Perianal hypertrophic donovanosis

A case of perianal donovanosis in a 15-year old boy, the 3rd to be reported from Punjab State, is presented. On admission the patient presented with beefy red granuloma with superficial ulcers with well-defined borders on the perianal area, perineum and groins, of 3 years duration. The lesions and biopsy contained donovan bodies. The patient was treated with 1 g streptomycin S04 daily for 27 days without effect. He had previously been given penicillin 1.2 million units, and later chloromycetin 1 g daily for 7 days, also without results. He was finally cured with tetracycline 500 mg q.i.d. for 20 days. This case was due to homosexual assault, but the infection can be fecally transmitted. It is extremely rare in North India.     

Effects of dilevalol in the anesthetized pig with a partially occluded coronary artery

Summary The beta-adrenoceptor antagonist dilevalol in a total dose of 430 g/kg IV, potently suppressed isoprenaline-induced increases in heart rate and max LVdP/dt (dose ratios of 42±6 and 38±5, respectively, in anesthetized pigs), but a dose of 1430 g/kg did not appreciably modify phenylephrine-induced increases in arterial blood pressure (dose ratio< 4) in both anesthetized and conscious pigs. The actions of dilevalol on ischemic myocardium of anesthetized pigs were investigated following a reduction of left anterior descending artery flow by 85–90%. Dilevalol (300 g/kg), administered after 15 minutes of ischemia, did not affect the ischemia-induced changes in systemic hemodynamics (such as heart rate, max LVdP/dt and cardiac output), myocardial perfusion, and wall-thickening of the ischemic segment during the following 15 minutes of ischemia and 2 hours of reperfusion. The reasons for the lack of antiischemic actions are most likely the absence of negative chronotropy and an absence of afterload reduction by dilevalol.     

NG-nitro L-arginine methyl ester: systemic and pulmonary haemodynamics,tissue blood flow and arteriovenous shunting in the pig

Summary The effects of N^G-nitro-Lrarginine methyl ester (L-NAME), an inhibitor of the endothelial nitric oxide (NO) biosynthesis, on systemic and pulmonary haemodynamics, and tissue as well as arteriovenous anastomotic blood flows were investigated in the anaesthetized pig, using simultaneous injections of radioactive microspheres of two different sizes (diameter: 15 and 50m). L-NAME (1, 3 and 10 mg·kg^–1) reduced systemic and pulmonary artery conductance and cardiac output, but heart rate and mean arterial blood pressure remained unchanged. L-arginine reversed the systemic and pulmonary haemodynamic changes induced by L-NAME. As detected with 15 m microspheres, L-NAME (1 and 3 mg·kg^–1) decreased tissue blood flow to and vascular conductance in the eyes, lungs, atria, kidneys, adrenals and liver. Furthermore, the difference between blood flows simultaneously measured with 15 and 50 m microspheres, which can be equated to blood flow through arteriovenous anastomoses with a diameter between about 28 and 90 m, was reduced by L-NAME (3 mg · kg^–1) in the skin of head and gluteal regions and, as indicated by the microsphere content of the lungs, in the total systemic circulation. These results suggest that in the anaesthetized pig (i) NO is involved in the regulation of both systemic and pulmonary vascular conductance, (ii) the decrease in systemic vascular conductance is in part due to constriction of systemic arteriovenous anastomoses, and (iii) the decrease in pulmonary vascular conductance, leading to reduction of cardiac output, seems to negate the expected rise in arterial blood pressure observed, for example, in rats and rabbits following inhibition of NO-synthesis. Correspondence to P. R. Saxena at the above address     

Successful treatment of metachronous contralateral intratubular germ cell neoplasia with partial orchiectomy and low‐dose radiation in a patient previously treated for testicular carcinoma

Intratubular germ cell neoplasia (ITGCN) of the testis is a precursor to testicular germ cell tumor (TGCT), which can lead to the development of invasive cancer. In patients with a history of previously treated unilateral TGCT, treatment for ITGCN of the contralateral testis needs to be balanced with the risks of subsequent infertility. Here, we present a 17‐ year‐ old patient with ITGCN diagnosed after treatment of contralateral nonseminomatous TGCT who was successfully treated with a partial orchiectomy followed by low‐dose radiation with preservation of his testosterone production.