Fabrication of Completely Polymer-Based Solar Cells with p- and n-Type Semiconducting Block Copolymers with Electrically Inert Polystyrene.

It is widely recognized that fullerene derivatives show several advantages as n-type materials in photovoltaic applications. However, conventional [6,6]-phenyl-C61-butyric acid methyl ester (PCBM) exhibits weak absorption in the visible region, and poor morphological stability, due to the facile aggregation. For further improvement of the device performance and durability, utilization of n-type polymeric materials instead of PCBM is considered to be a good way to solve the problems. In this study, we fabricated completely polymer-based solar cells utilizing p- and n-type block copolymers consisting of poly(3-hexylthiophene) (P3HT) and poly{[N,N'-bis(2-octyldodecyl)naphthalene-1,4,5,8-bis(dicarboximide)-2,6-diyl]-alt-5,5'-(2,2'-bithiophene)} [P(NDI2OD-T2)], respectively, containing common polystyrene (PSt) inert blocks, which decreased the size of phase separated structures. Electron mobility in synthesized P(NDI2OD-T2)-b-PSt film enhanced by a factor of 8 compared with homopolymer. The root mean square roughness of the blend film of two block copolymers (12.2 nm) was decreased, compared with that of the simple homopolymers blend (18.8 nm). From the current density-voltage characteristics, it was confirmed that the introduction of PSt into both P3HT and P(NDI2OD-T2) improves short-circuit current density (1.16 to 1.73 mA cm-2) and power-conversion efficiency (0.24% to 0.32%). Better performance is probably due to the uniformity of the phase separation, and the enhancement of charge mobility.

Molecular Markers of Tubulointerstitial Fibrosis and Tubular Cell Damage in Patients with Chronic Kidney Disease.

In chronic kidney disease (CKD), progressive nephron loss causes glomerular sclerosis, as well as tubulointerstitial fibrosis and progressive tubular injury. In this study, we aimed to identify molecular changes that reflected the histopathological progression of renal tubulointerstitial fibrosis and tubular cell damage. A discovery set of renal biopsies were obtained from 48 patients with histopathologically confirmed CKD, and gene expression profiles were determined by microarray analysis. The results indicated that hepatitis A virus cellular receptor 1 (also known as Kidney Injury Molecule-1, KIM-1), lipocalin 2 (also known as neutrophil gelatinase-associated lipocalin, NGAL), SRY-box 9, WAP four-disulfide core domain 2, and NK6 homeobox 2 were differentially expressed in CKD. Their expression levels correlated with the extent of tubulointerstitial fibrosis and tubular cell injury, determined by histopathological examination. The expression of these 5 genes was also increased as kidney damage progressed in a rodent unilateral ureteral obstruction model of CKD. We calculated a molecular score using the microarray gene expression profiles of the biopsy specimens. The composite area under the receiver operating characteristics curve plotted using this molecular score showed a high accuracy for diagnosing tubulointerstitial fibrosis and tubular cell damage. The robust sensitivity of this score was confirmed in a validation set of 5 individuals with CKD. These findings identified novel molecular markers with the potential to contribute to the detection of tubular cell damage and tubulointerstitial fibrosis in the kidney.

Cystic local recurrence of renal cell carcinoma after laparoscopic radical nephrectomy in a hemodialysis patient.

Although local recurrence of renal cell carcinoma after laparoscopic radical nephrectomy is sometimes reported, cystic local recurrence of renal cell carcinoma has rarely been reported. We report the case of a 59-year-old man with hemodialysis who developed cystic local recurrence of renal cell carcinoma accompanied by acquired cystic disease of the kidney in the retroperitoneal space after laparoscopic radical nephrectomy. A cystic tumor of 5.1 cm in diameter occurred in the left retroperitoneal space 15 months after left laparoscopic radical nephrectomy, and enlarged to 7.2 cm in diameter with enhanced mass along the wall of the cyst 36 months after surgery. The cystic tumor was removed and showed local recurrence of renal cell carcinoma on pathological examination.

Predictors for postoperative renal function after open partial nephrectomy: including postoperative biomarkers.

OBJECTIVES: To assess the predictors of postoperative renal insufficiency after open partial nephrectomy. METHODS: A total of 195 patients who underwent open partial nephrectomy were the participants in this study. Patients with a decrease in the estimated glomerular filtration rate of >25% from baseline were evaluated on the basis of multiple factors including patient-specific, surgical, tumor and postoperative factors. Postoperative estimated glomerular filtration rate data were recorded between 3 and 6 months after surgery. RESULTS: Of the 195 patients, 18 (9%) had a decrease in estimated glomerular filtration rate of >25%. Percentage of preserved renal parenchyma (P = 0.0078), nearness of tumor to renal sinus (P = 0.0108), location of tumor to middle part of kidney (P = 0.0112), postoperative highest lactase dehydrogenase (P < 0.0001), postoperative body temperature (P = 0.0314) and postoperative acute kidney injury (P < 0.0001) were significantly different between patients with a decrease in estimated glomerular filtration rate of >25% and those with a decrease in estimated glomerular filtration rate ≤25% on univariate analysis. Multivariate analysis showed that postoperative highest lactase dehydrogenase (P = 0.0408) and acute kidney injury (P = 0.0002) were independent predictors for decrease of estimated glomerular filtration rate >25%. In contrast, patient characteristic factors (chronic kidney disease stage), surgical factors (clamping time and PPRP) and tumor factors (radius, endophytic/exophytic, nearness and location component) were not significant predictors. CONCLUSIONS: Postoperative factors, lactase dehydrogenase and acute kidney injury, were strong predictors for renal insufficiency after open partial nephrectomy. Thus, a strict follow up is advisable in patients showing high postoperative levels of these two biomarkers.

Prognosis and characteristics of renal cell carcinoma in hemodialysis patients: bilateral occurrence does not influence cancer-specific survival.

OBJECTIVES: To compare characteristics and prognosis unilateral and bilateral renal cell carcinoma (RCC) in hemodialysis (HD) patients. METHODS: Overall 246 HD patients who had undergone a radical nephrectomy for RCC were enrolled in this study. Unilateral RCC occurred in 201 patients, synchronous bilateral RCC in 15 and metachronous bilateral RCC in 30. Cancer-specific survival (CSS) was accessed by the Kaplan-Meier method. RESULTS: Five-year CSS was not significantly different between the two groups (unilateral, 90%; bilateral, 90%; P=0.9509). In total 17 of the 201 patients (8.5%) with unilateral occurrence and four of the 45 patients (8.9%) with bilateral occurrence died from kidney cancer during the follow-up period. The presence of acquired cystic disease of kidney (unilateral, 73%; bilateral 91%; P=0.00319) and the mean duration of HD before surgery (unilateral: 157±91 months, bilateral: 189±83.5, P = 0.0319) were significantly different between the two groups. There were more multifocal tumors in bilateral than in unilateral occurrence (bilateral: 74%, unilateral: 30%, P<0.0001). There were significant differences in CSS according to HD duration before surgery (5-year CSS >180 months 82%, ≤180 months 95%; P=0.0004), tumor grade (G1 100%, G2 90%, G3 38%; P<0.0001), and tumor size (>4 cm 75%, ≤4 cm 98%; P<0.0001). CONCLUSIONS: The type of occurrence of RCC, unilateral or bilateral, in HD patients does not appear to influence CSS. Patients with a longer duration of HD have to be followed up rigorously because they tend to have poor cancer prognosis.

[Renal allograft rupture attributed to coughing while asleep: a case report].

Renal allograft rupture (RAR) is a rare but serious complication of renal transplantation. The most common cause of RAR is acute rejection but other causes have increased in frequency with advances in immunosuppressive therapy. We report a patient with RAR attributed to coughing while asleep. A 53-year-old male received a living-donor renal transplantation for end-stage renal failure due to diabetic nephropathy. The clinical course was satisfactory, and he was discharged on the 12th postoperative day with a serum creatinine level of 1.24 mg/dl. On the 24th morning, he felt sudden swelling and pain over the incision area soon after a big cough. Ultrasound and computed tomography revealed a perinephric hematoma. Emergency surgical exploration showed complete laceration of the abdominal fascia and 4-cm rupture at the anterolateral aspect of the kidney. High intra-abdominal pressure when coughing had torn the fascia, and the graft appeared to have ruptured under the fascial tension. Bleeding was controlled with a polyglactin 910 2/0 mattress parenchymal suture enforced with application of a fibrin tissue-adhesive collagen fleece. Twelve months after the repair, the patient's renal function was stable with a serum creatinine level of 1.3 mg/dl.

A case of renal cell carcinoma with intrahepatic vena caval tumor thrombus successfully managed by surgery in a long-term chronic hemodialysis patient with liver cirrhosis.

A 54-year-old man who had been under hemodialysis therapy for 16 years presented with gross hematuria at our department in February 2005. Imaging findings revealed right renal tumor of8.2 cm in diameter. In addition, the tumor extended into inferior vena cava at the level of the hepatic vein. There were no findings of distant metastasis. Right radical nephrectomy and thrombectomy were performed on April 2006. Histopathological analysis showed that the tumor was renal cell carcinoma of clear cell type, grade 2. Postoperative course was uneventful, and the adjuvant therapy with interferon alpha was initiated. He has been free from recurrence for 22 months after surgery.

Successful testis preservation for bilateral testicular tumors with a new chemotherapy-based protocol: initial results of three cases.

The treatment for bilateral testicular tumors is associated with infertility and hypogonadism. We carried out testis-preserving therapy treatment for three patients with synchronous bilateral tumors with seminoma. Our protocol of testis preservation consisted of unilateral orchiectomy for the larger tumor followed by three courses of chemotherapy with a cisplatin, etoposide and bleomycin regimen. All three patients showed no recurrence 24, 24, and 82 months after treatment. The serum testosterone level was maintained around the lower limit of the normal range in all patients without androgen replacement, and sexual function was not impaired. One patient showed oligospermia, preoperatively, and the number of sperm was preserved at a similar level after treatment. Azoospermia was observed in two patients before the treatment, and still persisted after treatment. Testis preservation with a chemotherapy-based new protocol was carried out successfully without recurrence. In addition, our protocol preserved a good quality of life in all patients.

[A case of bilharziasis diagnosed 10 years later].

A 31-year-old Japanese man had macroscopic hematuria 5 or 6 years previously. When he was examined at a local hospital, he was pronounced normal. However he still had macroscopic hematuria, so he visited our department. Urine cytodiagnosis was class II. Cystoscopy revealed irregular mucosa at the anterior wall and dome of the bladder. CT and MRI also demonstrated irregular thickness at the anterior wall of the bladder. A diagnosis of bilharziasis was made by histological specimen obtained by TUR-biopsy. The specimen did not show evidence of malignancy. When questioned about overseas travel, he said he had visited Malawi in Africa when he was 20 years old. As international exchange between Japan and other countries is now increasing, we will be examining more patients who have traveled to epidemic areas. In such patients, we should consider the possibility of Schistosomiasis.

Multidimensional voice evaluation in pretreatment glottic carcinoma.

It is generally accepted that, in glottic carcinoma, the voice will deteriorate, even in the early stages. This paper reports the degree of hoarseness and multidimensional vocal evaluation of glottic carcinoma patients. Forty-seven male glottic carcinoma patients and a control group of 13 normal subjects were included in this study involving psychoacoustic evaluation by doctors, acoustic analysis, phonogram, maximum phonation time and stroboscopy before treatment. A normal voice or mild hoarseness by psychoacoustic evaluation was found in 35% of cases with T1 and T2 glottic carcinoma. Patients with psychoacoustically inferior vocalization had high scores on acoustic analysis, small phonogram areas, and short maximum phonation time. Stroboscopy revealed attenuation or disappearance of the mucosal wave on the tumor side in all cases, whether the acoustic analysis data were within or beyond the normal limits. We identified two conditions offering superior vocalization in glottic carcinoma patients: (1) the lesion should be unilateral, and (2) the lesion should be flat with no protrusion. We should evaluate patients with glottic carcinoma not only with vocal examination but also using stroboscopy before biopsy.

Nephron-sparing tumorectomy for a large benign renal mass: a case of massive bilateral renal angiomyolipomas associated with tuberous sclerosis.

A case of massive bilateral angiomyolipomas (AML) associated with tuberous sclerosis in a 33-year-old woman is reported. She was hospitalized because she had been experiencing abdominal fullness and epigastralgia. Several imaging studies revealed massive bilateral renal tumors and she was diagnosed as having renal AML associated with tuberous sclerosis. Left nephrectomy was carried out after renal arterial embolization for intratumor hemorrhage. Two years after left nephrectomy, nephron-sparing surgery (tumorectomy) for right AML was done because of an increase in the size of the right renal AML and she hoped for a future pregnancy. The left kidney with AML weighed 5700 g and the right AML weighed 1700 g. Postoperative serous creatinine did not differ from that before operation and an increase in the size of the residual tumor was not observed 8 months after operation. We consider that tumorectomy is an effective therapy in patients with a very large tumor involving a solitary kidney.