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BackgroundGiven the uncertainties inherent in clinical measures of prostate cancer aggressiveness, clinically validated tissue biomarkers are needed. We tested whether Alpha-2-Glycoprotein 1, Zinc-Binding (AZGP1) protein levels, measured by immunohistochemistry, and RNA expression, by RNA in situ hybridization (RISH), predict recurrence after radical prostatectomy independent of clinical and pathological parameters.MethodsAZGP1 IHC and RISH were performed on a large multi-institutional tissue microarray resource including 1,275 men with 5 year median follow-up. The relationship between IHC and RISH expression levels was assessed using the Kappa analysis. Associations with clinical and pathological parameters were tested by the Chi-square test and the Wilcoxon rank sum test. Relationships with outcome were assessed with univariable and multivariable Cox proportional hazards models and the Log-rank test.ResultsAbsent or weak expression of AZGP1 protein was associated with worse recurrence free survival (RFS), disease specific survival, and overall survival after radical prostatectomy in univariable analysis. AZGP1 protein expression, along with pre-operative serum PSA levels, surgical margin status, seminal vesicle invasion, extracapsular extension, and Gleason score predicted RFS on multivariable analysis. Similarly, absent or low AZGP1 RNA expression by RISH predicted worse RFS after prostatectomy in univariable and multivariable analysis.ConclusionsIn our large, rigorously designed validation cohort, loss of AZGP1 expression predicts RFS after radical prostatectomy independent of clinical and pathological variables. Prostate 76:1409-1419, 2016. © 2016 Wiley Periodicals, Inc.

Background: Few studies have compared the surgical results of single-incision robotic cholecystectomy (SIRC) with those of conventional laparoscopic cholecystectomy (CLC). The purpose of this study was to evaluate the relative clinical efficacy of SIRC by comparing the number of postoperative days, pain level and complications between the 2 surgical methods.Methods: We retrospectively collected demographic, perioperative and postoperative data for all patients who underwent SIRC or CLC performed by a single surgeon from June 2016 to May 2017. Operative time was recorded, divided into anesthesia time, docking time, console time and total operation time. Postoperative pain was measured with the Numerical Pain Rating Scale.Results: A total of 121 patients underwent cholecystectomy during the study period, of whom 61 had SIRC and 60 had CLC. The mean total operation time of SIRC and CLC was 93.52 (SD 20.27) minutes and 37.67 (SD 19.73) minutes, respectively (p < 0.001). The total operation time excluding console time of SIRC was significantly longer than that of CLC (82.77 [SD 18.27] min v. 37.67 [SD 19.73] min) (p < 0.001). The mean Numerical Pain Rating Scale score was 4.73 (SD 1.2 3) (SIRC: 4.75 [SD 1.24]; CLC: 4.70 [SD 1.22]) (p = 0.8) within 1 hour after the operation; scores after 6 hours and 1 day decreased in a similar manner in the 2 groups (p = 0.1).Conclusion: Postoperative pain, use of an additional port, complication rates, operation time and cost of SIRC were similar to or greater than those of CLC. Large randomized controlled trials are needed to examine the true benefits of SIRC.Contexte : Peu d'etudes ont compare les resultats chirurgicaux de la cholecystectomie robotique par incision unique (CRIU) a ceux de la cholecystectomie laparoscopique classique (CLC). Le but de la presente etude etait d'evaluer l'efficacite clinique relative de la CRIU en comparant le nombre de jours postoperatoires, l'intensite de la douleur et les complications avec les 2 methodes chirurgicales.Methodes : Nous avons recueilli de maniere retrospective les donnees demographiques, perioperatoires et postoperatoires de tous les patients soumis a une CRIU ou a une CLC effectuee par un seul chirurgien entre juin 2016 et mai 2017. Le temps operatoire a ete enregistre, subdivise entre anesthesie, temps d'installation, temps a la console et duree totale de l'intervention. La douleur postoperatoire a ete mesuree au moyen d'une echelle numerique d'evaluation de la douleur.Resultats : En tout, 121 patients ont subi une cholecystectomie durant la periode de l'etude, dont 61, une CRIU et 60, une CLC. La duree operatoire totale moyenne des CRIU et des CLC a ete de 93,52 (E.-T. 20,27) minutes et de 37,67 (E.-T. 19,73) minutes, respectivement (p < 0,001). La duree operatoire totale excluant le temps a la console a ete significativement plus longue avec la CRIU qu'avec la CLC (82,77 [E.-T. 18,27] minutes c. 37,67 [E.-T. 19,73] minutes) (p < 0,001). Le score moyen a l'echelle numerique d'evaluation de la douleur a ete de 4,73 (E.-T. 1,23) (CRIU : 4,75 [E.-T. 1,24]; CLC : 4,70 [E.-T. 1,22]) (p = 0,8) 1 heure suivant l'intervention; apres 6 heures et apres 1 jour, les scores avaient diminue de facon similaire dans les 2 groupes (p = 0,1).Conclusion : La douleur postoperatoire, l'utilisation d'un port additionnel, les taux de complication, le temps operatoire et le cout de la CRIU ont ete similaires ou superieurs a ceux de la CLC. Il faudra realiser de plus grands essais randomises et controles pour analyser les benefices reels de la CRIU., Gallbladder disease is one of the most common diseases requiring surgical treatment. In the United States, more than 500 000 people are reported to undergo gallbladder surgery annually. (1) Since [...]

Background: The association of resection margin status with recurrence and survival after pancreatectomy for pancreas ductal adenocarcinoma (PDAC) remains controversial. The aim of this study was to identify the effect of R1 resection on recurrence pattern and survival after distal pancreatectomy for left‐sided PDAC. Methods: Patients who underwent distal pancreatectomy for PDAC at two high‐volume institutions between January 2010 and December 2017 were retrospectively reviewed. Perioperative characteristics, pathological outcomes, recurrence pattern, and survival data were collected to compare R0 resection and R1 resection. Results: Among 558 patients who underwent distal pancreatectomy for PDAC, 158 patients (28.3%) showed R1 resection margin. R1 patients were associated with large tumor size (3.3 cm vs. 3.7 cm, p =.006) and lower number of positive lymph nodes (1.3 vs. 2.0, p =.001). Median overall survival (37.3 months vs. 20.1 months, p <.001) and recurrence‐free survival (14.6 months vs. 6.9 months, p <.001) significantly differed between the R0 and R1 groups. Disease recurrence patterns were not statistically different between the two groups (p =.182). Among the recurrence patterns, peritoneal carcinomatosis had the shortest recurrence‐free survival (5.6 months, p <.05) and overall survival (13.6 months, p <.05) compared with all other recurrence patterns. Conclusions: R1 resection margin after distal pancreatectomy was associated with poor survival and early recurrence. There is no significant difference in recurrence pattern between R0 and R1. Among the recurrence patterns, peritoneal carcinomatosis showed the worst prognosis. [ABSTRACT FROM AUTHOR]

The objective of this study is to investigate the probability of mechanical trimming using hot half-trimming in actual hot stamping process. Hot half-trimmed part can be inaccurately positioned on mechanical trimming die by relatively low accuracy of automatic transferring system or manual way, leading to the change of clearance in mechanical trimming. Taking into account this position error, a suitable operation window for trimming of flat and inclined part was constructed by FE-simulation and then was verified by experiment. It was determined from the operation window that effective mechanical trimming for both flat and inclined part can be performed successfully with hot half-trimming depth of 1.0 mm in hot half-trimming and clearance between 0.1 mm and 0.124 mm in subsequent mechanical trimming, without regard to position error.

Research has been conducted on the chiral monodentate phosphine obtained by oxidation of the lithium complex. The steric and electronic properties of this phosphine have been investigated via the X-ray diffraction and IR spectroscopic studies and the results are reported.