Background and Objectives: Oxidative stress induced by increased reactive oxygen species (ROS) production plays an important role in carcinogenesis. The entire urinary tract is continuously exposed to numerous potentially mutagenic environmental agents which generate ROS during their biotransformation. In first line defense against free radicals, antioxidant enzymes superoxide dismutase (SOD2) and glutathione peroxidase (GPX1) both have essential roles. Altered enzyme activity and decreased ability of neutralizing free oxygen radicals as a consequence of genetic polymorphisms in genes encoding these two enzymes are well described so far. This study aimed to investigate the association of GPX1 (rs1050450) and SOD2 (rs4880) genetic variants with the urothelial bladder cancer (UBC) risk independently and in combination with smoking. Furthermore, we aimed to determine whether the UBC stage and pathological grade were influenced by GPX1 and SOD2 polymorphisms. Material and Methods: The study population included 330 patients with UBC (mean age 65 ± 10.3 years) and 227 respective controls (mean age 63.4 ± 7.9 years). Single nucleotide polymorphism (SNP) of GPX1 (rs1050450) was analyzed using the PCR-RFLP, while SOD2 (rs4880) SNP was analyzed using the q-PCR method. Results: Our results showed that UBC risk was significantly increased among carriers of at least one variant SOD2 Val allele compared to the SOD2 Ala16Ala homozygotes (OR = 1.55, p = 0.03). Moreover, this risk was even more pronounced in smokers with at least one variant SOD2 Val allele, since they have even 7.5 fold higher UBC risk (OR = 7.5, p < 0.001). Considering GPX1 polymorphism, we have not found an association with UBC risk. However, GPX1 genotypes distribution differed significantly according to the tumor stage (p ˂ 0.049) and pathohistological grade (p ˂ 0.018). Conclusion: We found that SOD2 genetic polymorphism is associated with the risk of UBC development independently and in combination with cigarette smoking. Furthermore, we showed that GPX1 genetic polymorphism is associated with the aggressiveness of the disease.
At the time when mass COVID-19 vaccination began, providing appropriate vaccination advice to uro-oncology patients became a challenge. This was a single-center cross-sectional observational study aimed to investigate the rate of COVID-19 vaccination among uro-oncology patients receiving systemic therapy for metastatic renal cell carcinoma and metastatic castration-resistant prostate cancer. Furthermore, we aimed to assess patients’ attitudes and identify factors influencing their decision to vaccinate against COVID-19. Data on patients’ sociodemographic characteristics, vaccination status, and awareness and attitudes about COVID-19 vaccination were collected from questionnaires completed by the patients. A total of 173 patients were enrolled in this study, and 124 (71.7%) of them completed the COVID-19 vaccination. Significantly higher vaccination rates were found in male patients, and also in older patients, highly educated patients, and those who lived with one household member. Furthermore, we found significantly higher vaccination rates in patients who had consulted with doctors involved in their treatment, particularly with urologists. A significant association was observed between COVID-19 vaccination and doctor’s advice, family member influence, and personal beliefs toward the vaccination. Our study showed multiple associations of patients’ sociodemographic characteristics with vaccination rates. Furthermore, consultation with doctors who are particularly involved in oncology treatment and advice received from them were associated with significantly higher vaccination rates among uro-oncology patients.
An open/closed gas-turbine simple Brayton cycle or Brayton-Rankine gas- and steam-turbine combined-cycle power-producing system is proposed, with the gas turbine recirculating a large portion of partly expanded high-temperature gas into an inverse mixing ejector. The inverse mixing ejector uses injected-gas velocity that is necessarily greater than jet-gas velocity to increase the hot-gas pressure up to the compressor-discharge level. This is a necessary condition for achieving very high cycle thermal efficiency. Maximum combined-cycle thermal efficiency can be expected to reach up to about 80%, up to an appropriate temperature-level Carnot-cycle efficiency. The inverse mixing ejector can operate in either subsonic or supersonic (necessary for higher cycle thermal efficiencies) regions of gas velocity. The gas turbine cycle can operate in either simple-cycle, single-intercooled-cycle or multi-intercooled-cycle mode.
This concept shows that an efficient combined cycle, comprising topping & bottoming cycle, does not have to be privilege of gas turbine plants only, but could also be achieved with steam turbine plants. An efficient power-producing concept of a combined steam-turbine cycle with addition of a recirculating steam compressor is disclosed. Topping part of such a combined steam-turbine cycle operates at elevated steam turbine inlet temperature and pressure, while its “waste heat” is recovered by the bottoming part of the combined cycle in a heat-recovery boiler (steam heat exchanger). The recirculating steam compressor pumps the cooled majority of the entire steam flow to the maximum cycle pressure, while smaller steam flow fraction continues its full expansion to some low pressure in a condenser. The cycle waste heat could be transferred to the bottoming part of the combined cycle in a variety of modalities, depending on the chosen main high-temperature steam-turbine inlet temperature and inlet pressure (supercritical/subcritical). At an assumed constant steam-turbine inlet temperature of 900°C (∼300 bar), a very high gross cycle thermal efficiency could potentially be achieved, ranging from 56 to 62% with the high-temperature steam-turbine pressure ranging from subcritical (30 bar) to supercritical (300 bar). Such a combined steam-turbine cycle seems to be a suitable energy conversion concept that could be applied in classic thermal power plants powered by coal, but also seems as an ideal option for application in the new generation of gas-cooled nuclear rectors, where the gaseous reactor coolant, heated up to 1000°C, would indirectly transfer its heat content to working fluid (superheated steam) of the topping part of the combined steam-turbine cycle. Alternatively, the proposed concept may be combined with renewable energy sources of a sufficient temperature level.
Background Cervical cancer is often associated with malignant ureteral obstruction and consequent hydronephrosis. Hydronephrosis caused in this way can be resolved by placing ureteral stents or performing a percutaneous nephrostomy. Complications that may occur during the retrograde ureteral stent placement are usually mild, but serious complications such as stent migration into the cardiovascular system are also possible. Here we present an unusual case where a ureteral stent entered the abdominal aorta during the cystoscopic ureteral stenting, which was resolved by a cystoscopic stent removal kept in check by endovascular catheters. Case presentations The 48-year-old female patient was treated in the regional secondary healthcare facility due to bilateral hydronephrosis caused by cervical cancer. The patient had bilateral percutaneous nephrostomies and ureteral stents. Due to the calcification of the left ureteral stent, an urethrorenoscopy with lithotripsy of the calculus in the left ureter was performed in the regional secondary healthcare facility, and the ureteral stent was cystoscopically replaced. The control radiography of the urinary tract showed a misplacement of the left ureteral stent, and a computed tomography showed that the stent was located in the abdominal aorta. The patient was referred to the University Clinical Center of Serbia, where a ureteral stent was cystoscopically removed from the abdominal aorta under the control of endovascular catheters. The patient was in good general condition at all times, with no signs of bleeding, and she was discharged from the hospital on the fourth postoperative day. Conclusions The migration of a ureteral stent into the abdominal aorta and the cardiovascular system in general is a rare type of ureteral stenting complication whose treatment requires a multidisciplinary approach. In order to prevent such complications, it is necessary to strictly adhere to the indications for the ureteral stent placement in the case of malignant ureteral obstruction. Also, this procedure should be performed according to the current guidelines and controlled by an X-ray or ultrasound.
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