Adult Wilms' tumor with calcification untreated for 5 years – a case report

BACKGROUND: Wilms' tumor is rarely found in adults and there are no established treatment guidelines for such tumors in adults. Whereas calcification is a common finding in neuroblastoma, it is considered uncommon in Wilms' tumor. CASE PRESENTATION: We report a case of adult Wilms' tumor with calcification in a 22-year-old man. He had been initially referred to our hospital with a chief complaint of right flank pain 5 years previously, when abdominal computed tomography had revealed focal calcification at the upper pole of the right kidney. Although we planned further assessment, he did not revisit our hospital again until 5 years later, again because of right flank pain. Ultrasound and computed tomography scan revealed a large mass lesion with calcification in the right kidney, invasive to the hepatic lobe. The patient underwent curative right nephrectomy and partial right hepatic lobectomy. Pathological analysis demonstrated a nephroblastoma (Wilms' tumor) with predominant epithelial histology infiltrating the hepatic lobe. The patient has been well without tumor recurrence for 15 months after surgery. CONCLUSIONS: Calcification may be a sign of slow tumor gowth and possibly a favorable prognosis in cases of adult Wilms' tumor

Apical Transport of Influenza A Virus Ribonucleoprotein Requires Rab11-positive Recycling Endosome

Influenza A virus RNA genome exists as eight-segmented ribonucleoprotein complexes containing viral RNA polymerase and nucleoprotein (vRNPs). Packaging of vRNPs and virus budding take place at the apical plasma membrane (APM). However, little is known about the molecular mechanisms of apical transport of newly synthesized vRNP. Transfection of fluorescent-labeled antibody and subsequent live cell imaging revealed that punctate vRNP signals moved along microtubules rapidly but intermittently in both directions, suggestive of vesicle trafficking. Using a series of Rab family protein, we demonstrated that progeny vRNP localized to recycling endosome (RE) in an active/GTP-bound Rab11-dependent manner. The vRNP interacted with Rab11 through viral RNA polymerase. The localization of vRNP to RE and subsequent accumulation to the APM were impaired by overexpression of Rab binding domains (RBD) of Rab11 family interacting proteins (Rab11-FIPs). Similarly, no APM accumulation was observed by overexpression of class II Rab11-FIP mutants lacking RBD. These results suggest that the progeny vRNP makes use of Rab11-dependent RE machinery for APM trafficking

Serum Soluble (Pro)Renin Receptor Levels in Maintenance Hemodialysis Patients.

The (pro)renin receptor [(P)RR] is cleaved by furin to generate soluble (P)RR [s(P)RR], which reflects the status of the tissue renin-angiotensin system. Hemodialysis patients have advanced atherosclerosis. The aim of this study was to investigate the relationships between serum s(P)RR levels and background factors, including indices of atherosclerosis, in hemodialysis patients. Serum s(P)RR levels were measured in hemodialysis patients and clearance of s(P)RR through the membrane of the dialyzer was examined. Furthermore, relationships between serum s(P)RR levels and background factors were assessed. Serum s(P)RR levels were significantly higher in hemodialysis patients (30.4 ± 6.1 ng/ml, n = 258) than those in subjects with normal renal function (21.4 ± 6.2 ng/ml, n = 39, P < 0.0001). Clearance of s(P)RR and creatinine were 56.9 ± 33.5 and 147.6 ± 9.50 ml/min, respectively. Serum s(P)RR levels were significantly higher in those with ankle-brachial index (ABI) of < 0.9, an indicator of severe atherosclerosis, than those with ABI of ≥ 0.9 (32.2 ± 5.9 and 30.1 ± 6.2 ng/ml, respectively, P < 0.05). An association between low ABI and high serum s(P)RR levels was observed even after correction for age, history of smoking, HbA1c, and LDL-C. Serum s(P)RR levels were significantly higher in hemodialysis patients when compared with subjects with normal renal function, although s(P)RR is dialyzed to some extent, but to a lesser extent than creatinine. High serum s(P)RR levels may be associated with atherosclerosis independent of other risk factors, suggesting that serum s(P)RR could be used as a marker for atherosclerotic conditions in hemodialysis patients

THE SIGNIFICANCE OF EXERCISE-INDUCED NORMALIZATION OF INVERTED T WAVE IN PATIENTS WITH OLD MYOCARDIAL INFARCTION

The purpose of this study was to investigate the significance of exercise- induced normalization of inverted T wave in patients with old myocardial infarction (MI). The subjects of the present study were eighteen patients with old anterior MI. The treadmill exercise test (TMT) was performed 8±1 months after MI onset. Based on the results of the TMT, these patients were divided into two groups: those who showed normalization of inverted T wave during exercise (Group Ⅰ), and those who did not show normalization of inverted T wave during exercise (Group Ⅱ). Between the two groups, the following elements were compared : patient characteristics (age, gender, max CK, coronary risk factor) ; left ventricular abnormal contraction segment (ACS) ; and coronary flow reserve (CFR), which represent coronary microvascular circulation as measured by the Doppler guide wire. There were no differences between the two groups in patient character- istics except the max CK. In Group Ⅰ, the max CK was higher (p＜0.05), the ACS was higher (p＜0.01), and the CFR was lower (p＜0.05), as compared with those of Group Ⅱ. According to these results, the area of MI was more extensive and the disturbance of coronary microcirculation was more remarkable in Group Ⅰ in comparison with Group Ⅱ. It is suggested that the exercise-induced normalization of inverted T wave can reflect the extent of MI and the disturbance of coronary microvascular circulation