STK11-mutated non–small cell lung cancers (NSCLC) show distinct clinicopathologic features, often with co-occurring KRAS and TP53 mutations that drive more aggressive disease. This study investigates the mutational landscape and clinical characteristics of STK11-mutated lung adenocarcinomas. We retrospectively reviewed 1,068 primary lung cancer cases from 2018 to 2022, identifying 14 STK11-mutant lung adenocarcinomas. We collected clinicopathologic data (demographics, histology, treatment), performed genomic profiling for co-mutations, and used immunohistochemistry to evaluate associated phenotypes. Patients with STK11 mutations (median age 67) were predominantly male smokers. KRAS or TP53 co-mutations appeared in 50
In the fall of 1926, a 40-year-old physician was admitted to Mayo Clinic with worsening bouts bouts of faintness and paraesthesias associated with missed meals and physical exertion and which could be prevented by food or sweet drinks. Given that the symptoms were similar to an insulin overdose, the patient wanted his "spontaneous hyperinsulinism" evaluated. The dedicated team of R.M. Wilder, F.N. Allan, M.H. Power and H.E. Robertson investigated of Langerhans. Upon surgical exploration by Dr. W.J.Mayo, the body and tail of the pancreas were found to have multiple tumors, and there were liver metastases. The disease was unresectable, and the patient died one month after surgery. Pathology revealed the tumor cells to be consistent with carcinoma of the Islets of Langerhans. Extracts dervied from the liver metastases lowered blood glucose in rabbits, proving the metastases were from the insulin-producing carcinoma. Thus, Wilders, et al. published the first report of an insulinoma in 1927. One century later, insulinomas remain fascinating and challenging. In commemoration of one century of insulinoma-related clinical and basic research, this narrative review describes key breakthroughs and presents, by means of seven case studies, the clinical spectrum of insulinomas and their clinical courses, from benign to fatally malignant.
BACKGROUND:EUS-guided gastroenterostomy (EUS-GE) is an effective option for the management of gastric outlet obstruction (GOO). Due to the poor prognosis of patients undergoing it, data on its long-term adverse events (AE) is scarce. Herein, we describe a cohort of patients with gastro-entero-colic fistula (GECF) as a late AE of previously successful EUS-GE. METHODS:Patients who developed a GECF after EUS-GE from 10 high-volume centers were analyzed. Information collected included demographic characteristics, indications, clinical and technical success rates, stent type and size, fistula characteristics, management, and outcomes. RESULTS:Sixteen cases were identified. The mean interval from index EUS-GE to the diagnosis of GECF was 4 to 8 weeks. The most common cause of GOO was pancreatic adenocarcinoma (PDAC). The transverse colon was the most common site for the GECF (14 patients). A 20×10 mm lumen apposing metal stent (LAMS) was utilized in 10 patients. Endoscopic management with a variety of modalities was successful in 13 cases. Follow-up interval after endoscopic management of the fistula averaged 2 to 4 weeks. At the time of the manuscript elaboration, 10 patients had died, 5 were alive, and 1 was lost to follow-up. CONCLUSIONS:This is the first description of a cohort of patients with GECF after EUS-GE. The exact mechanisms leading to GECF in these cases are unknown. Possible explanations include inadvertent colon puncture during the index procedure and/or entrapment of mesocolon. More data is needed to further characterize this AE.
INTRODUCTION AND OBJECTIVE:Past successful approaches to quantitative laryngoscopy relied on research prototypes and laser-add-ons which were not approved as medical devices, preventing the acquisition of quantitative laryngoscopic data in routine-diagnostics and complicating large-scale studies. We present a simple one-shot reference-grid calibration for a CE-marked stereo-laryngoscope commercially available for clinical use and validate it on an optical bench. METHODS:Using a 3D stereo-laryngoscope (XION GmbH, Berlin, Germany), we measured target distances (TD) of 2.5, 10, and 20 mm across working distances (WD) of 30, 45, 60, 75, and 90 mm in three runs, refocusing each time (30 measurements per target distance). A point-grid reference image with known spacing was captured. Relating each frame's stereo disparity to the reference grid yielded its px/mm scale. Precision was assessed as standard deviation (SD) of repeated measurements and accuracy was evaluated by Bland-Altman-analysis, reported as bias and 95% limits of agreement (LoA). RESULTS:Over all, measurements showed a SD of 1.0%, a small bias of -0.3% with LoA from -2.2% to +1.6%. Precision and accuracy remained stable across TD, indicating even measurement performance across the evaluated range. No relevant edge-of-field distortion was observed. CONCLUSIONS:The proposed calibration method for a commercially available, CE-marked, off-the-shelf stereo endoscope yields precise, submillimeter distance measurements and is adequate for clinical and scientific use in office-based transoral laryngoscopy, without custom hardware.
Background and objective:Postprostatectomy incontinence (PPI) reduces quality of life, yet remains undertreated despite effective surgical options. Persistently low intervention rates in Europe for PPI suggest a care gap. This study assessed patients' knowledge of surgical PPI treatments and barriers to treatment uptake. Methods:Cross-sectional baseline analysis of ProKontinenz trial. Men with persistent PPI for ≥12 mo after radical prostatectomy (≥2 pads/d, no prior incontinence surgery) from 34 certified prostate cancer centers were surveyed during January-June 2025, using validated questionnaires and 24-h pad test. The primary outcome was knowledge of incontinence surgery; secondary outcomes included information sources, treatment barriers, and associations with symptom burden/quality of life. Associations with knowledge were assessed using logistic regression. Key findings and limitations:A total of 526 of 692 men participated (90% response rate). Among the participants, common reasons for not considering incontinence surgery were satisfaction with incontinence products (79%), concerns about surgical risks (53%), and doubts about success of surgery (51%). Fifty-nine percent men reported no knowledge of surgical PPI treatment. Independent predictors of lacking knowledge were low urine loss (odds ratio [OR] 2.4, 95% confidence interval [CI] 1.3-4.7), less severe King's Health Questionnaire (KHQ)-score "role limitation" (OR 2.2, 95% CI 1.1-4.3), concerns about treatment success (OR 2.2, 95% CI 1.2-4.1), and missing information from the urologist (OR 4.2, 95% CI 1.1-16.7) or partner (OR 2.0, 95% CI 1.2-3.8). Limitations of the study include self-reported data and a nonvalidated definition of "knowledge." Conclusions and clinical implications:Among patients with PPI for ≥12 mo after radical prostatectomy, more than half did not have any knowledge of potentially effective surgery. Information deficits and symptom severity influence knowledge. Strengthening guideline-based information and clinician-patient communication may help close this gap.
