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Vasectomy in cryosurgery of the prostate
596
ABSTRACTS,
16th ANNUAL
turn by animals receiving cryosurgery + orchiectomy, and cryosurgery only. Reduction in tumor size and weight, assessed at 12 weeks postop, was strikingly reduced in those animals receiving cryosurgery + orchiectomy, followed in turn by animals receiving cryosurgery or orchiectomy alone. No reduction in tumor was noted in the control group. 43.
Vasectomy
in
Cryosurgery
of
the
Prostate.
HIDEKI,* JINNO HIROAKI,* UEDA KOSuKE,t AND OYAGURO KAZUO? (*Anjo Kosei Hospital, 12-38 Miyukihonmachi, Anjo, Aichi, and tNagoya City University Hospital, Kawasumi, Mizuho, Nagoya, Japan). WASHIDA
HIROTO,*
WATANABE
Cryosurgery of the prostate was performed on 166 patients from August 1975 to December 1978. There were 107 cases of benign hyperplasia of the prostate (BPH) and 59 cases of prostatic cancer (Pr.Ca.). Vasectomy was performed on 114 cases and the nonvasectomized group consisted of 52 cases. Epididymitis occurred in 20 of 166 cases (12.0%). In the vasectomized group, the incidence of epididymitis was 11.4% (13 of 114) and 13.5% (7 of 52) for the nonvasectomized group. BPH (107 cases): The incidence of epididymitis was 11.8% (9 of 76) for the vasectomized group and 12.9% (4 of 31) for the nonvasectomized group. Pr.Ca. (59 cases): The incidence of epididymitis was 10.5% (4 of 38) for the vasectomized group and 14.3% (3 of 21) for the nonvasectomized group. Regarding the incidence of epididymitis, there were no significant difference between the vasectomized group and the nonvasectomized group in BPH and Pr.Ca.. Retrospective studies were done on 20 cases of epididymitis. Fourteen of them developed epididymitis within 14 days after surgery. The left side was involved in 12 cases, the right side in 7 cases, and both sides in one case. There were 13 cases with infected urine and 7 cases with noninfected urine. It has not been demonstrated that vasectomy in cryosurgery of the prostate reduced the incidence of epididymitis. From the facts described, we may conclude that vasectomy as a routine in cryosurgery of the prostate is not indicated. WORKSHOP 2. RED BLOOD CELL AND BONE MARROW PRESERVATION 44. Historical Aspects Cryopreservation.
of Red
Cell and Bone
Marrow
B. GLASSMAN (Department of Laboratory Medicine, Medical University of South Carolina, 171 Ashley Avenue, Charleston, South Carolina 29403). ARMAND
Cryopreservation of human red blood cells traces its origin in part to a laboratory error that occurred in 1951. The first transfusions were associated with sig-
MEETING
niticant technical problems. Developments over the past 30 years have been related to physicochemical understanding of the use of cryopreservatives. Low glycerol cryopreservation and its modifications were described by Rowe in the 1960s. High glycerol methods and their subsequent modifications have been described by Tullis, Huggins, Meryman, and Valeri. The clinical usefulness of cryopreserved blood has led to increased demand. Use of frozen blood in the United States still represents less than 5% of the total. Clinical use of cryopreserved bone marrow awaits full development. The indications for replacement of bone marrow in patients who have been exposed to high levels of therapeutic radiation of chemotherapy are expanding. Problems with viability of the various hemo and myelo proliferative cells have yet to be overcome. A conference on Autologous Bone Marrow Transfusion was held in March 1979. Discussion of techniques, assessment of viability, and stem cell kinetics indicated that our understanding and development of techniques remains limited. Cryopreservation of red blood cells is a clinical reality. There appears to be clinical usefulness for cryopreservation of platelets and demands for other cells of the myeloid and lymphoid series that are as yet unmet. 45. Scientific and Cryopreservation.
Practical
Aspects
of Red
Cell
W. ROWE (The New York Blood Center, 310 East 67th Street, New York, New York 10021). ARTHUR
The principal driving force behind the vast research effort in red cell cryopreservation has been clinical need. The medically safe red cell preservation procedures used today are the “high glycerol-slow freeze” methods including the “cytoagglomeration” procedure and the “low glycerol-rapid freeze” procedure. All of these procedures utilize glycerol as the cryoprotectant but differ in concentration used, the rate of cooling and the method by which glycerol is both introduced and removed. Theoretical approaches on mechanisms of cryoprotection have concentrated on glycerol as the intracellular cryoprotective additive of choice for red cells while research on extracellular cryoprotection with HES, PVP, sugars, polymers, etc. remains neglected even though their potential has not been fully explored. The nature of freezing damage to red cells cryoprotected by either intracellular additives or extracellular additives requires further elucidation. Thawed red cells continue to hemolyze in vitro during post-thaw storage and may be due to enzymes, e.g. ATPase, in red cell membranes activated by freezing. Plasma as a resuspension medium reverses the postthaw hemolytic process better than crystalloid solutions. Prefreeze and post-thaw rejuvenation or supplementation with biochemical metabolites may enhance repair of freezing damage which could lead to extension of post-thaw shelf life of thawed red cells.
ABSTRACTS,
16th ANNUAL
turn by animals receiving cryosurgery + orchiectomy, and cryosurgery only. Reduction in tumor size and weight, assessed at 12 weeks postop, was strikingly reduced in those animals receiving cryosurgery + orchiectomy, followed in turn by animals receiving cryosurgery or orchiectomy alone. No reduction in tumor was noted in the control group. 43.
Vasectomy
in
Cryosurgery
of
the
Prostate.
HIDEKI,* JINNO HIROAKI,* UEDA KOSuKE,t AND OYAGURO KAZUO? (*Anjo Kosei Hospital, 12-38 Miyukihonmachi, Anjo, Aichi, and tNagoya City University Hospital, Kawasumi, Mizuho, Nagoya, Japan). WASHIDA
HIROTO,*
WATANABE
Cryosurgery of the prostate was performed on 166 patients from August 1975 to December 1978. There were 107 cases of benign hyperplasia of the prostate (BPH) and 59 cases of prostatic cancer (Pr.Ca.). Vasectomy was performed on 114 cases and the nonvasectomized group consisted of 52 cases. Epididymitis occurred in 20 of 166 cases (12.0%). In the vasectomized group, the incidence of epididymitis was 11.4% (13 of 114) and 13.5% (7 of 52) for the nonvasectomized group. BPH (107 cases): The incidence of epididymitis was 11.8% (9 of 76) for the vasectomized group and 12.9% (4 of 31) for the nonvasectomized group. Pr.Ca. (59 cases): The incidence of epididymitis was 10.5% (4 of 38) for the vasectomized group and 14.3% (3 of 21) for the nonvasectomized group. Regarding the incidence of epididymitis, there were no significant difference between the vasectomized group and the nonvasectomized group in BPH and Pr.Ca.. Retrospective studies were done on 20 cases of epididymitis. Fourteen of them developed epididymitis within 14 days after surgery. The left side was involved in 12 cases, the right side in 7 cases, and both sides in one case. There were 13 cases with infected urine and 7 cases with noninfected urine. It has not been demonstrated that vasectomy in cryosurgery of the prostate reduced the incidence of epididymitis. From the facts described, we may conclude that vasectomy as a routine in cryosurgery of the prostate is not indicated. WORKSHOP 2. RED BLOOD CELL AND BONE MARROW PRESERVATION 44. Historical Aspects Cryopreservation.
of Red
Cell and Bone
Marrow
B. GLASSMAN (Department of Laboratory Medicine, Medical University of South Carolina, 171 Ashley Avenue, Charleston, South Carolina 29403). ARMAND
Cryopreservation of human red blood cells traces its origin in part to a laboratory error that occurred in 1951. The first transfusions were associated with sig-
MEETING
niticant technical problems. Developments over the past 30 years have been related to physicochemical understanding of the use of cryopreservatives. Low glycerol cryopreservation and its modifications were described by Rowe in the 1960s. High glycerol methods and their subsequent modifications have been described by Tullis, Huggins, Meryman, and Valeri. The clinical usefulness of cryopreserved blood has led to increased demand. Use of frozen blood in the United States still represents less than 5% of the total. Clinical use of cryopreserved bone marrow awaits full development. The indications for replacement of bone marrow in patients who have been exposed to high levels of therapeutic radiation of chemotherapy are expanding. Problems with viability of the various hemo and myelo proliferative cells have yet to be overcome. A conference on Autologous Bone Marrow Transfusion was held in March 1979. Discussion of techniques, assessment of viability, and stem cell kinetics indicated that our understanding and development of techniques remains limited. Cryopreservation of red blood cells is a clinical reality. There appears to be clinical usefulness for cryopreservation of platelets and demands for other cells of the myeloid and lymphoid series that are as yet unmet. 45. Scientific and Cryopreservation.
Practical
Aspects
of Red
Cell
W. ROWE (The New York Blood Center, 310 East 67th Street, New York, New York 10021). ARTHUR
The principal driving force behind the vast research effort in red cell cryopreservation has been clinical need. The medically safe red cell preservation procedures used today are the “high glycerol-slow freeze” methods including the “cytoagglomeration” procedure and the “low glycerol-rapid freeze” procedure. All of these procedures utilize glycerol as the cryoprotectant but differ in concentration used, the rate of cooling and the method by which glycerol is both introduced and removed. Theoretical approaches on mechanisms of cryoprotection have concentrated on glycerol as the intracellular cryoprotective additive of choice for red cells while research on extracellular cryoprotection with HES, PVP, sugars, polymers, etc. remains neglected even though their potential has not been fully explored. The nature of freezing damage to red cells cryoprotected by either intracellular additives or extracellular additives requires further elucidation. Thawed red cells continue to hemolyze in vitro during post-thaw storage and may be due to enzymes, e.g. ATPase, in red cell membranes activated by freezing. Plasma as a resuspension medium reverses the postthaw hemolytic process better than crystalloid solutions. Prefreeze and post-thaw rejuvenation or supplementation with biochemical metabolites may enhance repair of freezing damage which could lead to extension of post-thaw shelf life of thawed red cells.