Ultrafast pump–probe measurements can discriminate the two forms of melanin found in biological tissue (eumelanin and pheomelanin), which may be useful for diagnosing and grading melanoma. However, recent work has shown that bound iron content changes eumelanin’s pump–probe response, making it more similar to that of pheomelanin. Here we record the pump–probe response of these melanins at a wider range of wavelengths than previous work and show that with shorter pump wavelengths the response crosses over from being dominated by ground-state bleaching to being dominated by excited-state absorption. The crossover wavelength is different for each type of melanin. In our analysis, we found that the mechanism by which iron modifies eumelanin’s pump–probe response cannot be attributed to Raman resonances or differences in melanin aggregation and is more likely caused by iron acting to broaden the unit spectra of individual chromophores in the heterogeneous melanin aggregate. We analyze the dependence on optical intensity, finding that iron-loaded eumelanin undergoes irreversible changes to the pump–probe response after intense laser exposure. Simultaneously acquired fluorescence data suggest that the previously reported “activation” of eumelanin fluorescence may be caused in part by the dissociation of metal ions or the selective degradation of iron-containing melanin.

As the most common pitfall in diagnosing adrenal cortical carcinoma is mistaking it for pheochromocytoma or vice versa, GATA3 may be useful in narrowing the differential diagnosis as a part of a panel of immunohistochemical markers. However, occasional GATA3 expression in the most common source of metastases within the adrenal gland, metastatic pulmonary adenocarcinoma, may confound the diagnosis due to the overlapping expression with pheochromocytoma and other carcinomas.

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(Background) Radiation failure for localized prostate cancer is seen in 20–60% of patients who do not undergo extirpative surgery. Though potentially curative, salvage prostatectomy (SS) has not been frequently performed historically due to high rates of complications and postoperative incontinence. With the advent of robotic-assisted radical prostatectomy, these rates appear to be improved. Retzius-sparing approaches have additionally been shown to improve continence outcomes in the index setting, and may further improve continence outcomes in salvage cases while maintaining oncologic integrity. (Methods) We performed a literature review and qualitative analysis of published papers on salvage Retzius-sparing robotic-assisted radical prostatectomy (SRS). Three studies met criteria and were included in analysis. (Results) There were more patients with Gleason Grade Group 1 disease after initial treatment in the SRS group vs. SS (22% vs. 8%). Patients most frequently underwent external beam radiation therapy in both groups (52% vs. 49%). 30-day complication rates were 10% and 26% for SRS and SS, respectively. Continence outcomes were significantly improved in SRS with 59% of continence (based on study criteria) compared to 38% in SS. Time to continence was similarly improved for SRS. Positive surgical margins and biochemical recurrence were not significantly different between SRS and SS in any study. (Conclusions) SRS is a safe and feasible option for salvage treatment of localized prostate cancer and may improve postoperative continence outcomes. Positive surgical margin and biochemical recurrence rates are similar to those reported in SS.

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healing promoting wrap of decellularized umbilical tissue, and a retrosigmoidal ileal conduit reconstruction to alleviate left ureteral tension.METHODS: We retrospectively reviewed patients with bladder cancer undergoing robotic-assisted radical cystectomy (RARC) and intracorporeal ileal conduit in our center by the same urologist (MMS) from December 2015 to June 2020. Patients were divided into two groups based on the ileal conduit reconstruction (multi-modal retrosigmoidal conduit or standard conduit with optional use of fluoroscence imaging/wound-healing promoting wrap). Patients demographics, postoperative complications and UEA status were collected and compared between groups. KM curves were used to evaluate the UEA stricture between groups.RESULTS: 52 patients received RARC and intracorporeal ileal conduit and 45 had been followed up, with 25 in the standard group and 20 in the retro-sigmoidal group. Most variables were comparable between groups. With a median follow-up time of 19 months (IQR 6-36) in standard group vs 8 months (IQR 4.75-11.5) in retro-sigmoidal group, the global UEA stricture rates were 34.8% vs 0% in the retrosigmoidal group (p[0.009, Figure 1). The left UEA stricture rate was 24% in standard group and the right UEA stricture rate was 16% in standard. Among the 10 benign UEA strictures (per ureter), the median time of stricture formation was 6months (IQR 3-8.5). The postoperative 30-day, 90-day complication rate, and 30-day readmission rate were comparable between groups.CONCLUSIONS: The use of this multi-modal retro-sigmoidal ileal conduit technique in RARC may reduce the UEA stricture rate. Further studies with larger cohorts are needed to validate this finding as well as help elucidate if some components of the multi-modal intervention are most important.