Autoimmune orchitis, epididymitis, and vasitis are immunogenetically distinct lesions

Experimental allergic orchitis (EAO), the principle animal model of noninfectious testicular inflammatory disease, is a genetically determined phenotype. Classical EAO, induced by inoculation with testicular homogenate and the appropriate adjuvants, is characterized by inflammatory infiltrates in the testis (orchitis), epididymis (epididymitis), and vas deferens (vasitis). In this study, the genetic control of susceptibility and resistance to these three lesions was analyzed in the mouse. The results obtained with independent inbred strains and H2 congenic mice show that the genetic control of all three lesions is complex and involves both H2 and non-H2-linked genes. Whole-genome exclusion mapping was performed on a backcross population segregating for all three phenotypes. Permutation-derived thresholds provided experimentwise, chromosomewise, comparisonwise, and marker-specific chromosomewise thresholds for declaration of significant regions linked to marker loci. Unique loci were identified on chromosome 8 for orchitis, chromosome 16 for epididymitis, and chromosome 1 for vasitis and have been designated as Orch6, Epd1, and Vas1, respectively. These results show that autoimmune orchitis, epididymitis, and vasitis are immunogenetically distinct lesions.     

Mumps orchitis: report of a mini-epidemic

PURPOSE: The incidence of mumps orchitis has declined dramatically since the introduction of vaccination. While in the past cases of mumps have only been seen occasionally at our institution, recently there has been a sharp increase in the number of confirmed cases. MATERIALS AND METHODS: Between June 1995 and April 1996, 11 patients with severe mumps orchitis were hospitalized at our clinic. Medical history, therapeutic measures and clinical outcome were recorded for each patient. RESULTS: All patients showed marked scrotal swelling with a temperature above 38.5 C. Serum C-reactive protein was significantly elevated (mean 140 mg./l.). The vaccination status of 1 of the 11 patients (9%) was unknown. Medical records from the remaining 10 patients indicated that they had not been vaccinated. Nine patients (82%) had a typical mumps parotitis preceding the orchitis. In 2 patients the clinical diagnosis of parotitis was uncertain but mumps serology was positive. None of the patients showed other manifestations of mumps. Antibodies to the mumps virus (IgG and IgM) were determined in 6 patients and positive in all cases. The average interval between parotitis and onset of orchitis was 10 days. All patients were hospitalized for an average of 6 days. Treatment included bed rest with local cooling, scrotal support and systemic treatment with nonsteroidal anti-inflammatory drugs. Ciprofloxacin or clavulanic acid/amoxicillin was administered as bacterial orchitis could not be excluded at initial presentation. The mean time to cessation of fever was 3.6 days (range 3 to 5). Antibiotics were administered for an average of 8.8 days (range 7 to 13) and anti-inflammatory drugs were given an average of 8.6 days (range 7 to 11). One patient required scrotal exploration. CONCLUSIONS: Since the introduction of a vaccine against the mumps virus there is a diminished risk for mumps and its complications. However, in case of scrotal swelling mumps orchitis should still be considered. Despite vaccination mumps has not been erradicated. Therefore, continued vaccination should be considered an important step in minimizing clinical outbreaks and working towards a possible eradication of this disease in the future.     

Acute epididymitis: a work-related injury?

Occupational medicine physicians frequently are presented with requests by employers to determine the work-relatedness of medical illnesses or injuries. Occasionally, this involves a sudden onset of acute epididymitis in the male employee after strenuous activity in the workplace. Because the vast majority of acute epididymitis cases have an underlying sexually transmitted disease component, this poses a real dilemma for the consulting physician. This article discusses the etiology and pathogenesis of acute epididymitis along with its epidemiologic significance and reviews workers' compensation and its possible legal interpretation when acute epididymitis occurs at the worksite.     

Altered bladder function and non-specific epididymitis

Disorders of bladder function characterized by physiological urethral obstruction were identified in nearly 50% of patients with non-specific epididymitis and anatomically normaly urinary tracts. This association supports the concept that reflux of urine into the ejaculatory ducts may occur and produce epididymitis. The pathophysiology of retrograde urination is reviewed and the predisposing conditions are discussed.     

Tubercular mastitis: a pragmatic approach to its management

Six cases of tubercular granulomatous mastitis were studied retrospectively. Three of these six cases posed diagnostic difficulties because of a lack of caseation in granuloma on fine needle aspiration cytology. A pragmatic approach is described here that is based on the correlation of the clinical features with the cytological findings. All six cases improved on therapeutic trial of antitubercular treatment.     

结核性脑膜炎与化脓性脑膜炎的放射诊断对比分析

目的:探讨结核性脑膜炎与化脓性脑膜炎的放射诊断对比效果.方法:化脓性脑膜炎12例和结核性脑膜炎28例分别都进行CT平扫加增强扫描.结果:化脓性脑膜炎中CT发现异常的为58.3%,结核性脑膜炎发现异常的占64.3%,CT发现异常的病例中均有相应的CT特征表现.结论:结核性脑膜炎与化脓性脑膜炎的放射诊断效果都比较好,结合临床可进一步明确判断疾病的性质,从而指导临床制定更为合理的治疗方案.     

Age patterns of smoking in US black and white women of childbearing age

OBJECTIVES: The purpose of the study was to describe age patterns of smoking among Black and White women of reproductive age, with cohort membership controlled for. METHOD: Data from the 1987 National Health Interview Survey Cancer Supplement, weighted to be nationally representative, were used to calculate the fractions of women who were ever smokers, quitters, and current smokers by age and race. Summary distributions of age patterns of smoking behaviors by race were estimated; proportional hazard models were used to avoid confounding of age and cohort. RESULTS: White women begin smoking at younger ages than do Blacks but are more likely to quit and to do so at young ages. Rates of current smoking converge between Blacks and Whites by age 25, and may cross over by 30. Education-standardized results show larger Black-White differentials in ever smoking and smaller differences in quitting. CONCLUSIONS: Our findings confirm that women's age patterns of smoking vary by race. Age x race interactions should be considered in smoking research and anti-tobacco interventions. For Black women, delayed initiation and failure to quit call for increased emphasis on interventions tailored to adults. These findings have possible implications for understanding Black-White differences in low birthweight, child health, and women's health.     

Granulomatous orchitis. A case report and review of the literature

We developed a method for determination of motor conduction along the mandibular and sensory conduction along the lingual and inferior alveolar nerves in 10 controls and 6 patients with lingual neuropathy following lower wisdom tooth extraction. Patients with lingual neuropathy had reduced/absent or delayed compound sensory action potentials and normal conduction along the fibers of the inferior alveolar nerve and mandibular nerve. The method provides a useful electrophysiological means of evaluating lingual nerve lesions.     

Experimental epididymitis and urethritis in grivet monkeys provoked by Chlamydia trachomatis

Fluorescence spectroscopy was applied to the development of sensitive analytical methods for the determination of thiazole and several congeners that contain substituted thiazole rings. Treatment to yield thionine, previously used spectrophotometrically to measure thiazole and fluorometrically only for sulfur determinations in inorganic systems, is further characterized and illustrated with the determination of the antibiotic thiopeptin. This method is selective for submicrogram quantities of thiazole rings in the presence of fused-ring derivatives and reduced analogs. It has a precision of +/- 2% RSD (n = 11) at the 15-ng/ml thiazole concentration level with a signal-to-noise ratio of 3:1. For thiopeptin, this method has an accuracy of 5% mean relative error (n = 8) over the 5--20-ppm range in medicated feed.     

Differential diagnosis of acute testicular pain using color-coded duplex ultrasonography: difference between testicular torsion and epididymitis

OBJECTIVE: To assess retrospectively the accuracy of colour-coded duplex sonography (CCDS) in distinguishing testicular torsion from epididymitis as the cause of acute testicular pain. PATIENTS AND METHODS: The results of CCDS were analysed for all 81 patients (mean age 27.2 years [6 weeks to 60 years]), admitted between 1.1.1995 and 30.6.1996 with the diagnosis of acute testicular pain. Testicular torsion was diagnosed when CCDS failed to detect perfusion in one testis. Regular arterial and venous perfusion of both testes excluded torsion. Epididymitis was diagnosed when hyperperfusion of the epididymis was demonstrated by CCDS. RESULTS: 20 of 22 cases of torsion, subsequently diagnosed at surgery, had been correctly diagnosed by CCDS (sensitivity 90.9%, specificity 98.3%). 55 patients had epididymitis, confirmed by the clinical course and follow-up having excluded torsion. Other causes (trauma, tumour, inguinal hernia) were found in the remainder of patients. CONCLUSION: With a positive predictive value of 95.2% and a negative one of 96.6% CCDS is a highly suitable method for recognizing or excluding testicular torsion and thus clarifying the cause of acute testicular pain.     

Omental fibroma: CT and US findings

The US, CT, and X-ray findings in a patient with omental fibroma of the lesser omentum are described. Ultrasound showed a solid mass with cystic areas in the central region. At CT the lesion showed peripheral enhancement and central hypodensity. On X-ray studies with barium, there was border distortion in the lesser curvature of the stomach. The mass was resected surgically. A pathologic diagnosis of fibroma was confirmed.     

Increased incidence of mumps orchitis in adolescence and adulthood--sequelae of low vaccination rate?

In recent years, mumps orchitis has become a rarely reported disease. However, since October 1994 a clear increase in the incidence of this disease has been observed. At four hospitals in the Saarland, Germany, 45 cases of mumps orchitis in adolescents and adults were diagnosed in this period. In addition to the case history and clinical findings, the diagnosis was confirmed by an increased IgM titer. None of the patients had been previously vaccinated. The main reason for this was a lack of parental knowledge of the necessity for this vaccination, one which has almost no side effects. The goal of this study is to describe the disease, present our own results, and indicate the need for vaccination. In addition to providing information, a further aim of the study is to increase the motivation of adolescents and adults for vaccination. Although many treatments for mumps have been published in recent years, the most successful therapy is still prophylactic vaccination.     

Primary epiploic appendagitis: US and CT findings

A retrospective review is presented of seven cases of epiploic appendagitis, with surgical confirmation in one case. The main clinico-analytical data and the US and CT findings are described, as well as the histopathologic features in the sole case that underwent surgical resection. We also calculated the frequency of this entity in patients undergoing emergency abdominal US on clinical suspicion of diverticulitis. In all seven cases the clinico-analytical evidence was nonspecific (localized acute abdominal pain and slight leukocytosis), mimicking in six cases the clinical presentation of sigmoid diverticulitis and in one case that of acute appendicitis. US imaging findings were characteristic: a hyperechoic mass localized under the point of maximum pain, adjacent to the anterior peritoneal wall and fixed during deep breathing. In none of the cases did color Doppler US show flow. CT findings were also typical and showed a mass with a peripheral hyperattenuated rim surrounding an area of fatty attenuation. Overall 7.1 % of patients investigated to exclude sigmoid diverticulitis finally showed findings of primary epiploic appendagitis. Primary epiploic appendagitis thus shows characteristic US and CT findings that allow its diagnosis and follow-up. This entity is much more frequent than previously reported, especially in patients referred for US to exclude sigmoid diverticulitis.     

Placenta accreta: evaluation with color Doppler US, power Doppler US, and MR imaging

PURPOSE: To determine the value of transabdominal ultrasound (US), transvaginal US, color Doppler US, power Doppler US, and magnetic resonance (MR) imaging in the diagnosis of placenta accreta. MATERIALS AND METHODS: Nineteen patients in the third trimester of pregnancy who were at risk for placenta accreta underwent color Doppler and power Doppler US; 18 patients also underwent MR imaging. Images were interpreted prospectively for signs of accreta by two reviewers. The reviewers' confidence in their diagnosis was graded on a five-point scale. RESULTS: Outcomes at delivery were as follows: normal placenta (n = 11), hysterectomy owing to uncontrollable bleeding (n = 1), and placenta accreta (n = 7). Five cases of lower-uterine-segment placenta accreta were diagnosed with a high level of confidence with vaginal and power Doppler US. In one patient with a posterior placenta who had previously undergone myomectomy, MR imaging enabled the diagnosis of placenta accreta, which was not well depicted at US. CONCLUSION: In patients with a history of uterine scars, vaginal US with power Doppler US performed well in the evaluation of lower-uterine-segment placenta accreta. MR imaging depicts posterior placenta accreta.     

Brachial plexus: demonstration at US

Because telomerase activity is necessary for cell immortality and probably associated with tumor progression, we have evaluated a possible aid for quantitation of the activity to predict intrahepatic recurrences after surgery in patients with hepatocellular carcinoma (HCC). HCC tissues obtained by surgical resection from 20 patients were studied. Telomerase activity was expressed as peaks with a periodicity through a fluorescence-based telomeric repeat amplification protocol using an autosequencer, and the quantity of activity was calculated from peak areas. A ratio of fluorescence intensity depending on telomerase to that of an internal standard was used as a value of relative telomerase activity (RTA). RTA in serially diluted S100 extracts from HepG2 cells was well correlated with the amount of the extracts. The mean RTA value of 36.4 +/- 27.8 (mean +/- SD, 3.21 to 105) in 9 patients suffering from early recurrences after surgery was significantly higher than that (9.84 +/- 7.65; mean +/- SD, 3.00 to 29.0) in 11 patients without intrahepatic recurrences during the early period (P = .004). These results indicate that RTA value can be a useful predictor for intrahepatic recurrences during the early period after surgical resection of HCC.     

Temporal patterns of the rabbit's nictitating membrane response to compound and component stimuli under mixed CS–US intervals.

The acquisition of the rabbit's nictitating membrane response to a tone and light compound and to its components was examined when compound presentations were reinforced at one conditioned stimulus–unconditioned stimulus (CS–US) interval and individual component presentations were reinforced at another CS–US interval. Examination of the time course of the CRs revealed that (a) despite the mixture of CS–US intervals, conditioned response (CR) timing remained accurate, that is, CRs reached their peaks at the alternative points of US delivery; (b) the momentary magnitude of the CR to the compound was predominately an additive function of the CR magnitude to the individual components; but (c) there was modest evidence of differentiation between the compound as a unit and the individual components. The results are discussed in terms of their implications for the study of the neural substrates of temporal and sensory integration as they modulate CR acquisition. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Acute cholecystitis: comparison of MR cholangiography and US

p70 S6 kinase plays an important role in growth factor-induced translational control and in cell cycle progression. Although the mechanism of p70 S6 kinase regulation is not fully understood, phosphorylation of serine and threonine residues of the enzyme is essential for its activation. The possible role of the serine-threonine kinase Akt in the activation of p70 S6 kinase induced by exposure of cells to heat has now been investigated. Overexpression of a mutant Akt1 (Akt-AA) in which the phosphorylation sites (Thr308 and Ser473) targeted by growth factors are replaced by alanine was shown to exert a dominant negative effect on Akt activation induced by platelet-derived growth factor (PDGF) or by heat treatment in CHO cells. Akt-AA also inhibited p70 S6 kinase activation induced by these stimuli. However, Akt-AA had no effect on the activation of p70 S6 kinase induced by 12-O-tetradecanoylphorbol 13-acetate, which did not stimulate Akt activity in these cells. These data suggest that Akt is required for heat treatment-induced activation of p70 S6 kinase.