Focused RF ablation using magnetic fluids

Cataloged from PDF version of article.In most developed countries, cancer is presently responsible for about 25% of all deaths. Heat therapies like hyperthermia and thermoablation are very promising approaches in the treatment of the cancer. Since these are physical treatment methods they have fewer side affects compared to chemo- and radio-therapy. Currently, various types of heat treatment modalities are available like microwave, ultrasound, RF capacitance hyperthermia, RF probe hyperthermia, magnetic fluid hyperthermia, but non of these methods have the ability to accurately deliver high heat energy to deeply seated tumors without damaging the healthy surrounding tissues. In this thesis, a novel RF ablation system was developed capable of focusing the heat in to very small areas in the order of millimeters, which will allow heating of the tumors without destroying collateral normal tissues. Generally, in this system the tumor ablation is achieved via coupling RF energy on the magnetic fluids which are previously dispersed in to the tumor tissue. By considering the human safety limits (nerve stimulation and tissue eddy current heating safeties) optimum treatment parameters like particle size of the magnetic fluids, frequency and strength of the applied RF field are obtained. The utilization of the optimum parameters may lead to the very effective operation of the ablation system where treatments can be done with very small amounts of fluid injections, in short durations. We believe that by the studies conducted in this thesis, magnetic fluid hyperthermia (tumor ablations using magnetic fluids) can be a much more effective method so that it can be used as the one of the most important tumor treatment techniques in future.Taşçı, T. OnurM.S

Malignant pleural mesothelioma with rarely seen metastases

Malignant mesothelioma, primarily located in the pleura, is a locally aggressive tumor. Distant metastases are rarely seen and mostly diagnosed postmortem. We present the third malignant pleural mesothelioma (MPM) case in the literature with bone marrow metastasis. A 36-year-old male patient presented with pain at the right mediastinal area and 5 × 6cm mass on the right side of his chest. 18-FDG positron emission tomography (PET) scan showed local uptake at the pleura, regional lymph nodes and 5th rib. The tru-cut biopsy reported as sarcomatoid type MPM. Cisplatin-pemetrexed therapy was planned. His medical condition deteriorated after 2 months and multiple metastases to brain, liver, adrenal glands and bone marrow were detected. The patient was lost 4 months after he was diagnosed. Brain and bone marrow metastasis of MPM are rarely seen. Physicians should be careful about the rapid progression and unexpected metastases of MPM

Comparison of the Different PCOS Phenotypes Based on Monocyte to HDL Cholesterol Ratio

In this study, we aimed to evaluate thedegree of inflammation in PCOS phenotypes by comparing the monocyte-to-HDLratios showing inflammatory and oxidative stress among different phenotypes ofPCOS. Inthis case-control study, we studied 186 women with PCOS and 59 age-matchedhealthy women. PCOS women were prospectively classified into four phenotypes based on NIH ExpertPanel criteria. The degree of inflammation between the non-PCOS control groupand four PCOS phenotypes was compared by measuring MHR. The prevalence ofphenotypes A, B, C and D were 29%, 22%, 26%, and 23%, respectively. MHR wasfound to be the highest in phenotype A (13.7 ± 4.9) among the PCOS phenotypesand the lowest level was found in phenotype D (9.0 ± 1.9), which is thenon-androgenic phenotype. MHRwere significantly different across the four PCOS phenotypes; with the highestvalue were present with phenotypeA. &nbsp;As an easily accessible simple marker, the monocyte /HDL ratio may be promising for detecting at-risk metabolic phenotypes in PCOS.</p

A nationwide survey on the impact of COVID-19 pandemic on minimal invasive surgery in urology practice

Objective: The beta-coronavirus (COVID-19) pandemic has changed the clinical approach of 93% of urologists worldwide, and this situation has affected the use of laparoscopic and robot-assisted laparoscopic methods, which are known as minimally invasive surgery (MIS). This study aimed to determine the effects of the COVID-19 pandemic on MIS in urology practice at national level. Design, setting and participants: A total of 234 urologists in Turkey participated in an online survey between August 22 and September 23, 2020. Outcome measurements and statistical analysis: Descriptive statistical analyses were conducted to determine the participants’ demographic characteristics and responses to multiple-choice questions. Results: While 54% of urologists stated that they were concerned about the possibility that the patients planned to undergo MIS were carrying COVID-19 or false-negative for the virus, 51% considered that open surgery was safer than MIS in this regard. The pandemic led to a difference in the preferences of 40% of the urologists in relation to open or MIS methods, and during the pandemic, 39% of the urologists always directed their patients to open surgery. It was determined that during the pandemic, there was a statistical decrease in the intensity and weekly application of MIS methods among all surgical procedures compared to the pre-pandemic (P <.001 and P <.001, respectively). MIS was preferred for oncological operations by 97.3% of the urologists during the pandemic, with the most performed operation being radical nephrectomy (90.7%). Among oncological operations, radical prostatectomy was most frequently postponed. To prevent virus transmission during MIS, 44% of the urologists reported that they always used an additional evacuation system and 52% took additional precautions. There were a total of 27 healthcare workers who took part in MIS and tested positive for COVID-19 after the operation. Conclusions: Although the number of operations has decreased during the ongoing pandemic, MIS is a method that can be preferred due to its limited contamination and mortality in urology practice provided that safety measures are taken and guideline recommendations are followed

The Relationship Between First-Trimester Aneuploidy Markers and Birth Weight

OBJECTIVE: We aimed to determine the relationship between the first-trimester aneuploidy screeningmaand the predicted weight at birth: Small for gestational age and large for gestational age.STUDY DESIGN: 594 low-risk pregnant women with a singleton pregnancy, who underwent firsttrimesteraneuploidy screening by measuring nuchal translucency, maternal serum free beta-humanchorionic gonadotropin, and pregnancy-associated plasma protein-A were included in the study. Thoseweighing above the 3rd percentile and below the 10th percentile were defined as small for gestationalage, and those over the 90th percentile were defined as large for gestational age.RESULTS: A total of 594 pregnant women were enrolled. The mean maternal age of the studied groupwas 28.8±5.5 years. Low maternal serum pregnancy-associated plasma protein-A levels and decreasednuchal translucency measurements were associated with the small for gestational age newborn (p&lt;0.001and p=0.001, respectively). There is a significant correlation with large for gestational age for newbornsonly with an increase in maternal serum pregnancy-associated plasma protein-A levels (p=0.001). betahumanchorionic gonadotropin levels were not associated with the birth weight (p=0.735).CONCLUSION: Maternal serum pregnancy-associated plasma protein-A levels, one of the markers in firsttrimesteraneuploidy screening, can be used in the prediction of small for gestational age and large forges-tational age However, due to its low correlation, it is not a suitable screening test for clinical practice. pregnant women with a singleton pregnancy, who underwent first-. Low maternal serum pregnancy-associated plasma protein-A levels and decreased nuchal translucency measurements were associated with the small for gestational age newborn (p&lt;0.001 and p=0.001, respectively). There is a significant correlation with large for gestational age for newborns only with an increase in maternal serum pregnancy-associated plasma protein-A levels (p=0.001). beta-human chorionic gonadotropin levels were not associated with the birth weight (p=0.735). CONCLUSION: Maternal serum pregnancy-associated plasma protein-A levels, one of the markers in first-trimester aneuploidy screening, can be used in the prediction of small for gestational age and large for ges-tational age However, due to its low correlation, it is not a suitable screening test for clinical practice. </p