PD-L1 expression and infiltration by CD4+ and FoxP3+ T cells are increased in Xp11 translocation renal cell carcinoma and indicate poor prognosis.

AIMS: Interaction between programmed death-1 ligand (PD-L1) and its receptor programmed death 1 (PD-1) on T cells inactivates antitumour immune responses. PD-L1 expression has been associated with poor prognosis in renal cell carcinoma (RCC) and predicts adverse outcome. This study was designed to evaluate the impact of PD-L1 expression and the immune microenvironment on the clinical outcome in Xp11 translocation renal cell carcinoma (TRCC) and, therefore, their potential relevance as prognostic biomarkers. METHODS AND RESULTS: The present retrospective analysis investigated expression of PD-L1 and immune cells CD8, CD4, CD3, forkhead box protein 3 (FoxP3) and PD-1 in TRCC compared to other types of RCC. FFPE specimens were collected between 2011 and 2017 from 311 patients who underwent nephrectomy at our institution for RCC. Specimens were immunostained for PD-L1, CD8, CD4, CD3, FoxP3 and PD-1, and an outcome analysis was conducted. PD-L1 expression rate was highest in TRCC (68%, 16 of 25), followed by mucinous tubular and spindle cell RCC and collecting duct carcinoma (33%, one of three), papillary RCC (27%, seven of 26), clear cell RCC (16%, 29 of 233), chromophobe RCC (11%, two of 18) and multilocular cystic RCC (0%, none of three). In TRCC, PD-L1 expression was associated with poor recurrence-free survival (RFS) (P = 0.041). The CD4high and FoxP3high groups showed a significantly shorter RFS (P = 0.05 and P = 0.031, respectively) compared to CD4low and FOXPlow groups. CONCLUSION: PD-L1 expression was higher in TRCC than in other types of RCC. High PD-L1 tumour cell expression and tumour infiltration by CD4+ and FoxP3+ immune cells were associated with poor RFS in TRCC.

Extramacular drainage of subretinal fluid during vitrectomy for macular hole retinal detachment in high myopia.

PURPOSE: To compare surgical outcomes between subretinal fluid drainage through the macular hole (MH) and through sites other than the MH during vitrectomy for MH retinal detachment in highly myopic eyes. METHODS: Retrospective analysis was performed on the medical records of 41 patients who underwent vitrectomy for MH retinal detachment in highly myopic eyes. Group M included eyes in which subretinal fluid was drained through MH. Group E included eyes in which subretinal fluid was drained through an extramacular break or retinotomy. Pre- and postoperative visual acuity, reattachment rate, and MH closure rate were investigated. RESULTS: Primary retinal reattachment was achieved in 13 of 21 eyes (62%) in Group M and in 19 of 20 eyes (95%) in Group E (P = 0.020). The MH was closed more frequently in Group E (15 eyes) than in Group M (7 eyes; P = 0.012). Ambulatory vision of 20/400 or better was achieved in 16 eyes in Group E and in 10 eyes in Group M (P = 0.033). CONCLUSION: Extramacular drainage of subretinal fluid resulted in better outcomes than the conventional procedure of drainage through the MH.

Discrete Sibson interpolation.

Natural-neighbor interpolation methods, such as Sibson's method, are well-known schemes for multivariate data fitting and reconstruction. Despite its many desirable properties, Sibson's method is computationally expensive and difficult to implement, especially when applied to higher-dimensional data. The main reason for both problems is the method's implementation based on a Voronoi diagram of all data points. We describe a discrete approach to evaluating Sibson's interpolant on a regular grid, based solely on finding nearest neighbors and rendering and blending d-dimensional spheres. Our approach does not require us to construct an explicit Voronoi diagram, is easily implemented using commodity three-dimensional graphics hardware, leads to a significant speed increase compared to traditional approaches, and generalizes easily to higher dimensions. For large scattered data sets, we achieve two-dimensional (2D) interpolation at interactive rates and 3D interpolation (3D) with computation times of a few seconds.

Fístula labiríntica na otite média crônica colesteatomatosa / Labyrinthine fístulae in chronic otitis media with cholesteatoma

A otite média crônica colesteatomatosa (OMCC) pode cursar com complicaçöes intra e/ou extracranianas, entre elas a fístula labiríntica. Neste trabalho, mostramos a incidência e a evoluçäo dos casos de fístula labiríntica decorrentes da OMCC em nosso serviço. FORMA DE ESTUDO: Clínico prospectivo. MATERIAL E MÉTODO: Dez pacientes com fístula labiríntica, do total de 82 pacientes com OMCC, foram submetidos à cirurgia no período de janeiro de 2001 a abril de 2002 e avaliados através de exame otorrinolaringológico completo, tomografia computadorizada e audiometria pré e pós-operatória. RESULTADOS: Perda auditiva, otorréia, zumbido e vertigem estavam presentes em 100 por cento, 90 por cento, 80 por cento e 40 por cento dos casos respectivamente na avaliaçäo clínica pré-operatória. Em um paciente a fístula aparecia apenas nos cortes tomográficos coronais e tivemos um caso de falso-negativo. Dos pacientes com zumbido, 66 por cento apresentaram melhora deste quadro no pós-operatório. DISCUSSÄO: Nos casos de fístula sem invasäo do espaço perilinfático (até grau II), notamos uma tendência de melhora dos quadros clínico e audiométrico após a cirurgia. Nas fístulas extensas, por outro lado, o resultado audiométrico se manteve inalterado. CONCLUSÄO: A tomografia continua sendo o exame de escolha para os quadros de OMCC com sensibilidade de 90 por cento para fístulas labirínticas. Nas fístulas grau II a cirurgia apresenta bom resultado funcional