Regarding the cosmetic side effects and hyperlipidemia, tacrolimus was found to be superior to cyclosporine A. Where hyperlipidemia is considered to be a risk factor for cardiovascular disease, tacrolimus use should be considered as a more acceptable treatment modality. However, the immunosuppressive regimen should be evaluated individually.
Primary malignant lymphoma of the bladder is unusual. We report a case of primary malignant lymphoma arising in the urinary bladder. A 54-year-old woman was admitted to our hospital with the chief complaint of dysuria, on May 26, 1995. Examination of IVP, ultrasonography, cystoscopy suggested a non-papillary bladder tumour. Diagnosis was established by histological examination.
Nontraumatic spontaneous splenic rupture (NSSR) has been encountered much more rarely compared with the traumatic splenic rupture. Although NSSR generally emerges in dialysis patients on account of such causes as the use of heparin during hemodialysis, uremic coagulopathy, infections, and secondary amyloidosis. Herein, we aimed to present a case of spontaneous splenic rupture which had developed soon after the inclusion of the case suffering from end-stage renal disease in routine hemodialysis program in the absence of any trauma or other prespecified risk factors for splenic rupture. A 55-year-old male patient was admitted to our hospital to have the ureteral double J stent removed. The operation was completed without any complication. Complaining an abdominal pain more prominent in the left upper abdominal quadrant in the first postoperative day, the patient underwent a through physical examination which disclosed abdominal distension, widespread tenderness, and rebound and defense positivity. The abdominal tomography depicted 122 × 114 × 95 mm lesion compatible with a hematoma. On the basis of these findings, an emergency exploratory operation was decided to be performed. Following clearance of the retroperitoneal hematoma, splenectomy was implemented. Experiencing progressive deterioration in his clinical status despite antibiotherapy, the patient unfortunately died of sepsis with multiorgan failure on the 25th postoperative day. In conclusion, NSSR is such an entity that may be missed out, can pursue variable clinical courses, and requires emergency therapy upon definitive diagnosis. The possibility of spontaneous bleedings should be kept in mind in any case with the history of hyperuricemia even in the absence of overt trauma, no matter if they are included in routine hemodialysis or not.
Herein, we present a case of testicular tumor in a young patient in whom the initial symptom was upper gastrointestinal bleeding secondary to duodenal invasion by retroperitoneal lymph node involvement. Although melanoma, renal, breast, bronchogenic, and gastric carcinoma are the most common metastatic tumors of the small bowel, testicular tumors should be considered in the differential diagnosis of duodenum invasion in a young man because they are the most common tumor in this age group.
We report the short-term results in 23 women who underwent endoscopic transvaginal bladder neck suspension for stress urinary incontinence. During follow-up for 3-14 months (mean 6 months) complete dryness was achieved in 15 (79%) of the 19 patients. Significant improvement with only minor occasional leaks after surgery was observed in 2 patients (10.5%) and the remaining 2 cases (10.5%) were failures. Four patients were lost to follow-up. No serious complication was noted. This relatively easy operation with acceptable success and morbidity rates has been found to be comparable with the other surgical techniques being used.
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