Parameters affecting prognosis after hemodialysis withdrawal: experience from a single center

Clinical and Experimental Nephrology - Withdrawal from maintenance hemodialysis is unavoidable in some patients due to their poor general condition; however, their survival days vary depending on...     

Mortality outcomes and clinical background of children on maintenance dialysis without receiving kidney transplantation

Clinical and Experimental Nephrology - Some pediatric patients on maintenance dialysis may need end-of-life care in the future because of being excluded from the indication of kidney...     

p37 Induces tumor invasiveness

Previous studies have shown a statistically significant correlation between human carcinomas and monoclonal antibody detection of a Mycoplasma hyorhinis-encoded protein known as p37. A potential mechanism of p37 is that it might promote invasion and metastasis. Recombinant p37 enhanced the invasiveness of two prostate carcinoma and two melanoma cell lines in a dose-dependent manner in vitro, but did not have a significant effect on tumor cell growth. Furthermore, the increased binding to cell surfaces and the enhanced invasive potential of cancer cells from exposure to p37 could be completely reversed by preincubation of the cancer cells with an anti-p37 monoclonal antibody. Sequence comparisons, followed by three-dimensional molecular modeling, revealed a region of similarity between p37 and influenza hemagglutinin A, a sialic acid-binding protein that plays a critical role in viral entry. Binding of p37 to prostate carcinoma cells was found to be at least partially sialic acid dependent because neuraminidase treatment decreased this binding. Taken together, these observations suggest that M. hyorhinis can infect humans and may facilitate tumor invasiveness via p37. These results further suggest that p37 may be a molecular target for cancer therapy.     

Diagnosis of early colorectal cancer invasion depth by quantitative evaluation of the basal indentation in CT colonography

Objective

To investigate the feasibility of diagnosing the invasion depth of early colorectal cancer (CRC) by quantitatively evaluating the basal indentation (BI)—i.e., the intestinal lateral deformity—in CT colonography (CTC).

Materials and methods

34 early CRCs (13 Tis CRCs and 21 T1 CRCs) in 32 patients who underwent a preoperative CTC were retrospectively examined. Two radiologists calculated the depth of the BI on a computed tomographic air-contrast enema (CT enema) image, the depth of the BI due to the geometric function (BI-G) on a cross-sectional multiplanar reconstruction (CS-MPR) image, and the ratio of the BI to the BI-G (i.e., the “BI ratio”) for each lesion. The BI ratios of the Tis and T1 CRCs were compared.

Results

The BI ratios were significantly higher in the T1 CRCs than in the Tis CRCs (p < 0.0001). The optimum cutoff value of the BI ratio for differentiating the T1 CRCs from the Tis CRCs was 1.64, with a sensitivity, specificity, and area under the curve of 90.5 %, 100 %, and 0.974, respectively.

Conclusions

We have demonstrated for the first time that quantitatively evaluating the BI can improve the accuracy of diagnosis of early CRC invasion depth.

     

Chemoradiotherapy for patients with recurrent lymph-node metastasis or local recurrence of gastric cancer after curative gastrectomy

Objectives

Whether chemoradiotherapy (CRT) is clinically beneficial for the management of postoperative recurrence of advanced gastric cancer remains unclear. We retrospectively studied treatment outcomes in patients who had unresectable localized recurrence after surgery for advanced gastric cancer and evaluated the safety and efficacy of CRT.

Methods

The study group comprised 21 patients who received concurrent CRT for unresectable localized recurrence after undergoing R0 resection for stage II/III advanced gastric cancer. Localized recurrence was defined as a few or limited recurrent lesions.

Results

The recurrence pattern was anastomotic recurrence in 7 patients, abdominal lymph-node recurrence in 12, and anastomotic recurrence plus abdominal lymph-node recurrence in 2. The median total dose of radiotherapy was 48.6 Gy (range 39.6–56.0), and the CRT completion rate was 100 % (21 of 21 patients). CRT-related grade 3 or higher toxicity comprised neutropenia in 33.3 % of patients and anorexia in 9.5 %. The response rate was 61.9 % (complete response 38.1 %, partial response 23.8 %). The median overall survival was 35.0 months.

Conclusions

We conclude that CRT may become one treatment strategy for the management of unresectable localized recurrence after curative resection of advanced gastric cancer.

     

A case of tubulocystic carcinoma of the kidney with aggressive features

Tubulocystic carcinoma of the kidney is rare and typically indolent. Our case involved an aggressive tubulocystic carcinoma as well as the radiological confirmation of its relation to papillary renal cell carcinoma. A 46-year-old male presented with renal multiloculated cysts with a solid part. On computed tomography and magnetic resonance imaging, the solid part showed the characteristics of papillary renal cell carcinoma. Contrast enhancement of the solid part was fluffy and sparse because of the coexistence of cysts. Perirenal fat invasion resulted in exophytic cysts, and renal-hilar cystic lymph node metastasis existed. The histopathological diagnosis was tubulocystic carcinoma associated with areas of papillary renal cell carcinoma and poorly differentiated carcinoma with metastasis. Our case suggests that the solid part enhancement of tubulocystic carcinoma tends to be fluffy and sparse, and exophytic cysts and cystic lymph nodes may show radiologically aggressive findings.     

SUV<Subscript>max</Subscript> on FDG-PET is a predictor of prognosis in patients with maxillary sinus cancer

Purpose

Our aim was to determine whether the maximum standardized uptake value (SUV_max) of the primary lesion demonstrated by [¹⁸F]-fluoro-2-deoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) is associated with the prognosis of maxillary sinus cancer.

Materials and methods

The relationships of clinicopathological factors including age, T stage, N stage, histologic type, treatment strategy, and primary tumor SUV_max with progression-free (PFS) and overall (OS) survival were evaluated using the log-rank test and Cox method in 31 patients with maxillary sinus cancer before combined superselective intra-arterial chemotherapy using high-dose cisplatin with concurrent radiotherapy, or radiotherapy alone.

Results

The median duration of follow-up was 55.4 (range 9.7–72.6) months. PFS and OS of patients exhibiting a high SUV_max (≥16 and ≥17, respectively) for the primary tumor were significantly lower than those of patients for whom the primary tumor SUV_max was low (p = 0.0010 and p = 0.033, respectively). Multivariate analyses showed that T stage (p = 0.0049) and primary tumor SUV_max (p = 0.026) were independently prognostic of poorer PFS and that only primary tumor SUV_max (p = 0.049) was independently prognostic of poorer OS.

Conclusion

SUV_max of the primary tumor determined by FDG-PET/CT before treatment could be a good surrogate marker for prognostication of maxillary sinus cancer.

     

Laparoscopic repair of bladder rupture in a neonate

Bladder rupture in a fetus is a rare occurrence. We report the first neonatal case of laparoscopic repair for prenatally diagnosed bladder rupture. A male neonate, who had presented with megacystis, bilateral hydronephrosis and hydroureters since 27 weeks‐of‐gestation, was delivered by emergency cesarean section because of sudden collapse of the bladder with massive ascites at 37 weeks‐of‐gestation. The diagnosis of bladder rupture was made by retrograde urethrocystography. Laparoscopic repair was carried out subsequent to urethral catheterization. Intraoperatively, laceration from the left side of the bladder dome to the posterior wall was observed. This tear was successfully repaired using a two‐layer interrupted suture without any postoperative complications. Laparoscopic repair could be the treatment of choice for bladder rupture, because it has the advantage of closure of the perforated site more certainly than bladder decompression alone, and with better cosmesis than open repair.