RESUMO
Simultaneously occurring embryonal cell tumors in a 38-year-old set of monozygotic twin brothers are reported. This is the eighth documented case of testicular cancer in twins and it is unique since it is the first report to describe bilateral testicular tumors in 1 of the twin brothers. The role of genetics in the development of certain cancers warrants further study. This documentation of testicular tumors in serologically proved identical twins is used as a basis for discussion of the role of heredity as a possible significant factor in germ cell tumor pathogenesis.
Assuntos
Doenças em Gêmeos , Disgerminoma/genética , Teratoma/genética , Neoplasias Testiculares/genética , Adulto , Disgerminoma/patologia , Feminino , Humanos , Masculino , Gravidez , Teratoma/patologia , Neoplasias Testiculares/patologia , Gêmeos MonozigóticosRESUMO
Patients with voiding disturbances comprise 20 per cent of the yearly outpatient visits to urologists. Of this number 25 per cent have significant neurogenic bladder dysfunction. The theoretical basis and experimental demonstration of urodynamics have been established and reported by multiple investigators during the last 15 years. Recent advances in clinical applications of fast-flow gas cystometry have led to the development of complete, portable urodynamic units that can be used conveniently in the urologist's office and are capable of simultaneously recording parameters of detrusor, urethral and skeletal muscle phincter function. This equipment is simple, efficient, economical and can be operated by well trained paramedical personnel, with minimal immediate direction required by a physician. With recent recognition by many third party carriers this equipment may amortize itself rapidly but, more importantly, it may serve to identify neurological diseases of the bladder that are undetected by other conventional methods of investigation. During the last 9 months 213 patients have undergone urodynamic evaluation at our outpatient urology clinic. These patients were categorized according to type and incidence of voiding disturbance and the number of neurogenic bladders diagnosed within each group was compiled and discussed. Several of the more interesting and unusual clinical examples are presented to familiarize the urologist with the interpretative aspects of this study.
Assuntos
Assistência Ambulatorial , Urodinâmica , Feminino , Humanos , Masculino , Doenças da Bexiga Urinária/fisiopatologia , Bexiga Urinaria Neurogênica/fisiopatologia , Transtornos Urinários/fisiopatologiaAssuntos
Adenocarcinoma/cirurgia , Neoplasias Renais/cirurgia , Adulto , Seguimentos , Humanos , Masculino , Métodos , Perfusão , ReimplanteRESUMO
A review is presented of vesical-related paragangliomas and 3 cases are reported. Methods for early diagnosis, including selective angiographic demonstration, and treatment of these rare tumors are discussed. A multi-team approach by the urologist, endocrinologist and anesthesiologist is stressed for better control of potentially dangerous vasomotor changes during diagnosis and surgical treatment of this tumor.
Assuntos
Paraganglioma , Neoplasias da Bexiga Urinária , Adolescente , Adulto , Feminino , Humanos , Hipertensão/tratamento farmacológico , Masculino , Paraganglioma/diagnóstico , Paraganglioma/cirurgia , Fenoxibenzamina/uso terapêutico , Bexiga Urinária/cirurgia , Neoplasias da Bexiga Urinária/diagnóstico , Neoplasias da Bexiga Urinária/cirurgiaRESUMO
Intravenous pyelography was performed after complete unilateral ureteral obstruction in dogs under conditions of mannitol diuresis and 3% NaCl solute loading. Pyelographic visualization with mannitol diuresis was uniformly poor. Satisfactory intravenous pyelograms were obtained in the 3% NaCl solute loaded group during the first 2 weeks, with nephrogram visualization noted up to 45 days postocclusion. The clinical use of pyelography, boosted by hypertonic solute loading during the early period after complete ureteral obstruction, may yield unexpected good quality studies.
Assuntos
Solução Salina Hipertônica , Cloreto de Sódio , Obstrução Ureteral/diagnóstico por imagem , Urografia , Animais , Diurese , Cães , Taxa de Filtração Glomerular , ManitolRESUMO
Intrarenal flow distribution in ischemic and nonischemic dog kidneys has been studied using the 133Xe washout technique and angiography. These preliminary studies showed two different hemodynamic alterations during perfusion, vasoconstriction, and diminution of cortical flow. Vasoconstriction of the renal artery and branches noted in both groups was observed to be a reversible phenomenon and disappeared within 1 hr of perfusion. A decrease in cortical flow was also seen at the beginning of perfusion in both groups, being much more severe in the ischemic group. Significant improvement in cortical flow was noted during the 1st hr of perfusion by both angiographic and washout techniques. This was most pronounced in the nonischemic group. The determination of flow distribution by 133Xe washout technique appears to correlate well with concomitant angiography. Future studies directed toward modification of preservation methods to minimize these changes may well lead to improvement of the present state of renal preservation.
