Xanthogranulomatous Pyelonephritis with Incomplete Double Ureter

Introduction. Xanthogranulomatous pyelonephritis (XGP) is a type of chronic renal inflammation that usually occurs in immunocompromised middle-aged women with chronic urinary tract infection or ureteral obstruction induced by the formation of ureteral stones. XGP with an incomplete double ureter is extremely rare. Case Presentation. A 76-year-old woman was referred to our department to undergo further examination for a left renal tumor that was detected by ultrasonography. Dynamic contrast computed tomography (CT) revealed an enhanced tumor in the upper renal parenchyma. Laparoscopic radical nephrectomy was performed based on a preoperative diagnosis of renal cell carcinoma. Histological sections showed the aggregation of foam cells; thus, XGP was diagnosed. Conclusion. We herein report a rare case of XGP in the upper pole of the kidney, which might have been associated with an incomplete double ureter

Assessment of activities and the participation domain based on the ICF for the elderly requiring care

ICFの「活動と参加」の評価を通して,要介護高齢者における生活機能低下の全体像を把握することを目的に調査を実施した.要介護高齢者672名を対象に,ICFの「活動と参加」の第2レベル73項目について,「実行状況」と「能力」の両面から評価点を評価し,Item　Indexとしてそれぞれの困難度を求めた.「活動と参加」における領域ごとの比較では第5領域「セルフケア」のItem Indexが最も低くなり,「実行状況」で37.7,「能力」で34.4となった.逆に高くなったのは第6領域「家庭生活」であり,それぞれ89.6,77.7となった.本研究の結果は要介護高齢者の生活機能低下の現状と評価手段としてのICF活用の可能性を示すものである.The purpose of this study was to understand the degree of functioning and disability level in elderly requiring care through the evaluation of each domain of "activity and participation" in ICF. The study investigated 672 elderly requiring care. In the investigation, regarding the 2nd level of 73 "activity and participation" domains in the ICF, the elderly were evaluated from "performance" and "capacity", and then converted to the Item Index. Subsequently, each item was evaluated, and the degree of difficulty for both performance and capacity was determined. In the comparison of both performance and capacity, the Item Index of Chapter 5 "SELF-CARE" was the lowest, while "performance" was 37. 7, and "capacity" was 34. 4. Conversely, the Item Index of Chapter 6 "DOMESTIC LIFE" became higher: it was 89. 6 and 77. 7 respectively. The results indicate the degree of both dysfunction and disability of the elderly requiring care, and also demonstrate the possibility of the ICF as an assessment tool

[Nine-month observation of effects of SO2 on the respiratory system in child Miyakejima citizens].

BACKGROUND: Mt. Oyama on Miyakejima Island erupted in June 2000 and all Miyake village citizens were forced to evacuate the island in the September, due to continuous eruptions and emission of unsafe amounts of volcanic gas, mainly sulfur dioxide (SO2). Beginning in February 2005, residents returned to live on the island despite the fact that volcanic gas was still being emitted. OBJECTIVE: To examine changes in the respiratory systems of included children from February 2006 to November 2006. METHODS: The study population was 141 children who participated in health checkups in November 2006, including 33 SO2 hypersusceptible children who had a current or past history of asthma, obstructive lung function, current symptoms of whistling and wheezing, and/or deterioration of respiratory symptoms. Respiratory effects were evaluated by a questionnaire for respiratory symptoms and by spirometry. SO2 was monitored at 7 sampling points within inhabited areas, and the mean SO2 concentration from February 2005 to November 2006 was 0.031 ppm. The area was categorized into four areas by average SO2 concentration, namely, areas L, H-1, H-2, and H-3, where the average SO2 levels were 0.019, 0.026, 0.032, and 0.045 ppm, respectively. RESULTS: Compared to children in area L, the frequencies of "phlegm" and "irritation of the nose" were significantly greater in the children in areas H-2 and H-3. %FVC and %FEV1 in hypersusceptible children were significantly reduced in November 2006 as compared to February 2006 (P = 0.047, 0.027), though no reduction observed in normosusceptible children. CONCLUSION: Respiratory functions in hypersusceptible Miyakejima children may be affected by SO2 exposure, and further follow-up observation is necessary

Adrenal Hemangioma: A Case of Retroperitoneal Tumor

Introduction. Adrenal hemangioma is a rare disease, with only some 60 cases reported previously. Due to the difficulty of the preoperative diagnosis of adrenal hemangioma, almost all of the cases were diagnosed by a histopathological analysis of surgical specimens. Case Presentation. A 52-year-old man was referred to our department for further examination of his left retroperitoneal tumor. He had received hemodialysis due to chronic renal failure resulting from membranous nephropathy. Computed tomography revealed a mass around his left hilum. Magnetic resonance imaging (MRI) and positron-emission tomography (PET)-CT were unable to confirm or deny malignancy, and tumor markers, including CEA and CA19-9, showed slight elevation. His tumor grew from 38 mm to 54 mm in diameter in 7 months of follow-up. We therefore planned retroperitoneal tumor resection with left nephrectomy. Histopathologically, hyperplastic small vessels with hemorrhaging and denaturation were seen. The endothelial cells showed no variants or division of the nucleus. Based on this diagnosis, no further therapy was performed. He has had no recurrence in the eight months since the surgery. Conclusion. We herein report a rare case of adrenal hemangioma

Effects of SO2 on respiratory system of adult Miyakejima resident 2 years after returning to the island.

BACKGROUND: Mt. Oyama in Miyakejima Island erupted in June, 2000. All Miyake villagers were forced to evacuate from the island in September, 2000, due to continuous eruptions and emissions of unsafe amounts of volcanic gas, mainly SO2. From February, 2005, Miyake villagers returned to the island despite volcanic gas still being emitted. OBJECTIVES: This study examines the 2-yr changes in Miyake residents' respiratory systems from autumn 2004 to November 2006. METHODS: The study population was 823 Miyake adult residents who participated in the health check-up in 2006. Respiratory effects were evaluated by a questionnaire for respiratory symptoms and spirometry. SO2 has been continuously monitored at 7 sampling points of the inhabited area. The mean SO2 concentration from February 2005 to November 2006 was 0.031 ppm. The area was categorized into 4 areas by SO2 concentration, namely, areas L, H-1, H-2 and H-3, where average SO2 concentrations were 0.019, 0.026, 0.032, and 0.045 ppm, respectively. RESULTS: The study subjects showed no deterioration in lung function. Prevalence of cough and phlegm among all participants were significantly higher in 2006 than in 2004, and age-, sex- and smoking-adjusted odds ratios of cough and phlegm were 1.75 (95%CI 1.33-2.30) and 1.44 (1.12-1.87). Prevalence of chronic bronchitis-like symptoms among normosusceptive subjects in 2006 was 4.1% which was significantly higher than that of 2.1% in 2004 (p=0.035). Compared to area L, the frequencies of phlegm and irritation of the nose were significantly increased in areas H-2 and H-3. CONCLUSION: SO2 exposure-related respiratory symptoms were observed in adult Miyakejima residents after returning to the island