Quistes de Rafe medio genitoperineal / Genitoperineal median Raphe cysts

Los quistes del rafe medio representan defectos del desarrollo embriológico de la zona genitc cuentran tapizados por diferentes epitelios según su ubicación. Estas lesiones, que son más comúnmente hall ca del meato uretral, pueden localizarse en cualquier lugar del rafe medio genitoperineal, desde el glandi ano. El tratamiento de elección es la escisión quirúrgica. Presentamos tres nuevos casos y revisamos la literatura.

[Immunology and deterioration of seminal parameters in varicocele]. / Inmunología y deterioro de parámetros seminales en varicocele.

OBJECTIVE: To investigate the occurrence of antisperm antibodies (ASAs) and their correlation to semen parameters in varicocele patients. METHODS: Semen samples from 137 patients with unilateral palpable clinical varicocele aged 15-35 years who consulted at the Infertility and Urology services of the Provincial del Centenario and Eva Peron teaching hospitals in Rosario (Argentina) were collected and analyzed according to the WHO standardized protocols and ASAs were tested with TAC II. Statistical analyses were performed using log linear models. RESULTS: Motility was impaired in 67.2% (p < 0.001) and morphology in 97.1%. Sperm concentration decreased in 19.7%, although it was not statistically different from that of the normal population. Of the infertile population with varicocele, 46.7% had positive ASAs with TAC II. CONCLUSIONS: We found a statistically significant correlation only between motility and sperm count (p < 0.01). Our study indicates that the severe dysspermia observed may be caused by autoimmune processes that trigger cellular and humoral mechanisms.

[Advantages of a new kit for the determination of antisperm autoantibodies]. / Ventajas de un nuevo kit para la determinación de auto anticuerpos antiespermáticos.

OBJECTIVES: It has been widely demonstrated that there is an increased level of sperm autoantibodies (SAA) in infertile than in normal fertile men, suggesting this could be a cause of infertility. This study was designed to correlate the direct agglutination methods of TAC II (a kit developed and validated by our staff) and the MAR-Screen (Fertility Technologies, Natick M.A., Bioscreen Inc.). METHODS: 645 semen samples from patients who consulted for infertility at the Infertility and Urology services of the Provincial del Centenario and Eva Perón de Granadero Baigorria teaching hospitals in Rosario (Argentina) and 30 fertile controls were analyzed. RESULTS: Statistical analysis showed a sensitivity of 87%, a specificity of 100%, a positive predictive value of 100% and a negative predictive value of 98% for TAC II. CONCLUSIONS: We recommend the use of TAC II. It has similar methodological characteristics as the MAR-Screen method and offers some advantages, such as the possibility to perform analysis on frozen sperm samples and oligospermic patients, since it is not necessary for the spermatozoa to be moving. Furthermore, the test has a higher immunological specificity because spermatozoa are washed.

[Abnormal glycosylation of soluble ABH antigens in tumors of the urinary tract]. / Glicosilación anormal de antígenos ABH solubles en patologías tumorales del tracto urinario.

OBJECTIVE: To determine the secretor expression in patients with bladder cancer, adenoma of the prostate and normal subjects. METHODS: The secretor character was determined in saliva of normal subjects (n = 40), patients with bladder cancer (n = 61) and adenoma of the prostate (n = 44) by the technique of hemoagglutination inhibition. RESULTS: 80% of the normal subjects were found to be secretors, which is in agreement with the data reported in the literature. Only 23 (37.71%) of the patients with bladder cancer were secretors and 24 (54.54%) of the patients with prostate adenoma expressed the secretor gene. CONCLUSIONS: The expression of soluble antigens decreased in patients with bladder cancer or prostate adenoma in comparison to the normal subjects. Deletion of ABH antigens in the membrane of tumor cells has been reported in other studies. This lack of expression results from a genetic alteration in the clones involved in tumor pathology. The decrease in soluble antigens in the patient groups analyzed might be due to the same mechanism of genetic alteration that could involve non tumor tissues. Most of the cancers in humans originate in epithelial cells and the changes in blood group antigens constitute an important aspect in tumor immunology.

[Round cells in semen and genital infections]. / Células redondas en semen e infecciones genitales.

OBJECTIVE: The correlation between leukocytospermia and genital infections remains controversial. Similarly, it is inaccurate to consider the increase of round cells (RC) in semen as leukocytospermia. The purpose of this study was to determine the possible association between round cells, leukocystospermia and bacterial infections in infertile patients. METHODS: 410 semen samples were analyzed to determine sperm concentration, motility, morphology and round cells according to standard WHO citeria. Immature germ cells were differentiated by the Papanicolau stain, while the Nahoum-Cardozo method was used for polymorphonuclear leukocytes (PMN). Bacteriological studies in semen first urine sprout and urethral secretion were performed. Gram-Nicolle stain was utilized for the direct examination. Cultures were made in enriched blood Columbia agar and Thayer Martin agar was used for common germs. For mycoplasma identification, both A7 Sheppard solid and liquid media were used. Presence of Chlamydia trachomatis in urethral secretion was investigated by direct immunofluorescence. RESULTS: 79% (324) of the samples were dispermic, 9.02% presented more than 10(6) RC/ml. Of these, only 29.7% (11) presented leukocytospermia. Spearman's ranked correlation, used to measure association between RC/field and PMN leukocytes/ml, showed a value of 0.2705 with an associated probability of 0.1046, indicating a non-significant association between variables. Bacteriological studies performed in 32 samples showed 13 were positive, but only 4 (30.7%) presented leukocytospermia. Of the 19 samples with negative bacteriology, 15.78% were leukocytospermic. There was no statistically significant correlation between increased RC and the presence of germs (chi 2: 0.14965, p < 0.05) or between PMN and germs (chi 2: 1.01390, p < 0.05). CONCLUSIONS: These data suggest the convenience of performing bacteriological studies in semen in spite of the presence of RC in the direct examination.

[Deletion of ABH antigens in urine sediment cells from patients with prostatic adenoma]. / Deleción antigénica ABH en células de sedimento urinario de pacientes con adenoma de próstata.

OBJECTIVE: This study was conducted to analyze ABH antigenic expression in urinary sediment of patients with benign prostatic hyperplasia (BPH) before and after deobstructive surgery. METHODS/RESULTS: The agglutination inhibition technique was utilized to determine the ABH antigenic expression in urinary sediments of 30 healthy subjects and 34 patients with BPH. The presence of neoplastic cells was also determined in urinary sediments of the patients by Papanicolaou's stain. These studies were performed before and 12 months after surgery. Membrane antigen expression was found in 100% of the healthy subjects and in only 50% of the patients with BPH before surgery. Only 25 patients returned for control evaluation after surgery. Of these, 17 were positive and of the remaining 8 patients who were negative preoperatively, only one continued to be negative. Urine cytology demonstrated progression to malignancy in this patient. CONCLUSIONS: Determination of ABH antigenic expression appears to be able to identify premalignant conditions and could be a useful complementary diagnostic method to cytology.

Cuerno cutaneo peneano: presentación de un caso: revición de la literatura / Cutaneous horn of the penis: case report: review of the literature

El cuerno cutáneo del pene es una lesión rarísimo con menos de 100 casos publicados en la literatura mundial. La importancia clínica de estas lesiones radica en la patología subyacente que conduce a los cambios hiperqueratósicos de la piel. En la mayoría de los pacientes la lesión es benigna, pero en un tercio de ellos representan la rxpresión clínica de uina patología maligna. El tratamiento de elección es la escisión completa de la lesión

[Fournier's gangrene. Our experience over 10 years. A review of the literature]. / Gangrena de Fournier. Nuestra experiencia en los últimos 10 años. Revisión de la literatura.

OBJECTIVE: To report our experience over the last 10 years with Fournier's gangrene, an extensive fulminant infection of the perineoscrotal region, and to review the literature. METHODS: The medical records of 9 patients with Fournier's gangrene that had been diagnosed from January 1988 to December 1997 were reviewed. Patient age, etiology and predisposing factors, microbiological findings, duration of hospital stay, treatment and outcome were analyzed. RESULTS: The mean age of the patients was 53.8 years (range 43-71). The source of the gangrene was perirectal (22.22%), urinary (66.66%) and cutaneous (11.11%). Predisposing factors included diabetes mellitus, alcoholism, malnutrition and low socio-economic status. All patients were treated with surgical debridement and broad-spectrum antimicrobial therapy. Two patients underwent delayed reconstructive surgery. Cystostomy was performed in 100% of the cases. Two patients died from severe sepsis. CONCLUSIONS: Necrotizing fasciitis of the perineum and genitalia is a severe condition with a high morbidity and mortality. Good management is based on aggressive debridement, broad-spectrum antibiotics and intensive supportive care.

Relación entre la expresión de antigenos ABH en cancer de vejiga y caracter secretor / The relationship between the expression of ABH secretor character

Existe amplia evidencia de que el cáncer está asociado con anormalidades en la regulación génetica expresada en la superficie de la membrana celular. El 80 por ciento de los individuos son capaces de secretar los antígenos ABH en saliva y otras secreciones. La presencia de estas sustancias está controlada por un gen que puede adoptar dos formas alélicas: SE dominante y SE recesiva. El objetivo de este trabajo fue investigar la relación entre la expresión antigénica ABH en célkulas de descamación urotelial y el carácter secretor en pacientes con cáncer de vejiga. Se examinaron 33 pacientes con tumores de vejiga clasificados en superficiales y profundos y una población de 40 individuos normales. Se investigó el carácter secretor en saliva y la expresión de los antígenos ABH uroteliales en sedimentos urinario. Se empleó para estos estudios la técnica de inhibición de la aglutinación. En la población normal todos expresaron los antígenos ABH en células de sedimento urinario y sólo el 80 por ciento presentó dichos antígenos en sus secreciones. En los pacientes con cáncer de vejiga el 30,31 por ciento resultó no secretor y de ellos el 70 por ciento presentó deleción antigénica ABH en sedimento urinario con mayor incidencia de tumores profundos. Nuestros resultados indicarían que los pacientes con cáncer de vejiga no secretores desarrollarían tumores con mayor grado de infiltración respecto de los pacientes secretores