WorldWideScience
1

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

DEFF Research Database (Denmark)

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

Király, István; Pataricza, János

2013-01-01

2

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

Science.gov (United States)

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

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

2006-05-01

3

Penile angiography and superselective embolization therapy in arterial priapism  

International Nuclear Information System (INIS)

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

4

Normal and variations of internal pudendal artery in penile arteriography  

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

Shim, Hyung Jin; Lee, Jong Beum; Lee, Yong Chul; Kim, Kun Sang [College of Medicine, Chung-Ang University, Seoul (Korea, Republic of)

1991-01-15

5

Normal and variations of internal pudendal artery in penile arteriography  

International Nuclear Information System (INIS)

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

6

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

DEFF Research Database (Denmark)

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

SchjØrring, Olav; Kun, Attila

2012-01-01

7

Correlation between penile angiography and duplex scanning of cavernous arteries in impotent men.  

Science.gov (United States)

During the diagnostic evaluation of patients with vasculogenic impotence duplex scanning has been proposed as a reliable noninvasive method to evaluate the cavernous arteries. However, the sensitivity and specificity of this test have never been elucidated. To provide insight into the clinical value of this test 25 men who presented with impotence and failed to respond to 60 mg. intracavernous papaverine were evaluated with duplex scanning and the results of this modality were compared to penile angiography. The cavernous arteries were considered normal by duplex scanning if the artery demonstrated either a 60% or greater increase in diameter and/or a peak flow velocity of greater than 25 cm. per second 5 minutes after papaverine injection. Penile angiography was considered normal if both cavernous arteries were visualized and appeared to be normal radiographically (after intracorporeal papaverine). In the 25 patients studied there was no significant difference in peak flow velocity between patients with normal or abnormal cavernous arteries by angiography. In addition, arterial dilatation (more than 60%) after papaverine injection did not correlate with the results of the angiogram. These data demonstrate that duplex scanning of the cavernous arteries does not correlate well with what is observed by penile angiography in a selected population of men with vasculogenic erectile dysfunction. Since penile angiography itself has limitations in the evaluation of the penile arteries, the reliability of duplex scanning to identify cavernous artery dysfunction needs additional confirmation. PMID:2188016

Rajfer, J; Canan, V; Dorey, F J; Mehringer, C M

1990-06-01

8

Hypoxic relaxation of penile arteries: involvement of endothelial nitric oxide and modulation by reactive oxygen species.  

Science.gov (United States)

Although obesity-related cardiovascular disease and hypoxia are associated with erectile dysfunction, little is known about the direct effects of hypoxia on penile arteries. In the present study, the effects of acute hypoxia (Po(2) = approximately 10 Torr, 20 min) were investigated in isolated penile arteries to determine the influence of endothelium removal, nitric oxide (NO) synthase (NOS), cyclooxygenase (COX), NADPH oxidase, changes in reactive oxygen species (ROS), and a high-fat diet. Hypoxia-relaxed penile arteries contracted with phenylephrine by approximately 50%. Relaxation to hypoxia and acetylcholine was reduced by endothelium removal and by inhibition of NOS (N(omega)-nitro-l-arginine) and COX (indomethacin) but was enhanced by Tempol and by NADPH oxidase inhibition with apocynin and gp91ds-tat. Basal superoxide levels detected by lucigenin chemiluminescence were reduced by Tempol and gp91ds-tat and were enhanced by NOS blockade. Hypoxic relaxant responses were enhanced by catalase and ebselen. Exogenous peroxide evoked relaxations of penile arteries, which were partially inhibited by endothelium removal and by the inhibition of COX and extracellular signal-regulated mitogen-activated protein kinase (MAPK) but enhanced by p38 MAPK blockade. The NO-dependent component of relaxation to hypoxia was impaired in penile arteries from high-fat diet-fed, obese rats associated with increased superoxide production. Thus hypoxic relaxation of penile arteries is partially mediated by endothelial NO in a manner that is normally attenuated by endogenous ROS production. Obesity further increases superoxide production and impairs the influence of NO. Therefore, cardiovascular disease involving decreased NO bioavailability and/or enhanced ROS generation may contribute to erectile dysfunction through impairing the relaxation of penile arteries to hypoxia. PMID:20581086

Prieto, Dolores; Kaminski, Pawel M; Bagi, Zsolt; Ahmad, Mansoor; Wolin, Michael S

2010-09-01

9

Penile arteriography in vasculogenic impotence  

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In nine patients with suspected vasculogenic impotence, magnification penile pharmacoarteriography was performed to evaluate detailed anatomy of penile arteries. Penile arteriography was done with aid of papaverine, which was injected both into corpus cavernosum and intraarterially. In all nine cases, selection of internal pudendal arteries of both sides was successful and satisfactory arteriograms of penile arteries were obtained.

Kim, Seung Hyup; Park, Jae Hyung; Han, Man Chung; Paick, Jae Seung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

1989-04-15

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

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

Necati Gürbüz

2009-01-01

11

Penile abnormalities  

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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

Yunus Söylet

2010-05-01

12

Comparison of digital subtraction angiography, CT angiography, and ultrasonic doppler examination in the evaluation of penile arterial lesions  

International Nuclear Information System (INIS)

CT angiography reconstructed by a multidetector-row helical CT scanner is a newly developed form of imaging. We compared CT angiography and ultrasonic Doppler examination with digital subtraction angiography (DSA) in the diagnosis of arterial lesion. Eighteen patients with arteriogenic erectile dysfunction (ED) underwent color Doppler study DSA, and CT angiography after providing informed consent. The CT angiography images were obtained by a multidetector-row helical CT scanner, Asteion TSX021A (TOSHIBA). We injected prostaglandin E1 into the penile cavernous body, and then rapidly infused nonionic contrast medium into the antecubital vein. DSA and CT angiography images of the bilateral internal pudendal arteries and cavernous arteries were examined for stenotic lesions or occlusion. We also compared the peak systolic blood flow velocity in the cavernous artery measured by color Doppler ultrasound with CT angiography and DSA. The CT anigography and color Doppler studies were performed on an outpatient basis, but DSA required hospitalization. In the 36 internal pudendal arteries, DSA represented 22 normal arteries and 14 stenosis or occlusions. CT angiography showed 15 normal arteries and 21 occlusions. For the diagnosis of stenosis or occlusion in the internal pudendal artery, the CT angiography image had a good agreement, with a sensitivity of 1.00, specificity of 0.68, and accuracy of 0.81. For diagnosis in the cavernous artery, CT angiography image also vernous artery, CT angiography image also showed a good agreement with DSA; however, the quality of the images of fine arteries was better in the DSA images. The inferior view and internal view of the pelvis in CT angiography were helpful for visulaizing the internal pudendal artery, especially at the pubic bone. There was insufficient correlation between peak systolic blood flow velocity and DSA findings. There were no serious complications involved in either examination. CT angiography has not yet reached the same level as DSA in the evaluation of fine arteries. However, CT angiography can produced images sufficient for the diagnosis of arteriogenic ED with some advantages. We believe that with improvement, CT angiography will become an adequate replacement for DSA in the diagnosis of penile arterisl lision. (author)

13

Penile Paraffinoma  

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Full Text Available Sclerosing lipogranuloma of the male genitalia is a rather uncommon condition. It presents as subcutaneous masses of the penis and scrotum. Paraffinoma or sclerosing lipogranuloma results from an injection of foreign substance such as paraffin or mineral oil. Here in a 23-year-old man presented with multiple small painless penile masses.

Serap Uta?

2010-03-01

14

Comparison of digital subtraction angiography, CT angiography, and ultrasonic doppler examination in the evaluation of penile arterial lesions  

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CT angiography reconstructed by a multidetector-row helical CT scanner is a newly developed form of imaging. We compared CT angiography and ultrasonic Doppler examination with digital subtraction angiography (DSA) in the diagnosis of arterial lesion. Eighteen patients with arteriogenic erectile dysfunction (ED) underwent color Doppler study DSA, and CT angiography after providing informed consent. The CT angiography images were obtained by a multidetector-row helical CT scanner, Asteion TSX021A (TOSHIBA). We injected prostaglandin E{sub 1} into the penile cavernous body, and then rapidly infused nonionic contrast medium into the antecubital vein. DSA and CT angiography images of the bilateral internal pudendal arteries and cavernous arteries were examined for stenotic lesions or occlusion. We also compared the peak systolic blood flow velocity in the cavernous artery measured by color Doppler ultrasound with CT angiography and DSA. The CT anigography and color Doppler studies were performed on an outpatient basis, but DSA required hospitalization. In the 36 internal pudendal arteries, DSA represented 22 normal arteries and 14 stenosis or occlusions. CT angiography showed 15 normal arteries and 21 occlusions. For the diagnosis of stenosis or occlusion in the internal pudendal artery, the CT angiography image had a good agreement, with a sensitivity of 1.00, specificity of 0.68, and accuracy of 0.81. For diagnosis in the cavernous artery, CT angiography image also showed a good agreement with DSA; however, the quality of the images of fine arteries was better in the DSA images. The inferior view and internal view of the pelvis in CT angiography were helpful for visulaizing the internal pudendal artery, especially at the pubic bone. There was insufficient correlation between peak systolic blood flow velocity and DSA findings. There were no serious complications involved in either examination. CT angiography has not yet reached the same level as DSA in the evaluation of fine arteries. However, CT angiography can produced images sufficient for the diagnosis of arteriogenic ED with some advantages. We believe that with improvement, CT angiography will become an adequate replacement for DSA in the diagnosis of penile arterisl lision. (author)

Kawanisi, Yasuo; Kimura, Kazunori; Lee, Kyong Soo; Koizumi, Takahiro; Nakatsuji, Hiroyoshi; Kojima, Keiji; Yamamoto, Akira; Numata, Akira [Takamatsu Red Cross Hospital (Japan)

2001-11-01

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

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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.)

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

2003-08-01

16

Angiography of penile vessels  

International Nuclear Information System (INIS)

A new simplified technique for evaluating the internal pudendal artery and the penile vessels is described using a new catheter configuration with a very short 90deg-angled tip. In 30 consecutive patients, a superselective catheterisation of the internal pudendal artery was achieved in 93%. To improve visualisation of the penile arteries, the selective intraarterial application of 0.2 mg nitrogylcerin in addition to the mandatory intracavernous injection of papaverin or prostaglandin E1 has proved to be of value. Examination of the blood flow velocity in the dorsal penile artery with Doppler ultrasound 2 minutes after intraarterial application of 0.2 mg nitroclycerin showed a mean elevation of the Doppler amplitude by the factor 2.4 (range 0.4-9). With regard to the maximal increase of the blood velocity (range 1-6 minutes), a high interindividual difference was observed. (orig.)

17

Penile embryology and anatomy.  

Science.gov (United States)

Knowledge of penile embryology and anatomy is essential to any pediatric urologist in order to fully understand and treat congenital anomalies. Sex differentiation of the external genitalia occurs between the 7th and 17th weeks of gestation. The Y chromosome initiates male differentiation through the SRY gene, which triggers testicular development. Under the influence of androgens produced by the testes, external genitalia then develop into the penis and scrotum. Dorsal nerves supply penile skin sensation and lie within Buck's fascia. These nerves are notably absent at the 12 o'clock position. Perineal nerves supply skin sensation to the ventral shaft skin and frenulum. Cavernosal nerves lie within the corpora cavernosa and are responsible for sexual function. Paired cavernosal, dorsal, and bulbourethral arteries have extensive anastomotic connections. During erection, the cavernosal artery causes engorgement of the cavernosa, while the deep dorsal artery leads to glans enlargement. The majority of venous drainage occurs through a single, deep dorsal vein into which multiple emissary veins from the corpora and circumflex veins from the spongiosum drain. The corpora cavernosa and spongiosum are all made of spongy erectile tissue. Buck's fascia circumferentially envelops all three structures, splitting into two leaves ventrally at the spongiosum. The male urethra is composed of six parts: bladder neck, prostatic, membranous, bulbous, penile, and fossa navicularis. The urethra receives its blood supply from both proximal and distal directions. PMID:20602076

Yiee, Jenny H; Baskin, Laurence S

2010-01-01

18

Penile arteriography in vasculogenic impotence  

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

Lee, Jong Beum; Shim, Hyung Jin; Lee, Kwan Seh; Lee, Yong Chul; Kim, Kun Sang [Chung Ang University College of Medicine, Seoul (Korea, Republic of)

1990-12-15

19

A diabetic patient with a black penile tip.  

Science.gov (United States)

This is a report of a patient with diabetes mellitus type II who presented with the rare complication of penile gangrene. The gangrene was unilateral and was associated with ipsilateral partial stenosis of the common iliac artery. An angioplasty followed by insertion of a stent, rehydration, and improved diabetic control did not improve the penile lesion, and penile amputation was carried out. In the postoperative period, the patient developed a bilateral basal pneumonia with a significant growth of saprophyte Mycobacterium gordonae from the bronchial aspirate. This is the first reported case of unilateral penile gangrene and also that of Mycobacterium gordonae infection in a patient with diabetes mellitus. PMID:10765009

Kumbkarni, Y; Magsino, C H; Dandona, P

1999-01-01

20

Stent-based percutaneous coronary interventions in small coronary arteries.  

Science.gov (United States)

A third to half of all percutaneous coronary interventions involve small diameter vessels of less than 3 mm. Small vessel size is a predictor of restenosis after balloon angioplasty, as well as after stent placement. Stents deployed in small arteries, have a higher metal-to-artery ratio; this may increase the risk of sub-acute thrombosis or restenosis. Various studies have shown that stent design, stent coating, and stent strut thickness may determine event-free survival. Dedicated stents for small vessels with less amount of metal, appropriate expansion to the vessel size with correct radial force and cells morphology, and less prothrombotic properties, may further improve the results of stenting in this setting (thinner struts, fewer cells, or loops per circumference). This review provides an update on the current status, review the major trials and define the clinical utility of small vessel stenting, particularly in the era of drug-eluting stents. PMID:16885069

Roguin, Ariel; Grenadier, Ehud

2006-01-01

21

Advances in the pathology of penile carcinomas.  

Science.gov (United States)

The incidence of penile cancer varies from country to country, with the highest figures reported for countries in Africa, South America, and Asia and lowest in the United States and Europe. Causes of this variation are not clear, but they are thought to be related to human papillomavirus infection, smoking, lack of circumcision, chronic inflammation, and poor genital hygiene. Most penile tumors are squamous cell carcinomas, and a variegated spectrum of distinct morphologies is currently recognized. Each one of these subtypes has distinctive pathologic and clinical features. About half of penile carcinomas are usual squamous cell carcinomas, and the rest corresponds to verrucous, warty, basaloid, warty-basaloid, papillary, pseudohyperplastic, pseudoglandular, adenosquamous, sarcomatoid, and cuniculatum carcinomas. Previous studies have found a consistent association of tumor cell morphology and human papillomavirus presence in penile carcinomas. Those tumors composed of small- to intermediate-sized, basaloid ("blue") cells are often human papillomavirus positive, whereas human papillomavirus prevalence is lower in tumors showing large, keratinizing, maturing eosinophilic ("pink") cells. Human papillomavirus-related tumors affect younger patients, whereas human papillomavirus-unrelated tumors are seen in older patients with phimosis, lichen sclerosus, or squamous hyperplasia. This morphologic distinctiveness is also observed in penile intraepithelial neoplasia. The specific aim of this review is to provide a detailed discussion on the macroscopic and microscopic features of all major subtypes of penile cancer. We also discuss the role of pathologic features in the prognosis of penile cancer, the characteristics of penile precursor lesions, and the use of immunohistochemistry for the diagnosis of invasive and precursor lesions. PMID:22595011

Chaux, Alcides; Cubilla, Antonio L

2012-06-01

22

Sonographic evaluation of penile in patients with erectile dysfunction  

International Nuclear Information System (INIS)

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

23

Malignant penile horn.  

Science.gov (United States)

The fifth case of carcinoma within a penile horn is reported in a patient who also had erythroplasia of Queyrat of the glans penis. Penile horns should be considered as pre-malignant lesions, since a third of them undergo malignant change and they may be associated with a pre-malignant condition of the glans penis. PMID:926252

Raghavaiah, N V; Soloway, M S; Murphy, W M

1977-12-01

24

Genetic fuzzy system predicting contractile reactivity patterns of small arteries  

DEFF Research Database (Denmark)

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

Tang, J; Sheykhzade, Majid

2014-01-01

25

Penile abnormalities  

OpenAIRE

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...

Yunus Söylet

2010-01-01

26

Penil kalcifylaksi  

DEFF Research Database (Denmark)

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

Kjaerskov, Mette Wanscher; Comstedt, Lisbeth Rosholm

2009-01-01

27

[Penile calciphylaxis].  

Science.gov (United States)

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. PMID:19486618

Kjaerskov, Mette Wanscher; Comstedt, Lisbeth Rosholm; Bygum, Anette; Yderstraede, Knud Bonnet

2009-05-25

28

Primary penile melanoma.  

Science.gov (United States)

Primary penile melanomas are exceedingly rare (less than 1% of primary penile cancers), 221 cases being reported to date in PubMed indexed medical literature. More than half of the cases occur on the gland, usually in older people than on cutaneous counterpart and have unfavourable prognosis mainly due to the belated diagnosis. We report the case of a 77 years old male diagnosed with a pigmented ulcerated nodular melanoma of the gland with maximal thickness of 4.5 mm, mitotic index 8 mitoses/mm2 and vascular emboli. No lymph node enlargements or distant metastases were identified at presentation. Six months after the diagnosis the patient was well, free of disease. Clinically, penile melanomas may be mistaken for several lesions such as squamous carcinoma, penile nevi, pyogenic granuloma, Kaposi sarcoma. Histopathologic diagnosis is usually straight forward except for highly pleomorphic tumors; discrimination between primary penile tumor and penile metastatic melanoma is the most delicate problem of differential diagnosis. The treatment is not standardized; surgical wide excision or partial/total penectomy completed with sentinel lymph node biopsy are the most frequent methods of treatment; multi-agent chemotherapy and/or high-dose interferon alpha 2b therapy are recommended for patients with locally un-controllable disease and/or metastases. PMID:25338349

Andrei, R; Cioplea, Mirela; Mageriu, V; Chuaibi, A; Cauni, V; Zurac, Sabina; Staniceanu, Florica

2014-01-01

29

Primary undifferentiated penile sarcoma in adolescence.  

Science.gov (United States)

We report a case of primary penile undifferentiated sarcoma. A 16-year-old adolescent man visited Pusan National University Hospital complaining of a painless mass on his penis that was increasing in size. Magnetic resonance images revealed a 5×5-cm mass and pathological examinations revealed small round cell sarcomas with neuroendocrine differentiation. The tumor, which had metastatic pulmonary nodules, was treated by tumorectomy and systemic chemotherapy. Thirty-four months after the initial diagnosis, the patient was still alive without evidence of local recurrence or metastatic disease. This is our second case of an undifferentiated penile sarcoma. PMID:23136636

Choi, Young Hoon; Kim, Hyeon Woo; Ahn, Jae Hyun; Hwang, Dae Sung; Lee, Jung Woo; Lee, Byung Ki; Jun, So Eun; Lim, Young Tak; Lee, Sang Don; Ha, Hong Koo

2012-10-01

30

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 ...

31

Calciphylaxis leading to penile necrosis.  

Science.gov (United States)

Penile gangrene is a rare disease. It represents a poor prognostic sign in end stage renal disease (ESRD) patients and an indicator of metastatic vascular calcification. Pathogenesis of this life threatening condition is not clearly understood and treatment is also controversial. We describe the case of a 61-year-old man known to have diabetes mellitus, chronic renal failure on haemodialysis, who was complaining of worsening groin pain for 4 weeks. On examination dry gangrene of glans penis was noted. Cultures from the penis showed multiple organisms. Computed tomography (CT) showed diffuse calcification of external and internal iliac arteries. Later, he developed caciphylaxis of right anterior thigh. His overall condition did not improve in spite of adequate antibiotics and he was shifted to intensive care unit (ICU) where he required high doses of vasopressors. Clinically he kept deteriorating and passed away due to septic shock. PMID:25252499

Haider, Imran; Siddiqui, Muhammad; Naji, Wisam; Sheikh, Maria; Waqar, Ayesha

2014-06-01

32

Penile metastasis from rectal carcinoma  

Directory of Open Access Journals (Sweden)

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.

Murhekar K

2007-01-01

33

Supra and infralevator neurovascular pathways to the penile corpora cavernosa  

Science.gov (United States)

The aim of this study was to provide a comprehensive description of both penile innervation and vascularisation. Eighty-five male cadavers were examined through gross and microscopic anatomical analysis. The pelvic nerve plexus had both parasympathetic and sympathetic roots. It was distributed to the external urethral sphincter giving rise to cavernous nerves which anastomosed in 70% of the cases with the pudendal nerve in the penile root. Accessory pudendal arteries were present in the pelvis in 70% of the cases, anastomosing in 70% of the cases with the cavernous arteries that originated from the pudendal arteries. Transalbugineal anastomoses were always seen between the cavernous artery and the spongiosal arterial network. There were 2 venous pathways, 1 in the pelvis and 1 in the perineum with a common origin from the deep dorsal penile vein. It is concluded that there are 2 neurovascular pathways destined for the penis that are topographically distinct. One is located in the pelvis and the other in the perineum. We were unable to determine the functional balance between these 2 anastomosing pathways but experimental data have shown that they are both involved in penile erection. These 2 neurovascular pathways, above and below the levator ani, together with their anastomoses, form a neurovascular loop around the levator ani. PMID:10634698

BENOIT, G.; DROUPY, S.; QUILLARD, J.; PARADIS, V.; GIULIANO, F.

1999-01-01

34

Radioisotope penile plethysmography: Technique for evaluating corpora cavernosal blood flow during early tumescence in patients with erectile dysfunction  

International Nuclear Information System (INIS)

Radioisotope penile plethysmography is a new adaptation of technetium-labeled red blood cell imaging. It is designed to assess penile corpora cavernosal blood flow during early tumescence in patients with erectile dysfunction. Peak corporal flow rates and volume changes in the penis were analyzed and compared with arterial integrity (arteriography) and venous-sinusoidal competence (cavernosometry). Peak corporal flow rates correlated most accurately with arterial integrity (r =.01). No significant correlation was identified with venous leakage variables (r =.01) The significant correlation of peak corporal flow and arteriography suggests that radioisotope penile plethysmography may assist in the evaluation of arterial inflow disorders in patients with erectile dysfunction

35

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 y 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

36

The normal distribution of thoracoabdominal aorta small branch artery ostia  

International Nuclear Information System (INIS)

The purpose of this study was to determine the normal distribution of aortic branch artery ostia. CT scans of 100 subjects were retrospectively reviewed. The angular distributions of the aorta with respect to the center of the T3 to L4 vertebral bodies, and of branch artery origins with respect to the center of the aorta were measured. At each vertebral body level the distribution of intercostal/lumbar arteries and other branch arteries were calculated. The proximal descending aorta is posteriorly placed becoming a midline structure, at the thoracolumbar junction, and remains anterior to the vertebral bodies within the abdomen. The intercostal and lumbar artery ostia have a distinct distribution. At each vertebral level from T3 caudally, one intercostal artery originates from the posterior wall of the aorta throughout the thoracic aorta, while the other intercostal artery originates from the medial wall of the descending thoracic aorta high in the chest, posteromedially from the mid-thoracic aorta, and from the posterior wall of the aorta low in the chest. Mediastinal branches of the thoracic aorta originate from the medial and anterior wall. Lumbar branches originate only from the posterior wall of the abdominal aorta. Aortic branch artery origins arise with a bimodal distribution and have a characteristic location. Mediastinal branches of the thoracic aorta originate from the medial and anterior wall. Knowing the location of aortic branch artery ostia may help disti aortic branch artery ostia may help distinguish branch artery pseudoaneurysms from penetrating ulcers.

37

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

DEFF Research Database (Denmark)

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

Buus, Niels H; Mathiassen, Ole N

2013-01-01

38

The normal distribution of thoracoabdominal aorta small branch artery ostia.  

Science.gov (United States)

The purpose of this study was to determine the normal distribution of aortic branch artery ostia. CT scans of 100 subjects were retrospectively reviewed. The angular distributions of the aorta with respect to the center of the T3 to L4 vertebral bodies, and of branch artery origins with respect to the center of the aorta were measured. At each vertebral body level the distribution of intercostal/lumbar arteries and other branch arteries were calculated. The proximal descending aorta is posteriorly placed becoming a midline structure, at the thoracolumbar junction, and remains anterior to the vertebral bodies within the abdomen. The intercostal and lumbar artery ostia have a distinct distribution. At each vertebral level from T3 caudally, one intercostal artery originates from the posterior wall of the aorta throughout the thoracic aorta, while the other intercostal artery originates from the medial wall of the descending thoracic aorta high in the chest, posteromedially from the mid-thoracic aorta, and from the posterior wall of the aorta low in the chest. Mediastinal branches of the thoracic aorta originate from the medial and anterior wall. Lumbar branches originate only from the posterior wall of the abdominal aorta. Aortic branch artery origins arise with a bimodal distribution and have a characteristic location. Mediastinal branches of the thoracic aorta originate from the medial and anterior wall. Knowing the location of aortic branch artery ostia may help distinguish branch artery pseudoaneurysms from penetrating ulcers. PMID:21944834

Cronin, Paul; Williams, David M; Vellody, Ranjith; Kelly, Aine Marie; Kazerooni, Ella A; Carlos, Ruth C

2011-12-01

39

Penile vein ligation for venogenic impotence.  

Science.gov (United States)

We have performed penile vein ligation on 35 patients with venogenic impotence from July 1989 to December 1991. The criteria for surgery were (1) age less than 60 years; (2) negative vasoactive agent intracavernous injection but normal penile arterial function, and (3) abnormal venous leakage documented by dynamic infusion cavernosometry and cavernosography. The procedure in venous ligation is excision of the deep dorsal vein from coronary sulcus to pubic arch, and ligation of cavernous veins after identification. The average follow-up was 27.5 months (range 12-37 months) for 30 patients. The 2 patients who revealed no erection at all immediately after operation had dense adhesion of penile hilar region caused in one case by severe pelvic trauma and in the other by pubic bone fracture. Twenty-eight (93.3%) patients were found to sustain excellent erection within 3 months postoperatively. However, only 12 (40.0%) patients sustained spontaneous erection at long-term follow-up, while another 7 (23.3%) responded to intracavernous injection. It is worth mentioning that tortuous and marked dilation of the deep dorsal vein and/or cavernous veins were found intraoperatively in 6 patients who were observed to have excellent erections postoperatively. Inadequate elimination of the leakage veins, especially crural veins, is the most likely factor in those who had a recurrence of erectile dysfunction. However, the corpus cavernosum, particularly a myopathic condition or inadequate neurotransmitters, also plays an important role. Complications included shortness of penis (3 patients), penile deviation (3), numbness of glans penis (4) and wound infection (1).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7925529

Hwang, T I; Yang, C R

1994-01-01

40

Primary Undifferentiated Penile Sarcoma in Adolescence  

OpenAIRE

We report a case of primary penile undifferentiated sarcoma. A 16-year-old adolescent man visited Pusan National University Hospital complaining of a painless mass on his penis that was increasing in size. Magnetic resonance images revealed a 5×5-cm mass and pathological examinations revealed small round cell sarcomas with neuroendocrine differentiation. The tumor, which had metastatic pulmonary nodules, was treated by tumorectomy and systemic chemotherapy. Thirty-four months after the initi...

Choi, Young Hoon; Kim, Hyeon Woo; Ahn, Jae Hyun; Hwang, Dae Sung; Lee, Jung Woo; Lee, Byung Ki; Jun, So Eun; Lim, Young Tak; Lee, Sang Don; Ha, Hong Koo

2012-01-01

41

Pulsed and Color Doppler Sonographic Findings of Penile Mondor' Disease  

Energy Technology Data Exchange (ETDEWEB)

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.

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

42

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 managemelected patients with conservative management. (author)

43

Penile abscess and necrotizing fasciitis secondary to neglected false penile fracture  

Directory of Open Access Journals (Sweden)

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

Al-Reshaid Reshaid

2010-01-01

44

Penile agenesis: A case report  

Directory of Open Access Journals (Sweden)

Full Text Available Absence of the penis is a rare congenital anomaly of the male infant that may be associated with other congenital anomalies. Management in the last two decades has changed from initial female gender assignment to penile reconstruction procedures. In our sub-region, training and experience in penile reconstruction are imperative.

Hussaini Yusuf Maitama

2014-11-01

45

Minimally Invasive Penile Implant Surgery  

Medline Plus

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

46

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 condition ...

47

Foscarnet-induced penile ulceration  

OpenAIRE

Foscarnet is used to treat infections with herpes viruses, including drug-resistant cytomegalovirus (CMV) and infections with herpes viruses 1 and 2 (HSV-1 and HSV-2). There are some reports of intravenous foscarnet-induced penile and vulvar ulceration. The authors report a case of severe penile ulcers after the initiation of intravenous foscarnet therapy

Torres, T.; Fernandes, I.; Sanches, M.; Selores, M.

2011-01-01

48

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

OpenAIRE

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.

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

2012-01-01

49

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

OpenAIRE

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

Bucca, Caterina; Rolla, Giovanni

1980-01-01

50

Nucleotide hydrolytic activity of isolated intact rat mesenteric small arteries  

DEFF Research Database (Denmark)

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

Juul, B; Lüscher, M E

1991-01-01

51

Penile blood flow scanning with TcO/sub 4/-99m labeled red blood cells after intracorporal papaverine injection  

International Nuclear Information System (INIS)

Twenty impotent males were evaluated during early tumescence using TcO/sub 4/-99m-labeled red blood cells. Erections were pharmacologically induced by injecting papaverine directly into the corpora cavernosum. A penile arterial blood flow index and penile venosinusoidal transit time were generated as a function of penile counts normalized to total iliac artery counts. These indices were compared with findings in arteriography and cavernosography and with corporal pressure-flow evaluations. The penile flows scan was a significant predictor of arterial flow and venosinusoidal resistance. Four patterns were identified relating flow and resistance to the cause of impotence. Penile flow scanning may provide an excellent screening examination in evaluating impotence

52

Penile Corporeal Reconstruction during Difficult Placement of a Penile Prosthesis  

Directory of Open Access Journals (Sweden)

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.

Sherif R. Aboseif

2008-11-01

53

Minimally Invasive Penile Implant Surgery  

Medline Plus

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

54

Minimally Invasive Penile Implant Surgery  

Medline Plus

Full Text Available ... prevention. And as you know, one of the issues with penile implants in the past was the ... a Peyronie’s case, where modeling is the potential issue. Now, since Bioflex isn’t surrounded by the ...

55

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 ...

56

Minimally Invasive Penile Implant Surgery  

Medline Plus

Full Text Available ... the next hour you’ll see a live panel discussion of penile implant surgery. For men with ... GOLDSTEIN, MD: There are physicians who are greatly stressed over this, and it really is – 00:26: ...

57

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 ...

58

Minimally Invasive Penile Implant Surgery  

Medline Plus

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

59

Minimally Invasive Penile Implant Surgery  

Medline Plus

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

60

Minimally Invasive Penile Implant Surgery  

Medline Plus

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

61

Minimally Invasive Penile Implant Surgery  

Medline Plus

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

62

Minimally Invasive Penile Implant Surgery  

Medline Plus

Full Text Available ... 1970s. Today we are thrilled to have two contemporary experts in penile implant surgery for the treatment ... the source of infection, and looking at the literature it is clear that it is the patient’s ...

63

Minimally Invasive Penile Implant Surgery  

Medline Plus

Full Text Available ... same – that is, placement of a penile prosthetic device in the two erection chambers of the corpora ... was the concept of getting infected after the device has been placed. And when you look at ...

64

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 ... then move the drape and unveil the final product. 00:27:54 IRWIN GOLDSTEIN, MD: It’s a ...

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Hemodynamics of small aneurysm pairs at the internal carotid artery.  

Science.gov (United States)

Cerebral aneurysms carry significant risks because rupture-related subarachnoid hemorrhage leads to serious and often fatal consequences. The rupture risk increases considerably for multiple aneurysms. Multiple aneurysms can grow from the same location of an artery, and the interaction between these aneurysms raises the rupture risk even higher. Four aneurysm pair cases at the internal carotid artery are investigated for their hemodynamic behaviors using patient-specific modeling. For each case, aneurysms are separated from the parent artery and three models are reconstructed, one with two aneurysms and the other two models with only one of the two aneurysms. Results show that the relative anatomic location of one aneurysm to the other may determine the hemodynamic environment of an aneurysm. The presence of a proximal aneurysm reduces the intra-aneurysmal flow into the distal aneurysm; the proximal aneurysm and larger aneurysm have a greater area under low wall shear stress. The average intra-aneurysmal inflow ratio ranges from 16% to 41%, and reduction of the inflow ratio by an aneurysm pair varies from 6% to 15%. The maximum wall shear stress increases for serial aneurysms, but decreases for parallel aneurysms. Interaction between parallel aneurysms is not significant; however, the proximal aneurysm in serial aneurysms may be subject to a greater rupture risk. PMID:22410434

Jou, Liang-Der; Morsi, Hesham; Shaltoni, Hashem M; Mawad, Michel E

2012-12-01

66

Ethical issues in penile transplantation  

OpenAIRE

This article provides an overview of the ethical issues associated with penile transplantation, a form of composite tissue allografting. There is only one reported case of human penile transplantation, and, as such, this technique is considered to be experimental. The ethical issues at stake involve both the graft donor and the graft recipient. With regard to the recipient, there are significant concerns relating to surgical risks and benefits, informed consent, body image (including surgical...

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

2010-01-01

67

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.)

68

Imaging of penile traumas - therapeutic implications  

Energy Technology Data Exchange (ETDEWEB)

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.)

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

2005-12-01

69

LARGE AND SMALL ARTERIAL ELASTICITY IN HEALTHY ACTIVE AND SEDENTARY PREMENOPAUSAL WOMEN  

Directory of Open Access Journals (Sweden)

Full Text Available The purpose of this study was to compare large and small arterial elasticity in apparently healthy sedentary and recreationally active adult women, and to examine if age affects large and small arterial elasticity. This cross-sectional study consisted of 43 premenopausal women without overt cardiovascular disease (age = 43.4 ± 4.7 yrs; mean ± SD. The subjects were grouped into a sedentary group or a leisurely active group (30 min, 3d wk of low intensity in addition to the following age groups: 35-40 years, n = 13; 41-45 years, n = 14; 46-54 years, n = 16. Subjects rested supine while pulse contour analysis was measured from the radial artery using an HDI/Pulsewave CR-2000 instrument (Hypertension Diagnostic, Inc. to examine arterial elasticity in the large and small arteries. Activity level and menopausal status was based on self-report. There were no differences in large (14.5 ± 1.0 ml/mmHg x 10; 14.9 ± 0.9 ml/mmHg x 10; mean ± SD and small (5.5 ± 0.5 ml/mmHg x 100; 6.4 ± 0.4 ml/mmHg x 100 arterial elasticity between the sedentary group and the recreationally active group, respectively. Large (12.8 ± 0.9 ml/mmHg x 10 arterial elasticity was lower in the oldest group (p = 0.008 compared to the youngest group (17.6 ± 5.9 ml/mmHg x 10. After adjusting for body mass index, large arterial elasticity (p = 0.022 remained lower in the oldest group. There was a trend for small arterial elasticity to be lower in the older group compared to the young group (p = 0.063. There was no difference in large and small arterial elasticity between healthy sedentary and recreationally active premenopausal women. This suggests that more strenuous physical activity may be necessary to gain beneficial effects on the vasculature. Large arterial elasticity is decreasing with advancing age independent of body mass index

Anette S. Fjeldstad

2007-06-01

70

Penile Epidermoid Cyst Consisted of Multiple Foci: A Case Report  

OpenAIRE

Penile epidermoid cysts are uncommon, and a small number of cases have been reported worldwide. We present the first documented patient with a penile epidermoid cyst which consisted of multiple focuses. A 37-year-old man presented to our department with a chief complaint of an asymptomatic, soft mass in the ventral part of the penis. The mass was nontender, freely movable and measuring 3 cm within the dermis. MRI (magnetic resonance imaging) revealed a high signal intensity on both T1- and T2...

Akiou Okumura; Kiyoshi Takagawa; Hideki Fuse

2012-01-01

71

T-Stenting-and-Small-Protrusion Technique for Bifurcation Stenoses After End-to-Side Anastomosis of Transplant Renal Artery and External Iliac Artery: Report of Two Cases.  

Science.gov (United States)

Bifurcation stenoses after end-to-side anastomosis of transplant renal artery (TRA) and external iliac artery (EIA), including stenoses at the anastomosis and the iliac artery proximal to the TRA, are rare. In the present article, we report two successfully managed cases of bifurcation stenoses after end-to-side anastomosis of the TRA and EIA using the technique of T-stenting and small protrusion (TAP stenting). PMID:25148922

Chen, Yong; Ye, Peng; Jiang, Wen-Jin; Ma, Shuo-Yi; Zhao, Jian-Bo; Zeng, Qing-le

2014-08-23

72

Ethical issues in penile transplantation.  

Science.gov (United States)

This article provides an overview of the ethical issues associated with penile transplantation, a form of composite tissue allografting. There is only one reported case of human penile transplantation, and, as such, this technique is considered to be experimental. The ethical issues at stake involve both the graft donor and the graft recipient. With regard to the recipient, there are significant concerns relating to surgical risks and benefits, informed consent, body image (including surgical expectations and outcomes) and compliance. Donor issues may include family consent and privacy, as well as graft harvesting (leaving the donor cadaver without a penis). Many of these ethical issues can be explored during the recipient's assessment and consent process. Because no medium-term or long-term outcome data for this procedure exist-only one such operation has ever been performed-the burdens and ethical issues concerning penile transplantation remain unknown. PMID:20835258

Zhang, Li-Chao; Zhao, Yong-Bing; Hu, Wei-Lie

2010-11-01

73

New insights into the control of small artery function in human pregnancy and estrogen receptor beta knockout mice  

OpenAIRE

Background: Available data clearly indicates functional and morphological differences between small and large arteries, and observations from studies on large arteries may not be applicable to understand the physiology of small arteries (~200-300mum) that actively participate in the regulation of peripheral vascular resistance, blood pressure and flow to target organs. These events confer cardiovascular adaptation to normal pregnancy (NP), however they are disturbed in preec...

Luksha, Leanid

2007-01-01

74

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

DEFF Research Database (Denmark)

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.

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

75

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

OpenAIRE

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

Campbell, Evelyn M.

2013-01-01

76

Anaphylaxis of small arteries: putative role of nitric oxide and prostanoids.  

Science.gov (United States)

This study investigated possible implication of nitric oxide and prostanoids in anaphylactic reaction in small mesenteric and coronary arteries. MATERIAL AND METHODS. Isolated arteries from guinea pigs, sensitized with 0.5 mL of horse serum or sham-sensitized, were challenged with 1% of horse serum in vitro. Contractile responses of arteries (normalized diameter, 350-450 microm) were recorded by a small blood vessel wire myograph. For inhibition of the release of NO or prostanoids, vessels were pretreated with N(G)-nitro-L-arginine methyl ester (30 microM) or indomethacin (10 microM), respectively. RESULTS. Antigen challenge was followed by contraction of both coronary and mesenteric vessels. Two patterns of contraction were observed: 1) peak contraction - an immediate transient contraction of relatively high amplitude; this was the most common pattern; 2) biphasic: the initial peak contraction was followed by a slow growing contraction with low amplitude. Biphasic pattern was observed in 60% of the mesenteric vessels and 40% of the coronary vessels. Inhibition of NO synthase significantly increased the peak contraction in the coronary vessels and the second-phase contraction in the mesenteric vessels. Inhibition of cyclooxygenase caused a decrease in the peak and second-phase contraction of both the coronary and mesenteric vessels. CONCLUSIONS. Despite anaphylactic contraction, nitric oxide seems to be released from the endothelium following antigen challenge in the small coronary and mesenteric arteries. This may contribute to the development of hypotension during anaphylaxis. Prostanoids are playing a different role - the contracting products of cyclooxygenase pathway are important for the development of anaphylactic contraction of the small isolated arteries. PMID:20234162

Laukeviciene, Ale; Ugincius, Paulius; Korotkich, Igor; Lazauskas, Robertas; Kevelaitis, Egidijus

2010-01-01

77

Minimally Invasive Penile Implant Surgery  

Medline Plus

Full Text Available ... This has been a discussion of penile implant surgery live from Coral Gables Hospital. OR-Live makes it easy for you to learn more. Just click on the “request information” button on your webcast screen and open the door to informed medical care. 01:03: ...

78

Minimally Invasive Penile Implant Surgery  

Medline Plus

Full Text Available ... it’s an acceptable way. It’s still a valid, successful way of doing it, but it allows contact ... penile prosthesis is probably one of the most successful device in the history of medicine. These devices ...

79

Minimally Invasive Penile Implant Surgery  

Medline Plus

Full Text Available ... pump goes in. Unnecessary dilation will cause more edema, and edema causes pain and infection. You can see there’s ... so that you don’t have any penile edema. As you can see we’re a minute ...

80

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 ... the penis – these two experts have advanced the surgery by using new, minimally invasive surgical techniques. Such techniques potentially reduce the infec— ...

81

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 ... migration, or contamination, in a negative pressure drain system. Now, I could tell you that in my ...

82

Minimally Invasive Penile Implant Surgery  

Science.gov (United States)

... this in perspective. A TV show is 30 minutes. You could place two penile implants in men in one TV show. That’s unbelievable. 00:48:03 PAUL PERITO, MD: Yeah. And going back to both of our principles: the less dissection you do, the – And that’s what my paper, one of the summaries of my paper, is ...

83

Minimally Invasive Penile Implant Surgery  

Medline Plus

Full Text Available ... MD: Wow, that’s fantastic. Okay, another question. The success rate of the inflatable penile prosthesis. 00:17: ... review publications on the Bioflex. And here’s a study showing survival of the two kinds of devices: ...

84

Minimally Invasive Penile Implant Surgery  

Medline Plus

Full Text Available ... believe an indication is any patient who has organic erectile dysfunction and who fails treatment with PD5 inhibitors such as Viagra, Levitra, or ... EID, MD: It will if the patient has organic erectile ... potent, then that’s not the treatment of choice. If he has, then the penile ...

85

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: I ... should be. Do you realize that across the United States there’s 300,000 breast implants a year? Across ...

86

Minimally Invasive Penile Implant Surgery  

Medline Plus

Full Text Available ... involved in penile implant surgery for the last 35 years, since the initial U.S. experience in the ... 14:34 PAUL PERITO, MD: Straightforward. 00:14:35 IRWIN GOLDSTEIN, MD: Where are we now, Dr. ...

87

Penile rehabilitation with a vacuum erectile device in an animal model is related to an antihypoxic mechanism: blood gas evidence.  

Science.gov (United States)

Our previous study showed that vacuum erectile device (VED) therapy has improved erectile function in rats with bilateral cavernous nerve crush (BCNC) injuries. This study was designed to explore the mechanism of VED in penile rehabilitation by analyzing cavernous oxygen saturation (SO2) and to examine the effect of VED therapy on preventing penile shrinkage after BCNC. Thirty adult Sprague-Dawley rats were randomly assigned into three groups: group 1, sham surgery; group 2, BCNC; and group 3, BCNC+VED. Penile length and diameter were measured on a weekly basis. After 4 weeks of therapy, the penile blood was extracted by three methods for blood gas analysis (BGA): method 1, cavernous blood was aspirated at the flaccid state; method 2, cavernous blood was aspirated at the traction state; and method 3, cavernous blood was aspirated immediately after applying VED. SO2 values were tested by the blood gas analyzer. The results showed that VED therapy is effective in preventing penile shrinkage induced by BCNC (Penile shortening: BCNC group 1.9±1.1 mm; VED group 0.3±1.0 mm; Pblood constructs in the corpus cavernosum right after VED application were 62% arterial and 38% venous blood. These findings suggest that VED therapy can effectively preserve penile size in rats with BCNC injury. The beneficial effect of VED therapy is related to antihypoxia by increasing cavernous blood SO2. PMID:23564044

Lin, Hao-Cheng; Yang, Wen-Li; Zhang, Jun-Lan; Dai, Yu-Tian; Wang, Run

2013-05-01

88

Preparation and evaluation of bicomponent and homogeneous polyester silk small diameter arterial prostheses.  

Science.gov (United States)

The development of a small diameter (?5?mm) arterial prosthesis requires the appropriate selection of materials, structure and fabrication method so as to provide adequate mechanical properties, superior biocompatibility and precise control over the diameter. In this study, 100% polyester, 100% silk fibroin and a combination of both yarns were woven into seamless tubular prototype prostheses with different basic weaves. After degumming/scouring they met a target inner diameter of 3.9±0.3?mm which demonstrates that weaving is a precise way to manufacture small caliber arterial prostheses. In conclusion, the bicomponent polyester/silk woven samples had superior mechanical properties and improved cytocompatibility compared to commercial ePTFE devices. PMID:23292721

Yang, Xiaoyuan; Wang, Lu; Guan, Guoping; King, Martin W; Li, Yuling; Peng, Lei; Guan, Ying; Hu, Xingyou

2014-01-01

89

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

DEFF Research Database (Denmark)

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

Thybo, N K; Stephens, N

1995-01-01

90

Sebaceous Hyperplasia of the Scrotum and Penile Shaft  

OpenAIRE

Sebaceous hyperplasia (SH) is a proliferative abnormality of sebaceous glands, most often seen in elderly individuals. It consists of single or multiple, asymptomatic, small yellow papules with a central depression. The face is most commonly affected, but there have been reports of SH on the chest or genitalia. A lobular array of well-differentiated mature sebaceous lobules is noted on histological preparations. In this report, we describe a patient with SH on the penile shaft and parts of th...

Kim, Hei Sung; Lee, Jun Young; Kim, Hyung Ok; Park, Young Min

2011-01-01

91

Minimally Invasive Penile Implant Surgery  

Medline Plus

Full Text Available ... California. I am Editor-in-Chief of the Journal of Sexual Medicine . I’ve been involved in penile implant surgery ... than it was before. So perhaps evidence-based medicine is not a bad thing after all, you know. 00:24:59 IRWIN GOLDSTEIN, MD: As an editor of a journal, I will support that. 00:25:03 J. ...

92

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

DEFF Research Database (Denmark)

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

Buus, C L; Aalkjær, Christian

1998-01-01

93

Penile Epidermoid Cyst Consisted of Multiple Foci: A Case Report  

Directory of Open Access Journals (Sweden)

Full Text Available Penile epidermoid cysts are uncommon, and a small number of cases have been reported worldwide. We present the first documented patient with a penile epidermoid cyst which consisted of multiple focuses. A 37-year-old man presented to our department with a chief complaint of an asymptomatic, soft mass in the ventral part of the penis. The mass was nontender, freely movable and measuring 3 cm within the dermis. MRI (magnetic resonance imaging revealed a high signal intensity on both T1- and T2-weighted images. Excision of the cyst was performed under local anesthesia. Macroscopically, the cut surface of the mass appeared to be full of a cheese-like material and the cyst consisted of multiple focuses. The cyst did not contain skin appendages. The pathological diagnosis was an epidermoid cyst of the penis. No recurrence has been noted in the year since the operation.

Akiou Okumura

2012-09-01

94

Penile venous anatomy: an additional description and its clinical implication.  

Science.gov (United States)

The human penile venous system has been well studied and described but the demonstration of extra venous channels in imaging films prompted us to seek refinement of our anatomical knowledge of this venous system. Cavernosography in 37 patients who had venous stripping surgery and now suffered recurrent erectile dysfunction consistently showed an independent vein, smaller than the deep dorsal vein, running almost in the same position of the deep dorsal vein even though the latter had been removed unequivocally in previous surgery. Cavernosography in 9 patients who underwent intraoperative films also demonstrated the presence of this cavernosal vein in addition to the deep dorsal vein. Meticulous dissection of the penis under the microscope was then performed in 21 male cadavers and we found a cavernosal vein coursing along each corpus cavernosum all the way distally to the glans and draining directly into the Santorini's plexus in 19 subjects. This is in contrast to the previous description that this cavernosal vein was a short vein in the penile hilum. Two sets of para-arterial veins, which have not been reported in the literature, were found to accompany each dorsal artery in all 21 subjects. This more extensive and extra venous drainage might have important implication for venous stripping surgery in the treatment of erectile dysfunction. PMID:14581520

Hsu, Geng-Long; Hsieh, Cheng-Hsing; Wen, Hsien-Sheng; Chen, Yi-Chang; Chen, Shyh-Chyan; Mok, Martin S

2003-01-01

95

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

96

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.

97

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

Science.gov (United States)

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

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

2014-09-01

98

VEGF immunoexpression in penile carcinoma  

OpenAIRE

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 treated by penectomy and those with positive nodes underwent groin lymphadenectomy. Tumor grading was 35 G1 and 12 G2/3. Primary lesion stage was 24 pT1 and 23 pT2-4. Positive inguinal nodes were ...

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

2002-01-01

99

Penile replantation, complication management, and technique refinement.  

Science.gov (United States)

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

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

2008-01-01

100

Selected Arterial Infusion Chemotherapy Combined with Target Drugs ?for Non-small Cell Lung Cancer with Multiple Brain Metastase  

OpenAIRE

Background and objective The aim of this study is to evaluate the efficacy of selected arterial infusion chemotherapy in treating non-small cell lung cancer (NSCLC) with multiple brain metastases and corresponding factors to influencing prognosis. Methods From September 2008 to October 2011, a total of 31 patients of NSCLC with multiple brain metastases (?3) received selected incranial, bronchial and corresponding target arterial infusion chemotherapy combined with EGFR-TKIs. Interventional...

Li, Jinduo; Guo, Zhi

2012-01-01

101

FRACTURAS DEL PENE / Penile fracture  

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: Spanish Abstract in spanish 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.

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

2014-08-01

102

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

International Nuclear Information System (INIS)

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

103

Reflex penile erection in anesthetized mice: an exploratory study.  

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Ejaculatory-like rhythmic contractions of the bulbospongiosus (BS) muscle and penile erection can be elicited in the urethane-anesthetized rat, following spinal cord transection, upon electrical stimulation (ES) of the dorsal penile nerve (DPN). The aim of this work was to investigate this reflex in anesthetized mice. Adult C57BL6 mice were anesthetized with isoflurane. The BS muscle and corpus cavernosum were instrumented to allow quantification of the BS muscle electromyographic activity (BS EMG) and intracavernosal pressure respectively. The femoral artery and jugular vein were catheterized to allow measurement of blood pressure and compound administration. ES of the DPN, via bipolar silver electrodes, reliably evoked erectile responses in mice with intact spinal cords. The overall amplitude of the erectile response was frequency- and pulse duration-dependent. Erectile responses were abolished by bilateral cut of the sensory branch of the pudendal nerve. Transection of the spinal cord potentiated the erectile responses and increased the area under the curve of the BS EMG when compared with those animals with intact spinal cords. However, no coordinated rhythmic contractions of the BS muscle during or after the ES could be observed, with or without spinal transection. Melanotan-II failed to enhance the erectile response induced by ES of the DPN, in mice with intact spinal cords. ES of the DPN in isoflurane-anesthetized mice could be a useful model in which to study the interplay between brain and spinal cord in the control of reflex penile erection, and could take advantage of knockout mice models. However, the lack of efficacy of Melanotan-II suggests that further experiments are necessary to confirm the future utility of this model. In contrast to rats, the expulsion reflex could not be reliably elicited in mice with or without spinal transection. This latter finding suggests the existence of fundamental differences in the organization of the spinal network controlling sexual reflexes between rats and mice. PMID:18599219

Allard, J; Edmunds, N J

2008-07-31

104

Penile paraffinoma and ulcers of penis.  

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The authors describe a case of 33 year old Caucasian married man with an irregular 6 cm penile mass associated with multiple penile ulcers. He reluctantly admitted that 10 years ago he had multiple mineral oil (Vaseline) self injections into the penis, for penile enlargement purposes. The patient had a surgical intervention 10 years ago, but he has recurrent ulcers on his penis. We have administered an intravenous antibiotic therapy combined with local therapy. The term paraffinoma describes a distinct histopathological finding that results from the injection of foreign oily substances into the skin. Although such procedure may be considered rare, they are still performed in some countries. The major point we want emphasis is following: a lot of people seek penile augmentations, it is necessary to remind physicians and the public that nonscientific and inadequate procedure such as Vaseline may lead to debilitating and destructive consequences (Tab. 1, Ref. 12). PMID:22180996

Bobik, O; Bobik, O

2011-01-01

105

Compulsive masturbation and chronic penile lymphedema.  

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Chronic penile lymphedema arises from the abnormal retention of lymphatic fluid in the subcutaneous tissues and may be secondary to local and systemic medical conditions such as sexually transmitted diseases, filariasis, malignancy, local radiotherapy, and surgery. This case report aims to consider compulsive masturbation as a possible cause of chronic penile edema. A 40-year-old man was referred to our institute for behavioral disturbance, including compulsive masturbation. Neuropsychiatric evaluation showed moderate mental retardation, mild dysarthria and limb incoordination, anxiety, depressed mood, and impulse dyscontrol. Brain MRI pointed out diffuse white matter lesions. Urogenital examination revealed an uncircumcised penis with non-tender edema of the shaft and prepuce with areas of lichenification. Since the most common local and systemic causes of edema were excluded, chronic penile edema due to compulsive masturbation was diagnosed and the compulsive behavior treated with an antidepressant and low-dose neuroleptics. Compulsive masturbation should be taken into account when counselling patients with penile edema. PMID:21792689

Calabrò, Rocco Salvatore; Galì, Alessandro; Marino, Silvia; Bramanti, Placido

2012-06-01

106

Dynamic imaging of a small artery underneath skin surface of a human finger by optical coherence tomography  

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Full Text Available OCT is a powerful tool for detection of physiological functions of micro organs underneath the human skin surface, besides the clinical application to ophthalmology, as recently demonstrated by the authors’ group. In particular, dynamics of peripheral vessels can be observed clearly in the time-sequential OCT images. Among the vascular system, only the small artery has two physiological functions both for the elastic artery and for muscle-controlled one. It, therefore, is important for dynamic analysis of blood flow and circulation. In the time-sequential OCT images obtained with 25 frames/sec, it is found that the small artery makes a sharp response to sound stress for contraction and expansion while it continues pulsation in synchronization with the heartbeats. This result indicates that the small artery exhibits clearly the two physiological functions for blood flow and circulation. In response to sound stress, blood flow is controlled effectively by thickness change of the tunica media which consists of five to six layers of smooth muscles. It is thus found that the thickness of the tunica media changes remarkably in response to external stress, which shows the activity of the sympathetic nerve. The dynamic analysis of the small artery presented here will allow us not only to understand the mechanism of blood flow control and also to detect abnormal physiological functions in the whole vascular system.

Masamitsu Haruna

2013-03-01

107

Bovine pericardium in penile prosthesis reimplantation  

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

Eduardo J. Lopes

2007-02-01

108

Bovine pericardium in penile prosthesis reimplantation  

Scientific Electronic Library Online (English)

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

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

2007-02-01

109

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

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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.

110

Penile length and circumference: an Indian study.  

Science.gov (United States)

Apprehension about the normal size of penis is a major concern for men. Aim of the present investigation is to estimate the penile length and circumference of Indian males and to compare the results with the data from other countries. Results will help in counseling the patients worried about the penile size and seeking penis enlargement surgery. Penile length in flaccid and stretched conditions and circumference were measured in a group of 301 physically normal men. Erected length and circumference were measured for 93 subjects. Mean flaccid length was found to be 8.21 cm, mean stretched length 10.88 cm and circumference 9.14 cm. Mean erected length was found to be 13.01 cm and erected circumference was 11.46 cm. Penile dimensions are found to be correlated with anthropometric parameters. Insight into the normative data of penile size of Indian males obtained. There are significant differences in the mean penile length and circumference of Indian sample compared to the data reported from other countries. Study need to be continued with a large sample to establish a normative data applicable to the general population. PMID:17568760

Promodu, K; Shanmughadas, K V; Bhat, S; Nair, K R

2007-01-01

111

Long-term results of combined tunica albuginea plication and penile prosthesis implantation for severe penile curvature and erectile dysfunction.  

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Penile prosthesis implantation is the recommended treatment in patients with penile curvature and severe erectile dysfunction (ED) not responding to pharmacotherapy. Most patients with mild-to-moderate curvature can expect cylinder insertion to correct both ED and penile curvature. In patients with severe curvature and in those with persistent curvature after corporeal dilation and prosthesis placement, intraoperative penile "modelling" over the inflated prosthesis has been introduced as an effective treatment. We report for the first time the long-term results of a patient treated with combined penile plication and placement of an inflatable penile prosthesis. PMID:24790766

Cormio, Luigi; Massenio, Paolo; Di Fino, Giuseppe; Lucarelli, Giuseppe; Mancini, Vito; Liuzzi, Giuseppe; Carrieri, Giuseppe

2014-01-01

112

Surgical or conservative treatment of penile fracture  

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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.

?or?evi? D.

2008-01-01

113

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  

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

Stankevicius, Edgaras; Dalsgaard, T.

2011-01-01

114

Potassium channel activation and relaxation by nicorandil in rat small mesenteric arteries  

Science.gov (United States)

We used whole-cell patch clamp to investigate the currents activated by nicorandil in smooth muscle cells isolated from rat small mesenteric arteries, and studied the relaxant effect of nicorandil using myography.Nicorandil (300??M) activated currents with near-linear current-voltage relationships and reversal potentials near to the equilibrium potential for K+.The nicorandil-activated current was blocked by glibenclamide (10??M), but unaffected by iberiotoxin (100?nM) and the guanylyl cyclase inhibitor LY 83583 (1??M). During current activation by nicorandil, openings of channels with a unitary conductance of 31?pS were detected.One hundred ?M nicorandil had no effect on currents through Ca2+ channels recorded in response to depolarizing voltage steps using 10?mM Ba2+ as a charge carrier. A small reduction in current amplitude was seen in 300??M nicorandil, though this was not statistically significant.In arterial rings contracted with 20?mM K+ Krebs solution containing 200?nM BAYK 8644, nicorandil produced a concentration-dependent relaxation with mean pD2=4.77±0.06. Glibenclamide (10??M) shifted the curve to the right (pD2=4.32±0.05), as did 60?mM K+. LY 83583 caused a dose-dependent inhibition of the relaxant effect of nicorandil, while LY 83583 and glibenclamide together produced greater inhibition than either alone.Metabolic inhibition with carbonyl cyanide m-chlorophenyl hydrazone (30?nM), or by reduction of extracellular glucose to 0.5?mM, increased the potency of nicorandil.We conclude that nicorandil activates KATP channels in these vessels and also acts through guanylyl cyclase to cause vasorelaxation, and that the potency of nicorandil is increased during metabolic inhibition. PMID:9886763

Davie, C S; Kubo, M; Standen, N B

1998-01-01

115

Use of penile implants in the constructed neophallus.  

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Creation of a neophallus in cases of loss of the penis or female to male trans-sexual is a challenge. The forearm flap is the most popular method used. A penile implant may be placed at the original procedure or at a later date to provide support for intercourse. The hydraulic nondistally expanding types provide the best support with less chance of distal erosion. Covering the device with cadaver pericardium or porcine small intestinal submucosa has been helpful in creating a neocorpus cavernosum. PMID:14551590

Mulcahy, J J

2003-10-01

116

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)

117

Successful Replantation of Amputated Penile Shaft following Industrial Injury  

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

A Ariafar

2010-09-01

118

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

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

Plesner, L; Juul, B

1991-01-01

119

Combined therapy with transcatheter arterial chemoembolization and percutaneous microwave coagulation for small hepatocellular carcinoma  

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Full Text Available AIM: To assess the efficacy of combined transcatheter arterial chemoembolization (TACE and percutaneous microwave coagulation therapy (PMCT for small hepatocellular carcinoma (HCC.METHODS: Thirty-five patients with a total of 41 HCC nodules (? 3 cm in diameter were treated with TACE followed by computed tomograghy (CT-guided percutaneous microwave coagulation therapy (PMCT within 1-3 wk.RESULTS: By biopsies and enhanced CT scans, complete necrosis of the tumor and 3-5 mm of the surrounding non-cancerous area were observed in 34 foci. In seven foci, incomplete necrosis of the surrounding parenchyma was observed. Serum alpha-fetoprotein (AFP levels returned to normal 10 d after treatment in 25 patients who originally had high serum AFP levels. The follow-up period was 6-31 mo, and all patients remained alive. One patient had a recurrence in the subsegments of the liver, and another patient had a recurrence near the original lesion.CONCLUSION: Combined therapy with TACE and PMCT is a safe and effective treatment without severe complications for small HCC.

Wei-Zhu Yang, Na Jiang, Ning Huang, Jing-Yao Huang, Qu-Bin Zheng, Quan Shen

2009-02-01

120

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

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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.

Su, Junjing; Laursen, Britt E

2012-01-01

121

Angiography of penile vessels. Modified angiographic technique and optimal use of vasodilators. Angiographie der A. pudenda und ihrer Aeste bei erektiler Dysfunktion. Modifizierte angiographische Technik und optimierter Einsatz vasodilatierender Substanzen  

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A new simplified technique for evaluating the internal pudendal artery and the penile vessels is described using a new catheter configuration with a very short 90deg-angled tip. In 30 consecutive patients, a superselective catheterisation of the internal pudendal artery was achieved in 93%. To improve visualisation of the penile arteries, the selective intraarterial application of 0.2 mg nitrogylcerin in addition to the mandatory intracavernous injection of papaverin or prostaglandin E{sub 1} has proved to be of value. Examination of the blood flow velocity in the dorsal penile artery with Doppler ultrasound 2 minutes after intraarterial application of 0.2 mg nitroclycerin showed a mean elevation of the Doppler amplitude by the factor 2.4 (range 0.4-9). With regard to the maximal increase of the blood velocity (range 1-6 minutes), a high interindividual difference was observed. (orig.).

Bohndorf, K.; Adam, G.; Guenther, R.W. (Technische Hochschule Aachen (Germany, F.R.). Klinik fuer Radiologische Diagnostik); Sikora, R.; Sohn, M. (Technische Hochschule Aachen (Germany, F.R.). Urologische Klinik)

1991-04-01

122

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)

123

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

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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

Juan F Granada

2010-10-01

124

Update in the management of penile cancer  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english Purpose: The management of penile cancer has evolved as less invasive techniques are applied in the treatment of the primary tumor and inguinal lymph nodes. Materials and Methods: Herein we review the literature focusing on advances in the preservation of the phallus as well as less morbid procedure [...] s to evaluate and treat the groins. Results: Promising imaging modalities for staging are discussed. New techniques are described and tables provided for penile preservation. We also review the contemporary morbidity of modified surgical forms for evaluation of the inguinal nodes. Conclusions: Advances in surgical technique have made phallic preservation possible in a greater number of primary penile cancers. The groins can be evaluated for metastasis with greater accuracy through new radiologic means as well as with less morbid modified surgical techniques.

Jorge R., Caso; Alejandro R., Rodriguez; Jose, Correa; Philippe E., Spies.

2009-08-01

125

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

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

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

2006-02-15

126

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

DEFF Research Database (Denmark)

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

Glavind-Kristensen, Marianne; Matchkov, Vladimir

2004-01-01

127

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

DEFF Research Database (Denmark)

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

Maigaard, S; Forman, Axel

1985-01-01

128

Clipping of incidental aneurysm of middle cerebral artery through small temporal craniotomy and linear skin incision.  

Science.gov (United States)

The authors introduced a new approach for clipping of the incidental aneurysm of the middle cerebral artery (MCA) and reported the clinical results. We retrospectively reviewed 26 patients with 27 incidental MCA aneurysms who were treated from January 2010 to December 2012. All clippings were performed through a small temporal craniotomy and linear skin incision. Follow-up imaging showed complete occlusion of 26 aneurysms (96.3%), residual neck in one (3.7%). In one case, residual neck of the aneurysm did not grow on serial follow up. In one of 26 cases (3.8%), approach-related complication was retraction injury of the temporal cortex. Two patients developed postoperative infarction on the MCA territories due to vasospasm and on the cerebellum due to unknown causes. These were not approach-related complications. Operation time was 95 min-250 min (mean 143 min). There were no complications of temporal muscle atrophy, scar deformity, paresthesia, or pain around the scalp incision and frontalis palsy. This approach offers good surgical possibilities and little approach related morbidity in the clipping of incidental MCA aneurysms. PMID:24765611

Mun, Jong Hyun; Cho, Kyu Yong; Lee, Rae Seop; Lim, Byung Chan; Choi, Tai Min; Lim, Jun Seob

2014-03-01

129

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)

130

Pulsative hematoma: A penile fracture complication  

Directory of Open Access Journals (Sweden)

Full Text Available Background. Fracture of the penis is a direct blunt trauma of the erect or semi-erect penis. It can be treated by conservative or surgical means. Retrospective analyses of conservative penile fracture treatment reveal frequent immediate and later complications. Case report. We presented a 41- year-old patient with pulsative hematoma caused by an unusual fracture of the penis. Fracture had appeared 40 days before the admittance during a sexual intercourse. The patient was treated surgically. Conclusion. Pulsative hematoma (pulsative diverticulum is a very rare, early complication of a conservatively treated penile fracture. Surgical treatment has an advantage over surgical one, which was confirmed by our case report.

Nale ?or?e

2007-01-01

131

Venous thromboembolism secondary to penile prosthesis.  

Science.gov (United States)

We report the case of a 65-year-old male who presented with an extensive iliofemoral venous thrombosis, which computed tomography demonstrated was secondary to compression of the right common and external iliac veins by a 5-cm diameter penile prosthesis reservoir. A similar occurrence has only been reported a handful of times previously, and only in urological journals, never in vascular literature. It is a potentially serious complication of penile prosthesis surgery, the risk of which can be minimized by ready awareness of this postoperative event. PMID:25017781

Shiraev, Timothy; Graham, Antony

2014-11-01

132

Regular physical activity is associated with improved small artery distensibility in young to middle-age stage 1 hypertensives.  

Science.gov (United States)

The aim of the present study was to investigate the association of physical activity with small artery elasticity in the early stage of hypertension. We examined 366 young-to-middle-age stage 1 hypertensives (mean blood pressure 145.6±10.3/92.5±5.8 mmHg), divided into two categories of physical activity, sedentary (n=264) and non-sedentary (n=102) subjects. The augmentation index was measured using the Specaway DAT System. Small artery compliance (C2) was measured by applanation tonometry, at the radial artery, with an HDI CR2000 device. After 6 years of follow-up, arterial distensibility assessment was repeated in 151 subjects. Heart rate was lower in active than in sedentary subjects (71.2±8.9 vs 76.6±9.7 bpm, p<0.001). After adjusting for age, sex, heart rate, smoking, and blood pressure, C2 was higher (8.0±2.6 vs 6.4±3.0 ml/mmHg × 100, p=0.008) in non-sedentary than in sedentary patients. The augmentation index was smaller in the former (8.8±20.1 vs 16.8±26.5%, p=0.044) but the difference lost statistical significance after further adjustment for blood pressure. After 6 years, C2 was still higher in the non-sedentary than sedentary subjects. In addition, an improvement in the augmentation index accompanied by a decline in total peripheral resistance was found in the former. These data show that regular physical activity is associated with improved small artery elasticity in the early phase of hypertension. This association persists over time and is independent of blood pressure and heart rate. PMID:25367435

Saladini, Francesca; Benetti, Elisabetta; Mos, Lucio; Mazzer, Adriano; Casiglia, Edoardo; Palatini, Paolo

2014-12-01

133

Penile lymphoma presenting as an advanced penile cancer: report of a case  

OpenAIRE

Penile lymphoma is a very rare neoplasm. We report the case of an 82-year-old man who presented with phimosis. The patient also complained of frequent and painful urination. Upon examination a painless penile ulcer and multiple inguinal lymph nodes were found. The shaft of the penis and the prostate were hard on palpation. Abdominal and transrectal ultrasound examination confirmed the involvement of the penis shaft and the prostate and also revealed involvement of the urinary bladder. Biopsy ...

Konstantinos Stamatiou; Hippocrates Moschouris; Athanasios Marinis; Drosos Karageorgopoulos; Kassiani Manoloudaki

2012-01-01

134

Role of human papillomavirus in penile cancer, penile intraepithelial squamous cell neoplasias and in genital warts.  

Science.gov (United States)

Using PCR, the overall prevalence of human papillomavirus (HPV) DNA in penile carcinoma is about 40-45%, which is similar to the detection rate of HPV-DNA in vulvar carcinoma (50%). In analogy to vulvar cancer two different pathways of penile carcinogenesis seem to exist. In contrast to basaloid and warty penile cancers which are regularly HPV-associated (about 80-100%), only a part of keratinizing and verrucous penile carcinomas appear to be related with HPV (33-35%). Penile intraepithelial neoplasias comprising Bowen's disease, erythroplasia of Queyrat and bowenoid papulosis are precursor lesions of basaloid and warty carcinomas of the penis. Precursors of keratinizing carcinomas and verrucous carcinomas are not established. Whether lichen sclerosus and squamous-cell hyperplasia precede penile keratinizing carcinoma is a matter of discussion. Giant condylomata acuminata may precede the development of verrucous carcinomas in some cases. Since high risk HPVs are more frequently found in verrucous carcinomas than in giant condylomas, HPV typing may be a helpful diagnostic step to differentiate giant condyloma from verrucous carcinoma. PMID:12838415

Gross, G; Pfister, H

2004-02-01

135

VEGF immunoexpression in penile carcinoma  

Directory of Open Access Journals (Sweden)

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 treated by penectomy and those with positive nodes underwent groin lymphadenectomy. Tumor grading was 35 G1 and 12 G2/3. Primary lesion stage was 24 pT1 and 23 pT2-4. Positive inguinal nodes were 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.

Antonio Carlos Pereira Martins

2002-01-01

136

VEGF immunoexpression in penile carcinoma  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english 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.

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

137

Phospholipase C-?1 modulates sustained contraction of rat mesenteric small arteries in response to noradrenaline, but not endothelin-1  

OpenAIRE

Vasoconstrictors activate phospholipase C (PLC), which hydrolyzes phosphatidylinositol 4,5-bisphosphate (PIP2), leading to calcium mobilization, protein kinase C activation, and contraction. Our aim was to investigate whether PLC-?1, a PLC isoform implicated in ?1-adrenoreceptor signaling and the pathogenesis of hypertension, is involved in noradrenaline (NA) or endothelin (ET-1)-induced PIP2 hydrolysis and contraction. Rat mesenteric small arteries were studied. Contractility was measured ...

Clarke, Christopher J.; Forman, Simon; Pritchett, James; Ohanian, Vasken; Ohanian, Jacqueline

2008-01-01

138

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

OpenAIRE

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

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

1994-01-01

139

Superficial Dorsal Vein Rupture Imitating Penile Fracture  

OpenAIRE

Dorsal vein rupture of the penis is a rare condition, and few cases have been reported in the literature. Herein we report a 41-year-old man who presented with mildly painful and acute swollen penis, which initially imitated a penile fracture but was surgically explored and shown to be a superficial dorsal vein rupture.

Baran, Caner; Topsakal, Medih; Kavukcu, Ender; Karadeniz, Tahir

2011-01-01

140

Imaging of penile and scrotal emergencies.  

Science.gov (United States)

Penile and scrotal emergencies are uncommon, but when they do occur, urgent or emergent diagnosis and treatment are necessary. Emergent conditions of the male genitalia are primarily infectious, traumatic, or vascular. Infectious conditions, such as epididymitis and epididymo-orchitis, are well evaluated at ultrasonography (US), and their key findings include heterogeneity and hyperemia. Pyocele and abscess may also be seen at US. Fournier gangrene is best evaluated at computed tomography, which depicts subcutaneous gas. Vascular conditions, such as testicular torsion, infarction, penile Mondor disease, and priapism, are well evaluated at duplex Doppler US. The key imaging finding of testicular torsion and infarction is a lack of blood flow in the testicle or a portion of the testicle. Penile Mondor disease is characterized by a lack of flow to and noncompressibility of the superficial dorsal vein of the penis. Clinical examination and history are usually adequate for diagnosis of priapism, but Doppler US may help confirm the diagnosis. Traumatic injuries of the penis and scrotum are initially imaged with US, which depicts whether the penile corpora and testicular seminiferous tubules are contained by the tunicae albuginea; herniation of contents and discontinuity of the tunica albuginea indicate rupture. In some cases, magnetic resonance imaging may be performed because of its ability to directly depict discontinuity of the tunica albuginea. Radiologists must closely collaborate with emergency physicians, surgeons, and urologists to quickly and efficiently diagnose or rule out emergent conditions of the male genitalia to facilitate prompt and appropriate treatment. PMID:23674771

Avery, Laura L; Scheinfeld, Meir H

2013-05-01

141

RETRACTED ARTICLE: Penile Strangulation by Metallic Rings  

OpenAIRE

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

Farooqui, Mohammad Rashid; Meena, R. S.

2011-01-01

142

MR Angiography of Collateral Arteries in a Hind Limb Ischemia Model: Comparison between Blood Pool Agent Gadomer and Small Contrast Agent Gd-DTPA  

Science.gov (United States)

The objective of this study was to compare the blood pool agent Gadomer with a small contrast agent for the visualization of ultra-small, collateral arteries (diameter0.10). Inter-observer variation was 24% and 18% for Gadomer and Gd-DTPA, respectively. In conclusion, blood pool agent Gadomer improved vessel conspicuity compared to Gd-DTPA. Steady-state MRA can be considered as an excellent non-invasive alternative to intra-arterial XRA for the visualization of ultra-small collateral arteries. PMID:21298092

Jaspers, Karolien; Versluis, Bas; Leiner, Tim; Dijkstra, Petra; Oostendorp, Marlies; van Golde, Jolanda M.; Post, Mark J.; Backes, Walter H.

2011-01-01

143

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

LENUS (Irish Health Repository)

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

Kennelly, M M

2012-04-01

144

Amplitude-Integrated Electroencephalographic Activity and Middle Cerebral Artery Doppler Flow Measurements in Preterm Small for Gestational Age Infants.  

Science.gov (United States)

Amplitude-integrated encephalography (EEG) is frequently used in neonatal intensive care units to monitor brain functions. Its bedside application and easy interpretation are the most important features. Brain development of small for gestational age infants can be affected by intrauterine chronic hypoxia. The current study aimed to evaluate cerebral functions of small for gestational age infants by means of amplitude-integrated EEG. Thirty- to 34-week-old 22 small for gestational age and 27 appropriate for gestational age preterm infants were included in the study. The mode of delivery, gender, birth weight, and Apgar scores of the patients were recorded. Following middle cerebral artery mean velocity measurement with cranial Doppler at the 24th hour of birth, an amplitude-integrated EEG recording was performed on all infants, for a period of 4 to 24 hours. Small for gestational age infants had significantly higher middle cerebral artery mean velocity than appropriate for gestational age infants (21.09 ± 4.25 vs 17.8 ± 4.07; P = .029). The amplitude-integrated EEG recordings showed lower "lower border of quiet sleep" and total Burdjalov score in small for gestational age infants when compared with appropriate for gestational age infants (2.5 [1-3.25] µV vs 3 [2.75-4] µV; P = .04, 8 [6-10], 9 [9-11]; P = .04, respectively). Increased middle cerebral artery blood flow observed in small for gestational age infants might be a marker of chronic intrauterine hypoxia to which these infants were exposed. These infants demonstrated a more immature pattern of amplitude-integrated EEG. PMID:25296921

Kolsuz, Leyla Daban; Topcuoglu, Sevilay; Gursoy, Tugba; Karatekin, Güner; Ovali, H Fahri

2014-10-01

145

Effect of hypoxia on force, intracellular pH and Ca2+ concentration in rat cerebral and mesenteric small arteries  

DEFF Research Database (Denmark)

1. The effect of severe hypoxia on force, intracellular Ca2+ concentration ([Ca2+]i) and pHi was studied in isolated small arteries from rat brain and rat mesenterium. The arteries were mounted for isometric force recording while [Ca2+]i was measured with fura-2 or pHi was measured with bis-carboxyethylcarboxyfluorescein (BCECF). 2. Hypoxia reduced the force development in response to arginine vasopressin (AVP) while [Ca2+]i was unchanged or only slightly reduced. Inhibition of acid extrusion by omission of sodium caused no force development in mesenteric arteries, but the fall in pHi was enhanced during hypoxia. In cerebral arteries, hypoxia reduced the force development associated with omission of sodium, and the fall in pHi was less than during normoxic conditions. When acid extrusion was intact, pHi was not affected by hypoxia and the changes in pHi during activation with AVP were similar during hypoxia and in the control situation. 3. Although a decrease in smooth muscle [Ca2+]i may be partly responsiblefor the reduced force development during hypoxia, [Ca2+]i-independent mechanism(s) may play an even more important role. Furthermore, although hypoxia and force development are associated with enhanced acid production, acid extrusion maintains pHi near the control level and it is unlikely that a decrease in smooth muscle pHi plays any role in the reduced force development during hypoxia.

Aalkjær, Christian; Lombard, J H

1995-01-01

146

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english Oscillatory contractile activity is an inherent property of blood vessels. Various cellular mechanisms have been proposed to contribute to oscillatory activity. Mouse small mesenteric arteries display a unique low frequency contractile oscillatory activity (1 cycle every 10-12 min) upon phenylephrin [...] e stimulation. Our objective was to identify mechanisms involved in this peculiar oscillatory activity. First-order mesenteric arteries were mounted in tissue baths for isometric force measurement. The oscillatory activity was observed only in vessels with endothelium, but it was not blocked by L-NAME (100 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.

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

1058-10-01

147

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

OpenAIRE

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

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

2009-01-01

148

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

DEFF Research Database (Denmark)

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

Schjerning, Jeppe; Uhrenholt, Torben R

2013-01-01

149

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

Science.gov (United States)

In arterioles, aldosterone counteracts the rapid dilatation (recovery) following depolarization-induced contraction. The hypothesis was tested that this effect of aldosterone depends on cyclooxygenase (COX)-derived products and/or nitric oxide (NO) synthase (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 endothelial NOS (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. PMID:23396453

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

2013-04-15

150

Transient Distal Penile Corporoglanular Shunt as an Adjunct to Aspiration and Irrigation Procedures in the Treatment of Early Ischemic Priapism  

Science.gov (United States)

Purpose Ischemic priapism, a compartment syndrome, requires urgent treatment in order to nourish the corpora cavernosa. As the first step, aspiration of blood and irrigation of the cavernosal bodies is performed to prevent fibrotic activity and secure erectile capability. During aspiration, there are risks of cardiovascular side effects of adrenergic agonists. We aimed to evaluate a transient distal penile corporoglanular shunt technique in place of aspiration and irrigation techniques for treatment of early ischemic priapism. Materials and Methods A transient distal penile shunt was applied to 15 patients with early ischemic priapism between January 2011 and May 2012. Priapism duration, history, causes, pain, and any prior management of priapism were assessed in all patients. A complete blood count and penile Doppler ultrasonography were performed, which showed attenuated blood flow in the cavernosal artery. A sterile closed system blood collection set, which has two needles and tubing, was used for the transient distal penile shunt. Results Ten of 15 patients with early ischemic priapism were successfully treated with this transient shunt technique. No additional procedures were needed after the resolution of rigidity in the 10 successfully treated patients. Conclusions The transient nature of this technique is an advantage over aspiration and irrigation in the treatment of early ischemic priapism. Our results indicate that the technique can be offered for patients with an ischemic priapism episode of no more than 7 hours. PMID:23789049

Çetinel, Cihangir; Horuz, Rahim; Tarhan, Fatih; Hamarat, Bilal; Goktas, Cemal

2013-01-01

151

Penile herpes zoster: an unusual location for a common disease  

OpenAIRE

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 aspe...

Milan Bjekic; Milica Markovic; Sandra Sipetic

2011-01-01

152

Lymph Node Metastases and Prognosis in Penile Cancer  

OpenAIRE

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

Zhu, Yao; Ye, Ding-wei

2012-01-01

153

Interdependence of contractile responses of rat small mesenteric arteries on nitric oxide and cyclo-oxygenase and lipoxygenase products of arachidonic acid.  

OpenAIRE

1. We have examined the effects of nitric oxide inhibition, indomethacin and the dual lipoxygenase/cyclo-oxygenase inhibitor, 3-amino-1-[m-(trifluoromethyl)-phenyl]-2-pyrazoline (BW755C), on the responses of small mesenteric arteries of Wistar rats, with and without endothelium, to noradrenaline, potassium chloride, endothelin-1, acetylcholine and sodium nitroprusside. 2. Noradrenaline, potassium chloride and endothelin-1 caused concentration-dependent contraction of small mesenteric arteries...

Wu, X. C.; Johns, E.; Michael, J.; Richards, N. T.

1994-01-01

154

The protective effect of intra-arterial vasopressin injections on the small bowel during fractionated abdominal irradiation  

International Nuclear Information System (INIS)

The radioprotective effect of vasopressin-induced intestinal ischemia was investigated in pigs. A bolus injection in the cranial mesenteric artery, of a vasopressin solution, 0.05 IU/kg body weight, was followed by irradiation of the small intestine with 6 MV roentgen rays. Three different fraction schedules were used. Weight changes in the animals and the histologic appearance of their intestines were recorded two weeks after irradiation and compared with the findings in untreated animals. Intra-arterial vasopressin was very effective in protecting the intestine. Vasopressin treatment given before 2 fractions with relatively high radiation doses in a 6-fraction regimen was so effective that it may form the basis of a treatment model applicable in man. (orig.)

155

Penile gangrene due to calcific uremic arteriopathy  

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Full Text Available Calcific uremic arteriopathy (CUA is a rare but potentially life-threatening complication of end-stage renal disease (ESRD and secondary hyperparathyroidism. It typically presents with ischemic necrosis involving areas of adiposity in the body mainly the trunk, buttocks, or proximal extremity. Patients can also present with digital ischemia and more rarely penile gangrene. The pathogenesis of CUA is not yet clear but several putative factors, mainly hyperparathyroidism and related metabolic abnormalities are implicated. A number of conditions can mimic CUA clinically and should be differentiated from it. We present in the current study, a patient who presented with progressive penile gangrene and skin necrosis due to CUA. We review the current understanding of the pathogenesis, diagnosis/differential diagnosis, and management of this rare but potentially life-threatening complication of ESRD.

Bappa Adamu

2011-06-01

156

Penile lymphoma presenting as an advanced penile cancer: report of a case  

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Full Text Available Penile lymphoma is a very rare neoplasm. We report the case of an 82-year-old man who presented with phimosis. The patient also complained of frequent and painful urination. Upon examination a painless penile ulcer and multiple inguinal lymph nodes were found. The shaft of the penis and the prostate were hard on palpation. Abdominal and transrectal ultrasound examination confirmed the involvement of the penis shaft and the prostate and also revealed involvement of the urinary bladder. Biopsy showed diffuse, large B-cell lymphoma. The patient was treated with systemic chemotherapy with full remission of the disease. We review the literature relevant to penile lymphoma and discuss this uncommon condition.

Konstantinos Stamatiou

2012-08-01

157

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

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

Bello Jibril

2012-09-01

158

Penile enlargement: from medication to surgery.  

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Penis lengthening pills, stretch apparatus, vacuum pumps, silicone injections, and lengthening and thickening operations are available for men who worry about their penis size. Surgery is thus far the only proven scientific method for penile enlargement. In this article, we consider patient selection, outcome evaluation, and techniques applied. In our view, sexological counseling and detailed explanation of risks and complications are mandatory before any operative intervention. PMID:20169492

Nugteren, Helena M; Balkema, G T; Pascal, A L; Schultz, W C M Weijmar; Nijman, J M; van Driel, M F

2010-01-01

159

Epidemiologic study on penile cancer in Brazil  

Scientific Electronic Library Online (English)

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

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

2008-10-01

160

Pulsative hematoma: A penile fracture complication  

OpenAIRE

Background. Fracture of the penis is a direct blunt trauma of the erect or semi-erect penis. It can be treated by conservative or surgical means. Retrospective analyses of conservative penile fracture treatment reveal frequent immediate and later complications. Case report. We presented a 41- year-old patient with pulsative hematoma caused by an unusual fracture of the penis. Fracture had appeared 40 days before the admittance during a sexual intercourse. The patient was treated surgically. C...

Nale ?or?e; Mi?i? Sava

2007-01-01

161

Simultaneous Surgical Treatment of Non-small Cell Lung Cancer and Off-pump Coronary Artery bypass Grafting  

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Full Text Available Background and objective Patients with resectable lung cancer and unstable coronary heart disease are at high risks of postoperative death or severe cardioovascular complications. They always pose a therapeutic challenge for thoracic surgeons. The aim of this study is to summarize clinical experience of radical lung resection for cancer with simultaneous off-pump coronary artery bypass grafting. Methods Seven patients who suffered from non small cell lung cancer concomitant arrhythmia, unstable angina and recent history of myocardial infarction had been carried out simultaneous radical lobectomy and off-pump coronary artery bypass grafting. Preoperative 6 patients had been confirmed to be misfit for either coronary arterioplasty or stent implanting by performing the coronary angiography. One patient had undergone stenting before the lung cancer had been diagnosed. The procedure through median sternotomy performed offpump coronary artery bypass grafting preceded lobectomy and mediastinal lymphadenectomy. Left upper lobectomy was performed in 2 patients, right upper lobectomy was performed in 1 patient, right upper and middle lobectomy was performed in one patient, video thoracoscopy assisted left lower lobectomy was performed in 1 patient, right lower lobectomy was performed in 2 patients. Results There was no death of patient in hospital, however, a patient died 7th month postoperatively because of cerebrovascular accident. Atrial fibrillation was observed postoperatively in 1 patient. Five patients were diagnosed as squamous cell lung cancer by pathology examination, and 2 patients were adenocarcinoma. Follow-up ranging from 2 months to 59 monthswas available for these patients postoperatively. None of the patients showed evidence of angina and myocardial infarction after surgery. In one patient, who underwent left superior lobectomy, local recurrence was found at 19 months after surgery. Conclusion In selected patients, simultaneous radical lung resection and off-pump coronary artery bypass grafting is a safe and effective treatment when unstable coronary heart disease and lung cancer coexist. The therapeutic strategy may decrease the incidence of postoperative complications.

Yi ZHANG

2009-04-01

162

Penile veins play a pivotal role in erection: the haemodynamic evidence.  

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Although penile venous surgery has almost been abandoned and the venous factor eliminated as a contributing factor to erectile dysfunction, new concepts of erection-related veins has recently been described and reported in literature. We sought to conduct a haemodynamic study on human cadavers in order to elucidate to what extent penile veins act in erection, and to explore the possible role of erection-related veins as an important contributor to impotence. From November 2002 to December 2003, seven fresh human cadavers of men who had no sexual activity for at least 6 months prior to death, and in whom the penis was intact were used for this study. Infusion cavernosometry was carried out with an induction flow of 150 mL/min before and after the erection-related veins were removed. A rigid erection was attained in all subjects, lasting significantly longer (p = 0.043) after removal of erection-related veins. Similarly, there were significant differences in the maintenance flow (p = 0.043), T(max) (p = 0.043), V(max) (p = 0.043), and pressure loss (p = 0.043). In cadaveric penises, a rigid erection could be maintained in spite of the fact that the low flow rate of 21 mL/min is much lower than the average arterial perfusion rate observed in cases of arterial insufficiency. We therefore concluded that penile veins may play a significant role in attaining sufficient erection, and further research is required to study this possible clinical implication. PMID:15811069

Hsieh, Cheng-Hsing; Wang, Chii-Jye; Hsu, Geng-Long; Chen, Shyh-Chyan; Ling, Pei-Ying; Wang, Tsu; Fong, Tsorng-Harn; Tseng, Guo-Fang

2005-04-01

163

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

164

Penile enlargement with methacrylate injection: is it safe?  

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

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

2013-01-01

165

Developments in the pathology of penile squamous cell carcinomas.  

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Most penile cancers are squamous cell carcinoma (SCC) originating in the epithelium covering glans, coronal sulcus, and foreskin. Several histologic subtypes have been described, each with distinctive clinicopathologic and outcome features. The most common subtype is the usual SCC, representing one half to two thirds of penile carcinomas. Penile verruciform tumors encompass verrucous, warty (condylomatous), and papillary, not otherwise specified, carcinomas. As a group, verruciform tumors are low grade, with low metastatic and mortality rates. In contrast, basaloid and sarcomatoid carcinomas are among the most aggressive penile tumors. Other SCC variants, such as carcinoma cuniculatum and pseudohyperplastic, adenosquamous and acantholytic carcinomas, are rare. The most relevant clinicopathologic and outcome features are outlined for each of these SCC subtypes, and an algorithm that might aid the pathologist in the histologic classification is presented. In addition, recommendations for handling penile cancer specimens, frozen section specimens, and pathology reports are provided. PMID:20691888

Chaux, Alcides; Velazquez, Elsa F; Algaba, Ferran; Ayala, Gustavo; Cubilla, Antonio L

2010-08-01

166

Minimally Invasive Penile Implant Surgery  

Medline Plus

Full Text Available ... in a peer reviewed, published article comparing the role of the lockout valve in devices that had ... MD: Oh, I think there are some other technical aspects, such as either too small, it wasn’ ...

167

Minimally Invasive Penile Implant Surgery  

Medline Plus

Full Text Available ... small Richardson retractor that I bent in the middle on a 45-degree angle. 00:42:04 ... dependent portion of the scrotum, right in the middle. Nobody can see it and it’s easier for ...

168

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

International Nuclear Information System (INIS)

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

169

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

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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.

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

170

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

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

Kleber Fernando Pereira

2010-05-01

171

Penile fracture: experience in 56 cases  

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

Leandro Koifman

2003-02-01

172

Penile fracture: experience in 56 cases  

Scientific Electronic Library Online (English)

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

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

2003-02-01

173

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. Th 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

174

CD34 immunoexpression in penile carcinoma  

OpenAIRE

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 nodes underwent groin lymphadenectomy. Tumor grading was 36 G1 and 24 G2/3. Primary lesion stage was 22 pT1 and 28 pT2-4. Positive inguinal nodes were observed in 18 patients. Selected paraffin ...

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

2002-01-01

175

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english 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.

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

2013-04-01

176

Penile Involvement and Henoch-Schönlein Purpura: A Case Report  

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

Önder YAVA?CAN

2012-01-01

177

Cutaneous Myeloid Sarcoma of the Penile Foreskin.  

Science.gov (United States)

Myeloid sarcoma, considered to herald the onset of a blast crisis in the setting of chronic myeloproliferative neoplasm/dysplasia, typically presents during the course of the disorder. Cutaneous involvement is uncommon and lesions on genital skin are seldom seen. We present a case of a well-differentiated myeloid sarcoma in the penile foreskin in an apparently healthy 29-year-old male presenting with phimosis. The unusual composition of the inflammatory cell infiltrate, and characteristic sparing of dermal blood vessels, nerves and smooth muscle fibres led to the correct diagnosis. Absence of commonly observed changes in the circumcision skin like those of balanitis xerotica was also helpful. Detailed hematological work up revealed a previously undiagnosed chronic myeloid leukemia in chronic phase. The patient also had simultaneous priapism, another rare presentation of chronic myeloid leukemia. One year hence, the patient is in hematological remission with no evidence of extramedullary disease. Although priapism has been described as a rare presenting symptom in chronic myeloid leukemia, the present case is unique as this is the first time a cutaneous myeloid sarcoma has been documented in the penile foreskin. PMID:24913300

Afrose, Ruquiya; Nebhnani, Deepa; Wadhwa, Neelam

2014-06-10

178

Role of heme oxygenase in modulating endothelial function in mesenteric small resistance arteries of spontaneously hypertensive rats.  

Science.gov (United States)

It has been proposed that endothelial dysfunction is due to the excessive degradation of nitric oxide (NO) by oxidative stress. The enzyme heme-oxygenase (HO) seems to exert a protective effect on oxidative stress in the vasculature, both in animal models and in humans. The objective of this study is to evaluate the effects of inhibition or activation of HO on endothelial function in mesenteric small resistance arteries of spontaneously hypertensive rats (SHR). Six SHR were treated with cobalt protoporphyrin IX 50 mg/Kg (CoPP), an activator of HO; six SHR with stannous mesoporphyrin 30 mg/Kg (SnMP), an inhibitor of HO, and six SHR with saline. As controls, six Wistar-Kyoto rats (WKY) were treated with CoPP, six WKY with SnMP, and six WKY with saline. Drugs were injected in the peritoneum once a week for 2 weeks. Systolic blood pressure (SBP) was measured (tail cuff method) before and after treatment. Mesenteric small resistance arteries were mounted on a micromyograph. Endothelial function was evaluated as a cumulative concentration-response curve to acetylcholine (ACH), before and after preincubation with N(G)-methyl-L-arginine (L-NMMA, inhibitor of NO synthase), and to bradykinin (BK). In SHR treatment with CoPP, improved ACH-and BK-induced vasodilatation (ANOVA p SnMP was devoid of effects on endothelial function. In WKY, both activation and inhibition of HO did not substantially affect endothelium-mediated vasodilatation. The stimulation of HO seems to induce an improvement of endothelial dysfunction in SHR by possibly reducing oxidative stress and increasing NO availability. PMID:19886854

Porteri, Enzo; Rodella, Luigi F; Rezzani, Rita; Rizzoni, Damiano; Paiardi, Silvia; de Ciuceis, Carolina; Boari, Gianluca E M; Foglio, Eleonora; Favero, Gaia; Rizzardi, Nicola; Platto, Caterina; Agabiti Rosei, Enrico

2009-10-01

179

Elevated plasma homocysteine in acute stroke was not associated with severity and outcome: stronger association with small artery disease.  

Science.gov (United States)

Homocysteine increases in the acute phase of ischaemic stroke and from the acute to the convalescent phase, suggesting that hyper-homocysteinaemia may be a consequence rather than a causal factor. Therefore we measured homocysteine plasma levels in stroke patients in order to investigate possible correlations of homocysteine with stroke severity and clinical outcome. Further we looked for eventual differences in stroke subtypes. We prospectively studied plasma homocysteine levels in acute stroke patients admitted to the stroke unit of our department. Seven hundred and seventy-five ischaemic stroke patients, 39 cerebral haemorrhages and 421 healthy control subjects have been enrolled. Stroke severity and clinical outcome were measured with the Scandinavian Stroke Scale, the Rankin Scale and the Barthel Index. Stroke severity by linear stepwise regression analysis was not an independent determinant of plasma homocysteine levels. Homocysteine was not correlated with outcome measured by the Barthel Index. Mean plasma homocysteine of both ischaemic and haemorrhagic stroke was significantly higher than controls (pstroke and of 3.69 (95% CI 1.90-7.17) for haemorrhagic stroke. Compared with the lowest quartile, the upper quartile was associated with an adjusted OR of ischaemic stroke due to small artery disease of 17.4 (95% CI 6.8-44.3). Homocysteine in the acute phase of stroke was not associated with stroke severity or outcome. Elevated plasma homocysteine in the acute phase of stroke was associated with both ischaemic and haemorrhagic stroke. Higher levels are associated with higher risk of small artery disease subtype of stroke. PMID:16388364

Perini, F; Galloni, E; Bolgan, I; Bader, G; Ruffini, R; Arzenton, E; Alba, S; Azzini, C; Bartolomei, L; Billo, G; Bortolon, F; Dudine, P; Garofalo, P G; L'Erario, R; Morra, M; Parisen, P; Stenta, G; Toso, V

2005-12-01

180

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

DEFF Research Database (Denmark)

BACKGROUND AND PURPOSE Small (KCa2) and intermediate (KCa3.1) conductance calcium-activated potassium channels (KCa) may 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 hypothesized that activation of these channels would produce relaxation of human bronchioles and pulmonary arteries. EXPERIMENTAL APPROACH Channel expression and functional studies were conducted in human isolated small pulmonary arteries and bronchioles. KCa2 and KCa3.1 currents were examined in human small airways epithelial (HSAEpi) cells by whole-cell patch clamp techniques. RESULTS While KCa2.3 expression was similar, KCa3.1 protein was more highly expressed in pulmonary arteries than bronchioles. Immunoreactive KCa2.3 and KCa3.1 proteins were found in both 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 relaxing pulmonary arteries, but less potent in bronchioles, than salbutamol. NS309 relaxations were blocked by the KCa2 channel blocker apamin, while the KCa3.1 channel blocker, charybdotoxin failed to reduce relaxation to NS309 (0.011 mu M). CONCLUSIONS AND IMPLICATIONS KCa2.3 and KCa3.1 channels are expressed in the endothelium of human pulmonary arteries and epithelium of bronchioles. KCa2.3 channels contributed to endo- and epithelium-dependent relaxations suggesting that these channels are potential targets for treatment of pulmonary hypertension and chronic obstructive pulmonary disease.

Kroigaard, C.; Dalsgaard, T.

2012-01-01

181

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

Energy Technology Data Exchange (ETDEWEB)

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

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

2011-04-15

182

Metastases of Urinary Bladder Cancer into Penile Cavernous Bodies  

OpenAIRE

There has been presented an interesting case of penile lesion by metastases of urinary bladder cancer. Metastasis has occurred through venous system: from vesico-prastatic plexus among dorsal veins into cavernous bodies at the moment of tumescence.

Abrosimova, ?. V.; Tikhomirov, N. S.

2011-01-01

183

Penile herpes zoster: an unusual location for a common disease  

Directory of Open Access Journals (Sweden)

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.

Milan Bjekic

2011-12-01

184

Penile herpes zoster: an unusual location for a common disease  

Scientific Electronic Library Online (English)

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

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

2011-12-01

185

The subclavian artery and its branches in the small green monkey (Cercopithecus aethiops sabeus  

Directory of Open Access Journals (Sweden)

Full Text Available Within experimental, human and veterinary medicine, more and more attention has been paid to experimental animals. One of them being the small green monkey (Cercopithecus aethiops sabeus. The small green monkey (Cercopithecus aethiops sabeus has a shod muzzle, small teeth, and is mostly of gray-greenish color; the lower pan of its neck, chest, belly and inner sides of its thoracic limbs being whitish. Its total length is about 110 cm, the tail being 50 cm long. On its head, on both sides, there are white hairs directed towards the neck, reminiscent of whiskers. The monkeys have large buccal sacs. The extremities and tail are more gray than the rest of the body. The skin of the face, ears and fore limbs is black. The digits are very long, whilst the thumb short. Cell cultures from the small green monkey are used for the cultivation of poliovirus in the manufacture of vaccines against poliomyelitis. In addition, kidney cultures from the same monkey serve for detection of the virus in biological material. This was the main reason that prompted us to undertake a study of one part of the monkey's cardiosvascular system and thus contribute to a better understanding of the structure of its body.

Blagojevi? Zdenka M.

2005-01-01

186

Penile prosthesis implantation in an academic institution in Latin America  

OpenAIRE

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...

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

2010-01-01

187

Traumatic degloving lesion of penile and scrotal skin  

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

Luiz A. Zanettini

2005-06-01

188

Management of penile trauma caused by a dog bite  

OpenAIRE

Background: Dog bites to the external genitalia are extremely rare. The literature shows only sporadic cases of penile injuries due to dog bites, presenting mostly as children and adolescents. Case presentation: We report the case of a 45-year old patient with avulsion and traumatic degloving of the penile skin, with exposure of the tunica albuginea, which surrounds the cavernous bodies. Conclusion: Dog bite wounds pose a serious medical threat. An effectiv...

A?imovi? Miodrag; Babi? Uroš; Argirovi? Aleksandar; A?imovi? Ljubomir; Šantri? Veljko; Bumbaširevi? Uroš; Rafailovi? Dragutin; Kajmakovi? Boris

2014-01-01

189

Multimodality imaging of penile cancer: what radiologists need to know.  

Science.gov (United States)

The purpose of this article is to provide a comprehensive update on the role of imaging in the diagnosis and management of penile cancer. Imaging plays a major role in the initial assessment, treatment planning, and follow-up of patients with penile carcinoma. MRI helps in assessing the T staging of the primary and in detecting local recurrence. PET/CT and CT are useful for detecting regional nodal and distant metastases. PMID:25117563

Suh, Chong Hyun; Baheti, Akshay D; Tirumani, Sree Harsha; Rosenthal, Michael H; Kim, Kyung Won; Ramaiya, Nikhil H; Shinagare, Atul B

2015-02-01

190

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

Science.gov (United States)

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

Pattnaik, Shrikant; Banerjee, Rupak; Kim, Jay

2012-04-01

191

A technique for reducing the beam width of the Doppler ultrasound probe with potential application for accurate location of small superficial arteries.  

Science.gov (United States)

A simple technique for reducing the beam width of the Doppler ultrasound probe is described. This is accomplished by attaching a plexiglas prism to the transducer surface of the conventional probe. It reduces the beam width by a ratio of 2.8:1. This improves the precision with which the probe is able to locate small superficial arteries. PMID:761117

Chinyanga, H M; Smith, J M

1979-01-01

192

Sentinel node lymophoscintigraphy in penile cancer  

International Nuclear Information System (INIS)

Objectives: To identify the value of sentinel node (SN) detection by lymphoscintigraphy in the penile cancer patients. Methods: Lymphoscintigraphy was performed in 19 patients (mean age 58.8 years, range 37-78 years) with squamous cell carcinoma of the penis. Tumor stage was T1N0 in 5 patients (26.3%), T1N1 in 1 patients (5.3%), T2N0 in 11 patients (57.9%), and T2N1 in 2 patients (10.5%). Technetium-99m nanocolloid with mean dose of 18.5 MBq, in a volume of 0.3-0.5 ml was injected subdermally at both sides of the tumor. Shortly after injection, a 30-min dynamic study was performed with a single-head gamma camera. Subsequent static anterior and lateral images of the pelvis were obtained at 30 min and 1 hour. Skin marking at SN was also done for intraoperative gamma probe guided biopsy. Results: The scintigraphy at 30 minutes revealed 55 SNs in 38 inguinal regions, including 1 or more unilateral nodes in 5 patients and bilateral lymphatic drainage in 11 patients. However, the study at 30 minutes revealed negative for SN in 3 patients. A total of 87 SNs in 18 patients were visualized (46 in the right groin, 41 in the left groin) and negative for SN in 1 patient at one hour after injection. The SN visualization rate was 94.7% (18/19). The lymphatic drainage was noted bilaterally in 57.9% of the patients (11/19). Visualization of the SNs before 30 min occurred in 15 patients (78.9%). At surgery, a total of 71 SNs (43 from the right groin, 28 from the left groin) were ident groin, 28 from the left groin) were identified and removed. All removing nodes were identified by the gamma probe detection. Two patients (10.5%) had a tumor positive SN and underwent standard regional lymph node dissection subsequently. Conclusions: The lymphoscintigraphy is a promising staging technique to detect early metastatic dissemination of penile cancer based on individual lymphatic drainage mapping. This technique enables to identify the patients with clinically node negative disease, who have a tumor positive SN and require regional lymph node dissection. The SN identification may lead to a more accurate staging and avoid extensive lymph node dissection in the majority of penile cancer patients with a tumor negative SN. (authors)

193

Selected Arterial Infusion Chemotherapy Combined with Target Drugs ?for Non-small Cell Lung Cancer with Multiple Brain Metastase  

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Full Text Available Background and objective The aim of this study is to evaluate the efficacy of selected arterial infusion chemotherapy in treating non-small cell lung cancer (NSCLC with multiple brain metastases and corresponding factors to influencing prognosis. Methods From September 2008 to October 2011, a total of 31 patients of NSCLC with multiple brain metastases (?3 received selected incranial, bronchial and corresponding target arterial infusion chemotherapy combined with EGFR-TKIs. Interventional treatment was performed every four weeks, two-six cycles with synchronized or sequential targeted drugs (erlotinib, gefitinib or icotinib. Follow-up CT and MRI were regularly finished at interval of four weeks after two cycles of interventional treatment were finished or during taking targeted drugs in order to evaluate efficacy of the therapy. The procedure was stopped for the tumor disease was worse or the patient could not tolerate the toxity of drugs any longer. Results 31 patients was performed two to six cycles of interventional therapy, 3cycles at average. Response assessment showed that 5 (16.1% patients got a complete response (CR, 7 (22.6% had a partial response (PR, 11 (35.5% had a stable disease (SD and 8 (25.8% had a progressive disease (PD. The objective response rate (ORR was 38.7%, and the disease control rate was 74.2%. The median progression free survival (PFS and overall survival (OS were 13.1 months and 15.1 months. The 6-month survival rate, one-year survival rate and two-year survival rate were 79%, 61.1%, and 31.1%, respectively. The patients’ OS and PFS were influenced by smoking state, tumor pathology, extracranial metastases, period of targeted drug taking and performance status, not by sex, age, before therapy and the total of brain metastases. Conclusion Selected arterial infusion chemotherapy with targeted drugs is one of the most effective and safe treatment to NSCLC with multiple brain metastases. Smoking status, tumor pathology, extracranial metastases, targeted drug taking and performance status are corresponding the patient’s prognosis.

Jinduo LI

2012-05-01

194

Arterial vascularization of the brain of the small green monkey, Cercopithecus aethiops sabeus  

Directory of Open Access Journals (Sweden)

Full Text Available Cell cultures from the small green monkey are used for the cultivation of poliovirus in the manufacture of vaccines against poliomyelitis. In addition kidney cultures from the same monkey serve for detection of the virus in biological material. This was the main reason that prompted us to undertake a study of one part of the monkey’s cardiosvascular system and thus contribute to a better understanding of the structure of its body.

Blagojevi? Zdenka M.

2004-01-01

195

The inner prepuce flap for penile scald burns.  

Science.gov (United States)

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

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

2014-01-01

196

Outcomes of Small Coronary Artery Stenting with Bare-Metal Stents vs. Drug-Eluting Stents: Results from the NHLBI Dynamic Registry  

Science.gov (United States)

Objectives Examine one year outcomes of patients with small coronary arteries in the National Heart, Lung and Blood Institute Dynamic Registry (NHLBI) undergoing drug-eluting stent (DES) vs. bare-metal stent (BMS) placement. Background While randomized trials of DES vs. BMS demonstrate reduced target vessel revascularization, it is unclear if similar outcomes are seen in unselected patients after percutaneous coronary intervention (PCI) for small coronary arteries. Methods Utilizing patients from the NHLBI Registry Waves 1–3 for BMS (1997–2002) and Waves 4–5 for DES (2004 and 2006), demographic, angiographic, in-hospital and one-year outcome data of patients with small coronary arteries treated with BMS (n= 686) vs. DES (n= 669) were evaluated. Small coronary artery was defined as 2.50 – 3.00 mm in diameter. Results Compared to BMS-treated patients, the mean lesion length of treated lesions was longer in the DES treated group (16.7 vs. 13.1 mm, pyear outcomes revealed that DES patients were at lower risk to undergo coronary artery bypass graft surgery (Hazard Ratio [HR] 0.40, 95% Confidence Interval [CI] 0.17–0.95, p=0.04), repeat PCI (HR 0.53, 95% CI 0.35–0.82, p=0.004), and experience the combined major adverse cardiovascular event rate (HR 0.59, 95% CI 0.42–0.83, p=0.002). There was no difference in the risk of death and myocardial infarction (MI) (HR 0.78, 95% CI 0.46–1.35, p=0.38). Conclusions In this real-world registry, patients with small coronary arteries treated with DES had significantly lower rates of repeat revascularization and major adverse cardiovascular events at one year compared to patients treated with BMS, with no increase in the risk of death and MI. These data confirm the efficacy and safety of DES over BMS in the treatment of small coronary arteries in routine clinical practice. PMID:21735515

Parikh, Shailja V.; Luna, Michael; Selzer, Faith; Marroquin, Oscar C.; Mulukutla, Suresh R.; Abbott, J. Dawn; Holper, Elizabeth M.

2011-01-01

197

Using Coban™ elastic bandage in penile wound dressing: A technical brief report  

Directory of Open Access Journals (Sweden)

Full Text Available One of the main issues in the penile surgery is wound dressing. There are several varied methods have been reported for circumcision or hypospadias dressing. We aim to report our experiment with Coban™ dressing in penile surgery.

Serpil Sancar

2015-01-01

198

Using Coban™ elastic bandage in penile wound dressing: A technical brief report  

OpenAIRE

One of the main issues in the penile surgery is wound dressing. There are several varied methods have been reported for circumcision or hypospadias dressing. We aim to report our experiment with Coban™ dressing in penile surgery.

Sancar, Serpil Department Of Pediatric Surgery; Ozcakir, Esra Department Of Pediatric Surgery

2014-01-01

199

Simultaneous penile prosthesis and male sling/artificial urinary sphincter.  

Science.gov (United States)

Erectile dysfunction (ED) and stress urinary incontinence (SUI) from urethral sphincteric deficiency is not an uncommon problem. The commonest etiology is intervention for localized prostate cancer and/or radical cystoprostatectomy for muscle invasive bladder cancer. Despite advances in surgical technology with robotic assisted laparoscopic prostatectomy and nerve sparing techniques, the rates of ED and SUI remain relatively unchanged. They both impact greatly on quality of life domains and have been associated with poor performance outcomes. Both the artificial urinary sphincter and penile prosthesis are gold standard treatments with proven efficacy, satisfaction and durability for end-stage SUI and ED respectively. Simultaneous prosthesis implantation for concurrent conditions has been well described, mostly in small retrospective series. The uptake of combination surgery has been slow due in part to technical demands of the surgery and to an extent, a heightened anxiety over potential complications. This paper aims to discuss the technical aspect of concurrent surgery for both disease entity and the current published outcomes of the various surgical techniques with this approach. PMID:23202702

Lee, Dominic; Romero, Claudio; Alba, Frances; Westney, O Lenaine; Wang, Run

2013-01-01

200

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

Science.gov (United States)

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

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

2011-12-01

201

The current status of stent placement in small coronary arteries < 3.0 mm in diameter.  

Science.gov (United States)

Data accrued to date indicate that stent placement in small vessels (corrugated stents are better than coil or meshwire stent design. Stents with thin struts appear to yield a lower restenosis rate compared with thick-strut stents. Coating the surface of stents with gold, phosphorylcholine or heparin does not appear to confer any additional long-term benefit compared with bare stainless-steel stents. On the other hand, impregnation of stents with anti-proliferative drugs, with or without a carrier polymer, has produced a significantly lower risk of restenosis, without an increase in stent thrombosis rate, compared with uncoated metal stents in multiple randomized trials. However, whether the clinico-anatomic benefits of drug-eluting stents can be sustained for several years and whether there are any long-term deleterious effects from the antiproliferative drug or carrier polymer remains unclear at this stage. PMID:15282416

Lau, Kean-Wah; Hung, Jui-Sung; Sigwart, Ulrich

2004-08-01

202

Effects of a long-term treatment with aliskiren or ramipril on structural alterations of subcutaneous small-resistance arteries of diabetic hypertensive patients.  

Science.gov (United States)

Structural alterations of subcutaneous small-resistance arteries are associated with a worse clinical prognosis in hypertension and non-insulin-dependent diabetes mellitus. The effects of the direct renin inhibitor aliskiren on microvascular structure were never previously evaluated. Therefore, we investigated the effects of aliskiren in comparison with those of an extensively used angiotensin-converting enzyme inhibitor, ramipril, on peripheral subcutaneous small-resistance artery morphology, retinal arteriolar structure, and capillary density in a population of patients with non-insulin-dependent diabetes mellitus. Sixteen patients with mild essential hypertension and with a previous diagnosis of non-insulin-dependent diabetes mellitus were included in the study. Patients were then randomized to 1 of the 2 active treatments (aliskiren 150 mg once daily, n=9; or ramipril 5 mg once daily, n=7). Each patient underwent a biopsy of the subcutaneous fat from the gluteal region, an evaluation of retinal artery morphology (scanning laser Doppler flowmetry), and capillary density (capillaroscopy), at baseline and after 1 year of treatment. Subcutaneous small arteries were dissected and mounted on a pressurized micromyograph, and the media-to-lumen ratio was evaluated. A similar office blood pressure-lowering effect and a similar reduction of the wall-to-lumen ratio of retinal arterioles were observed with the 2 drugs. Aliskiren significantly reduced media-to-lumen ratio of subcutaneous small-resistance arteries, whereas ramipril-induced reduction of media to lumen ratio was not statistically significant. No relevant effect on capillary density was observed. In conclusion, treatment with aliskiren or ramipril was associated with a correction of microvascular structural alterations in patients with non-insulin-dependent diabetes mellitus. PMID:24980672

De Ciuceis, Carolina; Savoia, Carmine; Arrabito, Emanuele; Porteri, Enzo; Mazza, Monica; Rossini, Claudia; Duse, Sarah; Semeraro, Francesco; Agabiti Rosei, Claudia; Alonzo, Alessandro; Sada, Lidia; La Boria, Elisa; Sarkar, Annamaria; Petroboni, Beatrice; Mercantini, Paolo; Volpe, Massimo; Rizzoni, Damiano; Agabiti Rosei, Enrico

2014-10-01

203

Involvement of calcium-sensing receptors in hypoxia-induced vascular remodeling and pulmonary hypertension by promoting phenotypic modulation of small pulmonary arteries.  

Science.gov (United States)

Phenotype modulation of pulmonary artery smooth muscle cells (PASMCs) plays an important role during hypoxia-induced vascular remodeling and pulmonary hypertension (PAH). We had previously shown that calcium-sensing receptor (CaSR) is expressed in rat PASMCs. However, little is known about the role of CaSR in phenotypic modulation of PASMCs in hypoxia-induced PAH as well as the underlying mechanisms. In this study, we investigated whether CaSR induces the proliferation of PASMCs in small pulmonary arteries from both rats and human with PAH. PAH was induced by exposing rats to hypoxia for 7-21 days. The mean pulmonary arterial pressure (mPAP), right ventricular hypertrophy index (RVI), the percentage of medial wall thickness to the external diameter (WT %), and cross-sectional total vessel wall area to the total area (WA %) of small pulmonary arteries were determined by hematoxylin and eosin (HE), masson trichrome and Weigert's staining. The protein expressions of matrix metalloproteinase (MMP)-2 and MMP-9, the tissue inhibitors of metalloproteinase (TIMP)-3, CaSR, proliferating cell nuclear antigen (PCNA), phosphorylated extracellular signal-regulated kinase (p-ERK), and smooth muscle cell (SMC) phenotype marker proteins in rat small pulmonary arteries, including calponin, SM?-actin (SMA?), and osteopontin (OPN), were analyzed by immunohistochemistry and Western blotting, respectively. In addition, immunohistochemistry was applied to paraffin-embedded human tissues from lungs of normal human and PAH patients with chronic heart failure (PAH/CHF). Compared with the control group, mPAP, RVI, WT % and WA % in PAH rats were gradually increased with the prolonged hypoxia. At the same time, the expressions of CaSR, MMP-2, MMP-9, TIMP-3, PCNA, OPN, and p-ERK were markedly increased, while the expressions of SMA? and calponin were significantly reduced in lung tissues or small pulmonary arteries of PAH rats. Neomycin (an agonist of CaSR) enhanced but NPS2390 (an antagonist of CaSR) weakened these hypoxic effects. We further found that the expression change of CaSR, PCNA, and SMC phenotypic marker proteins in PAH/CHF lungs was similar to those in PAH rats. Our data suggest that CaSR is involved in the pulmonary vascular remodeling and PAH by promoting phenotypic modulation of small pulmonary arteries. PMID:25063217

Peng, Xue; Li, Hong-Xia; Shao, Hong-Jiang; Li, Guang-Wei; Sun, Jian; Xi, Yu-Hui; Li, Hong-Zhu; Wang, Xin-Yan; Wang, Li-Na; Bai, Shu-Zhi; Zhang, Wei-Hua; Zhang, Li; Yang, Guang-Dong; Wu, Ling-Yun; Wang, Rui; Xu, Chang-Qing

2014-11-01

204

Penile rotation and penoscrotal transposition associated with hypospadias and bifid scrotum: A case report  

Directory of Open Access Journals (Sweden)

Full Text Available Penoscrotal transposition is a rare anomaly of the external genitalia that can be complete or incomplete while incomplete type is more common. Penile torsion is a rotational defect of the penile shaft. Various surgical methods are described for correction of incomplete penoscrotal transposition and penile torsion. Here we are presenting our experience of case of incomplete penoscrotal transposition and penile torsion correction.

Hayrettin Ozturk

2014-08-01

205

Penile rotation and penoscrotal transposition associated with hypospadias and bifid scrotum: A case report  

OpenAIRE

Penoscrotal transposition is a rare anomaly of the external genitalia that can be complete or incomplete while incomplete type is more common. Penile torsion is a rotational defect of the penile shaft. Various surgical methods are described for correction of incomplete penoscrotal transposition and penile torsion. Here we are presenting our experience of case of incomplete penoscrotal transposition and penile torsion correction.

Hayrettin Ozturk; Serkan Ozturk

2014-01-01

206

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

International Nuclear Information System (INIS)

At the beginning of April, 1986, a new protocol was adopted by us for the treatment of unresectable non-small cell lung cancer (NSCLC). It consisted of bronchial arterial infusion (BAI) of 100 mg/m2 of cisplatin (CDDP), and systemic chemotherapy (SC) with 80 mg/m2 of CDDP, 8 mg/m2 of mitomycin C (MMC) and 3 mg/m2 of vindesine (VDS) followed by radiotherapy (RT). By the end of December, 1989, 50 patients with NSCLC could receive irradiation of more than 40 Gy. They were classified into three groups according to concomitant therapy: BAI + SC + RT group (n=30), BAI + RT group (n=12) and SC + RT group (n=8). The overall response rate was 68%. The 1-year and 2-year survival rates was 68% and 26%, respectively. The median survival time was 11 months. Both response and survival rates tended to decrease with advance in clinical stage. These were no significant difference in response or survival rate between the three groups. However, the incidence of local recurrence inside the radiation field was the lowest in the BAI + SC + RT group, and distant metastasis occurred with the highest frequency in the BAI + RT group. Our results suggest that BAI is of value for controlling local recurrence and SC for lowering the incidence of distant metastasis of NSCLC when combined with RT. (author)

207

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

OpenAIRE

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

Gontero, Paolo

2002-01-01

208

Penile amputation and scrotal urethrostomy followed by chemotherapy in a dog with penile hemangiosarcoma.  

Science.gov (United States)

A 7 yr old castrated male standard poodle weighing 25 kg was presented with a 5 day history of hematuria, dysuria, and the presence of a 2.5 cm, firm swelling within the prepuce. Abdominal radiographs revealed a soft-tissue mass on the distal prepuce and lysis of the cranial margin of the os penis. The patient was sedated and an ulcerated hemorrhagic mass was identified at the tip of the penis. The mass was diagnosed as hemangiosarcoma via incisional biopsy. A penile amputation with scrotal urethrostomy was performed followed by chemotherapy with doxorubicin. PMID:25415220

Bolfer, Luiz; Schmit, Joanna M; McNeill, Amy L; Ragetly, Chantal A; Bennett, R Avery; McMichael, Maureen

2015-01-01

209

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

DEFF Research Database (Denmark)

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

Jensen, Lars JØrn; Salomonsson, Max

210

Atypical pearly penile papules mimicking primary syphilis.  

Science.gov (United States)

Pearly penile papules (PPP) are benign and common lesions in the male population. Several terms have been used to describe this entity, including Tyson glands, hirsutoid papillomas, papilla in the corona glandis, hirsutis papillary corona of the penis, corona capilliti, and pink pearly papules (1,2). PPP commonly develop after puberty and their incidence decreases with age (1). The prevalence of this condition is estimated to be 14%-48%, the incidence being higher among black males and uncircumcised men (1,3). Their histologic features are characteristic of angiofibroma and are typically localized to the corona and the sulcus of the penis but can also affect the shaft (1). PPP may resemble other entities such as condylomata acuminata, ectopic sebaceous glands, molluscum contagiosum and lichen nitidus, leading to hazardous and unwarranted treatments (1,2). Pearly penile papules are commonly seen in clinics for sexually transmitted disease (STD) and are a cause of anxiety in adolescence and young manhood (4). In some studies about PPP, human papillomavirus (HPV) was suggested to play a role (5), however, Hogewoning et al. showed that there is no association between PPP and HPV (3). Several modes of therapy are used for treating PPP, including cryotherapy, electrodesiccation, podophyllin, curettage, and carbon dioxide laser ablation; however, treatment should be reserved for patients who have cosmetic or psychological concerns from the appearance of this benign entity (2). We report on the case of a 41-year-old Caucasian man with a history of several months of two non-painful, smooth papules with a central depression, elevated borders, and annular shape on the dorsal surface of the penis near the neck (Fig. 1). Physical examination of the genitalia was otherwise unremarkable. Before his referral, the lesions had been misdiagnosed as primary syphilis and treated with penicillin without response. Because of the uncommon presentation and the patient´s fear of having a sexually transmitted disease, a skin biopsy was performed. Histologic examination revealed dermal ectatic venules embedded in a collagenous stroma with several stellate fibroblasts, recovered by a dome shaped acanthotic epidermis (Fig. 2). These findings matched the histologic features of angiofibroma, and the diagnosis of PPP was established. The benign nature of these lesions was explained to the patient and therefore no treatment was necessary. PPP may vary in shape, size, and color (1), usually range from 1 to 2 mm in width and 1 to 4 mm in length, and can be acuminate, dome, or annular shaped (6). Their color may be pink, white, yellowish, or rarely almost translucent, and they are commonly oriented in a single or double row on the corona, which may partially or completely encircle the glans (1). There are reports of profound proliferating PPP arranged radially from the meatus to the corona, spreading all over the glans (7), ectopic PPP on the penile shaft of a young boy without typical lesions on the corona (6), and typical coronal lesions on the ventral aspect of the penis in an adult man (8). However, PPP localized exclusively near the neck of the penis with the abovementioned morphology and without typical lesions in other localizations in an adult man, as in our patient, has not yet been described. This case thus represents an atypical and rare presentation of PPP that could be confused with primary syphilis or condylomata acuminata. The clinical manifestations of syphilis, the "great imitator" of skin diseases, are variable in appearance and have been reported for centuries (9). HPV is the most frequent sexually transmitted viral infection in the world (10) and a common reason to seek medical attention in sexually transmitted disease clinics. Physicians should be aware of the different clinical presentations of PPP and when the diagnosis is uncertain, a biopsy should be performed. PMID:25580796

Gouveia, Ana Isabel; Borges-Costa, João; Soares-Almeida, Luis

2014-12-01

211

Imaging in primary penile cancer: current status and future directions  

Energy Technology Data Exchange (ETDEWEB)

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

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

2010-01-15

212

Penile lymphoscintigraphy for sentinel node identification  

International Nuclear Information System (INIS)

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. 57Co-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 SNuring 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.)

213

Penile lymphoscintigraphy for sentinel node identification  

Energy Technology Data Exchange (ETDEWEB)

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.)

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

214

Distribution of mesenteric cranial artery in the small intestine of Procyon cancrivorus (Cuvier, 1798) (Mammalia, Procyonidae) = Comportamento da artéria mesentérica cranial no intestino delgado de mão-pelada Procyon cancrivorus (Cuvier, 1798) (Mammalia, Procyonidae)  

OpenAIRE

The mesenteric artery is a high caliber vessel dependent on the abdominal artery, right below the emergence of the vessels destined for the liver and stomach. The present study aimed to describe the behavior of the arterial vessel in the small intestine of the crab-eating raccoon (Procyon cancrivorus). The animals were collected on highways (roadkill). Cannulation of the abdominal aorta, perfusion with warmed water (40ºC) and stained latex injection (Neoprene 450, Dupont do Brasil and Sulvin...

Vanessa Morais Lima; Ana Lúcia Souza Rezende; Jussara Rocha Ferreira; Kleber Fernando Pereira

2010-01-01

215

In vivo high-resolution structural imaging of large arteries in small rodents using two-photon laser scanning microscopy  

Science.gov (United States)

In vivo (molecular) imaging of the vessel wall of large arteries at subcellular resolution is crucial for unraveling vascular pathophysiology. We previously showed the applicability of two-photon laser scanning microscopy (TPLSM) in mounted arteries ex vivo. However, in vivo TPLSM has thus far suffered from in-frame and between-frame motion artifacts due to arterial movement with cardiac and respiratory activity. Now, motion artifacts are suppressed by accelerated image acquisition triggered on cardiac and respiratory activity. In vivo TPLSM is performed on rat renal and mouse carotid arteries, both surgically exposed and labeled fluorescently (cell nuclei, elastin, and collagen). The use of short acquisition times consistently limit in-frame motion artifacts. Additionally, triggered imaging reduces between-frame artifacts. Indeed, structures in the vessel wall (cell nuclei, elastic laminae) can be imaged at subcellular resolution. In mechanically damaged carotid arteries, even the subendothelial collagen sheet (~1 ?m) is visualized using collagen-targeted quantum dots. We demonstrate stable in vivo imaging of large arteries at subcellular resolution using TPLSM triggered on cardiac and respiratory cycles. This creates great opportunities for studying (diseased) arteries in vivo or immediate validation of in vivo molecular imaging techniques such as magnetic resonance imaging (MRI), ultrasound, and positron emission tomography (PET).

Megens, Remco T. A.; Reitsma, Sietze; Prinzen, Lenneke; Oude Egbrink, Mirjam G. A.; Engels, Wim; Leenders, Peter J. A.; Brunenberg, Ellen J. L.; Reesink, Koen D.; Janssen, Ben J. A.; Ter Haar Romeny, Bart M.; Slaaf, Dick W.; van Zandvoort, Marc A. M. J.

2010-01-01

216

Contribution of both nitric oxide and a change in membrane potential to acetylcholine-induced relaxation in the rat small mesenteric artery.  

OpenAIRE

1. Acetylcholine stimulated repolarization and relaxation in isolated segments of rat small mesenteric artery (D100 = 325 +/- 9 microns) in which the smooth muscle cells were depolarized and contracted by submaximal concentrations of noradrenaline (0.75-2.5 microM). There was no significant difference either in the time taken to initiate relaxation or hyperpolarization, or for these parameters to reach maximum in response to acetylcholine. 2. The nitric oxide synthase inhibitor, NG-nitro L-ar...

Waldron, G. J.; Garland, C. J.

1994-01-01

217

CD34 immunoexpression in penile carcinoma  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english 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.

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

218

CD34 immunoexpression in penile carcinoma  

Directory of Open Access Journals (Sweden)

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 nodes underwent groin lymphadenectomy. Tumor grading was 36 G1 and 24 G2/3. Primary lesion stage was 22 pT1 and 28 pT2-4. Positive inguinal nodes were observed in 18 patients. Selected paraffin 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.

Antonio Carlos Pereira Martins

2002-01-01

219

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

Directory of Open Access Journals (Sweden)

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.

Alfredo Pinzón

2012-09-01

220

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Colombia | Language: Spanish Abstract in spanish 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).

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

2012-09-01

221

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.

222

Penile lesion from gunshot wound: a 43-case experience  

Directory of Open Access Journals (Sweden)

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

Cavalcanti Andre G.

2006-01-01

223

Metachronous penile metastasis from rectal cancer after total pelvic exenteration  

Directory of Open Access Journals (Sweden)

Full Text Available Despite its abundant vascularization and extensive circulatory communication with neighboring organs, metastases to the penis are a rare event. A 57-year-old male, who had undergone total pelvic exenteration for rectal cancer sixteen months earlier, demonstrated an abnormal uptake within his penis by positron emission tomography/computed tomography. A single elastic nodule of the middle penis shaft was noted deep within Bucks fascia. No other obvious recurrent site was noted except the penile lesion. Total penectomy was performed as a curative resection based on a diagnosis of isolated penile metastasis from rectal cancer. A histopathological examination revealed an increase of well differentiated adenocarcinoma in the corpus spongiosum consistent with his primary rectal tumor. The immunohistochemistry of the tumor cells demonstrated positive staining for cytokeratin 20 and negative staining for cytokeratin 7, which strongly supported a diagnosis of penile metastasis from the rectum. The patient is alive more than two years without any recurrence.

Satoru Inoue

2012-01-01

224

Osteosarcoma of the penile bone (os penis) in a dog.  

Science.gov (United States)

Osteosarcoma of the penile bone was diagnosed in a 5-year-old neutered male Rottweiler with recurrent dysuria. Imaging and cytological findings raised the suspicion for an osteosarcoma and ablation of the entire penis and scrotal urethrostomy was performed. The diagnosis was confirmed histologically. The dog recovered well and no postoperative signs of dysuria were observed. The dog survived without adjuvant chemotherapy for 12 months when multiple tumours in the thorax and abdomen led to it being euthanased. Penile osteosarcoma is a rare disease, but must be considered as a differential diagnosis in dogs presenting with dysuria. This is the second recorded case of a penile osteosarcoma in a dog, but the first with a detailed description of the diagnosis, treatment and outcome. PMID:19178479

Peppler, C; Weissert, D; Kappe, E; Klump, S; Kramer, M; Reinacher, M; Neiger, R

2009-01-01

225

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

226

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

DEFF Research Database (Denmark)

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.

Juul, B; Plesner, L

2011-01-01

227

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

OpenAIRE

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

Baltogiannis Dimitrios; Zotos Konstantinos; Tsambalas Stavros; Giannakis Dimitrios; Sofikitis Nikolaos

2011-01-01

228

Penile length and somatometric parameters: a study in healthy young Turkish men  

Science.gov (United States)

The purpose of this study was to determine average penile length and to investigate the relationship between penile length and somatometric parameters in a group of young, healthy Turkish men. A total of 1132 men were included in the study. The age, height and weight of the subjects were recorded. Penile length was measured in both flaccid and stretched states. The correlation between penile length and somatometric parameters was analysed. The mean age of the subjects was 20.3±0.9 years. The mean penile length in flaccid and stretched states was 9.3±1.3 and 13.7±1.6 cm, respectively (P<0.001). There was a positive correlation between flaccid and stretched penile length (r=0.800, P<0.001). The mean testicular volume was 22.0±2.8 cm3. A weak positive correlation was detected between penile length and mean testicular volume (r=0.143 for flaccid penile length and r=0.140 for stretched penile length, P<0.001 for both). Similarly, weak positive correlations were found between penile length (both flaccid and stretched) and height, weight and body mass index, respectively (P<0.001, for all). These results demonstrate that somatometric parameters are correlated with penile length. We believe that further studies would provide more information about the causal relationship. PMID:21151155

Aslan, Y?lmaz; Atan, Ali; Ömur Ayd?n, Ali; Nalçac?o?lu, Varol; Tuncel, Altug; Kad?o?lu, Ate?

2011-01-01

229

Incidence of penile curvature in various forms of hypospadias  

Directory of Open Access Journals (Sweden)

Full Text Available Introduction. Hypospadias is a congenital anomaly of the penis, characterised by ectopically positioned urethral meatus and associated anomalies (cryptorchidism, inguinal hernia, penile curvature. Proximal forms of hypospadias, as severe cases, are particularly accompanied by penile curvature (chordee. Distal types are considered to be mild degrees. Objective. To determine the incidence of congenital curvature within various forms of hypospadias in order to signify preoperative and intraoperative diagnosis of chordee as a part of hypospadias repair. Methods. The total of 454 patients with hypospadias were treated surgically in a five-year period (2001-2006. at the University Children's Hospital of Belgrade. The patients were divided into two groups according to the surgeon who had treated them. Only the first group of patients was tested for chordee as a part of standard procedure and complete treatment. In both groups we analyzed the number of patients treated for penile curvature within various types of hypospadias. We also compared scores in the two groups using Fisher test and ?2-test. Results. Scanning retrospective, 104 cases (22.9% of diagnosed and surgically corrected chordee were determined. In 31.6% of patients from the first group and 11.6% of patients from the second group we diagnosed and corrected some form of penile curvature was. Chordee was significantly more frequent in the first group, regarding hypospadias in general (p<0.01, as well as distal (p<0.05 and mid shaft forms (p<0.01. Conclusion. Penile curvature is not uncommon in hypospadias. In this study we report a significantly higher frequency as related to the patients in the second group who were not tested for curvature during hypospadias treatment. This is why standard techniques in hypospadias repair should definitely include the diagnosis and surgical correction of penile curvature.

?or?evi? Miroslav

2009-01-01

230

Management of penile trauma caused by a dog bite  

Directory of Open Access Journals (Sweden)

Full Text Available Background: Dog bites to the external genitalia are extremely rare. The literature shows only sporadic cases of penile injuries due to dog bites, presenting mostly as children and adolescents. Case presentation: We report the case of a 45-year old patient with avulsion and traumatic degloving of the penile skin, with exposure of the tunica albuginea, which surrounds the cavernous bodies. Conclusion: Dog bite wounds pose a serious medical threat. An effective initial treatment of the wound, as well as adequate supportive treatments are essential for the efficient healing of the resulting infection.

A?imovi? Miodrag

2014-01-01

231

Penile strangulation due to plastic bottle neck: a surgical emergency.  

Science.gov (United States)

Use of various metallic and non-metallic constricting objects on the external male genitalia for increasing sexual performance or because of autoerotic intentions is an unusual practice that can potentially lead to penile strangulation with severe consequences. Depending on the type of constricting material, emergency removal of such an object is a challenge. We report a case of a 45-year-old man who presented to our hospital with a hard plastic bottle neck at the base of his penis that led to penile strangulation. The constricting agent was successfully removed. The patient had an uneventful recovery. PMID:25427935

Agarwal, Akshay Anand; Singh, Kul Ranjan; Kushwaha, Jitendra Kumar; Sonkar, Abhinav Arun

2014-01-01

232

Therapeutic effectiveness of the superselective arterial gelfoam embolization in post-traumatic arterial priapism  

Energy Technology Data Exchange (ETDEWEB)

We retrospectively evaluated superselective embolization with Gelfoam for the management of post-traumatic arterial priapism. Six male patients with post-traumatic priapism underwent pudendal angiography and embolization. We evaluated the time and incidence of detumescence after embolization and compared normal erectile function and its duration with the results of other reports. In all patients, color Doppler sonography was performed pre- and post-angiographically. On pudendal arteriography, intracavernosal arteriovenous fistulas were observed in all patients, and pseudoaneurysm of the cavernosal artery (or common penile artery) in three. Detumescence and normal erectile function were achieved in all patients after superselective embolization. Using color Doppler sonography, the location of the lesion causing priapism was found, in four patients, to be the proximal or middle one-third of the cavernosal artery. Pudendal angiography with superselective embolization with Gelfoam is a safe and effective method for the correction of post-traumatic arterial priapism.

Kang, Byung Chul [Ewha Womans Univ. College of Medicine, Seoul (Korea, Republic of); Won, Je Hwan [Ajou Univ. College of Medicine, Suwon (Korea, Republic of)

1999-07-01

233

2D and 3D imaging of small animals and the human radial artery with a high resolution detector for PET.  

Science.gov (United States)

The performance of a pair of multicrystal, high-resolution, bismuth germanate (BGO) block detectors for positron emission tomography (PET) has been investigated. Utilizing the detectors at a separation of 100 mm, the spatial resolutions and count rate response of the block have been measured. These measurements indicate maximum spatial resolutions of 3.6 and 4.5 mm (FWHM) in the two axes of the block and a maximum coincidence rate of 3400 cps. The system has been used to observe the regional kinetics of positron-emitting radionuclides in the rat brain and the human radial artery. Designs for a small diameter, no-septa tomograph incorporating these detectors have been considered. Simulations demonstrate the possibilities of following tracer uptake within the rat brain and radial artery. Three-dimensional tomographic data-sets of a 20-mm uniform cylinder, obtained from rotating the two blocks, indicate good uniformity in the field of view (FOV) of 25 mm. PMID:18222881

Rajeswaran, S; Bailey, D L; Hume, S P; Townsend, D W; Geissbuhler, A; Young, J; Jones, T

1992-01-01

234

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

DEFF Research Database (Denmark)

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.

Matchkov, Vladimir; Larsen, Per

2008-01-01

235

Congenital fistula of the penile urethra: A case report  

Directory of Open Access Journals (Sweden)

Full Text Available Urethral fistulous opening to the penile shaft with or without chordee is extremely rare. Here, a 4-year-old boy with congenital urethral fistula is reported. English literature was reviewed for the former similar cases. Historical analysis showed that no appropriate nomenclature occurred for this isolated anomaly.

Tunc Ozdemir

2014-04-01

236

Metastases of Urinary Bladder Cancer into Penile Cavernous Bodies  

Directory of Open Access Journals (Sweden)

Full Text Available There has been presented an interesting case of penile lesion by metastases of urinary bladder cancer. Metastasis has occurred through venous system: from vesico-prastatic plexus among dorsal veins into cavernous bodies at the moment of tumescence.

?.V. Abrosimova

2011-06-01

237

Dysfunctional penile cholinergic nerves in diabetic impotent men  

International Nuclear Information System (INIS)

Impotence in the diabetic man may be secondary to a neuropathic condition of the autonomic penile nerves. The relationship between autonomic neuropathy and impotence in diabetes was studied in human corporeal tissue obtained during implantation of a penile prosthesis in 19 impotent diabetic and 15 nondiabetic patients. The functional status of penile cholinergic nerves was assessed by determining their ability to accumulate tritiated choline (34), and synthesize (34) and release (19) tritiated-acetylcholine after incubation of corporeal tissue with tritiated-choline (34). Tritiated-choline accumulation, and tritiated-acetylcholine synthesis and release were significantly reduced in the corporeal tissue from diabetic patients compared to that from nondiabetic patients (p less than 0.05). The impairment in acetylcholine synthesis worsened with the duration of diabetes (p less than 0.025). No differences in the parameters measured were found between insulin-dependent (11) and noninsulin-dependent (8) diabetic patients. The ability of the cholinergic nerves to synthesize acetylcholine could not be predicted clinically with sensory vibration perception threshold testing. It is concluded that there is a functional penile neuropathic condition of the cholinergic nerves in the corpus cavernosum of diabetic impotent patients that may be responsible for the erectile dysfunction

238

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

Directory of Open Access Journals (Sweden)

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.

P Famili

2012-11-01

239

Accessory renal arteries: a case report  

OpenAIRE

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...

Billakanti Prakash Babu; Anjali Roy; Hemalatha Bangera

2014-01-01

240

Novel optical system for in vitro quantification of full surface strain fields in small arteries: II. Correction for refraction and illustrative results.  

Science.gov (United States)

In a companion paper, we described a theoretical foundation for and initial experimental implementation of a novel stereo-digital image correlation (DIC) method for quantifying the size, shape and deformation of small cylindrical specimens along their full length and around their entire circumference. In this paper, we further show that this panoramic-DIC method can be used to study mouse carotid arteries without affecting their native mechanical properties and show the advantage of the approach in studying more complex mouse aorta. In particular, we first resolve the ubiquitous issue of refraction in non-contacting optical measurements of strain while tissues are immersed in physiologic saline and we show that surface preparation for DIC does not affect the inferred mechanical properties either qualitatively or quantitatively, the latter via the use of a four-fibre family hyperelastic constitutive relation and associated estimation of material parameters using nonlinear regression. We thus submit that panoramic-DIC-based strain measurement has significant potential to increase our understanding of arterial mechanics in genetic models of arterial health and disease by allowing investigators to exploit advances in transgenic mice. PMID:21347913

Genovese, K; Lee, Y U; Humphrey, J D

2011-03-01

241

Contemporary Patient Satisfaction Rates for Three-Piece Inflatable Penile Prostheses  

OpenAIRE

Among the many treatments for erectile dysfunction, implantation of a penile prosthesis has been associated with high patient satisfaction rates. Specifically, the placement of a three-piece inflatable penile prosthesis (IPP) confers the highest rates of satisfaction. We reviewed the literature over the past 20 years regarding satisfaction rates for penile prostheses, with a focus on patients who had undergone an initial IPP implantation for erectile dysfunction. In all, 194 articles were rev...

Bernal, Raymond M.; Henry, Gerard D.

2012-01-01

242

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

International Nuclear Information System (INIS)

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

243

Low-grade liquid silicone injections as a penile enhancement procedure: Is bigger better?  

OpenAIRE

To report our experience with 5 cases of complications of penile enhancement procedures secondary to liquid silicone injections and our method of management of its debilitating effects. All five patients were treated with excision of penile shaft skin down to buck's fascia followed by resurfacing with split thickness skin grafting. We conclude that penile enhancement procedures with liquid silicone by non-medical personnel could result in devastating consequences. We also demonstrate that a s...

Sasidaran, Ramesh; Zain, Mohd Ali Mat; Basiron, Normala Hj

2012-01-01

244

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

DEFF Research Database (Denmark)

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.

Kirkeby, H J; Forman, Axel

1989-01-01

245

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

Energy Technology Data Exchange (ETDEWEB)

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

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

2012-03-15

246

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english 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.

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

2012-04-01

247

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

Directory of Open Access Journals (Sweden)

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.

Carlos Teodósio Da Ros

2012-04-01

248

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

Directory of Open Access Journals (Sweden)

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

Ozgu Aydogdu

2011-06-01

249

Swelling of the small adrenergic storage vesicles and the loss of vesicular ATP induced by cocaine in the isolated rat tail artery.  

Science.gov (United States)

Exposure of the isolated rat tail artery to cocaine (greater than 0.03 mmol/l) was found to cause release of noradrenaline from the small (40 nm) storage vesicles in adrenergic varicosities (Palatý 1988). In the present study transmission electron microscopy was used to determine whether or not cocaine also affects the volume and the ATP content of the vesicles in situ. 1. Evaluation of electron micrographs of arterial segments fixed in a buffered mixture of paraformaldehyde and glutaraldehyde showed that cocaine (3 mmol/l; 15 min) caused significant, though non-uniform, swelling of the small vesicles. 2. To confirm the selectivity of the uranaffin method of ATP localization with respect to noradrenaline, the latter was depleted by prior injection of the rats with reserpine. As a result the fraction of the small vesicles containing electron-dense cores decreased from 55% in control specimens to 29%. 3. In the specimens processed by the uranaffin method, cocaine (3 mmol/l; 30 min) lowered the fraction of the vesicles containing electron-dense cores by about 80%. 4. After having been lowered by cocaine, the fractions of vesicles containing electron-dense cores in specimens processed by the chromaffin and uranaffin methods were restored during incubation of the tissue in cocaine-free medium supplemented with dopamine (7 mumol/l) and L-ascorbate (0.3 mmol/l). There was no restoration of the cores in the specimens processed by the uranaffin method when the tissue had been incubated in the absence of dopamine. 5. These observations support the hypothesis that unprotonated cocaine diffuses into and accumulates in the small vesicles in situ. They also suggest that, as in chromaffin granules (Caughey and Kirshner 1987), interaction of ATP and noradrenaline may be essential for effective storage of the nucleotide in the small vesicles. PMID:2067588

Palatý, V

1991-02-01

250

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

OpenAIRE

OBJECTIVE—To determine whether reduced fetal growth leads to raised blood pressure, reduced arterial compliance, and increased left ventricular mass in an Indian population.?DESIGN—A retrospective cohort study of men and women (age range 40-61 years) whose weight, length, and head circumference at birth were recorded.?SETTING—The Holdsworth Memorial Hospital, Mysore, South India.?SUBJECTS—435 men and women born in the hospital between 1934 and 1953.?MAIN OUTCOME MEASURES—Sy...

Kumaran, K.; Fall, C.; Martyn, C.; Vijayakumar, M.; Stein, C.; Shier, R.

2000-01-01

251

A penile torsion with a fistula due to previous hypospadias surgery: A case report  

Directory of Open Access Journals (Sweden)

Full Text Available We presented a case of penile torsion due to previous hypospadias surgery. A patient applied to our clinic for treatment of hypospadias fistula and accompanying penile torsion. Patient’s urethral fistula was repaired first and penile torsion was corrected in the second stage due to multiple fistula tracts. Proximal based flip flap technique was used for closure of the fistula and simple degloving with release of fibrous tissue and pedicle of the previous preputial island flap was used for correction of the penile torsion. Post hypospadias surgery torsion deformity as in our case may corrected with simple degloving and dissection at the level of the buck fascia.

Mustafa Rasid Toksoz

2015-01-01

252

Seasonal control of penile development of Siberian hamsters (Phodopus sungorus) by daylength and testicular hormones.  

Science.gov (United States)

Seasonal variation in prepubertal penile growth has not previously been studied. The present study assessed the influence of daylength and androgens on penile development in the Siberian hamster (Phodopus sungorus). Adult penile masses were achieved at 18 and 8 weeks of age in hamsters maintained from birth under short (10 h light:14 h dark) versus long (14 h light:10 h dark) daylengths, respectively. Insulin-like growth factor I concentrations, previously implicated in penile growth, did not differ between hamsters maintained in short versus long daylengths. Gonadectomized juvenile males maintained in short and long daylengths and administered testosterone attained adult penile masses well in advance of untreated gonad-intact males maintained in short daylengths. Hamsters from both photoperiods, castrated as juveniles and first treated with testosterone in adulthood, also achieved adult penile masses. The photoinhibited gonad is insufficient to promote penile growth, and prepubertal gonadal secretions during short daylengths are not necessary for eventual penile development. Among young born near the end of the mating season, onset of neuroendocrine refractoriness to short daylengths at about 100 days of age and subsequent gonadal development induces growth in all reproductive tissues. Timing of puberty and increased androgen secretion controlled by daylength are the primary determinants of postnatal penile growth, which may also be affected by prenatal and early postnatal organizational actions of androgens. PMID:12611603

Park, J H; Spencer, E M; Place, N J; Jordan, C L; Zucker, I

2003-03-01

253

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: Spanish Abstract in spanish La arteria circunfleja 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.

Mariano, del Sol; Bélgica, Vásquez.

2013-06-01

254

Penile fracture following husband abuse: a case report.  

Science.gov (United States)

The case of a 35-year-old fisherman who presented in a rural clinic with a sudden onset of painful penile swelling affecting the left lateral side with associated rapid detumescence is reported. He had tried to coerce his wife to a sexual intercourse when she forcefully bent his penis. He was initially managed with cold applications, oral diclofenac potassium, chymoral, and splinting of the penis and then referred to the urological services of a teaching hospital. He defaulted only to re-present about 2 weeks later with some improvement in his symptoms. Further advice to see the urologist was also rebuffed on financial grounds. When he reported about 1 month later, he was assessed to have grade 3 erectile dysfunction. In conclusion, penile fracture is a rare condition which follows unphysiological bending of the tumescent penis during sexual intercourse or masturbation. That following husband abuse is rarer. The sequelae can be devastating. PMID:19477737

Dienye, Paul O; Jebbin, Nze J; Gbeneol, Precious K

2009-12-01

255

Penile curvature incidence in hypospadias: can it be determined?  

Science.gov (United States)

The aim was to retrospectively determine the real incidence of congenital penile curvature in various forms of hypospadias, in order to indicate intraoperative assessment and correction of curvature. We analyzed 842 patients with hypospadias who underwent surgery from 2003 to 2010, classified into two groups. First group was intraoperatively checked for curvature as a routine procedure, while a curvature in the second group was assessed mostly in severe hypospadias. Results are analyzed using Fisher's and chi-square tests. In total, 238 cases (28.3%) of associated curvature were confirmed. Curvature was significantly more frequent in the first group, regarding hypospadias in general (P < 0.01), as well as distal (P < 0.05) and midshaft forms (P < 0.01). Penile curvature is common figure in hypospadias, including distal types. Intraoperative testing for associated curvature should be considered as a routine procedure in hypospadias repair. PMID:22007201

Stojanovic, Borko; Bizic, Marta; Majstorovic, Marko; Kojovic, Vladimir; Djordjevic, Miroslav

2011-01-01

256

Penile strangulation and necrosis due to condom catheter.  

Science.gov (United States)

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

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

2013-06-11

257

Penile Curvature Incidence in Hypospadias: Can It Be Determined?  

OpenAIRE

The aim was to retrospectively determine the real incidence of congenital penile curvature in various forms of hypospadias, in order to indicate intraoperative assessment and correction of curvature. We analyzed 842 patients with hypospadias who underwent surgery from 2003 to 2010, classified into two groups. First group was intraoperatively checked for curvature as a routine procedure, while a curvature in the second group was assessed mostly in severe hypospadias. Results are analyzed using...

Vladimir Kojovic; Marko Majstorovic; Marta Bizic; Borko Stojanovic; Miroslav Djordjevic

2011-01-01

258

Patient perspectives on quality of life after penile cancer  

DEFF Research Database (Denmark)

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.

Mortensen, Gitte Lee; Jakobsen, Jakob Kristian

2013-01-01

259

Doramectin reduces sexual behavior and penile erection in male rats.  

Science.gov (United States)

Doramectin (DOR) is an antiparasitic drug that is widely used in domestic animals. In mammals, DOR acts as a ?-aminobutyric acid receptor agonist. This neurotransmitter plays an important role in the regulation of sexual behavior. The present study investigated the effects of two medically relevant doses of DOR on sexual behavior in male rats. We also examined whether previous sexual experience modulates responses to DOR. General activity was first observed in an open field 24, 48, and 72 h after administration of 0.1 and 0.3 mg/kg DOR to determine the dose and time effects of the drug. Apomorphine-induced penile erection and sexual behavior in inexperienced male rats were then analyzed. The effects of previous sexual experience on subsequent sexual behavior in DOR-treated rats (0.3 mg/kg, 24 h prior to the test) were also assessed. The standard therapeutic dose (0.2 mg/kg) did not modify general activity or penile erection. A slightly concentrated dose of 0.3 mg/kg, which is still within the therapeutic range, decreased apomorphine-induced penile erection, whereas 0.2 mg/kg did not modify this behavior. Compared with controls, sexual behavior in inexperienced male rats was impaired after 0.3 mg/kg DOR. Previous sexual experience had little impact on the effects of 0.3 mg/kg DOR. In conclusion, the 0.2 mg/kg dose of DOR did not affect motor behavior or apomorphine-induced penile erection. At a more slightly higher dose level, the appetitive and consummatory phases of sexual behavior in inexperienced male rats were impaired. Previous sexual experience was unable to reverse this sexual impairment, suggesting that previous sexual experience does not exert a positive effect in attenuating sexual impairment produced by DOR treatment. PMID:23899514

Ferri, R; Todon E Silva, A F S; Cabral, D; Moreira, N; Spinosa, H S; Bernardi, M M

2013-01-01

260

Annualr elastolytic giant cell granuloma with penile involvement  

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

Sengupta Sujata

2006-01-01

261

Hydroxyfasudil ameliorates penile dysfunction in the male spontaneously hypertensive rat.  

Science.gov (United States)

Hypertension represents a major risk factor for erectile dysfunction. Although the etiology of hypertension-induced erectile dysfunction is multifactorial and still unknown, Rho-Rho kinase pathway is one of the key factors. To investigate whether administration of hydroxyfasudil, a Rho kinase inhibitor could prevent dysfunction of NO-induced relaxation in corpus cavernosum smooth muscle in the SHR (spontaneously hypertensive rat), twelve-week-old male SHRs were treated with hydroxyfasudil (3 or 10 mg/kg, i.p.) once a day for 6 weeks. Wistar rats and SHRs treatment with vehicle were used as age-matched controls. Penile cGMP concentrations and Rho kinase activities were determined, and penile function was estimated by organ bath studies with norepinephrine-induced contractions and acetylcholine-induced relaxations. The participation mRNA levels of eNOS and participation protein levels of eNOS and phosphorylated eNOS were investigated by quantitative real-time PCR methods and immunoblot analysis, respectively. The SHR showed significantly decreased cGMP concentrations, increased Rho kinase activities, norepinephrine-induced hyper-contractions, and acetylcholine-induced hypo-relaxations in the penile tissue. Treatment with hydroxyfasudil significantly improved the decreased penile cGMP concentrations, the increased Rho kinase activities, the increased norepinephrine-induced contractions, and the decreased acetylcholine-induced relaxation in a dose-dependent manner. Although there were no significant differences in expression protein levels of eNOS among any of the groups, down-regulation of eNOS mRNAs as well as phosphorylated eNOS were significantly ameliorated after treatment with hydroxyfasudil. Our data suggest that hydroxyfasudil ameliorates hypertension-associated dysfunction of NO-induced relaxation in corpus cavernosum smooth muscle possibly via inhibition of the Rho-Rho kinase pathway and activation of NO-eNOS pathway in the SHR. PMID:22750666

Saito, Motoaki; Ohmasa, Fumiya; Dimitriadis, Fotios; Tsounapi, Panagiota; Sejima, Takehiro; Shimizu, Shogo; Kinoshita, Yukako; Satoh, Keisuke

2012-10-01

262

Role of ultrasonography with color-Doppler in the emergency diagnosis of acute penile fracture: a case report.  

Science.gov (United States)

Penile fracture is the rupture of tunica albuginea, typically resulting from blunt trauma, intercourse, or penile manipulation. Diagnosis is made clinically. Ultrasound is not used frequently in diagnosis of penile fracture but it provides a fast, non-invasive alternative to more often used MRI and cavernography. We aimed to present diagnostic ultrasound and color Doppler images of a patient with acute penile fracture in conjunction with literature. PMID:24567928

Buyukkaya, Ramazan; Buyukkaya, Ayla; Ozturk, Beyhan; Kay?kç?, Ali; Yazgan, Ömer

2014-03-01

263

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

OpenAIRE

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

Sanjeev Kumar; Chandrashekhar Diwakar

2013-01-01

264

Non-visualization of sentinel lymph nodes in penile carcinoma  

International Nuclear Information System (INIS)

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

265

Penile Reconstruction: Evaluation of the Most Accepted Techniques  

Directory of Open Access Journals (Sweden)

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.

Alireza Babaei

2010-05-01

266

Non-visualization of sentinel lymph nodes in penile carcinoma  

Energy Technology Data Exchange (ETDEWEB)

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.)

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

267

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

OpenAIRE

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

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

2011-01-01

268

Limitations in the interpretation of biopsies in patients with penile squamous cell carcinoma.  

Science.gov (United States)

Surgeons often perform small or superficial penile biopsies that are difficult to classify definitely with regard to a benign or malignant nature, and if malignant, cannot always be accurately subclassified. Staging and therapeutic decisions rely on the identification, in these materials, of pathologic parameters related to prognosis. In this study, we evaluated the accuracy and completeness of pathologic information obtained from biopsies of 57 consecutive patients with squamous cell carcinoma (SSC) of the penis, and compared it with the information obtained from penectomies. Diagnostic accuracy was determined by recording discordances of critical factors in biopsies and penectomies. The evaluated parameters were as follows: cancer diagnosis, histologic type, tumor grade, depth of invasion (anatomical levels), and vascular invasion. Histologic subtypes of SCC were the following: usual 37, verruciform 11, mixed 7, pseudohyperplastic 1, and sarcomatoid 1. Grades were 1, 2, and 3 (well, moderately and poorly differentiated). Levels of invasion were lamina propria, corpus spongiosum, and corpus cavernosum in the glans; and lamina propria, dartos, and skin in the foreskin. In 2 patients with well-differentiated tumors a diagnosis of cancer could not be established in biopsy material. In 17 cases (30%) there was a biopsy-penectomy discordance of histologic types, especially of verruciform and mixed carcinomas. Biopsies failed to identify the correct histologic grade in 30% of the cases. A higher grade was usually identified in penectomy specimens. Because biopsies were superficial, the deepest point of invasion could not be determined in 91% of the cases. Vascular invasion was identified in biopsies in only 1 of 8 patients. In summary, biopsies were useful for cancer diagnosis except in 2 differentiated variants of penile squamous cell carcinoma. However, important pathologic parameters related to prognosis were missed on biopsy materials, and they were more accurately evaluated in penectomy specimens. We conclude that clinical and pathologic staging of penile cancer, at least in our material, cannot depend on biopsy information alone. Data from biopsies may be insufficient to make a decision whether to perform a groin dissection, or for prognostic evaluation in those patients in whom other treatment modalities (such as radiotherapy or chemotherapy) are being considered. PMID:15173919

Velazquez, Elsa F; Barreto, Jose E; Rodriguez, Ingrid; Piris, Adriano; Cubilla, Antonio L

2004-04-01

269

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english 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.

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

2014-10-01

270

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)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese 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.

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

2006-10-01

271

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  

Directory of Open Access Journals (Sweden)

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 porte. 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.OBJECTIVE: This transversal study was developed from the analysis of indicators which express the desirable approach for programmatic actions, with the objective of evaluating the performance of a Family Healthcare Center in its attendance to patients suffering from arterial hypertension living in a small municipal district. METHODS: The research was carried out starting from the analysis of the records of enrollment in the program, Record A from SIAB (Primary Care Information System, of 418 individuals suffering from arterial hypertension. It was also analyzed the information of 351 files from the health center. In addition, 376 interviews were carried out with individuals living in the vicinity of the health center, in the year of 2003. The following variables were studied: gender, age, family income, home conditions, health services used presence of diabetes mellitus, average number of individuals attended and attendance concentration. RESULTS: Women above 60 years of age prevailed in 65.7% of the cases. The hypertension prevalence rate on individuals who searched for care was of 18%, being different among gender, among women it was of 22.3%. The average number of appointments with a doctor was of 64.1%; 32.4% for appointments with a nurse, and 36.4% for home medical attendance. The information on files revealed that 25.8% of the individuals were not assisted in 2003 and 52.7% received no assistance in the last semester. The concentration of services was below preconization. CONCLUSION: The information revealed no organization on the attention to the preventive health care, focusing the assistance to a spontaneous demand, expressing unpreparedness in the use of information systems for the planning and evaluation of the actions.

Luciano Burigo de Sousa

2006-10-01

272

Penile injury due to blunt trauma after circumcision in a male child: A case report  

OpenAIRE

Injury in the case presented here is different from the cause of penile trauma. Our case has been exposed to blunt trauma after circumcision. Type developments of the penile trauma, treatment, and precautions have been discussed with the literature.

Hulya Ozturk; Serkan Ozturk

2014-01-01

273

A comprehensive, prospective study of penile dimensions in Chinese men of multiple ethnicities.  

Science.gov (United States)

This study aimed to establish a reference range of penile length and circumference of adult males in China, and to compare the penile dimensions of different ethnical backgrounds. To do this, penile length and circumference measurements were obtained from 5196 healthy males attending the Urology Counseling Clinic. The mean value of penile dimensions was a flaccid length of 6.5 ± 0.7 cm, a stretched length of 12.9 ± 1.2 cm and a flaccid circumference of 8.0 ± 0.8 cm. In the subgroup of 311 males, the mean erectile length was 12.9 ± 1.3 cm and the mean erectile circumference was 10.5 ± 0.9 cm, the mean flaccid and erectile glans lengths were 2.7 ± 0.3 and 3.4 ± 0.4 cm, respectively, and the mean flaccid and erectile glans diameters were 2.6 ± 0.2 and 3.4 ± 0.4 cm, respectively. We found that flaccid penile length and circumference varied among different ethnicities. This study established a reference range for penile dimensions, which will help when counseling patients worried about their penile size or seeking penis enlargement surgery. We also found that penile dimensions are different in different ethnicities, but further investigations are needed to validate this. PMID:24784891

Chen, X B; Li, R X; Yang, H N; Dai, J C

2014-01-01

274

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

Directory of Open Access Journals (Sweden)

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.

Sood Suneet

2010-06-01

275

Familial appearance of congenital penile curvature - case history of two brothers.  

Science.gov (United States)

The true prevalence of congenital penile curvature (CPC) is difficult to determine. Some study reports suggests that this problem may occur in as many as 10% of the male population [1]. However, a literature search of the Medline database revealed no reference concerning familial appearance of congenital penile curvature. For that reason we would like to present our case series. Two brothers aged 25 and 26 respectively were admitted to the department of urology due to congenital penile curvature. Each patient was assessed by a history, physical examination, auto-photography of the erect penis, and a thorough sexual history. Concomitant anomalies of penile layers were absent in both cases. The Yachia [2] and Essed-Schroeder [3] corporoplasty technique were applied respectively. In follow-up both brothers reported straight erections. A survey of the fetal penis at different stages of development shows some degree of curvature in a considerable number of embryos [4]. Penile curvature may thus be considered almost physiological in embryos between 35 and 45 mm in length. Thus, it has also been proposed that penile curvature is secondary to an arrest in normal penile development [5]. Therefore, some form of congenital local androgen deficiency may be responsible for inherited penile curvature. PMID:24579033

Zachalski, Wojciech; Matuszewski, Marcin; Krajka, Kazimierz; R?ba?a, Krzysztof

2013-01-01

276

Penile injury due to blunt trauma after circumcision in a male child: A case report  

Directory of Open Access Journals (Sweden)

Full Text Available Injury in the case presented here is different from the cause of penile trauma. Our case has been exposed to blunt trauma after circumcision. Type developments of the penile trauma, treatment, and precautions have been discussed with the literature.

Hulya Ozturk

2014-08-01

277

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

International Nuclear Information System (INIS)

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

278

Coronary Artery Bypass Graft  

Medline Plus

Full Text Available ... they are usually taken from your legs through multiple small incisions. If an artery is used, then ... used to help restart the heart or to control its rate. These wires are brought out through ...

279

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

DEFF Research Database (Denmark)

Previous gene deletion studies have provided insight into the critical role of L-type voltage-gated Ca2+ channels (Cav1.2) in regulation of blood pressure. Homozygous knockout is, however, lethal but this limitation can be overcome by a small RNA 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 Cav1.2 or with the control non-related siRNAs. The effect of transfection was evaluated after 3 days using qPCR and isometric myography.   In comparison to some other genes the expression of Cav1.2 is very sensitive to transfection procedure (see abstract Broegger et al.). The optimization has been made to avoid the unwanted changes in mRNA in the controls transfected with non-related siRNAs. The level of Cav1.2 mRNA correlated with the functional responses, although when Cav1.2 mRNA was above 60% of the control no changes in the contractility were seen. When mRNA was <50% it accompanied with significant reduction in the contractile responses.   We conclude that although in vivo siRNA-induced downregulation in small arteries is possible the optimization of the procedure for the specific gene is necessary. Analyses at both functional and molecular biological levels are beneficial for correct evaluation of the efficiency of downregulation. Due to its the importance for vascular reactivity, Cav1.2 can be suggested as a good candidate for this siRNA optimization procedure.

MØller, Kate; Aalkjær, Christian

2009-01-01

280

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)

281

Penile lymphangioma circumscriptum in advanced age: a rare case  

OpenAIRE

Lymphangioma circumscriptum is a lymphatic malformation that is observed at early ages. It affects mostly the skin and subcutaneous tissues, but may affect all of the body organs and extend to the muscles. A 67-year-old male was referred to our department complaining of vesicular and erythematous lesions on the glans penis and an edematous skin lesion on the penile shaft that had recurred over the last 6 months. The patient had no history of allergy, trauma, drug use, or insect bites. An exci...

Ali Akkoç; Ahmet Metin; Serdar Yan?k; Mevlüt Y?ld?z; Engin Kand?ral?; Muzaffer Ero?lu

2011-01-01

282

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

Directory of Open Access Journals (Sweden)

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

BrendaYHernandez

2014-02-01

283

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

International Nuclear Information System (INIS)

The present series consisted of 55 patients with non-small cell lung cancer in stage III who underwent radiotherapy from 1986-1989. They were divided into two groups: 35 patients with combined concurrent bronchial artery infusion (BAI) of CDDP (50 mg) and unevenly fractionated radiotherapy (combined group) and 20 with evenly fractionated irradiation (radiation group). The combined therapy was expected to achieve higher local control of disease. The rationale for the combined regime was based on the effects of CDDP, which causes cytostasis following intra-arterial infusion, and increased radiosensitivity from unevenly fractionated irradiation just after BAI. The radiotherapy group was considered a control in this study. The results of the combined group were limited to no CR, PR in 33 patients and NC in two with a period of 30±13 days for 50% reduction of tumor, superior to the radiation group. There was no difference between the two groups in the rate of local recurrence (combined group: 63%). The combined group showed 28 months of MST in cause-specific survival, a significant difference. Survival rates were 71% at one year, 27% at three years, and 15% at five years, including three survivors without recurrence. Stage III a patients in the combined group showed a better outcome than stage III b patients in the same group, and stage III a patients in the radiation group. Although radiation pneumonitis as a fatal side effect was noted in one patient of the combined gro noted in one patient of the combined group, the combined therapy presented here seemed to improve the prognosis of locally advanced lung cancer if properly indicated. (author)

284

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

International Nuclear Information System (INIS)

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

285

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

Directory of Open Access Journals (Sweden)

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

Ignjatovi? Ivan

2010-01-01

286

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

DEFF Research Database (Denmark)

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)

Holmquist, F; Kirkeby, H J

1992-01-01

287

MRI of penile fracture: diagnosis and therapeutic follow-up  

International Nuclear Information System (INIS)

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.)

288

MRI of penile fracture: diagnosis and therapeutic follow-up  

Energy Technology Data Exchange (ETDEWEB)

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.)

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

289

Disfunción eréctil de origen estructural peneano / Penile structural erectile dysfunction  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish La delicada armonía con la que los diferentes elementos del pene funcionan se puede ver alterada por diferentes patologías que dañan su estructura. Los fallos estructurales del pene condicionan un fracaso de este evento hemodinámico, y una disfunción eréctil que suele ser severa, resistente al trata [...] miento médico y generalmente irreversible. La pérdida de complianza en el tejido eréctil un drenaje anómalo de éste o las alteraciones severas en la geometría del pene son los mecanismos fisiopatológicos más frecuentes de estas disfunciones. Entre sus posibles causas figuran, entre otras, la enfermedad de La Peyronie, el priapismo, la diabetes, los traumatismos peneanos y la infiltración de los cuerpos cavernosos por algún proceso inflamatorio o neoplásico. Abstract in english The delicate harmony by which the various elements in the penis work may be altered by different pathologies that damage its structure. Structural anomalies in the penis cause a failure of the hemodynamic event and erectile dysfunction, which is usually severe, resistant to medical treatment and gen [...] erally non reversible. The most frequent physiopathologic mechanisms of these dysfunctions are loss of compliance in the erectile tissue, abnormal drainage, or severe alterations of penile geometry. Among possible etiologies are La Peyronie disease, priapism, diabetes, penile trauma, infiltration of corpora cavernosa by an inflammatory or neoplasic processes, and others.

Natalio, Cruz Navarro.

2010-10-01

290

Penile Agenesis: Report on 8 Cases and Review of Literature  

Directory of Open Access Journals (Sweden)

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 childs psychology, it is advised to perform masculinizing operations, and finally, no surgical intervention should be undertaken before counseling the parents.

Naser Sadeghian

2009-04-01

291

Penile Agenesis: Report on 8 Cases and Review of Literature  

Directory of Open Access Journals (Sweden)

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.

Alireza Mirshemirani

2009-06-01

292

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)

293

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

OpenAIRE

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

Piotr Paw?owski; Jaros?aw ?yczek; Robert Matys; Iwona Kubicka-Mendak; Iwona Stawiarska; Joanna Miedzinska; Pawe? Banatkiewicz; Aldona ?askawska-Wiatr; Justyna Wittych

2011-01-01

294

The treatment of ventral penile chordee without hypospadias by dorsal midline plication in an adolescent boy  

Directory of Open Access Journals (Sweden)

Full Text Available Herein we report of a case with isolated ventral penile chordee who underwent dorsal midline plication procedure. We aimed to present our experience and to review of the literature on current management.

Soner Coban

2014-04-01

295

The treatment of ventral penile chordee without hypospadias by dorsal midline plication in an adolescent boy  

OpenAIRE

Herein we report of a case with isolated ventral penile chordee who underwent dorsal midline plication procedure. We aimed to present our experience and to review of the literature on current management.

Soner Coban; Muhammet Guzelsoy; Ali Riza Turkoglu; Murat Aydos

2014-01-01

296

Modified Byars’ flaps for securing skin closure in proximal and mid-penile hypospadias  

OpenAIRE

Objective: The objective of this study was to describe a modification for skin closure combined with tubularized incised plate (TIP) urethroplasty in the repair of proximal and mid-penile hypospadias.

Abouzeid, Amr Abdelhamid

2011-01-01

297

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)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese 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

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

298

Urethral reconstruction in severe hypospadias using buccal mucosa graft and penile skin flap  

OpenAIRE

Introduction. Hypospadias represents the most frequent penile anomaly. The most challenging part of hypospadias surgery is urethral reconstruction. Many various tissues are used (local skin flaps, bladder mucosa grafts, buccal mucosa grafts etc.) for the reconstruction of the neourethra. Objective. Our aim was to evaluate advantages and disadvantages of combined buccal mucosa graft and penile skin flap in urethral reconstruction in severe hypospadias repair. Methods. Between December 20...

Majstorovi? Marko; Biži? Marta; Kojovi? Vladimir; Stojanovi? Borko; Krsti? Zoran; ?or?evi? Miroslav

2011-01-01

299

Disseminated metastatic penile squamous cell carcinoma detected by fluorodeoxyglucose PET/computerized tomography  

OpenAIRE

Penile cancer is an uncommon malignancy which of the management depends on the clinical stage and location of the lesion. Positron emission tomography/computerized tomography (PET/CT) is a promising method for detection of distant metastatic lesions and therapeutic strategy planning. Here, we report a case of penile squamous cell carcinoma of 57-year-old male patient, was referred to PET/CT department for investigation of metastases. There were significantly increased fluoro-18 fluorodeoxyglu...

Kaya, Zubeyde Rana; Sager, Sait; Halac, Metin; Sonmezoglu, Kerim

2012-01-01

300

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

International Nuclear Information System (INIS)

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

301

Focal Urethral Stricturing Following Intraurethral Mitomycin-C Gel and the Use of a Penile Clamp  

OpenAIRE

We present a case of a 51-year-old gentleman, previously diagnosed with high-grade superficial transitional cell carcinoma of the bladder and treated with intravesical mitomycin C and BCG, who developed serial recurrences in the prostatic urethra. This was resected and treated further with intraurethral mitomycin-C gel. He subsequently developed an almost impassable distal penile urethral stricture, corresponding to the site of penile clamp application which we hypothesise is secondary to a c...

Stanford, Richard F. J.; Thomas, Stephen A.

2012-01-01

302

he relationship of body mass index to penile length and testicular volume in adolescent boys  

OpenAIRE

Background Evidence suggests that obesity may be related to early onset of puberty in girls. However, few studies have found a link between body mass index (BMI) and puberty onset in boys. More study is needed to assess the relationship of BMI to penile length and testicular volume. Objective To investigate the relationship of BMI to penile length and testicular volume in adolescent boys. Methods A cross-sectional study was carried out on adolescent boys aged 9 to 14 years in Secangga...

Rizky Adriansyah; Muhammad Ali; Hakimi; Melda Deliana; Siska Mayasari Lubis

2012-01-01

303

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

Energy Technology Data Exchange (ETDEWEB)

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.

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

2009-12-15

304

Reference standard of penile size and prevalence of buried penis in Japanese newborn male infants.  

Science.gov (United States)

The present study set forth the reference values for penile size and determined the prevalence of buried penis in Japanese full-term newborns. The stretched penile length was measured and the presence of buried penis was assessed at 1-7 days of age in 547 Japanese full-term newborn infants born between 2008 and 2012 in Tokyo. The stretched penile lengths were compared at 1-12 hours and 1-7 days of age in 63 infants and by two observers in 73 infants to estimate postnatal changes and interobserver variation, respectively. The mean stretched penile length was 3.06 cm (SD, 0.26; 95% confidence interval [CI], 3.04-3.08) and the mean ratio of penile length to body length was 6.24 × 100(-1) (SD, 0.55 × 100(-1)), both of which were significantly smaller than those in Caucasian newborn infants. Buried penis was identified in 20 of 547 infants (3.7%; 95% CI, 2.1-5.2%). The first measurements of penile length at 1-12 hours were significantly smaller than the next measurements at 1-7 days (95% CI of the difference, 0.22-0.34). The 95% CI for the limits of agreement in the penile lengths measured by the two observers was -0.58 to -0.40 for the lower limit and 0.33 to 0.51 for the upper limit. These findings indicate that the penile length should be assessed after 24 hours of age by the reference standard of the same ethnicity for identifying micropenis and that buried penis is not uncommon in Japanese full-term newborns. PMID:24931740

Matsuo, Nobutake; Ishii, Tomohiro; Takayama, John I; Miwa, Masayuki; Hasegawa, Tomonobu

2014-01-01

305

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

OpenAIRE

Background. Excessive resection of penile skin is a rare but important complication of circumcision. Penis 'trapping' under the skin and consequent sexual dysfunction occur as a result. Case report. Excessive circumcision with complete resection of the penile skin is shown. Penis, trapped under the skin, was deliberated and skin defect was substituted with the full thickness skin graft. One year after the surgery penis has a good cosmetic appearance, adequate size and sexual function. Conclus...

Ignjatovi? Ivan; Kova?evi? Predrag; Medojevi? Nina; Poti? Milan; Mili? Vladimir

2010-01-01

306

Current and Future Strategies in the Diagnosis and Management of Penile Cancer  

OpenAIRE

Penile cancer is an uncommon malignancy that has a devastating effect on the patient while also being challenging to diagnose and treat. By implementing preventive measures, we can decrease the incidence of this disease and improve the quality of life of our patients. Early detection plays an important role in disease control and proper diagnostic modalities must be used in order to accurately identify the cancer and its progression. Primary penile lesions should be initially approached wh...

Spiess, Philippe E.; Simon Horenblas; Rodriguez, Alejandro R.; Lawindy, Samuel M.

2011-01-01

307

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

OpenAIRE

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. O...

Sood Suneet; Al-shaham Ali A

2010-01-01

308

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

OpenAIRE

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

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

2013-01-01

309

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

OpenAIRE

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

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

2007-01-01

310

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

OpenAIRE

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

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

2011-01-01

311

Association between HIV and subpreputial penile wetness in uncircumcised men in South Africa.  

OpenAIRE

OBJECTIVES: To describe the prevalence and characteristics of subpreputial penile wetness and to investigate the association between current levels of penile wetness and HIV infection. METHODS: Male attenders at a sexually transmitted infections clinic in Durban, South Africa were enrolled and treated for their presenting sexually transmitted infection complaint. They were asked to return after 14 days when a structured questionnaire was administered, and the degree of wetness of the glans pe...

O Farrell, N.; Morison, L.; Moodley, P.; Pillay, K.; Vanmali, T.; Quigley, M.; Hayes, R.; Sturm, Aw

2006-01-01

312

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

International Nuclear Information System (INIS)

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

313

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

Energy Technology Data Exchange (ETDEWEB)

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.

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

314

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

OpenAIRE

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

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

2010-01-01

315

Penile prosthesis implantation and tunica albuginea incision without grafting in the treatment of Peyronie's disease with erectile dysfunction  

OpenAIRE

We evaluated penile prosthesis implantation with tunica albuginea-relaxing incisions without grafting in the treatment of Peyronie's disease associated with erectile dysfunction. Between April 2005 and June 2011, 62 patients underwent surgery due to severe Peyronie's disease associated with erectile dysfunction. Malleable and inflatable penile prostheses were inserted in 49 and 13 cases, respectively. Penile prostheses were inserted into the corpora cavernosa using the standard ventral approa...

Djordjevic, Miroslav L.; Kojovic, Vladimir

2013-01-01

316

Human papillomavirus genotypes in penile cancers from Japanese patients and HPV-induced NF-?B activation  

OpenAIRE

The causal relationship between chronic inflammation and cancer is widely accepted. Numerous investigations have identified nuclear factor-?B (NF-?B) as an important modulator in driving chronic inflammation to cancer. This study aimed to determine the prevalence of human papillomavirus (HPV) in penile cancer in Japanese patients and whether NF-?B is subsequently overexpressed in penile cancer. Thirty-four specimens of penile tissue (16 malignant and 18 benign cases) were examined to deter...

Senba, Masachika; Mori, Naoki; Wada, Akihiro; Fujita, Shuichi; Yasunami, Michio; Irie, Sumiko; Hayashi, Tomayoshi; Igawa, Tsukasa; Kanetake, Hiroshi; Takahara, Osamu; Toriyama, Kan

2010-01-01

317

Penile traction therapy and Peyronie’s disease: a state of art review of the current literature  

OpenAIRE

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

Chung, Eric; Brock, Gerald

2013-01-01

318

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

Directory of Open Access Journals (Sweden)

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

Rossoni L.V.

2001-01-01

319

[Variant anatomy of penile venous vascular bed in adult man].  

Science.gov (United States)

The methods of anatomical preparation and X-ray examination were applied after the preliminary injection of blood vessels with the setting and radio-opaque masses, to study the variant anatomy of penile vascular bed. Organ complexes of minor pelvis and perineum, obtained from 54 cadavers of adult men, were used. It was found that the architecture and the places of the confluence of the main veins of penis are very variable. The trunks of the superficial and deep dorsal vein (DDV) may be single or double. Venous trunks tare connected by a network of anastomoses, more developed in the root of the penis. Valve apparatus in the anastomotic veins is presented only in 80% of the observations. Under normal conditions, the valves of the anastomotic veins provide the outflow of blood in DDV of the penis. The data obtained are of practical importance for understanding the anatomical causes of erectile dysfunction of venous origin. PMID:22724334

Ga?voronski?, I V; Mazurenko, R G

2012-01-01

320

Penile pyoderma gangrenosum successfully treated with topical Imiquimod  

Science.gov (United States)

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. PMID:22021975

Rathod, Santosh P.; Padhiar, Bela B.; Karia, Umesh K.; Shah, Bela J.

2011-01-01

321

Penile tuberculosis following intravesical Bacille Calmette-Guérin immunotherapy  

Science.gov (United States)

Bacille Calmette-Guérin (BCG) is an effective treatment for patients with superficial bladder cancer and bladder carcinoma in situ (CIS). It may cause side effects usually due to local and systemic inflammatory effects. We report a case of a male patient with non-invasive urothelial carcinoma of urinary bladder (Stage T1) who developed caseating granulomas on his glans penis as a complication of intravesical BCG immunotherapy. Though there are other reported cases of BCG dissemination noted in the literature, penile granuloma is rare. The first reported case was published in 1992 and since then only eleven cases are reported. It appears that both direct infectious processes and hypersensitivity reactions contribute to the clinical manifestations of a systemic BCG infection. Our case possibly represents a local infection of M bovis involving the glans penis. PMID:23671370

Chowdhury, Anadi Roy; Dey, Ranjan Kumar

2013-01-01

322

Penile lichen sclerosus after allogeneic stem cell transplantation.  

Science.gov (United States)

Graft-versus-host disease (GVHD) often complicates allogeneic stem cell transplantation (SCT) and affects mainly the gut, liver, lung and skin. The microscopic morphological features of late-phase sclerodermatous chronic GVHD in the skin, namely epidermal atrophy, lymphoplasmacytic infiltration, dense dermal fibrosis and adnexal atrophy, are histologically indistinguishable from those in sporadic systemic sclerosis, morphoea and the related condition of lichen sclerosus. Mucosal orifices including those of the genitourinary system may be severely affected. We present three SCT recipients with chronic GVHD and severe posthitis leading to phimosis requiring surgery. The excised prepuces showed features of lichen sclerosus including epidermal atrophy and a subepidermal zone of eosinophilic, homogeneous and hyalinized collagen above a band-like lymphoplasmacytic infiltrate. These cases add further evidence to support the notion that penile lichen sclerosus should be included within the expanding sclerodermoid spectrum of late-stage cutaneous chronic GVHD. PMID:18503592

Au, W-Y; Yeung, C-K; Cheung, M-C; Trendell-Smith, N J

2008-08-01

323

Arterial embolism  

OpenAIRE

Surgical and intensive care patients are at a heightened risk for arterial embolization due to pre-existing conditions such as age, hypercoagulability, cardiac abnormalities and atherosclerotic disease. Most arterial emboli are clots that originate in the heart and travel to distant vascular beds where they cause arterial occlusion, ischemia, and potentially infarction. Other emboli form on the surface of eroded arterial plaque or within its lipid core. Thromboemboli are large clots that disl...

Melville, R. M.

2013-01-01

324

Penile prosthesis implantation in an academic institution in Latin America  

Directory of Open Access Journals (Sweden)

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 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 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.

Mario Paranhos

2010-10-01

325

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

Directory of Open Access Journals (Sweden)

Full Text Available The mesenteric artery is a high caliber vessel dependent on the abdominal artery, right below the emergence of the vessels destined for the liver and stomach. The present study aimed to describe the behavior of the arterial vessel in the small intestine of the crab-eating raccoon (Procyon cancrivorus. The animals were collected on highways (roadkill. Cannulation of the abdominal aorta, perfusion with warmed water (40ºC and stained latex injection (Neoprene 450, Dupont do Brasil and Sulvinil stain, Glassuret S.A were performed, followed by formaldehyde fixation (10%. The dissection and photographic documents (Sony Cyber-shot, 8.1 megapixels made it possible to systemize the arteries and define the vascular patterns of the viscera. It was verified that the mesenteric cranial artery supports the entire jejune and the mesenteric portion of the ileum. Next to the mesenteric border, it becomes an anastomosis forming vascular arches from where straight arteries leave, supplying the mesenteric portion and sometimes also the jejunal antimesentericportion. The artery that irrigates the ileum comes up as a branch of the cranial mesenteric artery. Anatomic knowledge of the vascular pattern of the crab-eating raccoon (Procyon cancrivorus is of fundamental importance for researches regarding the arterialdistribution of the intestine considering anatomic variances.A artéria mesentérica é um vaso de grande calibre dependente da artéria aorta abdominal, imediatamente abaixo da emergência dos vasos destinados ao fígado e estômago. O objetivo do presente estudo foi descrever o comportamento dos vasos arteriais do intestino delgado em mão-pelada (Procyon cancrivorus. Os animais são procedentes de coleta em rodovias (mortos por acidente. Realizou-se a canulação da aorta abdominal, perfusão com água aquecida (40ºC e injeção de látex corado (Neoprene 450, Dupont do Brasil e Sulvinil Corante, Glassuret S.A, seguido de fixação em formaldeído (10%. As dissecações edocumentação fotográfica (Câmera Sony Cyber-shot, 8.1 megapixels permitiram sistematizar as artérias e definir os padrões vasculares da víscera. Verificamos que a artéria mesentérica cranial supre todo o jejuno e a face mesentérica do íleo. Próximo à borda mesentérica, anastomosa-se formando as arcadas vasculares e desta partem as artérias retas, que suprem à face mesentérica e, às vezes, a face antimesentérica do jejuno. A artéria que irriga o íleo surge como último ramo da artéria mesentérica cranial. O conhecimento anatômico do padrão vascular de mão-pelada (Procyon cancrivorus é de fundamental importância em pesquisas que se referem à distribuição arterial do intestino, levando-se em consideração as variações anatômicas.

Vanessa Morais Lima

2010-04-01

326

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

Energy Technology Data Exchange (ETDEWEB)

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.)

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

327

OUR EXPERIENCE WITH TUBULARIZED INCISED PLATE URETHROPLASTY FOR DISTAL AND MID-PENILE HYPOSPADIAS  

Directory of Open Access Journals (Sweden)

Full Text Available Hypospadias does not present an isolated genital anomaly but a complex urological, sex-ual, psychological and psychiatric, reproductive and aesthetic problem. Although there are over 200 operative techniques, this great surgical challenge presently does not have ideal operative solution. Nowadays, the use of urethral plate for urethroplasty, through various surgical tech-niques, presents a revolutionary concept in hypospadias surgery and it is being accepted by an ever-increasing number of hypospadiologists.Tubularized incised plate urethroplasty (TIP -Snodgrass procedure was performed on a total of 22 boys; 16 distal (72.7%, 5 mid-penile (22.7% and 1 proximal hypospadias in period from 1.1.2000 to 30.08.2003, by the same surgical team. The average patient age was 4.5 years (6 mon. to 12 years. All reconstructions have been done as primary urethroplasty while one distal hypospadias had one previous, unsuccessful MAGPI procedure. Complication included small urethrocutaneous fistulas in 4 (18% and meatal stenosis in 1 (4.5% child. Snodgrass pro-cedure is a successful method for reparation of distal hypospadias for it provides an excellent aesthetic result with acceptable complications. In order to evaluate the success of this method in reparation of mid- and proximal hypospadias, as well as the possibility of its application on previously unsuccessful or circumcised patients, it is necessary to gain additional experience al-though the first results are encouraging.

Danijela ?eri?

2003-10-01

328

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

Science.gov (United States)

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, 12.5, and 25 pmol) increased splanchnic SNA (SSNA), renal SNA (RSNA), MAP, and heart rate (HR) in a dose-dependent manner. Maximum increases in SSNA, RSNA, MAP, and HR elicited by apamin (12.5 pmol, n = 7) were 330 ± 40% (P < 0.01), 271 ± 40% (P < 0.01), 29 ± 4 mmHg (P < 0.01), and 34 ± 9 beats/min (P < 0.01), respectively. PVN injection of the nonpeptide SK channel blocker UCL1684 (250 pmol, n = 7) significantly increased SSNA (P < 0.05), RSNA (P < 0.05), MAP (P < 0.05), and HR (P < 0.05). Neither apamin injected outside the PVN (12.5 pmol, n = 6) nor peripheral administration of the same dose of apamin (12.5 pmol, n = 5) evoked any significant changes in the recorded variables. PVN-injected SK channel enhancer 5,6-dichloro-1-ethyl-1,3-dihydro-2H-benzimidazol-2-one (DCEBIO, 5 nmol, n = 4) or N-cyclohexyl-N-[2-(3,5-dimethyl-pyrazol-1-yl)-6-methyl-4-pyrimidin]amine (CyPPA, 5 nmol, n = 6) did not significantly alter the SSNA, RSNA, MAP, and HR. Western blot and RT-PCR analysis of punched PVN tissue showed abundant expression of SK1-3 channels. We conclude that SK channels expressed in the PVN play an important role in the regulation of sympathetic outflow and cardiovascular function. PMID:22647293

Gui, Le; LaGrange, Lila P.; Larson, Robert A.; Gu, Mingjun; Zhu, Jianhua

2012-01-01

329

Use of arterial conduit as an alternative technique in arterial revascularization during orthotopic liver transplantation.  

OpenAIRE

BACKGROUND: The risk of hepatic artery thrombosis after orthotopic liver transplantation is higher in cases of poor hepatic arterial inflow, small or anomalous recipient hepatic arteries, unsafe native hepatic arteries. AIMS: To assess the use of arterial conduits as alternative technique for graft revascularization. PATIENTS: At the Liver Transplant Center of the 'S. Giovanni Battista' Hospital in Torino, a review has been made of 600 consecutive orthotopic liver transplantations in 545 adul...

Rizzetto, Mario; Salizzoni, Mauro

2002-01-01

330

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

Directory of Open Access Journals (Sweden)

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.

Larissa Alves Afonso

2012-02-01

331

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

Scientific Electronic Library Online (English)

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

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

2012-02-01

332

Penile Revascularization for Erectile Dysfunction: a Systematic Review and Meta-Analysis of Effectiveness and Complications  

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Full Text Available

Introduction: Patients with arteriogenic erectile dysfunction (ED caused by traumatic localized arterial lesions can be treated successfully by penile revascularization (PR surgery. We aimed to determine the subjective and objective outcomes of PR surgery in patients with arteriogenic ED.

Materials and Methods: We searched for relevant publications released up to May 2008 in the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and Biological Abstracts. The citation lists of review articles and included trials were also searched. Published studies on different operative techniques of PR for men with ED due to traumatic penile arterial lesions were selected by 2 reviewers. Data on participants’ characteristics, study quality, population, intervention, cure and adverse effects were collected and analyzed.

Results: There were 25 studies that compared the selected operative techniques. Concerning subjective cure, the results in men younger than 30 years old were better than older ones (odds ratio, 3.7; 95% confidence interval, 2.2 to 6.4; P = .001. Venous leak (odds ratio, 1.8; 95% confidence interval, 1.2 to 2.6 and history of smoking (odds ratio, 3.4; 95% confidence interval, 2.2 to 5.6 influenced success rate. Inconsistent measurements of outcomes limited the findings, and none of the studies were randomized controlled trials.

Conclusion: Traumatic patients with arteriogenic ED might benefit from PR. Patient selection is vital for a successful outcome. Variations in penile vascular anatomy are also likely to b

Ali Reza Babaei

2009-02-01

333

Variant arteries at the base of the brain  

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

Nayak SB

2009-06-01

334

Urethral reconstruction in severe hypospadias using buccal mucosa graft and penile skin flap  

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Full Text Available Introduction. Hypospadias represents the most frequent penile anomaly. The most challenging part of hypospadias surgery is urethral reconstruction. Many various tissues are used (local skin flaps, bladder mucosa grafts, buccal mucosa grafts etc. for the reconstruction of the neourethra. Objective. Our aim was to evaluate advantages and disadvantages of combined buccal mucosa graft and penile skin flap in urethral reconstruction in severe hypospadias repair. Methods. Between December 2005 and August 2009, 48 patients with severe hypospadias, aged from nine months to 12 years (mean age 23 months underwent surgery. Thirty-four (71% had penoscrotal and 14 (29% scrotal hypospadias. Ventral penile curvature was present in all cases, and was corrected by incision of the short urethral plate. Urethroplasty was performed using a buccal mucosa graft combined with dorsal penile skin flap. Results. Mean follow-up was 22 months (range from 9 months to 3 years. Satisfactory functional and aesthetic results were achieved in 40 (83% patients. Fistula was noted in six cases and was solved by minor revision. Urethral stenosis in two cases was resolved by simple dilatation. Conclusion. Urethral reconstruction using the buccal mucosa graft and dorsal penile skin flap in severe hypospadias repair could be the method of choice. Using this technique, single stage urethral reconstruction is possible with satisfactory esthetical and functional results.

Majstorovi? Marko

2011-01-01

335

[Peripheral arteries].  

Science.gov (United States)

Peripheral arterial disease is a main cause of morbidity in industrialised countries. It chiefly affects older people. The most common causes are atherosclerosis and vasodilatatory abnormalities. In the presence of unexplained leg symptoms, peripheral arterial disease can be diagnosed or ruled out by non-invasive diagnostic methods such as history, clinical examination and the measurement of ankle and brachial artery pressure by Doppler ultrasound, as well as by calculating the ankle brachial index. Colour coded duplex sonography, computer tomography angiography, magnetic resonance angiography and arteriography are the imaging modalities used. Current diagnostic strategies are analysed for the different peripheral artery diseases. PMID:17479237

Vosshenrich, R; Reimer, P; Landwehr, P

2007-06-01

336

Accessory renal arteries: a case report  

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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

Billakanti Prakash Babu

2014-04-01

337

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

DEFF Research Database (Denmark)

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

Blædel, Martin; Raun, Kirsten

2012-01-01

338

Caverno-pudendal nervous communicating branches in the penile hilum.  

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

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

1999-01-01

339

Urethral pseudodiverticulum secondary to penile fracture and complete urethra dissection.  

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A 22-year-old man reported cracking sound and acute pain during sexual intercourse followed by rapid penile detumescence and ecchymosis. He experienced more pain because he could not urinate and had a palpably full bladder. Moreover, his urethra was bleeding. Physical examination revealed swollen, ecchymotic and deviated penis and penis ultrasonography showed an injury of the tunica albuginea and Buck's fascia with an expanding hematoma. Suprapubic catheter was positioned. Surgical exploration revealed a tear of tunica albuginea of both corpora cavernosa and complete urethral dissection. End-to-end urethral anastomosis and suture of corpora cavernosa lesion were performed. Vescical catheter was mantained for 6 days and suprapubic catheter for 3 months to allow a complete urethral healing. A pseudodiverticulum was found at anastomosis level on the urethrocistography 1 month after surgery. It disappeared by allowing micturition via the suprapubic catheter. The patient presented regular urinary flow and physiological erections 30 days later. In our experience, prompt surgical repair preserved erectile function and keeping the suprapubic catheter protected the urethra; this was the correct management for repairing the urethral lesion. PMID:23766837

Di Pierro, Giovanni B; Iannotta, Luca; Innocenzi, Michele; Caterina, Gulia; Grande, Pietro; Cristini, Cristiano; Gentile, Vincenzo

2013-01-01

340

[Penile dermatological lesions: how to identify premalignant lesions?].  

Science.gov (United States)

Penile squamous cell carcinoma is a highly evolving tumor. Thus an early diagnosis is a major matter in order to avoid tumoral spread and mutilating surgery. Intra-epithelial neoplasia is a carcinoma in situ involving a disorganized cytological structure and intraepithelial architecture without any change on the derma. It has a bimodal pathogenesis: it can be induced by papilloma virus HPV infection and thus Bowen's disease or Bowenoïd papulosis, or by a lichen sclerosus. Bowen's disease concerns mainly men after 50 years old. There are not any spontaneous remission and it transforms slowly in 20-30% of the cases into a squamous cell carcinoma. Its treatment is surgical removal of the lesion. The Bowenoïd papulosis concerns mainly young men. These lesions are rarely invasive and are likely to regress spontaneously. It can be treated conservatively. The lichen sclerosis is an inflammatory chronic disease which etiology is still unknown. It is localized on the glans and the prepuce. Its treatment is essentially circumcision. After treatment, patients must be followed-up and biopsies must be performed for any sign of degeneration. PMID:21397829

Bigot, P; Longvert, C

2011-03-01

341

BILATERAL ANATOMICAL VARIATION IN THE ARTERIAL SUPPLY OF FACE INVOLVING THE FACIAL AND TRANSVERSE FACIAL ARTERY  

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Full Text Available We present a case-report whereby a bilateral variation in the arterial supply of face was seen. The facial artery which is the main artery of face was seen terminating in the lower part of the face, as the inferior labial artery and few other branches; the transverse facial artery, which supplements the facial artery normally, was seen to enlarge and take over the course of facial artery, giving the superior labial and lateral nasal branches. The small pre-masseteric branch arising from facial artery was seen only on right side of face. It was absent on left side. Accurate knowledge of the normal and variant arterial anatomy of the facial artery is important for vascular radiology and will provide an anatomical basis to assist surgeons in performing maxillo-facial surgeries successfully. The details of this variation and its clinical significance are discussed herein.

Vrushali S. Kolte

2014-03-01

342

Women's relationship quality is associated with specifically penile-vaginal intercourse orgasm and frequency.  

Science.gov (United States)

A growing empirical literature demonstrates that the only sexual behavior consistently associated with indices of better physiological and psychological function is the one sexual behavior relevant to potential gene propagation. In the present study, 30 Portuguese women reported on their frequency of different sexual behaviors and corresponding orgasm rates and also completed the Perceived Relationship Quality Components (PRQC) Inventory. As hypothesized, frequency of penile-vaginal intercourse correlated positively with PRQC dimensions: Satisfaction, Intimacy, Trust, Passion, Love (all r >/= .40) and Global Relationship Quality (r = .55). Noncoital sexual behaviors with a partner were uncorrelated with the PRQC dimensions. Masturbation frequency was inversely associated with Love (r = -.38). Penile-vaginal orgasmic frequency correlated positively with PRQC dimensions: Satisfaction, Intimacy, Passion, Love (all r >/= .44) and Global Relationship Quality (r = .52). Penile-vaginal intercourse orgasmic consistency was inversely associated with masturbation frequency. Social desirability scores did not confound the associations. Results are discussed in terms of both evolutionary and psychoanalytic theories. PMID:17541850

Costa, Rui Miguel; Brody, Stuart

2007-01-01

343

Effect of blood flow on penile MR imaging at 1.5 T  

International Nuclear Information System (INIS)

Variations in signal intensity of the corpora cavernosa were observed in patients undergoing routine pelvic magnetic resonance (MR) imaging. This study was designed to determine whether changes in penile blood flow could account for these variations. T1- and T2-weighted images of the penis were obtained in 14 healthy patients and five patients before and after erection was achieved. There was marked variation in signal intensity of the corpora cavernosa in healthy patients. All patients in the second group demonstrated an increase in signal intensity on posterection images. In conclusion: decreased corpus cavernosal signal intensity can be seen in healthy patients; increased penile blood flow results in increased signal intensity on T1- and T2-weighted images; and changes in penile blood flow most likely account for the variations in signal intensity observed during MR imaging of the penis

344

Corporoplasty using bovine pericardium grafts in complex penile prosthesis implantation surgery  

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

Eduardo J. A. Lopes

2009-02-01

345

Conservative management of penile trauma may be complicated by abscess formation  

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Full Text Available Blunt penile trauma during sexual activity, although highly underreported due to the associated patient embarrassment, constitutes a real urological emergency requiring immediate attention and possibly early surgical intervention. We report a case of a 58-year old man who presented with penile pain following excessive masturbation. Although there were no clinical signs of penile deformity or hematoma, magnetic resonance imaging revealed the presence of a rupture in the tunica albuginea. The patient opted for non-surgical management and his recovery period was complicated by the formation of an abscess at the site of the albugineal tear thus prolonging his hospital stay. The abscess was surgically drained and the patient reports to have normal erections at 3-month follow up.

Athanasios Bantis

2014-10-01

346

he relationship of body mass index to penile length and testicular volume in adolescent boys  

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Full Text Available Background Evidence suggests that obesity may be related to early onset of puberty in girls. However, few studies have found a link between body mass index (BMI and puberty onset in boys. More study is needed to assess the relationship of BMI to penile length and testicular volume. Objective To investigate the relationship of BMI to penile length and testicular volume in adolescent boys. Methods A cross-sectional study was carried out on adolescent boys aged 9 to 14 years in Secanggang District, Langkat Regency, North Sumatera Province in August 2009. Subject's BMIs were calculated by dividing body weight (BW in kilograms by body height (BH in meters squared. Penile length (cm was measured with a spatula. We took the average of three measurements from the symphysis pubis to the tip of the glans penis. Testicular volume (mL was estimated by palpation using an orchidometer. Pearson's correlation test (r was used to assess the relationship of BMI to penile length and BMI to testicular volume. Results There were 108 participants, consisting of 64 primary school students and 44 junior high school students. Subjects' mean age was 11.7 (SD 1.62 years,; mean BW was 35.2 (SD 8.84 kg; mean testicular volume was 3.6 (SD 1.20 mL. We found no significant association between BMI and penile length (r=-0.25, P= 0.006, nor between BMI and testicular volume (r=-021; P=0.09. Conclusion There was no significant relationship of BMI to penile length nor BMI to testicular volume in adolescent boys. [

Rizky Adriansyah

2012-09-01

347

Isolated penile Kaposi's sarcoma in a HIV-positive patient stable on treatment for three years.  

Science.gov (United States)

Kaposi's sarcoma (KS) is an AIDS-defining condition. Typically, KS affects the skin with or without visceral involvement. The extensive use of antiretroviral therapy (ART) has decreased the incidence of KS amongst the HIV-positive population. We report a case of a 40-year-old man with HIV-1 infection with CD4 count of 551 cells/mm(3) and an undetectable viral load who presented with two skin-coloured KS lesions on the prepuce of the penis. Diagnosis was confirmed by histopathology. He had been commenced on ART three years earlier with a nadir CD4 count of 255 cells/mm(3). He had achieved and maintained viral suppression since commencing ART. The patient was initially treated with cryotherapy and 5% imiquimod as the lesions were presumed to be warts. The lack of response to treatment prompted further investigation. We carried out a literature search of published cases of penile KS over the past 10 years. The majority of articles regarding penile KS were published in the pre-ART era and involved patients with AIDS. Over the past 10 years, published cases of penile KS have almost exclusively been in HIV-negative men. We found 10 published cases of penile KS in HIV-negative men and only one other published case of penile KS in a HIV-positive man, who had severe immune suppression with CD4 count below 200 cells/mm(3). This is the first case report to describe a HIV-positive patient stable on ART with a CD4 count above 200 cells/mm(3) and suppressed HIV-1 viral load, to develop two KS lesions on the penis. Clinicians have to remain suspicious of penile lesions and appreciate the crucial role a biopsy with histopathological analysis plays in confirming a diagnosis. In addition, this case illustrates that unusual presentations of KS can still occur in treated HIV-positive patients with sustained immune recovery. PMID:24492851

Lebari, Dornubari; Gohil, Jesal; Patnaik, Lipsita; Wasef, Wafaa

2014-02-01

348

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

International Nuclear Information System (INIS)

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.)

349

Early-stage penile carcinoma metastasizing to brain: case report and literature review.  

Science.gov (United States)

Early-stage penile squamous cell carcinoma with subsequent distant metastases is rare. We report a case of a 35-year-old man with Stage pT1pN0 penile squamous cell carcinoma who underwent circumcision and bilateral inguinal lymphadenectomy. Further in the disease course, the patient developed metastases in the kidney, adrenal gland, retroperitoneal lymph nodes, lung, and brain. He underwent multiple resections, whole brain radiotherapy, and several chemotherapy regimens. All these metastases were histologically confirmed. Forty months after the first diagnosis, the patient died of thromboembolic complications. This case was unique because of the unusual pattern of dissemination, especially the spread to the brain. PMID:16098372

Lutterbach, Johannes; Pagenstecher, Axel; Weyerbrock, Astrid; Schultze-Seemann, Wolfgang; Waller, Cornelius Florian

2005-08-01

350

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

Energy Technology Data Exchange (ETDEWEB)

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.)

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

351

A new indication for tubularized incised plate urethroplasty: Isolated congenital penile urethrocutaneous fistula  

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Full Text Available Isolated congenital penile urethrocutaneous fistula is described as an unusual developmental anomaly in two infants who presented with an abnormal opening on the ventral aspect of penis with a normal foreskin and an absence of the chordee, hypospadias or other associated congenital anomalies. Tubularized incised plate urethroplasty augmented with dartos pedicle blanket wrap resulted in satisfactory recovery. Authors review their surgical experience with this new indication of tubularized incised plate urethroplasty in successful surgical repair of congenital penile urethrocutaneous fistula along with pertinent literature.

Gupta Vipul

2006-01-01

352

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

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

Soufiane Mellas

2010-07-01

353

Acute arterial occlusion - kidney  

Science.gov (United States)

Acute renal arterial thrombosis; Renal artery embolism; Acute renal artery occlusion; Embolism - renal artery ... back. Blood clots that travel through the bloodstream ( emboli ) can lodge in the renal artery. Pieces of ...

354

Coronary artery spasm  

Science.gov (United States)

Coronary artery spasm is a temporary, sudden narrowing of one of the coronary arteries (the arteries that supply blood to ... with angina (chest pain and pressure) have coronary artery spasm. Coronary artery spasm occurs most commonly in people ...

355

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

International Nuclear Information System (INIS)

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

356

Coronary arterial fistulas  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract A coronary arterial fistula is a connection between one or more of the coronary arteries and a cardiac chamber or great vessel. This is a rare defect and usually occurs in isolation. Its exact incidence is unknown. The majority of these fistulas are congenital in origin although they may occasionally be detected after cardiac surgery. They do not usually cause symptoms or complications in the first two decades, especially when small. After this age, the frequency of both symptoms and complications increases. Complications include 'steal' from the adjacent myocardium, thrombosis and embolism, cardiac failure, atrial fibrillation, rupture, endocarditis/endarteritis and arrhythmias. Thrombosis within the fistula is rare but may cause acute myocardial infarction, paroxysmal atrial fibrillation and ventricular arrhythmias. Spontaneous rupture of the aneurysmal fistula causing haemopericardium has also been reported. The main differential diagnosis is patent arterial duct, although other congenital arteriovenous shunts need to be excluded. Whilst two-dimensional echocardiography helps to differentiate between the different shunts, coronary angiography is the main diagnostic tool for the delineation of the anatomy. Surgery was the traditional method of treatment but nowadays catheter closure is recommended using a variety of closure devices, such as coils, or other devices. With the catheter technique, the results are excellent with infrequent complications. Disease name and synonyms Coronary arterial fistulas Coronary arterial fistulas or malformations

Qureshi Shakeel A

2006-12-01

357

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)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese 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.

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

2014-09-01

358

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

OpenAIRE

The authors describe the use of a self-expandable stent in a temporary deployment for treatment of a very wide-neck A1 segment of anterior cerebral artery (ACA) aneurysm following incomplete clipping. A 39-year-old hypertensive man presenting with seizure-like movement underwent computed tomography, which showed acute subarachnoid hemorrhage and an A1 segment of ACA aneurysm with superior and inferior projection. He underwent surgical clipping of the aneurysm, but superior and posterior porti...

Byun, Jun Soo; Kim, Jae Kyun; Lee, Hwa Yeon; Hwang, Sung Nam

2013-01-01

359

Abdominal electrical stimulation rescues failures to penile vibratory stimulation in men with spinal cord injury: a report of two cases.  

Science.gov (United States)

Most men with spinal cord injury are anejaculatory. To retrieve their semen for insemination, the procedure of penile vibratory stimulation is recommended over electroejaculation. Some men with spinal cord injury, however, cannot ejaculate with penile vibratory stimulation. We present 2 cases in which a simple, over-the-counter abdominal muscle stimulator rescued failures to penile vibratory stimulation. Use of this safe, easy, and inexpensive method may prevent some patients from undergoing more expensive, more invasive sperm retrieval methods such as electroejaculation or surgical sperm retrieval from the testis or epididymis. PMID:16808965

Kafetsoulis, Apostolos; Ibrahim, Emad; Aballa, Teodoro C; Goetz, Lance L; Lynne, Charles M; Brackett, Nancy L

2006-07-01

360

Results of combined Nesbit penile plication with plaque incision and placement of Dacron patch in patients with severe Peyronie's disease.  

Science.gov (United States)

We treated 9 men with severe curvature of the penis secondary to Peyronie's disease with penile plication and a previously unreported technique of incision of the Peyronie plaque and placement of Dacron patch. All men were potent before penile straightening. At a mean followup of 17.5 months all men achieved good to excellent correction of the deformity and they have remained potent. One patient initially complained of numbness of the glans penis and decreased penile rigidity distal to the Dacron patch but potency returned and the numbness resolved. PMID:8479026

Faerber, G J; Konnak, J W

1993-05-01

361

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

Energy Technology Data Exchange (ETDEWEB)

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.

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

2012-12-15

362

Semen retrieval by penile vibratory stimulation in men with spinal cord injury.  

Science.gov (United States)

Traumatic spinal cord injury resulting from car accidents, falls, violence or sport-related activities is a common occurrence throughout the world. Spinal cord injuries occur most often to young men in their parenting years. Among the medical challenges facing many of these men is the inability to ejaculate via sexual intercourse. To achieve biological fatherhood, their semen may be retrieved by methods of assisted ejaculation. This paper discusses the use of penile vibratory stimulation in men with spinal cord injury, and includes the topics: patient selection and management; proper placement and timing of stimulation; appropriate use of low-amplitude, high-amplitude or dual vibrators; and factors influencing ejaculatory success rate. Also summarized are recent data on semen quality in men with spinal cord injury. When performed properly, penile vibratory stimulation is a safe and easy method of obtaining semen from anejaculatory men with spinal cord injury. Semen quality is better when obtained by penile vibratory stimulation compared with electroejaculation, an alternative method of semen retrieval. For these reasons, and because of the low investment of time and money, it is recommended that penile vibratory stimulation be used as the first line of treatment for anejaculation in men with spinal cord injury. PMID:10438106

Brackett, N L

1999-01-01

363

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

International Nuclear Information System (INIS)

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

364

Blunt Trauma to the Penis Post Penile Augmentation Surgery: Case Report  

Directory of Open Access Journals (Sweden)

Full Text Available Introduction: Blunt trauma to the penis is a rare but potentially serious injury that can occur by various mechanisms (e.g., kicks, accidents, sexual activity, and falls. The most common clinical presentation is sudden pain, swelling, and discoloration. Depending on the type and severity of injury, management can include conservative treatment or surgery, with the ultimate goal being the prevention of delayed complications. Case presentation: A 30-year-old male presented with penile pain, swelling, and redness as a result of blunt trauma to his penis 1 week after penile enhancement surgery using a subcutaneous soft silicone implant. Once the patient’s blood pressure was stabilized, surgical management consisted of exploration with evacuation of a large hematoma and removal of the subcutaneous penile implant to avoid further perioperative and postoperative bleeding. Discussion: Postoperative bleeding is a risk factor associated with almost all types of surgical procedures, and its prevention is best achieved by identification and elimination of potential causes pre- and postoperatively. Hypertension is another risk factor for excessive postsurgical bleeding, particularly bleeding associated with prosthetic implant surgeries, and should be considered for any potential surgical patient. Conclusion: With penile prosthesis and implant surgery, hypertension is an especially serious risk factor. Early surgical management is warranted in cases involving a major hematoma and swelling. Even cases with minimal bleeding should be evaluated in a timely manner, with surgical treatment indicated, rather than watchful waiting, to prevent further damage to the penis.

James J. Elist

2014-11-01

365

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

Directory of Open Access Journals (Sweden)

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

Theddeus O.H. Prasetyono

2011-08-01

366

Un nuevo caso de ectopia testicular peneana / A new case of penile testicular ectopia  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Objetivo: Aportación de un nuevo caso de ectopia testicular peneana. Método: Presentamos el caso de un niño de 3 años, diagnosticado y operado de ectopia testicular peneana. Resultados: El examen físico reveló una tumoración ovoidea en el centro de la cara dorsal de la raíz del pene, acompañada de v [...] acuidad de la bolsa escrotal izquierda. La inguinotomía evidenció la salida del cordón espermático por el anillo inguinal superficial izquierdo, el cual se dirigía hacia el testículo ubicado en situación subdérmica en la raíz del pene. Se realizó funiculolisis y orquidopexia en la bolsa escrotal correspondiente. Conclusiones: El caso aquí presentado corresponde a una ectopia testicular peneana de localización central, con trayecto inguinal normal del cordón espermático. Abstract in english Objective: To report a new case of penile testicular ectopia. Methods: We present the case of a three-year old boy who was diagnosed of penile testicular ectopia and underwent surgery. Results: Physical examination revealed an ovoid tumor in the center of the dorsal side of the penile root, together [...] with empty left scrotum. Inguinal incision revealed the exit of the spermatic cord from the left superficial inguinal ring, which was directed to a testicle in a subdermal position in the root of the penis. Funiculolysis and orchyopexy were performed. Conclusions: The case here reported corresponds to a penile testicular ectopia of central localizations, with normal inguinal course of the spermatic cord.

Ángel Manuel, Tundidor Bermúdez.

2008-02-01

367

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english 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.

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

2013-07-01

368

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

Directory of Open Access Journals (Sweden)

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.

Alvaro Paez

2007-08-01

369

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)

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.

Jensen, Lars JØrn; Björling, K.

370

Slightly modified technique of the original essed plication procedure for congenital penile deviation  

Directory of Open Access Journals (Sweden)

Full Text Available PURPOSE: The Schroeder-Essed plication procedure is a standard technique for the correction of penile curvature. In a retrospective analysis we compared functional results and quality of life (LQ of the original technique with inverted sutures as described by Schroeder-Essed and our slight modification consisting of horizontal incisions into the tunica albuginea. MATERIALS AND METHODS: Twenty-six patients with congenital penis deviation were treated for penile deviation by the original Schroeder-Essed plication with inverted sutures (11 patients and by the described modification (15 patients. In case of modified technique, horizontal and parallel incisions 4 mm to 6 mm apart and about 8 mm - 10 mm long were made through the tunica albuginea. The outer edges of the incisions were then approximated with permanent inverted sutures (Gore-Tex® 3-0. Mean age was 21.6 years in the first group and 23.2 years in the second group. Average follow-up was 28 months and 13 months, respectively. The preoperative penile deviation angle was > 25º in all patients without difference between the 2 groups. RESULTS: All patients in both groups reported an improvement in their quality of life and full ability to engage in sexual intercourse. Nine patients (88% in the first group and 14 patients (93% in the second group were satisfied with the cosmetic result. In contrast, 10 patients (91% of the first and 13 patients (87% of the second group complained of penile shorting. Recurrence of deviation was only noticed in 2 males in the first group (18%. CONCLUSIONS: Our results indicate that this simple modification of the Schroeder-Essed plication offers good functional and cosmetic results. Most patients were satisfied with the penile angle correction results.

C Van Der Horst

2003-08-01

371

Slightly modified technique of the original essed plication procedure for congenital penile deviation  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english PURPOSE: The Schroeder-Essed plication procedure is a standard technique for the correction of penile curvature. In a retrospective analysis we compared functional results and quality of life (LQ) of the original technique with inverted sutures as described by Schroeder-Essed and our slight modifica [...] tion consisting of horizontal incisions into the tunica albuginea. MATERIALS AND METHODS: Twenty-six patients with congenital penis deviation were treated for penile deviation by the original Schroeder-Essed plication with inverted sutures (11 patients) and by the described modification (15 patients). In case of modified technique, horizontal and parallel incisions 4 mm to 6 mm apart and about 8 mm - 10 mm long were made through the tunica albuginea. The outer edges of the incisions were then approximated with permanent inverted sutures (Gore-Tex® 3-0). Mean age was 21.6 years in the first group and 23.2 years in the second group. Average follow-up was 28 months and 13 months, respectively. The preoperative penile deviation angle was > 25º in all patients without difference between the 2 groups. RESULTS: All patients in both groups reported an improvement in their quality of life and full ability to engage in sexual intercourse. Nine patients (88%) in the first group and 14 patients (93%) in the second group were satisfied with the cosmetic result. In contrast, 10 patients (91%) of the first and 13 patients (87%) of the second group complained of penile shorting. Recurrence of deviation was only noticed in 2 males in the first group (18%). CONCLUSIONS: Our results indicate that this simple modification of the Schroeder-Essed plication offers good functional and cosmetic results. Most patients were satisfied with the penile angle correction results.

C, Van Der Horst; F.J., Martinez Portillo; C, Seif; A, Musial; P, Alken; K.P, Jünemann.

2003-08-01

372

Arterial imaging with computerized fluoroscopy  

OpenAIRE

Computerized fluoroscopy (CF) allows visualization of any segment of the arterial vascular system with intravenous injection of small volumes of standard iodinated contrast media. Because it avoids the risk of arterial puncture and the need for hospitalization, this technique is safer and more economical than standard arteriography. Because of these advantages, CF is likely to expand the role of arteriography in the clinical management of vascular disease.

Turnipseed, William D.; Jistretta, Charles A.; Crummy, Andrew B.; Strother, Charles M.; Sackett, Joseph F.; Myerowitz, P. David; Shaw, Choring G.; Ergun, David L.

1981-01-01

373

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

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Full Text Available 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- or long-term complications. Conclusions. Results on combined penoscrotal and perineal approach to penile prosthetic surgery in this preliminary series of patients suggest that it is a safe technique and increases the chance of successful outcome in the surgical management of severe corporal fibrosis.

Sherif R. Aboseif

2008-11-01

374

Reconstructive Surgery for Severe Penile Inadequacy: Phalloplasty with a Free Radial Forearm Flap or a Pedicled Anterolateral Thigh Flap  

OpenAIRE

Objectives. Severe penile inadequacy in adolescents is rare. Phallic reconstruction to treat this devastating condition is a major challenge to the reconstructive surgeon. Phallic reconstruction using the free radial forearm flap (RFF) or the pedicled anterolateral thigh flap (ALTF) has been routinely used in female-to-male transsexuals. Recently we started to use these techniques in the treatment of severe penile inadequacy. Methods. Eleven males (age ...

Hoebeke, P.; Laecke, E.; Ceulemans, P.; Monstrey, S.; Lumen, N.

2008-01-01

375

Squamous cell carcinoma of the penis and scrotum in a patient with chronic scrotal and penile lymphedema  

OpenAIRE

Squamous cell carcinoma arising from tissue affected by chronic lymphedema is rare, though it is recognized that a variety of malignant tumors can arise in chronic congenital or acquired lymphedema. We describe, a case of scrotal and penile squamous cell carcinoma arising in a patient with a history of chronic scrotal and penile lymphedema of filarial origin. We here discuss the management and possible etiology of this unusual case.

Abhyankar Suhas; Kulkarni Ananta; Kulkarni Madhuri; Agarwal Naveen

2010-01-01

376

Squamous cell carcinoma of the penis and scrotum in a patient with chronic scrotal and penile lymphedema  

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Full Text Available Squamous cell carcinoma arising from tissue affected by chronic lymphedema is rare, though it is recognized that a variety of malignant tumors can arise in chronic congenital or acquired lymphedema. We describe, a case of scrotal and penile squamous cell carcinoma arising in a patient with a history of chronic scrotal and penile lymphedema of filarial origin. We here discuss the management and possible etiology of this unusual case.

Abhyankar Suhas

2010-01-01

377

Effects of fenfluramine, m-chlorophenylpiperazine, and other serotonin-related agonists and antagonists on penile erections in nonhuman primates.  

OpenAIRE

Fenfluramine, m-chlorophenylpiperazine (m-CPP), 1-phenylpiperazine, and the buspirone metabolite, 1-(2-pyrimidyl)piperazine given intravenously to adult rhesus monkeys regularly elicited penile erections. In contrast, serotonin (5-HT) agonists with 5-HT1A site specificity (8-OH-DPAT, buspirone) as well as trazodone, ritanserin, and metergoline were no different from saline in producing penile erections. Fenfluramine's effects were blocked by the 5-HT2 antagonists, ritanserin and metergoline, ...

Szele, Fg; Murphy, Dl; Garrick, Na

1988-01-01

378

Coronary Artery Bypass Graft  

Science.gov (United States)

Coronary Artery Bypass Graft Introduction Sometimes people have serious problems with their heart and the arteries that go into it. Coronary artery bypass graft surgery, or CABG, bypasses clogged arteries in the ...

379

Coronary Artery Bypass Graft  

Medline Plus

Full Text Available Coronary Artery Bypass Graft Introduction Sometimes people have serious problems with their heart and the arteries that go into it. Coronary artery bypass graft surgery, or CABG, bypasses clogged arteries in the ...

380

Hydroxyethyl starch increases patency and reduces thrombus formation following arteriotomy/intimectomy in small arteries: An experimental study in the rabbit  

International Nuclear Information System (INIS)

Twenty-four arteries of rabbit ears, divided into two groups of 12 vessels each, were prepared and 32P-labelled platelets were infused. Arteriotomy/intimectomy was performed after 1 hr and in vivo platelet accumulation recorded for 2 hr. Group A comprised untreated control animals and group B was treated with 1 g hydroxyethyl starch (HES), MW 450,000 in 17 ml saline/kg b.w. (Plasma-steril). Vessel bleeding-times were normal, patency was improved, and intraluminal thrombotic material was reduced after HES treatment. Initial in vivo platelet accumulation was rapid and reached similar levels in both groups. However, the platelet accumulation curves decreased more frequently following HES than in the control group. HES does not prevent platelet accumulation at trauma sites, but reduces the sizes of the thrombi formed and may enhance disaggregation/fibrinolysis

381

Arterial embolism  

Science.gov (United States)

... arm or leg. There may be signs of tissue death or gangrene. Tests to diagnose arterial embolism or reveal the source of emboli may include: Angiography of the affected extremity or organ Doppler ultrasound exam of an extremity Duplex Doppler ultrasound ...

382

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

Energy Technology Data Exchange (ETDEWEB)

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

Carillo, Viviana [Department of Medical Physics, San Raffaele Scientific Institute, Milano (Italy); Cozzarini, Cesare [Department of Radiotherapy, San Raffaele Scientific Institute, Milano (Italy); Perna, Lucia; Calandra, Mauro [Department of Medical Physics, San Raffaele Scientific Institute, Milano (Italy); Gianolini, Stefano [Medical Software Solutions GmbH, Hagendorn (Switzerland); Rancati, Tiziana [Prostate Cancer Program, IRCCS National Institute of Cancer, Milano (Italy); Spinelli, Antonello Enrico [Department of Medical Physics, San Raffaele Scientific Institute, Milano (Italy); Vavassori, Vittorio [Department of Radiotherapy, Cliniche Gavazzeni Humanitas, Bergamo (Italy); Villa, Sergio [Department of Radiotherapy 1, IRCCS National Institute of Cancer, Milano (Italy); Valdagni, Riccardo [Prostate Cancer Program, IRCCS National Institute of Cancer, Milano (Italy); Department of Radiotherapy 1, IRCCS National Institute of Cancer, Milano (Italy); Fiorino, Claudio, E-mail: fiorino.claudio@hsr.it [Department of Medical Physics, San Raffaele Scientific Institute, Milano (Italy)

2012-11-01

383

Primary penile adenocarcinoma with concurrent hypercalcaemia of malignancy in a dog.  

Science.gov (United States)

A 13-year-old male neutered Siberian husky crossbreed dog was presented with a 3-week history of haematuria and penile swelling. Clinical examination and computed tomography demonstrated a soft-tissue mass located at the base of the penis without signs of other primary tumours or metastasis. Clinicopathological findings revealed paraneoplastic hypercalcaemia. Fine-needle aspiration cytology of the mass suggested an epithelial tumour with several criteria of malignancy present. Following surgical excision of the mass, the hypercalcaemia resolved. Histopathology and immunohistochemistry revealed features consistent with an adenocarcinoma. Despite thorough examination, no perineal or anal sac tumour was found. To the authors' knowledge, this is the first reported case of a penile adenocarcinoma with hypercalcaemia of malignancy. PMID:25370307

Furtado, A R R; Parrinello, L; Merlo, M; Di Bella, A

2014-11-01

384

Interstitial brachytherapy for penile cancer: the experience of Oncology Centre in Bydgoszcz  

Directory of Open Access Journals (Sweden)

Full Text Available Purpose: The aim of this work was to analyze the treatment results and complications of patients with penile cancer treated in our centre.Material and methods: Thirty three patients were included in this retrospective research. The average age was 62. All patients underwent brachytherapy HDR or PDR procedures using a remote-after-loading system with iridium source.Results: Average follow-up was 60 months. Complete remission was observed in 24 patients (72.7% out of the whole group. Locoregional and distant recurrences were noted in 9 patients (27.3%. In all patients 5-year overall and disease free survival were 84.9% and 75.4%, respectively. The 5-year locoregional control rate was 78.8%.Conclusion: Radical brachytherapy could possibly be a good treatment option in selected patients with T1-3 penile cancer and lesions smaller than 4 cm in diameter.

Renata Kabaci?ska

2010-01-01

385

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english 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

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

2007-08-01

386

Penile intraepithelial neoplasia with pagetoid features: report of an unusual variant mimicking Paget disease.  

Science.gov (United States)

Precancerous lesions of the penis frequently share the morphologic features of the invasive counterpart. We have recently subclassified penile intraepithelial neoplasia into differentiated, warty, and basaloid subtypes, each one with distinctive microscopic morphology. Nevertheless, in our experience, some cases depart from this classification scheme and show unusual morphologic features, hindering the proper diagnosis on routine morphology alone. Herein we present a case of penile intraepithelial neoplasia with a pagetoid growth pattern, closely mimicking Paget disease. We describe the necessary steps to reach the final diagnose, including the use of immunohistochemistry for cytokeratin (CK) 7, CK20, CK34?E12, CAM 5.2, AE1/AE3, CEA, S100, Melan-A, and p63. We also discuss other differential diagnoses that should be considered such as malignant melanoma and urothelial carcinoma in situ with pagetoid spread and less common lesions such as pagetoid dyskeratosis, clear cell papulosis, and mucinous metaplasia. PMID:24565207

Amin, Ali; Griffith, Rogers C; Chaux, Alcides

2014-04-01

387

Value of magnetic resonance imaging in patients with penile induration (Peyronie's disease).  

Science.gov (United States)

Magnetic resonance imaging (MRI) is a noninvasive procedure that enables exact imaging of penile anatomy. A total of 34 patients with clinical Peyronie's disease underwent palpation, ultrasound and MRI after intracavernous injection of 10 micrograms. prostaglandin E1. MRI images were obtained before and after intravenous application of gadolinium-diethylenetriaminepentaacetic acid. In 34 patients 45 plaques were palpable. Ultrasound revealed evidence of lesions in 66.6% of the cases. On MRI 36 of 45 palpable plaques (80%) were detected. Not palpable or sonographically revealed indurations could be shown in 4 cases. After intravenous application of gadolinium-diethylenetriaminepentaacetic acid 4 plaques demonstrated contrast enhancement, thus indicating local inflammatory activity. The combination of clinical examination and sonography remains the method of choice for diagnosis and observation of patients with Peyronie's disease. MRI enables exact imaging of penile structures but it does not provide a significant advantage over standard investigative procedures. PMID:7869479

Vosshenrich, R; Schroeder-Printzen, I; Weidner, W; Fischer, U; Funke, M; Ringert, R H

1995-04-01

388

Partial penectomy after debridement of a Fournier's gangrene progressing with an isolated penile necrosis.  

Science.gov (United States)

Fournier's gangrene (FG) is a rare and often fulminant necrotizing fasciitis of the perineum and genital region frequently due to polymicrobial infection. This truly emergent condition is typically seen in elderly, diabetic and immune compromised patients. Here, we report an unusual case of FG with isolated glans penis necrosis in a diabetic 77-year-old male patient presented to the emergency department complaining 5 days of pain and darkening of the glans penis. Examination of the patient's glans penis was consistent with FG and included significant erythema and infectious discharge. He was given intravenous antibiotics and emergency debridement was done. On following days, the necrotic area spread to distal parts of both cavernosal areas. Partial penectomy was performed. Isolated penile involvement in FG is very rare. Performing partial penectomy in appropriate cases can save penile length, stop the progression of disease, and increase the quality of life. PMID:25541853

Akbulut, Fatih; Kucuktopcu, Onur; Sonmezay, Erkan; Simsek, Abdulmuttalip; Ozgor, Faruk; Gurbuz, Zafer Gokhan

2014-09-01

389

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

Science.gov (United States)

Penile carcinoma in situ, or Queyrat's erythroplasia, is a rare condition of the glans penis. This lesion has been associated with invasive squamous cell carcinoma; however, metastasis without an invasive component is extremely rare. There have only been 2 documented cases with metachronous metastases. We report a third case in which metastases were diagnosed at presentation. The patient was a 51-year-old man who presented with a glans penile lesion and bilateral inguinal masses later determined to be carcinoma in situ with metastases to the inguinal and pelvic lymph nodes. He subsequently underwent a partial penectomy and lymphadenectomy followed by adjuvant chemotherapy and radiation. This case is discussed, along with a brief review of the literature. PMID:18542829

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

2007-01-01

390

A new indication for tubularized incised plate urethroplasty: Isolated congenital penile urethrocutaneous fistula  

OpenAIRE

Isolated congenital penile urethrocutaneous fistula is described as an unusual developmental anomaly in two infants who presented with an abnormal opening on the ventral aspect of penis with a normal foreskin and an absence of the chordee, hypospadias or other associated congenital anomalies. Tubularized incised plate urethroplasty augmented with dartos pedicle blanket wrap resulted in satisfactory recovery. Authors review their surgical experience with this new indication of tubularized inci...

Gupta Vipul; Sharma S

2006-01-01

391

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english PURPOSE: Penile carcinoma is a common disease in northeast Brazil. This paper shows the results of the use of isolated gamma probe and discusses the incidence of false negative rates. MATERIALS AND METHODS: From July 2000 to September 2003, 27 newly diagnosed penile carcinoma patients (T1, T2, N0) w [...] ere included in this prospective study. The isolated gamma probe technique uses the sodium phytate technetium as a tracer and inguinal scanning with probe and after identified the lymph node it is removed. Lymphadenectomies were performed for positive inguinal lymph nodes metastasis. RESULTS: There were 27 patients (mean age 59.6). Follow up was 37 months. Patients from country were 72% and illiterate or semi-illiterate were 56.7%. The tumors were mostly located in the glans (81.4%). They were T1, 52 % and T2, 48 %. 81.4% of the patients underwent partial penectomy, and 18.6% underwent postectomy and excision with wide margins. In 48% of the patients, the highest radioactive count rate was located on the left side, while in 41% was located on the right side. Only one patient had a positive pathological lymph node metastasis at the moment of the surgery. Additionally 3 patients became inguinal lymph node positive at the follow up. This date yielded a sensibility rate of 25% and a false-negative rate of 42.8%. CONCLUSION: Isolated gamma probe technique for sentinel node penile carcinoma has a very low sensibility and a high false negative rate. Therefore it is highly advisable the addition of others methods such as lymphoscintigraphy, vital blue, ultrasonography and so on. The isolated gamma probe technique for sentinel node penile carcinoma detection is unreliable.

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

2007-02-01

392

Petroleum jelly-induced penile paraffinoma with inguinal lymphadenitis mimicking incarcerated inguinal hernia  

OpenAIRE

Chronic granulomatous inflammation may develop after injecting foreign oily substances into the penis. The disorder affects mainly the site of administration, but regional lymphadenopathy or even systemic disease can occur. We present a 39-year-old man with petroleum jelly-induced penile lesion and unilateral inguinal lymphadenitis mimicking incarcerated inguinal hernia. At hernioplasty no hernial sac was found, but enlarged lymph nodes suspicious for malignancy were identified. The histopath...

Sejben, Istva?n; Ra?cz, Andra?s; Sve?bis, Miha?ly; Patyi, Ma?rta; Cserni, Ga?bor

2012-01-01

393

Prenatal exposure to phthalates is associated with decreased anogenital distance and penile size in male newborns  

OpenAIRE

Reproductive effects from phthalate exposure have been documented mostly in animal studies. This study explored the association between prenatal exposure to phthalate metabolites, anogenital distance and penile measurements in male newborns in Toluca, State of Mexico. A total of 174 pregnant women provided urine samples for phthalate analysis during their last prenatal visit, and the 73 who gave birth to male infants were included in the study. The 73 male newborns were weighed and measured u...

Bustamante-montes, L. P.; Herna?ndez-valero, M. A.; Flores-pimentel, D.; Garci?a-fa?bila, M.; Amaya-cha?vez, A.; Barr, D. B.; Borja-aburto, V. H.

2013-01-01

394

Engaging men with penile cancer in qualitative research: reflections from an interview-based study.  

OpenAIRE

AIM: To explore the challenges of engaging men with penile cancer in qualitative interview research. BACKGROUND: Qualitative interviewing offers an ideal tool for exploring men's experiences of illness, complementing and providing context to gendered health inequalities identified in epidemiological research on men. But conducting interviews with men can be challenging and embarking on a qualitative interview study with males can feel like a daunting task, given the limited amount of practica...

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

2014-01-01

395

Intraarterial chemotherapy with gemcitabine and cisplatin in locally advanced or recurrent penile squamous cell carcinoma  

OpenAIRE

The prognosis of locally advanced or recurrent squamous cell carcinoma (SCC) of the penis after conventional treatment is dismal. This study aimed to evaluate the therapeutic effects of intraarterial chemotherapy with gemcitabine and cisplatin on locally advanced or recurrent SCC of the penis. Between April 1999 and May 2011, we treated 5 patients with locally advanced penile SCC and 7 patients with recurrent disease with intraarterial chemotherapy. The response rate and toxicity data were an...

Hui Han; Kai Yao; Yun-Lin Ye; Zhi-Ling Zhang; Zhuo-Wei Liu; Yong-Hong Li; Jian-Ye Liu; Zi-Ke Qin; Fang-Jian Zhou

2013-01-01

396

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

OpenAIRE

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 pres...

Soufiane Mellas; Fadl Tazi; Nawfel Mellas; Ouafae Masbah; Kawtar Znati; Afaf Laamarti; El, Jamal Fassi; Hassan Farih

2010-01-01

397

The 2011 WPATH Standards of Care and Penile Reconstruction in Female-to-Male Transsexual Individuals  

OpenAIRE

The World Professional Association for Transgender Health (WPATH) currently publishes the Standards of Care (SOC), to provide clinical guidelines for health care of transsexual, transgender and gender non-conforming persons in order to maximize health and well-being by revealing gender dysphoria. An updated version (7th version, 2011) of the WPATH SOC is currently available. Differences between the 6th and the 7th versions of the SOC are shown; the SOC relevant to penile reconstruction in fem...

Gennaro Selvaggi; Cecilia Dhejne; Mikael Landen; Anna Elander

2012-01-01

398

Histologic and immunohistochemical assessment of penile carcinomas in a North American population.  

Science.gov (United States)

Penile squamous cell carcinoma (SCC) is sometimes an aggressive disease that has a variable worldwide incidence, in part due to differing rates of inflammatory and infectious risk factors. In the developed world, penile SCC is a rare malignancy, and most studies therefore originate in less developed countries. The current study was undertaken to examine the morphologic and immunohistochemical features of penile SCC from a region with low disease incidence. Sixty-two complete or partial penectomy specimens from 59 patients were reviewed. Twenty-six patients had metastasis, 3 had recurrent disease, and 7 were dead due to tumor. Most patients were uncircumcised (72%). Twenty-two percent of carcinomas were associated with lichen sclerosis. Perineural invasion was significantly associated with metastasis (P=0.007). Most SCCs (65%) had the usual keratinizing morphology, and these tumors were significantly associated with the differentiated form of intraepithelial lesion (P<0.0001), p53 positivity (P=0.002), cyclin D1 positivity (P=0.007), and EGFR overexpression (P=0.003). Human papilloma virus (HPV)-associated tumors accounted for 27% and were basaloid (8%), warty (10%), mixed (6%), or lymphoepithelioma-like carcinoma (4%) variants. These were significantly associated with p16 expression (P<0.0001) and the undifferentiated form of intraepithelial lesion (P<0.001). Among all SCCs, there was no difference in the immunohistochemical or in situ hybridization profile between primary tumors and metastases. Although penile SCC is rare in the United States, the tumor variants, immunohistochemical profiles, and proportion of HPV-associated tumors are similar to those in less developed countries. Two distinct pathways appear to lead to carcinogenesis; one is related to underlying chronic inflammatory states, involves p53 mutation, cyclin D1 overexpression, and culminates in classic keratinizing SCC. The other pathway involves high-risk HPV infection, demonstrates strong p16 expression, and results in SCC with varied, but distinctive morphologies. PMID:25210933

Mentrikoski, Mark J; Stelow, Edward B; Culp, Stephen; Frierson, Henry F; Cathro, Helen P

2014-10-01

399

Penile Duplication and Two Anal Openings; Report of a Very Rare Case  

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Full Text Available Background: Penile duplication (diphallus is an extremely rare disorder. It is almost always associated with other malformations like double bladder, exstrophy of the cloacae, imperforate anus, duplication of the rectosigmoid and vertebral deformities. Meanwhile anal canal duplication, the most distal and least commonduplication of the digestive tube and is a very rare congenital malformation.Case Presentation: A 21 days old Egyptian neonate is reported with complete penile duplication and two scrotums with each one carrying two palpable testes. Both penises have normal shaft with normally located meatus. Clear urine voids from both meati spontaneously. The child had also a fold of redundant skin about 4×5 cm at the anal region in which two separate anal openings are present. In rectal examination we found two normal anuses passing stool spontaneously. Ascending (voiding cystourethrography revealed two penises with two separate meatuses and one bladder from which the two urethras go out separately.Intravenous pyelogram (IVP revealed two normal kidneys and ureters. Barium study revealed duplication of rectum and colon, otherwise normal GIT.Conclusion: In our review of the literature, we did not come across any other case of this variety of the penile duplication and congenital presence of two anuses. Unfortunately the patient expired before any surgical correction.

Mohamed Abdel Al M. Bakheet

2012-03-01

400

Impact of penile degloving and proximal ventral dissection on curvature correction in children with proximal hypospadias  

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Introduction: Penile degloving is an important step in orthoplasty. Although its role in correcting mild curvature in distal and midshaft hypospadias has been previously reported, its impact on ventral curvature (VC) correction in proximal defects warrants further investigation. Therefore, we sought to document the effect of degloving and proximal urethral dissection on VC correction in children with proximal hypospadias. Methods: We retrospectively reviewed the records of 137 patients who underwent proximal hypospadias repair between 1998 and 2006. VC, defined as mild (45%), was recorded before penile degloving and after erection test. Percent improvement in VC and need for further treatment (beyond degloving and proximal dissection) based on preoperative degree of curvature were assessed. ANOVA test was used to compare improvement among the 3 groups. Results: Mean age at repair was 14 months (range: 6–24). Penile degloving associated with proximal urethral dissection when necessary was responsible for the improvement in the degree of curvature in 7 of 9 (77%) patients with mild VC, 23 of 44 (52%) with moderate and 35 of 84 (40%) with severe VC. Additionally, degloving alone was sufficient for VC correction in 7 of 9 (77%) mild cases, 14 of 44 (30%) moderate and only 2 of 84 (2%) severe cases. The difference among these 3 groups was statistically significant (p curvature, with severe VC cases showing the least improvement. PMID:25553156

Weber, Bryce A.; Braga, Luis H.P.; Patel, Premal; Pippi Salle, Joao L.; Bägli, Darius J.; Khoury, Antoine E.; Lorenzo, Armando J.

2014-01-01

401

Sentinel lymph node biopsy in penile cancer: a comparative study using modified inguinal dissection  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english INTRODUCTION: In the case of clinically negative inguinal regions in penile cancer, the treatments proposed might vary from careful observation to radical dissection for all patients. We evaluated the effectiveness of the sentinel lymph node biopsy using lymphoscintigraphy in patients with penile ca [...] ncer and at least one negative inguinal region. MATERIALS AND METHODS: In 18 patients, biopsy of the sentinel lymph node from the 32 negative inguinal regions and modified radical lymphadenectomy in these regions regardless of the biopsy results was performed. Clinical staging, pathological results of the sentinel and the other lymph nodes removed during lymphadenectomy, tumor behavior, local and inguinal recurrence and specific disease mortality were accessed. RESULTS: The mean age of the study sample was 57.7 years (44 - 81 years) and the sentinel lymph node presented 0% false negative 66% sensitivity, and 79.3% specificity when compared with the modified inguinal lymphadenectomy as the gold standard treatment. CONCLUSION: Sentinel lymph node biopsy is a feasible method of assessing the presence of regional metastasis in patients with penile cancer and clinically negative inguinal regions. However, the optimal lymphoscintigraphy technique is still in evolution and requires further optimization at high volume centers.

Ubirajara, Ferreira; Marco A.V., Ribeiro; Leonardo O., Reis; Alessandro, Prudente; Wagner E., Matheus.

2008-12-01

402

Sentinel lymph node biopsy in penile cancer: a comparative study using modified inguinal dissection  

Directory of Open Access Journals (Sweden)

Full Text Available INTRODUCTION: In the case of clinically negative inguinal regions in penile cancer, the treatments proposed might vary from careful observation to radical dissection for all patients. We evaluated the effectiveness of the sentinel lymph node biopsy using lymphoscintigraphy in patients with penile cancer and at least one negative inguinal region. MATERIALS AND METHODS: In 18 patients, biopsy of the sentinel lymph node from the 32 negative inguinal regions and modified radical lymphadenectomy in these regions regardless of the biopsy results was performed. Clinical staging, pathological results of the sentinel and the other lymph nodes removed during lymphadenectomy, tumor behavior, local and inguinal recurrence and specific disease mortality were accessed. RESULTS: The mean age of the study sample was 57.7 years (44 - 81 years and the sentinel lymph node presented 0% false negative 66% sensitivity, and 79.3% specificity when compared with the modified inguinal lymphadenectomy as the gold standard treatment. CONCLUSION: Sentinel lymph node biopsy is a feasible method of assessing the presence of regional metastasis in patients with penile cancer and clinically negative inguinal regions. However, the optimal lymphoscintigraphy technique is still in evolution and requires further optimization at high volume centers.

Ubirajara Ferreira

2008-12-01

403

Corporoplasty using bovine pericardium grafts in complex penile prosthesis implantation surgery  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english 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.

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

2009-02-01

404

Intraarterial chemotherapy with gemcitabine and cisplatin in locally advanced or recurrent penile squamous cell carcinoma.  

Science.gov (United States)

The prognosis of locally advanced or recurrent squamous cell carcinoma (SCC) of the penis after conventional treatment is dismal. This study aimed to evaluate the therapeutic effects of intraarterial chemotherapy with gemcitabine and cisplatin on locally advanced or recurrent SCC of the penis. Between April 1999 and May 2011, we treated 5 patients with locally advanced penile SCC and 7 patients with recurrent disease with intraarterial chemotherapy. The response rate and toxicity data were analyzed, and survival rates were calculated. After 2 to 6 cycles of intraarterial chemotherapy with gemcitabine and cisplatin, 1 patients with locoregionally advanced disease achieved a complete response, and 4 achieved partial response. Of the 7 patients with recurrent disease, 2 achieved complete response, 3 achieved partial response, 3 had stable disease, and 1 developed progressive disease. An objective tumor response was therefore achieved in 10 of the 12 patients. The median overall survival for the patients was 24 months (range, 10-50 months). Three out of 10 patients who responded were long-term survivors after intraarterial chemotherapy. Intraarterial chemotherapy with gemcitabine and cisplatin may be effective and potentially curative in locoregionally advanced or recurrent penile SCC. The contribution of this therapy in the primary management of advanced or recurrent penile SCC should be prospectively investigated. PMID:23668929

Liu, Jian-Ye; Li, Yong-Hong; Liu, Zhuo-Wei; Zhang, Zhi-Ling; Ye, Yun-Lin; Yao, Kai; Han, Hui; Qin, Zi-Ke; Zhou, Fang-Jian

2013-11-01

405

Penile low-intensity shock wave therapy: a promising novel modality for erectile dysfunction.  

Science.gov (United States)

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

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

2014-05-01

406

Penile lichen sclerosus: Correlation between histopathologic features and risk of cancer.  

Science.gov (United States)

The relationship between penile lichen sclerosus (LS) and cancer development has not been clearly assessed so far. In order to define these histological features of LS that may indicate or precede a malignant degeneration, 104 biopsy specimens from 86 patients with LS of the glans (90.5%) and from 9 patients with a penile malignancy (7 squamous cell carcinomas, 1 in situ carcinoma, and 1 verrucous carcinoma) arising on LS (9.5%) were reviewed. Three different histopathologic LS patterns were identified: pattern 1 with a prominent lichenoid inflammatory infiltrate in the dermis (9%), pattern 2 characterized by a band-like infiltrate separated from the epidermis by a band of dermal sclerosis (44%), and pattern 3 showing prominent sclerosis with minimal or absent inflammatory infiltrate (9%). These patterns have previously been described in vulvar LS, and have been considered typical of early, mature, and late LS, respectively. In our study, we also found a fourth pattern in 38% of cases, with overlapping features between the first and third pattern, occasionally showing areas of epidermal thickening, with loss of the normal keratinocyte cytoarchitectural differentiation, mitoses and apoptotic cells. In our opinion, the histological features observed in this last pattern may be interpreted as areas of disease reactivation within a chronic stage. Furthermore, 7 out of 9 cases of penile cancer from our series (78%) were associated with this pattern, suggesting that it may correlate with a malignant degeneration. PMID:17311737

Innocenzi, Daniele; Nasca, Maria Rita; Skroza, Nevena; Panetta, Chiara; Potenza, Maria Concetta; Musumeci, Letizia; Micali, Giuseppe

2006-01-01

407

Intraarterial chemotherapy with gemcitabine and cisplatin in locally advanced or recurrent penile squamous cell carcinoma  

Directory of Open Access Journals (Sweden)

Full Text Available The prognosis of locally advanced or recurrent squamous cell carcinoma (SCC of the penis after conventional treatment is dismal. This study aimed to evaluate the therapeutic effects of intraarterial chemotherapy with gemcitabine and cisplatin on locally advanced or recurrent SCC of the penis. Between April 1999 and May 2011, we treated 5 patients with locally advanced penile SCC and 7 patients with recurrent disease with intraarterial chemotherapy. The response rate and toxicity data were analyzed, and survival rates were calculated. After 2 to 6 cycles of intraarterial chemotherapy with gemcitabine and cisplatin, 1 patients with locoregionally advanced disease achieved a complete response, and 4 achieved partial response. Of the 7 patients with recurrent disease, 2 achieved complete response, 3 achieved partial response, 3 had stable disease, and 1 developed progressive disease. An objective tumor response was therefore achieved in 10 of the 12 patients. The median overall survival for the patients was 24 months (range, 10-50 months. Three out of 10 patients who responded were long-term survivors after intraarterial chemotherapy. Intraarterial chemotherapy with gemcitabine and cisplatin may be effective and potentially curative in locoregionally advanced or recurrent penile SCC. The contribution of this therapy in the primary management of advanced or recurrent penile SCC should be prospectively investigated.

Hui Han

2013-11-01

408

Real-time software platform design for in-vivo navigation of a small ferromagnetic device in a swine carotid artery using a magnetic resonance imaging system.  

Science.gov (United States)

Using an 1.5T Siemens clinical Magnetic Resonance Imaging system (MRI), a 1.5 mm diameter ferromagnetic bead is moved across a pre-planned path in the carotid artery of a 25 kg living swine. The software architecture for the navigation and path planning is herein described. Using the real-time feedback capabilities of recent MRIs, the device is moved, controlled and tracked using the magnetic gradients coils already present for imaging purposes. Navigation of the ferromagnetic device has been achieved with a peak velocity of about 13 cm/s through a set of pre established 11 waypoints. The dedicated software architecture presented in this paper lies in a modified real-time MRI imaging sequence. The dedicated architecture permits the navigation of the ferromagnetic bead with an operating frequency of 24 Hz Real-time control of the magnetic core is achieved through the implementation of a simple 2D PID controller incorporated in the presented software platform. PMID:18003534

Chanu, A; Martel, S

2007-01-01

409

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)

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.

Long, Ronan M

2012-01-31

410

What is the origin of the arterial vascularization of the corpora cavernosa? A computer-assisted anatomic dissection study.  

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The purpose of this study was to identify the microscopic arterial vascularization of the corpora cavernosa (CC) of the penis using computer-assisted anatomic dissection (CAAD), determine the contribution of the different penile arteries towards this vascularization, detail the nature of cavernospongiosum shunts, and locate the anastomoses between these different arteries. Tissue specimens were taken from five donors who donated their bodies to science. The specimens were fixed in 10% formalin and sliced into a series of five 5-?m sections at intervals of 200 ?m. The first section was stained with hematoxylin-eosin or Masson's trichrome and the second with anti-protein S100. The cavernous artery of the penis is not the only source of arterial vascularization of the CC. In four of the five cases studied, we found two to four perforating branches arising from the dorsal arteries of the penis that join up with the cavernous artery of the penis or that are solely responsible for the vascularization of the distal third of the penis. The bulbo-urethral and urethral arteries are situated outside of the tunica albuginea of the corpus spongiosum on their lateral and dorsal sides. The anastomoses do not occur between the cavernous artery of the penis and the corpus spongiosum but between the cavernous artery of the penis and the urethral artery on the surface of the tunica albuginea. All of these arteries are accompanied by nerve branches. The CC were found to be vascularized by both cavernous and dorsal arteries of the penis. Intrapenile vascularization is organized around four arterial axes, which are anastomosed by multiple neurovascular shunts. PMID:23981086

Diallo, Djibril; Zaitouna, Mazen; Alsaid, Bayan; Quillard, Jeannine; Droupy, Stéphane; Benoit, Gérard; Bessede, Thomas

2013-11-01

411

Segmental arterial mediolysis in a preterm.  

Science.gov (United States)

We firstly report on a dystrophic preterm infant with segmental arterial mediolysis (SAM) found in arteries of placental, umbilical and cerebral tissues. These arterial lesions of unknown etiology developing in the elderly are characterized by segmental lysis of the abdominal splanchnic arteries followed by aneurysms and acute bleeding. Typically, the lesions occur in a skip pattern. We could find a small number of SAM in the spleen but much more in placental and umbilical tissues. Rarely, a vascular elastosis and splitting of individual vessels in the spleen and lung could be detected. The histological findings are similar to that of adult patients. PMID:15224122

Eifinger, Frank; Fries, Jochen; Bald, Rainer; Körber, Friederike; Kribs, Angela; Roth, Bernhard

2004-07-01

412

Isolating and using sections of bovine mesenteric artery and vein as a bioassay to test for vasoactivity in the small intestine  

Science.gov (United States)

Mammalian gastrointestinal systems are constantly exposed to compounds (desirable and undesirable) that can have an effect on blood flow to and from that system. Changes in blood flow to the small intestine can result in effects on the absorptive functions of the organ. Particular interest in toxins...

413

Renal artery stenting via brachial artery approach  

International Nuclear Information System (INIS)

Objective: To assess the effectiveness and safety of brachial artery access for percutaneous renal artery stenting. Methods: From January 2002 to January 2005, transbrachial artery renal angioplasty and stenting(RAS) was performed in 8 patients(7 males, 1 female)with severe renal artery stenosis. Imaging assessment of the target renal artery was performed before all procedures, which precluded the possibility of femoral approach. Either long guiding sheath or otherwise pigtail methods were selected according to patients' status for evaluation of the target renal artery during the procedure. Monitoring the blood pressure and renal function was followed up of 6 months after the procedure. Results: The technical success was 100% with no procedure-related complication and good outcome follow up to 6 months. Conclusion: Brachial artery access for renal artery stenting is a safe and technically feasible for renal artery stenosis, providing an alternative for unsuitable femoral approach. (authors)

414

Comparing the pre-operative and post-operative data of penile prosthetic implants with and without antibiotics  

Directory of Open Access Journals (Sweden)

Full Text Available Objective: The aim of this study is to evaluate surgical results and postoperative results of men diagnosed with organic erectile dysfunction (ED who underwent penile prosthesis (antibiotic-coated vs. non-coated implantation in the last 13 years. Additionally, we compared the frequency of complications between the two groups.Materials and methods: In the last 13 years, 202 men diagnosed with organic erectile dysfunction (ED had previously undergone penile prosthesis implantation. Patient data were evaluated retrospectively. Of the 202 patients, 175 were included to the study. The mean age of patients was 57.5 (34-83 years. Preoperatively, a physical examination, medical and sexual history, International Index of Erectile Function (IIEF questionnaire, Combined Injection and Stimulation (CIS test and, if necessary, Nocturnal Penile Tumescence (NPT / Penile Doppler ultrasonography (US were performed in all cases. Results: All patients were diagnosed with organic ED. We determined that 43 (21% patients had diabetes mellitus, 53 (26% had a history of radical pelvic surgery, 38 (19% had cardiovascular pathology and 19 (9% had other reasons for ED. Approximately 98% of patients and their partners were satisfied with the surgical results of the penile prosthesis operation. Conclusion: The infection rate results in the present study were not statistically significant, and the number of patients in our study was not sufficient to make reliable conclusions. Studies with a larger sample sizes are needed.

Yi?it Ak?n

2012-03-01

415

Tissue engineering penoplasty with biodegradable scaffold Maxpol-T cografted autologous fibroblasts for small penis syndrome.  

Science.gov (United States)

In this study, we investigated the safety and efficacy of a poly acid-co-glycolide biodegradable scaffold (Maxpol-T) coated by autologous fibroblasts (AF) for penile girth enlargement in small penis syndrome (SPS). Eighty patients with SPS were enrolled in a clinical study at 2 medical centers; 69 patients completed the study protocol. Scrotal skin was harvested under local anesthesia, and AFs were cultured and seeded on a Maxpol-T scaffold; the cografted scaffold was implanted under the Buck's fascia of penile shaft via a circumcising incision. Patients were followed up at 1, 3, and 6 months to evaluate penile girth changes. Patient satisfaction was assessed via Visual Analogue Scale and scored on the International Index of Erectile Function-5 (IIEF-5). Mean preoperative penile girth in the flaccid and erect state was 8.18 ± 0.83 cm and 10.26 ± 1.22 cm, respectively. At the 6-month postoperative follow-up, mean penile girth in the flaccid and erect state was increased to 12.19 ± 1.27 cm and 13.18 ± 1.31 cm, respectively (P < .001 for change in both flaccid and erect state). Sixty-five patients (94.2%) reported satisfaction with the procedure. Among them, 4 cases (5.8%) were dissatisfied, 7 cases (10.1%) were satisfied, 26 cases (37.7%) were very satisfied, and 32 cases (46.4%) were extremely satisfied. All men maintained IIEF-5 scores of more than 22. Complications included prolonged subcutaneous edema in 3 patients (4.3%) and pinpoint erosion at the suture area in 3 patients (4.3%). Implantation of autologous fibroblasts seeded on a Maxpol-T collagen scaffold holds promise as a safe and novel technique for penile girth enhancement in patients with SPS. PMID:21164145

Jin, Zhe; Wu, Yi-Guang; Yuan, Yi-Ming; Peng, Jing; Gong, Yan-Qing; Li, Guang-Yong; Song, Wei-Dong; Cui, Wan-Shou; He, Xue-You; Xin, Zhong-Cheng

2011-01-01

416

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)

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.

Jensen, P E; Hughes, A

1993-01-01

417

Coronary Artery Bypass Graft  

Medline Plus

Full Text Available ... known as coronary arteries. Symptoms and Their Causes Cholesterol deposits accumulate in the coronary arteries, forming “plaques” ... Healthy diet and medications that lower your blood cholesterol can help slow the process that clogs arteries. ...

418

Heart transplantation and arterial elasticity  

Directory of Open Access Journals (Sweden)

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

Colvin-Adams M

2013-12-01

419

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 scintigr