Effect of intraurethral Mitomycin-C on healing and fibrosis in rats with experimentally induced urethral stricture

BACKGROUND: In the pathogenesis of urethral stricture, fibrosis is associated with an excessive collagen increase. After the recognition that topical application of Mitomycin-C (MMC) inhibits fibroblast proliferation and is effective in preventing scar formation, many studies have been carried out on this subject outside the scope of urology. The aim of the present study is to observe the intraurethral impact of the employment of low doses of MMC on scar formation and fibrosis in experimental rat model. METHODS: Urethral injuries were made by internal urethrotomy knife. The study was carried out with 35 adult male Wistar albino rats. Five rats were allocated to the control group (group 1), 10 to a group that was administered 2 mg/L MMC (group 2) and 20 to a group that was administered 10 mg/L MMC (group 3). Mitomycin-C was administered to the injured urethra in the form of irrigation for 5 min. The rats were sacrificed 14 days later in order to evaluate chronic inflammation and fibrosis and their penises were histopathologically examined under light microscopy with hematoxilen eosin and trichrom stains. RESULTS: When group 2 was compared with control group, the differences in hemosiderin-laden macrophages (HLM), mononuclear cell infiltration (MCI) and fibrosis were found to be statistically significant (P < 0.01, P < 0.05, P < 0.005, respectively). When group 3 was compared with control group, the differences in HLM, MCI and fibrosis were also found to be statistically significant (P < 0.05, P < 0.05, P < 0.005, respectively). In the comparison of group 2 with group 3, no statistically significant differences were found in terms of the these parameters. CONCLUSIONS: Although MMC is toxic at high doses, the antifibrotic effect of the intraurethral low dose MMC may be useful in combination therapy for internal urethrotomy.     

The First Observation of Homozygous Hemoglobin S-Alpha Thalassemia Disease and Two Types of Sickle Cell Thalassemia Disease: (a) Sickle Cell-Alpha Thalassemia Disease, (b) Sickle Cell-Beta Thalassemia Disease

Six patients with sickle cell-thalassemia disease are reported together withhematologic and genetic data. A case of homozygous hemoglobin S-alphathalassemia disease, the son of parents with asymptomatic sickle cell-thalassemia disease and sickle cell trait, is presented, showing the possibilities involved in the presence of two genes for hemoglobin S and one gene forthalassemia.

Submitted on December 7, 1962 Accepted on July 15, 1963     

Brief Note: Hemoglobin S in Eti-Turks and the Allewits in Lebanon

(1) The incidence of sickling among 966 people belonging to the Eti-Turkcommunity in southern Turkey was found to be 16.8 per cent.

(2) Among the Allewits living in Lebanon—who are considered to have thesame racial background as the Eti-Turks—the incidence of sickling was only4 per cent.

Submitted on October 27, 1960 Accepted on February 9, 1961     

Immunotherapy of Primary Immunological Aborters: Rationale for the Use of Pooled Cryopreserved Purified Normal Peripheral Blood Mononuclear Cells

ABSTRACT: Patients with recurrent spontaneous abortions have been sucessfully treated in many centers with third-party immunization directed to a putative TLX antigen system. This immunotherapy requires the screening of a large number of donors to match the patients' red blood cell (RBC) phenotype and has the potential risks associated with transfusions from 30 to 50 donors. Our modified approach to third-party immunization is to use irradiated frozen-stored purified lymphocytes pooled from five normal donors. Mononuclear cells from normal donors are obtained in a cell separator. After sedimentation and Ficoll-Hypaque separation, the cells are stored in liquid N². The RBC depletion of the final preparation is of the order of 5 to 6 logs, theoretically decreasing the need for RBC phenotyping except for the Rh system. Using a highly sensitive fluorescence-activated cell sorter technique and an ADCC assay, we found that ABH, Rh, Fy^a Fy^b, Jk^aJk^b, MNS, and Kell antigens are either not expressed by cryopreserved human mononuclear cells, or, if so, they are below the level of detection of these highly sensitive assays. We conclude that the use of pooled frozen mononuclear cells is an adequate alternative for immunotherapy. It decreases the transfusion risks associated with exposure to a large number of donors and the need for RBC phenotyping, making this modality of treatment more accessible.     

Urinary enzyme changes in newborns with unconjugated hyperbilirubinemia

Various changes in renal function caused by unconjugated hyperbilirubinemia in newborns have been suggested in previous reports. Disclosing an injury in renal tubulus epithelium is feasible by measurement of urinary enzymes. Thus, renal function tests and urinary enzymes in 25 term newborns with unconjugated hyperbilirubinemia were evaluated before and after phototherapy. Ten healthy term newborns without hyperbilirubinemia formed the control group. Mean values of the variables obtained before and after phototherapy in the study group and in the controls were, respectively: urine osmolality (osm/kg H₂O); 0.147 ± 0.009, 0.174 ± 0.011, and 0.153 ± 0.018; endogenous creatinine clearance (mL/min per 1.73 m²): 45.7 ± 2.15, 46.0 ± 1.6 and 46.7 ± 3.9; fractional excretion of sodium (%): 1.27 ± 0.30, 0.79 ± 0.19 and 1.24 ± 0.07; tubular phosphorus reabsorption (%): 85.8 ± 3.3, 87.8 ± 2.8 and 86.6 ± 1.7; urinary N-acetyl-β-D glucosaminidase/creatinine (IU/mg): 0.617 ± 0.226, 0.574 ± 0.214 and 0.619 ± 0.210; fractional excretion of alkaline phosphatase (%): 0.422 ± 0.103, 1.001 ± 0.374 and 0.596 ± 0.201; fractional excretion of lactic dehydrogenase (LDH; %): 0.102 ± 0.019, 0.121 ± 0.023 and 0.119 ± 0.041; fractional excretion of AST (%): 0.433 ± 0.127, 0.530 ± 0.113 and 0.502 ± 0.074; fractional excretion of alanine aminotransferase (ALT; %) 0.856 ± 0.413, 1.619 ± 1.076 and 1.066 ± 0.366. No significant difference was found between these values before and after phototherapy in the study group, or between the values before phototherapy in hyperbilirubinemic neonates and in the control group. In conclusion, unconjugated hyperbilirubinemia up to a serum level of 18.4 mg/dL in term neonates does not seem to result in injury of normal tubulus epithelium as shown by urinary enzyme levels.     

The Hemoglobin E Syndromes. I. Hemoglobin E in Eti-Turks

During an electrophoretic study of the hemoglobin from 150 personsbelonging to the Eti-Turk community, two individuals with hemoglobin Etrait and one case of sickle-cell-hemoglobin E disease were discovered. Theresults of this investigation combined with those of other electrophoreticstudies performed previously in this community indicate that the incidence ofhemoglobin E among Eti-Turks is 1.37 per cent.

The importance of the occurrence of hemoglobin E in this community hasbeen discussed, and a possible relationship between Eti-Turks and somepeople of India has been postulated.

     

Roentgenographic Bone Changes in Chronic Iron Deficiency Anemia: A Study in Twelve Patients

Radiologic bone changes of the skull and long and short bones similar tothose of thalassemia are described in 12 patients with chronic iron deficiencyanemia. Certain differences between the roentgen findings of the present studyand those of the cases reported by other investigators are discussed.

Submitted on August 17, 1965 Accepted on September 15, 1965