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Testicular Function After Unilateral Orchiectomy for Cancer and Before Further Treatment
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DISEASES OF BLOOD VESSELS, HYPERTENSION AND RENOVASCULAR SURGERY
Testicular Function After Unilateral Orchiectomy for Cancer and Before Further Treatment
S. D. Fosso, 0. KLEPP, K. MOLNE AND A. AAK.VAAG, General Department, The Norwegian Radium Hospital, Oslo, Department of Obstetrics and Gynaecology, Rikshospitalet, University of Oslo and Hormone and Isotope Laboratory, Aker Hospital, Oslo, Norway Int. J. Androl., 5: 179-184 (Apr.) 1982 Of 35 patients who were examined after unilateral orchiectomy for a malignant germ cell tumor and before retroperitoneal surgery and/ or chemotherapy /radiotherapy 67 per cent were found to have low sperm counts, low motility indexes and a high number of abnormal sperm cells. Most patients also had slightly reduced serum testosterone levels. Based on these observations the author suggests that cryopreservation of semen from patients such as these appears to be oflittle value in providing subsequent fertility. W.J.C. 1 figure, 2 tables, 14 references
Interferons: Basic Research, Clinical Studies, and Their Support
R. M. FRIEDMAN, Department of Pathology, Uniformed Services University of the Health Sciences, School of Medicine, Bethesda, Maryland Arch. Path. Lab. Med., 106: 259-260 (June) 1982 In humans 3 general types of interferons have been characterized on the basis of immunologic specificity: a, f3 and y. a Interferon (leukocyte interferon) is the main interferon product (99 per cent) made by huffy coat cells stimulated by viruses. f3 Interferon is made by cultured epithelial cells in response to chemical inducers (synthetic double-stranded ribonucleic acid, polyribinosinic acid-polytibocytidylic acid). y Interferon is induced in lymphocytes by exposure to antigens to which the cells had been treated previously or to stimulators of mitotic acitivity. Thus, y interferons are classed as lymphokines. There are multiple subspecies of human y interferons, and a and /3 interferons have 15 per cent common structure. The multiple subspecies of a interferons have 85 per cent similarity in their amino acid sequence but are the products of different genes. Monoclonal antibodies to many of the a and f3 interferons have been made. These will help in the characterization of interferons and also in the development of rapid and sensitive immunoassays. Interferons were described initially as antiviral substances. They also have activity as negative cell growth control factors and as modifiers of the immune response. Interferons may slow cell growth without being toxic, thus, explaining the rationale for antitumor therapy. Interferon antiviral activity is multifaceted (inhibition of virus protein synthesis, impairment of assembly of virus particles). Interferons stimulate phagocytosis by macrophages, antibody production and cell-mediated immunity. Interferons are pyrogens (fever seems to be induced by interferons induced in tum by viruses). So far, studies of the inhibition of tumor growth by interferons are too preliminary to make any comment. The future availability of a greater quantity of interferon will permit more indepth studies. C.E.M. 10 references
DISEASES OF BLOOD VESSELS, HYPERTENSION AND RENOVASCULAR SURGERY March Myoglobinemia: A Hazard to Renal Function
I. MELAMED, Y. ROMEM, G. KEREN, Y. EPSTEIN AND E. DOLEV, Medical Corps, Israel Defense Forces, and Heller Institute of Medical Research, Chaim Sheba Medical Center, TelHashomer, Israel and Tel-Aviv University Medical School Arch. Intern. Med., 142: 1277-1279 (July) 1982 The authors assess the effect of exertional rhabdomyolysis on renal function. They determined serum muscle enzyme levels, serum myoglobin levels and creatinine clearances in a group of army recruits subjected to 8 weeks of vigorous physical activity. The activity consisted of jogging 4 km. daily and participating in hikes of first 10 km., then 30 km. and, finally, 45 km. in distance. Serum muscle enzymes and serum myoglobin levels were found to increase before the first hike in the first week of activity and remain elevated throughout the study. The average basal creatinine clearance of the 20 recruits was 130 ml. per minute ± 30.4. The average creatinine clearance increased after the first hike to a level of 165 ml. per minute ± 32.5. The average creatinine clearance then decreased to a value of 86 ml. per minute ± 22 after the second hike and, finally, it decreased for an average value of 70.4 ml. per minute ± 20.9 after the 45 km. hike. In the first week of activity serum myoglobin levels were found to increase to 5 times the average basal level and they remained at this level for the duration of the study. Average serum uric acid concentration demonstrated a similar pattern: it increased within the first week of activity and stayed at approximately 3 times the basal level for the rest of the study. The authors conclude that physical activity induces muscular damage as evidenced by the elevated serum muscle enzymes and myoglobin concentrations. Furthermore, the main injury to the muscle was found in the first week or so of exercise. After this time the myoglobin concentration (the most sensitive indicator of muscle injury) remained constant and increased no further. Persistent myoglobinemia was considered by the authors to result in decreased renal function as shown by the pathologically low creatinine clearance at the end of the study. Tubular obstruction, toxic reactions of the heme pigments, renal ischemia and decreased glomerular permeability are 4 postulated mechanisms by which this injury may occur. G.F.S. 2 figures, 3 tables, 19 references
What Should Blood Pressure be in Healthy Children
W.W. McCRORY, Division of Pediatric Nephrology, New York Hospital-Cornell Medical Center, New York, New York Pediatrics, 70: 143-145 (July) 1982 In a recent commentary it was suggested that the blood pressure of children need not increase as a natural consequence of aging and that, indeed, an increase might indicate impending disease. So strong was the position taken that it was even suggested that salt restriction might be inflicted upon pediatric patients to prevent the future development of hypertension. McCrory has responded to this stance with an editorial of his own, in which he pointed out that while there is reason to question direct age to blood pressure relationships there are many studies that indicate that blood pressure is related strongly to body mass and may be influenced by hormonal
DISEASES OF BLOOD VESSELS, HYPERTENSION AND RENOVASCULAR SURGERY
Testicular Function After Unilateral Orchiectomy for Cancer and Before Further Treatment
S. D. Fosso, 0. KLEPP, K. MOLNE AND A. AAK.VAAG, General Department, The Norwegian Radium Hospital, Oslo, Department of Obstetrics and Gynaecology, Rikshospitalet, University of Oslo and Hormone and Isotope Laboratory, Aker Hospital, Oslo, Norway Int. J. Androl., 5: 179-184 (Apr.) 1982 Of 35 patients who were examined after unilateral orchiectomy for a malignant germ cell tumor and before retroperitoneal surgery and/ or chemotherapy /radiotherapy 67 per cent were found to have low sperm counts, low motility indexes and a high number of abnormal sperm cells. Most patients also had slightly reduced serum testosterone levels. Based on these observations the author suggests that cryopreservation of semen from patients such as these appears to be oflittle value in providing subsequent fertility. W.J.C. 1 figure, 2 tables, 14 references
Interferons: Basic Research, Clinical Studies, and Their Support
R. M. FRIEDMAN, Department of Pathology, Uniformed Services University of the Health Sciences, School of Medicine, Bethesda, Maryland Arch. Path. Lab. Med., 106: 259-260 (June) 1982 In humans 3 general types of interferons have been characterized on the basis of immunologic specificity: a, f3 and y. a Interferon (leukocyte interferon) is the main interferon product (99 per cent) made by huffy coat cells stimulated by viruses. f3 Interferon is made by cultured epithelial cells in response to chemical inducers (synthetic double-stranded ribonucleic acid, polyribinosinic acid-polytibocytidylic acid). y Interferon is induced in lymphocytes by exposure to antigens to which the cells had been treated previously or to stimulators of mitotic acitivity. Thus, y interferons are classed as lymphokines. There are multiple subspecies of human y interferons, and a and /3 interferons have 15 per cent common structure. The multiple subspecies of a interferons have 85 per cent similarity in their amino acid sequence but are the products of different genes. Monoclonal antibodies to many of the a and f3 interferons have been made. These will help in the characterization of interferons and also in the development of rapid and sensitive immunoassays. Interferons were described initially as antiviral substances. They also have activity as negative cell growth control factors and as modifiers of the immune response. Interferons may slow cell growth without being toxic, thus, explaining the rationale for antitumor therapy. Interferon antiviral activity is multifaceted (inhibition of virus protein synthesis, impairment of assembly of virus particles). Interferons stimulate phagocytosis by macrophages, antibody production and cell-mediated immunity. Interferons are pyrogens (fever seems to be induced by interferons induced in tum by viruses). So far, studies of the inhibition of tumor growth by interferons are too preliminary to make any comment. The future availability of a greater quantity of interferon will permit more indepth studies. C.E.M. 10 references
DISEASES OF BLOOD VESSELS, HYPERTENSION AND RENOVASCULAR SURGERY March Myoglobinemia: A Hazard to Renal Function
I. MELAMED, Y. ROMEM, G. KEREN, Y. EPSTEIN AND E. DOLEV, Medical Corps, Israel Defense Forces, and Heller Institute of Medical Research, Chaim Sheba Medical Center, TelHashomer, Israel and Tel-Aviv University Medical School Arch. Intern. Med., 142: 1277-1279 (July) 1982 The authors assess the effect of exertional rhabdomyolysis on renal function. They determined serum muscle enzyme levels, serum myoglobin levels and creatinine clearances in a group of army recruits subjected to 8 weeks of vigorous physical activity. The activity consisted of jogging 4 km. daily and participating in hikes of first 10 km., then 30 km. and, finally, 45 km. in distance. Serum muscle enzymes and serum myoglobin levels were found to increase before the first hike in the first week of activity and remain elevated throughout the study. The average basal creatinine clearance of the 20 recruits was 130 ml. per minute ± 30.4. The average creatinine clearance increased after the first hike to a level of 165 ml. per minute ± 32.5. The average creatinine clearance then decreased to a value of 86 ml. per minute ± 22 after the second hike and, finally, it decreased for an average value of 70.4 ml. per minute ± 20.9 after the 45 km. hike. In the first week of activity serum myoglobin levels were found to increase to 5 times the average basal level and they remained at this level for the duration of the study. Average serum uric acid concentration demonstrated a similar pattern: it increased within the first week of activity and stayed at approximately 3 times the basal level for the rest of the study. The authors conclude that physical activity induces muscular damage as evidenced by the elevated serum muscle enzymes and myoglobin concentrations. Furthermore, the main injury to the muscle was found in the first week or so of exercise. After this time the myoglobin concentration (the most sensitive indicator of muscle injury) remained constant and increased no further. Persistent myoglobinemia was considered by the authors to result in decreased renal function as shown by the pathologically low creatinine clearance at the end of the study. Tubular obstruction, toxic reactions of the heme pigments, renal ischemia and decreased glomerular permeability are 4 postulated mechanisms by which this injury may occur. G.F.S. 2 figures, 3 tables, 19 references
What Should Blood Pressure be in Healthy Children
W.W. McCRORY, Division of Pediatric Nephrology, New York Hospital-Cornell Medical Center, New York, New York Pediatrics, 70: 143-145 (July) 1982 In a recent commentary it was suggested that the blood pressure of children need not increase as a natural consequence of aging and that, indeed, an increase might indicate impending disease. So strong was the position taken that it was even suggested that salt restriction might be inflicted upon pediatric patients to prevent the future development of hypertension. McCrory has responded to this stance with an editorial of his own, in which he pointed out that while there is reason to question direct age to blood pressure relationships there are many studies that indicate that blood pressure is related strongly to body mass and may be influenced by hormonal