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Robotic or open radical prostatectomy after previous open surgery in the pelvic region
Mahmoud Mustafa,Curtis A. Pettaway,John W. Davis,Louis Pisters 대한비뇨의학회 2015 Investigative and Clinical Urology Vol.56 No.2
Purpose: We sought to evaluate the feasibility and safety of open or robotic radical prostatectomy (RP) after rectum, sigmoid, orcolon surgery. Materials and Methods: Sixty-four patients with a median age of 65 years (range, 46–73 years) who underwent RP after previouspelvic surgery were included. Twenty-four patients (38%) underwent robotic RP and 40 patients (62%) underwent open RP. Bilaterallymph node dissection and nerve preservation were performed in 50 patients (78%) and 35 patients (55%), respectively. Variablesevaluated included demographic characteristics, perioperative complications, and functional and oncological outcomes. Themedian hospitalization and follow-up periods were 2 days (range, 1–12 days) and 21 months (range, 1–108 months), respectively. Results: No conversions from robotic to open surgery were performed and there were no intraoperative complications. Surgicalmargins were positive in 13 patients (20%), seminal vesicle involvement was detected in 6 patients (9%), and lymph node involvementwas found in 2 patients (3%). Postoperative complications included lymphocele in 1 patient, urethral stricture in 1 patient,and bowel obstruction and persistent bladder leakage in 2 patients. Eighty-eight percent of the patients were continent at 7months and 80% of patients were able to achieve erection with or without medical aid. Conclusions: Open or robotic RP can be done safely and effectively in patients who have previously undergone pelvic surgery. Although prior pelvic surgery of the large intestine was associated with increased morbidity, it should not be considered a contraindicationfor robotic or open RP.
Z-FA-FMK as a novel potent inhibitor of reovirus pathogenesis and oncolysis in vivo.
Kim, Manbok,Hansen, Kristina K,Davis, Lesley,van Marle, Guido,Gill, Michael John,Fox, Julie D,Hollenberg, Morley D,Rancourt, Derrick E,Lee, Patrick W K,Yun, Chae-Ok,Johnston, Randal N International Medical Press 2010 ANTIVIRAL THERAPY Vol.15 No.6
<P>BACKGROUND: Respiratory enteric orphan (reo)virus is a promising oncolytic viral candidate. Reoviral anticancer therapy is currently undergoing multiple clinical trials targeting various human cancers; however, there is no effective reoviral inhibitor that can be used to block unwanted reovirus replication during reoviral anticancer therapy. METHODS: Studies were conducted with transformed or normal cells in vitro and in vivo to characterize viral replication in the presence or absence of chemical inhibitors. RESULTS: We have identified a protease inhibitor that is very effective in the inhibition of viral replication. The dipeptide benzyloxycarbonyl-Phe-Ala-fluoromethyl ketone (Z-FA-FMK) effectively inhibited reovirus replication in a susceptible host and cured cells of a persistent infection with reovirus in vitro. Electron microscopic analysis of Z-FA-FMK-treated cells revealed that internalized reovirus virions, retained in a perinuclear localization, no longer undergo further processing into viral factories following Z-FA-FMK treatment, suggesting that Z-FA-FMK specifically affects a reovirus virion maturation step. Animal studies showed that reovirus infection of Ras oncogenic tumours and host heart tissues is completely blocked by Z-FA-FMK treatment in severe combined immunodeficiency mice. CONCLUSIONS: Z-FA-FMK is a very effective viral inhibitor that can prevent reovirus replication in vitro and reovirus-mediated myocarditis, as well as reovirus-mediated oncolysis, in vivo. A potential application of this drug for inhibition of reovirus infection is suggested.</P>
Roger Li,Firas G. Petros,Janet B. Kukreja,Stephen B. Williams,John W. Davis 대한비뇨의학회 2016 Investigative and Clinical Urology Vol.57 No.-
The practice of extended pelvic lymph node dissection (ePLND) remains one of the most controversial topics in the management of clinically localized prostate cancer. Although most urologists agree on its benefit for staging and prognostication, the role of the ePLND in cancer control continues to be debated. The increased perioperative morbidity makes it unpalatable, especially in patients with low likelihood of lymph node disease. With the advent of robotic assisted laparoscopic prostatectomy, many surgeons were slow to adopt ePLND in the robotic setting. In this study, we summarize the evidence for the prognostic and therapeutic roles of ePLND, review the clinical tools used for lymph node metastasis prediction and survey the numerous experiences of ePLND compiled by robotic urologic surgeons over the years.