erectile function after radical prostatectomy

In this study our aim is to increase the understanding of the prostate and related organs anatomy for better continence and erectile function results after urological surgery. Prostate and related organs were dissected from seven cadavers. After dissection, 165 serial sections with 300 mu m thickness were derived at a 100 mu m interval. The histological images were examined and imported to the computer. Three-dimensional (3D) remodeling had been performed. The findings were evaluated into three categories: macroscopic, microscopic and 3D reconstruction. Striated muscle fibers had been detected at the anterior fibromuscular stroma in histological sections. In 3D remodeling, urethra seemed to be a complete functional unit, beginning from the trigone up to the membranous urethra. The neurovascular bundles run under the pelvic fascia on both sides and go through to the bladder neck at 5 and 7 o'clock. Computer remodeling demonstrated that neurovascular structures had a close association with the bladder neck and the seminal vesicle. Computer program made it possible to rotate all 3D-reconstructed figures by 3601 and examine them from all possible angles. All reconstructed structures can be examined together at the same time or one by one. Surgeons must pay special attention to the continence area described as a single unit, beginning from trigone to the membranous urethra, during the surgery. Meticulous dissection of the neurovascular bundles, especially close to the seminal vesicles and bladder neck, during the radical prostatectomy is necessary. These reconstructions can be used for the educational purpose of medical students as well as the urology surgeons

Are cascading flows stable?

The stability of flows cascading down slopes as dense inclined plumes is examined, with particular reference to flows observed in Lake Geneva during winter periods of severe cooling. A previous conjecture by Turner that the flow may be in a state of marginal stability is confirmed: the observed mean velocity and density profiles are unstable to Kelvin-Helmholtz instability, but only marginally so; the growth rates of the most unstable small disturbances to the cascading flow in Lake Geneva are small, with e-folding periods of about 2 h. A reduction in the maximum velocity by about 20% is required to stabilize the flow. The possibility that stationary hydraulic jumps may occur in the observed flow is also considered. Several plausible flow states downstream of transitions are examined, allowing for mixing and density changes to occur, ranging from one that preserves the shape of the density and velocity profiles to one in which, as a consequence of mixing, the velocity and density become uniform in depth within the cascading flow. Neither of these extreme states is found to conserve the fluxes of volume, mass and momentum through a transition in which the energy flux does not increase, and to be unique or ‘stable' in the sense that no further transition is possible to a similar flow state without more entrainment. Stable transitions to intermediate downstream flows that conserve flow properties and reduce energy flux are, however, found, although the smallest value of the flow parameter, Fr≡ Umax2/gΔ h (where Umax is the maximum flow speed, g is the acceleration due to gravity, Δ is a fractional density difference within the flow and h is the flow thickness) at which transitions may occur is only slightly less than that of the cascading flow in Lake Geneva. In this sense, the observed flow is marginally unstable to a finite-amplitude transition or hydraulic jump. Velocity and density profiles of possible flows downstream of a transition are found. The amplitudes of possible transitions and the flux of water entrained from the ambient overlying water mass are limited to narrow range

Full numerical simulations of multifluid flows

To fully understand the behavior of multifluid systems, one must have good insight into the basic micromechanisms that govern the evolution of a single ‘‘structure’’ (e.g., a bubble or a drop) and the interactions of a few such basic entities. In addition to the usual questions about the relative magnitude of the various physical effects (inertia, viscosity, and surface tension) for multifluid systems, the effects of surface phenomena such as contaminants must be addressed. Full numerical simulations are, in principle, ideally suited to provide this information. Not only are all the quantitative data readily available, but various physical processes can be turned on and off at will. In practice, however, simulations of multifluid problems are one of the difficult areas of computational fluid dynamics. Almost all current studies of multifluid problems make a number of simplifications, such as inviscidness, Stokes flow, two‐dimensionality, or axisymmetry. Although such models capture some of the important behavior, they often put severe constraints on the problems that can be investigated.Many of the fundamental processes in multifluid flow involve fully three‐dimensional flows, where both inertia and viscous effects must be accounted for. To address these effects, we have recently developed a front‐tracking method for multifluid, incompressible flows that appears to be both accurate and robust. The method has been implemented for both two‐ as well as fully three‐dimensional situations. In this paper, we will discuss two problems that we are currently investigating using this numerical method: the Rayleigh–Taylor instability and the motion of bubbles and drops. For fluid mixing induced by unstable stratification, the Rayleigh–Taylor instability where a heavy fluid falls into a lighter underlying fluid, is the prototypical example. Indeed, for such flows its importance is similar to that of the Kelvin–Helmholtz instability for fluid mixing induced by a shear flow. For small density stratification, we show that three‐dimensionality can lead to a large amplitude vortex structure that differs considerably from what two‐dimensional simulations predict. The different vortical configuration leads to more rapid nonlinear growth for the fully three‐dimensional case, even though the linear growth rate is the same. We also show how viscosity stratification modifies the evolution. For the weakly stratified case, where inviscid calculations predict symmetric evolution with respect to the heavy and the light fluid, viscosity stratification leads to considerable asymmetry, with the more viscous fluid forming big round bubbles and the less viscous one being confined to narrow fingers. The effect of density stratification for viscous three‐dimensional motion will also be discussed. For many mixing problems, the long‐time state consists of a dispersed phase that forms drops or bubbles in another phase. We will discuss preliminary investigations of such flows. Calculations of rising bubbles for various values of surface tension and viscosity (both in two and three dimensions) appear to correlate well with experimental observations and steady‐state calculations in the literature. The interactions of bubbles with each other, density interfaces, and vortices will also be discussed.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/69841/2/PFADEB-3-5-1455-1.pd

Patients With Kidney Cancer

To develop a preoperative prognostic model in order to predict recurrence-free survival in patients with nonmetastatic kidney cancer.A multi-institutional data base of 1889 patients who underwent surgical resection between 1987 and 2007 for kidney cancer was retrospectively analyzed. Preoperative variables were defined as age, gender, presentation, size, presence of radiological lymph nodes and clinical stage. Univariate and multivariate analyses of the variables were performed using the Cox proportional hazards regression model. A model was developed with preoperative variables as predictors of recurrence after nephrectomy. Internal validation was performed by Harrells concordance index.The median follow-up was 23.6 months (1222 months). During the follow-up, 258 patients (13.7) developed cancer recurrence. The median follow-up for patients who did not develop recurrence was 25 months. The median time from surgery to recurrence was 13 months. The 5-year freedom from recurrence probability was 78.6. All variables except age were associated with freedom from recurrence in multivariate analyses (P 0.05). Age was marginally significant in the univariate analysis. All variables were included in the predictive model. The calculated c-index was 0.747.This preoperative model utilizes easy to obtain clinical variables and predicts the likelihood of development of recurrent disease in patients with kidney tumors

Anakinra for secondary amyloidosis in an adolescent with FMF and Behcet Disease

PubMe

Effect of Composition on the Spontaneous Emission Probabilities, simulated Emission Cross Sections and Local Environment of Tm+3, in Teo2-Wo3 Glass'

Cataloged from PDF version of article.Effect of composition on the structure, spontaneous and stimulated emission probabilities of various 1.0 mol% Tm2O3 doped (1 - x)TeO2 + (x)WO3 glasses were investigated using Raman spectroscopy, ultraviolet-visible-near-infrared (UV/VIS/NIR) absorption and luminescence measurements. Absorption measurements in the UV/VIS/NIR region were used to determine spontaneous emission probabilities for the 4f-4f transitions of Tm3+ ions. Six absorption bands corresponding to the absorption of the (1)G(4), F-3(2), F-3(3) and F-3(4), H-3(5) and H-3(4) levels from the H-3(6) ground level were observed. Integrated absorption cross-section of each band except that of H-3(5) level was found to vary with the glass composition. Luminescence spectra of the samples were measured upon 457.9 nm excitation. Three emission bands centered at 476 nm ((1)G(4) --> H-3(6) transition), 651 nm ((1)G(4) --> H-3(4) transition) and 800 nm ((1)G(4) --> H-3(5) transition) were observed. Spontaneous emission cross-sections together with the luminescence spectra measured upon 457.9 nm excitation were used to determine the stimulated emission cross-sections of these emissions. The effect of glass composition on the Judd-Ofelt parameters and therefore on the spontaneous and the stimulated emission cross-sections for the metastable levels of Tm3+ ions were discussed in detail. The effect of temperature on the stimulated emission cross-sections for the emissions observed upon 457.9 nm excitation was also discussed. (C) 2002 Elsevier Science B.V. All rights reserved

Light harvesting with Ge quantum dots embedded in SiO2 and Si3N4

Cataloged from PDF version of article.Germanium quantum dots (QDs) embedded in SiO2 or in Si3N4 have been studied for light harvesting purposes. SiGeO or SiGeN thin films, produced by plasma enhanced chemical vapor deposition, have been annealed up to 850 degrees C to induce Ge QD precipitation in Si based matrices. By varying the Ge content, the QD diameter can be tuned in the 3-9 nm range in the SiO2 matrix, or in the 1-2 nm range in the Si3N4 matrix, as measured by transmission electron microscopy. Thus, Si3N4 matrix hosts Ge QDs at higher density and more closely spaced than SiO2 matrix. Raman spectroscopy revealed a higher threshold for amorphous-to-crystalline transition for Ge QDs embedded in Si3N4 matrix in comparison with those in the SiO2 host. Light absorption by Ge QDs is shown to be more effective in Si3N4 matrix, due to the optical bandgap (0.9-1.6 eV) being lower than in SiO2 matrix (1.2-2.2 eV). Significant photoresponse with a large measured internal quantum efficiency has been observed for Ge QDs in Si3N4 matrix when they are used as a sensitive layer in a photodetector device. These data will be presented and discussed, opening new routes for application of Ge QDs in light harvesting devices. (C) 2014 AIP Publishing LLC

Different histological classifications for Henoch-Schönlein purpura nephritis : which one should be used?

Background: Nephritis is the most important chronic complication of IgA Vasculitis (IgAV)/Henoch-Sch\uf6nlein purpura (IGAV/HSP) and thus the main prognostic factor of this most common childhood vasculitis. Since the prognosis and treatment selection depends on the mode of interpretation of biopsy material, in this manuscript we have presented several issues related to the uneven application of different histological classifications in IgAV/Henoch-Sch\uf6nlein purpura nephritis (HSPN). The nephritis of IgAV/IGAV/HSP will be abbreviated as HSPN for this paper. Main body: In clinical practice we use different histological classifications for HSPN. It is not known which of these classifications best correlates with severity of renal disease and renal outcome in IgAV/IGAV/HSP. One of the major problem with existing histological classifications is that there is no consensus on the implementation of biopsy in the treatment of HSPN. There is a histologic classification system conventionally used in HSPN, of the International Study of Kidney Disease in Children (ISKDC). On the other hand there is the new classification system suggested for IgA nephropathy, the Oxford classification. The latter has been validated only in IgA nephropathy. There are also two further histologic classifications of Haas and Koskela that have been developed. Current treatment strategies in HSPN are not standardised nor predominantly based on histological classification. Conclusion: One of the possible solutions to problems related to the application of different histological classification in HSPN is the implementation of multicenter multinational prospective studies with joint collaboration between pediatric rheumatologists, nephrologists and nephropathologists to correlate the clinical features and outcome with the classification systems as well among the classifications. This classification should be the basis for the construction of guidelines for the treatment of patients with HSPN

Comparison of emotional approaches of medical doctors against COVID-19 pandemic: Eastern and Western Mediterranean countries

Background: Pandemics are states of disease that occur worldwide and sharply increase in populations. It causes life events which trigger anxiety, depression, anger, sleep deprivation, emotional distress and stress. World Health Organization (WHO) declared coronavirus disease 2019 (COVID-19) a pandemic on March 11, pointing to the over 118,000 cases in over 110 countries. Many healthcare workers became ill during the pandemic and some among them died. In this study, we aimed to evaluate and compare level of stress against COVID-19 pandemic among doctors from Turkey and Italy. Methods: This research is a cross-sectional study in which Perceived Stress Scale (PSS-10) and Secondary Traumatic Stress Scale (STSS) are administered online via social networks. All data collection tools were delivered to individuals between 1 and 15 June 2020 and filled in online with Google Forms application. In total, 618 individuals were included in this study and all of them were medical doctors. Results: Higher PS and STS levels were found related to female gender, being married, working in pandemic hospital and older ages. Stress levels were found statistically higher in Turkish doctors when compared to Italian doctors for both stress scales (Turkish/Italian PSS:20.18 ± 7.90/ 19.35 ± 6.71, STSS: 44.19 ± 13.29/ 38.83 ± 13.74). Conclusion: The number of doctors per 1000 of population is lower and per capita visits to a physician are higher in Turkey when compared to Italy. Besides pandemic, these heavier working conditions, increased weekly working hours can cause stress for Turkish doctors. Reporting information such this study is important and international collaborations are essential to plan future prevention strategies. We need to strengthen international ties and build more international collaborations rather than staying within our national silos. Additionally, interventions to promote mental well-being in health care professionals exposed to COVID-19 need to be immediately implemented

Comparison of α-glucosyl hesperidin of citrus fruits and epigallocatechin gallate of green tea on the Loss of Rotavirus Infectivity in Cell Culture

A number of secondary plant metabolites (e.g., flavonoids) possess antiviral/antimicrobial activity. Most flavonoids, however, are difficult to study, as they are immiscible in water-based systems. The relatively new semisynthetic α-glucosyl hesperitin (GH), and the natural plant product epigallocatechin gallate (EGCG) are unique among most flavonoids, as these flavonoids are highly soluble. The antiviral activity of these plant metabolites were investigated using the rotavirus as a model enteric virus system. Direct loss of virus structural integrity in cell-free suspension and titration of amplified RTV in host cell cultures was measured by a quantitative enzyme-linked immunosorbent assay (qEIA). After 30 min. 100 × 103 μg/ml GH reduced RTV antigen levels by ca. 90%. The same compound reduced infectivity (replication in cell culture) by a similar order of magnitude 3 to 4 days post inoculation. After 3 days in culture, EGCG concentrations of 80, 160, and 320 μg/ml reduced RTV infectivity titer levels to ca. 50, 20, and 15% of the control, respectively. Loss of RTV infectivity titers occurred following viral treatment by parallel testing of both GH and EGCG, with the latter, markedly more effective. Cytotoxicity testing showed no adverse effects by the phenolic concentrations used in this study. The unique chemical structure of each flavonoid rather than each phenolic’s inherent solubility may be ascribed to those marked differences between each molecule’s antiviral (anti-RTV) effects. The solubility of EGCG and GH obviated our need to use potentially confounding or obfuscating carrier molecules (e.g., methanol, ethanol, DMSO) denoting our use of a pure system environ. Our work further denotes the need to address the unique chemical nature of secondary plant metabolites before any broad generalizations in flavonoid (antiviral) activity may be proposed