A case of urinary calculus in a patient with Ehlers-Danlos syndrome.

Introduction: Treatment of urinary tract calculi in patients with Ehlers-Danlos syndrome, a connective tissue disorder, has rarely been reported. Case presentation: A 33-year-old woman with Ehlers-Danlos syndrome sought evaluation of right-sided abdominal pain from her family physician. Right-sided hydronephrosis was noted and she was referred to our hospital for further evaluation and treatment. A ureteral calculus with a maximum diameter of 8 mm was demonstrated at the right ureterovesical junction. Transurethral lithotripsy was performed under general anesthesia without complications. Conclusion: Lithotripsy may be safely performed in patients with Ehlers-Danlos syndrome.

A case of transvaginal lithotripsy for a giant vaginal calculus.

Introduction: Primary vaginal calculi are relatively rare, compared with secondary calculi. Primary calculi are often a result of urogenital sinus abnormalities, neurogenic bladder, or chronic incontinence. Case presentation: Forty-seven years old female with cerebral palsy since infancy had longstanding urinary incontinence. She visited her doctor for a fever and was referred to us with a urinary tract infection. Imaging revealed a large vaginal calculus. It was not possible to remove the calculus vaginally without crushing it, so we performed rigid cystoscopy with lithotripsy, using a pneumatic lithotripsy device. The calculus was completely removed without complications. Conclusion: We were able to remove a large primary vaginal calculus using ultrasonic and pneumatic lithotripsy through a rigid cystoscope. Minimally invasive surgery is a good option for patients with large vaginal calculi.

[A Case of Emphysematous Pyelonephritis after Starting Treatment for Acute Pyelonephritis].

A 68-year-old man sought evaluation at our emergency department in the early morning of day X with a feverfor3 days. The physical examination revealed pain in the left back, and an abdominal computed tomography (CT) showed a high density of fatty tissue around the left kidney. With a diagnosis of left acute bacterial pyelonephritis, he was hospitalized, antibacterial drug treatment was started, and he was transferred to our department on the same day. He had uncontrolled type 2 diabetes mellitus and had been treated with multiple drugs at another hospital. A decrease in blood pressure and respiratory failure was observed at night, and when contrast CT was performed the next morning, emphysema was observed in the parenchyma of the left kidney. The patient was diagnosed with class 2 left emphysematous pyelonephritis according to the classification of Huang et al. Double J stenting in the left ureter and conservative treatment were performed. Antibiotic treatment was continued and CT-guided percutaneous catheter drainage was performed on day 11. His general condition improved and he was discharged on day 32.

Renal Injury during Long-Term Crizotinib Therapy.

Crizotinib is highly effective against anaplastic lymphoma kinase-positive and c-ros oncogen1-positive non-small cell lung cancer. Renal dysfunction is associated with crizotinib therapy but the mechanism is unknown. Here, we report a case of anaplastic lymphoma kinase positive non-small cell lung cancer showing multiple cysts and dysfunction of the kidneys during crizotinib administration. We also present results demonstrating that long-term crizotinib treatment induces fibrosis and dysfunction of the kidneys by activating the tumor necrosis factor-α/nuclear factor-κB signaling pathway. In conclusion, this study shows the renal detrimental effects of crizotinib, suggesting the need of careful monitoring of renal function during crizotinib therapy.

Proprotein convertases modulate budding and branching morphogenesis of rat ventral prostate.

The onset of prostate morphogenesis is involved in the interaction between mesenchyme and epithelium. Proprotein convertases (PCs) activate a variety of growth and differentiation factors including mesenchymal and epithelial factors, such as insulin-like growth factor (IGF) and transforming growth factor-beta (TGF-beta), which induce ductal budding and branching. In this study, we provide evidence that PCs play a critical role in prostatic budding from the urogenital sinus (UGS) and ductal branching morphogenesis of the neonatal rat ventral prostate. PCs were expressed only in the epithelial cells of neonatal rat prostate. PC activity in the ventral prostate was modulated by endogenous androgen. PC inhibition suppressed prostatic budding and branching. Taken together, our data indicates that androgen-induced PCs initiate the development of the prostate.

Ureteral obstruction associated with pelvic inflammatory disease in a long-term intrauterine contraceptive device user.

We report herein a case of ureteral obstruction associated with pelvic inflammatory disease in a long-term intrauterine contraceptive device (IUD) user. A 62-year-old woman presented with a 2-week history of left flank pain and high fever, but no abdominal pain. She had forgotten the use of an IUD. Retrograde pyelography showed a stricture in the lower third of the left ureter. Magnetic resonance showed swelling of the uterus wall and left parametria, but did not reveal the presence of an IUD. Subtotal hysterectomy, bilateral salpingo-oophorectomy and left nephronureterectomy was performed. The IUD was then found in the uterine cavity. The results of pathological and bacteriological findings for Actinomyces infection were negative. Therefore we diagnosed this case as ureteral obstruction associated with pelvic inflammatory disease. Ureteral obstruction associated with pelvic inflammatory disease in a long-term IUD user is extremely rare.

Tuberculid of the penis with a scab on the nodule.

Tuberculids of the penis are extremely rare. The clinical features of tuberculids of the penis have been reported as ulceration or scars. We have experienced a case of tuberculid of the penis that appeared as a scab on nodule. A 56-year-old man presented with a 4-month history of a painless subcutaneous nodule at the glans penis. Pathological findings of the nodule showed granulomatous inflammation. Tuberculin tests were strongly positive, but tubercle bacilli could not be detected. The diagnosis was tuberculid of the penis and the patient received antituberculosis chemotherapy. The present paper reports an interesting and rare case of tuberculid of the penis with a scab on nodule.

Renal lymphoma associated with Castleman's disease.

We report the second case in the literature of a renal lymphoma associated with multicentric Castleman's disease.

[A case of cystic renal cell carcinoma: clinical usefulness of CT arteriography].

We report a case of cystic renal cell carcinoma (CRCC). In general, computed tomography (CT) and magnetic resonance imaging (MRI) are sufficient for diagnosing renal cell carcinoma (RCC). However, we often have difficulty in diagnosing CRCC based on these modalities alone. In the present case, to assess the contrast-enhancement of the cyst wall and the septum, we evaluated the usefulness of CT arteriography (CTA) by selective injection of contrast material into the renal artery. We believe that CTA could be a valid option for preoperative radiological differentiation of CRCC.

Pheochromocytoma of the urinary bladder without typical symptoms.

Pheochromocytoma of the urinary bladder is an unusual tumor that typically presents with hypertensive crises related to micturition. We report, herein, the case of a 62-year-old woman with bladder pheochromocytoma. The patient presented with a bladder tumor that was incidentally found by computed tomography (CT) without the triad of sustained hypertension, hematuria and postmicturitional syncope. Cystoscopy revealed a yellowish submucosal tumor in the right lateral wall of the bladder. Treatment consisted of transurethral resection in the initial diagnosis of bladder tumor. A definitive diagnosis was made postoperatively upon pathological examination. The patient has been followed up for 12 months and has shown no recurrence.