Antibody-coated bacteria in urine of patients with ileal conduit urinary diversion.

The antibody-coated bacteria (ACB) test is a helpful adjunct for differentiating pyelonephritis from cystitis in the intact urinary tract, particularly in female patients. This test was used in patients with ileal conduits and infected urine in an attempt to determine whether bacilluria was of renal or conduit origin. Every patient with infected conduit urine had a positive ACB test even though no patient had clinical stigmas of acute pyelonephritis. In patients with ileal conduits, the ACB test cannot be used alone as an indicator that bacilluria is a cause of symptoms or renal damage.

Vena cava tumor thrombus from renal cell carcinoma arising from adrenal vein.

Renal cell carcinoma is a highly vascular tumor with the propensity to propagate along venous channels. Vena cava tumor thrombi are reported to occur in approximately 4-10 per cent of cases and requires modification of the standard radical nephrectomy. We report the first 3 cases of vena caval tumor thrombus emanating not from the renal vein, but from the adrenal vein. The recognition of this occurrence is essential in order to avert an intraoperative catastrophe.

Residues in broiler chickens fed low levels of hexachlorobenzene.

Male broiler chicks (Hubbard-Hubbard) were fed graded levels (0, 0.0006, 0.006, 0.03, and 0.120 p.p.m.) of hexachlorobenzene (HCB) for 8 weeks. Gel permeation chromatography was used to prepare tissue samples from fat, heart, gizzard, leg muscle, breast muscle, kidney, and liver for analysis by gas-liquid chromatography employing electron capture detection. No treatment related trends could be determined for body or organ weights. Histopathologic examination of brain, liver, testes, pancreas, small intestine, ventriculus, spleen, kidney, lung, and heart failed to reveal lesions in either control or treated groups. A linear relationship was found between HCB accumulation in tissues and the dietary HCB level. HCB accumulation was greatest in adipose tissue followed by the heart, gizzard, leg, kidney, liver, and breast. The biomagnification of HCB in adipose tissue of broiler chickens was 11 to 18 times the concentration in the diet. For example, a concentration of 0.03 p.p.m. of HCB in the diet resulted in the accumulation of HCB in adipose tissue in excess of 0.5 p.p.m. After 7 weeks, birds were taken off rations containing HCB. After a withdrawal period of five weeks, 0.5 p.p.m. of HCB remained in adipose tissue of birds that had been fed 0.12 p.p.m. of HCB.

Radical retropubic prostatectomy.

We herein present a modification of the Campbell technique for radical retropubic prostatectomy used in 75 consecutive patients undergoing surgical extirpation of the malignant gland. This technique provides for predictable and careful anatomic removal of the prostate. The postoperative complications have been minimal and urinary incontinence has been negligible.

Genetic analysis of behaviors related to the solution of a detour learning task.

A diallel cross involving five noninbred (purebred) lines of Japanese quail indicated that additive and nonadditive genetic effects had important influences on behaviors involved in a detour learning task. Social isolation for 3 hr was used to provide additional motivation which enabled detection of differences among strains. The percentage of quail, within purebred lines, that solved a 4-min detour task three or more consecutive times ranged from 52 to 72. Differences among purebreds were significant for most of the components of the learning task. Further, the data suggested strain differences associated with the successful attainment of the desired goal when there was a similar level of general activity.

Neurogenic pulmonary edema associated with autonomic dysreflexia.

Neurogenic pulmonary edema is associated with a variety of central nervous system injuries and results from a massive centrally mediated sympathetic discharge. Another syndrome characterized by sympathetic overactivity is autonomic dysreflexia, which occurs in patients with spinal cord injury above T4 to T6. We describe a patient with a cervical spinal cord injury who had intense, prolonged autonomic dysreflexia following external sphincterotomy, which culminated in pulmonary edema. Traction on an over-inflated Foley catheter balloon was the stimulus for autonomic dysreflexia and deflation of the balloon resulted in prompt resolution of autonomic dysreflexia and pulmonary edema. The pathophysiology of neurogenic pulmonary edema and autonomic dysreflexia is discussed.

Isotope loopography, a new test: comparison with standard loopography and its relationship to renal function in patients with ileal conduit urinary diversion.

Reflux associated with the classic ileal conduit has been implicated as possibly contributing to long-term renal deterioration. When demonstrated on a standard loopogram reflux occurs under highly non-physiologic conditions. A new method of radioisotope loopography performed under physiologic conditions was devised and compared to the standard loopogram. The standard loopogram is more of an indicator for the capacity for reflux. The isotope loopogram is a more specific indicator for reflux that is potentially detrimental to renal function. Approximately 50 per cent of ureteroileal anastomoses that permit reflux with conventional loopography do not do so under the physiologic conditions of the isotope loopogram.

Urinary lactic dehydrogenase and serum C-reactive protein as means of localizing the site of urinary tract infection in patients with ileal conduits.

Many patients with ileal conduit urinary diversion have infected urine but far fewer have clinical pyelonephritis. A noninvasive diagnostic test to distinguish renal bacteriuria from conduit colonization in these patients would seem desirable. Urine total lactic dehydrogenase and lactic dehydrogenase isoenzymes, and serum C-reactive protein have been useful to distinguish pyelonephritis from cystitis in patients with intact urinary tracts. We used these tests in patients with ileal conduits who had urine containing more and less than 10(5) organisms per ml. All patients had elevated urine total lactic dehydrogenase-5 isoenzyme, and serum C-reactive protein. No statistically significant difference in any of these parameters existed between the groups. These results may indicate that all patients with conduits have pyelonephritis but only intermittently demonstrate bacteriuria, or that the conduit mucosa contributes lactic dehydrogenase to the urine. However, it does not appear that these tests alone can distinguish accurately renal bacteriuria from conduit colonization.