[Peripheral nerve lesions of the lower leg due to tibiofibular ganglion]. / Periphere Nervenläsion am Unterschenkel durch tibiofibulares Ganglion.

Cystic formations around the knee are a common object of orthopedic treatment. When associated with neurological or vascular deficits further diagnostic imaging is required. This case study demonstrates the appearance of an intramuscular ganglion causing drop foot, arising from the tibio-fibular joint.

[Urine cytology as a supplement to cystoscopy and biopsy in the control of bladder tumors]. / Urincytologi som supplement til cystoskopi og biopsi ved kontrol af blaeretumorer.

Throughout the years several investigations have either recommended or discredited exfoliative urine cytology because of high incidence of false negative or false positive results. Most authors agree that high grade bladder tumors are diagnosed with fairly high certainty (80-87%) by using exfoliative urine cytology whereas the value of urine cytology of low grade bladder tumors is uncertain. This investigation, including 200 patients who came for cystoscopic control of bladder tumors, revealed 87% accordance between cystoscopic biopsy and exfoliative urine cytology of high grade tumors while there were 47% false negative and no false positive of low grade tumors. On this background, it must be concluded that exfoliative urine cytology is an important investigation in diagnosing and controlling patients with bladder tumors, but the method can not always stand alone.

Renal acidification defects in patients with their first renal stone episode.

To rule out renal acidification defects, 40 consecutive patients with their first renal stone episode were evaluated by measurement of fasting morning urine pH levels followed by a short ammonium chloride loading test in cases with high levels. Two patients (5%) exhibited incomplete distal renal tubular acidosis, the rest had normal urinary acidification. In view of the short duration of stone disease in the patients studied, the acidification defects were considered to be primary, and the stone formation secondary. The results justify extension of these simple screening procedures for unmasking renal acidification defects to include all patients with renal stone disease.

Effect of orchidectomy on serum concentrations of testosterone and dihydrotestosterone in patients with prostatic cancer.

Because it is well known that prostatic cancer is dependent on testosterone, and that dihydrotestosterone is the active mediator of the androgen action in the prostatic cell, we studied serum concentrations of testosterone and dihydrotestosterone in 84 patients with prostatic cancer, 40 of whom were treated by orchidectomy, and 44 who were not treated. There was a significant correlation between testosterone and dihydrotestosterone concentrations in the untreated group, but no correlation among the patients treated by orchidectomy. The results indicate that the effectiveness of orchidectomy as androgen withdrawal treatment in prostatic cancer should be assessed by measurement of both dihydrotestosterone and testosterone concentrations.

Teflon injections in post-prostatectomy incontinence.

Twenty-five males with post-prostatectomy incontinence due to sphincter damage underwent transperineal or transurethral Teflon injections. The results were classified into three grades: good, moderate, and poor. Good or moderate results were obtained in 24%. No major immediate complications or longterm side-effects were observed. This intervention is associated with a minimum of discomfort for the patient and hospitalization can be limited to 48-72 hours. The results are not so good as those obtained in female incontinence, and the procedure cannot be recommended as first choice treatment in patients with post-prostatectomy incontinence, but because of the simplicity of the procedure, it is considered to be a valuable alternative in patients not suitable for prosthetic surgery.

Female urinary stress incontinence treated with Teflon injections.

Twenty-six women with urinary stress incontinence underwent transperineal or transurethral Teflon injections. The results were classified into three grades (good, moderate, and poor). Good or moderate results were obtained in 50%. No major immediate complications or long-term side-effects were observed. This intervention is associated with a minimum of discomfort for the patient and hospitalization can be limited to 48-72 h. The procedure can be carried out with good effect on women previously classically operated on without success and it does not prevent subsequent surgical intervention for urinary incontinence should this prove necessary.

Renal acidification defects in medullary sponge kidney.

Thirteen patients with medullary sponge kidney underwent a short ammonium chloride loading test to investigate their renal acidification capacity. All but 1 presented with a history of recurrent renal calculi and showed bilateral widespread renal medullary calcification on X-ray examination. Nine patients had some form of renal acidification defect; 8 had the distal type of renal tubular acidosis, 2 the complete and 6 the incomplete form. One patient had proximal renal tubular acidosis. These findings, which suggest that renal acidification defects play an important role in the pathogenesis of renal calculi in medullary sponge kidney, have considerable therapeutic implications.

Gonadotropin and androgen levels in patients operated upon for cryptorchidism.

53 patients previously operated upon for cryptorchidism were examined seven years (range 2-18) after the operation. We measured serum levels of sex-hormone-binding-globulin (SHBG), testosterone (T), free testosterone (free T), dihydrotestosterone (DHT), 4 androstenedione (4-AD), and dehydroepiandrosteronesulphate (DHAS), and the gonadotropin luteinizing hormone (LH) and follicular hormone stimulating (FSH). Compared to normal controls, there were decreased levels of free testosterone and DHT and increased levels of SHBG and DHAS. The FSH levels were elevated and LH values low. No relationship was found between androgen and gonadotropin levels, suggesting that the normal feed-back mechanism is malfunctioning. There were no hormonal differences between patients with previous unilateral and bilateral cryptorchidism, although SHBG levels were higher in the former. We concluded that cryptorchidism is probably due to a defect in the hypothalamic-pituitary axis and not to a primary defect in the testes.

Guanidine-dependent mutants of poliovirus: identification of three classes with different growth requirements.

Four mutants resistant to high (2.0 mM) guanidine were derived from a mutant resistant to intermediate (0.53 mM) levels of this drug. One of these mutants was found to be resistant to high guanidine and was shown to contain a mutation within 2C seen previously in this class of mutants, while lacking the mutation seen in the intermediate parent. The other three mutants were dependent on guanidine for growth and contained the mutation in 2C seen in the parental virus as well as a mutation seen previously in another dependent mutant. Comparison of the newly isolated dependent mutants to two previously described dependent mutants revealed that three classes of dependent mutants which vary in their requirements for optimal growth can be observed. We present a model for the interaction of guanidine with 2C that explains the occurrence of the three classes of dependent mutants.

Tumour of female paraurethral duct. Immunohistochemical similarity with prostatic carcinoma.

A case of adenocarcinoma derived from a female paraurethral duct is described. Morphologically the tumour looked like a prostatic adenocarcinoma. Furthermore, the tumour cells stained positively with antibodies to prostatic specific antigen and prostatic specific acid phosphatase. The karyotype of the patient was 45,x/46,xx/47,xxx/46,xt(x;13)(p11;q22) demonstrating that the patient was not a hermaphrodite. The tumour therefore represented female homology of a prostatic adenocarcinoma.