The aim of this study was to assess scrotal thermography in diagnostics of varicocele and suggest potential diagnostic criteria. Twelve patients with clinically diagnosed varicocele were examined with scrotal infrared digital thermography, physical examination and ultrasound/doppler. The main outcome measure was evaluation of thermography diagnostic criteria for varicocele. Mean temperature at left pampiniform plexus was ≥ 34 °C in 83%, and at right pampiniform plexus in all cases was ≤ 34 °C. In 92% of patients, temperature at the left testicle was ≥ 32 °C, whereas at the right testicle it was >32 °C in 50% patients. Temperatures between left and right pampiniform plexus and between left and right testicle were significantly different with P < 0.0001 and P < 0.006 respectively. In all patients, temperature difference between pampiniform plexuses was ≥ 0.6 °C. In 92% of patients, temperature at left pampiniform plexus was equal or higher to thigh temperature with the mean temperature difference of 1.1 ± 1.1 °C. Temperature at right pampiniform plexus was colder than the thigh in 92% of patients. This study suggests diagnostic criteria of five thermographic signs to easily diagnose varicocele. Scrotal thermography presents feasible, short and low cost diagnostic method for varicocele. Further study on a larger number of patients and healthy participants is needed to evaluate sensitivity and specificity of this method.

Background: Endemic nephropathy (EN) and associated urothelial cell cancers (UUC) are an environmental form of aristolochic acid nephropathy where the most probable rout of ingestion of aristolochic acid (AA) was made by bread contaminated with AA, leading to chronic dietary intoxication. Clinical courses of three members of the same family, similarly exposed to toxin, who exhibited different clinical courses of the disease are presented. Methods: Questionnaires on AA exposure were taken. Tissue samples were obtained during therapeutic nephrouretectomies. Histopathology, immunohistochemical detection of p53, p53 mutation screening in tumor DNA and analysis on the presence of aristolactam (AL)-DNA adducts were performed. Results: Case 1 had UUC with typical EN histopathological signs, whereas Case 2 had bilateral UUCs with typical EN histopathological signs. In contrast, the patient in Case 3 initially showed renal insufficiency, complicated afterwards by right UUC, and later on by left UUC with histopathological end-stage chronic changes but without typical EN changes. AA-DNA adducts and specific p53 mutational spectra (A:T→ T:A transversion) were found in tissues of cases 1 and 2. Conclusion: Diverse clinical courses seem to be related not to differences in exposure but to differences in metabolic activation or detoxification of AA and/or DNA repair resulting from different genetic polymorphisms.

With a goal to evaluate accuracy of kidney stone models created from medical images, comparison of computer-generated models against 3D scanned model is performed. Computer-generated models are made using 6 free and one commercial software for medical images obtained by computed tomography (CT) with a slice thickness of 5 mm. Digitized volume of the same kidney stone was obtained after its surgical removal and digitized using a contactless 3D scanner ATOS Compact Scan. Due to the complexity of kidney stone, the scanned reference model is not completely identical to real surgically removed stone from a patient. High maximum deviation is positioned mainly in the areas where the actual kidney stone is not scanned. The average surface deviation is in the range of 0.24354 mm to 0.44719 mm. Results reveals that the accuracy of the computer-generated models depends on quality of algorithms for tissue segmentation implemented in a particular software and on the skill of user. All software enabled us to create a 3D model of the kidney with clearly visible position of a kidney stone inside, accurate enough for planning the operation. It is possible to get a higher model accuracy by reducing the slice thickness during medical imaging; however, it increases the dose of radiation. Therefore, it is necessary to individually determine the optimum balance between the required quality of images and the amount of radiation that the patient is exposed to during recording.

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