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Biomedical subjects

C F Heyns

Publications and source records attributed to C F Heyns.

At least 55 records · Page 3Linked to original sources
PubMed1991

Presence of a low capacity androgen receptor in the gubernaculum of the pig fetus.

The aim of our study was to investigate the theory that the gubernaculum is an androgen-responsive structure responsible for fetal testicular descent. Using 3H-methyltrienolone (3H-R1881) as ligand, we performed a seven-point Scatchard analysis of androgen receptor binding in the gubernaculum, prostate, urethra and striated muscle tissue obtained from pig fetuses between 60 and 109 days of gestation. The gubernaculum demonstrated androgen receptor binding with an affinity and capacity significantly lower than that of fetal pig prostate and urethra, but not significantly different from that of striated muscle taken from both male and female fetuses. A marked increase in the size and mass of the gubernaculum of male (but not female) fetuses is known to accompany testicular descent. If the dramatic increase in the mass of the gubernaculum observed in male (but not female) fetuses were the result of androgen stimulation, it may be expected that the striated muscle mass (and therefore total body mass) of male fetuses should be greater than that of female fetuses, since the androgen receptor affinity and capacity of the gubernaculum is similar to that of striated muscle. However, we found no significant difference in total body mass between male and female pig fetuses at the same period of gestation. These findings raise doubt concerning the theory that growth of the gubernaculum during descent is the result of androgen stimulation.

Animals↗
PubMed1991

Pelvic lipomatosis associated with cystitis glandularis and adenocarcinoma of the bladder.

Pelvic lipomatosis is a rare condition characterized by an overgrowth of normal fat in the perivesical and perirectal spaces. Cystitis glandularis, cystica or follicularis has been observed in 75% of the patients with pelvic lipomatosis. Although cystitis glandularis is widely regarded as premalignant few reports have documented its transition to adenocarcinoma. We describe a 41-year-old man with pelvic lipomatosis in whom primary adenocarcinoma of the bladder developed 6 years after a histological diagnosis of cystitis cystica and glandularis was established. To our knowledge this is the second case reported of pelvic lipomatosis associated with proliferative cystitis and adenocarcinoma of the bladder, indicating that intestinal metaplasia of the urothelium may be a precursor of malignancy in these patients.

Adenocarcinoma↗
PubMed1991

Prostate carcinoma--the value of T stage and grade in predicting metastases and prognosis. A cost-effective approach to clinical staging.

In order to evaluate the initial T stage and tumour grade as predictors of metastatic disease and prognosis in adenocarcinoma of the prostate, 963 patients were reviewed. Of the patients, 41% presented with metastatic disease. Stage T4 tumours were associated with a consistently poor prognosis, and 70% of such patients had demonstrable distant metastases. No patient with TOf local disease had metastases or died of prostate cancer during follow-up. The incidence of metastases was also low in stages T1 and T2. High tumour grade correlated strongly with more advanced disease. Using this information a more cost-effective approach to the staging of prostate carcinoma is proposed.

Adenocarcinoma↗
PubMed1990

A true hermaphrodite with some unusual features.

A fifteen-month-old boy with ambiguous external genitalia was found to have a 46XX karyotype, an ovotestis in the right labioscrotal fold, and an absent left gonad. He also had a rudimentary uterus and fallopian tubes and a blind-ending vagina lined with squamous epithelium. These features are compared with those more commonly found in true hermaphroditism.

Disorders of Sex Development↗
PubMed1990

Exstrophy of the testis.

Among the anomalies of testicular descent exstrophy of the testis appears to be the most rare. We describe a full-term male newborn with the right testis and spermatic cord prolapsed from a skin defect at the neck of the scrotum. The cause of the anomaly is unknown.

Genital Diseases, Male↗
PubMed1990

3-dimensional imaging of the pelviocaliceal system by computerized tomographic reconstruction.

Safe and efficient performance of percutaneous nephrolithotomy requires 3-dimensional visualization of the pelviocaliceal anatomy. However, currently available modalities offer only 2-dimensional images, from which the operator must mentally reconstruct a 3-dimensional picture of the pelviocaliceal configuration. We evaluated the feasibility of obtaining 3-dimensional images of the pelviocaliceal system with the aid of computerized tomographic reconstruction and present 3 illustrative cases.

Computer Graphics↗
PubMed1990

The glycosaminoglycans of the gubernaculum during testicular descent in the fetus.

Tissues were obtained from 387 male pig fetuses ranging from 60 to 120 days of gestation. The relative wet mass and water content of the gubernaculum increased during and decreased after the period of testicular descent. The extracellular glycosaminoglycans (GAG) were assayed to determine whether these polyanionic macromolecules are responsible for the increased water content of the gubernaculum. The total GAG/wet tissue mass in the gubernaculum decreased during and increased after descent, while the total GAG/dry mass decreased during and after descent, indicating an accumulation of water during descent, with a loss of water and an increase in less hydrated tissue components after descent. The major GAG fraction in the gubernaculum was dermatan sulfate, but the percentage hyaluronate in the gubernaculum was two times higher than in striated muscle or umbilical cord, indicating that this GAG fraction may be responsible for the increased water content of the gubernaculum, which probably serves to dilate the inguinal canal and scrotum, thus facilitating descent.

Animals↗
PubMed1990

Immunosuppressive therapy for pemphigus vulgaris complicated by malakoplakia of the bladder.

Pemphigus vulgaris is an uncommon auto-immune disease which responds well to treatment with corticosteroids and azathioprine. Malakoplakia is a rare granulomatous disease associated with coliform infections and an altered cellular immune response. We report a 68-year-old female patient with pemphigus vulgaris who, after 2 years on maintenance prednisone and azathioprine immunotherapy, developed malakoplakia of the bladder associated with chronic E. coli urinary-tract infection. The malakoplakia responded well to treatment with cotrimoxazole, bethanechol chloride and ascorbic acid, combined with tapering of the corticosteroid dosage. Our patient presents an uncommon but interesting complication of long-term immunosuppressive therapy for pemphigus vulgaris.

Aged↗
PubMed1989

Spontaneous rupture of adult Wilms' tumor.

Wilms' tumor is uncommon in adults, and spontaneous retroperitoneal hemorrhage as the presenting sign of renal malignancy also is rare. A 22-year-old man with spontaneous rupture of a Wilms' tumor, who died within 5 months, is described. The factors that probably contributed to his rapid demise included preoperative tumor spilling, unfavorable histology, and the omission of radiotherapy owing to poor patient compliance. Although Wilms' tumor is known to have a poorer prognosis in adults than in children, the reason for this is not known. Due to the limited number of cases reported, the optimal treatment for adult Wilms' tumor remains to be defined. However, the recent literature indicates that radical surgery combined with maximal radiotherapy dosage and modification of the chemotherapy schedules used in children may be required to improve the prognosis for adults with Wilms' tumor.

Adult↗
PubMed1989

Recurrent spontaneous bladder rupture. A case report.

Spontaneous (non-traumatic) intraperitoneal rupture of the bladder in a 37-year-old pregnant woman was repaired at laparotomy. Nine months later she again presented with an intraperitoneal bladder rupture during pregnancy and fatal sepsis. Histological examination of the resected bladder wall showed acute ulcerative and necrotising cystitis. All patients with apparently spontaneous bladder rupture should undergo full urological evaluation to identify possible disease which might lead to recurrent rupture.

Adult↗
PubMed1989

The collagen content of the gubernaculum during testicular descent in the pig fetus.

Contracture of collagen fibres in the gubernaculum has been suggested as a mechanism responsible for fetal descent of the testis. We measured the collagen content of the gubernaculum, fetal thigh muscle and umbilical cord tissue by assaying its hydroxyproline and protein content in 194 male pig fetuses between 60 and 109 days of gestation. During the period of testicular descent (80-90 days of gestation), a decrease occurred in the hydroxyproline/wet mass and protein/wet mass of the gubernaculum, but not of fetal striated muscle or umbilical cord tissue, reflecting an increase in the water content of the gubernaculum during this period. An increase occurred in the hydroxyproline/protein concentration of the gubernaculum and fetal striated muscle, but not of umbilical cord tissue, denoting an accumulation of collagen in the gubernaculum after descent of the testis. In view of the absence of a firm distal attachment of the gubernaculum in the pig fetus, the increase in its collagen content is probably not a cause of descent by exerting traction on the testis, but merely reflects the involution of the gubernaculum noted after descent.

Animals↗
PubMed1987

Nephroblastoma in an ovotestis of a true hermaphrodite: a case report.

We describe a patient who presented with a painful mass in the left inguinoscrotal region, gynecomastia, perineal hypospadias with chordee and a bifid scrotum with a small gonad in the right hemiscrotum. At operation the left mass was found to be an ovotestis with hemorrhage in a corpus luteum cyst. A rudimentary uterus and fallopian tube were situated next to the ovotestis. The right gonad also was an ovotestis with a tiny focus of small cell malignancy that was suggestive of nephroblastoma.

Adult↗
PubMed1987

Benign prostatic hyperplasia and uterine leiomyomas in a female pseudohermaphrodite: a case report.

A 60-year old female pseudohermaphrodite with congenital adrenal hyperplasia presented with acute retention of urine and a lower abdominal mass. At laparotomy a large uterus with multiple leiomyomas was removed. Transurethral resection of the obstructing bladder neck revealed benign prostatic hyperplasia. This patient demonstrates that benign prostatic hyperplasia may develop in the presence of androgens from an extratesticular source.

Adrenal Hyperplasia, Congenital↗
PubMed1987

Intraperitoneal rupture of the bladder causing the biochemical features of renal failure.

A group of 20 patients with intraperitoneal rupture of the bladder was compared with a group of 20 patients with haematuria due to renal injury. In patients admitted to hospital within 24 h of sustaining an intraperitoneal bladder rupture, the mean serum levels of creatinine and potassium were increased and the mean serum sodium level was decreased. However, the individual serum creatinine values were within normal limits in six of the 11 patients in this group. Patients presenting more than 24 h after intraperitoneal bladder rupture had an increased mean serum urea, creatinine and potassium level and a decreased mean serum sodium and CO2 content. The individual serum urea and creatinine values on admission to hospital were higher than normal in all nine patients in this group but the serum urea/creatinine ratio was not significantly elevated. A dramatic decrease in serum urea and creatinine levels was seen within 24 h after laparotomy and suturing of the bladder rupture. In patients with abdominal symptoms and signs, haematuria and the biochemical features of renal failure (elevated serum urea, creatinine and potassium, decreased serum sodium and CO2 content), the clinician should suspect an intraperitoneal rupture of the bladder.

Acute Kidney Injury↗
PubMed1987

The gubernaculum during testicular descent in the human fetus.

This study of 178 male human fetuses and infants demonstrates that descent of the testis through the inguinal canal is a rapid process, with 75% of testes descending between 24 and 28 weeks of gestation. The gubernaculum is a cylindrical, gelatinous structure attached cranially to the testis and epididymis. While the testis is in the abdomen, the caudal tip of the gubernaculum is firmly attached to the region of the inguinal canal. In a few fetuses prior to descent the globular tip of the gubernaculum can be seen bulging through the external inguinal ring, covered by superficial fascia, with no macroscopically discernible extensions to the scrotum or any other area. Once the testis has passed through the inguinal canal, the bulbous lower tip of the gubernaculum is no longer firmly attached to any structure, nor does it extend to the bottom of the scrotum. Histologically the gubernaculum consists of undifferentiated mesenchymatous tissue. Prior to descent of the testis, there is an increase in the length of the intra-abdominal gubernaculum. The wet mass of the gubernaculum relative to the fetal mass increases rapidly prior to descent, while the relative wet mass of the testis remains constant during this period. There is also an increase in the wet/dry mass ratio of the gubernaculum, denoting an increase in its water content prior to descent. This indicates that a combination of growth processes is responsible for testicular descent, with the increase in the size of the gubernaculum playing the most important role in passage of the testis through the inguinal canal.

Cryptorchidism↗
PubMed1986

Hyperplasia and hypertrophy of the gubernaculum during testicular descent in the fetus.

The role of the gubernaculum during testicular descent was investigated in 115 male pig fetuses ranging from 68 to 109 days of gestation. Descent of the testis through the inguinal canal occurred between 77 and 94 days. There was a marked increase in the total and relative wet mass as well as the wet/dry mass ratio of the gubernaculum, denoting an increase in the water content of this structure during descent of the testis. Similar changes were not seen in other fetal tissues. Asymmetrical descent of the testes occurred in seven of the 40 fetuses between 81 and 92 days of gestation. Descended testes had gubernacula with a greater relative wet mass than the gubernacula of undescended testes. These findings indicate that the increase in mass of the gubernaculum plays an important part in testicular descent. An increase in both the DNA content (hyperplasia) and the RNA/DNA ratio (hypertrophy) was noted in the gubernaculum during descent of the testis. Hyperplasia in the gubernaculum occurred at a rapid rate initially and ceased after the completion of descent. Hyperplasia was also seen in the testis and epididymis, but occurred at a slower rate initially, with a rapid acceleration after the completion of descent. Cellular hypertrophy was not noted in the testis and epididymis, but did occur in umbilical cord tissue. If gonadotropins acting via androgen secretion by the testis provide the stimulus for these changes, the observed difference in response between the gubernaculum and testis could be due to a difference in end-organ sensitivity. However, it is also possible that some unidentified non-androgenic gubernaculotropin, possibly secreted by the fetal testis, provides the stimulus for gubernacular growth.

Animals↗