Renal Tubular Hypouricemia and Calcium Urolithiasis

The information concerning the relationship of hypouricemia with urinary tract stones is limited. We investigated the incidence and types of hypouricemia, and also studied its relationship to urinary tract stones. Hypouricemia was detected in 3 out of 1520 outpatients (0.20%). The loading tests using pyrazinamide, probenecid and benzbromarone showed that uric acid absorption was impaired before tubular secretion in two cases and incomplete postsecretory reabsorption in one case. Complication of urinary tract stone was found in two cases. The composition of the stones was mixed calcium oxalate and uric acid. Hypouricemia should be recognized as one of the causes of kidney stone formation

Evaluation and Management of Dietary Habits in Japanese Renal Stone Formers

To elucidate the relationship between the formation of kidney stones and diet, we carried out a dietary investigation in patients with urinary tract stones. Dietary intakes were estimated for 36 patients (24 men, 12 women) with calcium stones, and compared with the official dietary requirements for the Japanese. Total protein intake, animal protein intake and animal protein ratio were significantly higher for patients with stones in both men and women. Dietary salt intake was significantly higher for male patients and the total group. Dietary calcium and carbohydrate intakes were significantly lower for patients with stones in men and the total group, and tended to be lower for female patients. As a result of dietary guidance, the intakes of total protein, animal protein and salt were markedly reduced. The animal protein ratio was also lowered. Caloric intake and the dietary intakes of carbohydrate, fat and salt were reduced, too. However, the dietary calcium intake did not change. Chemical analysis of 24 hour-urine revealed that the excretion of urea nitrogen was reduced, which reflected the decrease in protein intake produced by the dietary regimen. The excretions of urate and oxalate also tended to decrease

Development and External Validation of a Nomogram Predicting the Probability of Significant Gleason Sum Upgrading among Japanese Patients with Localized Prostate Cancer

Objective. The aim of this study is to develop a prognostic model capable of predicting the probability of significant upgrading among Japanese patients. Methods. The study cohort comprised 508 men treated with RP, with available prostate-specific antigen levels, biopsy, and RP Gleason sum values. Clinical and pathological data from 258 patients were obtained from another Japanese institution for validation. Results. Significant Gleason sum upgrading was recorded in 92 patients (18.1%) at RP. The accuracy of the nomogram predicting the probability of significant Gleason sum upgrading between biopsy and RP specimens was 88.9%. Overall AUC was 0.872 when applied to the validation data set. Nomogram predictions of significant upgrading were within 7.5% of an ideal nomogram. Conclusions. Nearly one-fifth of Japanese patients with prostate cancer will be significantly upgraded. Our nomogram seems to provide considerably accurate predictions regardless of minor variations in pathological assessment when applied to Japanese patient populations

Regulatory T Cell as a Biomarker of Treatment-Free Remission in Patients with Chronic Myeloid Leukemia

Simple Summary Tyrosine kinase inhibitors (TKIs) have dramatically improved the treatment of chronic myeloid leukemia (CML). Recently, TKIs were discontinued in patients with CML with deep molecular remission, and some patients have been reported to be able to maintain long-term treatment-free remission (TFR). However, there is no certainty regarding which patients can maintain TFR. We focused on immunity in the TFR phase and investigated the immunological mechanism of continuous TFR or recurrence. Our results suggest that the group that maintains the TFR is immunologically activated. In addition, regulatory T cells can be used as a biomarker. These results may have important implications for future strategies for maintaining TFR in CML treatment. Treatment-free remission (TFR) has become a therapeutic goal in chronic myeloid leukemia (CML), and approximately half of the patients with chronic phase-CML (CML-CP) with deep molecular remission (DMR) by tyrosine-kinase inhibitors (TKIs) have achieved TFR. However, the mechanism of continuous TFR is still unclear, as there are fluctuate patients who have BCR-ABL-positive leukemia cells but do not observe obvious relapse. We focused on the immune response and conducted an immune analysis using clinical samples from the imatinib discontinuation study, JALSG-STIM213. The results showed that, in the group that maintained TFR for 3 years, changes in regulatory T (Treg) cells were observed early after stopping imatinib treatment. The effector Treg (eTreg) cells increased transiently at 1 month after stopping imatinib and then returned to baseline at 3 months after stopping imatinib treatment. There was no difference in the Treg phenotype, and CD8(+) T cells in the TFR group were relatively activated. High concentrations of imatinib before stopping were negatively correlated with eTreg cells after stopping imatinib. These data suggest immunological involvement in the maintenance of the TFR, and that Treg cells after stopping imatinib might be a biomarker for TFR. Furthermore, high imatinib exposure may have a negative immunological impact on the continuous TFR