Coexistence of an esophageal bronchogenic cyst and a thyroglossal duct cyst: a case report and review of literature

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How Does the COVID-19 Pandemic Influence Histopathological Outcomes for Urologic Cancers?

Objective: The coronavirus disease 2019 (COVID-19) pandemic disrupted all routine health care services and resulted in a significant reconfiguration of urologic cancer services and care pathways across the globe. This study aimed to retrospectively determine the pandemic’s impact on the urologic oncological surgery outcomes at a high-volume referral center.

Materials and methods: We compared the number and histopathological outcomes of urologic oncological procedures in a referral center coded during the pandemic and data of the period before the pandemic as control. Data were extracted from patient files and hospital records. The pathological examination included a complete histopathological staging according to TNM stage.

Results: A total of 683 patients were included in the study, 424 (62%) of which were operated in the pre-pandemic period. There was a 39% decline in urologic oncological surgical activity in the pandemic, mostly in renal and prostate cancer. The mean tumor size was larger in renal cancer patients who underwent surgery during the pandemic (5.6 cm vs 4.5 cm, p=0.002). During the pandemic, more lymph node involvement was seen after radical cystectomy and prostatectomy (50% vs 27.8%, p=0.024 and 12.5% vs 4.5%, p=0.026, respectively). No differences in terms of main pathologic features were observed in patients undergoing radical orchiectomy.

Conclusion: COVID-19 appeared to adversely effect oncologic outcomes in patiens undergone surgery for prostate and bladder cancer. Tumor development induced by a delay in diagnosis may cause severe consequences for patients. Reprioritizion of non-deferrable urologic oncological seems crucial.

Do bony pelvis parameters affect perioperative outcomes in open radical prostatectomy?

Objective

The present study aimed to evaluate the predictive value of bony pelvic parameters measured by computerized tomography (CT) for use in the estimation of the likely technical difficulties that may be encountered when performing open radical prostatectomy (RP) for localized prostate cancer.

Material and methods

One hundred patients, undergoing open RP for localized prostate cancer, were evaluated between October 2016 to November 2018. All operations were performed by the same experienced surgeon. Pelvic parameters were measured using spiral CT images. Data were retrospectively collected from medical, operative, radiology, and pathology records and analyzed. Positive surgical margin (PSM), presence of vesicourethral anastomosis stricture (VUAS) and urine leakage, operative time, urethral catheterization time, and estimated blood loss were used as indicators of operative difficulty. Univariate and multivariate analyses were performed to determine the significance of these variables.

Results

There was no significant correlation between the pelvic parameters of the patients and the presence of PSM, VUAS, and urine leakage. Only PSA levels and pathological tumor stage were higher in patients with PSM (p = 0.002 and p = 0.001). On univariate and multivariate analyses, none of the individual pelvic parameters assessed showed a significant relationship with the operation time, estimated blood loss, and urethral catheterization time. In univariate analysis, there was a significant relationship between PSA levels and pathological tumor stage and operation time (p = 0.048 and p = 0.001, respectively).

Conclusion

Bony pelvic parameters may not be a significant factor in influencing the perioperative outcomes of open RP. Higher PSA levels and pathological tumor stage may lead to surgical margin positivity and longer operative time.

The role of Wnt pathway antagonists in early-stage lung adenocarcinoma

PURPOSE

We aimed to examine the expression levels of the genes encoding adenomatous polyposis coli (APC) 1, APC-2, Dickkopf related protein (DKK)-1, DKK-3, secreted frizzled-related protein (SFRP)-2, SFRP-4, and SFRP-5, which play roles in the Wnt signaling pathway, in lung adenocarcinoma and adjacent normal lung tissues and to evaluate their relationships with clinicopathologic factors.

MATERIALS AND METHODS

The expression levels of genes in formalin-fixed paraffin-embedded samples of tumor tissue and adjacent intact lung tissue from 57 patients who underwent surgery for lung adenocarcinoma between 2011 and 2018 were determined by real-time PCR analysis.

RESULTS

The expression levels of the DKK-1 in tumor tissue, especially in stage I-II tumor tissue, were significantly suppressed compared to those in normal tissue (p < 0.025). Whereas DKK-1 expression was suppressed in the tumor tissue of patients with early-stage lung adenocarcinoma, expression of the SFRP-5 in these patients was significantly higher in tumor tissue than in normal tissue (p < 0.039).

CONCLUSION

In our study, opposing regulation was found between the SFRP-5 and DKK-1, which are known to be extracellular antagonists of the Wnt signaling pathway. The SFRP-5 was found to have an oncogenic role in adenocarcinoma development. Studies of the opposing regulation between these genes in early-stage lung adenocarcinoma may shed light on the mechanisms associated with the development of carcinogenesis. The relationships or interactions of these genes may serve as potential therapeutic targets.

Endovascular Treatment of a Giant Renal Vein Aneurysm Arising from a High-Flow Arteriovenous Fistula

Background: Renal vein aneurysms (RVAs) are considered rare clinical entities. RVAs can be secondary to thrombosis, venous hypertension, or renal arteriovenous fistula (RAVF). RVAs secondary to RAVF are rare. Patients with RVA may present with hypertension, abdominal pain, hematuria, or may even be asymptomatic. However, there may be life-threatening emergencies including aneurysm rupture, thrombosis, and pulmonary embolism. The treatment of RVAs includes reconstruction of the renal vein, nephrectomy, and endovascular treatment. Purpose: In this technical note, we report the endovascular treatment of a giant RVA that developed secondary to an acquired RAVF by the placement of multiple vascular plugs. Conclusion: Endovascular occlusion of the RAVF with vascular plugs is effective to prevent a life-threatening rupture of RVA. Clinical follow-up is crucial to detect leakage or migration of the vascular plugs.

Effect of vesicourethral anastomosis technique on functional results in retropubic radical prostatectomy

AIM

We aimed to compare the functional results of two different vesicourethral anastomosis (VUA) techniques used in open retropubic radical prostatectomy.

METHODS

A total of 476 patients including the first group with four-focus VUA at 12-, 3-, 6-, and 9-o'clock positions (n = 288) and the second group with six-focus VUA at 12-, 2-, 4-, 6-, 8-, and 10-o'clock (n = 188) were included in the study. Perioperative data, erectile function, and continence status over a 12-month period were compared.

RESULTS

Demographic and perioperative data were similar between two groups. The number of patients with VUA stricture in the first group was significantly higher those in the second group (5.1% vs 3.2%, P = .017). The mean time to stricture development was also shorter in the first group (48.9 vs 74.3 days, P = .002). The number of continent patients at the 6th and 12th months were higher in the second group (79.3% vs 62.8%, P < .001; 92.4% vs 81.3%, P = .032, respectively). There was no significant difference between two groups in terms of the number of potent patients (P = .194 for 6 months and P = .351 for 12 months).

CONCLUSIONS

Better continence results can be provided with the six-focus VUA technique compared with the four-focus technique. The number of anastomotic sutures in VUA may affect functional results and can be a determinative factor for surgeons who focus on functional results as well as oncological results.

A new technique in the treatment of ureteroenteric anastomosis stricture: Repair of ureteroenteric anastomosis stricture with low lombotomy incision (retroperitoneal approach)

INTRODUCTION AND AIM

Ureteroenteric anastomosis stricture (UEAS) is one of the complications of urinary diversion and may lead to serious consequences. In this study, we evaluated our UEAS revision technique outcomes performed with a low lombotomy incision in the lateral decubitus position.

MATERIALS AND METHODS

Eleven patients who underwent surgical repair due to isolated right UEAS between January 2010 and June 2019 were included in the study. Anastomosis stricture was confirmed by ultrasonography, computed tomography or magnetic resonance urography techniques. Ultrasonography was used to detect hydronephrosis, which is a finding secondary to stricture. However, opaque urography imaging methods were used to confirm the definitive diagnosis of the stricture. Demographic and clinical data, preoperative and postoperative 3rd month serum creatinine, estimated glomerular filtration rate (eGFR) and dynamic renal scintigraphy data of patients were evaluated.

RESULTS

The mean operation time was 49.7 ± 9.3 minutes. No perioperative complications were observed. While the overall stricture rate was 11.4%, the isolated right-sided stricture rate was 5.7%. Preoperative and postoperative serum creatinine values were similar. Preoperative eGFR value was 58.8 ± 12.9 mL/min/1.73 m² and postoperative value was 53.5 ± 11.5 mL/min/1.73 m² . T½ level decreased in postoperative period (22.3 ± 8.2 min vs 15.1 ± 4.3 min).

CONCLUSIONS

Open revision of the UEAS with retroperitoneal approach provides lower morbidity rates and shorter hospitalisation time compared to other methods. The retroperitoneal approach is the main advantage of this technique and prevents morbidity caused by other techniques performed intraperitoneally and owing to it is an open technique, it can be easily applied in isolated right-sided UEAS.

Treatment of a case of COVID-19 by intravenous immunoglobulin

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is a positive-sense single-stranded RNA virus. As of today, no specific treatment has been found COVID-19. İntravenous immunoglobulin (IVIG) is a widely used therapy to prevent life-threatening infections in patients with primary and secondary immune deficiencies and autoimmune/inflammatory conditions. IVIG administration could be beneficial in the treatment of patients with severe COVID-19. In this respect, this presentation aimed to report a case of COVID-19 treated with IVIG.

Comparison of robotic and open radical prostatectomy: Initial experience of a single surgeon

Objective:

In this study, we aimed to make a comprehensive comparison of the first hundred robot-assisted radical prostatectomy (RARP) and open retropubic radical prostatectomy (RRP) cases of a single surgeon in a high-volume center.

Methods:

Preoperative, perioperative and postoperative data were collected retrospectively. Perioperative, oncological data and functional results in the first year were compared between the two groups. There were 204 RARPs between January 1, 2014 and December 31, 2019, and 755 RRPs between April 1, 2007 and December 31, 2019.

Results:

While the operation time was in favor of the open group (117 vs 188 min, p<0.001), the estimated blood loss (328 vs 150 ml, p<0.001), blood transfusion rate (12 vs 2, p=0.021), and re-operation rate (6 vs 0, p=0.001) were in favor of the robotic group. Mean length of hospital stay (5.4 vs 3.1, p<0.001), urine leak rate (11 vs 2, p=0.033), complication rate (37 vs 16, p=0.018), and the 12th month continence rate (67 vs 85, p=0.002) were better in the robotic group.

Conclusions:

RARP may provide better perioperative outcomes and lower complication rates after the surgeon factor is eliminated in the early period. Since our case group includes the initial 100 patients, studies with larger patient groups with longer follow-up are needed to adapt these early results to general outcomes.

Butterfly vertebra and block vertebra cause overdiagnosis in trauma patients

Butterfly vertebra and block vertebra are usually reported incidental radiological view, which is a rare congenital defect of spine. Butterfly vertebra is a body formation characterized by anterior and median aplasia. The block vertebra is the result of an embryonically incomplete separation of vertebral bodies or arches or both. This rare congenital anomalies butterfly and block vertebra are usually stable and do not cause clinical symptoms.

Multiparametric Prostate Magnetic Resonance Imaging before Radical Prostatectomy: Can IT Predict Histopathology?

PURPOSE

We aimed to investigate the histopathological correlation of the suspected prostate malignancy detected in multiparametric prostate magnetic resonance imaging (mpMRI).

MATERIALS AND METHODS

The data of 93 patients underwent radical prostatectomy and had preoperative mpMRI were examined. Age and pre-operative Prostate-Specific Antigen value were retrospectively collected from patient files. The pathology specimens were examined again and post-operative ISUP grade group, other pathological findings (seminal vesicle invasion, lymph node involvement and extraprostatic extension), pre-operative mpMRI were re-examined and PIRADS score, extracapsular extension, seminal vesicle invasion, neurovascular bundle invasion, lymph node involvement and ADC values were recorded.

RESULTS

151 (92,07%) of 164 lesions detected in mpMRI were histopathologically correlated. 80% of patients with seminal vesicle invasion (P < 0.001), 28.8% of patients with extracapsular extension (P < 0.052) and 42.9% of patients with lymph node involvement (P = .001) in mpMRI were histopathologically correlated. A significant relationship was found between PIRADS scores and ISUP grade groups (P < 0.001). There was a negative correlation between ADC values and ISUP grade groups (P < 0.001).

CONCLUSION

Our study showed that the lesions detected by mpMRI showed a high histopathological correlation.

Improving effects of mesenchymal stem cells on symptoms of chronic obstructive pulmonary disease

AIM

We aimed to identify the improving effects of umbilical cord tissue-derived (UCTD) MSCs on the symptoms of COPD in our phase 1.2 clinical study.

MATERIAL METHODS

Our study consisted of five patients with COPD. Respiratory function tests, SGRQ symptom, activity and impact scores and 6-minute walk test (6MWT) were examined before UCTD MSC treatment. All the patients were administered a total of 4 doses of UCTD MSCs by intravenous infusion at two-week intervals. All the tests were repeated three months after the treatment for evaluation of the response to MSCs treatment.

RESULTS

The mean age of five male patients was 56. The mean pretreatment FEV1/FVC ratios were 66.9 %. Pretreatment mean SGRQ symptom, activity and impact scores of the patients were 78.2, 83.8 and 58.02 respectively. The mean walking distance of the patients was 307 meters before MSCs treatment. The mean FEV1/FVC value of raised to 69.58 % after the treatment. The mean SGRQ symptom, activity and impact scores were noted as 39.8, 60.98 and 45.18 respectively. The mean walking distance of the patients raised to 362 meters after the treatment.

CONCLUSIONS

Our results showed that four doses of MSC treatment considerably alleviated the severity of symptoms of COPD (Tab. 2, Fig. 7, Ref. 25).

Carbapenem-resistant Klebsiella pneumonia infection outbreak in a tertiary urology clinic: analysis of influencing factors with a controlled trial

Background/aim

Carbapenem-resistantKlebsiella pneumoniae (CR-KP) infections encountered in urology patients differentiate from infections caused by other factors, both in respect to prophylaxis and treatment stage, and require a special approach. We aimed to analyse the predisposing factors and the antibiotherapies for CR-KP infection outbreak in a tertiary urology clinic.

Materials and methods

There were 75 patients in the CR-KP positive group (Group I) and 146 patients in the CR-KP negative group (Group II). Analysis of the predisposing factors for CR-KP infection and comparison of the reinfection rate and the antibiotherapies in the 2 groups were the endpoints.

Results

In the first group, age, comorbidity, previous antibiotic use, and nephrostomy tube rates were higher (P = 0.015, P = 0.001, P = 0.004, and P < 0.001, respectively). In the second group, open urological surgery rate, and the proportion of patients presenting with flank pain, lower urinary tract symptoms, and haematuria were higher (P = 0.029, P < 0.001, P < 0.001, and P = 0.007). In the first group, the proportion of patients treated with transurethral bladder tumour resection was higher, whereas, percutaneous nephrolithotomy was higher in the second group (P = 0.045 for both). While hospitalization and Foley catheterization duration were longer in the first group (P < 0.001 for both), double J stent and nephrostomy duration were longer in the second group (P < 0.001 and P = 0.005). Mean leukocyte count at admission was higher in the first group (P < 0.001).

Conclusion

Advanced age, comorbidities, previous antibiotic use, and prolonged Foley catheterization duration are predisposing factors for this infection in the urology department. Two-week administration of combination antibiotic regimens containing carbapenem were effective for the treatment of this infection.

The Protective Effect of The Interleukin 1 Receptor Antagonist on Chronic Thromboembolic Pulmonary Hypertension Model

Chronic thromboembolic pulmonary hypertension (CTEPH) is one of the main reasons of severe pulmonary hypertension and has significantly higher morbidity and mortality rates. The pathogenesis of the disease is characterized by the incomplete resolution of acute embolisms. The elevated inflammatory conditions after the acute embolism are one of the critical factors. Therefore, we aimed to investigate whether or not anakinra is an option for treating CTEPH in an animal model. We studied twenty-one rats in this study They were randomly divided into three groups containing seven animals: the control group: saline-treated control; the embolism group: CTEPH + normal saline; the anakinra group: CTEPH + anakinra. We have observed that the layers of the segmental arteries and the alveolar were normal in the control group. In the cardiac tissue it was observed that muscular tissues and connective tissue were normal in the right ventricle. In embolism group, we detected a widening of the alveolar septum, a surrounding the alveolar infiltrates and a thickening of the segmental arteries in the muscular layer and a hypertrophy in the right ventricle tissues. We have determined that the lung and cardiac tissue specimens in the anakinra group are similar to control group. We have showed that anakinra was useful option for the CTEPH model in rats. Anakinra may be considered as protective effect and the regression of the increased inflammation in CTEPH. The effectiveness of anakinra will continue to be subject to the further experimental and clinical studies.

Diagnostic Value of MiR-125b as a Potential Biomarker for Stage I Lung Adenocarcinoma

Background:

We aimed at exploring biological functions of differentially expressed miRNAs during carcinogenesis, to identify miRNAs dysegulations involved in DNA repair mechanisms, and to evaluate potential of miRNAs as prognostic and diagnostic biomarkers for early lung adenocarcinomas (LAC).

Methods:

We obtained 21 LAC and paired adjacent normal formalin-fixed, paraffinembedded lung tissues from patients who underwent curative resection for stage I LAC. We compared expression levels of eight miRNAs involved in the DNA repair mechanism between LAC and adjacent tissues.

Results:

Expressions of Hsa-miR-9-5p, hsa-miR-24-3p, hsa-miR-125a-3p, hsa-miR- 125b-5p, hsa-miR-155-5p, and hsa-let-7a-5p were significantly up-regulated in stage I LAC tissues compared with those in the adjacent tissues. In addition, expressions of hsa-mir-9-5p, hsa-mir-24-3p, hsa-mir-125a-3p, hsa-mir-125b-5p, and hsa-mir-155-5p were significantly up-regulated in stage Ia LAC tissues, whereas expressions of hsa-mir- 125a-3p and hsa-mir-125b-5p were significantly up-regulated in stage Ib LAC tissues. Receiver operating characteristic (ROC) analysis revealed that AUROC of hsa-mir-125b- 5p was 0.875 (P < 0.001).

Conclusion:

Expression of hsa-mir-125b-5p could be used to distinguish LAC from adjacent tissues. Our result suggests that hsa-mir125b-5p can be a prognostic and diagnostic biomarker for LAC.

Analysis of factors affecting repeat microdissection testicular sperm extraction outcomes in infertile men

OBJECTIVE

There is no clear consensus on which patients and how many of microscopic testicular sperm extraction (mTESE) procedures will be successful. In this study, we aimed to evaluate the sperm retrieval rates and factors affecting these rates in men who underwent repeat mTESEs.

MATERIAL AND METHODS

A total of 346 patients who underwent mTESE for sperm retrieval were included in the study. Patients were divided into groups according to the number of mTESE operations. Patients' karyotype, follicle-stimulating hormone (FSH) and testosterone levels, varicocele presence, and testis volumes were recorded from patient files. The sperm retrieval rates were compared between groups, and predicting factors for successful sperm retrieval were evaluated.

RESULTS

Microscopic TESE was applied for the first time in 244 patients, 1-2 times in 73 patients, and 3-4 times in 29 patients. There was a significant difference between groups in preoperative FSH values and postoperative testicular histopathology (p=0.004 and p<0.001). The sperm retrieval rate in the group of patients who had not undergone previous TESE was higher than the group of patients that had undergone TESE for 1-2 times and 3-4 times (p=0.028). In addition, testicular volume, histology, karyotype, and Y-chromosome microdeletion were predicting factors for successful sperm retrieval (p=0.011, p=0.039, p=0.002, and p<0.001, respectively).

CONCLUSION

Our results confirm the necessity for repeat mTESE operations to be performed by experienced surgeons in reference centers to optimize the chance of reduced sperm retrieval rates with recurrent biopsies.

Lung cancer diagnosed with Mycobacterium tuberculosis or nontuberculosis mycobacteria concomitantly

Introduction

The concomitant occurrence of disease of Mycobacterium tuberculosis or nontuberculosis mycobacteria (NTM) and lung cancer has been reported in previous studies. We aimed to determine characteristics of the patients with lung cancer diagnosed with M. tuberculosis or NTM concomitantly.

Materials and Methods

From 2010 to 2015, the patients diagnosed with lung cancer and M. tuberculosis or NTM concomitantly were enrolled in the study. Patient data were collected retrospectively.

Result

Concomitant M. tuberculosis or NTM and lung cancer were diagnosed in 17 cases (1.2% of total lung cancer cases, 0.9% of total tuberculosis cases). M. tuberculosis was isolated from 11 (64.8%) patients and NTM disease was from 6 (35.2%) patients. Squamous cell carcinoma was the most common histological type. Tumoral stage was often advanced as stage III- IV (76.5%). Bronchial lavage smear positivity foracid-fast bacilli was found only in 4 (23.5%) patients. Tuberculosis treatment therapy was started only in 4 (23.5%) patients who had bronchial lavage smear positivity for acid-fast bacilli. So tuberculosis treatment was delayed for other 13 (76.5%) patients with bronchial lavage smear negative for acid-fast bacilli. Seven out of 17 (41.1%) patients died.

Conclusions

Physicians should consider concomitant M. tuberculosis or NTM when managing lung cancer. Tuberculosis patients may be mis diagnosed as lung cancer or vice versa.

The relationship between hematological parameters and the severity level of chronic obstructive lung disease

INTRODUCTION    Chronic obstructive pulmonary disease (COPD) is the most important lung disease leading to disability and even death. Recent studies have shown that the platelet indices are associated with several cardiovascular diseases; however, there is little data on COPD. OBJECTIVES    We aimed to explore the relationship between platelet indices, together with the platelet-to-lymphocyte ratio (PLR), white blood cell count to mean platelet volume ratio (WMR), and red cell distribution width (RDW) and the severity of COPD. PATIENTS AND METHODS    This retrospective study was based on data collected from a total of 153 COPD patients admitted to our outpatient clinic between March 2014 and March 2015. All of the participants underwent pulmonary function tests; FEV1, FVC, and FEV1/FVC were measured. The study population was divided into four according to the severity of COPD as group A (mild), group B (mild to moderate), group C (moderate to severe), and group D (severe).  RESULTS    A significant increase was found in platelet distribution width (PDW), MPV, plateletcrit, PLR, and RDW while WMR decreased as the COPD severity increases. In the multiple logistic regression analysis, we found that PDW and RDW were independently associated with the presence of severe COPD. ROC curve analysis showed that a PDW>14.85 was associated with severe COPD with 85% sensitivity and 86% specificity while RDW>14.45 was associated with severe COPD with 90% sensitivity and 87% specificity. CONCLUSIONS    The PDW and the RDW are independently associated with disease severity, which may indicate hypoxemia, underlying inflammation, and oxidative stress in COPD.

Methyl palmitate attenuates lipopolysaccharide-induced acute lung injury in mice

AIM

The study is aimed to determine the beneficial effects of methyl palmitate (MP) which has antioxidant and anti-inflammatory effects demonstrated on murine model of acute lung injury induced by lipopolysaccharide (LPS).

MATERIALS AND METHODS

Forty male BALB/C mice were randomly allocated into four groups (n=10, each): control group, methyl palmitate group (300 mg/kg), LPS group, and methyl palmitate -treated groups. Methyl palmitate or vehicle was given with an intraperitoneal administration 1 h before an intratracheal instillation of LPS (5 mg/kg). The severity of pulmonary injury was evaluated 6 h after LPS challenge. All experimental procedures complied with the requirements of the Animal Care and Ethics Committee of the Adnan Menderes University.

RESULTS

Methyl palmitate pretreatment significantly attenuated LPS-induced pulmonary histopathologic changes, alveolar hemorrhage, and neutrophil infiltration. Methyl palmitate pretreatment also reduced the concentrations of malondialdehyde in lung tissues.

CONCLUSIONS

This study indicates that methyl palmitate may have a protective effect against LPS-induced acute lung injury, and the potential mechanism of this action may involve the inhibition of NF-κB. activation.

Could spot urine analysis of calcium and uric acid help predict density of urinary stone in computerized tomography? A preliminary study

BACKGROUD

This research studies if Hounsfield density of urinary stone can be predicted without computerized tomography (CT) caused by because increased radiation exposure in follow-up of patients.

METHODS

The records of patients with renal or ureteral stone were analyzed retrospectively for the time period between November 2013 and April 2014. The inclusion criteria defined were: no multiple stones; stone size ≥3 mm; presence of renal and ureteral stones; absence of staghorn stone. All CT images were assessed in abdominal windows by a single radiologist. Hounsfield Unit (HU) value of CT was used to interpret the density of the stone. The density of the stone was measured in the longest axis of the stone center (core) and the edges (periphery) of each stone. Biochemical analysis of spot urine calcium (Ca) and uric acid (UA) was done at the time of diagnosis. Correlation and linear regression analysis was performed.

RESULTS

Forty patients were included the study and median age of patients is 22 (IQR 21-28). Since the unit was a military hospital, most patients admitted to hospital were young male conscripts with low median age. It has been found that spot urine uric acid and uric acid/Ca ratio is associated with stone density as HU (P=0.004, P<0.001). Although predictive value appeared low, linear regression model statistically predicted stone density as HU (P<0.001 R2=0.32). Stone size has proved to be positively correlated with stone density (P<0.001).

CONCLUSIONS

Despite the predictive value of urine analysis model is low, it may be considered to predict HU attenuation of stone. Spot urine analysis of calcium and uric acid may be helpful for both diagnosis and follow-up. We believe that controlled studies with larger patient populations will provide further insights into this issue.

Pretreatment Serum Albumin Level is an Independent Prognostic Factor in Patients with Stage IIIB Non-Small Cell Lung Cancer: A Study of the Turkish Descriptive Oncological Researches Group

BACKGROUND

Several prognostic factors have been studied in NSCLC, although it is unknown which is most useful. In this study, we aimed to investigate whether pre-treatment serum albumin level has prognostic value in patients with Stage IIIB NSCLC.

MATERIALS AND METHODS

This cross-sectional study included a total of 204 patients with Stage IIIB NSCLC who met the inclusion criteria. Pre-treatment serum albumin levels and demographic, clinical, and histological characteristics, as well as laboratory variables were recorded. A cut-off value was defined for serum albumin level and the patients were stratified into four groups on thios basis.

RESULTS

The majority of the patients was males and smokers, with a history of weight loss, and squamous histological type of lung cancer. The mean serum albumin level was 3.2±1.7 g/dL (range, 2.11-4.36 g/dL). A cut-off value 3.11 g/dL was set and among the patients with a lower level, 68% had adenocarcinoma and 82% were smokers. The patients with low serum albumin levels had a lower response rate to e first-line chemotherapy with a shorter progression-free survival and overall survival. Multivariate analysis showed that low serum albumin level was an independent poor prognostic factor for NSCLC.

CONCLUSIONS

This study results suggest that low serum albumin level is an independent poor prognostic factor in patients with Stage IIIB NSCLC, associated with reduction in the response rate to first-line therapy and survival rates.

Differential Expression of MicroRNAs in Chronic Obstructive Pulmonary Disease

BACKGROUND

This study aimed to investigate the associations of miRNA with COPD patients.

OBJECTIVES

Chronic obstructive pulmonary disease (COPD) is characterized by progressive and largely irreversible airflow limitation. COPD is one of the most common causes of death globally and it is still a serious public health problem worldwide. Pathogenesis of COPD is multifactorial including genetics and environmental factors.

MATERIAL AND METHODS

Sixty patients who were diagnosed with COPD according to GOLD guidance and 40 controls were involved in the study. This study was separated into four groups according to GOLD guidance. miR_16, miR_17, miR_29c, miR_92, miR_125, miR_126, miR_146, miR_155, miR_181, mir_122 expressions from the total miRNAs obtained were worked on by using real time-PCR method. The p-values are calculated based on a Student's t-test of the replicate 2^ (- Delta Ct) values for each gene in the control group.

RESULTS

The miRNAs expressions in normal and COPD patients were found differentially. The miR-29c (p = 0.043) and -126 (p = 0.012) were found significantly different compared to control group. When their expressions are evaluated according to stage, miR-92 expression showed down regulation stage II and no change was observed in other miRNAs. miR-29c and miR-126 expressions showed significant differences in stage III and only miR-126 expression showed significant difference in stage IV.

CONCLUSIONS

These results show that miRNA evaluations may give information about the diagnosis, staging and prognosis of the disease. In this study, we demonstrated that miR-29c and -126 are essential for the development of COPD.

Weight loss at the time of diagnosis is not associated with prognosis in patients with advanced-stage non-small cell lung cancer

PURPOSE

To investigate the prognostic value of weight loss before diagnosis in patients with advanced stage non-small cell lung cancer (NSCLC) treated with first-line chemotherapy.

METHODS

A total of 81 NSCLC patients with stages IIIB/IV were included in this retrospective cross-sectional study. Study variables were weight loss in the last 3 months before diagnosis, patient demographic, clinical and laboratory characteristics and histological features of the tumor before administering first-line chemotherapy. Then, the patients were stratified into 4 groups based on their weight loss before being diagnosed with NSCLC.

RESULTS

The patients were predominantly male (68%), with a smoking history (62%), 5 to 10 kg weight loss in the last 3 months (31%), and had metastatic disease (64%) and adenocarcinoma (40%) at the time of diagnosis. On the other hand, most of the patients with 5 to 10 kg weight loss in the last 3 months before diagnosis had squamous cell carcinoma (44%), stage IV disease (56%), and the first disease progression was in the brain (64%). Pre-diagnosis weight loss had a negative impact on progression-free survival (PFS), independent from weight loss during first-line chemotherapy, but no such effect was noticed on overall survival (OS).

CONCLUSIONS

Pre-diagnosis weight loss was found to have a negative impact on PFS in patients with NSCLC treated by first-line chemotherapy. Similar studies in larger patient series are warranted.

Silibinin attenuates methotrexate-induced pulmonary injury by targeting oxidative stress

The aim of the present study was to assess the protective effect of silibinin against methotrexate (MTX)-induced pulmonary toxicity. Rats were divided into four groups (MTX, MTX + silibinin, silibinin and control. MTX was injected intraperitoneally (i.p) into female Wistar rats (10 mg/kg/day for 3 days), which resulted in significant increases in the serum levels of alanine aminotransferase, aspartate aminotransferase and oxidant enzymes, including nitric oxide and myeloperoxidase. Furthermore, significant reductions were detected in the serum activity levels of the antioxidative enzymes, glutathione peroxidase and superoxide dismutase, when compared with the control group. However, administration of silibinin (100 mg/kg/day for 10 days, i.p.) was shown to ameliorate the MTX-induced pulmonary toxicity, as indicated by the normalization of the oxidative stress parameters. Furthermore, silibinin treatment was demonstrated to reduce the histopathological changes associated with MTX. In conclusion, silibinin exhibited protective effects against MTX-induced pulmonary toxicity, which may be attributed to its antioxidant activity.

The effect of methyl palmitate on treatment of experimental asthma

OBJECTIVE

To determine the effects of methyl palmitate on murine model of chronic asthma.

METHODS

The experimental study was conducted in the animal laboratory of DokuzEylul University, Turkey, from October to December, 2012, and comprised BALB/c mice whowere divided into four equal groups: three experimental and one control group. All groups except the control group were sensitised and challenged with ovalbumin. Mice with experimentally-induced asthma in Group I received saline; Group II dexamethasone 1mg/kg; Group III methyl palmitate300mg/kg intraperitoneally three times per week in the last four weeks of the study period. Animals were sacrificed 24h after the last administration of study drugs. Histological findings of airways were evaluated by light microscopic examination. Blood samples from vena cava inferior were taken for measurement of interleukin-5 levels. SPSS 15 was used for statistical analysis.

RESULTS

The 28 female mice in the study were divided into 4 groups of 7(25%) each. The age range of the animals was 6-8weeks, and the weight range was 18-20g. All histological parameters and interleukin-5 levels of asthma in the Group III were significantly ameliorated compared to the Group I (p<0.05). All histological parameters and interleukin-5 levels were similar between Group III and Group II.

CONCLUSIONS

Methyl palmitate exhibited anti-inflammatory effects by resolving the histological changes and reducing the interleukin-5 levels in murine model of chronic asthma.