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1

Rho kinase is involved in Ca2+ entry of rat penile small arteries.  

Science.gov (United States)

Tonic physiological activity of RhoA/Rho kinase contributes to the maintenance of penile flaccidity through its involvement in the Ca(2+) sensitization of erectile tissue smooth muscle. The present study hypothesized that Rho kinase is also involved in the modulation of Ca(2+) entry induced by alpha(1)-adrenoceptor stimulation of penile arteries. Rat penile arteries were mounted in microvascular myographs for simultaneous measurements of intracellular Ca(2+) ([Ca(2+)](i)) and force. The Rho-kinase inhibitor Y-27632 markedly reduced norepinephrine-mediated electrically induced contractions and the increases in both [Ca(2+)](i) and tension elicited by the alpha(1)-adrenoceptor agonist phenylephrine (Phe). In contrast, the protein kinase C (PKC) inhibitor Ro-31-8220 reduced tension without altering the Phe-induced increase in [Ca(2+)](i). In the presence of nifedipine, Y-27632 still inhibited the non-L-type Ca(2+) signal and blunted Phe contraction. Y-27632 did not impair the capacitative Ca(2+) entry evoked by store depletion with cyclopiazonic acid but largely reduced the Ba(2+) influx stimulated by Phe in fura-2 AM-loaded arteries. The addition of Y-27632 to arteries depolarized with high KCl markedly reduced tension without changing [Ca(2+)](i). In alpha-toxin-permeabilized penile arteries stimulated with threshold Ca(2+) concentrations, Y-27632 inhibited the sensitization induced by either guanosine 5'-O-(3-thiotriphosphate) (GTPgammaS) or Phe in the presence of GTPgammaS. However, Y-27632 failed to alter contractions induced by a maximal concentration of free Ca(2+). These results suggest that Rho kinase, besides its contribution to the Ca(2+) sensitization of the contractile proteins, is also involved in the regulation of Ca(2+) entry through a nonselective cation channel activated by alpha(1)-adenoceptor stimulation in rat penile arteries. PMID:18223191

Villalba, Nuria; Stankevicius, Edgaras; Simonsen, Ulf; Prieto, Dolores

2008-04-01

2

Involvement of large-conductance Ca(2+) -activated K(+) channels in both nitric oxide and endothelium-derived hyperpolarization-type relaxation in human penile small arteries  

DEFF Research Database (Denmark)

Large-conductance Ca(2+) -activated K(+) channels (BKC a ), located on the vascular smooth muscle, play an important role in regulation of vascular tone. In penile corpus cavernosum tissue, opening of BKC a channels leads to relaxation of corporal smooth muscle, which is essential during erection; however, there is little information on the role of BKC a channels located in penile vascular smooth muscle. This study was designed to investigate the involvement of BKC a channels in endothelium-dependent and endothelium-independent relaxation of human intracavernous penile arteries. In human intracavernous arteries obtained in connection with transsexual operations, change in isometric force was recorded in microvascular myographs, and endothelium-dependent [nitric oxide (NO) and endothelium-derived hyperpolarization (EDH)-type] and endothelium-independent (NO-donor) relaxations were measured in contracted arteries. In penile small arteries contracted with phenylephrine, acetylcholine evoked NO- and EDH-type relaxations, which were sensitive to iberiotoxin (IbTX), a selective blocker of BKC a channels. Iberiotoxin also inhibited relaxations induced by a NO-donor, sodium nitroprusside. NS11021, a selective opener of BKC a channels, evoked pronounced relaxations that were inhibited in the presence of IbTX. NS13558, a BKC a -inactive analogue of NS11021, failed to relax human penile small arteries. Our results show that BKC a channels are involved in both NO- and EDH-type relaxation of intracavernous penile arteries obtained from healthy men. The effect of a selective opener of BKC a channels also suggests that direct activation of the channel may be an advantageous approach for treatment of impaired endothelium-dependent relaxation often associated with erectile dysfunction.

Király, István; Pataricza, János

2013-01-01

3

Contribution of both Ca2+ entry and Ca2+ sensitization to the alpha1-adrenergic vasoconstriction of rat penile small arteries.  

Science.gov (United States)

Sympathetic adrenergic nerves maintain the flaccid state of the penis through the tonic release of norepinephrine that contracts trabecular and arterial smooth muscle. Simultaneous measurements of intracellular Ca(2+) concentration ([Ca(2+)](i)) and tension and experiments with alpha-toxin-permeabilized arteries were performed in branches of the rat dorsal penile artery to investigate the intracellular Ca(2+) signaling pathways underlying alpha(1)-adrenergic vasoconstriction. Phenylephrine increased both [Ca(2+)](i) and tension, these increases being abolished by extracellular Ca(2+) removal and reduced by about 50% by the L-type Ca(2+) channel blocker nifedipine (0.3 microM). Non-L-type Ca(2+) entry through store-operated channels was studied by inhibiting the sarcoplasmic reticulum Ca(2+)-ATPase with cyclopiazonic acid (CPA). CPA (30 microM) induced variable phasic contractions that were abolished by extracellular Ca(2+) removal and by the store-operated channels antagonist 2-aminoethoxydiphenyl borate (2-APB, 50 microM) and largely inhibited by nifedipine (0.3 microM). CPA induced a sustained increase in [Ca(2+)](i) that was reduced in a Ca(2+)-free medium. Under conditions of L-type channels blockade, Ca(2+) readmission after store depletion with CPA evoked a sustained and marked elevation in [Ca(2+)](i) not coupled to contraction. 2-APB (50 microM) inhibited the rise in [Ca(2+)](i) evoked by CPA and the nifedipine-insensitive increases in both [Ca(2+)](i) and contraction elicited by phenylephrine. In alpha-toxin-permeabilized penile arteries, activation of G proteins with guanosine 5'-O-(3-thiotriphosphate) and of the alpha(1)-adrenoceptor with phenylephrine both enhanced the myofilament sensitivity to Ca(2+). This Ca(2+) sensitization was reduced by selective inhibitors of PKC, tyrosine kinase (TK), and Rho kinase (RhoK) by 43%, 67%, and 82%, respectively. As a whole, the present data suggest the alpha(1)-adrenergic vasoconstriction in penile small arteries involves Ca(2+) entry through both L-type and 2-APB-sensitive receptor-operated channels, as well as Ca(2+) sensitization mechanisms mediated by PKC, TK, and RhoK. A capacitative Ca(2+) entry coupled to noncontractile functions of the smooth muscle cell is also demonstrated. PMID:17085536

Villalba, Nuria; Stankevicius, Edgaras; Garcia-Sacristn, Albino; Simonsen, Ulf; Prieto, Dolores

2007-02-01

4

Blunted non-nitric oxide vasodilatory neurotransmission in penile arteries from renal hypertensive rats.  

Science.gov (United States)

The present study was designed to explore whether there are any effects on neurogenic responses in penile small arteries during the development of hypertension in a one-kidney, one-clip (1K1C) model, a non-renin-dependent model of renovascular hypertension. Five weeks after surgery, male Sprague-Dawley rats were given vehicle, bendroflumethiazide (7.5 mg/kg/day), or L-arginine (2 g/kg/day) in their drinking water for five weeks. Experiments were performed on penile small artery rings (150-200 microm) mounted on microvascular myographs for electrical field stimulation (EFS), and erectile tissue was processed for immunohistochemistry. Maximal neurogenic contractions were unmodified in penile preparations. Relaxations induced by EFS were reduced in the presence of ADMA. In 1K1C rats, neurogenic vasorelaxation mediated by nitric oxide (NO) was unaltered, while relaxation resistant to NO synthase inhibition was blunted. L-arginine and bendroflumethiazide lowered blood pressure in 1K1C rats, but vasodilation was still blunted in the penile arteries. Immunoreactivity for factor VIII and neuronal NO synthase was unaltered in penile arteries from 1K1C animals. Endothelium-dependent vasorelaxation evoked by acetylcholine was also blunted in preparations from 1K1C rats, while exogenous NO relaxation was unaffected. Plasma concentrations and urinary excretion of ADMA did not differ among the experimental animals. Our findings indicate that the reduced release of a non-NO vasodilatory neurotransmitter accounts for the impaired neurogenic vasodilation of the penile arteries. Although ADMA inhibits penile vasorelaxation, it is unlikely to affect erectile function in 1K1C rats. PMID:16574496

Martnez, Ana Cristina; Stankevicius, Edgaras; Jakobsen, Preben; Simonsen, Ulf

2006-05-01

5

Penile angiography and superselective embolization therapy in arterial priapism  

International Nuclear Information System (INIS)

Purpose: To report feasibility, benefit and complications of penile angiography and superselective penile embolization in arterial priapism. Materials and Methods: Four consecutive patients (aged 28, 29, 40 and 49 years), who underwent penile angiography for arterial priapism (high-flow priapism) within a four-year period, were identified by a keyword search of our radiology information system. One patient had sustained a direct penile trauma (severe blow to the erected penis) and three patients suffered from recurrent spontaneous priapism. All patients had previously undergone corporeal aspiration and noradrenaline injection to achieve detumescence. Two patients had one or several unsuccessful spongiocavernous shunt procedures. Results: In three of the four patients, superselective pudendal and penile angiography demonstrated pathologic arteriocavernous shunting. In two of the three patients, superselective embolization using a coaxial micro-catheter was attempted. In one of the two patients, the cavernous artery became spastic before embolization material was actually injected, inducing immediate and lasting detumescence. In the other patient, unilateral Gelfoam embolization led to immediate detumescence but the priapism recurred 12 hours after the procedure. A subsequent contralateral Gelfoam embolization was successful. Erectile function was preserved in all cases. No procedure-related complications occurred. Conclusion: Our experience supports the prevailing opinion found in the current literature that superselective coaxial embolization constitutes the treatment of choice in patients with high-flow priapism. Prognosis is good with high probability of preserving the erectile function. (orig.)

2003-08-01

6

Normal and variations of internal pudendal artery in penile arteriography  

International Nuclear Information System (INIS)

Appreciation of the type and frequency of normal variations is important because branching patterns of internal pudendal artery (IPA) are highly variable and frequently differed from the classic description of anatomy. And these variations could be easily confused with arterial obstruction or abnormality. We analyzed 34 normal internal pudendal arteries from 17 men who were not believed to have arteriogenic impotence. The technique of studies were superselective IPA selection of catheter, and simultaneous infusion of intracavernosal and intraarterial papaverine with intraarterial lidocaine, under local anesthesia. The type and frequency of variations were 2 cases of hypoplastic dorsal penile artery (DPA) (6%), 1 case of one penile artery supplying both DPA (3%), 2 cases of accessory IPA (6%), and 4 cases of two DPA from one IPA (12%), 19 cases of two or more deep cavernosal artery from one IPA (56%). The overall frequency of both normal IPA in one man was 17.6% (N = 3 from 17 men). We wish anatomic variations and frequency should be fully recognized to avoid errors in interpretation of penile arteriography

1991-01-01

7

[Potency disorders before and after pelvic artery reconstruction: objectification by measuring penile artery pressure].  

Science.gov (United States)

Penile artery pressure was measured in 38 patients before and after aorto-iliac reconstruction using the Doppler technique. In 14 patients a markedly reduced penile pressure was found preoperatively which was significantly enhanced in 71% after operation. In 16% of all cases postoperative penile pressure was lower than the preoperative value. An improvement of sexual impairment was observed in 37% of the patients, while 26% reported a decrease of sexual function after operation. The reason seems to be an operative damage to the preaortal nerve plexus in most cases. Therefore, in younger patients with unilateral iliac artery occlusive disease an extraanatomical reconstruction is recommended. PMID:6714015

Schweiger, H; Zirngibl, H; Raithel, D

1984-02-01

8

Flow-Evoked Vasodilation Is Blunted in Penile Arteries from Zucker Diabetic Fatty Rats  

DEFF Research Database (Denmark)

Introduction.?? Endothelium-derived relaxing factors such as nitric oxide (NO), prostanoids, and endothelium-derived hyperpolarizing factor (EDHF) are thought to play an important role in vasodilation of penile arteries. Aim.?? The present study investigated the mechanisms involved in flow- and acetylcholine-induced vasodilation in penile arteries, and whether acetylcholine- and flow-mediated vasodilation is altered in Zucker diabetic fatty (ZDF) rats, a model of type 2 diabetes. Moreover, it was addressed whether enhanced myogenic tone may explain impaired flow-evoked vasodilation in arteries from ZDF rats. Methods.?? Penile dorsal arteries obtained from lean control and ZDF rats were suspended in a pressure myograph, and flow- and acetylcholine-evoked vasodilation was measured as changes in arterial diameter. Main Outcome Measure.?? Changes in penile arterial diameter. Results.?? Incubation with an inhibitor of NO synthase, asymmetric dimethyl-L-arginine (ADMA), and of cyclooxygenase, indomethacin, reduced acetylcholine but not flow-evoked vasodilation in penile arteries, while both responses were abolished by endothelial cell removal. Iberiotoxin, a blocker of large-conductance calcium-activated K(+) (BK(Ca) ) channels, inhibited flow-evoked vasodilation. Flow-evoked vasodilation was reduced in arteries from ZDF rats in the absence, but not in the presence, of indomethacin plus ADMA. Elevation of intraluminal pressure increased myogenic tone, which was reduced in arteries from ZDF rats. Conclusion.?? The present findings show that flow evokes endothelium-dependent EDHF-type vasodilation involving BK(Ca) channels in penile arteries. Flow-evoked vasodilation is reduced and only of EDHF-type in penile arteries from type 2 diabetic rats suggesting modulation of this pathway may restore endothelial function and preserve erection in diabetes. Schjørring O, Kun A, Flyvbjerg A, Kirkeby HJ, Jensen JB, and Simonsen U. Flow-evoked vasodilation is blunted in penile arteries from Zucker diabetic fatty rats. J Sex Med **;**:**-**.

Schjørring, Olav; Kun, Attila

2012-01-01

9

Microsurgical reimplantantion of a self-amputated penis with anastomosis of a single deep dorsal penile artery: Case report  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Microsurgical penile reimplantation was performed in a 24 years old man with chronic schizophrenia after a complete penile self-amputation. Urethra, corpora cavernosa and right deep dorsal penile artery were anastomosed microsurgically 6 hours after trauma. Skin necrosis on postoperative day 4 and distal urethral defect at the end of the first week developed. Necrotic tissues were debrided and a free skin graft was laid on the defect. During long-term follow-up, there was a distal urethral de...

2009-01-01

10

Penile fracture and penile reconstruction.  

Science.gov (United States)

The past decade has seen a significant development in penile reconstruction techniques, and the management of penile fracture has progressively shifted from a conservative approach to early surgical repair. The radial artery-based free flap phalloplasty now represents the gold-standard procedure for total phallic reconstruction both in men and in female-to-male transsexuals. PMID:21647621

Garaffa, Giulio; Raheem, Amr Abdel; Ralph, David John

2011-12-01

11

Microsurgical reimplantantion of a self-amputated penis with anastomosis of a single deep dorsal penile artery: Case report  

Directory of Open Access Journals (Sweden)

Full Text Available Microsurgical penile reimplantation was performed in a 24 years old man with chronic schizophrenia after a complete penile self-amputation. Urethra, corpora cavernosa and right deep dorsal penile artery were anastomosed microsurgically 6 hours after trauma. Skin necrosis on postoperative day 4 and distal urethral defect at the end of the first week developed. Necrotic tissues were debrided and a free skin graft was laid on the defect. During long-term follow-up, there was a distal urethral defect which was 1.5 cm in length, the sensation was decreased on distal penile shaft and glans and penile length was also shortened. The patient had morning erections, but he has not attempted sexual intercourse. We have observed rigid erection continuing for 10 minutes with combined injection stimulation test.

Necati Grbz

2009-01-01

12

Selective Embolization of Bilateral Arterial Cavernous Fistulas for Posttraumatic Penile Arterial Priapism  

International Nuclear Information System (INIS)

A 22-year-old man suffered a hiking accident with perineal trauma and developed a nonpainful priapism secondary to bilateral arterial-cavernosal fistulas. To minimize the risk of impotence in this young patient, successive selective embolizations with autologous blood clot were performed to close the fistulas. This led to an uncomplicated full recovery. No fistula was detectable on Doppler ultrasonography at 1-year follow-up. Review of the literature confirms the safety of embolization with autologous clot

1996-04-01

13

Penile replantation.  

Science.gov (United States)

Penile amputation is rare and hence the paucity of experience and publication. We present our case of self-inflicted penile amputation, which was successfully managed with microsurgical replantation, with relevant literature review. PMID:23960324

Krishnakumar, K S; Petkar, Kiran S; Lateef, Sameer; Vyloppilli, Suresh

2013-01-01

14

Structure and function of small arteries  

DEFF Research Database (Denmark)

The small arteries (prearteriolar vessels with lumen diameter less than approximately 500 microns) contribute importantly to and participate actively in the regulation of the peripheral resistance. New techniques, building on the classic histological and hemodynamic techniques, have enabled detailed in vitro investigation of small arteries. At present, research in small arteries is in its infancy, and our understanding of the heterogeneity of small arteries within vascular beds, between vascular beds, and between species is extremely limited. This review attempts to describe the current status of the field. New techniques, based primarily on a wire myograph (where the vessels are mounted as ring preparations) and a pressure myograph (where vessels are cannulated and pressure-lumen relations are determined), have allowed in vitro investigations of small arteries. The more physiological arrangement of the pressure myograph allows, for example, investigation of the vasoconstrictor response to raised intravascular pressure (the Bayliss response), whereas the less-sophisticated wire myograph is similar to use and may be more useful in certain situations where particular mechanisms are being investigated. Both techniques allow simultaneous measurements of vessel tone and a variety of parameters (e.g., membrane potential and intracellular ion activities) and thus allow precise determination of the relation between small artery structure and function. The vessels appear to remain fully viable with regard to the contractility of their smooth muscle cells as well as to the function of their perivascular nerves and their endothelium. The evidence suggests that the monovalent transport mechanisms in the plasma membrane, in particular potassium channels, play an important role in the determination of the membrane potential in small arteries, although the relation is more complex than indicated by the Goldman equation. Confirmation of these findings requires, however, simultaneous determinations of ion transport and vascular tone under conditions where vessels are subjected to mechanical loading. The membrane potential, through its effect on potential-dependent calcium channels, plays an important role in the determination of vascular tone. With regard to calcium homeostasis, current knowledge is hampered by the lack of direct measurements of the relation between cytoplasmic calcium and vascular tone. The evidence, however, suggests that besides potential-dependent calcium channels, receptor-operated calcium channels are present in the plasma membrane, although this still requires confirmation. The role of the sarcoplasmic reticulum is not clarified.(ABSTRACT TRUNCATED AT 400 WORDS)

Mulvany, M J; Aalkjær, Christian

1990-01-01

15

Penile Dysplasia  

Science.gov (United States)

Risk factors for penile cancer include intact foreskin, phimosis, HPV, other sexually transmitted infections, and perhaps HIV-related immune deficiency. IIB and extramural collaborators plan to use questionnaire data as well as micro-array and immunohistochemistry

16

Penile arteriography in vasculogenic impotence  

International Nuclear Information System (INIS)

Bifurcation aortography and selective internal pudendal arteriography were performed in 70 impotent men under the impression of vasculogenic impotence. Age range was 6 to 63 years old(average 32). 54 patients had the history of pelvic trauma. The studies were performed under local anesthesia and simultaneous intracavernosal and intraarterial Papavertine injection before filming. To reduce pain and arterial spasm, intraarterial Lidocaine and low osmolarity non-ionic contrast media were used. Arterial lesions were found in 50(93%) traumatic patients and 7(44%) non-traumatic patients. Internal iliac arterial lesion that causing pelvic steal syndrome was noted in 3 traumatic patients. Among trauma related cases there were bilateral arterial lesion in 19 patients and one axis lesion in 31 patients respectively. Among 16 non traumatic patients there were bilateral arterial lesions in 2 patients and unilateral lesion in 5 patients. Irrespective or bilaterally or unilaterally of the lesion, majority of arterial lesions were found at the distal internal pudendal artery or common penile artery level in traumatic patients. On the contrary, penile branch lesion was predominant site in non traumatic patients. With the improved arteriographic technique, selective penile arteriography appears accurate method in the diagnosis of arterial impotence

1990-12-01

17

Penile Cancer  

Science.gov (United States)

Squamous cell carcinoma of the penis represents approximately 0.5% of all cancers among men in the United States and other developed countries. Although rare, it is associated with significant disfigurement, and only half of the patients survive beyond 5 years. Proper evaluation of both the primary lesion and lymph nodes is critical, because nodal involvement is the most important factor of survival. The NCCN Clinical Practice Guidelines in Oncology for Penile Cancer provide recommendations on the diagnosis and management of this devastating disease based on evidence and expert consensus.

Clark, Peter E.; Spiess, Philippe E.; Agarwal, Neeraj; Biagioli, Matthew C.; Eisenberger, Mario A.; Greenberg, Richard E.; Herr, Harry W.; Inman, Brant A.; Kuban, Deborah A.; Kuzel, Timothy M.; Lele, Subodh M.; Michalski, Jeff; Pagliaro, Lance; Pal, Sumanta K.; Patterson, Anthony; Plimack, Elizabeth R.; Pohar, Kamal S.; Porter, Michael P.; Richie, Jerome P.; Sexton, Wade J.; Shipley, William U.; Small, Eric J.; Trump, Donald L.; Wile, Geoffrey; Wilson, Timothy G.; Dwyer, Mary; Ho, Maria

2014-01-01

18

[A case of penile cavernitis following a penile prosthesis implantation].  

Science.gov (United States)

A 25-year old man, who had an inferiority of having a small penis and normal potency, underwent intracavernous implantation of hand-made silicone rods by a cosmetic surgeon in order to enlarge his penis. He had pyrexia and swelling of the penis 2 days after the implantation, and penile cavernitis developed. The penile symptoms improved by drainage and strict chemotherapy, and then the silicone rods were removed from his penis. Histopathological findings of the corpus cavernosum showed marked inflammatory and granulomatous changes. The patient lost his potency due to poor blood flow into the cavernous. PMID:1767781

Kagebayashi, Y; Hayashi, Y; Hirao, K; Tanaka, N; Yoneda, T; Hirao, Y

1991-11-01

19

Reconstruction of small diameter arteries using decellularized vascular scaffolds.  

Science.gov (United States)

Although artificial vessels are available for large diameter arteries, there are no artificial vessels for small diameter arteries of < 4 mm. We created a decellularized vascular scaffold (length, 10 mm; outer diameter, 1.5 mm; inner diameter, 1.3 mm) from rat abdominal arteries. We measured the biomechanical characteristics of the scaffolds, implanted them to defects made in rat carotid arteries, and evaluated their patency and the endothelial cell linings. Silastic grafts were implanted as controls. The decellularized scaffolds demonstrated similar mechanical characteristics to normal arteries. All of the control grafts were occluded. Fibroblast-like cells were discovered in the thrombus, and fibrous organization was apparent. In contrast, patency of the grafts in 10 of 12 animals was observed 4 weeks after implantation. The internal cavity of the patent scaffold was completely lined by endotheliallike cells. Thus, the possibility of small artery reconstruction using decellularized scaffolds was demonstrated. PMID:24658963

Nagaoka, Yuki; Yamada, Hiroshi; Kimura, Tsuyoshi; Kishida, Akio; Fujisato, Toshia; Takakuda, Kazuo

2014-01-01

20

[Should asymptomatic small popliteal artery aneurysms be operated on?].  

Science.gov (United States)

The authors recently observed two patients who suffered acute lower limb ischemia secondary to thrombosis of a small (diameter of less than 2 cm) popliteal artery aneurysm. A literature search lead to the conclusion that small popliteal aneurysms, covered with mural thrombus and presenting a distorted neck due to elongation, are prone to thrombosis. Another risk factor is a restrained outflow bed as a result of previous micro-embolisations into the tibial arteries. The authors conclude that small popliteal artery aneurysms are not so innocent as is often presumed. PMID:23346827

Holemans, Ch; Van Damme, H; Defraigne, J O

2012-11-01

 
 
 
 
21

Klippel-Trenaunay syndrome with small vessel pulmonary arterial hypertension  

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A patient with Klippel-Trenaunay syndrome and pulmonary arterial hypertension not associated with chronic thrombo-embolic pulmonary hypertension is described. It is hypothesised that pulmonary arterial hypertension is another complication associated with the Klippel-Trenaunay syndrome, possibly due to haemodynamic changes of small vessel abnormalities.

Ulrich, S.; Fischler, M.; Walder, B.; Pfammatter, T.; Speich, R.

2005-01-01

22

Chronic penile strangulation  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Chronic penile strangulation is exceedingly rare with only 5 cases previously reported. We report an additional case of progressive penile lymphedema due to chronic intermittent strangulation caused by a rubber band applied to the penile base for 6 years. A 49-year-old man presented incapacity to exteriorize the glans penis. For erotic purposes, he had been using a rubber-enlarging band placed in the penile base for 6 years. With chronic use, he noticed that his penis swelled. Physical examin...

Lopes, Roberto I.; Lopes, Silvia I.; Lopes, Roberto N.

2003-01-01

23

Management of penile amputation injuries.  

Science.gov (United States)

Penile amputation is an uncommon injury resulting from self-mutilation, felonious assault, or accidental trauma. Management requires resuscitation and stabilization of the patient with particular attention to underlying psychiatric illness. Amputated tissue can be preserved under hypothermic conditions in preparation for surgical replantation. Current replantation techniques rely on microsurgical approximation of the dorsal structures and cavernosal arteries with uniformly good results. Phallic replacement may be necessary when the amputated segment is lost. Microsurgical free forearm flap phalloplasty is the current mainstay of penile replacement surgery. Although urethral complications remain problematic, the results continue to be acceptable with regard to appearance and function. A unique subset of patients sustaining amputation injury is children. Both replantation and phallic construction have been successful in children and represent an alternative to gender reassignment. PMID:11775199

Jezior, J R; Brady, J D; Schlossberg, S M

2001-12-01

24

Chronic penile strangulation  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english Chronic penile strangulation is exceedingly rare with only 5 cases previously reported. We report an additional case of progressive penile lymphedema due to chronic intermittent strangulation caused by a rubber band applied to the penile base for 6 years. A 49-year-old man presented incapacity to ex [...] teriorize the glans penis. For erotic purposes, he had been using a rubber-enlarging band placed in the penile base for 6 years. With chronic use, he noticed that his penis swelled. Physical examination revealed lymphedema of the penis, phimosis and a stricture in the penile base. The patient was submitted to circumcision and the lymphedema remained stable 10 months postoperatively. Chronic penile incarceration usually causes penile lymphedema and urinary disturbance. Treatment consists of removal of foreign devices and surgical treatment of lymphedema.

Lopes, Roberto I; Lopes, Silvia I; Lopes, Roberto N.

25

[Incomplete penile amputation: diagnostic and therapeutic challenge].  

Science.gov (United States)

Traumatic penile amputation is a severe injury associated with a potential for multidisciplinary dysfunction. Since such injuries are rare, diagnostic and therapeutic experience is minimal. While complete penile amputation is a straight-forward diagnosis, incomplete amputations are not as evident and diagnosis may be delayed. The therapeutic endpoint includes restoration of an acceptable appearance of the phallus and a urethral meatus that allows normal voiding. Other objectives include re-establishment of sexual potency and fertility. As in other amputations, the treatment of choice is meticulous microsurgical replantation, including re-anastomosis of dorsal and cavernosal arteries, the deep dorsal vein, the urethra and nerves, as well as suturing the tunica albuginea. While appropriate cosmetic results and normal voiding can be achieved in most cases, potency is less frequently achieved due to neurological deficit leading to impaired erection and loss of sensation. Penile amputation is thus a complex therapeutic challenge, as meticulous anatomic reconstruction of blood vessels and nerves is essential for restoration of function. Since incomplete penile amputation may be overlooked when other more obvious injuries draw attention, this injury should be suspected in all cases of penetrating injury of the male genitalia. We present a 17-year-old man who sustained an incomplete penile amputation in a traffic accident. PMID:9451890

Leibovici, D; Yaffe, B; Zisman, A

1997-12-01

26

Therapeutic strategies for patients with micropenis or penile dysmorphic disorder.  

Science.gov (United States)

Micropenis in adults is defined as a stretched length of micropenis who also suffer from penile dysmorphic disorder require careful and intensive psychological counselling. Corrective surgery for micropenis can be performed in patients with realistic expectations. Total phalloplasty using radial-artery-based forearm skin flaps can offer restoration of normal penile length in selected patients. More-conservative surgical techniques to improve length or girth are limited by minimal enhancement but associated with a significantly lower rate of complications and comorbidity compared to total phalloplasty. Emerging tissue engineering techniques might represent a suitable alternative to penile replacement surgery in the future. PMID:22890302

Kayes, Oliver; Shabbir, Majid; Ralph, David; Minhas, Suks

2012-09-01

27

Sonographic evaluation of penile in patients with erectile dysfunction  

International Nuclear Information System (INIS)

A review of the current state of knowledge is made on sonographic evaluation of penile in patients with erectile dysfunction. This sonography is developed with high resolution ultrasound on gray scale, combined with color Doppler ultrasonography; which the arteries of penile are examined before and during the erection. The penile ultrasonography has meant an important tool in the evaluation of specific patients who have submitted erectile dysfunction, particularly, in those with record of trauma and history of Peyronie's disease. In addition, through a sonographic evaluation has permitted to prove manifestations of the pathophysiological phenomena of the patient in order to establish their classification and guide their treatment

2012-01-01

28

Microsurgical penile replantation facilitated by postoperative HBO treatment.  

Science.gov (United States)

Successful microsurgical replantation of a penis amputated at the level of the pubis is a rare occurrence worldwide. Moreover, the use of hyperbaric oxygen (HBO) for a postoperative replant Pseudomonas wound infection has not been reported. There is also disagreement regarding the importance of microsurgical repair of only the dorsal arteries or only the profundi arteries of the penis. A case is reported of penile replantation with a postoperative Pseudomonas wound infection treated with HBO to prevent potential replant loss, with a worldwide literature review. At 1-year postoperative follow-up, the patient has normal urinary flow and reports spontaneous erection, with the ability for intromission and a sensate glans. HBO facilitated the success of a penile replantation complicated by postoperative Pseudomonas wound infection. In addition, a literature review supports the microsurgical repair of at least a single isolated dorsal penile artery, but not a single or multiple profundi arteries. PMID:14748025

Landstrm, Jerone T; Schuyler, Robert W; Macris, George P

2004-01-01

29

Genetic Fuzzy System Predicting Contractile Reactivity Patterns of Small Arteries  

Science.gov (United States)

Monitoring of physiological surrogate end points in drug development generates dynamic time-domain data reflecting the state of the biological system. Conventional data analysis often reduces the information in these data by extracting specific data points, thereby discarding potentially useful information. We developed a genetic fuzzy system (GFS) algorithm that is capable of learning all information in time-domain physiological data. Data on isometric force development of isolated small arteries were used as a framework for developing and optimizing a GFS. GFS performance was improved by several strategies. Results show that optimized fuzzy systems (OFSs) predict contractile reactivity of arteries accurately. In addition, OFSs identified significant differences that were undetectable using conventional analysis in the responses of arteries between groups. We concluded that OFSs may be used in clustering or classification tasks as aids in the objective identification or prediction of dynamic physiological behavior.

Tang, J; Sheykhzade, M; Clausen, B F; Boonen, H C M

2014-01-01

30

Genetic fuzzy system predicting contractile reactivity patterns of small arteries.  

Science.gov (United States)

Monitoring of physiological surrogate end points in drug development generates dynamic time-domain data reflecting the state of the biological system. Conventional data analysis often reduces the information in these data by extracting specific data points, thereby discarding potentially useful information. We developed a genetic fuzzy system (GFS) algorithm that is capable of learning all information in time-domain physiological data. Data on isometric force development of isolated small arteries were used as a framework for developing and optimizing a GFS. GFS performance was improved by several strategies. Results show that optimized fuzzy systems (OFSs) predict contractile reactivity of arteries accurately. In addition, OFSs identified significant differences that were undetectable using conventional analysis in the responses of arteries between groups. We concluded that OFSs may be used in clustering or classification tasks as aids in the objective identification or prediction of dynamic physiological behavior. PMID:24695357

Tang, J; Sheykhzade, M; Clausen, B F; Boonen, H C M

2014-01-01

31

Genetic fuzzy system predicting contractile reactivity patterns of small arteries  

DEFF Research Database (Denmark)

Monitoring of physiological surrogate end points in drug development generates dynamic time-domain data reflecting the state of the biological system. Conventional data analysis often reduces the information in these data by extracting specific data points, thereby discarding potentially useful information. We developed a genetic fuzzy system (GFS) algorithm that is capable of learning all information in time-domain physiological data. Data on isometric force development of isolated small arteries were used as a framework for developing and optimizing a GFS. GFS performance was improved by several strategies. Results show that optimized fuzzy systems (OFSs) predict contractile reactivity of arteries accurately. In addition, OFSs identified significant differences that were undetectable using conventional analysis in the responses of arteries between groups. We concluded that OFSs may be used in clustering or classification tasks as aids in the objective identification or prediction of dynamic physiological behavior.

Tang, J; Sheykhzade, Majid

2014-01-01

32

'Variant' angina: Evidence for small vessel coronary artery spasm  

International Nuclear Information System (INIS)

A unique case of 'variant' angina pectoris has been observed in a patient with normal coronary arteries and typical chest pain appearing spontaneously at rest, and repeatedly provoked by ergonovine maleate (0.1 mg iv) associated with large transmural perfusion defects on "2"0"1TI-imaging (after ergonovine) and a marked increase in T wave voltage despite no demonstrable spasm of a major coronary artery after the same doses of ergonovine. While saline solution could not provoke chest pain and treatment with a beta-blocking agent increased the frequency of ischemic attacks, a calcium antangonist therapy reduced and eventually eliminated the attacks. Thus, this case provides evidence for yet another aspect of a 'variant' form of angina pectoris: small vessel coronary artery spasm. (orig.)

1980-01-01

33

Minimally Invasive Penile Implant Surgery  

Medline Plus

Full Text Available ... or Cialis. The inflatable penile prosthesis consists of two cylinders, a reservoir, and pump, which are placed ... early 1970s. Today we are thrilled to have two contemporary experts in penile implant surgery for the ...

34

Minimally Invasive Penile Implant Surgery  

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Full Text Available ... the same that is, placement of a penile prosthetic device in the two erection chambers of the ... the opportunity for infection, the most feared penile prosthetic complication. On my immediate left is Dr. Francois ...

35

The penile flap in the rat: description and autotransplantation.  

Science.gov (United States)

Considering both its unique structural and functional properties, the reconstruction of the penis is still a challenging problem in reconstructive surgery. Reconstruction may be required in many situations, including traumas, congenital abnormalities, and female-to-male transsexual surgery. Currently, the only natural reconstructive method for the penis is its microvascular reattachment in amputation cases. In all other situations, and in nonreplantable amputations, there is no alternative but to reconstruct the penis using autologous tissues to create the most similar substitute, hoping for a possible allogeneic transplantation in the future. There are many unresolved issues and unanswered questions related to functional recovery after replantation of the penis. In this study, to overcome these drawbacks and to guide and show the feasibility of allogeneic transplantation of the penis in humans in the future, we describe a penile composite tissue flap based on the internal pudendal artery and its autotransplantation in an economical animal species. Fifty adult male Sprague-Dawley rats weighing 400 to 500 g were used. In 20 rats, the vascular anatomy of the male perineal region was determined by anatomic dissections. Based on this anatomic study, the penile composite flap was created based on the internal pudendal vessels. In 10 rats, the penile flap was raised as an island flap based on its vascular pedicle and replaced in situ. In 10 rats, distant flap transfer was accomplished to determine the feasibility of the flap being transferred as a free flap and to demonstrate the viability of the flap components in a heterotopic region. For this purpose, the flap was transferred to the groin region performing anastomoses between internal pudendal vessels and superficial epigastric vessels. In the control group (n=10), while the same surgical procedure was performed, the flap was transferred to the groin region but no anastomosis was performed. The procedure required approximately 3 to 4 hours of operating time in the free flap group. Five of the animals died in the early postoperative days, while all others survived. Direct observation and microangiography were used to assess the viability of the flaps. On the basis of direct observation on the seventh postoperative day, all the pedicled flaps survived completely. In the free-flap group, all but 1 of the vascularized flaps showed complete survival, whereas all the nonvascularized flaps completely necrosed. The authors conclude that the penile flap of the rat offers the following advantages: (1) the composite tissue flap is harvested from a small animal species, (2) the flap is an exact representation of the clinical original penile composition, (3) it can be transferred as a free flap without the need for an isogeneic animal, (4) the vascular pedicle is consistent and allows for microvascular anastomoses. The flap will provide a means for future physiological studies, especially for replantation cases. The feasible autotransplantation of the penile flap with successful results will also guide researchers towards the future allogeneic transfer of the penis in humans. PMID:15985799

Akyurek, Mustafa; Ozkan, Omer; Safak, Tunc; Ozgentas, H Ege; Dunn, Raymond M

2005-07-01

36

Overview of Contemporary Penile Rehabilitation Therapies  

Directory of Open Access Journals (Sweden)

Full Text Available Introduction. Post-prostatectomy erectile dysfunction affects a considerable number of men and is a significant quality of life issue. There has been a substantial amount of research on the treatment of post-prostatectomy ED, and now there is a rising interest in the concept of penile rehabilitation. The goal of penile rehabilitation is to moderate the destructive processes that occur after prostatectomy in order to preserve erectile function, either through spontaneous or assisted means. Methods. We reviewed published data and experiences of post-prostatectomy penile rehabilitation using regimented interventions of phosphodiesterase inhibitors, vacuum erectile device, and intracavernosal agents, and we present and analyze the research conducted. Results. These studies show improved objective and subjective clinical outcomes in regards to physical parameters, sexual satisfaction, and rates of spontaneous erections. Conclusion. These studies are often limited by small size, study period, and study design. There continues to be a need for large, randomized, placebo controlled trials with adequate followup to fully evaluate the efficacy and cost-effectiveness of the various proposed penile rehabilitation regiments before a clear standard can be established.

Run Wang

2008-09-01

37

Small arterial granular degeneration in familial Binswanger's syndrome.  

Science.gov (United States)

A 55-year-old mildly hypertensive woman died after having developed a subcortical dementia during the past 9 years, with focal neurological signs. She presented at the age of 46 years with short episodes of dizziness and diplopia, suggesting that transient ischemic attacks involved the posterior fossa structures. Over the next 8 years, she developed difficulty in walking, urinary incontinence and seizures. On examination in 1989, she was severely demented. There was tetraparesis, bilateral arm and leg spasticity with hyperreflexia and bilateral Babinski signs. She showed epilepsia partialis continua involving the eyes, left hemiface and limbs. CT showed hypodensity of the white matter and lacunes in the basal ganglia and centrum semiovale, moderate hydrocephalus with cerebellar and cortical atrophy. Clinical and radiological features were similar to those of Binswanger's disease. Similar cases had occurred in the family affecting the patient's grandfather, father and two brothers, suggesting an autosomal dominant hereditary disease. Postmortem examination disclosed a Binswanger type of leukoencephalopathy caused by a peculiar microangiopathy characterized by a slightly basophilic small arterial granular degeneration of the medial sheath associated with the presence of ballooned smooth muscle cells with clear cytoplasm. Electron microscopic study revealed degenerative changes in the parietal vessels with notable increase of basal-membrane-type material and electron-dense granular deposits. These lesions could correspond to a specific familial pathology of the small arteries of the brain. They are identical to those reported in some patients with autosomal dominant inheritance. For other patients with similar clinical features and the same familial pattern, reported as "hereditary multi-infarct dementia'' and "chronic familial vascular encephalopathy'', there are no sufficient objective pathological facts to consider that they have the same disease.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8140899

Gutirrez-Molina, M; Caminero Rodrguez, A; Martnez Garca, C; Arpa Gutirrez, J; Morales Bastos, C; Amer, G

1994-01-01

38

An unusual form of coronary artery fistula: a small aneurysm of vieussens' arterial ring communicating with the pulmonary artery.  

Science.gov (United States)

Vieussens' arterial ring (VAR) is the connection between the conus branch of the right coronary artery and the proximal right ventricular branch of the left anterior descending coronary artery. VARs are found in 48% of the population; however, pathologic VAR is rare. We experienced a case of pathologic VAR that involved a fistula connecting to the main pulmonary artery. PMID:24782968

Lee, Hae Young; Cho, Seong Ho

2014-04-01

39

Penile bulb imaging  

International Nuclear Information System (INIS)

Purpose: Because of the apparent relationship between potency loss and radiation doses to the erectile bodies, there is increasing rationale for incorporating penile bulb dosimetry into treatment planning and posttreatment evaluation. Because the location and shape of the penile bulb have not been described in detail on various imaging modalities, we herein describe the anatomic boundaries of the penile bulb on computed tomography (CT), magnetic resonance imaging (MR), and transrectal ultrasound (TRUS), before and after brachytherapy. Methods and Materials: Nonenhanced axial CT images were taken on a CTi CT Scanner (General Electric Medical Systems, Milwaukee, WI) with the patient in the supine position. Settings were at 300 ma, 140 kvp, 4-s scan time per slice, and collimation of 3 mm with data obtained at 3-mm intervals. Nonenhanced MR images were obtained with a 1.5 Tesla Signa Horizon LX Scanner using fast spin-echo T1-weighted (TR/TE, 466/20) and T2-weighted (TR/TE, 8000/90) images, with a slice thickness of 2 mm and an interslice gap of 0.5 mm. TRUS images were obtained with a Siemens SONOLINE Prima ultrasound machine at 6.0 MHz and a Winston-Barzell stepper unit. Results: The penile bulb is best visualized on T2-weighted MR images in the axial, sagittal, and coronal planes, appearing as an oval-shaped, hyperintense midline structure. On axial CT imaging, the bulb of the penis is typically readily identifiable, bounded by the paired crura laterally, the corpora spongiosum anteriorly, and the levator ani posteriorly. The penile bulb is typically well visualized on transverse TRUS, but usually only faintly seen on sagittal TRUS. The bulb is partially obscured on postimplant CT and MR images, presumably because of implant-related edema. Bulb volumes vary markedly from patient to patient, ranging from 5.6 to 12.4 cc (median: 8.1 cc). Conclusion: Closer attention to penile erectile tissue doses should lead to improved external beam radiation and brachytherapy delivery. It will benefit the radiation oncology community to become familiar with these imaging findings, so that penile bulb dosimetry can be incorporated into our daily practice

2002-07-15

40

Physiologic Compliance in Engineered Small-diameter Arterial Constructs Based on an Elastomeric Substrate  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Compliance mismatch is a significant challenge to long-term patency in small-diameter bypass grafts because it causes intimal hyperplasia and ultimately graft occlusion. Current engineered grafts are typically stiff with high burst pressure but low compliance and low elastin expression. We postulated that engineering small arteries on elastomeric scaffolds under dynamic mechanical stimulation would result in strong and compliant arterial constructs. Compare properties of engineered arterial c...

Crapo, Peter M.; Wang, Yadong

2010-01-01

 
 
 
 
41

Small artery structure during antihypertensive therapy is an independent predictor of cardiovascular events in essential hypertension  

DEFF Research Database (Denmark)

Structural changes of small resistance arteries occur early in the disease process of essential hypertension and predict cardiovascular events in previously untreated patients. We investigated whether on-treatment small artery structure also identifies patients at elevated risk despite normalization of blood pressure (BP).

Buus, Niels H; Mathiassen, Ole N

2013-01-01

42

Penile subcutaneous fibrolipoma postaugmentative phalloplasty.  

Science.gov (United States)

Fibrolipomas are a rare subtype of lipomas. We describe a case of a man suffering from subcutaneous penile fibrolipoma, who three months earlier has been submitted to an augmentative phalloplasty due to aesthetic dysmorphophobia. After six months from the excision of the mass, the penile elongation and penile enlargement were stable, and the patient was satisfied with his sexual intercourse and sexual life. To our knowledge, this is the first reported penile subcutaneous fibrolipoma case in the literature. The diagnostics and surgical features of this case are discussed. PMID:24195003

Vicini, Patrizio; De Marco, Ferdinando; Letizia, Piero; Alei, Lavinia; Antonini, Gabriele; Alei, Giovanni; Gentile, Vincenzo

2013-01-01

43

[Brachytherapy for penile carcinoma].  

Science.gov (United States)

Malignant tumours of the penis are a rare entity. They are mostly squamous cell carcinomas and arise from the glands or the coronal sulcus. Glans brachytherapy has been developed to avoid mutilating surgery and allow organ preservation. Indications of brachytherapy are tumours less than 4 cm with no invasion of the uretra or corpora cavernosa. Local control is equivalent after brachytherapy and surgery. This article describes the indications, the technique, outcome and toxicity of penile brachytherapy. PMID:23490170

Blanchard, P; Delannes, M; Haie-Meder, C

2013-04-01

44

Penile abscess and necrotizing fasciitis secondary to neglected false penile fracture  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Penile infection and abscess formation have been described in association with priapism, cavernosography, intracavernosal injection therapy, trauma and penile prosthesis. We report a case of penile abscess and necrotizing fasciitis of penile skin in a 37-year-old male, presented 3 weeks after neglected false penile fracture.

Al-Reshaid Reshaid; Madbouly Khaled; Al-Jasser Abdullah

2010-01-01

45

Penile abscess and necrotizing fasciitis secondary to neglected false penile fracture  

Directory of Open Access Journals (Sweden)

Full Text Available Penile infection and abscess formation have been described in association with priapism, cavernosography, intracavernosal injection therapy, trauma and penile prosthesis. We report a case of penile abscess and necrotizing fasciitis of penile skin in a 37-year-old male, presented 3 weeks after neglected false penile fracture.

Al-Reshaid Reshaid

2010-01-01

46

Penile anomalies in adolescence.  

Science.gov (United States)

This article considers the impact and outcomes of both treatment and underlying condition of penile anomalies in adolescent males. Major congenital anomalies (such as exstrophy/epispadias) are discussed, including the psychological outcomes, common problems (such as corporal asymmetry, chordee, and scarring) in this group, and surgical assessment for potential surgical candidates. The emergence of new surgical techniques continues to improve outcomes and potentially raises patient expectations. The importance of balanced discussion in conditions such as micropenis, including multidisciplinary support for patients, is important in order to achieve appropriate treatment decisions. Topical treatments may be of value, but in extreme cases, phalloplasty is a valuable option for patients to consider. In buried penis, the importance of careful assessment and, for the majority, a delay in surgery until puberty has completed is emphasised. In hypospadias patients, the variety of surgical procedures has complicated assessment of outcomes. It appears that true surgical success may be difficult to measure as many men who have had earlier operations are not reassessed in either puberty or adult life. There is also a brief discussion of acquired penile anomalies, including causation and treatment of lymphoedema, penile fracture/trauma, and priapism. PMID:21399858

Wood, Dan; Woodhouse, Christopher

2011-01-01

47

Management of penile fractures  

International Nuclear Information System (INIS)

Objective was to present our experience with surgical and conservative management of penile fracture. This prospective study was carried out in the Urology and Nephrology Center, at Al-Thawra General and Teaching Hospital, Sana'a, Yemen from June 2003 to September 2007 and included 30 patients presenting with penile fracture. Diagnosis was made clinically in all our patients. Six patients with simple fracture were treated conservatively while 24 patients with more severe injuries were operated upon. Patient's age ranged from 24-52 years (mean 31.3 years) 46.7% of patients were under the age of 30 years and 56.7% were unmarried. Hard manipulation of the erect penis for example during masturbation was the most frequent mechanism of fracture in 53.3% of patients. Solitary tear was found in 22 patients and bilateral corporal tears associated with urethral injury were found in 2 patients. Corporal tears were saturated with synthetic absorbable sutures and urethral injury was repaired primarily. All operated patients described full erection with straight penis except 3 of the 8 patients who were managed by direct longitudinal incision, in whom mild curvature during erection was observed. The conservatively treated patients described satisfactory penile straightness and erection. The optimal functional and cosmetic results are achieved following immediate surgical repair of penis fracture. Good results can also be obtained in some selected patients with conservative management. (author)

2007-09-00

48

Decellularized ovine arteries as small-diameter vascular grafts.  

Science.gov (United States)

Atherosclerosis and its complications still represent the leading cause of death in the developed countries. While autologous blood vessels may be regarded as the best solution for peripheral and coronary bypass, they are unavailable in most patients. Even though tissue engineering techniques are often applied to the development of small-diameter vascular grafts, limiting factors of this approach are represented by the lack of essential extracellular matrix proteins and/or poor biomechanical properties of the scaffolds used. Along these lines, the aim of this study was to develop a decellularization protocol for ovine carotids to be used as suitable small-diameter vascular grafts. Samples were treated either with sodium dodecyl sulphate (SDS) or with Trypsin and Triton X-100; a final nuclease digestion was performed for both protocols. Morphological analyses demonstrate complete removal of nuclei and cellular components in treated vessels, also confirmed by significant reduction in wall thickness and DNA content. Essential extracellular matrix proteins such as collagen, elastin, and fibronectin are well preserved after decellularization. From a mechanical point of view, Trypsin and Triton X-100 treated arteries show elastic modules and compliance comparable to native carotids, whereas the use of SDS makes samples stiffer, with a significant decrease in the compliance mean value and an increase in longitudinal and circumferential Young's modules. Itis demonstrated that the treatment where Trypsin and Triton X-100 are combined guarantees complete decellularization of carotids, with no significant alteration of biomechanical and structural properties, thus preserving a suitable environment for adhesion, proliferation, and migration of cells. PMID:25050540

Mancuso, L; Gualerzi, A; Boschetti, F; Loy, F; Cao, G

2014-08-01

49

Advances in understanding of mammalian penile evolution, human penile anatomy and human erection physiology: clinical implications for physicians and surgeons.  

Science.gov (United States)

Recent studies substantiate a model of the tunica albuginea of the corpora cavernosa as a bi-layered structure with a 360 complete inner circular layer and a 300 incomplete outer longitudinal coat spanning from the bulbospongiosus and ischiocavernosus proximally and extending continuously into the distal ligament within the glans penis. The anatomical location and histology of the distal ligament invites convincing parallels with the quadrupedal os penis and therefore constitutes potential evidence of the evolutionary process. In the corpora cavernosa, a chamber design is responsible for facilitating rigid erections. For investigating its venous factors exclusively, hemodynamic studies have been performed on both fresh and defrosted human male cadavers. In each case, a rigid erection was unequivocally attainable following venous removal. This clearly has significant ramifications in relation to penile venous surgery and its role in treating impotent patients. One deep dorsal vein, 2 cavernosal veins and 2 pairs of para-arterial veins (as opposed to 1 single vein) are situated between Buck's fascia and the tunica albuginea. These newfound insights into penile tunical, venous anatomy and erection physiology were inspired by and, in turn, enhance clinical applications routinely encountered by physicians and surgeons, such as penile morphological reconstruction, penile implantation and penile venous surgery. PMID:22739749

Hsieh, Cheng-Hsing; Liu, Shih-Ping; Hsu, Geng-Long; Chen, Heng-Shuen; Molodysky, Eugen; Chen, Ying-Hui; Yu, Hong-Jeng

2012-07-01

50

Minimally Invasive Penile Implant Surgery  

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Full Text Available MINIMALLY INVASIVE PENILE IMPLANT SURGERY CORAL GABLES HOSPITAL CORAL GABLES, FLORIDA March 26, 2007 00:00:10 ANNOUNCER: Over the next hour youll see a live panel discussion of penile implant surgery. For men with severe erectile dysfunction, the ...

51

Minimally Invasive Penile Implant Surgery  

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Full Text Available ... penile implants, maybe well decrease our infection rates. And I started looking at what is the ... Wow, thats fantastic. Okay, another question. The success rate of the inflatable penile prosthesis. 00:17:45 ...

52

Pharmacologically induced erect penile length and stretched penile lengh are both good predictors of post-inflatable prosthesis penile length.  

Science.gov (United States)

Inflatable penile prosthesis (IPP) remains the gold standard for the surgical treatment of refractory erectile dysfunction; however, current literature to aid surgeons on how best to counsel patients on their postoperative inflated penile length is lacking. The aim of this study was to identify preoperative parameters that could better predict postoperative penile length following insertion of an IPP. Twenty men were enrolled in a prospective study examining penile lengths before and after IPP surgery. Patients with Peyronie's disease were excluded from this analysis. Baseline preoperative characteristics, including body mass index, history of hypertension, diabetes, Sexual Health Inventory for Men scores and/or prior radical prostatectomy were recorded. All patients underwent implantation with a three-piece inflatable Coloplast penile prosthesis. We compared stretched penile length to pharmacologically induced erect lengths. Postoperatively, we measured inflated penile lengths at 6 weeks and assessed patients' perception of penile size at 12 weeks. The median (interquartile range) stretched penile length and pharmacologically induced erect penile length was 15 (3) and 14.25 (2)?cm, respectively (P=0.5). Median post-prosthesis penile length (13.52.13?cm) was smaller than preoperative pharmacologically induced length (P=0.02) and preoperative stretched penile length (P=0.01). The majority of patients (70%) had a decrease in penile length (median loss 0.51.5?cm); however, this loss was perceptible by 43% of men. Stretched penile length and pharmacologically induced erect penile length were equally good predictors of postoperative inflated length (Spearman's correlation 0.8 and 0.9, respectively). Pharmacologically induced erect penile length and stretched penile lengths are equal predictors of post-prosthesis penile length. The majority of men will experience some decrease in penile length following prosthesis implantation; however <50% report a subjective loss of penile length. PMID:24430278

Osterberg, E C; Maganty, A; Ramasamy, R; Eid, J F

2014-07-01

53

Nucleotide hydrolytic activity of isolated intact rat mesenteric small arteries  

DEFF Research Database (Denmark)

Segments of isolated intact rat mesenteric small arteries were incubated in physiological bicarbonate buffer in the presence of nano- to millimolar concentrations of ATP. ATP was hydrolysed, and when the vessel was transferred from one incubation to another, the enzyme activity was transferred with the vessel, consistent with the presence of an ecto-ATPase. The substrate, ATP, was shown to induce a modification of the hydrolytic activity which occurred the more rapidly the higher the concentration of ATP. The modified system hydrolysed ATP with a decreased substrate affinity. As the substrate induced a modification of the hydrolytic activity, steady-state velocity measurements for determination of kinetic parameters could not be obtained. Nevertheless, it was possible to compare the modification caused by ATP and UTP, and to compare the hydrolysis rates measured with [32P]ATP, [32P]UTP and [32P]GTP. It was concluded that the hydrolytic activity of the vessels did not distinguish between the nucleoside triphosphates (NTPs). In a histidine buffer, the activity was shown to be activated by micromolar concentrations of either Ca2+ or Mg2+, and not to be influenced by inhibitors of P-type, F-type and V-type ATPases. Functional removal of the endothelium before assay did not reduce the measured NTP hydrolysis. At millimolar concentrations of trinucleotide the hydrolysis rate was 10-15 mumol per min per gram of tissue or 0.11-0.17 mumol per min per 10(6) vascular smooth muscle cells. This value is equivalent to the maximal velocity obtained for the Ca2+ or Mg(2+)-dependent NTPase released to the medium upon 2 s of sonication of the vessels (Plesner, L., Juul, B., Skriver, E. and Aalkjaer, C. (1991) Biochim. Biophys. Acta 1067, 191-200). Comparing the characteristics of the released NTPase to the characteristics of the activity of the intact vessel, they showed a strong resemblance, but the substrate-induced modification of the enzyme was seen only in the intact preparation.

Juul, B; Lüscher, M E

1991-01-01

54

Penile intraepithelial neoplasia and other premalignant lesions of the penis.  

Science.gov (United States)

Invasive penile cancer is an aggressive malignancy that often requires partial or complete penile amputation. Premalignant penile lesions, such as penile intraepithelial neoplasia, will have been present prior to the development of invasive disease in a substantial percentage of patients. Early detection and treatment of premalignant penile lesions may prevent malignant progression while avoiding penile amputation. This review focuses on premalignant penile lesions and the associations of these lesions with the development of invasive penile cancer. PMID:20674690

Crispen, Paul L; Mydlo, Jack H

2010-08-01

55

Systemic arterial hypertension and small airways function: acute effects of diazoxide and furosemide.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Two groups of 10 patients with systemic arterial hypertension were studied by respiratory function tests before and after acute administration of diazoxide or furosemide. Small airways obstruction was present in a high percentage of patients and was partially reversed after the acute administration either of diazoxide or of furosemide. Systemic arterial hypertension seems to influence small airways caliber, through pulmonary vascular distension and/or pulmonary interstitial edema.

Bucca, Caterina; Rolla, Giovanni

1980-01-01

56

A review of penile metastasis  

Directory of Open Access Journals (Sweden)

Full Text Available Penile cancer as primary disease is relatively rare in developed countries. The penis is a rare site of metastases in spite of its rich vascularization. Approximately 500 cases have been reported in the literature; almost 70% of primary lesions are of pelvic origin (from genitourinary or recto-sigmoid primary tumors. We describe a case of penile metastasis from lung cancer. The rarity of the event prompted us to also explore related reviews and discuss the incidence, physiopathology, diagnosis and therapy of penile secondary cancer.

Elisabetta Nunzi

2012-03-01

57

Nonoperative versus surgical management of small (less than 3 cm), asymptomatic popliteal artery aneurysms.  

Science.gov (United States)

Popliteal artery aneurysms represent a common pathology that vascular surgeons are often confronted with. However, several issues remain incompletely understood, including indications for intervention and optimal methods of treatment. In the following article, our discussants debate the appropriate management of small popliteal artery aneurysms. Further complicating this discussion is the unclear relationship between popliteal artery aneurysm diameter and subsequent complications. Whereas with abdominal aortic aneurysms diameter is linked to rupture risk, it is less clear with popliteal artery aneurysms where complications are more likely to include thrombosis, embolization, and compression whether aneurysm diameter is accurately predictive. Perhaps other anatomic features should be included in our management algorithms? Regardless, our debaters will try to convince us whether small popliteal artery aneurysms warrant repair or not. PMID:21439460

Cross, Jane E; Galland, Robert B; Hingorani, Anil; Ascher, Enrico

2011-04-01

58

Reconstructive surgery in penile trauma and cancer.  

Science.gov (United States)

This article provides an overview of the current concepts in reconstructive surgery following penile trauma, penile fracture and penile cancer. It covers the initial management of penile trauma, with the aim of preservation of as much viable tissue as is practical, and also provides advice on dealing with penile avulsion and amputation injuries. The best treatment for penile fracture-immediate surgical exploration and repair-is outlined and discussed. Finally, penile cancer management is reviewed, from initial biopsy to definitive treatment of the penile lesion-including wide excision, partial glansectomy, total glansectomy, and partial and total penectomy. It is concluded that appropriate surgery in all these conditions reduces subsequent long-term problems in sexual function, cosmesis, psychology, and (in cancer cases) longevity. The same reconstructive techniques can be applied for different penile conditions, and it is suggested that surgeons become experienced in genital surgery as a whole, rather than in oncology or trauma alone. PMID:16474736

Summerton, Duncan J; Campbell, Alistair; Minhas, Suks; Ralph, David J

2005-08-01

59

Drugs Approved for Penile Cancer  

Science.gov (United States)

This page lists cancer drugs approved by the Food and Drug Administration (FDA) for penile cancer. The list includes generic names and brand names. The drug names link to NCIs Cancer Drug Information summaries.

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Minimally Invasive Penile Implant Surgery  

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Full Text Available ... cannot be treated by popular pills such as Viagra or Cialis. The inflatable penile prosthesis consists of ... who fails treatment with PD5 inhibitors such as Viagra, Levitra, or Cialis. 00:08:46 IRWIN GOLDSTEIN, ...

 
 
 
 
61

Minimally Invasive Penile Implant Surgery  

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Full Text Available ... advanced the surgery by using new, minimally invasive surgical techniques. Such techniques potentially reduce the infecthe opportunity for infection, the most feared penile prosthetic complication. On my ...

62

Minimally Invasive Penile Implant Surgery  

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Full Text Available ... 27 J. FRANCOIS EID, MD: I believe the number of physicians who only do penile implants, like ... 5%, I believe, and that is a historical number, which is by physicians who did a lot ...

63

Minimally Invasive Penile Implant Surgery  

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Full Text Available ... inflatable penile prosthesis consists of two cylinders, a reservoir, and pump, which are placed in the body ... the pump. The pump transfers fluid from the reservoir to the cylinders in the penis, inflating them. ...

64

Minimally Invasive Penile Implant Surgery  

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Full Text Available ... to a normal function. Theres two hotly debated topics among some of the icons of penile implantation -- ... a little bit longer. The other hotly debated topic would be the use of a scrotal drain. ...

65

Minimally Invasive Penile Implant Surgery  

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Full Text Available ... Cialis. The inflatable penile prosthesis consists of two cylinders, a reservoir, and pump, which are placed in ... pump transfers fluid from the reservoir to the cylinders in the penis, inflating them. This offers patients ...

66

Minimally Invasive Penile Implant Surgery  

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Full Text Available ... 000 implants that were removed for infection from 1992 to year 2000. You can see that 63% ... it says, Patient with inflatable penile prosthesis since 1992 but now needs revision. Is this a problem? ...

67

Minimally Invasive Penile Implant Surgery  

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Full Text Available ... men with erectile dysfunction. While technically the initial concept is still the same that is, placement of ... with penile implants in the past was the concept of getting infected after the device has been ...

68

Minimally Invasive Penile Implant Surgery  

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Full Text Available ... PENILE IMPLANT SURGERY CORAL GABLES HOSPITAL CORAL GABLES, FLORIDA March 26, 2007 00:00:10 ANNOUNCER: Over ... IRWIN GOLDSTEIN, MD: Hello, and welcome from sunny Florida. We are live in the Coral Gables Hospital ...

69

Minimally Invasive Penile Implant Surgery  

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Full Text Available ... to have two orgasms each time they make love. Here you see me changing gloves. We will ... the penile implant will enable him to make love with or without a curved penis. So one ...

70

Minimally Invasive Penile Implant Surgery  

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Full Text Available ... 51 IRWIN GOLDSTEIN, MD: So I have another question. May I interrupt, Dr. Eid? 00:10:52 ... IRWIN GOLDSTEIN, MD: Wow, thats fantastic. Okay, another question. The success rate of the inflatable penile prosthesis. ...

71

Minimally Invasive Penile Implant Surgery  

Medline Plus

Full Text Available ... EID, MD: Exactly. And it was as you know -- Im going to click to the next ... slide on the infection prevention. And as you know, one of the issues with penile implants in ...

72

Cavernous artery revascularization in vasculogenic impotence: new simplified technique.  

Science.gov (United States)

A new simplified technique of cavernous artery revascularization is presented. The arterial inflow to the corpora is obtained through a counterflow end-to-end anastomosis of the inferior epigastric artery to the proximal stump of the transected dorsal penile artery. The revascularization of the cavernous artery occurs through the common penile artery. This operation is particularly suitable for patients showing pudendal or common penile artery obstruction at arteriography. Optimal distal perfusion is obtained by a cross end-to-side anastomosis of the distal stump of the dorsal artery to the contralateral dorsal penile artery. To date 5 patients have been operated on using this method with good functional results in 80 per cent. PMID:3603904

Carmignani, G; Pirozzi, F; Spano, G; Corbu, C; De Stefani, S

1987-07-01

73

Histology of subcutaneous small arteries from patients with essential hypertension  

DEFF Research Database (Denmark)

The purpose of the present study was to determine the cellular basis for the increased ratio of media thickness to lumen diameter (media-lumen ratio) consistently found in the peripheral resistance arteries from patients with essential hypertension using an unbiased stereological principle (the "disector"). Segments of subcutaneous resistance arteries (approximately 200 microns internal diameter) were isolated from gluteal biopsies of skin and subcutaneous fat taken from 16 untreated patients with essential hypertension and 16 age- and sex-matched normotensive control subjects. Measured under standardized conditions (ie, relaxed and under controlled mechanical conditions) on an isometric myograph, vessels from hypertensive patients had a significant (P .05) on the basis of these measurements.(ABSTRACT TRUNCATED AT 250 WORDS)

Korsgaard, N; Aalkjær, Christian

1993-01-01

74

Magnetic resonance imaging of penile cancer.  

Science.gov (United States)

Penile cancer is a rare neoplasm that, although rare in the developed world, has devastating physical and psychological consequences for the patient. Novel MR imaging techniques such as lymphotropic nanoparticle-enhanced MR imaging may help identify metastatic lymph node disease. This article reviews the normal penile anatomy and MR imaging techniques and features of primary and metastatic penile cancer. Recent advances in penile cancer imaging are discussed. PMID:24792677

Gupta, Sumit; Rajesh, Arumugam

2014-05-01

75

Management of penile defects: a review.  

Science.gov (United States)

Penile amputation is a rare injury. Although, in principle, penile replantation can be performed using a variety of methods, few, if any, standardized procedures exist to deal with this medical emergency. The value of the various microsurgical techniques for replantation of the penis remains uncertain. This article provides a review of the management of penile defects and complications. PMID:22517572

Guizhong, Li; Feng, He; Guangling, Huang; Libo, Man; Kun, Liu; Yuming, Shen

2012-06-01

76

P2X1 receptors mediate sympathetic postjunctional Ca2+ transients in mesenteric small arteries.  

Science.gov (United States)

Brief, spatially localized Ca(2+) transients occur in the smooth muscle adjacent to perivascular nerves of small arteries during neurogenic contractions. We named these "junctional Ca(2+) transients" (jCaTs) and postulated that they arose from Ca(2+) entering smooth muscle cells through P2X(1) receptors activated by neurally released ATP. Nevertheless, the lack of potent, subtype-selective P2X-receptor antagonists made determining the exact molecular identity of the channels difficult. Here we used small, pressurized mesenteric arteries from P2X(1)-receptor-deficient mice (KO) to test the hypothesis that jCaTs arise from Ca(2+) entering the smooth muscle cell via P2X(1) receptors. In wild-type (WT) arteries, confocal microscopy of fluo-4 fluorescence during electrical field stimulation (EFS) of perivascular sympathetic nerves revealed jCaTs in the smooth muscle cells adjacent to the perivascular nerves, similar to those reported previously in rat arteries, and alpha-latrotoxin (2.5 nM) markedly increased the frequency of "spontaneous" jCaTs. In the KO arteries, however, neither EFS nor alpha-latrotoxin elicited any jCaTs. A potent P2X-receptor agonist, alpha,beta-methylene ATP (10.0 microM), elicited strong contractions and increased intracellular Ca(2+) concentration in WT arteries but elicited neither in KO arteries. A biphasic vasoconstriction in response to EFS was observed in WT arteries. In KO arteries, however, the initial rapid, transient component of the biphasic vasoconstriction was absent. The data support the hypothesis that jCaTs represent Ca(2+) that enters the smooth muscle cells through P2X(1) receptors activated by neurally released ATP and that this Ca(2+) is involved in the initial rapid component of the sympathetic neurogenic contraction. PMID:16920810

Lamont, Christine; Vial, C; Evans, R J; Wier, W G

2006-12-01

77

[The physiology of penile erection. II. Neurophysiology of penile erection].  

Science.gov (United States)

Selective cavernous and pudendal nerve stimulation enabled us to study the neurophysiologic-/neurovascular mechanisms of penile erection in 6 monkeys. Corporeal pressure recordings during different neurostimulation patterns demonstrated that tumescence and erection are controlled by the autonomic nervous system (Nn. cavernosi) and has to be understood as the vascular phase of erection. However, rigidity is related to the muscle tone of the striated bulbospongiosus and ischiocavernosus muscles which are innervated by somatomotoric fibers of the pudendal nerve. This mechanism is defined as the muscular phase of penile erection. PMID:3686765

Jnemann, K P; Lue, T F; Melchior, H

1987-09-01

78

Endothelin receptors mediating functional responses in human small arteries and veins.  

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1. In the present study, responses of human omental small arteries and veins to endothelin-1 and endothelin-3 were characterized by use of the ETB receptor selective agonist, sarafotoxin S6c, the ETA receptor antagonist, BQ123, the ETB receptor antagonist, IRL1038, the NO-synthase inhibitor NG-monomethyl-L-arginine (L-NMMA, 300 microM) and indomethacin (10 microM). 2. Small arteries (internal diameter 413 +/- 22 microns) and parallel running veins (646 +/- 35 microns) were mounted in a myogra...

Riezebos, J.; Watts, I. S.; Vallance, P. J.

1994-01-01

79

Study of concurrent radiotherapy and bronchial arterial infusion for unresectable non-small cell lung cancer  

Energy Technology Data Exchange (ETDEWEB)

The concurrent therapy of radiation and bronchial artery infusion (RT-BAI) for unresectable non-small cell lung cancer has been developed. The aim of the study is investigate to methods of the concurrent therapy and initial effect of the therapy. Seventy-seven patients were treated by RT-BAI since 1992. Primary tumor and lymph nodes were irradiated at 2 Gy once a day (conventional) or 2.4 Gy twice a day (hyperfractionation). During radiotherapy, angiography was performed and carboplatin was infused through tumor-associated vessels. Analysis of angiography revealed that only 12 patients had a bronchial artery as tumor associated artery and 55 patients had multiple tumor associated arteries. The mean reduction rate of primary tumors was 67.4% (conventional method 64.8%, hyperfractionation method 78.4%) and that of lymph nodes was 54.6% (conventional method 46.2%, hyperfractionation method 73.2%). There was no statistically significant difference in histological classifications. However there was a significant difference in the efficacy of the treatment by injection into only a bronchial artery and by injection into a number of arteries with tumors. Therefore anticancer drug should be infused into the largest possible number of tumor-associated vessels in unresectable non-small lung cancer, and the concurrence of therapy (RT-BAI) gives favorable results and in radiation therapy, the hyperfractionation method is preferable to the conventional method. (author)

Ota, Kiyotaka [Kanazawa Medical Univ., Uchinada, Ishikawa (Japan)

1999-12-01

80

Coronary angiography through ipsilateral ulnar approach in a patient with small-diameter radial artery  

Directory of Open Access Journals (Sweden)

Full Text Available Introduction. Coronary procedures cannot be completed in 5-15% of cases through initially used radial artery approach due to frequent radial artery anomalies and vasospasm. In these cases, the ulnar artery approach could be the safe and effective alternative wrist approach. Case report. A 60-year-old patient with stable angina pectoris, hypertension, dyslipidaemia and positive endurance test was admitted to our hospital for coronary angiography. Due to the backbone pains which also made prolonged lying in bed very uncomfortable and painful, we opted for the wrist approach (standard radial approach after both modified Allens tests had been performed, which gave the positive result. After sheath insertion into the right radial artery and unsuccessful advancement of the guidewire and the catheter, we performed the right forearm angiography, which revealed that the right radial artery had a small diameter and the right ulnar artery was the dominant one. Afterwards, the right ulnar artery was cannulated successfully and the coronary angiography was performed through this approach. Both sheaths were removed simultaneously immediately after the procedure and hemostasis was secured by the compression with two Terumo- bands over the puncture sites without any complications. The pulses of both arteries were checked regularly over the next 24 hours and they remained normal. A day after the procedure, the control Doppler-ultrasound check-up was performed and it confirmed the normal flow in both cannulated arteries. One-month follow-up was uneventful, and the patient did not experience any ischemic symptoms of the hand. Conclusion. This case is the proof that the ipsilateral ulnar approach can be a safe and effective alternative approach in patients with positive Allens test after the failure of initial radial attempt in cases where femoral approach should be avoided or the wrist approach should be maintained.

Staji? Zoran

2013-01-01

 
 
 
 
81

Penile cancer: epidemiology and treatment.  

Science.gov (United States)

Penile cancer is an aggressive disease, with major psychological and social impact. The etiological factors are poor genital hygiene, the presence of phimosis, viral infection, ultraviolet radiation, smoking, balanitis xerotic obliterans, and chronic lichen. Identifying prognostic factors is important to select patients at risk for lymph node metastasis and avoid unneeded lymphadenectomy. The presence of lymph node metastasis is currently the strongest prognostic factor but its evaluation is imperfect using clinical and laboratorial methods. The treatment for invasive penile cancer is based on the treatment of primary tumor, usually with amputation and regional lymphadenectomy, treatments that have a high morbidity rate. PMID:21373986

Guimares, Gustavo Cardoso; Rocha, Rafael Malagoli; Zequi, Stenio Cassio; Cunha, Isabela Werneck; Soares, Fernando Augusto

2011-06-01

82

Accuracy Evaluation in the Measurement of a Small Change in the Thickness of Arterial Walls and the Measurement of Elasticity of the Human Carotid Artery  

Science.gov (United States)

For the diagnosis of the early stages of atherosclerosis, it isimportant to evaluate the local acoustic characteristics of thearterial wall. For this purpose, it is necessary to increase thespatial resolution in the axial direction to several millimeters,which corresponds to the size of the macular lesion on the surface ofthe wall. We have proposed a method for measuring small velocitysignals on the intima and adventitia of the arterial wall from theskin surface using pulsive ultrasonic waves. The small change inthickness of the arterial wall is obtained by integrating thedifference between the two velocity signals on the intima andadventitia. The elastic property of the arterial wall is noninvasivelyevaluated from the change in thickness and the arterial innerpressure. In this paper, we evaluate the accuracy of the proposedmethod for measuring the small displacement. Moreover, we applied thismethod to evaluate the elastic property of the arterial wall of 50patients and 8 healthy subjects.

Hasegawa, Hideyuki; Kanai, Hiroshi; Hoshimiya, Nozomu; Chubachi, Noriyoshi; Koiwa, Yoshiro

1998-05-01

83

Reconstruction of pulmonary artery in a newborn using a porcine small intestinal submucosal patch.  

Science.gov (United States)

In this case report, we evaluated cellular structure and the growth potential of a porcine small intestinal submucosal patch used for pulmonary artery augmentation in a 20-day-old newborn with pulmonary atresia. The patch was resected 2 months postoperatively due to apparent abnormal wall thickening and evaluated by histologic and immunohistologic staining. PMID:22450088

Chalajour, Fariba; Barboza, Laura A; Boni, Lorenzo; Snyder, Radhika; Hanley, Frank L; Reddy, V Mohan; Riemer, R Kirk

2012-04-01

84

Cutting balloon angioplasty for treatment of lesions in small coronary arteries  

International Nuclear Information System (INIS)

Objective: To evaluate the clinical efficacy of cutting balloon angioplasty (CBA) for treating lesions in small coronary arteries. Methods: The diameter for reference of coronary artery is less than 2.7 mm which is considered as 'small vessel'. CBA procedures were performed on 25 lesions in 22 patients. Results: The procedure was successfully obtained in 21 lesions (84%). Seven severe stenotic lesions (diameter of stenosis ? 90%) underwent dilatation with small conventional balloon (1.5 mm diameter). Bail-out stenting was performed in 2 lesions because of severe dissections. Failure of cutting balloon to pass through the stenosis in one lesion. During follow-up, 5 patients had recurrence of coronary angina and 3 of them underwent coronary angiography for check up, In-stent restenosis (ISR) occurred in one patient, which was successfully re-dilated using CBA. One patient had total occlusion of the diagonal branch with ISR of LAD. One patient developed new lesion in other coronary artery. Conclusions: CBA is safe and effective, and provides a new therapeutic strategy for lesions in the small coronary arteries

2002-02-01

85

Investigation of small diameter decellularised artery as a potential scaffold for vascular tissue engineering  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The successful replacement of small-diameter blood vessels, affected by cardiovascular disease, with natural and synthetic bypass grafts remains limited due to long-term patency issues. The development of a small-diameter tissue engineered blood vessel (TEBV), with equivalent biomechanical properties to the vessel being replaced, may provide a potential solution. This thesis aims to determine the biomechanical properties of porcine coronary arteries (PCA) and the corresponding natural matrix ...

Campbell, Evelyn M.

2013-01-01

86

Effects of weight loss on structural and functional alterations of subcutaneous small arteries in obese patients.  

Science.gov (United States)

Structural alterations of subcutaneous small resistance arteries, as indicated by an increased media:lumen ratio, are frequently present in hypertensive and/or diabetic patients and may represent the earliest alteration observed. In addition, media:lumen ratios of small arteries have a strong prognostic significance. However, no data are available about the structure of small resistance arteries of obese patients, particularly after weight loss. We have investigated 27 patients with severe obesity. Twelve of them were normotensive, and 15 were hypertensive. All of the obese patients underwent bariatric surgery. We compared results obtained with those observed in 13 normotensive lean controls and in 13 hypertensive lean patients. All of the subjects and patients underwent a biopsy of subcutaneous fat during surgical intervention. In 8 obese patients, a second biopsy was obtained after consistent weight loss, during a surgical intervention for abdominoplasty. Subcutaneous small resistance arteries were dissected and mounted on a wire myograph, and structural parameters were measured. A concentration-response curve to acetylcholine was performed to evaluate endothelial function. Obese patients, independent from the presence of hypertension, show the presence of an increased media:lumen ratio and media cross-sectional area, together with an impaired endothelial-dependent vasodilatation. After surgical correction of obesity and consistent weight loss, a significant improvement of microvascular structure and of some oxidative stress/inflammation markers were observed. In conclusion, our data suggest that the presence of obesity is associated with structural alterations of subcutaneous small resistance arteries, mainly characterized by hypertrophic remodeling. Weight loss may improve microvascular structure. PMID:21555677

De Ciuceis, Carolina; Porteri, Enzo; Rizzoni, Damiano; Corbellini, Claudia; La Boria, Elisa; Boari, Gianluca E M; Pilu, Annamaria; Mittempergher, Francesco; Di Betta, Ernesto; Casella, Claudio; Nascimbeni, Riccardo; Rosei, Claudia Agabiti; Ruggeri, Giuseppina; Caimi, Luigi; Rosei, Enrico Agabiti

2011-07-01

87

Minimally Invasive Penile Implant Surgery  

Medline Plus

Full Text Available MINIMALLY INVASIVE PENILE IMPLANT SURGERY CORAL GABLES HOSPITAL CORAL GABLES, FLORIDA March 26, 2007 00:00:10 ANNOUNCER: Over the next hour you ... migration, or contamination, in a negative pressure drain system. Now, I could tell you that in my ...

88

Minimally Invasive Penile Implant Surgery  

Medline Plus

Full Text Available MINIMALLY INVASIVE PENILE IMPLANT SURGERY CORAL GABLES HOSPITAL CORAL GABLES, FLORIDA March 26, 2007 00:00:10 ANNOUNCER: Over the next hour youll see ... that across the United States theres 300,000 breast implants a year? Across the world theres only ...

89

Penile myiasis: a case report  

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We report a case of penile myiasis in a Brazilian man caused by the larva of Dermatobia hominis. Myiasis is a parasitic disease of humans and other vertebrates caused by larvae of several fly species. Although urinary myiasis is well recognised, infestation of the genital tissue is a rare occurrence. Once the diagnosis has been made, the treatment is usually straightforward and uncomplicated.

Passos, M.; Barreto, N.; Varella, R.; Rodrigues, G.; Lewis, D.

2004-01-01

90

Minimally Invasive Penile Implant Surgery  

Medline Plus

Full Text Available ... are doing penile prosthesis cases in the United States? 00:16:27 J. FRANCOIS EID, MD: I ... be. Do you realize that across the United States theres 300,000 breast implants a year? Across ...

91

Minimally Invasive Penile Implant Surgery  

Medline Plus

Full Text Available ... not have the best looking penis in the world, but hell be able to make love ... 300,000 breast implants a year? Across the world theres only 16,000 penile implants. Theres something ...

92

21 CFR 876.3350 - Penile inflatable implant.  

Science.gov (United States)

...2010-04-01 false Penile inflatable implant. 876.3350 Section 876.3350 Food...Devices § 876.3350 Penile inflatable implant. (a) Identification. A penile inflatable implant is a device that consists of...

2010-04-01

93

'Variant' angina: Evidence for small vessel coronary artery spasm  

Energy Technology Data Exchange (ETDEWEB)

A unique case of 'variant' angina pectoris has been observed in a patient with normal coronary arteries and typical chest pain appearing spontaneously at rest, and repeatedly provoked by ergonovine maleate (0.1 mg iv) associated with large transmural perfusion defects on /sup 201/TI-imaging (after ergonovine) and a marked increase in T wave voltage despite no demonstrable spasm of a major coronary artery after the same doses of ergonovine. While saline solution could not provoke chest pain and treatment with a beta-blocking agent increased the frequency of ischemic attacks, a calcium antagonist therapy reduced and eventually eliminated the attacks. Thus, this case provides evidence for yet another aspect of a 'variant' form of angina pectoris: small vessel coronary artery spasm.

Pfisterer, M.; Mueller-Brand, J.; Cueni, T.; Luetold, B.; Burkart, F.

1980-12-01

94

Spectacularly successful microsurgical penile replantation in an assaulted patient: one case report.  

Science.gov (United States)

Penile amputation is a rare condition for which immediate surgical replantation is warranted. We present herein one case of a 27-year-old male who presented to the Emergency Department after his wife cut his penis. The penis was replanted microsurgically. The deep dorsal penile veins and superficial veins were anastomosed. Although we could not reanastomose the arteries, wound healing occurred without any problem one week postoperatively and the patient regained erectile function 4 weeks after surgery. At 1-year follow-up examinations he reported on restored erectile function and a normal urinary function. PMID:22606628

Tazi, Mohammed Fadl; Ahallal, Youness; Khallouk, Abdelhak; Elfassi, Mohammed Jamal; Farih, Moulay Hassan

2011-01-01

95

Spectacularly Successful Microsurgical Penile Replantation in an Assaulted Patient: One Case Report  

Science.gov (United States)

Penile amputation is a rare condition for which immediate surgical replantation is warranted. We present herein one case of a 27-year-old male who presented to the Emergency Department after his wife cut his penis. The penis was replanted microsurgically. The deep dorsal penile veins and superficial veins were anastomosed. Although we could not reanastomose the arteries, wound healing occurred without any problem one week postoperatively and the patient regained erectile function 4 weeks after surgery. At 1-year follow-up examinations he reported on restored erectile function and a normal urinary function.

Tazi, Mohammed Fadl; Ahallal, Youness; Khallouk, Abdelhak; Elfassi, Mohammed Jamal; Farih, Moulay Hassan

2011-01-01

96

Penile metastasis from invasive bladder cancer  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Objective: To present the rare case of penile metastasis from bladder cancer. Patient report: A 68-year-old man with invasive bladder cancer disseminated in penile shaft and the pelvic lymph nodes is presented. The patient underwent cystoprostatectomy, total penectomy and adjuvant chemotherapy. Results: Ten months after surgery, patient is in complete remission. Conclusion: Despite the fact that secondary penile tumors usually require palliative therapy, in selected cases surgical treatment o...

Hadi-?oki? J.; Pej?i? T.; A?imovi? M.; Andrejevi? V.; Radosavljevi? R.

2009-01-01

97

Prosthetic penile infection: "rescue procedure" with rifamycin.  

Science.gov (United States)

Penile prosthetic implantation is a successful procedure for the management of male erectile impotence. However, infection remains the most serious complication requiring removal of the device. Later reinsertion can be difficult due to fibrosis and a shortened penis. We present 3 cases of penile infection with Staphylococcus epidermidis in which a new penile prosthesis was placed after 72 hours of continuous irrigation of the corpora cavernosa with rifamycin. The procedure requires judicious selection of patients and a stable clinical status. PMID:1433637

Teloken, C; Souto, J C; Da Ros, C; Thorel, E; Souto, C A

1992-12-01

98

[Progress in the treatment of penile defect].  

Science.gov (United States)

As the important external genitalia of males, penis has the functions of both urination and copulation. Battle wound, other trauma, and some diseases such as penile cancer can result in total and partial penile defect, which has great impact on the sufferers' mind and life. Therefore, the treatment of penile defect is receiving more and more importance from both the patients and doctors. The ideal treatment is expected to achieve a satisfactory appearance, unobstructed standing urination and successful copulation. Nowadays, the main clinical techniques for the treatment of penile defect include penile replantation, penile lengthening, and penile reconstruction. The progress made in transplantation immunity, tissue matching, immunosuppressive agents, and long-term surviving of animal allograft limb transplantation has prepared a firm ground for human penile allograft. The construction of penile tissues by tissue engineering techniques is still at the experimental stage. It would be a valuable research how to assimilate the constructed and autologous tissues in clinical practice so as to achieve better function and appearance of the penis. PMID:22049800

Zhao, Yong-bin; Zhang, Li-chao; Hu, Wei-lie

2011-10-01

99

Primary prevention and vaccination for penile cancer.  

Science.gov (United States)

The outcome of penile cancer is proportional to the stage at presentation. Strategies aimed at primary prevention would have a clear advantage, both for the individual and in terms of health economics. A number of preventative measures could be employed, including circumcision, smoking cessation, education on hygiene and human papillomavirus (HPV) prevention. There is a high prevalence of HPV infection associated with penile cancer worldwide. The recent development of HPV vaccines has facilitated interest in their use for the prevention of penile cancer. In this article we review the literature surrounding penile cancer prevention and HPV vaccination in men. PMID:23730331

Shabbir, Majid; Barod, Ravi; Hegarty, Paul K; Minhas, Suks

2013-06-01

100

Microneurovascular reimplantation in a case of total penile amputation  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Amputation of the penis is a rare condition reported from various parts of the world as isolated cases or small series of patients; the common aetiology is self-mutilating sharp amputation or an avulsion or crush injury in an industrial accident. A complete reconstruction of all penile structures should be attempted in one stage which provides the best chance for full rehabilitation of the patient. We report here a single case of total amputation of the penis, which was successfully reattache...

2008-01-01

 
 
 
 
101

Effect of antihypertensive treatment on small arteries of patients with previously untreated essential hypertension  

DEFF Research Database (Denmark)

In a double-blind randomized trial, the effects of treatment with an angiotensin-converting enzyme (ACE) inhibitor (perindopril) and a beta-blocker (atenolol) on small artery structure were compared in previously untreated essential hypertensive patients. Subjects (diastolic blood pressure > or = 100 and small arteries were dissected and mounted on a myograph for morphometry. The reduction in blood pressure with atenolol (drop in mean blood pressure 28.4 +/- 1.8 mm Hg) was greater than with perindopril (20.6 +/- 1.8 mm Hg, P <.05). Perindopril treatment caused an increase in small artery diameter (231 +/- 14 to 274 +/- 13 microns, P <.05) and a reduction in the ratio of media thickness to lumen diameter (7.94 +/- 0.65% to 5.96 +/- 0.42%, P <.05), whereas atenolol had no effect (246 +/- 14 to 231 +/- 13 microns and 7.14 +/- 0.47% to 6.79 +/- 0.45%, respectively). The change in small artery morphology caused by perindopril was not accompanied by any change in media cross-sectional area, suggesting that the change was due to "remodeling."(ABSTRACT TRUNCATED AT 250 WORDS)

Thybo, N K; Stephens, N

1995-01-01

102

Somatostatin and propranolol to treat small-for-size syndrome that occurred despite splenic artery ligation.  

Science.gov (United States)

We report our success with somatostatin and propranolol to treat small-for-size syndrome that occurred despite splenic artery ligation. A 48-year-old woman with cirrhosis due to autoimmune hepatitis underwent living-donor liver transplant; her graft-to-body weight ratio of the right lobe was 0.91%. After arterial reperfusion, portal pressure and flow were 24 cm H20 and 2.22 L/min (ie, 360 mL/100g graft/min), respectively. Following splenic artery ligation, the portal pressure decreased to 16 cm H20 and portal flow to 1.74 L/min (ie, 282 mL/100g graft/min). On the second postoperative day, small-for-size syndrome was diagnosed based on the marked prolongation of prothrombin time (international normalized ratio, 4.4), hyperbilirubinemia (359.1 micromol/L), rapid escalation of transaminases (alanine aminotransferase 2488 U/L, aspartate aminotransferase 1075 U/L) and very high portal flow rate (> 90 cm/sec). Oral propranolol (40 mg/day b.i.d.) and somatostatin infusion (250-microgram bolus followed by perfusion at a rate of 250 microgram/h for 5 days) were started. Prothrombin time and transaminase levels began to decrease the following day, although the bilirubin level increased to 495.9 micromol/L before returning to normal. The patient was discharged in excellent health 5 weeks after surgery. Despite reduction of portal pressure by splenic artery ligation, small-for-size syndrome may develop in patients with persistent high portal flow. To the best of our knowledge, this is the first report of the successful treatment of small-for-size syndrome by somatostatin and propranolol in the clinical setting. PMID:18194122

Ozden, Ilgin; Kara, Melih; Pinarbasi, Binnur; Salmaslioglu, Artur; Yavru, Aysen; Kaymakoglu, Sabahattin; Emre, Ali; Bilge, Orhan; Alper, Aydin

2007-12-01

103

Bovine pericardium in penile prosthesis reimplantation  

Digital Repository Infrastructure Vision for European Research (DRIVER)

We present a case of a patient who underwent a late penile prosthesis implant using bovine pericardium as a complement to the tunica albuginea involved in intense fibrosis that destroyed the corpus cavernosum after an infectious manifestation. The advantages of using bovine pericardium in the substitution of the tunica albuginea are discussed and its first use as a penile prosthesis lining is reported.

Lopes, Eduardo J.; Santos, Tarsila C.; Modesto Jacobino

2007-01-01

104

Penile replantation using the leech Hirudo medicinalis.  

Science.gov (United States)

A 37-year-old chronic schizophrenic man underwent penile replantation after complete autoamputation using a kitchen knife. We report the first case of using medicinal leeches to salvage a penile replant after the development of postoperative venous congestion. PMID:8973688

Pantuck, A J; Lobis, M R; Ciocca, R; Weiss, R E

1996-12-01

105

Ulcerative penile leishmaniasis in a child.  

Science.gov (United States)

Penile ulcers may be caused by several different agents. Rarely, cutaneous leishmaniasis may also be accompanied by penile ulcers. We report a five-year-old boy with who had an ulcer on the glans penis. Smears from the ulcer demonstrated amastigotes, biopsy showed histopathological features of leishmaniasis and Leishmania was grown in culture. Treatment with meglumine antimoniate injections led to improvement. PMID:24823403

Yesilova, Yavuz; Turan, Enver; Src, Hacer Altun; Kocarslan, Sezen; Tanrikulu, Osman; Eroglu, Naime

2014-01-01

106

Technical considerations and outcomes in penile replantation.  

Science.gov (United States)

Penile amputations are uncommon injuries, therefore, the management and outcome of these patients have been compiled from solitary case studies or short reviews. Accidental trauma during circumcision, injury inflicted by a partner following marital discord, and genital self-mutilation observed in patients with deep psychosis, account for a majority of the presentations. Initially, patients with total penile amputations were managed by resuturing the penile structures without repairing the vessels. A high incidence of skin and glans necrosis, urethral strictures, and a failure of sensory recovery were observed, though the penile shaft sometimes survived. Presently, microsurgical replantation has markedly improved the results, though issues of skin loss and urethral stricture still persist. A series of three patients with penile amputation is presented (complete?=?2, partial?=?1); the technical considerations and outcomes are discussed. PMID:24872770

Biswas, Gautam

2013-11-01

107

Partial removal of the pulmonary artery in video-assisted thoracic surgery for non-small cell lung cancer  

Science.gov (United States)

Lobectomy with partial removal of the pulmonary artery in video-assisted thoracic surgery (VATS) currently remains a challenge for thoracic surgeons. We were interested in introducing pulmonary vessel blocking techniques in open thoracic surgery into video-assisted thoracic surgery (VATS) procedures. In this study, we reported a surgical technique simultaneously blocking the pulmonary artery and the pulmonary vein for partial removal of the pulmonary artery under VATS. Seven patients with non-small-cell lung cancer (NSCLC) received lobectomy with partial removal of the pulmonary artery using the technique between December 2007 and March 2012. Briefly, rather than using a small clamp on the distal pulmonary artery to the area of invading cancer, we replaced a vascular clamp with a ribbon and Hem-o-lock clip to block the preserved pulmonary veins so as to prevent back bleeding and yield a better view for surgeons. The mean occlusion time of the pulmonary artery and pulmonary veins were 44.010.0 and 41.39.7 minutes, respectively. The mean repair time of the pulmonary artery was 25.313.7 minutes. No complications occurred. No patients showed abnormal blood flow through the reconstructed vessel. There were no local recurrences on the pulmonary artery. In conclusion, the technique for blocking the pulmonary artery and veins is feasible and safe in VATS and reduces the risk of abrupt intraoperative bleeding and the chance of converting to open thoracotomy, and extends the indications of VATS lobectomy.

Xu, Keping; Zhang, Zhi; Zhao, Jianqiang; Huang, Jianfeng; Yin, Rong; Xu, Lin

2013-01-01

108

Mechanisms of Ca2+ sensitization of force production by noradrenaline in rat mesenteric small arteries  

DEFF Research Database (Denmark)

1. Mechanisms of Ca2+ sensitization of force production by noradrenaline were investigated by measuring contractile responses, intracellular Ca2+ concentration ([Ca2+]i) and phosphorylation of the myosin light chain (MLC) in intact and alpha-toxin-permeabilized rat mesenteric small arteries. 2. The effects of noradrenaline were investigated at constant membrane potential by comparing fully depolarized intact arteries in the absence and presence of noradrenaline. Contractile responses to K-PSS (125 mM K+) and NA-K-PSS (K-PSS + 10 microM noradrenaline) were titrated to 30 and 75%, respectively, of control force, by adjusting extracellular Ca2+ ([Ca2+]o). At both force levels, [Ca2+]i was substantially lower with NA-K-PSS than with K-PSS. With K-PSS, the proportion of MLC phosphorylated (approximately 30%) was similar at 30 and 75% of control force; with NA-K-PSS, MLC phosphorylation was greater at the higher force level (40 vs. 34%). 3. In alpha-toxin-permeabilized arteries, the force response to 1 microM Ca2+ was increased by 10 microM noradrenaline, and MLC phosphorylation was increased from 35 to 45%. The protein kinase C (PKC) inhibitor calphostin C (100 nM) abolished the noradrenaline-induced increase in MLC phosphorylation and contractile response, without affecting the contraction in response to Ca2+. Treatment with ATP gamma S in the presence of the MLC kinase inhibitor ML-9 increased the sensitivity to Ca2+ and abolished the response to noradrenaline. 4. The present results show that that in rat mesenteric small arteries noradrenaline-induced Ca2+ sensitization is associated with an increased proportion of phosphorylated MLC. The results are consistent with a decreased MLC phosphatase activity mediated through PKC. Furthermore, while MLC phosphorylation is a requirement for force production, the results show that other factors are also involved in force regulation.

Buus, C L; Aalkjær, Christian

1998-01-01

109

VEGF immunoexpression in penile carcinoma  

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OBJECTIVE: To investigate the vessel endothelial growth factor (VEGF) as a risk factor in squamous cell carcinoma of the penis (SCCP). METHODS: Forty-seven patients with penile carcinoma were evaluated retrospectively. The mean age and standard deviation were 61.111.7 years. All of them were treated by penectomy and those with positive nodes underwent groin lymphadenectomy. Tumor grading was 35 G1 and 12 G2/3. Primary lesion stage was 24 pT1 and 23 pT2-4. Positive inguinal nodes were ...

2002-01-01

110

Evoked and spontaneous purinergic junctional Ca2+ transients (jCaTs) in rat small arteries.  

Science.gov (United States)

Confocal microscopy of fluo-4 fluorescence in pressurized rat mesenteric small arteries subjected to low-frequency electrical field stimulation revealed Ca2+ transients in perivascular nerves and novel, spatially localized Ca2+ transients in adjacent smooth muscle cells. These muscle Ca2+ transients occur with a very brief latency to the stimulus pulse (most jCaTs. As expected from spontaneous neurotransmitter release, jCaTs also occur spontaneously, with characteristics identical to evoked jCaTs. Visualization of sympathetic neurotransmission shows that purinergic components dominate at low frequencies of sympathetic nerve fiber activation. PMID:12242262

Lamont, Christine; Wier, W Gil

2002-09-20

111

Preservation of penile length in penile cancer and trauma by use of a pedicled flap.  

Science.gov (United States)

A surgical technique is described for the treatment of carcinoma and injury involving the distal penile shaft in which a standard partial penectomy would leave inadequate penile length for satisfactory voiding. As an alternative to standard total penectomy with perineal urethrostomy that is used in this situation, partial penectomy is performed and a flap of suprapubic and scrotal skin is rolled into a new proximal penile shaft covering. This technique offers the patient the advantage of voiding in the standing position with a penile stump, and the possibility for sexual satisfaction and less physical disfigurement. PMID:3379680

Benderev, T V

1988-07-01

112

Penile replantation, complication management, and technique refinement.  

Science.gov (United States)

We describe a case of complete guillotine-type penile amputation at the proximal penile shaft. The blood flow was established 10 h after trauma. Circulation in the replanted penis was quite good but there was progressive prepuce necrosis after the hematoma. Cosmetic and urinary outcome was good 6 weeks later. The repair of deep dorsal penile vessels helps in corpus tissue healing and glans circulation. The blood supply from the corpus tissue is sufficient for the survival of the replanted penis even when the repaired dorsal vessels were occluded. Surgical pitfalls in replantation procedures and complication management are discussed. PMID:18286649

Chou, Erh-Kang; Tai, Yu-Tzu; Wu, Chao-I; Lin, Meng-Shi; Chen, Hsin-Han; Chang, Sophia Chia-Ning

2008-01-01

113

[The physiology of penile rigidity].  

Science.gov (United States)

Penile tumescence and rigidity are considered to be a purely vascular process related to an increased inflow and a decreased outflow. This theory, which provides a satisfactory explanation for tumescence, is unable to explain the existence of high intracavernous pressures recorded both in animals and in man. Based on a hydrostatic model, the authors distinguish two phases involving different physiological mechanisms: an infrasystolic vascular phase and a suprasystolic muscular phase. During the vascular phase, the intracavernous pressure (ICP) can never exceed the systolic blood pressure. However, during the muscular phase, the ICP largely exceeds the systolic pressure, reaching values as high as 400 mmHg in man and 1,000 mmHg in animals. These variations in ICP can be explained by the contraction of perineal muscles, particularly the ischiocavernosus muscles. Various animal and human experiments are presented in support of this hypothesis. The pressure variations exerted on the glans during coitus by the perivaginal musculature are sufficient to induce reflex contractions of the ischiocavernosus muscles, promoting penile rigidity. PMID:1299511

Lavoisier, P; Aloui, R; Iwaz, J; Kokkidis, M J

1992-02-01

114

Vasorelaxant effects of oleamide in rat small mesenteric artery indicate action at a novel cannabinoid receptor.  

Science.gov (United States)

Oleamide (cis-9-octadecenoamide) exhibits some cannabimimetic responses despite its low affinities at the currently known cannabinoid receptors. Here we have investigated whether or not it is a vasorelaxant in rat small mesenteric arteries. Oleamide elicited vasorelaxation (EC50=1.2+/-0.2 microM, Rmax=99.1+/-3.9%, n=8) which was reduced by endothelial removal. Nitric oxide synthase inhibition reduced the response (EC50=5.3+/-1.6 microM, Rmax=59.2+/-7.7%, n=7; PRmax=58.4+/-1.9%, n=5; PRmax=66.8+/-4.5%, n=6; PRmax=75.1+/-1.9%; n=8; P<0.05). In contrast, neither the more selective CB1 receptor antagonist, AM251 (1 microM), nor the CB2 antagonist, SR144528 (1 microM), had significant effects. O-1918 (10 microM), a putative antagonist at a novel endothelial cannabinoid receptor (abnormal-cannabidiol site), markedly reduced the relaxation to oleamide (n=7; P<0.01). It is concluded that oleamide responses in the rat isolated small mesenteric artery are partly dependent on the presence of the endothelium, activation of Ca2+-sensitive K+ channels (KC)) and involve capsaicin-sensitive sensory nerves. Oleamide may share a receptor (sensitive to rimonabant and O-1918, and coupled to KC) and Gi/o) with anandamide in this vessel. This might be distinct from both of the known cannabinoid receptors and the novel abnormal-cannabidiol site. PMID:16415907

Hoi, Pui Man; Hiley, C Robin

2006-03-01

115

Diagnosis of vasculogenic impotence: Combination of penile xenon-133 washout and papaverine tests  

Energy Technology Data Exchange (ETDEWEB)

The present study evaluates both penile xenon-133 washout (XWT) and papaverine tests (PT) in the diagnosis of vasculogenic impotence. XWT was accomplished by subcutaneous injection of xenon-133 (1-2 mCi in 0.1 mL saline solution) into the dorsal coronal prepuce. Abnormal XWT was suggested in patients whose clearance time (T1/2) was longer than 7.5 minutes and whose penile blood flow rate (Q) was less than 6 mL/100 g tissue/min. PT was done by intracavernous injection of papaverine (60 mg in 20 mL normal saline). Abnormal PT was indicated in patients whose onset of full erection was more than ten minutes after papaverine injection and whose duration of erection was less than one hour. Ten young and 11 older normal volunteers were examined with XWT only; all showed normal results. A total of 60 impotent patients were examined with both XWT and PT and were classified into four groups: in 2 patients (3.3%) both XWT and PT were normal (group I); in 8 (13.3%) XWT was abnormal and PT normal (group II); in 14 (23.3%) XWT was normal and PT abnormal (group III); and in 36 (60%) both XWT and PT were abnormal (group IV). On further examination with bilateral hypogastric arteriography in 10 XWT-abnormal patients and on surgical correction of abnormal curvature in 5 XWT-abnormal patients, all (100%) were proved to have penile arterial insufficiency. Erection cavernosography performed in 15 PT-abnormal patients confirmed penile venous insufficiency in 80 percent. We conclude both XWT and PT are simple and effective for evaluation of the penile arterial blood flow and venous competence, respectively.

Lin, S.N.; Liu, R.S.; Yu, P.C.; Chang, L.S.; Yeh, S.H.; Kuo, J.S.

1989-07-01

116

Penile gangrene in diabetes mellitus with renal failure: A poor prognostic sign of systemic vascular calciphylaxis  

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Penile gangrene associated with chronic renal failure is very uncommon. A 52-year-old man with diabetes mellitus, diffuse atherosclerosis, ischemic cardiomyopathy and end-stage renal disease presented with blackening of distal penis for 10 days. His general condition was poor and gangrene of prepuce and glans was noted. Doppler and magnetic-resonance angiography revealed bilateral internal iliac artery obstruction. He underwent trocar suprapubic cystostomy and was planned for partial penectom...

Agarwal, Mayank Mohan; Singh, Shrawan K.; Mandal, Arup K.

2007-01-01

117

Early penile metastasis from primary bladder cancer as the first systemic manifestation: a case report  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Metastatic involement of penis is an exceptionally rare condition. 77% of the metastases are originated from the pelvic region; prostate and bladder are the most frequent primary locations. Retrograde venous route, retrograde lymphatic route, arterial spread, direct extension, implantation and secondary to instrumentation are the mechanisms of metastasis. Approximately two thirds of all penile metastasis are detected at a mean time of 18 months after the detection of the primary tumor and the...

So?nmez, Nurettin Cem; Cos?kun, Burhan; Arisan, Serdar; Gu?ney, Soner; Dalk?l?c?, Ayhan

2009-01-01

118

Effectiveness of contrast enhanced power doppler ultrasonography in the ?accid penile state  

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Objective: To investigate the effectiveness of contrast-enhanced power Doppler ultrasonography (CE-PDU) in diagnosing erectile dysfunction (ED) in the ?accid penile state, and in differentiating vascular pathology. Material and Methods: After routine evaluation of 20 patients with ED, peak systolic velocity (PSV) values were measured at baseline (PSV1), after echo-contrast agent (PSV2), and after vasoactive agent (PSV3) on the cavernosal arteries for each corporeal unit. End diastolic veloci...

2009-01-01

119

Maternal smoking and impaired endothelium-dependent nitric oxide-mediated relaxation of uterine small arteries in vitro  

DEFF Research Database (Denmark)

Objective This study aimed to investigate the endothelium-dependent relaxation of uterine small arteries from pregnant nonsmokers, smokers, and ex-smokers who stopped smoking early in pregnancy. Study Design Uterine arteries were dissected from myometrial biopsies obtained during elective cesarean sections of 34 uncomplicated, singleton pregnancies, and the vascular function was assessed in a wire myograph for isometric recordings. Serum cotinine verified self-reported smoking; 15 were nonsmokers, 10 were smokers, and 9 were ex-smokers. Results Arteries from smokers and ex-smokers had reduced bradykinin-induced relaxation compared to arteries from nonsmokers (P < .05). The relaxation response to the nitric oxide donor sodium nitroprusside was similar in arteries from nonsmokers and smokers but was better in arteries from ex-smokers (P < .05). Conclusion The findings suggest that maternal smoking reduces endothelium-dependent nitric oxide??mediated relaxation in uterine small arteries andthat smoking cessation early in pregnancy does not fully abolish this deleterious effect, despite improvement in relaxation to nitroprusside.

Andersen, Malene R; Uldbjerg, Niels

2011-01-01

120

Association of Small Artery Elasticity With Incident Cardiovascular Disease in Older Adults: The Multi-Ethnic Study of Atherosclerosis  

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Functional biomarkers like large artery elasticity (LAE) and small artery elasticity (SAE) may predict cardiovascular disease (CVD) events beyond blood pressure. The authors examined the prognostic value of LAE and SAE for clinical CVD events among 6,235 Multi-Ethnic Study of Atherosclerosis participants who were initially aged 4584 years and without symptomatic CVD. LAE and SAE were derived from diastolic pulse contour analysis. During a median 5.8 years of follow-up between 2000 and 2008...

Duprez, Daniel A.; Jacobs, David R.; Lutsey, Pamela L.; Bluemke, David A.; Brumback, Lyndia C.; Polak, Joseph F.; Peralta, Carmen A.; Greenland, Philip; Kronmal, Richard A.

2011-01-01

 
 
 
 
121

Elevated lipoprotein (a), small apolipoprotein (a), and the risk of arterial ischemic stroke in North American children  

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Lipoprotein (a) is a risk factor for adult cardiovascular events, in which the apolipoprotein (a) component is thought to promote atherogenesis and impair fibrinolysis. We investigated whether elevated plasma lipoprotein (a) concentration and small predominant apolipoprotein (a) isoform size (number of kringle-4 domains) are risk factors for childhood arterial ischemic stroke and correlate with plasma fibrinolytic function. Patients who had had an arterial ischemic stroke in childhood (29 day...

2013-01-01

122

Purinergic and adrenergic Ca2+ transients during neurogenic contractions of rat mesenteric small arteries.  

Science.gov (United States)

Contraction of small arteries is regulated by the sympathetic nervous system, but the Ca2+ transients during neurally stimulated contraction of intact small arteries have not yet been recorded. We loaded rat mesenteric small arteries with the fluorescent Ca2+ indicator fluo-4 and mounted them in a myograph that permitted simultaneous (i) high-speed confocal imaging of fluorescence from individual smooth muscle cells, (ii) electrical stimulation of perivascular nerves, and (iii) recording of isometric tension. Sympathetic neuromuscular transmission was achieved by electrical field stimulation (EFS) (frequency, 10 Hz; pulse voltage, 40 V; pulse duration, 0.2 ms) in the presence of capsaicin and scopolamine (to inhibit 'sensory' and cholinergic nerves, respectively). During the first 20 s of EFS, force rose to a small peak and then declined. During this time, junctional Ca2+ transients (jCaTs) were present at relatively high frequency. We have previously attributed jCaTs to influx of Ca2+ through post-junctional P2X receptors activated by ATP. Propagating asynchronous Ca2+ waves, previously associated with bath-applied alpha1-adrenoceptor agonists, were not initially present. During the next 2.5 min of EFS, force rose slowly, and asynchronous propagating Ca2+ waves appeared. The selective alpha1-adrenoceptor antagonist prazosin abolished both the slowly developing contraction and the Ca2+ waves, but reduced the initial transient contraction by only ~25 %. During 3 min of EFS in prazosin, the frequency of jCaTs declined markedly; at sites at which at least one jCaT occurred, the average probability of a jCaT was 0.008 +/- 0.002 pulse-1 in the first 20 s and 0.0007 +/- 0.0002 pulse-1 in the last 20 s. We suggest that (i) ATP released from sympathetic varicosities activates the initial, transient, contraction and the activator Ca2+ is derived largely from jCaTs, and (ii) sympathetically released noradrenaline (NA) activates the later, major contraction through mechanisms involving alpha1-adrenoceptors and which are associated with propagating Ca2+ waves. PMID:12740429

Lamont, Christine; Vainorius, Enrikas; Wier, W Gil

2003-06-15

123

Cuerpos extraos en pene / Penile foreign bodies  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Objetivo: Mostrar 8 casos de cuerpos extraos en pene. Mtodos/Resultados: Realizamos una presentacin fundamentalmente visual de variados artilugios o cuerpos extraos de ubicacin peneana. Conclusiones: Raramente la existencia de cuerpos extraos peneanos se debe a accidentes. Los cuerpos extraos [...] en pene son colocados por muy diversas razones, destacando principalmente dentro de actividades erticas o autoerticas, pudiendo tener consecuencias desde leves, a casos en los que puede acabar en amputacin peneana. Abstract in english Objective: To describe 8 cases of penile foreign bodies. Methods/Results: We provide an essentially visual overview of various objects or foreign bodies affecting the penis. Conclusions: The presence of penile foreign bodies is rarely due to an accident. These objects are placed for a wide variety o [...] f reasons, but primarily for erotic or self-arousal purposes. The consequences of penile foreign bodies can be mild or very severe, resulting in penile amputation.

Hctor, Pastor Navarro; Mara Jos, Donte Moreno; Pedro, Carrn Lpez; Miguel, Segura Martn; Juan Gabriel, Lorenzo Romero; Jos Mara, Pastor Guzmn; J., Pay Berbegal; Saturnino, Lujan Marco; Julio, Virseda Rodrguez.

124

Selective Arterial Embolization of Idiopathic Priapism  

International Nuclear Information System (INIS)

We report a case of idiopathic priapism that was only identified as high-flow or arterial priapism after drainage of the corpora cavernosa. Following failure of conservative and surgical treatment attempts, two consecutive embolizations of a unilateral penile artery were performed with gelgoam particles

1996-11-01

125

Penile traction therapy in Peyronie's disease  

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Penile traction therapy has traditionally been implemented to increase penile length but has recently been investigated for reducing the curvature associated with Peyronie's disease. The results of a few initial investigations have been conflicting, and further research is needed to confirm the true benefit of such therapy and its potential role in treating Peyronie's disease as both a monotherapy and in combination with other therapeutic options.

2009-01-01

126

[Organ-sparing surgery for penile cancer].  

Science.gov (United States)

In patients with penile cancer health-related quality of life is closely related to organ-sparing surgery. To achieve an ideally suited treatment modality for this rare but aggressive tumor entity different operating techniques like micrographic surgery, laser treatment, and glansectomy were developed. These should offer optimal oncological treatment while preserving sexual function. This article gives an overview of indications and limits of organ-sparing treatment in penile cancer. PMID:18551271

Schlenker, B; Gratzke, C; Tilki, D; Hungerhuber, E; Schneede, P; Reich, O; Stief, C G; Seitz, M

2008-07-01

127

Bovine pericardium in penile prosthesis reimplantation.  

Science.gov (United States)

We present a case of a patient who underwent a late penile prosthesis implant using bovine pericardium as a complement to the tunica albuginea involved in intense fibrosis that destroyed the corpus cavernosum after an infectious manifestation. The advantages of using bovine pericardium in the substitution of the tunica albuginea are discussed and its first use as a penile prosthesis lining is reported. PMID:17335602

Lopes, Eduardo J; Santos, Tarsila C; Jacobino, Modesto

2007-01-01

128

Bovine pericardium in penile prosthesis reimplantation  

Directory of Open Access Journals (Sweden)

Full Text Available We present a case of a patient who underwent a late penile prosthesis implant using bovine pericardium as a complement to the tunica albuginea involved in intense fibrosis that destroyed the corpus cavernosum after an infectious manifestation. The advantages of using bovine pericardium in the substitution of the tunica albuginea are discussed and its first use as a penile prosthesis lining is reported.

Eduardo J. Lopes

2007-02-01

129

Bovine pericardium in penile prosthesis reimplantation  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english We present a case of a patient who underwent a late penile prosthesis implant using bovine pericardium as a complement to the tunica albuginea involved in intense fibrosis that destroyed the corpus cavernosum after an infectious manifestation. The advantages of using bovine pericardium in the substi [...] tution of the tunica albuginea are discussed and its first use as a penile prosthesis lining is reported.

Lopes, Eduardo J.; Santos, Tarsila C.; Jacobino, Modesto.

130

Solitary Penile Neurofibroma with Erectile Dysfunction  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Neurofibromas of the penis, although very rare, are often associated with neurofibromatosis type 1. Primary solitary neurofibromas of the penis are extremely rare. We describe a 37-year-old man with a solitary neurofibroma in the dorsum of the penis. The patient reported difficulty with sexual intercourse owing to a penile mass and erectile dysfunction. After surgical excision of the neurofibroma, he had no pain and a normal sensation of the penile glans, and his erectile dysfunction improved...

Ji, Young Hwan; Cheon, Sang Hyeon; Lee, Joong Ho; Moon, Kyung Hyun; Kim, Young Min; Park, Seonghun; Park, Sungchan

2011-01-01

131

Surgical or conservative treatment of penile fracture  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Introduction: Penile fracture presents with rupture of corpora cavernosa. It is not rare but is remarkable. Treatment options are controversial. Aim: To establish the incidence, what are early and late complications in patients treated surgically or with conservative treatment options (prospective/retrospective and randomized analysis). To find out what therapy verified as superior. Material and method: The total of 32 patients with typical acute penile fracture were analyzed. The patients we...

Nale ?.; Niki? P.; Vukovi? I.; ?or?evi? D.

2008-01-01

132

Penile cancer: a case for guidelines.  

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INTRODUCTION: Aspects of the management of penile cancer remain controversial. In the management of early T1 N0 disease, treatments are divided between amputation and a variety of penis conserving techniques (PCT); local excision, laser techniques, chemotherapy and radiotherapy. We report on a retrospective series of patients with penile cancer. PATIENTS AND METHODS: Thirty-seven patients were diagnosed between 1987-1996. All patients records were retrieved. Data recorded included TNM stage, ...

2001-01-01

133

Organ-Preserving Surgery for Penile Carcinoma  

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Introduction. Penile carcinoma has traditionally been treated by either surgical amputation or radical radiotherapy, both associated with devastating anatomical, functional, and psychological impact on the patient's life. Innovative surgical techniques have focused on penile preservation in well-selected patients to minimize physical disfigurement and consequently maximize quality of life. The objective of this article is to define the current status of these organ-preserving surgical options...

2008-01-01

134

Effects of melatonin and Pycnogenol on small artery structure and function in spontaneously hypertensive rats.  

Science.gov (United States)

It was suggested that oxidative stress has a key role in the development of endothelial dysfunction, as well as microvascular structural alterations. Therefore, we have investigated 2 substances with antioxidant properties: melatonin and Pycnogenol. We treated 7 spontaneously hypertensive rats (SHRs) with melatonin and 7 with Pycnogenol for 6 weeks. We compared results obtained with those observed in 7 SHRs and 7 Wistar-Kyoto normotensive control rats kept untreated. Mesenteric small resistance arteries were dissected and mounted on a wire myograph, and a concentration-response curve to acetylcholine was performed. Aortic contents of metalloproteinase 2, Bax, inducible NO synthase, and cyclooxygenase 2 were evaluated, together with the aortic content of total collagen and collagen subtypes and apoptosis rate. A small reduction in systolic blood pressure was observed. A significant improvement in mesenteric small resistance artery structure and endothelial function was observed in rats treated with Pycnogenol and melatonin. Total aortic collagen content was significantly greater in untreated SHRs compared with Wistar-Kyoto control rats, whereas a full normalization was observed in treated rats. Apoptosis rate was increased in the aortas of untreated SHRs compared with Wistar-Kyoto control rats; an even more pronounced increase was observed in treated rats. Bax and metalloproteinase 2 expressions changed accordingly. Cyclooxygenase 2 and inducible NO synthase were more expressed in the aortas of untreated SHRs compared with Wistar-Kyoto control rats; this pattern was normalized by both treatments. In conclusion, our data suggest that treatment with Pycnogenol and melatonin may protect the vasculature, partly independent of blood pressure reduction, probably through their antioxidant effects. PMID:20421515

Rezzani, Rita; Porteri, Enzo; De Ciuceis, Carolina; Bonomini, Francesca; Rodella, Luigi F; Paiardi, Silvia; Boari, Gianluca E M; Platto, Caterina; Pilu, Annamaria; Avanzi, Daniele; Rizzoni, Damiano; Agabiti Rosei, Enrico

2010-06-01

135

Long-Term Results of Combined Tunica Albuginea Plication and Penile Prosthesis Implantation for Severe Penile Curvature and Erectile Dysfunction  

Science.gov (United States)

Penile prosthesis implantation is the recommended treatment in patients with penile curvature and severe erectile dysfunction (ED) not responding to pharmacotherapy. Most patients with mild-to-moderate curvature can expect cylinder insertion to correct both ED and penile curvature. In patients with severe curvature and in those with persistent curvature after corporeal dilation and prosthesis placement, intraoperative penile modelling over the inflated prosthesis has been introduced as an effective treatment. We report for the first time the long-term results of a patient treated with combined penile plication and placement of an inflatable penile prosthesis.

Massenio, Paolo; Di Fino, Giuseppe; Mancini, Vito; Carrieri, Giuseppe

2014-01-01

136

Surgical or conservative treatment of penile fracture  

Directory of Open Access Journals (Sweden)

Full Text Available Introduction: Penile fracture presents with rupture of corpora cavernosa. It is not rare but is remarkable. Treatment options are controversial. Aim: To establish the incidence, what are early and late complications in patients treated surgically or with conservative treatment options (prospective/retrospective and randomized analysis. To find out what therapy verified as superior. Material and method: The total of 32 patients with typical acute penile fracture were analyzed. The patients were between 20 and 56 years of age (Mean age 40+7.25 SD. A total of 11 patients that presented up to 48h after the rupture of tunica albuginea (34.37% were operated, while 9 patients (28.13% were conservatively treated. 12 patients (37.5% reported to andrology consulting room due to penile fibrous alterations and/or erectile dysfunction 6 to 14 months after the anamnesticaly established, typical penile fracture ("primary latent penile fracture". Both groups of patients were strictly clinically followed 3, 6, 9 and 12 months after the penile fracture. Eventual development of late complications (erectile dysfunction ED, penile curvature, induratio, caverno-urethral fistula and urethral stenosis was also recorded. Etiology of ED was investigated: anamnesticaly, by hormone and laboratory analysis, using penodynamic test (PGE1, Duplex Doppler echosonography, and dynamic cavernosography. Results: In the operated group of patients, (11 pts, 34.37% preserved erectile capacity was recorded and no penile deformity or plaque lesions on the site of suture, after the patients were recommended to have 4 weeks of sexual abstinence. The rupture of tunica albuginea was always transversal in relation to penile axis i.e. in relation to axial force against which the penis acts during the intercourse. The rupture is always on the basis or mid penile portion . Out of 21 (65.63% conservatively treated patients in 13 (61.9% plaque lesions (longitudinal diameter 2 cm was recorded, while sexual dysfunction was established in 13 patients (12 with ED and 1 patient with incapability for vaginal penetration. Evaluation of post therapeutical complications in relation to type of treatment, significantly higher frequency was recorded in the group of conservatively treated patients (p<0.01. Penile veno-oclusive dysfunction was registrated as significantly most frequent cause of ED (in 10 - 76.92% out of 13 patients. All patients with ED had palpable fibrous lesion similar to Peyrones plaque, while the degree of penile deviation correlated to the size of plaque lesion. Conclusion: The late complications of penile fracture were significantly more frequently recorded in the group of conservative treated patients (p< 0.01 which proves that this lesion presents as urgent urological entity. The penile rupture is always transversal, and most probable place of rupture is physiological penile curve since this is the site of weakened structural integrity.

?or?evi? D.

2008-01-01

137

Penile tourniquet: an invaluable technique.  

Science.gov (United States)

In 72 cases of minor penile surgeries, including circumcision (42), meatotomy (18), meatoplasty (8) and chordee correction (4), a ring cut from a surgical glove finger was used as a tourniquet at the base of the penis after infiltrating the skin and the glans with plain 1% xylocaine. The usual surgical procedures were performed and the tourniquet was released after securing the probable bleeding points. The postoperative results were excellent, with oedema of the penis being the only complication. There was no incidence of skin necrosis, sensory impairment, wound infection, erectile dysfunction or postoperative oozing. This bloodless technique not only curtailed the operating time and made the procedure simpler, but it also prevented the washout of xylocaine by impeding venous drainage. PMID:9406307

Pathak, K A

1997-10-01

138

Abdominal aortic aneurysms and coronary artery disease in a small country with high cardiovascular burden.  

Science.gov (United States)

We aimed to evaluate the frequency, clinical profiles and outcomes of abdominal aortic aneurysms (AAA), and their association with coronary artery disease (CAD) in a small country with high cardiovascular burden. Methods. Data were collected for all adult patients who underwent abdominal computed tomography scans at Hamad General Hospital in Qatar between 2004 and 2008. Results. Out of 13,115 screened patients for various reasons, 61 patients (0.5%) had abdominal aneurysms. The majority of AAA patients were male (82%) with a mean age of 67 12 years. The incidence of AAA substantially increased with age reaching up to 5% in patients >80?yrs. Hypertension was the most prevalent risk factor for AAA followed by smoking, dyslipidemia, renal impairment, and diabetes mellitus. CAD and peripheral arterial disease (PAD) were observed in 36% and 13% of AAA patients, respectively. There were no significant correlations between CAD or PAD and site and size of AAA. Conclusion. This is the largest study in our region that describes the epidemiology of AAA with concomitant CAD. As the mortality rate is quite high in this high risk population, routine screening for AAA in CAD patients and vice versa needs further studies for proper risk stratification. PMID:24701361

Al-Thani, Hassan; El-Menyar, Ayman

2014-01-01

139

Stent Implantation for Malignant Pulmonary Artery Stenosis in a Metastasizing Non-Small Cell Bronchial Carcinoma  

International Nuclear Information System (INIS)

A 58-year-old patient with recently diagnosed non-small cell bronchial carcinoma was referred to us with increasing shortness of breath and orthopnea by her family practitioner. To exclude the possibility of a pulmonary embolism, contrast medium-enhanced angio-CT of the thorax was performed. This showed a large mediastinal tumor, which, on the one hand, infiltrated and occluded the left upper lobe bronchus and, on the other, constricted the left pulmonary artery over a considerable part of its length. In view of the palliative situation and massively increasing dyspnea, balloon dilatation of the obstructed left pulmonary artery followed by stent placement was performed. This resulted in an immediate improvement of the symptoms. The originally strongly oxygen-dependent and heavily dyspneic patient could be relieved of the external supply of oxygen and was able to sleep normally without additional medication within 24 h. The patient was able ambulate freely within 2 days, with a markedly improved quality of life.

2008-07-01

140

Porcine small diameter arterial extracellular matrix supports endothelium formation and media remodeling forming a promising vascular engineered biograft.  

Science.gov (United States)

Patients with small caliber artery disorders, often lack the suitable autologous tissue needed for bypassing diseased vessels or for other vascular reconstructive procedures. We propose to decellularize small caliber porcine carotid artery, then recellularize it with vascular cells and function as scaffold for tissue engineering vascular graft replacements. Based on a modified decellularization method developed in our laboratory, the cellular contents of small caliber (<4?mm) arteries were carefully removed using an enzymatic and detergent decellularization procedure. Decellularization efficiency was evaluated using histology and scanning electron microscopy, which demonstrated the absence of cellular remains in the artery wall. Proteomic analysis of the scaffold revealed that the decellularized vessels retained their major extracellular matrix protein composition. Mechanical analyses revealed no significant change in the extracellular matrix (ECM) properties versus the native artery. The decellularized artery was reseeded with human umbilical vein endothelial cells (HUVECs) and smooth muscle cells (SMCs) and cultured under static or dynamic conditions in a perfusion bioreactor designed and developed in our laboratory for these studies. Dynamic co-culturing of SMC and HUVEC, in this custom-made perfusion bioreactor, led to a higher infiltration, migration and proliferation of SMC toward the media and to a more confluent endothelium formation on the luminal surface when compared with static culturing. In addition, vascular media remodeling by SMC correlated to the expression of remodeling related genes assessed by real-time reverse transcription-polymerase chain reaction and HUVEC cultivation contributed to the remodeling of several basement membrane proteins stained using immunohistochemistry. All together, these findings indicate the potential of such decellularized arterial ECM for future small caliber vascular graft reconstruction therapies. PMID:21919798

Dahan, Nitsan; Zarbiv, Gabriel; Sarig, Udi; Karram, Tony; Hoffman, Aaron; Machluf, Marcelle

2012-02-01

 
 
 
 
141

Penile cancer: current therapy and future directions.  

Science.gov (United States)

Background Penile cancer (PC) is a rare cancer in western countries, but is more common in parts of the developing world. Due to its rarity and the consequent lack of randomized trials, current therapy is based on retrospective studies and small prospective trials. Design Studies of PC therapy were searched in PubMed and abstracts at major conferences. Results PC is generally an aggressive malignancy characterized by early locoregional lymph node (LN) spread and later metastases in distant sites. Given the strong predictive value of LN involvement for overall survival, evaluating regional LNs is critical. Advanced LN involvement is increasingly being treated with multimodality therapy incorporating chemotherapy and/or radiation. A single superior cisplatin-based regimen has not been defined. Further advances may occur with a better collaboration on an international scale and comprehensive understanding of tumor biology. To this end, the preventive role of circumcision and understanding of the oncogenic roles of Human Papilloma Virus-16, and smoking may yield advances. Preliminary data suggest a role for agents targeting epidermal growth factor receptor and angiogenesis. Conclusion Advances in therapy for PC will require efficient trial designs, synergistic collaboration, incentives to industry and the efforts of patient advocacy groups and venture philanthropists. PMID:23293117

Sonpavde, G; Pagliaro, L C; Buonerba, C; Dorff, T B; Lee, R J; Di Lorenzo, G

2013-05-01

142

Imaging diagnosis of small hepatocellular carcinoma by CT during arterial portography and Lipiodol-CT  

International Nuclear Information System (INIS)

To evaluate the rates of detection for CT during arterial portography (CTAP) and Lipiodol-CT in small hepatocellular carcinoma (HCC), including early stage HCC, a comparative prospective study was performed in 24 candidates for surgery with 39 histopathologically proved lesions: eight lesions of early HCC, four of early advanced HCC and 27 of advanced HCC. The following results were obtained. Ten of 24 patients had multiple primary HCC foci, 70% of which were, moreover, located in different segments. Detection rates for digital subtraction angiography (DSA), CTAP and Lipiodol-CT were 67%, 87%, and 72%, respectively. For 13 lesions undetected by DSA, the detection rates for CTAP and Lipiodol-CT were 62% and 31%. For small HCC (n=16) of less than 2 cm in diameter, CTAP (75%) tended to be superior to Lipiodol-CT (44%). For early HCC (n-8), CTAP (63%) showed a significantly higher detection rate than Lipiodol-CT (25%). In contrast, detection rates for small (?2 cm) early advanced (n=3) and advanced HCCs (n=5) were almost the same: 67% and 100% by CTAP and 67% and 80% by Lipiodol-CT, respectively. To diagnose multiple primary HCCs in a candidate for surgery, CTAP is imperative following angiography. (author)

1991-01-01

143

Opening of small and intermediate calcium-activated potassium channels induces relaxation mainly mediated by nitric-oxide release in large arteries and endothelium-derived hyperpolarizing factor in small arteries from rat.  

Science.gov (United States)

This study was designed to investigate whether calcium-activated potassium channels of small (SK(Ca) or K(Ca)2) and intermediate (IK(Ca) or K(Ca)3.1) conductance activated by 6,7-dichloro-1H-indole-2,3-dione 3-oxime (NS309) are involved in both nitric oxide (NO) and endothelium-derived hyperpolarizing factor (EDHF)-type relaxation in large and small rat mesenteric arteries. Segments of rat superior and small mesenteric arteries were mounted in myographs for functional studies. NO was recorded using NO microsensors. SK(Ca) and IK(Ca) channel currents and mRNA expression were investigated in human umbilical vein endothelial cells (HUVECs), and calcium concentrations were investigated in both HUVECs and mesenteric arterial endothelial cells. In both superior (?1093 ?m) and small mesenteric (?300 ?m) arteries, NS309 evoked endothelium- and concentration-dependent relaxations. In superior mesenteric arteries, NS309 relaxations and NO release were inhibited by both N(G),N(G)-asymmetric dimethyl-l-arginine (ADMA) (300 ?M), an inhibitor of NO synthase, and apamin (0.5 ?M) plus 1-[(2-chlorophenyl)diphenylmethyl]-1H-pyrazole (TRAM-34) (1 ?M), blockers of SK(Ca) and IK(Ca) channels, respectively. In small mesenteric arteries, NS309 relaxations were reduced slightly by ADMA, whereas apamin plus an IK(Ca) channel blocker almost abolished relaxation. Iberiotoxin did not change NS309 relaxation. HUVECs expressed mRNA for SK(Ca) and IK(Ca) channels, and NS309 induced increases in calcium, outward current, and NO release that were blocked by apamin and TRAM-34 or charybdotoxin. These findings suggest that opening of SK(Ca) and IK(Ca) channels leads to endothelium-dependent relaxation that is mediated mainly by NO in large mesenteric arteries and by EDHF-type relaxation in small mesenteric arteries. NS309-induced calcium influx appears to contribute to the formation of NO. PMID:21880870

Stankevicius, Edgaras; Dalsgaard, Thomas; Kroigaard, Christel; Beck, Lilliana; Boedtkjer, Ebbe; Misfeldt, Mikkel W; Nielsen, Gorm; Schjorring, Olav; Hughes, Alun; Simonsen, Ulf

2011-12-01

144

Opening of Small and Intermediate Calcium-Activated Potassium Channels Induces Relaxation Mainly Mediated by Nitric-Oxide Release in Large Arteries and Endothelium-Derived Hyperpolarizing Factor in Small Arteries from Rat  

DEFF Research Database (Denmark)

This study was designed to investigate whether calcium-activated potassium channels of small (SK(Ca) or K(Ca)2) and intermediate (IK(Ca) or K(Ca) 3.1) conductance activated by 6,7-dichloro-1H-indole-2,3-dione 3-oxime (NS309) are involved in both nitric oxide (NO) and endothelium-derived hyperpolarizing factor (EDHF)-type relaxation in large and small rat mesenteric arteries. Segments of rat superior and small mesenteric arteries were mounted in myographs for functional studies. NO was recorded using NO microsensors. SK(Ca) and IK(Ca) channel currents and mRNA expression were investigated in human umbilical vein endothelial cells (HUVECs), and calcium concentrations were investigated in both HUVECs and mesenteric arterial endothelial cells. In both superior (similar to 1093 mu m) and small mesenteric (similar to 300 mu m) arteries, NS309 evoked endothelium- and concentration-dependent relaxations. In superior mesenteric arteries, NS309 relaxations and NO release were inhibited by both N(G),N(G)-asymmetric dimethyl-L-arginine (ADMA) (300 mu M), an inhibitor of NO synthase, and apamin (0.5 mu M) plus 1-[(2-chlorophenyl)diphenylmethyl]-1H-pyrazole (TRAM-34) (1 mu M), blockers of SK(Ca) and IK(Ca) channels, respectively. In small mesenteric arteries, NS309 relaxations were reduced slightly by ADMA, whereas apamin plus an IK(Ca) channel blocker almost abolished relaxation. Iberiotoxin did not change NS309 relaxation. HUVECs expressed mRNA for SK(Ca) and IK(Ca) channels, and NS309 induced increases in calcium, outward current, and NO release that were blocked by apamin and TRAM-34 or charybdotoxin. These findings suggest that opening of SK(Ca) and IK(Ca) channels leads to endothelium-dependent relaxation that is mediated mainly by NO in large mesenteric arteries and by EDHF-type relaxation in small mesenteric arteries. NS309-induced calcium influx appears to contribute to the formation of NO.

Stankevicius, Edgaras; Dalsgaard, T.

2011-01-01

145

Priapism secondary to penile metastasis of rectal cancer  

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Metastatic penile carcinoma is rare and usually originates from genitourinary tumors. The presenting symptoms or signs have been described as nonspecific except for priapism. Rectal adenocarcinoma is a very unusual source of metastatic penile carcinoma. We report a case of metastatic penile carcinoma that originated from the rectum. Symptomatic improvement occurred with palliative radiotherapy.

Park, Ji Chan; Lee, Wook Hyun; Kang, Min Kyu; Park, Suk Young

2009-01-01

146

Priapism secondary to penile metastasis of rectal cancer  

Directory of Open Access Journals (Sweden)

Full Text Available Metastatic penile carcinoma is rare and usually originates from genitourinary tumors. The presenting symptoms or signs have been described as nonspecific except for priapism. Rectal adenocarcinoma is a very unusual source of metastatic penile carcinoma. We report a case of metastatic penile carcinoma that originated from the rectum. Symptomatic improvement occurred with palliative radiotherapy.

Ji Chan Park, Wook Hyun Lee, Min Kyu Kang, Suk Young Park

2009-09-01

147

Successful replantation of amputated penile shaft following industrial injury.  

Science.gov (United States)

Penile amputation is an uncommon urological emergency. Although rare, traumatic amputation of penis is a challenging injury to treat. However, modern microsurgical reconstruction techniques have improved success rate of penile replantation and become the procedure of choice for managing these patients. Herein, we report on a case of penile amputation following an industrial accident. PMID:23022809

Salehipour, M; Ariafar, A

2010-10-01

148

Successful Replantation of Amputated Penile Shaft following Industrial Injury  

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Penile amputation is an uncommon urological emergency. Although rare, traumatic amputation of penis is a challenging injury to treat. However, modern microsurgical reconstruction techniques have improved success rate of penile replantation and become the procedure of choice for managing these patients. Herein, we report on a case of penile amputation following an industrial accident.

2010-01-01

149

Successful Replantation of Amputated Penile Shaft following Industrial Injury  

Directory of Open Access Journals (Sweden)

Full Text Available Penile amputation is an uncommon urological emergency. Although rare, traumatic amputation of penis is a challenging injury to treat. However, modern microsurgical reconstruction techniques have improved success rate of penile replantation and become the procedure of choice for managing these patients. Herein, we report on a case of penile amputation following an industrial accident.

A Ariafar

2010-09-01

150

Clinical application of radiofrequency ablation combined with bronchial artery infusion of docetaxel in treating non-small cell lung cancer  

International Nuclear Information System (INIS)

Objective: To discuss the clinical application of radiofrequency ablation combined with bronchial artery infusion of docetaxel in treating non-small cell lung cancer and to summarize the experience of using this therapy in clinical practice. Methods: Radiofrequency ablation was performed in twenty-one patients with lung cancer. The diagnosis was confirmed by CT-guided percutaneous needle biopsy or bronchoscopic biopsy in all patients. One week after radiofrequency ablation treatment, bronchial artery infusion of docetaxel was conducted. The therapeutic results were observed and evaluated. Results: After the treatment, the lesion's size was markedly reduced and the clinical symptoms were dramatically improved in all patients. Conclusion: Radiofrequency ablation combined with bronchial artery infusion of docetaxel is a safe, effective and simple technique with excellent therapeutic results for the treatment of non-small cell lung cancer. It is really worth popularizing this technique in clinical practice. (authors)

2010-05-01

151

Intracranial arterial dolichoectasia and small-vessel disease in stroke patients.  

Science.gov (United States)

Two studies found that stroke patients with intracranial arterial dolichoectasia (IADE) had lacunar infarction more often than the control subjects. The relation between IADE and other manifestations of small-vessel disease (multilacunar state, leukoaraiosis, and tat cribl) was not investigated. The magnetic resonance images of 510 patients with brain infarction in the Etude du Profil Genetique de l'Infarctus Cerebral (GENIC) study were evaluated for the diagnosis of multilacunar infarction (>1 lacunar infarct), leukoaraiosis (assessed in periventricular and subcortical regions according to Scheltens and colleagues' scale, with severe leukoaraiosis defined as a score > 8), tat cribl (using a semiquantitative score ranging from 0-8, with severe EC > 4), and IADE (using the consensus method). By comparison with stroke patients without IADE (n = 447), IADE(+) stroke patients (n = 63) had significantly more frequent multilacunar state (51 vs 33%), severe leukoaraiosis (34 vs 19%), and severe tat cribl (32 vs 12%). After adjustment for potential confounding factors, the odds ratios (95% confidence interval) for the presence of IADE were 2.05 (1.08-3.87) for multilacunar state, 2.40 (1.11-5.20) for severe leukoaraiosis, and 3.60 (1.43-9.08) for severe tat cribl. The factors significantly associated with tat cribl were older age and a familial history of stroke. IADE in stroke patients was independently associated with parenchymal manifestations of small-vessel disease. These conditions may have in common underlying pathophysiological processes. PMID:15739178

Pico, Fernando; Labreuche, Julien; Touboul, Pierre-Jean; Leys, Didier; Amarenco, Pierre

2005-04-01

152

Characterisation of Ca2+ or Mg(2+)-dependent nucleoside triphosphatase from rat mesenteric small arteries  

DEFF Research Database (Denmark)

When isolated rat mesenteric small arteries were submitted to 2 s of sonication, a nucleoside triphosphatase activity was released to the medium, mainly from the plasma membrane of the vascular smooth muscle cells. The activity was kinetically characterized: It hydrolysed ATP, UTP and GTP with the same substrate affinity and the same specific activity. CaATP, as well as MgATP were substrates for the enzyme with an apparent Km in the micromolar range. ATPase inhibitors: ouabain, vanadate, AlF4-, oligomycin and N-ethylmaleimide were without effect on the hydrolytic activity. Among other modifiers tested only N,N'-dicyclohexylcarbodiimide caused significant (greater than 30%) inhibition. In the presence of micromolecular concentrations of Ca2+ and Mg2+, small (less than 20 mM) concentrations of Na+, K+, Rb+, Cs+ and choline+, irrespective of the nature of the anion, activated the hydrolysis with an equilibrium ordered pattern, but concentrations of monovalent cation salts above 20 mM decreased the hydrolysis rate. No activation by monovalent cation salts was seen at millimolar concentrations of divalent cations and substrate. On the basis of the results a standard mixture is proposed, which allows a sensitive assay of the specific enzyme activity.

Plesner, L; Juul, B

1991-01-01

153

Effectiveness of contrast enhanced power doppler ultrasonography in the ?accid penile state  

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Full Text Available Objective: To investigate the effectiveness of contrast-enhanced power Doppler ultrasonography (CE-PDU in diagnosing erectile dysfunction (ED in the ?accid penile state, and in differentiating vascular pathology. Material and Methods: After routine evaluation of 20 patients with ED, peak systolic velocity (PSV values were measured at baseline (PSV1, after echo-contrast agent (PSV2, and after vasoactive agent (PSV3 on the cavernosal arteries for each corporeal unit. End diastolic velocity (EDV was only measured after vasoactive drug injection. Vascular pathology was classified according to PSV3 and EDV values. Results: PSV1 was measured in 58% and PSV2 in 93% of the patients, although the differences among the measurement rates of PSV1, PSV2 and PSV3 were not statistically significant. The PSV3 value was statistically different from those of PSV1 and PSV2, while the difference between PSV1 and PSV2 was insignificant. Among vascular subgroups PSV1 values were not different, but PSV2 and PSV3 values were significantly different. Conclusion: According to this study CE-PDU could show much more arterial signals in the penile ?accid state compared to classical power Doppler ultrasonography, though it was not statistically significant, so it seemed to be a promising technique in determining a cut-off value for PSV in the penile ?accid state, thus in making differential diagnosis of ED.

Do?an nal

2009-01-01

154

Leech therapy in penile replantation: a case of recurrent penile self-amputation.  

Science.gov (United States)

Penile amputation is a rare urologic trauma for which immediate surgical replantation is indicated. Microsurgical techniques can reduce skin and graft loss complications; nonetheless, such complications are still highly prevalent. We report a case of self-inflicted penile amputation and describe a nonmicrosurgical technique for replantation. To improve postoperative edema due to venous congestion, we applied medicinal leeches to the penis. The edema quickly resolved, but overlying skin loss occurred, which required superficial debridement. At follow-up the patient had glans re-epithelialization with normal voiding, sensation, and erections. To our knowledge, this is the first reported case of nonmicrosurgical penile replantation with leech therapy. PMID:15134999

Mineo, Michael; Jolley, Tracie; Rodriguez, Gabriel

2004-05-01

155

Technical recommendations for penile replantation based on lessons learned from penile reconstruction.  

Science.gov (United States)

Penile amputation is an exceptional surgical emergency. Immediate replantation yields a high success and low complication rate. We report a case of a self-inflicted penile amputation treated with successful microsurgical replantation. Postoperative edema caused minor skin slough and temporary venous congestion was treated with medicinal leech therapy. Follow-up at 18 months showed normal subjective sensation; voiding and erectile function were present. Surgical management and technique refinements are discussed, based on a review of the literature and on our experience in penile reconstruction. PMID:22399258

Roche, Nathalie A; Vermeulen, Bob T; Blondeel, Phillip N; Stillaert, Filip B

2012-05-01

156

Potassium magnesium supplementation for four weeks improves small distal artery compliance and reduces blood pressure in patients with essential hypertension.  

Science.gov (United States)

It has been postulated that the loss of arterial compliance may precede cardiovascular diseases, and that arterial compliance is an important parameter to consider when evaluating arterial diseases such as essential hypertension (EH) and the effects of antihypertensive treatment. In all, 133 EH patients and 147 healthy subjects were enrolled in this study. Large arterial compliance (C1) and small arterial compliance (C2) were measured by the CVProfilor DO-2020 CardioVascular Profiling System. Thirty-five patients randomly received magnesium potassium supplementation (magnesium, 70.8 mg/d; potassium, 217.2 mg/d) for four weeks, and 32 patients received lacidipin (4 mg/d) as a control. Before and after the four weeks, blood pressure, C1, and C2 were measured. It was found that arterial compliance was significantly lower in EH patients compared with healthy subjects (C1: 12.53 +/- 0.33 vs. 15.63 +/- 0.30 ml/mmHg x 10, p lacidipine, systolic and diastolic BP decreased 13.27 +/- 1.76 mm Hg and 6.33 +/- 1.55 mm Hg, and C1 and C2 compliance values increased 25.05% +/- 4.49% and 34.50% +/- 7.40%, respectively. On K+ and Mg2+ supplementation, systolic and diastolic BP decreased 7.83 +/- 1.87 mm Hg and 3.67 +/- 1.03 mm Hg, and C1 and C2 compliance values increased 12.44% +/- 4.43% and 45.25% +/- 6.67%, respectively. Decreases in systemic vascular resistance (mean arterial pressure divided by cardiac output) by 11.9% and 16.6 % (p lacidipine improved large arterial compliance significantly. PMID:16820345

Wu, Geru; Tian, Hongyan; Han, Ke; Xi, Yutao; Yao, Yan; Ma, Aiqun

2006-07-01

157

The vascular-disrupting agent, combretastatin-A4-phosphate, enhances neurogenic vasoconstriction in rat small arteries  

DEFF Research Database (Denmark)

Combretastatin-A4-phosphate (CA4P/CA4), an anti-cancer drug, induces tumour hypoxia by destabilizing the cytoskeleton in tumour endothelial cells. Hypertensive side effects have been observed. We hypothesized that CA4P/CA4 lead to endothelial dysfunction followed by increased vasoconstriction. Mesenteric small arteries and femoral arteries isolated from male Wistar rats were mounted in microvascular myographs for isometric tension recordings and electrical field stimulation (EFS). Immunoblotting of endothelial nitric oxide synthase (eNOS) was performed on human umbilical vein endothelial cells (HUVECs). CA4P failed per se to change vascular tone. In femoral arteries, endothelial cell removal, l-nitro-arginine (l-NNA, an inhibitor of eNOS) and CA4P enhanced phenylephrine-induced vasoconstriction, while in mesenteric arteries only l-NNA leftward shifted concentration-response curves for phenylephrine. CA4P enhanced vasoconstriction induced by low frequency (0.5-4Hz) EFS in femoral arteries, but not in mesenteric arteries. Neurogenic contractions were inhibited by prazosin, an α(1)-adrenoceptor antagonist. In mesenteric arteries, CA4P and l-NNA inhibited vasorelaxation induced by vanadate, a tyrosine phosphatase inhibitor. CA4P did not affect acetylcholine-induced relaxation. In HUVECs, CA4P increased phosphorylation at eNOS-Thr(495), a negative regulatory site, while the positive phosphorylation site eNOS-Ser(1177) was not affected. CA4 neither influenced the actions of phenylephrine, vanadate nor acetylcholine in femoral and mesenteric arteries. In conclusion, our findings suggest that CA4P, but not CA4, enhances sympathetic adrenergic vasoconstriction probably by increasing eNOS-Thr(495) phosphorylation, in a tissue selective manner. These findings encourage further investigation to show that the hypertension and regional organ ischemia induced by CA4P can be avoided by concomitant treatment with an α(1)-adrenoceptor antagonist.

Su, Junjing; Laursen, Britt E

2012-01-01

158

Plexiforme neurofibroma with compromising of the penile function.  

Science.gov (United States)

The objective of this article was to describe a case of Von Recklinghausen's disease with plexiform neurofibroma of the penis. The patient was 26 years old and reported difficulty with sexual intercourse owing to a penile mass, despite experiencing normal sensation and erection. Physical examination demonstrated this penile mass with caf au lait spots, subcutaneous neurofibromas, and lisch nodules. The treatment consisted of subcoronal incision and resection of the lesion. Pathologic examination revealed a plexiform neurofibroma. The patient recovered well with subsequent maintenance of penile sensation and erection. In cases of plexiform neurofibroma compromising penile function, total resection of penile mass offers a good therapeutic option. PMID:18342211

Barros, Rodrigo; Cavalcanti, Andre G; Favorito, Luciano A

2008-03-01

159

Penile strangulation: report of a fatal case.  

Science.gov (United States)

Penile strangulation or entrapment is an unusual entity that requires urgent treatment due to its potential complications. Several cases have been reported in the medical literature, some of them describing serious injuries such as necrosis, gangrene, and amputation of the penis. However, as far as we know, no fatal cases have been described before. We present the death of an adult male secondary to the complications due to penile strangulation with a plastic bottle neck. The time of incarceration was unknown, but according to a witness it could be about 10 to 14 days. The findings of autopsy were penile strangulation, necrosis of the penis, acute pyelonephritis, and bronchopneumonia. The subject's refusal to ask for medical help was the cause of this atypical evolution. PMID:22101437

Morentin, Benito; Biritxinaga, Begoa; Crespo, Lourdes

2011-12-01

160

Perineal nerve stimulation: role in penile erection.  

Science.gov (United States)

The effect of perineal nerve stimulation on penile erection was studied in ten dogs. Through a paraanal incision, the nerve was exposed in the ischiorectal fossa and a bipolar electrode was applied to it. A radiofrequency receiver was implanted subcutaneously in the abdomen. Upon perineal nerve stimulation, the corporeal pressure and EMG activity of the bulbo- and ischiocavernosus muscles increased; penile erection occurred. With increased stimulus frequency up to 80 Hz, the pressure and muscles' response augmented while the latency and duration of response diminished. No further changes occurred above a frequency of 80 Hz (P > 0.05). Response was reproducible indefinitely after an off-time of double the time of the stimulation phase. Penile erection upon perineal nerve stimulation is suggested to be an effect of corporeal pressure elevation resulting from cavernosus muscles' contraction. In terms of force and speed of contraction, a stimulus frequency of 80 Hz evokes the most adequate cavernosus muscles' contraction. PMID:9138054

Shafik, A

1997-03-01

 
 
 
 
161

New stent design for use in small coronary arteries during percutaneous coronary intervention  

Directory of Open Access Journals (Sweden)

Full Text Available Juan F Granada1, Barbara A Huibregtse2, Keith D Dawkins21The Jack H Skirball Center for Cardiovascular Research, Cardiovascular Research Foundation, Columbia University Medical Center, New York, NY, USA; 2Boston Scientific Corporation, Natick, MA, USAAbstract: Patients with diabetes mellitus, of female gender, increased age, and/or with peripheral vascular disease often develop coronary stenoses in small caliber vessels. This review describes treatment of these lesions with the paclitaxel-eluting 2.25 mm TAXUS Libert Atom stent. Given the same stent composition, polymer, antirestenotic drug (paclitaxel, and release kinetics as the first-generation 2.25 mm TAXUS Express Atom stent, the second-generation TAXUS Libert Atom stent incorporates improved stent design characteristics, including thinner struts (0.0038 versus 0.0052 inches, intended to increase conformability and deliverability. In a porcine noninjured coronary artery model, TAXUS Libert Atom stent implantation in small vessels demonstrated complete strut tissue coverage compared with the bare metal stent control, suggesting a similar degree of tissue healing between the groups at 30, 90, and 180 days. The prospective, single-armed TAXUS ATLAS Small Vessel trial demonstrated improved instent late loss (0.28 0.45 versus 0.84 0.57 mm, P < 0.001, instent binary restenosis (13.0% versus 38.1%, P < 0.001, and target lesion revascularization (5.8% versus 17.6%, P < 0.001 at nine months with the TAXUS Libert Atom stent as compared with the bare metal Express stent control, with similar safety measures between the two groups. The TAXUS Libert Atom also significantly reduced nine-month angiographic rates of both instent late loss (0.28 0.45 versus 0.44 0.61 mm, P = 0.03 and instent binary restenosis (13.0% versus 25.9%, P = 0.02 when compared with the 2.25 mm TAXUS Express Atom control. The observed reduction in target lesion revascularization with the TAXUS Libert Atom compared with the TAXUS Express Atom at nine months (5.8% versus 13.7%, P = 0.02 was sustained through three years (10.0% versus 22.1%, P = 0.008 with similar, stable safety outcomes between the groups. In conclusion, these data confirm the safety and favorable performance of the TAXUS Libert Atom stent in the treatment of small coronary vessels.Keywords: small vessel, paclitaxel, stent

Juan F Granada

2010-10-01

162

Coronary angiography through ipsilateral ulnar approach in a patient with small-diameter radial artery  

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Introduction. Coronary procedures cannot be completed in 5-15% of cases through initially used radial artery approach due to frequent radial artery anomalies and vasospasm. In these cases, the ulnar artery approach could be the safe and effective alternative wrist approach. Case report. A 60-year-old patient with stable angina pectoris, hypertension, dyslipidaemia and positive endurance test was admitted to our hospital for coronary angiography. Due to the backbone pains which also made...

2013-01-01

163

Model of structural and functional adaptation of small conductance vessels to arterial hypotension.  

Science.gov (United States)

Vascular networks adapt structurally in response to local pressure and flow and functionally in response to the changing needs of tissue. Whereas most research has either focused on adaptation of the macrocirculation, which primarily transports blood, or the microcirculation, which primarily controls flow, the present work addresses adaptation of the small conductance vessels in between, which both conduct blood and resist flow. A simple hemodynamic model is introduced consisting of three parts: 1) bifurcating arterial and venous trees, 2) an empirical description of the microvasculature, and 3) a target shear stress depending on pressure. This simple model has the minimum requirements to explain qualitatively the observed structure in normotensive conditions. It illustrates that flow regulation in the microvasculature makes adaptation in the larger conductance vessels stable. Furthermore, it suggests that structural changes in response to hypotension can account for the observed decrease in the lower limit of autoregulation in chronically hypotensive vasculature. Independent adaptation to local conditions thus yields a coordinated set of structural changes that ultimately adapts supply to demand. PMID:11009451

Quick, C M; Young, W L; Leonard, E F; Joshi, S; Gao, E; Hashimoto, T

2000-10-01

164

Digoxin inhibition of relaxation induced by prostacyclin and vasoactive intestinal polypeptide in small human placental arteries  

DEFF Research Database (Denmark)

Small chorionic plate arteries were obtained from human placentae following normal vaginal delivery. Tubal vascular preparations were dissected, mounted in organ baths, and their isometric tension was recorded. Digoxin (10(-6) M) caused a rise in basic tension, reaching a maximum of 17 per cent of contractions induced by potassium (124 mM) depolarization. Pretreatment with digoxin did not significantly influence the concentration-dependent contractile responses to 5-hydroxytryptamine and prostaglandin F2 alpha (PGF2 alpha). In preparations contracted with PGF2 alpha, cumulative addition of prostacyclin (PGI2) and vasoactive intestinal polypeptide (VIP) produced concentration dependent relaxations. Digoxin (10(-8) to 10(-6) M) inhibited and finally abolished these relaxant effects of PGI2 and VIP in a concentration-dependent fashion. Pretreatment by digoxin (10(-8) to 10(-6) M) diminished the relaxant effect of sodium nitroprusside, but the effect was less pronounced than that on PGI2- and VIP-induced relaxation. As PGI2 and VIP may be of importance for the maintenance of a low resistance of the fetal placental vascular bed, the finding that digoxin decreases the vasodilating effects of these agents might imply effects on placental resistance of cardiac glycosides when used in late human pregnancy.

Maigaard, S; Forman, Axel

1985-01-01

165

KATP-channel-induced vasodilation is modulated by the Na,K-pump activity in rabbit coronary small arteries  

DEFF Research Database (Denmark)

The purpose of the study was to evaluate the importance of the Na,K-pump in relaxations induced by K(ATP)-channel openers in rabbit coronary small arteries. Arterial segments were mounted in myographs for recording of isometric tension. Whole-cell patch clamp was used to assess K(ATP)-channel currents in isolated smooth muscle cells from the arteries. In arteries preconstricted with the thromboxane A(2) analogue U46619 pinacidil and cromakalim induced concentration-dependent relaxations. In arteries preconstricted with potassium (124 mM) only high concentrations of pinacidil had a small relaxant effect. In arteries preconstricted with U46619 pinacidil-induced relaxations were unaffected by pretreatment with N(omega)-nitro-L-arginine (L-NNA) and only slightly reduced after mechanical removal of the endothelium. Pinacidil induced relaxations were not significantly affected by 1 microM glibenclamide. However, the relaxations were partly inhibited in potassium-free media and by 1 microM ouabain. In contrast, the concentration-dependent relaxation to cromakalim was partly blocked by 1 microM glibenclamide and partly by 1 microM ouabain and when both drugs were present the inhibition increased. Ouabain (1 microM) and glibenclamide (1 microM) each partly inhibited an ATP-sensitive current induced by pinacidil and cromakalim. In the presence of both inhibitors a greater inhibition was seen. When the solution in the patch pipette was sodium-free the current was reduced and ouabain had no effect. The study suggests that the relaxation to cromakalim and most likely pinacidil is mediated through opening of K(ATP) channels. Inhibition of the Na,K-pump, however, may change the local environment for the K(ATP) channels (i.e. increases the ATP/ADPratio and/or decreases the transmembrane potassium gradient), which partly prevents the activation of the K(ATP)-channel current.

Glavind-Kristensen, Marianne; Matchkov, Vladimir

2004-01-01

166

Evaluation of newly developed small ({<=} 20 mm) enhancing nodules on the arterial phase CT after transcatheter arterial cheomoembolization in patients with hepatocellular carcinoma  

Energy Technology Data Exchange (ETDEWEB)

We assessed the clinical significance of newly developed small ({<=} 20 mm) early-enhancing hepatic nodules on arterial phase CT after performing transcatheter arterial cheomoembolization (TACE) is patients suffering with hepatocellular carcinoma (HCC). We searched for the radiologic reports that showed small early enhancing nodule ({<=} 20 mm) on the arterial phase imaging of follow-up CT after performing TACE. Thirty-seven lesions in 30 patients had round or oval shaped nodules and the numbers of nodule for one patient was less than five. We classified the nodules by size, location and the decreased attenuation seen on the portal venous phase. The latest follow-up CTs were reviewed to assess the nodules for the final diagnosis. All the follow-up CTs were two-phase spiral CT scans. Twenty-five (67%) of the 37 nodules were recurred HCC, as was determined on the basis of their interval growth and lipiodol uptake after TACE. Among the 37 nodules, seven (18%) disappeared on the latest follow-up CT and they were considered as definite pseudolesions. The remaining five (15%) were stable in size or they decreased in size, and they were considered as probable pseudolesions. The mean size of the nodules on initial CT was 11 mm. The mean size of the malignant nodules was 11 {+-} 4.2 mm and that of the benign pseudolesions was 9 {+-} 4.9 mm. The nodules located on the hepatic surface were possible to definite benign pseudolesions ({rho} < 0.05). All ten low attenuated nodules seen on the portal phase were HCCs. The seen on the follow-up CT scans of HCC patients after performing TACE, the newly developed small early-enhancing nodules were considered to have high potential of being HCC by their locations and enhancing patterns.

Moon, Yong Ju; Jeong, Yong Yeon; Kim, Jeong; Heo, Suk Hee; Chang, Nam Kyu; Lim, Hyo Sun; Shin, Sang Su; Kang, Heoung Keun [Chonnam National University, Gwangju (Korea, Republic of)

2006-02-15

167

[Penile reconstruction following amputation by electrocution].  

Science.gov (United States)

We report a case of penile reconstruction after traumatic loss of the penis in a 27-year old man who was electrocuted. Phalloplasty using the remaining stumps of the corpora cavernosa was performed. The functional and cosmetic aspects of the organ are good. PMID:11980006

Benchekroun, Abdellatif; Jira, Hassan; Kasmaoui, el-Hassan; Ghadouane, Mohamed; Nouini, Yassin; Faik, Mohamed

2002-02-01

168

RETRACTED ARTICLE: Penile Strangulation by Metallic Rings  

Digital Repository Infrastructure Vision for European Research (DRIVER)

A case of penile strangulation in a 35year old male truck driver by profession reported here. Two metallic rings were self introduced upto the base of penis, in order to prevent spontaneous ejaculation at night. There was marked oedema of penis distal to rings, and these rings were removed with an indigenous technique, non-operatively

Farooqui, Mohammad Rashid; Meena, R. S.

2011-01-01

169

Effects of pomace olive oil-enriched diets on endothelial function of small mesenteric arteries from spontaneously hypertensive rats  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Pomace olive oil (POM), an olive oil subproduct traditionally used in Spain, is a good source of minor components from the unsaponifiable fraction such as triterpenoids, mainly in the form of oleanolic acid, which induces vascular protection and vasodilatation. Our aim was to evaluate the effects of long-term intake of diets enriched in POM with high concentration in oleanolic acid on endothelial dysfunction associated to hypertension in small mesenteric arteries (SMA) from spontaneously hype...

Rodriguez Rodriguez, Rosalia; Herrera, M. D.; A?lvarez Sotomayor, Mari?a; Ruiz-gutie?rrez, Valentina

2009-01-01

170

Differences in sensitivity of rat mesenteric small arteries to agonists when studied as ring preparations or as cannulated preparations.  

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1. Pharmacological experiments on vascular tissue are normally performed on isometric ring or strip preparations. The aim of this study was to compare the isometric characteristics with the characteristics obtained if vessels were examined under the more physiologically appropriate isobaric condition. 2. Rat mesenteric small arteries were mounted either on two steel wires for isometric force measurement (wire-myograph) or cannulated for measurement of the internal diameter under isobaric cond...

Buus, N. H.; Vanbavel, E.; Mulvany, M. J.

1994-01-01

171

Intracellular sodium, membrane potential, and contractility of rat mesenteric small arteries  

DEFF Research Database (Denmark)

We have investigated effects of altered extracellular sodium, intracellular sodium concentration, and membrane potential on the contractile responses of rat isolated mesenteric small arteries (internal diameter ca. 200 microns), when mounted as ring preparations on an isometric myograph. To avoid possible neural effects, all vessels were denervated in vitro using 6-hydroxydopamine. In unstimulated vessels, exposure to low-Na+ solutions (25 mM sodium, sucrose, or choline-substituted) did not cause any response nor did exposure to ouabain (1 mM) for 1 hour [when intracellular sodium concentration increased to 64 mmol/(liter-cell)]. However, a response was obtained if ouabain-exposed vessels were subjected to low-sodium solutions (ca. 15% of maximal response). The magnitude of the response was dependent on the ratio of intracellular to extracellular sodium and was not inhibitable by the calcium blockers, felodipine (1 nM) or D600 (10 microM). This response could therefore be explained in terms of Na-Ca exchange mechanism. The responses of activated vessels to ouabain and to low-sodium solutions were also investigated. The responses of vessels to submaximal doses of noradrenaline or potassium were potentiated acutely by ouabain (by 10-30% of the maximal response), even if the extracellular sodium was reduced to 25 mM. In all cases, the potentiation by ouabain was accompanied by a depolarization (3-12 mV). However, only in the case of noradrenaline-activated vessels with normal extracellular sodium was the potentiation accompanied by an increase in intracellular sodium [by ca. 7 mmol/(liter-cell)]. Moreover, the latter response was inhibited by felodipine and D600. The results suggest that Na-Ca exchange mechanisms may be present in these vessels but that they only play a role under extreme conditions; under normal conditions the effect of ouabain on activated vessels seems to be primarily due to its depolarizing effect, and not to its effect on intracellular sodium.

Mulvany, M J; Aalkjær, Christian

1984-01-01

172

Longitudinal study of aortic isthmus Doppler in appropriately grown and small-for-gestational-age fetuses with normal and abnormal umbilical artery Doppler.  

LENUS (Irish Health Repository)

To establish reference ranges using longitudinal data for aortic isthmus (AoI) Doppler indices in appropriate-for-gestational-age (AGA) fetuses and to document the longitudinal trends in a cohort of small-for-gestational-age (SGA) fetuses with normal umbilical artery Doppler and in fetuses with intrauterine growth restriction (IUGR) and abnormal umbilical artery Doppler.

Kennelly, M M

2012-04-01

173

Penile replantation after self-inflicted complete amputation: case report.  

Science.gov (United States)

A case of penile replantation is reported in which a 37-year-old man suffered a self-inflicted complete penile amputation. Replantation was successfully performed; at 3 months after surgery, a urethrocystogram demonstrated the absence of urethral stricture. Although complete erection has yet to be obtained, no other functional impairments have been encountered at 7 months after replantation. Reconstruction of the venous system is considered to be one of the most important factors in achieving a successful penile replantation. PMID:8618222

Ishida, O; Ikuta, Y; Shirane, T; Nakahara, M

1996-01-01

174

Lymph Node Metastases and Prognosis in Penile Cancer  

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Lymph node status is a key prognostic factor in penile squamous cell carcinoma. Recently, growing evidence indicates a multimodality approach consisting of neoadjuvant chemotherapy followed by consolidation surgery improves the outcome of locally advanced penile cancer. Thus, accurate estimation of survival probability in node-positive penile cancer is critical for treatment decision making, counseling of patients and follow-up scheduling. This article reviewed evolving developments in assess...

2012-01-01

175

Case of carcinosarcoma arising in irradiated penile glans  

Energy Technology Data Exchange (ETDEWEB)

A 46-year-old man, who had received the radiotherapy on his penile cancer about 8 years ago, suffered again from the tumor of his penile glans, which was thought to consist of recurrent cancer and postirradiation sarcoma. The patient underwent a radical amputation of penis combined with a postoperative chemotherapy, and is still alive wthout the recurrence of his tumor. Although more than 20 cases of penile sarcoma were reported in Japan, no case arising after radiotherapy was found.

Takasaki, Etsuji; Murahashi, Isao; Toyoda, Masao; Yamada, Takashi (Dokkyo Univ. School of Medicine Tochigi (Japan)); Takayasu, Hisao

1983-09-01

176

A case of carcinosarcoma arising in irradiated penile glans  

International Nuclear Information System (INIS)

A 46-year-old man, who had received the radiotherapy on his penile cancer about 8 years ago, suffered again from the tumor of his penile glans, which was thought to consist of recurrent cancer and postirradiation sarcoma. The patient underwent a radical amputation of penis combined with a postoperative chemotherapy, and is still alive wthout the recurrence of his tumor. Although more than 20 cases of penile sarcoma were reported in Japan, no case arising after radiotherapy was found. (author)

1983-01-01

177

A key role for Na+/K+-ATPase in the endothelium-dependent oscillatory activity of mouse small mesenteric arteries  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english Oscillatory contractile activity is an inherent property of blood vessels. Various cellular mechanisms have been proposed to contribute to oscillatory activity. Mouse small mesenteric arteries display a unique low frequency contractile oscillatory activity (1 cycle every 10-12 min) upon phenylephrin [...] e stimulation. Our objective was to identify mechanisms involved in this peculiar oscillatory activity. First-order mesenteric arteries were mounted in tissue baths for isometric force measurement. The oscillatory activity was observed only in vessels with endothelium, but it was not blocked by L-NAME (100 M) or indomethacin (10 M), ruling out the participation of nitric oxide and prostacyclin, respectively, in this phenomenon. Oscillatory activity was not observed in vessels contracted with K+ (90 mM) or after stimulation with phenylephrine plus 10 mM K+. Ouabain (1 to 10 M, an Na+/K+-ATPase inhibitor), but not K+ channel antagonists [tetraethylammonium (100 M, a nonselective K+ channel blocker), Tram-34 (10 M, blocker of intermediate conductance K+ channels) or UCL-1684 (0.1 M, a small conductance K+ channel blocker)], inhibited the oscillatory activity. The contractile activity was also abolished when experiments were performed at 20C or in K+-free medium. Taken together, these results demonstrate that Na+/K+-ATPase is a potential source of these oscillations. The presence of ?-1 and ?-2 Na+/K+-ATPase isoforms was confirmed in murine mesenteric arteries by Western blot. Chronic infusion of mice with ouabain did not abolish oscillatory contraction, but up-regulated vascular Na+/K+-ATPase expression and increased blood pressure. Together, these observations suggest that the Na+/K+ pump plays a major role in the oscillatory activity of murine small mesenteric arteries.

F.R.C., Giachini; F.S., Carneiro; V.V., Lima; Z.N., Carneiro; M.W., Brands; R.C., Webb; R.C., Tostes.

178

A key role for Na+/K+-ATPase in the endothelium-dependent oscillatory activity of mouse small mesenteric arteries  

Directory of Open Access Journals (Sweden)

Full Text Available Oscillatory contractile activity is an inherent property of blood vessels. Various cellular mechanisms have been proposed to contribute to oscillatory activity. Mouse small mesenteric arteries display a unique low frequency contractile oscillatory activity (1 cycle every 10-12 min upon phenylephrine stimulation. Our objective was to identify mechanisms involved in this peculiar oscillatory activity. First-order mesenteric arteries were mounted in tissue baths for isometric force measurement. The oscillatory activity was observed only in vessels with endothelium, but it was not blocked by L-NAME (100 M or indomethacin (10 M, ruling out the participation of nitric oxide and prostacyclin, respectively, in this phenomenon. Oscillatory activity was not observed in vessels contracted with K+ (90 mM or after stimulation with phenylephrine plus 10 mM K+. Ouabain (1 to 10 M, an Na+/K+-ATPase inhibitor, but not K+ channel antagonists [tetraethylammonium (100 M, a nonselective K+ channel blocker, Tram-34 (10 M, blocker of intermediate conductance K+ channels or UCL-1684 (0.1 M, a small conductance K+ channel blocker], inhibited the oscillatory activity. The contractile activity was also abolished when experiments were performed at 20C or in K+-free medium. Taken together, these results demonstrate that Na+/K+-ATPase is a potential source of these oscillations. The presence of ?-1 and ?-2 Na+/K+-ATPase isoforms was confirmed in murine mesenteric arteries by Western blot. Chronic infusion of mice with ouabain did not abolish oscillatory contraction, but up-regulated vascular Na+/K+-ATPase expression and increased blood pressure. Together, these observations suggest that the Na+/K+ pump plays a major role in the oscillatory activity of murine small mesenteric arteries.

F.R.C. Giachini

2009-11-01

179

Histamine-dependent prolongation by aldosterone of vasoconstriction in isolated small mesenteric arteries of the mouse  

DEFF Research Database (Denmark)

In arterioles, aldosterone counteracts the rapid dilatation ("recovery") following depolarization-induced contraction. The hypothesis was tested that this effect of aldosterone depends on COX-derived products and/or NOS inhibition. Recovery of the response to high K(+) was observed in mesenteric arteries of wild type and COX-2(-/-) mice but it was significantly diminished in preparations from eNOS(-/-) mice. Aldosterone pretreatment inhibited recovery from wild type and COX-2(-/-) mice. The NO-donor sodium nitroprusside (SNP) restored recovery in arteries from eNOS(-/-) mice and this was inhibited by aldosterone. Actinomycin-D abolished the effect of aldosterone indicating a genomic effect. The effect was blocked by indomethacin and by the COX-1 inhibitor valeryl salicylate but not by NS-398 (10(-6) mol/L) or the TP-receptor antagonist S18886 (10(-7) mol/L). The effect of aldosterone on recovery in arteries from wild type mice and the SNP-mediated dilatation in arteries from eNOS(-/-) mice was inhibited by the histamine H2 receptor antagonist cimetidine. RT-PCR showed expression of mast cell markers in mouse mesenteric arteries. The adventitia displayed granular cells positive for toluidine blue vital stain. Confocal microscopy of live mast cells showed loss of quinacrine fluorescence and swelling after aldosterone treatment indicating degranulation. RT-PCR showed expression of mineralocorticoid receptors in mesenteric arteries and in isolated mast cells. These findings suggest that aldosterone inhibits recovery by stimulation of histamine release from mast cells along mesenteric arteries. The resulting activation of H2 receptors decreases the sensitivity to NO of vascular smooth muscle cells. Aldosterone may chronically affect vascular function through paracrine release of histamine.

Schjerning, Jeppe; Uhrenholt, Torben R

2013-01-01

180

The effect of vacuum devices on penile hemodynamics  

International Nuclear Information System (INIS)

External vacuum devices are being used increasingly for the management of erectile dysfunction. There is limited information regarding the effect of vacuum devices on penile blood flow and potential for ischemic penile injury. The penile xenon washout rate was measured before and after application of 2 vacuum systems in 15 subjects. Compared to flaccid state measurements the xenon washout rate did not change significantly with the Synergist Erection System but it was significantly reduced with the Osbon ErecAid System. However, the degree and duration of decrease in penile blood flow that may result in ischemic changes are unknown

1990-01-01

 
 
 
 
181

Arterial hypertension due to fructose ingestion: model based on intermittent osmotic fluid trapping in the small bowel  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Based on recently reported data that fructose ingestion is linked to arterial hypertension, a model of regulatory loops involving the colon role in maintenance of fluid and sodium homeostasis is proposed. In normal digestion of hyperosmolar fluids, also in cases of postprandial hypotension and in patients having the "dumping" syndrome after gastric surgery, any hyperosmolar intestinal content is diluted by water taken from circulation and being trapped in the bowel until reabsorption. High fructose corn sirup (HFCS soft drinks are among common hyperosmolar drinks. Fructose is slowly absorbed through passive carrier-mediated facilitated diffusion, along the entire small bowel, thus preventing absorption of the trapped water for several hours. Here presented interpretation is that ingestion of hyperosmolar HFCS drinks due to a transient fluid shift into the small bowel increases renin secretion and sympathetic activity, leading to rise in ADH and aldosterone secretions. Their actions spare water and sodium in the large bowel and kidneys. Alteration of colon absorption due to hormone exposure depends on cell renewal and takes days to develop, so the momentary capacity of sodium absorption in the colon depends on the average aldosterone and ADH exposure during few previous days. This inertia in modulation of the colon function can make an individual that often takes HFCS drinks prone to sodium retention, until a new balance is reached with an expanded ECF pool and arterial hypertension. In individuals with impaired fructose absorption, even a higher risk of arterial hypertension can be expected.

Kurbel Sven

2010-06-01

182

Arterial hypertension due to fructose ingestion: model based on intermittent osmotic fluid trapping in the small bowel.  

Science.gov (United States)

Based on recently reported data that fructose ingestion is linked to arterial hypertension, a model of regulatory loops involving the colon role in maintenance of fluid and sodium homeostasis is proposed.In normal digestion of hyperosmolar fluids, also in cases of postprandial hypotension and in patients having the "dumping" syndrome after gastric surgery, any hyperosmolar intestinal content is diluted by water taken from circulation and being trapped in the bowel until reabsorption. High fructose corn sirup (HFCS) soft drinks are among common hyperosmolar drinks. Fructose is slowly absorbed through passive carrier-mediated facilitated diffusion, along the entire small bowel, thus preventing absorption of the trapped water for several hours.Here presented interpretation is that ingestion of hyperosmolar HFCS drinks due to a transient fluid shift into the small bowel increases renin secretion and sympathetic activity, leading to rise in ADH and aldosterone secretions. Their actions spare water and sodium in the large bowel and kidneys. Alteration of colon absorption due to hormone exposure depends on cell renewal and takes days to develop, so the momentary capacity of sodium absorption in the colon depends on the average aldosterone and ADH exposure during few previous days. This inertia in modulation of the colon function can make an individual that often takes HFCS drinks prone to sodium retention, until a new balance is reached with an expanded ECF pool and arterial hypertension. In individuals with impaired fructose absorption, even a higher risk of arterial hypertension can be expected. PMID:20579372

Kurbel, Sven

2010-01-01

183

Case report: a novel solution to penile zipper injury--the needle holder.  

Science.gov (United States)

Penile injuries are relatively uncommon. The crush injury mediated by entrapment of the skin between the teeth and fastener of a zipper mechanism has been described. It is seen more commonly in uncircumcised children than adults. A number of treatment methods have been mentioned in the literature. An adult case presentation and novel method of management using two small needle holders is illustrated. PMID:15962196

McCann, Philip A

2005-04-01

184

Successful microsurgical penile replantation following self amputation in a schizophrenic patient  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Amputation of the penis is a rare condition reported from various parts of the world as isolated cases or small series of patients; the common etiology is self-mutilating sharp amputation or an avulsion or crush injury in an industrial accident. A complete reconstruction of all penile structures should be attempted in one stage which provides the best chance for full rehabilitation of the patient. We report here a single case of total amputation of the penis in an acute paranoid schizophrenic...

2010-01-01

185

Recurrent idiopathic high-flow priapism treated with selective arterial embolization after repeated initial treatments for low-flow priapism  

Digital Repository Infrastructure Vision for European Research (DRIVER)

High-flow priapism is most often seen following perineal and penile trauma. We report the case of a 32-year-old man who presented with recurrent idiopathic priapism initially treated as low-flow priapism on 8 previous emergency department visits. Pelvic angiography revealed an abnormal communication between the left cavernosal artery and the left corpus cavernosum and led to the diagnosis of high-flow priapism. Treatment involved embolization of the left common penile artery, which resulted i...

Wallis, Christopher J. D.; Hoag, Nathan; Pommerville, Peter J.; Huk, Michael E.

2009-01-01

186

Flow- and acetylcholine-induced dilatation in small arteries from rats with renovascular hypertension--effect of tempol treatment.  

Science.gov (United States)

We investigated whether renovascular hypertension alters vasodilatation mediated by nitric oxide (NO) and endothelium-derived hyperpolarizing factor (EDHF) and the influence of the superoxide dismutase mimetic tempol on vasodilatation. One-kidney one-clip hypertensive Sprague-Dawley rats, treated with either vehicle or tempol (from weeks 5 to 10 after placement of the clip), and uninephrectomized control rats were investigated. In renal hypertensive rats systolic blood pressure increased to 171+/-6 mmHg (n=10), while in tempol-treated rats systolic blood pressure remained normal (139+/-7 mmHg, n=5). In isolated pressurized mesenteric small arteries NO-mediated dilatation was obtained by increasing flow rate and EDHF-mediated dilatation by acetylcholine. In arteries from hypertensive rats, flow-induced dilatation was blunted, as compared to normotensive and tempol-treated rats, while acetylcholine-induced dilatation remained normal. Measured by dihydroethidium staining there was an increased amount of superoxide in arteries from vehicle-treated rats, but not from tempol-treated rats. Expression by immunoblotting of endothelial NO synthase and the NAD(P)H oxidase subunit p47phox remained unaffected by high blood pressure and tempol treatment. Simultaneous measurements of NO-concentration and relaxation were performed in isolated coronary arteries from the same animals. As compared to vehicle-treated rats, both acetylcholine-induced relaxation and NO-concentration increased in arteries from tempol-treated animals, while only the relaxation was improved by the NO donor, S-nitroso-N-acetylpenicillamine (SNAP). In conclusion renovascular hypertension selectively inhibits flow-induced NO-mediated vasodilatation, while EDHF-type vasodilatation remains unaffected, suggesting that high blood pressure leads to increased generation of superoxide contributing to decreased NO bioavailability. Furthermore, the abnormal endothelium function can be corrected by tempol treatment, but this seems to involve mechanisms partly independent of NO. PMID:17482591

Christensen, Frank Holden; Stankevicius, Edgaras; Hansen, Thomas; Jrgensen, Malene Munk; Valverde, Vanesa Lopez; Simonsen, Ulf; Buus, Niels Henrik

2007-07-01

187

Microneurovascular reimplantation in a case of total penile amputation  

Directory of Open Access Journals (Sweden)

Full Text Available Amputation of the penis is a rare condition reported from various parts of the world as isolated cases or small series of patients; the common aetiology is self-mutilating sharp amputation or an avulsion or crush injury in an industrial accident. A complete reconstruction of all penile structures should be attempted in one stage which provides the best chance for full rehabilitation of the patient. We report here a single case of total amputation of the penis, which was successfully reattached by using a microsurgical technique. After surgery, near-normal appearance and function including a good urine flow and absence of urethral stricture, capabilities of erection and near normal sensitivity were observed.

Bhatt Yogesh

2008-01-01

188

Endovascular treatment of a small aneurysm of the superior cerebellar artery with a flow-diverter device. A case report.  

Science.gov (United States)

We describe the case of a 62-year-old woman who presented with a small fusiform left superior cerebellar artery (SCA) aneurysm. Aneurysms located on the SCA are uncommon and their presentation, natural history and clinical management are poorly understood. Reports on the endovascular or surgical management of SCA aneurysms are rare and usually incorporated in clinical series of basilar artery or posterior circulation aneurysms. The patient was treated by delivery of a flow-diverter Pipeline Embolization Device (PED - Chestnut Medical/ev3) at the origin of vessel. She had no procedural complications and the aneurysm volume was reduced. This paper presents additional evidence to literature reports suggesting that the new endovascular flow-diverter devices are an effective and well-tolerated treatment for complex aneurysms. Our review contributes data on the incidence of recurrence as a measure of long-term efficacy of this therapeutic approach. PMID:23859291

Briganti, F; Marseglia, M; Leone, G; Briganti, G; Piccolo, D; Napoli, M; Caranci, F

2013-06-01

189

Congenital primary penile teratoma in a child.  

Science.gov (United States)

Teratomas rarely present as a pediatric congenital primary penile mass. We describe a 14-month-old boy with a blister-like mass on his distal left penis. The subcutaneous mass measured 1.5 cm (length)1.0 cm (width)1.2 cm (height) on ultrasonography. There were clear margins between these structures and the lesion. At the age of 5 years, he received an extirpation surgery. Histologic analysis revealed that it was a mature teratoma. In our view, surgical resection should be the treatment of choice for a pediatric penile mass with the alertness of teratomas because of the possibility of malignant alteration and invasion of adjacent structures till unresectable. PMID:24767514

Hu, Jianlin; Nagao, Koichi; Tai, Toshihiro; Ozaki, Yumi; Kobayashi, Hideyuki; Iuchi, Ami; Ishikawa, Yukio; Shibuya, Kazutoshi; Nakajima, Koichi

2014-06-01

190

[Three cases of penile self-mutilation].  

Science.gov (United States)

Penile self-mutilation is rare. We report our experience with 3 cases of penile self-amputation. One case was in a 48-year-old man who had no background history of mental disorders. He amputated his penis using a utility knife. He was referred to our hospital and underwent suture of the wound, but he took his own life one week after the surgery. Another case was in a 42-year-old man who had intelligence impairment. He amputated his penis using a kitchen knife. The other case was in a 41-year-old man who had schizophrenia. He amputated his penis using a piece of broken glass. PMID:23254788

Yoneda, Suguru; Kinjo, Takanori; Oida, Takeshi; Takezawa, Kentaro; Nomura, Hironori; Tei, Norihide; Takada, Shingo; Matsumiya, Kiyomi

2012-11-01

191

Successful penile replantation using loupe magnification.  

Science.gov (United States)

Traumatic penile amputation is a rare condition requiring urgent surgical consultation with almost immediate surgical intervention. Although seen in both paediatric and adult populations, the majority are seen in the latter age group. These injuries are penetrating in nature, usually occur with the organ flaccid and most are self-inflicted by mentally unstable patients. Currently replantation involves meticulous microsurgery to reduce skin, urethra and graft loss, but these complications may still occur. Non-microsurgical techniques have been utilised with good post-operative outcomes. This report describes penile replantation in a 24-year old mentally challenged patient using 4.5 loupe-magnification to restore a functional, fully erectile penis without tissue loss and a 20-year problem free follow-up. PMID:20490665

Naraynsingh, Vijay; Harnarayan, Patrick; Hariharan, Seetharaman

2011-06-01

192

Distal end side-to-side anastomoses of sequential vein graft to small target coronary arteries improve intraoperative graft flow  

Science.gov (United States)

Background End-to-side anastomoses to connect the distal end of the great saphenous vein (GSV) to small target coronary arteries are commonly performed in sequential coronary artery bypass grafting (CABG). However, the oversize diameter ratio between the GSV and small target vessels at end-to-side anastomoses might induce adverse hemodynamic condition. The purpose of this study was to describe a distal end side-to-side anastomosis technique and retrospectively compare the effect of distal end side-to-side versus end-to-side anastomosis on graft flow characteristics. Methods We performed side-to-side anastomoses to connect the distal end of the GSV to small target vessels on 30 patients undergoing off-pump sequential CABG in our hospital between October 2012 and July 2013. Among the 30 patients, end-to-side anastomoses at the distal end of the GSV were initially performed on 14 patients; however, due to poor graft flow, those anastomoses were revised into side-to-side anastomoses. We retrospectively compared the intraoperative graft flow characteristics of the end-to-side versus side-to-side anastomoses in the 14 patients. The patient outcomes were also evaluated. Results We found that the side-to-side anastomosis reconstruction improved intraoperative flow and reduced pulsatility index in all the 14 patients significantly. The 16 patients who had the distal end side-to-side anastomoses performed directly also exhibited satisfactory intraoperative graft flow. Three-month postoperative outcomes for all the patients were satisfactory. Conclusions Side-to-side anastomosis at the distal end of sequential vein grafts might be a promising strategy to connect small target coronary arteries to the GSV.

2014-01-01

193

Synergism of clinical evaluation and penile sonographic imaging in diagnosis of penile fracture: a case report  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Introduction Penile fracture is an uncommon urologic emergency, and is the traumatic rupture of the tunica albuginea covering the corpus cavernosa. This usually occurs following blunt trauma sustained during coitus, masturbation or self-manipulations to hide or suppress an erection. Clinical diagnosis can often be easily made with typical history and examination findings. However, the patient may present atypically and/or with a suspicion of associated urethral injury. The roles of various diagnostic investigations are being evaluated in these situations. Case presentation We report the case of a 31-year-old African man with penile fracture and suspected associated urethral injury that occurred after self-manipulations to hide an erection. Conclusions Penile ultrasound and sonourethrography provide useful additional diagnostic information to supplement clinical history and physical examination findings and can be performed easily, at low cost and with no delays to surgery.

Bello Jibril

2012-09-01

194

Solitary penile ulcer associated with infections mononucleosis.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Determining the cause of genital ulcers requires extensive laboratory investigation, particularly if there is no history of sexually transmitted disease. In a patient with a solitary penile erosion who was tired, weak, sweaty and febrile, hematologic and serologic tests suggested infectious mononucleosis, and bacteriologic and serologic studies, along with attempts at virus culture, ruled out syphilis and herpes simplex. The erosion healed soon after the other signs and symptoms resolved. It ...

Lawee, D.; Shafir, M. S.

1983-01-01

195

Penile fracture: experience in 56 cases  

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OBJECTIVE: The aim of this work is to report the diagnostic and therapeutic options for 55 patients with clinical diagnosis of penile fracture. MATERIALS AND METHODS: The patients were retrospectively assessed between 1982 and 2002. The primary diagnostic evaluation method for 55 patients (56 fractures) was clinical history and physical exam. Ten (17.8%) cases required complementary exams. Ultrasound (US) was performed in 2 cases, and magnetic resonance imaging (MRI) in 1 case. Retrograde ure...

Leandro Koifman; Cavalcanti, Andre? G.; Carlos Henrique Manes; Filho, Daibes R.; Favorito, Luciano A.

2003-01-01

196

Epidemiologic study on penile cancer in Brazil  

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OBJECTIVES: To assess epidemiologic characteristics of penile cancer in Brazil. MATERIALS AND METHODS: From May 2006 to June 2007, a questionnaire was distributed to all Brazilian urologists. Their patients' clinical and epidemiological data was analyzed (age, race, place of residence, history of sexually transmitted diseases, tobacco smoking, performance of circumcision, type of hospital service), as well as the time between the appearance of the symptoms and the diagnosis, the pathological ...

Favorito, Luciano A.; Nardi, Aguinaldo C.; Mario Ronalsa; Zequi, Stenio C.; Sampaio, Francisco J. B.; Sidney Glina

2008-01-01

197

Management of Penile Fracture and its Outcome  

International Nuclear Information System (INIS)

Objective: To describe the management and outcome of patients with penile fracture. Study Design: Case series. Place and Duration of Study: Department of Urology and Renal Transplantation, Jinnah Hospital, Lahore, from March 2008 to March 2011. Methodology: Sixteen patients presenting with clinical findings / history of penile fracture were included in this study. Diagnosis was made on the basis of history and clinical findings. Surgical exploration and repair was done on the same day. In all patients, a subcoronal circumferential degloving incision was made. Rent location and dimensions management and postoperative complication were noted. Postoperatively, erection was suppressed for 4 - 5 days. All patients were discharged with advice of avoidance of sex for about 8 weeks. Patients were followed-upto 6 months. Results: Majority of the patients (87.5%) were married and 13 (81.25%) were aged 18 - 45 years. The typical findings recorded in 100.0% patients were erection at time of fracture, detumescence, swelling and ecchymosis. Audible crackling sound and pain was present in 13 (81.25%) patients. Ten (62.5%) patients had rent in the proximal part of penile shaft and right lateral tear was present in 11 (68.75%) patients. Blood clots were evacuated and closure of rent was done with vicryl 2/0 (interrupted stitches). 100.0% patients had uneventful recovery with only 3 (18.75%) patients developed right chordae of erect penis after treatment. All (100.0%) patients were potent and without any problem of erection. Conclusion: Penile fracture is under-reported. A trauma to erect penis is essential to cause fracture. Surgical exploration and repair is the treatment of choice. (author)

2013-11-01

198

Severe Penile Curvature following Otis Urethrotomy  

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Urethral stricture is a common urological pathology with a high recurrence rate after treatment. Urethral manipulations are among its main causes. In this paper, urethral stricture developed secondary to urethral catheterization and was treated with cold-knife internal urethrotomy and the Otis urethrotomy procedure. During the follow-up period, severe ventral penile curvature preventing sexual intercourse developed due to fibrosis of the corpus spongiosum and tunica albuginea of the penis. Th...

Ersagun Karaguzel; Metin Gur; Tok, Dogan S.; Kazaz, X. Lke O.; Huseyin Eren; Omer Kutlu; Ozgur, Guner K.

2013-01-01

199

Epidemiologic study on penile cancer in Brazil  

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Full Text Available OBJECTIVES: To assess epidemiologic characteristics of penile cancer in Brazil. MATERIALS AND METHODS: From May 2006 to June 2007, a questionnaire was distributed to all Brazilian urologists. Their patients' clinical and epidemiological data was analyzed (age, race, place of residence, history of sexually transmitted diseases, tobacco smoking, performance of circumcision, type of hospital service, as well as the time between the appearance of the symptoms and the diagnosis, the pathological characteristics of the tumor (histological type, degree, localization and size of lesion, stage of disease, the type of treatment performed and the present state of the patient. RESULTS: 283 new cases of penile cancer in Brazil were recorded. The majority of these cases occurred in the north and northeast (53.02% and southeast (45.54% regions. The majority of patients (224, or 78.96% were more than 46 years of age while only 21 patients (7.41% were less than 35 years of age. Of the 283 patients presenting penile cancer, 171 (60.42% had phimosis with the consequent impossibility to expose the glans. A prior medical history positive for HPV infection was reported in 18 of the 283 cases (6.36%. In 101 patients (35.68% tobacco smoking was reported. The vast majority of the cases (n = 207; 73.14% presented with tumors localized in the glans and prepuce. In 48 cases (16.96% the tumor affected the glans, the prepuce and the corpus penis; in 28 cases (9.89% the tumor affected the entire penis. The majority of the patients (n = 123; 75.26% presented with T1 or T2; only 9 patients (3.18% presented with T4 disease. CONCLUSION: Penile cancer is a very frequent pathology in Brazil, predominantly affecting low income, white, uncircumcised patients, living in the north and northeast regions of the country.

Luciano A. Favorito

2008-10-01

200

Penile radionuclide studies in impotence: an overview  

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Over the years, an ever-increasing awareness of vasculogenic dysfunction as the major underlying cause of organic impotence has fostered the development of various radionuclide techniques for functional evaluation of the penile circulatory status. This article gives a brief overview of these techniques. However although these techniques have been effectively employed as a research tool, these tests have yet to gain acceptance as a routine clinical diagnostic tool for screening impotent patients. (UK).

Siraj, Q.H.; Hilson, A.J.W. (Royal Free Hospital, London (United Kingdom))

1993-07-01

 
 
 
 
201

Epidemiologic study on penile cancer in Brazil  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english OBJECTIVES: To assess epidemiologic characteristics of penile cancer in Brazil. MATERIALS AND METHODS: From May 2006 to June 2007, a questionnaire was distributed to all Brazilian urologists. Their patients' clinical and epidemiological data was analyzed (age, race, place of residence, history of se [...] xually transmitted diseases, tobacco smoking, performance of circumcision, type of hospital service), as well as the time between the appearance of the symptoms and the diagnosis, the pathological characteristics of the tumor (histological type, degree, localization and size of lesion, stage of disease), the type of treatment performed and the present state of the patient. RESULTS: 283 new cases of penile cancer in Brazil were recorded. The majority of these cases occurred in the north and northeast (53.02%) and southeast (45.54%) regions. The majority of patients (224, or 78.96%) were more than 46 years of age while only 21 patients (7.41%) were less than 35 years of age. Of the 283 patients presenting penile cancer, 171 (60.42%) had phimosis with the consequent impossibility to expose the glans. A prior medical history positive for HPV infection was reported in 18 of the 283 cases (6.36%). In 101 patients (35.68%) tobacco smoking was reported. The vast majority of the cases (n = 207; 73.14%) presented with tumors localized in the glans and prepuce. In 48 cases (16.96%) the tumor affected the glans, the prepuce and the corpus penis; in 28 cases (9.89%) the tumor affected the entire penis. The majority of the patients (n = 123; 75.26%) presented with T1 or T2; only 9 patients (3.18%) presented with T4 disease. CONCLUSION: Penile cancer is a very frequent pathology in Brazil, predominantly affecting low income, white, uncircumcised patients, living in the north and northeast regions of the country.

Favorito, Luciano A.; Nardi, Aguinaldo C.; Ronalsa, Mario; Zequi, Stenio C.; Sampaio, Francisco J. B.; Glina, Sidney.

202

Organ-Preserving Surgery for Penile Carcinoma  

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Full Text Available Introduction. Penile carcinoma has traditionally been treated by either surgical amputation or radical radiotherapy, both associated with devastating anatomical, functional, and psychological impact on the patient's life. Innovative surgical techniques have focused on penile preservation in well-selected patients to minimize physical disfigurement and consequently maximize quality of life. The objective of this article is to define the current status of these organ-preserving surgical options for penile carcinoma. Materials and Methods. An extensive review of the Pubmed literature was performed to find articles discussing only reconstructive surgery which have contributed significantly to change traditional, frequently mutilating treatments, to develop less disfiguring surgery, and to improve patients' quality of life over the last two decades. Results. Several articles were included in this analysis in which a major contribution to the change in therapy was thought to have occurred and was documented as beneficial. Some articles reported novel techniques of less-mutilating surgery involving different forms of glans reconstruction with the use of flaps or grafts. The issue of safe surgical margins was also addressed. Conclusion. The development of less-disfiguring techniques allowing phallus preservation has reduced the negative impact on functional and cosmetic outcomes of amputation without sacrificing oncological objectives in appropriately selected patients based on stage, grade, and location of the tumour. Until more prospective studies are available and solid evidence is documented, organ preservation should be offered with caution.

Tom M. Lopes

2008-11-01

203

Penile metastasis from primay mucinous adenocarcinoma of bladder.  

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Primary adenocarcinoma of the urinary bladder is not common. Though penile metastases from transitional cell carcinoma are reported, such metastases from adenocarcinoma of urinary bladder is unknown. We report a 55-year-old male having penile metastasis from primary mucinous adenocarcinoma of bladder. PMID:19718338

Neeli, Siddalingeshwar; Prabha, Vikram; Alur, Sharan; Malur, Prakash

2007-07-01

204

Change in Penile Length in Children: Preliminary Study  

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Purpose Studies of penile length in children have been rarely conducted. In Korea, great improvements in height and weight have been observed because of economic development over the past 25 years. We investigated the current status of penile length in Korean children and compared the results with those of a previous Korean study conducted in 1987. Materials and Methods The subjects in this study were 233 boys aged 1 to 158 months, each of whom had been brought to outpatient clinics between April and October 2011. Penile length was measured according to the stretched penile length (SPL) technique; testicular size was measured (in ml) by using orchidometry. A comparison of penile lengths between the current study and the 1987 study was made by using Student's t-test. Results SPL increased significantly by 0.7 to 1.1 cm in most age groups (p<0.05). Current anthropometric measures of Korean children such as height, body weight, and testicular size have increased compared with those from 1987. Conclusions Penile length has increased significantly over the last quarter century. Therefore, it is suggested that novel reference values for penile length in prepubertal Korean children be determined in studies with a larger community-based population in order to diagnose and treat size-related penile disorders.

Lee, Joong Ho; Ji, Young Hwan; Lee, Seung Kyu; Hwang, Hyun Ho; Ryu, Dong Soo; Kim, Kun Suk; Choo, Hyun Soo; Park, Seonghun; Moon, Kyung Hyun; Cheon, Sang Hyeon

2012-01-01

205

Sentinel Node Biopsy in Penile Cancer: Case Report  

International Nuclear Information System (INIS)

A case that illustrates the benefits of lymphatic mapping in penile cancer with sentinel nodes to detect lymphgammagraphy groin. This is a patient of 48 years who consulted the urology department for evaluation after partial penile amputation require at another institution by the appearance of a histologically confirmed lesion in the glans penis as Squamous Cell Carcinoma

2008-07-01

206

Ischemic changes associated with a large patent arterial duct in small infants.  

Science.gov (United States)

Infants with a large patent arterial duct (PDA) may develop signs of congestive heart failure secondary to pulmonary overcirculation. As the PVR decreases, the relative pulmonary blood flow (Qp :Qs ) increases and this may cause tachypnea, respiratory distress, failure to thrive, ventricular dysfunction and even ventilator dependency. The diastolic runoff from the systemic circulation may result in intestinal hypoperfusion resulting in necrotizing enterocolitis, and in severe cases, myocardial ischemia. Cardiac ischemia due to coronary steal is a recognized clinical entity. We present two cases of infants who developed coronary artery steal with the use of supplemental oxygen therapy during anesthesia induction for PDA occlusion. These cases highlight the importance of prudent use of supplemental oxygen therapy in infants with large PDAs. PMID:22936526

Crystal, Matthew A; Yacouby, Saeed; Petit, Christopher J

2014-01-01

207

Cytological diagnosis of nonulcerative penile neoplasms: report of two cases.  

Science.gov (United States)

Nonulcerative penile mass lesions are rare. Pathological diagnosis of these lesions would traditionally be a biopsy. We report two such primary penile lesions which were diagnosed by fine-needle aspiration cytology (FNAC). Both lesions were present in the shaft and were diagnosed as squamous cell carcinoma (SCC). The first patient had a recurrence on the penile stump of partial amputation without any ulceration. The second had a primary urethral carcinoma on the terminal penile shaft infiltrating the corpora cavernosa dorsally. Open biopsies were avoided in both cases. FNAC was associated with very little and tolerable discomfort. There were no complications. The aspirate yield was sufficient for cytological diagnosis. FNAC of nonulcerated penile lesions is safe, well tolerated, and capable of providing a cytological diagnosis. Hence, it is a very useful outpatient procedure and could be the procedure of choice for diagnosis. PMID:14648797

Harish, K; Alva, N Kishore; Arun Kumar, S P; Mangala Gouri, S R

2003-12-01

208

Penile enlargement with methacrylate injection: is it safe?  

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CONTEXT Penis size is a great concern for men in many cultures. Despite the great variety of methods for penile augmentation, none has gained unanimous acceptance among experts in the field. However, in this era of minimally invasive procedure, injection therapy for penile augmentation has become more popular. Here we report a case of methacrylate injection in the penis that evolved with penile deformity and sexual dysfunction. This work also reviews the investigation and management of this pathological condition. CASE REPORT A 36-year-old male sought medical care with a complaint of penile deformity and sexual dysfunction after methacrylate injection. The treatment administered was surgical removal. Satisfactory cosmetic and functional results were reached after two months. CONCLUSIONS There is a need for better structured scientific research to evaluate the outcomes and complication rates from all penile augmentation procedures. PMID:23538596

Torricelli, Fabio Cesar Miranda; Andrade, Enrico Martins de; Marchini, Giovanni Scala; Lopes, Roberto Iglesias; Claro, Joaquim Francisco Almeida; Cury, Jose; Srougi, Miguel

2013-03-01

209

Minimally Invasive Penile Implant Surgery  

Medline Plus

Full Text Available ... is prepped, we consider the skin to be contaminated. 00:08:24 IRWIN GOLDSTEIN, MD: Im ... this small fenestration, and then with the same contaminated or what I believe are the contaminated gloves, ...

210

Sneddon's syndrome--an inflammatory disorder of small arteries followed by smooth muscle proliferation. Immunohistochemical and ultrastructural evidence.  

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Sneddon's syndrome is a rare, but potentially severe, arterioocclusive disorder characterized by generalized livedo racemosa of the skin and various central nervous symptoms due to occlusion of medium-sized arteries of unknown cause. We have recently shown that, in skin, small to medium-sized arteries of the dermis-subcutis boundary are affected in a stage-specific sequence. An initial phase (stage I), characterized by the attachment of lymphohistiocytic cells and detachment of endothelial cells (endothelitis), is followed by an early phase (stage II), which displays partial or complete occlusion of the lumen by a plug of lymphohistiocytic cells and fibrin. In an intermediate phase (stage III), the occluding plug is replaced by proliferating subendothelial cells accompanied by the occurrence of dilated capillaries in the adventitia of the occluded vessel. The late phase (stage IV) shows fibrosis and shrinkage of the affected vessels. We investigated sections of paraffin-embedded specimens of 18 patients by immunohistochemistry using a panel of antibodies to detect endothelial cells, macrophages, T cells, smooth muscle-specific actin, and intermediate filaments (vimentin, desmin). We found that the cells involved in subendothelial proliferation were vimentin and actin positive (smooth-muscle-specific), but desmin negative and thus displayed the phenotype characteristic of smooth muscle cells, which was confirmed by ultrastructural studies. CD3+, UCHL-1+, and HLA-DR+ cells constituted a significant proportion of the inflammatory infiltrate in the early stages. The endothelial cells in the dilated capillaries of the adventitia were strongly HLA-DR positive. In later stages, endothelial cells and leukocytes were scarce. The data confirm the hypothesis that Sneddon's syndrome starts as an inflammatory and possibly immunologically mediated disorder, leading to a migration and proliferation of smooth cells of small arteries, resulting in a partial or complete narrowing of the vessel lumen. PMID:7694946

Sepp, N; Zelger, B; Schuler, G; Romani, N; Fritsch, P

1995-04-01

211

Penile fracture: experience in 56 cases  

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Full Text Available OBJECTIVE: The aim of this work is to report the diagnostic and therapeutic options for 55 patients with clinical diagnosis of penile fracture. MATERIALS AND METHODS: The patients were retrospectively assessed between 1982 and 2002. The primary diagnostic evaluation method for 55 patients (56 fractures was clinical history and physical exam. Ten (17.8% cases required complementary exams. Ultrasound (US was performed in 2 cases, and magnetic resonance imaging (MRI in 1 case. Retrograde urethrocystogram was performed in suspicious urethral injury, which happened for 7 patients. RESULTS: Of 56 assessed cases, 49 (89.5% were submitted to surgical exploration, and only 7 were conservatively conducted. Surgical treatment was performed in 48 patients (49 fractures, in these cases, 47 (95.9% presented tunica albuginea disruption and solely 2 (4.1% evidenced lesion of dorsal vein. Ultrasonography confirmed disruption of tunica albuginea in 1 (50% case, and in the other it was not possible to determinate the origin of the lesion, and the patient was submitted to surgical exploration, which confirmed the condition. MRI was used only in 1 case, confirming the lesion. Among 7 patients submitted to conservative management, until now, 3 (42.8% required surgical intervention to correct penile chordee. CONCLUSIONS: Penile fracture is an entity of eminently clinical diagnosis, which management should be surgical and immediate, avoiding thus complications related to erectile dysfunction. When suspecting an associated urethral injury, Urethrocystogram is recommended. In cases where there is diagnostic uncertainty, ultrasound and/or MRI may be used to reveal the condition.

Koifman Leandro

2003-01-01

212

Penile fracture: experience in 56 cases  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english OBJECTIVE: The aim of this work is to report the diagnostic and therapeutic options for 55 patients with clinical diagnosis of penile fracture. MATERIALS AND METHODS: The patients were retrospectively assessed between 1982 and 2002. The primary diagnostic evaluation method for 55 patients (56 fractu [...] res) was clinical history and physical exam. Ten (17.8%) cases required complementary exams. Ultrasound (US) was performed in 2 cases, and magnetic resonance imaging (MRI) in 1 case. Retrograde urethrocystogram was performed in suspicious urethral injury, which happened for 7 patients. RESULTS: Of 56 assessed cases, 49 (89.5%) were submitted to surgical exploration, and only 7 were conservatively conducted. Surgical treatment was performed in 48 patients (49 fractures), in these cases, 47 (95.9%) presented tunica albuginea disruption and solely 2 (4.1%) evidenced lesion of dorsal vein. Ultrasonography confirmed disruption of tunica albuginea in 1 (50%) case, and in the other it was not possible to determinate the origin of the lesion, and the patient was submitted to surgical exploration, which confirmed the condition. MRI was used only in 1 case, confirming the lesion. Among 7 patients submitted to conservative management, until now, 3 (42.8%) required surgical intervention to correct penile chordee. CONCLUSIONS: Penile fracture is an entity of eminently clinical diagnosis, which management should be surgical and immediate, avoiding thus complications related to erectile dysfunction. When suspecting an associated urethral injury, Urethrocystogram is recommended. In cases where there is diagnostic uncertainty, ultrasound and/or MRI may be used to reveal the condition.

Koifman, Leandro; Cavalcanti, Andr G.; Manes, Carlos Henrique; R. Filho, Daibes; Favorito, Luciano A..

213

Penile strangulation: report of two unusual cases.  

Science.gov (United States)

We report two cases of penile strangulation that presented to our emergency department. In the first case, a 60-year-old man, the object of strangulation was a metallic ring that was extricated using an orthopaedic cutter in the operating theatre. The patient recovered uneventfully. In the second case, a 77-year-old man, the object of strangulation was a plastic bottle, which was extricated using surgical instruments in the emergency department, but the patient subsequently developed postobstructive diuresis. The first case illustrates the difficulty that may be encountered in this delicate yet urgent situation, while the second case reports a rare complication. PMID:19296009

Ooi, C K; Goh, H K; Chong, K T; Lim, G H

2009-02-01

214

CD34 immunoexpression in penile carcinoma  

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OBJECTIVE: To investigate microvessel density as a risk factor in squamous cell carcinoma of the penis. METHODS: Fifty patients with penile carcinoma were evaluated retrospectively. The mean age and standard deviation were 60.811.8 years. All of them were treated by penectomy and with positive nodes underwent groin lymphadenectomy. Tumor grading was 36 G1 and 24 G2/3. Primary lesion stage was 22 pT1 and 28 pT2-4. Positive inguinal nodes were observed in 18 patients. Selected paraffin ...

2002-01-01

215

Distribution of mesenteric cranial artery in the small intestine of Procyon cancrivorus (Cuvier, 1798 (Mammalia, Procyonidae - doi: 10.4025/actascibiolsci.v32i2.5839 Distribution of mesenteric cranial artery in the small intestine of Procyon cancrivorus (Cuvier, 1798 (Mammalia, Procyonidae - doi: 10.4025/actascibiolsci.v32i2.5839  

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Full Text Available The mesenteric artery is a high caliber vessel dependent on the abdominal artery, right below the emergence of the vessels destined for the liver and stomach. The present study aimed to describe the behavior of the arterial vessel in the small intestine of the crab-eating raccoon (Procyon cancrivorus. The animals were collected on highways (roadkill. Cannulation of the abdominal aorta, perfusion with warmed water (40C and stained latex injection (Neoprene 450, Dupont do Brasil and Sulvinil stain, Glassuret S.A were performed, followed by formaldehyde fixation (10%. The dissection and photographic documents (Sony Cyber-shot, 8.1 megapixels made it possible to systemize the arteries and define the vascular patterns of the viscera. It was verified that the mesenteric cranial artery supports the entire jejune and the mesenteric portion of the ileum. Next to the mesenteric border, it becomes an anastomosis forming vascular arches from where straight arteries leave, supplying the mesenteric portion and sometimes also the jejunal anti-mesenteric portion. The artery that irrigates the ileum comes up as a branch of the cranial mesenteric artery. Anatomic knowledge of the vascular pattern of the crab-eating raccoon (Procyon cancrivorus is of fundamental importance for researches regarding the arterial distribution of the intestine considering anatomic variances.The mesenteric artery is a high caliber vessel dependent on the abdominal artery, right below the emergence of the vessels destined for the liver and stomach. The present study aimed to describe the behavior of the arterial vessel in the small intestine of the crab-eating raccoon (Procyon cancrivorus. The animals were collected on highways (roadkill. Cannulation of the abdominal aorta, perfusion with warmed water (40C and stained latex injection (Neoprene 450, Dupont do Brasil and Sulvinil stain, Glassuret S.A were performed, followed by formaldehyde fixation (10%. The dissection and photographic documents (Sony Cyber-shot, 8.1 megapixels made it possible to systemize the arteries and define the vascular patterns of the viscera. It was verified that the mesenteric cranial artery supports the entire jejune and the mesenteric portion of the ileum. Next to the mesenteric border, it becomes an anastomosis forming vascular arches from where straight arteries leave, supplying the mesenteric portion and sometimes also the jejunal anti-mesenteric portion. The artery that irrigates the ileum comes up as a branch of the cranial mesenteric artery. Anatomic knowledge of the vascular pattern of the crab-eating raccoon (Procyon cancrivorus is of fundamental importance for researches regarding the arterial distribution of the intestine considering anatomic variances.

Kleber Fernando Pereira

2010-05-01

216

Penile Implants among Prisoners--A Cause for Concern?  

Science.gov (United States)

Background We report the prevalence of penile implants among prisoners and determine the independent predictors for having penile implants. Questions on penile implants were included in the Sexual Health and Attitudes of Australian Prisoners (SHAAP) survey following concerns raised by prison health staff that increasing numbers of prisoners reported having penile implants while in prison. Methods Computer-Assisted Telephone Interviewing (CATI) of a random sample of prisoners was carried out in 41 prisons in New South Wales and Queensland (Australia). Men were asked, Have you ever inserted or implanted an object under the skin of your penis? If they responded Yes: Have you ever done so while you were in prison? Univariate logistic regression and logistic regression were used to determine the factors associated with penile implants. Results A total of 2,018 male prisoners were surveyed, aged between 18 and 65 years, and 118 (5.8%) reported that they had inserted or implanted an object under the skin of their penis. Of these men, 87 (73%) had this done while they were in prison. In the multivariate analysis, a younger age, birth in an Asian country, and prior incarceration were all significantly associated with penile implants (p<0.001). Men with penile implants were also more likely to report being paid for sex (p<0.001), to have had body piercings (p<0.001) or tattoos in prison (p<0.001), and to have taken non-prescription drugs while in prison (p<0.05). Conclusions Penile implants appear to be fairly common among prisoners and are associated with risky sexual and drug use practices. As most of these penile implants are inserted in prison, these men are at risk of blood borne viruses and wound infection. Harm reduction and infection control strategies need to be developed to address this potential risk.

Yap, Lorraine; Butler, Tony; Richters, Juliet; Malacova, Eva; Wand, Handan; Smith, Anthony M. A.; Grant, Luke; Richards, Alun; Donovan, Basil

2013-01-01

217

Penile Involvement and Henoch-Schnlein Purpura: A Case Report  

Directory of Open Access Journals (Sweden)

Full Text Available Henoch-Schnlein purpura (HSP, characterized by non-thrombocytopenic purpura accompanied by arthritis/arthralgia, gastrointestinal and genitourinary system involvement is the most common vasculitis in childhood. Associated penile involvement is very rare in patients with genitourinary system involvement. We report a 4.5 year-old boy with penile involvement and arthritis after a shortduration remission of HSP. Prednisolone (1mg/kg/day, orally and conservative measures resulted in complete recovery within five days. In conclusion, steroid treatment could be administered in HSP children with penile involvement although controversial.

nder YAVA?CAN

2012-01-01

218

Penile cutaneous horn ten years after treatment of verrucous squamous cell carcinoma on penile glans: case report.  

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Penile cutaneous horn is a clinical term that describes protruding hyperkeratosis, usually conical in shape, located on penile glans. Penile localization of this lesion, predominantly located on sun-exposed areas, is very rare. The association with malignancy on the penis makes proper identification of these lesions essential. We present a 45-year-old man with a cutaneous horn, 25 mm in size, located on the basis of penile glans. The patient had a history of phimosis, pseudoepitheliomatous balanoposthitis, surgical excision of penile verrucous squamous cell carcinoma (SCC) and postoperative radiotherapy of carcinoma in situ on the same localization, ten years before. Complete surgical removal of the horn with separate excision of the margins and base was done. Pathologic examination revealed squamous hyperplasia with suspicion of carcinoma in situ. Additional negative p16(INK4a) immunohistochemical analysis confirmed benign proliferative lesion. DNA polymerase chain reaction for human papilloma virus infection was negative. These findings suggested sparing surgical procedure in our patient, without indication for partial penile amputation, but with mandatory follow-up. Our case confirmed the association of pseudoepitheliomatous balanoposthitis with verrucous SCC, as well as the possible influence of radiotherapy on the development of penile cutaneous horn. Additionally, we showed the important role p16(INK4a) immunohistochemical analysis in the differential diagnosis of alterations adjacent to invasive SCC of the penis. PMID:22507472

Mokos, Ivica; Bukvi? Mokos, Zrinka; Ljubojevi?, Suzana; Cori?, Marijana; Grce, Magdalena; Michal, Michal

2012-01-01

219

Melanocortin receptors, melanotropic peptides and penile erection.  

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Penile erection is a complex physiologic event resulting from the interactions of the nervous system on a highly specialized vascular organ. Activation of central nervous system melanocortinergic (MC) receptors with either endogenous or synthetic melanotropic ligands may initiate and/or facilitate spontaneous penile erection. While the CNS contains principally the MC3 and MC4 receptor subtypes, there is conflicting data as to which receptor mediates erection. Although the MC4R is emerging as the principle effector of MC induced erection, the role of the MC3R is poorly understood. Manipulation of each receptor subtype with newly synthesized receptor specific agonists and antagonists, as well as knockout mice, has elucidated their individual contributions. Novel data from our laboratories suggests that antagonism of forebrain MC3R may enhance melanocortin-induced erections. Furthermore, melanocortin agents may interact with better-studied systems such as oxytocinergic pathways at the hypothalamic, brainstem or spinal level. Current therapies for erectile dysfunction target end organ vascular tissue. Manipulation of MC receptors may provide an alternative, centrally mediated therapeutic approach for erectile and other sexual dysfunctions. The non-specific "superpotent" MC agonist, PT-141, which is the carboxylate derivative of MT-II, has reached phase II human trials. Through their centrally mediated activity, melanocortin agonists have potential to treat erectile dysfunction as well as possible applications to the unmet medical needs of decreased sexual motivation and loss of libido. PMID:17584130

King, Stephen H; Mayorov, Alexander V; Balse-Srinivasan, Preeti; Hruby, Victor J; Vanderah, Todd W; Wessells, Hunter

2007-01-01

220

Association of small artery elasticity with incident cardiovascular disease in older adults: the multi-ethnic study of atherosclerosis.  

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Functional biomarkers like large artery elasticity (LAE) and small artery elasticity (SAE) may predict cardiovascular disease (CVD) events beyond blood pressure. The authors examined the prognostic value of LAE and SAE for clinical CVD events among 6,235 Multi-Ethnic Study of Atherosclerosis participants who were initially aged 45-84 years and without symptomatic CVD. LAE and SAE were derived from diastolic pulse contour analysis. During a median 5.8 years of follow-up between 2000 and 2008, 454 adjudicated CVD events occurred, including 256 cases of coronary heart disease (CHD), 93 strokes, and 126 heart failures (multiple diagnoses were possible). After adjustment for age, race/ethnicity, sex, clinic, height, heart rate, body mass index, systolic and diastolic blood pressure, use of antihypertensive and cholesterol-lowering medications, smoking, total cholesterol, high density lipoprotein cholesterol, triglycerides, diabetes, and high-sensitivity C-reactive protein, the hazard ratio for any CVD per standard-deviation increase in SAE was 0.71 (95% confidence interval: 0.61, 0.83; P LAE was not significantly related to CVD. In asymptomatic participants free of overt CVD, lower SAE added prognostic information for CVD, CHD, stroke, and heart failure events. PMID:21709134

Duprez, Daniel A; Jacobs, David R; Lutsey, Pamela L; Bluemke, David A; Brumback, Lyndia C; Polak, Joseph F; Peralta, Carmen A; Greenland, Philip; Kronmal, Richard A

2011-09-01

 
 
 
 
221

Combination of bronchial artery infusion chemotherapy and radiation therapy for locally advanced non-small cell lung cancer  

International Nuclear Information System (INIS)

Objective: To compare the efficacy between bronchial artery infusion (BAI) chemotherapy plus radiation therapy and systemic chemotherapy plus radiation for locally advanced non-small cell lung cancer (NSCLC). Methods: One hundred and twenty-one patients with stage III NSCLC were randomized into treatment group (58 cases) and control group (63 cases). In the treatment group, all patients were administered with BAI for 2-3 sessions, followed by irradiation 4-7 days after BAI. In the control group, altogether 4-6 cycles of standard systemic chemotherapy were given. Radiation was delivered alternately between the cycles of chemotherapy. Results: The short-term, long-term survival, median response duration and median survival time were similar between the two groups, except patients with stage IIIb who had a higher distant metastasis rate in the treatment group. The major side effects of chemotherapy and radiotherapy were hematological, gastrointestinal toxicities, pneumonitis, mediastinitis, and esophagitis, respectively. The side effects were milder, better tolerated and did not influence the regimen schedule in the treatment group, as compared with the control group. Seven patients withdrew from the control group, and in 28 patients, the scheduled chemotherapy and radiation was delayed or canceled. Conclusions: Bronchial artery infusion plus radiation is more advantageous over systemic chemotherapy plus radiation in less toxicities, better compliance, shorter treatment courses and more cost-effectiveness

2004-06-01

222

Differential effects of eNOS uncoupling on conduit and small arteries in GTP-cyclohydrolase I-deficient hph-1 mice  

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In the present study, we used the hph-1 mouse, which displays GTP-cyclohydrolase I (GTPCH I) deficiency, to test the hypothesis that loss of tetrahydrobiopterin (BH4) in conduit and small arteries activates compensatory mechanisms designed to protect vascular wall from oxidative stress induced by uncoupling of endothelial nitric oxide synthase (eNOS). Both GTPCH I activity and BH4 levels were reduced in the aortas and small mesenteric arteries of hph-1 mice. However, the BH4-to-7,8-dihydrobio...

D Uscio, Livius V.; Smith, Leslie A.; Katusic, Zvonimir S.

2011-01-01

223

Partial penile amputation due to penile tourniquet syndrome in a child troubled with primary nocturnal enuresis--a rare emergency.  

Science.gov (United States)

Penile tourniquet syndrome (PTS) or acquired constriction ring syndrome (ACRS) is a rare emergency that can lead to a wide range of vascular and soft tissue injuries in the penis. We are presenting a case of penile tourniquet syndrome in an 8-year-old child who had tied a thread around his penis due to primary nocturnal enuresis. On exploration, a constricting thread ring was noticed that was causing partial circumferential distal penile amputation. The thread ring was cut and debridement with primary repair of the wound was done in layers. Prevention of complications needs early diagnosis, timely intervention, and removal of the constriction. PMID:23290150

Pahwa, Harvinder Singh; Kumar, Awanish; Srivastava, Rohit; Kumar, Suresh; Goel, Apul; Ahmad, Arshad

2013-03-01

224

Evaluation of small ischemic lesions after carotid artery stenting: the usefulness of thin-slice diffusion-weighted MR imaging  

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There has been concern regarding the usefulness of diffusion-weighted imaging (DWI) to evaluate the ischemic lesions associated with carotid artery stent placement (CAS). Some small lesions may be detected not by standard DWI but by thin-slice DWI alone, since most of the cerebral lesions are very small in size and clinically silent. The purpose of this study is to compare the detectability of the small ischemic lesions after CAS by standard and thin-slice DWI. Both standard DWI with slice thickness of 6 mm and thin-slice DWI with slice thickness of 2 mm were obtained at the same MR examination within 2 to 7 days after 20 procedures of CAS in 17 patients. Number and measured diameter size of the detected lesions on both DWI were compared. All CAS procedures in 17 patients were successfully completed. The focal ischemic lesions were detected in 14 of 20 on thin-slice DWI and seven examinations on standard DWI. The total numbers of hyperintense lesions were 31 on thin-slice DWI and ten on standard DWI (p < 0.001). The sizes of these ten lesions on thin-slice DWI were larger than those of standard DWI, and the mean size of the thin-slice DWI and that of standard DWI were significantly different (p < 0.005). Thin-slice DWI was able to detect small cortical lesions better than standard DWI. Thin-slice DWI may be useful to evaluate small silent ischemic lesions after CAS. (orig.)

Yamatogi, Shigenari; Furukawa, Matakazu; Iida, Etsushi; Takahashi, Shotaro; Matsunaga, Naofumi [Yamaguchi University Graduate School of Medicine, Department of Radiology, Ube, Yamaguchi (Japan); Ishihara, Hideyuki; Kato, Shoichi; Suzuki, Michiyasu [Yamaguchi University Graduate School of Medicine, Department of Neurosurgery, Ube, Yamaguchi (Japan)

2011-04-15

225

Differential effects of eNOS uncoupling on conduit and small arteries in GTP-cyclohydrolase I-deficient hph-1 mice.  

Science.gov (United States)

In the present study, we used the hph-1 mouse, which displays GTP-cyclohydrolase I (GTPCH I) deficiency, to test the hypothesis that loss of tetrahydrobiopterin (BH(4)) in conduit and small arteries activates compensatory mechanisms designed to protect vascular wall from oxidative stress induced by uncoupling of endothelial nitric oxide synthase (eNOS). Both GTPCH I activity and BH(4) levels were reduced in the aortas and small mesenteric arteries of hph-1 mice. However, the BH(4)-to-7,8-dihydrobiopterin ratio was significantly reduced only in hph-1 aortas. Furthermore, superoxide anion and 3-nitrotyrosine production were significantly enhanced in aortas but not in small mesenteric arteries of hph-1 mice. In contrast to the aorta, protein expression of copper- and zinc-containing superoxide dismutase (CuZnSOD) was significantly increased in small mesenteric arteries of hph-1 mice. Protein expression of catalase was increased in both aortas and small mesenteric arteries of hph-1 mice. Further analysis of endothelial nitric oxide synthase (eNOS)/cyclic guanosine monophosphate (cGMP) signaling demonstrated that protein expression of phosphorylated Ser(1177)-eNOS as well as basal cGMP levels and hydrogen peroxide was increased in hph-1 aortas. Increased production of hydrogen peroxide in hph-1 mice aortas appears to be the most likely mechanism responsible for phosphorylation of eNOS and elevation of cGMP. In contrast, upregulation of CuZnSOD and catalase in resistance arteries is sufficient to protect vascular tissue from increased production of reactive oxygen species generated by uncoupling of eNOS. The results of our study suggest that anatomical origin determines the ability of vessel wall to cope with oxidative stress induced by uncoupling of eNOS. PMID:21963838

d'Uscio, Livius V; Smith, Leslie A; Katusic, Zvonimir S

2011-12-01

226

Penile herpes zoster: an unusual location for a common disease  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english Herpes zoster is a common dermatological condition which affects up to 20% of the population, most frequently involving the thoracic and facial dermatomes with sacral lesions occurring rarely and only a few reported cases of penile shingles. Case report: We report two cases of unusual penile clinica [...] l presentations of varicella zoster virus infection in immunocompetent men. The patients presented with grouped clusters of vesicles and erythema on the left side of penile shaft and posterior aspect of the left thigh and buttock, involving s2-s4 dermatomes. The lesions resolved quickly upon administration of oral antiviral therapy. Conclusion: Penile herpes zoster should not be overlooked in patients with unilateral vesicular rash.

Milan, Bjekic; Milica, Markovic; Sandra, Sipetic.

227

What Are the Risk Factors for Penile Cancer?  

Science.gov (United States)

... social and religious factors than on medical evidence. Phimosis and smegma Uncircumcised men with certain conditions may be at higher risk for penile cancer. Phimosis In men who are not circumcised, the foreskin ...

228

Clinical neuroanatomy and neurotransmitter-mediated regulation of penile erection.  

Science.gov (United States)

Erectile dysfunction (ED) has an adverse impact on men's quality of life. Penile erection, which is regulated by nerves that are innervated into the erectile tissue, can be affected by functional or anatomical trauma of the perineal region, including specific structures of the penis, causing ED. Penile erection is neurologically controlled by the autonomic nervous system. Therefore, it is of utmost importance to understand the neurogenic structure of the erectile tissue and the types of neurotransmitters involved in the penile erection process. Here, we highlight the basic clinical anatomy and erectile function of the penis. Understanding the clinical connotation of the relationship between penile erectile structure and function may provide fresh insights for identifying the main mechanisms involved in ED and help develop surgical techniques for the treatment of ED. PMID:24987557

Jung, Junyang; Jo, Hyun Woo; Kwon, Hyunseob; Jeong, Na Young

2014-06-01

229

Surgical Treatment for 11 Cases of Penile Verrucous Carcinoma  

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Penile verrucous carcinoma is a rare, well-differentiated and low-grade tumor. The surgeons are deficiently aware about the biological behavior and the clinicopathological characteristic of this disease, which raises difficulties during the treatment. In our present study, the clinical and pathological data of 11 patients with penile verrucous carcinoma, aged between 49 to 85 years was retrospectively analyzed. The tumors exhibited exophytic, papillary, caulifower-like or verrucose lesions of...

Chuanyu, Sun; Ke, Xu; Jie, Zheng; Guowei, Xia; Zujun, Fang; Qiang, Ding

2011-01-01

230

Traumatic degloving lesion of penile and scrotal skin  

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Avulsions of penile and scrotal skin are uncommon events and are caused mainly by accidents with industrial machines and agricultural machine belts. We report the case of a 30-year old patient with avulsion and traumatic degloving of the penile and scrotal skin, with exposure of the cavernous bodies, spongy body, and testes due to an industrial machine accident. Reconstruction was performed in steps, achieving a satisfactory esthetic result, normal voiding and reestablished sexual function.

Zanettini, Luiz A.; Aldo Fachinelli; Fonseca, Gabriela P.

2005-01-01

231

Traumatic degloving lesion of penile and scrotal skin  

Directory of Open Access Journals (Sweden)

Full Text Available Avulsions of penile and scrotal skin are uncommon events and are caused mainly by accidents with industrial machines and agricultural machine belts. We report the case of a 30-year old patient with avulsion and traumatic degloving of the penile and scrotal skin, with exposure of the cavernous bodies, spongy body, and testes due to an industrial machine accident. Reconstruction was performed in steps, achieving a satisfactory esthetic result, normal voiding and reestablished sexual function.

Luiz A. Zanettini

2005-06-01

232

Successful penile replantation with adjuvant hyperbaric oxygen treatment.  

Science.gov (United States)

Penile amputation and successful replantation is very uncommon, and routine standardized procedures for dealing with this medical condition do not exist. A case of a penile amputation and successful replantation is presented. This report presents the microsurgical procedure and postoperative care that led to successful engraftment and function. Of particular interest was the use of hyperbaric oxygen to accelerate the healing process. A review of the published data and future methods of increasing success of such surgical procedures is provided. PMID:17482954

Zhong, Zhaohui; Dong, Zhonggen; Lu, Qing; Li, Yuanwei; Lv, Chen; Zhu, Xuan; Zhao, Xiaokun; Zhang, Xuanzhi; Morales, Frank; Ichim, Thomas E

2007-05-01

233

The inner prepuce flap for penile scald burns.  

Science.gov (United States)

Preputial skin has similar color, texture, and composition to the skin of the penile shaft. The inner preputial skin may be transferred as a flap based upon Dartos fascia to resurface full-thickness burns of the penile shaft, providing a gliding and stretchable surface cover unique to the penis. The advantages of using the inner prepuce skin to resurface full-thickness burns of the penile shaft will be elucidated and the technique will be described. A retrospective chart review was performed of three patients whose penile shaft was resurfaced with inner prepuce flaps after tangential excision of their full-thickness scald burns. Patient 1 was a 9-year-old boy who sustained an 8% TBSA scald burn resulting in a full-thickness burn to the dorsum of his penis. Patient 2 was a 3-year-old boy who sustained a 60% TBSA immersion scald burn as a victim of child abuse, resulting in a circumferential penile burn. Patient 3 was an 8- year-old boy who sustained a 3% TBSA grease burn to the dorsum of his penis. The inner surface of the prepuce of the patients was intact. They were treated with an inner preputial flap. Full-thickness scald burns to the penis are unusual and challenging for the patient, family, and burn surgeon. It is advantageous that inner preputial skin is commonly spared. This specialized thin skin is ideal for resurfacing the penile shaft and should be used when available. PMID:24823339

Fuller, Sam M; Roughton, Michelle C; Gottlieb, Lawrence J

2014-01-01

234

Penile amputation and scrotal urethrostomy in 18 dogs.  

Science.gov (United States)

The objective of this study was to report the signalment, indications for surgery, postoperative complications and outcome in dogs undergoing penile amputation and scrotal urethrostomy. Medical records of three surgical referral facilities were reviewed for dogs undergoing penile amputation and scrotal urethrostomy between January 2003 and July 2010. Data collected included signalment, presenting signs, indication for penile amputation, surgical technique, postoperative complications and long-term outcome. Eighteen dogs were included in the study. Indications for surgery were treatment of neoplasia (n=6), external or unknown penile trauma (n=4), penile trauma or necrosis associated with urethral obstruction with calculi (n=3), priapism (n=4) and balanoposthitis (n=1). All dogs suffered mild postoperative haemorrhage (posturination and/or spontaneous) from the urethrostomy stoma for up to 21 days (mean 5.5 days). Four dogs had minor complications recorded at suture removal (minor dehiscence (n=1), mild bruising and swelling around the urethrostomy site and mild haemorrhage at suture removal (n=2), and granulation at the edge of stoma (n=1)). One dog had a major complication (wound dehiscence and subsequent stricture of the stoma). Long-term outcome was excellent in all dogs with non-neoplastic disease. Local tumour recurrence and/or metastatic disease occurred within five to 12 months of surgery in two dogs undergoing penile amputation for the treatment of neoplasia. Both dogs were euthanased. PMID:21968541

Burrow, R D; Gregory, S P; Giejda, A A; White, R N

2011-12-17

235

Effects of small and large face masks and translaryngeal and tracheostomy intubation on ventilation, upper-airway dead space, and arterial blood gases.  

Science.gov (United States)

Pulmonary function was examined in pentobarbital-anesthetized dogs that were spontaneously breathing through a large poorly fitted face mask, a small snug-fitted face mask, an endotracheal tube, and a tracheostomy tube. Increasing upper-airway dead space volumes were associated with higher minute ventilation and faster breathing rates. Minute and tidal alveolar ventilation, calculated ideal alveolar oxygen, alveolar-arterial oxygen gradient, venous admixture, arterial pH and blood gases, cardiac output, and systemic and pulmonary arterial blood pressure were not changed. The functional dead space of each mask was considerably less than that measured by water displacement. The small mask only slightly increased, and the endotracheal tube slightly decreased, the dead space estimated for a nasally breathing healthy dog. PMID:3083738

Haskins, S C; Patz, J D

1986-04-01

236

Absence of penile erections during paradoxical sleep. Peculiar penile events during wakefulness and slow wave sleep in the armadillo.  

Science.gov (United States)

The electroencephalogram (EEG) together with electromyogram (EMG) of the ischiocavernosus, bulbocavernosus and levator penis muscles were chronically monitored across behavioral states of the armadillo Chaetophractus villosus. This animal has a very long penis, which exhibits remarkable phenomena during wakefulness (W), slow wave sleep (SWS) and paradoxical sleep (PS). During W it remains retracted within a skin receptacle. During SWS penile protrusion can be observed together with very complex movements. Protrusion is a non erectile event during which the penis remains out of its receptacle but without rigidity. Penile erections are observed only during SWS. Contrasting with other mammals, no erections occur during PS. During this phase the penile muscles share the atonia of the body musculature characteristic of that phase. Some reflections on mechanisms of those penile events are presented. PMID:11696075

Affanni, J M; Cervino, C O; Marcos, H J

2001-09-01

237

Does kidney transplantation onto the external iliac artery affect the haemodynamic parameters of the cavernosal arteries?  

Science.gov (United States)

Reduced cavernosal arterial inflow has been hypothesized to be the likely cause of erectile dysfunction after kidney transplants in recipients revascularized through end-to-end anastomosis to the internal iliac artery, suggesting that end-to-side anastomosis at the external iliac artery is preferable. The aim of this study was to prospectively evaluate the effect of the use of the external iliac artery on erectile function, hormone profiles and penile blood flow by evaluating changes in penile colour Doppler ultrasound parameters in a consecutive series of 22 recipients before and after end-to-side external iliac artery transplantation. The mean International Index of Erectile FunctionErectile Function (IIEFEF) domain score decreased significantly 3 months after transplant (18.096.33 vs. 22.507.09, P=0.01). The reduction in peak systolic velocity (PSV) was significant for the cavernous artery homolateral to the side of transplant (42.6018.77 vs. 52.0119.91, P=0.01). The mean postoperative end diastolic velocity (EDV) did not differ significantly from the preoperative value (P=0.74). No statistical differences were found in the serum levels of testosterone or prolactin. Kidney grafts anastomosed at the external iliac artery produced significant (P=0.01) reductions in arterial inflow at the homolateral cavernosal artery that remained above the normal threshold. Whether these haemodynamic changes can explain the worsening of postoperative erectile function remains to be proven.

Gontero, Paolo; Oderda, Marco; Filippini, Claudia; Fontana, Francesco; Lazzarich, Elisa; Stratta, Piero; Turello, Ernesto; Tizzani, Alessandro; Frea, Bruno

2012-01-01

238

Spatial resonance in a small artery excited by vibration input as a possible mechanism to cause hand-arm vascular disorders  

Science.gov (United States)

Hand-arm vibration syndrome (HAVS) is collectively a vasospastic and neurodegenerative occupational disease. One of the major symptoms of HAVS is vibration white finger (VWF) caused by exaggerated vasoconstriction of the arteries and skin arterioles. While VWF is a very painful and costly occupational illness, its pathology has not been well understood. In this study a small artery is modeled as a fluid filled elastic tube whose diameter changes along the axial direction. Equations of motion are developed by considering interactions between the fluid, artery wall and soft-tissue bed. It is shown that the resulting wave equation is the same as that of the basilar membrane in the cochlea of mammals. Therefore, the artery system shows a spatial resonance as in the basilar membrane, which responds with the highest amplitude at the location determined by the vibration frequency. This implies that a long-term use of one type of tool will induce high-level stresses at a few identical locations of the artery that correspond to the major frequency components of the tool. Hardening and deterioration of the artery at these locations may be a possible cause of VWF.

Pattnaik, Shrikant; Banerjee, Rupak; Kim, Jay

2012-04-01

239

Intraoperative localization of vascular malformation of small bowel by selective intra-arterial dye injection  

Directory of Open Access Journals (Sweden)

Full Text Available Angiomatous malformation is the most common vascular abnormality, accounting for 30-40% cases of obscure GI bleeding from small bowel. Surgical resection is the treatment of choice in severe or recurrent hemorrhage requiring multiple blood transfusions. However, the diffuse nature of the lesions poses a challenge to localize them accurately preoperatively, for exact resection. We present a case in which we have used selective mesenteric angiography with selective cannulation and exact localization of the lesion by injecting dye such as methylene blue, indigo carmine, and fluorescein, to localize the angiomatous malformation before surgical resection and also to determine the exact resection to be done.

Eshpuniyani Priya

2010-01-01

240

The value of penile duplex in the prediction of intracavernous drug-induced priapism.  

Science.gov (United States)

The aim of this work is to assess the value of penile duplex in the prediction of intracavernous drug-induced ischemic priapism. A total of 400 patients with erectile dysfunction were evaluated before and after diagnostic intracavernous injection of a trimix solution (papaverine+phentolamine+PGE1) using color Doppler sonography. In all, 29 patients experienced sustained rigid erections for more than an hour. Patients were further divided into two groups. Group A included patients with spontaneous resolution of their rigid erection within 3 h (10/29) and group B included patients with priapism (19/29) that did not resolve within 3 h. In group A, patients had minimal cavernous artery blood flow within the first hour postinjection, that increased with relief of their erection. Group B patients had no blood flow in their cavernous artery an hour after intracavernous injection and for 6 h later. The disappearance of blood flow in the cavernous artery after an hour of sustained rigid erection predicted priapism with 100% specificity and sensitivity. The persistent absence of cavernous artery blood flow for more than an hour, as detected by color Doppler ultrasound, is an objective predictor of priapism. This may guide early intervention to resolve the prolonged erection. PMID:14961063

Shamloul, R; Ghanem, H M; Salem, A; Kamel, I I; Mousa, A A

2004-02-01

 
 
 
 
241

The lifetimes of small arterial gas emboli, and their possible connection to Inner Ear Decompression Sickness.  

Science.gov (United States)

We solved both the Diffusion and Laplace equations which predicted very similar results for the problem of a dissolving small gas bubble suspended in a liquid medium. These bubbles dissolved both because of surface tension and solute concentration effects. We focused on predicting bubble lifetimes ("td"), and dissolution dynamics - radius vs time (R vs t) for these contracting bubbles. We also presented a direct comparison of the predicted results, obtained by applying either Dirichlet or Neumann boundary conditions, to the bubble/medium interface. To the best of our knowledge, this is the first direct comparison that has ever been published on the application of these different boundary conditions to a moving gas/liquid boundary. We found that the results obtained by applying either Dirichlet or Neumann boundary conditions were very similar for small, short-lived bubbles (R0<25?,td<40s), but diverged considerably for larger, longer-lived bubbles. We applied our expressions to the timely problem of Inner Ear Decompression Sickness, where we found that our predictions were consistent with much of what is known about this condition. PMID:24657221

Solano-Altamirano, J M; Goldman, Saul

2014-06-01

242

Pathology of small cerebral arteries demonstrated by MRI: a marker of aging?  

Science.gov (United States)

Brain magnetic resonance imaging frequently identifies signal abnormalities in the white matter and cerebral cortex in the elderly. They are related to a degenerative disease of the small vessels that may be of ischemic (leukoaraiosis, lacunae and infarct) or hemorrhagic (microbleeds and hematomas) origin. These lesions are part of the aging process, and compounded by vascular risk factors. They increase the occurrence frequency and severity of ischemic or hemorrhagic stroke. Their importance is also associated with the presence of cognitive and/or affective symptoms, and their impact on the occurrence and evolution of dementia remains to be evaluated. The visible consequences of this microangiopathy on MRI probably represent the focal mark of a widespread cerebrovascular disease in the brain parenchyma. PMID:22182824

Cottier, Jean-Philippe; Edjlali, Myriam; Gaillard, Marie-Agns; Domengie, Florence; Aljishi, Ali; Casals, Xavier; Herbreteau, Denis; Hommet, Caroline

2011-12-01

243

Penile ossification: A traumatic event or evolutionary throwback? Case report and review of the literature  

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Penile ossification is very rare, with only a handful of histologically confirmed reported cases. The most common condition leading to penile ossification is Peyronies disease. Other conditions, such as gout, end-stage renal disease, diabetes mellitus, hyperparathyroidism and local trauma, have also been associated with penile ossification. We report a unique case of near-complete penile ossification of the corporal bodies with histologic confirmation on pathologic review. Our report summa...

2013-01-01

244

Long-term follow-up of penile curvature correction utilizing autologous albugineal crural graft  

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PURPOSE: Peyronie's disease is an acquired connective tissue disorder of the penile tunica albuginea with fibrosis and inflammation. The disease produces palpable plaques, penile curvature and pain during erections. Usually it results in impairment of the quality of life. Our objective is to review the long-term results of the albugineal grafting harvested from the penile crura for the treatment of severe penile curvature. MATERIALS AND METHODS: Thirty-three patients with Peyronie's disease w...

2012-01-01

245

Our 8 Years Experience on Penile Fractures: The Diagnosis and Treatment  

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Aim: The purpose of this study to present our experience with diagnosis and treatment management of penile fracture. Material and Method: Patients who were admitted our clinic with complaints of sudden penile swelling and pain during 8 years were screened. Clinical information of 30 patients aged between 16 and 45 retrospectively analyzed. The patients had applied to emergency room during the first 10 hours following penile swelling and pain. Results: Penile fracture was detected in 28 patien...

Mustafa Gunes; Necip Pirincci; ?lhan Gecit; Kerem Taken; Kursat Cecen; Kadir Ceylan

2012-01-01

246

Overexpression of ANXA1 in Penile Carcinomas Positive for High-Risk HPVs  

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The incidence of penile cancer varies between populations but is rare in developed nations. Penile cancer is associated with a number of established risk factors and associated diseases including phimosis with chronic inflammation, human papillomavirus (HPV) infection, poor hygiene and smoking. The objective of this study was to identify genes related to this type of cancer. The detection of HPV was analyzed in 47 penile squamous cell carcinoma samples. HPV DNA was detected in 48.9% of penile...

Calmon, Marilia Freitas; Mota, Ma?nlio Tasso Oliveira; Babeto, E?rica; Candido, Nata?lia Maria; Girol, Ana Paula; Mendiburu, Carlos Fabian; Bonilha, Jane Lopes; Silvestre, Rodrigo Vellasco Duarte; Rosa, Bruno Miziara; Thome?, Jorge Alberto; Medeiros, Gustavo Hernandez Ame?rico; Soares, Fernando Augusto; Guimara?es, Gustavo Cardoso; Arruda, Jose? Germano Ferraz; Oliani, Sonia Maria

2013-01-01

247

[Therapeutic strategies in penile cancer: state of the art].  

Science.gov (United States)

A systematic review of the current treatment options and of the outcomes of penile carcinoma has been performed with special focus on controversial issues. A MedLine search using specified search terms was done during the period 1988 - January 2013. Demolitive surgery is considered as the "gold standard" treatment of invasive penile carcinoma staged higher than T2, but negative psychological outcomes were reported. On the other hand, conservative surgical techniques have been associated with higher recurrence rates. Potency-sparing technique (glansectomy and apexes sparing) preserves penile length: the reconstruction of glans anatomy and function is a key point to restore anatomy and sexual functions. Techniques such as glanduloplasty have given satisfactory anatomic, functional and sexual outcomes. Lymphadenectomy is indicated in any case of inguinal palpable nodes that persist after a course of antibiotic therapy, but also in all the cases staged T2 or higher, or in any high-grade penile cancer. It is still being debated the extension of inguinal lymphadenectomy for penile cancer: unilateral, bilateral, and extended to pelvic lymph nodes. Due to the specific radioresistance of penile cancer, radiation therapy is currently indicated in case of unresectable penile cancers with palliative intent. Chemotherapy is indicated as adjuvant therapy for stage T1-T3, N1-3, M0, or as neo-adjuvant therapy in the event of extensive pelvic and inguinal lymphadenopathies, or as palliative treatment in patients with unresectable or metastatic cancers. New chemotherapy agents such as Cis - platinum and Taxanes have shown promising results in early trials. PMID:23559129

Gulino, Gaetano; Palermo, Giuseppe; Antonucci, Michele; Racioppi, Marco; Pinto, Francesco; Sacco, Emilio; Bassi, Pier Francesco

2013-01-01

248

Penile length is normal in most men seeking penile lengthening procedures.  

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Concerns over penile size and a desire for a longer penis are common in the male population. The number of male patients seeking an andrological consultation for the problem of 'short penis' is increasing. We looked at the numbers of patients presenting to a University andrology clinic over a 2-y period and correlated their perceived penis size with the accepted norms. Sixty-seven patients were evaluated with a median age of 27 (range 16-55) complaining of 'short penis' and requesting surgica...

Gontero, Paolo

2002-01-01

249

125I seed implantation combined with bronchial arteries infusion chemotherapy for non-small cell lung cancer  

International Nuclear Information System (INIS)

Objective: To evaluate the clinical efficacy of 125I seed implantation combined with bronchial arterial infusion chemotherapy in the treatment of non-small cell lung carcinoma (NSCLC). Methods: A total of 34 patients with NSCLC were enrolled in this study between September 2007 and September 2009, and were allocated to Group A and Group B according to the self-imposed treatment. Group A were treated with BAI, and Group B were treated with the combination treatment of 125I seed implantation plus BAI. Clinical effects and survival rate were estimated. Results: 16 patients were in Group A and 18 in Group B. Complete response (CR), partial response (PR), stable disease (SD) and progressive disease (PD) were 0, 12, 3 and 1 in Group A and 2, 13, 3 and 0 in Group B, respectively. The effective rates (CR + PR %) were 75% in Group A and 83.3% in Group B. The median survival time were 7.4 months in Group A and 12.6 months in Group B respectively. Conclusion: 125I seed implantation combined with BAI + BAE is an effective and safe treatment for NSCLC. It can significantly prolong the patient's survival time. (authors)

2011-10-01

250

On the decellularization of fresh or frozen human umbilical arteries: implications for small-diameter tissue engineered vascular grafts.  

Science.gov (United States)

Most tissues, including those to be decellularized for tissue engineering applications, are frozen for long term preservation. Such conventional cryopreservation has been shown to alter the structure and mechanical properties of tissues. Little is known, however, how freezing affects decellularization of tissues. The purpose of this study was two-fold: to examine the effects of freezing on decellularization of human umbilical arteries (HUAs), which represent a potential scaffolding material for small-diameter tissue-engineered vascular grafts, and to examine how decellularization affects the mechanical properties of frozen HUAs. Among many decellularization methods, hypotonic sodium dodecyl sulfate solution was selected as the decellularizing agent and tested on fresh HUAs to optimize decellularization conditions. The efficiency of decellularization was evaluated by DNA assay and histology every 12 up to 48h. The optimized decellularization protocol was then performed on frozen HUAs. The stiffness, burst pressure, and suture retention strength of fresh HUAs and frozen HUAs before and after decellularization were also examined. It appeared that freezing decreased the efficiency of decellularization, which may be attributed to the condensed extracellular matrix caused by freezing. While the stiffness of fresh HUAs did not change significantly after decellularization, decellularization reduced the compliance of frozen HUAs. Interestingly, the stiffness of decellularized frozen HUAs was similar to that of decellularized fresh HUAs. Although little difference in stiffness was observed, we suggest avoiding freezing if more efficient and complete decellularization is desired. PMID:24682764

Tuan-Mu, Ho-Yi; Yu, Chen-Hsiang; Hu, Jin-Jia

2014-06-01

251

Combination of radiotherapy with bronchial arterial infusion and/or systemic chemotherapy for non-small cell lung cancer  

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At the beginning of April, 1986, a new protocol was adopted by us for the treatment of unresectable non-small cell lung cancer (NSCLC). It consisted of bronchial arterial infusion (BAI) of 100 mg/m{sup 2} of cisplatin (CDDP), and systemic chemotherapy (SC) with 80 mg/m{sup 2} of CDDP, 8 mg/m{sup 2} of mitomycin C (MMC) and 3 mg/m{sup 2} of vindesine (VDS) followed by radiotherapy (RT). By the end of December, 1989, 50 patients with NSCLC could receive irradiation of more than 40 Gy. They were classified into three groups according to concomitant therapy: BAI + SC + RT group (n=30), BAI + RT group (n=12) and SC + RT group (n=8). The overall response rate was 68%. The 1-year and 2-year survival rates was 68% and 26%, respectively. The median survival time was 11 months. Both response and survival rates tended to decrease with advance in clinical stage. These were no significant difference in response or survival rate between the three groups. However, the incidence of local recurrence inside the radiation field was the lowest in the BAI + SC + RT group, and distant metastasis occurred with the highest frequency in the BAI + RT group. Our results suggest that BAI is of value for controlling local recurrence and SC for lowering the incidence of distant metastasis of NSCLC when combined with RT. (author).

Soejima, Toshinori; Kushima, Takeyuki; Sakaguchi, Toshiya; Yonezawa, Kazuyuki; Hashimura, Takahisa; Imanaka, Kazufumi; Adachi, Shuji; Sako, Masao; Kono, Michio (Kobe Univ. (Japan). School of Medicine)

1991-12-01

252

Imaging in primary penile cancer: current status and future directions  

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Penile cancer is a rare neoplasm in the developed world. Clinical assessment often results in inaccurate staging and radiological techniques have a key role in staging and postoperative assessment. Magnetic resonance imaging (MRI) depicts penile anatomy in detail and is the most accurate technique for local staging and postoperative follow-up. MRI and ultrasound (US), although helpful for assessment of lymph nodes, are not reliable enough for accurate nodal staging. US-guided fine needle aspiration cytology (FNAC), however, remains a valuable tool to confirm metastases in suspicious inguinal nodes. Lymphoscintigraphy with dynamic sentinel node biopsy (DSNB) is a promising technique used to predict occult lymph node metastases. Novel imaging techniques such as positron emission tomography/computed tomography (PET-CT) and nanoparticle enhanced MRI have high sensitivity and specificity for lymph node metastases but their availability is limited and clinical utility is not fully established. The radiologist needs to be familiar with the normal penile anatomy, imaging appearances of pre- and post-treatment penile cancer, and the advantages and limitations of the available imaging techniques. This review highlights the above points and presents a systematic approach to make the best use of imaging in the management of patients with penile cancer. (orig.)

Kochhar, Rohit; Taylor, Ben [Christie, NHS Foundation Trust, Department of Radiology, Manchester (United Kingdom); Sangar, Vijay [Christie, NHS Foundation Trust, Department of Urology, Manchester (United Kingdom)

2010-01-15

253

Investigation of vascular changes following penile vein ligation.  

Science.gov (United States)

In an effort to characterize the changes in penile vasculature that occur following penile vein ligation, we performed pharmaco-cavernosometry and pharmaco-cavernosography on 20 patients after penile vein ligation for comparison with preoperative studies. Three patients with return of erectile function underwent repeat study: 2 were completely normal and 1 had a mild leak from the deep dorsal vein. The remaining 17 patients had continued complaints of erectile impairment. Of these studies 4 showed no evidence of venous leakage, 11 identified a new site of leakage (7 corporo-spongiosal shunts, 2 crural veins and 2 with multiple sites of involvement) and 1 revealed persistent leak through the proximal stump of the resected deep dorsal vein, while 1 patient had an iodine allergy and underwent pharmaco-cavernosometry only. A repeat study in the latter patient showed flow volumes consistent with continued venous leakage. In summary, penile vein ligation appears to be effective at correcting venous leakage noted on cavernosography. However, new sites of leakage frequently appear postoperatively. A corporo-spongiosal shunt was the most frequent site of recurrent venous leakage. A surprisingly high percentage of patients with continued complaints of erectile dysfunction following penile vein ligation demonstrate no venous leakage on subsequent pharmaco-cavernosography. PMID:8051743

Kerfoot, W W; Carson, C C; Donaldson, J T; Kliewer, M A

1994-09-01

254

Therapeutic efficacy of Traditional Vein Chemotherapy and Bronchial Arterial Infusion Combining with CIKs on ? Stage Non-small Cell Lung Cancer  

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Full Text Available Background and objective The therapeutic efficacy of late lung-cancer was very poor, and cytokine-induced killer cells (CIK were paid more attention to treat non-small cell lung cancer (NSCLC. The aim of this study is to get insight into the role of bronchial arterial infusion bronchial arterial infusion (BAI plus CIK about NSCLC by comparing therapeutic efficacy among BAI, traditional vein chemotherapy and BAI plus CIK, for late NSCLC. Methods A total of 120 patients were enrolled in this study, dividing randomly into three groups: bronchial arterial infusion (BAI, traditional vein chemotherapy and BAI plus CIK. Clinical effects and side effects were estimated after two period of therapy. Results The effective rate (CR+PR% of combined group is higher than the traditional vein chemotherapy group (66.67%, n=39 and there are significant differences (?2=4.721, P=0.03; The side effect of rate of BAI plus CIK group is significantly lower than the traditional vein chemotherapy group, and so did the non-bone marrow inhibition side effects (P < 0.05. The tumor progression rate (PD% of bronchial arterial infusion (BAI group is higher than combined group (?2=4.287, P=0.038. There was no difference between the traditional vein chemotherapy group and combined group (?2=0.082, P=0.775. Conclusion Bronchial Artery Infusion combined with cytokine-induced killer cells is an ideal, safety, effective comprehensive treatment method for late stage lung cancer.

Guangqiang ZHAO

2009-09-01

255

Potassium and calcium channel gene expression in small arteries in porcine and rat models of diet-induced obesity  

DEFF Research Database (Denmark)

Obesity is an increasing problem worldwide leading to cardiovascular morbidity. Only limited information exists on the transcriptional regulation of arterial K+ and Ca2+ channels in obesity. We quantified, by real-time PCR, mRNA expression of K+ channels and L-type Ca2+ channels (LTCC) in small mesenteric (MA), middle cerebral (MCA), and left coronary arteries (LCA) of lean vs. obese rats and minipigs. Male Sprague Dawley rats were fed a high-fat (FAT; N=5), high-fructose (FRUC; N=7), high-fat/high-fructose (FAT/FRUC; N=7) or standard diet (STD; N=7-11) for 28 Weeks. FAT and FAT/FRUC became obese, whereas FRUC and STD were lean. Systolic blood pressure (SBP) averaged over 14 weeks was increased (P<0.001) in FRUC and FAT/FRUC but not in FAT. Kir, Kv1.2, Kv1.5, and Kv7.4 channels were up-regulated in FAT, whereas SKca and IKca channels were down-regulated in FAT/FRUC (P<0.05). There were no transcriptional changes in FRUC. Castrated male Göttingen minipigs with or without diabetes were fed a diet rich in fat, cholesterol and fructose (OB+DIAB; N=3 vs. OB; N=2, respectively) or a standard diet (STD; N=3) for 22-45 weeks. Body weight, total body fat content and plasma triglyceride levels were increased in OB and OB+DIAB. BKca, IKca, SKca and/or LTCC mRNA was up-regulated in LCA from OB and OB+DIAB (n.s.). Expression of BKca mRNA was increased, whereas IKca mRNA decreased in MCA from OB (n.s.). SKca mRNA was decreased in MA from OB (n.s.). Diet-induced obesity in rats and minipigs lead to complex changes in K+ and Ca2+ channel gene expression, which, in rats, did not seem to be linked with changes in SBP. These transcriptional changes may lead to disturbances in microvascular flow patterns in obesity.

Jensen, Lars Jørn; Salomonsson, Max

256

Penile lesion from gunshot wound: a 43-case experience  

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Full Text Available OBJECTIVE: To demonstrate the main aspects of diagnosis, treatment and follow-up of 43 patients with gunshot wounds to the penis. MATERIALS AND METHODS: The location of the lesion, the presence of associated lesions, the performance of complementary exams, surgical treatment, postoperative complications and long term follow-up of 43 patients with penile lesions from gunshot wounds were retrospectively analyzed. RESULTS: Of 43 cases assessed, 41 were submitted to surgical exploration (95.3% and 2 were submitted to conservative treatment (4.7%. We found penile lesions involving the corpus cavernosum in 37 cases; the remaining 4 patients presented no lesions involving the corpus cavernosum, urethra or testicles but did in the superficial structures. Ten cases presented an association with testicular lesions and 14 cases association with anterior urethral lesions. CONCLUSION: Penile lesions from gunshot wounds should be treated with immediate surgical intervention. In exceptional situations featuring superficial lesions only conservative treatment may be applied.

Cavalcanti Andre G.

2006-01-01

257

Lymph node metastases and prognosis in penile cancer.  

Science.gov (United States)

Lymph node status is a key prognostic factor in penile squamous cell carcinoma. Recently, growing evidence indicates a multimodality approach consisting of neoadjuvant chemotherapy followed by consolidation surgery improves the outcome of locally advanced penile cancer. Thus, accurate estimation of survival probability in node-positive penile cancer is critical for treatment decision making, counseling of patients and follow-up scheduling. This article reviewed evolving developments in assessing the risk for cancer progression based on lymph node related variables, such as the number of metastatic lymph nodes, bilateral lymph node metastases, the ratio of positive lymph nodes, extracapsular extension of metastatic lymph nodes, pelvic lymph node metastases, metastatic deposit in sentinel lymph nodes and N stage in TNM classification. Controversial issues surrounding the prognostic value of these nodal related predictors were also discussed. PMID:23359765

Zhu, Yao; Ye, Ding-Wei

2012-06-01

258

Penis auto-amputation and chasm of the lower abdominal wall due to advanced penile carcinoma: a case report  

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Abstract Introduction Penile cancer is uncommon. When penile cancer is left untreated, at an advanced stage it can have tragic consequences for the patient. Case presentation Our case report does not concern a new manifestation of penile cancer, but an interesting presentation with clinical significance that emphasizes the need to diagnose and treat penile cancer early. It is an unusual case of a neglected penile cancer in a 57-year-old Greek man that led to aut...

2011-01-01

259

Overexpression of ANXA1 in penile carcinomas positive for high-risk HPVs.  

Science.gov (United States)

The incidence of penile cancer varies between populations but is rare in developed nations. Penile cancer is associated with a number of established risk factors and associated diseases including phimosis with chronic inflammation, human papillomavirus (HPV) infection, poor hygiene and smoking. The objective of this study was to identify genes related to this type of cancer. The detection of HPV was analyzed in 47 penile squamous cell carcinoma samples. HPV DNA was detected in 48.9% of penile squamous cell carcinoma cases. High-risk HPV were present in 42.5% of cases and low-risk HPV were detected in 10.6% of penile squamous cell carcinomas. The RaSH approach identified differential expression of Annexin A1 (ANXA1), p16, RPL6, PBEF1 and KIAA1033 in high-risk HPV positive penile carcinoma; ANXA1 and p16 were overexpressed in penile squamous cells positive for high-risk HPVs compared to normal penile samples by qPCR. ANXA1 and p16 proteins were significantly more expressed in the cells from high-risk HPV-positive penile carcinoma as compared to HPV-negative tumors (p<0.0001) independently of the subtype of the carcinoma. Overexpression of ANXA1 might be mediated by HPV E6 in penile squamous cell carcinoma of patients with high-risk HPVs, suggesting that this gene plays an important role in penile cancer. PMID:23341933

Calmon, Marilia Freitas; Mota, Mnlio Tasso de Oliveira; Babeto, rica; Candido, Natlia Maria; Girol, Ana Paula; Mendiburu, Carlos Fabian; Bonilha, Jane Lopes; Silvestre, Rodrigo Vellasco Duarte; Rosa, Bruno Miziara; Thom, Jorge Alberto; Medeiros, Gustavo Hernandez Amrico; Soares, Fernando Augusto; Guimares, Gustavo Cardoso; de Arruda, Jos Germano Ferraz; Oliani, Sonia Maria; Villa, Luisa Lina; Vassallo, Jos; Rahal, Paula

2013-01-01

260

Tadalafil rehabilitation therapy preserves penile size after bilateral nerve sparing radical retropubic prostatectomy  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english OBJECTIVE: To evaluate the change in penile size r bilateral nerve sparing retropubic radical prostatectomy (BNSRRP) and possible effect of Tadalafil. MATERIALS AND METHODS: A total of 65 patients underwent BNSRRP and they were evaluated prospectively for a whole year of follow-up . The patients wer [...] e randomized to control without rehabilitation (Group 1) or Tadalafil rehabilitation group (Group 2). The patients were evaluated at months 3, 6 and 12 postoperatively for erectile function, penile measurements (flaccid penile length, penile length at maximum erection, penile circumference at flaccid status, and penile circumference at maximum erection), penile abnormalities and general health status. Statistical analysis was performed by Chi-Square test and significance was defined as p value

Ozgu, Aydogdu; Mehmet Ilker, Gokce; Berk, Burgu; Sumer, Baltaci; Onder, Yaman.

 
 
 
 
261

Traumatic degloving lesion of penile and scrotal skin  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english Avulsions of penile and scrotal skin are uncommon events and are caused mainly by accidents with industrial machines and agricultural machine belts. We report the case of a 30-year old patient with avulsion and traumatic degloving of the penile and scrotal skin, with exposure of the cavernous bodies [...] , spongy body, and testes due to an industrial machine accident. Reconstruction was performed in steps, achieving a satisfactory esthetic result, normal voiding and reestablished sexual function.

Zanettini, Luiz A.; Fachinelli, Aldo; Fonseca, Gabriela P..

262

A microbiological study of penile ulcers with clinical correlation  

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Full Text Available A microbiological study was conducted on 100 men with penile ulcers. Thirty eight cases with infection due to H ducreyi, 12 cases with Treponemal infection, 3 with Herpes and 2 with Calymmatobacterium granulomatis were detected. N. gonorrhoeae was isolated from 2 cases with ulcer confluent with the urinary meatus. Mixed infections were identified in 17 cases. No cause of ulceration could be found in 26 cases. A polymicrobial flora was identified in the ulcers of all patients. A past history of penile ulcers was more common in patients who were HIV antibody positive.

D?souza K

1992-01-01

263

Exposure and characterization of the action of noradrenaline at dopamine receptors mediating endothelium-independent relaxation of rat isolated small mesenteric arteries.  

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1. Previously, we reported that noradrenaline (NA), in addition to its alpha 1-adrenoceptor-mediated contractile effect, may relax the rat small mesenteric artery (SMA) in order to account for steep Schild plots obtained with compounds classified as alpha 1-adrenoceptor antagonists. In this study, a relaxant action of NA has been exposed in the rat isolated, endothelium-denuded SMA precontracted by the thromboxane A2-mimetic, U46619. 2. NA, but not the selective alpha 2-adrenoceptor agonist, ...

Graaf, P. H.; Saxena, P. R.; Shankley, N. P.; Black, J. W.

1995-01-01

264

Small dense LDL particles--a predictor of coronary artery disease evaluated by invasive and CT-based techniques: a case-control study  

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Coronary angiography is the current standard method to evaluate coronary atherosclerosis in patients with suspected angina pectoris, but non-invasive CT scanning of the coronaries are increasingly used for the same purpose. Low-density lipoprotein (LDL) cholesterol and other lipid and lipoprotein variables are major risk factors for coronary artery disease. Small dense LDL particles may be of particular importance, but clinical studies evaluating their predictive value for coronary atherosclerosis are few.

Toft-Petersen, Anne P; Hansen, Hans-Henrik Tilsted

2011-01-01

265

Assessment of arterial tumor vascularity in small hepatocellular carcinoma. Comparison between color Doppler ultrasonography and radiographic imagings with contrast medium: dynamic CT, angiography, and CT hepatic arteriography  

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Hepatocellular carcinoma (HCC) is characterized by tumor vascularization from the hepatic artery. The objective of our work was to compare color Doppler ultrasonography (CDU), including power Doppler ultrasonography (PDU) with radiographic imagings with contrast medium in regard to the detection of the arterial tumor vascularity of small hepatocellular carcinomas (HCC). We examined 42 small HCC lesions 2 cm or less in diameter in 37 patients for arterial tumor vascularity by conventional CDU, PDU, dynamic computed tomography (dCT), digital subtraction angiography (DSA), and CT hepatic arteriography (CTA). Color images were detected in 25 (59.5%) and 28 (66.7%) of the 42 lesions with conventional CDU and PDU, respectively, and tumor vascularity was detected in 26 (61.9%) by dCT, 23 (54.8%) by DSA, and 29 (69.0%) by CTA. Tumor vascularity could be detected in 51.9% by PDU and CTA, more than by conventional CDU, dCT, and DSA (44.4, 44.4, and 33.3%, respectively) in well-differentiated HCC, whereas the detection rates by these techniques were almost equal (86.7% by CDU, 93.3% by PDU, dCT, and DSA, 100% by CTA, respectively) in moderately and poorly differentiated HCC. PDU is superior to CDU, dCT and DSA and equal to CTA for the detection of tumor vascularity in small HCC, particularly in well-differentiated HCC.

Furuse, Junji E-mail: jfuruse@east.ncc.go.jp; Maru, Yasushi; Yoshino, Masahiro; Mera, Kiyomi; Sumi, Hajime; Sekiguchi, Ryuzo; Satake, Mitsuo; Hasebe, Takahiro; Ochiai, Atsushi

2000-10-01

266

Assessment of arterial tumor vascularity in small hepatocellular carcinoma. Comparison between color Doppler ultrasonography and radiographic imagings with contrast medium: dynamic CT, angiography, and CT hepatic arteriography  

International Nuclear Information System (INIS)

Hepatocellular carcinoma (HCC) is characterized by tumor vascularization from the hepatic artery. The objective of our work was to compare color Doppler ultrasonography (CDU), including power Doppler ultrasonography (PDU) with radiographic imagings with contrast medium in regard to the detection of the arterial tumor vascularity of small hepatocellular carcinomas (HCC). We examined 42 small HCC lesions 2 cm or less in diameter in 37 patients for arterial tumor vascularity by conventional CDU, PDU, dynamic computed tomography (dCT), digital subtraction angiography (DSA), and CT hepatic arteriography (CTA). Color images were detected in 25 (59.5%) and 28 (66.7%) of the 42 lesions with conventional CDU and PDU, respectively, and tumor vascularity was detected in 26 (61.9%) by dCT, 23 (54.8%) by DSA, and 29 (69.0%) by CTA. Tumor vascularity could be detected in 51.9% by PDU and CTA, more than by conventional CDU, dCT, and DSA (44.4, 44.4, and 33.3%, respectively) in well-differentiated HCC, whereas the detection rates by these techniques were almost equal (86.7% by CDU, 93.3% by PDU, dCT, and DSA, 100% by CTA, respectively) in moderately and poorly differentiated HCC. PDU is superior to CDU, dCT and DSA and equal to CTA for the detection of tumor vascularity in small HCC, particularly in well-differentiated HCC

2000-10-01

267

Argon-helium cryoablation combined with bronchial artery infusion for the treatment of advanced non-small cell lung carcinoma  

International Nuclear Information System (INIS)

Objective: To investigate the technique, efficacy and clinical significance of argon-helium cryoablation combined with bronchial artery infusion (BAI) for the treatment of advanced non-small cell lung carcinoma. Methods: Twenty patients, who met the requirements of this study, were divided into two groups. Patients in group A, were treated with argon-helium cryoablation only, whereas those in group B were treated with argon-helium cryoablation combined with BAI. Four week after the treatment, check-up CT scan or DSA were carried out. CT value of the tumor area both before and after the procedure was measured and compared.The clinical efficacy was evaluated based on the CT value, the parameters of CT perfusion imaging, RECIST criteria and the median survival time. Breslow method was used to figure out the median survival time and to draw the survival curves. Results: The coverage of spherical frozen region was over 90% in 80% patients (16/20). The difference was of no significance in the coverage between two groups (P > 0.05). The CT value of group A and group B was (16.73 9.43) Hu and (15.29 6.98) Hu, respectively, with no significant difference (P > 0.05). The blood flow (BF), blood volume (BV) and PS before the treatment were significantly different from that after the treatment in both group A and group B (P < 0.05). The difference in BV between two groups was statistically significant (P < 0.05). The therapeutic effect of group B was better than that of group A. During the follow-up period, 10 of the 20 patients died. The longest survival time was 20 months and the shortest survival time was 7 months, with the median survival time of 9 months in group A and 14 months in group B. By using Breslow method, the difference between two groups was of statistical significance (P < 0.05). The survival curves showed that the survival rate of group B was higher than that of group A. Conclusion: Argon-helium cryoablation combined with BAI is a safe and effect treatment for advanced non-small cell lung carcinoma, and its clinical efficacy is better than that of using cryoablation alone. CT perfusion imaging can reflex the changes after the operation, which is very helpful in accurately evaluating the therapeutic results. (authors)

2009-07-01

268

[A case of scrotal elephantiasis 30 years after treatment of penile carcinoma].  

Science.gov (United States)

A 67-year-old man visited our hospital with complaints of scrotal swelling associated with occasional febrile episodes. Physical examination disclosed a huge scrotal mass, approximately the size of a child's head, with numerous papillomatous lesions on its surface. His past medical history was significant in that he was diagnosed with penile carcinoma at the age of 35 years old and was treated with partial penectomy followed by radiation and chemotherapy at other hospital. During this admission tumor marker squamous cell carcinoma (SCC) and microbiological tests for mcroflariae were both negative. Ultrasound (US), computed tomographic (CT) scan and magnetic resonance imaging (MRI) revealed markedly thickened scrotal skin and small hydrocele with no evidence of local recurrence of the previous penile carcinoma. A percutaneous cystostomy was created because of chronic urinary retention and possible urine extravasation into the scrotum. Histopathological examination of the biopsy specimen from the scrotal mass demonstrated lymphangiectasia consistent with elephantiasis of the scrotum. Surgical excision of this huge scrotal mass was performed in August 1997. The resected tissue weighed 1,400 g. Convalescene was uneventful. He subsequently underwent perineal urethrostomy in place of the suprapubic cystostomy. PMID:9893234

Horinaga, M; Masuda, T; Jitsukawa, S

1998-11-01

269

Penile prosthesis in the surgical treatment of Peyronie's disease  

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Peyronie's disease appears to be a condition of middle-aged men. In many of them, the disease is accompanied by erectile dysfunction, which, until recently, was attributed to penile deformity. Later, it turned out that the erectile dysfunction has the same causes as in men without Peyronie's disease with vascular and psychological components.

2012-01-01

270

Priapism secondary to penile metastasis in a dog  

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A 4-year-old, male Newfoundland cross was presented for lethargy, anorexia, and dysuria. The main clinical finding was an enlarged and painful prostate gland. While the dog was hospitalized, priapism developed. Following euthanasia, microscopic examination revealed that a carcinoma involving both bladder and prostate gland had widely metastasized to the penile vasculature.

Rogers, Laura; Lo?pez, Alfonso; Gillis, Ann

2002-01-01

271

Successful microsurgical penile replantation after a workplace injury.  

Science.gov (United States)

Microsurgical techniques offer the opportunity for successful replantation of the amputated penis. We report the case of a patient who sustained a traumatic penile amputation as a result of a workplace accident. Microsurgical replantation was achieved with combined urological and plastic surgical input. PMID:17192726

Fuller, Andrew; Bolt, John; Carney, Bernard

2007-01-01

272

Penile length of newborns and children in Surakarta, Indonesia  

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Full Text Available Background Penile length is a factor for assessing abnormalities in external genitalia. To diagnose micropenis, a condition in which penile length is 36 weeks newborns were 1.88 (SD 0.14 cm and 2.37 (SD 0.26 cm, respectively. The mean penile lengths by age groupings were as follows: 0-<6 months, 2.67 (SD 0.58 cm; 6-<12 months, 2.67 (SD 0.58 cm; 1-<3 years, 2.80 (SD 0.84 cm; 3-<5 years, 3.50 (SD 0.55 cm; 5-<7 years, 3.50 (SD 0.71 cm; 7-<9 years, 3.85 (SD 0.53 cm; 9-<11 years, 4.50 (SD 0.71 cm; 11-<13 years, 4.63 (SD 1.13 cm; 13-<15 years, 5.53 (SD 1.45 cm; and 15-18 years, 6.16 (SD 1.19 cm.Conclusion Normal penile length in boys in Surakarta is smaller than the normal range reference currently in use.

Annang Giri Moelyo

2013-03-01

273

Penile length of newborns and children in Surakarta, Indonesia  

Directory of Open Access Journals (Sweden)

Full Text Available Background Penile length is a factor for assessing abnormalities in external genitalia. To diagnose micropenis, a condition in which penile length is 36 weeks newborns were 1.88 (SD 0.14 cm and 2.37 (SD 0.26 cm, respectively. The mean penile lengths by age groupings were as follows: 0-<6 months, 2.67 (SD 0.58 cm; 6-<12 months, 2.67 (SD 0.58 cm; 1-<3 years, 2.80 (SD 0.84 cm; 3-<5 years, 3.50 (SD 0.55 cm; 5-<7 years, 3.50 (SD 0.71 cm; 7-<9 years, 3.85 (SD 0.53 cm; 9-<11 years, 4.50 (SD 0.71 cm; 11-<13 years, 4.63 (SD 1.13 cm; 13-<15 years, 5.53 (SD 1.45 cm; and 15-18 years, 6.16 (SD 1.19 cm. Conclusion Normal penile length in boys in Surakarta is smaller than the normal range reference currently in use. [Paediatr Indones. 2013;53:65-9.].

Annang Giri Moelyo

2013-03-01

274

Simple, safe, and satisfactory secondary penile enhancement after near-total oncologic amputation.  

Science.gov (United States)

After oncologic penile amputation, the penile stump may prove of insufficient length, causing poor personal hygiene and scrotal excoriation and an inability to void while standing. In these cases, penile enhancement by uncovering its subcutaneous parts may offer a simple and satisfactory solution.From August 2003 to August 2007, penile enhancement was performed in 6 patients with a mean age of 63 years (range, 51-69 years) and only 1 cm (range, 0-1.5 cm) of remaining penile length when standing up.The skin on the penile stump was used to recreate a neoglans. The subcutaneously covered penile shaft was dissected deep to Buck's fascia up into the deep suspensory ligament. Ventrally, the bulbospongeous muscle was laid bare over 1 to 2 cm. After resection of pubic subcutaneous fat, the pubic and scrotal skin edges were anchored to the suspensory ligament, bulbospongious fascia, and tunica albuginea. The resulting bare surface of the penile shaft was covered by a skin graft.Partial neoglandular skin slough was observed in 2 patients and could be treated conservatively in both. Penile lymphedema was observed in the 1 patient whom had previously undergone radiotherapy. This was treated by secondary subcutaneous resection and skin tightening. At a mean follow-up of 2.5 years (range, 1-5 years), the cosmetic appearance was acceptable in all patients and their penile length ranged from 7.5 to 9 cm. All were able to void while standing without soiling themselves. PMID:19461286

Hage, J Joris

2009-06-01

275

Temporary Semi-Jailing Technique for Coil Embolization of Wide-Neck Aneurysm with Small Caliber Parent Artery Following Incomplete Clipping  

Science.gov (United States)

The authors describe the use of a self-expandable stent in a temporary deployment for treatment of a very wide-neck A1 segment of anterior cerebral artery (ACA) aneurysm following incomplete clipping. A 39-year-old hypertensive man presenting with seizure-like movement underwent computed tomography, which showed acute subarachnoid hemorrhage and an A1 segment of ACA aneurysm with superior and inferior projection. He underwent surgical clipping of the aneurysm, but superior and posterior portion of wide-neck aneurysm remained. We decided to treat the remnant aneurysm using an endovascular modality. After selection of the aneurysm, coil packing was performed assisted by the temporary semi-jailing technique. The Enterprise stent (Cordis Neurovascular, Miami, FL, USA) was deployed and recaptured repeatedly for angiography to ensure safety of the small caliber parent artery. Successful semi-deployment and recapture of the stent allowed subtotal coil occlusion of the aneurysm with good anatomic and clinical results. No complications were encountered. The stent could be recaptured up to the point where the proximal end of the stent marker was aligned with distal marker band of the microcatheter, approximately 70% of the stent length. The temporary semi-jailing technique is feasible for wide-neck aneurysm with small caliber parent artery.

Kim, Jae Kyun; Lee, Hwa Yeon; Hwang, Sung Nam

2013-01-01

276

Treatment of small coronary arteries with a paclitaxel-coated balloon catheter in the PEPCAD I study: are lesions clinically stable from 12 to 36 months?  

Science.gov (United States)

Aims: The one-year outcome of lesions in small coronary arteries by using a paclitaxel-iopromide-coated (3 g/mm) balloon catheter (DCB) has yielded good six-month angiographic and one-year clinical data. We now report the three-year clinical follow-up. Methods and results: One hundred and twenty patients with >70% stenoses <22 mm in length in small coronary vessels (vessel diameter: 2.25-2.8 mm) were treated with the DCB. The primary endpoint was angiographic in-segment late lumen loss. The secondary endpoints encompassed all other angiographic and clinical data up to three years post intervention. In total 82/120 (68.3%) patients with a vessel diameter of 2.350.19 mm were treated with the DCB only, and 32/120 (26.7%) patients required additional bare metal stent (BMS) deployment. Both the 12- and 36-month major adverse cardiac event rates were 5/82 (6.1%) for DCB only and 12/32 (37.5%) for DCB+BMS, primarily due to the need for target lesion revascularisation in 4/82 (4.9%) patients and 9/32 (28.1%) (p<0.001) patients, respectively. Total MACE rate after 36 months was 18/120 (15%; intention-to-treat). Conclusions: Treatment of small vessel coronary artery disease with a paclitaxel-iopromide-coated balloon exhibited good six-month angiographic and one-year clinical data that persisted during the three-year follow-up period. Randomised trials will clarify its role as an alternative to drug-eluting stents in the treatment of small vessel coronary artery disease. (ClinicalTrials.gov Identifier: NCT00404144). PMID:24058078

Unverdorben, Martin; Kleber, Franz X; Heuer, Hubertus; Figulla, Hans-Reiner; Vallbracht, Christian; Leschke, Matthias; Cremers, Bodo; Hardt, Stefan; Buerke, Michael; Ackermann, Hanns; Boxberger, Michael; Degenhardt, Ralf; Scheller, Bruno

2013-09-01

277

The imaging findings of small(?15mm) portal defects in the liver on CT arterial portography : evaluation with CT hepatic arteriography and lipiodol CT  

International Nuclear Information System (INIS)

To assess the malignant potential of small(?15mm) portal defects seen on CT arterial portography, the findings of CT hepatic arteriography and lipiodol CT were reviewed. In 91 patients who underwent both CTAP and CTHA, small portal defects were reviewed for frequency, multiplicity and location. We prospectively evauluated changes in the size and enhancement pattern of malignant lesions on follow up CT according to density on CTHA, location, lipiodol deposits on lipiodol CT, and multiplicity. Among the 91 patients, 102 small defects were defected in 42 patients(46%). Small portal defects were benign, malignant, and of undetermined malignant potential in 77%, 20% and 3% of cases, respectively. Small portal defects that were hyperattenuated on CTHA, and lipiodol deposits on lipiodol CT, were malignant in 42% and 70% of cases, respectively. Location and multiplicity did not show statistically significant variation between benign and malignant defects. Small portal defects are common and there is a high probability that portal defects smaller than 15mm are benign, even in patients with a known hepatic mass and defect that was hyperattenuated on CTHA. If a small defect showed lipiodol deposit on lipiodol CT, malignancy must be suspected

1999-05-01

278

Referrals into a dedicated British penile cancer centre and sources of possible delay.  

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Abstract Objective: To assess sources of delay in referral to a specialist Urology clinic for penile cancer. Methods: Patients with penile cancer seen during the period December 2002 - December 2007 were identified from the units database. Information regarding presentation, diagnosis, and pattern of referral was retrieved from records. Delay was defined as the time between the patient first noticing a penile lesion and date of first seeking medical advice, or additio...

2009-01-01

279

Penile cancer: is there an epidemiological role for smoking and sexual behaviour?  

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A retrospective study was carried out to determine whether penile cancer, like cervical cancer, was associated with smoking and sexual behaviour. Altogether 244 men with penile cancer and 232 matched controls completed a questionnaire by post or telephone. Data on marital state, socioeconomic group, occupation, history of phimosis and balanitis, sexual behaviour, and smoking were obtained. The results of statistical analyses confirmed that phimosis and balanitis were risk factors for penile c...

Hellberg, D.; Valentin, J.; Eklund, T.; Nilsson, S.

1987-01-01

280

Tadalafil rehabilitation therapy preserves penile size after bilateral nerve sparing radical retropubic prostatectomy  

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Full Text Available OBJECTIVE: To evaluate the change in penile size r bilateral nerve sparing retropubic radical prostatectomy (BNSRRP and possible effect of Tadalafil. MATERIALS AND METHODS: A total of 65 patients underwent BNSRRP and they were evaluated prospectively for a whole year of follow-up . The patients were randomized to control without rehabilitation (Group 1 or Tadalafil rehabilitation group (Group 2. The patients were evaluated at months 3, 6 and 12 postoperatively for erectile function, penile measurements (flaccid penile length, penile length at maximum erection, penile circumference at flaccid status, and penile circumference at maximum erection, penile abnormalities and general health status. Statistical analysis was performed by Chi-Square test and significance was defined as p value < 0.05. RESULTS: In Group 1 there was significant decrease in penile measurements at month 3 compared to preoperative measurements. There was decrease in all parameters at month 6 compared to month 3 but only the decrease in penile length at maximum erection was significant. There were no significant differences between postoperative months 6 and 12 for all measurements. In Group 2 there was a tendency to decrease in all measurements at month 3 compared to baseline. There was no significant difference for penile measurements between postoperative 3rd and 6th months and between 6th month and the first year. CONCLUSION: Although further large sampled trials are needed to describe the possible positive effect of tadalafil or other PDE5-I's on penile size after BNSRRP, tadalafil rehabilitation is effective in preserving penile size especially in the early postoperative period after BNSRRP.

Ozgu Aydogdu

2011-06-01

 
 
 
 
281

Evidence that acetylcholine-mediated hyperpolarization of the rat small mesenteric artery does not involve the K+ channel opened by cromakalim.  

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1. Acetylcholine causes a concentration-dependent hyperpolarization of the rat small mesenteric artery (diameter at 100 mmHg, 200-400 microns). In the absence of tone the average potential change was from approximately -60 to -75 mV. In the presence of tone induced by endothelin-1 (20 nM), acetylcholine caused vasorelaxation in association with a marked hyperpolarization; from approximately -32 to -71 mV. 2. A number of compounds known to antagonize the actions of cromakalim were tested for t...

Mcpherson, G. A.; Angus, J. A.

1991-01-01

282

Our 8 Years Experience on Penile Fractures: The Diagnosis and Treatment  

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Full Text Available Aim: The purpose of this study to present our experience with diagnosis and treatment management of penile fracture. Material and Method: Patients who were admitted our clinic with complaints of sudden penile swelling and pain during 8 years were screened. Clinical information of 30 patients aged between 16 and 45 retrospectively analyzed. The patients had applied to emergency room during the first 10 hours following penile swelling and pain. Results: Penile fracture was detected in 28 patients and dorsal penile vein rupture mimicking penile fracture was detected in 2 patients. The most common etiologies of penile fracture were coitus and manually bending the penis for detumescence. Diagnoses were made based on history and physical examination. The treatment was surgical in 28 cases with subcoronal circumferential degloving incision and 2 patients were treated with vein ligation due to dorsal vein rupture. Erectile dysfunction or penile curvature were not detected (except the last five cases during a mean follow up of 18.7 months (range 8-28. Discussion: Although conservative treatment options were adviced, many authors prefer surgery because of the rapid recovery, short hospitalization duration, less morbidity and less penil curvature during the long term period.

Mustafa Gunes

2012-10-01

283

Blood pressure, arterial compliance, and left ventricular mass: no relation to small size at birth in south Indian adults  

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OBJECTIVETo determine whether reduced fetal growth leads to raised blood pressure, reduced arterial compliance, and increased left ventricular mass in an Indian population.?DESIGNA retrospective cohort study of men and women (age range 40-61 years) whose weight, length, and head circumference at birth were recorded.?SETTINGThe Holdsworth Memorial Hospital, Mysore, South India.?SUBJECTS435 men and women born in the hospital between 1934and 1953.?MAIN OUTCO...

2000-01-01

284

Successful microsurgical penile replantation following self amputation in a schizophrenic patient.  

Science.gov (United States)

Amputation of the penis is a rare condition reported from various parts of the world as isolated cases or small series of patients; the common etiology is self-mutilating sharp amputation or an avulsion or crush injury in an industrial accident. A complete reconstruction of all penile structures should be attempted in one stage which provides the best chance for full rehabilitation of the patient. We report here a single case of total amputation of the penis in an acute paranoid schizophrenic patient. The penis was successfully reattached using a microsurgical technique. After surgery, near-normal appearance and function including a good urine flow and absence of urethral stricture, capabilities of erection and near normal sensitivity were observed. PMID:21116370

Gyan, Saurabh; Sushma, Sagar; Maneesh, Singhal; Rajesh, Sagar; Misra, Mc

2010-07-01

285

Penile strangulation and necrosis due to condom catheter.  

Science.gov (United States)

Condom catheters are often used in the management of male urinary incontinence, and are considered to be safe. As condom catheters are placed on the male genitalia, sometimes adequate care is not taken after placement owing to poor medical care of debilitated patients and feelings of embarrassment and shame. Similarly, sometimes the correct size of penile sheath is not used. Strangulation of penis due to condom catheter is a rare condition; only few such cases have been reported in the literature. Proper application and routine care of condom catheters are important in preventing this devastating complication especially in a neurologically debilitated population. We present a case of penile necrosis due to condom catheter. We will also discuss proper catheter care and treatment of possible complications. PMID:23758994

Ozkan, Heval S; Irkoren, Saime; Sivrio?lu, Nazan

2013-06-11

286

Metachronous penile metastasis from rectal cancer after total pelvic exenteration  

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Despite its abundant vascularization and extensive circulatory communication with neighboring organs, metastases to the penis are a rare event. A 57-year-old male, who had undergone total pelvic exenteration for rectal cancer sixteen months earlier, demonstrated an abnormal uptake within his penis by positron emission tomography/computed tomography. A single elastic nodule of the middle penis shaft was noted deep within Bucks fascia. No other obvious recurrent site was noted except the penile...

Kimura, Yuta; Shida, Dai; Nasu, Keiichi; Matsunaga, Hiroki; Warabi, Masahiro; Inoue, Satoru

2012-01-01

287

Penile lesion from gunshot wound: a 43-case experience  

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OBJECTIVE: To demonstrate the main aspects of diagnosis, treatment and follow-up of 43 patients with gunshot wounds to the penis. MATERIALS AND METHODS: The location of the lesion, the presence of associated lesions, the performance of complementary exams, surgical treatment, postoperative complications and long term follow-up of 43 patients with penile lesions from gunshot wounds were retrospectively analyzed. RESULTS: Of 43 cases assessed, 41 were submitted to surgical exploration (95.3%) a...

Cavalcanti, Andre G.; Renato Krambeck; Alexandre Araujo; Manes, Carlos H.; Favorito, Luciano A.

2006-01-01

288

Penile Degloving Injury in an Adolescent with Congenital Hypothyroid  

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This case follows a 17-year-old boy with congenital hypothyroidism who sustained penile skin avulsion secondary to a dog bite. Initially, an attempt was made to repair the wound using the avulsed skin flap itself as coverage. The repair was done immediately upon presentation to enhance the chances of adequate flap viability; however, the dorsal portion of the reconstruction necrosed within the following week. Ultimately a full thickness surgical graft (FTSG) repair was performed to ensure the...

Kiffin, Chauniqua; Porcelli, Matthew; Prychyna, Oksana; Pazmino, Byron; Pust, Daniel; Decostanza, Joseph

2012-01-01

289

Penile Prosthesis Implantation for Treatment of Postpriapism Erectile Dysfunction  

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Full Text Available Normal 0 false false false MicrosoftInternetExplorer4 st1:*{behavior:url(#ieooui } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} Introduction: Our aim was to evaluate the procedure and outcome of penile prosthesis surgery in the treatment of men with postpriapism erectile dysfunction. Materials and Methods: During the period between 1997 and 2004, a total of 17 patients with postpriapism erectile dysfunction underwent penile prosthesis implantation at our institution. Prosthesis implantation was done electively 6 to 18 months after priapism, when the patients presented with erectile dysfunction. Of the prosthesis implanted, 11 were malleable, 4 were 2-piece, and 2 were 3-piece prostheses (AMS, Minnetonka, Minnesota, USA. Results: All the 17 patients were successfully implanted with penile prosthesis. Intra-operatively, corporeal dilation was difficult due to extensive corporeal fibrosis, which led to urethral injury in 2 patients. There were no major postoperative complications. The median hospital stay was 5 days. The follow-up period ranged from 2 to 9 years (median, 6 years. All the patients were satisfied with the prosthesis. Conclusion: Penile prosthesis implantation is the modality of treatment for patients with postpriapism erectile dysfunction at our institution. It has a high patient satisfaction rate. Although procedure-related complications are common due to corporeal fibrosis, they were mostly minor ones and did not affect the outcome of the procedure.

Akbar A Jalal

2008-06-01

290

Long-time results after surgical correction of penile curvature  

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We performed a retrospective statistical evaluation of the success rate of a surgical correcture of penile curvature by use of a patient questionnaire, specifically considering the patient?s subjective satisfaction with the postoperative results. Neither the choice of surgical technique nor the observation period have some significant influence to the postoperative success rate. On the other hand ? with objectively comparable postoperative results ? considering the subjective p...

2005-01-01

291

Annualr elastolytic giant cell granuloma with penile involvement  

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Full Text Available Annular elastolytic giant cell granuloma is a recently described entity of unknown origin that presents as indolently growing papules and plaques over sun-exposed skin. Histology shows a granulomatous infiltrate with loss of elastin in the center of the lesion. We came across a patient who had penile lesions and a paucity of literature about the involvement of the external genitalia in this disorder.

Sengupta Sujata

2006-01-01

292

Penile tourniquet injury due to a coil of hair  

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Penile strangulation caused by a coil of hair is frequently an unrecognized clinical entity with several potential complications, such as necrosis of glans penis, urethrocutaneous fistulae and partial or complete amputation of the glans. We report on a 7 year old boy with a tourniquet injury to the penis secondary to strands of hair being tied around the glans at the level of the corona.

2006-01-01

293

Penile tourniquet injury due to a coil of hair  

Directory of Open Access Journals (Sweden)

Full Text Available Penile strangulation caused by a coil of hair is frequently an unrecognized clinical entity with several potential complications, such as necrosis of glans penis, urethrocutaneous fistulae and partial or complete amputation of the glans. We report on a 7 year old boy with a tourniquet injury to the penis secondary to strands of hair being tied around the glans at the level of the corona.

Chaware Suresh

2006-01-01

294

Molecular Research in Penile CancerLessons Learned from the Past and Bright Horizons of the Future?  

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Penile cancer is a rare tumor. There is a limited understanding of the biological mediators of prognostic and therapeutic importance in penile cancer. However, there exists some fundamental understanding of the major pathways involved in the development of penile pre-neoplastic lesions and neoplasms. The aim of the present review is to highlight our current state of molecular knowledge in penile cancer to foster the necessary tools for researchers to pave major advancements in our current tre...

Chris Protzel; Spiess, Philippe E.

2013-01-01

295

Non-visualization of sentinel lymph nodes in penile carcinoma  

International Nuclear Information System (INIS)

The purpose of this study was to analyse the incidence and cause of non-visualization of sentinel lymph nodes on preoperative lymphoscintigrams for penile cancer and its implications for further management. Preoperative lymphoscintigraphy was performed after injection of 99mTc-labelled nanocolloid in 123 clinically node-negative penile carcinoma patients. Anterior dynamic lymphoscintigraphy was performed during 20 min immediately after tracer injection. Subsequently, 5-min anterior and lateral static images were obtained 30 min and 2 h post injection. Lymphatic drainage to both groins was seen in 98 patients (79%), unilateral drainage in 23 patients (19%) and no drainage at all in two patients (2%). Thus, in 27 (11%) of 246 groins, no sentinel node was visualized. The amount of administered tracer dose was associated with non-visualization (p=0.01). Unilateral drainage was initially interpreted as a normal physiological phenomenon. After the occurrence of a tumour-positive node in a non-visualized groin, we explore non-visualized groins by blue dye mapping and intraoperative palpation. Sentinel nodes were retrieved in four out of eight such groins, of which one contained metastasis. In penile carcinoma patients, preoperative lymphoscintigraphy visualizes a sentinel node in 89% of groins. Visualization depends on the administered tracer dose. It is worthwhile to explore non-visualized groins. Sentinel nodes can be intraoperatively identified in more than half of these cases. (orig.)

2005-09-01

296

Penile lesion from gunshot wound: a 43-case experience  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english OBJECTIVE: To demonstrate the main aspects of diagnosis, treatment and follow-up of 43 patients with gunshot wounds to the penis. MATERIALS AND METHODS: The location of the lesion, the presence of associated lesions, the performance of complementary exams, surgical treatment, postoperative complicat [...] ions and long term follow-up of 43 patients with penile lesions from gunshot wounds were retrospectively analyzed. RESULTS: Of 43 cases assessed, 41 were submitted to surgical exploration (95.3%) and 2 were submitted to conservative treatment (4.7%). We found penile lesions involving the corpus cavernosum in 37 cases; the remaining 4 patients presented no lesions involving the corpus cavernosum, urethra or testicles but did in the superficial structures. Ten cases presented an association with testicular lesions and 14 cases association with anterior urethral lesions. CONCLUSION: Penile lesions from gunshot wounds should be treated with immediate surgical intervention. In exceptional situations featuring superficial lesions only conservative treatment may be applied.

Cavalcanti, Andre G.; Krambeck, Renato; Araujo, Alexandre; Manes, Carlos H.; Favorito, Luciano A..

297

Surgical reimplantation of penile glans amputation in children during circumcision.  

Science.gov (United States)

Circumcision is one of the oldest and most commonly performed surgical procedures. Unfortunately, various complications may occur during circumcision, ranging from trivial to tragic such as penile amputation which is a serious complication and a challenging injury to treat. We describe two cases of non-microsurgical successful reattachment of a distal penile glans which were amputated during circumcision. In the first case, a 5-year-old child underwent circumcision by an urologist under local anesthesia. In the second one, a 3-year-old child underwent circumcision by a general practitioner who used to make circumcision. In this article, the literature is reviewed; results and potential complications of this surgery are also discussed. Glans sensation was present, early morning erection was maintained, and there was an erectile response during penile manipulation in both cases. Although circumcision is not technically difficult, it should be taken seriously. The use of microsurgical reattachment is not always possible, especially in pediatric cases; it also requires special equipment and training. PMID:24669132

Khaireddine, Bouassida; Adnen, Hidoussi; Khaled, Ben M; Adel, Slama

2014-01-01

298

F-18 Fluorodeoxy Glucose Positron Emission Tomography/Computed Tomography Findings in a Rare Case of Penile Leiomyosarcoma  

Science.gov (United States)

Penile cancer is a rare entity accounting for only 0.4% all male malignancies. Penile leiomyosarcomas are even rarer with only around 35 cases reported in literature. We report a rare case of penile leiomyosarcoma illustrating F-18 Fluorodeoxy glucose (FDG) positron emission tomography/computed tomography (PET/CT) features and histopathology correlation.

Manohar, Kuruva; Mittal, Bhagwant Rai; Kashyap, Raghava; Bhattacharya, Anish; Kakkar, Nandita; Mete, Uttam Kumar

2011-01-01

299

Successful Remove of a Metal Axletree Causing Penile Strangulation in a 19-Year-Old Male by Degloving Operation  

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Penile strangulation caused by foreign bodies mostly occurs in adolescents and adult males. When it happens, foreign bodies are often not easy to be removed. Penile strangulation is a rarely described urological emergency, especially in the adolescent population. This paper demonstrates the successful removal of a metal axletree causing penile strangulation in a 19-year-old male with the help of degloving operation.

Gan, Weidong; Yang, Rong; Ji, Changwei; Lian, Huibo; Guo, Hongqian

2012-01-01

300

Arteria Circunfleja Iliaca Superficial: Importancia Antomo Quirrgica / Superficial Circumflex Iliac Artery: Anatomical Surgical Importance  

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: Spanish Abstract in spanish La arteria circunfleja ilaca superficial es un pequeo vaso que se origina, generalmente, en la arteria femoral a nivel del tringulo femoral, dirigindose paralela al ligamento inguinal hacia la espina ilaca anterosuperior. Actualmente es utilizada frecuentemente en colgajos libres llevados a cab [...] eza, cuello, miembros e incluso en reconstrucciones peneanas. Disecamos 68 regiones inguinales de cadveres formolizados en la disciplinas de anatoma topogrfica de las Universidades de La Frontera, Chile y Federal de Sao Paulo, Brasil. La arteria cincunfleja ilaca superficial tuvo un dimetro externo de 1,42 mm en promedio y la distancia desde su origen al ligamento inguinal fue de 15,1 mm. La arteria se origin directamente de la arteria femoral en 47 casos (69,1%); de un tronco comn con la arteria epigstrica superficial en 14 (20,5%) y de la arteria circunfleja femoral lateral en tres casos (4,41%) y en otros cuatro orgenes (5,9%). Aunque tiene un pequeo dimetro, la arteria circunfleja ilaca superficial es importante tanto para el anatomista como para los cirujanos vasculares y plsticos, siendo fundamental para el xito en la obtencin de un buen colgajo. Abstract in english The superficial circumflex iliac artery is a small vessel that originates, usually in the femoral artery at the femoral triangle, heading parallel to the inguinal ligament to the anterior superior iliac spine. Currently it is frequently used in free flaps for head, neck, limbs and even in penile rec [...] onstruction. We dissected 68 inguinal regions in corpses in formolized topographic anatomy courses of the Universidad de La Frontera, Chile and Federal University of So Paulo, Brazil. The superficial circumflex iliac artery had a diameter of 1.42 mm on average, and the distance from its origin to the inguinal ligament was 15.1 mm. The artery originated directly from the femoral artery in 47 cases (69.1%), from a common trunk with the superficial epigastric artery in 14 (20.5%) and the lateral femoral circumflex artery in three cases (4.41 %) and four other sources (5.9%). Although it has a small diameter, superficial circumflex iliac artery is important for the anatomist as well as vascular and plastic surgeons, and essential for success in obtaining a good flap.

del Sol, Mariano; Vsquez, Blgica.

 
 
 
 
301

/sup 99m/Tc penile scan: An investigative modality in priapism  

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A 99mTc penile scan was performed in 9 patients with priapism. The technique of the procedure is described. Penile scan is an easily obtainable modality that can differentiate between high- and low-flow forms of priapism. We believe that these scintigraphic findings facilitate management of priapism.

Hashmat, A.I.; Raju, S.; Singh, I.; Macchia, R.J.

1989-01-01

302

99mTc penile scan: An investigative modality in priapism  

International Nuclear Information System (INIS)

A 99mTc penile scan was performed in 9 patients with priapism. The technique of the procedure is described. Penile scan is an easily obtainable modality that can differentiate between high- and low-flow forms of priapism. We believe that these scintigraphic findings facilitate management of priapism

1989-01-01

303

The role of Nesbit's procedure in surgical reconstruction of penile deviation  

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Objective: We review our results after surgical reconstruction with the Nesbit's procedure for congenital or acquired penile deviation. Patients and methods: Etiology of penile deviation, surgical outcome for straightening the penis, postoperative patient satisfaction and clinical findings were evaluated for 5 patients undergoing Nesbit's procedure followed by a Medline review of contemporary literature regarding alternative surgical techniques. Follow-up included clinical examination, self...

Martenstein, C.; Peruth, J.; Hamza, A.

2012-01-01

304

The functional result two years after a microsurgical penile replantation. Case report.  

Science.gov (United States)

We describe the technique of microsurgical penile replantation and a case followed up after two years. The patient was a young man with decompensated schizophrenia who emasculated himself with a kitchen knife. A particularly good functional result was achieved including restoration of sensation in the penile shaft and in the glans, and return of erectile capacity. PMID:10505448

Lidman, D; Danielsson, P; Abdiu, A; Fhraeus, B

1999-09-01

305

Penile responses of rats (Rattus norvegicus) in extended ex copula tests.  

Science.gov (United States)

Prolonged tests of rats' penile responses outside the context of copulation (ex copula) were undertaken to facilitate analysis of these penile components of copulatory behavior. Penile erections and flips were evoked for 1 hr following penile sheath retraction (SR), and rats were retested for 30 min after a rest interval of 5 min to 4 hr. The number of penile responses declined sharply over the course of the hour. Following a 5-min rest, there was little likelihood of additional responses. Within 2 hr some measures of penile response potential approached their original high asymptotes; other measures were still depressed after 4-hr rest. In control tests, the penile sheath was unretracted (SU) during the first 60 min, and hence few or no penile responses occurred. This condition caused no reduction in the number of erections and flips in the subsequent 30-min SR test; hence the reduction in response potential during and after SR tests was due to the responses displayed, not to the conditions of restraint. Ejaculation occurred frequently in the SU condition but rarely in SR tests, results suggesting that sheath retraction may normally inhibit ejaculation in ex copula tests, and perhaps during copulation as well. PMID:4042619

Sachs, B D

1985-09-01

306

Renal Artery Embolization Combined With Radiofrequency Ablation in a Porcine Kidney Model: Effect of Small and Narrowly Calibrated Microparticles as Embolization Material on Coagulation Diameter, Volume, and Shape  

International Nuclear Information System (INIS)

The purpose of this study was to evaluate the effect of renal artery embolization with small and narrowly calibrated microparticles on the coagulation diameter, volume, and shape of radiofrequency ablations (RFAs) in porcine kidneys. Forty-eight RFAs were performed in 24 kidneys of 12 pigs. In 6 animals, bilateral renal artery embolization was performed with small and narrowly calibrated microparticles. Upper and lower kidney poles were ablated with identical system parameters. Applying three-dimensional segmentation software, RFAs were segmented on registered 2 mm-thin macroscopic slices. Length, depth, width, volumesegmented, and volumecalculated were determined to describe the size of the RFAs. To evaluate the shape of the RFAs, depth-to-width ratio (perfect symmetry-to-lesion length was indicated by a ratio of 1), sphericity ratio (perfect sphere was indicated by a sphericity ratio of 1), eccentricity (perfect sphere was indicated by an eccentricity of 0), and circularity (perfect circle was indicated by a circularity of 1) were determined. Embolized compared with nonembolized RFAs showed significantly greater depth (23.4 3.6 vs. 17.2 1.8 mm; p segmented (8.6 3.2 vs. 3.0 0.7 ml; p calculated (8.4 3.0 ml vs. 3.3 1.1 ml; p < 0.001); significantly lower depth-to-width (1.17 0.10 vs. 1.48 0.44; p < 0.05), sphericity (1.55 0.44 vs. 1.96 0.43; p < 0.01), and eccentricity (0.84 0.61 vs. 1.73 0.91; p < 0.01) ratios; and significantly greater circularity (0.62 0.14 vs. 0.45 0.16; p < 0.01). Renal artery embolization with small and narrowly calibrated microparticles affected the coagulation diameter, volume, and shape of RFAs in porcine kidneys. Embolized RFAs were significantly larger and more spherical compared with nonembolized RFAs.

2011-02-01

307

BLOOD FLOW RESISTANCE FOR A SMALL ARTERY WITH THE EFFECT OF MULTIPLE STENOSES AND POST STENOTIC DILATATION  

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Full Text Available An attention for the effect of a post stenotic dilatation and multiple stenoses on an arterial blood flow is made through this work. The resistance to flow ratio is investigated with the different values of yield stress, viscosity, and the flux. For this study we consider fully developed, one-dimensional non-Newtonian fluid namely Bingham plastic fluid flow through a single vessel. The radius of vessel is varying. The formula for the resistance to flow is determined and the results are found for the yield stress, viscosity and flux. The numerical values of the resistance to flow ratio vary from maximum radii of the two abnormal segments to the minimum radii.

Sanjeev Kumar

2013-08-01

308

A case of penile squamous cell carcinoma treated with a combination of antiepidermal growth factor receptor antibody and chemotherapy.  

Science.gov (United States)

Our previous study showed that the features of epidermal growth factor receptor (EGFR)-RAS signaling in penile squamous cell carcinoma (SCC) suggested potential benefits of anti-EGFR monoclonal antibodies (mAbs) for penile SCC. Here, we report, for the first time, a combination of nimotuzumab (an EGFR mAb) with chemotherapy that resulted in a partial response in a 44-year-old patient with penile SCC, who developed bilateral inguinal node metastasis after primary partial penile amputation. The literature of case reports of anti-EGFR mAbs in penile SCC was also reviewed. PMID:24263192

Men, Hai-Tao; Gou, Hong-Feng; Qiu, Meng; He, Jian-Ping; Cheng, Ke; Chen, Ye; Ge, Jun; Liu, Ji-Yan

2014-01-01

309

Hipertenso arterial e sade da famlia: ateno aos portadores em municpio de pequeno porte na regio Sul do Brasil / Arterial hypertension and family care: care provided to hypertensive individuals in a small municipality in Southern Brazil  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: A partir da anlise de indicadores, que expressem aproximao lgica das aes programticas, foi desenvolvido um estudo transversal com o objetivo de avaliar o desempenho de uma Equipe de Sade da Famlia na ateno s pessoas portadoras de hipertenso arterial em municpio de pequeno p [...] orte. MTODOS: A pesquisa foi realizada a partir da anlise das fichas de cadastro, Ficha A do Sistema de Informao de Ateno Bsica, de 418 pessoas portadoras de hipertenso arterial, do registro de informaes em 351 pronturios, localizados na unidade bsica de sade, em 376 entrevistas realizadas com os residentes na rea de atuao da equipe, no ano de 2003. Foram estudadas as seguintes variveis: sexo, idade, renda familiar, condies de moradia, servio de sade utilizado, presena de diabete melito, cobertura e concentrao de atendimento. RESULTADOS: Mulheres com idade acima de sessenta anos predominaram: (65,7% dos casos). A taxa de prevalncia de hipertenso arterial referida foi de 18%, sendo distinta entre os sexos: nas mulheres foi de 22,3%, a cobertura foi de 64,1% para consultas mdicas, 32,4% para consultas de enfermagem e 36,4% para atendimentos mdicos domiciliares. Os registros em pronturio revelaram que 25,8% dos portadores no foram atendidos em 2003 e 52,7% no receberem atendimento no ltimo semestre. A concentrao de atendimentos foi abaixo da preconizada. CONCLUSO: As informaes revelaram distanciamento da organizao da ateno na lgica da vigilncia sade, prevalecendo o atendimento demanda espontnea, expressando despreparo na utilizao dos sistemas de informao para o planejamento e avaliao das aes. Abstract in english OBJECTIVE: This transversal study was developed from the analysis of indicators which express the desirable approach for programmatic actions, with the objective of evaluating the performance of a Family Healthcare Center in its attendance to patients suffering from arterial hypertension living in a [...] small municipal district. METHODS: The research was carried out starting from the analysis of the records of enrollment in the program, Record A from SIAB (Primary Care Information System), of 418 individuals suffering from arterial hypertension. It was also analyzed the information of 351 files from the health center. In addition, 376 interviews were carried out with individuals living in the vicinity of the health center, in the year of 2003. The following variables were studied: gender, age, family income, home conditions, health services used presence of diabetes mellitus, average number of individuals attended and attendance concentration. RESULTS: Women above 60 years of age prevailed in 65.7% of the cases. The hypertension prevalence rate on individuals who searched for care was of 18%, being different among gender, among women it was of 22.3%. The average number of appointments with a doctor was of 64.1%; 32.4% for appointments with a nurse, and 36.4% for home medical attendance. The information on files revealed that 25.8% of the individuals were not assisted in 2003 and 52.7% received no assistance in the last semester. The concentration of services was below preconization. CONCLUSION: The information revealed no organization on the attention to the preventive health care, focusing the assistance to a spontaneous demand, expressing unpreparedness in the use of information systems for the planning and evaluation of the actions.

Luciano Burigo de, Sousa; Regina Kazue Tanno de, Souza; Maria Jos, Scochi.

310

Hipertenso arterial e sade da famlia: ateno aos portadores em municpio de pequeno porte na regio Sul do Brasil Arterial hypertension and family care: care provided to hypertensive individuals in a small municipality in Southern Brazil  

Directory of Open Access Journals (Sweden)

Full Text Available OBJETIVO: A partir da anlise de indicadores, que expressem aproximao lgica das aes programticas, foi desenvolvido um estudo transversal com o objetivo de avaliar o desempenho de uma Equipe de Sade da Famlia na ateno s pessoas portadoras de hipertenso arterial em municpio de pequeno porte. MTODOS: A pesquisa foi realizada a partir da anlise das fichas de cadastro, Ficha A do Sistema de Informao de Ateno Bsica, de 418 pessoas portadoras de hipertenso arterial, do registro de informaes em 351 pronturios, localizados na unidade bsica de sade, em 376 entrevistas realizadas com os residentes na rea de atuao da equipe, no ano de 2003. Foram estudadas as seguintes variveis: sexo, idade, renda familiar, condies de moradia, servio de sade utilizado, presena de diabete melito, cobertura e concentrao de atendimento. RESULTADOS: Mulheres com idade acima de sessenta anos predominaram: (65,7% dos casos. A taxa de prevalncia de hipertenso arterial referida foi de 18%, sendo distinta entre os sexos: nas mulheres foi de 22,3%, a cobertura foi de 64,1% para consultas mdicas, 32,4% para consultas de enfermagem e 36,4% para atendimentos mdicos domiciliares. Os registros em pronturio revelaram que 25,8% dos portadores no foram atendidos em 2003 e 52,7% no receberem atendimento no ltimo semestre. A concentrao de atendimentos foi abaixo da preconizada. CONCLUSO: As informaes revelaram distanciamento da organizao da ateno na lgica da vigilncia sade, prevalecendo o atendimento demanda espontnea, expressando despreparo na utilizao dos sistemas de informao para o planejamento e avaliao das aes.OBJECTIVE: This transversal study was developed from the analysis of indicators which express the desirable approach for programmatic actions, with the objective of evaluating the performance of a Family Healthcare Center in its attendance to patients suffering from arterial hypertension living in a small municipal district. METHODS: The research was carried out starting from the analysis of the records of enrollment in the program, Record A from SIAB (Primary Care Information System, of 418 individuals suffering from arterial hypertension. It was also analyzed the information of 351 files from the health center. In addition, 376 interviews were carried out with individuals living in the vicinity of the health center, in the year of 2003. The following variables were studied: gender, age, family income, home conditions, health services used presence of diabetes mellitus, average number of individuals attended and attendance concentration. RESULTS: Women above 60 years of age prevailed in 65.7% of the cases. The hypertension prevalence rate on individuals who searched for care was of 18%, being different among gender, among women it was of 22.3%. The average number of appointments with a doctor was of 64.1%; 32.4% for appointments with a nurse, and 36.4% for home medical attendance. The information on files revealed that 25.8% of the individuals were not assisted in 2003 and 52.7% received no assistance in the last semester. The concentration of services was below preconization. CONCLUSION: The information revealed no organization on the attention to the preventive health care, focusing the assistance to a spontaneous demand, expressing unpreparedness in the use of information systems for the planning and evaluation of the actions.

Luciano Burigo de Sousa

2006-10-01

311

A comparison of the early antithrombotic effects between low molecular weight heparin and heparin in small arteries following a severe trauma: an experimental study.  

Science.gov (United States)

Twenty-seven rabbits divided into 4 groups (2 control groups) received saline, standard heparin (400 IU both as anti-F Xa and activated partial thromboplastin time per kg of body weight), or low molecular weight heparin (lmwh) (Fragmin 560 IU as anti-F Xa and 140 IU as APTT units per kg of body weight). The figures represent the total dose given over 3 hours. The central arteries of the rabbits' ears were prepared and positioned in clamps. Platelets labeled with 32P were injected. Arteriotomy/intimectomy was performed. After reestablishment of blood flow, arteriotomy bleeding times, platelet accumulation, patency, and weight of thrombotic materials were measured. The bleeding time in the Heparin Group was significantly prolonged compared with its control group. But the bleeding times between the LMWH Group and the control group were not significantly different. The patency rates were increased in both the Heparin Group (100%, p radioactivity in all groups increased up to 15 minutes after the vessels were reperfused. There were no statistical differences between the treated groups and control groups. It was concluded that standard heparin is a very powerful inhibitor of thrombosis during the most crucial hours after reperfusion of severely traumatized small arteries, without significant effects on primary platelet adhesion/aggregation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8239417

Zhang, B; Dougan, P; Wieslander, J B

1993-09-01

312

Comparison of blood velocity measurements between ultrasound Doppler and accelerated phase-contrast MR angiography in small arteries with disturbed flow  

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Ultrasound Doppler (UD) velocity measurements are commonly used to quantify blood flow velocities in vivo. The aim of our work was to investigate the accuracy of in vivo spectral Doppler measurements of velocity waveforms. Waveforms were derived from spectral Doppler signals and corrected for intrinsic spectral broadening errors by applying a previously published algorithm. The method was tested in a canine aneurysm model by determining velocities in small arteries (3-4 mm diameter) near the aneurysm where there was moderately disturbed flow. Doppler results were compared to velocity measurements in the same arteries acquired with a rapid volumetric phase contrast MR angiography technique named phase contrast vastly undersampled isotropic projection reconstruction magnetic resonance angiography (PC-VIPR MRA). After correcting for intrinsic spectral broadening, there was a high degree of correlation between velocities obtained by the real-time UD and the accelerated PC-MRA technique. The peak systolic velocity yielded a linear correlation coefficient of r = 0.83, end diastolic velocity resulted in r = 0.81, and temporally averaged mean velocity resulted in r = 0.76. The overall velocity waveforms obtained by the two techniques were also highly correlated (r = 0.89 {+-} 0.06). There were, however, only weak correlations for the pulsatility index (PI: 0.25) and resistive index (RI: 0.14) derived from the two techniques. Results demonstrate that to avoid overestimations of peak systolic velocities, the results for UD must be carefully corrected to compensate for errors caused by intrinsic spectral broadening.

Jiang Jingfeng; Johnson, Kevin; Wieben, Oliver; Zagzebski, James [Medical Physics Department, University of Wisconsin-Madison School of Medicine and Public Health, WI (United States); Strother, Charles; Consigny, Dan [Radiology Department, University of Wisconsin-Madison School of Medicine and Public Health, WI (United States); Baker, Sara, E-mail: jjiang2@wisc.edu [School of Ultrasound, University of Wisconsin-Madison School of Medicine and Public Health, WI (United States)

2011-03-21

313

Bronchial artery infusion of Gemcitabine and Cisplatin combined with systemic chemotherapy for advanced non-small cell lung cancer: its short-term efficacy  

International Nuclear Information System (INIS)

Objective: To assess the short-term efficacy of bronchial artery infusion (BAI) of Gemcitabine (GEM) plus Cisplatin (DDP) combined with systemic chemotherapy of GEM for advanced non-small cell lung cancer (NSCLC). Methods: A total of 60 patients with pathologically proved primary NSCLC were randomly selected. BAI with GEM (1000 mg/m2) and DDP (DDP 50 mg/m2) was performed on the first day, and systemic chemotherapy of GEM (1000 mg/m2) was carried out on the eighth day. The clinical results were analyzed. Results: Of the 60 patients, CR, PR, SD and PD were obtained in 3, 35, 17 and 5, respectively, with an overall effective rate of 63%. Twenty-two patients had adenocarcinoma and the effective rate of them was 45%. Thirty-eight patients had squamous cell carcinoma and their effective rate was 74%. The difference in the effective rate between the above two pathologic types was significant (P<0.05). Central type lung cancer was seen in 37 cases, their effective rate was 73%. The peripheral type lung cancer was seen in the remaining 23 patients and the effective rate was 48%. The difference in the effective rate was statistically significant between the central type and the peripheral type (P<0.05). Conclusion: The combination of bronchial artery infusion with systemic chemotherapy by using GP plan is an effective, feasible approach in the treatment of advanced non-small cell lung cancer. The short-term efficacy of the treatment bears a close relationship to the anatomical location and pathological type of the cancer. (authors)

2012-02-01

314

Clinical experience with Mentor inflatable penile prosthesis in 206 patients.  

Science.gov (United States)

The Mentor inflatable penile prosthesis (IPP) has been implanted in 206 patients with organic (95.2%) or psychologic (4.8%) impotency. The patients have been followed up for an average of 18.1 (4-42) months. A satisfactory result has been achieved in 98 per cent of these patients. A life analysis of the series shows that 88 per cent of all devices implanted will survive forty-two months without mechanical failure. One hundred sixty-four of these patients had not had previous penile surgery while 42 had had one or more penile prostheses implanted previously. The projected forty-two-month survival for the Mentor prosthesis in these subgroups is 94 per cent and 74 per cent, respectively. The improved life expectancy of the Mentor IPP, compared with the Scott IPP, is due to the superior durability of Mentor's polyurethane cylinders and to the increased reliability of the Mentor snap-on connector system. In this respect, there have been only one cylinder failure and 3 connector failures in the Mentor series. The connector failures occurred early in the series before the development of connector pliers; there have been no connector failures in the last 202 consecutive implantations. Wear-induced tubing leaks, the most common cause of device failure, occurred in 2.9 per cent of all implantations. Tubing failures were more common in patients who have had previous surgery, occurring in 9 per cent of salvage procedures and 1.3 per cent of primary implantations. The reason for the difference in tubing survival in virgin and salvage procedures is unknown; possibly the subcutaneous scar tissue present in secondary surgical procedures increases the chance of tubing segments touching and abrasing each other. Laboratory studies suggest that the nylon-reinforced tubing used in the manufacture of devices implanted since 1985 is more durable than is the standard silicone tubing used in the construction of devices implanted previously. PMID:3529572

Merrill, D C

1986-09-01

315

Increase by lysophosphatidylcholines of smooth muscle Ca2+ sensitivity in alpha-toxin-permeabilized small mesenteric artery from the rat  

DEFF Research Database (Denmark)

1. Pharmacological characterization of different lysophosphatidylcholines was performed based on their effect on the Ca2+ sensitivity of contraction in alpha-toxin-permeabilized rat mesenteric arteries. Furthermore, the effect of noradrenaline on [3H]-myristate-labelled lysophosphatidylcholine levels was assessed, to investigate whether lysophosphatidylcholines could be second messengers. 2. Palmitoyl or myristoyl L-alpha-lysophosphatidylcholine increased the sensitivity to Ca2+, whereas lysophosphatidylcholines containing other fatty acids had less or no effect. 3. L-alpha-phosphatidylcholine, L-alpha-glycerophosphorylcholine, palmitic acid, myristic acid and choline, potential metabolites of lysophosphatidylcholines, did not affect contractions. 4. Noradrenaline (GTP was required) and GTP gamma S increased the sensitivity to Ca2+, and GDP-beta-S inhibited the effect of noradrenaline. Lysophosphatidylcholines, however, had no requirement for GTP and caused sensitization in the presence of GDP-beta-S. 5. Calphostin C, a relatively specific protein kinase C inhibitor, did not affect contraction induced by Ca2+, but abolished the sensitizing effect of lysophosphatidylcholine. 6. Noradrenaline caused no measurable changes in the levels of [3H]-myristate-labelled phosphatidylcholine and lysophosphatidylcholine at 30 s and 5 min stimulation. 7. These results suggest that lysophosphatidylcholines can increase Ca2+ sensitivity through a G-protein-independent, but a protein kinase C-dependent mechanism. However, the role for lysophosphatidylcholines as messengers causing Ca2+ sensitization during stimulation with noradrenaline remains uncertain because no increase in [3H]-myristate labelled lysophosphatidylcholine could be measured during noradrenaline stimulation.

Jensen, P E; Ohanian, J

1996-01-01

316

Treatment of penile strangulation caused by constricting devices.  

Science.gov (United States)

Constricting devices placed on the penis present a challenge to urologists. Various nonmetallic and metallic objects are placed on the penis to increase sexual performance or because of autoerotic intentions. We describe five different cases of strangulating objects (wedding ring, metal plumbing cuff, bull ring, hammer- head, and plastic bottle neck) and demonstrate that each case needs individual handling in removing the object. The treatment of penile strangulation is decompression of the constricted penis to facilitate free blood flow and micturition. It requires no particular skill but does require resourcefulness to perform the removal simply and effectively, and with as little discomfort for the patient as possible. PMID:11796305

Perabo, Frank G E; Steiner, Gabriel; Albers, Peter; Mller, Stefan C

2002-01-01

317

Penile metastasis as a first sign of lung cancer  

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Full Text Available Sevket Ozkaya1, Serhat Findik2, Atilla G Atici21Samsun Chest Diseases and Thoracic Surgery Hospital, Samsun, Turkey; 2Department of Pulmonary Medicine, Faculty of Medicine, Ondokuz Mayis University, Kurupelit, Samsun, TurkeyAbstract: Lung cancer does not generally produce any symptoms at the early stages and it rapidly metastasizes. Although lung cancer has a potential of metastasis to all organs and tissues, metastasis to the penis from lung cancer is very rare. We present a case with a penile lesion as the first sign of lung cancer.Keywords: lung cancer, metastasis, penis

Sevket Ozkaya

2009-07-01

318

Penile fracture with bilateral corporeal rupture without urethral involvement  

Science.gov (United States)

Concomitant urethral injury is rare in penile fracture. We report the case of a 34-year-old male who presented to the emergency department 12 hours after a blunt self-injury of the penis. Physical examination revealed a swollen, ecchymotic, and deviated circumcised penis without blood at the meatus. The fracture line extending along the bilateral corpora without urethral involvement was seen intraoperatively. The fracture side was repaired primarily. The patient healed and recovered without complication. To our knowledge, this is the second reported case of bilateral corporeal rupture without urethral involvement.

Yonguc, Tarik; Bozkurt, Ibrahim Halil; Ors, Bumin; Kozacioglu, Zafer; Arslan, Burak; Yonguc, Nilufer Goksin

2014-01-01

319

Coronary artery stent (image)  

Science.gov (United States)

... stent is a small, self-expanding, stainless steel mesh tube that is placed within a coronary artery to keep the vessel open. It may be used during a coronary artery bypass graft surgery to keep the grafted vessel open, after balloon ...

320

Human papillomavirus genotype prevalence in invasive penile cancers from a registry-based United States population  

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Full Text Available Background. Human papillomavirus (HPV is estimated to play an etiologic role in 40%-50% of penile cancers worldwide. Estimates of HPV prevalence in U.S. penile cancer cases are limited. Methods. HPV DNA was evaluated in tumor tissue from 79 invasive penile cancer patients diagnosed in 1998-2005 within the catchment areas of 7 U.S. cancer registries. HPV was genotyped using PCR-based Linear Array and INNO-LiPA assays and compared by demographic, clinical, and pathologic characteristics and survival. Histological classification was also obtained by independent pathology review. Results. HPV DNA was present in 50 of 79 (63% of invasive penile cancer cases. Sixteen viral genotypes were detected. HPV 16, found in 46% (36/79 of all cases (72% of HPV-positive cases was the most prevalent genotype followed equally by HPV 18, 33, and 45, which each comprised 5% of all cases. Multiple genotypes were detected in 18% of viral positive cases. HPV prevalence did not significantly vary by age, race/ethnicity, population size of geographic region, cancer stage, histology, grade, penile subsite, or prior cancer history. Penile cases diagnosed in more recent years were more likely to be HPV positive. Overall survival did not significantly vary by HPV status. Conclusions. The relatively high prevalence of HPV in our study population provides limited evidence of a more prominent and, possibly, increasing role of infection in penile carcinogenesis in the U.S. compared to other parts of the world.

BrendaYHernandez

2014-02-01

 
 
 
 
321

Erectile dysfunction in hypertensive men: sleep-related erections, penile blood flow and musculovascular events.  

Science.gov (United States)

To explore how hypertension affects penile erection, we studied erectile hemodynamics during nocturnal penile tumescence in 3 groups of middle-aged men: hypertensive patients with and without erectile dysfunction, and normotensive controls without erectile problems. The hypertensive patients were not taking antihypertensive medication. Evaluations included standard monitoring of penile circumference change as well as noninvasive monitoring of penile segmental pulsatile blood flow and activity in the bulbocavernosus-ischiocavernosus muscles. Variables differed in how they discriminated among groups. Median amplitude of penile blood flow during rapid eye movement sleep differed significantly among all 3 study groups: controls had the highest amplitudes, patients without erectile problems had lower values and patients with erectile complaints had the lowest values. By contrast, standard measures of nocturnal penile tumescence (that is based on penile circumference change during sleep) only distinguished the patients with erectile problems from the 2 other groups. Density of musculovascular event clusters during rapid eye movement sleep (nearly simultaneous muscle activity burst, blood flow burst and circumference pulsation) distinguished the 2 groups of hypertensive men from controls. The sensitivity of the blood flow measure to changes in the hypertensive men without erectile complaints may indicate that the measure can reveal subclinical signs of developing vasculogenic erectile dysfunction. PMID:2733110

Karacan, I; Salis, P J; Hirshkowitz, M; Borreson, R E; Narter, E; Williams, R L

1989-07-01

322

Report of 84 cases of penile Fracture inBeheshti Hospital center  

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Full Text Available Background and purpose : Penile fracture is the rupture of the corpus cavernousum due to trauma to the erect penis , which has various background etiologies in different countries according to their habits. The aim of this study was to determine and evaluate the frequency, etiologies and complications of penile fracture in our geographic area.Material and Methods : This analytical-cross sectional study was performed via census sampling among men referred to Sh. Beheshti Hospital of Babol Medical University during 1995 to 2004. Data were analyzed by Chi-Square, Fisher`s exact and T-test using SPSS release 12.Results : 84 patients with penile fracture (mean age of 18.1 years were studied. The frequency was higher in single patients (78% than married ones. The most important complaint of patients with penile fracture was penile pain (36%, hematoma (30%, and penile swelling (12%. Background factors were manipulation of erect penis (74%, sexual intercourse (18% trauma to erect pennies (8%. Urethral ruptures were seen in 8% of all patients with feacture. There were significant differences between urethral rupture and background etiologies (P=0.000 and marrital status (p=0.000 as 90% of the cases were single patient, referred to hospital due to manipulation of erect pennies (P=0.000.Conclusion : High frequency of penile manipulation among young boys in the study area in comparison with other studies results in penile fracture but subsequent urethral rupture was uncommon among men. Better and earlier diagnosis of penile fracture is related to determination of background etologies in the patients.

H. Shafi

2005-01-01

323

Peripheral Arterial Disease and Claudication  

Science.gov (United States)

... a device called a stent (a small wire mesh tube) will be left in the artery. The stent will help hold the artery open. Angioplasty is normally done while you are awake. If the narrow area of the artery is very long, you may need to have bypass surgery. For the surgery, your doctor will take a ...

324

Prospective and long-term evaluation of erect penile length obtained with inflatable penile prosthesis to that induced by intracavernosal injection.  

Science.gov (United States)

We compared erect penile length after inflatable penile prosthesis (IPP) implantation with that induced by in-tracavernosal injection (ICI) before surgery. A total of 11 patients with full erections induced by ICI of 0.25 mL of Trimix (papaverine, phentolamine and prostaglandin E1) at the time of penile color duplex Doppler ultrasonography were enrolled in this study. The patients subsequently underwent IPP implantation as the ultimate treatment for their erectile dysfunction (ED). Erect penile length consequent to IPP implantation was measured at 6 weeks, 6 months and at 1 year after surgery. The Sexual Health Inventory for Men (SHIM) was administered before, and at 6 months and 1 year after IPP implantation. Erect penile length (mean +/- s.e.) as induced by ICI was 13.2 +/- 0.4 cm, whereas the lengths attained with IPP were 12.4 +/- 0.3, 12.5 +/- 0.3 and 12.5 +/- 0.4 cm at the sixth week, sixth month and 1-year follow-ups, respectively. There were 0.83 +/- 0.25, 0.75 +/- 0.20 and 0.74 +/- 0.15 cm decreases in erect penile length at 6 weeks, 6 months and 1 year, respectively, after IPP implantation when compared with that after ICI (P 0.05). To our knowledge, this is the first study to objectively show a significant decrease in erect penile length after IPP implantation when compared with that after ICI. However, this decrease did not affect the effectiveness of IPP in treating ED. PMID:19525974

Wang, Run; Howard, Galen E; Hoang, Anthony; Yuan, Jiu-Hong; Lin, Hao-Cheng; Dai, Yu-Tian

2009-07-01

325

One-sheet spiraling full thickness skin graft for penile resurfacing after paraffinoma excision  

Digital Repository Infrastructure Vision for European Research (DRIVER)

In the midst of on-going non-illicit practice of silicone or paraffin injection to enlarge penis, the author reported 3 cases ofsurgical treatment to resurface the body of the penis after excision of the destructed penile skin using full thickness skin graft.The skin excision was performed technically through penile body degloving procedure. Full thickness skin graft was thenapplied as a single sheet donor tissue to cover the denuded penile body spirally. The full thickness graft, wh...

Prasetyono, Theddeus O. H.

2011-01-01

326

Penile fracture with bilateral corporeal rupture and complete urethral disruption: case report and literature review.  

Science.gov (United States)

Penile fracture is a rare injury most commonly sustained during sexual intercourse. We report the case of a 35-year-old man who presented with bilateral rupture of the corpora cavernosa and complete disruption of the urethra. A review of the literature on penile fracture is also presented. Urgent surgical exploration was performed and the injuries repaired primarily. In follow-up, the patient reported satisfactory erectile function. This case highlights the importance of early surgical repair and evaluation for concomitant urethral injuries in cases of penile fracture. PMID:21470546

Hoag, Nathan A; Hennessey, Kiara; So, Alan

2011-04-01

327

Reconstruction of the penile skin loss due to 'radical' circumcision with a full thickness skin graft  

Directory of Open Access Journals (Sweden)

Full Text Available Background. Excessive resection of penile skin is a rare but important complication of circumcision. Penis 'trapping' under the skin and consequent sexual dysfunction occur as a result. Case report. Excessive circumcision with complete resection of the penile skin is shown. Penis, trapped under the skin, was deliberated and skin defect was substituted with the full thickness skin graft. One year after the surgery penis has a good cosmetic appearance, adequate size and sexual function. Conclusion. Full thickness skin graft is a good option for augmentation of the penile skin loss in cases with intact hypodermal tissue and extensive skin loss, for the reconstruction in a single act.

Ignjatovi? Ivan

2010-01-01

328

Coronary Artery Bypass Graft  

Medline Plus

Full Text Available ... it with oxygen. This machine takes over the job of the heart and lungs while the heart ... they are usually taken from your legs through multiple small incisions. If an artery is used, then ...

329

Interstitial brachytherapy for penile carcinoma: an alternative to amputation.  

Science.gov (United States)

From 1987 to 1994, 15 patients with penile saquamous cell carcinoma were referred to the Ottawa Regional Cancer Centre. Seven had already been managed surgically. The other eight were treated with interstitial implantation. Mean age was 58 years (range 39-80). Two patients had previous incomplete local excision and six had biopsy only, with tumor from 1.5 to 4 cm in diameter. Six tumors were located on the glans, one on the corona and one at the base. All were clinically node negative. Six patients were implanted using a rigid technique with a fixed array of steel needles in pre-drilled plexiglass templates, and two with flexible nylon tubing. Implants were manually afterloaded with Iridium-192 wire. The prescribed dose of 60-65 Gy was delivered in 2.5-5.5 days. Local tumor control is 100% at a mean follow-up of 37 months (range 6-64). One patient died of metastases at 15 months with the primary controlled. The remaining seven patients are alive without evidence of disease. Six who were sexually active, continue to be so. One patient has a urethral stricture requiring dilatations. Cosmesis is generally good: mild to moderate hypopigmentation, telangiectasia and fibrosis may develop at the implant site. Intersititial brachytherapy for T1 or minimally invasive T2 penile squamous cell cercinoma up to 4 cm in diameter provides excellent local control with preservation of function and is a viable alternative to amputation. PMID:12803712

Crook, J; Esche, B; Grimard, L; Futter, N; Genest, P

1995-07-01

330

Pollakiuria and stranguria in a Labrador retriever with penile HSA.  

Science.gov (United States)

An approximately 8 yr old castrated male Labrador retriever presented for evaluation of weight loss, stranguria, and pollakiuria. Lysis of the proximal one-third of the os penis was diagnosed on abdominal radiographs, and a positive contrast urethrography revealed a smoothly marginated filling defect along the dorsal aspect of the urethra at the level of the radiographically observed osteolysis. Regional ultrasound revealed an echogenic mass at the proximal aspect of the os penis with a severely irregular and discontinuous periosteal surface. A penile hemangiosarcoma (HSA) was confirmed on histopathologic evaluation after a penile amputation and scrotal urethrostomy were performed. Although HSA is a common malignant neoplasm in dogs, lysis of the os penis has not previously been documented. Adjunctive chemotherapy, although recommended, was declined, and the patient survived 236 days postoperatively. That survival time is considerably longer than the average survival time for patients with HSA, other than cutaneous forms of HSA. Although an uncommon presentation, HSA of the penis should be considered a differential diagnosis in older canines with signs of lower urinary tract disease, especially in breeds that have been documented to be predisposed to HSA. PMID:24446403

Fry, Joanna K; Burney, Derek; Hottinger, Heidi; Fabiani, Michelle; Feagin, Clint

2014-01-01

331

Therapeutic results of non-small cell lung cancer in stage III. Combined synchronous irradiation with bronchial artery infusion of CDDP  

International Nuclear Information System (INIS)

The present series consisted of 55 patients with non-small cell lung cancer in stage III who underwent radiotherapy from 1986-1989. They were divided into two groups: 35 patients with combined concurrent bronchial artery infusion (BAI) of CDDP (50 mg) and unevenly fractionated radiotherapy (combined group) and 20 with evenly fractionated irradiation (radiation group). The combined therapy was expected to achieve higher local control of disease. The rationale for the combined regime was based on the effects of CDDP, which causes cytostasis following intra-arterial infusion, and increased radiosensitivity from unevenly fractionated irradiation just after BAI. The radiotherapy group was considered a control in this study. The results of the combined group were limited to no CR, PR in 33 patients and NC in two with a period of 3013 days for 50% reduction of tumor, superior to the radiation group. There was no difference between the two groups in the rate of local recurrence (combined group: 63%). The combined group showed 28 months of MST in cause-specific survival, a significant difference. Survival rates were 71% at one year, 27% at three years, and 15% at five years, including three survivors without recurrence. Stage III a patients in the combined group showed a better outcome than stage III b patients in the same group, and stage III a patients in the radiation group. Although radiation pneumonitis as a fatal side effect was noted in one patient of the combined group, the combined therapy presented here seemed to improve the prognosis of locally advanced lung cancer if properly indicated. (author)

1995-01-01

332

Successful penile reconstruction after multimodal therapy in patients with primitive neuroectodermal tumor originating from the penis.  

Science.gov (United States)

We herein present an extremely rare case of primitive neuroectodermal tumor originating in the penis. A 16-year-old male adolescent presented with painful penile swelling. Pathological, immunohistochemical and cytogenetical examinations of the specimens obtained from total penectomy confirmed the diagnosis of primitive neuroectodermal tumor. After total penectomy, the patient received adjuvant chemotherapy with ifosfamide-based regimen for 48 weeks. As a series of therapies, the patient underwent penile reconstruction surgery after completing adjuvant chemotherapy. The patient has not shown any evidence of recurrence for the 7 years after penile reconstruction surgery, and voiding function is completely normal. A favorable outcome was observed by multimodal therapy including aggressive resection for local control, intensive adjuvant chemotherapy, and penile reconstruction with cosmetic and functional success. Similar therapeutic approaches might be selected for children with primary malignant tumors of the penis. PMID:24350647

Akino, Tomoshige; Shinohara, Nobuo; Hatanaka, Kanako; Kobayashi, Nozomi; Yamamoto, Yuhei; Nonomura, Katsuya

2014-06-01

333

Simultaneous Inflatable Penile Prosthesis (IPP) and Male Sling Placement: Aiding in a Faster Return to Patient ...  

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Full Text Available ... Penile Prosthesis (IPP) and Male Sling Placement: Aiding in a Faster Return to Patient Quality-of-Life You must have Javascript enabled in your web browser. View Program Transcript Click Here ...

334

Recurrent Inguinal Hernia and Reservoir Migration after Three-Piece Penile Prosthesis Implantation  

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Full Text Available A healthy 60 years-old man was operated for bilateral inguinal hernia a year before implementation of penile prosthesis implantation. Three months after PPI, inguinal hernia recurrence occurred on left side in which reservoir of penile prosthesis was placed. Reservoir was both herniated and migrated. Although there are lots of complications due to penile prosthesis implantation, recurrent inguinal hernia is a rare complication in reservoir area. Surgeon must examine the inguinal region carefully before PPI operation. If there is a herniation, general surgeons should perform tension-free herniography. As a result of place and pressure of reservoir of penile prosthesis, weakness of wall might increase the likelihood of recurrence.

Ozcan Alt?nel

2011-09-01

335

Penile cancer brachytherapy HDR mould technique used at the Holycross Cancer Center  

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Full Text Available The aim of this pictorial essay is to present the mould based HDR brachytherapy technique used at the HolycrossCancer Center for penile cancer patients. We use images to describe this method step by step.

Piotr Paw?owski

2011-12-01

336

Experimental evidence of penile erections during paradoxical sleep in the rat.  

Science.gov (United States)

We have developed a new technique to chronically monitor penile erections in the rat across behavioural states. This technique, involving chronic erectile tissue pressure monitoring and simultaneous ischiocavernosus and bulbospongiosus (IC-BS) muscle electromyography, demonstrates for the first time that rats exhibit penile erections during paradoxical sleep (PS). No erectile events were observed during slow wave sleep. These PS-related erectile events were similar to visually confirmed, waking state, erections in that they were associated with an increase in baseline erectile tissue pressure and, with IC-BS muscle bursts, dramatic suprasystolic penile pressure peaks often greater than 1000 mmHg. PS-related erections were 11 +/- 7 s in duration and were observed in 28.5% of all PS episodes. This method of chronic penile erection monitoring in the rat provides a new animal model for investigating neural mechanisms of sleep-related erections. PMID:8025244

Schmidt, M H; Valatx, J L; Schmidt, H S; Wauquier, A; Jouvet, M

1994-01-31

337

Valproic Acid Prevents Penile Fibrosis and Erectile Dysfunction in Cavernous Nerve Injured Rats  

Science.gov (United States)

Introduction Bilateral cavernous nerve injury (BCNI) causes profound penile changes such as apoptosis and fibrosis leading to erectile dysfunction (ED). Histone deacetylase (HDAC) has been implicated in chronic fibrotic diseases. Aims This study will characterize the molecular changes in penile HDAC after BCNI and determine if HDAC inhibition can prevent BCNI-induced ED and penile fibrosis. Methods Five groups of rats (810 wks, n=10/group) were utilized: 1) sham, 2&3) BCNI 14 and 30 days following injury, and 4&5) BCNI treated with HDAC inhibitor valproic acid (VPA 250mg/kg; 14 and 30 days). All groups underwent cavernous nerve stimulation (CNS) to determine intracavernosal pressure (ICP). Penile HDAC3, HDAC4, fibronectin, and transforming growth factor-?1 (TGF-?1) protein expression (Western blot) were assessed. Trichrome staining and the fractional area of fibrosis were determined in penes from each group. Cavernous smooth muscle content was assessed by immunofluorescence to alpha smooth muscle actin (?-SMA) antibodies. Main Outcome Measures ICP; HDAC3, HDAC4, fibronectin and TGF-?1 protein expression; penile fibrosis; penile ?-SMA content. Results There was a voltage-dependent decline (pICP to CNS 14 and 30 days after BCNI. Penile HDAC3, HDAC4, and fibronectin were significantly increased (P<0.05) 14 days after BCNI. There was a slight increase in TGF-?1 protein expression after BCNI. Histological analysis showed increased (P<0.05) corporal fibrosis after BCNI at both time points. VPA treatment decreased (P<0.05) penile HDAC3, HDAC4, and fibronectin protein expression as well as corporal fibrosis. There was no change in penile ?-SMA between all groups. Furthermore, VPA-treated BCNI rats had improved erectile responses to CNS (P<0.05). Conclusion HDAC-induced pathological signaling in response to BCNI contributes to penile vascular dysfunction after BCNI. Pharmacological inhibition of HDAC prevents penile fibrosis, normalizes fibronectin expression, and preserves erectile function. The HDAC pathway may represent a suitable target in preventing the progression of ED occurring post-RP.

Hannan, Johanna L.; Kutlu, Omer; Stopak, Bernard L.; Liu, Xiaopu; Castiglione, Fabio; Hedlund, Petter; Burnett, Arthur L.; Bivalacqua, Trinity J.

2014-01-01

338

Penis auto-amputation and chasm of the lower abdominal wall due to advanced penile carcinoma: a case report  

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Full Text Available Abstract Introduction Penile cancer is uncommon. When penile cancer is left untreated, at an advanced stage it can have tragic consequences for the patient. Case presentation Our case report does not concern a new manifestation of penile cancer, but an interesting presentation with clinical significance that emphasizes the need to diagnose and treat penile cancer early. It is an unusual case of a neglected penile cancer in a 57-year-old Greek man that led to auto-amputation of the penis and a large chasm in the lower abdominal wall. The clinical staging was T4N3M0 and our patient was treated with a bilateral cutaneous ureterostomy, chemotherapy and radiotherapy. Our patient died 18 months after his first admission in our clinic. Conclusions Emphasis must be placed on early diagnosis and treatment of penile cancer, so further development of the disease can be prevented.

Baltogiannis Dimitrios

2011-12-01

339

Conservative treatment of penile carcinoma - a retrospective study of 10 years  

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Conservative treatment of penile squamous cell carcinoma has been advocated as a method of choice for tumours at early stages. Thirty patients with a mean age of 63.2 years were treated with CO2 laser ablation, radical local excision with preputial flap, direct closure or healing by secondary intention, circumcision alone or associated with CO2 laser and topical imiquimod. Sixteen patients had local recurrence. Partial penectomy was necessary in 3 patients. Conservative treatments of penile s...

Pereira, N.; Cabral, Ar; Vieira, R.; Figueiredo, A.

2013-01-01

340

The isolated gamma probe technique for sentinel node penile carcinoma detection is unreliable  

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PURPOSE: Penile carcinoma is a common disease in northeast Brazil. This paper shows the results of the use of isolated gamma probe and discusses the incidence of false negative rates. MATERIALS AND METHODS: From July 2000 to September 2003, 27 newly diagnosed penile carcinoma patients (T1, T2, N0) were included in this prospective study. The isolated gamma probe technique uses the sodium phytate technetium as a tracer and inguinal scanning with probe and after identified the lymph node it is ...

Gonzaga-silva, Lucio F.; Tavares, Jose M.; Freitas, Fernando C.; Tomas Filho, Manoel E.; Oliveira, Vladmir P.; Lima, Marcos V.

2007-01-01

 
 
 
 
341

A rare case of penile cancer in situ metastasizing to lymph nodes  

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Penile carcinoma in situ, or Queyrat's erythroplasia, is a rare condition of the glans penis. This lesion has been associated with invasive squamous cell carcinoma; however, metastasis without an invasive component is extremely rare. There have only been 2 documented cases with metachronous metastases. We report a third case in which metastases were diagnosed at presentation. The patient was a 51-year-old man who presented with a glans penile lesion and bilateral inguinal masses later determi...

Kim, Brian; Garcia, Francisco; Touma, Naji; Moussa, Madeleine; Izawa, Jonathan I.

2007-01-01

342

Penile entrapment in a plastic bottle - a case for using an oscillating splint saw.  

Science.gov (United States)

Penile entrapment is a rare but serious urological emergency, which can easily lead to stangulation and infarction. We report a case of penile entrapment in a polyethylene terephthalate (PET) bottle in a 49-year-old male. Attempts to cut the bottle with a scalpel or a glass saw were ineffective. Finally, the bottle neck was cut longitudinally with an oscillating saw intended for cutting plaster casts. PMID:16502059

May, Matthias; Gunia, Sven; Helke, Christian; Kheyri, Reza; Hoschke, Bernd

2006-01-01

343

The Nesbit operation for penile curvature: an easy and effective technical modification  

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PURPOSE: We report the results of an original technical modification to the Nesbit operation, designed to increase precision and simplify the correction of congenital or acquired penile curvature. MATERIALS AND METHODS: A total of 50 patients were considered candidates for surgical treatment of penile curvature and underwent a modified corporoplasty procedure involving plication suture on the convex aspect of the penis before tunica albuginea resection. Hospital records and followup data were...

2005-01-01

344

An innovative surgical technique for treating penile incarceration injury caused by heavy metallic ring  

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Penile incarceration injury by heavy metallic ring is a rare genital injury. A man may place metal object for erotic or autoerotic purposes, for masturbation or increasing erection, and due to psychiatric disturbances are some of the reasons for a penile incarceration injury. The incarcerating injury results in reduced blood flow distal to the injury, leading to edema, ischemia, and sometimes gangrene. These injuries are divided into five grades and their treatment options are divided into fo...

Baruah, S. J.; Bagchi, P. K.; Barua, S. K.; Deka, P. M.

2009-01-01

345

Cyclic AMP-dependent phosphorylation of neuronal nitric oxide synthase mediates penile erection  

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Nitric oxide (NO) generated by neuronal NO synthase (nNOS) initiates penile erection, but has not been thought to participate in the sustained erection required for normal sexual performance. We now show that cAMP-dependent phosphorylation of nNOS mediates erectile physiology, including sustained erection. nNOS is phosphorylated by cAMP-dependent protein kinase (PKA) at serine(S)1412. Electrical stimulation of the penile innervation increases S1412 phosphorylation that is blocked by PKA inhib...

2012-01-01

346

Tadalafil rehabilitation therapy preserves penile size after bilateral nerve sparing radical retropubic prostatectomy  

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OBJECTIVE: To evaluate the change in penile size r bilateral nerve sparing retropubic radical prostatectomy (BNSRRP) and possible effect of Tadalafil. MATERIALS AND METHODS: A total of 65 patients underwent BNSRRP and they were evaluated prospectively for a whole year of follow-up . The patients were randomized to control without rehabilitation (Group 1) or Tadalafil rehabilitation group (Group 2). The patients were evaluated at months 3, 6 and 12 postoperatively for erectile function, penile...

Ozgu Aydogdu; Mehmet Ilker Gokce; Berk Burgu; Sumer Baltaci; Onder Yaman

2011-01-01

347

Penile Rehabilitation Therapy with PDE-V Inhibitors Following Radical Prostatectomy: Proceed with Caution  

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Penile rehabilitation therapy following radical prostatectomy is a much debated topic. Erectile dysfunction is still a significant contributor to postoperative morbidity following radical prostatectomy, despite meticulous nerve-sparing technique. Secondary smooth muscle changes in the penis have been identified as the underlying causes of penile atrophy, veno-occlusive dysfunction, and fibrosis. Initial observations that intracavernous injection therapies used on a regular basis postoperativ...

Brewer, M. Eric; Kim, Edward D.

2009-01-01

348

Imaging Findings of Sonography and Computed Tomography for a Penile Leiomyosarcoma: A Case Report  

International Nuclear Information System (INIS)

We report the ultrasonographic and computed tomography (CT) findings of a deep type of penile leiomyosarcoma that helped characterize a penile mass along with a review of the published literature. Leiomyosarcoma of the penis is a very rare disease characterized by a lobulated, expansile, soft tissue mass in CT images, with peripheral rim enhancement and internal homogeneous low density. The ultrasonographic findings revealed a lobulated and heterogeneously hypoechoic solid mass at the distal tip of the penis

2009-12-01

349

Penile fracture repair: assessment of early results and complications using color Doppler ultrasound.  

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The aim of this study was to determine early results and complications of penile fracture treated with immediate surgical repair by means of color Doppler ultrasound study. Four patients with the clinical features of penile fracture were submitted to immediate surgical exploration via a subcoronal incision with repair of the torn cavernosal albuginea (unilateral in three cases, bilateral in one case) and anastomosis of the transected urethra (one case). Color Doppler ultrasound (CDUS) was per...

Gontero, Paolo

2000-01-01

350

Penile fracture with bilateral corporeal rupture and complete urethral disruption: case report and literature review  

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Penile fracture is a rare injury most commonly sustained during sexual intercourse. We report the case of a 35-year-old man who presented with bilateral rupture of the corpora cavernosa and complete disruption of the urethra. A review of the literature on penile fracture is also presented. Urgent surgical exploration was performed and the injuries repaired primarily. In follow-up, the patient reported satisfactory erectile function. This case highlights the importance of early surgical repair...

Hoag, Nathan A.; Hennessey, Kiara; So, Alan

2011-01-01

351

Penile ischemia and loss due to warfarin-induced skin necrosis.  

Science.gov (United States)

A 30-year-old man with a history of bilateral deep vein thromboses and recurrent penile ischemic episodes presented for distal penile amputation and skin graft. Despite suspicion, serologies indicated no hypercoagulable disorder. After surgery, the patient was bridged from enoxaparin to warfarin. Nine days after initiation of warfarin therapy, he developed necrotic arm ulcers, which were subsequently proved to be secondary to warfarin-induced skin necrosis. PMID:20451980

Talbert, Melissa; Wood, Hadley

2011-02-01

352

Penile and scrotal strangulation caused by a steel ring: a case report  

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Application of constricting devices on the external male genitalia for increasing sexual performance is an unusual practice that can potentially lead to penile strangulation with severe consequences. In this case report we describe a case of a 48 year old male who presented in our hospital with a steel ring on his external genitalia which led to penile strangulation and a short review of the literature. The foreign body was successfully removed by an angle grinder which was not immediately av...

Efthimiou, Ioannis; Kazoulis, Savas; Christoulakis, Ioannis

2008-01-01

353

Penile Replantation, Science or Myth? A Systematic Review  

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Full Text Available Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Introduction: Penile amputation is a rare urologic condition for which immediate surgical replantation is warranted. The surgical technique used for repair has been modified and refined. Our aim was to assess the effects of several interventions and management for amputated penis after replantation. Materials and Methods: We searched the MEDLINE (January 1966 to May 2007, EMBASE (January 1988 to January 2007, CINAHL (January 1982 to January 2007, PsycLIT (January 1984 to January 2007, ERIC (January 1984 to January 2007, and the bibliographic data of relevant articles; hand-searched conference proceedings; and contacted investigators to locate studies. All reported cases of penile replantation were studied. We assessed all titles, abstracts, and extracted data from the articles identified for inclusion. Outcome measures included cosmetic outcomes, acceptability, operative time, restoration of erectile function, sensibility of the glans, and long-term outcomes. Results: Eighty patients had undergone penile replantation. There was considerable variation in the interventions, patients, and outcome measures. The majority of the reported cases in this area continue to be of moderate quality, although more recent cases have been of higher quality in terms of both patients' demographics and surgical techniques. Data were not available in all of the cases for many of the outcomes expected to be reported. There were several important variations in the cases studied. Conclusion: The value of the various microsurgical techniques for replantation of the penis remains uncertain. Meticulous microsurgical techniques by experienced surgeons can reduce skin, urethra, and graft loss complications and produce a functional organ; nonetheless, such complications are still highly prevalent.

Mohammad Reza Safarinejad

2007-02-01

354

Penile necrosis due to calciphylaxis in a patient of end stage renal disease  

International Nuclear Information System (INIS)

A case of a 72-year-old diabetic, hypertensive male with end stage renal disease as a result of the underlying condition of calciphylaxis, presenting with gangrene of the glans penis is reported. In calciphylaxis, calcification of small and medium-sized arteries occurs, which may result in ischemia and gangrene. A computed tomography scan of the lower abdomen, pelvis and the upper thigh was performed, which showed diffuse and extensive calcification of the walls of the small and medium-sized arteries, with almost complete obliteration of the lumen of the small arteries. A 3-dimensional reconstruction of the penis using volume rendering technique, demonstrated the ulceration of the glans penis in an exquisite manner. The appearance is so peculiar that no histological confirmation is needed. A review of relevant literature related to the etiopathogenesis, radiological findings, treatment and prognosis is also discussed. (author)

2009-01-01

355

Preservation of Cavernosal Erectile Function after Soft Penile Prosthesis Implant in Peyronie's Disease: Long-Term Followup  

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The aim of this retrospective study is to evaluate the long-term followup of soft penile SSDA prosthesis, without plaque surgery in the treatment of Peyronie's disease. This study included 12 men with Peyronie's disease who underwent placement of a penile prosthesis. All patients were followed for at least 6 years. Prosthesis straightened the penile shaft in all cases, restoring patient sexual satisfaction. No operative or postoperative complications occurred, and no reoperations were needed....

2008-01-01

356

Penile traction therapy and Peyronies disease: a state of art review of the current literature  

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In recent years, penile traction therapy (PTT) has gained considerable interest as a novel nonsurgical treatment option for men with Peyronies disease (PD) and short penises. The current published literature suggests that selected cases of PD may benefit from a conservative approach with PTT, resulting in increased penile length and reduction of penile deformity. It appears to be safe and well tolerated but requires a great deal of patient compliance and determination. This article reviews...

2013-01-01

357

Increased adenosine contributes to penile fibrosis, a dangerous feature of priapism, via A2B adenosine receptor signaling  

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Priapism is a condition of persistent penile erection in the absence of sexual excitation. Of men with sickle cell disease (SCD), 40% display priapism. The disorder is a dangerous and urgent condition, given its association with penile fibrosis and eventual erectile dysfunction. Current strategies to prevent its progression are poor because of a lack of fundamental understanding of the molecular mechanisms for penile fibrosis in priapism. Here we demonstrate that increased adenosine is a nove...

Wen, Jiaming; Jiang, Xianzhen; Dai, Yingbo; Zhang, Yujin; Tang, Yuxin; Sun, Hong; Mi, Tiejuan; Phatarpekar, Prasad V.; Kellems, Rodney E.; Blackburn, Michael R.; Xia, Yang

2010-01-01

358

The use of iliac bone flap as a penile stiffener in a diabetic patient with erectile dysfunction.  

Science.gov (United States)

A diabetic man with erectile dysfunction in whom two previous attempts at penile prosthesis implantation had failed was treated by using an iliac bone flap as a penile stiffener. The patient had satisfactory sexual function with his penis; it retained its size and stiffness during the 1-year follow-up period. We recommend this method for use in patients in whom multiple earlier attempts at penile prosthesis implantation were unsuccessful. PMID:10359262

Akz, T; Kargi, E; Kapucu, M R; Erdo?an, B

1999-06-01

359

Penile Growth in Response to Human Chorionic Gonadotropin (hCG) Treatment in Patients with Idiopathic Hypogonadotrophic Hypogonadism  

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Penile growth is under androgenic control. Human chorionic gonadotropin (hCG) has a stimulatory effect on testicular steroidogenesis and penile growth. The purpose of this study was to evaluate the effect of hCG treatment on the gonadal response and penile growth in male idiopathic hypogonadotrophic hypogonadism (IHH) presenting with micropenis. A total of 20 IHH patients who met the criteria for micropenis were included in this study. hCG (1,500-2,000 IU) was administrated intramuscularly, 3...

Kim, Sun-ouck; Ryu, Kwang Ho; Hwang, In Sang; Jung, Seung Il; Oh, Kyung Jin; Park, Kwangsung

2011-01-01

360

Differential diagnosis of infundibular dilation versus a small aneurysm of the internal carotid artery: assessment by three-dimensional rotational angiography with volume rendering.  

Science.gov (United States)

We report our findings associated with the differential diagnosis of infundibular dilation (ID) versus a small intracranial aneurysm using three-dimensional rotational angiography with volume rendering (3DRA + VR). Angiographic findings associated with IDs found via two-dimensional digital subtraction angiography (2D-DSA) or 3DRA + VR were reviewed for 138 consecutive patients with known or suspected aneurysms. Two readers independently evaluated the results of 2D-DSA and 3DRA + VR according to the same diagnostic criteria. We also evaluated the ability of 3D-DSA to show the spatial relation between IDs and anterior choroidal (AchA)/posterior communicating (PcomA) arteries. 2D-DSA and 3DRA + VR found 41 and 48 IDs, respectively. 2D-DSA missed five AchA and two PcomA IDs. 2D-DSA was significantly inferior to 3DRA + VR for displaying the spatial relation between IDs and AchA/PcomA (P = 0). Thus, 3DRA + VR provides more useful information for distinguishing IDs from aneurysms. The superiority of 3DRA + VR might be because of its ability to display the spatial relation between IDs and AchA/PcomA. PMID:22986636

Shi, Wan-Yin; Li, Yong-Dong; Li, Ming-Hua; Gu, Bin-Xian; Gu, Jian-Ping

2013-07-01

 
 
 
 
361

Effects of small doses of ouabain on the arterial blood pressure of anesthetized hypertensive and normotensive rats  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english Ouabain increases vascular resistance and may induce hypertension by inhibiting the Na+ pump. The effects of 0.18 and 18 g/kg, and 1.8 mg/kg ouabain pretreatment on the phenylephrine (PHE; 0.1, 0.25 and 0.5 g, in bolus)-evoked pressor responses were investigated using anesthetized normotensive (co [...] ntrol and uninephrectomized) and hypertensive (1K1C and DOCA-salt treated) rats. Treatment with 18 g/kg ouabain increased systolic and diastolic blood pressure in all groups studied. However, the magnitude of this increase was larger for the hypertensive 1K1C and DOCA-salt rats than for normotensive animals, while the pressor effect of 0.18 g/kg ouabain was greater only in DOCA-salt rats. A very large dose (1.8 mg/kg) produced toxic effects on the normotensive control but not on uninephrectomized or 1K1C rats. Rat tail vascular beds were perfused to analyze the effects of 10 nM ouabain on the pressor response to PHE. In all animals, 10 nM ouabain increased the PHE pressor response, but this increase was larger in hypertensive DOCA-salt rats than in normotensive and 1K1C rats. Results suggested that a) increases in diastolic blood pressure induced by 18 g/kg ouabain were larger in hypertensive than normotensive rats; b) in DOCA-salt rats, smaller ouabain doses had a stronger effect than in other groups; c) hypertensive and uninephrectomized rats were less sensitive to toxic doses of ouabain, and d) after treatment with 10 nM ouabain isolated tail vascular beds from DOCA-salt rats were more sensitive to the pressor effect of PHE than those from normotensive and 1K1C hypertensive rats. These data suggest that very small doses of ouabain, which might produce nanomolar plasma concentrations, enhance pressor reactivity in DOCA-salt hypertensive rats, supporting the idea that endogenous ouabain may contribute to the increase and maintenance of vascular tone in hypertension.

L.V., Rossoni; V.D., Pinto; D.V., Vassallo.

362

Effects of small doses of ouabain on the arterial blood pressure of anesthetized hypertensive and normotensive rats  

Directory of Open Access Journals (Sweden)

Full Text Available Ouabain increases vascular resistance and may induce hypertension by inhibiting the Na+ pump. The effects of 0.18 and 18 g/kg, and 1.8 mg/kg ouabain pretreatment on the phenylephrine (PHE; 0.1, 0.25 and 0.5 g, in bolus-evoked pressor responses were investigated using anesthetized normotensive (control and uninephrectomized and hypertensive (1K1C and DOCA-salt treated rats. Treatment with 18 g/kg ouabain increased systolic and diastolic blood pressure in all groups studied. However, the magnitude of this increase was larger for the hypertensive 1K1C and DOCA-salt rats than for normotensive animals, while the pressor effect of 0.18 g/kg ouabain was greater only in DOCA-salt rats. A very large dose (1.8 mg/kg produced toxic effects on the normotensive control but not on uninephrectomized or 1K1C rats. Rat tail vascular beds were perfused to analyze the effects of 10 nM ouabain on the pressor response to PHE. In all animals, 10 nM ouabain increased the PHE pressor response, but this increase was larger in hypertensive DOCA-salt rats than in normotensive and 1K1C rats. Results suggested that a increases in diastolic blood pressure induced by 18 g/kg ouabain were larger in hypertensive than normotensive rats; b in DOCA-salt rats, smaller ouabain doses had a stronger effect than in other groups; c hypertensive and uninephrectomized rats were less sensitive to toxic doses of ouabain, and d after treatment with 10 nM ouabain isolated tail vascular beds from DOCA-salt rats were more sensitive to the pressor effect of PHE than those from normotensive and 1K1C hypertensive rats. These data suggest that very small doses of ouabain, which might produce nanomolar plasma concentrations, enhance pressor reactivity in DOCA-salt hypertensive rats, supporting the idea that endogenous ouabain may contribute to the increase and maintenance of vascular tone in hypertension.

L.V. Rossoni

2001-08-01

363

Influence of a small field-of-view size on the detection of coronary artery calcifications with MSCT: in vitro and in vivo study  

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The purpose of this study is to asses the impact of small field-of-view (FOV) sizes on the detection of coronary artery calcifications using multislice-spiral computed tomography (MSCT). First, a static chest phantom containing calcium inserts was scanned 10 times using a standardized scan protocol. Secondly, 50 patients (28 male, 63.6{+-}10.6 years) underwent cardiac MSCT using the same protocol. Images were reconstructed with three different FOV sizes (180 x 180, 220 x 220, 380 x 380 mm{sup 2}). Coronary calcium scoring and risk stratification were performed for each image series. In the phantom study, the Agatston score calculated with a FOV size of 180 x 180 mm{sup 2} was 657.80{+-}20.05. At a FOV of 220 x 220 mm{sup 2} and 380 x 380 mm{sup 2}, the corresponding values were 657.04{+-}21.36 and 655.04{+-}20.74, respectively. The corresponding values in the patient study were 541.65{+-}869.87, 541.91{+-}872.57 and 536.61{+-}867.81. No statistically significant differences in the calcium score were found comparing different FOV sizes. Significantly more lesions (p=0.00149) were detected in the patient study. Comparing the different FOV sizes of 180 x 180 mm{sup 2} and 220 x 220 mm{sup 2} (380 x 380 mm{sup 2}), four (six) patients had to be assigned to different risk groups. The use of small FOV sizes resulted in an improved detection of coronary calcifications influencing the risk stratification for further cardiac events in MSCT coronary calcium scoring. (orig.)

Mahnken, Andreas H.; Muehlenbruch, Georg; Das, Marco; Pohl, Saskia; Guenther, Rolf W.; Wildberger, Joachim E. [Aachen University of Technology, Department of Diagnostic Radiology, Aachen (Germany); Koos, Ralf [Aachen University of Technology, Medical Clinic I, Aachen (Germany); Stanzel, Sven [Aachen University of Technology, Institute of Medical Statistics, Aachen (Germany)

2006-02-01

364

Penile prosthesis implantation in an academic institution in Latin America  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english PURPOSE: We performed a retrospective study to analyze the effectiveness of implantable penile prostheses in the treatment of erectile dysfunction. MATERIALS AND METHODS: This study included 249 patients who received implants between 2001 and 2008. A total of 139 patients who underwent penile prosth [...] esis implantation were interviewed. RESULTS: Approximately half of patients had previously used oral drugs before implantation of the prosthesis. About 45% had diabetes, 25.9% had previously undergone radical prostatectomy (RP), and 64% had hypertension. Exchange was performed in 5.7% for fracture, inadequate size, or extrusion. A total of 24.5% of men had immediate postoperative pain, 7.9% had local infection, and 8.6% had other complications. Patients who had previously undergone RP were 3.2 times more likely to experience a postoperative complication than patients who had not (p = 0.061). Eighty-nine (64%) patients returned to having sex as they had before being diagnosed with ED. Ninety-two of the men (66.2%) had sexual intercourse one to two times per week. One hundred twenty patients (86.3%) rated their level of satisfaction as good, excellent or very good, which was similar to the percentage of partners. The mean follow-up was 40 months. CONCLUSION: Higher rates of postoperative infections and mechanical problems with the implant were found in this study as compared to other studies, which was probably associated with the relative lack of experience of the trainees who were performing the surgeries. Patients with a history of RP or diabetes mellitus prior to implantation were at higher risk of postoperative complications.

Paranhos, Mario; Andrade, Enrico; Antunes, Alberto A.; Barbieri, Ana L. N.; Claro, Joaquim A.; Srougi, Miguel.

365

A New, Innovative, Lengthening Surgical Procedure for Peyronie's Disease by Penile Prosthesis Implantation with Double Dorsal-Ventral Patch Graft: The "Sliding Technique"  

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Introduction.? Peyronie's disease is the result of the formation of fibrous plaques in the tunica albuginea of the penis; typical presentations of the disease are represented by pain during erection, erectile dysfunction, and penile deformities, such as curvature, narrowing, and penile shortening. The most complex treatment is related to penile shortening. Aim.? To find a safe procedure in penile shortening due to Peyronie's disease providing a satisfactory lengthening, allowing an early ...

2012-01-01

366

Distribution of mesenteric cranial artery in the small intestine of Procyon cancrivorus (Cuvier, 1798 (Mammalia, Procyonidae = Comportamento da artria mesentrica cranial no intestino delgado de mo-pelada Procyon cancrivorus (Cuvier, 1798 (Mammalia, Procyonidae  

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Full Text Available The mesenteric artery is a high caliber vessel dependent on the abdominal artery, right below the emergence of the vessels destined for the liver and stomach. The present study aimed to describe the behavior of the arterial vessel in the small intestine of the crab-eating raccoon (Procyon cancrivorus. The animals were collected on highways (roadkill. Cannulation of the abdominal aorta, perfusion with warmed water (40C and stained latex injection (Neoprene 450, Dupont do Brasil and Sulvinil stain, Glassuret S.A were performed, followed by formaldehyde fixation (10%. The dissection and photographic documents (Sony Cyber-shot, 8.1 megapixels made it possible to systemize the arteries and define the vascular patterns of the viscera. It was verified that the mesenteric cranial artery supports the entire jejune and the mesenteric portion of the ileum. Next to the mesenteric border, it becomes an anastomosis forming vascular arches from where straight arteries leave, supplying the mesenteric portion and sometimes also the jejunal antimesentericportion. The artery that irrigates the ileum comes up as a branch of the cranial mesenteric artery. Anatomic knowledge of the vascular pattern of the crab-eating raccoon (Procyon cancrivorus is of fundamental importance for researches regarding the arterialdistribution of the intestine considering anatomic variances.A artria mesentrica um vaso de grande calibre dependente da artria aorta abdominal, imediatamente abaixo da emergncia dos vasos destinados ao fgado e estmago. O objetivo do presente estudo foi descrever o comportamento dos vasos arteriais do intestino delgado em mo-pelada (Procyon cancrivorus. Os animais so procedentes de coleta em rodovias (mortos por acidente. Realizou-se a canulao da aorta abdominal, perfuso com gua aquecida (40C e injeo de ltex corado (Neoprene 450, Dupont do Brasil e Sulvinil Corante, Glassuret S.A, seguido de fixao em formaldedo (10%. As dissecaes edocumentao fotogrfica (Cmera Sony Cyber-shot, 8.1 megapixels permitiram sistematizar as artrias e definir os padres vasculares da vscera. Verificamos que a artria mesentrica cranial supre todo o jejuno e a face mesentrica do leo. Prximo borda mesentrica, anastomosa-se formando as arcadas vasculares e desta partem as artrias retas, que suprem face mesentrica e, s vezes, a face antimesentrica do jejuno. A artria que irriga o leo surge como ltimo ramo da artria mesentrica cranial. O conhecimento anatmico do padro vascular de mo-pelada (Procyon cancrivorus de fundamental importncia em pesquisas que se referem distribuio arterial do intestino, levando-se em considerao as variaes anatmicas.

Vanessa Morais Lima

2010-04-01

367

Prevalence of human papillomavirus and Epstein-Barr virus DNA in penile cancer cases from Brazil  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english Penile cancer is a potentially mutilating disease. Although its occurrence is relatively rare worldwide, penile cancer rates can be high in developing countries. A few studies have been conducted on the involvement of human papillomavirus (HPV) in penile carcinoma, which have found HPV present in 30 [...] -70% of penile malignant lesions, with a higher prevalence of HPV 16 and 18. It has been assumed that cofactors, such as Epstein-Barr virus (EBV) infections, may play a role in the progression of penile neoplasia. The aim of this study was to determine HPV and EBV prevalence in 135 penile malignant lesions from Brazilian men through the use of MY09/11 polymerase chain reaction (PCR), type-specific PCR and restriction fragment length polymorphism analysis. HPV prevalence among the men tested was 60.7%. Of the men who tested positive, 27 presented with HPV 16 (29.7%), five with HPV 18 (5.5%), 21 with HPV 45 (23.1%) and nine with HPV 6 (9.9%). Seven mixed infections were detected (9.2%), while 11 cases remained untyped (13.4%). Regarding EBV positivity, 46.7% of the samples contained EBV DNA with EBV-1 as the most prevalent type (74.6%). More than 23% of the men were co-infected with both HPV and EBV, while 35% presented exclusively with HPV DNA and 20% presented only with EBV DNA. Penile carcinoma aetiology has not been fully elucidated and the role of HPV and EBV infections individually or synergistically is still controversial. Hence, more studies are needed to determine their possible role in carcinogenesis.

Larissa Alves, Afonso; Natalia, Moyses; Gilda, Alves; Antnio Augusto, Ornellas; Mauro Romero Leal, Passos; Ledy do Horto dos Santos, Oliveira; Silvia Maria Baeta, Cavalcanti.

368

Relative androgen sensitivity of the vascular and striated-muscle systems regulating penile erection in rats.  

Science.gov (United States)

In this study we sought to compare the androgen sensitivity of the penile vascular erectile system with that of the striated muscles that augment the vascular effectors. All males were castrated 2 weeks before the experiments. At the time of castration, all males were implanted SC with a 45-mm testosterone (T)-filled Silastic capsule to maintain reflexive erections in ex copula tests. Experimental males had the bulbospongiosus (bulbocavernosus and levator ani) and ischiocavernosus muscles removed, while control animals underwent sham muscle excision surgery. After two baseline penile reflex tests, the T capsules were removed, and the groups were compared for the rate of loss of penile responses over 5 weeks. After these tests were completed, the T capsules were reimplanted and the two groups were compared for the rate of restoration of penile reflexes. These tests were conducted at 6, 12, 24, 36, 48, 72, and 96 h after reimplantation of the T capsules. Our results demonstrated that the vascular effector mechanisms responsible for initiating erections are androgen sensitive. The effects of T withdrawal and replacement on erection latency and low intensity erections (E1s) were manifested at about the same rate in the vascular and striated muscle effector systems. In contrast, the restoration of moderate intensity erections (E2s) by T occurred at a faster rate in rats with intact penile muscles. This result suggests that T was acting on the striated muscle effector systems to augment penile erection during this time, presumably due to the bulbospongiosus muscle exerting greater force on the penile bulb. PMID:8295945

Leipheimer, R E; Sachs, B D

1993-12-01

369

3',4'-Dihydroxyflavonol restores endothelium-dependent relaxation in small mesenteric artery from rats with type 1 and type 2 diabetes.  

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Diabetes is known to cause an overproduction of reactive oxygen species (ROS), contributing to the impairment of endothelium-dependent relaxation in microvasculature, however it is not clear whether antioxidants are able to reverse microvascular endothelial dysfunction. The aim of this study is to investigate whether the synthetic flavonol 3',4'-dihydroxyflavonol (DiOHF) could reduce the levels of reactive oxygen species (ROS) and improve endothelium-dependent relaxation in mesenteric arteries from both type 1 and type 2 diabetic rats. Endothelial function of third order mesenteric arteries from type 1 and type 2 diabetic rats was assessed using wire-myography. Superoxide levels in the mesenteric arteries were measured by L-012-induced chemiluminescence. Mesenteric arteries from type 1 and type 2 diabetic rats had elevated levels of superoxide production compared to control, which was accompanied by impaired responses to the endothelium-dependent relaxant, acetylcholine (ACh). The acute presence of DiOHF ex vivo significantly reduced the superoxide levels in the diabetic mesenteric arteries and restored endothelial function. The antioxidant activity of DiOHF is comparable to superoxide dismutase mimetics (tempol and MnTMPyP), which also significantly reduced the superoxide levels and improved endothelial function in diabetic arteries. Therefore, the synthetic flavonol DiOHF could effectively reduce oxidant stress and restore microvascular endothelium-dependent relaxation in diabetic rats. PMID:21453697

Leo, Chen-Huei; Hart, Joanne L; Woodman, Owen L

2011-06-01

370

Comparing Absorbable and Nonabsorbable Sutures in Corporeal Plication for Treatment of Congenital Penile Curvature  

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Full Text Available PURPOSE: To compare the outcome of corporeal plication using absorbable versus nonabsorbable sutures for the treatment of congenital penile curvature.MATERIALS AND METHODS: Thirty-eight men older than 15 years old with congenital penile curvature were enrolled in the study. Patients were randomly divided into two equal groups based on the suture material (Nylon versus Vicryl used in corporeal plication. Patients were followed up for a mean period of 8.1 1.4 months (range, 6 to 9.1 months. A standardized questionnaire was used to evaluate long-term outcome and patients satisfaction. RESULTS: Thirty-five patients (17 in Vicryl group and 18 in Nylon group completed the study. Mean age of the patients and degree of penile curvature were not significantly different between the two groups (P = .74. Postoperatively, 15 (88.2% and 16 (88.9% patients in Vicryl and Nylon groups had 75% or greater correction in penile curvature, respectively (P = .61. Patients satisfaction rate differed between two groups (82% in Vicryl group versus 66% in Nylon group, which did not reach statistical significance (P = .44. Palpable sutures were reported by 7 (39% patients in Nylon group and only 1 (6% in Vicryl group (P = .04. Shortening of penile length was reported by 3 (16.7% patients in Nylon group and 4 (23.5% in Vicryl group (P = .69.CONCLUSION: Corporeal plication technique using absorbable suture provides reasonable success rate with less frequent palpable suture knots.

Abbas Basiri

2011-11-01

371

Penile reconstruction for a case of genital lymphoedema secondary to proteus syndrome.  

Science.gov (United States)

To our knowledge penile lymphoedema secondary to Proteus syndrome has not previously been reported. Hence we report a case of a 16-year-old male who was referred with features of right hemi-hypertrophy and severe lymphoedema affecting his scrotum and penis. He had previously undergone scrotal reduction surgery at the age of 13, but had since developed worsening penile oedema. His main concern was that of cosmetic appearance prior to sexual debut, and he also complained of erectile dysfunction. An MRI confirmed gross oedema of the penile skin, but normal underlying cavernosal structure, and no other anatomical abnormality. Under general anaesthesia, the entire diseased penile skin was excised. Two full thickness skin grafts were harvested from the axillae, and grafted onto the dorsal and ventral penile shaft respectively. A compressive dressing and urinary catheter was applied for 7 days. Follow-up at 4 months confirmed complete graft take with minimal scarring, and the patient was very satisfied with the cosmetic outcome. He had also noticed a recovery in erectile activity, and feels psychologically and physically more prepared for sexual relations. PMID:22084799

Ashouri, F; Manners, J; Rees, R

2011-01-01

372

Mechanisms Predisposing Penile Fracture and Long-Term Outcomes on Erectile and Voiding Functions  

Science.gov (United States)

Purpose. To determine the mechanisms predisposing penile fracture as well as the rate of long-term penile deformity and erectile and voiding functions. Methods. All fractures were repaired on an emergency basis via subcoronal incision and absorbable suture with simultaneous repair of eventual urethral lesion. Patients' status before fracture and voiding and erectile functions at long term were assessed by periodic follow-up and phone call. Detailed history included cause, symptoms, and single-question self-report of erectile and voiding functions. Results. Among the 44 suspicious cases, 42 (95.4%) were confirmed, mean age was 34.5 years (range: 1860), mean follow-up 59.3 months (range 9155). Half presented the classical triad of audible crack, detumescence, and pain. Heterosexual intercourse was the most common cause (28 patients, 66.7%), followed by penile manipulation (6 patients, 14.3%), and homosexual intercourse (4 patients, 9.5%). Woman on top was the most common heterosexual position (n = 14, 50%), followed by doggy style (n = 8, 28.6%). Four patients (9.5%) maintained the cause unclear. Six (14.3%) patients had urethral injury and two (4.8%) had erectile dysfunction, treated by penile prosthesis and PDE-5i. No patient showed urethral fistula, voiding deterioration, penile nodule/curve or pain. Conclusions. Woman on top was the potentially riskiest sexual position (50%). Immediate surgical treatment warrants long-term very low morbidity.

Reis, Leonardo O.; Cartapatti, Marcelo; Marmiroli, Rafael; de Oliveira Junior, Eduardo Jeronimo; Saade, Ricardo Destro; Fregonesi, Adriano

2014-01-01

373

Human papillomavirus infection induces NF-?B activation in cervical cancer: A comparison with penile cancer  

Science.gov (United States)

This study aimed to determine the relationship between human papillomavirus (HPV) and nuclear factor-?B (NF-?B) in cervical cancer using 62 tissues of cervical cancer, and to compare the findings to penile cancer. HPV-DNA integration is a crucial factor for malignant transformation in cervical cancer and can be identified using in situ hybridization. Of the 62 cases, HPV infection was detected in 28 (45.2%). This frequency was lower than in penile cancer (68.2%) as shown by our previous study. The earliest age of onset of cervical and penile cancer was 18 and 35, respectively, whereas the mean age of the initial diagnosis of cervical and penile cancer was 50.1 and 59.6, respectively. The discrepancies of HPV prevalence, earliest ages of onset and mean ages between cervical and penile cancer patients may result from the gender-based synergistic action of HPV associated with multiple epidemiological co-factors. Of the 28 HPV-infected cases, NF-?B expression was observed in the nucleus in 18 (64.3%), in the cytoplasm in 19 (67.9%) and in the nucleus and/or cytoplasm in 27 cases (96.4%). The overexpression of NF-?B in cervical cancer cases suggests that NF-?B activation is a key modulator in driving chronic inflammation to cancer.

SENBA, MASACHIKA; BUZIBA, NATHAN; MORI, NAOKI; FUJITA, SHUICHI; MORIMOTO, KONOSUKE; WADA, AKIHIRO; TORIYAMA, KAN

2011-01-01

374

Panax notoginseng saponins improve the erectile dysfunction in diabetic rats by protecting the endothelial function of the penile corpus cavernosum.  

Science.gov (United States)

Diabetes mellitus (DM)-associated ED is predominantly due to neurovascular dysfunction mediated by nitric oxide (NO) suppression. Panax notoginseng saponins (PNS) are widely used for treating cardiovascular disease in China. The aim of this study was to evaluate the effects of PNS on penile erection and corpus cavernosum tissues in rats with diabetes-associated ED. Four weeks after PNS treatment, erectile function was assessed by intracavernous pressure (ICP) and mean arterial pressure (MAP) measurements. The level of NO, cyclic guanosine monophosphate (cGMP) and advanced glycation end products (AGEs) in cavernous tissue were assessed. Immunohistochemical staining and TUNEL (terminal deoxynucleotidyl transferase dUTP nick end labeling) were performed for detecting endothelial NO synthase (eNOS) and apoptosis, respectively. The results show that ICP/MAP ratio was significantly increased in high-dose (150 mg kg(-1) per day) PNS-treated group compared with the diabetic ED untreated group (DM group). Compared with the untreated group, the expression of eNOS and the levels of NO and cGMP were increased in the PNS-treated groups. Moreover, apoptosis was markedly decreased in the group that received 150 mg kg(-1) per day of PNS. These results suggest that PNS may be used for improving the ED in diabetic rats via the NO/cGMP pathway and restores the function of endothelium in corpus cavernosum. PMID:23595104

Lin, F; Gou, X

2013-01-01

375

Caverno-pudendal nervous communicating branches in the penile hilum.  

Science.gov (United States)

Classically, the peripheral neural pathways for erection are proerectile, issuing from the parasympathetic sacral fibres, and antierectile from the thoracolumbar sympathetic trunk. The cavernous nerves as terminal branches of the pelvic plexus convey the parasympathetic fibres to the penis. The pudendal nerve conveys sensory fibres from the penis and somatic fibres to the bulbos-pongiosus and ischiocavernosus striated mm. In animals, it has been demonstrated that the dorsal nerve of the penis contains sympathetic fibres. These findings suggest that communicating branches exist between the cavernous nerves and the dorsal nerve. Our aim in this study was to demonstrate the presence of such connections in man. We dissected 20 fresh male cadavers. The pelvic plexus and pudendal nerves were dissected to identify their terminal branches and connections. Histologic study was performed. Our results showed evidence of communicating nervous branches between the cavernous nerves and the dorsal nerve of the penis. Several variants existed concerning the number and type of connections. The presence of such communicating branches proves that the supralevator and infralevator neural pathways communicate and suggest the possibility of a kind of plasticity of the nervous supply of penile erection. Further studies are needed to identify the nature of these communicating branches. PMID:10549085

Colombel, M; Droupy, S; Paradis, V; Lassau, J P; Benot, G

1999-01-01

376

Penile metastasis from primary transitional cell carcinoma of the renal pelvis: first manifestation of systemic spread  

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Full Text Available Abstract Background Almost one-third of all penile metastases are detected at the same time as a primary tumor, whereas the remaining two-thirds are detected a mean of 18 months after the discovery of the primary tumor. Cutaneous metastasis of transitional cell carcinoma (TCC is extremely rare and generally accepted as the late manifestation of a systemic spread. Case presentation We report the first case of simultaneous penile and lung metastases from a primary TCC of the renal pelvis in a 76-year-old man, that occurred 8 years after a left nephroureterectomy. Conclusions This case report underscores the importance of physical examinations of the skin of patients who undergo surgical procedures for TCC from bladder as well as from the upper urinary tract, including those seemingly without metastatic disease, because of the possibility of skin and penile metastatic spread.

Casale Paolo

2004-12-01

377

Corporoplasty using bovine pericardium grafts in complex penile prosthesis implantation surgery  

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Full Text Available Purpose: This paper is the first, to our knowledge, to propose the use of a bovine pericardium graft in corporoplasty for penile prosthesis implantation. The advantages of bovine pericardium graft have been demonstrated by its use in cardiac surgery, including low cost, biocompatibility, impermeability, resistance to dilatation, flexibility, low likelihood of retraction, absence of antigenic reaction and natural absorption of the tissue. In this paper, we propose the use of this heterologous material graft in corporoplasty for penile prosthesis implantation. Materials and Methods: Five patients with a history of erosion, infection and fibrosis, mean time of follow-up 32 months (range 9-48 months. Bovine pericardium was used to cover large areas of implanted penile prostheses when use of the tunica albuginea was unfeasible. Results: The surgical procedure resulted in no complications in all patients. Conclusions: Bovine pericardium may substitute synthetic and autologous material with the additional advantages of lower cost and greater availability.

Eduardo J. A. Lopes

2009-02-01

378

Cutaneous temperature measurements in men with penile prostheses: a comparison study.  

Science.gov (United States)

To evaluate and compare the cutaneous temperature of the penis in normal men, those with erectile dysfunction (ED), those with semirigid penile prostheses (SRPPs), and those with inflatable penile prostheses (IPPs), and those before and after trimix injection to create a penile erection. A total of 68 patients were evaluated. Five patient groups were identified, including men with normal erectile function, with ED, with SRPPs, with IPPs, and following intracavernosal injection of trimix solution. Cutaneous glans temperature increased significantly by more than 2.2 degrees C in the trimix-injected group compared with all other groups (Ptrimix. Men with normal erectile function, ED, and IPPs did not have significant cutaneous temperature differences. PMID:15889119

Fogarty, J D; Bleustein, C B; Hafron, J M; Melman, A

2005-01-01

379

Early Onset Inflammation in Pre-Insulin-Resistant Diet-Induced Obese Rats Does Not Affect the Vasoreactivity of Isolated Small Mesenteric Arteries  

DEFF Research Database (Denmark)

Background: Obesity is an increasing burden affecting developed and emerging societies since it is associated with an increased risk of diabetes and consequent cardiovascular complications. Increasing evidence points towards a pivotal role of inflammation in the etiology of vascular dysfunction. Our study aimed to investigate signs of inflammation and their relation to vascular dysfunction in rats receiving a high fat diet. Methods: Diet-induced obese (DIO) rats were used as a model since these rats exhibit a human pre-diabetic pathology. Oral glucose and insulin tolerance tests were conducted on DIO rats and their controls prior to the development of insulin resistance. Furthermore, the plasma contents of selected cytokines [macrophage chemoattractant protein (MCP-1), interleukin-6 (IL-6), and interleukin-1 (IL-1)] and the concentration of adiponectin were measured. Using wire myography, we tested the vascular function of isolated small mesenteric arteries. Results: DIO animals had significantly (p <0.05) increased body weight (721.2 ± 6.3 g) compared to age- and sex-matched controls (643.4 ± 14.6 g), as well as a significant increase (p <0.01) in body fat percentage (29.7 ± 1.7% and 22.7 ± 0.97%, respectively). No significant difference in fasting plasma insulin levels could be detected between the two groups (chow-fed group 141.5 ± 15.1 pmol/l; high fat-fed group 125.9 ± 18.8 pmol/l). However, the levels of MCP-1 (89.7 ± 4.2 pg/ml vs. 60.8 ± 7.7 pg/ml) and IL-6 (61.6 ± 3.1 pg/ml vs. 41.6 ± 7.4 pg/ml) were significantly elevated in DIO animals (p <0.05) as compared to controls. Adiponectin levels were also significantly increased (p <0.01) in DIO rats (10.8 ± 0.7 ng/ml) versus controls (6.9 ± 0.5 ng/ml). No difference in vascular or endothelial function was evident as determined by responses to acetylcholine, sodium nitroprusside, endothelin-1, and calcitonin gene-related peptide. Conclusion: In DIO rats, which have not yet developed hyperinsulinaemia or glucose intolerance, the levels of inflammatory mediatorsMCP-1 and Il-6 are significantly increased without concomitant vascular dysfunction. The results show that inflammation and obesity are tightly associated, and that inflammation is manifested prior to significant insulin resistance and vascular dysfunction.

Blædel, Martin; Raun, Kirsten

2012-01-01

380

Yolk sac tumour of the penile shaft: a rare primary extra-gonadal presentation.  

Science.gov (United States)

Germ cell tumours (GCTs) commonly involve the ovaries, testes, and other midline structures in children and adolescents and comprised a variety of tumours that have a common histiogenetic origin. The yolk sac tumour (YST) variant is the most common one seen in over 80% of testicular GCTs in children. Other sites of occurrence of these tumours include the mediastinum, prostate, retroperitoneum, and sacrococcygeal region. Penile malignancies account for less than 10% of male malignancies in the elderly, while its occurrence in children is rare. We present the case of a 5-year-old child with YST of the penile shaft and uninvolved testes. PMID:22005377

Samaila, Modupeola Omotara; Maitama, Hussaini Y; Abdullahi, Kabiru; Mbibu, Hyacinth; Waziri, Garba Dahiru

2011-01-01

 
 
 
 
381

Fstula uretrocavernosa por fractura penena / Urethrocavernous fistula due to penile fracture  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish La fractura de pene con laceracin de la uretra se presenta con dolor y hematoma, detumescencia, fallo en la ereccin y uretrorragia. Describimos el tercer caso publicado en la literatura de fistula uretrocavernosa por fractura peneana ocurrida durante el coito. [...] Abstract in english Penile fracture with urethral laceration usually presents with pain and haematoma, detumescence, erectile failure and blood loss through urethral meatus. We describe the third published case of urethrocavernous fistula following blunt penile trauma sustained durind sexual intercourse. [...

Juaneda Castell, B.; Montlle Gonzlez, M.; Ponce de Len Roca, X.; Gausa Gascn, L.l.; Caparrs Sariol, J.; Villavicencio Mavrich, H..

382

Human papillomavirus infection induces NF-?B activation in cervical cancer: A comparison with penile cancer  

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This study aimed to determine the relationship between human papillomavirus (HPV) and nuclear factor-?B (NF-?B) in cervical cancer using 62 tissues of cervical cancer, and to compare the findings to penile cancer. HPV-DNA integration is a crucial factor for malignant transformation in cervical cancer and can be identified using in situ hybridization. Of the 62 cases, HPV infection was detected in 28 (45.2%). This frequency was lower than in penile cancer (68.2%) as shown by our previous stu...

Senba, Masachika; Buziba, Nathan; Mori, Naoki; Fujita, Shuichi; Morimoto, Konosuke; Wada, Akihiro; Toriyama, Kan

2011-01-01

383

Kaposi?s sarcoma: HIV-negative man with isolated penile localization  

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Full Text Available Kaposi?s sarcoma is the malignant proliferation of the endothelial cell vessels. Its genesis is still unclear; however, it seems to be related to the herpes virus infection (HHV-8. This neoplasia usually affects the lower limbs and the affected persons are mostly from the Mediterranean region. The exclusive penile localization of the Kaposi?s sarcoma in a patient with a negative HIV serologia is exceptional. Our case is of a 73-year old patient with a negative HIV serology presenting an exclusive penile localization of the Kaposi?s sarcoma treated by radiotherapy.

Soufiane Mellas

2010-07-01

384

Penile replantation: report of two cases and review of the literature.  

Science.gov (United States)

Penile amputation and successful replantation is very uncommon, and there is no routine standardized procedures for dealing with this medical condition. Here we report two cases of penile amputation and replantation involving different degrees of vascular insult leading to different pathogenesis, clinical presentation, surgical approach and prognosis. This report described the microsurgical procedure and postoperative care using bipedicled scrotal flap to achieve successful engraftment and function. A review of the published data and future methods to increase success of such surgical procedures is provided. PMID:23384873

Li, Gui-zhong; He, Feng; Huang, Guang-ling; Man, Li-bo; Liu, Kun; Shen, Yu-ming

2013-01-01

385

Penile and scrotal strangulation caused by a steel ring: a case report.  

Science.gov (United States)

Application of constricting devices on the external male genitalia for increasing sexual performance is an unusual practice that can potentially lead to penile strangulation with severe consequences. In this case report we describe a case of a 48 year old male who presented in our hospital with a steel ring on his external genitalia which led to penile strangulation and a short review of the literature. The foreign body was successfully removed by an angle grinder which was not immediately available in the operating theatre. The patient had an uneventful recovery. PMID:18638375

Efthimiou, Ioannis; Kazoulis, Savas; Christoulakis, Ioannis

2008-01-01

386

Contouring Variability of the Penile Bulb on CT Images: Quantitative Assessment Using a Generalized Concordance Index  

International Nuclear Information System (INIS)

Purpose: Within a multicenter study (DUE-01) focused on the search of predictors of erectile dysfunction and urinary toxicity after radiotherapy for prostate cancer, a dummy run exercise on penile bulb (PB) contouring on computed tomography (CT) images was carried out. The aim of this study was to quantitatively assess interobserver contouring variability by the application of the generalized DICE index. Methods and Materials: Fifteen physicians from different Institutes drew the PB on CT images of 10 patients. The spread of DICE values was used to objectively select those observers who significantly disagreed with the others. The analyses were performed with a dedicated module in the VODCA software package. Results: DICE values were found to significantly change among observers and patients. The mean DICE value was 0.67, ranging between 0.43 and 0.80. The statistics of DICE coefficients identified 4 of 15 observers who systematically showed a value below the average (p value range, 0.013 0.059): Mean DICE values were 0.62 for the 4 bad observers compared to 0.69 of the 11 good observers. For all bad observers, the main cause of the disagreement was identified. Average DICE values were significantly worse from the average in 2 of 10 patients (0.60 vs. 0.70, p < 0.05) because of the limited visibility of the PB. Excluding the bad observers and the bad patients, the mean DICE value increased from 0.67 to 0.70; interobserver variability, expressed in terms of standard deviation of DICE spread, was also reduced. Conclusions: The obtained values of DICE around 0.7 shows an acceptable agreement, considered the small dimension of the PB. Additional strategies to improve this agreement are under consideration and include an additional tutorial of the so-called bad observers with a recontouring procedure, or the recontouring by a single observer of the PB for all patients included in the DUE-01 study.

2012-11-01

387

Countercurrent aortography via radial artery  

Energy Technology Data Exchange (ETDEWEB)

Countercurrent aortography via radial artery was performed for detection of aortic arch anomalies in 4 infants with congenital heart disease. Author's cases of aortic arch anomalies were 3 cases of PDA, 1 case of coarctation of aorta, and 1 case of occlusion of anastomosis site on subclavian artery B-T shunt. And aberrant origin of the right SCA, interrupted aortic arch, hypoplastic aorta, anomalous origin of the right pulmonary artery from the ascending aorta can be demonstrated by this method. Countercurrent aortography affords an safe and simple method for detection of aortic arch anomalies without retrograde arterial catheterization, especially in small infants or premature babies.

Sohn, Hyung Kuk; Lee, Young Chun; Lee, Seung Chul; Jeon, Seok Chol; Joo, Kyung Bin; Lee, Seung Ro; Kim, Soon Yong [College of Medicine, Hanyang University, Seoul (Korea, Republic of)

1987-06-15

388

Variant arteries at the base of the brain  

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Full Text Available Abnormalities of the important arteries at the base of brain can lead to serious clinical conditions like stroke or other functional deficits. We report here a variant pattern of arteries seen at the base of the brain. The left internal carotid artery was slightly larger than the right and it terminated by dividing into anterior and middle cerebral arteries. It gave an abnormally large posterior communicating artery, which was almost equal in size to that of the middle cerebral artery. This posterior communicating artery replaced the distal part of the left posterior cerebral artery. The proximal part of the left posterior cerebral artery was very small. There were two anterior communicating arteries. The left vertebral artery was larger than the right vertebral artery. The knowledge of these anomalous arteries may be useful for radiologists, neurosurgeons and clinicians in general.

Nayak SB

2009-06-01

389

Sequential bilateral retinal artery occlusion  

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Full Text Available Noel Padrn-Prez,1 Janny Rosario Arons,2 Silvia Muoz,1 Luis Arias-Barquet,1 Jorge Arruga1,31Department of Ophthalmology, Hospital Universitari de Bellvitge, 2Hospital de l'Esperana Parc de Salut Mar, 3Institut Catal de Retina, Barcelona, SpainAbstract: An 86 year old woman experienced a sequential bilateral loss of vision over a period of less than 24 hours. Clinical findings and complementary studies suggested a bilateral atherogenic embolic event. Initially, she presented a superior branch retinal artery occlusion in her right eye followed by a central retinal artery occlusion with cilioretinal artery sparing in her left eye. Some conservative maneuvers performed did not improve visual acuity in the left eye. Supra-aortic Doppler ultrasonography revealed mild right internal carotid artery stenosis and moderate left internal carotid artery stenosis with a small, smooth, and homogeneous plaque. The transthoracic echocardiography showed a severe calcification of the mitral valve with a mild-moderate rim of stenosis. Central retinal artery occlusion and branch retinal artery occlusion are characterized by painless monocular loss of vision. Clinical approach and management attempt to treat the acute event, find the source of the vascular occlusion, and prevent further vascular events from occurring. Giant cell arteritis is a potentially treatable cause of central retinal artery occlusion and should be excluded in every single patient over 50 years old.Keywords: loss of vision, branch retinal artery occlusion, central retinal artery occlusion, Hollenhorst plaque

Padrn-Prez N

2014-04-01

390

Penile Hygiene: Puberty, Paraphimosis and Personal Care for Men and Boys with an Intellectual Disability  

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Background: Supporting men and boys with an intellectual disability (ID) to meet their penile hygiene needs is perhaps one of the least acknowledged but most confronting issues facing care staff. The delivery of intimate hygiene can be a challenging topic particularly as it has been drawn into the emerging sexuality discourse and the ongoing abuse

Wilson, N. J.; Cumella, S.; Parmenter, T. R.; Stancliffe, R. J.; Shuttleworth, R. P.

2009-01-01

391

Penile length and genital anomalies in Egyptian male newborns: epidemiology and influence of endocrine disruptors.  

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This is an attempt to establish the normal stretched penile length and prevalence of male genital anomalies in full-term neonates and whether they are influenced by prenatal parental exposure to endocrine-disrupting chemicals. A thousand newborns were included; their mothers were subjected to the following questionnaire: parents' age, residence, occupation, contact with insecticides and pesticides, antenatal exposure to cigarette smoke or drugs, family history of genital anomalies, phytoestrogens intake and history of in vitro fertilization or infertility. Free testosterone was measured in 150 neonates in the first day of life. Mean penile length was 3.40.37 cm. A penile length micropenis. Prevalence of genital anomalies was 1.8% (hypospadias 83.33%). There was a higher rate of anomalies in those exposed to endocrine disruptors (EDs; 7.4%) than in the non-exposed (1.2%; p<0.0001; odds ratio 6, 95% confidence interval 2-16). Mean penile length showed a linear relationship with free testosterone and was lower in neonates exposed to EDs. PMID:23509209

El Kholy, Mohamed; Hamza, Rasha Tarif; Saleh, Mohamed; Elsedfy, Heba

2013-01-01

392

Detection of penile metastasis from bladder cancer using F 18 FDG PET/CT  

International Nuclear Information System (INIS)

A 74 year old man who had experienced priapism for 2 months after radical cystectomy for bladder cancer visited our hospital, and underwent metastatic work up 18F fluorodeoxyglucose (FDG) positron emission tomography/computed tomography(PET/CT)showed diffuse hypermetabolic activity along the penis shaft, which was confirmed as a penile metastasis

2012-12-01

393

Reproducibility of histopathologic tumor grading in penile cancer--results of a European project.  

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Since reliable molecular prognostic parameters for inguinal lymph metastases in penile cancer are not available, tumor grading is often used as a surrogate prognostic tool for the indication of inguinal lymphadenctomy and has been integrated into the current TNM classification for penile cancer. The reliability of tumor grading is under discussion. We examined interobserver grading variability in 90 primary penile carcinomas, assessed by 12 different uropathologists from five European countries. Tumor grading, following the CAP scheme, was compared, and interobserver variability was calculated using kappa statistics. The interobserver variability was high as reflected by an overall low kappa coefficient (mean k?=?0.34) and reached a moderate level only in 26.4 % of the cases (range 0.02-0.67). The percentage of G1 tumors assigned ranged from 8.6 to 52.5 %, G2 tumors from 27.1 to 72.6 % and G3 tumors from 11.7 to 48.7 %. Only some observers assigned G4 with a range of 0.6-21.9 %. Subdivision into low and high grade according to UICC and EAU classifications differed significantly (P?penile carcinomas with the favored method does not allow a reliable prognostication of tumor aggressiveness. Inclusion of histological grading into the TNM classification currently seems not to be a benefit. PMID:24535700

Kakies, Ch; Lopez-Beltran, A; Comperat, E; Erbersdobler, A; Grobholz, R; Hakenberg, O W; Hartmann, A; Horn, L-C; Hhn, A K; Kllermann, J; Kristiansen, G; Montironi, R; Scarpelli, M; Protzel, Ch

2014-04-01

394

Penile Metastasis Secondary to Bladder Cancer: A Report of Two Cases  

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Penile metastasis secondary to primary bladder cancer is a rare entity and represents a challenging problem. The common mode of spread to the penis is by retrograde venous route. The overall outcome is dismal and most patients will die within 1 year even after optimum treatment. Here, we report two such cases.

Kumar, Narendra; Bhattacharyya, Tapesh; Mandal, A K; Gupta, Nalini; Rajwanshi, A; Kumar, Ritesh

2014-01-01

395

One-sheet spiraling full thickness skin graft for penile resurfacing after paraffinoma excision  

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Full Text Available In the midst of on-going non-illicit practice of silicone or paraffin injection to enlarge penis, the author reported 3 cases ofsurgical treatment to resurface the body of the penis after excision of the destructed penile skin using full thickness skin graft.The skin excision was performed technically through penile body degloving procedure. Full thickness skin graft was thenapplied as a single sheet donor tissue to cover the denuded penile body spirally. The full thickness graft, which is relativelyeasy to be performed, is no doubt much thinner than a skin flap, while it also bears a smaller degree of secondary contractionthan split skin graft. The color of the skin is considerably matched as it comes from the groin, which is a nearby area ofpenis. The size and skin sensitization of the penis looks to be natural. The only disadvantage is the common possibilityof either spiral or circular junctional scar in between graft edges and between the graft and the penile mucosa and skin todevelop hypertrophic scar. However, this possible scar problem applies also to any other surgical scar with any donor tissue.Fortunately, the 3 cases posed no scar problem and normal appearance. All the patients have also regained their normalsexual function. (Med J Indones 2011; 20:222-5Keywords: full thickness skin graft, paraffinoma, siliconoma, sexual function

Theddeus O.H. Prasetyono

2011-08-01

396

Detection of human papillomavirus DNA in semen from patients with intrameatal penile warts.  

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Fifteen semen specimens from 10 men with intrameatal penile warts attending a genitourinary clinic were tested by Southern blot hybridisation for the presence of human papillomavirus (HPV) DNA. Five specimens were positive for HPV types 6/11. This observation may have implications for screening of semen used for artificial insemination by donor.

1989-01-01

397

BILATERAL ANATOMICAL VARIATION IN THE ARTERIAL SUPPLY OF FACE INVOLVING THE FACIAL AND TRANSVERSE FACIAL ARTERY  

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Full Text Available We present a case-report whereby a bilateral variation in the arterial supply of face was seen. The facial artery which is the main artery of face was seen terminating in the lower part of the face, as the inferior labial artery and few other branches; the transverse facial artery, which supplements the facial artery normally, was seen to enlarge and take over the course of facial artery, giving the superior labial and lateral nasal branches. The small pre-masseteric branch arising from facial artery was seen only on right side of face. It was absent on left side. Accurate knowledge of the normal and variant arterial anatomy of the facial artery is important for vascular radiology and will provide an anatomical basis to assist surgeons in performing maxillo-facial surgeries successfully. The details of this variation and its clinical significance are discussed herein.

Vrushali S. Kolte

2014-03-01

398

Changes in Penile Morphometrics in Men with Erectile Dysfunction after Nerve-Sparing Radical Retropubic Prostatectomy.  

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There have been anecdotal reports of a decrease in penile size in men with erectile dysfunction (ED) after nerve-sparing radical retropubic prostatectomy (NSRRP). Penile circumference and length measurements are obtained by one physician from 100 men, age 47 to 74, who presented at various intervals (1.7&endash;27.6 months) for the treatment of ED after NSRRP from 1994 through 1997. All patients were asked to complete a brief male sexual function inventory at their initial visit. Penile measurements were obtained both in the flaccid and erect states, with erections being induced with intracorporal injections of Trimix. The sexual inventory scores were compared with those of an age-matched control cohort of 130 men presenting for evaluation of ED during the same time period and 132 age-matched men who completed the inventory at the time of a prostate screening. By self-report, men experiencing ED after NSRRP had better libido but more severe ED than men presenting with ED of other causes. There was a decrease in all penile dimensions after NSRRP. The flaccid and erect measurements of length and circumference decreased 8% and 9%, respectively after surgery (p > 0.05). The most substantial change occurred between the first 4 and 8 months postoperatively. The average change in volume between the first 4 and 8 months was 19% to 22% in the flaccid and erect state, respectively. There is a significant decrease in penile size in men with ED after NSRRP. The etiology may be denervation smooth muscle atrophy, apoptosis, or hypoxia-induced damage to the corpora. Further research is needed to elucidate the nature of these postoperative changes. PMID:10851312

Fraiman; Lepor; McCullough

1999-01-01

399

Unusual trivial trauma may end with extrusion of a well-functioning penile prosthesis: a case report  

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Abstract Background Diabetes mellitus (DM) is the most common indication for insertion of a penile prosthesis and is a risk factor for infection of such prostheses. Case presentation Two patients presented with infected prostheses following unusual trivial penile trauma. Both patients underwent exploration and removal of the prostheses with uneventful recovery. Conclusion Appropriate sizing of the prosthesis should be taken into account to ensure g...

2007-01-01

400

Tunical plication in the management of penile curvature due La Peyronies disease. Our experience on 47 cases  

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Abstract Background Peyronies disease is an acquired connective tissue disorder of the penile tunica albuginea with fibrosis and inflammation. The disease produces palpable plaques, penile curvature and pain during erections. Patients report negative effects in four major domains: physical appearance and self-image, sexual function and performance. These changes damage sexual life and compromise the quality of life. Our objective is to review the patient's sexual life afte...

2012-01-01

 
 
 
 
401

Desire for Penile Girth Enhancement and the Effects of the Self-Injection of Hyaluronic Acid Gel  

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Penile girth enhancement is a controversial subject but demands for enhancement are increasing steadily. Although various fillers have been widely used for soft tissue augmentation, there is no reliable material for this particular situation. Here we report a case of an acute hypersensitivity reaction in a man after his first self-injection of a filler material, which, he claimed, was hyaluronic acid gel for penile girth enhancement and glans penis augmentation.

Coskuner, Enis Rauf; Canter, Halil Ibrahim

2012-01-01

402

Coronary arterial fistulas  

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Full Text Available Abstract A coronary arterial fistula is a connection between one or more of the coronary arteries and a cardiac chamber or great vessel. This is a rare defect and usually occurs in isolation. Its exact incidence is unknown. The majority of these fistulas are congenital in origin although they may occasionally be detected after cardiac surgery. They do not usually cause symptoms or complications in the first two decades, especially when small. After this age, the frequency of both symptoms and complications increases. Complications include 'steal' from the adjacent myocardium, thrombosis and embolism, cardiac failure, atrial fibrillation, rupture, endocarditis/endarteritis and arrhythmias. Thrombosis within the fistula is rare but may cause acute myocardial infarction, paroxysmal atrial fibrillation and ventricular arrhythmias. Spontaneous rupture of the aneurysmal fistula causing haemopericardium has also been reported. The main differential diagnosis is patent arterial duct, although other congenital arteriovenous shunts need to be excluded. Whilst two-dimensional echocardiography helps to differentiate between the different shunts, coronary angiography is the main diagnostic tool for the delineation of the anatomy. Surgery was the traditional method of treatment but nowadays catheter closure is recommended using a variety of closure devices, such as coils, or other devices. With the catheter technique, the results are excellent with infrequent complications. Disease name and synonyms Coronary arterial fistulas Coronary arterial fistulas or malformations

Qureshi Shakeel A

2006-12-01

403

[Arterial heterogeneity].  

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More and more clinical observations and trial