Bazex syndrome: acrokeratosis paraneoplastica in association with simultaneous multiple genitourinary tumors

We report a patient with Bazex (Bazex-Dupre-Christol) syndrome in association with multifocal basal cell carcinoma, epidermoid carcinoma of the lung, adenocarcinoma of the prostate, and possibly undifferentiated carcinoma of the bladder. To our knowledge, this is the first report of a patient with Bazex syndrome that consisted of four tumors, including two genitourinary tumors.

Micro-spoon technique in estimation of sperm concentration in rat epididymis

Several technical procedures were described for estimation of epididymal sperm concentration until today. In all of the described techniques, epididymal material was drawn into a micro-pipette before counting procedure. We aimed to proceed this stage without using any pipette because of the difficulty in aspirating very viscous epididymal material into a micro-pipette. For measuring epididymal material we used a 2 microl reservoir which we named as a micro-spoon. It was filled with the epididymal material and layered in a tube with Ringer's solution of 2 ml containing sodium hyaluronate. Then, it was mixed in order to obtain 1/1000 diluted suspension. Sperm cells in this suspension were counted on a Makler chamber under a light microscope. The procedure was easy and time saving, compared to the other techniques.

Synthesis and analgesic activities of 2-substituted-1H-phenantro [9,10-d] imidazoles

Some 2-substituted-1H-phenantro [9, 10-d] imidazole compounds were synthesized and their analgesic activities were determined on the Swiss albino mice (25-35 g) of either sex. In the synthesis, phenantre-nequinone molecule was reacted with different aldehyde derivatives in acetic acid presence of ammonium acetate and finally 16 compounds were gained. All spectral and elemental analyses of the original compounds were completed and their structures were elucidated. Analgesic activity of the compounds were examined by using the Tail-Clip method. 2-Phenyl-1H-phenantro [9, 10-d] imidazole (comp.1) and 2-(4-chlorophenyl)-1H-phenantro [9, 10-d] imidazole (comp. 6) were found to be more active than the others and their LD50 values were found to be greater than 100 mg/kg (i.p.).

Can LDH activity in spermatic vein indicate testicular damage? A preliminary report

We aimed to investigate the relationship between varicocele and lactic dehydrogenase (LDH), an intracellular enzyme that indicates cellular damage. LDH levels were measured in the blood samples of 17 oligoasthenospermic infertile patients with varicocele which were obtained synchronously from spermatic and peripheral veins during operation. Sperm counts ranged from 1 to 74 million/ml, while motility ranged from 10% to 60%. LDH level in spermatic vein was found statistically higher than the level in peripheral vein (p = 0.042). There was no correlation between sperm counts and LDH level in spermatic vein. We found a significant increase in spermatic vein LDH level in varicocele. We think that further studies are needed to reveal the relationship between spermatic vein LDH level and varicocele.

Analgesic activity of Nepeta italica L

A screening study was performed on/by essential oils of Nepeta viscida Boiss and Nepeta italica L. using tail-flick and tail immersion (52.5 degrees C) methods. N. italica samples were collected from three different localities of Turkey. Surprisingly, only one of the essential oils showed significant activity, which was blocked by naloxone, indicating the involvement of opioid receptors. This was seen only with the mechanical but not the thermal algesic stimulus, suggesting a specific activity on opioid receptors, excluding mu receptors. The same, active essential oil also exhibited a non-competitive inhibition of acetylcholine contractions of isolated rat ileum but it was inactive on the isolated rat aorta. Furthermore, a correlation between the analgesic activity and the amount of 1,8-cineole was noticed.

Evaluation of 42 patients with chronic abacterial prostatitis: are there any underlying correctable pathologies?

Forty-two young men with abacterial prostatitis underwent physical examination, semen analyses, rectal US (TRUS) and magnetic resonance imaging (MRI) of the pelvis. Findings on TRUS showed no distinct differences like capsular irregularity, dilatation of the seminal vesicles and calcified foci in the prostate. In MRI pathologic conditions were noted as transitional zone cysts, prostatic utricle cysts and abscesses of the seminal vesicles. MRI had been found superior to TRUS in imaging the prostate and to predict associated pathologic conditions. It is also concluded that some additional factors as a cause of prostatitis must be determined in patients with chronic abacterial prostatitis.

The effects of hyperbaric oxygen on normal and ischemic colon anastomoses

BACKGROUND

Leakage from colonic anastomoses is a major complication causing increased mortality and morbidity, and ischemia is a well-known cause of this event. Inadequate tissue oxygenation could be reversed by using hyperbaric oxygen. This study was designed to investigate the effects of hyperbaric oxygen on the healing of ischemic and normal colon anastomoses in the rat model.

METHODS

Standardized left colon resection 3 cm above the peritoneal reflection and colonic anastomosis were performed in 40 Wistar rats divided into four groups. The control group (I) received no further treatment. To mimic ischemia, 2 cm mesocolon was ligated on either site of the anastomosis in group II and IV rats. Hyperbaric oxygen therapy was started immediately after surgery in group III and IV rats (therapeutic groups). All animals were sacrificed on the fourth postoperative day. After careful relaparotomy, in situ bursting pressure was measured. The hydroxyproline contents of the anastomotic segments in equal length were determined.

RESULTS

The hydroxyproline assay revealed that rats in group II with ischemic colonic anastomosis have significantly lower levels (P <0.05). The highest levels are in the group III rats with normal colonic anastomosis treated by hyperbaric oxygen (P <0.05). There was no significant difference in hydroxyproline levels between group II and group IV animals (P >0.05). Group III animals had significantly higher bursting pressures than any other group (P <0.05). Group II rats had lowest bursting pressures (P <0.05). Group IV animals had significantly higher levels than group II (P <0.05). Mean bursting pressure values both in groups III and IV and hydroxyproline levels in group III were significantly increased by hyperbaric oxygen therapy (P <0.05).

CONCLUSIONS

Ischemia impairs anastomotic healing. Hyperbaric oxygen increases anastomotic healing of both normal and ischemic colonic anastomosis and reverses ischemic damage. This study demonstrated that hyperbaric oxygen improves anastomotic healing.

The role of power Doppler ultrasonography in the diagnosis of prostate cancer: a preliminary study

OBJECTIVE

To determine the role of transrectal power Doppler ultrasonography (PDU) in the diagnosis of prostate cancer.

PATIENTS AND METHODS

Thirty-six patients (mean age 66.4 years, SD 7.7, range 59-82) with possible prostate cancer, suspected from an abnormal digital rectal examination or elevated prostate specific antigen level, underwent transrectal ultrasonography, transrectal PDU and biopsy. The vascularity on PDU was graded on a scale of 0-2, where grade 1-2 was considered positive and grade 0 negative.

RESULTS

The vascularity was grade 2 in 11 patients, grade 1 in 11 and grade 0 in 14; 20 of the 36 (56%) patients had prostate cancer. Of the 22 patients positive on PDU, 18 had malignant disease and four benign; two of 20 patients with histopathologically confirmed malignancy had a normal PDU. The sensitivity of PDU was 90%, the specificity 75% and the positive predictive value 82%.

CONCLUSION

Focal hypervascularity on PDU was associated with an increased likelihood of prostate cancer. Although ultrasonography alone cannot detect all cancers, even using PDU, the technique appears to increase the sensitivity and to help identify appropriate sites for biopsy.

Primary non-mucinous, non-papillary adenocarcinoma of the ureter

We report a case of primary, non-mucinous, non-papillary ureteral poorly differentiated adenocarcinoma. The primary focus could only be detected during surgical exploration, because computed tomography (CT), ultrasonography (US), intravenous urography (IVU) and other radiologic and endoscopic procedures revealed no primary neoplastic focus, only lymph node and various bone metastases. Total nephroureterectomy with a bladder cuff was performed to decrease pain of the patient and to remove the primary tumoral focus.

Utilising an ileal segment in the posterior urethral replacement procedures using anal sphincter to provide continence in dogs

We aimed to replace an ileal segment in the place of posterior urethra using the anal sphincter as a continence mechanism. The experiment was carried on three male street dogs. In the first stage, only urethral replacement with an ileal segment was done and pulled through the anal sphincter in a male dog to see if anal sphincter would do any help for continence. A protruding stoma was created on the perineum. Perineal end of the ileal segment was sutured to the bulbous urethra in the other two male dogs to provide urethral patency in the second step of the operation. The dog in which the first operation was made gained continence on the 12th postoperative day. The other two male dogs, in which ileourethral anastomosis were made, became continent on the postoperative 12th and 15th days. No residual urine was found by catheterisation performed after urination. In controls, neither the stoma nor the anastomosis sites developed stenosis. This procedure may be applied in patients with complete incontinence who can not be corrected by any other surgical procedures, and a very good cosmetic result may be obtained.

Nepetalactone: a new opioid analgesic from Nepeta caesarea Boiss

The essential oils of Nepeta species including Nepeta phyllochlamys P. H. Davis, N. nuda L. ssp. nuda, and N. caesarea Boiss. have been screened by use of the tail-flick and tail immersion (52.5 degrees C) methods. Of the species studied, only N. caesarea showed significant analgesic activity, besides marked sedation, which was also blocked by naloxone, indicating involvement of opioid receptors. Moreover, it was only active on mechanical, not thermal, algesic response which suggests specificity for specific opioid receptor subtypes, excluding mu-opioid receptors. Because 4a alpha,7alpha,7a alpha-nepetalactone is the main component of the essential oil of N. caesarea, and is present at very high levels (92-95%), it is concluded that 4a alpha,7alpha,7a alpha-nepetalactone is the active principle and has a specific opioid receptor subtype agonistic activity.

Regression of left ventricular hypertrophy in haemodialysis patients by ultrafiltration and reduced salt intake without antihypertensive drugs

BACKGROUND

Left ventricular hypertrophy (LVH) is very frequent in haemodialysis patients. Only few investigations have reported its regression, and only by the use of antihypertensive drugs. Because volume load is at least as important as pressure load, we investigated whether persistent strict volume control by ultrafiltration alone may be effective in improving LVH METHODS: Using blood pressure (BP) and cardiac dimensions as a guide, we treated all hypertensive patients in our dialysis unit during the 3 times weekly dialysis sessions for 4 h per session with as much ultrafiltration as they could stand. If they gained too much weight an extra isolated ultrafiltration (UF) session was applied. Special attention was given to dietary salt restriction. The study group of all 15 patients in whom echocardiographic assessment had been made at least 1.5 years previously was selected retrospectively, and we acknowledge that important confounding factors might not have been controlled for. Cardiothoracic index (CTI) was estimated on the chest X-ray. Diameters of left atrium (LA), left ventricle systolic (LVS) and diastolic (LVD), interventricular septum (IVS), posterior wall (PW), and left ventricular mass index (LVMI) were estimated by standard echocardiographic methods.

RESULTS

Mean arterial pressure of the study group had been lowered by UF before the first echocardiogram from predialysis 136+/-11 to 101+/-14 and from postdialysis 119+/-8 to 92+/-12 mmHg. During a mean follow-up period of 37+/-11 months LVMI decreased from 175+/-60 to 105+/-11 g/m2. CTI decreased further from 48+/-3 to 43+/-4%, while significant decreases of LA (22.5+/-3 to 19.9+/-4 mm/m2), LVS (18.7+/-4 to 15.9+/-3 mm/m2) and LVD (28.3+/-4 to 24.0+/-3 mm/m2) were seen in all patients. There also was a further decrease in both pre- and postdialysis BP to 116+/-12/73+/-7 and 105+/-7/65+/-3 mmHg respectively.

CONCLUSION

The results of this uncontrolled retrospective study suggest that good long-term BP control and a decrease of LVM can be achieved by continuous efforts to control hypervolaemia. The decrease in volume may be even more important than pressure reduction to achieve this goal.

New drainage technique in the ureteropelvic junction obstructions. Side-to-side ureterocalicostomy (or ureterocaliceal by-pass) preserving renal pelvis and ureteropelvic junction

We present a new ureterocalicostomy technique in a patient with intrarenal pelvis together with renal artery compression on the pelvis and ureteropelvic junction (UPJ). The patient had grade 4 hydronephrosis in the left kidney and angulation at the ureteropelvic junction. We performed side-to-side ureterocalicostomy between the ureter and lower calyx of the kidney.

Experimental testicular torsion and its effects on the contralateral testicle

OBJECTIVE

Following experimental unilateral torsion of the testis the histologic effects of unilateral testicular torsion on the contralateral testis were investigated.

MATERIALS AND METHODS

Utilizing detorsion or orchiectomy at 4 hours and 8 hours after torsion, the effects of early and late treatment modalities on the contralateral testicle were observed.

RESULTS

Morphometry of the contralateral testis revealed some alterations including focal sclerosis, decrease in mean seminiferous tubular diameter and a marked increase of the Leydig cells in some subgroups.

CONCLUSION

In spite of some changes, definite evidence for contralateral damage due to ipsilateral torsion contributing to male infertility was hardly observed.

Disappearance of mitral and tricuspid regurgitation in haemodialysis patients after ultrafiltration

BACKGROUND

Doppler echocardiography has recently revealed frequent occurrence of valvular (in particular mitral) regurgitation in dialysis (HD) patients. We hypothesized that this may be in part 'functional' and related to the cardiac dilatation which is also frequently present. Thus it would be possible to improve it by ultrafiltration.

METHODS

Mitral and tricuspid regurgitation was detected in 21 haemodialysis patients who had cardiomegaly but no manifest cardiac failure. They were treated by intensified ultrafiltration sessions, as much as they could tolerate, while all antihypertensive drugs were stopped. Doppler echocardiograms were then repeated.

RESULTS

Mitral regurgitation disappeared in 13 and tricuspid regurgitation in 14 patients, while lesser degrees of either of them persisted in seven. This was accompanied by decreases of body weight (5.4 +/- 2.7 kg) mean arterial pressure (125 +/- 15 to 95 +/- 11 mmHg), cardiothoracic index (from 0.57 to 0.47), and left atrial (28 +/- 4 to 22 +/- 3 mm/m2), left ventricular systolic (25 +/- 5 to 21 +/- 55 mm/m2) and left ventricular diastolic (31 +/- 5 to 27 +/- 5 mm/m2), and mitral annular diameters (19.4 +/- 2 to 16.6 +/- 2 mm/m2). Ejection fraction increased but remained below 50% in 11 patients.

CONCLUSION

Most of the mitral and tricuspid regurgitations seen in HD patients are partly or completely functional, due to dilatation of the mitral annulus which is related to volume overload. A more aggressive approach, while discontinuing antihypertensive drugs can correct or improve many of them and also ameliorate cardiac function.

Testicular needle biopsy: is it a safe and adequate method?

We aimed to investigate if testicular needle biopsy is adequate and safe for the examination of testis. Needle biopsies were performed on 21 testes of 5 patients with advanced prostate cancer and 11 patients with cryptorchidism before orchiectomy. Biopsies were done with the prostatic tru-cut needle. After needle biopsy, the tract and puncture sites were explored and an incisional biopsy was performed on each testis. Both needle specimens and open biopsy specimens were fixed in Bouin's solution and sent for histologic examination. There were small haematomas in two testes and moderate haemorrhage between tunica vaginalis layers in another. The tissues obtained by needle biopsy were sufficient except for two specimens and diagnostic accuracy was perfect. Nevertheless, measurement of the seminiferous tubules of the lamina propria could not be achieved in many cases.

Fibroepithelial polyp of the ureter associated with an adjacent ureteral calculus

Ureteral fibroepithelial polyps are rare benign tumours. Sometimes an ureteric calculus may be seen, proximal to the polyp. We describe a case of fibroepithelial polyp (FEP) associated with a calculus in the distal part of the right ureter. To our knowledge this is the first ureteral FEP reported in the literature associated with a ureteral calculus distal to it. Aetiology, clinical features, diagnosis and therapy of fibroepithelial polyps are discussed in the light of the literature.

Eighteen-month follow-up of cystovaginoplasty: a new augmentation operation for repair of vesicovaginal fistulae

We present an 18-month follow-up of a cystovaginoplasty case. Surgery was performed because of a large vesicovaginal fistula. A new technique using the vagina as a pouch was utilized.

Undescended testes in adults: clinical significance of resistive index values of the testicular artery measured by Doppler ultrasound as a predictor of testicular histology

PURPOSE

We evaluated the clinical significance of arterial impedance as a predictor of testicular histology in adults with undescended (inguinal) testes.

MATERIALS AND METHODS

We performed arterial impedance and testicular diameter measurements with the use of color Doppler ultrasonography on 22 adults with undescended testes. Arterial impedance of the contralateral descended testes served as controls. All patients later underwent inguinal orchiectomy and the testes were examined histologically.

RESULTS

Of the 22 undescended testes, 7 had arterial impedance values below 0.50, and the other 15 had values equal to or above 0.50. All testes with arterial impedance values below 0.50 had histologic scores between 2 and 3, whereas the others had scores of 3 and 8. Arterial impedance values and testicular volumes in the contralateral testes were significantly higher than the undescended testes. Although some of the testes with arterial impedance values above 0.50 had histologic score 3, testes with arterial impedance values below 0.50 never exceeded score 3. Volume differences of the undescended testes were not statistically significant.

CONCLUSIONS

Arterial impedance of an undescended testis may have a predictive value and provide more accurate information about its histology than the volume measurement itself.

Acupuncture and hypnotic suggestions in the treatment of non-organic male sexual dysfunction

We have examined the effects of acupuncture and hypnotic suggestions, and compared them with placebo in the treatment of male sexual dysfunction with no detectable organic cause. The study comprised 15 men (mean age 36.7 +/- 10.43 years) who received acupuncture treatment, 16 men (mean age 38.4 +/- 10.75 years) who underwent hypnosis (mean age 35.3 +/- 11.52 years) and 29 men (mean age 36.2 +/- 11.38 years) who served as controls. They were interviewed periodically; the patients' reports were verified by interviewing their partners. Men who received placebo had a 43-47% improvement in sexual function, while the rates of improvement in the treated groups were higher, but not significantly so. The success rates of acupuncture and hypnotic suggestions were 60% and 75% respectively. Although the improvement was not statistically significant, treatment with acupuncture could be used as an adjuvant therapy in non-organic male sexual dysfunction. The only treatment superior to placebo seemed to be hypnosis. A more effective treatment may be obtained by combining these therapeutic modalities, but this needs further study.

A further study of seminal plasma: lactate dehydrogenase and lactate dehydrogenase-X activities and diluted semen absorbance

Activities of total lactate dehydrogenase, which plays an important role in providing energy for cell metabolism, lactate dehydrogenase-X, an isoenzyme of lactate dehydrogenase supposed to be specific for germinal epithelium activity, diluted semen absorbance and some other properties have been measured in 51 seminal plasma samples. Aiming to study its clinical use as a marker of seminiferous epithelium activity, determination of isoenzyme-X and investigation of correlation between it and the spermiogram properties were carried out. Besides lactate dehydrogenase and lactate dehydrogenase-X activity, their ratio and diluted semen absorbance were correlated with the different properties of the spermiogram, the best correlation of the enzymes being obtained with the total sperm count and motile sperm count. Correlation of diluted semen absorbance with the total sperm count and motile sperm count was also noted, whereas it did not correlate with sperm concentration and motility rate. The data suggests the clinical utility of these properties as reliable markers for both germinal activity and spermatozoid quality when "total sperm count" and "mobile sperm count" are used to define sperm properties instead of just sperm concentration and motility rate.

Peroxidative damage in sickle-cell erythrocyte ghosts: protective effect of allopurinol

1. Malondialdehyde (MDA) levels of erythrocyte membranes of sickle-cell disease patients were measured as an indicator of peroxidative damage and allopurinol was used as a lipid peroxide scavenger. 2. Incubating sickle-cell erythrocytes with allopurinol significantly reduced MDA levels of erythrocyte membranes compared with before-treatment values. 3. Allopurinol seems to reduce the peroxidative damage in sickle-cell erythrocytes, but the mechanism is still unknown.

Assessment of testicular cytology by fine-needle aspiration and the imprint technique: are they reliable diagnostic modalities?

OBJECTIVE

To investigate whether testicular cytology may be considered diagnostic in the evaluation of infertile men.

PATIENTS AND METHODS

Specimens of testicular tissue obtained either surgically (imprint smear) or through fine-needle aspiration (FNA) were used as a source of cytological smears; 58 testes from 24 men with azoospermia or severe oligospermia and from five men with advanced prostate cancer were evaluated cytologically and compared with the histological diagnosis.

RESULTS

FNA caused no apparent trauma. The results from FNA smears generally agreed with the histological findings but four patients with no spermatozoa in the FNA smears were diagnosed histologically as hypospermatogenic and two others judged histologically as having Sertoli-cell-only (SCO) syndrome and spermatogenic arrest had detectable spermatozoa in their FNA smears. There was complete agreement between the results of imprint smears and histological findings in those patients with SCO syndrome and spermatogenic arrest. There were no evident differences in sperm counts between hypospermatogenesis and normal spermatogenesis on the imprint slides, but FNA smears detected this difference.

CONCLUSION

FNA of the testis is a relatively non-invasive and reproducible technique for evaluating qualitative and quantitative cytology. However, it is insufficient for diagnosing some testicular pathologies. Imprint smears supplement the histological diagnosis, especially if the histological slides are stained unsatisfactorily.

Calmodulin content and in vitro contractility of duodenum from streptozotocin-induced diabetic rats: effects of insulin therapy and calmodulin antagonism

The effects of experimental diabetes and insulin treatment on the decreased reactivity of isolated rat duodenum to KCl and calmidazolium, a specific calmodulin antagonist, were examined. After 8 weeks of streptozotocin diabetes, the contractile effect of KCl and the non-competitive antagonistic effect of calmidazolium against KCl on isolated rat duodenum were decreased. Calmodulin levels, as measured by radioimmunoassay, were also found to the decreased in duodenum from streptozotocin-diabetic rats. Neither impaired reactivity to KCl nor decreased calmodulin levels in diabetic rat duodenum were corrected by treatment with insulin (10 IU/kg for 20 days). Following insulin treatment, there was only a partial correction in the antagonistic effect of calmidazolium as shown by the increase in non-competitive antagonist affinity constant.

The efficacy of fluoxetine in the treatment of premature ejaculation: a double-blind placebo controlled study

PURPOSE

The efficacy of the selective serotonin re-uptake inhibitor fluoxetine in the treatment of premature ejaculation was examined.

MATERIALS AND METHODS

The study comprised 17 patients with premature ejaculation who presented to the urology clinic of our medical school. In this double-blind study the patients were randomized into treatment groups receiving 20 mg. fluoxetine daily for 1 week and 40 mg. daily afterward (group 1) or 1 capsule placebo daily for 1 week and 2 capsules daily afterward (group 2). The groups were evaluated according to the latent period of intravaginal ejaculation.

RESULTS

The latent period of intravaginal ejaculation in group 1 was significantly longer than that in group 2. Nausea, headache and insomnia were reported side effects.

CONCLUSIONS

Fluoxetine may be regarded as a safe and effective alternative in the treatment of premature ejaculation.

Lipoprotein levels in patients with pregnancy induced hypertension

The purpose of this prospective study was to investigate the levels of Lp(a), Apo(a), VLDL, LDL and HDL in 23 patients with pregnancy induced hypertension (PIH) and in 20 control. The Mann-Whitney U tests was used for comparisons between the two groups. Serum Lp(a) and Apo(a) levels were significantly raise in the PIH group (p < 0.05 and p < 0.05 respectively) and no significant correlations could be demonstrated for other lipoproteins.

Syntheses of some 2,3, 6-trisubstituted quinoxaline derivatives and investigation of their antispasmodic activities

Some 2, 3, 6-trisubstituted quinoxaline derivatives were synthesized and their antispasmodic activities were determined on the isolated rat ileum. In the synthesis, some dicarbonyl compounds were reacted with substituted or non-substituted o-phenylenediamines in the presence of acetic acid and gained eighteen compounds. All spectral and elemental analyses of the compounds complete and their structures were elucidated. The pharmacological experiments indicate that the compounds 12,13,18 were most active derivatives and their LD50 values were found to be greater than 100 mg/kg (i.p.).

Efficacy of testosterone, trazodone and hypnotic suggestion in the treatment of non-organic male sexual dysfunction

OBJECTIVE

To examine the effects of hypnotic suggestions or the administration of testosterone or trazodone to impotent men with no detectable organic cause for the impotence.

PATIENTS AND METHODS

The study comprised 79 men in whom clinical and laboratory examinations revealed no organic cause for their impotence: 20 men (mean age 38.7 +/- 11.47 years) received testosterone, 21 men (mean age 39.5 +/- 10.73 years) received trazodone, 20 men (mean age 34.2 +/- 11.69 years) underwent hypnosis and 18 men (mean age 39.1 +/- 11.46 years) served as controls. They were assessed by interview 4, 6 and 8 weeks after starting treatment: the patient's reports were verified by interviewing their partners.

RESULTS

Men who received a placebo had a 39% improvement in sexual function, while the rates of improvement in the treated groups were higher, but not significantly so. The success rates of testosterone and trazodone treatment and hypnotic suggestions were 60%, 67% and 80%, respectively.

CONCLUSION

Although the improvement was not statistically significant, treatment with testosterone and trazodone could be used as an adjuvant therapy in nonorganic male sexual dysfunction. The only treatment superior to placebo seemed to be hypnosis. A more effective treatment may be obtained by combining these therapeutic modalities, but this needs further study.

Effect of insulin treatment on smooth muscle calmodulin levels in rats with long-term streptozotocin-diabetes

Altered responses to several agonists have been reported in various smooth muscles from experimentally-diabetic animals suggesting a defective contractile process of smooth muscle. Recently, decreased smooth muscle calmodulin levels have been reported in streptozotocin-diabetic rats. However, the effectiveness of insulin on the decreased calmodulin levels in diabetic rats has not been questioned. Therefore, the present study was designed to examine the effect of insulin on smooth muscle calmodulin levels from streptozotocin-diabetic rats. Calmodulin levels of the smooth muscle were measured by a radioimmunoassay technique. Streptozotocin diabetes caused a significant decrease in tissue calmodulin levels of smooth muscles. Insulin therapy for 20 days did not correct the changes in calmodulin levels of rat smooth muscles, although it normalised blood glucose in streptozotocin-diabetic rats. These findings suggest that the altered smooth muscle calmodulin may contribute the defective contractile responses in diabetes and these changes may be resistant to insulin therapy.

A suspected case of bilateral crossed renal ectopia or bilateral jet effect

Crossed renal ectopia is a relatively unusual congenital anomaly. Bilateral crossed renal ectopia is considered the rarest form of this anomaly. A 19-year-old girl with intermittent flank pain was admitted to our department. Various clinical and laboratory examinations were carried out. Excretory urography showed a normal upper urinary tract anatomy, whereas the distal ends of the ureters crossed each other in the pelvis, which suggested bilateral crossed renal ectopia.

Failure of artificial insemination of husband's semen in the treatment of male infertility

In the management of infertility, in case semen quality is found insufficient and could not be improved by medical means, handling the available spermatozoa in the most beneficial way has been aimed. Thus, artificial insemination with low quality semen has become a therapeutic alternative. In this study homologous artificial insemination has been used to treat infertility caused by oligoasthenospermia. Eighteen couples have been treated for 58 cycles by intrauterine or paracervical insemination using cervical cups. During the same period 42 cycles with timed vaginal intercourse have been assessed. Though no pregnancies could be obtained following artificial insemination, one pregnancy occurred during no-treatment cycles.

3,4-Diaminopyridine and choline increase in vivo acetylcholine release in rat striatum

We investigated the effects of choline, 3,4-diaminopyridine and their combination on acetylcholine release from the corpus striatum of freely moving rats which were treated or not with atropine. Intraperitoneal administration of choline or intrastriatal administration of 3,4-diaminopyridine increased acetylcholine levels in striatal dialysates in a dose-dependent manner. When 3,4-diaminopyridine treatment was combined with choline, the observed effect was considerably greater than the sum of the increases produced by choline or 3,4-diaminopyridine alone. Administration of atropine (1 microM) in the dialysing medium was also found to be effective to stimulate striatal acetylcholine levels. 3,4-Diaminopyridine did not affect acetylcholine levels under these conditions. Whereas the choline-induced increase in acetylcholine release was significantly potentiated by atropine, co-administration of 3,4-diaminopyridine with choline failed to produce a further significant increase in the presence of atropine. These results suggest that a highly effective means for increasing acetylcholine release involves two concurrent treatments that increase neuronal choline levels and inhibition of the negative feedback modulation of acetylcholine release.

Urodynamic evaluation in spinal cord injuries

Spinal cord injury, regardless of its level, causes flaccid paralysis during the shock phase affecting the detrusor and rectal musculature. Then, depending on the level and severity of the lesion, the bladder gains spasticity or remains flaccid. Monitoring the reflex behaviour of detrusor and sphincter activities helps to select the treatment modalities. Thirty patients with cord injuries of various levels have been urodynamically tested at 3-month intervals. The shock phase of the acutely tested patients lasted about 8-9 weeks. Eventually, 23 of the cases were hyperreflexic, while 7 cases remained areflexic: 2 had detrusor-sphincter dyssynergia. The response to treatment has been investigated by cystometrographical and electromyographical methods.

The role of arginine, indomethacin and kallikrein in the treatment of oligoasthenospermia

We have treated 45 patients with various degrees of oligospermia and asthenospermia with arginine, indomethacin and kallikrein. Fifteen patients have received the amino acid L-arginine hydrochloride, 15 the antiinflammatory agent indomethacin, while 15 others the enzyme kallikrein. These drugs have been administered for at least 3 months to encompass a complete cycle of spermatogenesis. As a result, treatment with these drugs has increased sperm count and motility to some extent. Three pregnancies (20%) have been obtained by arginine and one pregnancy (6.6%) by indomethacin. Though arginine offers some hope for the future, improvement of the fertilizing capacity with these drugs is still controversial.

Endothelium-dependent and independent effects of garlic on rat aorta

Effects of garlic on isolated rat aorta were investigated by comparing with those of acetylcholine and L-arginine in the presence and absence of endothelium. For this purpose, certain linear and non-linear regression models were applied for concentration-response curves obtained by acetylcholine, L-arginine and garlic in the rat aorta. Garlic caused dose-dependent relaxations in isolated rat aorta which were attenuated by the removal of endothelium as in the case of acetylcholine. However, the relaxant responses to acetylcholine, L-arginine and garlic were not completely abolished by the endothelial denudation. Application of a number of regression models for the vasorelaxant effects of acetylcholine and garlic revealed that mechanism(s) of the effect of garlic may be different from that of acetylcholine. Furthermore, it was noted that L-arginine-induced relaxations, but not those induced by acetylcholine and garlic, are enhanced by a 2 or 4 h incubation period in the bathing medium. The findings obtained strongly suggested that the vasorelaxant effect of garlic is important in its hypotensive activity and mediated by the production of endothelium-and/or muscle-derived relaxing factors.

The characteristics of urolithiasis in east Thrace: a statistical review

During a 6-year period 390 patients with urinary tract calculus were studied: 293 had upper and 38 had lower urinary tract calculi. Of these, 59 passed their stones spontaneously on conservative therapy, 294 were treated surgically and 37 stones were removed by endoscopic means. Of the patients 10.54% had a history of urolithiasis, 5.34% reported family history. In contrast to the common belief, the highest admission rate was in winter. The male to female ratio was found to be 2.2:1, whereas it was equal (1:1) in childhood. The peak incidence was between the ages 30 and 39. Urinary tract infection and obstruction of varying severity were the common coexisting abnormalities. Calcium was the main component of both the upper and lower tract stones. Calcium oxalate+phosphate and calcium oxalate+struvite were the most common mixed stones. Blood typing did not reveal any specificity for urinary calculous disease. On the other hand, occupational groups leading a sedentary life were more prone to this malady.

Effect of short and long term streptozotocin diabetes on smooth muscle calmodulin levels in the rat

Diabetes mellitus is a metabolic disease associated with certain complications which have also been demonstrated in the experimental models of this disease. Altered responses to several agonists have been reported in various smooth muscles from alloxan or streptozotocin diabetic animals. Since these reports revealed a defect in the contractile process of smooth muscles from experimentally-induced diabetes, short and long term effects of diabetes on calmodulin levels in the smooth muscles of aorta, trachea, vas deferens and duodenum were investigated using streptozotocin diabetic rats. In spite of the fact that most of the reports have demonstrated the defective contractions in long term diabetic rats, short term effect (for 1 week) of diabetes on calmodulin levels in the smooth muscles of aorta, trachea, vas deferens and duodenum was also investigated in the present study using streptozotocin diabetic rats to understand whether the changes in calmodulin dependent contractile process begin at an earlier stage of the disease. Tissue calmodulin levels of the smooth muscles were measured by the radioimmunoassay technique using a [125I]-labeled kit. Although rats injected with streptozotocin exerted the characteristics of diabetes such as polyuria, polydipsy, polyphagy and elevated blood glucose levels, unchanged calmodulin levels were found in the rats with short term streptozotocin diabetes. In contrast, long term streptozotocin diabetes (for 8 weeks) was found to cause a significant decrease in tissue calmodulin levels of these four smooth muscles.(ABSTRACT TRUNCATED AT 250 WORDS)

The effect of allopurinol on Na+K+ATPase related lipid peroxidation in ischemic and reperfused rabbit kidney

1. Na+K+ATPase is a membrane bound enzyme whose activity is essential for maintenance of cell viability. Lipid peroxidation changes membrane fluidity and enzyme activity. 2. The purpose of this study was to investigate the effect of allopurinol (free radical scavenger) on Na+K+ATPase activity in rabbit kidney cortex membrane. In this in vivo study we created ischemia and reperfusion in rabbit kidneys. 3. Enzyme activity were low in ischemic and reperfused kidneys, compared to the controls. In allopurinol treated ischemic and reperfused groups, the levels of Na+K+ATPase activity were high compared to the untreated group. 4. It has been concluded that allopurinol may protect this enzyme activity.

Na+,K(+)-ATPase activity of rabbit kidney cortex membranes in ischemia and reperfusion

The activity of Na+,K(+)-ATPase in the microsomal fraction of rabbit kidney cortex was strongly decreased by ischemia and increased slightly, but not significantly, after reperfusion. These changes were correlated with a dramatic increase in lipid peroxidation in microsomes isolated from both ischemic and reperfused kidneys. This correlation may point to irreversible impairment of the enzymatic function under the influence of either oxygen free radicals or lipid peroxidation.