Tuberculous orchiepididymitis diagnosed by nucleic acid amplification test: A case report

Symptoms of tuberculous orchiepididymitis in a 39-year-old male started with swelling of left scrotum, followed by fistula formation with suppurative discharge. There was no any improvement produced by antibiotics. Surgical extirpation of inflammatory destroyed testicle and epidydimis was performed. Presence of tubercle bacilli was not shown by bacteriological analysis of testicle tissue. Tuberculous etiology was suggested after histopathological examination of testis and epididymis. Exudate from surgical wound was examined on presence of Mycobacterium tuberculosis DNA. Etiology of orchiepididymitis was proved by positive assay and inflammatory process was completely cured by antituberculotics therapy. By this report it was clearly shown that sometimes only molecular methods could confirm etiology of inflammatory process.     

Menetrier's disease associated with ulcerative colitis

In this paper a 21 year old patient was presented with Ménétrier's disease, associated with ulcerative colitis. The first symptoms of ulcerative colitis occurred at the age of eleven, since when the patient has been conservatively treated several times because of the exacerbations of the disease. During control examinations presence of polyploid changes in stomach was discovered by upper endoscopy. Gastrectomy was suggested because the patient had excessive anemic syndrome which required weekly substitutional therapy with deplasmatic eritrocytes, as well as hypoproteinemia, while multiple polyploid changes suspect for malignancy were gastroscopically identified. Patient accepted surgical treatment, and was transferred to the Clinic of Surgery. Total gastrectomy was performed, and patohistological finding confirmed Ménétrier's disease. After two weeks, the patient was released from the hospital in good general condition, with regular clinical and laboratory findings.     

Cisplatin may be a valid alternative approach in ovarian carcinoma with carboplatin hypersensitivity. Report of three cases

Platinum-based therapy is considered the standard treatment for patients with advanced ovarian cancer. Carboplatin has a more favorable toxicity profile than cisplatin; however, hypersensitivity reactions to carboplatin have been reported occasionally. We reviewed 112 cases of ovarian cancer treated with carboplatin at our institute to identify the hypersensitivity reactions to this chemotherapeutic agent. Hypersensitivity reactions were documented in nine cases (8%). No deaths occurred, but the reactions were judged severe in three of the 112 patients (2.6%). In our own experience with patients showing idiosyncrasy to carboplatin we observed successful resolution after retreatment with cisplatin. Since patients who relapse after initial treatment with carboplatin often respond to it a second time, it is important to continue this treatment.     

Analysis of 585 burn patients hospitalized over a 6-year period. Part III: Psychosocial data

We have examined the physical and psychosocial aberrations found in a series of 585 hospitalized burn patients. The implications of this data have been discussed as they apply to identifying persons at high risk for burn injury, and as they apply to estimation of the prognosis in severe burn injury. This is a step towards identifying a psychosocial profile for the evaluation of burned patients.     

Discovery and verification of amyotrophic lateral sclerosis biomarkers by proteomics

Recent studies using mass spectrometry have discovered candidate biomarkers for amyotrophic lateral sclerosis (ALS). However, those studies utilized small numbers of ALS and control subjects. Additional studies using larger subject cohorts are required to verify these candidate biomarkers. Cerebrospinal fluid (CSF) samples from 100 patients with ALS, 100 disease control, and 41 healthy control subjects were examined by mass spectrometry. Sixty‐one mass spectral peaks exhibited altered levels between ALS and controls. Mass peaks for cystatin C and transthyretin were reduced in ALS, whereas mass peaks for posttranslational modified transthyretin and C‐reactive protein (CRP) were increased. CRP levels were 5.84 ± 1.01 ng/ml for controls and 11.24 ± 1.52 ng/ml for ALS subjects, as determined by enzyme‐linked immunoassay. This study verified prior mass spectrometry results for cystatin C and transthyretin in ALS. CRP levels were increased in the CSF of ALS patients, and cystatin C level correlated with survival in patients with limb‐onset disease. Our biomarker panel predicted ALS with an overall accuracy of 82%. Muscle Nerve 42: 104–111, 2010     

Mitogen-stimulated lymphocyte proliferation and pituitary hormones in major depression

To assess cellular immune status and the hypothalamic-pituitary (HP) axis in patients with major depression, we examined peripheral blood mononuclear cells (PBMC) and measured the plasma levels of cortisol, adrenocorticotropin hormone (ACTH), growth hormone (GH), and prolactin (PRL). Twenty patients with major depression were compared with 20 control subjects matched for age, sex, and race. The dose-response curves for concanavalin-A (Con-A) and phytohemagglutinin (PHA) stimulation were not significantly different between the two groups. The patients had decreased Con-A-stimulated T-lymphocyte proliferation when compared to the control subjects, but only at the lowest suboptimal concentration of Con-A. None of the four concentrations of PHA-stimulated proliferation were different between the two groups, neither was PHA-induced interleukin-2 production. Within the patient group only, plasma prolactin (PRL) correlated significantly with stimulated lymphocyte proliferation using two optimal concentrations of PHA and one optimal concentration of Con-A, when the proliferation was expressed using the stimulation index.     

Identifying steep psychometric function slope quickly in clinical applications

Knowledge of an observer’s psychometric function slope is potentially useful in clinical visual psychophysics (for example, perimetry), however, the short test times necessary in a clinical setting typically prevent slope estimation. We explore, using computer simulation, the performance of several possible procedures for estimating psychometric function slope within limited presentations (aiming for approximately 30 or 140 trials). Procedures were based on either adaptive staircase or Bayesian techniques, and performance was compared to a Method of Constant Stimuli. An adaptation of the Ψ algorithm was best performing, being able to reliably identify steep from flat psychometric functions in less than 30 presentations, however reliable quantification of shallow psychometric functions was not possible.     

Robot-assisted laparoscopic Y-V plasty in 12 patients with refractory bladder neck contracture

We present preliminary results of a case series on refractory bladder neck contracture (BNC) treated with robot-assisted laparoscopic Y-V plasty (RAYV). Between 01/2013 and 02/2016, 12 consecutive adult male patients underwent RAYV in our hospital. BNC developed after transurethral procedures (n = 9), simple prostatectomy (n = 2) and HIFU therapy of the prostate (n = 1). Each patient had had multiple unsuccessful previous endoscopic treatments. All RAYV procedures were performed using a transperitoneal six-port approach (four-arm robotic setting). There were no intraoperative or major postoperative complications. During a median follow-up of 23.2 months two cases of refractory BNC were observed. In both cases a postoperative International Prostate Symptom Score (IPSS) of 20 and 25 was reported, respectively. In contrast, amongst the patients without evidence of refractory BNC the median IPSS was 6.5 reflecting an only mildly impaired voiding function in most cases, thus, suggesting a treatment success in 83.3% of patients. To the best of our knowledge, this is the first report on RAYV for refractory BNC. In our series RAYV was feasible in all patients, and only two cases of refractory BNC were reported during a median follow-up of almost 2 years. At the same time, no intraoperative or major postoperative complications were observed. More clinical data with a longer follow-up are needed in this promising field to reveal the actual efficacy and relevance of RAYV.     

Monitoring of lymphocyte micronuclei among newborns from Kragujevac in Central Serbia before and after environmental contamination

The air strikes on "Zastava" complex in Kragujevac, in the spring of 1999, caused extensive environmental pollution with damage to soil, water and air. Since the main problem was the leakage of several tones of polychlorinated biphenyls (PCBs) as well as heavy metals Cr and Ni into the environment and groundwater, we decided to evaluate influence of the environmental contamination on eventual changes of genetic constitution of human body cells. The subjects analyzed were 36 phenotypically healthy newborn babies, who were born 12 months (n=22) and 18 months (n=14) after environmental contamination, and 25 newborns in 1998 as a control group. For the assessment of mutagenic effects of environmental pollutants in vivo, the cytokinesis-block micronucleus test was employed. The results show significant increase of micronuclei (MN) in lymphocytes from newborns born 12 months after contamination (9.36 +/- 5.60), in comparison to controls (5.53 +/- 3.02) and newborns born 18 months after contamination (6.14 +/- 3.57). Only 3 newborns (12%) out of 25 controls showed more than 1 MN/1000 binucleated cells in respect to 8/22 after 12 months (36%) and 2/14 after 18 months from contamination (14%). The mean number of binucleated cells with MN significantly varied in function of sex and environmental changes in newborns born 12 months after contamination (as demonstrated by the analysis of covariance F=9.61, p <0.003). After 18 months of contamination, environmental components had no noticeable effects on MN frequency (F=0.5, p >0.48). These results suggest that the exposure to environmental pollutants in utero affects genetic constitution of fetus and increases MN values in their body cells, which is detectable right after birth in peripheral blood lymphocytes.