Immunotherapy in Urological Tumors

© 2019 MedReviews.The past decade has seen significant improvement in our understanding of tumor biological features, which has led to use of anti-programmed-death 1 (PD-1) and anti-PDligand-1 (PD-L1) agents and cytotoxic T lymphocytes antigen 4 (CTLA-4) inhibitors in a multitude of cancers. These immunotherapeutic agents have shown activity in melanoma, lung, head and neck, colorectal, urological, and other cancers. This article details the use of immunotherapy agents in urothelial, renal, prostate, and testicular tumors.Peer reviewe

Coronary sinus atresia in a pediatric case: Review of literature

AbstractIntroductionCoronary sinus (CS) is the venous drainage system of the heart. Absence of the CS or CS ostium atresia is rarely seen cardiac malformations. Congenital absence of CS usually is found together with other cardiac malformations.CaseA one day old newborn was referred to our hospital for cyanosis. His saturation was 84% patient was referred to cardiology unit. In echocardiographic examination hypoplastic left heart syndrome was revealed. Prostoglandin infusion was started, catheterization was planned for ductal stent implantation. Catheterization revealed the presence of persistent left superior vena cava (LSVC). When radiocontrast was given to LSVC, it drained to the CS. However CS did not drain to right atrium at normal anatomy. Coronary sinus drained to the base of right atrium, where right superior vena cava opened, via a tunnel shaped vein (shown by arrow and schematically in Fig. 1).DiscussionAbsence of coronary sinus is an extremely rare condition, and in patients with other congenital cardiac malformations. Such malformations can be managed surgically or percutaneously. But either method may disrupt coronary venous drainage therefore it should be paid great attention to the anatomy before doing these procedures. Also it is important to inform the cardiac surgeons before the operation of associated cardiac lesions.ConclusionCoronary sinus atresia is a rare condition that should be kept in mind especially in complex heart defects; diagnosis is critical before starting surgical procedure

Percutaneous ASD closure of children weighing less than 10 kg

Background: Traditionally the procedure of percutaneous ASD closure is carried out in children weighing more than 15 kg. The aim of this study was to discuss the success, efficacy and safety of the percutaneous closure of symptomatic ASD in children weighing less than 10 kg. Material and methods: This study was performed in two centres. A total of 44 patients were included. Demographic and angiographic data of these patients were gathered retrospectively from patients' records. Main indications for ASD closure were: failure to thrive, recurrent respiratory infections, bronchopulmonary dysplasia and genetic syndromes. Results: Median weight of patients was 9.0(8.12-9.50) kg. Bodyweight of 22 patients was less than 3 percentiles. In the follow-up, this number was lowered to 9 patients at 12 months. Median age of patients was 18.0(12.0-285) months. Minimum age and weight of patients was 3 months and 4.5 kg, respectively. Median mean pulmonary pressure was 24.0(20.0-29.5). The values of median defect size were measured in Cath lab as 13.0(10.75-15.3) mm. Median device size was 13(9-15) mm. Defect size was evaluated according to body weight and body surface area. The ratio of weight per defect size was 0.65(0.54-0.84) also the ratio of body surface area per defect size was 0.032(0.028-0.04). The ratio of total septum per device diameter was 2.5(2.1-3.1). Types of devices used were Amplatzer Septal Occluder, Cera Flex Septal Occluder, Figulla Flex II Atrial Septal Occluder, Memopart Septal Occluder. All cases were closed successfully, but the device had to be retrieved in one patient after successful positioning because it was detected that device compressed the aorta. No major complications were seen. Conclusion: In the experienced centres, percutaneous ASD closure can be done effectively and safely in symptomatic children weighing less than 10 kg

Role of kallistatin in pediatric patients with pulmonary arterial hypertension

Background and objectives. Kallistatin, a serine proteinase inhibitor, exerts its effect by vascular repair, angiogenesis inhibition, strong vasodilation, inhibition of vascular endothelial growth factor (VEGF), anti-inflammation, and anti-apoptosis. We hypothesized as to whether it has a protective role in pulmonary arterial hypertension (PAH)