Primary bone tumor.

BACKGROUND: Whether patients who are diagnosed on the basis of a single microscopic focus of prostate carcinoma with a Gleason score </= 7 (micro PC) have potentially life-threatening disease if they are not treated is unknown. METHODS: Pathologic findings and prostate specific antigen (PSA) outcome after radical prostatectomy (RP) for men who were diagnosed with micro PC were determined. Of 917 patients who were managed with RP during 1989-1999 at the Brigham and Women's Hospital, 66 patients (7%) were diagnosed on the basis of micro PC. Pathologic stage, tumor grade, tumor volume, margin status, and PSA outcome were investigated and are reported. Estimates of PSA outcome were calculated using the actuarial method of Kaplan and Meier. Pairwise comparisons were made using the log rank test. RESULTS: The finding of micro PC at biopsy was associated with macroscopic disease (involving at least half of a single lobe) in 92% of the patients in this series. Although these men had favorable pathologic findings (94% had organ confined disease, 89% had negative tumor margins, and 79% had a prostatectomy Gleason score </= 6), approximately 10% of the patients failed biochemically within 5 years after RP. CONCLUSIONS: The finding of micro PC at biopsy should not be used as a surrogate for clinically insignificant disease.

Biopsy↗

PubMed2000

Cadaveric renal allograft at the time of implantation has the similar immunological features with the rejecting allograft.

BACKGROUND: Compared to living donations, cadaveric transplants have a poorer outcome, and the immunologic status of renal tissues at the time of transplantation might influence the final outcome of the renal allograft. PATIENTS AND METHODS: We used quantitative RT-PCR to evaluate the differential expression of cytokine genes from 37 implantation tissues [18 cadaveric tissues (CI), 19 specimens from living donors (LI)]. We compared them with 17 acutely rejecting allograft (AR). RESULTS: Acute rejection within 6 months after transplantation occurred 8 times in patients with cadaveric allograft, but the living-donor recipients experienced 4 episodes (P<0.05). Proinflammatory cytokines were co-expressed more frequently in CI than in LI. The levels of IFN-gamma, TNF-alpha and IL-10 mRNA were also higher in CI. We compared the profiles of several cytokine expressions of CI with those of AR. The messages for IL-6 were more abundant in the CI, IFN-gamma was more expressed in AR, and the other cytokine expression levels were similar in both types. However, when comparing LI and AR, all the cytokine messages except IL-6 were up-regulated in AR than in LI. In CI, the levels of cytokine gene expressions were similar despite various cold ischemic time except IL-10 that were elevated for those cases where the operation was done within 4 hr of nephrectomy. CONCLUSIONS: The numbers and levels of gene transcription of inflammatory cytokines were higher in the tissues from a cadaver, and were not different from those of AR. This immunologic hostility at the time of implantation would contribute to the poorer outcome of cadaveric allograft.

Biopsy↗