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Radio frequency ablation treatment success of the small renal mass is strongly correlated with tumor size. Radio frequency ablation provides excellent and durable outcomes, particularly in tumors smaller than 3 cm. Of tumors 3 cm or larger, approximately 20% will recur such that alternative treatment techniques should be considered. However, most treatment failures are local and are often successfully treated with another ablation session.

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Abbreviations : LPN , laparoscopic partial nephrectomy ; SRBS , self-retaining barbed suture.

SummaryMyxococcus xanthus is a gliding bacterium with a complex life cycle that includes swarming, predation and fruiting body formation. Directed movements in M. xanthus are regulated by the Frz chemosensory system, which controls cell reversals. The Frz pathway requires the activity of FrzCD, a cytoplasmic methyl-accepting chemotaxis protein, and FrzF, a methyltransferase (CheR) containing an additional domain with three tetra trico-peptide repeats (TPRs). CheR methylated FrzCD on three residues, E168, E175 and E182, indicating that the TPRs regulate sitespecific methylation. E168 and E182 were predicted consensus methylation sites, but E175 is methylated on an HE pair. To determine the roles of these sites in vivo, we substituted each methylatable glutamate with either an aspartate or an alanine residue and determined the impact of the point mutants on single cell reversals, swarming and fruiting body formation. Single, double and triple methylation site mutants revealed that each site played a unique role in M. xanthus behaviour and that the pattern of receptor methylation determined receptor activity. This work also shows that methylation can both activate and inactivate the receptor.

Objective• To examine the association of renal morphology with renal function after partial nephrectomy (PN). Patients and Methods• We conducted a multi-institutional retrospective analysis of 322 PNs performed between 2003 and 2011.• The RENAL nephrometry score for each lesion was determined and the estimated glomerular filtration rate (eGFR) was calculated preoperatively and at last follow-up.• We divided patients into two RENAL nephrometry score groups, low (<8) and high (Ն8), and analysed and compared the outcomes of each group. • The primary outcome was median change in eGFR between preoperative and last follow-up (DeGFR). The secondary outcome was eGFR <60 mL/min/1.73m 2 at last follow-up.• Multivariable analysis was conducted to evaluate the risk factors for eGFR <60 mL/min/1.73 m 2 at last follow-up. Results• The median (interquartile range) follow-up was 25.2 (13.5-39.3) months. Low (n = 165) and high (n = 157) RENAL score groups were well-matched for baseline eGFR. The median tumour size (4.2 vs 2.4 cm, P < 0.001) was greater for the high group.• In all, 64% of the low and 88.2% of the high RENAL score group (P < 0.001) had decreased eGFR at last follow-up.• Median eGFR was -7 for the low vs -13.8 mL/min/ 1.73 m 2 for the high group (P = 0.001); eGFR <60 mL/ min/1.73 m 2 at last follow-up was 27.3% for the low vs 37.6% for the high group (P = 0.057).• Linear regression analysis showed that for each 1-point increase in RENAL score, there was 2.5% decrease in eGFR (P = 0.002); for each 1-cm increase in tumour size, there was 1.8% decrease in eGFR (P = 0.013). Area under curve analyses showed no significant difference between RENAL score and tumour size for prediction of de novo eGFR <60 mL/min/1.73 m 2 (P = 0.920) and DeGFR Ն50% (P = 0.85).• Multivariable analysis showed that increasing RENAL score (odds ratio [OR] 1.24, P = 0.046) and decreasing preoperative eGFR (OR 1.10, P < 0.001) were risk factors for eGFR <60 mL/min/1.73 m 2 at last follow-up. Conclusions• Increasing RENAL nephrometry score is an independent risk factor for eGFR <60 mL/min/1.73 m 2 after PN.• RENAL nephrometry score may serve as an additional measure for risk stratification before PN, but further investigation is required.

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