The preoperative serum CA125 can predict the lymph node metastasis in endometrioid-type endometrial cancer

Objectives: To evaluate the predictive value of preoperative CA125 in extra-uterine disease and its association with poorprognostic factors in endometrioid-type endometrial cancer (EC).Material and methods: A total of 423 patients with pathologically proven endometrioid-type EC were included in thestudy. The association between preoperative CA125 level and surgical–pathological factors was evaluated. The conventional cut-off value was defined as 35 IU/mL.Results: A high CA125 level ( > 35 IU/mL) was significantly associated with all of the studied poor prognostic factors,except grade. The risk of lymph node metastasis (LNM) increased from 15.9% to 45.7% when CA125 level was > 35 IU/mL (p < 0.05). The optimal cut-off value for the prediction of LNM in patients aged > 50 years was determined to be 16 IU/mL (sensitivity, specificity, positive predictive value, and negative predictive value were 71%, 60%, 35%, and 87%, respectively.)Conclusions: Preoperative CA125 level was significantly related with the extent of the disease and LNM. The age-dependent cut-off level of CA125 can improve the prediction of LNM in endometrioid-type EC. For older patients, CA125 level of > 16 IU/ml could be used to predict LNM. However, further studies are needed to evaluate the appropriate cut-off level of CA125 for younger patients

Controlled ovarian hyperstimulation with sequential letrozole co-treatment in normo/high responders

Objective: To investigate the effect of co-administration of letrozole in an ovarian stimulation protocol using recombinant FSH and GnRH antagonists for ICSI in normo/high responders

Boron removal from aqueous solutions by chitosan/functionalized-SWCNT-COOH: Development of optimization study using response surface methodology and simulated annealing

Boron contamination in water resources (especially drinking waters and agricultural land) is a major problem for the ecosystem. In this study, a novel synthesized chitosan/functionalized-SWCNT-COOH was prepared to separate boron (as boric acid) from aqueous solutions. Scanning electron microscopy (SEM) and X-ray diffraction (XRD) analysis revealed that SWCNT was dispersed in chitosan homogenously. Moreover, this study has related to the constrained optimization problem with an engineering approach. Response surface method (RSM) with face-centered central composite design (FCCCD) was chosen for maximizing the adsorption capacity as well as determining optimal independent factors such as pH, adsorbent dose, and concentration of boric acid. The optimized response (adsorption capacity) was reached 62.16 mg g(-1) under the optimal conditions (98.77 mg L-1 of boric acid concentration, pH of 5.46 and 76 min). The present study has indicated that the synthesized material can be used as an adsorbent for eliminating boric acid from aqueous solutions depending on its high adsorbent capacity to remove boron and has better performance than existing adsorbents. Furthermore, simulated annealing (SA) optimization technique was used to compare the findings of RSM. Moreover, the selected optimization techniques were compared with error functions. The optimal conditions derived from SA were 91.17 mg L-1 of boric acid concentration, pH of 5.86, and 76.17 min. The optimal adsorption capacity of SA was found to be 62.06 mg g(-1). These results revealed that the predictions of the two models are very close to each other

Experimental and theoretical approaches for magnetic, superconducting and structural characterization of Bi(1.75)Pb(0.2)5Sr(2)Ca(2)Cu(3-x)Sn(x)O(10+y) glass ceramics

TUGLUOGLU, NIHAT/0000-0001-9428-4347; Tasci, A. Tolga/0000-0001-9450-6499; KORALAY, HALUK/0000-0001-7893-344XWOS: 000418983300003In this work, the effect of the partial substitution of Sn for Cu on structural, electrical and magnetic properties in the superconducting ceramic glass Bi1.75Pb0.25Sr2Ca2Cu3-xSnxO10+y system (x = 0, 0.1, 0.5) has been examined. The structural characterization of samples produced by glass-ceramic technique were done by X-ray diffraction (XRD) and scanning electron microscopy (SEM) measurements. The electrical and magnetic properties were determined by resistance-temperature (R-T) measurement and magnetization-magnetic field measurement (M H) in the low temperature by using vibrating sample magnetometer (VSM), respectively. From the results of R-T measurement, the value of critical temperature (T-c(offset)) has been decreased from 98 K to 73 K with increasing Sn- concentration. The critical current density has also been decreased with increasing magnetic field intensity. It has been observed from M-H plots that it was decreased with increasing the value of temperature. We have observed from M-H curves that the area size of the hysteresis curve decreases with increasing the value of temperature.Scientific Research Projects Foundation of Gazi University AnkaraGazi University [BAP 05/2011-47]The Authors thank the financial support for this work through the Scientific Research Projects (BAP 05/2011-47) Foundation of Gazi University Ankara

Stage IB Endometrioid Type Endometrial Cancer: The Role of Lymphadenectomy and Adjuvant Radiation Therapy

Objective: Both performances of lymphadenectomy and benefit of adding adjuvant radiotherapy are controversial for patients with International Federation of Gynecology and Obstetrics stage IB endometrioid type endometrial cancer. We aimed to identify the role of lymphadenectomy and adjuvant radiation therapy as well as clinicopathological prognostic factors for this group of patients. Study Design: Records of all patients (n=132) with stage IB endometrioid endometrial cancer who were referred to or treated in our institution between Jan 1992 and Dec 2013 were retrospectively reviewed. Cox Proportional Hazard Regression Analysis was used to determine the effects of lymphadenectomy and adjuvant radiation as well as other clinicopathological factors on disease free survival and overall survival. Results: Mean age was 59.9 years (range, 45-82). Lymphadenectomy didn't perform in 36 (27.3%) patients and 23 (17.4%) patients did not have any kind of adjuvant treatment. Mean lymph node count was 18.8 (range, 3-67). Federation of Gynecology and Obstetrics grade, lymphovascular space invasion, lymphadenectomy, receiving adjuvant treatment and type of received adjuvant therapy were not associated with disease free survival and overall survival for the entire cohort. In a subgroup of patients with grade1&2 tumor, 5-year disease free survival rates were 80% and 50% (p=0.4), respectively and overall survival rates were 94.8% and 93.8% (p=0.2), respectively for patients who had or didn't have adjuvant radiotherapy. While performance of lymphadenectomy was not significantly associated with disease free survival in this subgroup (p=0.56), this association was statistically significant for overall survival (97.9% vs. 86.4%, p=0.04) Conclusion: Benefit of adjuvant radiotherapy in regard to prevention of recurrence needs to be confirmed by further studies. Lymphadenectomy had a survival benefit for patients with myometrial invasion greater than a half of myometrial thickness

Pulmonary recurrence in patients with endometrial cancer

Background: In this article, we aimed to define the clinical, pathological, and surgical factors predicting pulmonary recurrence (PR) and determining survival after PR in patients with endometrial cancer. Methods: Thirty-six (2.7%) patients were analyzed who suffered pulmonary failure in the first recurrence out of 1345 patients who had at least extrafascial hysterectomy plus bilateral salpingo-oophorectomy for endometrial cancer between January 1993 and May 2013. The recurrence was designated as an isolated PR in cases of the presence of recurrence only in the lung, while it was called a synchronized PR if the patient had extrapulmonary recurrence in addition to PR. Results: In the multivariate analysis in the entire cohort, only International Federation of Gynecology and Obstetrics stage was an independent prognostic factor for PR. Two-year overall survival (OS) was 52% in patients with PR. In the univariate analysis, early International Federation of Gynecology and Obstetrics stage, absence of lymphatic metastasis, negative lymphovascular space invasion, absence of cervical invasion, negative adnexal spread, negative peritoneal cytology, negative omental metastasis, adjuvant radiotherapy after initial surgery, isolated PR, and chemotherapy upon recurrence were associated with improved OS after PR. The OS was 54 months for patients with isolated PR, while it was 10 months for patients who had synchronized PR. Furthermore, OS was 43 months and 13 months for the patients who took chemotherapy and radiotherapy, respectively. Conclusion: Advanced stage is associated with PR. If recurrence is only in the lung, survival is better. Systemic treatment after PR is associated with improved survival. However, multi-center studies are required to standardize the treatment for PR

Prognostic effect of isolated paraaortic nodal spread in endometrial cancer

Objective: To evaluate the prognostic effect of isolated paraaortic lymph node metastasis in endometrial cancer (EC). Material and Methods: This retrospective study included patients with FIGO 2009 stage IIIC2 disease due to isolated paraaortic lymph node metastasis (LNM). Patients with sarcomatous histology, synchronous gynecologic cancers and patients with concurrent pelvic lymph node metastases or patients that have intraabdominal tumor spread were excluded. Kaplan-Meier method was used for calculation of progression free survival (PFS) and overall survival. Results: One thousand six hundred and fourteen patients were operated for EC during study period. Nine hundred and sixty-one patients underwent lymph node dissection and 25 (2.6%) were found to have isolated LNM in paraaortic region and these constituted the study cohort. Twenty (80%) patients had endometrioid EC. Median number of retrieved lymph nodes from pelvic region and paraaortic region was 21.5 (range: 5-41) and 34.5 (range: 1-65), respectively. Median number of metastatic paraaortic nodes was 1 (range: 1-32). The median follow-up time was 15 months (range 5-94). Seven (28%) patients recurred after a median of 20 months (range, 3-99) from initial surgery. Three patients recurred only in pelvis, one patient had upper abdominal spread and 3 had isolated extraabdominal recurrence. Involvement of uterine serosa, positive peritoneal cytology and presence of adnexal metastasis were significantly associated with diminished PFS (p<0.05). Conclusion: The presence of serosal involvement or adnexal involvement is as important as gross peritoneal spread and is related with poor survival in patients with isolated paraaortic nodal spread in EC. Chemotherapy should be the mainstay of treatment in this patient cohort which may eradicate systemic tumor spread

Current Minimal Invasive Surgery Treatment For Kidney Stones: Bezmialem Experience

Objective: We aimed to present the outcomes of patients with symptomatic kidney stones treated with percutaneous nephrolithotomy (PNL) or retrograde intrarenal surgery (RIRS)

Current Minimal Invasive Surgery Treatment for Kidney Stones: Bezmialem Experience

Objective: We aimed to present the outcomes of patients with symptomatic kidney stones treated with percutaneous nephrolithotomy (PNL) or retrograde intrarenal surgery (RIRS)

Lower plasma soluble TWEAK concentration in patients with newly diagnosed hypertension

Purpose: To determine circulating levels of the soluble TNF-like weak inducer of apoptosis (sTWEAK)and its association with demographic and biochemical parameters in a young group of patients with newly diagnosed and never treated hypertension. Methods: A total of 51 patients (mean age 21.7 ±1.4 years, body mass index (BMI) 24.5 ±1.6 kg/m2) with primary untreated hypertension, and 37 age- and BMI-matched healthy controls (mean age 22.5 ± 1.9 years, BMI 24.7 ± 1.5 kg/m2) were studied. Serums TWEAK and plasma asymmetrical dimethyl arginine (ADMA) levels were measured by EIA. Results: In patients and controls, mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 149.8±5.65/93.4±3.4 mmHg and 124.2±6.4/78.24±5.5 mmHg, respectively. Serum sTWEAK levels were lower in the patient group (882.6±228.9 μmol/L vs. 1060.2±231.7μmol/L, p=0.001), whereas plasma ADMA levels werehigher(0.837±0.34μmol/L vs.0.3176±0.25μmol/L, p < 0.001). sTWEAK serum levels correlated with SBP(r=-0.301; p=0.005) and DBP (r=-0.279; p=0.009). Circulating plasma ADMA levels also correlated with SBP (r=0.734; p < 0.001) and DBP (r=0.733; p < 0.001). Conclusion: Young patients with yet untreated primary hypertension have lower circulating serum sTWEAK level compared with healthy controls. Further research for possible associations among serum sTWEAK, endothelial dysfunction and other measures of atherosclerosis may be of benefit in order to better understand the pathophysiology of hypertension and to establish more effective treatment options