Our study aimed to assess the correlation between the measured PiCCO® parameters and extubation time and intensive care unit (ICU) length of stay in patients who underwent coronary artery bypass grafting (CABG) surgery and were managed by monitorization of cardiac output and cardiac performance parameters with PiCCO®. Method: This study was conducted by retrospective analysis data of all 44 patients who underwent CABG surgery during December 2015-March 2016 and were managed through PiCCO® monitorization. The patients' demographic characteristics (age, sex, weight, height, body mass index), American Society of Anesthesiologists physical conditions, comorbidities, ejection fractions, anesthetic management, operative details, hemodynamic data, PiCCO® parameters, extubation times, cardiovascular surgery ICU lengths of stay, requirements for vasoactive agent and blood transfusion, mortality, and morbidity were recorded from patient records and evaluated the correlation between the measured PiCCO® parameters and extubation time and ICU length of stay inpatients. Results: A significant increase was detected in the parameters of cardiac contractility and performance monitored with PiCCO® in the postoperative period (p<0.05). No significant correlation was found between PiCCO® parameters and extubation time and ICU length of stay (p<0.05). Conclusion: Coronary revascularization patients managed with the guidance of PiCCO® showed improved myocardial contractility and cardiac performance and no increase beyond what is anticipated in the extubation time and ICU lengths of stay of the patients. Thus, we believe that optimum volume and hemodynamic targets can be achieved in patients managed through monitorization of cardiac function parameters.
It is well known that interactions in the tumour microenvironment are very important in the progression of tumours. We investigated the relationship between chemokine ligand type 12 (CXCL12), chemokine receptor type 4 (CXCR4) and survival in advanced colorectal cancers (CRC). Primary tumour samples of stage III-IV CRC patients were investigated for CXCL12 and CXCR4. Chemokine ligand type 12 and CXCR4 expressions were significantly associated with poor prognostic factors (e.g. for CXCL12: lymphatic invasion [p = 0.009], positive surgical margin [p = 0.006], advanced stage [p = 0.028], etc.). Also, these parameters were independent risk factors for low LIR (e.g. for CXCL12: Odds ratio [OR] = 2.27, p = 0.001) and low tumour stroma-ratio (TSR; e.g. for CXCL12: OR = 1.18, p = 0.003). In univariate analysis, 5-year RFS and OS were poor (e.g. for CXCL12: RFS, p < 0.001 and OS, p = 0.001). Multivariate analysis showed that these parameters were independent poor survival parameters for RFS and OS (e.g. for CXCL12: Hazard ratio [HR] = 3.54 [CI: 1.52-4.67], p = 0.001 and HR = 2.74 [1.48-4.71], p = 0.025). We showed that CXCL12 and CXCR4 expressions are poor prognostic factors in lymph node-positive CRC patients and are associated with low TSR and low LIR.
ÖZMikst adenonöroendokrin kanserler nadir rastlanan tümörlerdir. Kolonik tübüler adenomlar ile mikrokarsinoid tümörlerin birlikteliği ise literatürde son derece ender bildirilmiştir. Bilindiği üzere, bu tümörlerdeki nöroendokrin bileşen glandüler patern, iğsi hücreli patern, skuamöz-osteoid metaplazi veya pleomorfizm gibi belirgin hitopatolojik değişkenlik gösteren geniş bir yelpaze sergiler. Nadiren çok az farklılaşmış olabilir ve undiferansiye karsinom ya da lenfomaya benzeyebilirler. Bununla beraber, karsinoid veya Zollinger-Ellison gibi birtakım sendromlarla ilişkili karsinoid tümörlerin immünohistokimyasal analizinde, bir amin veya peptit baskın olabileceği gibi çoğunun mültihormonal olduğu gösterilmiştir ve primer tümördeki aminler ve peptidler, üstte bulunan endokrin hücrelerde normal olarak bulunanlarla çoğu zaman eşleşmez. Ayrıca son zamanlarda, neoplastik endokrin ve endokrin dışı epitel hücrelerinin karışımlarını içeren artan sayıda tümör tarif edilmiştir. Dahası, endokrin ve epitel hücresi özelliklerinin aynı hücre içinde gözlendiği farklı tümör türleri de mevcuttur. Bütün bu literatür bilgileri ile benzer olarak, olgumuzda izlenen morfolojik ve immünhistokimyasal bulgular iki neoplastik bileşenin ortak bir öncü hücreden kaynaklandığını göstermektedir.Anahtar kelimeler: kompozit adenom, mikrokarsinoid, tübüler ABSTRACT Mixed adenoneuroendocrine cancers are rare tumors. The association of colonic tubulary adenomas with microcarcinoid tumors has been reported very rarely in the literature. As known, the neuroendocrine component in these tumors display a broad spectrum with marked variability in histopathology properties; such as glandular pattern, spindle cell pattern, squamousosteoid metaplasia or pleomorphism. Rarely, they may be very poorly differentiated and may resemble undifferentiated carcinoma or lymphoma. In addition, immunohistochemical analysis of carcinoid tumors associated with some syndromes such as Zollinger-Ellison and carcinoid has shown that, most are multihormonal as well as one amine or peptide may predominate and the amines and peptides in the primary tumor do not often match to those normally found in the overlying endocrine cells. However, an increasing number of tumors have recently been described including mixtures of neoplastic endocrine and nonendocrine epithelial cells. Furthermore, there are different types of tumors in which endocrine and epithelial cell characteristics are observed in the same cell. Similar to all this literature information, morphological and immunohistochemical findings in our case show that, the two neoplastic components originate from a common precursor cell. 130 To cite this article: Zengin M, Paşaoğlu HE. Kompozit kolonik adenom-mikrokarsinoid tümör, gerçekten tesadüf mü? Olgu sunumu. Turk Clin Lab 2017; 8(3): 130-133.Literatürde kompozit adenom-karsinoid tümör olarak rapor edilen hastaların klinik takipleri genel olarak benign olarak bildirilmiştir [15,16]. Ancak submukoza invazyonu izlenen bir olguda ise lenf nodu metastazı ve agresif davranış tari...
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