Introduction: Adrenocortical carcinoma (ACC) is a rare malignancy with an estimated incidence of 1-2 per million people. It may recur, after complete surgical removal by local or distant metastasis.Observation: We report a case of late metastatic ACC presented as a mesenteric mass, 10 years post left adrenalectomy. Our case was initially misdiagnosed radiologically as gastrointestinal stromal tumour (GIST), and then the decision for exploration was made. The mass could be safely excised and confirmed pathologically to be an adrenocortical tumour. (C) 2016 Pan African Urological Surgeons' Association. Production and hosting by Elsevier B. V.

Objective: To evaluate the effect of extended 12-core prostate biopsy in improving the detection rate of prostate cancer and increasing the accuracy of Gleason score.Methods: This study included 113 patients who underwent TRUS-guided lateral sextant biopsy (group I) and 176 patients who underwent extended 12-core biopsy (group II). Inclusion criteria for prostate biopsy were elevated serum PSA levels (> 3.0 ng/ml) and/or suspicious digital rectal examination (DRE).Results: Clinical characteristics were similar in both groups. Cancer was detected in 28 (24.8%) and 64 (36.4%) patients in group I and II respect tively, chi(2) = 4.26, p = 0.039. Among patients with cancer in group I, 14 were treated by radical prostatectomy (RP). The median Gleason sum was 6 (range 3-8) and 7 (range 5-9) for needle and prostatectomy specimens respectively. There was an agreement between the biopsy and prostatectomy Gleason sum in 7 (50%) patients while the biopsy Gleason sum was lower in 7 (50%) cases. Among patients with cancer in group II, 27 were treated by RP. The median and the range of Gleason sum was the same for needle and prostatectomy specimen (median 6, range 4-9). There was an agreement between the biopsy and prostatectomy specimen in 23 (85.2%) patients while the biopsy sum was lower than prostatectomy in 4 (14.8%) patients. The agreement between the biopsy and prostatectomy specimen was significantly higher in group II (82.5%) than group I (50%), Fisher's Exact Test, p = 0.026.Conclusion: Extended 12-core prostate biopsy significantly increases both the detection rate of prostate cancer and the accuracy of biopsy Gleason score. (c) 2005 Elsevier B.V. All rights reserved.

PURPOSE:A new modification for urinary diversion following cystectomy is presented.MATERIALS AND METHODS:A total of 20 patients with bladder cancer who were treated with radical cystectomy underwent urinary diversion using a new technique. The sigmoid colon is dismembered approximately 30 cm. proximal to the peritoneal reflection and detubularized by anterior incision in its proximal two-thirds. Ureters are reimplanted by nipple or submucosal tunnel technique. The rectosigmoid sheet is folded on itself and closed to form a rectosigmoid pouch. The terminal colon is reanastomosed end to side to the anterior surface of the rectum just proximal to the peritoneal reflection.RESULTS:During 4 to 36 months of followup all patients had complete daytime continence and only 2 had minimal nighttime fecal incontinence. The average daytime and nighttime evacuation frequency was 6 and 2 times, respectively. All patients were able to withhold voiding for an average of 30 minutes after maximum desire to void. Eight patients voided clear urine separated from stools in most instances while 12 voided mixtures of urine and stools. Postoperative excretory urogram revealed improvement of previously dilated systems in 8 renal units, deterioration in 4 and stable renal morphology in 28. An ascending pouchogram demonstrated good filling capacity in all cases. Urodynamic studies revealed low basic pressure within the pouch (mean 9.7 +/- 1.8 cm. water) with high compliance (mean 32.3 +/- 10).CONCLUSIONS:This type of diversion provides a low pressure urine reservoir with satisfactory early results of preservation of the upper urinary tract and evacuation pattern.

OBJECTIVE:To determine whether a defect in vasoactive intestinal peptide (VIP)-mediated vasodilatation underlies diabetic impotence.MATERIALS AND METHODS:Rats treated with streptozotocin for 8 weeks developed diabetes, as shown by hyperglycaemia and glycosuria, and had significant impairment of sexual function, as determined by tests of sexual behavior. The VIP content of the penis and major pelvic ganglion, the VIP release by the penis in vitro and the responsiveness of the vasculature of the penis in vivo to intracavernous VIP injection were determined.RESULTS:In diabetic rats, the VIP content of the major pelvic ganglion and penis was markedly increased, while the acetylcholine content of the penis was normal. The amount of VIP released in vitro by high potassium concentration or veratridine was similar for penile tissue slices of normal and diabetic rats. Intracavernous injection of VIP induced erection in the control rats but not in diabetic rats, whereas intracavernous injection of the adenylate-cyclase activator forskolin produced erection in both control and diabetic rats.CONCLUSION:Because VIP induces vasodilatation by activating adenylate cyclase, and forskolin produced erection in the diabetic rats, the failure of VIP to produce erection in these rats is unlikely to be due to a defect in the second-messenger mechanism or in the properties of vascular smooth muscle. Thus, a defect at the level of the VIP receptor or of the associated G-protein possibly explains the failure of intracavernous VIP to produce erection in the diabetic rats. Hence, an abnormality in VIP is a component of sexual dysfunction in the diabetic rat and the defect is at the level of the VIP receptor or associated G-protein.

OBJECTIVE:To determine the effect of diabetes mellitus (DM) on erectile function and evaluate the levels of nitric oxide synthetase (NOS) activity in streptozotocin-induced diabetic rats. MATERIALS AND METHODS:Rats were studied at 9 weeks and 14 weeks after the induction of DM by streptozotocin and compared with untreated control rats. Erectile potency was assessed physiologically by testing and recording mating behaviour. NOS activity was assayed in penile tissues and major pelvic ganglia (MPG) by conversion of [3H] L-arginine to [3H] citrulline. Histological, ultrastructural and immunohistochemical studies of penile tissues were performed in similar groups of rats. RESULTS:Diabetes mellitus adversely and significantly degraded all parameters of mating behaviour, thus indicating defective erectile potency. However, NOS activities in penile tissues from both groups of diabetic rats were significantly higher than those in controls (P < 0.01). In MPG, NOS activities were not significantly different between diabetic and control rats (P > 0.05). Histological, ultrastructural and immunohistochemical studies of penile tissues revealed no significant differences between control and diabetic rats, indicating an intact effector organ (smooth muscles) in rats with up to 14 weeks of DM. CONCLUSION:The impotence frequently observed in diabetic subjects would suggest that despite the increase in NOS activity in the penis, the pharmacological action of nitric oxide is impaired.

ADVERTISEMENT RETURN TO ISSUEPREVArticleNEXTNotes - The Effect of the Constitution of Cyclic Ketones Upon the Equilibrium Constants of Their CyanohydrinsA. El-AbbadyCite this: J. Org. Chem. 1956, 21, 7, 828–829Publication Date (Print):July 1, 1956Publication History Published online28 February 2003Published inissue 1 July 1956https://pubs.acs.org/doi/10.1021/jo01113a625https://doi.org/10.1021/jo01113a625research-articleACS PublicationsRequest reuse permissionsArticle Views52Altmetric-Citations1LEARN ABOUT THESE METRICSArticle Views are the COUNTER-compliant sum of full text article downloads since November 2008 (both PDF and HTML) across all institutions and individuals. These metrics are regularly updated to reflect usage leading up to the last few days.Citations are the number of other articles citing this article, calculated by Crossref and updated daily. Find more information about Crossref citation counts.The Altmetric Attention Score is a quantitative measure of the attention that a research article has received online. Clicking on the donut icon will load a page at altmetric.com with additional details about the score and the social media presence for the given article. Find more information on the Altmetric Attention Score and how the score is calculated. Share Add toView InAdd Full Text with ReferenceAdd Description ExportRISCitationCitation and abstractCitation and referencesMore Options Share onFacebookTwitterWechatLinked InRedditEmail Other access optionsGet e-Alertsclose Get e-Alerts