Minimal and Direct Access Surgery in Urology

An alternative method to laparoscopic surgery has been developed for urological procedures. The surgery is minimal access because the length of the single skin incision ranges from 3–6 cm depending on the type of operation. It is direct access because the surgeon sees the operative area directly and stereoscopically by eye without video-optical support. The procedure requires a special open-lumen retractorscope (JakoscopeTM) with a high intensity fiberoptic light system and modified standard hand instruments. Among the procedures performed nephrectomy, ureterolithotomy, prostatic adenomectomy, spermatic vein ligation and others have been performed. The kidney procedures have been operated retroperitoneally through a minilumbotomy incision. The procedures are simple, rapid and the instruments are inexpensive. The postoperative pain and morbidity are comparable to the laparoscopic approach

Minimal and Direct Access Surgery in Urology

An alternative method to laparoscopic surgery has been developed for urological procedures. The surgery is minimal access because the length of the single skin incision ranges from 3–6 cm depending on the type of operation. It is direct access because the surgeon sees the operative area directly and stereoscopically by eye without video-optical support. The procedure requires a special open-lumen retractorscope (JakoscopeTM) with a high intensity fiberoptic light system and modified standard hand instruments. Among the procedures performed nephrectomy, ureterolithotomy, prostatic adenomectomy, spermatic vein ligation and others have been performed. The kidney procedures have been operated retroperitoneally through a minilumbotomy incision. The procedures are simple, rapid and the instruments are inexpensive. The postoperative pain and morbidity are comparable to the laparoscopic approach

CD44 Expression in Oro-Pharyngeal Carcinoma Tissues and Cell Lines

Expression of CD44, a transmembrane hyaluronan-binding glycoprotein, is variably considered to have prognostic significance for different cancers, including oral squamous cell carcinoma. Although unclear at present, tissue-specific expression of particular isoforms of CD44 might underlie the different outcomes in currently available studies. We mined public transcriptomics databases for gene expression data on CD44, and analyzed normal, immortalized and tumour-derived human cell lines for splice variants of CD44 at both the transcript and protein levels. Bioinformatics readouts, from a total of more than 15,000 analyses, implied an increased CD44 expression in head and neck cancer, including increased expression levels relative to many normal and tumor tissue types. Also, meta-analysis of over 260 cell lines and over 4,000 tissue specimens of diverse origins indicated lower CD44 expression levels in cell lines compared to tissue. With minor exceptions, reverse transcribed polymerase chain reaction identified expression of the four main isoforms of CD44 in normal oral keratinocytes, transformed lines termed DT and HaCaT, and a series of paired primary and metastasis-derived cell lines from oral or pharyngeal carcinomas termed HN4/HN12, HN22/HN8 and HN30/HN31. Immunocytochemistry, Western blotting and flow cytometric assessments all confirmed the isoform expression pattern at the protein level. Overall, bioinformatic processing of large numbers of global gene expression analyses demonstrated elevated CD44 expression in head and neck cancer relative to other cancer types, and that the application of standard cell culture protocols might decrease CD44 expression. Additionally, the results show that the many variant CD44 exons are not fundamentally deregulated in a diverse range of cultured normal and transformed keratinocyte lines

Adrenal myelolipoma with abdominal pain: A rare presentation

Adrenal myelolipomas are rare benign tumors. Most of the cases are asymptomatic and discovered incidentally. We are reporting a case of myelolipoma involving right adrenal cortex of a 40-year-old woman who presented with abdominal pain. A short review of etiology, clinical features, and differential diagnoses of this neoplasm are also discussed. Radiologic features are often helpful in diagnosis but histology must be done to exclude other fat-containing lesions. Although uncommon, myelolipomas should be considered in differential diagnosis of retroperitoneal lesions

Venous spread of renal cell carcinoma: MDCT

BACKGROUND: The purpose of our study was to present multidetector computed tomography (MDCT) findings in venous spread of renal cell carcinoma (RCC), to determine the superior extent of tumor thrombus and to compare MDCT findings with surgical report. ----- METHODS: The prospective MDCT study was performed on 31 patients diagnosed with RCC with venous spread (19 males and 12 females; age range 39-80 years; mean age 62.6 years). CT scans were obtained by MDCT scanner, in triphasic scanning protocol. All postprocessing techniques were performed by two independent radiologists, and the findings were reported in their consensus. MDCT diagnosis was compared with surgical and pathohistological findings. ----- RESULTS: Tumor thrombus extension into renal vein only (T3b stage) was found in 13/31 (42%) patients. Involvement of infradiaphragmatic level of inferior vena cava (IVC) (T3c stage) was found in 14/31 (45%) patients and supradiaphragmatic level of IVC (T4b stage) in 4/31 (13%) patients. In 27/31 (87%) patients surgery was performed, while 4/31 (13%) could not undergo surgery. In comparison with surgical report, in 25/27 (93%) operated patients the upper extent of the tumor thrombus was correctly diagnosed by MDCT, and 2/27 (7%) patients were falsely diagnosed. ----- CONCLUSION: MDCT represents a fast, relatively inexpensive, and reliable diagnostic method for evaluating the venous spread of RCC as well as the level of its upper extent. Triphasic MDCT is often the only diagnostic method necessary for planning the surgical procedure. Surgery should be performed as soon as possible for MDCT findings to be valid