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Craniopharyngiomas: A 20-Year-Period Evaluative Single Center Study
(Scholars.Direct, 2021-06-21)
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Cvetkovski, Petar
Introduction: Craniopharyngioma is a rare histologically benign brain tumor with potential malignant clinical course because of the high propensity of recurrence, deriving from the remnants of Ratkhe’s pouch, presenting as solid mass and partly as fluid-filled cyst. There are two main histological subtypes: adamantinomatous and papillary. The aim of this study is to evaluate statistical features of this tumor in the Republic of North Macedonia. Materials and Methods: This is a 20-year-period retrospective, single center evaluative study (1998-2018) of 40 craniopharyngioma cases operated in the University Clinic of Neurosurgery, diagnosed at the Institute of Pathology, Medical Faculty, University ‘’Ss. Cyril and Methodius’’ in Skopje, Republic of North Macedonia on paraffin section slides routinely stained with H&E. Statistica for Windows 7 was used. Results: From total 4929 cases of benign and malignant brain tumors, craniopharyngioma comprise 40 cases (0.81%); 25 (62.5%) males (37.9 ± 17.8 years), 15 (37.5%) females (34.0 ± 25.4 years), age 3 to 68 years; Most prevalent localization: Sellar region - 11 (27.5%), cerebrum - 8 (20%). Adamantinomatous - 27 (67.5%) cases, papillary 13 (32.5%) cases. Age group distribution: the most cases - 7 (17.5%) in 0-9, 40-49, 60-69 years groups; least cases - 3 (7.5%) in 20-29 years group. Nine (22.5%) of 40 patients have had recurrent tumor (first 1-3 years). Adamantinomatous was diagnosed in 14 (51.85%) males and 13 (48.15%) females; Papillary in 11 (84.62%) males and 2 (15.38%) females. There is significant statistical difference between age groups and craniopharyngioma subtypes (Kruskal-Wallis ANOVA: H = 14.86; p = 0.0274). Conclusion: We found association/correlation between gender, age and histological subtype. Papillary craniopharyngioma appears more frequently in males and adamantinomatous was most prevalent in younger patients.
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A Case Report of Intraoperatively Diagnosed Cholangiocarcinoma after Unsuccessful Conservative Treatment of ERCP Complicated with Hemorrhage
(Vilnius University Press, 2018-12-03)
Bozinovska Beaka, Gordana
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Zdravkovska, Milka
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Burova, Blagica
Cholangiocarcinoma is a malignant tumor arising from the epithelium of the bile ducts. Most of these tumors are adenocarcinomas [1]. Intrahepatic cholangiocarcinoma accounts for 10% of all cholangiocarcinomas, hilar cholangiocarcinoma for 25%, and extrahepatic cholangiocarcinoma for 65% [2, 3]. Cholangiocarcinoma can develop in any part of the extrahepatic duct, occurring in 50–75% of reported cases in the upper third of the duct including the hepatic hilum, in 10–25% in the middle third, and in 10–20% in the lower third [4–6]. Approximately 95% of cases show extrahepatic obstruction at the time of diagnosis [7]. In a meta-analysis of 21 prospective trials, the rate of hemorrhage as a complication of ERCP was 1.3% (95% CI, 1.2%–1.5%) with 70% of the bleeding episodes classiﬁed as mild [8]. Hemorrhagic complications may be immediate or delayed, with recognition of occurring up to 2 weeks after the procedure. The risk of severe hemorrhage (ie, requiring >5 units of blood, surgery or angiography) is estimated to occur in fewer than1 per 1 000 sphincterotomies [9]. Despite new and advanced diagnostic methods, sometimes this type of tumor is finally diagnosed from pathological findings on excised tissue.
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Comparative Study for Application of Polypropylene Monofilament Light Mesh, Polypropylene Monofilament Heavy Mesh and Self Gripping Polypropylene Mesh in Patients with Inguinal Hernia Surgically Treated with Lichtenstein Technique
(Vilnius University Press, 2020-12-29)
Bozinovska Beaka, Gordana
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Zdravkovska, Milka
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Kalamaras, Patricija
<jats:p>Background / Objective. In our clinical study we have compared the results of intraoperative and postoperative period in patients with inguinal hernia treated operatively with Lichtenstein technique, where one of three different polypropylene meshes has been applied: polypropylene monofilament light mesh, polypropylene monofilament heavy mesh and self gripping polypropylene mesh. Follow up period have been one year. Methods. This study represents randomized, retrospective-prospective, comparative clinical study where 243 patients have been divided into three groups depends of prosthetic mesh that was applied with Lichtenstein technique. We have evaluated the connection between types of used mesh with some of followed parameters: postoperative pain intensity, postoperative patient mobilization, postoperative surgical site occurrences, duration of hospitalization, chronic pain, filling of foreign body in inguinal area and development of recurrences. Results. Patients with applied self gripping polypropylene mesh have significantly lowest pain, lowest hospital stay and lowest duration of surgical procedure than other two groups of patients. In term of chronic pain, only statistically significance we confirmed between the groups of heavy monofilament mesh and self griping polypropylene mesh, where higher number of patients from group with monofilament polypropylene light mesh reported chronic pain. In our study we confirmed that working status and patient age have significant influence on the intensity of postoperative pain in all three patients group. There is no statistical correlation between type of the mesh and surgical site occurrence rate. Conclusion. Patients with applied self gripping polypropylene mesh have significantly lowest pain, lowest hospital stay, lowest duration of surgical procedure and less number of patients experienced feeling of “foreign body” in their groin than other two groups of patients.</jats:p>

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