Allopurinol provides long-term protection for experimentally induced testicular torsion in a rabbit model

OBJECTIVE: To assess the effect of five antioxidants on exocrine function of rabbit testes retained in situ for 24 h and 3 months after experimental torsion. MATERIALS AND METHODS: The left testes of peripubertal rabbits were clamped for 60 min, after which the clamps were removed and the testes allowed to reperfuse. The right testes served as internal controls. There were eight rabbits in each of the following experimental groups: (a) sham; (b) 60-min ischaemia followed by reperfusion; (c) 60-min ischaemia followed by left orchidectomy. In five further groups, rabbits were exposed to 60-min ischaemia followed by reperfusion, but received one of the following antioxidants before reperfusion: acetyl salicylic acid, ascorbic acid, allopurinol, quercetin or superoxide dismutase. Both testes were excised at 24 h or 3 months. The degree of lipid peroxidation, a measure of free radical damage, was assessed in testicular tissue homogenates by measuring the tissue levels of malondialdehyde (MDA). The Johnsen score was used to assess the morphological damage at 24 h and 3 months for each group. RESULTS: At 3 months twisted viable testes allowed to reperfuse had higher MDA levels than controls; the left testes of rabbits treated with allopurinol had significantly lower MDA levels than untreated rabbits and rabbits given other antioxidants. Rabbits given quercetin, ascorbic acid or superoxide dismutase had lower (but not significantly) left testicular MDA levels than untreated rabbits, while rabbits given acetyl salicylic acid had even higher levels. Allopurinol-treated rabbits had a Johnsen score of > 7.6 and those given other antioxidants had scores of < 7.6 at 3 months. CONCLUSION: The twisted viable testis treated by orchidopexy contains high free radical levels at 3 months. Of the antioxidants studied, only allopurinol had a beneficial long-term effect, by significantly reducing testicular MDA levels at 3 months.     

Prevalence and predictors of research participant eligibility criteria in alcohol treatment outcome studies, 1970-98

AIMS: To describe the eligibility criteria (i.e. study participant inclusion and exclusion rules) employed in alcohol treatment outcome research and to identify predictors of their use. DESIGN: The eligibility criteria of 683 alcohol treatment outcome studies conducted between 1970 and 1998 were coded reliably into 14 general categories. Predictors of the use of eligibility criteria were then examined. FINDINGS: Patients were most often ruled ineligible for research studies because of their level of alcohol problems (39.1% of studies), comorbid psychiatric problems (37.8%), past or concurrent utilization of alcohol treatment (31.8%), co-occurring medical conditions (31.6%), and because they were deemed non-compliant and unmotivated (31.5%). The number of eligibility criteria employed in studies increased from the 1970s through the 1990s, and was positively associated with funding from the US National Institute of Alcohol Abuse and Alcoholism (NIAAA) and from the private sector, lack of an inpatient/residential treatment condition, presence of a pharmacotherapy, and use of a randomized, multiple-condition design. Principal investigators with doctoral degrees used more eligibility criteria than those with lower degrees. CONCLUSION: Participant eligibility criteria are extensively employed in alcohol treatment outcome research, and vary significantly across historical periods, funders and research designs. Researchers should report the details of subject eligibility criteria and excluded patients more fully, and, evaluate how eligibility criteria affect the cost, feasibility, and generalizability of treatment outcome research.     

Facial sinus of dental origin simulating osteomyelitis of the mandible

Summary Dento-alveolar abscesses which track through the cervical fascial plane producting swellings over the face and neck are frequently misdiagnosed. These lesions are often incised leading to the formation of a chronic facial simus with ultimate scarcling. This paper reports four children with facial sinus of dental origin and reviews the diagnostic and therapeutic problems of these lesions asscen in paediatric patients. In two of the four cases, the diagnosis was missed initially and the lesions were treated as chronic osteomyelitis of the mandible. The importance of an early diagnosis of the lesion and of recognising the ‘tilent cases’ in order to avoid repeated and unwanted surgery is highlighted. From the Department of Dental Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh.     

Well-circumscribed, minimally enhancing glioblastoma multiforme of the trigone: a case report and review of the literature

Glioblastoma multiforme (GBM) is known to present within the lateral ventricle but is relatively infrequent and predominantly found in the frontal horn or body of the ventricle. A GBM located within the trigone is rare, and one that appears well-circumscribed, homogeneous, and minimally contrast enhancing, as demonstrated in this patient, is highly unusual.