The Role of the Magnetic Resonance Imaging for the Accurate Management of Focal Therapy with High-Intensity Focused Ultrasound for the Localized Prostate Cancer

The concept of the currently attracted focal therapy is to treat clinical significant cancer with minimal invasion of health-related functions such as urethra, sphincter, neurovascular bundle, and bladder neck. The patients\u27 criteria have been decided with pathologic tumor features characterized according to a combination of cancer core length and Gleason grade with prostate biopsy. Because the area involved in a single treatment using high-intensity focused ultrasound (HIFU) is extremely small, only minor temperature changes are observed outside of the focal zone. HIFU has been considered as an attractive therapeutic modality for the focal treatment of the prostate with the aim of curing the cancer while preserving continence and erectile function. Clinical trials of focal ablation of prostate cancer with HIFU have been reported. In our protocol, magnetic resonance imaging (MRI) has played a major role in the diagnosis of the spatial location of the significant cancer, treatment planning, and the evaluation of the treatment efficacy and recurrence after the treatment. In the chapter in “MR Imaging,” we want to present the role of MRI in the accurate management of focal therapy with HIFU for the localized prostate cancer

Clinical impact of bladder biopsies with TUR-BT according to cytology results in patients with bladder cancer: a case control study

<p>Abstract</p> <p>Background</p> <p>There seems to be no consensus concerning taking bladder biopsies during transurethral resection of bladder tumor (TUR-BT). We investigate the clinical significance of bladder biopsy with TUR-BT and the relationship between urinary cytology and the biopsy results.</p> <p>Methods</p> <p>We reviewed a total of 424 patients with non-muscle invasive bladder cancer treated with TUR-BT between 1998 and 2005. Of the total, 293 patients also underwent a bladder biopsy. Biopsies from suspicious-appearing urothelium (N = 59) and those from normal-appearing urothelium (N = 234) were evaluated separately.</p> <p>Results</p> <p>Bladder cancer was observed in 23 cases (39.0%) who underwent a biopsy of suspicious-appearing urothelium. Among these 23 cases, 9 cases with visible tumor resection had carcinoma in situ (CIS) only in the biopsies from suspicious-appearing urothelium. Urinary cytology was negative in 3 of the 9 cases. Bladder cancer was observed in 26 cases (11.1%) who underwent a biopsy of normal-appearing urothelium. Of them, 5 cases with visible tumors had CIS only in the multiple biopsies from normal-appearing urothelium. Urinary cytology was positive in all of the 5 cases. No upstaging or upgrading cases were found in these patients by the addition of these two types of biopsy. Furthermore, therapy was not altered in these patients. With or without bladder biopsy was not a significant factor for tumor recurrence in either the univariate or multivariate analysis.</p> <p>Conclusions</p> <p>Based on the results, it is concluded the multiple biopsies from normal-appearing urothelium are not necessary in patients with negative cytology results because of the low detection rate and lack of influence on therapeutic decisions. Meanwhile, biopsy of suspicious-appearing urothelium is needed in patients with negative cytology results in order to detect CIS due to staging properties. This result supports a recent EAU guideline.</p

Preparation of Peptide Thioesters from Naturally Occurring Sequences Using Reaction Sequence Consisting of Regioselective S-Cyanylation and Hydrazinolysis

Vital roles of peptide/protein thioesters in protein chemistry, including chemical or semi synthesis of proteins, have encouraged studies on the development of methods for the preparation of such chemical units. Biochemical protocols using intein or sortase have proved to be useful in protein chemistry as methods suitable for naturally occurring sequences, including recombinant proteins. Although chemical protocols are potential options for thioester preparation, only a few are applicable to naturally occurring sequences, because standard chemical protocols require an artificial chemical device for producing thioesters. In this context, the chemical preparation of thioesters based on a reaction sequence consisting of regioselective S-cyanylation and hydrazinolysis was investigated. Regioselective S-cyanylation, which is required for cysteine-containing thioesters, was achieved with the aid of zinc-complex formation of a CCHH-type zinc-finger sequence. Free cysteine residues that are not involved in complex formation were selectively protected with a 6-nitroveratryl group followed by S-cyanylation of the zinc-binding cysteine. Hydrazinolysis of the resulting S-cyanopeptideand subsequent photo-removal of the 6-nitroveratryl group yielded the desired peptide hydrazide, which was then converted to the corresponding thioester. The generated thioester was successfully used in N–to–C-directed one-pot/sequential native chemical ligation using an N-sulfanylethylanilide peptide to give a 64-residue peptide toxin