Correlation of Preoperative and Radical Prostatectomy Gleason Score: Examining the Predictors of Upgrade and Downgrade Results

Preoperative Gleason score (GS) obtained from Trans Rectal Ultra Sonography (TRUS) is the most common grading system to evaluate the appropriate treatment for patients with clinically localized prostate cancer. But this method showed upgraded and downgraded results in comparison to Gleason score obtained from radical prostatectomy. The current study aimed to determine clinical or pathological variables to reduce the differences between biopsy and radical prostatectomy Gleason scores.Through retrospective review of 52 patients with radical prostatectomy, this study examined the correlations of preoperative Gleason score with age, prostate volume, PSA level, PSA density, digital rectal exam findings and percentage of positive core needle biopsies across two groups, including patients with preoperative GS≤6 (i.e. group one) and patients with preoperative GS≥7 (group two). The discordance between biopsy GS and radical prostatectomy GS was observed to be 52% in the current study. Among patients with preoperative GS≤6, prostate volume (P=0.026), PSA density (P=0.032) and percentage of positive core needle biopsies (P=0.042) were found to be significant predictors for upgrade. There was no significant predictor for downgrade in patients with preoperative GS≥7. Findings of this study revealed that in patients with preoperative GS≤6, smaller prostate volume, higher prostate density and higher positive results of core needle biopsies were associated with theupgrade of GS. Therefore, it should be considered when selecting treatment modalities among these patients

Concomitant Transurethral and Transvaginal-Periurethral Injection of Autologous Adipose Derived Stem Cells for Treatment of Female Stress Urinary Incontinence: A Phase One Clinical Trial

Stress urinary incontinence is a common medical problem among women. The urethral closure complex and/or the supportive mechanisms are responsible for incontinence in the majority of patients. Several surgical procedures with different degrees of invasiveness and outcomes have been reported to treat the problem. Although most of these procedures are reasonably effective, a general trend towards the study of natural and biocompatible tissues is emerging over popular synthetic materials. Here we report our experience of autologous adipose-derived stem cells transplantation into the periurethral region as a new method of stress urinary incontinence treatment. Ten women with symptoms of stress urinary incontinence were treated by injections of autologous adipose-derived stem cells into the periurethral region via transurethral and transvaginal approach under urethroscopic observation. This report presents the short-term outcome of the patients. The outcome measured by pad test results, ICIQ-SF scores, and Qmax. The mean age of the participants was 45.8±8.7 years. Urinary incontinence significantly decreased through the first two, 6 and 24 weeks after the injection therapy. The difference was significant in pad test results (P<0.001) and ICIQ-SF scores (P<0.001), especially comparing results between 2 and 6 weeks and among 6 and 24 weeks, but not for 2 and 6 weeks compared to each other. Surprisingly, Qmax showed improvement after the study period (means 32.6 vs. 35.7; P=0.002). This study showed that injection of the autologous adipose-derived stem cells to the periurethral region is a safe, yet short-term effective treatment option for stress urinary incontinence. Further studies with longer follow up are needed to confirm its long term efficacy

Design and Manipulation 3D Imaging System by using Photodiode Grid

Introduction: Radiation imaging is one of the applicable methods in diagnostic medicine and nondestructive testing for industrial applications. In nondestructive 3D imaging, in addition to the radiation source, there is a requirement for a suitable detection system, data acquisition system, mechanical sections for moving objects, reconstruction algorithm and finally a computer for processing and control. Method and Materials: One of the most important components of a digital radiation imaging system is its detector. Light photodiode is a new light sensor which is used in digital imaging systems because of its high efficiency. In the present research, a photodiode grid has been implemented to design and make a detection system. The photodiode grid has an array of 10×10 photodiodes in a 50×50 mm2 area. Beside the photodiode grid, a control board has been designed. Furthermore, a mechanical system has been designed to move the objects in the horizontal and vertical directions, and also rotate it around its own axis. The maximum displacement in the horizontal and vertical directions is 60 cm with step accuracy of about 0.015 mm. Step accuracy of the rotational movement is about 0.9 degrees.  Results: After the imaging system was constructed, background and uniformity of the system were tested. All the photodiodes in the imaging system showed good uniformity. The image data was transferred to a computer and processed using a MATLAB program to display the images on a monitor. As the physical resolution of the system is about the pixel size (5 mm), only the overall images of the object's dimensions were expected to be produced. Discussion and Conclusion: The fidelity of the detection system has been successfully tested using a visible light source and several test samples. The presented system is able to reconstruct 3D images and obtain cross-sectional images of the objects, by using the image processing algorithm specifically designed for it

Comparison of five methods in predicting difficult laryngoscopy: Neck circumference, neck circumference to thyromental distance ratio, the ratio of height to thyromental distance, upper lip bite test and Mallampati test

Background: Preoperative airway assessment tests have been presented to help in anticipating a difficult airway. We conducted this study to compare five methods in prediction of difficult laryngoscopy: Neck circumference (NC), NC to thyromental distance ratio (NC/TMD), the ratio of height to thyromental distance (RHTMD), upper lip bite test (ULBT) and Mallampati test (MMT). These five methods are the most commonly used ones and have different powers for it. It was not clear which of these methods predicts difficult laryngoscopy better. Materials and Methods: Six hundred consecutive patients participated in this study. NC, NC/TMD and RHTMD were measured, and ULBT and MMT were performed and recorded. The laryngoscopy view was graded according to Cormack and Lehane′s scale (CLS) and difficult laryngoscopy was defined as CLS grades 3 and 4. Accuracy of tests in predicting difficult laryngoscopy was assessed using the area under a receiver-operating characteristic curve. Results: The area under the curve in ULBT and RHTMD were significantly larger than that in TMD, NC and MMT. No statistically significant differences were noted between TMD, NC and MMT (all P > 0.05) (ULBT = RHTMD > NC/TMD > TMD = NC = MMT). RHTMD (>22.7 cm) exhibited the highest sensitivity (sensitivity = 64.77, 95% confidence interval [CI]: 53.9-74.7) and the most specific test was ULBT (specificity = 99.41%, 95% CI: 98.3-99.9). Conclusion: RHTMD and ULBT as simple preoperative bedside tests have a higher level of accuracy compared to NC/TMD, TMD, NC, MMT in predicting a difficult airway

Evaluation of the serum zinc level in patients with vitiligo.

Introduction Vitiligo is an acquired, idiopathic disorder characterized by circumscribed depigmented macules and patches, which affects approximately 0.1–2% of the general population worldwide. Zinc is an essential trace element that is necessary for growth and development at all stages of life. Some studies have reported an association between serum zinc levels and vitiligo. Aim To measure the serum zinc level in patients with vitiligo compared to healthy subjects. Material and methods One hundred patients with vitiligo and 100 healthy controls were referred to our clinic. The two groups were matched for age and sex. Atomic absorption spectrophotometry was used to measure serum zinc levels. The statistical analysis was performed using SPSS software. Results The mean serum level of zinc in vitiligo patients and controls was 80.11 ±17.10 μg/dl and 96.10 ±16.16 μg/dl, respectively. The serum zinc level in patients with vitiligo was significantly lower than in healthy controls (p = 0.0001). Conclusions The results of our study revealed a significant association between vitiligo and serum zinc levels. A relative decrease in the serum zinc level in vitiligo patients can highlight the role of zinc in the pathogenesis of vitiligo, and large-scale studies need to be conducted to confirm these findings and assess the effect of oral zinc supplements in patients with low zinc levels

Distraction osteogenesis for cleft palate closure: A finite element analysis

Background: Current methods of closure of the cleft palate result in the formation of scars and impairment of growth. Distraction osteogenesis (DO) might be an effective means to repair or at least reduce the size of wide clefts. This study investigates the biomechanical aspects of this process. Materials and Methods: DO simulation was applied to reduce the size of a unilateral hard palate cleft on a three-dimensional (3D) model of the maxilla. For the position of osteotomy lines, two different models were assumed, with the osteotomy line on the affected side in model A and on the intact side in model B. In each model, DO screws were placed on two different positions, anteriorly (models A1 and B1) and posteriorly (models A2 and B2). Displacement pattern of the bony island in each of the four models, reaction forces at DO locations, and von Mises stress were estimated. Mesh generation and data processing were carried out in the 3D finite element analysis package (ABAQUS V6.7-1; Simulia Corp., Providence, RI, USA). Results: In model B2, the island moved almost evenly, assuring a more complete closure of the cleft. The most uniform stress distribution was found in model B1. Conclusion: The results suggest that the best positions for the DO screw and the osteotomy line for closure of the cleft palate are posteriorly and on the intact side, respectively

Alarming carcinogenic and non-carcinogenic risk of heavy metals in Sabalan dam reservoir, Northwest of Iran

Abstract This research aims to assess contamination status of water and sediment in Sabalan dam reservoir (SDR) and evaluate the impact of water withdrawal depths on the carcinogenic and non-carcinogenic risks of metals for exposed people. Results of metal pollution indices revealed some degree of pollution in water and sediment of the reservoir, especially associated with arsenic. Risk assessment of metals in water of the SDR for non-carcinogenic materials through different scenarios of water withdrawal depth revealed that consuming water from the depth of 10 m can be somewhat troublesome to human health. The carcinogenic risk of arsenic from depth of 10 m of the reservoir was about four times greater than that from water surface. Minimum carcinogenic risk of consuming water in the reservoir was found to be 1.69 × 10E-4, which is higher than the maximum limit proposed by the U.S. EPA, indicating the water consumption from the SDR can result in harmful effects on human health

A data fusion approach for real-time traffic state estimation in urban signalized links

Summarization: Real-time estimation of the traffic state in urban signalized links is valuable information for modern traffic control and management. In recent years, with the development of in-vehicle and communication technologies, connected vehicle data has been increasingly used in literature and practice. In this work, a novel data fusion approach is proposed for the high-resolution (second-by-second) estimation of queue length, vehicle accumulation, and outflow in urban signalized links. Required data includes input flow from a fixed detector at the upstream end of the link as well as location and speed of the connected vehicles. A probability-based approach is derived to compensate the error associated with low penetration rates while estimating the queue tail location, which renders the proposed methodology more robust to varying penetration rates of connected vehicles. A well-defined nonlinear function based on traffic flow theory is developed to attain the number of vehicles inside the queue based on queue tail location and average speed of connected vehicles. The overall scheme is thoroughly tested and demonstrated in a realistic microscopic simulation environment for three types of links with different penetration rates of connected vehicles. In order to test the efficiency of the proposed methodology in case that data are available at higher sampling times, the estimation procedure is also demonstrated for different time resolutions. The results demonstrate the efficiency and accuracy of the approach for high-resolution estimation, even in the presence of measurement noise.Presented on: Transportation Research Part C: Emerging Technologie

State estimation in urban traffic networks: a two-layer approach

Summarization: Modern traffic control and management systems in urban networks require real-time estimation of the traffic states. In this paper, a novel approach for modeling traffic flow in urban networks that is especially suitable for state estimation is proposed. The complexity of the urban traffic model is reduced by assuming availability of connected vehicle data. We first investigate the observability issue in urban traffic networks using a graphical approach. Then, the proposed model for the evolution of the traffic flow in urban traffic networks is developed and used in two layers, i.e., link layer and network layer, to estimate, in high-resolution (second-by-second), the traffic states in the whole network. Traffic states in the link layer include queue tail location and the number of vehicles in the queue, while in the network layer, estimation of the total number of vehicles per link and turning rates at the intersections is carried out. In a first step, it is shown that the estimation approach only requires the detectors at the borders of the network. We further demonstrate that in the proposed scheme, one may reduce or drop the need for spot detectors for the price of reduced, but still reasonable estimation accuracy. The validation of the approach has been undertaken by comparing the produced estimates with realistic micro-simulation results as ground truth, and the achieved simulation results are promising.Παρουσιάστηκε στο: Transportation Research Part C: Emerging Technologie