Hydrocele Fluid Research Articles

Transforming growth factor ?-like activity in human hydrocele fluid

In this study transforming growth factor beta (TGF-beta)-like activity in human hydrocele fluid was investigated. Inhibition of DNA synthesis of adult rat hepatocytes in primary culture and stimulation of colony formation of normal rat kidney (NRK) fibroblasts, clone 49F in soft agar were observed in all acidified hydrocele fluids and these activities were neutralized by the specific antibody raised against human native TGF-beta. In samples obtained from recurrent cases of hydrocele, TGF beta-like activity was observed in its active form (without acidification). These results suggest that human hydrocele fluid contains TGF beta-like activity and that the active form of TGF-beta in recurrent hydrocele fluid may be responsible for the recurrence of the disease even after repeated aspiration.

Increased plasminogen activator enzymes of the tunica vaginalis in long-standing idiopathic hydrocele.

Previous research has shown increased fibrinolytic activity of the serous membranes as a reaction to stimuli that did not destroy their mesothelium. Large amounts of fluid remarkably stretch and chronically stimulate the tunica vaginalis in long-standing idiopathic hydrocele. For these reasons, a prospective controlled study was carried out in 30 male patients in order to investigate the possible alterations of the fibrinolytic capacity of this serosa by a method suitable for measuring plasminogen activator content of a single layer of cells. A possible role of plasminogen activator enzymes as a protective barrier against incidental absorption of fibrin/fibrinogen from the hydrocele fluid into vaginal tissues is considered.

Immunodiagnosis of bancroftian filariasis—Problems and progress

The immunodiagnosis of bancroftian filariasis is a major challenge to the immunoparasitologist. Significant progress is yet to be made in developing convenient laboratory animal model and inin vitro cultivation of filarial parasites making it very difficult to obtain required amount of parasite material for research. Parasitological examination techniques are not useful in low microfilaraemia, occult or chronic.filarial infections. A precise and accurate immunodiagnostic technique is very much needed for successful filaria control programmes. Such a test will also avoid the need for laborious night blood examination in bancroftian filariasis. Due to comparatively easy availability, a good amount of work has been done to explore immunodiagnostic potential of heterologous filarial antigens isolated fromLitomosoide carinii, Dirofilaria immitis, Brugia malayi, Setaria digitata, Setaria cervi and number of other filarial species. However, there has been limited or no significant success due to number of false negative and false positive reactions. Extensive study has also been made with antigens isolated fromWuchereria bancrofti microfilariae. Soluble antigens of microfilariae have been used in different immunological techniques such as skin test, counter immuno electrophoresis, indirect haemagglutination test, indirect fluorescent antibody test and enzyme linked immunosorbent assay. Fractionation of Wuchereria bancrofti microfilarial soluble antigens yielded mfS3e antigen fraction which was found to be highly reactive in microfilaraemia by enzyme linked immunosorbent assay, but the yield of the purified antigen was not sufficient enough to make it a practical proposition for large scale isolation of antigen. Wuchereria bancrofti microfilarial excretory-secretory antigens were found to be specific and highly sensitive requiring as little as 0.35 ng antigen protein per well in penicillinase enzyme linked immunosorbent assay for detection of filarial antibody. One ml of culture fluid was found to be sufficient for 400,000 tests. Field evaluation of this test showed that it can replace laborious night blood examination. Assay systems have been developed for detection of filarial antigen in serum, urine, hydrocele fluid and immune complexes using immunoglobulins from chronic filarial sera and antisera to excretory filarial antigens. Further purification of excretory-secretory antigens by affinity chromatography and production of monoclonal antibodies should hopefully give suitable reagents for use in sensitive assays such as enzyme immuno assay and immuno radiometric assay, providing an ideal assay system for detection of active filarial infection in the not too distant future.

Sclerotherapy with tetracycline solution for hydrocele

A study of sclerotherapy for hydrocele using different concentrations (10%, 5%, 2.5%)for tetracycline solution was done on 24 patients, 23 patients were cured. The effectiveness of sclerotherapy was the same for the three groups of patients with use of each different concentration of the solution. Pain was the only adverse effect. Nonspecific cellular foreign body reaction and fibrin strand proliferation were observed in the hydrocele fluid after this procedure. We consider sclerotherapy for hydrocele with tetracycline solution safe and the procedure of choice for patients in whom surgery or anesthesia is contraindicated, for patients who refuse surgery, and for economic reasons.

Hydrocele Following Internal Spermatic Vein Ligation: A Retrospective Study and Review of the Literature

We reviewed 82 consecutive infertile men with varicoceles and 1 teenage boy with a painful varicocele, all of whom underwent a total of 111 internal spermatic vein ligations (55 unilateral and 28 bilateral) by the suprainguinal approach (Palomo method). Of these patients 3 who underwent unilateral and 3 bilateral internal spermatic vein ligations subsequently suffered a total of 8 hydroceles after an average postoperative interval of 18.2 months. The protein concentration of the hydrocele fluid in the 2 most recent patients was consistent with lymphatic obstruction.

Cause of primary vaginal hydrocele and ascites in advanced liver cirrhosis

Primary hydrocele occurs due to a great reduction in protein outflow from the tunica vaginalis cavity and is not due to obstruction of fluid outflow because fluid continues to flow at a nearly normal rate. Fluid collects because of the increased osmotic pressure due to retained proteins and cholesterol. In other words, the fluid is captured from within the sac. Increased capillary permeability is secondary to the increased amount of hydrocele fluid. In idiopathic hydrocele, the hinderance of protein is due to the obstruction of the pores in the intercellular cement substance of the seroendothelial membrane. In acquired hydrocele, the hinderance of protein is due to lymphatic obstruction. The same mechanism may be applied to the occurrence of ascites in advanced liver cirrhosis. If we are able to recognize the substance that occludes the intercellular pores and dissolve it so the occluded pores are reopened, thus allowing the passage of hindered proteins, operation can be avoided and the problem of ascites can be solved.

Immune reactions to Wuchereria bancrofti infections in Tanzania. I. Serum-mediated adherence of leucocytes to microfilariae in vitro, using serum from different groups of patients

Studies on serum-mediated adherence of leucocytes to microfilariae of Wuchereria bancrofti in vitro were carried out in an area of Tanzania endemic for filarial infections. Patients were divided into age-matched groups according to parasitological and clinical conditions. No adherence was seen with serum from microfilariae-positive patients (with or without clinical disease). A slightly, but not statistically significantly, higher prevalence of adherence-positive sera was found among hydrocele patients (27%) and lymphangitis/elephantiasis patients (33%) than among endemic control patients (20%). These three positive groups exhibited a marked difference in age distribution of prevalence of positivity, with very high prevalences found among young hydrocele patients (48%) and old lymphangitis/elephantiasis patients (63%). The hydrocele fluid from hydrocele patients with adherence-positive serum also mediated adherence.

Testicular tumor: Occurring with hydrocele and positive cytologic fluid

Based on the pathogenesis of hydroceles, one may speculate that testicular tumor associated with hydrocele implies metastatic lymph node involvement. A unique case of positive cytologic result from hydrocele fluid in a patient with testicular tumor and lymph node metastases is presented to illustrate the concept.

Lymphography of the testis and its adnexa in the normal and in idiopathic hydrocele.

Using visual and radiologic lymphography, lymphatic drainage of testis, tunica vaginalis, epididymis, and vas was studied in 19 patients with inguinal hernia and epididymal cyst, and in 17 patients with idiopathic hydrocele. In the former, normal lymphatic trunks were demonstrated to lumbar nodes L1 to L4 and to iliac lymph nodes. In the hydrocele group, normal lumbar pathway was demonstrated in most cases; however, iliac route could not be shown, suggesting impairment of lymph drainage. Mean hydrocele fluid protein was found to be 5.8 gm/100 ml. Manometry of hydrocele, not previously reported, has shown that mean pressure in the hydrocele sac was 24.7 cm of fluid. Rapid reaccumulation of protein-rich fluid after tapping suggests increased capillary permeability. Possibly, a combination of impaired lymph drainage and increased capillary permeability is present in idiopathic hydrocele.

The Study of Electrophoretic Pattern of Hydrocele Fluid in Relation to Pathological Changes in Tunica Vaginalis

The Study of Electrophoretic Pattern of Hydrocele Fluid in Relation to Pathological Changes in Tunica Vaginalis

Determination of Serum Polysaccharides by the Tryptophane Reaction.

SummaryA colorimetric method based on the reaction of tryptophane with carbohydrates is described for the determination of serum non-glucosamine polysaccharide. The absorption maximum for the carbohy-drate-tryptophane compound is at 500 mμ for galactose and for mannose, 460 mμ for glucose, and 520 m//, for fructose. Glucuronic acid, glucosamine, and hemoglobin have maxima at wave lengths below 400 mμ. Glucuronic acid also exhibits a weak band at 480-500 mμ.The absorption curves for alcohol precipitates from serum, ascitic fluid, and hydrocele fluid differ from postulated galactose-mannose-glucosamine curves by showing greater absorption in the 400-480 mμ, range. This difference diminishes when the polysaccharide is partly freed from protein.Hemolysis, if marked, introduces a positive error in the method. The color produced by the carbohydrate tryptophane reaction obeys the Lambert-Beers law within the limits investigated.

Clinical Value of Prolan a Determinations in Teratoma Testis

Recent developments in hormonal assay have yielded biological methods of clinical importance in the early diagnosis and prognosis of teratoma testis. From reports of large series of patients suffering from this condition it would seem that the response of these tumors to radiation is accompanied by variations in the quantities of hormone excreted in the urine with such regularity as to render the quantitative determination of prolan A in the urine an accurate guide in prognosis and treatment. The purpose of this communication is to present the results of studies dealing with the presence of prolan A (the sex hormone of the anterior hypophysis) in the urine of patients suffering from teratoma testis, and to discuss the diagnostic and therapeutic significance of these observations. Zondek, in 1930, was the first to report an increased excretion of prolan A in the urine of patients suffering from teratoma testis. Heidrich, Fels and Mathias next (1930) applied this test to a case of chorionepithelioma of the testis, in which examination of the urine just before death revealed 50,000 mouse units per liter (prolan A and B). In 1931 Ferguson, Downes, Ellis, and Nicholson issued a preliminary note upon the use of the Aschheim-Zondek test in the diagnosis of teratoma testis, first reporting the observation that irradiation of the tumor is followed by the disappearance of prolan A from the urine and noting the absence of the hormone in benign lesions of the testis. In 1932 Zondek examined hydrocele fluid, urine, and tumor tissue from 14 patients suffering from teratoma testis. Ferguson, who has reviewed the literature upon the subject up to June 1933, cites nine publications reporting single cases in which prolan A determinations were made upon urine of patients before or after operation for teratoma testis. It remained for him to place the study on a comprehensive basis, with a report of 117 consecutive cases of teratoma testis in which the behavior of prolan A was studied by means of an extensive series of biological tests.

Thrombase—its preparation and properties

The preparation and properties of thrombase (fibrin ferment) were first described by Schmidt (1872). Serum was treated with 20 volumes of alcohol, and mixture allowed to react for at least a fortnight and preferably for three months. The precipitate was dried over sulphuric acid and extracted with water. This aqueous extract, added to a liquid containing fibrinogen and paraglobulin, which did not coagulate spontaneously ( i. e. , hydrocele fluid), rapidly produced coagulation. According to schmidt the reaction was due to a ferment since the rapidity of coagulation was profoundly influenced by the amount of the solution added, although the total fibrin separated remained constant in amount. Since that time a considerable amount of work has been done to investigate the phenomena observed in blood coagulation. As a result two distinct hypotheses have been advanced as to the place of thrombase in blood coagulation: ( a ) thrombase is the final cause of blood coagulation. The first hypothesis has been adopted by many observers notably Howell (1910), Bordet (1920) and Pickering (1928). The second hypothesis was originally put forward by Wooldridge (1886) who regarded blood coagulation as caused by the union of two antagonistic colloids obtained respectively from the blood and the tissues. The hypothesis has been adopted by Mills (1921), who considers that the action of thrombase only enters into the coagulation process in the concluding stages—that is, after a portion of the fibrinogen of the blood has reacted with a tissue protein to form fibrin. Nolf (1905) regards thrombase as an incomplete form of fibrin which is changes into the complete from by union with fibrinogen.

Quantitative Behavior of Prolan a in Teratoma Testis

The appearance of the sex hormone of the anterior hypophysis (Prolan A) in the urine of a man suffering from teratoma testis was first observed by Zondek in 1929. This case and one other observed subsequently by him were reported in March 1930. In September 1930, Heidrich and Fels reported in detail on the behavior of the anterior hypophyseal hormones (Prolan A and B) in a case of testicular chorionepithelioma. In April 1931 the writer and his associates reported their preliminary findings on the use of the Aschheim-Zondek test in the diagnosis of teratoma. In that paper the results in twelve cases of teratoma testis were reported and the observation first made that irradiation of the tumor causes the disappearance of Prolan A from the urine. The absence of the hormone in benign lesions of the testis was also noted. Zondek, in February 1932, reported his observations on the diagnosis of teratoma by means of biological test of the urine, hydrocele fluid, and tumor tissue. He has observed 14 cases, in 4 of which the diagnosis could not be verified by section. The remaining 10 are proved cases, in which the urine was tested before or after operation. Single case records reporting the presence of Prolan A in the urine in various types of teratoma testis have been published by Weinstein and Schofield, Wasterlain, Hady, Paschkis, Johnson, Kantrowitz, Lilienthal, Bollag, and the author. The foregoing constitute the published data on this subject to date. In addition many personal communications have been received relating to the findings of Prolan A in the urine in cases of teratoma testis. A study of 117 consecutive cases of teratoma testis in which the behavior of the hormone of the anterior hypophysis (Prolan A) was determined by means of over one thousand biological tests of the urine, is now presented.

Some Characteristics of Yellow Fever Virus

Summary 1. The virus of yellow fever occurs in the blood of experimentally infected rhesus monkeys in very high concentration: of eighteen specimens of blood taken from infected animals at the onset of fever and tested in dilution of 1:1,000,000, all proved infective; and of six specimens tested in dilution of 1:1,000,000,000, three produced fatal infection in normal monkeys. 2. A considerable variation in susceptibility was observed in these monkeys when a highly virulent strain of yellow fever virus was injected in very high dilutions, and very small amounts of the virus were frequently found to immunize animals without producing any outward signs of infection. 3. In the majority of the animals inoculated with minute quantities of virus the infection was characterized by a rather long incubation period, followed usually be a sharp, short febrile attack and death. 4. Human hydrocele fluid from persons not immune to yellow fever, either concentrated or diluted 1:1 with sterile physiological saline, was found to be a satisfactory diluent for the virus for titration purposes. 5. The development of yellow fever antibodies in the blood of experimentally infected animals was found to take place early during the course of disease. The serum taken at death from monkeys that died on the fourth, fifth, and sixth days after inoculation showed no protective properties, but the serum of animals that died on the seventh day or later protected fully against massive doses of virus. 6. The serum of monkeys that were inoculated with very minute doses of virus and died of yellow fever after a long incubation period, showed no protective properties. 7. The virus was found to possess a relatively high resistance to the action of post-mortem invading bacteria. The blood of a monkey that died of yellow fever and was kept after death for nine hours at a temperature varying between 78 and 86.5° F. was still found to be infective in 0.01 cc. amounts, although the organs of the animal at that time were already in an advanced state of decomposition.

A Synthetic Substitute for Ascitic Fluid in a Medium for Cultivation of Gonococcus.

Ever since its first cultivation by Bumm in 1885, the gonococcus has maintained a reputation for fastidiousness as regards its growth requirements. In consequence, a great number of media have been devised for it, the most successful and reliable of which are those containing human ascitic or hydrocele fluid. It is generally believed that the efficacy of these transudates depends, in large part at least, upon constituents other than their inorganic salts. To determine whether the rôle played by transudates in supporting the growth of gonococci may be attributed to substances other than the biologically important inorganic ions, a study of the function of the individual ions has been undertaken. Although this study is still in progress and will be published in detail later, we wish now to report that it is possible to cultivate the gonococcus on an agar medium containing only beef infusion and dextrose, providing it is made up in an aqueous solution of inorganic salts in kind and concentrations corresponding to those found in an ultrafiltrate of mammalian blood plasma. The solution, which for the sake of brevity we have called van Dyke-Hastings solution, is similar to that used by van Dyke and Hastings in their experiments on the response of guinea pig uterus to pituitary extract and is approximately isohydric, isosmotic, isionic with protein-free transudates. Its composition is given in Table I: Such a solution is simply prepared by mixing appropriate quantities of isotonic solutions of the individual salts. The composition of the stock solutions to be mixed is given in the second column of figures and the amounts used in preparing the van Dyke-Hastings solution are given in the last column of Table II.

ATTEMPTS TO REPRODUCE RHEUMATIC FEVER IN ANIMALS

Experiments have been described in which we attempted to reproduce in animals the lesions characteristic of rheumatic fever in the human. A large number of animals representing 7 species was employed. Among other materials, streptococci isolated in pure culture from the blood of rheumatic patients (proved to be so by biopsy or by autopsy) as well as whole blood, plasma, serum, pericardial, pleural and hydrocele fluid, filtrates from tonsils, subcutaneous nodules, lymph nodes, and nasopharyngeal washings obtained from such patients were used in a variety of combinations and with a number of procedures calculated to predispose the animal to the disease. A discussion is given of the criteria whose fulfillment is essential for the establishment of the experimental production of rheumatic disease in animals. Judged by these criteria, we have failed to reproduce the disease. This conclusion, we believe, holds true for all the work thus far reported in the literature.

THE SPINDLE‐CELLS IN RELATION TO COAGULATION OF FROG'S BLOOD

1. The thrombocytes of frog's blood, which alter so quickly on contact with glass or other water‐wettable surfaces, undergo no deformation and cytolysis as long as the blood is kept on solid paraffin.2. While the erythrocytes and the leucocytes of frog's blood can by means of the centrifuge be separated from the plasma, the thrombocytes, which have a density identical with that of the plasma, cannot be thus removed. A specimen of plasma obtained by simple use of the centrifuge clots on coming in contact with glass.3. From the centrifuged plasma of the frog the thrombocytes can be removed by passage through a charcoal filter. Plasma thus freed of thrombocytes readily clots on addition of tissue extract (thrombokinase), but will not spontaneously clot on contact with glass. In this respect it resembles hydrocele fluid, which is platelet‐free.4. Spontaneous coagulation of centrifuged frog's plasma is due wholly to disintegration of the contained thrombocytes. This disintegration in its turn is due to contact with a special kind of surface. As a result of the cell disintegration thrombin is liberated.5. Bird's blood, or centrifuged bird's plasma, has less tendency to undergo spontaneous coagulation on contact with glass. In this respect bird's blood differs both from amphibian and from mammalian blood.6. Tissue extract or thrombokinase prepared from the frog's ventricle is all but impotent to induce coagulation of cell‐free plasma. In this regard the tissue of the ventricle differs markedly from the connective tissue, liver, muscle, etc., of the frog.7. Contact cytolysis of frog's thrombocytes is due to a purely physical cause, and does not depend upon absorption by the cells of any soluble material derived from the effective water‐wettable surface. The better an adequate surface of insoluble material is chemically purified and freed of grease, the more rapidly does it induce cytolysis of the thrombocytes.8. Thrombokinase or tissue extract plays no part in the production of thrombin during simple spontaneous coagulation of the blood. In this regard the theory of Morawitz as to the precursor of fibrin‐ferment requires amendment.9. The word “prothrombin” (or “thrombogen”) might well be replaced by the phrase “unruptured thrombocytes,” for it would seem to be these that constitute prothrombin.10. In any representation of the chain of phenomena involved in spontaneous blood coagulation place must be given to an indispensable physical process, as a result of which the thrombocytes are induced to yield thrombin.The expenses of this research were defrayed in part by a grant from the James Cooper Fund of M'Gill University for Research in Experimental Medicine.

DURATION OF INFECTIVITY OF GONORRHEA IN THE MALE

The period in which gonorrhea began to infect man is unknown, but the earliest records make mention of it. The disease was treated crudely until 1879, when Neisser 1 discovered the diplococcus, which he termed the gonococcus, and which has since been looked on as the etiologic factor of the disease. Six years later, in 1885, Bumm, 2 a German investigator, reported that he had succeeded in securing the gonococcus through culture on peptone agar with serum as a medium. In the work reported here, smears were tried and then the different mediums were used and finally hydrocele agar was chosen, which agar was first described by Wertheim, 3 in 1899. In growing the gonococcus on this medium, the method of reduced oxygen tension, as described by Schwartz, 4 in 1920, was followed. At times it is difficult to obtain hydrocele fluid to make hydrocele agar, and often one has

Cultivation of the gonococcus

The gonococcus was first cultivated by Bumm1 on coagulated human placental serum in 1885, six years after its discovery by Neisser.2 Wertheim3 used a peptone agar with serum as a medium; the serum was inoculated with the infected material and added to the fluid agar in the proportion of two to one. Wassermann4 used pig serum agar with glycerol and nutrose. Thalman5 cultivated the gonococcus on plain agar, using a medium which in reaction was between the neutral points of litmus and phenolphthalein. He emphasized the importance of the reaction of the medium. Vannod6 isolated and maintained several strains of gonococcus on plain agar. Gurd 7 suggested a medium of nutrient agar with a small quantity of defibrinated sterile human blood. Martin8 published a review of methods of cultivating the gonococcus and of its differentiation from other gram-negative diplococci. He used beef infusion agar, the reaction of which was 0.6% acid to phenolphthalein, and moistened the surface with inactivated human serum. Hirshfelder0 published a new formula using bullock testicular infusion agar. Warden10 used a culture medium which contained ascitic or hydrocele fluid, blood or blood serum; later he used defibrinated rabbit blood with salt-free veal-peptone-agar, neutral to phenolphthalein, the medium being dried until the surface cracked. Vedder11 described a starch agar, the reaction of which was 0.2 to O.Sfc acid to phenolphthalein. Hall12 made a testicular infusion agar. Thomson13 used agar with human blood plasma. The more recent contributions on the cultivation of the gonococcus deal chiefly with the oxygen tension requirements and the importance of hydrogen-ion concentration. Nowak, in 1908, and Wherry and Oliver14 reduced the oxygen tension for the cultivation of the gonococcus with a growth of B. subtilis. Chapin l5 suggested the cultivation of the gonococcus in an atmosphere of CO-. Ruediger16 felt that the exclusion of air was