Biomedical subjects
Publications and source records attributed to J N Corriere.
Transient blindness was seen in 2 patients undergoing transurethral resection (TUR) of the prostate as the initial symptom of a severe TUR reaction. Cerebral edema of the occipital cortex is the most probable mechanism. Both fully recovered their vision when appropriately treated. Patients with visual disturbances during transurethral prostatectomy should be suspected of having a TUR reaction.
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Conventional approaches to therapy for cancer, such as chemotherapy, operative therapy and radiation therapy, can produce profound changes in host immunity. The effects of chemotherapy upon immune responses are related both to the dosage and duration of therapy and are readily reversible. Operative therapy likewise suppresses both humoral and cell-mediated immunity for two to three weeks, as manifested by in vitro and in vivo tests of these functions. Radiation therapy, however, seems to decrease host immune responses for more prolonged periods of time, up to ten years. Nutritional status may also affect both limbs of the immune system, and malnutrition is being recognized with increasing frequency as a clinical problem in patients with advanced primary malignant or metastatic disease, especially during antineoplastic therapy. Intravenous hyperalimentation is a safe and effective method for correcting nutritional deficits in patients with cancer; moreover, immunocompetence may be enhanced during adequate nutritional rehabilitation.
Free essential fatty acids (EFA) are reported to suppress cell-mediated immunity. Because Intralipid contains a high concentration of esterified EFA, the effects of this emulsion on in vitro lymphocyte transformation were studied. Intralipid concentrations of 11.5, 115, and 230 mg% in lymphocyte cultures increased phytohemagglutinin (PHA) stimulation by an average of 8.2% (not significant [NS]), 18.1% (p < 0.01), and 11.8% (NS), respectively. These same concentrations also increased Varidase stimulation in lymphocyte cultures by an average of 11.3 (p < 0.02), 18.9 (p < 0.02), and 4.4% (NS), respectively. Control wells did not demonstrate allergic reactions to Intralipid. These data demonstrate that Intralipid can significantly increase the mitogenic response of human thymic lymphocytes and the antigenic response of human lymphocytes, in vitro.
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Congenital torsion of the penis was observed in 5 newborns, 3 of whom had fathers with torsion of the penis. We believe that this common benign condition may be transmitted as an autosomal dominant trait.
We examined 82 healthy volunteers, 61 subfertile men with varicoceles and 27 subfertile men without varicoceles for testicular size and semen quality. In 13 volunteers we found unsuspected varioceles and a left testicle significantly smaller than the other 69 volunteers. The size of the right testicle and the sperm density in these patient groups were similar. Both testicles of subfertile male subjects with varicoceles were significantly smaller than the testicles of subfertile male subjects without varicoceles. However, the sperm densities of these 2 groups were similar. Finally, although subfertile male subjects with varicoceles had obviously statistically lower sperm densities than volunteers with varicoceles, the testicular sizes were similar. Perhaps varicocele ligations should be performed on all male subjects with this lesion at an early age to prevent progressive testicular atrophy and decreased fertility potential.
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Adrenergic and cholinergic histochemical staining techniques and in vitro muscle strip responses to adrenergic and cholinergic stimulation and blockade have failed to demonstrate any neuromorphologic or neuropharmacologic differences between the musculature of the canine trigone and that of the underlying detrusor. There is no evidence to suggest that a functional potential could be attributed to the trigone separate from that of the related bladder base.
Sympathetic nervous innervation of the canine urethra was studied using catecholamine histofluorescent straining and the in vitro muscle bath. Morphologically, adrenergic nerves were found terminating on the urethral smooth muscle. Pharmacologically, urethral strips responded like muscle strips from the bladder base to adrenergic stimulation. This evidence supports the concept that the sympathetic nervous system supplies and modulates the function of the smooth muscle stimulation of the rich periurethral vasculature nerve supply.
Levodopa therapy enhanced the ability of the bladder to store urine in two parkinsonian patients. In vitro canine muscle bath studies with the two major metabolites of levodopa, dopamine and norepinephrine, indicate that the effects of the drug on the peripheral sympathetic nervous system may play a major role in the improvement of urinary symptoms observed with levodopa therapy.
The response of muscle strips from the human anterior and posterior bladder base to autonomic stimulation and blockade was studied. The human bladder base, like that of the dog, possesses an abundance of cholinergic and alpha-adrenergic receptor sites. Neuropharmacologically, the musculature of the anterior base is similar to that of the posterior base (trigone plus detrusor musculature).
Circulating lymphocytes were incubated for 72 hours in either pure culture medium or a medium-urine mixture in the presence of phytohemagglutinin, concanavalin A or pokeweed mitogen, and assayed for blastogenesis and viability. The amount and osmolality of the urine were varied. Between 80 and 90 per cent of the cells remained viable during the entire study despite the culture mixture. If 50 percent of the culture was replaced by urine at an osmolality of 150, 300 or 500 mOsm, a severe but uniform depression of lymphocyte activity was seen. However, if only 25 percent or less of the medium was replaced by urine at 300 mOsm, the cells stimulated as well as they did in pure medium.
Selective chemical destruction of the adrenergic nerve terminals in the dog bladder with 6-hydroxydopamine does not result in vesicoureteral reflux. The sympathetic nerve supply of the bladder does not appear to play a role in maintaining the normal competence of the ureterovesical junction.
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