Loss of Nuclear BAP1 Expression Is Associated with High WHO/ISUP Grade in Clear Cell Renal Cell Carcinoma

Background BRCA1-associated protein 1 (BAP1) mutations are frequently reported in clear cell renal cell carcinoma (ccRCC); however, very few studies have evaluated the role of these mutations in other renal cell carcinoma (RCC) subtypes. Therefore, we analyzed BAP1 protein expression using immunohistochemistry in several RCC subtypes and assessed its relationship with clinicopathological characteristics of patients. Methods BAP1 expression was immunohistochemically evaluated in tissue microarray blocks constructed from 371 samples of RCC collected from two medical institutions. BAP1 expression was evaluated based on the extent of nuclear staining in tumor cells, and no expression or expression in < 10% of tumor cells was defined as negative. Results Loss of BAP1 expression was observed in ccRCC (56/300, 18.7%), chromophobe RCC (6/26, 23.1%), and clear cell papillary RCC (1/4, 25%), while we failed to detect BAP1 expression loss in papillary RCC, acquired cystic disease-associated RCC, or collecting duct carcinoma. In ccRCC, loss of BAP1 expression was significantly associated with high World Health Organization (WHO)/International Society of Urological Pathology (ISUP) grade (p = .002); however, no significant correlation was observed between loss of BAP1 expression and survival in ccRCC. Loss of BAP1 expression showed no association with prognostic factors in chromophobe RCC. Conclusions Loss of BAP1 nuclear expression was observed in both ccRCC and chromophobe RCC. In addition, BAP1 expression loss was associated with poor prognostic factors such as high WHO/ISUP grade in ccRCC

β-Defensin 2, an Antimicrobial Peptide, as a Novel Biomarker for Ulcerative Interstitial Cystitis; Can β-Defensin 2 Suspect the Dysbiosis of Urine Microbiota?

As urine is not sterile, inflammatory reactions caused by dysbiosis of the urinary microbiota may induce interstitial cystitis. A study was conducted to determine whether β-defensin 2 (BD-2), a specific antimicrobial peptide in the bladder, could be used as a novel diagnostic marker for ulcerative interstitial cystitis (IC). Urine samples from three female groups were examined: healthy controls (n = 34, Control group), non-Hunner type IC (n = 40, NHIC group), and Hunner type IC (n = 68, HIC group). Urine samples were collected via a transurethral catheter and assayed for BD-2 levels using enzyme linked immunosorbent assay. Under general or regional anesthesia, cystoscopy with diagnostic and therapeutic hydrodistension was performed in NHIC and HIC groups patients. These patients underwent a biopsy of the bladders. Based on the urinary specimens from 142 patients, BD-2 expression was found to be 18-fold higher in patients with Hunner type IC than in patients with non-Hunner type IC. The enhanced secretion of BD-2 exhibited a strong correlation with increased mast cell counts associated with bladder IC pathology. Enhanced urinary secretion of the antimicrobial peptide BD-2 from Hunner type IC patients associated with clinical phenotypes and demonstrated relatively robust levels to be used as a potential biomarker. Moreover, the increased urinary level of BD-2 may suggest a new possibility of biomarkers caused by dysbiosis of the urinary microbiota in ulcerative IC

Minimal Change Disease Is Associated with Mitochondrial Injury and STING Pathway Activation

We hypothesized that minimal change disease (MCD) pathogenesis may be associated with mitochondrial injury, and that the degree of mitochondrial injury at the time of diagnosis may serve as a valuable prognostic marker. We compared urinary mitochondrial DNA (mtDNA) at the time of diagnosis in patients with MCD and age- and sex-matched healthy controls (MHC) (n = 10 each). We analyzed the site and signal intensity of immunohistochemical (IHC) staining of stimulator of interferon genes (STING) using kidney tissues at the time of diagnosis in patients with MCD. Patients with MCD were divided into high (n = 6) and low-intensity (n = 14) subgroups according to the signal intensity. Urinary mtDNA levels were elevated in the MCD groups more than in the MHC group (p &lt; 0.001). Time-averaged proteinuria and frequency of relapses during the follow-up period were higher in the high-intensity than in the low-intensity subgroup (1.18 &plusmn; 0.54 vs. 0.57 &plusmn; 0.45 g/day, p = 0.022; and 0.72 &plusmn; 0.60 vs. 0.09 &plusmn; 0.22 episodes/year, p = 0.022, respectively). Mitochondrial injury may be associated with MCD pathogenesis, and the signal intensity of STING IHC staining at the time of diagnosis could be used as a valuable prognostic marker in MCD

Robot-assisted laparoscopic intracorporeal urachal mass resection and partial cystectomy for a huge urachal adenocarcinoma: a case report and review of literature

Urachal adenocarcinoma is rare, accounting for only 10% of adenocarcinomas of the bladder and the prognosis of urachal adenocarcinomas is poor since most cases are detected late. Since urachal adenocarcinoma is a rare disease, no effective standard treatment has yet been established. However, in recent studies, resection of carcinoma is considered the only treatment considered for non-metastatic cases. Although for large sized urachal adenocarcinoma, open surgery or laparoscopic surgery is usually considered, we have recently experienced huge urachal carcinoma by robotic surgery. We used cystoscopy and the robot to assess the cancer margins and safely perform the operation. A 71-year-old man with a medical history of hypertension and arrhythmia visited our urology department with urachal cancer detected by computed tomography (CT). CT showed a lobulated low-density mass, most likely urachal carcinoma, abutting the anterior dome of the bladder and anterior abdominal wall. We performed preoperative cystoscopy to assess the extent of the protrusion of the urachal cancer into the bladder wall and the area requiring resection during surgery. We confirmed the size and extent of the mass protruding into the anterior wall of the urinary bladder and Robot-assisted laparoscopic intracorporeal urachal mass resection and partial cystectomy using cystoscopy together was performed. After one month, the patient has no complications and no complaining symptoms complaints without any abnormal finding of follow up imaging test. Although more procedures must be performed to ensure the safety of robotic surgery as a treatment strategy for large urachal carcinomas, we confirm that robotic surgery can replace open or laparoscopic surgery for such tumors

Renal agenesis with ureterocele, duplicated megaureter and translocation of seminal vesicle: a case report and review of the literature

Background: Renal agenesis is a congenital malformation that occurs due to the inhibition of metanephric blastema induction due to a decrease in ureteric bud activity. Although renal agenesis is not very rare, unilateral renal agenesis with ureterocele occurs rarely, and the coexistance of unilateral renal agenesis, ureterocele, and blind ended proximal ureter is very rare. Recently, we experienced a case of left renal agenesis with huge ureterocele, blind ended proximal ureter, and duplicated ureter on Computed tomography (CT) of a 17-year-old man who visited our emergency department with hematuria. Ureterocelectomy and nephrectomy were performed, and a translocation of seminal vesicle was also observed. This case is a very rare case, so we judged that it may be helpful in making treatment decisions in similar cases later. Case summary: A 17-year-old man without specific medical history visited our emergency department with hematuria and voiding difficulty. CT showed left ectopic kidney, megaureter and the blind ended proximal ureter. After ureterocelectomy and nephrectomy, pathological examination revealed seminal vesicles in the periphery of the kidney. After one year, the patient has no complications and no complaining symptoms complaints without any abnormal finding of follow up imaging test. Conclusions: This case report focuses on the treatment of renal agenesis with ureterocele, blind ended proximal ureter, duplicated megaureter and translocation of seminal vesicle. This rare case of treatment will be helpful in the determination of treatment for similar cases in the future. To establish standard treatment, data accumulation and well-designed studies are required