L’adénome métanéphrique bilatéral du rein

L’adénome métanéphrique du rein est une tumeur épithéliale bénigne rare. Son diagnostic est exclusivement histologique. Le diagnostic différentiel se fait essentiellement avec le néphroblastome et le carcinome papillaire à cellules rénales. L’étude cytogénétique apporte des éléments importants pour différencier entre ces trois entités histologiques. L’adénome métanéphrique bilatéral est exceptionnel (pour autant que nous sachions un seul cas a été rapporté dans la littérature) et pose un problème de diagnostic différentiel avec le cancer rénal bilatéral. Nous rapportons une nouvelle observation de cette affection rare chez un patient âgé de 64 ans

Pseudotumoral Malacoplakia of the Bladder

Malacoplakia is a rare inflammatory condition most often affecting the genitourinary system. We report the case of a 24-year-old man who presented with gross hematuria, nocturia, frequency, dysuria and considerable weight loss during the preceding three months. Digital rectal examinationshowed a solid pelvic mass. Ultrasonography and computed tomography showed calyceal dilatation on the right side and a solid bladder mass 10 cm in diameter suspicious of bladder cancer. Transurethral resection of the tumor was incomplete, due to the large volume of the bladder mass. Histological examination of the resected specimen revealed malacoplakia of the bladder. The patient was treated with fluoroquinolone and vitamin C. Follow-up at 3 months showed marked regression of the bladder mass and complete resolution of the calyceal dilatation

Management of encrusted ureteral stents

Objectives: To present our experience in managing encrusted ureteral stents and to review the literature on the subject.Methods: A total of 22 patients with encrusted ureteral stent were treated in our department. Encrustation of the stent and associated stone burden were evaluated using plain radiography, sometimes supplemented by intravenous urography or ultrasonography. The treatment method was determined by the site of encrustation, the size of the stone burden and the availability of endourologic equipment.Results: Stents were inserted for stone disease in 17 patients, for congenital abnormality in 3 and for ureteric obstruction by malignancy in 2. Stents were left in place for a mean of 10.8 months (range 5–34 months). The site of encrustation was in the bladder in 15 (68.2%), ureter in 13 (59%) and kidney in 8 patients (36.4%); more than one site was involved in 11 (50%) cases. For upper coil encrustations, retrograde ureterorenoscopy was performed in 9 cases, percutaneous nephrolithotomy in 4 and open pyelolithotomy in 2. For lower coil encrustation, fragmentation by grasper and/or transurethral cystolithotripsy was attempted in 11 cases, and suprapubic cystolithotomy was required for failure in 7 cases. Sixteen patients (72.7%) were rendered stone-free and 5 (22.7%) had clinically insignificant residual stones (3mm or less).Conclusions: Encrustation is one of the most difficult complications of ureteral stents and its management is a complex clinical scenario for the treating surgeon. The combination of several surgical techniques is often necessary but the best treatment remains the prevention of this problem by providing patient education

Synchronous Primary Tumors of the Kidney and Pancreas: Case Report

The simultaneous presence of primary carcinomas in the same patient is uncommon and synchronous primary tumors involving the kidney and pancreas are extremely rare. There are a few reports in the English literature of synchronous primary malignancies of the kidney and pancreas. We present a 62-year-old man who had weight loss of 9 kg and epigastric pain. Findings showed a Furhman grade II renal papillary carcinoma confined to the kidney and a synchronous well differentiated pancreatic ductal adenocarcinoma.Key Words: Synchronous double cancer, renal cell carcinoma, pancreatic carcinom

ADRA1A-Gα_q signalling potentiates adipocyte thermogenesis through CKB and TNAP

Noradrenaline (NA) regulates cold-stimulated adipocyte thermogenesis(1). Aside from cAMP signalling downstream of β-adrenergic receptor activation, how NA promotes thermogenic output is still not fully understood. Here, we show that coordinated α(1)-adrenergic receptor (AR) and β(3)-AR signalling induces the expression of thermogenic genes of the futile creatine cycle(2,3), and that early B cell factors, oestrogen-related receptors and PGC1α are required for this response in vivo. NA triggers physical and functional coupling between the α(1)-AR subtype (ADRA1A) and Gα(q) to promote adipocyte thermogenesis in a manner that is dependent on the effector proteins of the futile creatine cycle, creatine kinase B and tissue-non-specific alkaline phosphatase. Combined Gα(q) and Gα(s) signalling selectively in adipocytes promotes a continual rise in whole-body energy expenditure, and creatine kinase B is required for this effect. Thus, the ADRA1A–Gα(q)–futile creatine cycle axis is a key regulator of facultative and adaptive thermogenesis

La métaplasie glandulaire de l’urètre masculin: Apropos d´une observation et revue de la littérature

La métaplasie glandulaire de l´urètre est une affection rare. Son diagnostic est surtout anatomopathologique en raison d´une symptomatologie insidieuse et non spécifique. Nous rapportons une observation rare de métaplasie glandulaire de l’urètre chez un jeune patient ayant présenté des signes urinaires irritatifs associés à des épisodes d'hématurie, et dont le diagnostic a été posé sur l'étude histologique des lésions papillaires et bulleuses de l'urètre postérieur objectivées à l'endoscopie. Cette entité histologique est peu connue, avec peu de cas rapportés dans la littérature. La localisation urétrale est estimée à 9%. L´hypothèse d´une transformation métaphasique des cellules urothéliales en réponse à une agression chronique est retenue. L´évolution est marquée par les récidives ainsi que la possibilité de la dégénérescence adénocarcinomateus

La Lithotripsie transurétrale utilisant la Gaine d’Amplatz dans le traitement des calculs prostatiques géants : à propos d’une observation.

A la différence des petits calculs prostatiques endogènes, fréquents et asymptomatiques, les calculs prostatiques géants exogènes sont rares avec peu de cas rapportés dans la littérature. Nous rapportons une observation de calculs prostatiques géants chez un patient de 53 ans et nous décrivons le traitement endoscopique à travers une gaine d'accès d'Amplatz placée en transurétrale. La fragmentation des calculs a été réalisée par un nephroscope, en utilisant une double énergie pneumatique et acoustique. Plusieurs techniques sont rapportées dans la littérature pour la gestion de ce type de calculs, par chirurgie à ciel ouvert, ou par voie endoscopiques en utilisant l'énergie laser, pneumatique ou acoustique. L'usage d'une gaine d'accès en transurétrale à l'avantage de travailler à basse pression, d'extraire de gros fragments et de raccourcir le temps opératoire

Dynamic DNA Nanotubes: Reversible Switching between Single and Double-Stranded Forms, and Effect of Base Deletions

DNA nanotubes hold great potential as drug delivery vehicles and as programmable templates for the organization of materials and biomolecules. Existing methods for their construction produce assemblies that are entirely double-stranded and rigid, and thus have limited intrinsic dynamic character, or they rely on chemically modified and ligated DNA structures. Here, we report a simple and efficient synthesis of DNA nanotubes from 11 short unmodified strands, and the study of their dynamic behavior by atomic force microscopy and <i>in situ</i> single molecule fluorescence microscopy. This method allows the programmable introduction of DNA structural changes within the repeat units of the tubes. We generate and study fully double-stranded nanotubes, and convert them to nanotubes with one, two and three single-stranded sides, using strand displacement strategies. The nanotubes can be reversibly switched between these forms without compromising their stability and micron-scale lengths. We then site-specifically introduce DNA strands that shorten two sides of the nanotubes, while keeping the length of the third side. The nanotubes undergo bending with increased length mismatch between their sides, until the distortion is significant enough to shorten them, as measured by AFM and single-molecule fluorescence photobleaching experiments. The method presented here produces dynamic and robust nanotubes that can potentially behave as actuators, and allows their site-specific addressability while using a minimal number of component strands