Gynaecological robotic surgery at a state hospital — our own experience

Objectives: In recent years, the rapid development of minimally invasive surgical methods, including robotic surgery, has resulted in a marked decline of the traditional methods in gynaecological surgery. The aim of the study was to share our experience with robotic surgery at a state hospital. Material and methods: A total of 40 patients, who underwent robotic gynaecological surgery (GS) between 2015 and 2017, were included. Age, BMI, previous abdominal operations (PAO), operation indications (OI), operative time (OT), pathological evaluation, uterine weight (UW), blood loss during surgery (BL), complications, and duration of the hospitalization (DoH) were analyzed. The Da Vinci XI was used during surgery. Results: A total of 40 patients were analyzed. Mean values were as follows: age — 48 years, BMI — 28, and PAO — 12%. The most common OI included uterine fibroids (52%) and abnormal uterine bleeding (45%). Mean OT, docking time and console time values were 166 min, 15 min, and 123 min, respectively. Mean BL was 93 mL. Mean UW was 256 gr, and DoH was 4 days. Perioperative and postoperative complications were observed in 10% and 20% of the cases, respectively. Conclusions: Robotic-assisted surgery is invaluable in gynaecology, especially in the case of endometriosis, extensive adhesion, and in some oncological patients, as it allows for better visualization and higher maneuverability. In order for a surgeon to prepare for such cases, the use of the robot in benign cases is necessary to complete the learning curve and gain speed

2-[2-(1H-Imidazol-3-ium-5-yl)eth­yl]-3-(pyridin-2-yl)-2H-imidazo[1,5-a]pyridin-4-ium bis­(perchlorate)

In the title mol­ecular salt, C17H17N5 +·2ClO4 −, the dihedral angles between the fused-ring system and the pendant five- and six-membered heterocyclic rings are 6.4 (2) and 41.29 (19)°, respectively. The O atoms of both perchlorate anions are disordered over two sets of sites with occupancy ratios of 0.614 (8):0.386 (8) and 0.591 (7):0.409 (7). An intra­molecular C—H⋯N contact occurs in the cation. In the crystal, the components are linked by N—H⋯O and C—H⋯O hydrogen bonds and π–π stacking inter­actions [centroid–centroid separation = 3.642 (3) Å]

1,1′-(Piperazine-1,4-di­yl)dipropan-2-ol

The asymmetric unit of the crystal contains one-fourth of the title compound, C10H22N2O2, with the centre of the piperazine ring located at a site of 2/m symmetry. The piperazine ring adopts a chair conformation. The methine and methylene C atoms of the 2-hydroxypropyl groups show symmetry-imposed disorder over two equally occupied and mutually exclusive sets of positions. Only intra­molecular O—H⋯N contacts are observed

First-line treatment of patients with HER2-positive metastatic gastric and gastroesophageal junction cancer

Fluoropyrimidine+cisplatin/oxaliplatin+trastuzumab therapy is recommended for the first-line treatment of HER2-positive metastatic gastric adenocarcinoma. However, there is no comprehensive study on which platinum-based treatment should be preferred. This study aimed to compare the treatment response and survival characteristics of patients with HER2-positive metastatic gastric or gastroesophageal junction (GEJ) cancer who received fluorouracil, oxaliplatin, and leucovorin (mFOLFOX)+trastuzumab or cisplatin and fluorouracil (CF)+trastuzumab as first-line therapy. It was a multicenter, retrospective study of the Turkish Oncology Group, which included 243 patients from 21 oncology centers. There were 113 patients in the mFOLFOX+trastuzumab arm and 130 patients in the CF+trastuzumab arm. The median age was 62 years in the mFOLFOX+trastuzumab arm and 61 years in the CF+trastuzumab arm (P = 0.495). 81.4% of patients in the mFOLFOX+trastuzumab arm and 83.1% in the CF+trastuzumab arm had gastric tumor localization (P = 0.735). The median progression-free survival (PFS) was significantly higher in the mFOLFOX+trastuzumab arm (9.4 months vs. 7.3 months, P = 0.024). The median overall survival (OS) was similar in both groups (18.4 months vs. 15.1 months, P = 0.640). Maintenance trastuzumab was continued after chemotherapy in 101 patients. In this subgroup, the median OS was 23.3 months and the median PFS was 13.3 months. In conclusion, mFOLFOX+trastuzumab is similar to CF+trastuzumab in terms of the median OS, but it is more effective in terms of the median PFS in the first-line treatment of HER2-positive metastatic gastric and GEJ cancer. The choice of treatment should be made by considering the prominent toxicity findings of the chemotherapy regimens

Kinetics and equilibrium constants of some pentacyanoferrate(II) complexes of nitrogen and sulfur containing heterocycles

The kinetics of the substitution reactions of Fe(CN)(5)H(2)O(3-)ion with a series of nitrogen and sulfur containing heterocycles were studied in aqueous media. In the presence of excess ligand, varied over a large range of concentrations, second-order rate constants were calculated at mu = 0.100 M NaClO4. Activation parameters for the formation reactions were found, Delta H* and Delta S*, 28 +/- 6 kJ/mol and 135 +/- 20 J/mol, respectively. The results are interpreted as being consistent with dissociative, SN1 mechanism. The kinetics of formation and dissociation were studied by stopped-flow technique at several temperatures. An investigation of the kinetics of exchange of coordinated heterocycles for 1,3,5-triazine, yielded rate saturation that is typical of a limiting SN1 mechanism. Activation parameters of the limiting first-order specific rate of dissociations were found with Delta H* and Delta S* 53 +/- 2 kJ/mol and 105 +/- 5 J/mol, respectively. From the specific rates of formation and dissociation reactions the equilibrium constants were calculated. (C) 1998 John Wiley & Sons, Inc

Synthesis, characterization and formation kinetics of Sn(II) and (IV)-schiff base complexes

The synthesis and characterization of Sn(II) and Sn(IV) complexes of nitrogen and oxygen ligands, {\it p}-dimethyl aminophenylenesalicyladimine ( DPS), N,N'phenylenebis(salicylaldimine)(PBS) and N, N'-triethylenetetramine bis (salicylaldimine)(TTS) are reported. The structure of free ligands and their tin complexes were determined by elemental analysis, ir and nmr measurements. The kinetics of formation of the complexes were studied by stopped-flow technique at several temperatures with $\mu$=0.100 M ($NaClO_4$). Activation parameters \DeltaH^* and \DeltaS^* were determined.The synthesis and characterization of Sn(II) and Sn(IV) complexes of nitrogen and oxygen ligands, {\it p}-dimethyl aminophenylenesalicyladimine ( DPS), N,N'phenylenebis(salicylaldimine)(PBS) and N, N'-triethylenetetramine bis (salicylaldimine)(TTS) are reported. The structure of free ligands and their tin complexes were determined by elemental analysis, ir and nmr measurements. The kinetics of formation of the complexes were studied by stopped-flow technique at several temperatures with $\mu$=0.100 M ($NaClO_4$). Activation parameters \DeltaH^* and \DeltaS^* were determined

Spectrophotometric determination of the pKapK_a values of some aminoacid complexes of pentacyanoferrate (II) and pentacyanoruthenate (II)

The syntheses, $pK_a$ and spectrospcopic characterization of $[Fe(CN)_5(H_2O)]^{-3}$ and $[Ru(CN)_5(H_2O)]^{-3}$ complexes of alanine(Ala), glycine(Gly), valine(Val), lysine(Lys), arginine(Arg) and cysteine(Cys) complexes were investigated in aqueous solution. The spectra of the complexes containing amino acid ligands were similar to that of $[Fe(CN)_5(H_2O)]^{-3}$. The $pK_a$ values of the complexes were measured by spectrophotometric titration at $22^\circ C$ and $\mu =0.100 M(NaClO_4)$.The syntheses, $pK_a$ and spectrospcopic characterization of $[Fe(CN)_5(H_2O)]^{-3}$ and $[Ru(CN)_5(H_2O)]^{-3}$ complexes of alanine(Ala), glycine(Gly), valine(Val), lysine(Lys), arginine(Arg) and cysteine(Cys) complexes were investigated in aqueous solution. The spectra of the complexes containing amino acid ligands were similar to that of $[Fe(CN)_5(H_2O)]^{-3}$. The $pK_a$ values of the complexes were measured by spectrophotometric titration at $22^\circ C$ and $\mu =0.100 M(NaClO_4)$