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We report a case of 2, 8-dihydroxyadenine (DHA) urolithiasis in a 65-year-old male. He initially visited another institution because right hydronephrosis was revealed in a medical checkup. Computed tomography demonstrated radiolucent right renal stones. We performed percutaneous nephrolithotripsy and flexible transurethral lithotripsy and removed the stones successfully. An analysis of the stone fragments revealed 2, 8-DHA urolithiasis. 2, 8-DHA stones are relatively rare and caused by adenine phosphoribosyltransferase deficiency., 本論文の要旨は，第285回日本泌尿器科学会東海地方会（2020年）で報告した．

We report a case of 2,8-dihydroxyadenine (DHA) urolithiasis in a 65-year-old male. He initially visited another institution because right hydronephrosis was revealed in a medical checkup. Computed tomography demonstrated radiolucent right renal stones. We performed percutaneous nephrolithotripsy and flexible transurethral lithotripsy and removed the stones successfully. An analysis of the stone fragments revealed 2,8-DHA urolithiasis. 2,8-DHA stones are relatively rare and caused by adenine phosphoribosyltransferase deficiency.

We report a case of 2, 8-dihydroxyadenine (DHA) urolithiasis in a 65-year-old male. He initially visited another institution because right hydronephrosis was revealed in a medical checkup. Computed tomography demonstrated radiolucent right renal stones. We performed percutaneous nephrolithotripsy and flexible transurethral lithotripsy and removed the stones successfully. An analysis of the stone fragments revealed 2, 8-DHA urolithiasis. 2, 8-DHA stones are relatively rare and caused by adenine phosphoribosyltransferase deficiency.

The Learning of Zhu Xi or Shushigaku 朱子学 was introduced to Japan in the early thirteenth century. However, it was never as widespread as it is generally assumed until the Kansei Edict of 1790 or the Prohibition of Heterodox Studies that proclaimed it as the official teaching at the Tokugawa shogunate’s schools, notably the later Shōheikō 昌平黌 (Shōhei School). Shushigaku was subsequently tied to written examinations primarily administered to heirs of the Tokugawa upper and lower vassals, which allowed them to receive promotions, acquire prestige, and, most importantly, seek new employments depending on their performances. In time, the Shushigaku curriculum was adopted in different degrees by an increasing number of feudal domain schools and private schools across the country, which contributed to its perceived predominance. This chapter focuses on the philosophical continuity and discontinuity between Zhu Xi and the Japanese Learning of Zhu Xi. Confucius says in Analects 2.15, “Learning without due reflection leads to perplexity; reflection without learning leads to perilous circumstances.” He explains why this is the case in Analects 13.5: “If people can recite all of these three hundred Songs and yet when given official responsibility, fail to perform effectively, or when sent to distant quarters, are unable to act on their own initiative, then even though they have mastered so many of them, what good are they to them?” Confucius argues that if we were to fall short in our reflection on learning to extend its relevance to novel circumstances, we would fail to deal with them effectively in a productive manner on our own. In our negligence to acclimate our learning to unfamiliar situations in “distant quarters,” he bodes, we would find their uncertainty perplexing and novelty perilous. One of the defining characteristics of the Learning of Zhu Xi in Japan, I suggest, is the dynamic interplay between its aspiration to establish continuity with Zhu Xi through meticulous learning of texts imported from China and Korea and its sustained effort to reflect upon this learning to appropriate Zhu Xi to the distant quarters of Japan. The appropriation, however, makes their reflected learning discontinuous with Zhu Xi, but it is also this discontinuity that allows for the forging of a new path, as it were, towards the construction of the very Japanese Shushigaku that it is.