eozinofil, monosit ve bazofil yüzde oranları incelenmiştir. Ayrıca ortalama alyuvar hacmi (OAH), ortalama alyuvar hemoglobini (OAHb) ve ortalama alyuvar hemoglobin derişimleri (OAHbD) de hesaplanmıştır. Bu araştırma ile Sakız ve Karayaka koyunları ile Sakız X Karayaka melezi G1'lere ait kan değerleri belirlenerek, melezlerin kimi kan değerlerinin yerli koyun ırklarında daha önce elde edilmiş değerlerden farklı olduğu gözlemlenmiştir. Ayrıca melezlere ait kan değerlerinin, genotiplerinin yaklaşık %75'ini aldıkları erkek Sakız koyunlarına daha çok benzerlik gösterdiği tespit edilmiştir.This study was conducted to compare the haematological parameters of Sakız male and Karayaka female with crossbred of Sakız X Karayaka male and female sheep. In the present study, 38 healthy sheep (7 male Sakız, 9 female Karayaka, and 15 female and 7 male crossbred sheep) were used. Blood samples obtained from the animals were analysed for erythrocyte (RBC) and leucocyte (WBC) numbers, haemoglobin concentrations (Hb), haematocrit values (PCV), sedimentation rates and percentages of lymphocytes, neutrophyls, monocytes, eosinophyls and basophyls. Mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH) and mean corpuscular haemoglobin concentration (MCHC) were also calculated. As a result, in order to establishing normal haematological values of Sakız, Karayaka and crossbred of Sakız X Karayaka sheep, present results also indicate that some of blood parameters of crossbred sheep were different from the some Turkish sheep breeds. Haematological parameters of crossbreed sheep were most likely similar to Sakız sheep from which 75% of genotype of crossbreed sheep were earn

Masseter muscle thickness and elasticity in periodontitis

This study aimed to compare the thickness and elasticity of the masseter muscle between patients with gingivitis and patients with periodontitis. A total of 124 patients (63 gingivitis, 61 chronic periodontitis) were recruited at the start of the study, but only 84 patients were declared as final participants. Patients were divided into two groups: (1) patients suffering from gingivitis and (2) those with generalized chronic periodontitis. Clinical (PI, plaque index; GI, gingival index; PD, probing depth; CAL, clinical attachment loss; and BOP, bleeding on probing scores) and ultrasonographic (thickness and elasticity of the masseter muscle) measurements of periodontitis were performed. There were no significant differences in gender, age, body mass index, education status, income level, or marital status between the two groups (P > 0.05). The mean age +/- SD for the gingivitis and periodontitis groups was 39.5 +/- 10.8 years and 44.8 +/- 8.8 years, respectively. There were significant differences between the two groups in the number of PI, GI, PD, CAL, and BOP scores. There were significant differences between the two groups when thickness of masseter during contraction and at rest was taken into account. The gingivitis group had significantly thicker masseter during both contraction and rest. On the other hand, when the elasticity of the masseter was evaluated, there were no significant differences found between the two groups and two sides for each group. Masseter muscle thickness in the periodontitis group was found to be decreased compared with that in the gingivitis group. Furthermore, loss of periodontal tissues due to periodontitis reduces the masticatory ability