A seven-year-old male cat that was previously diagnosed with – and treated for – left hydronephrosis due to suspected idiopathic proteinaceous materials in the renal pelvis, presented with a short history of anorexia and vomiting. The abdominal ultrasound revealed bilateral hydronephrosis, and the intravenous pyelography showed a moderate amount of free fluid in the retroperitoneal space at 48 hours. After the nephrectomy, the gross examination of the right kidney revealed a very thin capsule with urine leakage, and the right renal pelvis showed small, black deposits. The histopathology of the right kidney revealed hydronephrosis with compression atrophy, necrosis of the renal cortex/medulla, and a moderate lymphoplasmacytic inflammation. The crystallographic analysis revealed that the black deposits were composed of 100% protein and no minerals. The cat was diagnosed with hydronephrosis and spontaneous renal rupture caused by proteinaceous pelvic materials, secondary to the idiopathic renal lymphoplasmacytic inflammation. In addition to revealing the possibility that immune-mediated renal disease can induce spontaneous renal rupture in cats, this case report demonstrates the utility of imaging for diagnosing and monitoring hydronephrosis, detecting urine leakage, and planning surgery.

The identification of biomarkers predictive of neoadjuvant chemotherapy response in breast cancer patients would be an important advancement in personalized cancer therapy. In this study, we hypothesized that due to similarities between radiation-and chemotherapy-induced cellular response mechanisms, radiation-responsive genes may be useful in predicting response to neoadjuvant chemotherapy. Murine p53 null breast cancer cell lines representative of the luminal, basal-like and claudin-low human breast cancer subtypes were irradiated to identify radiationresponsive genes across subtypes. These murine tumor radiation-induced genes were then converted to their human orthologs, and subsequently tested as a predictor of pathologic complete response (pCR), which was validated on two independent published neoadjuvant chemotherapy datasets of genomic data with chemotherapy response. A radiation-induced gene signature consisting of 30 genes was identified on a training set of 337 human primary breast cancer tumor samples that was prognostic for survival. Mean expression of this signature was calculated for individual samples on two independent published datasets and was found to be significantly predictive of pCR. Multivariate logistic regression analysis in both independent datasets showed 1 Address for correspondence: Leo W. Jenkins Cancer Center, The Brody School of Medicine at East Carolina University, 600 Moye Boulevard, Greenville, NC 27834; oh.daniel.s@gmail.com. Supplementary Fig. S1. http://dx.doi.org/10.1667/RR13485.1.S1; Gene cluster A shown Fig. 3 (upper left) significantly enriched for genes involved in wound and inflammatory response as determined by DAVID. Supplementary Fig. S2. http://dx.doi.org/10.1667/RR13485.1.S1; Gene cluster B from Fig. 3 (upper left) significantly enriched for genes involved in M phase, mitotic cell cycle and ribosome as determined by DAVID. Supplementary Fig. S3. http://dx.doi.org/10.1667/RR13485.1.S1; Gene cluster C from Fig. 3 (upper left) significantly enriched for genes involved in muscle contraction, muscle cell development, and myofibril assembly as determined by DAVID. Supplementary Fig. S4. http://dx.doi.org/10.1667/RR13485.1.S1; Gene cluster D from Fig. 3 (upper left) significantly enriched for genes involved in positive regulation of mesenchymal cell proliferation, blood vessel development and cell motion as determined by DAVID. Supplementary Fig. S5. http://dx.doi.org/10.1667/RR13485.1.S1; Gene cluster E from Fig. 3 (upper left) significantly enriched for genes involved in zinc ion and DNA binding as determined by DAVID. SUPPLEMENTARY INFORMATION HHS Public Access

Purpose: To report the early clinical outcomes of combining intensity‐modulated radiation therapy (IMRT) and intensity‐modulated proton therapy (IMPT) in comparison with IMRT alone in treating the oropharynx cancer (OPC) patients. Materials and Methods: The medical records of 148 OPC patients were retrospectively reviewed, who underwent definitive radiotherapy (RT) with concurrent systemic therapy, from January 2016 till December 2019 at Samsung Medical Center. During the 5.5 weeks’ RT course, the initial 16 (or 18) fractions were delivered by IMRT in all patients, and the subsequent 12 (or 10) fractions were either by IMRT in 81 patients (IMRT only) or by IMPT in 67 (IMRT/IMPT combination), respectively, based on comparison of adaptive re-plan profiles and availability of equipment. Propensity‐score matching (PSM) was done on 76 patients (38 from each group) for comparative analyses. Results: With the median follow‐up of 24.7 months, there was no significant difference in overall survival and progression free survival between groups, both before and after PSM. Before PSM, IMRT/IMPT combination group experienced grade ≥3 acute toxicities less frequently: mucositis in 37.0% and 13.4% (p<0.001); and analgesic quantification algorithm (AQA) in 37.0% and 19.4% (p=0.019), respectively. The same trends were observed after PSM: mucositis in 39.5% and 15.8% (p=0.021); and AQA in 47.4% and 21.1% (p=0.016), respectively. In multivariate logistic regression, grade ≥3 mucositis was significantly less frequent in IMRT/IMPT combination group, both before and after PSM (p=0.027 and 0.024, respectively). AQA score ≥3 was also less frequent in IMRT/IMPT combination group, both before and after PSM (p=0.085 and 0.018, respectively). Conclusions: In treating the OPC patients, with comparable early oncologic outcomes, more favorable acute toxicity profiles were achieved following IMRT/IMPT combination than IMRT alone.

A 11-year-old, female Russian Blue cat was presented with anorexia, vomiting, and diarrhea lasting for 3 days. Abdominal ultrasonography revealed a hypoechoic, non-circumferential, and eccentrically formed intestinal loop with altered wall layering and thickening of the tunica muscularis. After surgical resection, histopathologic examination confirmed an infiltrative, round-cell neoplasm composed of sheets and cords of neoplastic mast cells within a fibrotic, edematous stroma. The cat was alive and healthy 6 months after surgery. To the best of our knowledge, this is the first reported case of an intestinal mast cell tumor in a Russian Blue cat in South Korea.

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