Nephrogenic adenoma of the urinary bladder and urethra

The histologic and ultrastructural features of nephrogenic adenomas of the urinary bladder and urethra were studied in multiple specimens obtained from eight patients. Three of these were studied by indirect immunofluorescence for Tamm-Horsfall uromucoprotein. The lesions are uncommon benign metaplastic proliferations of urothelium, occurring most frequently in males as small cystic, papillary, or nodular masses and most often presenting with hematuria. Typically the metaplastic tubules resemble nephronic tubules. A florid atypical and pseudoinfiltrative proliferation of these tubules may lead to an erroneous diagnosis of adenocarcinoma. Ultrastructural features of proximal convoluted tubules were identified in some of the tubules, but resemblance to specific segments of distal tubules was less certain. The ultrastructural features combined with the absence of Tamm-Horsfall protein in tubular lumina or cells suggest a mesonephric rather than metanephric homology. The lesions are appropriately treated by transurethral resection or fulguration, but persistent lesions were present in three patients up to 18 years after initial treatment.     

Pancreatic islet autotransplantation: results in dogs with chronic duct ligation

The influence of pancreatic acinar cell atrophy and fibrosis on islet tissue autotransplantation was studied in dogs. Thirty-nine dogs underwent pancreatic duct ligation. After 6 weeks marked acinar cell atrophy and fibrosis developed, similar to that in human chronic pancreatitis. Intravenous glucose tolerance testing revealed only a minor decrease in K value (percent/min decline in plasma glucose) from 2.9 +/- 0.2 to 2.4 +/- 0.1 during the 6 weeks. In a control group of normal dogs, 23 of 26 transplants were successful. In a group of 12 duct-ligated dogs, only 1 of 12 transplants was successful with identical techniques (p less than 0.001). Variations in technique to increase or decrease tissue dispersal did not improve the results in other groups (two successes in 27 dogs). New techniques are required if pancreatic islet transplantation is to be consistently effective in the presence of chronic inflammatory disease of the pancreas.     

What is a large breast? Measuring and categorizing breast size for tangential breast radiation therapy

Despite consensus in published studies that larger‐breasted patients who undergo radiation therapy tend to suffer from more severe acute skin reactions and a more adverse cosmetic outcome, there appears to be no consensus on the definition of a ‘large breast’. This paper describes an analysis of breast size that was undertaken on 50 patients and compares this data with other published studies. The desired outcome for the study was to formulate a definition of ‘large breast size’ that would be appropriate for Australian patients and that could be determined simply and quickly in busy radiation oncology clinics. Analysis suggests that cup and brassiere size may be used to separate breast size into two categories. On the basis of published data and results from this study, it is recommended that patients with a cup size ≥D or a bra size ≥18 could be categorized as having large breasts, with all other patients considered average in size.     

Carcinosarcoma of the renal pelvis

An unusual heterologous carcinosarcoma of the renal pelvis is reported. The differential diagnosis, problems related to nomenclature and histogenetic implications of this rare neoplasm are discussed.     

THE EFFECT OF RANITIDINE ON SYMPTOM RELIEF AND QUALITY OF LIFE OF PATIENTS WITH GASTRO-OESOPHAGEAL REFLUX DISEASE

SUMMARY A 4-week study involving 354 patients with the symptoms of gastro-oesophageal reflux disease was conducted to assess the effect of ranitidine (as effervescent tablets) on their relief and quality of life. All patients received 150 mg bd for 2 weeks, with those responding to treatment continuing on the same dosage for a further 2-week period and 'non-responders' having the dosage increased to 150 mg qds for a further 2 weeks. Quality of life and symptom assessments were carried out at 0, 2 and 4 weeks. Two weeks' treatment with ranitidine 150 mg bd was effective at controlling the GORD symptoms in 78% of patients. A 4-week treatment with either 150 mg bd or qds controlled the symptoms in 85% of patients. All patients had significant improvements in all dimensions of their quality of life over the study period.     

Pharmacodynamic behaviour of isolated resistance vessels obtained from hypertensive-diabetic rats

Summary— The influence of various vasodilator and constrictor drugs was studied in isolated mesenteric arteries obtained from obese and lean Zucker rats. The obese Zucker rats were moderately hypertensive and their isolated small arteries were not hypertrophied. All vasoconstrictor agents studied (noradrenaline, methoxamine, serotonin, calcium chloride, potassium chloride) caused the same effects in isolated arteries taken from obese and lean (control) Zucker rats, respectively. In vessels from obese Zucker rats, the vasodilator responses to sodium nitroprusside, methacholine, the K+-channel opener cromakalim and nifedipine were the same as in control preparations. In conclusion, isolated mesenteric arteries from obese Zucker rats do not show relevant structural changes, and the pharmacodynamic behaviour of such vessels appears to be the same as that of control preparations. Neither the diabetic hyperinsulinaemic state nor the hyperlipoproteinaemia in the obese Zucker rats appear to cause serious vascular damage.