Publications by authors named "Hansel D"

Introduction: Small cell neuroendocrine carcinoma of the urinary tract (SCNEC-URO) has an inferior prognosis compared to conventional urothelial carcinoma (UC). Here, we evaluate the predictors and patterns of relapse after surgery.

Materials And Methods: We identified a definitive-surgery cohort (n = 224) from an institutional database of patients with cT1-T4NxM0 SCNEC-URO treated in 1985-2021.

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Cortical neurons are characterized by their variable spiking patterns. We challenge prevalent theories for the origin of spiking variability. We examine the specific hypothesis that cortical synchrony drives spiking variability .

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Article Synopsis
  • This study explored how accurately upper tract urothelial carcinoma (UTUC) is diagnosed by comparing biopsy results with those from nephroureterectomy specimens.
  • Researchers analyzed data from 69 patients, focusing on the differences in diagnosis and the size of biopsy specimens, finding that larger biopsies were more likely to match surgical samples.
  • The findings emphasized that urinary cytology is highly effective, identifying high-grade carcinoma in 84% of cases, and suggested that it should be used alongside biopsies to improve diagnostic accuracy.
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  • Plasmacytoid urothelial carcinoma (UC) is a rare and aggressive type of bladder cancer analyzed in 52 patients, predominantly men, with a mean age of 64.
  • The tumors had a high-grade classification with a significant plasmacytoid component, and a variety of gene mutations were found, particularly in TP53, TERT, and CDH1.
  • Although specific gene mutations did not show a clear link to clinical outcomes, mutations in the mTOR pathway were associated with notably shorter survival rates for some patients.
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SMARCB1 loss has long been observed in many solid tumors. However, there is a need to elucidate targetable pathways driving growth and metastasis in SMARCB1-deficient tumors. Here, we demonstrate that SMARCB1 deficiency, defined as genomic SMARCB1 copy number loss associated with reduced mRNA, drives disease progression in patients with bladder cancer by engaging STAT3.

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Bladder cancer is a global health issue with sex differences in incidence and prognosis. Bladder cancer has distinct molecular subtypes with multiple pathogenic pathways depending on whether the disease is non-muscle invasive or muscle invasive. The mutational burden is higher in muscle-invasive than in non-muscle-invasive disease.

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Article Synopsis
  • Neoadjuvant chemotherapy (neoCTX) is shown to be the best treatment for surgically resectable neuroendocrine carcinoma of the urinary tract (NEC-URO), improving outcomes compared to immediate surgery.
  • A study involving 203 patients revealed that neoCTX significantly increased the downstaging rate of tumors, particularly with the combination of ifosfamide and etoposide (IA/EP).
  • Overall survival rates after five years were much higher for patients receiving neoCTX (57%) compared to those undergoing surgery alone (22%) or surgery followed by adjuvant chemotherapy (30%).
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Context.—: In the United States, review of digital whole slide images (WSIs) using specific systems is approved for primary diagnosis but has not been implemented for intraoperative consultation.

Objective.

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  • * A consensus conference in 2022 revealed that around 40% of pathologists do not regularly report T1 subcategories in bladder cancer diagnoses, highlighting a significant variability in practice.
  • * Most attendees supported the routine reporting of T1 subcategories, with semiquantitative methods being preferred over traditional histoanatomic approaches, though many had no strong preference for either method.
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Context: To provide high-quality, safe training during the COVID-19 pandemic, our anatomic pathology fellowship program implemented a hybrid virtual/in-person training model with supplemental digital material.

Objective: To evaluate the impact of this model.

Design: We examined Accreditation Council for Graduate Medical Education survey results and board pass rates for fellows before the pandemic (group 1); during the pandemic peak (group 2); and early and late after the pandemic peak (groups 3 and 4).

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Multiple studies worldwide have confirmed that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA can be detected in wastewater. However, there is a lack of data directly comparing the wastewater SARS-CoV-2 RNA concentration with the prevalence of coronavirus disease 2019 (COVID-19) in individuals living in sewershed areas. Here, we correlate wastewater SARS-CoV-2 signals with SARS-CoV-2 positivity rates in symptomatic and asymptomatic individuals and compare positivity rates in two underserved communities in Portland, Oregon to those reported in greater Multnomah County.

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Article Synopsis
  • * Between 2016 and 2022, males made up a larger percentage of interim chairs (66%) but females had a higher success rate of becoming permanent chairs (47% vs. 27%).
  • * The study surveyed interim chairs to identify gender differences but found no significant reasons for the advancement disparity, except that male interim chairs tended to be older than their female counterparts.
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SARS-CoV-2 is notable for its extremely high level of viral replication in respiratory epithelial cells, relative to other cell types. This may partially explain the high transmissibility and rapid global dissemination observed during the COVID-19 pandemic. Polymerase chain reaction (PCR) cycle threshold (Ct) number has been widely used as a proxy for viral load based on the inverse relationship between Ct number and amplifiable genome copies present in a sample.

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The mammalian target of rapamycin (mTOR) pathway regulates important cellular functions. Aberrant activation of this pathway, either through upstream activation by growth factors, loss of inhibitory controls, or molecular alterations, can enhance cancer growth and progression. Bladder cancer shows high levels of mTOR activity in approximately 70% of urothelial carcinomas, suggesting a key role for this pathway in this cancer.

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Despite advances in diagnosis and treatment, prostate cancer remains the second leading cause of cancer related mortality in men. Prognosis is variable and dependent on several clinical and genetic factors, including BRCA gene mutations. Recent clinical studies have reported that BRCA-associated prostate cancer is a more aggressive subtype with a higher probability of nodal involvement and distant metastases at the time of diagnosis, but radiological findings have not been described.

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Urinary bladder cancer (BCa) is the 10th most frequent cancer in the world, most commonly found among the elderly population, and becomes highly lethal once cells have spread from the primary tumor to surrounding tissues and distant organs. Cystectomy, alone or with other treatments, is used to treat most BCa patients, as it offers the best chance of cure. However, even with curative intent, 29% of patients experience relapse of the cancer, 50% of which occur within the first year of surgery.

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Aim: Optimal management of bladder cancer requires an accurate, standardised and timely pathological diagnosis, and close communication between surgeons and pathologists. Here, we provide an update on pathology reporting standards of transurethral resections of the bladder and cystectomies.

Methods: We reviewed recent literature, focusing on developments between 2013 and 2021.

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The success of the use of novel therapies in the treatment of advanced urothelial carcinoma has contributed to growing interest in evaluating these therapies at earlier stages of the disease. However, trials evaluating these therapies in the neoadjuvant setting must have clearly defined study elements and appropriately selected end points to ensure the applicability of the trial and enable interpretation of the study results. To advance the development of rational trial design, a public workshop jointly sponsored by the US Food and Drug Administration and the Bladder Cancer Advocacy Network convened in August 2019.

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The coronavirus disease 2019 (COVID-19) pandemic has challenged clinical diagnostic operations due to supply shortages and high staffing needs to collect nasopharyngeal (NP) swab samples. Saliva is an easily accessible alternative specimen type to overcome some of these challenges. In this study, we first used paired saliva and NP swab specimens ( = 128) to compare test performance characteristics with three RNA extraction platforms, i.

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Bladder cancer invasion depends on mammalian target of rapamycin complex 2 (mTORC2) activity, although the downstream mTORC2 effectors that mediate this effect have not been fully defined. One potential downstream effector is the arginine derivative nitric oxide (NO). This study identified a stage-associated increase in the expression of the NO-generating enzymes endothelial NO synthase (eNOS) and inducible NOS (iNOS) in human bladder cancer.

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Article Synopsis
  • Over the last 25 years, doctors have changed how they identify different types of genitourinary cancers, like prostate, bladder, kidney, and others.
  • For prostate cancer, new categories and grading systems help doctors understand it better, while bladder cancer also got new ways to classify and grade its types.
  • Research on testicular and adrenal gland cancers has improved knowledge about their different types and how they affect patients, resulting in better treatment options.
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The Genitourinary Pathology Society (GUPS) undertook a critical review of the recent advances in bladder cancer focusing on important topics of high interest for the practicing surgical pathologist and urologist. This review represents the second of 2 manuscripts ensuing from this effort. Herein, we address the effective reporting of bladder cancer, focusing particularly on newly published data since the last 2016 World Health Organization (WHO) classification.

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