Penile Corporeal Reconstruction during Difficult Placement of a Penile Prosthesis

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Viet Q. Tran

2008-01-01

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

Penile incerceration—A tight affair

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Faraj O. Alkizim

2015-01-01

Full Text Available A patient presents with penile ring incarceration after using it for penile enlargement and prolonging tumescence. We present a case study of removal of the penile ring under local anaesthesia in a setting where cutting tools were inadequate.

Evaluation of an improved method of simulating lung nodules in chest tomosynthesis

International Nuclear Information System (INIS)

Svalkvist, Angelica; Allansdotter Johnsson, Aase; Vikgren, Jenny

2012-01-01

Background Simulated pathology is a valuable complement to clinical images in studies aiming at evaluating an imaging technique. In order for a study using simulated pathology to be valid, it is important that the simulated pathology in a realistic way reflect the characteristics of real pathology. Purpose To perform a thorough evaluation of a nodule simulation method for chest tomosynthesis, comparing the detection rate and appearance of the artificial nodules with those of real nodules in an observer performance experiment. Material and Methods A cohort consisting of 64 patients, 38 patients with a total of 129 identified pulmonary nodules and 26 patients without identified pulmonary nodules, was used in the study. Simulated nodules, matching the real clinically found pulmonary nodules by size, attenuation, and location, were created and randomly inserted into the tomosynthesis section images of the patients. Three thoracic radiologists and one radiology resident reviewed the images in an observer performance study divided into two parts. The first part included nodule detection and the second part included rating of the visual appearance of the nodules. The results were evaluated using a modified receiver-operating characteristic (ROC) analysis. Results The sensitivities for real and simulated nodules were comparable, as the area under the modified ROC curve (AUC) was close to 0.5 for all observers (range, 0.43-0.55). Even though the ratings of visual appearance for real and simulated nodules overlapped considerably, the statistical analysis revealed that the observers to were able to separate simulated nodules from real nodules (AUC values range 0.70-0.74). Conclusion The simulation method can be used to create artificial lung nodules that have similar detectability as real nodules in chest tomosynthesis, although experienced thoracic radiologists may be able to distinguish them from real nodules

Penile cancer: epidemiology, pathogenesis and prevention.

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Bleeker, M C G; Heideman, D A M; Snijders, P J F; Horenblas, S; Dillner, J; Meijer, C J L M

2009-04-01

Penile cancer is a disease with a high morbidity and mortality. Its prevalence is relatively rare, but the highest in some developing countries. Insight into its precursor lesions, pathogenesis and risk factors offers options to prevent this potentially mutilating disease. This review presents an overview of the different histologically and clinically identified precursor lesions of penile cancer and discusses the molecular pathogenesis, including the role of HPV in penile cancer development. A systematic review of the literature evaluating penile carcinogenesis, risk factors and molecular mechanisms involved. Careful monitoring of men with lichen sclerosis, genital Bowen's disease, erythroplasia of Queyrat and bowenoid papulosis seems useful, thereby offering early recognition of penile cancer and, subsequently, conservative therapeutic options. Special attention is given to flat penile lesions, which contain high numbers of HPV. Their role in HPV transmission to sexual partners is highlighted, but their potential to transform as a precursor lesion into penile cancer has been unsatisfactorily explored. Further research should not only focus on HPV mediated pathogenic pathways but also on the non-HPV related molecular and genetic factors that play a role in penile cancer development. Options for prevention of penile cancer include (neonatal) circumcision, limitation of penile HPV infections (either by prophylactic vaccination or condom use), prevention of phimosis, treatment of chronic inflammatory conditions, limiting PUVA treatment, smoking cessation and hygienic measures.

Computer-aided detection of artificial pulmonary nodules using an ex vivo lung phantom: influence of exposure parameters and iterative reconstruction.

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Wielpütz, Mark O; Wroblewski, Jacek; Lederlin, Mathieu; Dinkel, Julien; Eichinger, Monika; Koenigkam-Santos, M; Biederer, Jürgen; Kauczor, Hans-Ulrich; Puderbach, Michael U; Jobst, Bertram J

2015-05-01

To evaluate the influence of exposure parameters and raw-data based iterative reconstruction (IR) on the performance of computer-aided detection (CAD) of pulmonary nodules on chest multidetector computed tomography (MDCT). Seven porcine lung explants were inflated in a dedicated ex vivo phantom shell and prepared with n=162 artificial nodules of a clinically relevant volume and maximum diameter (46-1063 μl, and 6.2-21.5 mm). n=118 nodules were solid and n=44 part-solid. MDCT was performed with different combinations of 120 and 80 kV with 120, 60, 30 and 12 mA*s, and reconstructed with both filtered back projection (FBP) and IR. Subsequently, 16 datasets per lung were subjected to dedicated CAD software. The rate of true positive, false negative and false positive CAD marks was measured for each reconstruction. The rate of true positive findings ranged between 88.9-91.4% for FBP and 88.3-90.1% for IR (n.s.) with most exposure settings, but was significantly lower with the combination of 80 kV and 12 mA*s (80.9% and 81.5%, respectively, pvolumes 300 μl (p<0.05). Similarly, it was significantly lower for diameters <12 mm compared to ≥12 mm (p<0.05). The rate of true positives for solid and part-solid nodules was similar. Nodule CAD on chest MDCT is robust over a wide range of exposure settings. Noise reduction by IR is not detrimental for CAD, and may be used to improve image quality in the setting of low-dose MDCT for lung cancer screening. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Role of penile doppler as a diagnostic tool in penile fracture

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Mohamed Azmi Hassali

2018-01-01

Full Text Available Penile fracture is defined as a traumatic rupture of either corpus cavernosum or the tunica albuginea; sometimes it can be both. It may be caused by exotic masturbation acts, sexual intercourse, or other trauma to this area. This can be accompanied by injury to the urethra, which is the cause of hematuria as a symptom for some patients. Typically, diagnosis of penile rupture or fracture depends on clinical examination and history told by the patients. We are stating the importance of medical imaging in the diagnosis of patients with penile fracture by presenting a case of patient suffered from penile fracture after a fall on his penis where it affected the erection of two-third of his penis. In which, the proper diagnosis by imaging studies and taking actions accordingly can save the patients from unnecessary surgeries that indeed increase the bill of the medical care directly and indirectly. Therefore, most patients can be diagnosed cost-effectively and treated surgically without a need to delay surgery, which is often the case if one was to resort to other investigations. Investigations such as retrograde urethrography for suspected urethral injury should only be used when the diagnosis of penile fracture is in doubt.

Penile manipulation: The most common etiology of penile fracture at our tertiary care center

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Md. Jawaid Rahman

2016-01-01

Full Text Available Penile fracture is the disruption of the tunica albuginea with rupture of the corpus cavernosum secondary to blunt trauma to the erect penis. It is an unusual condition, usually underreported. According to the published literature, vigorous vaginal intercourse with women on top position is the most common etiology across the globe including India with Middle Eastern countries being the exception. A total of seven patients of penile fracture presented in emergency in the last 6 months. The etiology was penile manipulation at the time of sexual excitement in six out of seven patients of penile fracture, which was contrary to the literature published except in Middle Eastern countries. All the patients were managed by emergency exploration and repair. Thus, the incidence and etiologies of penile fracture vary according to geographic region, sexual behavior, marital status, and culture.

Penile Subcutaneous Fibrolipoma Postaugmentative Phalloplasty

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Patrizio Vicini

2013-01-01

Full Text Available 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.

Effect of penile-extender device in increasing penile size in men with shortened penis: preliminary results.

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Nikoobakht, Mohammadreza; Shahnazari, Alireza; Rezaeidanesh, Maedeh; Mehrsai, Abdolrasoul; Pourmand, Gholamreza

2011-11-01

It has been suggested that the application of penile-extender devices increases penile length and circumference. However, there are a few scientific studies in this field. The aim of this study was to assess the efficacy of a penile-extender (Golden Erect(®) , Ronas Tajhiz Teb, Tehran, Iran) in increasing penile size. This prospective study was performed on subjects complaining about "short penis" who were presented to our clinic between September 15, 2008 and December 15, 2008. After measuring the penile length in flaccid and stretched forms and penile circumference, patients were instructed to wear Golden Erect(®) , 4-6 hours per day during the first 2 weeks and then 9 hours per day until the end of the third month. The subjects were also trained how to increase the force of the device during determined intervals. The patients were visited at the end of the first and third months, and penile length and circumference were measured and compared with baseline. The primary end point of the study was changes in flaccid and stretched penile lengths compared with the baseline size during the 3 months follow-up. Twenty-three cases with a mean age of 26.5 ± 8.1 years entered the study. The mean flaccid penile length increased from 8.8 ± 1.2 cm to 10.1 ± 1.2 cm and 10.5 ± 1.2 cm, respectively, in the first and third months of follow-up, which was statistically significant (P penis (9.3 ± 0.86 cm vs. 8.8 ± 0.66 cm, P penis girth enhancement using penile extender. Performing more studies is recommended. © 2010 International Society for Sexual Medicine.

Penile artery shunt syndrome: a novel cause of erectile dysfunction after penile revascularization surgery.

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Pavlinec, Jonathan G; Hakky, Tariq S; Yang, Christopher; Massis, Kamal; Munarriz, Ricardo; Carrion, Rafael E

2014-09-01

Penile revascularization is a surgical treatment option for erectile dysfunction (ED) in healthy individuals due to a focal arterial occlusion in the absence of generalized vascular disease. Most described failures have been attributed to graft stenosis or disruption of the anastomosis. We report a novel phenomenon called Penile Artery Shunt Syndrome that contributed to persistent ED in a patient after penile microvascular arterial bypass surgery. A 26-year-old man presented for evaluation of long-standing ED, which was attributed to trauma sustained 12 years earlier. He had difficulty obtaining and maintaining erections despite oral pharmacotherapy. Clinical data related to the case were studied, analyzed, and reviewed with urologic and radiologic specialists at multiple centers that collaborated in the care of this patient. Penile duplex ultrasound peak systolic velocities and five-item International Index for Erectile Function questionnaire scores were the main outcome measures. Initial diagnostic workup of the patient confirmed severe insufficiency of the left cavernosal artery, with no evidence of venous leak. The patient underwent penile microvascular arterial bypass surgery with anastomosis of the left inferior epigastric artery to the left dorsal penile artery. The patient had persistence of severe ED despite patent anastomosis by penile duplex ultrasound. Subsequent arteriography revealed an arterial shunt due to an aberrant obturator artery arising from the donor inferior epigastric artery. The patient underwent embolization of the aberrant obturator artery, with resolution of the shunt and marked improvement in erectile function. The presence of an aberrant obturator artery arising from the inferior epigastric artery may predispose to persistent ED after revascularization due to the creation of a shunt phenomenon. Pelvic arteriography may be useful in identifying anomalous anatomic considerations prior to penile revascularization and to evaluate patients

[Penile dimensions in type 2 diabetes].

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Belousov, I I; Kogan, M I; Ibishev, H S; Vorobyev, S V; Khripun, I A; Gusova, Z R

2015-12-01

The current literature provides a wide range of publications on the anthropometry of the penis specifying the relationship between penile dimensions and sex hormones, weight, height and erectile function. But most of the studies involved healthy volunteers or young patients with erectile dysfunction. Our study was conducted in patients with type 2 diabetes. Penile measurements obtained in the present study were compared those of the average Russian man. The patients were divided into groups with preserved and impaired erectile function. Erectile function was also studied relative to the variability of penile dimensions. The effect of DM duration on erectile function was defined. Comparative analysis revealed the relationship between penile anatomical dimensions and erectile function. We studied the effect of type 2 diabetes on the anatomical dimensions and elasticity of the penis, established the relationship between penile dimensions and elasticity of the penis. The correlation between the severity of erectile dysfunction and serum testosterone levels on one side, and penile dimensions on the other was found. The effect of penile dimensions on erectile function in DM patients was also examined. Determining penile dimensions and their variability due to various pathological conditions or processes, may eventually lead to better result of ED management.

Our Results in Penile Fractures

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Tufan Süelözgen

2016-06-01

Full Text Available Introduction Penile fracture is a urological emergency caused by direct trauma to an erected penis, tearing the tunica albuginea in the corpus cavernosum. The preferred treatment method is draining the hematoma and surgical repair of tunica albuginea tear as soon as possible following diagnosis. Materials and Methods Forty-nine patients who were diagnosed with penile fracture between January 2009 and December 2014 were reviewed. Physical examination was performed to see the extent of penile hematoma, the side of the penile curvature and the presence of blood in the external meatus. Two patients who were diagnosed with urethrorrhagia underwent retrograde urethrogram for urethral injury. In all patients, penile skin was peeled using a circular subcoronal degloving incision and tunica tear was repaired using absorbable suture materials. The patients were then followed for painful erections, penile deformities and erection angles. Results The average age of the 49 patients, who were included in the study, was 36.5 years (21-65. In their etiological questioning, most patients reported the fracture occurring during sexual intercourse. Retrograde urethrography was indicated in 2 patients with blood in the external meatus and were diagnosed with urethral injury. The patients were taken to emergency surgery. Tunica defects varied between 1 and 2 cm. Incomplete urethral injuries were primarily repaired around 18 French Foley catheter. None of the patients reported penile deformity or painful erections. Their erection angles were found to be within the normal range. Conclusion Even though it is a relatively rare condition, penile fractures are so important that might cause serious complications when not treated surgically. A thorough anamnesis and physical examination suffice for diagnosis.

Penile surgery and reconstruction.

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Perovic, Sava V; Djordjevic, Miroslav L J; Kekic, Zoran K; Djakovic, Nenad G

2002-05-01

This review will highlight recent advances in the field of penile reconstructive surgery in the paediatric and adult population. It is based on the work published during the year 2001. Besides the anatomical and histological studies of the penis, major contributions have been described in congenital and acquired penile anomalies. Also, a few new techniques and modifications of old procedures are described in order to improve the final functional and aesthetic outcome. The techniques for penile enlargement present a trend in the new millennium, but are still at the stage of investigation.

20-year experience with iatrogenic penile injury.

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Amukele, Samuel A; Lee, Gene W; Stock, Jeffrey A; Hanna, Moneer K

2003-10-01

We review our experience with the management of iatrogenic penile injuries. Apart from circumcision, serious damage to the penis can occur following hypospadias repair, surgery for priapism or total loss of the penis following surgical repair of bladder exstrophy. A retrospective analysis of patients with iatrogenic penile amputation referred to us between 1980 and 2000 was undertaken. Causes of injury and choice of management were reviewed. Of the 13 cases treated during the 20-year period mechanism of primary injury was circumcision in 4, hypospadias repair in 6, priapism in 1, bladder exstrophy repair in 1 and penile carcinoma in 1. A variety of techniques were used for phallic reconstruction. Penile degloving, division of suspensory ligament and rotational skin flaps achieved penile augmentation and enhancement. Reasonable cosmesis and penile length were achieved in all cases. In indicated cases microsurgical phalloplasty was technically feasible. However long-term followup showed various complications including erosions from the use of a penile stiffener. The ultimate goal of reconstructive surgery is to have a penis with normal function and appearance. The management of penile injury requires a wide variety of surgical techniques that are tailored to the individual patient. Expedient penile reconstruction is successful and therapeutic delay is associated with complications.

Accuracy of lung nodule volumetry in low-dose CT with iterative reconstruction: an anthropomorphic thoracic phantom study.

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Doo, K W; Kang, E-Y; Yong, H S; Woo, O H; Lee, K Y; Oh, Y-W

2014-09-01

The purpose of this study was to assess accuracy of lung nodule volumetry in low-dose CT with application of iterative reconstruction (IR) according to nodule size, nodule density and CT tube currents, using artificial lung nodules within an anthropomorphic thoracic phantom. Eight artificial nodules (four diameters: 5, 8, 10 and 12 mm; two CT densities: -630 HU that represents ground-glass nodule and +100 HU that represents solid nodule) were randomly placed inside a thoracic phantom. Scans were performed with tube current-time product to 10, 20, 30 and 50 mAs. Images were reconstructed with IR and filtered back projection (FBP). We compared volume estimates to a reference standard and calculated the absolute percentage error (APE). The APE of all nodules was significantly lower when IR was used than with FBP (7.5 ± 4.7% compared with 9.0 ±6.9%; p volumetry in low-dose CT by application of IR showed reliable accuracy in a phantom study. Lung nodule volumetry can be reliably applicable to all lung nodules including small, ground-glass nodules even in ultra-low-dose CT with application of IR. IR significantly improved the accuracy of lung nodule volumetry compared with FBP particularly for ground-glass (-630 HU) nodules. Volumetry in low-dose CT can be utilized in patient with lung nodule work-up, and IR has benefit for small, ground-glass lung nodules in low-dose CT.

CT volumetry of artificial pulmonary nodules using an ex vivo lung phantom: Influence of exposure parameters and iterative reconstruction on reproducibility

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Wielpütz, Mark O., E-mail: Mark.wielpuetz@med.uni-heidelberg.de [Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg (Germany); Translational Lung Research Center (TLRC-H), German Center for Lung Research (DZL), Im Neuenheimer Feld 350, 69120 Heidelberg (Germany); Lederlin, Mathieu, E-mail: mathieu.lederlin@chu-bordeaux.fr [Department of Thoracic and Cardiovascular Imaging, University Hospital of Bordeaux, Av de Magellan, 33600 Pessac (France); Department of Radiology, German Cancer Research Center (dkfz), Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Wroblewski, Jacek, E-mail: JacekWr@gmx.net [Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg (Germany); Translational Lung Research Center (TLRC-H), German Center for Lung Research (DZL), Im Neuenheimer Feld 350, 69120 Heidelberg (Germany); Dinkel, Julien, E-mail: jdinkel@partners.org [Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114 (United States); Department of Radiology, German Cancer Research Center (dkfz), Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Translational Lung Research Center (TLRC-H), German Center for Lung Research (DZL), Im Neuenheimer Feld 350, 69120 Heidelberg (Germany); Eichinger, Monika, E-mail: Monika.eichinger@thoraxklinik-heidelberg.de [Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Amalienstr. 5, 69126 Heidelberg (Germany); Translational Lung Research Center (TLRC-H), German Center for Lung Research (DZL), Im Neuenheimer Feld 350, 69120 Heidelberg (Germany); Department of Radiology, German Cancer Research Center (dkfz), Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); and others

2013-09-15

Objectives: To evaluate the influence of exposure parameters and raw-data based iterative reconstruction (IR) on the measurement variability of computer-aided nodule volumetry on chest multidetector computed tomography (MDCT). Materials and methods: N = 7 porcine lung explants were inflated in a dedicated ex vivo phantom and prepared with n = 162 artificial nodules. MDCT was performed eight consecutive times (combinations of 120 and 80 kV with 120, 60, 30 and 12 mA s), and reconstructed with filtered back projection (FBP) and IR. Nodule volume and diameter were measured semi-automatically with dedicated software. The absolute percentage measurement error (APE) was computed in relation to the 120 kV 120 mA s acquisition. Noise was recorded for each nodule in every dataset. Results: Mean nodule volume and diameter were 0.32 ± 0.15 ml and 12.0 ± 2.6 mm, respectively. Although IR reduced noise by 24.9% on average compared to FBP (p < 0.007), APE with IR was equal to or slightly higher than with FBP. Mean APE for volume increased significantly below a volume computed tomography dose index (CTDI) of 1.0 mGy: for 120 kV 12 mA s APE was 3.8 ± 6.2% (FBP) vs. 4.0 ± 5.2% (IR) (p < 0.007); for 80 kV 12 mA s APE was 8.0 ± 13.0% vs. 9.3 ± 15.8% (n.s.), respectively. Correlating APE with image noise revealed that at identical noise APE was higher with IR than with FBP (p < 0.05). Conclusions: Computer-aided volumetry is robust in a wide range of exposure settings, and reproducibility is reduced at a CTDI below 1.0 mGy only, but the error rate remains clinically irrelevant. Noise reduction by IR is not detrimental for measurement error in the setting of semi-automatic nodule volumetry on chest MDCT.

CT volumetry of artificial pulmonary nodules using an ex vivo lung phantom: Influence of exposure parameters and iterative reconstruction on reproducibility

International Nuclear Information System (INIS)

Wielpütz, Mark O.; Lederlin, Mathieu; Wroblewski, Jacek; Dinkel, Julien; Eichinger, Monika

2013-01-01

Objectives: To evaluate the influence of exposure parameters and raw-data based iterative reconstruction (IR) on the measurement variability of computer-aided nodule volumetry on chest multidetector computed tomography (MDCT). Materials and methods: N = 7 porcine lung explants were inflated in a dedicated ex vivo phantom and prepared with n = 162 artificial nodules. MDCT was performed eight consecutive times (combinations of 120 and 80 kV with 120, 60, 30 and 12 mA s), and reconstructed with filtered back projection (FBP) and IR. Nodule volume and diameter were measured semi-automatically with dedicated software. The absolute percentage measurement error (APE) was computed in relation to the 120 kV 120 mA s acquisition. Noise was recorded for each nodule in every dataset. Results: Mean nodule volume and diameter were 0.32 ± 0.15 ml and 12.0 ± 2.6 mm, respectively. Although IR reduced noise by 24.9% on average compared to FBP (p < 0.007), APE with IR was equal to or slightly higher than with FBP. Mean APE for volume increased significantly below a volume computed tomography dose index (CTDI) of 1.0 mGy: for 120 kV 12 mA s APE was 3.8 ± 6.2% (FBP) vs. 4.0 ± 5.2% (IR) (p < 0.007); for 80 kV 12 mA s APE was 8.0 ± 13.0% vs. 9.3 ± 15.8% (n.s.), respectively. Correlating APE with image noise revealed that at identical noise APE was higher with IR than with FBP (p < 0.05). Conclusions: Computer-aided volumetry is robust in a wide range of exposure settings, and reproducibility is reduced at a CTDI below 1.0 mGy only, but the error rate remains clinically irrelevant. Noise reduction by IR is not detrimental for measurement error in the setting of semi-automatic nodule volumetry on chest MDCT

Isolated penile torsion in newborns.

Science.gov (United States)

Eroglu, Egemen; Gundogdu, Gokhan

2015-01-01

We reported on the incidence of isolated penile torsion among our healthy children and our approach to this anomaly. Between 2011 and 2014, newborn babies with penile torsion were classified according to the angle of torsion. Surgical correction (penile degloving and reattachment for moderate cases and dorsal dartos flap technique in case of resistance) after 6 months was advised to the babies with rotations more than 45°. Among 1000 newborn babies, 200 isolated penile torsions were found, and among these, 43 had torsions more than 45°, and 4 of these had angles greater than 90°. The mean angle of the rotations was found 30.45° (median: 20°). In total, 8 children with 60° torsions were previously circumcised. Surgery was performed on 19 patients, with a mean patient age of 12 ± 2 months. Of these 19, 13 babies were corrected with degloving and reattachment. This technique was not enough on the remaining 6 patients; therefore, derotational dorsal dartos flap was added to correct the torsion. After a mean of 15.6 ± 9.8 months, residual penile rotation, less than 15°, was found only in 2 children. The incidence of isolated penile torsion is 20% in newborns. However, rotation more than 45° angles are seen in 4.3% of male babies. Correction is not necessary in mild degrees, and penile degloving with reattachment is enough in most cases. If the initial correction is insufficient, dorsal dartos flap rotation is easy and effective. Prior circumcision neither disturbs the operative procedure nor affects the outcomes.

The status of penile enhancement procedures.

Science.gov (United States)

Vardi, Yoram; Gruenwald, Ilan

2009-11-01

Most men who request surgical penile enhancement have a normal-sized and fully functional penis but visualize their penises as small (psychological dysmorphism). This fact by itself leads to controversy regarding the true indications for penile enhancement procedures in men without micropenis. One of the typical aspects of penile enhancement is the lack of true methodological evaluation of the more commonly performed procedures. Even recently, only few solid scientific studies are available which can shed some light on results and outcome of these controversial procedures. Although some additional data has emerged during the past year, there is still no consensus in regard to indications and surgical techniques used for penile augmentation or penile girth enhancement. There is further need for more studies to provide a better overview of the value and worthiness of these procedures.

Penile anthropometry in North Indian children

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Amilal Bhat

2015-01-01

Full Text Available Introduction: Physicians frequently encounter questions by parents regarding the normal size of a child′s penis. We evaluated normal variations of penile dimensions, correlation of penile length with height, weight, and body mass index (BMI of boys and analyzed the differences in penile dimensions from those reported from other countries. Materials and Methods: A cross-sectional study was conducted at our institution during October 2012-December 2012. A total of 250 subjects (birth to 10 years were evaluated and divided into 10 groups with 1-year interval taking 25 children in each. Penile dimensions measured twice by a single observer with Vernier calipers included the length of flaccid penis fully stretched and diameters at mid-shaft and corona. Diameters were multiplied by pi (π = 3.14 to calculate circumferences. Mean, standard deviation, and range were calculated. Height, weight, and BMI were noted and statistically correlated with the penile length using the Pearson correlation coefficient. Data were compared with similar studies reported on other populations in the past and individually evaluated with every study using Student′s t-test. Results: The mean values for the penile length, mid-shaft circumference, and coronal circumference were 3.34, 3.05, 3.29 cm during infancy, 4.28, 3.86, 4.11 cm during 4-5 years, and 5.25, 4.78, 5.05 cm during 9-10 years, respectively. The penile length increased with advancing age in successive age groups, but it did not have a direct correlation with either height, weight, or BMI. Penile dimensions in North Indian children were found to be statistically smaller in comparison with most studies from other countries. Conclusion: We provide the normal range and variations of penile dimensions in North Indian children.

Penile Enhancement Surgery: An Overview

OpenAIRE

Marta R. Bizic; Miroslav L. Djordjevic

2016-01-01

Penile size is a frequently observed concern in men of all ages. The way in which some men see their personality is defined, appraised, or reflected by their penis, with the view that ‘bigger is better’, is termed ‘phallocentrism’. In this review article, we assess the literature and evaluate the evidence on what is ‘normal’ in relation to penile size, and evaluate techniques for penile lengthening and girth augmentation with emphasis on the possible benefits and complications of the procedur...

Three-component hydraulic penile prosthesis malfunction due to penile fibrolipoma secondary to augmentative phalloplasty: A case report

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Gabriele Antonini

2016-01-01

Full Text Available Fibrolipomas are an infrequent type of lipomas. We describe a case of a man suffering from subcutaneous penile fibrolipoma, who twelve months earlier has been submitted to augmentative phalloplasty due to aesthetic dysmorphophobia. The same patient three years earlier has been submitted to three-component hydraulic penile prostheses implantation due to erectile dysfunction. After six months from removing of the mass, the penile elongation and penile enlargement were stable, the prostheses were correctly functioning and the patient was satisfied with his sexual intercourse and life. The diagnostics and surgical characteristics of this case are reported.

Penile Enhancement Surgery: An Overview

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Marta R. Bizic

2016-04-01

Full Text Available Penile size is a frequently observed concern in men of all ages. The way in which some men see their personality is defined, appraised, or reflected by their penis, with the view that ‘bigger is better’, is termed ‘phallocentrism’. In this review article, we assess the literature and evaluate the evidence on what is ‘normal’ in relation to penile size, and evaluate techniques for penile lengthening and girth augmentation with emphasis on the possible benefits and complications of the procedures reviewed.

Penile rehabilitation after radical prostatectomy

DEFF Research Database (Denmark)

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

2013-01-01

The pathophysiology of erectile dysfunction after radical prostatectomy (RP) is believed to include neuropraxia, which leads to temporarily reduced oxygenation and subsequent structural changes in penile tissue. This results in veno-occlusive dysfunction, therefore, penile rehabilitation programmes...

Sensitivity and accuracy of volumetry of pulmonary nodules on low-dose 16- and 64-row multi-detector CT : an anthropomorphic phantom study

NARCIS (Netherlands)

Xie, X.; Zhao, Yingru; Snijder, R.A.; van Ooijen, P.M.; de Jong, P.A.; Oudkerk, M.; de Bock, G.H.; Vliegenthart, R.; Greuter, M.J.

To assess the sensitivity of detection and accuracy of volumetry by manual and semi-automated quantification of artificial pulmonary nodules in an anthropomorphic thoracic phantom on low-dose CT. Fifteen artificial spherical nodules (diameter 3, 5, 8, 10 and 12 mm; CT densities -800, -630 and +100

Magnetic resonance imaging of penile paraffinoma: case report

International Nuclear Information System (INIS)

Cormio, Luigi; Di Fino, Giuseppe; Scavone, Carmen; Selvaggio, Oscar; Massenio, Paolo; Sanguedolce, Francesca; Macarini, Luca; Carrieri, Giuseppe

2014-01-01

Penile paraffinoma is a well-known delayed complication of paraffin oil injection into the penis for penile girth augmentation but its MRI features have not been previously described. A 35-year-old Ukraine man presented with erectile dysfunction, voiding difficulty and an irregular, hard and painful penile mass that had progressively grown over the last year. He reported having received, seven years before, several penile injections of paraffin oil for penile girth augmentation. On physical examination, the mass was tender, poorly delimited, and involved the whole penile shaft and the cranial part of the scrotum. Preoperative MRI, performed to determine the extent of tissue to be removed and the possibilities of penile reconstruction, showed a newly-formed homogeneous tissue, compressing but not infiltrating Buck’s fascia, iso-hypointense relative to muscle on T1-weighted sequences, and with a low signal intensity at T2-weighted sequences. On T1-weighted fat suppressed sequences, it did not enhance with contrast administration. MRI data were confirmed by surgical findings, as the newly-formed scar tissue did not infiltrate Buck’s fascia. Pathology confirmed the diagnosis of penile paraffinoma. MRI seems to provide an adequate imaging of the histological events occurring after injection of paraffin oil in the subcutaneous tissues. Penile paraffinoma remains a clinical diagnosis, but MRI features may be helpful in planning an adequate surgical strategy and, in selected cases, establishing the differential diagnosis with other penile diseases, including cancer

[Penile augmentation using acellular dermal matrix].

Science.gov (United States)

Zhang, Jin-ming; Cui, Yong-yan; Pan, Shu-juan; Liang, Wei-qiang; Chen, Xiao-xuan

2004-11-01

Penile enhancement was performed using acellular dermal matrix. Multiple layers of acellular dermal matrix were placed underneath the penile skin to enlarge its girth. Since March 2002, penile augmentation has been performed on 12 cases using acellular dermal matrix. Postoperatively all the patients had a 1.3-3.1 cm (2.6 cm in average) increase in penile girth in a flaccid state. The penis had normal appearance and feeling without contour deformities. All patients gained sexual ability 3 months after the operation. One had a delayed wound healing due to tight dressing, which was repaired with a scrotal skin flap. Penile enlargement by implantation of multiple layers of acellular dermal matrix was a safe and effective operation. This method can be performed in an outpatient ambulatory setting. The advantages of the acellular dermal matrix over the autogenous dermal fat grafts are elimination of donor site injury and scar and significant shortening of operation time.

Management of penile defects: a review.

Science.gov (United States)

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

2012-06-01

Penile amputation is a rare injury. Although, in principle, penile replantation can be performed using a variety of methods, few, if any, standardized procedures exist to deal with this medical emergency. The value of the various microsurgical techniques for replantation of the penis remains uncertain. This article provides a review of the management of penile defects and complications. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Penile Cancer Presenting With Acute Urinary Retantion: Case Report

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Ercan KAZAN

2015-06-01

Full Text Available Penile cancer is a rare malignancy in our country. Phimosis, , poor hygiene and smoking are major risk factors for penile cancer. Penile cancer in men have a strong correlation with human papilloma virus (HPV infection. Penile cancer is rare in circumcised men, particularly if they are circumcised as newborns. Penile cancer is usually asymptomatic and physical examination is essential for diagnosis. We report a case of penile cancer whose first symptom was acute urinary retention (AUR and review of the literature. [J Contemp Med 2015; 5(2.000: 131-134

Isolated Penile Torsion in Brothers: A Case Report

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Metin Gunduz

2012-04-01

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

A new surgical method for penile girth enhancement

OpenAIRE

Li, Xiaoge; Tao, Ling; Cao, Chuan; Shi, Haishan; Li, Le; Chen, Liang; Li, Shirong

2015-01-01

Objective: We developed a new surgical model of penile girth enhancement in dog, with minimal damage, fewer complications, and high success rate, to enable the experimental investigation of penile implants. Methods: We obtained materials for penile girth enhancement by processing the pericardium and blood vessel wall collected from pigs. Incisions were made at the penile bulb for the implantation of the materials, and facilitate observation and data collection, based on the anatomical feature...

Penile length and circumference: an Indian study.

Science.gov (United States)

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

2007-01-01

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

Sensitivity and accuracy of volumetry of pulmonary nodules on low-dose 16- and 64-row multi-detector CT: an anthropomorphic phantom study

International Nuclear Information System (INIS)

Xie, Xueqian; Zhao, Yingru; Ooijen, Peter M.A. van; Vliegenthart, Rozemarijn; Snijder, Roland A.; Greuter, Marcel J.W.; Jong, Pim A. de; Oudkerk, Matthijs; Bock, Geertruida H. de

2013-01-01

To assess the sensitivity of detection and accuracy of volumetry by manual and semi-automated quantification of artificial pulmonary nodules in an anthropomorphic thoracic phantom on low-dose CT. Fifteen artificial spherical nodules (diameter 3, 5, 8, 10 and 12 mm; CT densities -800, -630 and +100 HU) were randomly placed inside an anthropomorphic thoracic phantom. The phantom was examined on 16- and 64-row multidetector CT with a low-dose protocol. Two independent blinded observers screened for pulmonary nodules. Nodule diameter was measured manually, and volume calculated. For solid nodules (+100 HU), diameter and volume were also evaluated by semi-automated software. Differences in observed volumes between the manual and semi-automated method were evaluated by a t-test. Sensitivity was 100 % for all nodules of >5 mm and larger, 60-80 % for solid and 0-20 % for non-solid 3-mm nodules. No false-positive nodules but high inter-observer reliability and inter-technique correlation were found. Volume was underestimated manually by 24.1 ± 14.0 % for nodules of any density, and 26.4 ± 15.5 % for solid nodules, compared with 7.6 ± 8.5 % (P 5 mm in diameter. Semi-automated volumetry yielded more accurate nodule volumes than manual measurements. (orig.)

Penile paraffinoma and ulcers of penis.

Science.gov (United States)

Bobik, O; Bobik, O

2011-01-01

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

Successful penile reimplantation and systematic review of world ...

African Journals Online (AJOL)

Observation: To report on a case of successful macrosurgical penile reimplantation, discuss the etiologies, surgical techniques and outcomes of world literature on penile reimplantation and an update of current trends in penile surgery. A 40 year-old male, father of 3 children and a proprietor of a nursery school with no prior ...

PENILE ENHANCEMENT PROCEDURES: UROLOGICAL AND ETHICOLEGAL ISSUES

OpenAIRE

Marco Vella

2012-01-01

Phalloplasty procedures for most men requiring penile augmentation surgery are cosmetic procedures; generally the patients have a normal-sized and fully functional penis but they think that their penis is too small. There are not well defined indications for penile enhancement surgery and, except for the treatment of “micropenis”, there are not established guidelines and the outcome measures for success are still unclear. All penile enhancement techniques often do not reach the...

A critical analysis of penile enhancement procedures for patients with normal penile size: surgical techniques, success, and complications.

Science.gov (United States)

Vardi, Yoram; Har-Shai, Yaron; Harshai, Yaron; Gil, Tamir; Gruenwald, Ilan

2008-11-01

Most men who request surgical penile enhancement have a normal-sized and fully functional penis but visualize their penises as small (psychological dysmorphism). The aim of this review is to describe the various reported techniques and to provide the available scientific data on the success and complication rates of penile enhancement procedures. We performed an extensive systematic review based on a search of the MEDLINE database for articles published between 1965 and 2008. The following key words were used: penis, enhancement, enlargement, phalloplasty, reconstruction, girth, lengthening, and augmentation. Only English-language articles that were related to penile surgery and dysmorphobia were sought. We excluded articles in which fewer than five cases were described and articles in which the type of surgical treatment and the outcome were not clear. Of the 176 papers found, 34 were selected and critically analyzed. We found only a small number of well-designed and comprehensive studies, and most of the published articles reported data that were obtained from small cohorts of patients. The more recently published studies presented better methodologies and descriptions of the surgical techniques than did the older publications. In general, penile enhancement surgery can cause a 1-2-cm increase in penile length and a 2.5-cm augmentation of penile girth. Unwanted outcomes and complications, namely penile deformity, paradoxical penile shortening, disagreeable scarring, granuloma formation, migration of injected material, and sexual dysfunction were reported frequently in these studies. Disappointing short- and long-term patient satisfaction rates following these procedures were also reported in most studies. To date, the use of cosmetic surgery to enlarge the penis remains highly controversial. There is a lack of any standardization of all described procedures. Indications and outcome measures are poorly defined, and the reported complications are unacceptably high

Response of five lentil (lens culinaris) genotypes to artificial inoculation using /sup 15/N as a tracer

International Nuclear Information System (INIS)

Khan, H.; Mahmood, N.H.; Iqbal, M.

1997-01-01

Five lentil (lens culinaris) genotypes, viz NARC-3, 20-8, 88522, 89511 and Mansehra-89, were evaluated in the field and pot experiments for natural nodulation and to study the effect of artificial inoculation on their nodulation, yield and grain protein content. Natural nodulation was almost absent in all the tested genotypes. Artificial rhizobial inoculation significantly increased the biological and grain yields in all the genotypes. Maximum increase in yield and nodulation due to inoculation was recorded in case of Mansehra-89. Grain protein was also increased by inoculation but not significantly. (author)

Sensitivity and accuracy of volumetry of pulmonary nodules on low-dose 16- and 64-row multi-detector CT: an anthropomorphic phantom study

Energy Technology Data Exchange (ETDEWEB)

Xie, Xueqian; Zhao, Yingru; Ooijen, Peter M.A. van; Vliegenthart, Rozemarijn [University of Groningen, University Medical Center Groningen, Department of Radiology, EB44, P.O. Box 30.001, Groningen (Netherlands); University of Groningen, University Medical Center Groningen, Center for Medical Imaging-North East Netherlands, Department of Radiology, Groningen (Netherlands); Snijder, Roland A.; Greuter, Marcel J.W. [University of Groningen, University Medical Center Groningen, Department of Radiology, EB44, P.O. Box 30.001, Groningen (Netherlands); Jong, Pim A. de [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Oudkerk, Matthijs [University of Groningen, University Medical Center Groningen, Center for Medical Imaging-North East Netherlands, Department of Radiology, Groningen (Netherlands); Bock, Geertruida H. de [University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen (Netherlands)

2013-01-15

To assess the sensitivity of detection and accuracy of volumetry by manual and semi-automated quantification of artificial pulmonary nodules in an anthropomorphic thoracic phantom on low-dose CT. Fifteen artificial spherical nodules (diameter 3, 5, 8, 10 and 12 mm; CT densities -800, -630 and +100 HU) were randomly placed inside an anthropomorphic thoracic phantom. The phantom was examined on 16- and 64-row multidetector CT with a low-dose protocol. Two independent blinded observers screened for pulmonary nodules. Nodule diameter was measured manually, and volume calculated. For solid nodules (+100 HU), diameter and volume were also evaluated by semi-automated software. Differences in observed volumes between the manual and semi-automated method were evaluated by a t-test. Sensitivity was 100 % for all nodules of >5 mm and larger, 60-80 % for solid and 0-20 % for non-solid 3-mm nodules. No false-positive nodules but high inter-observer reliability and inter-technique correlation were found. Volume was underestimated manually by 24.1 {+-} 14.0 % for nodules of any density, and 26.4 {+-} 15.5 % for solid nodules, compared with 7.6 {+-} 8.5 % (P < 0.01) semi-automatically. In an anthropomorphic phantom study, the sensitivity of detection is 100 % for nodules of >5 mm in diameter. Semi-automated volumetry yielded more accurate nodule volumes than manual measurements. (orig.)

Inter- and intrascanner variability of pulmonary nodule volumetry on low-dose 64-row CT: an anthropomorphic phantom study

Science.gov (United States)

Xie, X; Willemink, M J; Zhao, Y; de Jong, P A; van Ooijen, P M A; Oudkerk, M; Greuter, M J W

2013-01-01

Objective: To assess inter- and intrascanner variability in volumetry of solid pulmonary nodules in an anthropomorphic thoracic phantom using low-dose CT. Methods: Five spherical solid artificial nodules [diameters 3, 5, 8, 10 and 12 mm; CT density +100 Hounsfield units (HU)] were randomly placed inside an anthropomorphic thoracic phantom in different combinations. The phantom was examined on two 64-row multidetector CT (64-MDCT) systems (CT-A and CT-B) from different vendors with a low-dose protocol. Each CT examination was performed three times. The CT examinations were evaluated twice by independent blinded observers. Nodule volume was semi-automatically measured by dedicated software. Interscanner variability was evaluated by Bland–Altman analysis and expressed as 95% confidence interval (CI) of relative differences. Intrascanner variability was expressed as 95% CI of relative variation from the mean. Results: No significant difference in CT-derived volume was found between CT-A and CT-B, except for the 3-mm nodules (pvolumetry of artificial pulmonary nodules between 5 mm and 12 mm in diameter. Inter- and intrascanner variability decreases at a larger nodule size to a maximum of 4.9% for ≥8 mm nodules. Advances in knowledge: The commonly accepted cut-off of 25% to determine nodule growth has the potential to be reduced for ≥8 mm nodules. This offers the possibility of reducing the interval for repeated CT scans in lung cancer screenings. PMID:23884758

Penile implants among prisoners-a cause for concern?

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Lorraine Yap

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

Penile Rehabilitation after Pelvic Cancer Surgery

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Fouad Aoun

2015-01-01

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

Compulsive masturbation and chronic penile lymphedema.

Science.gov (United States)

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

2012-06-01

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

Role of Human Papillomavirus in Penile Carcinomas Worldwide.

Science.gov (United States)

Alemany, Laia; Cubilla, Antonio; Halec, Gordana; Kasamatsu, Elena; Quirós, Beatriz; Masferrer, Emili; Tous, Sara; Lloveras, Belén; Hernández-Suarez, Gustavo; Lonsdale, Ray; Tinoco, Leopoldo; Alejo, Maria; Alvarado-Cabrero, Isabel; Laco, Jan; Guimerà, Nuria; Poblet, Enrique; Lombardi, Luis E; Bergeron, Christine; Clavero, Omar; Shin, Hai-Rim; Ferrera, Annabelle; Felix, Ana; Germar, Julieta; Mandys, Vaclav; Clavel, Christine; Tzardi, Maria; Pons, Luis E; Wain, Vincent; Cruz, Eugenia; Molina, Carla; Mota, Jose D; Jach, Robert; Velasco, Julio; Carrilho, Carla; López-Revilla, Ruben; Goodman, Marc T; Quint, Wim G; Castellsagué, Xavier; Bravo, Ignacio; Pawlita, Michael; Muñoz, Nubia; Bosch, F Xavier; de Sanjosé, Silvia

2016-05-01

Invasive penile cancer is a rare disease with an approximately 22 000 cases per year. The incidence is higher in less developed countries, where penile cancer can account for up to 10% of cancers among men in some parts of Africa, South America, and Asia. To describe the human papillomavirus (HPV) DNA prevalence, HPV type distribution, and detection of markers of viral activity (ie, E6*I mRNA and p16(INK4a)) in a series of invasive penile cancers and penile high-grade squamous intraepithelial lesions (HGSILs) from 25 countries. A total of 85 penile HGSILs and 1010 penile invasive cancers diagnosed from 1983 to 2011 were included. After histopathologic evaluation of formalin-fixed paraffin-embedded samples, HPV DNA detection and genotyping were performed using the SPF-10/DEIA/LiPA25 system, v.1 (Laboratory Biomedical Products, Rijswijk, The Netherlands). HPV DNA-positive cases were additionally tested for oncogene E6*I mRNA and all cases for p16(INK4a) expression, a surrogate marker of oncogenic HPV activity. HPV DNA prevalence and type distributions were estimated. HPV DNA was detected in 33.1% of penile cancers (95% confidence interval [CI], 30.2-36.1) and in 87.1% of HGSILs (95% CI, 78.0-93.4). The warty-basaloid histologic subtype showed the highest HPV DNA prevalence. Among cancers, statistically significant differences in prevalence were observed only by geographic region and not by period or by age at diagnosis. HPV16 was the most frequent HPV type detected in both HPV-positive cancers (68.7%) and HGSILs (79.6%). HPV6 was the second most common type in invasive cancers (3.7%). The p16(INK4a) upregulation and mRNA detection in addition to HPV DNA positivity were observed in 69.3% of HGSILs, and at least one of these HPV activity markers was detected in 85.3% of cases. In penile cancers, these figures were 22.0% and 27.1%, respectively. About a third to a fourth of penile cancers were related to HPV when considering HPV DNA detection alone or adding an HPV

Penile Cancer: Contemporary Lymph Node Management.

Science.gov (United States)

O'Brien, Jonathan S; Perera, Marlon; Manning, Todd; Bozin, Mike; Cabarkapa, Sonja; Chen, Emily; Lawrentschuk, Nathan

2017-06-01

In penile cancer, the optimal diagnostics and management of metastatic lymph nodes are not clear. Advances in minimally invasive staging, including dynamic sentinel lymph node biopsy, have widened the diagnostic repertoire of the urologist. We aimed to provide an objective update of the recent trends in the management of penile squamous cell carcinoma, and inguinal and pelvic lymph node metastases. We systematically reviewed several medical databases, including the Web of Science® (with MEDLINE®), Embase® and Cochrane databases, according to PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses) guidelines. The search terms used were penile cancer, lymph node, sentinel node, minimally invasive, surgery and outcomes, alone and in combination. Articles pertaining to the management of lymph nodes in penile cancer were reviewed, including original research, reviews and clinical guidelines published between 1980 and 2016. Accurate and minimally invasive lymph node staging is of the utmost importance in the surgical management of penile squamous cell carcinoma. In patients with clinically node negative disease, a growing body of evidence supports the use of sentinel lymph node biopsies. Dynamic sentinel lymph node biopsy exposes the patient to minimal risk, and results in superior sensitivity and specificity profiles compared to alternate nodal staging techniques. In the presence of locoregional disease, improvements in inguinal or pelvic lymphadenectomy have reduced morbidity and improved oncologic outcomes. A multimodal approach of chemotherapy and surgery has demonstrated a survival benefit for patients with advanced disease. Recent developments in lymph node management have occurred in penile cancer, such as minimally invasive lymph node diagnosis and intervention strategies. These advances have been met with a degree of controversy in the contemporary literature. Current data suggest that dynamic sentinel lymph node biopsy provides excellent

Penile enlargement with methacrylate injection: is it safe?

Directory of Open Access Journals (Sweden)

Fabio Cesar Miranda Torricelli

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

Penile enlargement with methacrylate injection: is it safe?

Science.gov (United States)

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

2013-01-01

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

Inter- and intrascanner variability of pulmonary nodule volumetry on low-dose 64-row CT : an anthropomorphic phantom study

NARCIS (Netherlands)

Xie, X.; Willemink, M. J.; Zhao, Y.; de Jong, P. A.; van Ooijen, P. M. A.; Oudkerk, M.; Greuter, M. J. W.; Vliegenthart, R.

Objective: To assess inter- and intrascanner variability in volumetry of solid pulmonary nodules in an anthropomorphic thoracic phantom using low-dose CT. Methods: Five spherical solid artificial nodules [diameters 3, 5, 8, 10 and 12mm; CT density 1100 Hounsfield units (HU)] were randomly placed

Penile pharmacoarteriography in impotence

International Nuclear Information System (INIS)

Bookstein, J.J.

1986-01-01

Conventional arteriography is unreliable in the evaluation of arteriogenic impotence, primarily because vasoconstriction of medium and small arteries can be indistinguishable from organic obstruction. Spinal anesthesia plus intracavernosal injections of papaverine can relieve vasoconstriction, but markedly increase the cost and complexity of penile arteriography. The authors have found that internal pudendal injection of papaverine and nitroglycerin provides effective dilation and allows penile arteriography to be performed on an outpatient basis. Arteriographic quality is further enhanced by selective internal pudendal injections, the use of highly concentrated nonionic agents, and direct magnification

A new surgical method for penile girth enhancement.

Science.gov (United States)

Li, Xiaoge; Tao, Ling; Cao, Chuan; Shi, Haishan; Li, Le; Chen, Liang; Li, Shirong

2015-01-01

We developed a new surgical model of penile girth enhancement in dog, with minimal damage, fewer complications, and high success rate, to enable the experimental investigation of penile implants. We obtained materials for penile girth enhancement by processing the pericardium and blood vessel wall collected from pigs. Incisions were made at the penile bulb for the implantation of the materials, and facilitate observation and data collection, based on the anatomical features of dog's penis. We measured the girth of the flaccid penis before and after the operation, and erectile function at 1-month postoperation. In addition to evaluation of recovery from the incision and local pathological changes, ultrasonic examination was performed to monitor the long-term changes associated with implantation. The mean girth of the flaccid penis significantly increased from 7.37±0.40 cm before the operation, to 8.70±0.56 cm postoperation. Dogs resumed normal mating at 1 month after the operation, without any significant change in the mating time. Ultrasonic examination clearly illustrated the implants, and helped in the measurement of the distance between the materials and the baculum. Chinese Rural dog is a promising animal model for penile girth enhancement surgery. The findings demonstrated that surgical implantation into penile bulb was associated with less damage, faster postoperative recovery, and higher success. For the first time, ultrasonic examination provided objective data on the surgical outcomes of penile girth enhancement.

Penile constriction injury: An experience of four cases

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Ajit Somaji Sawant

2016-01-01

Full Text Available Penile injury due to constriction by a foreign object is a rare known complication, commonly seen in pediatric age group. We report four cases of penile constriction injury in adults due to various foreign objects and different indications. Between October 2014 and March 2016, four patients (mean age 42.5 years presented with penile constriction injury with duration at presentation ranging from 18 h to 2 months. One patient had complete transection of the corpus and penile urethra. Three patients were managed successfully with daily dressings followed by split-skin grafting in one patient. One patient required delayed primary suturing after the resolution of local edema. The outcome was satisfactory in all patients with retained erectile function. Early medical attention and management is the key to success in penile constriction injury cases and to avoid complications and morbidity. Prompt removal can be challenging in cases of metal foreign bodies.

Sarcoidosis presenting as penile mass

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Hüseyin Semiz

2017-01-01

Full Text Available Sarcoidosis is an inflammatory disease with unknown cause characterized by noncaseating granuloma formations. It may present with bilateral hilar lymphadenopathy, skin lesions, eye, and musculoskeletal system involvement. Rare involvement of the genital organs (prostate, testis, epididymis has also been reported. However, penile involvement is observed quite rare. In this paper, we report a patient with penile mass who was diagnosed with sarcoidosis on the basis of the laboratory, radiological, and pathological investigations.

Influence of the in-plane artefact in chest tomosynthesis on pulmonary nodule size measurements

International Nuclear Information System (INIS)

Soederman, Christina; Allansdotter Johnsson, Aase; Vikgren, Jenny; Rossi Norrlund, Rauni; Molnar, David; Svalkvist, Angelica; Maansson, Lars Gunnar; Baath, Magnus

2016-01-01

The aim of the present study was to investigate how the in-plane artefact present in the scan direction around structures in tomosynthesis images should be managed when measuring the size of nodules in chest tomosynthesis images in order to achieve acceptable measurement accuracy. Data from measurements, performed by radiologists, of the longest diameter of artificial nodules inserted in chest tomosynthesis images were used. The association between the measurement error and the direction of the longest nodule diameter, relative to the scan direction, was evaluated using the Kendall rank correlation coefficient. All of the radiologists had chosen to not include the artefact in the measurements. Significant association between measurement error and the direction of the longest diameter was found for nodules larger than 12 mm, which indicates that, for these nodules, there is a risk of underestimating the nodule size if the in-plane artefact is omitted from manual diameter measurements. (authors)

The Pattern of Penile Gangrene in Sokoto, Nigeria | Ntia | African ...

African Journals Online (AJOL)

Early presentation, aggressive antibiotic therapy and urinary diversion can prevent or minimize penile loss. Some patients with partial penile loss require surgical reconstruction of the urethra and penis. Keywords: Penile gangrene, Fournier's gangrene, necrotizing fasciitis, phalloplasty, urethroplasty, neomeatoplasty

An unusual delayed complication of paraffin self-injection for penile girth augmentation.

Science.gov (United States)

De Siati, Mario; Selvaggio, Oscar; Di Fino, Giuseppe; Liuzzi, Giuseppe; Massenio, Paolo; Sanguedolce, Francesca; Carrieri, Giuseppe; Cormio, Luigi

2013-12-01

Penile self-injection of various oils is still carried out among Eastern Europe people for penile girth augmentation despite the potential destructive complications of this practice are well known. Penile reactions to such foreign bodies include scarring, abscess formation, ulceration, and even Fournier's gangrene; voiding problems due to mineral oil self-injection have been reported only once. To our knowledge, we describe the first case of paraffin self-injection for penile girth augmentation presenting with acute urinary retention. A 27-year-old Romanian man presented with severe penile pain and acute urinary retention five years after having practiced repeated penile self-injections of paraffin for penile girth augmentation. The penile shaft was massively enlarged, fibrotic and phymotic; urethral catheterization failed due to severe stricture of the proximal pendulum urethra. The patients refused placement of a suprapubic catheter and underwent immediate penile surgical exploration. The scarred tissue between dartos and Buck's fascia and a fibrotic ring occluding the urethra were removed and the penile skin reconstructed. Pathology confirmed the diagnosis of paraffinoma. The patient resumed normal voiding immediately after catheter removal on second postoperative day; he was very pleased with cosmetic, sexual and voiding results at six weeks, six months and 1 year follow-up. The present report describes a novel complication of penile self-injection for penile girth augmentation. Because of the increasing number of patients seeking penile augmentation, physicians dealing with sexual medicine should pay more attention to such request to prevent the use of non medical treatments that can turn into medical disasters.

Successful Replantation of Amputated Penile Shaft following Industrial Injury

Directory of Open Access Journals (Sweden)

M Salehipour

2010-09-01

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

Penile hair tourniquet resulting in hypospadias failure

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Lisieux E Jesus

2014-01-01

Full Text Available Penile hair tourniquet (PHT is a painless form of penile ischemia, typically seen in toddlers with long-haired mothers, caused by entanglement of hair on the balano-prepucial sulcus, normally associated with circumcision. Its association with hypospadias has been reported only once. A school-aged boy admitted for surgery to treat hypospadias failure was incidentally detected to have PHT and severe hourglass deformity of the penis. Urethral anastomosis and glanuloplasty were done after removal of the constricting ring, without complications. Normal erections were reported during follow up. Treatment may involve urethral reconstruction and penile reimplantation in extreme cases.

Lung Nodule Detection via Deep Reinforcement Learning

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Issa Ali

2018-04-01

Full Text Available Lung cancer is the most common cause of cancer-related death globally. As a preventive measure, the United States Preventive Services Task Force (USPSTF recommends annual screening of high risk individuals with low-dose computed tomography (CT. The resulting volume of CT scans from millions of people will pose a significant challenge for radiologists to interpret. To fill this gap, computer-aided detection (CAD algorithms may prove to be the most promising solution. A crucial first step in the analysis of lung cancer screening results using CAD is the detection of pulmonary nodules, which may represent early-stage lung cancer. The objective of this work is to develop and validate a reinforcement learning model based on deep artificial neural networks for early detection of lung nodules in thoracic CT images. Inspired by the AlphaGo system, our deep learning algorithm takes a raw CT image as input and views it as a collection of states, and output a classification of whether a nodule is present or not. The dataset used to train our model is the LIDC/IDRI database hosted by the lung nodule analysis (LUNA challenge. In total, there are 888 CT scans with annotations based on agreement from at least three out of four radiologists. As a result, there are 590 individuals having one or more nodules, and 298 having none. Our training results yielded an overall accuracy of 99.1% [sensitivity 99.2%, specificity 99.1%, positive predictive value (PPV 99.1%, negative predictive value (NPV 99.2%]. In our test, the results yielded an overall accuracy of 64.4% (sensitivity 58.9%, specificity 55.3%, PPV 54.2%, and NPV 60.0%. These early results show promise in solving the major issue of false positives in CT screening of lung nodules, and may help to save unnecessary follow-up tests and expenditures.

Penile Anomalies in Adolescence

Directory of Open Access Journals (Sweden)

Dan Wood

2011-01-01

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

Penile anomalies in adolescence.

Science.gov (United States)

Wood, Dan; Woodhouse, Christopher

2011-03-07

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

Sentinel node biopsy in penile cancer

DEFF Research Database (Denmark)

Jakobsen, J. K.; Krarup, K. P.; Sommer, P.

2015-01-01

INTRODUCTION & OBJECTIVES: Nodal involvement is a strong prognosticator in penile cancer and lymph node staging is crucial. Sentinel node biopsy (SNB) has proven a useful staging tool with few complications, but evidence rely mostly on single institution publications with a short follow-up. In th......INTRODUCTION & OBJECTIVES: Nodal involvement is a strong prognosticator in penile cancer and lymph node staging is crucial. Sentinel node biopsy (SNB) has proven a useful staging tool with few complications, but evidence rely mostly on single institution publications with a short follow...... died from complications. CONCLUSIONS: To our knowledge, this is the first complete national study on sentinel node biopsy. Penile cancer sentinel node biopsy with a close follow-up is a reliable lymph node staging and has few complications in a national multicentre setting. Inguinal lymph node...

[Thyroid nodule].

Science.gov (United States)

Clerc, Jérôme

2005-01-31

The thyroid nodule is a frequent, most often benign, chronic, multifocal and slowly progressive disease. The first line strategy is to diagnose cancerous nodules (thyroid nodules is controversial since the prognosis of thyroid cancer is excellent for lesions measuring less than 20 mm. Though imaging accuracy is quite limited in assessing the diagnosis of thyroid cancer, both ultrasounds (US) and thyroid scan are helpful to enhance nodular identification (>30%), to sort the nodules relevant for cytological sampling and to optimize the follow-up, the major source of health costs. Suspicious and non contributive FNAs must have a control FNA within 6 months. Nodules with a non suspicious FNA (>85%) require long term follow-up. This follow-up is mainly morphological. New or evolutive nodules, as assessed by palpation or US, will require iterative FNAs or should be considered for surgery. In patients with hyperfunctioning nodules on the scan (10 to 20%), a yearly evaluation of the TSH level is sufficient. These nodules account either for autonomously functioning ones, which slowly develop towards thyrotoxicosis, or for hyperplastic nodules frequently disclosing a lymphocytic thyroiditis. Morbidity due to thyroid autonomy is still underestimated especially in aging patients with TSH levels thyroid nodule is suggested.

War-related penile injuries in Libya: Single-institution experience.

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Etabbal, Abdalla M; Hussain, Fathi F; Benkhadoura, Mohamed O; Banni, Abdalla M

2018-06-01

To report on our initial experience in the management of war-related penile injuries; proper diagnosis and immediate treatment of penile injuries is essential to gain satisfactory results. Besides treating primary wounds and restoring penile function, the cosmetic result is also an important issue for the surgeon. The study was conducted in the Department of Urology at Benghazi Medical Center and comprised all patients who presented with a shotgun, gunshot or explosive penile injury between February 2011 and August 2017. The patient's age, cause of injury, site and severity of injuries, management, postoperative complications, and hospital stay, were recorded. In all, 29 males with war-related penile injuries were enrolled in the study. The mean (SD) age of these patients was 31.3 (10.5) years. The glans, urethra, and corporal bodies were involved in four (13.7%), 10 (34.4%), and 20 (68.9%) of the patients, respectively. According to the American Association for the Surgery of Trauma Penis Injury Scale, Grade III penile injuries were the most common (11 patients, 37.9%). The most common post-intervention complications were urethral stricture with or without proximal urethrocutaneous fistula (eight patients, 27.5%), followed by permanent erectile dysfunction (five patients, 17.2%). In patients who sustain war-related penile injuries the surgeon's efforts should not only be directed to restoring normal voiding and erectile function but also on the cosmetic appearance of the penis.

Penile prosthesis implant: scientific advances and technological innovations over the last four decades.

Science.gov (United States)

Chung, Eric

2017-02-01

Despite introduction of oral phosphodiesterase type 5 inhibitors and intracavernosal vasoactive agents, penile prosthesis implant remains a relevant and desired option with sales of penile prostheses continue to stay high, as many men became refractory to medical therapy and/or seeking a more effective and permanent therapy. There are two types of penile prosthesis implants: inflatable and non-inflatable types, and the inflatable penile implants can be subdivided into single-, two- and three-piece devices. Non-inflatable penile prosthesis (non-IPP) may be referred to as semi-rigid rod or malleable prosthesis. IPP is considered a superior option to malleable prosthesis as it produces penile rigidity and flaccidity that closely replicates a normal penile erectile function. Since the introduction of IPP by Scott in 1973, surgical landscape for penile prosthesis implantation has changed dramatically. Advances in prosthesis design, device technologies and surgical techniques have made penile prosthesis implant a more natural, durable and reliable device. The following article reviews the scientific advances and technological innovation in modern penile prosthesis implants over the last four decades.

Original Article Pubertal Development of Penile Nitric Oxide ...

African Journals Online (AJOL)

mn

penile tissue in different age groups in the rat and to measure serum testosterone levels ... shaft specimen was taken for nicotinamide adenine dinucleotide phosphate (NADPH) diaphorase ..... The rat as a model for the study of penile erection.

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

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Bello Jibril

2012-09-01

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.

Evaluation of stiffness feedback for hard nodule identification on a phantom silicone model.

Science.gov (United States)

Li, Min; Konstantinova, Jelizaveta; Xu, Guanghua; He, Bo; Aminzadeh, Vahid; Xie, Jun; Wurdemann, Helge; Althoefer, Kaspar

2017-01-01

Haptic information in robotic surgery can significantly improve clinical outcomes and help detect hard soft-tissue inclusions that indicate potential abnormalities. Visual representation of tissue stiffness information is a cost-effective technique. Meanwhile, direct force feedback, although considerably more expensive than visual representation, is an intuitive method of conveying information regarding tissue stiffness to surgeons. In this study, real-time visual stiffness feedback by sliding indentation palpation is proposed, validated, and compared with force feedback involving human subjects. In an experimental tele-manipulation environment, a dynamically updated color map depicting the stiffness of probed soft tissue is presented via a graphical interface. The force feedback is provided, aided by a master haptic device. The haptic device uses data acquired from an F/T sensor attached to the end-effector of a tele-manipulated robot. Hard nodule detection performance is evaluated for 2 modes (force feedback and visual stiffness feedback) of stiffness feedback on an artificial organ containing buried stiff nodules. From this artificial organ, a virtual-environment tissue model is generated based on sliding indentation measurements. Employing this virtual-environment tissue model, we compare the performance of human participants in distinguishing differently sized hard nodules by force feedback and visual stiffness feedback. Results indicate that the proposed distributed visual representation of tissue stiffness can be used effectively for hard nodule identification. The representation can also be used as a sufficient substitute for force feedback in tissue palpation.

Evaluation of stiffness feedback for hard nodule identification on a phantom silicone model.

Directory of Open Access Journals (Sweden)

Min Li

Full Text Available Haptic information in robotic surgery can significantly improve clinical outcomes and help detect hard soft-tissue inclusions that indicate potential abnormalities. Visual representation of tissue stiffness information is a cost-effective technique. Meanwhile, direct force feedback, although considerably more expensive than visual representation, is an intuitive method of conveying information regarding tissue stiffness to surgeons. In this study, real-time visual stiffness feedback by sliding indentation palpation is proposed, validated, and compared with force feedback involving human subjects. In an experimental tele-manipulation environment, a dynamically updated color map depicting the stiffness of probed soft tissue is presented via a graphical interface. The force feedback is provided, aided by a master haptic device. The haptic device uses data acquired from an F/T sensor attached to the end-effector of a tele-manipulated robot. Hard nodule detection performance is evaluated for 2 modes (force feedback and visual stiffness feedback of stiffness feedback on an artificial organ containing buried stiff nodules. From this artificial organ, a virtual-environment tissue model is generated based on sliding indentation measurements. Employing this virtual-environment tissue model, we compare the performance of human participants in distinguishing differently sized hard nodules by force feedback and visual stiffness feedback. Results indicate that the proposed distributed visual representation of tissue stiffness can be used effectively for hard nodule identification. The representation can also be used as a sufficient substitute for force feedback in tissue palpation.

Nodules size: An important factor in nodule mining?

Digital Repository Service at National Institute of Oceanography (India)

Valsangkar, A.B.

A study of about 850 different sized nodules from 234 sites in the Central Indian Basin (CIB) showed a clear inverse relationship between size and grade of nodules. Among the different sized nodules, only the small (less than 2 cm) and medium (2...

Thyroid nodule

International Nuclear Information System (INIS)

McKenney, J.F.

1975-01-01

A palpable mass or nodule may represent any one of a large and diverse group of conditions that involve the thyroid. Whether the patient is euthyroid, hypothyroid, or hyperthyroid can be assessed, and the cause of hypofunction or hyperfunction can usually be determined. Scintiscanning provides important information on the anatomic structure of thyroid nodules. A hot nodule should be ablated by either radioiodine or surgery. A warm nodule usually responds to suppression therapy; if regression does not occur, the problem should be reevaluated. A cold nodule should be surgically excised, as microscopic study of such a lesion is mandatory

Steatocystoma simplex in penile foreskin: a case report.

Science.gov (United States)

de Lima, Mário Maciel; de Lima, Mário Maciel; Granja, Fabiana

2016-03-08

Steatocystoma simplex is an uncommon skin lesion with a histological pattern that is identical to that of steatocystoma multiplex. We are reporting this case of steatocystoma simplex for its uncommon location in the penile foreskin, and its occurrence in a Wapishana man. A 56-year-old man of Wapishana ethnicity presented with complaints of referred penile discomfort and pain during sexual intercourse for 5 years. A physical examination revealed a mobile, compressible subcutaneous non-tender mass of 4 cm diameter located on the left-side of his penile foreskin. There were no signs of inflammation, no grip on the penile shaft, and no urethral discharge or enlargement of lymph nodes. We found no evidence of other cysts on cutaneous examination. We performed classical excision of the lesion under local anesthesia and confirmed the diagnosis of steatocystoma with the pathological report. As there were no complications, we discharged him the same day. Steatocystoma can be considered a differential diagnosis for cystic lesions on and around the penis.

[Penile augmentation and elongation using autologous dermal-fat strip grafting].

Science.gov (United States)

Yang, Zhe; Li, Yang-qun; Tang, Yong; Chen, Wen; Li, Qiang; Zhou, Chuan-de; Zhao, Mu-xin; Hu, Chun-mei

2012-05-01

To investigate the effect of autologous dermal-fat strip grafting in penile augmentation and elongation. From May 2004 to December 2010, 24 patients underwent penile enhancement with free dermal-fat strip grafting. Through suprapubic incision, the superior suspensory ligament and part deep suspensory ligament are cutted off to lengthen the penis. The resulted dead space is filled with the autologous dermal-fat strip (6.0-9.5 cm in length, 1.2-1.5 cm in width and 0.6-0.8 cm in depth) to enhance the penis. Primary healing was achieved in 23 cases. Incisional fat liquefaction happened in one case which healed after dressing change. The penile appearance was satisfactory both at rest or erection. The penile length and circumference increased by 2.5-4.8 cm (average, 3.2 cm) and 1.8-3.0 cm (average, 2.4 cm), respectively. 18 patients were followed up for 3 months to 5 years. All the patients were satisfactory on the cosmetic and functional results. No complication happened. It is safe and effective for penile augmention and elongation with autologous dermal-fat strip grafting and disconnection of penile suspensory ligament.

Anatomic Basis for Penis Transplantation: Cadaveric Microdissection of Penile Structures.

Science.gov (United States)

Tiftikcioglu, Yigit Ozer; Erenoglu, Cagil Meric; Lineaweaver, William C; Bilge, Okan; Celik, Servet; Ozek, Cuneyt

2016-06-01

We present a cadaveric dissection study to investigate the anatomic feasibility of penile transplantation. Seventeen male cadavers were dissected to reveal detailed anatomy of the dorsal neurovascular structures including dorsal arteries, superficial and deep dorsal veins, and dorsal nerves of the penis. Dorsal artery diameters showed a significant decrease from proximal to distal shaft. Dominance was observed in one side. Deep dorsal vein showed a straight course and less decrease in diameter compared to artery. Dorsal nerves showed proximal branching pattern. In a possible penile transplantation, level of harvest should be determined according to the patient and the defect, where a transgender patient will receive a total allograft and a male patient with a proximal penile defect will receive a partial shaft allograft. We designed an algorithm for different levels of penile defect and described the technique for harvest of partial and total penile transplants.

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

Science.gov (United States)

Bjekic, Milan; Markovic, Milica; Sipetic, Sandra

2011-01-01

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. 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. Penile herpes zoster should not be overlooked in patients with unilateral vesicular rash.

Severe congenital penile torsion with anterior urethral diverticulum: A case report

Directory of Open Access Journals (Sweden)

Amilal Bhat

2018-03-01

Full Text Available Introduction: We present a rare case of severe penile torsion of 180° along with giant congenital anterior urethral diverticula. Presentation of these two rare anomalies together is extremely rare and has not been reported yet. The extreme rarity of the case and its management warrants this presentation. Observation: A 5 years old boy presented to us as a case of epispadias with post-void dribbling and wetting of the underwears. On examination, he was found to be a case of severe congenital penile torsion with diversion and rotation of median raphae in a counterclockwise fashion upto the midline dorsally confirming 180° torsion. During voiding, there was appearance of a swelling in distal penile region with passage of urinary drops while compressing it. Micturating cystourethrogram showed diverticula in penile and bulbar urethra. Torsion was completely corrected by penile de-gloving in a plane between two layers of buck fascia and mobilization of the urethra along with spongiosum proximally upto the penoscrotal junction and distally upto the glans. Diverticula was laid open and underwent urethroplasty along with double breasting of thickened diverticular tissue. Torsion was completely corrected after surgery. Post-operative recovery was uneventful. Urine culture was sterile and uroflowmetry showed maximal urinary flow of 12 ml/s at 3 months postoperatively. Conclusions: Penile de-gloving and adequate urethral mobilization corrects the severe penile torsion of 180°. Correction of severe torsion and urethroplasty is feasible in a single stage with good results. Keywords: Penile torsion, Urethral diverticula, Congenital anomalies, Mobilization of urethra, Urethroplasty, Double Breasting, Correction of penile torsion

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

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Jared J. Wallen

2014-10-01

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

Management of penile fractures

International Nuclear Information System (INIS)

Ghilan, Abdulelah M. M.; Al-Asbahi, Waleed A.; Alwan, Mohammed A.; Al-Khanbashi, Omar M.; Ghafour, Mohammed A.

2008-01-01

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

Penile embryology and anatomy.

Science.gov (United States)

Yiee, Jenny H; Baskin, Laurence S

2010-06-29

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

Penile Embryology and Anatomy

Directory of Open Access Journals (Sweden)

Jenny H. Yiee

2010-01-01

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

The relation between sexual orientation and penile size.

Science.gov (United States)

Bogaert, A F; Hershberger, S

1999-06-01

The relation between sexual orientation and penile dimensions in a large sample of men was studied. Subjects were 5122 men interviewed by the Kinsey Institute for Research in Sex, Gender, and Reproduction from 1938 to 1963. They were dichotomously classified as either homosexual (n = 935) or heterosexual (n = 4187). Penile dimensions were assessed using five measures of penile length and circumference from Kinsey's original protocol. On all five measures, homosexual men reported larger penises than did heterosexual men. Explanations for these differences are discussed, including the possibility that these findings provide additional evidence that variations in prenatal hormonal levels (or other biological mechanisms affecting reproductive structures) affect sexual orientation development.

Penile Replantation After Five Hours of Warm Ischemia

Directory of Open Access Journals (Sweden)

Fernando N. Facio Jr.

2015-05-01

Full Text Available Although a rare occurrence, this event may occur as a result of self-mutilation among individuals with psychiatric disturbances or due to work-related accidents, iatrogenic injuries or the actions of individuals motivated by jealously, rage and feelings of betrayal. In western societies, most penile amputations are the result of self-aggression during a psychotic episode, the treatment of victims involves resuscitation, stabilization and immediate psychiatric support. The amputated tissue must be preserved under hypothermic conditions. Micro-surgery is currently the most widely employed method for penile replantation. This paper describes a successful case of penile replantation following 5 hours of warm ischemia.

Approaches to juxta-pleural nodule detection in CT images within the MAGIC-5 Collaboration

Energy Technology Data Exchange (ETDEWEB)

De Nunzio, G., E-mail: giorgio.denunzio@unisalento.it [University of Salento, Materials Science Department and Istituto Nazionale di Fisica Nucleare (INFN), Lecce (Italy); Massafra, A. [University of Salento, Physics Department and Istituto Nazionale di Fisica Nucleare (INFN), Lecce (Italy); Cataldo, R. [University of Salento, Materials Science Department and Istituto Nazionale di Fisica Nucleare (INFN), Lecce (Italy); De Mitri, I.; Peccarisi, M. [University of Salento, Physics Department and Istituto Nazionale di Fisica Nucleare (INFN), Lecce (Italy); Fantacci, M.E. [University of Pisa, Physics Department and Istituto Nazionale di Fisica Nucleare (INFN), Pisa (Italy); Gargano, G. [University of Bari, Physics Department and Istituto Nazionale di Fisica Nucleare (INFN), Bari (Italy); Lopez Torres, E. [CEADEN, Havana (Cuba)

2011-08-21

This work is a part of the MAGIC-5 (Medical Applications on a Grid Infrastructure Connection) experiment of the Italian INFN (Istituto Nazionale di Fisica Nucleare). A simple CAD (Computer-Assisted Detection) system for juxta-pleural lung nodules in CT images is presented, with the purpose of comparing different 2D concavity-patching techniques and assessing the respective efficiency in locating nodules. After a short introduction on the motivation, and a review of some CAD systems for lung nodules already published by the MAGIC-5 Collaboration, the paper describes the main lines of this particular approach, giving preliminary results and comments. In our procedure, candidate nodules are identified by patching lung border concavities in a hierarchical multiscale framework. Once located, they are fed to an artificial neural network for false positive reduction. The system has a modular structure that easily allows the insertion of arbitrary border-smoothing functions for concavity detection and nodule searching. In this paper the {alpha}-hull and morphological closing are compared, proving the higher sensitivity of the former, which also appears computationally less heavy.

Penile herpes zoster: an unusual location for a common disease

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Milan Bjekic

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.

Severe congenital penile torsion with anterior urethral diverticulum ...

African Journals Online (AJOL)

On examination, he was found to be a case of severe congenital penile torsion with diversion and rotation of median raphae in a counterclockwise fashion upto the midline dorsally confirming 180◦ torsion. During voiding, there was appearance of a swelling in distal penile region with passage of urinary drops while ...

Utilization of penile prosthesis and male incontinence prosthetics in Saudi Arabia

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Amjad Alwaal

2017-01-01

Conclusions: There is an increased utilization of penile prosthetics in Saudi Arabia. The private sector performs the majority of penile prosthesis procedures, and most of them are of the semirigid type. The governmental sector is more likely to perform inflatable penile prosthesis and male incontinence device procedures. Male incontinence prosthetics' use is very limited in Saudi Arabia.

An Impulse Control Disorder Case with Penile Fracture and Trichotillomania

OpenAIRE

CUMURCU, Birgül ELBOZAN

2014-01-01

Penile fractures are classically described as presenting with rapid detumescence of an erection associated with blunt trauma. This clinical finding is due to a tear in the tunica albuginea surrounding the corpora cavernosum. In this study, we report and discuss a case of trichotillomania and penile bending impulse resulting in penile fracture, which was operated in the urology clinic. The possible psychological and psychiatric problems underlying the impulsive behavior are discussed, and the ...

Application of CT-PSF-based computer-simulated lung nodules for evaluating the accuracy of computer-aided volumetry.

Science.gov (United States)

Funaki, Ayumu; Ohkubo, Masaki; Wada, Shinichi; Murao, Kohei; Matsumoto, Toru; Niizuma, Shinji

2012-07-01

With the wide dissemination of computed tomography (CT) screening for lung cancer, measuring the nodule volume accurately with computer-aided volumetry software is increasingly important. Many studies for determining the accuracy of volumetry software have been performed using a phantom with artificial nodules. These phantom studies are limited, however, in their ability to reproduce the nodules both accurately and in the variety of sizes and densities required. Therefore, we propose a new approach of using computer-simulated nodules based on the point spread function measured in a CT system. The validity of the proposed method was confirmed by the excellent agreement obtained between computer-simulated nodules and phantom nodules regarding the volume measurements. A practical clinical evaluation of the accuracy of volumetry software was achieved by adding simulated nodules onto clinical lung images, including noise and artifacts. The tested volumetry software was revealed to be accurate within an error of 20 % for nodules >5 mm and with the difference between nodule density and background (lung) (CT value) being 400-600 HU. Such a detailed analysis can provide clinically useful information on the use of volumetry software in CT screening for lung cancer. We concluded that the proposed method is effective for evaluating the performance of computer-aided volumetry software.

Sub-Coronal Inflatable Penile Prosthesis Placement With Modified No-Touch Technique: A Step-by-Step Approach With Outcomes.

Science.gov (United States)

Weinberg, Aaron C; Pagano, Matthew J; Deibert, Christopher M; Valenzuela, Robert J

2016-02-01

The surgical treatment of disorders of male sexual function requires specific exposure to correct the underlying problem safely and efficiently. Currently, sub-coronal exposure is used for treatment of phimosis, Peyronie's disease plaque (PDP), and semirigid penile prosthesis insertion. Infra-pubic and scrotal incisions are used for inflatable penile prosthesis (IPP) placement. However, men who present with several disorders might require multiple procedures and surgical incisions. To report a prospective review of our surgical experience and outcomes with a single sub-coronal incision for IPP placement with a modified no-touch technique. This approach allows for access to the entire corporal body for multiple reconstructive procedures. Two hundred men had IPPs placed through a sub-coronal incision using our modified no-touch technique. The penis was degloved to the level of the penoscrotal junction and the dartos muscle was everted and secured to the drapes. This allowed exclusion of the scrotal and penile skin from the operative field. After artificial erection, the patient's corpora were inspected for PDP and other abnormalities. Penoscrotal IPP models were placed in all cases with insertion proximal to the penoscrotal junction. After placement of the IPP, the abnormalities were repaired. Feasibility of the procedure, operative times, complication rate, utilization of accessory, reconstructive procedures, and post-operative penile length. Of the 200 men who had IPP placement, 92 had PDP that was treated, 106 (53%) consented to circumcision, 24 (12%) had their reservoir placed ectopically, and 31 (16%) had a prosthesis exchanged through the sub-coronal technique. Mean operative time was 73 minutes (39-161 minutes). Specialists in the surgical treatment of disorders of male sexual function can perform multiple procedures safely and easily through a modified no-touch single sub-coronal incision. This approach allows access to the entire corporal body, providing

A nonimaging scintillation probe to measure penile hemodynamics.

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Zuckier, L S; Korupolu, G R; Gladshteyn, M; Sattenberg, R; Goldstein, R; Ricciardi, R; Goodwin, P; Melman, A; Blaufox, M D

1995-12-01

We have developed a penile nonimaging scintillation (PNIS) probe consisting of a plastic well-type scintillation crystal interfaced to a portable computer and acquisition board. This report describes the design of the PNIS probe, performance characteristics, mode of usage and illustrative results which demonstrate its capabilities. With the PNIS probe, penile blood-pool studies were performed in nine patients utilizing 3.7 MBq (100 microCi) autologous 99mTc-labeled red blood cells (RBCs). Venous blood standards were assayed to enable conversion of the count rate to volummetric measurements. Washin of peripherally administered 99mTc-RBCs was mathematically analyzed to estimate penile blood volume and cavernosal flow rate in the flaccid state. The rate of change of penile blood volume after intracavernosal vasodilators was used to generate measures of stimulated flow. A major advantage of this device over the gamma-camera is a 3300-fold increase in count rate sensitivity, which allows for markedly improved temporal resolution while significantly reducing the radiopharmaceutical dosage. Additionally, the PNIS probe is portable, economical and is not dependent on operator-defined regions of interest. Count rate sensitivity is relatively constant within the bore, with the exception of the proximal region adjacent to the opening, where geometric efficiency is reduced. The PNIS probe is an effective device for measuring penile activity in radionuclide studies, allowing for acquisition of time-activity curves of the penis during flaccid washin of peripherally labeled red blood cells and after pharmacologic stimulation to induce erection.

One-stage and two-stage penile buccal mucosa urethroplasty

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G. Barbagli

2016-03-01

Full Text Available The paper provides the reader with the detailed description of current techniques of one-stage and two-stage penile buccal mucosa urethroplasty. The paper provides the reader with the preoperative patient evaluation paying attention to the use of diagnostic tools. The one-stage penile urethroplasty using buccal mucosa graft with the application of glue is preliminary showed and discussed. Two-stage penile urethroplasty is then reported. A detailed description of first-stage urethroplasty according Johanson technique is reported. A second-stage urethroplasty using buccal mucosa graft and glue is presented. Finally postoperative course and follow-up are addressed.

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

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

1999-08-01

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

Automated lung nodule classification following automated nodule detection on CT: A serial approach

International Nuclear Information System (INIS)

Armato, Samuel G. III; Altman, Michael B.; Wilkie, Joel; Sone, Shusuke; Li, Feng; Doi, Kunio; Roy, Arunabha S.

2003-01-01

We have evaluated the performance of an automated classifier applied to the task of differentiating malignant and benign lung nodules in low-dose helical computed tomography (CT) scans acquired as part of a lung cancer screening program. The nodules classified in this manner were initially identified by our automated lung nodule detection method, so that the output of automated lung nodule detection was used as input to automated lung nodule classification. This study begins to narrow the distinction between the 'detection task' and the 'classification task'. Automated lung nodule detection is based on two- and three-dimensional analyses of the CT image data. Gray-level-thresholding techniques are used to identify initial lung nodule candidates, for which morphological and gray-level features are computed. A rule-based approach is applied to reduce the number of nodule candidates that correspond to non-nodules, and the features of remaining candidates are merged through linear discriminant analysis to obtain final detection results. Automated lung nodule classification merges the features of the lung nodule candidates identified by the detection algorithm that correspond to actual nodules through another linear discriminant classifier to distinguish between malignant and benign nodules. The automated classification method was applied to the computerized detection results obtained from a database of 393 low-dose thoracic CT scans containing 470 confirmed lung nodules (69 malignant and 401 benign nodules). Receiver operating characteristic (ROC) analysis was used to evaluate the ability of the classifier to differentiate between nodule candidates that correspond to malignant nodules and nodule candidates that correspond to benign lesions. The area under the ROC curve for this classification task attained a value of 0.79 during a leave-one-out evaluation

Early nodule senescence is activated in symbiotic mutants of pea (Pisum sativum L.) forming ineffective nodules blocked at different nodule developmental stages.

Science.gov (United States)

Serova, Tatiana A; Tsyganova, Anna V; Tsyganov, Viktor E

2018-04-03

Plant symbiotic mutants are useful tool to uncover the molecular-genetic mechanisms of nodule senescence. The pea (Pisum sativum L.) mutants SGEFix - -1 (sym40), SGEFix - -3 (sym26), and SGEFix - -7 (sym27) display an early nodule senescence phenotype, whereas the mutant SGEFix - -2 (sym33) does not show premature degradation of symbiotic structures, but its nodules show an enhanced immune response. The nodules of these mutants were compared with each other and with those of the wild-type SGE line using seven marker genes that are known to be activated during nodule senescence. In wild-type SGE nodules, transcript levels of all of the senescence-associated genes were highest at 6 weeks after inoculation (WAI). The senescence-associated genes showed higher transcript abundance in mutant nodules than in wild-type nodules at 2 WAI and attained maximum levels in the mutant nodules at 4 WAI. Immunolocalization analyses showed that the ethylene precursor 1-aminocyclopropane-1-carboxylate accumulated earlier in the mutant nodules than in wild-type nodules. Together, these results showed that nodule senescence was activated in ineffective nodules blocked at different developmental stages in pea lines that harbor mutations in four symbiotic genes.

Computerized detection of lung nodules by means of "virtual dual-energy" radiography.

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Chen, Sheng; Suzuki, Kenji

2013-02-01

Major challenges in current computer-aided detection (CADe) schemes for nodule detection in chest radiographs (CXRs) are to detect nodules that overlap with ribs and/or clavicles and to reduce the frequent false positives (FPs) caused by ribs. Detection of such nodules by a CADe scheme is very important, because radiologists are likely to miss such subtle nodules. Our purpose in this study was to develop a CADe scheme with improved sensitivity and specificity by use of "virtual dual-energy" (VDE) CXRs where ribs and clavicles are suppressed with massive-training artificial neural networks (MTANNs). To reduce rib-induced FPs and detect nodules overlapping with ribs, we incorporated the VDE technology in our CADe scheme. The VDE technology suppressed rib and clavicle opacities in CXRs while maintaining soft-tissue opacity by use of the MTANN technique that had been trained with real dual-energy imaging. Our scheme detected nodule candidates on VDE images by use of a morphologic filtering technique. Sixty morphologic and gray-level-based features were extracted from each candidate from both original and VDE CXRs. A nonlinear support vector classifier was employed for classification of the nodule candidates. A publicly available database containing 140 nodules in 140 CXRs and 93 normal CXRs was used for testing our CADe scheme. All nodules were confirmed by computed tomography examinations, and the average size of the nodules was 17.8 mm. Thirty percent (42/140) of the nodules were rated "extremely subtle" or "very subtle" by a radiologist. The original scheme without VDE technology achieved a sensitivity of 78.6% (110/140) with 5 (1165/233) FPs per image. By use of the VDE technology, more nodules overlapping with ribs or clavicles were detected and the sensitivity was improved substantially to 85.0% (119/140) at the same FP rate in a leave-one-out cross-validation test, whereas the FP rate was reduced to 2.5 (583/233) per image at the same sensitivity level as the

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

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

2014-01-01

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

The impact of diabetes mellitus on penile length in men undergoing inflatable penile prosthesis implantation.

Science.gov (United States)

Akın, Yiğit; Şahiner, İlker Fatih; Usta, Mustafa Faruk

2013-09-01

To evaluate the changing cavernosal length of patients with diabetes mellitus (DM) and organic erectile dysfunction (ED) who were treated with inflatable, three-piece penile prostheses, a current surgical treatment option in our clinic, over the course of 12 years. Between April 2000 and December 2012, we retrospectively investigated data from patients who were diagnosed with organic ED and undergone penile prosthesis implantation (PPI). Of the 239 patients, 235 of them were included in the study. Four patients who were operated on for trans-sexuality were excluded from the study. All patients were divided into two groups as those with (Group 1) or without DM (Group 2). Data, including age, body mass index (BMI) in kg/m(2), surgical history, comorbidities, International Index of Erectile Function (IIEF) questionnaire scores, combined intracavernous injection and stimulation (CIS) test results, length of corpus cavernosum while implanting the penile prosthesis, complications, operative times, mean hospital stay, and satisfaction of the patient and partner, were recorded. Kruskal-Wallis and Mann-Whitney U tests were used for statistical analysis. A p-value of 0.05). The length of the corpus cavernosum and the destruction of cavernosal tissues do not depend only on DM. We conclude that these features may have multifactorial causes.

Surgical management of complete penile duplication accompanied by multiple anomalies.

Science.gov (United States)

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

2014-09-01

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.

Histological Correlates of Penile Sexual Sensation: Does Circumcision Make a Difference?

OpenAIRE

Guy Cox, MA, DPhil; John N. Krieger, MD; Brian J. Morris, DSc, PhD

2015-01-01

Introduction: The question of whether removal of sensory receptors in the prepuce by circumcision affects sensitivity and/or sexual pleasure is often debated. Aims: To examine histological correlates relevant to penile sensitivity and sexual pleasure. Methods: Systematic review of the scientific literature on penile structures that might affect sensitivity and sexual sensation. Articles were included if they contained original data on human male penile histology or anatomy. Individual a...

Radiation therapy of penile cancer: six to ten-year follow-up

International Nuclear Information System (INIS)

Grabstald, H.; Kelley, C.D.

1980-01-01

Ten patients with penile cancer were treated with radiation therapy between 1968 and 1973. Nine of ten remain free of disease though in 1 patient a new penile primary developed eight years after the radiation therapy and was treated by partial penectomy. One patient died following surgery for ''bleeding ulcer.'' He was free of penile cancer five years after radiation. The most common complication is urethral stricture and skin telangiectasia

Sonographic evaluation of penile in patients with erectile dysfunction

International Nuclear Information System (INIS)

Urena Trigueros, Christian

2012-01-01

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 [es

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

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Sood Suneet

2010-06-01

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

Clinical Outcomes of Penile Prosthesis Implantation Surgery

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Onur Dede

2016-06-01

Full Text Available Objective: We aimed to evaluating the outcomes of in­flatable penile prosthesis implantations and partner sat­isfaction. Methods: Data of 52 patients who underwent penile prosthesis implantation in single center between May 2010 and December 2015 were retrospectively analyzed. Types of prosthesis, complication and satisfaction rates of patients were recorded by EDITS (Erectile Dysfunction Inventory of Treatment Satisfaction questionnaire was used. Results: The mean age was 49.2±14.7 years for patients. The mean follow-up durations for 34.3±12.5 months. The mean hospital stay was 3.84±1.52 days. Evaluating of the couples satisfaction revealed that 44 (84% of the patient were very satisfied. There was not any complication and no patient need to underwent revision surgery. Conclusion: Inflatable penile prosthesis implants, with high levels of treatment success, patient and partner sat­isfaction, are effective and safe options for treatment of organic erectile dysfunction with acceptable complication and revision rates.

PENILE ENHANCEMENT PROCEDURES: UROLOGICAL AND ETHICOLEGAL ISSUES

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Marco Vella

2012-04-01

Full Text Available Phalloplasty procedures for most men requiring penile augmentation surgery are cosmetic procedures; generally the patients have a normal-sized and fully functional penis but they think that their penis is too small. There are not well defined indications for penile enhancement surgery and, except for the treatment of “micropenis”, there are not established guidelines and the outcome measures for success are still unclear. All penile enhancement techniques often do not reach the expected result and the grade of patient’s satisfaction is frequently poor. Phalloplasty procedures for psychological dysmorfism are not approved by any scientific society and the majority of these procedures are performed in private settings. The ethical and medicolegal problems resulting from a penis enhancement can be various and numerous, but few of them are reported in literature. After phalloplasty an attribution of professional responsibility and request of reimbursement is not rare. In this contribution the authors summarize a panorama of several urological and medico-legal aspects related to phalloplasty procedures.

Traumatic penile injuries: Mechanisms and problems of treatment in ...

African Journals Online (AJOL)

Patients and Methods: We analyzed retrospectively 23 cases of penile injuries presenting to the Urology Unit of a tertiary hospital in the Southeastern part of Nigeria from January ... Expertise in the use of flaps for a neophallus are still been developed, and penile prosthetic devices are not readily available in our setting.

Lung nodule assessment in computed tomography. Precision of attenuation measurement based on computer-aided volumetry

International Nuclear Information System (INIS)

Knoess, Naomi; Hoffmann, B.; Fabel, M.; Wiese, C.; Bolte, H.; Heller, M.; Biederer, J.; Jochens, A.

2009-01-01

Purpose: to compare the reproducibility (r) of CT value measurement of pulmonary nodules using volumetry software (LungCare, LC) and manual ROIs (mROI). Materials and methods: 54 artificial nodules in a chest phantom were scanned three times with CT. CT values were measured with LC and mROI. The intrascan-r was assessed with three measurements in the first scan, and the interscan-r with measurements in three consecutive scans (one observer). Intrascan-r und interobserver-r (two obs.) were assessed in the first scan and in contrast-enhanced CT of 51 nodules from 15 patients (kernels b50f and b80f). Intrascan-r and interscan-r were described as the mean range and interobserver-r as the mean difference of CT values. The significance of differences was tested using t-test and sign test. Results: reproducibility was significantly higher for volumetry-based measurements in both artificial and patient nodules (range 0.11 vs. 6.16 HU for intrascan-r, 2.22 vs. 7.03 HU for interscan-r, difference 0.11 vs. 18.42 HU for interobserver-r; patients: 1.78 vs. 13.19 HU (b50f-Kernel) and 1.88 vs. 27.4 HU (b80f-Kernel) for intrascan-r, 3.71 vs. 22.43 HU for interobserver-r). Absolute CT values differed significantly between convolution kernels (pat./mROI: 29.3 [b50f] and 151.9 HU [b80f] pat./LC: 5 [b50f] and 147 HU [b80f]). Conclusion: the reproducibility of volumetry-based measurements of CT values in pulmonary nodules is significantly higher and should therefore be recommended, e.g. in dynamic chest CT protocols. Reproducibility does not depend on absolute CT values. (orig.)

Computer-Aided Segmentation and Volumetry of Artificial Ground-Glass Nodules at Chest CT

NARCIS (Netherlands)

Scholten, Ernst Th.; Jacobs, Colin; van Ginneken, Bram; Willemink, Martin J.; Kuhnigk, Jan-Martin; van Ooijen, Peter M. A.; Oudkerk, Matthijs; Mali, Willem P. Th. M.; de Jong, Pim A.

OBJECTIVE. The purpose of this study was to investigate a new software program for semiautomatic measurement of the volume and mass of ground-glass nodules (GGNs) in a chest phantom and to investigate the influence of CT scanner, reconstruction filter, tube voltage, and tube current. MATERIALS AND

Stretch due to Penile Prosthesis Reservoir Migration

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E. Baten

2016-03-01

Full Text Available A 43-year old patient presented to the emergency department with stretch, due to impossible deflation of the penile prosthesis, 4 years after successful implant. A CT-scan showed migration of the reservoir to the left rectus abdominis muscle. Refilling of the reservoir was inhibited by muscular compression, causing stretch. Removal and replacement of the reservoir was performed, after which the prosthesis was well-functioning again. Migration of the penile prosthesis reservoir is extremely rare but can cause several complications, such as stretch.

Correlation of severity of penile torsion with type of hypospadias ...

African Journals Online (AJOL)

A. Bhat

shape on the penile shaft along the margins of the urethra, encircling the native meatus and preserving the ure- thral plate. After creating a dissection plane at the level of Buck's fascia, penile degloving is done down to the root of the penis. The.

Ultrasonographic study of subcutaneous penile granuloma secondary to silicone injection

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Lucio Dell'Atti

2016-10-01

Full Text Available Penile augmentation has been reported in the literature by injecting various materials. This study reports our experience in management of penile augmentation complications associated with selfpenile injection of silicone liquid. After a careful ultrasound study, the penile skin was excised through a circumferential sub-coronal incision and dissected with the silicon mass. Histology was well-compatible with silicone granulomas. The patient was discharged after 24 hours. Ultrasonography has permitted preoperatively to determine if the plane between the indurated inflammatory tissue and the Buck’s fascia was preserved for the complete surgical excision of affected tissue.

Computer-aided detection of pulmonary nodules: influence of nodule characteristics on detection performance

International Nuclear Information System (INIS)

Marten, K.; Engelke, C.; Seyfarth, T.; Grillhoesl, A.; Obenauer, S.; Rummeny, E.J.

2005-01-01

AIM: To evaluate prospectively the influence of pulmonary nodule characteristics on detection performances of a computer-aided diagnosis (CAD) tool and experienced chest radiologists using multislice CT (MSCT). MATERIALS AND METHODS: MSCT scans of 20 consecutive patients were evaluated by a CAD system and two independent chest radiologists for presence of pulmonary nodules. Nodule size, position, margin, matrix characteristics, vascular and pleural attachments and reader confidence were recorded and data compared with an independent standard of reference. Statistical analysis for predictors influencing nodule detection or reader performance included chi-squared, retrograde stepwise conditional logistic regression with odds ratios and nodule detection proportion estimates (DPE), and ROC analysis. RESULTS: For 135 nodules, detection rates for CAD and readers were 76.3, 52.6 and 52.6%, respectively; false-positive rates were 0.55, 0.25 and 0.15 per examination, respectively. In consensus with CAD the reader detection rate increased to 93.3%, and the false-positive rate dropped to 0.1/scan. DPEs for nodules ≤5 mm were significantly higher for ICAD than for the readers (p<0.05). Absence of vascular attachment was the only significant predictor of nodule detection by CAD (p=0.0006-0.008). There were no predictors of nodule detection for reader consensus with CAD. In contrast, vascular attachment predicted nodule detection by the readers (p=0.0001-0.003). Reader sensitivity was higher for nodules with vascular attachment than for unattached nodules (sensitivities 0.768 and 0.369; 95% confidence intervals=0.651-0.861 and 0.253-0.498, respectively). CONCLUSION: CAD increases nodule detection rates, decreases false-positive rates and compensates for deficient reader performance in detection of smallest lesions and of nodules without vascular attachment

Drugs Approved for Penile Cancer

Science.gov (United States)

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

Long anterior urethral stricture: Reconstruction by dorsally quilted penile skin flap

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Mohammad Sayed Abdel-Kader

2013-01-01

Conclusion: Free penile skin flaps offer good results (functional and cosmetic in long anterior urethral stricture. Meticulously fashioned longitudinal, circular or spiral penile skin flaps could bridge urethral defects up to 15 cm long.

Alterations in geochemical associations in artificially disturbed deep-sea sediments

Digital Repository Service at National Institute of Oceanography (India)

Nath, B.N.; Parthiban, G.; Banaulikar, S.; Sarkar, S.

Alterations in Geochemical Associations in Artificially Disturbed Deep-Sea Sediments B. NAGENDER NATH, G. PARTHIBAN, AND S. BANAULIKAR National Institute of Oceanography, Dona Paula, Goa, India SUBHADEEP SARKAR Department of Geology and Geophysics, Indian... the lithogenic component by transporting it from other locations within the Basin during commercial mining operations. Keywords manganese nodule mining, artificial benthic disturbance experiment, environmental impact assessment, metals Trace metals in marine...

Measurement of penile size in healthy Nigerian newborns using ...

African Journals Online (AJOL)

newborn male infants. J Pediatr 1975; 86:395–398. 6 Flatau E, Josefsberg Z, Reisner SH, Bialik O, Iaron Z. Letter: penile size in the newborn infant. J Pediatr 1975; 87:663–664. 7 Boas M, Boisen KA, Virtanen HE, Kaleva M, Suomi AM, Schmidt IM, et al. Postnatal penile length and growth rate correlate to serum testosterone.

Penile fracture in a patient with stuttering priapism | Badmus | West ...

African Journals Online (AJOL)

Penile fracture commonly results from trauma of sexual intercourse or masturbation. It is common in the Middle East and America, but rare in Nigeria and sub-Sahara Africa. We present a case of penile fracture, an uncommon urologic emergency, complicating priapism, another urologic emergency; precipitated in an ...

Automated computerized scheme for distinction between benign and malignant solitary pulmonary nodules on chest images

International Nuclear Information System (INIS)

Aoyama, Masahito; Li Qiang; Katsuragawa, Shigehiko; MacMahon, Heber; Doi, Kunio

2002-01-01

A novel automated computerized scheme has been developed to assist radiologists for their distinction between benign and malignant solitary pulmonary nodules on chest images. Our database consisted of 55 chest radiographs (33 primary lung cancers and 22 benign nodules). In this method, the location of a nodule was indicated first by a radiologist. The difference image with a nodule was produced by use of filters and then represented in a polar coordinate system. The nodule was segmented automatically by analysis of contour lines of the gray-level distribution based on the polar-coordinate representation. Two clinical parameters (age and sex) and 75 image features were determined from the outline, the image, and histogram analysis for inside and outside regions of the segmented nodule. Linear discriminant analysis (LDA) and knowledge about benign and malignant nodules were used to select initial feature combinations. Many combinations for subgroups of 77 features were evaluated as input to artificial neural networks (ANNs). The performance of ANNs with the selected 7 features by use of the round-robin test showed Az=0.872, which was greater than Az=0.854 obtained previously with the manual method (P=0.53). The performance of LDA (Az=0.886) was slightly improved compared to that of ANNs (P=0.59) and was greater than that of the manual method (Az=0.854) reported previously (P=0.40). The high level of its performance indicates the potential usefulness of this automated computerized scheme in assisting radiologists as a second opinion for distinction between benign and malignant solitary pulmonary nodules on chest images

Erect penile length and circumference dimensions of 1,661 sexually active men in the United States.

Science.gov (United States)

Herbenick, Debby; Reece, Michael; Schick, Vanessa; Sanders, Stephanie A

2014-01-01

Penile size continues to receive popular and empirical attention. Little is known about the process of self-measurement and whether the behaviors a man engages in to become erect for self-measurement are associated with his erect penile dimensions. The article aims to assess men's erect penile dimensions in a study in which the men would presumably be motivated to report accurate information about their penis size; and to explore associations between men's erect penile dimensions, their method of measurement, and their demographics. Data are from an Internet-based baseline phase of a large prospective daily diary study that compared men's use of a standard-sized condom to men's use of a condom sized to fit their erect penis. The main outcomes are participant characteristics, activities engaged in during self-measurement process, and self-reported erect penile length and circumference. For this sample of 1,661 men, the mean erect penile length was 14.15 cm (SD = 2.66; range = 4 to 26 cm), and the mean erect penile circumference was 12.23 cm (SD = 2.23; range = 3 to 19). Participant characteristics were not associated with measured length or circumference. Most men measured their penis while alone, using hand stimulation to become erect. In this sample of men who measured their erect penile length and circumference for the purposes of receiving a condom sized to fit their erect penis, we found a mean erect penile length of 14.15 cm and a mean erect penile circumference of 12.23 cm. The self-reported erect penile dimensions in this study are consistent with other penile dimension research. Also, findings suggest that mode of getting an erection may influence erect penile dimensions. Additionally, how a man becomes erect for self-measurement may be associated with his erect penile length and/or circumference. © 2013 International Society for Sexual Medicine.

Traumatic degloving lesion of penile and scrotal skin

Directory of Open Access Journals (Sweden)

Luiz A. Zanettini

2005-06-01

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

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

Directory of Open Access Journals (Sweden)

Ramesh Sasidaran

2012-01-01

Full Text Available To report our experience with 5 cases of complications of penile enhancement procedures secondary to liquid silicone injections and our method of management of its debilitating effects. All five patients were treated with excision of penile shaft skin down to buck′s fascia followed by resurfacing with split thickness skin grafting. We conclude that penile enhancement procedures with liquid silicone by non-medical personnel could result in devastating consequences. We also demonstrate that a simple method of excision of the entire penile shaft skin and resurfacing with split skin grafting showed improvement in cosmetic as well as functional outcome.

Pulsed and Color Doppler Sonographic Findings of Penile Mondor' Disease

Energy Technology Data Exchange (ETDEWEB)

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

2008-04-15

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

Venous Ligation: A Novel Strategy for Glans Enhancement in Penile Prosthesis Implantation

OpenAIRE

Hsu, Geng-Long; Hill, James W.; Hsieh, Cheng-Hsing; Liu, Shih-Ping; Hsu, Chih-Yuan

2014-01-01

Although penile implantation remains a final solution for patients with refractory impotence, undesirable postoperative effects, including penile size reduction and cold sensation of the glans penis, remain problematic. We report results of a surgical method designed to avoid these problems. From 2003 to 2013, 35 consecutive patients received a malleable penile implant. Of these, 15 men (the enhancing group) were also treated with venous ligation of the retrocoronal venous plexus, deep dorsal...

[Penile Tuberculosis : A Case Report].

Science.gov (United States)

Imanaka, Takahiro; Nomura, Hironori; Tsujimura, Go; Ko, Yoko; Kinjyo, Takanori; Yoshioka, Iwao; Takada, Shingo; Yahata, Yoko; Mizutani, Tetsu

2017-04-01

A 66-year-old man presented with a chief complaint of glans penis pain, induration, and discharge of pus. He was prescribed a course of antibiotics, but the condition persisted despite treatment. Thus, we differrentially diagnosed the patient with penile tuberculosis and pyoderma gangrenosum, and performed a biopsy of the penis. The biopsy result was thickening of the horny layer epidermis with only a foreign body granuloma composed of inflammatory cells, and did not lead to a definitive diagnosis. Thoraca-abdominal computed tomography revealed axillary lymphadenopathy with necrosis. Suspecting tuberculosis lymphadenitis, we performed T-spot and QuantiFERONtests. The result was T-spot negative and QuantiFERONpositive, so we diagnosed the patient with penile tuberculosis, and started antituberculosis medication. In about half a year after the start of treatment the symptoms subsided, and lymphadenopathy showed reduction.

Digital tomosynthesis for evaluating metastatic lung nodules: nodule visibility, learning curves, and reading times.

Science.gov (United States)

Lee, Kyung Hee; Goo, Jin Mo; Lee, Sang Min; Park, Chang Min; Bahn, Young Eun; Kim, Hyungjin; Song, Yong Sub; Hwang, Eui Jin

2015-01-01

To evaluate nodule visibility, learning curves, and reading times for digital tomosynthesis (DT). We included 80 patients who underwent computed tomography (CT) and DT before pulmonary metastasectomy. One experienced chest radiologist annotated all visible nodules on thin-section CT scans using computer-aided detection software. Two radiologists used CT as the reference standard and retrospectively graded the visibility of nodules on DT. Nodule detection performance was evaluated in four sessions of 20 cases each by six readers. After each session, readers were unblinded to the DT images by revealing the true-positive markings and were instructed to self-analyze their own misreads. Receiver-operating-characteristic curves were determined. Among 414 nodules on CT, 53.3% (221/414) were visible on DT. The main reason for not seeing a nodule on DT was small size (93.3%, ≤ 5 mm). DT revealed a substantial number of malignant nodules (84.1%, 143/170). The proportion of malignant nodules among visible nodules on DT was significantly higher (64.7%, 143/221) than that on CT (41.1%, 170/414) (p 0.8, and the average detection rate for malignant nodules was 85% (210/246). The inter-session analysis of the AUC showed no significant differences among the readers, and the detection rate for malignant nodules did not differ across sessions. A slight improvement in reading times was observed. Most malignant nodules > 5 mm were visible on DT. As nodule detection performance was high from the initial session, DT may be readily applicable for radiology residents and board-certified radiologists.

One-stage lingual augmented urethroplasty in repair of distal penile ...

African Journals Online (AJOL)

E. Elsayed

Abstract. Objectives: To evaluate the outcome of augmentation of shallow urethral plate by lingual graft in repair of distal penile hypospadias. Patients and methods: Between June 2008 and May 2011, the procedure was performed on 23 patients with mean age 2.3 years (range 1–3). All patients had distal penile ...

Penile Cancer

Science.gov (United States)

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

2014-01-01

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

Interstitial laser photocoagulation for benign thyroid nodules: time to treat large nodules.

Science.gov (United States)

Amabile, Gerardo; Rotondi, Mario; Pirali, Barbara; Dionisio, Rosa; Agozzino, Lucio; Lanza, Michele; Buonanno, Luciano; Di Filippo, Bruno; Fonte, Rodolfo; Chiovato, Luca

2011-09-01

Interstitial laser photocoagulation (ILP) is a new therapeutic option for the ablation of non-functioning and hyper-functioning benign thyroid nodules. Amelioration of the ablation procedure currently allows treating large nodules. Aim of this study was to evaluate the therapeutic efficacy of ILP, performed according to a modified protocol of ablation, in patients with large functioning and non-functioning thyroid nodules and to identify the best parameters for predicting successful outcome in hyperthyroid patients. Fifty-one patients with non-functioning thyroid nodules (group 1) and 26 patients with hyperfunctioning thyroid nodules (group 2) were enrolled. All patients had a nodular volume ≥40 ml. Patients were addressed to 1-3 cycles of ILP. A cycle consisted of three ILP sessions, each lasting 5-10 minutes repeated at an interval of 1 month. After each cycle of ILP patients underwent thyroid evaluation. A nodule volume reduction, expressed as percentage of the basal volume, significantly occurred in both groups (F = 190.4; P nodule volume; (iii) total amount of energy delivered expressed in Joule. ROC curves identified the percentage of volume reduction as the best parameter predicting a normalized serum TSH (area under the curve 0.962; P thyroid nodules, both in terms of nodule size reduction and cure of hyperthyroidism (87% of cured patients after the last ILP cycle). ILP should not be limited to patients refusing or being ineligible for surgery and/or radioiodine. Copyright © 2011 Wiley-Liss, Inc.

Computerized Detection of Lung Nodules by Means of “Virtual Dual-Energy” Radiography

Science.gov (United States)

Chen, Sheng; Suzuki, Kenji

2014-01-01

Major challenges in current computer-aided detection (CADe) schemes for nodule detection in chest radiographs (CXRs) are to detect nodules that overlap with ribs and/or clavicles and to reduce the frequent false positives (FPs) caused by ribs. Detection of such nodules by a CADe scheme is very important, because radiologists are likely to miss such subtle nodules. Our purpose in this study was to develop a CADe scheme with improved sensitivity and specificity by use of “virtual dual-energy” (VDE) CXRs where ribs and clavicles are suppressed with massive-training artificial neural networks (MTANNs). To reduce rib-induced FPs and detect nodules overlapping with ribs, we incorporated the VDE technology in our CADe scheme. The VDE technology suppressed rib and clavicle opacities in CXRs while maintaining soft-tissue opacity by use of the MTANN technique that had been trained with real dual-energy imaging. Our scheme detected nodule candidates on VDE images by use of a morphologic filtering technique. Sixty morphologic and gray-level-based features were extracted from each candidate from both original and VDE CXRs. A nonlinear support vector classifier was employed for classification of the nodule candidates. A publicly available database containing 140 nodules in 140 CXRs and 93 normal CXRs was used for testing our CADe scheme. All nodules were confirmed by computed tomography examinations, and the average size of the nodules was 17.8 mm. Thirty percent (42/140) of the nodules were rated “extremely subtle” or “very subtle” by a radiologist. The original scheme without VDE technology achieved a sensitivity of 78.6% (110/140) with 5 (1165/233) FPs per image. By use of the VDE technology, more nodules overlapping with ribs or clavicles were detected and the sensitivity was improved substantially to 85.0% (119/140) at the same FP rate in a leave-one-out cross-validation test, whereas the FP rate was reduced to 2.5 (583/233) per image at the same sensitivity

Inflatable penile prosthesis implant length with baseline characteristic correlations: preliminary analysis of the PROPPER study.

Science.gov (United States)

Bennett, Nelson; Henry, Gerard; Karpman, Edward; Brant, William; Jones, LeRoy; Khera, Mohit; Kohler, Tobias; Christine, Brian; Rhee, Eugene; Kansas, Bryan; Bella, Anthony J

2017-12-01

"Prospective Registry of Outcomes with Penile Prosthesis for Erectile Restoration" (PROPPER) is a large, multi-institutional, prospective clinical study to collect, analyze, and report real-world outcomes for men implanted with penile prosthetic devices. We prospectively correlated co-morbid conditions and demographic data with implanted penile prosthesis size to enable clinicians to better predict implanted penis size following penile implantation. We present many new data points for the first time in the literature and postulate that radical prostatectomy (RP) is negatively correlated with penile corporal length. Patient demographics, medical history, baseline characteristics and surgical details were compiled prospectively. Pearson correlation coefficient was generated for the correlation between demographic, etiology of ED, duration of ED, co-morbid conditions, pre-operative penile length (flaccid and stretched) and length of implanted penile prosthesis. Multivariate analysis was performed to define predictors of implanted prosthesis length. From June 2011 to June 2017, 1,135 men underwent primary implantation of penile prosthesis at a total of 11 study sites. Malleable (Spectra), 2-piece Ambicor, and 3-piece AMS 700 CX/LGX were included in the analysis. The most common patient comorbidities were CV disease (26.1%), DM (11.1%), and PD (12.4%). Primary etiology of ED: RP (27.4%), DM (20.3%), CVD (18.0%), PD (10.3%), and Priapism (1.4%), others (22.6%). Mean duration of ED is 6.2¡À4.1 years. Implant length was weakly negatively correlated with White/Caucasian (r=-0.18; Pprosthesis length is negatively correlated with some ethnic groups, prostatectomy, and incontinence. Positive correlates include CV disease, preoperative stretched penile length, and flaccid penile length.

Automated detection of pulmonary nodules in CT images with support vector machines

Science.gov (United States)

Liu, Lu; Liu, Wanyu; Sun, Xiaoming

2008-10-01

Many methods have been proposed to avoid radiologists fail to diagnose small pulmonary nodules. Recently, support vector machines (SVMs) had received an increasing attention for pattern recognition. In this paper, we present a computerized system aimed at pulmonary nodules detection; it identifies the lung field, extracts a set of candidate regions with a high sensitivity ratio and then classifies candidates by the use of SVMs. The Computer Aided Diagnosis (CAD) system presented in this paper supports the diagnosis of pulmonary nodules from Computed Tomography (CT) images as inflammation, tuberculoma, granuloma..sclerosing hemangioma, and malignant tumor. Five texture feature sets were extracted for each lesion, while a genetic algorithm based feature selection method was applied to identify the most robust features. The selected feature set was fed into an ensemble of SVMs classifiers. The achieved classification performance was 100%, 92.75% and 90.23% in the training, validation and testing set, respectively. It is concluded that computerized analysis of medical images in combination with artificial intelligence can be used in clinical practice and may contribute to more efficient diagnosis.

Digital tomosynthesis for evaluating metastatic lung nodules: Nodule visibility, learning curves, and reading times

International Nuclear Information System (INIS)

Lee, Kyung Hee; Goo, Jin Mo; Lee, Sang Min; Park, Chang Min; Bahn, Young Eun; Kim, Hyung Jin; Song, Yong Sub; Hwang, Eui Jin

2015-01-01

To evaluate nodule visibility, learning curves, and reading times for digital tomosynthesis (DT). We included 80 patients who underwent computed tomography (CT) and DT before pulmonary metastasectomy. One experienced chest radiologist annotated all visible nodules on thin-section CT scans using computer-aided detection software. Two radiologists used CT as the reference standard and retrospectively graded the visibility of nodules on DT. Nodule detection performance was evaluated in four sessions of 20 cases each by six readers. After each session, readers were unblinded to the DT images by revealing the true-positive markings and were instructed to self-analyze their own misreads. Receiver-operating-characteristic curves were determined. Among 414 nodules on CT, 53.3% (221/414) were visible on DT. The main reason for not seeing a nodule on DT was small size (93.3%, < or = 5 mm). DT revealed a substantial number of malignant nodules (84.1%, 143/170). The proportion of malignant nodules among visible nodules on DT was significantly higher (64.7%, 143/221) than that on CT (41.1%, 170/414) (p < 0.001). Area under the curve (AUC) values at the initial session were > 0.8, and the average detection rate for malignant nodules was 85% (210/246). The inter-session analysis of the AUC showed no significant differences among the readers, and the detection rate for malignant nodules did not differ across sessions. A slight improvement in reading times was observed. Most malignant nodules > 5 mm were visible on DT. As nodule detection performance was high from the initial session, DT may be readily applicable for radiology residents and board-certified radiologists.

Digital tomosynthesis for evaluating metastatic lung nodules: Nodule visibility, learning curves, and reading times

Energy Technology Data Exchange (ETDEWEB)

Lee, Kyung Hee; Goo, Jin Mo; Lee, Sang Min; Park, Chang Min; Bahn, Young Eun; Kim, Hyung Jin; Song, Yong Sub; Hwang, Eui Jin [Dept. of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul (Korea, Republic of)

2015-04-15

To evaluate nodule visibility, learning curves, and reading times for digital tomosynthesis (DT). We included 80 patients who underwent computed tomography (CT) and DT before pulmonary metastasectomy. One experienced chest radiologist annotated all visible nodules on thin-section CT scans using computer-aided detection software. Two radiologists used CT as the reference standard and retrospectively graded the visibility of nodules on DT. Nodule detection performance was evaluated in four sessions of 20 cases each by six readers. After each session, readers were unblinded to the DT images by revealing the true-positive markings and were instructed to self-analyze their own misreads. Receiver-operating-characteristic curves were determined. Among 414 nodules on CT, 53.3% (221/414) were visible on DT. The main reason for not seeing a nodule on DT was small size (93.3%, < or = 5 mm). DT revealed a substantial number of malignant nodules (84.1%, 143/170). The proportion of malignant nodules among visible nodules on DT was significantly higher (64.7%, 143/221) than that on CT (41.1%, 170/414) (p < 0.001). Area under the curve (AUC) values at the initial session were > 0.8, and the average detection rate for malignant nodules was 85% (210/246). The inter-session analysis of the AUC showed no significant differences among the readers, and the detection rate for malignant nodules did not differ across sessions. A slight improvement in reading times was observed. Most malignant nodules > 5 mm were visible on DT. As nodule detection performance was high from the initial session, DT may be readily applicable for radiology residents and board-certified radiologists.

Role of baseline nodule density and changes in density and nodule features in the discrimination between benign and malignant solid indeterminate pulmonary nodules

NARCIS (Netherlands)

Xu, D.M.; van Klaveren, R.J.; de Bock, G.H.; Leusveld, A.L.M.; Dorrius, M.D.; Zhao, Y.; Wang, Y.; de Koning, H.J.; Scholten, E.T.; Verschakelen, J.; Prokop, M.; Oudkerk, M.

Purpose: To retrospectively evaluate whether baseline nodule density or changes in density or nodule features could be used to discriminate between benign and malignant solid indeterminate nodules. Materials and methods: Solid indeterminate nodules between 50 and 500 mm(3) (4.6-9.8 mm) were assessed

Hypervascular hyperplastic nodules appearing in chronic alcoholic liver disease: benign intrahepatic nodules mimicking hepatocellular carcinoma

International Nuclear Information System (INIS)

Park, Won Kyu; Chang, Jay Chun; Kim, Jae Woon

2006-01-01

Hypervascular hyperplastic nodules in those patients with chronic alcoholic liver disease and who are hepatitis B and C negative have recently been reported on. The purpose of this study was to correlate the radiologic and pathologic findings with the clinical significance of these hypervascular hyperplastic nodules in chronic alcoholic liver disease. The study included eight hypervascular nodules of seven patients with chronic alcoholic liver disease, and these patients abused alcohol for more than 20 years. Eight hypervascular nodules were seen on the arterial phase of dynamic CT scans, but the possibility of HCC was excluded pathologically (n=4) or clinically. The radiologic and pathologic findings, and the changes of these nodules on follow up CT scans were retrospectively analyzed. All nodules showed good enhancement on the arterial phase. The tissue equilibrium phase of the dynamic CT scans showed isodensity in seven patients and low density in one patient. Ultrasound scans revealed hypoechoic findings for three nodules, isoechoic findings for two nodules, hyperechoic findings for one nodules, and two nodules were not detected. Angiograms (n=6) showed late incremental tumor staining, and all the nodules were well seen on the sinusoidal phase. CT during hepatic angiography (n=4) showed well stained tumor. CT during arterial portography (n=4) showed no defect in three nodules and nodular defect in on nodule. The MR images (n=3) showed low signal intensity in two nodules and iso-signal intensity in one nodule on T2WI. Five of six cases for which follow up CT scans were performed showed decrease in size and one was disappeared. Radiologically, it is often difficult to differentiate the hypervascular hyperplastic nodules seen in the chronic alcoholic liver disease from hepatocellular carcinoma, and histological confirmation is needed for excluded hepatocellular carcinoma. However, late tumor staining during the sinusoidal phase without any blood supply by feeding

Hypervascular hyperplastic nodules appearing in chronic alcoholic liver disease: benign intrahepatic nodules mimicking hepatocellular carcinoma

Energy Technology Data Exchange (ETDEWEB)

Park, Won Kyu; Chang, Jay Chun; Kim, Jae Woon [College of Medicine, Yeungnam University, Daegu (Korea, Republic of)] (and others)

2006-02-15

Hypervascular hyperplastic nodules in those patients with chronic alcoholic liver disease and who are hepatitis B and C negative have recently been reported on. The purpose of this study was to correlate the radiologic and pathologic findings with the clinical significance of these hypervascular hyperplastic nodules in chronic alcoholic liver disease. The study included eight hypervascular nodules of seven patients with chronic alcoholic liver disease, and these patients abused alcohol for more than 20 years. Eight hypervascular nodules were seen on the arterial phase of dynamic CT scans, but the possibility of HCC was excluded pathologically (n=4) or clinically. The radiologic and pathologic findings, and the changes of these nodules on follow up CT scans were retrospectively analyzed. All nodules showed good enhancement on the arterial phase. The tissue equilibrium phase of the dynamic CT scans showed isodensity in seven patients and low density in one patient. Ultrasound scans revealed hypoechoic findings for three nodules, isoechoic findings for two nodules, hyperechoic findings for one nodules, and two nodules were not detected. Angiograms (n=6) showed late incremental tumor staining, and all the nodules were well seen on the sinusoidal phase. CT during hepatic angiography (n=4) showed well stained tumor. CT during arterial portography (n=4) showed no defect in three nodules and nodular defect in on nodule. The MR images (n=3) showed low signal intensity in two nodules and iso-signal intensity in one nodule on T2WI. Five of six cases for which follow up CT scans were performed showed decrease in size and one was disappeared. Radiologically, it is often difficult to differentiate the hypervascular hyperplastic nodules seen in the chronic alcoholic liver disease from hepatocellular carcinoma, and histological confirmation is needed for excluded hepatocellular carcinoma. However, late tumor staining during the sinusoidal phase without any blood supply by feeding

Contemporary management of patients with penile cancer and lymph node metastasis.

Science.gov (United States)

Leone, Andrew; Diorio, Gregory J; Pettaway, Curtis; Master, Viraj; Spiess, Philippe E

2017-06-01

Penile cancer is a rare disease that causes considerable physical and psychological patient morbidity, especially at advanced stages. Patients with low-stage nodal metastasis can achieve durable survival with surgery alone, but those with extensive locoregional metastasis have overall low survival. Contemporary management strategies for lymph node involvement in penile cancer aim to minimize the morbidity associated with traditional radical inguinal lymphadenectomy through appropriate risk stratification while optimizing oncological outcomes. Modified (or superficial) inguinal lymph node dissection and dynamic sentinel lymph node biopsy are diagnostic modalities that have been recommended in patients with high-risk primary penile tumours and nonpalpable inguinal lymph nodes. In addition, advances in minimally invasive and robot-assisted lymphadenectomy techniques are being investigated in patients with penile cancer and might further decrease lymphadenectomy-related adverse effects. The management of patients with advanced disease has evolved to include multimodal treatment with systemic chemotherapy before surgical intervention and can include adjuvant chemotherapy after pelvic lymphadenectomy. The role of radiotherapy in the neoadjuvant or adjuvant setting remains largely unclear, owing to a lack of high-level evidence of possible benefits. New targeted therapies have shown efficacy in squamous cell carcinomas of other sites and might also prove effective in patients with penile cancer.

Management of Penile Fracture and its Outcome

International Nuclear Information System (INIS)

Khan, Z. I.

2013-01-01

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)

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

DEFF Research Database (Denmark)

Lindeborg, Lisa; Fode, Mikkel; Fahrenkrug, Lasse

2014-01-01

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

Long-term Results of Ventral Penile Curvature Repair in Childhood.

Science.gov (United States)

Golomb, Dor; Sivan, Bezalel; Livne, Pinhas M; Nevo, Amihay; Ben-Meir, David

2018-02-01

To assess the postpubertal outcome of ventral penile curvature repaired in infancy in terms of recurrence and aesthetics. Postpubertal patients treated for hypospadias and ventral penile curvature in infancy at a tertiary medical center were invited to undergo assessment of the quality of the repair. Findings were compared between patients with a straight penis after skin release and patients who required dorsal plication. The cohort included 27 patients of mean age 16.5 years who were reported with straight penis after surgery. Postpubertal curvature was found in 6 of 14 patients (43%) successfully treated by skin release and 10 of 13 patients (77%) who underwent dorsal plication (P = .087). Significant curvature (≥30 degrees) was found in 1 of 14 patients in the skin-release group and 4 of 13 in the dorsal plication group (P = .16). Rates of redo urethroplasty were 2 of 14 (14%) and 5 of 10 (50%), respectively. Patient satisfaction with the appearance of the penis did not differ significantly. Ventral penile curvature repaired in infancy often recurs after puberty. The need for dorsal plication has a trend-level association with recurrence of penile curvature in puberty. It might also be related to the degree of postpubertal penile curvature and the need for redo urethroplasty. Procedure type does not affect patient satisfaction with the postpubertal appearance of the penis. Copyright © 2017 Elsevier Inc. All rights reserved.

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

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

2012-03-15

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

Search for Nodulation and Nodule Development-related cystatin genes in the genome of Soybean (Glycine max

Directory of Open Access Journals (Sweden)

Songli Yuan

2016-10-01

Full Text Available Nodulation, nodule development and senescence directly affects nitrogen fixation efficiency, and previous studies have shown that inhibition of some cysteine proteases delay nodule senescence, so their nature inhibitors, cystatin genes, are very important in nodulation, nodule development and senescence. Although several cystatins are actively transcribed in soybean nodules, their exact roles and functional diversities in legume have not been well explored in genome-wide survey studies. In this report, we performed a genome-wide survey of cystatin family genes to explore their relationship to nodulation and nodule development in soybean and identified 20 cystatin genes that encode peptides with 97~245 amino acid residues, different isoelectric points (pI and structure characteristics, and various putative plant regulatory elements in 3000 bp putative promoter fragments upstream of the 20 soybean cystatins in response to different abiotic/biotic stresses, hormone signals and symbiosis signals. The expression profiles of these cystatin genes in soybean symbiosis with rhizobium strain Bradyrhizobium japonicum strain 113-2 revealed that 7 cystatin family genes play different roles in nodulation as well as nodule development and senescence. However, these genes were not root nodule symbiosis (RNS - specific and did not encode special clade cystatin protein with structures related to nodulation and nodule development. Besides, only two of these soybean cystatins were not upregulated in symbiosis after ABA treatment. The functional analysis showed that a candidate gene Glyma.15G227500 (GmCYS16 was likely to play a positive role in soybean nodulation. Besides, evolutionary relationships analysis divided the cystatin genes from Arabidopsis thaliana, Nicotiana tabacum, rice, barley and four legume plants into three groups. Interestingly, Group A cystatins are special in legume plants, but only include one of the above-mentioned 7 cystatin genes related to

Auxin transport, metabolism, and signalling during nodule initiation: indeterminate and determinate nodules

NARCIS (Netherlands)

Kohlen, W.; Ng, Jason Liang Pin; Deinum, E.E.; Mathesius, Ulrike

2018-01-01

Most legumes can form a unique type of lateral organ on their roots: root nodules. These structures host symbiotic nitrogen-fixing bacteria called rhizobia. Several different types of nodules can be found in nature, but the two best-studied types are called indeterminate and determinate nodules.

A Case Series of Patients Who Underwent Laparoscopic Extraperitoneal Radical Prostatectomy with the Simultaneous Implant of a Penile Prosthesis: Focus on Penile Length Preservation

Science.gov (United States)

2018-01-01

Purpose There are many grey areas in the field of penile rehabilitation after radical prostatectomy (RP). The preservation of the full dimensions of the penis is an important consideration for improving patients' compliance for the treatment. We present the first case series of patients treated by laparoscopic extraperitoneal RP and simultaneous penile prosthesis implantation (PPI) in order to preserve the full length of the penis and to improve patients' satisfaction. Materials and Methods From June 2013 to June 2014, 10 patients underwent simultaneous PPI (with an AMS InhibiZone prosthesis) and RP. Patients were evaluated by means of urological visits, questionnaires, and objective measurements before surgery, at discharge from the hospital, on postoperative days 21 to 28, each 3 months for the first year, and each 6 months thereafter. The main outcome measures were biochemical recurrence-free rate, penile length, and quality of life. Results Ten patients (mean age of 61 years; completed the study follow-up period (median, 32.2 months). No difference was found between the time of surgery and the 2-year follow-up evaluation in terms of penile length. The pre-surgery 36-Item Short Form Health Survey (SF-36) median score was 97. Patients were satisfied with their penile implants, and couples' level of sexual satisfaction was rated median 8. The median postoperative SF-36 score was 99 at 3 months follow-up. Conclusions Laparoscopic extraperitoneal RP surgery with simultaneous PPI placement seems to be an interesting possibility to propose to motivated patients for preserving the length of the penis and improving their satisfaction. PMID:29623695

Computed tomography of pulmonary nodules

International Nuclear Information System (INIS)

Nakata, Hajime; Honda, Hiroshi; Nakayama, Chikashi; Kimoto, Tatsuya; Nakayama, Takashi

1983-01-01

We have evaluated the value of computed tomography (CT) in distinguishing benign and malignant pulmonary nodules. CT was performed on 30 cases of solitary pulmonary nodules consisting of 17 primary lung cancers, 3 metastatic tumors and 10 benign nodules. The CT number was calculated for each lesion. Three benign nodules showed CT numbers well above the range of malignant nodules, and only in one of them was calcification visible on conventional tomography. In 6 benign nodules, the CT numbers overlapped those of malignant lesion and could not be differentiated. Thus the measurement of CT number can be useful to confirm the benign nature of certain nodules when calcification is unclear or not visible on conventional tomography. As for the morphological observation of the nodule, CT was not superior to conventional tomography and its value seems to be limited. (author)

The incidence of isolated penile torsion in North India: A study of 5,018 male neonates.

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Bhat, Amilal; Bhat, Mahakshit; Kumar, Vinay; Goyal, Suresh; Bhat, Akshita; Patni, Madhu

2017-10-01

Congenital penile torsion is a three-dimensional deformity with helical rotation of the distal corporal bodies with the penile crurae remaining fixed to the pubic rami. The first case of congenital penile torsion (hypospadias) was described in 1857. Isolated penile torsion is an under-reported anomaly. The reported incidence of isolated penile torsion is 1.7-27% and severe torsion is 0.7%. There are no studies available from Indian subcontinent on the incidence of isolated penile torque. The objective of this study was to determine the overall incidence of isolated penile torque in a north Indian population. A prospective study of deliveries of male children was conducted at our institute between April 2014 and June 2015. Penile torsion was measured using a small protractor either by the deviation of the median raphae or the direction of the meatus. Data were collected on the incidence of congenital isolated penile torsion, including the degree and direction (left or right) of torsion. Torsion was classified as mild (900). Statistical analysis was done using the chi-square test with variables of age and parity of the mother and weight of the child. There were 99 cases of isolated penile torque among 5018 male neonates assessed for penile torque. The incidence of isolated penile torque was 19.7 per 1000 births. The degree of torsion varied from 30 to 110° (average 51.46°). Seventy-nine percent (79%) of them had left side and 21% had right side torque (4:1). The degree of torsion was mild in 30%, with 20% having left side torque and 10% having right side torque (2:1). A moderate degree of torsion was seen in 69%: 84% of them had left torque and only 16% had right sided torque (5:1). Only one patient had severe left torque. The incidence of isolated congenital penile torsion was highest in the maternal age group of >30 years followed by the 26-30-year age group, and was lowest in 21-25 year age group. In multiparous women, the incidence of isolated congenital penile

Applying extender devices in patients with penile dysmorphophobia: assessment of tolerability, efficacy, and impact on erectile function.

Science.gov (United States)

Nowroozi, Mohammad Reza; Amini, Erfan; Ayati, Mohsen; Jamshidian, Hassan; Radkhah, Kayvan; Amini, Shahab

2015-05-01

Most men seeking penile enhancement techniques have a normal penile size. They are either misinformed or suffer from penile dysmorphophobia and should be discouraged from undergoing invasive procedures. Less invasive techniques including penile extenders are not associated with major complications and may be beneficial from a psychological perspective. We conducted this study to assess the efficacy and safety of AndroPenis (Andromedical, Madrid, Spain) penile extender. Between December 2010 and December 2013, 163 men presented to our institution complaining of small penile length and/or girth. All patients received structured psychosexual counseling. Fifty-four patients were willing to use the AndroPenis penile extender after counseling. Patients with major psychiatric disorders were excluded from enrollment. The patients were instructed to wear the device between 4 and 6 hours per day for 6 months. Penile dimensions including flaccid stretched and erected lengths were measured at baseline and after 1, 3, 6, and 9 months. Erectile function was assessed at baseline and 9 months after treatment using the simplified International Index of Erectile Function (IIEF-5). An institutional nonstandardized questionnaire was used to evaluate patient satisfaction at the end of study. Penile length and girth enhancement as well as satisfaction rate and improvement in erectile function were assessed during follow-up. At 6-month follow-up, a mean gain of 1.7 ± 0.8, 1.3 ± 0.4, and 1.2 ± 0.4 cm was noted for the flaccid, stretched, and erected penile lengths, respectively (all P values < 0.001). During the off treatment period, there were no significant changes in penile lengths. No effect on penile girth was observed. Patient satisfaction survey revealed modest satisfaction. From 13 patients with mild baseline erectile dysfunction, nine patients reported normal erectile function after 9 months. Penile extender as a minimally invasive technique is safe and

Micromonospora is a normal occupant of actinorhizal nodules

Indian Academy of Sciences (India)

Supplementary table 1. Number of isolates per nodule. Nodule Colonies Average Nodule Colonies Average. AV1 Nodule 1 2 13 EEM Nodule 1 17 9.4. Nodule 2 O Nodule 2 13. Nodule 3 2 Nodule 3 9. AV2 Nodule 1 19 16.1 Nodule 4 7. Nodule 2 25 Nodule 5 18. Nodule 3 38 Nodule 6 4. AV4 Nodule 1 8 14.0 Nodule 7 12.

Henoch-Schonlein purpura: ultrasonography of scrotal and penile involvement

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Youngsik Lim

2015-04-01

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

“Oversized” Penile Length In The Black People; Myth Or Reality ...

African Journals Online (AJOL)

... penile lengths, and flaccid penile lengths, were measured in 115 adult men of the Black race in Nigeria. The results were compared with reported similar main studies on people of other races, which were accessible to the authors. These studies were done in Italy, Greece, Korea, Britain, and the United States of America.

Penile prosthesis implant with bi-triangular excision and graft for surgical therapy of Peyronie’s disease: A case report

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Alexandre de Freitas Miranda

2016-01-01

Full Text Available We present a case of a 65-year-old man, who presented with moderate erectile dysfunction and a dorsal penile deviation of 60° caused by Peyronie’s disease. The patient underwent bi-triangularshaped plaque excision, followed by grafting and implantation of inflatable penile prosthesis. Complete penile straightening, without mechanical or geometric abnormalities, was achieved using bi-triangular excision and grafting. Postoperatively, the patient reported high satisfaction with the results and could perform sexual intercourse naturally. This novel technique corrects any degree of penile curvature, permits malleable and semi-rigid penile prosthesis implantation, avoids penile length loss, and eliminates additional incisions. To our knowledge, this case is the first in the literature in which the bi-triangular technique was successfully used for penile prosthesis implantation secondary to Peyronie’s disease. This new technique appears to be a good solution to correct penile curvature during penile prosthesis implantation for the treatment of Peyronie’s disease associated with erectile dysfunction.

Adjuvant Maneuvers for Residual Curvature Correction During Penile Prosthesis Implantation in Men with Peyronie's Disease.

Science.gov (United States)

Berookhim, Boback M; Karpman, Edward; Carrion, Rafael

2015-11-01

The surgical treatment of comorbid erectile dysfunction and Peyronie's disease has long included the implantation of an inflatable penile prosthesis as well as a number of adjuvant maneuvers to address residual curvature after prosthesis placement. To review the various surgical options for addressing curvature after prosthesis placement, with specific attention paid to an original article by Wilson et al. reporting on modeling over a penile prosthesis for the management of Peyronie's disease. A literature review was performed analyzing articles reporting the management of penile curvature in patients undergoing implantation of an inflatable penile prosthesis. Reported improvement in Peyronie's deformity as well as the complication rate associated with the various surgical techniques described. Modeling is a well-established treatment modality among patients with Peyronie's disease undergoing penile prosthesis implantation. A variety of other adjuvant maneuvers to address residual curvature when modeling alone is insufficient has been presented in the literature. Over 20 years of experience with modeling over a penile prosthesis have proven the efficacy and safety of this treatment option, providing the surgeon a simple initial step for the management of residual curvature after penile implantation which allows for the use of additional adjuvant maneuvers in those with significant deformities. © 2015 International Society for Sexual Medicine.

Incidence and predictive factors of isolated neonatal penile glanular torsion.

Science.gov (United States)

Sarkis, Pierrot E; Sadasivam, Muthurajan

2007-12-01

To determine the incidence of isolated neonatal penile glanular torsion, describe the basic characteristics, and explore the relationship between foreskin and glans torsion. A prospective survey was conducted of all male newborns admitted to nursery after delivery, or neonates less than 3 months presenting for circumcision. Cases with associated genital malformations were excluded. The incidence of isolated neonatal penile torsion was 27% (95% CI: 22.2%-31.84%), to the left in 99% of cases. In 3.5% of cases, the penis had an angle 20 degrees. Using Spearman's correlational coefficient, deviation of penile raphe from the midline at the foreskin tip had a better correlation with glans torsion than deviation of raphe at the coronal sulcus (0.727 vs 0.570; both significant at pscope of the study.

Successful removal of a penile constriction wedding ring in a rural ...

African Journals Online (AJOL)

Penile strangulation has been reportedacross all age groups. In children, strangulating materials may be placed on the penis as treatment for enuresis and incontinence, and as a punitive measure for masturbation. In adults, it is done mainly for erotic reasons.[1-3]. We report a case of a strangulating penile ring and the ...

Penile lesion from gunshot wound: a 43-case experience

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Cavalcanti Andre G.

2006-01-01

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

Ex Vivo Model of Human Penile Transplantation and Rejection: Implications for Erectile Tissue Physiology.

Science.gov (United States)

Sopko, Nikolai A; Matsui, Hotaka; Lough, Denver M; Miller, Devin; Harris, Kelly; Kates, Max; Liu, Xiaopu; Billups, Kevin; Redett, Richard; Burnett, Arthur L; Brandacher, Gerald; Bivalacqua, Trinity J

2017-04-01

Penile transplantation is a potential treatment option for severe penile tissue loss. Models of human penile rejection are lacking. Evaluate effects of rejection and immunosuppression on cavernous tissue using a novel ex vivo mixed lymphocyte reaction (MLR) model. Cavernous tissue and peripheral blood mononuclear cells (PBMCs) from 10 patients undergoing penile prosthesis operations and PBMCs from a healthy volunteer were obtained. Ex vivo MLRs were prepared by culturing cavernous tissue for 48h in media alone, in media with autologous PBMCs, or in media with allogenic PBMCs to simulate control, autotransplant, and allogenic transplant conditions with or without 1μM cyclosporine A (CsA) or 20nM tacrolimus (FK506) treatment. Rejection was characterized by PBMC flow cytometry and gene expression transplant array. Cavernous tissues were evaluated by histomorphology and myography to assess contraction and relaxation. Data were analyzed using two-way analysis of variance and unpaired Student t test. Flow cytometry and tissue array demonstrated allogenic PBMC activation consistent with rejection. Rejection impaired cavernous tissue physiology and was associated with cellular infiltration and apoptosis. CsA prevented rejection but did not improve tissue relaxation. CsA treatment impaired relaxation in tissues cultured without PBMCs compared with media and FK506. Study limitations included the use of penile tissue with erectile dysfunction and lack of cross-matching data. This model could be used to investigate the effects of penile rejection and immunosuppression. Additional studies are needed to optimize immunosuppression to prevent rejection and maximize corporal tissue physiology. This report describes a novel ex vivo model of human penile transplantation rejection. Tissue rejection impaired erectile tissue physiology. This report suggests that cyclosporin A might hinder corporal physiology and that other immunosuppressant agents, such as FK506, might be better suited

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

Energy Technology Data Exchange (ETDEWEB)

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

2007-07-15

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

Solitary pulmonary nodule

Science.gov (United States)

... Adenocarcinoma - chest x-ray Pulmonary nodule - front view chest x-ray Pulmonary nodule, solitary - CT scan Respiratory system References Gotway MB, Panse PM, Gruden JF, Elicker BM. Thoracic radiology: noninvasive diagnostic imaging. In: Broaddus VC, Mason RJ, ...

Clinicopathological Pattern of Penile Cancer in a Tertiary Care Centre in Nepal

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Dipesh K Gupta

2015-09-01

Conclusions: Penile carcinoma is primarily a disease of old. Growth over glans penis is the most common presentation and partial penectomy is feasible in most of the patients to allow oncological cure while preserving the organ for its native function. Keywords: inguinal lymph node dissection; partial penectomy; penile cancer.

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

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Faddan AA

2015-09-01

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

Lung nodule detection by microdose CT versus chest radiography (standard and dual-energy subtracted).

Science.gov (United States)

Ebner, Lukas; Bütikofer, Yanik; Ott, Daniel; Huber, Adrian; Landau, Julia; Roos, Justus E; Heverhagen, Johannes T; Christe, Andreas

2015-04-01

The purpose of this study was to investigate the feasibility of microdose CT using a comparable dose as for conventional chest radiographs in two planes including dual-energy subtraction for lung nodule assessment. We investigated 65 chest phantoms with 141 lung nodules, using an anthropomorphic chest phantom with artificial lung nodules. Microdose CT parameters were 80 kV and 6 mAs, with pitch of 2.2. Iterative reconstruction algorithms and an integrated circuit detector system (Stellar, Siemens Healthcare) were applied for maximum dose reduction. Maximum intensity projections (MIPs) were reconstructed. Chest radiographs were acquired in two projections with bone suppression. Four blinded radiologists interpreted the images in random order. A soft-tissue CT kernel (I30f) delivered better sensitivities in a pilot study than a hard kernel (I70f), with respective mean (SD) sensitivities of 91.1%±2.2% versus 85.6%±5.6% (p=0.041). Nodule size was measured accurately for all kernels. Mean clustered nodule sensitivity with chest radiography was 45.7%±8.1% (with bone suppression, 46.1%±8%; p=0.94); for microdose CT, nodule sensitivity was 83.6%±9% without MIP (with additional MIP, 92.5%±6%; pmicrodose CT for readers 1, 2, 3, and 4 were 84.3%, 90.7%, 68.6%, and 45.0%, respectively. Sensitivities with chest radiography for readers 1, 2, 3, and 4 were 42.9%, 58.6%, 36.4%, and 90.7%, respectively. In the per-phantom analysis, respective sensitivities of microdose CT versus chest radiography were 96.2% and 75% (pmicrodose CT, the applied dose was 0.1323 mSv. Microdose CT is better than the combination of chest radiography and dual-energy subtraction for the detection of solid nodules between 5 and 12 mm at a lower dose level of 0.13 mSv. Soft-tissue kernels allow better sensitivities. These preliminary results indicate that microdose CT has the potential to replace conventional chest radiography for lung nodule detection.

Conservative management of penile trauma may be complicated by abscess formation

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Athanasios Bantis

2014-11-01

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

Penile Enlargement : From Medication to Surgery

NARCIS (Netherlands)

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

2010-01-01

Penis lengthening pills, stretch apparatus, vacuum pumps, silicone injections, and lengthening and thickening operations are available for men who worry about their penis size. Surgery is thus far the only proven scientific method for penile enlargement. In this article, we consider patient

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

Science.gov (United States)

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

2014-01-01

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

Can Lung Nodules Be Cancerous?

Science.gov (United States)

... lung nodules be cancerous? Answers from Eric J. Olson, M.D. Yes, lung nodules can be cancerous, ... to determine if it's cancerous. With Eric J. Olson, M.D. AskMayoExpert. Pulmonary nodules. Rochester, Minn.: Mayo ...

Angiosarcoma of penis: Case report of an aggressive penile cancer

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Vinod Priyadarshi

2015-01-01

Full Text Available Angiosarcoma is a very rare mesenchymal tumor of penis. Though extremely unusual, it should be considered in the differential diagnosis in patients presenting with a penile growth or a localized subcutaneous penile lesions as they are very aggressive and there is a high chance of recurrence. One such case is reported here, which was aggressively treated with total penectomy and the patient did not show any recurrence in 2 years of follow-up.

Penile growth in response to hormone treatment in children with micropenis

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Rajendra B Nerli

2013-01-01

Full Text Available Introduction: Micropenis is defined as a stretched penile length 2.5 standard deviations less than the mean for age without the presence of any other penile anomalies, such as hypospadias. The term refers to a specific disorder that has a known set of causative factors and defined treatment modalities. The purpose of this study was to determine the effect of hormonal therapy on the gonadal response and penile growth in children who presented with micropenis. Materials and Methods: Children (<18 years who met the criteria for micropenis were included in this study. Children more than 11 years old were treated using a standard protocol of 1,500 to 2,000 IU human chorionic gonadotrophin administrated intramuscularly, once per week, for 6 weeks. Children less than 11 years old were treated with parenteral testosterone enanthate 25 mg once a month for 3 months. Response was evaluated in terms of change in testosterone levels and size of penis. Results: Serum testosterone levels at baseline and after 8 weeks of hormonal treatment were <20 and 449.4 ng/mL, respectively (P < 0.0001 in all children more than 11 years old. Stretched penile length after hormonal treatment increased from 15.54 to 37.18 mm in children less than 11 years old and from 26.42 to 64.28 mm in children more than 11 years old (P < 0.001. Conclusions: Management of isolated micropenis revolves around testosterone (direct administration or encouraging the patient′s body to make its own, and results with respect to increase in penile length are promising.

Management of Pulmonary Nodules

OpenAIRE

Arvin Aryan

2010-01-01

Pulmonary nodule characterization is currently being redefined as new clinical, radiological and pathological data are reported, necessitating a reevaluation of the clinical management."nIn approach to an incidentally detected pulmonary nodule, we should consider that there are different risk situations, different lesion morphologies, and different sizes with various management options."nIn this session we will review the different risk situations for patients with pulmonary nodules...

Reinnervating the penis in spina bifida patients in the United States: ilioinguinal-to-dorsal-penile neurorrhaphy in two cases.

Science.gov (United States)

Jacobs, Micah A; Avellino, Anthony M; Shurtleff, David; Lendvay, Thomas S

2013-10-01

Penile sensation is absent in some patients with myelomeningocele owing to the dysfunction of the pudendal nerve. Here, we describe the introduction of penile sensation via ilioinguinal-to-dorsal-penile neurorrhaphy in two patients with penile anesthesia due to neural tube defects. To establish penile sensation via ilioinguinal-to-dorsal-penile-nerve neurorrhaphy. A 20-year-old and a 35-year-old male with L5/S1 myelomeningocele were both highly functioning and ambulatory, with intact ilioinguinal nerve distribution sensation but anesthesia of the penis and glans. They were sexually active and able to ejaculate antegrade. Both had high International Index of Erectile Function scores for confidence to achieve erection sufficient for intercourse. An incision was made from anterior superior iliac crest to the glans penis to expose the inguinal canal and ilioinguinal nerve. The ilioinguinal and dorsal penile nerve were transected and anastomosed. The anastomotic site was then wrapped in a hemostatic agent and a drain was left in place. For penile rehabilitation, both patients were instructed to stimulate the penis while looking at the genitalia to encourage redistribution of perceived sensation. Presence of erogenous penile sensation was tested by neurologic examination and patient feedback, and patients completed sexual health questionnaires. Both patients reported paresthesias of the groin with penile stimulation 1 month after surgery. Both patients are now 24 months postoperative and have erogenous sensation on the ipsilateral glans and shaft during intercourse. Neither patient has difficulty achieving or maintaining erections. We present two patients with dorsal penile reinnervation via the ilioinguinal nerve. Although nerve reinnervation has been used in urological procedures, this is the first description of an attempt to resupply penile sensation via the dorsal penile nerve in the United States with a minimum of 18 months follow-up. Early follow-up suggests

Venous ligation: a novel strategy for glans enhancement in penile prosthesis implantation.

Science.gov (United States)

Hsu, Geng-Long; Hill, James W; Hsieh, Cheng-Hsing; Liu, Shih-Ping; Hsu, Chih-Yuan

2014-01-01

Although penile implantation remains a final solution for patients with refractory impotence, undesirable postoperative effects, including penile size reduction and cold sensation of the glans penis, remain problematic. We report results of a surgical method designed to avoid these problems. From 2003 to 2013, 35 consecutive patients received a malleable penile implant. Of these, 15 men (the enhancing group) were also treated with venous ligation of the retrocoronal venous plexus, deep dorsal vein, and cavernosal veins. The remaining 20 men formed the control group, treated with only a penile implant. Follow-up ranged from 1.1 to 10.0 years, with an average of 6.7 ± 1.5 years. Although preoperative glanular dimension did not differ significantly between the two groups, significant respective difference at one day and one year postoperatively was found in the glanular circumference (128.8 ± 6.8 mm versus 115.3 ± 7.2 mm and 130.6 ± 7.2 mm versus 100.5 ± 7.3 mm; both Penhance the glans penis dimension in implant patients.

Surgical reimplantation of penile glans amputation in children during circumcision

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Bouassida Khaireddine

2014-01-01

Full Text Available 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.

Clinicopathologic Characteristics and Treatment Outcomes of Penile Cancer

Science.gov (United States)

Nam, Jong Kil; Lee, Dong Hoon; Park, Sung Woo; Kam, Sung Chul; Lee, Ki Soo; Kim, Tae Hyo; Kim, Taek Sang; Oh, Cheol Kyu; Park, Hyun Jun

2017-01-01

Purpose The aim of this study was to assess the clinicopathologic characteristics of penile cancer, including patterns of therapy, oncologic results, and survival. Materials and Methods Between January 2005 and July 2015, 71 patients at 6 institutions who had undergone penectomy or penile biopsy were enrolled. Their medical records were reviewed to identify the mode of therapy, pathology reports, and cancer-specific survival (CSS) rate. Results Clinicopathologic and outcome information was available for 52 male patients (mean age, 64.3 years; mean follow-up, 61.4 months). At presentation, 17 patients were node-positive, and 4 had metastatic disease. Management was partial penectomy in 34 patients, total penectomy in 12 patients, and chemotherapy or radiotherapy in 6 patients. The pathology reports were squamous cell carcinoma in 50 patients and other types of carcinoma in the remaining 2 patients. Kaplan-Meier survival analysis showed a 5-year CSS rate of 84.0%. In univariate and multivariate analyses, the American Joint Committee on Cancer (AJCC) stage and pathologic grade were associated with survival. Conclusions Partial penectomy was the most common treatment of penile lesions. The oncologic outcomes were good, with a 5-year CSS of 84.0%. The AJCC stage and pathologic grade were independent prognostic factors for survival. PMID:28459145

Women's partnered orgasm consistency is associated with greater duration of penile-vaginal intercourse but not of foreplay.

Science.gov (United States)

Weiss, Petr; Brody, Stuart

2009-01-01

It has been asserted that women's likelihood or consistency of partnered orgasm (her orgasm as a result of sexual activities with a partner) is determined by duration of foreplay, but not by duration of penile-vaginal intercourse. The objective was to examine the extent to which women's likelihood or consistency of partnered orgasm is associated with duration of foreplay, duration of penile-vaginal intercourse, and age. In a representative sample of the Czech population, 2,360 women reported their consistency of orgasm with a partner (from "never" to "almost every time"), and estimates of their typical durations of foreplay and of penile-vaginal intercourse. The association of consistency of partnered orgasm with typical durations of both foreplay and penile-vaginal intercourse. In univariate analyses, consistency of partnered orgasm was more associated with penile-vaginal intercourse duration than with foreplay duration (consistency also correlated negatively with age). In multivariate analysis, foreplay ceased to be a significant correlate of partnered orgasm consistency (the exclusion of respondents reporting a penile-vaginal intercourse duration of 1 minute or less did not alter the results). When both sexual activity categories are examined in tandem on a population level, women's likelihood or consistency of partnered orgasm is associated with penile-vaginal intercourse duration, but not with foreplay duration. In contrast to the assumptions of many sex therapists and educators, more attention should be given to improve the quality and duration of penile-vaginal intercourse rather than foreplay.

Superficial Dorsal Venous Rupture of the Penis: False Penile Fracture That Needs to be Treated as a True Urologic Emergency.

Science.gov (United States)

Truong, Hong; Ferenczi, Basil; Cleary, Ryan; Healy, Kelly A

2016-11-01

A 38-year-old man with history of repaired penile fracture presented with rapid detumescence, penile pain, and ecchymosis during vaginal sexual intercourse concerning for recurrent fracture. Surgical exploration revealed ruptured superficial dorsal vein of the penis, which was subsequently ligated. Patients with traumatic penile vascular injuries often present with clinical features indistinguishable from a true penile fracture. Gradual detumescence and an absence of characteristic popping sound may indicate a vascular injury but they cannot safely rule out a true penile fracture. Both true and false penile fractures require emergent surgical exploration and repair to prevent long-term complications. Copyright © 2016 Elsevier Inc. All rights reserved.

Nonvenereal penile dermatoses: A retrospective study

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Ana Marcos-Pinto

2018-01-01

Full Text Available Context: A variety of nonvenereal diseases can affect the penis and diminish quality of life. Many present similar clinical features and a cutaneous biopsy may be necessary to clarify the diagnosis. Aims: To characterize nonvenereal penile dermatoses with histological confirmation in a southwestern Europe hospital during a 9-year period. Materials and Methods: A retrospective study was conducted. We reviewed all penile biopsies performed between January 1, 2007 and December 31, 2015 and studied the causes of the nonvenereal penile dermatoses. Results: The sample included a total of 108 patients, aged 62.9 (±17.8 years, between 16 years and 96 years of age. Eighteen dermatoses were identified. Inflammatory diseases were present in 65. 7% of patients (71/108 and neoplastic dermatoses in 34. 3% (37/108. Concerning inflammatory dermatoses, the most frequent were Zoon balanitis (27.8%, 30/108, followed by lichen sclerosus (15.7%, 17/108, psoriasis (11.1%, 12/108, and lichen planus (4.6%, 5/108. In patients with psoriasis, 10 had lesions only in the penis, similarly to all patients with lichen planus. The most frequent malignant tumor was squamous cell carcinoma (SCC (15.7%, 17/108. The most common in-situ tumor was erythroplasia of Queyrat (8.3%, 9/108. A case of basal cell carcinoma (BCC was found. Kaposi sarcoma and mycosis fungoides on penis were also diagnosed, as an additional form of presentation to their generalized disease. Conclusions: In this study, inflammatory diseases were the most frequently diagnosed dermatoses, while SCC was the most common malignant tumor found. In the majority of psoriasis and lichen planus cases, clinical lesions were only present in the genital area.

Comparison of muscle-to-nodule and parenchyma-to-nodule strain ratios in the differentiation of benign and malignant thyroid nodules: Which one should we use?

Energy Technology Data Exchange (ETDEWEB)

Aydin, Ramazan, E-mail: raydin1984@hotmail.com [Department of Radiology, Samsun Education and Research Hospital, Samsun (Turkey); Elmali, Muzaffer, E-mail: muzafel@yahoo.com.tr [Department of Radiology, Ondokuz Mayis University, Faculty of Medicine, Samsun (Turkey); Polat, Ahmet Veysel, E-mail: veyselp@hotmail.com [Department of Radiology, Ondokuz Mayis University, Faculty of Medicine, Samsun (Turkey); Danaci, Murat, E-mail: danacim55@yahoo.com [Department of Radiology, Ondokuz Mayis University, Faculty of Medicine, Samsun (Turkey); Akpolat, Ilkser, E-mail: ilkserakpolat@yahoo.com [Department of Pathology, Ondokuz Mayis University, Faculty of Medicine, Samsun (Turkey)

2014-03-15

Objective: The aim of this study is to investigate the diagnostic accuracy of muscle-to-nodule strain ratio (MNSR) in the differentiation of benign and malignant thyroid nodules and to see if there was a difference between MNSR and parenchyma-to-nodule strain ratios (PNSR) in diagnosis. Methods: A total of 106 consecutive patients (88 women and 18 men; age range 19–79 years) with thyroid nodules were prospectively examined using ultrasound and sonoelastography before the fine-needle aspiration biopsy. The mean MNSR and PNSR were calculated for each nodule and the elasticity score was determined according to four-point scoring system. Results: According to the four-point scoring system, 44 of the 83 benign nodules had a score of one or two while 22 of the 23 malignant nodules had a score of three or four (p < 0.001). Using ROC analysis, the best cutoff point for MNSR 1.85 and for PNSR 3.14 was calculated. The sensitivity and specificity for the MNSR were 95.6%, 92.8%, respectively; for the PNSR were 95.6%, 93.4%, respectively, when the best cutoff points were used (p < 0.001). The κ value for the PNSR and MNSR methods was 0.87, which indicated an almost perfect agreement (p < 0.001). Conclusions: Sonoelastography has a high diagnostic accuracy in the differentiation of benign and malignant thyroid nodules. There was no significant difference between MNSR and PNSR in the differentiation of benign and malignant thyroid nodules. Therefore, we think that MNSR could safely be used in situations where PNSR could not be used.

Compact-Morphology-based poly-metallic Nodule Delineation.

Science.gov (United States)

Schoening, Timm; Jones, Daniel O B; Greinert, Jens

2017-10-17

Poly-metallic nodules are a marine resource considered for deep sea mining. Assessing nodule abundance is of interest for mining companies and to monitor potential environmental impact. Optical seafloor imaging allows quantifying poly-metallic nodule abundance at spatial scales from centimetres to square kilometres. Towed cameras and diving robots acquire high-resolution imagery that allow detecting individual nodules and measure their sizes. Spatial abundance statistics can be computed from these size measurements, providing e.g. seafloor coverage in percent and the nodule size distribution. Detecting nodules requires segmentation of nodule pixels from pixels showing sediment background. Semi-supervised pattern recognition has been proposed to automate this task. Existing nodule segmentation algorithms employ machine learning that trains a classifier to segment the nodules in a high-dimensional feature space. Here, a rapid nodule segmentation algorithm is presented. It omits computation-intense feature-based classification and employs image processing only. It exploits a nodule compactness heuristic to delineate individual nodules. Complex machine learning methods are avoided to keep the algorithm simple and fast. The algorithm has successfully been applied to different image datasets. These data sets were acquired by different cameras, camera platforms and in varying illumination conditions. Their successful analysis shows the broad applicability of the proposed method.

Visual stimulation facilitates penile responses to vibration in men with and without erectile disorder

NARCIS (Netherlands)

Janssen, E.; Everaerd, W.; van Lunsen, R. H.; Oerlemans, S.

1994-01-01

This study compared reflexogenic and psychogenic penile responses in men with and without erectile disorder. It was hypothesized that men with psychogenic erectile dysfunction respond minimally to vibrotactile stimulation. An enhancement of penile responses was expected when vibration was combined

Management of penile fracture: Can it wait?

African Journals Online (AJOL)

S. Naouar

2018-02-14

Feb 14, 2018 ... Introduction. Penile fracture is the rupture of the tunica albuginea of the penis's .... ED in up to 50% of patients, in addition to prolonged recovery and hospital ... nificantly lower in patients having emergent rather than delayed.

Sexual Function and Quality of Life Before and After Penile Prosthesis Implantation Following Radial Forearm Flap Phalloplasty.

Science.gov (United States)

Young, Ezekiel E; Friedlander, Daniel; Lue, Kathy; Anele, Uzoma A; Khurgin, Jacob L; Bivalacqua, Trinity J; Burnett, Arthur L; Redett, Richard J; Gearhart, John P

2017-06-01

To provide sexual function and quality of life outcomes in patients with severe penile deficiency who underwent radial forearm flap phalloplasty with and without penile prosthesis implantation. Patients with history of severe penile deficiency who underwent microsurgical radial forearm flap phalloplasty with and without penile prosthesis implantation between 2007 and 2014 were identified. They completed a set of web-based validated questionnaires including the International Index of Erectile Function, the Pediatric Penile Perception Score, the Sexual Quality of Life for Men, and several items addressing general quality of life. Outcomes were compared between groups. Nine of the 12 identified patients who had prosthesis after phalloplasty and 4 out of the 7 phalloplasty-only patients completed the survey, resulting in an overall response rate of 68%. Among the phalloplasty-prosthesis patients, 66% reported current sexual activity and 78% reported regular masturbation, whereas 1 of the 4 phalloplasty-only patients reported both. Prosthesis patients scored notably higher in all domains of the International Index of Erectile Function except for sexual desire. In contrast, they demonstrated similar scores of penile perception, as well as general and sexual quality of life. Among patients who have undergone flap phalloplasty, the subsequent placement of penile prosthesis appears to effectively allow for both intercourse and masturbation, resulting in measurable improvements in orgasmic function, intercourse satisfaction, and overall sexual satisfaction. Despite these important benefits, prosthesis placement does not appear to result in improvements in penile perception scores, or general or sexual quality of life. Copyright © 2017 Elsevier Inc. All rights reserved.

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

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Larissa Alves Afonso

2012-02-01

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

Thyroid Nodule Imaging. Status and Limitations.

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Durre Sabih

2015-01-01

Full Text Available Thyroid nodules are common, occurring in almost two-thirds of some populations; among these only about 7% are malignant. The most important question with any new discovered thyroid nodule is, “is this malignant?” The main arbiter of malignancy or benignity remains fine needle aspiration and the mainstay of treatment surgery. But given the resources involved, doing an FNAC or surgery in every discovered nodule would be prohibitive to impossible. The clinician must decide which nodule to investigate and which to watch in the hope that this will never turn out to be malignant. FNACs are used basically to decide which nodule to operate upon (or more importantly which to not operate upon and clinical and imaging features are used to decide which nodule to investigate by FNAC and which to leave alone. This paper describes the various imaging options for looking at thyroid nodules and briefly discusses the advantages and disadvantages with each.

Cross-sectional study examining four types of male penile and urethral "play".

Science.gov (United States)

Rinard, Katherine; Nelius, Thomas; Hogan, LaMicha; Young, Cathy; Roberts, Alden E; Armstrong, Myrna L

2010-12-01

To provide further quantitative and qualitative evidence about men who insert foreign liquids and objects into their penis and/or urethra. As part of a larger, cross-sectional study examining men (n = 445) with genital piercings (GP), 2 questions inquired whether the respondents had penile tattoos and/or inserted other materials, such as fluids and foreign objects, into their penis and urethra. Four different practices have been described in the literature: embedding (a) foreign objects and/or (b) liquids subcutaneously into penile tissue, as well as inserting (c) liquids and/or (d) foreign objects into the urethra. In our study, 354 (78%) men with GP responded to the 2 questions; 85 (24%) replied affirmatively and 68 (80%) provided comments. Respondents coined their practices penile and/or urethral "play." Two respondents embedded metal balls into their penis, 1 at age 13 injected water for penis enlargement; 11 inserted liquids into the urethra, and 63 reported insertion of 32 different objects, frequently urethral sounds or "sounding" (n = 33/52%) were mentioned. Major motivation themes focused on sexual stimulation and experimentation. Penile tattoos (n = 14) were also reported, mainly for esthetics. Few complications or STDs were reported. Basic demographic assumptions of those who participate in these actions were challenged, and this study provides evidence of a wider distribution of men using penile or urethral play, and "sounding." Clinician awareness of these practices are important to obtain accurate health histories, manage genitourinary tract complications, as well as provide applicable patient education. Copyright © 2010 Elsevier Inc. All rights reserved.

[Aging reduces contents of endogenous CO, cAMP and cGMP in rat penile tissues].

Science.gov (United States)

Qin, Wen-Bo; Wang, Shu-Qiu; Li, Ming; Kang, Yu-Ming; Gui, Shi-Liang; Chi, Bao-Jin

2009-02-01

To explore the relationship of aging with the changes of endogenous carbon monoxide (CO), cGMP and cAMP contents in the penile tissues of rats. Twenty-four male rats were equally divided into an 8-month, a 16-month and a 24-month group, and their penile erection was detected by injecting apomorphine, their penile cavernous body harvested, and the contents of CO, cAPM and cGMP detected by improved dual wavelength spectrophotometry. The contents of CO, cAPM and cGMP were reduced with the increase of age, with statistically significant differences between the three age groups (P < 0.01). Aging significantly decreased the contents of CO, cAMP and cGMP in the penile tissues of the rats, which suggests that aging might play an important role in erectile dysfunction.

Management of an incidentally discovered pulmonary nodule

International Nuclear Information System (INIS)

Beigelman-Aubry, Catherine; Hill, Catherine; Grenier, Philippe A.

2007-01-01

The incidental finding of a pulmonary nodule on computed tomography (CT) is becoming an increasingly frequent event. The discovery of such a nodule should evoke the possibility of a small bronchogenic carcinoma, for which excision is indicated without delay. However, invasive diagnostic procedures should be avoided in the case of a benign lesion. The objectives of this review article are: (1) to analyze the CT criteria defining benign nodules, nodules of high suspicion of malignancy and indeterminate nodules, (2) to analyze the diagnostic performances and limitations of complementary investigations requested to characterize indeterminate lung nodules, (3) to review the criteria permitting to assess the probability of malignancy of indeterminate nodules and (4) to report on the new guidelines provided by the Fleischner Society for the management of small indeterminate pulmonary nodules, according to their prior probability of malignancy. (orig.)

Optimal anaesthesia techniques for penile surgeries

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Yu. A. Myagkov

2016-01-01

Full Text Available Spinal anaesthesia as a method of central neuraxial blockade is the best choice for penile surgeries due to the following reasons: protection against intraoperative stress and early postoperative pain, simplicity of the procedure which does not depend on constitutional and anatomical features of a patient, prevention of postoperative complications.

Expression of nodule-specific genes in alfalfa root nodules blocked at an early stage of development.

NARCIS (Netherlands)

Dickstein, R.; Bisseling, T.; Reinhold, V.N.; Ausubel, F.M.

1988-01-01

To help dissect the molecular basis of the Rhizobium-legume symbiosis, we used in vitro translation and Northern blot analysis of nodule RNA to examine alfalfa-specific genes (nodulins) expressed in two types of developmentally defective root nodules elicited by Rhizobium meliloti. Fix- nodules were

Comparison of oxidative/antioxidative status of penile corpus cavernosum blood and peripheral venous blood.

Science.gov (United States)

Yeni, E; Gulum, M; Selek, S; Erel, O; Unal, D; Verit, A; Savas, M

2005-01-01

The aim of the study is to determine and to compare the oxidative and antioxidative status of penile corpus cavernosum and peripheral venous blood. A total of 28 adult healthy males were included in the study. Whole blood was simultaneously withdrawn from penile corpus cavernosum and the cubital vein and their plasma separated. Total antioxidant capacity (TAC), vitamin C, total protein, albumin, uric acid, bilirubin and total peroxide (TP) levels of both plasma samples were measured and compared. While TAC, total protein, albumin, bilirubin and uric acid levels were higher, vitamin C levels were lower in cavernosal blood than that of peripheral blood. On the other hand, TP level was found to be higher in penile blood samples than that of peripheral blood. We thought that the normal erectile process of the penile cavernosal body leads to increased production of oxidants as in the mechanism of ischaemia-reperfusion; however, the increase of TAC can prevent development of oxidative injury.

INSIST-ED: Italian Society of Andrology registry on penile prosthesis surgery. First data analysis

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Edoardo Pescatori

2016-07-01

Full Text Available Objectives: The Italian Society of Andrology, i.e. “Società Italiana di Andrologia” (S.I.A., launched on December 2014 a prospective, multicenter, monitored and internal review board approved Registry for penile implants, the “INSIST-ED” (Italian Nationwide Systematic Inventarisation of Surgical Treatment for ED Registry. Purpose of this first report is to present a baseline data analysis of the characteristics of penile implant surgery in Italy. Material and methods: The INSIST-ED Registry is open to all surgeons implanting penile prostheses (all brands, all models in Italy, providing anonymous patient, device, surgical procedure, outcome, follow-up data, for both first and revision surgeries. A Registry project Board overviews all the steps of the project, and a Registry Monitor interacts with the Registry implanting surgeons. Results: As by April 8, 2016, 31 implanting surgeons actively joined the Registry, entering 367 surgical procedures in its database, that comprise: 310 first implants, 43 prosthesis substitutions, 14 device explants without substitution. Implanted devices account for: 288 three-component devices (81,3%, 20 two-component devices (5,4%, 45 non-hydraulic devices (12,3%. Leading primary ED etiologies in first implant surgeries resulted: former radical pelvic surgery in 111 cases (35,8%, Peyronie’s disease in 66 cases (21,3%, diabetes in 39 cases (12,6%. Two intraoperative complications have been recorded. Main reasons for 57 revision surgeries were: device failure (52,6%, erosion (19,3%, infection (12,3%, patient dissatisfaction (10,5%. Surgical settings for patients undergoing a first penile implant were: public hospitals in 251 cases (81%, private environments in 59 cases (19%. Conclusions: The INSIST-ED Registry represents the first European experience of penile prosthesis Registry. This baseline data analysis shows that: three-pieces inflatable prosthesis is the most implanted device, leading etiology of

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

OpenAIRE

Bakheet, Mohamed Abdel Al M.; Refaei, Mohammad

2012-01-01

Background Penile duplication (diphallus) is an extremely rare disorder. It is almost always associated with other malformations like double bladder, exstrophy of the cloacae, imperforate anus, duplication of the rectosigmoid and vertebral deformities. Meanwhile anal canal duplication, the most distal and least common duplication of the digestive tube and is a very rare congenital malformation. Case Presentation A 21 days old Egyptian neonate is reported with complete penile duplication and t...

Glansectomy and Split-thickness Skin Graft for Penile Cancer.

Science.gov (United States)

Parnham, Arie S; Albersen, Maarten; Sahdev, Varun; Christodoulidou, Michelle; Nigam, Raj; Malone, Peter; Freeman, Alex; Muneer, Asif

2018-02-01

Penile cancer is a rare malignancy that is confined to the glans in up to four out of five cases. Although descriptions of glansectomy exist, there are no contemporary video explanations or large published single centre series. To show the efficacy and safety of glansectomy and split-thickness skin graft (STSG) reconstruction. Data were collected retrospectively for patients identified from surgical theatre diaries between February 2005 and January 2016. 177 patients with histologically proven squamous-cell carcinoma on the glans underwent glansectomy and STSG at a tertiary referral centre in the UK. The median follow-up was 41.4 mo. The skin is incised at the subcoronal level and deepened onto Buck's fascia. Dissection is performed over or under Buck's fascia, depending on suspicion of invasion or risk of disease. The glans is excised and a neoglans is created using a STSG. Local recurrence, cancer-specific survival, overall survival, and complications. Sixteen out of 172 patients (9.3%) experienced local recurrence during the follow-up period. Eighteen out of 174 (10.7%) patients died of penile cancer, while 29 patients in total died during the follow-up period. Of 145 patients, 9% required operative intervention for complications, including graft loss and meatal stenosis. Limitations include the retrospective data collection and the lack of functional and sexual outcomes. Glansectomy and STSG comprise a safe procedure in terms of oncologic control and complications for patients with penile cancer confined to the glans penis. Further studies are required to assess functional and sexual outcomes in these patients. We report on the management of penile cancers confined to the head of the penis using glansectomy and a split-thickness skin graft to recreate the appearance of a glans. This technique is safe and effective, with limited complications. Copyright © 2016. Published by Elsevier B.V.

Postnatal penile length and growth rate correlate to serum testosterone levels

DEFF Research Database (Denmark)

Boas, Malene; Boisen, Kirsten A; Virtanen, Helena E

2006-01-01

in Denmark and at 0, 3 and 18 months in Finland with blood samples taken at 3 months (n = 630). Penile length and growth were registered and reproductive hormones (testosterone, sex hormone binding globulin, oestradiol) were analysed. RESULTS: Penile length increased from birth (3.49+/-0.4 cm) to 3 years...... and growth. DESIGN: Prospective, longitudinal population-based study taking place at two large primary obstetric centres at the University Hospitals of Copenhagen, Denmark, and Turku, Finland. METHODS: Infant boys, 728 Danish and 1234 Finnish, underwent clinical examinations at 0, 3, 18 and 36 months...... of age (4.53+/-0.51 cm) with the highest growth velocity from birth to 3 months (1.0 mm/month). Penile length and growth were significantly, positively correlated to serum testosterone (r = 0.31 and 0.076, P = 0.006 and 0.001 respectively) and to free testosterone index (r = 0.385 and 0.094, P = 0...

Relation between nodule size and 18F-FDG-PET SUV for malignant and benign pulmonary nodules.

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Shao Yiping

2008-09-01

Full Text Available Abstract The most common semiquantitative method of evaluation of pulmonary lesions using 18F-FDG PET is FDG standardized uptake value (SUV. An SUV cutoff of 2.5 or greater has been used to differentiate between benign and malignant nodules. The goal of our study was to investigate the correlation between the size of pulmonary nodules and the SUV for benign as well as for malignant nodules. Methods Retrospectively, 173 patients were selected from 420 referrals for evaluation of pulmonary lesions. All patients selected had a positive CT and PET scans and histopathology biopsy. A linear regression equation was fitted to a scatter plot of size and SUVmax for malignant and benign nodules together. A dot diagram was created to calculate the sensitivity, specificity, and accuracy using an SUVmax cutoff of 2.5. Results The linear regression equations and (R2s as well as the trendlines for malignant and benign nodules demonstrated that the slope of the regression line is greater for malignant than for benign nodules. Twenty-eight nodules of group one (≤ 1.0 cm are plotted in a dot diagram using an SUVmax cutoff of 2.5. The sensitivity, specificity, and accuracy were calculated to be 85%, 36% and 54% respectively. Similarly, sensitivity, specificity, and accuracy were calculated for an SUVmax cutoff of 2.5 and found to be 91%, 47%, and 79% respectively for group 2 (1.1–2.0 cm; 94%, 23%, and 76%, respectively for group 3 (2.1–3.0 cm; and 100%, 17%, and 82%,, respectively for group 4 (> 3.0 cm. The previous results of the dot diagram indicating that the sensitivity and the accuracy of the test using an SUVmax cutoff of 2.5 are increased with an increase in the diameter of pulmonary nodules. Conclusion The slope of the regression line is greater for malignant than for benign nodules. Although, the SUVmax cutoff of 2.5 is a useful tool in the evaluation of large pulmonary nodules (> 1.0 cm, it has no or minimal value in the evaluation of small

Comparison of chest radiography, chest digital tomosynthesis and low dose MDCT to detect small ground-glass opacity nodules: an anthropomorphic chest phantom study

International Nuclear Information System (INIS)

Doo, Kyung Won; Kang, Eun-Young; Yong, Hwan Seok; Ham, Soo-Youn; Lee, Ki Yeol; Choo, Ji Yung

2014-01-01

The purpose of this study was to evaluate the diagnostic performance of chest radiography (CXR), chest digital tomosynthesis (DT) and low dose multidetector computed tomography (LDCT) for the detection of small pulmonary ground-glass opacity (GGO) nodules, using an anthropomorphic chest phantom. Artificial pulmonary nodules were placed in a phantom and a total of 40 samples of different nodule settings underwent CXR, DT and LDCT. The images were randomly read by three experienced chest radiologists. Free-response receiver-operating characteristics (FROC) were used. The figures of merit for the FROC curves averaged for the three observers were 0.41, 0.37 and 0.76 for CXR, DT and LDCT, respectively. FROC analyses revealed significantly better performance of LDCT over CXR or DT for the detection of GGO nodules (P < 0.05). The difference in detectability between CXR and DT was not statistically significant (P = 0.73). The diagnostic performance of DT for the detection of pulmonary small GGO nodules was not significantly different from that of CXR, but LDCT performed significantly better than both CXR and DT. DT is not a suitable alternative to CT for small GGO nodule detection, and LDCT remains the method of choice for this purpose. (orig.)

Comparison of chest radiography, chest digital tomosynthesis and low dose MDCT to detect small ground-glass opacity nodules: an anthropomorphic chest phantom study

Energy Technology Data Exchange (ETDEWEB)

Doo, Kyung Won; Kang, Eun-Young; Yong, Hwan Seok [Korea University Guro Hospital, Korea University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Ham, Soo-Youn [Korea University Anam Hospital, Korea University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Lee, Ki Yeol; Choo, Ji Yung [Korea University Ansan Hospital, Korea University College of Medicine, Department of Radiology, Ansan (Korea, Republic of)

2014-12-15

The purpose of this study was to evaluate the diagnostic performance of chest radiography (CXR), chest digital tomosynthesis (DT) and low dose multidetector computed tomography (LDCT) for the detection of small pulmonary ground-glass opacity (GGO) nodules, using an anthropomorphic chest phantom. Artificial pulmonary nodules were placed in a phantom and a total of 40 samples of different nodule settings underwent CXR, DT and LDCT. The images were randomly read by three experienced chest radiologists. Free-response receiver-operating characteristics (FROC) were used. The figures of merit for the FROC curves averaged for the three observers were 0.41, 0.37 and 0.76 for CXR, DT and LDCT, respectively. FROC analyses revealed significantly better performance of LDCT over CXR or DT for the detection of GGO nodules (P < 0.05). The difference in detectability between CXR and DT was not statistically significant (P = 0.73). The diagnostic performance of DT for the detection of pulmonary small GGO nodules was not significantly different from that of CXR, but LDCT performed significantly better than both CXR and DT. DT is not a suitable alternative to CT for small GGO nodule detection, and LDCT remains the method of choice for this purpose. (orig.)

Penile brachytherapy: Results for 49 patients

International Nuclear Information System (INIS)

Crook, Juanita M.; Jezioranski, John; Grimard, Laval; Esche, Bernd; Pond, G.

2005-01-01

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

Functional and cosmetic outcome of partial penile disassembly ...

African Journals Online (AJOL)

A. Bhat

2017-07-04

Jul 4, 2017 ... Technique: Penile de-gloving with mobilization of urethral plate from ventral to dorsal ... BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). ..... Literature search , Clinical studies, Experimental studies, Data.

Performance of computer-aided detection of pulmonary nodules in low-dose CT: comparison with double reading by nodule volume

Energy Technology Data Exchange (ETDEWEB)

Zhao, Yingru; Vliegenthart, Rozemarijn; Wang, Ying; Ooijen, Peter M.A. van; Oudkerk, Matthijs [University of Groningen/University Medical Center Groningen, Center for Medical Imaging - North East Netherlands, Department of Radiology, P.O. Box 30.001, Groningen (Netherlands); Bock, Geertruida H. de [University of Groningen/University Medical Center Groningen, Department of Epidemiology, P.O. Box 30.001, Groningen (Netherlands); Klaveren, Rob J. van [Lievensberg Hospital, Department of Pulmonology, P.O. Box 135, Bergen op Zoom (Netherlands); Bogoni, Luca [CAD Group, Siemens Medical Solutions USA, Inc., Malvern, PA (United States); Jong, Pim A. de; Mali, Willem P. [University of Utrecht, Department of Radiology, University Medical Center Utrecht, P.O. Box 85500, Utrecht (Netherlands)

2012-10-15

To evaluate performance of computer-aided detection (CAD) beyond double reading for pulmonary nodules on low-dose computed tomography (CT) by nodule volume. A total of 400 low-dose chest CT examinations were randomly selected from the NELSON lung cancer screening trial. CTs were evaluated by two independent readers and processed by CAD. A total of 1,667 findings marked by readers and/or CAD were evaluated by a consensus panel of expert chest radiologists. Performance was evaluated by calculating sensitivity of pulmonary nodule detection and number of false positives, by nodule characteristics and volume. According to the screening protocol, 90.9 % of the findings could be excluded from further evaluation, 49.2 % being small nodules (less than 50 mm{sup 3}). Excluding small nodules reduced false-positive detections by CAD from 3.7 to 1.9 per examination. Of 151 findings that needed further evaluation, 33 (21.9 %) were detected by CAD only, one of them being diagnosed as lung cancer the following year. The sensitivity of nodule detection was 78.1 % for double reading and 96.7 % for CAD. A total of 69.7 % of nodules undetected by readers were attached nodules of which 78.3 % were vessel-attached. CAD is valuable in lung cancer screening to improve sensitivity of pulmonary nodule detection beyond double reading, at a low false-positive rate when excluding small nodules. circle Computer-aided detection (CAD) has known advantages for computed tomography (CT). (orig.)

Performance of computer-aided detection of pulmonary nodules in low-dose CT: comparison with double reading by nodule volume

International Nuclear Information System (INIS)

Zhao, Yingru; Vliegenthart, Rozemarijn; Wang, Ying; Ooijen, Peter M.A. van; Oudkerk, Matthijs; Bock, Geertruida H. de; Klaveren, Rob J. van; Bogoni, Luca; Jong, Pim A. de; Mali, Willem P.

2012-01-01

To evaluate performance of computer-aided detection (CAD) beyond double reading for pulmonary nodules on low-dose computed tomography (CT) by nodule volume. A total of 400 low-dose chest CT examinations were randomly selected from the NELSON lung cancer screening trial. CTs were evaluated by two independent readers and processed by CAD. A total of 1,667 findings marked by readers and/or CAD were evaluated by a consensus panel of expert chest radiologists. Performance was evaluated by calculating sensitivity of pulmonary nodule detection and number of false positives, by nodule characteristics and volume. According to the screening protocol, 90.9 % of the findings could be excluded from further evaluation, 49.2 % being small nodules (less than 50 mm 3 ). Excluding small nodules reduced false-positive detections by CAD from 3.7 to 1.9 per examination. Of 151 findings that needed further evaluation, 33 (21.9 %) were detected by CAD only, one of them being diagnosed as lung cancer the following year. The sensitivity of nodule detection was 78.1 % for double reading and 96.7 % for CAD. A total of 69.7 % of nodules undetected by readers were attached nodules of which 78.3 % were vessel-attached. CAD is valuable in lung cancer screening to improve sensitivity of pulmonary nodule detection beyond double reading, at a low false-positive rate when excluding small nodules. circle Computer-aided detection (CAD) has known advantages for computed tomography (CT). (orig.)

Complications of penile self-injections

DEFF Research Database (Denmark)

Svensøy, Johannes Nordsteien; Travers, Valentine; Osther, Palle Jörn Sloth

2018-01-01

OBJECTIVE: Penile implants and injection of foreign materials have been described in texts like Kama Sutra for more than 1500 years, and are still being practiced around the world. The extent of this practice is unknown, and the documentation available today only scratches the surface. This study...... in the form of radical excision of the lesions followed by skin grafting. Preventive measures to this physically and psychologically devastating problem are highly warranted....

Artificial life models in lung CTS

International Nuclear Information System (INIS)

Sorin, Cheran

2006-01-01

A new method for the analysis of 3D medical images is introduced. The algorithm is based on Biological Models of ants known as Artificial Life models. Test images (lung Computed Tomographies) undergo a 3D region growing procedure for the identification of the ribs cage. Active Contour Models (snakes) are used in order to build a confined area where ants are deployed. The ant-based approach, in which steps are allowed in any direction with different probabilities, allows a kind of tunneling effect for the successful identification of small 3D structures that are not clearly connected to the rest of the tree. The best approach is based on a gradient rule for the release of pheromone. A possible application, as part of a Computer Assisted Detection system for the identification of lung nodules, is the removal of the bronchial and vascular tree from lung CTs thus reducing the number of false positives a Nodule Hunter might report. (Full Text)

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

Directory of Open Access Journals (Sweden)

John P. Brusky

2008-01-01

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.

Three-Dimensional Photography for Quantitative Assessment of Penile Volume-Loss Deformities in Peyronie's Disease.

Science.gov (United States)

Margolin, Ezra J; Mlynarczyk, Carrie M; Mulhall, John P; Stember, Doron S; Stahl, Peter J

2017-06-01

Non-curvature penile deformities are prevalent and bothersome manifestations of Peyronie's disease (PD), but the quantitative metrics that are currently used to describe these deformities are inadequate and non-standardized, presenting a barrier to clinical research and patient care. To introduce erect penile volume (EPV) and percentage of erect penile volume loss (percent EPVL) as novel metrics that provide detailed quantitative information about non-curvature penile deformities and to study the feasibility and reliability of three-dimensional (3D) photography for measurement of quantitative penile parameters. We constructed seven penis models simulating deformities found in PD. The 3D photographs of each model were captured in triplicate by four observers using a 3D camera. Computer software was used to generate automated measurements of EPV, percent EPVL, penile length, minimum circumference, maximum circumference, and angle of curvature. The automated measurements were statistically compared with measurements obtained using water-displacement experiments, a tape measure, and a goniometer. Accuracy of 3D photography for average measurements of all parameters compared with manual measurements; inter-test, intra-observer, and inter-observer reliabilities of EPV and percent EPVL measurements as assessed by the intraclass correlation coefficient. The 3D images were captured in a median of 52 seconds (interquartile range = 45-61). On average, 3D photography was accurate to within 0.3% for measurement of penile length. It overestimated maximum and minimum circumferences by averages of 4.2% and 1.6%, respectively; overestimated EPV by an average of 7.1%; and underestimated percent EPVL by an average of 1.9%. All inter-test, inter-observer, and intra-observer intraclass correlation coefficients for EPV and percent EPVL measurements were greater than 0.75, reflective of excellent methodologic reliability. By providing highly descriptive and reliable measurements of

Diagnosis and management of solitary pulmonary nodules.

Science.gov (United States)

Jeong, Yeon Joo; Lee, Kyung Soo; Kwon, O Jung

2008-12-01

The advent of computed tomography (CT) screening with or without the help of computer-aided detection systems has increased the detection rate of solitary pulmonary nodules (SPNs), including that of early peripheral lung cancer. Helical dynamic (HD)CT, providing the information on morphologic and hemodynamic characteristics with high specificity and reasonably high accuracy, can be used for the initial assessment of SPNs. (18)F-fluorodeoxyglucose PET/CT is more sensitive at detecting malignancy than HDCT. Therefore, PET/CT may be selectively performed to characterize SPNs when HDCT gives an inconclusive diagnosis. Serial volume measurements are currently the most reliable methods for the tissue characterization of subcentimeter nodules. When malignant nodule is highly suspected for subcentimeter nodules, video-assisted thoracoscopic surgery nodule removal after nodule localization using the pulmonary nodule-marker system may be performed for diagnosis and treatment.

[Nodulation competitiveness of nodule bacteria: Genetic control and adaptive significance].

Science.gov (United States)

Onishchuk, O P; Vorobyov, N I; Provorov, N A

2017-01-01

The most recent data on the system of cmp (competitiveness) genes that determine the nodulation competitiveness of rhizobial strains, i.e., the ability to compete for nodule formation in leguminous plants, is analyzed. Three genetic approaches for the construction of economically valuable strains of rhizobia are proposed: the amplification of positive regulators of competitiveness, the inactivation of the negative regulators of this trait, and the introduction of efficient competitiveness factors into strains capable of active nitrogen fixation.

Comparison of the nodule vs. root transcriptome of the actinorhizal plant Datisca glomerata: actinorhizal nodules contain a specific class of defensins.

Directory of Open Access Journals (Sweden)

Irina V Demina

Full Text Available Actinorhizal root nodule symbioses are very diverse, and the symbiosis of Datisca glomerata has previously been shown to have many unusual aspects. In order to gain molecular information on the infection mechanism, nodule development and nodule metabolism, we compared the transcriptomes of D. glomerata roots and nodules. Root and nodule libraries representing the 3'-ends of cDNAs were subjected to high-throughput parallel 454 sequencing. To identify the corresponding genes and to improve the assembly, Illumina sequencing of the nodule transcriptome was performed as well. The evaluation revealed 406 differentially regulated genes, 295 of which (72.7% could be assigned a function based on homology. Analysis of the nodule transcriptome showed that genes encoding components of the common symbiosis signaling pathway were present in nodules of D. glomerata, which in combination with the previously established function of SymRK in D. glomerata nodulation suggests that this pathway is also active in actinorhizal Cucurbitales. Furthermore, comparison of the D. glomerata nodule transcriptome with nodule transcriptomes from actinorhizal Fagales revealed a new subgroup of nodule-specific defensins that might play a role specific to actinorhizal symbioses. The D. glomerata members of this defensin subgroup contain an acidic C-terminal domain that was never found in plant defensins before.

A Domino Effect? The Spread of Implantation of Penile Foreign Bodies in the Prison System

Directory of Open Access Journals (Sweden)

Ryan Malloy Flynn

2014-03-01

Full Text Available Subcutaneous penile insertion of foreign bodies is a practice performed globally but has mostly been reported outside of the United States. An incarcerated 29-year-old Caucasian male in a midwestern prison whittled a domino into a dog bone shape and placed it into his ventral penile subcutaneous tissue. He presented to our facility with erosion of the corners of the foreign body through his skin without evidence of infection. Self-insertion of foreign bodies into penile subcutaneous tissue by incarcerated American men for sexual enhancement is more widespread than previously reported. Erosion is a novel presentation.

Surgical Management of Penile and Preputial Neoplasms in Equine with Special Reference to Partial Phallectomy

Directory of Open Access Journals (Sweden)

Awad Rizk

2013-01-01

Full Text Available Penile and preputial neoplasia in horses occurs infrequently and represents diagnostic and therapeutic challenges. The present study was carried out on a total number of 21 equids (14 stallions and 7 donkeys suffered from different penile and preputial neoplasia. Diagnosis of neoplasms was based up on history of the case, clinical examination as well as histopathological evaluation. Animals with penile and preputial neoplasms were underwent local excision and partial phallectomy with a slightly modified version of the techniques described by William’s. The diagnosed neoplasms were penile and preputial squamous cell carcinomas (SCCs; ; sarcoid (; a-fibrosarcoma; and a melanoma. Local excision was curative in all cases except 5 stallions with SCCs. These stallions had extensive damage of the glans penis, free part of the penis and the inner lamina of the internal fold of the prepuce, and they underwent a partial phallectomy with successful outcome. Follow-up information was obtained by visit and telephone inquiries. In conclusion, penile and preputial neoplasms are commonly encountered in elderly male horses and SCCs are the most common type affecting male external genitalia. Partial phallectomy is effective for management of equine neoplasia if they are confined to the glans and body of the penis and there is no proximal spread or involvement to regional lymph nodes.

Blood transfusion and resuscitation using penile corpora: an experimental study.

Science.gov (United States)

Abolyosr, Ahmad; Sayed, M A; Elanany, Fathy; Smeika, M A; Shaker, S E

2005-10-01

To test the feasibility of using the penile corpora cavernosa for blood transfusion and resuscitation purposes. Three male donkeys were used for autologous blood transfusion into the corpus cavernosum during three sessions with a 1-week interval between each. Two blood units (450 mL each) were transfused per session to each donkey. Moreover, three dogs were bled up until a state of shock was produced. The mean arterial blood pressure decreased to 60 mm Hg. The withdrawn blood (mean volume 396.3 mL) was transfused back into their corpora cavernosa under 150 mm Hg pressure. Different transfusion parameters were assessed. The Assiut faculty of medicine ethical committee approved the study before its initiation. For the donkey model, the mean time of blood collection was 12 minutes. The mean time needed to establish corporal access was 22 seconds. The mean time of blood transfusion was 14.2 minutes. The mean rate of blood transfusion was 31.7 mL/min. Mild penile elongation with or without mild penile tumescence was observed on four occasions. All penile shafts returned spontaneously to their pretransfusion state at a maximum of 5 minutes after cessation of blood transfusion. No extravasation, hematoma formation, or color changes occurred. Regarding the dog model, the mean rate of transfusion was 35.2 mL/min. All dogs were resuscitated at the end of the transfusion. The corpus cavernosum is a feasible, simple, rapid, and effective alternative route for blood transfusion and venous access. It can be resorted to whenever necessary. It is a reliable means for volume replacement and resuscitation in males.

Effect of radiation dose level on accuracy and precision of manual size measurements in chest tomosynthesis evaluated using simulated pulmonary nodules

International Nuclear Information System (INIS)

Soederman, Christina; Allansdotter Johnsson, Aase; Vikgren, Jenny; Rossi Norrlund, Rauni; Molnar, David; Svalkvist, Angelica; Maansson, Lars Gunnar; Baath, Magnus

2016-01-01

The aim of the present study was to investigate the dependency of the accuracy and precision of nodule diameter measurements on the radiation dose level in chest tomosynthesis. Artificial ellipsoid-shaped nodules with known dimensions were inserted in clinical chest tomosynthesis images. Noise was added to the images in order to simulate radiation dose levels corresponding to effective doses for a standard-sized patient of 0.06 and 0.04 mSv. These levels were compared with the original dose level, corresponding to an effective dose of 0.12 mSv for a standard-sized patient. Four thoracic radiologists measured the longest diameter of the nodules. The study was restricted to nodules located in high-dose areas of the tomosynthesis projection radiographs. A significant decrease of the measurement accuracy and intra-observer variability was seen for the lowest dose level for a subset of the observers. No significant effect of dose level on the interobserver variability was found. The number of non-measurable small nodules (≤5 mm) was higher for the two lowest dose levels compared with the original dose level. In conclusion, for pulmonary nodules at positions in the lung corresponding to locations in high-dose areas of the projection radiographs, using a radiation dose level resulting in an effective dose of 0.06 mSv to a standard-sized patient may be possible in chest tomosynthesis without affecting the accuracy and precision of nodule diameter measurements to any large extent. However, an increasing number of non-measurable small nodules (≤5 mm) with decreasing radiation dose may raise some concerns regarding an applied general dose reduction for chest tomosynthesis examinations in the clinical praxis. (authors)

Hyperfunctioning thyroid nodules in children.

Science.gov (United States)

Abe, K; Konno, M; Sato, T; Matsuura, N

1980-10-01

We studied two cases of hyperfunctioning thyroid nodules in children. A 9-year-old girl and an 11-year-old girl had thyroid masses in otherwise nonpalpable thyroid glands. Scintiscan showed hyperfunctioning thyroid nodules. The former patient had elevated values for T4 and T3, and plasma thyrotropin (TSH) level failed to respond to stimulation with thyrotropin releasing hormone (TRH), whereas the latter patient had normal values for T4, and T3 and plasma TSH response to TRH was normal. After the surgical removal of nodules, scintiscan exhibited radioactivity in the contralateral lobe of the thyroid gland in the former and in the ectopic thyroid tissue in the latter. Results of microscopic examinations of thyroid nodules were consistent with adenomatous goiter.

Effect of radiation dose level on the detectability of pulmonary nodules in chest tomosynthesis

International Nuclear Information System (INIS)

Asplund, Sara A.; Svalkvist, Angelica; Maansson, Lars Gunnar; Baath, Magnus; Johnsson, Aase A.; Vikgren, Jenny; Flinck, Agneta; Boijsen, Marianne; Fisichella, Valeria A.

2014-01-01

To investigate the detectability of pulmonary nodules in chest tomosynthesis at reduced radiation dose levels. Eighty-six patients were included in the study and were examined with tomosynthesis and computed tomography (CT). Artificial noise was added to simulate that the tomosynthesis images were acquired at dose levels corresponding to 12, 32, and 70 % of the default setting effective dose (0.12 mSv). Three observers (with >20, >20 and three years of experience) read the tomosynthesis cases for presence of nodules in a free-response receiver operating characteristics (FROC) study. CT served as reference. Differences between dose levels were calculated using the jack-knife alternative FROC (JAFROC) figure of merit (FOM). The JAFROC FOM was 0.45, 0.54, 0.55, and 0.54 for the 12, 32, 70, and 100 % dose levels, respectively. The differences in FOM between the 12 % dose level and the 32, 70, and 100 % dose levels were 0.087 (p = 0.006), 0.099 (p = 0.003), and 0.093 (p = 0.004), respectively. Between higher dose levels, no significant differences were found. A substantial reduction from the default setting dose in chest tomosynthesis may be possible. In the present study, no statistically significant difference in detectability of pulmonary nodules was found when reducing the radiation dose to 32 %. (orig.)

Effect of radiation dose level on the detectability of pulmonary nodules in chest tomosynthesis

Energy Technology Data Exchange (ETDEWEB)

Asplund, Sara A.; Svalkvist, Angelica; Maansson, Lars Gunnar; Baath, Magnus [University of Gothenburg, Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg (Sweden); Sahlgrenska University Hospital, Department of Medical Physics and Biomedical Engineering, Gothenburg (Sweden); Johnsson, Aase A.; Vikgren, Jenny; Flinck, Agneta; Boijsen, Marianne; Fisichella, Valeria A. [University of Gothenburg, Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg (Sweden); Sahlgrenska University Hospital, Department of Radiology, Gothenburg (Sweden)

2014-07-15

To investigate the detectability of pulmonary nodules in chest tomosynthesis at reduced radiation dose levels. Eighty-six patients were included in the study and were examined with tomosynthesis and computed tomography (CT). Artificial noise was added to simulate that the tomosynthesis images were acquired at dose levels corresponding to 12, 32, and 70 % of the default setting effective dose (0.12 mSv). Three observers (with >20, >20 and three years of experience) read the tomosynthesis cases for presence of nodules in a free-response receiver operating characteristics (FROC) study. CT served as reference. Differences between dose levels were calculated using the jack-knife alternative FROC (JAFROC) figure of merit (FOM). The JAFROC FOM was 0.45, 0.54, 0.55, and 0.54 for the 12, 32, 70, and 100 % dose levels, respectively. The differences in FOM between the 12 % dose level and the 32, 70, and 100 % dose levels were 0.087 (p = 0.006), 0.099 (p = 0.003), and 0.093 (p = 0.004), respectively. Between higher dose levels, no significant differences were found. A substantial reduction from the default setting dose in chest tomosynthesis may be possible. In the present study, no statistically significant difference in detectability of pulmonary nodules was found when reducing the radiation dose to 32 %. (orig.)

Root nodule structure in Chamaecytisus podolicus

Directory of Open Access Journals (Sweden)

Monika Skawińska

2017-06-01

Full Text Available By means of microscopic analyses, it was shown that root nodules formed by Chamaecytisus podolicus exhibited all structural features typical for indeterminate nodules of temperate genistean shrubs: (i apical nodule meristem composed of infected and non-infected domains, (ii parenchymatous bacteroid-containing tissue with infected cells only resulting from mitotic activity of infected meristematic cells, (iii absence of infection threads, and (iv convoluted bacteroids singly enclosed in a symbiosome membrane. For the first time, it was shown that the nodule meristem is organized into longitudinal files of sister cells.

Detection of pulmonary nodules

International Nuclear Information System (INIS)

Vanzulli, A.; Zanello, A.; DelMaschio, M.; Paesano, P.; Panizza, P.; DelMaschio, A.

1989-01-01

The authors have prospectively studied 203 pulmonary nodules in 91 patients, selected by CT (gold standard), with both subtraction digital radiography (SDR) and conventional plain film. Subtracted images were obtained by using copper filter inserted between two photostimulable imaging plates. Five radiologists randomly analyzed all conventional and subtracted images. The authors calculated sensitivity, specificity, and positive and negative predictive values for both conventional radiography and SDR. Receiver operating characteristics (ROC) curves were calculated by plotting the number of nodules detected with different degrees of confidence. SDR detected 12% more nodules than conventional radiography. ROC curves demonstrated that the level of confidence was better for SDR (P <.05)

Nodule-Enriched GRETCHEN HAGEN 3 Enzymes Have Distinct Substrate Specificities and Are Important for Proper Soybean Nodule Development

Directory of Open Access Journals (Sweden)

Suresh Damodaran

2017-11-01

Full Text Available Legume root nodules develop as a result of a symbiotic relationship between the plant and nitrogen-fixing rhizobia bacteria in soil. Auxin activity is detected in different cell types at different stages of nodule development; as well as an enhanced sensitivity to auxin inhibits, which could affect nodule development. While some transport and signaling mechanisms that achieve precise spatiotemporal auxin output are known, the role of auxin metabolism during nodule development is unclear. Using a soybean root lateral organ transcriptome data set, we identified distinct nodule enrichment of three genes encoding auxin-deactivating GRETCHEN HAGEN 3 (GH3 indole-3-acetic acid (IAA amido transferase enzymes: GmGH3-11/12, GmGH3-14 and GmGH3-15. In vitro enzymatic assays showed that each of these GH3 proteins preferred IAA and aspartate as acyl and amino acid substrates, respectively. GmGH3-15 showed a broad substrate preference, especially with different forms of auxin. Promoter:GUS expression analysis indicated that GmGH3-14 acts primarily in the root epidermis and the nodule primordium where as GmGH3-15 might act in the vasculature. Silencing the expression of these GH3 genes in soybean composite plants led to altered nodule numbers, maturity, and size. Our results indicate that these GH3s are needed for proper nodule maturation in soybean, but the precise mechanism by which they regulate nodule development remains to be explained.

Imaging of penile traumas - therapeutic implications

Energy Technology Data Exchange (ETDEWEB)

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

2005-12-01

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

Classification decision tree in CT imaging: application to the differential diagnosis of solitary pulmonary nodules

International Nuclear Information System (INIS)

Ma Hongxia; Guo Yulin; Wang Qiuping; Qiang Yongqian; Liu Min; Guo Xiaojuan; Guo Youmin; Chen Qihang

2008-01-01

Objective: To establish classification and regression tree (CART) for differentiating benign from malignant solitary pulmonary nudules (SPN). Methods: One hundred and sixteen consecutive cases with 116 solitary pulmonary nodules, which finally were pathologically proven 54 malignant nodules and 62 benign nodules, were prospectively registered in this research. Twelve clinical presentations and 22 CT findings were collected as predictors. A classification tree was established to distinguish benign SPNs from malignant ones. In the observer test, two groups (one made of junior radiologists and one of senior radiologists) were independently presented with clinical information and CT images without knowing the pathologic and machine-learning results. Performance of observers and CART were compared by receiver operating characteristic analysis. Results: Receiver operating characteristic analysis showed areas under the curve of CART, senior radiologists and junior radiologists respectively were 0.910±0.029, 0.827±0.038, 0.612±0.052. Difference between areas(DBF) between CART and junior radiologists was 0.297(P<0.01). DBF between CART and senior radiologists was 0.083 (P<0.05). DBF between senior and junior radiologists was 0.214 (P<0.01). CART showed a best diagnostic efficiency, followed by junior radiologists, and then senior radiologists. Conclusion: Our data mining techniques using CART prove a high accuracy in differentiating benign from malignant pulmonary nodules based on clinical variables and CT findings. It will be a potentially useful tool in further application of artificial intelligence in the imaging diagnosis. (authors)

Pulmonary nodule registration in serial CT scans based on rib anatomy and nodule template matching

International Nuclear Information System (INIS)

Shi Jiazheng; Sahiner, Berkman; Chan, H.-P.; Hadjiiski, Lubomir; Zhou, C.; Cascade, Philip N.; Bogot, Naama; Kazerooni, Ella A.; Wu, Y.-T.; Wei, J.

2007-01-01

An automated method is being developed in order to identify corresponding nodules in serial thoracic CT scans for interval change analysis. The method uses the rib centerlines as the reference for initial nodule registration. A spatially adaptive rib segmentation method first locates the regions where the ribs join the spine, which define the starting locations for rib tracking. Each rib is tracked and locally segmented by expectation-maximization. The ribs are automatically labeled, and the centerlines are estimated using skeletonization. For a given nodule in the source scan, the closest three ribs are identified. A three-dimensional (3D) rigid affine transformation guided by simplex optimization aligns the centerlines of each of the three rib pairs in the source and target CT volumes. Automatically defined control points along the centerlines of the three ribs in the source scan and the registered ribs in the target scan are used to guide an initial registration using a second 3D rigid affine transformation. A search volume of interest (VOI) is then located in the target scan. Nodule candidate locations within the search VOI are identified as regions with high Hessian responses. The initial registration is refined by searching for the maximum cross-correlation between the nodule template from the source scan and the candidate locations. The method was evaluated on 48 CT scans from 20 patients. Experienced radiologists identified 101 pairs of corresponding nodules. Three metrics were used for performance evaluation. The first metric was the Euclidean distance between the nodule centers identified by the radiologist and the computer registration, the second metric was a volume overlap measure between the nodule VOIs identified by the radiologist and the computer registration, and the third metric was the hit rate, which measures the fraction of nodules whose centroid computed by the computer registration in the target scan falls within the VOI identified by the

Erect penile dimensions in a cohort of 778 Middle Eastern men: establishment of a nomogram.

Science.gov (United States)

Habous, Mohamad; Tealab, Alaa; Williamson, Ben; Binsaleh, Saleh; El Dawy, Sherif; Mahmoud, Saad; Abdelwahab, Osama; Nassar, Mohammed; Mulhall, John P; Veale, David; Muir, Gordon

2015-06-01

Accurate data regarding the size of the erect penis are of great importance to several disciplines working with male patients, but little high-quality research exists on the subject, particularly in different ethnic groups and for erect penis size. The aim of this study was to create a nomogram of erect penile dimensions in a large sample of Middle Eastern men. A retrospective cohort study of 778 men (mean age 43.7; range 20-82) attending urological outpatient clinics in Saudi Arabia was conducted. Exclusion criteria were age under 18 years, a presenting complaint of small or short penis, Peyronie's disease or complaint of congenital curvature, clinical hypogonadism, and previous penile surgery or trauma. Three erect penile dimensions following induction of erection using intracavernosal injection of Quadrimix. Mean patient body mass index (BMI) was 29.09 (standard deviation [SD] 5.76). The mean suprapubic skin-to-penile tip erect length was 12.53 cm (SD 1.93); the mean erect length from the symphysis pubis to the penile tip was 14.34 cm (SD 1.86); and the mean erect shaft circumference was 11.50 cm (SD 1.74). A nomogram was constructed and statistical analysis performed, demonstrating a weak negative correlation between BMI and erect penile length measured from the suprapubic skin (r = -0.283, P Middle Eastern men can be used as a standard when advising men with small penis anxiety. The importance of measuring erect size and allowing for infra-pubic fat interference in measurement is emphasized. We envisage that this tool can be used to educate and reassure concerned men about the size of their penises. © 2015 International Society for Sexual Medicine.

Diffusion-weighted MR imaging of thyroid nodules

International Nuclear Information System (INIS)

Bozgeyik, Zulkif; Coskun, Sonay; Ogur, Erkin; Dagli, A.F.; Ozkan, Yusuf; Sahpaz, Fatih

2009-01-01

The purpose of our study was to determine the diagnostic role of diffusion-weighted imaging (DWI) in the differentiating of malignant and benign thyroid nodules by using fine needle aspiration biopsy cytology criteria as a reference standard. The apparent diffusion coefficient (ADC) values of the normal-looking thyroid parenchyma were also evaluated both in normal patients and in patients with nodules. Between March 2007 and February 2008, 76 consecutive patients with ultrasound-diagnosed thyroid nodules and 20 healthy subjects underwent diffusion-weighted MR imaging by using single-shot spin echo, echo planar imaging. A total of 93 nodules were included in the study using the following b factors 100, 200, and 300 mm 2 /s. ADC values of thyroid nodules and normal area in all subjects were calculated and compared using suitable statistical analysis. Mean ADC values for malignant and benign nodules were 0.96±0.65 x 10 -3 and 3.06±0.71 x 10 -3 mm 2 /s. for b-300 factor, 0.56±0.43 x 10 -3 and 1.80±0.60 x 10 -3 mm 2 /s for b-200, and 0.30±0.20 x 10 -3 and 1.15±0.43 x 10 -3 mm 2 /s, for b-300, respectively. Mean ADC values of malignant nodules were lower than benign nodules. There were significant differences in ADC values between benign and malignant nodules. ADC values among normal-appearing thyroid parenchyma of patients and normal-appearing thyroid parenchyma of healthy subjects were insignificant at all b factors. Benign nodules have higher ADC values than malignant ones. DWI may be helpful in differentiating malign and benign thyroid nodules. (orig.)

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

Energy Technology Data Exchange (ETDEWEB)

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

2008-10-15

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

Penile enlargement: from medication to surgery.

Science.gov (United States)

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

2010-01-01

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

Management of thyroid nodules in children and adolescents

NARCIS (Netherlands)

Wiersinga, Wilmar M.

2007-01-01

Thyroid nodules in childhood and adolescence are less prevalent but more often malignant than in adulthood. Malignant nodules are predominantly papillary cancers; benign nodules are mostly solid colloid nodules/adenomas, but can be cystic or due lymphocytic thyroiditis. Previous neck irradiation

Effect of radiation dose level on the detectability of pulmonary nodules in chest tomosynthesis.

Science.gov (United States)

Asplund, Sara A; Johnsson, Åse A; Vikgren, Jenny; Svalkvist, Angelica; Flinck, Agneta; Boijsen, Marianne; Fisichella, Valeria A; Månsson, Lars Gunnar; Båth, Magnus

2014-07-01

To investigate the detectability of pulmonary nodules in chest tomosynthesis at reduced radiation dose levels. Eighty-six patients were included in the study and were examined with tomosynthesis and computed tomography (CT). Artificial noise was added to simulate that the tomosynthesis images were acquired at dose levels corresponding to 12, 32, and 70% of the default setting effective dose (0.12 mSv). Three observers (with >20, >20 and three years of experience) read the tomosynthesis cases for presence of nodules in a free-response receiver operating characteristics (FROC) study. CT served as reference. Differences between dose levels were calculated using the jack-knife alternative FROC (JAFROC) figure of merit (FOM). The JAFROC FOM was 0.45, 0.54, 0.55, and 0.54 for the 12, 32, 70, and 100% dose levels, respectively. The differences in FOM between the 12% dose level and the 32, 70, and 100% dose levels were 0.087 (p = 0.006), 0.099 (p = 0.003), and 0.093 (p = 0.004), respectively. Between higher dose levels, no significant differences were found. A substantial reduction from the default setting dose in chest tomosynthesis may be possible. In the present study, no statistically significant difference in detectability of pulmonary nodules was found when reducing the radiation dose to 32%. • A substantial radiation dose reduction in chest tomosynthesis may be possible. • Pulmonary nodule detectability remained unchanged at 32% of the effective dose. • Tomosynthesis might be performed at the dose of a lateral chest radiograph.

US Diagnosis for Thyroid Nodules with an Indeterminate Cytology

Energy Technology Data Exchange (ETDEWEB)

Ha, Jong Geun; Kim, Dong Wook [Busan Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of); Kang, Tae Woo [Saegyaero Hospital, Busan (Korea, Republic of)

2011-09-15

We wanted to assess the diagnostic efficacy of thyroid ultrasound (US) for evaluating thyroid nodules with indeterminate cytology. Among 1865 nodules in 1278 patients who received a prospective US diagnosis of their thyroid nodule(s) and who subsequently underwent US-guided fine-needle aspiration, 130 nodules with indeterminate cytology were enrolled in the study. Each thyroid nodule was prospectively classified by a single radiologist into 1 of 5 diagnostic categories: 'benign', 'probably benign', 'indeterminate', 'suspicious for malignancy' and 'malignant.' The solid nodules were classified using all 5 categories and the partially cystic nodules classified using 4 categories ('indeterminate' was omitted). We calculated the diagnostic efficacy of thyroid US by comparing the US diagnoses with the pathology results. Of 130 nodules with indeterminate cytology (130/1865, 7.0%), 62 nodules were surgically removed. Nineteen nodules were assigned to the indeterminate category on US. The malignantly rate of the US-indeterminate category was 56.5% (35/62). The sensitivity, specificity and positive and negative predictive values were 81.0%, 81.8%, 81.0%, 81.8% and 81.4%, respectively, when US-indeterminate nodules were excluded. There was no significant difference of diagnostic efficacy when these nodules were reclassified as malignant, but there was a significant difference of diagnostic efficacy when these nodules were reclassified as benign. Our US classification may be a feasible method for managing thyroid nodules with indeterminate cytology

Myiasis associated with penile carcinoma: a new trend in developing countries?

Directory of Open Access Journals (Sweden)

Leandro Koifman

Full Text Available ABSTRACT Objectives The aim of this study is to report an unusual form of penile cancer presentation associated with myiasis infestation, treatment options and outcomes. Materials and Methods We studied 10 patients with suspected malignant neoplasm of the penis associated with genital myiasis infestation. Diagnostic assessment was conducted through clinical history, physical examination, penile biopsy, larvae identification and computerized tomography scan of the chest, abdomen and pelvis. Clinical and pathological staging was done according to 2002 TNM classification system. Radical inguinal lymphadenectomy was conducted according to the primary penile tumor pathology and clinical lymph nodes status. Results Patients age ranged from 41 to 77 years (mean=62.4. All patients presented squamous cell carcinoma of the penis in association with myiasis infestation caused by Psychoda albipennis. Tumor size ranged from 4cm to 12cm (mean=5.3. Circumcision was conducted in 1 (10% patient, while penile partial penectomy was performed in 5 (50%. Total penectomy was conducted in 2 (20% patients, while emasculation was the treatment option for 2 (20%. All patients underwent radical inguinal lymphadenectomy. Prophylactic lymphadenectomy was performed on 3 (30% patients, therapeutic on 5 (50%, and palliative lymphadenectomy on 2 (20% patients. Time elapsed from primary tumor treatment to radical inguinal lymphadenectomy was 2 to 6 weeks. The mean follow-up was 34.3 months. Conclusion The occurrence of myiasis in the genitalia is more common in patients with precarious hygienic practices and low socio-economic level. The treatment option varied according to the primary tumor presentation and clinical lymph node status.

Myiasis associated with penile carcinoma: a new trend in developing countries?

Science.gov (United States)

Koifman, Leandro; Barros, Rodrigo; Schulze, Lucas; Ornellas, Antonio Augusto; Favorito, Luciano A

2017-01-01

The aim of this study is to report an unusual form of penile cancer presentation associated with myiasis infestation, treatment options and outcomes. We studied 10 patients with suspected malignant neoplasm of the penis associated with genital myiasis infestation. Diagnostic assessment was conducted through clinical history, physical examination, penile biopsy, larvae identification and computerized tomography scan of the chest, abdomen and pelvis. Clinical and pathological staging was done according to 2002 TNM classification system. Radical inguinal lymphadenectomy was conducted according to the primary penile tumor pathology and clinical lymph nodes status. Patients age ranged from 41 to 77 years (mean=62.4). All patients presented squamous cell carcinoma of the penis in association with myiasis infestation caused by Psychoda albipennis. Tumor size ranged from 4cm to 12cm (mean=5.3). Circumcision was conducted in 1 (10%) patient, while penile partial penectomy was performed in 5 (50%). Total penectomy was conducted in 2 (20%) patients, while emasculation was the treatment option for 2 (20%). All patients underwent radical inguinal lymphadenectomy. Prophylactic lymphadenectomy was performed on 3 (30%) patients, therapeutic on 5 (50%), and palliative lymphadenectomy on 2 (20%) patients. Time elapsed from primary tumor treatment to radical inguinal lymphadenectomy was 2 to 6 weeks. The mean follow-up was 34.3 months. The occurrence of myiasis in the genitalia is more common in patients with precarious hygienic practices and low socio-economic level. The treatment option varied according to the primary tumor presentation and clinical lymph node status. Copyright® by the International Brazilian Journal of Urology.

Tourniquet application and epinephrine injection to penile skin: is it safe?

Science.gov (United States)

Cakmak, M; Caglayan, F; Kisa, U; Bozdogan, O; Saray, A; Caglayan, O

2002-09-01

Although a tourniquet is frequently used in penile surgery there is still no consensus on safe application time. The aim of the present study is to investigate the effect of malondialdehyde (MDA) levels and histological changes in skin flaps after penile tourniquet application and epinephrine injection. A total of 36 male white New Zealand rabbits were randomly divided into six groups each containing six animals. A Mathieu-like flap was raised in all of the groups and a tourniquet was applied and the penis was subjected to ischemia for 10, 20 and 40 min in groups 1, 2 and 3, respectively. The flaps were then allowed to reperfuse for 5 min. Biopsies for MDA measurement were harvested in these groups. Subcutaneous 1/200,000 epinephrine was injected into penile skin in group 4 and 5 rabbits and biopsies for MDA measurement were harvested 10 and 40 min after injection. The control group was anesthetized without tourniquet usage or epinephrine injection. Specimens taken from the harvested flaps of all groups were submitted for histological evaluation. The mean MDA levels in all experimental groups were higher than in the control group and the difference was statistically significant. Edema, congestion and extravasation were observed in groups 1, 2 and 3. Minimal congestion and edema were observed in group 4 and severe edema and extravasation in group 5. Tourniquet usage for a duration of less than 10 min is clearly safer than prolonged usage. Epinephrine injection to penile skin may show a deleterious effect on wound healing.

Penile enhancement using a porcine small intestinal submucosa graft in a rat model.

Science.gov (United States)

Leungwattanakij, S; Pummangura, N; Ratana-Olarn, K

2006-01-01

Several biodegradable materials have been experimented for penile enhancement, but none show the potential for clinical use. This study was designed to use porcine small intestinal submucosa (SIS) augmenting the normal tunica albuginea to increase the functional girth of the rat penis. In all, 20 adult male Sprague-Dawley rats constituted the study population. The animals were divided into two groups: group 1 consisted of the control (n=10) and group 2 (n=10) consisted of rats that underwent penile enhancement by a longitudinal I-shaped incision of the tunica albuginea on both sides, and the dissection of the plane between tunica albuginea and cavernosal tissue was carried out (n=10). The incision was then patched with a 3 x 10 mm2 piece of SIS, using a 6/0 nylon suture material. The penile length and mid-circumference were then measured using a Vernier Caliper before and 2 months after surgery. All rat penises underwent histological examination using Masson's trichome and Verhoff's van Giesen's stain for collagen and elastic fibers. The penile length, mid-circumference and degree of fibrosis score were expressed as mean+/-s.e. (standard error) and analyzed using a Wilcoxon rank-sum test. A statistical significance was accepted at P-value enhancement.

Persistent pulmonary subsolid nodules: model-based iterative reconstruction for nodule classification and measurement variability on low-dose CT

International Nuclear Information System (INIS)

Kim, Hyungjin; Kim, Seong Ho; Lee, Sang Min; Lee, Kyung Hee; Park, Chang Min; Park, Sang Joon; Goo, Jin Mo

2014-01-01

To compare the pulmonary subsolid nodule (SSN) classification agreement and measurement variability between filtered back projection (FBP) and model-based iterative reconstruction (MBIR). Low-dose CTs were reconstructed using FBP and MBIR for 47 patients with 47 SSNs. Two readers independently classified SSNs into pure or part-solid ground-glass nodules, and measured the size of the whole nodule and solid portion twice on both reconstruction algorithms. Nodule classification agreement was analyzed using Cohen's kappa and compared between reconstruction algorithms using McNemar's test. Measurement variability was investigated using Bland-Altman analysis and compared with the paired t-test. Cohen's kappa for inter-reader SSN classification agreement was 0.541-0.662 on FBP and 0.778-0.866 on MBIR. Between the two readers, nodule classification was consistent in 79.8 % (75/94) with FBP and 91.5 % (86/94) with MBIR (p = 0.027). Inter-reader measurement variability range was -5.0-2.1 mm on FBP and -3.3-1.8 mm on MBIR for whole nodule size, and was -6.5-0.9 mm on FBP and -5.5-1.5 mm on MBIR for solid portion size. Inter-reader measurement differences were significantly smaller on MBIR (p = 0.027, whole nodule; p = 0.011, solid portion). MBIR significantly improved SSN classification agreement and reduced measurement variability of both whole nodules and solid portions between readers. (orig.)

Nitrogen assimilation in soybean nodules, 1

International Nuclear Information System (INIS)

Ohyama, Takuji; Kumazawa, Kikuo

1980-01-01

In order to elucidate the pathways to assimilate the ammonia produced by N 2 -fixation in soybean nodules, 15 N-labeled compounds were administered to intact nodules or nodule slices pretreated with various inhibitors of nitrogen assimilation. After exposure to 15 N 2 , 15 N-incorporation into various nitrogenous compounds was investigated in attached nodules injected with methionine sulfoximine (MSX) or azaserine (AS). MSX treatment increased the 15 N content of ammonia more than 6 times, however, depressed 15 N content of most of amides and amino acids. AS treatment enhanced 15 N content of amido-N of glutamine as well as ammonia, but decreased amino-N of glutamine and most of amino acids. Experiments with nodule slices pretreated with MSX or AS solution and then fed with 15 N-labeled ammonia or amido- 15 N of glutamine showed the same trends. Aminooxyacetate inhibited nitrogen flow from glutamic acid to other amino acids. These results strongly indicate that the ammonia produced by N 2 -fixation is assimilated by GS/GOGAT system to glutamic acid and then transaminated to various amino acids in situ. 15 N-incorporation patterns in nodule slices fed with 15 N-labeled ammonia, hydroxylamine, nitrite were similar, but nitrate seemed to be reduced in a definite compartment and assimilated similarly as in intact nodules fed with 15 N 2 (author)

Distal corporoplasty for distal cylinders extrusion after penile prosthesis implantation.

Science.gov (United States)

Carrino, Maurizio; Chiancone, Francesco; Battaglia, Gaetano; Pucci, Luigi; Fedelini, Paolo

2017-02-03

Distal extrusion of cylinders is a potential complication of the penile prosthesis implantation. Several methods have been proposed for repairing a distal penile erosion. We present our preliminary experience in "Distal corporoplasty" technique. We enrolled 18 consecutive patients whose underwent a distal corporoplasty with simultaneous reimplantation of an "AMS 700 inflatable penile prosthesis (LGX)" from January 2013 to November 2015 at our hospital. All procedures were performed by a single surgical team. Intraoperative and postoperative complications have been classified and reported according to Satava6 and Clavien-Dindo (CD) system.7 Mean values with standard deviations (±SD) were computed and reported for all items. Mean age of the patients was 53.61 (±11.90) years. Mean body max index (BMI) was 24.22 (±2.51). Mean operative time was 85.2 (±13.1) minutes. Blood losses were minimal. No intraoperative complications are reported according to Satava classification. Four out of 18 patients (22.22%) experienced postoperative complications according to CD system. All patients had sexual intercourse for the first time postsurgery after a mean of 59.11 ± 2.08 days. Mean follow-up was 22.11 (±9.95). Distal extrusion of cylinders is a potential complication of the penile prosthesis implantation. Distal corporoplasty was first described by Mulcahy. He reported a series of 14 patients with a follow-up of about 2 years with optimal functional outcomes. Moreover, distal corporoplasty resulted in shorter operative time, better function, less pain, and fewer recurrences than Gortex windsock repair.10 In our experience, distal corporoplasty is a simple and safe procedure in the treatment of distal cylinders extrusion when the prosthetic material is not exposed to the exterior.

Male circumcision decreases penile sensitivity as measured in a large cohort.

Science.gov (United States)

Bronselaer, Guy A; Schober, Justine M; Meyer-Bahlburg, Heino F L; T'Sjoen, Guy; Vlietinck, Robert; Hoebeke, Piet B

2013-05-01

WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: The sensitivity of the foreskin and its importance in erogenous sensitivity is widely debated and controversial. This is part of the actual public debate on circumcision for non-medical reason. Today some studies on the effect of circumcision on sexual function are available. However they vary widely in outcome. The present study shows in a large cohort of men, based on self-assessment, that the foreskin has erogenous sensitivity. It is shown that the foreskin is more sensitive than the uncircumcised glans mucosa, which means that after circumcision genital sensitivity is lost. In the debate on clitoral surgery the proven loss of sensitivity has been the strongest argument to change medical practice. In the present study there is strong evidence on the erogenous sensitivity of the foreskin. This knowledge hopefully can help doctors and patients in their decision on circumcision for non-medical reason. To test the hypothesis that sensitivity of the foreskin is a substantial part of male penile sensitivity. To determine the effects of male circumcision on penile sensitivity in a large sample. The study aimed at a sample size of ≈1000 men. Given the intimate nature of the questions and the intended large sample size, the authors decided to create an online survey. Respondents were recruited by means of leaflets and advertising. The analysis sample consisted of 1059 uncircumcised and 310 circumcised men. For the glans penis, circumcised men reported decreased sexual pleasure and lower orgasm intensity. They also stated more effort was required to achieve orgasm, and a higher percentage of them experienced unusual sensations (burning, prickling, itching, or tingling and numbness of the glans penis). For the penile shaft a higher percentage of circumcised men described discomfort and pain, numbness and unusual sensations. In comparison to men circumcised before puberty, men circumcised during adolescence or

Penile gangrene following condom catheter urinary drainage : A case report

Directory of Open Access Journals (Sweden)

Sandhya Gupta

2016-04-01

Full Text Available External urine collecting devices have been a boon to patients of urinary incontinence since their invention in late 90s. They have replaced the need for uncomfortable indwelling catheters in these patients. As safe as they may be, ghastly complications have occurred infrequently, mostly due to their inappropriate application. Such penile and urethral complications add to the morbidity of the patients significantly. They can be easily avoided by following few simple steps of catheter care, thus emphasizing the need to aware clinicians and health care workers about the correct application methods. Here we discuss a case of 60 year old male who developed penile skin necrosis and urethral fistula due to chronic use of condom catheter.

Persistent pulmonary subsolid nodules: model-based iterative reconstruction for nodule classification and measurement variability on low-dose CT.

Science.gov (United States)

Kim, Hyungjin; Park, Chang Min; Kim, Seong Ho; Lee, Sang Min; Park, Sang Joon; Lee, Kyung Hee; Goo, Jin Mo

2014-11-01

To compare the pulmonary subsolid nodule (SSN) classification agreement and measurement variability between filtered back projection (FBP) and model-based iterative reconstruction (MBIR). Low-dose CTs were reconstructed using FBP and MBIR for 47 patients with 47 SSNs. Two readers independently classified SSNs into pure or part-solid ground-glass nodules, and measured the size of the whole nodule and solid portion twice on both reconstruction algorithms. Nodule classification agreement was analyzed using Cohen's kappa and compared between reconstruction algorithms using McNemar's test. Measurement variability was investigated using Bland-Altman analysis and compared with the paired t-test. Cohen's kappa for inter-reader SSN classification agreement was 0.541-0.662 on FBP and 0.778-0.866 on MBIR. Between the two readers, nodule classification was consistent in 79.8 % (75/94) with FBP and 91.5 % (86/94) with MBIR (p = 0.027). Inter-reader measurement variability range was -5.0-2.1 mm on FBP and -3.3-1.8 mm on MBIR for whole nodule size, and was -6.5-0.9 mm on FBP and -5.5-1.5 mm on MBIR for solid portion size. Inter-reader measurement differences were significantly smaller on MBIR (p = 0.027, whole nodule; p = 0.011, solid portion). MBIR significantly improved SSN classification agreement and reduced measurement variability of both whole nodules and solid portions between readers. • Low-dose CT using MBIR algorithm improves reproducibility in the classification of SSNs. • MBIR would enable more confident clinical planning according to the SSN type. • Reduced measurement variability on MBIR allows earlier detection of potentially malignant nodules.

Subsolid pulmonary nodules: imaging evaluation and strategic management.

Science.gov (United States)

Godoy, Myrna C B; Sabloff, Bradley; Naidich, David P

2012-07-01

Given the higher rate of malignancy of subsolid pulmonary nodules and the considerably lower growth rate of ground-glass nodules (GGNs), dedicated standardized guidelines for management of these nodules have been proposed, including long-term low-dose computed tomography (CT) follow-up (≥3 years). Physicians must be familiar with the strategic management of subsolid pulmonary nodules, and should be able to identify imaging features that suggest invasive adenocarcinoma requiring a more aggressive management. Low-dose CT screening studies for early detection of lung cancer have increased our knowledge of pulmonary nodules, and in particular our understanding of the strong although imperfect correlation of the subsolid pulmonary nodules, including pure GGNs and part-solid nodules, with the spectrum of preinvasive to invasive lung adenocarcinoma. Serial CT imaging has shown stepwise progression in a subset of these nodules, characterized by increase in size and density of pure GGNs and development of a solid component, the latter usually indicating invasive adenocarcinoma. There is close correlation between the CT features of subsolid nodules (SSNs) and the spectrum of lung adenocarcinoma. Standardized guidelines are suggested for management of SSNs.

Improved pulmonary nodule classification utilizing quantitative lung parenchyma features.

Science.gov (United States)

Dilger, Samantha K N; Uthoff, Johanna; Judisch, Alexandra; Hammond, Emily; Mott, Sarah L; Smith, Brian J; Newell, John D; Hoffman, Eric A; Sieren, Jessica C

2015-10-01

Current computer-aided diagnosis (CAD) models for determining pulmonary nodule malignancy characterize nodule shape, density, and border in computed tomography (CT) data. Analyzing the lung parenchyma surrounding the nodule has been minimally explored. We hypothesize that improved nodule classification is achievable by including features quantified from the surrounding lung tissue. To explore this hypothesis, we have developed expanded quantitative CT feature extraction techniques, including volumetric Laws texture energy measures for the parenchyma and nodule, border descriptors using ray-casting and rubber-band straightening, histogram features characterizing densities, and global lung measurements. Using stepwise forward selection and leave-one-case-out cross-validation, a neural network was used for classification. When applied to 50 nodules (22 malignant and 28 benign) from high-resolution CT scans, 52 features (8 nodule, 39 parenchymal, and 5 global) were statistically significant. Nodule-only features yielded an area under the ROC curve of 0.918 (including nodule size) and 0.872 (excluding nodule size). Performance was improved through inclusion of parenchymal (0.938) and global features (0.932). These results show a trend toward increased performance when the parenchyma is included, coupled with the large number of significant parenchymal features that support our hypothesis: the pulmonary parenchyma is influenced differentially by malignant versus benign nodules, assisting CAD-based nodule characterizations.

Venous Ligation: A Novel Strategy for Glans Enhancement in Penile Prosthesis Implantation

Directory of Open Access Journals (Sweden)

Geng-Long Hsu

2014-01-01

Full Text Available Although penile implantation remains a final solution for patients with refractory impotence, undesirable postoperative effects, including penile size reduction and cold sensation of the glans penis, remain problematic. We report results of a surgical method designed to avoid these problems. From 2003 to 2013, 35 consecutive patients received a malleable penile implant. Of these, 15 men (the enhancing group were also treated with venous ligation of the retrocoronal venous plexus, deep dorsal vein, and cavernosal veins. The remaining 20 men formed the control group, treated with only a penile implant. Follow-up ranged from 1.1 to 10.0 years, with an average of 6.7 ± 1.5 years. Although preoperative glanular dimension did not differ significantly between the two groups, significant respective difference at one day and one year postoperatively was found in the glanular circumference (128.8 ± 6.8 mm versus 115.3 ± 7.2 mm and 130.6 ± 7.2 mm versus 100.5 ± 7.3 mm; both P<0.05, radius (38.8 ± 2.7 mm versus 37.1 ± 2.8 mm and 41.5 ± 2.6 mm versus 33.8 ± 2.9 mm; latter P<0.01, and satisfaction rate (91.7% versus 53.3%, P<0.01 as well. Based on our results, selective venous ligation appears to enhance the glans penis dimension in implant patients.

Penile hair coil strangulation of the child

African Journals Online (AJOL)

shanker

complete urethral transection and corporal injury in an uncircum- cised boy inflicted by ligation of thread at ... among adolescents and adults with the concept of helping improve erection in some of them and with ... For the severe cases of penile injury with a glans hanging to the penis by a very slim pedicle, El Bahnasawy ...

Identifying Psychosocial Distress and Stressors Using Distress-screening Instruments in Patients With Localized and Advanced Penile Cancer.

Science.gov (United States)

Dräger, Désirée Louise; Protzel, Chris; Hakenberg, Oliver W

2017-10-01

We examined the effects of treatment on the psychological well-being of patients with localized or advanced penile cancer using screening questionnaires to determine the consecutive need for psychosocial care. Penile cancer is a rare, but highly aggressive, malignancy. The psychological stress of patients with penile cancer arises from the cancer diagnosis per se and the corresponding consequences of treatment. In addition, cancer-specific distress results (eg, fear of metastasis, progression, relapse, death). Studies of the psychosocial stress of penile cancer patients are rare. We undertook a prospective analysis of the data from patients with penile cancer who had undergone surgery or chemotherapy from August 2014 to October 2016 at our department. Patients were evaluated using standardized questionnaires for stress screening and the identification for the need for psychosocial care (National Comprehensive Cancer Network Distress Thermometer and Hornheider screening instrument) and by assessing the actual use of psychosocial support. The average stress level was 4.5. Of all the patients, 42.5% showed increased care needs at the time of the survey. Younger patients, patients undergoing chemotherapy, and patients with recurrence were significantly more integrated with the psychosocial care systems. Finally, 67% of all patients received inpatient psychosocial care. Owing to the potentially mutilating surgery, patients with penile cancer experience increased psychological stress and, consequently, have an increased need for psychosocial care. Therefore, the emotional stress of these patients should be recognized and support based on interdisciplinary collaboration offered. Copyright © 2017 Elsevier Inc. All rights reserved.

MicroRNA Expression Profile in Penile Cancer Revealed by Next-Generation Small RNA Sequencing.

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Li Zhang

Full Text Available Penile cancer (PeCa is a relatively rare tumor entity but possesses higher morbidity and mortality rates especially in developing countries. To date, the concrete pathogenic signaling pathways and core machineries involved in tumorigenesis and progression of PeCa remain to be elucidated. Several studies suggested miRNAs, which modulate gene expression at posttranscriptional level, were frequently mis-regulated and aberrantly expressed in human cancers. However, the miRNA profile in human PeCa has not been reported before. In this present study, the miRNA profile was obtained from 10 fresh penile cancerous tissues and matched adjacent non-cancerous tissues via next-generation sequencing. As a result, a total of 751 and 806 annotated miRNAs were identified in normal and cancerous penile tissues, respectively. Among which, 56 miRNAs with significantly different expression levels between paired tissues were identified. Subsequently, several annotated miRNAs were selected randomly and validated using quantitative real-time PCR. Compared with the previous publications regarding to the altered miRNAs expression in various cancers and especially genitourinary (prostate, bladder, kidney, testis cancers, the most majority of deregulated miRNAs showed the similar expression pattern in penile cancer. Moreover, the bioinformatics analyses suggested that the putative target genes of differentially expressed miRNAs between cancerous and matched normal penile tissues were tightly associated with cell junction, proliferation, growth as well as genomic instability and so on, by modulating Wnt, MAPK, p53, PI3K-Akt, Notch and TGF-β signaling pathways, which were all well-established to participate in cancer initiation and progression. Our work presents a global view of the differentially expressed miRNAs and potentially regulatory networks of their target genes for clarifying the pathogenic transformation of normal penis to PeCa, which research resource also

Penile representations in ancient Greek art.

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Rempelakos, L; Tsiamis, C; Poulakou-Rebelakou, E

2013-12-01

The presentation of the cult of phallus in ancient Greece and the artistic appearance of the phenomenon on vase figures and statues, as indicative of the significant role of the male genitalia in all fertility ceremonies. The examination of a great number of penile representations from the ancient Greek pottery and sculpture and the review of the ancient theater plays (satiric dramas and comedies ). Phallus in artistic representation is connected either with gods of fertility, such as the goat-footed and horned Pan or the ugly dwarf Priapus or the semi-animal nailed figures Satyrs, devotees of the god Dionysus accompanying him in all ritual orgiastic celebrations. Phallus also symbolizes good luck, health and sexuality: people bear or wear artificial phalli exactly like the actors as part of their costume or carry huge penises during the festive ritual processions. On the contrary, the Olympic gods or the ordinary mortals are not imaged ithyphallic; the ideal type of male beauty epitomized in classical sculpture, normally depicts genitals of average or less than average size. It is noteworthy that many of these images belong to athletes during or immediately after hard exercise with the penis shrunk. The normal size genitalia may have been simply a convention to distinguish normal people from the gods of sexuality and fertility, protectors of the reproductive process of Nature. The representation of the over-sized and erected genitalia on vase figures or statues of ancient Greek art is related to fertility gods such as Priapus, Pan and Satyrs and there is strong evidence that imagination and legend were replacing the scientific achievements in the field of erectile function for many centuries.

Mechanisms Involved in Thromboxane A2-induced Vasoconstriction of Rat Intracavernous Small Penile Arteries

DEFF Research Database (Denmark)

Grann, Martin; Comerma Steffensen, Simon Gabriel; Arcanjo, Daniel Dias Rufino

2015-01-01

relaxation in rat mesenteric arteries. Our findings suggest that U46619 contraction depends on Ca2+ influx through L-type and TRP channels, and ROCKdependent mechanisms in penile arteries. Inhibition of the ROCK pathway is a potential approach for the treatment of erectile dysfunction associated......Diabetes is associated with erectile dysfunction and with hypercontractility in erectile tissue and this is in part ascribed to increased formation of thromboxane. Rho kinase (ROCK) is a key regulator of calcium sensitization and contraction in vascular smooth muscle. This study investigated...... the role of calcium and ROCK in contraction evoked by activation of the thromboxane receptors. Rat intracavernous penile arteries were mounted for isometric tension and intracellular calcium ([Ca2+]i) recording and corpus cavernosum for measurements of MYPT1 phosphorylation. In penile arteries, U46619...

Nonsurgical Medical Penile Girth Augmentation: Experience-Based Recommendations.

Science.gov (United States)

Oates, Jayson; Sharp, Gemma

2017-10-01

Penile augmentation is increasingly sought by men who are dissatisfied with the size and/or appearance of their penis. However, augmentation procedures are still considered to be highly controversial with no standardized recommendations reported in the medical literature and limited outcome data. Nevertheless, these procedures continue to be performed in increasing numbers in private settings. Therefore, there is a need for safe, effective, and minimally invasive procedures to be developed, evaluated, and reported in the research literature. In this article, we focus particularly on girth enhancement procedures rather than lengthening procedures as penile girth appears to be particularly important for sexual satisfaction. We discuss the advantages and disadvantages of the common techniques to date, with a focus on the minimally invasive injectable girth augmentation techniques. Based on considerable operative experience, we offer our own suggestions for patient screening, technique selection, and perioperative care. © 2017 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

Partially Cystic Thyroid Nodules: Ultrasound Findings of Malignancy

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Park, Jang Mi; Choi, Yoon Jung; Kwag, Hyon Joo [Dept. of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

2012-09-15

To seek for the ultrasound (US) findings of partially cystic thyroid nodules that are associated with malignancy. We reviewed the US characteristics of 22 surgically confirmed partially cystic papillary carcinomas, and compared them with those of 80 benign partially cystic nodules. The review cases were selected in a random order from a total of 1029 partially cystic nodules that were diagnosed with an US-guided fine needle aspiration biopsy over a period of 8 years (June 2003 to October 2010) at our institution. In partially cystic thyroid nodules, a taller-than-wide shape (100%, p<0.001) and spiculated or microlobulated margin (58.3%, p 0.003) were significantly associated with malignancy. In terms of internal solid portion of the nodule, eccentric configuration (68.0%, p<0.001), non-smooth margin (81.3%, p<0.001), hypoechogenecity (30.0%, p<0.042), and microcalcification (89.5%, p<0.001) were more frequently demonstrated in malignant nodules than benign ones. In partially cystic thyroid nodules, understanding the characteristics of US findings is important to make a precise diagnosis of malignant nodules.

Penile measurements in Tanzanian males: guiding circumcision device design and supply forecasting.

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Chrouser, Kristin; Bazant, Eva; Jin, Linda; Kileo, Baldwin; Plotkin, Marya; Adamu, Tigistu; Curran, Kelly; Koshuma, Sifuni

2013-08-01

Voluntary medical male circumcision decreases the risk in males of HIV infection through heterosexual intercourse by about 60% in clinical trials and 73% at post-trial followup. In 2007 WHO and the Joint United Nations Programme on HIV/AIDS (UNAIDS) recommended that countries with a low circumcision rate and high HIV prevalence expand voluntary medical male circumcision programs as part of a national HIV prevention strategy. Devices for adult/adolescent male circumcision could accelerate the pace of scaling up voluntary medical male circumcision. Detailed penile measurements of African males are required for device development and supply size forecasting. Consenting males undergoing voluntary medical male circumcision at 3 health facilities in the Iringa region, Tanzania, underwent measurement of the penile glans, shaft and foreskin. Age, Tanner stage, height and weight were recorded. Measurements were analyzed by age categories. Correlations of penile parameters with height, weight and body mass index were calculated. In 253 Tanzanian males 10 to 47 years old mean ± SD penile length in adults was 11.5 ± 1.6 cm, mean shaft circumference was 8.7 ± 0.9 cm and mean glans circumference was 8.8 ± 0.9 cm. As expected, given the variability of puberty, measurements in younger males varied significantly. Glans circumference highly correlated with height (r = 0.80) and weight (r = 0.81, each p <0.001). Stretched foreskin diameter moderately correlated with height (r = 0.68) and weight (r = 0.71, each p <0.001). Our descriptive study provides penile measurements of males who sought voluntary medical male circumcision services in Iringa, Tanzania. To our knowledge this is the first study in a sub-Saharan African population that provides sufficiently detailed glans and foreskin dimensions to inform voluntary medical male circumcision device development and size forecasting. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier

Current status of fine needle aspiration for thyroid nodules.

Science.gov (United States)

Ogilvie, Jennifer B; Piatigorsky, Eli J; Clark, Orlo H

2006-01-01

When not to perform fine needle aspiration of a thyroid nodule In summary, FNA of thyroid nodules has become one of the most useful, safe, and accurate tools in the diagnosis of thyroid pathology. Thyroid nodules that should be considered for FNA include any firm, palpable, solitary nodule or nodule associated with worrisome clinical features (rapid growth, attachment to adjacent tissues, new hoarseness, or palpable lymphadenopathy). FNA should also be performed on nodules with suspicious ultrasonographic features (microcalcifications, rounded shape, predominantly solid composition); dominant or atypical nodules in multinodular goiter; complex or recurrent cystic nodules; or any nodule associated with palpable or ultrasonographically abnormal cervical lymph nodes. Finally, FNA should be performed on any abnormal-appearing or palpable cervical lymph nodes. The management of thyroid nodules based on FNA findings is summarized in Table 2. It can be argued that in certain circumstances the results of thyroid FNA do not change the surgical management of a thyroid nodule, and thus preoperative FNA may be unnecessary. These cases include solitary nodules in patients who have a strong family history of thyroid cancer, multiple endocrine neoplasia type II, or radiation to the head and neck. These patients when they have thyroid nodules have at least a 40% risk for thyroid cancer and frequent multifocal or bilateral disease and should undergo total thyroidectomy with or without central neck lymph node dissection. Patients who have multinodular goiter and compressive symptoms, patients who have Graves disease and a thyroid nodule, or patients who have large (greater than 4 cm) or symptomatic unilateral thyroid nodules could also be considered for total thyroidectomy or lobectomy as indicated without preoperative FNA. Finally, patients who have a solitary hyperfunctioning nodule on radioiodine scan and a suppressed TSH have an extremely low incidence of malignancy and may be

Ultrasound stratification of the FDG-avid thyroid nodule

International Nuclear Information System (INIS)

Beech, P.; Lavender, I.; Jong, I.; Soo, G.; Ramdave, S.; Chong, A.; Nandurkar, D.

2016-01-01

Aim: To determine whether the malignancy risk in an 2-["1"8F]-fluoro-2-deoxy-D-glucose (FDG)-avid thyroid nodule can be stratified according to the presence or absence of suspicious ultrasound features and thereby identify which nodules require further cytological assessment. Materials and methods: A retrospective review of FDG-positron-emission tomography (PET) combined with computed tomography (CT) studies with FDG-avid thyroid nodules (defined as FDG uptake greater than blood pool) that were further assessed with ultrasound and fine-needle aspiration cytology or surgery was performed. FDG-avid thyroid nodules were classified as having either suspicious ultrasound features (marked hypo-echogenicity, irregular margins, microcalcifications, marked hypervascularity, or nodules that were taller than they were wide) or no suspicious ultrasound features and these findings were correlated with the subsequent cytological results. Results: Forty-eight FDG-avid thyroid nodules were assessed. On cytological assessment five nodules were malignant (10.4%), nine were indeterminate (18.75%), and 34 were benign (70.8%). On ultrasound, 24 (50%) had no suspicious features and 24 (50%) had one or more suspicious features. Of the nodules with no suspicious features, 22 (91.6%) were benign, two (8.3%) were indeterminate, and none were malignant. Of the nodules with suspicious features, five (20.8%) were malignant, seven (29.1%) were indeterminate, and 12 (50%) were benign. The absence of suspicious ultrasound features demonstrated a strong association with benign cytology (p=0.009). Out of the suspicious sonographic features, marked hypoechoic appearance (p=0.02), irregular margins (p=0.009), and taller than wide morphology (p=0.04) were statistically most significantly associated with malignancy. Conclusion: The rate of malignancy in FDG-avid thyroid nodules is low in the absence of specific suspicious ultrasound features. The SUV values are non-discriminatory to differentiate

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

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Jared Manwaring

2015-01-01

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

Pubertal development of penile Nitric Oxide Synthase (NOS ...

African Journals Online (AJOL)

Conclusion: The number of NADPH-positive fibers increases with age; however similar tumescence was recorded following electrostimulation in all age groups. NOS-nerve growth correlates with serum testosterone level. The increase of NADPH-positive fibers was accompanied by a decrease in the delay of onset of penile ...

Ultrasound-Guided Fine-Needle Aspiration Biopsy of Multiple Thyroid Nodules

International Nuclear Information System (INIS)

Kim, Ji Dae; Bae, Il Hun; Lee, Seung Young; Han, Gi Seok; Cha, Sang Hun; Kim, Sung Jin; Park, Kil Sun; Koong, Sung Soo; Lee, Ok Jun

2006-01-01

To standardize the number of nodules which necessitates ultrasound-guided, fine-needle, aspiration biopsy in patients who have multiple thyroid nodules with the same sonographic characteristics as each other. From February, 2002 to March, 2004, among patients whose diagnosis was confirmed by ultrasound-guided, fine-needle, aspiration biopsy, 545 nodules of 203 patients were found in sonography with more than two thyroid nodules. Each thyroid gland nodule was classified on a score from 0 to 2 points on the basis of the following 5 characteristics: internal content, margin, echogenicity, shape and calcification in sonography. When the score of all characteristics was the same, by deciding on nodules with the same sonographic characteristics and with the score of at least one characteristic being different, we divided the nodules with different sonographic characteristics in a patient. By methods such as given in the preceding descriptions, patients with multiple thyroid nodules were separated into two groups: one in which all nodules had the same sonographic characteristics and another in which nodules have at least one different sonographic characteristic. Then, each pathologic result was searched for the same case and different case in each patient group. Among the 203 patients who were diagnosed with multiple thyroid nodules in ultrasonography, 79 patients (38.9%) had nodules with the same ultrasonographic characteristics and 124 patients (61.1%) had nodules with at least one different ultrasonographic characteristic. All 79 patient's nodules with the same ultrasonographic characteristics in each patient showed the same pathologic result in all cases (100.0%) and there was no case showing a different pathologic result. Otherwise, among the 124 patient's nodules with different ultrasonographic characteristics, each patient showed the same pathologic result in 111 (89.5%) and different pathologic result in 13 (10.5%). In patients who have multiple thyroid nodules

Analysis of nodule meristem persistence and ENOD40 functioning in Medicago truncatula nodule formation

NARCIS (Netherlands)

Wan Xi,

2007-01-01

Medicago root nodules are formed as a result of the interaction of the plant with the soil-borne bacterium Sinorhizobium meliloti. Several plant genes are induced during nodule formation and MtENOD40 is one of the earliest genes activated. The precise function as well as the molecule

Monitoring Cu nodule formation using Ni marker layers

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Lafouresse, M.C., E-mail: mlafouresse@gmail.co [Department of Civil and Earth Resources Engineering, Kyoto University, Katsura, Kyoto 615-8540 (Japan); Fukunaka, Y. [Institute for Nanoscience and Nanotechnology, Waseda University, Shinjuku Ku, Tokyo 169-8555 (Japan); ISS Science Project Office, JAXA, Tsukuba-shi, Ibaraki 305-8505 (Japan); Matsuoka, T. [Department of Civil and Earth Resources Engineering, Kyoto University, Katsura, Kyoto 615-8540 (Japan); Schwarzacher, W. [H. H. Wills Physics Laboratory, Tyndall Avenue, Bristol BS8 1TL (United Kingdom)

2011-04-30

Highlights: {yields} Ni marker layers to monitor electrodeposited Cu nodule morphological evolution. {yields} The edges of the nodules trace out a straight line. {yields} Difference in growth between spheres and hemispheres. {yields} Nodule on nodule growth at high overpotential. {yields} No dramatic effect of the diffusion layer thickness on the film morphology. - Abstract: We have used Ni marker layers to study the evolution of the characteristic spheroidal nodule morphology in electrodeposited Cu films. Ultrathin Ni layers were electrodeposited in-between Cu layers, and cross sections prepared by electrochemical polishing. During growth of a typical spheroidal feature, the edge (i.e. where there is a discontinuity in the surface slope) traces out a straight line in the cross-sectional image. At high overpotential, the cross-sections show nodule-on-nodule growth, giving rise to the well known cauliflower morphology. Rotating disk electrode studies reveal that, surprisingly, the absolute diffusion layer thickness does not appear to play a major role in the development of spheres.

Monitoring Cu nodule formation using Ni marker layers

International Nuclear Information System (INIS)

Lafouresse, M.C.; Fukunaka, Y.; Matsuoka, T.; Schwarzacher, W.

2011-01-01

Highlights: → Ni marker layers to monitor electrodeposited Cu nodule morphological evolution. → The edges of the nodules trace out a straight line. → Difference in growth between spheres and hemispheres. → Nodule on nodule growth at high overpotential. → No dramatic effect of the diffusion layer thickness on the film morphology. - Abstract: We have used Ni marker layers to study the evolution of the characteristic spheroidal nodule morphology in electrodeposited Cu films. Ultrathin Ni layers were electrodeposited in-between Cu layers, and cross sections prepared by electrochemical polishing. During growth of a typical spheroidal feature, the edge (i.e. where there is a discontinuity in the surface slope) traces out a straight line in the cross-sectional image. At high overpotential, the cross-sections show nodule-on-nodule growth, giving rise to the well known cauliflower morphology. Rotating disk electrode studies reveal that, surprisingly, the absolute diffusion layer thickness does not appear to play a major role in the development of spheres.

Host range, symbiotic effectiveness and nodulation competitiveness ...

African Journals Online (AJOL)

ERIC-PCR DNA fingerprinting patterns were used to identify the isolates occupying nodules. All the isolates nodulated cowpea, groundnut (Arachis hypogeae) and mungbean (Vigna radiata), but only AII-2-1, AII-3-4 and BIII-2-2 nodulated soybean (Glycine max). Apart from cowpea where all the isolates were effective, there ...

Experience with Penile Circular Fasciocutaneous Flap in the ...

African Journals Online (AJOL)

With a mean follow-up of 26 months 2 patients developed a stricture at the proximal site of the repaired urethra necessitating resection and re-anastomosis. ... in the form of secondary hemorrhage, ischemia and sloughing of the penile skin, urethrocutaneous fistula which closed spontaneously and a decreased sensation at ...

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

Directory of Open Access Journals (Sweden)

Yuzo Nakano

2014-12-01

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

Assessment of psychosexual adjustment after insertion of inflatable penile prosthesis.

Science.gov (United States)

Tefilli, M V; Dubocq, F; Rajpurkar, A; Gheiler, E L; Tiguert, R; Barton, C; Li, H; Dhabuwala, C B

1998-12-01

To evaluate the psychosexual benefit obtained from multicomponent penile implant surgery in patients with erectile dysfunction. A psychosexual questionnaire was given to 35 patients undergoing penile prosthesis implantation before surgery and at 3 months, 6 months, and 1 year after surgery. The questionnaire consisted of 13 questions scored on a scale from 1 through 5. Results of the questionnaire were statistically analyzed for differences among the preoperative, 3-month postoperative, 6-month postoperative, and 1-year postoperative period. The general linear model evaluation showed a significant difference for each overall combination of the following pairs: preoperative versus 3 months postoperative (P=0.0005) and 3 months postoperative versus 6 months postoperative (P=0.002). There was no overall difference between psychosexual total score at 6 months after surgery and 1 year after prosthesis implantation (P=0.85). The patients perceived improvement in their erectile ability and libido. Concern about obtaining and maintaining an erection during intercourse was significantly alleviated. There was an increase in the frequency of sexual activity and an improvement in satisfaction with sex life. A decrease in feelings of sadness, depression, anxiety, anger, frustration, and embarrassment related to sexual activity was also noted. The current study demonstrates significant improvement in the psychosexual well being of multicomponent penile implant recipients, with attainment of a high level of patient satisfaction up to 1 year after surgery.

What is a Good Looking Penis? How Women Rate the Penile Appearance of Men with Surgically Corrected Hypospadias.

Science.gov (United States)

Ruppen-Greeff, Norma Katharina; Weber, Daniel M; Gobet, Rita; Landolt, Markus A

2015-08-01

Some men with corrected hypospadias perceive their penile appearance to be abnormal, although health professionals consider these results satisfactory. The aim of this study was to investigate how relevant women consider single aspects of penile appearance to be. Moreover, we studied whether women perceive hypospadias-affected surgically repaired genitals (HASRGs) to be as normal-looking as circumcised genitals and identified the most relevant predictors that influence whether a penis is perceived as normal. In this cross-sectional study, 105 women in different age groups (age range: 16-20, 25-30, and 40-45 years) completed a standardized questionnaire. Participants had to rate the importance of eight penile aspects and to indicate how normal they found the appearance of standardized photos of 10 HASRGs and of 10 circumcised genitals. Furthermore, they were asked about demographic characteristics and their sexuality. Results showed that women considered the position and shape of the meatus as the least important penile aspect. Furthermore, results showed that HASRGs with distal hypospadias were perceived to be as normal-looking as circumcised genitals, whereas genitals with more proximal hypospadias were perceived as significantly less normal. However, the difference need not be considered clinically relevant, as the effect size was small. Observer-related predictors of a more positive perception of HASRGs were higher age, higher sexual interest, and perceiving the general cosmetic penile appearance as more important and penile length as less important. Overall, women were found to consider the "position and shape of the meatus" as the least important penile aspect. These findings may stimulate reflections regarding the relevance of surgical correction of the meatus in minor forms of hypospadias. In addition, this study indicates that women perceived genitals of men with distal operated hypospadias (which represents the majority of hypospadias) to be as normal as

South African Papilionoid Legumes Are Nodulated by Diverse Burkholderia with Unique Nodulation and Nitrogen-Fixation Loci

Science.gov (United States)

Beukes, Chrizelle W.; Venter, Stephanus N.; Law, Ian J.; Phalane, Francina L.; Steenkamp, Emma T.

2013-01-01

The root-nodule bacteria of legumes endemic to the Cape Floristic Region are largely understudied, even though recent reports suggest the occurrence of nodulating Burkholderia species unique to the region. In this study, we considered the diversity and evolution of nodulating Burkholderia associated with the endemic papilionoid tribes Hypocalypteae and Podalyrieae. We identified distinct groups from verified rhizobial isolates by phylogenetic analyses of the 16S rRNA and recA housekeeping gene regions. In order to gain insight into the evolution of the nodulation and diazotrophy of these rhizobia we analysed the genes encoding NifH and NodA. The majority of these 69 isolates appeared to be unique, potentially representing novel species. Evidence of horizontal gene transfer determining the symbiotic ability of these Cape Floristic Region isolates indicate evolutionary origins distinct from those of nodulating Burkholderia from elsewhere in the world. Overall, our findings suggest that Burkholderia species associated with fynbos legumes are highly diverse and their symbiotic abilities have unique ancestries. It is therefore possible that the evolution of these bacteria is closely linked to the diversification and establishment of legumes characteristic of the Cape Floristic Region. PMID:23874611

High CRP values predict poor survival in patients with penile cancer

International Nuclear Information System (INIS)

Steffens, Sandra; Kuczyk, Markus A; Schrader, Andres J; Al Ghazal, Andreas; Steinestel, Julie; Lehmann, Rieke; Wegener, Gerd; Schnoeller, Thomas J; Cronauer, Marcus V; Jentzmik, Florian; Schrader, Mark

2013-01-01

High levels of circulating C-reactive protein (CRP) have recently been linked to poor clinical outcome in various malignancies. The aim of this study was to evaluate the prognostic significance of the preoperative serum CRP level in patients with squamous cell carcinoma (SCC) of the penis. This retrospective analysis included 79 penile cancer patients with information about their serum CRP value prior to surgery who underwent either radical or partial penectomy at two German high-volume centers (Ulm University Medical Center and Hannover Medical School) between 1990 and 2010. They had a median (mean) follow-up of 23 (32) months. A significantly elevated CRP level (>15 vs. ≤ 15 mg/l) was found more often in patients with an advanced tumor stage (≥pT2) (38.9 vs. 11.6%, p=0.007) and in those with nodal disease at diagnosis (50.0 vs. 14.6%, p=0.007). However, high CRP levels were not associated with tumor differentiation (p=0.53). The Kaplan-Meier 5-year cancer-specific survival (CSS) rate was 38.9% for patients with preoperative CRP levels above 15 mg/l and 84.3% for those with lower levels (p=0.001). Applying multivariate analysis and focusing on the subgroup of patients without metastasis at the time of penile surgery, both advanced local tumor stage (≥pT2; HR 8.8, p=0.041) and an elevated CRP value (>15 mg/l; HR 3.3, p=0.043) were identified as independent predictors of poor clinical outcome in patients with penile cancer. A high preoperative serum CRP level was associated with poor survival in patients with penile cancer. If larger patient populations confirm its prognostic value, its routine use could enable better risk stratification and risk-adjusted follow-up of patients with SCC of the penis

Qualitative elastography can replace thyroid nodule fine-needle aspiration in patients with soft thyroid nodules. A systematic review and meta-analysis

Energy Technology Data Exchange (ETDEWEB)

Nell, Sjoerd; Kist, Jakob W. [Department of Surgery, University Medical Center Utrecht (Netherlands); Debray, Thomas P.A. [Julius Center for Health Sciences and Primary Care Utrecht (Netherlands); Keizer, Bart de [Department of Radiology and Nuclear Medicine, University Medical Center Utrecht (Netherlands); Oostenbrugge, Timotheus J. van; Borel Rinkes, Inne H.M. [Department of Surgery, University Medical Center Utrecht (Netherlands); Valk, Gerlof D. [Department of Endocrinology, University Medical Center Utrecht (Netherlands); Vriens, Menno R., E-mail: mvriens@umcutrecht.nl [Department of Surgery, University Medical Center Utrecht (Netherlands)

2015-04-15

Context: Only a minority of thyroid nodules is malignant; nevertheless, many invasive diagnostic procedures are performed to distinguish between benign and malignant nodules. Qualitative ultrasound elastography is a non-invasive technique to evaluate thyroid nodules. Objective: To investigate the diagnostic value of qualitative elastography in distinguishing benign from malignant thyroid nodules in patients referred for fine-needle aspiration (FNA). Data sources: A systematic literature search (PubMed, Embase and Cochrane Library) was performed. Study selection: Included studies reported thyroid nodule elastography color scores and the related cytologic or histologic findings in patients with a thyroid nodule referred for FNA. Data extraction: Two independent reviewers extracted study data and assessed study quality. Pooled sensitivities and specificities of different populations were calculated using a bivariate Bayesian framework. Data Synthesis: Twenty studies including thyroid nodules were analyzed. Pooled results of elastography indicate a summary sensitivity of 85% (95% confidence interval [CI], 79–90%) and specificity of 80% (95% CI, 73–86%). The respective pooled negative predictive and positive predictive values were 97% (95% CI, 94–98%) and 40% (95% CI, 34–48%). The pretest probability of a benign nodule was 82%. Only 3.7% of the false-negative nodules was a follicular thyroid carcinoma. A pooled negative predictive value of 99% (95% CI, 97–100%) was found when only complete soft nodules (Asteria elastography 1) were classified as benign, which included 14% of the studied population. Conclusions: Elastography has a fair specificity and sensitivity for diagnostic accuracy. Its major strength entails the detection of benignity, especially when only completely soft nodules are qualified as benign. The outcomes of our analysis show that FNA could safely be omitted in patients referred for analysis of their thyroid nodule when elastography shows it

Isolate pulmonary nodule. CT-guided biopsy

International Nuclear Information System (INIS)

Bruneton, J.N.; Ettore, F.; Rogopoulos, A.; Geoffray, A.; Balu-Maestro, C.; Le Houcq, M.

1989-01-01

Transparietal CT-guided biopsy location can be successfully performed for isolate pulmonary nodules, defined as lesions with a maximal diameter of 3 cm, without any other parenchymal or mediastinal abnormality. A 21 G needle has been used according to an identical protocole in 64 cases (10 benign, 54 malignant). The biopsy was successful in 77.7% of the malignant cases. In relation to the diameter of the nodules, biopsy was successful in 66.7% of the nodules smaller than 2 cm and in 76% of the nodules ranging from 2 to 3 cm. The complications observed were rare (1 case of pneumothorax requiring drainage, 9 cases of pneumothorax without clinical signs and simply followed up, 4 cases of minor hemoptysis requiring no treatment and 5 cases of hematomas smaller than 5 cm on CT) [fr

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

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Theddeus O.H. Prasetyono

2011-08-01

Full Text Available In the midst of on-going non-illicit practice of silicone or paraffin injection to enlarge penis, the author reported 3 cases of surgical treatment to resurface the body of the penis after excision of the destructed penile skin using full thickness skin graft. The skin excision was performed technically through penile body degloving procedure. Full thickness skin graft was then applied as a single sheet donor tissue to cover the denuded penile body spirally. The full thickness graft, which is relatively easy to be performed, is no doubt much thinner than a skin flap, while it also bears a smaller degree of secondary contraction than split skin graft. The color of the skin is considerably matched as it comes from the groin, which is a nearby area of penis. The size and skin sensitization of the penis looks to be natural. The only disadvantage is the common possibility of either spiral or circular junctional scar in between graft edges and between the graft and the penile mucosa and skin to develop hypertrophic scar. However, this possible scar problem applies also to any other surgical scar with any donor tissue. Fortunately, the 3 cases posed no scar problem and normal appearance. All the patients have also regained their normal sexual function. (Med J Indones 2011; 20:222-5Keywords: full thickness skin graft, paraffinoma, siliconoma, sexual function

Pulmonary nodule: new concepts of an Old Problem

International Nuclear Information System (INIS)

Diederich, S.; Wormanns, D.

2003-01-01

In the past, a pulmonary nodule was considered malignant until proven otherwise, usually histologically, which frequently required invasive diagnostic procedures. The nodule was mostly detected on conventional chest radiographs and usually larger than 10 mm. Recently, modern (multi-slice) helical CT detects an increasing number of very small (≤ 10 mm) nodules, which are benign in > 95%. Consequently, the exclusion of malignancy demands different diagnostic procedures, which should be predominantly non-invasive. This article presents the current data as well as imaging techniques for the determination of the nature of pulmonary nodules and suggests concepts for the diagnostic approach to small pulmonary nodules. (orig.) [de

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

International Nuclear Information System (INIS)

Chung, Jin; Chung, Jae Joon; Yu, Jeong Sik; Kim, Joo Hee

2009-01-01

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

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

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

2009-12-15

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

Penile metastases from primary bronchus carcinoma – A case report and literature review

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D.E. Du Plessis

2015-03-01

Conclusions: Cases of metastases to the penis are very rare and often carry a grave prognosis, as it is a late manifestation of malignant disease. The average survival from the diagnosis of penile metastases in our review was just under 4 months. It is however important to be aware and recognise this rare phenomenon, and differentiate it from primary penis cancer. Treatment of penile metastases is mostly palliative, but much can be done to improve the patient's quality of life. Early correct diagnosis may also alter the treatment of the primary tumour.

Management of a solitary thyroid nodule

International Nuclear Information System (INIS)

Rao, R.S.

1999-01-01

Solitary nodule in the thyroid is a common clinical entity. A careful clinical assessment is the crucial first step in deciding the modality of treatment. The only worthwhile investigation is FNAC. Other investigations are done merely for the sake of a complete academic work up and can usually be dispensed with in most of the cases. Not every solitary nodule requires surgery. The optimum surgery for a solitary nodule is a total lobectomy. The specimen should be subjected to histological examination before recommending further treatment

Interobserver-variability of lung nodule volumetry considering different segmentation algorithms and observer training levels

International Nuclear Information System (INIS)

Bolte, H.; Jahnke, T.; Schaefer, F.K.W.; Wenke, R.; Hoffmann, B.; Freitag-Wolf, S.; Dicken, V.; Kuhnigk, J.M.; Lohmann, J.; Voss, S.; Knoess, N.

2007-01-01

Objective: The aim of this study was to investigate the interobserver variability of CT based diameter and volumetric measurements of artificial pulmonary nodules. A special interest was the consideration of different measurement methods, observer experience and training levels. Materials and methods: For this purpose 46 artificial small solid nodules were examined in a dedicated ex-vivo chest phantom with multislice-spiral CT (20 mAs, 120 kV, collimation 16 mm x 0.75 mm, table feed 15 mm, reconstructed slice thickness 1 mm, reconstruction increment 0.7 mm, intermediate reconstruction kernel). Two observer groups of different radiologic experience (0 and more than 5 years of training, 3 observers each) analysed all lesions with digital callipers and 2 volumetry software packages (click-point depending and robust volumetry) in a semi-automatic and manually corrected mode. For data analysis the variation coefficient (VC) was calculated in per cent for each group and a Wilcoxon test was used for analytic statistics. Results: Click-point robust volumetry showed with a VC of <0.01% in both groups the smallest interobserver variability. Between experienced and un-experienced observers interobserver variability was significantly different for diameter measurements (p = 0.023) but not for semi-automatic and manual corrected volumetry. A significant training effect was revealed for diameter measurements (p = 0.003) and semi-automatic measurements of click-point depending volumetry (p = 0.007) in the un-experienced observer group. Conclusions: Compared to diameter measurements volumetry achieves a significantly smaller interobserver variance and advanced volumetry algorithms are independent of observer experience

Penile fracture with disruption of both cavernosal bodies and complete urethral rupture in a 15-years-old male: Delayed surgical approach

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Carolina Talini

2016-09-01

Full Text Available Penile fracture is defined as the traumatic rupture of the tunica albuginea of the corpus cavernosa usually associated to trauma during sexual intercourse or masturbation. Historically penile fracture has been managed conservatively, but contemporary management includes early surgical exploration. The case presents a 15-year-old male who suffered a blunt penile trauma and was first managed with cystostomy and no penile exploration. Five months after trauma was submitted to definitive surgical correction of both, urethral rupture and bilateral corporal fracture. The proposed surgical techinique was a diamond-shape corpora anastomosis. Surgery did well and after 3 years he presented no late complications.

Impact of overexpression of cytosolic isoform of O-acetylserine sulfhydrylase on soybean nodulation and nodule metabolome

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Nitrogen-fixing nodules, which are also major sites of sulfur assimilation, contribute significantly to the sulfur needs of the whole soybean plants. Nodules are the predominant sites for cysteine accumulation and the activity of O-acetylserine sulfhydrylase (OASS; also known as O-acetylserine(thio...

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

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Aluizio Goncalves da Fonseca

2013-07-01

Full Text Available Objectives To evaluate the prevalence, distribution and association of HPV with histological pattern of worse prognosis of penile cancer, in order to evaluate its predictive value of inguinal metastasis, as well as evaluation of other previous reported prognostic factors. Material and Methods Tumor 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.

Sexual outcomes after partial penectomy for penile cancer: results from a multi-institutional study

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Salvatore Sansalone

2017-01-01

Full Text Available Penile cancer is an uncommon malignancy. Surgical treatment is inevitably mutilating. Considering the strong impact on patients′ sexual life we want to evaluate sexual function and satisfaction after partial penectomy. The patients in this study (n = 25 represented all those who attended our institutions and were diagnosed and treated for penile cancer from October 2011 to November 2013. All patients underwent partial penectomy and followed-up (mean: 14 months; range: 12-25. Sexual presurgical baseline was estimated using the International Index of Erectile Dysfunction 15 (IIEF-15. Sexual outcomes of each patient were estimated considering four standardized and validated questionnaires. We analyzed the means and ranges of IIEF-15 including erectile function (IIEF-1-5 and -15, orgasmic function (IIEF-9 and -10, sexual desire (IIEF-11 and -12, intercourse satisfaction (IIEF-6-8, and overall satisfaction (IIEF-13 and -14. Then, we also used Quality of Erection Questionnaire (QEQ, Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS and Self-Esteem and Relationship (SEAR to evaluate the sexual function and satisfaction of our patients. The final results showed that penile cancer leads to several sexual and psychosexual dysfunctions. Nevertheless, patients who undergo partial penectomy for penile cancer can maintain the sexual outcomes at levels slightly lower to those that existed in the period before surgery.

Thyroid nodules with nondiagnostic results on repeat fine-needle aspiration biopsy: which nodules should be considered for repeat biopsy or surgery rather than follow-up?

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Eun, Na Lae; Chang, Hang Seok; Gweon, Hye Mi; Kim, Jeong Ah; Youk, Ji Hyun; Son, Eun Jun [Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Yoo, Mi Ri [Dept. of Radiology, Dongjak Kyunghee Hospital, Seoul (Korea, Republic of); Park, Ah Young [Dept. of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan (Korea, Republic of); Moon, Hee Jung [Dept. of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

2016-07-15

The goal of this study was to assess the clinicopathologic and ultrasonographic features of thyroid nodules with nondiagnostic results on repeat ultrasonography (US)-guided fineneedle aspiration biopsy (FNAB) according to size and the number of suspicious findings and to determine the proper management of nodules with consecutive nondiagnostic results. This retrospective study included 297 nodules with nondiagnostic results on repeat FNAB that were evaluated by US over the course of at least 12 months of follow-up, a follow-up biopsy, or an operation. We compared clinical and US variables between benign and malignant nodules in thyroid nodules with repeat nondiagnostic results. The comparison of benign and malignant nodules with repeat nondiagnostic results revealed that age, marked hypoechogenicity, irregular or microlobulated margins, microcalcifications, and nonparallel shape were significantly associated with malignancy. Multivariate logistic regression analysis in malignant nodules revealed that microcalcifications and irregular or microlobulated margins were independently associated with malignancy. Among them, only irregular or microlobulated margins were independently significant as a predictor of malignancy in repeatedly nondiagnostic nodules measuring >10 mm. Using receiver operating characteristic analysis, the best cutoff value for the “number of suspicious findings” between benign and malignant nodules was three in nodules of all sizes, three in nodules measuring ≤10 mm, and two in nodules measuring >10 mm. Irregular or microlobulated margins may be the most frequent US features in repeatedly nondiagnostic nodules >10 mm. The presence of “two or more suspicious findings” can be used as the cutoff for distinguishing benign and malignant nodules.

Self and partner satisfaction rates after 3 part inflatable penile prosthesis implantation.

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Simsek, Abdulmuttalip; Kucuktopcu, Onur; Ozgor, Faruk; Ozkuvanci, Unsal; Baykal, Murat; Sarilar, Omer; Gurbuz, Zafer Gokhan

2014-09-30

To evaluate and present satisfaction rates of our patients and their partners after 3 part inflatable penile prosthesis implantation. We searched our hospital electronic data for patients who underwent inflatable penile prosthesis implantation between January 2008 and July 2013. Computer and archived file data were used to get information and reach the patients. We made telephone calls to patients and asked questionnaires about self and partner satisfaction rates. 36 patients underwent prosthesis implantation during the 5 year period. We were able to reach by telephone call 18 of them. The mean age of 18 patients was 55.7 ± 9.4 years and mean body mass index was 24.6 ± 2.1 kg/m2. The etiology was diabetes mellitus on 14 (77.8%) and radical pelvic surgery on 4 (22.2%) patients. 14 of 18 patients had penile Doppler ultrasound test. Doppler ultrasound demonstrated venous insufficiency in 8 and arterial insufficiency in 6 patients. Mean time from implantation to study was 20.8 ± 13.9 months. Out of 18 patients 2 had prosthesis removal operation because of infection in one patient and perforation in the other. Satisfaction rate was 88.9%, and recommendation rate was 94.4%. Causes of dissatisfaction were pain in one patient and insufficient rigidity plus shortening of the penis in the other one. Partner satisfaction rate was 94.4%. Penile Prosthesis Implantation (PPI) is the gold standard treatment of erectile dysfunction (ED) irresponsive to medical treatment. Infection and mechanical failure rates are going to be less according to the improvements in synthetic materials and coverings of the prosthesis, so patient and partner satisfaction rates will be higher.

Segmentation of nodules on chest computed tomography for growth assessment

International Nuclear Information System (INIS)

Mullally, William; Betke, Margrit; Wang Jingbin; Ko, Jane P.

2004-01-01

Several segmentation methods to evaluate growth of small isolated pulmonary nodules on chest computed tomography (CT) are presented. The segmentation methods are based on adaptively thresholding attenuation levels and use measures of nodule shape. The segmentation methods were first tested on a realistic chest phantom to evaluate their performance with respect to specific nodule characteristics. The segmentation methods were also tested on sequential CT scans of patients. The methods' estimation of nodule growth were compared to the volume change calculated by a chest radiologist. The best method segmented nodules on average 43% smaller or larger than the actual nodule when errors were computed across all nodule variations on the phantom. Some methods achieved smaller errors when examined with respect to certain nodule properties. In particular, on the phantom individual methods segmented solid nodules to within 23% of their actual size and nodules with 60.7 mm3 volumes to within 14%. On the clinical data, none of the methods examined showed a statistically significant difference in growth estimation from the radiologist

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

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Lin Wang

2015-01-01

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

Detection of small pulmonary nodules in high-field MR at 3 T: evaluation of different pulse sequences using porcine lung explants

International Nuclear Information System (INIS)

Regier, M.; Kaul, M.G.; Ittrich, H.; Bansmann, P.M.; Kemper, J.; Nolte-Ernsting, C.; Adam, G.; Kandel, S.; Hoffmann, B.; Heller, M.; Biederer, J.

2007-01-01

To evaluate two MR imaging sequences for the detection of artificial pulmonary nodules inside porcine lung explants. 67 agarose nodules ranging 3-20 mm were injected into ten porcine lungs within a dedicated chest phantom. The signal on T1-weighted images and radiopacity were adjusted by adding 0.125 mmol/l Gd-DTPA and 1.5 g/l of iodine. A T1-weighted three-dimensional gradient-echo (T1-3D-GRE; TR/TE:3.3/1.1 ms, slice:8 mm, flip-angle:10 ) and a T2-weighted half-Fourier fast-spin echo sequence (T2-HF-FSE; TR/TE:2000/66 ms, slice:7 mm, flip-angle:90 ) were applied in axial orientation using a 3-T system (Intera, Philips Medical Systems, Best, The Netherlands), followed by CT (16 x 0.5 mm) as reference. Nodule sizes and locations were assessed by three blinded observers. In nodules of >10 mm, sensitivity was 100% using 3D-GRE-MRI and 94% using the HF-FSE sequence. For nodules 6-10 mm, the sensitivity of MRI was lower than with CT (3D-GRE:92%; T2-HF-FSE:83%). In lesions smaller than 5 mm, the sensitivity declined to 80% (3D-GRE) and 53% (HF-FSE). Small lesion diameters were overestimated with both sequences, particularly with HF-FSE. This study confirms the feasibility of 3 T-MRI for lung nodule detection. In lesions greater than 5 mm, the sensitivity of the 3D-GRE sequence approximated CT (>90%), while sensitivity and PPV with the HF-FSE sequence were slightly inferior. (orig.)

Near total penile amputation caused by hair tourniquet, managed ...

African Journals Online (AJOL)

The hair tourniquet syndrome is an unusual phenomenon which can cause severe damage to the affected organ, sometimes even its loss. This problem requires urgent attention and prompt management to ensure anatomical and functional preservation. Herein we report a case of penile hair tourniquet which was ...

Comparing caudal and penile nerve blockade using bupivacaine in ...

African Journals Online (AJOL)

Background: Caudal anaesthesia is recommended for most surgical procedures of the lower part of the body, mainly below the umbilicus. It has been well established that a dorsal penile nerve block immediately after surgery decreases postoperative pain in children undergoing hypospadias repair. This study aimed to ...

Pseudoexstrophy associated with penile duplication and hypospadias: A case report and literature review

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Gursev Sandlas

2018-05-01

Full Text Available Bladder exstrophy is a rare developmental anomaly. Four principle variants of bladder exstrophy have been described and they themselves are rarer than the bladder exstrophy. Authors describe the management of a case of pseudoexstrophy type of variant in a 9 month old male child with penile duplication with torsion and coronal hypospadias. The rectal fascial defect was repaired without osteotomy as the distance between two pubic bones was <4 cm (3.1 cm. Genital reconstruction with excision of duplicate atrophic penile shaft and repair of coronal hypospadias with detorsion of the functional penile shaft could be accomplished. The patient had good outcome in terms of cosmesis and urinary stream. Total of 18 cases of the pseudoexstrophy have been described till date. Pseudoexstrophy of bladder is a very rare condition and can simultaneously present with other defects like omphalocele, anorectal malformations, pouch colon, multiple or solitary urogenital anomalies. The principles of correction though remain same with correction of abdominal wall defect with or without osteotomy depending upon severity of pubic diastasis. Other anomalies can undergo treatment as per standard protocol.

Uranium in Pacific deep-sea sediments and manganese nodules

International Nuclear Information System (INIS)

Kunzendorf, H.; Plueger, W.L.; Friedrich, G.H.

1983-01-01

A total of 1344 manganese nodules and 187 pelagic sediments from 9 areas in the North and the South Pacific were analyzed for U by the delayed-neutron counting technique. A strong positive correlation between U and Fe in nodules and sediments suggests a co-precipitative removal from sea water into the Fe-rich (ferromanganese mineral phase MnO 2 . Enrichment of U and Fe in nodules from the northwestern slopes of two submarine hills (U between 6 and 9 ppm) in the equatorial nodule belt is thought to be caused by directional bottom water flow creating elevated oxygenized conditions in areas opposed to the flow. Economically important nodule deposits from the nodule belt and the Peru Basin have generally low U contents, between 3 and 5 ppm. Insignificant resources of U of about 4 x 10 5 in the Pacific manganese nodules are estimated. (orig.)

[Penis-preserving surgery in patients with primary penile urethral cancer].

Science.gov (United States)

Maek, M; Musch, M; Arnold, G; Kröpfl, D

2014-12-01

Primary urethral cancer in males is a rare entity with only approximately 800 cases described, which is why it is difficult to formulate evidence-based guidelines for treatment. For tumors in the pT2 stage with a localization distal to the membranous urethra, a penis-preserving operation can be carried out. In the period from November 2006 to February 2014 a total of 4 patients with primary urethral cancer underwent a penis-preserving urethral resection. The tumor characteristics and treatment results were collated retrospectively. Of the four patients one had a transitional cell carcinoma of the mid-penile urethra in stage pT2 G2. In two out of the four patients a squamous cell carcinoma (PEC) was present in the mid-penile urethra in stages pT2 G2 and pT2 G3, respectively, with concomitant carcinoma in situ (CIS). The fourth patient had a PEC of the fossa terminalis in stage pT2 G2. Initially all patients underwent a penis-preserving resection. In one case, despite an initial R0 resection a local recurrence occurred and a complete penectomy was performed. Irradiation and lymphadenectomy were not carried out. At a mean follow-up of 37 months all patients are currently in complete remission. Primary penile urethral cancer can be treated by a penis-preserving operation. Close follow-up is essential because recurrence can arise despite an initial R0 resection.

Vasculature surrounding a nodule: A novel lung cancer biomarker.

Science.gov (United States)

Wang, Xiaohua; Leader, Joseph K; Wang, Renwei; Wilson, David; Herman, James; Yuan, Jian-Min; Pu, Jiantao

2017-12-01

To investigate whether the vessels surrounding a nodule depicted on non-contrast, low-dose computed tomography (LDCT) can discriminate benign and malignant screen detected nodules. We collected a dataset consisting of LDCT scans acquired on 100 subjects from the Pittsburgh Lung Screening study (PLuSS). Fifty subjects were diagnosed with lung cancer and 50 subjects had suspicious nodules later proven benign. For the lung cancer cases, the location of the malignant nodule in the LDCT scans was known; while for the benign cases, the largest nodule in the LDCT scan was used in the analysis. A computer algorithm was developed to identify surrounding vessels and quantify the number and volume of vessels that were connected or near the nodule. A nonparametric receiver operating characteristic (ROC) analysis was performed based on a single nodule per subject to assess the discriminability of the surrounding vessels to provide a lung cancer diagnosis. Odds ratio (OR) were computed to determine the probability of a nodule being lung cancer based on the vessel features. The areas under the ROC curves (AUCs) for vessel count and vessel volume were 0.722 (95% CI=0.616-0.811, plung cancer group 9.7 (±9.6) compared to the non-lung cancer group 4.0 (±4.3) CONCLUSION: Our preliminary results showed that malignant nodules are often surrounded by more vessels compared to benign nodules, suggesting that the surrounding vessel characteristics could serve as lung cancer biomarker for indeterminate nodules detected during LDCT lung cancer screening using only the information collected during the initial visit. Copyright © 2017 Elsevier B.V. All rights reserved.

Proton MR spectroscopy in solitary pulmonary nodules: a preliminary study

International Nuclear Information System (INIS)

Yang Chunshan; Xiao Xiangsheng; Li Huimin; Liu Shiyuan; Li Chengzhou; Li Shenjiang

2005-01-01

Objective: To study the characteristics and the regularities of the metabolites in solitary pulmonary nodules with proton MR spectroscopy, and to investigate the clinical value of MR spectroscopy in differentiating benign from malignant pulmonary nodules. Methods: Sixty-nine patients with solitary pulmonary nodules underwent routine MRI and single-voxel MR spectroscopy using Siemens Vision 1.5 T MR system. MR spectroscopy characteristics and parameters of the metabolites were observed and recorded. Ten pathologic specimens were examined with single-voxel MR spectroscopy. The MR spectroscopy results of the pathologic specimens were compared with those of the solitary pulmonary nodules in vivo. Results: The Cho peak (2.86 ± 1.89) of the malignant nodules was higher than that of the inflammatory (0.87 ± 0.74), tuberculous nodules (0.97 ± 1.09), and hamartoma (0.42 ± 0.53) (P 0.05). Conclusion: MR spectroscopy is reliable in evaluating pulmonary nodules in vivo. The Cho peak, Cho/Cr, and Lac peak of the malignant nodules were higher than those of inflammatory, tuberculous nodules, and hamartoma. MR spectroscopy is helpful in differentiating benign from malignant pulmonary nodules. (authors)

Dipyridamole reduces penile apoptosis in a rat model of post-prostatectomy erectile dysfunction

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Omer Kutlu

Full Text Available ABSTRACT Purpose: Despite the nerve-sparing technique, many patients suffer from erectile dysfunction after radical prostatectomy (RP due to cavernous nerve injury. The aim of this study was to evaluate dipyridamole as a potential treatment agent of post-radical prostatectomy erectile dysfunction. Material and methods: A total of 18 male Sprague-Dawley rats were randomized into three experimental Groups (SHAM+DMSO, BCNI+DMSO and BCNI+DIP. An animal model of bilateral cavernous nerve crush injury (BCNI was established to mimic the partial nerve damage during nerve-sparing RP. After creating of BCNI, dimethyl sulphoxide (DMSO was administered transperitoneally as a vehicle to SHAM+DMSO and BCNI+DMSO Groups. BCNI+DIP Group received dipyiridamole (10mg/kg/day as a solution in DMSO for 15 days. Afterwards, rats were evaluated for in vivo erectile response to cavernous nerve stimulation. Penile tissues were also analyzed biochemically for transforming growth factor-β1 (TGF-β1 level. Penile corporal apoptosis was determined by TUNEL method. Results: Erectile response was decreased in rats with BCNI and there was no significant improvement with dipyridamole treatment. TGF-β1 levels were increased in rats with BCNI and decreased with dipyridamole treatment. Dipyridamole led to reduced penile apoptosis in rats with BCNI and there was no significant difference when compared to sham operated rats. Conclusions: Although fifteen-day dipyridamole treatment has failed to improve erectile function in rats with BCNI, the decline in both TGF-β1 levels and apoptotic indices with treatment may be helpful in protecting penile morphology after cavernous nerve injury.

Near total penile amputation caused by hair tourniquet, managed ...

African Journals Online (AJOL)

V.K. Dikshit

2015-12-02

Dec 2, 2015 ... Abstract. The hair tourniquet syndrome is an unusual phenomenon which can cause severe damage to the affected organ, sometimes even its loss. This problem requires urgent attention and prompt management to ensure anatomical and functional preservation. Herein we report a case of penile hair ...

[Penile enhancement surgery: widening and lengthening lipopenisculpture].

Science.gov (United States)

Abecassis, M; Berreby, S; Boccara, D

2010-04-01

The male genitalia cosmetic surgery matches an ever growing need. The aim of this study is to describe our penile lengthening and widening procedures, the benefits and complications that could result from it. We perform these procedures since 1992 and treated close to 2000 patients. Thanks to our expertise and after succeeding in standardizing our techniques, we achieved a retrospective survey on 103 patients operated between 2004 and 2006. We describe here the two processes of our operating technique and we analyse the results obtained 1 month, 3 months and 1 year after the surgery. In most cases, combining a penis adipose tissue grafting, a suspensory ligament section and an adequate skin plasty is proven to be necessary in order to obtain both lengthening and widening increases. One year later, the increase is about 2.7 cm in length, corresponding to 28%, and 2.6 cm in circumference, corresponding to 27%. The complications (cutaneous necrosis, haematoma, lymphoedema, disharmonies), whenever they may exist, are most of the time spontaneously resolutive. Combining a penile fat tissue grafting with a suspensory ligament section allows us to answer to most of patients' expectations. However, several liposculpturing sessions might be necessary in order to get satisfactory results. Copyright 2009 Elsevier Masson SAS. All rights reserved.

TIRADS for sonographic assessment of hypofunctioning and indifferent thyroid nodules.

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Schenke, Simone; Rink, T; Zimny, M

2015-01-01

To test the feasibility of the Thyroid Imaging Reporting And Data System (TIRADS) according to Horvath and Kwak for the assessment of thyroid nodules. Retrospective analysis of patients with thyroid nodules applying the following inclusion criteria: B-mode-ultrasound, surgery and histological results. Thyroid nodules were classified as TIRADS 2, 3, 4A, 4B, 4C, 5 and 6. A total of 172 patients were included (133 women, 48 ± 13 years, 39 men, 49 ± 11 years) with 222 thyroid nodules (24.9 ± 11.5 mm). Final histological diagnosis revealed 203 benign nodules (91%) and 19 malignant nodules (9%; 18 papillary thyroid carcinoma, PTC, and one medullary thyroid carcinoma, MTC). One hundred and sixty thyroid nodules were hypofunctioning in 99mTc-pertechnetate-scintigraphy, 14 nodules were hyperfunctioning and 46 nodules were classified as indifferent. In two cases with small carcinoma nodules (39%) were not clearly classifiable, including 3 carcinoma (4.1%). According to Kwak, the prevalence of malignancy was 6.9% in TIRADS 2, 0% in 3, 2% in 4A, 4.1% in 4B, 23.1% in 4C, and 100% in 5 and 6, respectively. Notably, in the subgroup of hot nodules, 11 (79%) were graded as TIRADS 4A or higher, and thus advisable for fine-needle aspiration biopsy in both TIRADS. The TIRADS described by Horvath is not practicable due to numerous unclassifiable nodules. The revised TIRADS published by Kwak is feasible and suitable to assess the prevalence of malignancy, but it cannot replace scintigraphic imaging. Fine-needle-biopsy is not necessary in nodules categorized as (K)TIRADS 3, 4A and 5.

Is there an inhibitory role of cortisol in the mechanism of male sexual arousal and penile erection?

Science.gov (United States)

Uckert, Stefan; Fuhlenriede, Mark H; Becker, Armin J; Stief, Christian G; Scheller, Friedemann; Knapp, Wolfram H; Jonas, Udo

2003-12-01

It has been speculated for more than 2 decades whether there is a significance of adrenal corticosteroids, such as cortisol, in the process of normal male sexual function, especially in the control of sexual arousal and the penile erectile tissue. However, only few in vivo studies have been carried out up until now on the effects of cortisol on human male sexual performance and penile erection. In order to evaluate further the role of cortisol in male sexual activity, the present study was conducted to detect serum levels of cortisol in the systemic and cavernous blood taken during different penile conditions from healthy males. The effects of cortisol derivative prednisolone, catecholamine norepinephrine (NE) and the peptide endothelin-1 (ET-1) on isolated human corpus cavernosum (HCC) were investigated using the organ bath technique. Fifty-four healthy adult male subjects were exposed to erotic stimuli in order to elicit penile tumescence and rigidity. Whole blood was simultaneously aspirated from the corpus cavernosum and the cubital vein during different penile conditions. Serum levels of cortisol (microg/dl) were determined by means of a radioimmunoassay (ELISA). In the healthy volunteers, cortisol serum levels significantly decreased in the systemic circulation and the cavernous blood with increasing sexual arousal, when the flaccid penis became rigid. During detumescence, the mean cortisol level remained unaltered in the systemic circulation, whereas in the cavernous compartment, it was found to decrease further. Under all penile conditions, no significant differences were registered between cortisol levels in the systemic circulation and in the cavernous blood. Cumulative addition of NE and ET-1 (0.001-10 microM) induced contraction of isolated HCC strips, whereas the contractile response to prednisolone was negligible. Our results strongly suggest an inhibitory role for cortisol in the mechanism of male sexual response and behaviour. These properties are

[Nodules on localized scleroderma or morphea].

Science.gov (United States)

Bayle, P; Bazex, J; Marguery, M-C; Lamant, L

2005-02-01

Localized scleroderma or morphea usually appears as flat or depressed lesions. We report 3 cases of morphea with atypical appearance, alternating pigmented and depigmented patches with nodules or sclerous bands, occurring in adult men. The occurrence of nodular elements on generalized or localized scleroderma, although rare, was first reported in the literature by Addisson in 1884. These nodules usually appear during evolution. These scleroderma are then described as being keloidal or nodular. We report 3 cases of nodules on localized scleroderma which appeared at the beginning of the dermatosis and where the scleroderma had a similar unusual irregularly pigmented appearance.

Evaluation of thyroid nodules by 123I thyroid scintigraphy and computed tomography

International Nuclear Information System (INIS)

Kurihara, Yoshiko; Imanishi, Yoshimasa; Ehara, Norishige

1991-01-01

We have already reported that computed tomography (CT) could be used to quantify iodine concentration in the thyroid. Correlation between CT value and iodine concentration in thyroid tissues was represented by the following formula (n=31, r=0.96): iodine concentration=(CT value-65)/104 (mg/g). In this study, we evaluated thyroid nodules by 123 I thyroid scintigraphy and histograms of CT values in the nodules. Radioiodine accumulation and the histograms on CT of the thyroid nodules were correlated with the histopathology of 35 thyroid nodules (22 benign nodules, 13 malignant nodules) of 27 patients. Results showed no definite correlation between radioiodine accumulation in the thyroid nodule and the pattern on CT reflecting iodine concentration in the nodule. Some nodules with little radioiodine accumulation had considerable iodine concentration. Benign thyroid nodules tended to have lower iodine concentration than malignant nodules. Fifteen (94%) of 16 nodules showing only minimal iodine concentration were benign. We conclude that the function and/or differentiation of tumor cells in the thyroid nodule must be evaluated not only radioiodine accumulation in the nodule but also by iodine concentration in the nodule and that thyroid nodules with only minimal iodine concentration are most likely benign. (author)

Percutaneous radiofrequency ablation for benign nodules of the thyroid gland

International Nuclear Information System (INIS)

Baek, Jung Hwan; Jeong, Hyun Jo; Kim, Yoon Suk; Kwak, Min Sook; Chang, Sun Hee; Rhim, Hyun Chul

2005-01-01

We wanted to evaluate the efficacy and safety of using ultrasound guided percutaneous radiofrequency ablation for the benign nodules of the thyroid gland. We studied 148 patients with benign thyroid nodules (200 total nodules) that were confirmed histopathologically, and we performed ultrasound guided radiofrequency ablation. The radiofrequency ablation was done 1 to 5 times per one nodule, and follow-up ultrasonography was performed one to nineteen months after the ablation procedures. The physical changes and the decrease of volume of the nodules were evaluated, and the complications related to radiofrequency ablation were observed. The mean initial nodule volume was 0.01-95.61 ml (mean; 6.83 ± SD of 10.63 ml) and the nodule volume after radiofrequency ablation was decreased to 0.00-46.56 ml (mean; 1.83 ± SD of 4.69 ml). The mean volume reduction rate was 73.2%. Reduction of more than 50% was noted in 90% of all cases. For 180 nodules (90%), the decrease was 50% or more, in 20 nodules (10%), the decrease was 49% or less. On gray-scale ultrasonogram obtained after ablation, the echogenicity of the nodules changed to darker, and on the doppler-sonogram, the vascular flow within the nodules disappeared in all cases. Most patients complained pain during or right after the procedure, but the pain was transient and subsided after medication. Two patients developed hoarseness that was improved in 1 week and 2 months, respectively. Sonoguided percutaneous radiofrequency ablation can be one of the treatments for benign nodules of the thyroid gland

Methotrexate in the treatment of penile carcinoma.

Science.gov (United States)

Sklaroff, R B; Yagoda, A

1980-01-15

Eight patients with epidermoid carcinoma of the penis received methotrexate, five with high-dose methotrexate, 250--1500 mg/m2 with citrovorum rescue Q 2--4 weeks, and three with low-dose methotrexate, 0.5--3.0 mg/kg weekly. Three (38%) patients achieved a complete or partial remission which persisted for 11, 3 and 2 months, respectively. Methotrexate appears to be an active agent in the treatment of advanced penile cancer.

Penile Inversion Vaginoplasty with or without Additional Full-Thickness Skin Graft: To Graft or Not to Graft?

Science.gov (United States)

Buncamper, Marlon E; van der Sluis, Wouter B; de Vries, Max; Witte, Birgit I; Bouman, Mark-Bram; Mullender, Margriet G

2017-03-01

Penile inversion vaginoplasty is considered to be the gold standard for gender reassignment surgery in transgender women. The use of additional full-thickness skin graft as neovaginal lining is controversial. Some believe that having extra penile skin for the vulva gives better aesthetic results. Others believe that it gives inferior functional results because of insensitivity and skin graft contraction. Transgender women undergoing penile inversion vaginoplasty were studied prospectively. The option to add full-thickness skin graft is offered in patients where the penile skin length lies between 7 and 12 cm. Neovaginal depth was measured at surgery and during follow-up (3, 13, 26, and 52 weeks postoperatively). Satisfaction with the aesthetic result, neovaginal depth, and dilation regimen during follow-up were recorded. Satisfaction, sexual function, and genital self-image were assessed using questionnaires. A total of 100 patients were included (32 with and 68 without additional full-thickness skin graft). Patient-reported aesthetic outcome, overall satisfaction with the neovagina, sexual function, and genital self-image were not significantly associated with surgical technique. The mean intraoperative neovaginal depth was 13.8 ± 1.4 cm. After 1 year, this was 11.5 ± 2.5 cm. The largest decline (-15 percent) in depth is observed in the first 3 postoperative weeks (p skin graft use, in penile inversion vaginoplasty. The additional use of full-thickness skin graft does not influence neovaginal shrinkage, nor does it affect the patient- and physician-reported aesthetic or functional outcome. Therapeutic, IV.

Self and partner satisfaction rates after 3 part inflatable penile prosthesis implantation

Directory of Open Access Journals (Sweden)

Abdulmuttalip Simsek

2014-09-01

Full Text Available Objective: To evaluate and present satisfaction rates of our patients and their partners after 3 part inflatable penile prosthesis implantation. Materials and methods: We searched our hospital electronic data for patients who underwent inflatable penile prosthesis implantation between January 2008 and July 2013. Computer and archived file data were used to get information and reach the patients. We made telephone calls to patients and asked questionnaires about self and partner satisfaction rates. Results: 36 patients underwent prosthesis implantation during the 5 year period. We were able to reach by telephone call 18 of them. The mean age of 18 patients was 55.7 ± 9.4 years and mean body mass index was 24.6 ± 2.1 kg/m2. The etiology was diabetes mellitus on 14 (77.8% and radical pelvic surgery on 4 (22.2% patients. 14 of 18 patients had penile Doppler ultrasound test. Doppler ultrasound demonstrated venous insufficiency in 8 and arterial insufficiency in 6 patients. Mean time from implantation to study was 20.8 ± 13.9 months. Out of 18 patients 2 had prosthesis removal operation because of infection in one patient and perforation in the other. Satisfaction rate was 88.9%, and recommendation rate was 94.4%. Causes of dissatisfaction were pain in one patient and insufficient rigidity plus shortening of the penis in the other one. Partner satisfaction rate was 94.4%. Conclusion: Penile Prosthesis Implantation (PPI is the gold standard treatment of erectile dysfunction (ED irresponsive to medical treatment. Infection and mechanical failure rates are going to be less according to the improvements in synthetic materials and coverings of the prosthesis, so patient and partner satisfaction rates will be higher.

The thyroid nodule. Thyrotropin and peripheral thyroid hormones

International Nuclear Information System (INIS)

Zimny, M.

2008-01-01

Thyrotropin, free triodothyronine and thyroxine represent the standard serological parameters for the diagnostic work-up of the thyroid but only a minority of thyroid nodules present with subclinical or overt thyroid disorders. Besides a review of the regulation and principle of function of thyroid hormones as well as the effects of subclinical or overt hyperthyroidism, the significant role of these parameters beyond the assessment of hyperthyroidism in thyroid nodules is discussed. There is evidence that the level of thyrotropin within the normal range is predictive for the relevance of autonomous functioning nodules and the risk of malignancy of non-functioning thyroid nodules. Furthermore, the ratio of triodothyronine and thyroxine indicates the etiology of hyperthyroidism. Thyrotropin represents the main parameter to determine the adequate dose of thyroid hormone therapy of thyroid nodules. (orig.)

Semi-automated volumetric analysis of artificial lymph nodes in a phantom study

International Nuclear Information System (INIS)

Fabel, M.; Biederer, J.; Jochens, A.; Bornemann, L.; Soza, G.; Heller, M.; Bolte, H.

2011-01-01

Purpose: Quantification of tumour burden in oncology requires accurate and reproducible image evaluation. The current standard is one-dimensional measurement (e.g. RECIST) with inherent disadvantages. Volumetric analysis is discussed as an alternative for therapy monitoring of lung and liver metastases. The aim of this study was to investigate the accuracy of semi-automated volumetric analysis of artificial lymph node metastases in a phantom study. Materials and methods: Fifty artificial lymph nodes were produced in a size range from 10 to 55 mm; some of them enhanced using iodine contrast media. All nodules were placed in an artificial chest phantom (artiCHEST ® ) within different surrounding tissues. MDCT was performed using different collimations (1–5 mm) at varying reconstruction kernels (B20f, B40f, B60f). Volume and RECIST measurements were performed using Oncology Software (Siemens Healthcare, Forchheim, Germany) and were compared to reference volume and diameter by calculating absolute percentage errors. Results: The software performance allowed a robust volumetric analysis in a phantom setting. Unsatisfying segmentation results were frequently found for native nodules within surrounding muscle. The absolute percentage error (APE) for volumetric analysis varied between 0.01 and 225%. No significant differences were seen between different reconstruction kernels. The most unsatisfactory segmentation results occurred in higher slice thickness (4 and 5 mm). Contrast enhanced lymph nodes showed better segmentation results by trend. Conclusion: The semi-automated 3D-volumetric analysis software tool allows a reliable and convenient segmentation of artificial lymph nodes in a phantom setting. Lymph nodes adjacent to tissue of similar density cause segmentation problems. For volumetric analysis of lymph node metastases in clinical routine a slice thickness of ≤3 mm and a medium soft reconstruction kernel (e.g. B40f for Siemens scan systems) may be a suitable

The Penile Perception Score after distal hypospadias repair with ...

African Journals Online (AJOL)

perception, including the following items: meatus, glans, skin, and general appearance. The pediatric Penile. Perception Score (PPS) was calculated, consisting of the sum of these four items, and the study proved that pediatric PPS is a significant self-assessment test for repair and for appraisal for surgical procedures used ...

Thyroid nodule classification using ultrasound elastography via linear discriminant analysis.

Science.gov (United States)

Luo, Si; Kim, Eung-Hun; Dighe, Manjiri; Kim, Yongmin

2011-05-01

The non-surgical diagnosis of thyroid nodules is currently made via a fine needle aspiration (FNA) biopsy. It is estimated that somewhere between 250,000 and 300,000 thyroid FNA biopsies are performed in the United States annually. However, a large percentage (approximately 70%) of these biopsies turn out to be benign. Since the aggressive FNA management of thyroid nodules is costly, quantitative risk assessment and stratification of a nodule's malignancy is of value in triage and more appropriate healthcare resources utilization. In this paper, we introduce a new method for classifying the thyroid nodules based on the ultrasound (US) elastography features. Unlike approaches to assess the stiffness of a thyroid nodule by visually inspecting the pseudo-color pattern in the strain image, we use a classification algorithm to stratify the nodule by using the power spectrum of strain rate waveform extracted from the US elastography image sequence. Pulsation from the carotid artery was used to compress the thyroid nodules. Ultrasound data previously acquired from 98 thyroid nodules were used in this retrospective study to evaluate our classification algorithm. A classifier was developed based on the linear discriminant analysis (LDA) and used to differentiate the thyroid nodules into two types: (I) no FNA (observation-only) and (II) FNA. Using our method, 62 nodules were classified as type I, all of which were benign, while 36 nodules were classified as Type-II, 16 malignant and 20 benign, resulting in a sensitivity of 100% and specificity of 75.6% in detecting malignant thyroid nodules. This indicates that our triage method based on US elastography has the potential to substantially reduce the number of FNA biopsies (63.3%) by detecting benign nodules and managing them via follow-up observations rather than an FNA biopsy. Published by Elsevier B.V.

The transverse penile pedicled flap urethroplasty: description of a simplified technique for the dissection of the Fascio-cutaneous flap.

Science.gov (United States)

Shittu, O B; Sotunmbi, P T

2015-06-01

Urethroplasty is often required for long urethral strictures or urethral strictures that have recurred after repeated urethral dilatations or urethrotomy. The transvers penile skin pedicled flap is very versatile for the reconstruction of long urethral stricture. However the meticulous sharp dissection required to develop it takes a long time to do and may be associated with button hole injuries to the vascular pedicle and the penile skin. We describe a simplified technique of raising the flap which does not require sharp dissection and is very quick to accomplish. Technique involves using a circumcising distal penile shaft skin incision to de-glove the penis by blunt dissection. The skin substitute, adequate to give appropriate urethra calibre is similarly dissected bluntly along with its vascular pedicle from the proximal penile skin. The techniques used to facilitate successful blunt dissection are described. In 9 adults with long, multiple urethral strictures, the average time to develop the flap was 15 minutes and complication have been limited to temporary urethro-cutaneous fistula at the ventral part of the circular skin closure. These fistulae closed on conservative treatment. No patient suffered button-hole injuries to either the vascular pedicle or the penile skin. This modification to the standard sharp dissection is very quick to accomplish. It also avoids the creation of button-hole injuries to either the vascular pedicle or the penile skin. It should make the use of this versatile flap more attractive in the reconstruction of long urethral strictures in those who may wish to use this option for reconstruction of long urethral strictures.

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

Science.gov (United States)

Coskuner, Enis Rauf; Canter, Halil Ibrahim

2012-07-01

Penile girth enhancement is a controversial subject but demands for enhancement are increasing steadily. Although various fillers have been widely used for soft tissue augmentation, there is no reliable material for this particular situation. Here we report a case of an acute hypersensitivity reaction in a man after his first self-injection of a filler material, which, he claimed, was hyaluronic acid gel for penile girth enhancement and glans penis augmentation.

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

OpenAIRE

Coskuner, Enis Rauf; Canter, Halil Ibrahim

2012-01-01

Penile girth enhancement is a controversial subject but demands for enhancement are increasing steadily. Although various fillers have been widely used for soft tissue augmentation, there is no reliable material for this particular situation. Here we report a case of an acute hypersensitivity reaction in a man after his first self-injection of a filler material, which, he claimed, was hyaluronic acid gel for penile girth enhancement and glans penis augmentation.

Use of Volumetry for Lung Nodule Management: Theory and Practice.

Science.gov (United States)

Devaraj, Anand; van Ginneken, Bram; Nair, Arjun; Baldwin, David

2017-09-01

A consistent feature of many lung nodule management guidelines is the recommendation to evaluate nodule size by using diameter measurements and electronic calipers. Traditionally, the use of nodule volumetry applications has primarily been reserved for certain lung cancer screening trials rather than clinical practice. However, even before the first nodule management guidelines were published more than a decade ago, research has been ongoing into the use of nodule volumetry as a means of measuring nodule size, and this research has accelerated in recent years. This article aims to provide radiologists with an up-to-date review of the most recent literature on volumetry and volume doubling times in lung nodule management, outlining their benefits and drawbacks. A brief technical review of typical volumetry applications is also provided. © RSNA, 2017.

Bean nodulation patterns in soils of different texture at Morogoro ...

African Journals Online (AJOL)

Thus, nodulation success by the inoculum was total in the clay but only dismal in the sandy soil. The unexpected discrepancy between inoculum success on the one hand and nodulation plus plant growth response on the other, is discussed. Keywords: Bean nodulation, ELISA typing of nodules, phaseolus vulgaris

System for automatic detection of lung nodules exhibiting growth

Science.gov (United States)

Novak, Carol L.; Shen, Hong; Odry, Benjamin L.; Ko, Jane P.; Naidich, David P.

2004-05-01

Lung nodules that exhibit growth over time are considered highly suspicious for malignancy. We present a completely automated system for detection of growing lung nodules, using initial and follow-up multi-slice CT studies. The system begins with automatic detection of lung nodules in the later CT study, generating a preliminary list of candidate nodules. Next an automatic system for registering locations in two studies matches each candidate in the later study to its corresponding position in the earlier study. Then a method for automatic segmentation of lung nodules is applied to each candidate and its matching location, and the computed volumes are compared. The output of the system is a list of nodule candidates that are new or have exhibited volumetric growth since the previous scan. In a preliminary test of 10 patients examined by two radiologists, the automatic system identified 18 candidates as growing nodules. 7 (39%) of these corresponded to validated nodules or other focal abnormalities that exhibited growth. 4 of the 7 true detections had not been identified by either of the radiologists during their initial examinations of the studies. This technique represents a powerful method of surveillance that may reduce the probability of missing subtle or early malignant disease.

Vocal nodules in a colombian teachers group with dysphonia

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Andrés Felipe Alvarado Díaz

2013-12-01

Full Text Available Objectives: This study determined the prevalence of vocal nodules associated with dysphonia in teachers aged from 35 to 65 years, taking into consideration both individual and occupational variables. Methodology: Descriptive study that included the information contained in 262 medical records of teachers diagnosed with dysphonia in occupational health consultations at the institutions that provide health services in Bogotá, Colombia from March 2009 to March 2012. The presence of laryngeal nodules was based on the findings of a nasofibrolaryngoscopy procedure. Results: Nodules were found in 67 teachers, which corresponded to a rate of 25.5%, being apparently (highest observed rates associated primarily with the following variables: females, ages from 45 to 54 years, bilateral nodules, and teaching position (preschool and physical education. Of the teachers with nodules, 76.1% had fewer than five doctor's appointments, and 75% had more than 90 days of sick leave. Conclusion: A high percentage of teachers have vocal nodules associated with dysphonia. This may be apparently related to different variables such as sex, type of nodule, area and teaching position. Was observed only a statistically significant association among presence of nodules and age (p=0.018. In addition this disorder generates a large number of incapacities and employee absenteeism.

Evaluation of diffuse thyroid diseases and thyroid nodules by CT

International Nuclear Information System (INIS)

Okamoto, Kyoko; Imanishi, Yoshimasa; Nakaji, Shunsuke; Shinagawa, Toshihito

2007-01-01

Imanishi et al. have previously reported that the changes in CT values reveal not only the change in iodine concentration in thyroid follicles, but also represent secondary changes in follicular content and follicular cells and/or interstitial structures. Thus, we performed thyroid CT without contrast material in 138 controls, 417 cases with diffuse thyroid diseases, and 279 cases with thyroid nodules, and evaluated the CT images based on the relation between the change in CT values and pathological changes. In 89% of the controls and 43% of patients with diffuse thyroid diseases, the thyroid CT revealed diffuse high density. In contrast, the 94% of thyroids that demonstrated diffuse low density were from patients with diffuse thyroid diseases. Eighty-four percent of malignant nodules and 64% of benign nodules had inhomogeneous densities, and only 26% of benign thyroid nodules had homogeneous density. However, 71% of nodules that showed high and low densities with regular and clear borders, and 82% of nodules that showed papillary proliferation in a cyst pattern were benign. Although only 58% of nodules with calcification were malignant, 66% of nodules with calcification in the central portion, and 86% of nodules with calcification of a disseminated and convergent pattern in distribution were malignant. Sixty-two percent of thyroids that surrounded nodules had chronic thyroiditis, hypoplasia and/or adenomatous goiter. Thus, unclear borders between a nodule and the surrounding thyroid tissue did not increase the possibility of malignancy. However, the unclear and/or lobulated border between a nodule and extra thyroid tissue increased the possibility of malignancy. We concluded that thyroid CT without contrast material is useful for the diagnosis of thyroid diseases. (author)

Penile duplication and two anal openings; report of a very rare case.

Science.gov (United States)

Bakheet, Mohamed Abdel Al M; Refaei, Mohammad

2012-03-01

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

Does penile rehabilitation have a role in the treatment of erectile dysfunction following radical prostatectomy?

Science.gov (United States)

Blecher, Gideon; Almekaty, Khaled; Kalejaiye, Odunayo; Minhas, Suks

2017-01-01

In men undergoing radical treatment for prostate cancer, erectile function is one of the most important health-related quality-of-life outcomes influencing patient choice in treatment. Penile rehabilitation has emerged as a therapeutic measure to prevent erectile dysfunction and expedite return of erectile function after radical prostatectomy. Penile rehabilitation involves a program designed to increase the likelihood of return to baseline-level erectile function, as opposed to treatment, which implies the therapeutic treatment of symptoms, a key component of post-radical prostatectomy management. Several pathological theories form the basis for rehabilitation, and a plethora of treatments are currently in widespread use. However, whilst there is some evidence supporting the concept of penile rehabilitation from animal studies, randomised controlled trials are contradictory in outcomes. Similarly, urological guidelines are conflicted in terms of recommendations. Furthermore, it is clear that in spite of the lack of evidence for the role of penile rehabilitation, many urologists continue to employ some form of rehabilitation in their patients after radical prostatectomy. This is a significant burden to health resources in public-funded health economies, and no effective cost-benefit analysis has been undertaken to support this practice. Thus, further research is warranted to provide both scientific and clinical evidence for this contemporary practice and the development of preventative strategies in treating erectile dysfunction after radical prostatectomy.

Graphite nodule count and size distribution in thin-walled ductile cast iron

DEFF Research Database (Denmark)

Pedersen, Karl Martin; Tiedje, Niels Skat

2008-01-01

Graphite nodule count and size distribution have been analysed in thin walled ductile cast iron. The 2D nodule counts have been converted into 3D nodule count by using Finite Difference Method (FDM). Particles having a diameter smaller than 5 µm should be neglected in the nodule count as these ar......Graphite nodule count and size distribution have been analysed in thin walled ductile cast iron. The 2D nodule counts have been converted into 3D nodule count by using Finite Difference Method (FDM). Particles having a diameter smaller than 5 µm should be neglected in the nodule count...... as these are inclusions and micro porosities that do not influence the solidification morphology. If there are many small graphite nodules as in thin walled castings only 3D nodule count calculated by FDM will give reliable results. 2D nodule count and 3D nodule count calculated by simple equations will give too low...

Decreased Endogenous Hydrogen Sulfide Generation in Penile Tissues of Diabetic Rats with Erectile Dysfunction.

Science.gov (United States)

Zhang, Yan; Yang, Jun; Wang, Tao; Wang, Shao-Gang; Liu, Ji-Hong; Yin, Chun-Ping; Ye, Zhang-Qun

2016-03-01

Hydrogen sulfide (H2S) is an endogenous gasotransmitter. The levels of H2S-generating enzyme expression and endogenous H2S production in diabetic rats with erectile dysfunction (ED) remain unknown. The aim of this study was to investigate the expression of the H2S-generating enzymes and endogenous production of H2S in penile tissues of diabetic ED rats. Experimental rats were randomly divided into normal control group, apomorphine (APO)-positive group and APO-negative group. Primary rat corpus cavernosum smooth muscle cells (CCSMCs) and aortic endothelial cells (AECs) were isolated and cultured in vitro under 3 different conditions: normal glucose (NG) condition, high glucose (HG) condition, and osmotic control (OC) condition. Erectile function; H2S concentrations in plasma or penile tissues; expression of H2S-generating enzymes and endogenous H2S production in penile tissues, CCSMCs, and AECs. Erectile function was significantly decreasedin the APO-negative group. In addition to significantly decreased expression of cysteine aminotransferase (CAT), d-amino acid oxidase (DAO), and 3-mercaptopyruvate sulfurtransferase (3-MST), the H2S concentrations in plasma and penile tissues and endogenous H2S production were significantly decreased in the APO-negative group. Endogenous H2S production by cystathionine β-synthase (CBS) and cystathionine γ-lyase (CSE) decreased to the same levels in the APO-negative and APO-positive groups as that in the normal control group. However, CBS and CSE expression remained unchanged in the 3 groups. Under HG conditions, H2S-generating enzyme expression in AECs did not change, while CAT, DAO, and 3-MST expression in CCSMCs was significantly decreased. In both cell types, H2S production by these enzymes was decreased in the HG group. Endogenous H2S production was significantly decreased in the diabetic ED rats' penile tissues due to downregulated expression of the CAT/3-MST and DAO/3-MST pathways and low activities of CBS and CSE

Presentation, Management and Outcome of Penile Fractures in a ...

African Journals Online (AJOL)

between the buck's fascia and tunica albuginea as well rupture of the suspensory ligament of the penis which results in deviation or 'dislocation' of the penis, with or without hematoma (10,11). Prompt surgical exploration and repair of the tunica albuginea is advocated for restoration of normal penile erection and sexual ...

Laryngeal ultrasound and pediatric vocal fold nodules.

Science.gov (United States)

Ongkasuwan, Julina; Devore, Danielle; Hollas, Sarah; Jones, Jeremy; Tran, Brandon

2017-03-01

The term vocal fold nodules refers to bilateral thickening of the membranous folds with minimal impairment of the vibratory properties of the mucosa. Nodules are thought to be related to repetitive mechanical stress, associated with voice use patterns. Diagnosis is typically made in the office via either rigid or flexible laryngeal stroboscopy. Depending on the individual child, obtaining an optimal view of the larynx can be difficult if not impossible. Recent advances in high-frequency ultrasonography allows for transcervical examination of laryngeal structures. The goal of this project was to determine if laryngeal ultrasound (LUS) can be used to identify vocal fold nodules in dysphonic children. Prospective case-control study in which the patient acted as his or her own control. Forty-six pediatric patients were recruited for participation in this study; the mean age was 4.8 years. Twenty-three did not have any vocal fold lesions and 23 had a diagnosis of vocal fold nodules on laryngeal stroboscopy. Recorded LUSs were reviewed by two pediatric radiologists who were blinded to the nodule status. There was substantial inter-rater agreement (κ = 0.70, 95% confidence interval [CI]: 0.50-0.89) between the two radiologists regarding the presence of nodules. There was also substantial agreement (κ = 0.87, 95% CI: 0.72-1) between LUS and laryngeal stroboscopy. Sensitivity of LUS was 100% (95% CI: 85%-100%) and specificity was 87% (95% CI: 66%-97%). LUS can be used to identify vocal fold nodules in children with substantial agreement with laryngeal stroboscopy. 3b Laryngoscope, 127:676-678, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Sonographically guided fine-needle biopsy of thyroid nodules: the effects of nodule characteristics, sampling technique, and needle size on the adequacy of cytological material

International Nuclear Information System (INIS)

Degirmenci, B.; Haktanir, A.; Albayrak, R.; Acar, M.; Sahin, D.A.; Sahin, O.; Yucel, A.; Caliskan, G.

2007-01-01

Aim: To evaluate the effects of sonographic characteristics of thyroid nodules, the diameter of needle used for sampling, and sampling technique on obtaining sufficient cytological material (SCM). Materials and methods: We performed sonography-guided fine-needle biopsy (FNB) in 232 solid thyroid nodules. Size-, echogenicity, vascularity, and localization of all nodules were evaluated by Doppler sonography before the biopsy. Needles of size 20, 22, and 24 G were used for biopsy. The biopsy specimen was acquired using two different methods after localisation. In first method, the needle tip was advanced into the nodule in various positions using a to-and-fro motion whilst in the nodule, along with concurrent aspiration. In the second method, the needle was advanced vigorously using a to-and-fro motion within the nodule whilst being rotated on its axis (capillary-action technique). Results: The mean nodule size was 2.1 ± 1.3 cm (range 0.4-7.2 cm). SCM was acquired from 154 (66.4%) nodules by sonography-guided FNB. In 78 (33.6%) nodules, SCM could not be collected. There was no significant difference between nodules with different echogenicity and vascularity for SCM. Regarding the needle size, the lowest rate of SCM was obtained using 20 G needles (56.6%) and the highest rate of adequate material was obtained using 24 G needles (82.5%; p = 0.001). The SCM rate was 76.9% with the capillary-action technique versus 49.4% with the aspiration technique (p < 0.001). Conclusion: Selecting finer needles (24-25 G) for sonography-guided FNB of thyroid nodules and using the capillary-action technique decreased the rate of inadequate material in cytological examination

Quantifying risk of penile prosthesis infection with elevated glycosylated hemoglobin.

Science.gov (United States)

Wilson, S K; Carson, C C; Cleves, M A; Delk, J R

1998-05-01

Elevation of glycosylated hemoglobin above levels of 11.5 mg.% has been considered a contraindication to penile prosthesis implantation in diabetic patients. We determine the predictive value of glycosylated hemoglobin A1C in penile prosthesis infections in diabetic and nondiabetic patients to confirm or deny this prevalent opinion. We conducted a 2-year prospective study of 389 patients, including 114 diabetics, who underwent 3-piece penile prosthesis implantation. All patients had similar preoperative preparation without regard to diabetic status, control or glycosylated hemoglobin A1C level. Risk of infection was statistically analyzed for diabetics versus nondiabetics, glycosylated hemoglobin A1C values above and below 11.5 mg.%, insulin dependent versus oral medication diabetics, and fasting blood sugars above and below 180 mg.%. Prosthesis infections developed in 10 diabetics (8.7%) and 11 nondiabetics (4.0%). No increased infection rate was observed in diabetics with high fasting sugars or diabetics on insulin. There was no statistically significant increased infection risk with increased levels of glycosylated hemoglobin A1C among all patients or among only the diabetics. In fact, there was no meaningful difference in the median or mean level of glycosylated hemoglobin A1C in the infected and noninfected patients regardless of diabetes. Use of glycosylated hemoglobin A1C values to identify and exclude surgical candidates with increased risk of infections is not proved by this study. Elevation of fasting sugar or insulin dependence also does not increase risk of infection in diabetics undergoing prosthesis implantation.

Autonomous nodule of the thyroid: correlation of patient age, nodule size, and functional status

International Nuclear Information System (INIS)

Blum, M.; Shenkman, L.; Hollander, C.S.

1975-01-01

In light of new techniques for measuring circulating thyroid hormones and for studying the thyroid gland, we present our experience with 35 patients with solitary autonomous nodules of the thyroid to define more precisely the clinical course of patients with this disorder. The patients ranged in age from 19 to 80 years and 31 of the 35 were female. Younger patients were generally euthyroid and sought attention because of a thyroid mass; virtually all older patients were hyperthyroid. Eighteen had obvious clinical features of hyperthyroidism and 5 over age 70 had apathetic hyperthyroidism; all 5 of the elderly and 13 of the 18 under age 70 had elevated thyroxine (T 4 ) and triiodothyronine (T 3 ) levels. Isolated elevation of T 3 and elevated basal metabolic rate were observed in 5 previously untreated clinically hyperthyroid young patients. In each of these, thyroid uptake of 131 I was not suppressible with exogenous T 3 and BMR was elevated in those tested. Two elderly patients, who had previously been treated for conventional hyperthyroidism with radioactive iodine, had T 3 toxicosis when hyperthyroidism recurred. There was a strong positive correlation between the age of the patient, the size of the nodule and the thyroid functional state. The mean area of the nodules projected on 131 I rectilinear scan for euthyroid patients was 5.1 cm 2 . The mean area of the nodules in hyperthyroid subjects was significantly higher, 13.4 cm 2 in patients with T 3 toxicosis and 19.3 cm 2 in subjects with conventional hyperthyroidism. Progression from a euthyroid state to hyperthyroidism was observed in four patients. One of these became thyrotoxic within days after an injection of iodinated contrast medium. Spontaneous resolution of nodules occurred in two patients

Penile prosthesis surgery in out-patient setting: Effectiveness and costs in the “spending review” era

Directory of Open Access Journals (Sweden)

Nicola Mondaini

2014-09-01

Full Text Available Introduction: Penile implant patients are required to remain in the hospital after the operation for monitoring, antibiotic and analgesia administration. Cost containment, however, has resulted in the increased use of ambulatory surgery settings for many surgical procedures. Few studies have studied the feasibility of performing penile prosthesis insertion in an outpatient setting. The results are controversial and nowadays, in the most of centers that deal with prosthetic surgery, patients are still hospitalized. Aim: The aim of our investigation was to compare the feasibility of the performance as well as the complication profiles of penile implant surgery performed in an in-patient and an outpatient setting at a single center by a single surgeon. Methods: From January 2009 to June 2014, 50 patients of the same uro-andrological unit underwent penile prosthesis implantation performed by a single surgeon (N.M.. Twenty implantations were performed in an ambulatory day surgery setting. Main outcome measures: Effectiveness and costs of outpatient setting versus the in-patient setting of the penile prosthesis surgery. Results: There were some differences between the two groups in the intra-operative parameters, such as, operating time. Time lost from work was similar in both groups approximating 14 days. The mean number of analgesic pills ingested by the patients post-operatively was similar in both groups, averaging just under 25 pills per patient. There weren’t post-operative complications in the outpatient group. Cost were 17% less in outpatient clinic. Conclusions: The outpatient setting for this surgery is safe and effective even in patients with comorbidities or in case of secondary procedures. Costs are reduced by 17%.

Development of a clinical decision model for thyroid nodules

Directory of Open Access Journals (Sweden)

Eberhardt John

2009-08-01

Full Text Available Abstract Background Thyroid nodules represent a common problem brought to medical attention. Four to seven percent of the United States adult population (10–18 million people has a palpable thyroid nodule, however the majority (>95% of thyroid nodules are benign. While, fine needle aspiration remains the most cost effective and accurate diagnostic tool for thyroid nodules in current practice, over 20% of patients undergoing FNA of a thyroid nodule have indeterminate cytology (follicular neoplasm with associated malignancy risk prevalence of 20–30%. These patients require thyroid lobectomy/isthmusectomy purely for the purpose of attaining a definitive diagnosis. Given that the majority (70–80% of these patients have benign surgical pathology, thyroidectomy in these patients is conducted principally with diagnostic intent. Clinical models predictive of malignancy risk are needed to support treatment decisions in patients with thyroid nodules in order to reduce morbidity associated with unnecessary diagnostic surgery. Methods Data were analyzed from a completed prospective cohort trial conducted over a 4-year period involving 216 patients with thyroid nodules undergoing ultrasound (US, electrical impedance scanning (EIS and fine needle aspiration cytology (FNA prior to thyroidectomy. A Bayesian model was designed to predict malignancy in thyroid nodules based on multivariate dependence relationships between independent covariates. Ten-fold cross-validation was performed to estimate classifier error wherein the data set was randomized into ten separate and unique train and test sets consisting of a training set (90% of records and a test set (10% of records. A receiver-operating-characteristics (ROC curve of these predictions and area under the curve (AUC were calculated to determine model robustness for predicting malignancy in thyroid nodules. Results Thyroid nodule size, FNA cytology, US and EIS characteristics were highly predictive of

Root developmental programs shape the Medicago truncatula nodule meristem

NARCIS (Netherlands)

Franssen, H.; Xiao, T.T.; Kulikova, O.; Wan, X.; Bisseling, T.; Scheres, B.; Heidstra, R.

2015-01-01

Nodules on the roots of legume plants host nitrogen-fixing Rhizobium bacteria. Several lines of evidence indicate that nodules are evolutionarily related to roots. We determined whether developmental control of the Medicago truncatula nodule meristem bears resemblance to that in root meristems

VATS intraoperative tattooing to facilitate solitary pulmonary nodule resection

Directory of Open Access Journals (Sweden)

Boutros Cherif

2008-03-01

Full Text Available Abstract Introduction Video-assisted thoracic surgery (VATS has become routine and widely accepted for the removal of solitary pulmonary nodules of unknown etiology. Thoracosopic techniques continue to evolve with better instruments, robotic applications, and increased patient acceptance and awareness. Several techniques have been described to localize peripheral pulmonary nodules, including pre-operative CT-guided tattooing with methylene blue, CT scan guided spiral/hook wire placement, and transthoracic ultrasound. As pulmonary surgeons well know, the lung and visceral pleura may appear featureless on top of a pulmonary nodule. Case description This paper presents a rapid, direct and inexpensive approach to peripheral lung lesion resection by marking the lung parenchyma on top of the nodule using direct methylene blue injection. Methods In two patients with peripherally located lung nodules (n = 3 scheduled for VATS, we used direct methylene blue injection for intraoperative localization of the pulmonary nodule. Our technique was the following: After finger palpation of the lung, a spinal 25 gauge needle was inserted through an existing port and 0.1 ml of methylene blue was used to tattoo the pleura perpendicular to the localized nodule. The methylene blue tattoo immediately marks the lung surface over the nodule. The surgeon avoids repeated finger palpation, while lining up stapler, graspers and camera, because of the visible tattoo. Our technique eliminates regrasping and repalpating the lung once again to identify a non marked lesion. Results Three lung nodules were resected in two patients. Once each lesion was palpated it was marked, and the area was resected with security of accurate localization. All lung nodules were resected in totality with normal lung parenchymal margins. Our technique added about one minute to the operative time. The two patients were discharged home on the second postoperative day, with no morbidity. Conclusion

Survival impact of early lymph node staging in a national study on 454 Danish men with penile cancer

DEFF Research Database (Denmark)

Jakobsen, J. K.; Krarup, K. P.; Sommer, P.

2015-01-01

N) stage so extranodal metastatic extension entails stage pN3. We report population based national survival data from 454 Danish penile cancer patients staged according to the TNM 2009 criteria and evaluate the survival impact of lymph node staging at diagnosis. MATERIAL & METHODS: Penile squamous cell...... intervals. Survival impact of lymph node staging was evaluated in a multivariate cox regression model with adjustment for tumour stage, age and Charlson comorbidity score. RESULTS: Of a total of 454 men 39 did not undergo lymph node staging of any kind. Median follow-up of patients who survived was 7......-45) %. Penile cancer-specific 5-year survival for pN0, pN1, pN2, pN3 and pNx patients was 97 (94-98)%, 82 (62- 92)%, 57 (36-74)%, 12 (5-22)% and 53 (35-69)%. Lymph node staging had a significant impact on penile cancer specific survival after adjustment for age, T-stage and comorbidity (Nx vs all N0, N1, N2, N3...

Long-term follow-up sonography of benign cystic thyroid nodules after a percutaneous ethanol injection: the incidence of malignancy-mimicking nodules

International Nuclear Information System (INIS)

Park, Ji Sung; Kim, Dong Wook; Eun, Choong Ki; Choi, Seok Jin; Rho, Myung Ho

2008-01-01

To evaluate the incidence of malignancy-mimicking sclerosed thyroid nodules, from long-term follow-up ultrasonography (US) after an US-guided percutaneous ethanol injection (PEI). We examined 86 benign cystic thyroid nodules from 80 patients. The nodules were classified into two groups based on whether an aspiration (Group A, n = 26) or non-aspiration (Group B, n 60) of infused ethanol was performed. The final follow-up US over 12 months was performed in all patients. Of the 86 nodules, the cystic portion of 82 (95.3%) cases, from 76 patients, completely disappeared subsequent to the first follow-up US (Group A, n = 24, Group B, n = 58) (Chi-square test, ρ > 0.05). Moreover, 46 sclerosed thyroid nodules showed two or more of the 'five sonographic criteria' upon a follow-up US (Group A, n = 13, 50.0%, Group B, n = 32, 53.3%). A higher ratio of the cystic portion of the nodules was associated with a higher incidence of the 'five sonographic criteria' for malignancies detected via a follow-up US (ρ < 0.01; Student's t-test). For the long-term follow-up US, the 'five sonographic criteria' were observed in half the patients who received US-guided PEI. Also, by acknowledging the possibility that sonographic findings mimic a malignancy, since the sclerosed thyroid nodule, patients may avoid an unnecessary biopsy

Botulinum toxin in the treatment of vocal fold nodules.

Science.gov (United States)

Allen, Jacqui E; Belafsky, Peter C

2009-12-01

Promising new techniques in the management of vocal fold nodules have been developed in the past 2 years. Simultaneously, the therapeutic use of botulinum toxin has rapidly expanded. This review explores the use of botulinum toxin in treatment of vocal nodules and summarizes current therapeutic concepts. New microsurgical instruments and techniques, refinements in laser technology, radiosurgical excision and steroid intralesional injections are all promising new techniques in the management of vocal nodules. Botulinum toxin-induced 'voice rest' is a new technique we have employed in patients with recalcitrant nodules. Successful resolution of nodules is possible with this technique, without the risk of vocal fold scarring inherent in dissection/excision techniques. Botulinum toxin usage is exponentially increasing, and large-scale, long-term studies demonstrate its safety profile. Targeted vocal fold temporary paralysis induced by botulinum toxin injection is a new, well tolerated and efficacious treatment in patients with persistent vocal fold nodules.

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

Directory of Open Access Journals (Sweden)

Enis Rauf Coskuner

2012-01-01

Full Text Available Penile girth enhancement is a controversial subject but demands for enhancement are increasing steadily. Although various fillers have been widely used for soft tissue augmentation, there is no reliable material for this particular situation. Here we report a case of an acute hypersensitivity reaction in a man after his first self-injection of a filler material, which, he claimed, was hyaluronic acid gel for penile girth enhancement and glans penis augmentation.

Evaluation of percutaneous ethanol injections in benign thyroid nodules.

Science.gov (United States)

Perez, Camila Luhm Silva; Fighera, Tayane Muniz; Miasaki, Fabiola; Mesa Junior, Cleo Otaviano; Paz Filho, Gilberto Jorge da; Graf, Hans; Carvalho, Gisah Amaral de

2014-12-01

The objective of this study was to evaluate the efficacy and safety of percutaneous ethanol injection (PEI) in the treatment of benign thyroid nodules. We evaluated 120 patients with benign thyroid nodules. Patients underwent evaluation of serum TSH and free T4, cervical ultrasound, and thyroid scintigraphy (in those with suppressed TSH levels). The application of sterile ethanol 99% was guided by ultrasound, with the injected volume amounting to one-third of the nodule volume. Response was considered complete (reduction of 90%); partial (reduction between 50 and 90%); or none (reduction of nodules were evaluated for normalization of TSH levels. Among the nodules studied, 30.8% were solid, 56.7% were mixed, 12.5% were cystic, and 21.6% were hyperfunctioning. The initial volume of the treated nodules ranged from 0.9 to 74.8 mL (mean 13.1 ± 12.4 mL). We performed 1-8 sessions of PEI, applying an average of 6.2 mL of ethanol for patient. After 2 years of follow-up, 17% of patients achieved a complete response (94% reduction); 53%, a partial response (70% reduction); and 30%, no response. A reduction in the volume of autonomous nodules was noted in 70% of cases, and 54% had a normalized value of TSH. The main side effect is local pain, lasting less than 24 hours in most cases. This study showed that PEI is a safe and effective procedure for treatment of benign, solid or mixed thyroid nodules. Most cases resulted in significant reduction in nodule volume, with normalization of thyroid function.

On the computed tomographic diagnosis of pulmonary nodules

International Nuclear Information System (INIS)

Higashi, Yuuichirou

1988-01-01

Computed tomography (CT) was used to examine 53 pulmonary nodules which were considered not definitely calcified on plain radiographs or conventional tomograms. An average CT number was calculate for each lesion. For the primary lung cancers, the average CT number was 36 HU with a standard deviation of 6.6 HU, while the benign lesions had the mean CT number of 69 HU, with a standard deviation of 42.8 HU. The mean CT number separating lung malignancies from benign lesions was 78.8 HU. To evaluate the attenuation values within each nodule, iso-CT value map was obtained by using Siemens therapy planning system, MEVAPLAN. Nodules were classified into five categories, Type I to V. All of three nodules classified as Type IV were benign. Iso-CT value map was effective in establishing the benignancy of nodules. The quantitative computed tomographic analysis of pulmonary nodules was evaluated by dual-energy CT. Dual-energy CT has the potential to eliminate the effect of spectral hardening by use of monoenergic images derived from dual-kV data and to separate high CT numbers due to calcium from those due to high density organic material. (author)

Activation of cell divisions in legume nodulation

DEFF Research Database (Denmark)

Nadzieja, Marcin

organogenesis. Coordination of these two interdependent processes results in formation of nodules - bacterial accommodating structures where fixation of atmospheric nitrogen takes place. Plant hormones such as auxin and cytokinin play important roles in nodulation. In some legumes the infection process...... of auxin transport inhibitors or cytokinin alone was shown to induce cortical cell divisions in the absence of rhizobia in certain legume species. While the roles of auxin and cytokinin in nodulation have been studied extensively, the precise timing, location and means of molecular crosstalk between...

Direct detection of radicals in intact soybean nodules

DEFF Research Database (Denmark)

Mathieu, C; Moreau, S; Frendo, P

1998-01-01

Electron paramagnetic resonance spectroscopy has been employed to examine the nature of the metal ions and radicals present in intact root nodules of soybean plants grown in the absence of nitrate. The spectra obtained from nodules of different ages using this non-invasive technique show dramatic...... differences, suggesting that there are both qualitative and quantitative changes in the metal ion and radical species present. A major component of the spectra obtained from young nodules is assigned to a complex (Lb-NO) of nitric oxide (NO.) with the heme protein leghemoglobin (Lb). This Lb-NO species, which...... has not been previously detected in intact root nodules of plants grown in the absence of nitrate, is thought to be formed by reaction of nitric oxide with iron(II) leghemoglobin. The nitric oxide may be generated from arginine via a nitric oxide synthase-like activity present in the nodules...

The aluminosilicate fraction of North Pacific manganese nodules

Science.gov (United States)

Bischoff, J.L.; Piper, D.Z.; Leong, K.

1981-01-01

Nine nodules collected from throughout the deep North Pacific were analyzed for their mineralogy and major-element composition before and after leaching with Chester-Hughes solution. Data indicate that the mineral phillipsite accounts for the major part (> 75%) of the aluminosilicate fraction of all nodules. It is suggested that formation of phillipsite takes place on growing nodule surfaces coupled with the oxidation of absorbed manganous ion. All the nodules could be described as ternary mixtures of amorphous iron fraction (Fe-Ti-P), manganese oxide fraction (Mn-Mg Cu-Ni), and phillipsite fraction (Al-Si-K-Na), these fractions accounting for 96% of the variability of the chemical composition. ?? 1981.

Original technique for penile girth augmentation through porcine dermal acellular grafts: results in a 69-patient series.

Science.gov (United States)

Alei, Giovanni; Letizia, Piero; Ricottilli, Francesco; Simone, Pierfranco; Alei, Lavinia; Massoni, Francesco; Ricci, Serafino

2012-07-01

Although different techniques for augmentation phalloplasty have been reported in the medical literature, this issue is still highly controversial, and none of the proposed procedures has been unanimously approved. The aim of this study is to describe an innovative surgical technique for penile girth augmentation with porcine dermal acellular grafts, through a small transverse incision at the penile base, along the penopubic junction. Between 2000 and 2009, 104 patients were referred to our institution for penile enhancement. After a preoperative psychosexual consultation and a general medical assessment, 69 patients were deemed suitable good candidates for surgery. The average penis circumference was measured at the mid-length of the penis and was 8.1 cm (5.4-10.7 cm) and 10.8 cm (6.5-15.8 cm) during flaccidity and erection, respectively. All patients received penile augmentation with porcine dermal acellular grafts. Results evaluation of an innovative technique for penile girth augmentation through exogenous porcine grafts and small penobubic incision. Postoperative measurements were performed at 6 and 12 months. At the 1-year follow-up, the average penis circumference was 11.3 cm (8.2-13.2 cm, 3.1 cm mean increase) during flaccidity and 13.2 cm (8.8-14.5 cm, 2.4 cm mean increase) during erection. No major complications occurred in the series. Minor complications were resolved with conservative treatment within 3 weeks. Sexual activity was resumed from 1 to 2 months after surgery. The psychosexual impact of the operation was beneficial in the majority of cases. Penile girth enlargement with acellular dermal matrix grafts has several advantages over augmentation with autogenous dermis-fat grafts: the elimination of donor site morbidity and a significantly shorter operation time. With this approach, through a short dorsal incision at the base of the penis, the scar is concealed in a crease covered by pubic hair and thus hardly visible. © 2012

Trends in Penile Prosthetics: Influence of Patient Demographics, Surgeon Volume, and Hospital Volume on Type of Penile Prosthesis Inserted in New York State.

Science.gov (United States)

Kashanian, James A; Golan, Ron; Sun, Tianyi; Patel, Neal A; Lipsky, Michael J; Stahl, Peter J; Sedrakyan, Art

2018-02-01

Penile prostheses (PPs) are a discrete, well-tolerated treatment option for men with medical refractory erectile dysfunction. Despite the increasing prevalence of erectile dysfunction, multiple series evaluating inpatient data have found a decrease in the frequency of PP surgery during the past decade. To investigate trends in PP surgery and factors affecting the choice of different PPs in New York State. This study used the New York State Department of Health Statewide Planning and Research Cooperative (SPARCS) data cohort that includes longitudinal information on hospital discharges, ambulatory surgery, emergency department visits, and outpatient services. Patients older than 18 years who underwent inflatable or non-inflatable PP insertion from 2000 to 2014 were included in the study. Influence of patient demographics, surgeon volume, and hospital volume on type of PP inserted. Since 2000, 14,114 patients received PP surgery in New York State; 12,352 PPs (88%) were inflatable and 1,762 (12%) were non-inflatable, with facility-level variation from 0% to 100%. There was an increasing trend in the number of annual procedures performed, with rates of non-inflatable PP insertion decreasing annually (P New York State and the results might not be generalizable to men in other states. Also, patient preference was not accounted for in these analyses, which can play a role in PP selection. During the past 14 years, there has been an increasing trend in inflatable PP surgery for the management of erectile dysfunction. Most procedures are performed in the ambulatory setting and not previously captured by prior studies using inpatient data. Kashanian JA, Golan R, Sun T, et al. Trends in Penile Prosthetics: Influence of Patient Demographics, Surgeon Volume, and Hospital Volume on Type of Penile Prosthesis Inserted in New York State. J Sex Med 2018;15:245-250. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

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

Science.gov (United States)

Witty, Karl; Branney, Peter; Bullen, Kate; White, Alan; Evans, Julie; Eardley, Ian

2014-01-01

To explore the challenges of engaging men with penile cancer in qualitative interview research. Qualitative interviewing offers an ideal tool for exploring men's experiences of illness, complementing and providing context to gendered health inequalities identified in epidemiological research on men. But conducting interviews with men can be challenging and embarking on a qualitative interview study with males can feel like a daunting task, given the limited amount of practical, gender-sensitive guidance for researchers. Reflecting on a researcher's experience of conducting qualitative research on men with penile cancer, this paper explores the potential challenges of interviewing this group, but also documents how engagement and data collection were achieved. This is a reflective paper, informed by the experiences of a male researcher (KW) with no nurse training, who conducted 28 interviews with men who had been treated for penile cancer. The researcher's experiences are reported in chronological order, from the methodological challenges of recruitment to those of conducting the interview. The paper offers a resource for the novice researcher, highlighting some advantages and disadvantages of conducting qualitative interview research as a nurse researcher, as well as recommendations on how to overcome challenges. Engaging men with penile cancer in qualitative interview raises practical, methodological, ethical and emotional challenges for the researcher. However, when these challenges are met, men will talk about their health. Methodological procedures must enable an open and ongoing dialogue with clinical gatekeepers and potential participants to promote engagement. Support from colleagues is essential for any interviewer, no matter how experienced the researcher is.

Penile vibratory stimulation in the treatment of post-prostatectomy incontinence

DEFF Research Database (Denmark)

Fode, Mikkel; Sønksen, Jens

2015-01-01

AIMS: To examine penile vibratory stimulation (PVS) in the treatment of post-prostatectomy urinary incontinence (UI). METHODS: Patients with post-prostatectomy UI were included in a 12-week trial. A 24-hr pad test and a 72-hr voiding diary were collected at baseline. Participants were randomized ...

Ultrasound assistance in differentiating malignant thyroid nodules from benign ones

International Nuclear Information System (INIS)

Zahir, S.T.; Sefidrokh, S.; Heidari, F.; Vakili, M.; Ghaneei, A.

2017-01-01

The search is ongoing for simple, effective ways to identify and differentiate thyroid nodules in order to avoid invasive procedures. This study aims to perform an ultrasound assessment of clinically suspected patients with malignant nodules, to perform a fine needle biopsy on them, and to compare the results obtained. Methods: In total, 135 patients with thyroid nodules suspected to be malignant in the ultrasound underwent ultrasound-guided fine needle biopsies. The patients' gender, age, ultrasound views (echogenicity, shape, and calcification type), nodule size, number of nodules, and needle biopsy results were retrospectively evaluated. Results: Of the 135 patients, 117 (86.7 percent) were female and 18 (13.3 percent) were male. In terms of age, 67 (49.16 percent) were younger than 40 and the rest were older. According to the Chi-square test, a significant relationship was found between the type of nodule and calcification found in the ultrasound views (p=0.001). The nodule type was not significantly related to gender (p=0.563) or to the number of nodules (p=0.128); however, there was a significant relationship between nodule size and type (p=0.001). Ultrasound specificity, sensitivity, positive and negative predictive values, and accuracy for differentiating benign from malignant nodules were 93.2 percent, 93.8 percent, 81.1 percent, 98 percent, and 93.3 percent, respectively. Conclusions: Ultrasound views (comet tail artefact and linear echogenic foci) were better predictors of benign nodules than of malignant ones, while round, echogenic foci, brighter and larger than typical micro-calcifications without any visible echoes and multiple punctuate round echogenic foci were better predicted malignancy. (author)

Contemporary management of penile cancer: greater than 15 year MSKCC experience.

Science.gov (United States)

Moses, Kelvin A; Winer, Andrew; Sfakianos, John P; Poon, Stephen A; Kent, Matthew; Bernstein, Melanie; Russo, Paul; Dalbagni, Guido

2014-04-01

Penile cancer is a rare malignancy, and few guidelines are available to define treatment paradigms. For greater understanding of the natural history of surgically treated penile cancer, we analyzed the experience at our institution. Using an institutional database, we identified 127 patients treated for squamous cell carcinoma of the penis from 1995-2011. Cancer-specific survival (CSS) was calculated using the Kaplan-Meier method. Survival data were compared using the log-rank test. The difference in risk of cancer-specific death by lymph node status and histological grade was determined by univariate Cox regression analysis. Five year CSS for pTis, pT1, pT2, and pT3/4 was 100%, 84% (95% CI 58%-95%), 54% (95% CI 33%-71%), and 54% (95% CI 25%-76%), respectively (p ≤ .005). Three year CSS for patients with N0, N+, and Nx disease was 90% (95% CI 47%-99%), 65% (95% CI 47%-79%), and 86% (95% CI 73%-93%), respectively (p = .03). The receipt of neoadjuvant chemotherapy did not change per 5 year period over the 16 years of our study. Median follow up was 2.8 years. Penile cancer patients with advanced disease had poor survival. Tumor stage and nodal status were significant predictors of CSS. Penis-sparing approaches may be considered for most patients; however, pathological stage and grade dictate the management and ultimate outcome. Further studies are necessary to clarify the benefits of chemotherapy in this disease.

Survey on the Contemporary Management of Intraoperative Urethral Injuries During Penile Prosthesis Implantation.

Science.gov (United States)

Sexton, Stephanie J; Granieri, Michael A; Lentz, Aaron C

2018-04-01

Intraoperative urethral injury is an uncommon event during the placement of a penile prosthesis, and alternative management strategies have been proposed with continuation of implantation after urethral injury. To evaluate surgeon practices in the management of intraoperative urethral injury. An online survey was sent to the society listservs of the Genitourinary Reconstructive Surgeons (GURS) and the Sexual Medicine Society of North America (SMSNA). Physicians were queried on their fellowship training, experience with penile prosthesis implantation, and management of urethral injuries during prosthesis placement. The response data were analyzed using SAS 9.4 (SAS Institute, Cary, NC, USA). The χ 2 test and Fisher exact test were used to determine associations between variables. Survey responses. 131 survey responses were analyzed. Of the responders, 41.2% were GURS fellowship trained, 19.1% were SMSNA trained, 30.5% were non-fellowship trained, and 9.2% were trained in other fellowships. 25.4% of participants performed more than 50 implantations per year, 37.7% performed 20 to 50 per year, and 36.9% performed fewer than 20 per year. Urethral injury during prosthesis implantation was uncommon, with 26.2% reporting 0 injury, 58.5% reporting 1 to 3 injuries, and 15.4% reporting more than 3 career injuries. Injuries were most commonly encountered during corporal dilation (71.1%) compared with corporal exposure (12.5%) or penile straightening maneuvers (7.0%). There was no statistically significant difference with aborting or continuing implantation among GURS-trained, SMSNA-trained, other fellowship-trained, and non-fellowship-trained surgeons. Of all responders, 55% would abort the procedure after distal urethral injury, whereas 45% would continue the procedure with unilateral or bilateral insertion of cylinders. Patient factors that increased likelihood of terminating the procedure in the case of urethral injury included immunosuppression, spinal cord injury, and

One-stage and two-stage penile buccal mucosa urethroplasty

African Journals Online (AJOL)

G. Barbagli

2015-12-02

Dec 2, 2015 ... there also seems to be a trend of decreasing urethritis and an increase of instrumentation and catheter related strictures in these countries as well [4–6]. The repair of penile urethral strictures may require one- or two- stage urethroplasty [7–10]. Certainly, sexual function can be placed at risk by any surgery ...

Hyper-functioning Thyroid Nodule with Scintigraphic Owl's Eye Appearance

International Nuclear Information System (INIS)

Al-Kordi, R.S.; Elgazzar, A.H.

2006-01-01

Hyper-functioning thyroid nodules may produce various scintigraphic appearances on thyroid scans. Autonomously hyper functioning thyroid nodules invariably demonstrate degenerative changes. These changes may give rise to central or less commonly peripheral photopenic areas on a thyroid scan within otherwise a hot nodule. In this report we present a case of hyper functioning autonomous nodule with peripheral degeneration and residual central functioning tissue giving the appearance of an owl's eye. Although rare, this pattern can be seen in a variety of benign and malignant thyroid conditions. (author)

Large Penile Mass With Unusual Benign Histopathology

Directory of Open Access Journals (Sweden)

Nate Johnson

2015-09-01

Full Text Available Pseudoepitheliomatous hyperplasia is an extremely rare condition presenting as a lesion on the glans penis in older men. Physical exam without biopsy cannot differentiate malignant from nonmalignant growth. We report a case of large penile mass in an elderly male with a history of lichen sclerosis, highly suspicious for malignancy. Subsequent surgical removal and biopsy demonstrated pseudoepitheliomatous hyperplasia, an unusual benign histopathologic diagnosis with unclear prognosis. We review the literature and discuss options for treatment and surveillance.

A Novel Case of Penile Gangrene in a Patient Treated with Ibrutinib for Chronic Lymphocytic Leukemia

OpenAIRE

Skelton IV, William Paul; Akhavan, Neeka N.; Taylor, Zachary A.; Nguyen, Thu-Cuc; Hassan, Hassan; Townsend, Tabitha N.; Pathak, Prajwol; Trikha, Gaurav; Dang, Nam H.; Dang, Long H.; Ali, Azka

2016-01-01

Introduction. Ibrutinib is commonly used for the treatment of patients with CLL in either first-line or relapsed/refractory settings. Case Presentation. We present the case of a 74-year-old Caucasian man with CLL who presented with penile gangrene upon initiation of ibrutinib treatment. Our case is the first showing the complication of penile gangrene associated with ibrutinib use. The gangrene was self-limited upon discontinuing ibrutinib. Conclusion. Our finding describes a very rare yet im...

A Structural and Histochemical Study of Actinorhizal Nodules of Casuarina equisetifolia Linn.

Directory of Open Access Journals (Sweden)

Mohammad Athar

2001-03-01

Full Text Available Casuarina equisetifolia Linn. is an introduced actinorhizal plant grown as roadside ornamental tree and as forest plantation in Pakistan. Actinorhizal nodules are formed on the roots of C. equisetifolia as a response to infection by Frankia. Structure of C. equisetifolia nodules is described using histochemical methods to elucidate the nature of micro-symbiont within the nodules. C. equisetifolia nodules were similar to a root in general anatomical structure and resembled with Myrica-type nodules. The nodule consisted of a distinct periderm enclosing the cortex. The cortex showed patches of infected cells interspersed among uninfected ones. Inside the cortex there was a stele bounded by an endodermis, which contained tannins. The phloem-xylem relationship was amphicribral. A poorly defined meristem was also observed. Apart from simple nodules, dichotomously branched and coralloid nodules were also observed. The stele in simple and branched nodules reached up to the tip of the nodules. The micro-symbiont was observed in the nodule tissues in hyphal form only. The histochemical tests revealed absence of vacuoles and starch grains, and presence of tannins and lignin.

Surgical and Pathological Changes after Radiofrequency Ablation of Thyroid Nodules

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Chiara Dobrinja

2015-01-01

Full Text Available Background. Radiofrequency ablation (RFA has been recently advocated as an effective technique for the treatment of symptomatic benign thyroid nodules. It is not known to what extent it may affect any subsequent thyroid surgery and/or histological diagnosis. Materials and Methods. RFA was performed on 64 symptomatic Thy2 nodules (benign nodules and 6 symptomatic Thy3 nodules (follicular lesions/follicular neoplasms. Two Thy3 nodules regrew after the procedure, and these patients accepted to undergo a total thyroidectomy. Here we present how RFA has affected the operation and the final pathological features of the surgically removed nodules. Results and Conclusions. RFA is effective for the treatment of Thy2 nodules, but it should not be recommended as first-line therapy for the treatment of Thy3 nodules (irrespective of their mutational status, as it delays surgery in case of malignancy. Moreover, it is unknown whether RFA might promote residual tumor progression or neoplastic progression of Thy3 lesions. Nevertheless, here we show for the first time that one session of RFA does not affect subsequent thyroid surgery and/or histological diagnosis.

Cold thyroid nodules show a marked increase in proliferation markers.

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Krohn, Knut; Stricker, Ingo; Emmrich, Peter; Paschke, Ralf

2003-06-01

Thyroid follicular adenomas and adenomatous thyroid nodules are a frequent finding in geographical areas with iodine deficiency. They occur as hypofunctioning (scintigraphically cold) or hyperfunctioning (scintigraphically hot) nodules. Their predominant clonal origin suggests that they result from clonal expansion of a single cell, which is very likely the result of a prolonged increase in proliferation compared with non-affected surrounding cells. To test whether increased cell proliferation is detectable in cold thyroid nodules, we studied paraffin-embedded tissue from 40 cold thyroid nodules and their surrounding normal thyroid tissue for the occurrence of the proliferating cell nuclear antigen (PCNA) and Ki-67 (MIB-1 antibody) epitopes as markers for cell proliferation. All 40 thyroid nodules were histologically well characterized and have been studied for molecular characteristics before. The labeling index (number of labeled cells versus total cell number) for nodular and surrounding tissue was calculated. In 33 cold thyroid nodules a significant (p thyroid nodules a significant (p thyroid epithelial cell proliferation is a uniform feature common to most cold nodules. However, the increase of proliferation markers shows a heterogeneity that is not correlated with histopathologic, molecular, or clinical characteristics.

Initial application of digital tomosynthesis for detection of pulmonary nodules

International Nuclear Information System (INIS)

Sun Zhiyuan; Su Hong; Zhao Yane; Ju Bing; Chang Shuanghui; Hu Qiuju; Lu Guangming

2010-01-01

Objective: To discuss the value of digital tomosynthesis for detection of pulmonary nodules. Methods: Thirty patients suspected of having pulmonary nodules underwent chest radiography, digital tomosynthesis and CT examination. Above image data were transferred to postprocessing work station and were reviewed by 2 radiologists with 3 years of chest-radiology diagnosis experience in a double-blind method. The number, location and size of nodules were recorded. Then, 2 radiologists reviewed the all images once more, and discuss in consensus. The sensitivities of chest radiography and digital tomosynthesis for detection of pulmonary nodules were respectively calculated according to the CT results. Chi-square test was used for radiography, digital tomosynthesis and CT examination. Results: Of 30 patients, 21 were detected having pulmonary nodules by X-ray radiography and 9 were negative, the total number of 40 nodules was detected, while 89 nodules in 26 patients were detected by digital tomosynthesis, and only 4 patients were negative. CT demonstrated 102 nodules in 27 patients, and 3 patients were negative. Taking CT as 'gold standard', the sensitivities of X-ray radiography and digital tomosynthesis were 27.4%(28/102)and 87.2%(89/102), X 2 =4.35, P<0.05, respectively. Conclusion: Digital tomosynthesis has a high sensitivity for detection of pulmonary nodules compared with X-ray radiography, and could be an excellent and necessary supplementary technique of X-ray radiography. (authors)

Automatic Solitary Lung Nodule Detection in Computed Tomography Images Slices

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Sentana, I. W. B.; Jawas, N.; Asri, S. A.

2018-01-01

Lung nodule is an early indicator of some lung diseases, including lung cancer. In Computed Tomography (CT) based image, nodule is known as a shape that appears brighter than lung surrounding. This research aim to develop an application that automatically detect lung nodule in CT images. There are some steps in algorithm such as image acquisition and conversion, image binarization, lung segmentation, blob detection, and classification. Data acquisition is a step to taking image slice by slice from the original *.dicom format and then each image slices is converted into *.tif image format. Binarization that tailoring Otsu algorithm, than separated the background and foreground part of each image slices. After removing the background part, the next step is to segment part of the lung only so the nodule can localized easier. Once again Otsu algorithm is use to detect nodule blob in localized lung area. The final step is tailoring Support Vector Machine (SVM) to classify the nodule. The application has succeed detecting near round nodule with a certain threshold of size. Those detecting result shows drawback in part of thresholding size and shape of nodule that need to enhance in the next part of the research. The algorithm also cannot detect nodule that attached to wall and Lung Chanel, since it depend the searching only on colour differences.

Computerized detection of lung nodules in digital chest radiographs

International Nuclear Information System (INIS)

Giger, M.L.; Doi, K.; MacMahon, H.

1987-01-01

Detection of cancerous lung nodules in chest radiographs is one of the more important tasks performed by a radiologist. In addition, the ''miss rate'' associated with the radiographic detection of lung nodules is approximately 30%. A computerized scheme that alerts the radiologist to possible locations of lung nodules should allow this number of false-negative diagnoses to be reduced. The authors are developing a computer-aided nodule detection scheme based on a difference image approach. They attempt to eliminate the camouflaging background structure of the normal lung anatomy by creating, from a single-projection chest image, two images: one in which the signal-to-noise ratio (SNR) of the nodule is maximized and another in which that SNR is suppressed while the processed background remains essentially the same. Thus, the difference between these two processed images should consist of the nodule superimposed on a relatively uniform background in which the detection task may be simplified. This difference image approach is fundamentally different from conventional subtraction techniques (e.g., temporal or dual-energy subtraction) in that the two images which are subtracted arise from the same single-projection chest radiograph. Once the difference image is obtained, thresholding is performed along with tests for circularity, size and growth in order to extract the nodules. It should be noted that once an original chest image is input to the computer the nodule detection process is totally automated

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

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Emrah Okulu

2013-07-01

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

The effects of penile girth enhancement using injectable hyaluronic acid gel, a filler.

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Kwak, Tae Il; Oh, MiMi; Kim, Je Jong; Moon, Du Geon

2011-12-01

Despites the debates on penile girth enhancement (PGE), demands for enhancement are increasing. Recently, various fillers have been widely used for soft tissue augmentation with proven efficacy and safety. To identify the feasibility and efficacy of PGE by injection of filler. Fifty patients with subjective small penis who visited Korea University Guro outpatient clinic were enrolled and prospectively followed. Restylane Sub-Q (Q-med, Upssala, Sweden) was injected into the fascial layer of penile body via 21G cannula with "Back & Forth Technique" and homogenized with a roller. From April 2006 to February 2008, 50 patients were enrolled and 41 patients were followed until 18 months after PGE. Changes in penile girth at midshaft were measured by tapeline at 1 and 18 months. Patient's visual estimation of residual volume (Gr 0-4), patient's satisfaction (Gr 0-4), and any adverse reactions were also evaluated. Mean injected volume was 20.56 cc (18-22). Compared with basal girth of 7.48 ± 0.35 cm, maximal circumference was significantly increased to 11.41 ± 0.34 cm at 1 month (P < 0.0001) and maintained as 11.26 ± 0.33 cm until 18 months. In patient's visual estimation, two patients complained the decrease as Gr 3 with focal depression at 1 month. At 18 months, all patients answered as Gr 4 without asymmetry. Patient's and partner's satisfaction score was 3.71 ± 0.46 and 3.65 ± 0.48 at 1 month and 3.34 ± 0.53 and 3.38 ± 0.49 at 18 months. There were no inflammatory signs or serious adverse reactions in all cases. Considering the property of material, methods, and follow-up results of 18 months, PGE using filler is a very effective and safe technique for penile augmentation. © 2010 International Society for Sexual Medicine.

Thyroid nodules with minimal cystic changes have a low risk of malignancy

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Na, Dong Gyu; Kim, Dae Sik; Kim, Soo Jin; Kim, Ji Hoon

2016-01-01

The goal of this study was to determine the risk of malignancy of thyroid nodules with minimal cystic changes. A total of consecutive 1,000 thyroid nodules (≥1 cm) with final diagnoses from two institutions were included in this study. The risk of malignancy of thyroid nodules was analyzed according to the internal content, which was categorized as purely solid, minimally cystic (cystic changes ≤10%), and partially cystic (cystic changes >10%). We also assessed the risk of malignancy of nodules with minimal cystic changes depending on echogenicity and presence of any suspicious ultrasonografic (US) features. The overall frequency of purely solid, minimally cystic, and partially cystic nodules was 730/1,000 (73%), 61/1,000 (6.1%), and 209/1,000 (20.9%), respectively, with risks of malignancy of 14.8% (108/730), 3.3% (2/61), and 3.3% (7/209), respectively. The risk of malignancy of nodules with minimal cystic changes was significantly lower than that of purely solid nodules (P=0.013). The risk of malignancy of nodules with minimal cystic changes was also lower than that of purely solid nodules in the group of hypoechoic nodules (P=0.063) and in the group of nodules with suspicious US features (P=0.028), but was not significantly different from that of partially cystic nodules regardless of echogenicity or the presence of suspicious US features (P≥0.652). Thyroid nodules with minimal cystic changes have a low risk of malignancy, similar to that of partially cystic nodules regardless of echogenicity or the presence of suspicious US features. The US lexicon could define solid nodules as nodules with purely solid internal content in order to enhance the accuracy of estimated risks of malignancy

Multidimensional integrative analysis uncovers driver candidates and biomarkers in penile carcinoma

DEFF Research Database (Denmark)

Marchi, Fabio Albuquerque; Martins, David Correa; Barros-Filho, Mateus Camargo

2017-01-01

Molecular data generation and their combination in penile carcinomas (PeCa), a significant public health problem in poor and underdeveloped countries, remain virtually unexplored. An integrativemethodology combin ing genome-wide copy number alteration, DNA methylation, miRNA and mRNA expression...

Benign and malignant thyroid nodules after neck irradiation

International Nuclear Information System (INIS)

Fjaelling, M.T.; Tisell, L.E.; Carlsson, S.; Hansson, G.; Lundberg, L.M.; Oden, A.

1986-01-01

A total of 444 persons were examined for the presence of thyroid nodules on average of 43 years after having been treated with x-rays for cervical tuberculous adenitis. Of this total, 101 subjects had undergone surgery for thyroid nodules: 25 for carcinoma (6%) and 76 for benign nodules (17%). Carcinoma occurred with the same frequency in multinodular and uninodular glands. Because of the uneven age distribution in the current series, it could not be decided whether there was a higher susceptibility of the young thyroid to the induction of thyroid carcinoma or benign nodules. The dosage range for the whole series was 0.40 to 50.90 Gy (40-5090 rad). There was a positive correlation between the absorbed radiation dose and the probability of developing benign and malignant thyroid nodules, even after doses of 20 Gy or more. The risk of developing thyroid carcinoma was equal for men and women, while the female-to-male ratio for benign nodules was 2.9:1, indicating that risk factors associated with females are of less importance in irradiated than in nonirradiated populations. The median latency for carcinoma was 40 years, suggesting that the increased risk of thyroid carcinoma after irradiation remains for the rest of the patient's life

Penile Anaerobic Dysbiosis as a Risk Factor for HIV Infection

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Cindy M. Liu

2017-07-01

Full Text Available Sexual transmission of HIV requires exposure to the virus and infection of activated mucosal immune cells, specifically CD4+ T cells or dendritic cells. The foreskin is a major site of viral entry in heterosexual transmission of HIV. Although the probability of acquiring HIV from a sexual encounter is low, the risk varies even after adjusting for known HIV risk factors. The genital microbiome may account for some of the variability in risk by interacting with the host immune system to trigger inflammatory responses that mediate the infection of mucosal immune cells. We conducted a case-control study of uncircumcised participants nested within a randomized-controlled trial of male circumcision in Rakai, Uganda. Using penile (coronal sulcus swabs collected by study personnel at trial enrollment, we characterized the penile microbiome by sequencing and real-time PCR and cytokine levels by electrochemiluminescence assays. The absolute abundances of penile anaerobes at enrollment were associated with later risk of HIV seroconversion, with a 10-fold increase in Prevotella, Dialister, Finegoldia, and Peptoniphilus increasing the odds of HIV acquisition by 54 to 63%, after controlling for other known HIV risk factors. Increased abundances of anaerobic bacteria were also correlated with increased cytokines, including interleukin-8, which can trigger an inflammatory response that recruits susceptible immune cells, suggesting a mechanism underlying the increased risk. These same anaerobic genera can be shared between heterosexual partners and are associated with increased HIV acquisition in women, pointing to anaerobic dysbiosis in the genital microbiome and an accompanying inflammatory response as a novel, independent, and transmissible risk factor for HIV infection.

Visualization of pulmonary nodules with magnetic resonance imaging (MRI)

International Nuclear Information System (INIS)

Plathow, C.; Deutsches Krebsforschungszentrum; Meinzer, H.-P.; Kauczor, H.-U.

2006-01-01

Visualization of pulmonary nodules using magnetic resonance imaging (MRI) plays a minor role compared with computed tomography (CT). Technical developments made it possible to apply MRI more and more frequently in functional imaging. Imaging of the motion of pulmonary nodules during respiration, e.g., to optimize high precision therapy techniques, is a new field of research. This paper describes developments in analysis and visualization of pulmonary nodules during respiration using MRI. Besides actual 2D techniques new 3D techniques to quantify motion of pulmonary nodules during respiration are presented. (orig.) [de

[Treatment of autonomous and cystic thyroid nodules with intranodular ethanol injection].

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Braga-Basaria, Milena; Trippia, Marcus Adriano; Stolf, Anderson Ravy; Mesa, Cléo; Graf, Hans

2002-01-01

Intranodular ethanol injection has been used for the past 10 years as an efficient modality for treating patients with thyroid nodules. Several studies have reported the success of this therapy in autonomous and cystic nodules and, more recently, in cold benign nodules. To evaluate the efficacy of this therapeutic modality on the treatment of autonomous and cystic thyroid nodules. 42 patients (26 with cystic and 16 with autonomous nodules) were treated with ultrasound guided intranodular 99% ethanol injection and followed for 6 months. No major complications were observed during or after treatment, however, most of the patients reported slight to moderate pain and/or discomfort after the injection. Most of the nodules showed reduction after the treatment. Autonomous nodules had a mean reduction of 50.3% and cystic nodules of 69.3%. No significant differences in pretreatment serum total T3, total T4 or TSH were observed among the patients in the cystic group. Patients in the autonomous group with hyperfunctioning nodules showed a decrease in serum total T3, total T4 and an increase in serum TSH levels, hence, proving the effectiveness of this therapy. Intranodular ethanol injection is a safe and efficient treatment for autonomous and cystic nodules of the thyroid.

Pulmonary nodule characterization, including computer analysis and quantitative features.

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Bartholmai, Brian J; Koo, Chi Wan; Johnson, Geoffrey B; White, Darin B; Raghunath, Sushravya M; Rajagopalan, Srinivasan; Moynagh, Michael R; Lindell, Rebecca M; Hartman, Thomas E

2015-03-01

Pulmonary nodules are commonly detected in computed tomography (CT) chest screening of a high-risk population. The specific visual or quantitative features on CT or other modalities can be used to characterize the likelihood that a nodule is benign or malignant. Visual features on CT such as size, attenuation, location, morphology, edge characteristics, and other distinctive "signs" can be highly suggestive of a specific diagnosis and, in general, be used to determine the probability that a specific nodule is benign or malignant. Change in size, attenuation, and morphology on serial follow-up CT, or features on other modalities such as nuclear medicine studies or MRI, can also contribute to the characterization of lung nodules. Imaging analytics can objectively and reproducibly quantify nodule features on CT, nuclear medicine, and magnetic resonance imaging. Some quantitative techniques show great promise in helping to differentiate benign from malignant lesions or to stratify the risk of aggressive versus indolent neoplasm. In this article, we (1) summarize the visual characteristics, descriptors, and signs that may be helpful in management of nodules identified on screening CT, (2) discuss current quantitative and multimodality techniques that aid in the differentiation of nodules, and (3) highlight the power, pitfalls, and limitations of these various techniques.

Frequency of Thyroid Nodules among Patients with Colonic Polyps

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Cevdet Duran

2012-01-01

Full Text Available Aim. Colonic polyps and thyroid nodules are common diseases and their frequency increases with age. In the literature, there is no study investigating the coexistence of colonic polyps and thyroid nodules. Therefore, this study was designed to investigate thyroid nodule prevalence in patients with colonic polyps. Material and Methods. Sixty-six patients with colonic polyps and 146 patients without colonic polyps enrolled into the study. Age and sex matched control group was composed from patients without colonic polyps. Colonoscopic examinations, thyroid ultrasonographies were performed in all patients, and TSH were measured. Results. Male/female ratio in polyp and control groups were 40/26 versus 68/78, respectively (P=0.058. Mean ages were similar in both groups (53.3±11.4 versus, 51.8±11.4, P=0.373. Thyroid nodule was detected in 44 (66.7% patients with polyps and in 61 (41.8% controls (P=0.001. Patients with adenomatous polyps had 5 or more thyroid nodules compared to patients with hyperplastic polyps (P=0.03. Thyroid nodules were more prevalent among patients aged 50 or older compared to 50 years or less (P=0.023. Conclusion. Thyroid nodules were detected more common in patients with colonic polyps. Further studies are needed to clarify this coexistence.

Penile Cancer in Cali, Colombia: 10 Years of Casuistry in a Tertiary Referral Center of a Middle-Income Country

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Lina M. Rengifo

2015-10-01

Full Text Available Background: Penile cancer is a rare disease in Colombia; in Cali, it represents 0.7% of all cancers. Penile cancer has been associated with old age, bad hygiene, smoking and lack of circumcision. This study aimed to describe the sociodemographic and clinical characteristics of patients with penile cancer who consulted to a tertiary referral hospital. Methods: A case series of all penile cancer cases at a reference institution in Cali during 2001-2010. Socioeconomic, demographic and clinical features of patients were described, and bivariate analyses were carried out. Results: There were 46 penile cancer cases. The average age was 60 ± 16.9 years. The main reason for consultation was an exophytic mass on the penis (75.0%. The most common location was the glans (69.6%, and the more frequent histology type was the squamous cell carcinoma (95.7%. With regard to risk factors, 65.5% of the patients had history of smoking and 90.9% did not have circumcision. Patients who underwent radical amputation had higher rates of positive nodes (55% vs. 13.5%, p=0.015 and ulcerative lesions (77.8% vs. 29.7%, p=0.018 than those who did not have the procedure done. Recurrence was associated with the presence of lymphadenopathy (p=0.02 and history of circumcision (p=0.015. Conclusion: Most of the patients with penile cancer found in this study had old age, history of tobacco use and lack of circumcision. Patients who presented with lymph node metastasis had to undergo more radical procedures and suffered a greater rate of recurrence compared with those without lymph node involvement. Robust studies to determine the risk factors among low-income populations are required.

Application of texture analysis method for classification of benign and malignant thyroid nodules in ultrasound images.

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Abbasian Ardakani, Ali; Gharbali, Akbar; Mohammadi, Afshin

2015-01-01

The aim of this study was to evaluate computer aided diagnosis (CAD) system with texture analysis (TA) to improve radiologists' accuracy in identification of thyroid nodules as malignant or benign. A total of 70 cases (26 benign and 44 malignant) were analyzed in this study. We extracted up to 270 statistical texture features as a descriptor for each selected region of interests (ROIs) in three normalization schemes (default, 3s and 1%-99%). Then features by the lowest probability of classification error and average correlation coefficients (POE+ACC), and Fisher coefficient (Fisher) eliminated to 10 best and most effective features. These features were analyzed under standard and nonstandard states. For TA of the thyroid nodules, Principle Component Analysis (PCA), Linear Discriminant Analysis (LDA) and Non-Linear Discriminant Analysis (NDA) were applied. First Nearest-Neighbour (1-NN) classifier was performed for the features resulting from PCA and LDA. NDA features were classified by artificial neural network (A-NN). Receiver operating characteristic (ROC) curve analysis was used for examining the performance of TA methods. The best results were driven in 1-99% normalization with features extracted by POE+ACC algorithm and analyzed by NDA with the area under the ROC curve ( Az) of 0.9722 which correspond to sensitivity of 94.45%, specificity of 100%, and accuracy of 97.14%. Our results indicate that TA is a reliable method, can provide useful information help radiologist in detection and classification of benign and malignant thyroid nodules.

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

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Javid, L.; Pansota, M. S.; Ahmad, I.; Tariq, M.; Tabassum, S. A. [Bahawal Victoria Hospital Quaid-e-Azam Medical College, Bahawalpur (Pakistan). Dept. of Urology

2014-04-15

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

Comparison between tubularised incised plate urethroplasty and onlay island flap repair in mid and proximal penile hypospadias.

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Javid, Latif; Pansota, Mudassar Saeed; Ahmad, Iftikhar; Tariq, Muhammad; Tabassum, Shafqat Ali

2014-04-01

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

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

International Nuclear Information System (INIS)

Javid, L.; Pansota, M.S.; Ahmad, I.; Tariq, M.; Tabassum, S.A.

2014-01-01

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

The penile cuff test: A clinically useful non-invasive urodynamic investigation to diagnose men with lower urinary tract symptoms

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Christopher Harding

2009-01-01

Full Text Available Objectives: To summarize the development of a novel non-invasive test to categorize voiding dysfunction in men complaining of lower urinary tract symptoms (LUTS - the penile cuff test. Methods: The test involves the controlled inflation of a penile cuff during micturition to interrupt voiding and hence estimate isovolumetric bladder pressure (p ves.isv . The validity, reliability, and clinical usefulness of the test were determined in a number of studies in men with LUTS. Results: The penile cuff test can be successfully performed in over 90% of men with LUTS. The reading of cuff pressure at flow interruption (p cuff.int gives a valid and reliable estimate of invasively-measured p ves.isv and when combined with the reading for maximum flow rate obtained during the test (Q max produces an accurate categorization of bladder outlet obstruction (BOO. Use of this categorization prior to treatment allows improved prediction of outcome from prostatectomy. Conclusion: The penile cuff test fulfils the criteria as a useful clinical measurement technique applicable to the diagnosis and treatment planning of men with LUTS.

Transcription reprogramming during root nodule development in Medicago truncatula.

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Sandra Moreau

Full Text Available Many genes which are associated with root nodule development and activity in the model legume Medicago truncatula have been described. However information on precise stages of activation of these genes and their corresponding transcriptional regulators is often lacking. Whether these regulators are shared with other plant developmental programs also remains an open question. Here detailed microarray analyses have been used to study the transcriptome of root nodules induced by either wild type or mutant strains of Sinorhizobium meliloti. In this way we have defined eight major activation patterns in nodules and identified associated potential regulatory genes. We have shown that transcription reprogramming during consecutive stages of nodule differentiation occurs in four major phases, respectively associated with (i early signalling events and/or bacterial infection; plant cell differentiation that is either (ii independent or (iii dependent on bacteroid differentiation; (iv nitrogen fixation. Differential expression of several genes involved in cytokinin biosynthesis was observed in early symbiotic nodule zones, suggesting that cytokinin levels are actively controlled in this region. Taking advantage of databases recently developed for M. truncatula, we identified a small subset of gene expression regulators that were exclusively or predominantly expressed in nodules, whereas most other regulators were also activated under other conditions, and notably in response to abiotic or biotic stresses. We found evidence suggesting the activation of the jasmonate pathway in both wild type and mutant nodules, thus raising questions about the role of jasmonate during nodule development. Finally, quantitative RT-PCR was used to analyse the expression of a series of nodule regulator and marker genes at early symbiotic stages in roots and allowed us to distinguish several early stages of gene expression activation or repression.

Advances in intelligent diagnosis methods for pulmonary ground-glass opacity nodules.

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Yang, Jing; Wang, Hailin; Geng, Chen; Dai, Yakang; Ji, Jiansong

2018-02-07

Pulmonary nodule is one of the important lesions of lung cancer, mainly divided into two categories of solid nodules and ground glass nodules. The improvement of diagnosis of lung cancer has significant clinical significance, which could be realized by machine learning techniques. At present, there have been a lot of researches focusing on solid nodules. But the research on ground glass nodules started late, and lacked research results. This paper summarizes the research progress of the method of intelligent diagnosis for pulmonary nodules since 2014. It is described in details from four aspects: nodular signs, data analysis methods, prediction models and system evaluation. This paper aims to provide the research material for researchers of the clinical diagnosis and intelligent analysis of lung cancer, and further improve the precision of pulmonary ground glass nodule diagnosis.

Penile erection responses of Nigella sativa seed extract on isolated rat corpus cavernosum

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Aminyoto, M.; Ismail, S.

2018-04-01

Nigella sativa L. (NS) from Ranunculaceae family is known as black cumin in Indonesia. The seed has been used as an aphrodisiac in ethnobotanical studies and reported to have pharmacological activities such as antihypertensive through the relaxant effect of vascular smooth muscles but the direct effect to the blood vessels of the corpus cavernosum is still unknown. The purpose of this study was to examine the response of NS seed extract on penile erection in vitro. NS seeds were macerated in ethanol solvent for three days in room temperature and repeated for two times. Penile erection responses was assessed using isolated rat corpus cavernosum in Krebs-Henseleit solution, temperature 37°C, pH 7.4, aerated with carbogen gas. After acclimation, corpus cavernosum was contracted with a phenylephrine solution. Ethanolic extract of NS seeds or control solution were given after reaching the plateu phase of the highest contraction. This study showed that the contraction response of the corpus cavernosum decreased after addition of NS extract and this action was increased with the addition of the extract concentration. This study concluded that NS seed ethanol extract affects the penile erection response directly through the relaxation of blood vessels in the corpus cavernosum.

A Novel Collaborative Protocol for Successful Management of Penile Pain Mediated by Radiculitis of Sacral Spinal Nerve Roots From Tarlov Cysts.

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Goldstein, Irwin; Komisaruk, Barry R; Rubin, Rachel S; Goldstein, Sue W; Elliott, Stacy; Kissee, Jennifer; Kim, Choll W

2017-09-01

Since 14 years of age, the patient had experienced extreme penile pain within seconds of initial sexual arousal through masturbation. Penile pain was so severe that he rarely proceeded to orgasm or ejaculation. After 7 years of undergoing multiple unsuccessful treatments, he was concerned for his long-term mental health and for his future ability to have relationships. To describe a novel collaboration among specialists in sexual medicine, neurophysiology, and spine surgery that led to successful management. Collaborating health care providers conferred with the referring physician, patient, and parents and included a review of all medical records. Elimination of postpubertal intense penile pain during sexual arousal. The patient presented to our sexual medicine facility at 21 years of age. The sexual medicine physician identifying the sexual health complaint noted a pelvic magnetic resonance imaging report of an incidental sacral Tarlov cyst. A subsequent sacral magnetic resonance image showed four sacral Tarlov cysts, with the largest measuring 18 mm. Neuro-genital testing result were abnormal. The neurophysiologist hypothesized the patient's pain at erection was produced by Tarlov cyst-induced neuropathic irritation of sensory fibers that course within the pelvic nerve. The spine surgeon directed a diagnostic injection of bupivacaine to the sacral nerve roots and subsequently morphine to the conus medullaris of the spinal cord. The bupivacaine produced general penile numbness; the morphine selectively decreased penile pain symptoms during sexual arousal without blocking penile skin sensation. The collaboration among specialties led to the conclusion that the Tarlov cysts were pathophysiologically mediating the penile pain symptoms during arousal. Long-term follow-up after surgical repair showed complete symptom elimination at 18 months after treatment. This case provides evidence that (i) Tarlov cysts can cause sacral spinal nerve root radiculitis through

Quantitative CT: technique dependence of volume estimation on pulmonary nodules

Science.gov (United States)

Chen, Baiyu; Barnhart, Huiman; Richard, Samuel; Colsher, James; Amurao, Maxwell; Samei, Ehsan

2012-03-01

Current estimation of lung nodule size typically relies on uni- or bi-dimensional techniques. While new three-dimensional volume estimation techniques using MDCT have improved size estimation of nodules with irregular shapes, the effect of acquisition and reconstruction parameters on accuracy (bias) and precision (variance) of the new techniques has not been fully investigated. To characterize the volume estimation performance dependence on these parameters, an anthropomorphic chest phantom containing synthetic nodules was scanned and reconstructed with protocols across various acquisition and reconstruction parameters. Nodule volumes were estimated by a clinical lung analysis software package, LungVCAR. Precision and accuracy of the volume assessment were calculated across the nodules and compared between protocols via a generalized estimating equation analysis. Results showed that the precision and accuracy of nodule volume quantifications were dependent on slice thickness, with different dependences for different nodule characteristics. Other parameters including kVp, pitch, and reconstruction kernel had lower impact. Determining these technique dependences enables better volume quantification via protocol optimization and highlights the importance of consistent imaging parameters in sequential examinations.

A case of cyclist's nodule in a female patient

African Journals Online (AJOL)

origin (Fig. 1). e nodule measured 12 mm × 7 mm × 15 mm and showed no flow on Doppler. A magnetic resonance image (MRI) of the pelvis was also performed and showed a poorly circumscribed nodule, isointense to muscle on all sequences, in the right perineum (Fig. 2). A diagnosis of a cyclist's nodule was made ...

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

Science.gov (United States)

Maddineni, Satish B; Lau, Maurice M; Sangar, Vijay K

2009-08-08

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

Self-contained inflatable penile prosthesis: magnetic resonance appearance

International Nuclear Information System (INIS)

Levin, M.F.; Munk, P.L.; Vellet, A.D.; Chin, J.L.

1994-01-01

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

The influence of inspiratory effort and emphysema on pulmonary nodule volumetry reproducibility.

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Moser, J B; Mak, S M; McNulty, W H; Padley, S; Nair, A; Shah, P L; Devaraj, A

2017-11-01

To evaluate the impact of inspiratory effort and emphysema on reproducibility of pulmonary nodule volumetry. Eighty-eight nodules in 24 patients with emphysema were studied retrospectively. All patients had undergone volumetric inspiratory and end-expiratory thoracic computed tomography (CT) for consideration of bronchoscopic lung volume reduction. Inspiratory and expiratory nodule volumes were measured using commercially available software. Local emphysema extent was established by analysing a segmentation area extended circumferentially around each nodule (quantified as percent of lung with density of -950 HU or less). Lung volumes were established using the same software. Differences in inspiratory and expiratory nodule volumes were illustrated using the Bland-Altman test. The influences of percentage reduction in lung volume at expiration, local emphysema extent, and nodule size on nodule volume variability were tested with multiple linear regression. The majority of nodules (59/88 [67%]) showed an increased volume at expiration. Mean difference in nodule volume between expiration and inspiration was +7.5% (95% confidence interval: -24.1, 39.1%). No relationships were demonstrated between nodule volume variability and emphysema extent, degree of expiration, or nodule size. Expiration causes a modest increase in volumetry-derived nodule volumes; however, the effect is unpredictable. Local emphysema extent had no significant effect on volume variability in the present cohort. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Use of Volumetry for Lung Nodule Management: Theory and Practice

NARCIS (Netherlands)

Devaraj, A.; Ginneken, B. van; Nair, A.; Baldwin, D.

2017-01-01

A consistent feature of many lung nodule management guidelines is the recommendation to evaluate nodule size by using diameter measurements and electronic calipers. Traditionally, the use of nodule volumetry applications has primarily been reserved for certain lung cancer screening trials rather

Surgical resection of highly suspicious pulmonary nodules without a tissue diagnosis

International Nuclear Information System (INIS)

Heo, Eun-Young; Lee, Kyung-Won; Jheon, Sanghoon; Lee, Jae-Ho; Lee, Choon-Taek; Yoon, Ho-II

2011-01-01

The safety and efficacy of surgical resection of lung nodule without tissue diagnosis is controversial. We evaluated direct surgical resection of highly suspicious pulmonary nodules and the clinical and radiological predictors of malignancy. Retrospective analyses were performed on 113 patients who underwent surgical resection without prior tissue diagnosis for highly suspicious pulmonary nodules. Clinical and radiological characteristics were compared between histologically proven benign and malignant nodules after resection. Total costs, length of hospitalization and waiting time to surgery were compared with those of patients who had tissue diagnosis prior to surgery. Among 280 patients with pulmonary nodules suspicious for lung cancer, 113 (40.4%) underwent operation without prior tissue diagnosis. Lung nodules were diagnosed as malignant in 96 (85%) of the 113 patients. Except for forced expiratory volume in 1 s, clinical characteristics were not significantly different according to the pathologic results. Forty-five (90%) of 50 patients with ground-glass opacity nodules had a malignancy. Mixed ground-glass opacity, bubble lucency, irregular margin and larger size correlated with malignancy in ground-glass opacity nodules (P<0.05). Fifty-one (81%) of 67 patients with solid nodules had a malignancy. Spiculation, pre-contrast attenuation and contrast enhancement significantly correlated with malignancy in solid nodules (P<0.05). Surgical resection without tissue diagnosis significantly decreased total costs, hospital stay and waiting time (P<0.05). Direct surgical resection of highly suspicious pulmonary nodules can be a valid procedure. However, careful patient selection and further investigations are required to justify direct surgical resection. (author)

Thallium 201 thyroid scan: differential diagnosis of benign and malignant nodules

International Nuclear Information System (INIS)

Oh, Jong Sub; Kim, Byong Geun; Park, Byung Ran; Kim, Se Jong; Ko, Kang Seok; Kim, Min Joong; Ji, Joo Yun

1995-01-01

To evaluate useful findings and diagnostic value of TI-201 thyroid scan in differentiating benign from malignant nodules. We studied 77 cold thyroid nodules proven histologically(27 malignant and 50 benign). Early (5-15 min) and delayed images(3-5 hours) were obtained after intravenous injection of thallium 201. In these nodules, we retrospectively analyzed the degree of TI-201 uptake in early and delayed images, histopathologic type, size, and presence or absence of cystic change in the sonograms of 22 malignant nodules. Useful finding for diagnosis of malignant nodules was strong uptake of TI-201 in early and delayed images(specificity: 98%, sensitivity: 63%, positive predictive value: 94.4%). Useful finding for benign nodules was no uptake of TI-201 in delayed image(specificity: 88.9%, sensitivity: 68%, positive predictive value: 91.9%). The accuracy of TI-201 thyroid scan in differentiating benign from malignant nodules was 66.2%. The nodules with strong TI-201 uptake in early image and low TI-201 uptake in delayed image were malignant in 29.4%. Cystic changes were found in 40% of malignant nodules with atypical TI-201 uptake. TI-201 thyroid scan showed high specificity in follicular neoplasm and adenomatous goiter in which differentiation of benignancy and malignancy is difficult with only cytologic examination. We consider that TI-201 thyroid scan is valuable in differentiating benign from malignant nodules and when combined with fine needle aspiration and ultrasound examination, it will enable more accurate differential diagnosis between benign and malignant thyroid nodules

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

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S J Baruah

2009-01-01

Full Text Available 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.

Contemporary Management of Penile Cancer: Greater than 15-Year MSKCC Experience

Science.gov (United States)

Moses, Kelvin A.; Winer, Andrew; Sfakianos, John P.; Poon, Stephen A.; Kent, Matthew; Bernstein, Melanie; Russo, Paul; Dalbagni, Guido

2014-01-01

Introduction Penile cancer is a rare malignancy, and few guidelines are available to define treatment paradigms. For greater understanding of the natural history of surgically treated penile cancer, we analyzed experience at our institution. Materials and Methods Using an institutional database, we identified 127 patients treated for squamous cell carcinoma of the penis from 1995 – 2011. Cancer-specific survival (CSS) was calculated using the Kaplan-Meier method. Survival data were compared using the log-rank test. The difference in risk of cancer-specific death by lymph node status and histological grade was determined by univariate Cox regression analysis. Results Five-year CSS for pTis, pT1, pT2, and pT3/4 was 100%, 84% (95% CI 58%-95%), 54% (95% CI 33%-71%), and 54% (95% CI 25%-76%), respectively (P ≤ .005). Three-year CSS for patients with N0, N+, and Nx disease was 90% (95% CI 47%-99%), 65% (95% CI 47%-79%), and 86% (95% CI 73%-93%), respectively (P = .03). The receipt of neoadjuvant chemotherapy did not change per 5 year period over the 16 years of our study. Median follow-up was 2.8 years. Conclusions Penile cancer patients with advanced disease had poor survival. Tumor stage and nodal status were significant predictors of CSS. Penis-sparing approaches may be considered for most patients; however, pathological stage and grade dictate the management and ultimate outcome. Further studies are necessary to clarify the benefits of chemotherapy in this disease. PMID:24775572

[EFFECTIVENESS OF ADVANCED SKIN FLAP AND V-SHAPED VENTRAL INCISION ALONG THE ROOT OF PENILE SHAFT FOR CONCEALED PENIS].

Science.gov (United States)

Lin, Junshan; Li, Dumiao; Zhang, Jianxing; Wu, Qiang; Xu, Yali; Lin, Li

2015-09-01

To investigate effectiveness of advanced skin flap and V-shaped ventral incision along the root of penile shaft for concealed penis in children. Between July 2007 and January 2015, 121 boys with concealed penis were treated with advanced skin flap and V-shaped ventral incision along the root of penile shaft. The age varied from 18 months to 13 years (mean, 7.2 years). Repair was based on a vertical incision in median raphe, complete degloving of penis and tacking its base to the dermis of the skin. Advanced skin flap and a V-shaped ventral incision along the root of penile shaft were used to cover the penile shaft. The operation time ranged from 60 to 100 minutes (mean, 75 minutes). Disruption of wound occurred in 1 case, and was cured after dressing change; and primary healing of incision was obtained in the others. The follow-up period ranged from 3 months to 7 years (median, 24 months). All patients achieved good to excellent cosmetic results with a low incidence of complications. The results were satisfactory in exposure of penis and prepuce appearance. No obvious scar was observed. The penis had similar appearance to that after prepuce circumcision. A combination of advanced skin flap and V-shaped ventral incision along the root of penile shaft is a simple, safe, and effective procedure for concealed penis with a similar appearance result to the prepuce circumcision.

An unanswered question in pediatric urology: the post pubertal persistence of prepubertal congenital penile curvature correction by tunical plication.

Science.gov (United States)

Ozkuvanci, Ünsal; Ziylan, Orhan; Dönmez, M Irfan; Yucel, Omer Baris; Oktar, Tayfun; Ander, Haluk; Nane, Ismet

2017-01-01

The aim of this study is to analyze post pubertal results of pre pubertal tunica albuginea plication with non-absorbable sutures in the correction of CPC. The files of patients who underwent tunica albuginea plication without incision (dorsal/lateral) were retrospectively reviewed. Patients younger than 13 years of age at the time of operation and older than 14 years of age in November 2015 were included. Patients with a penile curvature of less than 30 degrees & more than 45 degrees and penile/urethral anomalies were excluded. All of the patients underwent surgery followed by circumcision. The mean age of patients at the time of the operation was 9.7 years (range, 6-13 years). The mean degree of ventral penile curvature measured during the operation was 39 degrees while it was 41 degrees in the lateral curvatures. All of the patients were curvature-free at the end of the operation. At the time of the follow-up examination, the mean age was 16.7 years (range, 14-25 years). Six patients had a straight (0-10 degrees) penis during erection and seven patients had recurrent penile curvatures ranging from 30 to 50 degrees. Pre pubertal tunica albuginea plication of congenital penile curvature (30-45 degrees) with non-absorbable sutures performed without incision is a minimal invasive method especially when performed during circumcision. However, recurrence might be observed in half of the patients after puberty. Copyright® by the International Brazilian Journal of Urology.

An unanswered question in pediatric urology: the post pubertal persistence of prepubertal congenital penile curvature correction by tunical plication

Directory of Open Access Journals (Sweden)

Ünsal Ozkuvanci

Full Text Available ABSTRACT Objective: The aim of this study is to analyze post pubertal results of pre pubertal tunica albuginea plication with non-absorbable sutures in the correction of CPC. Materials and Methods: The files of patients who underwent tunica albuginea plication without incision (dorsal/lateral were retrospectively reviewed. Patients younger than 13 years of age at the time of operation and older than 14 years of age in November 2015 were included. Patients with a penile curvature of less than 30 degrees & more than 45 degrees and penile/urethral anomalies were excluded. All of the patients underwent surgery followed by circumcision. Results: The mean age of patients at the time of the operation was 9.7 years (range, 6-13 years. The mean degree of ventral penile curvature measured during the operation was 39 degrees while it was 41 degrees in the lateral curvatures. All of the patients were curvature-free at the end of the operation. At the time of the follow-up examination, the mean age was 16.7 years (range, 14-25 years. Six patients had a straight (0-10 degrees penis during erection and seven patients had recurrent penile curvatures ranging from 30 to 50 degrees. Conclusion: Pre pubertal tunica albuginea plication of congenital penile curvature (30-45 degrees with non-absorbable sutures performed without incision is a minimal invasive method especially when performed during circumcision. However, recurrence might be observed in half of the patients after puberty.

Uranium-throium isotopes and transition metal fluxes in two oriented manganese nodules from the Central Indian Basin: implications for nodule turnover

Digital Repository Service at National Institute of Oceanography (India)

Banakar, V.K.

turnover. Mar. Geol., 95:71-76. Transition metal fluxes to the top and bottom of two oriented manganese nodules (SS-657 and SK-176) were deter- mined by combining radiochemical and geochemical analyses. Distinct differences in transition metal fluxes, 2a... of rotation of the nodule several times over time intervals which are smaller than the time resolution involved in U-Th isotope dating techniques. Introduction orientation of a nodule, the turnover exposing the accreting surfaces to different environ...

Towards automatic pulmonary nodule management in lung cancer screening with deep learning.

Science.gov (United States)

Ciompi, Francesco; Chung, Kaman; van Riel, Sarah J; Setio, Arnaud Arindra Adiyoso; Gerke, Paul K; Jacobs, Colin; Scholten, Ernst Th; Schaefer-Prokop, Cornelia; Wille, Mathilde M W; Marchianò, Alfonso; Pastorino, Ugo; Prokop, Mathias; van Ginneken, Bram

2017-04-19

The introduction of lung cancer screening programs will produce an unprecedented amount of chest CT scans in the near future, which radiologists will have to read in order to decide on a patient follow-up strategy. According to the current guidelines, the workup of screen-detected nodules strongly relies on nodule size and nodule type. In this paper, we present a deep learning system based on multi-stream multi-scale convolutional networks, which automatically classifies all nodule types relevant for nodule workup. The system processes raw CT data containing a nodule without the need for any additional information such as nodule segmentation or nodule size and learns a representation of 3D data by analyzing an arbitrary number of 2D views of a given nodule. The deep learning system was trained with data from the Italian MILD screening trial and validated on an independent set of data from the Danish DLCST screening trial. We analyze the advantage of processing nodules at multiple scales with a multi-stream convolutional network architecture, and we show that the proposed deep learning system achieves performance at classifying nodule type that surpasses the one of classical machine learning approaches and is within the inter-observer variability among four experienced human observers.

A solitary hyperfunctioning thyroid nodule harboring thyroid carcinoma: review of the literature.

Science.gov (United States)

Mirfakhraee, Sasan; Mathews, Dana; Peng, Lan; Woodruff, Stacey; Zigman, Jeffrey M

2013-05-04

Hyperfunctioning nodules of the thyroid are thought to only rarely harbor thyroid cancer, and thus are infrequently biopsied. Here, we present the case of a patient with a hyperfunctioning thyroid nodule harboring thyroid carcinoma and, using MEDLINE literature searches, set out to determine the prevalence of and characteristics of malignant "hot" nodules as a group. Historical, biochemical and radiologic characteristics of the case subjects and their nodules were compared to those in cases of benign hyperfunctioning nodules. A literature review of surgical patients with solitary hyperfunctioning thyroid nodules managed by thyroid resection revealed an estimated 3.1% prevalence of malignancy. A separate literature search uncovered 76 cases of reported malignant hot thyroid nodules, besides the present case. Of these, 78% were female and mean age at time of diagnosis was 47 years. Mean nodule size was 4.13 ± 1.68 cm. Laboratory assessment revealed T3 elevation in 76.5%, T4 elevation in 51.9%, and subclinical hyperthyroidism in 13% of patients. Histological diagnosis was papillary thyroid carcinoma (PTC) in 57.1%, follicular thyroid carcinoma (FTC) in 36.4%, and Hurthle cell carcinoma in 7.8% of patients. Thus, hot thyroid nodules harbor a low but non-trivial rate of malignancy. Compared to individuals with benign hyperfunctioning thyroid nodules, those with malignant hyperfunctioning nodules are younger and more predominantly female. Also, FTC and Hurthle cell carcinoma are found more frequently in hot nodules than in general. We were unable to find any specific characteristics that could be used to distinguish between malignant and benign hot nodules.

Competitive nodulation blocking of cv. Afghanistan pea is related to high levels of nodulation factors made by some strains of Rhizobium leguminosarum bv. viciae

NARCIS (Netherlands)

Hogg, B.; Davies, A.E.; Wilson, K.E.; Bisseling, T.; Downie, J.A.

2002-01-01

Cultivar Afghanistan peas are resistant to nodulation by many strains of Rhizobium leguminosarum bv. viciae but are nodulated by strain TOM, which carries the host specificity gene nodX. Some strains that lack nodX can inhibit nodulation of cv. Afghanistan by strain TOM. We present evidence that

Cooled microwave ablation of thyroid nodules: Initial experience

Energy Technology Data Exchange (ETDEWEB)

Korkusuz, Yücel [Department of Nuclear Medicine, University Hospital Frankfurt (Germany); Mader, Oscar Maximilian, E-mail: info@dzta.de [Department of Nuclear Medicine, University Hospital Frankfurt (Germany); Kromen, Wolfgang [Department of Neuro Radiology University Hospital (Germany); Happel, Christian [Department of Nuclear Medicine, University Hospital Frankfurt (Germany); German Centre for Thermoablation of Thyroid Nodules, University Hospital, Frankfurt (Germany); Ahmad, Shadi [Department of General and Visceral Surgery, Agaplesion Elisabethenstift, Darmstadt (Germany); Gröner, Daniel; Koca, Mithat; Mader, Alexander [Department of Nuclear Medicine, University Hospital Frankfurt (Germany); Grünwald, Frank; Korkusuz, Hüdayi [Department of Nuclear Medicine, University Hospital Frankfurt (Germany); German Centre for Thermoablation of Thyroid Nodules, University Hospital, Frankfurt (Germany)

2016-11-15

Highlights: • cMWA is a safe and effective treatment for thyroid nodules. • Ultrasound imaging allows guidance during microwave ablation. • Pain level during cMWA treatment is reduced in comparison to RFA. - Abstract: Objective: To evaluate if internally cooled microwave ablation (cMWA) is a safe and effective method for treatment of benign and malign thyroid nodules. Methods: 9 patients with 11 symptomatic cold benign thyroid nodules and 1 recurrent thyroid carcinoma ranging in volume from 9.1 to 197 ml (mean size 52 ±  57 ml) were treated with cMWA. The mean age of the patients was 59 years. Pain during the treatment was measured on a 10-point scale. Side effects revealed by ultrasound or patients’ complaints were documented. Periablative efficacy was measured 24 h after cMWA as change (Δ) in serum thyreoglobulin (Tg). Nodule elasticity was measured on a 4-point scale, blood circulation and echogenicity on a 3-point scale. Results: All patients tolerated cMWA well. Median pain intensity averaged 2.1 ± 0.8 (range: 1–3). Postablative hematoma was observed in all cases. In no cases ablation led to hoarseness, superficial burns, nodule ruptures, vagal reactions or dysphagia. cMWA lead to a significant decrease of blood circulation, nodule echogenicity and a significant increase of elasticity (Δ  =  1.1  ±  0.33; 0.8  ±  0.4 and 1.1  ±  0.6 points)(p < 0.05). An average increase of 4495 ng/ml Tg was measured (p < 0.05). Conclusions: cMWA is an effective and secure method for treatment of thyroid nodules.

Alteration in the etiology of penile fracture in the Middle East and Central Asia regions in the last decade; a literature review

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Ahmad A Majzoub

2015-01-01

Full Text Available Penile fracture is a well-recognized, relatively uncommon medical condition and its etiology differs according to geographic area. In this review article, we evaluated literature reported in the past decade, aiming to verify whether there has been any change in the etiology of this condition. A literature review was done for studies published in the past 10 years and focusing on the etiology of penile fracture. Inclusion criteria comprised articles in English language, of sample size more than 10 patients and originating from the Middle East and Central Asia. Data relating to the studied population, etiology of penile fracture, clinical presentation, investigations, management, and outcome was analyzed. One thousand six hundred and twenty-nine patients from 21 original articles were included in the study. The mean age ΁ standard deviation of the patients was 33.3 ΁ 3.23 years. Etiologies of penile fracture were vigorous sexual intercourse, manual bending of erect penis, vigorous masturbation, rolling over in bed and blunt trauma in 41%, 29%, 10%, 14% and 6% patients, respectively. Treatment choices were surgery and conservative, in 1580 (95%, 83 (5% patients, respectively. A higher incidence of complications was found in conservatively treated patients. As a conclusion, in the last 10 years, vigorous sexual intercourse was the commonest etiology of penile fracture in the Middle East and Central Asia regions. Surgery remains the preferred treatment option for patients diagnosed with penile fracture.

A Novel Case of Penile Gangrene in a Patient Treated with Ibrutinib for Chronic Lymphocytic Leukemia

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William Paul Skelton IV

2016-01-01

Full Text Available Introduction. Ibrutinib is commonly used for the treatment of patients with CLL in either first-line or relapsed/refractory settings. Case Presentation. We present the case of a 74-year-old Caucasian man with CLL who presented with penile gangrene upon initiation of ibrutinib treatment. Our case is the first showing the complication of penile gangrene associated with ibrutinib use. The gangrene was self-limited upon discontinuing ibrutinib. Conclusion. Our finding describes a very rare yet important adverse event associated with ibrutinib use.

Root nodule symbiosis in Lotus japonicus drives the establishment of distinctive rhizosphere, root, and nodule bacterial communities.

Science.gov (United States)

Zgadzaj, Rafal; Garrido-Oter, Ruben; Jensen, Dorthe Bodker; Koprivova, Anna; Schulze-Lefert, Paul; Radutoiu, Simona

2016-12-06

Lotus japonicus has been used for decades as a model legume to study the establishment of binary symbiotic relationships with nitrogen-fixing rhizobia that trigger root nodule organogenesis for bacterial accommodation. Using community profiling of 16S rRNA gene amplicons, we reveal that in Lotus, distinctive nodule- and root-inhabiting communities are established by parallel, rather than consecutive, selection of bacteria from the rhizosphere and root compartments. Comparative analyses of wild-type (WT) and symbiotic mutants in Nod factor receptor5 (nfr5), Nodule inception (nin) and Lotus histidine kinase1 (lhk1) genes identified a previously unsuspected role of the nodulation pathway in the establishment of different bacterial assemblages in the root and rhizosphere. We found that the loss of nitrogen-fixing symbiosis dramatically alters community structure in the latter two compartments, affecting at least 14 bacterial orders. The differential plant growth phenotypes seen between WT and the symbiotic mutants in nonsupplemented soil were retained under nitrogen-supplemented conditions that blocked the formation of functional nodules in WT, whereas the symbiosis-impaired mutants maintain an altered community structure in the nitrogen-supplemented soil. This finding provides strong evidence that the root-associated community shift in the symbiotic mutants is a direct consequence of the disabled symbiosis pathway rather than an indirect effect resulting from abolished symbiotic nitrogen fixation. Our findings imply a role of the legume host in selecting a broad taxonomic range of root-associated bacteria that, in addition to rhizobia, likely contribute to plant growth and ecological performance.

Effect of Scanning and Reconstruction Parameters on Three Dimensional Volume and CT Value Measurement of Pulmonary Nodules: A Phantom Study

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Datong SU

2017-08-01

Full Text Available Background and objective The computed tomography (CT follow-up of indeterminate pulmonary nodules aiming to evaluate the change of the volume and CT value is the common strategy in clinic. The CT dose needs to considered on serious CT scans in addition to the measurement accuracy. The purpose of this study is to quantify the precision of pulmonary nodule volumetric measurement and CT value measurement with various tube currents and reconstruction algorithms in a phantom study with dual-energy CT. Methods A chest phantom containing 9 artificial spherical solid nodules with known diameter (D=2.5 mm, 5 mm, 10 mm and density (-100 HU, 60 HU and 100 HU was scanned using a 64-row detector CT canner at 120 Kilovolt & various currents (10 mA, 20 mA, 50 mA, 80 mA,100 mA, 150 mA and 350 mA. Raw data were reconstructed with filtered back projection and three levels of adaptive statistical iterative reconstruction algorithm (FBP, ASIR; 30%, 50% and 80%. Automatic volumetric measurements were performed using commercially available software. The relative volume error (RVE and the absolute attenuation error (AAE between the software measures and the reference-standard were calculated. Analyses of the variance were performed to evaluate the effect of reconstruction methods, different scan parameters, nodule size and attenuation on the RPE. Results The software substantially overestimated the very small (D=2.5 mm nodule's volume [mean RVE: (100.8%±28%] and underestimated it attenuation [mean AAE: (-756±80 HU]. The mean RVEs of nodule with diameter as 5 mm and 10 mm were small [(-0.9%±1.1% vs (0.9%±1.4%], however, the mean AAEs [(-243±26 HU vs (-129±7 HU] were large. The ANOVA analysis for repeated measurements showed that different tube current and reconstruction algorithm had no significant effect on the volumetric measurements for nodules with diameter of 5 mm and 10 mm (F=5.60, P=0.10 vs F=11.13, P=0.08, but significant effects on the measurement of CT

Application of a kernel-based online learning algorithm to the classification of nodule candidates in computer-aided detection of CT lung nodules

International Nuclear Information System (INIS)

Matsumoto, S.; Ohno, Y.; Takenaka, D.; Sugimura, K.; Yamagata, H.

2007-01-01

Classification of the nodule candidates in computer-aided detection (CAD) of lung nodules in CT images was addressed by constructing a nonlinear discriminant function using a kernel-based learning algorithm called the kernel recursive least-squares (KRLS) algorithm. Using the nodule candidates derived from the processing by a CAD scheme of 100 CT datasets containing 253 non-calcified nodules or 3 mm or larger as determined by the consensus of two thoracic radiologists, the following trial were carried out 100 times: by randomly selecting 50 datasets for training, a nonlinear discriminant function was obtained using the nodule candidates in the training datasets and tested with the remaining candidates; for comparison, a rule-based classification was tested in a similar manner. At the number of false positives per case of about 5, the nonlinear classification method showed an improved sensitivity of 80% (mean over the 100 trials) compared with 74% of the rule-based method. (orig.)

Dissecting the Root Nodule Transcriptome of Chickpea (Cicer arietinum L.).

Science.gov (United States)

Kant, Chandra; Pradhan, Seema; Bhatia, Sabhyata

2016-01-01

A hallmark trait of chickpea (Cicer arietinum L.), like other legumes, is the capability to convert atmospheric nitrogen (N2) into ammonia (NH3) in symbiotic association with Mesorhizobium ciceri. However, the complexity of molecular networks associated with the dynamics of nodule development in chickpea need to be analyzed in depth. Hence, in order to gain insights into the chickpea nodule development, the transcriptomes of nodules at early, middle and late stages of development were sequenced using the Roche 454 platform. This generated 490.84 Mb sequence data comprising 1,360,251 reads which were assembled into 83,405 unigenes. Transcripts were annotated using Gene Ontology (GO), Cluster of Orthologous Groups (COG) and Kyoto Encyclopedia of Genes and Genomes (KEGG) metabolic pathways analysis. Differential expression analysis revealed that a total of 3760 transcripts were differentially expressed in at least one of three stages, whereas 935, 117 and 2707 transcripts were found to be differentially expressed in the early, middle and late stages of nodule development respectively. MapMan analysis revealed enrichment of metabolic pathways such as transport, protein synthesis, signaling and carbohydrate metabolism during root nodulation. Transcription factors were predicted and analyzed for their differential expression during nodule development. Putative nodule specific transcripts were identified and enriched for GO categories using BiNGO which revealed many categories to be enriched during nodule development, including transcription regulators and transporters. Further, the assembled transcriptome was also used to mine for genic SSR markers. In conclusion, this study will help in enriching the transcriptomic resources implicated in understanding of root nodulation events in chickpea.

Nonphotosynthetic CO2 fixation by alfalfa (Medicago sativa L.) roots and nodules

International Nuclear Information System (INIS)

Anderson, M.P.; Heichel, G.H.; Vance, C.P.

1987-01-01

The dependence of alfalfa (Medicago sativa L.) root and nodule nonphotosynthetic CO 2 fixation on the supply of currently produced photosynthate and nodule nitrogenase activity was examined a various times after phloem-girdling and exposure of nodules to Ar:O 2 . Phloem-girdling was effected 20 hours and exposure to Ar:O 2 was effected 2 to 3 hours before initiation of experiments. Nodule and root CO 2 fixation rates of phloem-girdled plants were reduced to 38 and 50%, respectively, of those of control plants. Exposure to Ar:O 2 decreased nodule CO 2 fixation rates to 45%, respiration rates to 55%, and nitrogenase activities to 51% of those of the controls. The products of nodule CO 2 fixation were exported through the xylem to the shoot mainly as amino acids within 30 to 60 minutes after exposure to 14 CO 2 . In contrast to nodules, roots exported very little radioactivity, and most of the 14 C was exported as organic acids. The nonphotosynthetic CO 2 fixation rate of roots and nodules averaged 26% of the gross respiration rate, i.e. the sum of net respiration and nonphotosynthetic CO 2 assimilation. Nodules fixed CO 2 at a rate 5.6 times that of roots, but since nodules comprised a small portion of root system mass, roots accounted for 76% of the nodulated roots system CO 2 fixation. The results indicate that nodule CO 2 fixation in alfalfa is associated with N assimilation

Survey of management of solitary thyroid nodules in Germany.

Science.gov (United States)

Dietlein, M; Wegscheider, K; Vaupel, R; Schmidt, M; Schicha, H

2008-01-01

To compare the opinions of practitioners in primary care with those of thyroid specialists in Germany on the management of solitary thyroid nodules (Papillon 2005). Questionnaires were filled in by 2,191 practitioners and 297 thyroid specialists between June 1 and September 30, 2005. The test cases and their modifications described a solitary thyroid nodule of 2-3 cm with different levels of thyroid function and a hypoechogenic nodule of 1 cm in diameter. TSH determination and sonography were found to be standard procedures, followed by scintigraphy (selected by 84.7% of practitioners and 95.1% of specialists, p nodule calcitonin determination was advocated by 54.0% of endocrinologists and by 32.2% of nuclear medicine physicians (p thyroid nodule would be treated medically by 77.8% of practitioners and by 85.7% of specialists, the combination of levothyroxine and iodine being clearly preferred (60.9% of practitioners and 67.1% of specialists). For a hyperfunctioning nodule the preference of radioiodine therapy was significantly higher in the specialist group (88.8%) than among the practitioners (52.2%). The main differences of opinion between practitioners and specialists focused on calcitonin screening and referral to radioiodine therapy.

Pseudo-capsule “coffin effect”: How to prevent penile retraction after implant of three-piece inflatable prosthesis

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Enrico Caraceni

2014-06-01

Full Text Available Objective: Following three-component implantation of a penile prosthesis, some patients are dissatisfied with their penile length. This may be due to the procedure by itself or pre-existing risk factors or psychological reasons. We supposed that formation of a restricted pseudo-capsule due to a late prosthesis activation can inhibit later system expansion. We aimed to identify the presence or absence of penile retraction after implant and to prevent it by immediate prosthesis activation after implantation. Material and methods. Forty-six patients operated with three-piece inflatable penile prosthesis (AMS 700 CX o LGX were enrolled. In 27 patients prosthesis was first activated four weeks after surgery (NEA group and in 19 patients prosthesis was activated immediately after surgery (DEA group. Length and girth of the penis was evaluated before (in DEA group and after the surgical procedure. Results. The average post implant dorsal length of the erect penis in group NEA was found 3.28 cm shorter than in group with early activation (DEA. In DEA group there was no lenght difference between pre-operative stretching (14.57 cm and post operative erection (14.98 cm. When early activation was not performed, the clinical result was a smaller penis in erect phase. Conclusion. Reduced lenght of the penis after implantation can be caused by the presence of a pseudo-capsule that limits the elongation of the prosthesis and of the penis (“coffin effect”. Timing of first activation seems to be the key in order to prevent the risk of penile retraction after implantation. Early activation is identified as the best measure to maintain the length of the pre implant erect penis after the prosthetic hydraulic implant.

Cowpea and peanut in southern Africa are nodulated by diverse Bradyrhizobium strains harboring nodulation genes that belong to the large pantropical clade common in Africa.

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Steenkamp, Emma T; Stepkowski, Tomasz; Przymusiak, Anna; Botha, Wilhelm J; Law, Ian J

2008-09-01

Cowpea (Vigna unguiculata) and peanut (Arachis hypogaea) in southern Africa are nodulated by a genetically diverse group of Bradyrhizobium strains. To determine the identity of these bacteria, a collection of 22 isolates originating from the root nodules of both hosts in Botswana and South Africa was investigated using the combined sequences for the core genome genes rrs, recA, and glnII. These data separated the majority of the isolates into one of three unique lineages that most likely represent novel Bradyrhizobium species. Some isolates were also conspecific with B. yuanmingense and with B. elkanii, although none grouped with B. japonicum, B. canariense or B. liaoningense. To study the evolution of nodulation genes in these bacteria, the common nodulation gene, nodA, and host-specific nodulation genes, nodZ, noeE, and noeI, were analyzed. The nodA phylogeny showed that the cowpea and peanut Bradyrhizobium isolates represent various locally adapted groups or ecotypes that form part of Clade III of the seven known BradyrhizobiumnodA clades. This large and highly diverse clade comprises all strains from sub-Saharan Africa, as well as some originating from the Americas, Australia, Indonesia, China and Japan. Some similar groupings were supported by the other nodulation genes, although the overall phylogenies for the nodulation genes were incongruent with that inferred from the core genome genes, suggesting that horizontal gene transfer significantly influences the evolution of cowpea and peanut root-nodule bacteria. Furthermore, identification of the nodZ, noeI, and noeE genes in the isolates tested indicates that African Bradyrhizobium species may produce highly decorated nodulation factors, which potentially represent an important adaptation enabling nodulation of a great variety of legumes inhabiting the African continent.

Sclerosing lymphangitis of the penis associated with marked penile oedema and skin erosions.

Science.gov (United States)

Karray, Mehdi; Litaiem, Noureddine; Jones, Mariem; Zeglaoui, Faten

2017-07-27

Sclerosing lymphangitis of the penis is a benign, under-reported condition consisting of a asymptomatic firm cord-like swelling around the coronal sulcus of the penis usually affecting men in the second or third decade of life. Penile oedema and erosions are rarely reported. Clinical signs may be remarkable contrasting with the self-limited character of the disease. We report a new case of sclerosing lymphangitis of the penis occurring in a 59-year-old patient marked by penile swelling and several overlying skin erosions, and discuss the clinical features and the pathogenesis aspects of the disease. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Isolation and identification of female DNA on postcoital penile swabs.

Science.gov (United States)

Cina, S J; Collins, K A; Pettenati, M J; Fitts, M

2000-06-01

After sexual assault, cells originating from the assailant may be recovered from the victim. Through polymerase chain reaction (PCR)-based technology, positive scientific identification of the assailant may be made from these cells. Described is a prospective study describing a method for positively identifying cells from a female sex partner obtained from postcoital swabs of the penis of the male sex partner. Swabs were taken from the penis of a man at 1- to 24-hour intervals after coitus. DNA was isolated from each swab through standard organic extraction methods. The presence of female DNA was detected using the gender-specific amelogenin marker. Extracted DNA was amplified for eight different genetic loci using the Promega PowerPlex kit (Promega) and Amplitaq Gold (Perkin Elmer). Amplified samples were electrophoresed on precast sequencing gels (Hitachi) and were analyzed fluorescently using Hitachi's FMBIO 2 fluorescent scanner and software. Each sample obtained from a penile swab or condom was compared to male and female buccal controls. Female DNA was isolated from all postcoital penile swabs as determined by exclusive amplification of the X-chromosome specific 212 base pair amelogenin marker. In all cases, scientific identification of the female DNA from the swabs was determined by coamplification of eight STR loci (PowerPlex) and was compared to female and male control profiles. Cells shed from a female victim during sexual intercourse can be retrieved from the penis of a male offender after sexual intercourse during a 1- to 24-hour postcoital interval. DNA can be extracted from these cells and can be used to scientifically identify the female sexual participant through PCR-based technology. It is suggested that penile swabs be taken from alleged perpetrators of sexual assaults to associate them with a female victim.

Crowdsourcing the nodulation gene network discovery environment.

Science.gov (United States)

Li, Yupeng; Jackson, Scott A

2016-05-26

The Legumes (Fabaceae) are an economically and ecologically important group of plant species with the conspicuous capacity for symbiotic nitrogen fixation in root nodules, specialized plant organs containing symbiotic microbes. With the aim of understanding the underlying molecular mechanisms leading to nodulation, many efforts are underway to identify nodulation-related genes and determine how these genes interact with each other. In order to accurately and efficiently reconstruct nodulation gene network, a crowdsourcing platform, CrowdNodNet, was created. The platform implements the jQuery and vis.js JavaScript libraries, so that users are able to interactively visualize and edit the gene network, and easily access the information about the network, e.g. gene lists, gene interactions and gene functional annotations. In addition, all the gene information is written on MediaWiki pages, enabling users to edit and contribute to the network curation. Utilizing the continuously updated, collaboratively written, and community-reviewed Wikipedia model, the platform could, in a short time, become a comprehensive knowledge base of nodulation-related pathways. The platform could also be used for other biological processes, and thus has great potential for integrating and advancing our understanding of the functional genomics and systems biology of any process for any species. The platform is available at http://crowd.bioops.info/ , and the source code can be openly accessed at https://github.com/bioops/crowdnodnet under MIT License.

Diffuse Anterior Retinoblastoma with Sarcoidosis-Like Nodule

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Koji Kitazawa

2015-12-01

Full Text Available Background: Retinoblastomas account for 4% of malignancies in children, 1-2% of which are diffuse infiltrating retinoblastomas. Diffuse anterior retinoblastoma is rare and does not involve the retina. Here, we report on a diffuse anterior retinoblastoma with large sarcoidosis-like nodules on the iris that were responsive to anti-inflammatory therapy. Case: We present a 6-year-old girl who had anterior uveitis with white nodules on the iris and posterior surface of the cornea in her right eye. The nodules initially responded well to anti-inflammatory treatment. However, anterior segment optical coherence tomography (AS-OCT showed that the nodules gradually grew, shrinking the iris. We then collected the aqueous humor for diagnosis. A biopsy revealed clusters of small cells with a high nuclear-to-cytoplasm ratio with partial rosette formation. Therefore, we diagnosed diffuse anterior retinoblastoma without retinal involvement and performed enucleation of the right eye. The histopathology demonstrated undifferentiated cells similar to those seen on the biopsy, and tumor cells invaded the iris stroma, posterior surface of the cornea, ciliary body, and sclera. After the enucleation, she underwent chemotherapy and remains alive. Conclusion: A differential diagnosis of retinoblastoma should be considered when white nodules refractory to anti-inflammatory therapy occur in the eye, even in the absence of obvious retinal masses. AS-OCT findings are useful in assessing retinoblastoma.

Computer-aided diagnosis (CAD) of subsolid nodules: Evaluation of a commercial CAD system

International Nuclear Information System (INIS)

Benzakoun, Joseph; Bommart, Sébastien; Coste, Joël; Chassagnon, Guillaume; Lederlin, Mathieu; Boussouar, Samia

2016-01-01

Highlights: • CAD sensitivity is still limited for automated detection of subsolid nodules. • CAD detection rate is higher for part-solid than for pure ground-glass nodules. • Part-solid nodule detection is not better for nodules with larger solid component. - Abstract: Objectives: To evaluate the performance of a commercially available CAD system for automated detection and measurement of subsolid nodules. Materials and methods: The CAD system was tested on 50 pure ground-glass and 50 part-solid nodules (median diameter: 17 mm) previously found on standard-dose CT scans in 100 different patients. True nodule detection and the total number of CAD marks were evaluated at different sensitivity settings. The influence of nodule and CT acquisition characteristics was analyzed with logistic regression. Software and manually measured diameters were compared with Spearman and Bland-Altman methods. Results: With sensitivity adjusted for 3-mm nodule detection, 50/100 (50%) subsolid nodules were detected, at the average cost of 17 CAD marks per CT. These figures were respectively 26/100 (26%) and 2 at the 5-mm setting. At the highest sensitivity setting (2-mm nodule detection), the average number of CAD marks per CT was 41 but the nodule detection rate only increased to 54%. Part–solid nodules were better detected than pure ground glass nodules: 36/50 (72%) versus 14/50 (28%) at the 3-mm setting (p < 0.0001), with no influence of the solid component size. Except for the type (i.e. part solid or pure ground glass), no other nodule characteristic influenced the detection rate. High-quality segmentation was obtained for 79 nodules, which for automated measurements correlated well with manual measurements (rho = 0.90[0.84–0.93]). All part-solid nodules had software-measured attenuation values above −671 Hounsfield units (HU). Conclusion: The detection rate of subsolid nodules by this CAD system was insufficient, but high-quality segmentation was obtained in 79% of

Computer-aided diagnosis (CAD) of subsolid nodules: Evaluation of a commercial CAD system

Energy Technology Data Exchange (ETDEWEB)

Benzakoun, Joseph, E-mail: benzakoun.joseph@gmail.com [Hôpital Hôtel-Dieu, 1 parvis Notre-Dame, 75004 Paris (France); Université Paris Descartes, 12 rue de l’Ecole de Médecine, 75006 Paris (France); Bommart, Sébastien, E-mail: s-bommart@chu-montpellier.fr [CHU de Montpellier, 191 avenue du Doyen Gaston Giraud, 34000 Montpellier (France); INSERM U 1046, 371 avenue du Doyen G. Giraud, 34000 Montpellier (France); Coste, Joël, E-mail: joel.coste@htd.aphp.fr [Hôpital Hôtel-Dieu, 1 parvis Notre-Dame, 75004 Paris (France); Université Paris Descartes, 12 rue de l’Ecole de Médecine, 75006 Paris (France); Chassagnon, Guillaume, E-mail: gchassagnon@gmail.com [Université Paris Descartes, 12 rue de l’Ecole de Médecine, 75006 Paris (France); Hôpital Cochin, Radiologie, 27 rue du Faubourg Saint Jacques, 75014 Paris (France); Lederlin, Mathieu, E-mail: mathieu.lederlin@chu-rennes.fr [CHU de Rennes, Radiologie, 2 Rue Henri le Guilloux, 35000 Rennes (France); Université de Rennes 1, 9 Rue Jean Macé, 35000 Rennes (France); Boussouar, Samia, E-mail: samiaboussouar@gmail.com [Université Paris Descartes, 12 rue de l’Ecole de Médecine, 75006 Paris (France); Hôpital Européen Georges Pompidou, 20 Rue Leblanc, 75015 Paris (France); and others

2016-10-15

Highlights: • CAD sensitivity is still limited for automated detection of subsolid nodules. • CAD detection rate is higher for part-solid than for pure ground-glass nodules. • Part-solid nodule detection is not better for nodules with larger solid component. - Abstract: Objectives: To evaluate the performance of a commercially available CAD system for automated detection and measurement of subsolid nodules. Materials and methods: The CAD system was tested on 50 pure ground-glass and 50 part-solid nodules (median diameter: 17 mm) previously found on standard-dose CT scans in 100 different patients. True nodule detection and the total number of CAD marks were evaluated at different sensitivity settings. The influence of nodule and CT acquisition characteristics was analyzed with logistic regression. Software and manually measured diameters were compared with Spearman and Bland-Altman methods. Results: With sensitivity adjusted for 3-mm nodule detection, 50/100 (50%) subsolid nodules were detected, at the average cost of 17 CAD marks per CT. These figures were respectively 26/100 (26%) and 2 at the 5-mm setting. At the highest sensitivity setting (2-mm nodule detection), the average number of CAD marks per CT was 41 but the nodule detection rate only increased to 54%. Part–solid nodules were better detected than pure ground glass nodules: 36/50 (72%) versus 14/50 (28%) at the 3-mm setting (p < 0.0001), with no influence of the solid component size. Except for the type (i.e. part solid or pure ground glass), no other nodule characteristic influenced the detection rate. High-quality segmentation was obtained for 79 nodules, which for automated measurements correlated well with manual measurements (rho = 0.90[0.84–0.93]). All part-solid nodules had software-measured attenuation values above −671 Hounsfield units (HU). Conclusion: The detection rate of subsolid nodules by this CAD system was insufficient, but high-quality segmentation was obtained in 79% of

Penile involvement in Systemic Sclerosis: New Diagnostic and Therapeutic Aspects

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Antonio Aversa

2010-01-01

Full Text Available Systemic Sclerosis (SSc is a connective tissue disorder featuring vascular alterations and an immunological activation leading to a progressive and widespread fibrosis of several organs such as the skin, lung, gastrointestinal tract, heart, and kidney. Men with SSc are at increased risk of developing erectile dysfunction (ED because of the evolution of early microvascular tissutal damage into corporeal fibrosis. The entity of penile vascular damage in SSc patients has been demonstrated by using Duplex ultrasonography and functional infra-red imaging and it is now clear that this is a true clinical entity invariably occurring irrespective of age and disease duration and constituting the ‘‘sclerodermic penis’’. Once-daily phosphodiesterase type-5 (PDE5 inhibitors improve both sexual function and vascular measures of cavernous arteries by improving surrogate markers of endothelial dysfunction, that is, plasma endothelin-1 and adrenomedullin levels, which may play a potential role in preventing progression of penile fibrosis and ED. Also, the beneficial effect of long-term PDE5i add-on therapy to SSc therapy in the treatment of Raynaud's phenomenon is described.

Suprapubic cystostomy for the management of urethral injuries during penile prosthesis implantation.

Science.gov (United States)

Anele, Uzoma A; Le, Brian V; Burnett, Arthur L

2014-12-01

Urethral injury is an uncommon surgical complication of penile prosthesis (PP) surgery. Conventional dogma requires abortion of the procedure if the adjacent corporal body is involved or delayed implantation to avert device infection associated with urinary extravasation. Besides the setback of the aborted surgery, this management approach also presents the possible difficulty of encountering corporal fibrosis at the time of reoperation. We report an approach using primary urethral repair and temporary suprapubic cystostomy for the management of incidental urethral injuries in a cohort of patients allowing for successful completion of unaborted PP implantation. We performed a retrospective analysis of all patients receiving PPs from 1990 to 2014 in which incidental urethral injuries were repaired and PP implantation was completed with suprapubic cystostomy (suprapubic tube [SPT] insertion). After allowing for urethral healing and urinary diversion via SPT for 4-8 weeks, the PP was activated. Successful management was determined by the absence of perioperative complications within 6 months of implantation. We identified four cases, all receiving inflatable PPs, managed with temporary suprapubic cystostomy. These patients sustained urethral injuries during corporal dissection (one patient), corporal dilation (one patient), and penile straightening (two patients). All patients were managed safely and successfully. Primary urethral repair followed by temporary suprapubic cystostomy offers a surgical approach to complete PP implantation successfully in patients who sustain urethral injury complications, particularly for complex PP surgeries. Anele UA, Le BV, and Burnett AL. Suprapubic cystostomy for the management of urethral injuries during penile prosthesis implantation.

Multimodal imaging of choroidal nodules in neurofibromatosis type-1

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Vinod Kumar

2018-01-01

Full Text Available Choroidal nodules in neurofibromatosis type-1 are common and are best imaged with near-infrared reflectance (NIR imaging. The authors describe swept-source optical coherence tomography angiography (SSOCTA of choroidal nodules. These nodules are seen as hyperflow areas on SSOCTA and correlate well to bright patches on NIR imaging. The utility of multicolor scanning laser imaging in detecting these abnormalities is also described.

Position of solitary thyroid nodules by gammagraphy

International Nuclear Information System (INIS)

Basteris M, J.; Gomez D, R.

2007-01-01

In this work it is presented which it is the position more frequent of the solitary thyroid nodules. It was used the method of retrospective longitudinal observational investigation in 125 patients that went to the laboratory for realization of detection of thyroid nodules in the years 2004 and 2005 through gammagraphy. (Author)

Chinese herbal medicines for benign thyroid nodules in adults.

Science.gov (United States)

Wu, Wenxun; Yin, Detao; Yang, Weimin; Kan, Quancheng; Liu, Zhangsuo; Ren, Xiaoyan; Zhai, Chenguang; Zhang, Shengjun

2014-03-04

A thyroid nodule is a discrete lesion within the thyroid gland that might be palpable and is ultrasonographically distinct from the surrounding thyroid parenchyma. Thyroid nodules are more common as age increases and occur more frequently in women. Benign thyroid nodules often cause pressure symptoms and cosmetic complaints. In China and many other countries, doctors use Chinese herbal medicines (CHM) to treat thyroid nodules. To assess the effects of Chinese herbal medicines in the treatment of benign thyroid nodules in adults. Review authors searched the following electronic databases: The Cochrane Library, MEDLINE, EMBASE, the Chinese Biomedical Literature Database (CBM), the China National Knowledge Infrastructure (CNKI), VIP information (a Chinese database), WANFANG Data (a Chinese database), the Chinese Conference Papers Database and the Chinese Dissertation Database (all searched up to April 2013). Randomised controlled trials comparing CHM or CHM plus levothyroxine versus levothyroxine, placebo or no treatment in adults with benign thyroid nodules. Two review authors independently extracted data, assessed studies for risk of bias and evaluated overall study quality according to GRADE (Grading of Recommendations Assessment, Development and Evaluation), with differences resolved by consensus. We included one randomised trial involving 152 participants with a randomisation ratio of 2:1 (CHM vs no treatment). The trial applied adequate sequence generation; however, allocation concealment was unclear. Duration of treatment was three months, and follow-up six months. Our a priori defined outcomes of interest (i.e. nodule volume reduction ≥ 50%; pressure symptoms, cosmetic complaints or both; health-related quality of life; all-cause mortality; cancer occurrence; changes in number and size of thyroid nodules; changes in thyroid volume; and socioeconomic effects) were not investigated in the included study. Thyrotropin (TSH), thyroxine (T4) and tri

Combination of radiological and gray level co-occurrence matrix textural features used to distinguish solitary pulmonary nodules by computed tomography.

Science.gov (United States)

Wu, Haifeng; Sun, Tao; Wang, Jingjing; Li, Xia; Wang, Wei; Huo, Da; Lv, Pingxin; He, Wen; Wang, Keyang; Guo, Xiuhua

2013-08-01

The objective of this study was to investigate the method of the combination of radiological and textural features for the differentiation of malignant from benign solitary pulmonary nodules by computed tomography. Features including 13 gray level co-occurrence matrix textural features and 12 radiological features were extracted from 2,117 CT slices, which came from 202 (116 malignant and 86 benign) patients. Lasso-type regularization to a nonlinear regression model was applied to select predictive features and a BP artificial neural network was used to build the diagnostic model. Eight radiological and two textural features were obtained after the Lasso-type regularization procedure. Twelve radiological features alone could reach an area under the ROC curve (AUC) of 0.84 in differentiating between malignant and benign lesions. The 10 selected characters improved the AUC to 0.91. The evaluation results showed that the method of selecting radiological and textural features appears to yield more effective in the distinction of malignant from benign solitary pulmonary nodules by computed tomography.

Relation between grade and abundance of manganese nodules

Digital Repository Service at National Institute of Oceanography (India)

Sudhakar, M.

Data from more than 1000 locations in the Central Indian Ocean Basin (CIOB) where both bulk nodule chemistry and abundance were determined and utilized to study the relationship between grade and abundance of manganese nodule deposits. Grade...

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

DEFF Research Database (Denmark)

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

2012-01-01

Background: Besides being a causative agent for genital warts and cervical cancer, human papillomavirus (HPV) contributes to 40-85% of cases of anal, penile, vaginal and vulvar cancer and precancerous lesions. HPV types 16 & 18 in particular contribute to 74-93% of these cases. Overall the number...... of new cases of these four cancers may be relatively high implying notable health care cost to society. The aim of this study was to estimate the incidence and the health care sector costs of anal, penile, vaginal and vulvar cancer. Methods: New anogenital cancer patients were identified from the Danish...... Groups) and DAGS (Danish Outpatient Groups System) charges as cost estimates for inpatient and outpatient contacts, respectively. Health care consumption by cancer patients diagnosed in 2004-2007 was compared with that by an age-and sex-matched cohort without cancer. Hospital costs attributable to four...

Malignant priapism due to penile metastases: Case series and literature review

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Francesco De Luca

2016-07-01

Full Text Available Malignant priapism secondary to penile metastases is a rare condition. This term was originally used by Peacock in 1938 to describe a condition of painful induration and erection of the penis due to metastatic infiltration by a neoplasm. In the current literature there are 512 case reports. The primary tumor sites are bladder, prostate and rectum. The treatment has only palliative intent and consists of local tumor excision, penectomy, radiotherapy and chemotherapy. We present one case of malignant priapism originated from prostate cancer, and two from urothelial carcinoma of the bladder. Different approaches in diagnosis and therapy were performed. The entire three patient reported a relief of the pain following the treatment, with an improvement of their quality of life, even though it was only temporary as a palliative. Malignant priapism is a rare medical emergency. Penile/pelvis magnetic resonance imaging (MRI scan and corporal biopsies are considered an effective method of diagnosis of the primary organ site.

Gamma radiation induced and natural variability for nodulation in legumes

Energy Technology Data Exchange (ETDEWEB)

Maherchandani, N; Rana, O P.S. [Haryana Agricultural Univ., Hissar (India). Dept. of Genetics

1977-09-01

Gamma radiation induced variability for nodulation was studied in 112 M4 mutant lines of cowpea variety C-15-2. Ten lines superior in nodulation to the original variety have been identified. Natural variability for nodulation and plant growth was investigated in 75 genotypes of chickpea. A number of genotype were found to be superior to cultivated variety C-235 for nodulation characters. Nodule characters were found to be related to dry matter accumulation but not to grain yield. Another experiment on 10 varieties of chick pea conducted under aseptic conditions revealed that host genotypes showed specificity for Rhizobial strains and different Rhizobial strains differed in their effectiveness on different host genotypes. H 551 and H 355 were the most responsive varieties.

Dissecting the Root Nodule Transcriptome of Chickpea (Cicer arietinum L..

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Chandra Kant

Full Text Available A hallmark trait of chickpea (Cicer arietinum L., like other legumes, is the capability to convert atmospheric nitrogen (N2 into ammonia (NH3 in symbiotic association with Mesorhizobium ciceri. However, the complexity of molecular networks associated with the dynamics of nodule development in chickpea need to be analyzed in depth. Hence, in order to gain insights into the chickpea nodule development, the transcriptomes of nodules at early, middle and late stages of development were sequenced using the Roche 454 platform. This generated 490.84 Mb sequence data comprising 1,360,251 reads which were assembled into 83,405 unigenes. Transcripts were annotated using Gene Ontology (GO, Cluster of Orthologous Groups (COG and Kyoto Encyclopedia of Genes and Genomes (KEGG metabolic pathways analysis. Differential expression analysis revealed that a total of 3760 transcripts were differentially expressed in at least one of three stages, whereas 935, 117 and 2707 transcripts were found to be differentially expressed in the early, middle and late stages of nodule development respectively. MapMan analysis revealed enrichment of metabolic pathways such as transport, protein synthesis, signaling and carbohydrate metabolism during root nodulation. Transcription factors were predicted and analyzed for their differential expression during nodule development. Putative nodule specific transcripts were identified and enriched for GO categories using BiNGO which revealed many categories to be enriched during nodule development, including transcription regulators and transporters. Further, the assembled transcriptome was also used to mine for genic SSR markers. In conclusion, this study will help in enriching the transcriptomic resources implicated in understanding of root nodulation events in chickpea.

Selenium hyperaccumulation by Astragalus (Fabaceae) does not inhibit root nodule symbiosis.

Science.gov (United States)

Alford, Elan R; Pilon-Smits, Elizabeth A H; Fakra, Sirine C; Paschke, Mark W

2012-12-01

A survey of the root-nodule symbiosis in Astragalus and its interaction with selenium (Se) has not been conducted before. Such studies can provide insight into how edaphic conditions modify symbiotic interactions and influence partner coevolution. In this paper plant-organ Se concentration ([Se]) was investigated to assess potential Se exposure to endophytes. • Selenium distribution and molecular speciation of root nodules from Se-hyperaccumulators Astragalus bisulcatus, A. praelongus, and A. racemosus was determined by Se K-edge x-ray absorption spectroscopy. A series of greenhouse experiments were conducted to characterize the response of root-nodule symbiosis in Se-hyperaccumulators and nonhyperaccumulators. • Nodules in three Se-hyperaccumulators (Astragalus crotalariae, A. praelongus, and A. preussii) are reported for the first time. Leaves, flowers, and fruits from Se-hyperaccumulators were routinely above the hyperaccumulator threshold (1,000 µg Se g(-1) DW), but root samples rarely contained that amount, and nodules never exceeded 110 µg Se g(-1) DW. Nodules from A. bisulcatus, A. praelongus, and A. racemosus had Se throughout, with a majority stored in C-Se-C form. Finally, an evaluation of nodulation in Se-hyperaccumulators and nonhyperaccumulators indicated that there was no nodulation inhibition because of plant Se tolerance. Rather, we found that in Se-hyperaccumulators higher levels of Se treatment (up to 100 µM Se) corresponded with higher nodule counts, indicating a potential role for dinitrogen fixation in Se-hyperaccumulation. The effect was not found in nonhyperaccumulators. • As the evolution of Se hyperaccumulation in Astragalus developed, root-nodule symbiosis may have played an integral role.

Atypical Localized Rheumatoid Nodule: Case Report

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KORHAN BARIS BAYRAM

2015-01-01

Full Text Available Rheumatoid nodules can be seen in about 30% of patiens with rheumatoid arthritis. They are occasionally localized subcutaneous, but they can rarely seen in visceral organs. Their appearance can be confused with many clinical conditions when they have atypical localizations. To exclude the presence of a malignancy, these lesions should always be investigated. We aimed to discuss a patient with rheumatoid nodule localized in close neighborhood of hyoid bone, presumed as malignancy.

Treatment of hyperfunctioning thyroid nodules by percutaneous ethanol injection

OpenAIRE

Larijani, Bagher; Pajouhi, Mohammad; Ghanaati, Hossein; Bastanhagh, Mohammad-Hassan; Abbasvandi, Fereshteh; Firooznia, Kazem; Shirzad, Mahmood; Amini, Mohammad-Reza; Sarai, Maryam; Abbasvandi, Nasreen; Baradar-Jalili, Reza

2002-01-01

Abstract Background Autonomous thyroid nodules can be treated by a variety of methods. We assessed the efficacy of percutaneous ethanol injection in treating autonomous thyroid nodules. Methods 35 patients diagnosed by technetium-99 scanning with hyperfunctioning nodules and suppressed sensitive TSH (sTSH) were given sterile ethanol injections under ultrasound guidance. 29 patients had clinical and biochemical hyperthyroidism. The other 6 had sub-clinical hyperthyroidism with suppressed sTSH ...

Radio-guided thoracoscopic surgery (RGTS) of small pulmonary nodules.

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Ambrogi, Marcello Carlo; Melfi, Franca; Zirafa, Carmelina; Lucchi, Marco; De Liperi, Annalisa; Mariani, Giuliano; Fanucchi, Olivia; Mussi, Alfredo

2012-04-01

The demand for adequate tissue sampling to determine individual tumor behavior is increasing the number of lung nodule resections, even when the diagnosis is already recognized. Video-assisted thoracic surgery (VATS) is the procedure of choice for diagnosis and treatment of small pulmonary nodules. Difficulties in localizing smaller and deeper nodules have been approached with different techniques. Herein we report our 13-years' experience with radio-guided thoracoscopic resection. Patients with pulmonary nodules smaller than 1 cm and/or deeper than 1 cm, below the visceral pleura, underwent computed tomography (CT)-guided injection of a solution, composed of 0.2 ml (99)Tc-labeled human serum albumin microspheres and 0.1 ml nonionic contrast, into the nodule. During the VATS procedure, an 11-mm-diameter collimated probe connected to a gamma ray detector was introduced to scan the lung surface. The area of major radioactivity, which matched with the area of the nodule, was resected. From 1997 to 2009, 573 patients underwent thoracoscopic resection of small pulmonary nodules, 211 with the radio-guided technique. There were 159 men and 52 women, with an average age of 60.6 years (range = 12-83). The mean duration of the surgical procedure was 41 min (range = 20-100). The procedure was successful in 208/211 cases. Three patients (0.5%) required conversion to a minithoracotomy. The mean length of pleural drainage and hospital stay was 2.3 and 3.7 days, respectively. Histological examination showed 98 benign lesions and 113 malignant lesions (61 metastases and 52 primary lung cancers). This study confirms that radio-guided localization of small pulmonary nodules is a feasible, safe, and quick procedure, with a high rate of success. The spread of the sentinel lymph node technique has increased the availability of technology required for RGTS.

Follicular variant of papillary carcinoma presenting as a hyperfunctioning thyroid nodule.

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Gabalec, Filip; Svilias, Ioannis; Plasilova, Ivana; Hovorkova, Eva; Ryska, Aler; Horacek, Jiri

2014-03-01

In this study, we describe a case of papillary carcinoma in a 15-year-old girl who presented with a hyperfunctioning (hot) thyroid nodule and discuss it in the context of current management guidelines for patients with thyroid nodules. In adults, hot nodules rarely require cytologic or histologic evaluation, and hyperthyroidism is often treated with radioiodine (131I). However, in children and adolescents, the malignancy rate for nodules (both cold and hot) is higher and surgery is often necessary. Surgery may serve as a therapy, as well as a diagnostic tool, to treat hot nodules in children and adolescents.

Nodule activity and allocation of photosynthate of soybean during recovery from water stress

Science.gov (United States)

Fellows, R. J.; Patterson, R. P.; Raper, C. D. Jr; Harris, D.; Raper CD, J. r. (Principal Investigator)

1987-01-01

Nodulated soybean plants (Glycine max [L.] Merr. cv Ransom) in a growth-chamber study were subjected to a leaf water potential (psi w) of -2.0 megapascal during vegetative growth. Changes in nonstructural carbohydrate contents of leaves, stems, roots, and nodules, allocation of dry matter among plant parts, in situ specific nodule activity, and in situ canopy apparent photosynthetic rate were measured in stressed and nonstressed plants during a 7-day period following rewatering. Leaf and nodule psi w also were determined. At the time of maximum stress, concentration of nonstructural carbohydrates had declined in leaves of stressed, relative to nonstressed, plants, and the concentration of nonstructural carbohydrates had increased in stems, roots, and nodules. Sucrose concentrations in roots and nodules of stressed plants were 1.5 and 3 times greater, respectively, than those of nonstressed plants. Within 12 hours after rewatering, leaf and nodule psi w of stressed plants had returned to values of nonstressed plants. Canopy apparent photosynthesis and specific nodule activity of stressed plants recovered to levels for nonstressed plants within 2 days after rewatering. The elevated sucrose concentrations in roots and nodules of stressed plants also declined rapidly upon rehydration. The increase in sucrose concentration in nodules, as well as the increase of carbohydrates in roots and stems, during water stress and the rapid disappearance upon rewatering indicates that inhibition of carbohydrate utilization within the nodule may be associated with loss of nodule activity. Availability of carbohydrates within the nodules and from photosynthetic activity following rehydration of nodules may mediate the rate of recovery of N2-fixation activity.

Satisfaction with penile appearance after hypospadias surgery: The patient and surgeon view

NARCIS (Netherlands)

M.A.M. Mureau (Marc); F.M.E. Slijper (Froukje); A.K. Slob (Koos); F.C. Verhulst (Frank); R.J.M. Nijman (Rien)

1996-01-01

textabstractPurpose: We studied the degree of agreement between hypospadias patient and surgeon satisfaction with the cosmetic surgical result, and the relation between penile length, meatal position and patient satisfaction. Materials and Methods: Cosmetic and functional results in 35 boys with

Promise and pitfalls of molecular markers of thyroid nodules

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Jadhav, S.; Lila, Anurag; Bandgar, Tushar; Shah, Nalini

2012-01-01

Thyroid nodules are common in the general population with a prevalence of 5-7% The initial evaluation of thyroid nodules commonly involves thyroid function tests, an ultrasound (USG) and fine needle aspiration biopsy (FNAB). The optimal management of patients with thyroid nodules with indeterminate cytology is plagued by the lack of highly sensitive and specific diagnostic modalities In this article we attempt to review the available literature on the molecular markers which are increasingly being studied for their diagnostic utility in assessing thyroid nodules. The various molecular markers consist of gene mutations, gene re arrangements, RNA based assays and immunohistochemical markers. The molecular markers definitely would help to optimise the management of such patients. PMID:23565369

Promise and pitfalls of molecular markers of thyroid nodules

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S Jadhav

2012-01-01

Full Text Available Thyroid nodules are common in the general population with a prevalence of 5-7% The initial evaluation of thyroid nodules commonly involves thyroid function tests, an ultrasound (USG and fine needle aspiration biopsy (FNAB. The optimal management of patients with thyroid nodules with indeterminate cytology is plagued by the lack of highly sensitive and specific diagnostic modalities In this article we attempt to review the available literature on the molecular markers which are increasingly being studied for their diagnostic utility in assessing thyroid nodules. The various molecular markers consist of gene mutations, gene re arrangements, RNA based assays and immunohistochemical markers. The molecular markers definitely would help to optimise the management of such patients.

Solitary necrotic nodules of the liver mimicking hepatic metastasis: report of two cases

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Yoon, Kwon Ha; Yun, Ki Jung; Lee, Jung Min [Wonkwang University School of Medicine, Iksan (Korea, Republic of); Kim, Chang Guhn [Chunbuk National University Medical School, Cheongju (Korea, Republic of)

2000-09-01

We present two cases of solitary necrotic nodules of the liver which on radiologic images mimicked hepatic metastasis. Solitary necrotic nodule of the liver is a rare but benign entity which histopathologically consists of an outer fibrotic capsule with inflammatory cells and a central core of amorphous necrotic material. The lesion was seen on contrast-enhanced CT as an ovoid-shaped hypoattenuating nodule; on CT during hepatic arteriography as enhancing nodule; on intraoperative US as a target-appearing hypoechoic nodule; on T2WI as a hyperintensity nodule, and on dynamic MR as a subtle peripheral enhancing nodule. Although the radiologic features are not specific, solitary necrotic nodule of the liver should be included in the differential diagnosis of hepatic metastasis.

Prognosis of thyroid nodules in individuals living in the Zhitomir region of Ukraine.

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Naomi Hayashida

Full Text Available After the accident at the Chernobyl Nuclear Power Plant (CNPP, the incidence of thyroid cancer increased among children. Recently, a strong relationship between solid thyroid nodules and the incidence of thyroid cancer was shown in atomic bomb survivors. To assess the prognosis of benign thyroid nodules in individuals living in the Zhitomir region of Ukraine, around the CNPP, we conducted a follow-up investigation of screening data from 1991 to 2000 in the Ukraine.Participants of this study were 160 inhabitants with thyroid nodules (nodule group and 160 inhabitants without thyroid nodules (normal control group intially identified by ultrasonography from 1991 to 2000. All participants were aged 0 to 10 years old and lived in the same area at the time of the accident. We performed follow-up screening of participants and assessed thyroid nodules by fine needle aspiration biopsy.Among the nodule group participants, the number and size of nodules were significantly increased at the follow-up screening compared with the initial screening. No thyroid nodules were observed among the normal control group participants. The prevalence of thyroid abnormality, especially nodules that could be cancerous (malignant or suspicious by fine needle aspiration biopsy, was 7.5% in the nodule group and 0% in the normal control group (P<0.001.Our study indicated that a thyroid nodule in childhood is a prognostic factor associated with an increase in the number and size of nodules in individuals living in the Zhitomir region of Ukraine.

Clinical significance of pulmonary nodules detected on abdominal CT in pediatric patients

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Breen, Micheal; Lee, Edward Y.; Zurakowski, David

2015-01-01

The clinical significance of a pulmonary nodule that is detected incidentally on CT studies in children is unknown. In addition, there is limited information regarding the management of incidentally detected pulmonary nodules discovered on abdominal CT studies in children. The purpose of this study was to investigate the clinical significance of incidental pulmonary nodules detected on abdominal CT studies in children. This was a retrospective study performed following institutional review board approval. Abdominal CT reports in patients younger than 18 years of age from July 2004 to June 2011 were reviewed for the terms ''nodule,'' ''nodular'' or ''mass'' in reference to the lung bases. The study population included those pediatric patients in whom pulmonary nodules were initially detected on abdominal CT studies. The largest pulmonary nodules detected on CT studies were evaluated for their features (size, shape, margin, attenuation, location, and presence of calcification and cavitation). Follow-up CT studies and clinical records were reviewed for demographic information, history of underlying malignancies and the clinical outcome of the incidental pulmonary nodules. Comparison of malignant versus benign pulmonary nodules was performed with respect to the size of the nodule, imaging features on CT, and patient history of malignancy using the Student's t-test and Fisher exact test. Youden J-index in receiver operating characteristic (ROC) analysis was used to determine the optimal cut-off size for suggesting a high risk of malignancy of incidentally detected pulmonary nodules. Pulmonary nodules meeting inclusion criteria were detected in 62 (1.2%) of 5,234 patients. The mean age of patients with nodules was 11.2 years (range: 5 months-18 years). Thirty-one patients (50%) had follow-up CT studies and two of these patients (6%) were subsequently found to have malignant pulmonary nodules. Both of these

Clinical significance of pulmonary nodules detected on abdominal CT in pediatric patients

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Breen, Micheal; Lee, Edward Y. [Boston Children' s Hospital and Harvard Medical School, Department of Radiology, Boston, MA (United States); Zurakowski, David [Boston Children' s Hospital and Harvard Medical School, Departments of Anesthesiology and Surgery, Boston, MA (United States)

2015-11-15

The clinical significance of a pulmonary nodule that is detected incidentally on CT studies in children is unknown. In addition, there is limited information regarding the management of incidentally detected pulmonary nodules discovered on abdominal CT studies in children. The purpose of this study was to investigate the clinical significance of incidental pulmonary nodules detected on abdominal CT studies in children. This was a retrospective study performed following institutional review board approval. Abdominal CT reports in patients younger than 18 years of age from July 2004 to June 2011 were reviewed for the terms ''nodule,'' ''nodular'' or ''mass'' in reference to the lung bases. The study population included those pediatric patients in whom pulmonary nodules were initially detected on abdominal CT studies. The largest pulmonary nodules detected on CT studies were evaluated for their features (size, shape, margin, attenuation, location, and presence of calcification and cavitation). Follow-up CT studies and clinical records were reviewed for demographic information, history of underlying malignancies and the clinical outcome of the incidental pulmonary nodules. Comparison of malignant versus benign pulmonary nodules was performed with respect to the size of the nodule, imaging features on CT, and patient history of malignancy using the Student's t-test and Fisher exact test. Youden J-index in receiver operating characteristic (ROC) analysis was used to determine the optimal cut-off size for suggesting a high risk of malignancy of incidentally detected pulmonary nodules. Pulmonary nodules meeting inclusion criteria were detected in 62 (1.2%) of 5,234 patients. The mean age of patients with nodules was 11.2 years (range: 5 months-18 years). Thirty-one patients (50%) had follow-up CT studies and two of these patients (6%) were subsequently found to have malignant pulmonary nodules. Both of these

The role of radiation therapy after incomplete resection of penile cancer

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

2008-07-15

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

Tubularized Penile-Flap Urethroplasty Using a Fasciocutaneous Random Pedicled Flap for Recurrent Anterior Urethral Stricture