Gland Volume Research Articles

Morphometric Study about Effect of Sleep Deprivation on Prostate of Rats with Protective Effect of Omega 3 Fatty Acids

Background: Even though sleep makes up nearly a third of a person's lifetime, we do not fully appreciate its significance. The partial or nearly complete loss of sleep from an organism that results in a number of detrimental health issues is known as sleep deprivation. Aim: To investigate how omega 3 fatty acids affect the size and weight of the prostate gland in sleep-deprived rats. Study design: Random control trial. Methodology: Thirty male Sprague Dawley rats (population) aged three to four months and weighing 200 to 300 grammes were utilised. They were kept in a controlled setting at the NIH's animal house in Islamabad. Rats were randomised into three groups by using lottery method, with n = 10 rats in each group. The control group was designated as group A. They experienced a regular cycle of sleep and wakefulness. Rats in group B, which experienced sleep deprivation for 16 hours followed by an 8-hour sleep window each day for 8 weeks, were placed in the sleep-deprived group. The standard lab diet was provided to Groups A and B. For eight weeks, Group C received a typical lab meal combined with omega 3 fatty acids while also being sleep deprived for 16 hours, followed by an 8-hour sleep window each day. Results: In comparison to groups A and C that received omega 3, the gland weight and volume in group B were significantly lower. Group A: Weight and volume of the prostate: Prostate weight ranged from 1.85 to 0.50 grammes on average. The computed RTBWI was 0.60 + 0.22. The prostate's mean SD volume was 166.81 45.67 mm3. GROUP B: Weight of the prostate: Prostate weight ranged from 1.30 to 0.22 grammes on average. In the sleep-deprived group B compared to the control group A, the weight of the prostate was considerably lower (p-value=0.008). The computed RTBWI was 0.37 + 0.22. The prostate's mean SD volume was 127.88 67.35 mm3. GROUP C: Weight of prostate gland: In experimental group C, the prostate's mean SD weight was 2.19 0.42gm. According to the RTBWI calculation, it was 0.64 0.07. The prostate's mean SD volume was 182.89 44.16 mm3. Practical Implication: Today, sleep deprivation is a big problem, and this study will assist researchers in examining how Omega 3 fatty acids can help prevent this problem and the harmful effects it has on the prostate glands. Conclusion: It was concluded that Omega 3 fatty acids played a protective role while sleep deprivation had a negative impact on the weight and volume of the prostate gland. Keywords: Sleep Deprivation, Omega 3 Fatty Acids, Prostate and Protective Effect.

The Relationship of Solitary Parathyroid Adenoma Volume with Pre- and Post-operative Parathormone and Calcium Levels

Objective: Parathyroid size, weight, position and histopathological characteristics have been investigated as possible candidates of predictive value. We aimed to investigate the relationship between the volume of the parathyroid gland as calculated by sonographic measurements and the amount of postoperative decrease in serum calcium and parathyroid hormone (PTH) levels .
 Materials and Methods: Preoperative and postoperative plasma levels of corrected calcium and intact PTH were noted. The size of each adenomatous parathyroid gland was calculated as an ellipsoid based on the preoperative sonographic measurements using the formula “V=π/6 x diameters”. 
 Results: A total of 61 (76.3%) females and 19 (23.8%) males were included in the study. The median age of the patients was 58 years. The average volume of the adenomatous parathyroid gland was calculated to be 13.4 cm3. Plasma levels of both calcium and PTH significantly decreased following surgery (p:0.000, p:0.000, respectively). There was significant correlation between the adenoma volume and the change in calcium value (r: -0.500, p:0.000) but not for the PTH value (r: 0.036, p:0.750).
 Conclusion: Our significant results may suggest a relationship between the volume of adenoma and plasma calcium levels, but more extended studies with larger patient groups are needed for more consistent results.

Effects of Autoimmune Protocol (AIP) diet on changes in thyroid parameters in Hashimoto's disease.

In the scientific world, the nutritional needs of persons with Hashimoto's autoimmune thyroid disease are discussed, and there is a lot of interest in the autoimmune protocol (AIP). The aim of the study was to check the effects of AIP on thyroid parameters in euthyroid patients with Hashimoto's disease. Among 28 people with Hashimoto's (including 1 male) the consumption of nutrients, anthropometrics, symptoms of the disease, values of thyroid parameters: FT3, FT4, TSH, thyroid ultrasound and autoimmune aTPO, aTG were analyzed before and after 12 weeks of using the AIP diet. The impact of changes in the consumption of selected nutrients on changes in thyroid biochemical parameters were analyzed using multiple regression models, where the dependent variables of the created models were changes in thyroid biochemical parameters. After applying the AIP diet, the number of people reporting symptoms of malaise decreased, the levels of FT3 and FT4 as well as TSH decreased, remaining within the reference concentration range. aTG decreased slightly, but aTPO increased significantly. Ultrasound examination also showed a decrease in the volume of the thyroid gland. The body weight of the subjects decreased, which indicates a caloric deficit. Given the numerous advantages of the AIP diet, extending the observation time of the diet, along with its personalization in terms of food selection, energy and nutritional value, could show changes in both well-being and biochemical test results to a greater extent. The use of a personalized AIP protocol can improve the quality of life, a positive change in mental state, reduction of stress, and above all, the improvement of adverse ailments associated with Hashimoto's disease.

Age-related morphometrics of normal adrenal glands based on deep learning-aided segmentation

Objective.This study aims to evaluate the morphometrics of normal adrenal glands in adult patients semiautomatically using a deep learning-based segmentation model.Materials and Methods.A total of 520 abdominal CT image series with normal findings, from January 1, 2016, to March 14, 2019, were retrospectively collected for the training of the adrenal segmentation model. Then, 1043 portal venous phase image series of inpatient contrast-enhanced abdominal CT examinations with normal adrenal glands were included for analysis and grouped by every 10-year gap. A 3D U-Net-based segmentation model was used to predict bilateral adrenal labels followed by manual modification of labels as appropriate. Quantitative parameters (volume, CT value, and diameters) of the bilateral adrenal glands were then analyzed.Results.In the study cohort aged 18–77 years old (554 males and 489 females), the left adrenal gland was significantly larger than the right adrenal gland [all patients, 2867.79 (2317.11–3499.89) mm3 vs. 2452.84 (1983.50–2935.18) mm3, P < 0.001]. Male patients showed a greater volume of bilateral adrenal glands than females in all age groups (all patients, left: 3237.83 ± 930.21 mm3 vs. 2646.49 ± 766.42 mm3, P < 0.001; right: 2731.69 ± 789.19 mm3 vs. 2266.18 ± 632.97 mm3, P = 0.001). Bilateral adrenal volume in male patients showed an increasing then decreasing trend as age increased that peaked at 38–47 years old (left: 3416.01 ± 886.21 mm3, right: 2855.04 ± 774.57 mm3).Conclusions.The semiautomated measurement revealed that the adrenal volume differs as age increases. Male patients aged 38–47 years old have a peaked adrenal volume.

Intranasal 15d-PGJ2 inhibits the growth of rat lactotroph pituitary neuroendocrine tumors by inducing PPARγ-dependent apoptotic and autophagic cell death.

PPARγ agonists have been reported to induce cell death in pituitary neuroendocrine tumor (PitNET) cell cultures. However, the therapeutic effects of PPARγ agonists in vivo remain unclear. In the present study, we found that intranasal 15d-PGJ2, an endogenous PPARγ agonist, resulted in growth suppression of Fischer 344 rat lactotroph PitNETs induced by subcutaneous implantation with a mini-osmotic pump containing estradiol. Intranasal 15d-PGJ2 reduced the volume and weight of the pituitary gland and the level of serum prolactin (PRL) in rat lactotroph PitNETs. 15d-PGJ2 treatment attenuated pathological changes and significantly decreased the ratio of PRL/pituitary-specific transcription factor 1 (Pit-1) and estrogen receptor α (ERα)/Pit-1 double-positive cells. Moreover, 15d-PGJ2 treatment induced apoptosis in the pituitary gland characterized by an increased ratio of TUNEL-positive cells, cleavage of caspase-3, and elevated activity of caspase-3. 15d-PGJ2 treatment decreased the levels of cytokines, including TNF-α, IL-1β, and IL-6. Furthermore, 15d-PGJ2 treatment markedly increased the protein expression of PPARγ and blocked autophagic flux, as evidenced by the accumulation of LC3-II and SQSTM1/p62 and the decrease in LAMP-1 expression. Importantly, all these effects mediated by 15d-PGJ2 were abolished by cotreatment with the PPARγ antagonist GW9662. In conclusion, intranasal 15d-PGJ2 suppressed the growth of rat lactotroph PitNETs by inducing PPARγ-dependent apoptotic and autophagic cell death. Therefore, 15d-PGJ2 may be a potential new drug for lactotroph PitNETs.

MILK ALLERGY IN JERSEY COWS: FIRST REPORT IN BRAZIL

Allergy to milk is the only auto-allergic disease in cattle. It is characterized by the retention and absorption of milk itself, making milk proteins, especially alpha casein, have access to the bloodstream, resulting in a type I hypersensitivity. The purpose of this report is to describe a case of auto-allergic disease in cattle. Here we report the case of a four-year-old Jersey female bovine, which was pregnant and weighing 400Kg. The animal was being treated at (hidden for revision) and had a history of an acute allergic reaction. Its owner reported sudden onset of skin lesions, salivation, and difficulty breathing. As the animal was participating in an agricultural exhibition, it was not being milked to generate mammary gland engorgement (milk retention). In physical examination findings wherein there is presence of multifocal urticarial papules and plaques, mainly on the sides and right and left flanks, besides the absence of pruritus, edema in mucocutaneous regions of the upper and lower eyelids of the right and left eyes, submandibular edema, excessive salivation, inspiratory dyspnea with half-open mouth breathing, respiratory distress, apathy, cough, tachycardia tachypnea, ruminal hypomotility and increased volume of the mammary gland, characterizing milk retention. Clinical suspicion was milk allergy with anaphylactic reaction (type I hypersensitivity). Treatment was based on promethazine administration (1mg/kg; IV) and immediate full milking of the mammary gland. After 12 h of treatment, clinical respiratory signs resolved, and after 24 h, skin changes resolved completely. Based on clinical signs and treatment success, the clinical suspicion of milk allergy causing anaphylactic reaction (type I hypersensitivity) was confirmed.

The outcomes of same-day discharge following holmium laser enucleation of the prostate (HoLEP) surgeries: our experience during the COVID-19 pandemic.

To describe the outcomes of Same-Day Discharge (SDD) following Holmium Laser Enucleation of the Prostate (HoLEP) in patients during the COVID-19 pandemic. A retrospective review of HoLEP surgeries at a single institution between January 2021 and March 2022 was performed. Patient demographic and operative data were collected, and postoperative outcomes were evaluated in terms of safety and efficacy and compared in both groups using a t-test and chi-square test. Logistic regression was also performed to identify factors that correlate with the failure of SDD. A total of 155 patients were identified; 135 patients were successfully discharged on the same day and 20 were admitted (87% SDD rate). Admitted HoLEP patients had a significantly higher median prostate-specific antigen (5.7 vs 3.9ng/dL, P < 0.001), prostate volume (152.3 vs 100.6mL, P < 0.001), and enucleated tissue weight (90.3 vs 56.9g, P = 0.04) compared to the SDD group. The SDD group had a 2.9% (n = 4) readmission rate and a 5.2% (n = 7) Emergency Department (ED) visit rate. There was no significant difference in the rate of postoperative ED visits (P = 0.64), readmissions (P = 0.98), complications, and catheterization time (P = 0.98) between both groups. Preoperative predictors of SDD failure included prostate gland volume > 150mL (OR = 7.17; CI 2.01-25.67; P < 0.01) and history of antiplatelet/anticoagulation use (OR = 6.59; CI 2.00-21.67; P < 0.01). Same-day discharge following HoLEP is a safe and effective approach that can be performed in most patients using a liberal discharge criteria and relying on postoperative findings only.

Abstract #1406804: Study of Thyroid Parenchymal Vascularity Pattern and its Predictors in Untreated Graves’ Disease

Increased thyroid gland vascularity is an important diagnostic finding in case of Graves’ disease. However, the relation of thyroid gland vascularity with thyroid hormones or autoantibody levels with is less clear. Few studies have reported correlation of gland vascularity and thyroid hormones whereas few have found no such association. We aimed to study different patterns of thyroid parenchymal vascularity and its determinants in untreated Graves’ disease patients. A total of 71 treatment naïve Graves’ disease patients were included in the study. Detailed clinical, hormonal and radiological evaluations were done and data were recorded. The thyroid parenchymal vascularity was divided into three patterns (Grade 1, Grade 2 and Grade 3) based on increasing vascularity pattern with Grade 1 being least to Grade 3 being highest as described previously in literature. Comparison and correlation analysis were done using appropriate statistical tools. Our cohort consisted of 52 females and 19 males with a mean age of 34.4±9.4 years. Among all patients, 14.08% patients had Grade1 vascularity pattern (Group A), 47.89% had Grade 2 vascularity pattern (Group B) and rest 38.03% had Grade 3 vascularity pattern (Group C) respectively. No difference was noted with regards to thyroid hormone levels (FT3, FT4 or TSH) or thyroid autoantibody levels (anti-TSH receptor antibodies) between the three subgroups (p–non-significant). Thyroid volumes were significantly higher in patients with higher vascularity pattern with Group C having highest (median volume-23.9 cc) and Group A having lowest (median volume-11.3cc) respectively (p<0.01). Among our Graves’ disease patients, majority had Grade 2 thyroid parenchymal vascularity pattern. No significant difference was noted between the three groups with regards to thyroid hormone levels or anti TSH receptor antibody titres. Thyroid gland volumes were significantly higher in patients having higher gland vascularity pattern.

Analysis of options for reducing the duration of simultaneous operations in plastic surgery

The main problem of simultaneous operations is their duration, which, as a rule, is more than 4 hours, which exceeds the allowable time and often causes complications in the postoperative period. Aim of the study was to evaluate the effectiveness of simultaneous operations performed by two surgical teams simultaneously. Material and methods. The object of the study was 24 patients aged 25 to 55 years, who simultaneously underwent classical abdominoplasty with navel transposition and anchor breast lift on implants by one and two surgical teams. The evaluation and comparison of the duration of surgical interventions according to the data of anesthesia charts have been carried out. Further, the assessment of the condition of patients before surgery and for 1 day in the postoperative period was carried out using the questionnaire for assessing the quality of recovery after anesthesia (QOR-40, quality of recovery 40-item questionnaire).Results and discussion. Performing abdominoplasty simultaneously with the correction of the shape and volume of the mammary glands by two surgical teams simultaneously reduces the duration of the intervention by 27 % on average, and therefore the quality of recovery of patients in the postoperative period is signifcantly higher. Prolonged exposure to general anesthesia and other potentially dangerous intraoperative conditions (for example, blood loss, hypotension, hypothermia, infections) interfere with the maintenance of physiological homeostasis by the body. And, therefore, reducing the time of surgery is important to reduce the frequency of complications. In order to minimize the operation time in combined cases of abdominoplasty and breast plastic surgery, it is logical to involve two operating teams at the same time, which reduces the total operating time to 3 hours. Conclusions. Today one of the main methods of solving problems associated with the duration of complex simultaneous operations is the simultaneous coordinated work of two surgical teams to minimize the duration of intervention and reduce postoperative complications.

Ultrasonographic Assessment of Submandibular Salivary Gland at a Tertiary Care Centre of Nepal

Background: There various disease condition which can leads to increased size of the submandibular gland. Normal dimensions of salivary gland is useful for identification and diagnosis of various associated pathology. The study objective was to assess the normal dimension of submandibular gland using ultrasonograph at a tertiary care centre of Nepal. Methods: The descriptive cross-sectional study was conducted in Department of Radiology and Imaging College of Medical Sciences, Bharatpur, Nepal among 126 patients. Ultrasound of submandibular gland was done of all patients with Toshiba Aplio 500 superficial probe. The data was collected and entered into Statistical Package for the Social Sciences version 16 and analyzed using descriptive statistics. Later the data was presented in form of tables. Results: There were in total 126 patients who participated in the study. Among them 78 (61.9%) were females and rest were males. The mediolateral width of right submandibular salivary gland (2.70±0.40 cms) was slightly greater than the left side. The volume of left salivary gland (6.91±2.32 cm3) was slightly larger than the right side in male. However, there was no statistically significant difference between male and female Conclusion: This study concluded that the volume of left salivary gland was slightly larger than the right side. The volume of salivary gland of females was more than male. Keywords: Submandibular gland, Salivary gland, Ultrasonography.

Long-term effects of radioiodine treatment on thyroid functions and ultrasonographic features in patients with toxic adenoma and toxic multinodular goitre.

This study aimed to investigate the long-term effect of radioiodine (RAI) treatment on thyroid functions and ultrasonographic changes in the thyroid gland and toxic nodules. Thyroid function tests and ultrasonography reports of patients diagnosed with toxic adenoma (TA) or toxic multinodular goitre (TMNG) between 2000 and 2021 were retrospectively analysed. We included 100 patients whom thyroid function and ultrasonography results were obtained from our outpatient clinic before and at least 36months post-RAI. At the end of the follow-up period, the mean thyroid volume reduction in patients with TA and TMNG was 56.6% ± 3.1% and 51.1% ± 6.7%, respectively; the mean volume decrease of all toxic nodules was 80.5% ± 1.9%. The volume of the thyroid and toxic nodules was significantly reduced up to 12years (p < 0.01). Between 3 and 10years after RAI therapy, the annual incidence of hypothyroidism was 2.0% and 1.5% in the TA and TMNG groups, respectively. Toxic nodules were more frequently solid and hypoechoic in post-RAI ultrasounds (p < 0.01). The volume of thyroid gland and toxic nodules continuously decreases, as the risk of hypothyroidism increases up to 10years after RAI treatment. After RAI treatment, patients should be followed up to check their thyroid functions. In post-RAI examinations, toxic nodules may show ultrasonographic features suspicious for malignancy. History taking should include previous RAI therapies and old scintigraphy scans should be evaluated to avoid unnecessary procedures and non-diagnostic biopsy results.

PD38-08 AVOIDING UNNECESSARY TARGETED PROSTATE BIOPSIES USING MACHINE LEARNING

You have accessJournal of UrologyCME1 Apr 2023PD38-08 AVOIDING UNNECESSARY TARGETED PROSTATE BIOPSIES USING MACHINE LEARNING Roxana Esmaili, Ghazal Khajir, Michael Leapman, Preston Sprenkle, Darryl Martin, and John Onofrey Roxana EsmailiRoxana Esmaili More articles by this author , Ghazal KhajirGhazal Khajir More articles by this author , Michael LeapmanMichael Leapman More articles by this author , Preston SprenklePreston Sprenkle More articles by this author , Darryl MartinDarryl Martin More articles by this author , and John OnofreyJohn Onofrey More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003336.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Magnetic resonance imaging (MRI)-targeted transrectal ultrasound (TRUS) guided needle biopsy is the current gold standard for diagnosing prostate cancer in patients with suspicion for prostate cancer. This leads to a frequent needle biopsy to determine the presence of clinically significant prostate cancer (csPCa) with a high rate of invasive overdiagnosis in patients with non-aggressive cancer. Supervised machine learning (ML) algorithms provide a mathematical framework to make predictions about csPCa in order to make personalized decisions to perform a biopsy or not and avoid unnecessary targeted needle biopsies. METHODS: From January 2016 to February 2020, 1099 patients underwent multiparametric MRI before TRUS fusion biopsy. We included PI-RADS score (version 2), gland volume, lesion region of interest volume before biopsy, PSA value, PSA density, and patient age at the time of biopsy as input variables to calculate the probability of csPCa for each lesion for each patient before biopsy using different ML classification algorithms: logistic regression (LR); random forest (RF); naïve Bayes (NB); and nearest neighbor (NN). Gleason Grade Group ≥2 was used as a reference for the presence of csPCa. Ten-fold cross-validation stratified over patients validated the ML approaches and compared to univariate models. RESULTS: Area under the receiver operating characteristic curves (AUC) and net reduction curves show that multivariate LR (AUC 81.3%) outperformed RF (AUC 79.2%), NN (AUC 71.8%) and NB (AUC 78.3%) and outperformed standard univariate LR using PSA density (AUC 71.4%) and PI-RADS (AUC 73.9%). The algorithms were evaluated at a point on the ROC curve for high sensitivity. Using the multivariate LR model, 636 (41.38%) targeted biopsies could have been avoided while missing only 90 (5.86%) csPCa, which is reasonable with a threshold probability of 25% and a net benefit of 0.21. CONCLUSIONS: Our findings suggest that multivariate ML models using clinical data can be used to avoid unnecessary targeted biopsy cores among patients with suspicion of prostate cancer undergoing prostate biopsy. Source of Funding: JAO supported by NIH R42 CA224888. DTM supported by DoD W81XWH-19-PCRP-IDA. © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e996 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Roxana Esmaili More articles by this author Ghazal Khajir More articles by this author Michael Leapman More articles by this author Preston Sprenkle More articles by this author Darryl Martin More articles by this author John Onofrey More articles by this author Expand All Advertisement PDF downloadLoading ...

MP59-16 MAGNETIC RESONANCE IMAGING TRANSITION ZONE VOLUME IS HIGHLY CONCORDANT WITH ENUCLEATED VOLUME AFTER HOLMIUM LASER ENUCLEATION OF THE PROSTATE DUE TO VARIATION IN THE TRANSITION ZONE INDEX

You have accessJournal of UrologyCME1 Apr 2023MP59-16 MAGNETIC RESONANCE IMAGING TRANSITION ZONE VOLUME IS HIGHLY CONCORDANT WITH ENUCLEATED VOLUME AFTER HOLMIUM LASER ENUCLEATION OF THE PROSTATE DUE TO VARIATION IN THE TRANSITION ZONE INDEX Jordan Krieger, Margaret A Knoedler, Shane A Wells, Ali S Antar, Ethan Richmond, Trevor L Everett, Alex G Thomas, Christopher M Manakas, Daniel R Gralnek, and Matthew D Grimes Jordan KriegerJordan Krieger More articles by this author , Margaret A KnoedlerMargaret A Knoedler More articles by this author , Shane A WellsShane A Wells More articles by this author , Ali S AntarAli S Antar More articles by this author , Ethan RichmondEthan Richmond More articles by this author , Trevor L EverettTrevor L Everett More articles by this author , Alex G ThomasAlex G Thomas More articles by this author , Christopher M ManakasChristopher M Manakas More articles by this author , Daniel R GralnekDaniel R Gralnek More articles by this author , and Matthew D GrimesMatthew D Grimes More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003312.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Holmium laser enucleation of the prostate (HoLEP) aims to remove the entire prostate transition zone. Whole prostate gland volume (WGV) is often used to predict HoLEP enucleated volume. However, WGV and enucleated volume are sometimes discordant implying variability in the ratio of transition zone volume (TZV) to WGV (transition zone index, TZI). We aim to determine the relationship between TZI and WGV and assess the concordance between HoLEP enucleated volume and MRI estimated WGV and TZV. METHODS: A prospective HoLEP database was queried to identify patients with MRI within one year of HoLEP. TZI was calculated by dividing TZV by WGV. Patients were categorically stratified based on ellipsoid WGV, as measured by a radiologist. The ratio between TZI and WGV was assessed using stratified analysis and regression. Concordance was defined as the ratio of enucleated volume to WGV and TZV with mean values compared using ANOVA. RESULTS: We analyzed 218 patients with mean WGV of 101g (range 16.7 - 388) and TZV of 63.6g (range 6.06 - 346). TZV was more concordant with enucleated volume compared to WGV (mean 0.984, SD 0.297) vs 0.56 (SD 0.187, p<0.001). Mean TZI and enucleated specimen concordance all varied significantly when stratified by prostate volume (Table 1). Regression analysis revealed a significant, positive, non-linear relationship between WGV and TZI, but with high variability between individual patients (r=0.62) (Figure 1). CONCLUSIONS: MRI transition zone volume measurements are highly concordant with HoLEP enucleated volumes, especially when compared with whole gland volume measurements. On average, larger prostates have a higher TZI, but TZI is highly variable in individual patients and may not be accurately predicted from WGV alone. Therefore, preoperative transition zone measurement with MRI provides a valuable, accurate, and non-invasive tool for estimating enucleated volume prior to HoLEP. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e814 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jordan Krieger More articles by this author Margaret A Knoedler More articles by this author Shane A Wells More articles by this author Ali S Antar More articles by this author Ethan Richmond More articles by this author Trevor L Everett More articles by this author Alex G Thomas More articles by this author Christopher M Manakas More articles by this author Daniel R Gralnek More articles by this author Matthew D Grimes More articles by this author Expand All Advertisement PDF downloadLoading ...

Patient- and Tumor-associated Predictive Factors for Urinary Incontinence After Radical Prostatectomy for Nonmetastatic Prostate Cancer: a Systematic Review and Meta-analysis

Despite the fact that urinary incontinence (UI) occurs after radical prostatectomy (RP) quite often, it is currently not completely understood which factors really increase the risk of UI development. The results of a systematic review of patient- and tumor-related prognostic factors that cause post-prostatectomy urinary incontinence (PPI) are presented. The primary results evaluated the presence of UI within 3 months after the RP. Secondary outcomes included the presence of UI in 3–12 months and &gt;12 months after RP. The study of databases including Medline, EMBASE and CENTRAL was conducted between January 1990 and June 2022. The articles about patient- and tumor-related prognostic factors with univariate and multivariate analysis were included. Surgical influencing factors were excluded. Risk of bias (RoB) was assessed using Quality In Prognosis Studies (QUIPS) indicators. A random-effects metaanalysis was performed for all prognostic factors where it was possible. 83 studies (5 randomized controlled trials, 15 prospective, 61 retrospective and 2 case-control studies) which included 55,302 patients were analyzed. The significant prognostic factors for postoperative UI within 3 months after RP were age, membranous urethral length (MUL), prostate gland volume (PGR), and Charlson Comorbidity Index (CCI). The results of the literature analysis indicate that increased age, shorter MUL, greater PGR and higher CCI are the independent prognostic factors for urinary incontinence within 3 months after RP. At the same time, all of them, except CCI, are the prognostically significant factors for the period 3–12 months after surgery. Increased age, increased prostate volume, shorter membranous urethral length, and lower physical fitness were found to be associated with worse urinary incontinence during the first 3 months after surgery. During the next 3–12 postoperative months, all of these factors except the physical fitness remained the prognostic ones.

Risk factors for hypocalcemia and correlation between thyroid volume and incidental parathyroidectomy after total thyroidectomy: single center experience

Aim: We aimed to investigate correlation between the effects of age, sex, disease, pathologic diagnosis, parathyroid autotransplantation, presence of parathyroid in the pathology specimen and clinicopathological variables and thyroid volume, postoperative hypocalcemia after bilateral total thyroidectomy.&#x0D; Material and Method: A retrospective study planned in tertiary university hospital on patients undergone bilateral total thyroidectomy and neck dissection when necessary surgery for thyroid pathologies. Minimum calcium values in the postoperative period were recorded as transient or permanent hypocalcemia. The cases were statistically analyzed for the relationship between the volume of the thyroid gland removed and hypocalcemia. The effects of sex, pathological diagnosis, preoperative hyperthyroidism, anatomical retrosternal extension, number of parathyroid glands seen and preserved intraoperatively, parathyroid gland autoimplantation, parathyroid gland removal in the pathological specimen, nerve monitoring, bilateral total thyroidectomy and central and lateral neck dissection were analyzed for postoperative hypocalcemia.&#x0D; Results: Totally 763 patients were included in the study. The mean age of the patients was 50.6 years (SD:12.8) and the sex of 575 (75.4%) patients was female. Hypocalcemia was more common in women than in men (31% vs 17%; p

Comparison of biochemical markers and technetium 99m methoxyisobutylisonitrile imaging in primary and secondary hyperparathyroidism.

To investigate the differences in biochemical marker levels and the extent of lesion visualization on technetium 99m methoxyisobutylisonitrile (99mTc-MIBI) imaging between primary hyperparathyroidism (PHPT) and secondary hyperparathyroidism (SHPT). Nineteen patients with PHPT and 14 patients with SHPT were enrolled in the study, all of whom underwent routine 99mTc-MIBI dual-phase planar imaging, single-photon emission computed tomography combined with computed tomography (SPECT/CT fusion) imaging, and serum biochemical and hormonal investigations prior to surgery. The target-to-non-target (T/NT) ratios were calculated based on images from the early and delayed phases of 99mTc-MIBI planar imaging and also based on SPECT/CT fusion imaging. The volume of the parathyroid glands was measured following their excision. A total of 62 parathyroid glands were removed: 14 parathyroid adenomas and five parathyroid carcinomas in PHPT patients; and 18 parathyroid adenomas, 17 parathyroid hyperplasia lesions, and eight instances of nodular hyperplasia with adenoma in SHPT patients. The median volume of the lesions in PHPT and SHPT was 1.69 cm3 and 0.52 cm3 respectively, and the difference between them was statistically significant (P = 0.001). The median T/NT ratios calculated at the early phase of 99mTc-MIBI planar imaging, the delayed phase of 99mTc-MIBI planar imaging, and the subsequent SPECT/CT fusion imaging were 1.51, 1.34, and 2.75, respectively, in PHPT, and 1.46, 1.30, and 1.38, in SHPT, respectively. The T/NT ratio difference between PHPT and SHPT on the SPECT/CT fusion imaging was statistically significant (P = 0.002). The histopathology subtypes of the lesions were associated with significant differences in two areas: the T/NT ratios on the SPECT/CT fusion imaging and the volume of the lesions (P=0.002, P<0.001). The proportion of positive findings on 99mTc-MIBI dual-phase planar imaging and the T/NT ratios of 99mTc-MIBI SPECT/CT fusion imaging were higher in PHPT than in SHPT. The volume of parathyroid lesions in SHPT was smaller than in PHPT.

Ultrasound-Guided Transcutaneous Injection in the Lacrimal Gland: A Description of Sonoanatomy and Technique.

Purpose: To develop a method of injecting a volume up to 50% of the lacrimal gland (LG) volume while minimizing patient discomfort and maximizing accurate drug delivery. Herein we describe a series of ultrasound (US)-guided transcutaneous injections in the LG and discuss the safety and feasibility of this technique. Methods: Ultrasonography was performed in 40 patients with aqueous deficient dry eye disease using a GE Logic E10 (Milwaukee, Wisconsin, USA) US machine with a 6-24 MHz transducer. US was performed by 2 medical experts in ultrasonography. We recorded the injection and observed an enlargement of the LG ensuring delivery within the LG before the needle was removed. Assessment of injection-related adverse event was performed immediately after the injection. Results: The position of the injection needle within the LG was documented in all 40 patients. Injection of the stem cells and vehicle (N = 20) or solely vehicle (N = 20) led to an enlargement of the glandular structures in all cases. No serious adverse reactions related to the injections were observed. Conclusion: US-guided injection into the LG enables injection on a closed eye causing minimum patient discomfort and maximum certainty of accurate drug delivery. US can provide real-time images and may be used to safely guide the needle ensuring correct placement and injection within the gland capsule. This reduces the risk of injury to the eye and adjacent structures and makes a precise transcutaneous injection possible. Clinical Trial Registration number: NCT04615455.

Melatonin in the regulation of human life and its role in development pathology

The aim of our study was to research the literature data available for analysis of the melatonin role in the neurological and mental disorders origin. Materials and methods: to compile a literature review by keywords, articles there were selected and analyzed in the MEDLINE / PubMed and e-library databases from 1993 to 2021. For a detailed analysis, 42 literature sources were selected for the melatonin role in the development of neurological and mental disorders. Results: Melatonin is a hormone with unique adaptive capabilities. Violation of its production, both quantitatively and its rhythm, is the starting point, leading at the initial stages to desynchronizes, followed by the emergence of organic pathology. Consequently, the very fact of a violation of melatonin production can be the cause of various diseases. It was found that the volume of the pineal gland can change with the development of various types of neurological and psychiatric diseases, which is associated with a violation of the synthesis of melatonin and serotonin. Melatonin has been found to have important protective properties in Alzheimer's disease - the ability to inhibit the formation of beta-amyloid peptide in the brain, which is the morphological basis of this disease. The same correlation was found in patients with autism, psychosis and obsessive-compulsive disorder compared with healthy volunteers. Regarding the neuroprotective properties of melatonin, it should be noted its effectiveness in age-related diseases (Alzheimer's, Parkinson's, vascular diseases) Conclusion: Melatonin can be considered as a unique bioregulator, adaptogen and stabilizer of the whole organism and, in particular, the functions of the central nervous system. It has been proven that disruption of melatonin metabolism leads to various neurological and mental disorders.

Imaging patterns of the arterial supply of the prostate gland in adult Ghanaian men.

Prostatic arterial embolization (PAE) is a novel procedure in West Africa and Ghana. A thorough understanding of the prostate artery's (PA) anatomy and pattern is required for successful prostatic arterial embolization and to guarantee targeted intervention. This study focuses onprostate arterial supply in adult males, including prevalence, variability, and imaging pattern. A prospective cross-sectional study was conducted, at Euracare Advanced Diagnostics and Heart Centre. Patients who presented for Computed Tomography Angiography of the pelvis were included in the study. A total of 52 males were included and 104 pelvic CT angiography (one for each side) were analyzed, including: prostatic artery diameter, prostatic gland volume and prostate artery branching pattern. The PA branching pattern was classified using de Assis et al. classification. Thirty-seven (71.15%) men had enlarged prostate volume (>30ml). On each side there was only one prostatic artery and no accessory one was found. Only three types of arterial branching were identified: type I, II,III. The type I artery was the most common origin 58.7% (61/104). PA originating from the anterior division of the internal iliac artery (type II) and the type III is from the internal pudendal artery, accounted for 16.3% (17/104) and 25% (26/104) respectively. The most frequent type of PA origin was type I followed by type III then II. Knowing the different and most frequent types of anatomy of PA may help standardization and effectiveness of the PAE in developing countries.

3D Transoral Endoscopic Thyroid.

Transoral endoscopic thyroidectomy with vestibular approach (TOETVA) is a feasible new surgical procedure that does not require visible incisions. We describe our experience with three-dimensional (3D) TOETVA. We recruited 98 patients who were willing to undergo 3D TOETVA. Inclusion criteria were: (a) patients with a neck ultrasound (US) with an estimated thyroid diameter of 10cm or less; (b) estimated US gland volume ≤45ml; (c) nodule size ≤50mm; (d) benign tumor, such as thyroid cyst, goiter with one nodule, or goiter with multiple nodules; (e) follicular neoplasia; and (f) papillary microcarcinoma without evidence of metastases. The procedure is performed using a three-port technique at the oral vestibule, a 10mm port for the 30° endoscope, and two additional 5mm ports for dissecting and coagulation instruments. The CO2 insufflation pressure is set at 6mmHg. An anterior cervical subplatysmal space is created from the oral vestibule to the sternal notch and laterally to the sternocleidomastoid muscle. Thyroidectomy is performed entirely 3D endoscopically with conventional endoscopic instruments and intraoperative neuromonitoring. There were 34% total thyroidectomies and 66% hemithyroidectomies. Ninety-eight 3D TOETVA procedures were successfully performed without any conversions. The mean operative time was 87.6 minutes (59-118 minutes) for lobectomy and 107.6 minutes (99-135 minutes) for bilateral surgery. We observed one case of transient postoperative hypocalcemia. Paralysis of the recurrent laryngeal nerve did not occur. The cosmetic outcome was excellent in all patients. This is the first case series of 3D TOETVA.