Efficacy of Laparoscopic Partial Cystectomy with a Transurethral Resectoscope in Patients with Bladder Endometriosis: See-Through Technique.

PURPOSE: Bladder endometriosis (BE) is rare. Deep invasive endometriosis is difficult to control with medications alone; such cases need surgical treatment. Good results of laparoscopic partial cystectomy with a transurethral (TU) resectoscope by the see-through technique for patients with BE are reported. MATERIALS AND METHODS: From January 2008 to February 2016, 12 cases of symptomatic BE were seen in our institution. The chief complaints of 9 cases were micturition pain during menstruation. Preoperative cystoscopy showed a bladder mass with blueberry spots. All surgeries were performed under general anesthesia. Laparoscopic surgery was performed with a fan of 4 ports in the lower abdomen. First, the uterus and bilateral ovaries were checked. Then, the TU resectoscope was inserted. When the affected bladder wall was identified, it was again observed with the laparoscopic light source off, which made it possible to observe the twilight leaking inside from the bladder. This twilight came from the light source of the TU resectoscope via the unaffected bladder wall. In contrast, the thickness of the affected wall prevented the light from inside the bladder from passing through it. We call this the "see-through technique." The tumor was then safely dissected with both laparoscopic and TU resection procedures. Finally, the bladder was sutured by laparoscopic procedures using absorbable sterile surgical suture. The urethral catheter was removed after cystography 7 days after the operation. RESULTS: The surgical margins of all cases were negative. There has been no recurrence of BE so far in any patients. There were no major adverse events perioperatively and the urinary symptoms improved in all cases. CONCLUSIONS: By laparoscopic partial cystectomy assisted with a TU resectoscope and see-through technique, the edge of BE could be easily and precisely identified. These procedures are effective and safe for BE surgical treatment.

snRNAs from Radical Prostatectomy Specimens Have the Potential to Serve as Prognostic Factors for Clinical Recurrence after Biochemical Recurrence in Patients with High-Risk Prostate Cancer.

In patients with high-risk prostate cancer (HRPC) after radical prostatectomy (RP), biochemical recurrence (BCR) increases the risk of distant metastasis. Accordingly, additional prognostic biomarkers are required to identify the subpopulation of patients with HRPC who develop clinical recurrence (CR) after BCR. The objective of this study was to identify biomarkers in formalin-fixed paraffin-embedded (FFPE) RP samples that are prognostic for CR in patients with HRPC who experience BCR after RP (post-RP BCR). First, we performed a preliminary RNA sequencing analysis to comprehensively profile RNA expression in FFPE RP samples obtained from patients with HRPC who developed CR after post-RP BCR and found that many snRNAs were very abundant in preserved FFPE samples. Subsequently, we used quantitative polymerase chain reaction (qPCR) to compare the expression levels of highly abundant snRNAs in FFPE RP samples from patients with HRPC with and without CR after post-RP BCR (21 CR patients and 46 non-CR patients who had more than 5 years of follow-up after BCR). The qPCR analysis revealed that the expression levels of snRNA RNU1-1/1-2 and RNU4-1 were significantly higher in patients with CR than in patients without CR. These snRNAs were significantly correlated with clinical recurrence-free survival (RFS) in patients with HRPC who experienced post-RP BCR. Furthermore, snRNA RNU1-1/1-2 could serve as an independent prognostic factor for clinical RFS in post-RP BCR of HRPC cases where known prognostic factors (e.g., Gleason score) cannot distinguish between CR and non-CR patients. Our findings provide new insights into the involvement of snRNAs in prostate cancer progression.

A case of complete resection of prostate stromal sarcoma after neoadjuvant chemotherapy.

Introduction: Prostatic stromal sarcoma is an extremely rare malignancy of the prostate with a poor prognosis. Case presentation: A 65-year-old man presented with dyschezia, and computed tomography showed a large prostate mass. The diagnosis was prostate stromal sarcoma by transrectal needle biopsy. Magnetic resonance imaging suggested rectal infiltration. The patient underwent 4 courses of neoadjuvant chemotherapy with gemcitabine and docetaxel hydrate followed by total pelvic exenteration. Conclusion: No recurrence has occurred at 5 years after the surgery. This is the first report of complete resection in prostate stromal sarcoma after neoadjuvant chemotherapy with gemcitabine and docetaxel hydrate.

Synthesis, optical and electrochemical properties of 4,4'-bibenzo[c]thiophene derivatives.

We designed and synthesized unsubstituted 4,4'-bibenzo[c]thiophene 4,4'-BBT and its silyl-substituted derivatives 1,1'-Si-4,4'-BBT and 1,1',3,3'-Si-4,4'-BBT with one or two tert-butyldimethylsilyl groups on each thiophene ring, as new π-building blocks in emitters, photosensitizers and semiconductors for organic optoelectronic devices. The characterization of 4,4'-BBT, 1,1'-Si-4,4'-BBT and 1,1',3,3'-Si-4,4'-BBT was successfully determined by FTIR, 1H and 13C NMR measurements, high-resolution mass spectrometry (HRMS) analysis, photoabsorption and fluorescence spectroscopy, cyclic voltammetry (CV) and density functional theory (DFT) calculations. Moreover, a single-crystal X-ray structural analysis was successfully made for 1,1'-Si-4,4'-BBT and 1,1',3,3'-Si-4,4'-BBT. The photoabsorption and fluorescence maxima (λ abs max and λ fl max) of the three 4,4'-bibenzo[c]thiophene derivatives in toluene exhibit bathochromic shifts in the order of 4,4'-BBT (359 nm and 410 nm) < 1,1'-Si-4,4'-BBT (366 nm and 420 nm) < 1,1',3,3'-Si-4,4'-BBT (371 nm and 451 nm). The HOMO and LUMO energy levels rise in the order of 4,4'-BBT (-5.55 eV and -2.39 eV) < 1,1'-Si-4,4'-BBT (-5.45 eV and -2.34 eV) < 1,1',3,3'-Si-4,4'-BBT (-5.34 eV and -2.30 eV), but the rise of the HOMO energy level is larger than that of the LUMO energy level, resulting in the bathochromic shift of the photoabsorption band from 4,4'-BBT to 1,1',3,3'-Si-4,4'-BBT. The fluorescence quantum yields (Φ fl) of 4,4'-BBT, 1,1'-Si-4,4'-BBT and 1,1',3,3'-Si-4,4'-BBT in toluene are 0.41, 0.41 and 0.36, respectively. It is worth mentioning that in the solid state 1,1'-Si-4,4'-BBT and 1,1',3,3'-Si-4,4'-BBT show relatively high Φ fl-solid values of 0.22 and 0.25, respectively, whereas 4,4'-BBT exhibits poor solid-state fluorescence properties (Φ fl-solid < 0.02). This work provides an efficient synthetic method for the 4,4'-bibenzo[c]thiophene derivatives and their photophysical properties in the solution and solid state, electrochemical properties and X-ray crystal structures.

Initial detection of circulating tumor cells from metastatic prostate cancer patients with a novel small device.

BACKGROUND: Various devices for isolating and detecting circulating tumor cells (CTCs) have been developed, whereas the CellSearch® system has been clinically used in numerous prostate CTC studies. CTCs might become more useful surrogate markers of prostate cancer, and they should be measured in all settings, but a smaller, low-cost CTC capture system is required. METHODS: An inexpensive and highly sensitive microfluidic CTC-capture polymeric chip, developed by the Toyama Industrial Technology Center, as described in the following text, was used to assess the number of CTCs from patients with metastatic prostate cancer. After verifying that cultured human prostate cancer cells (PC3 and LNCaP) could be captured with the chip coated with anti-epithelial cell adhesion molecule (CD326) antibody, whole blood samples of 14 patients with prostate cancer were screened. RESULTS: The average capture efficacy of PC3 cells was 94.60% in phosphate-buffered saline (PBS) and 83.82% in whole blood. The average capture efficacy of LNCaP cells was 82.73% in PBS and 75.78% in whole blood. CTCs were detected by the chip device in all 14 patients with metastatic prostate cancer using 2-mL blood samples. Although fewer CTCs were detected in patients with oligometastases, all patients with multiple distant metastases had CTCs. The average CTC count was 48 cells/mL (range 1-81 cells/mL). CONCLUSION: This CTC-chip will be able to capture CTCs and be useful to check CTCs as a surrogate marker in prostate cancer with smaller samples and lower cost in any small institution.

A Case of Primary Malignant Lymphoma of the Prostate Gland Presenting as Right Lower Back Pain and Dysuria.

A 73-year-old man presented with right lower back pain and dysuria. Right hydronephrosis and a large pelvic large mass were seen on computed tomography (CT). Although his prostate-specific antigen (PSA) was 0.5 ng/mL, an irregularly enlarged, stony, hard prostate was palpable on digital rectal examination. A prostate tumor was suspected, and a transrectal prostate biopsy and right transurethral ureteral stent placement were performed. Histological and immunohistochemical studies revealed diffuse large B-cell lymphoma. Positron emission tomography-computed tomography showed abnormal uptake in the stomach, cecum, right obturator lymph nodes, para-aortic lymph nodes, and dorsal left kidney. No abnormal findings were seen on bone marrow histology. Clinical stage IVA was confirmed according to Ann Arbor criteria. The patient achieved a complete response after 8 cycles of combination chemotherapy with rituximab, pirarubicin, cyclophosphamide, vincristine, and prednisolone.