This study concerns the nature of two different cell populations in a juvenile granulosa cell tumor (GCT) of the infantile testis. Immunohistochemical features of the tumor were compared with those of normal infantile testes (six cases) and ovaries (six cases). The testicular neoplasm showed follicles, cysts and solid nodules composed of an internal layer of polyhedral cells that expressed cytokeratin and vimentin. Most of the follicles and nodules were surrounded by an external layer of spindle cells that reacted to muscle-specific actin, vimentin, and focally to desmin. A neoplastic rather than reactive origin of the spindle cell population is favored by their concentric arrangement in a peritubular-like or theca-like fashion and by their immunohistochemical correlation with normal peritubular-myoid and theca externa cells. Sertoli and granulosa cells of normal infantile gonads were positive for cytokeratin and vimentin; peritubular myoid and theca externa cells expressed muscle-specific actin, vimentin...

Juvenile Granulosa Cell Tumor of the Testis: A Comparative Immunohistochemical Study with Normal Infantile Gonads

In situ extracorporeal shock wave lithotripsy (ESWL) for the management of primary ureteric calculi in children

Summary— The value of duplex scanning in the assessment of impotence was evaluated in 146 impotent men. Scanning was by means of a Diasonics DRF 400 and penile artery measurements were taken before and after the intracorporeal injection of papaverine hydrochloride. The penile/brachial index was measured in 82 patients and its predictive value compared with the results of duplex scanning and papaverine-induced erection. On scanning evidence of good arterial inflow but poor erections, indirect evidence of venous leakage was assumed.



The results showed that the deep artery responses best charaterised the erectile response, with the dorsal artery being less helpful.



All 37 patients with full erections following papaverine exhibited bilateral deep artery peak velocities of 25 cm/s. Of the remaining 109 sub-optimal responders, 17 also has this finding; all had undergone dynamic cavernosography, with 16 exhibiting venous leakage.



The penile/brachial index was found to classify 13 patients incorrectly.



A critical value of deep artery response to attain erection is postulated, enabling more logical use of cavernosography. The penile/brachial index was shown to be suspect and it was concluded that duplex scanning is a useful, non-invasive method in the assessment of impotence.

Duplex scanning in suspected vasculogenic impotence: a worthwhile exercise?

History of endoscopic treatment of vesicoureteral reflux

Value of Cystourethroscopy in the Assessment of Children With Recurrent Urinary Tract Infections and/or Enuresis

Forty-one children aged 6–14 years consecutively referred for recurrent urinary tract infections (RUTI) and/or enuresis constituted the study group. Cystourethroscopy (CUS) was carried out in 40 children and pathologic findings were revealed in 70% of children with RUTI in the absence of vesico-ureteral reflux (VUR). However, only in 4 patients did CUS influence treatment. Based on these data we conclude that routine CUS is not justified in the evaluation of this group of children unless anatomical infravesical lesions are suspected. VUR was proven in 44% of children with RUTI. In 86% of these ureters abnormal ureteric orifices were demonstrated. We therefore find CUS to be valuable in the assessment of children with both RUTI and VUR, because this examination is helpful in selecting patients who might need operation for severe VUR. CUS was not of therapeutic benefit to children with enuresis. Five patients with macroscopic haematuria during urinary tract infection were not managed differently following CUS.

D. Ehlers

Papers

Value of Cystourethroscopy in the Assessment of Children With Recurrent Urinary Tract Infections and/or Enuresis

Value of cystourethroscopy in the assessment of children with recurrent urinary tract infections and/or enuresis.