Fluid movement in the lumen of the rat epididymis: effect of vasectomy and subsequent vasovasostomy

Intraluminal fluid movement rate was measured in four regions of the rat epididymis. The fastest flow occurred in the proximal caput epididymis (18.5 +/- 3.7 mm/hour) and the slowest in the distal cauda (2.5 +/- 0.5 mm/hour). Vasectomy significantly reduced caput fluid flow rates unless a sperm granuloma was present at the vasectomy site. Thirty days after vasovasostomy, caput fluid movement remained reduced in animals unless a granuloma was present. Failures of this or other aspects of epididymal biology to return to normal after vasovasostomy could play a role in the frequent infertility which persists after the operation.     

Quantitative MRI volume changes in late onset schizophrenia and Alzheimer''s disease compared to normal controls

Volumes of medial and lateral temporal lobe structures were assessed using magnetic resonance imaging (MRI) in 11 patients with late-life onset schizophrenia (LOS), 18 normal elderly controls and 12 patients with moderate cognitive impairment due to Alzheimer's disease (AD) who had no non-cognitive symptoms. While both patient groups has smaller volumes of several medial temporal regions (e.g. entorhinal cortex, left hippocampus), schizophrenics had significantly smaller anterior superior temporal gyri (STG) than normal controls, but AD patients did not. We have previously demonstrated anterior STG volume to be reduced in early life onset schizophrenia.     

Image processing in digital radiography

Image processing is a critical part of obtaining high-quality digital radiographs. Fortunately, the user of these systems does not need to understand image processing in detail, because the manufacturers provide good starting values. Because radiologists may have different preferences in image appearance, it is helpful to know that many aspects of image appearance can be changed by image processing, and a new preferred setting can be loaded into the computer and saved so that it can become the new standard processing method.Image processing allows one to change the overall optical density of an image and to change its contrast. Spatial frequency processing allows an image to be sharpened, improving its appearance. It also allows noise to be blurred so that it is less visible. Care is necessary to avoid the introduction of artifacts or the hiding of mediastinal tubes.     

Storage phosphor digital mammography

Digital mammography using storage phosphor CR is still in the investigational stage. It is the only digital mammography system that has been tested in preliminary clinical trials with promising early results. Further clinical studies are needed to assess the impact of the limited spatial resolution of storage phosphor technology on its application as a digital screening mammography system. Further studies also are needed to determine the optimum image processing parameters needed in digital mammography.     

Clinical and genetic changes in a case of a Cushing''s carcinoma

A 30-year-old presented In 1984 with a clinically nonfunctional tumour which subsequently developed Into a metastatic corticotrophlnoma from which he died despite surgery In 1984,1986 and 1991 and external radiotherapy In 1986. Molecular genetic analysis of tumour and metastatic tissue revealed loss of heterozygosity at loci on the autosomes 1p, 3p, 10q26,11q13 and 22q12. Tissue taken at surgery In 1986 also revealed positive cytoplasmic Immunostalning for p53 protein. No such staining was evident in tissue taken at first surgery in 1984. Further analysis of Invasive pituitary adenomas may reveal loci associated with such behaviour, enabling better prediction of subsequent clinical outcome than is possible using standard histological techniques, and delivery of early, aggressive treatment to those tumours which show molecular markers associated with a poor prognosis.     

LYSOSOMAL IRON ACCUMULATION AND TUBULAR DAMAGE IN RAT PUROMYCIN NEPHROSIS AND AGEING

1. Energy dispersive X-ray spectrometry was used to examine the relationship between proteinuria and increased urinary iron excretion, and structural and functional damage in puromycin nephrosis. 2. After 11–12 days rats treated with puromycin (10 mg/100g, i.v.i.) had greater proteinuria (211.6 ± 35.7 mg/day, mean ± s.e.m.) and urinary iron excretion (15.4 ± 2.2 μg/day) than salinetreated controls (14.5 ± 1.4 mg/day and 1.1 ± 0.2 μg/day, respectively, both P<0.001). 3. On day 13, mean lysosomal iron concentration of proximal tubular cells (306.6 ± 64.5 vs 11.9 ± 8.6 mg%, P<0.001), and proximal tubular cell damage assessed semi-quantitively (1.17 ± 0.10 vs 0.62 ± 0.10, P<0.001) were higher and creatinine clearance (0.15 ± 0.01 vs 0.29 ± 0.02 mL/min perg kidney weight, P<0.001) lower than in control rats. 4. At days 35, 60 and 360 there were no differences in any of the measured parameters between rats treated with puromycin or saline, and in both groups proteinuria, tissue damage and lysosomal iron concentration increased with time. 5. Lysosomal iron accumulation was the only independent predictor of both functional and structural damage. 6. In conclusion, the apparent association between proteinuria and tubulo-interstitial damage in puromycin nephrosis, and with ageing, is best explained by factors associated with accumulation of iron within lysosomes of proximal tubule cells.     

Hypercalcemic hyperparathyroidism and hypophosphatemic osteomalacia complicating neurofibromatosis

Summary Neurofibromatosis is sometimes complicated by impaired renal tubular reabsorption of phosphate, hypophosphatemia, and osteomalacia. Hyperparathyroidism has also been reported in patients with neurofibromatosis. When hypercalcemia and elevated levels of parathyroid hormone are found in osteomalacia, however, it may be difficult to determine if the hyperparathyroidism was primary or tertiary. We describe a patient with neurofibromatosis, hypercalcemic hyperparathyroidism, hypophosphatemic osteomalacia, vitamin D deficiency, and clear-cell hyperplasia of all four parathyroid glands. Serial biomechanical, bone biopsy, and densitometric studies confirmed that treatment with ergocalciferol, calcium, and phosphate supplements significantly improved the osteomalacia but caused increased parathyroid overactivity. After subtotal parathyroidectomy, the parathyroid hormone concentration became normal and the bone mineral content increased at the spine and hip, but inappropriate phosphaturia persisted. The findings indicate that hyperparathyroidism, osteomalacia, and vitamin D deficiency adversely affect each other.     

Management of venous stasis ulcer: long-term follow-up

In this study 112 patients (122 lower limbs) who had chronic venous stasis ulceration refractory to conservative management were treated surgically. Subfascial ligation was performed on 118 limbs and the long saphenous vein was removed in 4. Complications consisted of postoperative thrombophlebitis (2%), wound infection (2%) and wound infection with ulcer necrosis (1.5%). These all responded to conservative management. Follow-up (mean 7.9 years, median 11 years) showed a good or excellent result in 82% of cases, with healing of the ulcer and no ulcer recurrence despite significant noncompliance with support stockings. This paper is a long-term follow-up study of a surgical procedure for chronic venous stasis ulcers. The authors believe that the 82% good and excellent results may indicate that surgical intervention for refractory venous ulcers is a worthwhile procedure, providing potentially satisfactory long-term results.