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Preliminary experimental IRE trials safely ablated healthy canine and cancerous human prostates, as examined in the short- and medium-term. IRE-relevant prostate properties are now experimentally and numerically defined. Importantly, the electric field required to kill healthy prostate tissue is substantially higher than previously characterized tissues. These findings can be applied to optimize IRE prostate cancer treatment protocols.

High grade injury can be successfully managed conservatively. However, grade V injury and the need for platelet transfusion predict the need for emergency intervention while older patient age and hypotension predict complications.

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Objective• To detail the 9-year experience of renal trauma at a modern Level 1 trauma centre and report on patterns of injury, management and complications. Patients and methods• We analysed 338 patients with renal injuries who presented to our institution over a 9-year period.• Data on demographics, clinical presentation, management and complications were recorded. Results• Males comprised 74.9% of patients with renal injuries and the highest incidence was amongst those aged 20-24 years.• Blunt injuries comprised 96.2% (n = 325) of all the renal injuries, with road trauma being the predominant mechanism accounting for 72.5% of injuries.• The distribution of injury grade was; 21.6% grade 1 (n = 73), 24.3% grade 2 (n = 82), 24.9% grade 3 (n = 84), 16.6% grade 4 (n = 56), and 12.7% grade 5 (n = 43).• Conservative management was successful in all grade 1 and 2 renal injuries, and 94.9%, 90.7% and 35.1% of grade 3, 4 and 5 injuries respectively. • All but one of the 13 patients with penetrating injuries were successfully managed conservatively. Conclusions• Road trauma is the greatest cause of renal injury.• Most haemodynamically stable patients are successfully managed conservatively.

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Routine re-imaging in patients with renal trauma outside the initial 48-hour window in the absence of a clear clinical indication had little benefit and changed treatment in less than 1%.

OBJECTIVE. Theaimof thisstudywastoassess therolesof transrectal colorDoppler andgray-scale sonography in revealing prostatic cancer,using biopsy as the referencestandard. SUBJECTSAND METHODS. Twohundred fifty-sixpatients referred forurologic studies underwent transrectal sonography using gray-scale and color Doppler scanning. All abnor mal areas shown on gray-scale or color Doppler sonography or both were targeted and biopsies were performed. The patients also underwent random sextant biopsies. All biopsies were mdi viduallycorrelatedwith histopathologic findingsandall resultswereanalyzed. RESULTS.Cancer wasfoundonbiopsyin 100patients (39%),andequivocal sonographicresults or prostatic intraepithelial neoplasia was found in 22 other patients (9%). In 16 of the patients in whom cancer was detected, the tumors were correctly revealed only with color Dop pIer sonography.These 16patients had a meanGleason scoreof 6.4 (range, 5â€"8). Biopsy find ings in these 16 patients showed eight patients with extensive lesions, three with moderate lesions, and five with minimal lesions. However, in nine other patients with cancer (9% of can cers detected), both gray-scale and color Doppler sonography failed to reveal lesions that were found on sextant biopsy. An analysis showed that, although highly sensitive, color Doppler sonography wassomewhatlessspecificthangray-scalesonography. CONCLUSION. ColorDopplersonography should become a routinepartof transrectalsonography of theprostateglandto improvedetectionandtargetingoflesions.The practiceof performing random sextant biopsies should also continue. P rostatic cancer is the most common malignancy in the American male population. Although widely ac ceptedand usedin the diagnosisof prostatic cancer, transrectal sonography has limitations.Prostaticcarcinomasmay be isoechoicI 1] and consequently not visualized on gray-scale sonography. Conversely, the most common sonographic appearance for prostate carci nomaâ€"theperipheral zone hypoechoic le sionâ€"canalso, on histopathologic examination of biopsy specimens, be found to represent a be nign lesion [2, 31.Limitations such as these may be partly over come by advances in technique. Several reports To evaluate the role of color Doppler transrectal sonography in detecting prostatic cancer in referred urologic patients, we pro spectively compared its usefulness with that of gray-scale imaging (keeping in mind the role of sextant biopsies) and correlated the results with biopsy findings. Subjects and MethodsThe population in this study consisted of 256 consecutive patients referred by urologists during theperiodbetween April andSeptember 1996. The patientswere40â€"84 yearsold (meanage,64years). Forty-threepatients(17%) were referredbecauseof an abnormality found on digital rectal examination, I 17 (46%) because of a raised (or rising) level of prostate-specific antigen (PSA), 90 (35%) because of botha raisedlevelof PSAandanabnormality on