Determination of Kα,ß excitation factors in thin target for selected elements from Y to Te at 59.54 keV excitation energy.

The paper presents the first measurements of the Kα and Kß excitation factors for some selected elements from Y to Te. To determine the Kα and Kß excitation factors, the experimental values of K shell X-ray production cross sections and total absorption photoelectric cross sections were used. The measurements were performed using a Si(Li) detector coupled with 2048 multichannel analyzer and an Am-241 annular radioisotope source which is emitted 59.54 keV γ-photons. It is observed that the Kα excitation factors are 5-6 times larger than the Kß excitation factors. The measured excitation factors were compared only with theoretical calculated ones since there are no other experimental reports for the present elements in the literature. The present experimental values of Kα and Kß excitation factors are in satisfactory agreement with the theoretical results.

Effect of home-based Kegel exercises on quality of life in women with stress and mixed urinary incontinence.

The aim of this study was to assess the effects of home-based Kegel exercises in women with stress and mixed urinary incontinence. A total of 90 women with urodynamically proven urinary stress (SUI) and mixed (MUI) incontinence awaiting anti-incontinence surgery were recruited in the urogynaecology clinic of Ankara Zekai Tahir Burak Women's Health Research and Education Hospital. Of these, 18 women were excluded due to low compliance and the remaining 72 were divided into two groups according to urodynamic diagnosis (SUI group, n = 38; MUI group, n = 34). Age, BMI, menopausal status and medical history of the women were recorded. The women took Kegel exercise, consisting of 10 sets of contractions/day; each set included 10 repetitions, for at least 8 weeks. To evaluate the pelvic floor muscle strength, the modified Oxford grading system was used before and after Kegel exercising. The Incontinence Impact Questionnaire (IIQ-7); Urogenital Distress Inventory (UDI-6) and the Patient Global Impression of Improvement (PGI-I) questions were compared before and after 8 weeks of Kegel exercising. The age, BMI, gravidity, menopausal status, macrosomic fetus history, hypertension and asthma were similar between the groups. There were statistically significant lower scores in both IIQ-7 and UDI-6 before and after Kegel exercises within each group (p < 0.001). The mean change of the IIQ-7 and UDI-6 score was statistically significantly higher in the SUI group than in the MUI group (p = 0.023 and p = 0.003, respectively). Results of the Oxford scale were also statistically significantly higher after Kegel exercises within each group (p = < 0.001). In total, 68.4% of the women in the SUI group and 41.2% of the women in the MUI group reported improvements which were statistically significant (p = 0.02). We conclude that home-based Kegel exercises, with no supervision, have been found effective in women with SUI and MUI. The improvement was more prominent in women with SUI.

Tension-free vaginal tape procedure for treatment of female stress urinary incontinence with intrinsic sphincter deficiency: short-term outcomes.

AIM: The aim of this paper was to evaluate the short-term outcomes of tension-free vaginal tape procedures in female stress urinary incontinence with intrinsic sphincter deficiency, and to identify possible effective factors for cure rate of this treatment. METHODS: Forty-nine women who underwent tension-free vaginal tape procedures due to urodynamically proven stress urinary incontinence with intrinsic sphincter deficiency were included in this study. All women were followed up at 6 months postoperatively. Outcomes were evaluated by cough/Valsalva stress test, incontinence-related quality of life forms (Incontinence Impact Questionnaire and Urogenital Distress Inventory). Procedure-related complications were noted. Multivariable regression was used to identify the odds for poor surgical outcome. RESULTS: In 49 patients, postoperative quality of life scores decreased significantly as compared with preoperative scores. Forty-one (83.7%) patients were found as cured, while 3 (6.1%) women were in failure. The complaints decreased in 5 (10.2%) women, postoperativeley. Low maximal urethral clossure pressure measured by urodynamics was found as a significant effective factor for poor surgical outcome. CONCLUSION: Tension-free vaginal tape is an effective minimal invasive surgical procedure with low complication incidence for female stress urinary incontinence with intrinsic sphincter deficiency in short term. However, intrinsic sphincter deficiency patients with low maximal urethral closure pressure should be informed preoperatively about possible poor outcomes.

Long-term surgical outcomes of vaginal sacrospinous ligament fixation in women with pelvic organ prolapse.

AIM: Few studies have demonstrated the effects of the sacrospinous ligament fixation (SLF) in the long-term period. Aim of the study was to evaluate the short- and long-term outcomes of SLF. METHODS: This was a longitudinal cohort study. Fifty-one patients who had undergone SLF were evaluated postoperatively at 1 and 7 years. The characteristics of patients, intra- and postoperative complications, length of hospital stay period, short and long-term outcomes of the surgeries were recorded. Objective success was evaluated by vaginal and POP-Q examination at 1 and 7 years postoperatively. RESULTS: Out of 51 patients, 46 (90.19%) patients underwent vaginal hysterectomy, 36 (70.58%) patients anterior colporrhaphy, 31 (60.78%) patients posterior colporrhaphy and 11 (21.56%) patients transobturator tape concomitantly with SLF. The differences of Aa, Ba, Ap, Bp and total vaginal length (TVL) scores between preoperative, postoperative at 1 and 7 years were statistically significant (P<0.001). Cystocele rate, at 1 year and at 7 years, were 8 out of 51 (15.68%) and 9 out of 35 (25.71%), respectively. The objective cure rate for the apical vaginal vault prolapse at 1 year and at 7 years were 96% (49/51) and 94.28% (33 /35), respectively. CONCLUSION: SLF is an appropriate and safe treatment procedure in patients with vaginal vault prolapse in the seven years of follow-up period.

Risk factors for mesh erosion after vaginal sling procedures for urinary incontinence.

OBJECTIVES: To identify risk factors for mesh erosion in women undergoing vaginal sling procedures for urinary incontinence with synthetic meshes, and to estimate the incidence of mesh erosion after these procedures. STUDY DESIGN: Retrospective study of women who underwent vaginal sling procedures between January 2007 and January 2013. In total, 1439 consecutive women with stress urinary incontinence were investigated. Five hundred and sixty-six (39.3%) women underwent a tension-free vaginal tape (TVT) procedure and 873 (60.7%) women underwent a transobturator tape (TOT) procedure. All procedures were performed using meshes of the same type and size. Women who experienced mesh erosion were defined as cases, and women who were not re-admitted or identified with mesh erosion during the study period were defined as controls. Demographics, operative techniques and outcomes were taken from medical records. Multivariate regression identified the odds of mesh erosion. RESULTS: Sixty-one of 1439 (4.2%) women were found to have mesh erosion in the postoperative period: 41 (67.2%) after TOT procedures and 20 (32.8%) after TVT procedures. The rate of mesh erosion was 4.7% in the TOT group and 3.5% in the TVT group, and this difference was significant (p<0.05). Mean age, body mass index, current smoking, menopausal status and diabetes mellitus were significantly higher among cases than controls. Univariate analysis showed that length of vaginal incision >2 cm, recurrent vaginal incision for postoperative complications, and previous pelvic organ prolapse or incontinence surgery were significant risk factors for erosion. Multivariate analysis demonstrated that older age, diabetes mellitus, current smoking, length of vaginal incision >2 cm, recurrent vaginal incision for postoperative complications, and previous pelvic organ prolapse or incontinence surgery were independent risk factors for mesh erosion. CONCLUSIONS: Mesh erosion following vaginal sling procedures is a frustrating complication with relatively low incidence. It was found to occur more often after TOT procedures than TVT procedures. Older age, diabetes mellitus, smoking, length of vaginal incision >2 cm, recurrent vaginal incision for postoperative complications, and previous vaginal surgery for pelvic organ prolapse or incontinence increased the risk of mesh erosion. Identification of risk factors may enable surgeons to prevent or minimize this complication.

Larynx osteosarcoma: case report.

We present the case of a laryngeal osteosarcoma in a 69-year-old man, which generated many diagnostic and treatment difficulties. The patient was admitted to the hospital because of persisting hoarseness and a laryngeal tumor was seen on laryngoscopy. Total laryngectomy was performed and the pathological examination of the resected material showed osteosarcoma of the larynx. Postoperative radiotherapy was planned but the patient declined any treatment. He was readmitted to the hospital 5 months later with a neck tumor and enlarged lymph nodes on the right side of the neck. Chemotherapy started and during treatment metastatic lymph nodes on the left side of the neck and pulmonary metastases were detected.

Maternal serum levels of dehydroepiandrosterone sulfate and labor induction in postterm pregnancies.

OBJECTIVES: To study the relationship between maternal endogenous dehydroepiandrosterone sulfate (DHEAS) levels, success of labor induction, and Bishop scores in postterm pregnancies. METHODS: There were 65 postterm pregnancies. Group 1 consisted of women spontaneously in the active phase of labor, and group 2 of women with hypotonic uterine contractions whose labor was inducted by oxytocin. Levels of DHEAS were studied from venous blood samples. Demographic data and Bishop scores were recorded. RESULTS: The demographic characteristics of patients were similar, but DHEAS levels were higher in group 1 than in group 2 (P<0.001). Linear regression analysis showed a significant relationship between DHEAS and Bishop scores. DHEAS levels in women delivered vaginally were significantly higher than in women delivered by cesarean section. From the receiver operating characteristics (ROC) curve, DHEAS levels might determine the mode of delivery and success of labor induction; however, Bishop scores do not. CONCLUSIONS: DHEAS levels may be an important factor influencing the efficiency of labor and the success of labor induction in postterm pregnancies.

A randomized trial of amifostine as radioprotector in the radiotherapy of head and neck cancer.

PURPOSE: Radiotherapy (RT) for head and neck cancer typically involves the major salivary glands bilaterally and can cause acute and chronic xerostomia and mucositis. The degree of xerostomia has been reported to depend on the radiation dose and the salivary gland volume irradiated. In this study, we evaluated the efficacy of the radioprotector amifostine to improve xerostomia and mucositis in head and neck cancer patients who received RT. PATIENTS AND METHODS: A total of 53 patients with head and neck cancer entered this prospective randomized study. Patients were randomly assigned to undergo RT or RT plus short intravenous (i.v.) infusion of amifostine 210 mg/m(2) before each RT fraction. RESULTS: No statistically significant difference was seen between the 2 arms in terms of mucositis. Acute xerostomia occurred in 31 (93.9%) patients in the amifostine arm and all of the patients in the RT-alone arm (p <0.05). Grade 3 acute xerostomia occurred in 13 (39.3%) patients in the amifostine arm, and in 9 (45%) patients in the RT-alone arm (p=0.04). Late xerostomia occurred in 19 (57.5%) patients in the amifostine arm, and in 14 (70%) patients in RT-alone arm (p=0.03). CONCLUSION: The administration of amifostine in head and neck cancer patients receiving RT improved significantly acute and late xerostomia, while did not offer protection in the prevention of mucositis. Further prospective studies are needed in order to better define the role of this agent.

Prognostic importance of the nucleolar organizer region score in ovarian epithelial tumors.

OBJECTIVE: The score of the silver-stained nucleolar organizer region (AgNOR) is frequently found to be high in malignant tumors. We studied AgNOR in ovarian epithelial tumors diagnosed in our hospital between 1993 and 1998. MATERIALS AND METHOD: In our study 67 ovarian epithelial tumors (18 cystadenoma, 16 borderline type, 34 cystadenocarcinoma) were stained using the method previously described by Crocker. One-way ANOVA and logistic regression tests were used to find the statistical relationship between grade, recurrence, mortality rates and AgNOR scores in tumors (p values of <0.05 were considered statistically significant). RESULTS: The mean AgNOR scores of 28 mucinous and 39 serous ovary tumors were calculated. The lowest AgNOR score of 1.33 was found in cystadenomas and the highest AgNOR score of 4.92 was found in serous and mucinous cystadenocarcinomas. In addition the relationship between mortality rate, recurrence and AgNOR score in carcinomas were studied. CONCLUSION: AgNOR scores in carcinomas were found to be higher than adenomas, and the highest AgNOR score was found in grade-III carcinomas. This shows that the AgNOR score can be used as a prognostic index in malignancies.