The most common cause of lower urinary tract obstruction in male infants is posterior urethral valves. Although the incidence has remained stable, the neonatal mortality for this disorder has improved due to early diagnosis and intensive neonatal care, thanks in part to the widespread use of prenatal ultrasound evaluations. In fact, the most common reason for the diagnosis of posterior urethral valves presently is the evaluation of infants for prenatal hydronephrosis. Since these children are often diagnosed early, the urethral obstruction can be alleviated rapidly through catheter insertion and eventual surgery, and their metabolic derangements can be normalized without delay, avoiding preventable infant mortality. Of the children that survive, however, early diagnosis has not had much effect on their long-term prognosis, as 30% still develop renal insufficiency before adolescence. A better understanding of the exact cause of the congenital obstruction of the male posterior urethra, prevention of postnatal bladder and renal injury, and the development of safe methods to treat urethral obstruction prenatally (and thereby avoiding the bladder and renal damage due to obstructive uropathy) are the goals for the care of children with posterior urethral valves[1].

A targeted, mass spectrometry-based method, termed "SureQuant pTyr," enables highly sensitive and reproducible profiling of tyrosine phosphorylation levels in human colorectal tumors and reveals dysregulated signaling networks for enhanced tumor characterization and biomarker identification.

Purpose-Recent investigations have shown increased oxalate excretion in patients in whom kidney stones formed after contemporary bariatric surgery. We determined whether there is an increased prevalence of hyperoxaluria after such procedures performed in nonstone formers.Materials and Methods-A total of 58 nonstone forming adults who underwent laparoscopic Roux-en-Y (52) or a biliopancreatic diversion-duodenal switch procedure (6) collected 24-hour urine specimens 6 months or greater after bariatric surgery. Standard stone risk parameters were assessed. Comparisons were made with a group of healthy nonstone forming adults and stone formers in a commercial database.Results-The bariatric group had a significantly higher mean urinary oxalate excretion compared to that in controls and stone formers (67.2 vs 34.1 and 37.0 mg per day, respectively, p <0.001). Mean oxalate excretion of patients who underwent a biliopancreatic diversion-duodenal switch procedure was higher than in the Roux-en-Y group (90 vs 62 mg per day, p <0.05). There was a significant correlation between urine oxalate excretion on the 2 collection days but some patients showed significant variability. Of the patients 74% showed hyperoxaluria in at least 1, 24-hour urine collection and 26% demonstrated profound hyperoxaluria, defined as oxalate excretion more than 100 mg per day, in at least 1 collection. This occurred in 3 of the 6 patients in the biliopancreatic diversion-duodenal switch group and in 12 of the 52 in the Roux-en-Y cohort. Hyperoxaluria was not uniformly expressed.Conclusions-There is a high prevalence of hyperoxaluria in patients without a history of kidney stones who undergo bariatric surgery. A significant proportion of these patients have profound hyperoxaluria, which is not uniformly expressed. Keywordskidney; kidney calculi; hyperoxaluria; bariatric surgery; obesityThe prevalence of obesity in the United States is now 33%. 1 Studies have shown that obesity is associated with increased mortality, diabetes, heart failure, hypertension, obstructive sleep apnea, coronary artery disease and stroke. 2 These negative outcomes have prompted many individuals to attempt to lose weight using various methods. The initial management approach is based on lifestyle changes, including exercise and diet. While they are successful in some †Correspondence: Department of Urology, Wake Forest University Medical Center, Medical Center Blvd., Winston-Salem, North Carolina 27157 (telephone: 336-716-5692; FAX: 336-716-5711; e-mail: dassimos@wfubmc.edu Laparoscopic bariatric surgery provides a minimally invasive surgical option. This is a popular option in this population, as evidenced by greater than 100,000 of these procedures performed per year in the United States. 3 These patients have experienced several benefits, including significant weight reduction, reversal of insulin resistance, improvement in hypertension and other cardiovascular risks, and decreased mortality. 4Potential complications are associated with this procedure, including ...

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