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1.
Medicina (Kaunas) ; 60(7)2024 Jul 17.
Artículo en Inglés | MEDLINE | ID: mdl-39064581

RESUMEN

Background and Objectives: Immune thrombocytopenia (ITP) is an autoimmune disease characterized by the autoantibody-mediated destruction of platelets. The treatment of ITP aims to maintain a sufficient platelet count to prevent bleeding. First-line treatment options include corticosteroids and intravenous immunoglobulin (IVIg), while second-line treatments include splenectomy, rituximab and other immunosuppressive agents, and thrombopoietin (TPO) receptor agonists. This study aims to discuss the treatment methods and results from 100 patients with ITP at the Mugla Training and Research Hospital through a pharmacological approach. Materials and Methods: Demographic characteristics, clinical findings, bone marrow aspiration and biopsy results, and treatments and treatment responses at the time of diagnosis of the 100 patients with ITP who were treated and followed up in the period 2015-2023 were evaluated retrospectively. Results: In the third month after treatment, the overall response percentage was 100% in patients who received steroids only and 88% in patients who received IVIg treatment alone or in combination with steroids (p > 0.05). The most preferred second-line treatments were splenectomy (41%), eltrombopag (26%), and rituximab (10%). Bone marrow biopsy was performed in 54% of patients, where 35.1% showed increased megakaryocytes, 44.4% adequate megakaryocytes, and 14.8% decreased megakaryocytes. It is noted that eltrombopag and rituximab, in particular, yield higher complete remission rates than immunosuppressive drugs. Conclusions: Considering the side effects of immunosuppressive medications, IVIg, splenectomy, and steroid therapy, the use of new agents such as eltrombopag, which are easily tolerated and have a lower risk of side effects, is expected to increase.


Asunto(s)
Benzoatos , Hidrazinas , Inmunoglobulinas Intravenosas , Púrpura Trombocitopénica Idiopática , Rituximab , Esplenectomía , Humanos , Femenino , Masculino , Estudios Retrospectivos , Persona de Mediana Edad , Púrpura Trombocitopénica Idiopática/tratamiento farmacológico , Púrpura Trombocitopénica Idiopática/mortalidad , Adulto , Estudios Transversales , Rituximab/uso terapéutico , Benzoatos/uso terapéutico , Hidrazinas/uso terapéutico , Inmunoglobulinas Intravenosas/uso terapéutico , Esplenectomía/estadística & datos numéricos , Anciano , Pronóstico , Pirazoles/uso terapéutico , Adolescente , Inmunosupresores/uso terapéutico , Corticoesteroides/uso terapéutico , Análisis de Supervivencia
2.
Ann Diagn Pathol ; 50: 151680, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33341704

RESUMEN

BACKGROUND: TROP-2, a novel marker of trophoblastic cells, is being widely analyzed for its possible role in carcinogenesis and clinical behavior of various carcinomas. In this study, we aimed to evaluate the relationship between clinicopathologic parameters and TROP2 expression in prostatic adenocarcinomas. METHODS: 101 prostatic adenocarcinomas treated by radical prostatectomy in our hospital between 2013 and 2018 were reviewed retrospectively for histopathological features, and one representative block of each case was stained with TROP2 antibody. Histopathologic prognostic features were assessed for their relationship with TROP2 expression. RESULTS: The mean age was found as 64.11 year. TROP2 was stained in over 10% of the tumoral cells in 64 (63.4.%) cases. Gleason grade group, perineural invasion, lymphovascular invasion, ganglionic and seminal vesicle involvement, lateral and basal surgical margin positivity showed a significant relationship with TROP2 staining. CONCLUSION: TROP2 is overexpressed in various human cancers and TROP2 overexpression appears to correlate with poor prognosis leading to the suggestion that TROP2 could be a therapeutic target for various carcinomas. Our results suggest that TROP2 expression is higher in advanced tumors and these results need to be supported by larger studies.


Asunto(s)
Adenocarcinoma/diagnóstico , Adenocarcinoma/metabolismo , Antígenos de Neoplasias/metabolismo , Moléculas de Adhesión Celular/metabolismo , Neoplasias de la Próstata/patología , Adenocarcinoma/cirugía , Anciano , Biomarcadores de Tumor/metabolismo , Supervivencia sin Enfermedad , Humanos , Inmunohistoquímica/métodos , Masculino , Márgenes de Escisión , Persona de Mediana Edad , Clasificación del Tumor/métodos , Invasividad Neoplásica/patología , Pronóstico , Prostatectomía/métodos , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Trofoblastos/metabolismo , Trofoblastos/patología
3.
Transfus Apher Sci ; 59(2): 102694, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-31882363

RESUMEN

Thrombotic thrombocytopenic purpura (TTP) is a disease characterized by the presence of microangiopathic hemolytic anemia (MAHA) and thrombocytopenia, caused by the congenital or acquired decrease of the enzyme activity which degrades unusual large vWF multimers. There is no identifiable cause in half of the acquired TTP cases. Herein, we report four possible pesticide-related cases with decreased ADAMTS13 enzyme activity, increased titer of ADAMTS13 inhibitor and typical clinical and laboratory presentation.


Asunto(s)
Plaguicidas/efectos adversos , Púrpura Trombocitopénica Trombótica/etiología , Adulto , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven
4.
J Oncol Pharm Pract ; 26(6): 1520-1523, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32028839

RESUMEN

INTRODUCTION: Mucinous adenocarcinomas of the testicular surface epithelial tumors are very rare and are similar to malignant ovarian-type surface epithelial tumors. Although only 32 cases have been reported to date, there are only five cases of primary testicular mucinous carcinoma with access to literature in English. So there is still limited information about clinical, etiopathogenesis and treatment options. CASE REPORT: In this article, we discuss a 56-year-old male patient diagnosed with testicular mucinous adenocarcinoma due to its rarity in the light of literature review.Management and outcome: We preferred cisplatin-paclitaxel regimen for adjuvant treatment. We then used sequential treatments including oxaliplatin, 5-fluorourasil, etoposide, gemcitabine, and docetaxel to treat metastatic disease. The patient underwent lung metastasectomy for the first relapse. The patient was diagnosed in November 2013 and the response to treatment was evaluated in December 2019 and stable disease was detected. The patient, who has a total survival of 73 months, is still under treatment. DISCUSSION: Excluding malign transformation and borderline mucinous testicular tumors from mucinous cystadenomas of the testis, the knowledge on carcinogenesis, clinical course, and treatment of primary testicular mucinous adenocarcinomas is very limited.


Asunto(s)
Adenocarcinoma Mucinoso/terapia , Testículo/patología , Adenocarcinoma Mucinoso/patología , Humanos , Masculino , Persona de Mediana Edad
5.
Andrologia ; 52(10): e13769, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-32799376

RESUMEN

This study aimed to determine oxidative stress in the tissue after testicular torsion biochemically and histopathologically and to examine the effects of Nesfatin-1 treatment on this injury. Thirty-two rats were randomly divided into four groups: sham, torsion + detorsion (4 hr torsion followed by 1 hr detorsion), ischaemia/reperfusion + saline (I/R + S) and I/R + nesfatin-1. I/R + S group a single-dose saline treatment was administered intraperitoneally at the two-hundred-tenth minute of torsion (ischaemia; 10 cc/kg). Similarly, I/R + nesfatin-1 group a single dose of nesfatin-1 treatment was administered intraperitoneally at the two-hundred-tenth minute of ischaemia (10 µg/kg). Myeloperoxidase, total oxidant status and oxidative stress index values were significantly increased in the I/R and I/R + S group compared to the sham group. Superoxide dismutase was significantly decreased in the I/R + S group compared to the sham group. No significant difference was found between the I/R + nesfatin-1 group and the other I/R groups (I/R and I/R + S) in terms of biochemical parameters. The mean diameter of the seminiferous tubule decreased in the I/R groups. However, the mean diameter of the seminiferous tubules was not significantly different between the I/R + S group and the I/R + nesfatin-1 group. Thus, the administration of nesfatin-1 after ischaemia did not reduce testicular-oxidative stress.


Asunto(s)
Daño por Reperfusión , Torsión del Cordón Espermático , Animales , Humanos , Masculino , Malondialdehído/metabolismo , Estrés Oxidativo , Ratas , Ratas Wistar , Daño por Reperfusión/metabolismo , Daño por Reperfusión/prevención & control , Torsión del Cordón Espermático/tratamiento farmacológico , Torsión del Cordón Espermático/metabolismo , Testículo/metabolismo
6.
Transfus Apher Sci ; 58(4): 447-448, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31320278

RESUMEN

Acquired hemophilia A, due to spontaneous autoantibody against FVIII, is a rare hemorrhagic disorder with an incidence of about 1 per million population per year. If unrecognized and untreated, it is associated with a high morbidly and mortality rate of 8-12%. Autoantibody against coagulation factor VIII neutralizes procoagulant activity. We report herein is such a rare case of acquired hemophilia in a patient with CLL.


Asunto(s)
Autoanticuerpos/sangre , Inhibidores de Factor de Coagulación Sanguínea/sangre , Factor VIII/antagonistas & inhibidores , Hemofilia A/sangre , Leucemia Linfocítica Crónica de Células B/sangre , Anciano , Factor VIII/metabolismo , Femenino , Humanos
7.
Turk J Med Sci ; 49(1): 153-161, 2019 Feb 11.
Artículo en Inglés | MEDLINE | ID: mdl-30764592

RESUMEN

Background/aim: This study was designed to determine the characteristic features of upper urinary system urothelial carcinomas (UUSUCs) and to evaluate the clinicopathological parameters associated with prognosis. Materials and methods: A total of 74 cases of UUSUC were included, from three different centers. Demographic data and histopathological features such as tumor localization, concomitant tumor in the urinary system, distant metastasis with overall survival and disease-free survival obtained from the hospital records were evaluated retrospectively. Histopathologic prognostic features such as grade, perineural invasion, lymphovascular invasion, tumor necrosis, and surgical margin status were also evaluated. Results: Seventy cases (94.6%) underwent open nephroureterectomy whereas 4 cases (5.4%) had laparoscopic nefroureterectomy. Thirty-eight (51.4%) cases were located in the pelvis, 7 (9.5%) in the ureter, 29 (39.2%) both in the pelvis and ureter. Fifty-six (75.7%) cases were alive; however, 18 (24.3%) patients were found to be dead. pTa, pT1, pT2, pT3, and pT4 tumors were reported in 16 (21.6%), 13 (17.6%), 4 (5.4%), 28 (37.8%), and 13 (17.6%) patients, respectively. Histopathologically, 17 cases (23%) were low-grade, 57 cases (77%) were high-grade. Statistically significant correlation was observed between overall survival and lymph node metastasis, distant metastasis, tumor necrosis, and differentiation by univariate analysis. Only distant metastasis was statistically associated with overall survival by multivariate analysis. We found no significant relationship between disease-free survival and all parameters. Conclusion: Differentiation and necrosis of tumor, lymph node involvement, and presence of distant metastasis is associated with the overall survival of urothelial carcinoma of the upper urinary system.


Asunto(s)
Carcinoma de Células Transicionales , Neoplasias Renales , Metástasis Linfática/diagnóstico , Nefroureterectomía , Neoplasias Ureterales , Carcinoma de Células Transicionales/diagnóstico , Carcinoma de Células Transicionales/mortalidad , Carcinoma de Células Transicionales/patología , Carcinoma de Células Transicionales/fisiopatología , Correlación de Datos , Femenino , Humanos , Neoplasias Renales/diagnóstico , Neoplasias Renales/mortalidad , Neoplasias Renales/patología , Neoplasias Renales/fisiopatología , Masculino , Márgenes de Escisión , Persona de Mediana Edad , Clasificación del Tumor , Invasividad Neoplásica , Estadificación de Neoplasias , Nefroureterectomía/efectos adversos , Nefroureterectomía/métodos , Nefroureterectomía/estadística & datos numéricos , Pronóstico , Estudios Retrospectivos , Análisis de Supervivencia , Turquía/epidemiología , Neoplasias Ureterales/diagnóstico , Neoplasias Ureterales/mortalidad , Neoplasias Ureterales/patología , Neoplasias Ureterales/fisiopatología , Urotelio/patología
8.
Eur J Clin Invest ; 48(7): e12963, 2018 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-29856477

RESUMEN

BACKGROUND: This study investigated the effect of matrix metalloproteinase (MMP)-9 and 10, and stress hyperglycaemia on the necessity of emergency renal replacement therapy (RRT) and mortality in nondiabetic geriatric patients with acute kidney injury (AKI). MATERIALS AND METHODS: The present observational and longitudinal study included 101 nondiabetic geriatric patients (age >65 years) with AKI. The serum levels of MMP-9 and MMP-10 were evaluated in these patients. Serum glucose level >140 mg/dL at the time of admission was accepted as stress hyperglycaemia. RESULTS: The average age of patients was 81 ± 7.1 years. Stress hyperglycaemia was diagnosed in 34.6% of the cases; the majority of these cases were patients with high-serum urea, CRP, and chronic kidney disease. The average levels of MMP-9 and MMP-10 were found to be 199 ± 38 and 16.5 ± 7.5 ng/mL, respectively. Thirty-one cases (30.6%) mortality during hospitalization and 20 cases (20%) underwent emergency RRT. Multiregression analysis showed the serum urea (P < .001) and stress hyperglycaemia (P = .03) to be independently associated with mortality. Also, serum urea (P = .01), potassium level (P = .03), and MMP-10 levels (P = .03) were independently associated with the necessity of the emergency RRT. The MMP-9 levels exhibited no relation with the necessity of emergency RRT and mortality. CONCLUSION: Stress hyperglycaemia is a common condition among nondiabetic geriatric patients with AKI and is related to mortality. Serum MMP-10 levels serve as an important predictor of the necessity of emergency RRT in these patients.


Asunto(s)
Lesión Renal Aguda/diagnóstico , Hiperglucemia/complicaciones , Metaloproteinasa 10 de la Matriz/metabolismo , Metaloproteinasa 9 de la Matriz/metabolismo , Estrés Fisiológico/fisiología , Lesión Renal Aguda/etiología , Lesión Renal Aguda/terapia , Anciano , Anciano de 80 o más Años , Biomarcadores/metabolismo , Tratamiento de Urgencia/estadística & datos numéricos , Femenino , Humanos , Estudios Longitudinales , Masculino , Valor Predictivo de las Pruebas , Terapia de Reemplazo Renal/estadística & datos numéricos
9.
J Craniofac Surg ; 27(3): e260-1, 2016 May.
Artículo en Inglés | MEDLINE | ID: mdl-26999700

RESUMEN

Dermoid cysts are benign lesions seen in young adults. The second most common localization is the floor of the mouth. They are usually asymptomatic over years but can be symptomatic due to secondary changes or the size. Herein, we report a case of 19-year-old woman who applied to emergency service with dyspnea, dysphagia and enlarging of a mass in the submental region. The patient cannot be entubated because of the mass pushing the tongue base backward closing the laryngeal view. Elective tracheostomy was performed for providing airflow during the operation. After the operation a cystic mass fulfilled with keratin lined by keratinized stratified squamous epithelium in addition to the dermal appendages such as sweat glands and follicular structures were seen histopathologically and the case was diagnosed as dermoid cyst of the submental region. In such patients with quick enlarging of mass causing airway obstructions, the tracheostomy can be the preferable method because of the difficulties in entubation.


Asunto(s)
Trastornos de Deglución/etiología , Quiste Dermoide/complicaciones , Disnea/etiología , Neoplasias de la Boca/complicaciones , Biopsia con Aguja Fina , Trastornos de Deglución/diagnóstico , Quiste Dermoide/diagnóstico , Quiste Dermoide/cirugía , Diagnóstico Diferencial , Disnea/diagnóstico , Femenino , Humanos , Imagen por Resonancia Magnética , Neoplasias de la Boca/diagnóstico , Adulto Joven
10.
Dermatol Online J ; 22(7)2016 Jul 15.
Artículo en Inglés | MEDLINE | ID: mdl-27617723

RESUMEN

Cutaneous metastasis can be rarely first manifestation of internal cancers; these usually develop with advanced stage malignancies. Cutaneous metastasis of ovarian cancer is rare and the majority of are seen around the pelvic region compatible with the localization of the primary ovarian tumor. Herein, we report a patient with ovarian cancer with widespread and distant cutaneous metastases showing multiple nodules and ulcers.


Asunto(s)
Adenocarcinoma/secundario , Neoplasias Quísticas, Mucinosas y Serosas/secundario , Neoplasias Ováricas/patología , Neoplasias Cutáneas/secundario , Adenocarcinoma/patología , Anciano , Femenino , Humanos , Neoplasias Quísticas, Mucinosas y Serosas/patología , Piel/patología , Neoplasias Cutáneas/patología , Tórax
11.
Int J Gen Med ; 17: 2029-2036, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38741678

RESUMEN

Background: Colorectal cancers (CRC) are one of the most common tumors that are being researched for new biomarkers worldwide. In this context, studies are being carried out to estimate whether various hematological parameters can be used for predicting prognosis. In this study, our aim was to evaluate the relation between platelet (PLT) levels as well as neutrophil-to-lymphocyte ratio (NLR), platelet (PLT)-to-lymphocyte ratio (PLR), and Lymphocyte-to-CRP ratio (LCR) which are easily accessible inflammatory response indicators. Methods: In this retrospective cross-sectional study, 111 patients diagnosed as colorectal adenocarcinoma were included. Patients with clinical evidence of an infection, recurrent colorectal cancer, previous history of a hematological disease, and a neoadjuvant chemo/radiotherapy were excluded. Demographic features such as age, gender, and histopathologic parameters such as tumor size, surgical margin status (proximal, distal, and radial), the presence of serosal inflammation, lymphovascular invasion (LVI), perineural invasion (PNI), lymph node metastasis (LNM) and distant metastasis, preoperative blood sample analysis, and CRP levels were noted. Statistical analysis for the association between hematologic parameters platelet (PLT) levels as well as neutrophil-to-lymphocyte ratio (NLR), platelet (PLT)-to-lymphocyte ratio (PLR), and Lymphocyte-to-CRP ratio (LCR) and histopathological features were done. Results: Among 111 patients, the mean age was 65.37, and the mean tumor size was 5.41 cm. Lymphovascular invasion, perineural invasion, radial surgical margin positivity, lymph node metastasis, localization, and stage were statistically significantly related to the number of platelets. For NLR, PNI (p=0.001), LNM (p=0.048), and stage (early/advanced) (p=0.045) were significantly related. None of the parameters were related to PLR and LCR. Conclusion: Perineural invasion, lymph node metastasis, and the stage of the tumor could be the major histopathological features that could be related to hematologic parameters; however, this should be researched by larger studies as if they can be used as prognostic markers.

12.
Medicine (Baltimore) ; 103(29): e38997, 2024 Jul 19.
Artículo en Inglés | MEDLINE | ID: mdl-39029054

RESUMEN

The prognostic significance of angiogenesis has been demonstrated in various types of cancer. However, in colorectal cancer (CRC), there are conflicting results regarding the relationship between angiogenesis and clinical-histopathological prognostic factors. Mast cells are immune system cells found in the inflammatory microenvironment; their role in carcinogenesis and prognosis remains unclear although they are considered to cause cancer development and progression. The present study aims to evaluate the prognostic significance of mast cell accumulation and angiogenesis assessed by microvessel density (MVD) in patients with CRC. Patients who underwent curative resection and who were not treated with neoadjuvant chemotherapy were included. The anti-CD34 antibody and anti-CD117 antibody were utilized for the immunohistochemical assessment of MVD and the mast cell count (MCC) in the tissue samples, respectively. The relationship between MCC, MVD, survival and clinical-histopathological prognostic factors were evaluated. A total of 94 patients were enrolled to the study. In a median 49-month follow-up, 65 patients (69.1%) died. The 5-year disease-free survival was 61.1% and 31.3% for the group with CD34 < 18.3% and CD34 > 18.3%, respectively (P = .001). The same groups presented 5-year overall survival rates of 77, 1% and 51, 4%, respectively (P, .012). The MVD was found to be associated with the pathological T stage, lymph node metastasis and distant metastasis (P < .05). Although the MCC was positively correlated with MVD, there was no association between the MCC and clinical-histopathological prognostic factors. MVD-assessed angiogenesis was significantly related to survival and the clinical-histopathological prognostic factors in patients diagnosed with CRC.


Asunto(s)
Neoplasias Colorrectales , Mastocitos , Densidad Microvascular , Neovascularización Patológica , Proteínas Proto-Oncogénicas c-kit , Humanos , Neoplasias Colorrectales/patología , Neoplasias Colorrectales/irrigación sanguínea , Neoplasias Colorrectales/mortalidad , Masculino , Femenino , Mastocitos/patología , Persona de Mediana Edad , Pronóstico , Anciano , Neovascularización Patológica/patología , Proteínas Proto-Oncogénicas c-kit/metabolismo , Adulto , Antígenos CD34/metabolismo , Inmunohistoquímica , Supervivencia sin Enfermedad , Anciano de 80 o más Años
13.
Cureus ; 14(11): e31545, 2022 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-36540526

RESUMEN

Chronic lymphocytic leukemia (CLL) is a hematological disease characterized by the proliferation of monoclonal B-lymphocytes. Although autoimmune complications such as autoimmune hemolytic anemia and immune thrombocytopenia are common in CLL patients, nonhematological autoimmune complications are rather rare. The most common renal involvements are membranoproliferative glomerulonephritis and minimal change disease. Focal segmental glomerulosclerosis (FSGS) is predominantly associated with Hodgkin's lymphoma among hematological malignancies. FSGS associated with CLL is rarely reported in the literature, with a poor understanding of the common pathophysiology and a very limited experience with this co-occurrence. Although Rai Stage 1/Binet Stage B CLL, our 61-year-old case, who was diagnosed with secondary FSGS, which is a very rare complication, was treated with fludarabine, cyclophosphamide, and rituximab (FCR) combination. Following the treatment, a complete response was achieved about CLL, and the patient, whose renal findings recovered, is in remission and under follow-up for six years. Although the mechanisms between CLL and autoimmune complications are not fully elucidated, it is usually related to immune disorders like an abnormal T-cell response and polyclonal antibody production. While FSGS is very rare in lymphoma, its co-existence with CLL is reported only in a limited number of case reports. Steroids may be used in these patients; however, in cases not responding to steroids, treatment of the underlying CLL is required.

14.
North Clin Istanb ; 9(4): 331-336, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36276561

RESUMEN

OBJECTIVE: Acute myeloid leukemia (AML) is a hematological malignancy that frequently affects elderly population. With introducing the hypomethylating agents (HMAs) in elderly AML treatment, survival rates and quality of life have improved. However, long-term management in elderly and frail patients is still a challenge. In the present study, we aimed to determine whether HMA maintenance therapy is required until disease progression in frail and elderly AML patients by examining with a real-life data. METHODS: In a multicenter study, we analyzed non-promyelocytic elderly AML patients who were treated with first-line azacitidine or decitabine monotherapy in two different groups, retrospectively. While patients were treated with HMA until progression in the maintenance group, 6+3 cycles of azacitidine or decitabine were administered as a standard care of elderly AML patients in the non-maintenance group. Survival outcomes were compared between the groups. RESULTS: HMA therapy was maintained until progression in 20 patients, and HMA therapy was terminated after 6+3 cycles in 21 patients. Patients received a median of 6 (1-14) HMA cycles during follow-up time. The median 7.5 months of overall survival were observed (2-17 months) in maintenance and 3 months (1-13 months) in non-maintenance groups (p=0.001). CONCLUSION: Despite long-term exposure to HMA may appear as a risk factor for complications and toxicities in elderly and frail AML patients, the maintenance of therapy until disease progression provides a significant survival advantage. Therefore, we suggest that HMA therapy should continue until disease progression regardless the sort of HMA.

15.
PLoS One ; 17(5): e0266137, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35511824

RESUMEN

OBJECTIVE: Dental mesenchymal stem cells (MSCs) are potential for use in tissue regeneration in inflammatory diseases due to their rapid proliferating, multilineage differentiation, and strong anti-inflammatory features. In the present study, immunoregulatory and glandular tissue regeneration effects of the dental follicle (DF)MSCs in Sjögren's Syndrome (SS) were investigated. METHODS: Dental follicle (DF) tissues were obtained from healthy individuals during tooth extraction, tissues were digested enzymatically and DFMSCs were cultured until the third passage. DFMSCs were labeled with Quantum dot 655 for cell tracking analysis. The induction of the SS mouse model was performed by the injection of Ro60-273-289 peptide intraperitoneally. DFMSCs were injected intraperitoneally, or into submandibular, or lacrimal glands. Splenocytes were analyzed for intracellular cytokine (IFN-γ, IL-17, IL-10) secretion in T helper cells, lymphocyte proliferation, and B lymphocyte subsets. Histologic analysis was done for submandibular and lacrimal glands with hematoxylin-eosin staining for morphologic examination. RESULTS: The systemic injection of DFMSCs significantly reduced intracellular IFN-γ and IL-17 secreting CD4+ T cells in splenocytes (p<0.05), and decreased inflammatory cell deposits and fibrosis in the glandular tissues. DFMSCs differentiated to glandular epithelial cells in submandibular and lacrimal injections with a significant reduction in lymphocytic foci. The results showed that few amounts of DFMSCs were deposited in glandular tissues when applied intraperitoneally, while high amounts of DFMSCs were located in glandular tissues and differentiated to glandular epithelial cells when applied locally in SS murine model. CONCLUSION: DFMSCs have the potential for the regulation of Th1, Th17, and Treg balance in SS, and ameliorate glandular dysfunction. DFMSCs can be a beneficial therapeutic application for SS.


Asunto(s)
Células Madre Mesenquimatosas , Síndrome de Sjögren , Animales , Saco Dental/patología , Modelos Animales de Enfermedad , Interleucina-17 , Células Madre Mesenquimatosas/patología , Ratones , Síndrome de Sjögren/patología , Síndrome de Sjögren/terapia
17.
Arch Esp Urol ; 74(3): 359-362, 2021 Apr.
Artículo en Inglés, Español | MEDLINE | ID: mdl-33818434

RESUMEN

OBJECTIVES: We present a unique case with a ureteral fibroepithelial tumor originating from the ureter, which could be confused with a bladder tumor on ultrasound examination due to its movement in and out of the bladder. METHODS: In cystoscopy, a papillary tumor lesion emerging from the right ureteral orifice was seen. After scanning the other quadrants, however, the tumor was not observed at the right ureteral orifice. It was then protruded back into the bladder. The tumor was seen several times to protrude into the bladder and return to the ureter, possibly due to ureteral peristalsis. Then, a semi-rigid ureteroscope was introduced through the right ureteric orifice, and the tumor was excised in one piece using Holmium laser fiber with 365µm of diameter. The size of the removed tumor was approximately 8 cm long. A double-j stent of 4.8 Fr was placed in the ureter. RESULTS: The patient was discharged on the first day without complications. The fibroepithelial polyps of the ureter, which consist of the stroma of mesoderm origin, covered with histologically normal or hyperplastic urothelial epithelial cells, are extremely rare tumors. It is important to distinguish these polyps from urothelial cancers, since these two entities are different in treatment and prognosis, although similar in symptoms and imaging procedures. CONCLUSIONS: Minimally invasive treatment techniques can be safely applied in the treatment of such exceedingly rare tumors.


OBJETIVO:  Presentamos un caso único de tumor fibroepitelial ureteral originado en el uréter que se puede confundir con un tumor vesical por ecografía debido al movimiento dentro y fuera de la vejiga. MÉTODOS: En la cistoscopia, se vió una lesión tumoral papilar saliendo del meato ureteral. Después de mirar el resto de zona de la vejiga, dejamos de ver el tumor en el meato ureteral derecho. Una vez más, protuía después, en la vejiga. Se realizó una ureteroscopia semirrígida y se quitó el tumor en una pieza con laser holmium de 365. El tumor tenía una longitud de 8 cm. Se colocó un catéter doble J 4.8 Fr en el uréter. RESULTADOS: El paciente fue dado de alta en el primer día postoperatorio sin complicaciones. El pólipo fibroepitelial del uréter consiste en estroma del mesodermo cubierto de histológica normal o hiperplásica. Estos tumores son extremadamente raros. Es importante diferenciarlos de los tumores uroteliales ya que el tratamiento y pronóstico es diferente, aunque los síntomas y las técnicas de imagen son parecidas. CONCLUSIONES:  Las técnicas mínimamente invasivas se pueden aplicar a estos tumores tan poco comunes.


Asunto(s)
Pólipos , Uréter , Neoplasias Ureterales , Humanos , Pólipos/diagnóstico por imagen , Pólipos/patología , Pólipos/cirugía , Uréter/patología , Neoplasias Ureterales/diagnóstico por imagen , Neoplasias Ureterales/patología , Neoplasias Ureterales/cirugía , Ureteroscopía , Vejiga Urinaria/diagnóstico por imagen , Vejiga Urinaria/patología , Vejiga Urinaria/cirugía
18.
Turk J Obstet Gynecol ; 18(1): 1-6, 2021 Mar 12.
Artículo en Inglés | MEDLINE | ID: mdl-33715320

RESUMEN

OBJECTIVE: There is a growing debate on the existence of the G-spot. G-spot amplification by various surgical interventions has become mainstream for esthetic vaginal surgery despite a lack of conclusive proof of the G-spot. The aim of this study was to search for histologic evidence in regions of so-called hyperintense focus (HF) (considered as the G-spot) using magnetic resonance imaging (MRI) mapping and biopsied tissues. MATERIALS AND METHODS: Fifteen patients who had grade 2 or higher anterior compartment defects were enrolled in the study. All patients were subjected to MRI. When a HF was seen, its localization, dimensions, and distances to adjacent structures were measured in images. Dissections in the anterior vaginal wall were performed in accordance with the measurements derived from MRI and tissue measuring 0.5x0.5 cm was biopsied from the determined HF. RESULTS: An HF was determined in MRI of three (20%) patients. However, no significant neurovascular tissue density was observed histologically in any of the biopsy specimens obtained from the surgical dissections under the guidance of MRI mapping. CONCLUSION: Our findings denote that there is no G-spot in the anterior vaginal wall.

19.
Case Rep Med ; 2020: 5727569, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32180809

RESUMEN

Rosai-Dorfman disease (RDD) is a rare and benign pathology of sinus histiocytosis of unknown etiology. Lymphadenopathy is the predominant clinical manifestation, but diverse organs can also be affected. Histological features involve S-100+ histiocytes with characteristic nuclear features within the enlarged sinusoids of the lymph nodes. The clinical course is unpredictable, but is often benign with spontaneous resolution of disease in most patients. We report a patient with bilateral massive enlargement of cervical, axillary, and inguinal lymph nodes, moderately enlarged spleen, and a weight loss of 15 kg. Excisional biopsy from the cervical lymph node showed that the dilated sinusoids were infiltrated by lymphocytes, plasma cells, and large histiocytes with CD 68 and S-100 protein positive. Due to the slow progression of the disease, oral prednisolone with a body weight of 1 mg/kg was started in March 2016. The steroid dosage has been adjusted many times during the clinical follow-up. After 33 months, steroid treatment resulted in partial shrinkage of lymph nodes, the spleen returned to its normal size, and the patient gained weight. After 38 months of follow-up, no systemic symptoms, sign, or extranodal involvement were detected, and the patient continued with low-dose steroid treatment.

20.
Turk J Surg ; 36(1): 65-71, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32637878

RESUMEN

OBJECTIVES: This study aimed to evaluate outcomes, complications, and follow-up results of ultrasound-guided vacuum-assisted breast biopsy (UG-VABB) in BI-RADS 4 A and B lesions. MATERIAL AND METHODS: Between Agust 2014 to January 2018, fifty BI-RADS 4A and BI-RADS 4B lesions of 41 patients biopsied with 10G vacuum needle by a single radiologist were retrospectively evaluated. RESULTS: All patients were females and mean age of the 41 patients was 50.12 ± 8.63. Of all lesions, 84% was benign, 6% was ADH, 4% was in-situ cancer, and 6% was diagnosed as malign. Follow-up duration after VABB was 0-51 months and mean was 20.92 months. Complications were as vasovagal-induced seizure in 3 patients (7.3%) and intramammary hematoma in 16 patients (39%). Hematoma was diagnosed in 3 patients (7.3%) at the 6th month follow-up and it was resolved in all patients at the 12th month follow-up. Higher breast density resulted in higher hematoma rates. There was no relationship between lesion BI-RADS subgroups, lesion size or sample number and hematoma development. During the follow-up, residue lesion in 1 (2.4%) patient and scar tissue in 2 (4.9%) patients was detected. CONCLUSION: US-guided VABB, with low complication rates and low scar development, is also a therapeutic excision method without remaining residue, which should be primarily preferred in smaller than 2 cm BI-RADS 4A and 4B lesions whose malignancy rates are relatively low. Hematoma, which is the most frequent complication, resorbed entirely in the 12th month in all patients.

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