Evidence for an association between the SRD5A2 (type II steroid 5 alpha-reductase) locus and prostate cancer in Italian patients.

We have investigated the contributions of three polymorphic markers in the SRD5A2 gene to prostate cancer in a group of Italian patients. We have genotyped cases and controls for a polymorphic (TA)n dinucleotide repeat and two functional substitutions, A49T and V89L, substituting respectively alanine with threonine at codon 49, and valine to leucine at codon 89. We found a substantially increased but not significant risk associated with the 49T mutation and a reduction of risk for the V89L substitution. In conclusion, we report on preliminary evidence for both increased and decreased risk associated with separate markers at this locus.

[The use of type A botulin toxin in the treatment of detrusor-sphincter dyssynergia]. / L'impiego della tossina botulinica tipo A nel trattamento della dissinergia detrusore sfintere.

The detrusor-sphincter dyssynergia (DSD) is a common and significant problem for patients with spinal cord lesions. If not treated, DSD can lead to severe and potentially lethal complications (urinary tract infections and renal damage). BTX inhibits acetylcholine release at the neuromuscular junction, producing muscle chemical denervation in the site of injection. The aim of this preliminary study was to test the safety and the effects of BTX injection in the spastic urethral rhabdosphincter in patients with DSD. Five patients (3 M, 2 F; mean age 43 years, range 22-56) with DSD entered the study. Videourodynamic parameters were controlled before BTX injection at 10 days, at 3 and 6 months after infiltration. The aim of this preliminary study was to test the safety and the effects of BTX injection in the spastic urethral rhabdosphincter in patients with DSD. The post void residual urine volume, the maximum pressure of emptying and the maximum pressure of urethral closure are reported in Tab. II-III-IV. Patients reported subjective improvement of bladder emptying and improved quality of life. No adverse effects related to pharmacological activity of BTX or to infiltration procedures were observed.

[Echographic features in the diagnosis of renal abscess]. / Aspetti ecografici nella diagnosi di ascesso renale.

The Authors emphasize sonographic aspects of Renal Abscess in early phase and in proclaimed disease. The advent of the sonography and its extensive use marked an inversion of tendency in Perinephric Abscess evolution. So it is possible to point out small Abscesses and in early phase. Leukocytes tags Scintiscan and CT can confirm the diagnostic tentative.

[Urethral echography: potential and limitations]. / L'ecografia uretrale: possibilità e limiti.

Since in the early years of 1980, the diagnostic for images about male's urethral injury was exclusively assigned to urethrocystography. Sially in repeated check the gonads too often are exposed to ionizing radiations. Our results show urethrocystography/ultrasonography good correlation (13/15) cases) with 86% sensibility. Even if the urethrocystography is a methodic of first instance, the urethral ultrasonography is efficacious in follow up of urethral injury, particularly in the study of anterior urethra.

[Echographic characteristics of calcifying fibrous pseudotumor of the epididymis]. / Aspetti ecografici dello pseudotumore fibroso calcificante dell'epididimo.

Calcifying fibrous pseudotumor of epididymis is a rare neoplasia. The A.A. report echographical aspects about two clinical acses examined in 1993. Peculiar aspects of tumour are characterized by acoustic obstruction of the fibrous tissue and contextual iperechogenic spots, so to stimulate a calcific pseudocapsula. The A.A. revalue the echographical images after surgical exploration and discuss about differential diagnosis with TBC.

[Echography problems in acute scrotum: torsion of the hydatid of Morgagni]. / Problematiche ecografiche nello scroto acuto: torsione dell'idatide del Morgagni.

The A.A. discuss about a clinical case of acute scrotum in which the echographical aspects aren't been exhaustived for the etiology. Surgical exploration showed Morgagni's hydatid torsion while the echography doubted between acute phlogosis and neoplasia.

[Transrectal echographic micturitional evaluation of bladder neck pathology]. / Valutazione ecografica trans-rettale perminizionale della patologia del collo vescicale.

Dynamic transrectal echography is the primary method to evaluate bladder neck diseases during micturition for its safety, noninvasiveness and excellent imaging. In order to find some features for every kind of disease, we have examined 32 patients with BPH, Carcinoma, Marion disease and also evaluated the morphological images after prostate surgery. Enlargement of the prostate gland may restrict the urethral lumen and deviate its intra-prostate way, such that the urethra can't be allocated in one sagittal echographic plane. The third lobe, when it exists, can act like a valve against the urine flow. Prostate carcinoma, at first, can be asymptomatic on urodynamic study. Urethral invasion and its organic stenosis is shown by a very thin, longer and irregular profiles. Bladder neck sclerosis is an unusual disease, but its diagnosis can be easy if a posterior "beak" at internal meatus level, urethral dilatation after stenosis and positive Stop-Test exist. After surgery, one can observe full relaxation of the internal sphincter and the voluntary skeletal sphincter, located at the level of the membranous urethra, providing itself a continence mechanism.

Early diagnosis of genito-urinary tumours by urinary cytology.

Urinary Cytology, if performed with accuracy, plays an important (sometimes decisive) role in early diagnosis of genito-urinary tumours. It offers many advantages: easiness in carrying out, possibility to repeat the examination at will, painless execution, no invasiveness and restricted cost. The Authors report on their experience in performing cytologic examination on fresh urine specimens, formalin-fixed in Swinnex milliphore-filter and stained according to a slightly modified Papanicolau method (Alcohol 80 degrees + Haematoxylin-). Thanks to a carefully executed technique of concentration and cellular preservation, the Authors were able to obtain complete specimens, interpreted easily, and to identify the main morphologic changes of neoplastic cells, namely the characteristic nucleo-cytoplasmatic alterations. Between 1986 and 1987 the Authors examined 600 patients, admitted to Urologic Dept. of Saronno General Hospital, employing, amongst others diagnostic procedure (cystoscopy, needle biopsy, CAT, ecc.), urinary cytology: they observed 94% of true results (positive or negative for genito-urinary tumours) in comparison with 4% of false positive and 2% of false negative only; these results compared to others, appeared until now, in Medical literature, lead to regard this technique, further improved by more experience in cytology, as a greatly valuable and highly reliable diagnostic method, mainly in early discovery of genito-urinary neoplasms.