Primary penile lymphoma presenting as a penile ulcer.

Primary penile lymphoma is rare. The clinical manifestations can be quite subtle, which may lead to misdiagnosis. Treatments have included radical surgery, chemotherapy and radiation. We report on an 18-year-old man with primary penile lymphoma whose lesion caused prolonged diagnostic uncertainty. He was treated with chemotherapy alone, and he has had no tumor recurrence for 27 months.

The laparoscopic diagnosis of transverse testicular ectopia.

Transverse testicular ectopia is a rare but well documented abnormality in which both testes descend through 1 inguinal canal. We report on a 14-month-old boy in whom laparoscopy was diagnostic for this abnormality. Laparoscopic examination of the pelvis is imperative to rule out the presence of müllerian remnants that commonly occur in patients with transverse testicular ectopia. Our case further supports the use of laparoscopy in patients with nonpalpable undescended testes.

Interleukin 2 production, proliferative response, and receptor expression by cord blood mononuclear cells.

To analyze the elements of the interleukin 2 (IL-2) system in newborns, the proliferative responsiveness to, production of, and expression of cell surface receptors for IL-2 were quantitated in cord blood mononuclear cells (CBMC) from 25 normal, full-term newborns and were compared to results in peripheral blood mononuclear cells (PBMC) from 15 juveniles and 28 adults in order to examine the IL-2 system as a function of age. Proliferative responsiveness of purified cord blood T lymphocytes to a saturating amount of human, recombinant IL-2 was significantly greater (p less than 0.05) than that of T lymphocytes from juveniles or adults at all three cell concentrations used. Similarly, phytohemagglutinin (PHA)--induced IL-2 production by CBMC was significantly greater (p less than 0.05) than that produced by PBMC from juveniles or adults with a mean value of 20.3U/ml compared to 11.1U/ml and 11.2U/ml for juveniles and adults, respectively. However, the proportion of CBMC and PBMC from juveniles expressing cell-surface IL-2 receptors (IL-2R) following PHA stimulation was equivalent. These results indicate a significantly enhanced proliferative responsiveness to, and production of, IL-2, but equivalent IL-2R expression, by cord blood T lymphocytes as compared to normal children and adults demonstrating that full-term newborns possess a fully competent IL-2 system at birth.

Insurmountable antagonism of ouabain-induced coronary constriction by prazosin.

A linear dose-response curve was produced by the addition of ouabain (10(-8)-10(-6) M) to the media bathing segments of porcine right coronary arteries. A concentration of 10(-6) M ouabain produced constriction equal to 47% of that resulting from exposure to 35 mM KCl. The ouabain dose-response curve was competitively displaced one order of magnitude by the previous addition of verapamil (2.2 X 10(-8) M), and non-competitively by the prior exposure to prazosin (6.5 X 10(-7)-6.5 X 10(-13) M). The inhibitory effect of prazosin appears to be unrelated to its alpha 1-adrenergic blocking action.

Comparative cardiotoxicity of bupivacaine and lidocaine in the isolated perfused mammalian heart.

This study was designed to compare the direct actions of bupivacaine and lidocaine on the isolated perfused guinea pig Langendorff heart preparation. Sixty min after mounting, either bupivacaine HCl (0.3 or 3 micrograms/ml) or lidocaine HCl (10 or 30 micrograms/ml) was added to the perfusate, and the effect (if any) was compared to untreated control values 30, 60, and 90 min later. Although the highest concentrations of both drugs invariably produced statistically significant reductions in heart rate, df/dt, coronary blood flow, and myocardial oxygen consumption (MVO2), these reductions were consistently greater after bupivacaine. Moreover, arrhythmias occurred in 6 of 12 preparations in those hearts exposed to 3 micrograms/ml of bupivacaine. Most often these arrhythmias consisted of heart block and bi- or trigeminy. Additional studies indicated that the reduction in coronary blood flow and MVO2 produced by 3 micrograms/ml of bupivacaine was a consequence of its direct negative inotropic and chronotropic action. Although the myocardial depression produced by bupivacaine and lidocaine could be reversed readily by substituting fresh perfusate, increasing the extracellular calcium concentration in stepwise increments did not augment the negative inotropic or chronotropic effect produced by 3 micrograms/ml of bupivacaine or 10 micrograms/ml of lidocaine. We conclude that 3 micrograms/ml of unbound bupivacaine is more cardiotoxic than 30 micrograms/ml of unbound lidocaine in this model.