Biomedical subjects
Publications and source records attributed to C Servadio.
Two cases of torsion of the testis following previous "fixation" are reported. Prompt recognition of this emergency situation and detorsion may save the ischaemic organ. The importance of adequate bilateral fixation of the testicles within the tunica vaginalis is stressed to prevent possible recurrences.
Hyperthermia - the sustained controlled heating of tissues to 42-43 degrees C - is being studied and used as a means of treatment, particularly to selectively destroy malignant cells. This may be achieved by heat alone, or in conjunction with other forms of treatment, such as radiotherapy or chemotherapy, thanks to a synergistic effect obtained. A new microwave apparatus has been designed and developed which permits precise, controlled and safe hyperthermic treatment of the human prostate. Following extensive laboratory and experimental studies, a first series of treatments on humans has been carried out. Initial observations on our first 192 treatments, on 32 patients, are reported.
Typical lesions of benign prostatic hyperplasia (BPH) were induced experimentally in the ventral prostate of adolescent (6 week old) male rats by citral, a nonsteroidal compound. Incipient BPH changes were already observed in the acinar glands 10 days after citral administration. A longer period of treatment (1 month) significantly enhanced epithelial hyperplasia, whereas the stromal elements were less reactive. Characteristic BPH lesions involving both prostatic compartments were found after 3 months of treatment. Castration prior to citral administration prevented such BPH changes; however, citral did not prevent the involutive lesions of castration. The mechanism of action of citral is yet unknown, various possibilities concerning the induction of BPH in rats are presented and discussed. The potential advantage of this model, especially as BPH is not necessarily linked to age or exogenous hormones, may offer new alternative pathways for understanding the complexity of BPH pathogenesis in animals and perhaps even in man.
A 40-year-old male had been addicted to heroin, morphine, hashish, and other narcotics for 12 years. At examination, 2 years after abstinence from drugs, his semen analysis revealed oligozoospermia, asthenozoospermia, and morphologically abnormal spermatozoa such as "round-headed" and "kinked"--sperm with neck abnormalities and immature forms. There was no evidence of other morphological abnormalities or of the presence of morphologically normal sperm. A possible correlation is discussed between the long-lasting drug addiction and morphological sperm abnormality, endocrinological function, karyotype, and immunological status.
Recently more conservative surgery of renal cell carcinoma is being performed. Patients with small, low-grade and low-stage tumors can be treated by enucleation or partial nephrectomy and will have about the same cure rate as those patients who were treated before by radical nephrectomy. Six patients, who would have been candidates for chronic dialysis, underwent enucleation or partial nephrectomy. Three of them had Stage I, and three had Stage II renal cell carcinomas. Patients were followed up 6 to 52 months (average 34) after surgery, and no local recurrence or distant metastases were found. It has recently been recognized that not every patient with renal cell carcinoma requires radical nephrectomy. Renal parenchyma can be saved without a decline in effective control of the tumor or a change in prognosis.
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beta-Endorphin was estimated in normozoospermic, oligozoospermic and azoospermic human semen. The mean amount in normozoospermic specimens was 278.6 +/- 43.6 (SE) pg/ml while in the others only 191.1 +/- 25 pg/ml. Both values are significantly higher than those present in the blood.
A single an-encephalus neonate kidney graft was transplanted into the portal system of a 6-year-old recipient who had previously undergone removal of the right kidney and inferior vena cava because of Wilms tumor. The left kidney ceased to function shortly thereafter. The child was supported very poorly on hemodialysis, and showed repeated very high levels of cytotoxic antibodies in her serum. The first cross-negative kidney graft that was available harbored two main arteries and duplicate collecting system with two very thin ureters. These vascular anatomic and pathologic variations of both donor graft and recipient necessitated the use of the portal system for renal graft venous drainage and the aorta for the graft revascularization. The ureters that had pinpoint-like lumen were inserted together into the lumen of the native ureter stump and fixated. One year after the transplantation the serum creatinine level is 1.8 mg/dL.
We studied the incidence of myelosuppression and renal function in 33 patients treated by repeated resections of bladder tumors and thiotepa instillations for at least 26 months in the presence of vesicoureteral reflux. Of the 33 patients 28 had unilateral and 5 had bilateral reflux. Transient myelosuppression occurred in 5 patients (15.1 per cent), including 2 with bilateral reflux. Renal function remained stable in all but 2 patients who had decreased renal function when thiotepa was started. Our experience has shown that long-term thiotepa instillation in the presence of vesicoureteral reflux is relatively safe, with no significantly increased incidence of myelosuppression and no detrimental effect on renal function.
A mouse ear reaction for testing cell mediated immunity of human lymphocytes using the local graft-versus-host reaction assay is described. Five million human mononuclears were locally injected into the ears of immune suppressed NZW mice. The reaction mounted was quantitated by determining the 125I-Iodo-Deoxyuridine (125I-UdR) incorporation in both ears. The ratio of 125I-UdR incorporation, of the injected to that of the non-injected ear (GVHR index), 7 days after lymphocyte injection, served as an accurate measure for the extent of the reaction. Only normal human mononuclears and purified, separated normal human T lymphocytes mounted a local graft-versus-host reaction. Whereas normal human B lymphocytes, chronic lymphatic leukemia B lymphocytes, mononuclears from patients with transitional cell carcinoma of the bladder, irradiated normal human mononuclears, mouse syngeneic mononuclears, or human erythrocytes gave no positive reaction. These experiments demonstrate that this assay can be used to quantitate an in-vivo specific graft-versus-host reaction.
27 patients with recurrent low-grade, low-stage transitional cell carcinoma (TCC) of the bladder and uni- or bilateral vesico-ureteral reflux were followed for up to 18 years in order to study a possible higher incidence of TCC of the upper tract. None of the patients developed tumours of the upper collecting system during the follow-up period. Routine bladder instillations with Thiotepa may be one explanation of such a finding.
Seminal fluid from 170 men was examined for acrosomal abnormalities of sperm (Papanicolaou procedure X 1000) and for y-positive cells (quinacrine-stained smears). No correlation was found between these parameters, suggesting that acrosomal abnormalities are similarly distributed among x- and y-bearing spermatozoa. The proportion of y-positive sperm was found to be low (23.6 + 10.7% (SD) for the oligozoospermic specimens and 23.7 +/- 9.8% for specimens with sperm counts above 40 million/ml). Three degrees of fluorescence intensity were observed--weak, moderate, and strong--the strong fluorescence being associated with the highest percentage of y-bodies (30.6 +/- 12.7%, 36.6 +/- 5.7%) and the weak fluorescence with the lowest (16.7 +/- 7.0%, 15.0 +/- 9.5%). It is suggested that structural abnormalities and/or metabolic alterations in either the DNA molecule or the chromosomal proteins may be responsible for variability in the ability to bind quinacrine compounds.
A previous failure to detect DNase activity in human sperm sonicates was ascribed to an inadequate amount of sperm used. In the present work aliquots contained more sperm (1.5-2.5/10(6)), permitting the detection of enzyme activity. The latter was significantly higher in spermatozoa of oligozoospermic origin compared with activity in normospermic specimens.