Adult Wilms' tumor with calcification untreated for 5 years – a case report

BACKGROUND: Wilms' tumor is rarely found in adults and there are no established treatment guidelines for such tumors in adults. Whereas calcification is a common finding in neuroblastoma, it is considered uncommon in Wilms' tumor. CASE PRESENTATION: We report a case of adult Wilms' tumor with calcification in a 22-year-old man. He had been initially referred to our hospital with a chief complaint of right flank pain 5 years previously, when abdominal computed tomography had revealed focal calcification at the upper pole of the right kidney. Although we planned further assessment, he did not revisit our hospital again until 5 years later, again because of right flank pain. Ultrasound and computed tomography scan revealed a large mass lesion with calcification in the right kidney, invasive to the hepatic lobe. The patient underwent curative right nephrectomy and partial right hepatic lobectomy. Pathological analysis demonstrated a nephroblastoma (Wilms' tumor) with predominant epithelial histology infiltrating the hepatic lobe. The patient has been well without tumor recurrence for 15 months after surgery. CONCLUSIONS: Calcification may be a sign of slow tumor gowth and possibly a favorable prognosis in cases of adult Wilms' tumor

Surgical correction of buried penis after traffic accident – a case report

BACKGROUND: Buried penis, most commonly seen in children, is particularly debilitating in adults, resulting in inability to void while standing and it also affects vaginal penetration. We report a case of buried penis due to a traffic accident, which caused dislocation of the fractured pubic bone that shifted inside and pulled the penis by its suspensory ligament. CASE PRESENTATION: A 55-year-old man was admitted to our hospital with a chief complaint of hidden penis while in the sitting position. He had suffered a pelvic fracture in a traffic accident four years previously, and his penis was covered with suprapubic fat when he was in a sitting position. He was unable to have sexual intercourse. We performed a penile lengthening procedure, including inverse V-Y-plasty of the dorsal skin of the penile root, suspensory desmotomy and fat removal, under general anesthesia. There was a good cosmetic result with satisfactory penile erection, which allowed successful sexual intercourse after surgery. CONCULSION: We performed penile elongation surgery with inverse V-Y-plasty of the dorsal skin of the penile root, suspensory desmotomy, and fat removal. Surgical treatment of buried penis achieves marked aesthetic and functional improvement, and benefits the majority of patients, resulting in satisfactory erection and successful sexual intercourse

ヒト腎細胞癌由来の樹立細胞株KU-2の性状について (1)クローン分離とクローン株の形態学的観察 (2)生長度測定と細胞周期 (3)C型ウイルスの検出

A KU-2 cell line derived from human renal cell carcinoma was established by an indirect culture system using the nude mouse in November, 1976. These cells have been examined from different points of view including light and electron microscopic observation, and chromosomal analysis. Histopathological characteristics of the KU-2 cell line, even after being transplanted back to nude mouse, remain similar. However, the characterization of this established cell line has not been fully elucidated. In the present experiments, attempts have been made to study the cloning of KU-2 cells and morphological feature of clones, cell growth and kinetics, and detection of the type C virus in the culture. These results suggested that the KU-2 cell line was not homogeneous but composed of a heterogeneous population of cells based on morphological difference of 6 clones and discrepancy between population doubling time and generation time when calculated from the growth curve and synchronous culture of the KU-2 cells, which may be explained by the cytotoxic effect of excess thymidine. Also the type C virus was negative in the medium

同側腎無形成を合併したCA19-9産生精嚢嚢胞の1例

29歳男, 残尿感, 会陰部痛を主訴として受診.直腸診にて波動を有する前立腺を触知した.MRIでは右腎は欠損し, 同側の精嚢は拡張し嚢胞状変化を伴っていた.経直腸的精嚢穿刺術を施行し, 内容液は血性膿汁であった.初診時, 血清CA19-9が145.8U/mlと異常高値であったが抗生剤投与と穿刺術にて正常化し, 症状も消失したA case of CA19-9-producing seminal vesicle cyst with ipsilateral renal agenesis is reported. A 29-year-old man was admitted to our hospital for perineal pain and urinary retention. Digital rectal examination revealed a large soft mass that fluctuated in the area of the prostate and seminal vesicles. Magnetic resonance imaging revealed a right kidney defect, and ipsilateral dilation and cystic enlargement of the right seminal vesicle. Transrectal puncture of the seminal vesicle cyst was performed. The contents were pus and old red blood cells. Initially, the serum CA19-9 level was extremely high (145.8 U/ml) but was normalized by the treatment with antibiotics after the puncture. The symptoms subsided without recurrence

Extensive Delayed Brain Atrophy after Resuscitation in a Patient with Multiple System Atrophy

Brain magnetic resonance imaging (MRI) of multiple system atrophy (MSA) shows atrophy in the cerebrum, cerebellum, and brainstem. It is also characterized by specific patterns such as hyperintense lateral putaminal rim. MRI of hypoxic encephalopathy shows atrophy mainly in the gray matter, and laminar necrosis in the cerebral cortex is often observed. Here, we report an MSA patient damaged by hypoxic insult and resuscitated after 18-min cardiac arrest. The brain of the patient developed severe atrophy within a period of 10 months. Furthermore, brain atrophy was observed in the white and gray matter, which preserved the brain atrophy pattern in MSA. We assume that alpha-synuclein oligomerization is involved in the neural cell death and brain atrophy. It might have caused further neural cell death in the brain damaged by hypoxia. Alpha-synuclein, which is involved in the pathogenesis of MSA, is suggested to be a prion. Misfolded alpha-synuclein may propagate through cell-to-cell transmission and cause wide pathological change, visible as atrophied MR imaging

持続性勃起症を伴う精巣腫瘍の陰茎転移の稀な1症例

持続勃起症の原因は主として, 動脈性持続勃起症と静脈性持続勃起症とに分類される.これらの分類によって治療法が異なるため, その分類は重要である.しかし, 今回, 分類不能な持続勃起症として経過し, 治療途中で精巣腫瘍からの陰茎転移による持続勃起症であると診断されたきわめて稀な症例(86歳男)を著者らが経験したので, それを報告したPriapism is thought as a condition of penile erection that persists beyond or is unrelated to sexual stimulation. Commonly two different entities of priapism are known, one is low-flow priapism and the other is high-flow priapism. It is important to distinguish these two conditions for the subsequent different treatments. We report a rare case of an indistinguishable priapism caused by penile metastasis of testicular cancer

Clinical Evaluation of Minimum-incision Endoscopic Radical Prostatectomy in Initial 50 Patients

To assess the feasibility of minimum-incision endoscopic radical prostatectomy (MIERP) in the management of localized prostate cancer. Methods: We conducted clinical evaluations of mean blood loss, operation time, and postoperative course in 50 cases of MIERP performed at Osaka Medical College Hospital from June 2006 to October 2009. The operations were performed according to the MIERP development protocol at our department, with incisions of 10 cm or less in the early cases and 6-7 cm in later cases. Results: In all 50 cases, average bleeding was significantly shortened compared with 19 cases by the conventional method at our institution. The postoperative start of oral intake, start of ambulation, use of analgesics, timing of catheter removal, and duration of hospitalization were all significantly improved with MIERP compared with the conventional method. MIERP patients were divided into 3 consecutive groups (initial 16 cases, midterm 17 cases, and latest 17 cases); mean operation time/mean blood loss were 253 min/1,485 mL, 253.4 min/2,340.9 mL, and 177 min/1,274 mL, respectively. Conclusion: Surgical experience involving approximately 30 cases was required to achieve stable clinical results. MIERP is less invasive than conventional retropubic radical prostatectomy and may be safely introduced to resident urologists