Effect of verumontanum resection in transurethral resection of the prostate on postoperative voiding function and incontinence

Objective: We evaluated the effect of verumontanum resection after transurethral resection of the prostate on postoperative urination and incontinence symptoms in patients. Materials and Methods: A total of 68 patients who had undergone transurethral resection of the prostate during the period between January 2006 and January 2009 were included in the study. The patients were separated into two groups. After transurethral resection of the prostate, a verumontanum resection was carried out in the first group of patients, but no additional operation was carried out in the second group. At the end of the third and sixth months, all patients were assessed in terms of the International Prostate Symptom Score, maximum urinary flow rate, quality of life and urinary incontinence. Results: At the end of the sixth month, the obstructive International Prostate Symptom Score of the group in which verumontanum resection was carried out was found to be significantly better, but in terms of other parameters, no significant differences were detected between the two groups. The results achieved at the end of the sixth month were significantly better then the third month's results in both groups. In one patient who had a verumontanum resection, total incontinence developed and, consequently, an artificial urinary sphincter was placed. Conclusion: Although verumontanum resection causes no serious urination changes in patients, it was shown that the verumontanum and its circumference can be safely resected without affecting the patient's continence status.     

Relationship disorders and cognitive functioning in young children

The aim of this study was to investigate the cognitive functioning of young children with or without relationship disorders with their mother. Mother-infant dyads were recruited during the first three postpartum days. Parent Infant Relationship Global Assessment Scale (PIRGAS) scores and mother-child relationship disorders were decided when children were 41-49 months of age by integrating the data obtained from psychiatric interview with mothers, Clinical Problem Solving Procedure (CPSP) and home observation. Cognitive functioning of young children was evaluated with Stanford-Binet Intelligence Scale. The young children without relationship problems/disorders had higher intelligence quotient (IQ) scores even after controlling for the effect of independent variables on cognitive functioning. These findings suggest that there is a link between the quality of the mother-child relationship and cognitive functioning in young children. Therefore, physicians should assess the interactions of children with their mothers even if they are brought for reasons other than relationship problems.     

Kras-mutation influences outcomes for palliative primary tumor resection in advanced colorectal cancer-a Turkish Oncology Group study

Purpose

We aimed to investigate the prognostic effect of primary tumor resection (PTR) prior to bevacizumab-based treatments in unresectable metastatic colorectal cancer (mCRC).

Managerial Control Vs Professional Autonomy: An Empirical Study on Perceptions and Expectations of Physicians at Teaching Hospitals in Turkey

This study investigates the effects of work context on professional job processes in large organizations in general, and the differences of perceptions and expectations of physicians for professional autonomy in different work environments in specific. An empirical study was conducted on “perceptions and expectations of physicians” in terms of their control over diagnosis and treatment process in different teaching hospitals in Turkey. Results exhibit that the difference between expectation and perception on “the control over diagnosis and treatment process”, one of the crucial elements in professional autonomy of physicians, is statistically significant among the surveyed hospitals. The reason of this difference seems to be the managerial practices of each organization. Thus, the study emphasizes the need of assessing the problematic job procedures and of changing them with the most effective ones to create a synergy instead of conflict in the work setting. This synergy in the health care organizations means a balance between managerial control and professional autonomy and a better health service to the patient.     

Percutaneous Treatment of Splenic Cystic Echinococcosis: Results of 12 Cases

Purpose

Cystic echinococcosis (CE) in the spleen is a rare disease even in endemic regions. The aim of this study was to examine the efficacy of percutaneous treatment for splenic CE.

Materials and Methods

Twelve patients (four men, eight women) with splenic CE were included in this study. For percutaneous treatment, CE1 and CE3A splenic hydatid cysts were treated with either the PAIR (puncture, aspiration, injection, respiration) technique or the catheterization technique.

Results

Eight of the hydatid cysts were treated with the PAIR technique and four were treated with catheterization. The volume of all cysts decreased significantly during the follow-up period. No complication occurred in seven of 12 patients. Abscess developed in four patients. Two patients underwent splenectomy due to cavity infection developed after percutaneous treatment, while the spleen was preserved in 10 of 12 patients. Total hospital stay was between 1 and 18 days. Hospital stay was longer and the rate of infection was higher in the catheterization group. Follow-up period was 5–117 months (mean, 44.8 months), with no recurrence observed.

Conclusion

The advantages of the percutaneous treatment are its minimal invasive nature, short hospitalization duration, and its ability to preserve splenic tissue and function. As the catheterization technique is associated with higher abscess risk, we suggest that the PAIR procedure should be the first percutaneous treatment option for splenic CE.

     

Percutaneous Treatment of Simple Hepatic Cysts: The Long-Term Results of PAIR and Catheterization Techniques as Single-Session Procedures

Purpose

The purpose of our study is to evaluate results of percutaneous aspiration with alcohol sclerotherapy in symptomatic patients with simple hepatic cysts by employing single-session techniques either by a needle or a catheter.

Materials and Methods

We retrospectively included 39 simple hepatic cysts in 35 patients treated via percutaneous aspiration and single-session alcohol sclerotherapy between years 1993 and 2012. Indications were pain (n = 28) or ruling out cystic echinococcus (CE) disease (n = 7). 29 cysts in 26 patients were treated by needle technique (Group A) and ten cysts in nine patients were treated by single-session catheter technique (Group B). Patients were followed for 4–173 months (median: 38 months).

Results

All patients were successfully treated. Before procedure, cyst volumes were 21–676 cc (median: 94 cc). Post-procedure cyst volumes at last follow-up were 0-40 cc (median: 1 cc). The mean decrease in cyst volume was 95.92 ± 2.86 % in all patients (95.96 ± 3.26 % in Group A and 95.80 ± 6.20 % in Group B). There was no statistically significant difference between the volume reduction rates of Group A and Group B. Only one patient, in Group B, developed a major complication, an abscess. Hospitalization period was 1 day for all patients.

Conclusions

For patients with symptomatic simple hepatic cysts smaller than 500 cc in volume by using puncture, aspiration, injection, and reaspiration (PAIR) technique with only needle, single-session alcohol sclerotherapy of 10 min is a safe and effective procedure with high success rate.

     

Understanding the relationship between visual-angle and eye-angle for reliable determination of the field-of-view in ultra-wide field fundus photography

Visual-angle has been used as the conventional unit to determine the field-of-view (FOV) in traditional fundus photography. Recently emerging usage of eye-angle as the unit in wide field fundus photography creates confusion about FOV interpretation in instrumentation design and clinical application. This study aims to systematically derive the relationship between the visual-angle θ_v and eye-angle θ_e, and thus to enable reliable determination of the FOV in wide field fundus photography. FOV conversion ratio θ_e/θ_v, angular conversion ratio Δθ_e/Δθ_v, retinal conversion ratio Δd/Δθ_v, retinal distance and area are quantitatively evaluated. Systematic analysis indicates that reliable conversion between the θ_v and θ_e requires determined nodal point and spherical radius of the eye; and the conversion ratio is not linear from the central field to peripheral region. Based on the eye model with average parameters, both angular conversion (Δθ_e/Δθ_v) and retinal conversion (Δd/Δθ_v) ratios are observed to have a 1.51-fold difference at the central field and far peripheral region. A conversion table, including θ_e/θ_v, Δθ_e/Δθ_v, Δd/Δθ_v, retinal area and percentage ratio, is created for reliable assessment of imaging systems with variable FOV.