Endovascular treatment of massive retroperitoneal haemorrhage due to inferior adrenal artery injury. A case report.

Massive retroperitoneal haemorrhage because of adrenal bleeding following blunt trauma is a rare entity. We describe a 23-year-old woman with massive retroperitoneal haemorrhage as a result of inferior adrenal artery (IAA) disruption following a car accident. Superselective transcatheter embolization of the IAA using polyvinyl alcohol particles was performed successfully to control haemorrhage. To our knowledge, this is the second report of massive retroperitoneal haemorrhage caused by IAA disruption successfully treated by transcatheter embolization.

Subureteric polydimethylsiloxane injection in the treatment of vesico-ureteric reflux.

Endoscopic treatment of vesico-ureteric reflux is a viable alternative to open surgery. We evaluated the effectiveness of polydimethylsiloxane in the endoscopic treatment of vesico-ureteric reflux. In the period between September 1994 and March 1996, 30 ureteral units of 20 children with vesico-ureteric reflux were treated by means of subureteric polydimethylsiloxane injection. Median age was 8 years in the group including 8 female and 12 male patients. Of the 30 ureteral units, 26 had no reflux at the end of the first injection. Two of the remaining four units were not refluxing after the second injection procedure. Contralateral reflux was observed postoperatively in two of the eleven patients who were treated for unilateral disease. It seems that endoscopic polydimethylsiloxane injection is an effective procedure in the treatment of vesico-ureteric reflux.

Inhibition of penile erection in rats by a long-acting somatostatin analogue, octreotide (SMS 201-995).

OBJECTIVE: To assess the effect of a new somatostatin analogue (SMS 201-995, octreotide) on erectile function in rats. MATERIALS AND METHODS: Animals were fasted and anaesthetized intraperitoneally with pentobarbital. A cannula was placed in the trachea and the femoral vein cannulated for intravenous infusion. The hypogastric and pelvic nerve, major pelvic ganglion, and the nerve fibres to the lower genitourinary tract were identified. In 20 animals, these nerves were stimulated unilaterally using bipolar silver-wire electrodes; the stimulation was repeated every 15 min for 1 h. Twenty animals were divided into two equal groups; after measuring penile erection to obtain basal values, the animals received either saline or 50 micrograms SMS 201-995 over 1 h and 30 min later, the stimulation was repeated. RESULTS: After administering SMS 201-995 or saline, the levels of penile erection reduced linearly in both groups, but SMS 201-995 caused a greater decrease than in the control group (P < 0.05) and from baseline (P < 0.01) at all times. CONCLUSION: SMS 201-995 inhibits penile erection in rats and the systems may serve as an in vivo animal model for further investigation.

Effect of essential amino acid supplementation in acute renal failure.

The effect of intravenous (i.v.) essential amino acids (EAA) in the treatment of acute renal failure was evaluated in 50 patients. Thirty patients (Group A) received daily 13.4 g of i.v. EAA solution [Nephramine (Don Baxter, McGraw) 250 ml/d]+dopamine i.v. 2 micrograms/kg/min + 20% hypertonic glucose solution 500 ml/d as compared with twenty patients (Group B) who received dopamine i.v. 2 micrograms/kg/min + 20% hypertonic glucose solution 500 ml/d. In Group A patients showed lower daily increase in blood urea nitrogen (BUN) (p < 0.05), higher serum total protein and albumin levels on the 15th day of the posttherapy period (p < 0.001), lower complication rate (p < 0.005), lower mortality rate (p < 0.005) and a reverse relation between serum total protein concentration, duration of oliguria and age (p < 0.01, r2 = 0.26; p < 0.001, r2 = 0.32). These data suggest that treatment of such patients with i.v. EAA solutions significantly improves survival.

The use of intraurethral prostatic spiral in high risk patients for surgery with benign prostatic hyperplasia.

Under local anaesthesia, 31 patients underwent insertion of an expandable stainless steel tubular spiral into the prostatic urethra under fluoroscopic control. All were considered to be at major risk from prostatic surgery. Most of them had long-term indwelling urethral catheters (14 patients). The spiral allowed unobstructed voiding and is a good alternative to an indwelling urethral catheter. We recommend insertion of a spiral in patients with urinary obstruction if they are unfit for surgery.

[Effect of antisperm antibodies in male infertility]. / Antisperm antikorlarinin erkek infertilitesine etkisi.

Antisperm antibodies and their relationship with infertility has been investigated in semen and serum samples of 100 infertile and 25 fertile males. The investigation of antisperm antibodies has been done by latex agglutination test in semen samples and by ELISA procedure in serum samples. In addition, the semen samples have been investigation for several characteristics. Antisperm antibodies have been found 7% positive in blood and 30% positive in semen. In 28.5% of the patients with positive antisperm antibodies in blood, antisperm antibodies in semen have also been found to be positive. For cases with infertility of unknown cause the antisperm antibodies ratio has been found to be significantly high (p less than 0.002). These results have shown the importance of further investigation of antisperm antibodies in cases with infertility of unknown reasons.

Comparison of the effects of surgical and autologous fascial suture materials on testicular histology in rats subjected to orchiopexy.

In this study orchiopexy was performed in 30 Sprague-Dawley rats in order to compare traumatic effects of surgical and autologous fascial suture materials on testicular histology. Abscess formation was observed in 72.7% of the chromic, in 36.3% of the nylon, and in 18.1% of the vicryl fixed groups. There were no abscess formations in the dartos and autologous fascial fixed group. Examination of the testes revealed complete absence of spermatogenesis in the chromic fixed group. Spermatogenesis was normal, 72% in the vicryl, 18.1% in the nylon, 90.9% in the dartos and autologous fascial suture fixed groups. Antisperm antibody was not observed in any rat sera. We consider that it is preferred to use dartos pouch fixation. If necessary, it is advisable to use autologous fascial suture materials.

Effect of testicular torsion on the contralateral testis.

It has been previously shown that unilateral testicular torsion can cause disruptive anatomic changes in the contralateral testis in rats. In this experimental study plasma and urine prostaglandin E2 levels were studied correlatively with testicular histopathology in acute testicular torsion cases. As a result of this study, necrobiotic morphologic alterations causing testis necrosis and significant increase in plasma prostaglandin E2 levels were observed. Contralateral testicular histology was analyzed in all dogs. None of them showed abnormal tubular architecture.

Clinical, endocrinological and histopathological evaluation of male infertility.

In the years 1980-1988, 135 infertile males, 38 azoospermic and 98 oligozoospermic patients were studied. Physical findings, hormonal (FSH, LH, testosterone and prolactin) estimations were carried out. After doing testicular biopsies, all findings were evaluated.