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At least 1,297 records · Page 72Linked to original sources
PubMed2003

The role of the complexed-to-total prostate-specific antigen ratio in predicting the final pathological stage of clinically localized prostate cancer.

OBJECTIVES: To examine the association between the complexed-to-total (C:T) prostate-specific antigen (PSA) ratio and prostate cancer pathological stage to assess whether the C:T PSA ratio may predict the final pathological stage in patients with clinically localized prostate cancer. PATIENTS AND METHODS: In a prospective study, 101 men with clinically localized prostate cancer underwent a staging pelvic lymphadenectomy and radical prostatectomy. Total PSA (tPSA) and PSA complexed to alpha(1)-antichymotrypsin (cPSA) were measured from preoperative plasma and were correlated with the clinical and pathological stage, and with surgical margin status. The pathological stage was determined as organ-confined (n=59) and extracapsular extension (n=42). RESULTS: The distributions of tPSA and cPSA were significantly different in men with locally confined and those with locally extended disease. This finding was not observed for the C:T PSA ratio. The area under the receiver operating characteristic (ROC) curve to predict the final pathological stage was significantly greater for tPSA (0.684) and cPSA (0.677) than for the C:T PSA ratio (p<0.032). TPSA (0.685) and cPSA (0.670) also showed areas under the ROC curve greater than that of the C:T PSA ratio (0.542) (p<0.05) for prediction of positive surgical margins. CONCLUSIONS: Our results show that the C:T PSA ratio does not improve the performance of total PSA for predicting the final pathological stage in patients with clinically localized prostate cancer.

Aged↗
PubMed2001

Substance abuse, pathological gambling, and impulsiveness.

This study evaluated behavioral and self-report indices of impulsiveness in pathological gambling substance abusers (n=27), non-pathological gambling substance abusers (n=63), and non-pathological gambling/non-substance abusing controls (n=21). The Bechara card task measured preferences for decks of cards that ranged in magnitude and probability of delayed and immediate rewards and punishers. The Stanford Time Perception Inventory (STPI) assessed orientation to the future, the Zuckerman Sensation Seeking Scale evaluated sensation seeking, and the Eysenck and Barratt scales measured impulsivity. A Principal Components analysis revealed that these personality measures comprised three distinct measures of impulsivity: impulse control, novelty seeking and time orientation. Linear contrast analyses revealed that substance abuse and pathological gambling resulted in additive effects on the impulse control and time orientation factors, but not on the novelty-seeking scale. Performance on the card task did not correlate with any of the three factors derived from the personality scale scores, but the presence of both substance abuse and pathological gambling had an additive effect on preferences for decks containing greater immediate gains but resulting in large punishers and overall net losses. These results provide further evidence of an association among substance abuse, pathological gambling, and impulsivity.

Adult↗
PubMed2000

Modeling Alzheimer's disease in transgenic mice: effect of age and of presenilin1 on amyloid biochemistry and pathology in APP/London mice.

In transgenic mice that overexpress mutant Amyloid Precursor Protein [V717I], or APP/London (APP/Lo) (1999a. Early phenotypic changes in transgenic mice that overexpress different mutants of Amyloid Precursor Protein in brain. J. Biol. Chem. 274, 6483-6492; 1999b. Premature death in transgenic mice that overexpress mutant Amyloid precursor protein is preceded by severe neurodegeneration and apoptosis. Neuroscience 91, 819-830) the AD related phenotype of plaque and vascular amyloid pathology is late (12-15 months). This typical and diagnostic pathology is thereby dissociated in time from early symptoms (3-9 months) that include disturbed behavior, neophobia, aggression, glutamate excitotoxicity, defective cognition and decreased LTP. The APP/Lo transgenic mice are therefore a very interesting model to study early as well as late pathology, including the effect of age. In ageing APP*Lo mice, brain soluble and especially "insoluble" amyloid peptides dramatically increased, while normalized levels of secreted APPsalpha and APPsbeta, as well as cell-bound beta-C-stubs, remained remarkably constant, indicating normal alpha- and beta-secretase processing of APP. In double transgenic mice, i.e. APP/LoxPS1, clinical mutant PS1[A246E] but not wild-type human PS1 increased Abeta, and plaques and vascular amyloid developed at age 6-9 months. The PS1 mutant caused increasing Abeta42 production, while ageing did not. Amyloid deposits are thus formed, not by overproduction of Abeta, but by lack of clearance and/or degradation in the brain of ageing APP/Lo transgenic mice. The clearance pathways of the cerebral amyloid peptides are therefore valuable targets for fundamental research and for therapeutic potential. Although hyper-phosphorylated protein tau was evident in swollen neurites around the amyloid plaques, neurofibrillary pathology is not observed and the "tangle" aspect of AD pathology is therefore still missing from all current transgenic "amyloid" models. Also the "ApoE4" risk for late onset AD remains a problem for modeling in transgenic mice. We have generated transgenic mice that overexpress human ApoE4 (2000. Expression of Human Apolipoprotein E4 in neurons causes hyperphosphorylation of Protein tau in the brains of transgenic mice. Am. J. Pathol. 156 (3) 951-964) or human protein tau (1999. Prominent axonopathy in the brain and spinal cord of transgenic mice overexpressing four-repeat human tau protein. Am. J. Pathol. 155, 2153-2165) in their neurons. Both develop a similar although not identical axonopathy, with progressive degeneration of nerves and with muscle wasting resulting in motoric problems. Remarkably, ApoE4 transgenic mice are, like the tau transgenic mice, characterized by progressive hyper-phosphorylation of protein tau also in motor neurons which explains the motoric defects. Further crossing with the APP/Lo transgenic mice is ongoing to yield "multiple" transgenic mouse strains to study new aspects of amyloid and tau pathology.

Aging↗
PubMed2005

Unargued issues on the pathological assessment of response in primary systemic therapy for breast cancer.

PURPOSE: The role of primary systemic therapy (PST) in the treatment of operable breast cancer is currently under intensive investigation in the hope of allowing greater conservation of the breast, and emerging evidence suggests that induction of a pathological complete response (pCR) is at least, to some extent, predictive of long-term clinical response. In this review, we highlight the issues of pathologic evaluation after PST. METHODS: We performed a computer-assisted MEDLINE search, and additional references were found in the bibliographies of these articles. RESULTS: So far, several grading classifications are used to assess pathologic responses after PST, and pCR rates vary from 1% to 54.7% according to the PST regimens employed. However, the term "pCR" has not been applied in a consistent, standardized manner, and the pCR rates appear to depend not only on the differences in the definition of pCR, but also on the extent of tissue sampling and the techniques used for pathologic examination. So far, only limited information is available about the reliability and validity of the definition of pathologic responses. CONCLUSION: Assessment of pCR needs to be standardized, and each grading system should be verified for reliability and validity. As a lack of standard for tumor processing and evaluation may result in considerable fluctuation of pCR rates between trials, we should take into account the differences in the definition of pathologic response when comparing the results of PST.

Breast Neoplasms↗
PubMed2001

Radiologic-pathologic correlation in focal cortical dysplasia and hemimegalencephaly in 18 children.

To describe the radiologic-pathologic correlation in children who underwent epilepsy surgery for medically intractable epilepsy with pathologically confirmed focal cortical dysplasia and hemimegalencephaly, we conducted a retrospective review on the magnetic resonance imaging and pathology of 18 children (10 boys and 8 girls). The preoperative MRIs were reviewed by one neuroradiologist who did not know the radiologic diagnosis and the pathology reports. MRI revealed focal cortical dysplasia (10), hemimegalencephaly (3), hamartomas (2), polymicrogyria (1), pial hemosiderosis (1), and no abnormality (1). Pathologic examination revealed focal cortical dysplasia (9), forme fruste of tuberous sclerosis (5), hemimegalencephaly (3), and focal cortical dysplasia with mesial temporal sclerosis (1). MRI was accurate in making the preoperative diagnosis in 16 out of 18 patients. On MRI, 12 patients had abnormal gyral formation and 12 had abnormal cortical thickness. Eleven patients manifested loss of gray-white differentiation, and 11 patients had abnormal signal on T(2)-weighted image. Pathologically, 15 patients had neuronal heterotopia, 12 had misalignment or disorientation of neurons, 11 had large neurons, and 10 had abnormal cortical lamination. The presence of ectopic and large neurons and abnormal cortical lamination may be responsible for the MRI characteristics.

Biopsy↗
PubMed1998

Patterns of drug-induced cardiovascular pathology in the beagle dog: relevance for humans.

In toxicity studies, the examination of tissue sections for pathological changes is the principle method for the identification of organ toxicity and characterisation of the hazard of novel drugs for humans. Study of the patterns of pathological alterations also represents an important means of developing an understanding of the mechanism of toxicity. However as pathological change frequently represents a final common expression of diverse processes, additional functional information is often required for a clear understanding of the mechanisms of toxicity. This is exemplified in the evaluation of the effects of drugs on the beagle dog cardiovascular system where an understanding of mechanisms is crucial in the assessment of human risk. Particular patterns of drug-induced structural change in the myocardium or blood vessels are frequently linked to specific mechanisms of toxicity. However, assessment based on the interpretation of patterns of cardiovascular pathology alone may be misleading. Quite different changes in cardiac and vascular function or direct cellular toxicity may also be manifest by pathological features in common. Therefore, a clear understanding of mechanism frequently requires additional in vivo or in vitro physiological, pharmacological, biochemical or other mechanistic information. The beagle dog remains an important model for the study of cardiovascular toxicity because in this species, haemodynamic changes and pathological alterations can be related in a way that provides the basis for the safe study in humans of novel drugs with cardiovascular activity.

Animals↗
PubMed2000

ERBB2 overexpression in breast carcinomas: no positive correlation with complete pathological response to preoperative high-dose anthracycline-based chemotherapy.

The predictive value of ERBB2 amplification/expression to doxorubicin use is controversial. Preoperative chemotherapy, followed by the pathological assessment of tumour response to treatment provide optimal conditions for the evaluation of the predictive value of biological parameters. We report here data on the predictive value of ERBB2 in a series of 54 cases of breast cancer treated by preoperative high-dose anthracycline-based chemotherapy. Our series consisted of 26 women presenting an inflammatory breast cancer (IBC) and of 28 women with poor prognosis primary cancer (PPPC). Patients received a total of four cycles with doxorubicin (75 mg/m(2) for IBC or 70 mg/m(2) for PPPC) and cyclophosphamide (6 g/m(2) for IBC or 1400 mg/m(2) for PPPC), every 21 days. ERBB2 expression was determined by immunohistochemistry (clone CB11) performed on a tumour biopsy taken before chemotherapy. All patients underwent surgery as a second step of treatment, and the tumour response was assessed on pathological specimens. A complete pathological response was observed in 24 of the 54 cases (44%) (95% confidence interval (CI), 31-57). Pathological complete response was positively correlated with high histological grade (P=0. 02) and with the absence of oestrogen (P=0.003) or progesterone (P=0. 02) receptor expression. ERBB2 overexpression was found in 18 of the 54 cases (33%). A complete pathological response was observed in 33% of these cases (6/18). This figure was not significantly different from the 50% rate of complete response observed for tumours with no detectable ERBB2 expression (18/36). In this small series, ERBB2 overexpression was not a significant predictive marker of the pathological response to high-dose doxorubicin-based chemotherapy.

Adult↗
PubMed1999

Attractors and pathological aspects in excitable cells.

In this article, physiological and pathological forms of excitability are studied in a two-dimensional electrical model of excitable cell endowed with a generic inward persistent conductance. Bifurcation analysis of the model is performed as a function of the maximal inward persistent conductance, the input current, or the voltage dependency of the activation function. Several discharge modes are exhibited, including: (1) a basic mode that corresponds to a resting potential and production of action potential; (2) bistability between resting potential and self-sustained spiking; (3) a pacemaker mode of discharge; and (4) bistability between resting potential and plateau potential. These behaviours can be compared to experimentally described physiological and pathological forms of excitability that depend upon inward persistent conductances. In the results obtained, attractors allow for a qualitative description of physiological and pathological states. However, it is not possible to obtain an unambiguous identification of particular 'physiological attractors' or 'pathological attractors'. In the perspective of the theory of dynamical systems, we suggest that pathological states can be modelled in two different ways, i.e. by bifurcation (as in the present model) or by perturbation. We also highlight some other theoretical concepts that may be relevant to a theoretical description of pathology.

Animals↗
PubMed1999

Dose-dependent effect of tamoxifen therapy on endometrial pathologies in postmenopausal breast cancer patients.

To assess whether a higher cumulative tamoxifen dose is associated with increased incidence of various types of endometrial pathologies, we compared cumulative dose of tamoxifen treatment as well as demographic characteristics, risk factors for endometrial cancer, transvaginal ultrasonographic endometrial thickness, and various treatments for the primary breast cancer between 159 postmenopausal breast cancer tamoxifen-treated patients without endometrial pathologies (group I) and 67 similar patients with endometrial pathologies (group II). A similar comparison was made between group I patients and similar patients with proliferative endometrium (group IIa), with endometrial hyperplasia (group IIb), with endometrial polyps (group IIc), and with endometrial cancer (group IId). Overall cumulative tamoxifen dose was significantly higher in group II as compared to group I (27.4+/-33.4 and 17.4+/-20.2, respectively; P<0.0252). Transvaginal ultrasonographic endometrial thickness was significantly higher in group II than in group I patients (16.3+/-11.3 mm and 12.1+/-6.3 mm, respectively; P<0.0147). The frequency of diabetes mellitus, of previous postmenopausal bleeding, and of previous exposure to hormone replacement therapy was significantly higher in group II than in group I patients (P<0.001, P<0.0001 and P<0.001, respectively). There were no significant differences in all parameters tested between group I, group IIa, group IIb, group IIc, and group IId. However, there was an obvious trend for higher cumulative tamoxifen dose in patients with benign endometrial pathologies as compared to those without endometrial pathologies or to those with endometrial cancer (Group I = 17.4+/-20.2 g, group IIa = 22.5+/-18.5 g, group IIb = 28.1+/-20.3 g, group IIc = 31.4+/-42.7 g and group IId = 10.4+/-12.6 g). Endometrial pathologies, except for endometrial cancer, are associated with a high cumulative dose of tamoxifen in postmenopausal breast cancer patients.

Aged↗
PubMed2003

Treatment issues pertaining to pathological gamblers with a comorbid disorder.

Evidence of an increased risk for various psychiatric disorders among pathological gamblers far exceeds our understanding of the impact that this psychiatric comorbidity has on the outcome of treatment for pathological gambling. One major source of the problem is that treatment efficacy and effectiveness studies for pathological gambling typically have not addressed comorbidity's impact on outcome. This paper discusses epidemiological, clinical, health service delivery, and research issues pertaining to the intersection of pathological gambling treatment outcome and comorbid psychiatric disorders. It is argued that this topic suffers from major knowledge gaps in terms of the nature of comorbidity of pathological gambling and other psychiatric disorders and the role of client characteristics on treatment outcome for pathological gambling. Research priorities are identified.

Combined Modality Therapy↗
PubMed2001

The additive effect of neurotransmitter genes in pathological gambling.

As access to gambling increases there is a corresponding increase in the frequency of addiction to gambling, known as pathological gambling. Studies have shown that a number of different neurotransmitters are affected in pathological gamblers and that genetic factors play a role. Polymorphisms at 31 different genes involved in dopamine, serotonin, norepinephrine, GABA and neurotransmitters were genotyped in 139 pathological gamblers and 139 age, race, and sex-matched controls. Multivariate regression analysis was used with the presence or absence of pathological gambling as the dependent variable, and the 31 coded genes as the independent variables. Fifteen genes were included in the regression equation. The most significant were the DRD2, DRD4, DAT1, TPH, ADRA2C, NMDA1, and PS1 genes. The r(2) or fraction of the variance was less than 0.02 for most genes. Dopamine, serotonin, and norepinephrine genes contributed approximately equally to the risk for pathological gambling. These results indicate that genes influencing a range of brain functions play an additive role as risk factors for pathological gambling. Multi-gene profiles in specific individuals may be of assistance in choosing the appropriate treatment.

Adult↗
PubMed2002

How treatments for pathological gambling can be informed by treatments for substance use disorders.

Substance use disorders and pathological gambling share similarities in terms of diagnostic criteria, epidemiology, and clinical course. However, relatively few studies have evaluated the efficacy of treatments for gambling disorders. As interest in pathological gambling grows, adaptation of effective treatments from the field of substance abuse may advance the study of treatment for pathological gambling. This article reviews the similarities and differences between pathological gambling and substance use disorders. It describes psychotherapeutic and pharmacological treatments for substance use disorders and their translation to pathological gambling. Future research should consider investigating the onset and course of pathological gambling within the context of other psychiatric disorders, biological abnormalities associated with gambling, and combined effects of psychotherapy and pharmacotherapy in the treatment of this disorder.

Animals↗
PubMed2002

Pathological differentiation of suspected cases of pentastomiasis in China.

We report nine cases of suspected pentastomiasis from China, and propose that diagnosis of this rare parasitic disease should be made aetio-pathologically, subaetio-pathologically, and presumptively. In none of our cases' lesions we could find either a whole or part of an embedded nymph; hence, no aetio-pathologic diagnosis of pentastomid infection was established. In three cases, subaetio-pathologic diagnoses of pentastomiasis were made upon the discovery of a peculiar set of relics from lesions, namely two pairs of circumoral hooks of pentastomid from lesions. In one of these three cases, an extra scissors-like image indicating a longitudinal section of a hook of the embedded pentastomid nymph, probably Linguatula serrata, was found. In the other six cases, none of the relics of the aetiological agents were found, and our diagnoses were made presumptively by a series of relatively specific pathologic features, i.e. pearly lesions over the peritoneal surface of the abdominal cavity under the serosa of the intestinal wall or under the capsules of liver and spleen. They tend to be uniquely protuberant, sometimes linked by a short thin stalk to the surface. The hyalinization and calcification of these centrally caseated granulomatous nodules tend to be concentric and targetoid in appearance. Tuberculosis, the most easily confused condition, was easily ruled out pathohistologically. We believe that there is a need for presumptive pathologic diagnosis of human pentastomid infection not only in China, but worldwide.

Aged↗
PubMed2001

Use of various combinations of free, complexed and total prostate-specific antigen levels as predictors of the pathologic stage of prostate cancer.

BACKGROUND: The efficacy of various combinations of total, free and complexed prostate-specific antigen (PSA) levels were assessed to predict the pathologic stage of prostate cancer. METHODS: Total PSA (tPSA), free PSA (fPSA) and complexed PSA (cPSA) levels were measured preoperatively in 52 patients with clinical localized prostate cancer who had undergone radical prostatectomy. Pathologic stages were classified as: organ-confined (n = 27); capsular penetration (n = 14); seminal vesicle involvement (n = 8); involvement of the surgical margins (n = 10); and lymph node involvement (n = 3). RESULTS: The fPSA/tPSA and fPSA/cPSA ratios significantly differed between patients with organ-confined disease and non-organ-confined disease (P = 0.035, P = 0.033, respectively) and between those with favorable versus unfavorable pathology (P = 0.001, P = 0.014, respectively), but tPSA, cPSA, fPSA and the cPSA/tPSA ratio did not. Using a fPSA/tPSA cutoff level of 11%, the prediction of organ-confined disease would increase from 52 to 67% and the rate of predicting favorable pathology would increase from 42 to 62%. A fPSA/cPSA cutoff level of 12% would increase the rate of predicting organ-confined disease to 79% and the rate of predicting favorable pathology would increase to 69%. The positive predictive value of the fPSA/cPSA ratio was higher than that of the fPSA/tPSA ratio, although the receiver operating characteristic curve of the fPSA/cPSA ratio was not different from that of the fPSA/tPSA ratio. CONCLUSION: Although there was no predictive difference found between fPSA/tPSA and fPSA/cPSA ratio, both ratios may help predict the pathologic stage of prostate cancer.

Aged↗
PubMed2001

Prediction of tumour volume and pathological stage in radical prostatectomy specimens is not improved by taking more prostate needle-biopsy cores.

OBJECTIVE: To determine what, if any, additional prognostic information is available from the prostate needle biopsy by comparing the number of biopsy cores obtained with the pathology assessed from the radical retropubic prostatectomy (RRP) specimen. PATIENTS AND METHODS: The results from 135 consecutive patients who underwent RRP at a single institution were reviewed. Needle biopsy information (number of cores, percentage of positive cores, laterality of the positive cores, and Gleason sum) were compared with the pathological data of the RRP specimen, including stage, Gleason sum and tumour volume. Patients were further stratified into those with six or fewer cores (96 men) or more than six cores (39 men). Clinical data, including biopsy information and pathological findings, were compared using univariate and multivariate models. RESULTS: Overall, univariate analysis showed that the total prostate-specific antigen (PSA) level, number of positive cores, bilateral positive cores and percentage of positive cores were directly correlated with tumour volume (P=0.01). Also, PSA and percentage of positive cores were directly correlated with extracapsular extension (P=0.008 and P=0.01, respectively). In the multivariate model, the most important independent predictors of RRP tumour volume and pathological stage were the preoperative PSA level and percentage of cancer in the biopsy (P<0.01). There was no significant relationship between the number of cores obtained and the predicted pathology of the RRP specimen. There were no differences in the number of positive cores, bilateral positive cores or percentage tumour in the cores between men with more or less than six biopsies. In men with more than six core biopsies, there was no significant increase in prognostic information for tumour volume and extracapsular extension, or a correlation between the Gleason sum on biopsy and the RRP specimen. Taking more than six biopsies did not result in a significantly greater detection of potentially indolent tumours (defined as a tumour volume of <0.5 mL). CONCLUSIONS: While taking more prostate needle biopsy cores seems to improve the detection of prostate cancer, there appears to be no major improvement in prognostic information over that gained from traditional sextant biopsies. Furthermore, the results suggest that the percentage of positive cores is the best predictor of both pathological stage and tumour volume, from among the information readily available from prostate needle biopsy. Given the variability in the number of cores obtained for diagnosis in clinical practice, these results add credence to the use of the percentage of positive cores in the biopsy set, with known predictors such as PSA and Gleason score, into future models that attempt to predict tumour biology.

Adult↗
PubMed1998

Prediction of pathological stage and clinical outcome in prostate cancer: an improved pre-operative model incorporating biopsy-determined intraductal carcinoma.

OBJECTIVE: To relate the predictive value of serum prostate specific antigen (PSA) levels, histological grade and intraductal carcinoma (IDC-P, a possible marker of poor prognosis) to pathological stage and subsequent clinical outcome, and thus derive an improved predictive model to aid the decision to initiate potentially curative therapy in localized prostate cancer. MATERIALS AND METHODS: Fifty-nine radical prostatectomy specimens were histologically graded, allocated a pathological stage and the tumour volume determined by image analysis. Pre-operative (needle biopsy) tumour grade, the presence or absence of IDC-P, and serum PSA levels were correlated with the pathological stage. This was used to define the sequence and values that would be incorporated into a predictive model for pathological stage and clinical outcome. RESULTS: There were close correlations between cancer volume and tumour grade (P = 0.004) and between cancer volume and serum PSA level (P = 0.003). However, in tumours with IDC-P, serum PSA level did not correlate with tumour volume of IDC-P (P > 0.9). IDC-P was an independent variable that significantly improved the prediction of pathological stage and tumour volume, and furthermore, was closely related to (r = 0.53, P = 0.001) and accurately predicted treatment failure. CONCLUSION: The model which best predicted pathological stage and clinical outcome involved first identifying those cancers with IDC-P as having the poorest outcome. Cancers without IDC-P were then separated into low- and high-risk groups on the basis of serum PSA levels below and above 10 ng/mL, and those in the high-risk group further stratified using Gleason grading. Furthermore, the use of a sequential consideration of pre-operative variables including IDC-P allowed cases to be grouped which, after radical surgery, closely correlated with clinical outcome.

Biopsy, Needle↗
PubMed2003

Colour Doppler ultrasonography for detecting perineural invasion (PNI) and the value of PNI in predicting final pathological stage: a prospective study of men with clinically localized prostate cancer.

OBJECTIVES: To assess the ability of colour Doppler transrectal ultrasonography (CD-TRUS) to improve the accuracy of detecting perineural invasion (PNI, reported to be an independent predictor of extraprostatic extension) and in predicting the pathological stage of the cancer, comparing it with the results of grey-scale TRUS-guided biopsies. PATIENTS AND METHODS: This prospective study included 47 men with clinically localized disease; all underwent 10-core TRUS-guided biopsy and two bilateral CD-TRUS-guided biopsies, targeted on the area adjacent to the neurovascular bundle. The rates and accuracy of PNI detection on 10-core and CD-TRUS-targeted biopsies were compared with the pathological outcome. Various patient, clinical and pathological factors were compared, and multivariate analysis used to assess the value of the technique in predicting PNI and pathological outcome. RESULTS: CD-TRUS-guided biopsies predicted the presence of PNI in the radical prostatectomy specimens with a sensitivity of 89%, and specificity and positive predictive values of 100%. Seven of 24 (29%) patients with PNI on the needle biopsies had pT3 disease. Conversely, the absence of PNI on guided biopsy accurately predicted pathologically localized disease in 96% (negative predictive value) of patients. However, the results of multivariate analysis showed that serum prostate-specific antigen was the only strong predictor of pT3. CONCLUSION: CD-TRUS is a useful tool for detecting PNI and predicting pathological localized cancer; it can be used in candidates for nerve-sparing radical prostatectomy.

Biopsy, Needle↗
PubMedDate not supplied

The relative importance of acromial morphology and age with respect to rotator cuff pathology.

The purpose of this study was to examine the relationship between patient age, acromial morphology, and rotator cuff pathology. Data on 523 patients who had arthroscopic and/or open shoulder surgery were reviewed. Acromial morphology was classified by the system of Bigliani. All patients were categorized by postoperative diagnosis as having tendinitis of the rotator cuff, partial rotator cuff tear, complete rotator cuff tear, and non-rotator cuff-related pathology. Univariate analysis results for acromial morphology (P <.001), age (P <.001), and gender (P =.019) showed a significant association with rotator cuff pathology. Fifty percent of patients with rotator cuff tendinitis had type I acromions, and 58% of patients with full-thickness rotator cuff tears had type III acromions. Stratified univariate analysis revealed no significant association between acromial morphology and rotator cuff pathology in patients who were over 50 years old. Patients with full-thickness rotator cuff tears were significantly older than those with partial-thickness tears or tendinitis. A larger proportion of male patients than female patients had full-thickness rotator cuff tears. Multivariable logistic regression analysis identified acromial morphology, age, and gender as independent multivariate predictors of rotator cuff pathology. Age, acromial morphology, and gender all have an independent association with rotator cuff pathology.

Acromion↗