Pathways of abnormal stress-induced Ca2+ influx into dystrophic mdx cardiomyocytes.

In Duchenne muscular dystrophy, deficiency of the cytoskeletal protein dystrophin leads to well-described defects in skeletal muscle, but also to dilated cardiomyopathy, accounting for about 20% of the mortality. Mechanisms leading to cardiomyocyte cell death and cardiomyopathy are not well understood. One hypothesis suggests that the lack of dystrophin leads to membrane instability during mechanical stress and to activation of Ca2+ entry pathways. Using cardiomyocytes isolated from dystrophic mdx mice we dissected the contribution of various putative Ca2+ influx pathways with pharmacological tools. Cytosolic Ca2+ and Na+ signals as well as uptake of membrane impermeant compounds were monitored with fluorescent indicators using confocal microscopy and photometry. Membrane stress was applied as moderate osmotic challenges while membrane current was quantified using the whole-cell patch-clamp technique. Our findings suggest a major contribution of two primary Ca2+ influx pathways, stretch-activated membrane channels and short-lived microruptures. Furthermore, we found evidence for a secondary Ca2+ influx pathway, the Na+-Ca2+ exchange (NCX), which in cardiac muscle has a large transport capacity. After stress it contributes to Ca2+ entry in exchange for Na+ which had previously entered via primary stress-induced pathways, representing a previously not recognized mechanism contributing to subsequent cellular damage. This complexity needs to be considered when targeting abnormal Ca2+ influx as a treatment option for dystrophy.

[The dependence of uroflowmetry on the size of the prostate gland]. / Zaleznosc przeplywu cewkowego od wielkosci gruczolu krokowego.

The authors studied dependence of weight of tissue obtained for open adenomectomy due to BPH on uroflowmetry parameters. They have made retrospective analysis of 388 patients. In this study the patients have been qualified for four groups in dependence on weight specimens. The average values of uroflowmetry parameters vary in particular groups but the differences are not statistically significant (p > 0.5). In conclusion parameters defined by uroflowmetry are independent on prostate size.

[Iatrogenic uretero-vaginal fistula]. / Jatrogenna przetoka moczowodowo-pochwowa.

A case is presented of iatrogenic late ureterovaginal fistula treated with ureteral transplantation with a very good result. It was found that this was the method of choice in this type of fistulae, and temporary internal ureteral splinting was worthwhile to use as a prophylaxis of iatrogenic ureteral damage.

[A case of kidney and ureter tuberculosis causing diagnostic difficulties]. / Przypadek gruzlicy nerki i moczowodu sprawiajacy trudnosci diagnostyczne.

A case is presented of tuberculosis of the kidney and ureter with negative bacteriological examination, suspected of malignant tumour. The diagnosis was based on histological examination of ureteral specimen taken intraoperatively.

A comparison of transurethral and transrectal microwave hyperthermia in poor surgical risk benign prostatic hyperplasia patients.

From 1987 to 1989, 36 poor surgical risk patients with benign prostatic hyperplasia (BPH) were treated with transrectal or transurethral microwave hyperthermia. Most of the 36 patients treated (85%) had severe signs and symptoms of urinary outflow obstruction. Of the patients 22 (61%) underwent transrectal and 14 (39%) underwent transurethral hyperthermia. Followup ranged from 10 to 28 months (mean 19 months) for the transrectal hyperthermia group and 7 to 16 months (mean 10 months) for the transurethral hyperthermia group. The patients were given 6 hyperthermia sessions of 30 minutes each with the temperature controlled on the rectal or urethral surface at 45C. Hyperthermia was well tolerated with mild acute toxicity and no late complications were observed. In the important subjective and objective parameters, major improvement was noted more frequently in the 14 transurethral than in the 22 transrectal hyperthermia treated patients (p less than 0.05). The Food and Drug Administration severity score, prostate volume, post-voiding residual volume and urethral flow showed substantial improvement in 79, 86, 79 and 79%, respectively, of the 14 transurethral hyperthermia treated patients compared to 41, 45, 82 and 82%, respectively, for the 22 transrectal hyperthermia treated patients. A prospective randomized trial comparing transrectal and transurethral hyperthermia is required to define the role of each treatment mode in patients with BPH.