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Male sex and tumor diameter are independent risk factors for relapse or persistent disease in differentiated thyroid cancer
No full textBackground. Differentiated thyroid cancer (DTC) is one of the most frequently observed neoplasms today. Recurrence of DTC has been previously reported to be dependent on tumor characteristics, the tumor size, the presence of lymph node metastasis, the presence of extra thyroid invasion, the presence of distant metas‑ tasis, oncogenes such as B‑RAF proto‑oncogene, ad‑ vanced age and male sex. However, many studies have failed to associate many of these data with relapse. The objective of the study was to evaluate the re‑ lationship between some histopathological and mor‑ phological findings with thyroid cancer relapse or per‑ sistent disease in a cohort of 393 DTC patients. Methods. We retrospectively analyzed 393 subjects with DTC, diagnosed in our institution between January 2000 and December 2010. Results. Histopathological analysis indicated papil‑ lary carcinoma in 362 (92.1%) subjects and follicular carcinoma in 31 (7.9%) subjects. Eighty‑two (20.9%) of the subjects relapsed or had persistent disease. Male subjects had a higher trend for relapse (RR 1.739 %95 CI: 1.059‑2.856) p=0.029). 18.8% of female sub‑ jects relapsed or had persistent disease, whereas the relapse rate was 30.4% in male subjects. Every 1 cm increase in tumor size increased the risk of relapse by 25% (RR=1.25, 95% CI: 1.11‑1.41, p<0.001). Male sex, nodule diameter, and tumor diameter were detected to be independent parameters for relapse or persistent disease (p=0.002; p<0.0001, p<0.001 respectively). Conclusion. We demonstrated that tumor diameter and male sex were the only parameters affecting re‑ lapse or persistent disease in our cohort. A possible reason for different reports from different studies may be non‑standardization of study protocols and surgical cure rates. Copyright © 2018 Balkan Medical Union
Assessment of Scapular Morphometry
No full textThe current study was undertaken to assess the incidence of different types of suprascapular notch, acromion dimensions and the lower and upper scapular angles. The suprascapular notch and variations of the acromion are clinically important in suprascapular nerve compression and subacromial impingement. Measurements were taken from 73 Anatolian dry scapulae of unknown age or sex. The suprascapuar notch was classified according to that of Rengachary et al. (1979). Its width and depth, the distance between supraglenoid tubercle and the deepest point of notch, as well as the upper and lower scapular angles were also determine measured. The type of acromion was assessed according to shape (type I (cobra), type II (square), type III (intermediate)) and tilt (type I (flat), type II (curve). Acromion length and the distance between acromion and coracoid process were also measured. The frequency of different types of suprascapular notch were type I (28.8 %), type II (23.3 %), type III (13.7 %), type IV (20.5 %), type V (2.7 %), type VI (5.5 %)and absence (5.5 %). Acromion type were type I (45.5 %), type II (7.5 %) and type III (47.0 %), acromion tilt type I (15.2 %), and type II (84.8 %). An understanding of the association between the anatomical structures of the scapula and morphometric measurements is clinically important
Development of a decision support system to select materials for pressure vessels
No full textImprovements in technologies applied in material field and continual increase in the number of material types force to develop and use new approaches in material selection. In this paper, a multi-criteria decision support system, called MATSEL, is developed to make material selection decisions for pressure vessel components more thorough and inclusive. MATSEL consists of two separate stages. In the first elimination stage of the MATSEL, it obtains a feasible set of materials for a specified pressure vessel component. MATSEL, then, uses three different multi criteria approaches namely ELECTRE, TOPSIS and VIKOR in the second stage to rank the feasible materials. An overall total score is obtained by summing the rankings of every feasible material and MATSEL proposes the material with the lowest total score as the most suitable one for the specified component. In this study, the statistical similarities between the rankings are also calculated to analyze the differences between rankings if there are any. Instead of inputting the materials every time MATSEL is used, a material data base is formed with the usage of ASME (American Society of Mechanical Engineers) and Ashby material selection diagrams for selection of alternative materials for the specified application
Acoustic Design of Sivas Cultural Center Multipurpose Hall
No full textWithin the scope of this work, the analysis and evaluation of the acoustic designs which are developed to be provided within the same volume regarding the acoustic conditions intended for different functions including the conference function, the concert function and the opera/theatre function was carried out for the Sivas Cultural Center Multipurpose Hall*. In the light of the analyses, proposals concerning the meeting the requirements of acoustic comfort recommended by the regulations in effect in our country, international standarts and the literature have been submitted. As a result of these proposals that are developed for Sivas Cultural Center Multipurpose Hall, acoustic conditions which are recommended by national /international legislations are fulfilled for 3 different utilization scenarios (conference / concert / opera - theatre functions)
Ketamine dosing for sedation during repeated radiotherapy sessions in children
No full textBackground/aim: We report the analysis of ketamine doses needed and the recovery tones in pediatric oncology patients undergoing repeated radiotherapy sessions.
Materials and methods: In a single-blind prospective study design, thirty-three pediatric patients undergoing radiotherapy due to oncologic disorders received 2 mg/kg ketamine and 10 mu g/kg atropine intravenously and the rescue drug to be administered was ketamine at 0.5 mg/kg when the sedation level was inadequate. Total ketamine consumption, additional doses, and recovery time were recorded.
Results: Data of 635 consecutive radiotherapy sessions were evaluated. There was no significant alteration in total ketamine consumption required to complete the radiotherapy periods during consecutive procedures (P > 0.05). However, the recovery times started to decrease by the fourth session (P = 0.02) and continued to decrease onwards during the whole study period (P = 0.001). The mean of the first recovery time was 13.68 +/- 3.99 min, whereas the mean of the last recovery time was 7.66 +/- 6.35 min.
Conclusion: A requirement for an incremental increase in ketamine dose after subsequent administrations was not detected, despite a significant decrease in recovery times being anticipated when ketamine is used repeatedly for sedative purposes in consecutive radiotherapy sessions
RmSAT-CFAR: Fast and accurate target detection in radar images
No full textAs the first step of automatic image interpretation systems, automatic detection of the targets should be accurate and fast. Constant False Alarm Rate (CFAR) is the most popular target detection framework for Synthetic Aperture Radar (SAR) images. For CFAR, modeling of the clutter is crucial since the decision threshold is calculated based on this model. We have developed a new target detection approach in which clutter is modeled using a Rayleigh mixture model that fits well to a variety of high-resolution SAR imagery. For computational efficiency, we use summed area tables (SAT) for computing background statistics. The resulting approach, called RmSAT-CFAR, is a promising general-purpose SAR target detection tool. This paper describes the open-source software for RmSAT-CFAR. Details of RmSAT-CFAR is published in the study named Fast Target Detection in Radar Images using Rayleigh Mixtures and Summed Area Tables. In addition to Rayleigh mixture and SATs, the software also uses tiling and parallelization to obtain faster and scalable results. This software repository also contains open source implementations for following algorithms: (a) Cell Averaging CFAR (CA-CFAR), (b) Automatic Censored CFAR (AC-CFAR), and (c) Adaptive and Fast CFAR (AAF-CFAR). (C) 2017 The Authors. Published by Elsevier B.V
Serum Magnesium and Calcium Levels in Children With Breath-holding Spells
No full textObjective: Although breath-holding spells (BHS) are the most common form of non epileptic paroxysmal events in infancy, the pathophysiology of these events remain unknown. Several studies have indicated that multiple factors can be involved in the pathogenesis of BHS. The aim of this study was to assess the associations between BHS and serum magnesium and calcium levels.
Materials and Methods: This prospective, case-control study enrolled 79 consecutive children with BHS and 114 healthy children, who were included as controls, without any illness between October 2012 and January 2014. Mean hemoglobin (Hb), mean corpuscular volume, serum iron, serum iron binding protein, magnesium(Mg), calcium(Ca), phosphorus (P), and alkaline phosphatase levels and Ca/Mg ratiowere compared between the two groups.
Results: Overall, the Hb, Ca, and P levels were in the normal range in both groups; however, the mean Hb, Ca, and P levels were significantly lower in the BHS group than in the control group. Furthermore, there was no significant difference in the mean serum Mg level or Ca/Mg ratio between the groups.
Conclusion: Therefore, low Hb, Ca, and P levels may decrease the threshold of BHS and thus constitute a risk factor for the development of BHS
Outcomes for core decompression with multiple drilling of the osteonecrosis of the femoral head in patients with solid organ transplantation
No full textObjectives: This study aims to investigate the clinical and radiological outcomes of core decompression surgery performed with multiple drilling in solid organ transplantation patients with osteonecrosis of femoral head (ONFH) and evaluate the effectiveness of this procedure in regard to duration of corticosteroid use and stage of osteonecrosis.
Patients and methods: A total of 22 solid organ transplantation (kidney, liver or heart) patients (14 males, 8 females; mean age 43.3 years; range. 23 to 67 years) who were scheduled to undergo core decompression surgery with multiple drilling for ONFH were evaluated. Patients' Harris hip scores (HHSs) and radiographic data including Association Research Circulation Osseous (ARCO) staging and Kerboul grading were retrospectively reviewed at pre- and postoperative controls.
Results: Patients were followed-up for mean 34.3 months (range, 12 to 76 months). Two patients (9.09%) were performed total hip arthroplasty. These two patients' Kerboul grade was 3. There was no statistically significant relationship between preoperation and postoperative final control in terms of ARCO staging. There was no statistically significant difference between pre- and postoperative HHSs.
Conclusion: Although multiple drilling is a safe and minimally invasive surgery, its effect is limited, particularly in solid organ transplantation patients with ONFH due to long-term corticosteroid use. Therefore, solid organ transplantation patients should be closely monitored in terms of ONFH development
Retinal detachment in albinism
No full textPurpose: To report the visual and anatomic outcomes of albino retinal detachment (ARD) repair.
Methods: Collaborative retrospective analysis of ARD. Outcome measures were number of surgical interventions, final retinal reattachment, and best corrected visual acuity (BCVA) at last follow-up.
Results: Seventeen eyes of 16 patients (12 males; mean age =37.8 years) had the following complications at presentation: macula off (14), total (7) or inferior detachment (5), proliferative vitreoretinopathy (5), detectable break (16), lattice (5), horseshoe tears (9), and giant tear or dialysis (4). Mean number of interventions was 1.8 (range = 1-5) and included cryopexy (15) with scleral buckle (11), and/or vitrectomy (8). Mean initial BCVA was counting finger (CF) 1 m and at last follow-up (mean 77 months) CF4m with mean improvement of 4.5 lines (early treatment diabetic retinopathy study) (P=0.05). Intraoperative choroidal hemorrhage occurred in three eyes. The retina was finally attached in 14 eyes, with residual inferior detachment in three eyes with silicone oil in situ. Silicone oil was kept in six of seven eyes because of residual inferior detachment (3) and removal of silicone oil, which led to redetachment (1) or fear of redetachment (2).
Conclusion: Repair of ARD may require several interventions, with the need to keep silicone oil in several cases due to nystagmus and reduced melanin pigment
Percutaneous Balloon Kyphoplasty Vertebral Augmentation for Compression Fracture Due to Vertebral Metastasis: A 12-Month Retrospective Clinical Study in 72 Patients
No full textBackground: Vertebral compression fracture is common in osteoporosis, but can also occur due to bone metastases, for which current treatment options are limited and include bone-strengthening with cement and supportive care. Kyphoplasty is a surgical method of bone augmentation that can reduce pain, stabilize vertebral bone, and restore some or all of the vertebral body height. The aim of this study was to investigate the clinical results of balloon kyphoplasty in the correction of vertebral deformity due to metastatic vertebral compression fracture.
Material/Methods: A retrospective clinical study included 72 patients (82 vertebral bodies) with metastases resulting in vertebral compression fracture, treated by percutaneous balloon kyphoplasty; 9 patients were found incidentally to have vertebral metastases. Bone mineral density (BMD) levels were measured. Patient responses from questionnaires, including the visual analog scale (VAS) for pain intensity, and the Oswestry Disability Index (ODI) for disability, were scored. The local kyphosis angle (KA) and the vertebral height ratio (VHR) were measured. All patients were followed up for 12 months. The initial postoperative and 12-month postoperative values, and the preoperative and postoperative values were compared.
Results: Following balloon kyphoplasty, the KA, VHR, VAS, and ODI scores significantly improved at the final 12-month follow-up compared with preoperative levels (p<0.05, and p<0.001). There was cement leakage in 6 procedures (8.3%) and adjacent segment fracture in 11 procedures (15.2%).
Conclusions: Balloon kyphoplasty was an effective method to reduce pain, reduce disability, and improve quality of life by eliminating kyphotic deformity in pathological vertebral compression fractures due to vertebral metastases