Objective
To evaluate the discrepancy between tumor sizes determined from preoperative computed tomography (CT) and surgical specimens and its clinical implications.
Material and method
The charts of ...86 patients who underwent surgical resection of a renal mass between 1995 and 2007 were reviewed retrospectively. Tumor size was determined both from preoperative CT and pathologic specimen. Histopathologic evaluation was done. Wilcoxon test was used to compare the mean radiographic tumor size on CT with the mean pathologic size.
P
< 0.05 was considered as the threshold for statistical significance.
Results
The median age was 59 (21–84). Clinical stage was T1a in 13, T1b in 47, and ≥T2 in 26; pathologic stage was T1a in 12, T1b in 45, and ≥T2 in 29 patients. Histological subtype was clear cell, papillary, chromophobe, sarcomatoid, and oncocytic in 72, 7, 5, 1, and 1 patients, respectively. Mean radiographic and pathologic size was 6.33 and 6.43 cm, respectively (
p
= 0.342). On the average, radiographic measurement underestimated pathologic size by 1 mm. When subgroups of patients according to tumor size were formed as <4, 4–7, and >7 cm, mean radiographic size was 2.79, 5.44, and 9.57 cm, mean pathologic size was 3.47, 5.62, and 9.26 cm, respectively. In subgroups of <4, 4–7, and >7 cm; radiographic measurement underestimated pathologic size by 0.68 (
p
= 0.018) and 0.18 cm (
p
= 0.470) and overestimated by 0.31 cm (
p
= 0.454), respectively.
Conclusion
Overall discrepancy between radiographic and pathologic tumor sizes was 1 mm. No significant stage shift due to measurement error was detected. Our findings suggest that CT is an accurate method with which to estimate renal tumor size preoperatively.
To evaluate the clinical and histopathological results of adult unilateral cryptorchidism patients.
Data from adult unilateral cryptorchidism patients that underwent orchiectomy in our clinic between ...between January 2004 and March 2013 were retrospectively evaluated. Patients were divided into three groups as intra-abdominal, inguinal canal and superficial inguinal region according to the location of the undescended testes. Patients were also grouped according to their testicular volume (<4 cc, 4.1-12 cc, and >12 cc). Histopathology results of orchiectomy specimens were classified as follows: 1. Sertoli cells only, testicular atrophy and vanished testis (anorchia) 2. Hypospermatogenesis, and 3. Maturation arrest. Patients were grouped as normospermia, azoospermia and oligo/astheno/teratospermia groups according to semen analysis results. Correlations between testicular localization, testicular size, semen analysis and pathology results were evaluated. Incidental tumor detection rates were also calculated.
Two hundred and forty-four adult unilateral cryptorchidism patients underwent orchiectomy in our clinic. There was no a significant relationship between location of the testis and testicular pathology results (p=0.707). Most common semen analysis results was normospermia in patients with high testicular volume group however azoospermia and oligoasthenospermia observed commonly in patients with low testicular volume group. There was a significant relationship between testicular volume and semen analysis results (p=0.023). No significant relationship was observed between semen analysis and pathological results (p=0.929). After an evaluation of all factors with possible effects on the semen analysis results, only testicular volume (p=0.036) was found to have a significant impact. Only one case (0.4%) was incidentally diagnosed seminoma after a review of 233 patients with available histopathological results on record.
Adult unilateral cryptorchidism has a minimal effect on male fertility or even this effect can be overlooked. Low detection rates of incidental germ cell tumors also make an orchiectomy decision questionable in such cases.
To compare two different doses of lidocaine used for periprostatic nerve block on pain perception during transrectal ultrasound (TRUS) guided prostate biopsy.
A total of 288 patients with elevated ...prostate specific antigen (PSA) levels and/or abnormal digital rectal examination who underwent TRUS-guided prostate biopsy were included in the study. The patients were divided into 3 groups: Group 1 (n=103) prostate biopsy were performed after administering perianal intrarectal application of 10 mL 2% lidocaine gel, Group 2 (n=98) 2 mL of 2% lidocaine injection on each side following rectal installation of lidocaine gel and Group 3 (n=87) 4 mL of 2% lidocaine injection on each side after rectal instillation of lidocaine gel. Patients' pain scores during biopsy procedure were reported using visual analogue score (VAS). Independent sample t test, ANOVA test and Tukey test were used for statistical evaluation.
The mean age, prostate volume and PSA level were 65.6±8.4 years, 58.2±34.8 mL, and 11.8±3.4 ng/mL respectively. There were no statistically significant differences in baseline characteristics between the groups. The mean VAS scores were 2.4±1.8 in Group 1, 2.5±1.9 in Group 2 and 1.6±1.6 in Group 3. Patients in Group 3, reported significant pain reduction compared with patients in Groups 1 and 2 (p=0.002, and 0.001, respectively). However, there was no statistically significant difference in VAS scores between Groups 1 and 2 (p=0.815).
According to our results we recommend the use of perianal intrarectal lidocain gel application, and periprostatic nerve block with injection of 4 ml 2% lidocaine per side combination in TRUS-guided prostate biopsies. Further large-scale randomized control studies are needed to validate these finding.
Objective: The purpose of this study was to compare the use of an intravitreal injection of infliximab and of dexamethasone combined with vancomycin to treat experimental endophthalmitis induced by ...Staphylococcus epidermidis. Materials and Methods: The study was conducted between March 25 and April 13, 2012. Twenty-five six-monthold healthy rabbits were used, each weighing 2.5-3 kg. The rabbits were randomized into five groups with five animals per group. Endophthalmitis was induced by 0.1 mL (103 colony-forming units) S. epidermidis in all groups. In group 1, injection was not implemented after the occurrence of endophthalmitis. In groups 2, 3, and 4, the following intravitreal injections were given 24 h after the occurrence of endophthalmitis: group 2, 0.1 mg/0.1 mL vancomycin; group 3, 1 mg/0.1 mL vancomycin and 1 mg/0.1 mL dexamethasone; and group 4, 1 mg/0.1 mL vancomycin and 2 mg/0.1 mL infliximab. Group 5 was the control/uninfected group. The rabbits were clinically assessed each day for seven days. On day 9, a histopathologic evaluation was performed after enucleation. Results: After a clinical evaluation, no statistically significant difference was found between the vancomycinv + infliximab and vancomycin + dexamethasone groups (p>0.05). The difference was significant when both groups were compared with the vancomycin group (p<0.001). After the histopathologic evaluation, no statistically significant difference was found among the three groups (p>0.05). Conclusion: An intravitreal injection of infliximab and of dexamethasone combined with vancomycin have similar clinical and histopathologic effects. To supplement the antibiotic treatment of endophthalmitis, infliximab in a safe dose range can be used as an alternative to dexamethasone to suppress inflammation and prevent ocular damage. Keywords: Infliximab, dexamethasone, vancomycin, staphylococcus epidermidis, endophthalmitis OZ Amac: Bu calismada tavsanlarda Stafilokok epidermidis ile olusturulan deneysel endoftalmilerde vankomisin ile kombine; intravitreal infliksimab ile intravitreal deksametazonun etkinliklerinin karsilastirilmasi amaclanmistir Gerec ve Yontem: Calisma 25 Mart 2012-13 Nisan 2012 tarihleri arasinda uygulandi. Calismada; 6 aylik, 2, 5-3 kg agirliginda, 25 adet saglikli tavsan kullanildi. Denekler herbiri 5 tavsandan olujan 5 gruba ayrildi. Grup 1'e; 0,lmL (103 Colony Forming Units) Stafilokok epidermidis ile endoftalmi olusturulduktan sonra herhangi bir tedavi uygu-lanmadi. Grup 2, 3 ve 4'e endoftalmi olusturulduktan 24 saat sonra sirasiyla; 1mg/0, 1mL vankomisin, 1mg/0, 1mL vankomisin ve 1mg/0, 1mL deksametazon, 1mg/0, 1mL vankomisin ve 2mg/0, 1mL infliksimab intravitreal olarak enjekte edildi. Grup 5 ise kontrol/nonenfekte grup olarak calismaya alindi. Denekler 1, 2, 3, 4, 5, 6 ve 7. gunlerde klinik olarak degerlendirildi. 9. gun enukleasyon uygulanarak histopatolojik inceleme yapildi. Bulgular: Klinik degerlendirmede; vankomisin + infliksimab verilen grup ile vankomisin + deksametazon verilen grup kendi arasinda karjilajtirildiginda istatistiksel olarak anlamli farkin olmadigi (p>0, 05), her iki grup sadece vankomisin verilen grup ile karjilajtirildiginda istatistiksel olarak anlamli farkin oldugu goruldu (p<0, 00l). Histopatolojik olarak gruplar arasinda yapilan karsilastirmada; vankomisin + infliksimab, vankomisin + deksa-metazon ve vankomisin gruplari arasinda istatistiksel olarak anlamli farkin olmadigi goruldu (p>0, 05). Sonuc: Endoftalmide intravitreal infliksimab ile intravitreal deksametazon uygulamasinin klinik ve histopatolojik olarak benzer etkinlikte oldugu gorulmujtur intravitreal uygulamada infliksimab deksametazona alternatif olabilir Anahtar Kelimeler: infliksimab, deksametazon, vankomisin, stafilokok epidermidis, endoftalm
Aim: Prostate-specific antigen (PSA) may elevate in case of prostate cancer, benign prostatic hyperplasia (BPH) as well as chronic prostatitis. In chronic prostatitis and BPH distinction PSA, free / ...total PSA ratio isn’t usefull. The aim of this study is to question the place of PSA density in the distinction of BPH and prostatitis. Materials and Methods: In our clinic BPH pre - diagnosed, data of transurethral resection of prostate (TUR-P) performed and histologically diagnosed as no chronic prostatitis observed (group 1), with TUR-P performed but chronic prostatitis diagnosed (group 2) patients were retrospectively analyzed. The age, PSA, biopsy history, prostate size and PSA density (PSAD = PSA level / prostate volume) of patients were recorded. Results: Chronic prostatitis was determined in 100 of 641 patients (%15. 6). Biopsy before TUR-P was performed to 28 patients in the chronic prostatitis group, and 27 patients in BPH group (n=100) and in only 4 patients (%14. 3) in the chronic prostatitis group pathological evidence of prostatitis was determined. PSA (p<.001) and prostate volume (p=0.017) was larger in the chronic prostatitis group when compared with the BPH group. Also PSA density (p<.001) was higher. Conclusion: PSA density was higher in patients with chronic prostatitis.
To evaluate the efficacy of phacoemulsification combined with posterior capsulorhexis, core vitrectomy and ciliary sulcus intraocular lens (IOL) implantation in patients with Fuchs' heterochromic ...uveitis (FHU).
A total of 18 eyes of 18 patients with FHU underwent cataract surgery were included in the study. 18 eyes with FHU underwent posterior capsulorhexis, core vitrectomy and poly (methyl methacrylate) (PMMA) IOL implantation in the ciliary sulcus. Subjects were chosen for this procedure based on an intraoperative vitreous haziness assessment, performed by indirect ophthalmoscopy. Patients with +2 or more vitreous haziness qualified for this procedure.
Of the 83 eyes with FHU that underwent cataract surgery, 18 eyes (21.6%) of 18 patients were employed in the study. There were 11 (61.1%) men and 7 (38.9%) women in the study; ages ranged from 23 to 47, with a mean of 32.06 years. Follow-up ranged from 8 months to 49 months. There were no intraoperative complications except for peripheral iris bleeding in 7 eyes. There was no severe intraocular inflammation in any patient postoperatively. All patients had 0.05 or better logMAR visual acuity after corneal suture removal. Glaucoma developed in 2 patients. For the short term period, the main vision threatening problem was suture-induced astigmatism.
Cataract surgery combined with posterior capsulorhexis, core vitrectomy and IOL implantation in the ciliary sulcus is safe and leads to good visual outcome due to the removal of the hazy vitreous in patients with FHU.
Objective: To evaluate the efficacy of phacoemulsification combined with posterior capsulorhexis, core vitrectomy and ciliary sulcus intraocular lens (IOL) implantation in patients with Fuchs' ...heterochromic uveitis (FHU). Materials and Methods: A total of 18 eyes of 18 patients with FHU underwent cataract surgery were included in the study. 18 eyes with FHU underwent posterior capsulorhexis, core vitrectomy and poly (methyl methacrylate) (PMMA) IOL implantation in the ciliary sulcus. Subjects were chosen for this procedure based on an intraoperative vitreous haziness assessment, performed by indirect ophthalmoscopy. Patients with +2 or more vitreous haziness qualified for this procedure. Results: Of the 83 eyes with FHU that underwent cataract surgery, 18 eyes (21.6%) of 18 patients were employed in the study. There were 11 (61.1%) men and 7 (38.9%) women in the study; ages ranged from 23 to 47, with a mean of 32.06 years. Follow-up ranged from 8 months to 49 months. There were no intraoperative complications except for peripheral iris bleeding in 7 eyes. There was no severe intraocular inflammation in any patient postoperatively. All patients had 0.05 or better logMAR visual acuity after corneal suture removal. Glaucoma developed in 2 patients. For the short term period, the main vision threatening problem was suture-induced astigmatism. Conclusion: Cataract surgery combined with posterior capsulorhexis, core vitrectomy and IOL implantation in the ciliary sulcus is safe and leads to good visual outcome due to the removal of the hazy vitreous in patients with FHU. Keywords: Phacoemulsification, Fuchs' heterochromic uveitis, core vitrectomy Amac: Bu calismada Fuchs' heterokromik uveiti (FHU) olan hastalarda arka kapsuloreksis, kor vitrektomi ve silier sulkusa intraokuler lens (IOL) implantasyonu ile kombine fakoemulsifikasyon cerrahisinin etkinligini degerlendirmek amaclanmistir. Gerec ve Yontem: Fuchs' heterokromik uveiti olan ve katarakt cerrahisi uygulanan 18 hastanin 18 gozu calismaya alindi. FHU olan 18 goze; arka kapsuloreksis, kor vitrektomi ve silier sulkusa polimetilmetakrilat (PMMA) IOL implantasyonu uygulandi. Intraoperatif, indirekt of talmoskop ile vitreusta bulaniklik derecesi degerlendirilerek; +2 veya daha fazla vitreus bulanikligi olan hastalar bu prosedure dahil edildi. Bulgular: Fuchs' heterokromik uveiti olan ve katarakt cerrahisi uygulanan 83 gozun 18'i (%21,6) calismaya dahil edildi. 23 ile 47 yas araliginda (ortalama 32.06 yil) olan hastalarin 11'i (%61,1) erkek, 7'si (%38,9) kadin idi. Hastalarin takip suresi 8 ay ile 49 ay arasinda degismekteydi. 7 gozde gelisen iris periferinde kanama disinda; intraoperatif herhangi bir komplikasyon gorulmedi. Hicbir hastada postoperatif siddetli intraokuler inflamasyon gorulmedi. Korneal suturler alindiktan sonra, tum hastalar logMAR' a gore 0,05 veya daha iyi seviyede gorme keskinligine sahipti. 2 hastada glokom gelisti. Kisa donemde gorme seviyesini etkileyen ana problem suture bagli astigmatizma idi. Sonuc: Fuchs' heterokromik uveiti olan hastalarda; arka kapsuloreksis, kor vitrektomi ve silier sulkusa IOL implantasyonu ile kombine katarakt cerrahisi guvenilirdir. Bulanik olan vitreusun uzaklastirilmasina bagli olarak, gorsel sonuclari iyi olan bir prosedurdur. Anahtar Kelimeler: Fakoemulsifikasyon, Fuchs' heterokromik uveiti, kor vitrektomi
The purpose of this study was to compare the use of an intravitreal injection of infliximab and of dexamethasone combined with vancomycin to treat experimental endophthalmitis induced by
The study ...was conducted between March 25 and April 13, 2012. Twenty-five six-month-old healthy rabbits were used, each weighing 2.5-3 kg. The rabbits were randomized into five groups with five animals per group. Endophthalmitis was induced by 0.1 mL (103 colony-forming units)
in all groups. In group 1, injection was not implemented after the occurrence of endophthalmitis. In groups 2, 3, and 4, the following intravitreal injections were given 24 h after the occurrence of endophthalmitis: group 2, 0.1 mg/0.1 mL vancomycin; group 3, 1 mg/0.1 mL vancomycin and 1 mg/0.1 mL dexamethasone; and group 4, 1 mg/0.1 mL vancomycin and 2 mg/0.1 mL infliximab. Group 5 was the control/uninfected group. The rabbits were clinically assessed each day for seven days. On day 9, a histopathologic evaluation was performed after enucleation.
After a clinical evaluation, no statistically significant difference was found between the vancomycin+infliximab and vancomycin+dexamethasone groups (p>0.05). The difference was significant when both groups were compared with the vancomycin group (p<0.001). After the histopathologic evaluation, no statistically significant difference was found among the three groups (p>0.05).
An intravitreal injection of infliximab and of dexamethasone combined with vancomycin have similar clinical and histopathologic effects. To supplement the antibiotic treatment of endophthalmitis, infliximab in a safe dose range can be used as an alternative to dexamethasone to suppress inflammation and prevent ocular damage.
The histopathological report of the biopsy material retrieved from hyperemic areas of the bladder during control cystoscopy of a 70-year-old man who had a bladder cancer diagnosis three years ...previously, indicated the presence of a carcinoma in situ (CIS). Intravesical immunotherapy treatment was initiated. After severe symptoms of dysuria emerging during intravesical immunotherapy with BCG, the immunotherapy treatment dosage was lowered. His treatment was then discontinued due to the progression of symptoms. A biopsy was performed due to higher prostate spesific antigen (PSA) and digital rectal examination abnormalities which indicated granulomatous prostatitis. An antituberculosis treatment was initiated because the PPD test result was 25 mm and the QuantiFERON test was positive. After one month, the patient's PSA levels were reduced, and his clinical status improved. The symptoms of severe dysuria, sterile pyuria, abnormal digital rectal examination findings and high PSA levels during intravesical BCG treatment should remind us diagnosis of granulomatous prostatitis. It should not be forgotten that diagnosis of granulomatous prostatitis was established histopathologically, and the patient benefited from medical treatment.
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