Characteristics of Renal Cell Carcinoma Harboring TPM3-ALK Fusion

The World Health Organization 2016 edition assigned anaplastic lymphoma kinase (ALK) rearrangement-associated renal cell carcinoma (ALK-RCC) as an emerging renal tumor entity. Identifying ALK-RCC is important because ALK inhibitors have been shown to be effective in treatment. Here, we report the case of a 14-year-old young man with ALK-RCC. Computed tomography revealed a well-demarcated 5.3-cm enhancing mass at the upper pole of the left kidney. There was no further history or symptoms of the sickle-cell trait. The patient underwent left radical nephrectomy. Pathologically, the mass was diagnosed as an unclassified RCC. Targeted next-generation sequencing identified a TPM3-ALK fusion gene. The present report and literature review demonstrate that TPM3-ALK RCC may be associated with distinct clinicopathological features. Microscopically, the tumors showed diffuse growth and tubulocystic changes with inflammatory cell infiltration. Tumor cells were dis-cohesive and epithelioid with abundant eosinophilic cytoplasm and cytoplasmic vacuoles. If morphological features and TFE3 expression are present in adolescent and young patients, molecular tests for ALK translocation should be performed. This awareness is critically important, because ALK rearrangement confers sensitivity to ALK inhibitors.

A Case of Emphysematous Prostatitis / 대한비뇨기과학회지

Emphysematous prostatitis is characterized by pockets of gas within the prostate due to gas-forming organisms. Although only one case of emphysematous prostatitis had been reported in the literature, it was incidental finding associated with emphysematous cystitis. We consider that it is the result of aerobic urinary tract infections or may be caused by gastrointestinal fistula or iatrogenic surgical and diagnostic instrumentation. We report a case of emphysematous prostatitis in a 66 years old male with diabetes mellitus.

A Case of Emphysematous Prostatitis / 대한비뇨기과학회지

Emphysematous prostatitis is characterized by pockets of gas within the prostate due to gas-forming organisms. Although only one case of emphysematous prostatitis had been reported in the literature, it was incidental finding associated with emphysematous cystitis. We consider that it is the result of aerobic urinary tract infections or may be caused by gastrointestinal fistula or iatrogenic surgical and diagnostic instrumentation. We report a case of emphysematous prostatitis in a 66 years old male with diabetes mellitus.

Early Experience of the Transvaginal Burch Bladder Neck Suspension for Female Stress Urinary Incontinence / 대한비뇨기과학회지

Ever since Pereyra described needle suspension of the bladder neck as a form of surgical therapy for the treatment of stress urinary incontinence in women numerous modifications have been presented. Each of these modifications has helped to found healthy anatomical and surgical principles that ensure patient safety, decrease morbidity and improve effectiveness. We had treated 8 patients of stress urinary incontinence with or without cystocele by transvaginal Burch procedure. By fixing suspension sutures to the Cooper`s ligament we expected to achieve a static suspension independent of everyday patients` activities. The duration of follow up was 3 months to 6 months. Them were no serious operative complications. Incontinence was completely disappeared in 6 patients (75%) and significantly improved in 1 patient (12.5%), and failed in 1 patients (12.5%). Although the small number of patients and limited follow up, we believe that fixation of suspension sutures to the Cooper`s ligament can favorably influence long-term results of treatment for female stress urinary incontinence.

A Study about IgG Subclasses Concentration of Chronic Cough Patient and Changes of Immunoglobulin Levels after RU 41.740 Administration

PURPOSE: People who suffer from chronic or recurrent respiratory disease have immunoglobulin deficiency due to hypofunction of B cell. Among these immunoglobulin deficiency, it has been reported that only one or two subclass of IgG are deficient with normal quantity of IgG and IgA. Therefore it is necessary to measure IgG subclasses in chronic or recurrent respiratory infection for diagnosis. The purpose of this study is to measure IgG subclass in children with chronic respiratory disease and administration of RU 41.740 which was obtained from Klebsiella pneumonia, K2O strain(it has proven role in control of immunity) comparing the changes of immunoglobulin levels and IgG subclasses with the control group. So that better therapeutic approaches can be made for these diseases. Subjectsand METHODS: Thirty-six patients who visited to Konkuk university hospital due to chronic and recurrent coughing from January 1993 to June 1994, were selected for this research. Their age ranged from 2~13 year old and patients with evident history of allergy or tuberculosis were excluded. RU 41.740 with antibiotics were given to 31 subjects and 5 subjects were given placebo with antibiotics. For all subjects IgG, A, M, E, IgG1, G2, G3, G4 were measured. Immunoglobulins were remeasured from 15 subjects who received RU 41.740 and from 5 subjects who received placebo. Results : 1) Five subjects out of 36 were low or low-normal IgG group and all combined with IgG subclass deficiency, and all of low or low-normal IgG group had IgG3 deficiency. Eighteen subjects out of 31 normal IgG group accompanied IgG subclass deficiency and 12 subjects had IgG3 deficiency, which is most common IgG subclass deficiency. 2) Four subjects out of 36 were IgA deficiency group. Three subjects from 4 accompanied IgG subclass deficiency and had IgG4 subclass eficiency. 3) After the RU 41.740 administration, the levels of IgG and IgG subclasses increased significantly in study group. There were no significant change in IgG and IgG subclasses levels in placebo group CONCLUSIONS: In patients with chronic or recurrent respiratory disease, it is necessary to measure IgG subclass. These diseases tend to be chronic and recurrent and can be severely complicated causing bronchiectasis and incurable otitis media. Generally these diseases are not responsive to antibiotics. Therefore therapies should be directed to increasing immunological function for better results.

Quantitative Histological Analysis of the Ureteropelvic Junction Obstruction / 대한비뇨기과학회지

The ureteropelvic junction is one of the most common site of obstruction in the upper urinary tract, though the etiology is still unclear. In the present study, a quantitative histological analysis of the ureteropelvic junction(UPJ) obstruction was performed on 23 patient specimens(10 children, 13 adults) and 14 normal control specimens(6 children, 8 adults). Color image analysis system was employed to examine and compare collagen and smooth muscle components of the lamina muscularis layer. Tissue matrix ratio, that is collagen-to-smooth muscle ratio, was calculated using Bio Scan OPTIMAS Ver 4.02. Relative ratio of lamina propria and lamina muscularis to UPJ was calculated as percentage provided by "Img Pro" computer program. The results showed an increased tissue matrix ratio of 0.68+/-0.42 in the child patient group compared with the value of 0.30+/-0.10 in the child control group(p0.05). Our findings emphasize a significant increase in the tissue matrix ration(collagen-to-smooth muscle ratio) of the UPJ obstruction.

A Case of Renal Artery Aneurysm with Calcification / 대한비뇨기과학회지

Renal artery aneurysms, previously considered to be rare, have been diagnosed more frequently in recent years mainly due to extensive use of angiography. Most aneurysms are asymptomatic, found incidentally, and their presenting symptoms may include microscopic or gross hematuria, flank pain and renovascular hypertension. The diagnosis may be highly suggestive when rim like calcification is exist on KUB with symptoms, and renal angiography is needed to confirm diagnosis. The treatment may be conservative or operative according to size and site. Operative management may include nephrectomy, revascularization, and aneurysmectomy. We report a case of left renal artery aneurysm with incomplete ring-like calcification in a 52-year-old hypertensive woman. The selective renal angiography showed renal artery aneurysm arising from the bifurcation of left main renal artery Because of the risk of aneurysmal rupture through its weak portion with incomplete calcification and the possibility of the renovascular hypertension due to anastomotic stenosis after aneurysmectomy, we performed nephrectomy.

A Case of Extramammary Paget's Disease Involving the Penis and Scrotum / 대한비뇨기과학회지

Extramammary Paget's disease is a rare clinicopathologic entity. Because it is often associated with a subjacent or visceral malignancy and recurrence, extramammary Paget's disease is considered as malignant condition. We present one case of extramammary Paget's disease involving the penis and scrotum with clinical presentation and brief review of relevant literature.