Publications by authors named "D Kajaia"

5 Publications

  • Page 1 of 1

MOLECULAR CHARACTERISTICS OF THE HETEROGENEITY OF NON-INVASIVE PAPILLARY UROTHELIAL CARCINOMAS AND THE MARKERS OF THEIR RECURRENCE.

Georgian Med News 2021 Jul-Aug(316-317):178-184

Tbilisi State Medical University, Georgia.

Urothelial carcinoma represents the most common type of bladder cancer (>90%) and is the most frequent malignancy of the urinary tract. Most of the urothelial carcinomas are non-invasive at the time of diagnosis, however they are characterised with the risk of recurrence after surgical treatment. The aim of our study was to investigate the characteristics of tumor heterogeneity and markers of its progression in urothelial papillary carcinomas. Study included following groups: normal urothelial epithelium, urothelial papilloma, urothelial neoplasms with low malignant potential (PUNLM), non-invasive low grade papillary urothelial carcinomas (LGPUC) and non-invasive high grade papillary urothelial carcinomas (HGPUC). In addition, study included relapsed cases of non-invasive LGPUC and HGPUC. Nuclear features and mitotic counts was assessed using digital pathology software QuPath in standard H&E stained specimens. In addition, the presence of mitosis was detected as PHH3 labelled cells by immunohistochemistry. Proliferation was measured as Ki67 labelling index by immunohistochemistry. Tumor heterogeneity was investigated by the differential expression pattern of CK5, CK7 and CK20 by immunohistochemistry. Study results showed, that Nuclear features, as well as the number of mitosis, proliferation index and intratumoral heterogeneity significantly correlate with the presence of higher grade non-invasive urothelial lesions. In addition, it is possible to distinguish two major groups of non-invasive LGPUC and HGPUC, based on nuclear and phenotypic heterogeneity and mitotic and proliferative activity, I group which is characterised with higher intratumoral heterogeneity, higher mitotic count and higher proliferative activity, represents the high risk group of non-invasive LGPUC and HGPUC recurrence.
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September 2021

[Robot-assisted laparoscopic bladder diverticulum resection (RABDR)].

Aktuelle Urol 2021 May 11. Epub 2021 May 11.

Sozialstiftung Bamberg, Klinik für Urologie, Kinderurologie und roboterassistierte minimalinvasive Urologie, Bamberg.

Aims:  Since October 2018, urinary bladder diverticulum resections at our Department of Urology have been carried out with robot assistance and with minimal invasivion, Paediatrical urological and robot-assisted minimally invasive urological surgery for the Bamberg Social Foundation were performed with the DaVinci robotic system. The aim of the present study was to record the surgical results of our patients and to compare these if necessary with available data on optimal diagnostic and therapy.

Methods:  In this retrospective analysis, we included all patients who received RAHDR between October 2018 and March 2020. The primary endpoints were postoperative blood loss (postoperative haemoglobin decrease), the operation time (min), complications according to the Clavien-Dindo classification, length of hospital stay (days), postoperative residual urine, postoperative urine extravasation at the anastomosis of the bladder, postoperative quality of life and postoperative satisfaction with micturition.

Results:  We reviewed a total of 11 patients, all of whom were male. Mean age was 64.8 years (52-82). Average BMI was 26.5 (19-37). 3 patients were ranked with ASA score III, 5 with II and 3 with I. The average residual urine value preoperatively was 183 ml (90-240). A cystogram to rule out extravasation was performed on day 6 postoperatively. The mean duration of surgery was 212 min (148-294) and the mean duration of hospitalisation was 7.6 days (6-10). The mean residual urinary value after surgery was 25 ml (10-60). The mean postoperative maximum of flow was measured at 27.7 ml/s (11-55). No contrast agent extravasation in the cystogram was detected in any of the patients. The complications according to Clavien were not measurable. The mean postoperative haemoglobin decrease was 1.61 g/dl (0-3. 2).

Conclusions:  In most cases, the removal of one or more bladder diverticula is possible using the minimally invasive robotic technique. Various surgeries such as YV-bladder neck plastic, prostate adenoma enucleation, bladder stone restoration, and inguinal herniotomy can be carried out simultaneously. A robot-assisted urinary bladder diverticulum resection is an effective and gentle procedure. However, it must be considered that it brings financial disadvantages due to the lack of adequate representation within the German DRG-system (Diagnosis Related Groups).
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http://dx.doi.org/10.1055/a-1327-5509DOI Listing
May 2021

[Uretero-iliac artery fistula as a urological emergency].

Aktuelle Urol 2020 Nov 19. Epub 2020 Nov 19.

Sozialstiftung Bamberg, Klinik für Urologie, Kinderurologie und roboterassistierte minimalinvasive Urologie, Bamberg.

Uretero-iliac artery fistulae represent a urological emergency with considerable mortality. We present 2 cases of a uretero-iliac artery fistula. Nowadays, minimally-invasive endovascular therapy seems to be the treatment of choice. For an optimal outcome, a multidisciplinary team with imminent availability of radiology, vascular surgery, urology and anaesthesia is required.
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http://dx.doi.org/10.1055/a-1180-0191DOI Listing
November 2020

[A rare case of renal ectopic thyroid tissue].

Aktuelle Urol 2021 Feb 23;52(1):64-66. Epub 2020 Sep 23.

Sozialstiftung Bamberg, Klinik für Urologie, Kinderurologie und roboterassistierte minimalinvasive Urologie, Bamberg.

We present a rare case of ectopic thyroid tissue found during robotic nephrectomy of a kidney with a suspected malignant tumour. Such cases of ectopic thyroid tissue are extremely rare in the literature. If ectopic thyroid tissue occurs, it is usually found in the neck region or in the upper mediastinum. Clinical symptoms depend on size, localisation and hormonal function of the ectopic tissue. Surgical resection remains the treatment of choice; in individual cases, conservative treatment can be an option. This case report aims to emphasise that renal tumours of unknown origin might be paraneoplastic or ectopic tissue of other organs.
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http://dx.doi.org/10.1055/a-1182-1961DOI Listing
February 2021

Pap testing and direct immunofluorescence for Chlamydia trachomatis infection in pregnant women.

Georgian Med News 2006 Feb(131):27-30

Obstetric Clinic N2, Tbilisi State Medical University.

The aim of the study was to determine the potential for both Pap testing and direct immunofluorescence assay for detection of chlamydia trachomatis infection in pregnant women. A total of 351 pregnant women (first to second trimesters; age range: 15-30 years) were recruited. The background data relating to social and marital status, age, anamnestic data were recorded. Serum samples were tested for IgM antibodies specific to Chlamydia trachomatis by ELISA. Cervical Pap smears were stained by Papanicolaou and direct immunofluorescence. In the present study the overall rate of C. trachomatis infections in pregnant women was 33%. Pap testing suggested a diagnosis of chlamydia trachomatis infection in 8.5% of cases only, direct fluorescence showed positivity in all patients. The highest incidence of unmarried status was recorded in the patients with mixed chlamydial infection and trichomoniasis, also with chlamydial monoinfection, rare visits to the gynecologists were common in patients with mixed chlamydial infection and trichomoniasis, mixed chlamydial and HPV infections, also with chlamydial monoinfection, multiple lifetime sex partners were reported by the patients with combined chlamydial infection and trichomoniasis, also with chlamydial monoinfection. The prevalence of asymptomatic C. trachomatis infection was lower in women with mixed non-viral infections. The incidence of pelvic inflammatory disease was higher in the patients with mixed chlamydial infection and trichomoniasis, mixed chlamydial and HPV infections, and chlamydial monoinfection, incidence of spontaneous abortions was higher in the patients with mixed chlamydial and HSV infections, also with chlamydial monoinfection, incidence of ectopic pregnancy was higher in the patients with mixed chlamydial infection and trichomoniasis, also with mixed chlamydial and HPV infections. Chlamydial infection including cervicitis was frequently diagnosed in women with mixed chlamydial and HSV infections, also with chlamydial monoinfection.
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February 2006
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