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OBJECTIVE: Obesity has a negative effect on the quality of life (QoL), and therefore, the goal of bariatric surgery is not only to decrease excess weight but also to improve QoL and obesity-related comorbidities. Laparoscopic sleeve gastrectomy (LSG) has become the most commonly applied bariatric procedure worldwide, although there is a lack of prospective data on QoL in patients undergoing this procedure. Therefore, this prospective study aimed to compare QoL of obese patients before, and one year after LSG, and also to analyze the weight loss process and resolution of obesity-related comorbidities. PATIENTS AND METHODS: Patients undergoing LSG between January 2019 and December 2019 were included. They completed the Bariatric Quality of Life index (BQL) before surgery and one year after. Anthropometric data and obesity-related comorbidities were recorded. RESULTS: Thirty-eight patients were included in the study. The mean age was 37.9 ± 11.2 years, and the majority were women (68.4%). One year after the surgery, the mean body mass index (BMI) decreased from 45.5 ± 8.2 kg/m2 to 29.3 ± 6.1 kg/m2 (p<0.0001), and the mean percentage excess weight loss (%EWL) was 85.1 ± 22.3%. The preoperative total score of BQL was 46.05 ± 7.01 points and postoperatively it increased to 66.52 ± 5.53 points (p<0.0001). BQL total score and %EWL was positively and significantly correlated (r=0.479, p=0.002). Postoperatively, all obesity-related comorbidities were improved, although de novo gastroesophageal reflux disease (GERD) appeared in 7.8% of the cases. CONCLUSIONS: LSG improves QoL and allows resolution of obesity-related comorbidities, but a small proportion of patients may develop troublesome GERD postoperatively. [ABSTRACT FROM AUTHOR]

Introduction: The creation of an abdominal stoma is a common procedure performed by surgeons as a part of the treatment for benign and malignant conditions in general surgery. Stoma formation is simple, but sometimes the associated postoperative complications have an impact on the patients’ physical and psychological state. The majority of complications do not require reoperation, but when it is indicated, we have to assess the most appropriate option for the patient.

Background: Lymph node status in gastric cancer is known as an independent prognostic factor that guides the surgical and oncological treatment and independently influences long-term survival. Several studies suggest that the lymph node ratio has a greater importance in survival than the number of metastatic lymph nodes.

Background:Clostridium difficile (CD) is the major cause of nosocomial antibiotic-associated infections, having as main manifestation diarrhea and life-threatening inflammation of the colon. Surgery may be necessary in up to 80% of patients due to the frequent complications associated with this condition. The mortality rate of this devastating disease could reach 50% even after proper treatment.

We present the case of a 48-year-old patient with a recurrent rectovaginal fistula, who we treated surgically by transposing the gracilis muscle. The patient with a history of ulcerative colitis underwent colorectal resection with mechanical anastomosis and diverting ileostomy for rectal cancer. She was subsequently treated by radiation and chemotherapy. Six weeks later, the ileostomy was removed, but afterwards the patient developed a recto-vaginal fistula. A new diverting ileostomy was performed. After eight months, a transvaginal surgical procedure was performed, and the diverting ileostomy was closed after four months. Two years after the last surgery, the patient performed an MRI scan, which revealed the relapse of the rectovaginal fistula. This time the patient was reoperated using a flap of the gracilis muscle interposed between the rectum and the vagina, but the patient refused any diverting stoma. The rectovaginal fistula relapsed again after thirteen days. Fortunately, after six months of intensive systemic and local treatment with aminosalicilic-5-acid, the fistula closed by itself. Our conclusion is that with a well-managed medical treatment, the gracilis flap, because of its good vascular supply, could be successfully used to treat rectovaginal fistulas even in patients with ulcerative colitis who underwent rectal surgery and radiation therapy for cancer.

Castleman disease represents a rare lymphoproliferative disorder of unknown etiology. It is usually located in the mediastinum and in very few cases in the retroperitoneal space. We present the case of a 43-year-old male patient with a retroperitoneal tumor that was incidentally diagnosed during an abdominal computed tomography scan. The patient underwent surgery by open approach, and the tumor, which was adherent to the superior pole of the left kidney, was entirely removed. The histology examination revealed a vascular-hyaline-type Castleman disease. The postoperative evolution was uneventful, with no signs of tumor recurrence at the 4-month check-up. The surgeon should be aware of the possible retroperitoneal location of Castleman disease, even if it is a rare occurrence, and a complete removal of the tumor is followed by a favorable long-term prognosis.

Malignant melanoma is a neoplasia that has its origin in the melanocytes, the melanin-synthesizing pigment cells present in the epidermis or sometimes in the dermis. Sentinel lymph node biopsy (SLNB) is the standard procedure used for staging patients with malignant melanoma in the majority of surgical centers in the world. With a probability of approximately 20% of finding positive lymph nodes, it spares a large number of patients of a complete lymphatic dissection. The aim of this study is to evaluate the factors that can predict the positivity of sentinel lymph nodes in malignant melanoma patients. We performed a retrospective study analyzing the histopathologic reports of patients who underwent SLNB for malignant melanoma between 2012 and 2015. There were 32 patients identified, out of which only three (9.37%) had positive SLN, so the majority of our patients were spared of regional lymphatic dissection. In our series, lymphatic invasion (p = 0.01), Breslow index >4 mm (p = 0.0064), AJCC staging (p = 0.0008), the presence of precursory lesions (p = 002), and microsatellitosis (p = 0.017) were predictive factors for the positivity of the SLN in malignant melanoma patients. Although our results are similar to those published in the literature, we consider that larger cohort studies should be performed to consolidate our results.

Objective: To evaluate and demonstrate the accuracy of fine-needle aspiration (FNA) in thyroid lesions in our department and to highlight probable causes of errors leading to unsatisfactory sampling, which may depend on the characteristics of the nodule.

Introduction: The aim of this presentation is to highlight the usefulness of high-frequency ultrasound (18 MHz) in localized morphea for: identification of the lesion, guided skin biopsy, quantification of skin thickness, evaluating the severity by measuring total echogenicity.

Introduction: Sentinel node biopsy is the gold standard for axillary assessment of patients with breast cancer without axillary metastases on clinical and radiological examination. Internationally accepted biopsy methods currently use a radioactive tracer (Te) or different variations of vital stain, or the combination of the two. Due to the high cost of technical and organizational difficulty related to the radioactive material, as well as the disadvantages of using the vital stain method, great effort is being made to find alternative solutions. The aim of this study was to determine the effectiveness of the exclusive use of vital stain versus the radioactive isotope, and the need to use the combined method. A second goal was the comparative analysis of the radioactive method and intraoperative assessment of suspicious (non-sentinel) lymph nodes.

Anca Chiriac,1–3 Piotr Brzezinski,4 Cosmin Moldovan,5 Cristian Podoleanu,6 Marius Florin Coros,7 Simona Stolnicu8 1Department of Dermatology, Nicolina Medical Center, Iasi, 2Department of Dermatology, Apollonia University, Iasi, 3Department of Dermatology, P. Poni Research Institute, Romanian Academy Iasi, Romania; 4Department of Dermatology, 6th Military Support Unit, Utska, Poland; 5Department of Histology, 6Department of Cardiology, 7Department of Surgery, 8Department of Pathology, University of Medicine and Pharmacy of Targu‑Mures, Targu-Mures, Romania Background: Basal cell carcinoma (BCC) is the most common form of skin cancer, affecting millions of people worldwide. The treatment concept for BCCs is the surgical one, but it is costly, as such, searching for alternative medical therapeutics is justified. Aim: To highlight the efficacy of high concentration (70%) trichloroacetic acid (TCA) as a choice therapy for low-risk BCC. Method and patient: Authors present, for the first time, the use of a high concentration TCA applied once a week for 2 consecutive weeks with a toothpick, on a patient with BCC on the right preauricular area. Results: On examination 4 weeks later, the lesion was not clinically and dermatoscopically evidenced. Conclusion: High concentration TCA could be an effective and safe, non-invasive choice of therapy for low-risk BCC, easy to perform, not expensive, with good cosmetic results, especially for patients who are not likely to undergo invasive or expensive treatments. Keywords: basal cell carcinoma, therapy, trichloroacetic acid, dermatology

Florina Pogacean,1 Alexandru R Biris,2 Maria Coros,1 Mihaela Diana Lazar,1 Fumiya Watanabe,3 Ganesh K Kannarpady,3 Said A Farha Al Said,4 Alexandru S Biris,3 Stela Pruneanu1 1Department of Isotopic Physics and Technology, 2Department of Mass Spectrometry, Chromatography, and Applied Physics, National Institute for Research and Development of Isotopic and Molecular Technologies, Cluj-Napoca, Romania; 3Center for Integrative Nanotechnology Sciences, University of Arkansas at Little Rock, Little Rock, Arkansas, USA; 4Department of Physics, College of Science, King Abdulaziz University, Jeddah, Saudi Arabia Abstract: In this paper, we present a novel approach for the electrochemical detection of S-captopril based on graphene AuAg nanostructures used to modify an Au electrode. Multi-layer graphene (Gr) sheets decorated with embedded bimetallic AuAg nanoparticles were successfully synthesized catalytically with methane as the carbon source. The two catalytic systems contained 1.0 wt% Ag and 1.0 wt% Au, while the second had a larger concentration of metals (1.5 wt% Ag and 1.5 wt% Au) and was used for the synthesis of the Gr-AuAg-1 and Gr-AuAg-1.5 multicomponent samples. High-resolution transmission electron microscopy analysis indicated the presence of graphene flakes that had regular shapes (square or rectangular) and dimensions in the tens to hundreds of nanometers. We found that the size of the embedded AuAg nanoparticles varied between 5 and 100 nm, with the majority being smaller than 20 nm. Advanced scanning transmission electron microscopy studies indicated a bimetallic characteristic of the metallic clusters. The resulting Gr-AuAg-1 and Gr-AuAg-1.5 samples were used to modify the surface of commonly used Au substrates and subsequently employed for the direct electrochemical oxidation of S-captopril. By comparing the differential pulse voltammograms recorded with the two modified electrodes at various concentrations of captopril, the peak current was determined to be well-defined, even at relatively low concentration (10-5 M), for the Au/Gr-AuAg-1.5 electrode. In contrast, the signals recorded with the Au/Gr-AuAg-1 electrode were poorly defined within a 5×10-6 to 5×10-3 M concentration range, and many of them overlapped with the background. Such composite materials could find significant applications in nanotechnology, sensing, or nanomedicine. Keywords: bimetallic AuAg nanoparticles, electrochemical detection, multi-layer graphene

An immature teratoma is a germinal malignant tumor composed of three germ cell layers, occurring more frequently in young women. It is the second most frequent among the malignant germinal tumors after dysgerminoma, and it is the only neoplasm with germ cells that are histologically graded. Even if we do not have a consensus regarding its therapeutical management, it has a good prognosis, with an excellent overall survival rate and good fertility preservation. More studies are needed regarding the necessity of adjuvant chemotherapy in pediatric oncology, and because of chemotherapy's long-term adverse effects, surveillance or a targeted treatment is preferred, but the main therapy is fertility-sparing surgery. Special attention should be given to the genetic mapping of the histological pieces for patient risk stratification due to its value in prognosis and future treatment.

Surface modification of textile fabrics and leathers is very versatile and allows the products quality improvement. In this work, cotton and leather substrates were pre-treated with cold atmospheric pressure plasma (CAPP) and further coated with TiO 2 -SiO 2 -reduced graphene oxide composites in dispersion form. By using a Taguchi scheme, this research evaluated the effect of three significant parameters, i.e., the pre-treatment with CAPP, organic dispersion coating and TiO 2 -SiO 2 -reduced graphene oxide (TS/GR) composites, that may affect the morpho-structural properties and photocatalytic activity of modified cotton and leather surfaces. The characteristics of cotton/leather surfaces were evaluated by morphological, structural, optical and self-cleaning ability using scanning electron microscopy with energy dispersive X-ray spectroscopy (SEM/EDX), X-ray powder diffraction (XRD), attenuated total reflection-Fourier Transform Infrared spectroscopy (ATR-FTIR) and UV-Vis spectroscopy. The self-cleaning performance of the obtained cotton and leather samples was evaluated by photocatalytic discoloration of berry juice surface stains under UV light irradiation for 12 h. The successfulness of coating formulations was proven by the SEM analysis and UV-Vis spectroscopy. The XRD patterns and ATR-FTIR spectra revealed the cellulose and collagen structures as dominant components of cotton and leather substrates. The CAPP treatment did not damage the cotton and leather structures. The photocatalytic results highlighted the potential of TiO 2 -SiO 2 -reduced graphene oxide composites in organic dispersion media, as coating formulations, for further use in the fabrication of innovative self-cleaning photocatalytic cotton and leather products.

This paper aims to revisit the relationship between gastroesophageal reflux disease and laparoscopic sleeve gastrectomy in obese patients by reviewing the recent available literature, in the form of a narrative review. The interpretation of the current evidence is challenged by the fact that published data are contradictory and comparison between studies is difficult. Most studies investigate the presence of gastroesophageal reflux disease by assessing only the symptoms reported by patients. A few studies have objectively investigated gastroesophageal reflux disease by functional tests and endoscopic evaluation. Also, the surgical technique of laparoscopic sleeve gastrectomy plays an important role in the incidence of postoperative gastroesophageal reflux disease. In conclusion, surgeons must be aware of the existence of gastroesophageal reflux disease and, at the same time, patients should be informed regarding the possible effect of laparoscopic sleeve gastrectomy on gastroesophageal reflux disease., Competing Interests: The authors declare no conflict of interest., (Copyright: © 2021 Fundacja Videochirurgii.)