Diagnostic and prognostic accuracy of miR-21 in renal cell carcinoma: A systematic review protocol

Introduction: Renal cell carcinoma (RCC) is the most common neoplasm in adult kidneys. One of the most important unmet medical needs in RCC is a prognostic biomarker to enable identification of patients at high risk of relapse after nephrectomy. New biomarkers can help improve diagnosis and hence the management of patients with renal cancer. Thus, this systematic review aims to clarify the prognostic and diagnostic accuracy of miR-21 in patients with RCC. Methods and analysis: We will include observational studies evaluating the diagnostic and prognostic roles of miR-21 in patients with renal cancer. The index test and reference standards should ideally be performed on all patients. We will search PubMed, SCOPUS and ISI Web of Science with no restriction of language. The outcome will be survival measures in adult patients with RCC. Study selection and data extraction will be performed by two independent reviewers. QUADAS-1 will be used to assess study quality. Publication bias and data synthesis will be assessed by funnel plots and Begg's and Egger's tests using Stata software V.11.1. Ethics and dissemination: No ethical issues are predicted. These findings will be published in a peerreviewed journal and presented at national and international conferences. Trail registration number: This systematic review protocol is registered in the PROSPERO International Prospective Register of Systematic Reviews, registration number CRD42015025001

Bilateral maxillary, sphenoid sinuses and lumbosacral spinal cord extramedullary relapse of CML following allogeneic stem cell transplant

Isolated extramedullary relapse of chronic myelogenous leukemia (CML) after allogeneic stem cell transplant is rare. There is a case report of a child who developed a granulocytic sarcoma of the maxillary and sphenoid sinuses and lumbosacral spinal cord mass 18 months after allogeneic bone marrow transplant for CML. He was presented with per orbital edema and neurological deficit of lower extremities and a mass lesion was found on spinal cord imaging. No evidence of hematologic relapse was identified at that time by bone marrow histology or cytogenetic. The patient died 1 month later with a picture of pneumonia, left ventricular dysfunction and a cardiopulmonary arrest on a presumed underlying sepsis with infectious etiology. Granulocytic sarcoma should be considered in the differential diagnosis of mass lesions presenting after allogeneic bone marrow transplantation for CML, even if there is no evidence of bone marrow involvement. © 2016, Tehran University of Medical Sciences (TUMS). All Rights Reserved

SMAD4 Expression in Renal Cell Carcinomas Correlates With a Stem-Cell Phenotype and Poor Clinical Outcomes

Renal cell carcinoma (RCC) is the most lethal neoplasm of common urologic cancers with poor prognoses. SMAD4 has a principal role in TGF-β (Transformis growth factorβ)-induced epithelial to mesenchymal transition (EMT) as a key factor in gaining cancer stem cell (CSC) features and tumor aggressiveness. This study aimed to evaluate the expression patterns and clinical significance of SMAD4 in RCC and the impact of its targeting on stem cell/mesenchymal cells and EMT characteristics in renal spheroid derived cells (SDCs) compared to parental cells (PCs) in RCC. The expression pattern and clinical significance of SMAD4 was evaluated in RCC. SDCs were enriched using a sphere culture system. Then SDCs and their PCs were compared with respect to their sphere and colony formation, expression of putative CSC markers, invasiveness as well as expression of genes, including stemness/mesenchymal, SMAD4 and TGFβ1genes. Finally, the effect of SMAD4 knockdown on SDCs was analyzed. We demonstrated that SMAD4 is positively correlated with decreased disease specific survival (DSS) in RCC patients and clear cell RCC (ccRCC) subtype and associates with poor DSS in patients with RCC, especially in ccRCC as the most metastatic RCC subtype. SDCs exhibited higher stem cell/mesenchymal properties. Inhibition of SMAD4 in PCs accelerated the dissociation of SDCs and decreased their clonogenicity, invasiveness, expression of mesenchymal markers and expression of SMAD4 and TGFβ1 genes compared to SDCs before transfection. We suggest that targeting SMAD4 may be useful against renal CSCs and may improve RCC prognosis. © Copyright © 2021 Rasti, Madjd, Saeednejad Zanjani, Babashah, Abolhasani, Asgari and Mehrazma

The value of serum uric acid as a mortality prediction in critically ill children

Objective: The role of initial serum uric acid on admission in critically ill patients is controversial; we presumed that uric acid level can predict the mortality of the admitted patients to intensive care unit as a simple test. Methods: Totally, 220 consecutively admitted children (96 girls, 124 boys) with mean age 3.5 years, who were at least 24 hours in pediatric intensive care unit (PICU), were enrolled in a prospective cohort study during January 2006 to December 2007. The subsequent PICU admission in the same hospitalization, those who were discharged from the hospital and then re-admitted to the PICU during the observation period, and the patients with chronic renal failure were excluded. Serum uric acid level was measured during the first day of PICU admission. Death or transfer from PICU was considered as final outcome. The statistical analysis was done by using linear regression analysis, ROC curve, Student t-test, and Chisquare. P value less than 0.05 was considered significant. Findings: From 44 patients who had serum uric acid level more than 8 mg/dl, 17 cases died showing with a higher relative risk of 1.88, higher mortality (P8 mg/dl and needed vasopressor was 1.04, and in those under mechanical ventilation 1.33. In patients who scored pediatric risk of mortality of >38 it was 1.4, and in septic cases 4 (P<0.05). Stepwise linear regression analysis showed that mainly the need for mechanical ventilation (P=0.001) and vasopressor had statistically significant correlation with the poor outcome (P=0.001). Conclusion: Uric acid level during the first day of intensive critical care admission is not an independent risk of mortality in PICU. Need for mechanical ventilation or inotropic agents was associated with poor outcome and only higher uric acid level in sepsis played an additive risk factor role. © 2010 by Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences

Case Report - Management of Klippel-Trenauny syndrome with multiple organ involvement

Klippel-Trenauny syndrome is a disturbance in the development of the mesodermal and ectodermal tissues occurring in utero, which is characterized by vascular nevi, varicose veins, soft tissue, and occasionally, bone hyperplasia. Our patient is a 6-year-old boy with presentation of left lower extremity over growth, abdominal mass, abdominal pain, bilateral buttock mass, rectal bleeding, and skin hemangiomatosis. The major problems of this case were involvement of the levator ani, external anal sphincter, and encasement of the sciatic nerves within the buttock mass. We concluded that the use of muscle and nerve stimulator for detection and saving sphincters and the nerves in these cases could improve the results of surgical resection

Pancreatic neuroendocrine tumor in a child of 3.5 years old

Background: Pancreatic neuroendocrine tumor is rarely seen, particularly in children. One of the symptoms of this tumor is jaundice that may be misdiagnosed as the sign of hepatitis A, especially in countries with a high prevalence of this infectious disease. Methods: We present a 3.5-year-old girl with four weeks of icterus, who was misdiagnosed with hepatitis A. Results: The patient was finally diagnosed as having a low grade pancreatic neuroendocrine carcinoma. Conclusion: Pediatricians should be aware of or consider a tumor in differential diagnosis of jaundice, especially prolonged one in children. © 2015, Children's Hospital, Zhejiang University School of Medicine and Springer-Verlag Berlin Heidelberg

Correlation between serum level of fibroblast growth factor 2 and severity of reflux nephropathy

Introduction. Fibroblast growth factor 2 (FGF2) is a potent mitogenic factor of cortical fibroblasts and induces kidney fibrosis. We hypothesized that serum levels of FGF2 has an association with the severity of vesicoureteral reflux (VUR) and renal parenchymal scar. Results. The mean level of FGF2 was 65.0 ± 19.0 pg/mL in the VUR group and 62.5 ± 15.3 pg/mL in the control group (P >.05). There was no correlation between serum levels of FGF2 and sex, age, or the grade of VUR. Of the 28 children with VUR, 19 had renal parenchymal scar on dimercaptosuccinic acid renal scintigraphy. The mean serum level of FGF2 was not significantly different in the children with and without renal parenchymal scar. Conclusions. This study showed no correlation between serum FGF2 and renal parenchymal scar or grade of VUR. Materials and Methods. Between 2007 and 2009, a total of 28 children with VUR were enrolled in this study and were compared with 52 healthy children. All children with VUR underwent technetium Tc 99m dimercaptosuccinic acid renal scintigraphy. Fibroblast growth factor 2 was measured in both groups. © 2015, Iranian Society of Nephrology. All rights reserved

Her2/neu Expression in Wilms' Tumor and Correlation With Histopathologic Findings

BACKGROUND: Wilms' tumor is an emberyonal tumor arising from remnants of immature renal tissue. Her2/neu is an onco-protein which mediates cellular proliferation, differentiation and survival. METHODS: In the current study, we analyzed Her2/neu expression in 40 Wilms' tumors. The clinico-demographic data of 40 patients with Wilms' tumor were retrieved. Immunohistochemical staining for HER2/neu was performed. Her2/neuimmunoreactivity was evaluated by Canadian Consensus 2007 scoring system. RESULTS: Among the 38 specimens with epithelial component, 68.5 were positive for Her2/neu, whereas there was immunoreactivity in 37 of 38 blastemal, and 12 of 31 stromal components. The Her2/neu expression was significantly higher in early stages (81.5) than in advanced stages (36.4) in epithelial component, but not in other components. CONCLUSION: This study suggested that Her2/neuexpression is associated with epithelial cell differentiation accompanied by lower stages of tumor. No significant relationship was found between Her2/neu positivity and tumor size and patient's age and gender

The effects of Taraxacum officinale L. and Berberis vulgaris L. root extracts on carbon tetrachloride induced liver toxicity in rats

Background: Taraxacum officinale and Berberis vulgaris have long been used as herbal remedies for treatment of a variety of complaints including liver dysfunction and gallbladder disease. However scientifically reliable data are needed to verify their minimum effective doses. Objective: In present study, the effects of Taraxacum officinale L. and Berberis vulgaris L. root extracts at the different doses 10, 20 and 30 times higher than average dose (THD) used in traditional systems of medicines were tested against carbon tetrachloride (CCl4) induced liver toxicity in rats. Methods: The root extracts of T. officinale at doses of 250, 500 and 750 mg/kg/day and B. vulgaris at doses of 300, 600 and 900 mg/kg/day, relative to 10, 20 and 30 THD average doses used in traditional systems of medicines were prepared by dissolving dry extracts in 5 dimethvl sulfoxide in distilled water. Eighty male Wistar rats, 5 months old, were divided in 8 groups of 10 rats each. Liver intoxication was induced in 7 groups by intraperitoneal injection of 1 ml/kg of 1:1 CCl4 in olive oil for two successive days. One group was kept as control and six different doses of medicinal plants . extracts were administered to six groups simultaneously with CCl4 administration. After three days the serum levels of ALT, AST and ALP, liver tissue glutathione level and catalase activities as well as liver tissue microvesicular steatosis and pericentral coagulation necrosis were determined. Results: In control group the blood levels of ALT, AST, ALP and liver tissue injury were increased whereas the serum GSH level and catalase activity decreased significantly after 3 days of beginning of carbon tetrachloride liver toxicity as compared to normal group. In T. officinale treated group at the dose of 750 mg/kg/day, the serum ALT and ALP levels and in B. vulgaris at the dose of 900 mg/kg/day, the serum ALP levels reduced significantly as compared to control group. The liver micro vesicular steatosis was inhibited significantly in both groups at the doses of 30 THD as compared to control group. Conclusion: In the present study administration of T. officinale and B. vulgaris root extracts at with 30 THD ameliorated CCl 4 induced liver damage