50 research outputs found
Bone metastases from renal cell carcinoma: patient survival after surgical treatment
<p>Abstract</p> <p>Background</p> <p>Surgery is the primary treatment of skeletal metastases from renal cell carcinoma, because radiation and chemotherapy frequently are not effecting the survival. We therefore explored factors potentially affecting the survival of patients after surgical treatment.</p> <p>Methods</p> <p>We retrospectively reviewed 101 patients operatively treated for skeletal metastases of renal cell carcinoma between 1980 and 2005. Overall survival was calculated using the Kaplan-Meier method. The effects of different variables were evaluated using a log-rank test.</p> <p>Results</p> <p>27 patients had a solitary bone metastasis, 20 patients multiple bone metastases and 54 patients had concomitant visceral metastases. The overall survival was 58% at 1 year, 37% at 2 years and 12% at 5 years. Patients with solitary bone metastases had a better survival (p < 0.001) compared to patients with multiple metastases. Age younger than 65 years (p = 0.036), absence of pathologic fractures (p < 0.001) and tumor-free resection margins (p = 0.028) predicted higher survival. Gender, location of metastases, time between diagnosis of renal cell carcinoma and treatment of metastatic disease, incidence of local recurrence, radiation and chemotherapy did not influence survival.</p> <p>Conclusions</p> <p>The data suggest that patients with a solitary metastasis or a limited number of resectable metastases are candidates for wide resections. As radiation and chemotherapy are ineffective in most patients, surgery is a better option to achieve local tumor control and increase the survival.</p
Analyzing the gene expression profile of anaplastic histology Wilms’ tumor with real-time polymerase chain reaction arrays
Characterization of a Temperature-Sensitive Mutant of a Ubiquitin-Conjugating Enzyme and Its Use as a Heat-Inducible Degradation Signal
The ubiquitin/proteasome pathway is a highly conserved
mechanism of proteolysis in all eukaryotes.
Ubiquitin (Ub) is conjugated to proteolytic substrates
through the sequential action of ubiquitin-activating
(E1/Uba) and ubiquitin-conjugating (E2/Ubc) enzymes.
The mechanism of substrate recognition and ubiquitination
is an area of active investigation, and we have
begun a site-directed mutagenesis approach to define
the biochemical and biophysical properties of ubiquitin-
conjugating enzymes. We have characterized a
specific mutation in Ubc4 (Ubc4P62S) which was previously
shown to cause a temperature-sensitive growth
defect in several other Ubc’s. Ubc4P62S was rapidly degraded
in vivo, contributing to the loss of function.
However, reconstitution experiments revealed that
the catalytic activity of Ubc4P62S was reversibly inactivated
at 37°C, demonstrating that the primary defect
of Ubc4P62S is its inability to form a ubiquitin thioester
bond at high temperature. The in vivo defect is compounded
by increased susceptibility of Ubc4P62S to degradation
by the ubiquitin/proteasome pathway. We
have exploited the temperature-dependent degradation
of the P62S mutant to destabilize an otherwise
stable test protein (glutathione S-transferase). The use
of this mutant may provide a useful cis-acting temperature-
inducible degradation signal
Complimentary role of FDG-PET imaging and skeletal scintigraphy in the evaluation of patients of prostate carcinoma
Prostate cancer is one of the most common malignancies of elderly
males. Management depends on the accurate estimation of disease both at
initial diagnosis and in its subsequent course. In the present study,
we evaluated the diagnostic utility of positron emission tomography
with 18 F-fluorodeoxyglucose (FDG-PET) in patients having prostate
cancer. The findings were compared with the results of bone scan (BS)
for the detection of bone metastases. Sixteen patients (age range,
55-83 years) with confirmed diagnosis of prostate cancer were included
in the prospective study. Three patients had undergone bilateral
orchidectomy, 1 had hormonal therapy, 9 had undergone both, and 3 had
no therapy. All the patients underwent wholebody BS and FDG-PET within
1 week. Interpretation of BS and FDG-PET were performed qualitatively.
Osseous abnormalities detected by both methods were compared.
Involvement of the disease in other sites as seen on FDG-PET was also
noted. BS detected 197 osseous lesions, whereas FDG-PET could detect 97
(49%) bone lesions. However, in 3 patients without any prior
therapeutic intervention, FDG-PET results were superior or equivalent
to that of BS. FDG-PET also detected extensive involvement of the
disease in the bone marrow in 4 patients, lymph node metastases at
various sites in 8, liver metastases in 2, and lung metastases in 1
patient. FDG-PET could demonstrate less number of osseous metastases in
comparison with BSs, but the results have to be interpreted in the
background of prior treatment administered and the tumor biology of the
lesion. It is evident that FDG-PET could detect the unknown soft tissue
involvement of the disease with good sensitivity, which might play an
important role in the management of prostate cancer. Overall, in the
absence of novel PET tracers, both skeletal scintigraphy and FDG-PET
imaging can play a complimentary role in the management of prostate
cancer
Complimentary role of FDG-PET imaging and skeletal scintigraphy in the evaluation of patients of prostate carcinoma
Prostate cancer is one of the most common malignancies of elderly
males. Management depends on the accurate estimation of disease both at
initial diagnosis and in its subsequent course. In the present study,
we evaluated the diagnostic utility of positron emission tomography
with 18 F-fluorodeoxyglucose (FDG-PET) in patients having prostate
cancer. The findings were compared with the results of bone scan (BS)
for the detection of bone metastases. Sixteen patients (age range,
55-83 years) with confirmed diagnosis of prostate cancer were included
in the prospective study. Three patients had undergone bilateral
orchidectomy, 1 had hormonal therapy, 9 had undergone both, and 3 had
no therapy. All the patients underwent wholebody BS and FDG-PET within
1 week. Interpretation of BS and FDG-PET were performed qualitatively.
Osseous abnormalities detected by both methods were compared.
Involvement of the disease in other sites as seen on FDG-PET was also
noted. BS detected 197 osseous lesions, whereas FDG-PET could detect 97
(49%) bone lesions. However, in 3 patients without any prior
therapeutic intervention, FDG-PET results were superior or equivalent
to that of BS. FDG-PET also detected extensive involvement of the
disease in the bone marrow in 4 patients, lymph node metastases at
various sites in 8, liver metastases in 2, and lung metastases in 1
patient. FDG-PET could demonstrate less number of osseous metastases in
comparison with BSs, but the results have to be interpreted in the
background of prior treatment administered and the tumor biology of the
lesion. It is evident that FDG-PET could detect the unknown soft tissue
involvement of the disease with good sensitivity, which might play an
important role in the management of prostate cancer. Overall, in the
absence of novel PET tracers, both skeletal scintigraphy and FDG-PET
imaging can play a complimentary role in the management of prostate
cancer
Infantile fibromatosis of scrotum
Infantile fibromatosis is a benign but locally aggressive tumour, the
tumour presenting as asymptomatic, firm and solid mass. The most
frequent types are the infantile fibromatosis (head, neck, shoulder,
upper arm or thigh), extra-abdominal fibromatosis (chest wall, back and
thigh) and fibromatosis colli (neck), but only rarely has it been
reported to involve the external genitalia or scrotum. We report a case
of infantile fibromatosis of scrotum in a 1-year-old child
Characterization of a Temperature-Sensitive Mutant of a Ubiquitin-Conjugating Enzyme and Its Use as a Heat-Inducible Degradation Signal
Hand-assisted laparoscopic radical nephrectomy in the treatment of a renal cell carcinoma with a level ii vena cava thrombus
Excision of renal cell carcinoma (RCC) with corresponding vena cava thrombus is a technical challenge requiring open resection and vascular clamping. A 58 year old male with a right kidney tumor presented with a thrombus extending 1 cm into the vena cava. Using a hand-assisted transperitoneal approach through a 7 cm gel-port, the right kidney was dissected and the multiple vascular collaterals supplying the tumor were identified and isolated. The inferior vena cava was mobilized 4 cm cephalad and 4 cm caudal to the right renal vein. Lateral manual traction was applied to the right kidney allowing the tumor thrombus to be retracted into the renal vein, clear of the vena cava. After laparoscopic ultrasonographic confirmation of the location of the tip of the tumor thrombus, an articulating laparoscopic vascular stapler was used to staple the vena cava at the ostium of the right renal vein. This allowed removal of the tumor thrombus without the need for a Satinsky clamp. The surgery was completed in 243 minutes with no intra-operative complications. The entire kidney and tumor thrombus was removed with negative surgical margins. Estimated blood loss was 300 cc. We present a laparoscopic resection of a renal mass with associated level II thrombus using a hand-assisted approach. In patients with minimal caval involvement, our surgical approach presents an option to the traditional open resection of a renal mass