Jacek Kudelski

ULTRASTRUCTURE OF THE TUNICA ALBUGINEA IN CONGENITAL PENILE CURVATURE

PURPOSE We investigated the ultrastructure of the tunica albuginea in individuals with congenital penile curvature to explain the pathology of this disease. MATERIALS AND METHODS Included in our study were 15 patients 17 to 24 years old with congenital penile curvature. Study material consisted of samples of the tunica albuginea excised from the greater curvature of the corpus cavernosum during surgical correction. Control samples were obtained from the lesser curvature on the side opposite the study material during the same operation. The 2 types of tissue were analyzed using transmitter electron microscopy. RESULTS Ultrastructural examination of the control material revealed numerous collagen fibers that were homogenous in size and organization on cross section. Periodic striation was typical in collagen that produced fibers. In the study group the tunica albuginea structure had a chaotic pattern of collagen fibers that formed bundles with disrupted 3-dimensional organization. Diameter of the fibers differed greatly on cross section. We observed periodic widening and fragmentation of collagen fibers with the complete disappearance of striation and transformation into electron dense, fibrous granulated material. Disrupted fibroblasts without cell membrane and cellular organelles between collagen fibers were also visible. There was elastin accumulation without any morphological differences in the control and study groups. CONCLUSIONS Our results show that ultrastructural changes in the tunica albuginea may cause congenital penile curvature, possibly by altering mechanical properties.

Copper, Zinc, and Cu/Zn Ratio in Transitional Cell Carcinoma of the Bladder

Introduction: Many epidemiological and experimental studies report a strong role of chemical carcinogens in the etiology of bladder cancer. However, involvement of trace elements in the tumorigenesis of transitional cell carcinoma of the bladder has been poorly investigated. The aim of this study was to examine the relationship between zinc, copper and bladder cancer. Materials and Methods: Zinc and copper concentration and Cu/Zn ratio in two 36-sample series of bladder cancer tissue and sera from patients with this neoplasm were matched with those of the control group. The amount of trace elements in every tissue sample was determined using atomic absorption spectrometry. This was correlated with tumor stage. Results: While the copper concentrations reached statistically higher values in the bladder cancer tissue, the zinc levels in the sera and bladder tissue of the patients with this carcinoma were substantially lower as compared to those of the control group. The serum Cu/Zn ratio was significantly higher in the bladder cancer group and this increase was greater in the patients with muscle-invasive neoplasm. Conclusions: The results obtained suggest a relationship between trace elements and the bladder cancer.

Successful microsurgical replantation of an amputated penis.

Traumatic amputation of the penis is a rare condition. The paper presents a 22-year old man who suffered a complete penile amputation in a result of an unfortunate accident. Microsurgical replantation of the penis was performed in the case with a complete return of sensation, sexual function and physiologic miction. Microsurgical replantation is the treatment of choice for this injury.

Phospholipid Composition and Electric Charge in Healthy and Cancerous Parts of Human Kidneys

Phospholipids are ubiquitous in nature and are essential for the lipid bilayer of cell membranes. Their structural and functional properties are pivotal for the survival of the cell. In this study the phospholipids of healthy and cancerous human renal tissues from the same patients are compared with special reference to the electric charge of the membrane. A simple and highly effective normal-phase method is described for analyzing phospholipids content. This work is focused on changes of phospholipids content (PtdIns, phosphatidylinositol; PtdSer, phosphatidylserine; PtdEtn, phosphatidylethanoloamine; PtdCho, phosphatidylcholine) in cell membranes of renal cancer of pT1 stage, G2 grade, without metastasis. Surface charge density of healthy and cancerous human renal tissues was measured by electrophoresis. The measurements were carried out at various pH of solution. Depending on the surface charge density as a function of pH, acidic (CTA) and basic (CTB) functional group concentrations and their average association constants with hydrogen (KAH) or hydroxyl (KBOH) ions were evaluated. The process of cancer transformation was accompanied by an increase in total amount of phospholipids as well as an increase in CTA and KBOH, whereas KAH and CTB were decreased compared with unchanged tumor cells.

Lead concentration in the bladder tissue and blood of patients with bladder cancer

Abstract Objective. To investigate the relationship between lead and bladder cancer. Material and methods. The levels of lead concentration in blood and bladder cancer tissue from a sample set of 36 bladder cancer patients were measured and then compared with those of a normal group. The levels of lead obtained in the bladder cancer tissue were evaluated depending on the stage of the tumour. The level of lead concentration in each tissue sample was determined by atomic absorption spectrometry. Results. The lead concentration reached statistically higher values in both the bladder cancer tissue and the blood of patients with this carcinoma compared with those of the control group. No relationship between lead concentration levels in the bladder cancer tissue and blood of patients with this neoplasm on stage of tumour was demonstrated. Conclusion. The results suggest that there is a relationship between exposure to lead and the initialization and development of bladder cancer.

Microsurgical Replantation of the Amputated Penis and Scrotum in a 29-Year-Old Man

A 29-year-old mentally ill farmer underwent microsurgery for the resuturing of the penis and testicles which he himself had chopped off with an ax. Microsurgery of the urethra, corpora cavernosa, arteries and veins was begun 10 h after the trauma. The veins, arteries and testicles were anastomosed and covered with a free flap of the scrotum skin. Three weeks after surgery, the anastomosed tested showed good healing. However, in 65% of the penis, necrosis had occurred.

Microsurgical replantation of sexual organs in three patients

Objective : The present study deals with microsurgical replantation technique. Material and Methods : The technique was applied in 3 patients whose sexual organs had been accidentally cut off. Results : Necrosis of the sutured organs occurred in 2 cases. In 1 case, however, healing with proper miction and sexual function was achieved. Prolonged period (over 12 hours) from the accident to operation as well as the extensive injury of tissues with the vascular system crush were considered to be the main reason for failure. Conclusions : Microsurgical reconstruction of penis and testes with the use of vessel grafts prolonged the hypoxia which led to necrosis. Disturbances in vein blood outflow from the sutured organs contributed to this process as well. The third case resulted in success mostly due to quick intervention (5 h from injury) as well as to proper microsurgical reconstruction of vessels, nerves, and urethra. In addition suprapubic urine diversion was successfully applied and the urethra healed on the perforated catheter. Routine antibiotics as well as antithrombotic prophylactics were administered in all of the 3 cases.

Chromium in urothelial carcinoma of the bladder

INTRODUCTION AND OBJECTIVES Many epidemiological and experimental studies report a strong role of chemical carcinogens in the etiology of bladder cancer. However, the involvement of heavy metals in tumourigenesis of urothelial carcinoma of the bladder has been poorly investigated. Therefore, the aim of this study was to examine the relationship between chromium (Cr) and bladder cancer. MATERIAL AND METHODS Chromium concentration in two 36-sample series of bladder cancer tissue and sera from patients with this neoplasm were matched with those of a control group. The amount of trace elements in every tissue sample was determined using atomic absorption spectrometry. This was correlated with tumour stage. RESULTS While the median chromium concentration levels reached statistically higher values in the bladder cancer tissue, compared with the non-cancer tissue (99.632ng/g and 33.144ng/g, respectively; p<0.001), the median Cr levels in the sera of the patients with this carcinoma showed no statistical difference when compared to those of the control group (0.511μg/l and 0.710μg/l, respectively; p=0.408). The median levels of Cr in the bladder tissue, depending on the stage of the tumour, compared with the tissue without the neoplasm, observed the same relationship for both non-muscle invasive and muscle-invasive tumours (p<0.001 and p<0.01, respectively). CONCLUSIONS This study shows that patients with urothelial carcinoma of the bladder had higher tissue Cr levels than people without tumour, while no difference was found in the Cr serum levels between the two groups of patients under investigation.