Diagnosis and treatment of carcinosarcoma of the renal pelvis: A case report.

Carcinosarcoma is a rare type of renal pelvis malignancy, the diagnosis of which requires the presence of malignant epithelial and mesenchymal components. The prognosis of this disease is extremely poor due to its rapid progression and widespread metastases. The present study describes a case of carcinosarcoma involving the right renal pelvis in a 73-year-old female who presented with intermittent hematuria and right-flank pain that had persisted for one month. Computed tomography revealed a 2.4×2.5 cm mass in the right renal pelvis, which was diagnosed as a right renal pelvic tumor. Laparoscopic radical resection of the right kidney and ureter was performed. Following surgery, immunohistochemical analysis showed positive reactions for epithelial and mesenchymal markers. Based on these findings, the patient was diagnosed with carcinosarcoma. Thus, immunohistochemical analysis is a critical method for the accurate diagnosis of carcinosarcoma.

Serum ALDH1A1 is a tumor marker for the diagnosis of non-small cell lung cancer.

BACKGROUND: ALDH1A1 (aldehyde dehydrogenase 1 family, member A1) is highly expressed in non-small-cell lung cancer (NSCLC). We assessed the potential clinical value of serum ALDH1A1 in the diagnosis and prognosis of non-small-cell lung cancer. METHOD: Between 2010 and 2011, serum samples from 100 non-small-cell lung cancer patients before tumor resection, 60 patients with benign lung disease, and 60 healthy volunteers were collected and analyzed retrospectively for ALDH1A1, using sandwich ELISA. We further evaluated the serum and tumor ALDH1A1 levels of non-small-cell lung cancer patients before and after surgery. We compared the diagnostic and prognostic values of serum ALDH1A1 with that of carcinoembryonic antigen. RESULTS: Elevated serum ALDH1A1 levels were observed in 55 of the 100 (55%) non-small-cell lung cancer patients. The ALDH1A1 levels were much higher in patients with advanced stages than in those with early stage tumors. Of the 30 non-small-cell lung cancer patients who underwent surgery, 19 had elevated serum ALDH1A1 levels before surgery, but the serum ALDH1A1 level was undetectable by postoperative day 7. Analysis of receiver operating characteristic curves showed that ALDH1A1 might be better than carcinoembryonic antigen in distinguishing non-small-cell lung cancer from benign disease or the healthy control. Combined application of ALDH1A1 and carcinoembryonic antigen significantly increased the sensitivity of carcinoembryonic antigen alone, with an accuracy of 83%. CONCLUSIONS: Our results showed that serum levels of ALDH1A1 were correlated with carcinogenesis and progression of non-small-cell lung cancer. Detection of serum ALDH1A1 can be helpful in the diagnosis and prognosis of non-small-cell lung cancer. The diagnosis rate of non-small-cell lung cancer could be significantly improved when carcinoembryonic antigen is combined with ALDH1A1.

Bis(4-cyano-1-methyl-pyridinium) bis-(1,2-dicyano-ethene-1,2-dithiol-ato-κS,S')cuprate(II).

The title ion-pair compound, (C(7)H(7)N(2))(2)[Cu(C(4)N(2)S(2))(2)], was obtained by the direct reaction of CuCl(2)·2H(2)O, disodium maleonitrile-dithiol-ate (Na(2)mnt) and 4-cyano-1-methyl-pyridinium iodide. The anion and one pyridinium cation lie entirely on a mirror plane, whereas for the other cation, a crystallographic mirror plane runs through the N and para-C atoms of the pyridine ring, the methyl C atom, and the cyano group. In the crystal, ions are linked into a three-dimensional network by C-H⋯N hydrogen bonds.

Macrophages and T lymphocytes are the predominant cells in intimal arteritis of resected renal allografts undergoing acute rejection.

BACKGROUND: In acute renal allograft rejection, T-cell-mediated processes have been generally regarded as dominant. Although there is recent evidence that macrophages play important roles in acute vascular rejection, less is known about the exact proportion of immunocytes in the intimal arteritis of renal allografts with unfavorable outcomes. METHODS: By immunohistochemical staining using nine primary antibodies, we classified the proportions of infiltrating immunocytes in intimal arteritis and glomerulitis in five allografts resected because of acute irreversible graft failure. RESULTS: All five allografts had features of antibody-mediated rejection based on criteria established by the Banff classification. In intimal arteritis, CD3+ T-lymphocytes accounted for 30.6±13.3% of the immunocytes and macrophages for 40.4±9.2%. 45.4% of the T-cells were CD8+ cytotoxic T-cells. Neutrophils were also present but accounted for a relatively low proportion of the cells (8.8±8.6%). B-cells and plasma cells all accounted for <5% of the immunocytes. NK cells were readily detected (4.2±4.2%). When we compared types of arteritis, the CD15+ neutrophils accounted for as many as 27.8±15.1% of immunocytes in V3 vasculitis and only 1.0±1.4% in V2 vasculitis. CD3+ T-lymphocytes accounted for 25.8±7.3% of immunocytes in V3 vasculitis and 41.5±7.9% in V2 vasculitis. In glomerulitis, the immunocytes were mainly macrophages (53.1±9.1%) and neutrophils (34.6±9.9%). CONCLUSION: Macrophages and T-lymphocytes accounted for the highest percentage of immunocytes in the intimal arteritis of irreversible renal failure associated with antibody-mediated rejection. 45.4% of the T-cells were CD8+ cytotoxic T-cells. Neutrophils and NK cells were also present in these lesions. The proportion of neutrophils in V3 vasculitis was much higher than in V2 vasculitis. These observations suggest that besides macrophages and T-lymphocytes, neutrophils may also play a role in the more severe arterial lesion. To our knowledge this is the first report of this observation. Macrophages and neutrophils were the main inflammatory cells in the glomerulitis of acute rejection.

Three dimensional morphometry of the knee to design the total knee arthroplasty for Chinese population.

Anthropometric data on the proximal tibia and distal femur of 172 normal knees (94 male knees, 78 female knees) were obtained using three dimensional computer tomographic measurements. We measured the tibial mediolateral (tML) and tibial anteroposterior (tAP) dimension in resected proximal tibia surface, femoral mediolateral (fML) and femoral anteroposterior (fAP) dimension in resected distal femur surface. The measurements were compared with the similar dimensions of five total knee prostheses conventionally used in China. We found that in the smaller sized prostheses the tibial mediolateral dimension was undersized, while in the larger size prostheses the tibial mediolateral dimension was overhang. For all sizes of prostheses the femoral mediolateral dimension was overhang. We found a progressively decreased in the aspect ratio (ML/AP %) with an increasing anteroposterior dimension both in the tibia and femur, as compared to the constant aspect ratio shown by the conventional total prostheses. Male had larger values in mediolateral dimension and aspect ratio than female under a given anteroposterior dimension both in the tibia and femur. There were strong correlations between measurements of the tibia and femur. The results of this study may provide guidelines for designing suitable total knee prosthesis for the Chinese population, especially for design of gender-specific prostheses.

Presence of donor-and-recipient-derived DNA microchimerism in the cell-free blood samples of renal transplantation recipients associates with the acceptance of transplanted kidneys.

AIM: To examine whether the existence of the donor-and recipient-derived DNA chimerism in recipient's plasma can be a predictive marker for the status of transplanted organ. METHODS: One hundred and twenty-six female patients who had been transplanted with male kidneys were enrolled in the present study. In these female recipients, the SRY(1), DYZ(1)(1st) and DYZ(1)(2nd) genes on the Y chromosome from the plasma were prospectively examined using reverse transcription polymerase chain reaction (RT-PCR). RESULTS: SRY, DYZ(1)(1st) and DYZ(1)(2nd) sequences were detected in the cell-free blood (plasma) of 97 (77%) of 126 female patients with male kidney. The average time that the transplanted kidneys functioned was 8.7 years and 5.4 years among microchimerism-positive and microchimerism-negative recipients, respectively. The frequency of the patients who had acute rejection after renal transplantation was approximately 10% and 28% in microchimerism-positive and microchimerism-negative recipients, respectively. Serum creatinine levels in microchimerism-positive patients were significantly lower than those in microchimerism-negative patients. CONCLUSION: These results suggest that plasma DNA microchimerism present in certain patients following renal transplantation and measurement of plasma DNA microchimerism using quantitative RT-PCR might be a useful predictor for the acceptance of transplanted kidneys.

[Effects of donor-specific bone marrow cell infusion on chimerism and acute rejection in kidney transplantation].

OBJECTIVE: To evaluate the effect of donor-specific bone marrow cell infusion on the production of chimerism and acute rejection in kidney transplantation. METHODS: Sixty-one patients, 48 males and 13 females, aged 38.4 (23 - 45), underwent transplantation of cadaveric kidneys, 24 of which underwent kidney transplantation combined with donor-specific bone marrow cell infusion and 37 of which underwent pure transplantation of kidney. During the kidney transplantation combined with donor-specific bone marrow cell infusion the donor bone marrow cells (DBMC) were isolated from the thoracic vertebrae and iliac bones of the donors-cadavers and infused into the recipients of the kidneys of the same donors. After operation the peripheral blood was collected from the 61 recipients every 2 - 3 months for at least 1 year to undergo PCR to detect the presence of chimerism, and the rates of chimerism and acute rejection were compared between these 2 groups. RESULTS: During the follow-up the presence rate of chimerism was 87.5% (21/24) in the marrow recipients, significantly higher than that in the control group (40.5%, 15/37, P < 0.001). The prevalence of acute rejection in the chimerism positive patients was 19.4% (7/16), significantly lower than that in the chimerism negative patients (44%, 11/25, P < 0.05). CONCLUSION: Donor-specific bone marrow cell infusion in cadaver kidney transplantation induces the production of chimerism, and increases the immune tolerance to the donor organs, thus finally decreasing the incidence of acute rejection. Chimerism is correlated with immune tolerance.