[Impacted ureteral stents with cystine encrustation in cystinuric patients : report of two cases].

A 23-year-old man and a 62-year-old man suffering from cystinuria underwent extracorporeal shock wave lithotripsy (ESWL) for right renal stone and left ureteral stone, respectively. They had double-J stents placed before ESWL, but since attempts to retrieve the stents were unsuccessful due to encrustation, they were referred to our clinic. Multimodal endourologic and open approaches including ESWL, transurethral ureterolithotripsy, and pyelolithotomy were required to render them stent- and stone-free. The guidelines do not recommend routine stenting before ESWL ; therefore, the indication and duration of indwelling stents should be minimized. Multimodal options including not only ESWL and endoscopic surgery but also open surgery, should be attempted for the management of encrusted stents. Close monitoring and follow up are important to the prevent complications of ureteral stents.

[A case of primary urothelial carcinoma of the prostate responsive to MVAC intra-arterial chemotherapy: a case report].

A 70-year-old man visited a urological clinic on May 2008 complaining of dysuria and nocturia since 2 years prior. He was diagnosed as having gross benign prostatic hypertrophy, and was referred to a nearby hospital for transurethral resection of prostate (TURP). During TURP, a papillary tumor was found in the prostatic urethra on the left side and a biopsy was performed. A pathological examination revealed urothelial carcinoma G3. Cystoprostatectomy was planned, but the patient refused the procedure. Therefore, he underwent three courses of MVAC intra-arterial chemotherapy (methotrexate, vinblastin, doxorubicin, cisplatinum) at our hospital. After chemotherapy, no tumor was found in the prostatic urethra and a pathological report of repeat TUR showed no tumor. Currently, the patient is alive and there has been no evidence of recurrence for 1 year and 10 month.

A case of amniotic band syndrome with cleft lip and palate.

The patient was a 5-day-old boy born at 37 weeks and 4 days. At birth, an amniotic band encircling and constricting his left middle finger was noted, in addition to multiple anomalies including a right-side cleft lip and palate, a club foot, and syndactyly on the left hand. We performed cheiloplasty at 5 months, and palatoplasty at 18 months.

Osteoclast and osteoblast activities on carbonate apatite plates in cell cultures.

Previous studies have demonstrated that carbonate apatite (CA) is superior to hydroxyapatite (HA) and ß-tricalciumphosphate (ß-TCP) with regard to osteoclastic resorption, but evidence on osteoclast and osteoblast response remains controversial. In the present study, the expression of bone related mRNA is examined on CA, HA, ß-TCP, and titanium plates. ICR mouse osteoblast cells are cocultured with ICR mouse bone marrow cells. Crude osteoclast-like cell-rich suspensions are then seeded onto plates and cultured for 48 h. Total RNA is extracted and mRNA expression is examined by real-time RT-PCR. Amounts of vacuolar-type ATPase, cathepsin K, and TRAP mRNA are significantly greater on CA than on the other plates. The amount of osteoprotegerin mRNA is significantly greater on CA than on the other plates. RANKL mRNA expression, which is generally regarded as an osteoblast maker, varies with material, but shows no significant differences between CA and the other plates. The formation and activity of osteoclasts is greater with CA than with the other plates. Thus, CA is superior to ß-TCP as a bioresorbable bone substitute for tissue engineering.

Bone tissue engineering using porous carbonate apatite and bone marrow cells.

Porous blocks of carbonate apatite (CA) were prepared by holding together CA particles ranging in size from 300 to 500 microm through sintering at 750 degrees C for 2 hours. Bone marrow cells taken from Fischer rats were seeded onto and inside the CA blocks and cultured for 14 days to allow stem cells to proliferate to osteoblasts capable of inducing bone formation. Hybrids made of CA blocks and cultured bone marrow cells were then implanted into the back of syngeneic rats. Microfocus x-ray computed tomographic images of tissues containing CA blocks before decalcification suggested that new bone was formed in this extraosseous site 4 and 8 weeks after implantation. These data indicate that the hybrid made of CA and bone marrow cells is capable of inducing heterotopic bone formation in vivo.

Does the expression of HPV16/18 E6/E7 in head and neck squamous cell carcinomas relate to their clinicopathological characteristics?

Human papilloma virus (HPV) has been recently proposed to be implicated in the development of head and neck squamous cell carcinoma (HNSCC) in patients without cancer risk. We examined the expression of HPV16/18 E6/E7 in 71 cases of HNSCCs and investigated abnormalities of the p53 gene in 62 of these 71 cases. Expression of HPV16 E6/E7 was observed in 11 of the 71 cases (15.5%), while expression of HPV18 E6/E7 was not observed in any of the cases. Most of the HPV16 E6/E7-positive cases were histopathologically characterized by their verrucous or papillary structure and koilocytosis of the adjacent mucosa. There was no clear relationship between expression of HPV16 E6/E7 and tumor stage, prognosis or the positive rate of p53 abnormality. These results suggest that approximately 15% of HNSCCs are caused by HPV16 infection and the subsequent constitutive expression of E6 and E7, and that some HPV-initiated tumors lose their original characteristics during tumor progression.

Expression and cellular localization of TSC-22 in normal salivary glands and salivary gland tumors: implications for tumor cell differentiation.

TGF-beta-stimulated clone-22 (TSC-22) was reported to be a differentiation-inducing factor which negatively regulates the growth of salivary gland cancer cells. In the present study, we examined the expression of TSC-22 in salivary gland tumors by immunohistochemistry. In pleomorphic adenoma (PA), most of the sparse myoepithelial-like tumor cells, which are considered as the differentiated cells because they produce extracellular matrix, expressed TSC-22. However, only a limited number of cases of the solid myoepithelial-like tumor cells in PA, which are considered as the growing cells, expressed TSC-22. In adenoid cystic carcinoma (ACC), inner ductal cells in the tubular structure, strongly expressed TSC-22, though the outer myoepithelial-like tumor cells did not express TSC-22. In the cribriform structure, myoepithelial-like tumor cells did not express TSC-22. However, a small ductal structure in the micro-cyst wall strongly expressed TSC-22. Sparse type myoepithelial-like tumor cells in ACC also expressed TSC-22. In mucoepidermoid carcinoma, epidermoid tumor cells and mucous-producing tumor cells in mucoepidermoid carcinoma frequently expressed TSC-22. Thus, the expression of TSC-22 was frequently observed in the cells with differentiated-phenotypes, although rarely in the cells with growing potentials. These results suggest that TSC-22 may play an important role in maintaining the differentiated phenotype in salivary gland tumors.

Cell-mediated bioresorption of sintered carbonate apatite in rabbits.

Bone apatite contains carbonate and is therefore not pure hydroxyapatite. We have successfully developed sintered carbonate apatite (CA) with a concentration of carbonate of 6 weight% and have evaluated its osteoconductive and bioresorption characteristics. Cylindrical porous sintered CA and sintered hydroxyapatite (HA) measuring 4 x 4 mm with a porosity of 20% were implanted into surgically-created bone defects in the knees of rabbits. The animals were killed after 1, 3, 6 and 12 months. The defects were evaluated by microfocus CT and histology. Bone growth into and around both materials increased. Newly-formed bone was placed in direct contact with both. Osteoclast-like cells resorbed only CA, and were coupled with osteoblasts. The porosity of sintered CA increased, indicating bioresorption, whereas that of sintered HA did not increase. Our findings indicate that sintered CA may be useful as a bioresorbable bone substitute.