Comparación entre el efecto de la nefrolitotomía percutánea miniaturizada vs. convencional en la función renal evaluada mediante gammagrafía renal con DMSA / Comparison of the effect of miniaturized and standard percutaneous nephrolithotomy on renal function assessed with DMSA scintigraphy

Introducción y objetivos Nos propusimos realizar un estudio clínico para comparar los efectos de la nefrolitotomía percutánea (NLP) convencional y miniaturizada sobre la función renal evaluada mediante imágenes de gammagrafía en pacientes con cálculos renales primarios. Materiales y métodos Se incluyeron 104 pacientes en este estudio prospectivo entre mayo de 2014 y febrero de 2017. Los pacientes elegibles se dividieron en dos grupos: NLP miniaturizada (NLPm) y NLP convencional (NLPc) mediante muestras emparejadas (escenario 1:1). Se realizó una gammagrafía cortical con ácido dimercaptosuccínico de tecnecio-99m antes y después de la intervención. Resultados No hubo diferencias entre los dos grupos en cuanto a las tasas de éxito (NLPm [63,5%] frente a NLPc [71,2%], p=0,403), creatinina sérica, tasa de filtración glomerular, funciones renales diferenciales evaluadas antes y después de la intervención (p≥0,05). No hubo relación entre el tipo de procedimiento y la formación de nuevo tejido cicatricial (p=0,780). Las tasas de complicaciones graves (grados 3 y 4 según la clasificación de Clavien-Dindo modificada) fueron más altas en la NLPc (p=0,034). La carga litiásica, el tiempo quirúrgico, el descenso de la hemoglobina, los accesos múltiples, la transfusión de sangre y la angioembolización fueron mayores en los pacientes con riñones cicatrizados (p<0,001, p=0,008, p=0,004, p<0,001, p=0,003, p=0,001, respectivamente). En el análisis multivariante, sólo el acceso múltiple resultó estadísticamente significativo para predecir la formación de tejido cicatricial nuevo (p<0,001, OR: 24,28). Conclusiones La NLP miniaturizada y la convencional son intervenciones fiables y efectivas para el tratamiento de cálculos renales de gran tamaño. No se encontraron diferencias significativas entre los dos procedimientos en cuanto a la disminución de la función renal (AU)

Introduction and Objectives We aimed to present a clinical study that compares standard and miniaturized percutaneous nephrolithotomy (PNL) effects on kidney function with scintigraphic imaging in primary kidney stone patients. Materials and Methods One hundred four patients were included in this prospective study between May 2014 and February 2017. Eligible patients were divided into two groups miniaturized PNL (mPNL) and standard PNL (sPNL) with matched-pair analysis (1:1 scenario). Technetium-99m Dimercaptosuccinic Acid cortical scintigraphy imaging was performed before and after the operation. Results There were no differences between the two groups in terms of success rate (mPNL(63.5%) vs. sPNL(71.2%), p=0.403), serum creatinine, glomerular filtration rate, split renal functions pre- and postoperatively (p≥0.05). There was no relationship between the type of operation and new scar formation (p=0.780). The rates of serious complication (grades 3 and 4 according to modified Clavien-Dindo Classification) were higher in sPNL (p=0.034). Stone burden, duration of operation, hemoglobin drop, multiple access, blood transfusion, and angioembolization were higher in patients with scarred kidneys (p<0.001, p=0.008, p=0.004, p<0.001, p=0.003, p=0.001, respectively). In multivariate analysis, only multiple access was found statistically significant for predicting new scar formation (p<0.001, OR:24.28). Conclusions Miniaturized and standard PNL are reliable and successful operations for treating large kidney stones. No significant difference was found between the operation types regarding a decrease in renal function (AU)

Factors affecting anxiety, depression, and stress among patients with hepatocellular carcinoma during COVID-19 pandemic.

OBJECTIVE: Patients with chronic disease whose treatments are limited may experience depression, anxiety, and stress-related symptoms, as well as an increase in the levels of these conditions. This study aims to determine the factors affecting the depression, stress, and anxiety levels of hepatocellular carcinoma (HCC) patients due to the fear of COVID-19 exposure. PATIENTS AND METHODS: 118 patients with advanced HCC treated with non-transplant treatment options or on the waiting list due to the lack of a donor were enrolled. To evaluate the stress, depression, and anxiety levels during the COVID-19 process, Depression Anxiety Stress Scales (DASS-21) and the Coronavirus Anxiety Scale (CAS) were administered to 118 patients through a face-to-face interview. Sociodemographic and clinical characteristics were recorded, and the primary endpoint measure was the total score of DASS. In addition, the multilayer perceptron (MLP) model was constructed to predict the scores of the DASS-21 total. RESULTS: There were significant differences between DASS depression (p=0.010; p=0.030) DASS anxiety (p=0.010; p=0.010) and DASS total (p=0.046; p=0.023) scores in terms of gender and protective effect of the vaccine. Also, a significant difference between gender for the CAS scale was determined (p=0.044). The median score of the DASS total in the COVID-19 group was higher than in the non-COVID-19 group; however, the increase was not significant. MLP model revealed that chronic disease, gender, age, place of residence, smoking, type of vaccine, and COVID-19 exposure were the most important predictors for the DASS total. CONCLUSIONS: Chronic disease, gender, and age were prominent factors in predicting the DASS-21 total score in HCC patients. Therefore, the crucial factors were clinically considered for managing depression, stress, and anxiety in HCC patients.

Comparison of the effect of miniaturized and standard percutaneous nephrolithotomy on renal function assessed with DMSA scintigraphy.

INTRODUCTION AND OBJECTIVES: We aimed to present a clinical study that compares standard and miniaturized percutaneous nephrolithotomy (PNL) effects on kidney function with scintigraphic imaging in primary kidney stone patients. MATERIALS AND METHODS: One hundred four patients were included in this prospective study between May 2014 and February 2017. Eligible patients were divided into two groups miniaturized PNL (mPNL) and standard PNL (sPNL) with matched-pair analysis (1:1 scenario). Technetium-99m Dimercaptosuccinic Acid cortical scintigraphy imaging was performed before and after the operation. RESULTS: There were no differences between the two groups in terms of success rate (mPNL (63.5%) vs. sPNL (71.2%), p=0.403), serum creatinine, glomerular filtration rate, split renal functions pre- and postoperatively (p≥0.05). There was no relationship between the type of operation and new scar formation (p=0.780). The rates of serious complication (grades 3 and 4 according to modified Clavien-Dindo Classification) were higher in sPNL (p=0.034). Stone burden, duration of operation, hemoglobin drop, multiple access, blood transfusion, and angioembolization were higher in patients with scarred kidneys (p<0.001, p=0.008, p=0.004, p<0.001, p=0.003, p=0.001, respectively). In multivariate analysis, only multiple access was found statistically significant for predicting new scar formation (p<0.001, OR: 24.28). CONCLUSIONS: Miniaturized and standard PNL are reliable and successful operations for treating large kidney stones. No significant difference was found between the operation types regarding a decrease in renal function.

Injection-Locked, Single Frequency, Multi-core Yb-doped Phosphate Fiber Laser.

For the first time, we demonstrate injection locking and single frequency operation of a multi-core Yb-doped phosphate fiber laser (MCF). The 19 MCF laser cores operated in CW mode at 1030 nm. Each laser core was locked to the frequency and polarization of the single-frequency master laser, and produced milliwatts of power with similar lasing thresholds. The pump beam was homogenized with a simple technique to increase uniform lasing behavior of the cores. This behavior was verified using a MCF laser model developed in-house. This unique MCF laser can be useful for applications of coherent, coupled oscillator networks, for example in an all-optical coherent Ising machine configuration.

Chemically linked metal-matrix nanocomposites of boron nitride nanosheets and silver as thermal interface materials.

Herein, novel hybrid nanocomposite thermal interface materials (TIMs) relying on the chemical linkage of silver, boron nitride nanosheets (BNNSs), and organic ligands are reported. These TIMs were prepared using a co-electrodeposition/chemisorption approach where the electrolytic reduction of silver ions into silver nano-/micro-crystals was coupled with the conjugation of ligand-coated nanosheets onto silver crystals. Furthermore, the influence of the bond strength of silver/nanosheet links on the thermal, mechanical, and structural properties is investigated using a combination of techniques including laser flash analysis, phase-sensitive transient thermoreflectance, nanoindentation, and electron microscopy. The internal nanostructure was found to be strongly dependent on the linker chemistry. While the chemical grafting of 4-cyano-benzoyl chloride (CBC) and 2-mercapto-5-benzimidazole carboxylic acid (MBCA) on BNNSs led to the uniform distribution of functionalized-nanosheets in the silver crystal matrix, the physical binding of 4-bromo-benzoyl chloride linkers on nanosheets caused the aggregation and phase separation. The thermal conductivity was 236-258 W m-1 K and 306-321 W m-1 K for physically and chemically conjugated TIMs, respectively, while their hardness varied from 400-495 MPa and from 240 to 360 MPa, respectively. The corresponding ratio of thermal conductivity to hardness, which is a critical parameter controlling the performance of TIMs, was ultrahigh for the chemically conjugated TIMs: 1.3 × 10-6 m2 K-1 s for MBCA-BNNS and 8.5 × 10-7 m2 K-1 s for CBC-BNNS. We anticipate that these materials can satisfy some of the emerging thermal management needs arising from the improved performance and efficiency, miniaturization, and/or high throughput of electronic devices, energy storage devices, energy conversion systems, light-emitting diodes, and telecommunication components.

Measurement of carrier envelope offset frequency for a 10 GHz etalon-stabilized semiconductor optical frequency comb.

We report Carrier Envelope Offset (CEO) frequency measurements of a 10 GHz harmonically mode-locked, Fabry-Perot etalon-stabilized, semiconductor optical frequency comb source. A modified multi-heterodyne mixing technique with a reference frequency comb was utilized for the measurement. Also, preliminary results from an attempt at f-2f self-referencing measurement are presented. The CEO frequency was found to be ~1.47 GHz for the particular etalon that was used.

Simple sequence repeat-based assessment of genetic relationships among Prunus rootstocks.

Ten SSR loci, previously developed for Prunus, were analyzed to examine genetic relationships among 23 rootstock candidates for sweet and sour cherries, of the species P. avium, P. cerasus, P. mahaleb, and P. angustifolia. Five genotypes of P. laurocerasus, not used as rootstock, were included in the molecular analysis. The number of alleles per locus ranged from 8 to 12, with a mean of 9, while the number of microsatellite genotypes varied from 8 to 17, indicating that the SSRs were highly informative. The degree of heterozygosity (0.61) was high. Clustering analysis resulted in two main clusters. The first cluster was divided into two subclusters; the first subcluster consisted of P. avium and P. cerasus, and the second subcluster consisted of P. laurocerasus. The second cluster was divided into two subclusters. The first subcluster consisted of P. mahaleb genotypes and the second consisted of P. angustifolia genotypes. The reference rootstocks also clustered with their associated botanical species. Unweighted pair-group method with arithmetic mean analysis demonstrated that P. laurocerasus genotypes had less genetic variation and that P. avium genotypes were more closely related to P. cerasus. The SSR-based phylogeny was generally consistent with Prunus taxonomy information, suggesting the applicability of SSR analysis for genotyping and phylogenetic studies in the genus Prunus.

Dynamic line-by-line pulse shaping with GHz update rate.

We introduce a novel scheme for dynamic line-by-line pulse shaping with GHz update rates. Four lines of an optical frequency comb source are used to injection-lock four individual VCSEL, which are subsequently electrically modulated at 0.4 to 1 GHz through current modulation. This concept could be considered a completely new way of pulse shaping as the light is not simply modified, but rather regenerated with the desired properties. We also discuss an important drawback of line-by-line pulse shapers that ultimately limits the modulation speed capability.

RAPD-based study of genetic variation and relationships among wild fig genotypes in Turkey.

The fig tree (Ficus carica L.) is of significant socio-economic importance in Turkey, with 25% of the world's fig production. Genetic variation and relationships among 14 wild-grown figs sampled from Coruh Valley in Turkey were characterized by random amplified polymorphic DNA (RAPD). Ninety-eight DNA fragments were scored after amplification of DNA samples with 13 random primers; 70% of the scored bands were polymorphic. Genetic distances between the fig genotypes ranged from 0.21 to 0.62. Genotypes 08-ART-02 and 08-ART-06 were found to be the most closely related, whereas 08-ART-09 and 08-ART-10 were the most distant. The 14 wild-grown genotypes were grouped into six main clusters and one outgroup. We conclude that RAPD analysis is efficient for genotyping wild-grown fig genotypes.

Identification of Turkish and standard apple rootstocks by morphological and molecular markers.

Two local (Vezir-1 and Vezir-2) and two standard (M9 and MM106) clonal apple rootstocks were compared using both morphological and molecular markers. International Union for the Protection of New Varieties of Plants criteria were used for morphological evaluation, which did not clearly separate these rootstocks. We tested 47 random decamer primers for random amplified polymorphic DNA analysis; 15 of them gave reproducible polymorphic patterns, yielding 109 bands, which showed 78% polymorphism. Based on a dendrogram obtained by unweighted pair group method using arithmetic average analysis, three clusters were obtained. The highest genetic similarities were found between M9 and Vezir-2 (0.670). The random amplified polymorphic DNA markers proved to be more efficient than the standard morphological markers for the identification of rootstocks.

Signet ring cells in fine needle aspiration cytology of breast carcinomas: review of the cytological findings in ten cases identified by histology.

OBJECTIVE: To establish whether the presence of signet ring cells (SRCs) in histology sections of breast carcinoma cases was reflected by their presence in fine needle aspiration cytology (FNAC) smears, correlating to the histological type of breast carcinoma. METHODS: We reviewed the FNAC findings of ten cases that had been diagnosed as primary breast carcinoma with SRCs on histological sections between 1998 and 2007. Slides and histological sections were obtained from the archives of Ege University Hospital. RESULTS: FNA smears were reviewed for the following cytomorphological features: background, cellularity, architecture, nuclear pleomorphism and the presence of SRCs. The background was bloody in eight cases, necrotic in one, and clean in one. There was no mucinous material in any of the cases. Cellularity was prominent in five cases (hypercellular), moderate in three (cellular) and low in two (hypocellular). Loosely cohesive groups of tumour cells of varying size were observed in all cases. A plasmacytoid appearance to some of the tumour cells was seen in all cases and discohesive tumour cells were present in eight. Nuclear pleomorphism was high in six cases and moderate in four. SRCs were observed in seven of the ten cases. Two of these seven cases also had a tubular pattern and one had tumour giant cells. CONCLUSIONS: FNAC should be evaluated carefully regarding the presence of SRCs when cells with a plasmacytoid appearance are observed in either hyper- or hypocellular smears. The presence of single SRCs in FNACs with hypercellularity, high nuclear grade and tubular formation or tumour giant cells may be a clue in favour of ductal carcinoma. The presence of single SRCs in FNACs with hypocellularity and mild to moderate nuclear grade may be suggestive of lobular carcinoma. However, larger studies would be needed to establish the predictive value of the presence of SRCs on FNAC.

Characteristics of meat emulsion systems as influenced by different levels of lemon albedo.

The effect of the addition of lemon albedo on the functional properties of emulsions was studied by using a model system. Oil/water (O/W) model emulsion systems were prepared by the addition of two types of lemon albedo (raw and dehydrated) at five concentrations (0.0%, 2.5%, 5.0%, 7.5% and 10%) to mechanically deboned chicken meat. The emulsion capacity, stability, viscosity and flow properties of the prepared model emulsions were analyzed. In addition, the colour parameters of cooked emulsion gel were determined. The addition of lemon albedo increased the emulsion capacity (EC) and the highest EC value was reached with 5% of albedo added. However, further increase in the albedo concentration caused an inverse trend in the EC values. A similar trend was observed in the emulsion stability (ES) values. Dehydrated albedo (DA) addition caused higher EC and ES values than did raw albedo (RA). DA increased the L(∗), a(∗) and b(∗) values of the cooked emulsion gels. Emulsion viscosity (EV) values were positively correlated with an increase in albedo concentration and the highest EV value was obtained from the emulsions with 10% albedo. Albedo addition did not change the flow properties of the emulsions and, in addition, increased the pseudoplasticity. As a consequence, the use of lemon albedo might be a potential dietary fiber source to enhance the functional and technological properties for frankfurter-type meat products.

Wideband all-order polarization mode dispersion compensation via pulse shaping.

We demonstrate the application of ultrafast pulse-shaping techniques for experimental wideband all-order polarization mode dispersion (PMD) compensation, for the first time to our knowledge. PMD is treated as arbitrary variations of state of polarization and phase versus wavelength, in an all-order sense. Consequently, two pulse shapers are implemented in a serial manner to compensate for the polarization and the phase spectra independently. We report compensation of subpicosecond pulses (14 nm bandwidth around 1550 nm) that are anomalously spread to more than 2 ps as a result of PMD. This PMD compensation scheme can potentially be a powerful and cost-effective solution for fiber optic telecommunication networks.

Melatonin inhibits neural apoptosis induced by homocysteine in hippocampus of rats via inhibition of cytochrome c translocation and caspase-3 activation and by regulating pro- and anti-apoptotic protein levels.

In the present study, we examined the molecular mechanism by which homocysteine causes neuronal cell apoptosis. We further investigated the mechanisms of melatonin's ability to reduce homocysteine-induced apoptosis. Consistent with its antioxidant properties, melatonin reduced homocysteine-induced lipid peroxidation and stimulated glutathione peroxidase enzyme activity in hippocampus of rats with hyperhomocysteinemia. Furthermore, melatonin treatment diminished cytochrome c release from mitochondria and reduced caspase 3 and caspase 9 activation induced by hyperhomocysteinemia. Chronic hyperhomocysteinemia also led to poly(ADP-ribose) polymerase cleavage and subsequently DNA fragmentation. Treatment with melatonin markedly inhibited poly(ADP-ribose) polymerase cleavage and reduced DNA damage. Hyperhomocysteinemia caused an elevation of pro-apoptotic Bax levels while reducing anti-apoptotic protein, Bcl-2, levels. Daily administration of melatonin up-regulated Bcl-2 and down-regulated Bax levels. We propose that, in addition to its antioxidant properties, melatonin has the ability to protect neuronal cells against apoptosis mediated homocysteine neurotoxicity by modulating apoptosis-regulatory proteins in the hippocampus of rats.

Predictive value of C-reactive protein in patients with unstable angina pectoris undergoing coronary artery stent implantation.

In-stent restenosis is a major problem following coronary stent implantation, and inflammation plays an active role. We evaluated the effectiveness of the inflammatory marker C-reactive protein (CRP) as a predictor of in-stent restenosis after successful stent implantation, in 86 patients with unstable angina pectoris. Plasma CRP was measured in all patients before the procedure, and at 48 - 72 h and 1, 2 and 3 months post-procedure. An angiographic loss of 50% at follow-up was accepted as in-stent restenosis. We found negative and positive predictive values of the pre-procedural plasma CRP for determining 6-month in-stent restenosis of 34% and 61%, respectively. We also found a strong correlation between the 3-month post-procedural CRP value and 6-month in-stent restenosis; the negative and positive predictive values being 8% and 76%, respectively. In conclusion, we showed that a plasma CRP value > 3 mg/l in the third month after coronary stent implantation was a strong predictor of angiographic in-stent restenosis.

Broadband polarization correction with programmable liquid-crystal modulator arrays.

We demonstrate a novel method of parallel, multiwavelength state-of-polarization (SOP) correction. Using a new liquid-crystal modulator array design, we are able to rotate the distorted input SOP spectrum to a fixed linear state on a wavelength-by-wavelength basis. We report experimental correction of up to 25.5-dB polarization-dependent loss over a 13-nm bandwidth around 1550 nm.