A human case of Dioctophyma renale (giant kidney worm) accompanied by renal cancer and a retrospective study of dioctophymiasis.

Due to the rarity of human cases and the nonspecific clinical symptoms of dioctophymiasis, Dioctophyma renale infection is not well recognized and is easily neglected or misdiagnosed. Recently, we diagnosed a human case of dioctophymiasis accompanied by renal cancer. To enhance the understanding of human dioctophymiasis, this case is presented here, and a retrospective study of this disease was conducted based on relevant papers screened from PubMed and three Chinese databases. In the end, 32 papers describing 37 human cases of dioctophymiasis were assessed. These cases were distributed in ten countries of Asia, Europe, North America and Oceania, with the highest number in China (n = 22). The majority of the cases occurred in adults (91.9%, 34/37) and involved the kidneys (83.8%, 31/37). Ectopic parasitism mainly occurred in subcutaneous tissue (83.3%, 5/6). A proportion of 45.9% (17/37) of individuals had a history of eating raw or undercooked fish or frogs. The main clinical manifestations of human dioctophymiasis were loin pain (59.5%) and hematuria (59.5%). All the cases were diagnosed based on the morphological characteristics of eggs or adults in urine or tissue sections. Currently, there is no strictly defined therapeutic approach. This is the first retrospective analysis of human cases of dioctophymiasis. These review data will deepen our understanding of dioctophymiasis and help avoid misdiagnosis in clinical practice.

Renal cell carcinoma in octogenarians: nephron sparing surgery should remain the standard of care.

PURPOSE: Data regarding clinical outcomes in elderly patients with renal cell carcinoma are scarce. We determined management, and overall and cancer specific survival in elderly patients with renal cell carcinoma. MATERIALS AND METHODS: Using the Surveillance, Epidemiology, and End Results database we identified 59,944 patients who underwent partial or radical nephrectomy for renal cell carcinoma between 1988 and 2005. Patients were separated into 2 groups of those younger than 80 years, and those 80 years old or older, and were stratified by clinical variables. Chi-square, multivariate logistic regression and Kaplan-Meier analyses were used to determine differences between the cohorts in terms of surgical approach, and overall and cancer specific survival. RESULTS: In total, 4,227 patients (7.5%) were older than 80 years old. Younger patients more likely underwent partial nephrectomy than their older counterparts (13% vs 8%, p <0.001). At a median followup of 37 months (range 0 to 215) for patients younger than 80 years, and 27 months (range 0 to 203) for octogenarians, older patients were 2.32 times more likely to die (95% CI 2.22-2.42, p <0.001) and 1.33 times more likely to die of renal cell carcinoma (95% CI 1.23-1.43, p <0.001) than their younger counterparts. Older patients who underwent radical nephrectomy were 2.54 times more likely to die of renal cell carcinoma (95% CI 1.68-3.84, p <0.001) than older patients who underwent partial nephrectomy. CONCLUSIONS: Older patients are less likely to undergo partial nephrectomy than their younger counterparts. Octogenarians treated with partial nephrectomy are less likely to die of renal cell carcinoma than those who undergo radical nephrectomy.

Validation of a postoperative prognostic model consisting of tumor microvascular invasion, size, and grade to predict disease-free and cancer-specific survival of patients with surgically resected renal cell carcinoma.

OBJECTIVES: To determine the value of microvascular invasion, tumor size, and Fuhrman grade to predict the survival of patients with surgically resected renal cell carcinoma (RCC). METHODS: A total of 771 consecutive patients (T1-4, Nx, M0) were retrospectively reviewed. For each patient with RCC, the prognostic Sao Paulo score (SPS) was calculated using the following variables: tumor size (>7 cm vs

Leishmanicidal metabolites from Cochliobolus sp., an endophytic fungus isolated from Piptadenia adiantoides (Fabaceae).

Protozoan parasites belonging to genera Leishmania and Trypanosoma are the etiological agents of severe neglected tropical diseases (NTDs) that cause enormous social and economic impact in many countries of tropical and sub-tropical areas of the world. In our screening program for new drug leads from natural sources, we found that the crude extract of the endophytic fungus Cochliobolus sp. (UFMGCB-555) could kill 90% of the amastigote-like forms of Leishmania amazonensis and inhibit by 100% Ellman's reagent reduction in the trypanothione reductase (TryR) assay, when tested at 20 microg mL(-1). UFMGCB-555 was isolated from the plant Piptadenia adiantoides J.F. Macbr (Fabaceae) and identified based on the sequence of the internally transcribed spacer (ITS) regions of its ribosomal DNA. The chromatographic fractionation of the extract was guided by the TryR assay and resulted in the isolation of cochlioquinone A and isocochlioquinone A. Both compounds were active in the assay with L. amazonensis, disclosing EC(50) values (effective concentrations required to kill 50% of the parasite) of 1.7 microM (95% confidence interval = 1.6 to 1.9 microM) and 4.1 microM (95% confidence interval = 3.6 to 4.7 microM), respectively. These compounds were not active against three human cancer cell lines (MCF-7, TK-10, and UACC-62), indicating some degree of selectivity towards the parasites. These results suggest that cochlioquinones are attractive lead compounds that deserve further investigation aiming at developing new drugs to treat leishmaniasis. The findings also reinforce the role of endophytic fungi as an important source of compounds with potential to enter the pipeline for drug development against NTDs.

The effect of dimethylnitrosamine on the activities of renal prenolsulfotransferase and arylsulfatases A and B in Schistosona mansoni infected mice.

The activities of renal phenolsulfotransferase and arylsulfatases A and B were estimated in 400 male Swiss albino mice classified into four groups: Normal controls, Schistosoma mansoni infected group, Dimethylnitrosamine (DMN) treated group and infected treated group. The activity levels of the studied enzymes were significantly increased in all groups when compared with the control group, also the statistical analyses showed a high significant increase of the three enzymes levels in the infected treated group; when compared separately with treated or infected groups. It was concluded, therefore, that schistosomal infection is implicated in the development of kidney cancer which may arise from the pattern of hepatic mixed-function oxidase induction characterized for schistosomiasis and its temporal relationship with the procarcinogenic initiating events. Furthermore, the striking significant increase in the enzymatic activity levels of the acid hydrolases arylsulfatases due to the lesion of both cytotoxic effects of dimethylnitrosamine as well as pathological change of schistosomiasis which may play an active role in the initiation of the malignant process by detoxifying endogenous sulfated aromatic metabolites.

Renin in Wilms' tumor: prorenin as an indicator.

In a prospective study, 25 children with nephroblastoma (Wilms' tumor) had preoperative plasma prorenin and renin concentrations measured. The mean plasma renin and prorenin concentrations in the patients were raised compared with a control group of patients without nephroblastoma. Four children had recurrence of tumor and, in three, this was associated with an increase in plasma prorenin concentration. Nephroblastoma tissue contained immunoreactive renin and renin messenger RNA, and the renin protein was immunologically and biochemically similar to normal human renin. We conclude that prorenin concentrations in plasma are an indicator of nephroblastoma.

Molecular analysis of genetic changes in the origin and development of renal cell carcinoma.

Renal cell carcinoma has been characterized by an abnormality on the short arm of chromosome 3 which suggests the presence of a tumor suppressor gene at this location. In order to more precisely define the location of the renal cell carcinoma gene and to differentiate molecular changes occurring in early stages of renal neoplasia versus those occurring later in malignant progression, DNA from normal and tumor tissue from 60 patients with various stages of renal cell carcinoma was analyzed for loss of alleles at different chromosomal loci. In tumor tissue from 51 of 58 evaluable patients (88%) there was loss of heterozygosity at one or more of 10 loci tested on chromosome 3 independently of tumor stage. Analysis of the genotypes identified the distal portion of 3p bounded by D3S2 and D3S22 (3p21-26) as the region of the disease gene. In tumor tissue from patients with advanced renal cell carcinoma, we found loss of heterozygosity on chromosome 11p in 5 of 21 (24%), on chromosome 13 in 3 of 9 (33%), and on chromosome 17 in 2 of 19 (11%). We found no loss of heterozygosity at the loci on chromosomes 11, 13, or 17 in tumor tissue from patients with localized renal cell carcinoma (N = 5). These data suggest the existence of a tumor suppressor gene on chromosome 3p which may be essential to the genesis of sporadic renal cell carcinoma and that other tumor suppressor genes are associated with progression of this malignancy.