The first case of periureteric hibernoma. Case report.

Hibernoma is a rare type of soft tissue neoplasm originating from brown fat tissue. The present case is the first periureteric hibernoma concentrically surrounding the ureter with a concomitant renal pelvis stone.

Management of undeflatable Foley catheter balloons in women.

The inability to deflate a self-retaining balloon catheter is a rare problem but may be encountered by physicians. Many techniques have been described to solve the problem, some of which may be dangerous. The technique must not disturb the patient or create any additional morbidity. Those methods commonly used are the instillation of ether, liquid paraffin, chloroform or mineral oil through the inflation channel the use of a fine wire to burst the balloon or to recanalize the obstructed inflation channel; bursting or deflating the balloon through suprapubic, transvaginal or urethral routes: and the overinflation technique. The techniques which might be most appropriate for women are explained in a stepwise manner. First the catheter is cut in the proximal segment of the valve. If this is not successful, a ureteric catheter stylet is advanced through the inflation channel until it touches the balloon. If this is still unsuccessful, the balloon is deflated through the drainage channel using the technique proposed by Davies and Thomas. As a second choice, an intravenous cannula with its inner needle drawn back is advanced through the urethra next to the catheter; towards the balloon which, is then punctured with the inner needle. If these steps are followed, the patient will have no additional discomfort and no trauma to the surrounding tissues, and there will be no need for cystoscopy or any other expensive intervention.

A comparison of various methods to burst Foley catheter balloons and the risk of free-fragment formation.

OBJECTIVE: To compare the efficiencies of bursting balloons and the risks of forming free fragments after rupture using needles, the stylet of a ureteric catheter, instillation with ether or overinflation. MATERIALS AND METHODS: Two hundred 18 F 'silkolatex' Foley balloon catheters were divided into four groups of 50. Each balloon was inflated with 30 mL of distilled water, the catheters immersed in urine collected from healthy volunteers and maintained at 37 degrees C for 48 h. Attempts were made to burst the balloons with a needle (group 1), by overinflation (group 2), by ether instillation (group 3) and using the stylet of 7 F ureteric catheter through the inflation channel (group 4). RESULTS: The ratio of the burst to deflated balloons and the formation of free fragments were 100% and 0% in the group 1, 94% and 83% in the group 2, 100% and 100% in group 3 and 16% and 0% in the group 4, respectively. CONCLUSION: Bursting the catheter balloons using a needle seems to be the most appropriate method, being efficient and having little risk of forming free fragments.

[Evaluation of 18 epididymo-orchitis cases]. / Epididimo-orsitli 18 olgunun degerlendirilmesi.

Eighteen patients with epididymo-orchitis were reviewed clinically, microbiologically and serologically. While there were positive urine culture in 5 patients before treatment, only one of them had positive culture in the epididymal aspirate. The epididymo-orchitis in two patients was the complications of the brucellosis. Ofloxacin or doxycycline was used in the treatment of 16 patients for 2-3 weeks and all, except one patient were recovered completely. The cases secondary to the brucellosis were treated with rifampicin plus doxycycline combination for 6 weeks. After treatment, no positive urine cultures were noted in all patients. As a result the epididymal aspiration to clarify etiological agent is not necessarily needed and empirical treatment may be generally curative.

Urethrocutaneous fistula due to a coil of hair.

Strangulation of the penis by a coil of hair is often an unrecognized clinical entity with severe potential complications. In this report, a five-year-old boy with urethrocutaneous fistula caused by the wrapping of a single strand of hair around the penis is presented.

Seminal parameters of ejaculates collected successively with sixty minute interval in infertile men: effect of combination of prazosin and terbutaline on these parameters.

Out of 37 infertile men, 33 who were able to give two ejaculates by masturbation successively with a sixty minute interval, were studied. There was no significant change in sperm density in the second ejaculation whereas seminal volume decreased (P less than 0.01) and sperm motility increased (P less than 0.05) significantly. After a seven-day treatment with combination of prazosin (alpha 1-blocker) and terbutaline (beta 2-stimulator), the same successive ejaculates were obtained from only 27 of these patients. In this case sperm density and motility changed insignificantly, whereas seminal volume again decreased (P less than 0.01) significantly. The changes in seminal parameters were not significant between the pre- and post-treatment second ones. In a short-term study there are not any alterations to observe. The favourable results with a long-term treatment, published by Japanese authors, require a confirmation by further studies.

The effects of caffeine and theophylline on the triple adenosine triphosphatase enzyme activities of spermatozoa from males with oligoasthenospermia.

The triple ATPase activities of washed spermatozoa of oligoasthenospermic men (but not of normals) were enhanced by the addition of caffeine and theophylline, which are known to have a stimulating effect on sperm motility. The biochemical mechanism of action of caffeine and theophylline on sperm homeostasis is discussed.

The effect of spermine, spermidine and kallikrein on the triple adenosine triphosphatase enzyme activity of spermatozoa in males with oligoasthenozoospermia.

Unknown factors in the seminal plasma of normal semen that affect the motility of spermatozoa have a positive effect on adenosine triphosphatase (ATPase) enzyme activity. In an attempt to produce such an effect, spermine, spermidine and kallikrein were added to the incubation media in which spermatozoal ATPase enzyme activity was determined. These seminal substances increased the triple ATPase enzyme activity of spermatozoa from oligoasthenozoospermic men. We propose that the ATPase enzyme activity of spermatozoa may indicate sperm motility as a biochemical test.

Effect of testicular torsion on the contralateral testis and prevention of this effect by prednisolone.

This study was instituted to evaluate the effect of unilateral testicular torsion on contralateral testicular histology and the prevention of this effect by prednisolone. Fifty Swiss albino rats were equally divided into 5 groups. In group 1, it was observed that, due to torsion, the mean seminiferous tubular diameter and percentage of spermatogenetic activity of the contralateral testes were reduced and an inflammatory reaction was also noted. In group 2, detorsion increased the above-mentioned damage, and in group 3, orchiectomy failed to prevent it. In group 4, it was seen that prednisolone slightly increased the mean percentage of spermatogenetic activity and produced proliferation of the Leydig cells in the intact testicle. In group 5, when prednisolone was injected just after torsion, no damage to the contralateral testes appeared. It has been thought that damage to the contralateral testes may arise from an autoimmune mechanism and prednisolone appeared to be very helpful in preventing damage by immunologic suppression.

The effect of zinc, arginine, fructose and seminal supernatant of normal semen on the triple adenosine triphosphatase activities of the spermatozoa from males with oligoasthenozoospermia.

When the spermatozoa of oligoasthenozoospermic patients were suspended with the supernatant of normal semen, an increase in triple ATPase enzyme activities besides enhancement of spermatozoa motilities were observed. This suggests that factor or factors present in the supernatant of normal semen that effects spermatozoa motility also have a positive effect on triple ATPase enzyme activities. In an attempt to produce such an effect, zinc, arginine and fructose were added to the incubation media where the spermatozoal ATPase enzyme activities were determined. Zinc increased Ca2+-Mg2+ ATPase enzyme activity without affecting Na+/K+-Mg2+ and Mg2+ ATPase activities. Triple ATPase enzyme activities remained unchanged after arginine and fructose additions. As a result zinc is thought to be one of the factors that affect spermatozoa motility in seminal plasma.

Reduced activities of triple adenosine triphosphatase in seminal plasma and spermatozoa of patients with oligoasthenospermia.

Na+- and K+-activated and Mg2+-dependent adenosine triphosphatase, Mg2+-activated adenosine triphosphatase and Ca2+- and Mg2+-activated adenosine triphosphatase activities were determined in washed spermatozoa and in two fractions (pellet and supernatant) of seminal plasma of oligoasthenospermic patients and men with normal spermiograms. The activities of triple adenosine triphosphatase oligoasthenospermics were significantly lower than those of normals. The morphologic features of spermatozoa of oligoasthenospermics were of normal standards. Possible explanations for the significantly lowered triple adenosine triphosphatase activities from patients with oligoasthenospermia are given with special reference to the ion transport functions of the triple adenosine triphosphatase enzyme system.