Solitary Renal Fossa Recurrence of Renal Cell Carcinoma After Nephrectomy

Renal cell carcinoma without metastasis responds well to surgical excision but is known to recur postnephrectomy. In a small but significant number of patients this recurrence is not accompanied by metastasis, which is important as these people benefit from further surgery. We examined 20 articles from the current literature to ascertain how best to treat this condition. Surgical management renders better results than conservative or medical therapies. Readily available investigations such as blood tests and computed tomography can help determine the right patients for surgery in an evidence-based fashion. Current findings have allowed us to suggest a protocol for the treatment of solitary renal fossa recurrence of postnephrectomy renal cell carcinoma. There are further opportunities for study in validating our protocol, and in novel renal cell carcinoma treatment strategies that have not been tested on solitary renal fossa recurrences.Key words: Renal cancer, Recurrence, Nephrectomy, Complications, ManagementKidney cancers represent 2% of cancers worldwide; the most common type is renal cell carcinoma. Curative treatment of localized disease is a nephrectomy. Following surgery, recurrence can happen locally with an incidence of 1.61%.^1–5 A solitary renal fossa local recurrence is rare but important to distinguish from local recurrence with metastasis, which would not benefit from surgical resection. The 5-year survival postresection of local recurrence for those without metastasis compared with those with metastasis was 62% compared with 0%.⁴ The kidneys are bordered by the colon, spleen, liver, stomach, and associated neurovascular structures, all of which may be invaded in this form of recurrence; specific morbidity is related to the invasion and subsequent resection of these organs. General morbidity is caused by the surgery itself, with pain, infection, and hemorrhage being major contributors (Figure 1). This article explains predictive factors in recurrence, useful diagnostic modalities, and management, and provides recommendations and highlights opportunities for further study.Open in a separate windowFigure 1Computed tomography image of a patient with renal fossa recurrence of renal cancer after nephrectomy. Of note is the large mass identifiable in the spleen.     

Blood shizonticidal activities of phenazines and naphthoquinoidal compounds against Plasmodium falciparum in vitro and in mice malaria studies

Due to the recent advances of atovaquone, a naphthoquinone, through clinical trials as treatment for malarial infection, 19 quinone derivatives with previously reported structures were also evaluated for blood schizonticide activity against the malaria parasite Plasmodium falciparum. These compounds include 2-hydroxy-3-methylamino naphthoquinones (2-9), lapachol (10), nor-lapachol (11), iso-lapachol (12), phthiocol (13) and phenazines (12-20). Their cytotoxicities were also evaluated against human hepatoma and normal monkey kidney cell lines. Compounds 2 and 5 showed the highest activity against P. falciparum chloroquine-resistant blood-stage parasites (clone W2), indicated by their low inhibitory concentration for 50% (IC₅₀) of parasite growth. The therapeutic potential of the active compounds was evaluated according to the selectivity index, which is a ratio of the cytotoxicity minimum lethal dose which eliminates 50% of cells and the in vitro IC₅₀. Naphthoquinones 2 and 5, with activities similar to the reference antimalarial chloroquine, were also active against malaria in mice and suppressed parasitaemia by more than 60% in contrast to compound 11 which was inactive. Based on their in vitro and in vivo activities, compounds 2 and 5 are considered promising molecules for antimalarial treatment and warrant further study.     

Gene Expression Analysis Reveals Inhibition of Radiation-Induced TGFβ-Signaling by Hyperbaric Oxygen Therapy in Mouse Salivary Glands

A side effect of radiation therapy in the head and neck region is injury to surrounding healthy tissues such as irreversible impaired function of the salivary glands. Hyperbaric oxygen therapy (HBOT) is clinically used to treat radiation-induced damage but its mechanism of action is largely unknown. In this study, we investigated the molecular pathways that are affected by HBOT in mouse salivary glands two weeks after radiation therapy by microarray analysis. Interestingly, HBOT led to significant attenuation of the radiation-induced expression of a set of genes and upstream regulators that are involved in processes such as fibrosis and tissue regeneration. Our data suggest that the TGFβ-pathway, which is involved in radiation-induced fibrosis and chronic loss of function after radiation therapy, is affected by HBOT. On the longer term, HBOT reduced the expression of the fibrosis-associated factor α-smooth muscle actin in irradiated salivary glands. This study highlights the potential of HBOT to inhibit the TGFβ-pathway in irradiated salivary glands and to restrain consequential radiation induced tissue injury.     

Uniform nomenclature for the mitochondrial contact site and cristae organizing system

The mitochondrial inner membrane contains a large protein complex that functions in inner membrane organization and formation of membrane contact sites. The complex was variably named the mitochondrial contact site complex, mitochondrial inner membrane organizing system, mitochondrial organizing structure, or Mitofilin/Fcj1 complex. To facilitate future studies, we propose to unify the nomenclature and term the complex “mitochondrial contact site and cristae organizing system” and its subunits Mic10 to Mic60.Mitochondria possess two membranes of different architecture and function (Palade, 1952; Hackenbrock, 1968). Both membranes work together for essential shared functions, such as protein import (Schatz, 1996; Neupert and Herrmann, 2007; Chacinska et al., 2009). The outer membrane harbors machinery that controls the shape of the organelle and is crucial for the communication of mitochondria with the rest of the cell. The inner membrane harbors the complexes of the respiratory chain, the F₁F_o-ATP synthase, numerous metabolite carriers, and enzymes of mitochondrial metabolism. It consists of two domains: the inner boundary membrane, which is adjacent to the outer membrane, and invaginations of different shape, termed cristae (Werner and Neupert, 1972; Frey and Mannella, 2000; Hoppins et al., 2007; Pellegrini and Scorrano, 2007; Zick et al., 2009; Davies et al., 2011). Tubular openings, termed crista junctions (Perkins et al., 1997), connect inner boundary membrane and cristae membranes (Fig. 1, A and B). Respiratory chain complexes and the F₁F_o-ATP synthase are preferentially located in the cristae membranes, whereas preprotein translocases are enriched in the inner boundary membrane (Vogel et al., 2006; Wurm and Jakobs, 2006; Davies et al., 2011). Contact sites between outer membrane and inner boundary membrane promote import of preproteins, metabolite channeling, lipid transport, and membrane dynamics (Frey and Mannella, 2000; Sesaki and Jensen, 2004; Hoppins et al., 2007, 2011; Neupert and Herrmann, 2007; Chacinska et al., 2009; Connerth et al., 2012; van der Laan et al., 2012).Open in a separate windowFigure 1.MICOS complex. (A) The MICOS complex (hypothetical model), previously also termed MINOS, MitOS, or Mitofilin/Fcj1 complex, is required for maintenance of the characteristic architecture of the mitochondrial inner membrane (IM) and forms contact sites with the outer membrane (OM). In budding yeast, six subunits of MICOS have been identified. All subunits are exposed to the intermembrane space (IMS), five are integral inner membrane proteins (Mic10, Mic12, Mic26, Mic27, and Mic60), and one is a peripheral inner membrane protein (Mic19). Mic26 is related to Mic27; however, mic26Δ yeast cells show considerably less severe defects of mitochondrial inner membrane architecture than mic27Δ cells (Harner et al., 2011; Hoppins et al., 2011; von der Malsburg et al., 2011). The MICOS complex of metazoa additionally contains Mic25, which is related to Mic19, yet subunits corresponding to Mic12 and Mic26 have not been identified so far. MICOS subunits that have been conserved in most organisms analyzed are indicated by bold boundary lines. (B, top) Wild-type architecture of the mitochondrial inner membrane with crista junctions and cristae. (bottom) This architecture is considerably altered in micos mutant mitochondria: most cristae membranes are detached from the inner boundary membrane and form internal membrane stacks. In some micos mutants (deficiency of mammalian Mic19 or Mic25), a loss of cristae membranes was observed (Darshi et al., 2011; An et al., 2012). Figure by M. Bohnert (Institute of Biochemistry and Molecular Biology, University of Freiburg, Freiburg, Germany).To understand the complex architecture of mitochondria, it will be crucial to identify the molecular machineries that control the interaction between mitochondrial outer and inner membranes and the characteristic organization of the inner membrane. A convergence of independent studies led to the identification of a large heterooligomeric protein complex of the mitochondrial inner membrane conserved from yeast to humans that plays crucial roles in the maintenance of crista junctions, inner membrane architecture, and formation of contact sites to the outer membrane (Fig. 1 A). Several names were used by different research groups to describe the complex, including mitochondrial contact site (MICOS) complex, mitochondrial inner membrane organizing system (MINOS), mitochondrial organizing structure (MitOS), Mitofilin complex, or Fcj1 (formation of crista junction protein 1) complex (Harner et al., 2011; Hoppins et al., 2011; von der Malsburg et al., 2011; Alkhaja et al., 2012). Mitofilin, also termed Fcj1, was the first component identified (Icho et al., 1994; Odgren et al., 1996; Gieffers et al., 1997; John et al., 2005) and was observed enriched at crista junctions (Rabl et al., 2009). Mutants of Mitofilin/Fcj1 as well as of other MICOS/MINOS/MitOS subunits show a strikingly altered inner membrane architecture. They lose crista junctions and contain large internal membrane stacks, the respiratory activity is reduced, and mitochondrial DNA nucleoids are altered (Fig. 1 B; John et al., 2005; Hess et al., 2009; Rabl et al., 2009; Mun et al., 2010; Harner et al., 2011; Head et al., 2011; Hoppins et al., 2011; von der Malsburg et al., 2011; Alkhaja et al., 2012; Itoh et al., 2013). It has been reported that the complex interacts with a variety of outer membrane proteins, such as channel proteins and components of the protein translocases and mitochondrial fusion machines, and defects impair the biogenesis of mitochondrial proteins (Xie et al., 2007; Darshi et al., 2011; Harner et al., 2011; Hoppins et al., 2011; von der Malsburg et al., 2011; Alkhaja et al., 2012; An et al., 2012; Bohnert et al., 2012; Körner et al., 2012; Ott et al., 2012; Zerbes et al., 2012; Jans et al., 2013; Weber et al., 2013). The MICOS/MINOS/MitOS/Mitofilin/Fcj1 complex thus plays crucial roles in mitochondrial architecture, dynamics, and biogenesis. However, communication of results in this rapidly developing field has been complicated by several different nomenclatures used for the complex as well as for its subunits (

In vitro free radical scavenging activity of hepatic metallothionein induced in an Indian freshwater fish, Channa punctata Bloch

Mammalian metallothioneins (MT) have been reported to scavenge free radicals. There is no experimental evidence to show that fish MT has a similar property. In the present study cadmium-induced MT (Cd-MT) from the liver of an Indian freshwater fish Channa punctata Bloch was investigated for its free radical scavenging activity using three different in vitro assays. Exposure to cadmium chloride (0.2 mg/kg body weight; three doses on alternate days) resulted in a marked induction of Cd-MT in liver. Only a single isoform of Cd-MT was found to be induced. Molecular weight of Cd-MT was found to be 14 kDa as deduced by SDS-PAGE analysis. The purified Cd-MT effectively scavenged the following free radicals: superoxide radical (O2*-), 2,2'-azinobis 3-ethylbenzothiazoline-6-sulfonic acid (ABTS*+) and 1,1-diphenyl-picrylhydrazyl radical (DPPH*). The radical scavenging effect was found to be concentration-dependent. Also, the purified MT exhibited an inhibitory effect on ferric nitrilotriacetate (Fe-NTA) induced oxidative DNA damage in vitro. The cysteine residues of MT are proposed to be the main candidate for its radical scavenging activity. Findings of the present study strongly suggest a free radical scavenging role for fish MT. Present study adds to the little existing knowledge about fish MT and its possible biological functions.     

Constitutive homo- and hetero-oligomerization of TbetaRII-B, an alternatively spliced variant of the mouse TGF-beta type II receptor

Transforming growth factor (TGF)-beta ligands signal through transmembrane type I and type II serine/threonine kinase receptors, which form heteromeric signalling complexes upon ligand binding. Type II TGF-beta receptors (TbetaRII) are reported to exist as homodimers at the cell surface, but the oligomerization pattern and dynamics of TbetaRII splice variants in live cells has not been demonstrated thus far. Using co-immunoprecipitation and bioluminescence resonance energy transfer (BRET), we demonstrate that the mouse TbetaRII receptor splice variant TbetaRII-B is capable of forming ligand-independent homodimers and heterodimers with TbetaRII. The homomeric interaction of mouse (m)TbetaRII-B isoforms, however, is less robust than the heteromeric interactions of mTbetaRII-B with wild-type TbetaRII, which indicates that these receptors may be more likely to heterodimerize when both receptors are expressed. Moreover, we demonstrate that mTbetaRII-B is a signalling receptor with ubiquitous tissue expression. Our study thus demonstrates previously unappreciated complex formation of TGF-beta type II receptors, and suggests that mTbetaRII-B can direct TGF-beta-induced signalling in vitro and in vivo.