[A rare case of adenocarcinoma of the bladder following ileocystoplasty]

This is a report of a case of well-differentiated adenocarcinoma found 14 years after ileocystoplasty. Total cystectomy and right ureterocutaneostomy were performed, and the origin of this tumor was proved to be the ileal part of ileocystoplasty. This is a rare case of adenocarcinoma in the ileal part of ileocystoplasty, because a review of the literature revealed only three other such cases.

[A case of giant hydronephrosis with renal pelvic calcification]

A 26-year-old man had asymptomatic macroscopic hematuria. A left hydronephrotic sac outlined with a thin curvilinear shadow of calcium deposition was found in a plain film and stenosis at the ureteropelvic junction (UPJ) in a retrograde pyelogram. Left nephrectomy was performed and the fluid content was 1330 ml. Histologic examination showed subepithelial calcification of the renal pelvis and fibrous proliferation at the UPJ.

Thyrotropin-releasing hormone-induced changes in electroencephalographic and vagal activity in the cross-circulated brain of the rat

The effects of centrally administered thyrotropin-releasing hormone (TRH) on vagal efferent and cortical electroencephalographic (EEG) activity were assessed in rat brains which were functionally isolated from the body trunk and maintained via cross-circulation. Upon withdrawal of inputs from the trunk, cervical vagal activity was markedly attenuated. The decreased activity was partially restored by TRH with a latent period of a few minutes. On the other hand, TRH immediately but transiently augmented the fast waves of the EEG. The change in brain activity produced by TRH appears to simulate the state which makes possible the generation of vagal efferent activity even though inputs from the body trunk are withdrawn.

[A case of transitional cell carcinoma occurring in the bladder and bilateral renal pelvis]

A 41-year-old male patient underwent transurethral resection for multiple bladder tumors in January, 1979. The pathological examination of the specimen revealed non-invasive transitional cell carcinoma G 2. Thereafter, transurethral coagulation and vesical instillation of various antitumor agents were carried out several times for tumor recurrence during the following eight months. X-ray examination for evaluation of macrohematuria, 15 months following the above treatment, showed left renal pelvic tumor. Left total nephro-ureterectomy was performed in July, 1981. However, microhematuria and class V in urine cytology were continuously observed postoperatively. Right total nephroureterectomy, followed by surgery of the internal shunt, was performed in January, 1982, after diagnosis of renal pelvic tumor by further investigation. Under maintenance hemodialysis, vagotomy and pylorus plastic operation were performed for gastroduodenal bleeding after the above surgery. Total cystectomy and urethrectomy along with irradiation during and after surgery were performed for tumor recurrence in November, 1982 and July, 1983 respectively. Unfortunately, the patient died of multiple liver metastasis and gastro-intestinal bleeding in September, 1983. All the tumor specimens showed the same histological characteristics, i.e., transitional cell carcinoma G 3. Twenty six Japanese cases of epithelial tumors of the bilateral upper urinary tract are reviewed.

Agonadism with positive H-Y antigen

A 30-year-old phenotypic female was investigated because of absence of the vagina. Her serum gonadotropins were elevated while testosterone was in the normal range for females. Stimulation with human chorionic gonadotropin (hCG) gave no response of testosterone. No uterus, Fallopian tubes, Wolffian derivatives, or the gonads were found at laparotomy. Chromosome analysis showed a 46,XY karyotype. The expression of the H-Y antigen was positive. The results suggest that testicular degeneration in agonadism is not caused by a defective H-Y antigen.