[Indication for surgery of pediatric testicular and funicular hydroceles in view of natural course]

PURPOSE

The purpose of this study is to confirm the definite indication for surgery of pediatric testicular and funicular hydroceles in view of natural course.

METHODS

During the period from 1978 to 1994, we encountered 160 hydroceles in 149 pediatric patients. Patients ages ranged from 5 days after birth to 13 years and the mean follow-up periods was 4.7 years. We investigated the indication for surgery of pediatric hydroceles in six points of view: value of an aspiration of hydroceles, of what testicular or funicular or both, communication, size, age and testicular development.

RESULTS

Nevertheless, of 160 hydroceles, 66 (41%) were performed an aspiration of hydroceles, the aspiration of hydrocele was ineffective in the majority of patients. Common hydroceles in neonates and infants required no specific treatment, as the majority of hydrocele resolve spontaneously, however surgical treatment was required for a communicating large hydrocele that had been often attacked by aspiration and appeared at older age. Funicular hydroceles were more difficult to spontaneous healing. Ipsilateral testis manifests a well-developed comparing control material.

CONCLUSION

The indication for surgery of pediatric hydroceles were as follows: 1) hydroceles complicated by a inguinal hernia or cryptorchidism, 2) hydroceles appeared at older age and not resolved during 2-3 years over, 3) giant communicating funicular and testicular hydroceles present with an/hindrance for daily life.

Inhibition by iota-carrageenan of the spread of murine cytomegalovirus from the peritoneal cavity to the blood plasma

The mechanism of iota-carrageenan (i-CAR)-induced protection against murine cytomegalovirus (MCMV) infection of mice was analysed. The virus titres in the target organs on the fourth day correlated with that in the plasma at 1 h after intraperitoneal inoculation of MCMV, irrespective of i-CAR treatment. Pretreatment of mice with i-CAR induced infiltration of polymorphonuclear neutrophils into the peritoneal cavity and inhibition of viral spread from the peritoneal cavity to the plasma. Although the direct relationship of these two phenomena was unclear, the inhibition by i-CAR of viral spread resulted in protection against MCMV infection of mice.

[A case of intracranial malignant melanoma with increased uptake of IMP in SPECT]

A patient with intracranial malignant melanoma was assessed by 123I-IMP SPECT. Early image, performed 30 minutes after intravenous injection of 111 MBq 123I-IMP, demonstrated an accumulation similar to normal gray matter-defect. Delayed image, performed 4-hour after injection, demonstrated increased accumulation of 123I-IMP. 123I-IMP SPECT, especially delayed scan, was valuable for qualitative diagnosis of intracranial malignant melanoma.

Protective effect of MDP-Lys(L18), a synthetic derivative of muramyldipeptide, on murine cytomegalovirus infection

The host-mediated antiviral effect of N alpha-(N-acetylmuramyl-L-alanyl-D-isoglutaminyl)-N epsilon-stearoyl-L-lysine [MDP-Lys(L18)] was evaluated in mice against murine cytomegalovirus (MCMV) infection. Mice treated with 800 micrograms of MDP-Lys(L18) on day 2 before the virus challenge survived systemic lethal infection. The protective effect of MDP-Lys(L18) was evidenced by an increase in plaque-forming units per LD50 and a decrease in virus titers in the target organs. No significant difference in the serum interferon level and 2',5'-oligoadenylate synthetase activity was observed among the mice treated with test compounds or phosphate-buffered saline, thought they were higher in MCMV-infected mice than in mock-infected mice. The natural killer (NK) activity was augmented remarkably in the mice treated with MDP-Lys(L18) or its original component, muramyldipeptide (MDP). MDP-Lys(L18) showed neither virocidal nor virostatic activity on MCMV in vitro. Thus, MDP-Lys(L18)-induced resistance against MCMV infection seems to be host-mediated. The MDP-Lys(L18)-induced resistance was not abrogated by the treatment with anti-asialo GM1 serum. The NK activity augmented by MDP-Lys(L18) may contribute to some part of the protective effect, though the augmentation of the NK activity alone did not correlate completely with the protective effect of MDP-Lys(L18). In addition, no difference was observed in anti-MCMV activity among peritoneal exudate cells from mice treated with MDP-Lys(L18), MDP or phosphate-buffered saline. Therefore, another host-mediated factor(s) may also participate in the antiviral effect of MDP-Lys(L18).

Bilateral pararenal lymphatic cysts associated with hypertension

A case of bilateral pararenal lymphatic cysts is reported. These cysts surrounded the renal parenchyma in a multilobulated fashion and were contained in the intracapsular space. The lymphangiography showed the communication between cysts and lymphatic channels. Histopathological findings suggested the possible nature of this lesion to be congenital lymphatic anomalies.

47,XXY/48,XXY,+21 chromosomal mosaicism presenting as hypospadias with scrotal transposition

The syndrome of 47,XXY/48,XXY,+21 chromosomal mosaicism, double aneuploidy, is extremely rare and characterized by combined manifestations of Klinefelter's and Down's syndromes. We report a case of XXY/XXY,+21 mosaicism presenting with hypospadias associated with scrotal transposition.