[IgG4-related kidney disease: a long-term follow up case of pseudotumor of the renal pelvis].

A 69-year-old man had undergone left ureteronephrectomy because of a left renal pelvic tumor, however the pathological diagnosis was inflammatory pseudotumor. About 1 year later, computed tomography showed a mass at the right kidney near the hilar. Ureterorenoscopy and urine cytology were performed, and their results showed no evidence of malignancy. He had been followed closely without therapy. The mass increased in size during follow-up, and we reviewed the surgical specimen of the left ureteronephrectomy. Immunohistochemical studies revealed diffuse infiltration by IgG4 positive plasma cell. His serum IgG4 was high. We diagnosed him as IgG4-related kidney disease. In response to treatment with corticosteroid, the size of the tumor and serum IgG4 levels decreased. Most reported cases of IgG4-related disease involving kidney have a history of prior pancreatic involvement. We report a rare long term follow-up case of IgG4-related kidney disease without pancreatic involvement.

Laparoscopic repair of a ureteric sciatic hernia: report of a case.

Ureteric sciatic hernias are extremely rare. Here we report a case of a 78-year-old woman presented with colicky left abdominal pain. Computed tomography revealed a ureteric sciatic hernia, and drip infusion pyelography revealed dilated left ureter with herniation of the ureter into the sciatic foramen. The hernia was successfully repaired laparoscopically. We have described the diagnosis and management of the patient, followed by a review of the literature on sciatic hernias.

[Ductal adenocarcinoma of the prostate: a report of 7 cases].

Ductal adenocarcinoma of the prostate is a rare subtype of prostatic adenocarcinoma, defined by morphological criteria as one that has papillary or cribriform architecture composed of high columnar cells with pseudostratified nuclei. We clinically evaluated 7 cases of ductal adenocarcinoma of the prostate in our hospital. The median age was 69 years old and median initial serum PSA level was 22.8 ng/ml. Two cases presented with dysuria, two with macrohematuria and one with abnormality on chest radiograph. Five cases were diagnosed on prostate biopsy, one on TUR-P and one on radical prostatectomy. Two had pure ductal adenocarcinoma and five had mixed ductal adenocarcinoma. Four had metastatic disease, and were treated by hormonal therapy. Among three with non-metastatic disease, two underwent radical prostatectomy with adjuvant radiotherapy and one underwent external beam radiotherapy with hormonal therapy. Three cases with non-metastatic disease have no biochemical recurrence. Among four with metastatic disease, one underwent chemotherapy of Docetaxel and one had found a new lesion in lung.

Naftopidil vs silodosin in medical expulsive therapy for ureteral stones: a randomized controlled study in Japanese male patients.

The aim of the present study was to compare the efficacy of the selective α(1D) -adrenoceptor antagonist naftopidil and the selective α(1A) -adrenoceptor antagonist silodosin (as an example) in the management of ureteral stones in Japanese male patients. A total of 74 patients with symptomatic ≤ 10 mm ureteral stones were enrolled in a prospective study and randomized into two groups: Group 1 received 50 mg naftopidil daily, whereas Group 2 received 8 mg silodosin daily. Patients were followed-up for up to 6 weeks. The primary endpoint was stone expulsion rate and secondary endpoints were stone expulsion time, the rate of interventions, such as transurethral ureterolithotripsy, extracorporeal shock wave lithotripsy, or ureteral stenting, and side effects. There were no significant differences between the two groups with respect to age, stone size, and location. The stone expulsion rate was 61% and 84% in the naftopidil and silodosin groups, respectively (P = 0.038). No significant differences were noted in stone expulsion time or the rate of interventions between the two groups. The findings suggest that α(1A)-adrenoceptor blockade was clinically superior for stone expulsion our study population.

[Tegafur-uracil markedly reduced pulmonary metastasis from renal cell carcinoma refractory to sorafenib, interferon and interleukin 2].

In September 2003, a 68-year-old man was with renal cell carcinoma(RCC)underwent left radical nephrectomy. The pathological diagnosis was renal cell carcinoma, clear cell type, grade 1, pT3bNxMx stage III. Seventeen months later, lung metastasis was detected by CT and treated with recombinant interferon(IFN) -α2b (Intron A®) 600×104 units until the regrowth lung metastasis in May, 2008. Sorafenib, an antiangiogenic molecular-targeted agent, at a dose of 800 mg per day, was administered as the second time treatment. Nevertheless, it was discontinued in 2 months because of an increase in tumor size, severe hand-foot syndrome and thrombocytopenia. Therefore, the treatment was switched to natural human IFNa with tegafur-uracil at 300 mg per day since February 2009. After that, a nearly complete disappearance of the lung lesion was obtained 7 months later and maintained for 9 months.

Efficacy of low dose tamsulosin in medical expulsive therapy for ureteral stones in Japanese male patients: a randomized controlled study.

OBJECTIVE: To evaluate the efficacy of low dose tamsulosin for facilitating spontaneous passage of ureteral stones in Japanese male patients. METHODS: A total of 71 patients with symptomatic ureteral stones, 10 mm or smaller in size, were randomly allocated into groups 1 and 2. Group 1 received tamsulosin (0.2 mg/day) for a maximum of 4 weeks and group 2 received no medication. The primary endpoint was the stone expulsion rate and the secondary endpoints were stone expulsion time and analgesic use. RESULTS: There were no significant differences between the groups in terms of age, stone size and location. The stone expulsion rate was significantly higher in group 1 than in group 2 (77% vs 50%, P = 0.002). No significant differences were noted in the stone expulsion time and analgesic use between the groups. CONCLUSION: Low dose tamsulosin can significantly facilitate spontaneous passage of ureteral stones without significant side-effects in Japanese male patients.