The bulbar urethra is the location where urethral stricture is most commonly observed. The most successful method for long and recurrent urethral stenosis is graft urethroplasty. The most successful ...graft source is buccal mucosa, with advantages like easy adaptation to the corporeal bed, thick epithelium, thin lamina propria with rich vascular structure and easy ability to obtain the graft. In this study we aimed to retrospectively assess the outcomes and predictive factors affecting surgical success of our buccal mucosal graft urethroplasty surgery performed for bulbar urethra stenosis with moderate length.
In this study, we monitored 51 patients with mean 4.4 cm bulbar urethral stricture length for mean 17 months follow-up. From operative and postoperative data, stenosis length, operation duration, Qmax, International Prostate Symptom Score, International Index of Erectile Function-Erectile Function and OF, success rates in total and in subgroups (age, according to DVIU, etiology, BMI and DM), follow-up duration, complications, re-stricture time and number were assessed.
The total success of the operations was 86.3%. In 17 months, the re-stricture rate was 13.7%. Oral and urethral complications were all minor. The complications with longest duration (6 months) were ejaculation, erection problems and urethral fistula. Mean time to re-stricture was 11 months. All re-stricture patients were relieved by one DVIU session each.
For bulbar urethral stricture longer than 2 cm and with recurrence, the dorsal buccal mucosa graft replacement is a very successful method with low complication rates.
La uretra bulbar es la localización en la que se observa con más frecuencia la estenosis uretral. La técnica con mayores tasas de éxito para el tratamiento de estenosis largas y recurrentes que facetan la uretra es la uretroplastia con injerto. La procedencia del injerto que ha mostrado resultados más satisfactorios es la mucosa oral, por sus beneficios como la fácil adaptación al lecho de cuerpos cavernosos, un epitelio grueso, una lámina propia fina con una estructura vascular rica, además de ser fácil de obtener. En este estudio nos propusimos evaluar retrospectivamente los resultados de nuestra cirugía de uretroplastia con injerto de mucosa oral realizada para la estenosis de uretra bulbar con longitud moderada y los factores predictivos asociados al éxito quirúrgico.
En este estudio se evaluaron 51 pacientes con una longitud media de 4,4 cm de estenosis de uretra bulbar durante una media de 17 meses de seguimiento. A partir de los datos operatorios y postoperatorios, se evaluó la longitud de la estenosis, el tiempo quirúrgico, el Qmax, la IPSS, la IIEF-EF y la OF, las tasas de éxito globales y por subgrupos (edad, según sesiones de UIVD, etiología, IMC y DM), la duración del seguimiento, las complicaciones, el tiempo y el número de reestenosis.
El éxito global de las intervenciones fue del 86,3%. En 17 meses, la tasa de reestenosis fue del 13,7%. Las complicaciones orales y uretrales fueron todas menores. Las complicaciones de mayor duración (6 meses) fueron los trastornos de eyaculación y erección y la fístula uretral. El tiempo medio de reestenosis fue de 11 meses. Todos los pacientes con reestenosis se resolvieron con una sesión de UIVD cada uno.
Para la estenosis de uretra bulbar de más de 2 cm y recurrentes, la sustitución con injerto de mucosa bucal dorsal es un método muy exitoso con tasas bajas de complicaciones.
Background
Heart failure with preserved ejection fraction (HFpEF) is a syndrome in which patients have symptoms and signs of heart failure but preserved ejection fraction. Left atrial (LA) volume and ...function are known to be impaired in these patients. Two-dimensional speckle-tracking echocardiography (2D-STE) has recently enabled the quantification of LA deformation dynamics. In this study, we evaluated the use of 2D-STE for the diagnosis of HFpEF.
Patients and methods
The study included 83 patients with suspected HFpEF. Patients were divided into two groups after HFpEF had been diagnosed according to current guidelines. Parameters of diastolic dysfunction were evaluated, including left ventricular mass index (LVMI), LA volume index (LAVI), E/A ratio, deceleration time (DT), E/E’, and STE parameters such as global longitudinal LA strain during ventricular systole (GLAs-res) and strain during late diastole (GLAs-pump).
Results
The values of BNP, LVMI, DT, LAVI, and GLAs-res were significantly different between the two groups. In univariate analysis, a strong negative correlation was seen between GLAs-res and BNP (
r
= −0.567,
p
< 0.001) as well as between GLAs-res and DT (
r
= −0.665,
p
< 0.001), while a moderate negative correlation was found between GLAs-res and LVMI (
r
= −0.458,
p
< 0.001) and GLAs-res and LAVI (
r
= −0.316,
p
= 0.004). In logistic regression analysis, GLAs-res (
p =
0.049, OR = 0.71, 95 % CI = 0.451–0.99), BNP (
p =
0.025, OR = 1.08, 95 % CI = 1.01–1.14), and LAVI (
p =
0.042, OR = 1.59, 95 % CI = 1.02–2.48) were found to be independent predictors of HFpEF.
Conclusion
LA function as assessed by 2D-STE is impaired in patients with HFpEF. A GLAs-res value of < 17.5 % can be useful for the diagnosis of HFpEF.
Abstract
Study question
Does serum Kisspeptin (KP) levels discriminate between fertile and infertile women with polycystic ovary syndrome (PCOS)?
Summary answer
Serum KP levels can be used as a ...potential discriminatory biomarker for infertility in women with PCOS.
What is known already
PCOS is the most common cause of anovulatory infertility and not fully elucidated pathology. A persistent rapid gonadotropin-releasing hormone (GnRH) pulse frequency in patients with PCOS exist throughout ovulatory cycle. KP is a neuropeptide that increases GnRH pulsatile release during ovulation. Therefore, KP may have a key role as a central regulator of fertility in PCOS patients. Although, recent studies showed that the KP concentration is higher in PCOS patients, the evidence is limited as to whether serum KP levels determine infertility in PCOS.
Study design, size, duration
This was a single center prospective cohort study conducted at Goztepe Prof. Dr. Suleyman Yalcin City Hospital Affiliated to Istanbul Medeniyet University, Istanbul, Turkey between January 2023 to February 2023. Our study enrolled 30 fertile and 30 infertile women with PCOS, who were aged between 18 and 45 years. PCOS was defined according to the criteria of the Rotterdam ESHRE- ASRM sponsored consensus group (2004).
Participants/materials, setting, methods
Venous blood samples from the participants were obtained after fasting and between 8 a.m. and 10 a.m. on days 2-5 of the menstrual cycle. Samples were thawed, and a human KISS1 (Kisspeptin 1) ELISA kit (Elabscience, USA,lot no:E-EL-H5618) was applied to measure KP serum concentrations. Patient characteristics and KP concentrations were compared among the two groups. Statistical analysis was performed by Mann-Whitney, Spearman correlations, and linear regression analysis. A p-value <0.05 was considered significant.
Main results and the role of chance
The mean age of the patients was 27.57±5.39 years in the fertile PCOS group and 26.80± 4.85 years in the infertile PCOS group (p = 0.63). There was no significant difference among the groups in terms of body mass index (BMI), duration of infertility, serum FSH, LH, LH-to-FSH ratio, E2, antimullerian hormone (AMH), TSH, prolactin, 17OHP, total testosterone, SHBG, HbA1c, HOMA-IR, neutrophil–lymphocyte ratio levels and antral follicle count (AFC). DHEA-S was significantly higher in the infertile PCOS group (306.73±94.869 mcg/ dL), compared to the fertile PCOS group (258.08±84.29 mcg/ dL, p = 0.037). The mean KP level was significantly higher in the infertile PCOS group (444.80±136.61 ng/ mL), compared to the fertile PCOS group (333.02±131.10 ng/ mL, p = 0.001). The KP level was positively correlated with AFC, AMH, and total testosterone levels (R = 0.495, R = 0.548, R = 0.362, p < 0.05, respectively) in the infertile PCOS group. Furthermore, ROC analysis showed that the optimal cut-point value was found to be 285.59. When this cut-off value of serum KP levels was taken, the sensitivity was 0.96 and the specificity was 0.50. Linear regression analysis revealed that AMH was positively associated with KP levels (p = 0.022).
Limitations, reasons for caution
Due to the limited number of women with available samples, we were not able to analyze KP serum levels according to specific PCOS phenotypes
Wider implications of the findings
Serum KP levels are higher in infertile women with PCOS compared to fertile women with PCOS. Infertility caused by PCOS can be predicted by serum KP levels. In the future identification, KP in PCOS may be applied to develop potential therapeutic agents.
Trial registration number
Not applicable
Particle Flow Algorithms (PFAs) attempt to measure each particle in a hadronic jet individually, using the detector subsystem that provides the best energy/momentum resolution. Calorimeters that can ...exploit the power of PFAs emphasize spatial granularity over single particle energy resolution. In this context, the CALICE Collaboration developed the Digital Hadron Calorimeter (DHCAL). The DHCAL uses Resistive Plate Chambers (RPCs) as active media and is read out with 1 × 1 cm
2
pads and digital (1-bit) resolution. In order to obtain a unique dataset of electromagnetic and hadronic interactions with unprecedented spatial resolution, the DHCAL went through a broad test beam program. In addition to conventional calorimetry, the DHCAL offers detailed measurements of event shapes, rigorous tests of simulation models and various analytical tools to improve calorimetric performance. Here we report on the results from the analysis of DHCAL data and comparisons with the Monte Carlo simulations.
We aimed to reveal the role of 5-fluorouracil (5-FU) and Leucovorin (LV) along with transient receptor potential protein melastatin 2 (TRPM2) channels in breast and colon cancer cells during the ...treatment process.
5-FU and LV are widely used in breast and colon cancers for chemotherapy. It has been reported that the expression of TRPM2 channels increased intensively in cancer cells.
Breast (MCF7) and colon (Caco-2) cells were cultured and divided into seven main groups. The cells in the group were incubated with 5-FU and LV for 24 hrs and then incubated with Antranilic acid. The effects of medicines were investigated on all molecular pathways of apoptosis.
It was found that 5FU and LCV, administered separately and together on breast cancer cell culture and colon cancer cell culture increased the intracellular calcium levels by stimulation of TRPM2 channels in both cancer cells.
As the result of our study, it has been shown that apoptotic effects of 5FU and LV on both colon and breast cancer cells were directly related to TRPM2 channels and that TRPM2 channels played an important role in the whole molecular pathway of apoptosis leading to increased intracellular Ca2+ (Ca2+) levels and increased mitochondrial depolarisation (Fig. 6, Ref. 43).
Objectives:
Previous studies showed the association between the major adverse cardiovascular outcomes and both higher neutrophil and lower lymphocyte counts. We aimed to investigate whether there is ...an association between the neutrophil-lymphocyte ratio (NLR) value and the development of coronary collateral circulation (CCC) in patients with coronary chronic total occlusion (CTO).
Methods:
A total of 274 patients with CTO were included in this study. Patients were then classified according to their Rentrop collateral grades as either poor (Rentrop grades 0-1) or good (Rentrop grades 2-3). Clinical information and analyses of blood samples were obtained from a review of the patients’ charts.
Results:
Although there was no difference between the two groups with regard to cardiovascular risk profiles, the NLR values were significantly higher in the patients who had poorly developed CCC (2.6 ± 0.5 vs 2.2 ± 0.4, p<0.001). NLR, high-sensitivity C-reactive protein (hs-CRP), white blood cell count (WBC), age, diabetes, fasting glucose levels and body mass index were found to have univariate association with poorly developed CCC (p<0.1). In a multivariate logistic regression model, NLR (odds ratio 1.88, 95% confidence interval (CI) 1.37–2.74; p<0.001), high-sensitivity C-reactive protein and WBC were found to be the independent predictors of poor CCC. In receiver operator characteristic curve analysis, the optimal cut-off value of NLR to predict poor CCC was found as 2.17, with 77% sensitivity and 65% specificity.
Conclusion:
NLR, as a novel cardiovascular risk marker, is an important, simple and inexpensive method which can be used by the cardiologist as a screening inflammation tool to estimate the development of CCC in patients with CTO.
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