Ethanolamine oleate sclerotherapy for hydroceles and spermatoceles: a survey of 158 patients with ultrasound followup.

Sclerotherapy with 5% ethanolamine oleate was used to treat 102 hydroceles in 100 patients and 63 spermatoceles in 58 patients. Scrotal ultrasound examination was performed before the sclerotherapy and at each followup visit. Of the hydroceles 98% were cured completely and 68% were cured after only 1 sclerosant instillation, while 60% of the spermatoceles resolved completely and 33% partially, with 7% failures. No hydroceles recurred during an average followup of 43 months, whereas spermatocele recurred in 4 patients more than 1 year after successful treatment, with a mean followup of 46 months. Approximately half of the patients experienced pain after treatment, 3 had infection and 2 had hematoma. No changes in the structure or size of the testicles were found by ultrasound during followup. Ethanolamine oleate sclerotherapy is a safe, effective and economical form of outpatient therapy that can be recommended as primary treatment for hydroceles in adults and as an alternative to surgery for spermatoceles with 1 to 3 cysts in elderly men in whom fertility is not important.     

Acanthoma supratrochantericum.

We report the cases of five patients with lesions of benign reactive hyperplasia of the skin in the hip joint region. In view of the distinct clinical features, and in analogy with previously reported cases of acanthoma fissuratum, we termed this condition acanthoma supratrochantericum.     

Re-fixation in a lymph node revealing solution is a powerful method for identifying lymph nodes in colorectal resection specimens.

AIM: To verify an impact of a lymph node revealing solution (LRS) on the number of lymph nodes (LN) revealed in colorectal resection specimens. MATERIAL AND METHOD: Fifty-nine cases of rectosigmoid carcinomas divided into two subgroups-stage pT2&3 (20 cases) and ypT2&3 (with pre-operative radiotherapy-39 cases)-were formalin fixed for 42-72 h, serially sectioned and re-fixed in LRS containing ethanol, diethyl ether, glacial acetic acid, and formalin for 24 h. The number of LNs was matched to a control group consisting of 34 cases of colorectal carcinoma, 14 pT2&3 and 20 ypT2&3 rectosigmoid carcinomas examined routinely. Results were statistically tested by Student's t-test. RESULTS: In the study group the total number of revealed LNs was 869, range 1-48, average 14.7 per specimen, median 15. In the control group the number of LNs was 200, range 0-13, average 5.9 per specimen, median 6. The difference between the study and the control group was statistically significant (P = 0.05). CONCLUSION: Using LRS leads to a significant increase in the number of revealed LNs in colorectal resection specimens and makes it possible to find more than 12 LNs in a majority of stage pT2 and pT3 adenocarcinomas.     

Change in the amount of epsilon-hexosyllysine, UV absorbance, and fluorescence of collagen with age in different animal species

Skin and aorta collagen specimens of Wistar rats, white mice, beagle dogs, cats, horses, and human necropsies of different ages were examined with respect to the content of glycated products. The data presented show that (a) glycation and accumulation of the chromophore(s) are comparable in collagen samples from different species of comparable age; (b) glycation and pigmented accumulation increase markedly during the first 5-10 years of age; (c) the extent of glycation is different in different tissues (in particular, glycation of aortal collagen is about twice that of skin collagen); and (d) collagen pigmentation as followed by fluorescence is comparable in aortal and skin collagen (except below 10 years); pigmentation measured by absorbance at 350 nm is, on the contrary, lower in aortal than in skin collagen. Based on the assumption of constant blood glucose level during the life span, it appears feasible to conclude that the degree of nonenzymatic collagen glycation reflects the time period for which the protein was exposed to the action of sugars. This period, because of increased cross-linking, is likely to be extended in older animals. Other factors, such as differences in collagen turnover between different tissues and the intensity of the removal process of the glycated products, should be taken into consideration as well.     

The significance of histopathological changes of the normal tunica albuginea in Peyronie's disease

Five patients with Peyronie's disease were operated and the tissue specimens from the plaque involving the tunica albuginea and from the tunica of the unaffected contralateral side were obtained. The specimens were then subjected to histopathological examination and the findings were correlated with those of men, proved not to have Peyronie's disease but operated for other reasons. In the specimen of plaque, the changes varied from collagen destruction to cartilaginous and osseous metaplasia. However, in the tunica of the contralateral side the changes such as disregularity of collagen bundles extending even to wide-spread focal areas, and apperance of pale, rough, eosinophilic collagen degeneration instead of its characteristic bright birefringence, and focal mucinous degeneration were noted. Interestingly, these alterations were not observed in the specimens of normal tunica, albuginea in the control group. But the existence of minimal alterations, the regularity in the apparently normal contralateral tunica albuginea specimens in Peyronie's disease implied that there was an active turnover in collagen production, and the possible factor causing collagen degeneration and so plaque formation was probably the microtraumatization of the tunica albuginea.     

Studies on azopyrazole derivatives. Part 9: Synthesis and antibacterial evaluation of novel phenylhydrazones and their substituted 4-arylazopyrazole derivatives.

6-Methyl-2,4-heptandione (1) was coupled with diazonium salts of sulfanilamide (2) and 4-aminobenzoic acid (3). Resulting new hydrazones, namely 4-methyl-2-oxovaleraldehyde p-substituted phenylhydrazones 4 and 5, were refluxed with various hydrazines to synthesize the title compounds 6-15. Their structure elucidation was made on the basis of their analytical and spectroscopic data. The antibacterial activity was evaluated. Some of the compounds tested exerted moderate to potent antibacterial activity against Staphylococcus aureus, Staphylococcus epidermidis and Streptococcus pyogenes.     

Determination of correction based on natural visual acuity in myopes]

The authors demonstrate the possibility to assess the correction in ametropes according to the value of their natural vision. To this end they use normalized optotype tables with Landolt rings which have a constant diminution coefficient between individual consecutive lines. By means of this elaborated method the authors were able to assess in twenty myopic subjects that a correction of -1.0 corresponds to an improvement by four lines, one line thus corresponds to a correction of -0.25 dioptres.     

Short communication: treatment of relapsing-remitting multiple sclerosis 96 patients with IFN-beta1b: results of a 6-year follow-up.

The first pharmacon with proved efficacy for the treatment of patients with the relapsing-remitting or relapsing-progressive form of multiple sclerosis (MS) was interferon-beta1b (IFN-beta1b). In 1996, we started treating 34 relapsing-remitting (RRMS) and 2 relapsing-progressive MS (RPMS) patients with IFN-beta1b. Of these 36 patients, 28 received continuous medication for 6 years. The primary end point of the study was the effect of 6 years of continuous IFN-beta1b treatment on the annual relapse rate, the secondary end point was the change in the progression index during the 6 years, and the tertiary end point was the alteration in the expanded disability status scale (EDSS) score of the patients. Finally, we give the reasons for the dropouts. The relapse rate decreased by 80.62% (p < 0.001), the mean EDSS score increased significantly, by approximately 0.5 points, to 2.21 +/- 1.48 (p = 0.016), and the reduction in the mean progression index was 67.19% (p < 0.001). This increase of < 0.5 point in the EDSS score is appreciably different from the 3-point deterioration expected after 6 years for the natural course of the disease. The significant improvement in the progression index clearly demonstrates that 6 years of IFN-beta1b therapy slowed the progression of the disease, thereby improving the quality of life of these MS patients.     

Milk of calcium hydronephrosis

There are very few reported cases of 'milk of renal calcium' since Holm's first presentation of this rare condition in 1948 [Rosenberg, J. Urol., 101: 714, 1967]. We recently had the opportunity to study 2 more cases, which are described herein.     

Functional changes in the right and left ventricle during development of cardiac hypertrophy and after its regression.

OBJECTIVE: The aim was to determine left and right ventricular functional reserves and collagen concentration during the development of cardiac hypertrophy and after its regression. METHODS: Two experimental models of cardiac hypertrophy (chronic thyroxine or isoprenaline treatment of adult rats) were compared 24 h and five weeks after the agent was last given. Pressure changes in the left (right) ventricle before and after acute aortic (pulmonary artery) ligation were recorded in open chest anaesthetised animals. The difference in dP/dtmax after and before ligation was regarded as the functional reserve. The total collagen concentration was determined in both ventricles separately by means of hydroxyproline. RESULTS: Left and right ventricular weight increased by 20% and 30% respectively in the two models employed. In the thyroxine treated group, the functional reserve of the left ventricle rose very noticeably, whereas in the isoprenaline treated group it decreased. The right ventricular functional reserve did not differ from that in the controls in either of the two groups. The collagen concentration rose in the left ventricle in the isoprenaline group only. Five weeks after the last administration of the agent, cardiac mass and ventricular function did not differ from the control values in either of the models studied; the only exception was the incomplete regression of left ventricular hypertrophy and persistent structural and functional impairment of the left ventricle in the isoprenaline treated group. CONCLUSIONS: Our results indicate that hearts undergoing a comparable degree of experimental hypertrophy may have different functional and structural properties; significant differences were found between the right and left ventricular response. Regression of hypertrophy together with a reversal of ventricular function usually occurs unless the myocardium has received severe structural damage.