Perioperative Outcomes of Open Extra-peritoneal Versus Laparoscopic Radical Cystoprostatectomy: A single Center Comparative Study.

PURPOSE: To compare 90-day  perioperative complications and pathological outcomes between laparoscopic radical cystectomy (LRC) and extraperitoneal radical cystectomy (EORC) approaches. MATERIALS AND METHODS: All operations were performed in a single high-volume tertiary referee center by the same surgical team.Males ≥ 18 years with pre-cystectomy clinical T1-T3 disease and having undergone an ileal conduit were included. Exclusion criteria included patients with inflammatory bowel disease, previous pelvic and/or abdominal irradiation, neo-adjuvant chemotherapy, and/or clinical T4 disease. Perioperative outcomes such as operative time, estimated blood loss, transfusion rate, hospital stay, and 90-day complications were evaluated. The recovery duration of regular bowel activity, mean stool passage,and ileus rates were recorded. RESULTS: A total of 221 patients met the inclusion criteria(81 LRC and 130 EORC). Demographics and preoperative parameters were comparable. Intraoperative estimated blood lossfavored LRC by a median of 450 mL (200-900) P=.021) vs. a median of 700 mL (300-2900) for EORC. The transfusion rate did not differ between the two groups; %14.8 (N=12) for the LRC and %20.8 (N=27) for EORC (P=.37). The median hospital stay was 9 (4-49) days for EORC and 8 (4-29) days for LRC (P=.011). The need for analgesics to control pain through an epidural catheter was higher for EORC (P=.042). There was no difference in overall complication rates (P=.47). CONCLUSION:   Although LRC appears to have a slight advantage over EORC, both techniques yield satisfactory results in regard to ileus rates and 90-day perioperative complications.

Comparative Synthesis of Silver Nanoparticles: Evaluation of Chemical Reduction Procedures, AFM and DLS Size Analysis.

The size of silver nanoparticles plays a crucial role in their ultimate application in the medical and industrial fields, as their efficacy is enhanced by decreasing dimensions. This study presents two chemical synthesis procedures for obtaining silver particles and compares the results to a commercially available Ag-based product. The first procedure involves laboratory-based chemical reduction using D-glucose (C6H12O6) and NaOH as reducing agents, while the second approach utilizes trisodium citrate dehydrate (C6H5Na3O7·2H2O, TSC). The Ag nanoparticle suspensions were examined using FT-IR and UV-VIS spectroscopy, which indicated the formation of Ag particles. The dimensional properties were investigated using Atomic Force Microscopy (AFM) and confirmed by Dynamic Light Scattering (DLS). The results showed particle size from microparticles to nanoparticles, with a particle size of approximately 60 nm observed for the laboratory-based TSC synthesis approach.

Tradition or Innovation in Sternal Dehiscence Repair: Robicsek Versus Titanium Plate.

Objectives: Sternotomy is still the most commonly used incision in cardiac surgery. Sternal complications are seen at a rate of 0.5% to 6.1%. Sternal dehiscence increases morbidity and mortality after cardiac surgery. To prevent dehiscence, the search for alternative sternum closure methods continues today. Titanium plates produced for this purpose can also be used in patients who are re-operated due to sternal dehiscence. In our study, we investigated the effects of titanium plate repair and robicsek repair on the results in patients who were reoperated due to sternal dehiscence. Methods: Thirty-four patients who underwent reoperation due to sternal detachment in our hospital between September 2013 and December 2020 and had no signs of infection in the pre-operative period were analyzed retrospectively. The patients were divided into three groups according to the surgical method applied. These groups are as follows: Group 1: The cases in which the robicsek method was used, Group 2: the cases in which the titanium plate method was used, and Group 3: The cases where the robicsek + titanium plate methods were used together. Results: There was no significant difference between the groups in terms of basic demographic characteristics and risk factors, leading to sternal dehiscence. There was no significant difference between the groups in terms of mortality and length of hospital stay. Considering the infection rates in the post-operative period, 20% and 21.4% post-operative infections were detected in Group 1 and Group 3, respectively, while 70% post-operative infection was observed in Group 2, which was repaired only with the Robicsek technique (p<0.05). Conclusion: As supported by most studies in the literature, titanium plate application provides a superior sternum stabilization compared to the classical wire cerclage method. When evaluated in terms of cost-effectiveness, titanium plate method can be applied in high-risk patients in terms of sternal dehiscence.

Solid Renal Mass in a Transplanted Allograft Kidney: Mucinous Tubular and Spindle Cell Renal Cell Carcinoma.

Renal transplantation is the main treatment for end-stage kidney disease. Transplantation reduces the mortality rate and increases life quality in this population but cancer in allograft kidney is a major problem. Here, we report a 39-year male who had renal transplantation 10 years ago. On routine follow-up, radiologic imaging revealed a 32 mm mass in the allograft kidney. After partial nephrectomy, histopathologic examination revealed mucinous tubular and spindle cell variant of renal cell carcinoma(MTSCC). To our best knowledge, this is the first case in the literature that underwent partial nephrectomy in the transplanted kidney and was diagnosed with MTSCC. Key Words: Renal mass, Mucinous tubular and spindle cell tumor, Kidney transplantation.

Impact of OCT scan-patterns in identifying morphological features of lamellar macular holes and macular pseudoholes.

AIM: To evaluate the impact of the optical coherence tomography (OCT) scan patterns on the detection of the features associated with lamellar macular hole (LMH) and macular pseudohole (MPH). METHODS: This is a retrospective analysis of 100 consecutive eyes with LMH (n=41) and MPH (n=59) having at least three of the following OCT features, which include mandatory criteria for the diagnosis of LMH and MPH: Epiretinal membrane, epiretinal proliferation, verticalization, intraretinal cystoid spaces, foveoschisis, irregular foveal contour, foveal cavity with undermined edges, and ellipsoid line disruption. Primary outcome measurement was the detection frequency of the features in three different OCT scan patterns: 1) volume scan; 2) six radial scans (R6); and 3) vertical and horizontal radial scans (R2). RESULTS: Of the total eight features, the maximal detection frequency was found as 4.45±1.45, 4.35±1.47, and 3.70±1.59, by the volume, R6 and R2, respectively. R2 was inferior to the other patterns in detection of the total features (P<0.001), whereas R6 and volume patterns were found comparable (P=0.312). CONCLUSION: The physician should be aware that the selection of the OCT-scan pattern may influence the detection of mandatory morphological criteria for the diagnosis of LMH and MPH.

The effects of environmental tax on Ecological Footprint and Carbon dioxide emissions: a nonlinear cointegration analysis on Turkey.

This article presents a nonlinear analysis in Turkey on the effect of an environmental tax (ET) on the ecological footprint (EFP) and carbon dioxide (CO2) emissions. In the literature, most of the studies examining the effects of environmental taxes (ETs) on environmental degradation (ED) have used linear methods. The number of studies examining this relationship with nonlinear methods is few. However, there is no study examining the long-run effects of ETs on the EFP, which is one of the most important indicators of ED, using nonlinear analysis. This study contributes to the literature by investigating the long-run effects of ETs on EFP and CO2 emissions in Turkey by nonlinear analysis. Therefore, the model consisting of annual data for the period 1994-2019 was estimated by Dufrénot et al. (2006) nonlinear cointegration test. According to the estimation results obtained, ETs do not have any long-run effects on EFP and CO2 emissions. Accordingly, it can be concluded that ETs in Turkey do not affect preventing ED.

Machine learning based prediction of lattice thermal conductivity for half-Heusler compounds using atomic information.

Half-Heusler compound has drawn attention in a variety of fields as a candidate material for thermoelectric energy conversion and spintronics technology. When the half-Heusler compound is incorporated into the device, the control of high lattice thermal conductivity owing to high crystal symmetry is a challenge for the thermal manager of the device. The calculation for the prediction of lattice thermal conductivity is an important physical parameter for controlling the thermal management of the device. We examined whether lattice thermal conductivity prediction by machine learning was possible on the basis of only the atomic information of constituent elements for thermal conductivity calculated by the density functional theory in various half-Heusler compounds. Consequently, we constructed a machine learning model, which can predict the lattice thermal conductivity with high accuracy from the information of only atomic radius and atomic mass of each site in the half-Heusler type crystal structure. Applying our results, the lattice thermal conductivity for an unknown half-Heusler compound can be immediately predicted. In the future, low-cost and short-time development of new functional materials can be realized, leading to breakthroughs in the search of novel functional materials.

Adenocarcinoma in Orthotopic Neobladder 19 Years After Radical Cystoprostatectomy.

Radical cystectomy and orthotopic neobladder are the most preferred surgical approaches for the treatment of invasive bladder cancer. Secondary tumour of ileum on neobladder is very rare. We report a 67-year man complaining of hematuria with the history of ileal neobladder for 19 years.  An ileal adenocarcinoma of neobladder was detected with transurethral resection. He also had a non-functioning right kidney. A neobladderectomy. with right nephroureterectomy and ureterocutaneostomy was performed. An adenocarcinoma invading subserosal layer was reported. At six months postoperatively, patient was free of recurrence and progression. Seconder tumour of neobladder is a very rare condition. Early diagnosis and excision of neobladder may provide cure. Key Words: Bladder cancer, Urinary diversion, Cystectomy, Ileum, Adenocarcinoma.

Study on crystallographic and electronic structure of micrometre-scale ZnO and ZnO:B rods via X-ray absorption fine-structure spectroscopy.

X-ray absorption near-edge structure (XANES) and extended X-ray absorption fine-structure (EXAFS) spectra were recorded to investigate the electronic structure and local crystal structure of ZnO and ZnO:B powders produced via hydrothermal synthesis. ZnO and ZnO:B grow as micrometre-scale rods with hexagonal shape, as confirmed by scanning electron microscopy micrographs. The number of broken ZnO:B rods increases with increasing B concentration, as observed in the images, due to B atoms locating in between the Zn and O atoms which weakens and/or breaks the Zn-O bonds. However, no disorder within the crystallographic structure of ZnO upon B doping is observed from X-ray diffraction results, which were supported by EXAFS results. To determine the atomic locations of boron atoms in the crystal structure and their influence on the zinc atoms, EXAFS data were fitted with calculated spectra using the crystal structure parameters obtained from the crystallographic analysis of the samples. EXAFS data fitting and complementary k-weight analysis revealed the positions of the B atoms - their positions were determined to be in between the Zn and O atoms.

Reattachment of Rhegmatogenous Retinal Detachment via Fibrin Tissue Adhesive.

PURPOSE: To manage reattachment of rhegmatogenous retinal detachment using tissue adhesive (fibrin glue) in five patients. METHODS: Five eyes of five patients with rhegmatogenous retinal detachment were treated with 23-gauge pars plana vitrectomy and the application of fibrin glue (Tisseel Lyo) into the break under air without laser photocoagulation or cryopexy. RESULTS: The median age of patients was 64 (range, 46-82) years, and the median duration of symptoms was 15 (range, 7-60) days. Three eyes had inferior and two had superior rhegmatogenous retinal detachments. Successful retinal reattachment was achieved in all cases and maintained during the following 10 to 24 months. The median best-corrected visual acuity improved from 2 / 100 preoperatively to a Snellen visual acuity of 20 / 50 by 6 months postoperatively. No postoperative complications were detected during the follow-up period. CONCLUSIONS: Excellent adhesive effects of fibrin glue with respect to sealing retinal tears with no side effects were seen in our study. With further prospective studies, this technique could be an alternative method to conventional retinopexy.

Reattachment of Rhegmatogenous Retinal Detachment via Fibrin Tissue Adhesive

Purpose@#To manage reattachment of rhegmatogenous retinal detachment using tissue adhesive (fibrin glue) in five patients. @*Methods@#Five eyes of five patients with rhegmatogenous retinal detachment were treated with 23-gauge pars plana vitrectomy and the application of fibrin glue (Tisseel Lyo) into the break under air without laser photocoagulation or cryopexy. @*Results@#The median age of patients was 64 (range, 46–82) years, and the median duration of symptoms was 15 (range, 7–60) days. Three eyes had inferior and two had superior rhegmatogenous retinal detachments. Successful retinal reattachment was achieved in all cases and maintained during the followıng 10 to 24 months. The median best-corrected visual acuity improved from 2 / 100 preoperatively to a Snellen visual acuity of 20 / 50 by 6 months postoperatively. No postoperative complications were detected during the follow-up period. @*Conclusions@#Excellent adhesive effects of fibrin glue with respect to sealing retinal tears with no side effects were seen in our study. With further prospective studies, this technique could be an alternative method to conventional retinopexy.

Reattachment of Rhegmatogenous Retinal Detachment via Fibrin Tissue Adhesive

Purpose@#To manage reattachment of rhegmatogenous retinal detachment using tissue adhesive (fibrin glue) in five patients. @*Methods@#Five eyes of five patients with rhegmatogenous retinal detachment were treated with 23-gauge pars plana vitrectomy and the application of fibrin glue (Tisseel Lyo) into the break under air without laser photocoagulation or cryopexy. @*Results@#The median age of patients was 64 (range, 46–82) years, and the median duration of symptoms was 15 (range, 7–60) days. Three eyes had inferior and two had superior rhegmatogenous retinal detachments. Successful retinal reattachment was achieved in all cases and maintained during the followıng 10 to 24 months. The median best-corrected visual acuity improved from 2 / 100 preoperatively to a Snellen visual acuity of 20 / 50 by 6 months postoperatively. No postoperative complications were detected during the follow-up period. @*Conclusions@#Excellent adhesive effects of fibrin glue with respect to sealing retinal tears with no side effects were seen in our study. With further prospective studies, this technique could be an alternative method to conventional retinopexy.

Probing local distortion around structural defects in half-Heusler thermoelectric NiZrSn alloy.

The half-Heusler NiZrSn (NZS) alloy is particularly interesting owing to its excellent thermoelectric properties, mechanical strength, and oxidation resistance. However, the experimentally investigated thermal conductivity of half-Heusler NZS alloys shows discrepancies when compared to the theoretical predictions. This study investigates the crystal structure around atomic defects by comparing experimental and theoretical X-ray absorption fine structure (XAFS) spectra of the crystal structure of a half-Heusler NZS alloy. The results of both Zr and Ni K-edge XAFS spectra verified the existence of atomic defects at the vacancy sites distorting the C1b-type crystal structure. We concluded that the distortion of the atoms around the interstitial Ni disorder could be the probable reason for the observed lower thermal conductivity values compared to that predicted theoretically in half-Heusler alloys. Our study makes a significant contribution to the literature because the detailed investigation of the lattice distortion around atomic defects will pave the way to further reduce the thermal conductivity by controlling this distortion.

Youtube as an Information Source During the Coronavirus Disease (COVID-19) Pandemic: Evaluation of the Turkish and English Content.

INTRODUCTION: YouTube is an important online source of information and has two billion users globally. Its viewing numbers tend to increase exponentially in extraordinary global situations. Our aim in this study was to review and evaluate the contents of the most frequently viewed YouTube videos during the Coronavirus disease 2019 (COVID-19) pandemic.  Methods: In this qualitative study, contents of the most frequently viewed Turkish and English YouTube videos regarding the COVID-19 pandemic were examined and scored with modified DISCERN, medical information and content index (MICI), and video power index (VPI) during April 2020. RESULTS: The mean DISCERN score of Turkish videos was similar to that of English videos (2.55±1.40 and 2.43±1.25, respectively). The total MICI score tended to be higher in Turkish videos. News channels released 86.9% of all 168 videos and 65.2% of all 23 misleading videos. When the descriptive characteristics of videos were compared in terms of their content category, average view counts, view ratios, and VPIs of misleading videos were higher than those of the useful videos. Only, the likes ratio of useful videos was higher than that of the misleading videos. CONCLUSIONS: Since there is no peer-review system on YouTube, people can almost release every type of video. It is very important for the content of videos that are released through news channels to be accurate because the important messages can be spread among people in society through them. In our study, especially some Turkish videos included many different rumors and faulty statements. During the extraordinary situations such as the pandemic, the videos of official health authorities and international institutions should be more visible on YouTube.

YouTube as an information source during the Coronavirus disease (COVID-19) pandemic

BakcgroundYouTube is an important online source of information. And its viewing numbers tend to increase exponentially in extraordinary situations. Our aim in this study was to evaluate the contents of the most frequently viewed YouTube videos during the COVID-19 pandemic. MethodsIn this study, contents of the most frequently viewed Turkish and English videos regarding COVID-19 pandemics are examined and scored with modified DISCERN, MICI and VPI. ResultsThe mean DISCERN score of Turkish videos is similar to English videos (2.55{+/-}1.40 and 2.43{+/-}1.25 respectively). Total MICI score tends to be higher in Turkish videos. 86.9% of all 168 videos and 65.2% of all 23 misleading videos were released by news channels. Average view counts, view ratios, and VPIs of misleading videos are higher than the useful videos. DiscussionSince there is not a peer-review system on YouTube, it is very important for the content of videos that are released through news channels to be accurate because the important messages can be spread among people in society through them. Especially some Turkish videos included many different rumors and faulty statements. During the extraordinary situations such as the pandemics, the videos of official health authorities and international institutions should be more visible in YouTube.

Clinical impact of FDG PET/CT in alimentary tract malignancies: an updated review.

The use of 18F-fluorodeoxyglucose (FDG) positron emission tomography combined with computed tomography (PET/CT) is well established in the evaluation of alimentary tract malignancies. This review of the literature and demonstration of correlative images focuses on the current role of PET/CT in the diagnosis (including pathologic/clinical staging) and post-therapy follow-up of esophageal, gastric, and colorectal cancers. PET/CT provides utility in the management of esophageal cancer, including detection of distant disease prior to resection. In gastric cancer, PET/CT is useful in detecting solid organ metastases and in characterizing responders vs. non-responders after neoadjuvant chemotherapy, the latter of which have poorer overall survival. In patients with GIST tumors, PET/CT also determines response to imatinib therapy with greater expedience as compared to CECT. For colorectal cancer, PET/CT has proven helpful in detecting hepatic and other distant metastases, treatment response, and differentiating post-radiation changes from tumor recurrence. Our review also highlights several pitfalls in PET/CT interpretation of alimentary tract lesions.

Emergent Treatment of Acute Cholangitis and Acute Cholecystitis.

Acute pathology of the biliary tract including cholangitis and cholecystitis can lead to biliary sepsis if early decompression is not performed. This article provides an overview of the presenting signs and symptoms and role of interventional radiology in the management of patients with acute cholangitis or acute cholecystitis. It is especially important to understand the role of IR in the context of other treatment options including medical management, endoscopy, and surgery.

Paget-Schroetter syndrome in pregnancy: A case report and discussion of management options.

Paget-Schroetter syndrome is a form of primary venous thoracic outlet syndrome whereby thrombosis of the subclavian vein is instigated by repeated and vigorous overhead activity of the arm. We describe a 35-year-old pregnant white woman at 8 weeks' gestation, a competitive swimmer by profession, who was diagnosed with a left upper extremity thrombus. First rib resection through an infraclavicular approach was performed 1 week after percutaneous pharmacomechanical thrombectomy. Repeated venography demonstrated residual thrombus requiring percutaneous pharmacomechanical thrombectomy with balloon venoplasty. We present a challenging case with focus on the unique diagnostic evaluation and management of pregnant patients with this condition.

Papillon-Lefevre Syndrome: A case report / Síndrome de Papillon-Lefevre: descripción de un caso

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