[Bilateral asynchronous ureteral tumors associated with a horseshoe kidney: a case report]

A case of bilateral asynchronous ureteral tumors in a 58-year-old man associated with a horseshoe kidney was reported. First, left heminephrectomy with total left ureterectomy had been performed because of the left ureteral carcinoma. Three years and 8 months later, he was admitted and an emergency right nephrostomy was made on account of false anuria. Then, right ureterectomy with total cystectomy was the choice of treatment against the ureteral tumor on the right side. This case of bilateral ureteral tumors associated with a horseshoe kidney appears to be the first one reported in the Japanese literature.

[Effect of cefaclor in urinary tract infections (the first report)]

A part of our continuous investigation on the clinical effect of cefaclor against urinary tract infections was reported herein. Cefaclor, a daily dose of 0.75 g t.i.d., has been applied for the treatment of (I) 26 cases with the simple UTI and (II) 41 cases with the complicated. Rates of effectiveness were obtained 100% in (I) and 80% in (II). Side effects were noted in 8 cases (8.4%) out of total 95 cases.

Pituitary and gonadal function in prepubertal and pubertal boys with hypospadias

Luteinizing hormone releasing hormone (LRH) and human chorionic gonadotrophin (hCG) tests were performed in 18 prepubertal and 29 pubertal boys with hypospadias to examine pituitary and gonadal function. Thirty-one normal boys were also examined as controls. In the prepubertal group, the mean level of serum peak LH after LRH was significantly higher and the mean level of serum peak testosterone after hCG was significantly lower in boys with hypospadias than in normal boys, though about half of the patients had peak LH levels within ± 2 sd of the normal mean. There was little or no response to hCG in 3 out of 18 boys with hypospadias.

In the pubertal group, serum levels of LH, FSH and testosterone in all cases were clearly higher than those in the prepubertal group and distinct or moderate responses to LRH and hCG were found in all boys including patients examined. Although serum basal FSH and testosterone levels were similar in the two groups, the mean levels of serum basal LH, peak LH and FSH in LRH test were significantly higher and the mean level of serum peak testosterone after hCG was significantly lower in boys with hypospadias than in normal boys. However, more than half of the patients had these levels within ± 2 sd of the normal means. The difference was more marked in LH than in FSH levels. An elevated mean serum FSH suggests hypofunction of not only the Leydig cells but also of the seminiferous tubules at least in some boys with hypospadias.

Gonadal findings in cryptorchid boys with Noonan's phenotype

7 patients with Noonan's syndrome, aged 5-16 years, complicated by bilateral cryptorchidism were examined by LH-RH and HCG stimulation tests, long-term HCG stimulation and testicular biopsy. 2 patients showed a good response and there was no effects in the remainder. Histological examination of the tests confirmed interstitial fibrosis in every case and showed abnormalities of the seminiferous tubules in 4 patients while in 1 patient the seminiferous tubules were composed of spermatocytes and spermatids. These hormonal and histological findings show different patterns of disturbance of the pituitary-gonadal system in male patients with Noonan's syndrome.