Analysis of various potential prognostic markers and survival data in clear cell renal cell carcinoma

ABSTRACT Purpose Clear cell renal cell cancers frequently harbor Von Hippel-Lindau gene mutations, leading to stabilization of the hypoxia-inducible factors (HIFs) and their target genes. In this study, we investigated the relationship between vascular endothelial growth factor (VEGF), HIF-1α, HIF-2α, p53 positivity, microvessel density, and Ki-67 rates with prognostic histopathologic factors (Fuhrman nuclear grade, stage, and sarcomatoid differentiation) and survival in clear cell renal cell carcinomas. Material and Methods Seventy-two nephrectomy specimens diagnosed as clear cell renal cell carcinoma between 2000 and 2012 were reevaluated. Immunohistochemically VEGF, HIF-1α, HIF-2α, p53, CD34 (for microvessel density evaluation), and Ki-67 antibodies were applied to the tumor areas. The relationships of these antibodies with prognostic factors and survival rates were evaluated with statistical analyses. Results Mean survival time was 105.6 months in patients with ccRCC. Patients with high expression of VEGF, HIF-1α and HIF-2α positivity, a high Ki-67 proliferation index, and a high microvessel density evaluation score had a shorter survival time (p<0.05). Conclusions Our findings supported that with the use of these immunohistochemical markers, prognosis of renal cell carcinoma may be predicted at the first step of patient management. New treatment modalities targeted to HIF-1α and HIF-2α might be planned as well as VEGF-targeted therapies in the management of clear cell renal cell carcinomas.

Microcalcified Hepatic Metastases Incidentally Detected on F-18 NaF PET/CT in a Patient with Prostate Cancer / 대한핵의학회잡지

F-18 NaF PET/CT evaluation has gained importance in recent years. Achievements from F-18 NaF PET/CT are: higher sensitivity of positron imaging, higher target background ratio with higher tracer accumulation in bone hydroxyapatite and higher specificity through CT correlation. These properties have also given directions to new research fields based on imaging microcalcifications, very recently. A limited number of cases have reported the F-18 NaF uptake in macrocalcified soft tissue metastases. Although the presence of microcalcification was not proved; accumulation of F-18 NaF in the metastatic brain lesion with no visible calcification on the CT, in a patient with ductal breast carcinoma has also been reported. Herein we present a patient with microcalcified hepatic metastasis of prostate cancer incidentally detected on F-18 NaF PET/CT which was confirmed with histochemical staining.

Primary Pulmonary Lymphoepithelioma-like Carcinoma on FDG PET/CT / 대한핵의학회잡지

A 69-year-old male smoker was referred to ¹⁸F-f luorodeoxyglucose (FDG) pos i t r on emi s sion tomography-computed tomography (PET/CT) with the indication of a suspicious solitary pulmonary nodule. FDG PET/CT determined a 2.5 × 2-cm soft-tissue lesion (SUVmax, 16.2) with spiculated margins in the hilum of the right lung. A 1-cm diameter lymphadenopathy on the right hilum with an SUVmax of 3.2 was also determined. Transbronchial biopsy of the right hilar lymphadenopathy did not reveal any malignant features in histopathologic examination, and it was determined to be reactive. The patient underwent a right upper lobe segmentectomy, and the histopathologic evaluation revealed that the tumor was a primary lymphoepithelioma-like carcinoma (LELC) of the lung with negative Epstein-Barr virus (EBV) on in situ hybridization studies. In this case report, we mainly focus on the FDG avidity of this very rare kind of tumor comparatively with previous reports and possible explanations of discordancy in FDG avidity in relation to histopathologic characteristics.

Evaluation of Temperament and Character Features as Risk Factors for Depressive Symptoms in Patients with Restless Legs Syndrome

BACKGROUND AND PURPOSE: Restless legs syndrome (RLS) is a common sleep-related movement disorder that is frequently associated with psychological disturbances. Personality traits are of considerable importance with respect to coping with chronic illness and disease vulnerability. This study assessed the temperament and character traits of RLS patients using an approach that involves the psychobiological model of personality. METHODS: The personality features of 65 newly diagnosed and untreated RLS patients with no neurological or psychiatric diseases and 109 healthy controls were determined using the Temperament and Character Inventory and compared using covariance analyses. The International RLS Study Group Severity Scale was used to assess the severity of the RLS symptoms, and the Beck Depression Inventory was used to assess the presence and severity of depressive symptoms. RESULTS: RLS patients scored significantly higher than healthy controls on the temperament dimension of harm avoidance (HA, p=0.02) and significantly lower on self-directedness (SD, p=0.001). No significant difference was observed in terms of the temperament dimension of novelty seeking (p=0.435). HA scores were significantly correlated with the BDI score but not with the RLS severity or duration. CONCLUSIONS: High HA and low SD scores are the main characterizing personality features of RLS patients. These personality dimensions may be among the factors predisposing patients to development of the depressive symptoms that are frequently associated with RLS.

Complications of brucellosis in adults: an experience from a state hospital in southeastern anatolia region of Turkey

To evaluate the complications and systems involvement of acute Brucella infection in adults Retrospective study Midyat State Hospital, Mardin, Turkey Seventy-eight patients with acute brucellosis. Brucellosis treatment The frequency of complications and systems involvements. This retrospective study was carried out at the Infectious Diseases and Neurology clinics between April 2007 and August 2008. The diagnosis of brucellosis was made with compatible clinical findings, positive Brucella agglutination 1/160 titers, and / or the isolation of Brucella species. Complication was defined as the presence of symptomsor physical signs of infection at a particular anatomic site in a patient with active brucellosis. This study focuses on the frequency of complications in cases with brucellosis. Out of 78 patients, 46 [59%] were female and 32 [41%] were male. The mean age of patients was 36.4 +/- 14.2 years. Skeletal complications were the most frequent, found in 26 [33.8%] cases, followed by hematological [n=25, 32.1%], cutaneous [n=3, 3.9%], nervous [n=2, 2.6%], genitourinary [n=2, 2.6%], respiratory [n=1, 1.3%] and gastrointestinal system [n=1, 1.3%]. Brucellosis, whether in an endemic region or not, remains a diagnostic puzzle due to occasional misleading unusual presentations and non-specificsymptoms.Itisa systemic infection in which any organ or system of the body can be involved. Our data showed that brucellosis is a preventable disease. Knowledge and early diagnoses of the complications are especially important