Jennifer Gordetsky

University Center Rochester, Rochester, Minnesota, United States

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Publications (26)60.98 Total impact

  • Jennifer Gordetsky, Ronald Rabinowitz
    Urology 10/2014; 84(4):737-9. · 2.42 Impact Factor
  • Journal of nephrology 12/2013; 26(Suppl. 22):192-197. · 2.02 Impact Factor
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    ABSTRACT: It remains unanswered whether and how intraoperative frozen section analysis contributes to the surgical margin status on radical prostatectomy specimens. We aimed to determine whether frozen section analysis during radical prostatectomy reduces the incidence of positive surgical margins. We retrospectively analyzed a consecutive series of patients undergoing robot-assisted laparoscopic radical prostatectomy performed at our institution between 2004 and 2011. We identified 2608 cases, including 1128 (43.3%) where intraoperative frozen section analysis was performed to assess surgical margins. Of the cases with positive (n = 60; 5.3%)/negative (n = 1029; 91.2%)/atypical or indeterminate (n = 39; 3.5%) frozen section analyses, 22 (36.7%)/83 (8.1%)/4 (10.3%) were found to have positive surgical margins on radical prostatectomy specimens, respectively. Thus, 109 (9.7%) of 1128 cases with frozen section analysis had positive surgical margins, compared with 163 (11.0%) of 1480 cases with no frozen section analysis (P = .264). When the patients were subgrouped by histopathologic characteristics, frozen section analysis led to a considerable reduction in the rate of positive surgical margins in cases with biopsy Gleason score 7 (12.4% → 8.7%; P = .087)/8 (28.6% → 16.3%; P = .048)/≥7 (15.3% → 10.1%; P = .012) tumor or pT3b (36.6% → 23.2%; P = .075)/≥pT3b (38.1% → 25.4%; P = .091) disease. Multivariate analysis further revealed that performing frozen section analysis in biopsy Gleason score 7 or higher tumors was an independent predictor of negative surgical margins (odds ratio, 0.61; P = .018). In addition, frozen section analysis of the distal urethra or apex of the prostate (7.5%, P = .035) as well as multiple negative frozen section analyses (≥2: 6.2%, P = .001; ≥4: 2.2%, P = .007) correlated with significantly lower rates of positive surgical margin, compared with no frozen section analysis. Overall, intraoperative frozen section analysis did not dramatically change surgical margin status of radical prostatectomy. Nonetheless, it could be useful in preventing incomplete tumor resection, especially in men with high-grade (Gleason score ≥7) tumor at the apex.
    Human pathology 04/2013; · 3.03 Impact Factor
  • Jennifer Gordetsky, Philip Katzman, Hani Rashid
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    ABSTRACT: A 17-year-old boy presented for evaluation of an abdominal mass. Imaging revealed a 12.5-cm left upper pole renal mass. Biopsy demonstrated a malignant neoplasm consistent with blastemal-type Wilms tumor. The patient received neoadjuvant chemotherapy followed by laparoscopic radical nephrectomy. Examination revealed an unremarkable kidney uninvolved by tumor abutted by a 7.3 cm encapsulated mass. Histology revealed a triphasic Wilms tumor (nephroblastoma) with favorable histology. This tumor was classified as a juxtarenal Wilms tumor, a rare form of extrarenal Wilms tumor, with only 7 cases described in the literature. We present the first case of a juxtarenal Wilms tumor described in an adolescent.
    Urology 08/2012; 80(4):922-4. · 2.42 Impact Factor
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    ABSTRACT: Semenogelins and eppin are seminal plasma proteins that form a complex and inhibit sperm motility. However, the role of these proteins in prostate cancer is poorly understood. We immunohistochemically stained for semenogelins I and II and eppin in 291 radical prostatectomy specimens. We then evaluated the association between their expressions in nuclei, cytoplasms, or intraluminal secretions of benign/high-grade prostatic intraepithelial neoplasia/carcinoma cells and clinicopathologic profile available for our patient cohort. Stains were positive in 32%/77%/84% (nuclear semenogelin I), 87%/94%/84% (nuclear semenogelin II), 56%/64%/37% (nuclear eppin), 7%/15%/11% (cytoplasmic semenogelin I), 6%/11%/9% (cytoplasmic semenogelin II), 68%/74%/95% (cytoplasmic eppin), 97%/98%/13% (secreted semenogelin I), 98%/97%/11% (secreted semenogelin II), and 97%/98%/48% (secreted eppin) of benign/prostatic intraepithelial neoplasia/carcinoma, respectively. The levels of nuclear semenogelin I/cytoplasmic eppin were significantly higher in carcinoma than in benign (P < .001/P < .001) or prostatic intraepithelial neoplasia (P < .001/P < .001) and in prostatic intraepithelial neoplasia than in benign (P < .001/P = .006). Significantly higher nuclear semenogelin II expression was found in prostatic intraepithelial neoplasia than in benign (P < .001) or carcinoma (P < .001). Significantly lower nuclear eppin expression was seen in carcinoma than in benign (P < .001) or prostatic intraepithelial neoplasia (P < .001). Secreted semenogelin I, secreted semenogelin II, and secreted eppin were all significantly lower in carcinoma than in benign (P < .001) or prostatic intraepithelial neoplasia (P < .001). There were no statistically significant correlations between each stain and clinicopathologic features except significantly lower nuclear eppin expression in Gleason score 8 or higher tumors. Kaplan-Meier and log-rank tests further revealed that patients with nuclear semenogelin I-positive tumor had a significantly higher risk for biochemical recurrence (P = .046). Multivariate Cox model showed a trend toward significance (P = .093) in nuclear semenogelin I positivity as an independent predictor for recurrence. These results suggest that nuclear semenogelin I expression could be a reliable prognosticator in men who undergo radical prostatectomy.
    Human pathology 05/2012; 43(11):1991-2000. · 3.03 Impact Factor
  • Bonnie Choy, Jennifer Gordetsky, Hiroshi Miyamoto
    European Urology 05/2012; 62(2):354-5. · 10.48 Impact Factor
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    ABSTRACT: To investigate the role of frozen section assessment in sparing unnecessary orchiectomy for suspected lesions, we retrospectively reviewed intraoperative testicular and paratesticular frozen section assessments performed at our institution between the years 1993 and 2010. Frozen section assessments were performed on 45 testicular lesions (age, 5-60 [mean, 32.2] years; lesion size, 0.5-9.7 [mean, 2.1] cm) and 20 paratesticular lesions (age, 26-76 [mean, 43.5] years; lesion size, 0.4-11.0 [mean, 2.8] cm) before the decision to complete radical orchiectomy. Benign/malignant frozen section assessment diagnoses were reported in 26/19 testicular cases and 17/3 paratesticular cases, respectively. Of the 26 benign testicular frozen section assessments, 5 cases resulted in orchiectomy, where permanent diagnoses included epidermoid cyst, large cell calcifying Sertoli cell tumor, fibrous pseudotumor, abscesses, and sarcoidosis, caused by a concern for potential malignancy or questionable viability of the testicles. Of the 19 malignant testicular frozen section assessments, orchiectomy was performed in 16 cases with germ cell tumor, but not in the remaining 3 cases with lymphoma. Of the 17 benign paratesticular frozen section assessments, 2 cases, both fibrous pseudotumors, resulted in orchiectomy. There were statistically significant differences in the size of the testicular (P < .001) or paratesticular (P < .001) lesions between benign and malignant frozen section assessments. Thus, in 36 (83.7%) of 43 cases with benign frozen section assessments, in addition to all 3 cases of lymphoma, orchiectomy was successfully avoided. These results suggest that frozen section assessment is useful for permitting testicular preservation, especially in men with small, nonpalpable, incidentally found masses as well as other benign lesions where a clinical diagnosis of malignancy is in doubt.
    Human pathology 03/2012; 43(9):1514-9. · 3.03 Impact Factor
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    ABSTRACT: No abstract available.
    Urologia Internationalis 01/2012; 88(2):247-8. · 1.07 Impact Factor
  • Jennifer Gordetsky, Edwin van Wijngaarden, Jeanne O'Brien
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    ABSTRACT: Study Type - Diagnostic (validating cohort). Level of Evidence 2a. What's known on the subject? and What does the study add? FSH is a hormone released by the anterior pituitary gland via stimulation from gonadotrophin-releasing hormone and potentially other factors. FSH reflects the status of spermatogenesis (i.e. the ability to produce sperm) as a result of the feedback between the testis and hypothalamus/pituitary glands. An elevated FSH level is indicative of abnormal spermatogenesis and may indicate primary testicular failure. The range for 'normal' FSH varies somewhat between institutions but has been defined by the Strong Memorial Hospital (Rochester, NY, USA) clinical laboratory as 1.4-18.1 IU/L based on the ADVIA Centaur (Siemens Medical Solutions, Tarrytown, NY, USA) FSH assay. The findings obtained in the present study could be helpful for predicting male factor infertility in patients with a borderline high FSH level (≈4.5 IU/L) and a low testosterone level compared to someone with a borderline high FSH level and a normal testosterone level. Although the 'normal' range for FSH is qualified as a value in the range 1.4-18.1 IU/L, the present study shows that an FSH level >4.5 IU/L was associated with abnormal semen analysis in terms of morphology and sperm concentration in the present patient population. Therefore, these findings suggest that FSH values lower than those currently considered normal may be associated with abnormal semen analysis, and that the 'normal' range for FSH used in clinical settings may need to be reconsidered. • To examine the correlation between follicle-stimulating hormone (FSH) and testosterone/FSH levels with semen analysis parameters to evaluate whether the range for judging normal FSH levels should be reconsidered. • The present study included 610 male infertility patients from a single urology infertility clinic between 2004 and 2008. • Patients (n=153) were excluded for obstructive azoospermia, hypogonadotrophic hypogonadism, steroid use or failure to complete testing. • Abnormal semen analysis values were based on the WHO 1999 criteria. • We performed t-tests, anova, chi-squared tests and logistic regression to statistically examine the association between the FSH (or testosterone/FSH ratio) level and semen parameters. • The FSH level showed statistically significant associations, as well as evidence of a dose response, with abnormal sperm concentration and morphology but not with semen volume. • In men with FSH levels >7.5 IU/L, the risk of abnormal semen quality was five- to thirteen-fold higher than that of men with FSH levels <2.8 IU/L depending on the specific semen parameter. • Similarly, semen parameters were had a greater probability of being abnormal with decreasing testosterone/FSH ratios. • A significantly increased risk of abnormal semen analyses among men with FSH levels >4.5 IU/L and decreasing testosterone/FSH ratios suggests that redefining normal FSH in infertile men would be valuable.
    BJU International 12/2011; 110(4):568-72. · 3.05 Impact Factor
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    ABSTRACT: Lymph node count has prognostic implications in bladder cancer patients who are treated with radical cystectomy. Lymph nodes that are too small to identify grossly can easily be missed, potentially leading to missed nodal metastases and inaccurate nodal counts, resulting in inaccurate prognoses. We investigated whether there is a benefit to submitting the entire lymph node packet for histological examination to identify additional lymph nodes. We prospectively assessed 61 pelvic lymphadenectomy specimens in 14 consecutive patients undergoing radical cystectomy. The specimens were placed in Carnoy's solution overnight, then analyzed for lymph nodes. The residual tissue was entirely submitted to assess for additional lymph nodes. In 61 specimens, we identified 391 lymph nodes, ranging from 4-44 nodes per patient. We identified 238 (61%) lymph nodes with standard techniques and 153 (39%) lymph nodes in submitted residual tissue. The number of additional lymph nodes found in the residual tissue ranged from 0 to 26 (0-75%) per patient. These lymph nodes ranged in size from 0.05 to 1 cm. All additional lymph nodes were negative for metastatic disease. Submitting the entire specimen for histological examination allowed for identification of more lymph nodes in radical cystectomy pelvic lymphadenectomy specimens. However, as none of the additional lymph nodes contained metastatic disease, it is unclear if there is a clinical benefit in evaluating lymph nodes that are neither visible nor palpable in lymphadenectomy specimens.
    Modern Pathology 09/2011; 25(1):140-4. · 5.25 Impact Factor
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    ABSTRACT: Fibrous pseudotumours of the testicular and paratesticular tissues are fibroinflammatory reactive lesions that can clinically mimic neoplasms. Very little is known about the role of frozen section analysis (FSA) for these lesions in terms of intraoperative surgical management. We recently experienced 5 patients with testicular/paratesticular fibrous pseudotumours in whom frozen sections were used to demonstrate its non-neoplastic nature prior to the decision for radical surgery. In 2 cases, FSA resulted in testicular-sparing surgery. In contrast, the remaining 3 cases ultimately underwent radical orchiectomy, due to questionable viability of the testicle involved by inflammatory/infiltrative lesions and in 1 case a slight possibility of lymphoproliferative malignancy. Urologists should be aware of this entity and its gross features, such as firm masses and diffuse fibrous proliferation encasing the testicle to help determine intraoperative management. In select cases, intraoperative FSA is helpful in obviating radical orchiectomy.
    Canadian Urological Association journal = Journal de l'Association des urologues du Canada 08/2011; 5(4):E47-51. · 1.66 Impact Factor
  • Urology 07/2011; 78(1):237. · 2.42 Impact Factor
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    ABSTRACT: Little is known about the role of semenogelins, seminal plasma proteins that play critical roles in semen clotting and subsequent liquefaction in the presence of zinc and prostate-specific antigen, in human malignancies. We investigated the expression of semenogelins in four human prostate cancer lines by RT-PCR and Western blotting as well as in 70 radical prostatectomy specimens by immunohistochemistry. Effects of semenogelin overexpression on prostate cancer cell proliferation were also assessed. mRNA/protein signals for semenogelins I (SgI) and II (SgII) were detected only in androgen-sensitive LNCaP cells cultured with zinc. Transfection of SgI/SgII increased/decreased cell growth of androgen receptor (AR)-positive/semenogelin-negative CWR22Rv1 in the presence of zinc, whereas it showed marginal effects in AR-negative/semenogelin-negative PC-3 and DU145. Immunohistochemical studies showed that SgI and SgII stain positively in 55 (79%) and 31 (44%) cancer tissues, respectively, which was significantly higher than in corresponding benign tissues [SgI-positive in 13 (19%) cases (P < 0.0001) and SgII-positive in 15 (21%) cases (P = 0.0066)]. Among the histopathological parameters available for our patient cohort, there was an inverse association only between Gleason score (GS) and SgII expression (GS ≤ 7 vs. GS ≥ 8: P = 0.0150; GS7 vs. GS ≥ 8: P = 0.0111). Kaplan-Meier and log-rank tests further revealed that patients with SgI-positive/SgII-negative tumor have the highest risk for biochemical recurrence (P = 0.0242). These results suggest the involvement of semenogelins in prostate cancer and their prognostic values in predicting cancer progression after radical prostatectomy. Additional functional analyses of semenogelins are necessary to determine their biological significance in prostate cancer.
    The Prostate 07/2011; 71(10):1108-14. · 3.84 Impact Factor
  • The Journal of Urology 04/2011; 185(4). · 3.75 Impact Factor
  • Journal of Urology - J UROL. 01/2011; 185(4).
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    ABSTRACT: The discovery of local anesthesia revolutionized urologic surgery. We investigate the evolution of intraurethral anesthesia in urologic surgery beginning in 1884. A review of the literature was performed, reviewing the history of local anesthesia for urologic surgery, with a specific emphasis on intraurethral anesthesia. Using the University of Rochester libraries catalog "Voyager," a search was performed reviewing the primary literature published on intraurethral anesthesia beginning from 1884 through 2009. We also reviewed published literature in Ovid Med and PubMed for articles relevant to the topic of intraurethral anesthesia. The search terms were intraurethral, cocaine, lidocaine, and anesthesia. In the 1840s, it was demonstrated that ether, nitrous oxide, and chloroform could prevent the pain of surgery, resulting in a dramatic increase in surgery. At Massachusetts General Hospital between 1845 and 1847, surgeries increased 2.5-fold. Four decades later, it was demonstrated that cocaine allowed for adequate analgesia without the side effects of general anesthesia, resulting in a dramatic increase in urologic surgery. Cocaine was gradually replaced as an intraurethral anesthetic as safer local anesthetics, such as lidocaine, became introduced. Modern studies show conflicting results over the efficacy and ideal administration of intraurethral anesthetics. Local anesthesia was rapidly accepted by urologists around the world and used in a wide variety of urologic surgeries, contributing to the acceptance of anesthesia and a revolution of the practice of surgery. To this day, intraurethral anesthesia continues to be a widely used and effective technique in urology, although the ideal method of use is largely left up to individual preference.
    Urology 01/2011; 77(1):12-6. · 2.42 Impact Factor
  • Journal of Urology - J UROL. 01/2011; 185(4).
  • Journal of Urology - J UROL. 01/2011; 185(4).
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    ABSTRACT: Wine is one of the oldest documented medicinal remedies, dating back thousands of years. We explore the medicinal uses of wine, with a focus on the treatment of genitourinary disease, beginning in ancient Egypt, India, and Israel, and then moving forward to include Greek, Roman, and Arabic medicine. Our review continues into the Middle Ages and renaissance, and finally evaluates the medicinal properties of wine as we understand them in our current scientific paradigm and its specific application to urology. A review of the literature was completed, reviewing the medical theories and medicinal uses of wine from ancient civilization to the present. Wine has been used in the treatment of genitourinary disease for thousands of years. This agent has been employed by physicians in nearly all cultures and in all eras of medical history. Medical uses include, but are not limited to, appetite stimulant, anesthetic, tonic, antiseptic, vasodilator, diuretic, antibacterial agent, and diaphoretic. The physiologic properties and value of this ancient medicine continue to be studied today. The medicinal use of wine has common applications over thousands of years and multiple civilizations. The pharmacologic and physiologic properties of this agent continue to be studied and applied in the modern era and continue to be relevant in the field of urology.
    The Canadian Journal of Urology 02/2010; 17(1):5017-21. · 0.74 Impact Factor
  • Journal of Urology - J UROL. 01/2010; 183(4).

Publication Stats

46 Citations
60.98 Total Impact Points

Institutions

  • 2008–2013
    • University Center Rochester
      • Department of Urology
      Rochester, Minnesota, United States
  • 2011–2012
    • University of Rochester
      • Department of Pathology and Laboratory Medicine
      Rochester, NY, United States