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Sarcomatoid renal cell carcinoma (sRCC) is a rare variant of renal cell carcinoma (RCC) and is associated with a poor prognosis. We reviewed the outcomes of patients from oncology centers in Turkey. Our aim is to share our real-life experience and to contribute to the literature. The demographic and clinical features, treatment, and survival outcomes of 148 patients with sRCC were analyzed. The median age at the time of diagnosis was 58 years (range: 19-83 years). Most patients (62.8%) had clear-cell histology. Most patients were in the intermediate Memorial Sloan-Kettering Cancer Center (MSKCC) risk group (67.6%) and were stage 4 at the time of diagnosis (63.5%). The most common sites of metastasis were the lung (60.1%), lymph nodes (47.3%), and bone (35.8%). The patients received a median of two lines (range: 0-6) of treatment. The most common side effects were fatigue, hematological side effects, hypertension, and hypothyroidism. The median follow-up was 20.9 months (range: 1-162 months). The median overall survival (OS) was 30.8 months (95% confidence interval: 24.9-36.7 months). In multivariate analysis, high MSKCC scores, sarcomatoid differentiation rates >50%, having stage 4 disease, and having lung metastasis at the time of diagnosis were independent factors for poor prognosis affecting OS. No difference was observed between patients who received tyrosine kinase inhibitor (TKI) as the first or second-line treatments. Similarly, no difference between TKI and immunotherapy as the second-line treatment. In conclusion, sRCC is a rare variant of RCC with a poor prognosis and response to treatment. Larger-scale prospective studies are needed to define an optimal treatment approach for longer survival in this aggressive variant.

Extra-pulmonary accumulation of Tc-99m-macroaggregated albumin (MAA) is described as uptake areas out of the lung in perfusion scintigraphy. If the particles spread throughout the body before reaching the lung via venous collaterals or due to right-to-left shunt, or if the particles are too small to occlude the pulmonary capillaries, then the agent can be seen at different locations of the body. Extra-pulmonary accumulation of Tc-99m-MAA can be detected mostly in the liver as well as in the brain, kidney, thyroid, myocardium, spleen and vertebra. Herein, we present lung scanning images with unexpected hepatic accumulation of Tc-99m-MAA. This pulmonary perfusion scintigraphy was performed in a patient with end-stage renal disease due to dyspnea in the post-operative period of kidney transplantation. © 2019 by Turkish Society of Nuclear Medicine.

Super scan is a well-known finding described in skeletal scintigraphy characterized by uniform symmetrically increased radiopharmaceutical uptake by bones and consequently diminished renal parenchymal activity. Sy et al. hypothesized that the faint visualization of renal cortex in bone scintigraphy might be the result of increased uptake of radiopharmaceutical by pathologic bones and reduced phosphate excretion. The super scan on18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) has been observed in various conditions such as prostate cancer, lung cancer, renal adenocarcinoma, gastric cancer and primitive neuroectodermal tumor of the kidney. Herein we report the first case of super scan in a 68-year-old-woman with parathyroid carcinoma observed both in18F-FDG PET/CT and Tc-99m methylene diphosphonate bone scintigraphy. There were extensive hypermetabolic lesions throughout the skeleton in18F-FDG PET/CT. In contrast to the intense hypermetabolism of the skeleton; the liver, skeletal muscles of the limbs, mediastinum, bowel and especially the brain showed very low FDG uptake. Additionally, there was increased skeletal radiotracer uptake relative to soft tissue, and faint genitourinary tract activity in bone scintigraphy. © 2017 by Turkish Society of Nuclear Medicine.

Primitive neuroectodermal tumor (PNET) arise from Kulchitsky cells and are rarely seen in the female genital tract. Differential diagnosis of PNET can be made based on immunohistochemical profiles and genetic analyses. Genital tract pNETs are very aggressive pathologies with different clinical and molecular manifestations and there are no standard guidelines for treatment. We aimed to present two cases of uterine PNETs with different symptomatology and clinical findings. © 2015, Turkish Society of Obstetrics and Gynecology. All rights reserved.

Introduction: Diffuse large B cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin lymphoma (NHL). Although gender has not been included in prognostic systems, male gender has been found as a bad prognostic indicator in Hodgkin lymphoma, follicular lymphoma and chronic lymphocytic leukemia. The relationship between gender and prognosis is not clear in patients with DLBCL treated with rituximab-containing regimens. The aim of this meta-analysis is to determine the prognostic/predictive role of gender in patients with DLBCL treated with rituximab-containing regimens. Material and methods: We systematically searched for studies investigating the relationships between gender and prognosis in DLBCL treated with rituximab-containing regimens. After careful review, survival data were extracted from eligible studies. A meta-analysis was performed to generate combined hazard ratios for overall survival, disease-free survival (DFS) and event-free survival (EFS). Results: A total of 5635 patients from 20 studies were included in the analysis. Our results showed that male gender was associated with poor prognosis in terms of overall survival (OS) (hazard ratio (HR) = 1.155; 95% confidence interval (CI): 1.037-1.286; p < 0.009). The pooled hazard ratio for DFS and EFS showed that male gender was not statistically significant (HR = 1.219; 95% CI: 0.782-1.899; p = 0.382, HR = 0.809; 95% CI: 0.577- 1.133; p = 0.217). Conclusions: The present meta-analysis indicated male gender to be associated with a poor prognosis in patients with DLBCL treated with rituximab- containing regimens. Copyright © 2015 Termedia & Banach.

PubMedID: 10925738 The effect of Blastocystis hominis (B. hominis) in both immunocompetent and immunocompromised subjects has been the subject of debate in recent years, mostly in response to its unknown pathogenicity and frequency of occurrence. We performed a non-randomised, open labelled, single institute study in our hospital in order to investigate the clinical significance and frequency of B. hominis in patients suffering from hematological malignancy (HM) who displayed symptoms of gastrointestinal diseases during the period of chemotherapy-induced neutropenia. The presence and potential role of other intestinal inclusive of parasites were also studied. At least 3 stool samples from each of 206 HM patients with gastrointestinal complaints (the HM group) were studied. These were compared with stool samples from a control group of 200 patients without HM who were also suffering from gastrointestinal complaints. Samples were studied with saline-lugol, formalin-ether, and trichome staining methods. Groups were comparable in terms of gender, age and type of gastrointestinal complaints. In the HM group, the most common parasite was B. hominis. In this group, 23 patients (13%) had B. hominis, while in the control group only 2 patients (1%) had B. hominis. This difference was statistically significant (P < 0.05). Symptoms were non-specific for B. hominis or other parasites in the HM group. The predominant symptoms in both groups were abdominal pain (87-89.5%), diarrhea (70-89.5%), and flatulence (74-68.4%). Although all patients with HM were symptom-free at the end of treatment with oral metranidazol (1,500 mg per day for 10 days) 2 patients with HM had positive stool samples containing an insignificant number of parasites (< 5 cells per field). In conclusion, it appears that B. hominis is not rare and should be considered in patients with HM who have gastrointestinal complaints while being treated with chemotherapy. Furthermore, metranidazol appears to be effective in treating B. hominis infection.

PubMedID: 24299454 Metformin is a biguanide group oral antidiabetic drug used for the treatment of type 2 diabetes mellitus. Nausea, vomiting, diarrhea, abdominal pain, and anorexia are the most common adverse effects encountered during treatment. Lactic acidosis is a serious side effect seen with metformin use, and while the incidence of lactic acidosis is similar to other oral antidiabetics, metformin is not recommended to patients with certain risk factors, such as cardiovascular, pulmonary, and renal and liver failure. We describe a chronic hemodialysis patient treated with metformin, presenting to the nephrology department with altered mental status. © 2013 International Society for Hemodialysis.

This study was designed to determine the effects of different chemical fertilizers on the yield and quality of some strawberry cultivars such as Douglas, Chandler, 216 (Doritt) and Oso Grande which are popular in California, Israel and Spain. Four different chemical fertilizers including Urea, Fetrilon (13 % Fe), Sheffer (S 5-3-7) and Bayfolon (enriched with amino acid 11-8-6) were used in different doses. Experiment was designed as 4 replicates. Fertilizers were administered 0.5-1 gram pure nitrogen per plant during growing season from January to early May, twice a week. Totally 40 applications were made. Pure nitrogen necessary for every application was calculated according to the fertilizers and doses and given from the soil. Honey and bumble bees alone and together were used for pollination. Phenological observations and pomological analyses were done according to the cultivars, fertilizers and doses. The highest yield was obtained from Douglas and it was followed by Oso Grande. Although all the fertilizers and their doses have given satisfactory results in yield/plant depending on cultivars, due to the economical reasons urea is recommended. Better shaped fruits were obtained in cultivars pollinated with both bumble and honey bees.

[No abstract available]

Membranoproliferative glomerulonephritis (MPGN) is the most common cause of nephrotic syndrome in young adults. This is a unique clinical entity developing secondary to autoimmune disorders or infections, and renal failure may be the presenting feature of the disease. Here we reported a case with nephrotic syndrome (NS) diagnosed 2 years before with multiple myeloma (MM). At the beginning, hypertension, edema, anemia, moderate renal failure, hypoalbuminemia, severe proteinuria and dyslipidemia were found. She was treated with prednisolone plus conservative measures including anti-hypertensives, angiotensin converting enzyme inhibitor (ACEI), dipyridamol and low salt diet. Two years later, MM was detected and treated with anti-neoplastic agents. Remission was achieved both for the MM and for the renal disease. At the end of 4 years after the diagnosis of MM, relapse occurred without renalfailure. It is known that NS accompanies to MM, but NS preceding MM is very rare. For this reason, the possibility of the development of a malignant disease should be considered in cases with idiopathic glomerulonephritis. © 2013 by Türkiye Klinikleri.

OBJECTIVE: Continuous Ambulatory Peritoneal Dialysis is more frequently used as renal replacement therapy for end stage renal failure patients. The aim of this study was to evaluate the effects of pentoxifylline on cytokines and permeability of peritoneum in continuous ambulatory peritoneal dialysis patients. MATERIAL and METHODS: 21 patients with peritoneal dialysis followed at Çukurova University Department of Nephrology were included. Pentoxifylline was given 2x400 mg daily for three weeks in addition to the standard therapy. All of the patient characteristics such as age, sex, accompanied disease, duration of peritoneal dialysis, edema, body weight, drugs were recorded. Peritoneal equilibration test was done before and after pentoxifylline therapy. Kt/Vurea and creatinine clearance were calculated. Peritoneal transport type, ultrafiltrate and urine volumes and peritoneal sodium excretion were determined. RESULTS: There was no difference for the Kt/Vurea, creatinine clearence, the serum and peritoneal dialysate levels of BUN, creatinine, sodium, albumin, IL-1, IL-6, IL-10, TNF-alpha, beta-2 microglobulin between baseline and after the pentoxifylline therapy. Additionally, there was no difference for measured parameters in diabetic and nondiabetic groups. Relationships between peritoneal sodium excretion and Kt/Vurea, ultrafiltration and sum of urine volume+ultrafiltrate were not found. There was a statistically significant negative correlation between serum albumin and serum IL-10 levels at baseline and after pentoxifylline therapy (p; 0,049). CONCLUSION: Pentoxifylline was not found to be effective in peritoneal permeability. This may be related to the short duration of pentoxifylline therapy and/or the relatively small number of the patients.

Posttransplant malignancy is one of the most important complications of organ transplantation. Immunosuppressive drugs, viral infections such as human herpes virus 8 or Epstein-Barr virus, exposure to carcinogenic factors such as sun, and host factors can be etiologic factors in the development of malignant disease. In this paper we report 2 cases of late posttransplant lymphoproliferative disorder with malign behavior.

PubMedID: 23379550 [No abstract available]

Imatinib is an important example of tyrosine kinase inhibitors (TKIs) used in clinical practice. Imatinib blocks the ATP binding site of the Bcr-Abl fusion protein and selectively inhibits Bcr-Abl tyrosine kinase (TK) activity. Treatment of chronic myelocytic leukemia (CML) with imatinib is encouraging and it has an acceptable toxicity profile, and as such has changed the management of CML during the last decade. As with all drugs used in clinical practice, side effects of imatinib have been reported in studies with extended follow-up periods. In addition, some neoplastic disorders have been reported to occur during imatinib therapy. Herein we present a CML case that developed non-Hodgkin's lym-phoma (NHL) while receiving imatinib treatment.

Extramedullary hematopoiesis (EMH) is the production of hematopoietic precursors outside the bone marrow cavity, and it causes mass effects according to its localization. Magnetic resonance imaging (MRI) and/or computed tomography (CT) scans are used most commonly to detect EMH foci. We report herein a case with thalassemia intermedia causing paravertebral mass associated with EMH detected by CT scan. We further evaluated the case with positron emission tomography (PET) CT, and lung cancer, which was not revealed in the CT scan, was detected coincidentally.

Transthyretin (TTR) amyloidosis is a common form of systemic hereditary amyloidosis. Neuropathy, cardiomyopathy, renal and ocular involvement are the most common symptoms of TTR amyloidosis. A 50 year-old female patient was admitted to our clinic due to hypotension, nausea, vomiting, diarrhea, hypokalemia and walking disability. Physical examination revealed hypotension (75/40 mmHg) and weakness of lower and upper extremities (4/5). Laboratory investigations were as follows; white blood cell 6300/mm3, hemoglobin 10 mg/dL, hematocrit 29.2%, platelet 185.000/mL, glucose 91 mg/dL, BUN 8 mg/dL, creatinine 0.4 mg/dL, Na 136 mEq/L, K 1.8 mEq/L, CL 92 mEq/L, total protein 4.9 g/dL, serum albumin 2.1 g/dL and daily proteinuria 3 g. Panendoscopy revealed bulbitis, pangastritis, monilial esophagitis and biopsy specimen from the antrum revealed TTR amyloidosis. Gastritis and monilial esophagitis improved with the administration of an H2 receptor blocker and nystatin. Hypokalemia improved with potassium infusion. After two months, her complaints of diarrhea and walking disability persisted. Visual Evoked Potential (VEP) EMG revealed mixed type polyneuropathy of upper and lower extremities. At that time, blood pressure was 90/60 mmHg, and laboratory examinations were as follows: BUN 24 mg/dL, Cr 0.5 mg/dL, total protein 4.4 g/dL and serum albumin 1.8 g/dL. In conclusion, careful systemic evaluation is necessary in unknown etiology of hypotension and/or neuropathy, and signs and symptoms should be well evaluated. Familial amyloidosis may present with different clinical findings such as hypokalemia, as in our patient without a familial history. Proteinuria may be an important clue. Here we discussed a patient with TTR amyloidosis diagnosed by antral biopsy and negative family history. Analysis for TTR mutation and liver transplantation were not done. Conservative measures and cholchicine therapy did not cause improvement. Copyright © 2006 by Türkiye Klinikleri.

In this study, two collections were evaluated: 64 varieties in the main collection of Malatya, while 12 varieties were investigated in Adana and Pozanti. Phenotypical and agronomical performances were combined. Characterisation was performed according to the descriptors of UPOV for shape in profile view, shape in frontal view, symmetry along the suture, dept of suture, dept of pedicel cavity, shape of tip, skin pubescence, ground colour, over colour, texture of flesh, adherence of stone to flesh, bitterness of kernel characters of 64 varieties in Malatya. The other characters such as fruit size, flesh juiciness, eating quality, fruit attractiveness, stone size and stone shape were done according to IPBGR descriptors in Malatya varieties. The characterisation of varieties in Pozanti and Adana were performed according to IPBGR apricot descriptor. In addition, self pollination studies were carried out, sensitivity to monilinia were evaluated and the presence of viruses (PPV, ACLSV, PNRSV) has been tested in important Turkish apricot varieties.

PubMedID: 15717627 Renal involvement may occur in cases with malignant disorders. Glomerular injury may be the first sign of these diseases and may predict the overall survival. In some cases, glomerular injury may be associated with tumor antigens, and in some others, viruses cause renal injury together with underlying malignant disease. Here we report four cases with malignant diseases and accompanying glomerular injury and review the literature.