The Influence of the Intraductal Carcinoma of the Prostate on the Short-Term Oncological Outcomes

Aim: The presence of intraductal carcinoma of the prostate (IDC-P) in radical prostatectomy (RP) specimens correlates with adverse prognostic factors such as worse biochemical recurrence-free survival, higher grade and stage disease. This study aimed to investigate the effect of IDC-P in radical prostatectomy specimens on short-term oncological outcomes. Materials and methods: Patients who underwent RP at our clinic for prostate cancer between May 2016 and November 2019 were included in the study. They were divided into two groups based on the presence of IDC-P in RP specimens. Their clinical, pathological, and oncologic data were evaluated retrospectively. Results: A total of 98 patients underwent RP with a mean age of 65.5 years (50-83) and a mean follow-up time of 31.2 months (6-52). Seventy and 28 patients were evaluated in the group without IDC-P and group with IDC-P, respectively. Surgical margin positivity (p=0.307) and lymph node metastasis (p=0.017) rates were higher in the group with IDC-P. Although there were no statistical differences between the groups, at follow-up biochemical recurrence rate (p=0.052) was higher, and mean time to biochemical recurrence rates were lower (p=0.057) in the group with IDC-P. The group with IDC-P was associated with a 3-fold increase in prostate cancer-specific mortality to the group without IDC-P (p=0.037). Conclusions: Patients with IDC-P at RP specimens have more advanced disease, shorter biochemical recurrence-free, and cancerspecific survival than those without IDC-P. Defining the presence of IDC-P in RP specimens is critical in choosing the appropriate treatment strategy and predicting the prognosis (AU)

Objetivo: La presencia de carcinoma intraductal dela próstata (IDC-P) en muestras de prostatectomía radical(RP) se correlaciona con factores de pronóstico adversotales como peor recurrencia bioquímica de supervivenciasin la enfermedad, así como mayor grado y estadío másavanzado de la enfermedad. El objetivo de este estudio erainvestigar el efecto de la IDC-P en muestras de prostatectomía radical en resultados oncológicos a corto plazo.Materiales y procedimientos: En este estudio hansido incluidos los pacientes que fueron sometidos a una RPdebido a cáncer de próstata en nuestra clínica entre mayodel 2016 y noviembre del 2019. Fueron divididos en dosgrupos según la presencia de IDC-P en sus muestras RP.Sus datos clínicos, patológicos y oncológicos fueron evaluados retrospectivamente.Resultados: Un total de 98 pacientes fueron sometidos a una RP con una edad media de 65,5 años (50-83) ycon un periodo de seguimiento medio de 31,2 meses (6-52). Se evaluaron 70 y 28 pacientes en el grupo sin IDCP y en el grupo con IDC-P, respectivamente. Dentro delgrupo con IDC-P, las tasas de positividad de margen quirúrgico (p=0,307) y metástasis en nodos linfáticos (p=0,017)son más elevadas. A pesar de no haber diferencias estadísticas entre ambos grupos, la tasa de recurrencia químicadurante el seguimiento (p=0,052) es más elevada y la tasadel tiempo medio hasta la recurrencia química (p=0,057)es menor en el grupo con IDC-P. El grupo con IDC-P hasido asociado a un aumento de la moralidad específica delcáncer de próstata 3 veces superior al del grupo sin IDC-P(p=0,037).Conclusiones: Los pacientes con IDC-P en las muestras RP se encuentran en en estadío de la enfermedad másavanzada, así como una recurrencia bioquímica sin la enfermedad y una supervivencia específica más cortas que aquellos sin IDC-P. La determinación de la presencia de IDC-Pen muestras RP es crítica a la hora de elegir una estrategiade tratamiento adecuada y la predicción del pronóstico (AU)

The Anatomy of the Sigmoid-Transverse Junction According to the Tentorial Angle.

Dural sinuses have critical importance during intracranial approaches. Detailed anatomical knowledge of the dural sinuses is crucial for surgeons to reduce unexpected venous bleeding. The aim of this study was to investigate anatomical relation of sigmoid sinus and tentorium cerebelli according to clinically palpable landmarks and cranial morphometry. The authors evaluated 222 individuals' (94 women, 128 men) 3-dimensional computed tomography angiograms, retrospectively. The authors also studied on 12 mid-sagittal cut dried hemiskulls and 8 formalin fixed cadaver heads hemisected midsagitally. All measurements were completed using Osirix-Lite version 9 software. Craniometrical values were measured to define cranium morphology. Furthermore, level of the sigmoid sinus according to asterion and tentorial angle were evaluated in detail. Our results demonstrated that there were significant differences between parameters and genders, except vertical angle of the tentorium cerebelli. Distance between asterion and sigmoid sinus was statistically different between right and left sides in favor of the left side. This also varied depending on the position of the sigmoid sinus, as well. Only transverse angle between the upper point of external acoustic meatus and asterion demonstrated a significant correlation with age. This study evaluated the detailed 3D anatomy of sigmoid sinus and tentorium cerebelli related with the cranium morphology. Determining to sigmoid sinus anatomy according to clinically palpable landmarks has advantages for setting surgical protocols and reducing to unexpected injuries while surgery to these structures.

The morphometry of the cavernous part of the internal carotid artery.

BACKGROUND: In the study, the morphometric evaluation of internal carotid artery (ICA) was performed in order to show the differences between the age groups and genders. MATERIALS AND METHODS: In the study, descriptive measurements of intercarotid distance on the computed tomography of 173 (88 male [M], 85 female [F]) pa- tients and the intercavernous distance on magnetic resonance images (MRIs) of 49 (19 M, 30 F) individuals were reviewed. RESULTS: Intercarotid distance was found to be close to the border of statistical significance and for results of the comparative measurements that were per- formed in the study; no significant sex-associated difference was observed for the distance between the gender and midpoint of the sella turcica and medial margin of the right ICA. Compared to gender, the distance between the base of the sella turcica and the base of the left ICA is found to be closed to of statistical significance. A statistically significant difference was obtained for the distance between the midpoint of sella turcica and medial margin of the left ICA and for the distance between the base of the sella turcica and the base of right ICA. Although it is observed that there is a weak correlation between the age and the distance between midpoint of the sella turcica and medial margin of the right ICA, statistically there is a significant difference between them. CONCLUSIONS: Obtained results, planning of surgical interventions are supportive and guiding in terms of prevention of damage of to ICA in three dimensional thinking and operations.

Single-stage repair of adult aortic coarctation and concomitant coronary artery disease: an unusual surgical approach through median sternotomy.

Surgical repair of postductal aortic coarctation associated with severe coronary artery disease is in most cases a difficult decision to make. As staged procedures are associated with a higher rate of morbidity and mortality, simultaneous operative management of both pathologies is desirable. We describe a case of a 51-year-old man who was referred to our department for surgical treatment of postductal aortic coarctation and concomitant coronary artery disease, which we managed with single-stage surgery through median sternotomy.

Diurnal variation of QT dispersion in patients with and without coronary artery disease.

QT dispersion defined as interlead QT variability in a 12-lead electrocardiogram was proposed by Day and associates as a simple method to evaluate the repolarization heterogenicity of the ventricular myocardium. The frequency of onset of myocardial infarction and sudden death has been reported to have a circadian variation, with a peak incidence in the early morning hours. The authors investigated whether there is diurnal variation of QT interval and QT interval dispersion in healthy subjects and in patients with coronary artery disease. The study population consisted of two groups. Group I consisted of 62 subjects without coronary artery disease and group II consisted of 82 patients with coronary artery disease. Twelve-lead ECG was recorded for each patient in the morning (between 7 AM and 8 AM), afternoon (between 3 PM and 5 PM) and at night (between 11 PM and 1 AM), on the day after performance of coronary angiography. QTc dispersion was significantly higher in patients with coronary artery disease than in healthy subjects in the morning hours and afternoon (p<0.001). Although the differences were much prominent in group I than group II, both QTc dispersion of morning and afternoon were significantly greater than those at night. There were no statistically significant differences between group I and group II at nighttime with respect to maximum QTc, minimum QTc intervals, and QTc dispersion (p>0.05). In conclusion, QT dispersion shows diurnal variation with an increase in the morning hours in both patients with coronary artery disease and subjects without coronary artery disease. The mechanism of diurnal variation of QT dispersion in patients with coronary artery disease is quite different from that of healthy subjects.