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Some receptors remain unoccupied even when an agonist produces a maximal response. Such empty ones are called spare receptors. In presence of spare receptors the maximum effect of an agonist drug is achieved with fewer than 100% of the receptors being occupied. To determine the presence of spare receptors, scientists often compare the concentration of the drug needed to produce 50% of the maximum effect (EC50) with the concentration of the drug needed to occupy 50% of the receptors (Kd). If the...
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A type of Lewis acid-base chemistry involves the formation of a complex ion (or a coordination complex) comprising a central atom, typically a transition metal cation, surrounded by ions or molecules called ligands. These ligands can be neutral molecules like H2O or NH3, or ions such as CN− or OH−. Often, the ligands act as Lewis bases, donating a pair of electrons to the central atom. These types of Lewis acid-base reactions are examples of a broad subdiscipline called coordination...
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Radical Reactivity: Nucleophilic Radicals01:16

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Radicals adjacent to electron-donating groups are called nucleophilic radicals. These radicals readily react with electrophilic alkenes. The SOMO–LUMO interactions are the driving force for the reaction, where the high-energy SOMO of the electron-rich, nucleophilic radicals interacts with the low-energy LUMO of the electron-deficient, electrophilic alkenes. Such SOMO–LUMO interactions are the basis of reactive radical traps, affecting the selectivity in radical reactions. For...
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Radicals01:27

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Roots, often written as radicals, identify the quantity that must be raised to a specific exponent to produce a given value. A radical expression consists of two main components: the radicand, which is the value placed inside the root symbol, and the index, which indicates the degree of the root being taken. The notation n√a indicates the principal nth root of a. If n equals 2, the operation is the square root, while n = 3 defines the cube root. When n is even, a negative radicand does...
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Radical Reactivity: Electrophilic Radicals01:02

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Radicals adjacent to electron‐withdrawing groups are called electrophilic radicals. These radicals readily react with nucleophilic alkenes. For example, the malonate radical, in which the radical center is flanked by two electron‐withdrawing groups, reacts readily with butyl vinyl ether, which consists of an electron‐donating oxygen substituent. The reaction between electrophilic malonate radical and nucleophilic vinyl ether is favored because the radical has a...
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The oxidation of an organic compound in the presence of air or oxygen is called autoxidation. For example, cumene reacts with oxygen to form hydroperoxide. Autoxidation involves initiation, propagation, and termination steps. Many organic compounds are susceptible to autoxidation—especially ethers in the presence of oxygen, which form hydroperoxides. Even though this reaction is slow, old ether bottles contain small amounts of peroxide, which leads to laboratory explosions during ether...
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The pubovesical complex-sparing technique on laparoscopic radical prostatectomy.

Rafael Batista Rebouças1,2,3, Rodrigo Campos Monteiro1,3, João Paulo Pereira Lima1

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Summary

This study presents a pure laparoscopic approach to radical prostatectomy, preserving the pubovesical complex (PVC). The technique proved feasible and safe, maintaining urinary continence post-surgery.

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Area of Science:

  • Urology
  • Surgical Oncology
  • Minimally Invasive Surgery

Background:

  • Radical prostatectomy poses challenges in preserving urinary continence.
  • Robot-assisted techniques with pubovesical complex (PVC) preservation have been described.
  • This study explores a pure laparoscopic execution of PVC-sparing radical prostatectomy.

Observation:

  • A 61-year-old male patient with localized prostate cancer underwent a transperitoneal laparoscopic radical prostatectomy.
  • The procedure involved meticulous dissection to preserve the pubovesical complex (PVC) and neurovascular bundles.
  • Surgical technique focused on maintaining the integrity of the bladder neck and prostatic apex.

Findings:

  • The laparoscopic radical prostatectomy with pubovesical complex (PVC) preservation was completed in 150 minutes with 300mL blood loss.
  • Postoperative recovery was rapid, with drain removal on day 1 and discharge on day 2.
  • The patient achieved complete urinary continence within 7 days and had a PSA <0.04ng/mL at 30 days.

Implications:

  • Pure laparoscopic radical prostatectomy with pubovesical complex (PVC) sparing is a feasible and safe surgical option.
  • This technique may offer advantages in early functional recovery, particularly urinary continence.
  • Further research is warranted to validate these findings in larger, controlled studies.