[A Case of BRCA2 Mutation-Positive Intraductal Carcinoma of the Prostate].

A 75-year-old man presented with macroscopic hematuria and a high serum prostate-specific antigen (PSA) level. Macroscopic hematuria had subsided by the time of consultation. The PSA level was 38.590 ng/ml, which, along with rectal examination and magnetic resonance imaging findings, led to the suspicion of prostate cancer. Transrectal needle biopsy of the prostate revealed intraductal carcinoma of the prostate (IDC-P). Computed tomography and bone scintigraphy were performed, and the prostate cancer was classified as cT2cN0M0. After 6 months of combined androgen blockade therapy, a radical prostatectomy was performed; however, PSA levels continued to increase, and the patient was diagnosed with castration resistant prostate cancer. Multiple bone metastases appeared 5 months after the initiation of abiraterone therapy. Three courses of docetaxel and two courses of cabazitaxel were administered, but the disease progression continued. The IDC-P was found to be positive for the BRCA2 mutation by BRACAnalysis® performed at the start of cabazitaxel therapy. To our knowledge, no other cases of BRCA2 mutation positive IDC-P have been reported in Japan. After we started administration of Olaparib, the patient's PSA level was lowered and the disease progression stopped.

[Treatment of patients with COVID-19 on Hemodialysis: Efficacy of Remdesivir]. / Tratamiento de pacientes con COVID-19 en Hemodiálisis: Eficacia de Remdesivir.

BACKGROUND: There is no standard therapy for hemodialysis (HD) patients with COVID-19. Data on remdesivir in HD patients with COVID-19 are scarce. METHODS: We retrospectively analyzed 25 HD patients with COVID-19 treated with remdesivir. RESULTS: The median age of the patients was 78 years (range, 45-92 years) and was predominantly male (84%). A total of 44% of the patients had mild disease, 36% had moderate-1, and 20% had moderate-2. The most common symptoms were fever (76%) and coughing (44%). The most common comorbidity was renal failure (100%), followed by hypertension (60%) and cardiac disease (44%). The most frequent biomarker was elevated creatinine (100%), followed by C-reactive protein (80%), lymphopenia (76%), and D-dimer (68%). C-reactive protein levels decreased significantly before and after remdesivir administration (p < 0.001). Two patients showed deterioration, but none died. All patients recovered from COVID-19 and no adverse effects of treatment with remdesivir were observed. CONCLUSION: Our study suggests the safe use of remdesivir in HD patients with COVID-19.

Hiccups as a specific neurological manifestation in males with COVID-19.

Several clinical manifestations of COVID-19 have been reported in the literature since then. In addition to upper respiratory symptoms, dysgeusia and anosmia are relatively common neurological manifestations with COVID-19. We had five cases of hiccups in succession; therefore, we assume that hiccups might be a specific symptom of COVID-19. We retrospectively analyzed 46 patients with COVID-19 diagnosed from February 2021 to May 2021. Among the 46 patients, 5 developed hiccups (11%). All patients were male. The median age of was 56 years. None of the patients were smokers. Further, all patients exhibited pneumonia without dysgeusia or anosmia. The median onset of hiccups was 5 days after diagnosis, with a median duration of 2 days. All patients recovered from hiccups and COVID-19. Hiccups might be a specific neurological symptom in male patients with COVID-19.

Red face may be a specific sign of SARS-CoV-2 alpha variant.

Japan is currently suffering the fourth wave of the COVID-19 pandemic, with the dominant type being SARS-CoV-2 alpha variant. Patients with COVID-19 variant types show more aggressive symptoms. In the present study, three patients developed a red face during treatment. Two of them suddenly worsened shortly after. We assumed that the red face reflected a cytokine storm and conjectured that it may be a specific sign of variant type COVID-19, because we have never seen it in patients with non-variant type. Moreover, we believe that red face may be predictive of a sudden deterioration.

The Combination of Gemcitabine, Cisplatin, and Paclitaxel as Salvage Chemotherapy for Advanced Urothelial Carcinoma.

There is no standard second-line or salvage treatment for advanced urothelial carcinoma (UC). Here we investigated the efficacy and safety of gemcitabine, cisplatin, and paclitaxel (GCP) combination chemotherapy as salvage chemotherapy for advanced UC. We retrospectively analyzed the cases of 23 patients with advanced UC who showed progression or recurrence after cisplatin-based chemotherapy. Gemcitabine (1000 mg/m2), and paclitaxel (80 mg/m2) were administered on days 1 and 8. Cisplatin (70 mg/m2) was administered on day 1. The 3-week cycle regimen was repeated until disease progression if it had no intolerable toxicity. The overall response rate was 61% (95%CI, 41-78%). The median overall survival and progression-free survival times were 14 months and 5.5 months, respectively. Of the already known risk factors of chemotherapy for advanced UC, only the performance status was a prognostic factor for OS. Overall, 16 of the 23 patients (70%) experienced grade 3/4 toxicities, and no fatal adverse events were observed. GCP therapy was a promising option as second-line or salvage therapy for advanced UC.

Pretreatment of Japanese cedar by ionic liquid solutions in combination with acid and metal ion and its application to high solid loading.

BACKGROUND: Lignocellulosic biomass from plant biomass, especially softwoods, are well-known to present difficulties during attempts at hydrolysis due to their rigid structure. Pretreatment of lignocellulosic biomass with ionic liquids (ILs) is attractive as this requires to a low input of energy. However, IL pretreatment has the disadvantage of the presence of large amounts of water. Recently, it was reported that a small amount of acid has a positive effect on the degradation of biomass in IL with water. In this study the pretreatment of Japanese cedar, the most abundant softwood in Japan, was investigated using a combination of IL, acid and metal ions. RESULTS: First, the novel ionic liquid pretreatment was investigated by changing the pretreatment solvent and the anti-solvent. A mixture of IL, acid and ferric oxide (Fe(3+)) ion was most effective for pretreatment, and an acetone-water mixture was also most effective on the precipitation of biomass. These optimized pretreatment combinations attained a higher degree of glucose release from the pretreated biomass. The amount of cellulose was concentrated from to a level of 36 to 84% of the insoluble fraction by the optimized pretreatment. Based on this result, it was assumed that the extraction of the lignin fraction from the biomass into an anti-solvent solution was attained. Finally, this optimized pretreatment was applied to the enzymatic hydrolysis of Japanese cedar at high-solid biomass loading, and 110 g/L of glucose production was attained. In addition, the ethanol fermentation with this hydrolyzed solution by Saccharomyces cerevisiae achieved 50 g/L ethanol production, and this yield reached 90% of the theoretical yield. CONCLUSIONS: We developed an effective pretreatment protocol by changing to a pretreatment solvent containing IL, acid, metal ion and anti-solvent. The optimized pretreatment has an effect on softwood and separately retrieved lignin as a by-product. The saccharified solution at high-solid biomass loading was converted to ethanol in a high yield. This proposed methodology would boost the performance of the bioconversion of low-cost materials to other chemicals, and would not be limited to only ethanol but also would include other target chemicals.