[Renal functional compensation after unilateral radical nephrectomy of renal cell carcinoma].

OBJECTIVE: To investigate factors influencing renal functional compensation(RFC) of the preserved kidney after radical nephrectomy (RN). METHODS: A total of 286 patients treated with RN in Peking University People's Hospital were retrospectively analyzed. Preoperative body mass index (BMI), systolic blood pressure (SBP), history of smoking, history of chronic diseases and other basic information, as well as preoperative blood biochemistry, urine routine, imaging examination results were recorded. All the patients underwent 99mtechnetium-diethylenetriamine pentaacetic acid (99mTc-DTPA) renal scans before operation. The surgical method, pathology and blood creatinine values from 1 month to 60 months after RN were recorded. Preoperative and postoperative estimated glomerular filtration rate (eGFR) was calculated by the chronic kidney disease epidemiology collaboration (CKD-EPI) formula. Renal functional compensation was defined as percent change in eGFR of the preserved kidney after RN compared with the preoperative eGFR. Univariate and multivariate regression analyses were used to identify predictive factors of RFC. RESULTS: Median age was 61 years and 65.4% of the patients were male. Early stage (T1 or T2) tumors were found in 83.6% of the cases. 18.5% of the patients had preoperative diabetes mellitus, 39.5% had hypertension, 19.2% had a history of smoking, and 27.6% were found to have renal cyst on the contralateral side. In the study, 226 cases underwent laparoscopic radical nephrectomy and 60 cases underwent open radical nephrectomy. Renal clear cell carcinoma was the most common pathological type, accounting for 88.5%. The median tumor maximum diameter was 4.5 cm (0.7-13.5 cm). Median renal function compensation was 27% one month after radical nephrectomy. Functional stability was then observed to 5 years. The results of univariate analysis showed that age, gender, preoperative blood uric acid, preoperative urine protein, contralateral renal cyst, and percentage of split renal function of contralateral kidney were correlated with RFC (P < 0.05). Among them, UA level and split renal function of contralateral kidney were strongly negatively correlated with RFC. The results of multivariate linear regression analysis showed age (P < 0.001), blood uric acid (P < 0.001), urine protein (P=0.002), preoperative eGFR (P < 0.001) and the split renal function of contralateral kidney (P < 0.001) were independent predictors of RFC. CONCLUSION: The basic examinations, such as blood biochemistry, urine routine and renal scan before RN are of great significance in predicting the compen-satory ability of the preserved kidney after RN, which is supposed to be taken into consideration when making clinical decision.

Subepithelial neutrophil infiltration as a predictor of the surgical outcome of chronic rhinosinusitis with nasal polyps.

BACKGROUND: Neutrophils present as major inflammatory cells in refractory chronic rhinosinusitis with nasal polyps (CRSwNP), regardless of the endotype. However, their role in the pathophysiology of CRSwNP remains poorly understood. We investigated factors predicting the surgical outcomes of CRSwNP patients with focus on neutrophilic localization. METHODS: We employed machine-learning methods such as the decision tree and random forest models to predict the surgical outcomes of CRSwNP. Immunofluorescence analysis was conducted to detect human neutrophil elastase (HNE), Bcl-2, and Ki-67 in NP tissues. We counted the immunofluorescence-positive cells and divided them into three groups based on the infiltrated area, namely, epithelial, subepithelial, and perivascular groups. RESULTS: On machine learning, the decision tree algorithm demonstrated that the number of subepithelial HNE-positive cells, Lund-Mackay (LM) scores, and endotype (eosinophilic or non-eosinophilic) were the most important predictors of surgical outcomes in CRSwNP patients. Additionally, the random forest algorithm showed that, after ranking the mean decrease in the Gini index or the accuracy of each factor, the top three ranking factors associated with surgical outcomes were the LM score, age, and number of subepithelial HNE-positive cells. In terms of cellular proliferation, immunofluorescence analysis revealed that Ki-67/HNE-double positive and Bcl-2/HNE-double positive cells were significantly increased in the subepithelial area in refractory CRSwNP. CONCLUSION: Our machine-learning approach and immunofluorescence analysis demonstrated that subepithelial neutrophils in NP tissues had a high expression of Ki-67 and could serve as a cellular biomarker for predicting surgical outcomes in CRSwNP patients.

Multi-mission satellite remote sensing data for improving land hydrological models via data assimilation.

Satellite remote sensing offers valuable tools to study Earth and hydrological processes and improve land surface models. This is essential to improve the quality of model predictions, which are affected by various factors such as erroneous input data, the uncertainty of model forcings, and parameter uncertainties. Abundant datasets from multi-mission satellite remote sensing during recent years have provided an opportunity to improve not only the model estimates but also model parameters through a parameter estimation process. This study utilises multiple datasets from satellite remote sensing including soil moisture from Soil Moisture and Ocean Salinity Mission and Advanced Microwave Scanning Radiometer Earth Observing System, terrestrial water storage from the Gravity Recovery And Climate Experiment, and leaf area index from Advanced Very-High-Resolution Radiometer to estimate model parameters. This is done using the recently proposed assimilation method, unsupervised weak constrained ensemble Kalman filter (UWCEnKF). UWCEnKF applies a dual scheme to separately update the state and parameters using two interactive EnKF filters followed by a water balance constraint enforcement. The performance of multivariate data assimilation is evaluated against various independent data over different time periods over two different basins including the Murray-Darling and Mississippi basins. Results indicate that simultaneous assimilation of multiple satellite products combined with parameter estimation strongly improves model predictions compared with single satellite products and/or state estimation alone. This improvement is achieved not only during the parameter estimation period ([Formula: see text] 32% groundwater RMSE reduction and soil moisture correlation increase from [Formula: see text] 0.66 to [Formula: see text] 0.85) but also during the forecast period ([Formula: see text] 14% groundwater RMSE reduction and soil moisture correlation increase from [Formula: see text] 0.69 to [Formula: see text] 0.78) due to the effective impacts of the approach on both state and parameters.

MiR-129 is involved in the occurrence of uterine fibroid through inhibiting TET1.

OBJECTIVE: To detect the expressions of micro ribonucleic acid (miR)-129 and its target gene in uterine fibroid tissues and to investigate the role of miR-129 in the occurrence of uterine fibroid. PATIENTS AND METHODS: The expressions of miR-129 and its target gene ten-eleven translocation 1 (TET1) were detected via quantitative reverse transcription-polymerase chain reaction (qRT-PCR). Dual-luciferase reporter gene and Western blotting were used to verify the regulatory relation between miR-129 and target gene. The effects of miR-129 on the proliferation, apoptosis, cycle and extracellular matrix (ECM) of uterine fibroid cells were investigated via transfection with miR-129 mimics and TET1 small-interfering RNA (siRNA). RESULTS: MiR-129 was lowly expressed in uterine fibroid. The expression of miR-129 was regulated by sex hormones. The highly expressed miR-129 promoted apoptosis and inhibited proliferation through reducing the low expression of TET1. At the same time, miR-129 affected the accumulation of ECM. CONCLUSIONS: The expression of miR-129 in uterine fibroid is lower, and the proliferation capacity of tumor cells is enhanced, thus promoting the occurrence and development of uterine fibroid.

Quercetagetin inhibits macrophage-derived chemokine in HaCaT human keratinocytes via the regulation of signal transducer and activator of transcription 1, suppressor of cytokine signalling 1 and transforming growth factor-ß1.

BACKGROUND: Inflammatory chemokines, such as macrophage-derived chemokine (MDC/CCL22), are elevated in the serum and lesioned skin of patients with atopic dermatitis (AD), and are ligands for C-C chemokine receptor 4, which is predominantly expressed on T helper 2 lymphocytes, basophils and natural killer cells. We have previously reported that quercetagetin has an inhibitory activity on inflammatory chemokines, which is induced by interferon (IFN)-γ and tumour necrosis factor (TNF)-α, occurring via inhibition of the signal transducer and activator of transcription 1 (STAT1) signal. OBJECTIVES: To investigate the specific mechanisms of quercetagetin on the STAT1 signal. METHODS: We confirmed the inhibitory activity of quercetagetin on MDC and STAT1 in HaCaT keratinocytes. The interaction between STAT1 and IFN-γR1 was investigated using immunoprecipitation. The small interfering RNA approach was used to investigate the role of suppressor of cytokine signalling 1 (SOCS1) and transforming growth factor (TGF)-ß1 induced by quercetagetin. RESULTS: Quercetagetin inhibited the expression of MDC at both the protein and mRNA levels in IFN-γ- and TNF-α-stimulated HaCaT human keratinocytes. Moreover, quercetagetin inhibited the phosphorylation of STAT1 through upregulation of SOCS1. Increased expression of SOCS1 disrupted the binding of STAT1 to IFN-γR1. Furthermore, quercetagetin augmented the expression of TGF-ß1, which is known to modulate the immune response and inflammation. CONCLUSIONS: These results suggest that quercetagetin may be a potent inhibitor of the STAT1 signal, which could be a new molecular target for anti-inflammatory treatment, and may thus have therapeutic applications as an immune modulator in inflammatory diseases such as AD.

Toxicity study of a new camptothecin anti-cancer agent CKD-602 in dogs: 4-week continuous intravenous dose by infusion pump and 4-week repeated intravenous dose.

In evaluating toxicity, one of the most important factors is the administration method, because it can affect the exposure and absorbance level of the test article, and, consequently, influence the interpretation of toxicity test results. Continuous intravenous (IV) administration is a widely used administration method for anti-cancer drugs in clinical settings. Previous studies have reported the toxic effects of the test article following repeated IV dosing of CKD-602, a novel camptothecin-derivative anti-tumor agent that was developed by Chong Kun Dang Pharmaceutical Corporation in Seoul, Korea. However, CKD-602-related toxicities induced by IV infusion administration have not yet been evaluated, although the drug is more widely used in clinical settings. In the present study, CKD-602 was administered using a continuous IV infusion pump and using repeated IV administration at doses of 0, 0.003, or 0.01 mg/kg/day for 4 weeks to compare and evaluate the drug-induced toxicities using the two different administration methods. Higher mortality, more severe clinical symptoms, increased complete blood count, serum biochemistry, and histopathology were demonstrated when CKD-602 was administered using the 4-week continuous IV infusion pump method compared with the repeated IV administration method. Based on these results, we conclude that the administration of CKD-602 using the 4-week continuous IV infusion pump method can elicit more severe toxicity than that using 4-week repeated IV dosing method. Thus, more attention should be paid to the administration of CKD-602 using continuous IV infusion in the clinical setting.

A Chinese pedigree of cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy (CARASIL): clinical and radiological features.

Cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy (CARASIL) is a rare hereditary cerebral vascular disease thought to be confined to Japan. This paper reports a Chinese pedigree of CARASIL in which two patients exhibited all of the typical clinical features of the disease. The radiological features are also discussed and compared with those of CADASIL. These cases illustrate the unique clinical and radiological features of CARASIL and challenge the idea that CARASIL is limited to the Japanese population.

Removal of manganese from water using combined chelation/membrane separation systems.

The addition of the chelating polymer polyacrylic acid (PAA) to assist in the removal of manganese from groundwater by membranes was investigated using membranes with different pore sizes under various operating conditions. Negligible manganese removal was achieved with the UF and NF membranes at acidic pH values, but removals exceeding 90% could be achieved at elevated pH (pH 9), presumably due to the formation of manganese hydroxides. Mn removal increased substantially when PAA was added to the feed solution, due to chelation of Mn by the PAA and rejection of the chelates by the membranes. The chelate could be broken at acidic pH, releasing free PAA that could then be separated from the Mn ions and reused. Smaller PAA molecules were lost in the first regeneration cycle, but negligible PAA was lost in subsequent cycles. In the systems with PAA, nitrate ions were rejected more efficiently than in the PAA-free systems, presumably because of electrical repulsion between nitrate ions and PAA sorbed on the membrane surface. With increasing PAA dose, the volumetric flux first decreased and then increased; the latter result was accompanied by a change in the physical-chemical form of the polymers, as indicated by an increase in turbidity.

Note on the use of reciprocity of chiral recognition in designing liquid chromatographic chiral stationary phases.

A new high-performance liquid chromatographic chiral stationary phase (CSP) was prepared from (S)-N-(3,5-dimethylbenzoyl)leucine N-phenyl N-allyl amide. The new CSP was applied for the resolution of N-(3,5-dinitrobenzoyl)-alpha-amino amides and esters and the chromatographic resolution results were compared with those on another CSP derived from (S)-N-(3,5-dimethoxylbenzoyl)leucine N-phenyl N-allyl amide. The new CSP was found to exert greater enantioselectivity than the other one. These results are contrary to what was expected from the reciprocity of chiral recognition. From these results it was concluded that the reciprocity of chiral recognition should be used with some degree of care in developing effective CSPs or in predicting chromatographic resolution behaviors.

New chiral crown ether stationary phase for the liquid chromatographic resolution of alpha-amino acid enantiomers.

A new chiral stationary phase (CSP) for the liquid chromatographic separation of enantiomers was prepared by bonding a novel enantiopure (diphenyl-substituted 1,1'-binaphthyl) crown ether to 5 microm silica gel. The resulting CSP was applied to the separation of the enantiomers of various natural and unnatural alpha-amino acids. All alpha-amino acids tested were resolved very well on the new CSP, with the exception of proline, which does not contain a primary amino group. The resolution of alpha-amino acid enantiomers on this new CSP was found to be dependent on the type and amounts of organic and acidic modifiers, and on column temperature.

Video compression with dense motion fields.

We propose a motion-compensated video coding system employing dense motion fields. The dense motion field is calculated at the transmitter, and the motion information is efficiently encoded and transmitted along with the residual frame. The motion estimation is performed by existing techniques in the literature, while we focus on the coding of the motion field and the displaced frame difference (DFD) frame. The dense motion field formulation leads to several novel and distinct advantages. The motion field is encoded in a lossy manner to make the motion rate manageable. The more accurate and precise motion description allows us to predict where the DFD energy will be significant, thus leading to a more efficient DFD encoder compared to applying traditional still-image coding techniques. Furthermore, the dense motion field framework allows us to refine and tailor the motion estimation process such that the resulting DFD frame is easier to encode. Simulations demonstrate superior performance against standard block-based coders, with greater advantages for sequences with more complex motion.

Liquid chromatographic resolution of biphenyl dimethyl dicarboxylate (DDB) and its analogues on a chiral stationary phase.

Racemic biphenyl dimethyl dicarboxylate (DDB) and its analogues have been successfully resolved on a commercial HPLC chiral column, (3R,4S)-Whelk-O 1. In general, cyclic amide analogues of DDB, which were derived from pyrrolidine or piperidine, showed greater enantioselectivity and greater retention than the corresponding N,N-dialkyl amide or N-alkyl amide or ester analogues. From these results, it was concluded that the carbonyl oxygen of the DDB analogues plays an important role as a hydrogen bond acceptor, though the steric bulkiness of the amide functionality of DDB analogues may be another factor governing chiral recognition. The conformational stability of the two enantiomers of DDB and its analogues was also found to be high enough for the two enantiomers to be resolvable on (3R,4S)-Whelk-O 1.

Chemoradiation as primary or adjuvant treatment for locally advanced carcinoma of the vulva.

PURPOSE: To determine the impact of primary or adjuvant chemotherapy and radiation (CRT) on the survival rates of patients with locally advanced vulvar carcinoma. METHODS AND MATERIALS: Between 1973 and 1998, 54 patients with vulvar cancer were treated with radiation therapy, among which 20 received CRT, while 34 patients received radiation therapy (RT) alone. Of the 20 patients, 14 were treated for primary or recurrent disease (pCRT), and 6 after radical vulvectomy for high-risk disease (aCRT). Of the 34 patients, 12 were treated primarily (pRT) and 22 received adjuvant treatment (aRT). Chemotherapy consisted of 2 courses of 5-fluorouracil (5-FU) and mitomycin C administered during RT. Six patients received cisplatin in place of mitomycin C. In CRT groups, radiation was administered to the vulva, pelvic, and inguinal lymph nodes to a median dose of 45 Gy with additional 6-17 Gy to gross disease. In RT groups, the median dose to the microscopic diseases was 45 Gy. Nine patients received external beam boost and 16 patients received supplementary brachytherapy in the forms of (226)Ra or (241)Am plaques to sites of macroscopic disease. RESULTS: Overall survival was superior in the patients treated with pCRT versus pRT with statistical significance (p = 0.04). There was also a statistically significant improvement in disease-specific (p = 0.03) and relapse-free survival (p = 0.01) favoring pCRT. No statistically significant trends of improved survival rates favoring aCRT over aRT were observed. CONCLUSION: Concurrent radiation therapy and chemotherapy decreases local relapse rate, improves disease-specific and overall survival over RT alone as primary treatment for locally advanced vulvar cancer.

Liquid chromatographic resolution of 2-hydroxycarboxylic acids on a new chiral stationary phase derived from (S)-leucine.

Enantiomers of racemic 2-hydroxycarboxylic acids have been resolved as their O-ethoxycarbonyl pi-basic anilide derivatives on a new chiral stationary phase (CSP) derived from N-(3,5-dinitrobenzoyl)leucine N-phenyl N-alkylamide and the resolution results have been compared with those on various commercial pi-acidic CSPs. The resolution results demonstrate that the new CSP derived from N-(3,5-dinitrobenzoyl)leucine N-phenyl N-alkylamide is most effective among the five CSPs tested for the resolution of 2-hydroxycarboxylic acid derivatives. In order to elucidate the chiral recognition mechanism exerted by the new CSP, the resolution of slightly differently modified derivatives of 2-hydroxycarboxylic acids on the new CSP has been investigated. Based on the resolution results, a chiral recognition mechanism utilizing three simultaneous interactions such as the face to face pi-pi interaction and the two hydrogen bonding interactions between the CSP and the more retained enantiomer of the analyte has been proposed.

Effect of the double bond pi-conjugation of the aromatic group of racemic analytes on the liquid chromatographic separation of enantiomers.

Various arylcarbinol esters were resolved on a commercial chiral column, (S, S) Whelk-O1. Among others, the analytes in which the aryl group is in conjugation with the double bond(s) to the chiral center were resolved much better on (S, S) Whelk-O1 than the corresponding non-double bonded analytes. From these results, it was proposed that the double bond pi-conjugation of the aromatic group of racemic analytes is very important for the chiral recognition. In addition, the size of the acyl group of arylcarbinol esters has been demonstrated to be important for the chiral recognition. In general, the large acyl group such as pivaloyl group was very effective for the chiral recognition of arylcarbinol esters on (S, S) Whelk-O1.

Effects of hypoxia on corneal epithelial permeability.

PURPOSE: Epithelial permeability to fluorescein (Pdc) increases with closed-eye soft contact lens wear. Possible mechanisms responsible for this change include corneal hypoxia (and acidosis) during overnight wear and interference of the lens with normal tear exchange. In this study we used a local environmental chamber to examine the effects of hypoxia on Pdc. METHODS: After baseline slit-lamp examination, autofluorescence, and central corneal thickness measurements, 35 subjects were fitted with a pair of airtight swimming goggles. One eye was exposed to a humidified gas mixture containing 95% nitrogen (N2) and 5% carbon dioxide (CO2), and the fellow (control) eye was exposed to air. The experimental eye and the eye measured first were assigned using a randomized block design. After the subjects wore the goggles for 1 hour, corneal thickness measurements were repeated and Pdc was assessed as previously described. A final slit-lamp examination was performed by a masked examiner to assess epithelial integrity. RESULTS: There was no significant difference in the mean ln(Pdc) (95% confidence interval) for eyes exposed to N2/CO2 when compared with paired eyes exposed to air (-2.70 [-2.99, -2.41] vs -2.51 [-2.72, -2.30] ln[nm/sec], P = .272). Although there was also no substantial difference in the slit-lamp appearance of the experimental and control eyes, the mean (95% confidence interval) change in corneal thickness for the hypoxic eyes was 19.78 (15.72, 23.84) microm compared with 3.40 (-0.67, 7.47) microm (P < .0001) in the control eyes. CONCLUSION: One hour of hypoxia caused a significant increase in corneal thickness with no apparent change in Pdc. This suggests that other factors, either alone or in combination with hypoxia, may be responsible for increased Pdc during closed-eye contact lens wear.

Myofascial pain syndrome and trigger-point management.

BACKGROUND AND OBJECTIVES: Myofascial pain syndrome (MPS) is a common condition often resulting in referral to a pain clinic. The epidemiology, pathogenesis, and various diagnostic tools are reviewed, and a variety of treatment methods are discussed. METHODS: Extensive periodical literature and textbooks are reviewed, and selected manuscripts are critically analyzed. RESULTS: The incidence of MPS with associated trigger points appears to vary between 30 and 85% of people presenting to pain clinics, and the condition is more prevalent in women than in men. Patients complain of regional persistent pain, ranging in intensity and most frequently found in the head, neck, shoulders, extremities, and low back. Muscle histologic abnormalities have been described in some studies. Similarly, electromyographic, thermographic, and pressure algometric studies have inconsistently identified abnormalities. A multidisciplinary approach to treatment appears to be most beneficial and may include such modalities as trigger-point injections, dry needling, stretch and spray, and transcutaneous electrical nerve stimulation. CONCLUSIONS: The definitive pathogenesis of MPS is currently unknown, and no single diagnostic method is consistently positive. While trigger-point injection is the most widely employed method of treatment, other modes of therapy have also proved to be effective.

Diagnosis of primary cardiac lymphoma. Report of a case with cytologic examination of pericardial fluid and imprints of transvenously biopsied intracardiac tissue.

BACKGROUND: Primary cardiac lymphoma (PCL) is a treatable disease when appropriately diagnosed. Therefore, a prompt, safe method with high diagnostic accuracy is prerequisite to successful therapy for PCL. CASE: A 57-year-old male presented with exertional dyspnea and atrial fibrillations. A pericardial effusion (PE) and several tumor masses occupying both atria were found. Cytologic examinations of PE and of imprints of the tissues obtained by transvenous biopsy of the cardiac tumors revealed numerous small, round tumor cells and lymphoglandular bodies, suggestive of malignant lymphoma. This cytologic impression was confirmed by immunocytochemical studies on the same cytologic material. Histologic studies reaffirmed the diagnosis of B-cell lymphoma. The patient received eight courses of chemotherapy, with complete remission of the illness. CONCLUSION: Cardiac lymphoma can be quickly and safely diagnosed by cytologic examination of PE or transvenously biopsied cardiac tissue, with confirmation by immunocytochemical studies. Exploratory thoracotomy for biopsy can be avoided.