Urologic Oncology: Seminars and Original Investigations. A Twenty-Fifth Anniversary History

This narrative reviews the history of Urologic Oncology: Seminars and Original Investigations from its inception and founding through its development to reach its current status. It describes the difficulties it experienced during its initial years when it almost folded, its resuscitation when it was designated as the “official journal” of the Society of Urologic Oncology, its merger with Seminars in Urologic Oncology to strengthen the content of both journals in a new format, its acceptance for indexation by the National Library of Medicine, its progress to monthly publication in addressing the needs of both authors and readership, and its current status as a leading multidisciplinary journal in urologic oncology. As a founding editor and managing editor for the first 5 years and then as editor-in-chief for the next 20 years, the author has been integrally involved in each step of the Journal's development and maturation. The Journal has been referred to as “the journal that almost never was” as it now has reached its 25th year of publication. This article commemorates the Journal's 25th Anniversary and gratefully acknowledges all of those investigators, authors, reviewers, editors, publishers and the readership who have contributed to the Journal's ongoing success.     

Porous tantalum in reconstructive surgery of the knee: a review

Porous tantalum represents an alternative metal for primary and revision total knee arthroplasty (TKA) with several unique properties. Tantalum is a transition metal, which in its bulk form has shown excellent biocompatibility and is safe to use in vivo as evidenced by its current application in pacemaker electrodes, cranioplasty plates, and as radiopaque markers. Current designs for orthopedic implants maintain a high volumetric porosity (70%-80%), low modulus of elasticity (3 MPa), and high frictional characteristics, making this metal conducive to biologic fixation. The low modulus of elasticity of such components allows for more physiologic load transfer and relative preservation of bone stock. Its more bioactive nature and ingrowth properties have led to its use in primary as well as revision knee components with good early clinical results reported. In revision arthroplasty, it has been used as a structural bone graft substitute. Formation of a bone-like apatite coating in vivo affords strong fibrous ingrowth properties and allows for substantial soft-tissue attachment with the potential for use in cases such as mega-prostheses and patella salvage. Although porous tantalum is in its early stages of evolution, the initial clinical data and basic science studies support its use as an alternative to traditional orthopedic implant materials.     

Is surgical clipping becoming underused?

Summary Coil embolization is a treatment for intracranial aneurysms with a particular appeal for posterior circulation aneurysms. However, although this procedure is effective in well-selected intracranial aneurysms, it has a series of limitations that may be overlooked as a result of its rapid technological evolution and its minimally invasive appearance. The author analyses the data that lead him to consider that since the introduction of coil embolisation in 1991 and its progressive diffusion, the technique of surgical clipping risks being underused as a therapeutic procedure for intracranial aneurysms because of the shortage of vascular neurosurgeons trained and experienced in its use.     

Cauda equina syndromes in conservative care: four case reports

The clinical picture of “full-blown” cauda-equina syndrome is well documented. It is considered a neurological emergency, as prompt decompressive surgery has been show to enhance recovery and reduce the occurrence of disability and dysfunction. However, cauda equina syndrome can be easily overlooked in its early stages when its clinical picture is less distinct. The evidence for appropriate management of early cauda equina syndrome is sparse compared with that for the full-blown syndrome.The syndrome may occur as a rare complication of lumbar intervertebral disc herniation and will therefore be encountered occasionally in chiropractic practice. Although it is extremely rare for I to be associated with spinal manipulation, the risk of temporal association is increased if the clinician fails to recognise the syndrome in its early stages. This paper presents four cases of patients who presented to chiropractors in the UK with symptoms of cauda equina syndrome. These cases illustrate acute and chronic cauda equina syndrome as well as its early and full-blown clinical pictures. The aetiology of cauda-equina syndrome and its identification and management in a chiropractic setting are also discussed.     

A critical assessment of the width coefficient, K, as an indicator of nutritional status

The width coefficient, K, was assessed critically to examine its underlying assumptions, its relationship to absolute dimensions of body size, and its ability to identify children classified as malnourished by internationally accepted criteria. The scientific integrity of the formula to calculate K depended on the assumption that the body could be viewed as a cylinder with a density of 1.0 g/ml. The empirical testing of the former assumption showed that the body could not be viewed as a cylinder and papers describing body density suggest that age and sex dependency militate against the acceptance of an age- and sex-independent value of 1.0 g/ml. As an indicator of nutritional status K performed well in that it identified children below 75% of weight for age, but it could only identify 47% of children below 90% weight for height. The relative complexity of its calculation and interpretation militate against the use of K as an indicator of malnutrition for the general health worker, but its ability to identify moderately malnourished children by weight for age gives it credibility in the absence of an age assessment.     

The flip side of tumor immunity

A large amount of data suggest that tumors are, to some degree, dependent for their growth on a positive level of immune reaction, a level that is unique for each tumor. Each tumor gradually adjusts its immunogenicity to the level that will, in the immunologic context of its own particular host, maximize its growth. Thus, it follows that immunosuppression may be as likely as immunoaugmentation to have a therapeutic effect.     

阿司匹林在不育症及辅助生殖技术中的应用

阿司匹林在不育症及辅助生殖技术中作为辅助治疗药物,其有效性众说不一,安全性有待检验。本文就阿司匹林对卵巢、子宫内膜、抗心磷脂抗体、妊娠率的影响及安全性,以及在辅助生殖技术中的应用作一综述。     

虚拟现实技术在乳腺癌术后康复训练中的应用进展

阐述了虚拟现实技术概况，虚拟现实技术在乳腺癌患者中的应用方式，用于乳腺癌患者康复训练的效果；总结了虚拟现实技术的优势与不足，旨在为临床更好地应用虚拟现实技术进行乳腺癌术后患肢功能康复训练提供参考。     

Der Fuß — eine nicht medizinische Betrachtung

No other organ of the human body has such an extensive meaning beyond medicine as the foot. The evolution of humans is directly linked to the function of the foot. Without walking upright on our feet we would not be as distinctly different from other mammals, specifically primates, as we are now. In mythology, the foot takes a predominant role as part of the human body. In religion, it is a symbol of humility and submission. Art celebrates the foot for its beauty and gracefulness but also its sexuality. Ultimately, the foot is essential in its role as being our means of standing and walking. Not to forget its role in our economy where crafts and products connected to the foot make up a substantial part of our national economy.     

The Use of Tissue Glue in Prominent Ear Correction Surgery

Cyanoacrylate tissue glues have been used for many years in otoplasty and specific indications for its use are as described. As well as being an effective means of dressing the postauricular suture line, its use in gluing the pinna back to the postauricular skin may negate the use of the head bandage in the postoperative period.     

Challenges of using mass spectrometry as a bladder cancer biomarker discovery platform

Introduction Bladder cancer (BCa) is one of the most prevalent malignancies worldwide, mostly due to its high recurrence rates. In consequence, the necessity of repeated screening for reappearance demonstrates the urgent need for novel biomarkers as alternatives to invasive standard procedures. Methods Proteomic technologies have emerged as powerful platforms for unbiased biomarker discovery and revolutionized the classical “target-driven” analysis of single marker candidates. Although proteome profiling is still far from demonstrating its full potential in clinical diagnosis, first studies clearly denote its significant potential. Conclusions This review provides a discussion of the challenges related to clinical proteomics using mass spectrometry, emphasizing bladder cancer biomarker discovery. An outline of the technological prerequisites for reliable proteome profiling, data mining and interpretation, as well as, reflections on future trends in the field are provided.     

The utility of adipose-derived stem cells and stromal vascular fraction for oncologic soft tissue reconstruction: Is it safe? A matter for debate

Autologous free-fat grafting (AFG) has emerged as an attractive proposition for soft-tissue reconstruction of various contour defects because it obviates more complex reconstructive options and reduces operative times and donor-site morbidity. Nonetheless, a common complication of this procedure is the resorption of the engrafted fat. Cell-assisted lipotransfer (CAL) is now a well-regarded technique where adipose-derived stem cell (ASC)-rich stromal vascular fraction is admixed with lipoaspirate, increasing the volumetric outcome of fat grafts in light of its potent angiogenic and adipogenic properties. Criticisms, however, remain regarding this modality especially for the treatment of post-oncologic defects. Laboratory data has attested to its propensity to perpetuate tumor cells as a result of its paracrine effects on the host microenvironment. This review article aims to present the underlying facts behind ASC therapy and provide meaningful discourse as to its utility in post-oncologic soft tissue reconstruction.     

Three-dimensional technology for documentation and record keeping for patients with facial clefts

The surface laser scanner has great potential as a method for documentation of cleft infant due to its accuracy, ease of use, and convenience. The image scan be stored in the computer for easy access. As purchasing costs decrease, its acquisition will be facilitated, resulting in an increase in its use.     

Update in the surgical principles and therapeutic outcomes of inguinal lymph node dissection for penile cancer

ObjectivesInguinal lymph node dissection (ILND) for the treatment of metastatic penile squamous cell carcinoma (SCC) has historically been associated with significant morbidity. This review addresses the surgical principles and techniques to decrease its perioperative morbidity, while optimizing its oncologic outcomes.Materials and methodsA review of the English scientific literature from 1966 to present was conducted using the PubMed search engine as well as of additional cited works not initially noted in the search using as keywords penile cancer, inguinal lymph node dissection, inguinal lymph node metastasis, morbidity, and complications.ResultsThe contemporary outcomes of ILND in the context of penile cancer have built on the significant contributions made by surgeons and scientists worldwide. In this review, we provide a comprehensive overview of the principles of ILND optimizing oncological outcomes, while minimizing its attributable morbidity. It is hoped this review will serve as a benchmark for clinicians to approach this often highly aggressive tumor phenotype.ConclusionsILND remains an important diagnostic and therapeutic procedure for patients with penile SCC, as contemporary ILND series have reported a decrease in its associated morbidity, with the potential for further treatment outcomes in years to come. ILND can in appropriately selected patients render them disease-free, thus justifying its associated morbidity.     

他达拉非治疗ED的进展

他达拉非是治疗ED的有效药物,大量的研究已经证实了其在ED患者中的临床疗效。相对于西地那非和伐地那非,他达拉非最为显著的特点是它的长效性,接受治疗的ED患者可以在长达36 h的时间窗内自然地达到有效的勃起。他达拉非对患有内科合并症的ED患者具有良好的疗效,它还能有效地改善患者的心理以及晨勃现象,使患者恢复生活的自信。他达拉非的长效性使患者性生活符合“自然、愉快、正常的性生活”这一治疗要求,从而成为越来越多患者的首选药物。     

DNA聚合酶θ与肿瘤关系的研究进展

DNA聚合酶θ（POLQ）是DNA聚合酶A家族成员之一,在肿瘤细胞和部分人体正常组织中高表达。POLQ通过参与DNA损伤耐受,在维持人体细胞染色体稳定从而避免疾病的发生过程中起着重要的作用。同时POLQ因其低保真度的特性导致组织细胞突变易感性,其表达异常增高及缺陷均可导致肿瘤等疾病的发生。笔者就目前关于POLQ参与损伤耐受的机制、低保真度导致突变易感性以及其在肿瘤发展中作用的研究进展作一综述。

     

The use of poly-L-lactic acid filler in facial aesthetics

The use of poly-L-lactic acid in facial aesthetic surgery has been utilized for over a decade. More recently approved by the Food and Drug Administration as a stimulatory filler for the correction of shallow to deep facial lines, it is gaining popularity in the United States. The advantages of its use include its stimulatory action on collagen formation, the longevity of its effect, and the low side effect profile. Despite these advantages, meticulous preparation practices and injection techniques are paramount to achieving a satisfactory outcome. We review poly-L-lactic acid as a filler, along with its associated side effects, indications of use, and techniques of injection.     

Preoperative iodine therapy in toxic goiter indications and limitations

The most favorable response to iodine therapy occurs in patients who have had no previous treatment. The quantity of iodine necessary to effect the maximum clinical improvement is determined very largely by the size of the thyroid and the degree of active hypertrophy and hyperplasia at the time the iodine therapy is instituted. The best clinical index of the degree of hypertrophy and hyperplasia of the thyroid is the consistency and vascularity of the gland. Patients who have had iodine previously show the greatest variations in their response to its use as a preparation for operation. Excess quantities of iodine over prolonged periods of time deprive the patients of the advantages of this otherwise valuable therapeutic aid in preparing them for the operative ordeal, unless there has been an interval of at least one month without iodine before its resumption as a preoperative preparation. Even though the response, in such cases, may not be so favorable as one might hope for, it appears to be a wise procedure to resume the iodine before performing thyroidectomy. Thrill and bruit are sufficient indication for its resumption. If the patient has had sufficient iodine to completely involute the thyroid, its further use is not likely to be beneficial. However, the drug should not be discontinued, in such cases, immediately preceding thyroidectomy. The presence of adenomas in the thyroid is not, per se, a contraindication to the use of iodine preliminary to thyroidectomy. Even though we do not understand and cannot satisfactorily explain all of the phenomena observed after the administration of iodine, its preoperative use in the surgery of toxic goiter is justifiable, provided we confine ourselves to its beneficial effects and do not transgress its limitations.     

Microcystic Adnexal Carcinoma: An Uncommon Tumor with Debatable Origin

BACKGROUND: Microcystic adnexal carcinoma is an uncommon skin appendage neoplasm exhibiting both pilar and sweat duct differentiation. This tumor remains a subject of controversy as to its differentiation profile, histogenesis, and classification which is reflected in the nomenclature used to designate the neoplasm in question. Beyond this controversy the tumor remains a diagnostic challenge because of its rarity, the histologic mimicry it may display, and its banal cytologic appearance; it also poses a therapeutic challenge, as it is characterized by slow but aggressive and destructive local growth extending beyond clinical margins together with a high tendency for perineural invasion and recurrence. OBJECTIVE: We report two cases of this unusual tumor illustrating some of its characteristics. Our review emphasizes the divergent opinions concerning its differentiation profile and its origin. An organoid nevus as the origin of microcystic adnexal carcinoma in one of our patients is discussed in this context.     

Mastitis: Comparative Etiology and Epidemiology

Mastitis is broadly defined as the inflammation of the mammary gland; however, the concept of mastitis is customized to address its social and clinical impact in the case of humans and the health, welfare, and economic consequences for other mammals. There are many microbial, host, and environmental factors that influence the development of mastitis. Some are common to all mammals as well as inherent to each species. Together these factors influence the most prevalent etiological agents for each species and might determine the possibility of interspecies transmission with its consequences to public health. The present review will summarize and compare reports on mastitis etiology and its epidemiology in humans and food animal species.