A metastatic ureteral tumor successfully treated with multidisciplinary therapy including radiotherapy.

Introduction: Metastatic ureteral tumors are difficult to diagnose pathologically. Treatment is only available for the primary disease, and prognosis is generally poor. Case presentation: A 63-year-old patient with a history of gastric cancer presented with asymptomatic right-sided hydronephrosis. Ureteroscopic examination revealed tissue in the ureter consistent with gastric cancer. The lesion was localized, and the patient was treated with chemotherapy and radiotherapy as part of a multidisciplinary treatment. The prognosis was better than in other reports. To the best of our knowledge, this is the first case of a patient with metastatic gastric cancer who received multidisciplinary treatment including radiotherapy and had a good prognosis. Conclusion: In cases where a localized metastatic ureteral tumor cannot be ruled out, ureteroscopy is an effective therapeutic strategy.

Role of Oxidative Stress and Ca2+ Signaling in Psychiatric Disorders.

Psychiatric disorders are caused by complex and diverse factors, and numerous mechanisms have been proposed for the pathogenesis of these disorders. Accumulating evidence suggests that oxidative stress is one of the general factors involved in the pathogenesis/pathophysiology of major psychiatric disorders, including bipolar disorder, depression, anxiety disorder, and schizophrenia. Indeed, some clinical trials have shown improvement of the symptoms of these disorders by antioxidant supplementation. However, the molecular basis for the relationship between oxidative stress and the pathogenesis of psychiatric disorders remains largely unknown. In general, Ca2+ channels play central roles in neuronal functions, including neuronal excitability, neurotransmitter release, synaptic plasticity, and gene regulation, and genes that encode Ca2+ channels have been found to be associated with psychiatric disorders. Notably, a class of Ca2+-permeable transient receptor potential (TRP) cation channels is activated by changes in cellular redox status, whereby these TRP channels can link oxidative stress to Ca2+ signals. Given the unique characteristic of redox-sensitive TRP channels, these channels could be a target for delineating the pathogenesis or pathophysiology of psychiatric disorders. In this review, we summarize the outcomes of clinical trials for antioxidant treatment in patients with psychiatric disorders and the current insights into the physiological/pathological significance of redox-sensitive TRP channels in the light of neural functions, including behavioral phenotypes, and discuss the potential role of TRP channels in the pathogenesis of psychiatric disorders. Investigation of redox-sensitive TRP channels may lead to the development of novel therapeutic strategies for the treatment of psychiatric disorders.

The Prognostic Value of Systemic Inflammatory Markers in Advanced Renal Cell Carcinoma Patients Treated With Molecular Targeted Therapies.

BACKGROUND/AIM: The present study examined the impact of systemic inflammatory markers including C-reactive protein (CRP)/Albumin (Alb) and neutrophil lymphocyte ratio (NLR)/Alb on the prognosis of patients treated with first line molecular targeted therapy for advanced RCC. PATIENTS AND METHODS: A total of 131 patients with advanced RCC treated with molecular targeted therapy as first line treatment from May 2008 to April 2019 were retrospectively analyzed. RESULTS: High CRP, high NLR, low Alb and high CRP/Alb showed significantly worse progression-free survival (PFS) and overall survival (OS) than low CRP, low NLR, high Alb, low CRP/Alb and low NLR/Alb, respectively. In multivariate analyses, prior nephrectomy (p=0.0321) and NLR/Alb ratio (p=0.0327) were independent prognostic factors for PFS. Furthermore, prior nephrectomy (p=0.0013) and CRP/Alb ratio (p=0.0020) were independent prognostic factors for OS. CONCLUSION: CRP/Alb and NLR/Alb ratios are useful and independent prognostic biomarkers in patients with advanced RCC treated with molecular targeted therapy.

Numerical simulations of particle behaviour in a realistic human airway model with varying inhalation patterns.

OBJECTIVES: For dry powder inhalers, the airflow properties in the airways could affect the deposition of inhaled particles; the flow patterns vary inherently between patients. This paper provides an evaluation of the effects of six airflow patterns on the behaviour of inhaled particles, as determined by using numerical simulations. METHODS: Constant-velocity and unsteady inhalation flows were employed. The unsteady inhalation flow was set as an inhalation curve with a peak inspiratory flow rate. Under a constant flow of 28.3 l/min, the total flow rates were calculated to confirm the validity of the numerical simulation. The effects of different inhalation patterns on the particle behaviour in a realistic human airway model were revealed via numerical simulation. KEY FINDINGS: Different flow rates affected the behaviour and deposition of the inhaled particles. Under an inhalation flow pattern, different airflow tendencies were observed between the right and left bronchi. Particle deposition in the airways was promoted by a vortex following terminal-velocity-like breath-holding. The inhalation flow pattern affected the behaviour and deposition of inhaled particles in the airway. CONCLUSIONS: Our results indicated that particle deposition in a realistic human airway model was promoted by a vortex formation following the terminal-velocity-like breath-holding. Moreover, the inhalation flow pattern significantly influenced the behaviour and deposition of inhaled particles in the airways. Additionally, the effect of flow patterns on the particle deposition in each airway position was quantitatively evaluated by numerical simulations for a realistic human airway model.

The Impact of Antibiotics on Prognosis of Metastatic Renal Cell Carcinoma in Japanese Patients Treated With Immune Checkpoint Inhibitors.

BACKGROUND/AIM: The present study aimed to examine the influence of antibiotics (AB) on the clinical outcomes of Japanese patients treated with immune check point inhibitors (ICIs) for metastatic renal cell carcinoma (RCC) patients. PATIENTS AND METHODS: A total of 31 patients with metastatic RCC treated with ICIs from November 2016 to April 2019 were retrospectively reviewed and analyzed. RESULTS: Five patients were treated with AB prior to ICIs treatment. Median progression free survival (PFS) of patients treated with AB vs. patients not treated with AB was 2.8 months and 18.4 months, respectively. The difference between PFS was statistically significant (p=0.0004). In multivariate analyses, AB use (p=0.0377) and presence of immune related adverse events (p=0.0042) were independent prognostic factors for PFS in association with ICIs therapy. CONCLUSION: The use of AB before ICIs treatment was a predictor of poor ICIs response in metastatic RCC.