Pigmented renal cell carcinoma: a case with unusual findings and review of the literature

A few cases of pigmented renal cell carcinoma have been reported in the literature so far. It has been described in both conventional and chromophobe subtypes of renal cell carcinoma. The nature of these pigmentations is consistent with melanin, neuromelanin, and lipochrome granules. We report a rare case of pigmented renal carcinoma due to the accumulation of abnormal phagolysosomal bodies, with histochemical features consistent with neuromelanin. A review of cases of pigmented conventional renal cell carcinoma in literature is also presented. Awareness of pigmentation in primary renal cell carcinoma is important in differentiating it from primary and metastatic malignant melanoma and other malignancies that can show pigmentation. Whether the presence and nature of the pigmentation has any clinical importance has yet to be established

morphology of the testicular tissue of unilateral inguinal cryptochid testes in children: electron microscopic study

The aim of this study is to review the ultrastructural changes of the inguinal cryptochid testes of children at different ages. Children between one and sixteen years old with inguinal cryptochid testes, referred for surgical correction were biopsied. The testicular tissue obtained was processed for electron microscopical examination. Princess Basmah Teaching Hospital in Irbid-Jordan. Prospective study. The process of cellular differentiation in the seminiferous tubules was slow or embryologically arrested. There were progressive degenerative changes and increased thickening of the basement membrane as the duration of testicular retention in the inguinal region increased. The ultra-structural changes of the inguinal cryptochid testes were advanced time wise. Further studies to define the time needed for irreversible changes to take place to help in better timing of the surgical correction without losing fertility

Ureteric injuries during obstetric and gynecologic procedures

To review the ureteric injuries resulting from obstetric and gynecologic procedures with a comparative analysis of current pertinent literature. From January 1994 - December 1997, the medical records of all patients who sustained ureteric injuries as a result of obstetric or gynecologic procedures and managed at the Princess Basma Teaching Hospital, North of Jordan were reviewed. The clinical presentations, investigations, features of injury and treatment modalities were studied. There were 17 patients with 19 ureteric injuries incurred during obstetric or gynecologic procedures during the study period. Patients were relatively young and presented with loin pain. The left lower ureter was injured in 11 cases. Hysterectomy, alone, accounted for 13 injuries mainly in association with malignancy. Deliveries, in general, were associated with very low rate of injury. Ureteric ligation was the most common mechanism of injury [47%]. Injuries were intraoperatively recognized in 41.2% [7/17] of cases. Patients were treated by either endourological or formal surgical repair. The overall success rate after an average of 32.3 months of follow-up was achieved in 89.5% [17/19]. This outcome was not significantly altered by either the features of injury or by the treatment schedules. Iatrogenic ureteric injury is still a major cause of harm and concern. The time taken to detect the injury remains the most important morbidity-related factor. Recent trends towards earlier intervention and the use of various endourological means of repair deserve support and promotion

Blood lead levels and gamma-glutamyl transferase activity in battery factory workers in Jordan

The aim of this study is to investigate blood lead levels in workers of lead acid battery factories and the relationship between those levels and the activity of y-glutamyl transferase [y-GT]. Samples of blood were collected during the period from July 2001 to August 2001 from 95 workers of the 2 lead-acid battery factories in Amman, Jordan. They were categorized into 2 groups based on the nature of their work: direct [high exposure] and indirect contact [low exposure] groups. Lead concentration in whole venous blood and y-GT activity was measured. Mean blood lead levels were 51.4 +/- 1.8 and 23.9 +/- 3.8 ug/dl for both direct and indirect groups. y-Glutamyl transferase mean activity was found to be 29.2 +/- 2.6 U/L for direct and 23 +/- 5.7 U/L for indirect contact groups. Fifty healthy individuals were selected as controls. Their mean blood lead levels and y-GT mean activity were 12.3 +/- 0.5 ug/dl and 25.6 +/- 1.2 U/L. As results indicated, no significant relation was found between lead blood levels and y-GT activity [p=0.303] or between lead blood levels and duration of exposure in both direct and indirect groups [p=0.61]. However, significant relation was found between lead blood levels and type of work [p value approached zero] and between lead blood levels and duration of exposure in those workers with lead blood levels exceeding 20 ug/dl and employed for more than one year [p value approached zero]. Lead blood levels among workers in lead acid battery factories in Jordan are high. In most cases, they are higher than the limit permitted by the World Health Organization. Therefore, good protection measures should be taken in such factories to avoid the negative impact of high lead blood levels on the health of workers