Fungal Bezoars Mimicking an Enterovesica Fistula: A Unique Case Report.

Fungal colonization or infection of the urinary tract system is relatively common in patients with diabetes or a compromised immune system. However, fungal intravesical bezoars are extremely rare. We present a unique case with multiple, gas-holding fungals bezoars and emphysematous cystitis caused by

Down's syndrome screening: population statistic dependency of screening performance.

Background: The choice of parameter sets used to calculate Down's syndrome risks is important. This study details analysis of samples from affected and unaffected pregnancies and evaluates whether published population data is optimal. Screening efficiency realized with measurement procedure-specific population parameters is compared with selected population sets available in the literature.

Evaluation of Down's syndrome screening population data sets by simulation: analyser-specific parameters may be superior to meta-analysis-derived parameters.

Objective: Choice of parameter sets used to calculate Down's syndrome risks is complicated. Published population statistics were compared with assay-specific parameters to optimise screening efficiency.

Design: Weight-corrected Gaussian population statistics for alpha-fetoprotein (AFP), human chorionic gonadotropin (HCG) and unconjugated oestriol (uE(3)), expressed as log(10) multiples of median (MoM) were established for a Belgian cohort of 748 unaffected pregnancies.

Medians for second-trimester maternal serum markers: geographical differences and variation caused by median multiples-of-median equations.

Objectives: To establish gestational age-specific mid-trimester normal medians for the prenatal serum markers alpha fetoprotein (AFP), human chorionic gonadotropin (HCG) and unconjugated oestriol (uE3) for a Belgian population by using the Beckman Coulter Access chemiluminiscent immunoassays; to compare these data with data obtained from other geographical regions; to propose regression coefficients for regressed medians and analyse variation induced by different regression equations; to evaluate the effect of formulas used for gestation correction on estimating risk in Down's syndrome.

Design: Data derived from 862 fresh serum samples from women being screened for Down's syndrome pregnancy, composed of selected pregnancies deemed to be normal, were examined in a retrospective study. Regressed medians were calculated by using a first-degree logarithmic-linear fit of the raw data.

Weight correction of MoM values: which method?

Background: Adjusting maternal serum markers for maternal weight is considered to be a standard practice when screening for pregnancies associated with Down's syndrome. The choice of model for taking maternal weight into account is, however, rarely explicitly evaluated.

Method: The relationship between the maternal serum markers alphafetoprotein (AFP), human chorionic gonadotropin (HCG) and unconjugated oestriol (uE3), determined with the Beckman Coulter access reagents and maternal weight was investigated in a cohort of 752 Belgian women being screened for pregnancy associated with Down's syndrome.

Cryptorchidism and extragonadal germ cell tumor.

A patient with an extragonadal germ cell tumor and a history of bilateral cryptorchidism is reported. The rarity of this concurrence in a single patient is discussed. The necessity for thorough investigation of the cryptorchid testes in patients with metastatic germ cell cancer remains essential.

Role of penile nocturnal tumescence and rigidity measurement in the diagnosis of erectile impotence.

Reviewing a group of 100 patients undergoing nocturnal penile tumescence and rigidity measurement (NPTR), we tried to define normal values and compared these results with those of other authors. We also tried to answer two important questions: Is an abnormal NPTR registration always a proof of biogenic impotence? Is a normal NPTR always a proof of psychogenic impotence?

[Development of a new gastrointestinal prokinetic; pharmacology of cisapride].

The synthesis of benzamides derived from 1-substituted-3-methoxy or 3-hydroxy-4-piperidinamine resulted in the selection of a substituted benzamide, cisapride, which displays potent gastrokinetic properties. Pharmacological studies showed that cisapride improves both motility and transit of the oesophagus, the stomach, the small and large intestines. Moreover it markedly improves gastropyloroduodenal coordination.

Effect of ridogrel on vascular contractions caused by vasoactive substances released during platelet activation.

Ridogrel (6.3 x 10(-6) to 10(-4) M) inhibited contractions of isolated rat caudal arteries and rabbit femoral arteries caused by U-46619. The slope of an Arunlakshana-Schild plot (pA2-value: 3.

R 50 595, a selective non-competitive antagonist of cisapride, BRL 24924 and 5-hydroxytryptamine on the guinea-pig ileum.

5-Hydroxytryptamine and substituted benzamides such as cisapride and BRL 24924 enhance the twitch responses of the electrically stimulated longitudinal muscle-myenteric plexus preparation of the guinea-pig. The effects of these benzamides and 5-HT could possibly be mediated via similar receptor-effector systems. The aim of our study was therefore to determine whether R 50 595, an analogue of cisapride devoid of intrinsic activity, could specifically interfere with the effects of cisapride and BRL 24924 and if so, whether it would also affect the responses to serotonin.

Bilateral ureteral inverted papillomas in association with bladder carcinoma: a case report and review of the literature.

A case of multiple inverted papillomas of both ureters, in association with a bladder carcinoma, is presented. Inverted papilloma is a rare benign urothelial tumor. Because of its curability by conservative surgery, it should be considered in the differential diagnosis of a ureteral filling defect and ureteral obstruction.

Computer-assisted method for the analysis of postprandial gastrointestinal motility in conscious dogs.

A fully automated system to quantify different parameters of gastrointestinal motility and gastroduodenal co-ordination in conscious dogs was designed and built around a personal technical computer (HP 9816). Online it performs sampling of contractions on four different sites of the digestive tract for two dogs simultaneously, data reduction, drift correction and storage of data on hard disk. Offline it performs baseline determination, peak detection, calculation of motility parameters such as amplitude and interval, plus co-ordination between gastric and duodenal motility and presentation of the results in both tabular and graphic form.

Nebivolol is devoid of intrinsic sympathomimetic activity.

Nebivolol is a chemically novel, potent and selective beta 1-adrenoceptor-blocking agent that acutely lowers arterial blood pressure in hypertensive patients and rats without depressing, or even enhancing, left ventricular function. These properties could be compatible with a partial agonistic effect of beta-adrenoceptor-blocking agents. It was the aim of the present study to investigate whether nebivolol has intrinsic sympathomimetic properties.

Pharmacokinetic evaluation of the in vitro and in vivo pharmacological profile of the major metabolites of ketanserin in the rat.

In order to explain the differences between the in vitro and in vivo pharmacological activity of two major metabolites of ketanserin [+)-3-[2-[4-(4-fluorobenzoyl)-1-piperidinyl]-2,4(1H,3H)-quinazolinedione , R 41 468), viz. 6-hydroxyketanserin and ketanserin-ol, the pharmacokinetics of ketanserin and both metabolites were studied after oral and subcutaneous administration to male Wistar rats. The intrinsic potency of 6-hydroxyketanserin as a serotonin S2-antagonist is similar to that of ketanserin, as assessed by receptor-binding and pharmacological studies in vitro.

Prejunctional muscarinic (M1)-receptor interactions on guinea-pig ileum: lack of effect of cisapride.

Unlabelled: 1. Cisapride stimulates gastrointestinal motility, probably by enhancing the release of acetylcholine from myenteric nerve endings. Such an effect could be mediated via presynaptic muscarinic (M1)-receptors.

Clinical aspects in the surgical treatment of varicocele in subfertile men. II. The role of the epididymal factor.

Ninety-six couples, consulting for primary (n = 73) or secondary (n = 23) infertility, and thought to be infertile due to a varicocele in the husband associated with sperm abnormalities, were subjected to a follow-up study. Of these, 57 were surgically corrected and 39 were not, depending only on the patient's choice. All women were intensively treated where necessary.

Clinical aspects in the surgical treatment of varicocele in subfertile men. I. Comparison of observed and expected pregnancy rates.

Ninety-six couples, consulting for primary (n = 73) or secondary (n = 23) infertility, and thought to be infertile due to a varicocele in the husband associated with sperm abnormalities, were subjected to a follow-up study. Of these, 57 were surgically corrected and 39 were not, depending only on the patient's choice. All women were intensively treated where necessary.

Cerebral antivasoconstrictive effects of flunarizine.

Flunarizine is a selective Ca++-antagonist with weaker H1-histaminergic antagonistic properties. Flunarizine reduces vasospasm caused by an exaggerated Ca++-influx in depolarized arteries and by vasoactive substances released from aggregating platelets. This Ca++-antagonist also antagonizes the mutual amplification of the vasoconstrictor action of the platelet products.

Calcium antagonism and vascular smooth muscle.

Vasoconstriction results from an exaggerated increase of intracellular Ca2+ concentration which initiates the contractile process within the vascular smooth muscle. The dependency of these cells on extracellular Ca2+ to trigger the contractile process when exposed to naturally occurring vasoactive substances such as those released from aggregating blood platelets varies in different vascular areas. This is one of the factors that determine the different sensitivity to the inhibitory effect of various calcium antagonist.

Interaction between S2-serotonergic and alpha 1-adrenergic receptor activities at vascular sites.

Serotonin enhances (amplifies) the vasoconstrictor effect of norepinephrine not only on isolated large blood vessels and isolated perfused vascular beds but also in vivo. This amplification can be observed with endogenous serotonin released from aggregating platelets and with endogenous norepinephrine released from the adrenergic nerves in the blood vessel wall. It is due to an interaction between S2-serotonergic and alpha 1-adrenergic mechanisms.

Vasoconstrictor expression of human platelet-vessel wall interactions: inhibition by the Ca2+ entry blocker flunarizine.

Human blood platelets, stimulated with thrombin, induced contractions of isolated basilar artery segments of the dog. These platelet-mediated vascular contractions were inhibited in a concentration-dependent way by flunarizine, a Ca2+ entry blocker, selective for vascular tissues (IC50: 5.5 X 10(-7) M).