Ex-vivo donor partial nephrectomy at the time of donor-directed renal transplantation.

The outcome of nephron-sparing surgical management of small renal masses is generally favorable, specifically in terms of long term renal function, overall survival, and oncologic outcomes. Given the overall prognosis and renal function preservation, transplantation of kidneys with small renal masses has increasingly been accepted as a donor option for renal transplantation. We present a case of an incidental renal mass on preoperative donor transplant evaluation and subsequent ex-vivo donor partial nephrectomy at the time of renal transplantation.

Factors Affecting the Completion of Genitourinary Physical Examinations Prior to Urologic Consultation.

BACKGROUND: Proper instruction during medical training regarding performing adequate physical examinations prior to urologic consultations greatly improves patient care. We evaluated the frequency of genitourinary (GU) physical examinations performed prior to urologic consultation to determine the influence of factors affecting the completion of these examinations. METHODS: Between January 2013 and December 2014, 1,596 consultations were requested by primary providers and completed by the urology department at a major tertiary care teaching institution. We reviewed patient medical records retrospectively and recorded the number of GU examinations performed prior to consultation. Patient demographics were evaluated for trends in the rates of examination. A total of 9 available urology residents saw at least one consult each. RESULTS: We identified a total of 1,596 urologic consultations during the study period, of which 233 of 407 (57.2%) (51 female and 182 male patients) received GU examinations prior to the urologic consult in the emergency department (ED) and 394 of 1,189 (33.1%) (118 female and 276 male patients) received GU examinations by the inpatient care team. Staff in the ED were 3.11 times more likely to perform a GU examination on a male patient than a female patient, and the inpatient teams were 1.48 times more likely to perform a GU examination on a male patient than a female patient. The likelihood of examination by either team was low in patients aged ≥65 years. CONCLUSION: Prior to urologic consultation, GU examinations are inconsistently performed. This variability may affect patient care and could be the subject of a future study.

A case report of a renal diffuse B-cell lymphoma.

Diffuse large B-cell lymphomas (DLBCL) are the most common lymphomas worldwide. They also appear to be the most common primary retroperitoneal lymphomas, but this presentation is relatively uncommon in the literature. Retroperitoneal masses, including lymphomas, often present with nonspecific symptoms and laboratory values, necessitating radiographic assessment and consideration of mass biopsy prior to the initiation of treatment. Here we present a case of a primary retroperitoneal DLBCL as well as a review of the clinical presentation, imaging findings, and differential diagnosis of such tumors.

A case of a metanephric adenoma of the kidney surgically treated with robot-assisted laparoscopic partial nephrectomy.

Metanephric adenomas are a rare neoplasm of the kidney with less than 200 cases reported. We report a case of a metanephric adenoma incidentally found on imaging in a 52-year-old Hispanic female and treated with robot-assisted laparoscopic partial nephrectomy. A brief review of the literature is also included.

Going green in Cryptococcus neoformans: the recycling of a selectable drug marker.

Cryptococcus neoformans is an opportunistic fungal pathogen that primarily affects immunocompromised individuals. Reverse genetics is commonly used to identify and characterize genes involved in a variety of cellular processes. In C. neoformans there is a limited set of positive selectable markers available to make gene deletions or other genetic manipulations. This has hampered the application of reverse genetics in this organism. We have adapted the Bacteriophage P1 Cre-loxP system for use in C. neoformans and successfully excised and reused the same drug marker, G418, to make two sequential gene deletions, lac1Delta and cap59Delta, in the same strain. This tool will allow investigators to make multiple sequential gene deletions in the same strain, which should facilitate the analysis of multigene families.