Cutaneous temperature measurements in men with penile prostheses: a comparison study.

To evaluate and compare the cutaneous temperature of the penis in normal men, those with erectile dysfunction (ED), those with semirigid penile prostheses (SRPPs), and those with inflatable penile prostheses (IPPs), and those before and after trimix injection to create a penile erection. A total of 68 patients were evaluated. Five patient groups were identified, including men with normal erectile function, with ED, with SRPPs, with IPPs, and following intracavernosal injection of trimix solution. Cutaneous glans temperature increased significantly by more than 2.2 degrees C in the trimix-injected group compared with all other groups (P<0.001). Using cutaneous temperature measurements of the penis, patients with SRPPs had significantly lower cutaneous glans temperatures than normals (P<0.02), those in the ED group (P<0.04), and those in the IPP-deflated group (P<0.01). The mean temperature difference was 1.44+/-0.40 degrees C. Using cutaneous temperature measurements of the penis, men with SRPPs have a colder glans as compared with men with normal erectile function, ED, IPPs, and those who have received an injection of trimix. Men with normal erectile function, ED, and IPPs did not have significant cutaneous temperature differences.

Efficiency and efficacy of different intracorporeal ultrasonic lithotripsy units on a synthetic stone model.

PURPOSE: The efficiency and efficacy of the available intracorporeal ultrasonic lithotripters were compared in a stone model experiment. MATERIALS AND METHODS: Plaster of Paris (POP) stone phantoms having ratios of 1:1, 1.5:1, and 2:1 with water were fabricated into cubes of various hardnesses weighing an average of 24.6 g. The stones were immersed in water in a plastic container, and continuous irrigation through a rigid nephroscope was used. Ultrasonic lithotripters from ACMI, Olympus, Storz, and Wolf manufacturers were evaluated for efficacy in breaking up the three POP concentrations. Time to complete stone fragmentation, occurrence of probe or tubing occlusion, and probe overheating were evaluated. RESULTS: Efficiency of fragmentation and time to fragmentation of the Storz lithotripter were significantly different from those of the Wolf (p = 0.01 and p = 0.02, respectively) and ACMI (p = 0.001 and p = 0.02, respectively) lithotripters. Comparison of the efficiency of fragmentation and time to fragmentation of the ACMI and Wolf lithotripters showed significant differences (p = 0.005 and p = 0.03, respectively) in favor of the Wolf device. The Olympus lithotriptor resulted in incomplete fragmentation of phantoms of all POP concentrations. CONCLUSION: The Storz ultrasonic lithotriptor was found to have the lowest fragmentation time and highest efficiency in the fragmentation of phantom stones.

Stone recurrence after endopyelotomy.

OBJECTIVES: The purpose of this study was to evaluate whether repair of the ureteropelvic junction (UPJ) obstruction reduces the incidence of stones in stone-forming patients with concurrent UPJ obstruction. METHODS: We performed a retrospective study evaluating 90 patients with UPJ obstruction who underwent endopyelotomy and simultaneous stone extraction (group A) and 80 patients without UPJ obstruction who underwent only stone extraction (group B). Group A consisted of 52 men and 38 women with an average age of 54.4 years (range 15 to 82), and group B of 46 men and 34 women with an average age of 53.5 years (range 8 to 94). Metabolic evaluation was available in 47 patients of group A and 42 patients of group B. RESULTS: We achieved a stone-free state in all patients of both groups. Stone recurrence was observed in 7 patients (8%) in group A and in 32 patients (40%) in group B. Nine of 47 patients (19%) in group A showed metabolic abnormalities. In group B we found 30 of 42 patients (71.4%) with metabolic abnormalities. CONCLUSIONS: Our results suggest that correction of the anatomic obstruction facilitates the drainage of the previously entrapped urine, and thus decreases the incidence of recurrent urinary stone formation.

GABA and benzodiazepine receptors in the cat motor thalamus after lesioning of nigro- and pallidothalamic pathways.

Binding parameters of [3H]muscimol ([3H]MUS) and [3H]flunitrazepam ([ 3H]FLU) were determined in the thalamic area of overlap of nigro- and pallidothalamic pathways at short- (1-10 weeks) and long-term (6-11 months) survival times after kainic acid lesioning of substantia nigra pairs reticularis (SNr) and/or entopeduncular nucleus (EPN). No statistically significant lesion-induced changes in Kd could be established in any of the lesioned groups. Bmax values for both binding sites, when corrected for nerve cell densities, revealed some changes in all but one instance (no statistically significant changes in the number of [3H]MUS binding sites were detected after SNr lesions). Significant bilateral increase in the number of [3H]MUS binding sites was found after unilateral EPN and combined EPN + SNr lesions. In the first group the changes were transient; in the second, the number of binding sites appeared to be still on the rise at 8 months postlesion. The latter increase was interpreted as resulting from plasticity type changes in GABAergic local circuit neurons in response to massive deafferentation from extrinsic inhibitory inputs. Changes in [3H]FLU binding sites were of different character and of extremely low magnitude compared to changes in [3H]MUS binding sites. Subtle, but statistically significant, ipsilateral increase in the number of [3H]FLU binding sites as a function of time postlesion was found in the SNr lesioned group. In two other lesioned groups small magnitude increase occurred bilaterally, although in the EPN lesioned group it was more pronounced on the operated side. The results are consistent with earlier suggestion that [3H]MUS and [3H]FLU binding sites in the motor thalamus appear to be associated with different types of GABAergic synapses with none of them being directly associated with the basal ganglia thalamic pathways.

Distribution and binding parameters of GABA and benzodiazepine receptors in the cat motor thalamus and adjacent nuclear groups.

Quantitative receptor binding autoradiography technique was utilized to study GABA and benzodiazepine receptors in the cat motor thalamus (ventral anterior, ventral medial and ventral lateral nuclei) and adjacent thalamic subdivisions. Binding parameters (Bmax and Kd) and distribution pattern of the binding sites for 3 tritiated ligands [3H]muscimol ([3H]MUS), [3H]flunitrazepam ([3H]FLU) and [3H]baclofen ([3H]BAC) were analyzed and compared using measurements from discrete and anatomically well-defined thalamic regions. There was little correlation in the regional distribution of the 3 binding sites. The concentration of [3H]BAC binding sites in thalamic nuclei of interest was very low, practically at the limit of resolution of the quantitative autoradiographic technique; whereas appreciable quantities of [3H]MUS and [3H]FLU binding sites were present in the motor and adjacent limbic nuclei of the thalamus. There was more difference between the nuclei in regard to the number of high affinity GABA receptors than benzodiazepine receptors. Moreover, the ratio of Bmax[3H]MUS/Bmax[3H]FLU varied from 2.2 to 4.4 in different thalamic regions suggesting the presence of a diverse population of GABAA and benzodiazepine receptors. The distribution pattern of the 3 binding sites was compared to the topography of GABAergic afferents of the basal ganglia origin and the frequency of GABAergic synapses formed by thalamic local circuit neurons (LCN) in the motor thalamus that were established earlier. It was concluded that in the cat motor thalamus: (1) none of the ligands studied appear to reveal the receptors associated with nigro- or pallidothalamic synapses; (2) [3H]MUS binding sites may be associated with the dendrodendritic contacts formed by LCN; and (3) the [3H]FLU binding sites are physically unrelated to [3H]MUS binding sites. The concentration of [3H]FLU and [3H]MUS binding sites in the midline nuclei and of [3H]MUS binding sites in the limbic nuclei was remarkably high. It was concluded that in addition to previously suggested limbic structures, the midline nuclei with their very high content of benzodiazepine receptors may be considered as a neuroanatomical substrate of certain forms of anxiety.