Six Cases of Prenatal and Neonatal Torsion of the Spermatic Cord

Torsions of the spermatic cord occurring from the intrauterine period to the end of the first year of life are termed perinatal. These are divided into prenatal and postnatal torsions, depending on their occurrence in the intrauterine or postuterine period. From January 1984 to January 1996, 6 cases were identified at our institution, involving 4 prenatal and 2 postnatal extravaginal torsions of the spermatic cord. These cases are reviewed with regard to optimal therapeutic approaches for the treatment of both the affected gonad as well as the contralateral one, and whether the event occurred prenatally or postnatally. The authors also propose several clinical indications useful for obstetricians, pediatricians, urologists and nurses.     

Glutathione S-transferase null genotypes in transitional cell bladder cancer: a case-control study

OBJECTIVES: This study was conducted (1) to examine whether the GSTM1 and GSTT1 null genotypes are risk factors for bladder cancer, and (2) to study a possible association of these genotypes with disease severity. METHODS: This case-control study was undertaken over a 21-month period and included 89 newly diagnosed transitional cell bladder cancer patients and 147 controls; both patients and controls originated from a defined population (residents of the loannina region, Northwestern Greece) and were similar with regard to mean age, male to female ratio and smoking habits. The GSTM1 and GSTT1 genotypes were identified by multiplex polymerase chain reaction on peripheral blood DNA samples. Genotype frequencies among patients and controls were assessed and the association of the genotypes with tumor grade and stage at presentation were statistically evaluated by the chi(2) test. RESULTS: The GSTM1 null genotype was strongly associated with bladder cancer. The odds ratio, attributable and population attributable risks were estimated at 2.76, 0.64 and 0.40, respectively. The correlation between the GSTM1 null genotype with stage, although not statistically significant, was estimated at an odds ratio of 2.6 for invasive disease. The correlation of GSTM1 null genotype with tumor grade did not yield a statistically significant result. The GSTT1 null genotype was not statistically associated with bladder cancer. CONCLUSION: According to our study, individuals with the GSTM1 null genotype carry a substantially higher risk for bladder carcinogenesis. The GSTM1 null genotype is not associated with more aggressive disease in terms of tumor grade, although there is a correlation between this genotype and stage of the disease.     

Varicocele in schoolboys

This study was conducted to examine the effect of height and weight on the incidence of varicocele in schoolboys aged 5-16 years and the impact of varicocele on testicular size. Genital stage, height, weight, varicocele grade, and testicular size were recorded for 3047 school boys who were clinically examined while standing by a specialist in urology. Left varicocele was detected in 98 of the boys who were all aged 9-16 years. The mean weight of boys with and without varicocele was 42 kg (95% confidence interval [CI] 40-44 kg) and 47 (95% CI 47-47 kg), respectively (p =.00). There was no difference in mean height between the two groups nor in left and right testicular volume. Although 6 boys with varicocele had a left testicular volume > or =2 mL less than right, there were also 7 boys of comparable age who had a left testicular volume > or =2 mL larger than right. The incidence of varicocele in Greek adolescents is low. Boys with varicocele weighed significantly less but there were no significant differences in height or left versus right testicular volumes. In the light of these observations, the use of left testicular hypotrophy (> or =2 mL compared with the right testicle) should be reconsidered as an indicator for varicocele-induced damage of the testicle in this age group.     

Study of conjunctival goblet cell morphology and tear film stability in pseudoexfoliation syndrome

Background Tear secretion and tear film stability seem to be influenced by pseudoexfoliation syndrome (PEX). Histopathological evaluation of conjunctival goblet cells in PEX patients might explain the influence on tear film stability.Methods In a prospective, cross-sectional study, 40 eyes of 40 patients with PEX (study group) had measurement of Schirmer test with anesthesia and break-up time prior to cataract surgery. At the end of an uneventful operation, a 1×1.5 mm sample of conjunctival tissue was obtained and light and electron microscopy were performed. Results were compared with a control group. Histology evaluation was masked. Primary outcome measures included Schirmer test with anesthesia, break-up time, goblet cell density and morphological character of conjunctiva and conjunctival goblet cells.Results Both Schirmer test and break-up time values were significantly lower (P=0.01 and P=0.001) in the PEX patients (mean 10.6 mm and 8.6 s respectively) than in the control group (13.4 mm and 12.3 s respectively). The number of goblet cells in patients with PEX compared with the control group showed no statistically significant difference (P=0.66). Use of trichrome stain revealed significant differences in the staining properties of goblet cells between patients with PEX and controls. On electron microscopy, typical pseudoexfoliation filaments were found in the connective tissue of conjunctiva of PEX patients. Remarkable changes of mucin pockets in the study group were also noticed; they had extremely irregular distribution, various forms of size and appearance and even complete collapse.Conclusion Pseudoexfoliation seems to alter basic features of goblet cell morphology, thus affecting tear film stability. Further studies are necessary to determine the exact mechanism.     

Conductive keratoplasty for low to moderate hyperopia: 1-year results

PURPOSE: To assess the safety, efficacy, and stability of conductive keratoplasty in the treatment of low to moderate hyperopia and evaluate the impact of the procedure on the quality of vision. METHODS: Thirty-six eyes (25 patients; 13 female and 12 male) were treated for hyperopia up to +3.25 D with a Refractec ViewPoint CK system and followed for 1 year. Mean age was 50.2 +/- 8.7 years (range 31 to 71). RESULTS: Before surgery, mean spherical equivalent refraction was +1.90 +/- 0.60 D (range +1.00 to +3.25 D), decreasing at 1 year after conductive keratoplasty to -0.06 +/- 0.80 D, and was within +/- 0.50 D of emmetropia in 68% (24 eyes) and within +/- 2.00 D in all eyes. Twelve months after conductive keratoplasty, uncorrected visual acuity was 20/20 or better in 19 eyes (50%) and 20/40 or better in 32 eyes (89%). No eye lost > or = 2 Snellen lines or had induced cylinder > or = 2.00 D. The mean root mean square values for higher order optical aberrations were 0.060 +/- 0.039 before and 0.174 +/- 0.170 at 3 months after surgery. No statistically significant changes in contrast sensitivity were noted. CONCLUSIONS: Conductive keratoplasty for low to moderate hyperopia provided safe, effective, and stable results both in refraction and quality of vision.     

Relationship between intrafollicular levels of prolactin and sex steroids and in-vitro fertilization of human oocytes

In this study the importance of Intrafollicular prolactin (PRL)and sex steroid levels, as indices of the potential invitrofertilization and development of human oocytes, was investigated.Oocytes were recovered from 20 normal female volunteers treatedwith a fixed schedule including norethisterone and clomiphene.The embryos which developed after in-vitro fertilization weregraded on a scale of 0 to 10 using morphological criteria. IntrafollicularPRL, oestradiol, progesterone and androstenedione levels didnot differ significantly between follicles containing oocyteswhich fertilized and those which did not fertilize in vitro.Nor did these hormones differ significantly between folliclesgiving rise to embryos with a bad score (0–5) and thosewith a good score (6–10). No significant correlation wasfound between serum and follicular fluid PRL levels. It is suggestedthat fertiliza tion and developmental potential of human oocytesin vitro cannot be predicted by the intrafollicular levels ofPRL and sex steroids at the time of laparoscopic egg recovery.     

Serological profile and virological evaluation of hepatitis B and hepatitis C virus infection among HIV infected patients in Greece

In this study we evaluate the prevalence of HBV and HCV infections and the HBV and/or HCV viral load as well as HCV genotype among 737 HIV-infected patients. 89/737 (12.1%) were HBsAg(+) and the majority of them (60.7%) were HBeAg(+), in contrast to general Greek population; anti-HBc seropositivity was detected in 48.1% of the study population. Serum HBV-DNA levels were 5.75 +/- 1.66 (-log 10 copies/ml) and HBeAg(+) coinfected patients had significantly higher levels than HBeAg(-) ones (7.40 +/- 0.64 vs 4.59 +/- 1.01, respectively, p < 0.001). 8.2% of HIV-infected patients were anti-HCV(+) and the majority of them (85.7%) had HCV-RNA levels more than 700.000 IU/I. The most common HCV-genotype was genotype-1 (12/28, 42.9%), representing a difficult-to-treat special population.     

Epi-LASIK: histological findings of separated epithelial sheets 24 hours after treatment

PURPOSE: To report the histological findings of four eyes of three patients who underwent epi-LASIK treatment for the correction of low myopia. METHODS: The epithelial sheets were harvested either immediately after separation (one eye) or were accidentally dislocated and harvested from the operative eyes 24 hours after treatment (three eyes). All sheets underwent optical and transmission electron microscopy. RESULTS: Histological evaluation showed that the majority of the epithelial cells were morphologically normal in all examined specimens. CONCLUSIONS: Histological examination of specimens in four eyes showed that 24 hours after mechanical separation the epithelial cells' morphology was close to normal.     

Assessing the knowledge of bronchial asthma among primary health care physicians in Crete: A pre- and post-test following an educational course

Aim  

To assess the level of knowledge for bronchial asthma of the primary healthcare physicians serving a rural population on the island of Crete, both before and immediately after a one-day educational course.     

Retroperitoneal anomalies in men with testicular germ cell tumours

OBJECTIVES: To assess whether vascular and other retroperitoneal anomalies are more frequent during retroperitoneal lymph node dissection (RPLND) for metastatic testicular tumours (when retroperitoneal masses persist after chemotherapy) than would be expected, based on the initial observations from one centre with a large experience of RPLND in the UK. PATIENTS AND METHODS: A prospective series of 278 consecutive patients treated with RPLND for testicular tumours comprised the sample population. For each patient the presence or absence of four factors from the history was recorded. Each patient then underwent RPLND. During surgery, a template was constructed of the anatomy of the retroperitoneum and the information stored. Eight different retroperitoneal anatomical anomalies were identified in the sample population; the incidence of each was then compared with the largest available study of a normal population, and differences analysed statistically. RESULTS: Of the 278 patients who had RPLND, 55 had 59 anomalies (21%), found by history and as retroperitoneal vascular and urological anomalies; cryptorchidism was present in 7.6%, 9.5 times the incidence in the control population (P < 0.01). A left-sided inferior vena cava was present in 3.6% of patients, 21 times the incidence in the control population (P < 0.001); a retro-aortic left renal vein in 3.2%, four times that in the control population (P < 0.05); and ipsilateral renal agenesis had an incidence of 1% in the test population, 11 times greater than in the control population (P < 0.01). CONCLUSIONS: This prospective study of 278 RPLNDs provides evidence that some retroperitoneal anatomical anomalies are associated with testicular germ cell tumours. The link between maldescent and testicular tumours, rather than an isolated association, should be considered as part of a spectrum of retroperitoneal anomalies that occur in these men.