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While BRAF inhibitor combinations with EGFR and/or MEK inhibitors have improved clinical efficacy in BRAFV600E colorectal cancer (CRC), response rates remain low and lack durability. Preclinical data suggest that BRAF/MAPK pathway inhibition may augment the tumor immune response. We performed a proof-of-concept single-arm phase 2 clinical trial of combined PD-1, BRAF and MEK inhibition with sparatlizumab (PDR001), dabrafenib and trametinib in 37 patients with BRAFV600E CRC. The primary end point was overall response rate, and the secondary end points were progression-free survival, disease control rate, duration of response and overall survival. The study met its primary end point with a confirmed response rate (24.3% in all patients; 25% in microsatellite stable patients) and durability that were favorable relative to historical controls of BRAF-targeted combinations alone. Single-cell RNA sequencing of 23 paired pretreatment and day 15 on-treatment tumor biopsies revealed greater induction of tumor cell-intrinsic immune programs and more complete MAPK inhibition in patients with better clinical outcome. Immune program induction in matched patient-derived organoids correlated with the degree of MAPK inhibition. These data suggest a potential tumor cell-intrinsic mechanism of cooperativity between MAPK inhibition and immune response, warranting further clinical evaluation of optimized targeted and immune combinations in CRC. ClinicalTrials.gov registration: NCT03668431.

p53 is an independent risk stratification marker in Barrett's esophagus (BE), but no universally accepted definition exists for abnormal p53 staining. Herein, we assess p53 stains in two cohorts to: 1) define abnormal p53 staining in BE-related dysplasia (BERD), and 2) assess the specificity and sensitivity of this cut point for the diagnosis of dysplasia.Cohort 1 (n= 313) included 1) dysplastic BE biopsies, 2) prior non-dysplastic BE (NDBE) biopsies from the same patients, and 3) NDBE biopsies from patients who never progressed to dysplasia. Cohort 2 (n=193) consisted of BE biopsies in which p53 staining aided in diagnosing dysplasia. Automated p53 staining quantification was performed on cohort 1. A semi-quantitative p53 analysis, performed on both cohorts, included: 1) number of strongly positive glands, 2) strong glandular surface staining, 3) percentage of strongly positive glands, and 4) null phenotype.NDBE biopsies from cohort 1 patients who progressed to dysplasia were more likely to show p53 positivity than non-progressors (16.9% vs 0.6%) (p=0.0001). The optimal quantitative cut point for distinguishing dysplastic from never-dysplasia biopsies was 10 strongly positive cells. By semiquantitative analysis, a single strongly p53-positive gland distinguished dysplastic from never-dysplasia BE (sensitivity 98.6%, specificity 99.4%). The semi-quantitative and quantitative analyses correlated (p=0.0001). In cohort 2, the sensitivity and specificity for BERD of ≥1 strongly positive p53 gland were 86.0 and 88.6%.A single strongly positive p53 gland is sensitive and specific for BERD. Automated p53 analysis may reduce subjectivity associated with the diagnosis of BERD.

Programmed cell death ligand 1 (PD-L1) on tumor cells is a significant prognostic biomarker for a number of malignancies, although less is known about the significance of PD-L1 positive immune cells in colon carcinoma. The purpose of this study is to evaluate the role of PD-L1 in a large cohort of colon carcinomas to identify patterns of PD-L1 expression in the tumor microenvironment and its correlation with other key immune subsets to better understand the impact of these immune cells. We assessed 1218 colon carcinomas on representative tissue microarray sections, gathered relevant clinicopathologic information, and performed immunohistochemical staining for mismatch repair proteins, CD8, CD163, LAG3, PD-L1, FoxP3, and BRAF V600E. We then performed automated quantification; manual quantification was used for PD-L1 tumor cells and immune cells. Dual PD-L1/PU.1 immunostain was also performed. The majority of PD-L1 positive cells expressed PU.1 thus representing tumor-associated macrophages. Based on the median number of PD-L1 positive immune cells (7.6/mm

While advances in single cell genomics have helped to chart the cellular components of tumor ecosystems, it has been more challenging to characterize their specific spatial organization and functional interactions. Here, we combine single cell RNA-seq and spatial transcriptomics by Slide-seq, to create a detailed spatial map of healthy and dysplastic colon cellular ecosystems and their association with disease progression. We profiled an inducible genetic CRC mouse model that recapitulates key features of human CRC, assigned cell types and epithelial expression programs to spatial tissue locations in tumors, and computationally used them to identify the regional features spanning different cells in the same spatial niche. We find that tumors were organized in cellular neighborhoods, each with a distinct composition of cell subtypes, expression programs, and local cellular interactions. Three cellular neighborhood archetypes were associated with tumor progression, were active at the same time in different spatial parts of the same tumor, involved dysplasia-specific cellular layouts, and relied on distinct mechanisms: (1) inflammatory epithelial regions with endothelial cells and monocytes expressing angiogenesis, inflammation and invasion programs; (2) epithelial stem-like regions, associated with plasma and B cell activity; and (3) epithelial-to-mesenchymal transition (EMT) regions with dysplastic cells expressing a Wnt signaling program. Comparing to scRNA-seq and Slide-seq data from human CRC, we find that both cell composition and layout features were conserved in both species, with mouse archetypal neighborhoods correlated with malignancy and clinical outcome in human patient tumors, highlighting the relevance of our findings to human disease.

Background: This study aimed to determine the contribution of color Doppler ultrasonography (CDUS) performed before varicocelectomy to the success of surgical treatment and to evaluate the correlation between CDUS findings and semen parameters. Methods: A total of 84 patients diagnosed with grade 3 left varicocele in our clinic between 2016 and 2018 were evaluated. The patients in whom the decision for varicocelectomy was based on only physical examination (PE) findings and abnormal semen analysis (SA) were defined as Group 1, while the patients undergoing varicocelectomy based on PE, CDUS and SA findings were defined as Group 2. The patients diagnosed with varicocele based on PE and CDUS findings who were included in a followup protocol due to normal semen parameters were defined as Group 3. Results: In Group 1, there was a total of 28 patients and the mean number of ligated internal spermatic veins was 4.53 (range, 2-10). In Group 2, there was a total of 30 patients and the number of ligated internal spermatic veins was 3.76 (range, 1-8). No statistically significant difference was found between Group 1 and 2 in terms of the number of internal spermatic veins ligated during varicocelectomy. No statistically significant correlation was found between semen parameters and the number of veins ligated during varicocelectomy in Group 1 and 2 and between semen parameters and CDUS findings group 2 and 3. Conclusions: In patients with primary grade 3 varicocele, diagnosed by physical examination there is no need for additional imaging in primary cases.

ABTRACTWe aimed to assess the correlation between ISUP 2014 grades of needle biopsy (NB) and radical prostatectomy (RP) specimens and the parameters effecting this correlation. A total of 353 patients, who underwent a radical prostatectomy with diagnose of prostate cancer, were included in the study. Especially, the maximum percentage of core involved by cancer (MPCI) of upgraded group was significantly higher than those of correlated group and downgraded group. MPCI might be used as a preoperative value to determine risk classification and to help counsel patients with regard to treatment decision and prognosis of disease.

The sedimentology, geochemistry and paleontology of the pelagic upper Campanian Maastrichtian Bozova Formation in the "Mazidag" (Mazıdağı) - Mardin area, SE Turkey, reveal paleoceanographic and paleoecological changes for the first time. A 119.25 m-thick composite stratigraphic section is characterized by alternating marls, clayey limestones, shales, and black shales; no coarse siliciclastic admixture or turbidite intercalations were recorded in the section. Biostratigraphic data indicate the presence of the Radotruncana calcarata Zone, and the UC15de/UC16 nannofossil zones. Stable isotope and elemental geochemical analyses have been carried out in the studied section. The isotope curves display similar patterns compared to reference curves from European and Chinese basins in the same interval. The prominent negative carbon isotope excursion determined in the upper interval can be correlated with the Late Campanian Event. Proxy elements display generally two relative rising trends in productivity from the lower part and the middle part of the succession. The lower part of the section records relatively more dysoxic/anoxic conditions and coincides with common black shale beds. The presence of both diverse planktonic foraminifera and calcareous nannofossils in the studied interval indicates a fully marine, warm-water, low-latitude Tethysian oceanic environment. In addition, the plant fossils derived from the nearby land mass indicate that a tropical humid climate was similar to that in northeast Australia. Therefore, warm water, tropical humid atmospheric conditions developed in the studied area causing the rise in productivity, precipitation and transportation of plant debris into offshore environments.

AimMicropapillary carcinoma (MPC) is a recognised WHO variant of colonic carcinoma (CC), although little is known about its prognosis, immune microenvironment and molecular alterations. We investigated its clinical, pathological and immunological characteristics.MethodsWe assessed 903 consecutive CCs and used the WHO definition to identify MPC. We recorded serrated and mucinous differentiation and mismatch repair (MMR) status. We performed immunohistochemistry and quantification on tissue microarrays for HLA class I/II proteins, beta-2-microglobulin (B2MG), CD8, CD163, LAG3, PD-L1, FoxP3, PD-L1and BRAF V600E.ResultsWe classified 8.6% (N=78) of CC as MPC. Relative to non-MPC, MPC was more often high grade (p=0.03) and showed serrated morphology (pConclusionMPCs are associated with high-grade differentiation and a less active immune microenvironment than non-MPC. MPC is not associated with inferior disease-specific survival.

Colorectal cancers (CRCs) are a leading cause of cancer-related death. Most CRCs are immune cold, and do not respond to checkpoint blockade therapy except for microsatellite-high CRCs harboring high mutational burdens. Deciphering the mechanism by which CRC cells evade immune surveillance has the potential to dramatically improve the prognosis of CRC patients. During tumor evolution of CRCs, epigenetic changes play critical roles in addition to accumulation of genetic mutations. However, distinct mutational patterns and patient backgrounds render it challenging to distinguish the driver epigenetic alterations from passenger epigenetic alterations induced by gene mutations or other environmental factors. Identification of the driver epigenetic alterations may provide novel mechanistic insights into colon cancer biology including how they evade immune surveillance. Here, we utilized the colon cancer organoid orthotopic transplantation approach to establish colon cancer organoids from different stages of the tumors, and performed comprehensive epigenomic and transcriptomic analyses to understand the epigenetic alterations during tumor evolution. We found that in vivo environment induces epigenetic alterations that converge on SOX17, a transcription factor that is required for endoderm development. SOX17 is re-expressed in colon cancers in vivo, but not in the in vitro organoid culture, and reprograms tumor cell fate with fetal intestinal gene expressions. Importantly, SOX17 knockout leads to tumor rejection in immunocompetent mice, but not in immunodeficient mice, by turning immune cold tumors into hot tumors with robust intratumoral infiltration of activated CD8+ T cells. Mechanistically, SOX17 directly downregulates Ifngr1 expression and mitigates MHC-I expression to evade CD8+ T cell-mediated tumor cell killing. Together, our result reveals that SOX17 is a master transcription factor that induces the in vivo epigenetic reprograming of tumors, which contributes to the immune evasion of colon cancers. Citation Format: Norihiro Goto, Saori Goto, Peter Westcott, Shinya Imada, Judith Agudo, Omer Yilmaz. SOX17 plays a critical role in immune evasion of colorectal cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 1352.

The micropalaeontology of the mid-Cretaceous Derdere Formation (Mardin Group) from outcrops close to the town of Derik in south-eastern Turkey is described here. In thin sections from the carbonates that form the majority of this formation, rich and diverse micropalaeontological assemblages are present. These include larger benthonic foraminifera, planktonic foraminifera, and other microfossils, including calcareous algae. Alveolinid foraminifera are particularly common and include a new species – Simplalveolina mardinensis. In contrast to some previous studies, the majority of the section can be demonstrated to be Cenomanian (notably middle Cenomanian) in age with no confirmation of extension into the Albian or Turonian. Deposition took place on a carbonate ramp within a range of discrete deposition settings ranging from peritidal to outer ramp. A notable feature is the small-scale (a few metres) shallowing-up cycles within the inner-ramp facies that may be allocyclic or autocyclic in origin. Three major deepening events are recognised within the succession, characterised by more open marine microfauna and microfacies. These occur at the base of the formation, within the mid-Cenomanian lower part, and towards the top of the formation. These may correlate with three Cenomanian deepening phases seen in other parts of the Arabian Plate.

Objective:The objective of this study is to investigate the bleeding control safety along with the need for preoperative blood preparation and postoperative blood transfusion in the transurethral resection of the prostate with monopolar system (M-TURP) for the treatment of benign prostatic obstruction (BPO).Materials and Methods:We retrospectively analysed 379 patients with BPO who underwent M-TURP procedure between January 2016 and December 2019 at a single centre. Importantly, we collected the demographic data, use of 5-alpha-reductase inhibitor (5-ARI), postoperative haemoglobin (Hb) and haematocrit levels, platelet counts, and transfusion rates of these patients.Results:The minimum, maximum and the mean ages of the patients were 43, 79 and 67.44±7.74 years, respectively. The minimum, maximum and the mean prostate volumes of the patients measured via transrectal ultrasonography were 30, 95 and 53.42±18.12 mL, respectively. In total, 99 patients (26.1%) had received 5-ARI for at least three months before surgery. The mean decrease of the preoperative Hb in the postoperative 48th hour was 0.99±0.87 gr/dL. Only 9 patients (2.4%) received the transfusion of blood products (erythrocytes or fresh frozen plasma). The preoperative Hb level was inversely and significantly correlated with the decrease in postoperative Hb and the need for transfusion (p

To analyse the association of prostate cancer (PCa) Gleason score evaluated upon prostate biopsy with clinical PSA values, total and free testosterone (TT and FT, respectively) levels measured prior to biopsy.A descriptive study.Department of Urology, Sultan Abdulhamid Han Education and Research Hospital, from July to December 2019.A total of 85 patients were included and classified into non-PCa (group 1) and PCa (group 2) groups according the results of prostate biopsy pathology. Age, digital rectal examination (DRE) findings; prostate volume (PV); free/total prostate specific antigen (PSA) ratio (f/tPSA); PSA density (PSA-D) and total PSA (tPSA), free PSA (fPSA), TT and FT levels of the two groups were evaluated. Associations of the ISUP grade of patients in group 2 with age, DRE findings for PCa; PV; PSA-D; f/tPSA and tPSA, fPSA, TT and FT levels were analysed.Mean patient age was 63.00 (57.50-70.00) years. Mean age, significant DRE findings for PCa, tPSA levels and PSA-D were significantly higher in group 2 (p0.05), whereas PV was significantly higher in group 1 (p0.05). The ISUP grade of patients in group 2 was significantly and positively correlated with age and tPSA levels (p0.05). ISUP grade was significantly and positively correlated with significant DRE findings for PCa (p0.05). However, ISUP grade was negatively correlated with PV and f/tPSA (p0.05). No significant difference was observed between the two groups in terms of TT and FT levels (p0.05).TT and FT levels evaluated before prostate biopsy did not provide any additional benefit in predicting Gleason score grade before biopsy. Key Words: Prostate biopsy, prostate cancer, ISUP grade, Gleason score, total testosterone, free testosterone.

Objective:In this study, we aimed to determine the contribution of hounsfield unit (HU) measurement with non-contrast-enhanced computed tomography to the treatment of a single ureteral stone, and compare the value of HU and intraoperative “GATA scale” score in deciding for DJ stent placement in patients with a single ureteral stone.Materials and Methods:Ninety patients diagnosed with a single ureteral stone in our clinic between January 2018 and September 2018 were evaluated prospectively. We planned a new scale called “GATA scale” with three benchmarks. The validity and reliability of HU were compared with those of GATA scale score. Statistical significance was defined as p

Objectives: Chemical cystitis is a disease that causes mortality and morbidity. It’s treatment is really difficult. We aimed to present a low-cost, successful, easy-to-access, and easily applicable treatment option for the treatment of this disease. Materials and Methods: 16 Sprague-Dawley rats were divided into 4 groups. 1 group is a sham group, 2’nd is saline, 3’rd surfactant before chemical cystitis, and 4’th group is surfactant after chemical cystitis. On the 4th day, all groups are sacrificed and their bladders are sent for histochemical examination. The pathological data of the subjects were evaluated according to the levels of hemorrhage, edema, inflammation, and congestion. Data were evaluated by scoring between 0-2. 0 none, 1 Moderate, and 2 highly present. Results: There was no statistically significant difference found between the groups in terms of all parameters (p=0.111). The difference was not found statistically significant in the pairwise comparison of the groups (p>0.05). Conclusion: Surfactant had no preventive or therapeutic effect on the chemical cystitis developed in mice. The simple saline application seems to be more effective.

Acigol (Nevsehir, Central Anatolia) is a drained crater lake. Acigol maar was formed by the violent vapor explosions due to the interaction of hot rhyolitic magma with the (sub-)surface water during the latest Pleistocene. A 844 cm-deep borehole was drilled at the maar and 713 cm-thick Acigol Core Succession (ACS) was retrieved. The ACS is mainly composed of lower laminated and upper non-laminated mudstones (sandy, silty, and clayey) with rare organic and volcanic interlayers. Eleven ostracod taxa (Cypris pubera, Plesiocypridopsis newtoni, Heterocypris salina, Eucypris cf. heinrichi, Candona candida, Candona meerfeldiana, Pseudocandona marchica, Cyclocypris sp., Ilyocypris bradyi, Limnocythere inopinata, and Darwinula stevensoni) were determined in this study. Along with ostracods, gastropods (Gyraulus piscinarum and Stagnicola sp.), pelecypods (Pisidium personatum), charophytes, and fish remains were also observed, while diatoms are the most frequent and abundant assemblage of the ACS. The assemblage at the lower parts of ACS mainly indicates wetter, freshwater to oligohaline, and oligotrophic and relatively deep lacustrine conditions alternating with short lake shrinkage intervals. On the other hand, the fauna at the upper part of the ACS points out to saline, shallow, and warmer lacustrine conditions.

A new fossil conifer Araucaria rothwellii J.Kvacek from the Campanian-Maastrichtian marine sediments of the Bozova Formation in southeastern Turkey is described based on leaf compressions and leaf ...

This study describes and interprets Upper Cretaceous volcaniclastics interbedded with hemipelagic to pelagic limestones, marls, and turbidites from the Western Pontides, northwestern Turkey. The Dereköy Formation, the Unaz Formation (red pelagic limestone unit), and the Cambu Formation can be distinguished, overlain by the turbiditic Akveren Formation. Biostratigraphic ages from the predominantly volcaniclastic Dereköy Formation indicate Turonian (Dicarinella concavata planktonic foraminifera zone, CC13/UC8-9 nannofossil zones) to middle/late Santonian ages up to CC17/UC13. The Unaz Formation, deposited during the late Santonian (UC13, Dicarinella asymetrica Zone), is overlain by the volcaniclastic Cambu Formation of latest Santonian (CC17b/UC13) to early/middle Campanian (CC20/UC15a) age. However, turbidite intercalations are already present diachronously from CC19/UC14d onwards, and the turbiditic Akveren Formation ranges up into the late Maastrichtian (Abathomphalus mayaroensis Zone). Geochemistry of the volcaniclastic units reveals information about the volcanic series and tectonic setting, although element mobility has to be considered. An overall trend of calc-alkaline to high-K calc-alkaline series and basaltic to basalt-andesitic rock types was identified. A negative Nb anomaly with respect to Th and Ce in all samples confirms the existence of a volcanic arc, also indicated by a negative Ti anomaly. Biostratigraphic age constraints give evidence for volcanic arc activity mainly between Turonian and early Campanian, ca. 91 - 79 Ma. Various geochemical data, especially element variations normalized to N-MORB, show two types of volcanic arc basalts (VAB): (1) Calc-alkaline to high-K calc-alkaline VAB have increased Nb and Zr values, (2) more tholeiitic VABs are depleted in Nb, Zr, Ti, V. The volcaniclastics successions were deposited in an arc setting triggered by different stages of subduction of the Neotethys Ocean to the south and contemporaneous spreading in the Western Black Sea Basin to the north. An extensional regime caused formation of small but deeper-water sedimentary basins along the southern shore of the Black Sea where volcaniclastic complexes interfingered within short lateral distances with pelagic and mass-flow deposits.

WOS: 000459524900008, PubMed: 30500554, Heracleum sphondylium L. subsp. ternatum (Velen.) Brummitt. commonly known as "hogweed" is traditionally used to manage several human ailments. This investigation assessed, for the first time, the enzyme inhibitory properties, antioxidant activity, phytochemical profile, antimutagenic, and antimicrobial potential of the ethyl acetate, methanol, and water extracts of H. sphondylium. We also established the possible interactions of identified phenolic compounds with cholinesterases, amylase, glucosidase, and tyrosinase using in silico docking studies. Chlorogenic acid was found in high amounts in the methanol extract of H. sphondyliurn. The methanol extract was an effective inhibitor of acetylcholinesterase (1.70 mg galantamine equivalent (GALAE)/g extract) while the ethyl acetate extract showed pronounced inhibitory action against butyrylcholinesterase (1.77 mg GALAE/g extract). The extracts exhibited low inhibition against amylase (0.12-0.84 mmol acarbose equivalent (ACAE)/g extract) and a more pronounced inhibition against glucosidase (2.29-3.65 mmol ACAE/g extract). In silico results showed that rutin and quercetin (-70.4 and -72.2 Kcal/mol, for rutin and quercetin respectively) docked to the enzymatic cavity of acetylcholinesterase but these phenolic compounds showed less affinity with butyrylcholinesterase (-15.0 and -5.2 Kcal/mol, for rutin and quercetin respectively). The extracts did not induce any mutations on the bacterial strains, while they have excellent antimutagenic capacity against well-known mutagens (inhibition values 98%, 97% and 96%). The methanol extract (0.78 mg/ml) showed moderate antifungal activity while the ethyl acetate extract (0.78-3.12 mg/ml) showed weak to moderate antimicrobial activity. This study provides valuable baseline data which might serve for the development of future pharmacophores for the management of human ailments.

Background: In the diagnosis of prostatic diseases, the need for markers other than prostate specific antigen (PSA) has been increasing in recent years. So, we aimed to determine the predictive value, the neutrophil lymphocyte ratio, platelet-to-lymphocyte ratio and mean platelet volume before prostate biopsy in predicting the results of pathology. Transrectal ultrasound-guided biopsy of the prostate was performed because of high PSA values and compared values of these parameters to predict of pathology results. Methods: 2715 patients who underwent 10 - 12 quadrant transrectal ultrasound-guided prostate biopsies between January 2008 and January 2018 have been evaluated retrospectively. Patients were divided into groups according to the biopsy pathology results by benign (group 1), atypical small acinar proliferation (ASAP) (group 2) and prostate cancer (group 3). A total of 204 patients who were benign prostate hyperplasia in 71 patients (34.8%), atypical small acinar proliferation in 80 (39.21%) and prostate adenocarcinoma (PCa) in 53 patients (25.98%) were included in the study by systematic sampling. Before the biopsy total PSA (tPSA), free PSA (fPSA), rate of percentage of free to total prostate specific antigen (f/tPSA) rate, PSA density (PSA-D), white blood cell (WBC) count, blood neutrophil count (NC), blood lymphocyte count (LC), neutrophil lymphocyte ratio (NLR), mean platelet volume (MPV), platelet count (PLT) and platelet-to-lymphocyte ratio (PLR) were measured and compared in all groups. Differences in continuous variables were assessed using the ANOVA. Logistic regression was used to analyze the linear relationship between predictive variables and pathology results. P < 0.05 was considered statistically significant. Results: NLR and PLR values were lower in group 1 than group 2 and were found statistically significant between in group 1 and group 2 (p: 0.03 and p: 0.02, respectively). MPV value was found 1.7 times higher in patients who were diagnosed with ASAP pathology than those with benign pathologies. Although there was statistically significant increase in MPV values in logistic regression results, no statistically significant diagnostic value was found. In addition MPV value was found 0.5 times higher in patients who were diagnosed patients with ASAP than prostate cancer group. ROC analysis showed that the optimal threshold was 7.65 femtoliter (sensitivity: 51%; specificity: 30%) and was found to be a statistically significant diagnostic value to distinguish groups 2 and 3. The lowest value of MPV was found in group 3. Conclusions: In cases where the PSA value is insufficient in predicting the pathology result, the effect of NLR, PLR and MPV on differential diagnosis can be kept in mind. While NLR and PLR are more useful in the diagnosis of ASAP, MPV is more effective in the diagnosis of malignancy.

Background: In this study, we aimed to share our experiences in patients with epidermoid cyst of the testis. We report the demographic and clinical characteristics and the long term results in patients with epidermoid cysts. Materials and Methods: Thirteen patients with epidermoid cyst of the testis treated between June 2000 and January 2018 were retrospectively evaluated. Ten patients with available data were included in the study. Patients’ age, scrotal localization of symptoms, physical examination findings, serum tumor marker levels, pathology results and follow-up periods were recorded. Results: The current cohort consisted of 10 patients. The mean age at diagnosis was 29.7 years (range, 20 to 53 years). Eighty percent of the lesions were localized to the left hemiscrotum and 20% to the right hemiscrotum. One patient had a history of unilateral undescended testis. Serum tumor markers were normal in all patients. The mean scrotal mass lesion volume at diagnosis was 28 mm3 (range, 13 to 51 mm3). The mean follow-up period was 66.9 months (range, 12 to 216 months). Conclusions: Epidermoid cyst of the testis should be kept in mind, particularly in patients with lesions negative for tumor markers and radiological findings typical of epidermoid cysts. Annual follow-up is not required.

Aim We evaluated the COVID‐19 infection threat in patients receiving intravesical BCG therapy which has immunotherapeutic effects and is of vital importance in most of the individuals with high‐risk non‐muscle‐invasive bladder cancer (NMIBC) and investigated the need for postponement of this therapy. Methods A total of 71 patients, who were diagnosed with high‐risk NMIBC and on intravesical BCG treatment regularly (induction or maintenance), were enrolled in the study. The patients were classified into two groups depending on whether they were diagnosed with COVID‐19 during the pandemic period or not. Results Of 71 patients, 26 underwent a COVID‐19 polymerase chain reaction test with clinical suspicion during the pandemic period. Of these 26 patients, 4 were diagnosed with COVID‐19. Age of the patients, working status (working/retired), compliance with containment measures against the pandemic, number of BCG courses, adverse effects after BCG therapy, and systemic immune‐inflammation index, which is an inflammation‐related parameter, were not different between groups (p>0.05). Neutrophil/lymphocyte ratio was significantly higher in the COVID‐19 positive group (p

Aims This study aims to analyse the novel Coronavirus disease- (COVID-19) related testicular pain in hospitalised patients because of COVID-19 and to review as an aetiological factor for epididymitis, orchitis or both. Methods A total of 91 patients were included in the study. A questionnaire was formed for the questioning of testicular pain or epididymo-orchitis in patients with COVID-19. Demographics and past medical history was also recorded. Patients' neutrophil and lymphocyte counts, neutrophil-lymphocyte ratios (NLR), C-reactive protein (CRP) levels and D-dimer values were recorded. Patients with COVID-19 were divided into two groups according to absence or presence of testicular pain or epididymo-orchitis as group 1 and group 2. All results were compared for both groups. Results The median age of patients was similar in both groups. Testicular pain was occurred in 10.98% of the patients. Clinical presentation of epididymo-orchitis was diagnosed in only one patient. No statistically significant difference was reported in terms of patients' age, levels of CRP and D-Dimer or NLR and results of questionnaire form queries between the two groups (P > .05). Conclusion Testicular pain was observed more frequently in hospitalised COVID-19 cases. While no inflammation marker which is related to predict of testicular pain or epididymo-orchitis was found in patients with COVID-19.

Aim We aimed to investigate the predictor role of the systemic immune-inflammation index (SII) on Bacille Calmette-Guerin (BCG) response in patients with high-risk non-muscle invasive bladder cancer (NMIBC). Methods A total of 96 patients with high-risk NMIBC, who received intravesical BCG, were enrolled in the study. BCG responsive group (group 1) and BCG failure group (group 2) were compared in terms of demographic and pathological data, peripheral lymphocyte, neutrophil and platelet counts, neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), SII, recurrence-free survival (RFS) and progression-free survival (PFS). The SII was calculated as in the formula: SII = neutrophil × platelet/lymphocyte. The prognostic ability of the SII for progression was analysed with multivariate backward stepwise regression models. Results The mean follow-up time 34.635 ± 14.7 months. Group 2 had significantly higher SII, peripheral lymphocyte, neutrophil and platelet counts than group 1. An ROC curve was plotted for the SII to predict the BCG failure and the cut-off point was calculated as 672.75. Effect of the SII to the model was statistically significant (P = .003) and a higher SII increased the progression onefold. A tumour greater than 30 mm in size and a high SII together increased the progression 3.6 folds. Conclusions The SII might be a successful, non-invasive and low-cost parameter for prediction of BCG failure in patients with high-risk NMIBC. The cut-off value for SII is 672.75 and above this level BCG failure and progression to MIBC might be anticipated. However, these results should be validated in prospective randomised controlled studies with large patient groups.

Aims: This study aims to analyze the novel Coronavirus disease (COVID-19) related testicular pain in hospitalized patients due to COVID-19 and to review as an etiological factor for epididymitis, orchitis or both. Methods: A total of 91 patients were included in the study. A questionnaire was formed for the questioning of testicular pain or epididymo-orchitis in patients with COVID-19. Demophrahics and past medical history was also recorded. Patients’ neutrophil and lymphocyte counts, neutrophil-lymphocyte ratios (NLR), C-reactive protein (CRP) levels and D-dimer values were recorded. Patients with COVID-19 were divided into two groups according to absence or presence of testicular pain or epididymo-orchitis as group 1 and group 2. All results were compared for both groups. Results: The median age of patients was similar in both groups. Testicular pain was occured in 10.98% of the patients. Clinical presentation of epididymo-orchitis was diagnosed in only one patient. No statistically significant difference was reported in terms of patients’ age, levels of CRP and D-Dimer or NLR and results of questionnaire form queries between the two groups (p>0.05). Conclusion: Testicular pain was observed more frequently in hospitalized COVID-19 cases. While no inflammation marker which is related to predict of testicular pain or epididymo-orchitis was found in patients with COVID-19.

OBJECTIVE To investigate 18 independent peroperative parameters that may have an effect on fever after percutaneous nephrolithotomy (PCNL). STUDY DESIGN A descriptive study. PLACE AND DURATION OF STUDY Departments of Urology, Nevsehir State Hospital, and Sultan Abdulhamid Han Education and Research Hospital, Turkey, from January 2016 to June 2019. METHODOLOGY Two hundred and seventy-six patients, who underwent PCNL between 2016 and 2019 in two institutions, were evaluated retrospectively. Patients were divided as Group I and II, according to the absence or presence of fever after PCNL, then peroperative parameters were compared. RESULTS There was no statistically significant difference between Group I and II in terms of age, gender, side of stone, ipsilateral open stone surgery or PCNL history, presence of renal anatomic anomaly, preoperative hydronephrosis grade, stone size in computed tomography (CT), stone Houndsfield Unit (HU) value, skin stone distance, duration of operation, postoperative D-J insertion rate and postoperative blood transfusion requirement (p >0.05). Guy' s Stone Score (GSS), number of calyceal access and duration of achieving limpid urine coming out of the nephrostomy tube were significantly higher in Group II (p

Recent studies have shown that Cenomanian-Santonian carbonate sedimentary rocks rich in rudists are widespread throughout southeastern Turkey. The Derdere and Karababa formations have been analysed in the Sabunsuyu section (Kilis Province). On a field scale, we can distinguish rudist-rich beds that rhythmically alternate with bioclastic levels composed of bivalves, gastropods and roveacrinids in these formations. Although pelagic faunal elements (predominantly planktic foraminifera and pithonellids) are documented in the lowermost part of the series, the rudist-rich facies are represented mainly in the Derdere and Karababa formations. Rudists, benthic and planktic foraminifera indicate middleelate Cenomanian and Turonian-Santonian ages for the Derdere and Karababa formations, respectively. Based on studied facies, five microfacies have been recognised and categorised in three facies groups: inner ramp, mid ramp and outer ramp. Evidence such as gradual changes in facies and absence of extensive uninterrupted barrier reefs indicate that the Derdere Formation was deposited in a ramp depositional system. The sedimentology and taphonomic signature of the rudist shell beds have been described in order to obtain a better understanding of the depositional environment and the physical processes that controlled Cenomanian-Santonian sedimentation. Monospecific tabular beds characterise mainly the upper part of the series (topmost part of Derdere Formation and Karababa Formation); more complex rudist concentrations, characterised by moderate species diversity, increase upsection. The rudist levels are associated with highstand systems tract deposits because of the suitability of trophic conditions in the rudist-dominated ramp. (C) 2020 Elsevier Ltd. All rights reserved.

Objective: In this study, we aimed to determine the predictive factor for additional treatment requirement in active surveillance (AS) for patients with low or very low-risk prostate cancer (PCa) and we investigated the effect of tumor burden by total core involvement rate in biopsy to predict of need for additional treatment.Material and methods: 107 patients with PCa in AS between 2005 and 2018 have been evaluated retrospectively. Groups were divided into two groups according to the need for additional treatment. Group 1 received additional treatment, group 2 did not receive additional treatments and active surveillance was continued. Patient’s total prostate-specific antigen (tPSA), prostate-specific antigen density (PSA-D), total core involvement count, quantity and rate at biopsy pathology results and follow-up period were recorded and compared in the two groups. Results: The current cohort includes 107 patients. Mean age at diagnosis was 63.01years. Mean tPSA values at diagnosis were 6.09 ng/mL and 5.2 ng/mL in the group 1 and group 2, respectively. Mean follow-up period was 38.1 months (range, 12 to 134 months). Only PSA-D measurement significantly predicted need for additional treatment (p = 0.017). ROC analysis showed that the optimal threshold was 0.13 ng/mL/cc (sensitivity: 70.8%; specificity: 57.1%). Additional treatment requirement was not detected in patients with PSA-D cut-off level less than 0.07 ng/mL/cc. Conclusions: Total tumor burden of less than 5% is safe for patients with low or very low-risk PCa in AS. A 0.13 ng/mL/cc cut-off level of PSA-D can predict to need for additional treatment in patients managed by AS.