Surgical salvage in patients with advanced testicular cancer: indications, risks and outcomes

The purpose of this review is to present a comprehensive and updated review of the literature and summary of the indications, risks and outcomes related to salvage, desperation and late relapse surgery for advanced testicular cancer. After completing a thorough review of the current literature, this review has attempted to provide an overview of the indications for salvage, desperation and late relapse retroperitoneal lymph node dissection (RPLND) followed by a summary of the histopathologic and clinical outcomes regarding each. Recent literature, combined with a significant contribution from historical studies suggest that while testicular cancer is a relatively uncommon malignancy overall, it represents the most common solid organ malignancy for young men. Although a significant number of men are cured with a combination of first-line treatments, the remaining men are a diverse and often challenging cohort who require the benefit of expertise to improve their outcomes. The role of surgical strategies in the salvage, desperation and late relapse settings is unquestionable, although the most important question remains who will benefit. This often requires a multi-disciplinary approach at centers specializing in this disease process in order to recognize who should get surgery, what surgery to do and how to minimize the potential morbidity associated with the operation

A heterogeneous "resting" pool of synaptic vesicles that is dynamically interchanged across boutons in mammalian CNS synapses

Using pHluorin-tagged synaptic vesicle proteins we have examined the partitioning of these probes into recycling and nonrecycling pools at hippocampal nerve terminals in cell culture. Our studies show that for three of the major synaptic vesicle components, vGlut-1, VAMP-2, and Synaptotagmin I, approximately 50-60% of the tagged protein appears in a recycling pool that responds readily to sustained action potential stimulation by mobilizing and fusing with the plasma membrane, while the remainder is targeted to a nonrecycling, acidic compartment. The fraction of recycling and nonrecycling (or resting) pools varied significantly across boutons within an individual axon, from 100% resting (silent) to 100% recycling. Single-bouton bleaching studies show that recycling and resting pools are dynamic and exchange between synaptic boutons. The quantitative parameters that can be extracted with the approaches outlined here should help elucidate the potential functional role of the resting vesicle pool

A heterogeneous "resting" pool of synaptic vesicles that is dynamically interchanged across boutons in mammalian CNS synapses

Using pHluorin-tagged synaptic vesicle proteins we have examined the partitioning of these probes into recycling and nonrecycling pools at hippocampal nerve terminals in cell culture. Our studies show that for three of the major synaptic vesicle components, vGlut-1, VAMP-2, and Synaptotagmin I, approximately 50-60% of the tagged protein appears in a recycling pool that responds readily to sustained action potential stimulation by mobilizing and fusing with the plasma membrane, while the remainder is targeted to a nonrecycling, acidic compartment. The fraction of recycling and nonrecycling (or resting) pools varied significantly across boutons within an individual axon, from 100% resting (silent) to 100% recycling. Single-bouton bleaching studies show that recycling and resting pools are dynamic and exchange between synaptic boutons. The quantitative parameters that can be extracted with the approaches outlined here should help elucidate the potential functional role of the resting vesicle pool

Post-Norris Ambiguities: Unanswered Questions For Women and the Pension Industry

On April 25, 1978, the United States Supreme Court decided Los Angeles Department of Water and Power v. Manhart in a way that was bound to have a profound effect on the pension industry. The division of opinion in the Manhart Court was indicative of the difficulty of the question presented. In Part I, this article examines the Court\u27s findings in Manhart, as well as its conclusions in a more recent case, Arizona Governing Committee v. Norris, in which the Supreme Court extended its Manhart holding in a way bound to have an equally significant impact on pension programs. In Parts II and III, this article addresses two issues concerning the future of the pension industry which the Court has left unanswered: whether the relief granted to compensate for past sex discrimination in pension programs is to be retroactive or prospective only; and whether the size of these awards is to be determined by topping up, i.e., by requiring that benefits payable to the formerly disadvantaged sex be raised to the level now payable to the favored sex, or by the adoption of unisex actuarial tables which average the mortality experience of the sexes and provide mid-level benefits to all employees. In Part IV, this article contemplates the cost and Economic Retirement Income Security Act (ERISA) consequences which could accrue from possible solutions to the problem of remedying past sex discrimination in pension programs. Finally, Part V of this article deals with other practical ramifications likely to result from the Manhart and Norris decisions

Optical Mapping of Release Properties in Synapses

Synapses are important functional units that determine how information flows through the brain. Understanding their biophysical properties and the molecules that underpin them is an important goal of cellular neuroscience. Thus, it is of interest to develop protocols that allow easy measurement of synaptic parameters in model systems that permit molecular manipulations. Here, we used a sensitive and high-time resolution optical approach that allowed us to characterize two functional parameters critical to presynaptic efficacy: vesicle fusion probability (Pv) and readily-releasable pool size (RRP). We implemented two different approaches to determine the RRP size that were in broad agreement: depletion of the RRP by high-frequency stimulation and saturation of the calcium sensor during single action potential stimuli. Our methods are based on reporters that provide a robust, quantitative, purely presynaptic readout and present a new avenue to study molecules that affect synaptic vesicle exocytosis

Effects of the Boy Scouts of America Personal Fitness Merit Badge on Cardio-Metabolic Risk, Health Related Fitness and Physical Activity in Adolescents Boys

International Journal of Exercise Science 10(7): 964-976, 2017. A growing number of adolescents are more sedentary and have fewer formal opportunities to participate in physical activity. With the mounting evidence that sedentary time has a negative impact on cardio-metabolic profiles, health related fitness and physical activity, there is a pressing need to find an affordable adolescent physical activity intervention. One possible intervention that has been overlooked in the past is Boy Scouts of America. There are nearly 900,000 adolescent boys who participate in Boy Scouts in the United States. The purpose of this research study was to evaluate the effect of the Personal Fitness merit badge system on physical activity, health-related fitness, and cardio-metabolic blood profiles in Boy Scouts 11-17 years of age. Participants were fourteen (N = 14) Boy Scouts from the Great Salt Lake Council of the Boy Scouts of America who earned their Personal Fitness merit badge. Classes were held in the Spring of 2016 where boys received the information needed to obtain the merit badge and data were collected. Results from the related-samples Wilcoxon signed rank test showed that the median of differences between VO2 peak pre-test and post-test scores were statistically significant (p = 0.004). However, it also showed that the differences between the Pre-MetS (metabolic syndrome) and Post-MetS scores (p = 0.917), average steps taken per day (p = 0.317), and BMI (p = 0.419) were not statistically significant. In conclusion, the merit badge program had a positive impact on cardiovascular endurance, suggesting this program has potential to improve cardiovascular fitness and should be considered for boys participating in Boy Scouts

Comparison of transabdominal ultrasound and electromagnetic transponders for prostate localization.

The aim of this study is to compare two methodologies of prostate localization in a large cohort of patients. Daily prostate localization using B-mode ultrasound has been performed at the Nebraska Medical Center since 2000. More recently, a technology using electromagnetic transponders implanted within the prostate was introduced into our clinic (Calypso(R)). With each technology, patients were localized initially using skin marks. Localization error distributions were determined from offsets between the initial setup positions and those determined by ultrasound or Calypso. Ultrasound localization data was summarized from 16619 imaging sessions spanning 7 years; Calypso localization data consists of 1524 fractions in 41 prostate patients treated in the course of a clinical trial at five institutions and 640 localizations from the first 16 patients treated with our clinical system. Ultrasound and Calypso patients treated between March and September 2007 at the Nebraska Medical Center were analyzed and compared, allowing a single institutional comparison of the two technologies. In this group of patients, the isocenter determined by ultrasound-based localization is on average 5.3 mm posterior to that determined by Calypso, while the systematic and random errors and PTV margins calculated from the ultrasound localizations were 3 - 4 times smaller than those calculated from the Calypso localizations. Our study finds that there are systematic differences between Calypso and ultrasound for prostate localization