A case of xanthogranuloma of the urinary bladder

A case of xanthogranuloma of the urinary bladder is reported. A 68-year-old man was referred to our hospital for the evaluation of microscopic hematuria. At that time, he did not have an abdominal tumor and ultrasonography showed no abnormality of the kidneys and the bladder wall. Two months later, he was admitted with the chief complaints of perineal discomfort and non tender fist size mass was palpable in the lower abdomen. Ultrasonography, computed tomographic scan and magnetic resonance imaging MRI demonstrated a supravesical mass which was strongly suspected as urachal tumor. Total cystectomy with urachal resection was performed. The histological diagnosis was xanthogranuloma. The patient has been in good health without recurrence, 4 years after surgery. We discuss xanthogranuloma of the urinary bladder in the literature.     

A case of Oberling's retroperitoneal xanthogranuloma in pilot

A rare case of retroperitoneal mass identified in the pilot, aged 48, is described. There has been noted the complexity of differential diagnosis between the benign and malignant process associated with the given type of tumor which led to some problems when making an expert decision. The tumor was found to be non-removable, however, considering the good clinical state of the pilot, he was permitted of flying activity which he continues to perform successfully more than 10 years. The pilot state remains good which confirms the benign character of the process. The observation is of great interest both clinically and from the flight-surgeon's appraisal standpoint.     

Papillary-like bladder calcifications following intravescical mitomycin C. A case report

Hyperplastic pulpitis, which is regarded as one type of asymptomatic irreversible pulpitis, occurs usually in young teeth where pulps are exposed by caries or trauma. If apices are mature, root canal therapy is recommended. In this case, the success of partial pulpotomy in a crown-fractured permanent incisor with hyperplastic pulpitis, which had been contaminated with oral microflora for six months is reported.     

Hamartoma of the urinary bladder: case report and review of the literature

In this first article for the feature Humanism and Medicine, Rita Charon introduces an excerpt from Richard Selzer's introduction to his latest book, The Doctor Stories. In her introductory and concluding comments, Charon contemplates the role of stories in medicine and how both truth and healing can be found in both listening to and telling stories. In the excerpt presented, surgeon and writer Selzer muses on his twin crafts. As a writer, Selzer can fully appreciate that which he witnesses in his life as a doctor. His ruminations on his own dual citizenship suggests that all doctors, perhaps, can deepen their commitment to medicine, to their patients, and to themselves by strengthening their capacity to behold their patients and to grasp their predicaments. Selzer also traces his origins and, by implication, projects his future. As practicing physicians and medical educators, readers of Academic medicine might be inspired to do the same.     

A case of asynchronous renal cell carcinoma and urothelial cancer of the urinary bladder and left ureter

A 49-year-old male with left renal cell carcinoma and urothelial cancer (bladder and residual left ureter), which asynchronously occurred, was reported. He had received radical nephrectomy due to renal cell carcinoma 12 years earlier. He was followed up by his local physician for 7 years postoperatively, during which time no metastatic lesion was detected. However, he presented with macroscopic hematuria on January 7, 1992, and a diagnosis of urinary bladder cancer was made at our hospital. Computerized tomography demonstrated a non-papillary, broad-based tumor on the left wall of the urinary bladder, which histologically was transitional cell carcinoma (grade 3). Radical cystectomy, ureterectomy of the left residual ureter and ileal conduit were performed. Histological examinations showed that the urinary bladder tumor was transitional cell carcinoma, grade 3, pT-3b, and CIS (transitional cell carcinoma, grade 3) was found in the residual left ureter. Chemotherapy containing cis-platinum was performed as an adjuvant therapy, but multiple lung metastatic lesions appeared 2 months postoperatively, the histology of which was transitional cell carcinoma, suggesting metastasis from the urothelial cancer. Chemotherapy was ineffective, and he died of the disease 9 months after the operation. If this patient had been under long-term follow-up, the urothelial cancer may have been resected completely by transurethral resection. Our report indicated the importance of examination of the urinary tract in patients with such cancers, as well as the necessity of long-term follow-up.     

Colloid cyst xanthogranuloma of the third ventricle--a case report

Diagnosis and treatment of malignant pericardial effusion are difficult in clinical practice. This paper reports the feasibility and reliability of percutanous trans-catheter intervention for the diagnosis and treatment of malignant pericardial effusion. Under echocardiagraphic guidence, pericardial puncture was performed and a heamostasis sheath was placed in situ by Seldinger technique. Through the sheath multiple biopsies of the pericardium were taken for pathological examination. A pigtail catheter was inserted to drain off the effusion. According to pathological report suitable anti-cancer drugs were instilled into the pericardial cavity through indwelling catheter for 3-5 days. The catheter was withdrawn when fluid did not re-accumulate. Diagnosis was made in over 96.0% of the cases. Upon follow-up for 3-6 months, complete remission was seen in 96.0% of the treated patients. No significant complication was found in all patients. Percutaneous trans-catheter intervention is a useful approach for the diagnosis and treatment of malignant pericardial effusion.     

Quality of life following bladder training in older women with urinary incontinence

The elaboration of new mortality tables by the Swiss statistical office has allowed to estimate the impact of different pathology or risk factors on the average life duration of the resident population in Switzerland. Thus, attributable death of the smoking habits have for effect to decrease the life expectancy of swiss citizens of 2.9 years for men and 0.7 years for women, for the period 1988/1993. The calculation of mortality rates attributable to this factor of risk shows nevertheless that the risk of death has decreased since the end of years 1960 for all quinquennial age groups between 35 and 74 years. The smoking habits would be responsible of approximately 16% of deaths observed in the swiss population and 20% of premature deaths (between 25 and 64 years). The present analysis shows furthermore that different evolutions of the mortality associated with the smoking habits characterize men and women.     

A comparison of patient recovery following unilateral and bilateral endoscopic preperitoneal herniorrhaphy

This study examined the effects of prenatal ethanol exposure on hippocampal theta activity in adult rats. Subjects were randomly selected from four prenatal treatment conditions: untreated, 0, 3, or 5 g/kg/day ethanol. At approximately 90 days of age, all subjects were surgically implanted with a bipolar electrode in the CA1 region of the hippocampus. Four epochs of hippocampal theta rhythm activity were recorded while the subjects were moving and four more while still, and a normalized theta score was computed and compared among groups. The 5 g/kg male group demonstrated a significantly higher theta score than controls, indicating either an increase in type I (movement-associated) theta and/or a decrease in type II (information-processing) theta activity. These results are consistent with prior reports that prenatal ethanol exposure alters hippocampal function and support clinical indications that monitoring the EEG of children may prove to be useful in the diagnosis of fetal alcohol syndrome and/or the detection of alcohol-related birth defects.     

A case of bladder agenesis

A plasmid (5.4 kbp) from Salmonella Typhi D4 has been identified as encoding a restriction and modification (R-M) system. DNA fragments (2537 bp) that carried the genes for restriction endonuclease and methyltransferase encoded on the plasmid were sequenced. Two divergently arranged open reading frames of 957 bp for the restriction endonuclease consisting of 318 aa (amino acids) and 1140 bp for the DNA methyltransferase consisting of 379 aa were identified. These sequences were similar to the sequences of the SsoII R-M system, including the interspace between the two genes.     

MALT lymphoma of the bladder: report of a case]

Laryngeal metastases from remote primary tumours are uncommon. They derive mostly from melanomas or renal cell carcinomas. The generally rare laryngeal adenocarcinomas can only be classified as metastatic tumours in the presence of a distant primary of the same histology. Only five cases of a laryngeal secondary originating from adenocarcinoma of the large bowel have been reported in the world literature. A further case is presented which to our knowledge is the first to arise from the rectum, a site which suggests haematogenous tumour spread. This paper emphasizes the need for the search of synchronous metastatic disease and discusses the therapeutic options on the grounds of current management of singular colorectal secondaries.     

Primary osteosarcoma of the urinary bladder

PURPOSE: To review the effects on intraocular pressure control of the use of standard and heparin-coated intraocular lenses (IOLs) following combined cataract and glaucoma surgery after a minimum period of 2 years. METHODS: Case note review of all patients with glaucoma who required cataract extraction combined with trabeculectomy and who were randomized to either of the two IOL types. The number of ocular hypotensive medications and the intraocular pressures were recorded pre-operatively and at 3, 6, 18 and 24 months following surgery. RESULTS: The two groups (9 receiving standard IOLs and 10 heparin-coated IOLs) were comparable for age, sex and follow-up, as were the pre-operative intraocular pressures and number of treatments. Post-operatively, all patients achieved an intraocular pressure < 21 mmHg at the final visit, with only one patient in each group requiring topical medication, but the standard lens group had a higher intraocular pressure at 2 years (p<0.05). The magnitude of the fall from the pre-operative values was greater in the heparin-coated lens group at 2 years after surgery (p<0.02). The presence of a visible drainage bleb occurred equally frequently in the two groups. CONCLUSIONS: Use of a heparin-coated IOL does not adversely affect the intraocular pressure control following combined cataract and drainage surgery. The greater fall in intraocular pressure at 2 years in those receiving a heparin-coated IOL may have occurred by chance.     

Plastic repair of the urinary bladder

Clinical observations of 76 patients in whom an artifical urinary bladder was constructed from the rectum are presented. 52 patients were operated upon for cancer of the urinary bladder, total papillomatosis, a metastasis of uterine cancer in the bladder, cancer of the sigmoid with the urinary bladder involvement, sarcoma and cancer of the prostate with the bladder involvement. 17 patients were operated upon for extrophy, 7 -- for cancer of the urethra. An isolation of the rectum is followed by ligation of the upper rectal and vein. Fifteen patients died postoperatively due to peritonitis (6), ascending infection of the urinary tract (4), postoperative shock (I), phlegmon of the minor pelvis (I). In late postoperative period an artificial urinary bladder provides for reservoir and excretory functions.     

Ureterocystoplasty--ureteral augmentation of the urinary bladder

The article is preceded by an introduction to world-wide communication networks. Some important basic features are explained. The major impact is on temporary and future aspects of the Internet for psychiatry. A variety of advantages in World Wide Web telemedicine for patients, clients, psychotherapists, clinicians and scientists are extensively demonstrated. Useful and established possibilities are discussed. Finally, the risks of this kind of communication are shown and listed.