Risk Stratification and Early Oncologic Outcomes Following Robotic Prostatectomy

Results of this study suggest that robotic prostatectomy provides good cancer outcomes for clinically localized disease

Trends in the Rates of Pediatric Pyeloplasty for Ureteropelvic Junction Obstruction over 19 Years: A PHIS Database Study

Background. Over the past 20 years, the management of ureteropelvic junction obstruction (UPJ) has shifted. While many urologists note a decrease in the number of pyeloplasties performed over time, the nature of the change in practice has yet to be defined. In the current study, we utilize a national, multi-institutional database of children’s hospitals to evaluate trends in patients undergoing pyeloplasty as well as the rate of surgical reconstruction over the past 20 years. Material/Methods. We queried the Pediatric Health Information System (PHIS) database for all children undergoing primary pyeloplasty between 1992 and 2011. Clinical variables, including age at time of surgery, gender, length of stay (LOS), and geographic region, were determined. Age-adjusted rate of repair was also calculated per 100,000 PHIS inpatients. Results. 6,013 patients were included in the study, of which 71.6% were male and 64.2% were under the age of 24 months at time of surgery. Over the study period, the median age at time of surgery increased from 2–4 months to 12–14 months (P<0.01). LOS decreased from a median of 5 days to 2 days (P<0.001). The rate of surgery increased by 10.6 pyeloplasties per 100,000 PHIS inpatients from 1992 to 2011 (P<0.01). The highest rate of pyeloplasty was in the northeast. The increase in pyeloplasties performed from 1992 to 1999 was specific to children aged greater than 24 months, while rates stayed the same in infants younger than 2 years during the same time period. In contrast, from 1999 to 2011, the rate of pyeloplasty decreased in patients less than 2 years of age, while the rate remained constant in patients over age 2. Conclusion. The rate of pyeloplasty increased in PHIS hospitals from 1992 to 2011. Trends are due to an increase in surgery in infants younger than 2 years from 1992 to 1999, followed by a progressive surgical rate decline, characterized by a shift towards patients older than 2 years of age

Prophylactic Bilateral Gonadectomy for Ovotesticular Disorder of Sex Development in a Patient With Mosaic 45,X/46,X,idic(Y)q11.222 Karyotype

Ovotesticular disorder of sex development is historically thought to confer a relatively low risk of germ cell malignancy relative to other disorders of sex development. This is likely due in part to the high prevalence of a normal 46,XX karyotype in these patients. However, disorders of sex development represent a broad phenotypic spectrum, and often patients cannot be neatly categorized with a single diagnosis. We report an atypical case of ovotesticular disorder of sex development in a child with ambiguous genitalia and 45,X/46,XY mosaic karyotype. Prophylactic bilateral gonadectomy was performed at age 14 months

Fully automated kidney image biomarker prediction in ultrasound scans using Fast-Unet++

Abstract Any kidney dimension and volume variation can be a remarkable indicator of kidney disorders. Precise kidney segmentation in standard planes plays an undeniable role in predicting kidney size and volume. On the other hand, ultrasound is the modality of choice in diagnostic procedures. This paper proposes a convolutional neural network with nested layers, namely Fast-Unet++, promoting the Fast and accurate Unet model. First, the model was trained and evaluated for segmenting sagittal and axial images of the kidney. Then, the predicted masks were used to estimate the kidney image biomarkers, including its volume and dimensions (length, width, thickness, and parenchymal thickness). Finally, the proposed model was tested on a publicly available dataset with various shapes and compared with the related networks. Moreover, the network was evaluated using a set of patients who had undergone ultrasound and computed tomography. The dice metric, Jaccard coefficient, and mean absolute distance were used to evaluate the segmentation step. 0.97, 0.94, and 3.23 mm for the sagittal frame, and 0.95, 0.9, and 3.87 mm for the axial frame were achieved. The kidney dimensions and volume were evaluated using accuracy, the area under the curve, sensitivity, specificity, precision, and F1

Endothelin Receptor A Blockade Enhances Taxane Effects in Prostate Cancer

Endothelin (ET) 1 is important in the growth of prostate cancer cells through the activation of the endothelin A (ET(A)) receptor. ET receptor blockade is a new therapeutic target in treating advanced prostate cancer. This study investigates the impact of the combination of the ET(A) antagonist atrasentan (ABT-627) and taxane chemotherapy on prostate cancer cell survival in vitro and on the delay of prostate cancer in a xenograft mouse model. In vitro, PPC-1 cells transfected with an ET(A)-overexpressing vector were treated with ABT-627, paclitaxel/docetaxel, or both. Clonogenic viability and cell death assays were used to determine cell survival and apoptosis, respectively. ABT-627 and docetaxel combination treatment was used in vivo to treat mice with established ET(A)-overexpressing PPC-1 xenograft tumors, and tumor growth rates were assessed. Cell proliferation and vascularity were determined with Ki-67 and CD31 staining, respectively. Cells treated with combination therapy had significantly fewer viable cells and more programmed cell death than cells given monotherapy. Xenograft tumor growth rates were significantly lower in mice treated with combination therapy than in animals given a single agent. Ki-67 immunostaining demonstrated significantly fewer proliferative cells following combination therapy than following monotherapy. This study demonstrates ABT-627 to have additive antitumor effects when used in combination with taxane drugs both in vitro and in vivo