Chronic prostatitis/chronic pelvic pain syndrome in males may be an autoimmune disease, potentially responsive to corticosteroid therapy.

UNLABELLED: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) represents the most common form of prostatitis. No known etiology factor in most cases can be found. It is possible that at least in some cases autoimmune response could be causative factor. Common treatment options include antibiotics, alpha blockers, myorelaxants, phytotherapeuticals, non steroidal anti-inflammatory drugs, hormonal treatment and surgery but corticosteroids have not been investigated. HYPOTHESIS: Chronic pelvic pain syndrome is in some cases autoimmune disease and this could have repercussions on treatment using low dose corticosteroids. RATIONALE: Currently corticosteroids are not a standard treatment option in CP/CPPS. Theoretical, experimental and scarce clinical evidence suggest that treatment with low dose corticosteroids could be beneficial in some patients with chronic prostatitis. If our hypothesis could be supported with well designed, randomized clinical trials this could change the approach of the medical treatment of CP/CPPS.

Biomechanical aspect of supravesical urine derivation by Bricker's method.

The findings obtained by excretory urography in 15 patients of various age and occupation confirmed the study premise that in the upright position after the procedure of supravesical urine derivation as described by Bricker, the isolated segment of the ileum does not function as a conduit but forms a siphon-like receptaculum which, according to the laws of liquid mechanics, prevents or reduces the ascent of gases and bacteria into the upper urinary ducts. This also appears to be a logical explanation for a decreased incidence of infection of proximal urinary ducts in Bricker's method of supravesical urine derivation as compared to other mechanically comparable surgical procedures.

The biomechanical aspect of testis hydrocele.

The liquid content of the hydrocele or watery hernia presses blood vessels of the testis. This pressure occurs in the accordance with hydrostatic and hydraulic laws. However, none of 223. 568 studies on the pressure in mammalian organisms registered worldwide has reported on the pressure values in case of testis hydrocele. Results obtained by observation of 20 patient with testis hydrocele suggested that the hydrostatic pressure of testis hydrocele always surpassed the pressure of blood vessels within the scrotum, proving that the pressure of a fluid as a mechanical factor plays an important role in the malfunction of spermatogenesis as well as in hypoxemic hypoxia of the testis.

Clinical course in 52 severely wounded patients treated in the intensive care unit during the war in Croatia.

Fifty-two severely wounded patients, admitted directly from a battlefield or after surgical treatment in a war hospital, were treated in the Surgical Intensive Care Unit of the 'Sisters of Mercy' University Hospital in Zagreb during the 1991 war in Croatia. Considering the severity of the wounds, blood loss was not as severe as expected. This can be attributed to the nature of the injuries as most of the patients were wounded by fragments of explosive devices which cause less tissue destruction than military bullets. Low serum potassium levels, metabolic acidosis, low total protein levels and consequently low serum calcium levels correlated with wound severity. Low serum potassium levels were caused by its redistribution. Reperfusion liver injury was also present. Consumption coagulopathy was one of the characteristic disturbances in this type of injury. There was a relatively big difference between fluid input and output caused by fluid loss through drain sites and large open wound surfaces. The low mortality of the severely wounded was due to their young age and the well-organized military medical service which was developed from the civilian medical service in a short time.

I-131 MIBG and bone scintigraphy in a patient with MEN.

The case of a patient with MEN is described. Emphasis is placed on the role of I-131 MIBG and bone scintigraphy as a part of the diagnostic and follow-up procedures.

A biomechanical aspect of the lumbal approach to the kidney.

Functional differences between surgically attacked musculature of the lumbal region and intact musculature of the contralateral side were assessed in 71 patients by the method of Multic-Labar, Moire topography, electromyography and X-ray analysis of the thoraco-lumbar spine. The following conclusions were derived from the results obtained. In the intact musculature of the lumbal segment of the spine, sliding forces reached 200 kN in males an 170 kN in females aged >25 and <30 years. In younger and older age groups, the values were lower, assuming a form of the ascending and descending limb of a parabole, respectively. Upon healing, the lumbal musculature damaged by surgical resection showed decreased values of the pulling and sliding forces by 15 and 25 kN on an average, respectively, as definite values independent of age and sex. Kinematic alterations included myogenic geneses of a stationary form, with normal innervation, involving the whole damaged musculature. Summa summarum, results of analyses suggested the values of kinematic forces of pulling and sliding forces of the musculature damaged by surgical resection to be definitely significantly reduced, thus confirming the premise of the study.

Immunohistochemical staining and serotest markers during development of a sarcomatoid and small cell prostate tumor.

Prostate cancer with marked neuroendocrine (NE) differentiation belongs to the hormone resistant carcinomas. We report the development of TSH-secreting small cell prostate cancer (SCPC) from high grade adenocarcinoma (Gleason score 8) with an elevated number of chromogranin A positive cells located in benign structures adjacent to the cancer. Conversion to SCPC was followed-up during 4 years. The initial adenocarcinoma exerted a stronger positivity for PAP than for PSA (respective staining indexes, Sls, 2.2 and 1.8, maximum staining 3.0). In the developed SCPC, 2 cell subpopulations that were derived from epithelial cells were found (positive stain for EMA and CEA, respectively) and from one of them originated CEA-positive liver metastases. Blood CEA and NSE levels were elevated in SCPC (284 ng/ml and 24.5 ng/ml). However, blood TPS level which reflects proliferation of epithelial cells was within the normal range. The development of a << pure >> sarcomatoid prostatic tumor from adenocarcinoma with 2 areas of similar differentiation grades (Gleason score 7 and 9-10) that initially differ in staining for PSA and PAP (SIs for PSA were 1.2 and 0.02 and for PAP were 1.6 and 0.02, respectively) was followed-up during 4 years of treatment with Estracyt. Adenocarcinoma tissue specimens was slightly CEA-positive. The disappearance of lower grade adenocarcinoma during treatment was accompanied by the development of sarcomatoid areas that were 100% vimentin positive. In the last year of follow-up the primary tumor was composed only of vimentin positive sarcomatoid cells with a slight positivity for Chromogranin A, NSE and ACTH. In parallel, normal serum PSA and PAP values and elevated CEA and NSE serotests (12.6 ng/ml and 24.7 ng/ml, respectively) were found. Blood TPS level was at the upper limit of the normal range. Scintigraphy revealed extensive liver metastases. The recorded data indicate (i) extremely poor prognoses associated with high grade adenocarcinomas that demonstrate stronger immunohistochemical positivity for PAP than that for PSA (ii), chromogranin A positive cells in benign structures adjacent to the cancer as a possible paracrine promoter of SCPC from poorly differentiated adenocarcinoma, and (iii) a high degree of heterogeneity of both SCPC and sarcomatoid prostatic neoplasms with some evidence for definite links (EMA and CEA) to secretory epithelial cells.

[Barber-Johnson analysis of bed utilization in hospital-based health care in the Croatian Republic during peace and war:1986-1991]. / Barber-Johnsonove analize koristenja kreveta u sustavu stacionarne zdravstvene zastite Republike Hrvatske u mirnodopskim i ratnim uvjetima: 1986-1991. godine.

Intensity of bed utilization in Croatia's hospitals in the peace-time period 1986-90 and the war year of 1991 was evaluated. The study covered 32 general-and-teaching hospitals disposing with 21,300 beds in 1986-90 and 27 of these hospitals with 19.000 beds in 1991. Basic information derives from hospital's statistical reports analyses by the Barber-Johnson's technique. While length of stay was reduced in the 1986-90 period, average number of discharges and deaths per available beds increased (1986/26.1; 1990/26.9). In the peace year of 1990 the performances of 11 of the 32 hospitals grouped in a zone limited to 10.0-12.9 days for the length of stays and 1.1-2.5 days for turnover interval. In the war year of 1991 the performances of 10 of the 27 hospitals were grouped in a zone defined by 8.5-10.9 days for length of stay and by 3.1 and 6.2 days for turnover interval. The Barber-Johnson's analysis provides key information in the decision making about hospital beds utilization, as well as in the evaluation of such decisions.

The biomechanics of the kidney: the isothermal function of the capsule adipose renis.

The paper describes the research in the field of thermodynamics. It deals with the function of capsule adipose renis. This homogenous tissue of low temperature acts as an independent thermal conductor. In fact, by encapsulating the kidney, it acts as a vacuum-flask, providing insulation for the kidney from two surrounding thermal areas, the warmer being on the interperitoneum and the cooler on the skin surface.

Effects of local chemotherapy and immunotherapy on the recurrence and progression of superficial bladder cancer.

409 cases of superficial bladder carcinoma (pTa, pTi, Tis) are reported. They are divided into three groups: 171 patients treated by TUR alone, 124 treated by TUR and local thio-TEPA, and 114 patients treated by TUR and BCG vaccine locally. It was found that the frequency of recurrence fell by 56.7, 41.9 and 26.3%, while the progression of the illness declined correspondingly by 19.8, 16.9 and 11.4%. In other words, in terms of recurrence and progression, the poorest results were found for the group treated by TUR only, and the best results were found with the TUR and BCG group.