Case Report: Nontuberculous mycobacterial infections in children with complete DiGeorge anomaly.

Children with complete DiGeorge anomaly (cDGA) have congenital athymia, resulting in severe T cell immunodeficiency and susceptibility to a broad range of infections. We report the clinical course, immunologic phenotypes, treatment, and outcomes of three cases of disseminated nontuberculous mycobacterial infections (NTM) in patients with cDGA who underwent cultured thymus tissue implantation (CTTI). Two patients were diagnosed with complex (MAC) and one patient with .

Metastatic Urothelial Carcinoma from Transplanted Kidney with Complete Response to an Immune Checkpoint Inhibitor.

Background: Donor-derived malignancy is a rare complication in patients who undergo organ transplant. Approaches to treatment have largely been individualized based on clinical circumstances given the lack of evidence-based guidelines, with therapeutic options ranging from discontinuation of immunosuppression and transplantectomy to the addition of chemotherapy or radiotherapy. .

Phase 2 clinical trial of TORC1 inhibition with everolimus in men with metastatic castration-resistant prostate cancer.

Background: Activation of the PI3K-Akt-mTOR signaling pathway is common in advanced castration resistant prostate cancer (CRPC), typically through PTEN loss. Preclinical studies suggest that Akt-driven CaP cells are genetically susceptible to mammalian target of rapamycin (mTOR, or TORC1) inhibition. Everolimus is a Food and Drug Administration-approved inhibitor of TORC1.

Low-Grade Papillary Schneiderian Carcinoma of the Sinonasal Cavity and Temporal Bone.

Objectives:: The aim of this study was to further characterize a newly described neoplasm, low-grade papillary Schneiderian carcinoma, occurring simultaneously in the sinonasal cavity and mastoid. Additionally, the authors review the only 2 similar cases within the literature and describe the common clinical features, radiographic findings, and pathologic characteristics of this exceptionally rare disease process.

Methods:: Chart review for single patient, review of literature.

Macrophage Epithelial Reprogramming Underlies Mycobacterial Granuloma Formation and Promotes Infection.

Mycobacterium tuberculosis infection in humans triggers formation of granulomas, which are tightly organized immune cell aggregates that are the central structure of tuberculosis. Infected and uninfected macrophages interdigitate, assuming an altered, flattened appearance. Although pathologists have described these changes for over a century, the molecular and cellular programs underlying this transition are unclear.

Can Radiologic Staging With Multiparametric MRI Enhance the Accuracy of the Partin Tables in Predicting Organ-Confined Prostate Cancer?

Objective: The purpose of this study is to investigate the accuracy of multiparametric MRI with endorectal coil and Partin tables in predicting organ-confined (OC) prostate cancer in a contemporary cohort undergoing radical prostatectomy (RP) and to assess the possible added value of radiologic staging based on multiparametric MRI to the predictive accuracy of Partin tables.

Materials And Methods: One hundred fifty-eight consecutive subjects underwent 3-T multiparametric MRI with endorectal coil before RP between November 2010 and November 2013. Data were randomly split 60% and 40% into derivation (n = 95) and validation (n = 62) datasets.

Apparent Diffusion Coefficient Values of the Benign Central Zone of the Prostate: Comparison With Low- and High-Grade Prostate Cancer.

Objective: The apparent diffusion coefficient (ADC) values for benign central zone (CZ) of the prostate were compared with ADC values of benign peripheral zone (PZ), benign transition zone (TZ), and prostate cancer, using histopathologic findings from radical prostatectomy as the reference standard.

Materials And Methods: The study included 27 patients with prostate cancer (mean [± SD] age, 60.0 ± 7.

Evaluation of cold ischemia for preservation of testicular function during partial orchiectomy in the rat model.

Objective: We hypothesized that cold ischemia during partial orchiectomy would lead to higher serum testosterone levels and preservation of testicular architecture than warm ischemia in a prepubescent rat model.

Materials And Methods: Eighteen prepubescent male Sprague-Dawley rats were randomized to three different surgical groups: sham surgery, bilateral partial orchiectomy with 30 min of cord compression with cold ischemia, or bilateral partial orchiectomy with 30 min of cord compression with warm ischemia. Animals were killed at puberty, and serum, sperm, and testicles were collected.

Comparing 3-T multiparametric MRI and the Partin tables to predict organ-confined prostate cancer after radical prostatectomy.

Objectives: The purpose of our study was to test our hypothesis that multiparametric magnetic resonance imaging (mpMRI) may have a higher prognostic accuracy than the Partin tables in predicting organ-confined (OC) prostate cancer and extracapsular extension (ECE) after radical prostatectomy (RP).

Methods And Materials: After institutional review board approval, we retrospectively reviewed 60 patients who underwent 3-T mpMRI before RP. mpMRI was used to assess clinical stage and the updated version of the Partin tables was used to calculate the probability of each patient to harbor OC disease.

Improving the lens design and performance of a contemporary electromagnetic shock wave lithotripter.

The efficiency of shock wave lithotripsy (SWL), a noninvasive first-line therapy for millions of nephrolithiasis patients, has not improved substantially in the past two decades, especially in regard to stone clearance. Here, we report a new acoustic lens design for a contemporary electromagnetic (EM) shock wave lithotripter, based on recently acquired knowledge of the key lithotripter field characteristics that correlate with efficient and safe SWL. The new lens design addresses concomitantly three fundamental drawbacks in EM lithotripters, namely, narrow focal width, nonidealized pulse profile, and significant misalignment in acoustic focus and cavitation activities with the target stone at high output settings.

Small renal mass biopsy--how, what and when: report from an international consensus panel.

To discuss the use of renal mass biopsy (RMB) for small renal masses (SRMs), formulate technical aspects, outline potential pitfalls and provide recommendations for the practicing clinician. The meeting was conducted as an informal consensus process and no scoring system was used to measure the levels of agreement on the different topics. A moderated general discussion was used as the basis for consensus and arising issues were resolved at this point.

Bone marrow biopsy: RNA isolation with expression profiling in men with metastatic castration-resistant prostate cancer--factors affecting diagnostic success.

Purpose: To determine the rate at which computed tomographically guided pelvic percutaneous bone biopsy in men with metastatic castration-resistant prostate cancer (mCRPC) yields adequate tissue for genomic profiling and to identify issues likely to affect diagnostic yields.

Materials And Methods: This study was institutional review board approved, and written informed consent was obtained. In a phase II trial assessing response to everolimus, 31 men with mCRPC underwent 54 biopsy procedures (eight men before and 23 men both before and during treatment).

Appropriate and safe utilization of helicopter emergency medical services: a joint position statement with resource document.

This position statement with accompanying resource document is the result of a collaborative effort of a writing group comprised of members of the Air Medical Physician Association (AMPA), the American College of Emergency Physicians (ACEP), the National Association of EMS Physicians (NAEMSP), and the American Academy of Emergency Medicine (AAEM). This document has been jointly approved by the boards of all four organizations. Patients benefit from the appropriate utilization of helicopter emergency medical services (HEMS).

Development and clinical validation of a real-time PCR assay for PITX2 DNA methylation to predict prostate-specific antigen recurrence in prostate cancer patients following radical prostatectomy.

Prostate cancer is the most common cancer among men. The prospective discrimination of aggressive and clinically insignificant tumors still poses a significant and, as yet, unsolved problem. PITX2 DNA methylation is a strong prognostic biomarker in prostate cancer.

Increasing dwell time of mitomycin C in the upper tract with a reverse thermosensitive polymer.

Unlabelled: Abstract Background and Purpose: Topical chemotherapy for urothelial cancer is dependent on adequate contact time of the chemotherapeutic agent with the urothelium. To date, there has not been a reliable method of maintaining this contact for renal or ureteral urothelial carcinoma. We evaluated the safety and feasibility of using a reverse thermosensitive polymer to improve dwell times of mitomycin C (MMC) in the upper tract.

Apical surgical margins status in robot-assisted laparoscopic radical prostatectomy does not depend on disease characteristics.

Background And Purpose: Positive surgical margins (PSM) during robot-assisted laparoscopic radical prostatectomy (RALP) are generally considered an adverse event. We attempted to identify the factors associated with PSM and their location.

Patients And Methods: Records of patients undergoing RALP between 2003 and 2009 were retrospectively reviewed.

Clinical predictors of renal mass pathological features.

Objective: • To evaluate the influence of radiographic tumour size and other preoperative variables on the pathological characteristics of the lesion to determine the distribution of pathological features and assess preoperative risk factors for potentially aggressive versus probably indolent renal lesions.

Patients And Methods: • Retrospective review of records for 768 patients who underwent surgery for single, sporadic renal mass between 2000 and 2008 in a tertiary academic institution. • Demographic, radiographic and pathological variables were recorded and analysed with regression analyses for risk factors for potentially aggressive pathological features (malignant pathology, high Fuhrman grade, lymphovascular invasion and extracapsular extension).

Multicenter clinical validation of PITX2 methylation as a prostate specific antigen recurrence predictor in patients with post-radical prostatectomy prostate cancer.

Purpose: Radical prostatectomy is potentially curative in patients with clinically localized prostate cancer. However, biochemical recurrence affects 15% to 30% of men who undergo radical prostatectomy. We previously reported the prognostic potential of PITX2 gene promoter methylation using conventional assays.

Predicting occult multifocality of renal cell carcinoma.

Background: Multifocal renal cell carcinoma (RCC) has been reported in up to 25% of all radical nephrectomy specimens. Modern imaging tends to underestimate the rate of multifocality. Recognition of multifocality before treatment may guide physicians and patients to the type of intervention and tailor long-term follow-up.

111-In-capromab pendetide imaging using hybrid-γ camera-computer tomography technology is not reliable in detecting seminal vesicle invasion in patients with prostate cancer.

Objectives: In this study, we evaluate the diagnostic utility of a hybrid γ-camera-computer tomography (SPECT-CT) indium-111 (111-In)-capromab pendetide scan in detecting seminal vesicle invasion (SVI) in select patients evaluated for primary surgical treatment of prostate cancer (CaP).

Methods And Materials: We retrospectively analyzed a prospective database of patients who underwent preoperative SPECT-CT imaging with 111-In-capromab-pendetide as part of a staging evaluation who were subsequently treated with radical surgery in our center. Only patients with clinically localized disease were included.

Utilization of (111)In-Capromab pendetide SPECT-CT for detecting seminal vesicle invasion with recurrent prostate cancer after primary in situ therapy.

The aim of this study was to evaluate the diagnostic value of a hybrid (111)In-capromab pendetide fused computed tomography (CT) scan in detecting seminal vesicle invasion (SVI) in the setting of recurrent prostate cancer following primary in situ therapy. The study population comprised 59 patients, who biochemically failed primary in situ treatment based on American Society for Therapeutic Radiology and Oncology criteria. The patients underwent an (111)In-capromab pendetide/CT scan at the time of biochemical failure with a prostate (12-core) and seminal vesicle (SV) (8-core) biopsy.

Changes in Gleason score grading and their effect in predicting outcome after radical prostatectomy.

Objectives: To compare Gleason scores (GS) originally assigned in the mid 1990s with the current pathologic evaluation of the same prostatectomy slides, and to assess the GS migration effect on outcome in patients undergoing surgical treatment of prostate cancer.

Methods: We reviewed medical charts of consecutive patients who underwent a radical prostatectomy for T2-T3 prostate cancer at our Medical Center between 1995 and 1997. Prostate specimen slides of 204 patients were reviewed and GS was reassigned in a blinded fashion by a single uropathologist in 2008.

Use of 111in-capromab pendetide immunoscintigraphy to image localized prostate cancer foci within the prostate gland.

Purpose: We compared the results of a preoperative (111)In-capromab pendetide scan co-registered with computerized tomography with pathological findings in the surgically excised prostate to determine whether the scan can efficiently detect cancer in the prostate.

Materials And Methods: This prospective trial included 25 hormone naïve men with clinically localized prostate cancer who underwent (111)In-capromab pendetide single photon emission computerized tomography/computerized tomography as part of the preoperative evaluation. In addition to routine histological analysis, representative prostate sections were stained for prostate specific membrane antigen using the same antibody used in the scan.

Can the conventional sextant prostate biopsy accurately predict unilateral prostate cancer in low-risk, localized, prostate cancer?

We evaluate the reliability of routine sextant prostate biopsy to detect unilateral lesions. A total of 365 men with complete records including all clinical and pathologic variables who underwent a preoperative sextant biopsy and subsequent radical prostatectomy (RP) for clinically localized prostate cancer at our medical center between January 1996 and December 2006 were identified. When the sextant biopsy detects unilateral disease, according to RP results, the NPV is high (91%) with a low false negative rate (9%).