Emphysematous pyelonephritis in a transplant kidney.

Emphysematous pyelonephritis (EPN) is a severe necrotizing infection of the kidney and its surrounding tissues. It is characterized by the production of gas within the kidney and perinephric structures. EPN often affects diabetic women but can also occur in nondiabetic patients who have ureteral obstruction and in immunocompromised patients. Herein, we report EPN in a 23-year-old woman who had a renal transplantation.

Effect of intralesional verapamil for treatment of Peyronie's disease: a randomized single-blind, placebo-controlled study.

PURPOSE: We aimed to assess the effect of intralesional verapamil on the treatment of Peyronie's disease. MATERIALS AND METHODS: This randomized study involved 80 patients. First, they were divided into two groups. The first group (case: 40 patients) received intralesional verapamil and the second group (control: 40 patients) local saline injection. They were followed about 24 weeks and evaluated for the size of plaques, plaque softening, reduction of pain and amelioration of penile deformity and erectile dysfunction (estimated by the International Index of Erectile Function) before and after treatment. RESULTS: Reduction of plaque size was seen in 17.5% of the case group and 12.8% of the control group (P: 0.755). Pain was reduced in 30% of the case group and 28.2% of the control group (P: 0.99). Curvature was decreased in 17.5% of the case group and 23.1% the control group (P: 0.586). Plaque softening was seen in 30% of the case group compared with 25.6% improvement in the control group (P: 0.803). Also we found 5% and 2.6% improvement in sexual dysfunction in the case and control groups, respectively. (P: 0.985). CONCLUSION: Although in some studies verapamil has been found to be effective in the treatment of Peyronie's disease, we did not find any improvement in comparison with the control group. Furthermore, larger scale studies are warranted to assess the effect of this drug on the treatment of Peyronie's disease.

Thyroid function studies in the nephrotic syndrome.

Total serum and urinary thyroxine (T4), triiodothyronine (T3), and thyroxine-binding globulin (TBG) as well as serum free T4, thyroid-stimulating hormone (TSH), and T3 resin uptake (T3RU) were measured in seven patients with the nephrotic syndrome. The nephrotic syndrome was defined by proteinuria exceeding 3 g/24 h. All patients were clinically euthyroid. Most values for total serum T4, free T4, T3, T3RU, TBG, and TSH were within normal limits. However, the mean serum T3 and TBG values were significantly lower in patients compared with the control group. The values (mean +/- 2 SD) for urinary T4 were 24.3 +/- 20.3 in the patient group and 1.5 +/- 0.7 microgram/24 h in the control group. Urinary T3 values for patients and the control group were 2100 +/- 856 and 848 +/- 253 ng/24 h respectively. Urinary TBG was 2.1 +/- 1.8 mg/24 h in the patients and undetectable in the control group. There was no correlation between daily urinary T3 and T4 and urinary TBG. There was a weak correlation between daily urinary protein excretion and urinary T4 (r = 0.5).

Esophageal motor function in Graves' disease.

Esophageal motor function was studied in 10 patients with untreated Graves' disease and 15 healthy volunteers who served as controls. A noncompliant recording system with a triple-lumen assembly was used. Resting upper- and lower-esophageal-sphincter pressures, amplitude, duration, and velocity of peristaltic contractions in the body of the esophagus, and the number of repetitive and simultaneous contractions were measured. There was no significant difference in peristaltic amplitude and duration between the controls and the patients with Graves' disease. However, there was a significant increase in velocity of contractions in Graves' disease as compared with controls. On restudy of 5 patients who became euthyroid after treatment with 131I, all the measured parameters were unchanged except for velocity of the peristaltic contractions. The value for this measurement decreased essentially to the same as that found in the control subjects. It is concluded that: (1) thyrotoxicosis increases the propagation velocity of esophageal contraction, and (2) thyroid hormones may play a physiologic role in the control of esophageal motor function.