Tumor focality does not predict biochemical recurrence after radical prostatectomy in men with clinically localized prostate cancer.

Purpose: We characterized prostate cancer focality in regard to clinicopathological features, prognostic value and impact on biochemical outcome.

Materials And Methods: We retrospectively reviewed the records of 1,366 patients in our prospective database who underwent radical prostatectomy between 1999 and 2010 for clinically localized prostate cancer with pathological evaluation using whole mount sectioning techniques and tumor mapping. Unifocal disease was defined as the identification of a solitary cancer focus in the prostate without additional tumor foci or satellite lesions, ie multifocal disease, on histopathological evaluation.

Multivariate statistical identification of human bladder carcinomas using ambient ionization imaging mass spectrometry.

Diagnosis of human bladder cancer in untreated tissue sections is achieved by using imaging data from desorption electrospray ionization mass spectrometry (DESI-MS) combined with multivariate statistical analysis. We use the distinctive DESI-MS glycerophospholipid (GP) mass spectral profiles to visually characterize and formally classify twenty pairs (40 tissue samples) of human cancerous and adjacent normal bladder tissue samples. The individual ion images derived from the acquired profiles correlate with standard histological hematoxylin and eosin (H&E)-stained serial sections.

Pathological characterization of unifocal prostate cancers in whole-mount radical prostatectomy specimens.

Objective: • To characterize the anatomical distribution and pathological features of unifocal cancers, which have been reported to occur in 17-33% of men undergoing radical prostatectomy (RP), in whole- mount prostatectomy specimens.

Patients And Methods: • Between 1999 and 2008, a retrospective review of 1274 patients undergoing RP for clinically localized prostate cancer with pathological evaluation using whole-mount sectioning techniques and tumour mapping was performed from our prospective database. • The study cohort comprised those patients who were found to have unifocal tumours.

Impact of age and gender on adherence to infection control guidelines and medical regimens in cystic fibrosis.

Rationale: The goal of the present research was to examine the impact of age and gender on adherence to both infection control (IC) guidelines and traditional medical treatments in a cystic fibrosis (CF) population. Adherence behaviors are consistently suboptimal in chronic illness populations, particularly pulmonary diseases; understanding the factors related to adherence behaviors in CF can aid in the development of interventions to promote adherence.

Method: Participants consisted of 74 individuals with CF ages 9 years and above.

Multivariate statistical differentiation of renal cell carcinomas based on lipidomic analysis by ambient ionization imaging mass spectrometry.

Desorption electrospray ionization (DESI) mass spectrometry (MS) was used in an imaging mode to interrogate the lipid profiles of thin tissue sections of 11 sample pairs of human papillary renal cell carcinoma (RCC) and adjacent normal tissue and nine sample pairs of clear cell RCC and adjacent normal tissue. DESI-MS images showing the spatial distributions of particular glycerophospholipids (GPs) and free fatty acids in the negative ion mode were compared to serial tissue sections stained with hematoxylin and eosin (H&E). Increased absolute intensities as well as changes in relative abundance were seen for particular compounds in the tumor regions of the samples.

pT0 prostate cancer after radical prostatectomy.

The purpose of our study was to perform a literature review of current data to determine the frequency and correlates of pT0 prostate cancer after radical prostatectomy alone. A comprehensive search was made of MEDLINE and PUBMED. Seven studies were identified involving 18,135 patients with 74 reported pT0 cases.

Intratubular germ cell neoplasms of the testis and bilateral testicular tumors: clinical significance and management options.

Objectives: Intratubular germ cell neoplasia (ITGCN) is the precursor lesion for invasive testicular germ cell tumors (TGCTs) of adolescents and young adults. The rising incidence of these tumors has prompted a rigorous investigation of the etiology, diagnosis and management of ITGCN. Bilateral testicular cancer is closely linked with ITGCN, as patients with unilateral testicular cancer are at the highest risk for a future malignancy in the contralateral testicle.

Cholesterol sulfate imaging in human prostate cancer tissue by desorption electrospray ionization mass spectrometry.

Development of methods for rapid distinction between cancerous and non-neoplastic tissues is an important goal in disease diagnosis. To this end, desorption electrospray ionization mass spectrometry (DESI-MS) imaging was applied to analyze the lipid profiles of thin tissue sections of 68 samples of human prostate cancer and normal tissue. The disease state of the tissue sections was determined by independent histopathological examination.

How do you tell whether a change in surgical technique leads to a change in outcome?

Purpose: Surgeons routinely evaluate and modify their surgical technique to improve patient outcome. It is also common for surgeons to analyze results before and after a change in technique to determine whether the change led to better results. Simple comparison of results before and after surgical modification may be confounded by the surgical learning curve.

Acetaminophen inhibits hemoprotein-catalyzed lipid peroxidation and attenuates rhabdomyolysis-induced renal failure.

Hemoproteins, hemoglobin and myoglobin, once released from cells can cause severe oxidative damage as a consequence of heme redox cycling between ferric and ferryl states that generates radical species that induce lipid peroxidation. We demonstrate in vitro that acetaminophen inhibits hemoprotein-induced lipid peroxidation by reducing ferryl heme to its ferric state and quenching globin radicals. Severe muscle injury (rhabdomyolysis) is accompanied by the release of myoglobin that becomes deposited in the kidney, causing renal injury.

Radical prostatectomy as initial monotherapy for patients with pathologically confirmed high-grade prostate cancer.

Objective: To report the long-term outcome of high-grade prostate cancer treated with radical prostatectomy (RP) as initial monotherapy, analyse the effect of clinical and pathological variables on survival, and report cancer-related symptoms.

Patients And Methods: A retrospective chart review was conducted to identify patients with Gleason 8-10 prostate cancer found on pathological review in men undergoing RP as initial therapy for clinically localized disease between 1988 and 2005. Kaplan-Meier analysis was used to calculate event-free survival.

Prostate size is associated with surgical difficulty but not functional outcome at 1 year after radical prostatectomy.

Purpose: We assessed the impact of prostate size on operative difficulty as measured by estimated blood loss, operating room time and positive surgical margins. In addition, we assessed the impact on biochemical recurrence and the functional outcomes of potency and continence at 1 year after radical prostatectomy as well as postoperative bladder neck contracture.

Materials And Methods: From 1998 to 2007, 3,067 men underwent radical prostatectomy by 1 of 5 dedicated prostate surgeons with no neoadjuvant or adjuvant therapy.

Nerve-sparing prostatectomy and urinary function: a prospective analysis using validated quality-of-life measures.

Objectives: To prospectively study whether urinary function and bother are directly related to neurovascular bundle preservation at radical prostatectomy using validated quality-of-life questionnaires.

Methods: A total of 91 consecutive patients undergoing radical prostatectomy were prospectively studied using the University of California, Los Angeles, Prostate Cancer Index and the International Prostate Symptom Score. The patients were divided into 2 groups (>50% nerve sparing vs View Article and Find Full Text PDF

A case of high-risk penile epithelioid hemangioendothelioma.

Background: A 48-year-old, previously healthy man presented to his local urologist with several small, violaceous, indurated lesions along the shaft of his penis and glans, which caused discomfort and penile curvature. Four weeks previously, the lesions were three small painless blemishes. Peyronie disease was initially diagnosed, but the disease progressed despite steroid treatment.

Outcomes after radical prostatectomy in men receiving previous pelvic radiation for non-prostate malignancies.

Objective: To report the perioperative and functional outcomes of nine patients treated at our institution who had radical prostatectomy (RP) after previous pelvic radiotherapy (RT) for non-prostate malignancies.

Patients And Methods: From 1993 to 2007, nine patients had RP after external beam RT for testicular seminoma (six), anorectal cancer (two) and colon cancer (one). Clinical information was obtained from a prospective prostate cancer database.

Preservation of ejaculation in patients undergoing nerve-sparing postchemotherapy retroperitoneal lymph node dissection for metastatic testicular cancer.

Objectives: To evaluate the clinical parameters associated with the recovery of ejaculation after nerve-sparing postchemotherapy retroperitoneal lymph node dissection (PC-RPLND) for nonseminomatous germ cell tumor.

Methods: We queried our institutional database for all patients who had undergone nerve-sparing PC-RPLND from 1995 to 2005 using a bilateral template. Nerve sparing was performed whenever technically feasible and oncologically prudent.

Pathological upgrading and up staging with immediate repeat biopsy in patients eligible for active surveillance.

Purpose: Active surveillance with selective delayed intervention is a treatment regimen used in patients with low risk prostate cancer. Decision making is based on pretreatment prostate specific antigen, clinical stage and prostate biopsy results. We reviewed our experience with immediate repeat biopsy in patients eligible for active surveillance with selective delayed intervention.

The role of endorectal coil MRI in preoperative staging and decision-making for the treatment of clinically localized prostate cancer.

Introduction: The optimal management of newly diagnosed prostate cancer requires individualization of the treatment plan based upon the most accurate clinical characterization of tumor location and extent of disease. The role of imaging in prostate cancer staging continues to evolve. In this review, we address the utility of endorectal coil magnetic resonance imaging (eMRI) in both local staging and its ability to facilitate the decision in choosing one treatment strategy over another after the initial diagnosis of localized prostate cancer.

A case of port-site recurrence and locoregional metastasis after laparoscopic partial nephrectomy.

Background: A 63-year-old man underwent hand-assisted laparoscopic partial nephrectomy for a 4.5 cm right renal mass, pathologically confirmed as type 2 papillary renal cell carcinoma (RCC). Two years later he was referred to a specialist oncology center after routine follow-up raised suspicion for metastatic disease.

Risk stratification for positive lymph nodes in prostate cancer.

Purpose: To evaluate the risk of positive lymph nodes using preoperative clinical parameters.

Methods And Materials: We reviewed our prospectively collected database for all patients who received RRP and PLND between January 1993 and November 2005 as primary therapy for prostate cancer. We excluded patients who had hormonal ablation or radiation therapy prior to surgery and patients with missing PSA, clinical stage, or biopsy Gleason score.

Compliance in cystic fibrosis: an examination of infection control guidelines.

The goal of this research was to begin the process of evaluating acceptability of infection control (IC) recommendations to CF patients and their families, determine whether compliance with IC guidelines differs from compliance with traditional CF medical treatment with respect to the variables predictive of compliance, and assess which patients are most likely to comply with IC recommendations. Participants were recruited during routine outpatient visits at a regional CF center located in a pediatric hospital. The sample included 44 child and adolescent patients, aged 9-18 years and their guardian, and 27 adult patients.

Modified technique for neurovascular bundle preservation during radical prostatectomy: association between technique and recovery of erectile function.

Objectives: To prospectively evaluate whether a modified surgical technique for neurovascular bundle (NVB) preservation during radical prostatectomy (RP) is associated with an improvement in erectile function (EF) recovery after RP.

Patients And Methods: Data from patients treated before technique modification was used to create a predictive model for EF at 6 months after RP using age, date of surgery, and nerve sparing (none vs unilateral vs bilateral) as predictors for patients who received the modified technique (MT) to estimate the expected outcomes had they received the standard technique (ST), and compared these with actual outcomes. In the MT, the neurovascular bundle (NVB) is completely mobilized off the prostate from the apex to above the seminal vesicles including incision of Denonvilliers' fascia before urethral division and mobilization of the prostate off the rectum.

Proximity of collateral ligament origin to the axis of rotation of the proximal interphalangeal joint of the finger.

Study Design: Descriptive anatomical study.

Objective: To determine the proximity of proximal interphalangeal (PIP) joint collateral ligament origin to the axis of rotation (AOR) of the joint.

Background: Normal function of the PIP joints of the hands requires competent collateral ligaments.

The association between total and positive lymph node counts, and disease progression in clinically localized prostate cancer.

Purpose: We examined the association between the number of LNs removed, the number of positive LNs and disease progression in patients undergoing pelvic lymph node dissection and radical retropubic prostatectomy for clinically localized prostate cancer.

Materials And Methods: We analyzed 5,038 consecutive patients who underwent radical retropubic prostatectomy between 1983 and 2003. Clinicopathological parameters, including the administration of neoadjuvant hormonal therapy, preoperative prostate specific antigen, specimen Gleason score, surgeon and pathological stage, were collected prospectively in our prostate cancer database.

Recovery of erectile function after salvage radical prostatectomy for locally recurrent prostate cancer after radiotherapy.

Objectives: To analyze the feasibility of neurovascular bundle (NVB) preservation and peripheral nerve grafting during salvage radical prostatectomy (RP) for radiorecurrent prostate cancer and analyze their effect on the recovery of potency.

Methods: Of 100 patients who underwent salvage RP with curative intent from 1984 to 2003, 7 patients had bilateral NVBs preserved, 22 had a unilateral NVB preserved with (n = 11) and without (n = 11) a unilateral nerve graft, and 9 had bilateral NVBs resected with bilateral nerve grafts. Preoperative erections were graded as normal (grade 1) in 12 patients and full but recently diminished (grade 2) in 16.