Neutrophil gelatinase-associated lipocalin, or NGAL, an acute phase protein, is part of the lipocalin family. NGAL is highly induced in inflammatory conditions and ischemia, and is a critical component of innate immunity to bacterial infection. Recently, NGAL has been proven as an emerging biomarker for predicting acute kidney injury (AKI). Meanwhile, numerous studies have also demonstrated that NGAL may be a potential biomarker for the diagnosis, prediction, prevention, and prognosis of non--AKI diseases such as chronic kidney diseases, vascular disorders, cancer, preeclampsia, and allergies. This article systematically reviews the clinical utilities of NGAL as a new biomarker for non--AKI diseases.

A 21-year-old man presented after being struck by a car and underwent a computed tomography scan of the chest and spine. Three hours later, his clear yellow urine sample was sent to the laboratory. A routine urinalysis with the Roche Urisys® 2400 indicated the specific gravity (SG) as a flag, i.e., an error for SG. A manual repeat of the SG measurement was also not readable by refractometer (no boundary line on the scale) but was 1.015 according to Roche Chemstrips®. The urine osmolality was 500 mOsm/kg (adult reference interval, 50-1200 mOsm/kg).

Résumé -La précipitation phosphocalcique a été induite de 2 façons dans le perméat de lactosé-rum de fromagerie : soit par alcalinisation simple, soit par effet combiné alcalinisationensemencement du milieu par des cristaux de phosphate dicalcique. L'alcalinisation simple s'est avérée inefficace, alors que l'ensemencement a provoqué une cristallisation intense, accompagnée d'une baisse de calcium et de phosphate solubles du perméat. Sur une zone de pH comprise entre 6,6 et 8,0, à 25 et 50 "C, il est apparu que les conditions pH 8,0 et 50 oC provoquaient la précipita-tion la plus complète, soit 61 % du calcium et 32% du phosphate solubles. L'observation microscopique et la stoechiométrie du précipité obtenu dans ces conditions suggèrent qu'un précipité amorphe et plus alcalin que la phase de nucléation est formé.

CASE DESCRIPTION Two calculi were discovered in an 84-year-old woman who was a bedridden resident of a nursing home. One calculus was just external to the vagina, and the other was inside. Both were foul smelling, 1 to 3 cm in diameter, tan in color, porous, and crispy (Fig. 1). A chemical analysis revealed the calculi to be composed of magnesium and ammonium phosphate. The patient did not have a urethrovaginal fistula. QUESTIONS 1. How does one classify vaginal calculi? 2. What conditions might cause a vaginal calculus? 3. What differentiation should be exercised for vaginal calculus? The answers are on the next page.