Elevated Plasma Concentration of 4-Pyridone-3-carboxamide-1-ß-D-ribonucleoside (4PYR) Highlights Malignancy of Renal Cell Carcinoma.

Nicotinamide (NA) derivatives play crucial roles in various biological processes, such as inflammation, regulation of the cell cycle, and DNA repair. Recently, we proposed that 4-pyridone-3-carboxamide-1-ß-D-ribonucleoside (4PYR), an unusual derivative of NA, could be classified as an oncometabolite in bladder, breast, and lung cancer. In this study, we investigated the relations between NA metabolism and the progression, recurrence, metastasis, and survival of patients diagnosed with different histological subtypes of renal cell carcinoma (RCC). We identified alterations in plasma NA metabolism, particularly in the clear cell RCC (ccRCC) subtype, compared to papillary RCC, chromophobe RCC, and oncocytoma. Patients with ccRCC also exhibited larger tumor sizes and elevated levels of diagnostic serum biomarkers, such as hsCRP concentration and ALP activity, which were positively correlated with the plasma 4PYR. Notably, 4PYR levels were elevated in advanced stages of ccRCC cancer and were associated with a highly aggressive phenotype of ccRCC. Additionally, elevated concentrations of 4PYR were related to a higher likelihood of mortality, recurrence, and particularly metastasis in ccRCC. These findings are consistent with other studies, suggesting that NA metabolism is accelerated in RCC, leading to abnormal concentrations of 4PYR. This supports the concept of 4PYR as an oncometabolite and a potential prognostic factor in the ccRCC subtype.

Simple method for correcting imperfectly placed fiducial markers for image-guided radiotherapy technologies of the prostate cancer.

One of the main method of treating prostate cancer is radiotherapy . Contemporary techniques as IGRT concentrate on proper delivery and exact delineation of the target. We present the simple method of correction the visualisation of gold markers implanted before radiotherapy . In the case when one or two seeds were located imperfectly or were lost with stool or urine we implant additional seeds which create the spatial figure recognised in CT and MRI . Implantation of additional seeds is safe and very simple method which can "rescue" sense of image guided procedure in the case of unfavourable primary fiducial seeds location.

Minimally Invasive Treatment of Vesico-ureteral Reflux Using Endoscopic Injection of Polyacrylate-Polyalcohol Copolymer (Vantris) in Patients After Kidney Transplantation.

BACKGROUND: Urinary tract infections (UTIs) are the most common infectious complications among kidney recipients. They occur due to the lack of an effective antireflux mechanism in the majority of techniques used during kidney transplantation. Subureteral injection of tissue bulking substance is a feasible alternative to open ureteral reimplantation. This paper, to the best of the authors' knowledge, is the first to evaluate the application of polyacrylate/polyalcohol copolymer (Vantris) as the agent for minimally invasive VUR treatment. MATERIALS AND METHODS: Between January 2018 and February 2019, 7 patients presenting with recurrent UTIs and the diagnosis of VUR (vesico-ureteric reflux) after kidney transplantation were enrolled in the study. Patients qualified for the study underwent cystoscopy and, if possible, minimally invasive, endoscopic subureteral application of 1 mL of polyacrylate/polyalcohol copolymer according to the subureteral transurethral injection (STING) technique. RESULTS: Endoscopic subureteral injection of tissue bulking substance (polyacrylate/polyalcohol copolymer) was successfully performed in 6 patients. In 1 patient it could not be completed because of an inconvenient location of the neo-orifice. In 4 patients (57%) no reduction of the reflux grade was observed in follow-up imaging. The number of UTIs in the follow-up was significantly reduced in 6 of 7 patients (86%) after polyacrylate/polyalcohol copolymer subureteral injection. CONCLUSIONS: Endoscopic treatment of VUR with polyacrylate/polyalcohol copolymer is an effective and safe method as a first-line treatment for patients with recurrent UTIs after kidney transplantation. To obtain clear conclusions, however, it is necessary to study a larger number of patients with a longer follow-up period after surgery.

The Metastasis of Renal Cell Carcinoma to the Urethra and Local Tumor Recurrence.

We present the case of metastasis of renal cell carcinoma to the urethra in a 77-year-old woman who underwent -nephrectomy 6 years ago due to renal cell carcinoma. After 3 years, she returned to the ward due to a small, palpable nodule in the area of the urethra that turned out to be a cancer of the clear cell carcinoma. Despite the resection of the -lesion with negative margins in the pathology examination, a local regrowth in the same area was diagnosed in the MRI 8 months after the first episode of metastasis and was successfully removed. The patient keeps urine properly.

Nicotinamide metabolism alterations in bladder cancer: Preliminary studies.

OBJECTIVES: Cancer is one of the main cause of death in Western countries. Inflammation plays an important role in the pathogenesis of cancer. Nicotinamide (NA) - known for its anti-inflammatory properties - participates in the processes related to the cell cycle regulation and DNA repair, which are relevant in cancer development. This study aimed to investigate the nicotinamide metabolism alterations in bladder cancer. METHODS: Blood and plasma samples of patients with bladder cancer were collected. Blood pyridine and adenine nucleotides concentration were measured using high performance liquid chromatography (HPLC). Plasma nicotinamide metabolites concentration were determined using high performance liquid chromatography - mass spectrometry (LC/MS). RESULTS: Our results indicated that the development of bladder cancer caused significant decrease in the concentration of N-methylnicotinamide (MetNA) (0.07 ± 0.02 vs 0.1 ± 0.03 µmol/l) and an increase in the concentration of N-methyl-2-pyridone-5-carboxamide (Met2PY) - one of the final nicotinamide metabolites: (1.1 ± 0.15 vs 0.7 ± 0.07 µmol/l) in comparison to the control. The association between the stage of cancer and the increase in both, Met2PY and Met4PY levels was observed. Blood ATP and NAD levels were significantly decreased in bladder cancer patients as compared to the control (970.8 ± 77.84 vs 1165.00 ± 57.76 µmol/l; 45.86 ± 2.98 vs 53.06 ± 2.28 µmol/l respectively). CONCLUSIONS: Bladder cancer development caused substantial changes in nicotinamide metabolism, such as decreased plasma MetNA and increased Met2PY concentration. Analysis of the nicotinamide and its metabolites concentrations - as new biomarkers - may allow to track the course of pathological processes in cancer.

[Giant hydronephrosis of the upper left kidney in the case of complete, one-sided double pelvis]. / Olbrzymie wodonercze górnego bieguna nerki w przypadku calkowitego, jednostronnego zdwojenia górnych dróg moczowych.

We present the case of giant hydronephrosis in double pelvis of the left kidney. Patient was admitted to the urology department with hypertension and palpable giant mass in the abdomen. During imaging examination (CT, MRI ) the diagnosis of double pelvis and ureter on left side was established. The upper collecting system was extremely hydronephrotic and afunctional. Patient underwent partial nephrectomy - upper part of left kidney. We evacuated 9 liters of stagnated urine. After surgery blood pressure normalised, renal efficiency remained normal.

[A case of non-seminomatous testis tumor]. / Przypadek guza jadra typu non-seminoma.

The authors present a case of germ cell tumor with combined histology, because of the unheard size of primary mass. Testis tumors in virtue of their localisation and simplicity of self-observation in most cases are early diagnosed. Unfortunately there are the cases of the patients who because of the shame, hide the disease even from the family for a long time.