The Safe Surgical Margin for the Testis Sparing Surgery in Testicular Cancer.

BACKGROUND: Testis sparing surgery (TSS) has an important role in preserving the functional capacity of testicular cancer (TC). Germ cell neoplasia in situ (GCNIS) lesions in the remaining testis have a significant risk for local recurrence. AIM: We aimed to evaluate the presence of satellite GCNIS lesions around the primary tumor and to measure the distance of the furthest GCNIS lesion to the primary tumor. SUBJECT AND METHODS: The radical orchiectomy specimens of patients (n = 37) with a tumor size of ≤3 cm were reevaluated by the same pathologist. The satellite GCNIS lesions located around the primary tumor were detected, and the furthest GCNIS lesion distance to the primary tumor was measured under light microscopy. RESULTS: The mean tumor size was 1,9 ± 0,6 cm. The mean furthest GCNIS distance to the primary tumor was 5,08 ± 2,77 mm. A total of 19 (51,4%) patients had the furthest GCNIS lesions <5 mm, and 28 (75,6%) patients had the furthest GCNIS lesions <7 mm away from the primary lesion. CONCLUSIONS: Leaving a 5 mm safety margin during TSS would lead to excise the satellite GCNIS lesions in half of the patients. Increasing the safety margin to 7 mm would lead to excise the satellite GCNIS lesions at 75% of the patients.

The effect of epidural analgesia added to general anesthesia on systemic immune-inflammation index in radical prostatectomy surgery: A retrospective study.

Background: Systemic immune-inflammation index (SII) is increasingly valued for its simplicity and predictability. Anesthesia/analgesia technique may affect cancer survey. Aims: The primary aim of this study is to offer a comparative evaluation for the effect of different anesthesia/analgesia techniques employed in radical prostatectomy surgery on SII, a new inflammatory index. Patients and Methods: Eighty-one patients who underwent radical prostatectomy between January 1, 2012, and December 31, 2020, were included in the study. We recorded oncological demographic data of Group G (n = 45) and Group GE (n = 36), preoperative and postoperative (within the first 4 hrs and 24th hr) SII values, perioperative surgical bleeding, and amount of blood transfusion. Results: Despite the lack of significant difference in the SII values between the groups, both the peak SII level and the SII change in the postoperative period became higher in Group G than in Group GE. In addition, the amount of surgical bleeding and blood transfusion was observed to be significantly lower in Group GE (P < 0.001, P = 0.092, respectively). Conclusions: GE in radical prostatectomy surgery in terms of SII, the SII change in the postoperative period was more pronounced in Group G. However, a significant difference was noted in surgical bleeding in Group GE. We can conclude that comparing the SII values of different anesthesia techniques with prospective studies might thus create a difference in survival and metastasis at the micro-level.

Diffusion-weighted imaging measurements of central smell regions in COVID-19 patients: insular gyrus, corpus amygdala, and thalamus.

OBJECTIVE: The aim of this study was to investigate central smell centers with cranial magnetic resonance imaging (MRI) diffusion-weighted imaging (DWI) in COVID-19. PATIENTS AND METHODS: This retrospective study evaluated cranial MRI images of 54 adults. The experimental group (Group 1), consisting of 27 patients with positive COVID-19 real-time polymerase chain reaction (RT-PCR) assays, was compared to the control group (Group 2), comprising 27  healthy controls without COVID-19. The apparent diffusion coefficient (ADC) values were measured in the corpus amygdala, thalamus, and insular gyrus in both groups. RESULTS: Thalamus ADC values of the COVID-19 group were significantly lower compared to the control group bilaterally. However, no differences were found in the insular gyrus and corpus amygdala ADC values between the two groups. Positive correlations were observed between the insular gyrus and corpus amygdala ADC values and the thalamus ADC values. Insular gyrus ADC values (right) were higher in females. Left insular gyrus and corpus amygdala ADC values were higher in COVID-19 patients with smell loss. Right insular gyrus and left corpus amygdala ADC values were lower in COVID-19 patients with lymphopenia. CONCLUSIONS: Diffusion restriction in olfactory areas can be considered an obvious indicator that the COVID-19 virus affects and damages the immune system at the neuronal level. Given the urgency and lethality of the current pandemic, acute onset odor loss should be considered a high suspicion-adhesive index for patients with SARS-CoV-2 infection. Therefore, the sense of smell should be considered and evaluated simultaneously with other neurological symptoms. DWI should be widely used as an early imaging method for central nervous system (CNS) infections, especially in relation to COVID-19.

Preoperative and postoperative ultrasound elastography findings of the sciatic nerve in patients with unilateral lumbar foraminal disc herniation: a pre-test and post-test design.

OBJECTIVE: The aim of this study was to compare preoperative and postoperative findings of the sciatic nerve by using B-mode ultrasound, strain elastography (SE), and shear wave elastography (SWE) in patients with unilateral lumbar foraminal disc herniation. PATIENTS AND METHODS: In this prospective study group, patients with complaints of foraminal disc herniation due to one level (L4-5 or L5-S1) were included. Preoperative and postoperative (one month after surgery) B-mode ultrasound, SE, and SWE findings of the affected sciatic nerve in patients who underwent unilateral spinal decompression surgery were compared. Evaluations were performed on the axial plane from the gluteal region using a convex probe of 5-9L MHz. The reference method used to assess nerve root compression was 1.5-T Magnetic Resonance Imaging (MRI). RESULTS: A total of 20 patients (9 males, 11 females) with a mean age of 46.2±13.1 years were included. The cross-sectional area (CSA), diameter, SWE values of the sciatic nerve were significantly higher in the affected side compared to those of the non-affected side (all for p<0.05). Blue and blue-green were the most common color codes in the affected side while green and green-yellow-red were the most common color codes in the non-affected side. The CSA, diameter, and SWE values of the sciatic nerve decreased after the surgery in the affected side (all for p<0.05), nonetheless. those did not differ in the non-affected side (all for p>0.05). CONCLUSIONS: Lumbar decompression surgery decreases the sciatic nerve diameter, CSA, and stiffness of the sciatic nerve.

Immediate post-operative intravesical instillation of a single dose chemotherapy is not superior to continuous saline irrigation.

INTRODUCTION AND OBJECTIVES: To evaluate whether there is any difference between immediate postoperative instillation of intravesical chemotherapy (IPOIC) and continuous saline bladder irrigation (CSBI) in terms of bladder cancer (BC) recurrence in patients with primary low- or intermediate-risk non-muscle-invasive BC (NMIBC). MATERIALS AND METHODS: Medical records of 1482 patients who underwent transurethral resection of bladder tumor between March 1994 and August 2020 were reviewed retrospectively. Patients were divided into two groups according to IPOIC and/or CSBI administration status [Group-1 = CSBI alone; Group-2 = CSBI following IPOIC]. Low- and intermediate-risk NMIBC patients were also divided into subgroups according to IPOIC and/or CSBI administration status. RESULTS: A total of 594 patients with primary NMIBC were included. Of the patients, 86 (14.5%) were female and 508 (85.5%) were male with a median age of 69 (60-78) years. The frequency of patients in Group-1 and Group-2 were 361 (60.8%) and 233 (39.2%), respectively. Recurrent disease was observed in 213 (35.9%) patients. There was no difference between the groups when they were compared for recurrent disease frequency, median time to first recurrence and frequency of recurrence within first 12 months (P = .064, P = .671, and P = .145, respectively). Disease recurrence rates in low-risk NMIBC patients was lower when they were treated with "CSBI following IPOIC" when compared to "CSBI alone" (P = .042). However, no difference was observed in low-risk NMIBC subgroups when they were compared for pathological features of recurrent tumors such as number, size, grade, stage, and presence of carcinoma in situ (P > .05, for each). CONCLUSIONS: "CSBI following IPOIC" combination was not superior to "CSBI alone" for preventing adverse pathological outcomes in recurrent low- and intermediate-risk NMIBC.

Low-Cost RoHS Compliant Solution Processed Photovoltaics Enabled by Ambient Condition Synthesis of AgBiS2 Nanocrystals.

Two major challenges exist before colloidal nanocrystal solar cells can take their place in the market: So far, these devices are based on Pb/Cd-containing nanocrystals, and second, the synthesis of these nanocrystals takes place in an inert atmosphere at elevated temperatures due to the use of air-sensitive chemicals. In this report, a room-temperature, ambient-air synthesis for nontoxic AgBiS2 nanocrystals is presented. As this method utilizes stable precursors, the need for the use of a protective environment is eliminated, enabling the large-scale production of AgBiS2 nanocrystals. The production cost of AgBiS2 NCs at room temperature and under ambient conditions reduces by ∼60% compared to prior reports based on hot injection, and the solar cells made of these nanocrystals yield a promising power conversion efficiency (PCE) of 5.5%, the highest reported to date for a colloidal nanocrystal material free of Pb or Cd synthesized at room temperature and under ambient conditions.

Cytogenetic abnormalities in 179 cases with male infertility in Western Region of Turkey: report and review.

PURPOSE: In this study we aimed to evaluate the postnatally screened karyotype results in couples who were referred because of primary infertility between 2000 and 2006 in Izmir. METHODS: The records of a total of 179 cases were evaluated retrospectively. RESULTS: A total of 21 cases (11.74%) showed chromosomal alteration. Thirteen (7.26%) were 47,XXY; three (1.68%) were pericentric inversion of chromosome 9; one (0.56%) 46,XY/45,XO; one (0.56%) 46,XY/47,XXY/48,XXXY; one (0.56%) 46,XY,t(X;1); one (0.56%) 46,XY/46,XY,del(Y)(q11.2) and one (0.56%) 46,XX. CONCLUSIONS: The rate of gonosomal chromosomal abnormalities was nearly three times higher in our region than the rate in the literature. Chromosomal analysis is strongly suggested particularly in those who suffer fertility problems.

Successful Treatment of Renal Infiltration Complicated by Atypical Hemolytic Uremic Syndrome in a Leukemic Child.

Renal infiltration in children with acute leukemia has been reported previously; however, it has rarely been described in association with atypical hemolytic uremic syndrome (aHUS). We present a case of 9-year-old boy who developed life-threatening aHUS in the 1st week of Burkitt leukemia/lymphoma diagnosis with renal infiltration. Complete resolution of aHUS was achieved after therapeutic plasma exchange. This is an uncommon complication of Burkitt leukemia/lymphoma in a pediatric case.

Actinomyces infection in female genital tract.

OBJECTIVES: To analyze clinical and laboratory characteristics of patients with pelvic actinomyces. STUDY DESIGN: We studied five patients with pelvic actinomyces who were admitted between January 1, 2002 and December 31, 2002. The initial complaints, diagnostic methods, therapeutic alternatives and results of the therapies were examined. RESULTS: The ages of the cases varied between 32 and 52 years old. All five patients had been using an intrauterine device. Three cases had hydronephrosis due to infection. Two patients were diagnosed postoperatively while the other three cases were diagnosed with cervical smear and endometrial biopsy; penicillin G was administered to all. The patients are still under surveillance, and without any problems. CONCLUSION: In patients with an intrauterine device, actinomyces should be remembered in differential diagnosis of pelvic infections. Preoperative diagnosis is of the utmost importance in order to prevent morbidity of this infiltrative infection. Long-term penicillin therapy proved to be successful. Complicated or resistant cases to medical therapy should be candidates for surgical therapy.

[A case of diphtheria resulting in death]. / Olümle sonuçlanmis bir difteri vakasi.

A 10 years old girl admitted to the hospital on 7.5.1983. She was sent from Etimesgut Hospital with the preliminary diagnosis of diphtheria bronchopneumonia, and glomerulonephritis. Cultures taken from the throat and nose of the patient yielded toxigenic diphtheria bacilli. Inspite of antitoxin and antibiotic treatment and a tracheostomy the patient died two days later. Diphtheritic membranes occluding larynx and trachea were found at the autopsy. In six out of the nine of the family members the throat cultures were found to be positive for toxigenic C. diphtheriae. The family was visited by a woman who had a bloody nasal discharge and ulcers around her nostrils. Close contacts, including the neighbours and the classmates of the children were checked for diphtheria bacilli and all were found to be negative.

A retained surgical sponge (gossypiboma) mimicking a paraspinal abscess.

Gossypiboma (textiloma, gauzoma, muslinoma) is a rare iatrogenic mass caused by the retention of gauze fibres during surgery. This intraoperative complication has rarely been reported for an intraspinal or paraspinal location. Here, we present a patient in whom a retained surgical sponge between the paraspinal muscles was encountered 3 years after lumbar surgery, and discuss the radiological and pathological appearance and differential diagnosis.

Recovery of ovarian function after detorsion: Doppler findings.

Adnexal torsion is one of the most common surgical gynecologic emergencies and needs prompt diagnosis. It usually occurs during reproductive age, which makes the early diagnosis all the more important in attempting to preserve ovarian function. If adnexal torsion is suspected from the clinical findings, Doppler ultrasound can be the best tool in diagnosis. It can also be helpful in assessing recovery of the ovary after surgical treatment. We present a case of adnexal torsion successfully diagnosed with power Doppler ultrasound and managed by detorsion. The postoperative gray-scale and power Doppler examination confirmed the recovery of ovarian follicles and stoma.