Notes

Isatuximab as well as carfilzomib and dexamethasone as opposed to carfilzomib as well as dexamethasone throughout relapsed numerous myeloma people using kidney problems: IKEMA subgroup examination.
Among 61 DTC patients, 11 didn't answer the phone or the questions so 50 patients were included in the study. Breast cancer family history was reported in 14 (28%) patients and thyroid cancer family history in 8 (16%) patients. No relapse was reported during follow up.All patients underwent to mammography in 2015 or in 2016 within screening programs and no breast cancer were diagnosed.

The female predominance of diseases of the thyroid and breast makes difficult the separation of an expected association with a casual linkageThe relationship between the co-occurrence of breast and thyroid cancer remains controversial and inconclusive.

Breast cancer, Breast surgery, Hormone therapy, Thyroid cancer, Thyroidectomy.
Breast cancer, Breast surgery, Hormone therapy, Thyroid cancer, Thyroidectomy.
Surgery in association with lymphadenectomy is the treatment of choice for the gastric adenocarcinoma. Aim is to report our experience in the surgical treatment of gastric cancer in a European center.

A prospectively maintained database identified 515 patients. Staging laparoscopy was performed to rule out peritoneal carcinomatosis in suspicious cases. Type of surgery and lymphadenectomy were determined according to the Japanese guidelines and pathological staging according to the TNM classification. Survival was analysed using the Kaplan-Meier method.

Staging laparoscopy avoided 150 (29.1%) unnecessary laparotomies. A total of 356 patients underwent surgery with curative intent. Overall postoperative morbidity and mortality rates were 16.8% and 5.9%, respectively. Two hundred-fifty-one patients (70%) were T3-T4. Negative lymph-nodes were observed in 71 patients (19.9%). One-hundred- seventy-nine were at least stage III. At a mean follow-up of 80.6 months, the overall and disease-free survival rates were 54.4% and 50.6%, respectively. The survival stratification based on the type of lymphadenectomy showed an overall survival rate of 43% and 65.5% in case of D1 and D2 lymphadenectomy, respectively. Based on the tumor stage the overall survival rate was 90%, 62.7%, 36.4% and the disease-free survival was 90%, 54.3%, 31.3%, for stage I, II and III, respectively.

Total or subtotal gastrectomy with D2 lymphadenectomy and adjuvant therapy for the treatment of locally advanced gastric cancer proved a valuable strategy. Staging laparoscopy is recommended.

Gastric cancer, Laparoscopy, Lymphadenectomy, Prognosis, Surgery.
Gastric cancer, Laparoscopy, Lymphadenectomy, Prognosis, Surgery.
The aim of our study was to improve poor results of preliminary colporrhaphy and anterior levatoroplasty performed for patients with low and middle rectocele.

55 patients who had undergone colporrhaphy and anterior levatoroplasty for rectocele in 2012- 2015 and contacted the clinic with complaints of ongoing obstructive defecation were included in this investigation. They had a comprehensive medical examination using defecography, ultrasound, magnetic resonance imaging, anorectal functional tests. This study revealed perineum descending in 20 patients, apical prolapse 23 patients, and 12 patients demonstrated simultaneous pathology. All these patients were performed additional abdominal sacrocolporectopexy in 2015-2017 and results were estimated.

Abdominal sacrocolporectopexy significantly improved anatomical and functional results of previous surgery which was confirmed by the listed methods of research. The average location of the anorectal area and utero-cervical zone became higher. So, perineum descendents and apical prolapsed were improved.

Sacrocolporectopexy is often used for surgical treatment of pelvic organ prolapse. Our study shows its efficiency in patients with perineum descending and upper rectocele.

Abdominal sacrocolporectopexy is an effective method of surgical correction of relapses and unsatisfactory results of treatment of patients with pelvic prolapse, manifested by perineum body descending and apical prolapse.

Apical prolapse, Levatoroplasty, Perineum descending, Rectocele, Sacrocolporectopexy.
Apical prolapse, Levatoroplasty, Perineum descending, Rectocele, Sacrocolporectopexy.
The aim of this study was to present our experiences for anesthesia management in patients undergoing robot-assisted radical prostatectomy (RARP) in light of current literature data.

This clinical retrospective study included 103 patients who underwent robot-assisted radical prostatectomy. All patient data were obtained from the patient files and anesthesia follow-up forms. Demographic datas, intraoperative fluids, blood products requirement and blood gas parameters were recorded.

A total 15 of 103 patients data were lack, the remaining 88 patients were evaluated. Combination of crystalloid and colloid was used for intravenous fluid management. About 11% of patients required transfusion during surgery. The mean pH and pO2 values of the patients were observed to decrease whereas pCO2 and lactate values increased.

Radical Prostatectomy can be performed either using open technique as a traditional approach or laparoscopic or robot-assisted technique as a minimally invasive approach. Today, minimally invasive approaches have replaced traditional open prostatectomy. Anaesthesia management of these minimally invasive techniques is very different and challenging from open technique in many aspects.

Although minimally invasive techniques have good surgical outcomes such as less blood loss, smaller surgical incision, and shorter hospitalization, these techniques bring new problems that anesthesiologists have to deal with. Increased RARP operations has led to the anesthesiologists more likely to encounter perioperative problems.

Anesthesia, Minimally invasive techniques, Radical prostatectomy.
Anesthesia, Minimally invasive techniques, Radical prostatectomy.
Obesity is a leading cause of preventable death worldwide and is increasing in both adults and children. Bariatric surgery is the most effective treatment for this condition and its related comorbidities. We aimed to evaluate the effectiveness of different staple line reinforcement techniques on staple line reinforcement through bursting pressures.

Different stapler line strengthening techniques were performed on resected stomach patterns of 48 patients. The patients were enrolled prospectively into 4 groups according to surgeons preferred type of staple line reinforcement. selleck chemical Data concerning patient demographic variables, surgical parameters, postoperative complications, postoperative readmissions, burst pressure and burst point were collected. None of the obese patients were excluded from this study.

There were no statistically significant differences in the characteristics of the groups. The number of staple cartridges fired and the linearity of the staple line were similar in all groups, (p 0.524-0.265). However, there were significant differences in the burst pressure measurements in groups I, II, IIIand IV (p .001). In all groups, the burst point on the staple line of resected stomach was most commonly in the fundus section.

We believe that the burst pressure in Fibrin sealant group is significantly higher and that fibrin glue can be effective in preventing stapler line leakage. We believe that more advanced studies are needed.

Fibrin Sealant, Leakage, Reinforcement.
Fibrin Sealant, Leakage, Reinforcement.Chronic lymphocytic leukemia is a genetically heterogeneous disease, and a complex set of genetic alterations is associated with its pathogenesis. CLL is the most common leukemia in the western countries, whereas it is rare in Asia, including Korea. The prognostic models integrate the traditional staging systems developed by Rai et al. and Binet et al. with biochemical and genetic markers. With the advent of molecular biology, a variety of targeted agents, including anti-CD20 antibodies, inhibitors of BCR signaling pathway, and BCL-2 inhibitors, have been introduced, which has changed the landscape of CLL treatment greatly. This review will focus on the risk stratification and the management of CLL in the era of novel small molecules.Extranodal natural killer (NK)/T cell lymphoma (ENKTL) is a distinct subtype of Non-Hodgkin's lymphoma mainly involving the nasal area. Since the entity was first recognized, treatment strategies have been evolving from anthracycline-based chemotherapy and radiotherapy to L-asparaginase containing regimens and recently immune checkpoint inhibitors. With the currently used combined chemotherapy and radiotherapy, more than 70% of patients with localized disease can be cured. L-asparaginase containing regimens have significantly improved treatment outcomes among patients with advanced disease. However, the treatment outcomes of patients with disease refractory to L-asparaginase containing regimens or who experience recurrence remain poor. In this article, we cover the current treatments for ENKTL and emerging treatment approaches.Primary central nervous system lymphoma (PCNSL) is a rare subtype of extranodal lymphoma primarily involving the brain, spinal cord, or leptomeninges. PCNSL is associated with a relatively poor prognosis compared to other extranodal diffuse large B-cell lymphomas. However, methotrexate-based induction chemotherapy followed by consolidative chemotherapy or high-dose therapy and autologous stem cell transplantation has improved the survival outcome, together with reduced neurotoxicity. Recent studies found that aberrant activation of the B-cell receptor-signaling pathway and activation of the NF-κB are frequent genetic alterations and could be good targets for the treatment of PCNSL. Herein, we have reviewed the current status and recent advances in the biology and management of PCNSL.Light chain (AL) amyloidosis is a disease in which malignant plasma cell clones affect multiple organs including the heart and kidney. The mechanism for organ function deterioration in AL amyloidosis differs from multiple myeloma. Thus, not all agents used to treat multiple myeloma shows similar efficacy in AL amyloidosis. In AL amyloidosis, both hematologic and organ responses after treatment are important to improve the clinical outcome. Especially, improving heart function is one of the key aspects in the treatment of AL amyloidosis. With recent advances in the understanding of the pathophysiologic mechanism of AL amyloidosis, novel treatment methods are under active trial. In this article, I have reviewed the advances in pathophysiology, diagnosis, risk stratification, and treatment of AL amyloidosis.The therapeutic strategy for relapsed and refractory multiple myeloma (RRMM) integrates a holistic approach regarding patient, disease, and drug-related factors. Patient-related factors include age, frailty status, and underlying comorbidities, especially cardiovascular and renal diseases and peripheral neuropathies that affect tolerability to multiple drug combinations or transplantations. Disease-related factors encompass these multiple patient-related factors, particularly the aggressiveness of the disease and cytogenetics. Regarding drug-related factors, the approval of novel proteasome inhibitors (such as carfilzomib and ixazomib), immunomodulatory agents (such as pomalidomide), monoclonal antibodies (such as daratumumab and elotuzumab), and new classes of drugs increasingly makes the choice treatment more complex and necessitates a comprehensive summary and an update of the efficacy and toxicities of each antimyeloma drug and its combinations. Further, careful monitoring of the side effects and supportive care throughout the course of treatment are important to achieve better outcomes for patients with RRMM.
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