Mixed epithelial and stromal tumor of the kidney: A case report.

Mixed epithelial and stromal tumor (MEST) is a rare neoplasm of the kidney, affecting mostly women at menopausal age. While few cases of malignant transformation have been described in the literature, MEST is usually considered a benign tumor with minimal risk of local recurrence or distance metastases. The current study presents a case of a 18-year old male patient with a cystic tumor of the left kidney incidentally diagnosed on magnetic resonance imaging of the heart performed for other reasons. The patient underwent a partial nephrectomy, with perioperative course being uneventful. The pathology report revealed MEST of the kidney. No local recurrence nor disease progression have been observed in the patient during the one-year follow-up period. The present case report is evidence that may help in developing guidelines on the management of patients with benign renal masses.

Waste-activated sludge disruption by dry ice: bench scale study and evaluation of heat phase transformations.

The freezing process consists of dissipating heat from the product until the final temperature is lower than the temperature of crystallisation of that product. Freezing can be used for numerous applications, including for disruption of waste-activated sludge (WAS). The aim of this study was to calculate the estimated amount of heat conveyed between the solidified carbon dioxide and the WAS, in the following ratios: 0.25:1; 0.5:1; 0.75:1 and 1:1. In heat of phase transformations, dry ice sublimation, water solidification, the amount of heat transferred by other substances and heat transferred from the sludge (dry sludge) were taken into account during the process of WAS freezing. Heat changes on the surface of WAS were registered using a thermovision camera. The effectiveness of WAS disintegration was confirmed by several biochemical parameters such as soluble chemical oxygen demand (increase over 14 times), degree of disintegration (48%), proteins (increase over 5 times), carbohydrates (increase almost 7 times), RNA (increase by 2.23 mg L-1), ammonia nitrogen (increase over 23 times), phosphates (increase almost 27 times) and turbidity (increased over 7 times). It was found that dry ice pretreatment of WAS can be an intriguing alternative for the conventional methods used.

TIMP4 expression is regulated by miR-200b-3p in prostate cancer cells.

In prostate cancer TIMP4 expression level fluctuates with tumor progression. The mechanism and factors influencing its expression remain unclear. The aim of the study was to test the hypothesis on regulation of TIMP4 by microRNA-200b-3p. The levels of TIMP4 and miR-200b-3p expression were determined by real time PCR in 27 prostate carcinomas and eight benign prostatic hyperplasia samples. We found that miR-200b-3p positively correlated with TIMP4 expression in cancer samples (r = 0.46; p < 0.02). Moreover, mean miR-200b-3p level and TIMP4 expression were both higher in cancer tissues compared to benign prostatic hyperplasia samples (p > 0.05). Next, to test probable mechanisms of the regulation androgen-sensitive human prostate adenocarcinoma cells (LNCaP) were transfected with synthetic-miR-200b-3p or its synthetic antagonist. Modulation of miR-200b-3p in LNCaP cells had an impact on TIMP4 expression confirming the observation made in analyzed clinical samples. Two targets of miR-200b-3p: ZEB1 and ETS1 were investigated subsequently as potential regulators of TIMP4, however, no effect of their modulation on TIMP4 expression in LNCaP cells was found. Concluding, miR-200b-3p mediates regulation of TIMP4 expression in prostate cancer but exact mechanism needs to be investigated.

FGF23 Producing Mesenchymal Tumor.

A 40-year-old patient was referred to Clinic of Endocrinology due to hypophosphatemia causing pain, cramps, and weakness of muscles. Moreover, his bone mineral density was very low. The previous treatment with phosphorus and active vitamin D metabolites was ineffective. In lab tests the hypophosphatemia, hyperphosphaturia, and elevated FGF23 levels were found. Somatostatin receptor scintigraphy (SRS) showed increased radiotracer uptake in the right maxillary sinus and CT scans confirmed presence of tumor in this localization. Biopsy and cytological examination created suspicion of mesenchymal tumor-glomangiopericytoma. Waiting for surgery the patient was treated with long acting Somatostatine analogue, and directly before operation short acting Octreotide and intravenous phosphorus were used. Histology confirmed the cytological diagnosis and the phosphatemia return to normal values in 10 days after the tumor removal.

High-resolution esophageal manometry with ECG monitoring for management of premature ventricular complexes-associated dysphagia.

We report a novel technique for diagnosing a new cause of esophageal dysphagia in a patient without organic heart and esophageal disease. A coincidence between intermittent esophageal dysphagia and cardiac arrhythmia, frequent premature ventricular complexes (PVC) were confirmed by clinical observation, simultaneous ECG monitoring, and motility study. High-resolution esophageal manometry (HRM) revealed abnormal peristaltic waves only during frequent PVC. Abnormal peristaltic waves and PVC disappeared simultaneously and completely within 15 min after intravenous infusion of antiarrhythmic agent (140 mg propafenone). Oral treatment with antiarrhythmic drugs was not tolerated or ineffective. Complete remission of PVC and dysphagia was achieved immediately after radiofrequency catheter ablation of arrhythmogenic focus located in the right ventricular outflow tract. This case demonstrates a new technique for the management of a syndrome called "PVC-associated dysphagia" that can be mediated by cardioesophageal reflex. Interdisciplinary cooperation and simultaneous HRM with ECG monitoring may confirm the diagnosis and guide effective treatment.

[Gastroesophageal reflux disease--nonacid reflux]. / Choroba refluksowa przelyku--refluks niekwasny.

In most of cases treatment of gastroesophageal reflux disease (GERD) is not an issue. However, some 20% of patients complain of persisting symptoms despite IPP therapy. The reasons of this condition are still under studies. The most attention is paid to a nonacid reflux as a cause of these health discomforts. It is a type of GERD where pH of refluxate > 4.0. This group of patients can be selected thanks to a new diagnostic form, called multichannel intraluminal impedance. The correlation of symptoms, such as episodes of nonacid reflux, the mechanism of its genesis, and treatment potentials are still under persistent studies. It is too early a stage to jump into final conclusions. Researches that are carried on suggest that the main symptoms of this disease are regurgitations, chronic cough or other atypical symptoms. Thanks to the new diagnostic method, i.e., multichannel intraluminal impedance, and promising results of endoscopic and surgical treatments, a new solution of helping patients suffering with this disease is being introduced.