An Unusual Cause of Vaginal Bleeding and Abdominal Pain -Prolapsed Ureterocele

EDITORIAL COMMENT: The editor has never seen a urinary tract vulval mass like this. However, in 1963 at the Austin Hospital, Melbourne, he saw and unfortunately failed to photograph, a pink vulval mass in a woman with paraplegia who had turned her bladder inside out and passed it per urethra like an intussusception. The nature of the mass became apparent when urine spurted from the ureteric orifices. This woman was managed by a urologist by ureteric transplantation into an ileal loop.     

First Antenatal Visit Haematocrit and Pregnancy Induced Hypertension

First antenatal visit haematocrit values during the first and second trimesters were retrospectively collected from 546 nulliparas with singleton pregnancies. The results were analysed for correlation with development of pregnancy induced hypertension (PIH) later in pregnancy. It was found that women with higher haematocrit values, especially over 0.40, had an increased risk of developing PIH. However, there appeared to be no absolute level of haematocrit which had sufficient discriminative value to be useful in clinical practice.     

腹腔镜腹膜后淋巴结切除术：附13例报告

从１９９３年１２月～１９９６年１月，应用腹腔镜腹膜后淋巴结切除诊治临床Ⅰ期非精原性生殖细胞睾丸肿瘤１３例。右侧８例，左侧５例。全部采用改良腹膜后清扫范围和改良技术。１２例完成手术，手术时间２１０～４００分钟，１例因出血改为开放性手术，所有病人均不需输血，无其他并发症。１０例恢复顺行射精，３例未报告。本法是创伤小，恢复快，住院时间短，准确可靠的诊疗方法。     

Effect of human recombinant cytokines on the induction of macrophage procoagulant activity

A panel of human recombinant cytokines was tested for induction of procoagulant activity (PCA) in human monocyte-derived macrophages. Nonadherent culture conditions were used, and PCA was determined with whole cells rather than cell lysates. It was assured by Limulus amebocyte lysate assay that tested cytokines displayed low levels of endotoxin activity within the range of biologic activity. Additional evidence to rule out an endotoxin effect was provided by heat- inactivation experiments. Interferon-gamma (IFN-gamma), interleukin-1 beta (IL-1 beta), and tumor necrosis factor-alpha (TNF-alpha) were strong macrophage PCA inducers. The low level of PCA induced by IL-2, granulocyte-macrophage colony-stimulating factor (GM-CSF), M-CSF, IL-4, IL-6, IL-10, and IFN-alpha could not be distinguished from that induced by traces of endotoxin contaminating the preparations. Transforming growth factor-beta decreased constitutively expressed PCA within 24 hours of exposure. PCA induced by IFN-gamma, IL-1 beta, and TNF-alpha depended largely on tissue factor expression, as evidenced by experiments with factor X-deficient plasma and antitissue factor antibodies. In macrophages subcultured in adherence, IL-1 beta was a strong PCA inducer, whereas IFN-gamma and TNF-alpha promoted little PCA increase. This observation and different kinetics of PCA induction suggested that mechanisms of PCA induction are distinct for the three cytokines. Thus, we showed that well-characterized cytokines critically involved in the promotion of cell-mediated antimicrobial defense/delayed-type hypersensitivity and considered for clinical application promote local fibrin deposition by a direct effect on macrophages.