Curvilinear calcification in renal cancers: Two etiologies

Two cases of hypernephroma are presented, each containing central curvilinear calcification. The etiology of these calcifications is discussed, together with the significance of calcifications in renal masses.     

Tooth mobility measurements following two methods of eliminating nonworking side occlusal interferences

Abstract The objective of this study was to compare tooth mobility following two methods of eliminating nonworking side interference (NWSI). The first method involved the complete elimination of any tooth contact on the NWS. The second method involved the reduction of the NWSI to a level which was harmonious with the occlusion on the working side. Thirty-three clinically healthy individuals having nonworking side interferences and no pathological signs of occlusal trauma, participated in the study. After 1 month of intensive training in oral hygiene, the volunteers were divided into three groups of 11 each. The first two groups were experimental and the third group received no occlusal adjustment to serve as a control. In the first group tooth mobility measurements and periapical x-ray films of teeth with nonworking interferences were taken. Occlusal interferences were then totally eliminated by selective tooth grinding. Two months later mobility and x-ray recordings of same teeth were repeated. In the second group the same procedure was performed, but nonworking side interferences were adjusted to harmonious contacts with occlusion on the working side. Tooth mobility was measured in hundredths of a millimeter, using the microperiodontometer designed by Mühlemann (1954). Data were subjected to statistical analysis and the following conclusions were drawn:

• 1 Tooth mobility was significantly (P < 0.001) reduced after complete elimination of nonworking side interferences, as well as after adjusting the nonworking side interferences to harmonious contacts with occlusion on the working side (P < 0.01).
• 2 The reduction in mobility was significantly (P < 0.001) greater when occlusal interferences were completely eliminated than when harmonious contacts were achieved.
• 3 There were no detectable radiographic changes, either in the interproximal alveolar bone level or periodontal ligament spaces, 2 months following occlusal adjustment.

     

Condyloma acuminatum of male urethra. Successful management with 5-fluorouracil

A case of extensive condyloma acuminatum of the entire male urethra was successfully managed with 5-fluorouracil intraurethral instillations. Review of the literature disclosed 9 previously reported cases in which the entire male urethra was involved. The common presentations and different modalities of treatment are reviewed.     

Management of giant vesicovaginal and vesicourethrovaginal fistulas

We herein report on 15 patients with giant vesicovaginal (7) and vesicourethrovaginal (8) fistulas repaired since July 1979. All fistulas were repaired by a suprapubic approach with or without a concomitant vaginal approach. All 7 patients with giant vesicovaginal fistulas underwent a standard racket incision of the bladder with excision of the fistula, closure of the vagina and bladder, and an omental interposition, and were cured. Four patients with giant vesicourethrovaginal fistulas had a similar successful closure but only 2 were cured of the incontinence, while 2 remained totally incontinent owing to failure of the bladder outlet sphincteric mechanism. The latter 2 patients were managed by a Tanagho bladder flap urethral reconstruction: 1 remained totally incontinent and finally underwent diversion, while 1 was improved but not cured totally. Four patients were managed by repair of the fistula simultaneously with a Tanagho bladder flap: 2 had no previous abdominal repairs and both achieved continence postoperatively, while 2 had numerous attempts at repair (including abdominal approaches) before referral and only 1 was cured. Giant vesicovaginal fistulas can be repaired successfully in almost all patients. Although vesicourethrovaginal fistulas can be closed as readily there is a high likelihood of sphincteric inadequacy in patients with extensive urethral involvement. A bladder flap urethral reconstruction is valuable in these patients, particularly in the absence of prior suprapubic procedures.     

Uropharmacology: IX. direct-acting smooth muscle stimulants and depressants

Agents which exert their effect on the lower urinary tract by stimulating or depressing the activity of smooth muscle directly are discussed. Many of these drugs also exert other actions on the urinary tract mediated via the autonomic nervous system.     

Unsuspected duplex ureters.

Three cases of unsuspected duplex ureters are presented. It is suggested that nonvisualizing upper pole segments should be suspected whenever a duplication occurs on the contralateral side regardless of the radiographic appearance.     

Tuberous sclerosis complex and renal angiomyolipoma. Collective review.

Numerous case reports of renal angiomyolipoma with or without tuberous sclerosis continue to be published with increasing frequency in the urologic literature. The need for a comprehensive and updated review of the subject is timely. A collective pathologic, clinical, and radiologic review of the subjects of tuberous sclerosis complex and renal angiomyolipoma is presented; and a plan for the urologic management is discussed.