Modifications of the urethral rest and stress profiles after different types of surgery for urinary stress incontinence

Summary. Full urodynamic assessment, including urethral profiles at rest and under stress, using microtransducers, was made before and at least 6 months after surgery for urinary stress incontinence in 86 patients. Cure was assessed objectively. Procedures compared were Burch colposus-pension, Pereyra urethrovesical suspension and anterior colporrhaphy. The Burch colposuspension increased the pressure transmission ratio more efficiently than the vaginal operations and the cure rate was 91%. Only 50% of Pereyra operations were successful and success was related to an increase in the functional urethral length and in the pressure transmission ratio. The success rate for anterior colporrhaphy was 57% and was associated with a significant decrease in the maximal urethral closure pressure and the continence area. The prognostic value of the urethral profiles at rest and under stress and the therapeutic implications are discussed.     

Über einen Fall von Lungenhistoplasmom mit möglicher Infektion in Italien

Es wird der Fall eines Histoplasmoms, das in Venezuela klinisch diagnostiziert und nach partieller Lungenresektion pathol.-anat. Bestätigt wurde, mitgeteilt. Eine Reihe von Daten läßt vermuten, daß die Patientin sich eventuell in Italien angesteckt hat. Obwohl bisher nur wenige Fälle von autochthoner Histoplasmose in Europa bekannt geworden sind, scheint es den Autoren nicht unwahrschein-lich, daß durch eingehendere Untersuchungen der Habitat des Pilzes auch in Europa nachgewiesen werden könnte.

Resumen

Se relata el caso de un histoplasmoma pulmonar observado en Venezuela en el cual se sespecha que la infectión con el hongo tuvo lugar en Venezia/Italia. Puesto que ya se han relatado otros casos de histoplasmosis autóctona en Europa se sospecha de que contrario a la opinión general, debe haber el habitat del hongo en Europa.
Se propone que se hagan investigaciones para asegurar o excluir deflnitivamente lo expuesto.     

ENDORPHINS AND THE REGULATION OF THE HUMAN MENSTRUAL CYCLE

In order to assess a possible influence of endogenous opioids upon gonadotrophin secretion in women, we examined the effects of i.v. administration of 10 mg naloxone, a specific opiate antagonist, in ten normal menstruating women, in thirteen women with amenorrhoea and/or hyperprolactinaemia and in two women with putative deficiency of gonadotrophin-releasing hormone (GnRH). In thirteen subjects, a saline vehicle control study (randomized order of administration) was also performed. In the normal women, naloxone failed to elicit changes in serum gonadotrophin levels when administered during the early follicular phase of the menstrual cycle. However, significant increments of LH were observed from 30 to 165 min following naloxone administration during the late follicular phase. Similar LH responses occurred in the amenorrhoeic and hyperprolactinaemic women. There was a tendency towards a concomitant increment in FSH levels, which reached statistical significance variably from 60 to 105 min post-naloxone. The LH response to naloxone in individual subjects showed a significant (P > 0·01) quadratic (U-shaped) relationship to the log basal oestradiol concentration. No response to naloxone was observed in the two patients with GnRH deficiency despite a brisk response to an exogenous GnRH bolus. Taken together, these data suggest that central nervous system inhibitory opioid pathways may be involved in the regulation of LH secretion in normal women and that excessive production of endogenous opioids may play a role in the pathophysiology of some amenorrhoeic conditions.     

Concentrations of calmodulin in sperm in relation to their motility in fertile euspermic and infertile asthenozoospermic men

The relationship between calmodulin and sperm motility was assessed in euspermic and asthenozoospermic men using radioimmunoassay and time-lapse photography, respectively. There was a significant decrease in the % sperm motility, mean sperm velocity, motility index and % of progressively motile sperm in the asthenozoospermic group when compared with euspermic men. The former also exhibited a higher % of sperm with erratic or circular motility. Calmodulin concentration in sperm from the asthenozoospermic men was 4.8 +/- 1.4 micrograms/mg protein compared with 12.6 +/- 2.3 in euspermic men (P less than 0.0005). The differences observed in sperm motility characteristics between the two groups may, thus, be due to the observed differences in the concentration of calmodulin.