Shinichi Nemoto

Xanthogranulomatous pyelonephritis in childhood: case report and review of English and Japanese literature.

Xanthogranulomatous pyelonephritis is an uncommon disease that is usually seen in middle-aged women and is much rarer in children. We report a case of diffuse xanthogranulomatous pyelonephritis in a 3-year-old boy who had a nonfunctioning hydronephrotic right kidney on an excretory urogram. A review of the English and Japanese literature on xanthogranulomatous pyelonephritis in childhood revealed 2 remarkable differences regarding the incidence of sex and radiological findings. The majority of patients were girls in the English literature, whereas the opposite sex was seen in the majority of cases in Japan. The involved kidney was functioning on an excretory urogram in the majority of cases reported in the English literature, however, in all cases from Japan the involved kidney was non functioning. These findings further support the newer concept that xanthogranulomatous pyelonephritis in childhood exists in focal as well as diffuse forms.

Elastase--does this enzyme play any role in bladder cancer invasion?

Elastase activity in bladder cancer tissue and normal bladder epithelium was assayed with succinyl trialanine paranitroanilide (Suc-Ala3-NA), a synthetic substrate of elastase. Elastase in the tissue extract liberated paranitroanilide (NA) from Suc-Ala3-NA and coexistant endopeptidases produced alanine-NA and dialanine-NA. These products were detected by high performance liquid chromatography. All activities of elastase and endopeptidases in bladder cancer tissues from 20 patients are significantly higher than those in 17 normal bladder epithelia. In 20 bladder cancer cases evaluated, the relation between the activities of elastase and endopeptidases and the background factors of each bladder cancer case was examined. There was a significantly different activity of elastase between the superficial bladder cancer group (less than or equal to T1) and the invasive group (T2 less than or equal to). Elastase is assumed to play an important role in cancer invasion.

Long-term intra-arterial infusion chemotherapy with Adriamycin for advanced bladder cancer

SummaryLong-term intra-arterial infusion chemotherapy with Adriamycin (ADM) was performed in cases of bladder cancer prior to total cystectomy. This report describes the effects in 13 cases evaluated more than 3 weeks after infusion of 10 mg ADM once or twice weekly.An oblique skin incision approximately 10 cm long was made in the gluteal region to expose the gluteus maximus muscle. A teflon catheter was then inserted into the gluteal artery and fixed; the distal end was brought out from under the skin in the precordial region. A similar procedure was performed on the contralateral side.The catheter was inserted through the superior and inferior gluteal arteries in five and eight cases, respectively. In the former group, partial response was obtained in two cases, minimal response in two and no response in one, so that primary tumor remission was evident in 40% of the cases. In the latter group, all cases but one attained partial response, i.e., remission was seen in 87.5% of cases treated by inferior gluteal infusion.Skin erosion of the gluteal, perineal, and anal regions and sciatica-like pain were observed in some cases; however neither myocardial effect nor bone marrow suppression, which have been reported as side-effects of ADM, were observed in any of the cases.These results suggest that this therapeutic modality could be effective in the preoperative work-up of candidates for total cystectomy, and also that it could be useful in the treatment of patients in whom total cystectomy is contraindicated.

Renal Cell Carcinoma in a Solitary Kidney Treated by Partial Nephrectomy —Case Report and Review of Japanese Literature

Renal cell carcinoma in a solitary kidney is rather rare. We present a case of this condition occurring in a 50-year-old man. He was treated by partial nephrectomy and temporary hemodialysis for postoperative acute renal failure. Perusal of the literature reveals that in situ partial nephrectomy, if possible, seems to be a reasonable treatment of choice for renal cell carcinoma in a solitary kidney. This is the fifth case ever reported in Japan.