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Background: The present study investigated the association between Postoperative Cognitive Dysfunction (POCD) and increased serum S100B level after Robotic-Assisted Laparoscopic Radical Prostatectomy (RALRP). Methods: The study included 82 consecutive patients who underwent RALRP. Serum S100B levels were determined preoperatively, after anesthesia induction, and at 30 minutes and 24 hours postoperatively. Cognitive function was assessed using neuropsychological testing preoperatively, and at 7 days and 3 months postoperatively. Results: Twenty four patients (29%) exhibited POCD 7 days after surgery, and 9 (11%) at 3 months after surgery. Serum S100B levels were significantly increased at postoperative 30 minutes and 24 hours in patients displaying POCD at postoperative 7 days (p = 0.0001 for both) and 3 months (p = 0.001 for both) compared to patients without POCD. Duration of anesthesia was also significantly longer in patients with POCD at 7 days and 3 months after surgery compared with patients without POCD (p = 0.012, p = 0.001, respectively), as was duration of Trendelenburg (p = 0.025, p = 0.002, respectively). Composite Z score in tests performed on day 7 were significantly correlated with duration of Trendelenburg and duration of anesthesia (p = 0.0001 for both). Conclusions: S100B increases after RALRP and this increase is associated with POCD development. Duration of Trendelenburg position and anesthesia contribute to the development of POCD. Trial Registry Number: Clinicaltrials.gov (N° NCT03018522). Resumo: Introdução: O presente estudo investigou a associação entre Disfunção Cognitiva Pós-Operatória (DCPO) e aumento do nível sérico de S100B após Prostatectomia Radical Laparoscópica Assistida por Robô (PRLAR). Métodos: O estudo incluiu 82 pacientes consecutivos submetidos a PRLAR. Os níveis séricos de S100B foram determinados: no pré-operatório, após indução anestésica, e aos 30 minutos e 24 horas do pós-operatório. A função cognitiva foi avaliada com testes neuropsicológicos no pré-operatório, no 7° dia pós-operatório (7DPO) e aos 3 meses após a cirurgia (3MPO). Resultados: Observamos 24 pacientes (29%) com DCPO no 7DPO e 9 pacientes com DCPO (11%) após 3 meses da cirurgia. Quando comparados com os pacientes sem DCPO, os níveis séricos de S100B estavam significantemente aumentados aos 30 minutos e às 24 horas do pós-operatório nos pacientes que apresentaram DCPO no 7DPO (p = 0,0001 para os dois momentos) e 3 mês após a cirurgia (p = 0,001 para os dois momentos) A duração anestésica também foi significantemente maior em pacientes com DCPO no 7DPO e 3MPO1 em comparação com pacientes sem DCPO (p = 0,012, p = 0,001, respectivamente), assim como a duração da posição de Trendelenburg (p = 0,025, p = 0,002, respectivamente). O escore Z composto nos testes realizados no 7DPO foi significantemente correlacionado com a duração da posição de Trendelenburg e a duração da anestesia (p = 0,0001 para ambos). Conclusão: S100B aumenta após PRLAR e o aumento está associado ao desenvolvimento de DCPO. A duração anestésica e o tempo decorrido em posição de Trendelenburg contribuem para o desenvolvimento de DCPO. Número de registro do estudo: Clinicaltrials.gov (n° NCT03018522)

Objective: The present study was aimed to determine the effect of penile prosthesis implantation (PPI) surgery on penile sensation by evaluating the penile electromyography (EMG) variables. Methods: The research was designed as a prospective study. Thirty patients who were diagnosed with organic erectile dysfunction and had underwent PPI surgery between January 2017 and January 2018 in the Urology Clinic of Antalya Training and Research Hospital were included in this study. Penile sensory EMG was performed on each patient 1 day prior to the surgery by the Physical Therapy and Rehabilitation clinic. Additionally, the control EMG study was also performed in the 3rd and 6th postoperative months. Results: We included 27 patients in this study who attended regular follow-ups and had complete EMG results. Out of the 27 patients, 23 (85.2%) patients had received malleable (ProMedon) penile prosthesis, one (3.7%) patient had received a two-piece inflatable (Ambicor) penile prosthesis, and three (11.1%) patients had received a three-piece inflatable (AMS 700 CXR) penile prosthesis. The mean nerve conduction value (NCV) of the patients was 29.85 (standard derivation: 22.54; range: 0–78.4) m/s during the preoperative period, whereas it was 27.64 (standard derivation: 24.72; range: 0–83.3) m/s in the 3rd postoperative month and 24.80 (standard derivation: 22.31; range: 0–88.4) m/s in the 6th postoperative month. There was no significant difference between preoperative NCV and 3rd postoperative month NCV (p=0.607). Similarly, no significant difference was observed between preoperative NCV and 6th postoperative month NCV (p=0.276). Additionally, the change between NCV values at postoperative 3rd and 6th months was not statistically significant (p=0.553). Conclusion: Significant loss of penile sensation does not occur in patients who undergo PPI surgery.

Recent research suggests that when high concentration gradients (HCG) are present, resulting sharp density differences can cause the dispersive flux relationship to deviate from its classical Fickian form. This paper presents stable, upward, miscible displacement experiments conducted in two different types of porous media for a wide range of concentration differences between resident and displacing fluids. The considered groundwater velocities ranged from advection-dominated transport to velocities where the contribution of molecular diffusion is important, with the corresponding Peclet numbers ranging from 0.2 to 320. In addition to single component displacing fluids, mixtures consisting of multiple solutes were considered. The results of this study provide further evidence that classical Fick's law over-estimates the dispersion coefficient under HCG conditions. The decrease in the apparent dispersion coefficient is shown to be a nonlinear function of both concentration difference and groundwater velocity. This observation is attributed to gravitational effects at the sub-continuum scale which are not directly accounted for in classical variable density advection/dispersion models. Mixture experiments showed that the dispersive behaviors of individual components in a groundwater contaminant mixture are coupled., (Copyright © 2012 Elsevier B.V. All rights reserved.)