Sentinel Lymph Node Biopsy in Penile Cancer: A Comparative Study Using Modified Inguinal Dissection

Introduction In the case of clinically negative inguinal regions in penile cancer, the treatments proposed might vary from careful observation to radical dissection for all patients. We evaluated the effectiveness of the sentinel lymph node biopsy using lymphoscintigraphy in patients with penile cancer and at least one negative inguinal region Materials and Methods In 18 patients, biopsy of the sentinel lymph node from the 32 negative inguinal regions and modified radical lymphadenectomy in these regions regardless of the biopsy results was performed. Clinical staging, pathological results of the sentinel and the other lymph nodes removed during lymphadenectomy, tumor behavior, local and inguinal recurrence and specific disease mortality were accessed. Results: The mean age of the study sample was 57.7 years (44 - 81 years) and the sentinel lymph node presented 0% false negative 66% sensitivity, and 79.3% specificity when compared with the modified inguinal lymphadenectomy as the gold standard treatment Conclusion: Sentinel lymph node biopsy is a feasible method of assessing the presence of regional metastasis in patients with penile cancer and clinically negative inguinal regions However, the optimal lymphoscintigraphy technique is still in evolution and requires further optimization at high volume centers34672573

Physicochemical and biological characterization of 1E10 Anti-Idiotype vaccine

<p>Abstract</p> <p>Background</p> <p>1E10 monoclonal antibody is a murine anti-idiotypic antibody that mimics N-glycolyl-GM3 gangliosides. This antibody has been tested as an anti-idiotypic cancer vaccine, adjuvated in Al(OH)₃, in several clinical trials for melanoma, breast, and lung cancer. During early clinical development this mAb was obtained <it>in vivo </it>from mice ascites fluid. Currently, the production process of 1E10 is being transferred from the <it>in vivo </it>to a bioreactor-based method.</p> <p>Results</p> <p>Here, we present a comprehensive molecular and immunological characterization of 1E10 produced by the two different production processes in order to determine the impact of the manufacturing process in vaccine performance. We observed differences in glycosylation pattern, charge heterogeneity and structural stability between <it>in vivo</it>-produced 1E10 and bioreactor-obtained 1E10. Interestingly, these modifications had no significant impact on the immune responses elicited in two different animal models.</p> <p>Conclusions</p> <p>Changes in 1E10 primary structure like glycosylation; asparagine deamidation and oxidation affected 1E10 structural stability but did not affect the immune response elicited in mice and chickens when compared to 1E10 produced in mice.</p

Barriers to prostate cancer screening: psychological aspects and descriptive variables - is there a correlation?

Methods. aEuro integral Patients (345) who underwent DRE for the first time from February 2006 to December 2007 were evaluated for their psychological reactions and feelings after the examination. Results. aEuro integral The average age of the patients was 52.8 years (25 - 85 years); 40.94%% had felt fear (examination fear 15.94%%, and diagnosis fear 25%%), 26.45%% shame and 48.26%% indicated they were not thinking about anything. There was no correlation between age, educational level and emotional reactions. Most patients (96.8%%) would undergo a DRE again and 52.35%% had considered it better than they had imagined. Of these patients, 41.81%% were illiterate/incomplete elementary school. Only 4.12%% described having a negative experience. The factors that persuaded the patients to book an appointment were: 50.1%% made their own decision, 26.67%% were recommended by a physician, 18.55%% family/friends and 6.67%% were influenced by the media. Wives booked 24.06%% of the consultations. Although 85.47%% of patients had some previous knowledge about the examination, 80.81%% felt they had further clarification afterward. Lower educational level was related to lack of information about DRE, while 52.38%% who made their own decision had previous knowledge of the importance of DRE. Conclusion. aEuro integral The majority of the patients found DRE less awkward than they had imagined it to be and would repeat the examination in the future. Fear and shame before the examination are present and are barriers to the DRE.141667

Testicular components volume density alteration associated to cis-platinum: can antioxidants offer protection?

Objectives: Cis-platinum based chemotherapy agents are widely used in treatment of testicular cancer and its deleterious effects on spermatogenesis are well known. Therefore an extensive survey was undertaken to evaluate the effects of antioxidants in combination with Cis-platinum in an attempt to minimize its effects upon spermatogenic function of adult rats. Methods: A short-term prospective study (thirteen days) including twenty-four adult male Wistar rats was performed. Animals were assigned into one of three groups (eight per group): GI-control, GII-Cis-platinum treated and GIII-Cis-platinum plus superoxide dismutase and catalase. Histological analyses included germ cell counts, germ to Sertoli cell ratios and estimation of volume density components as well as the determination of the sperm reserves. Data was examined through one-way analysis of variance at 5% level of significance. Results: Germ cell numbers, germ cell to Sertoli cell ratios, organ weights (except body weight) and sperm reserves presented no differences among groups. However, the volumetric proportion of some components (tubular epithelium, tunica propria, Leydig cell nuclei and stroma) were affected (p<0.05) by treatment. The most prominent testicular component, the seminiferous epithelium was reduced (p<0.05) in Cis-platinum treated animals (GII). Conclusion: The use of antioxidant in association with Cis-platinum did not affect sperm production (germ cell numbers, germ to Sertoli cell ratios and sperm reserves) of adult rats. However, the deleterious effect of Cis-platinum on the seminiferous tubule epithelium was minimized by antioxidants. (C) 2009 AEU. Published by Elsevier Espana, S.L. All rights reserved.34328228

The impact of core biopsy fragmentation in prostate cancer

Since accurate tumor localization and quantification are essential requisites avoiding prostate cancer overtreatment, we analyzed the impact of core fragmentation and the relation between core biopsy taken and pathological information in regard to cancer extension and aggressiveness (Gleason score). One hundred and ninety-nine men submitted to trans-rectal prostate biopsy by the same urologist between October 2006 and October 2008 were included, and the number of cores obtained by biopsy compared to the number of cores examined by the same pathologist. Total core number obtained by biopsy was 21.54 (+/- 3.56) compared to 24.08 (+/- 4.77) examined by the pathologist, P < 0.01. Dividing prostate gland by areas such as base, mid and apical right and left, all areas showed statistically different core number between biopsy and pathological examination report (P < 0.01). Mean ratio of positive core cancer length was 0.41 (+/- 0.12) and 0.32 (+/- 0.8) comparing individual and overall cores analysis, respectively (P < 0.01). The mean Gleason score in the individual and overall cores analysis were 6.6 (6-9) and 6.3 (6-9), respectively, P < 0.01. Considering the ongoing trend for earlier diagnosis of increasing numbers of younger men with low-risk prostate cancer, this study is original and demonstrates the possibility of core fragmentation, explaining in part over- and under-staging. One core per container and an overall Gleason score and percentage of adenocarcinoma for each container are encouraged.42496596

Videolaparoscopic orchiectomy and nephrectomy: Training model in rats

Objective: Videolaparoscopic surgery conducted on small animals has proved to be of great importance for the improvement of surgical skills. This is a report utilizing an experimental model for laparoscopic orchiectomy and nephrectomy in training courses for urologists. Material and Methods: Of 350 American Wistar rats enrolled, 319 animals underwent laparoscopic orchiectomy and nephrectomy under intraperitoneal general anesthesia. Graspers, dissectors, and a 0-degree telescope were introduced into the peritoneal cavity by two trocars of 5 mm and one of 10 mm, respectively. Results: Of 350 rats enrolled, 15 (4.2%) died due to anesthetic complications and 16 (4.5%) due to cannibalism and stress during transport. A total of 319 rats were operated on, 178 underwent bilateral orchiectomy, two per model (356 operations), and in 141 animals one nephrectomy per model (141 operations) was performed. A total of 497 operations were performed involving 140 urologists. The animals were easy to handle providing adequate practice without the occurrence of any major intraperitoneal lesion and hemorrhage. Conclusion: Nephrectomy and orchiectomy are feasible in rats, and this model can be utilized for training videolaparoscopic surgeries. Copyright (c) 2006 S. Karger AG, Basel.76212612

Extra-anatomical transobturator bypass graft for femoral artery involvement by metastatic carcinoma of the penis: report of five patients

Objectives Squamous cell carcinoma (SCC) of the penis with inguinal lymph node involvement aggravates prognosis and can cause femoral artery bleeding, hemorrhagic shock and even death. The objective of this study is to describe the use of extra-anatomical transobturator bypass graft for femoral artery involvement by metastatic carcinoma of the penis. Casuistic and method Five patients with SCC and inguinal lymphatic metastasis involving the femoral vessels, who underwent extra-anatomical arterial bypass through obturator foramen between 1999 and 2007, were reviewed. The surgical technique and the postoperative outcome were described. Results After extra-anatomical transobturator bypass, all patients presented distal pulses. The mean time of surgery was 6 h. In four patients, a knitted Dacron tube was used; and in one, the contralateral devalvulated greater saphenous vein was used. Concomitantly, two patients underwent mass resection and one patient underwent node dissection 2 weeks after bypass. Two patients chose not to undergo inguinal resection, opting for palliative chemotherapy after the vascular procedure. The average follow-up period was 12 months and four patients have died-three due to pulmonary metastasis, and one due to acute myocardial infarct. No prosthetic complication was identified and no patient presented femoral bleeding. Conclusions The use of the transobturator bypass can benefit patients presenting with penile SCC and inguinal lymph nodes metastasis involving the femoral vessels, allowing resection of extensive tumor lesions, as well as avoidance of local complications.26548749

Split technique in horseshoe kidney transplantation

Background/Aims: Nowadays, owing to a greater number of patients waiting for a kidney donation and to a shortage of organs donated, more suitable organ acceptance criteria have been formulated. Horseshoe kidney transplantations have become feasible giving good allograft outcomes. The aim of this paper is to illustrate the split technique in horseshoe kidney transplantation and to report long-term results. Methods: During the period from February 2004 to February 2005, two horseshoe kidneys were harvested from multiple organ retrieval. The surgical features and outcomes of these 2 cases are described separately. Mean follow-up time was 12.3 months. Conclusions: Organs that were previously said to be marginal are being used more regularly and the more suitable selection does not exclude elderly donors with or without underlying diseases. Horseshoe kidney transplantation requires greater skills and experience of the surgeons compared to conventional kidney transplantation. This kind of renal abnormality has to be considered a feasible option for transplantation. Good long-term results are reported. Copyright (c) 2006 S. Karger AG, Basel.7716

Kidney Transplant Anastomosis Internal or External Iliac Artery?

Introduction: We compared the best technique for arterial anastomosis in kidney transplantation, end-to-side anastomosis to the external iliac artery or end-to-end anastomosis to the internal iliac artery. Materials and Methods: A total of 38 patients with end-stage renal disease who received a kidney transplant from a deceased donor were randomized into two groups in order to undergo either end-to-end anastomosis to the internal iliac artery or end-to-side anastomosis to the external iliac artery. Length of arterial anastomosis, cold ischemia time, hospital stay, serum creatinine level, recovery of urinary output, and surgical and clinical complications during hospitalization were evaluated. After 3 years, in the patients with a functioning allograft, creatinine clearance measure, Doppler ultrasonographic study, survival, graft loss, and erectile function were compared between the two groups. Results: Postoperative analyses showed similar recovery of urinary output (P=.39) and creatinine (P=.95) between the two groups. No differences in clinical (P=.55) and surgical (P=.80) complications or in hospital stay (P=.90) were noted. The 3-year follow-up demonstrated no differences in Doppler ultrasonography results, creatinine clearance (P=.80), patient survival (P=.22), and graft loss (P=.72). Erectile dysfunction was similar, being related only to pre-operative medical history and age. Conclusion: Both techniques showed similar results in short- and long-term follow-ups. Larger prospective studies are warranted to clarify the risk of renal artery stenosis and development of erectile dysfunction.6426026