Absorbability of mucosa in total replacement of urinary bladder with jejunum. An experimental study.

The absorption of urine components in jejunum substitute for the urinary bladder was studied experimentally in dogs. For this purpose, determination of the blood urea, creatinine, and electrolyte levels as well as measurements of the radioactivity in blood samples after intravesical instillations of radioactive iodine, were done at various intervals after total replacement of the urinary bladder with jejunum. The absorption was found to decrease greatly in one month and to be negligible one year postoperatively.

Effect of growth hormone cotreatment with human chorionic gonadotropin in testicular steroidogenesis and seminal insulin-like growth factor-1 in oligozoospermia.

OBJECTIVE: To study the GH synergy with hCG in testicular steroidogenesis and seminal insulin-like growth factor-1 (IGF-1) in oligozoospermia. SETTING: University endocrine unit. PATIENTS: Eight oligospermic, non-GH-deficient men. INTERVENTIONS: Three different protocols spaced 3 months apart were applied in each man: plain hCG protocol: 1,500 IU IM three times every other day; GH + hCG protocol: with the addition of 4 IU SC GH daily 8 days before and throughout the hCG phase; placebo + hCG: substitution of GH by NaCL 0.9%. Blood sampling was performed before and on the 8th day (for 2nd- and 3rd-day protocols) and 24 hours after each hCG administration. Semen was collected three times during each protocol. MAIN OUTCOME MEASURES: Plasma for P, 17-OHP, androstenedione, DHEA, DHEAS, T, and E2 and plasma and seminal IGF-1 three times during each study. RESULTS: Serum IGF-1 levels increased more than threefold after GH administration. Seminal IGF-1 activity was unaffected by GH treatment or hCG administration, showing random fluctuations within each subject without correlation to the respective plasma levels. The incremental response of each steroid under hCG did not differ between the three protocols, apart from increased P levels under GH. CONCLUSIONS: Short-term GH cotreatment with hCG did not affect seminal IGF-1 concentration and had a weak synergist effect on steroidogenesis.

DNA flow-cytometric, histological and hormonal analysis of sertoli cell only syndrome (SECOS).

Sertoli cell only syndrome (SECOS) was identified on histology in 21 cases (16,28%) among 129 testicular biopsies performed in our department for azoospermia over the last 5 years. In these patients history, clinical features, hormonal levels, and histological findings were analyzed. In addition DNA flow-cytometric analysis was performed and showed an almost complete absence of haploid cells. All patients presented with elevated serum FSH levels suggesting a Sertoli cell damage or reduced production of inhibin due to the absence of sermatogenic cells. An good correlation was found between histological findings and DNA histograms. In conclusion SECOS is a syndrome of unknown aetiology presenting in men with azoospermia. DNA flow-cytometric analysis is a reliable, rapid and easy method in the diagnosis of SECOS, and can replace histological examination.

Multiple transrectal ultrasound guided prostatic biopsies: morbidity and tolerance.

OBJECTIVE: Early detection of prostate cancer has become a matter of vital importance in modern societies. Ultrasound guided transrectal biopsy is the current standard urological procedure to detect prostate cancer. In this study our intention was to confirm the high tolerance and low complication rate of this procedure, facts already established in urologists' minds. MATERIAL AND METHODS: In order to evaluate the morbidity as well as the acceptance of the procedure, we investigated 120 patients who underwent ultrasound guided transrectal biopsies of the prostate, in our department from September 1995 to January 1996. All patients at each biopsy underwent 6 needle passes and took periprocedural antibiotic therapy. Alongside with recording the periprocedural side effects of this method patients answered a questionnaire in order to evaluate the pain they experienced by this procedure. RESULTS: Twenty patients were found to have prostate cancer at various stages. All patients tolerated well the whole procedure. Pain was the most common complaint among patients. Several complications were recorded; the most common of all was haematuria. Only two patients required admission to hospital because they developed fever after the procedure. CONCLUSION: Ultrasound guided transrectal biopsy of the prostate is a well-tolerated and effective method for obtaining multiple biopsy specimens from the prostate with low incidence of serious complications. Its is also accurate enough, allowing its use in everyday urology, as a diagnostic procedure.

[Association of a rare form of testicular ectopia, a persistent Müllerian duct syndrome and a supernumerary ectopic epididymis]. / Association d'une forme rare d'ectopie testiculaire, d'un "syndrome de persistance du canal de Müller" et d'un épididyme ectopique surnuméraire.

We report the first case of persistence of the Müllerian duct associated with transverse testicular ectopia and a supernumerary ectopic epididymis in the same hemiscrotum. The patient is a thirty-year-old man with azoospermia. Uterine and Fallopian tube structures were clearly recognizable within the Müllerian remnants. The ectopic supernumerary epididymis was detected at the lower pole of one of the two testicles and had to be removed surgically.

Speech processing abilities in children with speech vs speech and language difficulties.

This paper reports on the speech processing skills of a group of four year old children with specific speech difficulties and examines the impact of an additional language impairment on these skills. Forty seven children with speech difficulties were tested on two speech output measures and one speech input measure to assess the accuracy of their phonological representations. Their performance was compared to a matched control group n = 47 and analysed according to the presence/absence of an additional language impairment. It was found that children with both speech and language difficulties had poorer speech processing abilities compared to both the normal controls and the children with speech-only difficulties. The clinical implications of these findings are outlined.

Word recognition in developmental dyslexia: a connectionist interpretation.

We present a study of the accuracy, consistency, and speed of word naming in a dyslexic boy, JM, who has severe impairments in the ability to use sub-lexical, phonological reading strategies. For words that he can recognise, JM's naming latencies do not differ from those of control subjects matched for reading age, and he is generally consistent from one occasion to the next. He can also match printed homophones with their definitions--a skill that requires access to well-specified orthographic representations. The data are interpreted as evidence for the creation of efficient recognition devices for words within JM's sight vocabulary. However, he shows a continuing inability to use phonological decoding strategies to deal with words that he cannot recognize by sight. Overall we argue our results pose problems for stage models of reading development, and that they may best be interpreted within a connectionist framework of the development of word recognition skills.

Seminal fibronectin-like antigen and transferrin concentrations in infertile and fertile men.

Fibronectin like antigen (Fn) and transferrin (Trs) levels were measured in the seminal plasma of 40 fertile and 102 infertile men. The concentrations of both proteins were significantly (P < 0.001) higher in the fertile controls compared to the infertile groups. The levels of Fn and Trs (mean value +/- SEM) in the fertile men were 857.9 +/- 9.8 micrograms ml-1 and 164.0 +/- 6.5 micrograms ml-1, respectively; in the azoospermic men (n = 17) 552.7 +/- 24.65 micrograms ml-1 and 20.7 +/- 2.19 micrograms ml-1, respectively; in the group of severe oligozoospermia (n = 35) 568.34 +/- 25.7 micrograms ml-1 and 31.1 +/- 4.18 micrograms ml-1, respectively; in the moderate oligozoospermic group (n = 8) 572.50 +/- 47.9 micrograms ml-1 and 43.4 +/- 15.4 micrograms ml-1 respectively, and in the asthenozoospermic group (n = 26) 512.76 +/- 40.4 micrograms ml-1 and 47.0 +/- 7.9 micrograms ml-1, respectively. Of special interest was the finding from a group of 16 normospermic men (partners of couples with unexplained infertility) who showed significantly lower levels of Fn like antigen, 632.5 +/- 26.9 micrograms ml-1 (P < 0.001) and Trs 41.8 +/- 6.94 micrograms ml-1 (P < 0.0001) compared to normals. No correlation was found between Fn levels with either Trs or FSH levels or sperm count. In conclusion, our results indicate that male infertility is associated with changes in seminal plasma Fn like antigen concentrations and that it can be possibly used as an index of sperm fertilizing capacity.

Is dyslexia a form of specific language impairment? A comparison of dyslexic and language impaired children as adolescents.

Two groups of adolescents with a childhood history of language impairment were compared with a group of developmentally dyslexic young people of the same age and nonverbal ability. The study also included two comparison groups of typically developing children, one of the same age as those in the clinical groups, and a younger comparison group of similar reading level to the dyslexic students. Tests of spoken and written language skills revealed that the adolescents with dyslexia were indistinguishable from those with resolved language impairments on spoken language tasks, and both groups performed at age-expected levels. However, both dyslexic readers and those with resolved specific language impairments showed deficits in phonological awareness. On written language tasks, a different pattern of performance was apparent. In reading and spelling, adolescents with dyslexia performed only as well as those with persistent oral language impairments and younger controls. However, their reading comprehension was better. The theoretical and educational implications of these findings are discussed.

Segmentation and speech perception in relation to reading skill: a developmental analysis.

The present paper examines the processing of speech by dyslexic readers and compares their performance with that of age-matched (CA) and reading-ability-matched (RA) controls. In Experiment 1, subjects repeated single-syllable stimuli (words and nonwords) presented either in a favorable signal-to-noise ratio or with noise masking. Noise affected all subjects to the same extent. Dyslexic children performed as well as controls when repeating high-frequency words, but they had difficulty relative to CA-controls with low-frequency words and relative to both CA- and RA-controls when repeating nonwords. In Experiments 2 and 3, subjects made auditory lexical decisions about the stimuli presented in Experiment 1. Dyslexics performed less well than CA-controls, gaining similar scores to RA-controls. Thus, their difficulty in repeating low-frequency words could be reinterpreted as a difficulty with nonword repetition. Taken together, these results suggest that dyslexics have difficulty with the nonlexical procedures (including phoneme segmentation) involved in verbal repetition. One consequence is that they take longer to consolidate "new" words; verbal memory and reading processes are also compromised.

Sensitivity of exfoliative cytology in bladder cancer using the divided one-urine specimen examination.

The urine of 104 patients with bladder cancer was examined by exfoliative cytology. Three staining methods (Giemsa, Papanicolaou and Oil Red O) were used and the results compared with the histological diagnosis. Giemsa was found to be superior to the other two methods but the highest sensitivity (which was statistically significant) was obtained by a combination of the three methods.

Measurement of the volume of residual urine using 131I-hippuran and the gamma camera.

A modification of the method of determining the volume of residual urine in the bladder using 131I-Hippuran and the gamma camera is described. The method was applied to 26 patients with either normal or impaired renal function and proved to be both reliable and accurate.

The contribution of the obturator nerve block in the transurethral resection of bladder tumors.

This study was designed to evaluate the efficacy of local block of the obturator nerve to avoid it's stimulation during transurethral resection (TUR) or tumors localised on the lateral bladder wall. Forty-five patients were studied, in whom the TUR operations were performed under spinal anaesthesia. The patients were divided into two groups: in the first group a local block of the obturator nerve was done, while the second group served as controls, and the stimulation of the nerve was avoided by reduction of the electrocoagulation voltage, incomplete bladder filling and resections of smaller ships. In the first group no stimulation was observed while in 5 patients of the second group was not possible to totally resect the tumor due to the persistent stimulation of the obturator nerve. In conclusion the local block of the obturator nerve is an effective method to avoid it's stimulation, easily performed and without complications.

Increased 17-OH-progesterone levels following hCG stimulation in men with idiopathic oligozoospermia and raised FSH levels.

Leydig cell function was investigated in 71 men with idiopathic oligospermia and compared to 14 fertile controls by assessing the steroidogenic response to GnRH and the repetitive administration of hCG (1500 IU x3). The oligospermic men were divided into two groups according to their basal serum FSH values (FSH < 8, n = 35; FSH > 8, n = 36), this level being defined by the mean + 3 SD of the levels in normal men (3.71 + 4.08 mIU/ml). Oversecretion of LH was supported by the findings of: (a) higher basal LH levels (p < 0.0001) in both oligospermic groups, although still within the normal range; (b) higher Dmax LH and area LH (p < 0.0001) levels in the FSH > 8 group; (c) a strong position correlation (p < 0.001) of the above parameters with the respective levels of FSH. No difference in basal testosterone levels was observed between the three groups, whereas basal levels of 17-OHP were significantly higher (p < 0.05) in the group with FSH > 8. The testosterone/LH ratio was significantly (p < 0.0001) lower in the FSH > 8 group, and was correlated inversely to the basal blood levels of FSH (p < 0.0001) and to the area LH (p < 0.04). After the hCG test, there was no difference in the testosterone and oestradiol response between the groups, whereas the secretion of 17-OHP and the ratio of 17-OHP/testosterone was significantly higher (p < 0.0001) in the group with FSH > 8 compared with the other two groups.(ABSTRACT TRUNCATED AT 250 WORDS)

[Extracorporeal shockwave lithotripsy: our experience in 5,000 cases]. / Litotricia extracorpórea por ondas de choque: nuestra experiencia en 5,000 casos.

The authors report their experience on 7,500 patients who underwent extracorporeal shock wave lithotripsy (ESWL1). The first 6,800 were treated with the standard Dornier HM-3 lithotripter, while the remaining 700 were treated with the modified HM-3 machine equipped with the new ellipsoid (and the double-shot generator). The authors present the results and conclusions from their experience with 5,000 ESWL treatments which were performed at their Urology Department. An analysis is made on patient age, sex, stone site, duration of sessions, average number of shock waves used, exposure time, number of electrodes per session, retreatments, and results achieved relative to stone size. Furthermore, the authors report on the complications and treatment in special cases; i. e., patients with horseshoe kidneys, solitary kidneys, spinal cord lesions, radiolucent calculi, hemophilia, and staghorn stones. The mean duration of treatment was 37 minutes. The average number of shock waves used was 1,703. The mean radiation exposure time was 1.9 minutes. Two electrodes per session were required in 48% of the patients. Three months following lithotripsy, 72% of the patients were stone-free, 19% had small remaining stone fragments, and 9% had unimportant stone particles.

Deoxyribonucleic acid measurements in transitional cell carcinomas: comparison of flow and image cytometry techniques.

PURPOSE: We compared the results of deoxyribonucleic acid (DNA) ploidy determinations performed by flow cytometry and image cytometry in transitional cell carcinomas of the bladder. MATERIALS AND METHODS: In 81 cases of transitional cell carcinoma of the bladder DNA indexes were measured by flow cytometry of bladder washings and tumor tissue samples, and by image cytometry of imprints from tumor tissue samples. RESULTS: There was good correlation between bladder washings and tissue samples analyzed by flow cytometry in 68 cases but aneuploidy was missed with bladder washings in 13 (16%). There was also good correlation between flow and image cytometry in 75 cases (92.59%) regarding the detection of aneuploidy. There was agreement between detection of aneuploidy and DNA index in 45 cases (55.5%), while both methods detected an aneuploid population in 30 (37%) but there was disagreement regarding DNA index. Aneuploid populations were missed by flow cytometry in 6 cases (7.4%). Furthermore, in 10 cases peridiploid peaks were found on the image cytometry histograms, which were not visible on flow cytometry. However, it was not possible to assess accurately if these were true peridiploid populations. CONCLUSIONS: There is good overall correlation between DNA content measured by flow and image cytometry but image cytometry has the advantage of visual discrimination, permitting preferential selection and analysis of tumor cells. However, certain problems remain with image cytometry, particularly in the case of peridiploid peaks, which cannot be classified accurately as showing true peridiploid or right shifted diploid populations.

[Estimation of serum beta 2 microglobulin in carcinoma of the bladder (author's transl)]. / Dosage de la bêta 2-microglobuline sérique dans le cancer de la vessie.

beta 2 Microglobulin is a low molecular weight protein synthesised by lymphocytes and neoplastic cells. The authors measured levels of this substance in the plasma of 40 patients with carcinoma of the bladder and normal renal function. 26 subjects were used as controls. Plasma levels were markedly higher in the bladder carcinoma sufferers than in the normal controls. Levels were also higher in invasive carcinomas than in superficial lesions. beta 2 microglobulin may therefore not be considered to be a specific indicator of carcinoma of the bladder but rather as a factor offering the possibility of measurement of the secretory activity of tumour cells.