Computer analysis of micturition parameters and accuracy of uroflowmeter

Several micturition parameters in healthy volunteers have been studied with digital computer analysis. The accuracy of the uroflowmeter has also been tested. Total voiding time, average flow rate, maximum flow rate, volume and time at maximum flow rate are all the function of volume voided. The first half of urinary volume is rapidly evacuated in the first one third of the total voiding time, and the rest in the remaining two thirds of the voiding period. When the constant stream hits at the center of the disk, the response of the flowmeter is fairly good. Once the urinary stream is accelerated and/or hits at the edge of the disk, the response is not reliable.

[Thoraco-lumbar spinal tumor associated with papilledema (author's transl)]

Increased intracranial pressure and papilledema are occasionally observed in patients harboring spinal tumors in the cervical region or at the craniocervical junction, and the mechanical obstruction to the cerebrospinal fluid circulation is assumed to be responsible for such symptoms and signs. However, increased intracranial pressure is very rare in spinal tumors locating in the dorso-lumbar region; only 44 such cases having been reported in the literature. Recently we saw a 58-year-old female who presented with three brief episodes of loss of consciousness associated with nausea and vomiting, progressive dementia and insomnia. Neurologic examination disclosed an early papilledema, weakness of both legs and dementia. A left carotid angiogram revealed a small aneurysm arising from C2 segment of the internal carotid artery. Right carotid and bilateral vertebral angiograms were not contributory. The aneurysm was clipped at the first operation. The aneurysm was found apparently unruptured. A ventriculoperitoneal shunt failed to improve her dementia. Finally, a total myelographic block was found at L1 level, and a neurinoma arising from the right D12 was removed. After this, all symptoms and signs disappeared within 3 weeks. Pertinent literature on the low spinal cord tumor associated with an intracranial pressure was reviewed and the mechanism of the elevation of intracranial pressure in such cases were discussed.

Arteriovenous malformations in the posterior fossa

We have operated on 12 of 14 cases of arteriovenous malformation (AVM) in the posterior fossa since 1968, with one death. The lesions were in the cerebellum in 10 cases (three anteromedial, one central, three lateral, and three posteromedial), and in the cerebellopontine angle in two; in two cases the lesions were directly related to the brain stem. The AVM's in the anterior part of the cerebellum were operated on through a transtentorial occipital approach.

Demonstration of non-infectious hemagglutinating particles of rabies virus and isolation of the hemagglutinin by disruption of the virion with Nonidet P-40

Non-infectious hemagglutinating particles of rabies virus accumulated in the fluid phase of chick embryo cell cultures at 6 days post-infection, though they were undetectable at 4 days. They were characterized as looped filaments resembling viral envelope as revealed by electron microscopy. Another form of hemagglutinin (HAnin) was obtained by solubilization of partially purified virions with Nonidet P-40 (NP-40) followed by successive high speed and CsCl density gradient centrifugations. The density of the isolated HAnin averaged 1.28 g/cm3. SDS-polyacrylamide gel electrophoresis of the HAnin demonstrated that it was mainly composed of a glycoprotein (G) with a molecular weight of 83,000. Electron microscopically, it differed from the above non-infectious hemagglutinating particles, being much smaller in size and showing a star- or rosette-like appearance with a diameter of about 25 nm, composed of a central particle surrounded by particles resembling envelope-spikes. Virus-neutralizing (VN) and hemagglutination inhibiting (HI) antibodies were produced in rabbits immunized with the HAnin isolated from virions.

The EEG in normal pressure hydrocephalus

Fourteen patients with NPH were studied with special reference to associated EEG changes, one case being reported in detail. In 13 cases the EEG was abnormal, the abnormality most frequently observed being a of the rhythmic slow wave type, consisting of bursts of monorhythmic theta or delta waves seen in both hemispheres. This type of abnormality was present in 7 cases. In 4 of the 5 cases with serial EEG's the abnormality became more accentuated with the advance of the illness. In 4 of 5 cases in whom postoperative EEGs were obtained there was significant improvement of the EEG after the shunting procedure. There were stron correlations between the EEG abnormality described, demonstrable ventricular reflux on cisternography, and the effectiveness of the shunt operation. It was considered that serial EEGs are a useful diagnostic procedure in following up patients at risk of developing NPH.

Sphincterotomy and micturition parameters: quantitative analysis of sphincterotomy in 24 patients

The effect of transurethral external sphincterotomy, performed in 24 patients, was evaluated quantitatively on micturition parameters and blood loss. The total urethral resistance, residual urine, and the maximum and average urinary flow rates were all improved with a statistically significant difference (p less than 0.01). Of 7 patients with indwelling catheter, all but one became catheter free. Erythrocytes and hemoglobin decreased 6% in number and 9% in weight, respectively. Moderate degree of stress incontinence were noted in 15 patients (63%).

Crossed ectopia of solitary kidney. A report of two cases and a review of the literature

Two cases of crossed ectopia of solitary kidney found in two boys are present. This rare anomaly has been accompanied by imperforate anus and inguinal hernia in one boy and by imperforate anus, urethrorectal fistula, cryptorchism, and penoscrotal and vertebral anomalies in the other. 21 cases have been collected and the present two patients appear to be the 22nd and 23rd cases reported in the world literature.

Acute renal insufficiency following hydrostatic pressure treatment: comments on technical procedure

A man with a solitary bladder carcinoma suffered acute tubular necrosis following hydrostatic pressure therapy. The nephrotoxicity caused by antibiotics and/or the septicemic shock seems to be responsible. The animal experiment suggested changes in the technique: 1) the bladder should be overdistended via a Foley catheter with a rubber ballon at the tip to prevent a possible postoperative complication and 2) one should try to decrease rather than maintain the high intravesical pressure during overdistension to avoid bladder wall rupture. The overstretching of a blood vessel alone is quite sufficient to bring the anoxia upon the bladder tumor, which is verfied by the biophysical principle.