Recurrent eosinophilic cystitis: a case responsive to steroids.

We report a case of eosinophilic cystitis that was responsive to prednisone but that recurred when the drug was withdrawn. The cause of eosinophilic cystitis remains an enigma but it probably represents a form of allergy. Investigation of etiology and therapeutic options are discussed.     

Recurrent eosinophilic cystitis with peripheral eosinophilia and hyperimmunoglobulinemia E

A case of recurrent eosinophilic cystitis with peripheral eosinophilia and hyperimmunoglobulinemia E, which responded successfully to initial and secondary steroid therapies is reported.     

Papillary and polypoid cystitis. A report of eight cases

Eight patients from 20 months to 79 years of age (average, 49 years) with papillary or polypoid inflammatory lesions of the urinary bladder were studied. On cystoscopic examination or initial pathologic examination, several of the lesions were thought to be neoplasms. Their clinical and pathologic features, however, were typical for papillary and polypoid cystitis. Microscopic examination disclosed thin, finger-like papillae or broad-based polypoid lesions with prominent stromal edema typically associated with chronic inflammation. The lesions were covered by, and adjacent to, urothelium that was usually normal but was occasionally metaplastic. A history of recent catheterization was present in only one case. These cases illustrate that occasional papillary or polypoid urothelial lesions are inflammatory rather than neoplastic.     

Two cases of encrusted cystitis

Encrusted cystitis is a type of severe cystitis, which progresses chronically and is characterized by excessively alkaline urine and calcifications within the bladder wall. We report two cases of encrusted cystitis. Both cases were high aged and had severe anemia with chronic cystitis. They complained of gross hematuria, voiding frequency and pain upon urination. Urine pH was 8-9, and urine cytology was negative. Urine culture contained Corynebacterium Group D2. Abdominal computed tomography and transurethral resection revealed wall bladder wall calcification and inflammatory change. We diagnosed it as encrusted cystitis. The patients underwent excision of plaques of calcified encrustation, adapted antibiotic therapy and acidification of urine. It is essential to diagnose encrusted cystitis early and to provide adequate treatment promptly.     

Two cases of eosinophilic cystitis induced by tranilast.

We report 2 cases of eosinophilic cystitis induced by Tranilast, which was used for the treatment of bronchial asthma. In case 2 Tranilast itself and its metabolic derivative proved to be inciting agents by a drug-induced lymphocyte stimulation test. The literature on this association is reviewed.     

Three cases of emphysematous cystitis

Emphysematous cystitis is a rare form of acute cystitis presenting with gas collection in the bladder wall and lumen. We report three cases of emphysematous cystitis. The first patient was a 71-year-old woman with gross hematuria. Intravenous pyelography and cystoscopy revealed a characteristic gas collection in the bladder. The second patient was a 59-year-old man with abdominal fullness who was hospitalized for treatment of a cerebral infarction. Abdominal radiography and computed tomographic (CT) scan demonstrated emphysematous cystitis. The third patient was a 67-year-old man with diarrhea and abdominal pain after operation for rectal cancer. CT scan accidentally showed gas bubbles in the bladder wall and lumen. All of the cases, the symptoms were improved after treatment with antibiotics.     

Recurrent interstitial cystitis following cystoplasty: fact or fiction?

The severity of symptoms in interstitial cystitis may necessitate surgical treatment in approximately 10% of the patients. Substitution cystoplasty provides satisfactory results in most of these cases, while avoiding the need for urinary diversion. It has been suggested that interstitial cystitis may affect the bowel segment used in this form of operation. We studied bowel segments removed from cystoplasties in 5 patients with interstitial cystitis and compared these to bowel used for lower urinary reconstruction for other disorders in 6 patients. All segments showed varying degrees of inflammation, fibrosis and mastocytosis but there was no difference between the 2 groups for these features. We conclude that inflammation and fibrosis is the usual reaction of bowel to exposure to urine, and they do not represent a specific spread of interstitial cystitis in those patients. However, this reaction does mimic the histological appearance of interstitial cystitis in the bladder and may suggest a model for this disease.     

Recurrent cystic meningiomas. Report of two cases

The Authors report 2 cases of recurrent cystic meningiomas among 22 cases operated on. After a review of the literature, the pathogenesis of the recurrences of these tumors is discussed, concluding that wrong interpretation of neuroradiological examination and/or incomplete extirpation of tumoral capsule are the main factors responsible of recurrences of cystic meningiomas.     

Changing trends in necrotizing enterocolitis. Experience with 302 cases in two decades.

Three hundred two infants with necrotizing enterocolitis (NEC) were treated from 1972 to 1990. One hundred eighteen were treated medically while 184 infants required operation. Comparisons were made between two treatment periods, 1972 to 1982 (n = 176) and 1983 to 1990 (n = 126). Infants in the more recent era were of lower birth weight (1505 +/- 853 g versus 1645 +/- 836 g), earlier gestational age (30.4 +/- 4.7 weeks versus 32.4.5 weeks; [p less than 0.01]), had symptom onset at an older age (15.7 +/- 13.9 days versus 10.0 +/- 10.8 days; [p less than 0.001]), and a lower incidence of hyaline membrane disease (p less than 0.001). Fewer patients in the 1983 to 1990 group had acidosis (p less than 0.001) and severe oliguria (p less than 0.001). Operation was performed sooner after diagnosis in the second group (2.6 versus 3.8 days; [p less than 0.001]). Survival was unaffected by sex, maternal complications, or whether infants were inborn or transferred from other facilities. Improved survival (1983 to 1990) was observed in those infants between 24 to 27 weeks gestation (p less than 0.002) and those weighing less than 1000 g (p less than 0.001). Since 1983 portal vein air (PVA) on abdominal radiographs was used as an indicator for operation. Survival in infants with PVA has improved from 29% to 64% (p less than 0.02). Despite patients being more immature and weighing less, the overall survival rate improved from 58% (1972 to 1982) to 82% (1983 to 1990) (p less than 0.001). Operative survival rate improved from 51% to 75% (p less than 0.002). Long-term survival was 75% overall and 65% for surgical infants in the 1983 to 1990 group (p less than 0.05).     

Eosinophilic cystitis in view of two cases

Authors present their experiences with eosinophilic cystitis. In both of their cases the preoperative evaluation presumed bladder cancer, the histologic examination, however, showed eosinophilic cystitis. In this report a discussion is given on the diagnostic and treatment possibilities of the entity.     

输尿管镜下气压弹道碎石术治疗输尿管结石(附302例报告)

目的 探讨输尿管镜下气压弹道碎石术治疗输尿管结石的临床效果。方法 对302例输尿管结石患者采用输尿管镜下气压弹道碎石治疗。男185例，女117例。平均年龄42岁。结石位于上段68例，中段106例，下段128例。结石横径5～12mm，纵径6～24mm。结果 输尿管镜直视下1次操作成功264例，成功率87．4％，4～6周内结石全部排净。发生并发症20例，其中输尿管穿孔14例，采取保守治疗8例，开放手术治疗6例，9例随访3～10个月未发现输尿管狭窄；泌尿系感染6例。结论 输尿管镜下气压弹道碎石术是治疗输尿管结石的有效方法之一。     

Emphysematous cystitis.

Case A 39-year-old homeless man presented with weight loss, urinaryfrequency and urinary incontinence. On examination he had apalpable bladder and extensive peripheral neuropathy. Initialblood glucose level was 43.5 mmol/l, serum creatinine was 107µmol/l and Hb_A1c was 16.2%. He     

Eosinophilic cystitis.

Allergy is an unlikely cause of the eosinophilic cystitis in the case presented because of the young age of the patient and the insignificant levels of IgE (immunoglobulin E) found in her serum.     

胆石性肠梗阻的诊断与治疗：附302例分析

目的：分析胆石性肠梗阻（BI）的临床特点和诊治现状。 方法：回顾1995年1月—2014年12月间中南大学湘雅医院收治的18例BI患者资料,并汇总近20年22篇中文文献中284例患者资料,分析并总结BI发病特点与诊治现状。 结果：302例BI患者中男86例（28.2%）,女216例（71.8%）;年龄36~89岁,平均63.4岁;术前确诊率为24.2%（73/302）;294例（97.4%）行小肠切开取石术,8例（2.6%）行肠切除肠吻合术;结石嵌塞于十二指肠27例（8.9%）,空肠71例（23.5%）,回肠末端201例（66.6%）,结肠3例（1.0%）;一期行胆囊切除术94例（31.1%）,胆管切开取石术4例（1.3%）;术后并发症发生率为27.2%（82/302）,术后病死率为0.7%（2/302）。 结论：BI多见于老年女性患者,常伴有较低的术前确诊率和较高的术后并发症率。

     

Interstitial cystitis.

Twenty histologically proven cases of interstitial cystitis were investigated in an attempt to find evidence of a possible autoimmune mechanism in its aetiology. HLA tissue typing was performed, autoantibody profiles were obtained, and a questionnaire of the patients' past history completed, especially with respect to other autoimmune conditions. An experiment was designed to test the effect of sodium cromoglycate on rat bladders. The results are discussed in relation to the management of patients with interstitial cystitis.