Introduction: Penile strangulation injuries are rare but well-recognized entities in the medical literature. Prolonged edema and ischemia can lead to tissue and neurovascular damage that is sometimes irreversible.

Aims: The aims of this case report are to discuss a novel treatment technique in reversing the ischemia reperfusion injury associated with a case of penile strangulation. Methods: We used hyperbaric oxygen treatments in a successful attempt for penile tissue salvage after a prolonged case of penile strangulation.

Results: The patient was successfully treated with five ninety-minute hyperbaric oxygen treatments. He was discharged home with improved penile sensation and the ability to void without difficulty.

Conclusion: Post-strangulation treatment varies based on the grade of injury incurred. Typically, when severe necrosis or gangrene is present a partial or total penectomy is performed. We propose hyperbaric oxygen treatments as a novel, minimally invasive method to attempt penile sparing in such an injury.

Since the first successfully performed in 1976 [1], Percutaneous Nephrolithotomy (PCNL) has gradually become the major treatment option for renal stones. Four years later, with the application of Extracorporeal Shock Wave Lithotripsy (ESWL), it is preferred by many urologists and patients as a low morbidity outpatient procedure. However, with the decrease of incidence of large and complex renal calculi and the improvement of armamentarium, Flexible Ureteroscopy (FURS), also termed Retrograde Intrarenal Surgery (RIRS), has becoming an important alternative to PCNL and ESWL over the last decade.

The backbone of modern immunosuppressant regimens after kidney transplantation is Calcineurin Channel Inhibitor (CNI) drugs including tacrolimus and cyclosporine A. Its mechanism is binding to immunophilins, forming complexes, binding to calcineurin, and leading to inhibition of T cell activation. Since CNI drugs are eliminated by cytochrome P450 system, especially the CYP3A subfamily, exploring their interaction exhibits great importance. It is known that CYP3A4 and CYP3A5 are involved in tacrolimus metabolism while CYP3A5 alone plays a major role in cyclosporine A metabolism. The polymorphism of CYP3A4 and CYP3A5 genes results in different CNI drugs dose requirements in transplant recipients. Pharmacogenetic approaches to figure out donors’ and recipients’ CYP3A4 and CYP3A5 genotypes may give us better understanding of pharmacodynamics of CNI drugs. Additionally, monitoring CNI blood concentration can reflect its pharmacokinetics. Combination of pharmacodynamics and pharmacokinetics may be used as a guide in clinical practice to administer CNI drugs in optimal dose, to avoid acute rejection or adverse effects of CNI drugs such as nephrotoxicity.

Median raphe cysts may occur at any site along the midline of the ventral side of the male genital area between the meatus and anus. The cysts are usually asymptomatic in childhood and may progress later and become symptomatic during adolescence and adulthood. The most common location of the cysts is penile shaft and parameatal position, glans penis and scrotum is very rare. We present a case of median raphe cyst of the scrotum in an adult patient who was treated with surgical excision.

Background: Rapamycin plays a protective role in kidney Ischemia Reperfusion (IR) injury in early stage, but the mechanisms involved haven’t been thoroughly revealed so far. We hypothesized this protective effect of rapamycin is relevant to the remodeling of immune microenvironment. With this purpose, we aim to investigate the change in proportion of Dendritic Cells (DCs), macrophages and Natural Killer T (NKT) cells in spleen, peripheral blood and IR induced kidney before and after rapamycin administration in a murine renal IR model. In addition, the effect of rapamycin on damage-promoting and damage-preventing cytokines in IR induced kidney was also investigated.

Materials and Methods: Balb/c mice were subjected to renal 30 min ischemia followed by 24h reperfusion. Rapamycin (2.5ml/kg) was administered by gavage daily, starting 1day before the operation. Renal function and histological changes were assessed. The proportion of NKT cells, macrophages and DCs in peripheral blood, spleen and kidney was detected by flow cytometry. The expression of pro-inflammatory cytokines Interleukin-6 (IL-6), Monocyte Chemotactic Protein-1(MCP-1), Tumor Necrosis Factor-α (TNF-α), Interleukin-1β (IL-1β) and anti-inflammatory cytokines Interleukin-10(IL-10), Transforming Growth Factor-β1 (TGF-β) were determined by RT-qPCR.

Results: Rapamycin significantly improved renal function and ameliorated histological injury and inhibit cellular apoptosis in IR-induced kidney tissue. The proportion of macrophages in spleen was decreased in rapamycin-treated group than in the sham and IR group. In contrast, the proportion of macrophages was raised in rapamycin group in comparison with the sham and IR group in the kidney. In spleen, rapamycin increased the proportion of DCs compared with the sham and IR group, but the proportion was decreased in peripheral blood and kidney. In rapamycin-treated group, the proportion of NKT cells in spleen was significantly decreased but increased in peripheral blood and kidney. In addition, rapamycin dramatically down-regulated the expression of IL-6, MCP-1, TNF-α and IL-1β and up-regulated IL-10 and TGF-β compared with IR group.

Conclusion: Rapamycin may protect kidney from IR injury through remodeling immune microenvironment- -modulating the proportion of DCs macrophages and NKT cells in spleen, peripheral blood and kidney and the expression of inflammatory- related cytokines.

ATP is involved in a number of physiological and pathological mechanisms in the urinary bladder. This review summarizes the main role of ATP and its metabolites, by acting on P1 and P2 purinoceptors present in the bladder wall. The ATP role in the urethra is not addressed. Prevalent mechanisms of modulation of ATP activity are also presented. Possible ATP release mechanisms from urothelium are presented and future directions proposed.

According to the American Cancer Society, bladder cancer is the 6th most common cancer in the U.S. When diagnosed and treated early, the 5 year survival rate is 94%. However, patients with invasive cancer have a much worse prognosis, with a 50% 5-year survival rate.

Renal Cell Carcinoma (RCC) is the seventh most common cancer in men and the tenth in women, with the second highest mortality among urogenital cancers. Patients with distant metastasis have a 5 year survival rate of <15%, mainly due to radio- and chemoresistance of metastatic RCC.