Renal transizyonel hücreli karsinom için olası serum belirteçleri: Literatürün gözden geçirilmesi ile birlikte bir olgunun sunumu

Üriner sistemin üst bölümünün ürotelyal tümörü, relatif olarak nadir görülen malignitelerden biridir. Prostat ve testis kanserlerine özgü serum belirteçleri bilinmesine rağmen, renal ve ürotelyal tümörler için spesifik belirteçlerin tanımlanmasına ihtiyaç vardır. Bu makalede, yüksek preoperatif serum düzeyine sahip Karsinoembryonik antijen (CEA) ve Eritrosit sedimentasyon hızına (ESR) sahip olgu sunulacaktır. Preoperatif metastazı olmayan hastaya uygulanan radikal nefroüreterektomi operasyonu sonrası, histolojik tanı yüksek grade’li renal pelvis ürotelyal karsinomu olarak rapor edilmiştir. Cerrahi sınırlar negatif olup serum CEA ve ESR düzeyinde postoperatif erken dönemde tamamen düzelme görülmüştür.Urothelial tumors of the upper urinary tract are relatively rare malignancies of urinary system. Despite the presence of specific serum parameters for prostate and testicular cancer, new markers need to be identified for renal and urothelial cancers. We report a case of huge renal pelvis tumor with high serum levels of carcinoembryonic antigen (CEA) and erythrocyte sedimentation rate (ESR). No distant metastasis was evident preoperatively. Radical nephroureterectomy was performed and the tumor was histologically diagnosed as high grade urothelial carcinoma of the renal pelvis. Surgical margins were negative and marked decrease in serum level of CEA and normalization of ESR, were noticed immediately after surgery

Strategies to Limit Radiation Dose in Pediatric Computed Tomography Applications

Bilgisayarlı tomografi, pediyatrik yaş grubunda kullanımı gün geçtikçe artan bir görüntüleme tekniğidir. Pediatrik yaş grubunun radyasyona duyarlı olması ve radyasyonun kanser riski oluşturmasında kümülatif dozun etkin olması verilen doza dikkat edilmesini gerektirmektedir. Çocuklara erişkin protokollerinin uygulanması, kilo bağımlı değişikliklerin yapılmaması, verilen dozun ölçümünde ve riskin belirlenmesinde standartların belli olmaması, yüksek dozlar için cezai müeyyidenin olmaması önemli sorunlardır. Ancak gerekli durumlarda, -sadece- hedef vücut alanlarının bilgisayarlı tomografi ile değerlendirilmesi, parametrelerin çocuklar için yeniden düzenlenmesi ve her çocuğa özel protokol değişikliklerinin yapılması ile radyasyon dozu önemli ölçüde azaltılabilir. Radyasyonu azaltmada, kullanılan tomografi aletinin teknik parametre değişiklikleri (tüp akımı, kilovolt piki, masa hızı) iyi bilinmeli ve dikkatlice uygulanmalıdır. Anahtar Kelimeler: bilgisayarlı tomografi, çocukluk çağı, radyasyon, SUMMARYComputed tomography is an increasingly used imaging modality in childhood. Since pediatric population possess increased radiosensitivity and radiation-related cancer risk is related with cumulative dose, the radiation exposure must be carefully established. Use of the same CT settings for adults and children, deficiency of weight adjusted protocols, lack of consensus for the measurement of dose and related risks of radiation, and absence of penalties for higher doses are essential problems. Radiation dose can significantly be decreased with evaluation of -onlytargeted part of the body in appropriate conditions, rearrangement of the scanning parameters for children, and subject based protocol and dose adjustment for each children. The alternations in technical parameters of CT device like tube current, kilovoltage peak, table speed should be well-known and carefully applied for limitation of the radiation dose

Identification of An mtDNA Setpoint Associated with Highest Levels of CD44 Positivity and Chemoresistance in HGC-27 and MKN-45 Gastric Cancer Cell Lines

Objective Cancer stem cells (CSCs) have important roles in survival and chemoresistance. These cells are commonly recognized with CD44 and CD24 markers. In this study, we aimed to analyze the effects of mtDNA content on cell surface positivity for anti-CD24 and anti-CD44 antibodies and chemoresistance level in AGS, HGC-27 and MKN-45 gastric cancer (GC) cell lines and to determine a setpoint for mtDNA copy for each cell line. Materials and Methods In this experimental study, we initially decreased mtDNA levels in AGS, HGC-27 and MKN-45 by EtBr treatment. This depletion was confirmed with quantitative polymerase chain reaction (qPCR). Changes in cell surface positivity for anti-CD24 and anti-CD44 antibodies in control and mtDNA-depleted AGS, HGC-27 and MKN-45 were then analyzed with flow cytometry. Changes in chemoresistance (5-FU and cisplatin) were analyzed for all cell lines. The relationship between mtDNA content and cell surface positivity for CD24 and CD44 markers was examined. Results The highest CD44 positivity was found in HGC-27 and MKN-45 ρlow cells which had 33-40% mtDNA content of control cells, however, CD24 positivity decreased with mtDNA depletion in all cell lines. The highest chemoresistance levels were found in all ρlow cells. mtDNA-recovered (i.e. reverted) HGC-27 and MKN-45 cells partially maintained their increased chemoresistance while reverted AGS cells did not maintain an increased level of chemoresistance. Conclusion mtDNA depletion triggers chemoresistance in cancer cell lines and is correlated with increase and decrease of CD44 and CD24 positivity respectively in HGC-27 and MKN-45 GC cell lines. A mtDNA content above or below the identified setpoint (33-40% of that in control cells), results in the decrease of CD44 positivity and chemoresistance levels

Choreiform Movement Disorder Secondary to Intracerebral Cavernoma: Case Report

Although vascular factors are considered primarily in the etiology of hemichorea among the elderly, chorea related to congenital vascular malformations including cavernous angioma are reported very rarely. We found cavernous angioma to be the cause of persistant, unilateral chorea localized to the right lower extremity in a 83 year-old woman. In this article we would like to highlight the etiology of chorea in patients with late onset movement disorder

Correlation of renal B-mode ultrasonographic findings with diabetic nephropathy stage

Amaç: Çalışmamızda diabetik nefropati’nin farklı evrelerindeki hastalarda, B-mod Ultrasonografi (US) ile tespit edilen renal morfolojik özelliklerin kontrol grubu kullanılarak karşılaştırılması amaçlanmıştır. Yöntem: Kontrol grubu olarak 20 sağlıklı kişi alınmıştır. Çalışma grubu olarak ise tip-2 diabet tanısı olan 69 hasta alınmıştır. Heriki gruptaki hastalar böbreklerin boyutu; parenkim kalınlığı ve parenkim eko şiddeti yönünden B-mod US ile değerlendirilmiştir. Diabetik hastalar, 24 saatlik idrardaki albumin ekskresyon oranlarına (AEO) göre 3 gruba ayrılmıştır (Grup-1: AEO 300 mg/ gün); ve her grup için ortalama renal parenkim kalınlığı ve renal uzunluk hesaplanmıştır. SPSS programı kullanılarak, bu değerler için gruplar arası karşılaştırma yapılmıştır. Bulgular: Böbrek boyutlarına göre, çalışma grubu ile kontrol grubu arasındaki farklılık araştırıldığında, istatistiksel olarak anlamlı farklılık gözlenirken, ortalama parenkim kalınlığının kontrol grubu ile hasta grupları arasında istatistiksel olarak farklı olmadığı görülmüştür. Hasta grupları, kendi içinde kıyaslandığında yine istatistiksel olarak anlamlı farklılık izlenmemiştir. Kortikal hiperekojenite saptanma oranlarının,ortalama serum BUN ve kreatinin klerens değerlerinin ise nefropati evresiyle korelasyonu izlenmiştir. Sonuç: Diabetik hastalarda, ilerleyen nefropati ile birlikte ultrasonografik olarak parenkim kalınlıkları anlamlı olarak değişmezken, eko şiddetinde artma ve sağlıklı bireylere göre böbrek boyutlarında azalma gerçekleşmektedir.Aim: We aimed to investigate the renal morphological features detected by B-mode ultrasonography (US) in various clinical stages of diabetic nephropathy by means of a control group. Methods: As control group, 20 healthy person were selected. As study group, 69 patients with type-2 diabetes were included. All cases in both groups were evaluated with B-mode US in terms of renal length, parenchymal thickness and echogenicity. Diabetic patients were divided into 3 groups according to 24-hour urinary albumin excretion ratios (AER) (Group-1: AER300 mg/ day); and mean renal parenchymal thickness and length were measured. By SPSS programme, mean values were compared between groups. Results: When mean renal length was compared between control and study groups, significant difference was noticed; but when mean renal parenchymal thickness was compared, no significant difference was demonstrated between two groups. When study groups were compared between each other,no statistically significant difference was seen. Cortical hyperechogenicity ratios; mean serum BUN and creatinine clearance rates, were correlated with nephropathy stage. Conclusion: With progression of nephropathy in diabetic patients,renal parenchymal thickness do not significantly differ; but hyperechogenicity and decrease in renal dimensions (control versus study group) occur

Attidutes of nursing students towards reading habits: A vacational school sample

Amaç: Okuma alışkanlığının, bireylerin yaşamları boyunca elde ettikleri bilgileri, becerileri, anlayışları güçlendirip artıran ve aynı zamanda bu değerlerin bireysel ve toplumsal yaşama uyarlanmasına olanak sağladığı göz önünde bulundurulduğunda, konusu insan olan hemşirelik öğrencilerine ve dolayısıyla hemşirelik mesleğine katkı sağlayacağı düşünülmektedir. Buradan hareketle bu araştırma bir sağlık yüksekokulu hemşirelik bölümünde öğrenim gören öğrencilerin kitap okuma alışkanlıklarına ilişkin tutumlarını belirlemek amacıyla planlanmıştır. Yöntem: Araştırmada bazı sosyo-demografik bilgilere yönelik anket formu ve Gömleksiz (2004) tarafından geliştirilen Kitap Okuma Alışkanlığına İlişkin Tutum Ölçeği kullanılmıştır. Verilerin değerlendirilmesinde yüzde, frekans, Varyans analizi (ANOVA), Mann-Whitney U testi, Kruskal-Wallis istatistik testleri uygulanmıştır. Bulgular: Araştırmaya katılan öğrencilerin %75.3ü kız, %78.9unun en çok roman ve hikaye türü kitaplar okuduğu belirlenmiştir. Sonuç: Hemşirelik öğrencilerinin bireysel gelişim amacıyla kitap okudukları, daha çok roman-hikaye türünde kitapları tercih ettikleri, kız öğrencilerin erkek öğrencilere göre kitap okumaya ilişkin tutumlarının daha olumlu olduğu, babanın eğitim durumunun okuma alışkanlığına ilişkin tutumları etkilediği ancak annenin eğitim durumunun, daha önce yaşanılan yerin ve ekonomik gelirin okuma alışkanlığına ilişkin tutumları etkilemediği, genel olarak sınıf artıkça okuma alışkanlığına ilişkin tutumların olumlu yönde etkilendiği belirlenmiştir.Aim: Considering the fact that it allows individuals to improve and enhance the knowledge, skills and understanding that they obtain throughout their lives and, at the same time, to adapt these values to individual and social life, reading habit is thought to contribute to nursing students and therefore to nursing profession, whose subject is human. Thus, this study was planned to determine the attitudes of the students of a health school of nursing towards reading habits. Method: A socio-demographic information questionnaire and the Attitude Scale towards Reading Habit developed by Gömleksiz (2004) were used in the study. Data were analyzed through percentage, frequency, analysis of variance (ANOVA), Mann-Whitney U test, Kruskal-Wallis statistical tests. Results: It was found that 75.3% of the students were female, 78.9 % of the students read novels and story type books. Conclusions: It was found that nursing students read for personal development; they preferred novels and stories; female students had more positive attitudes about reading than male students; the fathers level of education affected attitudes towards reading habit; but the mothers level of education, previous location of residence and financial income did not affect attitudes towards reading habit and, in general, attitudes about reading habit were affected in a positive way in later years of study

Calcium Phosphate Stone Morphology: Plain Radiographic Findings and Interobserver Variabilities

Abstract: In current study, visual appearance of pure calcium phosphate (CaP) urinary stones by its morphology from plain radiograph (KUB), were investigated. We reviewed patients with urinary stone disease who underwent stone surgery. Among cases with crystallographically analyzed stones; 60 patients with pure CaP renal or ureteral stones (greater than 1 cm) were selected. Two endourologists and a uroradiologist familiar with the radiographic patterns of different types of pure stones were invited separately, to evaluate pretreatment KUB. Four different radiographic patterns were identified mainly with the assistance of previous studies. Smooth edged, homogenous stones with denser opacity were included in Group 1. Stones with irregular edges and stippled border were included in Group 2. Relatively uniform stones with radial striations and moderate density were decided to form Group 3. Calculi with the least radiodensity and loosely aggregated with a lacy structure were included in Group 4. Overall, 68.9% of CaP calculi were included in Groups 1 and 2 by all participants. Best concordance between endourologists and the uroradiologist was demonstrated in the evaluation of smaller calculi (< 150 mm2). On KUB, CaP urinary calculi were mostly seen as dense relatively homogenous stones and sometimes with stippled borders. With an increase in pretreatment stone size, interobserver and interdisciplinary variabilities increased