Scrotal pop off in a congenital anterior urethral diverticulum.

INTRODUCTION AND OBJECTIVE: Congenital anterior urethral diverticulum is a rare entity. This teaching video shows the scrotal pop-off mechanism for an anterior urethral diverticulum and the unique voiding pattern of a boy who empties his bladder by compression of his scrotum. The findings during urethroscopy and open reconstruction are also demonstrated. PATIENT AND METHODS: A four-year-old boy presented to the clinic with a poor urinary stream and scrotal swelling during voiding. Physical examination during voiding revealed a dumbbell-shaped anterior urethral diverticulum with scrotal pop off and preserved renal function. RESULTS: Open excision of the scrotal part of diverticulum was performed. Urethroplasty was conducted using a de-epithelialised diverticular wall flap from the penobulbar urethra. On follow up the boy voided with a good flow and resolution of symptoms. CONCLUSION: Scrotal pop off with completion of voiding by manual compression of the diverticulum may preserve bladder and renal function. The preferred treatment of anterior urethral diverticulum is open excision of the diverticulum and reconstruction. The wall of the diverticulum may be used to reinforce the repair ventrally, where the corpus spongiosum is deficient.

Cereal dietary fiber consumption and diverticular disease: a lifespan study in rats.

The relationship between consumption of dietary fiber (DF) from white bread, wholemeal bread, or bran and the development of diverticular disease of the colon has been investigated in a lifespan study using 1800 Wistar rats in nine diet groups. Use of the rat as a model for the human condition was validated by demonstration of significant relationships between fiber intake and fecal output and transit time, and the observation of true acquired diverticula, both single and multiple. Significant inverse relationships (mostly with p less than 0.001) were observed between the incidence of diverticula (and prediverticula) and the concentrations of fiber in the diets, measured by the neutral detergent fiber and Southgate methods. The study offers strong support to the Painter-Burkitt view of human diverticular disease as being due to fiber deficiency, if the extrapolation from rat to man is valid. On the same assumption, the amount of additional fiber required to be consumed in order to achieve a substantial reduction in incidence of the disease is very large. Effects of fiber on body weight, food intake, mineral levels, blood composition and properties, mortality, organ weights, and incidence of tumors and lesions are reported. Significantly fewer mammary tumors were found in rats fed the very high fiber stock diet than in those fed the purified diets.

Malignant changes in glossal leukoplakia.

This paper reviews 117 cases of leukoplakia of the tongue seen at Christie Hospital and Holt Radium Institute between 1932-1972. After confirmation of non-malignancy by biopsy these cases were kept on follow-up for a varying period of time. It was found that 20 (17%) of them eventually developed carcinoma of the tongue. Of the others 11 (9.4%) developed malignancy of other sites. Of the 20 who developed carcinoma of the tongue nine died of their glossal disease despite treatment, two of other carcinomas and five of intercurrent non-malignant disease. It is submitted by the author that cases of glossal leukoplakia should never be totally dismissed from follow-up.

Effect on uridine diphosphate glucuronyltransferase activity of depleting and restoring phospholipids to guinea-pig liver microsomal preparations.

Phospholipid depletion substantially inhibited the maximum demonstrable activities of the forward (glucuronidation) and reverse reactions of UDP-glucuronyltransferase towards p-nitrophenol in guinea-pig liver microsomal preparations. Dispersions of liver phospholipids restored activity, whereas non-phospholipid amphipaths failed to do so effectively. These results suggest that the system is probably phospholipid-dependent rather than conformationally constrained by phospholipids.

Effect of phototherapy on bilirubin excretion in man and the rat.

Further evidence that the bilirubin excreted by Gunn rats during phototherapy is unconjugated is presented. The unconjugated bilirubin is not carried into bile as a water-soluble complex with rapidly excreted bilirubin derivatives, nor as a result of leakage of plasma protein into bile. Phototherapy does not augment biliary excretion of bilirubin in normal nonjaundiced rats, but does increase the concentration of conjugated bilirubin in the bile of patients with alcoholic cirrhosis, although their serum bilirubin concentrations are unaffected. The mechanism for augmented excretion of unconjugated bilirubin during phototherapy remains unexplained.