Retroperitoneal Extragonadal Nonseminomatous Germ Cell Tumor with Synchronous Orbital Metastasis

A huge retroperitoneal tumor with a right orbital mass was detected and proved to be an extragonadal nonseminomatous germ cell tumor on biopsy. BEP chemotherapy caused some regression in orbital mass however no change in retroperitoneal tumor size as well as serum tumor marker levels occurred. Herein, we present a rarely seen entity of extragonadal retroperitoneal nonseminomatous germ cell tumor with synchronous orbital metastases and discuss its diagnosis and management

Hemodynamic Monitoring Using A Pulse Counter Vigileo Flotrac Cardiac Output System In Transapical Off-Pump Minimally Invasive Mitral Valve Repair

The aim of this study was to present our anesthetic management and early hemodynamic recovery after transapical off-pump neochords implantation. Observational prospective study. The perioperative records of 13 patients who underwent mitral valve repair using the Neochord DS1000 system were analyzed. Hemodynamic measurements recorded with the Vigileo Flotrac invasive arterial cardiac output system were evaluated. Thirteen patients were included in the study. Transfusions of a total of 2 U of erythrocytes and 11 U of plasma were performed. After Neochord implantation, the mean cardiac output increased at a statistically significant level according to the values measured after induction p = 0.003. Increased cardiac output measurement after placement of the neochordaes and elimination of insufficiency have emerged as indications of early hemodynamic recover

Ureteric Duplication is not a Contraindication for Robot-Assisted Laparoscopic Radical Cystoprostatectomy and Intracorporeal Studer Pouch Formation

The authors found that duplicated ureters was not a contraindication to robot-assisted laparoscopic radical cystoprostatectomy in this case

Spinodal phases in Cr coated low carbon steel through cathodic arc PVD technique

Bu çalışmada, katodik ark fiziksel buhar biriktirme yöntemi ile krom kaplanan, krom kaplama sonrası farklı sürelerde yüksek bias voltajı etkisi ile krom iyonu bombardımanı uygulanan ve darbeli bias voltajı uygulaması ile krom kaplanan düşük karbonlu çelik malzemelerde meydana gelen spinodal fazlar karakterize edilerek, gelişimleri incelenmiştir. Elektron mikroskopisi, elementel analizler ve kesitlerden alınan derinlik profili çalışmaları ile gerek kaplama sonrası uygulanan krom bombardımanı, gerekse darbeli bias uygulamasında yüksek bias periyodlarındaki krom bombardımanının, krom kaplama ve düşük karbonlu çelik taban malzeme arasında radyasyon destekli yayınma mekanizması ile gerçekleşen bir iyon demeti karışımı prosesine neden olduğu tespit edilmiştir. Bunun sonucunda, taban malzemeden kaplama yüzeyine büyük oranda demir atomu yayınmış ve yüzeylerde çok kısa süreler içerisinde spinodal ayrışma fazları meydana gelmiştir. Bu fazların morfolojileri, literatürde demir-krom (Fe-Cr) sistemindeki spinodal ayrışma çalışmalarında elde edilen mikroyapılar ve bilgisayar simülasyonu ile oluşturulan spinodal yapılar ile oldukça büyük benzerlikler göstermiştir. Ayrıca bombardıman uygulanan örneklerde, spinodal ayrışma yapılarının bir karakteristiği olan tepe/vadi oluşumları ile fazlar arasındaki bileşimsel dalgalanmalar gibi sonuçların gözlenmesi de spinodal fazların oluşumunu doğrulamaktadır.  Elde edilen mikroyapılara bakıldığında, taneli taban malzeme üzerinde epitaksik olarak büyüyen kaplamalardaki bazı tanelerde, spinodal ayrışma fazları oluşmadığı görülmüştür. Bununla birlikte, bombardıman süresinin artması ile bu tanelerde de spinodal ayrışma yapılarına benzer oluşumlar gözlenmiştir. Anahtar Kelimeler: İyon bombardımanı, radyasyon destekli yayınma, spinodal ayrışma.In this study, spinodal decomposition phases formed in low carbon steel samples which were Cr coated, Cr coated and bombarded with Cr ions through applying high bias voltage (1 keV) and Cr coated through applying pulsed bias voltage in a cathodic arc physical vapour deposition (PVD) system were characterized and compared. 1.5 mm thick IF (interstitial free) steel sheets were used as substrate. The bombardment periods after the coating were 1 minute, 2 minutes and 3 minutes. In pulsed bias mode, bias voltage was alternately increased to 1 keV for 5 seconds (bombardment section) and decreased to 150 eV for 10 seconds (coating section) along 10 minutes. Total bombardment time was 3.3 minutes in 10 minutes of pulsed bias. In order to determine the spinodal decomposition phases, Field Emission Microscopy (FEM), Scanning Electron Microscopy (SEM), Energy Dispersive Spectral Analysis (EDS) and Glow Discharge Optic Emission Spectroscopy (GDOES) studies were performed. Not only the bombardment applied after the coating process, but also the one applied during the high bias voltage period in the pulsed bias mode caused radiation enhanced diffusion between Cr coating and low carbon steel substrate. This was proven by EDS analysis, GDOES analysis and elemental maps taken from cross sections of the samples. Fe content of coatings increased gradually by increasing bombardment time. As a result of ion beam mixing, severe iron diffusion from the substrate to the Cr coating?s surface took place and this resulted in formation of spinodal decomposition phases in a very short time. These phases? morphologies were quite similar to microstructures obtained from spinodal decomposition studies in Fe-Cr system and computer simulated spinodal structures in literature. Besides, it was observed through the EDS analysis and FEM studies of the bombarded samples that hill/valley formations and compositional fluctuations which were the characteristics of spinodal decomposition process were also present. Hills were Cr rich and valleys were Fe rich parts of the spinodal structures. It was observed in FEM micrographs that hills and valleys were getting wider with increasing bombardment period and it was another characteristic of spinodal decomposition structures. When the average cohesive energy of the Fe-Cr system (4.19 eV)  and the relationship between the cohesive energy and the critical temperature (Tc»100Ekoh)  at which radiation enhanced diffusion (RED) would be efficient were taken into consideration, ion beam mixing in our system woud take place through RED regime. Altough both metals have similar cohesive energies, dominant Fe movement to the Cr coating was observed in pulsed bias mode instead of an isotropic mixing. While Fe-Cr alloys must be heat treated for very long times (up to 500 hours) in conventional spinodal decomposition processes, it is very interesting that the spinodal decomposition phases formed in 1-3 minutes in this study. It is believed that the diffusion enhanced by the radiation effected the spinodal decomposition kinetics. As a result of thermally activated migration of  defects caused by Cr ion bombardment and short range diffusions in very hot thermal spikes formed by the collisions between bombarding ions and target atoms accelerated the diffusion processes which make the spinodal decomposition occur. In some grains of the coatings which grew on grained microstructure of the substrate material epitaxially, spinodal decomposition was not observed. These smooth grains with no hill/valley structure were supposed to be s phase which was not decomposed during the bombardment and cooling periods. The coherency strain between the grains may have displaced the spinodal line (coherent  spinodal) in some grains resulting in not occuring spinodal decomposition in chemical spinodal line. However, spinodal structures started to form in those smooth grains by increasing the bombardment time and temperature. It was observed via EDS analysis taken from the samples which were not only bombarded after coating but also coated through applying pulsed bias that Fe content increased by increasing the bombardment time. Formation of spinodal structures in smooth grains and increasing of the Fe content concurrently by increasing the bombardment time points that spinodal decomposition occurs in Fe rich part of the spinodal line in those smooth grains. As a potential development of this study, more efficient temperature control should be applied to determine chemical and coherent spinodal lines in Fe-Cr alloys produced by ion bombardment of Cr coated low carbon steels.Keywords: Ion bombardment, radiation enhanced diffusion, spinodal decomposition

What if the Hand Piece Spring Disassembles During Robotic Radical Prostatectomy?

These authors report on the successful management of a disassembled hand piece spring during robotic radical prostatectomy

Setting Measures for Tackling Agricultural Diffuse Pollution of Küçük Menderes Basin

We explained the methodology used in setting the basic and supplementary measures for diffuse pollutants at Küçük Menderes Basin. As the majority of diffuse pollutants arise from livestock breeding and agricultural activities, we focused to propose measures regarded with tackling the pollution from agricultural activities. The types and distribution of diffuse loads were expressed by total nitrogen and phosphorous parameters. We used the results of a yearlong surface water quality monitoring involving physico-chemical, chemical and biological parameters with specific pollutants and priority substances, set in the European Union Water Framework Directive as the AquaTool input data. The AquaTool model was run for attaining the outcomes of a series of measures determined according to the ecological sensitivity of each water body. The removal efficiency of pollution loads provided by the best management practices in agricultural activities and livestock breeding were compiled from literature, and typical removal rates were further determined for the basin. We produced nine alternative scenarios at first cycle for determining compliance measures for mitigating point and diffuse sources of pollution in surface water bodies, and water quality improvements observed in the Model were reported. A number of exemptions were defined for some of the water bodies that could not achieve the environmental objectives at the end of first implementation cycle. 759 proposed measures for tackling diffuse pollution were 81% of the total measures considered. Additionally, the measures for mitigating diffuse agricultural pollution were almost equal to half of the diffuse pollutant measures, and 40% of the overall measures liste

The Incidence and Management of Pleural Injuries Occurring during Open Nephrectomy

Objective. To evaluate the incidence, management, and risk factors of pleural injuries occurring during open nephrectomy. Methods. Between June 2004/and June 2008, 165 patients (167 renal units) underwent open simple (n = 37, 22.2%), partial (n = 39, 23.4%) or radical (n = 91, 54.5%) nephrectomy in our institution. Results. Flank, Chevron, and abdominal midline incisions were used in 148(88.6%), 17(10.2%), and in 2(1.2%) surgical procedures, respectively. Ribs were excised in 109(65.3%) procedures (11th rib, 10th-11th ribs, and 11th-12th ribs). Intraoperative pleural injuries were detected in 20(12%) procedures, 16(80%) were treated successfully with simple evacuation technique, and 4 required chest tube insertion. Age, sex, surgery type, incision type, and surgery site were not associated with pleural injury occurrence (P > .05). Rib resection was the only parameter associated with pleural injury occurrence. Conclusion. Pleural injuries occur in 12% of open nephrectomy procedures, and 80% can be repaired successfully. Few of them (2.4%) need chest tube insertion. Performing rib resection is a significant risk factor for pleural injury occurrence during nephrectomies

Determination of crop water stress index (CWSI) of second crop corn in a semiarid climate

This study was carried out to determine the relationship between the canopy-air temperature differential and vapor pressure deficit (VPD), which can be used to quantify the crop water stress index (CWSI) under fully irrigated ( 100 %) and maximum water stress (0 %) conditions of furrow irrigated corn. The effects of five different irrigation levels (100, 70, 50, 30 and 0 % replenishment of soil water depleted from the 0.90 m soil profile depth) on corn yields and the resulting CWSI were investigated. The highest yield and total water use were obtained under fully irrigated corn plots (100 % replenishment of soil water depleted). The trends in CWSI values were consistent with the soil water content induced by deficit irrigation. CWSI increased with increased soil water deficit. An average CWSI of 0.22 before irrigation time provided the highest grain corn yield. The yield was directly correlated with seasonal mean CWSI values and a second order polynomial equation “Y = 59258CWSI2 -72051CWSI +24060” can be used to predict the grain yield of corn as a second crop under the semiarid climate