Colon cancer with isolated metastasis to the kidney at the time of initial diagnosis

Blood-borne metastases to the kidneys from solid tumors have received little attention in the medical literature because they usually occur in a setting of advanced systemic disease, and renal involvement is a elatively minor cause of symptoms. Although the frequency of metastases to the kidney in cancer patients is 7–13% in large autopsy series, incidental discovery of a renal metastasis as the first manifestation of a primary tumor is a very rare event. The most common primary malignancy to involve the kidney is bronchogenic carcinoma, followed by breast and gastrointestinal cancers. In this article, we report a patient with left colon cancer and isolated metastasis to the right kidney at the time of initial diagnosis. Left hemicolectomy and right nephrectomy were performed. Adjuvant systemic chemotherapy consisting of 5-fluorouracil (5-FU) and folinic acid (FA) was given. 5-FU and FA were stopped after four cycles because metastases to the lung and liver occurred about 3 mo after the surgery during adjuvant chemotherapy. Capecitabine was started. The patient died 9 mo after the discovery of the isolated renal metastasis. Nephrectomy is more for diagnostic clarification in the setting of synchronous primary because it has no effect on survival and its effect on quality of life is minimal; as seen in our case, the other organ metastases rapidly occur and the survival is limited. Nephrectomy may also compromise the choice of chemotherapy agents that require renal clearance, thus a careful evaluation of renal functions is necessary if a nephrectomy is performed. In the matter of a decreased renal clearance, the doses of these drugs should be decreased or the choice should be reevaluated.     

Spontaneous Pneumothorax in Children with Osteosarcoma: Report of Three Cases and Review of the Literature

Spontaneous pneumothorax is a rare manifestation of primary lung cancer or metastasis. It is estimated that < 1% of all cases of spontaneous pneumothorax are tumor-associated and metastatic osteogenic or soft-tissue sarcomas are associated most commonly with pneumothorax especially in the setting of cytotoxic chemotherapy or radiotherapy. In this article, we report three pediatric cases with osteosarcoma that developed spontaneous pneumothorax during chemotherapy with a review of the literature. Two of them had lung metastasis at the time of the detection of pneumothorax and the remaining patient was found to have a bronchopleural fistula.

SPx is an emergency situation and early diagnosis and management can improve prognosis and quality of life of the patient however the optimal management has yet to be determined.     

The role of postoperative radiotherapy in node negative breast cancer patients with pT3-T4 disease.

AIMS: To evaluate the role of postmastectomy radiotherapy (PMRT) in patients with pT3-T4N0M0 breast cancer. METHODS: 156 patients with T3-T4N0M0 breast cancer were retrospectively analyzed. RESULTS: Locoregional recurrences were seen in 17 of 156 patients with a median time for development of 27 months (5.7-248.7 months). Two of 9 patients who were not treated with post-operative radiation therapy had locoregional recurrence as compared with 16 of 147 patients receiving radiotherapy. In multivariate analysis, presence of locoregional recurrence was the only significant prognostic factor for overall survival (18% vs. 86%, p<0.001, RR=9.05). The patients with a median number of dissected lymph nodes >or=10 had a significantly better locoregional disease free survival rate as compared with patients with dissected lymph nodes <10 (90% vs. 78%, p=0.04). Chest wall recurrences were clearly higher in patients without chest wall RT since 5 of 49 patients without RT had recurrences in the chest wall region while only 4 of 107 who received chest wall RT had recurrence. However receiving RT to peripherical lymphatic regions had no additional effect on reducing recurrences in these regions (5% vs. 4%). CONCLUSIONS: Due to the lack of phase III randomized trials directly addressing the role of postmastectomy radiotherapy in these stages, our series suggest that postmastectomy radiotherapy to the ipsilateral chest wall is recommended for patients with PT3N0 and T4N0 breast cancer. The need for irradiating axillary or supraclavicular region shall be neglected in patients who undergo sufficient axillary sampling.     

Prospects for cationic polymers in gene and oligonucleotide therapy against cancer

Gene and antisense/ribozyme therapy possesses tremendous potential for the successful treatment of genetically based diseases, such as cancer. Several cancer gene therapy strategies have already been realized in vitro, as well as in vivo. A few have even reached the stage of clinical trials, most of them phase I, while some antisense strategies have advanced to phase II and III studies. Despite this progress, a major problem in exploiting the full potential of cancer gene therapy is the lack of a safe and efficient delivery system for nucleic acids. As viral vectors possess toxicity and immunogenicity, non-viral strategies are becoming more and more attractive. They demonstrate adequate safety profiles, but their rather low transfection efficiency remains a major drawback. This review will introduce the most important cationic polymers used as non-viral vectors for gene and oligonucleotide delivery and will summarize strategies for the targeting of these agents to cancer tissues. Since the low efficiency of this group of vectors can be attributed to specific systemic and subcellular obstacles, these hurdles, as well as strategies to circumvent them, will be discussed. Local delivery approaches of vector/DNA complexes will be summarized and an overview of the principles of anticancer gene and antisense/ribozyme therapy as well as an outline of ongoing clinical trials will be presented.     

Mutations in <Emphasis Type="Italic">APC</Emphasis>, <Emphasis Type="Italic">CTNNB1</Emphasis> and <Emphasis Type="Italic">K-ras</Emphasis> genes and expression of hMLH1 in sporadic colorectal carcinomas from the Netherlands Cohort Study

Background  

The early to intermediate stages of the majority of colorectal tumours are thought to be driven by aberrations in the Wnt (APC, CTNNB1) and Ras (K-ras) pathways. A smaller proportion of cancers shows mismatch repair deficiency. The aim of this study was to analyse the co-occurrence of these genetic alterations in relation to tumour and patient characteristics.     

Anopheles population dynamics in two malaria endemic villages in Faiyum Governorate, Egypt

Anopheles populations were monitored for one year in 2 neighboring villages in Faiyum Governorate, Egypt, to study factors causing differences in malaria prevalence. Both villages contained the following species: Anopheles pharoensis, An. sergentii, An. multicolor and An. tenebrosus. Abundant larval breeding sites in Abheet, the village with the higher malaria rate, accounted for the higher adult densities observed from human and animal biting collections and from indoor resting collections. Anopheles pharoensis and An. sergentii were the dominant species in Abheet with seasonal biting activity extending from May to December, reaching a peak in November. In El Zawya, the village with the lower malaria rate, An. pharoensis dominated, reaching seasonal peaks in June and August. Inside houses, An. sergentii was common from May to January in Abheet, but rare in El Zawya. Anopheles pharoensis and An. sergentii were both incriminated as malaria vectors based upon their seasonal abundance and the finding of sporozoite positive specimens during the peak malaria season.     

Antibacteriophage action on the larvicidal activity of Bacillus thuringiensis H-14 and Bacillus sphaericus against Culex pipiens

An organically polluted mosquito breeding water was tested for the presence of bacteriophages which could inhibit the larvicidal activity of B. thuringiensis H-14 and B. sphaericus. More than one bacteriophage were isolated which could inhibit the tested bacteria. The sensitivity of the two bacterial species to 12 antibiotics was tested. Two of them, showed no antibacterial action, were selected and considered as antivirus agents in the bacteriophage assays; namely, Amoxycillin and Co-Trimoxazole. Results indicated their antivirus activity as the addition of the antibiotics to the isolated phages could permit normal bacterial growth as well as persistence of larvicidal activity against Culex pipiens larvae.     

The diagnostic,predictive, and prognostic role of serum epithelial cell adhesion molecule (EpCAM) and vascular cell adhesion molecule-1 (VCAM-1) levels in breast cancer

The purpose of this study was to determine the clinical significance of vascular cell adhesion molecule-1 (VCAM-1) and epithelial cell adhesion molecule (EpCAM) in breast cancer (BC) patients. Ninety-six BC patients and 30 age- and sex-matched healthy controls were enrolled into this study. Pretreatment serum markers were determined by the solid-phase sandwich (enzyme-linked immunosorbent assay (ELISA)). The median age at diagnosis was 48 years (range 29–80 years). Majority of the patients (71 %) had luminal subtype, and 38.5 % had metastatic disease. Twenty-nine (30 %) patients showed tumor progression, and 20 (21 %) patients died during follow-up. Median progression-free survival (PFS) and overall survival (OS) were 8.6?±?1.7 and 35.5?±?1.5 months, respectively. The baseline serum EpCAM levels of the patients were significantly higher than those of the controls (p?VCAM-1 between the patients and controls (p?=?0.47). No significant correlation was detected between the levels of the serum markers and other clinical parameters (p?>?0.05). Patients with HER-2-positive and triple-negative tumors had significantly poorer PFS (p?=?0.04 and p?=?0.001, respectively), while metastatic disease and chemotherapy unresponsiveness had significantly adverse effect on OS analysis (p?p?VCAM-1 levels nor serum EpCAM levels were identified to have a prognostic role on either PFS or OS (VCAM-1 p?=?0.76 and p?=?0.32; EpCAM p?=?0.16 and p?=?0.69, respectively). Even though any predictive or prognostic role could not be determined for both markers, serum levels of EpCAM were found to have diagnostic value in BC patients.     

The ecological characteristics of Anopheles mosquitoes associated with low malaria transmission in Siwa oasis, Egypt

The ecology of Anopheles sergentii and An. multicolor was investigated over eight months to examine the entomological factors maintaining the low Plasmodium vivax transmission in Siwa oasis. The two species were encountered as larvae while the dominant species, Anopheles sergentii was also collected as adults. Breeding sites were characterized for the two species in six localities. Larvae of both species were common during June and November. In Bahi El Din as an indicator village with a higher endemicity, An. sergentii females were endophilic but more common inside animal sheds than in houses, attracted more to donkey-baited traps than to human hosts, more endophagic as human biters and were more common in May/June and November. Female survivorship was higher in November than in the other months. Vector potential of An. sergentii was predicted and revealed that the species characteristics (low human contact, short survival and zoophilic feeding behavior) are responsible for maintaining such low and unstable malaria in Siwa oasis.     

Comparison of the life table characteristics of Anopheles sergentii (Diptera: Culicidae) from two malarious areas in Egypt

Life table characteristics were examined for the malaria vector, An. serenti from two Faiyum villages: Tersa (T) and El Nazlah (N) from Siwa oasis (Sw) under constant laboratory conditions at 25 degrees C and 70% RH. Females of T, N and Sw completed 4, 5, and 2 gonotrophic cycles (gc) respectively. The first gc required a significantly longer period (p<0.05) than the subsequent ones. Development times for Sw immatures were longer (p<0.05) than for the other colonies. Life expectancies at emergence for males of the 3 colonies were significantly shorter than for their respective females. Generation time was shorter (p<0.05) for T (mean = 31.15 days) than for Sw (37.81 days) or N (43.64 days) colonies. The birth rate of Sw colony (mean = 0.33 female female/female) was significantly higher (p相似文献