It is evident that epigenetic factors, especially DnA methylation, have essential roles in obesity development. Here, using pig as a model, we investigate the systematic association between DnA methylation and obesity. We sample eight variant adipose and two distinct skeletal muscle tissues from three pig breeds living within comparable environments but displaying distinct fat level. We generate 1,381 Gb of sequence data from 180 methylated DnA immunoprecipitation libraries, and provide a genome-wide DnA methylation map as well as a gene expression map for adipose and muscle studies. The analysis shows global similarity and difference among breeds, sexes and anatomic locations, and identifies the differentially methylated regions. The differentially methylated regions in promoters are highly associated with obesity development via expression repression of both known obesity-related genes and novel genes. This comprehensive map provides a solid basis for exploring epigenetic mechanisms of adipose deposition and muscle growth.

Renal cortical tumors have distinct histological subtypes with varying degrees of metastatic potential. Conventional clear cell RCC, which comprises two thirds of renal cortical tumors presenting with localized disease, has a less favorable outcome when compared with papillary and chromophobe RCC. Controlling for size and stage, chromophobe, and not papillary, RCC was a significant variable for disease progression compared with conventional clear cell RCC. Knowledge of renal cortical tumor histological subtype is critical for projecting prognosis, tailoring follow-up strategies, and designing clinical trials.

Purpose-We reviewed indications and outcomes in patients undergoing ileal ureter replacement for ureteral reconstruction. December 1989 and September 2007, 105 patients underwent ileal ureter replacement, of whom 14 were excluded from study due to incomplete data. The remaining 91 patients (99 renal units) comprised the study cohort. Materials and Methods-BetweenResults-Mean patient age was 46.8 years and mean followup was 36.0 months. Indications for an ileal ureter were stricture following genitourinary surgery in 29 cases (31.9%), radiation induced stricture in 17 (18.7%), nonurological surgery iatrogenic injury in 16 (17.6%) and retroperitoneal fibrosis in 11 (12.1%). Only 4 patients (4.4%) had primary ureteral cancer. Long-term complications included anastomotic stricture in 3 patients (3.3%) and fistula in 6 (6.6%). Serum creatinine decreased or remained stable in 68 patients (74.7%) and hyperchloremic metabolic acidosis developed in 3. No patient complained of excessive urinary mucous production.Conclusions-In 68.1% of patients indications for an ileal ureter included radiation induced stricture or iatrogenic injury. The ileal ureter is a reasonable option for long-term ureteral reconstruction with preserved renal function in carefully selected patients. Keywordsureter; ileum; reconstructive surgical procedures; iatrogenic disease SINCE its first description in 1906 by Shoemaker 1 and later popularization by Goodwin et al in the late 1950s, 2 the use of ileal segments for ureteral substitution has become a valuable procedure in reconstructive urology. Although it was initially described for tubercular obstruction, recent decades have seen the indications for its use broaden. We report a contemporary series representing changes in indications, patient selection and clinical outcomes. PATIENTS AND METHODS Study DesignAfter receiving institutional review board approval we retrospectively analyzed the records of all patients who underwent ileal ureter replacement at

BACKGROUND. Traditionally, postchemotherapy (PC) surgery for metastatic nonseminomatous germ cell tumor (NSGCT) has used a full bilateral retroperitoneal lymph node dissection (RPLND) from the crus of the diaphragm to the bifurcation of the common iliac arteries, from ureter to ureter. With the primary landing zone well defined in low‐volume retroperitoneal disease, the authors performed modified dissections in the PC setting in a select population; and, herein, they report disease outcome. METHODS. From 1991 to 2004, a retrospective review of the testicular cancer database at the authors' institution was performed to identify patients with NSGCT, normal serum tumor markers after cisplatin‐based chemotherapy, and residual retroperitoneal tumor who underwent modified PC‐RPLND. All patients had metastatic disease at initial presentation that was limited to the primary landing zone (left or right). RESULTS. One hundred patients were identified, including 43 who underwent a right modified template, 18 patients who underwent a left full modified template, and 39 patients who underwent a left modified template. Pathology revealed cancer in 2% of patients, teratoma in 62% of patients, and necrosis in 36% of patients. The 2‐ and 5‐year disease‐free survival rate was 95%, and the median follow‐up was 31.9 months (range, 1–152 months). Four patients developed recurrent disease with a median time to recurrence of 8.25 months (range, 6–11 months). All recurrences were outside the boundaries of a full bilateral RPLND. CONCLUSIONS. Selected patients at PC surgery can be managed with modified PC‐RPLND. Cancer 2007. © 2007 American Cancer Society.