"Skin-CNS-bladder" reflex pathway for micturition after spinal cord injury and its underlying mechanisms.

Purpose: A "skin-CNS-bladder" reflex pathway for inducing micturition after spinal cord injury has been established in cat. This reflex pathway which is basically a somatic reflex arc with a modified efferent limb that passes somatic motor impulses to the bladder, has been designed to allow spinal cord injured patients to initiate voiding by scratching the skin.

Materials And Methods: The skin-CNS-bladder reflex was established in the cat by intradural microanastomosis of the left L7 ventral root (VR) to the S1 VR while leaving the L7 dorsal root (DR) intact to conduct cutaneous afferent signals that can trigger the new micturition reflex arc.

Chromosomal basis of adenocarcinoma of the prostate.

Prostate cancer is the most frequent malignancy and the second leading cause of cancer deaths among males in the Western world. The clinical course of the disease is highly complex, and genetic factors underlying tumorigenesis are poorly understood. The challenge that lies ahead is to identify the important gene(s) that causes adenocarcinoma of the prostate.

Loss of heterozygosity of the TP53 tumor suppressor gene and detection of point mutations by the non-isotopic RNAse cleavage assay in prostate cancer.

Mutation within the TP53 tumor suppressor gene is a frequent occurrence in human cancers, resulting in a poor prognosis, response to therapy, and overall survival time. Mutations have been primarily detected in advanced prostate cancer; however, the involvement of the gene through loss of heterozygosity (LOH) in primary prostate cancers has not been investigated due to lack of identifiable polymorphisms within this gene. Using the nonisotopic RNAse cleavage assay (NIRCA), we screened for point mutations and identified an ApaI restriction site polymorphism located in intron 7 within the TP53 gene.

Highly complex chromosomal aberrations in bone marrow of a patient with metastatic prostate neoplasm.

Prostate cancer is the single most common malignancy among men in North America. Nevertheless, cytogenetic evaluation of bone marrow in patients with metastatic prostate neoplasm has been rare and, to date, only five such patients have been reported. We report an additional case where chromosomal abnormalities of a bizarre nature were found in the bone marrow.

Genetics of bladder cancer.

Bladder cancer manifests many different forms, ranging from superficial to aggressive muscle invasion, which suggests that various genetic alterations are responsible. Several attempts have been made to establish correlations between specific genetic alterations and various grades of the disease. Numerous types of chromosomal abnormalities have been observed, involving [1p, 1q, 2q, 3p, 4p, 5q, i(5p), +7, +8, 8p, 9p, 9q, 10q23-25, 11p, 11q, +11, 13q, 14q, 17p, 18q, 21q, and Y].

A possible new reflex pathway for micturition after spinal cord injury.

In order to restore bladder function after spinal cord injury, a controllable new reflex pathway has been established in rats. It involves a somatic reflex arc with an artificially modified efferent branch which passes the somatic motor impulses to the bladder. This is achieved by intradural microanastomosis of the left L4 ventral root to L6 ventral root, while leaving the L4 dorsal root intact as a starter of micturition.

Simultaneous presence of schistosomiasis and advanced cancer in prostate.

A forty-nine-year-old patient was found to have Schistosoma eggs inside his prostatic cancer. At the time of diagnosis, the patient already had spread of metastatic disease in lumbar spine. Review of the literature revealed this to be the first such case published in English literature.

Initial experience with therasonic lithotriptor.

Piezoelectric shock wave lithotripsy has been shown to offer a low-cost, safe, anesthesia-free yet effective means of disintegrating urinary calculi. The Therasonic lithotriptor combines proprietary piezoelectric shock wave technology for effective stone fragmentation with a multi-purpose urologic table and both fluoroscopic and ultrasound imaging for accurate stone localization and real-time treatment monitoring. From December 1, 1988 to November 15, 1989, 138 patients with 172 calculi were treated (94.

Asynchronous erosion of inflatable penile prosthesis into small and large bowel.

Complications of a 3-piece inflatable penile prosthesis reservoir are rare, with rupture and fluid leakage being the most common. We recently encountered a patient in whom the reservoir migrated twice into the bowel. A review of the literature suggests that a previous major pelvic or abdominal operation might contribute to erosion of the reservoir into the adjacent viscera.

A retrospective analysis of the metabolic status of stone formers in the New York City metropolitan areas.

Eighty stone-forming patients were evaluated as outpatients for risk factors involved in stone formation. Analyses of the major stone risk parameters in the 24-hour collections indicated low volume (less than 2L) in about 79% of these patients. Forty percent of all patients were found to be hypocitraturic, 30% were hyperoxaluric, 18% were hypercalciuric, and 13% were hyperuricosuric.

Primary renal aspergillosis.

Primary renal aspergillosis has been reported only five times previously. We report the first case with primary renal aspergillosis where reconstructive and not extirpative surgery was used. Patients who have predisposing factors such as diabetes, malignancies, or immunosuppression represent the primary target for fungal infection.

Arteriovenous malformations of the bladder.

We report a rare case of a localized arteriovenous malformation of the bladder mimicking a bladder tumor and presenting with gross hematuria. The mass was successfully resected transurethrally.

Traumatic acute incarcerated scrotal hernia.

A 23-year-old male presented to the ER with left scrotal pain and swelling after being struck with a knee in the left inguinoscrotal area during a basketball game. Upon examination, an incarcerated scrotal hernia with necrotic segment of small bowel was found. Bowel was resected and direct reanastomosis performed.

The erect penis--injury prone organ.

Erection converts the safe, flaccid penis into a vulnerable organ. During erection, the usually thick tunica albuginea becomes very thin and easily fracturable. Penile fracture is an under-reported urologic injury, with only approximately 100 cases reported in the world literature.

Triple therapy for adult Wilms tumor.

Adult Wilms tumor is still considered a rarity. Approximately 170 adult Wilms tumors have been reported. The final diagnosis is usually established with surgery.

Simultaneous occurrence of transitional cell carcinoma and urothelial adenocarcinoma associated with xanthogranulomatous pyelonephritis.

We report on a patient with xanthogranulomatous pyelonephritis, in situ transitional cell carcinoma, and focal prosoplasia revealing abrupt conversion of transitional epithelium to moderately well-differentiated adenocarcinoma. The etiology and pathogenesis of mucinous adenocarcinoma in the renal pelvis very likely involves the prosoplastic transition of pre-existing transitional carcinoma to adenocarcinoma. The urologist should be aware of the increased possibility of this tumor developing in a patient with longstanding infection, and frozen section should be performed more often because the gross structure of the tumor frequently appears normal.

Testosterone receptors in corpora cavernosa of penis.

Despite existing information that most impotent patients have normal serum testosterone, testosterone is still used frequently in the treatment of impotence. In 11 patients who underwent penile implantation, we measured the presence of testosterone receptors in the corpora cavernosa. An average value of 1.

Malignant Sertoli cell tumor of testicle.

The eleventh case of malignant Sertoli cell tumor of the testicle is described. The tumor displayed malignant character with local invasion into the epididymis. Retroperitoneal lymph node dissection revealed a malignant deposit around the left renal artery.

Comparative evaluation of impotence with vibration and nocturnal monitoring.

Vibratory stimuli were used for diagnostic evaluation of 130 impotent patients. The stimuli were applied to the glans penis, and erectile response was measured and displayed on a recorder. The erectile response to vibration was compared with nocturnal penile tumescence (NPT) monitoring and to artificially produced full erection.

Genitourinary trauma.

A general review of genitourinary trauma is presented. Current practices, as well as old and more recent controversies involving diagnostic and therapeutic approaches, are discussed. The close cooperation between radiologists and urologists is essential for the most effective management of genitourinary trauma.

Cholinergic receptors in corpora cavernosa.

In a group of 13 patients who underwent penile surgery, a small amount of cavernosal tissue was removed and examined for content of cholinergic receptors. Three patients did not display any amount of cholinergic receptors. Values in the other 10 patients ranged from 34 to 136 femtomols.