ABSTRACT
OBJECTIVE: The possible relationships between the histopathological findings of carotid body tumors and age, gender, tumor diameter, and Shamblin classification were investigated. In addition, preoperative embolization status, development of neurological complications, need for vascular reconstruction, hemoglobin change, and discharge time were examined and the effects of these variables on each other were analyzed. METHODS: Between 2008 and 2022, 46 cases who underwent carotid body tumor excision were examined retrospectively. The cases were followed for an average of 81 months postoperatively. Histopathological materials were reexamined and the effect of categorical variables was analyzed. RESULTS: Mean tumor diameter was 3.55 ± 1.26 cm, mean discharge time was 3.91 ± 2.37 days, and mean hemoglobin change was 1.86 ± 1.25. Neurological complications developed in 13% of cases. The amount of hemoglobin change was significantly (p = 0.003) higher in those who developed neurological complications, whereas the tumor diameter and discharge time were found to be insignificantly higher. Surgical complications requiring vascular repair occurred in 10.8% of cases. Tumor diameter (p = 0.017) and hemoglobin change (p = 0.046) were significantly higher in these patients. There were significant correlations between higher Shamblin classification and tumor diameter, discharge time, postoperative hemoglobin value, and number of surgical and neurological complications. No significant difference was found between Ki-67, capsular invasion, mitosis, pleomorphism, prominent nucleoli, mean island diameter, and tendency of islands to merge with categorical variables. CONCLUSION: As the tumor diameter increases, the operation becomes more difficult and the postoperative complication rate increases. We think that subadventitial and capsular removal of the tumor is effective in preventing recurrence. To reach a histopathological conclusion, a larger series of studies including tumors with high Ki-67 and mitosis rates, large size, and one or more of the criteria for necrosis are needed.
ABSTRACT
OBJECTIVE: Implantation failure is a multifactorial problem of reproductive medicine. However, the mechanism of this process is still not fully understood. There is increasing evidence that these cases of recurrent implantation failure might have an immunologic background. Uterine natural killer (NK) cells provide immune-modulation at the interface between maternal decidua and the trophoblast. The aim of this study to evaluate whether there was a significant difference in the number of endometrial CD56+ NK between women with a history of recurrent implantation failure and women who had a live birth. MATERIALS AND METHODS: Patients with a history of recurrent implantation failure were included in the study. Twenty-five women with a history of recurrent implantation failure were assigned to the case group, and 25 women who had one or more live births were assigned to the control group. Endometrial biopsies were obtained during the luteal phase on the 21st-24th day of the menstrual cycle. RESULTS: There was a statistically significant difference between the groups concerning the number of deliveries (p<0.001) and miscarriages (p<0.001). The mean number of uNK was 10.5±10.5 cells/mm2 in the case group and 19.2±11.2 cells/mm2 in the control group. There was a statistically significant difference between the two groups (p=0.003). CONCLUSION: Implantation failure is a multifactorial problem of reproductive medicine. The results of our study suggest that uterine NK play a role in the progress of normal pregnancy and reduced uterine NK cell numbers were associated with implantation failure.
