Giant renal calculus in a horseshoe kidney presenting as an abdominal lump.

We report a case of giant renal calculus of 14 × 10.5 × 9 cm in size and weighing 790 g, in a horseshoe kidney, along with two large calculi on the opposite side. Patient presented with unusual complaint of an abdominal lump only. Physical examination revealed a stony hard mass on the left side of the abdomen, extending from the subcostal region to just above the iliac crest. A giant renal calculus on the left and two large calculi on the right side of a horseshoe kidney were diagnosed on computed tomography (CT) scan. Percutaneous nephrolithotomy, followed after 5 days by open pyelolithotomy was done for the stones on the right and left side, respectively. Analysis revealed a calcium phosphate stone. This case is worth reporting as it was not only the 8th heaviest renal stone reported in the English literature, but also the first giant stone to be reported in a horseshoe kidney.

Ultra long high resolution beam by multi-zone rotationally symmetrical complex pupil filter.

An ultra long high resolution beam with extension of depth of focus (DoF) in the axial direction as well as high resolution in the transverse direction has been demonstrated by a seven-zone rotationally symmetrical complex pupil filter imposed at the aperture of a focusing lens. Both amplitude and phase of the transmitted light are modulated in different zones. The scalar diffraction theory is used to optimize the zone parameters. Simulation results show that extended DoF of the beam is increased by 16 times while the spot size at the beam waist is reduced to 0.7 times.

Efficient asymmetric synthesis of the vasopeptidase inhibitor BMS-189921.

[reaction: see text] An efficient asymmetric synthesis of the vasopeptidase inhibitor BMS-189921 was accomplished. Two short enantioselective syntheses of the common key intermediate (S)-alpha-aminoazepinone 6b were developed. Olefin 3 was converted to 6b via asymmetric hydrogenation. Alternatively, enyne 12 was converted to racemic alpha-aminoazepinone 15b, which was transformed to 6b by a practical dynamic resolution.

Confirmation of the structure of tetra-O-(tert-butyldimethylsilyl)-D-glucono-1,4-lactone formed by silylation of D-glucono-1,5-lactone.

The structure of tetra-O-(tert-butyldimethylsilyl)-D-glucono-1,4-lactone made by the silylation of D-glucono-1,5-lactone has been confirmed by single-crystal X-ray analysis.

Bilateral single system ectopic ureters opening into vestibule with bladder agenesis.

Almost 80% of ectopic ureters are associated with duplicated system, and 5-17% of ectopic ureters are bilateral. Ectopic ureters usually open into urethra, vestibule and vagina in females and into posterior urethra and seminal vesicles in males. Bilateral single-system ectopic ureter (BSSEU) is a rare entity in urology. BSSEU opening into a vestibule with the absence of urinary bladder is an extremely rare occurrence. We report such a case and briefly discuss its management.

Occult renal cell carcinoma manifesting as nasal mass and epistaxis.

Metastasis of renal cell carcinoma (RCC) to the nasal cavity and paranasal sinuses is rare, with fewer than 50 cases described in the literature. Nasal metastasis as the initial presentation of RCC is even rarer. Metastases to the nasal cavity usually represent advanced disease with poor outcome. The authors report a case of metastatic RCC presenting with right nasal cavity mass and epistaxis, followed by a brief review of the relevant literature.

Laparoscopic ureterolysis and omental wrapping in patients with retroperitoneal fibrosis and obstructive uropathy: a single-center experience.

OBJECTIVES: To analyze the outcomes with mid- to long-term follow-up of laparoscopic ureterolysis (LU) and omental wrapping in retroperitoneal fibrosis (RPF) with obstructive uropathy. PATIENTS AND METHODS: Records of 9 patients with RPF who had obstructive uropathy at presentation and had undergone LU and omental wrapping at our center during January 2004 to June 2012 were collected and analyzed. RESULTS: Six females and three males underwent LU for RPF. Underlying causes of RPF could not be found in 8 (89%) cases. Two patients underwent bilateral LU. Mean operative time and estimated blood loss were 213 minutes (range, 180-280 minutes) and 119 mL (range, 70-200 mL), respectively. No case required conversion to open surgery. The only significant intraoperative complication (1/9 [11%]) was ureteral injury, which was easily repaired intraoperatively. The postoperative complication rate was 44% (4/9). Most complications (75% [3/4]) were minor and did not need specific treatment. The mean follow-up period was 46 months (range, 4-72 months). The success rate at last follow-up was 89%. CONCLUSIONS: Treatment of RPF is still controversial. Any future prospective randomized comparative trials seem unlikely in view of the low incidence of RPF. LU and omental wrapping in the setting of obstructive uropathy are safe and an effective alternative with a high success rate at mid- to long-term follow-up.

Remarkable beta-selectivity in the synthesis of beta-1-C-arylglucosides: stereoselective reduction of acetyl-protected methyl 1-C-arylglucosides without acetoxy-group participation.

An efficient and practical process to generate beta-C-arylglucoside derivatives was achieved. The process described involves Lewis acid mediated ionic reduction of a peracetylated 1-C-aryl methyl glucoside derived from the addition of an aryl-Li to selectively protected delta-D-gluconolactone. The reduction of the 2-acetoxy-1-C-oxacarbenium ion intermediates proceeds with a high degree of selectivity to give beta-C-arylglucosides without 2-acetoxy group participation. Furthermore, during the reduction process we also identified an unprecedented critical role of water. By changing from the usual benzyl ether protecting groups because of cost and chemical compatibility concerns, the new process is made additionally efficient and highly selective.

Practical integration of polymerase chain reaction amplification and electrophoretic analysis in microfluidic devices for genetic analysis.

An integrated system of a silicon-based microfabricated polymerase chain reaction (microPCR) chamber and microfabricated electrophoretic glass chips have been developed. The PCR chamber was made of silicon and had aluminum heaters and temperature sensors integrated on the glass anodically bonded cover. Temperature uniformity in the reaction chamber was +/-0.3 degrees C using an improved novel "joint-heating" scheme. Thermal cycling was digitally controlled with a temperature accuracy of +/- 0.2 degrees C. Small operating volumes together with high thermal conductivity of silicon made the device well suited to rapid cycling; 16 s/cycle were demonstrated. For analysis of the PCR products, the chamber output was transferred to the glass microchip by pressure. Analysis time of PCR amplified genomic DNA was obtained in the microchip in less than 180 s. The analysis procedure employed was reproducible, simple and practical by using viscous sieving solutions of hydroxypropylmethylcellulose and dynamically coated microchip channels with poly(vinylpyrrolidone). DNA fragments that differ in size by 18 base pairs (bp) were resolved. Analysis of genomic male and female amplified DNA by microPCR was achieved in microchip, and application of the integrated microPCR-microchip for the identification of bird sex was tested. Genomic DNA samples from several bird species such as pigeon and chicken were analyzed. Hence, the system could be used as well to determine the sex of avian species.