Negative Sm Research Articles

Bladder Postoperative Spindle Cell Nodule: Malignant Mimicry in the Postoperative Setting

Bladder Postoperative Spindle Cell Nodule: Malignant Mimicry in the Postoperative Setting

Global Soil Moisture–Climate Interactions during the Peak Growing Season

Abstract Soil moisture (SM) during the vegetation growing season largely affects plant transpiration and photosynthesis, and further alters the land energy and water balance through its impact on the energy partition into latent and sensible heat fluxes. To highlight the impact of strong vegetation activity, we investigate global SM–climate interactions over the peak growing season (PGS) during 1982–2015 based on multisource datasets. Results suggest widespread positive SM–precipitation (P), SM–evapotranspiration (ET), and negative SM–temperature (T) interactions with non-negligible negative SM–P, SM–ET, and positive SM–T interactions over PGS. Relative to the influence of individual climate factors on SM, the compounding effect of climate factors strengthens SM–climate interactions. Simultaneously, variations of SM are dominated by precipitation from 50°N toward the south, by evapotranspiration from 50°N toward the north, and by temperature over the Sahara, western and central Asia, and the Tibetan Plateau. Importantly, the higher probability of concurrent SM wetness and climate extremes indicates the instant response of SM wetness to extreme climate. In contrast, the resistance of vegetation partially contributes to a consequent slower response of SM dryness to extreme climate. We highlight the significance of the compounding effects of climate factors in understanding SM–climate interaction in the context of strong vegetation activity, and the response of SM wetness and dryness to climate extremes.

The Risk Analyses of Lymph Node Metastasis and Recurrence for Submucosal Invasive Colorectal Cancer: Novel Criteria to Skip Completion Surgery.

Simple SummaryCompletion surgery is recommended for patients with submucosal invasive colorectal cancer (pT1 CRC) with known risk factors for lymph node metastasis (LNM). However, completion surgery would be able to be skipped for more of the population with very low risk for LNM and recurrence. The present study thus analyzed both short- and long-term outcomes for high-risk pT1 CRC patients who underwent surgery, showing that lymphovascular invasion was a potential independent risk factor for LNM, and rectal cancer and undifferentiated histology were independent risk factors for poor relapse-free survival in patients with high-risk pT1 CRC. No LNMs were observed in pT1 CRCs with an SM invasion depth ≤2000 µm that had no other risk factors except for budding. Based on the results, novel criteria to skip completion surgery for high-risk pT1 CRC have been established in the current study, which were also validated in an independent validation cohort.(1) Background: Additional surgical resection after endoscopic resection (ER) is recommended for patients with submucosal invasive colorectal cancer (pT1 CRC) who have risk factors for lymph node metastasis (LNM) (high-risk pT1 CRC). This study aimed to identify risk factors for LNM and metastatic recurrence and to determine the low-risk population for whom additional surgery can be omitted among high-risk pT1 CRCs. (2) Methods: We retrospectively identified 404 patients with pT1 CRC who underwent ER or surgery, and patients were divided into three groups: low-risk (n = 79); high-risk pT1 with ER (n = 40); and high-risk with surgery (n = 285). We also enrolled another 64 patients with high-risk pT1 CRC in an independent validation cohort. (3) Results: In the high-risk with surgery group, LNM was seen in 11.2%, and vascular and lymphatic invasions were significantly independent risk factors for LNM on multivariate analysis. No LNMs were observed in pT1 CRCs with a negative vertical margin and SM invasion depth ≤2000 µm that had no other risk factors except for budding. Five patients developed metastatic recurrence in the high-risk with surgery group, and rectal cancer and undifferentiated histology were significantly independent risk factors for poor relapse-free survival. No LNM or recurrent cases were seen in high-risk pT1 CRCs that met these criteria: differentiated adenocarcinoma, no lymphovascular invasion, colon cancer, SM invasion depth ≤2000 μm, and a negative vertical margin, which were validated in an independent validation cohort. (4) Conclusions: Completion surgery may be skipped for high-risk pT1 CRCs that meet our proposed criteria.

Rare Earth Element Accumulation and Fractionation in a Lake Ecosystem Impacted by Past Uranium Mining.

Rare earth elements (REEs) are a natural resource of vital economic interest. While REE mining and processing are known for severe environmental issues, REEs are also by-products of other mining processes (e.g. uranium). Here, we provide an in-depth assessment of REE distribution across a lake system impacted by adjacent uranium mining over a long period (Bow Lake, Ontario, Canada). We observed a robust REE-U correlation with a consistent La/U ratio of 2.0 ± 0.2 and La concentrations up to 2200µgg-1. Selective extraction results demonstrated that 80-94% of REEs were acid extractible, while 3-8% of REEs were extracted by an alkaline solution (i.e. bound to natural organic matter). Analysis of specific REE patterns, together with a strong REE-P correlation, suggest that (co)precipitation with P mineral would be an important mechanism sequestrating REEs into Bow Lake sediments. Moreover, we identified three sources of particles delivering REEs into the lake with unique REE patterns: mine tailings, U ores and Precambrian bedrock. Negative Sm anomalies were detected in three soil samples and associated with the Precambrian bedrock. We also detected positive Gd and La anomalies in the sediments. Lanthanum anomalies were strongly correlated with U authigenic accumulation and thus associated with microbial processes requiring La, such as methanotrophy. This research demonstrates that lake sediments adjacent to U mining could represent ecological risks given that La and other REE concentrations largely exceed the maximum permissible concentrations. Water and sediment quality criteria are therefore required as both primary REE mining and extraction of REEs as by-products from legacy metallurgical tailings are increasing.

Surgeon volume and body mass index influence positive surgical margin risk after robot-assisted radical prostatectomy: Results in 732 cases

ABSTRACTObjectives: To evaluate clinicopathological and perioperative factors associated with the risk of focal and non-focal positive surgical margins (PSMs) after robot-assisted radical prostatectomy (RARP).Patients and methods: The study was retrospective and excluded patients who were under androgen-deprivation therapy or had prior treatments. The population included: negative SM cases (control group), focal and non-focal PSM cases (study groups). PSMs were classified as focal when the linear extent of cancer invasion was ≤1 mm and non-focal when >1 mm. The independent association of factors with the risk of focal and non-focal PSMs was assessed by multinomial logistic regression.Results: In all, 732 patients underwent RARP, from January 2013 to December 2017. An extended pelvic lymph node dissection was performed in 342 cases (46.7%). In all, 192 cases (26.3%) had PSMs, which were focal in 133 (18.2%) and non-focal in 59 (8.1%). Independent factors associated with the risk of focal PSMs were body mass index (odds ratio [OR] 0.914; P = 0.006), percentage of biopsy positive cores (BPC; OR 1.011; P = 0.015), pathological extracapsular extension (pathological tumour stage [pT]3a; OR 2.064; P = 0.016), and seminal vesicle invasion (pT3b; OR 2.150; P = 0.010). High surgeon volume was a protective factor in having focal PSM (OR 0.574; P = 0.006). Independent predictors of non-focal PSMs were BPC (OR 1,013; P = 0,044), pT3a (OR 4,832; P < 0.001), and pT3b (OR 5,153; P = 0.001).Conclusions: In high-volume centres features related to host, tumour and surgeon volume are factors that predict the risk of focal and non-focal PSMs after RARP.Abbreviations: AJCC: American joint committee on cancer; AS: active surveillance; ASA: American society of anesthesiologists; BCR: biochemical recurrence; BMI: body mass index; BPC: percentage of biopsy positive cores; ePLND: extended lymph node dissection; H&E: haematoxylin and eosin; IQR, interquartile range; ISUP: international society of urologic pathology; LNI: lymph node invasion; LOS: length of hospital stay; mpMRI: multiparametric MRI; (c)(p)N: (clinical) (pathological) nodal stage; OR: odds ratio; OT: operating time; PSA-DT: PSA-doubling time; (P)SM: (positive) surgical margin; (NS)(RA)RP: (nerve-sparing) (robot-assisted) radical prostatectomy; RT: radiation therapy; (c)(p)T: (clinical) (pathological) tumour stage

Petrogenesis of Alta'ameem meteorite (Iraq) inferred from major, trace, REE and PGE+Au content

Alta'ameem Meteorite (AM) is an unaltered ordinary LL chondrite that hit an area near Kirkuk City in northern Iraq on 1977. It has an ash-gray colour with a thin black fusion crust, and consists of spheroidal chondrules and variously shaped clasts aggregated together by a fine grained matrix. The chondrules of Alta'ameem Meteorite include all known types in similar meteorites elsewhere. Mineralogically, the AM consists of silicates (olivine - Fa27.7; pyroxene - Fs23.2 (Opx) and 20.5 (Cpx); plagioclase - Ab73.5An22.1Or4.7), alloys and metals (taenite, tetrataenite, kamacite, and native copper), oxides (ilmenite and chromite), sulfides (troilite), and phosphates (apatite) as well as few unidentified minerals including a Fe-Ti-Cr oxide and Fe-Ni sulfide. The chemistry of AM is dominated by SiO2, MgO, and FeOt accounting for >91 wt% of the bulk composition with minor amounts of Al2O3, CaO, Na2O, S, Ni and Cr. It contains 3675 ppb REE which is within the range of most chondrites, with a negative (−0.8) Sm- and positive (+1.2) Tb-anomalies and a near flat normalized trend (LaN/YbN = 1.16). The concentration of PGEs and Au, Ni, Co, and Cr is low in comparison to most chondrites. The K/La, Ru/Rh vs. Pt/Pd, and Pd/Ir ratio (1.85), and low PGE indicates that the AM is somewhat distinct from other meteorites. The AM has W0 weathering grade and very weak (S2) shock metamorphism. Although the AM has some petrographical and geochemical differences with other chondrites, it still can be considered as LL5 chondrite.

PD46-10 STANDARDIZED MAGNETIC RESONANCE IMAGING READING FOR PREDICTION OF EXTRAPROSTATIC EXTENSION AND PROSTATECTOMY OUTCOME IN PATIENTS WITH LOW-, INTERMEDIATE- AND HIGH-RISK PROSTATE CANCER

You have accessJournal of UrologyProstate Cancer: Detection and Screening V1 Apr 2015PD46-10 STANDARDIZED MAGNETIC RESONANCE IMAGING READING FOR PREDICTION OF EXTRAPROSTATIC EXTENSION AND PROSTATECTOMY OUTCOME IN PATIENTS WITH LOW-, INTERMEDIATE- AND HIGH-RISK PROSTATE CANCER Jan Philipp Radtke, Maya Müller-Wolf, Martin Freitag, Constantin Schwab, Gencay Hatiboglu, Wilfried Roth, Matthias Roethke, Heinz-Peter Schlemmer, Markus Hohenfellner, Boris Hadaschik, and Dogu Teber Jan Philipp RadtkeJan Philipp Radtke More articles by this author , Maya Müller-WolfMaya Müller-Wolf More articles by this author , Martin FreitagMartin Freitag More articles by this author , Constantin SchwabConstantin Schwab More articles by this author , Gencay HatibogluGencay Hatiboglu More articles by this author , Wilfried RothWilfried Roth More articles by this author , Matthias RoethkeMatthias Roethke More articles by this author , Heinz-Peter SchlemmerHeinz-Peter Schlemmer More articles by this author , Markus HohenfellnerMarkus Hohenfellner More articles by this author , Boris HadaschikBoris Hadaschik More articles by this author , and Dogu TeberDogu Teber More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2741AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To investigate the value of multiparametric magnetic resonance imaging (mpMRI) to predict extracapsular extension (ECE) and a negative surgical margin status (SM) at radical prostatectomy (RP) for different prostate cancer (PC) risk groups. METHODS 1070 men underwent 3 Tesla mpMRI including T2-weighted, diffusion weighted imaging and dynamic contrast enhanced sequences without an endorectal coil before MRI/TRUS-fusion guided prostate biopsy. MRI were analyzed using PIRADS. We also investigated an ESUR score for extraprostatic disease. 132 men subsequently underwent RP at our department. Median number of cores taken per patient was 26 (24 systematic and 2 MRI-targeted biopsies). Biopsies were assessed according to START. Pathological stage and SM status at RP was used as reference for ECE. The cohort was classified into low-, intermediate- and high-risk groups according to NCCN criteria. Two different definitions of significant PC were investigated. Statistical analyses included regression analyses, Receiver operating characteristics (ROC) and Youden's index to assess an ESUR score-cutoff. RESULTS Preoperatively, 20 patients had low-, 78 intermediate- and 34 high-risk PC. Final pathology showed pT3 in 58 and pT4 in one patient. Area under curve (AUC) in ROC curve analysis was 0.86 for ESUR-ECE-score to detect pT3a disease. Youden-selected threshold was 4. At ECE-score≥4, the probability of positive SM were significantly increased (p=0.03). Positive/negative predictive value (PPV/NPV) of ECE-score≥4 for harboring pT3 was 82.5%/71.4%, 25.0%/93.3%, 89.5%/76.3% and 88.2%/35.3% for the overall-cohort, low-, intermediate- and high-risk cohort). Logistic regression analyses detected a significant Odd Ratio for pT3 disease for ECE-score, Tumor volume≥0.7 ml, significant PC according to Epstein criteria and high-risk according to NCCN criteria. Interestingly, in the high-risk subgroup 6/34(17.6%) patients were correct assessed as not harboring pT3 by imaging, thus allowing nerve-sparing surgery. The SM-status was determined by ESUR-ECE-score, tumor diameter and PIRADS, but not by surgical approach (robotic versus retropubic RP)(p=0.523). CONCLUSIONS Prediction of pT3 disease is crucial to plan nerve-sparing surgery and to achieve negative SM in RP. MpMRI has promising potential to estimate pT3. The standardized ECE Scoring system is an independent predictor of pT3 and may help to plan nerve-sparing RP with oncologic security, even in high-risk patients. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e960 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jan Philipp Radtke More articles by this author Maya Müller-Wolf More articles by this author Martin Freitag More articles by this author Constantin Schwab More articles by this author Gencay Hatiboglu More articles by this author Wilfried Roth More articles by this author Matthias Roethke More articles by this author Heinz-Peter Schlemmer More articles by this author Markus Hohenfellner More articles by this author Boris Hadaschik More articles by this author Dogu Teber More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

The impact of length and location of positive margins in predicting biochemical recurrence after robot-assisted radical prostatectomy with a minimum follow-up of 5 years

To evaluate the role of positive surgical margin (PSM) size/focality and location in relation to risk of biochemical recurrence (BCR) after robot-assisted radical prostatectomy (RARP). Clinicopathological data were collected from 904 patients who underwent RARP at a single European institution from 2002 to 2006. PSM status after RARP was defined as cancer cells at the inked margin, and was stratified by size/focality and location. The outcome variable was BCR, defined as a postoperative PSA level of ≥0.2 ng/mL. We modelled clinicopathological covariates including PSM size/focality and location using Cox proportional hazards regression. In subgroup analyses, we assessed the effect of PSM size and location at different pathological stages and grades of disease. Compared with negative SM, a PSM of >3 mm/multifocal was associated with an increased risk of BCR in the entire cohort (hazard ratio [HR] 2.84, 95% confidence interval 1.76-4.59), while unifocal PSMs of ≤3 mm were not significantly associated with BCR. In subgroup analyses, the negative impact of >3 mm/multifocal PSM appeared greatest in those with lower postoperative stage and grade of disease. The prognostic role of PSM location was unconfirmed, although data indicated that posterolateral PSMs may be of lower significance in RARP patients. The study is limited by lack of central pathology review, and lack of statistical adjustment for tumour volume, lymph node status, and surgeon volume. We found that men with >3 mm/multifocal PSMs have a higher risk of BCR than those with unifocal PSMs of ≤3 mm or negative SMs, especially if they have lower risk disease. Posterolateral margins may be of little significance in a RARP population.

Primary Gleason Grade 4 at the Positive Margin Is Associated with Metastasis and Death Among Patients with Gleason 7 Prostate Cancer Undergoing Radical Prostatectomy

BackgroundThe presence of a positive surgical margin (PSM) at radical prostatectomy (RP) has been linked to an increased risk of biochemical recurrence and receipt of secondary therapy; however, its association with other oncologic end points remains controversial. ObjectiveTo evaluate the association of primary Gleason grade (GG) at the site of PSM with subsequent clinical progression and mortality among patients with Gleason score (GS) 7 prostate cancer (PCa). Design, setting, and participantsWe identified 1036 patients who underwent RP between 1996 and 2002. A single uropathologist re-reviewed all specimens noted to have a PSM to record GG at the margin. Outcome measurements and statistical analysisSurvival was estimated using the Kaplan-Meier method. Cox models were used to analyze the association of margin primary GG with outcome. Results and limitationsOverall, 338 men (33%) had a PSM; of those, 242 had PSM GG3 and 96 had PSM GG4. Median postoperative follow-up was 13 yr. Compared with men with PSM GG3 or a negative SM, we noted that men with PSM GG4 had significantly worse 15-yr systemic progression-free survival (74% vs 90% vs 93%, respectively; p<0.001) and cancer-specific survival (86% vs 96% vs 97%, respectively; p=0.002). On multivariable analysis, the presence of PSM GG4 was associated with increased risks of systemic progression (hazard ratio [HR]: 2.77; p=0.003) and death from PCa (HR: 3.93; p=0.02) among men with a PSM. Limitations include the relatively small rate of disease recurrence. ConclusionsPSM primary GG4 was independently associated with adverse oncologic outcomes among men with GS7 PCa. Pending external validation, GG at the PSM may be considered for inclusion in pathologic reports and risk stratification following RP. Patient summaryAmong patients with Gleason grade 7 prostate cancer and a positive surgical margin at the time of prostatectomy, we found that higher Gleason grade at the margin was associated with worse oncologic outcomes.

Safe-R: a novel score, accounting for oncological safe nerve-sparing at radical prostatectomy for localized prostate cancer

The objectives of the study were to describe a novel score (safe-R), combining information on surgical margin status (SM) and extend of nerve-sparing (NS) applicable for all patients undergoing radical prostatectomy (RP), and to test the impact of our frozen-section navigated nerve-sparing approach (NeuroSAFE) on safe-R score. We retrospectively analyzed 9,635 RPs performed at our center between 2002 and 2011. Of these, 47 % were conducted with NeuroSAFE. Proportions of NS and SM status were assessed. Subsequently, a score for oncological safe NS (safe-R) was developed; Safe-R was categorized as 3 (for negative SM and bilateral NS), 2 (for negative SM and unilateral NS), 1 (for negative SM without NS), and 0 (for patients with positive SM), respectively. The impact of NeuroSAFE on safe-R was analyzed by chi-square test and confirmed by multinomial logistic regression, adjusting for preoperative risk factors. Applying NeuroSAFE resulted in enhanced safe-R score, indicating lower rates of positive SM and higher rates of NS, across all risk categories (all p < 0.001). For example in high-risk patients, NeuroSAFE resulted in lower proportions of safe-R 0 (27.6 vs. 33.6 %) and higher proportions of safe-R 3 (32.4 vs. 17.1 %, p < 0.001). Linkage between the NeuroSAFE approach and safe-R was confirmed after multinomial logistic adjustment for preoperative risk factors. All results were confirmed in a propensity-matched cohort (matched for preoperative risk factors and year of surgery, data not shown). Safe-R represents a novel tool to assess and report on oncological safe nerve-sparing in RP. NeuroSAFE is associated with enhanced safe-R scores.

The lithophile trace elements in enstatite chondrites

We report on the abundances of a selected set of lithophile trace elements (namely REEs, Y, Rb, Ba, Sr, Zr, Hf, Nb, Th, U) in a comprehensive suite of enstatite chondrites (EC-13 EH and 11 EL). EH3 and EL3 display only minor deviations from chondritic distributions for these elements. In most metamorphosed EC, a wide range of compositions is observed and suggests a mobility of many of the elements studied during the history of these rocks. For example, EL6 chondrites exhibit light-REE and Nb depletions, negative Eu anomalies, and positive Y anomalies. More important trace element fractionations are observed in metamorphosed EH like St Marks (Rb depletion), LAP 02225 (Rb, Nb, Zr, Eu, light REE depletions) and Galim (b), which displays large Ba, Sr, Eu, Nb and light REE depletions.Leaching experiments were undertaken to investigate the contributions of sulfides in the whole rock budgets. These phases control not only the REE budget, but also important fractions of the other elements we studied. These fractions strongly depend on the type of the rock (EH or EL, and metamorphic grade). For many elements, the sulfide contributions increase with the metamorphic grades. The trace element abundances of silicate residues are extremely variable. Negative Sm and Yb anomalies are observed in EL3 and EH3 residues, and are certainly the results of early nebular processes. Such anomalies are lacking in residues obtained with most metamorphosed EC, underlining the importance of trace element redistributions during metamorphism. In addition, EL6 residues display distinctive positive Y anomalies that could be potentially ascribed to a less chalcophile behavior than Ho in the conditions that prevailed during EL metamorphism.

360 SAFE-R: A NOVEL SCORE, ACCOUNTING FOR ONCOLOGICAL SAFE NERVE-SPARING

You have accessJournal of UrologyProstate Cancer: Localized (I)1 Apr 2013360 SAFE-R: A NOVEL SCORE, ACCOUNTING FOR ONCOLOGICAL SAFE NERVE-SPARING Andreas Becker, Meike Adam, Jens Hansen, Pierre Tennstedt, Thomas Steuber, Georg Salomon, Alexander Haese, Lars Budaeus, Uwe Michl, Hans Heinzer, Hartwig Huland, Markus Graefen, and Thorsten Schlomm Andreas BeckerAndreas Becker Hamburg, Germany More articles by this author , Meike AdamMeike Adam Hamburg, Germany More articles by this author , Jens HansenJens Hansen Hamburg, Germany More articles by this author , Pierre TennstedtPierre Tennstedt Hamburg, Germany More articles by this author , Thomas SteuberThomas Steuber Hamburg, Germany More articles by this author , Georg SalomonGeorg Salomon Hamburg, Germany More articles by this author , Alexander HaeseAlexander Haese Hamburg, Germany More articles by this author , Lars BudaeusLars Budaeus Hamburg, Germany More articles by this author , Uwe MichlUwe Michl Hamburg, Germany More articles by this author , Hans HeinzerHans Heinzer Hamburg, Germany More articles by this author , Hartwig HulandHartwig Huland Hamburg, Germany More articles by this author , Markus GraefenMarkus Graefen Hamburg, Germany More articles by this author , and Thorsten SchlommThorsten Schlomm Hamburg, Germany More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.1747AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Risk-stratification based on preoperative data cannot reliably predict organ-confined disease. This is of particular relevance for selecting patients for nerve-sparing (NS) radical prostatectomy (RP). We assessed the impact of our intraoperative neurovascular structure adjacent frozen section examination (NeuroSAFE) guided nerve-sparing approach on the frequency of nerve-sparing and surgical margin rates in D'Amico low-, intermediate-, and high-risk patients, applying a novel score (SAFE-R), combining surgical margin status (SM) and extend of NS. METHODS From January 2002 to January 2011, 9,674 consecutive RPs were performed at our center. Of these, 4,518 (47%) were conducted with NeuroSAFE. Proportions of NS, SM-status were assessed. Subsequently, a score for oncological safe NS (SAFE-R) was developed. SAFE-R was categorized as 3 (for negative SM and bilateral NS), 2 (for negative SM and unilateral NS), 1 (for negative SM without NS) and 0 (for patients with positive SM), respectively. The impact of NeuroSAFE on SAFE-R was analyzed by chi-square test and confirmed with a multinominal logistic regression, controlling for preoperative risk-factors. All analyses were stratified for patients of low- intermediate- or high-risk according to the D'Amico classification. RESULTS D'Amico high-, intermediate- and low-risk profile was found in 1,319 (13.6%), 4,245 (43.9%) and 4,110 (42.5%) of all patients respectively. Within the low-risk group, a SAFE-R-0 (positive SM) was significantly less prevalent and SAFE-R scores of 2 or 3 (uni- or bilateral NS and negative SM) were more prevalent in patients undergoing neuroSAFE, compared to non-neuroSAFE patients (10.5 vs. 13.2%, and 88.1 vs. 85.7%, respectively, p<0.001). Similarly, in intermediate and high-risk patients, neuroSAFE resulted in lower proportions of SAFE-R score 0 (15.9 vs. 19.9% and 27.6 vs. 33.6%) and higher proportions of SAFE-R score 3 (53.7 vs. 44.1% and 32.4 vs. 17.3%, respectively, all p<0.001). Linkage between the neuroSAFE approach and SAFE-R was confirmed after multinominal logistic adjustment for preoperative risk factors. CONCLUSIONS SAFE-R represents a novel score to assess and report on oncological safe nerve-sparing in RP. Frozen section navigated nerve-sparing (NeuroSAFE) is associated with enhanced SAFE-R-scores without compromising oncological safety, even in high-risk patients. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e146 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Andreas Becker Hamburg, Germany More articles by this author Meike Adam Hamburg, Germany More articles by this author Jens Hansen Hamburg, Germany More articles by this author Pierre Tennstedt Hamburg, Germany More articles by this author Thomas Steuber Hamburg, Germany More articles by this author Georg Salomon Hamburg, Germany More articles by this author Alexander Haese Hamburg, Germany More articles by this author Lars Budaeus Hamburg, Germany More articles by this author Uwe Michl Hamburg, Germany More articles by this author Hans Heinzer Hamburg, Germany More articles by this author Hartwig Huland Hamburg, Germany More articles by this author Markus Graefen Hamburg, Germany More articles by this author Thorsten Schlomm Hamburg, Germany More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

361 QUALITY OF LIFE OUTCOMES IN MEN UNDERGOING TREATMENT OF LOCALIZED PROSTATE CANCER: INITIAL RESULTS FROM THE KAISER PERMANENTE SOUTHERN CALIFORNIA REGION

INTRODUCTION AND OBJECTIVES: Risk-stratification based on preoperative data cannot reliably predict organ-confined disease. This is of particular relevance for selecting patients for nerve-sparing (NS) radical prostatectomy (RP). We assessed the impact of our intraoperative neurovascular structure adjacent frozen section examination (NeuroSAFE) guided nerve-sparing approach on the frequency of nerve-sparing and surgical margin rates in D’Amico low-, intermediate-, and high-risk patients, applying a novel score (SAFE-R), combining surgical margin status (SM) and extend of NS. METHODS: From January 2002 to January 2011, 9,674 consecutive RPs were performed at our center. Of these, 4,518 (47%) were conducted with NeuroSAFE. Proportions of NS, SM-status were assessed. Subsequently, a score for oncological safe NS (SAFE-R) was developed. SAFE-R was categorized as 3 (for negative SM and bilateral NS), 2 (for negative SM and unilateral NS), 1 (for negative SM without NS) and 0 (for patients with positive SM), respectively. The impact of NeuroSAFE on SAFE-R was analyzed by chi-square test and confirmed with a multinominal logistic regression, controlling for preoperative risk-factors. All analyses were stratified for patients of lowintermediateor high-risk according to the D’Amico classification. RESULTS: D’Amico high-, intermediateand low-risk profile was found in 1,319 (13.6%), 4,245 (43.9%) and 4,110 (42.5%) of all patients respectively. Within the low-risk group, a SAFE-R-0 (positive SM) was significantly less prevalent and SAFE-R scores of 2 or 3 (unior bilateral NS and negative SM) were more prevalent in patients undergoing neuroSAFE, compared to non-neuroSAFE patients (10.5 vs. 13.2%, and 88.1 vs. 85.7%, respectively, p 0.001). Similarly, in intermediate and high-risk patients, neuroSAFE resulted in lower proportions of SAFE-R score 0 (15.9 vs. 19.9% and 27.6 vs. 33.6%) and higher proportions of SAFE-R score 3 (53.7 vs. 44.1% and 32.4 vs. 17.3%, respectively, all p 0.001). Linkage between the neuroSAFE approach and SAFE-R was confirmed after multinominal logistic adjustment for preoperative risk factors. CONCLUSIONS: SAFE-R represents a novel score to assess and report on oncological safe nerve-sparing in RP. Frozen section navigated nerve-sparing (NeuroSAFE) is associated with enhanced SAFE-R-scores without compromising oncological safety, even in highrisk patients.

The U-Pb age, geochemistry and tectonic significance of granitoids in the Soursat Complex, Northwest Iran

The Soursat Complex in northwestern of Iran is part of the Sanandaj-Sirjan metamorphic belt. Three granitoid suites are present: Type I- syenogranite and deformed syenogranite; Type II- Turkeh Dare and Pichagchi plutons; and Type III- quartz porphyry. The granites can be assigned to a medium-K calc-alkaline to high-K calc-alkaline series. The Type I granitoids are weakly to strongly peraluminous and belong to a S-type suite, whereas Type II plutons are metaluminous to weakly peraluminous with I-type character. Type III granitoids are weakly peraluminous and can be labelled as a highly fractionated I-type suite. U/Pb zircon dating of the syenogranite and deformed syenogranite from Type I and Type II granitoids by laser inductively coupled plasma mass spectrometry (LA-ICP-MS) yielded ^{238}U/^{206}Pb emplacement ages of ~540 Ma (543±6 Ma and 537±8 Ma) and 59.0±2.7 Ma, respectively. Rare Earth Elements in the Type I granitoids are strongly fractionated with (La/Lu)_N= 32 to 52 and negative Eu anomalies (Eu/Eu*= 0.09-0.72), typical for plagioclase fractionation; the primitive mantle-normalized element patterns are homogeneous with marked negative Ba, Nb, Ta, Sr and Eu anomalies. Based on geochemical data, Type I granitoids are formed in a continent-continent collision, which could be related to Cadomian collision along the northern margin of Gondwana after its final amalgamation. Types II and III granitoids have I-type affinities and show homogeneous and moderately fractionated REE patterns with (La/Lu)_N= 17-34. Primitive mantle-normalized element patterns are homogeneous with marked negative Nb, Ta, Sm and Ti anomalies. The Soursat Complex is shown to contain early- to syn-collisional granitoid magmatism of Ediacaran-Cambrian age and a subsequent group of Palaeocene I-type granitoids that are syn- to post-collisional with respect to the Arabia-Eurasia collision and are interpreted to represent roll-back during the closure of Neotethys, pre-dating the Arabia-Eurasia collision.

Geochemical evolution of basaltic volcanism within the tertiary basins of southeastern Korea and the opening of the East Sea (Sea of Japan)

We determined the geochemical and Sr–Nd–Hf–Pb isotopic compositions of volcanic rocks within the Tertiary basins of southeastern Korea to better understand the petrogenetic evolution of local volcanism. The volcanic rocks in this region are divided into two major groups based on their geochemical characteristics and spatiotemporal distributions: Eoil from the Yangnam Basin, and Daljeon from the Pohang Basin.The Eoil rocks (16–22Ma K–Ar ages) are primarily subalkaline basalt to basaltic andesite, whereas the Daljeon samples (13–15Ma K–Ar ages) are sodic alkaline phonotephrites. The Eoil basaltic rocks exhibit light rare earth element (LREE)-enrichment patterns with chondrite-normalized (La/Yb)N ratios of 3.6–5.0. Daljeon phonotephrites are typified by significant LREE-enrichment [(La/Yb)N=32.0–33.2] and slight negative Sm and Eu anomalies on the chondrite-normalized REE patterns. The Eoil samples show an arc signature on the primitive mantle-normalized multi-element variation diagrams, with high large ion lithophile element (LILE) enrichment and the depletion of high field strength elements (HFSE). In contrast, the Daljeon samples are dominated by high ratios of Nb and Ta to LILE and HREE, resembling typical oceanic island basalt (OIB) but distinguished by a significant trough in K, Rb, Sm, and Ti, and a positive anomaly in P. In Sr–Nd isotope space, all samples fall in the depleted quadrant, but the Eoil basaltic rocks are characterized by lower 143Nd/144Nd ratios at a given 87Sr/86Sr ratio than those of the Daljeon phonotephrites. The Eoil rocks have elevated 176Hf/177Hf ratios compared with the Daljeon samples, exhibiting a decoupling of Nd and Hf isotopes in Hf–Nd space. These observations, together with the Eoil volcanic rocks showing more radiogenic Pb isotopic compositions than the Daljeon samples, indicate two distinct mantle sources for the volcanism. The source of Eoil magmatism might be mantle wedge metasomatized by the addition of subducted pelagic sediment melts, whereas hydrous mineral-bearing sub-continental lithospheric mantle could be the dominant source for the Daljeon volcanism. The difference may be related to changes in the geodynamic setting induced by a back-arc opening in the East Sea, which culminated at around 15Ma. Lithospheric thinning caused by rifting produced the East Sea and the resultant thermal effect of asthenospheric upwelling may have initiated partial melting of the metasomatized lithospheric mantle, producing the Daljeon volcanism.

Influence of Positive Surgical Margin Status After Radical Nephroureterectomy on Upper Urinary Tract Urothelial Carcinoma Survival

The influence of a positive surgical margin (PSM) on survival outcome of post radical nephroureterectomy (RNU) for upper urinary tract urothelial carcinoma (UUT-UC) is unclear. The objectives of this study were to determine the significance of PSM on cancer-specific survival (CSS), recurrence-free survival (RFS), and metastasis-free survival (MFS) post RNU. From a multicenter collaborative database, data on SM status, stage, grade, lymph node status, lymphovascular invasion (LVI), tumor location, follow-up, and survival was retrieved for 472 patients. Patients underwent open RNU with bladder cuff excision. Clinicopathological features were compared using χ(2) or Fisher exact test and unpaired t test for categorical and continuous variables, respectively. Survival was estimated using the Kaplan-Meier method, and univariate and multivariate Cox proportional hazards regression models were calculated. Median follow-up was 27.5 months (12.1-49.3 months). PSM was identified in 44 patients (9.3%) and correlated with pT stage (p = 0.002), grade (p < 0.001), LVI (p < 0.001), and location (p < 0.001). Univariate analyses revealed that PSM was a poor prognostic factor for CSS, RFS, and MFS (p = 0.003, 0.04, and <0.001, respectively). The 5-yr CSS and MFS for PSM was 59.1 and 51.6%, respectively, compared with 83.3 and 79.3% for patients with negative SM. Multivariate analyses revealed that SM status was an independent predictor of MFS [hazard ratio 2.7; p = 0.001). PSM after RNU is an important prognostic factor for developing UUT-UC metastases. The status of the surgical margin should be systematically reported on the pathological report and may be a useful variable to include in nomogram risk prediction tools.

1557 ROLE OF POSITIVE SURGICAL MARGINS IN PATIENTS WITH ORGAN CONFINED PROSTATE CANCER. IMPLICATIONS FOR ADJUVANT TREATMENTS

You have accessJournal of UrologyProstate Cancer: Localized VI1 Apr 20101557 ROLE OF POSITIVE SURGICAL MARGINS IN PATIENTS WITH ORGAN CONFINED PROSTATE CANCER. IMPLICATIONS FOR ADJUVANT TREATMENTS Alberto Briganti, Nazareno Suardi, Umberto Capitanio, Umberto Capitanio, Andrea Salonia, Andrea Russo, Lorenzo Rocchini, Claudio Doglioni, Cesare Cozzarini, Giorgio Guazzoni, Patrizio Rigatti, and Francesco Montorsi Alberto BrigantiAlberto Briganti More articles by this author , Nazareno SuardiNazareno Suardi More articles by this author , Umberto CapitanioUmberto Capitanio More articles by this author , Umberto CapitanioUmberto Capitanio More articles by this author , Andrea SaloniaAndrea Salonia More articles by this author , Andrea RussoAndrea Russo More articles by this author , Lorenzo RocchiniLorenzo Rocchini More articles by this author , Claudio DoglioniClaudio Doglioni More articles by this author , Cesare CozzariniCesare Cozzarini More articles by this author , Giorgio GuazzoniGiorgio Guazzoni More articles by this author , Patrizio RigattiPatrizio Rigatti More articles by this author , and Francesco MontorsiFrancesco Montorsi More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1322AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Recent prospective, randomized trials have shown a positive impact of adjuvant radiation therapy (RT) in patients (pts) with Gleason 6-10 and positive surgical margins (SM+). However, despite a trend toward significance even in pts with organ confined (pT2) disease, these studies enrolled only few patients with pT2 SM+. We hypothesized that the outcome of patients with pT2 and SM+ have heterogeneous outcome which differ according to other cancer characteristics. METHODS The study included 1637 ps with node-negative, pT2 disease treated with radical prostatectomy (RP) and pelvic lymph node dissection (PLND) for clinically localized prostate cancer between 1986 and 2007 at a single European tertiary referral center. All pts had complete clinical and pathological data. Pts were divided into 4 groups according to pathological characteristics: pT2 Gleason 6 and negative SM (SM-; group 1; n=861, 52.6%), pT2 Gleason 6 and SM+ (n=123, 7.5%; group 2), pT2 Gleason 7-10 SM- (n=429; 30.1%; group 3), pT2 Gleason 7-10 SM+ (n=161;9.8%; group 4). No pts received any adjuvant treatment after surgery. The Kaplan Meier method assessed the rate of biochemical recurrence (BCR) defined as two consecutive PSA values >0.2 ng/ml. Multivariable Cox regression models tested the association between SM+ and BCR in each category after accounting for pre-op PSA and pathological Gleason sum RESULTS Mean PSA at RP was 7.3 ng/ml (median 6.2 ng/ml; range: 0.4-40 ng/ml). RP Gleason sum was ¡Ü6, 7 and 8-10 in 60.1, 37 and 2.9% pts, respectively. Overall, BCR free survival rates at 2,5 and 8 years were 96,91 and 84%, respectively. Overall, pts with SM+ had significantly lower 2,5 and 8 BCR free survival rates compared to pts with SM- (91, 80 and 76 vs 98,93 and 86% vs respectively; p<0.001). However, when stratified according to Gleason sum, pts with SM+ and Gleason 6 (group 2) had similar 2,5 and 8 year BCR free survival rates as compared to pts with Gleason 6 and SM- (group 1; 95,89 and 89 vs 98,94 and 89%; p=0.2). Conversely, pts with SM+ and high Gleason score (7-10; group 4) had significantly lower 2,5 and 8 year BCR free survival rates as compared to pts with high Gleason but SM- (group 3; 87,71 and 60 vs 96,89 and 76%; p<0.001). At multivariable analyses where presence of SM+ was a significant predictor of BCR only in patients with high Gleason score (HR: 2.6; p=0.01) CONCLUSIONS We demonstrated that SM+ in pT2 disease matters only in presence of high Gleason score. Our results seem to indirectly suggest that, even in presence of SM+, pts with lower Gleason might not be considered candidates for adjuvant treatments Milan, Italy© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e601-e602 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alberto Briganti More articles by this author Nazareno Suardi More articles by this author Umberto Capitanio More articles by this author Umberto Capitanio More articles by this author Andrea Salonia More articles by this author Andrea Russo More articles by this author Lorenzo Rocchini More articles by this author Claudio Doglioni More articles by this author Cesare Cozzarini More articles by this author Giorgio Guazzoni More articles by this author Patrizio Rigatti More articles by this author Francesco Montorsi More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...

Spin Moment of SmFe&lt;formula formulatype="inline"&gt; &lt;tex Notation="TeX"&gt;$_{7}$&lt;/tex&gt;&lt;/formula&gt; Observed by Magnetic Compton Scattering

Magnetism of SmFe7 was studied by magnetic Compton scattering experiment with the synchrotron radiation along with those of SmFe x(x = 2, 3) and Sm 6Fe 23. Spin moment and orbital moment for SmFe7 were 6.60, and 7.20 muB /f.u., respectively. The magnetic Compton profile revealed that the spin moment of SmFe7 compounds consists of negative Sm moment and positive Fe moment. The comparison to other Sm-Fe crystals shows that the spin, orbital, and total moments increase linearly against a Fe/Sm ratio.

Mixing enthalpies in samarium–transition metal melts

The mixing enthalpies in homogeneous melts of samarium with transition metals (Cr, Mn, Fe, Co, Ni) are measured by high-temperature calorimetry over the entire concentration range (in the Sm−Cr system up to 10 at.% Cr). The mixing enthalpies gradually change from positive (Sm−Cr system) to sign-variable (Sm−Mn system) and finally to negative (Sm−Fe, Sm−Co, and Sm−Ni systems). The extreme values of the integral enthalpy are (kJ/mole): 0.96 ± 0.17 and −0.69 ± 0.19 (Sm–Mn, 1600 K); −4.20 ± 0.93 (Sm–Fe, 1829 K); −14.63 ± 1.91 (Sm–Co, 1829 K); and −34.62 ± ± 1.73 (Sm−Ni, 1780 K).

Potassic late orogenic Stephanian volcanism in the Southwest French Massif central (Decazeville, Figeac, Lacapelle-Marival basins): an example for mantle metasomatism along strike-slip faults?

AbstractIn the southwestern part of the French Massif central (Decazeville basin, at the Sillon Houiller fault termination; Figeac and Lacapelle-Marival basins along the Argentat fault), Stephanian volcanism exhibits shoshonitic affinities. Their chondrite-normalized rare earth element (REE) patterns are enriched in light REE, but almost flat for heavy REE, with marked negative Eu anomalies. Primitive mantle-normalized element spectra show negative Nb, Ta, P, Sm, Ti, and positive Th, U, Pb anomalies, respectively. εNd values are negative and homogeneous (−6 to −4). This volcanism shares the same geochemical patterns as the late-orogenic Stephanian-Permian magmatism from the southern part of the Variscan belt (Pyrénées, Alps, Sardinia). We explain these geochemical characteristics as resulting from the partial melting of a metasomatised mantle. We propose a new mechanism to explain this melting process: horizontal displacement along the main late-orogenic strike-slip faults might bring into contact a hydrated lower crust with the lithospheric mantle. Mantle metasomatism within the strike-slip fault zone may then induce partial melting.