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Sample records for penile small arteries

  1. Role for Tyrosine Kinases in Contraction of Rat Penile Small Arteries

    DEFF Research Database (Denmark)

    Villalba, Nuria; Kun, Attila; Stankevicius, Edgaras; Simonsen, Ulf

    2010-01-01

    ABSTRACT Introduction. The devasting effect of cancer and treatment thereof contribute to sexual dysfunction. Recently, a series of tyrosine kinase inhibitors have been approved either as add-on or for targeted treatment of cancer. However, tyrosine kinases are not only important for cell growth and proliferation, but also in regulation of vascular tone. Aim. The present study investigated whether tyrosine kinases contribute to contractility in rat penile arteries, and addressed whether they are...

  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)

    Király, István; Pataricza, János

    2013-01-01

    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.

  3. 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)

    Király, István; Pataricza, János; Bajory, Zoltán; Simonsen, Ulf; Varro, András; Papp, Julius Gy; Pajor, Lászlo; Kun, Attila

    2013-01-01

    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-depe...

  4. Involvement of nitric oxide in the non-adrenergic non-cholinergic neurotransmission of horse deep penile arteries: role of charybdotoxin-sensitive K(+)-channels.

    OpenAIRE

    Simonsen, U.; Prieto, D; Sánez de Tejada, I.; García-Sacristán, A.

    1995-01-01

    1. The involvement of nitric oxide (NO) and the signal transduction mechanisms mediating neurogenic relaxations were investigated in deep intracavernous penile arteries with an internal lumen diameter of 600-900 microns, isolated from the corpus cavernosum of young horses. 2. The presence of nitric oxide synthase (NOS)-positive nerves was examined in cross and longitudinal sections of isolated penile arteries processed for NADPH-diaphorase (NADPH-d) histochemistry. NADPH-d-positive nerve fibr...

  5. Penile abnormalities

    Directory of Open Access Journals (Sweden)

    Yunus Söylet

    2010-05-01

    Full Text Available Hypospadias is a congenital development anomaly of penis. The meatus is located in between glans penis and perineum. Frenulum is absent. The glans does not fuse on the ventral side. Ventral preputial development is incomplete. There is usually associated a variable degree of chordee. Hypospadias is classifed according to level of meatus. Severe hypospadias and chordee, bilateral undescended testis, small penis may be the signs of a sexual development disorder and further diagnostic evaluation is indicated. Circumcision without repair of hypospadias is contraindicated. Surgical correction of hypospadias should be completed by 15 months of age. Epispadias, penile agenesis, diphallia, penile torsion, penoscrotal fusion, concealed penis, micropenis, priapism and penoscrotal transposition are the other penile anomalies. This section is basically written for the diagnosis of penile anomalies and associated malformations, timing of surgery and to give take home messages for the pediatricians. Surgical correction of penile anomalies requires experiences in the field of pediatric urology and it is performed by Pediatric Surgeons and Pediatric Urologists. (Turk Arch Ped 2010; 45 Suppl: 94-9

  6. Penile angiography and superselective embolization therapy in arterial priapism; Penisangiographie und superselektive Embolisationstherapie bei high-flow Priapismus

    Energy Technology Data Exchange (ETDEWEB)

    Dinkel, H.P.; Triller, J. [Inst. fuer Diagnostische Radiologie, Inselspital, Univ. Bern (Switzerland); Hochreiter, W. [Urologische Klinik, Inselspital, Univ. Bern (Switzerland)

    2003-08-01

    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.) [German] Ziel: Untersuchung der Interventionsmoeglichkeiten bei arteriellem (high-flow) Priapismus durch endovaskulaere superselektive Embolisation der Penisarterien. Methode: Alle innerhalb eines Vierjahreszeitraums (1/99-5/2002) wegen Priapismus zur Angiographie zugewiesenen Patienten wurden erfasst. Eine elektronische RIS-Abfrage ergab vier Maennern im Alter von 28, 29, 40 und 49 Jahren. Bei einem Patienten lag anamnestisch ein peniles Trauma vor; bei drei Patienten bestand ein spontaner, rezidivierender Priapismus. Bei allen Patienten wurden zunaechst eine kavernoese Blutaspiration und intrakavernoese Noradrenalininjektionen durchgefuehrt, um eine Detumeszenz zu erreichen. Zwei Patienten hatten zuvor eine oder mehrere frustrane kavernosospongioese Shuntprozeduren. Ergebnisse: Bei drei von vier Maennern wurde angiographisch eine pathologische arterio-kavernoese Hyperperfusion nachgewiesen. Zwei Patienten wurden durch superselektive Embolisation behandelt. Dabei kam es allerdings in einem Fall vor der Einbringung des Embolisats zu einem spastischen Verschluss der A. profunda penis (A. cavernosa), wodurch umgehend eine dauerhafte Detumeszenz erzielt wurde. Bei einem weiteren Patienten wurde die A. profunda penis rechts mit Gelfoam embolisiert, wodurch die Detumeszenz erreicht wurde; am Folgetag kam es zu einem Rezidiv, das durch kontralaterale arteriokavernoese Hyperperfusion bedingt war und mit einer linksseitigen Teilembolisation erfolgreich behandelt wurde. Postinterventionell blieb die Erektionsfaehigkeit jeweils vollstaendig erhalten. Schlussfolgerung: Unsere Erfahrungen bestaetigen die in der Literatur vorherrschende Meinung, dass die transarterielle Katheterembolisation als Therapieverfahren der Wahl beim arteriellen Priapismus betrachtet werden darf. Die Prognose des arteriellen Priapismus ist gut bei hoher Chance des volstaendigen Erhalts der erektilen Funktion. (orig.)

  7. Structure and function of small arteries

    DEFF Research Database (Denmark)

    Mulvany, M J; Aalkjær, Christian

    1990-01-01

    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...

  8. Endothelin-1 contributes to endothelial dysfunction and enhanced vasoconstriction through augmented superoxide production in penile arteries from insulin-resistant obese rats: role of ETA and ETB receptors

    Science.gov (United States)

    Sánchez, A; Martínez, P; Muñoz, M; Benedito, S; García-Sacristán, A; Hernández, M; Prieto, D

    2014-01-01

    Background and Purpose We assessed whether endothelin-1 (ET-1) inhibits NO and contributes to endothelial dysfunction in penile arteries in a model of insulin resistance-associated erectile dysfunction (ED). Experimental Approach Vascular function was assessed in penile arteries, from obese (OZR) and lean (LZR) Zucker rats, mounted in microvascular myographs. Changes in basal and stimulated levels of superoxide (O2?) were detected by lucigenin-enhanced chemiluminescence and ET receptor expression was determined by immunohistochemistry. Key Results ET-1 stimulated acute O2? production that was blunted by tempol and the NADPH oxidase inhibitor, apocynin, but markedly enhanced in obese animals. ET-1 inhibited the vasorelaxant effects of ACh and of the NO donor S-nitroso-N-acetyl-DL-penicillamine in arteries from both LZR and OZR. Selective ETA (BQ123) or ETB receptor (BQ788) antagonists reduced both basal and ET-1-stimulated superoxide generation and reversed ET-1-induced inhibition of NO-mediated relaxations in OZR, while only BQ-123 antagonized ET-1 actions in LZR. ET-1-induced vasoconstriction was markedly enhanced by NO synthase blockade and reduced by endothelium removal and apocynin. In endothelium-denuded penile arteries, apocynin blunted augmented ET-1-induced contractions in OZR. Both ETA and ETB receptors were expressed in smooth muscle and the endothelial layer and up-regulated in arteries from OZR. Conclusions and Implications ET-1 stimulates ETA-mediated NADPH oxidase-dependent ROS generation, which inhibits endothelial NO bioavailability and contributes to ET-1-induced contraction in healthy penile arteries. Enhanced vascular expression of ETB receptors contributes to augmented ROS production, endothelial dysfunction and increased vasoconstriction in erectile tissue from insulin-resistant obese rats. Hence, antagonism of ETB receptors might improve the ED associated with insulin-resistant states. PMID:25091502

  9. Penile Trauma

    Science.gov (United States)

    ... of penile injuries each year. How Does the Penis Normally Work? Male Reproductive Organs Medical Illustration Copyright © ... All rights reserved The main roles of the penis are to carry urine and sperm out of ...

  10. Structure and function of small arteries

    DEFF Research Database (Denmark)

    Mulvany, M J; Aalkjær, Christian

    1990-01-01

    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)

  11. Sonographic features of penile-gland lithiasis

    OpenAIRE

    Solivetti, F. M.; Drusco, A.; Pizzi, G.; F. Elia; A. Andreoli

    2008-01-01

    A 52-year-old man presented with a small, red, tender swelling near the penile frenulum at the lower edge of the base of the glans. Lower urinary tract symptoms were absent. Ultrasonography revealed a stone lodged in the distalmost portion of the glands of Littre. Combined with a good knowledge of penile anatomy, use of this simple imaging tool allows reliable diagnosis of even the rarest cases of penile pathology.

  12. Sonographic features of penile-gland lithiasis.

    Science.gov (United States)

    Solivetti, F M; Drusco, A; Pizzi, G; Elia, F; Andreoli, A

    2008-06-01

    A 52-year-old man presented with a small, red, tender swelling near the penile frenulum at the lower edge of the base of the glans. Lower urinary tract symptoms were absent. Ultrasonography revealed a stone lodged in the distalmost portion of the glands of Littre. Combined with a good knowledge of penile anatomy, use of this simple imaging tool allows reliable diagnosis of even the rarest cases of penile pathology. PMID:23396221

  13. Penile reconstruction.

    Science.gov (United States)

    Garaffa, Giulio; Sansalone, Salvatore; Ralph, David J

    2013-01-01

    During the most recent years, a variety of new techniques of penile reconstruction have been described in the literature. This paper focuses on the most recent advances in male genital reconstruction after trauma, excision of benign and malignant disease, in gender reassignment surgery and aphallia with emphasis on surgical technique, cosmetic and functional outcome. PMID:22426595

  14. Penile reconstruction

    OpenAIRE

    Garaffa, Giulio; Sansalone, Salvatore; David J. Ralph

    2012-01-01

    During the most recent years, a variety of new techniques of penile reconstruction have been described in the literature. This paper focuses on the most recent advances in male genital reconstruction after trauma, excision of benign and malignant disease, in gender reassignment surgery and aphallia with emphasis on surgical technique, cosmetic and functional outcome.

  15. General Information about Penile Cancer

    Science.gov (United States)

    ... Penile Cancer Treatment Penile Cancer Treatment (PDQ®) General Information About Penile Cancer Key Points Penile cancer is ... the PDQ Adult Treatment Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...

  16. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... our gloves. It’s really – it’s a high-scroll [sp?] incision, Dr. Goldstein, so we avoid any cuts ... who only do penile implants, like Dr. Greiner [sp?] and myself, is quite small. 00:16:37 ...

  17. Videodermatoscopy of pearly penile papules. Case reports

    Directory of Open Access Journals (Sweden)

    Hristo Petrov Dobrev

    2015-01-01

    Full Text Available Pearly penile papules are harmless dermatological condition characterized by small dome-shaped to filiform skin-colored papules located in one to several rows along the sulcus or corona of the glans penis. We describe six male patients with pearly penile papules whose diagnosis was assisted by means of videodermatoscopy. All lesions showed a characteristic whitish pink cobblestone appearance arranged in one or several rows. Each papule contained central dotted or commalike vessels and was surrounded by crescent-shaped whitish structures. Videodermatoscopy may assist the diagnosis of pearly penile papules and successfully differentiate them from genital warts and molluscum contagiosum.

  18. Chronic penile strangulation

    Directory of Open Access Journals (Sweden)

    Roberto I Lopes

    2003-08-01

    Full Text Available 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 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.

  19. Chronic penile strangulation

    Scientific Electronic Library Online (English)

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

    2003-08-01

    Full Text Available 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.

  20. Evolution of penile prosthetic devices

    OpenAIRE

    Le, Brian; Burnett, Arthur L.

    2015-01-01

    Penile implant usage dates to the 16th century yet penile implants to treat erectile dysfunction did not occur until nearly four centuries later. The modern era of penile implants has progressed rapidly over the past 50 years as physicians' knowledge of effective materials for penile prostheses and surgical techniques has improved. Herein, we describe the history of penile prosthetics and the constant quest to improve the technology. Elements of the design from the first inflatable penile pro...

  1. Review of penile fracture

    International Nuclear Information System (INIS)

    A detailed current review was performed of penile fracture. A literature search and analysis were compiled of studies made in the last 15 years about the proper management of penile fracture. These have allowed for a practical guide to the diagnosis and early treatment by the urologist

  2. '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 201TI-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.)

  3. Genetic fuzzy system predicting contractile reactivity patterns of small arteries

    DEFF Research Database (Denmark)

    Tang, J; Sheykhzade, Majid

    2014-01-01

    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.

  4. Penil kalcifylaksi

    DEFF Research Database (Denmark)

    Kjaerskov, Mette Wanscher; Comstedt, Lisbeth Rosholm

    2009-01-01

    A 64-year-old diabetic man on peritoneal dialysis developed painful necrotic ulcers of the glans penis over a period of six months. On suspicion of atherosclerotic necrosis, a partial resection of his penis was performed. Histological examination showed calciphylaxis. This vasculopathy with calcification and intimal fibrosis in small blood vessels is mostly seen in patients with end-stage renal disease. The condition is characterized by painful livedoid and infiltrated plaques and ulcers. Involvement of the penis is rare, but probably underdiagnosed. Udgivelsesdato: 2009-May-25

  5. Penile rehabilitation after pelvic cancer surgery.

    Science.gov (United States)

    Aoun, Fouad; Peltier, Alexandre; van Velthoven, Roland

    2015-01-01

    Erectile dysfunction is the most common complication after pelvic radical surgery. Rehabilitation programs are increasingly being used in clinical practice but there is no high level of evidence supporting its efficacy. The principle of early penile rehabilitation stems from animal studies showing early histological and molecular changes associated with penile corporal hypoxia after cavernous nerve injury. The concept of early penile rehabilitation was developed in late nineties with a subsequent number of clinical studies supporting early pharmacologic penile rehabilitation. These studies included all available phosphodiesterase type 5 inhibitors, intracavernosal injection and intraurethral use of prostaglandin E1 and to lesser extent vacuum erectile devices. However, these studies are of small number, difficult to interpret, and often with no control group. Furthermore, no studies have proven an in vivo derangement of endothelial or smooth muscle cell metabolism secondary to a prolonged flaccid state. The purpose of the present report is a synthetic overview of the literature in order to analyze the concept and the rationale of rehabilitation program of erectile dysfunction following radical pelvic surgery and the evidence of such programs in clinical practice. Emphasis will be placed on penile rehabilitation programs after radical cystoprostatectomy, radical prostatectomy, and rectal cancer treatment. Future perspectives are also analyzed. PMID:25785286

  6. A microfluidic platform for probing small artery structure and function†‡

    OpenAIRE

    Gunther, Axel; Yasotharan, Sanjesh; Vagaon, Andrei; Lochovsky, Conrad; Pinto, Sascha; Yang, Jingli; Lau, Calvin; Voigtlaender-Bolz, Julia; Bolz, Steffen-Sebastian

    2010-01-01

    Although pathologic changes to the structure and function of small blood vessels are hallmarks of various cardiovascular diseases, limitations of conventional investigation methods (i.e. pressure myography) have prohibited a comprehensive understanding of the underlying mechanisms. We developed a microfluidic device to facilitate assessment of resistance artery structure and function under physiological conditions (37 °C, 45 mmHg transmural pressure). The platform allows for on-chip fixation,...

  7. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... next hour you’ll see a live panel discussion of penile implant surgery. For men with severe ... 01:03:32 ANNOUNCER: This has been a discussion of penile implant surgery live from Coral Gables ...

  8. 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 ...

  9. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... initial concept is still the same – that is, placement of a penile prosthetic device in the two ... of the mouth. And I said to myself, “Well, gee, if we could do that for penile ...

  10. Penile metastasis from rectal carcinoma

    Directory of Open Access Journals (Sweden)

    Murhekar K

    2007-01-01

    Full Text Available Penile metastases are infrequent and often originate from genitor-urinary organs including bladder and prostate. In the present communication, we report an unusual case of penile metastasis from rectal adenocarcinoma. Though uncommon, this presentation is not unknown. A review of literature of penile metastases in colorectal cancers is also summarized here.

  11. Overview of Contemporary Penile Rehabilitation Therapies

    Directory of Open Access Journals (Sweden)

    Run Wang

    2008-09-01

    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.

  12. 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

  13. Penile Corporeal Reconstruction during Difficult Placement of a Penile Prosthesis

    OpenAIRE

    Aboseif, Sherif R.; Kim, Dennis H.; Lesser, Timothy F.; Tran, Viet Q.

    2008-01-01

    For some patients with impotence and concomitant severe tunical/corporeal tissue fibrosis, insertion of a penile prosthesis is the only option to restore erectile function. Closing the tunica over an inflatable penile prosthesis in these patients can be challenging. We review our previous study which included 15 patients with severe corporeal or tunical fibrosis who underwent corporeal reconstruction with autologous rectus fascia to allow placement of an inflatable penile prosthesis. At a mea...

  14. Pulsed and Color Doppler Sonographic Findings of Penile Mondor' Disease

    Energy Technology Data Exchange (ETDEWEB)

    Han, Hye Yeon; Chung, Dong Jin; Kim, Kum Won; Hwang, Cheol Mog [University of Konyang School of Medicine, Daejeon (Korea, Republic of)

    2008-04-15

    Penile Mondor's disease is a rare disease that's characterized by thrombosis in the dorsal vein of the penis. Doppler ultrasonography (US) clearly visualizes dorsal vein thrombosis and the associated hemodynamic alterations. Previous studies have demonstrated the typical color Doppler US findings of superficial dorsal vein thrombosis without the flow signals in this area, yet this is insufficient to understand the hemodynamics in penile Mondor's disease. We report here for the first time a cavernosal artery flow signal pattern in a penile Mondor's disease patient, in addition to its previously reported classic US findings. In conclusion, the Doppler US findings of thrombus without blood flow in the superficial dorsal vein and the low-flow, high resistance in the cavernosal artery may be suggestive of penile Mondor's disease.

  15. Penile abscess and necrotizing fasciitis secondary to neglected false penile fracture

    Directory of Open Access Journals (Sweden)

    Al-Reshaid Reshaid

    2010-01-01

    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.

  16. 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)

  17. Radioisotope penile plethysmography: A technique for evaluating corpora cavernosal blood flow during early tumescence

    Energy Technology Data Exchange (ETDEWEB)

    Schwartz, A.N.; Graham, M.M.; Ferency, G.F.; Miura, R.S.

    1989-04-01

    Radioisotope penile plethysmography is a nuclear medicine technique which assists in the evaluation of patients with erectile dysfunction. This technique attempts to noninvasively quantitate penile corpora cavernosal blood flow during early penile tumescence using technetium-99m-labeled red blood cells. Penile images and counts were acquired in a steady-state blood-pool phase prior to and after the administration of intracorporal papaverine. Penile counts, images, and time-activity curves were computer analyzed in order to determine peak corporal flow and volume changes. Peak corporal flow rates were compared to arterial integrity (determined by angiography) and venosinusoidal corporal leak (determined by cavernosometry). Peak corporal flow correlated well with arterial integrity (r = 0.91) but did not correlate with venosinusoidal leak parameters (r = 0.01). This report focuses on the methodology and the assumptions which form the foundation of this technique. The strong correlation of peak corporal flow and angiography suggests that radioisotope penile plethysmography could prove useful in the evaluation of arterial inflow disorders in patients with erectile dysfunction.

  18. 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’ll see a live panel discussion of penile implant surgery. For men with severe erectile dysfunction, the ...

  19. Minimally Invasive Penile Implant Surgery

    Science.gov (United States)

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

  20. Pressure Myography to Study the Function and Structure of isolated small arteries

    DEFF Research Database (Denmark)

    SchjØrring, Olav; Carlsson, Rune

    2015-01-01

    Small arteries play an important role in regulation of peripheral resistance and organ perfusion. Here we describe a series of the methods allowing measurements in pressurized segments of small arteries from the systemic and coronary circulation of mice as well as other species. The pressure myography techniques described include measurements of wall structure, wall stress, strain, and of myogenic tone. The pressurized perfused small arteries also allow evaluation of responses to increases in pressure, flow, and drugs, where the main readout is changes in vascular diameter.

  1. Ultrasound Diagnosis of Penile Fracture.

    Science.gov (United States)

    Nizamani, Waseem Mehmood; Ali, Syed Imtiaz; Vaswani, Aneel Kumar; Shahani, Bhesham Kumar

    2015-10-01

    Arare but possibly underreported urological emergency is penile fracture which results from tear in the tunica albuginea of the penis. The proposed etiology is forceful manipulation of an erect penis or secondary to blunt trauma. We would like to report a case of young patient presenting with large penile shaft hematoma and deformity. The patient did not provide obvious history of trauma or sexual intercourse. The ultrasound of penis was performed which suggested the diagnosis of penile fracture and ultrasound findings were correlated with peroperative findings. PMID:26522196

  2. Multiple Instances of Peripheral Artery Emboli from Occult Primary Small Cell Lung Cancer

    OpenAIRE

    GABRIELLI, ROBERTO; Rosati, Maria Sofia; Chiappa, Roberto; Vitale, Silvio; Millarelli, Massimiliano; Caselli, Giovanni

    2012-01-01

    Most peripheral artery emboli originate in the heart, and systemic neoplastic emboli are infrequently associated with bronchogenic carcinoma. To our knowledge, there have been no reports of pulmonary vein infiltration by small cell lung cancer.

  3. Penile Corporeal Reconstruction during Difficult Placement of a Penile Prosthesis

    Directory of Open Access Journals (Sweden)

    Sherif R. Aboseif

    2008-11-01

    Full Text Available For some patients with impotence and concomitant severe tunical/corporeal tissue fibrosis, insertion of a penile prosthesis is the only option to restore erectile function. Closing the tunica over an inflatable penile prosthesis in these patients can be challenging. We review our previous study which included 15 patients with severe corporeal or tunical fibrosis who underwent corporeal reconstruction with autologous rectus fascia to allow placement of an inflatable penile prosthesis. At a mean follow-up of 18 months (range 12 to 64, all patients had a prosthesis that was functioning properly without evidence of separation, herniation, or erosion of the graft. Sexual activity resumed at a mean time of 9 weeks (range 8 to 10. There were no adverse events related to the graft or its harvest. Use of rectus fascia graft for coverage of a tunical defect during a difficult penile prosthesis placement is surgically feasible, safe, and efficacious.

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

    OpenAIRE

    BUCCA, Caterina; ROLLA, Giovanni

    1980-01-01

    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.

  5. 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 NCI’s Cancer Drug Information summaries.

  6. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... Coral Gables Hospital in beautiful Coral Gables, Florida. My name is Irwin Goldstein. I am Director, San ... infection, the most feared penile prosthetic complication. On my immediate left is Dr. Francois Eid, clinical associate ...

  7. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... techniques potentially reduce the infec—the opportunity for infection, the most feared penile prosthetic complication. On my ... slide, and that is the slide on the infection prevention. And as you know, one of the ...

  8. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... give you today is based on a recent abstract where I reviewed my last 300 penile prostheses. ... ve already been talking about that. In this abstract what I wanted to look at is I ...

  9. Minimally Invasive Penile Implant Surgery

    Medline Plus

    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 ...

  10. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... Irwin Goldstein. I am Director, San Diego Sexual Medicine at Alvarado, San Diego, California. I am Editor-in-Chief of the Journal of Sexual Medicine . I’ve been involved in penile implant surgery ...

  11. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... to make sure that we have a happy customer after everything is done. 00:20:26 IRWIN ... minimally invasive penile implant. Any of the objective data that I’m going to give you today ...

  12. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... to a normal function. There’s 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. ...

  13. Minimally Invasive Penile Implant Surgery

    Medline Plus

    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. ...

  14. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... normal sex life and has been an excellent treatment for hundreds of thousands of men for the ... contemporary experts in penile implant surgery for the treatment of men with erectile dysfunction. While technically the ...

  15. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... Today we are thrilled to have two contemporary experts in penile implant surgery for the treatment of ... the corpora cavernosa of the penis – these two experts have advanced the surgery by using new, minimally ...

  16. Imaging of penile traumas - therapeutic implications

    Energy Technology Data Exchange (ETDEWEB)

    Bertolotto, Michele; Calderan, Loretta; Cova, Maria Assunta [Universita di Trieste, UCO di Radiologia, Trieste (Italy)

    2005-12-01

    Injury to the penis may result from penetrating or nonpenetrating trauma. Nonpenetrating injury to the erect penis can produce albugineal tear, intracavernous hematoma or extraalbugineal hematoma from rupture of the dorsal vessels. Nonpenetrating injury to the flaccid penis usually follows blunt perineal traumas producing extratunical or cavernosal haematomas, or cavernosal artery tear followed by high flow priapism. Differential diagnosis between albugineal tear and other penile injuries must be obtained as soon as possible, since early surgical repair of albugineal tear reduces significantly the rate of postraumatic curvature and fibrosis. Ultrasonography (US) is able to detect the exact site of the tear in most patients as an interruption of the thin echogenic line of the tunica albuginea. Other imaging techniques are rarely required in the clinical practice. Color Doppler US is the imaging modality of choice to evaluate patients with high flow priapism. Focal or diffuse cavernosal fibrosis can be identified with US as echogenic areas in the cavernosal bodies. Postraumatic erectile dysfunction can result from fibrotic changes, nerve and vascular impairment or both. Doppler evaluation of penile vasculature is required in young patients with postraumatic impotence before surgical revascularization procedures. (orig.)

  17. Imaging of penile traumas - therapeutic implications

    International Nuclear Information System (INIS)

    Injury to the penis may result from penetrating or nonpenetrating trauma. Nonpenetrating injury to the erect penis can produce albugineal tear, intracavernous hematoma or extraalbugineal hematoma from rupture of the dorsal vessels. Nonpenetrating injury to the flaccid penis usually follows blunt perineal traumas producing extratunical or cavernosal haematomas, or cavernosal artery tear followed by high flow priapism. Differential diagnosis between albugineal tear and other penile injuries must be obtained as soon as possible, since early surgical repair of albugineal tear reduces significantly the rate of postraumatic curvature and fibrosis. Ultrasonography (US) is able to detect the exact site of the tear in most patients as an interruption of the thin echogenic line of the tunica albuginea. Other imaging techniques are rarely required in the clinical practice. Color Doppler US is the imaging modality of choice to evaluate patients with high flow priapism. Focal or diffuse cavernosal fibrosis can be identified with US as echogenic areas in the cavernosal bodies. Postraumatic erectile dysfunction can result from fibrotic changes, nerve and vascular impairment or both. Doppler evaluation of penile vasculature is required in young patients with postraumatic impotence before surgical revascularization procedures. (orig.)

  18. Penile rehabilitation after radical prostatectomy

    DEFF Research Database (Denmark)

    Fode, Mikkel; Ohl, Dana A; Ralph, David; Sønksen, Jens

    2013-01-01

    The pathophysiology of erectile dysfunction after radical prostatectomy (RP) is believed to include neuropraxia, which leads to temporarily reduced oxygenation and subsequent structural changes in penile tissue. This results in veno-occlusive dysfunction, therefore, penile rehabilitation programmes focus on tissue oxygenation. Animal studies support the use of phosphodiesterase type 5 inhibitors (PDE5Is) after cavernous nerve damage but results from human studies are contradictory. The largest s...

  19. Penile injuries: A 10-year experience

    OpenAIRE

    Krishna Reddy, S.V.; Shaik, Ahammad Basha; Sreenivas, K

    2014-01-01

    We report our 10-year experience with penile injuries. We retrospectively reviewed the records of 156 cases of male external genitalia injuries between May 2002 and December 2012. Of these, only 26 patients presented without urethral injuries and were included in this study. Patients were divided into 4 groups: Group 1 (n = 12) with patients with penile fractures injuries; Group 2 (n = 5) with patients with penile amputation injuries; Group 3 (n = 2) with patients with penile penetrating inju...

  20. Phalloplasty: A panacea for 46,XY disorder of sex development conditions with penile deficiency?

    Science.gov (United States)

    Callens, Nina; Hoebeke, Piet

    2014-01-01

    In cases of severe penile inadequacy, such as in pathological conditions involving penile amputation (e.g. penile cancer), or in 46,XY disorders of sex development with severe undervirilization or maldevelopment of the penis (e.g. idiopathic micropenis, cloacal exstrophy), standard (surgical) penile lengthening techniques do not provide patients with a phallus suitable for sexual intercourse. Genital dissatisfaction can lead to low self-esteem and psychosexual dysfunction. Therefore, phalloplasty, the gold standard in transgender surgery, may provide a possibility to achieve a satisfactory genital appearance and sexual function. Small series have reported cosmetically acceptable and erogenous sensate neophalli with incorporation of a neourethra to allow voiding in a standing position and with enough bulk to allow penile prosthesis insertion for pleasurable intercourse. Although early results seem promising, further publication of series with large numbers and longer follow-up is needed to evaluate to what extent phalloplasty improves physical and sexual outcomes. Complications are of particular concern because of associated scarring and loss of sensitive tissue. Without full preoperative workups assessing patients' expectations and reasons for undergoing surgery, they may still struggle with self/penile image and with psychological barriers for engaging in sexual activity. Recommendations for the psychosocial management of boys and men with penile deficiency are suggested. PMID:25247659

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

    Directory of Open Access Journals (Sweden)

    Staji? Zoran

    2013-01-01

    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 Allen’s 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 Allen’s test after the failure of initial radial attempt in cases where femoral approach should be avoided or the wrist approach should be maintained.

  2. 21 CFR 876.3630 - Penile rigidity implant.

    Science.gov (United States)

    2010-04-01

    ...2010-04-01 false Penile rigidity implant. 876.3630 Section 876.3630 Food...Devices § 876.3630 Penile rigidity implant. (a) Identification. A penile rigidity implant is a device that consists of a...

  3. 21 CFR 876.3350 - Penile inflatable implant.

    Science.gov (United States)

    2010-04-01

    ...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...

  4. Small in-stent Low Density on CT Angiography after Carotid Artery Stenting

    OpenAIRE

    Okahara, Mika; Kiyosue, Hiro; Kashiwagi, Junji; Ueda, Shinya; Hori, Yuzo; Mori, Hiromu

    2008-01-01

    Carotid stenting (CAS) for carotid stenosis has developed rapidly over the last decade. Instent low density area supposed plaque protrusion or thrombus is sometimes observed on CT angiography after CAS. We evaluate the frequency and time course of the small in-stent low density after carotid artery stenting and discuss its nature and clinical significance.

  5. 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

  6. 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’ll see a live ... from sunny Florida. We are live in the Coral Gables Hospital in beautiful Coral Gables, Florida. My ...

  7. Minimally Invasive Penile Implant Surgery

    Medline Plus

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

  8. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... see. Right now you’re going to see something that is very valuable to assess what you’ ... world there’s only 16,000 penile implants. There’s something wrong with that disparity. Here I am, I’ ...

  9. 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’ll see ... we could have this treatment option be completely risk-less. 00:04:24 IRWIN GOLDSTEIN, MD: So ...

  10. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... not have the best looking penis in the world, but he’ll be able to make love ... 300,000 breast implants a year? Across the world there’s only 16,000 penile implants. There’s something ...

  11. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... hole and they isolate the rest of the mouth. And I said to myself, “Well, gee, if we could do that for penile implants, maybe we’ll decrease our infection rates.” And I started looking at what is the source of infection, and looking at the literature it is clear that it is the patient’s ...

  12. Bestrophin is important for the rhythmic but not the tonic contraction in rat mesenteric small arteries

    DEFF Research Database (Denmark)

    Broegger, Torbjoern; Jacobsen, Jens Christian Brings

    2011-01-01

    Aims We have previously characterized a cGMP-dependent Ca2+-activated Cl– current in vascular smooth muscle cells (SMCs) and have shown its dependence on bestrophin-3 expression. We hypothesize that this current is important for synchronization of SMCs in the vascular wall. In the present study, we aimed to test this hypothesis by transfecting rat mesenteric small arteries in vivo with siRNA specifically targeting bestrophin-3. Methods and results The arteries were tested 3 days after transfection in vitro for isometric force development and for intracellular Ca2+ in SMCs. Bestrophin-3 expression was significantly reduced compared with arteries transfected with mutated siRNA. mRNA levels for bestrophin-1 and -2 were also significantly reduced by bestrophin-3 down-regulation. This is suggested to be secondary to specific bestrophin-3 down-regulation since siRNAs targeting different exons of the bestrophin-3 gene had identical effects on bestrophin-1 and -2 expression. The transfection affected neither the maximal contractile response nor the sensitivity to norepinephrine and arginine-vasopressin. The amplitude of agonist-induced vasomotion was significantly reduced in arteries down-regulated for bestrophins compared with controls, and asynchronous Ca2+ waves appeared in the SMCs. The average frequency of vasomotion was not different. 8Br-cGMP restored vasomotion in arteries where the endothelium was removed, but oscillation amplitude was still significantly less in bestrophin-down-regulated arteries. Thus, vasomotion properties were consistent with those previously characterized for rat mesenteric small arteries. Data from our mathematical model are consistent with the experimental results. Conclusion This study demonstrates the importance of bestrophins for synchronization of SMCs and strongly supports our hypothesis for generation of vasomotion.

  13. Synergism of diabetic and inflammatory culture conditions on reactivity of isolated small arteries

    DEFF Research Database (Denmark)

    Blædel, Martin Mads; Boonen, Harrie C.M.

    Background: Cardiovascular disease (CVD) is the manifestation of atherosclerosis, which has been linked to obesity, the metabolic syndrome (MS) and overt type 2 diabetes (T2DM). Vascular dysfunction has been proposed to precede atherosclerosis, and in addition, a correlation between vascular dysfunction and local vascular inflammation has been suggested. Aim: This study addresses the involvement of vascular risk factors of MS and T2DM such as elevated glucose, increased insulin levels, as well as selected cytokines on vascular contractile function. Methods: Small mesenteric resistance arteries isolated from 8 week old male SD rats were cultured for 21 hours in Endothelial Basal Medium (EBM-2) in petri dishes and in the absence or presence of either 30 mM D-glucose, 100 nM insulin, 100 ng/mL TNFa or any combination of these. Contractile reactivity of normalised arteries was then determined by wire myography as a response to cumulatively increasing concentrations of noradrenaline (NA). Results: 21 hour culture of isolated mesenteric arteries significantly reduced the arteries maximal high potassium-induced contractile reactivity and increased the contractility to noradrenaline slightly. Arteries that had been incubated in the presence of either D-glucose, insulin, or TNFa alone, displayed unchanged sensitivity and max. responses to NA as compared to control conditions (21 hour incubation in EBM-2 only). However, when arteries were incubated in combinations of glucose, insulin or TNF-a, the NA-induced max. responses and sensitivity significantly increased. Conclusion: These results suggest that the continuous presence of inflammatory cytokines may significantly enhance hyperglycaemia and hyperinsulinaemia-induced changes in vascular reactivity of cultured small arteries. An increased vascular inflammatory status might therefore be pivotal for the development of CVD in diabetes.

  14. Usefulness of automated feeder-detection software for identification of access routes to small pancreaticoduodenal artery aneurysms during embolotherapy.

    Science.gov (United States)

    Miyayama, Shiro; Yamashiro, Masashi; Ogi, Takahiro; Kayahashi, Masanori; Kawamura, Kenji; Yoshida, Miki; Terada, Takuro; Kosugi, Ikuko

    2015-12-01

    The mortality rate of patients with ruptured pancreaticoduodenal artery aneurysms is high; therefore, it is recommended to treat pancreaticoduodenal artery aneurysms regardless of their size. In small pancreaticoduodenal artery aneurysms, however, identification of the access route on two-dimensional arteriography is sometimes difficult because of the superimposition of many hypertrophied branches of pancreaticoduodenal arteries on the aneurysm. We report two cases of ruptured pancreaticoduodenal artery aneurysm embolized successfully with metallic coils, assisted by automated feeder-detection software using cone-beam computed tomography data. This new technology may reduce physicians' workload during the procedure. PMID:25585537

  15. Genetic Fuzzy System Predicting Contractile Reactivity Patterns of Small Arteries

    OpenAIRE

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

    2014-01-01

    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 art...

  16. Secondary penile carcinoma originated from pancreas.

    OpenAIRE

    Ahn, T. Y.; Choi, E H; Kim, K S

    1997-01-01

    Secondary penile cancers are rarely seen and most of them are originated from genitourinary and gastrointestinal tract. But metastatic penile cancer originated from pancreas are extremely rare and two cases have been reported in the literature, only one of them was pathological proven in autopsy. We report a case of secondary penile carcinoma originated from the pancreas as the primary site which was pathologically proven.

  17. Integrative Modeling of Small Artery Structure and Function Uncovers Critical Parameters for Diameter Regulation

    OpenAIRE

    vanBavel, Ed; Tuna, Bilge Guvenc

    2014-01-01

    Organ perfusion is regulated by vasoactivity and structural adaptation of small arteries and arterioles. These resistance vessels are sensitive to pressure, flow and a range of vasoactive stimuli. Several strongly interacting control loops exist. As an example, the myogenic response to a change of pressure influences the endothelial shear stress, thereby altering the contribution of shear-dependent dilation to the vascular tone. In addition, acute responses change the stimulus for structural ...

  18. The Production of Small Arterial Lesions in Nephrectomized Rats by the Administration of Pure Cathepsin D

    OpenAIRE

    Kai-Yamamoto, M.; Kanaide, H.; Yamamoto, H; Kurozumi, T.; Kato, K; Nakamura, M

    1982-01-01

    Pure cathepsin D was successfully obtained from rat liver by using affinity chromatography on pepstatin-aminohexyl-Sepharose gel. I.p. injection of more than 100 ?g of pure cathepsin D into bilaterally nephrectomized rats produced a slight elevation of blood pressure, an accumulation of peritoneal fluid and fibrinoid-necrosis-type lesions in small arteries and arterioles. The pressor and vasculotoxic effect of cathepsin D was apparently much milder than that of renin.

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

    DEFF Research Database (Denmark)

    Thybo, N K; Stephens, N

    1995-01-01

    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)

  20. Concentrated ambient air particles induce vasoconstriction of small pulmonary arteries in rats.

    OpenAIRE

    Batalha, Joao R F; Saldiva, Paulo H.N.; Clarke, Robert W.; Coull, Brent A.; Stearns, Rebecca C; Lawrence, Joy; Murthy, G G Krishna; Koutrakis, Petros; Godleski, John J

    2002-01-01

    The objective of this study was to determine whether short-term exposures to concentrated ambient particles (CAPs) alter the morphology of small pulmonary arteries in normal rats and rats with chronic bronchitis (CB). Sprague-Dawley male rats were exposed to CAPs, using the Harvard Ambient Particle Concentrator, or to particle-free air (sham) under identical conditions during 3 consecutive days (5 hr/day) in six experimental sets. CB was induced by exposure to 276 +/- 9 ppm of sulfur dioxide ...

  1. Penile length of newborns and children in Surakarta, Indonesia

    OpenAIRE

    Annang Giri Moelyo; Melita Widyastuti

    2013-01-01

    Background Penile length is a factor for assessing abnormalities in external genitalia. To diagnose micropenis, a condition in which penile length is < - 2.5 standard deviations (SD), a reference is required for diagnosis. Age and race/ethnic groups are factors that contribute to normal penile length. To date, Indonesia does not have such a reference for normal penile length in newborns and children. Objective To assess normal penile length in newborns and children in Surakarta, Central J...

  2. Comparison of penile brachial index and penile arteriography

    International Nuclear Information System (INIS)

    Thirty patients complaining of erectile dysfunction were evaluated by measurement of the penile brachial index and arteriography. The PBIs were measured in five healthy controls. Half of the patients were studied in a vascular laboratory and the other half in a radiology-urology erectile dysfunction clinic. A poor correlation was found between PBI and arteriographic findings. No statistical difference was observed between the correlation coefficients for the two laboratory sites. Factors responsible for accurate and inaccurate assessments are discussed, and the process by which PBI measurements are obtained and their relationship to the physiology of erections is explained

  3. Implantation of AMS 700 LGX penile prosthesis preserves penile length without the need for penile lengthening procedures.

    Science.gov (United States)

    Negro, Carlo Luigi Augusto; Paradiso, Matteo; Rocca, Alessandro; Bardari, Franco

    2016-01-01

    Implantation of an inflatable penile prosthesis (IPP) is a well-established definitive solution for erectile dysfunction when conservative treatments fail. Penile implants may shorten the penis. The AMS 700 LGX IPP is in common use but reports on its mechanical reliability, medium-term postsurgical patient satisfaction, and mean penile length preservation are lacking. We investigate the mean penile length, mechanical reliability, and patient satisfaction at 6 and 12 months after implantation of the AMS 700 LGX. This prospective study consecutively enrolled men undergoing first-time IPP implant surgery from February 2009 to April 2012. Stretched flaccid penile length, penile length at 50% and 100% of stiffness (P50 and P100) and International Index of Erectile Function (IIEF) and Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) scores, were measured at 6 and 12 months postsurgery. Of 45 patients who underwent AMS 700 LGX implantation (median age 61 years) and completed 6 months' follow-up, 36 (80%) completed the study. A significant difference in stretched flaccid penile length was seen between 6 and 12 months (P = 0.033). P100 was also significantly increased at 6 and 12 months, with a mean 10% increase (1.3 ± 0.4 cm) from baseline to 12 months. Differences in mean IIEF scores at 6 and 12 months were significant for the desired domain (P = 0.0001) and for overall satisfaction (P = 0.002); however, mean EDITS scores at 6 and 12 months were not significantly improved. AMS 700 LGX is a powerful tool for preserving penile length in men undergoing penile prosthesis implantation. PMID:26112480

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

    DEFF Research Database (Denmark)

    Buus, C L; Aalkjær, Christian

    1998-01-01

    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.

  5. [Prosthetic implants for penile induration].

    Science.gov (United States)

    Zanollo, A; Beretta, G; Zanollo, L; Spinelli, M

    1990-09-01

    From 1982 to 1988 we have evaluated 283 patients affected by Peyronie's disease. 81 of these complained erectile disfunction. Semirigid penile prosthesis were inserted in 38 patients with severe induratio penis plastica. Following surgery the patients were given a sexual questionnaire in order to determine whether they had realised their expectations as well as partner acceptance. Our results appear to be favourable and prosthesis insertion in selected patients with Peronie's disease seems to be the safest, most economical and best accepted choice. PMID:2148022

  6. New technique "Right Anterior Small Thoracotomy (RAST operation)" for beating heart grafting of the right internal thoracic artery to the posterior descending artery to the posterior descending artery in a third redo CABG patient. A novel coronary technique.

    Science.gov (United States)

    Guida, Maximo; Guida, Gustavo; Pecora, Giuseppina; Garate, Estefania De

    2014-01-01

    Third REDO-CABG is a challenge for the surgical team. Usually a patent mammary is the only graft working and the sternotomy becomes a risky procedure. Injury to a patent graft has been associated to a high mortality rate. Many different approaches have been proposed. We describe a novel technique to approach the right coronary artery through a right anterior small thoracotomy using the right mammary prolonged with saphenous vein for grafting the posterior descending artery on the beating heart. The technique is very simple and feasible because anatomically the right coronary artery and the right mammary are very close and the mobilization of the heart is minimal. PMID:25372923

  7. Concentrated ambient air particles induce vasoconstriction of small pulmonary arteries in rats.

    Science.gov (United States)

    Batalha, Joao R F; Saldiva, Paulo H N; Clarke, Robert W; Coull, Brent A; Stearns, Rebecca C; Lawrence, Joy; Murthy, G G Krishna; Koutrakis, Petros; Godleski, John J

    2002-12-01

    The objective of this study was to determine whether short-term exposures to concentrated ambient particles (CAPs) alter the morphology of small pulmonary arteries in normal rats and rats with chronic bronchitis (CB). Sprague-Dawley male rats were exposed to CAPs, using the Harvard Ambient Particle Concentrator, or to particle-free air (sham) under identical conditions during 3 consecutive days (5 hr/day) in six experimental sets. CB was induced by exposure to 276 +/- 9 ppm of sulfur dioxide (5 hr/day, 5 days/week, 6 weeks). Physicochemical characterization of CAPs included measurements of particle mass, size distribution, and composition. Rats were sacrificed 24 hr after the last CAPs exposure. Histologic slides were prepared from random sections of lung lobes and coded for blinded analysis. The lumen/wall area (L/W) ratio was determined morphometrically on transverse sections of small pulmonary arteries. When all animal data (normal and CB) were analyzed together, the L/W ratios decreased as concentrations of fine particle mass, silicon, lead, sulfate, elemental carbon, and organic carbon increased. In separate univariate analyses of animal data, the association for sulfate was significant only in normal rats, whereas silicon was significantly associated in both CB and normal rats. In multivariate analyses including all particle factors, the association with silicon remained significant. Our results indicate that short-term CAPs exposures (median, 182.75 micro g/m3; range, 73.50-733.00 micro g/m3) can induce vasoconstriction of small pulmonary arteries in normal and CB rats. This effect was correlated with specific particle components and suggests that the pulmonary vasculature might be an important target for ambient air particle toxicity. PMID:12460797

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

    DEFF Research Database (Denmark)

    Plesner, L; Juul, B; Skriver, E; Aalkjær, Christian

    1991-01-01

    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-, ...

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

    DEFF Research Database (Denmark)

    Thybo, N K; Stephens, N; Cooper, A; Aalkjær, Christian; Heagerty, A M; Mulvany, M J

    1995-01-01

    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

  10. FRACTURAS DEL PENE / Penile fracture

    Scientific Electronic Library Online (English)

    Carmen, Zevallos M; Francisco M, González V; María José, Ruiz L; Fernando, Alarcón S.

    2014-08-01

    Full Text Available Introducción: La fractura del cuerpo cavernoso representa una urgencia urológica infrecuente pero grave, ya que la lesión de estructuras cercanas y una demora en su tratamiento suele generar complicaciones morfológicas y funcionales irreversibles. Casos clínicos: Registramos 5 casos de fractura pene [...] ana en nuestro hospital en el período 2008-2012, con afectación del cuerpo cavernoso derecho y hematoma asociado en todos ellos. La edad promedio fue de 33,5 (rango 26-44) años. Todos relataron los síntomas característicos excepto uno, que permaneció sin dolor. Se realizó una ecografía urgente en 3 casos para confirmar el diagnóstico y evaluar la extensión de la lesión. Los pacientes fueron intervenidos quirúrgicamente de urgencia, el postoperatorio transcurrió sin incidencias y actualmente todos se encuentran asintomáticos. Abstract in english Background: Penile fracture occurs when the erect penis is bent suddenly and forcefully, rupturing the tunica albuginea of one or both of the corpus cavernosum. A delay in its treatment may lead to functional and morphological sequelae. Case reports: We report five patients aged 26 to 44 years with [...] penile fracture and right corpus cavernosum involvement. All patients excepting one had felt pain. An emergency ultrasound was done in three cases to confirm the diagnosis and the extension of the lesion. All were operated, had an uneventful postoperative period and are currently asymptomatic.

  11. Effects of glucagon-like peptide-1 in diabetic rat small resistance arteries.

    Science.gov (United States)

    Bayram, Zeliha; Nacitarhan, Cahit; Ozdem, Sadi S

    2014-09-01

    We investigated the functional effects of glucagon-like peptide-1 [GLP-1(7-36)] and GLP-1(9-36) and the mechanism(s) playing a role in the effects of these agents in isolated small resistance arteries from control and diabetic rats. Cumulative concentrations of GLP-1(7-36) and GLP-1(9-36) produced concentration-dependent relaxations in endothelium-intact but not endothelium-denuded arteries that were significantly decreased in diabetic rats. GLP-1 receptor antagonist exendin(9-39) significantly inhibited responses to GLP-1 analogs. Nitric oxide/cyclic guanosine monophosphate pathway blockers, but not indomethacin, significantly decreased responses to GLP-1(7-36) or GLP-1(9-36) in control and diabetic rats. 4-Aminopyridine or glibenclamide incubation did not alter relaxations to GLP-1 analogs. GLP-1(7-36)- and GLP-1(9-36)-induced relaxations were blunted significantly and to similar extends by charybdotoxin and apamin combination in control and diabetic rats. Catalase did not affect, whereas superoxide dismutase (SOD) caused a significant increase in relaxations to GLP-1 analogs only in diabetic rats. We provided evidence about the relaxant effects of GLP-1(7-36) and GLP-1(9-36) in resistance arteries that were reduced in diabetic rats. Both calcium-activated potassium channels and endothelium played a major role in relaxations. Increment in certain reactive oxygen species and/or reduction in superoxide dismutase function might play a role in reduced relaxant responses of resistance arteries to GLP-1(7-36) and GLP-1(9-36) in diabetic rats. PMID:24887687

  12. 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)

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

    2011-01-01

    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 us...

  13. 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)

    Stankevicius, Edgaras; Dalsgaard, T.; Kroigaard, C.; Beck, L.; Bødtkjer, Ebbe; Misfeldt, M. W.; Nielsen, G.; Schjorring, O.; Hughes, A.; Simonsen, U.

    2011-01-01

    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 u...

  14. Angiographic Evaluation of Carotid Artery Grafting with Prefabricated Small-Diameter, Small-Intestinal Submucosa Grafts in Sheep

    International Nuclear Information System (INIS)

    The purpose of this study was to report the longitudinal angiographic evaluation of prefabricated lyophilized small-intestinal submucosa (SIS) grafts placed in ovine carotid arteries and to demonstrate a variety of complications that developed. A total of 24 grafts, 10 cm long and 6 mm in diameter, were placed surgically as interposition grafts. Graft patency at 1 week was evaluated by Doppler ultrasound, and angiography was used for follow-up at 1 month and at 3 to 4 months. A 90% patency rate was found at 1 week, 65% at 1 month, and 30% at 3 to 4 months. On the patent grafts, angiography demonstrated a variety of changes, such as anastomotic stenoses, graft diffuse dilations and dissections, and aneurysm formation. These findings have not been previously demonstrated angiographically by other investigators reporting results with small-diameter vessel grafts made from fresh small-intestinal submucosa (SIS). The complications found were partially related to the graft construction from four SIS layers. Detailed longitudinal angiographic study should become an essential part of any future evaluation of small-vessel SIS grafting.

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

    DEFF Research Database (Denmark)

    Andersen, Malene R; Uldbjerg, Niels

    2011-01-01

    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.

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

    DEFF Research Database (Denmark)

    Andersen, Malene R; Uldbjerg, Niels; Stender, Steen; Sandager, Puk; Aalkjær, Christian

    2011-01-01

    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 nonsm...

  17. Acute cerebral arterial embolism following pemetrexed and carboplatin treatment in non-small-cell lung cancer: A case report

    OpenAIRE

    Takeda, Masayuki; KOBAYASHI, Takehiko; MARUMO, SATOSHI; KOSHIMO, YOSHIHIKO; TERANISHI, TAKASHI; HIGAMI, YUICHI; KATO, MOTOKAZU

    2013-01-01

    Thromboembolism is a known vascular toxicity associated with tumor chemotherapy. The combination of pemetrexed and carboplatin has exhibited significant antitumor activity, with mild manageable toxicity in patients with advanced non-small-cell lung cancer (NSCLC), whereas cerebral arterial embolism has not been recognized as a side effect associated with this regimen. This is the case report of an unusual case of NSCLC, in which the patient suffered a left middle cerebral arterial embolism fo...

  18. Penile Cancer Metastases to the Groin

    Directory of Open Access Journals (Sweden)

    Yong He

    2014-02-01

    Full Text Available Penile cancer is a relatively uncommon cancer in the United States, spreading locally and through lymphatic channels. Metastatic disease is rare but has been reported in the liver, lungs, bone, brain, heart, and skin. Here we report a case of penile squamous cell carcinoma that had metastasized to the groin and presented as a chronic non-healing wound. [Arch Clin Exp Surg 2014; 3(1.000: 56-58

  19. Organ-Preserving Surgery for Penile Carcinoma

    OpenAIRE

    Martins, Francisco E.; Rodrigues, Raul N.; Tomé M. Lopes

    2008-01-01

    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-preser...

  20. Surgical or conservative treatment of penile fracture

    Directory of Open Access Journals (Sweden)

    ?or?evi? D.

    2008-01-01

    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 Peyrone’s 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.

  1. The impact of surgical treatment for penile cancer -- patients' perspectives.

    OpenAIRE

    Witty, K; Branney, P.; Evans, J.; Bullen, K.; White, A.; Eardley, I.

    2013-01-01

    PURPOSE OF THE RESEARCH: Penile cancer is a rare but highly treatable condition. Whilst over 80% survive for over five years, treatment can have a significant impact on quality of life. There has been little research conducted to date on men's experiences of treatment for penile cancer. The Patients Experiences of Penile Cancer study (PEPC) aimed to redress this shortfall by exploring men's experiences of surgical treatment for penile cancer. METHODS AND SAMPLE: The study used a narrative his...

  2. Cerebral small-resistance artery structure and cerebral blood flow in normotensive subjects and hypertensive patients

    Energy Technology Data Exchange (ETDEWEB)

    De Ciuceis, Carolina; Porteri, Enzo; Rizzoni, Damiano; Boari, Gianluca E.M.; Rosei, Enrico Agabiti [University of Brescia, Clinica Medica, Department of Clinical and Experimental Sciences, Brescia (Italy); Cornali, Claudio; Mardighian, Dikran; Fontanella, Marco M. [University of Brescia, Section of Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Brescia (Italy); Pinardi, Chiara [Spedali Civili, Medical Physics Unit, Brescia (Italy); University of Brescia, Section of Neuroradiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Brescia (Italy); Rodella, Luigi F.; Rezzani, Rita [University of Brescia, Section of Anatomy, Department of Clinical and Experimental Sciences, Brescia (Italy); Gasparotti, Roberto [University of Brescia, Section of Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Brescia (Italy); University of Brescia, Section of Neuroradiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Brescia (Italy)

    2014-12-15

    The aim of this study was to prospectively investigate whether the structure of cerebral small-resistance arteries is related to cerebral perfusion parameters as measured with dynamic susceptibility-weighted contrast magnetic resonance imaging (DSC-MRI) in a selected cohort of hypertensive and normotensive patients. Ten hypertensive and 10 normotensive patients were included in the study. All patients underwent neurosurgical intervention for an intracranial tumor and were investigated with DSC-MRI at 1.5 T. Cerebral small-resistance arteries were dissected from a small portion of morphologically normal cerebral tissue and mounted on an isometric myograph for the measurement of the media-to-lumen (M/L) ratio. A quantitative assessment of cerebral blood flow (CBF) and volume (CBV) was performed with a region-of-interest approach. Correlation coefficients were calculated for normally distributed variables. The institutional review board approved the study, and informed consent was obtained from all patients. Compared with normotensive subjects, hypertensive patients had significantly lower regional CBF (mL/100 g/min) in the cortical grey matter (55.63 ± 1.90 vs 58.37 ± 2.19, p < 0.05), basal ganglia (53.34 ± 4.39 vs 58.22. ± 4.33, p < 0.05), thalami (50.65 ± 3.23 vs 57.56 ± 4.45, p < 0.01), subcortical white matter (19.32 ± 2.54 vs 22.24 ± 1.9, p < 0.05), greater M/L ratio (0.099 ± 0.013 vs 0.085 ± 0.012, p < 0.05), and lower microvessel density (1.66 ± 0.67 vs 2.52 ± 1.28, p < 0.05). A statistically significant negative correlation was observed between M/L ratio of cerebral arteries and CBF in the cortical grey matter (r = -0.516, p < 0.05), basal ganglia (r = -0.521, p < 0.05), thalami (r = -0.527 p < 0.05), and subcortical white matter (r = -0.612, p < 0.01). Our results indicate that microvascular structure might play a role in controlling CBF, with possible clinical consequences. (orig.)

  3. Integrative modeling of small artery structure and function uncovers critical parameters for diameter regulation.

    Science.gov (United States)

    VanBavel, Ed; Tuna, Bilge Guvenc

    2014-01-01

    Organ perfusion is regulated by vasoactivity and structural adaptation of small arteries and arterioles. These resistance vessels are sensitive to pressure, flow and a range of vasoactive stimuli. Several strongly interacting control loops exist. As an example, the myogenic response to a change of pressure influences the endothelial shear stress, thereby altering the contribution of shear-dependent dilation to the vascular tone. In addition, acute responses change the stimulus for structural adaptation and vice versa. Such control loops are able to maintain resistance vessels in a functional and stable state, characterized by regulated wall stress, shear stress, matched active and passive biomechanics and presence of vascular reserve. In this modeling study, four adaptation processes are identified that together with biomechanical properties effectuate such integrated regulation: control of tone, smooth muscle cell length adaptation, eutrophic matrix rearrangement and trophic responses. Their combined action maintains arteries in their optimal state, ready to cope with new challenges, allowing continuous long-term vasoregulation. The exclusion of any of these processes results in a poorly regulated state and in some cases instability of vascular structure. PMID:24497993

  4. 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.

  5. Priapism secondary to penile metastasis of rectal cancer

    Directory of Open Access Journals (Sweden)

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

    2009-09-01

    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.

  6. Successful Replantation of Amputated Penile Shaft following Industrial Injury

    Directory of Open Access Journals (Sweden)

    A Ariafar

    2010-09-01

    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.

  7. 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)

    Stankevicius, Edgaras; Dalsgaard, T.

    2011-01-01

    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.

  8. Small high-density lipoprotein is associated with monocyte subsets in stable coronary artery disease

    Science.gov (United States)

    Krychtiuk, Konstantin A.; Kastl, Stefan P.; Pfaffenberger, Stefan; Pongratz, Thomas; Hofbauer, Sebastian L.; Wonnerth, Anna; Katsaros, Katharina M.; Goliasch, Georg; Gaspar, Ludovit; Huber, Kurt; Maurer, Gerald; Dostal, Elisabeth; Oravec, Stanislav; Wojta, Johann; Speidl, Walter S.

    2014-01-01

    Objective: High-density lipoprotein (HDL) particles are heterogeneous in structure and function and the role of HDL subfractions in atherogenesis is not well understood. It has been suggested that small HDL may be dysfunctional in patients with coronary artery disease (CAD). Monocytes are considered to play a key role in atherosclerotic diseases. Circulating monocytes can be divided into three subtypes according to their surface expression of CD14 and CD16. Our aim was to examine whether monocyte subsets are associated with HDL subfractions in patients with atherosclerosis. Methods: We included 90 patients with angiographically stable CAD. Monocyte subsets were defined as classical monocytes (CD14++CD16-; CM), intermediate monocytes (CD14++CD16+; IM) and non-classical monocytes (CD14+CD16++; NCM). HDL subfractions were measured by electrophoresis on polyacrylamide gel. Results: Serum levels of small HDL correlated with circulating pro-inflammatory NCM and showed an inverse relationship to circulating CM independently from other lipid parameters, risk factors, inflammatory parameters or statin treatment regime, respectively. IM were not associated with small HDL. In particular, patients with small HDL levels in the highest tertile showed dramatically increased levels of NCM (14.7 ± 7% vs. 10.7 ± 5% and 10.8 ± 5%; p = 0.006) and a decreased proportion of CM (79.3 ± 7% vs. 83.7 ± 6% and 83.9 ± 6%; p = 0.004) compared to patients in the two lower tertiles. In contrast, intermediate HDL, large HDL and total HDL were not associated with monocyte subset distribution. Conclusion: Small HDL levels are associated with pro-inflammatory NCM and inversely correlated with CM. This may suggest that small HDL could have dysfunctional anti-inflammatory properties in patients with established CAD. PMID:25463093

  9. Bilateral multicystic renal dysplasia with potter sequence: A case with penile agenesis

    International Nuclear Information System (INIS)

    Hereditary renal adysplasia (HRA) is rare autosomal dominant condition. Patients have several other anomalies including Potter facies, thoracic, cardiac, and extremity deformities. The case present dysmorphic facial features such as hypertelorism, prominent epicanthic folds, a flat and broad nose, choanal stenosis, low set ears and a receding chin. He had femoral bowing, hypoplastic right tibia and agenesis of the right foot. He had rich and thin skin. He had also a dysplastic empty scrotum, penile agenesis, and anal atresia. The autopsy revealed pulmonary hypoplasia, ventricular septal defect, bilateral multicystic renal dysplasia, agenesis of ureter and bladder, intraabdominal testicles, and a single umbilical artery. The penile agenesis was first reported, and including the consanguinity in the parents might further delineate the bilateral multicystic HRA. Vater/caudal regression anomalies, Mullerian duct/aplasia, unilateral renal agenesis, and cervicothoracic somite anomalies association and Coloboma, heart anomaly, choanal atresia, retardation, retardation, genital and ear anomalies syndrome has been considered in differential diagnosis. (author)

  10. 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)

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

    DEFF Research Database (Denmark)

    Su, Junjing; Laursen, Britt E

    2012-01-01

    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 ?(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 ?(1)-adrenoceptor antagonist.

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

    DEFF Research Database (Denmark)

    Plesner, L; Juul, B

    1991-01-01

    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.

  13. Potassium and calcium channel gene expression in small arteries in porcine and rat models of diet-induced obesity (Poster)

    DEFF Research Database (Denmark)

    Jensen, Lars Jørn; Salomonsson, Max; Sørensen, Charlotte Mehlin; von Holstein-Rathlou, Niels-Henrik; Pedersen, Henrik Duelund; Christoffersen, Berit Ø.; Olsen, Lisbeth Høier; Ludvigsen, Trine Pagh

    2014-01-01

    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/h...

  14. Clinical observation of trans-artery infusion chemotherapy with carboplatin or cisplatin in advanced non-small-cell lung cancer

    International Nuclear Information System (INIS)

    Objective: To evaluate the effect of trans-artery infusion chemotherapy with carboplatin in advanced non-small-cell lung cancer. Methods: Fifty-two patients with advanced non-small-cell lung cancer pathologically confirmed were treated by trans-artery chemotherapy. They were divided into Carbo group and CDDP group according to anti-cancer drug. The effectiveness of treatment and complication were observed respectively, ?2 test was applied for statistical analysis. Results: There were 27 patients in Carbo group and 25 in CDDP group. In Carbo group, 15 had partial remission (PR), 8 were stable (S) and progression (P) was observed in 4. A responsive rate of 55.6% was obtained. In CDDP group, 15 cases showed rumor partial remission (PR), 7 were stable (S) and 3 were progression (P). The responsive rate was 60%. There was no statistical significance between them (P>0.05). There was no statistical significance in incidence rate of myelosuppression, nausea and vomiting between Carbo group and CDDP group (P>0.05). Conclusion: Compared with CD- DP, trans-artery infusion chemotherapy with Carbo has no better therapeutic effect and no less adverse effects. We maintain CDDP as anti-cancer drag when we perform arterial infusion chemotherapy of advanced non-small-cell lung cancer. (authors)

  15. Different effect of rho kinase inhibition on calcium signaling in rat isolated large and small arteries.

    OpenAIRE

    Martinsen, Anneloes; Yerna, Xavier; Rath, Géraldine; Leon Gomez, Elvira; Dessy, Chantal; Morel, Nicole

    2012-01-01

    In addition to its role in the regulation of artery contraction, Rho kinase (ROCK) was reported to be involved in the cytosolic calcium response to vasoconstrictor agonists in rat aorta and superior mesenteric artery (SMA). However, it remains to be determined whether ROCK also contributes to calcium signaling in resistance arteries, which play a major role in blood pressure regulation. The investigation of the effect of ROCK inhibition on the calcium and contractile responses of rat resistan...

  16. Male penile propulsion into spiraled spermathecal ducts of female chrysomelid beetles: A numerical simulation approach.

    Science.gov (United States)

    Filippov, Alexander; Kovalev, Alexander; Matsumura, Yoko; Gorb, Stanislav N

    2015-11-01

    Genital diversification in animals is an interesting evolutionary phenomenon. Sexual selection is the main driving force behind the diversification. However, evolutionary mechanisms that have established and maintained variations in genitalia shape parameters observed in related species are not well understood. Here, for the first time, we used numerical simulations to test the hypothesis that variations in female spermathecal duct shapes among related beetle species mechanically interfere with penile propulsion in varying ways. Our numerical simulations showed that high curvature of the spiraled spermathecal ducts of the female have effects with a threshold-based interaction on male penile insertion. The relative size of spirals observed in the beetle, Cassida rubiginosa, studied here is not small enough to interfere with penile propulsion. But the model revealed that propulsion is impeded by the presence of reverse turns in spermathecal ducts. This type of morphology leads to an increase in the velocity of the propulsion but also to an increase in the propulsion energy cost for males. Our results showed that quantitative differences in spermathecal duct shape can mediate qualitative differences in penile motion. This explains, in part, the mechanism behind origin and maintenance of genital divergence among closely related species in general. PMID:26341386

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

    Directory of Open Access Journals (Sweden)

    Juan F Granada

    2010-10-01

    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® Liberté® 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 Liberté 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 Liberté 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 Liberté Atom stent as compared with the bare metal Express stent control, with similar safety measures between the two groups. The TAXUS Liberté 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 Liberté 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 Liberté Atom stent in the treatment of small coronary vessels.Keywords: small vessel, paclitaxel, stent

  18. VEGF immunoexpression in penile carcinoma

    Scientific Electronic Library Online (English)

    Antonio Carlos Pereira, Martins; Sérgio, Britto; Clécio, Takata; Haylton Jorge, Suaid; Adauto José, Cologna; Silvio, Tucci Jr; Whemberton M., Araujo.

    Full Text Available 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 61.1±11.7 years. All of them were treate [...] d 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 observed in 15 patients. Selected paraffin embedded sections were submitted to VEGF immunohistochemical analysis by the avidin-biotin-immunoperoxidase method with antigen retrieval. All slides were examined using an automatic analyzer system and the proportion of labeled cells in 10 high magnification power fields (400X) were recorded in a blind analysis. RESULTS: Median (%) labeling index was 2.3 in G1 versus 2.2 in G2/3 tumors (p=0.60), and 4.0 in pT1 versus 1.8 pT2-4 tumors (p=0.10). The respective data for pN0 patients was 2.8 and for pN+ was 2.1 (p=0.20). Survival curves showed no association with patients survival. CONCLUSION: In squamous cell carcinoma of the penis the VEGF immunoexpression has no association with tumor grade or stage, as well as with patient survival.

  19. Advanced coronary artery calcification and cerebral small vessel diseases in the healthy elderly

    International Nuclear Information System (INIS)

    Coronary artery calcification (CAC) scores are widely accepted to predict risk of coronary heart diseases and are associated with atherosclerosis in other vasculatures. Cerebral small vessel diseases (SVDs), including white matter lesions (WML), silent lacunar infarction (SLI) and cerebral microbleeds (CMB), are considered to develop in conjunction with pro-atherogenic conditions, measured by CAC scores. Of 672 individuals aged ?65 years that underwent health screening, 312 subjects with brain magnetic resonance imagings (MRIs) were enrolled in this study. The distribution of baseline characteristics among individuals with or without MRIs was not different. Clinical and laboratory information was collected and CAC scores were measured using multi-detector computed tomography. Cerebral SVD were independently assessed by 2 raters who were unaware of the CAC scores. The prevalence of CAC (CAC>0) was 71.7% in men and 50.0% in women. The associations between moderate-to-extensive CAC (CAC score ?100) and WML (adjusted odds ratio and 95% confidence interval, 4.99 and 1.33-18.73), SLI (5.04 and 1.86-13.63) and CMB (6.07 and 1.54-23.94) remained significant after adjusting for relevant confounders. This study documents significant associations between CAC and cerebral SVDs. The findings suggest that SVDs in the brain and CAC in the heart may develop under similar systemic pathogenic processes. (author)

  20. Isolated Penile Torsion in Brothers: A Case Report

    Directory of Open Access Journals (Sweden)

    Metin Gunduz

    2012-04-01

    Full Text Available Penile torsion can be congenital and associated with hypospadias and chordee, or can be acquired after circumcision. The incidence of isolated neonatal penile torsion was 1.7 to 27% in the literature. The majority were between 10 and deg; and 20 and deg;. Generally, torsion was to the left in cases. The techniques for correction of penile torsion described in the literature are penile de-gloving and reattaching of skin, resection of Buck's fascia incising the base of the penis and removing angular ellipses of corporeal tissue with subsequent plication of tunica, and dorsal dartos flap rotation in severe cases. In conclusion, penile torsion may be familial. Therefore, brothers should be examined carefully. The degloving and realignment technique is successful in isolated penile torsion. [Arch Clin Exp Surg 2012; 1(2.000: 122-124

  1. Effects of ATP and UTP on [Ca2+]i, membrane potential and force in isolated rat small arteries

    DEFF Research Database (Denmark)

    Juul, B; Plesner, L; Aalkjær, Christian

    2011-01-01

    We have investigated excitation-contraction coupling mechanisms associated with the activation of purinoceptors and putative pyrimidinoceptors by assessing the effects of ATP and UTP on cytoplasmic Ca2+ activity ([Ca2+]i), membrane potential (Em) and force in rat mesenteric small arteries. UTP induced a sustained concentration-dependent contractions, closely associated with concentration-dependent increases in [Ca2+]i. Superfusion with 0.1 mM UTP caused a sustained depolarisation of 12 +/- 1 mV ...

  2. Involvement of Potassium Channels and Calcium-Independent Mechanisms in Hydrogen Sulfide-Induced Relaxation of Rat Mesenteric Small Arteries.

    Science.gov (United States)

    Hedegaard, Elise R; Gouliaev, Anja; Winther, Anna K; Arcanjo, Daniel D R; Aalling, Mathilde; Renaltan, Nirthika S; Wood, Mark E; Whiteman, Matthew; Skovgaard, Nini; Simonsen, Ulf

    2016-01-01

    Endogenous hydrogen sulfide (H2S) is involved in the regulation of vascular tone. We hypothesized that the lowering of calcium and opening of potassium (K) channels as well as calcium-independent mechanisms are involved in H2S-induced relaxation in rat mesenteric small arteries. Amperometric recordings revealed that free [H2S] after addition to closed tubes of sodium hydrosulfide (NaHS), Na2S, and GYY4137 [P-(4-methoxyphenyl)-P-4-morpholinyl-phosphinodithioic acid] were, respectively, 14%, 17%, and 1% of added amount. The compounds caused equipotent relaxations in isometric myographs, but based on the measured free [H2S], GYY4137 caused more relaxation in relation to released free H2S than NaHS and Na2S in rat mesenteric small arteries. Simultaneous measurements of [H2S] and tension showed that 15 µM of free H2S caused 61% relaxation in superior mesenteric arteries. Simultaneous measurements of smooth muscle calcium and tension revealed that NaHS lowered calcium and caused relaxation of NE-contracted arteries, while high extracellular potassium reduced NaHS relaxation without corresponding calcium changes. In NE-contracted arteries, NaHS (1 mM) lowered the phosphorylation of myosin light chain, while phosphorylation of myosin phosphatase target subunit 1 remained unchanged. Protein kinase A and G, inhibitors of guanylate cyclase, failed to reduce NaHS relaxation, whereas blockers of voltage-gated KV7 channels inhibited NaHS relaxation, and blockers of mitochondrial complex I and III abolished NaHS relaxation. Our findings suggest that low micromolar concentrations of free H2S open K channels followed by lowering of smooth muscle calcium, and by another mechanism involving mitochondrial complex I and III leads to uncoupling of force, and hence vasodilation. PMID:26493746

  3. 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)

    Kennelly, M M

    2012-04-01

    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.

  4. The Emerging Role and Promise of Biomarkers in Penile Cancer.

    Science.gov (United States)

    Vuichoud, Camille; Klap, Julia; Loughlin, Kevin R

    2016-02-01

    Penile cancer is a rare malignancy, which can be a source of devastating psychosexual distress because of its implication on sexual function and self-image. Current penile staging relies on invasive techniques and is often inaccurate. The authors review the promising biomarkers currently under investigation and their application to the staging and prognosis of penile cancer. Further development of such biomarkers provides the potential of improved clinical management of this disease. PMID:26614036

  5. Involvement of IP3-receptor activation in endothelin-1-induced Ca(2+) influx in rat pulmonary small artery.

    Science.gov (United States)

    Kato, K; Okamura, K; Hatta, M; Morita, H; Kajioka, S; Naito, S; Yamazaki, J

    2013-11-15

    We examined the endothelin-1 (ET-1)-induced increase in the intracellular free Ca(2+) concentration ([Ca(2+)]i) in fura-2-loaded rat pulmonary small arteries. ET-1 (30 nM) elicited a long-lasting increase in [Ca(2+)]i in physiological salt solution (PSS). In subsequent experiments, arteries were pretreated with BQ-788, an ETB-specific blocker, to allow us to focus on responses mediated via the ETA receptor, the existence of which was confirmed by immunohistochemistry. In Ca(2+)-free PSS, ET-1 evoked a small transient increase in [Ca(2+)]i, indicating Ca(2+) release from the SR (sarcoplasmic reticulum). After a switch to PSS (containing 2mM CaCl2), ET-1 elicited a long-lasting increase in [Ca(2+)]i that was not inhibited by 1 ?M nicardipine, an L-type Ca(2+)-channel inhibitor, suggesting involvement of a Ca(2+)-influx pathway independent of that channel. In arteries preincubated with 30 ?M cyclopiazonic acid (CPA) or 2 ?M thapsigargin (TG), the ET-1-induced Ca(2+)-release was greatly reduced, and the induced Ca(2+)-influx was attenuated. U-73122, a phospholipase C (PLC) inhibitor, had inhibitory effects similar to those of CPA and TG on the ET-1-induced Ca(2+)-release and Ca(2+)-influx, whereas U-73343, an inactive analogue of U-73122, had no such effects. Two putative membrane-permeable IP3-receptor blockers, 2-aminoethoxydiphenyl borate (2APB, 50 ?M) and Xestospongin C (20 ?M), (a) almost completely inhibited the ET-1-induced Ca(2+)-release and Ca(2+)-influx, and (b) reduced the ET-1-induced contraction. These results indicate that in rat pulmonary small arteries, ET-1 induces receptor-operated Ca(2+) influx via the ETA receptor, and that this influx interacts with InsP3-receptor activation. PMID:24157978

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

    Scientific Electronic Library Online (English)

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

    2009-11-01

    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 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 µM) or indomethacin (10 µM), 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 µM, an Na+/K+-ATPase inhibitor), but not K+ channel antagonists [tetraethylammonium (100 µM, a nonselective K+ channel blocker), Tram-34 (10 µM, blocker of intermediate conductance K+ channels) or UCL-1684 (0.1 µM, a small conductance K+ channel blocker)], inhibited the oscillatory activity. The contractile activity was also abolished when experiments were performed at 20°C 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.

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

    DEFF Research Database (Denmark)

    Schjerning, Jeppe; Uhrenholt, Torben R

    2013-01-01

    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.

  8. Current penile-rehabilitation strategies: Clinical evidence

    Science.gov (United States)

    Segal, Robert L.; Bivalacqua, Trinity J.; Burnett, Arthur L.

    2013-01-01

    We review the current strategies used for penile rehabilitation (PR) after a radical prostatectomy, where PR is defined as the attempt to restore spontaneous erectile function so that the patient can generate erections with no need for erectile aids. We searched PubMed for relevant reports, using the keywords ‘radical prostatectomy’, ‘penile rehabilitation’, ‘phosphodiesterase inhibitors’, ‘vacuum erection device’, ‘injection therapy’, ‘urethral suppository’, and ‘erectile dysfunction’. In all, 155 articles were identified and reviewed, and had a level of evidence ranging from 1b-4. The use of PR strategies should be based on the patient’s goals after a thorough explanation of realistic expectations, and the risks and consequences of the various treatment options. While a multitude of studies suggest a benefit with PR strategies, there are no established, proven regimens. Further research is needed to establish the optimal approaches to PR.

  9. Not all penile cancers are created equal.

    Science.gov (United States)

    Choi, Kellen; Hale, Nathan; Olsen, Daniel; Deem, Samuel

    2015-10-01

    Warty carcinoma variant of squamous cell carcinoma of the penis is a rare condition, making up 7% to 10% of all penile carcinomas. We present a case of warty carcinoma variant of squamous cell carcinoma of the penis in a 43-year-old Caucasian. The tumor presented in a locally invasive manner, requiring a total penectomy. The primary lesion measured over 15 cm x 16 cm, covering the entire perineum. The clinical features, diagnosis, surgical treatment and pathology are reviewed. In light of the locally invasive nature of warty carcinoma of the penis and high recurrence rate, early diagnosis and aggressive treatment is necessary for this type of unique penile cancer. PMID:26432973

  10. Penile skin necrosis - complication following selfcircumcision.

    OpenAIRE

    Sagar, Jayesh; Sagar, Bethani; Shah, Dharmendra K.

    2005-01-01

    Circumcision is one of the commonest operations performed throughout the world for ritual, traditional or medical reasons. Self-circumcision may lead to disastrous complications. There have been reports of the complications following use of the constricting devices for improved sexual performance and for auto-erotic intentions, but cases of self-circumcision leading to complications such as necrosis of the penile skin and strangulation of the penis are very rarely reported. This case represen...

  11. Epidemiologic study on penile cancer in Brazil

    Scientific Electronic Library Online (English)

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

    2008-10-01

    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 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.

  12. Organ-Preserving Surgery for Penile Carcinoma

    Directory of Open Access Journals (Sweden)

    Tomé M. Lopes

    2008-11-01

    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.

  13. Type 2 diabetes: increased expression and contribution of IKCa channels to vasodilation in small mesenteric arteries of ZDF rats.

    Science.gov (United States)

    Schach, Christian; Resch, Markus; Schmid, Peter M; Riegger, Guenter A; Endemann, Dierk H

    2014-10-15

    Impaired endothelial function, which is dysregulated in diabetes, also precedes hypertension. We hypothesized that in Type 2 diabetes, the impaired endothelium-dependent relaxation is due to a loss of endothelium-derived hyperpolarization (EDH) that is regulated by impaired ion channel function. Zucker diabetic fatty (ZDF), Zucker heterozygote, and homozygote lean control rats were used as the experimental models in our study. Third-order mesenteric arteries were dissected and mounted on a pressure myograph; mRNA was quantified by RT-PCR and channel proteins by Western blotting. Under nitric oxide (NO) synthase and cyclooxygenase inhibition, endothelial stimulation with ACh fully relaxes control but not diabetic arteries. In contrast, when small-conductance calcium-activated potassium (KCa) channels and intermediate- and large-conductance KCa (I/BKCa) are inhibited with apamin and charybdotoxin, NO is able to compensate for ACh-induced relaxation in control but not in diabetic vessels. After replacement of charybdotoxin with 1-[(2-chlorophenyl)diphenylmethyl]-(1)H-pyrazole (TRAM-34; IKCa inhibitor), ACh-induced relaxation in diabetic animals is attenuated. Specific inhibition with TRAM-34 or charybdotoxin attenuates ACh relaxation in diabetes. Stimulation with 1-ethyl-2-benzimidazolinone (IKCa activator) shows a reduced relaxation in diabetes. Activation of BKCa with 1,3-dihydro-1-[2-hydroxy-5-(trifluoromethyl)phenyl]-5-(trifluoromethyl)-(2)H-benzimidazol-2-one NS619 leads to similar relaxations of control and diabetic arteries. RT-PCR and Western blot analysis demonstrate elevated mRNA and protein expression levels of IKCa in diabetes. Our results suggest that the compensatory effect of NO and EDH-associated, endothelium-dependent relaxation is reduced in ZDF rats. Specific blockade of IKCa with TRAM-34 reduces NO and EDH-type relaxation in diabetic rats, indicating an elevated contribution of IKCa in diabetic small mesenteric artery relaxation. This finding correlates with increased IKCa mRNA and protein expression in this vessel. PMID:25128173

  14. Association of Small Dense LDL Serum Levels and Circulating Monocyte Subsets in Stable Coronary Artery Disease

    Science.gov (United States)

    Krychtiuk, Konstantin A.; Kastl, Stefan P.; Pfaffenberger, Stefan; Lenz, Max; Hofbauer, Sebastian L.; Wonnerth, Anna; Koller, Lorenz; Katsaros, Katharina M.; Pongratz, Thomas; Goliasch, Georg; Niessner, Alexander; Gaspar, Ludovit; Huber, Kurt; Maurer, Gerald; Dostal, Elisabeth; Wojta, Johann; Oravec, Stanislav; Speidl, Walter S.

    2015-01-01

    Objective Atherosclerosis is considered to be an inflammatory disease in which monocytes and monocyte-derived macrophages play a key role. Circulating monocytes can be divided into three distinct subtypes, namely in classical monocytes (CM; CD14++CD16-), intermediate monocytes (IM; CD14++CD16+) and non-classical monocytes (NCM; CD14+CD16++). Low density lipoprotein particles are heterogeneous in size and density, with small, dense LDL (sdLDL) crucially implicated in atherogenesis. The aim of this study was to examine whether monocyte subsets are associated with sdLDL serum levels. Methods We included 90 patients with angiographically documented stable coronary artery disease and determined monocyte subtypes by flow cytometry. sdLDL was measured by an electrophoresis method on polyacrylamide gel. Results Patients with sdLDL levels in the highest tertile (sdLDL?4mg/dL;T3) showed the highest levels of pro-inflammatory NCM (15.2±7% vs. 11.4±6% and 10.9±4%, respectively; p<0.01) when compared with patients in the middle (sdLDL=2-3mg/dL;T2) and lowest tertile (sdLDL=0-1mg/dL;T1). Furthermore, patients in the highest sdLDL tertile showed lower CM levels than patients in the middle and lowest tertile (79.2±8% vs. 83.9±7% and 82.7±5%; p<0.01 for T3 vs. T2+T1). Levels of IM were not related to sdLDL levels (5.6±4% vs. 4.6±3% vs. 6.4±3% for T3, T2 and T1, respectively). In contrast to monocyte subset distribution, levels of circulating pro- and anti-inflammatory markers were not associated with sdLDL levels. Conclusion The atherogenic lipoprotein fraction sdLDL is associated with an increase of NCM and a decrease of CM. This could be a new link between lipid metabolism dysregulation, innate immunity and atherosclerosis. PMID:25849089

  15. 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

  16. Involvement of K channels and calcium-independent mechanisms in hydrogen sulfide-induced relaxation of rat mesenteric small arteries

    DEFF Research Database (Denmark)

    Hedegaard, Elise R; Gouliaev, Anja; Winther, Anna K; Arcanjo, Daniel D R; Aalling, Mathilde; Sivasubramaniam, Nirthika; Wood, Mark E; Whiteman, Matthew; Skovgaard, Nini; Simonsen, Ulf

    2015-01-01

    Endogenous hydrogen sulfide (H2S) is involved in the regulation of vascular tone. We hypothesized that lowering of calcium and opening of K channels as well as calcium-independent mechanisms are involved in H2S-induced relaxation in rat mesenteric small arteries. Amperometric recordings revealed that free [H2S] after addition to closed tubes of NaSH, Na2S, and GYY4137 were, respectively, 14%, 17%, and 1% of added amount. The compounds caused equipotent relaxations in isometric myographs, but bas...

  17. Thrombophlebitis of the penile superficial vein, penile mondor's disease: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Park, Sang Hyun; Kim, Young Hwa; Kim, Doo Sang; Shin, Hyung Chul; Bae, Won Kyung; Kim, Il Young [Soonchunhyang University, Chunan (Korea, Republic of); Kim, Hyun Cheol [Kyung-Hee University, Seoul (Korea, Republic of)

    2007-07-15

    Mondor's disease is commonly known as thrombophlebitis of the superficial vein in the breast, and this disease occurs rarely in the penis. Despite extensive information about the clinical presentation and course of this disease, imaging findings for this disease are limited. We report gray scale and power Doppler sonographic findings of penile Mondor's disease.

  18. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... small, it wasn’t sized properly, or the space for the reservoir wasn’t appropriately made. There ... request information” button on your webcast screen and open the door to informed medical care. 01:03: ...

  19. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... corpora. Try to spare these little tiny lateral vessels that you’ll see – superficial epigastrics – so that ... small Richardson retractor that I bent in the middle on a 45-degree angle. 00:42:04 ...

  20. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... has been around pretty much since the late 1980s, so that gives us 20 year of exposure. ... being too small, I’ve found that, “What am I doing giving it to somebody else?” No, ...

  1. Proteome Analysis of Human Arterial Tissue Discloses Associations Between the Vascular Content of Small Leucine-Rich Repeat Proteoglycans and Pulse Wave Velocity

    DEFF Research Database (Denmark)

    Lyck Hansen, Maria; Beck, Hans Christian

    2015-01-01

    OBJECTIVES: We hypothesized that arterial stiffness is associated with changes in the arterial protein profile, particularly of extracellular matrix components. We aimed at determining differentially expressed proteins by quantitative proteome analysis in arterial tissue from patients with different degrees of arterial stiffness. APPROACH AND RESULTS: Arterial stiffness, assessed by carotid-femoral pulse wave velocity (PWV), central blood pressure and augmentation index by pulse wave analysis were measured the day before surgery in a group of patients undergoing coronary artery bypass grafting. Protein extracts of well-defined, homogenous, nonatherosclerotic individual samples of the left mammary artery from 10 of these patients with high PWV and 9 with low PWV were compared by quantitative proteome analysis, using tandem mass tag labeling and nano-liquid chromatography mass spectrometry/mass spectrometry. Of 418 quantified proteins, 28 were differentially expressed between the groups with high and low PWV (P<0.05). Three of 7 members of the extracellular matrix family of small leucine-rich repeat proteoglycans displayed significant differences between the 2 groups (P=0.0079; Fisher exact test). Three other ECM proteins were differentially regulated, that is, collagen, type VIII, ?-1 and ?-2 and collagen, type IV, ?-1. Several proteins related to smooth muscle cell function and structure were also found in different amounts between the 2 groups. CONCLUSIONS: Changes in the arterial amounts of small leucine-rich proteoglycans, known to be involved in collagen fibrillogenesis, and of some nonfibrillar collagens in combination with alterations in proteins related to functions of the human arterial smooth muscle are associated with arterial stiffness, as determined by PWV.

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

    DEFF Research Database (Denmark)

    Schjerning, Jeppe; Uhrenholt, Torben R; Svenningsen, Per; Vanhoutte, Paul M; Skott, Ole; Jensen, Boye L; Hansen, Pernille B L

    2013-01-01

    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-d...

  3. Small artery structure adapts to vasodilatation rather than to blood pressure during antihypertensive treatment

    DEFF Research Database (Denmark)

    Mathiassen, Ole N; Buus, Niels H; Larsen, Mogens L; Mulvany, Michael J; Christensen, Kent L

    2007-01-01

    OBJECTIVE: Correction of the abnormal structure of resistance arteries in essential hypertension may be an important treatment goal in addition to blood pressure (BP) reduction. We investigated how this may be achieved in a prospective clinical study. METHODS: Plethysmography was used to measure forearm resting vascular resistance (Rrest) and minimum vascular resistance (Rmin) as a measure of vascular structure. Two different groups of patients with essential hypertension were examined at baseli...

  4. A2B adenosine receptor contributes to penile erection via PI3K/AKT signaling cascade-mediated eNOS activation.

    Science.gov (United States)

    Wen, Jiaming; Grenz, Almut; Zhang, Yujin; Dai, Yingbo; Kellems, Rodney E; Blackburn, Michael R; Eltzschig, Holger K; Xia, Yang

    2011-08-01

    Normal penile erection is under the control of multiple factors and signaling pathways. Although adenosine signaling is implicated in normal and abnormal penile erection, the exact role and the underlying mechanism for adenosine signaling in penile physiology remain elusive. Here we report that shear stress leads to increased adenosine release from endothelial cells. Subsequently, we determined that ecto-5'-nucleotidase (CD73) is a key enzyme required for the production of elevated adenosine from ATP released by shear-stressed endothelial cells. Mechanistically, we demonstrate that shear stress-mediated elevated adenosine functions through the adenosine A(2B) receptor (A(2B)R) to activate the PI3K/AKT signaling cascade and subsequent increased endothelial nitric oxide synthase (eNOS) phosphorylation. These in vitro studies led us to discover further that adenosine was induced during sustained penile erection and contributes to PI3K/AKT activation and subsequent eNOS phosphorylation via A(2B)R signaling in intact animal. Finally, we demonstrate that lowering adenosine in wild-type mice or genetic deletion of A(2B)R in mutant mice significantly attenuated PI3K/AKT activation, eNOS phosphorylation, and subsequent impaired penile erection featured with the reduction of ratio of maximal intracavernosal pressure to systemic arterial pressure from 0.49 ± 0.03 to 0.41 ± 0.05 and 0.38 ± 0.04, respectively (both P<0.05). Overall, using biochemical, cellular, genetic, and physiological approaches, our findings reveal that adenosine is a novel molecule signaling via A(2B)R activation, contributing to penile erection via PI3K/AKT-dependent eNOS activation. These studies suggest that this signaling pathway may be a novel therapeutic target for erectile disorders. PMID:21566208

  5. Increased contractility to noradrenaline and normal endothelial function in mesenteric small arteries from the goto-kakizaki rat model of type 2 diabetes

    DEFF Research Database (Denmark)

    Brøndum, Emil Toft; Kold-Petersen, H; Nilsson, H; Flyvbjerg, Allan; Aalkjaer, C

    2008-01-01

    Type 2 diabetes is associated with many circulatory manifestations, including alteration in endothelial function and hypertension. In this study we investigate the morphology and contractile response as well as the endothelial function of resistance arteries from the spontaneously diabetic Goto-Kakizaki (GK) rat, a model of lean type 2 diabetes expressing glucose intolerance. METHODS: Isolated mesenteric small arteries were investigated under isometric conditions in a wire myograph system using ...

  6. Role of Schwann cells in the regeneration of penile and peripheral nerves.

    Science.gov (United States)

    Wang, Lin; Sanford, Melissa T; Xin, Zhongcheng; Lin, Guiting; Lue, Tom F

    2015-01-01

    Schwann cells (SCs) are the principal glia of the peripheral nervous system. The end point of SC development is the formation of myelinating and nonmyelinating cells which ensheath large and small diameter axons, respectively. They play an important role in axon regeneration after injury, including cavernous nerve injury that leads to erectile dysfunction (ED). Despite improvement in radical prostatectomy surgical techniques, many patients still suffer from ED postoperatively as surgical trauma causes traction injuries and local inflammatory changes in the neuronal microenvironment of the autonomic fibers innervating the penis resulting in pathophysiological alterations in the end organ. The aim of this review is to summarize contemporary evidence regarding: (1) the origin and development of SCs in the peripheral and penile nerve system; (2) Wallerian degeneration and SC plastic change following peripheral and penile nerve injury; (3) how SCs promote peripheral and penile nerve regeneration by secreting neurotrophic factors; (4) and strategies targeting SCs to accelerate peripheral nerve regeneration. We searched PubMed for articles related to these topics in both animal models and human research and found numerous studies suggesting that SCs could be a novel target for treatment of nerve injury-induced ED. PMID:25999359

  7. Surgical Management of a Locally Advanced Symptomatic Recurrence of Penile Sarcoma Secondary to Prostate Brachytherapy

    Scientific Electronic Library Online (English)

    Tariq S., Hakky; Patrick, Espiritu; Alejandro R., Rodriguez; Nicholas, Gould; Philippe E., Spiess.

    2013-04-01

    Full Text Available Background The surgical management of patients with symptomatic metastatic or locally advanced recurrences involving the penis remains poorly characterized. The aim of the present abstract and video is to detail our experience in the surgical management of a specific patient with a locally advanced [...] symptomatic recurrence of penile sarcoma secondary to prostate cancer treated with primary brachytherapy. Materials and Methods A 70 year old male patient initially treated for localized prostate cancer with interstitial brachytherapy at an outside facility developed an unfortunate secondary malignancy consisting of a locally advanced penile sarcoma involving as well the prostate and base of the bladder. Despite our best efforts to control his pain, he developed a very symptomatic local recurrence with a secondary penile abscess and purulent periurethral drainage. At this time, it was felt a surgical resection consisting of a total penectomy, urethrectomy, cystoprostatectomy, and ileal conduit urinary diversion would be the best option for local cancer control in this particular patient. Results The patient underwent the surgical resection without any complications as illustrated in this surgical video, with a jejunal intestinal mass identified at the time of surgery which was resected with a primary bowel anastomosis performed. The patient was discharged from hospital uneventfully with his symptomatic local recurrence being successfully managed and the patient no longer requiring oral narcotics for pain control. The pathological report confirmed a locally advanced sarcoma involving the penile, prostate, and bladder which was resected with negative surgical margins and the jejunal mass was confirmed to represent a small bowel sarcoma metastatic site. Conclusion As highlighted in the present video, the treatment of a symptomatic sarcoma local recurrence contiguously involving the penis can be successfully managed provided the patient is informed of the potential morbidity and psychosocial implications imparted by performing a total penectomy and adjacent organ resection.

  8. Penile brachytherapy: Results for 49 patients

    International Nuclear Information System (INIS)

    Purpose: To report results for 49 men with squamous cell carcinoma (SCC) of the penis treated with primary penile interstitial brachytherapy at one of two institutions: the Ottawa Regional Cancer Center, Ottawa, and the Princess Margaret Hospital, Toronto, Ontario, Canada. Methods and Materials: From September 1989 to September 2003, 49 men (mean age, 58 years; range, 22-93 years) had brachytherapy for penile SCC. Fifty-one percent of tumors were T1, 33% T2, and 8% T3; 4% were in situ and 4% Tx. Grade was well differentiated in 31%, moderate in 45%, and poor in 2%; grade was unspecified for 20%. One tumor was verrucous. All tumors in Toronto had pulsed dose rate (PDR) brachytherapy (n = 23), whereas those in Ottawa had either Iridium wire (n 22) or seeds (n = 4). Four patients had a single plane implant with a plastic tube technique, and all others had a volume implant with predrilled acrylic templates and two or three parallel planes of needles (median, six needles). Mean needle spacing was 13.5 mm (range, 10-18 mm), mean dose rate was 65 cGy/h (range, 33-160 cGy/h), and mean duration was 98.8 h (range, 36-188 h). Dose rates for PDR brachytherapy were 50-61.2 cGy/h, with no correction in total dose, which was 60 Gy in all cases. Results: Median follow-up was 33.4 months (range, 4-140 months). At 5 years, actuarial overall survival was 78.3% and cause-specific survival 90.0%. Four men died of penile cancer, and 6 died of other causes with no evidence of recurrence. The cumulative incidence rate for never having experienced any type of failure at 5 years was 64.4% and for local failure was 85.3%. All 5 patients with local failure were successfully salvaged by surgery; 2 other men required penectomy for necrosis. The soft tissue necrosis rate was 16% and the urethral stenosis rate 12%. Of 8 men with regional failure, 5 were salvaged by lymph node dissection with or without external radiation. All 4 men with distant failure died of disease. Of 49 men, 42 had an intact and tumor-free penis at last follow-up or death. The actuarial penile preservation rate at 5 years was 86.5%. Conclusions: Brachytherapy is an effective treatment for T1, T2, and selected T3 SCC of the penis. Close follow-up is mandatory because local failures and many regional failures can be salvaged by surgery

  9. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... can see that you end up with a beautiful watertight closure just using your stay sutures to approximate it, as long as you’ve made it a small corporotomy. The other thing I want you to notice is that – and ...

  10. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... the implant and I’ve made my corporotomy too big, I can put a nice superficial suture in ... percent. 01:01:35 PAUL PERITO, MD: Will fail every five years, so most ... you were saying about it being too small. The longer you wait to get this ...

  11. Minimally Invasive Penile Implant Surgery

    Medline Plus

    Full Text Available ... do not want that lockout mechanism to be bent, the neck of the reservoir to be bent, because that’ll render the lockout mechanism, which ... is a very small Richardson retractor that I bent in the middle on a 45-degree angle. ...

  12. Penile cancer: Perspective from a Canadian tertiary care centre

    Science.gov (United States)

    Beech, Benjamin; Izawa, Jonathan; Pautler, Stephen; Chin, Joseph; Power, Nicholas

    2015-01-01

    Introduction: Penile squamous cell carcinoma (SCC) is rare in North America; however, the morbidity can be devastating. This analysis represents the first reported penile cancer experience at a tertiary care centre in Canada. Methods: We carried out a retrospective review of all patients who received care at our centre for penile SCC from 2005 until the present time. Epidemiological and clinical data were collected for all patients. Survival analysis was performed using Kaplan-Meier methods with log-rank test and Cox regression for univariate and multivariate analysis, respectively. Results: We identified 42 patients who were treated at our centre for penile SCC. Of these, 29% underwent excisional biopsy, 38% had partial penectomy, and 33% had total penectomy. Five patients with high-risk tumours underwent modified inguinal lymph node dissection (ILND), while 7 patients had radical ILND for clinically palpable disease. Overall, the median cancer specific survival (CSS) was undefined, with a 60% survival at 102 months. However CSS was significantly correlated to pT stage, pN stage, and tumour grade. The median follow-up was 25 months (interquartile range: 11–48). Conclusion: These findings confirm the poor CSS of patients with positive lymph nodes in penile SCC. Patients with pN0 after ILND had a durable CSS. Risk factors for penile SCC were confirmed as elevated body mass index, positive smoking history, and lack of circumcision. This first epidemiologic report on penile SCC from a Canadian tertiary care centre should be expanded to other national centres.

  13. Pulmonary Artery Invasion, High-Dose Radiation, and Overall Survival in Patients With Non-Small Cell Lung Cancer

    International Nuclear Information System (INIS)

    Purpose: To investigate whether high-dose radiation to the pulmonary artery (PA) affects overall survival (OS) in patients with non-small cell lung cancer (NSCLC). Methods and Materials: Patients with medically inoperable/unresectable NSCLC treated with definitive radiation therapy in prospective studies were eligible for this study. Pulmonary artery involvement was defined on the basis of pretreatment chest CT and positron emission tomography/CT fusion. Pulmonary artery was contoured according to the Radiation Therapy Oncology Group protocol 1106 atlas, and dose-volume histograms were generated. Results: A total of 100 patients with a minimum follow-up of 1 year for surviving patients were enrolled: 82.0% underwent concurrent chemoradiation therapy. Radiation dose ranged from 60 to 85.5 Gy in 30-37 fractions. Patients with PA invasion of grade ?2, 3, 4, and 5 had 1-year OS and median survival of 67% and 25.4 months (95% confidence interval [CI] 15.7-35.1), 62% and 22.2 months (95% CI 5.8-38.6), 90% and 35.8 months (95% CI 28.4-43.2), and 50% and 7.0 months, respectively (P=.601). Two of the 4 patients with grade 5 PA invasion died suddenly from massive hemorrhage at 3 and 4.5 months after completion of radiation therapy. Maximum and mean doses to PA were not significantly associated with OS. The V45, V50, V55, and V60 of PA were correlated significantly with a worse OS (P<.05). Patients with V45 >70% or V60 >37% had significantly worse OS (13.3 vs 37.9 months, P<.001, and 13.8 vs 37.9 months, P=.04, respectively). Conclusions: Grade 5 PA invasion and PA volume receiving more than 45-60 Gy may be associated with inferior OS in patients with advanced NSCLC treated with concurrent chemoradiation

  14. Penile herpes zoster: an unusual location for a common disease

    Directory of Open Access Journals (Sweden)

    Milan Bjekic

    2011-12-01

    Full Text Available 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 clinical 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.

  15. Penile herpes zoster: an unusual location for a common disease

    Scientific Electronic Library Online (English)

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

    2011-12-01

    Full Text Available 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.

  16. Penile metastasis from rectum cancer primarily interpreted as Peyronie's disease

    DEFF Research Database (Denmark)

    Brønserud, Majken Munk; Sørensen, Flemming Brandt; Rahr, Hans; Osther, Palle Jörn Sloth

    2015-01-01

    We report an unusual case of penile metastasis derived from a rectal adenocarcinoma, which was first interpreted as Peyronie's disease. The patient had a single palpable mass in the penile shaft within the corpus cavernosum, with no ulceration or pain in the area. Two years earlier he had been treated for rectal cancer with neoadjuvant radiation therapy and abdomino-perineal resection. The mass in the penis later turned out to be a manifestation of widespread metastatic disease. The patient live...

  17. Penile Prosthesis Implantation for Treatment of Postpriapism Erectile Dysfunction

    OpenAIRE

    Akbar A Jalal; Mohammed H Durazi

    2008-01-01

    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 im...

  18. Penile prosthesis implantation in an academic institution in Latin America

    OpenAIRE

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

    2010-01-01

    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 prosthesis 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 underg...

  19. Penile Agenesis: Report on 8 Cases and Review of Literature

    OpenAIRE

    Alireza Mirshemirani; Ahmad Khaleghnejad; Hoshang Pourang; Naser Sadeghian; Mohsen Rouzrokh; Shadab Salehpour

    2009-01-01

    Background:Penile agenesis (PA) is an extremely rare anomaly with profound urological and psychological consequences. The opening of the urethra could be either over the pubis or at any point on perineum or most frequently in anterior wall of the rectum. The aim of treatment is an early female gender assignment and feminizing reconstruction of the perineum. Case(s) Presentation:We report 8 cases of penile agenesis with urination and defecation through the rectum, apparently normal scrotum, bi...

  20. Traumatic degloving lesion of penile and scrotal skin

    Directory of Open Access Journals (Sweden)

    Luiz A. Zanettini

    2005-06-01

    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.

  1. Curative effect of bronchial arterial infusion and CT guided percutaneous ethanol injection in advanced non-small cell lung cancer

    International Nuclear Information System (INIS)

    Objective: To observe the therapeutic effect of chemotherapy combined bronchial arterial infusion (BAI) with CT guided percutaneous ethanol injection (PEI) in advanced non small cell lung cancer (NSCLC). Methods: Data of 36 cases with NSCLC treated by BAI from Oct, 2004 to Oct, 2005 were retrospectively analyzed. Among them, 21 cases were also treated by PEI (group A). 15 cases received BAI only (group B). Results: The efficient rate was 81% for group A (3 CR, 14 PR and 4 S) and 60% for group B (no CR, 9 PR, 4 S, 2 P ). Significant difference developed between group A and group B in efficient rate and half or one year survival rates, with group A higher than that of group B. Conclusion: Combining interventional therapy of BAI and PEI showed good therapeutic effect in the treatment of advanced lung cancer, without severe side-effect. (authors)

  2. Penile rehabilitation following prostate cancer treatment: review of current literature.

    Science.gov (United States)

    Clavell-Hernandez, Jonathan; Wang, Run

    2015-01-01

    Radical prostatectomy (RP) and radiotherapy (RT) are highly effective in improving prostate cancer survival. However, both have a detrimental effect on erectile function (EF). Penile rehabilitation consists of understanding the mechanisms that cause erectile dysfunction (ED) and utilizing pharmacologic agents, devices or interventions to promote male sexual function. For the past decade, many researchers have pursued to define effective treatment modalities to improve ED after prostate cancer treatment. Despite the understanding of the mechanisms and well-established rationale for postprostate treatment penile rehabilitation, there is still no consensus regarding effective rehabilitation programs. This article reviews a contemporary series of trials that assess penile rehabilitation and explore treatment modalities that might play a role in the future. Published data and trials related to penile rehabilitation after RP and RT were reviewed and presented. Although recent trials have shown that most therapies are well-tolerated and aid in some degree on EF recovery, we currently do not have tangible evidence to recommend an irrefutable penile rehabilitation algorithm. However, advancements in research and technology will ultimately create and refine management options for penile rehabilitation. PMID:25851656

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

    Energy Technology Data Exchange (ETDEWEB)

    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

    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.)

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

    Science.gov (United States)

    Pattnaik, Shrikant; Banerjee, Rupak; Kim, Jay

    2012-04-01

    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.

  5. Extracellular Calcium-Dependent Modulation of Endothelium Relaxation in Rat Mesenteric Small Artery: The Role of Potassium Signaling

    Science.gov (United States)

    Hangaard, Lise; Jessen, Peter B.; Kamaev, Dmitrii; Aalkjaer, Christian; Matchkov, Vladimir V.

    2015-01-01

    The nature of NO- and COX-independent endothelial hyperpolarization (EDH) is not fully understood but activation of small- and intermittent-conductance Ca2+-activated K+ channels (SKCa and IKCa) is important. Previous studies have suggested that the significance of IKCa depends on [Ca2+]out. Also it has been suggested that K+ is important through localized [K+]out signaling causing activation of the Na+,K+-ATPase and inward-rectifying K+ channels (Kir). Here we tested the hypothesis that the modulating effect of [Ca2+]out on the EDH-like response depends on [K+]out. We addressed this possibility using isometric myography of rat mesenteric small arteries. When [K+]out was 4.2?mM, relaxation to acetylcholine (ACh) was stronger at 2.5?mM [Ca2+]out than at 1?mM [Ca2+]out. Inhibition of IKCa with TRAM34 suppressed the relaxations but did not change the relation between the relaxations at the low and high [Ca2+]out. This [Ca2+]out-dependence disappeared at 5.9?mM [K+]out and in the presence of ouabain or BaCl2. Our results suggest that IKCa are involved in the localized [K+]out signaling which acts through the Na+,K+-ATPase and Kir channels and that the significance of this endothelium-dependent pathway is modulated by [Ca2+]out. PMID:26504829

  6. Penile fracture and its treatment: Is retrograde urethrograghy necessary for management of penile fracture?

    Directory of Open Access Journals (Sweden)

    Kamalati Ali

    2014-12-01

    Full Text Available ?Abstract?Objective: Penile fracture, being defined as rupture of the tunica albuginea of the corpus cavernosum, is uncommon. Here, we analyze fi ndings on our patients during a 10-year period and evaluate the role of retrograde urethrography. Methods: From February 2002 to April 2012, 116 patients were admitted with penile fracture at Ghaem Medical Center. Patient history and physical examination were taken at their admittance to detect probable urethral injury. Before surgery, retrograde urethrography was performed in all patients. The size and site of the tunical rupture were recorded. Then the rupture of tunica albuginea was sutured with nonabsorbable (3-0 nylon sutures and the ties were placed on the internal surface (continuous method. All patients were followed up for 12 months. Results: Patients' mean age was(32.78±10.61 years and ranged (16-62 years. The mechanism of trauma was sexual intercourse in 103 patients (89% and sturbation in 13 patients (11%. The most common site of injury found after exploration was right (55% and lateral (74% of the corpus cavernosum. The size of the tunical rupture was from 0.5 to 3.0 cm (mean 0.88±0.72. Three of the patients had Marphan's syndrome. Urethral injury was detected by retrograde urethrography in 4 patients (3% who had macroscopic hematuria and urethrorrhagia. During 12 months follow-up, no complication was seen. Conclusion: There is no need to perform retrograde urethrography unless the patients have gross hematuria or urethrorrhagia. The key to success in treatment of penile fracture is to achieve a rapid diagnosis based on history and a physical examination, avoid unnecessary imaging tests and perform immediate surgery to reconstruct the site of injury. Key words: Penis; Radiography; Urogenital system; Treatment outcome

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

    Directory of Open Access Journals (Sweden)

    Eshpuniyani Priya

    2010-01-01

    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.

  8. Penile augmentation with resultant foreign material granuloma and sequalae.

    Science.gov (United States)

    Inn, Fam Xeng; Imran, Farrah-Hani; Ali, Mohd Faizal; Ih, Rizuana; Z, Zulkifli

    2012-10-01

    Throughout history, a proportion of men appear to correlate penis size and dimensions directly with physical fitness and sexual prowess. Foreign materials, such as paraffin oil, paraffin balm, mineral oils, and silicone, have been used to promise an improvement in penile shaft contour and dimensions. These materials are injected directly into the penis; inducing granuloma formation to achieve increased penis length and girth. However, the result is a severely disfigured and swollen penis, which cannot achieve erection. Local complications of penile lipogranuloma include infection, ulceration, local migration, and cavernosal invasion; leading to functional impairment. Meanwhile, systemic complications include foreign body embolization, organ infarct, and death. Penile lipogranuloma is best treated surgically. Granulomatous skin needs to be completely excised; wound closure with a scrotal skin flap, Cecil's inlay operation and split thickness skin graft commonly used options. Our case series has shown that penile lipogranuloma, induced by subcutaneous foreign body injections into the penile shaft, and its subsequent adverse outcomes to patients and their partners. PMID:23613653

  9. Identification of somatic gene mutations in penile squamous cell carcinoma.

    Science.gov (United States)

    Ferrándiz-Pulido, Carla; Hernández-Losa, Javier; Masferrer, Emili; Vivancos, Ana; Somoza, Rosa; Marés, Roso; Valverde, Claudia; Salvador, Carlos; Placer, Jose; Morote, Juan; Pujol, Ramon M; Ramon, Santiago; Cajal, Y; de Torres, Ines; Toll, Agusti; García-Patos, Vicente

    2015-10-01

    There is a lack of studies on somatic gene mutations and cell signaling driving penile carcinogenesis. Our objective was to analyze somatic mutations in genes downstream of EGFR in penile squamous cell carcinomas, especially the mTOR and RAS/MAPK pathways. We retrospectively analyzed somatic mutations in 10 in situ and 65 invasive penile squamous cell carcinomas by using Sequenom's Mass Spectrometry iPlex Technology and Oncocarta v1.0 Panel. The DNA was extracted from FFPE blocks and we identified somatic missense mutations in three in situ tumors and in 19 invasive tumors, mostly in PIK3CA, KRAS, HRAS, NRAS, and PDGFA genes. Somatic mutations in the PIK3CA gene or RAS family genes were neither associated with tumor grade, stage or outcome, and were equally often identified in hrHPV positive and in hrHPV negative tumors that showed no p53 expression. Mutations in PIK3CA, KRAS, and HRAS are frequent in penile squamous cell carcinoma and likely play a role in the development of p53-negative tumors. Although the presence of these mutations does not seem to correlate with tumoral behavior or outcome, they could be biomarkers of treatment failure with anti-EGFR mAb in patients with penile squamous cell carcinoma. © 2015 Wiley Periodicals, Inc. PMID:26216163

  10. Penile lymphoscintigraphy for sentinel node identification

    Energy Technology Data Exchange (ETDEWEB)

    Valdes Olmos, R.A.; Hoefnagel, C.A. [Netherlands Cancer Inst., Amsterdam (Netherlands). Dept. of Nuclear Medicine; Tanis, P.J.; Jansen, L.; Nieweg, O.E. [Netherlands Cancer Inst., Amsterdam (Netherlands). Dept. of Surgery; Meinhardt, W.; Horenblas, S. [Netherlands Cancer Inst., Amsterdam (Netherlands). Dept. of Urology

    2001-05-01

    Lymphoscintigraphy for sentinel node (SN) identification has been extensively validated in breast cancer and melanoma. The aim of this study was to evaluate the findings of lymphoscintigraphy for SN identification in carcinoma of the penis. Lymphoscintigraphy was performed in 74 consecutive patients (mean age 62.2 years, range 28-87 years) with clinically lymph node-negative squamous cell carcinoma of the penis (stage T2 or greater). Following local anaesthesia by xy-locaine 10% spray, technetium-99m nanocolloid (mean dose 64.8 MBq, range 40-131 MBq) in a volume of 0.3-0.4 ml was injected intradermally around the tumour. Shortly after injection, a 20-min dynamic study was performed with a dual-head gamma camera; subsequently, static anterior and lateral images were obtained at 30 min and 2 h using simultaneous cobalt-57 flood source transmission scanning. {sup 57}Co-assisted skin marking defined SN location for gamma probe/blue dye-guided biopsy, which was performed the next day. The SN visualization rate was 97% (72/74). Lymphatic drainage was bilateral in 81% of the cases (58/72), exclusively to the left groin in 13% (9/72) and only to the right groin in 6%. Bilateral lymph node drainage was synchronous in 38% (22/58) and asynchronous in 62% (in 18 patients the initial route was the left groin, and in the other 18, the right groin). Visualization before 30 min occurred in 66 patients (93%), in 64 of them (88%) already during the dynamic study. A total of 173 SNs were visualized (85 in the right groin, 88 in the left groin). Pitfalls were caused by inguinal skin contamination during injection (four patients) and intracavernous administration (one patient). At surgery, a total of 161 SNs were identified and removed. Sixteen patients (22%) had a tumour-positive SN and underwent standard regional lymph node dissection subsequently. During follow-up (median 28 months, range 3-74 months), two patients with a negative SN developed lymph node metastases in the mapped basin. It is concluded that penile lymphoscintigraphy is a valid and well-tolerated method for lymphatic mapping and SN identification. Although bilateral early inguinal drainage is the most frequent pattern, late imaging is recommended principally in patients with initial unilateral drainage in order to exclude delayed lymph node filling in the contralateral groin. SN identification may lead to a more accurate staging and avoid extensive lymph node dissection in the majority of patients with penile carcinoma. (orig.)

  11. Necrosis cutánea y peneana inducidas por warfarina / [title language=en]Warfarin-induced skin and penile necrosis

    Scientific Electronic Library Online (English)

    Alfredo, Pinzón; Catalina, Arias; Ana María, Cárdenas.

    2012-09-01

    Full Text Available Presentamos el caso de un hombre adulto mayor con múltiples episodios de trombosis venosa y arterial en diferentes localizaciones, quien desarrolló necrosis cutánea extensa y peneana pocos días después del uso de un antagonista de vitamina K (warfarina). Como parte del estudio de trombofilia se obse [...] rvó deficiencia de proteína C y S. (Acta Med Colomb 2012; 37: 142-146). Abstract in english We present the case of an elderly man with multiple episodes of venous and arterial thrombosis in different locations, who developed extensive skin and penile necrosis few days after the use of a vitamin K antagonist (warfarin). As part of the thrombophilia study, we observed protein C and S deficie [...] ncy. (Acta Med Colomb 2012; 37: 142-146).

  12. Necrosis cutánea y peneana inducidas por warfarina [title language=en]Warfarin-induced skin and penile necrosis

    Directory of Open Access Journals (Sweden)

    Alfredo Pinzón

    2012-09-01

    Full Text Available Presentamos el caso de un hombre adulto mayor con múltiples episodios de trombosis venosa y arterial en diferentes localizaciones, quien desarrolló necrosis cutánea extensa y peneana pocos días después del uso de un antagonista de vitamina K (warfarina. Como parte del estudio de trombofilia se observó deficiencia de proteína C y S. (Acta Med Colomb 2012; 37: 142-146.We present the case of an elderly man with multiple episodes of venous and arterial thrombosis in different locations, who developed extensive skin and penile necrosis few days after the use of a vitamin K antagonist (warfarin. As part of the thrombophilia study, we observed protein C and S deficiency. (Acta Med Colomb 2012; 37: 142-146.

  13. Penile Dysmorphic Disorder: Development of a Screening Scale.

    Science.gov (United States)

    Veale, David; Miles, Sarah; Read, Julie; Troglia, Andrea; Carmona, Lina; Fiorito, Chiara; Wells, Hannah; Wylie, Kevan; Muir, Gordon

    2015-11-01

    Penile dysmorphic disorder (PDD) is shorthand for men diagnosed with body dysmorphic disorder, in whom the size or shape of the penis is their main, if not their exclusive, preoccupation causing significant shame or handicap. There are no specific measures for identifying men with PDD compared to men who are anxious about the size of their penis but do not have PDD. Such a measure might be helpful for treatment planning, reducing unrealistic expectations, and measuring outcome after any psychological or physical intervention. Our aim was, therefore, to validate a specific measure, termed the Cosmetic Procedure Screening Scale for PDD (COPS-P). Eighty-one male participants were divided into three groups: a PDD group (n = 21), a small penis anxiety group (n = 37), and a control group (n = 23). All participants completed the COPS-P as well as standardized measures of depression, anxiety, social phobia, body image, quality of life, and erectile function. Penis size was also measured. The final COPS-P was based on nine items. The scale had good internal reliability and significant convergent validity with measures of related constructs. It discriminated between the PDD group, the small penis anxiety group, and the control group. This is the first study to develop a scale able to discriminate between those with PDD and men anxious about their size who did not have PDD. Clinicians and researchers may use the scale as part of an assessment for men presenting with anxiety about penis size and as an audit or outcome measure after any intervention for this population. PMID:25731908

  14. Radiation Dose-Volume Effects and the Penile Bulb

    International Nuclear Information System (INIS)

    The dose, volume, and clinical outcome data for penile bulb are reviewed for patients treated with external-beam radiotherapy. Most, but not all, studies find an association between impotence and dosimetric parameters (e.g., threshold doses) and clinical factors (e.g., age, comorbid diseases). According to the data available, it is prudent to keep the mean dose to 95% of the penile bulb volume to <50 Gy. It may also be prudent to limit the D70 and D90 to 70 Gy and 50 Gy, respectively, but coverage of the planning target volume should not be compromised. It is acknowledged that the penile bulb may not be the critical component of the erectile apparatus, but it seems to be a surrogate for yet to be determined structure(s) critical for erectile function for at least some techniques.

  15. Penile lesion from gunshot wound: a 43-case experience

    Directory of Open Access Journals (Sweden)

    Cavalcanti Andre G.

    2006-01-01

    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.

  16. Henoch-Schonlein purpura: ultrasonography of scrotal and penile involvement

    Directory of Open Access Journals (Sweden)

    Youngsik Lim

    2015-04-01

    Full Text Available Testicular or scrotal involvement has been reported in children with Henoch-Schonlein purpura (HSP, but there are very few reports on penile involvement. We report the initial and follow-up ultrasonographic findings of scrotal and penile involvement of HSP in a 5-year-old boy. On ultrasonography, scrotal soft tissue thickening and epididymal swelling with increased vascularity were noted, and on the penis, a focal mass-like lesion appeared on the dorsal surface of the distal penis, having a hypoechoic mass-like appearance without visible vascular flow on a Doppler study. After 2 days of treatment, follow-up ultrasonography showed normal scrotum and penis with a resolved soft tissue mass-like lesion. Therefore, we think that HSP ultrasonographic findings involving the scrotum and penis might help to diagnose scrotal and penile involvement in a case of HSP and to avoid unnecessary medication and/or surgical procedures.

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

    Scientific Electronic Library Online (English)

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

    2011-06-01

    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 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

  18. Serum YKL-40 and uterine artery Doppler -- a prospective cohort study, with focus on preeclampsia and small-for-gestational-age

    DEFF Research Database (Denmark)

    Gybel-Brask, Dorte; HØgdall, Estrid

    2014-01-01

    OBJECTIVE: To test if serum YKL-40 is increased in women developing preeclampsia or small-for-gestational age fetuses. We also assessed the association between uterine artery pulsatility index, notching and serum YKL-40 levels. DESIGN: Prospective cohort study. SETTING: A primary referral unit for obstetric ultrasound. POPULATION: A total of 1214 unselected pregnant women enrolled at nuchal translucency examination between 11(+3) and 13(+6) weeks of gestation. METHODS: All women had ultrasound and blood sample collection at the nuchal translucency scan, a 20-week malformation scan and 25-week and 32-week fetal growth examinations. Uterine artery Doppler was assessed and outcome was registered from medical records. MAIN OUTCOME MEASURES: Preeclampsia, hypertension, small-for-gestational age. RESULTS: Serum YKL-40 was associated with increasing maternal age (p < 0.0001), body mass index (p = 0.0002), primiparity (p = 0.0003), and hypertension (p = 0.015). Serum YKL-40 increased from 12 to 20 weeks and decreased from 20-25 and 25-32 weeks of gestation. No association was found between preeclampsia and serum YKL-40. Small-for-gestational-age at birth was significantly associated with a 5.4% increase in serum YKL-40 at 32 weeks of gestation (95% CI 1.5-9.3, p = 0.005). An association was found between uterine artery pulsatility index at 32 weeks and small-for-gestational age (p = 0.0015) but not between YKL-40 and uterine artery notching (p = 0.83). CONCLUSIONS: Serum YKL-40 was not associated with preeclampsia. Increasing serum YKL-40 was related to maternal age, body mass index and small-for-gestational age and may reflect an exaggerated inflammatory response.

  19. CD34 immunoexpression in penile carcinoma

    Scientific Electronic Library Online (English)

    Antonio Carlos Pereira, Martins; Sérgio, Britto; Clécio, Takata; Silvio, Tucci Jr.; Tiago José, Borelli-Bovo; José Anastácio, Dias Neto.

    Full Text Available 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 60.8±11.8 years. All of them were treated by penectomy and with positive node [...] s 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 embedded sections were submitted to CD34 immunohistochemical analysis by the avidin-biotin-immunoperoxidase method with antigen retrieval. All slides were examined using an automatic analyzer system and the number of micro-vessels in 10 high magnification power fields (400X) were counted in a blind analysis. RESULTS: Median number of microvessels was 631 in G1 versus 695 in G2/3 tumors (p=0.78), and 696 in pT1 versus 566 pT2-4 tumors (p=0.23). The respective data for pN0 patients was 525 and for pN+ was 696 (p=0.01), which is an unexpected result. CONCLUSION: CD34 immunoexpression or microvessel density determined by this method bear no association with tumor grade, stage or prognosis.

  20. Potassium and calcium channel gene expression in small arteries in porcine and rat models of diet-induced obesity (Poster)

    DEFF Research Database (Denmark)

    Jensen, Lars JØrn; Salomonsson, Max

    2014-01-01

    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.

  1. Penile metastasis from rectum cancer primarily interpreted as Peyronie's disease

    DEFF Research Database (Denmark)

    BrØnserud, Majken Munk; SØrensen, Flemming Brandt

    2015-01-01

    We report an unusual case of penile metastasis derived from a rectal adenocarcinoma, which was first interpreted as Peyronie's disease. The patient had a single palpable mass in the penile shaft within the corpus cavernosum, with no ulceration or pain in the area. Two years earlier he had been treated for rectal cancer with neoadjuvant radiation therapy and abdomino-perineal resection. The mass in the penis later turned out to be a manifestation of widespread metastatic disease. The patient lived three years after discovery of metachronous metastases in penis and lungs.

  2. Penile cutaneous horn: An enigma-newer insights and perspectives

    Directory of Open Access Journals (Sweden)

    Kaliaperumal Karthikeyan

    2015-01-01

    Full Text Available Cutaneous horn refers to unusually cohesive keratinized material and not a true pathologic diagnosis. Though cutaneous horn has been described at various sites, horn over the penis is very rare and represents the most unusual site. The role of chronic irritation, phimosis, surgical trauma and radiotherapy have been implicated in penile horn formation. Penile horns present as elongated, keratinous, white or yellowish projections that range from a few millimeters to centimeters in size arising from the glans penis. Histopathology of the keratotic mass reveals nothing but keratin. The underlying mass may vary from verruca vulgaris to squamous cell carcinoma. The treatment is based on the pathology.

  3. Isolated Penile Fournier's Gangrene Presenting with Glans Penis Involvement.

    Science.gov (United States)

    Temiz, Mustafa Zafer; Yuruk, Emrah; Aykan, Serdar; Tuken, Murat; Kandirali, Engin

    2015-10-01

    Fournier's Gangrene (FG) is a type of necrotizing infection or gangrene usually affecting the perineum. Penile gangrene is a rare disease because of rich collateral circulation and blood flow in the perineum and lower abdomen. We report an unusual and rare presentation of FG with isolated glans penis necrosis in a 62-year-old man. The patient underwent subtotal penectomy and closure of the wound with penile skin flap after covering the spongious tissue with dartos fascial flap enclosing the urethra. The recovery phase was uneventful and the patient had no urinating symptoms during follow-up. PMID:26522204

  4. Activation of endothelial and epithelial KCa2.3 calcium-activated potassium channels by NS309 relaxes human small pulmonary arteries and bronchioles

    DEFF Research Database (Denmark)

    Kroigaard, Christel; Dalsgaard, Thomas

    2012-01-01

    Background and purpose: Small (KCa2) and intermediate (KCa3.1) conductance calcium-activated potassium channels (KCa) have been proposed to contribute to both epithelium- and endothelium-dependent relaxations, but this has not been established in human pulmonary arteries and bronchioles. Therefore, we investigated the expression of KCa2.3 and KCa3.1 channels, and hypothesised that activation of these channels produce relaxation of human bronchioles and pulmonary arteries. Experimental approach: Channel expression and functional studies were conducted in isolated human small pulmonary arteries and bronchioles, and KCa2 and KCa3.1 currents were examined in human small airways epithelial (HSAEpi) cells by whole-cell patch-clamp. Results: While KCa2.3expression was similar, KCa3.1 protein was highest expressed in pulmonary arteries compared to bronchioles. Immunoreaction to KCa2.3 and KCa3.1 were found both in the endothelium and epithelium. KCa-currents were present in HSAEpi cells and sensitive to the KCa2.3 blocker UCL1684 and the KCa3.1 blocker TRAM-34. In pulmonary arteries contracted by U46619 and in bronchioles contracted by histamine, the KCa2.3/KCa3.1 activator, NS309, induced concentration-dependent relaxations. NS309 was equally potent in pulmonary arteries, but less potent in bronchioles if compared to relaxation induced by salbutamol. NS309 relaxation was sensitive to the KCa2 blocker apamin, while the KCa3.1 blocker, charybdotoxin failed to reduce relaxation to 0.01-1 µM NS309. Conclusions and implications: Thus, KCa2.3 and KCa3.1 are expressed in the endothelium of human pulmonary arteries and epithelium of bronchioles. KCa2.3 channels contribute to endo- and epithelium-dependent relaxations suggesting that these channels are potential targets for treatment of pulmonary hypertension and chronic obstructive pulmonary disease. © 2012 The Authors. British Journal of Pharmacology © 2012 The British Pharmacological Society.

  5. Role of small conductance calcium-activated potassium channels expressed in PVN in regulating sympathetic nerve activity and arterial blood pressure in rats

    OpenAIRE

    Gui, Le; LaGrange, Lila P.; Larson, Robert A.; Gu, Mingjun; ZHU, JIANHUA; Chen, Qing-Hui

    2012-01-01

    Small conductance Ca2+-activated K+ (SK) channels regulate membrane properties of rostral ventrolateral medulla (RVLM) projecting hypothalamic paraventricular nucleus (PVN) neurons and inhibition of SK channels increases in vitro excitability. Here, we determined in vivo the role of PVN SK channels in regulating sympathetic nerve activity (SNA) and mean arterial pressure (MAP). In anesthetized rats, bilateral PVN microinjection of SK channel blocker with peptide apamin (0, 0.125, 1.25, 3.75, ...

  6. Small- and intermediate-conductance calcium-activated K+ channels provide different facets of endothelium-dependent hyperpolarization in rat mesenteric artery.

    OpenAIRE

    Crane, GJ; Gallagher, N; Dora, KA; Garland, CJ

    2003-01-01

    Activation of both small-conductance (SKCa) and intermediate-conductance (IKCa) Ca2+-activated K+ channels in endothelial cells leads to vascular smooth muscle hyperpolarization and relaxation in rat mesenteric arteries. The contribution that each endothelial K+ channel type makes to the smooth muscle hyperpolarization is unknown. In the presence of a nitric oxide (NO) synthase inhibitor, ACh evoked endothelium and concentration-dependent smooth muscle hyperpolarization, increasing the restin...

  7. Antiphase oscillations of endothelium and smooth muscle [Ca2+]i in vasomotion of rat mesenteric small arteries

    DEFF Research Database (Denmark)

    Rahman, Awahan; Matchkov, Vladimir; Hughes, Alun; Nilsson, Holger; Aalkjær, Christian

    2007-01-01

    The mechanisms leading to vasomotion in the presence of noradrenaline and inhibitors of the sarcoplasmic/endoplasmic reticulum calcium ATPase were investigated in isolated rat mesenteric small arteries. Isobaric diameter and isometric force were measured together with membrane potential in endothelial cells and smooth muscle cells (SMC). Calcium in the endothelial cells and SMC was imaged with confocal microscopy. In the presence of noradrenaline and cyclopiazonic acid, ryanodine-insensitive osc...

  8. Serum YKL-40 and uterine artery Doppler – a prospective cohort study, with focus on preeclampsia and small-for-gestational-age

    DEFF Research Database (Denmark)

    Gybel-Brask, Dorte; Høgdall, Estrid; Johansen, Julia; Christensen, Ib Jarle; Skibsted, Lillian

    2014-01-01

    OBJECTIVE: To test if serum YKL-40 is increased in women developing preeclampsia or small-for-gestational age fetuses. We also assessed the association between uterine artery pulsatility index, notching and serum YKL-40 levels. DESIGN: Prospective cohort study. SETTING: A primary referral unit for obstetric ultrasound. POPULATION: A total of 1214 unselected pregnant women enrolled at nuchal translucency examination between 11(+3) and 13(+6) weeks of gestation. METHODS: All women had ultrasound a...

  9. 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

  10. Effects of ATP and UTP on [Ca2+]i, membrane potential and force in isolated rat small arteries

    DEFF Research Database (Denmark)

    Juul, B; Plesner, L

    2011-01-01

    We have investigated excitation-contraction coupling mechanisms associated with the activation of purinoceptors and putative pyrimidinoceptors by assessing the effects of ATP and UTP on cytoplasmic Ca2+ activity ([Ca2+]i), membrane potential (Em) and force in rat mesenteric small arteries. UTP induced a sustained concentration-dependent contractions, closely associated with concentration-dependent increases in [Ca2+]i. Superfusion with 0.1 mM UTP caused a sustained depolarisation of 12 +/- 1 mV (SE, n = 8). In Ca(2+)-free medium, the increase in [Ca2+]i and the contraction obtained with UTP (1 mM) were both transient and were inhibited by prior exposure to noradrenaline (NA). In vessels depolarised with KCl, UTP caused no change in Em, but a sustained increase in force and a transient increase in [Ca2+]i were induced, leading to an increased force/[Ca2+]i ratio. Similar effects on [Ca2+]i, Em and force were observed with ATP; but the effect of ATP on force was transient, whereas the effect on [Ca2+]i and Em declined only slowly. There was no crosstachyphylaxis between the responses to ATP and UTP: in the presence of 1 mM of either, the other drug induced contractions in low concentrations, as if they acted through distinct receptors. The results suggest that both UTP and probably ATP release intracellular Ca2+, possibly from the stores emptied by NA. The sustained response to UTP appears to be due to an influx of extracellular Ca2+. UTP but not ATP was found to enhance the force-generating effect of [Ca2+]i.

  11. Anatomical evaluation of penile venous system by CT cavernosography in patients with erectile dysfunction and venous leakage

    Directory of Open Access Journals (Sweden)

    P Famili

    2012-11-01

    Full Text Available Background: Erectile dysfunction is an important problem in men and an organic cause is found in about 50% of cases. When a vasculogenic etiology is suspected, imaging assessments are of great help. Cavernosography is traditionally recognized as an imaging modality for evaluation of venous leakage in men with impotency. We employed CT cavernosography as a novel technique for demonstrating penile venous anatomy and leaking veins.Methods: In the present case series study, we recruited 45 patients with erectile dysfunction by convenient sampling at Hazrat Rasoul Akram Hospital in Tehran, Iran, during one year (1390. The patients had previously been diagnosed with venous incompetency by Doppler study. After intracavernosal injection of prostaglandin E1, we injected sterile normal saline into the corpora cavernosa to achieve penile erection. Later, we injected contrast media into the corpus cavernosum, which was followed by CT scan of the penis and pelvic area to show the venous anatomy and leakage sites.Results: The mean age of the patients was 35.8±8.9 years. 36 (80% patients had venous leakage in crural veins, 27 (60% in cavernosal veins, 27 (60% in circumflex veins, 24 (52.3% in urethral veins, 21 (46.7% in deep dorsal vein, 3 (6.7% in para-arterial veins and 3 (6.7% in corpus spongiosum. Conclusion: The results of this study show the high prevalence of venous leakage in patients referring for erectile dysfunction. Moreover, CT cavernosography was shown to be a useful method for evaluating penile venous system and its related leakage sites which are important for surgical planning.

  12. Penile length of newborns and children in Surakarta, Indonesia

    Directory of Open Access Journals (Sweden)

    Annang Giri Moelyo

    2013-03-01

    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.

  13. Penile length of newborns and children in Surakarta, Indonesia

    Directory of Open Access Journals (Sweden)

    Annang Giri Moelyo

    2013-03-01

    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.].

  14. Penile torsion correction by diagonal corporal plication sutures

    Scientific Electronic Library Online (English)

    Brent W., Snow.

    2009-02-01

    Full Text Available Penile torsion is commonly encountered. It can be caused by skin and dartos adherence or Buck’s fascia attachments. The authors suggest a new surgical approach to solve both problems. If Buck’s fascia involvement is demonstrated by artificial erection then a new diagonal corporal plication suture is [...] described to effectively solve this problem.

  15. Accessory renal arteries: a case report

    OpenAIRE

    Billakanti Prakash Babu; Anjali Roy; Hemalatha Bangera

    2014-01-01

    During dissection of abdomen by the undergraduate medical students three accessory renal arteries were observed on the right side. The superior accessory artery was a small vessel arising from aorta just above the normal renal artery. It entered the anterior surface of kidney just below the upper pole. The middle and inferior arteries were caudal to the normal renal artery. The middle artery was arising from testicular artery and entered the anterior surface of kidney below the hilum. The inf...

  16. Pulmonary adenocarcinoma presenting with penile metastasis: a case report

    Directory of Open Access Journals (Sweden)

    Karanikas Christos

    2012-08-01

    Full Text Available Abstract Introduction Penile metastases are an extremely rare occurrence, and most primary malignancies are located in the urinary bladder, prostate, rectum, and rectosigmoid. Although very few cases of penile metastases have been reported, those of lung cancer as the primary tumor are very rare. Among the latter, squamous cell carcinomas constitute the majority, whereas adenocarcinomas are almost exceptions. To the best of our knowledge, only two cases have been reported. Case presentation We report the case of a 59-year-old Greek man who presented with persistent cough and chest pain that had started one month prior to a medical appointment. A physical examination, complete laboratory work-up, computed tomography scanning (of the chest, brain, and abdomen, pelvic magnetic resonance imaging, penile ultrasonography, bone scanning, and histological analyses were conducted. Afterward, a lung adenocarcinoma metastatic to the bones, brain, adrenals, lymph nodes, and penis was diagnosed. The primary lesion was a mass of 4cm in diameter in the apical segment of the lower lobe of the right lung. The patient was treated with bone and brain radiotherapy and various cycles of first- and second-line chemotherapy, and partial response was achieved five months after the initial appointment. Conclusions Although these metastatic sites are well known to occur from a primary pulmonary malignancy, penile metastasis is extremely rare. Its identification requires prompt awareness by the physician despite the dismal prognosis. Furthermore, since the penis usually is omitted from the physical examination and lung cancer is the leading cause of cancer-related deaths, more penile metastases may be detected in the future, making early detection and appropriate management of great importance.

  17. siRNA-induced in vivo downregulation of L-type calcium channels in rat small mesenteric arteries.

    DEFF Research Database (Denmark)

    Matchkov, Vladimir; Larsen, Per

    2008-01-01

    Ca2+ entry via L-type voltage-gated Ca2+ channels (Cav1.2) is a key factor in regulation of excitation-contraction coupling in smooth muscle cells (SMCs). Previous gene deletion studies have provided insight into the critical role of the pore-forming ?1C subunit in regulation of blood pressure. Homozygous knockout is, however, lethal but this limitation can be overcome by transient downregulation with small interference (siRNA). A specific downregulation of gene expression with siRNA can be a helpful tool in investigations of proteins in the vascular bed. The 1st to 3rd order branches of the mesenteric artery of anestisized Wistar rats were transfected with siRNAs targeting different exons of the ?1C gene or with control non-related siRNAs. The effect of transfection was analyzed after 3 and 10 days using quantitative PCR and immunohistochemistry. The functional effects of transfection were studied using isometric myography. Specific transfection downregulates mRNA of Cav1.2 by 93±2% within 3 days but the mRNA level recovered 10 days after transfection (110±13 % of the control level). Immunohistochemistry identified reduced Cav1.2 expression in the arteries transfected with siRNA directed against Cav1.2 ? subunit. Surprisingly, normalized internal diameter of Cav1.2 downregulated arteries was significant reduced by 33±10% (n=7) vs. arteries transfected with non-related siRNA. The maximal force development to K+-depolarization was significantly reduced (by 72±10%, n=6). The responses to noradrenaline, vasopressin and caffeine were also suppressed in Cav1.2 downregulated arteries. The reduced force development was accompanied with reduced nifedipine sensitive [Ca2+]i increase. The responses to K+-depolarization and agonist-stimulation in arteries transfected with siRNA directed against ?1C were upregulated in comparison with the controls 10 days after transfection. This upregulation was not, however, nifedipine-sensitive. Using in vivo transfection of arteries with siRNA we demonstrated the importance of Cav1.2 for vascular structure and reactivity and its tight coupling with other cellular Ca2+ handling processes.

  18. Combined technetium radioisotope penile plethysmography and xenon washout: A technique for evaluating corpora cavernosal inflow and outflow during early tumescence

    Energy Technology Data Exchange (ETDEWEB)

    Schwartz, A.N.; Graham, M.M. (Univ. of Washington Medical Center, Seattle (USA))

    1991-03-01

    Combined technetium radioisotope penile plethysmography and xenon washout is a new technique that measures both corporal arterial inflow and venous sinusoidal outflow during early tumescence in patients with erectile dysfunction. Fourteen patients were studied using 99mTc-RBCs to measure inflow and 133Xe or 127Xe in saline to measure outflow. Tumescence was induced by injecting papaverine intracorporally. Peak corporal rates corrected for inflow (r = 0.88) and uncorrected for outflow (r = 0.91) and change in volume over 2 min centered around peak inflow (r = 0.96) all correlated with angiography. Outflow measurements did not correlate with intracorporal resistance. Thus, outflow rates alone could not be used to predict venous sinusoidal competence. Normal inflow rate is greater than 20 ml/min; probable normal 12-20; indeterminate inflow 7-12; and abnormal inflow less than 7 ml/min. Technetium-99m radioisotope penile plethysmography and xenon washout can be performed together and both provide a method for simultaneously evaluating the relationship between corporal inflow and outflow rates in patients with erectile dysfunction.

  19. [Surgical peculiarities of gunshot injuries to arteries of the extremities caused by modern small arms and light weapons].

    Science.gov (United States)

    Samokhvalov, I M; Reva, V A; Denisov, A V; Ozeretskovski?, L B; Pronchenko, A A

    2014-10-01

    The aim of the given study was development of surgical tactics in case of femoral artery injury, caused by medium-calibre bullet, on the basis acute experiment on large biological objects. Experimental animals were shot into mid third of the femora by a rifle cartridge in 7,62-mm calibre (AK-47 made in 1943). The analysis of microstructure, made in 5 cross-sections performed every 1-centimetre way from the wound canal, showed that there were no any damages of arterial wall. Authors came to conclusion that the surgical debridement of the gunshot wound, made by a rifle cartridge in 7,62-mm calibre of AK-47, should consist of exsection of devitalized section of artery. PMID:25532307

  20. Arteria Circunfleja Iliaca Superficial: Importancia Anátomo Quirúrgica / Superficial Circumflex Iliac Artery: Anatomical Surgical Importance

    Scientific Electronic Library Online (English)

    Mariano, del Sol; Bélgica, Vásquez.

    2013-06-01

    Full Text Available La arteria circunfleja ilíaca superficial es un pequeño vaso que se origina, generalmente, en la arteria femoral a nivel del triángulo femoral, dirigiéndose paralela al ligamento inguinal hacia la espina ilíaca anterosuperior. Actualmente es utilizada frecuentemente en colgajos libres llevados a cab [...] eza, cuello, miembros e incluso en reconstrucciones peneanas. Disecamos 68 regiones inguinales de cadáveres formolizados en la disciplinas de anatomía topográfica de las Universidades de La Frontera, Chile y Federal de Sao Paulo, Brasil. La arteria cincunfleja ilíaca superficial tuvo un diámetro externo de 1,42 mm en promedio y la distancia desde su origen al ligamento inguinal fue de 15,1 mm. La arteria se originó directamente de la arteria femoral en 47 casos (69,1%); de un tronco común con la arteria epigástrica superficial en 14 (20,5%) y de la arteria circunfleja femoral lateral en tres casos (4,41%) y en otros cuatro orígenes (5,9%). Aunque tiene un pequeño diámetro, la arteria circunfleja ilíaca superficial es importante tanto para el anatomista como para los cirujanos vasculares y plásticos, siendo fundamental para el éxito en la obtención 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 São 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.

  1. The contribution of intrapulmonary shunts to the alveolar-to-arterial oxygen difference during exercise is very small

    DEFF Research Database (Denmark)

    Vogiatzis, Ioannis; Zakynthinos, Spyros; Boushel, Robert; Athanasopoulos, Dimitris; Guenette, Jordan A; Wagner, Harrieth; Roussos, Charis; Wagner, Peter D

    2008-01-01

    Exercise is well known to cause arterial PO2 to fall and the alveolar-arterial PO2 difference(Aa PO2 ) to increase. Until recently, the physiological basis for this was considered to be mostly ventilation/perfusion ((.)VA/(.)Q) inequality and alveolar-capillary diffusion limitation. Recently, arterio-venous shunting through dilated pulmonary blood vessels has been proposed to explain a significant part of the Aa PO2 during exercise. To test this hypothesis we determined venous admixture during 5...

  2. Penile Low-Intensity Shock Wave Therapy: A Promising Novel Modality for Erectile Dysfunction

    OpenAIRE

    Abu-Ghanem, Yasmin; Kitrey, Noam D; Gruenwald, Ilan; Appel, Boaz; Vardi, Yoram

    2014-01-01

    Penile extracorporeal low-intensity shock wave therapy (LIST) to the penis has recently emerged as a novel and promising modality in the treatment of erectile dysfunction (ED). LIST has angiogenic properties and stimulates neovascularization. If applied to the corpora cavernosa, LIST can improve penile blood flow and endothelial function. In a series of clinical trials, including randomized double-blind sham-controlled studies, LIST has been shown to have a substantial effect on penile hemody...

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

    Scientific Electronic Library Online (English)

    Carlos Teodósio, Da Ros; Túlio Meyer, Graziottin; Eduardo, Ribeiro; Márcio Augusto, Averbeck.

    2012-04-01

    Full Text Available 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 were submitted to a grafting with tunica albuginea from the penile crura for the correction of penile curvature. The results were evaluated after 6 months of the procedure. Variables studied were overall satisfaction with the procedure, correction of the penile curvature, erectile capacity, penile shortening and the presence of surgical complications. RESULTS: Mean follow-up after surgery was 41 months. Complete correction of the curvature was achieved in 30 patients (90%). The mean preoperative curvature was 91.8 degrees and median plaque length was 2 cm (ranged from 1 to 5 cm). Three patients (9%) experienced recurrence of the penile curvature and required a new procedure. In 30 men (90%) the procedure fulfilled their expectations and in 31 patients (93.9%) their opinions were that sexual partners were satisfied with the penile correction. Penile shortening or augmentation was referred in 6 (18.1%) and 1 (3%) patient, respectively. CONCLUSION: Our series demonstrated that grafting the albugineal defect after incision of the tunica albuginea with tunica from the crus for the correction of penile curvature is safe and results in satisfactory straight erections duringa long-term follow-up.

  4. Satisfaction and complications with the Titan® one-touch release penile implant

    DEFF Research Database (Denmark)

    Lindeborg, Lisa; Fode, Mikkel; Fahrenkrug, Lasse; Sønksen, Jens

    2014-01-01

    OBJECTIVE: The aim of this study was to assess complication rates and patient satisfaction with Coloplast Titan® one-touch release (OTR) inflatable penile implants inserted at one university hospital centre between November 2008 and April 2011. MATERIAL AND METHODS: Overall, 33 patients with organic erectile dysfunction underwent penile implant surgery during the study period. The Titan OTR inflatable penile implants were inserted using a penoscrotal approach. Patient and partner satisfaction wa...

  5. US and MRI Findings of Penile Metastasis from Rectal Adenocarcinoma: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Ha Yeun [Kangwon National University Hospital, Chuncheon (Korea, Republic of)

    2012-03-15

    Metastatic tumors of the penis originating from the gastrointestinal tract are rare clinical conditions. We experienced a case of penile metastasis in a 59-year-old man who underwent an abdomino-peritoneal resection for a moderately-differentiated adenocarcinoma of the rectum 4 years earlier. We report penile ultrasonography and magnetic resonance imaging findings on this uncommon metastatic penile tumor from a rectal adenocarcinoma and briefly review radiologic findings and relevant literature

  6. Alpha-adrenoceptor function in isolated penile circumflex veins from potent and impotent men

    DEFF Research Database (Denmark)

    Kirkeby, H J; Forman, Axel

    1989-01-01

    Alpha-adrenoceptor functions were investigated in isolated human penile circumflex veins from six potent and four impotent men. Contractions elicited by noradrenaline and phenylephrine were inhibited by prazosin, yohimbine, phentolamine and papaverine. No differences were found between vessels from potent and impotent men. The results suggest that alpha-adrenoceptors in penile circumflex veins are of both alpha 1- and alpha 2-type, and that no changes in alpha-adrenoceptor function occur in impotence associated with an increased penile venous outflow.

  7. Reconstruction of Long Anterior Urethral Strictures by Dorsally Quilted Penile Skin Flap

    OpenAIRE

    Abuzeid, Abdel Moneim M.; Abdel Kader, M. S.

    2012-01-01

    Objective. To present the results of reconstruction of long (>5?cm), penile, bulbar, and bulbopenile urethral strictures by penile skin flap as dorsal onlay in one-stage procedure. Patients and Methods. Between January, 1998 and December, 2004, 18 patients (aged from 28-65 years) presented with long urethral strictures, 5.6–13.2?cm (penile in 6, bulbar in 2 and combined in 10 cases), those were repaired utilizing long penile skin flaps placed as dorsal onlay flap in one stage (Orandi flap 6?c...

  8. Value of positron emission tomography in diagnosing synchronous penile metastasis from urothelial bladder cancer.

    Science.gov (United States)

    Rouanne, M; Alhammadi, A; Vilain, D; Radulescu, C; Lebret, T

    2015-01-01

    Metastases to the penis are extremely rare events. Most frequently, penile metastases come from the urogenital system (bladder, prostate) or the rectum-sigmoid colon. Usually painful, penile lesions may be asymptomatic, making diagnosis more challenging. Hence, we report the adding value of (18)F-fludeoxyglucose-positron emission tomography/computed tomography ((18)F-FDG PET/CT) in the detection of penile metastases originating from urothelial carcinoma of the bladder. Arguably, penile metastases must be considered as an advanced disease requiring essentially palliative care. Therefore, accurate staging of clinically localized muscle-invasive bladder cancer is crucial to avoid useless curative intent radical surgery. PMID:26376852

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

    Directory of Open Access Journals (Sweden)

    Andreasen Annette

    2011-01-01

    Full Text Available Abstract Background 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. Methods We performed a study of 194 consecutive patients with chest pain, a priori considered of low to intermediate risk for significant coronary stenosis (>50% lumen obstruction who were referred for elective coronary angiography. Plasma lipids and lipoproteins were measured including the subtype pattern of LDL particles, and all patients were examined by coronary CT scanning before coronary angiography. Results The proportion of small dense LDL was a strong univariate predictor of significant coronary artery stenosis evaluated by both methods. After adjustment for age, gender, smoking, and waist circumference only results obtained by traditional coronary angiography remained statistically significant. Conclusion Small dense LDL particles may add to risk stratification of patients with suspected angina pectoris.

  10. Sex therapy and the penile prosthesis: a synthesis.

    Science.gov (United States)

    Schover, L R; von Eschenbach, A C

    1985-01-01

    Although the availability of the penile prosthesis has changed the evaluation and treatment of erectile dysfunction, urologists and sex therapists have not combined their skills to develop comprehensive treatment plans. This paper describes one effort to use sex therapy techniques in evaluating and treating candidates for a penile prosthesis. The preoperative assessment focuses on multiaxial diagnosis of sexual problems in patient and partner and on the effects a prosthesis might have on their sexual and marital relationship. Men at high risk for a negative psychological reaction after surgery are offered presurgical sex therapy. Routine follow-up visits are scheduled for all patients during postoperative recovery and at 2-3 months postsurgery. If sexual dysfunction or dissatisfaction persists, sex therapy is again recommended. A case history exemplifies our methods, and the issue of financial costs of counseling vs. predicted benefits in terms of patient satisfaction is discussed. PMID:4039371

  11. Self-contained inflatable penile prosthesis: magnetic resonance appearance

    International Nuclear Information System (INIS)

    The appearance of an inflatable penile prosthesis, visualized on a short tau inversion recovery sequence, is reported, in a patient who had magnetic resonance imaging for pelvic pain subsequent to radical cystoprostatectomy for bladder carcinoma. With suppression of adjacent fat signal, the prosthesis is well delineated from adjacent structures. The fluid-containing cylinders of the prosthesis are of very bright signal intensity, with the relief valve assembly of low signal intensity. 5 refs., 2 figs

  12. Penile Prosthesis: What Should We Do about Complications?

    OpenAIRE

    Bettocchi, C.; Ditonno, P.; Palumbo, F.; Lucarelli, G; Garaffa, G.; Giammusso, B.; Battaglia, M.(Lawrence Berkeley National Laboratory and University of California, 94720, Berkeley, California, USA)

    2008-01-01

    Even in the era of phoshodiesterase type 5 inhibitors, penile implants are considered the definitive solution for the treatment of organic erectile disfunction. The advent of new surgical tools and new infection-resistant materials has significantly reduced the risk of intra and post-operative complications and the need for revision surgery. Various companies have also improved their mechanical systems in order to reduce the risk of failures, and their products are now so good they may last l...

  13. Penile Augmentation with Resultant Foreign Material Granuloma and Sequalae

    OpenAIRE

    Inn, Fam Xeng; Imran, Farrah-Hani; Ali, Mohd Faizal; IH, Rizuana; Z, Zulkifli

    2012-01-01

    Throughout history, a proportion of men appear to correlate penis size and dimensions directly with physical fitness and sexual prowess. Foreign materials, such as paraffin oil, paraffin balm, mineral oils, and silicone, have been used to promise an improvement in penile shaft contour and dimensions. These materials are injected directly into the penis; inducing granuloma formation to achieve increased penis length and girth. However, the result is a severely disfigured and swollen penis, whi...

  14. Patient perspectives on quality of life after penile cancer

    DEFF Research Database (Denmark)

    Mortensen, Gitte Lee; Jakobsen, Jakob Kristian

    2013-01-01

    Penile cancer (PC) is a rare, but ominous disease. In 50-60% of squamous cell carcinomas of the penis, human papilloma virus infection, particularly with types 16 and 18, is part of the pathogenesis. Depending on cancer invasiveness, PC is treated with local resection of the glans and partial or total penectomy. This quality of life (QoL) study aimed at obtaining in-depth knowledge about patients' experiences with PC.

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

    DEFF Research Database (Denmark)

    Jensen, P E; Ohanian, J; Stausbøl-Grøn, B; Buus, N H; Aalkjær, Christian

    1996-01-01

    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 lysopho...

  16. Non-visualization of sentinel lymph nodes in penile carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Kroon, Bin K.; Horenblas, Simon [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Urology, Amsterdam (Netherlands); Valdes Olmos, Renato [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Nuclear Medicine, Amsterdam (Netherlands); Nieweg, Omgo E. [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Surgery, Amsterdam (Netherlands)

    2005-09-01

    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 {sup 99m}Tc-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.)

  17. Penile Reconstruction: Evaluation of the Most Accepted Techniques

    Directory of Open Access Journals (Sweden)

    Alireza Babaei

    2010-05-01

    Full Text Available Purpose: Loss of the penis can have a devastating effect on the lives of sufferers with significant psychogenic implications. Penile reconstruction or phallus construction poses a difficult challenge and a demanding problem to the urologists and plastic surgeons. Different techniques have been used forconstruction of a total penis and reconstruction of severely injured penis. The objective of this review was to determine the efficacy, advantages and disadvantages of the most popular penile reconstruction (PR and phallus construction techniques.Materials and Methods: We searched without language restriction MEDLINE, Pre-MEDLINE EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL from January 1960 to January 2009. In addition, we searched the citation lists of relevant articles and book chapters. Studies evaluating the functional and cosmetic results of different techniques of total phallus construction (TPC and penile reconstruction (PR were identified. Two authors independently evaluated studies for selection, study quality, and extracted data. The primary outcome was creation of a sensate and cosmetically acceptable phallus. The secondary outcomes were competent neourethra that allows voiding in comfortable position, sexual intercourse, and the rate of complications. Results: One hundred and forty-six studies with a total of 1622 patients were included in this review.Conclusion: Data from the available studies are insufficient to recommendany technique for TPC or PR. In the absence of evidence to support any method, the review authors recommend the one-stage TPC or PR. Further studies are warranted, preferably multi-centered studies.

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

    Science.gov (United States)

    Sachs, B D

    1985-09-01

    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

  19. Recurrent furunculosis as a cause of isolated penile lymphedema: a case report

    Directory of Open Access Journals (Sweden)

    Sood Suneet

    2010-06-01

    Full Text Available Abstract Introduction Isolated lymphedema of the penis is extremely rare: combined involvement of the scrotum and penis is the norm. Furunculosis as a cause is not, to our knowledge, previously reported. We present a case of isolated penile lymphedema that responded to excision of lymphedematous tissue and reconstruction with flaps. Case presentation A 32-year-old Arab man presented with a three-year history of a gradually increasing, painless penile swelling. Our patient's main complaint was non-erectile sexual dysfunction. The swelling was preceded by at least three prior episodes of severe furunculosis at the penile root. He had no other contributory past medical or family history. On examination there was gross penile enlargement, maximally at the mid shaft, associated with thickened skin at the sites of prior furunculosis. The glans and scrotum were normal. Both testes were palpable. Serology for filariasis, and urinary tract ultrasound and computed tomography scan were normal. The clinical diagnosis was lymphedema following recurrent penile furunculosis. At operation the lymphedematous tissues were removed. Closure of the penile shaft was accomplished by bilateral advancement of flaps from both ends of the penis. He resumed normal sexual activity one month after surgery. At 12 months, he had a good cosmetic result, with no signs of recurrence. Conclusions Furunculosis at the penile root may result in lymphedema confined to the penile shaft, sparing the scrotum. Excision of abnormal tissue and cover with a skin flap gave excellent cosmetic results, and allowed satisfactory sexual activity.

  20. Optimizing Penile Length in Patients Undergoing Partial Penectomy for Penile Cancer: Novel Application of the Ventral Phalloplasty Oncoplastic Technique

    Scientific Electronic Library Online (English)

    Jared J., Wallen; Adam S., Baumgarten; Tim, Kim; Tariq S., Hakky; Rafael E., Carrion; Philippe E., Spiess.

    2014-10-01

    Full Text Available The ventral phalloplasty (VP) has been well described in modern day penile prosthesis surgery. The main objectives of this maneuver are to increase perceived length and patient satisfaction and to counteract the natural 1-2 cm average loss in length when performing implantation of an inflatable peni [...] le prosthesis. Similarly, this video represents a new adaptation for partial penectomy patients. One can only hope that the addition of the VP for partial penectomy patients with good erectile function will increase their quality of life. The patient in this video is a 56-year-old male who presented with a 4.0x3.5x1.0 cm, pathologic stage T2 squamous cell carcinoma of the glans penis. After partial penectomy with VP and inguinal lymph node dissection, pathological specimen revealed negative margins, 3/5 right superficial nodes and 1/5 left superficial nodes positive for malignancy. The patient has been recommended post-operative systemic chemotherapy (with external beam radiotherapy) based on the multiple node positivity and presence of extranodal extension. The patient’s pre-operative penile length was 9.5 cm, and after partial penectomy with VP, penile length is 7 cm.

  1. Necrosis de pene: Revisión de 18 casos en el Hospital de Especialidades Centro Médico nacional Siglo XXI / Penile necrosis: a review of 18 cases at the Hospital de Especialidades Centro Médico nacional Siglo XXI

    Scientific Electronic Library Online (English)

    Guillermo, Montoya Martínez; José Manuel, Otero García; Virgilio, López Samano; José, González Martínez; Eduardo, Serrano Brambila.

    2006-08-01

    Full Text Available Objetivo: Presentar la experiencia en el manejo de necrosis de pene en nuestro centro hospitalario. Métodos: Se realizó la revisión de expedientes clínicos con diagnóstico de necrosis de pene en el servicio de Urología del Hospital de Especialidades Centro Medico Nacional Siglo XXI de enero de 1995 [...] a marzo de 2005. Resultados: Se encontraron 18 casos con necrosis de pene con edades entre 28 a 78 años (edad media de 58.1 años). Los antecedentes personales patológicos con mayor incidencia fueron la diabetes mellitus en 10 casos e insuficiencia renal crónica terminal en 11 casos. Los motivos de consultas fueron presencia de escaras en pene en cinco casos, exudado purulento, inflamación de glande y prepucio en tres casos, priapismo isquémico en dos casos, síndrome de Fournier dos casos, uretrorrea un caso, necrosis de pene secundario a compresión extrínseca en un caso y absceso periuretral un caso. De los 18 casos a 13 se les realizó penectomía total o parcial, de los cuales 3 fallecieron. A 5 pacientes se les dio manejo conservador con antibióticos, uno de ellos falleció. El análisis de patología reportó trombosis arterial y venosa además de necrosis isquémica en 3 casos; trombosis arterial y venosa, necrosis isquémica y calcificación distrófica arterial y venosa en 10 casos. Conclusiones: Los cambios vasculares oclusivos son un factor condicionante en la mayoría de los pacientes con necrosis de pene esto además se hace más evidente en pacientes con insufiiencia renal crónica terminal, diabetes mellitus e hipertensión arterial sistémica. Las manifestaciones clínicas de la necrosis de pene son escaras, momificación, autoamputación y sobreinfección, es por eso que el diagnostico temprano y el tratamiento oportuno es determinante en la evolución de este padecimiento. Abstract in english Objectives: To report the experience in the management of penile necrosis at our hospital. Methods: We performed a review of the medical penile necrosis at the Department of the Urology of the Hospital de Especialidades Centro Médico nacional Siglo XXI from January 1995 to March 2005. Results: 18 ca [...] ses of penile necrosis were found, with ages from 28 to 78 years (mean age 58.1 yr.). Diabetes mellitus and end stage renal disease were the most frequent associated diseases, with 10 and 11 cases respectively. Reasons for consultation were penile scars in 5 cases, purulent exudation, inflammation of the glans penis and prepuce in 3 ,ischemic priapism in 2, Fournier`s syndrome in 2, urethral bleeding in one, penile necrosis secondary to extrinsic compression in one,and periurethral abscess in another. Thirteen out of the 18 cases underwent partial or complete penectomy, and three of them died. Five patients were managed conservatively with antibiotics, one of them died. The pathology report showed ischemic necrosis in 3 cases, arterial and venous thrombosis, ischemic necrosis and dystrophic arterial and venous calcifications in 10 cases. Conclusions: Occlusive vascular changes are a conditioning factor in most patients with penile necrosis. This is more evident in patients with end stage renal disease,diabetes mellitus and hypertension. Clinical features of penile necrosis include scars, mummification, self-amputation,and superinfection, so that an early diagnosis and proper treatment are decisive for the evolution of this disease.

  2. Hipertensão arterial e saúde da família: atenção aos portadores em município de pequeno porte na região 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)

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

    2006-10-01

    Full Text Available OBJETIVO: A partir da análise de indicadores, que expressem aproximação à lógica das ações programáticas, foi desenvolvido um estudo transversal com o objetivo de avaliar o desempenho de uma Equipe de Saúde da Família na atenção às pessoas portadoras de hipertensão arterial em município de pequeno p [...] orte. MÉTODOS: A pesquisa foi realizada a partir da análise das fichas de cadastro, Ficha A do Sistema de Informação de Atenção Básica, de 418 pessoas portadoras de hipertensão arterial, do registro de informações em 351 prontuários, localizados na unidade básica de saúde, em 376 entrevistas realizadas com os residentes na área de atuação da equipe, no ano de 2003. Foram estudadas as seguintes variáveis: sexo, idade, renda familiar, condições de moradia, serviço de saúde utilizado, presença de diabete melito, cobertura e concentração de atendimento. RESULTADOS: Mulheres com idade acima de sessenta anos predominaram: (65,7% dos casos). A taxa de prevalência de hipertensão arterial referida foi de 18%, sendo distinta entre os sexos: nas mulheres foi de 22,3%, a cobertura foi de 64,1% para consultas médicas, 32,4% para consultas de enfermagem e 36,4% para atendimentos médicos domiciliares. Os registros em prontuário revelaram que 25,8% dos portadores não foram atendidos em 2003 e 52,7% não receberem atendimento no último semestre. A concentração de atendimentos foi abaixo da preconizada. CONCLUSÃO: As informações revelaram distanciamento da organização da atenção na lógica da vigilância à saúde, prevalecendo o atendimento à demanda espontânea, expressando despreparo na utilização dos sistemas de informação para o planejamento e avaliação das ações. 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.

  3. Treatment of penile carcinoma: To cut or not to cut?

    International Nuclear Information System (INIS)

    Purpose: The aim of this study was to assess the outcome in patients with penile cancer. Methods and Materials: A total of 60 patients with penile carcinoma were included. Of the patients, 45 (n = 27) underwent surgery, and 51 underwent definitive (n = 29) or postoperative (n = 22) radiotherapy (RT). Median follow-up was 62 months. Results: Median time to locoregional relapse was 14 months. Local failure was observed in 3 of 23 patients (13%) treated with surgery with or without postoperative RT vs. in 19 of 33 patients (56%) given organ-sparing treatment (p = 0.0008). Of 22 local failures, 16 (73%) were salvaged with surgery. Of the 33 patients treated with definitive RT (n = 29) and the 4 patients refusing RT after excisional biopsy, local control was obtained with organ preservation in 13 (39%). In the remaining 20, 4 patients with local failure underwent salvage conservatively, resulting in an ultimate penis preservation rate of 17 of 33 (52%) patients treated with definitive RT. The 5-year and 10-year probability of surviving with an intact penis was 43% and 26%, respectively. There was no survival difference between the patients treated with definitive RT and primary surgery (56% vs. 53%; p 0.16). In multivariate analysis, independent factors influencing survival were N-classification and pathologic grade. Surgery was the only independent predictor for better local control. Conclusion: Based on our study findings, in patients with penile cancer, local control is superior with surgery. However, there is no difference in survival between patients treated with surgery and those treated with definitive RT, with 52% organ preservation

  4. Stent farmacológico autoexpansível miniaturizado em coronárias de pequeno calibre: eficácia tardia / Miniaturized self-expanding drug-eluting stent in small coronary arteries: late effectiveness

    Scientific Electronic Library Online (English)

    Flavio Roberto Azevedo de, Oliveira; Luiz Alberto Piva e, Mattos; Alexandre, Abizaid; Andrea S., Abizaid; J. Ribamar, Costa; Ricardo, Costa; Rodolfo, Staico; Roberto, Botelho; J. Eduardo, Sousa; Amanda, Sousa.

    2013-11-01

    Full Text Available FUNDAMENTO: Na angioplastia coronária percutânea (ACP), os vasos de fino calibre representam um fator de risco para reestenose. O stent farmacológico (SF) autoexpansível Sparrow®, de perfil menor que os sistemas atuais, nunca foi testado nesse cenário. OBJETIVOS: Avaliar a eficácia tardia do SF Spar [...] row®, com relação à perda luminal tardia intrastent (PLT intrastent) aos oito meses. MÉTODOS: Estudo prospectivo, randomizado, em P com doença arterial coronária (DAC) sintomática ou com isquemia documentada, submetido à ACP em vasos de calibre Abstract in english BACKGROUND: Small vessels represent a risk factor for restenosis in percutaneous coronary angioplasty (PCA). The Sparrow® self-expanding drug-eluting stent, which has a lower profile than the current systems, has never been tested in this scenario. OBJECTIVES: To evaluate the late effectiveness of t [...] he Sparrow® drug-eluting stent, regarding in-stent late lumen loss (LLL). METHODS: Patients with ischemia, symptomatic or documented, were submitted to PCA in vessels with reference diameter

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

    Directory of Open Access Journals (Sweden)

    BrendaYHernandez

    2014-02-01

    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.

  6. 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)

  7. Report of 84 cases of penile Fracture inBeheshti Hospital center

    Directory of Open Access Journals (Sweden)

    H. Shafi

    2005-01-01

    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.

  8. Functional effects, binding sites and immunolocalization of endothelin-1 in isolated penile tissues from man and rabbit

    DEFF Research Database (Denmark)

    Holmquist, F; Kirkeby, H J

    1992-01-01

    Functional effects of endothelin-1 (ET-1) were investigated in isolated preparations of human and rabbit corpus cavernosum (CC) and human penile circumflex veins (CV). In all preparations, ET-1 induced slowly developing, concentration-dependent contractions. The threshold concentration of ET-1 in CV was approximately 10 and 112 times lower than the threshold concentrations in human and rabbit CC, respectively. Furthermore, the contractions in CV reached a defined maximum at 10(-7) M ET-1 (-log EC50 = 9.12 +/- 0.17), whereas no maximum was obtained in CC preparations within the concentration range used (less than or equal to 3 x 10(-7) M). Pretreatment with the Ca++ channel blocker nimodipine partly reduced the ET-1-induced contractions in human and rabbit CC, but had no significant effect on CV preparations. In a Ca(++)-free medium containing the chelator ethyleneglycol-bis-(beta-aminoethylether)-N,N'-tetra-acetic acid, the contractions induced by ET-1 were reduced, but not abolished, in all preparations. Thecontractions induced by ET-1 are thus mediated mainly by influx of Ca++, although there seem to exist differences in the relative contribution of L-type Ca++ channels in CC and CV. Furthermore, additional mechanisms beside Ca++ influx are likely to be involved in both tissues. A high density of [125I]ET-1 binding sites was observed throughout the stroma and in the muscle layer of the deep penile artery in both human and rabbit CC. In the human CV, numerous binding sites were observed, but no clear difference between the various structures of the vessel wall could be detected.(ABSTRACT TRUNCATED AT 250 WORDS)

  9. A penal problem: the increasing incidence of implantation of penile foreign bodies.

    Science.gov (United States)

    Flynn, Ryan M; Mostafa, Hesham I; Khan, Omar A; Haselhuhn, Gregory D; Jain, Samay

    2014-12-01

    Our objective is to describe a novel presentation of subcutaneous penile insertion of foreign bodies. This is a practice performed globally and mostly has been reported outside of the United States. We present three cases of incarcerated males that implanted sculpted dominos into the penile subcutaneous tissue. The patients presented with erosion of the foreign bodies through the skin without evidence of infection. We believe that insertion of foreign bodies into penile subcutaneous tissue by incarcerated American males for sexual enhancement is more widespread than previously reported. Erosion is a novel presentation. PMID:25483769

  10. Male Circumcision and Anatomic Sites of Penile High-Risk Human Papillomavirus in Rakai, Uganda

    OpenAIRE

    Tobian, Aaron A R; Kong, Xiangrong; Gravitt, Patti E.; Eaton, Kevin P.; Kigozi, Godfrey; SERWADDA, David; Oliver, Amy E.; Nalugoda, Fred; Makumbi, Frederick; Chen, Michael Z.; Wawer, Maria J.; Quinn, Thomas C; GRAY, RONALD H.

    2011-01-01

    Male circumcision (MC) reduces penile high-risk human papillomavirus (HR-HPV) on the coronal sulcus and urethra. HR-HPV varies by anatomic site, and it is unknown whether MC decreases HR-HPV on the penile shaft. We assessed the efficacy of MC to reduce HR-HPV on the penile shaft and compared it to known efficacy of MC to reduce HR-HPV on the coronal sulcus. HIV-negative men randomized to receive immediate circumcision (intervention) or circumcision delayed for 24 months (control) were evaluat...

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

    OpenAIRE

    BrendaYHernandez; MarcTGoodman; ElizabethUnger; CharlesF.Lynch; WendyCozen; EdwardSPeters; EdwardJWilkinson; GlennCopeland; ClaudiaHopenhayn; YoujieHuang; MegWatson; SeanFAltekruse; ChristopherLyu

    2014-01-01

    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 ...

  12. Human Papillomavirus Genotype Prevalence in Invasive Penile Cancers from a Registry-Based United States Population

    OpenAIRE

    Hernandez, Brenda Y; Goodman, Marc T.; Unger, Elizabeth R; Steinau, Martin; Powers, Amy; Lynch, Charles F; Cozen, Wendy; Saber, Maria Sibug; Peters, Edward S.; Wilkinson, Edward J.; Copeland, Glenn; Hopenhayn, Claudia; Huang, Youjie; Watson, Meg; Altekruse, Sean F.

    2014-01-01

    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 seven U.S. cancer registries. HPV was genotyped using PCR-based Linear Array and INNO-LiPA assays and compared by demographic, clinical, and pathologic characteristics ...

  13. Penile Rehabilitation After Radical Prostatectomy: Important Therapy or Wishful Thinking?

    Science.gov (United States)

    Dall’Era, Joseph E; Mills, Jesse N; Koul, Hari K; Meacham, Randall B

    2006-01-01

    On the basis of data accumulated thus far, it is reasonable to discuss the implementation of a “penile rehabilitation” program with patients undergoing radical prostatectomy. Central to discussions of penile rehabilitation after radical prostatectomy is evidence demonstrating significant fibrotic changes in the corpus cavernosum that occur postoperatively. Several studies have been published evaluating the efficacy of various pro-erectogenic agents. The limited data regarding intracavernous injections and vacuum constriction devices suggest that an increased percentage of treated patients experienced a return of natural erections compared with patients who received no treatment. Longer, prospective, randomized, placebo-controlled studies will be needed to confirm the utility of these treatments. Data from contemporary studies evaluating the chronic use of oral phosphodiesterase type 5 inhibitors suggest a beneficial effect on endothelial cell function among men suffering from erectile dysfunction due to a variety of causes. Limited data suggest that this effect might be seen among post-prostatectomy patients, implying a possible role for these agents in enhancing the return of sexual function in such individuals. PMID:17192800

  14. Penile Agenesis: Report on 8 Cases and Review of Literature

    Directory of Open Access Journals (Sweden)

    Alireza Mirshemirani

    2009-06-01

    Full Text Available Background:Penile agenesis (PA is an extremely rare anomaly with profound urological and psychological consequences. The opening of the urethra could be either over the pubis or at any point on perineum or most frequently in anterior wall of the rectum. The aim of treatment is an early female gender assignment and feminizing reconstruction of the perineum. Case(s Presentation:We report 8 cases of penile agenesis with urination and defecation through the rectum, apparently normal scrotum, bilateral descended testis, normally located anus, urethral opening in anus, 46xy karyotype and associated anomalies. In 2 cases parents refused any surgical interventions, but in 6 cases we did perform different operations (transforming five cases to females and one case to male gender.Conclusion:We recommend feminizing operations in newborns or infants, but in older patients, regarding the child's psychology, it is advised to perform masculinizing operations, and finally, no surgical intervention should be undertaken before counseling the parents.

  15. MRI of penile fracture: diagnosis and therapeutic follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Uder, Michael; Gohl, Dietrich; Takahashi, Masahide; Kramann, Bernhard; Schneider, Guenther [Universitaet des Saarlandes, Homburg/Saar (Germany). Radiologische Klinik; Derouet, Harry [Universitaet des Saarlandes, Homburg/Saar (Germany). Urologische Klinik; Defreyne, Luc [Department of Radiology and Medical Imaging, University Hospital of Gent (Belgium)

    2002-01-01

    A rupture of corpus cavernosum (CC) is a rare injury of the erect penis. The present study describes the role of MRI for diagnosis and follow-up of this injury. Four patients with clinically suspected acute penile fractures underwent MRI. Imaging findings were confirmed at surgery. In three patients, follow-up MRI was also available at 1, 6 and 16 weeks after surgical repair. In all patients pre-contrast T1-weighted images (T1WI) clearly disclosed ruptures of CC, which depicted as discontinuity of low signal intensity of the tunica albuginea (TA). Concomitant subcutaneous haematoma were well visualised both on T1-weighted (T1WI) and T2-weighted images, whereas haematoma in CC were optimally demonstrated on contrast-enhanced T1WI. On follow-up MRI all fractures presented similar healing process. Shortly after the repair, the tunical suture showed an increase in signal intensity on pre-contrast T1WI and was strongly enhanced with the administration of contrast material. Then the tear site gradually recovered low signal intensity on all spin-echo sequences by 4 months after surgery. These serial findings may suggest the formation of vascularised granulation tissue during cicatrisation. Magnetic resonance imaging is of great value for the diagnosis and follow-up in patients with penile fracture. (orig.)

  16. Coronary arteries

    International Nuclear Information System (INIS)

    Coronary angiography (CA) is presently considered the gold standard for the assessment of the coronary arteries. However, the presence of ionizing radiation, its invasiveness and the small associated risk of morbidity prompted long ago the development of more patient-friendly imaging modalities. A promising technique, magnetic resonance imaging (MRI), has been regarded as the major modality in the coming decade. Although still in its infancy qualitatively, its flexibility and non-invasiveness opens the door for a comprehensive evaluation of the heart and the coronary arteries in one single sitting with high anatomical definition and excellent soft tissue contrast capabilities, double-oblique tomographic sections and the possibility to quantify an innumerable number of cardiovascular physiological parameters. Numerous ideas have been assessed, comprising breath-hold and free-breathing two-dimensional and three-dimensional measurements. New ongoing trials with intravascular contrast agents may provide for all these techniques the long-awaited essential boost for reliable magnetic resonance coronary angiography (MRCA). Introduction of parallel MRI acquisition techniques, such as simultaneous acquisition of spatial harmonics (SMASH) and sensitivity encoding (SENSE) may provide the speed enhancement required to shorten imaging time for all techniques explored to date. (orig.)

  17. 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)

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

    OpenAIRE

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

    2009-01-01

    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...

  19. Malignant priapism secondary to isolated penile metastasis from a renal pelvic carcinoma

    OpenAIRE

    LIU, SULAI; Zeng, Fuhua; Qi, Lin; Jiang, Shusuan; Tan, Pingping; Zu, Xiongbing; Xie, Yu; HAN, WEIQING

    2014-01-01

    We report a case of isolated penile metastasis from renal pelvic carcinoma in a 69-year-old man with malignant priapism. The patient had radical resection of the renal pelvic carcinoma 2 months earlier with urothelial carcinoma (UC) and sarcomatoid differentiation histology. Physical examination showed no visible skin lesions, but a palpable hard nodule was present over the penile shaft. The imaging studies did not reveal other metastases. Cavernous-Glans shunt and nodule resection were perfo...

  20. Own Experience in Treatment of Patients with Penile Cancer Using Photodynamic Therapy

    OpenAIRE

    Filonenko, Elena; Kaprin, Andrey; Alekseev, Boris; Urlova, Antonina

    2015-01-01

    Penile cancer is a rare pathology. For penile cancer surgical treatment, radiotherapy, chemotherapy, and combined modality treatment are available. Because of great importance of this organ for mental condition of patient, the development of organ-preserving methods allowing to minimize impact on patient's quality of life without compromising of oncological results is desirable. In the Center of Laser and Photodynamic diagnosis and treatment of tumors in P.A. Herzen Moscow Cancer Research Ins...

  1. Shah's Indian penile prosthesis placement after phallic reconstruction with radial forearm flap

    OpenAIRE

    Patwardhan, Sujata K.; Shah, Rupin; Kulkarni, Vijay; Varma, Radheshyam R.

    2008-01-01

    We report a successful implantation of Indian penile prosthesis after total phallic reconstruction. The differential stiffness of the Shah penile prosthesis is felt to have less potential for erosion, the most common complication of rigid prosthetic stiffening devices when used in a neo-phallus. This prosthesis is an alternative to the inflatable prosthesis in patients who choose a rigid prosthesis due to economical constraints.

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

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Jin; Chung, Jae Joon; Yu, Jeong Sik; Kim, Joo Hee [Gangnam Severance Hospital, Seoul (Korea, Republic of)

    2009-12-15

    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.

  3. Force, membrane potential, and [Ca2+]i during activation of rat mesenteric small arteries with norepinephrine, potassium, aluminum fluoride, and phorbol ester. Effects of changes in pHi

    DEFF Research Database (Denmark)

    Jensen, P E; Hughes, A; Boonen, H C; Aalkjær, Christian

    1993-01-01

    In activated rat mesenteric small arteries, the effect of pHi on force, membrane potential, and free cytosolic calcium ([Ca2+]i) was assessed. Arteries were mounted in a myograph for isometric force development, and [Ca2+]i, pHi, or membrane potential was measured simultaneously with force. During activation with norepinephrine, potassium, aluminum fluoride (AlF-4), and phorbol 12-myristate 13-acetate (PMA, a phorbol ester), the vessels depolarized and [Ca2+]i increased, although the ratio of fo...

  4. A Preliminary Report on Combined Penoscrotal and Perineal Approach for Placement of Penile Prosthesis with Corporal Fibrosis

    OpenAIRE

    Aboseif, Sherif R.; Jocelyn M. Rieder; Tran, Viet Q.; Brusky, John P.

    2008-01-01

    Purpose. This paper aims at describing the combined penoscrotal and perineal approach for placement of penile prosthesis in cases of severe corporal fibrosis and scarring. Materials and methods. Three patients with extensive corporal fibrosis underwent penile prosthesis placement via combined penoscrotal and perineal approach from 1997 to 2006. Follow-up ranged from 15 to 129 months. Results. All patients underwent successful implantation of semirigid penile prosthesis. There were no short- o...

  5. Hpv-Associated Penile Pigmented Lesion

    Directory of Open Access Journals (Sweden)

    Ananiev J.

    2014-06-01

    Full Text Available HPV infection is involved in the etiology of a number of nonmalignant, premalignant and malignant cutaneous lesions. One of them is the so-called giant condyloma of Buschke-Löwenstein type (Buschke-Löwenstein tumor, BLT, which sometimes can imitate clinically other tumors or tumor-like conditions. Clinicians face a particular challenge in cases of BLT where, clinically, the lesions demonstrate a permanent brown hyperpigmentation in parallel with the dermatoscopic lack of the characteristic melanocytic network, globules or regression zones. There are uncommon clinical presentations with solitary, sharply demarcated pigmented lesions. In these cases the histopathological verification of the lesion is obligatory and the most efficient treatment method in the early period of the disease is the complete surgical excision. We report a case of a 74-year-old man who was admitted to the University Hospital “Lozenetz” in connection with profuse variceal bleeding of the esophagus associated with liver cirrhosis of unknown etiology. He underwent a consultative examination at the department of dermatology because of suspected advanced stage melanoma of the prepuce. Computed tomographic analysis indicated diffuse bone metastases located in the small pelvis and femur, as well as metastatic disease in the left inguinal lymph nodes. However, the subsequent histopathologic examination of the lesion, rather than showing melanoma, confirmed the presence of HPV-associated giant condyloma of Buschke and Löwenstein in initial stage, without histopathological evidence for invasive and destructive tumor growth. After his death, the patient’s relatives did not give consent for an autopsy, and therefore the genesis of the metastases, demonstrated by nuclear magnetic resonance imaging (NMR, remained unclear. In some cases, the clinical picture of the malignant and premalignant cutaneous lesions in the genital area could be problematic. The complete surgical excision with a subsequent histopathological verification is the best way to find out the exact diagnosis

  6. Semi-rigid penile prosthesis as a salvage management of idiopathic ischemic stuttering priapism

    Directory of Open Access Journals (Sweden)

    Faddan AA

    2015-09-01

    Full Text Available Amr A Faddan, Alexey V Aksenov, Carsten M Naumann, Klaus P Jünemann, Daniar K Osmonov Department of Urology and Pediatric Urology, University Hospital Schleswig-Holstein, Kiel, Germany Introduction: Priapism is the persistent erection resulting from dysfunction of the mechanisms that regulate penile swelling, stiffness, and sagging. It is a full or partial erection that persists for a period more than 4 hours beyond sexual stimulation and/or orgasm or is unrelated to sexual stimulation. Ischemic priapism should be managed in a step-by-step fashion. Objective: To demonstrate step-by-step management of stuttering refractory ischemic priapism. We report a case of stuttering refractory ischemic priapism. Moreover, we reviewed different approaches to priapism management in the literature. Case presentation: A 53-year-old male presented with a painful erection of 29 hours’ duration, probably caused by consumption of alcohol. The penile blood gas showed a pH of 7.08, PCO2 of 75 mmHg and PO2 of 39 mmHg. Aspiration was followed by irrigation of an ?-adrenergic, Winter and T-shunt operations were preformed, and finally a semi-rigid penile prosthesis was implanted to overcome the refractory stuttering ischemic priapism. Conclusion: In case of stuttering refractory ischemic priapism, immediate implantation of a penile prosthesis is a simple and effective procedure that manages both the acute episode and the inevitable erectile dysfunction that would otherwise occur, while preserving penile length. Keywords: priapism, stuttering priapism, shunting operation, penile prosthesis 

  7. Magnetic resonance imaging of penile metastases: a report on five cases

    Energy Technology Data Exchange (ETDEWEB)

    Lau, T.N. [Singapore General Hospital, (Singapore). Department of Diagnostic Radiology; Wakeley, C.J.; Goddard, P. [Bristol Royal Infirmary, Bristol, (United Kingdom). Department of Clinical Radiology

    1999-08-01

    Five cases of penile metastases are presented. Axial and sagittal T1-weighted and T2-weighted scans were performed in all patients. In some, coronal images were also obtained. The penile metastases were most often seen as discrete masses in the corpora cavernosa or corpus spongiosum. An atypical pattern of diffuse infiltration is also illustrated. Limitations of cavernosography, ultrasound (US) and computed tomography (CT) are discussed. The magnetic resonance (MR) features of penile metastases and possible role MR may have in the management of these patients are described. Metastatic deposits in the penis are uncommon. First described by Eberth in 1870 in a patient with a primary rectal carcinoma, there have since been over 300 cases reported in the literature. The imaging of penile metastases is, however, less clearly defined. Until now, cavernosography, ultrasound (US) and computed tomography (CT) have been used. These techniques have limitations. Only recently has magnetic resonance imaging (MRI) been employed. We describe five cases of penile metastases evaluated with MRI and discuss the role and features of penile metastases on MRI. Copyright (1999) Blackwell Science Pty Ltd 12 refs., 4 figs.

  8. Penile pyoderma gangrenosum successfully treated with topical Imiquimod

    Directory of Open Access Journals (Sweden)

    Santosh P Rathod

    2011-01-01

    Full Text Available Pyoderma gangrenosum(PG is a rare ulcerating inflammatory neutrophilic dermatosis. Genital involvement has been rarely reported. We report such a case of 24- year- old, male patient living with HIV/AIDS(PLHIV who presented with progressive genital ulceration, not responding to oral antibiotics and aciclovir, gradually increasing in size over 15-18 months. Repeated biopsies showed acute on chronic inflammation. The lesion partially responded to oral and topical corticosteroids but soon increased in size after tapering the dosage of the steroids.Then patient was given Imiquimod 5% cream to be applied over the lesion once daily for 2-4 weeks. Lesion cleared completely in 4 weeks and is in remission since last 6 months. The case report highlights the successful use of topical Imiquimod 5% cream in the treatment of penile PG.

  9. Penile prosthesis implantation in an academic institution in Latin America

    Scientific Electronic Library Online (English)

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

    2010-10-01

    Full Text Available 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.

  10. Comparison of Small Intestinal Submucosa-Covered and Noncovered Nitinol Stents with PTFE Endografts in Injured Ovine Femoral Arteries: A Pilot Study

    International Nuclear Information System (INIS)

    The purpose of this study was to compare performance of small intestinal submucosa (SIS)-covered endografts (SCEs) to polytetra-fluoroethylene (PTFE)-covered endografts (PCEs) and to bare nitinol stents (BSs) in injured sheep femoral artery (FA). Bare Zilver 6 mm x 40 mm nitinol stents (n = 6), Zilver stents covered with SIS (n = 6), and Palmaz stents 6 mm x 37 mm covered with PTFE (n = 6) were implanted in the balloon-injured FAs of nine female sheep. Follow-up arteriograms were obtained before animal sacrifice at 1, 3 and 6 months, with three animals at each time point. The FAs with the implanted device were explanted for histologic studies and morphologic measurements. Stent implantation was technically successful in all sheep. All BS and SCEs were patent at each time point. Five BSs and five SCEs exhibited formation of progressive eccentric intimal hyperplasia (IH) that was more advanced in SCE at 6 months. Cross-sectional area narrowing averaged 60% for BSs and 67% for SCEs. One BS, one SCE and two patent PCEs exhibited mild-to-moderate formation of concentric IH. Four PCS occluded one at 1 month, two at 3 months and one at 6 months. Performance of the devices placed into sheep FAs depended on their relation to the curving peri-articular portion of the FA during extremity flexion. BSs and SCEs placed in this portion exhibited progressive growth of eccentric IH while PCEs placed in this portion occluded

  11. High-dose-rate interstitial brachytherapy for the treatment of penile carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Petera, J.; Odrazka, K.; Zouhar, M.; Bedrosova, J.; Dolezel, M. [Dept. of Oncology and Radiotherapy, Charles Univ. Medical School and Teaching Hospital, Hradec Kralove (Czech Republic)

    2004-02-01

    Background: interstitial low-dose-rate (LDR) brachytherapy allows conservative treatment of T1-T2 penile carcinoma. High-dose-rate (HDR) is often considered to be dangerous for interstitial implants because of a higher risk of complications, but numerous reports suggest that results may be comparable to LDR. Nevertheless, there are no data in the literature available regarding HDR interstitial brachytherapy for carcinoma of the penis. Case report: a 64-year-old man with T1 NO MO epidermoid carcinoma of the glans is reported. Interstitial HDR brachytherapy was performed using the stainless hollow needle technique and a breast template for fixation and good geometry. The dose delivered was 18 x 3 Gy twice daily. Results: after 232 days from brachytherapy, the patient was without any evidence of the tumor, experienced no serious radiation-induced complications, and had a fully functional organ. Conclusion: HDR interstitial brachytherapy is feasible in selected case of penis carcinoma, when careful planning and small single fractions are used. (orig.)

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

    Scientific Electronic Library Online (English)

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

    2012-02-01

    Full Text Available 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.

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

    Directory of Open Access Journals (Sweden)

    Larissa Alves Afonso

    2012-02-01

    Full Text Available 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.

  14. Accessory renal arteries: a case report

    Directory of Open Access Journals (Sweden)

    Billakanti Prakash Babu

    2014-04-01

    Full Text Available During dissection of abdomen by the undergraduate medical students three accessory renal arteries were observed on the right side. The superior accessory artery was a small vessel arising from aorta just above the normal renal artery. It entered the anterior surface of kidney just below the upper pole. The middle and inferior arteries were caudal to the normal renal artery. The middle artery was arising from testicular artery and entered the anterior surface of kidney below the hilum. The inferior artery was arising from aorta just above its bifurcations and entered the lower pole of kidney. The importance of accessory renal arteries in surgical procedures of the posterior abdominal wall and renal transplantation are discussed. [Int J Res Med Sci 2014; 2(2.000: 765-768

  15. Own experience in treatment of patients with penile cancer using photodynamic therapy.

    Science.gov (United States)

    Filonenko, Elena; Kaprin, Andrey; Alekseev, Boris; Urlova, Antonina

    2015-01-01

    Penile cancer is a rare pathology. For penile cancer surgical treatment, radiotherapy, chemotherapy, and combined modality treatment are available. Because of great importance of this organ for mental condition of patient, the development of organ-preserving methods allowing to minimize impact on patient's quality of life without compromising of oncological results is desirable. In the Center of Laser and Photodynamic diagnosis and treatment of tumors in P.A. Herzen Moscow Cancer Research Institute the methods of photodynamic therapy in patients with penile cancer have been developed. From 2011 to 2013 the treatment was conducted in 11 patients with precancer and cancer of penile. The average age was 56.6. According to morphological diagnosis photodynamic therapy (PDT) was performed using two methods. One method included topical application of agent for PDT and the second intravenous administration of photosensitizer. For topical application alasens was used and for intravenous injection we applied radachlorine. All patients had no complications. Complete regression was achieved in 9 patients, and partial regression in 2. Thus, the results showed that photodynamic therapy for penile cancer stage Tis-1N0M0 permits performing organ-preserving treatment with satisfactory oncological results and no impairment of patient's quality of life. PMID:25834812

  16. The importance of psychosexual counselling in the re-establishment of organic and erotic functions after penile prosthesis implantation.

    Science.gov (United States)

    Pisano, F; Falcone, M; Abbona, A; Oderda, M; Soria, F; Peraldo, F; Marson, F; Barale, M; Fiorito, C; Gurioli, A; Frea, B; Gontero, P

    2015-09-01

    Although many studies about penile prosthesis implantation (PPI) have been published so far, only a small amount of them take into account patients and partners outcome in terms of satisfaction and erotic function. The aim of this study is to explore the value of psycosexual counselling in and the sexual and erotic function of penile prosthesis recipients. Thirty patients and their partners were randomised into two groups. In arm A (case group) patients and their partners underwent a multistep psychosexual counselling before and after surgery. In arm B (control group) surgery was performed without the specific psychosexual counselling scheme. Specific questionnaires (International Index of Erectile Function (IIEF) and the Sexual Daydreaming Scale (SDS)) were administered before surgery and 12 months afterwards. Twenty-four months postoperatively patients were asked to complete the Global Assessment Questions (GAQ) and the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS), while their partners were asked to answer to the EDITS partner's section. Between January 2009 and October 2011, we enrolled 30 patients undergoing PPI in our institution (15 in each arm). Twenty-four months postoperative follow-up is available for all of them. No significant differences between the two groups in terms of baseline questionnaires scores were observed. Mean IIEF score was significantly higher in case group (arm A 68.3, arm B 53.4, P-valueerotic function according to SDS was significantly higher in the study group for both patients and their partners. Improvement in satisfaction rates were confirmed at 24 months, with statistically significant scores for EDITS in arm A patients and partners as compared with arm B. PPI with a pre- and postoperative psychosexual counselling scheme resulted in better postoperative sexual activity and erotic function for both patients and partners than PPI alone. PMID:26268774

  17. Penile squamous cell carcinoma: anatomic, pathologic and viral studies in Paraguay (1993-2007).

    Science.gov (United States)

    Velazquez, Elsa F; Cubilla, Antonio L

    2007-08-01

    In developed countries, penile squamous cell carcinoma (SCC) account for subtypes of penile carcinomas have been described. Most SCCs are of the usual type (60%). Less frequent variants include basaloid (10%), warty (10%), papillary (15%), verrucous (3%), sarcomatoid (4%) and adenosquamous (1%). Mixed forms also exist. Because there is a correlation between histologic subtype and biologic behavior, accurate subtyping is important. The prevalence of human papillomavirus (HPV) in invasive SCC is approximately 42%, with a strong association of HPV and basaloid and warty variants. Among the most important prognostic factors are histologic grade and depth of invasion. It is important for surgical pathologists to know the anatomy of the penis and possible routes of tumor spread because negative resection margins are crucial to avoid local recurrences. The most frequently involved margins are the urethra and periurethral tissues, including Buck's fascia. Probable precursor lesions of penile carcinoma include squamous hyperplasia, low and high grade squamous intraepithelial neoplasia and lichen sclerosus. PMID:17879626

  18. Corporoplasty using bovine pericardium grafts in complex penile prosthesis implantation surgery

    Scientific Electronic Library Online (English)

    Eduardo J. A., Lopes; Andre Y., Kuwano; Andreia N., Guimaraes; Jesuino P., Flores; Modesto A. O., Jacobino.

    2009-02-01

    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, impermeabil [...] ity, 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.

  19. Complete Penile Necrosis in a Patient With Heparin-induced Thrombocytopenia: A Case Report

    Directory of Open Access Journals (Sweden)

    Anne-Sophie Blais

    2014-01-01

    Full Text Available Penile necrosis is a rare condition that has been mostly described in association with diabetes mellitus and end-stage renal disease. We report an unusual case of acute penile necrosis because of heparin-induced thrombocytopenia. A 75-year-old man presented with acute renal failure and experienced cardiac complications during the hospitalization. The patient was treated twice with intravenous heparin. He developed symptoms of penile necrosis 4 days after the reintroduction of heparin. At that moment, the platelet count dropped by 61%, and the analysis of heparin-pf4 antibodies was positive for heparin-induced thrombocytopenia. The patient underwent a total penectomy and a perineal urethrostomy.

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

    Science.gov (United States)

    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

    2010-03-01

    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 novel causative factor contributing to penile fibrosis in two independent animal models of priapism, adenosine deaminase (ADA)-deficient mice and SCD transgenic mice. An important finding is that chronic reduction of adenosine by ADA enzyme therapy successfully attenuated penile fibrosis in both mouse models, indicating an essential role of increased adenosine in penile fibrosis and a novel therapeutic possibility for this serious complication. Subsequently, we identified that both mice models share a similar fibrotic gene expression profile in penile tissue (including procollagen I, TGF-beta(1), and plasminogen activator inhibitor-1 mRNA), suggesting that they share similar signaling pathways for progression to penile fibrosis. Thus, in an effort to decipher specific cell types and underlying mechanism responsible for adenosine-mediated penile fibrosis, we purified corpus cavernosal fibroblast cells (CCFCs), the major cell type involved in this process, from wild-type mice. Quantitative RT-PCR showed that the major receptor expressed in these cells is the adenosine receptor A(2B)R. Based on this fact, we further purified CCFCs from A(2B)R-deficient mice and demonstrated that A(2B)R is essential for excess adenosine-mediated penile fibrosis. Finally, we revealed that TGF-beta functions downstream of the A(2B)R to increase CCFC collagen secretion and proliferation. Overall, our studies identify an essential role of increased adenosine in the pathogenesis of penile fibrosis via A(2B)R signaling and offer a potential target for prevention and treatment of penile fibrosis, a dangerous complication seen in priapism.-Wen, J., Jiang, X., Dai, Y., Zhang, Y., Tang, Y., Sun, H., Mi, T., Phatarpekar, P. V., Kellems, R. E., Blackburn, M. R., Xia, Y. Increased adenosine contributes to penile fibrosis, a dangerous feature of priapism, via A(2B) adenosine receptor signaling. PMID:19858092

  1. Doppler ultrasound of the uterine arteries: the importance of bilateral notching in the prediction of pre-eclampsia, placental abruption or delivery of a small-for-gestational-age baby.

    Science.gov (United States)

    Harrington, K; Cooper, D; Lees, C; Hecher, K; Campbell, S

    1996-03-01

    The use of Doppler studies of the uterine arteries in the prediction of pre-eclampsia and intrauterine growth retardation has had mixed success. The introduction of color Doppler imaging and the use of the "notch' to define an abnormal waveform have helped to improve the predictive value of uterine artery Doppler screening. The aim of this study was to evaluate the use of uterine artery Doppler in a group of women of mixed race and parity. This study was a prospective, cross-sectional analysis of 1326 unselected women who were screened with continuous wave uterine Doppler at 19-21 weeks, as part of a fetal anomaly/dating scan. A total of 214 women with abnormal uterine artery waveforms (notching) were referred for assessment at 24 weeks; 191 attended and had color Doppler imaging/pulsed Doppler studies of both uterine arteries. Data from 185 pregnancies were suitable for analysis. There were abnormal uterine Doppler findings (uni- or bilateral notching) in 110 patients at 24 weeks; 48 had bilateral notching. The sensitivity of notching for the prediction of proteinuric pregnancy-induced hypertension (PPIH) was similar in primiparas (76.9%), multiparas (77.7%), African-Caribbean women (82.6%) and Caucasian women (71.4%). The sensitivity of bilateral notching for the prediction of PPIH requiring delivery before 34 weeks was 81.2%, and 57.6% for babies small for gestational age (SGA), with positive predictive values of 27% (PPIH), 31.2% (SGA) and 37.5% (any complication). Patients with persistent bilateral notching are particularly at risk of developing PPIH or delivering an SGA baby before 34 weeks' gestation; they warrant increased surveillance, and may be a group that could benefit from prophylactic therapies. PMID:8705410

  2. Microflora of the penile skin-lined neovagina of transsexual women

    OpenAIRE

    Claeys Geert; De Backer Ellen; Saerens Bart; dos Santos Lopes Santiago Guido; Monstrey Stan; Gerris Jan; Verstraelen Hans; Weyers Steven; Vaneechoutte Mario; Verhelst Rita

    2009-01-01

    Abstract Background The microflora of the penile skin-lined neovagina in male-to-female transsexuals is a recently created microbial niche which thus far has been characterized only to a very limited extent. Yet the knowledge of this microflora can be considered as essential to the follow-up of transsexual women. The primary objective of this study was to map the neo-vaginal microflora in a group of 50 transsexual women for whom a neovagina was constructed by means of the inverted penile skin...

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

    Directory of Open Access Journals (Sweden)

    Soufiane Mellas

    2010-07-01

    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.

  4. Penile plaque as predictor of an advanced anorectal carcinoma: A case report.

    Science.gov (United States)

    Fabiani, Andrea; Filosa, Alessandra; Fioretti, Fabrizio; Mammana, Gabriele

    2015-06-01

    The secondary involvement of the penis by tumors from others organs is a rare event representing only 0.8% of overall metastasis in the genitourinary tract. The most frequent clinical findings is priapism, but occasionally, solitary metastases to the penile skin, mucosa of the glans, corpus spongiosum or lesions of the albuginea mimicking an induratio penis have been reported. We report a case of penile plaque predicting the relapse of an anorectal carcinoma. The precise etiology of this particular manifestation is not well understood and the prognosis is poor. There are no individual treatments with curative intent. PMID:26150041

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

    OpenAIRE

    Senba, Masachika; Buziba, Nathan; Mori, Naoki; FUJITA, SHUICHI; MORIMOTO, KONOSUKE; WADA, AKIHIRO; TORIYAMA, KAN

    2010-01-01

    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...

  6. MR diagnosis of penile agenesis: is it just absence of a phallus?

    Energy Technology Data Exchange (ETDEWEB)

    Goenka, Ajit; Jain, Vaibhav; Sharma, Raju; Gupta, Arun K. [All India Institute of Medical Sciences, Department of Radiodiagnosis, New Delhi (India); Bajpai, Minu [All India Institute of Medical Sciences, Department of Paediatric Surgery, New Delhi (India)

    2008-10-15

    Penile agenesis is an extremely rare anomaly that results from absence of the genital tubercle or its failure to develop into a penis during embryonic life. Associated anomalies of the genitourinary and distal gastrointestinal tracts are frequently present. Imaging modalities, particularly MRI and cystography, play a crucial role in establishing the diagnosis and guiding further management. We report a child with penile agenesis with a urethroanal fistula and a blind-ending anterior urethra who had been reared as a male until presentation. (orig.)

  7. Pannus Is the New Prepuce? Penile Cancer in a Buried Phallus

    Science.gov (United States)

    Manwaring, Jared; Vourganti, Srinivas; Nikolavsky, Dmitriy; Valente, Alfredo L.; Byler, Timothy

    2015-01-01

    Two males presented to our urology department with complaints of bleeding and malodor from buried phallus within a suprapubic fat pad. Although both men had neonatal circumcisions, advanced penile carcinoma was found in both men. Formal penectomies showed high grade, poorly differentiated squamous cell carcinoma invading the corporal bodies and urethra. Buried penis represents a difficulty in early detection of suspicious lesions but may also provide an environment susceptible to poor hygiene and subsequent chronic inflammation. Patients with buried penis may be at a higher risk for development of invasive penile cancer and may benefit from regular and thorough genital exams. PMID:26446361

  8. Buried penis: An unrecognized risk factor in the development of invasive penile cancer

    OpenAIRE

    Abdulla, Alym; Daya, Dean; Pinthus, Jehonathan; Davies, Timothy

    2012-01-01

    One of the documented benefits of neonatal circumcision is protection against invasive penile cancer. To date there have been a handful of published cases of invasive penile cancer in men circumcised as neonates. We report a case of a 73-year-old man, with a history of neonatal circumcision with no evidence of previous human papillomavirus exposure, who developed a buried penis secondary to obesity. He was diagnosed with Grade 2, pT3N0 squamous cell carcinoma of the penis. This report suggest...

  9. [Arterial heterogeneity].

    Science.gov (United States)

    Gouëffic, Y; Davaine, J-M; Merlini, T; Rimbert, A; Hérisson, F; Heymann, M-F; Heymann, D; Steenman, M; Lambert, G

    2013-01-01

    More and more clinical observations and trials support the concept of heterogeneity of atheroma according to the arterial bed. In a pilot study named "Étude Comparative des Lésions Athéromateuses" (ECLA), we have shown that carotid and femoral plaques possess different characteristics. Carotid arteries display increased lipid content compared to femoral arteries whereas femoral arteries are more prone to calcify and to develop osteoid metaplasia. These observations should lead the researcher and the clinician to look at the cellular and molecular mechanisms governing the heterogeneity of atheromas. At last, a better understanding of the characteristics of plaques should help us to determine plaque stability, to prevent cardiovascular events and to choose the best medical, endovascular or surgical option. PMID:23159822

  10. 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)

    Blædel, Martin; Raun, Kirsten

    2012-01-01

    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.

  11. Identifying the needs of penile cancer sufferers: A systematic review of the quality of life, psychosexual and psychosocial literature in penile cancer

    OpenAIRE

    Lau Maurice M; Maddineni Satish B; Sangar Vijay K

    2009-01-01

    Abstract Background Penile cancer is an uncommon malignancy with an incidence of 1 per 100,000. Conservative and radical treatments can be disfiguring and may have an impact on sexual function, quality of life (QOL), social interactions, self-image and self-esteem. Knowledge of how this disease affects patients is paramount to developing a global, multi-disciplinary approach to treatment. Methods A Medline/PubMed literature search was conducted using the terms "sexual function penis cancer"; ...

  12. Human Papilloma Virus: Prevalence, distribution and predictive value to lymphatic metastasis in penile carcinoma

    Scientific Electronic Library Online (English)

    Aluizio Goncalves da, Fonseca; Fernando Augusto, Soares; Rommel Rodriguez, Burbano; Rodrigo Vellasco, Silvestre; Luis Otavio Amaral Duarte, Pinto.

    2013-07-01

    Full Text Available Objectives To evaluate the prevalence, distribution and association of HPV with histological pattern of worse prognosis of penile cancer, in order to evaluate its predictive value of inguinal metastasis, as well as evaluation of other previous reported prognostic factors. Material and Methods Tum [...] or samples of 82 patients with penile carcinoma were tested in order to establish the prevalence and distribution of genotypic HPV using PCR. HPV status was correlated to histopathological factors and the presence of inguinal mestastasis. The influence of several histological characteristics was also correlated to inguinal disease-free survival. Results Follow-up varied from 1 to 71 months (median 22 months). HPV DNA was identified in 60.9% of sample, with higher prevalence of types 11 and 6 (64% and 32%, respectively). There was no significant correlation of the histological characteristics of worse prognosis of penile cancer with HPV status. Inguinal disease-free survival in 5 years did also not show HPV status influence (p = 0.45). The only independent pathologic factors of inguinal metastasis were: stage T ? T1b-T4 (p = 0.02), lymphovascular invasion (p = 0.04) and infiltrative invasion (p = 0.03). conclusions HPV status and distribution had shown no correlation with worse prognosis of histological aspects, or predictive value for lymphatic metastasis in penile carcinoma.

  13. Detection of human papillomavirus DNA in semen from patients with intrameatal penile warts.

    OpenAIRE

    Green, J.; Monteiro, E; GIBSON, P

    1989-01-01

    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.

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

    Science.gov (United States)

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

    2009-01-01

    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…

  15. Penile metastasis secondary to bladder cancer: A report of two cases

    Directory of Open Access Journals (Sweden)

    Narendra Kumar

    2014-01-01

    Full Text Available 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.

  16. Long-term patient satisfaction after surgical correction of penile curvature via tunical plication

    Directory of Open Access Journals (Sweden)

    Alvaro Paez

    2007-08-01

    Full Text Available OBJECTIVE: To assess patient satisfaction and functional results at long term follow-up after surgical correction for Peyronie's disease (PD and congenital penile curvature (CPC with the technique of tunical plication. MATERIALS AND METHODS: One hundred and two men operated for PD (n = 76 or CPC (n = 26 in four different departments of urology in public hospitals agreed to answer a six-question telephone questionnaire about treatment satisfaction. Tunica albuginea plication procedures represented the standard surgical approach. Subjects under investigation were correction of the deformity, feeling of bumps under the skin, pain during erection, penile sensory changes, development of erectile dysfunction (ED and postoperative ability for complete vaginal intromission. Subjective response rates were compared using the chi square test on the basis of the etiology of the disease (CPC or PD. RESULTS: Significant differences (p < 0.05 between patients with CPC and PD were noticed in the prevalence of postoperative penile deformity, sensory changes, ED and ability to complete vaginal intromission, PD patients always showing a more pessimistic view. No significant differences (p = ns were detected in terms of unpleasant nodes under the penile skin or pain during erection. CONCLUSIONS: Long-term outcome after surgical correction for PD and CPC with the technique of tunical plication can be poor. Probably patient expectations are above the real performance of surgical techniques. Preoperative information should be more exhaustive.

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

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Dong Yun; Lee, Jong Jin [Univ. of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2012-12-15

    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 {sup 18}F fluorodeoxyglucose (FDG) positron emission tomography/computed tomography(PET/CT)showed diffuse hypermetabolic activity along the penis shaft, which was confirmed as a penile metastasis.

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

    Directory of Open Access Journals (Sweden)

    Theddeus O.H. Prasetyono

    2011-08-01

    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 of surgical 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 then applied as a single sheet donor tissue to cover the denuded penile body spirally. The full thickness graft, which is relatively easy to be performed, is no doubt much thinner than a skin flap, while it also bears a smaller degree of secondary contraction than split skin graft. The color of the skin is considerably matched as it comes from the groin, which is a nearby area of penis. The size and skin sensitization of the penis looks to be natural. The only disadvantage is the common possibility of either spiral or circular junctional scar in between graft edges and between the graft and the penile mucosa and skin to develop 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 normal sexual function. (Med J Indones 2011; 20:222-5Keywords: full thickness skin graft, paraffinoma, siliconoma, sexual function

  19. New technique "Right Anterior Small Thoracotomy (RAST operation)" for beating heart grafting of the right internal thoracic artery to the posterior descending artery to the posterior descending artery in a third redo CABG patient. A novel coronary technique / Nova técnica "Pequena toracotomia anterior direita (operação RAST)" para enxerto da artéria torácica interna direita para a artéria descendente posterior com o coração batendo em paciente de terceira RM. Uma técnica coronária nova

    Scientific Electronic Library Online (English)

    Maximo, Guida; Gustavo, Guida; Giuseppina, Pecora; Estefania De, Garate.

    2014-09-01

    Full Text Available A terceira reoperação de revascularização miocárdica é um desafio para a equipe cirúrgica. Normalmente, uma mamária patente é a única possibilidade de enxerto e a esternotomia torna-se um procedimento arriscado. A lesão de enxerto patente tem sido associada a uma alta taxa de mortalidade. Muitas abo [...] rdagens diferentes têm sido propostas. Descrevemos uma nova técnica de abordagem da artéria coronária direita através de uma pequena toracotomia anterior direita usando a mamária direita prolongada com enxerto de veia safena para a artéria descendente posterior com o coração batendo. A técnica é muito simples e viável, pois anatomicamente a artéria coronária direita e a mamária direita estão muito próximas e a mobilização do coração é mínima. Abstract in english Third REDO-CABG is a challenge for the surgical team. Usually a patent mammary is the only graft working and the sternotomy becomes a risky procedure. Injury to a patent graft has been associated to a high mortality rate. Many different approaches have been proposed. We describe a novel technique to [...] approach the right coronary artery through a right anterior small thoracotomy using the right mammary prolonged with saphenous vein for grafting the posterior descending artery on the beating heart. The technique is very simple and feasible because anatomically the right coronary artery and the right mammary are very close and the mobilization of the heart is minimal.

  20. Genetics of Pulmonary Arterial Hypertension

    OpenAIRE

    Austin, Eric D; Loyd, James E.; John A. Phillips

    2009-01-01

    Tremendous progress has been made in understanding the genetics of hereditable pulmonary arterial hypertension (HPAH) since its description in the 1950s. Germline mutations in the gene coding bone morphogenetic receptor type 2 (BMPR2) are detectable in the majority of cases of HPAH, and in a small proportion of cases of idiopathic pulmonary arterial hypertension (IPAH). HPAH is an autosomal dominant disease characterized by reduced penetrance, variable expressivity, female predominance, and g...

  1. Continuing EGFR-TKI treatment in combination with super-selective arterial infusion chemotherapy beyond disease progression for patients with advanced EGFR-mutant non-small cell lung cancer.

    Science.gov (United States)

    Qi, Huiwei; Jiang, Sen; Yu, Dong; Ni, Huijuan; Hu, Qiong; Zhang, Jie

    2015-12-01

    Regional therapy has shown promising results in patients with an oligo-metastasis after the occurrence of resistance to epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs). This study evaluated the efficacy and safety of continuing EGFR-TKI therapy concurrently with arterial infusion chemotherapy in 6 patients (median age 55.9 years) with advanced EGFR-mutant non-small cell lung cancer (NSCLC) who had a locally progressive, centrally located lung lesion after EGFR-TKI therapy. The patients received a super-selective arterial infusion of docetaxel (75 mg/m(2)) every 28 days concurrently with EGFR-TKI therapy until further progressive disease (PD) or unacceptable adverse effects (AEs) occurred. Treatment outcomes were assessed via progression-free survival (PFS) times (PFS-1: time to PD after EGFR-TKI therapy; PFS-2: time to further PD after arterial infusion chemotherapy with EGFR-TKI therapy), the occurrence of treatment-related AEs, and patient responses to the QLQ-LC13 quality-of-life questionnaire. Three of the 6 patients achieved partial responses, and three had stable disease. The median PFS-1 was 10.42 months, and the median PFS-2 was 4.1 months (range, 2.1-5.7 months). The median overall survival (OS) was 28.6 months (range, 24.1-32.9 months). All AEs were either grade 1 or grade 2 in severity, and no unexpected AEs were observed. One patient died of lung cancer. The patients reported significant reductions from baseline in symptoms of cough, chest pain, dyspnea, and hemoptysis (P < 0.05 for all comparisons). Thus, continuing EGFR-TKI therapy in combination with super-selective arterial infusion chemotherapy beyond PD for patients with advanced EGFR-mutant NSCLC is feasible, and this approach warrants further investigation. PMID:26496741

  2. Satisfaction and complications with the Titan® one-touch release penile implant

    DEFF Research Database (Denmark)

    Lindeborg, Lisa; Fode, Mikkel

    2014-01-01

    Abstract Objective. The aim of this study was to assess complication rates and patient satisfaction with Coloplast Titan® one-touch release (OTR) inflatable penile implants inserted at one university hospital centre between November 2008 and April 2011. Material and methods. Overall, 33 patients with organic erectile dysfunction underwent penile implant surgery during the study period. The Titan OTR inflatable penile implants were inserted using a penoscrotal approach. Patient and partner satisfaction was assessed with the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaire. Results. One implant was removed because of infection, and three patients underwent revision surgery due to problems with autoinflation, deflation, and a displaced reservoir, respectively. In all cases the problems were solved and the implants were salvaged. Further complications included one patient with haematoma and sustained scrotal pain, one patient with meatal stenosis, and four patients with infections not related to the implant. In total, 30 EDITS questionnaires were administered and 26 (87%) were completed. Twenty-two patients (85%) reported being satisfied with the implant and two (8%) were dissatisfied. Twenty-four patients (92%) would recommend a penile implant to someone with a similar medical condition. Eighteen patients (72%) believed that their partner was satisfied with the implant. Nineteen patients (76%) felt that the process of achieving an erection with the implant was natural. Conclusion. Although it is important to inform patients about potential problems such as infection, pain and mechanical failure, the results show that inflatable penile implants are a good treatment choice for erectile dysfunction when conservative measures have failed.

  3. Comparing caudal and penile nerve blockade using bupivacaine in hypospadias repair surgeries in children

    Directory of Open Access Journals (Sweden)

    Mahin Seyedhejazi

    2011-01-01

    Full Text Available Background: Caudal anaesthesia is recommended for most surgical procedures of the lower part of the body, mainly below the umbilicus. It has been well established that a dorsal penile nerve block immediately after surgery decreases postoperative pain in children undergoing hypospadias repair. This study aimed to compare caudal or penile nerve block using bupivacaine in postoperative pain control in hypospadias repair in children. Patients and Methods: After local ethical committee approval and obtaining informed parental consent, 85 American society of Anesthesiologists status I and II patients, aged 6 months to 6 years old, undergoing hypospadias repair, were prospectively enrolled in this study. The patients were randomly divided into the following two groups: Caudal block was performed in 44 and penile block was performed in 41 patients. Cardiorespiratory systems data, analgesic requirement and complications were compared between the groups. Results: There were statistically significant haemodynamic (blood pressureand heart rate alteration during operation in each group (P<0.01. The haemodynamic parameters were stable during operation in successful blocks in both groups. Caudal block success rate is 97.7%, whereas in penile block is 92.6%. Nineteen of 43 patients (44% in caudal group and 29 of 41 patients (70% in penile group received analgesia in the postoperative period and this difference was significant between the two groups (P = 0.025. Conclusions: Without ultrasonography and with blind block, with anatomic landmarks only, the caudal block success rate is high and if there is no contraindication for caudal block, it is the best choice in children under 6 years old (or 25 kg for hypospadias repai.

  4. Significance of CaV3.2 T-type Ca2+ channels for pressure- and flow-dependent vasomotor responses in rat and mouse mesenteric small arteries : (Oral Communication)

    DEFF Research Database (Denmark)

    Jensen, Lars JØrn; Björling, K.

    We investigated the potential significance of CaV3.2 channels in the myogenic response (MR) and flow-mediated vasodilatation (FMVD). CaV3.2 channels were immunolocalized to EC and VSMC in rat and mouse small mesenteric arteries. The myogenic tone at pressures of 40-120 mmHg was significantly larger in young CaV3.2-/- mice (8-15 weeks) vs. age-matched WT mice (P<0.05; N=3-4), whereas no difference was observed in older (6-8 months) WT vs. KO mice (N=4-5). In young WT mice, the CaV3.2 blocker NiCl2 (30 µM) significantly enhanced myogenic tone (P<0.05; N=4), whereas in old WT mice this effect was not seen (N=4). In young and old CaV3.2-/- mice no effects of NiCl2 were observed. The FMVD response in rat mesenteric arteries was not blocked by L-NAME, but was almost abolished by the SKCa/IKCa channel blockers apamin/TRAM-34 (50 nM/1 µM) (P<0.01; N=6). Interestingly the vessels constricted to flow in the presence of 100 µM NiCl2 (P<0.001; N=6), and this led us to investigate FMVD in CaV3.2-/- mice. The FMVD responsewas not significantly different in old WT (N=8) vs. CaV3.2-/- mice (N=8), whereas preliminary data suggested a reduced FMVD in young KO mice. Expression of Cagna1A/C/G and TRPC1/3/6 mRNA was similar in WT vs. CaV3.2-/- mice. CONCLUSION: FMVD responses appear to rely on an endothelium-dependent hyperpolarization in rat small mesenteric arteries. CaV3.2 channels are negative feedback modulators of myogenic tone in small mesenteric artery in young mice. The age-dependent decline in CaV3.2-mediated negative feedback modulation in old animals might be clinically relevant.

  5. Desire for Penile Girth Enhancement and the Effects of the Self-Injection of Hyaluronic Acid Gel

    OpenAIRE

    Coskuner, Enis Rauf; Canter, Halil Ibrahim

    2012-01-01

    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.

  6. Desire for penile girth enhancement and the effects of the self-injection of hyaluronic acid gel

    Directory of Open Access Journals (Sweden)

    Enis Rauf Coskuner

    2012-01-01

    Full Text Available 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.

  7. Segmented Coronary Artery Aneurysms and Kawasaki Disease

    Directory of Open Access Journals (Sweden)

    Hamid Reza Ghaemi

    2011-05-01

    Full Text Available Kawasaki disease (KD is an acute vasculitis syndrome of unknown etiology. It occurs in infants and young children,affecting mainly small and medium-sized arteries, particularly the coronary arteries. Generalized microvasculitis occurs in the first 10 days, and the inflammation persists in the walls of medium and small arteries, especially the coronary arteries, and changes to coronary artery aneurysms.We report the case of a 10-month-old girl referred to our center three months after the onset of disease due to the aneurysmsof the coronary arteries. During the acute phase of her illness, she received 2 gr/kg intravenous gamma globulin; and afterher referral to us, the patient was treated by antiaggregant doses of acetylsalicylic acid (ASA (5 mg/kg and Warfarin (1 mg/daily. At three months’ follow-up, the aneurysms still persisted in the echocardiogram.

  8. Decompression sickness in breath-hold diving, and its probable connection to the growth and dissolution of small arterial gas emboli.

    Science.gov (United States)

    Goldman, Saul; Solano-Altamirano, J M

    2015-04-01

    We solved the Laplace equation for the radius of an arterial gas embolism (AGE), during and after breath-hold diving. We used a simple three-region diffusion model for the AGE, and applied our results to two types of breath-hold dives: single, very deep competitive-level dives and repetitive shallower breath-hold dives similar to those carried out by indigenous commercial pearl divers in the South Pacific. Because of the effect of surface tension, AGEs tend to dissolve in arterial blood when arteries remote from supersaturated tissue. However if, before fully dissolving, they reach the capillary beds that perfuse the brain and the inner ear, they may become inflated with inert gas that is transferred into them from these contiguous temporarily supersaturated tissues. By using simple kinetic models of cerebral and inner ear tissue, the nitrogen tissue partial pressures during and after the dive(s) were determined. These were used to theoretically calculate AGE growth and dissolution curves for AGEs lodged in capillaries of the brain and inner ear. From these curves it was found that both cerebral and inner ear decompression sickness are expected to occur occasionally in single competitive-level dives. It was also determined from these curves that for the commercial repetitive dives considered, the duration of the surface interval (the time interval separating individual repetitive dives from one another) was a key determinant, as to whether inner ear and/or cerebral decompression sickness arose. Our predictions both for single competitive-level and repetitive commercial breath-hold diving were consistent with what is known about the incidence of cerebral and inner ear decompression sickness in these forms of diving. PMID:25598211

  9. Lisinopril alters contribution of nitric oxide and K(Ca) channels to vasodilatation in small mesenteric arteries of spontaneously hypertensive rats.

    Science.gov (United States)

    Albarwani, S; Al-Siyabi, S; Al-Husseini, I; Al-Ismail, A; Al-Lawati, I; Al-Bahrani, I; Tanira, M O

    2015-01-01

    To investigate lisinopril effect on the contribution of nitric oxide (NO) and K(Ca) channels to acetylcholine (ACh)-induced relaxation in isolated mesenteric arteries of spontaneously hypertensive rats (SHRs). Third branch mesenteric arteries isolated from lisinopril treated SHR rats (20 mg/kg/day for ten weeks, SHR-T) or untreated (SHR-UT) or normotensive WKY rats were mounted on tension myograph and ACh concentration-response curves were obtained. Westernblotting of eNOS and K(Ca) channels was performed. ACh-induced relaxations were similar in all groups while L-NMMA and indomethacin caused significant rightward shift only in SHR-T group. Apamin and TRAM-34 (SK(Ca) and IK(Ca) channels blockers, respectively) significantly attenuated ACh-induced maximal relaxation by similar magnitude in vessels from all three groups. In the presence of L-NMMA, indomethacin, apamin and TRAM-34 further attenuated ACh-induced relaxation only in SHR-T. Furthermore, lisinopril treatment increased expression of eNOS, SK(Ca) and BK(Ca) proteins. Lisinopril treatment increased expression of eNOS, SK(Ca), BK(Ca) channel proteins and increased the contribution of NO to ACh-mediated relaxation. This increased role of NO was apparent only when EDHF component was blocked by inhibiting SK(Ca) and IK(Ca) channels. Such may suggest that in mesenteric arteries, non-EDHF component functions act as a reserve system to provide compensatory vasodilatation if (and when) hyperpolarization that is mediated by SK(Ca) and IK(Ca) channels is reduced. PMID:25194131

  10. Penile myiasis as a differential diagnosis for genital ulcer: a case report

    Scientific Electronic Library Online (English)

    Mauro R.L., Passos; Dennis C., Ferreira; Wilma N.C., Arze; José Carlos S., Silva; Felipe D.L., Passos; José Alexandre R., Curvelo.

    2008-04-01

    Full Text Available The genital localized myiasis is a rare zooparasitic dermatosis. This case reported to a penile myiasis by Dermatobia hominis larvae in a 62 year-old man, who is a retired military official from São Gonçalo city, Rio de Janeiro state, Brazil. This patient was guided to the sexually transmitted disea [...] ses (STD) clinic from Universidade Federal Fluminense (UFF) by professionals from a urology outpatient clinic of a public hospital from Rio de Janeiro state. The exam showed a 2 cm diameter nodular lesion with a hyperemic area in the glands penis that had arisen 20 days before the exam. It evolved in a favorable way after larvae removal, through previous local anesthesia and slight pressure in lesion's base with the extraction of the larvae. Penile myiasis is not a very frequent situation, although it must be considered as an option in differential diagnosis of genital infectious diseases, even among people of low economical level, as in the case presented.

  11. Long-term patient satisfaction after surgical correction of penile curvature via tunical plication

    Scientific Electronic Library Online (English)

    Alvaro, Paez; Juan, Mejias; Jorge, Vallejo; Ignacio, Romero; Miguel de, Castro; Fernando, Gimeno.

    2007-08-01

    Full Text Available OBJECTIVE: To assess patient satisfaction and functional results at long term follow-up after surgical correction for Peyronie's disease (PD) and congenital penile curvature (CPC) with the technique of tunical plication. MATERIALS AND METHODS: One hundred and two men operated for PD (n = 76) or CPC [...] (n = 26) in four different departments of urology in public hospitals agreed to answer a six-question telephone questionnaire about treatment satisfaction. Tunica albuginea plication procedures represented the standard surgical approach. Subjects under investigation were correction of the deformity, feeling of bumps under the skin, pain during erection, penile sensory changes, development of erectile dysfunction (ED) and postoperative ability for complete vaginal intromission. Subjective response rates were compared using the chi square test on the basis of the etiology of the disease (CPC or PD). RESULTS: Significant differences (p

  12. Surgical Management of a Locally Advanced Symptomatic Recurrence of Penile Sarcoma Secondary to Prostate Brachytherapy

    OpenAIRE

    Hakky, Tariq S; Patrick Espiritu; Alejandro R. Rodriguez; Nicholas Gould; Spiess, Philippe E

    2013-01-01

    Background The surgical management of patients with symptomatic metastatic or locally advanced recurrences involving the penis remains poorly characterized. The aim of the present abstract and video is to detail our experience in the surgical management of a specific patient with a locally advanced symptomatic recurrence of penile sarcoma secondary to prostate cancer treated with primary brachytherapy. Materials and Methods A 70 year old male patient initially treated for localized prostate c...

  13. Detection of human papillomavirus DNA by PCR in semen from patients with and without penile warts.

    OpenAIRE

    Green, J.; Monteiro, E; Bolton, V N; Sanders, P.; Gibson, P. E.

    1991-01-01

    OBJECTIVES--To determine the prevalence of urethral HPV infection, as indicated by the presence of HPV DNA in semen, in males with and without penile warts. DESIGN--Prevalence study of HPV types 6/11 and 16 DNA using PCR and Southern blot hybridisation analysis of semen. SETTING--Department of Genitourinary Medicine, Blundell Street Clinic, Leeds General Infirmary and the Assisted Conception Unit (ACU) Kings' College, London. SUBJECTS--Patients attending the Genitourinary Clinic for treatment...

  14. Comparison of Efficacy of Sertralin on Patients with Premature Ejaculation By Penile Biothesiometry

    Directory of Open Access Journals (Sweden)

    Emrah Okulu

    2013-07-01

    Full Text Available Aim: We examine the efficacy of the low dose, high dose and on demand use of sertraline on patients with primary premature ejaculation.The value of penile biothesiometry on interpretation of responses from these treatments is also evaluated. Material and Method: A total of 70 men, 23 to 55 years old(mean age 36.4,with premature ejaculation were randomized into two treatment groups,each consisting of 35 patients,receiving placebo,sertraline, in a fashion.Because 10 patients dropped out for some reason,the study was completed with 32 patients in placebo,28 patients in sertraline groups. The study was divided into five periods in order, i.e. before treatment(BT, low dose(LD, high dose(HD, on demand(OD and after treatment(AT.Patients did not use any of these drugs during BT and AT periods. Drug visits, intravaginal ejaculation latencies and sexual satisfaction score of the previous period were recorded,penile biothesiometric analysis was performed as well. Results: The percentage of patients with a SES score ‘moderate’ or ‘good’ for placebo group on LD period, was 25%;for sertraline group was 46.4%, but on HD and OD periods it was about %40 for placebo group and 71.4% for sertraline group.According to latancies and penile biothesiometric data,both sertraline group was superior to placebo in all LD, HD and OD periods(pOD>LD.Drug caused non-serious side effects in 10 of 60 patients(16.6%. Discussion: Sertraline is effective in primary premature ejaculation.On demand use of both drugs following a two week high dose use,is an effective treatment for primary premature ejaculation with less side effects. Penile biothesiometry can be used to evaluate the efficacy of pharmacotherapy in primary premature ejaculation in place of intravaginal latency measurements and satisfaction scores.

  15. Corporoplasty using bovine pericardium grafts in complex penile prosthesis implantation surgery

    OpenAIRE

    Eduardo J. A. Lopes; Andre Y. Kuwano; Andreia N. Guimaraes; Jesuino P. Flores; Modesto A. O. Jacobino

    2009-01-01

    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 ...

  16. Radiotherapy for node positive penile cancer: Experience of the leeds teaching hospitals

    OpenAIRE

    Franks, KN; Kancherla, K; Sethugavalar, B; Whelan, P.; Eardley, I.; Kiltie, AE

    2011-01-01

    Purpose: We studied the outcomes in patients with node positive penile cancer who received radiotherapy to inguinal and pelvic nodes. Although half of node positive cases are cured by lymphadenectomy, little data are available on the potential further benefits and toxicities of postoperative radiotherapy. Materials and Methods: We retrospectively audited the clinical notes and electronic records of 23 patients referred to a specialist center from 2002 to 2008 who received radiotherapy to the ...

  17. Penile Low-Intensity Shock Wave Therapy: A Promising Novel Modality for Erectile Dysfunction

    Science.gov (United States)

    Kitrey, Noam D.; Gruenwald, Ilan; Appel, Boaz; Vardi, Yoram

    2014-01-01

    Penile extracorporeal low-intensity shock wave therapy (LIST) to the penis has recently emerged as a novel and promising modality in the treatment of erectile dysfunction (ED). LIST has angiogenic properties and stimulates neovascularization. If applied to the corpora cavernosa, LIST can improve penile blood flow and endothelial function. In a series of clinical trials, including randomized double-blind sham-controlled studies, LIST has been shown to have a substantial effect on penile hemodynamics and erectile function in patients with vasculogenic ED. LIST is effective in patients who are responsive to phosphodiesterase 5 inhibitors (PDE5i) and can also convert PDE5i nonresponders to responders. The response to LIST wanes gradually over time, and after 2 years, about half of the patients maintain their function. Extensive research is needed to understand the effect of LIST on erectile tissue, to modify the treatment protocol to maximize its outcomes, and to identify the patients who will benefit the most from this treatment. PMID:24868332

  18. Prognostic factors in Taiwanese patients with penile-invasive squamous cell carcinoma.

    Science.gov (United States)

    Geng, Jiun-Hung; Huang, Shu-Pin; Huang, Chao-Yuan

    2015-10-01

    In Taiwanese patients, carcinoma of the penis is an uncommon disease. We retrospectively reviewed potential prognostic factors in Taiwanese patients with invasive-penile squamous cell carcinoma (SCC). From 1997 to 2009, 52 patients were enrolled. The median patient age at diagnosis was 66.5 years and the peak incident occurred during the 6(th) and 7(th) decades of life. Thirteen patients (25%) died of penile cancer, with a mean follow-up time of 45 months (interquartile range: 15-64 months). The 5-year cumulative cancer-specific survival rate was 81%, with 100% for those with Stage I, 90% for those with Stage II, 60% for those with Stage III, and 14% for those with Stage IV. Eleven variables, including grade, tumor, node, metastasis (TNM) stage, involvement of corpus spongiosum or corpora cavernosa, lymphovascular or perineural invasion, lymphadenectomy, and palpable lymph node, with p < 0.05 using univariate analysis were chosen for multivariate regression analysis. Three of these potential prognostic factors, including histological grade, distant metastasis, and lymphovascular invasion, remained statistically significant. Our study is the first report using the latest TNM classification (2009) to determine these potential predictors with penile SCC in Taiwan. PMID:26520691

  19. A preliminary study of the sensory distribution of the penile dorsal and ventral nerves: implications for effective penile block for circumcision.

    LENUS (Irish Health Repository)

    Long, Ronan M

    2012-01-31

    OBJECTIVE: To determine the sensory innervation of the penis, as regional anaesthesia is often used either for postoperative analgesia or as the sole anaesthetic technique for circumcision. Since first described in 1978 the dorsal penile nerve block has become the standard technique, but some blocks are ineffective; a better understanding of the sensory innervation of the penis might improve the efficacy of the dorsal penile block technique. PATIENTS AND METHODS: In 13 men undergoing circumcision with local anaesthetic, cutaneous sensation was tested before and after infiltration of the dorsal aspect of the penis, and then again after infiltration of the ventral aspect. The area of anaesthesia was mapped using pin-prick sensation. RESULTS: Ten of the 13 patients showed a similar pattern of sensory distribution. After the dorsal block, the dorsal aspect of the shaft of the penis and glans penis became insensate. The ventral aspect of the shaft remained sensate up to and including the frenulum. After successful ventral infiltration all sensate areas became insensate and circumcision proceeded. In one case the frenulum and distal ventral foreskin was anaesthetized after the dorsal block and ventral infiltration was not required. No patient experienced pain during circumcision. CONCLUSION: For consistently successful regional anaesthesia of the foreskin in circumcision, a dorsal block must be used. This should be combined with ventral infiltration at the site of incision. This method will avoid inconsistencies and allow pain-free circumcision using local anaesthesia in most men.

  20. Mesenteric artery ischemia

    Science.gov (United States)

    ... ischemia is often seen in people who have hardening of the arteries in other parts of the ... long-term (chronic) mesenteric artery ischemia caused by hardening of the arteries ( atherosclerosis ): Abdominal pain after eating ...

  1. Hardening of the arteries

    Science.gov (United States)

    Hardening of the arteries, also called atherosclerosis, occurs when fat, cholesterol, and other substances build up in ... the arteries and cause problems throughout the body. Hardening of the arteries is a common disorder.

  2. Heart transplantation and arterial elasticity

    Directory of Open Access Journals (Sweden)

    Colvin-Adams M

    2013-12-01

    Full Text Available Monica Colvin-Adams,1 Nonyelum Harcourt,1 Robert LeDuc,2 Ganesh Raveendran,1 Yassir Sonbol,3 Robert Wilson,1 Daniel Duprez11Cardiovascular Division, University of Minnesota, Minneapolis, MN, USA; 2Division of Biostatistics University of Minnesota, Minneapolis, MN, USA; 3Cardiovascular Division, St Luke's Hospital System, Sugar Land, TX, USAObjective: Arterial elasticity is a functional biomarker that has predictive value for cardiovascular morbidity and mortality in nontransplant populations. There is little information regarding arterial elasticity in heart transplant recipients. This study aimed to characterize small (SAE and large (LAE artery elasticity in heart transplant recipients in comparison with an asymptomatic population free of overt cardiovascular disease. A second goal was to identify demographic and clinical factors associated with arterial elasticity in this unique population.Methods: Arterial pulse waveform was registered noninvasively at the radial artery in 71 heart transplant recipients between 2008 and 2010. SAEs and LAEs were derived from diastolic pulse contour analysis. Comparisons were made to a healthy cohort of 1,808 participants selected from our prevention clinic database. Multiple regression analyses were performed to evaluate associations between risk factors and SAE and LAE within the heart transplant recipients.Results: LAE and SAE were significantly lower in heart transplant recipients than in the normal cohort (P <0.01 and P < 0.0001, respectively. Female sex and history of ischemic cardiomyopathy were significantly associated with reduced LAE and SAE. Older age and the presence of moderate cardiac allograft vasculopathy were also significantly associated with reduced SAE. Transplant duration was associated with increased SAE.Conclusion: Heart transplants are associated with peripheral endothelial dysfunction and arterial stiffness, as demonstrated by a significant reduction in SAE and LAE when compared with a healthy population. Furthermore, cardiac allograft vasculopathy is associated with a significant reduction in SAE, suggesting a potential use in screening heart transplant recipients at risk for developing this complication.Keywords: heart transplant, endothelial function, arterial elasticity, cardiac allograft vasculopathy

  3. Arterial stenosis following radiotherapy

    International Nuclear Information System (INIS)

    Published reports of arterial stenosis following radiotherapy are reviewed. In oncological practice, this complication is rare but experimental studies have demonstrated the role of irradiation in producing arterial lesions. The histological specificity and the mechanisms of radiation and related arterial lesions are discussed. Atherosclerosis risk factors and chemotherapy could have a synergic role on artery stenosis. Cases reported of arterial stenosis after radiotherapy include subclavicular artery after breast cancer, carotid artery after head and neck cancer, coronary artery and abdominal aorta or its trunks after pelvic and abdominal irradiation. The radiotherapy parameters described are not unusual. Therapeutical modalities and their indications are presented

  4. Hipertensão arterial e sua correlação com alguns fatores de risco em cidade brasileira de pequeno porte Hipertensión arterial y su correlación con algunos factores de riesgo en ciudad brasileña de pequeño tamaño Arterial hypertension and its correlation with some risk factors in a small brazilian town

    OpenAIRE

    Flávia Miquetichuc Nogueira Nascente; Paulo César Brandão Veiga Jardim; Maria do Rosário Gondim Peixoto; Estelamaris Tronco Monego; Humberto Graner Moreira; Priscila Valverde de Oliveira Vitorino; Weimar Kunz Sebba Barroso Souza; Luiz Nazário Scala

    2010-01-01

    FUNDAMENTO: A hipertensão arterial (HA) é um problema de saúde que atinge um grande número de hipertensos não diagnosticados ou não tratados adequadamente e que possui um alto índice de abandono ao tratamento. OBJETIVO: Estimar a prevalência da HA e sua correlação com alguns fatores de risco cardiovasculares na população adulta de Firminópolis-GO. MÉTODOS: Estudo descritivo, observacional e transversal com base populacional, amostra aleatória simples (> 18 anos): questionários padronizados co...

  5. Percutaneous transluminal angioplasty (PTA) of supra-aortic arteries especially the internal carotid artery

    International Nuclear Information System (INIS)

    We present our experience with 105 patients in whom percutaneous transluminal angioplasty was performed in 112 stenosed or occluded supra-aortic arteries. Symtoms of cerebrovascular and/or vertebrobasilar insufficiency were present in 104 of the 105 patients. The angioplasty was successful in 35 stenoses of the internal carotid artery, 2 stenoses of the common carotid artery, 1 stenosis of the external carotid artery, 15 stenoses of the vertebral artery, 3 stenoses of the innominate artery and 44 stenoses of the subclavian artery. There were only 4 minor-complications (2 haematomas, 1 transient ischemic attack, 1 small thrombus of the internal carotid artery which was detected by 111-indium platelet scintigraphy and treated by thrombendarterectomy before the appearance of neurological symptoms). All patients were symptom free after angioplasty. During the observations period of 3 to 109 months (average 58 months) there were only two cases with re-stenosis after subclavian angioplasty. The results of more than 700 personal and international published percutaneous transluminal angioplasties of supra-aortic arteries are presented. The results suggest that angioplasty of supra-aortic arteries is an effective method. On strict definition of the indications, the complication rate for angioplasty of the supra-aortic arteries is not likely to be higher than that for operative treatment. (orig.)

  6. Percutaneous transluminal angioplasty (PTA) of supra-aortic arteries especially the internal carotid artery

    Energy Technology Data Exchange (ETDEWEB)

    Kachel, R.; Basche, S. (Medizinische Akademie, Erfurt (Germany, F.R.). Radiologische Klinik); Heerklotz, I.; Grossmann, K. (Medizinische Akademie, Erfurt (Germany, F.R.). Klinik fuer Innere Medizin); Endler, S. (Medizinische Akademie, Erfurt (Germany, F.R.). Klinik fuer Neurologie und Psychiatrie)

    1991-06-01

    We present our experience with 105 patients in whom percutaneous transluminal angioplasty was performed in 112 stenosed or occluded supra-aortic arteries. Symtoms of cerebrovascular and/or vertebrobasilar insufficiency were present in 104 of the 105 patients. The angioplasty was successful in 35 stenoses of the internal carotid artery, 2 stenoses of the common carotid artery, 1 stenosis of the external carotid artery, 15 stenoses of the vertebral artery, 3 stenoses of the innominate artery and 44 stenoses of the subclavian artery. There were only 4 minor-complications (2 haematomas, 1 transient ischemic attack, 1 small thrombus of the internal carotid artery which was detected by 111-indium platelet scintigraphy and treated by thrombendarterectomy before the appearance of neurological symptoms). All patients were symptom free after angioplasty. During the observations period of 3 to 109 months (average 58 months) there were only two cases with re-stenosis after subclavian angioplasty. The results of more than 700 personal and international published percutaneous transluminal angioplasties of supra-aortic arteries are presented. The results suggest that angioplasty of supra-aortic arteries is an effective method. On strict definition of the indications, the complication rate for angioplasty of the supra-aortic arteries is not likely to be higher than that for operative treatment. (orig.).

  7. Graft Arterial Stenosis in Kidney En Bloc Grafts From Very Small Pediatric Donors: Incidence, Timing, and Role of Ultrasound in Screening.

    Science.gov (United States)

    Bent, C; Fananapazir, G; Tse, G; Corwin, M T; Vu, C; Santhanakrishnan, C; Perez, R V; Troppmann, C

    2015-11-01

    In previous studies with different donor selection criteria and noncontemporary surgical techniques, graft arterial stenosis (GAS) has been reported to occur more frequently in adult recipients of pediatric en bloc renal allografts (EBKT) as compared to single adult donor allografts. The purpose of our study was to evaluate the incidence of GAS within our EBKT recipient population and to evaluate clinical and imaging features of those cases with GAS. In a retrospective cohort study, we analyzed 182 EBKT performed at a single institution. We identified cases of suspected GAS based on clinical factors, lab results, and noninvasive imaging. Diagnosis of GAS was confirmed by digital subtraction angiography. Two EBKT recipients (1.1% of 182) had angiographically confirmed GAS at 2.5 and 4.5 months after transplant. In both cases, the stenoses were short segment within the proximal (perianastomotic) donor aorta, color Doppler ultrasound demonstrated peak systolic velocities of >400?cm/s, and poststenotic parvus tardus waveforms were present. Both patients underwent angioplasty and demonstrated postintervention improvement in renal function and blood pressure. Restenosis did not occur during follow up. In conclusion, recipients of EBKT have a low incidence of GAS, similar to the lowest reported for adult single allografts. PMID:26153092

  8. Identifying the needs of penile cancer sufferers: A systematic review of the quality of life, psychosexual and psychosocial literature in penile cancer

    Directory of Open Access Journals (Sweden)

    Lau Maurice M

    2009-08-01

    Full Text Available Abstract Background Penile cancer is an uncommon malignancy with an incidence of 1 per 100,000. Conservative and radical treatments can be disfiguring and may have an impact on sexual function, quality of life (QOL, social interactions, self-image and self-esteem. Knowledge of how this disease affects patients is paramount to developing a global, multi-disciplinary approach to treatment. Methods A Medline/PubMed literature search was conducted using the terms "sexual function penis cancer"; "quality of life penis cancer" and "psychological effects penis cancer" from 1985 to 2008. Articles containing quantitative data on QOL, sexual function or psychological well-being were included. Results 128 patients from 6 studies were included. 5 studies contained retrospective data whilst 1 study collected prospective data on erectile function. In the 6 studies 13 different quantitative tools were used to assess psychological well-being, QOL and sexual function. The General Health Questionnaire (GHQ showed impaired well-being in up to 40% in 2 studies. Patients undergoing more mutilating treatments were more likely to have impaired well-being. The Hospital Anxiety and Depression Score (HADS demonstrated pathological anxiety up to 31% in 2 studies. 1 study used the Diagnostic and Statistical Manual of Mental Disorders of psychiatric illness (DSM III-R with 53% exhibiting mental illness, 25% avoidance behaviour and 40% impaired well-being. 12/30 suffered from post-traumatic stress disorder. The IIEF-15 was the commonest tool used to assess sexual function. The results varied from 36% in 1 study with no sexual function to 67% in another reporting reduced sexual satisfaction to 78% in another reporting high confidence with erections. Conclusion The treatment of penile cancer results in negative effects on well-being in up to 40% with psychiatric symptoms in approximately 50%. Up to two-thirds of patients report a reduction in sexual function. This study demonstrates that penile cancer sufferers can exhibit significant psychological dysfunction, yet no standardised tools or interventional pathways are available. Therefore, there is a need to identify and assess adequate tools to measure psychological and sexual dysfunction in this group of patients.

  9. Force, membrane potential, and [Ca2+]i during activation of rat mesenteric small arteries with norepinephrine, potassium, aluminum fluoride, and phorbol ester. Effects of changes in pHi

    DEFF Research Database (Denmark)

    Jensen, P E; Hughes, A

    1993-01-01

    In activated rat mesenteric small arteries, the effect of pHi on force, membrane potential, and free cytosolic calcium ([Ca2+]i) was assessed. Arteries were mounted in a myograph for isometric force development, and [Ca2+]i, pHi, or membrane potential was measured simultaneously with force. During activation with norepinephrine, potassium, aluminum fluoride (AlF-4), and phorbol 12-myristate 13-acetate (PMA, a phorbol ester), the vessels depolarized and [Ca2+]i increased, although the ratio of force to [Ca2+]i was less during potassium activation than with the other types of activation. Changes in pHi, with a constant pHo, were induced with NH4Cl or by changing PCO2. In resting vessels, the effects of the changes in pHi on tension, membrane potential, and [Ca2+]i were negligible. In vessels activated with norepinephrine or AlF-4, alkalinization caused an acute decrease of tone, which could be explained by a decrease in [Ca2+]i consequent to repolarization of the membrane. In vessels activated with potassium orPMA, the effects of alkalinization were smaller. This is consistent with acute alkalinization, affecting steps proximal in the excitation-contraction coupling distal to activation of G proteins. Acidification caused a transient increase in tone and [Ca2+]i, irrespective of the mode of stimulation, without affecting the membrane potential. Ryanodine did not abolish the transient increase in tone and [Ca2+]i. Thus, acute intracellular acidification may induce tone by release of an intracellular ryanodine-insensitive calcium pool or by affecting transmembranal calcium flux although in a membrane potential-independent way.

  10. Regional differences in the response to vasoconstrictor agents of dog and monkey isolated coronary arteries.

    OpenAIRE

    Miwa, K.; Toda, N

    1984-01-01

    Contractile responses to vasoconstrictor agents were compared in helical strips of dog and monkey epicardial coronary arteries of different sizes. Contractions of large, medium and small arteries induced by KCl ( 30mM ) were virtually identical. Contractions induced by 5-hydroxytryptamine (5-HT) (10(-9) - 2 X 10(-6) M) were in the order of large greater than medium greater than small arteries in dogs, and large = medium greater than small arteries in monkeys. Cinanserin suppressed these respo...

  11. [Cerebral artery bypass surgery].

    Science.gov (United States)

    Kivipelto, Leena; Lehecka, Martin; Niemelä, Mika; Hernesniemi, Juha

    2014-01-01

    Cerebral artery bypass surgery makes it possible to improve or replace cerebral circulation by bringing blood flow from extracranial arteries into the cerebral arteries or by creating new flow routes between cerebral arteries. Cerebral artery bypass operations play an important role in the treatment of the rare moyamoya disease causing cerebral artery stenosis and disturbances of the cerebral circulation and in the treatment of cerebral aneurysms that are unamenable to treatment with traditional microsurgical or endovascular techniques. Compared with conservative therapy, bypass surgery does, however, not seem beneficial in the prevention of strokes and hemodynamic disturbances of the cerebral circulation associated with atherosclerotic occlusion of the carotid artery. PMID:25158582

  12. Psychological/psychiatric trauma in patients with penile cancer and partial or total penectomy

    Directory of Open Access Journals (Sweden)

    Novac B.

    2013-01-01

    Full Text Available Penile cancer, which is a considerable challenge for countries in the developing world, is a mutilated affection for the patient, considering both the local modifications that are determined by it, as well as from the treatment point of view. In this way, for the more advanced disease phase, aggressive therapy with partial or total penectomy is still the conventional and necessary treatment. There are very few studies about the extent and nature of the psychological effects of penile cancer. Thus, considering that psychological/psychiatric dysfunctions in patients with penectomy are likely to be common and taking into account the current contradictions that exist regarding this area of research, we decided to evaluate the impact of penile cancer and/or partial or total penectomy on levels of anxiety and depression, as studied through some specific scales such as the Hamilton Rating Scale for Depression (HAM-D and the Hamilton Anxiety Rating Scale (HAM-A. We found increased anxiety and depression, especially in the case of the group with total penectomy, but also in the biopsy group, which comprised patients that had lesions in the terminal stage, such as an inextirpable tumor. The most reduced levels of depression and anxiety were observed in the postectomy group. Our findings presented here and further knowledge about the psychological, social and sexual aspects of these specific patients will help health professionals and organizations to identify treatment options and/or make recommendations for rehabilitation and support services. Additionally, there is a continuous need to identify and assess proper scales to measure the psychological/psychiatric trauma in this group of patients, as well as focusing on the identification of the exact patients that require professional psychological intervention.

  13. Titanium-bone-anchored penile epithesis: preoperative planning and immediate postoperative results.

    Science.gov (United States)

    Selvaggi, Gennaro; Branemark, Rickard; Elander, Anna; Liden, Mattias; Stalfors, Joacim

    2015-02-01

    The principle of osseointegration is accepted and used in reconstructive surgery. This study presents the first series of five patients where titanium implants have been implanted into the pubic bones of female-to-male (FTM) transsexual patients, in order to attach a "bone-anchored" penile epithesis. Following patient selection based on patients' wishes, pubic bones of 10 FTM transsexuals were analysed by CT-scan and a virtual planning was made. A surgical plan was also developed. To date, five FTM transsexuals have undergone the two-stage surgery. During stage-1, two titanium implants ("fixtures") are implanted onto the pubic bone. Four weeks postop, a new CT scan is performed to analyze osseointegration and the final implant position. During stage-2, the soft tissue of the pubic area is reduced; abutments are inserted and passed through the skin. A few weeks after stage 2 surgery, a penile epithesis is connected to the skin-penetrating titanium implants. Two out of 10 patients who received preoperative CT scan presented with smaller pubic bones, not able to accommodate the fixtures as chosen originally. Preoperative virtual planning is crucial for the selection of the appropriate implants size. The stage-1 and stage-2 surgery occurred uneventfully in all five patients. One patient presented with a wound infection 1 week after stage-2 surgery. Postoperative CT scan demonstrates implant osseointegration in all cases. This experimental clinical study demonstrates that titanium osseointegration is feasible onto the pubic bone. This new approach for penile reconstruction constitutes another alternative for both transsexual patients and cases following genital development disorders, post-trauma and surgery. PMID:24931337

  14. Penile urethra replacement with autologous cell-seeded tubularized collagen matrices.

    Science.gov (United States)

    De Filippo, Roger E; Kornitzer, Benjamin S; Yoo, James J; Atala, Anthony

    2015-03-01

    Acellular collagen matrices have been used as an onlay material for urethral reconstruction. However, cell-seeded matrices have been recommended for tubularized urethral repairs. In this study we investigated whether long segmental penile urethral replacement using autologous cell-seeded tubularized collagen-based matrix is feasible. Autologous bladder epithelial and smooth muscle cells from nine male rabbits were grown and seeded onto preconfigured tubular matrices constructed from decellularized bladder matrices obtained from lamina propria. The entire anterior penile urethra was resected in 15 rabbits. Urethroplasties were performed with tubularized matrices seeded with cells in nine animals, and with matrices without cells in six. Serial urethrograms were performed at 1, 3 and 6 months. Retrieved urethral tissues were analysed using histo- and immunohistochemistry, western blot analyses and organ bath studies. The urethrograms showed that animals implanted with cell-seeded matrices maintained a wide urethral calibre without strictures. In contrast, the urethras with unseeded scaffolds collapsed and developed strictures. Histologically, a transitional cell layer surrounded by muscle was observed in the cell-seeded constructs. The epithelial and smooth muscle phenotypes were confirmed with AE1/AE3 and ?-actin antibodies. Organ bath studies of the neourethras confirmed both physiological contractility and the presence of neurotransmitters. Tubularized collagen matrices seeded with autologous cells can be used successfully for long segmental penile urethra replacement, while implantation of tubularized collagen matrices without cells leads to poor tissue development and stricture formation. The cell-seeded collagen matrices are able to form new tissue, which is histologically similar to native urethra. PMID:23172803

  15. The role of radiation therapy after incomplete resection of penile cancer

    Energy Technology Data Exchange (ETDEWEB)

    Langsenlehner, T.; Mayer, R.; Prettenhofer, U.; Kapp, K.S. [Dept. of Therapeutic Radiology and Oncology, Medical Univ. of Graz (Austria); Quehenberger, F. [Inst. for Medical Informatics, Statistics and Documentation, Medical Univ. of Graz (Austria); Langsenlehner, U. [Div. of Oncology, Dept. of Internal Medicine, Medical Univ. of Graz (Austria); Pummer, K. [Dept. of Urology, Medical Univ. of Graz (Austria)

    2008-07-15

    Purpose: to retrospectively assess the outcome in patients treated with adjuvant radiotherapy for penile cancer. Patients and methods: between 1987 and 2006, 24 patients (median age, 62.7 years; range, 35.5-90.4 years) with squamous cell carcinoma of the penis (T1, n = 10; T2, n = 11; T3, n = 3) received megavoltage external radiotherapy (n = 22) or {sup 192}Ir high-dose-rate brachytherapy (n = 2) following total penectomy (n = 7), partial penectomy (n = 10), or local excision (n = 7); lymphadenectomy was performed in eight patients. In 14 patients, radiotherapy was delivered after incomplete tumor resection, and in 20 patients the planning target volume included the regional lymph nodes. Median total dose of external radiotherapy was 56 Gy/1.8-2 Gy (range, 50-60 Gy). Brachytherapy was given with a total dose of 45 Gy/3 Gy. Results: during a median follow-up of 58.4 months, penile or perineal recurrence was found in four patients giving a 5-year local control rate of 74.8%. Regional failure occurred in two patients. 5-year metastases-free survival and progression-free survival rates were 86.7% and 64.5%, respectively. Four patients died due to tumor progression. The actuarial 5-year cause-specific and overall survival rates were 84.3 and 56.6%, respectively. Conclusion: radiation therapy is a successful method of treatment for penile cancer in terms of local control and organ preservation after microscopically incomplete surgery. Radiotherapy of the regional lymph nodes might also be effective in preventing regional recurrence and can be considered in case of high-risk features and following excision of extensive lymph node involvement. (orig.)

  16. The value of magnetic resonance imaging in the diagnosis of penile fracture

    Scientific Electronic Library Online (English)

    Ibrahim, Guler; Kemal, Ödev; Havva, Kalkan; Cihan, Simsek; Suat, Keskin; Mehmet, Kilinç.

    2015-04-01

    Full Text Available Purpose We studied the use of magnetic resonance imaging in the diagnosis of penile fracture. Materials and Methods Between 1997 and 2012, fifteen patients (age range 17-48 years, mean age 37 years) with suspected penile fracture underwent MRI examinations. Ten patients were injured during sexual i [...] ntercourse, whereas four patients were traumatized by non-physiological bending of the penis during self manupilation, one patient was traumatized falling from the bed. Investigations were performed with 1.5T MR unit. With the patient in the supine position, the penis was taped against the abdominal wall and surface coil was placed on the penis. All patients were studied with axial, coronal, sagittal precontrast and postcontrast T1-weighted TSE(TR/TE:538/13 msn) and T2-weighted TSE(5290/110 msn) sequences. All patient underwent surgical exploration. The follow-up ranged from 3 months to 72 months. Clinically all patients showed normal healing process without complications. In 11 patients a shortening and thickening of tunica albuginea was observed. Three patients have post traumatic erectil disfunction. Results In all patient corpus cavernosum fractures were clearly depicted on a discontinuity of the low signal intensity of tunica albuginea. These findings were most evident on T1WI and also depicted on T2W sequences. Images obtained shortly after contrast medium administration showed considerable enhancement only in rupture site. Subcutaneous extratunical haematoma in all patients were also recognizable on T2 WI. MRI findings were confirmed at surgery. Conclusions Magnetic resonance imaging is of great value for the diagnosis of penile fracture. Furthermore this method is well suited for visualising the post-operative healing process

  17. Penile vibratory stimulation in the treatment of post-prostatectomy incontinence

    DEFF Research Database (Denmark)

    Fode, Mikkel; Sønksen, Jens

    2015-01-01

    AIMS: To examine penile vibratory stimulation (PVS) in the treatment of post-prostatectomy urinary incontinence (UI). METHODS: Patients with post-prostatectomy UI were included in a 12-week trial. A 24-hr pad test and a 72-hr voiding diary were collected at baseline. Participants were randomized to receive PVS for the first 6 weeks (group 1) or for the final 6 weeks (group 2) of the study. The primary outcome was the difference in leakage between groups 1 and 2 at 6 weeks as measured by changes ...

  18. Minimizing Penile Implant Infection: A Literature Review of Patient and Surgical Factors.

    Science.gov (United States)

    Holland, Bradley; Kohler, Tobias

    2015-12-01

    Inflatable penile prosthesis (IPP) is an effective treatment for erectile dysfunction in patients' refractory to oral or injectable treatment. While the rate of infection has decreased over the past decade, it is still the most feared complication of IPP placement. Here, we assemble possible patient and surgical factors attributing to the risk of infection. Studies have been gathered addressing each of these factors, and an Oxford Level of Evidence is assigned to each recommendation based on strength of the study. The goal of this review is to inform surgeons of possible risks in order to further reduce the risk of infection and thus increase success of IPP placement. PMID:26480830

  19. Incidence and cost of anal, penile, vaginal and vulvar cancer in Denmark

    DEFF Research Database (Denmark)

    Olsen, J.; Jorgensen, T. R.; Kofoed, K.; Larsen, H. K.

    2012-01-01

    Background: Besides being a causative agent for genital warts and cervical cancer, human papillomavirus (HPV) contributes to 40-85% of cases of anal, penile, vaginal and vulvar cancer and precancerous lesions. HPV types 16 & 18 in particular contribute to 74-93% of these cases. Overall the number of new cases of these four cancers may be relatively high implying notable health care cost to society. The aim of this study was to estimate the incidence and the health care sector costs of anal, peni...

  20. Glans reconstruction with the use of an inverted urethral flap after distal penile amputation for carcinoma.

    Science.gov (United States)

    Sansalone, Salvatore; Garaffa, Giulio; Vespasiani, Giuseppe; Zucchi, Alessandro; Kuehhas, Franklin Emmanuel; Herwig, Ralf; Silvani, Mauro; Pecoraro, Stefano; Loreto, Carla; Leonardi, Rosario

    2013-03-01

    Restoration of adequate cosmesis and preservation of sexual and urinary function are the main goals of penile reconstructive surgery following amputation for carcinoma. Split thickness skin grafts and oral mucosa grafts have been widely used for the creation of a pseudoglans with excellent cosmetic and functional results. The main drawbacks associated with the use of grafts are donor site morbidity, the lack of engorgement of the pseudoglans and the risk of poor graft take, which may lead to contracture and poor cosmetic results. In the present series the long term cosmetic and functional outcomes of glans reconstruction with an inverted distal urethral flap are described. PMID:23695401

  1. Fratura de pênis com trauma uretra / Penile fracture with urethral trauma

    Scientific Electronic Library Online (English)

    Arlindo Monteiro de, Carvalho Junior; Fábio Martinez de, Melo; Gabriella Alves de Lima, Félix; Juliana Fernandes, Sarmento; Maria Luisa Dutra, Capriglione.

    2013-08-01

    Full Text Available [...] Abstract in english We reported a case of a twenty-nine-year-old male who presented a penile fracture associated with urethral injury caused by a sexual intercourse. An ideal anamnesis and a special physical examination were determinant to correct diagnostics. Ultrasonography and uretrocistography must be performed for [...] confirmation. The treatment is based on the presence of associated urethral injury. The surgical repair of cavernous body and urethra can produce good results, with a favorable prognosis and minimal rate of complications.

  2. Comparison between Tubularised Incised Plate Urethroplasty and Onlay Island Flap Repair in Mid and Proximal Penile Hypospadias

    International Nuclear Information System (INIS)

    Objectives: To evaluate the surgical outcome of tubularised incised plate urethroplasty and onlay island flap repair for mid and proximal penile hypospadias. Methods: The prospective study was conducted at the Bahawal Victoria Hospital, Bahawalpur from June 2011 to May 2013. A total of 60 patients with mid and proximal penile hypospadias in the age range of 02 to 06 years were included. Patients with hypospadias other than mid and proximal penile, with chordee and history of previous hypospadias repair were excluded. Patients were divided into two equal groups. Urethroplasty was done for group I and flap repair for group II. The follow-up period was 12-24 months. SPSS 16 was used for statistical analysis. Results: The mean duration of surgery was 62+-8.72 minutes for group I and 90+-11.25 minutes for group II (p<0.0001). In group I, only 03 (10.0%) patients had complications, while in group II, 09 (30.0%) patients developed complications (p=0.02). Cosmetic results were also excellent in group I compared to group II. Conclusion: Tubularised incised plate urethroplasty was better and superior than onlay island flap repair in terms of less operative time, complication rate and satisfactory cosmetic results for mid and proximal penile hypospadias. (author)

  3. Aspectos clínico-epidemiológicos associados ao câncer de pênis / Clinico-epidemiological aspects associated with penile cancer

    Scientific Electronic Library Online (English)

    Angela Adamski da Silva, Reis; Leonardo Barcelos de, Paula; Adriano Augusto Peclat de, Paula; Vera Aparecida, Saddi; Aparecido Divino da, Cruz.

    2010-06-01

    Full Text Available O objetivo desta revisão bibliográfica foi descrever a epidemiologia, o comportamento biológico dos tumores e os fatores de risco para o câncer de pênis, como a infecção pelo HPV. A fimose e os processos de irritação crônica relacionados à má higiene estão comumente associados com esse tumor, enquan [...] to a circuncisão neonatal protege contra a aparição da doença. Existe forte evidência da associação dos HPV 16 e 18 com o carcinoma peniano em mais de 50% dos casos. Pacientes com lesões penianas suspeitas devem se submeter ao exame físico, geralmente sendo este suficiente para determinar o diagnóstico e o estadiamento, assim como auxiliar na escolha terapêutica. Abstract in english The general objective of this article is to review the current literature regarding the epidemiology, biological behavior and risk factors for penile cancer development, such as HPV infection. Phimosis and chronic irritation related to poor hygiene are commonly associated with penile cancer, whereas [...] neonatal circumcision reduces the relative risk for the disease. There is strong evidence that HPV types 16 and 18 are associated with penile carcinoma in as many as 50% of cases. Patients with penile lesions should undergo physical examination, which is often sufficient to diagnose and to define tumor stagging, as well as contributes to decision-making regarding therapeutical approaches and case management.

  4. Popliteal artery aneurysms.

    Science.gov (United States)

    Davidovic, L B; Lotina, S I; Kostic, D M; Cinara, I S; Cvetkovic, S D; Markovic, D M; Vojnovic, B R

    1998-08-01

    Altogether 59 patients with 76 popliteal artery aneurysms were treated during the last 36 years. There were 50 (85%) male and 9 (15%) female patients with an average age of 61 years. Nineteen (32%) patients had bilateral aneurysms. The clinical manifestations of the aneurysms included ruptures 4 (5.3%); deep venous thrombosis 4 (5.3%); sciatic nerve compression 1 (1.3%); leg ischemia 52 (68.4%), and asymptomatic pulsatile masses 15 (19.7%). Seventy (92%) aneurysms were atherosclerotic, one (1.3%) mycotic, and four (5.3%) traumatic; one (1.3%) developed owing to fibromuscular displasia. Seven (9.2%) small, asymptomatic aneurysms were not operated on. Reconstructive procedures end-to-end anastomosis, graft interposition, bypass) after aneurysmal resection or exclusion using a medial or posterior approach were done in 59 cases. An autologous saphenous vein graft was used in 49 cases, polytetrafluoroethylene (PTFE) in 5, and heterograft in 2 cases. The in-hospital mortality rate was 2.9%, the early patency rate 93.3%, and limb salvage 95%. The long-term patency rate after a mean follow-up of 4 years was 78% and long-term limb salvage 89%. The total limb salvage was 73%, and the total amputation rate was 27%. The dangerous complications associated with popliteal artery aneurysms and the good results after elective procedures suggest that operative treatment is appropriate. PMID:9673552

  5. Strategies for penile prosthesis placement in Peyronie's disease and corporal fibrosis.

    Science.gov (United States)

    Yafi, Faysal A; Sangkum, Premsant; McCaslin, Ian Ross; Hellstrom, Wayne J G

    2015-04-01

    Peyronie's disease (PD) is a wound healing disorder of the tunica albuginea of the penis. PD is generally categorized into two phases: the early acute inflammatory and late chronic fibrotic. Surgical reconstruction is only recommended during the latter established phase. There are a variety of options when erections are functional. However, when erectile dysfunction is present, the gold standard treatment is the placement of an inflatable penile prosthesis with or without additional straightening procedures. General recommendations include that after implanting and inflating the cylinders, if a clinically significant curvature is present, manual modeling is performed. If a residual curve >30° remains after modeling, then various techniques, including plaque releasing incision, is the next step. Grafting can be considered if tunical defects are >2.0 cm. Causes of corporal fibrosis include complications from an infected implant such as explantation, priapism, penile trauma, and prolonged use of an intracavernosal injection agent. Implant placement in the setting of corporal fibrosis can be technically challenging. Available strategies include incision or excision of the scar, corporotomies with or without grafting, the use of cavernotomes, or other specialized dilators, implant downsizing, and transcorporeal resection. PMID:25712763

  6. Penile Metastases of Recurrent Prostatic Adenocarcinoma without PSA Level Increase: A Case Report

    Directory of Open Access Journals (Sweden)

    Antonio Pierro

    2012-01-01

    Full Text Available We report a case of penile metastases from recurrent prostatic adenocarcinoma that was the first sign of a widespread metastatic disease in the absence of any increase in prostate-specific antigen (PSA level. In April 2011, an 80-year-old man presented to our Radiotherapy Unit with multiple palpable hard nodules in the penis, dysuria, and moderate perineal pain, 7 years after he had received radiotherapy for prostate cancer. Nodules in the penis had appeared in February 2011. The ultrasound and magnetic resonance (MR imaging suggested the diagnosis of multiple penile metastases. A total body computed tomography scan revealed a systemic spread of the disease, with multiple metastases in the liver, bones, and lungs. PSA level was 0.126 ng/ml. A fine needle aspiration biopsy of the liver lesion was undertaken, and the histopathologic examination revealed the prostatic origin of the metastases, so androgen deprivation therapy was started. The diagnosis of metastases should be considered in a patient with prior history of prostate malignancies presenting with solid nodules in the penis, even if the PSA level is low.

  7. Celulitis de pene tras sexo oral / Penile cellulitis after oral sex

    Scientific Electronic Library Online (English)

    Francisco, Serrano de la Cruz Torrijos; Francisco Javier, Ramada Benlloch; Joaquín Ulises, Juan Escudero; Milagros, Fabuel Deltoro; Emilio, López Alcina; Pedro, Navalón Verdejo; Macarena, Ramos de Campos; Emilio, Marqués Vidal.

    2008-10-01

    Full Text Available Objetivo: En la actualidad la prevalencia de relaciones sexuales en las que se incluye sexo oral es elevada, esto conlleva una serie de peculiaridades en las infecciones, balanopostitis y celulitis, que pueden producirse en relación con estas prácticas. Métodos: Aportamos 2 nuevos casos de celulitis [...] penea0 na tratados en el Servicio de Urología de nuestro hospital. Discusión: Revisamos las indicaciones de profilaxis, tratamiento médico y quirúrgico referidas en la literatura y practicadas en nuestros pacientes. Conclusiones: La anamnesis ante balanopostitis y celulitis peneanas, debe incluir referencias explícitas a la práctica de sexo oral. La precocidad en el tratamiento, tanto médico como quirúrgico, influye favorablemente en la evolución de las lesiones. Abstract in english Objective: Nowadays, there is the high prevalence of sexual intercourse including oral sex, which implies some peculiarities in the infections, balanitis and cellulitis they may produce. Methods: We report two new cases of penile cellulitis treated in the urology department in our hospital. Discussi [...] on: We review the indications of prophylaxis, and the medical and surgical treatment both referred in the literature and carried out in our patients. Conclusions: When dealing with balanitis and penile cellulitis, the history should include explicit references to the practice of oral sex. Early medical or surgical treatment has a favourable influence on the evolution of the lesions.

  8. A common presentation to an uncommon disease. Penile Mondor's disease: a case report and literature review

    Directory of Open Access Journals (Sweden)

    Walsh JC

    2014-10-01

    Full Text Available John C Walsh,1 Sabré Poimboeuf,2 Daniel S Garvin1 1Naval Air Station Lemoore, Lemoore, CA, USA; 2Lemoore Naval Hospital, Lemoore, CA, USA Abstract: Penile Mondor's disease, or superficial thrombophlebitis of the dorsal vein of the penis, is a relatively uncommon but potentially anxiety-inducing self-limiting condition that should be easily recognizable by any primary care practitioner. It typically presents with a cord-like mass and pain to the dorsal penis and has a myriad of causes, including trauma, excessive sexual activity, excessive exercise, or malignancy. Although Penile Mondor’s disease is typically a clinical diagnosis, Doppler ultrasound is the initial imaging modality of choice if there is question or doubt about the diagnosis. Accurate diagnosis and reassurance about the condition's benign and self-limiting nature assuages most patients' fears. Treatment is primarily symptomatic but may vary depending on possible underlying disease processes. Keywords: thrombophlebitis, cord-like mass, penis, dorsal vein

  9. Extended long term functional outcome of inflatable penile prosthesis in a single institution.

    LENUS (Irish Health Repository)

    Thomas, A Z

    2011-02-01

    We sought to evaluate the extended long term functional outcome of the AMS700 three piece inflatable prosthesis in men with erectile dysfunction in a single urological department and assess our revision rates. Patients that underwent first-time insertion or revision of an AMS700 3 piece inflatable penile prosthesis between 1984-2007 were included. Data was obtained from medical records and long term follow up of patients was conducted by telephone interview. The medical records of 38 patients were available for review. Of these 38 men, 56 prostheses were inserted. The mean follow up was 8.4 years (101 months). The revision rate at 50 months postoperatively was 7\\/38 (18%). The overall revision rate was 18\\/38 (47%). The mean time to revision in these 18 patients was 72 months (12-156 months) after initial insertion of AMS700 penile prosthesis. This study highlights that with longer follow u revision rates markedly increase after 72 months.

  10. [Laser and ultrasonic therapy in simultaneous emission for the treatment of plastic penile induration].

    Science.gov (United States)

    Felipetto, R; Viganò, L; Pagni, G L; Minervini, R

    1995-03-01

    Induratio penis plastica (IPP) or Peyronie's Disease is characterized by the presence of one or more fibrous patches in the tunica albuginea or intercavernous septum. IPP is a slowly evolving disease which may cause a bending of the penis as well as pain during erection. As an alternative to the numerous pharmacological therapies already existing, or in association with them, some kinds of physical treatments, such as ionophoresis, ultrasound therapy and laser therapy, have recently been used. In this study we have evaluated the effectiveness of physical therapy combined with laser and Ultrasounds in the treatment of IPP. Sixty-eight patients were randomly divided into three groups: the first group was treated with orgotein infiltrations, the second with laser and Ultrasounds and the third with an association of both treatments. On the basis of this study, we can affirm that the effectiveness of laser therapy associated with ultrasounds in treating painful symptomatology of IPP at its initial phase overlaps that of orgotein infiltrations. No measurable modifications were documented neither in patch dimensions nor in their echostructures and in no case remarkable modifications of the penile bending were evidenced. Therefore laser therapy associated with ultrasounds represents at the moment an efficacious alternative to medical treatment of IPP at the initial phase, as it does not present any kind of contraindications and it is surely better tolerated than any treatment with penile infiltrations. PMID:7570257

  11. Standardization of Penile Plethysmography Testing in Assessment of Problematic Sexual Interests.

    Science.gov (United States)

    Murphy, Lisa; Ranger, Rebekah; Fedoroff, J Paul; Stewart, Hannah; Dwyer, R Gregg; Burke, William

    2015-09-01

    Penile plethysmography (PPG) is an objective measure of sexual arousal for men, commonly used to assess sexual arousal to both abnormal (i.e., paraphilic) and normal stimuli. While PPG has become a standard measure in the assessment and treatment of male sex offenders and men with paraphilic interests in both Canada and the United States, there is a lack of standardization of stimulus sets and interpretation of results between sites. The current article critically reviews the current state of the art while highlighting clinical and research efforts that may be undertaken in an attempt to reduce issues arising from lack of standardization across sites. Types and themes of stimulus sets, assessment apparatuses, laboratory preparation, and testing procedures are discussed. The continued development of standardized testing protocol and procedures across multiple international sites continues to be encouraged to promote unified PPG administration and interpretation, thus further enhancing the practical utility of the measurements and decreasing inter-rater discrepancies and error. Murphy L, Ranger R, Fedoroff JP, Stewart H, Dwyer RG, and Burke W. Standardization of penile plethysmography testing in assessment of problematic sexual interests. J Sex Med 2015;12:1853-1861. PMID:26350584

  12. Comparison of the effects of prostanoids on human penile circumflex veins and corpus cavernosum tissue

    DEFF Research Database (Denmark)

    Kirkeby, H J; Andersson, K E

    1993-01-01

    The mechanical effects of the prostaglandins PGE1, PGE2, PGF2 alpha and PGI2 were investigated in human isolated penile circumflex veins (CV) and corpus cavernosum (CC) tissue. PGE1 did not affect resting tension, while the compound produced relaxation of both CC and CV preparations after precontraction with noradrenaline (NA) 3 x 10(-6)M. PGE2 produced contraction in CC and CV preparations. After precontraction with NA, however, relaxation was induced in both tissues. PGF2 alpha induced contraction in CC and CV preparations, while no relaxant responses were seen in preparations precontracted with NA. PGI2 produced no mechanical effects in unstimulated CV preparations, whereas dose-related contraction was induced in CC tissue strips. After precontraction with NA, PGI2 showed no effect in 2 of 6 CC preparations, while relaxation was seen in 4. In CV preparations precontracted with NA, PGI2 produced relaxation. Local synthesis of prostanoids may influence resting tension and modulate NA-induced responses not only in human penile CC but also in CV smooth muscle.

  13. Pulmonary Arterial Hypertension: The Clinical Syndrome

    OpenAIRE

    Lai, Yen-Chun; Potoka, Karin C.; Champion, Hunter C.; Mora, Ana L.; Gladwin, Mark T

    2014-01-01

    Pulmonary arterial hypertension (PAH) is a progressive disorder in which endothelial dysfunction and vascular remodeling obstruct small pulmonary arteries, resulting in increased pulmonary vascular resistance and pulmonary pressures. This leads to reduced cardiac output, right heart failure, and ultimately death. In this review, we attempt to answer some important questions commonly asked by patients diagnosed with PAH pertaining to the disease, and aim to provide an explanation in terms of c...

  14. Traumatic Axillary Artery Dissection with Radial Artery Embolism

    International Nuclear Information System (INIS)

    This report describes a case of pathologically proven traumatic arterial dissection, presenting as complete occlusion of the axillary artery with radial artery embolism. Occlusion of the axillary artery by traumatic dissection mimicked transection and radial artery embolism mimicked congenital absence of the radial artery on the initial angiogram, but these were correctly diagnosed with the following sonogram

  15. Hipertensão arterial e sua correlação com alguns fatores de risco em cidade brasileira de pequeno porte Hipertensión arterial y su correlación con algunos factores de riesgo en ciudad brasileña de pequeño tamaño Arterial hypertension and its correlation with some risk factors in a small brazilian town

    Directory of Open Access Journals (Sweden)

    Flávia Miquetichuc Nogueira Nascente

    2010-10-01

    Full Text Available FUNDAMENTO: A hipertensão arterial (HA é um problema de saúde que atinge um grande número de hipertensos não diagnosticados ou não tratados adequadamente e que possui um alto índice de abandono ao tratamento. OBJETIVO: Estimar a prevalência da HA e sua correlação com alguns fatores de risco cardiovasculares na população adulta de Firminópolis-GO. MÉTODOS: Estudo descritivo, observacional e transversal com base populacional, amostra aleatória simples (> 18 anos: questionários padronizados com medidas de pressão arterial (critério de HA > 140 x 90 mmHg, peso, altura, índice de massa corporal (IMC e circunferência da cintura (CC. Dados armazenados (Microsoft Acess e analisados pelo Epi-info. RESULTADOS: Investigados 1.168 indivíduos, com predomínio de mulheres. Sexo feminino - 63,2% com média de idade entre 43,2 ± 14,9 anos. Prevalência de sobrepeso em 33,7% e obesidade em 16,0% dos indivíduos. Prevalência de CC alterada em 51,8% e de tabagismo em 23,2%. Sedentarismo no trabalho e no lazer presente em 67,6% e em 64,8% dos indivíduos, respectivamente, com proporção maior entre as mulheres. Etilismo em 33,3% da amostra. A prevalência de HA foi de 32,7%, em maior número entre os homens (35,8% do que entre as mulheres (30,9%. Encontrada correlação positiva da HA com IMC, CC e faixa etária. Correlação negativa de HA e escolaridade, com 18,2% de hipertensos com nove anos ou mais de estudo. CONCLUSÃO: Encontrada alta prevalência de HA, excesso de peso e CC. O sexo feminino representou fator de proteção para o risco de HA. Encontradas correlação positiva da HA com IMC, CC, e faixa etária e correlação negativa com escolaridade.FUNDAMENTO: La hipertensión arterial (HA es un problema de salud que alcanza a un gran número de hipertensos no diagnosticados o no tratados adecuadamente y que posee un alto índice de abandono del tratamiento. OBJETIVO: Estimar la prevalencia de la HA y su correlación con algunos factores de riesgos cardiovasculares en la población adulta de Firminópolis-GO. MÉTODOS: Estudio descriptivo, observacional y transversal con base poblacional, muestra aleatoria simple (>18 años: cuestionarios estandarizados con medidas de presión arterial (criterio de HA > 140 x 90 mmHg, peso, altura, índice de masa corporal (IMC y circunferencia de la cintura (CC. Datos almacenados (Microsoft Acess y analizados por el Epi-info. RESULTADOS: Investigados 1.168 individuos, con predominio de mujeres. Sexo femenino (63,2% con media de edad entre 43,2 ± 14,9 años. Prevalencia de sobrepeso en 33,7% y obesidad en 16,0% de los individuos. Prevalencia de CC alterada en 51,8%y de tabaquismo en 23,2%. Sedentarismo en el trabajo y en el ocio presente en 67,6% y en 64,8% de los individuos, respectivamente, con proporción mayor entre las mujeres. Etilismo en 33,3% de la muestra. La prevalencia de HA fue de 32,7%, en mayor número entre los hombres (35,8% que entre las mujeres (30,9%. Encontrada correlación positiva de la HA con IMC, CC y franja etárea. Correlación negativa de HA y escolaridad, con 18,2% de hipertensos con nueve años o más de estudio. CONCLUSIÓN: Encontrada alta prevalencia de HA, exceso de peso y CC. El sexo femenino representó factor de protección para el riesgo de HA. Encontradas correlación positiva de la HA con IMC, CC, y franja etárea y correlación negativa con escolaridad.BACKGROUND: Arterial hypertension (AH is a health problem that affects a large number of undiagnosed or inadequately treated hypertensive individuals and presents a high rate of treatment nonadherence. OBJECTIVE: To estimate the prevalence of AH and its correlation with some cardiovascular risk factors among the adult population of the town of Firminopolis, state of Goiás, Brazil. METHODS: Descriptive, observational and cross-sectional population-based study of a simple random sample (age > 18 years: standardized questionnaires with blood pressure (BP measurements (AH criterion: BP > 140 x 90 mmHg, weight, height, Body Mass Index (BMI and waist circumference (WC. Dat

  16. Penile primary melanoma: analysis of 6 patients treated at Brazilian national cancer institute in the last eight years

    Scientific Electronic Library Online (English)

    Gustavo Ruschi, Bechara; Aline Barros de Santos, Schwindt; Antonio Augusto, Ornellas; Diogo Eugenio Abreu da, Silva; Felipe Monnerat, Lott; Franz Santos de, Campos.

    2013-12-01

    Full Text Available Purpose To describe our experience in treating penile melanoma in 06 patients followed at our institution. Materials and Methods Between 2004 and 2012 six consecutive patients with penile melanoma were treated at our Institution. Stage of the disease was classified according to the 2002 AJCC patho [...] logic system. Melanoma in situ (TIS) was diagnosed in one patient. One patient was staged as T1b, two patients as T2b and two patients as T4b. The clinical and pathological findings were evaluated. Immunohistochemical tests were performed for Melan-A, HNB-45, S-100 and C-KIT. All histological specimens were examined by the same pathologist (ABSS). The patients with Cis, stages T1b and one patient T2b underwent only local excision. One patient T2b underwent local excision and sentinel lymph node dissection. Two patients with melanoma stage T4b underwent partial penile amputation. One of these last patients had palpable inguinal lymph nodes at diagnosis and underwent bilateral inguinal lymphadenectomy and received systemic chemotherapy (dacarbazine, 30 cycles). Results Mean follow-up was 36.3 months. One patient, with stage T2b, died after 12 months due to disease recurrence with bilateral inguinal involvement. The patient who underwent chemotherapy progressed with lung metastases and died after 14 months of follow up. The disease-free survival at five years was 33.3%. Conclusion: Penile melanoma is a disease with poor prognosis in most cases. Local excision or partial penile amputation may have effective control for stages T1 and T2 lesions. Patients who have clinically proven metastases died despite surgical and adjuvant chemotherapy.

  17. Digital ischemia: angiographic differentiation of embolism from primary arterial disease

    International Nuclear Information System (INIS)

    Embolic disease is often overlooked as a cause of digital ischemia. Unilateral symptoms, in particular, should suggest the possibility of emboli arising from the subclavian or more distal upper extremity vessels. Emboli may originate in the subclavian artery as the result of atherosclerosis at its origin or arterial injury secondary to thoracic outlet compression. Arteriography can be useful in the identification of upper extremity emboli and their source, and should include studies of the aortic, arch, proximal subclavian artery, and digital arteries. Retrograde subclavian injections may be required to adequately demonstrate the origin of the subclavian artery. Magnification technique is often essential in differentiating small digital artery emboli from primary arterial diseases, such as Buerger disease or scleroderma

  18. Vertebral artery aneurysms.

    Directory of Open Access Journals (Sweden)

    Ravi Kumar C

    2000-04-01

    Full Text Available Vertebral artery (VA aneurysms are rare. We present our experience with three cases of VA aneurysms. Two aneurysms were located close to the origin of basilar artery while the third patient had a giant posterior inferior cerebellar artery aneurysm. These aneurysms were operated by the far lateral inferior suboccipital approach with good results.

  19. Impact of penile rehabilitation with low-dose vardenafil on recovery of erectile function in Japanese men following nerve-sparing radical prostatectomy

    Directory of Open Access Journals (Sweden)

    Yuzo Nakano

    2014-12-01

    Full Text Available Erectile dysfunction (ED is a major complication after radical prostatectomy (RP; however, debate continues regarding the efficacy of penile rehabilitation in the recovery of the postoperative erectile function (EF. This study included a total of 103 consecutive sexually active Japanese men with localized prostate cancer undergoing nerve-sparing RP, and analyzed the postoperative EF, focusing on the significance of penile rehabilitation. In this series, 24 and 79 patients underwent bilateral and unilateral nerve-sparing RPs, respectively, and 10 or 20 mg of vardenafil was administered to 35 patients at least once weekly, who agreed to undergo penile rehabilitation. Twelve months after RP, 48 (46.6% of the 103 patients were judged to have recovered EF sufficient for sexual intercourse without any assistance. The proportion of patients who recovered EF in those undergoing penile rehabilitation (60.0% was significantly greater than that in those without penile rehabilitation (38.2%. Of several parameters examined, the preoperative International Index of Erectile Function-5 (IIEF-5 score and nerve-sparing procedure were significantly associated with the postoperative EF recovery rates in patients with and without management by penile rehabilitation, respectively. Furthermore, univariate analysis identified the preoperative IIEF-5 score, nerve-sparing procedure and penile rehabilitation as significant predictors of EF recovery, among which the preoperative IIEF-5 score and nerve-sparing procedure appeared to be independently associated with EF recovery. Considering these findings, despite the lack of independent significance, penile rehabilitation with low-dose vardenafil could exert a beneficial effect on EF recovery in Japanese men following nerve-sparing RP.

  20. Penile density and globally used chemicals in Canadian and Greenland polar bears.

    Science.gov (United States)

    Sonne, Christian; Dyck, Markus; Rigét, Frank F; Beck Jensen, Jens-Erik; Hyldstrup, Lars; Letcher, Robert J; Gustavson, Kim; Gilbert, M Thomas P; Dietz, Rune

    2015-02-01

    Industrially produced chemicals have been a major environmental concern across our entire Globe since the onset of rapid industrial development around the early 1900. Many of the substances being used are known to be endocrine disrupting chemicals (EDCs) and are also known to be long-range dispersed and to biomagnify to very high concentrations in the tissues of Arctic apex predators such as polar bears (Ursus maritimus). A major concern relating to EDCs is their effects on vital organ-tissues such as bone and it is possible that EDCs represent a more serious challenge to the species' survival than the more conventionally proposed prey reductions linked to climate change. We therefore analyzed penile bone mineral density (BMD) as a key phenotype for reproductive success in 279 polar bear samples born 1990-2000 representing eight polar bear subpopulations. Since EDC concentrations were not available from the same specimens, we compared BMD with published literature information on EDC concentrations. Latitudinal and longitudinal BMD and EDC gradients were clearly observed, with Western Hudson bears having the highest BMD and lowest EDCs, and North East Greenland polar bears carrying the lowest BMD and highest EDCs. A BMD vs. polychlorinated biphenyls (PCB) regression analysis showed that BMD decreased as a function of the eight subpopulations' PCB concentrations and this relationship was close to being significant (p=0.10, R(2)=0.39). Risk quotient (RQ) estimation demonstrated that PCBs could be in a range that may lead to disruption of normal reproduction and development. It is therefore likely that EDCs directly affect development and bone density in polar bears. Canadian bears had in general the best health and the North East Greenland subpopulation being at the highest risk of having negative health effects. While reductions in BMD is in general unhealthy, reductions in penile BMD could lead to increased risk of species extinction because of mating and subsequent fertilization failure as a result of weak penile bones and risk of fractures. Based on this, future studies should assess how polar bear subpopulations respond upon EDC exposure since information and understanding about their circumpolar reproductive health is vital for future conservation. PMID:25601730

  1. Microflora of the penile skin-lined neovagina of transsexual women

    Directory of Open Access Journals (Sweden)

    Claeys Geert

    2009-05-01

    Full Text Available Abstract Background The microflora of the penile skin-lined neovagina in male-to-female transsexuals is a recently created microbial niche which thus far has been characterized only to a very limited extent. Yet the knowledge of this microflora can be considered as essential to the follow-up of transsexual women. The primary objective of this study was to map the neo-vaginal microflora in a group of 50 transsexual women for whom a neovagina was constructed by means of the inverted penile skin flap technique. Secondary objectives were to describe possible correlations of this microflora with multiple patients' characteristics, such as sexual orientation, the incidence of vaginal irritation and malodorous vaginal discharge. Results Based on Gram stain the majority of smears revealed a mixed microflora that had some similarity with bacterial vaginosis (BV microflora and that contained various amounts of cocci, polymorphous Gram-negative and Gram-positive rods, often with fusiform and comma-shaped rods, and sometimes even with spirochetes. Candida cells were not seen in any of the smears. On average 8.6 species were cultured per woman. The species most often found were: Staphylococcus epidermidis, Streptococcus anginosus group spp., Enterococcus faecalis, Corynebacterium sp., Mobiluncus curtisii and Bacteroides ureolyticus. Lactobacilli were found in only one of 30 women There was no correlation between dilatation habits, having coitus, rinsing habits and malodorous vaginal discharge on the one hand and the presence of a particular species on the other. There was however a highly significant correlation between the presence of E. faecalis on the one hand and sexual orientation and coitus on the other (p = 0.003 and p = 0.027 respectively. Respectively 82%, 58% and 30% of the samples showed an amplicon after amplification with M. curtisii, Atopobium vaginae and Gardnerella vaginalis primer sets. Conclusion Our study is the first to describe the microflora of the penile skin-lined neovagina of transsexual women. It reveals a mixed microflora of aerobe and anaerobe species usually found either on the skin, in the intestinal microflora or in a BV microflora.

  2. Incidence and cost of anal, penile, vaginal and vulvar cancer in Denmark

    DEFF Research Database (Denmark)

    Olsen, J.; Jorgensen, T. R.

    2012-01-01

    Background: Besides being a causative agent for genital warts and cervical cancer, human papillomavirus (HPV) contributes to 40-85% of cases of anal, penile, vaginal and vulvar cancer and precancerous lesions. HPV types 16 & 18 in particular contribute to 74-93% of these cases. Overall the number of new cases of these four cancers may be relatively high implying notable health care cost to society. The aim of this study was to estimate the incidence and the health care sector costs of anal, penile, vaginal and vulvar cancer. Methods: New anogenital cancer patients were identified from the Danish National Cancer Register using ICD-10 diagnosis codes. Resource use in the health care sector was estimated for the year prior to diagnosis, and for the first, second and third years after diagnosis. Hospital resource use was defined in terms of registered hospital contacts, using DRG (Diagnosis Related Groups) and DAGS (Danish Outpatient Groups System) charges as cost estimates for inpatient and outpatient contacts, respectively. Health care consumption by cancer patients diagnosed in 2004-2007 was compared with that by an age-and sex-matched cohort without cancer. Hospital costs attributable to four anogenital cancers were estimated using regression analysis. Results: The annual incidence of anal cancer in Denmark is 1.9 per 100,000 persons. The corresponding incidence rates for penile, vaginal and vulvar cancer are 1.7, 0.9 and 3.6 per 100,000 males/females, respectively. The total number of new cases of these four cancers in Denmark is about 270 per year. In comparison, the total number of new cases cervical cancer is around 390 per year. The total cost of anogenital cancer to the hospital sector was estimated to be 7.6 million Euros per year. Costs associated with anal and vulvar cancer constituted the majority of the costs. Conclusions: Anogenital cancer incurs considerable costs to the Danish hospital sector. It is expected that the current HPV vaccination program will markedly reduce this burden.

  3. Popliteal artery entrapment syndrome

    International Nuclear Information System (INIS)

    Popliteal artery entrapment syndrome is an uncommon cause of intermittent claudication in young athletic persons. A 32 years old soldier presented with 14 months history of intermittent claudication. On the basis of history, physical examination and angiographic findings a diagnosis of popliteal artery entrapment was made. Exploration revealed a fibrous band tightly compressing popliteal artery and irreversibly damaged popliteal artery. Short saphenous vein graft was used to bypass the occluded segment of popliteal artery. This led to complete resolution of symptoms and continuation of active service. (author)

  4. The Molecular Genetics and Cellular Mechanisms Underlying Pulmonary Arterial Hypertension

    OpenAIRE

    Machado, Rajiv D

    2012-01-01

    Pulmonary arterial hypertension (PAH) is an incurable disorder clinically characterised by a sustained elevation of mean arterial pressure in the absence of systemic involvement. As the adult circulation is a low pressure, low resistance system, PAH represents a reversal to a foetal state. The small pulmonary arteries of patients exhibit luminal occlusion resultant from the uncontrolled growth of endothelial and smooth muscle cells. This vascular remodelling is comprised of hallmark defects, ...

  5. Superior Mesenteric Artery Syndrome: An Infrequent Complication of Scoliosis Surgery

    OpenAIRE

    Metin Keskin; Turgut Akgül; Adem Bayraktar; Fatih Dikici; Emre Bal?k

    2014-01-01

    Superior mesenteric artery syndrome is a rare condition that causes a proximal small intestinal obstruction due to contraction of the angle between the superior mesenteric artery and the aorta. Scoliosis surgery is one of the 15 reasons for superior mesenteric artery syndrome, which can present with acute or chronic manifestations. Although conservative treatment is usually possible, surgical treatment is required in certain cases that cannot be treated using conservative methods. In this pap...

  6. Bilateral Ductal Stenting for Discontinuity of the Pulmonary Artery via the Femoral and Carotid Arteries in an Infant

    OpenAIRE

    Baspinar, Osman; Sahin, Derya Aydin

    2015-01-01

    Bilateral ductal stenting should be performed in cases of discontinuity of the pulmonary branches and pulmonary atresia. Performing this procedure via the carotid artery in small infants can be very difficult and challenging. We present a case of bilateral ductal stenting via both the femoral and carotid arteries in a little child with tetralogy of Fallot with pulmonary atresia and a nonconfluent pulmonary artery and bilateral ductus arteriosus.

  7. Ischemic stroke: carotid and vertebral artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Vilela, P.; Goulao, A. [Hospital Garcia de Orta, Servico de Neurorradiologia, Almada (Portugal)

    2005-03-01

    Ischemic strokes may have distinct aetiologies, including several different intrinsic arterial pathological disorders. The diagnosis and understanding of these arterial diseases is critical for the correct management of stroke as different treatment approaches are undertaken according to the aetiology. Atherosclerosis is by far the most common arterial disease among adults, and other pathological processes include arterial dissection, small vessel disease, inflammatory and non-inflammatory vasculopathy and vasomotor disorders. In children, there are several vasculopathies responsible for vaso-occlusive disease such as sickle-cell anemia, acute regressive angiopathy and Moya-Moya disease, neurofibromatosis, dissections, vasculitis associated with intracranial and systemic infections. An overview of the major carotid and vertebral pathological diseases responsible for ischemic stroke in adults and children, highlighting the accuracy of the different imaging modalities for its diagnosis and the imaging appearance of these diseases, is given. (orig.)

  8. Trombose em artérias pulmonares pequenas e médias em granulomatose de Wegener: um estudo com microscopia confocal por varredura a laser / Thrombosis in small and medium-sized pulmonary arteries in Wegener's granulomatosis: a confocal laser scanning microscopy study

    Scientific Electronic Library Online (English)

    Alfredo Nicodemos Cruz, Santana; Alexandre Muxfeldt, Ab' Saber; Walcy Rosolio, Teodoro; Vera Luiza, Capelozzi; Carmen Silvia Valente, Barbas.

    2010-12-01

    Full Text Available OBJETIVO: A granulomatose de Wegener (GW) pode causar dano nas células endoteliais e fenômenos tromboembólicos. Entretanto, poucos estudos analisaram a microcirculação pulmonar - artérias pulmonares de pequeno/médio calibre (APPMC) - em pacientes com GW. O objetivo deste estudo foi quantificar tromb [...] os de fibrina em amostras de APPMC de pacientes com GW. MÉTODOS: Analisamos 24 APPMC de seis pacientes com GW e 16 APPMC de quatro pacientes controles sem WG. Utilizamos CD34 para a marcação do endotélio em todas as amostras e microscopia confocal a laser para detectar trombos de fibrina intravasculares. Calculamos a área total do vaso, a área livre do lúmen e a área trombótica. RESULTADOS: A média da área total do vaso foi similar no grupo GW e no grupo controle (32.604 µm² vs. 32.970 µm², p = 0,8793). Trombos foram identificados em 22 das 24 APPMC (91,67%) no grupo GW, e em nenhuma do grupo controle (p Abstract in english OBJECTIVE: Wegener's granulomatosis (WG) can cause endothelial cell damage and thromboembolic events. Nevertheless, there have been few studies on the pulmonary microcirculation-small and medium-sized pulmonary arteries (SMSPA)-in patients with WG. The objective of this study was to quantify fibrin [...] thrombi in the SMSPA of patients with WG. METHODS: We analyzed 24 SMSPA samples collected from six patients with WG and 16 SMSPA samples collected from four patients without WG. In all samples, we used the endothelial cell marker CD34 and confocal laser scanning microscopy in order to detect intravascular fibrin thrombi. We calculated the total vessel area, the free lumen area, and the thrombotic area. RESULTS: The mean total vessel area was similar in the WG and control groups (32,604 µm² vs. 32,970 µm², p = 0.8793). Thrombi were present in 22 (91.67%) of the 24 WG group samples and in none of the control group samples (p

  9. Penile fracture: penoscrotal approach with degloving of penis after Magnetic Resonance Imaging (MRI).

    Science.gov (United States)

    Antonini, Gabriele; Vicini, Patrizio; Sansalone, Salvatore; Garaffa, Giulio; Vitarelli, Antonio; De Berardinis, Ettore; Von Heland, Magnus; Giovannone, Riccardo; Casciani, Emanuele; Gentile, Vincenzo

    2014-03-01

    Fracture of the penis, a relatively uncommon emergency in Urology, consists in the traumatic rupture of the tunica albuginea of the corpus cavernosum. Examination and clinical history can be highly suspicious of penile fracture in the majority of cases and ultrasonography (USS) can be useful to identify the exact location of the tunical rupture, which is proximal in 2/3 of cases and therefore manageable through a penoscrotal approach. Although expensive and not readily available in the acute setting, Magnetic Resonance Imaging (MRI) may play a role in the differential diagnosis with rupture of a circumflex or dorsal vein of the penis or when the tunical rupture is not associated with tear of the overlying Buck's fascia. This form of imaging is more sensitive than USS at identifying the presence of a tunical tear. The treatment of choice is immediate surgical repair, which allows preserving erectile function and minimizing corporeal fibrosis. PMID:24704930

  10. Early history of inflatable penile prosthesis surgery: a view from someone who was there.

    Science.gov (United States)

    Mobley, David F

    2015-01-01

    The publication of the use of an inflatable penile prosthesis (IPP) in 1973 by Dr. FB Scott. changed the world of treatment options for erectile dysfunction (ED). Much has been written since then about techniques, improvements, management of difficult cases, complications and their management, and mechanical and device changes over time. Few reports, if any, are available in the medical literature regarding the early development, surgical techniques, and controversies surrounding its introduction to the world's urological community. This article is, for the most part, the observations of one who was "there" in the early and mid-1970's and was a witness to the history of this remarkable marvel of creativity, engineering, design, and to the personalities involved. PMID:25432494

  11. A rare case of metachronous penile and urethral metastases from a rectal mucinous adenocarcinoma.

    Science.gov (United States)

    Christodoulidou, Michelle; Sahdev, Varun; Muneer, Asif; Nigam, Raj

    2015-01-01

    Metastatic lesions in the penis are uncommon in patients with prostate or bladder cancer but penile metastatic lesions from rectal tumours are rare with only 65 cases reported in the literature. We describe the case of a 70-year-old man who developed metastatic lesions within his corpus cavernosum 2?years after being diagnosed and treated for a mucinous adenocarcinoma of the rectum and a year after a wedge resection of an isolated lung metastasis. He proceeded with total penectomy and intraoperatively two skip lesions were also found within the wall of his urethra; histological analysis proved that these were also metastatic lesions. A perineal urethrostomy was formed with the remaining macroscopically healthy urethra. He made a good recovery from his operation and continued his treatment under the oncology team. PMID:26546626

  12. Sentinel-lymph node procedure in breast, uterine cervix, prostate, vulva and penile cancers: Practical methodology

    International Nuclear Information System (INIS)

    The nodal status is the strongest prognostic factor in early stage cancers. The sentinel-lymph node (S.L.N.) is defined as the first draining lymph node of an organ; the lymph node status is determined by the histological results of S.L.N.. The lymphadenectomy, with high morbidity, is realised only in case of metastatic S.L.N.. The S.L.N. identification, in most of cases, is performed using the combination of blue dye and radiocolloid 99mTc injections. The purpose of this article is to give some practical details about the S.L.N. isotopic procedure in breast cancer, vulva and penile cancer, uterine cervix and prostate cancer. (author)

  13. Epidemiological study of penile cancer in Pernambuco: experience of two reference centers

    Scientific Electronic Library Online (English)

    Thiago Costa do, Couto; Rodrigo Medeiros Barbosa, Arruda; Moisés Costa do, Couto; Felipe Dubourcq, Barros.

    2014-12-01

    Full Text Available Objectives To investigate and analyze the epidemiological profile of penile cancer in the state of Pernambuco and compare this information with other studies related to the issue. Material and Methods We conducted a retrospective, observational and descri [...] ptive study of all patients with penile cancer in two reference centers in Pernambuco - Brazil, from 2007 to 2012. The variables studied were: age, region from the state, socio-economic situation, previous postectomy, smoking, time from the beginning of injury to diagnosis, staging of the primary lesion, tumor differentiation, treatment performed and death due to cancer. Results The total number of patients was 88. The highest prevalence was seen in those aged between 66 and 75 years. About the socio-economic situation, 67% worked informally and 64.8% received up to two minimum wages. Of all patients, 57% were married and 50% illiterate. The Metropolitan Region of Recife was the one with the highest number of cases, 41%. Tobacco smoking was reported in 48.9% of cases and prior postectomy in 3.4%. Most often it was observed an average period of six months from the onset of symptoms to diagnosis. And when the lesion was diagnosed, it usually had 2 to 5 cm (64.7%), stage T2 in 50% and well differentiated in 79.6%. Partial penectomy was performed in 76.1% and total in 17%. Death was observed in 27.3%. Conclusion The clinical profile and epidemiological characteristics found in this study are similar to other national and international studies related to the issue, i.e., typical of underdeveloped or developing countries.

  14. CO2 laser ablation of external genital lesions with a SwiftLase flashscanner: treatment of extramammary Paget's disease of the vulva, penile condylomata, and other lesions

    Science.gov (United States)

    Sacknoff, Eric J.; Schweitzer, Jay; Slatkine, Michael; Mead, Douglass S.

    1995-05-01

    The ability to vaporize extremely thin layers of epithelial tissue without any char and with minimal thermal necrosis is extremely advantageous in the treatment of superficial lesions of the external genitalia. We present a novel CO2 laser `SwiftLase' flashscan technology capable of providing char free ablation of 3 mm diameter lesions with only 150 micron residual thermal necrosis depth at power level as low as 10 watts. These power levels are achievable with a small transportable CO2 laser. The SwiftLaser is a miniature opto- mechanical scanner which homogeneously covers a 3 mm diameter surface with a 0.1 mm spot size focused beam within 0.1 seconds. The instantaneous beam's dwelling time is 1 millisecond. The instantaneous power density level at the focal point is higher than the threshold for char free ablation, thus providing a large char free ablation crater. Since depth of each ablated layer is 0.1 mm, the depth of treatment can be precisely controlled. The SwiftLaser technology has extensively and successfully been used in the last two years for the treatment of HPV in female lower tracts (Vulvectomy). The same technique may be performed with extramammary Paget's disease of the vulva, penile condylomata, and other epithelial disorders of the external genitalia without damage to surrounding healthy tissue. Technique and clinical results will be discussed.

  15. Comparison of Postoperative Analgesic Efficacy of Penile Block, Caudal Block and Intravenous Paracetamol for Circumcision: A prospective Randomized Study

    Scientific Electronic Library Online (English)

    Ahmet Hakan, Haliloglu; Mehmet Ilker, Gokce; Semih, Tangal; Mehmet Salih, Boga; Hakan, Tapar; Ebru, Aladag.

    2013-07-01

    Full Text Available Purpose To evaluate the postoperative analgesic efficacy of penile block, caudal block and intravenous paracetamol administration following circumcision. Materials and Methods In this prospective randomized study a total of 159 patients underwent circumcision under general anesthesia at urology c [...] linic of Ufuk University Faculty of Medicine and Sorgun State Hospital between May 2012 and September 2012. The patients were randomized to three groups to receive penile block (Group 1), caudal block (Group 2) and intravenous paracetamol administration (group 3). Pain measurement of the patients was done via CHEOPS scoring system at 30,60,120 and 180 minutes postoperatively and compared. Statistical tests were performed with a conventional statistics program and statistical significance was set at a p value of

  16. Resistant metastatic penile carcinoma and response to biochemotherapy with paclitaxel and epidermal growth factor receptor monoclonal antibody, nimotuzumab

    Directory of Open Access Journals (Sweden)

    Avinash Pandey

    2013-01-01

    Full Text Available Carcinoma penis is one of the common malignancies in developing world especially among rural population. Multimodality treatment with surgery, radiation and chemotherapy for advanced penile carcinoma with groin nodal metastasis is crucial to optimise the outcome. Cisplatin, fluorouracil, methotrexate, vinorelbine, bleomycin and paclitaxel are the common chemotherapeutic agents used along with local therapy. Paucity of data to show superiority of one chemotherapeutic regime over another and only modest response to any combination chemotherapy. Progression of disease after surgery, radiation and chemotherapy is associated with poor outcome and quality of life. Nimotuzumab, Anti EGFR monoclonal antibody, along with paclitaxel in our case of resistant metastatic penile carcinoma has shown good symptomatic palliation and clinical response.

  17. More than just a cut: a qualitative study of penile practices and their relationship to masculinity, sexuality and contagion and their implications for HIV prevention in Papua New Guinea

    Directory of Open Access Journals (Sweden)

    Kelly Angela

    2012-07-01

    Full Text Available Abstract Background Male circumcision (MC has been shown to reduce vaginal transmission of HIV to men. While community acceptability is important in a countries preparedness to introduce MC, it is equally important to map contemporary MC and other penile cutting practices, and the socio-cultural dimensions underpinning these practices. Methods A total of 482 men and women (n?=?276 and n?=?210, respectively participated in 82 semi-structured and 45 focus group discussions from four different provinces of Papua New Guinea (PNG, each representing one of the four socially and geographically diverse regions of the country. Results Of the men interviewed 131 self-reported that they had undergone a penile alteration with some reporting multiple types. Practices were diverse and could be grouped into five broad categories: traditional (customary penile cutting; contemporary penile cutting; medical circumcision; penile inserts; and penile bloodletting practices in which sharp objects are used to incise the glans and or inserted and withdrawn from the male urethra or in order to induce bleeding. Socio-cultural traditions, enhanced sexual pleasure and improved genital hygiene were key motivators for all forms of penile practices. Conclusions The findings from this study highlight the complex and diverse nature of penile practices in PNG and their association with notions of masculinity, sexuality and contagion. Contemporary penile practices are critical to a community’s acceptance of MC and of a country’s ability to successfully implement MC in the context of a rich and dynamic culture of penile practices. If a MC program were to be successfully rolled out in PNG to prevent HIV it would need to work within and build upon these diverse cultural meanings and motivators for penile practices already commonly performed in PNG by men.

  18. A large unilateral renal artery aneurysm in a young child

    Energy Technology Data Exchange (ETDEWEB)

    Robitaille, P.; Lord, H. [Dept. of Pediatrics, Nephrology Div., Hospital Ste-Justine, Montreal, PQ (Canada); Dubois, J.; Rypens, F. [Dept. of Radiology, Hospital Ste-Justine, Sainte-Catherine, Montreal, PQ (Canada); Oligny, L.L. [Dept. of Pathology, Hospital Ste-Justine, Sainte-Catherine, Montreal, PQ (Canada)

    2004-03-01

    The case of a 13-month-old boy with fibromuscular dysplasia (FMD) presenting with a large saccular aneurysm of the left renal artery and renovascular hypertension is reported. Renal and intrarenal arteries showed numerous small aneurysms alternating with stenoses. All arterial lesions were localized to the left kidney. After left nephrectomy, the patient's blood pressure normalized. Histopathologic examination of the arteries disclosed changes typical of medial fibroplasias, the most frequently described form of FMD in children. This diagnosis is rewarding as it represents a surgically curable cause of severe hypertension. (orig.)

  19. A large unilateral renal artery aneurysm in a young child

    International Nuclear Information System (INIS)

    The case of a 13-month-old boy with fibromuscular dysplasia (FMD) presenting with a large saccular aneurysm of the left renal artery and renovascular hypertension is reported. Renal and intrarenal arteries showed numerous small aneurysms alternating with stenoses. All arterial lesions were localized to the left kidney. After left nephrectomy, the patient's blood pressure normalized. Histopathologic examination of the arteries disclosed changes typical of medial fibroplasias, the most frequently described form of FMD in children. This diagnosis is rewarding as it represents a surgically curable cause of severe hypertension. (orig.)

  20. Penile ulceration caused by a foreign body reaction in a crew member on board a cruise ship.

    Science.gov (United States)

    Garcia-Castaneda, Jenny; Harb-De la Rosa, Alfredo

    2015-01-01

    A crew member had a foreign body implanted subcutaneously on his dorsum penis stealthily 6 years earlier by a fellow crew member without any medical training. He presented to the ship's medical centre after a week of pain, erythema and oedema over the foreign body, which was eventually removed by the patient, leaving behind a penile ulceration. He was treated conservatively initially with intravenous and then with oral antibiotics until complete secondary wound closure was achieved. PMID:25792164

  1. Penile Prosthetic Surgery and its Role in the Treatment of End-Stage Erectile Dysfunction – An Update

    OpenAIRE

    Jain, S.; Terry, TR

    2006-01-01

    The treatment of erectile dysfunction has been revolutionised with the introduction of orally active phosphodiesterase inhibitors which are successful in 70–80% of men. However, there remain a group of men in whom conservative treatment fails and surgical insertion of a penile prosthesis is required. This type of surgery has in the past been associated with technical difficulties and a high complication rate. This has spurred numerous developments in prosthesis design and surgical technique w...

  2. Ruptured visceral artery aneurysms.

    Science.gov (United States)

    Chiaradia, M; Novelli, L; Deux, J-F; Tacher, V; Mayer, J; You, K; Djabbari, M; Luciani, A; Rahmouni, A; Kobeiter, H

    2015-01-01

    Visceral artery aneurysms are rare but their estimated mortality due to rupture ranges between 25 and 70%. Treatment of visceral artery aneurysm rupture is usually managed by interventional radiology. Specific embolization techniques depend on the location, affected organ, locoregional arterial anatomy, and interventional radiologist skill. The success rate following treatment by interventional radiology is greater than 90%. The main complication is recanalization of the aneurysm, showing the importance of post-therapeutic monitoring, which should preferably be performed using MR imaging. PMID:26054246

  3. Duplicated middle cerebral artery

    OpenAIRE

    Perez, Jesus; Machado, Calixto; Scherle, Claudio; Hierro, Daniel

    2009-01-01

    Duplicated middle cerebral artery (DMCA) is an anomalous vessel arising from the internal carotid artery. The incidence DMCA is relatively law, and an association between this anomaly and cerebral aneurysms has been documented. There is a controversy whether DMCA may have perforating arteries. This is an important fact to consider in aneurysm surgery. We report the case of a 34-year-old black woman who suffered a subarachnoid hemorrhage and the angiography a left DMCA, and an aneurysm in an i...

  4. Two giant stones located in the penile and prostatic urethra: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Deniz Bolat

    2012-12-01

    Full Text Available Urethral stones account for less than 2% of all urinary stone diseases in developed countries. Most urethral stones are associated with abnormalities that predispose individuals to urinary stasis and infections, such as strictures, lower urinary tract surgery, congenital or acquired diverticula, chronic urinary infections, foreign bodies, and schistosomiasis. The aim of this case report was to present a fifty-nine-year-old man with two giant penile and prostatic ureteral stones who received a different treatment approach. After the impacted urethral stone was seen in the anterior urethra in ureteroscopy, urethrotomy was performed with a 3 cm vertical incision in the penile urethra. Pneumatic lithotripsy was performed extracorporeally via incision. The stone in the penile urethra was disintegrated and extracted using forceps. The prostatic stone was pushed back into the bladder and disintegrated by the same urethral incision with a lithotripter through a cystourethroscope. For large, impacted urethral stones, external urethrotomy combined with externally pneumatic lithotripsy may prevent long urethral incisions. Therefore, this technique may reduce the risk of postoperative stricture.

  5. Uptake of 3H-choline and synthesis of 3H-acetylcholine by human penile corpus cavernosum

    International Nuclear Information System (INIS)

    The neuroeffectors which relax penile smooth muscle and lead to erection are unknown; physiological studies of human corpus cavernosum, in vitro, have suggested a significant role of cholinergic neurotransmission. To further characterize the importance of cholinergic nerves, biopsies of human corpus cavernosum were obtained at the time of penile prosthesis implantation. Tissues were incubated in 3H-choline (10-5M, 80 Ci/mmol) in oxygenated physiological salt solution at 370C, pH 7.4 for 1 hour. Radiolabelled compounds were extracted with perchloric acid (0.4 M) and acetylcholine and choline were separated by HPLC; 14C-acetylcholine was used as internal standard. 3H-choline was accumulated by the tissues (20 +/- 1.9 fmol/mg), and 3H-acetylcholine was synthesized (4.0 +/- 1.1 fmol/mg). In control experiments, heating of the tissue blocked synthesis of 3H-acetylcholine. Inhibition of high affinity choline transport by hemicholinium-3 (10-5M) diminished tissue accumulation of 3H-choline and significantly reduced the synthesis of 3H-acetylcholine (0.5 +/ 0.2 fmol/mg, p < 0.05). These results provide direct evidence of neuronal accumulation of choline and enzymatic conversion to acetylcholine in human corpus cavernosum. Taken together with the physiological studies, it can be concluded that cholinergic neurotransmission in human corpus cavernosum plays a role in penile erection

  6. Arterial waveform analysis.

    Science.gov (United States)

    Esper, Stephen A; Pinsky, Michael R

    2014-12-01

    The bedside measurement of continuous arterial pressure values from waveform analysis has been routinely available via indwelling arterial catheterization for >50 years. Invasive blood pressure monitoring has been utilized in critically ill patients, in both the operating room and critical care units, to facilitate rapid diagnoses of cardiovascular insufficiency and monitor response to treatments aimed at correcting abnormalities before the consequences of either hypo- or hypertension are seen. Minimally invasive techniques to estimate cardiac output (CO) have gained increased appeal. This has led to the increased interest in arterial waveform analysis to provide this important information, as it is measured continuously in many operating rooms and intensive care units. Arterial waveform analysis also allows for the calculation of many so-called derived parameters intrinsically created by this pulse pressure profile. These include estimates of left ventricular stroke volume (SV), CO, vascular resistance, and during positive-pressure breathing, SV variation, and pulse pressure variation. This article focuses on the principles of arterial waveform analysis and their determinants, components of the arterial system, and arterial pulse contour. It will also address the advantage of measuring real-time CO by the arterial waveform and the benefits to measuring SV variation. Arterial waveform analysis has gained a large interest in the overall assessment and management of the critically ill and those at a risk of hemodynamic deterioration. PMID:25480767

  7. Evolución clínica en los pacientes con implante de prótesis peneana / Clinical evolution in patients with penile prosthesis implant

    Scientific Electronic Library Online (English)

    José, Carreño Rodríguez; Janet, Martínez Abreu; Alberto, Toledo Viera.

    2009-08-01

    Full Text Available Objetivos: 1) Evaluar la satisfacción y evolución clínica de los pacientes con prótesis peneana, como tratamiento de la disfunción eréctil biogénica severa. 2) Identificar las complicaciones más frecuentes asociadas a la intervención quirúrgica. 3) Comparar el comportamiento de la satisfacción sexua [...] l de los pacientes con implante de prótesis peneana y su pareja, antes y después de aplicado el tratamiento. Método: Se realizó un estudio descriptivo longitudinal con metodología cuantitativa y cualitativa donde se evaluaron a 25 hombres a los cuales se les había insertado prótesis peneana en el Hospital Faustino Pérez de Matanzas. Resultados: Las complicaciones que se presentaron en nuestra casuística fueron la perforación de la albugínea, el dolor post operatorio, el pene fino y la expulsión de uno o dos cilindros, esta última en un paciente que presentó sepsis peri protésica. Conclusiones: El implante de prótesis peneana constituyó una opción de tratamiento efectiva que logró un 88% de satisfacción sexual en los pacientes implantados. Los pacientes tratados con la implantación de prótesis peneana y sus parejas refirieron incremento en el erotismo, la actividad sexual satisfactoria, mejoría en la auto estima, la comunicación de pareja, el rendimiento laboral, las relaciones personales y sociales y el fortalecimiento del vínculo de la pareja. Abstract in english Objectives: 1). To evaluate the satisfaction and clinical outcome in patients with penile prosthesis implant as a treatment to Severe Biogenic Erectile Dysfunction. 2). To identify the most frequent complications associated with the surgical intervention. 3). To compare the behaviour of sexual satis [...] faction in partners and patients with penile prosthesis implant before and after the application of the treatment. Methods: A descriptive, (longitudinal) study with quantitative and qualitative methodology was done, where 25 men with penile prosthesis implants, performed at Faustino Perez Hospital, were evaluated. Results: The complications presented in the procedures were perforation of the tunica albuginea, postoperatory pain, thin penis and the expulsion of one or two cylinders, this latter case in a patient who presented periprosthetic sepsis. Conclusions: The penile prosthetic implant constitutes an option of effective treatment which achieves an 88 % of sexual satisfaction in patients. Both partners and patients treated with penile prosthetic implantation referred increase in erotism, satisfactory sexual activity, improvement of self-esteem, quality of communication with their partner, better labour results, interpersonal and social relationships and strengthening of couple's bonds.

  8. BILATERAL DUPLICATION OF RENAL ARTERIES

    OpenAIRE

    Prajkta A Thete; Mehera Bhoir; M. V. Ambiye

    2014-01-01

    Routine dissection of a male cadaver revealed the presence of bilateral double renal arteries. On the right side the accessory renal artery originated from the abdominal aorta just above the main renal artery. On the left side the accessory renal artery originated from the abdominal aorta about 1 cm above the main renal artery. Knowledge of the variations of renal vascular anatomy has importance in exploration and treatment of renal trauma, renal transplantation, renal artery embolization, su...

  9. Application of Human Amniotic Membrane in Canine Penile Tunica Albuginea Defect: First Step toward an Innovating New Method for Treatment of Peyronie?s Disease

    Scientific Electronic Library Online (English)

    M., Salehipour; K., Izadpanah; A., Safaei; M., Kamranpoor; Farsiani, M.R..

    2014-06-01

    Full Text Available Purposes To evaluate the efficacy of human amniotic membrane (AM) grafting in the canine penile tunica albuginea defect; we developed an animal model as the first step toward an innovating new method for the treatment of Peyronie’s disease, penile cancers, and congenital deformities of the penis. [...] Material and Methods From August to September 2011, ten healthy male dogs were selected. A rhomboid incision about 3x2cm over the tunica albuginea and its overlying squamous epithelium was made and then excised. The amniotic membrane was folded twice on itself and grafted on the defect. After 8 weeks, artificial erection was made for 5 dogs and for the other 5 dogs after 12 weeks. After artificial erection, partial penectomy was done and histopathological evaluation was performed on the grafts. Results Artificial erection performed successfully in all of the dogs. No infection or any other complication was seen. Histopathological examination showed complete re-epithelialization with squamous epithelium and collagen fiber deposition. Also, no dysplasia was seen. Conclusions The amniotic membrane can be used as a suitable substitution for tunica albuginea. It is safe, inexpensive, biodegradable, and available and may be used for the treatment of Peyronie’s disease, penile cancers, congenital penile deformities, and penile reconstructive surgery.

  10. The 133Xe clearance technique in the assessment of hypogastric arteries insufficiency

    International Nuclear Information System (INIS)

    The clearance of the radioactive inert gas 133Xenon injected intramuscularly in the gluteal region was studied in healthy subjects and in patients with aortoiliac disease, in order to measure the muscular blood flow (MBF) in the vascular bed of the hypogastric arteries. At rest MBF averaged 6.0 +- 2.1 SD ml/100 g per min in healthy subjects and 5.1 +- 2.7 ml/100 g per min in patients with arterial disease. After exercise-induced hyperemia, maximal MBF in healthy subjects averaged 121.6 +- 60.9 ml/100 g per min, a value markedly higher than the corresponding 6.0 +- 3.6 ml/100 g per min observed in vascular disease patients. The 133Xe values corresponded well, in patients with occlusive vascular disease, with the results obtained in the same subjects by measurement of the penile blood pressure using a Doppler shift ultrasound detector. The 133Xe clearance is a simple and reliable procedure, which could be particularly useful for an assessment of the conditions of hypogastric arteries prior to abdominal surgery. (orig.)

  11. [Transposition of Great Artery].

    Science.gov (United States)

    Konuma, Takeshi; Shimpo, Hideto

    2015-07-01

    Transposition of the great artery is one of common congenital cardiac disease resulting cyanosis. Death occurs easily in untreated patients with transposition and intact ventricular septal defect (VSD) in infancy at a few days of age when posterior descending coronary artery (PDA) closed. Since there are 2 parallel circulations, flow from pulmonary to systemic circulation is necessary for systemic oxygenation, and Balloon atrial septostomy or prostaglandin infusion should be performed especially if patient do not have VSD. Although the advent of fetal echocardiography, it is difficult to diagnose the transposition of the great arteries (TGA) as abnormality of great vessels is relatively undistinguishable. The diagnosis of transposition is in itself an indication for surgery, and arterial switch procedure is performed in the case the left ventricle pressure remains more than 2/3 of systemic pressure. Preoperative diagnosis is important as associated anomalies and coronary artery branching patterns are important to decide the operative indication and timing of surgery. PMID:26197905

  12. Penile density and globally used chemicals in Canadian and Greenland polar bears

    DEFF Research Database (Denmark)

    Sonne, Christian; Dyck, Markus

    2015-01-01

    Industrially produced chemicals have been a major environmental concern across our entire Globe since the onset of rapid industrial development around the early 1900. Many of the substances being used are known to be endocrine disrupting chemicals (EDCs) and are also known to be long-range dispersed and to biomagnify to very high concentrations in the tissues of Arctic apex predators such as polar bears (Ursus maritimus). A major concern relating to EDCs is their effects on vital organ-tissues such as bone and it is possible that EDCs represent a more serious challenge to the species' survival than the more conventionally proposed prey reductions linked to climate change. We therefore analyzed penile bone mineral density (BMD) as a key phenotype for reproductive success in 279 polar bear samples born 1990-2000 representing eight polar bear subpopulations. Since EDC concentrations were not available from the same specimens, we compared BMD with published literature information on EDC concentrations. Latitudinal and longitudinal BMD and EDC gradients were clearly observed, with Western Hudson bears having the highest BMD and lowest EDCs, and North East Greenland polar bears carrying the lowest BMD and highest EDCs. A BMD vs. polychlorinated biphenyls (PCB) regression analysis showed that BMD decreased as a function of the eight subpopulations' PCB concentrations and this relationship was close to being significant (p=0.10, R(2)=0.39). Risk quotient (RQ) estimation demonstrated that PCBs could be in a range that may lead to disruption of normal reproduction and development. It is therefore likely that EDCs directly affect development and bone density in polar bears. Canadian bears had in general the best health and the North East Greenland subpopulation being at the highest risk of having negative health effects. While reductions in BMD is in general unhealthy, reductions in penile BMD could lead to increased risk of species extinction because of mating and subsequent fertilization failure as a result of weak penilebones and risk of fractures. Based on this, future studies should assess how polar bear subpopulations respond upon EDC exposure since information and understanding about their circumpolar reproductive health is vital for future conservation.

  13. A Rare Coronary Artery Anomaly; Double Right Coronary Artery

    Directory of Open Access Journals (Sweden)

    Orhan Önalan

    2010-12-01

    Full Text Available A double right coronary artery is an extremely rare coronary artery anomaly. Difficulties in diagnosis might cause underestimation of the incidence of double right coronary artery. Interestingly, most of the cases about this anomaly were reported from Turkey. In this case report, we aimed to present double right coronary artery in a patient who was admitted with atypic chest pain.

  14. Magnetic resonance angiography in imaging of arterial cerebral circle

    International Nuclear Information System (INIS)

    3D TOF magnetic resonance angiography is commonly used in the imaging of the brain arterial system. As a non-invasive technique of investigation, it is becoming more and more popular in everyday practice. The purpose of the study was to compare 3D TOF MR angiography examinations performed on two units: Visart 6.0 and Gyroscan ASC NT using producers' software. MR angiography was performed in 55 patients. Visart 6.0 was used in 30 cases and Gyroskan ACS NT in 25 cases. We evaluated the anterior part of the arterial circle of the brain. Measurements were taken once for each parameter. The anterior choroidal artery (AChA) was identified with certainty in 73% and anterior communicating artery (AComP) in 81%. Statistical significance was noted in measurements of the diameter of the internal carotid artery (ICA), anterior choroidal artery (AChA), and posterior communicating artery (AComA) in source images and post processing 3D TOF images obtained on both units. Differences in measurements of A1 and M1 diameters of the anterior and medial cerebral arteries did not reach statistical significance. Measurements of the vessels should be made in source images. 3D TOF magnetic resonance angiography allows us to detect even small arterial vessels fitting appropriate field of view (FOV) and thickness of the layer and using appropriate short TE parameters. (author)

  15. Study of the response of the penile corporal tissue and cavernosus muscles to micturition

    Directory of Open Access Journals (Sweden)

    El Sibai Olfat

    2008-03-01

    Full Text Available Abstract Background The reaction of the corpora cavernosa (CC, the corpus spongiosum (CS, the bulbocavernosus (BCM and ischiocavernosus (ICM muscles to passage of urine through the urethra during micturition is not known. We investigated the hypothesis that the passage of urine through the urethra stimulates the corporal tissue and cavernosus muscles. Methods In 30 healthy men (mean age 42.8 ± 11.7 years, the electromyographic activity (EMG of the CC, CS, BCM, and ICM were recorded before and during micturition, and on interruption of and straining during micturition. These tests were repeated after individual anesthetization of urethra, corporal tissue, and cavernosus muscles. Results During micturition, the slow wave variables (frequency, amplitude, conduction velocity of the CC and CS decreased while the motor unit action potentials of the BCM and ICM increased; these EMG changes were mild and returned to the basal values on interruption or termination of micturition. Micturition after individual anesthetization of urethra, corporal tissue and cavernosal muscles did not effect significant EMG changes in these structures, while saline administration produced changes similar to those occurring before saline administration. Conclusion The decrease of sinusoidal and increase of cavernosus muscles' EMG activity during micturition apparently denotes sinusoidal relaxation and cavernosus muscles contraction. Sinusoidal muscle relaxation and cavernosus muscles contraction upon micturition are suggested to be mediated through a 'urethro-corporocavernosal reflex'. These sinusoidal and cavernosus muscle changes appear to produce a mild degree of penile tumescence and stretch which might assist in urinary flow during micturition.

  16. Expanded criteria for Video Endoscopic Inguinal Lymphadenectomy (VEIL) in penile cancer: palpable lymph nodes

    Scientific Electronic Library Online (English)

    Alexandre Stievano, Carlos; Pedro, Romanelli; Ricardo, Nishimoto; Luis M., Montoya; Cesar Augusto Braz, Juliano; Renato Meirelles M. da, Costa Jr; Antonio C. L., Pompeo; Marcos, Tobias-Machado.

    2013-12-01

    Full Text Available Introduction Open inguinal lymphadenectomy is the gold standard for the treatment of inguinal metastasis in patients with penile cancer (PC). Recently the Video Endoscopic Inguinal Lymphadenectomy (VEIL) was proposed as an option to reduce the morbidity of the procedure in patients without palpable [...] inguinal lymph nodes (PILN), however the oncological equivalency in patients with PILN remains poorly studied. The aims of this video are the demonstration of VEIL in patients with PILN and present the preliminary experience comparing patients with and without PILN. Materials and Methods The video illustrates the procedure performed in two cases that were previously underwent partial penectomy for PC with PILN. Data from the series of 15 patients (22 limbs operated) with PILN underwent VEIL were compared with our series of VEIL in 25 clinically N0 patients (35 limbs operated). Results The comparison between the groups with and without PILN found, respectively, these outcomes: age 52,45 × 53,2 years, operative time 126,8 × 95,5 minutes, hospital stay 5. × 3.1 days, drainage time 6.7 × 5.7 days, 9 resected lymph nodes on average in both groups, global complications 32% × 26%, cellulitis 4.5% × 0%, lymphocele 23% in both groups, skin necrosis 0% × 3%, myocutaneous necrosis 4.5% × 0%, pN+ 33% × 32%, cancer specific mortality 7% × 5% and mean follow-up 17.3 × 35.3 months. None of the variables presented p

  17. Glandectomy with preservation of corpora cavernosa in the treatment of penile carcinoma

    Directory of Open Access Journals (Sweden)

    Fonseca Aluizio G. da

    2003-01-01

    Full Text Available INTRODUCTION: The objective of this work is to describe a conservative surgical technique as an alternative to classic penile amputations, aiming the local control of the disease, in addition to trying to preserve the patient's sexual function. SURGICAL TECHNIQUE: After a circular incision of the skin around the penis, the subfascial plane is developed until the base of the organ. The dorsal neurovascular bundle and the urethra are isolated in their distal extremities. The neurovascular bundle is sectioned distally. A retrocoronal dissection plane is developed between the glans and the corpora cavernosa. When this stage is complete, the glans is fixed only to the urethra, which is distally sectioned as well. The neurovascular bundle is fixed to the dorsal albuginea. Following the spatulation of the urethra, a neomeatus is created using the overlay skin of the penis. Between January 2001 and July 2002, we employed this technique in 6 patients who had epidermoid carcinoma of the penis, which were limited to the glans, superficial, well or moderately differentiated and measuring up to 3 cm. COMMENTS: Several conservative surgical methods for treatment of carcinoma of the penis aim the organ's preservation, in an attempt of improving the quality of life of patients, however the indexes of local recurrence and failure in disease control are significant. The described technique showed to be safe and effective for disease control, in addition to preserving sexual function in all patients who were treated, representing, thus, a quite appealing conservative surgical alternative in selected cases.

  18. Renal artery stenosis

    International Nuclear Information System (INIS)

    Renal artery disease is a potentially correctable cause of hypertension. Previous studies have suggested the utility of duplex sonography in accurately detecting and grading the severity of renal artery stenosis. The purpose of this paper is to evaluate color flow Doppler for this use. Forty-three kidneys were examined by color-flow Doppler and conventional duplex sampling in patients with suspected renovascular hypertension or those undergoing aortography for unrelated reasons. Doppler tracings were obtained from the renal arteries and aorta with calculation of the renal aortic ratio (RAR) and resistive index (RI). Results of Doppler sampling with color flow guidance were compared with aortograms in a blinded fashion

  19. Carotid artery surgery - discharge

    Science.gov (United States)

    ... Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease. J. Am. Coll. Cardiol . 2011;124:e54-e130. Eisenhauer AC, White CJ, Bhatt DL. Endovascular treatment of noncoronary obstructive vascular disease. In: Bonow ...

  20. Carotid Artery Disease

    Science.gov (United States)

    ... normal activities without any restrictions. A new “nonsurgical” endovascular treatment uses angio- plasty and stents to open blocked carotid arteries. This procedure’s safety and efficacy continues to ...

  1. Renal arteries (image)

    Science.gov (United States)

    A renal angiogram is a test used to examine the blood vessels of the kidneys. The test is performed ... main vessel of the pelvis, up to the renal artery that leads into the kidney. Contrast medium ...

  2. Neonatal pulmonary artery thrombosis

    OpenAIRE

    Jadhav, Mangesh; Sapre, Ashish; Garekar, Swati; Kulkarni, Snehal

    2012-01-01

    Pulmonary artery thrombosis in neonates is a rare entity. We describe two neonates with this diagnosis; their presentation, evaluation, and management. These cases highlight the importance of this differential diagnosis when evaluating the cyanotic neonate.

  3. Neonatal pulmonary artery thrombosis

    Directory of Open Access Journals (Sweden)

    Mangesh Jadhav

    2012-01-01

    Full Text Available Pulmonary artery thrombosis in neonates is a rare entity. We describe two neonates with this diagnosis; their presentation, evaluation, and management. These cases highlight the importance of this differential diagnosis when evaluating the cyanotic neonate.

  4. Arterial hypoxaemia in cirrhosis

    DEFF Research Database (Denmark)

    Møller, S; Hillingsø, Jens; Christensen, E; Henriksen, J H

    1998-01-01

    BACKGROUND: Although low arterial oxygen tension (Po2) has been claimed to occur in one to two thirds of patients with cirrhosis, hypoxaemia appears to be rare in clinical practice. AIMS: To assess the frequency of arterial hypoxaemia in cirrhosis in relation to clinical and haemodynamic characteristics. PATIENTS: One hundred and forty two patients with cirrhosis without significant hepatic encephalopathy (grades 0-I) (41 patients in Child class A, 57 in class B, and 44 in class C) and 21 patien...

  5. Buerger's disease associated with visceral artery occlusions: computed tomography angiography findings of a case

    International Nuclear Information System (INIS)

    Full text: Introduction: Thromboangiitis obliterans or Buerger's Disease (BD) is characterized by occlusive segmental and often multiple inflammatory lesions of medium and small-sized arteries and superficial veins.This disease rarely effects the visceral arteries. Objectives and tasks: In this report, we present the computed tomography angiography (CTA) findings of a BD case associated with inferior mesenteric and splenic artery occlusions. Materials and methods: A 35-year-old man with BD is referred to our department for aorta and bilateral lower extremity arterial CTA examination. Results: On CTA, abdominal aorta and bilateral iliac arteries were normal. The distal 2/3 of the anterior tibial artery was thin and there were multisegmented stenoses at proximal 1/3 part. Right posterior tibial artery was occluded. In addition to the stenoses of the extremity arteries, splenic artery was occluded and the spleen was feeding by collateral vessels. The proximal part of the inferior mesenteric artery was occluded, as well and the distal segment was filling retrogradely via collaterals. Conclusion: BD rarely effects the visceral arteries. CTA which is used commonly in daily radiology practice, is a reliable imaging modality for the detection of the visceral artery occlusions in addition to the pathologies of the extremity arteries in BD patients

  6. Activation of Penile Proadipogenic Peroxisome Proliferator-Activated Receptor ? with an Estrogen: Interaction with Estrogen Receptor Alpha during Postnatal Development

    OpenAIRE

    Goyal, Hari O.; Tim D. Braden; Dennis, John C.; Schwartz, Dean D.; Judd, Robert L; Frank F. Bartol; Coleman, Elaine S.; Edward E. Morrison; Mansour, Mahmoud M.

    2008-01-01

    Exposure to the estrogen receptor alpha (ERα) ligand diethylstilbesterol (DES) between neonatal days 2 to 12 induces penile adipogenesis and adult infertility in rats. The objective of this study was to investigate the in vivo interaction between DES-activated ERα and the proadipogenic transcription factor peroxisome proliferator-activated receptor gamma (PPARγ). Transcripts for PPARs α, β, and γ and γ1a splice variant were detected in Sprague-Dawley normal rat penis with...

  7. Global metabolic optimality in the structure of the coronary arteries

    CERN Document Server

    Keelan, Jonathan; Hague, James P

    2014-01-01

    The structure of the large coronary arteries is both heritable and reasonably consistent between individuals, but the extent to which this results from evolutionary pressure towards an energy-efficient, globally-optimal, structure is unknown. We present an algorithm for the determination of an energetically globally optimal arterial tree in arbitrary tissue geometries. We demonstrate through application of the algorithm that it is possible to generate in-silico vasculatures that closely match porcine anatomical data on all length scales. We therefore conclude that evolutionary pressure has resulted in a near globally optimal structure of the larger coronary arteries. We also examine the effect of changing length scales, predicting that the structures of the coronary arteries can change from a meandering form for small animals to very straight vessels for large animals. The method presented here is not limited to hearts, and represents a major advance in modeling the arterial vasculature, that could have impor...

  8. Giant Coronary Artery Aneurysm Following Takeuchi Repair for Anomalous Left Coronary Artery from the Pulmonary Artery

    OpenAIRE

    Shannon M. Dunlay; Crystal R. Bonnichsen; Dearani, Joseph A.; Warnes, Carole A.

    2013-01-01

    A 33 year old woman with anomalous left coronary artery arising from the pulmonary artery status post Takeuchi repair at age 7 presented for evaluation. The Takeuchi procedure creates an aortopulmonary window and an intrapulmonary tunnel that baffles the left coronary artery to the aorta. A mediastinal mass was identified as a giant aneurysm of the left coronary artery resulting in compression of the pulmonary artery and left upper pulmonary vein. The patient underwent open repair with patch ...

  9. Expression of the androgen receptor gene in rat penile tissue and cells during sexual maturation.

    Science.gov (United States)

    Gonzalez-Cadavid, N F; Swerdloff, R S; Lemmi, C A; Rajfer, J

    1991-09-01

    The cessation of rat and human penile growth at completion of sexual maturation appears to be related to a tissue-specific decrease in the number of androgen receptors (AR) in the penis. To find out whether this is due to either transcriptional or translational regulation of the AR gene, we determined the levels of AR mRNA by Northern blots in the corpora cavernosa from groups of 16-, 19-, 22-, 27-, 52-, and 90-day-old rats. The AR mRNA rapidly decreases with age and is nearly undetectable in the 52- and 90-day-old rats, paralleling the decline in AR number. The persistence of a low amount of AR mRNA in the adult penis was confirmed by reverse transcription/polymerase chain reaction amplification of total RNA, and its level was estimated by a semiquantitative modification of this procedure at less than 1/25th of that found in the youngest rats. Smooth muscle cells derived from the 16- and 90-day-old corpora cavernosa express in the AR gene in vitro in approximately the same levels, suggesting that there are factors in culture that up-regulate the AR mRNA. Our results are compatible with the assumption that the age-dependent decrease in AR in the rat penis is due to transcriptional regulation, although they do not exclude the less likely alternative of a selective effect on AR mRNA stability and support the use of this model for studying tissue-specific factors controlling the developmental expression of the AR gene. PMID:1874196

  10. Extracorporeal transient distal penile corporoglanular shunt in early ischemic priapism treatment

    Scientific Electronic Library Online (English)

    Onder, Canguven; Raidh A., Talib.

    2014-10-01

    Full Text Available Purpose Ischemic priapism, which is a compartment syndrome, needs urgent treatment in order to nourish corpora cavernosa. As the first step, the aspiration of blood and/or the irrigation of the cavernosal bodies are performed to prevent fibrotic activity and secure erectile capability. While perfor [...] ming aspiration and irrigation, there are some risks of the procedure in which most refrained one is cardiovascular side effects of adrenergic agonists. We aimed to evaluate extracorporeal transient distal penile corporoglanular shunt technique in place of aspiration/ irrigation techniques for early ischemic priapism treatment. Materials and Methods In this transient shunt technique, a sterile closed system blood collection set (BD Vacutainer, Cat. No.: 367282; NJ, USA), which has two 21G needles, was used. The length of the needle and tubing was 19 mm. (0.75 inch) and 178 mm. (7 inches), respectively. This blood collection set was designed to be used not only for blood collection but can also be used for short term infusions (maximum 2 hours). Results Ten patients out of fifteen with early ischemic priapism were successfully treated with this transient shunt technique. The permanent detumescence achieved in the first 10 minutes in nine out of fifteen patients. No additional procedure needed after the disappearance of rigidity in successfully treated patients. The permanent detumescence achieved in the first 10 minutes in nine out of fifteen patients. Conclusions We demonstrated that this extracorporeal transient shunt technique gets some advantages over aspiration and irrigation in early ischemic priapism treatment. Our results indicate that the presented technique to be offered for the patients with an ischemic priapism episode of no more than 7 hours.

  11. Hipertensão arterial e sua associação com índices antropométricos em adultos de uma cidade de pequeno porte do interior do Brasil / Hypertension and its association to anthropometric indexes in adults from a small city ln Brazil

    Scientific Electronic Library Online (English)

    Flávia Miquetichuc Nogueira, Nascente; Paulo César Brandão Veiga, Jardim; Maria do Rosário Gondim, Peixoto; Estelamaris Tronco, Monego; Weimar Kunz Sebba, Barroso; Humberto Graner, Moreira; Priscila Valverde de Oliveira, Vitorino; Luiz Nazário, Scala.

    Full Text Available OBJETIVO: Estimar a prevalência da Hipertensão Arterial (HA) em adultos e sua associação com o Índice de Massa Corporal (IMC) e Circunferência da Cintura (CC). MÉTODOS: Estudo descritivo, observacional e transversal, de base populacional, com amostra aleatória simples (>18 anos). Investigados 1.168 [...] indivíduos. Questionários padronizados. Realizadas medidas de pressão arterial (critério de HA > 140x90mmHg), peso, altura e CC. Dados armazenados (programa Microsoft Access) e analisados por meio do programa Epi-info, versão 3.3.2. RESULTADOS: Predomínio do sexo feminino (63,2%), idade média 43,2 ± 14,9 anos. Prevalência de HA de 32,7%, com tendência a ser maior entre homens (35,8%) que entre mulheres (30,9%) (p=0,084). Associação positiva (p Abstract in english OBJECTIVE: Estimate the prevalence of Arterial Hypertension (AH) and its association with Body Mass Index (BMI) and Abdominal Circumference (AC) in the adult population from the city of Firminópolis, in the state of Goiás, Brazil. METHODS: Descriptive, observational, cross sectional population-based [...] study substantiated by a home survey of a simple random sample (>18 years old). The study evaluated 1168 individuals. Standardized questionnaires. Measurements performed were Blood Pressure (BP) (hypertension: BP > 140x90mmHg), weight,, height and AC. Microsoft Office Access and Epi-info, 3.3.2 version were used for data storage and analysis, respectively. RESULTS: There was a predominance of females (63.2%), mean age was 43.2 ±14.9 years old. Prevalence of hypertension was 32.7%, with tendency to be higher among the male population (35.8%) when compared to the female (30.9%) (p=0.084). Association between AH and BMI was positive (p

  12. Congenital coronary artery anomaly simulating a ventricular septal defect.

    Science.gov (United States)

    Azari, Ali; Moravvej, Zahra; Fazlinezhad, Afsoon; Bigdelu, Leila

    2015-11-01

    Anomalous origin of the circumflex artery of the right sinus of Valsalva is a rare finding which may be present with other cardiac malformations. A 19-year-old man presented with syncope. A transthoracic echocardiogram revealed discrete subaortic stenosis with a small defect just below the aortic valve, suggesting a ventricular septal defect. Transesophageal echocardiography showed anomalous origin of the circumflex artery from the right sinus of Valsalva. This was confirmed by coronary angiography. The patient underwent successful web resection without concomitant coronary surgery. Failure to demonstrate a coronary artery anomaly can be misleading for surgeons and perilous for patients. PMID:24719168

  13. Sexual scripting of heterosexual penile-anal intercourse amongst participants in an HIV prevention trial in South Africa, Uganda and Zimbabwe.

    Science.gov (United States)

    Duby, Zoe; Hartmann, Miriam; Montgomery, Elizabeth T; Colvin, Christopher J; Mensch, Barbara; van der Straten, Ariane

    2016-01-01

    Sexual risk-taking is influenced by individual, interpersonal and social factors. This paper presents findings from a qualitative follow-up study to a clinical trial evaluating biomedical HIV prevention products among African women, explored participants' perceptions and experiences of heterosexual penile-anal intercourse, as well as the gendered power dynamics and relationship contexts in which this sexual behaviour occurs. In-depth interviews were conducted with 88 women from South Africa, Uganda and Zimbabwe. Findings reveal that despite its social stigmatisation, women engage in penile-anal intercourse for reasons including male pleasure, relationship security, hiding infidelity, menstruation, vaginal infections, money and beliefs that it will prevent HIV transmission. In addition, participants described experiences of non-consensual penile-anal intercourse. We used sexual scripting theory as an analytical framework with which to describe the sociocultural and relationship contexts and gendered power dynamics in which these practices occur. These data on the distinct individual, dyadic and social contexts of heterosexual penile-anal intercourse, and the specific factors that may contribute to women's HIV risk, make a unique contribution to our understanding of heterosexual behaviour in these sub-Saharan countries, thereby helping to inform both current and future HIV prevention efforts for women in the region. PMID:26223703

  14. Effects of vasodilators on isolated human uteroplacental arteries

    DEFF Research Database (Denmark)

    Allen, J; Skajaa, K; Maigaard, S; Forman, Axel

    1991-01-01

    The effects of the vasodilator drugs hydralazine, labetalol, prazosin, and nitrendipine were studied on responses to K+ (124 mmol/L), noradrenaline, vasopressin, and angiotensin II in small human maternal intramyometrial arteries and on responses to K+, prostaglandin (PG) F2 alpha, and angiotensin II in fetal stem villous arteries. The vessels were dissected from biopsy specimens obtained during term cesareans and mounted in organ baths. Hydralazine failed to inhibit responses to any of the agon...

  15. Pulmonary arterial dysfunction in insulin resistant obese Zucker rats

    OpenAIRE

    Cogolludo Angel; Moreno Enrique; Moreno Laura; Menendez Carmen; Moral-Sanz Javier; Perez-Vizcaino Francisco

    2011-01-01

    Abstract Background Insulin resistance and obesity are strongly associated with systemic cardiovascular diseases. Recent reports have also suggested a link between insulin resistance with pulmonary arterial hypertension. The aim of this study was to analyze pulmonary vascular function in the insulin resistant obese Zucker rat. Methods Large and small pulmonary arteries from obese Zucker rat and their lean counterparts were mounted for isometric tension recording. mRNA and protein expression w...

  16. Life threatening coronary artery spasm in childhood Kimura's disease

    OpenAIRE

    Horigome, H.; Sekijima, T; Ohtsuka, S; Shibasaki, M.

    2000-01-01

    A 13 year old boy is described with hypereosinophilia associated with Kimura's disease, who showed repeated life threatening syncopal attacks during daily activities or at rest. Coronary arteriography demonstrated small aneurysms with irregular vessel walls of both coronary arteries, and the absence of organic stenotic lesions. Infusion of a minimal dose of ergonovine into the right coronary artery induced severe spasm of the vessel. Ventricular fibrillation recurred even after administration...

  17. Excess adenosine in murine penile erectile tissues contributes to priapism via A2B adenosine receptor signaling.

    Science.gov (United States)

    Mi, Tiejuan; Abbasi, Shahrzad; Zhang, Hong; Uray, Karen; Chunn, Janci L; Xia, Ling Wei; Molina, Jose G; Weisbrodt, Norman W; Kellems, Rodney E; Blackburn, Michael R; Xia, Yang

    2008-04-01

    Priapism, abnormally prolonged penile erection in the absence of sexual excitation, is associated with ischemia-mediated erectile tissue damage and subsequent erectile dysfunction. It is common among males with sickle cell disease (SCD), and SCD transgenic mice are an accepted model of the disorder. Current strategies to manage priapism suffer from a poor fundamental understanding of the molecular mechanisms underlying the disorder. Here we report that mice lacking adenosine deaminase (ADA), an enzyme necessary for the breakdown of adenosine, displayed unexpected priapic activity. ADA enzyme therapy successfully corrected the priapic activity both in vivo and in vitro, suggesting that it was dependent on elevated adenosine levels. Further genetic and pharmacologic evidence demonstrated that A2B adenosine receptor-mediated (A2BR-mediated) cAMP and cGMP induction was required for elevated adenosine-induced prolonged penile erection. Finally, priapic activity in SCD transgenic mice was also caused by elevated adenosine levels and A2BR activation. Thus, we have shown that excessive adenosine accumulation in the penis contributes to priapism through increased A2BR signaling in both Ada -/- and SCD transgenic mice. These findings provide insight regarding the molecular basis of priapism and suggest that strategies to either reduce adenosine or block A2BR activation may prove beneficial in the treatment of this disorder. PMID:18340377

  18. Hipertensión arterial: Aspectos fisiopatológicos

    Directory of Open Access Journals (Sweden)

    Alfredo Vázquez Vigoa

    1996-12-01

    Full Text Available Se revisaron los aspectos fisiopatológicos que intervienen en la génesis de la enfermedad hipertensiva para actualizar los conocimientos en relación con los mecanismos que generan la hipertensión arterial. Se hizo hincapié en el aumento de la resistencia periférica, los trastornos de excreción del sodio y las alteraciones del transporte de sodio a través de la membrana. Comentamos además las nuevas teorías sobre recientes sustancias vasoactivas capaces de incrementar el tono vascular, como la endotelina, y relacionamos los sistemas locales o autocrinos de renina/angiotensina/aldosterona con la hipertensión arterial. Se concluye que sobre el sustrato o fondo poligénico de la hipertensión se superponen alteraciones humorales capaces de perpetuar la elevación de la presión arterial.The physiopathological aspects involved in the genesis of the hypertensive disease were revised in order to up-date the understanding regarding the mechanisms which generate high blood pressure. Emphasis was made in the increased peripheral resistance, the disorders of sodium excretion and on alterations regarding the sodium transport through the membrane. In addition, new theories about certain vasoactive substances recently found, capable of increasing the vascular tone such as endotelin, are also pointed out. Local or self endocrine systems of renin/angiotensin/aldosterone were found to be related to arterial hypertension. The authors concluded that certain humoral alterations capable of perpetuating the elevated arterial pressure are superimposed over the polygenic sustrate of hypertension.

  19. Blood Flow in Arteries

    Science.gov (United States)

    Ku, David N.

    Blood flow in arteries is dominated by unsteady flow phenomena. The cardiovascular system is an internal flow loop with multiple branches in which a complex liquid circulates. A nondimensional frequency parameter, the Womersley number, governs the relationship between the unsteady and viscous forces. Normal arterial flow is laminar with secondary flows generated at curves and branches. The arteries are living organs that can adapt to and change with the varying hemodynamic conditions. In certain circumstances, unusual hemodynamic conditions create an abnormal biological response. Velocity profile skewing can create pockets in which the direction of the wall shear stress oscillates. Atherosclerotic disease tends to be localized in these sites and results in a narrowing of the artery lumena stenosis. The stenosis can cause turbulence and reduce flow by means of viscous head losses and flow choking. Very high shear stresses near the throat of the stenosis can activate platelets and thereby induce thrombosis, which can totally block blood flow to the heart or brain. Detection and quantification of stenosis serve as the basis for surgical intervention. In the future, the study of arterial blood flow will lead to the prediction of individual hemodynamic flows in any patient, the development of diagnostic tools to quantify disease, and the design of devices that mimic or alter blood flow. This field is rich with challenging problems in fluid mechanics involving three-dimensional, pulsatile flows at the edge of turbulence.

  20. Transcatheter Arterial Embolization for Spontaneous Rupture of the Omental Artery

    International Nuclear Information System (INIS)

    We encountered a rare case of spontaneous rupture of the omental artery. A 25-year-old man without any episode of abdominal trauma or bleeding disorders came to the emergency unit with left upper abdominal pain. Hematoma with extravasation of the greater omentum and a hemoperitoneum was confirmed on abdominal contrast-enhanced computed tomography. Bleeding from the omental artery was suspected based on these findings. Transcatheter arterial embolization was successfully performed after extravasation of the omental artery, which arises from the left gastroepiploic artery, was confirmed on arteriography. Partial ometectomy was performed 10 days after transcatheter arterial embolization, revealing that the hematoma measured 10 cm in diameter in the greater omentum. Pathological examination showed rupture of the branch of an omental artery without abnormal findings, such as an aneurysm or neoplasm. Thus, we diagnosed him with spontaneous rupture of the omental artery. The patient recovered and was discharged from the hospital 10 days after the surgery, with a favorable postoperative course.

  1. Experimental studies on reconstruction of peripheral arteries by high voltage cathode ray irradiated allografts

    International Nuclear Information System (INIS)

    The use of cathode ray irradiated arterial allografts on the reconstruction of small peripheral arteries is described. The fate of irradiated arterial allografts implanted subcutaneously in rats was compared histologically with that of allografts which were fresh, frozen or stored in 70% alcohol. Follow-up studies were made of 10 dogs in which irradiated arterial allografts had been implanted in the femoral artery to be evaluated; long term patency by arteriography, gross and histologic changes of the implanted allografts, and the luminal surface of the implanted allografts by scanning electron microscopic studies. For the purpose of antigenic studies, extracts of canine arteries which had been irradiated, frozen or stored in 70% alcohol, were prepared and tested by the following immunological methods: precipitation, Ouchterlony gel diffusion, and passive cutaneous anaphylaxis. From the results obtained in these experiments, it was concluded that, compared with fresh or frozen grafts and those stored in 70% alcohol, irradiated arterial allografts are the most suitable substitute for the reconstruction of small arteries because of the paucity of morphological damage and inflammatory reaction. The excellent and long term patency of the canine femoral artery implanted with irradiated arterial allografts was proved. On the basis of immunological studies, it is evident that cathode ray irradiation to the arterial allografts can greatly reduce their antigenicity. (Evans, J.)

  2. Cambios morfométricos peneanos tras prostatectomía radical: revisión de la evidencia / Penile morphometric changes after radical prostatectomy: Evidence-based

    Scientific Electronic Library Online (English)

    J.I., Martínez-Salamanca; C., Martínez-Ballesteros; L., Portillo; I., Moncada; J., Carballido.

    2010-08-01

    Full Text Available Introducción: La prostatectomía radical en cualquiera de sus abordajes representa el tratamiento de elección del cáncer localizado de la próstata y especialmente en pacientes jóvenes sexualmente activos con deseo de mantener su vida sexual. Además de la bien conocida y definida disfunción eréctil po [...] stoperatoria, el período de silencio eréctil causa en muchos pacientes (9-71%) cambios estructurales, a veces irreversibles, en la estructura peneana. Estos cambios tisulares derivan en una pérdida de longitud y grosor del pene, que preocupa a los pacientes. Objetivo: Revisar de manera sistemática los datos publicados en la literatura médica hasta el momento en relación con los cambios peneanos tras prostatectomía radical. Material y métodos: Realizamos una búsqueda sistemática en PubMed, EMBASE, Cochrane, SCOPUS y Science Citation Index durante el período de enero de 1990 a septiembre de 2009 para los términos «prostatectomy», «organ size», «fibrosis», «sexual activity», «erectile dysfunction», «penile size», «radical prostatectomy», «prostatic neoplasms», «body weights» y «penis measures». Se seleccionaron 7 series de pacientes para su análisis. Resultados: Se exponen los diferentes métodos de medición peneana y sus potenciales sesgos y diferencias. Asimismo, repasamos las principales teorías fisiopatogénicas para explicar este fenómeno. Finalmente, se detallan los resultados de diferentes series de pacientes comunicadas. Conclusiones: Parece un hecho demostrado que el pene sufre cambios importantes en su longitud y grosor tras prostatectomía radical. Diferentes autores han comunicado los datos de sus series así como las diferentes opciones de tratamiento (inhibidores de la 5-PDE, dispositivos de vacío [DV], extensores del pene, etc.). Las estrategias encaminadas a preservar y a proteger el tejido cavernoso y la túnica albugínea tras el procedimiento así como las que aumenten la oxigenación y permitan recuperar la erección en el menor tiempo posible impactarán positivamente en la calidad de nuestros pacientes. Abstract in english Introduction: Radical prostatectomy in all its approaches is the treatment of choice for localized prostate cancer and especially in young, sexually active patients with a desire to keep their sex life. In addition to the well-known and defined postoperative erectile dysfunction, erectile silent per [...] iod causes, in many patients (9-1%), structural changes, in the penile structure, sometimes irreversible. These tissue changes, resulting in a loss of length and girth, that concern patients. Objective: To systematically review to date published data in the literature regarding penile changes after radical prostatectomy. Material and methods: We performed a systematic search in: PubMed, EMBASE, Cochrane, SCOPUS, Science Citation Index period January 1990 to September 2009 for the terms "prostatectomy", "organ size", "fibrosis", "sexual activity", "erectile dysfunction", "penile size", "radical prostatectomy", "prostatic neoplasms", "body weights" and "penis measures". Seven series of patients were selected for analysis. Results: We described the different measurement methods and their potential biases and differences. Also, we reviewed main physiopathogenic theories to explain this phenomenon. Finally, we detail the results of different series of patients reported. Conclusions: It seems to be a proven fact that the penis undergoes major changes in its length and girth after radical prostatectomy. Several authors have communicated the data of their series and the different treatment options (5PDE inhibitors, vacuum devices, penile extenders, etc.). Strategies addressed to preserve and protect cavernous tissue and tunica albuginea after the procedure, as well as to increase oxygenation and allow erection to be recovered in the shortest posible time positive will impact on the quality of life of our patients.

  3. The Role of Accessory Obturator Arteries in Prostatic Arterial Embolization

    OpenAIRE

    Bilhim, T; Pisco, J; Campos Pinheiro, L; Rio Tinto, H; Fernandes, L.; Pereira, J.

    2014-01-01

    In 9 of 491 patients (1.8%) who underwent prostatic arterial embolization (PAE) for benign prostatic hyperplasia from March 2009-November 2013, prostatic arteries arose from the external iliac artery via an accessory obturator artery (AOA). Computed tomography angiography performed before the procedure identified the variant and allowed planning before the procedure. The nine AOAs were catheterized from a contralateral femoral approach. Bilateral PAE was technically successful in the nine pat...

  4. Endothelial derived hyperpolarization in renal interlobar arteries

    DEFF Research Database (Denmark)

    Brasen, Jens Christian; Sørensen, Charlotte M.

    2015-01-01

    In small arteries, vascular smooth muscle cells (VSMCs) and endothelial cells (ECs) are connect by myoendothelial junctions (MEJ), usually extending from the EC. Ca2+ activated K+ channels (IKCa and SKCa) located in the MEJ are suggested to play a role in NO-independent endothelium derived hyperpolarization (EDH) of VSMCs. The IKCa and SKCa channels could affect the VSMC through direct electrical coupling via myoendothelial gap junctions (MEGJ). Alternatively, K+ released from the EC into the in...

  5. Twenty-four-hour exposure to altered blood flow modifies endothelial Ca2+-activated K+ channels in rat mesenteric arteries

    DEFF Research Database (Denmark)

    Hilgers, Rob H P; Janssen, Ger M J; Fazzi, Gregorio E; De Mey, Jo G R

    2010-01-01

    We tested the hypothesis that changes in arterial blood flow modify the function of endothelial Ca2+-activated K+ channels [calcium-activated K+ channel (K(Ca)), small-conductance calcium-activated K+ channel (SK3), and intermediate calcium-activated K+ channel (IK1)] before arterial structural remodeling. In rats, mesenteric arteries were exposed to increased [+90%, high flow (HF)] or reduced blood flow [-90%, low flow (LF)] and analyzed 24 h later. There were no detectable changes in arterial ...

  6. Catheterization of cerebral arteries under real-time MR imaging guidance: an experimental study in pigs

    International Nuclear Information System (INIS)

    Objective: To investigate the feasibility of catheterization of cerebral arteries under the real-time MR imaging guidance in experimental pigs. Methods: Ten small-sized female pigs were selected for this study. Via the femoral access, percutaneous catheterization with a 3 F active MR-tracking microcatheter was performed under real-time MRI guidance and the microcatheter was separately placed into bilateral ascending pharyngeal arteries. After the procedure, all the pigs were sacrificed and sent for pathologic examination. Gross pathologic examination of aortic arches, brachio-cephalic arteries, carotid arteries and ascending pharyngeal arteries was performed to search for the perforation and dissection. Results: MR angiography revealed that in pigs the bilateral ascending pharyngeal arteries formed an arteriolar network at the cranial base, supplying blood flow to the brain. Catheterization of ascending pharyngeal arteries from the femoral artery access was successfully performed in all 10 pigs with the help of real-time MR imaging-guidance. A single procedure took about 4-12 minutes. Macroscopically, no evidence of vascular injury of aortic arches, brachio-cephalic arteries, carotid arteries and ascending pharyngeal arteries was found. Conclusion: Under real-time MRI guidance the catheterization of cerebral arteries can be correctly and quickly accomplished in experimental pigs. (authors)

  7. Left Anterior Descending Artery-Pulmonary Artery Fistula

    Directory of Open Access Journals (Sweden)

    Turan Ege

    2011-12-01

    Full Text Available Despite the fact that coronary arteriovenous fistulas constitute approximately half (48% of coronary artery anomalies, they are rarely seen anomalies. In this report,we aim to present a coronary arteriovenous fistula case detected during a coronary angiography between left anterior descending artery and pulmonary artery.

  8. Implante de cartilagem auricular autóloga no reparo de desvio de pênis de bovinos / Implantation of the autologous auricular cartilagem in the repair of penile deviation in cattle

    Scientific Electronic Library Online (English)

    Duvaldo, Eurides; Luiz A.F., Silva; Carlos R., Daleck; Maria C.S., Fioravanti; Gentil F., Gonçalves; Olizio C., Silva; Andrigo B., Nadri.

    2009-03-01

    Full Text Available Dezoito novilhos de diferentes raças, com idade de 18-24 meses foram submetidos a remoção do ligamento apical para ocasionar desvio de pênis. Decorridos 60 dias os animais foram colocados em presença de fêmeas em estro, sendo verificado desvio ventral e lateral direito do pênis, com incapacitade de [...] cópula. Os animais foram submetidos ao transplante autólgo de um segmento da cartilagem do pavilhão auricular, sobre a túnica albugínea, substituindo o ligamento apical do pênis removido. Os bovinos quando em presença de fêmeas em estro não apresentaram desvio de pênis e alteração do comportamento sexual. Notou-se a presença de poucas células mononucleares, polimorfonucleares e células gigantes e formação de tecido conjuntivo fibroso, ocasionando aderências resistentes e capacidade de sustentar a extremidade livre do pênis. O método cirúrgico mostrou-se eficiente para corrigir desvios ventral e lateral de pênis de bovinos. Abstract in english Eighteen 18 to 24-month-old mixed breed bullocks were submitted to removal of the apical ligament of the penis to induce penile deviation. After 60 days from the surgery the steers were put together with cows in heat. A ventral and right lateral penis deviation leading to incapacity to copulate was [...] observed. The bullocks were then submitted to an autolgous transplant of a cartilage segment from the ear pinna placed on top of the tunica albuginea, replacing the penile ligament apical tha had been removed. The implanted material was well tolerated; histologically with only infiltration few mononuclear cells, polymorpho nucleated cells and giant cells, and fibrosis, which caused strong adherence and provided ability to sustain the free penile extremity. The bullocks that were cows in heat did not show any degree of penile deviation nor any change in sexual behavior. The surgical method described here was shown to be satisfactory as to be indicated for correction of ventral and right lateral penile deviation in bullocks.

  9. Implante de cartilagem auricular autóloga no reparo de desvio de pênis de bovinos Implantation of the autologous auricular cartilagem in the repair of penile deviation in cattle

    Directory of Open Access Journals (Sweden)

    Duvaldo Eurides

    2009-03-01

    Full Text Available Dezoito novilhos de diferentes raças, com idade de 18-24 meses foram submetidos a remoção do ligamento apical para ocasionar desvio de pênis. Decorridos 60 dias os animais foram colocados em presença de fêmeas em estro, sendo verificado desvio ventral e lateral direito do pênis, com incapacitade de cópula. Os animais foram submetidos ao transplante autólgo de um segmento da cartilagem do pavilhão auricular, sobre a túnica albugínea, substituindo o ligamento apical do pênis removido. Os bovinos quando em presença de fêmeas em estro não apresentaram desvio de pênis e alteração do comportamento sexual. Notou-se a presença de poucas células mononucleares, polimorfonucleares e células gigantes e formação de tecido conjuntivo fibroso, ocasionando aderências resistentes e capacidade de sustentar a extremidade livre do pênis. O método cirúrgico mostrou-se eficiente para corrigir desvios ventral e lateral de pênis de bovinos.Eighteen 18 to 24-month-old mixed breed bullocks were submitted to removal of the apical ligament of the penis to induce penile deviation. After 60 days from the surgery the steers were put together with cows in heat. A ventral and right lateral penis deviation leading to incapacity to copulate was observed. The bullocks were then submitted to an autolgous transplant of a cartilage segment from the ear pinna placed on top of the tunica albuginea, replacing the penile ligament apical tha had been removed. The implanted material was well tolerated; histologically with only infiltration few mononuclear cells, polymorpho nucleated cells and giant cells, and fibrosis, which caused strong adherence and provided ability to sustain the free penile extremity. The bullocks that were cows in heat did not show any degree of penile deviation nor any change in sexual behavior. The surgical method described here was shown to be satisfactory as to be indicated for correction of ventral and right lateral penile deviation in bullocks.

  10. There Is No Correlation Between Erectile Dysfunction and Dose to Penile Bulb and Neurovascular Bundles Following Real-Time Low-Dose-Rate Prostate Brachytherapy

    International Nuclear Information System (INIS)

    Purpose: We evaluated the relationship between the onset of erectile dysfunction and dose to the penile bulb and neurovascular bundles (NVBs) after real-time ultrasound-guided prostate brachytherapy. Methods and Materials: One hundred forty-seven patients who underwent prostate brachytherapy met the following eligibility criteria: (1) treatment with 125I brachytherapy to a prescribed dose of 160 Gy with or without hormones without supplemental external beam radiation therapy, (2) identification as potent before the time of implantation based on a score of 2 or higher on the physician-assigned Mount Sinai Erectile Function Score and a score of 16 or higher on the abbreviated International Index of Erectile Function patient assessment, and (3) minimum follow-up of 12 months. Median follow-up was 25.7 months (range, 12-47 months). Results: The 3-year actuarial rate of impotence was 23% (34 of 147 patients). An additional 43% of potent patients (49 of 113 patients) were using a potency aid at last follow-up. The penile bulb volume receiving 100% of the prescription dose (V100) ranged from 0-0.05 cc (median, 0 cc), with a dose to the hottest 5% (D5) range of 12.5-97.9 Gy (median, 40.8 Gy). There was no correlation between penile bulb D5 or V100 and postimplantation impotency on actuarial analysis. For the combined right and left NVB structures, V100 range was 0.3-5.1 cc (median, 1.8 cc), and V150 range was 0-1.5 cc (median, 0.31 cc). There was no association between NVB V100 or V150 and postimplantation impotency on actuarial analysis. Conclusion: Penile bulb doses are low after real-time ultrasound-guided prostate brachytherapy. We found no correlation between dose to either the penile bulb or NVBs and the development of postimplantation impotency.

  11. Pharmacological modulation of arterial stiffness.

    LENUS (Irish Health Repository)

    Boutouyrie, Pierre

    2011-09-10

    Arterial stiffness has emerged as an important marker of cardiovascular risk in various populations and reflects the cumulative effect of cardiovascular risk factors on large arteries, which in turn is modulated by genetic background. Arterial stiffness is determined by the composition of the arterial wall and the arrangement of these components, and can be studied in humans non-invasively. Age and distending pressure are two major factors influencing large artery stiffness. Change in arterial stiffness with drugs is an important endpoint in clinical trials, although evidence for arterial stiffness as a therapeutic target still needs to be confirmed. Drugs that independently affect arterial stiffness include antihypertensive drugs, mostly blockers of the renin-angiotensin-aldosterone system, hormone replacement therapy and some antidiabetic drugs such as glitazones. While the quest continues for \\'de-stiffening drugs\\

  12. Carotid artery stenting; Karotisangioplastie

    Energy Technology Data Exchange (ETDEWEB)

    Fiehler, Jens [Universitaetsklinikum Eppendorf, Hamburg (Germany). Klinik und Poliklinik fuer Neuroradiologische Diagnostik und Intervention, Diagnostikzentrum

    2009-09-15

    An ipsilateral stenosis of the internal carotid artery is found in 10 - 15 % of all ischemic strokes and indicates an increased risk of a second stroke. Carotid artery stenting (CAS) is a therapy that is established for many years. CAS reveals complication rates and long-term efficacy comparable to carotid endarterectomy (TEA). Especially younger patients seem to benefit from CAS. Abilities and experiences of the therapist and the choice of the techniques used are critical for patient safety. The efficacy of CAS for treatment of asymptomatic carotid stenosis is probable but still unproven in prospective-randomized trial. (orig.)

  13. CAROTID ARTERY DISEASE

    Directory of Open Access Journals (Sweden)

    H. Van Damme

    2009-05-01

    Full Text Available Carotid artery disease (CAD become a commonly seen disease in general medical practice, due to the general population aging. Stroke, one of the most frequent complications of CAD and represents the third cause of death in Western countries. The leading cause of stroke in CAD is atheroembolism rather than flow-reduction. This paper reviewed imaging techniques, medical treatment and esepecially carotid endarterectomy (from point of view of indications, surgical technique and results and carotid artery stenting for the correct management of CAD.

  14. Radiative transport in large arteries

    OpenAIRE

    Ruh, Dominic; Subramanian, Sivaraman; Theodor, Michael; Zappe, Hans; Seifert, Andreas

    2013-01-01

    A refined model for the photon energy distribution in a living artery is established by solving the radiative transfer equation in a cylindrical geometry, using the Monte Carlo method. Combining this model with the most recent experimental values for the optical properties of flowing blood and the biomechanics of a blood-filled artery subject to a pulsatile pressure, we find that the optical intensity transmitted through large arteries decreases linearly with increasing arterial distension. T...

  15. Yogaterapia de la hipertensión arterial esencial

    Scientific Electronic Library Online (English)

    Gustavo, Atencio Sariol; Alberto, Lucas.

    1996-06-01

    Full Text Available Se evalúa la utilidad práctica de un protocolo de entrenamiento yoga específico, como complemento del tratamiento de 18 pacientes con hipertensión arterial esencial no controlada, procedentes de un consultorio del médico de la familia del municipio Playa. Durante 40 semanas practicaron, con frecuenc [...] ia de 3 veces semanales, ejercicios sencillos de hatha yoga, combinados con psicología grupal con basamento conductual y yoga tendientes al cambio de hábitos, y principios de atracción y educación para la salud en general. Se logró un decrecimiento significativo de la presión arterial, de los niveles de colesterol sanguíneo y de noradrenalina en orina de 14 horas. También disminuyó la dosis de medicamentos hipotensores en general. Dentro de lo limitado de este pequeño estudio, se concluye que el yoga puede ser beneficioso como coadyuvante en el manejo de los pacientes hipertensos. Abstract in english The practical usefulness of a protocol of specific yoga training, is assessed as a complement for the treatment of uncontrolled essential arterial hypertension, in 18 patients coming from a family physician's office, at Playa municipe. During 40 weeks they practiced, three times weekly, simple hatha [...] yoga exercises, in combination with behavioural based group psicology and yoga intended for habits changing, and principles of attraction and health education. A significant decrease of arterial pressure, of blood cholesterol levels, and of urine norepinephrine, was achieved. Generally, the dose of hypotensive drugs also decreased. It is concluded, within the limits of this small study, that yoga may be beneficial as a coadyuvant in managing hypertensive patients.

  16. Yogaterapia de la hipertensión arterial esencial

    Directory of Open Access Journals (Sweden)

    Gustavo Atencio Sariol

    1996-06-01

    Full Text Available Se evalúa la utilidad práctica de un protocolo de entrenamiento yoga específico, como complemento del tratamiento de 18 pacientes con hipertensión arterial esencial no controlada, procedentes de un consultorio del médico de la familia del municipio Playa. Durante 40 semanas practicaron, con frecuencia de 3 veces semanales, ejercicios sencillos de hatha yoga, combinados con psicología grupal con basamento conductual y yoga tendientes al cambio de hábitos, y principios de atracción y educación para la salud en general. Se logró un decrecimiento significativo de la presión arterial, de los niveles de colesterol sanguíneo y de noradrenalina en orina de 14 horas. También disminuyó la dosis de medicamentos hipotensores en general. Dentro de lo limitado de este pequeño estudio, se concluye que el yoga puede ser beneficioso como coadyuvante en el manejo de los pacientes hipertensos.The practical usefulness of a protocol of specific yoga training, is assessed as a complement for the treatment of uncontrolled essential arterial hypertension, in 18 patients coming from a family physician's office, at Playa municipe. During 40 weeks they practiced, three times weekly, simple hatha yoga exercises, in combination with behavioural based group psicology and yoga intended for habits changing, and principles of attraction and health education. A significant decrease of arterial pressure, of blood cholesterol levels, and of urine norepinephrine, was achieved. Generally, the dose of hypotensive drugs also decreased. It is concluded, within the limits of this small study, that yoga may be beneficial as a coadyuvant in managing hypertensive patients.

  17. Traumatic carotid artery dissection.

    Science.gov (United States)

    Opeskin, K

    1997-09-01

    Traumatic carotid artery dissection is rarely seen as a cause of death in the forensic setting. Three cases of traumatic carotid artery dissection that demonstrate many of the typical features are presented. There is usually a history of some violent trauma to the head or neck, motor vehicle accidents being the commonest cause. The carotid artery may be injured anywhere from the common carotid portion to the cavernous sinus, resulting in infarction of the corresponding cerebral hemisphere. Clinically, symptoms may include loss of consciousness, hemiparesis, aphasia, and Horner's syndrome, these typically occurring after an interval of hours to days. Carotid artery injury may not be associated with evidence of external injury and initially may go undetected or may be misinterpreted in the setting of associated neck or head trauma. The commonest mechanisms are thought to be blunt neck trauma and neck hyperextension. The cases presented highlight the importance of early diagnosis if surgery is to be possible to avoid a fatal outcome. PMID:9290871

  18. A New Technique for Superselective Catheterization of Arteries: Preshaping of a Micro-Guide Wire into a Shepherd's Hook Form

    International Nuclear Information System (INIS)

    We wanted to introduce a new technique for superselective catheterization of arteries with preshaping of a micro-guide wire into a shepherd's hook form, and this is useful for superselection of small arteries branching at an acute angle from a large parent artery for the treatment of tumors and hemorrhages. We developed a superselective catheterization technique by using preshaping of a micro-guide wire into a shepherd's hook form. We encountered six patients in our practice for whom we failed to catheterize the small tumor-feeding arteries that branched at an acute angle from wide parent arteries during chemoembolization of hepatocellular carcinoma; the parent arteries were the right inferior phrenic artery (n = 4) and the left gastric artery (n = 1) from the celiac axis with celiac stenosis due to compression by the median arcuate ligament and the proper hepatic artery from the gastroduodenal artery (n = 1) in a patient who had celiac axis occlusion with collateral circulation via the pancreaticoduodenal arcade from the superior mesenteric artery. In these consecutive six patients, we tested the usefulness of this new technique with employing preshaping of a micro-guide wire into a shepherd's hook form for superselective catheterization of targeted vessels. The target arteries were successfully catheterized and satisfactory transcatheter arterial chemoembolization was performed in all six patients. There were no significant complications such as arterial dissection. We developed a technique that is effective for superselection of vessels with preshaping of micro-guide wire into a shepherd's hook hook form, and we successfully applied it during chemoembolization of hepatocellular carcinoma. This technique can be useful for superselection of small arteries that branch from a large parent artery at acute angles for the treatment of tumors and hemorrhages

  19. Civilian popliteal artery injuries

    Scientific Electronic Library Online (English)

    M A, Banderker; P H, Navsaria; S, Edu; W, Bekker; A J, Nicol; N, Naidoo.

    2012-11-01

    Full Text Available BACKGROUND: Civilian popliteal artery injuries are associated with significant amputation rates. AIM: The aim of this study was to identify factors associated with limb loss in patients with popliteal artery injuries. PATIENTS AND METHODS: We performed a retrospective chart review of prospectively c [...] ollected data on patients with popliteal artery injuries presenting to the Trauma Centre at Groote Schuur Hospital, Cape Town, from 1 January 1999 to 31 December 2008. Demographic data, mechanism of injury, haemodynamic status, limb viability, special investigations, associated injuries, ischaemic time, surgical treatment and amputation rates were analysed. RESULTS: One hundred and thirty-six patients with popliteal artery injuries were identified. Penetrating and blunt trauma accounted for 81 (59.6%) and 55 (40.4%) injuries, respectively. Associated injuries included fractures in 66 patients (48.6%), knee dislocations in 29 (21.3%) and popliteal vein injuries in 59 (43.4%). Fifty-seven patients (41.9%) presented with a compartment syndrome. Arterial injuries were treated with reversed vein grafting in 68 patients, primary anastomosis in 33, prosthetic graft insertion in 11, and primary amputation in 7. Thirty-two patients underwent delayed amputation, giving an overall amputation rate of 37.5%. A delay of more than 7 hours of ischaemic time between injury and definitive repair (p=0.0236) and the presence of a compartment syndrome (p=0.003) were significantly associated with an increased amputation rate. CONCLUSION: The most significant factors associated with the high amputation rate of 37.5% were an ischaemic time longer than 7 hours, and the presence of a compartment syndrome.

  20. Large scale estimation of arterial traffic and structural analysis of traffic patterns using probe vehicles

    OpenAIRE

    Hofleitner, Aude; Herring, Ryan; Bayen, Alexandre; Han, Yufei; Moutarde, Fabien; De La Fortelle, Arnaud

    2012-01-01

    Estimating and analyzing traffi c conditions on large arterial networks is an inherently diffi cult task. The fi rst goal of this article is to demonstrate how arterial tra c conditions can be estimated using sparsely sampled GPS probe vehicle data provided by a small percentage of vehicles. Traffi c signals, stop signs, and other flow inhibitors make estimating arterial traffi c conditions significantly more diffi cult than estimating highway traffi c conditions. To address these challenges,...

  1. Placement of Endovascular Stent across the Branching Arteries: Long-term Serial Evaluation of Stent-tissue Responses Overlying the Arterial Orifices in an Experimental Study

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Il; Chung, Jin Wook, E-mail: chungjw@snu.ac.kr [Seoul National University College of Medicine, Department of Radiology (Korea, Republic of); Kim, Hyun Beom [National Cancer Center of Korea, Department of Radiology and Center for Liver Cancer, Research Institute and Hospital (Korea, Republic of); Park, Jae Hyung [Seoul National University College of Medicine, Department of Radiology (Korea, Republic of); Seo, Jeong Wook [Seoul National University College of Medicine, Department of Pathology (Korea, Republic of); Kim, Hyo-Cheol; Jae, Hwan Jun; Lee, Whal [Seoul National University College of Medicine, Department of Radiology (Korea, Republic of)

    2012-10-15

    PurposeThis study was designed to investigate the effects of stenting across the branching arteries on the patency and stent-tissue responses over the branching arterial orifices. Methods: Thirteen dogs were observed after placing aortic stents across the celiac arteries (CA), superior mesenteric arteries (SMA), and renal arteries (RA). The animals were grouped according to stent types: large-cell group (n = 6) and small-cell group (n = 7). Angiography was performed to evaluate the branching artery patency at 2, 6, and 12 months after stent insertion, and the stent-tissue responses covering the orifices were evaluated on histopathologic examination. Results: All branching arteries were patent on follow-up angiography; however, three patterns of stent-tissue responses over the orifices were observed: neointimal layering, bridging septa, and papillary hyperplasia. Although neointimal layering and bridging septa were evenly observed, severe papillary hyperplasia was more frequent at SMA and CA than RA. Four RA showed less than 50% ostial patency, and localized infarct was observed in six kidneys (24%). The ostial patency tended to decrease with small-cell stent during the follow-up period. Conclusions: Various stent-tissue responses over the branching artery orifices are induced by the aortic stent covering the branching arteries and may not be easily detected by conventional angiography. Subclinical renal infarct also may occur despite patent renal angiography.

  2. Acquired origin of the left anterior descending coronary artery from the pulmonary artery: A complication of the arterial switch operation

    Directory of Open Access Journals (Sweden)

    Saltik Levent

    2011-01-01

    Full Text Available The prevalence of coronary anomalies in the transposition of the great arteries is high. Transfer of the coronary arteries during arterial switch operation is the principle step and incomplete transport of the coronary arteries to the neoaortic root results into iatrogenic coronary problems. We present a case with the residual left anterior descending coronary artery originating from the pulmonary artery as a complication of the failure of transfer during the arterial switch operation.

  3. Embolization of pulmonary AVMs of feeding arteries less than 3 mm: reports of two cases and an 8-year follow-up without embolization

    Science.gov (United States)

    Andersen, Poul Erik; Kjeldsen, Anette D

    2012-01-01

    Pulmonary arteriovenous malformations (PAVMs) with feeding arteries of 3 mm or more have been shown to be associated with paradoxical embolization and serious neurologic complications. Therefore it is generally recommended to occlude feeding arteries of this size, while smaller feeding arteries often are left untreated. However, neurologic complications have also been described in patients with small PAVMs, and it has not been possible to stratify risk by size of feeding artery and thus there is no evidence that 3 mm is the critical size of the feeding artery potentially giving complications. Further, it is well-known that with time PAVMs and their feeding arteries may enlarge. Also, embolization of small feeding arteries will minimize the risk of paradoxical emboli and reduce the need for CT follow-up controls in these patients. Two cases demonstrate the possibility to embolize small feeding arteries. PMID:23986830

  4. Remodelling of the microarchitecture of resistance arteries in cardiovascular diseases

    DEFF Research Database (Denmark)

    Bloksgaard, Maria; Brewer, Jonathan R.

    Small resistance artery structure is an independent predictor of cardiovascular events in essential hypertension [1, 2] and diabetes (types I and II) [3, 4]. In particular, the media-to-lumen ratio (M:L) is predictive of cardiovascular events. The exact nature of this resistance artery remodeling is largely unknown, and the presented project aims to investigate this. Innovative multiphoton excitation microscopy will be applied on live (vital), isolated, cannulated and pressurized arteries from parietal pericardial biopsies obtained during open cardiac surgery (coronary artery bypass grafting and cardiac valve replacement surgery). Using the intrinsic properties of the live tissue, that is the autofluorescence of elastin and smooth muscle/endothelial cells and the second harmonic generation from collagen fibers, the quantity, distribution and orientation of elastin structures, collagen fibers, and endothelial and smooth muscle cells will be determined in relation to a range of distending pressures (50, 100, 150, 200 mmHg) and in relation to the frequently determined M:L. We present here our initial results from (pig) pericardial biopsies where we describe the microarchitecture of the tissue in comparison to other well-studied microvascular beds (e.g. rat mesentery). In the future we aim to compare the microarchitecture of small resistance arteries from parietal pericardial biopsies between patients with and without (treated) hypertension, diabetes and/or ischemic heart disease. 1. Buus, N.H., et al., Small artery structure during antihypertensive therapy is an independent predictor of cardiovascular events in essential hypertension. J Hypertens, 2013. 31(4): p. 791-7. 2. Mathiassen, O.N., et al., Small artery structure is an independent predictor of cardiovascular events in essential hypertension. J Hypertens, 2007. 25(5): p. 1021-6. 3. Rizzoni, D. and E. Agabiti Rosei, Small artery remodeling in hypertension and diabetes. Curr Hypertens Rep, 2006. 8(1): p. 90-5. 4. Rizzoni, D., et al., Prognostic significance of small-artery structure in hypertension. Circulation, 2003. 108(18): p. 2230-5.

  5. Post-irradiation vasculopathy of intracranial major arteries in children

    International Nuclear Information System (INIS)

    We report two rare cases of post-irradiation vasculopathy of intracranial major arteries in children. A 13-year-old girl suffered from transient right hemiparesis 1 year after irradiation for suprasellar germinoma. Left carotid angiograms revealed marked stenoses of the intracranial internal carotid, middle cerebral, and anterior cerebral arteries, which were previously normal, and moyamoya vessels. A 2.5-year-old girl underwent internal irradiation with 198Au colloid for cystic craniopharyngioma. At the age of 10 years, she suddenly became unconscious after vomiting. Computed tomographic scans showed a right frontal intracerebral hematoma. Right carotid angiograms disclosed complete obstruction of the intracranial internal carotid, middle cerebral, and anterior cerebral arteries and moyamoya vessels, previously not present. The danger of radiation therapy causing occlusive vasculopathy in small and major cerebral arteries in children is emphasized. To prevent permanent ischemic neurological deficits, vasculopathy should be treated either medically or surgically as early as possible. (author)

  6. A decade of modelling drug release from arterial stents.

    Science.gov (United States)

    McGinty, Sean

    2014-11-01

    Drug-eluting stents have revolutionised the treatment of coronary artery disease. These small medical devices have attracted much interest over the past decade from biologists, clinicians, engineers and mathematicians alike. This article provides a comprehensive review of the modelling of drug release from arterial stents and the subsequent drug transport through arterial tissue, and acts as a useful reference equally for those who are already involved in drug-eluting stents research and for those who are starting out in the field. Assembled in this review are the main models of drug release and arterial drug transport that have been published in the literature to date. Many of the models presented in this paper have evolved from drug transport models in other applications. Furthermore, the ideas presented in this review may also be extended to other drug-delivery applications, such as drug coated balloons, transdermal patches and therapeutic contact lenses. PMID:25014771

  7. La prótesis de pene en el tratamiento de la disfunción eréctil / Penile prosthesis for the treatment of erectile dysfunction

    Scientific Electronic Library Online (English)

    G., Atienza Merino.

    2006-02-01

    Full Text Available La disfunción eréctil es una patología que, con diferentes grados de intensidad, afecta a cerca del 20% de los varones adultos españoles. Su tratamiento se realiza habitualmente de forma escalonada, reservándose las prótesis de pene para cuando han fracasado otros tratamientos previos. El objetivo d [...] e este trabajo es evaluar, de acuerdo al estado de conocimiento actual, la efectividad y seguridad de las prótesis de pene en el tratamiento de la disfunción eréctil. Para ello se seleccionaron 52 artículos, observándose porcentajes de supervivencia protésica a los 5 años del 78-91% y siendo las complicaciones quirúrgicas del 3-8%. Los fallos mecánicos y la infección fueron menores en las prótesis semirrígidas que en las hinchables, obteniéndose altos niveles de satisfacción postoperatoria, tanto entre los pacientes como en sus parejas, mayores incluso que con el resto de tratamientos disponibles en la actualidad. La implantación de una prótesis de pene debe reservarse para la disfunción eréctil de carácter orgánico en la que hayan fracasado otros tratamientos previos, debiendo valorarse la relación riesgo/beneficio e informando al paciente de los resultados que se esperan conseguir y de las posibles complicaciones que puedan surgir. La mayor preocupación de nuestra sociedad con respecto a la función eréctil, unido a la disponibilidad de fármacos eficaces frente a su disfunción, hace previsible un aumento en la demanda de implantación de prótesis de pene en los próximos años, en aquellos pacientes altamente motivados, pero refractarios a los tratamientos menos invasivos. Abstract in english The erectile dysfunction is a pathology that, with different degrees of intensity, affects nearly the 20% ofthe spanish adult men. The treatment is usually performed in stages, reserving the penile prosthesis forwhen other previous treatments have failed. The aim of this work is to evaluate, accordi [...] ng to the state ofpresent knowledge, the effectiveness and security of the penile prosthesis for the treatment of the erectiledysfunction. With this purpose 52 articles were selected, observing a 5 years prosthesis survival of 78-91% and a 3-8% of surgical complications. Mechanical failures and infection percentages were smaller in thesemi-rigid prosthesis that in the inflatable ones, with high levels of postoperative satisfaction in patients aswell as in their couples, even greater than in other treatments available at the present time. The penile prosthesis implantation must be reserved for the organic erectile dysfunction when previoustreatments have failed, evaluating the risk-benefit relation and informing the patient of the results that arehoped to be obtained and of the possible complications that can arise. In view of the great concern of our society with the erectile function and the availability of effective drugs,an increase in the demand of penile prosthesis implantation is predictable in those patients highly motiva-ted, but refractory to the less invasive treatments.

  8. MRI of the pulmonary artery after arterial switch operation for transposition of the great arteries

    International Nuclear Information System (INIS)

    Twenty-six children who underwent an arterial switch operation for transposition of the great arteries were examined with MRI and Doppler ultrasound (US). The aim was to determine the capability of MRI for detecting a possible stenosis of the pulmonary arteries. In 10 children angiocardiography (ACG) was done after the MRI examination. Using ACG as the gold standard, MRI was sensitive in the detection of pulmonary artery stenosis. MRI was more precise in the localization of a stenosis than was Doppler US. Right ventricular hypertrophy was a sensitive indicator of pulmonary artery stenosis. These results suggest that MRI could serve as a screening examination for pulmonary artery stenosis after an arterial switch operation. (orig.)

  9. Erectile dysfunction after prostate three-dimensional conformal radiation therapy. Correlation with the dose to the penile bulb

    Energy Technology Data Exchange (ETDEWEB)

    Magli, A.; Ceschia, T.; Titone, F.; Parisi, G.; Fongione, S. [University Hospital Udine (Italy). Dept. of Radiation Oncology; Giangreco, M. [Udine Univ. (Italy). Hygiene and Epidemiology Inst.; Crespi, M.; Negri, A. [University Hospital Udine (Italy). Dept. of Medical Physics; De Giorgi, G. [University Hospital Udine (Italy). Dept. of Urology

    2012-11-15

    Purpose: Erectile dysfunction is associated with all the common treatment options for prostate cancer. The aim of this research was to evaluate the relationship between erectile function and radiation dose to the penile bulb (PB) and other proximal penile structures in men receiving conformal radiotherapy (CRT) without hormonal therapy (HT) for prostate cancer, whose sexual function was known before treatment. Patients and methods: The study included 19 patients treated with 3D-CRT for localized prostate cancer at our department, who were self-reported to be potent before treatment, had not received HT, and had complete follow-up data available. Our evaluation was based on the International Index of Erectile Function (IIEF-5). Dose-volume histograms (DVHs) were used to evaluate the dose to the PB. Statistical analysis was performed with an unconditional logistic regression model. Results: All patients reported change in potency after radiation. Eight patients (42%) remained potent but showed a decrease of 1 or 2 levels of potency, as defined by the IIEF-5 questionnaire (reduced potency group), while 11 patients (58%) reported a change of higher levels and revealed a severe erectile dysfunction after 2 years (impotence group). Multivariate analysis of morphological and dosimetric variables yielded significance for the mean dose (p = 0.05 with an odds ratio of 1.14 and 95% CI 1-1.30). Patients receiving a mean dose of less than 50 Gy to the PB appear to have a much greater likelihood of maintaining potency. Conclusion: Our data suggest a possible existence of a dose-volume correlation between the dose applied to the PB and radiation-induced impotence. (orig.)

  10. STUDY OF LATERAL CIRCUMFLEX ARTERY

    Directory of Open Access Journals (Sweden)

    Pavan P Havaldar

    2014-06-01

    Full Text Available Background: The lower limb arteries are commonly involved with peripheral occlusive arterial diseases and the femoral artery at femoral triangle is widely used for certain clinical procedures like arterial catheterization, as it can be readily accessed. Lateral circumflex femoral artery is a laterally running branch given off near the root of the profunda femoris. It supplies blood to head and neck of femur, greater trochanter, vastus lateralis and knee. It has many implications in clinical practice, it is used in an anterolateral thigh flap, aortopoplitial bypass, coronary artery bypass surgery, extracranial- intracranial bypass surgery. Methods: 50 adult lowerlimbs were procured from embalmed cadavers of J.J.M. Medical College and S.S.I.M.S & R.C, Davangere, Karnataka, India for the study. Dissection of femoral triangle was carried out according to Cunningham’s manual. Site and mode of origin of the branches of femoral artery were studied, configuration of the femoral origin lateral circumflex femoral artery and its prevalence were studied. Results: out of 50 cases Lateral circumflex femoral artery took origin from profunda femoris in 45 specimens and from the femoral artery in 5 specimens. Conclusion: The knowledge of normal origin and variation of lateral circumflex femoral artery is very valuable in preventing iatrogenic injury to these vessels during surgical procedures of femoral triangle. As medial and lateral circumflex femoral arteries supply blood to head and neck of femur, it is important to avoid injuring them during surgery of hip joint to prevent necrosis of femoral head. Lateral circumflex femoral artery has many implication in clinical practice. It is used in an anterolateral thigh flap.

  11. Arterial endothelial cells

    DEFF Research Database (Denmark)

    Hagensen, Mette K; Vanhoutte, Paul M. G.; Bentzon, Jacob Fog

    2012-01-01

    For more than a decade, a prevailing hypothesis in research related to arterial disease has been that circulating endothelial progenitor cells (EPCs) provide protection by their innate ability to replace dysfunctional or damaged endothelium. This paradigm has led to extensive investigation of EPCs in the hope of finding therapeutic targets to control their homing and differentiation. However, from the very beginning, the nomenclature and the phenotype of EPCs have been subject to controversy and...

  12. Huge pulmonary artery aneurysm

    OpenAIRE

    Hammad, Aiman M; Al-Qahtani, Sultan M; Al-Zahrani, Mohammed A.

    2009-01-01

    Pulmonary artery aneurysms (PAAs) are uncommon entities. PAAs are caused mostly by trauma (often iatrogenic), infections and Behcet’s disease (BD). Less common causes are pulmonary hypertension, congenital heart disease and neoplasm. BD is a multisystem disorder presenting with recurrent oral and genital ulcerations, as well as ocular involvement, and PAA is one of its rare complications. A case of huge PAA, in which the usual criteria for the clinical diagnosis of BD were present, is describ...

  13. Artery phantoms for intravascular optical coherence tomography: healthy arteries

    OpenAIRE

    Bisaillon, Charles-Étienne; Dufour, Marc L.; Lamouche, Guy

    2011-01-01

    We present a method to make phantoms of coronary arteries for intravascular optical coherence tomography (IV-OCT). The phantoms provide a calibrated OCT response similar to the layered structure of arteries. The optical properties of each layer are achieved with specific concentrations of alumina and carbon black in a silicone matrix. This composition insures high durability and also approximates the elastic properties of arteries. The phantoms are fabricated in a tubular shape by the success...

  14. Pregnancy after uterine arterial embolization

    OpenAIRE

    Cláudio E. Bonduki; Paulo C. Feldner, Jr.; Juliana da Silva; Rodrigo A. Castro; Marair G. F. Sartori; Girão, Manoel J. B. C.

    2011-01-01

    OBJECTIVE: To evaluate pregnancy outcomes, complications and neonatal outcomes in women who had previously undergone uterine arterial embolization. METHODS: A retrospective study of 187 patients treated with uterine arterial embolization for symptomatic uterine fibroids between 2005-2008 was performed. Uterine arterial embolization was performed using polyvinyl alcohol particles (500-900 mm in diameter). Pregnancies were identified using screening questionnaires and the study database. RESULT...

  15. Hipertensão arterial na infância Arterial hypertension in childhood

    Directory of Open Access Journals (Sweden)

    Cláudia Maria Salgado

    2003-06-01

    Full Text Available OBJETIVOS: realizar uma revisão crítica da literatura atual, enfocando aspectos práticos e relevantes para o diagnóstico e tratamento ambulatorial da criança com hipertensão arterial. FONTE DE DADOS: artigos clássicos e revisão sistemática da literatura atual através de busca eletrônica nos bancos de dados Medline e Lilacs, nos últimos 10 anos, utilizando-se as palavras-chave hipertensão arterial, recém-nascido, lactente, pré-escolar, criança e adolescente, selecionando-se aqueles que trouxeram informações relevantes. SÍNTESE DOS DADOS: a hipertensão arterial e a obesidade são um problema de saúde pública em todo o mundo. A hipertensão arterial essencial do adulto inicia-se na infância, e, além disso, pode ser secundária a várias doenças. O pediatra tem por obrigação medir adequadamente a pressão arterial de seus pacientes. Quando descoberta, a hipertensão arterial deve ser investigada para ser adequadamente tratada. A investigação depende da idade e do grau de elevação da pressão arterial, devendo preocupar-se não somente com a causa da hipertensão, mas também com os seus efeitos em órgãos alvo. CONCLUSÕES: o reconhecimento precoce da pressão arterial anormal e a intervenção (investigação e tratamento adequada são necessários para diminuir a morbidade/mortalidade cardiovascular e renal futura.OBJECTIVE: to critically review recent medical literature, focusing on practical features that are relevant for diagnosis and outpatient treatment of pediatric hypertension. SOURCES OF DATA: classic articles and systematic review of recent literature through electronic search of Medline and Lilacs databases over the last 10 years, using the key words arterial hypertension, newborns, infants, preschool, children and adolescents. Those articles containing relevant information were selected. SUMMARY OF THE FINDINGS: arterial hypertension and obesity are public health problems all over the world. Essential arterial hypertension in adults begins in childhood and can also be secondary to several diseases. Pediatricians must measure the arterial pressure of the patients in a proper manner. When arterial hypertension is detected, it must be investigated in order to be adequately treated. The investigation depends on the age and the rising degree of the arterial pressure, taking into consideration the cause of hypertension, as well as its effects on target organs. CONCLUSIONS: the early recognition of an abnormal arterial pressure followed by adequate investigation and treatment are required to reduce the cardiovascular and renal morbidity/mortality.

  16. Radiative transport in large arteries.

    Science.gov (United States)

    Ruh, Dominic; Subramanian, Sivaraman; Theodor, Michael; Zappe, Hans; Seifert, Andreas

    2013-12-01

    A refined model for the photon energy distribution in a living artery is established by solving the radiative transfer equation in a cylindrical geometry, using the Monte Carlo method. Combining this model with the most recent experimental values for the optical properties of flowing blood and the biomechanics of a blood-filled artery subject to a pulsatile pressure, we find that the optical intensity transmitted through large arteries decreases linearly with increasing arterial distension. This finding provides a solid theoretical foundation for measuring photoplethysmograms. PMID:24466476

  17. Arterial mapping of lower limbs

    International Nuclear Information System (INIS)

    A bibliographic review is realized in the arterial mapping of lower limbs by ultrasonographic. The physical properties of the Doppler effect applied to diagnostic ultrasound are described. The anatomical characteristics of the general arterial system and specifically of the lower limbs arterial system are mentioned. Pathologies of the ischemic arterial disease of lower limbs are explained. The study characteristics of lower limbs arterial mapping are documented to determine its importance as appropriate method for the assessment of lower limb ischemia. An adequate arterial mapping of lower limbs is recognized in atherosclerotic ischemic disease as a reliable initial method alternative to arteriography. Arteriography is considered as reference pattern for therapeutic decision making in patients with critical ischemia of the lower limbs. Non-invasive methods to assess the arterial system of lower limbs has evidenced the advantages of the arterial mapping with Doppler, according to the consulted literature. The combination morphological and hemodynamic information has been possible and a map of the explored zone is made. The arterial mapping by ultrasonography has offered similar reliability to angiography

  18. Arterial responses during migraine headache

    DEFF Research Database (Denmark)

    Iversen, Helle Klingenberg; Nielsen, T H; Olesen, J; Tfelt-Hansen, P

    1990-01-01

    The superficial temporal artery has been thought to be the main focus of pain during migraine attacks, but its diameter has never been measured directly. The use of a new, high-resolution ultrasound machine to measure arterial size in 25 migraine patients with unilateral head pain showed that the lumen was wider on the painful than on the non-painful side during a migraine attack. The diameters of both radial arteries and the temporal artery on the non-painful side were smaller during than betwe...

  19. Resistant spontaneous coronary artery spasm.

    Science.gov (United States)

    Keskin, Kudret; ?ahin, Alparslan; Y?ld?z, Süleyman Sezai; Aksan, Gökhan

    2015-10-01

    Coronary artery spasm should always be suspected in patients who have myocardial infarction with normal coronary arteries. This case report presents a 33-year-old woman with anterior myocardial infarction, whose coronary angiograph revealed normal left anterior descending artery and new onset complete occlusion of the circumflex artery at the time of the procedure. Nitroglycerin up to 800 mcg was administered without success. In such resistant cases, when all efforts fail, including prompt recognition and application of vasodilator drugs, retracting the catheter and waiting may play a role. PMID:26536989

  20. Dissecting aneurysm of the cervical internal carotid artery

    International Nuclear Information System (INIS)

    On lifting a heavy case, a 51-year-old male experienced a sudden onset of headache with giddiness and clouded vision. A week later, vertigo and right hand numbness were added to his symptoms. The next day anisocoria (right > left) and dilation of the left retinal veins were noted. Cranial computed tomography (CT) scan appeared normal and there were no other remarkable neurological findings. The patient was treated conservatively for cerebral infarction, however, the headache worsened and diplopia occurred. Neurological examination on admission revealed nothing unusual except for left Horner's syndrome. Physical examination showed a palpable sausage-like painless tumor on the left side of the neck. Angiography showed a narrowing of the internal carotid artery in the cervical region with a small dissecting aneurysm at the C3 level. Cervical CT scan at the upper C3 level showed a low density lunar defect in the high density section of the enlarged left internal carotid artery. The patient was operated on by superficial temporal artery-middle cerebral artery anastomosis to increase the intracranial blood flow. Postoperatively the symptoms were quickly relieved. Angiography 1 month later showed less narrowing of the carotid artery, though the dissecting aneurysm still remained. Postoperative cervical CT scan showed the left internal carotid artery to be of normal size. The patient returned to his work in normal condition 2 months later. It is emphasized that cervical CT scan may be useful in the diagnosis of this unusual type of cervical dissecting aneurysm. (author)

  1. Internal carotid artery rupture caused by carotid shunt insertion

    Science.gov (United States)

    Illuminati, Giulio; Caliò, Francesco G.; Pizzardi, Giulia; Vietri, Francesco

    2015-01-01

    Introduction Shunting is a well-accepted method of maintaining cerebral perfusion during carotid endarterectomy (CEA). Nonetheless, shunt insertion may lead to complications including arterial dissection, embolization, and thrombosis. We present a complication of shunt insertion consisting of arterial wall rupture, not reported previously. Presentation of case A 78-year-old woman underwent CEA combined with coronary artery bypass grafting (CABG). At the time of shunt insertion an arterial rupture at the distal tip of the shunt was detected and was repaired via a small saphenous vein patch. Eversion CEA and subsequent CABG completed the procedure whose postoperative course was uneventful. Discussion Shunting during combined CEA-CABG may be advisable to assure cerebral protection from possible hypoperfusion due to potential hemodynamic instability of patients with severe coronary artery disease. Awareness and prompt management of possible shunt-related complications, including the newly reported one, may contribute to limiting their harmful effect. Conclusion Arterial wall rupture is a possible, previously not reported, shunt-related complication to be aware of when performing CEA. PMID:26255001

  2. Association between internal carotid artery dissection and arterial tortuosity

    Energy Technology Data Exchange (ETDEWEB)

    Saba, Luca; Piga, Mario [Azienda Ospedaliero Universitaria (A.O.U.), Department of Radiology, Monserrato, Cagliari (Italy); Argiolas, Giovanni Maria; Siotto, Paolo [Azienda Ospedaliero Brotzu (A.O.B.), Department of Radiology, di Cagliari (Italy); Sumer, Suna; Wintermark, Max [Neuroradiology Division, Neuroradiology, UVA Department of Radiology, Charlottesville, VA (United States); Raz, Eytan [New York University School of Medicine, Department of Radiology, New York, NY (United States); Sapienza University of Rome, Department of Neurology and Psychiatry, Rome (Italy); Sanfilippo, Roberto; Montisci, Roberto [Azienda Ospedaliero Universitaria (A.O.U.), Department of Vascular Surgery, di Cagliari (Italy)

    2014-10-18

    Carotid artery dissection is an important cause of ischemic stroke in all age groups, particularly in young patients. The purpose of this work was to assess whether there is an association between the presence of an internal carotid artery dissection (ICAD) and the arterial tortuosity. This study considered 124 patients (72 males and 52 females; median age 57 years) with CT/MR diagnosis of ICAD of the internal carotid artery were considered in this multi-centric retrospective study. The arterial tortuosity was evaluated and, when present, was categorized as elongation, kinking, or coiling. For each patient, both the right and left sides were considered for a total number of 248 arteries in order to have the same number of cases and controls. Fisher's exact test was applied to test the association between elongation, kinking, coiling, dissection, and the side affected by CAD. Fisher's exact test showed a statistically significant association between the ICAD and kinking (p = 0.0089) and coiling (p = 0.0251) whereas no statistically significant difference was found with arterial vessel elongation (p = 0.444). ICAD was more often seen on the left side compared to the right (p = 0.0001). These results were confirmed using both carotid arteries of the same patient as dependent parameter with p = 0.0012, 0.0129, and 0.3323 for kinking, coiling, and elongation, respectively. The presence of kinking and coiling is associated with ICAD. (orig.)

  3. Dual anterior descending coronary artery associated with coronary artery disease

    Directory of Open Access Journals (Sweden)

    Siqueira Luciane da L. V.

    2003-01-01

    Full Text Available The patient is a male with risk factors for coronary artery disease, who was referred for cardiac catheterization after acute myocardial infarction in the inferior wall. The patient underwent transluminal coronary angioplasty in the right coronary artery with successful stent implantation.

  4. TECAB - Totally Endoscopic Coronary Artery Bypass

    Medline Plus

    Full Text Available ... And the bypass vessel is the so-called “internal mammary artery.” That’s an artery, as opposed to ... transverse thoracic muscle here. is to the LAD internal emory artery bypass graft to the LAD. We ...

  5. Genetics Home Reference: Pulmonary arterial hypertension

    Science.gov (United States)

    ... literature OMIM Genetic disorder catalog Conditions > Pulmonary arterial hypertension On this page: Description Genetic changes Inheritance Diagnosis ... definitions Reviewed September 2012 What is pulmonary arterial hypertension? Pulmonary arterial hypertension is a progressive disorder characterized ...

  6. Renal arterial aneurysm--an incidental finding at autopsy.

    Directory of Open Access Journals (Sweden)

    Vaideeswar P

    1998-01-01

    Full Text Available Herein we describe a rare case of saccular renal artery aneurysm seen as an incidental autopsy finding in an elderly, hypertensive female. The aneurysm was seen as a small exophytic mass with calcified wall and lumen occluded by recanalized thrombus.

  7. Relation of arterial stiffness with gestational age and birth weight

    OpenAIRE

    Cheung, Y.; Wong, K; Lam, B.; Tsoi, N

    2004-01-01

    Background: The cardiovascular risk of individuals who are born small as a result of prematurity remains controversial. Given the previous findings of stiffer peripheral conduit arteries in growth restricted donor twins in twin–twin transfusion syndrome regardless of gestational age, we hypothesised that among children born preterm, only those with intrauterine growth retardation are predisposed to an increase in cardiovascular risks.

  8. Postpartum vertebral artery dissection.

    Science.gov (United States)

    Finley, Amanda; Rogers, Brenton; Richards, Theodore; Vogel, Heather

    2015-01-01

    We report a case of a right vertebral artery dissection in a 35-year-old woman, 3?weeks post partum, with manifestations of vertebrobasilar disease. She was 3?weeks out from the uneventful delivery of her fourth child, with presentation of acute neurological symptoms, predominantly intractable vertigo. Vertigo can have many non-specific generalised symptoms and clinical findings. Postpartum women have a lengthy list of possible aetiologies of vertigo not limited to our initially suspected preeclampsia, dural venous thrombosis and vertebral dissection. PMID:26604230

  9. Endotelio e hipertensión arterial / Endothelium and arterial hypertension

    Scientific Electronic Library Online (English)

    Leonardo, Cobos S.

    2014-10-01

    Full Text Available Se ha demostrado el rol de la función endotelial en la salud cardiovascular y su relación con la hipertensión arterial. Ciertos estudios demuestran que la disfunción endotelial es un posible mecanismo que produce hipertensión arterial (HTA), mientras otros demuestran que la HTA per se produce daño e [...] ndotelial. Se conoce varias condiciones clínicas asociadas a la disfunción endotelial, por lo que es de gran interés la protección del endotelio. Abstract in english Role of endothelial function in cardiovascular health and its relation with arterial hypertension has been demonstrated. Some studies show that endothelial dysfunction may produce arterial hypertension but other studies find that arterial hypertension per se produces endothelial damage. Due to the f [...] act of various clinical conditions associated to endothelial dysfunction it is of great interest protection of the endothelium.

  10. Embolization of pulmonary AVMs of feeding arteries less than 3 mm: reports of two cases and an 8-year follow-up without embolization

    OpenAIRE

    Andersen, Poul Erik; Kjeldsen, Anette D

    2012-01-01

    Pulmonary arteriovenous malformations (PAVMs) with feeding arteries of 3 mm or more have been shown to be associated with paradoxical embolization and serious neurologic complications. Therefore it is generally recommended to occlude feeding arteries of this size, while smaller feeding arteries often are left untreated. However, neurologic complications have also been described in patients with small PAVMs, and it has not been possible to stratify risk by size of feeding artery and thus there...

  11. Superficial femoral artery: current treatment options

    Energy Technology Data Exchange (ETDEWEB)

    Tepe, Gunnar; Schmehl, Joerg; Heller, Stephan; Wiesinger, Benjamin; Claussen, Claus D. [University of Tuebingen, Department of Diagnostic Radiology, Tuebingen (Germany); Duda, Stephan H. [Jewish Hospital, Department of Diagnostic and International Radiology, Berlin (Germany)

    2006-06-15

    Treatment of the superficial femoral artery (SFA) has been among the least effective of all endovascular procedures in terms of long-term patency. The relatively small vessel lumen, in conjunction with a high plaque burden, slow flow, and a high frequency of primary occlusions, contributes to a considerable rate of acute technical failures. Because of these technical limitations a much effort has been made during the past years. This manuscript should summarize the hopes and limitations of different approaches such as brachytherapy, cutting balloons, stents and stent grafts, drug-eluting stents, and drug-coated balloons. (orig.)

  12. Actualización en el diagnóstico y terapéutica en hipertensión pulmonar arterial Update in the diagnosis and therapy for pulmonary arterial hypertension

    Directory of Open Access Journals (Sweden)

    Mónica Zagolin B

    2006-07-01

    Full Text Available Pulmonary Arterial Hypertension includes a heterogeneous group of disorders with a common genetic, pathological and hemodinamyc origin. It is characterized by a high pulmonary artery pressure due to a primary vascular disease, as a consequence of genetic and environmental factors. The common pathway is a vascular imbalance towards vasoconstriction and proliferation inside the small vessels. According to the World Health Organization, 2003, Pulmonary Arterial Hypertension is classified as idiopathic, familiar or associated to connective tissue diseases, HIV, drugs, porto-pulmonary hypertension, congenital intracardiac shunts and others. The diagnosis is based in hemodynamics. Echocardiogram is a non invasive and right ventricular catheterization is an invasive diagnostic tool. Follow up is based on a clinical and functional assessment through functional class classification, dyspnea scores and 6-minute walking test. The prognosis is historically devastating but new therapies are changing the natural history of the disease. New treatments have demonstrated improvement in symptoms, hemodynamic profiles and survival. Intravenous, subcutaneous or inhaled prostanoids such as Epoprostenol, Treprostinil or Iloprost respectively have been approved for Pulmonary Arterial Hypertension treatment as well as oral endothelial receptor blockers. They are all considered first line treatments for arterial pulmonary hypertensive patients with even better benefits than lung transplantation. Phosphodiesterase inhibitors (Sildenafil, have been recently approved for the treatment of pulmonary arterial hypertension

  13. Actualización en el diagnóstico y terapéutica en hipertensión pulmonar arterial / Update in the diagnosis and therapy for pulmonary arterial hypertension

    Scientific Electronic Library Online (English)

    Mónica, Zagolin B; Eduardo, Wainstein G; Polentzi, Uriarte G.

    2006-07-01

    Full Text Available [...] Abstract in english Pulmonary Arterial Hypertension includes a heterogeneous group of disorders with a common genetic, pathological and hemodinamyc origin. It is characterized by a high pulmonary artery pressure due to a primary vascular disease, as a consequence of genetic and environmental factors. The common pathway [...] is a vascular imbalance towards vasoconstriction and proliferation inside the small vessels. According to the World Health Organization, 2003, Pulmonary Arterial Hypertension is classified as idiopathic, familiar or associated to connective tissue diseases, HIV, drugs, porto-pulmonary hypertension, congenital intracardiac shunts and others. The diagnosis is based in hemodynamics. Echocardiogram is a non invasive and right ventricular catheterization is an invasive diagnostic tool. Follow up is based on a clinical and functional assessment through functional class classification, dyspnea scores and 6-minute walking test. The prognosis is historically devastating but new therapies are changing the natural history of the disease. New treatments have demonstrated improvement in symptoms, hemodynamic profiles and survival. Intravenous, subcutaneous or inhaled prostanoids such as Epoprostenol, Treprostinil or Iloprost respectively have been approved for Pulmonary Arterial Hypertension treatment as well as oral endothelial receptor blockers. They are all considered first line treatments for arterial pulmonary hypertensive patients with even better benefits than lung transplantation. Phosphodiesterase inhibitors (Sildenafil), have been recently approved for the treatment of pulmonary arterial hypertension

  14. Evaluating the relationship between erectile dysfunction and dose received by the penile bulb: Using data from a randomised controlled trial of conformal radiotherapy in prostate cancer (MRC RT01, ISRCTN47772397)

    International Nuclear Information System (INIS)

    Aim: To evaluate the relationship between erectile function and the radiation dose to the penile bulb and other proximal penile structures in men receiving conformal radiotherapy (CFRT) for prostate cancer (PCa). Methods: The Medical Research Council (MRC) RT01 trial randomised 843 men who had localised PCa to receive either 64 or 74 Gy after 3-6 months neoadjuvant hormonal treatment. Fifty-one men were selected who were potent prior to hormonal treatment, having completed both pre-hormone and 2-year post-CFRT Quality of Life assessments, and on whom dose volume data were available for analysis. The men were divided into three groups according to 2-year follow-up: potent, reduced potency, and impotent. The bulb of the penis together with the crura, were outlined on restored treatment plans. Dose-volume histograms were generated and compared between the three groups. An ordered logistic regression model was used to calculate the odds ratio of a range of dose-volume parameters to the penile bulb and effect on erectile dysfunction. The dose to the penile bulb was correlated to the dose received by the crura. Results: Of the 51 patients, 12 remained potent, 22 had reduced potency, and 17 were impotent at 2 years. No differences were seen in mean dose to the penile bulb by allocated treatment (t test = 1.61, p = 0.11). The mean doses to the penile bulb received by the potent, reduced potency, and impotent groups were 45.5 Gy (SD 17.1), 48 Gy (SD 16.1), and 59.2 Gy (SD 13.8), respectively. There was a strong correlation between the mean dose received by the penile bulb and dose to the crura (r = 0.82, p < 0.0001). 83.3% of impotent patients received a D90 ?50 Gy to the penile bulb compared with 29.4% of patients who maintained potency at 2 years (p 0.006). Conclusion: There is evidence from this study to suggest a dose volume effect on the penile bulb and erectile dysfunction. A D90 ?50 Gy is associated with a significant risk of erectile dysfunction and this should form a basis for selecting dose constraints in future dose escalation studies

  15. Stem villous arteries from the placentas of heavy smokers: functional and mechanical properties

    DEFF Research Database (Denmark)

    Clausen, Helle Vibeke; Jorgensen, J C; Ottesen, B

    1999-01-01

    OBJECTIVE: The aim of the study was to compare the mechanical and functional properties of isolated small stem villous arteries from the placentas of women who smoked heavily (>/=15 cigarettes/d) during pregnancy with those from the placentas of nonsmokers. STUDY DESIGN: Isolated stem villous arteries were mounted in small-vessel myographs. Circumference-tension relationships were established with 124 mmol/L potassium chloride. Concentration-response curves were obtained for endothelin 1, prosta...

  16. Angioplasty and stent placement - carotid artery

    Science.gov (United States)

    Carotid angioplasty and stenting; CAS; Angioplasty - carotid artery ... Artery Disease. J Am Coll Cardiol .2011; International Carotid Stenting Study Investigators. Dobson EJ, Featherstone RL, Bonati LH, ...

  17. [Management of arterial hypertension].

    Science.gov (United States)

    Groha, P; Schunkert, H

    2015-09-01

    Arterial hypertension is one of the most frequent diseases in the western world and is one of the three most important risk factors for heart diseases. The 2013 guidelines of the European Societies of Hypertension and Cardiology (ESH/ESC) provide a clear action plan for evidence-based diagnostics and therapeutic measures in hypertensive subjects and simplify target blood pressures across various patient groups. Non-pharmacological options play a central role in the treatment of arterial hypertension. The indications for drug therapy arise from three criteria including the level of hypertension, risk profile of the patient, as well as response to non-pharmacological therapy. For the first choice monotherapy five substance groups are available: diuretics, beta blockers, angiotensin-converting enzyme (ACE) inhibitors, angiotensin (AT) 1 receptor antagonists and calcium antagonists. By combination therapy, the responder rate can be significantly increased with respect to a normalization of blood pressure. A true treatment resistance, in which the therapeutic goal is not reached in spite of a triple combination with maximum dosage, is extremely rare. Further treatment options are combinations of four drug classes and changes of medication. Hypertensive emergencies require a rapid intervention; nevertheless, the magnitude of blood pressure lowering can greatly vary depending on the individual clinical picture. PMID:26303172

  18. Arterial anatomy of the thumb.

    Science.gov (United States)

    Ames, E L; Bissonnette, M; Acland, R; Lister, G; Firrell, J

    1993-08-01

    The anatomical literature has indicated that the arterial supply to the thumb comes from the princeps pollicis artery. However, this simplified description does not often correlate with intraoperative findings. The purpose of this study was to investigate and clarify this important area of anatomy by dissection of fresh cadaver hands. 40 dissections were completed on 35 intravascularly injected and five non-injected hands. Five patterns were identified. The most common pattern showed both a superficial and deep vessel to the first web space in 54% of specimens. Dominant vessels included the superficial palmar branch of the radial artery in 8%, first palmar metacarpal artery in 18% and dorsal metacarpal artery in 8%. Only three specimens correlated with the textbook description. We conclude that the term "princeps pollicis" is actually a misnomer. PMID:8409651

  19. Transposition of the great arteries

    Directory of Open Access Journals (Sweden)

    Castela Eduardo

    2008-10-01

    Full Text Available Abstract Transposition of the great arteries (TGA, also referred to as complete transposition, is a congenital cardiac malformation characterised by atrioventricular concordance and ventriculoarterial (VA discordance. The incidence is estimated at 1 in 3,500–5,000 live births, with a male-to-female ratio 1.5 to 3.2:1. In 50% of cases, the VA discordance is an isolated finding. In 10% of cases, TGA is associated with noncardiac malformations. The association with other cardiac malformations such as ventricular septal defect (VSD and left ventricular outflow tract obstruction is frequent and dictates timing and clinical presentation, which consists of cyanosis with or without congestive heart failure. The onset and severity depend on anatomical and functional variants that influence the degree of mixing between the two circulations. If no obstructive lesions are present and there is a large VSD, cyanosis may go undetected and only be perceived during episodes of crying or agitation. In these cases, signs of congestive heart failure prevail. The exact aetiology remains unknown. Some associated risk factors (gestational diabetes mellitus, maternal exposure to rodenticides and herbicides, maternal use of antiepileptic drugs have been postulated. Mutations in growth differentiation factor-1 gene, the thyroid hormone receptor-associated protein-2 gene and the gene encoding the cryptic protein have been shown implicated in discordant VA connections, but they explain only a small minority of TGA cases. The diagnosis is confirmed by echocardiography, which also provides the morphological details required for future surgical management. Prenatal diagnosis by foetal echocardiography is possible and desirable, as it may improve the early neonatal management and reduce morbidity and mortality. Differential diagnosis includes other causes of central neonatal cyanosis. Palliative treatment with prostaglandin E1 and balloon atrial septostomy are usually required soon after birth. Surgical correction is performed at a later stage. Usually, the Jatene arterial switch operation is the procedure of choice. Whenever this operation is not feasible, adequate alternative surgical approach should be implemented. With the advent of newer and improved surgical techniques and post operative intensive care, the long-term survival is approximately 90% at 15 years of age. However, the exercise performance, cognitive function and quality of life may be impaired.

  20. Mediastinal course of the bronchial arteries. Helical CT evaluation

    International Nuclear Information System (INIS)

    This study reviewed 5-mm helical CT examinations, performed preoperatively in 261 consecutive patients with primary lung cancer to identify the location of the bronchial arteries in the mediastinum and the relation between mediastinal course of the bronchial arteries and the location of their orifices. The helical CT scans were acquired with small 170-mm fields of view and spans of 11.5-cm during a 23-second breath hold and the rapid injection of contrast medium targeting the upper mediastinum and pulmonary hili. The parameters were 5-mm collimation, table speed of 5-mm/sec (pitch. 1:1), 5-mm reconstruction, 120 KV, 250 mA. Two series of scans at the same location, started at 20 and 90 seconds, respectively, after initiating the injection of contrast medium, were obtained. Helical CT was performed with a X-Vigor scanner (Toshiba Medical, Tokyo, Japan). The arteries were identified as bronchial arteries if they could be traced from their orifice in the thoracic aorta to around a main bronchus or the intermediate bronchus. Five of the 266 patients were excluded from the study. Right bronchial arteries were demonstrated in 77 patients (29.5%), and left bronchial arteries in 102 patients (39.1%). The mediastinal course of the right bronchial arteries with orifices in the aorta could be divided into three patterns. By far the most frequent pattern by far was the intercosto-bronchial type (56 arteries), in which the right bronchial arteries emerged from the right wall of the descending aorta and approached the right main bronchus posteriorly. Of the 23 right bronchial arteries that emerged from the anterior wall of the descending aorta or aortic arch, 19 pursued a pre-carinal course and 7 took a pre-esophageal course, depending on the height of their orifices. Left bronchial arteries were demonstrated in 102 patients. In 93 patients the left bronchial arteries emerged from the anterior wall of the descending aorta and passed anteriorly to reach the posterior wall of the left main bronchus. It was concluded from the results of our investigation that clinical applications of CT images of the bronchial arteries are possible. The information provided by helical CT may be useful before procedures such as pre-carinal lymph node biopsy by mediastinoscopy or operations on the esophagus in patients, especially in males with large lung tumors. Use of the recently developed modality multi-detector row CT allowed demonstration of the other mediastinal courses and orifices of bronchial arteries and even the intra-pulmonary courses of the bronchial arteries, which should help improve the success rate of bronchial arterial embolization and decrease the risk of breeding in surgical procedures. (K.H.)

  1. Mediastinal course of the bronchial arteries. Helical CT evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Mori, Koichi [Mitsui Memorial Hospital, Tokyo (Japan)

    2001-03-01

    This study reviewed 5-mm helical CT examinations, performed preoperatively in 261 consecutive patients with primary lung cancer to identify the location of the bronchial arteries in the mediastinum and the relation between mediastinal course of the bronchial arteries and the location of their orifices. The helical CT scans were acquired with small 170-mm fields of view and spans of 11.5-cm during a 23-second breath hold and the rapid injection of contrast medium targeting the upper mediastinum and pulmonary hili. The parameters were 5-mm collimation, table speed of 5-mm/sec (pitch. 1:1), 5-mm reconstruction, 120 KV, 250 mA. Two series of scans at the same location, started at 20 and 90 seconds, respectively, after initiating the injection of contrast medium, were obtained. Helical CT was performed with a X-Vigor scanner (Toshiba Medical, Tokyo, Japan). The arteries were identified as bronchial arteries if they could be traced from their orifice in the thoracic aorta to around a main bronchus or the intermediate bronchus. Five of the 266 patients were excluded from the study. Right bronchial arteries were demonstrated in 77 patients (29.5%), and left bronchial arteries in 102 patients (39.1%). The mediastinal course of the right bronchial arteries with orifices in the aorta could be divided into three patterns. By far the most frequent pattern by far was the intercosto-bronchial type (56 arteries), in which the right bronchial arteries emerged from the right wall of the descending aorta and approached the right main bronchus posteriorly. Of the 23 right bronchial arteries that emerged from the anterior wall of the descending aorta or aortic arch, 19 pursued a pre-carinal course and 7 took a pre-esophageal course, depending on the height of their orifices. Left bronchial arteries were demonstrated in 102 patients. In 93 patients the left bronchial arteries emerged from the anterior wall of the descending aorta and passed anteriorly to reach the posterior wall of the left main bronchus. It was concluded from the results of our investigation that clinical applications of CT images of the bronchial arteries are possible. The information provided by helical CT may be useful before procedures such as pre-carinal lymph node biopsy by mediastinoscopy or operations on the esophagus in patients, especially in males with large lung tumors. Use of the recently developed modality multi-detector row CT allowed demonstration of the other mediastinal courses and orifices of bronchial arteries and even the intra-pulmonary courses of the bronchial arteries, which should help improve the success rate of bronchial arterial embolization and decrease the risk of breeding in surgical procedures. (K.H.)

  2. Bilateral stroke: unpaired anterior cerebral artery infarct rare presentation

    Directory of Open Access Journals (Sweden)

    Kekathi Vidyasagar

    2015-01-01

    Full Text Available ACA territory is an uncommon site for occlusive vascular strokes. Small degree of asymmetry of anterior arteries is present in 80% of patients. Common variants of anterior cerebral arteries include aplasia or hypoplasia of A1 segment. Hypoplasia is found in 10% and aplasia in 1-2% of postmortem examinations. Of all ischemic strokes ACA territory strokes constitutes only 0.6 to 3%. Bilateral ischemic stroke in unpaired ACA is rare entity. We report a case of unpaired ACA due to hypoplasia of right ACA, presenting as stuttering hemiplegia with bilateral focal neurological deficit. [Int J Res Med Sci 2015; 3(1.000: 331-333

  3. Artery phantoms for intravascular optical coherence tomography: healthy arteries.

    Science.gov (United States)

    Bisaillon, Charles-Étienne; Dufour, Marc L; Lamouche, Guy

    2011-09-01

    We present a method to make phantoms of coronary arteries for intravascular optical coherence tomography (IV-OCT). The phantoms provide a calibrated OCT response similar to the layered structure of arteries. The optical properties of each layer are achieved with specific concentrations of alumina and carbon black in a silicone matrix. This composition insures high durability and also approximates the elastic properties of arteries. The phantoms are fabricated in a tubular shape by the successive deposition and curing of liquid silicone mixtures on a lathe setup. PMID:21991552

  4. High-resolution coronary MR angiography for evaluation of patients with anomalous coronary arteries: visualization of the intramural segment

    International Nuclear Information System (INIS)

    Anomalous origin of the coronary artery from the contralateral coronary sinus is a rare coronary anomaly associated with sudden death. The inter-arterial course is most closely associated with sudden death, but it has been suggested that the presence of an intramural segment of a right anomalous coronary is associated with more symptoms and therefore may be an important criterion for intervention in these patients. To demonstrate that MR angiography can accurately determine the presence or absence of an intramural segment in an anomalous coronary artery. All studies of children who underwent MR angiography for the evaluation of an anomalous coronary artery were retrospectively reviewed by two pediatric radiologists in consensus. Criteria for an intramural anomalous coronary artery were the presence of a small or slit-like ostium and the relative smaller size of the proximal intramural portion of the coronary artery in relation to the more distal epicardial coronary artery. The anomalous coronary artery was classified as not intramural if these two findings were absent. These findings were correlated with operative reports confirming the presence or absence of an intramural segment. Twelve patients (86%) met MR angiography criteria for the presence of an intramural course. Only 2 patients (14%) met MR angiography criteria for a non-intramural course. When correlating with intraoperative findings, MR angiography was successful in distinguishing between intramural and non-intramural anomalous coronary arteries in all cases (P = 0.01). MR angiography may be able to reliably identify the intramural segment of an anomalous coronary artery in older children using the imaging criteria of a small or slit-like ostium and relative decrease in size of the proximal portion of the anomalous coronary artery compared to the distal portion of the anomalous coronary artery. Determining the presence of the intramural segment may help with surgical planning and may be an important criterion for the determination of intervention in patients with inter-arterial anomalous right coronary arteries. (orig.)

  5. High-resolution coronary MR angiography for evaluation of patients with anomalous coronary arteries: visualization of the intramural segment

    Energy Technology Data Exchange (ETDEWEB)

    Biko, David M. [UCSF Benioff Children' s Hospital Oakland, Department of Diagnostic Imaging, Oakland, CA (United States); The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); Chung, Claudia; Chung, Taylor [UCSF Benioff Children' s Hospital Oakland, Department of Diagnostic Imaging, Oakland, CA (United States); Hitt, David M. [Philips Healthcare, Cleveland, OH (United States); Kurio, Gregory [UCSF Benioff Children' s Hospital Oakland, Department of Cardiology, Oakland, CA (United States); Reinhartz, Olaf [UCSF Benioff Children' s Hospital Oakland, Department of Cardiac Surgery, Oakland, CA (United States)

    2015-08-15

    Anomalous origin of the coronary artery from the contralateral coronary sinus is a rare coronary anomaly associated with sudden death. The inter-arterial course is most closely associated with sudden death, but it has been suggested that the presence of an intramural segment of a right anomalous coronary is associated with more symptoms and therefore may be an important criterion for intervention in these patients. To demonstrate that MR angiography can accurately determine the presence or absence of an intramural segment in an anomalous coronary artery. All studies of children who underwent MR angiography for the evaluation of an anomalous coronary artery were retrospectively reviewed by two pediatric radiologists in consensus. Criteria for an intramural anomalous coronary artery were the presence of a small or slit-like ostium and the relative smaller size of the proximal intramural portion of the coronary artery in relation to the more distal epicardial coronary artery. The anomalous coronary artery was classified as not intramural if these two findings were absent. These findings were correlated with operative reports confirming the presence or absence of an intramural segment. Twelve patients (86%) met MR angiography criteria for the presence of an intramural course. Only 2 patients (14%) met MR angiography criteria for a non-intramural course. When correlating with intraoperative findings, MR angiography was successful in distinguishing between intramural and non-intramural anomalous coronary arteries in all cases (P = 0.01). MR angiography may be able to reliably identify the intramural segment of an anomalous coronary artery in older children using the imaging criteria of a small or slit-like ostium and relative decrease in size of the proximal portion of the anomalous coronary artery compared to the distal portion of the anomalous coronary artery. Determining the presence of the intramural segment may help with surgical planning and may be an important criterion for the determination of intervention in patients with inter-arterial anomalous right coronary arteries. (orig.)

  6. A New Technique for Superselective Catheterization of Arteries: Preshaping of a Micro-Guide Wire into a Shepherd's Hook Form

    Energy Technology Data Exchange (ETDEWEB)

    Baek, Jee Hyun; Chung; Jin Wook; Jae, Hwan Jun; Lee, Whal; Park, Jae Hyung [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2007-06-15

    We wanted to introduce a new technique for superselective catheterization of arteries with preshaping of a micro-guide wire into a shepherd's hook form, and this is useful for superselection of small arteries branching at an acute angle from a large parent artery for the treatment of tumors and hemorrhages. We developed a superselective catheterization technique by using preshaping of a micro-guide wire into a shepherd's hook form. We encountered six patients in our practice for whom we failed to catheterize the small tumor-feeding arteries that branched at an acute angle from wide parent arteries during chemoembolization of hepatocellular carcinoma; the parent arteries were the right inferior phrenic artery (n = 4) and the left gastric artery (n = 1) from the celiac axis with celiac stenosis due to compression by the median arcuate ligament and the proper hepatic artery from the gastroduodenal artery (n = 1) in a patient who had celiac axis occlusion with collateral circulation via the pancreaticoduodenal arcade from the superior mesenteric artery. In these consecutive six patients, we tested the usefulness of this new technique with employing preshaping of a micro-guide wire into a shepherd's hook form for superselective catheterization of targeted vessels. The target arteries were successfully catheterized and satisfactory transcatheter arterial chemoembolization was performed in all six patients. There were no significant complications such as arterial dissection. We developed a technique that is effective for superselection of vessels with preshaping of micro-guide wire into a shepherd's hook hook form, and we successfully applied it during chemoembolization of hepatocellular carcinoma. This technique can be useful for superselection of small arteries that branch from a large parent artery at acute angles for the treatment of tumors and hemorrhages.

  7. Right coronary artery arising as a terminal extension of the left circumflex artery (a rare coronary artery anomaly)

    OpenAIRE

    Tanr?verdi, Halil; ?eleci, Deniz; Kuru, Ömür; Semiz, Ender

    2007-01-01

    A single coronary artery is a very rare type of coronary artery anomaly that may present in various forms. A patient is presented in whom the right coronary artery coursed as the terminal branch of the left circumflex artery. This is the second case of this anomaly in the literature.

  8. Multi-detector Computed Tomography Angiography of the Hepatic Artery in Liver Transplant Recipients

    Energy Technology Data Exchange (ETDEWEB)

    Boraschi, P.; Donati, F.; Cossu, M.C.; Gigoni, R.; Vignali, C.; Filipponi, F.; Bartolozzi, C.; Falaschi, F. [Pisa Univ. Hospital (Italy). 2nd Dept. of Radiology

    2005-08-01

    PURPOSE: To evaluate the ability of multi-detector row computed tomography angiography (CTA) in detecting hepatic artery complications in the follow-up of liver transplant patients, performing volume-rendering as reconstruction technique. MATERIAL AND METHODS: The anatomy of hepatic artery was studied in 27 liver transplant recipients with a four-row CT scanner using the following parameters: collimation, 1 mm; slice width, 1 mm; table feed, 6-8 mm/s; spiral reconstruction time, 0.5 s; reconstruction interval, 0.5 mm; mAs, 160; kVp, 120. Before the study, the patients received 1000 ml of water as oral contrast agent to produce negative contrast in the stomach and the small bowel. A non-ionic contrast medium was infused intravenously at a rate of 5 ml/s with a bolus tracking system. Volume-rendering of hepatic artery was performed with the 3D Virtuoso software. RESULTS: The celiac trunk, the hepatic artery, and the right and left hepatic arteries were successfully displayed in high detail in all patients. Side branches, including small collaterals, and hepatic artery anastomosis could also be readily visualized. Volume-rendered CTA detected six hepatic artery stenoses, two hepatic artery thromboses, and two intrahepatic pseudoaneurysms. In two cases, CT detected hepatic artery stenosis with a diameter reduction of less than 50%, while digital subtraction angiography showed a normal artery. CONCLUSION: Volume-rendered multi-detector CTA is a promising non-invasive technique, since it allows images of high quality to be generated with excellent anatomical visualization of the hepatic artery and its complications in liver transplant recipients.

  9. Access to the ophthalmic artery by retrograde approach through the posterior communicating artery for intra-arterial chemotherapy of retinoblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Pham, Chi-Tuan; Blanc, Raphael; Pistocchi, Silvia; Bartolini, Bruno; Piotin, Michel [Fondation Rothschild Hospital, Department of Interventional Neuroradiology, Paris (France); Lumbroso-Le Rouic, Livia [Institut Curie, Department of Ocular Oncology, Paris (France)

    2012-08-15

    Intra-arterial infusion of chemotherapy into the ophthalmic artery for treatment of retinoblastoma has been realized after catheterization of the internal carotid and temporary balloon occlusion beyond the orifice of the ophthalmic artery, or more recently after superselective canulation of the ophthalmic artery by a microcatheter. The superselective catheterization of the ophthalmic artery could be cumbersome because of the implantation of the ostium on the carotid siphon or because of the tortuosity of the carotid siphon. We report our experience of using a retrograde approach through the posterior communicating artery that allows a more direct angle of access to the origin of the ophthalmic artery. (orig.)

  10. Limited Role for C. pneumoniae, CMV and HSV-1 in Cerebral Large and Small Vessel Atherosclerosis

    OpenAIRE

    Voorend, M; van der Ven, A. J. A. M.; Kubat, B.; LODDER, J; Bruggeman, C A

    2008-01-01

    Aims: To explore whether Chlamydia pneumoniae, Cytomegalovirus and Herpes Simplex Virus type 1 could be detected in large and small cerebral arteries, as well as in an area of brain parenchyma where white matter lesions (leukoaraiosis) can be found, in patients with clinically unmanifested cerebrovascular atherosclerosis. Methods and results( Arterial specimens from the basilar artery and middle cerebral artery, and brain samples from the basal ganglia and periventricular white matter were ob...

  11. ROCK inhibition prevents fetal serum-induced alteration in structure and function of organ-cultured mesenteric artery

    OpenAIRE

    Huh, Yang Hoon; Zhou, Qian; LIAO, James K.; Kitazawa, Toshio

    2011-01-01

    Chronic treatment with fetal bovine serum (FBS) causes contractility reduction, morphological alteration and DNA synthesis in organ-cultured vascular tissues. Here, we tested the hypothesis that chronic inhibition of ROCK has a protective effect on FBS-induced alterations in small arteries. Rabbit mesenteric arterial rings were cultured in FBS-supplemented culture medium with or without Y-27632, a reversible ROCK inhibitor. Chronic Y-27632 treatment prevented FBS-induced gradual arterial cons...

  12. STUDY OF MEDIAL CIRCUMFLEX ARTERY

    Directory of Open Access Journals (Sweden)

    Pavan P Havaldar

    2014-06-01

    Full Text Available Background: The proper knowledge of the course and ramification of blood vessels of lower limbs is very important for surgeons and interventional radiologist. Medial circumflex femoral artery usually originates from posteromedial aspect of the profunda femoris, but often originates from femoral artery itself. It has an important role in supplying blood to femoral neck and head, fatty tissue in acetabular fossa and used in flaps reconstructive surgery. Methods: 50 adult lowerlimbs were procured from embalmed cadavers of J.J.M. Medical College and S.S.I.M.S & R.C, Davangere, Karnataka, India for the study. Dissection of femoral triangle was carried out according to Cunningham’s manual. Site and mode of origin of the branches of femoral artery were studied, configuration of the femoral origins of medial and lateral circumflex femoral artery and their prevalence were studied. Results: Out of 50 extremities, Medial circumflex femoral artery took origin from profunda femoris in 41 specimens and from femoral artery in 9 specimens. Conclusion: The knowledge of normal origin and variation of medial circumflex femoral artery is very valuable in preventing iatrogenic injury to these vessels during surgical procedures of femoral triangle.

  13. Interventional management of gastroduodenal lesions complicating intra-arterial hepatic chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Proietti, Stefania; Doenz, Francesco; Qanadli, Salah D.; Schnyder, Pierre; Denys, Alban [Universitaire Vaudois, Department of Radiology, Centre Hospitalier, Lausanne (Switzerland); Baere, Thierry de [Institut Gustave-Roussy, Department of Interventional Radiology, Villejuif (France); Bessoud, Bertrand [Hopital Bicetre, Department of Radiology, Le Kremlin-Bicetre (France)

    2007-08-15

    Herein we report the efficacy of embolization of small patent gastric or duodenal vessels for treating gastroduodenal complications after hepatic arterial infusion therapy (HAIC). Catheter ports were implanted percutaneously from a femoral approach in three cases or surgically in the gastroduodenal artery in two cases. Acute abdominal pain developed on average after four HAIC courses of 5FU-oxaliplatin, mytomycin, oxaliplatin or fotemustine. Esophagogastroduodenoscopy showed gastroduodenal lesions (gastroduodenitis with or without ulcerations) in all cases. Despite the interruption of the HAIC, symptoms persisted and led to selective hepatic arteriography showing a patent right gastric artery (n = 4) or a recanalized gastroduodenal artery (n = 1) responsible for gastroduodenal misperfusion. Successful embolizations of the arteries responsible for gastroduodenal misperfusion (right gastric artery in four cases and gastroduodenal artery in one case) using 0.018 platinium coils relieved the patients' symptoms and allowed the HAIC to continue. In gastroduodenal complications of HAIC, a selective hepatic arteriography should be performed to search any artery responsible for the misperfusion of the toxic agent in the gastroduodenal area. Embolization of these arteries allowed the HAIC to be restored. (orig.)

  14. Numerical study for blood flow in pulmonary arteries after repair of tetralogy of Fallot.

    Science.gov (United States)

    Chern, Ming-Jyh; Wu, Ming-Ting; Her, Sheau-Wei

    2012-01-01

    Pulmonary regurgitation (PR) is a common phenomenon in pulmonary arteries in patients after repair of tetralogy of Fallot (TOF). The regurgitation fraction of left pulmonary artery (LPA) is usually greater than right pulmonary artery (RPA) according to clinic data. It may be related to blood flow in pulmonary arteries. Therefore, understanding hemodynamics in pulmonary arteries helps to comprehend the reason. The aim of this study is to use 3D reconstructed pulmonary artery models from magnetic resonance imaging (MRI) and to use numerical approaches for simulation of flow variations in pulmonary arteries after repair of TOF. From the numerical results, the blood flow is influenced by the bifurcation angles and geometry of pulmonary artery. The regurgitation happens first in LPA after repair of TOF due to the small angle between LPA and main pulmonary artery (MPA). The recirculation region which obstructs forward blood flow to the left lung is found in LPA during acceleration of systole. We also analyze the pressure distribution; the extreme pressure variations are in dilation area of MPA. Numerical data including regurgitation in MPA, LPA, and RPA are compared with phase contrast MR measured data. Good agreements are found between numerical results and measured data. PMID:23431355

  15. Development of a New Subclavian Arterial Infusion Chemotherapy Method for Locally or Recurrent Advanced Breast Cancer Using an Implanted Catheter-Port System After Redistribution of Arterial Tumor Supply

    International Nuclear Information System (INIS)

    Locally or recurrent advanced breast cancers can receive arterial blood supply from various arteries, such as the internal thoracic artery (ITA), the lateral thoracic artery, and the other small arterial branches originating from the subclavian artery. Failure to catheterize and subsequent formation of collateral arterial blood supply from various arteries are some of the reasons why the response to conventional selective transarterial infusion chemotherapy is limited and variable. To overcome this problem, we developed a new subclavian arterial infusion chemotherapy method using an implanted catheter-port system after redistribution of arterial tumor blood supply by embolizing the ITA. We named this technique ('redistributed subclavian arterial infusion chemotherapy' (RESAIC)). Using RESAIC, patients can be treated on an outpatient basis for extended periods of time. Eleven patients underwent RESAIC, and the complete remission and partial response rate in 10 evaluable patients was 90%: complete remission [CR] n = 4, partial remission n = 4, stable disease n = 1, and not evaluable n = 1. Three of four patients with CR had no distant metastasis, and modified radical mastectomy was performed 1 month after conclusion of RESAIC. The resected specimens showed no residual cancer cells, and pathologically confirmed complete remission was diagnosed in each of these cases. Although temporary grade-3 myelosuppression was seen in three patients who were previously treated by systemic chemotherapy, there was no other drug-induced toxicity or procedure-related complications. RESAIC produced a better response and showed no major complications compared with other studies despite the advanced stage of the cancers.

  16. Arterial dysfunction but maintained systemic blood pressure in cavin-1-deficient mice.

    Science.gov (United States)

    Swärd, Karl; Albinsson, Sebastian; Rippe, Catarina

    2014-01-01

    Caveolae are omega-shaped plasma membrane micro-domains that are abundant in cells of the vascular system. Formation of caveolae depends on caveolin-1 and cavin-1 and lack of either protein leads to loss of caveolae. Mice with caveolin-1 deficiency have dysfunctional blood vessels, but whether absence of cavin-1 similarly leads to vascular dysfunction is not known. Here we addressed this hypothesis using small mesenteric arteries from cavin-1-deficient mice. Cavin-1-reporter staining was intense in mesenteric arteries, brain arterioles and elsewhere in the vascular system, with positive staining of both endothelial and smooth muscle cells. Arterial expression of cavin-1, -2 and -3 was reduced in knockout (KO) arteries as was expression of caveolin-1, -2 and -3. Caveolae were absent in the endothelial and smooth muscle layers of small mesenteric arteries as determined by electron microscopy. Arginase, a negative regulator of nitric oxide production, was elevated in cavin-1 deficient arteries as was contraction in response to the ?1-adrenergic agonist cirazoline. Detailed assessment of vascular dimensions revealed increased media thickness and reduced distensibility, arguing that enhanced contraction was due to increased muscle mass. Contrasting with increased ?1-adrenergic contraction, myogenic tone was essentially absent and this appeared to be due in part to increased nitric oxide production. Vasomotion was less frequent in the knock-out vessels. In keeping with the opposing influences on arterial resistance of increased agonist-induced contractility and reduced myogenic tone, arterial blood pressure was unchanged in vivo. We conclude that deficiency of cavin-1 affects the function of small arteries, but that opposing influences on arterial resistance balance each other such that systemic blood pressure in unstressed mice is well maintained. PMID:24658465

  17. Phenolic Extract from Moringa oleifera Leaves Inhibits Key Enzymes Linked to Erectile Dysfunction and Oxidative Stress in Rats' Penile Tissues

    Science.gov (United States)

    Oboh, Ganiyu; Ademiluyi, Adedayo O.; Ademosun, Ayokunle O.; Olasehinde, Tosin A.; Oyeleye, Sunday I.; Boligon, Aline A.; Athayde, Margareth L.

    2015-01-01

    This study was designed to determine the antioxidant properties and inhibitory effects of extract from Moringa oleifera leaves on angiotensin-I-converting enzyme (ACE) and arginase activities in vitro. The extract was prepared and phenolic (total phenols and flavonoid) contents, radical (nitric oxide (NO), hydroxyl (OH)) scavenging abilities, and Fe2+-chelating ability were assessed. Characterization of the phenolic constituents was done via high performance liquid chromatography-diode array detection (HPLC-DAD) analysis. Furthermore, the effects of the extract on Fe2+-induced MDA production in rats' penile tissue homogenate as well as its action on ACE and arginase activities were also determined. The extract scavenged NO?, OH?, chelated Fe2+, and inhibited MDA production in a dose-dependent pattern with IC50 values of 1.36, 0.52, and 0.38?mg/mL and 194.23?µg/mL, respectively. Gallic acid, chlorogenic acid, quercetin, and kaempferol were the most abundant phenolic compounds identified in the leaf extract. The extract also inhibited ACE and arginase activities in a dose-dependent pattern and their IC50 values were 303.03 and 159.59?µg/mL, respectively. The phenolic contents, inhibition of ACE, arginase, and Fe2+-induced MDA production, and radical (OH?, NO?) scavenging and Fe2+-chelating abilities could be some of the possible mechanisms by which M. oleifera leaves could be used in the treatment and/or management of erectile dysfunction.

  18. Phenolic Extract from Moringa oleifera Leaves Inhibits Key Enzymes Linked to Erectile Dysfunction and Oxidative Stress in Rats' Penile Tissues.

    Science.gov (United States)

    Oboh, Ganiyu; Ademiluyi, Adedayo O; Ademosun, Ayokunle O; Olasehinde, Tosin A; Oyeleye, Sunday I; Boligon, Aline A; Athayde, Margareth L

    2015-01-01

    This study was designed to determine the antioxidant properties and inhibitory effects of extract from Moringa oleifera leaves on angiotensin-I-converting enzyme (ACE) and arginase activities in vitro. The extract was prepared and phenolic (total phenols and flavonoid) contents, radical (nitric oxide (NO), hydroxyl (OH)) scavenging abilities, and Fe(2+)-chelating ability were assessed. Characterization of the phenolic constituents was done via high performance liquid chromatography-diode array detection (HPLC-DAD) analysis. Furthermore, the effects of the extract on Fe(2+)-induced MDA production in rats' penile tissue homogenate as well as its action on ACE and arginase activities were also determined. The extract scavenged NO (?) , OH (?) , chelated Fe(2+), and inhibited MDA production in a dose-dependent pattern with IC50 values of 1.36, 0.52, and 0.38?mg/mL and 194.23?µg/mL, respectively. Gallic acid, chlorogenic acid, quercetin, and kaempferol were the most abundant phenolic compounds identified in the leaf extract. The extract also inhibited ACE and arginase activities in a dose-dependent pattern and their IC50 values were 303.03 and 159.59?µg/mL, respectively. The phenolic contents, inhibition of ACE, arginase, and Fe(2+)-induced MDA production, and radical (OH (?) , NO (?) ) scavenging and Fe(2+)-chelating abilities could be some of the possible mechanisms by which M. oleifera leaves could be used in the treatment and/or management of erectile dysfunction. PMID:26557995

  19. Quistes del rafe medio del pene. Presentación de dos casos / Penile medial raphe cysts. Presentation of two cases

    Scientific Electronic Library Online (English)

    Niurka, García Sosa; Francisco J, Fong Aldama.

    2014-08-01

    Full Text Available Los quistes del rafe medio del pene son lesiones benignas, infrecuentes en urología pediátrica, y usualmente asintomáticos. Se localizan en la región parameatal y borde inferior del prepucio. Se presentaron dos casos que acudieron a consulta de Urología, por el hallazgo del quiste por parte de los p [...] adres de los pacientes. Ambos quisten tenían de 1 a 2 cm de diámetro. Ninguno de los casos reportados se les había realizado la circuncisión previamente. A los dos casos se les hizo la marsupialización del quiste mediante cirugía ambulatoria, siendo la evolución post operatoria satisfactoria. Abstract in english Penile medial raphe cysts are benign lesions, infrequent in pediatric urology, usually asymptomatic. They are located in the parameatal region and the low edge of the foreskin. We presented two cases assisting to the Urology consultation because the patients´ parents discovered the cysts. Both cysts [...] were 1- 2cm diameter. No one of the patients was previously circumcised. It was carried out the marsupialization of both cysts in ambulatory surgery, being satisfactory post-surgery evolution.

  20. Vilosite de etiologia desconhecida em placentas de gestações com hipertensão arterial e de gestações com recém-nascidos pequenos para a idade gestacional / Villitis of unknown etiology in placentas of pregnancies with hypertensive disorders and of small-for-gestational-age infants

    Scientific Electronic Library Online (English)

    Albina Milani, Altemani; Adriana Rocha, Gonzatti.

    2003-01-01

    Full Text Available OBJETIVOS: Analisar a freqüência da vilosite de etiologia desconhecida (VED) e suas características histológicas em placentas de gestações com hipertensão arterial materna e de gestações com recém-nascidos (RN) pequenos para a idade gestacional. MÉTODOS: Foram estudadas 213 placentas de mães e RN se [...] m evidências clínicas ou sorológicas de infecção. Estas placentas foram subdivididas conforme a condição materna em: normotensas - 151 casos, doença hipertensiva específica da gravidez (DHEG) - 37 e hipertensão crônica - 25 e, de acordo com o peso do RN, em: pequenos (PIG)- 38 casos e adequados para a idade gestacional (AIG) - 175. Destas placentas, 81 pertenciam a uma amostra aleatória, que foi utilizada para determinar a freqüência de VED na população estudada. Foram retirados oito fragmentos do parênquima placentário e as secções histológicas foram coradas por HE. Para análise estatística foram utilizados os testes de qui-quadrado e exato de Fisher, sendo p Abstract in english BACKGROUND: The objectives of this study are to analyze the frequency and the histopathological features of the villitis of unknown etiology (VUE) in placentas of pregnancies with hypertensive disorders and of small-for-gestational-age infants (SGA). METHODS: Two hundred and thirteen placentas from [...] pregnancies without clinical or laboratorial evidence of infection were studied. These cases were subdivided according to: a) maternal condition in: non-complicated pregnancy (NCP)- 151 cases, pregnancy-induced hypertension (PIH)- 37 and sustained chronic hypertension (SCH)- 25 and b) newborn weight in: small for gestational age (SGA)- 38 cases and adequate for gestational age (AGA)- 175. Of these placentas, 81 belong to the random sample, which was used to determine the frequency of VUE in the population studied. Eight blocks were taken from placental parenchyma and the histological sections were stained with hematoxylin and eosin. Frequency tables of categorical data were analyzed using the chi- square test and Fisher test; statistical significance was considered for p

  1. Pancreaticoduodenal Artery Aneurysm Formation with Superior Mesenteric Artery Stenosis

    OpenAIRE

    Kitaoka, Tadashi; Deguchi, Juno; Kamiya, Chiaki; Suzuki, Jun; SATO, Osamu

    2014-01-01

    Celiac stenosis or occlusion is attributed partly to increase blood flow at pancreatic arcade from the superior mesenteric artery (SMA) system and may play a causal role in true aneurysm of pancreaticoduodenal artery (PDAA) formation. However, despite possible increased blood flow in the pancreatic arcades like celiac stenosis, PDAAs with a stenotic SMA are extremely rare, with only three cases have been reported in the literature. We report a case of PDAA with SMA stenosis and review the lit...

  2. Pancreaticoduodenal Artery Aneurysm Formation with Superior Mesenteric Artery Stenosis

    Science.gov (United States)

    Kitaoka, Tadashi; Kamiya, Chiaki; Suzuki, Jun; Sato, Osamu

    2014-01-01

    Celiac stenosis or occlusion is attributed partly to increase blood flow at pancreatic arcade from the superior mesenteric artery (SMA) system and may play a causal role in true aneurysm of pancreaticoduodenal artery (PDAA) formation. However, despite possible increased blood flow in the pancreatic arcades like celiac stenosis, PDAAs with a stenotic SMA are extremely rare, with only three cases have been reported in the literature. We report a case of PDAA with SMA stenosis and review the literature. PMID:25298835

  3. Application of dual-arterial phase CT scan in diagnosis of hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Objective: To compare the value of dual-arterial phase (DAP) combining portal phase as well as conventional arterial and portal phase enhanced CT scan in the diagnosis of hepatocellular carcinoma. Methods: 60 cases with positive AFP were received conventional dual-phase enhanced CT scan and dual-arterial phase combing portal phase enhanced CT scan respectively. Conventional dual-phase included arterial phase (20-25s) and portal phase (35-40s). Dual-arterial phase included early arterial phase (17-20s), late arterial phase (25-30s) and portal phase (35-40s). The detection rate and accuracy for hepatocellular carcinoma, especially for small liver carcinoma were analyzed. Results: The positive diagnosis rate of HCC with conventional dual-phase method and DAP combining portal phase method was 89.6% and 97.7%, respectively. Diagnostic accuracy for small lesions was higher with DAP method than with the conventional dual-phase CT scan. Conclusion: DAP combining portal phase enhanced CT scan is of higher clinical applied value in diagnosis of hepatocellular carcinoma, especially small liver carcinoma. (authors)

  4. Study on blood supply of lung metastasis with trans-pulmonary arterial lipiodol infusion

    International Nuclear Information System (INIS)

    Objective: To evaluate the blood supply of pulmonary metastases using small volume of lipiodol through pulmonary arterial infusion. Methods: 10 cases of lung metastasis were enroled including the primary tumors of liver cancer (n=5), renal carcinoma (n=3), chordoma (n=1) and malignant neurofibroma (n=1). Plain CT scan was performed to exclude calcification or ossification within metastasis and then pulmonary arterial DSA was undertaken to evaluate tumor vessels or staining. After pulmonary arteriovenous fistula or other anomalous circulation was excluded by lobar arterial DSA, small volume of lipiodol was infused under fluoroscopy (0.5-1.5 ml for each lobar artery, total volume less than 3.0 ml). CT scan was immediately performed. Blood supply of the pulmonary metastases was assessed according to the accumulation of lipiodol on CT scans. Results: No cases but one experienced cough, expectoration, suffocating or dyspnea. No complication of cerebral or visceral embolism occurred. Totally 27 nodules were studied including 6 nodules with cloudy lipiodol accumulation and 6 nodules with tiny granules of lipiodol accumulation. No enlarged tumor vessel or tumor stain was observed within all 27 nodules on pulmonary arterial DSA. Conclusions: Pulmonary artery supplys only parts of pulmonary metastases, especially those sited at the peripheral region of the lung. Infusion of small volume of lipiodol through pulmonary artery is safe, and the increased density of lung field could return normal after several days. (authors)

  5. Piezo1 in Smooth Muscle Cells Is Involved in Hypertension-Dependent Arterial Remodeling

    Directory of Open Access Journals (Sweden)

    Kevin Retailleau

    2015-11-01

    Full Text Available The mechanically activated non-selective cation channel Piezo1 is a determinant of vascular architecture during early development. Piezo1-deficient embryos die at midgestation with disorganized blood vessels. However, the role of stretch-activated ion channels (SACs in arterial smooth muscle cells in the adult remains unknown. Here, we show that Piezo1 is highly expressed in myocytes of small-diameter arteries and that smooth-muscle-specific Piezo1 deletion fully impairs SAC activity. While Piezo1 is dispensable for the arterial myogenic tone, it is involved in the structural remodeling of small arteries. Increased Piezo1 opening has a trophic effect on resistance arteries, influencing both diameter and wall thickness in hypertension. Piezo1 mediates a rise in cytosolic calcium and stimulates activity of transglutaminases, cross-linking enzymes required for the remodeling of small arteries. In conclusion, we have established the connection between an early mechanosensitive process, involving Piezo1 in smooth muscle cells, and a clinically relevant arterial remodeling.

  6. Use of chitosan and polypropylene for the surgical correction of penile deviation in bulls: clinical and histological aspects / Uso de chitosan y polipropileno en la corrección quirúrgica de la desviación del pene en toros: aspectos clínicos e histológicos

    Scientific Electronic Library Online (English)

    RR, Rabelo; LAB, Brito; AP, Rodrigues; AM, Moraes; A, Damasceno; VAS, Vulcani; LAF, Silva; CRO, Lima.

    Full Text Available Los problemas en el tracto reproductivo pueden causar dificultad o incapacidad para copular. La desviación prematura del pene es una causa importante de la impotencia en bovinos machos. El objetivo de este estudio fue realizar una evaluación clínica e histológica de la corrección de la desviación in [...] ducida quirúrgicamente en el pene de los toros, mediante la fijación del ligamento apical del pene en la túnica albugínea con implantes sintéticos o biológicos. Veintiún bovinos machos saludables no castrados mestizos, con una libido normal fueron sometidos a la inducción quirúrgica por la extirpación de un fragmento del ligamento apical del pene y su sustitución por una losa de quitosano y una malla de polipropileno después de la confirmación de la desviación del pene. Aunque el examen microscópico reveló que las losas de quitosano han demostrado ser menos irritantes para el tejido receptor. Se observó que todos los animales fallaron en restablecer el eje normal del pene. Por lo tanto, las técnicas quirúrgicas propuestas con implantes sintéticos no eran eficaces para la corrección de la desviación del pene inducida en los toros. Abstract in english Problems in the reproductive tract may result in difficulty or inability to copulate. Premature penile deviation is an important cause of impotency in male bovines. The aim of the study was to perform clinical and histological evaluation of the correction of surgically induced penile deviation in bu [...] lls by fixing the penile apical ligament in the tunica albuginea using synthetic or biological implants. Twenty-one animals with normal penile conformation were subjected to surgical induction of penile deviation by excision of a fragment from the penile apical ligament and replacement with a chitosan slab or polypropylene mesh. The scarification of the tunica albuginea was assessed as a control. The results showed that the tested or evaluated surgical techniques were ineffective in penile deviation correction, since all the animals failed to reestablish the normal axis of the penis. However, microscopic exam revealed that the chitosan slabs proved to be less irritating to the receptor tissue. Therefore, the proposed surgical techniques using synthetic or biological implants were ineffective for the correction of induced penile deviation in bulls.

  7. Comparative study of traditional long incision vein harvesting and multiple incisions with small skin bridges in patients with coronary artery bypass grafting at King Abdullah University Hospital - Jordan / Estudo comparativo entre a exérese da veia safena tradicional por incisão contínua e incisões múltiplas com pequenos "patchs" de pele em pacientes submetidos à revascularização do miocárdio no Hospital Universitário King Abdullah - Jordânia

    Scientific Electronic Library Online (English)

    Emad Mohamed, Hijazi.

    2010-06-01

    Full Text Available OBJETIVO: A exérese da veia safena pode estar associada a complicações da ferida, dor da incisão, infecção e resultado cosmético ruim. O objetivo deste estudo é determinar a diferença de complicações da ferida e as taxas de infecção entre as duas técnicas de exérese de veia safena, incisão longa ver [...] sus múltiplas incisões curtas separadas (tunneling) para a revascularização do miocárdio no Hospital Universitário King Abdullah, Jordânia. MÉTODOS: Analisamos, retrospectivamente, os dados de 1.050 procedimentos eletivos consecutivos de revascularização do miocárdio realizados no período de 5 de maio de 2003 a 31 de dezembro de 2007, em nossa instituição. Safenectomia utilizando exérese tradicional por incisões contínuas (Grupo 1) foi realizada em seiscentos e cinquenta pacientes (n=650), enquanto a safenectomia utilizando múltiplas incisões com pequenos patchs de pele - tunelização (Grupo 2) foi empregada em quatrocentos (n=400). Safenectomia foi realizada pelo assistente ou pelo cirurgião cardíaco principal. Reação inflamatória, deiscência, celulites, linfangite, drenagem, necrose ou abscesso que necessitasse curativo, antibióticos ou desbridamento antes da cicatrização completa sem escara foram definidos como complicações da ferida. Não houve diferença estatística entre os grupos com relação aos fatores de risco pré-operatório em ambos os grupos. Os resultados dos testes foram considerados significativos quando P Abstract in english OBJECTIVE: Saphenous vein harvesting can be associated with wound complications, incision pain, infection, and poor cosmetic outcome. The objective of our study is to determine the difference in wound complication and infection rates between two saphenous vein harvesting techniques, long incision ve [...] rsus multiple short interrupted incisions (tunneling) for coronary artery bypass grafting at the King Abdullah University Hospital - Jordan. METHODS: Retrospectively we analyzed data from 1,050 consecutive elective coronary artery bypass procedures performed from May 5, 2003, to December 31, 2007, in our institution. Saphenectomy using traditional Long incision vein harvesting (Group 1) performed in six hundred and fifty patients (n=650), while saphenectomy using multiple incisions with small skin bridges - tunneling (Group 2) performed in four hundred patients (n=400). Saphenectomy performed by the cardiac surgery assistant or main cardiac surgeon. Inflammation, dehiscence, cellulites, lymphangitis, drainage, necrosis, or abscess necessitating dressing, antibiotics or debridement before complete healing without eschar were defined as wound complications. There was no statistical difference in preoperative risk factors in both groups. Test results were considered significant when P

  8. Automated classification of cerebral arteries in MRA images

    International Nuclear Information System (INIS)

    The detection of unruptured aneurysms is a major task in magnetic resonance angiography (MRA). However, it is difficult for radiologists and/or neurosurgeons to detect small aneurysms on maximum intensity projection (MIP) images because adjacent vessels may overlap with the aneurysms. Therefore, we proposed a method for making a new MIP image, the SelMIP image, containing interested vessels only by manually selecting a cerebral artery from a list of cerebral arteries recognized automatically. For the automated classification of cerebral arteries, two three-dimensional images, a target image and a reference image, were compared. Image registration was performed using global matching and rigidity transformation. The segmented vessel regions were classified into eight cerebral arteries by calculating the Euclidian distance between a voxel in the target image and each of the voxels in the eight labeled vessel regions in the reference image. In applying the automated cerebral arteries recognition algorithm to 110 MRA studies, the results of subjective evaluation were that 76.4% (84/110) were rated as good, 13.6% (15/110) as adequate, and 10.0% (11/110) as poor. The results rated good or adequate are considered acceptable and would be adequate for clinical use. Overall, 90.0% (99/110) of MRA studies attained a clinically acceptable result. Our new viewing technique will be useful in assisting radiologists to detectaneurysms and reducing the interpretation time. (author)

  9. The impact of peripheral arterial disease and acute ischemic stroke

    International Nuclear Information System (INIS)

    Peripheral arterial disease (PAD) is associated with coronary artery disease (CAD) and stroke, but data on the relationship between PAD and acute ischemic stroke are lacking. Therefore, we investigated this relationship. A total of 101 patients were enrolled on admission to Harasanshin General Hospital (Fukuoka, Japan) with their first ischemic stroke. All 101 patients underwent cranial CT and/or brain magnetic resonance imaging, duplex ultrasonography of the extracranial carotid arteries, and transthoracic echocardiography. The subjects were aged 41 to 92 years. PAD was present in 81/101 patients (80.2%), including 57/73 (78.1%) with small artery occlusion, 11/13 (84.6%) with large artery occlusion, and 13/15 (86.7%) with cardiogenic embolism. In 42 of these 81 patients (51.9%), PAD was asymptomatic. Serum apoprotein A1 levels were significantly higher and the intima-media thickness was significantly greater in the patients with PAD than in those without PAD. The modified Rankin scale score was significantly higher on admission in patients with PAD than in those without PAD. Stepwise logistic regression analysis revealed that the apoprotein A1 level and the modified Rankin scale score on admission were strongly associated with the occurrence of stroke in patients with PAD. Our results suggest that PAD is frequently associated with acute ischemic stroke. It may be important to perform screening for PAD in patients who have suffered an ischemic stroke. (author)

  10. [Aneurysms of the extracranial part of the carotid artery].

    Science.gov (United States)

    Lovricevi?, I; Despot, I; Desyo, D; Vukeli?, M; Zovak, M; Budi, S

    1996-01-01

    The purpose of this article is to take firm position on the surgical treatment of the carotid artery aneurysm on the basis of ten years of experience, considering their rare occurrence and significant pathology. From January 1984 to December 1994, ten patients with aneurysms or pseudoaneurysms of extracranial carotid arteries were diagnosed and operated in the Department of Vascular Surgery, Clinical Hospital "Sestre milosrdnice" in Zagreb. In the same period, eight hundred operations of extracranial carotid arteries were performed. Special emphasis is put on the etiology of the disease where atherosclerosis is prevalent, but cases of traumatic, mycotic and postoperative aneurysms are also shown. In symptomatology, signs of palpable local tumor dominated in six patients, while in three patients central nervous system symptoms were found. All patients with neurologic symptoms were in the group with atherosclerotic aneurysms. In nine patients resection of the aneurysm and reconstruction with the interposition of a part of vena saphena magna or with allograft was performed. In one patient, neoanastomosis of the internal carotid artery in the common carotid artery was performed following the resection of a small aneurysm. In the early postoperative period there was no morbidity nor mortality. In view of frequent preoperative neurologic complications and good postoperative results, surgical treatment is indicated in all cases. Reconstruction is always indicated, and the procedure of choice is reconstruction with the interposition of a part of great saphenous vein. PMID:9213714

  11. Carotid artery stenting for stenosis with intraluminal thrombus

    International Nuclear Information System (INIS)

    Since intraluminal thrombus in the context of carotid artery stenosis is rarely encountered, treatment for this condition remains controversial. The present paper describes six cases of carotid artery stenosis with thrombus and discusses the efficacy and complications of carotid artery stenting (CAS). From April 2002 to May 2004, six patients with carotid artery stenosis and intraluminal thrombus receiving medical therapy underwent CAS at our institution. CAS was performed with distal protection alone (method 1) in three patients, and three other patients underwent CAS with reversed-flow system and distal protection (method 2). Two of six patients experienced worsening neurologic symptoms despite medical therapy. All six patients were successfully treated with CAS and showed satisfactory patency of the artery. Embolic lesions were detected on diffusion-weighted MRI after the procedure in all patients treated with method 1 but not in patients treated with method 2. Complications included stent thrombosis (n=1) and in-stent thrombus (n=1). All six patients achieved a modified Rankin Scale 1 or 2 classification at 30 days after stenting. In conclusion, CAS was feasible for stenosis even with intraluminal thrombus. Use of method 2 for this condition may reduce the incidence of thromboembolic events although our series was small in number. (orig.)

  12. Carotid artery stenting for stenosis with intraluminal thrombus

    Energy Technology Data Exchange (ETDEWEB)

    Tsumoto, Tomoyuki; Terada, Tomoaki; Tsuura, Mitsuharu; Matsumoto, Hiroyuki; Masuo, Osamu; Yamaga, Hiroo; Itakura, Toru [Wakayama Medical University, Department of Neurological Surgery, Wakayama (Japan)

    2006-01-01

    Since intraluminal thrombus in the context of carotid artery stenosis is rarely encountered, treatment for this condition remains controversial. The present paper describes six cases of carotid artery stenosis with thrombus and discusses the efficacy and complications of carotid artery stenting (CAS). From April 2002 to May 2004, six patients with carotid artery stenosis and intraluminal thrombus receiving medical therapy underwent CAS at our institution. CAS was performed with distal protection alone (method 1) in three patients, and three other patients underwent CAS with reversed-flow system and distal protection (method 2). Two of six patients experienced worsening neurologic symptoms despite medical therapy. All six patients were successfully treated with CAS and showed satisfactory patency of the artery. Embolic lesions were detected on diffusion-weighted MRI after the procedure in all patients treated with method 1 but not in patients treated with method 2. Complications included stent thrombosis (n=1) and in-stent thrombus (n=1). All six patients achieved a modified Rankin Scale 1 or 2 classification at 30 days after stenting. In conclusion, CAS was feasible for stenosis even with intraluminal thrombus. Use of method 2 for this condition may reduce the incidence of thromboembolic events although our series was small in number. (orig.)

  13. The Senescence Process of Internal Thoracic Artery

    OpenAIRE

    Francesco Rivasi; Giuseppe Barbolini; Luca Roncati; Antonio Manenti

    2013-01-01

    OBJECTIVE. The Internal Thoracic Artery (ITA) is the most widely used arterial conduit for coronary artery by-pass, because it is very rarely affected by atherosclerosis. However, the state of its wall at the time of grafting procedure could influence the long-term outcome of coronary artery by-pass. METHODS. We have investigated 20 specimens of distal human ITA, derived from 14 male patients and 6 female patients, aged between 68 and 77 years, operated for atherosclerotic coronary artery dis...

  14. Trombose arterial relacionada à artroplastia total de joelho: revisão de literatura / Arterial thrombosis in total knee arthroplasty: a literature review

    Scientific Electronic Library Online (English)

    Ronald, Fidelis Júnior; Marco Martins, Amatuzzi; Pedro Puech, Leão; Luiz Eugênio Garcez, Leme.

    Full Text Available As complicações arteriais após artroplastia total de joelho (ATJ) são raras, no entanto a doença arterial oclusiva (DAO) associada à osteoartrose crônica do joelho, pode representar um problema. Uma vez que as seqüelas podem ser desastrosas, a abordagem operatória da ATJ deveria ser diferente quando [...] a DAO esteja presente. A maior parte dos casos referidos esteve atribuída aos seguintes fatores: uso de torniquete, manipulação operatória excessiva ou correção de contratura de flexão. A DAO é subestimada nos pacientes com osteoartrose e a maior parte dos casos ocorre em pacientes com evidências clínicas ou radiológicas de doença arterial. A avaliação vascular deveria ser considerada nestas situações. Alem disso, é difícil reconhecer e tratar prontamente um membro isquêmico no período pós-operatório de uma ATJ. Em que pese à pequena incidência da trombose arterial, é referido um alto risco de amputação. A revisão de literatura mostrou que a incidência referida de DAO em pacientes apresentando osteoartrose de joelho e aspectos da trombose arterial pós ATJ. Foram, ainda, identificados os fatores preditivos de complicações isquêmicas ateroscleróticas na ATJ. Lesões devidas ao trauma direto de artérias normais, levando aos pseudo-aneurismas, fístulas artério-venosas e sangramento não foram estudadas. Abstract in english Arterial complications after Total Knee Arthroplasty (TKA) are quite rare, however, the arterial occlusive disease (AOD) associated with chronic knee osteoarthrosis may represent a problem. Since the sequels can be disastrous, the surgical TKA approach should be different when AOD is present. Most o [...] f the cases reported have been attributed to the following factors: use of tourniquet; excessive intraop-erative manipulation; or the correction of a flexion contracture. AOD is underesti-mated among people with osteoarthrosis and most of cases occur among patients with previous clinical or radiological evidences of arterial disease. A vascular evaluation should be considered in those situations. Furthermore, it's difficult to recognize and promptly deal with an ischemic leg in the post-operative TKA period. In spite of the small incidence of arterial thrombosis, a high amputation risk is re-ported. We have made a literature review, which showed the reported AOD inci-dence among patients presenting degenerative knee osteoarthrosis and post-TKA arterial thrombosis aspects. Also, the predictive factors for ischemic atherosclerotic complications in TKA were identified. Lesions due to direct trauma of normal arter-ies, leading to pseudoaneurysms, arteriovenous fistulas and bleeding weren't studied.

  15. The Biomechanics of Arterial Aneurysms

    Science.gov (United States)

    Lasheras, Juan C.

    2007-01-01

    The formation of an arterial aneurysm is believed to be a multifactorial and predominantly degenerative process, resulting from a complex interplay between biological processes in the arterial wall and the hemodynamic stimuli on the vessel's wall. Once an aneurysm forms, the repetitive pressure and shear stresses exerted by the blood flow on the weakened arterial wall generally, but not always, cause a gradual expansion. As the wall geometry, composition, and strength progressively degrade through the enlargement process, the aneurysm ruptures when the wall of the distended artery fails to support the stresses resulting from the internal blood flow. This review surveys recent progress in this area and provides a critical assessment of the contribution made by hemodynamics studies to the current understanding of the pathogenesis of the disease and to its clinical management.

  16. Idiopathic arterial calcification in childhood

    Energy Technology Data Exchange (ETDEWEB)

    Patel, Maya [Department of Paediatric Radiology, Red Cross Children' s Hospital, Cape Town (South Africa); Red Cross Children' s Hospital, School of Child and Adolescent Health, University of Cape Town, Klipfontein Road, Rondebosch, Cape Town (South Africa); Andronikou, Savvas; Solomon, Rustum; Sinclair, Paul; McCulloch, Mignon [Department of Paediatric Radiology, Red Cross Children' s Hospital, Cape Town (South Africa)

    2004-08-01

    Idiopathic arterial calcification in infancy is usually fatal with death in early life and diagnosis at post mortem. This report describes a unique, late presentation with hypertension and cardiac failure in a child aged 33 months, found to have widespread arterial calcification at radiological imaging. The calcium-phosphate axis was normal and there was no other demonstrable cause for calcification. Additionally, the histological features of arterial calcification at renal biopsy paralleled the findings in infants with this disorder. The late presentation in this case is unusual and has not been previously reported. Ultrasound and CT are sensitive for calcification, and the disease should be suspected in children presenting with cardiac or respiratory manifestations and features of arterial calcification, where no metabolic cause is established. (orig.)

  17. Coronary artery anatomy and variants

    Energy Technology Data Exchange (ETDEWEB)

    Malago, Roberto; Pezzato, Andrea; Barbiani, Camilla; Alfonsi, Ugolino; Nicoli, Lisa; Caliari, Giuliana; Pozzi Mucelli, Roberto [Policlinico G.B. Rossi, University of Verona, Department of Radiology, Verona (Italy)

    2011-12-15

    Variants and congenital anomalies of the coronary arteries are usually asymptomatic, but may present with severe chest pain or cardiac arrest. The introduction of multidetector CT coronary angiography (MDCT-CA) allows the detection of significant coronary artery stenosis. Improved performance with isotropic spatial resolution and higher temporal resolution provides a valid alternative to conventional coronary angiography (CCA) in many patients. MDCT-CA is now considered the ideal tool for three-dimensional visualization of the complex and tortuous anatomy of the coronary arteries. With multiplanar and volume-rendered reconstructions, MDCT-CA may even outperform CCA in determining the relative position of vessels, thus providing a better view of the coronary vascular anatomy. The purpose of this review is to describe the normal anatomy of the coronary arteries and their main variants based on MDCT-CA with appropriate reconstructions. (orig.)

  18. Coronary artery anatomy and variants

    International Nuclear Information System (INIS)

    Variants and congenital anomalies of the coronary arteries are usually asymptomatic, but may present with severe chest pain or cardiac arrest. The introduction of multidetector CT coronary angiography (MDCT-CA) allows the detection of significant coronary artery stenosis. Improved performance with isotropic spatial resolution and higher temporal resolution provides a valid alternative to conventional coronary angiography (CCA) in many patients. MDCT-CA is now considered the ideal tool for three-dimensional visualization of the complex and tortuous anatomy of the coronary arteries. With multiplanar and volume-rendered reconstructions, MDCT-CA may even outperform CCA in determining the relative position of vessels, thus providing a better view of the coronary vascular anatomy. The purpose of this review is to describe the normal anatomy of the coronary arteries and their main variants based on MDCT-CA with appropriate reconstructions. (orig.)

  19. Coronary artery disease in women.

    OpenAIRE

    Chiamvimonvat, V.; Sternberg, L

    1998-01-01

    OBJECTIVE: To review and recognize how presentation, investigation, risk factor modification, and treatment of coronary artery disease (CAD) is different for women than for men. QUALITY OF EVIDENCE: Epidemiologic data are from well-recognized, peer-reviewed medical journals. Most data on treatment are from randomized controlled trials. MAIN FINDINGS: Coronary artery disease is the leading cause of mortality in women, with incidence after menopause equal to that of men. Diabetes and postmenopa...

  20. Pulmonary arterial hypertension: an update

    OpenAIRE

    Hoendermis, E.S.

    2011-01-01

    Pulmonary arterial hypertension (PAH), defined as group 1 of the World Heart Organisation (WHO) classification of pulmonary hypertension, is an uncommon disorder of the pulmonary vascular system. It is characterised by an increased pulmonary artery pressure, increased pulmonary vascular resistance and specific histological changes. It is a progressive disease finally resulting in right heart failure and premature death. Typical symptoms are dyspnoea at exercise, chest pain and syncope; furthe...