Retrospective evaluation of neutrophil to lymphocyte ratio in patients with metastatic testicular cancer

Objectives: Our aim was to evaluate the impact of neutrophil to lymphocyte ratio [NLR] in patients with metastatic testicular cancer [tCa]

Design: Retrospective view of prospective recorded data

Setting: Clinical study was conducted at multicentre between May 2010 and September 2016

Subjects: Patients with tCa who underwent radical orchiectomy were enrolled. Similar surgical methods, laboratory analyses, and radiologic examinations were performed and all patients were divided into 2 groups. Group 1 [n = 108] consisted of patients with non-metastatic testicular cancer; Group 2 [n = 38] consisted of patients with metastatic [solid organ-lymph node metastasis] tCa

Intervention: Radical orchiectomy, blood sample

Main outcome measures: Demographic, preoperative, and postoperative data were noted. Postoperative complications were interpreted according to modified Clavien classifications. Statistical significant p was p

Results: Mean follow-up was 36.4 [4 - 72] months. Mean age was 39 years [19 - 71 years]. There were significant differences between groups in preoperative NLR, tCa markers and diameter of tumour [p = 0.03, p <0.001, p = 0.01, respectively]. Besides, invasion to lymphovascular, rete testis, cord, epididymis, and surgical margin positivity, postoperative tCa markers were significantly higher in group 2 than group 1. Area under ROC curve was 0.69, [p <0.001] and cut-off value for NLR was 3.11 in terms of any metastasis. There was no serious complication after operation. Five patients experienced wound infections [Clavien 1]

Conclusions: Preoperative NLR could help us to predict lymph node and solid organ metastasis in patients with tCa. If the NLR is over 3.1, clinicians should be aware of metastasis

extremely rare cause of hematuria: adamantinoma like neuroectodermal tumor of bladder

Primary primitive neuroectodermal tumour [PNET] is a rare entity and have severe malign potential. However, PNET is derived from central nervous system, it can rarely occur in another soft tissue. Herein, we present an extremely rare cause of hematuria in an 83-year-old man, who was diagnosed as adamantinoma like PNET, in bladder. After transurethral surgical treatment, there was no recurrence, in short-term clinical follow-up. According to our best knowledge, he was the oldest patient who had PNET in bladder, in published literature

Actual medical management of stone diseases in pediatric population

Although the prevalence of urolithiasis is nearly 2 - 3% in childhood, the risk of recurrence may range between 6.5 - 54%. There has been an increase in stone disease in the pediatric age groups. The stone disease in children has multifactorial etiology. After the diagnosis, detailed metabolic evaluation is required. High recurrence rates, therapeutic irregularities and deficiency in diagnosis may lead to co-morbidities such as loss of kidney. After the exact diagnosis, surgical options such as stone extraction and correction of the anatomical anomalies come into question. Besides these, medical and supportive treatments are needed for preventing recurrence, urinary infection and, preserving renal function. Supportive care includes increased fluid intake and dietary modifications. Medical treatment depends on the cause of urinary stone disease. Morbidities of pediatric urolithiasis can be prevented by early diagnosis, detailed metabolic analysis, regular follow- up and medical treatment protocols

Impact of transurethral resection on urinary flow rate in children with posterior urethral valve in short term follow-up

To evaluate the correction rate of urinary flow rate after posterior urethral valve [PUV] resection for predicting success after operation. This retrospective study was performed between March 2006 and February 2013 at the Department of Pediatric Urology, Akdeniz University School of Medicine, Antalya, Turkey. Of the 67 patients with PUV, 52 patients were enrolled. Physical examinations, urine and blood analyses, uroflowmetry [UFM] including maximum flow rate [Qmax] and average flow rate [Qavg], and post voiding residual urine volume [PVR] were recoded. The UFM, PVR, voiding cystourethrography, serum creatinine levels were recorded in clinical visits. Additional operations were performed if there were symptoms of urinary obstruction. Statistical analyses were carried out. The mean age was 9 +/- 2.9 years. The mean follow-up was 10.6 +/- 4.2 months. There was a significant difference between preoperative and postoperative serum creatinine [p=0.028], Qmax [p=0.001], Qavg [p=0.002], and PVR [p=0.001]. Postoperative serum creatinine was significantly positively correlated with postoperative PVR [p=0.024]. In logistic regression analysis, success on PUV resection was associated with preoperative Qavg [p=0.016] and PVR [p=0.004], and postoperative Qavg [p=0.039] and PVR [p=0.030]. Of the 42 [80.7%] patients, significant improvements in UFM, PVR, and serum creatinine levels were obtained after first operation. In 10 patients, re-operations were performed. Short-term effectiveness of PUV resection may be predicted by changes in UFM and PVR parameters in selected patients

Comparison of laparoscopic vessel sealing devices in a porcine model: turkurolap group study

To compare the effectiveness of different electrosurgical devices used during laparoscopic surgery in Turkey. Retrospective study. Gulhane Military Medical Academy, Experimental laboratory, Turkey. Six large White-Landrace-Pietrain pigs, with a mean weight of 63 +/- 3.61 kg, were used in 2011. Laparoscopic Vessel Sealing Devices. Sealing time, demarcation, destruction, sticking, and burning effects of laparoscopic electrosurgical devices were investigated in blood vessels and ureters. Sealing process was significantly shorter with Liga Sure Atlas [LS-lO mm and LS-5 mm], Plasma Trissector Gyrus [PTG] and Harmonic Scalpel [HS] in gonadal vessels. The shortest superficial demarcation was provided with HS. The sticking effects of the LS-5 mm and PTG were lower in ureters. The superficial demarcation was shorter with PTG than LS-5 mm, LS-10 mm and HS in ureters. HS stands out a bit more among devices with electrosurgical effects and fewer side effects to surrounding tissues than other devices in our study. Electrosurgical device should be selected according to necessity of the kind of dissection

Kidney metastasis of invasive ductal breast carcinoma mimicking renal cell carcinoma

A 56-year-old female patient was admitted to the urology outpatient clinic with severe macroscopic hematuria. She was diagnosed with right kidney cancer after clinical and radiological evaluations. Pathology reported a metastasis of invasive ductal breast carcinoma in the right kidney after laparoscopic radical right nephrectomy was performed. After physical and radiological evaluations, she was referred to the Department of General Surgery, and was treated with radical mastectomy and axillary lymph node dissection for breast cancer. She was later referred to the Department of Medical Oncology at our institute for chemotherapy. We aimed for clinicians to be more aware of metastasis to the kidney, and perform regular and thorough breast examination for women every year

Increased peripheral CD4[+] CD25[high] Treg in prostate cancer patients is correlated with PSA

To determine peripheral frequencies of CD4[+]CD25[high]Foxp3[+] regulatory T cells [Treg] in prostate cancer [PCa] patients, and to investigate if there is a correlation between peripheral Treg and total serum prostate specific antigen [PSA] levels in PCa patients. Peripheral blood mononuclear cells from 56 subjects undergoing diagnostic prostate biopsies PSA >/= 2.5ng/ml were analyzed for Treg numbers. Association between the peripheral Treg and serum PSA values was first determined in the entire population, including people with no prostate pathology, PCa, and benign prostate hyperplasia [BPH] patients, and second, in 9 PCa patients before and after curative prostatectomy. In this study, the 3 groups were compared. This project was performed in the Akdeniz University Immunology laboratory, and the Urology outpatient clinic, Antalya, Turkey from December 2008 to January 2010. Peripheral Treg frequencies were significantly increased in the PCa patients [n=19, 3.23 +/- 1.59] compared with BPH patients [n=27, 1.66 +/- 0.80], and healthy subjects [n=10, 1.08 +/- 0.43] [p=0.007]. The percentage of Treg in BPH patients was also significantly higher than healthy subjects [p=0.007]. The increase of Treg in BPH and PCa patients was positively correlated with total serum PSA levels [r=0.75; p=0.007]. Peripheral Treg densities are correlated with PSA in BPH and PCa patients, suggesting that PSA may have a role in Treg induction and/or maintenance