Objective:To identify anomalies of major retroperitoneal vascular structure (AMRVS) during oncological retroperitoneal surgery and to investigate the effects of these anomalies in surgical procedures.Materials and Methods:Two hundred twenty-nine patients who underwent systematic para-aortic and bilateral pelvic lymph node dissection up to the renal vein between September 2006 and December 2008 were included. Normal architecture and structural anomalies of inferior vena cava, abdominal aorta, renal arteries and veins, and common iliac artery and vein were studied.Results:The mean age of the patients was 54.2 years. Anomalies of major retroperitoneal vascular structure were present in 39 patients (17%). Anomalies of renal vessels were identified in 31 patients. Supernumerary renal arteries and veins observed in 11 patients (17%) were the most common renal vessel anomaly. Great vessel injury was present in 19 patients (8.3%). Vascular complication rate was 20.5% in patients with AMRVS. However, in 4 of 8 patients with vascular complication and AMRVS, the complication was not related with anomalous vascular structures. None of the complications was serious and were corrected surgically. There was no difference between patients with AMRVS and those without AMRVS regarding age, body mass index, the extent of upper abdominal dissemination of malignancy and presence of comorbidity for intraoperative bleeding. There was no difference in intraoperative hemorrhage and amount of transfused red blood cell units between the groups.Conclusion:Great vessel anomalies, discovered in 1 of 6 patients, were together with increased risk of vascular complications. The probability of presence of vascular anomalies should be taken into account during lymph node dissection.
This study aims to make a systematic review of technology-supported collaborative creativity pedagogy and practices in the field of education by focusing on peer-reviewed articles published in journals between 2014 and 2019. The targeted educational levels were specified as elementary, secondary education and teacher education students. 21 studies were examined from different aspects: (a) forms of technology and technological features with pedagogical affordances and (c) teachers and students' roles, and the pedagogical approach, (c) problems and solutions. A narrative synthetic approach was employed to categorize, analyse and synthesize the data according to themes developed. The findings indicate majority of the studies employed different types of pedagogies, and yet all follow student-directed pedagogies or theories drawing on social-constructivism. In the selected studies, three teachers' roles were identified: giving planned or explicit guidance, promoting dialogue between students during the process of creation and orchestrating collaborative creativity flow of students. And, students' roles were also found to be in parallel with the teachers' roles. With regard to forms of technology, among 5 major technological forms, web-based were the favoured technology due to its affordances. Besides, the selected studies showed there are teacher-related, student-related and techrelated problems, and students overcome these problems through solving the problem together, being considerate about their team members and valuing their teachers' effort. Therefore, the papers selected for this review indicated that the problems were not perceived as obstacles to collaborative creativity both by students and teachers. Instead, they were considered as a means to boost collaboration and creativity.
Cervical invasion may have an effect on lymphatic spread and change the site of metastatic LNs. Large prospective studies are needed to clarify the alteration of LN metastasis in cervix invaded EC patients.
Background: To investigate the impact of ovarian transposition (OT) on survival rates of the patients with stage Ib squamous cell cervical cancer. Materials and Methods: Ninety-two subjects who underwent a radical hysterectomy including oophorectomy were evaluated. For nineteen (20.7%) , OT was performed. Patients were divided into two groups, OT versus oophorectomy alone. The primary end-point of this study was to investigate the impact of OT on tumor recurrence rate and time, 5-year disease-free survival (DFS) and overall survival (OS) . These comparisons were performed for subgroups including patients who received radiotherapy versus who did not. Statistical analyses were conducted using the Chi-square test, T-test and Mann-Whitney test. OS was examined using the Kaplan-Meier method. P≤0.05 was considered to be statistically significant. Results: The median follow-up period was 89 months for OT and 81 months for the oophorectomy group (p>0.05). Both groups experienced similar recurrence rates (31.6% vs. 26.4%, p=0.181). The median duration from surgery to recurrence, and surgery to death were also similar between the groups (p>0.05). The 5-year DFS and OS rates were both 68.4% for the OT group, and 73.6% and 77.8% for the oophorectomy group (p=0.457 and p=0.307, respectively). While the 5-year DFS rate was not statistically significant between the OT and oophorectomy groups who did not receive radiotherapy (p=0.148), the 5-year OS rate was significantly higher in the oophorectomy group (95.4% vs 66.7%, respectively) without radiotherapy (p=0.05). The 5-year DFS and OS rates were statistically similar between the groups who received adjuvant radiotherapy (p>0.05). Conclusions: Ovarian transposition has not significantly negative effect on the survival rates when adjuvant radiotherapy will be applied, while 5-year OS may be less in OT group if radiotherapy is not mandatory.
Background/aim: To evaluate the effects of hysterectomy on rat ovaries and the possible protective role of peroxisome proliferatoractivated receptor gamma (PPAR-γ) agonist-rosiglitazone against ovarian reserve decrement. Materials and methods: Forty-five adult Wistar albino rats were randomly divided into three groups. Hysterectomy was performed (n = 15) in group 1 [H]; 1 mg/kg/day PPAR-γ agonist/rosiglitazone was used for 50 days after hysterectomy (n = 15) in group 2 [H + R]; a sham operation was performed (n = 15) in group 3 [control, C]. Blood samples were collected for anti-Müllerian hormone (AMH) evaluation in all groups and simultaneous ovarian Doppler examination was performed in [H] and [H + R] groups before and after (50 days) hysterectomy. All animals were sacrificed to obtain ovaries for histological examination. Results: AMH levels were found to be significantly decreased at postoperative day 50 in all groups (P < 0.05). Histopathologic analysis showed that primary, preantral, and antral follicle counts were significantly higher in the [H] group as compared to the [C] and [H + R] groups (P < 0.05). There was no significant difference between the [C] and [H + R] groups in terms of follicle numbers (P > 0.05). In the ovarian Doppler blood flow analysis, all parameters were significantly decreased in group [H] (P < 0.05), but not in the [H + R] group (P > 0.05) on postoperative day 50. Conclusion: Hysterectomy affects the histopathological structure of rat ovaries and PPAR-γ agonist-rosiglitazone improves the ovarian Doppler blood flow parameters.
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