Student evaluation of online learning during the COVID-19 pandemic.

The aim of the paper is to provide knowledge with regard to what extent a student's engagement, travel time to the business school, and nationality determine their perception of the value of business school education. We have analyzed what determines the evaluation of online studies, the frequency of participation in online courses, and the preferences regarding the mode of study in the future (offline vs. online). For this purpose, we conducted research in late March and early April 2020 among management students attending one business school in Warsaw. The respondents included native residents of Poland, as well as migrants from countries of the former Soviet Union. We analyze survey responses provided by 317 respondents. We used the chi-squared test, the Kruskal-Wallis test, and the Mann-Whitney test to verify relationships between variables. According to the analysis, the student engagement variable determines the current evaluation of online studying, the change in frequency of participation since the introduction of online classes, and the preferred mode of study (online or offline). The time required to commute to the business school determines only the preferred mode of study in the future, while students' nationality determines their assessment of online studying and the frequency of participation in online courses.

Image analysis discloses differences in nuclear parameters between ERG+ and ERG- prostatic carcinomas.

Prostatic carcinoma (PC) is the most frequent urologic cancer and one of the most frequent cancers in males; it is a heterogeneous disease, in terms of molecular features, morphology and prognosis. About half of cases depends on TMPRSS2-ETS translocation which leads to a production of ERG transcription factor. ERG+ and ERG- cancers seem to differ in a number of features, which could lead to an altered nuclear structure; the aim of the study was to test this hypothesis. The material consisted of total 39 PC cases, representing ERG+ and ERG-, as well as Gleason pattern 3 and 4. Filtering by color deconvolution and automatic segmentation were used, and the properly detected nuclei were manually selected. From each case fifty nuclei were obtained; then geometric features and texture parameters were assessed. The analysis of the collected data showed differences both between ERG+/ERG- and Gleason pattern 3 and 4 cases in most of the features analyzed. Our results suggest that indeed the ERG status, thus likely TMPRSS2-ETS translocation, has an impact on morphology of nuclei in PC, and their differences are evident enough to be detectable by image analysis.

3D laparoscopy as a tertiary cytoreductive (TCR) surgery in infiltrating ureter recurrent epithelial ovarian cancer - case report and a mini-review of the literature.

The paper describes a case of a 61-year-old woman with recurrent epithelial ovarian cancer infiltrating the ureter treated with 3D laparoscopy as a tertiary cytoreductive surgery (TCR). In addition, a mini-review of the literature concerning TCR is presented.

Prostate cancer with different ERG status may show different FOXP3-positive cell numbers.

Prostatic carcinoma is the most frequent cancer in males in the Western world. A significant proportion of these cancers have a recurrent translocation involving ETS family genes, which leads to the overexpression of ERG transcription factor. Prostate cancers, which bear this mutation, differ in a number of features, including tumor microenvironment. One of the components of the tumor microenvironment is FOXP3 positive lymphocytes, which may participate in breaking immunosurveillance and promoting tumor growth. The aim of the study was to analyze the relationships between ERG expression, number of FOXP3 positive cells and other features of the tumor. The study group consisted of 65 cases. Tissue microarrays composed of 2 mm tissue cores were used for immunohistological evaluation. Immunohistochemistry for ERG and FOXP3 was performed according to the routinely applied protocol. The FOXP3 positive cells were counted and the results were expressed as the number of cells per mm2. The average number of FOXP3 positive cells was 33.30/mm2 for all cases, 21.43/mm2 for the ERG negative and 42.28/mm2 for the ERG positive group (p < 0.02). There were no significant relationships between FOXP3 positive cell count and any other parameters studied. Our results suggest that the immune response may differ between ERG negative and ERG positive prostatic carcinomas.

Mast cells influence neoangiogenesis in prostatic cancer independently of ERG status.

A significant proportion of prostatic adenocarcinomas show recurrent translocation leading to ERG expression. Previously we found that ERG+ cases have higher microvessel density than negative ones. One factor influencing angiogenesis in cancer is mast cells. The aim of the present study was to evaluate the relationship between microvessels, mast cells and ERG status. Tissue microarrays prepared from 113 radical prostatectomy specimens were analyzed with immunohistochemistry for CD31, tryptase and chymase. Vascular profiles and tryptase-positive and chymase-positive cells were counted. The average number of tryptase-positive cells was 28.93/mm2 and chymase-positive cells 9.91/mm2. The average number of CD31+ vascular profiles was 352.66/mm2. The average number of tryptase-positive cells was 26.35/mm2 for ERG- cases and 32.12/mm2 for ERG+ cases. The average number of chymase-positive cells was 8.14/mm2 for ERG- cases and 12.06/mm2 for ERG+ cases. The average number of CD31+ vascular profiles was 321.34/mm2 for ERG- cases and 390.74/mm2 for ERG+ cases. The number of CD31+ vascular profiles was positively correlated with the number of tryptase-positive and chymase-positive cells (R = 0.26 and R = 0.20). In summary, we demonstrated an interrelationship between mast cells, microvascular density and ERG status in prostatic carcinoma.

Selected morphologic features influencing the prognosis of conventional renal cell carcinomas co-expressing P53 and MDM2.

Renal cell carcinoma is the most deadly of common urologic malignancies. The classical prognostic factors, including tumor type, grade and stage, as well as performance status of the patient, offer important information, but there is a need for new biomarkers which could improve the quality of prognostication. It has been proposed that tumors co-expressing P53 and MDM2 could represent a specific, more aggressive subgroup. The aim of the study was to explore this hypothesis using tissue microarrays, using two different anti-P53 antibodies. The material analyzed consisted of 470 cases of renal clear cell carcinoma. Reaction for P53 was positive in 15.1 or 13.2% of cases, depending on the antibody used. Reaction for MDM2 was positive in 37.9% of cases; 6.5 or 5.3% of cases coexpressed P53 and MDM2. Both P53-positive and double P53/MDM2-positive cases were higher grade and more likely to contain a sarcomatoid component, but their stage was similar to negative cases. PAb1081 P53-positive MDM2-positive cases were larger than the rest of the tumors (7.6 cm vs. 6.1 cm, p < 0.001). Our data support the hypothesis of prognostic significance of P53, and double P53/MDM2 positivity, yet further studies are needed to clarify the issue.

Frequency of ERG-positive prostate carcinoma in Polands.

Prostatic carcinoma (PC) is one of the most frequent cancers in men. Molecular pathogenesis of PC remains poorly understood. Translocations involving ERG were found to be the single most frequent genetic event. A strong correlation exists between this translocation and ERG positivity on immunohistochemistry. The rate of ERG positivity and its relationship with other clinicopathological parameters differ between populations and between studies; in particular, there are few data on ERG-positive PC in Eastern Europeans. In the present study, tissue microarrays of unselected PC cases were constructed and standard immunohistochemistry for ERG performed. The results were compared with the basic pathologic prognostic parameters. The group under study consisted of 113 cases; 52 (46.02%) were positive for ERG. The positive cases showed a slightly higher Gleason score (median 6 vs. 7). The majority of ERG-positive cases showed nerve bundle invasion and were also less likely to be prostate confined than negative ones. In conclusion, the frequency of ERG-positive PC in our series is similar to Western populations, and they show some unfavorable prognostic features.

[Prospective evaluation of pain associated with indwelling JJ stents following ureterorenoscopic lithotripsy]. / Prospektywna ocena dolegliwosci bólowych zwiazanych z pozostawieniem cewników JJ po ureterorenoskopii z litotrypsja.

AIM: Routine placement of JJ ure teric stents, following uncomplicated endoscopic removal of a ureteral stone, still remains debatable. Indwelling JJ stents are not without any risks. They often can cause marked discomfort, or even pain. The aim of this study was to prospectively evaluate patient's perceived pain due to renal colic and indwelling JJ stent left following ure terorenoscopic lithotripsy (URSL). MATERIAL AND METHODS: 54 patients with colicky pain due to distal ureteric stone, and who underwent uncompli cated ureterorenoscopic lithotripsy, were included in the study. Follow ing URSL, patients were randomly selected to have either JJ stent left in situ (Group I), or remain without a stent (Group II). Among all study par ticipants levels of pain prior, as well as 14 days after the procedure were evalu ated with the use of a visual analogue pain scale. RESULTS: Pain perception at the time of colic did not vary between men and women (6.30 +/- 1.33 and 6.38 +/- 1.11, respectively, p=0.293). Similarly, no differences in perceived pain were noted 14 days following URSL. Mean pain score in patients with indwelling JJ stent was 2.12 +/- 1.23 as compared to 2.15 +/- 0.67 in those without it (p=0.148). CONCLUSIONS: No increase in pain levels due to indwelling JJ stent could be observed. Further research to allow for better assessment of discomfort and pain caused by an indwelling JJ stent on a larger cohort, and which could also discriminate patients' psy chosomatic symptoms, is needed.

[Surgical management of severe Peyronie's disease]. / Chirurgiczne leczenie ciezkich postaci choroby Peyronie.

Peyronie's disease (lat. induratio penis plastica) is a process of the fibrotic plaques oand other localized fibrotic conditions have been considered to be the result of an abnormal size, pain and improved penile curvature. At early stages intralesional injections may decrease penile curvature and decrease plaque volume although the exact mechanism of action on Peyronie disease is unknown. In serious cases surgery is recommended, based on ultrasound examination, cavernosography and cavernosometry. There are three mail surgical procedures to correct the curvature in Peyronie's disease: Nesbit plication, plaque excision followed by skin grafting, another autograft or synthetic material, and implantation of a penile prosthesis Aim of this study is to present our experience in surgical treatment of severe stadium in Peyronie's disease. Peyronie plaque was excised in 8 man, previously potent with severe satium of the disease. In every case saphenous autograft replacing excised plaque was used. In every case was not intra and postoperative complications. All patients reported satisfactory cosmetic and functional result. The satisfactory result of the treatment of severe stadium Peyronie disease is based on the surgical method. Saphenous graft is effective, safe and successful technique in our knowledge.

Artificial urinary sphincter implantation with periprostatic cuff placement for urinary incontinence in men.

Introduction: Artificial urinary sphincter (AUS) implantation is the treatment of choice for male urinary incontinence (UI). The aim of the present study was to evaluate treatment outcomes of UI in men using an AUS with a cuff placed around the prostatic urethra. Material and methods: Forty-three men with preserved prostatic urethra were selected for AUS implantation due to UI. Twenty patients had the cuff implanted around the prostate using the retropubic approach (Group 1), and 23 had the cuff placed around the bulbous urethra (Group 2). Both groups were compared in terms of continence quality as well as intra- and postoperative complications. Results: The groups were comparable with respect to age and duration of follow-up. Median time to complications was 90.3 and 10.7 months in Group 1 and Group 2, respectively (p = 0.007). The complication rate was 40% and 58.3% in Group 1 and 2, respectively (p = 0.001). Complete continence was obtained in 80% of patients from Group 1 and 33.3% of men from Group 2A (p = 0.001). Conclusions: The analysis indicates that cuff placement around the prostatic urethra results in better continence and is characterised by fewer complications. This method is dedicated for patients who have not had the prostate gland removed. Due to the retrospective nature of this analysis and small groups of patients, it is not possible to formulate ultimate recommendations.

The accuracy of a postprocessing technique--volume render mode--in three-dimensional endoanal ultrasonography of anal abscesses and fistulas.

OBJECTIVE: This study aimed to evaluate the accuracy of a 3-dimensional volume render mode endoanal ultrasonography in the assessment of anal abscesses and fistulas. PATIENTS AND METHODS: Three-dimensional endoanal ultrasonography was performed preoperatively in 62 patients with clinical diagnoses of an anal abscess and/or an anal fistula. The accuracy of a volume render mode endoanal ultrasonography was evaluated blindly by 2 observers through a retrospective analysis of all the stored images of anal abscesses and fistulas. Differences in classification of the type of anal abscesses and in determination of the type and location of internal openings of anal fistulas were assessed. RESULTS: In classification of the primary tract, the agreement between the volume render mode endoanal ultrasonography and surgery was much higher than that for the 3-dimensional endoanal ultrasonography (marginal homogeneity test P > .1, κ = 0.96, and marginal homogeneity test P = .0048, κ = 0.28, respectively). In localizing the internal openings and in classifying anal abscesses, the agreement for both methods with surgery was identical. The interobserver agreement showed complete agreement (100%) with regard to luminance and thickness parameters and very high accuracy for the opacity and filter parameters. CONCLUSIONS: This study demonstrated that volume render mode endoanal ultrasonography is a useful adjunct method to the 3-dimensional endoanal ultrasonography, showing better classification results of the types of anal fistulas.

Incidental sonographic detection of mucosa-associated lymphoid tissue lymphoma of the urinary bladder found in a very young woman: report of a case.

We report a rare case of a mucosa-associated lymphoid tissue (MALT)-type lymphoma of the bladder, incidentally found on sonography in a 17-year-old girl during the workup of arterial hypertension. The diagnosis was established by a transurethral biopsy. Treatment consisted of transurethral resection of the bladder tumor and subsequent chemotherapy. To the best of our knowledge, this is the youngest patient with asymptomatic MALT-type lymphoma of the urinary bladder.

Prevalence of chronic venous disorders among employees working in prolonged sitting and standing postures.

Research was conducted to determine the prevalence and severity of chronic venous disorders (CVD) among people working in prolonged sitting or static standing postures. Clinical examination and duplex Doppler sonography were performed on 126 employees working in a sitting (96 individuals) or a standing posture (30 individuals). Evidence of CVD was found in 59.4% of individuals working in a sitting posture and in 83.4% of those working in a standing posture, and was significantly higher in employees working in a standing posture (p = .015). Incompetent perforating veins and vena saphena magna valves, and bilateral changes were the more frequent signs of CVD. The investigation showed that prolonged standing and sitting at work increases risk of developing CVD. Further, people working in a standing posture are at a significantly greater risk for CVD than those working in a prolonged sitting posture. They should thus be the subject of specific prophylaxis interventions.

Postpartum endoanal ultrasound findings in primiparous women after vaginal delivery.

BACKGROUND: Natural childbirth is regarded as the most frequent cause of anal sphincter defects. The majority of obstetric injuries are detectable only by anal endosonography (AES), in from 6.8% to 35% of women after vaginal delivery. PURPOSE: To evaluate prospectively anal sphincters in primiparous women in the first days after delivery to estimate the prevalence of anal sphincter defects and to correlate selected risk factors with the recognized injuries. MATERIAL AND METHODS: A total of 112 consecutive primiparous women aged 19-40 years (mean 29.3 years) underwent three-dimensional (3D) AES with the use of a BK Medical scanner Profocus 2202 in the first weeks after delivery. RESULTS: Twelve tears (10.7%) in the perineum, including three extending to anal sphincters (2.6%) were found on AES. As many as 86 (76.8%) women had medio-lateral episiotomies due to the practice pattern in our hospital or as a consequence of obstetric factors. The statistical analysis did not prove a significant association between diagnosed injuries and episiotomy (P=0.73), nor a traumatic effect of epidural anesthesia, fetus head circumference > or =34 cm, or birth weight > or =3525 g. CONCLUSION: Anal sphincter tears following childbirth were found in only 2.6% of primiparous women, suggesting that vaginal delivery might not imply high risk of pelvic floor damage as has previously been assumed. The results do not confirm that medio-lateral episiotomy is conducive to obstetric anal sphincter defects.

Clinical significance of transurethral tru-cut biopsy in confirmation of bladder tumor invasive character.

OBJECTIVES: To evaluate the feasibility of resection (TURBT) replacement in patients with strong suspicion of invasive bladder tumor by transurethral tru-cut biopsy carried out during cystoscopy. METHODS: Fifty-eight patients (52 men and six women; mean age 65 years, range 43-79) presenting with extensive bladder tumor suggested by ultrasound and computed tomography were included in the study. Each patient was submitted to transurethral, cystoscopically-guided tru-cut biopsy of bladder tumor before the planned TURBT. Comparison of histopathological assessment of tissue cores, resection and radical cystectomy specimens was carried out. RESULTS: Histopathological analysis of resection specimens and tissue cores were in complete accordance with previous tissue cores assessment in terms of type and grade of bladder cancer. Histological type of bladder tumor revealed by tru-cut biopsy and radical cystectomy was identical in 56 (96.6%) cases. Tumor grade was the same in biopsy cores and radical cystectomy specimens in 55 (95%) cases. CONCLUSIONS: Endoscopic tru-cut bladder tumor biopsy allows us to collect sufficient amounts of tissue material for histopathological confirmation of detrusor muscle infiltration in patients presenting with bladder tumors suspected to cause muscle invasiveness. The procedure is carried out under cystoscopic control and is fast, efficient, safe, easy to perform and less invasive than standard TURB in cases of an extensive bladder tumor.

Anorectal malformation as a cause of recurring perineal abscesses - value of anorectal endosonography and magnetic resonance imaging: a case report.

Malformations of the rectum and urinary tract frequently coexist, and the prevalence of urogenital defects in patients with a rectal defect ranges from 20 to 54%. In most patients, anorectal malformations are diagnosed and treated surgically in early childhood. In this report, we present a case of a 52-year-old male with a history of urological operations in infancy due to a congenital urethral malformation and multiple recurrent episodes of perineal abscesses with urinary retention. Anorectal endosonography and magnetic resonance imaging revealed the presence of a large cystic lesion adjacent to the rectal wall which became smaller at the level of the puborectalis. The walls of the lesion had a layered structure identical to the wall of the rectum. In addition, the examinations showed hypotrophy of the left lobe of the prostate and lack of left semnal vesicles. Thus, the lesion was diagnosed as duplication of the rectum or rectal diverticulum. Surgery was performed by an interdisciplinary team of colorectal surgeons and urologist. The lesion was removed laparoscopically. The pathological report revealed that the cystic wall was typical of the intestinal wall, consistent with a diagnosis of rectal duplication.

Kidney ultrasound - what is important for a urologist?

Kidney ultrasound is one of the basic procedures in the practice of a urologist. Apart from the location and the size, description of renal morphology should contain the thickness of the anterior lip parenchyma in a transverse section and the location of possible narrowings. Uneven outline of the kidney is a sign of past inflammatory conditions. In the case of the pelvicalyceal system dilation, it is advised to specify the dimensions of the pelvis and calyces. Convex shape of the calyces proves elevated pressure within the pelvicalyceal system. Hydronephrosis is present when urinary retention has led to thinning the renal parenchyma. In each case, one should identify the reason for urinary retention in the upper urinary tract. Urinary retention on both sides requires one to exclude urinary bladder tumor, it may also be caused by a benign prostatic hyperplasia. Ultrasound examination is a sensitive method of renal stones detection, regardless of their chemical composition. Cyst description in an ultrasound image should cover its morphological features, differentiating between the so-called simple or complex cysts. In the case of a solid lesion, ultrasound makes it possible to detect parenchymal lesions usually starting with the size of 2-2.5 cm. It enables one to particularly diagnose angiomyolipomas. As regards the remaining parenchymal lesions, differentiation of the lesion nature is impossible. In some cases of angiomyolipoma, when it contains bleeding areas present and when it is deficient in adipose tissue, it resembles adenocarcinoma. It is necessary that the description includes the exact location, especially the dimensions and relation of the tumor to the renal sinus. In the case of larger lesions, respiratory motion of the kidney, the condition of the adrenal gland and the presence of enlarged lymph nodes should be controlled. Additionally, one should evaluate the renal vein and inferior vena cava in terms of a neoplastic plug presence.

Laparoscopic nephrectomy in a hemophilia B patient.

Surgery in patients with hemophilia is a serious challenge. It requires a comprehensive approach, as well as careful postoperative monitoring. We present here the first case of a transperitoneal laparoscopic radical nephrectomy (TLRN) for renal cell carcinoma, of the clear-cell type, performed in a hemophilia B patient. The level of factor IX clotting activity before surgery and on postoperative days 1-6 was maintained at 65-130% and at 30-40% on subsequent days until healing of the post-operative wound was achieved. The intraoperative and postoperative courses were uneventful. TLRN can therefore be considered safe and effective for renal cell carcinoma. In hemophilia patients, the TLRN procedure requires proper preparation, as well as adequate substitution therapy for the deficient coagulation factor provided by a multidisciplinary team in a comprehensive center.

Obesity and renal cancer incidence and mortality--a systematic review of prospective cohort studies.

INTRODUCTION AND OBJECTIVE: There have been many studies published recently on obesity and the risk of renal cancer; however, the epidemiological evidence for such an association has not been consistent. Therefore, a systematic review was conducted of the prospective cohort studies to assess the association between obesity and the risk of renal cancer incidence and death. MATERIALS AND METHODS: A search was conducted of the PubMed database and references to published studies from inception until May 2013. Guidelines for Assessing Quality in Prognostic Studies on the Basis of Framework for Potential Biases were followed for quality assessment of studies included in the systematic review. RESULTS: Twenty eligible studies were identified and included in the systematic review. Among the 20 selected studies, overall study quality was high. Although the evidence from the prospective cohort studies, linking obesity with renal cancer incidence, has not been entirely consistent, there is a convincing body of data for a positive relationship. Moreover, cumulative data is compelling for a strong positive association between obesity and fatal renal cancer. CONCLUSIONS: There is a relatively consistent amount of evidence that obesity increases the risk of renal cancer and fatal renal cancer. Further research is needed as better understanding of mechanisms by which obesity may influence renal cancer development and progression will aid the fostering of strategies for prevention and treatment of one of the most lethal human malignancies.

Laparoscopic implantation of an artificial urinary sphincter around the prostatic urethra.

OBJECTIVE: To report the first laparoscopic periprostatic implantation of an artificial urinary sphincter (AUS) after a transurethral resection of the prostate. BACKGROUND: The implantation of an AUS is a standard procedure for severe urinary incontinence. In men it is usually implanted through a perineal approach, with the cuff placed around the bulbous urethra, bladder neck, or even around the prostate. METHOD: We report a laparoscopic periprostatic implantation of an AUS after a transurethral resection of a prostate in a 72-year-old-man with incontinence. RESULTS: The operative duration was 180 min and the blood loss was 150 mL. There were no complications. After activating the AUS the patient was totally continent. CONCLUSION: The laparoscopic periprostatic implantation of an AUS is a safe, effective and considerably less invasive procedure.