Glycoprotein non-metastatic melanoma protein B promotes tumor growth and is a biomarker for lymphangioleiomyomatosis.

Lymphangioleiomyomatosis (LAM) is a rare, progressive cystic lung disease affecting almost exclusively female-sexed individuals. The cysts represent regions of lung destruction caused by smooth muscle tumors containing mutations in one of the two tuberous sclerosis (TSC) genes. mTORC1 inhibition slows but does not stop LAM advancement.

Population Based Time Trends in the Epidemiology and Mortality of Gastroesophageal Junction and Esophageal Adenocarcinoma.

Background: Limited data are available on the epidemiology of gastroesophageal junction adenocarcinoma (GEJAC), particularly in comparison to esophageal adenocarcinoma (EAC). With the advent of molecular non-endoscopic Barrett's esophagus (BE) detection tests which sample the esophagus and gastroesophageal junction, early detection of EAC and GEJAC has become a possibility and their epidemiology has gained importance.

Aims: We sought to evaluate time trends in the epidemiology and survival of patients with EAC and GEJAC in a population-based cohort.

Prevalence and Predictors of Barrett's Esophagus After Negative Initial Endoscopy: Analysis From Two National Databases.

Background & Aims: Guidelines suggest a single screening esophagogastroduodenoscopy (EGD) in patients with multiple risk factors for Barrett's esophagus (BE). We aimed to determine BE prevalence and predictors on repeat EGD after a negative initial EGD, using 2 large national databases (GI Quality Improvement Consortium [GIQuIC] and TriNetX).

Methods: Patients who underwent at least 2 EGDs were included and those with BE or esophageal adenocarcinoma detected at initial EGD were excluded.

Lymphangioleiomyomatosis: where endocrinology, immunology and tumor biology meet.

Lymphangioleiomyomatosis (LAM) is a cystic lung disease found almost exclusively in genetic females and caused by small clusters of smooth muscle cell tumors containing mutations in one of the two tuberous sclerosis genes (TSC1 or TSC2). Significant advances over the past 2-3 decades have allowed researchers and clinicians to more clearly understand the pathophysiology of LAM, and therefore better diagnose and treat patients with this disease. Despite substantial progress, only one proven treatment for LAM is used in practice: mechanistic target of rapamycin complex 1 (mTORC1) inhibition with medications such as sirolimus.

Estradiol Augments Tumor-Induced Neutrophil Production to Promote Tumor Cell Actions in Lymphangioleiomyomatosis Models.

Lymphangioleiomyomatosis (LAM) is a rare cystic lung disease caused by smooth muscle cell-like tumors containing tuberous sclerosis (TSC) gene mutations and found almost exclusively in females. Patient studies suggest LAM progression is estrogen dependent, an observation supported by in vivo mouse models. However, in vitro data using TSC-null cell lines demonstrate modest estradiol (E2) responses, suggesting E2 effects in vivo may involve pathways independent of direct tumor stimulation.

Neutrophil elastase from myeloid cells promotes TSC2-null tumor growth.

Chronic inflammation promotes progression of many cancers, with circulating myeloid-derived suppressor cell (MDSC) levels correlating with poor prognosis. Here we examine effects of MDSCs on lymphangioleiomyomatosis (LAM), a rare disease occurring almost exclusively in women whereby estrogen-sensitive metastatic TSC2-null tumors grow throughout the lungs, markedly reducing pulmonary function. The LAM cell origin remains unknown; however, previous work demonstrated that Tsc2 inactivation in the mouse uterus induced estrogen-dependent myometrial tumors with nearly all features of LAM.

Acute bowel morbidity after prostate brachytherapy with cesium-131.

Purpose: The present study evaluates the severity and time to resolution of bowel symptoms in men undergoing prostate brachytherapy (PB) with cesium-131 ((131)Cs).

Methods And Materials: A longitudinal, prospective study of patients who had undergone PB with (131)Cs at a single institution was performed. All patients were asked to complete the Expanded Prostate Cancer Index Composite preoperatively and at 2 weeks and 1, 3, and 6 months postoperatively.

Resection of a staggering 36-cm angiomyolipoma.

Angiomyolipomas (AMLs) are benign tumours characterized by fat, smooth muscle and vascular components. Epithelioid AML is a recognized variant of AML that is comprised of epithelioid smooth muscle cells. We present a case of a 41-year-old male who presented with light-headedness, dizziness, right-sided abdominal pain and, on subsequent computed tomography, was found to have an enormous right kidney mass characteristic of an AML.

Partial nephrectomy without hilar control or cooling: longitudinal data over 5 years.

Introduction: Partial nephrectomy for the management of small renal masses has become a well accepted technique. Contemporary series have shown its safety and efficacy in well selected patients. We present our experience of partial nephrectomies exclusively without hilar control or parenchymal cooling stratified into imperative and elective patients.

Management of bilateral synchronous renal cell carcinoma in a single versus staged procedure.

Objectives: The presentation of synchronous bilateral renal lesions is rare. We report our experience with the surgical management of these lesions in both a single and staged procedure.

Methods: We retrospectively reviewed the records of all patients with bilateral synchronous renal lesions who underwent surgical management by one surgeon between 2000-2007.

Dosimetric outcomes in prostate brachytherapy: is downsizing the prostate with androgen deprivation necessary?

Objectives: A large prostate volume has historically been a relative contraindication to prostate brachytherapy (PB) because of concerns of toxicity and potential pubic arch interference. Common practice has been to downsize large prostates with androgen deprivation therapy (ADT) before proceeding with brachytherapy. The present study compares postimplant dosimetry in patients with prostate volumes >50 cc with those with prostate volumes View Article and Find Full Text PDF

Overcoming pubic arch interference with free-hand needle placement in men undergoing prostate brachytherapy.

Purpose: The present study evaluates the postimplant dosimetry when free-hand needles were placed to overcome interference from the pubic arch.

Methods And Materials: A review of all patients who underwent prostate brachytherapy at our institution from 2001 to 2006 was performed. Postimplant dosimetry in men requiring free-hand needle placement was compared with postimplant dosimetry in men not requiring free-hand needle placement.

Prostate brachytherapy after ileal pouch-anal anastomosis reconstruction.

Objective: To determine the safety of prostate brachytherapy in patients with clinically localized prostate cancer who have undergone proctocolectomy with ileal pouch-anal anastomosis (IPAA).

Methods: We performed a retrospective chart review of patients with a prior history of IPAA reconstruction who underwent prostate brachytherapy at our institution. Clinical records were reviewed for demographic characteristics, postoperative dosimetry, changes in bowel function, and oncologic outcomes.

Planning based on postneedle volume with early dosimetric assessment is beneficial for Cesium-131 permanent prostate seed implantation.

Purpose: This study reports on prostate edema after prostate brachytherapy using Cesium-131 ((131)Cs) and describes our method to compensate.

Methods And Materials: Thirty-one patients underwent brachytherapy using an afterloading technique. Volume measurements of the prostate were taken at various time intervals relative to the date of implant.

Laparoscopic nephrectomy using the EnSeal Tissue Sealing and Hemostasis System: successful therapeutic application of nanotechnology.

The potential impact of nanotechnology in the field of urology is broad with diagnostic and therapeutic benefits that have only recently begun to be explored. Application of nanotechnology principles to tissue and vessel sealing during laparoscopic procedures may reduce associated thermal injury and inflammatory response. We report our initial experience using the EnSeal Tissue Sealing and Hemostasis System during laparoscopic nephrectomy and discuss its potential advantages and disadvantages compared with those of contemporary technologies.

Complete ureteral stent encrustation managed with serial nephroscopy and laser lithotripsy.

Encrustation is a well-established complication of retained biomaterials in the urinary tract. Severe stent encrustation is a potentially serious complication of prolonged indwelling ureteral stenting often managed with open surgery when endoscopic techniques are unsuccessful. We present a case of a 2800-mm2 stent encrustation managed with serial nephroscopy and laser lithotripsy.

Feasibility and outcome of retrograde endoscopy in a post-prostatectomy population.

Purpose: To determine the feasibility of retrograde endoscopy after radical retropubic prostatectomy (RRP) and its effects on post-prostatectomy continence.

Patients And Methods: We retrospectively reviewed all patients who underwent RRP at our institution between 1999 and 2005, identifying those who subsequently required endoscopic instrumentation. Patient records were examined for the interval between procedures, method of endoscopy, and continence after endoscopy compared with baseline post-prostatectomy continence.

Correlation between risk factors for vascular disease and the American Urological Association Symptom Score.

Objective: To evaluate the correlation between risk factors for vascular disease and the American Urological Association Symptom Score (AUA-SS), by comparing the presence of these risk factors with the degree of lower urinary tract symptoms (LUTS).

Patients And Methods: We retrospectively reviewed the medical history, AUA-SS, and prostate volume of men who had a radical prostatectomy. The degree of LUTS in men with and without risk factors for cardiovascular disease was compared.

MutL-catalyzed ATP hydrolysis is required at a post-UvrD loading step in methyl-directed mismatch repair.

Methyl-directed mismatch repair is a coordinated process that ensures replication fidelity and genome integrity by resolving base pair mismatches and insertion/deletion loops. This post-replicative event involves the activities of several proteins, many of which appear to be regulated by MutL. MutL interacts with and modulates the activities of MutS, MutH, UvrD, and perhaps other proteins.