Robotic surgery does not affect upstaging of T1 renal masses

Partial nephrectomy is the mainstay of treatment for localized kidney cancer. A proportion of patients are upstaged post-operatively to locally advanced di     

Management of ectopic ureterocele

We present our experience with 32 cases of ureterocele in children treated between 1972-1984. Five children with ureterocele in a single system underwent ureterocelectomy and ureteral reimplantation. Ten cases were managed by ureteropyeloanastomosis with ureterocelectomy and reimplantation with good results. Nine heminephrectomies and eight nephrectomies were done. The most common complication was ureterovesical stenosis in a "double barrel" reimplant. We were able to preserve renal parenchyma drained by a ureterocele in 15 cases.     

Radiologically guided percutaneous fine-needle aspiration biopsy of pelvic and retroperitoneal masses: a retrospective study of 68 cases

Fine-needle aspiration (FNA) of the pelvis and retroperitoneum (excluding the pancreas, kidney, and adrenal masses) has not achieved its full potential as a diagnostic modality. We reviewed 68 percutaneous, radiologically guided FNAs from these locations to assess the clinical utility and complication rate of this procedure. Satisfactory material was obtained in 66 cases (97.1%), of which 37 were deemed positive (55%), 3 suspicious (4%), 4 atypical (6%), and 22 negative (32%) for malignancy; two cases (3%) were unsatisfactory. Compared to biopsy (36 patients) and clinical information, the sensitivity and specificity of FNA for malignancy were 90.2% and 100%, respectively, yielding a positive predictive value of 100% and a negative predictive value of 86.6%. The four false-negative cases (5.9%) were due to sampling error. One patient had a minor complication (hematoma) from the procedure. We conclude that FNA is the procedure of choice for detecting most malignancies in these two locations.     

Detection of hepatitis C virus RNA in serum and peripheral blood mononuclear cells in patients with chronic hepatitis C treated with interferon alpha

PCR was used to detect hepatitis C virus (HCV) RNA in serum and peripheral blood mononuclear cells (PBMCs) for evaluation of a six-month course of Interferon therapy in 18 patients with histologically confirmed chronic hepatitis C. At follow-up six months after the end of therapy positive-stranded (genomic) and negative-stranded (anti-genomic, presumptive replicative intermediate) HCV RNA could be detected in PBMCs of all ten patients who either did not respond to therapy or suffered a relapse; genomic strand RNA was detected in five patients who responded but then relapsed. The study confirms that interferon therapy leads to inhibition of HCV replication but not eradication of the virus. Persistence of the virus at extrahepatic sites may explain its reactivation after cessation of interferon therapy.     

Association of jaagsiekte sheep retrovirus with pulmonary carcinoma in Sardinian moufflon (Ovis musimon)

Bronchiolo-alveolar carcinoma has been described in man and in several animal species, including cattle, dogs, opossums, goats and sheep. In sheep, a bronchiolo-alveolar carcinoma, known as ovine pulmonary carcinoma (OPC), is caused by jaagsiekte sheep retrovirus (JSRV), an exogenous type D retrovirus. In the mid-1980s, a severe outbreak of a disease resembling OPC was described in captive Sardinian moufflon (Ovis musimon). In the present study, the use of polymerase chain reaction (PCR) amplification of nucleic acids extracted from archival material established that JSRV was associated with OPC in affected moufflon. JSRV was detected in the lungs and mediastinal lymph nodes. Immunohistochemical and in-situ PCR demonstrated that in the lungs, JSRV proviral DNA was localized in transformed and untransformed type II pneumocytes and in the alveolar macrophages. In the mediastinal lymph nodes, JSRV DNA was mainly located in the cortical follicles and paracortex. These data suggest that JSRV is the cause of OPC in Sardinian moufflon, as it is in Sardinian sheep.