Prostate cancer detection using e-nose and AI for high probability assessment

This research aims to develop a diagnostic tool that can quickly and accurately detect prostate cancer using electronic nose technology and a neural network trained on a dataset of urine samples from patients diagnosed with both prostate cancer and benign prostatic hyperplasia, which incorporates a unique data redundancy method. By analyzing signals from these samples, we were able to significantly reduce the number of unnecessary biopsies and improve the classification method, resulting in a recall rate of 91% for detecting prostate cancer. The goal is to make this technology widely available for use in primary care centers, to allow for rapid and non-invasive diagnoses.

Cortistatin deficiency reveals a dysfunctional brain endothelium with impaired gene pathways, exacerbated immune activation, and disrupted barrier integrity

BACKGROUND

Brain activity governing cognition and behaviour depends on the fine-tuned microenvironment provided by a tightly controlled blood-brain barrier (BBB). Brain endothelium dysfunction is a hallmark of BBB breakdown in most neurodegenerative/neuroinflammatory disorders. Therefore, the identification of new endogenous molecules involved in endothelial cell disruption is essential to better understand BBB dynamics. Cortistatin is a neuroimmune mediator with anti-inflammatory and neuroprotective properties that exerts beneficial effects on the peripheral endothelium. However, its role in the healthy and injured brain endothelium remains to be evaluated. Herein, this study aimed to investigate the potential function of endogenous and therapeutic cortistatin in regulating brain endothelium dysfunction in a neuroinflammatory/neurodegenerative environment.

METHODS

Wild-type and cortistatin-deficient murine brain endothelium and human cells were used for an in vitro barrier model, where a simulated ischemia-like environment was mimicked. Endothelial permeability, junction integrity, and immune response in the presence and absence of cortistatin were evaluated using different size tracers, immunofluorescence labelling, qPCR, and ELISA. Cortistatin molecular mechanisms underlying brain endothelium dynamics were assessed by RNA-sequencing analysis. Cortistatin role in BBB leakage was evaluated in adult mice injected with LPS.

RESULTS

The endogenous lack of cortistatin predisposes endothelium weakening with increased permeability, tight-junctions breakdown, and dysregulated immune activity. We demonstrated that both damaged and uninjured brain endothelial cells isolated from cortistatin-deficient mice, present a dysregulated and/or deactivated genetic programming. These pathways, related to basic physiology but also crucial for the repair after damage (e.g., extracellular matrix remodelling, angiogenesis, response to oxygen, signalling, and metabolites transport), are dysfunctional and make brain endothelial barrier lacking cortistatin non-responsive to any further injury. Treatment with cortistatin reversed in vitro hyperpermeability, tight-junctions disruption, inflammatory response, and reduced in vivo BBB leakage.

CONCLUSIONS

The neuropeptide cortistatin has a key role in the physiology of the cerebral microvasculature and its presence is crucial to develop a canonical balanced response to damage. The reparative effects of cortistatin in the brain endothelium were accompanied by the modulation of the immune function and the rescue of barrier integrity. Cortistatin-based therapies could emerge as a novel pleiotropic strategy to ameliorate neuroinflammatory/neurodegenerative disorders with disrupted BBB.

From contigs towards chromosomes: automatic improvement of long read assemblies (ILRA)

Recent advances in long read technologies not only enable large consortia to aim to sequence all eukaryotes on Earth, but they also allow individual laboratories to sequence their species of interest with relatively low investment. Long read technologies embody the promise of overcoming scaffolding problems associated with repeats and low complexity sequences, but the number of contigs often far exceeds the number of chromosomes and they may contain many insertion and deletion errors around homopolymer tracts. To overcome these issues, we have implemented the ILRA pipeline to correct long read-based assemblies. Contigs are first reordered, renamed, merged, circularized, or filtered if erroneous or contaminated. Illumina short reads are used subsequently to correct homopolymer errors. We successfully tested our approach by improving the genome sequences of Homo sapiens, Trypanosoma brucei, and Leptosphaeria spp., and by generating four novel Plasmodium falciparum assemblies from field samples. We found that correcting homopolymer tracts reduced the number of genes incorrectly annotated as pseudogenes, but an iterative approach seems to be required to correct more sequencing errors. In summary, we describe and benchmark the performance of our new tool, which improved the quality of novel long read assemblies up to 1 Gbp. The pipeline is available at GitHub: https://github.com/ThomasDOtto/ILRA.

Heat Stress Factors Expressed during Seed Maturation Differentially Regulate Seed Longevity and Seedling Greening

Heat Stress Factor A9 (A9), a seed-specific transcription factor contributing to seed longevity, also enhances phytochrome-dependent seedling greening. The RNA-seq analyses of imbibed-seed transcripts here reported indicated potential additional effects of A9 on cryptochrome-mediated blue-light responses. These analyses also suggested that in contrast to the A9 effects on longevity, which require coactivation by additional factors as A4a, A9 alone might suffice for the enhancement of photomorphogenesis at the seedling stage. We found that upon its seed-specific overexpression, A9 indeed enhanced the expected blue-light responses. Comparative loss-of-function analyses of longevity and greening, performed by similar expression of dominant-negative and inactive forms of A9, not only confirmed the additional greening effects of A9, but also were consistent with A9 not requiring A4a (or additional factors) for the greening effects. Our results strongly indicate that A9 would differentially regulate seed longevity and photomorphogenesis at the seedling stage, A9 alone sufficing for both the phytochrome- and cryptochrome-dependent greening enhancement effects.

In-silico simulated prototype-patients using TPMS technology to study a potential adverse effect of sacubitril and valsartan

Unveiling the mechanism of action of a drug is key to understand the benefits and adverse reactions of a medication in an organism. However, in complex diseases such as heart diseases there is not a unique mechanism of action but a wide range of different responses depending on the patient. Exploring this collection of mechanisms is one of the clues for a future personalized medicine. The Therapeutic Performance Mapping System (TPMS) is a Systems Biology approach that generates multiple models of the mechanism of action of a drug. Each molecular mechanism generated could be associated to particular individuals, here defined as prototype-patients, hence the generation of models using TPMS technology may be used for detecting adverse effects to specific patients. TPMS operates by (1) modelling the responses in humans with an accurate description of a protein network and (2) applying a Multilayer Perceptron-like and sampling strategy to find all plausible solutions. In the present study, TPMS is applied to explore the diversity of mechanisms of action of the drug combination sacubitril/valsartan. We use TPMS to generate a wide range of models explaining the relationship between sacubitril/valsartan and heart failure (the indication), as well as evaluating their association with macular degeneration (a potential adverse effect). Among the models generated, we identify a set of mechanisms of action associated to a better response in terms of heart failure treatment, which could also be associated to macular degeneration development. Finally, a set of 30 potential biomarkers are proposed to identify mechanisms (or prototype-patients) more prone of suffering macular degeneration when presenting good heart failure response. All prototype-patients models generated are completely theoretical and therefore they do not necessarily involve clinical effects in real patients. Data and accession to software are available at http://sbi.upf.edu/data/tpms/

Characterization of the accessible genome in the human malaria parasite Plasmodium falciparum

Human malaria is a devastating disease and a major cause of poverty in resource-limited countries. To develop and adapt within hosts Plasmodium falciparum undergoes drastic switches in gene expression. To identify regulatory regions in the parasite genome, we performed genome-wide profiling of chromatin accessibility in two culture-adapted isogenic subclones at four developmental stages during the intraerythrocytic cycle by using the Assay for Transposase-Accessible Chromatin by sequencing (ATAC-seq). Tn5 transposase hypersensitivity sites (THSSs) localize preferentially at transcriptional start sites (TSSs). Chromatin accessibility by ATAC-seq is predictive of active transcription and of the levels of histone marks H3K9ac and H3K4me3. Our assay allows the identification of novel regulatory regions including TSS and enhancer-like elements. We show that the dynamics in the accessible chromatin profile matches temporal transcription during development. Motif analysis of stage-specific ATAC-seq sites predicts the in vivo binding sites and function of multiple ApiAP2 transcription factors. At last, the alternative expression states of some clonally variant genes (CVGs), including eba, phist, var and clag genes, associate with a differential ATAC-seq signal at their promoters. Altogether, this study identifies genome-wide regulatory regions likely to play an essential function in the developmental transitions and in CVG expression in P. falciparum.

Automated image analysis in the study of lymphocyte subpopulation in eosinophilic oesophagitis

BACKGROUND

Eosinophilic oesophagitis (EoE) is characterized by the presence of eosinophils in oesophageal mucosa. Other inflammatory cells, mainly lymphocytes, dendritic cells, and mast cells may also play an important role in this disease. The aim of this study is to compare the inflammatory pattern of the mucosa between EoE and gastro-oesophageal reflux disease (GERD), using automatic image analysis in digital slides, and to assess treatment response after elimination diet and food challenge test.

METHODS

From 2010 to 2013, 35 oesophageal biopsies from EoE and GERD patients were randomly selected. In six EoE biopsies, patients had been treated with selective food exclusion diet. Immunohistochemical study with CD3, CD20, CD4, and CD8 for lymphocyte populations, CD1a for dendritic cells, and CD117/c-kit for mast cells was performed. Slides were scanned using Leica Aperio Scanscope XT with 40× magnification. Immunohistochemical expression was quantified in 245 immunohistochemistry digital slides with Leica Aperio positive pixel count algorithm using two different approaches: whole slide analysis versus selection of a 2 mm2 hot spot area.

RESULTS

Average eosinophil cell count was significantly higher (p < 0.001) in the first biopsy of EoE patients before treatment (30.75 eosinophils per high power field - HPF) than in GERD patients (0.85 eosinophils/HPF) or in EoE patients after treatment with elimination diet (1.60 eosinophils/HPF). In the immunohistochemical study, manual count and automatic image analysis showed a significant increase in the number of CD3 and CD8 cells in EoE patients, compared with GERD patients. However, the increase of CD117/c-kit was only statistically significant when manual counting procedures were used. CD20 positive cell count also showed a non-statistically significant tendency to reduce after elimination diet treatment.

CONCLUSIONS

Positive pixel count algorithm can be a useful tool to quantify the immunohistochemical expression of inflammatory cells in the diagnosis and follow up of eosinophilic oesophagitis.

Predictive factors of insulin resistance resolution with adjustable gastric band surgery

INTRODUCTION

The aim of the study was to evaluate preoperative factors associated with remission of diabetes and weight loss after laparoscopic gastric band surgery.

MATERIAL AND METHODS

A retrospective cohort of 95 patients who had an adjustable gastric band placed were included. A preliminary descriptive study of prognostic factors was performed using the logistic regression model with SPSS 17.0. The independent variables were age, sex, body mass index (BMI), diabetes status and degree of obesity; dependent variables were the proportion of weight loss, change in diabetes status score and percent changes in fasting sugar and glycosylated hemoglobin.

RESULTS

The variables that were significantly associated with the percentage of changes in fasting blood sugar and glycated hemoglobin were: the degree of obesity in the first year; preoperative and diabetes status respectively. The analysis of the need for antidiabetic treatment using the modified diabetes status score showed preoperative BMI, age and gender as significant predictors.

CONCLUSIONS

In patients undergoing gastric band surgery, weight loss is the fundamental mechanism by which insulin sensitivity increases. This improvement in glucose metabolism is influenced by factors such as sex, age, insulin treatment, duration of diabetes and degree of preoperative obesity.

Medical resource utilization among community-acquired pneumonia patients initially treated with levofloxacin 750 mg daily versus ceftriaxone 1000 mg plus azithromycin 500 mg daily: a US-based study

OBJECTIVE

The 2007 American Thoracic Society/Infectious Diseases Society of America (ATS/IDSA) guidelines recommend that community-acquired pneumonia (CAP) patients admitted to hospital wards initially receive respiratory fluoroquinolone monotherapy or beta-lactam plus macrolide combination therapy. There is little evidence as to which regimen is preferred, or if differences in medical resource utilization exist between therapies. Thus, the authors compared length of hospital stay (LOS) and length of intravenous antibiotic therapy (LOIV) for patients who received initial levofloxacin 750 mg daily versus ceftriaxone 1000 mg plus azithromycin 500 mg daily ('combination therapy').

RESEARCH DESIGN AND METHODS

Adult hospital CAP cases from January 2005 to December 2007 were identified by principal discharge diagnosis code. Patients with a chest infiltrate and medical notes indicative of CAP were included. Direct intensive care unit admits and healthcare-associated cases were excluded. A propensity score technique was used to balance characteristics associated with initial antimicrobial therapy using multivariable regression to derive the scores. Propensity score categories, defined as propensity score quintiles, rather than propensity scores themselves, were used in the least squares regression model to assess the impact of LOS and LOIV.

RESULTS

A total of 495 patients from six hospitals met study criteria. Of these, 313 (63%) received levofloxacin and 182 (37%) received combination therapy. Groups were similar with respect to age, sex, most comorbidities, presenting signs and symptoms, and Pneumonia Severity Index (PSI) risk class. Patients on combination therapy were more likely to have heart failure and receive pre-admission antibiotics. Adjusted least squares mean (+/-SE) LOS and LOIV were shorter with levofloxacin versus combination therapy: LOS, 4.6 +/- 0.17 vs. 5.4 +/- 0.22 days, p < 0.01; and LOIV, 3.6 +/- 0.17 vs. 4.8 +/- 0.21 days, p < 0.01. Results for PSI risk class III or IV patients were: LOS, 5.0 +/- 0.30 vs. 5.9 +/- 0.37 days, p = 0.07; and LOIV, 3.7 +/- 0.33 vs. 5.2 +/- 0.39 days, p < 0.01. Due to the retrospective study design, limited sample size, and scope (single health-network), the authors encourage replication of this study in other data sources.

CONCLUSIONS

Given the LOS and LOIV reductions of 0.8 and 1.2 days, respectively, utilization of levofloxacin 750 mg daily for CAP patients admitted to the medical floor has the potential to result in substantial cost savings for US hospitals.

Cutaneous horn in glans penis: a new clinical case

This report presents a case of a 65-year-old male suffering from a penile cutaneous horn. This lesion is usually seen in sun-exposed areas and its occurrence on the penis is rare. One-third of cases of penile horns are associated with underlying malignancies. Standard treatment is electrosurgical excision with removal of a broad base.

Conservative treatment with transurethral resection, neoadjuvant chemotherapy followed by radiochemotherapy in stage T2-3 transitional bladder cancer

PURPOSE

Organ preservation has been investigated in patients (p) with infiltrating transitional cell carcinoma (TCC) of the bladder over the past decade as an alternative to radical cystectomy. This is a trimodal schedule study, including transurethral resection of bladder tumor (TURB), neoadjuvant chemotherapy and concomitant radiochemotherapy (RTC).

PATIENTS AND METHODS

From April 1996 until August 2005, 29 evaluable patients (p) with T2-T3NXM0 bladder cancer were enrolled. After a transurethral resection of bladder tumor (TURB), we administered 2 cycles of induction chemotherapy with CMV (15 p) or Gemcitabine-Cisplatin (14 p) followed by radiotherapy 45 Gy 1.8 Gy/fraction and two cycles of concomitant cisplatin 70 mg/m(2). 2-3 weeks later, a cystoscopy with tumor-site biopsy was performed. If complete histological response, p were treated with consolidation radiotherapy until 64.8 Gy. For p with residual or recurrent tumor, cystectomy was performed.

RESULTS

We included 28 men and 1 women (median age 63, range 39-72 years) with PS (ECOG) 0-1. The stage was: 21 p T2; 6 p T3a; and 2 p T3b. Toxicity was higher in CMV compared with Gem- Cis: grade (3/4) neutropenia 4/15 (26%) vs 1/14 (7%); febrile neutropenia 3/15 (20%) vs 1/14 (7%); grade (3/4) trombocytopenia 2/15 (13%) vs 1/14 (7%). Toxicities with concomitant RCT were low-moderate: urocystitis (26%) and enteritis (18%).

RESPONSE

microscopically complete TURB was obtained in 20 p (69%), but not in 9 p (31%) (7 microscopic, and 2 macroscopic residual tumor). We found a complete histologic response after induction RCT in 25 p (86%). After a median follow-up of 69.4 months (m) (range: 8-97.7), there were 8 deaths, with a overall survival of 72%. Furthermore 14 of 29 p (48%) were alive with intact bladder, and median survival time with intact bladder was 63.6 m (50.1-77.2); were predictive of best outcome T2 stage vs T3 (p < 0.0001), and complete histologic resection in initial TURB vs residual tumor (p = 0.0004).

CONCLUSIONS

Combined treatment provide high response rates and can be offered as an alternative option to radical cystectomy in selected patients with TCC. Patients with T2 stage and complete histologic resection in initial TURB had the best outcome.

HPLC quantification of perphenazine in sheep plasma: Application to a pharmacokinetic study

A high performance liquid chromatographic (HPLC) method for the determination of perphenazine (PPZ) in sheep plasma was developed and validated. The separation was achieved using a 5 microm C18 column (125 mm x 4 mm) with a mobile phase composed of acetonitrile and an aqueous solution of H(3)PO(4) and TBA (inverse gradient). The flow rate was 1.5 mL/min and the UV detection was performed at 258 nm. The method was validated with respect to linearity, intra and inter-day precision and accuracy, limit of quantification, limit of detection and storage stability. This method was used to perform a pilot pharmacokinetic study of PPZ after subcutaneous administration to one ewe.

Tissue antioxidant capacity and bacterial translocation under total parenteral nutrition

Alterations in the antioxidative system have been observed during total parenteral nutrition (TPN). Light exposure or changes in the composition of TPN formulas may affect this system. Bacterial translocation (BT) is frequent under TPN and may be related to oxidative status. The aim of this study was to determine the adverse effects of standard and glutamine-enriched TPN, with or without light exposure, on oxidative status (liver and kidney-reduced glutathione, GSH) and its relationship to BT. Thirty-three adult Wistar rats underwent central-venous cannulation and were randomly assigned to one of four groups receiving different TPN regimes for 10 days. The TPN group (n = 10) had standard TPN, the TPN(-) group (n = 8) standard TPN without light exposure, the GTPN group (n = 8) glutamine-enriched TPN, and the GTPN(-) group (n = 7) glutamine-enriched TPN without light exposure. A sham group (n = 16) receiving chow and water ad libitum and saline i.v. served as controls. At the end of the experiment, GSH was determined in liver and kidney tissue. Mesenteric lymph nodes and peripheral and portal blood samples were cultured for BT. Compared to sham rats, TPN groups had statistically significant lower GSH levels, but there were no differences between standard or glutamine-enriched groups or light-exposure groups. Sham animals had 12% BT. Significantly higher BT (P < 0.05) occurred in TPN rats: 70% in the TPN group, 88% in the TPN(-) group, 86% in GTPN (-) animals, and only 50% in the GTPN group (P = 0.06 vs TPN group). In conclusion, (1) TPN reduces antioxidant capacity; (2) glutamine supplementation or light protection does not improve tissue antioxidant capacity under TPN; (3) the absence of light exposure does not improve TPN-related BT; and (4) glutamine supplementation tends to reduce BT only in the presence of light.

2-Hydroxyacid dehydrogenase from Haloferax mediterranei, a D-isomer-specific member of the 2-hydroxyacid dehydrogenase family

An NAD-dependent D-2-hydroxyacid dehydrogenase (EC 1.1.1.) was isolated and characterized from the halophilic Archaeon Haloferax mediterranei. The enzyme is a dimer with a molecular mass of 101.4 +/- 3.3 kDa. It is strictly NAD-dependent and exhibits its highest activity in 4 M NaCl. The enzyme is characterized by a broad substrate specificity 2-ketoisocaproate and 2-ketobutyrate being the substrates with the higher Vmax/Km. When pyruvate and 2-ketobutyrate were the substrates the optimal pH was acidic (pH 5) meanwhile for 2-ketoisocaproate maximum activity was achieved at basic pH between 7.5 and 8.5. The optimum temperature was 52 degrees C and at 65 degrees C there was a pronounced activity decrease. This new enzyme can be used for the production of D-2-hydroxycarboxylic acid.

[Subacute intestinal obstruction caused by giant bladder diverticulum]

A case of a patient affected with intestinal obstruction of 4 days of evolution is presented. The diagnosis of giant bladder diverticulum due to Benign Prostatic Hypertrophy was made by abdominal ultrasound at Emergency Room, and afterwards was confirmed by cystography. A trabeculated wall and a diverticulum at the posterior side was seen with the cystography. The diverticulum full of urine couldn't be emptied due to a narrow diverticular neck and the rectum was obstructed. When a urethral catheter was put in, the symptoms of intestinal obstruction disappeared 800 ml of urine were passed through the catheter and the rectum compression was released; the gas was allowed to pass through the bowel and it's seen in plain X-Ray. This case is presented, considering its unusual this way of presentation of a giant bladder diverticulum. We have reviewed the literature en Medline since 1966 and we have not found a similar case.

[Clinical course of prostatic abscess treated with transperineal drainage]

It is true that appearance of prostate abscesses is currently not so frequent due to the antibiotic therapy available to stop any kind of infectious process which may trigger abscess formation. Even so, it is important to channel right from the beginning the correct diagnosis and treatment in order to avoid, as far as possible, any complications that may derive from the process. This paper deals with the case of a young patient diagnosed in our service with a prostate abscess, and faced with that suspicion we advocated the use of transrectal ultrasound (TRU) as the method for diagnostic imaging. Also, TRU offers great help as guidance in the transperineal puncture, so as to drain the purulent content. It should not be forgotten the valuable information provided by ultrasound to confirm that the treatment used was effective.

Renal aspergillosis and AIDS

Primary renal aspergillosis is an extremely rare entity. Only 19 cases have been reported, 3 of them in patients with AIDS. We report one new case of renal aspergillosis in a patient with AIDS. His disease pattern was multiple bilateral renal abscesses with a normal excretory pathway. The treatment established was percutaneous drainage and systemic antifungal drugs. He had a bad evolution and died 14 weeks after diagnosis. In the previously reported cases of aspergillosis in patients with AIDS, the manifestation was unilateral renal abscess.

Value of morphometry as an independent prognostic factor in renal cell carcinoma

Nuclear morphometry was performed in 159 adenocarcinomas of the kidney. The mean and SD of the following nuclear parameters were calculated: area, perimeter, major axis, minor axis and a shape factor. Median survival, including all stages, was 72 months and cumulative survival at 5, 10 and 15 years of 50, 42 and 33%, respectively. Values of morphometric parameters, except for shape factor, tend to increase in proportion to stage. Nuclear area was the best parameter to predict the variability in survival time. The Cox regression model was performed for each stage, and the relationship with length of survival time was studied. For stage T1-2 N0 M0, nuclear area was the only variable chosen as an independent significant predictor of outcome. For the rest of the stages, no variables were selected as predictors at any significant level.

Depth perception by a holographic imaging system

A holographic optical system for checking human depth perception is proposed. The system does not use any kind of dissociative element; it uses incoherent light for the reconstruction of holograms and allows the binocular disparity to vary from 0 to 650 arcsec. The depth perception of observers can be checked in conditions closer to normal life.

[Abdominal echography to determine the weight of the prostate]

The relationship of post-operatively determined prostatic gland weight and that calculated prior the procedure, by means of abdominal ultrasound techniques using the "ellipsoid method", has been studied in 88 patients undergoing retropubic adenectomy. The regression line was nearly optimal, Y = 0.946 X + 2.295, and the correlation coefficient between both weight measures was r = 0.915. Abdominal ultrasound examinations are a simple, quick and safe means to evaluate prostate weight, prior to deciding the type of surgery (open adenectomy or transurethral resection) for prostate adenoma.

[Surgical treatment of uretero-vaginal fistulae caused by gynecologic surgery]

The present paper is a review of 71 cases of uretero-vaginal fistulae secondary to pelvic surgery which were treated in the Urology Unit of our hospital. Surgical management of these fistula intrinsically depends on their number, location and severity. The results obtained by the different techniques were analyzed, emphasizing their merit when using the Turner-Warwick technique (uretero-cystoneostomy on psoic bladder) and any urodynamic troubles this technique can bring about when used bilaterally in patients from radical gynaecological surgery.

Unusual foreign bodies in the urethra and bladder

We report 8 cases of self-inserted unusual foreign bodies in the lower urinary tract, all being treated from 1976 to 1990. Three of them were located in the urethra and 5 in the bladder. Several objects were found (electric cable, tweezers, hairpin, drawing pin, pebbles, paper clip). In 4 cases the objects were inserted for masturbatory purposes. Five of the patients were psychologically ill or handicapped. The most common reason for consultation was dysuria, and the treatment procedures were endoscopy in 5 patients and cystotomy in the other 3.

[Treatment of obstruction caused by prostatic hypertrophy with prazosin. 1-year follow-up]

Since Caine demonstrated the presence of alpha-adrenergic receptors in prostate tissue in 1975, an alpha-blocker capable of producing maximum relaxation of prostatic tissue with minimum side effects has been sought. Prazosin, a selective alpha-1 blocking agent, must meet these requirements. We report the results of a study undertaken in 28 patients with benign hyperplasia of the prostate demonstrated by flowmetry, clinically and by ultrasound. A significant improvement was observed in all patients except for the ultrasound measured prostate size, which remained unchanged. Undesired effects were observed in 36% of the patients. Despite the initial improvement, 89.3% had abandoned treatment at 1 year principally owing to deterioration of the clinical picture and because they were submitted to surgery (the majority) or treatment with other drugs. We can conclude from our results that prazosin is useful for short-term therapy; i.e., until the patient can be referred for surgery.

[Dimethyl sulfoxide in the treatment of interstitial cystitis]

The paper presents the results obtained with endovesical dimethylsulphoxide in the treatment of interstitial cystitis in 30 women. Up to 80% patients showed clinical improvement with an average of 10 installations. Volume of maximal vesical capacity was increased in 24 patients (80%), the increase being greater than 100 cc in 10 cases. Presently, 24 (80%) patients remain under treatment, 14 with one instillation monthly and 10 once every six months. Six patients are fully asymptomatic without treatment after an average symptoms-free interval of 32 months. Since this is directly related to a decrease both in pain and miction frequency, the increase in vesical capacity appears to be a good improvement index. Dimethylsulphoxide in neither a healing nor a definite therapy but it seems to be effective in the management of this unknown disease.

Femoral intraosseous neurilemoma

The neurilemoma (benign schwannoma) is a benign tumor which arises from the Schwann cells of the peripheral nerves. In an intraosseous localization it is a very rare lesion, only forty cases being reported in the literature, and only two of these with the tumor located in the femur. This paper reports on a patient with a large neurilemoma in the lower part of the left femur.

Renal cell carcinoma: late recurrence in 2 cases

We present 2 patients with late recurrence 16 and 11 years after nephrectomy for renal cell carcinoma. Metastases were solitary and their location very uncommon (vastus externo muscle and colon). In the reviewed series of 5,758 patients with renal cell carcinoma only a temporal muscle metastasis and another in the colon were observed but none of them was solitary.

Urological complications associated to uterus didelphys with unilateral hematocolpos. A case report and review of the literature

Complete duplication of vagina, cervix and uterus, with imperforate hemivagina and renal agenesis is a rare condition with less than 120 cases published. In those articles, urological complications are uncommon with only a 10% of the total. We report 2 cases of uterus didelphys with unilateral hematocolpos and ipsilateral renal agenesis with urological clinical complications. One of them presented a very rare onset complaining of acute urinary retention. The other patient was referred for difficulty in micturition and abdominal pain which is the most common symptom of this entity. A description of both cases and a literature review of this congenital complex syndrome and its urological complications are reported.

[Experimental surgical model of hydrocele for the use of sclerotherapy]

Sclerosant therapy for different pathological conditions (testicular hydrocele, pneumothorax) is a little known and scantily used procedure in the clinical setting. We have developed a surgical procedure in the dog that permits reproducing adult hydrocele. This experimental model is useful for morphometric assessment of the sclerosant effects of the commonly used agents (magnesium silicate hydrate, carbolic acid, ethanolamine oleate, hydroxytetracycline chlorhydrate and quinacrine chlorhydrate). Our results show that the degree of sclerosis achieved with quinacrine and hydrotetracycline is significantly superior to that obtained with other agents.

ABO blood groups and bladder carcinoma

Following some reports concerning the possible influence of ABO blood groups on constitutional types and different features of human pathology, we have investigated if there are relationships between ABO blood groups and bladder tumors. Our findings show that tumoral behavior in patients with bladder carcinoma and blood group O has a tendency to an increased aggressivity with higher tumoral grade and more relapses than what is seen in tumors of patients with A blood group. Although this difference is not statistically significant, we believe that blood group ABO should be considered as a constitutional prognostic factor in bladder carcinoma and further investigations in this field are needed.

[Acute urinary retention caused by hematocolpos associated with uterus didelphys and ipsilateral renal agenesis]

Acute urinary retention from compressive hematocolpos is an uncommon form of presentation of the multi-malformation syndrome arising from failed fusion of the Müllerian ducts and is characterized by uterus didelphys, vaginal duplication (one with hematocolpos), and unilateral renal agenesis. A case is reported and the literature reviewed.

[Aztreonam versus tobramycin in acute pyelonephritis. A comparative study]

We performed a comparative study between the monobactam antibiotic aztreonam and the aminoglycoside tobramycin in patients diagnosed as having acute pyelonephritis. The respective doses were 1 gr. IM daily for 7 days, and 100 mgr. IM q 12 h for the same period of time. Clinically, 100% of uncomplicated acute pyelonephritis and 87.5% of complicated infections cured with aztreonam. Tobramycin achieved an 80% cure rate for both types of infections. Microbiologically aztreonam was effective in all uncomplicated acute pyelonephritis, and in 69.56% of the complicated cases (overall microbiological cure rate = 78.7%). The therapeutic failures were ascribable to infections from S. faecalis, an organism naturally resistant to aztreonam. Thus, the microbiological cure rate was 84.2% in complicated pyelonephritis from organisms sensitive to this antimicrobial. The microbiological cure rate for tobramycin was 70% in acute uncomplicated, and 80% in complicated infections. We observed a good clinical and biological tolerance to both antimicrobials. No side effects were observed. Serum and blood biochemical analyses, and coagulation tests revealed no changes.