Diclofenac sodium and spasmolytic drugs in the treatment of ureteral colic: a comparative study

Forty-nine patients with ureteral colic were included in this prospective double-blind study investigating the analgesic efficacy and side effects of a prostaglandin synthetase inhibitor Diclofenac sodium (Voltaren) versus a spasmolytic drug Tropenzilium bromide (Palerol). The analgesic efficacy and side effects of the calcium antagonist Nifedipine (Nidilat) applied sublingually in ureteral colic were also investigated. It was concluded that diclofenac sodium was more efficient for relieving pain due to acute ureteral obstruction and had fewer side effects than spasmolytic drugs. Nifedipine proved to have an analgesic effect equivalent to that of Tropenzilium bromide.

Immunohistochemical detection of beta-human chorionic gonadotropin in urothelial carcinoma

Histologic sections from the specimens of 60 patients with urothelial carcinoma were stained immunohistochemically to search for beta-human chorionic gonadotropin (B-HCG) production. There were 6 doubtful, 5 weak and 1 strong positive B-HCG stainings among 65 sections from 60 patients. De novo acquisition of B-HCG production capability of tumour cells seemed to be predictive for early haematogenous dissemination of the disease, but the data obtained in this particular study were insufficient to suggest B-HCG as a routine prognostic marker.

Raveron versus placebo in the conservative treatment of benign prostatic hyperplasia (BPH)

Thirty patients with BPH were randomized into two groups to receive Raveron and placebo for 6 weeks. The subjective and objective signs associated with BPH were evaluated before and after treatment. There was no significant difference between the effects of Raveron and placebo.

Histopathological changes in adult cryptorchid testes

The histological specimens of 73 patients who presented with undescended testes after puberty were re-evaluated. None of the specimens revealed carcinoma in situ but in the specimens of 5 patients severe atypia was detected. None of the patients, including 5 with severe atypia, has shown any evidence of invasive testicular tumour during follow-up.

Significance of scrotal violation in the prognosis of patients with testicular tumours

Thirty-five patients with testicular cancer who had scrotal contamination during or prior to their primary treatment were compared with 70 patients who had undergone radical inguinal orchiectomy. The survival curves, disease-free intervals and 2-year survival rates of the two groups did not differ significantly and we do not advocate additional aggressive surgical treatment to the scrotum and superficial inguinal lymph nodes in these patients.

Primary carcinoma of the renal pelvis and ureter. A collective review

During an 18-year period, 17 patients with renal pelvic and 8 with ureteral carcinoma were seen in our clinic. The lesion was transitional cell carcinoma in 23 patients, and epidermoid and anaplastic carcinoma, respectively, in 2 others. Because of frequent tumour recurrence in the lower tract, we recommend total nephroureterectomy including a cuff of the bladder as the treatment of choice for renal pelvic neoplasms. For ureteral tumours, less aggressive and conservative procedures can be considered.

[Fournier's gangrene: report of 6 cases]

6 patients with Fournier's gangrene a rare but life threatening disease, who were successfully managed are presented. Mortality rates between 17-45 percent have been reported for this disease, but through the use of broad-spectrum antibiotics, aggressive surgical debridement and when possible with multiple drainage incisions to avoid skin defects, the mortality rate has been reduced to 0 percent. We have found an association with diabetes mellitus in 2 cases, which is one of the serious predisposition factors and should not be forgotten.

Tissue alpha-fetoprotein and human chorionic gonadotrophin in non-seminomatous testicular tumours. A comparative study with serum levels

The correlation between tissue localisation and serum levels of alpha-fetoprotein (AFP) and human chorionic gonadotrophin (HCG) was studied in 20 tissue samples from 18 patients with non-seminomatous testicular tumours. Specific immunoperoxidase stains were used for tissue staining and serum measurements were made by radioimmunoassay. There was a close correlation between the tissue demonstration of AFP and HCG and elevated levels of serum markers. The cellular localisations of AFP and HCG were different and no cell stained concomitantly for both AFP and HCG. From these results and from the demonstration of tumour markers in the tissue of some patients with normal serum marker levels, it was concluded that immunocytochemical localisation of the tumour markers was more sensitive than serum measurements.

Association between HLA antigens and bladder tumors

HLA antigen type was studied in 55 patients with transitional cell carcinoma of the bladder. The results showed high HLA-B5 and low HLA-BW35 frequencies. Histological grade, stage, and recurrence rate of tumors were also evaluated separately. The results were more significant in recurrent tumors.

Prognostic factors in superficial bladder cancer

A retrospective analysis of 91 patients with superficial transitional cell carcinoma (stages Ta and T1) is reported. In all of the patients transurethral resection was the treatment of choice. With the recurrence rate as the primary endpoint of interest it appeared that the number of tumours at presentation, invasion of the lamina propria, and histological grade were to be of prognostic importance. The frequency of tumour progression in our group was found to be 10 per cent. All of the patients who developed muscle invasion had lamina propria invasion at presentation.

Fracture of the penis and long-term results of surgical treatment

Twenty-five patients with fracture of the penis were treated surgically between 1968 and 1984. Long-term follow-up was obtained in 17. In no case were there any early post-operative complications. All patients stated that they were achieving normal, painless erections; two patients developed a slight penile curvature but this did not affect their sexual activities. We strongly recommend early surgical intervention because of these encouraging results. Urethral injury associated with the fracture did not occur in this series.

The role of delay in stage III testicular tumours

Twenty-nine patients with stage III testicular tumours seen between 1979 and 1984 were analysed for the relation between delay in both diagnosis and chemotherapy, and prognosis. The complete response (CR) rate was 40% for patients who were treated within 6 months from onset of symptoms, and 26.3% for patients who had an interval longer than 6 months. We believe that delay in diagnosis and chemotherapy may affect the response to treatment. Health education of the male population for self-examination of the testes is an important factor to minimize this delay.

Incidental carcinoma of the prostate: factors influencing prognosis

Thirty-four patients with TO carcinoma of the prostate were reviewed in an attempt to correlate their clinical progress with the histopathological features of the tumour at presentation. Two different grading systems were used. It was found that no matter which system was used, the poorer the histopathological grade the poorer the prognosis.

The role of delay in stage-III testicular tumors

Twenty-eight patients with stage-III testicular tumors seen between 1979 and 1984 were analyzed for the effect of delay on diagnosis and chemotherapy and prognosis. A statistically significant relation was determined between the symptom-diagnosis interval and extent of the disease. The complete response (CR) rate was 67% for patients treated within 6 months of symptoms, on the contrary only 16% of patients with interval longer than 6 months to treatment had CR (p less than 0.05). We believe that delay in diagnosis and chemotherapy may affect the response to treatment. Health education of the male population for self-examination of the testes is an important factor for minimizing this delay.

Haemoglobin F levels in patients with testicular tumours

This study was designed to examine haemoglobin F levels prior to therapy in 39 patients with testicular tumours (10 seminoma, 29 non-seminomatous tumours) and 20 controls. HbF levels were significantly increased in the group with testicular tumours (1.66 +/- 0.12%) compared with normal controls (0.99 +/- 0.08%) (P less than 0.001). Non-seminomatous tumours had more pronounced levels than seminomas (P less than 0.001). No correlation was found between HbF level and stage of the disease. We suggest that HbF production could be significantly reactivated in adult patients with testicular tumours and may be a useful marker.

The advantages of bilateral simultaneous stone removal from the upper urinary tract

An anterior transperitoneal approach was used to remove the stones from both kidneys and/or ureters simultaneously in 18 patients. The morbidity of this type of surgery in our study was very low and there were no surgical difficulties in exposing the intrarenal structures. Furthermore, especially in secondary cases, this approach was easier and more time-saving than the classical flank approach. We recommend its use at least in selected groups of patients in whom peritoneal gross contamination is not expected.

Surgical management of vesicoureteral reflux in children

The authors report on ten years of experience in ureteroneocystostomies on 80 ureters in 50 children suffering from vesicoureteral reflux. Complete follow-up was obtained in all cases. Postoperative radiograms revealed cure of reflux in 85 per cent of the renal units. A slightly modified Politano-Leadbetter procedure was used in all of the cases. Postoperative urinary tract infection occurred in 13 patients. This relatively low success rate is discussed briefly.

Biopsy of apparently normal bladder mucosa in patients with bladder carcinoma and its prognostic importance

A total of 100 cold cup biopsies were obtained from apparently normal vesical mucosa of 25 patients admitted to Hacettepe University Hospital between 1980 and 1981. Dysplasia was found to occur in 40.49, hyperplasia in 17.35, squamous metaplasia in 9.91 per cent. Dysplasia was shown to be increasing parallel with the increase in the grade and stage of the tumour. The frequency of dysplasia and hyperplasia in the recurrent and non-recurrent groups differed significantly (p less than 0.001). In other words, recurrence was seen more frequently in patients with positive random biopsies. Although recurrence phenomena cannot be explained on the basis of mucosal abnormalities alone, this study shows that these subendoscopic lesions do have some prognostic role in recurrences.

Effects of diethylstilbestrol diphosphate on serum and tissue ribonuclease levels in prostatic carcinoma

Thirty-six patients with prostatic carcinoma and benign prostatic hyperplasia (BPH) were studied. Transurethral resection (TUR) was performed in all, and serum and tissue ribonuclease (RNase) levels were determined with the spectrophotometric method using yeast RNA as the substrate. In patients with untreated prostatic carcinoma, statistically significant increased RNase levels were found in serum and tissue. Treatment with diethylstilbestrol diphosphate (DESDP) led to a decrease in RNase levels. In the same patients RNase serum levels after DESDP treatments also showed a parallel decrease with serum prostatic acid phosphatase (sPAP) levels. We have concluded that the serum RNase measurement may be useful for TNM classification and immunostaging.

Herpes simplex type 2 neutralization antibodies in patients with cancers of urinary bladder, prostate, and cervix

In the blood samples obtained from a total of 68 patients with cancers of the urinary bladder, prostate, and cervix, who applied to the Departments of Urology, Obstetrics, and Gynecology of Hacettepe Medical Faculty, neutralizing antibodies were sought for against herpes simplex type 2 by neutralization test. The same test was applied to 35 control patients with no known malignancies. In contrast to the presence of the antibody in 62.86% of the control subjects, this ratio was 90.70% in patients with cancer of the urinary bladder, 87.50% in those with prostatic carcinoma, and 88.89% in those with cancer of the cervix.

Tissue acid and alkaline phosphatase in prostatic carcinoma

Twenty-eight patients admitted with infravesical obstruction symptoms were studied. Fourteen of these patients were suffering from prostatic carcinoma defined as inoperable. The remaining 14 patients were diagnosed as benign prostatic hyperplasia (BPH) and transurethral resection (TUR) was performed to all of them. Specimens obtained by TUR were used to analyze tissue activities of total and tartarate labil acid phosphatase, and alkaline phosphatase. Enzymatic levels in the tissue were estimated by using fluorimetric method (FU/mg). The estimated averages seemed to vary in favor of the malignant tissue, however this variation was not found to be statistically significant. Different inhibition levels were observed in benign and malignant tissue with the addition of L(+) tartarate. The average levels of the alkaline phosphatase were found to be lower than those of acid phosphatase, but the former showed no difference between the malignant and benign groups.