Effect of spermatocele fluid on growth of human prostatic cells in culture.

The present study was carried out to investigate whether testicular fluid derived from a spermatocele contains substance(s) that promote the growth of human prostatic cells in culture. Human spermatocele fluid was centrifuged to sediment spermatozoa. The supernatant was then added to cultures of human prostatic stromal or epithelial cells that were isolated from surgical specimens of benign prostatic hyperplasia. Addition of spermatocele fluid in quantities of 1 microgram/ml of protein resulted in a significant increase in the number of both prostatic stromal and epithelial cells at the end of a 6-day culture period. Human serum at equivalent protein concentrations in the culture medium had no stimulatory effect. At least two separate growth-promoting factors were found in spermatocele fluid, one for stromal cells and one for epithelial cells. The mitogen for stromal cells was heat labile and persisted after treatment with activated charcoal. The factor for epithelial cells was heat stable but was removed by charcoal treatment. These observations are consistent with the concept that the human testis secretes nonandrogenic substances that can promote prostatic growth.

Urosound. In-office ultrasonography for pediatric urology.

Ultrasound has proved to be very accurate in evaluating children with common urologic problems such as renal obstruction and urinary infection and in screening for uropathology among children with siblings known to have urologic disease. The benefits of ultrasound in a pediatric population include diagnostic accuracy, ease of use, absence of radiation exposure, and no risk of adverse reactions to contrast agents. As a consequence, ultrasound has become routine in the evaluation of children with urologic conditions, and its use has been expanded to screening of healthy infants for urinary tract abnormalities. One (1.3 per cent) of 73 otherwise-healthy babies studied had urologic problems severe enough to warrant surgery. Steinhart and associates recommended the routine use of ultrasound in healthy infants, because a significant number of infants harbor silent urinary tract abnormalities that can be detected by ultrasound at a low cost. Obstetricians and other primary-care physicians as well as urologists have incorporated the office use of ultrasound into the care for their patients and thus avoid the inconvenience and difficulties of outside referral. In addition, the clinician as a sonographer occupies a unique position that permits sonographic information to be related directly to the clinical problem. In this review, we have included more than three times the number of patients studied in the initial report. The ease and accuracy of office ultrasound that we described initially have been confirmed by subsequent experience. The urosound examination is indicated for the initial evaluation of patients with voiding symptoms, urine infection, or hematuria, as well as to screen patients with known congenital anomalies, such as hypospadias. Urosound can be employed in the surveillance of children with dysfunctional voiding to measure the completeness of bladder emptying and hydronephrosis. The degree of hydronephrosis in cases of ureteropelvic junction obstruction, megaureters, ectopic ureters, and ureteroceles and that remaining after surgery may be documented by urosound examination. We have found that when the urosound study is abnormal, further diagnostic evaluation is more efficiently planned. Office-based pediatric urologist-operated ultrasound supplements the information elicited from routine history, physical examination, laboratory studies, and other radiologic investigations.

Correlation of computerized tomographic changes and histological findings in 80 patients having radical retroperitoneal lymph node dissection after chemotherapy for testis cancer.

A total of 80 patients with stage B3 or B2/C germ cell testis tumors underwent computerized tomography before and after chemotherapy. The volume and computerized tomographic density of metastatic retroperitoneal tumor were measured on all scans. The patients then underwent full bilateral retroperitoneal lymphadenectomy. The change in volume and density of retroperitoneal disease was correlated with the histological type of the primary testis tumor and with the histological findings at retroperitoneal lymphadenectomy. In all 15 patients (100 per cent) without teratomatous elements in the original tumor and who had a greater than 90 per cent decrease in the volume of retroperitoneal masses as a response to systemic chemotherapy no teratoma or active cancer was found in the surgical specimen. In contrast, 7 of 9 patients (78 per cent) with teratomatous elements in the original specimen had either teratoma or carcinoma in the retroperitoneal lymphadenectomy specimens despite having a greater than 90 per cent decrease in tumor volume. This difference was significant (p less than 0.05). These data suggest that patients with no teratomatous elements in the original specimen and a greater than 90 per cent decrease in the volume of retroperitoneal masses in response to chemotherapy can be observed carefully for signs of recurrence rather than undergoing post-chemotherapy retroperitoneal lymphadenectomy.