A Systematic Study on the Synthesis of n-Butyl Substituted 8-Aminoquinolines

A systematic study on the synthesis of 8-aminoquinoline derivatives with an n-butyl group at each alternate position of the quinoline ring was carried out. Skraup Reaction and its Doebner-von Miller variation were used to obtain most of the quinoline ring except for the 2-butyl-8-aminoquinolines and 4-butyl-8-aminoquinolines where the commercially available methylquinoline derivatives were used as precursors. The structures of the synthesized compounds were characterized by FTIR, H-1-NMR, COSY, C-13-NMR and HRMS spectra

Psychologic Resilience and Related Factors in the Euthymic Bipolar Patients

Bipolar I disorder is characterized by full blown manic episodes and is not only affected by biological factors but also by psychological and cultural factors. This fact attracted the attention onto the psychological resilience, which is the ability of dealing with stressful life-events and overcoming the traumatic experiences, and it has become a phenomenon that is taken into consideration to empower the protective factors for the disorder. The object of this study was to examine social, clinical and physical factors that could enhance the psychological resilience. The subjects of the study were between the ages of 18 and 69, literate and in the phase of euthymic mood. In the study, the 67,4 % of the subjects were women and the average age was 37,7. The scales were Personal Information Form and Psychological Resilience Scale for Adults. It was found that there was a meaningful relationship between attempting to suicide and psychological resilience (p: 0,02 and t: -2,4). When the relationship between being physically active and psychological resilience was examined, it was found that there was a meaningful and a negative correlation between psychological resilience and having a sedentary life style (p: 0,02 and r: -0,35), and between psychological resilience and the time spent in sleep (p: 0,021 and r: -0,35). As a result, resilience is a factor that can be enhanced with different factors and it takes roles both in the process of the disorder to smoothen the course of the disorder and before the symptoms of the disorder appears. [JCBPR 2018; 7(3.000): 120-126

Impact of transrectal prostate needle biopsy on erectile function: Results of power Doppler ultrasonography of the prostate

We evaluated the impact of transrectal prostate needle biopsy (TPNB) on erectilefunction and on the prostate and bilateral neurovascular bundles using power Doppler ultraso-nography imaging of the prostate. The study consisted of 42 patients who had undergone TPNB.Erectile function was evaluated prior to the biopsy, and in the 3rd month after the biopsy usingthe first five-item version of t he International Index of Erectile Function (IIEF-5). Prior to and3 months after the biopsy, the resistivity index of the prostate parenchyma and both neurovas-cular bundles was measured. The mean age of the men was 64.2 (47e78) years. Prior to TPNB, 10(23.8%) patients did not have erectile dysfunction (ED) and 32 (76.2%) patients had ED. The meanIIEF-5 score was 20.8 (range: 2 e25) prior to the b iopsies, and the mean IIEF-5 score was 17.4(range: 5e25; p < 0.001) after 3 months. For patients who were previously potent in the pre-biopsy period, th e ED rate was 40% (n Z 4/10) at the 3rd month evaluation. In these patients,all the resistivity index value s were significantly decreased. Our results showed that TPNB maylead to an increased risk of ED. The presence of ED in men after TPNB might have an organic basis.Copyright ª 2013, Kaohsiung Medical University. Published by Elsevier Taiwan LLC. All rightsreservedPublisher's Versio

Transperitoneal Laparoscopic Adrenalectomy for Adrenal Tumours: Experience with 54 Patients

Objective: To present our laparoscopic surgery experience in the treatment of adrenal masses. Methods: Between January 2008 and March 2015, a total of 58 adrenal glands in 54 patients (39 females, 15 males) underwent transperitoneal laparoscopic adrenalectomy (TLA) to remove an adrenal mass. The patients underwent hormonal evaluation, triphasic magnetic resonance imaging, and/or abdominal computed tomography. Thirty-one patients (57.4%) had a hormonally active adrenal mass. Results: Twenty-nine right, 21 left, and 4 bilateral TLA were performed. The mean age and body mass index of the patients were 49.5±11.2 years and 27.2±4.3 kg/m2, respectively. The mean adrenal mass size, operation time, estimated blood loss, and hospitalisation duration were 35.9±15.0 mm, 92.7±29.6 minutes, 50.8±33.1 ml, and 3.7±2.5 days, respectively. No minor or major complications were observed postoperatively. In pathological examinations, 38 (70.3%) patients had adenoma or adrenal hyperplasia, 8 (14.7%) had pheochromocytoma, 2 (3.7%) had periadrenal paraganglioma, 2 (3.7%) had adrenal cysts, 1 (1.9%) had schwannoma, 1 (1.9%) had myelolipoma, 1 (1.9%) had myeloid metaplasia, and 1 (1.9%) had adrenal cortical carcinoma. Conclusion: TLA is a safe and efficient minimally invasive treatment option with a low morbidity rate in the surgical treatment of adrenal masses

Virtual reality tumor navigated robotic radical prostatectomy by using three-dimensional reconstructed multiparametric prostate MRI and 68Ga-PSMA PET/CT images: a useful tool to guide the robotic surgery?

Objectives: To evaluate the use and benefits of tumor navigation during performing robotic assisted radical prostatectomy (RARP). Patients and Methods: Borders of the visible tumor(s) was/were and surrounding structures marked on multiparametric prostate magnetic resonance imaging (mpMRI) and 68Ga-labeled prostate-specific membrane antigen ligand using positron emission computed tomography (Ga68 PSMA-PET/CT). Three dimensional (3D) reconstruction of the images were done that were transferred to virtual reality (VR) headsets and Da Vinci surgical robot via TilePro. Images were used as a guide during RARP procedures in five cases. Indocyanine green (ICG) guided pelvic lymph node dissection (n = 2) and Martini Klinik Neurosafe technique (n = 2) were also applied. Results: Mean patient age was 60.6 ± 3.7 years (range, 56-66). All VR models were finalized with the agreement of radiologist, urologist, nuclear physician, and engineer. Surgeon examined images before the surgery. All VR models were found very useful particularly in pT3 diseases. Pathological stages included pT2N0 (n = 1), pT3aN0 (n = 1), pT3aN1 (n = 2), and pT3bN1 (n = 1). Positive surgical margins (SMs) occurred in two patients with extensive disease (pT3aN1 and pT3bN1) and tumor occupied 30% and 50% of the prostate volumes. Mean estimated blood loss was 150 ± 86.6 cc (range, 100-300). Mean follow-up was 3.4 ± 1.7 months (range, 2-6). No complication occurred during perioperative (0-30 days) and postoperative (30-90 days) periods in any patient. Conclusions: 3D reconstructed VR models by using mpMRI and Ga68 PSMA-PET/CT images can be accurately prepared and effectively applied during RARP that might be a useful tool for tumor navigation. Images show prostate tumors and anatomy and might be a guide for the console surgeon. This is promising new technology that needs further study and validation

The Impact of Visible Tumor (PI-RADS >= 3) on Upgrading and Adverse Pathology at Radical Prostatectomy in Low Risk Prostate Cancer Patients: A Biopsy Core Based Analysis

Deciding on the management of prostate cancer (PCa), especially GG1 PCa, is quite difficult. The most important thing that will help us in making active surveillance or definitive treatment decision is whether the tumor is a clinically significant tumor. To understand this, we discussed in this article that multiparametric MR, PI-RADS scoring and targeted biopsy can be used

Diagnostic Accuracy of Multiparametric Magnetic Resonance Imaging to Identify Clear Cell Renal Cell Carcinoma in cT1a Renal Masses

PurposeThe detection of small renal masses is increasing with the use of cross-sectional imaging, although many incidental lesions have negligible metastatic potential. Among malignant masses clear cell renal cell carcinoma is the most prevalent and aggressive subtype. A method to identify such histology would aid in risk stratification. Our goal was to evaluate a likelihood scale for multiparametric magnetic resonance imaging in the diagnosis of clear cell histology.Materials and methodsWe retrospectively reviewed the records of patients with cT1a masses who underwent magnetic resonance imaging and partial or radical nephrectomy from December 2011 to July 2015. Seven radiologists with different levels of experience who were blinded to final pathology findings independently reviewed studies based on a predefined algorithm. They applied a clear cell likelihood score, including 1-definitely not, 2-probably not, 3-equivocal, 4-probably and 5-definitely. Binary classification was used to determine the accuracy of clear cell vs all other histologies. Interobserver agreement was calculated with the weighted κ statistic.ResultsA total of 110 patients with 121 masses were identified. Mean tumor size was 2.4 cm and 50% of the lesions were clear cell. Defining clear cell as scores of 4&nbsp;or greater demonstrated 78% sensitivity and 80% specificity while scores of 3 or greater showed 95% sensitivity and 58% specificity. Interobserver agreement was moderate to good with a mean κ of 0.53.ConclusionsA clear cell likelihood score used with magnetic resonance imaging can reasonably identify clear cell histology in small renal masses and may decrease the number of diagnostic renal mass biopsies. Standardization of imaging protocols and reporting criteria is needed to improve interobserver reliability

Diagnostic Performance and Interreader Agreement of a Standardized MR Imaging Approach in the Prediction of Small Renal Mass Histology.

Purpose To assess the diagnostic performance and interreader agreement of a standardized diagnostic algorithm in determining the histologic type of small (≤4 cm) renal masses (SRMs) with multiparametric magnetic resonance (MR) imaging. Materials and Methods This single-center retrospective HIPAA-compliant institutional review board-approved study included 103 patients with 109 SRMs resected between December 2011 and July 2015. The requirement for informed consent was waived. Presurgical renal MR images were reviewed by seven radiologists with diverse experience. Eleven MR imaging features were assessed, and a standardized diagnostic algorithm was used to determine the most likely histologic diagnosis, which was compared with histopathology results after surgery. Interreader variability was tested with the Cohen κ statistic. Regression models using MR imaging features were used to predict the histopathologic diagnosis with 5% significance level. Results Clear cell renal cell carcinoma (RCC) and papillary RCC were diagnosed, with sensitivities of 85% (47 of 55) and 80% (20 of 25), respectively, and specificities of 76% (41 of 54) and 94% (79 of 84), respectively. Interreader agreement was moderate to substantial (clear cell RCC, κ = 0.58; papillary RCC, κ = 0.73). Signal intensity (SI) of the lesion on T2-weighted MR images and degree of contrast enhancement (CE) during the corticomedullary phase were independent predictors of clear cell RCC (SI odds ratio [OR]: 3.19; 95% confidence interval [CI]: 1.4, 7.1; P = .003; CE OR, 4.45; 95% CI: 1.8, 10.8; P &lt; .001) and papillary RCC (CE OR, 0.053; 95% CI: 0.02, 0.2; P &lt; .001), and both had substantial interreader agreement (SI, κ = 0.69; CE, κ = 0.71). Poorer performance was observed for chromophobe histology, oncocytomas, and minimal fat angiomyolipomas, (sensitivity range, 14%-67%; specificity range, 97%-99%), with fair to moderate interreader agreement (κ range = 0.23-0.43). Segmental enhancement inversion was an independent predictor of oncocytomas (OR, 16.21; 95% CI: 1.0, 275.4; P = .049), with moderate interreader agreement (κ = 0.49). Conclusion The proposed standardized MR imaging-based diagnostic algorithm had diagnostic accuracy of 81% (88 of 109) and 91% (99 of 109) in the diagnosis of clear cell RCC and papillary RCC, respectively, while achieving moderate to substantial interreader agreement among seven radiologists. © RSNA, 2018 Online supplemental material is available for this article

Can we predict patients that will not benefit from invasive mechanical ventilation? A novel scoring system in intensive care: the IMV mortality prediction score (IMPRES)

KUCUK, Ahmet Oguzhan/0000-0002-6993-0519; Kirakli, Cenk/0000-0001-6013-7330; KUCUK, Mehtap PEHLIVANLAR/0000-0003-2247-4074; Aksoy, Iskender/0000-0002-4426-3342WOS: 000504051300010PubMed: 31655511Background/aim: The present study aimed to define the clinical and laboratory criteria for predicting patients that will not benefit from invasive mechanical ventilation (IMV) treatment and determine the prediction of mortality and prognosis of these critical ill patients. Materials and methods: The study was designed as an observational, multicenter, prospective, and cross-sectional clinical study. It was conducted by 75 researchers at 41 centers in intensive care units (ICUs) located in various geographical areas of Turkey. It included a total of 1463 ICU patients who were receiving invasive mechanical ventilation (IMV) treatment. A total of 158 parameters were examined via logistic regression analysis to identify independent risk factors for mortality; using these data, the IMV Mortality Prediction Score (IMPRES) scoring system was developed. Results: The following cut-off scores were used to indicate mortality risk: 8, very high risk. There was a 26.8% mortality rate among the 254 patients who had a total IMPRES score of lower than 2. The mortality rate was 93.3% for patients with total 1M PRES scores of greater than 8 (P < 0.001). Conclusion: The present study included a large number of patients from various geographical areas of the country who were admitted to various types of ICUs, had diverse diagnoses and comorbidities, were intubated with various indications in either urgent or elective settings, and were followed by physicians from various specialties. Therefore, our data are more general and can be applied to a broader population. This study devised a new scoring system for decision-making for critically ill patients as to whether they need to be intubated or not and presents a rapid and accurate prediction of mortality and prognosis prior to ICU admission using simple clinical data