Prognostic significance of surgical margin status and gleason grade at the positive surgical margin in predicting biochemical recurrence after radical prostatectomy in a turkish patient cohort

Objective: To investigate the prognostic role of positive surgical margin (PSM) features in addition to well-defined risk factors in predicting biochemical recurrence (BCR) after radical prostatectomy. Materials and Methods: This study used the prostate cancer database from the Urooncology Association in Turkey. Clinical, surgical, pathological and follow-up data were recorded from the database. PSM features, including number, location, linear length and Gleason grade (GG) were also recorded. Kaplan-Meier survival analyses were performed to assess differences in BCR-free survival (BCR-FS). In order to identify prognostic factors affecting BCR-FS, univariate and multivariate Cox regression analyses were performed. Results: The study included 984 patients who met the eligibility criteria. The median follow-up time was 29 (minimum: 6, maximum: 210) months, and BCR was detected in 178 (18.1%) patients. BCR-FS was found to be significantly lower in patients with higher total prostate-specific antigen, higher International Society of Urological Pathology (ISUP) grade, extraprostatic extension (EPE), seminal vesicle invasion, lymphovascular invasion, lymph node involvement, PSM and GG at PSM (PSMGG) >= 4 (log-rank p<0.001, p<0.001, p<0.001, p<0.001, p<0.001, p<0.001, p<0.001 and p=0.005). ISUP grade, EPE and PSM were identified as independent prognostic factors in predicting BCR-FS [Hazard ratio (HR): 1.89, p=0.035 and HR: 4.65, p<0.001, HR: 1.82, p=0.030, HR: 1.77, p=0.042, respectively]. Unlike the univariate analysis, in multivariate analysis, PSMGG did not prove to be an independent prognostic factor in predicting BCR-FS. Conclusion: PSM GG >= 4 was found to be significantly associated with shorter BCR-FS. There is a need for large, randomised prospective studies to clarify the role of PSMGG to be used in nomograms as an independent predictor to determine patients who would benefit from adjuvant radiation therapy

Anatomic and Functional Results of Cartilage Type 1 Tympanoplasty in Children and the Evaluation of the Success of Surgery with Parental Perceptions

Objective:This study aims to determine the anatomic and functional results of cartilage Type 1 tympanoplasty in children and to evaluate the success of surgery with parental perceptions.Methods:Only pediatric patients who had undergone cartilage Type 1 tympanoplasty were included in this study. Patients older than 16 years and patients who had otorrhoea during the previous month, chronic otitis media with cholesteatoma and patients who had undergone mastoidectomy or ossiculopasty were excluded. The ‘anatomical’ success was accepted as an intact graft in the last control in the at least 6th month postoperatively. A satisfaction questionnaire with four questions about the perceptual results of surgical intervention was applied to the patients’ parents on the telephone.Results:In total, 44 ears of 41 cases (22 male 19 female) were included in the study. The mean age was 13.2±2.7 (8-16) and the mean follow-up time was 17 (7-36) months. Anatomical success rate was 88.6% (39/44). As a preoperative mean, the pure tone hearing threshold was 30.7±7.7 dB and the postoperative mean pure-tone hearing threshold was 18.8±7.8 dB. Among the operated ears, 88.6% (39/44) of the perforations were treated successfully. Of the 41 paediatric patients’ parents, only 28 (68.2%) could be reached by telephone; nineteen (68%) of the 28 parents contacted thought that the hearing level had improved postoperatively and only 10 parents (35%) stated that his/her child could attend a preoperatively-restricted activity postoperatively.Conclusion:Outcomes of cartilage tympanoplasty in children satisfy both surgeons and parents. Chronic otitis media in children must be managed with surgery as soon as favourable conditions are provided

An evaluation of clinical, radiological and three-dimensional dental tomography findings in ectodermal dysplasia cases

Background:This study aimed to review the results related to head and jaw disorders in cases of ectodermal dysplasia. The evaluation of ectodermal dysplasia cases was made by clincal examination and examination of the jaw and facial areas radiologically and on cone-beam 3-dimensional dental tomography (CBCT) images. Material and Methods: In the 36 cases evaluated in the study, typical clinical findings of pure hypohidrotic ectodermal displasia (HED) were seen, such as missing teeth, dry skin, hair and nail disorders. CBCT images were obtained from 12 of the 36 cases, aged 1.5- 45 years, and orthodontic analyses were made on these images. Results: The clinical and radiological evaluations determined, hypodontia or oligodontia, breathing problems, sweating problems, a history of fever, sparse hair, saddle nose, skin peeling, hypopigmentation, hyperpigmentation, finger and nail deformities, conical teeth anomalies, abnormal tooth root formation, tooth resorption in the root, gingivitis, history of epilepsy, absent lachrymal canals and vision problems in the cases which included to the study. Conclusions: Ectodermal dysplasia cases have a particular place in dentistry and require a professional, multi- disciplinary approach in respect of the chewing function, orthognathic problems, growth, oral and dental health. It has been understood that with data obtained from modern technologies such as three-dimensional dental tomography and the treatments applied, the quality of life of these cases can be improved

Diagnostic Value of the Video Head Impulse Test in Patients with Vertigo: Can It Be Used as a Screening Tool?

Background and Aim: Several laboratory tools are used to evaluate balance disorders but, there is still no screening test to determine the site and the severity of the lesion. The aim was to investigate whether video Head Impulse Test (vHIT) can be used as a screening test in patients with chronic or recurrent vertigo and dizziness. Methods: The files of 965 patients who were followed up in our vertigo outpatient clinic were reviewed retrospectively. Vestibulo-Ocular Reflex (VOR) gains and saccadic movements of the right and left lateral canals in the vHIT test, and Canal Paresis (CP) in the Caloric Testing (CT) were noted. Results: A total of 325 patients were included in our study. In CT results, the group that CP was most frequently detected was Menière’s Disease (MD) group (71 patients (74.7%). While vHIT results were found to be pathological in the vast majority of patients in the Vestibular Neuritis (VN) group (72.7%), the results were found to be normal at the highest rate in the vestibular migraine group (77.9%). Correlation analysis showed a significant but weak correlation between the degree of CP in the CT and the VOR gains of the lateral canals in vHIT in all groups. Conclusion: Although it has high sensitivity in cases with VN and vestibulopathy, we think that vHIT cannot be used as a screening tool in patients with vertigo, especially for chronic cases, since its sensitivity rate differs in the long term according to the cause of the disease

Towards clinical translation of upscaled osteogenic grafts using human adipose tissue progenitors

Tissue engineering is an emerging strategy in medical field that focuses on regeneration or replacement of lost or damaged tissue and organs. Most of the tissues in human body have no or limited self renewal and regeneration potential which decrease with ageing. Today, bone is one of the most transplanted organs of human body every year. Bone defects or missing bone segments may occur due to trauma, injury, tumour removal and infections. Increased life span in modern society results in an increased demand for organ and tissue substitutes. So far, most of the tissue engineering approaches proposed solutions which only allow the generation of small scale of grafts with confined clinical relevance. Translation of tissue engineering and regenerative medicine approaches from bench to bedside faces with some vital issues that limit their immediate therapeutic applications. Providing autologous cells of clinical grade isolated from a relevant source to avoid potential clinical complications is the primary issue to be handled. Other than this, when enlarging the size of the engineered constructs vascularization of the graft upon in vivo implantation, the complexity and costs of the manufacturing protocols are among the other main problems. This thesis addresses possible solutions for limitations mentioned above by implementing stromal vascular fraction (SVF) cells from adipose tissue to provide pre-vascularization into up-scaled tissue engineered osteogenic constructs and by developing simplified approaches based on the coupling of reparative surgery to a streamlined cell isolation and intraoperative generation of osteogenic constructs from SVF cells

Organoid platforms for eye research

Ophthalmic diseases originating from trauma, inherited genetic background or as result of other systemic diseases affects a large portion of the human population. Advances in cell-based therapies promise to improve the vision and patient comfort. Today novel regenerative medicine approaches in ophthalmology have been significantly influenced by induced pluripotent stem cells (iPSCs) and their potential in ocular disease modeling and treatment of ocular diseases. iPSCs have been successfully demonstrated to form organoids, organ mimicries recapitulating cellular phenotypes and functions of organs/tissues&nbsp;in vitro. Anterior and posterior eye compartments have been addressed utilizing organoid technologies to elaborate the development of human eye and generate disease models. Cornea, retina, and lacrimal gland organoids have been generated from iPSCs and efforts to use them in associated diseases attracts tremendous interest.&nbsp;Organ-on-a-chip (OoC) platforms mimicking native microphysiological environments have been established that allow cell differentiation and tissue growth rather than using research animals to improve the&nbsp;in vitro&nbsp;models. Such tools facilitate investigation of cellular mechanotransduction, tissue morphogenesis and advanced control of other physiological factors affecting&nbsp;in vitro&nbsp;performance of organoids. As growing interest of pharma industry on bioengineered OoCs, organoid models in eye research become more attractive.&nbsp;&nbsp;&nbsp;ACKNOWLEDGEMENT:The author has been supported by TÜBİTAK projects 117S264 and 121C313, TÜBA-GEBİP and BAGEP awards.</p