Brain function assessment in different conscious states

Background: The study of brain functioning is a major challenge in neuroscience fields as human brain has a dynamic and ever changing information processing. Case is worsened with conditions where brain undergoes major changes in so-called different conscious states. Even though the exact definition of consciousness is a hard one, there are certain conditions where the descriptions have reached a consensus. The sleep and the anesthesia are different conditions which are separable from each other and also from wakefulness. The aim of our group has been to tackle the issue of brain functioning with setting up similar research conditions for these three conscious states.Methods: In order to achieve this goal we have designed an auditory stimulation battery with changing conditions to be recorded during a 40 channel EEG polygraph (Nuamps) session. The stimuli (modified mismatch, auditory evoked etc.) have been administered both in the operation room and the sleep lab via Embedded Interactive Stimulus Unit which was developed in our lab. The overall study has provided some results for three domains of consciousness. In order to be able to monitor the changes we have incorporated Bispectral Index Monitoring to both sleep and anesthesia conditions.Results: The first stage results have provided a basic understanding in these altered states such that auditory stimuli have been successfully processed in both light and deep sleep stages. The anesthesia provides a sudden change in brain responsiveness; therefore a dosage dependent anesthetic administration has proved to be useful. The auditory processing was exemplified targeting N1 wave, with a thorough analysis from spectrogram to sLORETA. The frequency components were observed to be shifting throughout the stages. The propofol administration and the deeper sleep stages both resulted in the decreasing of N1 component. The sLORETA revealed similar activity at BA7 in sleep (BIS 70) and target propofol concentration of 1.2 μg/mL.Conclusions: The current study utilized similar stimulation and recording system and incorporated BIS dependent values to validate a common approach to sleep and anesthesia. Accordingly the brain has a complex behavior pattern, dynamically changing its responsiveness in accordance with stimulations and states. © 2010 Ozgoren et al; licensee BioMed Central Ltd

The course of metastatic prostate cancer under treatment

The first-line management of metastatic prostate cancer is hormonal therapy. However, resistance to this treatment will emerge within an average of 24 months. Our purpose was to determine the course of metastatic prostate cancer under treatment. A total of 56 patients who were diagnosed with metastatic prostate cancer were enrolled. As initial management, 3 kinds of hormonal therapy consisting of bilateral orchiectomy (BSO) alone, BSO + anti-androgene (AA) and LH-RH + AA were applied. The patients were followed until the emergence of hormone resistance. Serum PSA levels at the time of first diagnosis, post-treatment nadir PSA levels, time to nadir PSA, time to hormonal resistance and PSA levels at hormonal resistance were assessed, retrospectively. The localization and number of metastases and the survival term from the beginning of the emergence of hormone resistance until death were investigated No significant differences could be established between the groups. The mean time to reach hormone refractory status was 30.3 months for the whole study group. The average term of survival was 42.7 months for the whole group. Distance metastases were found in 8 patients during follow-up. There were no statistical differences between the groups in terms of treatment modalities applied for metastatic prostate cancer. Patients with androgen independent prostate cancer demonstrated progression despite chemical or surgical castration, and had poor prognosis. Initial hormonal therapy failed after an average of 2 years in metastatic prostate cancer. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/2193-1801-3-725) contains supplementary material, which is available to authorized users

Pilates for Better Sex: Changes in Sexual Functioning in Healthy Turkish Women After Pilates Exercise

PMID = 2582647

Tubeless percutaneous nephrolithotomy: Can be a choice, why not?

Percutaneous nephrolithotomy (PCNL) has been widely accepted and is commonly used to treat renal calculi. The optimal drainage of kidney after PCNL has not been clearly determined yet. Placement of an 18F to 24F nephrostomy tube at the end of the procedure is accepted as standard of care to date. The main advantages are adequate renal drainage, hemostatic tamponade and providing renal access for second look PCNL. However, based on the concept that the purpose of the tube is only to maintain adequate drainage of the kidney, a "tubeless" approach has been developed by placing a ureteral stent or catheter to provide drainage after PCNL instead of a nephrostomy tube. Tubeless PCNL is an effective and safe procedure for treatment of renal stones in selected cases. This procedure can even be chosen for patients with previous renal surgery, and hemorrhagic tendency. By using this method, less postoperative pain and a shorter hospital stay can be achieved, when compared with conventional PCNL. There is a controversy over ideal drainage system after PCNL in recent years. Herein, we made a systematic review for efficacy and safety of tubeless PCNL, totally tubeless PCNL, discussed different variations and compared the outcomes of this technique with standart PCNL. © Karadag et al.; Licensee Bentham Open

Erratum to Flexible ureterorenoscopy versus semirigid ureteroscopy for the treatment of proximal ureteral stones: A retrospective comparative analysis of 124 patients [Urology Journal, Vol 12, No 4 (2015)]

[No abstract available

Supplementary Material for: Clinicopathologic Features And Efficacy Of Induction Chemotherapy In Nasopharyngeal Carcinoma: Real-World Experience

Introduction: Nasopharyngeal carcinoma (NPC) accounts for 0.01% of all carcinomas, and 70% of patients have locally advanced disease with a poor prognosis. The mainstay therapy is chemoradiotherapy (CRT), and concurrent administration of platinum-based agents and irradiation provides high local control rates. However, induction (neoadjuvant) chemotherapy (ICT) prior to chemoradiotherapy is recommended for large tumors with a high tumor burden at category 1 level. For induction chemotherapy, platinum-based doublet or triplet combination regimens are recommended. Selected patients with high tumor burden at the time of diagnosis who did not receive induction chemotherapy before chemoradiotherapy were given adjuvant (consolidation) therapy after chemoradiotherapy. This multi-center study aims to share our experience in treatment of NPC and evaluate the factors associated with survival. Methods: The study included patients diagnosed with NPC who were followed and treated between 2008 and 2022. 142 patients from 6 centers were evaluated. The factors associated with disease-free survival (DFS) overall survival (OS) were evaluated. Results: The median age of our patients was 51 years (IQR: 16-81 years), and the male:female ratio was 2.5:1. A majority of patients (71%) had stage 3-4 disease. They had locally advanced disease, and 48 patients (34%) received induction chemotherapy. Twenty patients (14%) received adjuvant therapy. The median follow-up was 41 months (range, 2.7 to 175.1 months). The median DFS in NPC was 92.6 months (range, 71.9 to 113.3 months), with the 40th month DFS of 70.9%. The median OS was 113 months (range, 91 to 135 months), with the 40th month OS of 84.7%. Median DFS was 95.3 months (range, 64.2 to 126.4 months) in patients who received induction chemotherapy before CRT, which was longer than in the CRT-only group (p=0.6). DFS at the 40th month was 75.1% in patients treated with induction chemotherapy compared to 65.1% in the CRT-only group. Median OS was 117 months (range, 92 to 142 months) in patients receiving induction chemotherapy, which was longer than in the CRT-only group (p=0.4). OS at the 40th month was 86.7% in patients receiving ICT, but 83.6% in the CRT-only group. Conclusions: Both objective response rate (ORR) and survival were longer in patients who radiologically responded to chemoradiotherapy following induction chemotherapy. Non-response to induction chemotherapy is a negative predictive indicator. The role of induction chemotherapy in locally advanced NPC is increasing