- Email: [email protected]
Address correction for universal medical instruments corp.
In a double-blind study we detected 6 of 50 (14%) patients with false positive HCG.’ Since some of these patients proved to have elevated levels of serum LH, it is apparent that the antisera utilized by commercial assays was not highly specific. Since the first 130 amino acids of the &HCG also shared in LH and it is only the 30 terminal amino acids of beta subunit that are specific for HCG, a false positive test may occur in a patient with elevated serum LH. Since patients with testicular tumors have undergone orchiectomy and/or intensive chemotherapy, they may have elevated serum LH due to hypogonadism. To rule out the false positive results obtained by the commercial RIA, one may measure simultaneous serum HCG and LH. We have utilized a highly specific carboxyLtermina1 RIA on concentrated 24hour urine utilizing kaoline-acetone technique of extracting urinary HCG. This assay utilizes an He3 RIA specific to the unique carboxyl-terminal peptide of HCG P-subunit (residues 123 to 145) described previously.’ Some investigators have reported measuring serum LH and HCG before and after administration of testosterone. If the false positive test result is due to the elevated serum LH, it should disappear after suppression of serum LH by testosterone.
lapse foilowing a playground fall. The presenting perineal mass was so large that the gynecologists were convinced that this was a uterine prolapse, and indeed, the mass was visually quite distressing. She had no difficulty in voiding. I was asked to see the child in consultation and cystoscoped her under general anesthesia, using the panendoscope to vaginoscope her also. This definitively made the diagnosis of massive urethral prolapse and a normal cervix. I did not undertake surgical repair because of the large size of the prolapse, and that an unusual amount of tissue would have to be removed. The child was placed on enforced bed rest and catheter (12-F) drainage for forty-eight hours. On removal of the catheter, she voided well. The prolapse was visibly less congested and edematous. She was discharged for outpatient care and followed for a total of two months. At that time, the urethra, almost normal in appearance, was asymptomatic and was producing no functional difficulty. She has not returned since that date. Dr. Redman points out in a personal communication that most of these cases occur in black females and that most of the reports on management have come from large charity hospitals or from practitioners in the South who see black patients. Certainly, in this case, as in Dr. Redman’s, conservative management produced a happy result, and the use of the cystourethroscope as a vaginoscope reassured us as to the correct diagnosis.
Nasser Javadpour, M.D. National Cancer Institute Bethesda, Maryland References
Toxey M. Morris, M.D. Hattiesburg, Mississippi 39401
1. TavaduourN. and Scares T: False nositive and False neeatiw alpha:feto$tein and human chorionic gonadotropin assays1, testic&r cancer. a doable-blind study, Cancer 48: 2279 (1981). 2. JavadpourN, and Chen H-?: Improved HC6 detection utilizing the P-subunit carboxyl-terminal radioimmunoassayof concentrated %-hour urine in patients with testicular cancer, J Urol
ADDRESS MEDICAL
1% 176 (1981).
CORRECTION FOR UNIVERSAL INSTRUMENTS CORP.
To the Editor:
CONSERVATIVE MANAGEMENT URETHRAL PROLAPSE
We wish to correct the address given on page 588 for Universal Medical Instruments Corporation in our article on “Aspiration Biopsy of the Prostate,” published in the June issue (vol. 19, pages 587-591, 1982) of UROLOGY. The correct address is: Universal Medical Instruments Corporation, Box 100 Ballston Spa, New York 12920; telephone (318)
OF
To the Editor: I was pleased to see Dr. John Redman’s summary of 3 cases of “Conservative Management of Urethral Prolapse in Female Children,” published in the May issue ~;vol. 19, pages 505-506) of UROLOGY. I wish to reinforce Dr. Redman’s recommendation for consideration of conservative management by presentation of an additional case. A six-year-old black female child was admitted to the gynecologic service of our hospital in January, 1981, with a presumptive diagnosis of uterine pro-
UROLOGY
!
SElTE.MBER
198.2 ’ VOLUME
‘XX, NUMBER
885-4396. Joseph J. Kaufman, Britt Marie Ljung, Philip Walther, Jerry Waisman, Los Angeles, California
3
M.D. M.D. M.D. M.D. 90024
351
lapse foilowing a playground fall. The presenting perineal mass was so large that the gynecologists were convinced that this was a uterine prolapse, and indeed, the mass was visually quite distressing. She had no difficulty in voiding. I was asked to see the child in consultation and cystoscoped her under general anesthesia, using the panendoscope to vaginoscope her also. This definitively made the diagnosis of massive urethral prolapse and a normal cervix. I did not undertake surgical repair because of the large size of the prolapse, and that an unusual amount of tissue would have to be removed. The child was placed on enforced bed rest and catheter (12-F) drainage for forty-eight hours. On removal of the catheter, she voided well. The prolapse was visibly less congested and edematous. She was discharged for outpatient care and followed for a total of two months. At that time, the urethra, almost normal in appearance, was asymptomatic and was producing no functional difficulty. She has not returned since that date. Dr. Redman points out in a personal communication that most of these cases occur in black females and that most of the reports on management have come from large charity hospitals or from practitioners in the South who see black patients. Certainly, in this case, as in Dr. Redman’s, conservative management produced a happy result, and the use of the cystourethroscope as a vaginoscope reassured us as to the correct diagnosis.
Nasser Javadpour, M.D. National Cancer Institute Bethesda, Maryland References
Toxey M. Morris, M.D. Hattiesburg, Mississippi 39401
1. TavaduourN. and Scares T: False nositive and False neeatiw alpha:feto$tein and human chorionic gonadotropin assays1, testic&r cancer. a doable-blind study, Cancer 48: 2279 (1981). 2. JavadpourN, and Chen H-?: Improved HC6 detection utilizing the P-subunit carboxyl-terminal radioimmunoassayof concentrated %-hour urine in patients with testicular cancer, J Urol
ADDRESS MEDICAL
1% 176 (1981).
CORRECTION FOR UNIVERSAL INSTRUMENTS CORP.
To the Editor:
CONSERVATIVE MANAGEMENT URETHRAL PROLAPSE
We wish to correct the address given on page 588 for Universal Medical Instruments Corporation in our article on “Aspiration Biopsy of the Prostate,” published in the June issue (vol. 19, pages 587-591, 1982) of UROLOGY. The correct address is: Universal Medical Instruments Corporation, Box 100 Ballston Spa, New York 12920; telephone (318)
OF
To the Editor: I was pleased to see Dr. John Redman’s summary of 3 cases of “Conservative Management of Urethral Prolapse in Female Children,” published in the May issue ~;vol. 19, pages 505-506) of UROLOGY. I wish to reinforce Dr. Redman’s recommendation for consideration of conservative management by presentation of an additional case. A six-year-old black female child was admitted to the gynecologic service of our hospital in January, 1981, with a presumptive diagnosis of uterine pro-
UROLOGY
!
SElTE.MBER
198.2 ’ VOLUME
‘XX, NUMBER
885-4396. Joseph J. Kaufman, Britt Marie Ljung, Philip Walther, Jerry Waisman, Los Angeles, California
3
M.D. M.D. M.D. M.D. 90024
351