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Objectives: The aim of this study was to investigate the relationship between quality of life (QOL) and residual urine volume in patients undergoing bacille Calmette-Guérin (BCG) therapy. Methods: Patients requiring BCG therapy, including those with carcinoma in situ, were enrolled prospectively. The urine volume collected through urethral catheterization was measured as post-voiding residual volume (PVR) during BCG therapy. Patients were divided into two groups: small PVR (SPVR), with PVR less than 30 ml, and large PVR (LPVR), with PVR greater than or equal to 30 ml. QOL status was assessed using the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 system before and after BCG therapy. Moreover, some patients were assessed by International Prostate Symptom Score (IPSS) at the same time as assessment with the EORTC QLQ-C30 system. The primary end point was the evaluation of QOL during BCG therapy. Results: Among the 69 patients with non–muscle-invasive bladder cancer included in this study, 43 were in the SPVR group and 26 were in the LPVR group. The proportions of women and analgesic use in the SPVR group were higher than that in the LPVR group; however, medication use for dysuria in the SPVR group was less than that in the LPVR group. In the QOL analyses, cognitive function and emotional function in the functional scale and fatigue, nausea/vomiting, and dyspnoea in the symptomatic scale were worse in the SPVR group than in the LPVR group. In the multivariate analysis, fatigue was worse in the SPVR group than in the LPVR group. Conclusions: During BCG therapy, patients in the SPVR group had worse QOL, especially fatigue, than those in the LPVR group. Level of evidence: Not applicable for this multicentre audit. [ABSTRACT FROM AUTHOR]

Cystitis cystica is a relatively common chronic reactive inflammatory disease caused by chronic irritation of the bladder mucosa. It is broadly considered one of the classifications of proliferative cystitis. The predilection site is the bladder trigone area, which may present with symptoms such as frequent urination, hematuria, and lower abdominal discomfort; however, it rarely causes bladder outlet obstruction. We present the case of a 59-year-old male patient suffering from incomplete urinary retention due to internal urethral orifice obstruction resulting from cystitis cystica. Following transurethral resection, the patient's dysuria rapidly improved, and the tumor did not recur., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Yagi et al.)

A 74-year-old woman presented to our hospital with the main complaint of anorexia and weight loss for several months. Computed tomography (CT) revealed right urinary stone, hydronephrosis, multiple lymphadenopathy, and a mass in the right kidney. Considering these findings, she was suspected to have renal malignancy (kidney or renal pelvis cancer) with multiple lymph node metastases; therefore, nephrectomy was performed. Her pathological diagnosis was xanthogranulomatous pyelonephritis (XGPN). There was no postoperative renal function decline, and multiple lymphadenopathy also disappeared on CT 3 months after surgery. It was judged to be reactive swelling due to inflammation. XGPN is a pathological condition characterized by accumulation of mast cells and activated macrophages in the renal tissue; and, the renal tissue recognizes yellowish granulation growth because of repeating pyelonephritis due to urinary tract passing impairment. In some cases, it is difficult to differentiate XGPN from renal malignancy. Moreover, lymphadenopathy may be lymph node metastasis but may also present reactive enlargement due to the effect of inflammation, making it even more difficult to differentiate when accompanied by lymphadenopathy. We report this case in which it was difficult to differentiate XGPN from renal malignancy considering the scarcity of reports of XGPN accompanied by multiple lymphadenopathy.

Objectives: This study aims to investigate whether a cribriform pattern on prostate biopsy may be a factor in suspicion of intraductal carcinoma of the prostate after radical prostatectomy., Methods: This retrospective study assessed 100 men who underwent prostatectomy from 2015 to 2019. Participants were grouped as 76 patients with Gleason pattern 4 and 24 patients without this pattern. All 100 participants underwent retrograde radical prostatectomy and limited lymph node dissection. The same pathologist evaluated all specimens. The cribriform pattern was evaluated with haematoxylin and eosin counterstaining, and intraductal carcinoma of the prostate was evaluated with immunohistochemical analysis of cytokeratin 34βE12., Results: Patients with intraductal carcinoma of the prostate on immunohistochemical analysis showed a significant tendency to relapse in the postoperative period, and those with the cribriform pattern on biopsy had a significant recurrence rate. In univariate and multivariate analyses, intraductal carcinoma of the prostate confirmed in biopsy tissue was an independent predictor of biochemical recurrence after prostatectomy. The rate of intraductal carcinoma of the prostate confirmation was 28% of cases with a cribriform pattern in biopsy tissue, which was increased to 62% in prostatectomy tissues., Conclusion: The cribriform pattern in the biopsy tissue may be a predictor for intraductal carcinoma of the prostate., Competing Interests: We declare that we have no conflicts of interest.Approval of the research protocol by an Institutional Reviewer Board and the approval number: R2‐24. Informed consent: NA. Registry and the registration no. of the study/trial: NA. Animal studies: NA., (© 2022 The Authors. BJUI Compass published by John Wiley & Sons Ltd on behalf of BJU International Company.)

A 71-year-old man was referred to us with a right renal mass that was discovered by computed tomography (CT) examination for acquired hemophilia and leukemoid reaction. He presented with persistent low-grade fever and purpura on the lower legs caused by acquired hemophilia. Contrastenhanced CT scan showed a right renal tumor 6.0×7.4 cm in diameterwith inhomogeneous enhancement. The result of his urine cytology was negative. After improvement of his coagulation by treatment with immunosuppressants and steroids, he underwent open nephrectomy. Histology of renal tissue revealed urothelial carcinoma (G3, pT4, N1). After surgery, his complete blood counts and coagulation improved without administration of immunosuppressants and steroids. Therefore, he was diagnosed with renal pelvic cancer with acquired hemophilia and leukemoid reaction.

Purpose: To evaluate the effects of a new active collagenase inhibitor, Pirocton Olamine (PO), on acid demineralization in dentin and to investigate possible mechanisms of the inhibitory effects., Methods: Demineralized bovine dentin sections were cyclically exposed to one of the test solutions containing PO (0-0.33%) and NaF (0.07%) for 3 minutes, then to a Clostridium histolyticum (Ch-collagenase) collagenase solution for 16 hours and finally to an acetate buffer solution for 6 hours for further demineralization within a single day. This cyclic treatment was repeated three times for 3 days. Changes in the mineral loss and lesion depth were quantified by transverse microradiography, and the extent of the degradation by the collagenase in the collagen matrix was measured by microscopic observation after the completion of the 3-day cyclic treatments. Possible mechanisms of PO inhibitory effects on collagen matrix degradation were tested by incubating PO with one of the substances (Ch-collagenase, bovine tendon collagen pieces, zinc2+ (acetate) which is essential ion for collagenolytic activity) at 37 degrees C. Following 1 hour incubation, the incubated solutions were filtrated and PO concentrations (unbound to the substances) in the filtrates were spectroscopically measured., Results: With increasing PO concentrations, the inhibition rates of collagen matrix degradation and the mineral loss were increased. Moreover, there was a positive statistical correlation between mineral loss and collagen matrix degradation, demonstrating that preservation of the collagen matrix would contribute to inhibiting acid demineralization. While the spectroscopic measurements indicated that PO possessed binding to these substances, PO exerted its inhibitory action primarily on the collagenolytic activity.

Immunoglobulin A nephropathy (IgAN) is a form of chronic glomerulonephritis of unknown etiology and pathogenesis. Immunogenetic studies have not conclusively indicated that human leukocyte antigen (HLA) is involved. As a first step in investigating a possible relationship between HLA class II genes and IgAN, we analyzed the extent of linkage disequilibrium (LD) in this region of chromosome 6p21.3 in a Japanese test population and found extended LD blocks within the class II locus. We designed a case-control association study of single-nucleotide polymorphisms (SNPs) in each of those LD blocks, and determined that SNPs located in the HLA- DRA gene were significantly associated with an increased risk of IgAN ( P = 0.000001, odds ratio = 1.91 [95% confidence interval 1.46-2.49]); SNPs in other LD blocks were not. Our data imply that some haplotype of the HLA- DRA locus has an important role in the development of IgAN in Japanese patients.