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Byline: V. V. S. S. Chandrasekharam (1), M. Srinivas (1), C. S. Bal (2), A. K. Gupta (3), S. Agarwala (1), D. K. Mitra (1), V. Bhatnagar (1) Keywords: Keywords Hydronephrosis; Ureteropelvic junction obstruction; Renal function; Pyeloplasty Abstract: The functional outcome and factors influencing improvement after pyeloplasty for ureteropelvic junction (UPJ) obstruction are still debated. This retrospective study was aimed at evaluating the factors associated with functional improvement in symptomatic unilateral hydronephrosis (HDN). Patients (n=68) who underwent successful pyeloplasty for unilateral symptomatic UPJ obstruction without any other associated urological abnormality were included. Preoperative evaluation included a diuretic renogram (DR) to confirm obstruction and assess the split renal function (SRF). A follow-up DR was obtained 3months and 1, 2, and 5years postoperatively. An absolute increase in the differential function of the operated kidney by over 5% was considered significant such kidneys were classified as improved (group A) and the others as unimproved (group B). The difference between the preoperative and 3-month SRF was highly significant (P&lt 0.001). Significant (P&lt 0.01) improvement in SRF continued until 1year after pyeloplasty. Patients who presented with a mass had significantly greater improvement (P&lt 0.05) than those who presented with other clinical features. In group A, a significantly higher number of patients presented with a mass. It was also evident that patients aged less than 1year showed significantly greater (P&lt 0.01) improvement in SRF than older patients. Thus, in unilateral symptomatic HDN with impaired function, patients who present with a mass or those in whom pyeloplasty was performed before 1year of age showed significantly greater improvement. Author Affiliation: (1) Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India, IN (2) Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India, IN (3) Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India, IN Article note: Accepted: 19 December 2000

For the assessment of germ-cell maturation of the seminiferous tubules, DNA flowcytometry is a rapid and sensitive method. Phosporus 31P magnetic resonance spectroscopy (MRS) is a non-invasive alternative that demonstrates the metabolic status of the testis, reflecting the type and relative proportion of germ cells in the testis. This study was designed to evaluate the utility of 31P MRS in reflecting the haploid-cell population of the testis as measured by DNA flowcytometry. A single testicle was evaluated in male Wistar pre-pubertal rats at 30, 40, 50, and 60 days of age. In order to minimize the contamination of signals from the contralateral testis, scrotum, and tail, the technique was modified and the testis was evaluated ex-vivo with an intact blood supply. At 30 days of age the percentage of haploid cells was 43.6 ± 1.8, and this increased to 72.7 ± 1.4 at 60 days of age. During this period, the testicular phosphomonoester/adenosine triphosphate (PM/ATP) ratio changed from 1.70 ± 0.21 to 0.32 ± 0.08. There was a significant (P < 0.001) linear correlation between the proportion of haploid cells evaluated by DNA flowcytometry and the PM/ATP ratio evaluated by 31P MRS. 31P MRS is thus a reliable, noninvasive technique for accurately assessing the status of the seminiferous epithelium. [ABSTRACT FROM AUTHOR]