Papillary Renal Cell Carcinoma in Transplanted Kidney and Xp11.2 Translocation/Transcription Factor E3-Rearranged Renal Cell Carcinoma in the Native Kidney: A Case Report.

Concomitant renal cell carcinomas (RCC) of both native and allograft kidneys are extremely rare, and only a few cases have been reported in the available English literature. A particularly rare variant within the adult population is the Xp11.2 translocation/transcription factor E3 (TFE3)-rearranged RCC. Although few case reports of TFE3-rearranged RCC have been reported in children who underwent kidney transplantation (KT), no case of adults with TFE3-rearranged RCC following KT has been reported. Herein, we presented the radiological and pathological findings of a rare metachronous papillary RCC in the allograft kidney and TFE3-rearranged RCC in the native kidney. The TFE3-rearranged RCC in the native kidney exhibited slow expansion in size over five years. Radiologically, it appeared as a slightly enhanced, lobulated mass on contrast-enhanced CT. MRI revealed high signal intensity on T1-weighted images and low signal intensity on T2-weighted images.

Deep Deterministic Policy Gradient-Based Autonomous Driving for Mobile Robots in Sparse Reward Environments.

In this paper, we propose a deep deterministic policy gradient (DDPG)-based path-planning method for mobile robots by applying the hindsight experience replay (HER) technique to overcome the performance degradation resulting from sparse reward problems occurring in autonomous driving mobile robots. The mobile robot in our analysis was a robot operating system-based TurtleBot3, and the experimental environment was a virtual simulation based on Gazebo. A fully connected neural network was used as the DDPG network based on the actor-critic architecture. Noise was added to the actor network. The robot recognized an unknown environment by measuring distances using a laser sensor and determined the optimized policy to reach its destination. The HER technique improved the learning performance by generating three new episodes with normal experience from a failed episode. The proposed method demonstrated that the HER technique could help mitigate the sparse reward problem; this was further corroborated by the successful autonomous driving results obtained after applying the proposed method to two reward systems, as well as actual experimental results.

Effects of light intensity and nitrogen starvation on glycerolipid, glycerophospholipid, and carotenoid composition in Dunaliella tertiolecta culture.

Time-course variation of lipid and carotenoid production under high light (300 µE/m²s) and nitrogen starvation conditions was determined in a Dunaliella tertiolecta strain. Nanoelectrospray (nanoESI) chip based direct infusion was used for lipid analysis and ultra-performance liquid chromatography (UPLC) coupled with a photodiode array (PDA) or atmospheric chemical ionization mass spectrometry (APCI-MS) was used for carotenoid analysis. A total of 29 lipids and 7 carotenoids were detected. Alterations to diacylglyceryltrimethylhomoserine (DGTS) and digalactosyldiacylglycerol (DGDG) species were significant observations under stress conditions. Their role in relation to the regulation of photosynthesis under stress condition is discussed in this study. The total carotenoid content was decreased under stress conditions, while ã-carotene was increased under nitrate-deficient cultivation. The highest productivity of carotenoid was attained under high light and nitrate sufficiency (HLNS) condition, which result from the highest level of biomass under HLNS. When stress was induced at stationary phase, the substantial changes to the lipid composition occurred, and the higher carotenoid content and productivity were exhibited. This is the first report to investigate the variation of lipids, including glycerolipid, glycerophospholipid, and carotenoid in D. tertiolecta in response to stress conditions using lipidomics tools.

Metabolic profiles and free radical scavenging activity of Cordyceps bassiana fruiting bodies according to developmental stage.

The metabolic profiles of Cordyceps bassiana according to fruiting body developmental stage were investigated using gas chromatography-mass spectrometry. We were able to detect 62 metabolites, including 48 metabolites from 70% methanol extracts and 14 metabolites from 100% n-hexane extracts. These metabolites were classified as alcohols, amino acids, organic acids, phosphoric acids, purine nucleosides and bases, sugars, saturated fatty acids, unsaturated fatty acids, or fatty amides. Significant changes in metabolite levels were found according to developmental stage. Relative levels of amino acids, purine nucleosides, and sugars were higher in development stage 3 than in the other stages. Among the amino acids, valine, isoleucine, lysine, histidine, glutamine, and aspartic acid, which are associated with ABC transporters and aminoacyl-tRNA biosynthesis, also showed higher levels in stage 3 samples. The free radical scavenging activities, which were significantly higher in stage 3 than in the other stages, showed a positive correlation with purine nucleoside metabolites such as adenosine, guanosine, and inosine. These results not only show metabolic profiles, but also suggest the metabolic pathways associated with fruiting body development stages in cultivated C. bassiana.

Alteration of media composition and light conditions change morphology, metabolic profile, and beauvericin biosynthesis in Cordyceps bassiana mycelium.

Metabolic alterations of Cordyceps bassiana mycelium were investigated under the following culture medium and light conditions: dextrose agar supplemented with 0.5% yeast extract (SDAY) medium with light (SL), SDAY medium without light (SD), nut medium without light (ND), and iron-supplemented SDAY medium without light (FD). The levels of asparagine, aspartic acid, glutamic acid, glutamine, histidine, lysine, ornithine, and proline were significantly higher under SD and SL conditions. The levels of most of the alcohols, saturated fatty acids, unsaturated fatty acids, fatty acid esters, sterols, and terpenes were higher under the ND condition than in the other conditions, but beauvericin was not detectable under the ND condition. The FD condition was favorable for the enhanced production of aminomalonic acid, malic acid, mannonic acid, and erythritol. Thus, the metabolic characteristics of C. bassiana can be manipulated by varying the cultivation conditions, rendering this fungus potentially favorable as a nutraceutical and medicinal resource.

Gas chromatography/mass spectrometry-based metabolic profiling and differentiation of ginseng roots according to cultivation age using variable selection.

Ginseng roots are an important herbal resource worldwide, and the adulteration of ginseng with age is recognized as a serious problem. It is therefore crucial to develop objective criteria or standard protocols for differentiating ginseng root samples according to their cultivation age. The reported study used GC/MS combined with multivariate statistical analysis with variable selection to obtain metabolic profiling and an optimal partial least squares-discriminant analysis (PLS-DA) model for the differentiation of ginseng according to cultivation age. Relative levels of various metabolites, such as amino acids, alcohols, fatty acids, organic acids, and sugars, were measured for various ginseng cultivation ages. Increasing cultivation age resulted in the production of higher levels of panaxynol and panaxydol, which are active polyacetylene compounds in ginseng. In addition, optimized PLS-DA models for the prediction of ginseng age were obtained by selecting variables based on a variable importance in the projection cut-off value of 1.3. Proline, glucaric acid, mannose, gluconic acid, glucuronic acid, myoinositol, panaxydol, and panaxynol are suggested as key and relevant compounds with which to differentiate the age of ginseng samples. The findings of this study suggest that GC/MS-based metabolic profiling can be used to differentiate ginseng samples according to cultivation age.

Effects of clopidogrel on the pharmacokinetics of sibutramine and its active metabolites.

Sibutramine is metabolized by the enzymes CYP2B6 and CYP2C19 into 2 active metabolites, M1 (mono-desmethyl sibutramine) and M2 (di-desmethyl sibutramine). Clopidogrel is a mechanism-based inhibitor of CYP2B6 and CYP2C19. In this study, 13 extensive metabolizers of CYP2B6 and CYP2C19 were evaluated to clarify whether clopidogrel inhibits the formation of the active metabolites of sibutramine. In the control phase, each subject received a 15-mg oral dose of sibutramine. After a washout period of 2 weeks, in the clopidogrel phase, the subjects received 300 mg of clopidogrel on the first day and then 75-mg once daily for 6 days. One hour after the last dosing of clopidogrel, all subjects received 15-mg of sibutramine. Compared with the control phase, the mean sibutramine and M1 plasma concentrations were higher after clopidogrel treatment. Clopidogrel significantly increased the half-life (242% of control phase) and area under the plasma concentration-time curve from 0 to infinity (AUC(inf)) (227% of control phase) of sibutramine and decreased the apparent oral clearance (31% of control phase) of sibutramine. Pharmacokinetic analysis showed significant increases in the AUC(inf) (162% of control phase) of M1. The CYP2B6 and CYP2C19 inhibitor clopidogrel significantly inhibited the formations of M1 from sibutramine and M2 from sibutramine by 37% and 64%, respectively. Therefore, CYP2B6 and CYP2C19 are in vivo catalysts for the formation of the 2 active metabolites of sibutramine.

Initial experience with laparoendoscopic single-site surgery by use of a homemade transumbilical port in urology.

PURPOSE: We present our initial experience with laparoendoscopic single-site surgery (LESS) by a single surgeon in the urologic field. MATERIALS AND METHODS: From May 2009 to April 2010, 30 consecutive patients underwent LESS including seven cases of nephrectomy, five cases of nephroureterectomy with bladder cuff excision, four cases of ureterolithotomy, eight cases of marsupialization, and six cases of varicocelectomy. We performed a retrospective analysis of the medical records of the above patients. The single port was made with a surgical glove and an Alexis® wound retractor (Applied Medical, Rancho Santa Margarita, CA, USA). The wound retractor was put into the peritoneal space through an umbilical incision, and a laparoscopic triangle was secured by crossing both instruments. All operations were performed by the transperitoneal approach. RESULTS: Mean patient age was 54.8 years. Mean operative time was 171.2±109.1 minutes. Mean estimated blood loss was 265.0±395.5 ml. Mean incision length was 3.2±1.4 cm. Mean length of hospitalization was 5.2±2.9 days. There was one laparoscopic conversion and two open conversions. There were two cases of transient ileus that improved with conservative treatment. Mean visual analogue pain scales on the operative day and first postoperative day were 6.3/10 and 3.1/10, respectively. CONCLUSIONS: In our experience, LESS for urologic surgery is feasible, safe, and clinically applicable. We consider the homemade single-port device to be a relatively cost-effective and convenient device. If surgical instruments for LESS and appropriate ports specified for LESS are developed, LESS would be a surgical treatment technique that could be used as an alternative to the conventional types of laparoscopic surgery.

The usefulness of colonoscopy as a screening test for detecting colorectal polyps.

BACKGROUND/AIMS: Colonic polyps are the most common lesions encountered during screening colonoscopy. The purpose of this study is to evaluate the usefulness of colonoscopy to detect colonic polyps in adults. METHODOLOGY: From January 2003 to September 2005, a total of 4,629 adults underwent colonoscopic screening as a part of a health evaluation program. We analyzed the completed questionnaires, and the colonoscopic and pathologic findings. RESULTS: Complete colonic evaluation was possible in 4,491 (97.0%) subjects, and 804 (17.9%) had adenomatous polyps, including 153 subjects (3.4%) with advanced adenomas. There were no significant complications such as bowel perforation or massive bleeding requiring transfusion in relation to the procedure. There was a trend toward an increased prevalence of adenomatous polyps with age. Among the subjects with polyps, 72.1% of the subjects had distal polyps and the relative risk for proximal polyp, according to the distal findings, was 5.4 (95% CI: 4.5-6.3) for adenomatous polyp, 5.1 (95% CI 3.6-7.0) for advanced adenoma as compared to the finding of no adenomatous polyp. CONCLUSIONS: Colonoscopy performed by experienced colonoscopists as a screening test is feasible for detecting subjects with colorectal polyps.

The effect of adenovirus-IkappaBalpha transduction on the chemosensitivity of lung cancer cell line with resistance to cis-diamminedichloroplatinum(II)(cisplatin) and doxorubicin(adriamycin).

Resistance to chemotherapeutic agents is the major reason for treatment failure of cancer chemotherapy. Some chemotherapeutic drugs induce the activation of NF-kappaB in cancer cells that results in their resistance to anticancer drugs. But the role of NF-kappaB in acquired resistance has not been well investigated. In this study, we transferred the "super-repressor" form of the NF-kappaB inhibitor by adenoviral vector (ad-IkappaBalpha) to human lung cancer cell lines with resistant to cisplatin (PC-14-DDP) and adriamycin (PC-14-ADR), and observed the sensitivity change. Electrophoretic mobility shift assay showed that ad-IkappaBalpha blocked the activation of NF-kappaB induced by cisplatin and adriamycin. Transduction with ad-IkappaBalpha restored the sensitivity of cisplatin and adriamycin resistant lung cancer cell lines (PC-14-DDP and PC-14-ADR) to a level compatible to the parental cell lines. Annexin-V analysis suggested that the enhancement of chemosensitivity was probably a result of the induction of apoptosis. These data demonstrated that ad-IkappaBalpha blockade of chemotherapeutic induced NF-kappaB activation increased apoptosis induction and the chemosensitivity of lung cancer cell lines with acquired resistance to cisplatin and adriamycin. Therefore, gene transfer of IkappaBalpha-SR seems to represent a new therapeutic strategy for the solution of low sensitivity and lung cancer resistance to anticancer drugs.