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1

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.)

2

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

3

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

4

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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. H...

Prieto, D.; Kaminski, Pm; Bagi, Z.; Ahmad, M.; Wolin, Ms

2010-01-01

5

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

6

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

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

Necati Gürbüz; Bedi Özbay; Nadir Kalfazade; Serdar Karada?; Eray Kemahl?; Muzaffer Ba?; Ali ?hsan Ta?ç?

2009-01-01

7

Correlation between penile cavernosal artery blood flow and retinal vascular findings in arteriogenic erectile dysfunction  

Directory of Open Access Journals (Sweden)

Full Text Available Ahmed M Emarah1, Shawky M El-Haggar2, Ihab A Osman2, Abdel Wahab S Khafagy21Departments of Ophthalmology, 2Andrology and Sexology, Cairo University Hospital, EgyptObjectives: Arteriogenic erectile dysfunction (ED is a target organ disease of atherosclerosis, and therefore might be a predictor of systemic atherosclerosis. Being systemic, it might be possible to evaluate the extent of atherosclerosis from retinal vascular findings. We investigated the possible correlation between penile cavernosal artery blood flow and retinal vascular findings in patients with arteriogenic ED.Patients and methods: Sixty patients with ED were divided according to the peak systolic velocity (PSV in their penile cavernosal arteries into two groups; Group A included 30 patients with PSV less than 25 cm/sec, and Group B included 30 patients with PSV more than 35 cm/sec. Blood flow in the penile cavernosal artery was measured with color Doppler ultrasonography. All patients were assessed by ocular fundus examination under amydriatic conditions to evaluate retinal vascular atherosclerotic changes using Hyman’s classification.Results: Evidence of retinal vascular atherosclerotic changes was found in 19 patients (63.3% in Group A and in 10 patients (33.3% in Group B.Conclusions: Our study confirms the possibility of predicting penile arterial vascular status in patients with ED from their retinal vascular findings by using amydriatic simple, practical funduscopy.Keywords: erectile dysfunction, atherosclerosis, retinal vascular atherosclerosis

Ahmed M Emarah

2010-09-01

8

[Surgical mangement of erectile impotence with special reference to Small-Carrion penil prosthesis (author's transl)].  

Science.gov (United States)

Due to increasing number of radical surgeries for malignant tumors of the pelvis the incidence of iatrogenically caused erectile impotence rises. Available surgical management comprises implantation of rigid penile prothesis or inflatable device. The authors prefer a rigid implant (Small-Carrion penile prothesis) on account of its simplicity and have been impressed with the results. PMID:848193

Das, S P; Gottesman, J E; Kösters, S A

1977-01-01

9

Nitric Oxide: A Physiologic Mediator of Penile Erection  

Science.gov (United States)

Nitric oxide (NO) is a cytotoxic agent of macrophages, a messenger molecule of neurons, and a vasodilator produced by endothelial cells. NO synthase, the synthetic enzyme for NO, was localized to rat penile neurons innervating the corpora cavernosa and to neuronal plexuses in the adventitial layer of penile arteries. Small doses of NO synthase inhibitors abolished electrophysiologically induced penile erections. These results establish NO as a physiologic mediator of erectile function.

Burnett, Arthur L.; Lowenstein, Charles J.; Bredt, David S.; Chang, Thomas S. K.; Snyder, Solomon H.

1992-07-01

10

Penile abnormalities  

Directory of Open Access Journals (Sweden)

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

11

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

International Nuclear Information System (INIS)

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

12

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

Energy Technology Data Exchange (ETDEWEB)

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

13

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 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)

14

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

Energy Technology Data Exchange (ETDEWEB)

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

15

Pulsed and Color Doppler Sonographic Findings of Penile Mondor's Disease  

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This report describes the color and pulsed Doppler US findings of penile Mondor's disease. The pulsed Doppler US findings of penile Mondor's disease have not been previously published, so we report here for the first time on the cavernosal arterial flow signal pattern of penile Mondor's disease. Penile Mondor's disease is rare disease that's characterized by thrombosis in the dorsal vein of the penis. The previous reports on penile Mondor's disease are concerned with the color Doppler US find...

Han, Hye Yeon; Chung, Dong Jin; Kim, Kum Won; Hwang, Cheol Mog

2008-01-01

16

Unsuspected distal penile artery disease as demonstrated with pudendal angiography in patients with major pelvic trauma  

International Nuclear Information System (INIS)

To assess the relationship between trauma and arteriogenic impotence, the authors have compared the distribution of hemodynamically significant arterial lesions in a group of men who became impotent after major pelvic trauma (N = 27) with that in a group of impotent men with no history of trauma (N = 87) and with that in a group of impotent men who had sustained minor pelvic or perineal trauma that was not temporally related to the onset of impotence (N = 81). No significant difference was found (P>10). In all trauma subgroups, most of the disease was concentrated in the cavernosal arteries

17

Structure and function of small arteries  

DEFF Research Database (Denmark)

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

Mulvany, M J; Aalkjær, Christian

1990-01-01

18

Penile Dysplasia  

Science.gov (United States)

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

19

Penile Trauma  

Science.gov (United States)

... Prostatic Hyperplasia/Enlarged Prostate) C Cancer of the Ureter and Renal Pelvis Circumcision Cloacal Exstrophy Complete Blood Count (CBC) Conn's Syndrome Continent Urinary Diversion Contrast and Radionuclide ... Kidneys Ectopic Ureter ED: Non-Surgical Management (Erectile Dysfunction) ED: Penile ...

20

Penile cavernosal artery pseudoaneurysm.  

Science.gov (United States)

A patient presented with a mass in the cavernous body. The mass, 1 cm in diameter, was detected in the left cavernous body on the MRI and color Doppler ultrasound of the penis of the patient, who presented with pain approximately 3 months after a blunt trauma to the pelvic region. According to the statement of the patient, any direct trauma to the penis was obscure. The lesion was resected and pathological examination of the removed mass revealed pseudoaneurysm. PMID:22096087

Köse, Osman; Sa?lam, Hasan S; Adsan, Oztu?

2012-01-01

 
 
 
 
21

Devastating penile mycosis leading to penile gangrene.  

Science.gov (United States)

Infective penile gangrene is a rare but known complication of circumcision. The causes may vary from neutropenia, diabetes mellitus, and human immunodeficiency virus infection to lymphoproliferative malignancy. Penile mycosis leading to penile gangrene is a rare entity. Only 1 case has been reported in an adult. Juvenile diabetes mellitus is a peculiar predisposing factor for mycotic infections. We report a case of mycotic penile gangrene in a diabetic child to highlight its potentially preventable disastrous outcome. PMID:23830080

Hombalkar, N N; Vaze, Dhananjay; Guha, Poonam; Dhandore, Priya D; Gurav, Prakash D

2013-09-01

22

Minimally Invasive Penile Implant Surgery  

Medline Plus

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

23

Large artery: an important target for cerebral small vessel diseases.  

Science.gov (United States)

Large arteries are the upstream vessels of cerebral small vessels, through which blood flow is transported. Since structurally and functionally connected, large arteries and cerebral small vessels are physiologically correlated. However, large vessel diseases and small vessel diseases are investigated separately in old era. More and more evidence suggested they are inter-mingled and should be considered together. When a deep brain lacunar infarct occurs, it is of necessity to perform high-resolution magnetic resonance imaging to screen intracranial large artery atherosclerosis, which requires more intensified treatment. It may be the appropriate strategy to keep longitudinal monitoring of the trend of large artery stiffness and give intervention such as aggressive blood pressure control to prevent cerebral white matter lesions (WMLs) occurrence or progression. More data from cohort studies are required, especially the biomarkers of "diseased" artery stiffness. In the future, when randomized clinical trials are performed, the end points should take both large artery and small vessel damages into consideration. The two diseases are in the same "boat", i.e., the pan-vessel diseases. In order to save one, we have to save both. PMID:25333053

Xu, Wei-Hai

2014-08-01

24

Erectile dysfunction after radiotherapy for prostate cancer and radiation dose to the penile structures: A critical review  

International Nuclear Information System (INIS)

Erectile dysfunction (ED) is a common sequela after external beam radiotherapy and brachytherapy for prostate cancer. There are several structures in the vicinity of the prostate that are critical to erectile function and that receive a substantial radiation dose: neurovascular bundles (NVBs), internal pudendal arteries (IPAs), accessory pudendal arteries, corpora cavernosa and the penile bulb. Most reports analyzing the correlation between radiation dose to these structures and radiation-induced ED are limited by the small number of patients analyzed in each study. So far, there is no evidence for a role of the NVBs in radiation-induced ED. There are no reports on the IPAs, based on reduced arterial flow in the penis. Several studies show contradicting results on the corpora cavernosa, which house the erectile tissue required for erection. There are contradicting reports on the penile bulb, although studies with more patients tend not to find any correlation. Sparing of the penile bulb to improve potency-preservation is not sufficiently supported by the current literature. If sparing of the penile bulb is achieved by reducing the margin for the apex, an oncological risk is taken, while it is uncertain whether this will improve potency-preservation

25

Chronic penile strangulation  

Directory of Open Access Journals (Sweden)

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

Roberto I Lopes

2003-08-01

26

Chronic penile strangulation  

Scientific Electronic Library Online (English)

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

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

2003-08-01

27

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

28

Genetic fuzzy system predicting contractile reactivity patterns of small arteries.  

Science.gov (United States)

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

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

2014-01-01

29

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

30

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

31

Evaluation of arteriogenic impotence: A nonselective penile angiographic technique performed after intracorporal papaverine injection  

International Nuclear Information System (INIS)

Arteriogenic impotence was evaluated in 18 patients using aortic contrast agent injections performed during early penile tumescence. Erections were pharmacologically induced by administering papaverine directly into the corpora cavernosa. Six patients underwent angiography both before and after papaverine administration. The penile vessels were diagnostically seen on all 18 postpapaverine angiograms. On none of the six prepapaverine angiograms were penile vessels identified. Arteriogenic impotence correlated most accurately with the presence and quality of the cavernosal arteries. The location and pattern of arterial lesions could frequently be categorized according to the patient's underlying disease (diabetes, atherosclerosis, trauma). Arterial and venosinusoidal insufficiency commonly coexist

32

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

33

Minimally Invasive Penile Implant Surgery  

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

34

Minimally Invasive Penile Implant Surgery  

Medline Plus

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

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 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

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

37

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 distinguish branch artery pseudoaneurysms from penetrating ulcers.

38

Decellularized ovine arteries as small-diameter vascular grafts.  

Science.gov (United States)

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

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

2014-08-01

39

Penile subcutaneous fibrolipoma postaugmentative phalloplasty.  

Science.gov (United States)

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

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

2013-01-01

40

[Brachytherapy for penile carcinoma].  

Science.gov (United States)

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

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

2013-04-01

 
 
 
 
41

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)

42

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

43

Penile abscess and necrotizing fasciitis secondary to neglected false penile fracture  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

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

2010-01-01

44

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

45

Complications of trans-bronchial arterial chemo-embolization for non-small cell lung cancer  

International Nuclear Information System (INIS)

Objective: Retrospectively evaluate the incidence and correlative factors of complication of transcatheter bronchial arterial chemo-embolization for the treatment of non-small cell lung cancer. Methods: Transcatheter bronchial arterial embolization was performed in 135 cases of non-small cell lung cancer. Bronchial arterial angiograms were taken prior to confirm the blood supply route of the lesions. Chemo- embolization was then performed through the catheterized bronchial artery or the super-selected catheterized branches with co-axial technique. Chemotherapy was taken first with the perfusion of combined three drugs: carboplatin 300 mg, MMC 10-20 mg or Epirubicin 40-60 mg, 5-FU 1000 mg; and then followed by bronchial arterial embolization with gelfoam particles or lipiodol separately. Results: Complications happened in 5.9% cases, including 1 case of spinal medullary ischemia (0.7%), 5 cases of intercostal artery ischemic syndrome(3.7%), and 2 cases of pulmonary artery embolization(1.5%). All complications were relieved after one to four weeks treatment. Spinal medullary ischemic and intercostal ischemic syndrome occurred both in the cases of main bronchial arterial embolization. Spinal medullary ischemia and pulmonary arterial embolization only happened in patients embolized with lipiodol, while intercostal ischemic syndrome was seen in both gelfoam particles and lipiodol embolization. Conclusions: Transcatheter bronchial arterial embolization should be performed carefully. Super-selective catheterization with gelfoam particles is the method of choice to avoid potential ischemic complications. (authors)

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

Minimally Invasive Penile Implant Surgery  

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Full Text Available ... MD: Wow, that’s fantastic. Okay, another question. The success rate of the inflatable penile prosthesis. 00:17:45 J. FRANCOIS EID, MD: The inflatable penile prosthesis is probably one of the most successful device in the history of medicine. These devices are ...

48

Minimally Invasive Penile Implant Surgery  

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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 ...

49

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

50

Minimally Invasive Penile Implant Surgery  

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Full Text Available ... last 300 penile prostheses. All of these were Titan three-piece penile prostheses, so what you’re ... mechanism, which is a beautiful aspect of the Titan – 00:40:23 IRWIN GOLDSTEIN, MD: Where’s this ...

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Minimally Invasive Penile Implant Surgery  

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Full Text Available ... abstract where I reviewed my last 300 penile prostheses. All of these were Titan three-piece penile prostheses, so what you’re going to see today, ... in a Dacron cloth and then put some material called Paralene in between. This is an interesting ...

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Dynamic analysis of a small artery of a human finger by optical coherence tomography  

Science.gov (United States)

OCT is highly potential for development of a new field of dynamic skin physiology, as recently reported by the authors. In this paper, we demonstrate dynamic analysis of a small artery of a human finger by the SS-OCT. Among the vascular system, only the small artery has two physiological functions both for the elastic artery (like main and middle arteries) and for muscle-controlled one (like arterioles). It, therefore, is important for dynamic analysis of blood flow and circulation. In the time-sequential OCT images obtained with 25 frames/s, 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, reflecting activity of the sympathetic nerve. The dynamic OCT 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.

Kuwabara, Mitsuo; Takahashi, Natsuki; Takada, Daisuke; Ohmi, Masato; Haruna, Masamitsu

2011-03-01

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

Energy Technology Data Exchange (ETDEWEB)

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

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

1989-04-01

54

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

International Nuclear Information System (INIS)

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

55

Does prolonged semi-erection in prepubertal high flow priapism result in increased penile size?  

Directory of Open Access Journals (Sweden)

High flow priapism is a rare pathology resulting mainly from trauma to the perineum leading to arterial-lacunar fistula. Management includes arterial embolization using absorbable material, as well as conservative approach. In this case, the effect of prolonged semi-erection in prepubertal high flow priapism on increased penile size is discussed.

Ziad M. Awwad

2005-03-01

56

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

Bucca, Caterina; Rolla, Giovanni

1980-01-01

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Embolization for Acute Small-Bowel Bleeding from the Collateral Artery of the Superior Mesenteric Left Deep Circumflex Iliac Artery Associated with Narrowing of the Bilateral Common External Iliac Arteries  

International Nuclear Information System (INIS)

We present a case of acute small-bowel bleeding from the collateral artery of the superior mesenteric-left deep circumflex iliac artery that was successfully managed by transarterial coil embolization.

58

A review of penile metastasis  

Directory of Open Access Journals (Sweden)

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

Elisabetta Nunzi

2012-03-01

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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

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Minimally Invasive Penile Implant Surgery  

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

 
 
 
 
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Minimally Invasive Penile Implant Surgery  

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Full Text Available ... to limit that portion to the smallest amount proportion of the cylinder. So if a cylinder is ... minimally invasive penile implant. Any of the objective data that I’m going to give you today ...

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Minimally Invasive Penile Implant Surgery  

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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 ...

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Minimally Invasive Penile Implant Surgery  

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

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Minimally Invasive Penile Implant Surgery  

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Full Text Available ... of thousands of men for the past 20 years. OR-Live makes it easy for you to ... in penile implant surgery for the last 35 years, since the initial U.S. experience in the early ...

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Minimally Invasive Penile Implant Surgery  

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Full Text Available ... of penile implant surgery. For men with severe erectile dysfunction, the condition generally cannot be treated by popular ... implant surgery for the treatment of men with erectile dysfunction. While technically the initial concept is still the ...

66

Minimally Invasive Penile Implant Surgery  

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Full Text Available ... live panel discussion of penile implant surgery. For men with severe erectile dysfunction, the condition generally cannot ... body during surgery. To inflate the prosthesis, the man just presses on the pump. The pump transfers ...

67

Minimally Invasive Penile Implant Surgery  

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Full Text Available ... is 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 ...

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Minimally Invasive Penile Implant Surgery  

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Full Text Available MINIMALLY INVASIVE PENILE IMPLANT SURGERY CORAL GABLES HOSPITAL CORAL GABLES, FLORIDA March 26, 2007 00:00:10 ANNOUNCER: Over ... have advanced the surgery by using new, minimally invasive surgical techniques. Such techniques potentially reduce the infec— ...

69

Minimally Invasive Penile Implant Surgery  

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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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Minimally Invasive Penile Implant Surgery  

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

71

Minimally Invasive Penile Implant Surgery  

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

72

Minimally Invasive Penile Implant Surgery  

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Full Text Available ... While technically the initial concept is still the same – that is, placement of a penile prosthetic device ... preparation or does your prep pretty much the same? 00:07:12 PAUL PERITO, MD: Our prep ...

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Minimally Invasive Penile Implant Surgery  

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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 ...

74

Minimally Invasive Penile Implant Surgery  

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

75

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

76

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.)

77

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

78

Small artery reconstruction with a new vascular prosthesis.  

Science.gov (United States)

In the Surgical Department of the University of Erlangen, 307 reconstructions in all areas of the arterial tree were performed with PTFE (GORE-TEX) grafts, of which 188 were performed in the femoral-popliteal and femoral-crural areas. Femoral-popliteal bypass grafts above the knee joint remained patent in 93% of the patients during an average follow-up time of 6.7 months. Below the knee joint, the patency rate was 85% during an average follow-up time of 5.6 months. In the proximal aorta, aorta-renal, and aorta-femoral areas, long-term results with the PTFE graft have been excellent. PMID:7405260

Raithel, D; Groitl, H

1980-01-01

79

Vasodilator effects of adrenomedullin on small pulmonary arteries and veins in anaesthetized cats  

Science.gov (United States)

This study was conducted to determine adrenomedullin (AM) action sites in the pulmonary vascular bed and the relation between its vasodilator effects and vascular tone. Moreover, an examination was made into whether calcitonin gene-related peptide (CGRP) receptors mediate pulmonary vasodilatations induced by AM. To this end, we directly measured internal diameter (i.d.) changes in small pulmonary arteries and veins (100–1100??m i.d.) by use of an X-ray televison system on the in vivo cat lung. Under control (resting vascular tone) conditions, AM injections into the left main pulmonary artery caused dose-related i.d. increases in both small arteries and veins. The mean i.d. increase of the 100–1100??m arteries (4±1, 11±2, and 17±2% with 0.01, 0.1, and 1?nmol?kg?1 AM, respectively) was significantly larger than that for the veins (1±1, 5±2, and 7±2% with 0.01, 0.1 and 1?nmol?kg?1 AM, respectively) whatever the injected dose of AM. When unilobar hypoxia (5% O2) had decreased the i.d. of the 100–1100??m arteries and veins by 16±3 and 6±3%, respectively, AM (0.1?nmol?kg?1) was able to induce significantly larger i.d. increases in the arteries (28±3%) and veins (11±3%) than those under control conditions. The AM-induced i.d. response pattern in the serially connected pulmonary arteries was quite different from that induced by CGRP; AM caused a greater increase in smaller vessels (100–500??m) than in larger vessels (500–1100??m). In the case of CGRP, a greater increase was observed in the larger vessels. CGRP8–37 (100?nmol?kg?1, i.v., followed by a continuous infusion of 0.2?nmol?kg?1?min?1) had no significant effect on the i.d. increase induced by AM (0.1?nmol?kg?1) in any serial segments of the arteries and veins. The results indicate that, in the cat, AM induces greater vasodilatation in small pulmonary arteries and lesser vasodilatation in small veins, the maximum dilatation being in the more peripheral arterial segment (100–500??m). The vasodilator effect of AM was enhanced when vascular tone was elevated. The data suggest that the AM-induced pulmonary vasodilatation is not mediated by CGRP receptors but by its own specific receptor. PMID:9208134

Shirai, Mikiyasu; Shimouchi, Akito; Ikeda, Soichiro; Ninomiya, Ishio; Sunagawa, Kenji; Kangawa, Kenji; Matsuo, Hisayuki

1997-01-01

80

Neurogenic Contraction Induced by the Antiarrhythmic Compound, AVE 0118, in Rat Small Mesenteric Arteries.  

Science.gov (United States)

The purpose of this study was to investigate the vasoactivity of two inhibitors of potassium ion (K(+) ) channels, a potential antiarrhythmic compound, AVE 0118, and 4-aminopyridine (4-AP). Basal and stimulated tones of rat small mesenteric arteries as well as the possible involvement of KV 1.5 ion channel in the mechanism of vascular effect induced by the compounds were analysed. The standard organ bath technique for vascular tone and immunohistochemistry for the localization of ion channels in the arterial tissue were performed. Third- or fourth-order branch of arterial segments was mounted in myographs for recording the isometric tension. AVE 0118 (10(-5)  M) and 4-AP (10(-5)  M) modulated neither the basal tone nor the contraction induced by noradrenaline but increased the contraction evoked by electrical field stimulation, sensitive to the block of alpha-1 adrenergic receptors. KV 1.5 ion channel-specific immunostaining demonstrated the presence of immunoreactive nerves, and Schwann-cell-specific (S100) immunostaining confirmed the presence of myelin sheath in rat small mesenteric arteries. The study supports an indirect, sympathetic effect of AVE 0118 similar to that of 4-AP, which is mediated, at least in part, by blocking neuronal KV 1.5 type potassium ion channels in the medio-adventitial layer of rat small mesenteric artery. PMID:24629214

Kun, Attila; Seprényi, György; Varró, András; Papp, Julius Gy; Pataricza, János

2014-10-01

 
 
 
 
81

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

Directory of Open Access Journals (Sweden)

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

Staji? Zoran

2013-01-01

82

Endothelium-derived Relaxing Factors of Small Resistance Arteries in Hypertension  

Science.gov (United States)

Endothelium-derived relaxing factors (EDRFs), including nitric oxide (NO), prostacyclin (PGI2), and endothelium-derived hyperpolarizing factor (EDHF), play pivotal roles in regulating vascular tone. Reduced EDRFs cause impaired endothelium-dependent vasorelaxation, or endothelial dysfunction. Impaired endothelium-dependent vasorelaxation in response to acetylcholine (ACh) is consistently observed in conduit vessels in human patients and experimental animal models of hypertension. Because small resistance arteries are known to produce more than one type of EDRF, the mechanism(s) mediating endothelium-dependent vasorelaxation in small resistance arteries may be different from that observed in conduit vessels under hypertensive conditions, where vasorelaxation is mainly dependent on NO. EDHF has been described as one of the principal mediators of endothelium-dependent vasorelaxation in small resistance arteries in normotensive animals. Furthermore, EDHF appears to become the predominant endothelium-dependent vasorelaxation pathway when the endothelial NO synthase (NOS3)/NO pathway is absent, as in NOS3-knockout mice, whereas some studies have shown that the EDHF pathway is dysfunctional in experimental models of hypertension. This article reviews our current knowledge regarding EDRFs in small arteries under normotensive and hypertensive conditions.

2014-01-01

83

Penile injuries: A 10-year experience.  

Science.gov (United States)

We report our 10-year experience with penile injuries. We retrospectively reviewed the records of 156 cases of male external genitalia injuries between May 2002 and December 2012. Of these, only 26 patients presented without urethral injuries and were included in this study. Patients were divided into 4 groups: Group 1 (n = 12) with patients with penile fractures injuries; Group 2 (n = 5) with patients with penile amputation injuries; Group 3 (n = 2) with patients with penile penetrating injuries; and Group 4 (n = 7) with patients with penile soft tissue injuries. Grading of injury was done using the American Association for the Surgery of Trauma (AAST)-Organ injury scale of penile injury. Penile injuries without urethral injuries are urological emergencies which require immediate attention. PMID:25295134

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

2014-09-01

84

Penile injuries: A 10-year experience  

Science.gov (United States)

We report our 10-year experience with penile injuries. We retrospectively reviewed the records of 156 cases of male external genitalia injuries between May 2002 and December 2012. Of these, only 26 patients presented without urethral injuries and were included in this study. Patients were divided into 4 groups: Group 1 (n = 12) with patients with penile fractures injuries; Group 2 (n = 5) with patients with penile amputation injuries; Group 3 (n = 2) with patients with penile penetrating injuries; and Group 4 (n = 7) with patients with penile soft tissue injuries. Grading of injury was done using the American Association for the Surgery of Trauma (AAST)-Organ injury scale of penile injury. Penile injuries without urethral injuries are urological emergencies which require immediate attention. PMID:25295134

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

2014-01-01

85

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.

86

Does prolonged semi-erection in prepubertal high flow priapism result in increased penile size?  

International Nuclear Information System (INIS)

High flow priapism is a rare pathology resulting mainly from trauma to the perineum leading to arteliar-lacunar fistula. Management includes arterial embolization using absorbable material, as well as conservative approach. In this case, the effect of prolonged semi-erection in prepubertal high flow priapism on increased penile size is discussed. (author)

87

Minimally Invasive Penile Implant Surgery  

Medline Plus

Full Text Available ... 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 immediate left is Dr. Francois Eid, clinical associate professor of urology at the Weill Cornell ...

88

Minimally Invasive Penile Implant Surgery  

Medline Plus

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

89

Minimally Invasive Penile Implant Surgery  

Medline Plus

Full Text Available ... for the last 35 years, since the initial U.S. experience in the early 1970s. Today we are ... specialists are doing penile prosthesis cases in the United States? 00:16:27 J. FRANCOIS EID, MD: I ...

90

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 ...

91

21 CFR 876.5020 - External penile rigidity devices.  

Science.gov (United States)

...2010-04-01 2010-04-01 false External penile rigidity devices. 876.5020... Therapeutic Devices § 876.5020 External penile rigidity devices. (a) Identification . External penile rigidity devices are...

2010-04-01

92

Age-related remodeling of small arteries is accompanied by increased sphingomyelinase activity and accumulation of long-chain ceramides.  

Science.gov (United States)

The structure and function of large arteries alters with age leading to increased risk of cardiovascular disease. Age-related large artery remodeling and arteriosclerosis is associated with increased collagen deposition, inflammation, and endothelial dysfunction. Bioactive sphingolipids are known to regulate these processes, and are also involved in aging and cellular senescence. However, less is known about age-associated alterations in small artery morphology and function or whether changes in arterial sphingolipids occur in aging. We show that mesenteric small arteries from old sheep have increased lumen diameter and media thickness without a change in media to lumen ratio, indicative of outward hypertrophic remodeling. This remodeling occurred without overt changes in blood pressure or pulse pressure indicating it was a consequence of aging per se. There was no age-associated change in mechanical properties of the arteries despite an increase in total collagen content and deposition of collagen in a thickened intima layer in arteries from old animals. Analysis of the sphingolipid profile showed an increase in long-chain ceramide (C14-C20), but no change in the levels of sphingosine or sphingosine-1-phosphate in arteries from old compared to young animals. This was accompanied by a parallel increase in acid and neutral sphingomyelinase activity in old arteries compared to young. This study demonstrates remodeling of small arteries during aging that is accompanied by accumulation of long-chain ceramides. This suggests that sphingolipids may be important mediators of vascular aging. PMID:24872355

Ohanian, Jacqueline; Liao, Aiyin; Forman, Simon P; Ohanian, Vasken

2014-05-01

93

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

DEFF Research Database (Denmark)

We have previously characterized a cGMP-dependent Ca(2+)-activated Cl(-) current in vascular smooth muscle cells (SMCs) and have shown its dependence on bestrophin-3 expression. We hypothesize that this current is important for synchronization of SMCs in the vascular wall. In the present study, we aimed to test this hypothesis by transfecting rat mesenteric small arteries in vivo with siRNA specifically targeting bestrophin-3.

Broegger, Torbjoern; Jacobsen, Jens Christian Brings

2011-01-01

94

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

95

Mechanisms involved in the vasorelaxant effect of (-)-stepholidine in rat mesenteric small arteries.  

Science.gov (United States)

The purpose of the present investigation was to clarify whether the hypotensive action of the protoberberine alkaloid, and dopamine receptor antagonist, (-)-stepholidine, can be ascribed to an effect on peripheral small arteries. For this purpose isolated mesenteric small arteries were suspended in microvascular myographs for isometric tension recording. Relaxations mediated by dopamine D1 receptors were antagonized by (-)-stepholidine. (-)-Stepholidine inhibited in a concentration-dependent manner the contractile responses evoked by noradrenaline (10(-6) M), but not the contractile responses evoked by depolarizing solution (KCl, 60 mM) or 9,11-dideoxy-11alpha,9alpha-epoxymethano prostaglandin F2alpha (U46619, 10(-7) M). Mechanical endothelial cell removal, blockade of K+ channels, muscarinic receptors or adrenoceptors did not influence the inhibitory effect of (-)-stepholidine on the contractile response evoked with noradrenaline in the segments. (-)-Stepholidine caused rightward shifts of the concentration-response curves for noradrenaline and phenylephrine. The pA2 values for (-)-stepholidine were 6.05 and 5.94 against noradrenaline and phenylephrine, respectively. Electrical field stimulation induced prazosin-sensitive frequency-dependent contractions in mesenteric small arteries. These contractions were significantly inhibited by 10(-6) and 10(-5) M (-)-stepholidine. In membranes from the rat cerebral cortex labelled with [3H]prazosin, (-)-stepholidine (10(-7)-10(-4) M) completely inhibited the specific binding of the ligand with a pKi of 5.6. The present investigation suggests the inhibitory effect of (-)-stepholidine on the alpha1-adrenoceptor-mediated contractions induced by exogenously added and nerve-released noradrenaline in peripheral small arteries might contribute to a hypotensive effect of the drug. PMID:9988103

Lei, S; Orensanz, L M; Mulvany, M J; Simonsen, U

1999-01-22

96

A high-resolution method with increased matrix size can characterize small arteries around a giant aneurysm in three dimensions.  

Science.gov (United States)

Visualization of the small arteries around a giant intracranial aneurysm remains challenging, even with three-dimensional (3D) rotational angiography. Here we present a new method with the increased matrix size to visualize three-dimensional course of the anterior choroidal artery around a giant aneurysm to help estimate the risk of intraoperative complications. PMID:22712458

Yoshino, Masanori; Kin, Taichi; Shojima, Masaaki; Nakatomi, Hirofumi; Oyama, Hiroshi; Saito, Nobuhito

2012-12-01

97

Comparison of colour coded Duplex sonography and selective penile pharmacoangiography for the evaluation of arteriogenic impotence  

International Nuclear Information System (INIS)

42 patients with suspected vasculogenic impotence were examined via colour Duplex sonographie. Penile vascular anatomy was mapped and peak velocity was determined in both cavernosal arteries before and after intracorporeal injection of 15 mg papaverine and 0,5 mg regitine. In all patients the results could be compared with selective penile pharmacoangiography as the gold standard. In 34/42 patients colour Duplex sonography and angiography led to an identical evaluation of penile blood supply. 4 patients were classified false-negative and 4 patients false-positive. Sensitivity and specificity were calculated for each side separately. Sensitivity was 82.4% for left side angiogram and 83.3% for right side angiogram. Specificity was 88% for left side angiogram and 87.5% for right side angiogram. Peak flow velocity was significantly diminished in pathological angiograms. (orig.)

98

Microneurovascular reimplantation in a case of total penile amputation  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

Bhatt Yogesh; Vyas Kinnari; Srivastava Rajat; Panse Nikhil

2008-01-01

99

Penile prosthesis insertion for acute priapism.  

Science.gov (United States)

Shunt surgery is not universally successful toward detumescence, may lead to erectile dysfunction, and can make eventual penile prosthesis insertion difficult. Penile prosthesis insertion during a priapistic episode alleviates ischemic pain, allows the patient to resume sexual function sooner, and prevents corporal scarring and shortening that makes subsequent prosthesis implantation difficult. PMID:23905940

Tausch, Timothy J; Mauck, Ryan; Zhao, Lee C; Morey, Allen F

2013-08-01

100

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

 
 
 
 
101

Technical Considerations and Outcomes in Penile Replantation  

Science.gov (United States)

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

Biswas, Gautam

2013-01-01

102

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

103

Endothelin-1 stimulates small artery VCAM-1 expression through p38MAPK-dependent neutral sphingomyelinase.  

Science.gov (United States)

Endothelin-1 (ET-1) stimulates vascular cell adhesion molecule (VCAM-1) expression, a process associated with arterial remodelling. However, the pathways activated by ET-1 that lead to VCAM-1 expression are not fully understood. It is reported that sphingomyelinases are necessary for VCAM-1 expression in response to cytokines. Our aim was to investigate the role of sphingomyelinases in ET-1-induced VCAM-1 expression. Acid and neutral sphingomyelinase activities were measured in extracts from rat mesenteric small arteries (RMSA). ET-1 (1-100 nmol/l) stimulated neutral but not acid sphingomyelinase. The activation was rapid, peaking within 5 min and transient, returning towards baseline by 10 min and inhibited by BQ-788, GW4869 and SB203580, which are inhibitors of ET(B) receptor, neutral sphingomyelinase and p38MAPK, respectively. Both GW4869 and SB203580 are reported to inhibit activation of neutral sphingomyelinase 2 implicating it in the response to ET-1. Accordingly we investigated the expression of this isoform and found it was present in RMSA, predominantly in endothelial cells. Treatment of RMSA with ET-1 (1-100 nmol/l) for 16 h increased VCAM-1 expression, which was inhibited by GW4869 and SB203580. These results indicate that ET-1 stimulates arterial VCAM-1 expression through p38MAPK-dependent activation of neutral sphingomyelinases. This suggests a role for sphingolipids in ET-1-induced vascular inflammation in cardiovascular disease. PMID:22627111

Ohanian, Jacqueline; Forman, Simon P; Katzenberg, Gideon; Ohanian, Vasken

2012-01-01

104

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

DEFF Research Database (Denmark)

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

Andersen, Malene R; Uldbjerg, Niels

2011-01-01

105

Penile metastasis of chondrosarcoma of the jaw.  

Science.gov (United States)

Metastasis to the penis is an unusual event. Bladder and prostate tumors are the main sources of penile metastasis. Other sites include the rectosigmoid, kidney, and, less frequently, the pancreas, liver, nasopharynx, and lung. Other sources include malignant melanoma and Burkitt's lymphoma. The differential diagnosis includes idiopathic priapism, venereal or infectious disease, tuberculosis, Peyronie's disease, and primary penile tumor. Chondrosarcoma of the jaw is responsible for 10% of all chondrosarcomas that originate with craniofacial bones. Its behavior is usually characterized by local aggression; however, distant metastasis is uncommon. We report a case of chondrosarcoma of the jaw with penile metastasis. This is the first case described in published medical reports. PMID:12670583

Cardoso Guimarães, Gustavo; Rodrigues De Souza, Ricardo; Paiva Gadêlha Guimarães, Andréa; Filho, Waldec David; Valeschka De Matos Granja, Nara; Karan Kalil, Ricardo; Augusto Soares, Fernando; Lopes, Ademar

2003-04-01

106

Selective Arterial Embolization of Idiopathic Priapism  

International Nuclear Information System (INIS)

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

107

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

108

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.

109

Penile haemodynamic changes in post-radical cystectomy patients.  

Science.gov (United States)

The aim of this study was to assess the penile vascular changes in post-radical cystectomy patients. A prospective assessment took place between January 2003 and January 2005 of 45 potent men who underwent radical cystectomy and diversion for invasive bladder cancer. Nerve sparing (NS) technique was applied in 21 cases, while others were not subjected to NS (non-nerve sparing group; NNS = 24 cases). All patients were comparable in preoperative clinical and pathological parameters. A control arm was the preoperative normal indices of the same patients. Preoperative penile duplex ultrasounds (PDU) for all cases were carried out, and then follow-up 2, 6 and 12 months thereafter. On first postoperative visit, none of NS cases showed any arterial insufficiency, while two cases of NNS (8.3%) had peak systolic velocity (PSV) 5 cm/sec. In NS cystectomy group, the PSV showed statistically insignificant change [p > 0.05 (mean: 53.6, cm/sec)]. Shortly after surgery, the EDV values increased, followed by gradually significant improvement (decrease in EDV values) in comparison with control state (mean: 5.9 cm/sec). On the other hand, the NNS cases showed statistically insignificant changes in PSV (mean: 49.3 cm/sec), with deterioration in EDV that did not improve with time, in contrast to NS cases (mean: 13.15 cm/sec). The main significant penile vascular changes were in EDV (venogenic mechanism) in post-cystectomy patients. There was a gradual progressive improvement in venogenic competence mechanism in NS cases with insignificant deterioration of arteriogenic mechanism in both groups (NS/NNS). PMID:20158540

Hekal, I A; Mosbah, A; El-Bahnasawy, M S; El-Assmy, A; Shaaban, A

2011-02-01

110

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

DEFF Research Database (Denmark)

Objective Structural abnormality of resistance arteries is a characteristic pathophysiological phenomenon in essential hypertension and can be assessed in vitro as an increase in the media : lumen ratio (M : L) of isolated small arteries. We have investigated whether M: L is a risk predictor in uncomplicated essential hypertensive patients. Recently, high M: L was demonstrated as a prognostic marker in patients at high cardiovascular risk, including normotensive type 2 diabetic patients. Since diabetes is associated with pressure-independent changes in M: L, the relevance of this finding to essential hypertension has been uncertain. Methods We conducted a follow-up survey of 159 essential hypertensive patients, who had previously been submitted to a M: L evaluation while participating in a clinical trial. They composed a homogeneous moderate-risk group, with no concomitant diseases, and represented 1661 years of follow-up. Results Thirty patients suffered a documented predefined cardiovascular event during follow-up. Increased relative risk (RR) was associated withM: L>-0.083 (mean level of the hypertensive cohort), RRU2.34 [95% confidence interval (CI) 1.11-4.95], and with M: L>-0.098 (mean level of a normotensive control groupR2SD), RRU2.49 (95% CI 1.21-5.11). Both results remained significant (RRU2.19, 95% CI 1.04-4.64, and RRU2.20, 95% CI 1.06-4.56, respectively) when adjusted for Heart Score level (10-year mortality risk-estimate, integrating age, gender, systolic blood pressure, cholesterol and smoking). Conclusion Abnormal resistance artery structure independently predicts cardiovascular events in essential hypertensive patients at moderate risk. J Hypertens 25:1021-1026 Q 2007 Lippincott Williams & Wilkins. Journal of Hypertension 2007, 25:1021-1026

Mathiassen, Ole Norling; Buus, Niels Henril

2007-01-01

111

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

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

International Nuclear Information System (INIS)

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

113

Cuerpos extraños en pene / Penile foreign bodies  

Scientific Electronic Library Online (English)

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

Héctor, Pastor Navarro; María José, Donáte Moreno; Pedro, Carríón López; Miguel, Segura Martín; Juan Gabriel, Lorenzo Romero; José María, Pastor Guzmán; J., Payá Berbegal; Saturnino, Lujan Marco; Julio, Virseda Rodríguez.

2009-08-01

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Penile cancer: a case for guidelines.  

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

Munro, N. P.; Thomas, P. J.; Deutsch, G. P.; Hodson, N. J.

2001-01-01

115

Organ-Preserving Surgery for Penile Carcinoma  

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

Martins, Francisco E.; Rodrigues, Raul N.; Lopes, Tom Amp M.

2008-01-01

116

Penile traction therapy in Peyronie's disease  

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

Greenfield, Jason M.

2009-01-01

117

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

International Nuclear Information System (INIS)

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

118

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

DEFF Research Database (Denmark)

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

Stankevicius, Edgaras; Dalsgaard, T.

2011-01-01

119

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)

120

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

DEFF Research Database (Denmark)

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

Plesner, L; Juul, B

1991-01-01

 
 
 
 
121

Zotarolimus-eluting stent utilization in small-vessel coronary artery disease (ZEUS).  

Science.gov (United States)

The role of the second-generation zotarolimus-eluting stent RESOLUTE in small-vessel coronary artery disease is unclear. The aim of this study was examine the angiographic results of RESOLUTE in de novo coronary lesions of ?50 % diameter stenosis in target vessels ?2.5 mm. From August 2008 to April 2010, 142 symptomatic patients with 159 lesions who fitted the inclusion criteria were treated with RESOLUTE. The mean age of patients was 66 ± 10 years, with male predominance (66 %). Diabetes mellitus was found in 62 (43.7 %) patients, whereas multivessel disease was observed in 105 (73.9 %). The mean stent size and length used were 2.33 ± 0.13 and 22 ± 8 mm, respectively. Follow-up angiography was performed on 143 (89.9 %) lesions in 127 (89.4 %) patients at a mean of 10.3 ± 3.6 months. Angiographic restenosis was found in 9 (6.3 %) lesions; the late loss was 0.26 ± 0.34 mm. At 1-year follow-up there were four cardiovascular deaths, two nonfatal myocardial infarctions, and six repeated revascularizations. The resultant major adverse cardiac event rate was 8.5 %. The use of RESOLUTE to treat small-vessel disease is associated with good clinical and angiographic outcomes at 1 year. PMID:23436214

Jim, Man-Hong; Yiu, Kai-Hang; Fung, Raymond Chi-Yan; Ho, Hee-Hwa; Ng, Andrew Kei-Yan; Siu, Chung-Wah; Chow, Wing-Hing

2014-01-01

122

Development of neuromuscular junctions on small mesenteric arteries of the rat.  

Science.gov (United States)

This ultrastructural study has investigated the development of the innervation of second order mesenteric arteries from the ileum region of the rat intestine, particularly, the time course of the formation of the plexus of varicose axons around the arteries, and the formation of autonomic neuromuscular junctions. The time points studied were postnatal days-2, -4, -8 and -13. This study has revealed that the formation of neuromuscular junctions with mature structural characteristics occurred at;2 weeks postnatal. The plexus of varicose axons developed predominantly between day-4 and day-13, which agrees with previous light microscopy studies of catecholamine containing nerves around similar vessels. At day-2 and day-4, the axons lacked varicosities and were mainly contained in large bundles located in the outer region of the adventitia. The medio-adventitial border consisted of a dense layer of extracellular matrix and fibroblasts. By day-8, there were more axons and most were distributed in smaller bundles. Some had grown through the adventitia to lie at the medio-adventitial border and axon varicosities were also observed. Some varicosities had formed rudimentary neuromuscular contacts. By day-13, there were significantly more contacting varicosities compared to day-8. They were structurally more mature, being twice the size with three times the number of synaptic vesicles and consistently contained a mitochondrion. Conversely, the neuromuscular contact areas were similar at both time points. Some organisation of the synaptic vesicles associated with the prejunctional membrane, was evident in varicosities at day-8 but there were no presynaptic membrane specialisations similar to the putative neurotransmitter release sites found at mature skeletal neuromuscular junctions. The aggregation of small vesicles at the prejunctional membrane was more pronounced in neuromuscular junctions at day-13 with some having presynaptic membrane specialisations. Comparison of the structure of developing autonomic neuromuscular junctions with that of skeletal neuromuscular junctions has revealed a number of similarities. PMID:10573607

Luff, S E

1999-01-01

123

Priapism secondary to penile metastasis of rectal cancer  

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

Ji Chan Park, Wook Hyun Lee

2009-01-01

124

Priapism secondary to penile metastasis of rectal cancer  

Directory of Open Access Journals (Sweden)

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

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

2009-09-01

125

Successful Replantation of Amputated Penile Shaft following Industrial Injury  

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

Ariafar, A.; Salehipour, M.

2010-01-01

126

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

127

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

128

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

Directory of Open Access Journals (Sweden)

Full Text Available Juan F Granada1, Barbara A Huibregtse2, Keith D Dawkins21The Jack H Skirball Center for Cardiovascular Research, Cardiovascular Research Foundation, Columbia University Medical Center, New York, NY, USA; 2Boston Scientific Corporation, Natick, MA, USAAbstract: Patients with diabetes mellitus, of female gender, increased age, and/or with peripheral vascular disease often develop coronary stenoses in small caliber vessels. This review describes treatment of these lesions with the paclitaxel-eluting 2.25 mm TAXUS® 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

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

Effect of defibrinogenation on the early patency rate of experimental small calibre arterial grafts.  

Science.gov (United States)

The effect of defibrinogenation with Arvin was studied in a new animal model of early thrombosis of a 3 mm diameter polytetrafluoroethylene (PTFE) graft with a poor run-off. Fifteen control animals were compared with fourteen animals treated with subcutaneous Arvin 20 units kg-1 body weight day-1, starting 2 days before surgery and continuing for 2 days postoperatively. The peroperative fibrinogen level in the controls was 2.8 +/- 0.9 gl-1 compared with 0.4 +/- 0.3 gl-1 in the treated group. There was no significant difference in the peroperative or postoperative platelet count or haematocrit value between the two groups. Plasma viscosity and whole blood viscosity (at a low shear rate of 0.7s-1) were significantly less during and after surgery in the defibrinogenated group. The degree of defibrinogenation in these animals produced no problems with haemostasis during surgery or in the postoperative period. The cumulative patency rates of the controls at 24 h, 48 h, and 4 days were 43 per cent, 28 per cent and 28 per cent compared with 86 per cent (P less than 0.05), 73 per cent (P less than 0.05) and 73 per cent (P less than 0.05) respectively in the defibrinogenated group. In this model of a narrow PTFE graft with a poor run-off, defibrinogenation was a safe and effective method of improving early patency of small calibre arterial grafts. PMID:3607412

Mahir, M S; Hynd, J W; Flute, P T; Dormandy, J A

1987-06-01

131

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

132

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

133

Epigenetic Mechanisms in Penile Carcinoma  

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Full Text Available Penile carcinoma (PeCa represents an important public health problem in poor and developing countries. Despite its unpredictable behavior and aggressive treatment, there have only been a few reports regarding its molecular data, especially epigenetic mechanisms. The functional diversity in different cell types is acquired by chromatin modifications, which are established by epigenetic regulatory mechanisms involving DNA methylation, histone acetylation, and miRNAs. Recent evidence indicates that the dysregulation in these processes can result in the development of several diseases, including cancer. Epigenetic alterations, such as the methylation of CpGs islands, may reveal candidates for the development of specific markers for cancer detection, diagnosis and prognosis. There are a few reports on the epigenetic alterations in PeCa, and most of these studies have only focused on alterations in specific genes in a limited number of cases. This review aims to provide an overview of the current knowledge of the epigenetic alterations in PeCa and the promising results in this field. The identification of epigenetically altered genes in PeCa is an important step in understanding the mechanisms involved in this unexplored disease.

Hellen Kuasne

2013-05-01

134

Update in the management of penile cancer  

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Full Text Available 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 procedures 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

2009-08-01

135

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

136

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

137

Pulsative hematoma: A penile fracture complication  

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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

138

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

DEFF Research Database (Denmark)

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

Mulvany, M J; Aalkjær, Christian

1984-01-01

139

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

140

Streptococcus constellatus and Prevotella bivia penile abscess.  

Science.gov (United States)

Streptococcus constellatus (S. constellatus) is known to cause abscesses in the oral, genitourinary, and gastrointestinal tracts, frequently in association with anaerobic bacteria. We report a rare case of S. constellatus and Prevotella bivia (P. bivia) causing a penile abscess, which was successfully treated with surgical drainage and antibiotic treatment. PMID:17982605

Nalmas, Sandhya; Bishburg, Eliahu; Chan, Trini

2007-01-01

 
 
 
 
141

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

142

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

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

2009-11-01

143

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.

144

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

145

Analysis of the characteristics of the flow velocity waveforms in left atrial small arteries and veins in the dog.  

Science.gov (United States)

To clarify the characteristics of the phasic blood velocity pattern in small arteries and veins on the left atrial surface, we used our newly developed fiber-optic laser Doppler velocimeter. We intended particularly to examine the influence of atrial contraction and relaxation on velocity waveforms to obtain some insight into the nature of the mechanical force acting on the atrial intramyocardial vascular beds. In 14 anesthetized open-chest dogs, the left atrial appendage was gently displaced to expose small branches of the artery and vein. Vessels with an outer diameter of about 150-500 microns were chosen for the measurements because their walls are transparent to laser light. The fiber tip (velocity sensor) was fixed on the vessel surface with a drop of cyanoacrylate when good-quality Doppler signals were consistently observed. Additional experiments with three dogs were performed to observe the blood velocities in the atrial artery and vein during arrhythmia. The blood velocity waveform in the artery was similar to the pattern of aortic pressure during ventricular ejection (peak velocity, 18.8 +/- 7.8 cm/sec) but was characterized by a pronounced dip during atrial contraction. The temporal coincidence between the dip formation and atrial contraction was confirmed during atrial flutter with an atrioventricular block. After isoproterenol administration (2 micrograms i.v.), the acceleration rate of the forward flow velocity increased by 176% (p less than 0.05), and reverse flow appeared during atrial contraction in five cases out of eight (p = 0.013). The blood flow velocity in atrial small veins, on the other hand, was predominant during atrial contraction (peak velocity, 15.6 +/- 5.8 cm/sec). Isoproterenol increased the acceleration rate of this forward flow velocity by 121% (p less than 0.01). Nitroglycerin did not change the blood velocity waveform significantly in atrial arteries or in veins. The phase opposition between arterial inflow into and venous outflow from the atrial myocardium indicates that a large portion of the coronary inflow to the atrial myocardium may be stored due to the presence of atrial myocardial vascular capacitance. We conclude that atrial myocardial contraction impedes atrial inflow and promotes venous outflow from atrial capacitance vessels. PMID:2680148

Kajiya, F; Tsujioka, K; Ogasawara, Y; Hiramatsu, O; Wada, Y; Goto, M; Yanaka, M

1989-11-01

146

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

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

Kurbel Sven

2010-06-01

147

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.)

148

[Doppler velocimetry of the arcuate arteries in adolescent pregnant women: predictive value in small for gestational age newborn infants].  

Science.gov (United States)

A prospective study on 25 adolescent pregnant women was carried out. A single measurement of the systolic-diastolic ratio (S/D) was taken using continuous Doppler on arcuate arteries on both sides of the uterus. All measurements were taken after the 16th week of amenorrhea. The relationship between Doppler velocimetry and birthweight was established. Seven newborns were small for gestational age. The sensitivity of this method was 94.4% and specificity was 57.1%. Positive predictive value was 80.0% while negative predictive value was 85.0%. The importance of measuring both arcuate arteries and determining the site of placental insertion for proper interpretation of results is stressed. PMID:1845194

Leible, S; Molina, R; Walton, R; Arroyo, A; Valdés, E; Gómez, C

1991-01-01

149

A case of carcinosarcoma arising in irradiated penile glans  

International Nuclear Information System (INIS)

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

150

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

Science.gov (United States)

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

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

2014-10-15

151

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

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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

152

The effect of vacuum devices on penile hemodynamics  

International Nuclear Information System (INIS)

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

153

The effect of vacuum devices on penile hemodynamics  

Energy Technology Data Exchange (ETDEWEB)

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

Katz, P.G.; Haden, H.T.; Mulligan, T.; Zasler, N.D. (Medical College of Virginia, Richmond (USA))

1990-01-01

154

Successful microsurgical penile replantation following self amputation in a schizophrenic patient  

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

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

2010-01-01

155

Congenital primary penile teratoma in a child.  

Science.gov (United States)

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

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

2014-06-01

156

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

157

Epidemiologic study on penile cancer in Brazil  

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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

158

Management of Penile Fracture and its Outcome  

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

159

Measurement of endothelial dysfunction via peripheral arterial tonometry predicts vasculogenic erectile dysfunction.  

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Endothelial cell dysfunction is associated with cardiovascular disease and vasculogenic erectile dysfunction (ED). Measured via peripheral artery tonometry (PAT), endothelial dysfunction in the penis is an independent predictor of future cardiovascular events. The aim of the study was to determine whether measurement of endothelial dysfunction differentiates men with vasculogenic ED identified by duplex ultrasound from those without. A total of 142 men were retrospectively assessed using patient history, penile duplex ultrasonography (US) and PAT (EndoPAT 2000). ED was self-reported and identified on history. Vasculogenic ED was identified in men who exhibited a peak systolic velocity (PSV) of ?25?cm?s(-1) at 15?min following vasodilator injection. The reactive hyperemia index (RHI), a measurement of endothelial dysfunction in medium/small arteries, and the augmentation index (AI), a measurement of arterial stiffness, were recorded via PAT. Penile duplex US was used to categorize men into those with ED (n=111) and those without ED (n=31). The cohort with ED had a PSV of 21±1?cm?s(-1) (left cavernous artery) and 22±1?cm?s(-1) (right cavernous artery). The control group without ED had values of 39±2?cm?s(-1) (left) and 39±2?cm?s(-1) (right). Given the potential for altered endothelial function in diabetes mellitus, we confirmed that hemoglobin A1c, urinary microalbumin and vibration pulse threshold were not different in men with vasculogenic ED and those without. RHI in patients with ED (1.85±0.06) was significantly decreased compared to controls (2.15±0.2) (Pheart rate. Measurement of endothelial function with EndoPAT differentiates men with vasculogenic ED from those without. RHI could be used as a non-invasive surrogate in the assessment of vasculogenic ED and to identify those patients with higher cardiovascular risk. PMID:24784889

Kovac, J R; Gomez, L; Smith, R P; Coward, R M; Gonzales, M A; Khera, M; Lamb, D J; Lipshultz, L I

2014-11-01

160

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

 
 
 
 
161

Changes in functional and histological distributions of nitric oxide synthase caused by chronic hypoxia in rat small pulmonary arteries  

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Chronic hypoxia (CH) increases lung tissue expression of all types of nitric oxide synthase (NOS) in the rat. However, it remains unknown whether CH-induced changes in functional and histological NOS distributions are correlated in rat small pulmonary arteries. We measured the effects of NOS inhibitors on the internal diameters (ID) of muscular (MPA) and elastic (EPA) pulmonary arteries (100–700 ?m ID) using an X-ray television system on anaesthetized rats. We also conducted NOS immunohistochemical localization on the same vessels. Nonselective NOS inhibitors induced ID reductions in almost all MPA of CH rats (mean reduction, 36±3%), as compared to ?60% of control rat MPA (mean, 10±2%). The inhibitors reduced the ID of almost all EPA with similar mean values (?26%) in both CH and control rats. On the other hand, inducible NOS (iNOS)-selective inhibitors caused ID reductions in ?60% of CH rat MPA (mean, 15±3%), but did so in only ?20% of control rat MPA (mean, 2±2%). This inhibition caused only a small reduction (mean, ?4%) in both CH and control rat EPA. A neuronal NOS-selective inhibitor had no effect. The percentage of endothelial NOS (eNOS)-positive vessels was ?96% in both MPA and EPA from CH rats, whereas it was 51 and 91% in control MPA and EPA, respectively. The percentage for iNOS was ?60% in both MPA and EPA from CH rats, but was only ?8% in both arteries from control rats. The data indicate that in CH rats, both functional and histological upregulation of eNOS extensively occurs within MPA. iNOS protein increases sporadically among parallel-arranged branches in both MPA and EPA, but its vasodilatory effect is predominantly observed in MPA. Such NOS upregulation may serve to attenuate hypoxic vasoconstriction, which occurs primarily in MPA and inhibit the progress of pulmonary hypertension. PMID:12839863

Shirai, Mikiyasu; Pearson, James T; Shimouchi, Akito; Nagaya, Noritoshi; Tsuchimochi, Hirotsugu; Ninomiya, Ishio; Mori, Hidezo

2003-01-01

162

Sentinel Node Biopsy in Penile Cancer: Case Report  

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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

163

[A case of penile metastasis of malignant melanoma with priapism].  

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A metastatic penile tumor of malignant melanoma is very rare. The patient had priapism caused by metastatic penile tumor and the primary cancer was in the end stage. However, in this case, we could relieve the dysuria and pain by percutaneous cystostomy and partial penectomy. The corpus spongiosumcorpus cavernosum shunt could not relieve the priapism and might have accelerated the metastasis. PMID:19378827

Okinami, Takeshi; Ishitoya, Satoshi; Imamura, Masaaki; Maeda, Sumihiro; Okumura, Kazuhiro; Nose, Kensuke

2009-03-01

164

Vimentin positive acantholytic penile squamous cell carcinoma with rhabdoid features.  

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Acantholytic variant of penile squamous cell carcinoma (SCC) is an exceedingly rare and associated with bad prognosis. Histologically it mimics angiosarcoma due to pseudovascular spaces. Vimentin immunopositivity in such cases represent epithelial to mesenchymal transition manifested by cellular discohesion. We describe a case of vimentin positive acantholytic penile SCC in a 55-year-old patient. PMID:25022397

Chavan, Ramesh Y; Bali, Akshay; Savita, K S; Chethan, J V

2014-01-01

165

Minimally Invasive Penile Implant Surgery  

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Full Text Available ... the base of the penis and we’re measuring to get an initial measurement, and we will ... small, it wasn’t sized properly, or the space for the reservoir wasn’t appropriately made. There ...

166

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

167

Penile veins are the principal component in erectile rigidity: a study of penile venous stripping on defrosted human cadavers.  

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The human erectile mechanism is an intricate interplay of hormonal, vascular, neurological, sinusoidal, pharmacological, and psychological factors. However, the relative influence of each respective component remains somewhat unclear, and merits further study. We investigated the role of venous outflow in an attempt to isolate the key determinant of erectile function. Dynamic infusion cavernosometry and cavernosography was conducted on 15 defrosted human cadavers, both before and after the systematic removal and ligation of erection-related penile veins. Preoperatively, an infusion rate of more than 28.1 mL/min (from more than 14.0 to 85.0 mL/min) was required to induce a rigid erection (defined as intracavernosal pressure [ICP] exceeding 90 mmHg). Following surgery, we were able to obtain the same result at a rate of 7.3 mL/min (from 3.1 to 13.5 mL/min) across the entire sample. Thus, we witnessed statistically significant postoperative differences (all P ? .01), consistently elevated ICP, lower perfusion volumes, and a general reduction in time taken to attain rigidity. The cavernosograms provided further evidence substantiating the critical role played by erection-related veins, whereas histological samples confirmed the postoperative integrity of the corpora cavernosa. Given that our use of cadavers eliminated the influence of hormonal, arterial, neurological, sinusoidal, pharmacological, and psychological factors, we believe that our study demonstrates that the human erection is fundamentally a mechanical event contingent on venous competence. PMID:22604630

Hsu, Geng-Long; Hung, Yi-Ping; Tsai, Mang-Hung; Hsieh, Cheng-Hsing; Chen, Heng-Shuen; Molodysky, Eugen; Huynh, Chi Can; Yu, Hong-Jeng

2012-01-01

168

Heterogeneity in function of small artery smooth muscle BKCa: involvement of the beta1-subunit.  

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Arteriolar myogenic vasoconstriction occurs when increased stretch or membrane tension leads to smooth muscle cell depolarization and opening of voltage-gated Ca2+ channels. To prevent positive feedback and excessive pressure-induced vasoconstriction, studies in cerebral artery smooth muscle have suggested that activation of large conductance, Ca2+-activated K+ channels (BKCa) provides an opposing hyperpolarizing influence reducing Ca2+ channel activity. We have hypothesized that this mechanism may not equally apply to all vascular beds. To establish the existence of such heterogeneity in vascular reactivity, studies were performed on rat vascular smooth muscle (VSM) cells from cremaster muscle arterioles and cerebral arteries. Whole cell K+ currents were determined at pipette [Ca2+] of 100 nM or 5 microM in the presence and absence of the BKCa inhibitor, iberiotoxin (IBTX; 0.1 microM). Similar outward current densities were observed for the two cell preparations at the lower pipette Ca2+ levels. At 5 microM Ca2+, cremaster VSM showed a significantly (P STOCs) were more apparent (frequency and amplitude) and occurred at more negative membrane potentials in cerebral compared to cremaster SMCs. Also consistent with decreased STOC activity in cremaster SMCs was an absence of detectable Ca2+ sparks (0 of 76 cells) compared to that in cerebral SMCs (76 of 105 cells). Quantitative PCR showed decreased mRNA expression for the beta1 subunit and a decrease in the beta1:alpha ratio in cremaster arterioles compared to cerebral vessels. Similarly, cremaster arterioles showed a decrease in total BKCa protein and the beta1:alpha-subunit ratio. The data support vascular heterogeneity with respect to the activity of BKCa in terms of both beta-subunit regulation and interaction with SR-mediated Ca2+ signalling. PMID:19359368

Yang, Yan; Murphy, Timothy V; Ella, Srikanth R; Grayson, T Hilton; Haddock, Rebecca; Hwang, Yun T; Braun, Andrew P; Peichun, Gui; Korthuis, Ronald J; Davis, Michael J; Hill, Michael A

2009-06-15

169

Ca2+ signaling in arterioles and small arteries of conscious, restrained, optical biosensor mice  

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Two-photon fluorescence microscopy and conscious, restrained optical biosensor mice were used to study smooth muscle Ca2+ signaling in ear arterioles. Conscious mice were used in order to preserve normal mean arterial blood pressure (MAP) and sympathetic nerve activity (SNA). ExMLCK mice, which express a genetically-encoded smooth muscle-specific FRET-based Ca2+ indicator, were equipped with blood pressure telemetry and immobilized for imaging. MAP was 101 ± 4 mmHg in conscious restrained mice, similar to the freely mobile state (107 ± 3 mmHg). Oscillatory vasomotion or irregular contractions were observed in most arterioles (71%), with the greatest oscillatory frequency observed at 0.25 s?1. In a typical arteriole with an average diameter of ~35 ?m, oscillatory vasomotion of a 5–6 ?m magnitude was accompanied by nearly uniform [Ca2+] oscillations from ~0.1 to 0.5 ?M, with maximum [Ca2+] occurring immediately before the rapid decrease in diameter. Very rapid, spatially uniform “Ca2+ flashes” were also observed but not asynchronous propagating Ca2+ waves. In contrast, vasomotion and dynamic Ca2+ signals were rarely observed in ear arterioles of anesthetized exMLCK biosensor mice. Hexamethonium (30 ?g/g BW, i.p.) caused a fall in MAP to 74 ± 4 mmHg, arteriolar vasodilation, and abolition of vasomotion and synchronous Ca2+ transients. Summary: MAP and heart rate (HR) were normal during high-resolution Ca2+ imaging of conscious, restrained mice. SNA induced continuous vasomotion and irregular vasoconstrictions via spatially uniform Ca2+ signaling within the arterial wall. FRET-based biosensor mice and two-photon imaging provided the first measurements of [Ca2+] in vascular smooth muscle cells in arterioles of conscious animals. PMID:25339912

Fairfax, Seth T.; Mauban, Joseph R. H.; Hao, Scarlett; Rizzo, Mark A.; Zhang, Jin; Wier, W. Gil

2014-01-01

170

Penile cancer: Clinical Practice Guidelines in Oncology.  

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Squamous cell carcinoma of the penis represents approximately 0.5% of all cancers among men in the United States and other developed countries. Although rare, it is associated with significant disfigurement, and only half of the patients survive beyond 5 years. Proper evaluation of both the primary lesion and lymph nodes is critical, because nodal involvement is the most important factor of survival. The NCCN Clinical Practice Guidelines in Oncology for Penile Cancer provide recommendations on the diagnosis and management of this devastating disease based on evidence and expert consensus. PMID:23667209

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

2013-05-01

171

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

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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, t...

Blagojevi? Zdenka M.; Blagojevi? M.; C?, Nikolic? Zora; Dreki? Dmitar M.; Mrvi? Verica; ?eli? Dijana J.; Zori? Zoran D.

2005-01-01

172

Computed tomography during arteriography and arterial portography in small hepatocellular carcinoma and dysplastic nodule. A prospective study  

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We studied the relationship between the findings of computed tomography during arteriography (CTA) and computed tomography during arterial portography (CTAP), and pathologic findings of 81 small nodular lesions (3 cm or less in diameter) in resected liver specimens. The 81 lesions consisted of 8 dysplastic nodule (DN) lesions, 23 well-differentiated hepatocellular carcinomas (early HCCs) and 50 moderately or poorly differentiated HCCs (advanced HCCs). We also performed standard computed tomography (CT), digital subtraction angiography (DSA), magnetic resonance imaging (MRI), and ultrasonography, and compared sensitivities with CTA, CTAP, or combination of CTA and CTAP with other imaging methods. Forty-four of the 50 advanced HCCs, 12 of the 23 early HCCs, and none of 8 DNs hyperattenuated with CTA and hypoattenuated with CTAP. The sensitivity for the early HCCs was significantly higher for CTA and CTAP in combination as compared with DSA or standard CT. The sensitivity for the advanced HCCs was significantly higher for CTA and CTAP in combination than with DSA. The sequential changes of the blood supply from the portal vein to the hepatic artery during the development of the HCCs were observed. Although CTA and CTAP in combination were useful for the distinction of advanced HCC from early HCC or DN, CTA and CTAP used in combination were not superior to CTA alone in the detection of such lesions. (author)

173

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

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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

174

Increasing resolution of cerebral small arteries in 3D TOF MR angiography. Efficacy of nitroglycerin-MRA (NTG-MRA) in patients with neurovascular disease  

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MRI and MRA were performed in 63 patients suspected of having neurovascular disease. NTG-MRA enabled us to visualize cerebral small peripheral arteries more clearly. Most stenotic sites were seen as slightly dilated after NTG administration. Secondly, we examined whether there was any significant difference in the resolution of small arteries according to the presence or absence of neurovascular disease. With NTG-MRA, the rate of increase in resolution in patients with neurovascular stenosis was significantly higher than that in patients without neurovascular stenosis. (author)

175

Surgical management of complete penile duplication accompanied by multiple anomalies  

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Diphallus (penile duplication) is very rare and seen once every 5.5 million births. It can be isolated, but is usually accompanied by other congenital anomalies. Previous studies have reported many concurrent anomalies, such as bladder extrophy, cloacal extrophy, duplicated bladder, scrotal abnormalities, hypospadias, separated symphysis pubis, intestinal anomalies and imperforate anus; no penile duplication case accompanied by omphalocele has been reported. We present the surgical management of a patient with multiple anomalies, including complete penile duplication, hypo-gastric omphalocele and extrophic rectal duplication.

Karaca, Irfan; Turk, Erdal; Ucan, A. Basak; Yayla, Derya; Itirli, Gulcin; Ercal, Derya

2014-01-01

176

A presentation of glandular penile metastases from prostate adenocarcinoma.  

Science.gov (United States)

Secondary tumours of the penis are rare; they most commonly arise from the prostate and the bladder. These lesions are often associated with disseminated malignancy and have a poor prognosis, with a 6-month mortality of up to 80% reported. Penile metastases have a variety of clinical manifestations including incidental penile nodules, cutaneous findings, urinary symptoms, pain and malignant priapism. Treatment options are mainly targeted at improving the patients' quality of life and are tailored to their clinical condition, but are primarily palliative. This study reports a case of a 92-year-old man with a presentation of glandular penile metastases from prostate adenocarcinoma treated conservatively. PMID:22486259

Nason, Gregory J; O'Reilly, Michael K; Long, Ronan M; Ingoldsby, Helen; Barrett, Ciara; O'malley, Kiaran J

2012-08-01

177

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

178

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

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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

179

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.

180

Penile herpes zoster: an unusual location for a common disease  

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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

 
 
 
 
181

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

182

Clinical neuroanatomy and neurotransmitter-mediated regulation of penile erection.  

Science.gov (United States)

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

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

2014-06-01

183

Intracavernosal metaraminol for treatment of intraoperative penile erection.  

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Four patients developed penile erection when regional anaesthesia was induced with spinal block. In another patient, penile erection developed during fentanyl-induced general anaesthesia. Injection of metaraminol into corpus cavernosum successfully achieved detumescence in all these patients. The dose of metaraminol ranged from 10 to 25 micrograms, much less than that required for the treatment of vasodilator-induced priapism. Intracavernosal injection of metaraminol is a simple, effective an...

Tsai, S. K.; Hong, C. Y.

1990-01-01

184

Penile prosthesis in the surgical treatment of Peyronie's disease  

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Peyronie's disease appears to be a condition of middle-aged men. In many of them, the disease is accompanied by erectile dysfunction, which, until recently, was attributed to penile deformity. Later, it turned out that the erectile dysfunction has the same causes as in men without Peyronie's disease with vascular and psychological components. In all cases, the pathology of the disease is characterized by the formation of a fibrous plaque, which will lead to penile curvature at different de...

Ateia, D.; Voinescu, O.; Geavlete, R.

2012-01-01

185

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

186

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

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

Eshpuniyani Priya

2010-01-01

187

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

Science.gov (United States)

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

Solano-Altamirano, J M; Goldman, Saul

2014-06-01

188

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

189

Use of radioactive tracers in the evaluation of penile hemodynamics: history, methodology and measurements.  

Science.gov (United States)

Radionuclide tracer techniques are intimately associated with some of the early ground-breaking investigations in erectile dysfunction and have evolved along with the field. At the present time, the various investigations can be grouped into four categories: labeled blood-pool; tracer washout; tracer washin and combined blood-pool/tracer and tracer washout examinations. Blood pool studies are most useful in assessing the integrity of arterial inflow, but may also be used to generate indices of venous leak. A non-imaging version of the blood-pool test may represent a simple and cost-effective alternative. Washout of intracavernosal xenon during erection seems the most rigorous method of testing venous integrity. Washout using 99mTc-labeled substances may emerge as a convenient alternative to the more technically difficult xenon examinations. Dual-isotope blood pool and washout examinations, though complicated, represent an ideal method of analyzing penile hemodynamics, with potential to contribute significantly to the understanding of penile physiology. Development of improved pharmacologic stimuli and augmentation of testing protocols by intracavernosal pressure monitoring may further improve the utility of quantitative and physiologic nuclear medicine examinations in erectile dysfunction. PMID:9205877

Zuckier, L S

1997-06-01

190

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

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Metastatic involement of penis is an exceptionally rare condition. 77% of the metastases are originated from the pelvic region; prostate and bladder are the most frequent primary locations. Retrograde venous route, retrograde lymphatic route, arterial spread, direct extension, implantation and secondary to instrumentation are the mechanisms of metastasis. Approximately two thirds of all penile metastasis are detected at a mean time of 18 months after the detection of the primary tumor and the remaining one third is presented at the same time with primary tumor. Diagnosis is usually made by biopsy and also non invasive methods as MRI or colour-coded duplex ultrasonography. Treatment options in these patients are local excision, partial or complete penectomy, external beam radiation therapy and chemotheraphy. Despite these alternatives prognosis is usually poor.We present a case of urethelial carcinoma of the bladder and coincidental prostate adenocarcinoma with penile metastasis which is presented with priapism 6 months after radical cystectomy as the first systemic manifestation. We performed biopsy initially for staging and the patient underwent MRI showing the extension of the disease. The patient underwent radiotherapy of 56 gy and priapism partially resolved after the treatment. Chemotheraphy was also planned but the patient died 3 months following radiotheraphy. PMID:20184686

Sönmez, Nurettin Cem; Co?kun, Burhan; Arisan, Serdar; Güney, Soner; Dalkiliç, Ayhan

2009-01-01

191

Small Dense Low Density Lipoprotein Particles Are Associated with Poor Outcome after Angioplasty in Peripheral Artery Disease  

Science.gov (United States)

Purpose In patients suffering from symptomatic peripheral artery disease (PAD), percutaneous revascularization is the treatment of choice. However, restenosis may occur in 10 to 60% in the first year depending on a variety of factors. Small dense low density lipoprotein (sdLDL) particles are associated with an increased risk for cardiovascular events, but their role in the process of restenosis is not known. We conducted a prospective study to analyze the association of sdLDL particles with the outcome of balloon angioplasty in PAD. The composite primary endpoint was defined as improved walking distance and absence of restenosis. Methods Patients with angiographically documented PAD of the lower extremities who were scheduled for lower limb revascularization were consecutively recruited for the study. At baseline and at three month follow-up triglyceride, total cholesterol, LDL size and subclasses and HDL cholesterol and ankle-brachial index (ABI) were measured. Three months after the intervention duplex sonography was performed to detect restenosis. Results Sixty-four patients (53% male) with a mean age of 68.6±9.9 years were included. The proportion of small- dense LDL particles (class III and IV) was significantly lower (33.1±11.0% vs. 39.4±12.1%, p?=?0.038) in patients who reached the primary end-point compared with those who did not. Patients with improved walking distance and without restenosis had a significantly higher LDL size at baseline (26.6±1.1 nm vs. 26.1±1.1 nm, p?=?0.046) and at follow-up (26.7±1.1 nm vs. 26.2±0.9 nm, p?=?0.044) than patients without improvement. Conclusions Small-dense LDL particles are associated with worse early outcome in patients undergoing percutaneous revascularization for symptomatic PAD. PMID:25265512

Mosimann, Kathrin; Husmann, Marc; Thalhammer, Christoph; Wilkinson, Ian; Berneis, Kaspar; Amann-Vesti, Beatrice R.

2014-01-01

192

Arteriographic findings and erectile function in men with occlusive arterial disease in the legs  

International Nuclear Information System (INIS)

A series of 56 men under 70 years of age were examined with conventional aortography because of arterial insufficiency in the legs, as well as an evaluation of their sexual function. The aortograms were evaluated with respect to the penile blood supply, and related to potency and penile blood pressure. Patients with bilateral occlusions or occlusion on one side and stenosis on the other in the penile blood supply had a statistical significant higher impotence rate and lower penile blood pressure index than patients without visible lesions on the arteriograms. It is concluded that the conventional aortography only will give a rough estimate of the erectile function, but it may be of some value in predicting the effect on the potency of a reconstructive vascular operation in the aorto-iliac area. (orig.)

193

Coronary Artery Bypass Graft  

Medline Plus

Full Text Available ... by the bypass machine. Veins taken from the legs, or arteries going to the chest wall or ... are used, they are usually taken from your legs through multiple small incisions. If an artery is ...

194

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

195

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

196

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

Science.gov (United States)

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

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

2014-06-01

197

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

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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

198

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

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

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

2012-01-01

199

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

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

Yilmaz, Ibrahim Edhem; Barazani, Yagil; Tareen, Basir

2013-01-01

200

Penile augmentation with resultant foreign material granuloma and sequalae.  

Science.gov (United States)

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

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

2012-10-01

 
 
 
 
201

Penile lymphoscintigraphy for sentinel node identification  

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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

202

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 (approximately 1 microm) 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). PMID:20210434

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

203

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

Kroigaard, Christel; Dalsgaard, Thomas

2012-01-01

204

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

205

Double disruption of ?2A- and ?2C-adrenoceptors induces endothelial dysfunction in mouse small arteries: role of nitric oxide synthase uncoupling.  

Science.gov (United States)

Knockout mice lacking both ?2A- and ?2C-adrenergic receptors (?2A/?2C-ARKO) provide a model for understanding the mechanisms underlying the deleterious effects of sympathetic hyperactivity on the cardiovascular system. Thus, in the present study we investigated the vascular reactivity of large and small arteries of ?2A/?2C-ARKO mice. Aorta and mesenteric small arteries (MSAs) from 7-month-old male ?2A/?2C-ARKO mice and congenic C57BL6/J mice (wild-type, WT) were studied. In the aorta, noradrenaline- and serotonin-induced contraction was similar between groups, but in MSAs there was an increase in agonist-induced contraction in ?2A/?2C-ARKO compared with WT. The l-NAME effect was reduced in MSAs of ?2A/?2C-ARKO mice compared with WT mice, as was basal NO evaluated by a 4,5-diaminofluorescein diacetate probe. Increased total endothelial nitric oxide synthase (eNOS) protein expression was observed in MSAs from ?2A/?2C-ARKO mice, while the dimer/monomer ratio of eNOS was decreased. Mesenteric small arteries from ?2A/?2C-ARKO mice showed an increase in ethidium bromide-positive nuclei, indicating oxidative stress, which was attenuated by incubation with l-NAME. The sympathetic hyperactivity present in ?2A/?2C-ARKO mice alters vascular reactivity only in certain types of arteries. Moreover, after chronic sympathetic hyperactivity, uncoupling eNOS may be a significant source of superoxide anion and reduced NO bioavailability in small vessels, increasing the contractile tone. PMID:25037566

Couto, Gisele K; Davel, Ana P; Brum, Patrícia C; Rossoni, Luciana V

2014-10-01

206

Should Bilateral Uterine Artery Notching be used in the Risk Assessment for Preeclampsia, Small-for-Gestational-Age, and Gestational Hypertension?  

Science.gov (United States)

Objective To determine the value of bilateral uterine artery notching in the second trimester in the risk assessment for preeclampsia, gestational hypertension, and small-for-gestational age (SGA) without preeclampsia. Methods This prospective cohort study included 4,190 singleton pregnancies that underwent ultrasound examination between 23-25 weeks of gestation. The 95th percentile of the mean pulsatility index (PI) and resistance index (RI) of both uterine arteries were calculated. Multivariable logistic regression analyses were performed to determine if bilateral uterine artery notching is an independent explanatory variable for the occurrence of preeclampsia, early-onset preeclampsia (?34 weeks), late-onset preeclampsia (>34 weeks), gestational hypertension and delivery of an SGA without preeclampsia, while controlling for confounding factors. Results 1) The prevalence of preeclampsia, early-onset preeclampsia, late-onset preeclampsia, SGA and gestational hypertension were 3.4%, 0.5%, 2.9%, 10%, and 7.9%, respectively; 2) 7.2% of the study population had bilateral uterine artery notching; 3) bilateral uterine artery notching was an independent explanatory variable for the development of preeclampsia [odds ratio (OR) 2.1; 95% confidence interval (CI):1.28-3.36], early-onset preeclampsia (OR: 4.47; 95%CI: 1.50-13.35), and gestational hypertension (OR: 1.50; 95%CI: 1.02-2.26), but not for late-onset preeclampsia or SGA. Conclusions Bilateral uterine notching between 23-25 weeks of gestation is an independent risk factor for the development of early-onset preeclampsia and gestational hypertension. Thus, bilateral uterine artery notching should be considered in the assessment of risk for the development of these pregnancy complications. PMID:20587434

Espinoza, Jimmy; Kusanovic, Juan Pedro; Bahado-Singh, Ray; Gervasi, Maria Teresa; Romero, Roberto; Lee, Wesley; Vaisbuch, Edi; Mazaki-Tovi, Shali; Mittal, Pooja; Gotsch, Francesca; Erez, Offer; Gomez, Ricardo; Yeo, Lami; Hassan, Sonia S.

2010-01-01

207

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.

208

Incidence of penile curvature in various forms of hypospadias  

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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

209

Use of penile extender device in the treatment of penile curvature as a result of Peyronie's disease. Results of a phase II prospective study  

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NTRODUCTION: Pilot experiences have suggested that tension forces exerted by a penile extender may reduce penile curvature as a result of Peyronie's disease. AIM: To test this hypothesis in a Phase II study using a commonly marketed brand of penile extender. METHODS: Peyronie's disease patients with a curvature not exceeding 50 degrees with mild or no erectile dysfunction (ED) were eligible. Fifteen patients were required to test the efficacy of the device assuming an effect...

Tizzani, Alessandro; Gontero, Paolo

2009-01-01

210

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.

211

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

212

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

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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

213

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

Scientific Electronic Library Online (English)

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

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

214

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

Scientific Electronic Library Online (English)

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

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

2011-06-01

215

A microbiological study of penile ulcers with clinical correlation  

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

D?souza K

1992-01-01

216

Management of penile trauma caused by a dog bite  

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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

217

Traumatic degloving lesion of penile and scrotal skin  

Scientific Electronic Library Online (English)

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

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

218

Autologous blood-clot embolisation of cavernosal artery pseudoaneurysm causing delayed high-flow priapism  

Science.gov (United States)

Summary Background: High-flow priapism is a rare condition characterized by a prolonged and painless erection. Since it may permanently impair erectile function, it must be managed and treated as soon as possible, in order to restore potency. The case we are presenting here was successfully treated by embolizing the penile artery using an autologous clot. Case Report: A case of delayed painless high-flow priapism that occured after blunt straddle-type perineal trauma, that was persistent for more than 30 days is being presented. Doppler ultrasonographic examination of the cavernosal artery revealed a 1.5 cm-diameter pseudoaneurysm at the right cavernosal artery, together with a high-velocity shunt between the two cavernous arteries. Extravasation from the proximal sites of both of the cavernous arteries and a right cavernosal artery pseudoaneurysm was detected on angiography. The patient was successfully treated by embolization of the penile artery with an autologous clot in two sessions with a 3-day interval. Conclusions: This experience along with a survey of the literature made us conclude that embolization of cavernous artery by means of an autologous clot is a very effective procedure and a method of choice for treatment of high-flow priapism and for restoration of penile erectile function. What makes our case even more interesting and important, is the fact that priapism of one month’s duration could well be treated by means of this method. PMID:23807886

Yesilkaya, Yakup; Peynircioglu, Bora; Gulek, Bozkurt; Topcuoglu, Melih; Inci, Kubilay

2013-01-01

219

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

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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

220

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

International Nuclear Information System (INIS)

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

 
 
 
 
221

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

International Nuclear Information System (INIS)

This paper reports on the performance of a pair of multi-crystal, high resolution, bismuth germanate (BGO) block detectors for positron emission tomograpy (PET). Utilizing the detectors ar a separation of 100 mm, the spatial resolutions have been measured in the two axes of the block. These measurements indicate maximum spatial resolutions of 3.6 and 4.5 mm (FWHM). The system has been used to observe the regional kinetics of positron-emitting radionuclides in the rat brain sand the human radial artery. Designs for a small diameter, no-septa tomograph incorporating these detectors have been considered. Simulations performed demonstrate the possibilities of following tracer uptake within the rat brain and radial artery. 3D tomographic data-sets acquired from a uniform cylinder, obtained by rotating the two detectors, indicate good uniformity in the field of view (FOV) of 25 mm

222

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

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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

223

Congenital fistula of the penile urethra: A case report  

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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

224

Dysfunctional penile cholinergic nerves in diabetic impotent men  

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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.

Blanco, R.; Saenz de Tejada, I.; Goldstein, I.; Krane, R.J.; Wotiz, H.H.; Cohen, R.A. (Boston Univ. School of Medicine, MA (USA))

1990-08-01

225

21 CFR 876.3630 - Penile rigidity implant.  

Science.gov (United States)

...Identification. A penile rigidity implant is a device that consists of a pair of semi-rigid rods implanted in the corpora cavernosa of the penis to provide rigidity. It is intended to be used in men diagnosed as having erectile dysfunction....

2010-04-01

226

Voluntary control of penile tumescence among homosexual and heterosexual subjects.  

Science.gov (United States)

Voluntary control of erectile responses represents a major threat to the validity of penile plethysmography. This study was designed to determine whether individuals can mimic a sexual orientation that differs from their actual sexual orientation. Since the presumed mechanism underlying voluntary control of penile tumescence involves a shift in attentional focus, a recall test was employed to assess the relationship between the ability to influence erectile responses and recall of critical test stimuli. Homosexual and heterosexual subjects were exposed to sexual materials under standard and "faking" instructions. The faking instructions consisted of asking subjects to suppress erectile responses to preferred stimuli and to enhance penile tumescence in the presence of nonpreferred stimuli. Across groups, results revealed some degree of suppression of erections but no significant enhancement of erections. Self-reported cognitive arousal under both conditions was consistent with erectile data. However, subjects' perceived control over erectile responses tended to be greater than their actual performance. No significant differences in recall were obtained. The recall procedure appears to interfere with subjects' ability to control erectile responses. Implications for clinical applications of penile plethysmography are summarized with suggestions for future research. PMID:1546933

Adams, H E; Motsinger, P; McAnulty, R D; Moore, A L

1992-02-01

227

Penile length of newborns and children in Surakarta, Indonesia  

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

Annang Giri Moelyo

2013-03-01

228

Penile length of newborns and children in Surakarta, Indonesia  

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

Annang Giri Moelyo

2013-03-01

229

Sunitinib, a small-molecule receptor tyrosine kinase inhibitor, suppresses neointimal hyperplasia in balloon-injured rat carotid artery.  

Science.gov (United States)

The migration and proliferation of vascular smooth muscle cells (VSMCs) induced by growth factors play a critical role in in-stent stenosis after percutaneous coronary intervention (PCI). The present study tested the hypothesis that sunitinib malate (sunitinib), a tyrosine kinase inhibitor of multiple receptors for growth factors, can reduce neointimal formation after arterial injury in vivo and sought to reveal the underlying mechanism in vitro. Male Wistar rats with balloon-injured carotid arteries were administered either sunitinib or a vehicle orally for 2 weeks. Sunitinib significantly inhibited neointimal hyperplasia relative to control by reducing active cell proliferation. In cultured human aortic smooth muscle cells (HASMCs), sunitinib significantly inhibited platelet-derived growth factor (PDGF)-induced increases of DNA synthesis, cell proliferation, and migration relative to controls as evaluated by [(3)H] thymidine incorporation, cell number, and the Boyden chamber assay, respectively. Immunoblot analyses showed that sunitinib suppressed phosphorylation of PDGF-BB inducible extracellular signal-regulated kinase and autophosphorylation of PDGF ?-receptor, which are the key signaling steps involved in HASMC activation. These results indicate that sunitinib inhibits neointimal formation after arterial injury by suppressing VSMC proliferation and migration presumably through inactivation of PDGF signaling. As such, it may be a potential therapeutic agent, which targets arterial restenosis after PCI. PMID:23324994

Ishii, So; Okamoto, Yoshihisa; Katsumata, Harumi; Egawa, Seiko; Yamanaka, Daisuke; Fukushima, Makoto; Minami, Shiro

2013-07-01

230

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

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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

231

Clopidogrel, independent of vascular P2Y12 receptor, improves the arterial function in small mesenteric arteries from Ang II-hypertensive rats.  

Science.gov (United States)

The P2Y12 receptor antagonist clopidogrel blocks platelet aggregation, improves systemic endothelial nitric oxide bioavailability, and has anti-inflammatory effects. Since P2Y12 receptors have been identified in the vasculature, we hypothesized that clopidogrel ameliorates angiotensin II (Ang II) -induced vascular functional changes by blockade of P2Y12 receptors in the vasculature. Male Sprague Dawley rats were infused with Ang II (60 ng.min-1) or vehicle for 14 days. The animals were treated with clopidogrel (10mg*kg-1*day-1) or vehicle. Vascular reactivity was evaluated in second-order mesenteric arteries. Clopidogrel treatment did not change systolic blood pressure [(mmHg) control-vehicle, 117+/-7.1 vs. control- Clopidogrel, 125+/-4.2; AngII-vehicle, 197+/-10.7 vs. AngII-Clopidogrel, 198+/-5.2], but it normalized increased phenylephrine-induced vascular contractions [(%KCl) vehicle-treated, 182.2+/-18 vs. Clopidogrel, 133+/-14%), as well as impaired vasodilation to acetylcholine [(%) vehicle-treated, 71.7+/-2.2 vs. Clopidogrel, 85.3+/-2.8) in Ang II-treated animals. Vascular expression of P2Y12 receptor was determined by western blot. Pharmacological characterization of vascular P2Y12 was performed with the P2Y12 agonist 2-MeS-ADP. Although 2-MeSADP induced endothelium-dependent relaxation [(Emax %) = 71%+/-12), as well as contractile vascular responses (Emax %= 83+/-12) these actions are not mediated by P2Y12 receptor activation. 2-MeS-ADP produced similar vascular responses in control and Ang II rats. These results indicate potential effects of Clopidogrel, such as improvement of hypertension-related vascular functional changes that are not associated with direct actions of clopidogrel in the vasculature, supporting the concept that activated platelets contribute to endothelial dysfunction, possibly via impaired NO bioavailability. PMID:19811450

Giachini, Fernanda Rc; Osmond, David A; Zhang, Shali; Carneiro, Fernando S; Lima, Victor V; Inscho, Edward W; Webb, R Clinton; Tostes, Rita C

2009-10-01

232

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

International Nuclear Information System (INIS)

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

233

Reduced anti-contractile effect of perivascular adipose tissue on mesenteric small arteries from spontaneously hypertensive rats: role of Kv7 channels.  

Science.gov (United States)

Perivascular adipose tissue (PVAT) has been shown to produce vasoactive substances and regulate vascular tone. This function of PVAT has been reported to be altered in hypertension. However, the underlying mechanisms are not fully understood. In this study we used age-matched normotensive Wistar-Kyoto (WKY) rats and spontaneously hypertensive rats (SHR) as well as Sprague-Dawley rats and tested effects of PVAT on mesenteric small arteries. Vessels were mounted in a Mulvany-Halpern myograph and cumulative concentration-response relations to noradrenaline were determined in the presence or absence of PVAT. We found that PVAT has an anti-contractile effect on mesenteric small vessels, irrespective of strains. A reduced effect of PVAT was observed in SHR compared to WKY rats; the difference between strains was eliminated by 10 ?M XE991, a blocker of Kv7 (KCNQ) voltage-dependent potassium channels. The anti-contractile effect of PVAT was not affected by depolarizing smooth muscle cells with high K(+) solution. Sensitivities to exogenous vasodilators acetylcholine or sodium nitroprusside were not potentiated but reduced in vessels with PVAT. Our results suggest that the reduced anti-contractile effect of PVAT in SHR correlates with a deficiency in Kv7 channels. Diffusion hindrance of PVAT is also a factor that should be considered in investigations on rat mesenteric small arteries. PMID:23059186

Li, Rui; Andersen, Ingrid; Aleke, Josefin; Golubinskaya, Veronika; Gustafsson, Helena; Nilsson, Holger

2013-01-01

234

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

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Full Text Available Abstract Background Coronary angiography is the current standard method to evaluate coronary atherosclerosis in patients with suspected angina pectoris, but non-invasive CT scanning of the coronaries are increasingly used for the same purpose. Low-density lipoprotein (LDL cholesterol and other lipid and lipoprotein variables are major risk factors for coronary artery disease. Small dense LDL particles may be of particular importance, but clinical studies evaluating their predictive value for coronary atherosclerosis are few. Methods We performed a study of 194 consecutive patients with chest pain, a priori considered of low to intermediate risk for significant coronary stenosis (>50% lumen obstruction who were referred for elective coronary angiography. Plasma lipids and lipoproteins were measured including the subtype pattern of LDL particles, and all patients were examined by coronary CT scanning before coronary angiography. Results The proportion of small dense LDL was a strong univariate predictor of significant coronary artery stenosis evaluated by both methods. After adjustment for age, gender, smoking, and waist circumference only results obtained by traditional coronary angiography remained statistically significant. Conclusion Small dense LDL particles may add to risk stratification of patients with suspected angina pectoris.

Andreasen Annette

2011-01-01

235

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)

dth (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.

236

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

237

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

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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

238

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.

239

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

240

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

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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

 
 
 
 
241

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

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

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

1991-03-01

242

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

International Nuclear Information System (INIS)

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

243

Isolated pump erosion of an inflatable penile prosthesis through the scrotum in a diabetic patient.  

Science.gov (United States)

Isolated pump erosion is a rare complication in patients with inflatable penile prosthesis. We describe a case of a diabetic patient who underwent inflatable penile prosthesis implantation with subsequent isolated pump erosion. Repeated attempts of conservative repair of the erosion failed. Finally, the inflatable penile prosthesis was replaced with a malleable one to avoid new pump erosion. In case of isolated pump erosion, replacement of the inflatable penile prosthesis with a malleable one looks to be a good alternative salvage treatment for the patient. PMID:23695409

Talib, Raidh A; Shamsodini, Ahmad; Salem, Emad A; Canguven, Onder; Al Ansari, Abdulla

2013-03-01

244

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

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

Mustafa Gunes

2012-10-01

245

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

246

Penile Prosthesis Implantation for Treatment of Postpriapism Erectile Dysfunction  

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

Akbar A Jalal

2008-06-01

247

Penile torsion correction by diagonal corporal plication sutures  

Scientific Electronic Library Online (English)

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

Brent W., Snow.

2009-02-01

248

[The penis was gone. A case report on penile cancer].  

Science.gov (United States)

Penile cancer is a rare disease. Patients develop symptoms early in the course of the disease for which reason late stages are seldom in western countries. The present case report describes a 64-year-old man with complete erosion of the penis, leaving an ulcer measuring 10 by 15 cm. The case report discusses incidence, symptoms, aetiology and different modalities of treatment and their correlation with survival. PMID:19925745

Hedeland, Rikke Lindgaard; Kromann-Andersen, Bjarne

2009-11-01

249

Penile tourniquet injury due to a coil of hair  

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

Chaware Suresh; Gajbhiye Raj; Singh A

2006-01-01

250

Penile Curvature Incidence in Hypospadias: Can It Be Determined?  

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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

251

Self-contained inflatable penile prosthesis: magnetic resonance appearance  

International Nuclear Information System (INIS)

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

252

Granuloma de silicona en el pene "siliconoma" / Penile silicone granuloma  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish OBJETIVO: Mostrar la experiencia adquirida con un caso de "siliconoma" peneano, de interés clínico por su infrecuente presentación. METODO /RESULTADOS: Presentamos el caso de un paciente con alteración de la función sexual secundaria a la inyección subcutánea de silicona líquida en el pene, dando lu [...] gar a la formación de un granuloma "siliconoma" peneano y a la migración de partículas del compuesto a raíz de pene y a rafe medio escrotal. Se procedió a la extirpación quirúrgica del "siliconoma " peneano y de las partículas migradas reparando el defecto peneano con piel escrotal. CONCLUSIONES: La inyección subcutánea de silicona líquida es una práctica no justificada que produce efectos devastadores y requiere cirugías importantes para la eliminación del material inyectado. Abstract in english OBJECTIVES: To report our experience with one case of penile silicone granuloma, that has clinical interest for its unfrequent presentation. METHODS/RESULTS: We report the case of a patient with sexual dysfunction secondary to subcutaneous injection of liquid silicone in the penis resulting in a pen [...] ile granuloma and migration of the particles to the penile root and midline scrotal raphe. We proceeded to the surgical excision of the granuloma and migrated particles, repairing the penile defect with scrotal skin. CONCLUSIONS: Subcutaneous injection of liquid silicone is a practice that does not have any justification because of its devastating effects and requires major perations for the elimination of the injected material.

Fructuoso, García Díez; Francisco Miguel, Izquierdo García; Manuel Emilio, Benéitez Álvarez; Rafael, Guerreiro González; Javier, Casasola Chamorro; Victor de, Blas Gómez; Francisco Javier, Gallo Rolanía; Juan Manuel, Roa Luzuriaga.

253

Surgical reimplantation of penile glans amputation in children during circumcision  

Science.gov (United States)

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

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

2014-01-01

254

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.)

255

Penile Reconstruction: Evaluation of the Most Accepted Techniques  

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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

256

The relationship between the localization and etiology in children’s penile tourniquet syndrome: A case report and literature review  

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Though the penile tourniquet syndrome is rarely seen, it is a disease which causes complications from a simple edema to severe necrosis and amputation. Whether simple or complicated, the penile strangulation that is the causative factor, except babies, whom are usually questionable. Our aim is to investigate the relation between perpetrators and location of disease in the penile tourniquet syndrome.

Ozdamar, Mustafa Yasar Bozok University; Zengin, Kursad Bozok University; Tanik, Serhat; Albayrak, Sebahattin; Gucuk, Adnan Abant Izzet Baysal University; Gurdal, Mesut

2014-01-01

257

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.

258

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

Energy Technology Data Exchange (ETDEWEB)

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

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

2011-03-21

259

99mTc penile scan: An investigative modality in priapism  

International Nuclear Information System (INIS)

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

260

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

Energy Technology Data Exchange (ETDEWEB)

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

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

1989-01-01

 
 
 
 
261

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

262

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

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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

263

Locally recurrent penile apocrine carcinoma initially diagnosed as metastatic adenocarcinoma of colon.  

Science.gov (United States)

Apocrine carcinoma is a rare malignant adnexal neoplasm. The differential diagnosis between apocrine carcinoma and cutaneous metastasis is often difficult. Here, we report a case of locally recurrent penile apocrine carcinoma initially diagnosed as metastatic adenocarcinoma of the colon. A 75-year-old man with a history of surgical resection due to sigmoid colon cancer and penile metastasis two years prior to this study presented with a nodule at the left penile base. He underwent a wide local resection of the penile mass under a suggested preoperative diagnosis of extra-mammary Paget's disease (EMPD) associated with previous sigmoid colon cancer. However, the previously and currently resected penile masses were identified as primary apocrine carcinoma upon hematoxylin and eosin (H&E) staining and immunohistochemical staining. Although the incidence is extremely rare, both clinicians and pathologists should be alert to the possibility of synchronous double primary apocrine carcinoma in cancer patients with malignant cutaneous lesions. PMID:24385708

Lee, Ok-Jun; Yun, Seok-Joong; Kim, Wun-Jae; Choi, Song-Yi; Lee, Ho-Chang; Song, Hyung-Geun; Lim, Sung-Nam; Lee, Ki-Hyeong; Kim, Seung-Taik; Han, Hye-Suk

2013-12-01

264

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)

265

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

266

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

Scientific Electronic Library Online (English)

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

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

2006-08-01

267

[Approval process of "medical devices" exemplified by the penile prosthesis].  

Science.gov (United States)

The penile prosthesis AMS Hydroflex was successfully introduced in 1985, yet only 5 years later was withdrawn from the market. The approval process of medical devices in the USA and Switzerland is critically analyzed. While the American Food and Drug Administration (FDA) is responsible for approving the marketing of medical devices in the USA no such office exists in Switzerland. In Switzerland the physician takes full responsibility when using a device. It is, however, intended to introduce similar to the USA three regulatory control categories depending upon the degree of regulation necessary to assure safety and effectiveness of each device. PMID:8119812

Gasser, T C; Riehmann, M; Bruskewitz, R C

1993-12-01

268

Treatment of penile strangulation caused by constricting devices.  

Science.gov (United States)

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

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

2002-01-01

269

Penile fracture with bilateral corporeal rupture without urethral involvement  

Science.gov (United States)

Concomitant urethral injury is rare in penile fracture. We report the case of a 34-year-old male who presented to the emergency department 12 hours after a blunt self-injury of the penis. Physical examination revealed a swollen, ecchymotic, and deviated circumcised penis without blood at the meatus. The fracture line extending along the bilateral corpora without urethral involvement was seen intraoperatively. The fracture side was repaired primarily. The patient healed and recovered without complication. To our knowledge, this is the second reported case of bilateral corporeal rupture without urethral involvement. PMID:24454602

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

2014-01-01

270

Early Rebleeding of Small Anterior Communicating Artery Aneurysm with Presumed Extrusion of Coil Loop to Outside the Aneurysmal Wall during Endovascular Treatment  

Science.gov (United States)

Summary Although endovascular treatment has been proved to be as effective as surgical clipping in the prevention of rebleeding of ruptured aneurysm, early rebleeding after coil embolization has seldom been reported. We experienced early rehemorrhage in two patients of ruptured small anterior communicating artery aneurysms of complete treatment with coil-embolization initially. In both cases what interested us was not early rebleeding itself but how the presumed extrusion of the first part of coil loop beyond aneurysmal wall developed. However, there was no evidence of intraprocedural rupture and moreover complete occlusion with only one or two coils was obtained. Our two patients underwent successful second treatment. We discovered the presumed extruded first part of the coil loop initially was located inside the enlarged aneurysmal sac in retreatment stage. In case of coil embolization of ruptured small anterior communicating aneurysm, the phenomenon we experienced with no evidence of intraprocedural rupture in spite of obvious extrusion of coil loop beyond the aneurysmal wall can be a sign of necessity for early follow-up study including plain radiography to track the change in the presumed extruded coil loop. PMID:20465938

Pyun, HW; Hyun, DK; Lee, DH; Park, SW; Lim, MK

2009-01-01

271

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 group, the combined therapy presented here seemed to improve the prognosis of locally advanced lung cancer if properly indicated. (author)

272

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.

273

Relationship between penile size and somatometric parameters in 2276 healthy young men.  

Science.gov (United States)

The aim of this study was to determine the average penile length of a group of healthy, young Turkish men, and to investigate the relationship between penile length and somatometric parameters in the same group. The flaccid and stretched length and circumference of the penis was measured in a group of 2276 physically normal, young men. The correlation between penile length and weight, height and body mass index (BMI) of the participants was determined by Pearson's analysis. The mean age of the participants was 21.1 ± 3.1 (18-39) years. The mean flaccid, fully stretched and circumferential length of the participants' penises were 8.95 ± 1.04, 13.98 ± 1.58 and 8.89 ± 0.86 cm, respectively. There was a significant relationship between all of these variables (P<0.01). Although weak positive correlations were found between the mean circumference length and BMI, there were no correlations between both the flaccid and stretched lengths and BMI. The penile length must be known to be able to determine the abnormal penile sizes and to make convenient decisions in the counseling and/or treatment of people with short penis concerns. Our study provides mean penile lengths in a large sample of healthy, young Turkish men, and the penile dimensions were found to be weakly correlated with somatometric parameters. PMID:22189447

Söylemez, H; Atar, M; Sancaktutar, A A; Penbegül, N; Bozkurt, Y; Onem, K

2012-01-01

274

Report of 84 cases of penile Fracture inBeheshti Hospital center  

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

H. Shafi

2005-01-01

275

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

Science.gov (United States)

We report a case of isolated penile metastasis from renal pelvic carcinoma in a 69-year-old man with malignant priapism. The patient had radical resection of the renal pelvic carcinoma 2 months earlier with urothelial carcinoma (UC) and sarcomatoid differentiation histology. Physical examination showed no visible skin lesions, but a palpable hard nodule was present over the penile shaft. The imaging studies did not reveal other metastases. Cavernous-Glans shunt and nodule resection were performed, and histological examination showed metastasis UC with sarcomatoid differentiation. To our knowledge, we describe the first case of malignant priapism due to isolated penile metastasis of renal pelvic carcinoma. PMID:25210564

Liu, Sulai; Zeng, Fuhua; Qi, Lin; Jiang, Shusuan; Tan, Pingping; Zu, Xiongbing; Xie, Yu; Han, Weiqing

2014-07-01

276

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

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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

277

Butea superba Roxb. enhances penile erection in rats.  

Science.gov (United States)

This study aimed to investigate the effects of ethanol extracts of Butea superba in increasing intracavernous pressure (ICP) in vivo. The extracts were prepared from fresh and dried root cores and fresh and dried root barks. Penile erection was induced in aged rats by electrical stimulation of the cavernous nerve. Cavernous smooth muscle relaxation was also observed in vitro in the presence of the extract, cGMP or isobutyl-methylxanthine (IBMX) alone or the extract together with cGMP or IBMX. The dried root core extract from Phrae was the most effective in increasing the ICP. The dose-response relationship study revealed a bell-shape curve with the maximum effective dose at 1 mg/kg. The ICP of the control and 1 mg/kg extract-treated animals were 45.3 +/- 2.5 and 100.9 +/- 14.0 mmHg, respectively. The extract, cGMP and IBMX alone induced dose dependent muscle relaxation. B. superba significantly enhanced the effects of cGMP and IBMX. The results suggest that ethanol extracts of B. superba are effective in enhancing penile erection. The dried root core extract from Phrae is the most effective part with a maximal dose of 1 mg/kg. The results also suggest that B. superba may act through cAMP/cGMP pathways. PMID:16619349

Tocharus, Chainarong; Smitasiri, Yuthana; Jeenapongsa, Rattima

2006-06-01

278

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.

279

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

280

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

 
 
 
 
281

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

282

Neurofibromatosis and arterial aneurysms.  

Science.gov (United States)

Neurofibromatosis (NF) is a common autosomal dominant disease characterized by the development of hamartomatous or neoplastic lesions due to the proliferation of neural crest cells. An association of aneurysmal arterial lesions with NF, which may have catastrophic complications, has been rarely reported. Our recent experiences with the diagnosis and management of three male NF patients with aneurysms is described. A 19-year-old-man with refractory hypertension due to unilateral, complex, unreconstructable renal artery aneurysms was successfully treated by nephrectomy. Histopathology demonstrated intramural renal artery Schwann cell proliferation. A 44-year-old patient underwent ligation of a ruptured superior mesenteric artery aneurysm. Finally, a femoral-popliteal artery saphenous vein bypass graft with aneurysm exclusion was performed in a 58-year-old-man with a 3.5 cm symptomatic popliteal artery aneurysm. In NF, the underlying pathology in large arteries is intramuscular Schwann cell proliferation with secondary fibrosis. Mesodermal dysplasia may affect small arteries resulting in stenosis, post-stenotic dilatation, or aneurysmal degeneration. Clinicians should be aware of the unusual association of NF with aneurysms, particularly the occult development of visceral and renal artery aneurysms. These lesions are subject to sudden rupture with potentially devastating consequences, and they mandate a high index of suspicion in NF patients. PMID:8600855

Huffman, J L; Gahtan, V; Bowers, V D; Mills, J L

1996-04-01

283

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

284

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

Science.gov (United States)

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

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

2013-07-01

285

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

International Nuclear Information System (INIS)

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

286

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.

L.V. Rossoni

2001-08-01

287

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english Ouabain increases vascular resistance and may induce hypertension by inhibiting the Na+ pump. The effects of 0.18 and 18 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 (co [...] ntrol 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.

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

288

A case of penile fracture with complete urethral disruption during sexual intercourse: a case report  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Penile fracture is a rare condition. Primarily it is a rupture of the corpus cavernosum that occurs when the penis is erect. The rupture can also affect the corpus spongiosum and the urethra. We report a case of a 37 year old man who presented with acute penile pain, penile swelling and the inability to pass urine after a blunt trauma during sexual intercourse. In emergency surgery we found bilateral partial rupture of the corpus cavernosum with complete urethral and corpus spongiosum disruption. In the one year follow up the patient presented with normal erectile and voiding function. Emergency surgical repair in penile fracture can preserve erectile and voiding function.

Jagodi? Klemen

2007-05-01

289

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

Directory of Open Access Journals (Sweden)

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

Piotr Paw?owski

2011-12-01

290

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

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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.

Tanvir Rizvi

2009-01-01

291

Penile gangrene with abscess formation after modified Al-ghorab shunt for idiopathic ischemic priapism.  

Science.gov (United States)

Penile gangrene is a rare but unfortunate complication of surgical intervention and priapism shunts. The literature regarding penile gangrene following surgical correction of priapism is sparse, the majority of which dates back to thirty to forty years. Here, we present the case of a 60-year-old man who presented with priapism that required operative management with a modified Al-Ghorab shunt and eventually suffered from complete necrosis of the penis with abscess formation in both corpora cavernosa. PMID:25276468

Ford-Glanton, Beneranda S; Patel, Parth; Siddiqui, Sameer

2014-01-01

292

Resurfacing of total penile full-thickness burn managed with the Versajet hydrosurgery system.  

Science.gov (United States)

Reconstruction of penile skin loss resulting from various causes is a challenge for clinician. Especially in a potent man, functional and cosmetic outcomes are demanded. Conservative treatment with topical agents is not enough for the full-thickness burn although hypertrophic scar and secondary contracture usually occurs. Resurfacing of total penile full-thickness burn after wound management with the Versajet hydrosurgery system (a water-jet powered debrider) is described for the first use in our hospital. PMID:20182375

Yeh, Chin-Choon; Lin, Yu-San; Huang, Kuo-Feng

2010-01-01

293

Distal penile prosthesis extrusion: treatment with distal corporoplasty or Gortex windsock reinforcement.  

Science.gov (United States)

Subcutaneous extrusion of penile prosthesis cylinders beneath the glans penis is an unusual but difficult complication of penile prosthesis. Without surgical repair, extrusion, infection, and corporeal fibrosis may ensue. Twenty-eight patients with distal corporeal extrusion were reviewed to identify the optimum treatment outcome for these penile prosthesis complications. Records of 28 men with subcutaneous distal penile prosthesis cylinder extrusion were reviewed. Mean age was 56.2 y. Etiology of erectile dysfunction was diabetes mellitus in 11, vasculogenic in 10, Peyronie's disease in five, radical pelvic surgery in five. Duration of penile prosthesis was 8-72 months (mean 42.6). No patient had penile prosthesis infection or device exposure through the skin. Distal corporoplasty was treated on 18/28 men using cylinder repositioning and direct tunica albuginea repair. Ten men underwent repair using a Gortex windsock. 8/18 corporoplasty and 6/10 windsock patients required glans fixation for treatment of hypermobile glans following cylinder relocation. In two patients with windsock repair, extrusion recurrence occurred 6 and 18 months following surgery and 1/6 had post operative infection requiring prosthesis removal. Mean surgical time for corporoplasty was 52.8 minutes while windsock reconstruction was 89.6 minutes. Distal subcutaneous penile prosthesis cylinder extrusion produces coital pain and predisposes to cylinder exposure and infection. Early repair with or without additional prosthetic materials will return penile prostheses to a normal functioning state. Distal corporoplasty with cylinder repositioning appears to be a simple, low morbidity solution to this difficult dilemma. Outcomes with distal corporoplasty result in better function, less pain, and fewer recurrences than Gortex windsock repair. PMID:11979321

Carson, C C; Noh, C H

2002-04-01

294

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

Science.gov (United States)

We report a successful implantation of Indian penile prosthesis after total phallic reconstruction. The differential stiffness of the Shah penile prosthesis is felt to have less potential for erosion, the most common complication of rigid prosthetic stiffening devices when used in a neo-phallus. This prosthesis is an alternative to the inflatable prosthesis in patients who choose a rigid prosthesis due to economical constraints. PMID:19468370

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

2008-01-01

295

Use of a polytetrafluoroethylene tube graft as a circumferential neotunica during placement of a penile prosthesis.  

Science.gov (United States)

Various techniques have evolved for augmentation of the tunica albuginea in cases when tunical tissue has been found deficient during penile prosthesis implantation. An intraoperative situation occurred in which the size of the tunical defect did not permit primary tunical closure or allow for approximation by placement of a tunical patch graft. In this case, to ensure satisfactory insertion of a penile prosthesis a polytetrafluoroethylene (Gore-Tex) tube graft was used as a circumferential neotunica. PMID:1433566

Seftel, A D; Oates, R D; Goldstein, I

1992-11-01

296

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

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

Fontana, Dario; Rolle, Luigi; Destefanis, Paolo; Ceruti, Carlo

2005-01-01

297

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

298

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

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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

299

Penile Replantation, Science or Myth? A Systematic Review  

Directory of Open Access Journals (Sweden)

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

Mohammad Reza Safarinejad

2007-02-01

300

Coronary arteries  

Energy Technology Data Exchange (ETDEWEB)

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

Wielopolski, P.A.; Oudkerk, M. [Dept. of Radiology, Daniel den Hoed Cancer Center, University Hospital Rotterdam (Netherlands); Geuns, R.J.M. van; Feyter, P.J. de [Thoraxcentre, University Hospital Rotterdam (Netherlands)

2000-01-01

 
 
 
 
301

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

302

Detection of papillomavirus in equine periocular and penile squamous cell carcinoma.  

Science.gov (United States)

Squamous cell carcinoma (SCC) is the most common tumor arising in the periocular and penile areas of horses. Both ultraviolet radiation and papillomaviruses have been implicated in the pathogenesis of SCC in various species, including the horse. This retrospective study used polymerase chain reaction (PCR) to detect papillomavirus DNA in archival biopsy samples from equine periocular and penile SCC from 3 different geographic areas (northeast, southeast, and central United States). Forty-two periocular SCCs were tested; none contained papillomavirus DNA. Twenty-two penile SCCs were tested, and papillomavirus DNA was identified in 10 (43%) cases. Sequencing of the PCR products revealed homology with Equus caballus papillomavirus 2 (EcPV-2). No geographic distribution in the detection of papillomavirus was identified. Penile SCCs were significantly more likely to be papillomavirus positive than the periocular SCCs (P < 0.001). The role of papillomavirus in the development of penile SCC requires further investigation. The differing pathogeneses of periocular and penile SCC suggest that the tumors may respond differently to treatment. PMID:24323055

Newkirk, Kim M; Hendrix, Diane V H; Anis, Eman A; Rohrbach, Barton W; Ehrhart, Eugene J; Lyons, Jerry A; Kania, Stephen A

2014-01-01

303

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

304

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

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

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

2010-01-01

305

The relationship between the localization and etiology in children’s penile tourniquet syndrome: A case report and literature review  

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Full Text Available Though the penile tourniquet syndrome is rarely seen, it is a disease which causes complications from a simple edema to severe necrosis and amputation. Whether simple or complicated, the penile strangulation that is the causative factor, except babies, whom are usually questionable. Our aim is to investigate the relation between perpetrators and location of disease in the penile tourniquet syndrome.

Mustafa Yasar Ozdamar

2014-04-01

306

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

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

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

2011-01-01

307

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

Science.gov (United States)

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

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

1999-06-01

308

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

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In recent years, penile traction therapy (PTT) has gained considerable interest as a novel nonsurgical treatment option for men with 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

309

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

Igor Piacentini; Salvatore Blanco; Flavio Fortuna; Caterina Lania; Marco Grasso

2008-01-01

310

Pityriasis versicolor on penile shaft in a renal transplant recipient.  

Science.gov (United States)

Pityriasis versicolor is a superficial infection of the stratum corneum, which is caused by the Malassezia species. Tge Malassezia species consist of 12 subspecies, including M. furfur, M. pachydermatis, M. symphodialis and M. globasa. The Malassezia species are classified as a normal flora, particularly in the sebum rich areas of the skin, and they convert from saprophytic yeast to parasitic mycelial morpholgic form to cause clinical disease. But majorities of their distributions are in the upper back, the neck, the thighs, and the forearm, and not in the penis. It is well known that the renal transplant patients, who take immunosuppressive agents, have impairment in the protective cell mediated immunity. Thus, they are more susceptible to infectious diseases, such as a fungal infection. Therefore, clinical manifestations show higher incidence of disease, but they mostly occur in an expected distribution. We here report a case of pityriasis versicolor in a renal transplant recipient on penile shaft, which is an unusual area. PMID:22879720

Ryu, Han-Won; Cho, Jae-We; Lee, Kyu-Suk

2012-08-01

311

[Regional metastases of penile cancer: optimal treatment policy].  

Science.gov (United States)

Emergence of regional penile cancer (PC) metastases reduces late survival of PC patients from 94.4 to 83.9%. PC stage can hardly be diagnosed by clinical data significantly. Bilateral inguinal lymphadenectomy is indicated for all PC patients with enlarged and clinically negative regional lymph nodes in poorly differentiated primary tumor (G3) and stages T2-3. Follow-up can be recommended for patients with stage Tis-T1, low and moderate anaplasia (G1-2) of the primary tumor. Metastases to the iliac lymph nodes are an indication to pelvic lymphadenectomy. Preventive removal of the iliac lymph nodes in intact inguinal ones is not justified. Unremovable fixed regional lymph nodes should be exposed to radiotherapy. PMID:15457947

Matveev, B P; Matveev, V B; Khalf'ian, E A; Volkova, M I; Gurari?, L L

2004-01-01

312

Is there a rationale for penile rehabilitation following radical prostatectomy?  

Science.gov (United States)

Erectile function recovery after radical prostatectomy (RP) is an increasingly prominent quality-of-life outcome following surgery. Following RP many men, despite the advent of cavernous nerve-sparing surgical technique, have moderately or significantly impaired erectile function (EF). The term penile rehabilitation (PR) is used to define interventions that maintain the health of erectile tissue in the context of nervous, vascular, and structural tissue injury. The goal of PR is to regain, as closely re-approximate, preoperative erectile function. PR is based on an increasing volume of preclinical and clinical data, but conclusive evidence of efficacy has not been established, and therefore the concept of PR remains controversial. The optimal PR regimen has not been established, but all strategies rely on one or more erectile dysfunction treatments to be administered on a regular basis regardless of actual use for sexual activity. This review highlights recent studies and evidence related to PR. PMID:24692247

Barazani, Yagil; Stahl, Peter J; Nagler, Harris M; Stember, Doron S

2015-01-01

313

Tubing Erosion of an Inflatable Penile Prosthesis Long after Implantation  

Science.gov (United States)

Introduction Erosion through skin of connecting tubing of an inflatable penile prosthesis (IPP) has not been previously reported. Aim The aim of this study was to present a case of tubing erosion, review the pertinent literature, and discuss the possible causes and management options, including preservation of the device and its components. Methods A 42-year-old male failing to respond to medical treatment for erectile dysfunction underwent insertion of an AMS 700 IPP in 1986. Six years later, a revision was necessary because of a leak in the right cylinder and 4 years after, the pump was replaced. Fourteen years after the original implant, he presented with a portion of the tube connecting the pump to the right cylinder eroding through the skin. There was no infection. The skin area involved was resected and the original pump and tubing were buried in a new scrotal pocket after thorough irrigation. Results The IPP remained in place, allowing vaginal penetration and without infection for another 11 years. Three years later, it was de-functionalized, converted into a fixed volume device. It eventually was replaced 25 years after originally implanted with a semirigid prosthesis because it did not provide sufficient rigidity and because of concerns about the presence of “screws” detected during pelvic imaging. Conclusions Mechanical failures in the early IPP models, as illustrated in this case, were expected. However, the long survival of the device is remarkable. Erosion of the connecting tubing through the skin is unique and, under exceptional circumstances, may be managed conservatively without replacing components of the IPP. Clinicians unfamiliar with procedures involving inflatable devices need to be aware of “foreign bodies” visible in radiological examinations in men who have had revisions of an IPP. Morales A. Tubing erosion of an inflatable penile prosthesis long after implantation. Sex Med 2014;2:103–106. PMID:25356305

Morales, Alvaro

2014-01-01

314

Penile prosthesis implantation in an academic institution in Latin America  

Scientific Electronic Library Online (English)

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

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

315

Penile prosthesis implantation in an academic institution in Latin America  

Scientific Electronic Library Online (English)

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

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

2010-10-01

316

Cellular basis of endothelial dysfunction in small mesenteric arteries from spontaneously diabetic (db/db -/-) mice: role of decreased tetrahydrobiopterin bioavailability.  

Science.gov (United States)

1. Endothelium-dependent and -independent regulation of vascular tone in small mesenteric arteries (SMA) from control (db/db +/?) and diabetic (db/db -/-) mice was compared. 2. Phenylephrine-induced maximum contraction, but not sensitivity, of SMA in db/db -/- compared to db/db +/? was enhanced. 3. Acetylcholine (ACh), but not sodium nitroprusside (SNP), -induced relaxation was reduced in SMA from db/db -/- compared to db/db +/?. 4. ACh-induced relaxation of SMA was inhibited by a combination of N(omega)-nitro-L-arginine and indomethacin in db/db +/?, but not in db/db -/-. 5. Acute incubation of SMA with tetrahydrobiopterin (BH(4), 10 microM) and sepiapterin (100 microM) enhanced ACh-induced relaxation in SMA from db/db -/-, but not from db/db +/? 2,4-diamino-6-hydroxypyrimidine, an inhibitor of GTP cyclohydrolase I, (10 mM), impaired the sensitivity of SMA from db/db +/? to ACh, which was restored by co-incubation with BH(4) (10 microM). 6. BH(4) and superoxide dismutase (SOD, 150 u ml(-1)), either alone or in combination, had no effect on either ACh or SNP-induced relaxation in SMA from eNOS -/- mice. 7. Incubation of SMA with SOD (150 iu ml(-1)), catalase (200 iu ml(-1)) and L-arginine (1 mM) had no effect on ACh-induced relaxation of SMA. However, the combination of polyethylene glycol-SOD (200 iu ml(-1)) and catalase (80 u ml(-1)) improved the sensitivity of ACh-induced relaxation in db/db -/-, but not in db/db +/?. 8. These data suggest that increased production of superoxide anions and decreased availability of BH(4) result in an 'uncoupling' of nitric oxide synthase and endothelial dysfunction in SMA from db/db -/- mice. PMID:12010774

Pannirselvam, Malarvannan; Verma, Subodh; Anderson, Todd J; Triggle, Chris R

2002-05-01

317

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

International Nuclear Information System (INIS)

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.)

318

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

319

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

Fontana, Dario; Destefanis, Paolo; Rolle, Luigi; Ceruti, Carlo

2012-01-01

320

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

 
 
 
 
321

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

Directory of Open Access Journals (Sweden)

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

322

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

323

Dislodgement of a sirolimus-eluting stent in the circumflex artery and its successful deployment with a small-balloon technique.  

Science.gov (United States)

Coronary stent dislodgement or embolization before deployment is a rare but serious complication in interventional cardiology. A 60-year-old male presented with unstable angina five years after coronary artery bypass surgery. There was a stenosis (70%) in the obtuse marginal branch of the circumflex artery. During percutaneous coronary intervention, a sirolimus-eluting stent was stripped from its balloon mainly because of significant proximal angulation and incarcerated within the proximal circumflex artery. A smaller balloon dilatation catheter was advanced and pushed through the inside of the slipped stent. Using this technique, the stent could be advanced into the lesion and was successfully deployed. To our knowledge, this is the first case report on sirolimus-eluting stent dislodgement. PMID:21743268

Sentürk, Tunay; Ozdemir, Bülent; Ye?ilbursa, Dilek; Serdar, Osman Ak?n

2011-07-01

324

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

Directory of Open Access Journals (Sweden)

Full Text Available The aim of this retrospective study is to evaluate the long-term followup of soft penile SSDA prosthesis, without plaque surgery in the treatment of Peyronie's disease. This study included 12 men with Peyronie's disease who underwent placement of a penile prosthesis. All patients were followed for at least 6 years. Prosthesis straightened the penile shaft in all cases, restoring patient sexual satisfaction. No operative or postoperative complications occurred, and no reoperations were needed. All patients have undergone further examination with basal and dynamic eco color Doppler. The findings are encouraging as the penis preserves the ability to enhance the tumescence and penile girth. We can conclude that SSDA penile prosthesis is safe and effective in Peyronie's disease.

Igor Piacentini

2008-12-01

325

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

Science.gov (United States)

The aim of this retrospective study is to evaluate the long-term followup of soft penile SSDA prosthesis, without plaque surgery in the treatment of Peyronie's disease. This study included 12 men with Peyronie's disease who underwent placement of a penile prosthesis. All patients were followed for at least 6 years. Prosthesis straightened the penile shaft in all cases, restoring patient sexual satisfaction. No operative or postoperative complications occurred, and no reoperations were needed. All patients have undergone further examination with basal and dynamic eco color Doppler. The findings are encouraging as the penis preserves the ability to enhance the tumescence and penile girth. We can conclude that SSDA penile prosthesis is safe and effective in Peyronie's disease. PMID:19081839

Grasso, Marco; Lania, Caterina; Fortuna, Flavio; Blanco, Salvatore; Piacentini, Igor

2008-01-01

326

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

Science.gov (United States)

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

Lin, F; Gou, X

2013-01-01

327

Butea superba (Roxb.) improves penile erection in diabetic rats.  

Science.gov (United States)

The objective of the present study was to investigate the effect of ethanolic extract of Butea superba (Roxb.) on erectile dysfunction in diabetic rats by the measurement of intracavernous pressure (ICP) and on cavernosal smooth muscle relaxation. Male Sprague-Dawley rats were induced to become diabetic by a single intravenous injection of Streptozotocin (55 mg kg(-1) body weight). The ethanolic extract at the concentration of 1, 10 and 100 mg kg(-1) BW was administered orally once a day to diabetic rats in each group for 4 weeks. Diabetic rats showed a significant decrease in both ICP and the relaxation of the cavernosal smooth muscle compared with the normal rats. The extract of B. superba significantly increased the ICP with the effective dose of 10 mg kg(-1) BW (61.00 ± 11.11 mmHg versus 39.61 ± 11.01 mmHg in the diabetic control group). Moreover, the B. superba-treated group also showed enhanced relaxation of the cavernosal smooth muscle with EC(50) of 1.17 mg ml(-1). These results suggest that the extract of B. superba enhanced penile erection in diabetic rats by increasing the ICP. This might be explained by the increased blood flow as a result of the relaxation of the cavernous smooth muscle. PMID:22129362

Tocharus, C; Sooksaen, P; Shimbhu, D; Tocharus, J

2012-05-01

328

Urethral pseudodiverticulum secondary to penile fracture and complete urethra dissection.  

Science.gov (United States)

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

329

Pentoxifylline treatment and penile calcifications in men with Peyronie's disease  

Science.gov (United States)

This retrospective cohort study from a single clinical practice enrolled patients with evidence of calcified Peyronie's disease (PD) plaques detected on penile ultrasound at the time of initial presentation. The primary objective was to describe the effect of pentoxifylline (PTX) treatment on subtunical calcifications in men with PD. A PD-specific questionnaire was administered and sonographic evaluations were performed at baseline and follow-up visits. Descriptive statistics and ?2 analysis were used to characterize the effect of PTX on calcified tunical plaques. In all, 71 men (mean age: 51.9 years) with PD and sonographic evidence of calcification were identified. Of them, 62 of these men were treated with PTX for a mean duration of 1 year, and nine with vitamin E or no treatment. Improvement or stabilization in calcium burden at follow-up was noted in 57 (91.9%) of men treated with PTX versus four (44.4%) of those not treated with PTX (P<0.001). PTX users were much less likely to have a subjective worsening of their clinical condition (25.0% versus 78.3%, P=0.002). Treatment with PTX appeared to stabilize or reduce calcium content in PD plaques. A randomized controlled trial is warranted to further explore this effect. PMID:21102473

Smith, James F; Shindel, Alan W; Huang, Yun-Ching; Clavijo, Raul I; Flechner, Lawrence; Breyer, Benjamin N; Eisenberg, Michael L; Lue, Tom F

2011-01-01

330

Arterial embolism.  

Science.gov (United States)

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 dislodge from the surface of athesclerotic lesions and occlude distal arteries causing immediate ischemia. Atheroemboli, which originate from fracturing the lipid core tend to cause a process of organ dysfunction and systemic inflammation, termed cholesterol embolization syndrome. The presentation of arterial emboli depends on the arterial bed that is affected. The most common manifestations are strokes and acute lower limb ischemia. Less frequently, emboli target the upper extremities, mesenteric or renal arteries. Treatment involves rapid diagnosis, which may be aided by precise imaging studies and restoration of blood flow. The type of emboli, duration of presentation, and organ system affected determines the treatment course. Long-term therapy includes supportive medical care, identification of the source of embolism and prevention of additional emboli. Patients who experienced arterial embolism as a result of clots formed in the heart should be anticoagulated. Arterial emboli from atherosclerotic disease of the aorta or other large arteries should prompt treatment to reduce the risk for atherosclerotic progression, such as anti-platelet therapy and the use of statin drugs. The use of anticoagulation and surgical intervention to reduce the risk of arterial embolization from atherosclerotic lesions is still being studied. PMID:23724391

Lyaker, Michael R; Tulman, David B; Dimitrova, Galina T; Pin, Richard H; Papadimos, Thomas J

2013-01-01

331

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

332

Prepuce and partial penile amputation for treatment of preputial gland neoplasia in two ferrets.  

Science.gov (United States)

Preputial tumours in ferrets are frequently malignant and therefore warrant prompt investigation. As many cases do not respond favourably to surgery, even in combination with radiation therapy, wide surgical resection has been recommended. Such a procedure may necessitate partial or total penile resection but outcomes have thus far not been well described. The current case series describes two ferrets in which surgical resection, including penile amputation, was performed using 10 and 5 mm margins, respectively. In the first case, no recurrence of preputial gland adenocarcinoma was noted for 32 months postsurgery, whereas multiple attempts at surgery and radiation therapy were unsuccessful in the second. These cases suggest that margins of at least 1 cm may help achieve a better outcome. Penile amputation for the treatment of preputial tumours appears to be well tolerated by ferrets, as demonstrated by these cases. PMID:24962052

van Zeeland, Y R A; Lennox, A; Quinton, J F; Schoemaker, N J

2014-11-01

333

[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

334

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

335

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

336

Penile Gangrene: An Unusual Complication of Priapism in a Patient with Bladder Carcinoma  

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A 40-year-old, apparently healthy farmer presented with a 4-day history of progressively painful penile erection with no known predisposing or precipitating factor. He had an emergency El-Ghorab shunt which resulted in almost complete detumescence. He was noticed to have developed ischemic changes of the distal part of the penile skin which progressed to gangrene of the distal part of the penis on the 4th day post intervention. Abdomino-pelvic ultrasound revealed an intravesical mass and urin...

Ajape, Abdulwahab A.; Bello, Ahmad

2011-01-01

337

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

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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 fluorodeoxyglucose activities in supradiaphragmatic and infradiaphragmatic lymphatic stations. PMID:23919076

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

2012-07-01

338

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

International Nuclear Information System (INIS)

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 fluorodeoxyglucose activities in supradiaphragmatic and infradiaphragmatic lymphatic stations. (author)

339

Penile Fracture in A Patient With Spinal Cord Injury: A Case Report  

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Herein, we present a case of penile fracture (PF) in a patient with spinal cord injury (SCI). A 36-year-old male patient with T12 paraplegia ASIA-B fell during transfer from wheelchair to the bed. He had no complaint during the night. He observed swelling of the penis when he was doing clean intermittent catheterization in the morning. On physical examination, edema and ecchymosis were observed on the penis. Penil ultrasound revealed haematoma in the corpus cavernosum. The diagnosis of PF was...

Gu?zelku?c?u?k, U?mu?t; Duman, I?ltekin; Erten, Koray; Yilmaz, Bilge; Tan, Arif Kenan

2013-01-01

340

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

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Penile incarceration injury by heavy metallic ring is a rare genital injury. A man may place metal object for erotic or autoerotic purposes, for masturbation or increasing erection, and due to psychiatric disturbances are some of the reasons for a penile incarceration injury. The incarcerating injury results in reduced blood flow distal to the injury, leading to edema, ischemia, and sometimes gangrene. These injuries are divided into five grades and their treatment options are divided into four groups. Surgical techniques are reserved for the advanced grades (Grades IV and V). We describe an innovative surgical technique, which can be adopted in Grades II and III injuries. PMID:19672365

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

2009-04-01

 
 
 
 
341

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

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

B., Juaneda Castell; M., Montlleó González; X., Ponce de León Roca; L.l., Gausa Gascón; J., Caparrós Sariol; H., Villavicencio Mavrich.

1043-10-01

342

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

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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

343

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

344

Arterial embolization in the treatment of post-traumatic priapism.  

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Priapism is a prolonged penile erection not associated with sexual arousal. Two types of priapism have been described: the more common one is the "veno-occlusive" priapism and can be frequently observed as the consequence of an intracavernosal injection of vaso-active drugs for the treatment of erectile dysfunction. The less common type of priapism is known as "high flow" priapism and usually follows perineal or direct penile trauma. The clinical presentation in case of high flow priapism is quite typical: hystory of recent penile or perineal trauma followed, by the onset of a painless, incomplete and constant erection of the penis. A color-flow Doppler sonogram should be performed as first diagnostic step: this examination allows to identify the presence of patent cavernous arteries and prominent venous drainage with focal area of high flow turbulence along the pathway of one or both the cavernous arteries. An arterial blood sample taken from the corpora will confirm the diagnosis. At first, conservative therapeutical attempts can be suggested, with mechanical external compression of the perineum, the use of ice packs, corporeal aspiration and irrigation with saline. Besides, intracorporeal administration of alpha-agonists and methylene blue should be performed. Unfortunately, these conservative measures often result unsuccessful, and more invasive approaches must be considered. The radiological superselective transcatheter embolization of the proximal artery supplying arterial-lacunar fistula should be the present treatment of choice in these cases of high-flow priapism refractory to conservative and medical treatments. The first successful management of high flow priapism by selective arterial embolization was reported by Wear and coworkers in 1977. Autologous clots and gelatine sponge have been extensively used and become very popular as the embolic agent. More recently, platinum microcoils have been proposed with the aim to achieve more precise and selective embolization. In our single-case-experience on the treatment of high flow priapism by arterial embolization, we used the recently introduced tungsten microcoils. At the time of the follow-up, 2 months later, patient reported satisfactory intercourse with an approximately 75% of penile rigidity. By comparison with microsurgical ligature of the damaged vessel, selective embolization is, at least theoretically, a less invasive procedure, particularly with reference to the trauma caused to the erectile tissue. High-flow priapism is a fairly rare urological pathology which does not require immediate and emergency treatment (as is the case, instead, with venous-occlusive priapism), since the risk of post-ischaemic fibrosis is excluded thanks to the fact that oxygen is supplied to the cavernous tissue. Once the diagnosis has been established with certainty, therefore, the specialist has the necessary time at disposal to arrange for the most appropriate therapeutic steps. When, as is frequently the case, conservative measures prove ineffective, the current treatment of choice for cases of fistula of the cavernous artery would appear to be superselective embolization of the artery, provided same can be performed at specialized centres and by experienced personnel. PMID:10417850

Colombo, F; Lovaria, A; Saccheri, S; Pozzoni, F; Montanaris, E

1999-01-01

345

Arterial Catheterization  

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... arterial lines are maintained with some fluid, like normal saline. Sometimes a blood thinner is also given to prevent clotting of the line. Other medications are not generally given in an arterial ... to normal after the catheter is removed. Source: Manthous, C., ...

346

Metformin restores intermediate-conductance calcium-activated K+ channel- and small-conductance calcium-activated K+ channel-mediated vasodilatation impaired by advanced glycation end products in rat mesenteric artery.  

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The present study was designed to investigate the effect of metformin on the impairment of intermediate-conductance and small-conductance Ca(2+)-activated potassium channels (IKCa and SKCa)-mediated relaxation in diabetes and the underlying mechanism. The endothelial vasodilatation function of mesenteric arteries was assessed with the use of wire myography. Expression levels of IKCa and SKCa and phosphorylated Thr(172) of AMP-activated protein kinase (AMPK) were measured using Western blot technology. The channel activity was observed using a whole-cell patch voltage clamp. Reactive oxygen species (ROS) were measured using dihydroethidium and 2',7'-dichlorofluorescein diacetate. Metformin restored the impairment of IKCa- and SKCa-mediated vasodilatation in mesenteric arteries from streptozotocin-induced type 2 diabetic rats and that from normal rats incubated with advanced glycation end products (AGEs) for 3 hours. In cultured human umbilical vein endothelial cells (HUVECs), 1 ?M metformin reversed AGE-induced increase of ROS and attenuated AGE- and H2O2- induced downregulation of IKCa and SKCa after long-term incubation (>24 hours). Short-term treatment (3 hours) with 1 ?M metformin reversed the decrease of IKCa and SKCa currents induced by AGE incubation for 3 hours without changing the channel expression or the AMPK activation in HUVECs. These results are the first to demonstrate that metformin restored IKCa- and SKCa-mediated vasodilatation impaired by AGEs in rat mesenteric artery, in which the upregulation of channel activity and protein expression is likely involved. PMID:25123289

Zhao, Li-Mei; Wang, Yan; Yang, Yong; Guo, Rong; Wang, Nan-Ping; Deng, Xiu-Ling

2014-11-01

347

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

International Nuclear Information System (INIS)

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

348

Severe, disabling, and/or chronic penile pain associated with Peyronie disease: management with subcutaneous steroid injection.  

Science.gov (United States)

Penile pain is one of the most distressing, limiting, and difficult to treat manifestations of Peyronie disease. The use of steroid injections for penile deformities associated with Peyronie disease has been ineffective. However, use of steroid injections in managing penile pain has been poorly investigated. The aim of this study was to examine the efficacy and safety of subcutaneous, nonintralesional steroid injections in patients with severe, disabling, and/or chronic penile pain associated with Peyronie disease. This was a single-institution retrospective study of 16 patients with severe, disabling, and/or chronic penile pain associated with Peyronie disease who underwent subcutaneous, nonintralesional injection of triamcinolone (50 mg) between 2004 and 2006. Preinjection and postinjection analog pain scales were used to assess treatment efficacy. All 16 patients (mean age, 47.6 ± 11.1 years) had penile pain associated with erections for an average of 13.9 months (range, 3-36 months) prior to injections. Mean preinjection and postinjection penile pain scores were 6.6 ± 2.1 and 0.5 ± 0.5, respectively. On average, patients were pain free at follow-up visits within 10.6 ± 7.6 weeks. The mean pain-free duration was 23.8 months (range, 3-52 months). The mean cumulative dose of triamcinolone was 75.0 mg (range, 50-200 mg), with a mean of 1.5 injections (range, 1-4 injections). All 16 patients had overall improvement in pain scores. There were no adverse events or geometric penile changes after injections. Subcutaneous, nonintralesional injections of triamcinolone is an effective, safe, and durable means of managing severe, disabling, and/or chronic penile pain in patients with Peyronie disease. Future studies are needed to validate these findings. PMID:19684339

Dickstein, Rian; Uberoi, Jayant; Munarriz, Ricardo

2010-01-01

349

Penile metastasis of cutaneous malignant melanoma: a true hematogenous spread?: Case report and review of the literature.  

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Penile involvement has been implicated as a metastatic site in several tumors; approximately 300 cases have been reported. Of these, only two cases showed cutaneous melanoma as the primary site. Our patient presented with a painless mass on the penile shaft together with other distant metastases. A magnetic resonance image demonstrated two sites of deposit in the subcutaneous tissue on the radix penis, and fine needle aspiration cytology of the mass confirmed the presence of melanoma cells. The patient died of systemic disease without any further treatment for penile involvement. This unusual involvement is presented with a review of the related literature. PMID:16718273

Kurul, Sidika; Aykan, Faruk; Tas, Faruk

2006-06-01

350

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

351

Warfarin-induced penile necrosis in a patient with heparin-induced thrombocytopenia.  

Science.gov (United States)

A 56-yr-old man with lung adenocarcinoma presented with subsegmental pulmonary thrombosis. Platelet count on presentation was 531 x 10(9)/L. The patient was anticoagulated with subcutaneous low molecular weight heparin (LMWH). Next day, oral anticoagulation was initiated with 5 mg of warfarin once daily with LMWH and LMWH was discontinued at third hospital day. On the third day of oral anticoagulation therapy, he complained of left leg swelling and prolonged painful penile erection of 24 hr-duration. His platelet count reached a nadir 164 x 10(9)/L at that time, and the patient had a deficiency of protein C and S, with an activity level of 16% and 20% of normal value. Warfarin was stopped and he underwent penile aspiration. The next day, left leg edema and penile erection was disappeared, but penile and glans penis necrosis was started. This case illustrates that processes underlying heparin-induced thrombocytopenia (HIT) may also underlie warfarin-induced skin necrosis. PMID:20808689

Chang, In Ho; Ha, Moon Soo; Chi, Byung Hoon; Kown, Yong Wook; Lee, Sang-Jae

2010-09-01

352

Human papillomavirus and penile cancers in Rio de Janeiro, Brazil: HPV typing and clinical features  

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Full Text Available OBJECTIVE: To determine the prevalence of human papillomavirus (HPV DNA in penile cancers in Rio de Janeiro, Brazil. MATERIALS AND METHODS: We studied, prospectively, 80 consecutive cases of patients with penile cancers who underwent surgical treatment at three different Hospitals in Rio de Janeiro between March 1995 and June 2000. Of these patients, 72 were diagnosed with invasive squamous cell carcinoma and 8 patients with verrucous carcinoma. The following parameters were observed: presence or absence of HPV DNA viral type, histological subtypes, clinical stage and overall survival. RESULTS: HPV DNA was detected in 75% of patients with invasive carcinomas and in 50% of patients with verrucous carcinomas. High risk HPVs were detected in 15 of 54 (27.8% patients with HPV positive invasive tumors and in 1 of 4 (25% patients with HPV positive verrucous tumors. HPV 16 was the most frequent type observed. No correlation was observed between HPV status and histological subtype (p = 0.51 as well as HPV status and stage stratification (p = 0.88. HPV status was also not significantly associated with the presence of regional metastases (p = 0.89. The overall survival was related to the presence of lymph node metastases (p < 0.0001. CONCLUSIONS: HPV infection may have contributed to malignant transformation in a large proportion of our penile cancer cases but only inguinal metastasis was a prognostic factor for survival in these patients with penile carcinoma.

Marcos A. Scheiner

2008-08-01

353

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

354

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

Science.gov (United States)

Penile metastasis secondary to primary bladder cancer is a rare entity and represents a challenging problem. The common mode of spread to the penis is by retrograde venous route. The overall outcome is dismal and most patients will die within 1 year even after optimum treatment. Here, we report two such cases. PMID:24600185

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

2014-01-01

355

'A reservoir within a reservoir' - An unusual complication associated with a defunctioned inflatable penile prosthesis reservoir  

Science.gov (United States)

INTRODUCTION Inflatable penile prostheses (IPP) have been a successful method of treating men with erectile dysfunction since the early 1970s. IPP are comprised of two intracorporal cylinders, a scrotal pump and a fluid reservoir. PRESENTATION OF CASE We present a case of a retained reservoir in a sixty eight year old gentlemen presenting with a cystic abdominal mass and bothersome LUTS, 15 years after the removal of the penile components of a three-piece penile prosthesis. Percutaneous drainage of the cyst was performed, with four litres of purulent fluid evacuated. A midline laparotomy was required to remove the reservoir and drain the collection completely. DISCUSSION Inflammatory reaction and subsequent erosion of an IPP reservoir is an infrequent but severe complication of IPP insertion, replacement or infection. Infection remains the primary indication for penile prosthesis removal and in this setting removal of the reservoir is routine. A thorough literature search has identified that in the non-infective setting, the routine removal of the original reservoir is not standard practice during three-component IPP replacement. In patients with a history of IPP presenting with new LUTS, reservoir erosion should be considered in the differential diagnosis and investigation with cystoscopy and computed tomography included early in the investigatory armament of the urologist. CONCLUSION It is our belief that a defunctionalized reservoir serves no purpose; rather it can only cause trouble in the future. Consequently, at our institution we do not leave defunctionalized reservoirs in situ. PMID:25247874

Abboudi, Hamid; Bolgeri, Marco; Nair, Rajesh; Chetwood, Andrew; Symes, Andrew; Thomas, Philip

2014-01-01

356

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.

357

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

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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

358

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

359

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

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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

360

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

 
 
 
 
361

Penile absorption of EMLA cream in piglets: implications for use of EMLA in neonatal circumcision.  

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EMLA (eutectic mixture of lidocaine and prilocaine) cream is currently not recommended for use in infants methemoglobinemia as a result of the o-toluidine metabolite of prilocaine. We studied bioavailability and changes in methemoglobin levels following topical penile exposure to 1 g of EMLA cream for 1 hour in piglets. Lidocaine, prilocaine, and o-toluidine concentrations were measured simultaneously using a high-performance liquid chromatography method. The systemic bioavailability of EMLA was low: 4.0 +/- (SD) 4.7% for lidocaine (range 0-13.6; n = 8) and 7.2 +/- 5.7% for prilocaine (range 0-14.5; n = 8). The ratio between exposure to o-toluidine with EMLA versus intravenous administration (i.e., AUCEMLA/AUCIV; see text) was also low: 4.2 +/- 9.3% (range 0-28.6; n = 9). The mean maximum methemoglobin value after intravenous administration was 1.23 +/- 0.64% (range 0.5-3.0; n = 12) and after penile application 0.99 +/- 0.36% (range 0.5-2.0; n = 12). The methemoglobin value was elevated significantly above baseline after intravenous administration (p = 0.03), but not after penile application of EMLA. These findings suggest that penile administration of 1 g of EMLA may be safe for neonatal circumcision, but further study is required. PMID:8835088

Gazarian, M; Taddio, A; Klein, J; Kent, G; Koren, G

1995-01-01

362

Coronary arterial fistulas  

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

Qureshi Shakeel A

2006-12-01

363

Somatic mutations of STK11 gene in human papillomavirus positive and negative penile cancer  

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Full Text Available Abstract Background Human papillomavirus (HPV infection accounts for about 40-50% of all cases of penile carcinoma suggesting that other factors, including host genetic status, are involved in neoplastic transformation. In this perspective, STK11 gene, which has been found frequently mutated in HPV-related cervical carcinoma, has been analyzed in HPV-positive and HPV-negative invasive penile cancers to establish its mutational status and the possible correlation of HPV infection with specific genetic alterations. Methods Genomic DNAs extracted from 26 cases of penile squamous cell carcinoma were analyzed for genetic alterations in the exons 1 to 9 of STK11 gene by quantitative real-time PCR. Ratios of potentially deleted and non-deleted exons were indicative of specific loss of STK11 coding regions. DNA samples of 5 cancer cases were subjected to standard PCR amplification of STK11 exons 1 to 9 and analyzed for somatic mutations by direct nucleotide sequencing analysis. Results Heterozygous deletions of STK11 exon 1 and 2 were identified in 2 out of 14 HPV-positive (14.3% and 1 out of 12 HPV-negative cases (8.3%. Complete nucleotide sequencing analysis of exons 1 to 9 showed a single nucleotide change upstream the exon 2 coding region in 1 out of 5 penile carcinoma samples. Conclusions The present results suggest that single nucleotide mutations and/or deletions of STK11 gene are rare events in penile cancer. Moreover, no significant association was observed between STK11 alterations and HPV infection in these tumors.

Annunziata Clorinda

2013-01-01

364

Formulas for determining the dimensions of venous graft required for penile curvature correction.  

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To evaluate the quantity of penile veins for use as patch material for the treatment of penile curvature, we devised two formulas: from the calculus of applied civil engineering and a diagram from the goniometry of the cadavers' penises, respectively, and the techniques for their application. From March 1995 to July 2003, a total of 65 consecutive patients with penile curvature - 41 men with Peyronie's deformity and 24 with congenital penile deviations - underwent grafting with autologous deep dorsal veins with or without cavernosal veins as patch material. The patched veins required were calculated from the formula (pi)r(2)theta/45 degrees , which is derived from calculus. The tunical incision sector was meticulously performed in accordance with our diagram which is interpolated from seven male cadavers via goniometry and consequently the length of patched veins required was 2 (pi)r(theta)(')/theta. The corporotomy defect was fashioned with the detubularized veins after they were adequately prepared and spliced. In these patients, the average available area of the veins was 4.9 x 2.2 cm(2) (range, 4.5 x 1.8 to 5.6 x 2.4), which seemed adequate in all cases for patching, although 11 of them required two patches. Overall, 21 patients required a modified Nesbit's procedure on the contralateral/ipsilateral tunica to attain a satisfactory penile shape. Because of its anatomical vicinity and its availability as material, the deep dorsal vein associated with the cavernosal vein may play an indispensable role in grafting even with local anaesthesia on an outpatient basis. PMID:16524364

Hsu, G-L; Hsieh, C-H; Wen, H-S; Ling, P-Y; Chen, S-Y; Huang, H-M; Tseng, G-F

2006-10-01

365

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

366

Analysis of the Effect of Estrogen/Androgen Perturbation on Penile Development in Transgenic and Diethylstilbestrol-Treated Mice  

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Because both androgens and estrogens have been implicated in penile morphogenesis, we evaluated penile morphology in transgenic mice with known imbalance of androgen and estrogen signaling using scanning electron microscopy (SEM), histology, and immunohistochemistry of androgen and estrogen receptors ?/?. Penises of adult wild-type, estrogen receptor-? knockout (?ERKO), estrogen receptor-? knockout (?ERKO), aromatase knockout (Arom-KO), and aromatase overexpression (Arom+) mice were eva...

Blaschko, Sarah D.; Mahawong, Phitsanu; Ferretti, Max; Cunha, Tristan J.; Sinclair, Adriane; Wang, Hong; Schlomer, Bruce J.; Risbridger, Gail; Baskin, Laurence S.; Cunha, Gerald R.

2013-01-01

367

Tunical plication in the management of penile curvature due La Peyronie’s disease. Our experience on 47 cases  

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Abstract Background 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. Patients report negative effects in four major domains: physical appearance and self-image, sexual function and performance. These changes damage sexual life and compromise the quality of life. Our objective is to review the patient's sexual life afte...

Iacono Fabrizio; Prezioso Domenico; Ruffo Antonio; Illiano Ester; Romeo Giuseppe; Amato Bruno

2012-01-01

368

SQUAMOUS CELL CARCINOMA OF THE PENIS AND SCROTUM IN A PATIENT WITH CHRONIC SCROTAL AND PENILE LYMPHEDEMA  

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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

369

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

370

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

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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

371

Experimental evidence of the compressibility of arteries.  

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A definitive answer to the question whether artery walls are incompressible is to our opinion not yet categorically provided. Experimental-based evidence on the level of compressibility in artery walls is not easily achieved because of the difficulties associated with the measurement of very small differences in volumes under physiological pressure in these biological tissues. Past experiments aimed at addressing the question considered different species, different arteries, the experimental devices were not accurate enough and a statistical analysis of the results was missing. A precise experimental device together with a thorough testing protocol, a careful selection of arteries and a statistical analysis is presented for a definitive evaluation of the artery wall compressibility. We provide experimental evidence that in saphenous and femoral porcine arteries under physiological pressure range a relative compressibility of 2-6% is observed. The pre-assumption of incompressibility in many phenomenological constitutive models of artery walls should probably be re-evaluated. PMID:25173235

Yosibash, Zohar; Manor, Itay; Gilad, Ilan; Willentz, Udi

2014-11-01

372

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

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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

373

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

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

Mauro R.L. Passos

2008-04-01

374

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

375

Update on plication procedures for Peyronie’s disease and other penile deformities  

Science.gov (United States)

Plication techniques are not a panacea for deformities associated with Peyronie’s disease or congenital curvature. However, they do provide certain advantages, both theoretic and real, over competing procedures such as grafting. Depending on the technique, plication procedures have minimal risk of de novo erectile dysfunction, minimal risk of injury to the dorsal neurovascular bundle, and may be used for a variety of angulation deformities, including multiplanar curvature and severe degrees of curvature. A variety of incisions may be used, including the classic circumcision with degloving but also ventral raphe, dorsal penile inversion, and penoscrotal. These may be helpful in preventing postoperative morbidity and in sparing the prepuce if desired. Plication may also be combined with procedures such as penile prosthesis for correction of residual curvature. Lastly, despite its complications, plication techniques are very well tolerated, are relatively simple to perform and result in the very high satisfaction rates. PMID:23205060

Mobley, Elizabeth M.; Fuchs, Molly E.; Myers, Jeremy B.

2012-01-01

376

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.

377

Update on plication procedures for Peyronie's disease and other penile deformities.  

Science.gov (United States)

Plication techniques are not a panacea for deformities associated with Peyronie's disease or congenital curvature. However, they do provide certain advantages, both theoretic and real, over competing procedures such as grafting. Depending on the technique, plication procedures have minimal risk of de novo erectile dysfunction, minimal risk of injury to the dorsal neurovascular bundle, and may be used for a variety of angulation deformities, including multiplanar curvature and severe degrees of curvature. A variety of incisions may be used, including the classic circumcision with degloving but also ventral raphe, dorsal penile inversion, and penoscrotal. These may be helpful in preventing postoperative morbidity and in sparing the prepuce if desired. Plication may also be combined with procedures such as penile prosthesis for correction of residual curvature. Lastly, despite its complications, plication techniques are very well tolerated, are relatively simple to perform and result in the very high satisfaction rates. PMID:23205060

Mobley, Elizabeth M; Fuchs, Molly E; Myers, Jeremy B; Brant, William O

2012-12-01

378

Role of ultrasonography with color-Doppler in diagnosis of penile Mondor's disease.  

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Penile Mondor's disease (superficial thrombophlebitis of the penis dorsal vein) is an uncommon and benign pathology that affects sexually active men. Although the diagnosis is made by physical examination in most patients, sonography may be required in some cases. Color-Doppler ultrasonography clearly visualizes dorsal vein thrombosis and the associated hemodynamic alterations. We describe the symptoms, the sonographic findings and treatment of this disease in a 26-year-old male with superficial thrombophlebitis of the penis dorsal vein. PMID:25177389

Dell'Atti, Lucio

2014-09-01

379

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

380

Human papillomavirus DNA in the urogenital tracts of men with gonorrhoea, penile warts or genital dermatoses.  

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OBJECTIVE--To assess the presence of human papillomavirus (HPV) DNA in urethral and urine specimens from men with and without sexually transmitted diseases. DESIGN--Prospective study. SETTING--Two London departments of genitourinary medicine PATIENTS--100 men with urethral gonorrhoea, 31 men with penile warts and 37 men with genital dermatoses. METHODS--Urethral and urine specimens were taken, HPV DNA extracted and then amplified using the polymerase chain reaction. HPV types 6, 11, 16, 18, 3...

Hillman, R. J.; Ryait, B. K.; Botcherby, M.; Taylor-robinson, D.

1993-01-01

 
 
 
 
381

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

382

Factors affecting the degree of penile deformity in Peyronie disease: an analysis of 1001 patients.  

Science.gov (United States)

Only a few studies have investigated the association between the severity of Peyronie disease (PD) and clinical parameters such as age and associated comorbidities. The aim of this study was to report the relationship between the degree of curvature of the penis and the clinical parameters among patients with PD. A total of 1001 patients with PD were evaluated retrospectively in terms of penile deformity, erectile status, and risk factors for systemic vascular diseases. The degree of curvature was assessed with a protractor during maximum erection in response to a combined injection and stimulation test and/or vacuum device. A modified Kelami classification was used to categorize penile deformities as follows: patients with deformities without curvature (notching, hourglass, and swan neck deformity, group 1), with mild curvature (? 30 degrees, group 2), with moderate curvature (31-60 degrees, group 3), or with severe curvature (> 60 degrees, group 4). Chi-square tests, 1-way analysis of variance, and univariate and multiple ordinal regression analyses were used for statistical analysis. Penile deformity without curvature was detected in 12.3% of the patients, whereas the curvature was less than 30 degrees in 39.5%, 30 to 60 degrees in 34.5%, and more than 60 degrees in 13.5% of the patients. Multiple ordinal regression analysis identified age (P = .013), side of deformity (P = .007), erectile dysfunction (P < .0001), and diabetes mellitus (P = .001) as significant independent predictors of the severity of penile curvature. In conclusion, patients' age, side of deformity, erectile function, and diabetes were significantly associated with the degree of curvature. PMID:21233397

Kadioglu, Ates; Sanli, Oner; Akman, Tolga; Canguven, Onder; Aydin, Memduh; Akbulut, Fatih; Kucukdurmaz, Faruk

2011-01-01

383

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

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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 rep...

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

2007-01-01

384

Pentoxifylline treatment and penile calcifications in men with Peyronie’s disease  

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This retrospective cohort study from a single clinical practice enrolled patients with evidence of calcified Peyronie’s disease (PD) plaques detected on penile ultrasound at the time of initial presentation. The primary objective was to describe the effect of pentoxifylline (PTX) treatment on subtunical calcifications in men with PD. A PD-specific questionnaire was administered and sonographic evaluations were performed at baseline and follow-up visits. Descriptive statistics and ?2 analys...

Smith, James F.; Shindel, Alan W.; Huang, Yun-ching; Clavijo, Raul I.; Flechner, Lawrence; Breyer, Benjamin N.; Eisenberg, Michael L.; Lue, Tom F.

2011-01-01

385

Total preputial flap: a reliable and versatile technique for urethral and penile reconstruction.  

Science.gov (United States)

We revisit the technique of total preputial flap (TPF) and its application for urethroplasty, penile skin coverage of both and present our results in 43 patients (41 hypospadias, 2 epispadias). There were no instances of flap necrosis. In patients without prior attempts at reconstruction (n?=?36), we observed four urethrocutaneous fistulas. TPF allowed the repair of cases of proximal hypospadias in one stage with an acceptable complication rate. PMID:24860798

Ludwikowski, Barbara; González, Ricardo

2014-01-01

386

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

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

Emrah Okulu

2013-07-01

387

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

388

Penile Tumescence Assessment Used for a Diagnosis of Paraphilia: A Pedophilia Case Report  

Directory of Open Access Journals (Sweden)

Full Text Available We report on the use of penile tumescence assessment to diagnose a paraphiliac clientwho was in denial about his problem. An 18-year-old male was accused of sexually assaultinga 4-year-old girl using physical restraint and vaginal penetration with a finger. During apsychiatric evaluation requested by the court, a comprehensive psychosexual assessmentrevealed that the subject was in denial about clarification of the paraphiliac experience.Penile tumescence under distinct visual stimulus was evaluated with electrobioimpedencevolumetric assessment using child and adult female pictures in separate time frames. Bothtypes of stimuli evoked arousal responses. However, child female stimuli demonstratedstronger responses than did adult female ones. Deviant sexual interest in children as well asa diagnosis of pedophilia was implied. Paraphiliac clients tend to be in denial toward psychosexualassessment which limits the interpretation of its results. Penile tumescence assessmentmay be more reliable than psychosexual assessment alone for detecting and diagnosingparaphilia. Further study is warranted in order to aid in more accurate diagnoses of paraphilia.

Ker-Li Hsueh

2003-02-01

389

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.

390

Porcine radial artery decellularization by high hydrostatic pressure.  

Science.gov (United States)

Many types of decellularized tissues have been studied and some have been commercially used in clinics. In this study, small-diameter vascular grafts were made using HHP to decellularize porcine radial arteries. One decellularization method, high hydrostatic pressure (HHP), has been used to prepare the decellularized porcine tissues. Low-temperature treatment was effective in preserving collagen and collagen structures in decellularized porcine carotid arteries. The collagen and elastin structures and mechanical properties of HHP-decellularized radial arteries were similar to those of untreated radial arteries. Xenogeneic transplantation (into rats) was performed using HHP-decellularized radial arteries and an untreated porcine radial artery. Two weeks after transplantation into rat carotid arteries, the HHP-decellularized radial arteries were patent and without thrombosis. In addition, the luminal surface of each decellularized artery was covered by recipient endothelial cells and the arterial medium was fully infiltrated with recipient cells. Copyright © 2012 John Wiley & Sons, Ltd. PMID:23233238

Negishi, Jun; Funamoto, Seiichi; Kimura, Tsuyoshi; Nam, Kwangoo; Higami, Tetsuya; Kishida, Akio

2012-12-12

391

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

392

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

393

The adult penile urethra is a novel entry site for HIV-1 that preferentially targets resident urethral macrophages.  

Science.gov (United States)

The penile urethra is routinely targeted by sexually transmitted bacterial and viral pathogens, and also represents a probable site for HIV type-1 (HIV-1) entry. Yet, the mechanisms of urethral HIV-1 transmission are unknown. To describe the initial steps of