Osteolytic bone destruction resulting from relapse of a testicular tumour 23 years after inguinal orchiectomy and adjuvant chemotherapy: a case report

<p>Abstract</p> <p>Introduction</p> <p>Late relapse of a testicular germ cell tumour is an uncommon occurrence. We report a case of osteolytic bone metastasis appearing 23 years after the initial treatment of a metastatic testicular mixed tumour (choriocarcinoma and embryonal carcinoma). This is one of the longest periods of recurrence reported for testicular germ cell tumours.</p> <p>Case presentation</p> <p>A 52-year-old Caucasian man who underwent a right inguinal orchiectomy due to testicular tumour in 1984 presented to our outpatient clinic in a generally bad condition of health and with severe pain of his right hip joint and os ischii caused by osteolytic metastasis.</p> <p>Conclusions</p> <p>This case emphasizes the need for a life-long follow-up of patients with primary metastatic testicular cancer.</p

Perforation of the Urinary Bladder Caused by Transurethral Insertion of a Pencil for the Purpose of Masturbation in a 29-Year-Old Female

The urethra is a usual site of introduction of foreign bodies for autoerotic stimulation. We present an unusual case of bladder perforation caused by foreign body that was self-inserted in the urethra and consequently slipped inside the bladder in a 29-year-old female patient with psychiatric disease. The patient was referred to our department for macroscopic hematuria and abdominal pain. Imaging studies revealed the presence of a foreign body in the pelvic area which had perforated the left lateral wall of the bladder. The foreign body was removed via open cystotomy. In psychiatric patients hematuria and pelvic pain may result from insertion of a foreign body in the bladder usually during masturbation

A Case Report of Urinary Bladder Carcinosarcoma and Review of the Literature

Carcinosarcoma of the bladder is an unusual tumour characterized by a combination of malignant epithelial and soft tissue elements. Most of the reported cases have been case reports or small series. Optimal treatment is uncertain. We herein report our experience in such a case treated with transurethral resection followed by radiotherapy with adverse final outcome. Treatment of bladder carcinosarcomas should be aggressive and multimodal but optional treatment is still unknown. Radiotherapy alone is insufficient as a treatment option of these aggressive tumors

Conservative management of penile trauma may be complicated by abscess formation

Blunt penile trauma during sexual activity, although highly underreported due to the associated patient embarrassment, constitutes a real urological emergency requiring immediate attention and possibly early surgical intervention. We report a case of a 58-year old man who presented with penile pain following excessive masturbation. Although there were no clinical signs of penile deformity or hematoma, magnetic resonance imaging revealed the presence of a rupture in the tunica albuginea. The patient opted for non-surgical management and his recovery period was complicated by the formation of an abscess at the site of the albugineal tear thus prolonging his hospital stay. The abscess was surgically drained and the patient reports to have normal erections at 3-month follow up

Construction of confidence intervals for the maximum of the Youden index and the corresponding cutoff point of a continuous biomarker.

Evaluation of the overall accuracy of biomarkers might be based on average measures of the sensitivity for all possible specificities -and vice versa- or equivalently the area under the receiver operating characteristic (ROC) curve that is typically used in such settings. In practice clinicians are in need of a cutoff point to determine whether intervention is required after establishing the utility of a continuous biomarker. The Youden index can serve both purposes as an overall index of a biomarker's accuracy, that also corresponds to an optimal, in terms of maximizing the Youden index, cutoff point that in turn can be utilized for decision making. In this paper, we provide new methods for constructing confidence intervals for both the Youden index and its corresponding cutoff point. We explore approaches based on the delta approximation under the normality assumption, as well as power transformations to normality and nonparametric kernel- and spline-based approaches. We compare our methods to existing techniques through simulations in terms of coverage and width. We then apply the proposed methods to serum-based markers of a prospective observational study involving diagnosis of late-onset sepsis in neonates

Statistical inference for the difference between two maximized Youden indices obtained from correlated biomarkers.

Currently, there is global interest in deriving new promising cancer biomarkers that could complement or substitute the conventional ones. Clinical decisions can often be based on the cutoff that corresponds to the maximized Youden index when maximum accuracy drives decisions. When more than one classification criteria are measured within the same individuals, correlated measurements arise. In this work, we propose hypothesis tests and confidence intervals for the comparison of two correlated receiver operating characteristic (ROC) curves in terms of their corresponding maximized Youden indices. We explore delta-based techniques under parametric assumptions, or power transformations. Nonparametric kernel-based methods are also examined. We evaluate our approaches through simulations and illustrate them using data from a metabolomic study referring to the detection of pancreatic cancer

Proposed Light Wavelengths during Healing of Grafted Tomato Seedlings Enhance Their Adaptation to Transplant Shock

Tomato, which is mainly established with grafted seedlings, is one of the most popular vegetables worldwide with a high nutritional value,. Market demand for grafted seedlings is high in specific seasons; thus, commercial nurseries face a problem of limited space availability during the healing stage. Light quality is an essential parameter during healing that can adjust seedling development towards desirable traits and lead to time and space saving during seedling production. Moreover, transplant shock constitutes another challenge that could limit crop yield. The objective of this study was to evaluate the overall quality of grafted tomato seedlings and their potential adjustment to transplant shock as affected by different light spectra during healing in a chamber. Evaluations were conducted immediately after exiting the healing chamber and after transplantation into pots. Light wavelengths were used from fluorescent lamps (FL) or light-emitting diodes with red (R), blue (B), red–blue combinations with 12 and 24% blue (12B and 24B), and white (W) emitting 11% blue. W enhanced the dry shoot biomass and the root architecture before and after transplantation. 24B led to an increased stem diameter, root development, and phenolic and antioxidant accumulation at both phases of the experiment. 12B enhanced the leaf area before transplantation and root development after transplantation. FL, R and B induced inferior seedling growth compared to the red–blue-containing LEDs, with B performing poorly in almost all tested parameters. Overall, red, including 11–24% blue, provides the optimum light conditions during the healing stage for the production of high-quality grafted tomato seedlings, with advanced capabilities of abiotic stress adaptation to transplant shock

Metastatic Mucinous Adenocarcinoma of the Prostate with PSA Value of 8.6 ng/mL at 5-Year-Followup after Prostatectomy, Radiotherapy, and Androgen Deprivation

Introduction. Mucinous adenocarcinoma of the prostate is a rare variant of prostate cancer. Its malignant potential and the clinical course of the affected patients remain, by and large, controversial. No data exist about the course of metastatic mucinous adenocarcinoma of the prostate. Case Presentation. This case report describes the excellent clinical course of a 68-year-old patient with metastatic mucinous adenocarcinoma of the prostate, treated by radical prostatectomy, irradiation, and androgen deprivation. Conclusion. In our case, mucinous adenocarcinoma of the prostate does not appear to behave differently than acinar prostate cancer. Its malignant potential is dependent on its Gleason score