Prostate cancer cells demonstrate unique metabolism and substrate adaptability acutely after androgen deprivation therapy.

Background: Androgen deprivation therapy (ADT) has been the standard of care for advanced hormone-sensitive prostate cancer (PC), yet tumors invariably develop resistance resulting in castrate-resistant PC. The acute response of cancer cells to ADT includes apoptosis and cell death, but a large fraction remains arrested but viable. In this study, we focused on intensively characterizing the early metabolic changes that result after ADT to define potential metabolic targets for treatment.

Epigenetic field alterations in non-tumor prostate tissues detect prostate cancer in urine.

Prostate cancer (PC) development involves epigenetic DNA methylation changes that occur in the tumor. However, distinct DNA methylation changes have been previously found to encompass a widespread cancer field defect involving normal prostate tissue. In the current study, we analyzed a series of DNA methylation field markers to determine if they predict the presence of PC in urine.

Tandem histone methyltransferase upregulation defines a unique aggressive prostate cancer phenotype.

Background: Histone modifications alter transcriptional gene function and participate in cancer progression. Enhancer-of-Zeste-Homologue-2 (EZH2) and Nuclear-Receptor-Binding-SET-domain2 (NSD2) methylate H3K27 and H3K36, respectively, to regulate transcription. Given the therapeutic interest in these enzymes, we investigated expression and coregulation in hormone-sensitive (HS) and castrate-resistant (CR) prostate cancer (PC).

Synthetic Lethal Metabolic Targeting of Androgen-Deprived Prostate Cancer Cells with Metformin.

The initiation of androgen-deprivation therapy (ADT) induces susceptibilities in prostate cancer cells that make them vulnerable to synergistic treatment and enhanced cell death. Senescence results in cell-cycle arrest, but cells remain viable. In this study, we investigated the mechanisms by which prostate cancer cells undergo senescence in response to ADT, and determined whether an FDA-approved antidiabetic drug metformin has a synergistic effect with ADT in prostate cancer both and Our results show that longer term exposure to ADT induced senescence associated with p16 and/or p27 induction.

Validation of an epigenetic field of susceptibility to detect significant prostate cancer from non-tumor biopsies.

Background: An epigenetic field of cancer susceptibility exists for prostate cancer (PC) that gives rise to multifocal disease in the peripheral prostate. In previous work, genome-wide DNA methylation profiling identified altered regions in the normal prostate tissue of men with PC. In the current multicenter study, we examined the predictive strength of a panel of loci to detect cancer presence and grade in patients with negative biopsy tissue.

The impact of statins in combination with androgen deprivation therapyin patients with advanced prostate cancer: A large observational study.

Background: Statins are thought to possess antineoplastic properties related to their effect on cell proliferation and steroidogenesis. Progression to castrate resistant prostate cancer (CaP) includes de-regulation of androgen synthesis suggesting a role for statins in this setting. Our goal was to assess the role of statin use on oncologic outcomes in patients with advanced CaP being treated with androgen deprivation therapy (ADT).

Does the Renal Parenchyma Adjacent to the Tumor Contribute to Kidney Function? A Critical Analysis of Glomerular Viability in Partial Nephrectomy Specimens.

Objective: To evaluate the viability of glomeruli in the peritumor parenchyma of partial nephrectomy specimens removed for renal cell carcinoma (RCC) and relate it to kidney function, to better understand the contribution of peritumor parenchyma to renal function.

Materials And Methods: A retrospective analysis of 53 partial nephrectomies containing RCC was performed. Glomeruli within 0.

Clinical pathway after robotic nephroureterectomy: omission of pelvic drain with next-day catheter removal and discharge.

Objective: To determine the feasibility of applying a postoperative clinical pathway after robotic nephroureterectomy (RNU) targeting safe omission of a pelvic drain and removal of the bladder catheter on the day after surgery with hospital discharge on postoperative day 1 (POD#1).

Methods: We reviewed a prospectively collected database of all RNUs performed by a single surgeon (R.A.

Histologic impact of dual-modality intracorporeal lithotripters to the renal pelvis.

Objective: To test the hypothesis that dual-modality intracorporeal lithotripters used during percutaneous nephrolithotomy create a degree of tissue trauma in the dual-modality mode (ballistic and ultrasonic) similar to that in the single-modality mode (ultrasonic).

Materials And Methods: The lithotripter devices tested were the Cyberwand and Swiss LithoClast Select. The activated probes, in both single- and dual-modality modes, were applied directly to the renal pelvis of 11 fresh nephrectomy specimens.

Optimization of near infrared fluorescence tumor localization during robotic partial nephrectomy.

Purpose: Near infrared fluorescence allows the differentiation of tumors and normal parenchyma during robotic partial nephrectomy. This may facilitate tumor excision but requires proper dosing of indocyanine green. Under dosing causes inadequate fluorescence of peritumor parenchyma.

Fournier's Gangrene in a Heterosexual Man: A Complication of Neisseria meningitidis Urethritis.

A 55-year-old heterosexual male presented to the emergency department with a symptomatology consistent with urethritis and Fournier's gangrene. Urethral swab and operative tissue cultures were positive for coagulase-negative Staphylococcus and an intracellular Gram-negative diplococcus. The latter was initially thought to be Neisseria gonorrhea; however, DNA sequencing technique confirmed it to be Neisseria meningitidis.

Regaining candidacy for heart transplantation after robotic assisted laparoscopic radical prostatectomy in left ventricular assist device patient.

Several factors may highlight the relevance of prostate cancer to the pre-heart-transplant population. First, the expansion in candidate selection criteria led to increased number of men over the age of fifty to be considered for heart transplantation. With the introduction of left ventricular assist device (LVAD) therapy, waiting-list mortality has dramatically declined over the past decade.

Feasibility of robotic-assisted laparoscopic nephroureterectomy in left ventricular assist device patient.

Left ventricular assist devices (LVADs) have revolutionized management options for patients with advanced heart failure. It is not uncommon for patients treated with these devices to present with noncardiac surgical conditions including urologic problems. Maintaining perioperative hemodynamic and hematologic stability is a special challenge.

Evaluation of a new 240-μm single-use holmium:YAG optical fiber for flexible ureteroscopy.

Background And Purpose: Numerous holmium:yttrium-aluminum-garnet laser fibers are available for flexible ureteroscopy. Performance and durability of fibers can vary widely among different manufacturers and their product lines with differences within a single product line have been reported. We sought to evaluate a newly developed nontapered, single-use 240-μm fiber, Flexiva™ 200 (Boston Scientific, Natick, MA), during clinical use and in a bench-testing model.

Risk and prevention of acute urinary retention after robotic prostatectomy.

Purpose: Acute urinary retention after catheter removal is a recognized complication following open or robot-assisted radical prostatectomy. We evaluated patient and surgery related risk factors to determine whether acute urinary retention could be prevented. To our knowledge this has not previously been investigated for prostatectomy done by any technique.

Resilience of disposable endoscope optical fiber properties after repeat sterilization.

Objective: The PolyScope(®) (Lumenis, Santa Clara, CA) is a disposable flexible ureteroscope composed of a single-use flexible catheter and a reusable fiber optic bundle. We tested the resilience of the optical properties of the reusable optical fiber after repeat sterilization.

Methods: Optical properties evaluated were resolution, distortion, and light transmission.