No abstract available.
Arteriovenous Malformations* ; Uterus*

No abstract available.
Arteriovenous Malformations* ; Uterus*

No abstract available.
Drug Therapy* ; Uterine Cervical Neoplasms*

PURPOSE: The placement of a ureteral stent following a ureteroscopy (URS) with a stone extraction is routine. However, many patients complain of stent pain and urinary symptoms in the postoperative period. Reducing the frequency of stenting would decrease the need for re-instrumentation, reduce costs, and increase patient satisfaction provided that the efficacy and safety are not compromised. In order to evaluate the necessity of stenting, a comparison of patients with and without stenting after URS for ureteral calculi is reported. MATERIALS AND METHODS: 45 patients with ureteral calculi amenable to ureteroscopic management were prospectively randomized into stented (23 patients) and unstented (22 patients) groups. Standard ureteroscopic basketing and lithotripsy were performed with a ureteroscope (8.5Fr) with or without ureteral dilatation. Postoperative symptom questionnaires were obtained from each patient. Radiographic follow-up to assess the stone-free rate and evidence of obstruction was performed in all patients. RESULTS: There was no statistically significant difference in the age, stone size, operation time, and hospital stay, between the unstented and stented groups (p>0.05). In addition, there was no statistically significant difference in the flank pain and urinary symptoms (p>0.05), except for hematuria between the 2 groups. Hematuria was more severe and long standing in the stent group (p=0.001). CONCLUSIONS: Uncomplicated ureteroscopy for calculus retrieval can safely be performed without the placement of a postoperative stent. Considering its complications and side effects, we do not believe that a routine placement of a ureteral stent following an uncomplicated ureteroscopy for a stone is necessary.
Calculi ; Dilatation ; Flank Pain ; Follow-Up Studies ; Hematuria ; Humans ; Length of Stay ; Lithotripsy ; Patient Satisfaction ; Postoperative Period ; Prospective Studies ; Surveys and Questionnaires ; Stents* ; Ureter* ; Ureteral Calculi ; Ureteroscopes ; Ureteroscopy*

Cancer of the vulva accounts for approximately 0.5% of all gynecologic malignancies. At diagnosis, one-third of these cases is detected in an advanced stage (FIGO stages III, IV), and local extension of primary vulvar cancer may involve adjacent midline structures such as the clitoris, urethra, vagina, and anus. Initial surgical therapy of such locally advanced primary cancers may compromise the functional integrity of midline structures, necessitating ultraradical surgery including pelvic exenteration. In view of the relatively elderly age of the patients and the morbidity of this ultraradical dissection, concomitant chemoradiation therapy - that the efficacy had been proven in head and neck cancer, anal cancer has approached for patients with locally advanced vulvar cancer. We experienced a case of stage III vulvar cancer patient, who underwent concomitant chemoradiation therapy with 5-fluorouracil(FU) and cisplatin and who showed complete response. So, we report this case with brief review of the literatures.
Aged ; Anal Canal ; Anus Neoplasms ; Cisplatin ; Clitoris ; Diagnosis ; Female ; Head and Neck Neoplasms ; Humans ; Pelvic Exenteration ; Urethra ; Vagina ; Vulvar Neoplasms*

BACKGROUND: Examination of urine for decoy cells (DCs) is a useful screening test for polyomavirus (PV) activation. We explored the significance of the amount of DCs in persistent shedding, PV nephropathy and acute rejection. METHODS: A case-controlled study was performed in 88 renal allograft patients who had DCs detected at least once in four or more urine samples. RESULTS: Fifty one patients were classified into the high-grade shedding group (HG) and 37 patients into the low-grade shedding group (LG) according to DC shedding (> or =10 or <10 DCs/10 high power field [HPF]). DC shedding of more than three consecutive months was significantly more prevalent in the HG as compared with their LG counterparts (p<0.0001). Urinary DCs were present for more than one year in 29.4% of the HG and 8.1% of the LG. Real-time polymerase chain reaction for PV was higher in both urine (51.4% vs. 11.1%) and plasma (9.1% vs. 0%) of the HG than the LG. The prevalence of PV nephropathy was higher in the HG than the LG (p=0.019). However, there was no significant difference in the prevalence of acute rejection. CONCLUSIONS: Shedding of > or =10 DCs/10 HPF is associated with sustained shedding, polymerase chain reaction positivity and PV nephropathy, but not a predictor of acute rejection.

BACKGROUND: Examination of urine for decoy cells (DCs) is a useful screening test for polyomavirus (PV) activation. We explored the significance of the amount of DCs in persistent shedding, PV nephropathy and acute rejection. METHODS: A case-controlled study was performed in 88 renal allograft patients who had DCs detected at least once in four or more urine samples. RESULTS: Fifty one patients were classified into the high-grade shedding group (HG) and 37 patients into the low-grade shedding group (LG) according to DC shedding (> or =10 or <10 DCs/10 high power field [HPF]). DC shedding of more than three consecutive months was significantly more prevalent in the HG as compared with their LG counterparts (p<0.0001). Urinary DCs were present for more than one year in 29.4% of the HG and 8.1% of the LG. Real-time polymerase chain reaction for PV was higher in both urine (51.4% vs. 11.1%) and plasma (9.1% vs. 0%) of the HG than the LG. The prevalence of PV nephropathy was higher in the HG than the LG (p=0.019). However, there was no significant difference in the prevalence of acute rejection. CONCLUSIONS: Shedding of > or =10 DCs/10 HPF is associated with sustained shedding, polymerase chain reaction positivity and PV nephropathy, but not a predictor of acute rejection.

BACKGROUND: Pilomatricoma is a benign, appendageal tumor differentiating towards the normal hair follicles and is characterized by basaloid, transitional, and shadow cells. It is most frequently seen in children; however, a bimodal onset distribution is observed in the first and sixth decades. OBJECTIVE: The purpose of this study was to analyze the clinical and histopathological features of pilomatricomas in patients over 50 years of age, and to compare these features with those occurring in patients under 20 years of age. METHODS: We retrospectively reviewed the medical records and histopathological findings of 73 patients under 20 years and above 50 years of age. The morphological stages of the tumors were analyzed through histopathological findings. RESULTS: The age of patients in the over 50-year age group ranged from 50 to 82 years, with a mean age of 60 years. The male-to-female ratio was 1.1:1. The duration of lesions was from 1 month to several years, with half of the patients having the tumors for over 12 months. The predilection sites were the head (51%), followed by the upper extremities (21%), neck (15%), trunk (6%), and lower extremities (6%). In 73% of the patients over 50 years of age, pilomatricoma was less likely the suspected diagnosis compared with that in the under 20-year age group. Epidermal cysts were most likely suspected in patients over 50 years of age. Histopathologically, half of the tumors were located in the subcutis, which was not significantly different when compared with pilomatricomas in the under 20-year age group. The most common evolutional stage of tumors was early regressive (52%), followed by late regressive (27%), fully developed (15%), and early stage (6%). Capsulation (9%), inflammatory cell infiltration (60%), multinucleated giant cells (36%), calcification (33%), and ossification (12%) were observed. With the exception of capsulation, there were no significant differences in these histopathological features in pilomatricomas in patients over 50 years of age compared with those in patients under 20 years of age. CONCLUSION: Pilomatrichomas in patients over 50 years of age show no pain, are located in the head and neck, are present for a long duration, and have various clinical presentations when compared with those in patients under 20 years of age. However, they are not rare tumors in adults. Accordingly, pilomatricomas should be included in the clinical differential diagnosis of a solitary, deep skin tumors presenting in adults, especially when they occur on the head.
Adult ; Child ; Diagnosis ; Diagnosis, Differential ; Epidermal Cyst ; Giant Cells ; Hair Follicle ; Head ; Humans ; Lower Extremity ; Medical Records ; Neck ; Pilomatrixoma* ; Retrospective Studies ; Skin ; Upper Extremity

Platelet-rich plasma (PRP) is a promising biomaterial rich in bioactive growth factors, offering potential as a therapeutic agent for various diseases. However, its effectiveness in central nervous system disorders like vascular dementia (VaD) remains underexplored. This study investigated the potential of PRP to mitigate VaD progression in vivo. A rat model of VaD was established via bilateral common carotid artery occlusion and hypovolemia operation. Rats were randomly assigned to receive either PRP or platelet-poor plasma (PPP)—the latter being a byproduct of PRP preparation and used as a reference standard—resulting in the groups designated as ‘operated group (OP)+PRP’ and ‘OP+PPP’, respectively. PRP or PPP (500 μl) was administered intraperitoneally on the day of the operation and postoperative days 2, 4, 6, and 8. Cognitive function was assessed using the Y-maze, Barnes maze, and passive avoidance tests. On postoperative day 8, hippocampal samples were subjected to histological and semi-quantitative analyses. OP exhibited significant memory decline compared to controls, while the ‘OP+PRP’ group showed notable improvement. Histological analysis revealed increased neuronal loss and neuroinflammation in OP hippocampi, mitigated in ‘OP+PRP’. Semi-quantitative analysis showed decreased expression of brain-derived neurotrophic factor (BDNF) and its receptor tropomyosin receptor kinase B (TrkB) in OP, restored in ‘OP+PPP’ and further in ‘OP+PRP’. These results highlight PRP’s protective effects against VaD-induced hippocampal damage and cognitive impairment, partially attributed to BDNF/TrkB pathway upregulation.

Platelet-rich plasma (PRP) is a promising biomaterial rich in bioactive growth factors, offering potential as a therapeutic agent for various diseases. However, its effectiveness in central nervous system disorders like vascular dementia (VaD) remains underexplored. This study investigated the potential of PRP to mitigate VaD progression in vivo. A rat model of VaD was established via bilateral common carotid artery occlusion and hypovolemia operation. Rats were randomly assigned to receive either PRP or platelet-poor plasma (PPP)—the latter being a byproduct of PRP preparation and used as a reference standard—resulting in the groups designated as ‘operated group (OP)+PRP’ and ‘OP+PPP’, respectively. PRP or PPP (500 μl) was administered intraperitoneally on the day of the operation and postoperative days 2, 4, 6, and 8. Cognitive function was assessed using the Y-maze, Barnes maze, and passive avoidance tests. On postoperative day 8, hippocampal samples were subjected to histological and semi-quantitative analyses. OP exhibited significant memory decline compared to controls, while the ‘OP+PRP’ group showed notable improvement. Histological analysis revealed increased neuronal loss and neuroinflammation in OP hippocampi, mitigated in ‘OP+PRP’. Semi-quantitative analysis showed decreased expression of brain-derived neurotrophic factor (BDNF) and its receptor tropomyosin receptor kinase B (TrkB) in OP, restored in ‘OP+PPP’ and further in ‘OP+PRP’. These results highlight PRP’s protective effects against VaD-induced hippocampal damage and cognitive impairment, partially attributed to BDNF/TrkB pathway upregulation.