We report a case of ALK-positive renal cell carcinoma coincident with Hodgkin lymphoma. The patient was a 19 year-old-girl without sickle cell trait. The right renal tumor was discovered concomitantly with Hodgkin lymphoma (HL). After chemotherapy for HL, right nephrectomy was performed. Microscopically, the tumor showed a solid and focally pseudo-papillary growth pattern studded with tubular structures. Most tumor cells were small bland eosinophilic cells, but rhabdoid cells, vacuolated cells, pleomorphic multinucleated giant cells were also admixed. The variety of growth patterns and cell features led us to speculate a possibility of ALK-positive renal cell carcinoma (ALK + RCC). ALK was immunohistochemically positive, and fluorescence in situ hybridization analysis detected a split signal of the ALK gene. We examined previously reported partner genes (STRN, TPM3, VCL and EML4) by RT-PCR, but fusion gene was not detected. RCC showing solid or cribriform growth patterns with vacuolated cells with intracytoplamic lumina, rhabdoid cells, and mucus production indicates the possibility of ALK + RCC.
Introduction Mamushi bites are the most common venomous snakebites in Japan. The clinical course of a common mamushi bite is known, and its alarming complication and cause of death are acute renal failure due to the venom. However, reports of mamushi bites in kidney transplant recipients are lacking, and the clinical course is unknown. Case presentation A 66‐year‐old man who was bitten by a mamushi 3 years after kidney transplantation. Similar to the course of a typical mamushi bite, his severity gradually worsened to its peak 3 days after the bite, after which he turned lightly. A sufficient amount of infusion and continued immunosuppressive drugs were used to avoid acute renal failure. Conclusion Even if the mamushi bite occurs in a kidney transplant recipient, the course and management may be the same as usual by continuing the immunosuppressive drugs and a sufficient amount of infusion.
Summary Gravel-packing sand and formation minerals dissolve in the hot alkaline water injected with steam. This dissolution is believed to cause gravel-pack failure and other production problems. This paper describes the use of ammonium salts in reducing dissolution by reducing the pH of generator effluents from values of 11 and greater to between 9 and 10. These salts, such as ammonium chloride and ammonium nitrate, do not significantly change feedwater pH. Both laboratory and field test results are presented. This paper also presents a brief summary of other methods proposed to prevent gravel and formation dissolution. In addition, the need for more prevent gravel and formation dissolution. In addition, the need for more information about the role of silica dissolution in causing production problems is discussed briefly. problems is discussed briefly. Introduction Steam injection for the recovery of heavy oil continues to be an important recovery technique. Gravel-pack failure, casing collapse, and sand production have been identified as some of the production problems associated with steam operations. Dissolution of gravel-packing sand and formation minerals in the hot alkaline water injected with steam is believed to contribute to these production problems. problems. When steam is generated in "once-through"-type generators, a portion of the feedwater remains as liquid, carrying dissolved solids downhole with the steam. This liquid effluent becomes alkaline as bicarbonate ions, which are present in most feedwaters, decompose during steam generation to yield CO2 in the vapor phase and carbonate and hydroxide ions in the liquid phase. The pH of generator effluents often ranges between values of 11.0 and 12.5. Feedwater enters the generator with a pH that is nearly neutral. Reed demonstrated that the solubility of gravel and formation minerals increases dramatically with increased temperature and pH. The hot alkaline water injected with just one steam cycle can dissolve more than 1 ton of gravel and sand . The volume of material lost by dissolution can cause liner or casing collapse as well as sand production. Furthermore, as the hot water becomes concentrated in silicon and then cools as it flows through the formation, siliceous compounds can precipitate, potentially reducing formation permeability. In addition to the problem of silica dissolution, the elevated pH results in rock alterations that can cause formation damage.
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