Laparoscopic management of a cornual ectopic pregnancy associated with persistant gestational throphoblastic disease: a case report

A 30-year-old woman underwent laparoscopy for diagnosis and treatment of ectopic pregnancy. A dark-red bulging mass was observed in the right uterine horn. Laparoscopic hysterotomy was performed. The histological examination revealed a hydatidiform mole, which was confirmed by DNA ploidy analysis showing triploidy (69 XXY) as apartial hydatidiform mole after the cytogenetic examination. On the third postoperative day, the thoracic computed tomography scan revealed punctuate lesions. These lesions disappeared after single-agent chemotherapy with methothrexate. To the best of our knowledge, this is the first case of cornual persistent gestational trophoblastic neoplasia managed by laparoscopic surgery.     

Echinococcal cyst of the kidney: A review of the management of 11 cases

Echinococcal cyst of the kidney is uncommon, accounting for only 2 to 3% of all hydatid diseases. This study is a review of 11 cases of echinococcal cysts all of which were located in the kidney. All patients presented non-specific clinical symptoms. Serologic tests were carried out and excretory urography and sonography were taken. Computed tomography was performed in five patients. Out of 11 cases, four underwent total nephrectomy, and seven enucleation. Albeit rare, hydatid disease should be considered in the differential diagnosis of space-occupying lesions of the urinary tract.     

Erectile dysfunction in hypertensive men: sleep-related erections, penile blood flow and musculovascular events

To explore how hypertension affects penile erection, we studied erectile hemodynamics during nocturnal penile tumescence in 3 groups of middle-aged men: hypertensive patients with and without erectile dysfunction, and normotensive controls without erectile problems. The hypertensive patients were not taking antihypertensive medication. Evaluations included standard monitoring of penile circumference change as well as noninvasive monitoring of penile segmental pulsatile blood flow and activity in the bulbocavernosus-ischiocavernosus muscles. Variables differed in how they discriminated among groups. Median amplitude of penile blood flow during rapid eye movement sleep differed significantly among all 3 study groups: controls had the highest amplitudes, patients without erectile problems had lower values and patients with erectile complaints had the lowest values. By contrast, standard measures of nocturnal penile tumescence (that is based on penile circumference change during sleep) only distinguished the patients with erectile problems from the 2 other groups. Density of musculovascular event clusters during rapid eye movement sleep (nearly simultaneous muscle activity burst, blood flow burst and circumference pulsation) distinguished the 2 groups of hypertensive men from controls. The sensitivity of the blood flow measure to changes in the hypertensive men without erectile complaints may indicate that the measure can reveal subclinical signs of developing vasculogenic erectile dysfunction.     

Penile blood flow and musculovascular events during sleep-related erections of middle-aged men

The relationships among penile segmental pulsatile blood flow, pelvic musculovascular events, phases of nocturnal penile tumescence, and sleep stages were studied by all-night polysomnography in 23 healthy middle-aged men. Penile blood flow peaked during maximal tumescence. Bursts of phasic musculovascular activity were more frequent during ascending and maximal tumescence than during detumescence and baseline. Both penile blood flow and the number of musculovascular events increased during REM sleep. These data describe important local aspects of penile erectile mechanisms in normal men. The findings on musculovascular events support the notion that the bulbocavernosus-ischiocavernosus muscles have a role in human penile erection.     

Effects of the MTHFR C677T polymorphism on prostate specific antigen and prostate cancer

Prostate cancer is the most common malignancy and the second leading cause of cancer related deaths among men in many countries. Serum levels of prostate-spesific antigen (PSA) have attracted attention for prediction purposes. The methylenetetrahydrofolate reductase (MTHFR) gene play a critical role in cancer development, but its potential impact on prostate cancer has not been well studied. The C677T variant lies in exon 4 at the folate binding site of the MTHFR gene and results in substitution of an alanine by a valine residue. The present study was carried out 55 cases with prostate cancer and 50 healthy men. Polymerase chain reaction (PCR), restriction fragment length polymorphism (RFLP), and agarose gel electrophoresis techniques were employed to determine MTHFR C677T mutation. The frequencies of the CT genotype (p= 0.025) and T allele (p= 0.023) was found to be higher in control subjects when compared with patients group. No statistical difference was found between the alleles of MTHFR and PSA levels after (PSA-BT)/ before (PSA-AT) antiandrogen treatment or tumor stages. We suggest that the heterozygote CT genotype and the 677T allele of the MTHFR polymorphism might be associated with an decreased prostate cancer risk.     

A case report of prenatally diagnosed ophthalmo-acromelic syndrome type Waardenburg

Ophthalmo-acromelic syndrome type Waardenburg is an extremely rare autosomal recessive syndrome comprising eye malformations ranging from true anophthalmia to mild microphthalmia with acromelic malformations. We report a case of ophthalmo-acromelic syndrome type Waardenburg diagnosed prenatally.     

The addition of O2 to the CO2 does not prevent the systemic effects of the CO2 pneumoperitoneum in a rabbit model

CO2 pneumoperitoneum used in endoscopic surgery induces systemic effects by CO2 absorption. It was claimed that a reduction in CO2 pneumoperitoneum-induced metabolic hypoxemia was achieved by the addition of small amounts of O2 to the CO2 in a rabbit ventilated model. We reevaluated the effects of the addition of O2 to the CO2 pneumoperitoneum upon CO2 absorption in a rabbit model. The effects of a pneumoperitoneum using 100% CO2, 90% CO2 + 10% O2, 95% CO2 + 5% O2, or 100% O2 on arterial blood gases, acid base and O2 homeostasis were evaluated in nonintubated rabbits. A pneumoperitoneum pressure of 10 cm H2O (approximately 7.35 mm Hg) was used. CO2 pneumoperitoneum of 120 minutes affected blood gases and acid base homeostasis. Whereas partial pressure of CO2 and HCO3 increased (P < 0.001) during pneumoperitoneum, pH and partial pressure of O2 decreased (P < 0.001). Similar results were obtained in O2-CO2 pneumoperitoneum (P > 0.05). CO2 pneumoperitoneum profoundly affected blood gases and acid base homeostasis, resulting in metabolic hypoxemia. The addition of O2 to the CO2 did not prevent the systemic effects of CO2 pneumoperitoneum in nonintubated animals.