Road Upgrading in Terms of Geometric and Functional Characteristics

The road network plays a vital role in the economy of any country and maintaining the infrastructure at a level that serves the current traffic needs is a critical element. Road maintenance directly affects road users. If it is not adequate or if it is not done in time, the damage that will occur, in a national and provincial network, may be unmanageable and will affect the increased operating costs of vehicles, delays in travel, increase in the accident index and generally reduce the reliability of transport services. When corrective interventions can no longer be postponed or cancelled, extensive restoration and reconstruction work takes place, which costs much more than the simple / preventive maintenance that can be planned and carried out in a timely manner. The protection of the existing road network is necessary and its maintenance in good condition is a dominant issue for a Management Body and often precedes as a priority even a new investment in the field of road infrastructure. This paper focuses on road network management from the point of view of upgrading and maintenance. An optimization methodology is proposed depending on the condition of the road, so that the choice of operation is optimal for the current situation. In this way, unnecessary expenses, which are brought about by the usual maintenance works, are avoided, while the street cannot serve modern traffic needs efficiently

Castrati singers: surgery for religion and art

The act of castration was practiced from ancient times. In countries of Middle and Far East, castration was often done to provide eunuchs as guardians of the harems. In Europe and especially in Italy, it was carried out to preserve the male voice unbroken into adult life. From 16th century till the end of 18th century, castrati singers dominated opera with their supernatural voices. Boys were castrated mainly before the age of 9 years and when they grew up they had feminine characteristics, such as smooth, hairless bodies, breasts, infantile penis. The training procedure to become a castrato singer was very intense and lasted up to ten years. The most common surgical technique was either to sever the spermatic cords or crush the testis with the fingers. The voice of a castrato was the outcome of a larynx the size of a child’s combined with the lung volume of an adult male. The castrati singers became superstars who dominated opera, singing both male and female roles for more than 200 years. Castrated for art, the beauty, range and flexibility of their voices raised them to mythical status

Metastasis to Sartorius Muscle from a Muscle Invasive Bladder Cancer

Bladder cancer constitutes the ninth most common cancer worldwide and approximately only 30% of cases are muscle invasive at initial diagnosis. Regional lymph nodes, bones, lung, and liver are the most common metastases from bladder cancer and generally from genitourinary malignancies. Muscles constitute a rare site of metastases from distant primary lesions even though they represent 50% of total body mass and receive a large blood flow. Skeletal muscles from urothelial carcinoma are very rare and up to date only few cases have been reported in the literature. We present a rare case of 51-year-old patient with metastases to sartorius muscle 8 months after the radical cystectomy performed for a muscle invasive bladder cancer

CIRCULATION OF TUMOR ANTIGENS CEA AND CA 19-9 IN CELL CULTURES AND IN EXPERIMENTAL HEPATIC AND RENAL FAILURE

AIM OF OUR STUDY WAS THE CORRELATION OF TUMOR MARKER'S CEA AND CA 19-9 CIRCULATION IN EXPERIMENTAL CHEMICALLY INDUCED ACUTE RENAL AND HEPATIC FAILURE IN RATS. WE ALSO CORRELATED THOSE TUMOR MARKERS TO TUMOR GROWTH OF PRODUCTION AND SECRETION COLON CARCINOMA CELL LINE SW 480 WHICH WAS STUDIED IN VITRO IN CONTINUOUS CELL CULTURES AND IN VIVO AFTER IMPLANTATION IN MICE. OUR RESULTS INDICATE THAT: 1) CEA AND CA 19-9 ARE SECRETED IN A DIFFERENT WAY FROM THE SUBPOPULATIONS OF THE CELL LINE SW 480 OF COLON CANCER. 2) RENAL AND HEPATIC FAILURE INFLUENCED THE LEVELS OF CEA BUT NOT THOSE OF CA 19-9 IN RATS.ΣΚΟΠΟΣ ΤΗΣ ΕΡΓΑΣΙΑΣ ΜΑΣ ΗΤΑΝ Η ΜΕΛΕΤΗ ΤΗΣ ΚΥΚΛΟΦΟΡΙΑΣ ΤΩΝ ΚΑΡΚΙΝΙΚΩΝ ΔΕΙΚΤΩΝ CEA ΚΑΙ CA 19-9 ΣΕ ΚΥΤΤΑΡΟΚΑΛΛΙΕΡΓΕΙΕΣ ΚΑΡΚΙΝΟΥ ΠΑΧΕΟΣ ΕΝΤΕΡΟΥ SW 480 ΚΑΙ ΣΕ ΠΕΙΡΑΜΑΤΙΚΗ ΗΠΑΤΙΚΗ ΚΑΙ ΝΕΦΡΙΚΗ ΑΝΕΠΑΡΚΕΙΑ, ΩΣΤΕ ΝΑ ΣΥΣΧΕΤΙΣΘΕΙ Η ΕΚΦΡΑΣΗ ΤΩΝ ΔΕΙΚΤΩΝ ΑΥΤΩΝ ΤΟΣΟ ΜΕ ΤΗΝ ΑΝΑΠΤΥΞΗ ΤΟΥ ΟΓΚΟΥ ΟΣΟ ΚΑΙ ΜΕ ΚΑΤΑΣΤΑΣΕΙΣ ΜΗ ΚΑΚΟΗΘΕΙΣ.ΒΡΕΘΗΚΕ ΟΤΙ ΟΙ ΚΥΤΤΑΡΙΚΟΙ ΥΠΟΠΛΗΘΥΣΜΟΙ ΤΗΣ ΣΕΙΡΑΣ SW 480 ΕΚΚΡΙΝΟΥΝ ΜΕ ΔΙΑΦΟΡΕΤΙΚΟ ΤΡΟΠΟ ΤΟΥΣ ΔΥΟ ΔΕΙΚΤΕΣ ΚΑΙ ΟΤΙ ΤΟ CEA ΔΙΝΕΙ ΨΕΥΔΕΙΣ ΘΕΤΙΚΕΣ ΤΙΜΕΣ ΣΤΗΝ ΗΠΑΤΙΚΗ ΚΑΙ ΝΕΦΡΙΚΗ ΑΝΕΠΑΡΚΕΙΑ. ΑΝΤΙΘΕΤΑ ΤΟ CA 19-9 ΔΕ ΦΑΙΝΕΤΑΙ ΝΑ ΕΠΗΡΕΑΖΕΤΑΙ ΣΤΙΣ ΚΑΤΑΣΤΑΣΕΙΣ ΑΥΤΕΣ

Prediction of post radical nephrectomy complications based on patient comorbidity preoperatively

Objectives: Comorbidity along with tumor and patient characteristics is taken into account when deciding for the surgical treatment of renal cell carcinoma (RCC). Comorbidity has also been used as an independent predictive factor for postoperative complications of several major urological procedures including radical nephrectomy for RCC. The aim of the present study was to objectively evaluate the association between comorbidity and postoperative complications after radical nephrectomy for RCC, using standardized systems to grade both comorbidity and severity of postoperative complications. Materials and methods: Clinicopathological data of 171 patients undergoing open radical nephrectomy for lesions suspected of RCC were prospectively recorded for a period of 3 years. Comorbidity was scored using the Charlson Comorbidity Index (CCI) while postoperative complications were graded according to the Clavien-Dindo system. Results: Patients were predominantly males (59.1%); their age ranged from 35 to 88 years (mean +/- SD: 63.6 +/- 11.9 yrs) with 50.8% of them being <= 65 yrs. CAI ranged from 0 to 8 with the majority (85.3%) scoring <= 2. The procedure was uncomplicated in 57.3% cases; 10 patients suffered major (grade III/IV) complications and 4 patients died within the 40 days postoperative period. CCI correlated with the manifestation of any postoperative complication, Clavien( )>= 1, OR (95% CI): 1.47 (1.09-1.96), p = 0.011 and the occurrence of severe complications, Clavien > 2. OR (9.5% CI): 1.29 (1.01-1.63), p = 0.038. Conclusions: The present prospective study showed that considerable complications occur in patients with major comorbidities. CCI is easily calculated and should be incorporated in preoperative consultation especially in cases of elder patients with severe comorbidity and favorable tumor characteristics where less invasive interventions or even active surveillance could be applied

Efficacy of tolterodine in preventing urge incontinence immediately after prostatectomy

Purpose: Urgency and urge incontinence are frequently observed after prostatectomy. Although symptoms ameliorate within a relatively short time, they usually cause significant stress and anxiety to the patient as far as their duration is concerned. Aim of our study was to determine the efficacy of tolterodine in preventing urgency and urge incontinence after catheter removal in patients that underwent prostatectomy for benign prostate hyperplasia. Patients and methods: Twenty-seven patients with moderate/severe lower urinary tract symptoms due to benign prostatic enlargement, scheduled for prostatectomy, were randomised into two groups, Group A (14 pts) received tolterodine 2 mg b.i.d starting the day of surgery, while group B patients received no such treatment. Tolterodine treatment was discontinued 15 days after catheter removal. All patients completed the International Prostatic Symptom Score (IPSS) and the International Continence Society (ICS-BPH) forms the day before surgery, and three times more, one, fifteen and thirty days after catheter removal. Results: Pre-operative total IPSS and frequency of urgency/urge incontinence as determined by questions 3 and 4 of the ICS-BPH questionnaire were equally distributed between groups, Tolterodine was well tolerated and no adverse effects were reported. Post-operative IPSS and QoL scores did not differ between groups. However, the frequency of urge incontinence both the first day and fifteen days after catheter removal was significantly lower in the tolterodine group (16.6% vs. 69.2%, p=0.004 and 8.3% vs. 38.4%, p=0.039, respectively). Conclusion: Tolterodine was well tolerated in all patients and had a beneficial effect regarding the postoperative urge incontinence. Trials of a larger scale could determine which patients would benefit more, especially according to the presence of storage lower urinary tract symptoms prior to surgery

Local anesthesia during transrectal ultrasonography-guided prostate biopsy: does it have any effect on sexual function?

Introduction TRUS (Trans Rectal Ultra Sonographic)-guided biopsy of the prostate is the procedure of choice for prostate cancer diagnosis in urological clinical practice. TRUS-guided biopsies are associated with pain and anxiety and may interfere with sexual function and potency. The aim of this study was to evaluate whether local anesthesia during TRUS-guided prostate biopsies has any effect on the sexual behavior of patients and to compare the periprostatic infiltration with lidocaine to simple sonographic gel application in a randomized prospective trial. Patients and Methods A total of 62 consecutive patients were included in the study randomized in two groups; Group A (n = 30, control group) and Group B (n = 32, lidocaine infiltration group). Interviews regarding their sexual status were conducted at the time they were informed of the need for biopsy, at the time of biopsy and at two scheduled interviews following the biopsy. Results Similar results of sexual dysfunction were observed between the two groups. About 6% of patients experienced some degree of dysfunction in anticipation of biopsy (P > 0.02 between the two groups) that was resolved by the end of the follow-up period. In total, only one Group B patient continued to show sexual dysfunction at the time of the last interview compared to two patients in Group A. Conclusions Local infiltration with lidocaine does not seem to play a role in sexual dysfunction following prostate biopsies. Psychological factors influence patients and the urologist should be ready to inform and reassure both the patient and his family