scholarly journals Cautery artifact understages urothelial cancer at initial transurethral resection of large bladder tumours

2017 ◽  
Vol 11 (5) ◽  
pp. 203 ◽  
Author(s):  
Matthew Truong ◽  
Lorraine Liang ◽  
Janet Kukreja ◽  
Jeanne O’Brien ◽  
Jerome Jean-Gilles ◽  
...  
Keyword(s):  
Transurethral Resection ◽  
Urothelial Cancer ◽  
Tumour Size ◽  
Accurate Determination ◽  
Bladder Tumour ◽  
Billing Data ◽  
Accurate Staging ◽  
Resident Involvement ◽  
Bladder Tumours

Introduction: We sought to determine how frequently cautery (thermal) artifact precludes an accurate determination of stage at initial transurethral resection of bladder tumour (TURBT) of large bladder tumours.Methods: We queried our institution’s billing data to identify patients who underwent TURBT for large bladder tumours >5cm (CPT 52240) by two urologists at an academic centre from January 2009 through April 2013. Only patients who underwent initialstaging TURBT for urothelial cancer were included. Pathological reports were reviewed for stage, number of separate pathological specimens per TURBT, and presence of cautery artifact. Operative reports were reviewed for whether additional cold cup biopsies were taken of other suspicious areas of the bladder, resident involvement, and type of electrocautery.Results: We identified 119 patients who underwent initial staging TURBT for large tumours. Cautery artifact interfered with accurate staging in 7/119 (6%) of cases. Of these, six patients underwent restaging TURBT, with 50% percent experiencing upstaging to T2 disease. Tumour size, tumour grade, whether additional cold cup biopsies were taken, number of separate pathological specimens sent, and resident involvement were not associated with cautery artifact (all p>0.05). Bipolar resection had a higher rate of cautery artifact 5/42 (12%), compared to monopolar resection 2/77 (2.6%) approaching significance (p=0.095).Conclusions: Cautery artifact may delay accurate staging at initial TURBT for large tumours by understaging up to 6% of patients.

scholarly journals Effect of Continuously Warmed Irrigating Solution during Transurethral Resection

1988 ◽  
Vol 16 (3) ◽  
pp. 324-328 ◽  
Author(s):  
T. Harioka ◽  
M. Murakawa ◽  
J. Noda ◽  
K. Mori
Keyword(s):  
Body Temperature ◽  
Operating Room ◽  
Spinal Anaesthesia ◽  
Transurethral Resection ◽  
Room Temperature ◽  
Bladder Tumour ◽  
Body Temperatures ◽  
Lower Abdomen ◽  
Deep Body ◽  
Bladder Tumours

The effects of a continuously warmed irrigating solution on body temperature during transurethral resection of the prostate and of bladder tumours were studied in forty patients. Anaesthesia was spinal and deep body temperatures of the forehead and lower abdomen were measured, using a deep body thermometry system. Both forehead and lower abdominal deep body temperatures decreased significantly in the patients who underwent transurethral resection of the prostate with an irrigating solution at operating room temperature, but did not decrease in the patients who received a continuously warmed irrigating solution. The same results were obtained for the patients who underwent transurethral resection of bladder tumour. Our results indicate that a continuously warmed irrigating solution could prevent the fall in body temperature during transurethral resection, especially prostate resection, under spinal anaesthesia.

scholarly journals A retrospective analysis of the factors associated with increased risk of readmission within 30 days following primary transurethral resection of bladder tumour

2021 ◽  
Author(s):  
tarun jindal ◽  
Ankush Sarwal ◽  
Prateek Jain ◽  
Rajan Koju ◽  
Satyadip Mukherjee
Keyword(s):  
Transurethral Resection ◽  
Tumour Size ◽  
Bladder Tumour ◽  
Unplanned Readmission ◽  
Perioperative Morbidity ◽  
Anti Platelet Agent ◽  
Invasive Tumour ◽  
Increased Risk ◽  
History Of ◽  
Muscle Invasive

Background Transurethral resection of bladder tumour (TURBT) is associated with a perioperative morbidity of 5-10% which can lead to unplanned readmissions. In this study, we aim to identify factors that lead to an increased risk of unplanned readmissions within 30 days of primary TURBT. Methods A retrospective study was conducted to identify patients who had their primary TURBT at our institute from 2011-2019. The clinico-demographic factors, history of smoking, intake of anti-platelet drugs, co-morbidities, tumour size (< 3 cm or > 3cm), multifocality and histopathological type were abstracted. The patients who had a readmission were identified and reasons for admission were recorded. Results A total of 435 patients were identified. The median age was 66 years. There were 378 (86.9%) males, 110 (25.3%) had history of smoking and 37 (8.5%) had history of intake of an anti-platelet agent. In the cohort 166 (38.2%) were diabetic, 239 (54.9%) were hypertensive, 72 (16.6%) had COPD, 78 (7.9%) had hypothyroidism. A total of 206 (47.4%) had a tumour of >3cm, multifocality was seen in 140 (32.2%) while muscle invasive tumour was present in 161 (37%) patients. A total of 22 (5.06%) had re-admissions within 30 days with hematuria being the commonest etiology. On the univariate and multivariate analysis, history of smoking ( p=0.006 and 0.008, respectively) or intake of anti-platelet agents (p<0.001 and <0.001, respectively) were significantly associated with increased unplanned readmission. Conclusion Our study revealed smoking and intake of anti-platelet agents as the factors leading to increased risk of unplanned readmissions.

A quantitative approach to inner shell losses

1978 ◽  
Vol 36 (1) ◽  
pp. 526-527 ◽  
Author(s):  
R.D. Leapman ◽  
P. Rez ◽  
D.F. Mayers
Keyword(s):  
Energy Transfer ◽  
Cross Section ◽  
Cross Sections ◽  
Accurate Determination ◽  
Background Intensity ◽  
Core Excitation ◽  
Quantitative Basis ◽  
Cross Section Differential ◽  
Bound Electrons

Microanalysis by EELS has been developing rapidly and though the general form of the spectrum is now understood there is a need to put the technique on a more quantitative basis (1,2). Certain aspects important for microanalysis include: (i) accurate determination of the partial cross sections, σx(α,ΔE) for core excitation when scattering lies inside collection angle a and energy range ΔE above the edge, (ii) behavior of the background intensity due to excitation of less strongly bound electrons, necessary for extrapolation beneath the signal of interest, (iii) departures from the simple hydrogenic K-edge seen in L and M losses, effecting σx and complicating microanalysis. Such problems might be approached empirically but here we describe how computation can elucidate the spectrum shape.The inelastic cross section differential with respect to energy transfer E and momentum transfer q for electrons of energy E0 and velocity v can be written as

Fast calibration of CBED patterns for quantitative analysis

1993 ◽  
Vol 51 ◽  
pp. 674-675
Author(s):  
M.A. Gribelyuk ◽  
M. Rühle
Keyword(s):  
Reciprocal Lattice ◽  
Accurate Determination ◽  
Incident Beam ◽  
Crystal Thickness ◽  
Structure Model ◽  
Beam Direction ◽  
Transmitted Beam ◽  
Reciprocal Vector ◽  
On Line

A new method is suggested for the accurate determination of the incident beam direction K, crystal thickness t and the coordinates of the basic reciprocal lattice vectors V1 and V2 (Fig. 1) of the ZOLZ plans in pixels of the digitized 2-D CBED pattern. For a given structure model and some estimated values Vest and Kest of some point O in the CBED pattern a set of line scans AkBk is chosen so that all the scans are located within CBED disks.The points on line scans AkBk are conjugate to those on A0B0 since they are shifted by the reciprocal vector gk with respect to each other. As many conjugate scans are considered as CBED disks fall into the energy filtered region of the experimental pattern. Electron intensities of the transmitted beam I0 and diffracted beams Igk for all points on conjugate scans are found as a function of crystal thickness t on the basis of the full dynamical calculation.

Computer-Assisted High-Re Solution TEM

1990 ◽  
Vol 48 (1) ◽  
pp. 162-163
Author(s):  
F.A. Ponce ◽  
H. Hikashi
Keyword(s):  
Signal To Noise Ratio ◽  
Accurate Determination ◽  
Computer Software ◽  
Video Camera ◽  
Image Contrast ◽  
Objective Lens ◽  
Computer Assisted ◽  
Optical Parameters ◽  
Astigmatism Correction

The determination of the atomic positions from HRTEM micrographs is only possible if the optical parameters are known to a certain accuracy, and reliable through-focus series are available to match the experimental images with calculated images of possible atomic models. The main limitation in interpreting images at the atomic level is the knowledge of the optical parameters such as beam alignment, astigmatism correction and defocus value. Under ordinary conditions, the uncertainty in these values is sufficiently large to prevent the accurate determination of the atomic positions. Therefore, in order to achieve the resolution power of the microscope (under 0.2nm) it is necessary to take extraordinary measures. The use of on line computers has been proposed [e.g.: 2-5] and used with certain amount of success.We have built a system that can perform operations in the range of one frame stored and analyzed per second. A schematic diagram of the system is shown in figure 1. A JEOL 4000EX microscope equipped with an external computer interface is directly linked to a SUN-3 computer. All electrical parameters in the microscope can be changed via this interface by the use of a set of commands. The image is received from a video camera. A commercial image processor improves the signal-to-noise ratio by recursively averaging with a time constant, usually set at 0.25 sec. The computer software is based on a multi-window system and is entirely mouse-driven. All operations can be performed by clicking the mouse on the appropiate windows and buttons. This capability leads to extreme friendliness, ease of operation, and high operator speeds. Image analysis can be done in various ways. Here, we have measured the image contrast and used it to optimize certain parameters. The system is designed to have instant access to: (a) x- and y- alignment coils, (b) x- and y- astigmatism correction coils, and (c) objective lens current. The algorithm is shown in figure 2. Figure 3 shows an example taken from a thin CdTe crystal. The image contrast is displayed for changing objective lens current (defocus value). The display is calibrated in angstroms. Images are stored on the disk and are accessible by clicking the data points in the graph. Some of the frame-store images are displayed in Fig. 4.

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