In vivo percutaneous microwave ablation in kidneys: Correlation with ex vivo data and ablation work

Purpose

To compare diameters of in vivo microwave ablation (MWA) performed in swine kidneys with ex vivo diameters, and to correlate with ablation work (AW), a new metric reflecting total energy delivered.

Treatment of haemophilia A in Tunisia: efficacy and inhibitor study

Cryoprecipitate is the principal type of factor VIII (FVIII) concentrate used for treating haemophilia A in Tunisia. Allergic reactions, viral transmission, and inhibitor formation remain the most serious complications of FVIII therapy. The aims of the study presented here were to evaluate the efficacy of FVIII therapy, to investigate the inhibitor prevalence, and the factors which may affect inhibitor formation in our haemophilia A patients. Plasma samples were screened for FVIII inhibitors by the Bethesda method. 30 minutes FVIII recovery was also determined for each patient. In this prospective study, 18 previously treated haemophilia A patients, four with severe (FVIII concentration <2%) and 14 with moderate haemophilia, were closely followed up during administration of 223 FVIII concentrates (cryoprecipitate and/or fresh frozen plasma). The median age of the patients involved in the study was 13.5 years (range 5 to 53). Clinical response to FVIII was consistently good to excellent. In the majority of cases, actual and predicted FVIII recovery correlated' well. Adverse reactions were not observed. Five patients, aged less than 18 years and minimally treated (>36 FVIII exposure days), were found to have low titre FVIII inhibitors (<10 Bethesda units) at the end of the study. Inhibitor activity was detected in one patient with severe and in four patients with moderate haemophilia. In conclusion, FVIII therapy was effective, well tolerated, and low titre inhibitors identified did not preclude continued on demand FVIII therapy. Our study has also demonstrated that patients' age and treatment regimen do not affect inhibitor formation. Further studies are necessary to confirm these findings.     

Islet Isolation From Human Pancreas With Extended Cold Ischemia Time

The general consensus among transplant centers is that a cold ischemia time (CIT) beyond 8 hours results in reduced yields and quality of human islets. We sought to optimize the isolation process and enzymes for pancreata with extended CIT. We processed 16 extended CIT pancreata (13.2 ± 0.7 hours). Donors averaged 50.8 ± 2.6 (standard error of the mean) years old with a body mass index of 28.6 ± 1.5. Glands were shipped in cold organ preservation solution without oxygenated perfluorocarbon. Isolations were performed under a protocol optimized for digestion with the new cGMP collagenase from Roche. Purification used continuous Euroficoll/University of Wisconsin gradients. Islets were cultured in two types of Prodo cGMP islet culture media and/or in Miami 1A media. Glucose-stimulated insulin secretion assays were performed after 8 to 16 days of culture. Prepurification yield averaged 415 ± 41 KIEQ postpurification, 359 ± 29 KIEQ (purification loss 13.5%); and postculture 317 ± 27 KIEQ (culture loss 11.7%). Our process liberated an average of 4278 IEQ/g of pancreas (97 ± 5 g). Most islets were recovered in the purest fraction (purity 79.7% ± 1.9%). Culture loss in our enhanced culture media was 11.7%. After 2 to 3 days in culture, viability was 92% ± 1%. Islets exhibited compactness and dithizone staining. Glucose-stimulated insulin secretion assays performed after 3 to 23 days in our PIM(R) media resulted in a stimulation index of 6.8 ± 1.7 (G50 to G350). We concluded that our human islet isolation process permitted the recovery of large numbers of high-quality human islets from extended CIT pancreata and that our cGMP islet culture media was superior to the current standard CMRL-based media.     

Mesonephric remnant hyperplasia: an unusual benign mimicker of prostate cancer

Mesonephric remnant (MR) hyperplasia in the prostate is a rarely reported condition that is usually distinguished from prostatic adenocarcinoma by the absence of cytologic atypia as well as the absence of prostatic markers (prostate-specific antigen and prostatic acid phosphatase) expression. We report a case of prostatic MR hyperplasia with architectural and cytologic atypia in a 56-year-old man. The microscopic appearance strongly suggested malignancy, but immunohistochemistry allowed the diagnosis to be corrected. The presence of MRs in prostate tissues may be more common than appreciated or reported. Once the possibility is considered, the diagnosis is easily confirmed using immunochemistry.