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Sample records for inflatable penile prosthesis

  1. 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

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

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  4. 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.

  5. 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.

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

    LENUS (Irish Health Repository)

    Thomas, A Z

    2011-02-01

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

  7. Tubing erosion of an inflatable penile prosthesis long after implantation.

    Science.gov (United States)

    Morales, Alvaro

    2014-06-01

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

  8. 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.

  9. Utilization of penile prosthesis and male incontinence prosthetics in Saudi Arabia.

    Science.gov (United States)

    Alwaal, Amjad; Al-Sayyad, Ahmad J

    2017-01-01

    Erectile dysfunction is a prevalent disease affecting over 50% of men between the ages of 40 and 70 years. Penile prosthesis represents the end of the line treatment when other less invasive therapies fail or are contraindicated. Male stress urinary incontinence can significantly diminish quality of life and lead to embarrassment and social withdrawal. Surgical therapies, such as male urethral slings and artificial urinary sphincters (AUS), are considered effective and safe treatments for male stress incontinence. No data exist on the utilization of penile prosthesis or male incontinence surgical treatment in Saudi Arabia. Generally, urological prosthetic surgery is performed either in private hospitals or in government hospitals. Our aim was to assess the trend of penile prosthesis and male incontinence device utilization in Saudi Arabia. We utilized sales' data of penile prosthetics, male slings, and AUS from the only two companies selling these devices in Saudi Arabia (AMS ® and Coloplast ® ), from January 2013 to December 2016. There were 2599 penile prosthesis implantation procedures done in the study period, with 67% of them performed in private institutions. There was a progressively increased use of penile prosthetics which nearly doubled from 2013 to 2016. The main type of prosthesis utilized was the semirigid type 70% versus 11% of the 2-piece inflatable and 17% of the 3-piece inflatable device. Only 10 slings and 31 AUS were inserted during the same study period. 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.

  10. Utilization of penile prosthesis and male incontinence prosthetics in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    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.

  11. 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.

  12. 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.

  13. 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.

  14. 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.

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

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    Carlo Luigi Augusto Negro

    2016-01-01

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

  16. 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.

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

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    David F Mobley

    2015-04-01

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

  18. 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

  19. 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.

  20. Safety and efficacy outcome of mentor alpha-1 inflatable penile prosthesis implantation for impotence treatment.

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    Goldstein, I; Newman, L; Baum, N; Brooks, M; Chaikin, L; Goldberg, K; McBride, A; Krane, R J

    1997-03-01

    We investigated safety and efficacy outcome pertaining to the Mentor Alpha-1, 3-piece inflatable penile prosthesis for impotence treatment. A 2-phase, multi-institutional, large scale retrospective study, with independently analyzed medical record (phase I) and questionnaire (phase II) data from consecutive eligible patients of 7 physician investigators was performed from March to October 1993. In phase I there were no morbidities of any type in 394 of the 434 patients (90.8%) (mean age 61 years, range 24 to 88) who underwent Alpha-1 implantation (mean followup 22.2 months, range 0.67 to 44.5). The risk of prosthesis malfunction (fluid leak and auto-inflation) was 2.5%. No cylinder aneurysms were reported. A total of 93.1% of Alpha-1 devices was free from explantation (4.4%) or revision surgery (2.5%) for approximately 2 years from the original implant date. Kaplan-Meier actuarial analyses revealed that cumulative survival of the Alpha-1 prostheses at 12, 24 and 36 months was 98 +/- 1%, 93 +/- 2% and 85 +/- 7% until device malfunction, and 91 +/- 2% 83 +/- 4% and 75 +/- 7% until surgical intervention (revision or explantation). In phase II 89% of the men claimed fulfilled expectations with the Alpha-1 prosthesis as impotence treatment. Satisfaction responses 80% or greater were noted with regard to intercourse ability and confidence, and device rigidity and function. Implantation did not result in greater than 80% satisfaction in partner relationships or feelings (as judged by the patient), social or work confidence, or intercourse frequency. Factors adversely affecting satisfaction included partner feelings of dissatisfaction (as judged by the patient), specific physician investigators and need for explantation/revision surgery. In 1 of the largest multi-institutional implant outcome studies thus far performed, safety and efficacy data concerning the Alpha-1 contemporary inflatable device were found markedly improved over earlier inflatable prostheses and now

  1. Preperitoneal placement of an inflatable penile prosthesis reservoir for postoperative erectile dysfunction after radical cystoprostatectomy with orthotopic neobladder

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    Jung Kwon Kim

    2016-09-01

    Full Text Available Purpose: To describe a case of safe placement of an inflatable penile prosthesis reservoir for postoperative erectile dysfunction (ED with a history of radical cystoprostatectomy with an orthotopic Studer neobladder. Materials and Methods: A 55-year-old bladder cancer patient, who underwent radical cystoprostatectomy with orthotopic Studer neobladder 2 years prior, suffered from postoperative ED. A 3-piece inflatable penile prosthesis was implanted via a penoscrotal incision. The alternative reservoir placement began with a longitudinal 4-cm incision, which was 2 finger-breaths to the left and lateral to the umbilicus. Thereafter, the anterior and posterior rectus sheaths were dissected and incised. Then, the transversalis fascia entering into the preperitoneal space was incised, followed by circumferential sweeping using the forefinger, and, finally, placement of a 100 mL ‘flat’ reservoir. The reservoir was filled with 65 mL saline and then evaluated for back pressure. The reservoir tubing exited through the defect of the rectus sheaths and tunneled through the abdominal fat into the penoscrotal wound. Results: Total operative time was 105 minutes, and the estimated blood loss was minimal. The patient was discharged at postoperative day 1 and experienced no perioperative complications. At the 6-month follow-up, there was no abdominal bulging from the preperitoneal reservoir, and the reservoir was not palpable. Conclusions: The preperitoneal placement of the flat reservoir at the level of the umbilicus is a safe and acceptable surgical technique for postoperative ED after radical cystoprostatectomy with orthotopic neobladder.

  2. Patient’s satisfaction after 2-piece inflatable penile prosthesis implantation: An Italian multicentric study

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    Giorgio Gentile

    2016-03-01

    Full Text Available Introduction: Penile prosthesis implant represents a valuable solution for pts with severe erectile dysfunction (ED, non-responders to medical management. The aim of our study was to evaluate the satisfaction of patients (pts after 2-pieces inflatable penile prosthesis (IPP. Aim of the study: to evaluate safety, reliability and post-operative patient’s satisfaction after implantation of two-pieces IPP. Materials and Methods: This retrospective multicentric analysis concerns a group of 42 patients undergone 2-pieces IPP implantation from November 2005 to November 2013, in four Centers of proven experience. As a first step, a detailed review of all clinical reports was performed. Secondly, every patient was asked to fill the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS specifically modified, in order to assess their own satisfaction after surgery and, its impact on patient’s quality of sexual life. Results: 42 pts were evaluated (AMS-Ambicor: 28; Coloplast- Excell: 14; mean age, at time of operation: 60,7 years; mean follow up: 27,6 months; etiology of ED: vascular 23,8%, diabetes 19%, La Peyronie D. 7,1%, consequence of radical prostatectomy 31%, consequence of other pelvic surgery 11,9%, spinal trauma 7%. Mean operative time: 117 ± 58 min, mean postoperative hospital stay 3 ± 1,6 days. Post operative short-term complications: 4 pts (9,5%. Post operative long-term complications: 4 pts (9,5%. Long-term functional results (Questionnaire: 71% of pts (30 reported regular use of the prosthesis, at least 1 time/week, the satisfaction was good in 42% of pts (18, quite good in 33,3% (14, quite bad in 2,4% (1, very bad in 7,1% (3, 6 pts (14,4% didn’t answer. Conclusions: 2 pieces IPP appears to be associated with a low complication rate and good satisfaction of pts especially in the elderly. It also assures satisfactory rates of aesthetics and functional results.

  3. Autoinflation Leading to Failure of Two-Piece Ambicor Implantable Penile Prosthesis: An Outcome from a Methodical Treatment of Recalcitrant Stuttering Priapism

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    R. Charles Welliver

    2014-01-01

    Full Text Available Introduction. We present the case of a patient who received a two-piece Ambicor penile prosthesis for idiopathic recurrent “stuttering” priapism refractory to other treatment options. The patient returned unable to deflate the device due to an interesting anatomically induced mechanical failure. Aims. To describe the method and findings of this inflatable prosthesis failure. Results. Prosthesis failure occurred due to restrictive corporal diameter and the unique characteristics of fluid reservoir location in the two-piece inflatable prosthesis. The patient was successfully converted to a semirigid prosthesis with resolution of the pain that was due to his prosthesis autoinflation. Conclusion. Stuttering priapism remains a challenging clinical problem. Penile implantation is a reasonable long-term solution in a patient refractory to less invasive options. In patients with fibrotic corpora, a malleable device should be considered (at least temporarily if unable to dilate comfortably to 13 mm.

  4. 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.

  5. Distal corporoplasty for distal cylinders extrusion after penile prosthesis implantation.

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    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.

  6. 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

  7. 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.

  8. Suprapubic cystostomy for the management of urethral injuries during penile prosthesis implantation.

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    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.

  9. Failure of the inflatable penile prosthesis due to abnormal folding of a low-profile reservoir – A selected case from an overall series and systematic review

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    Roberto Alejandro Navarrete

    2017-09-01

    Full Text Available We present a case from a running series of inflatable penile prosthesis failure due to improper folding of the Conceal™ reservoir. The Conceal™ Low-Profile reservoir gained popularity due to claims of improved cosmesis and ease of implantation. As the number of patients receiving this and other low-profile reservoirs increases, it is imperative to review and document any novel complications. While the Conceal™ reservoir may be preferred in ectopic placement, it may be more prone to fluid lockout facilitated by conformational change. Our review did not identify prior reports of improper folding, which we believe is unique to these low-profile reservoirs.

  10. 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.

  11. Penile prosthesis implantation in Chinese patients with severe erectile dysfunction: 10-year experience

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    Song, Wei-Dong; Yuan, Yi-Ming; Cui, Wan-Shou; Wu, Alex K; Zhu, Yi-Chen; Liu, Jing; Wang, Lin; Bai, Guang-Yi; Peng, Jing; Zhang, Zhi-Chao; Gao, Bing; Guo, Ying-Lu; Lue, Tom F; Xin, Zhong-Cheng

    2013-01-01

    We retrospectively evaluated the clinical outcome of penile prosthesis implantation (PPI) in Chinese patients with severe erectile dysfunction (SED). From July 2000 to December 2011, 224 patients (mean age: 35.9±11.8 years, range: 20–75 years) with SED underwent PPI by experienced surgeon according to standard PPI procedure at our centre. A malleable prosthesis (AMS 650) was implanted in 45 cases (20.1%), and a three-piece inflatable prosthesis (AMS 700 CXM or AMS 700 CXR) was implanted in 179 cases (79.9%). Surgical outcomes, including postoperative complications, clinical efficacy and couple satisfaction, were evaluated over than 6 months postoperatively using medical record abstraction, IIEF-5, quality of life (QoL) scores, and the patient/partner sexual satisfaction score proposed by Bhojwani et al. Of the 224 patients eligible for the study, 201 subjects (89.7%) completed follow-up. All of patients could perform sexual intercourse post PPI with the mean postoperative IIEF-5 and QoL scores were 20.02±2.32 and 5.28±0.76, respectively, which were significantly improved compared with the preoperative scores (6.29±1.5 and 2.13±0.84, Preported by 178 men (88.6%), and overall satisfaction with the PPI surgery was reported by 89.0% of men and 82.5% of partners. Patient satisfaction in the three-piece inflatable prosthesis group was higher than in the malleable prosthesis group (P<0.05). Satisfaction, however, between the types of prostheses, did not differ in the partner survey. PPI is a safe and effective treatment option for Chinese patients with SED and experienced surgeon perform PPI according to standard PPI procedure could reduce the postoperative complications of PPI and could improve patient satisfaction ratio and QoL. PMID:23872664

  12. Dorsal Phalloplasty to Preserve Penis Length after Penile Prosthesis Implantation

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    Osama Shaeer

    2017-03-01

    Full Text Available Objectives: Following penile prosthesis implantation (PPI, patients may complain of a decrease in visible penis length. A dorsal phalloplasty defines the penopubic junction by tacking pubic skin to the pubis, revealing the base of the penis. This study aimed to evaluate the efficacy of a dorsal phalloplasty in increasing the visible penis length following PPI. Methods: An inflatable penile prosthesis was implanted in 13 patients with severe erectile dysfunction (ED at the Kamal Shaeer Hospital, Cairo, Egypt, from January 2013 to May 2014. During the surgery, nonabsorbable tacking sutures were used to pin the pubic skin to the pubis through the same penoscrotal incision. Intraoperative penis length was measured before and after the dorsal phalloplasty. Overall patient satisfaction was measured on a 5-point rating scale and patients were requested to subjectively compare their postoperative penis length with memories of their penis length before the onset of ED. Results: Intraoperatively, the dorsal phalloplasty increased the visible length of the erect penis by an average of 25.6%. The average length before and after tacking was 10.2 ± 2.9 cm and 13.7 ± 2.8 cm, respectively (P <0.002. Postoperatively, seven patients (53.8% reported a longer penis, five patients (38.5% reported no change in length and one patient (7.7% reported a slightly shorter penis. The mean overall patient satisfaction score was 4.9 ± 0.3. None of the patients developed postoperative complications. Conclusion: A dorsal phalloplasty during PPI is an effective method of increasing visible penis length, therefore minimising the impression of a shorter penis after implantation.

  13. Quantifying risk of penile prosthesis infection with elevated glycosylated hemoglobin.

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    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.

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

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    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.

  15. 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 

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

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    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

  17. 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.

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

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    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%.

  19. Penile Prosthesis First and Replacement Surgeries: Analysis of Patient and Partner Satisfaction.

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    Lledó-García, Enrique; Jara-Rascón, José; Moncada Iribarren, Ignacio; Piñero-Sánchez, Javier; Aragón-Chamizo, Juan; Hernández-Fernández, Carlos

    2015-07-01

    Among the many treatments for erectile dysfunction, implantation of a penile prosthesis has been associated with high patient satisfaction rates. Prosthesis replacement has become an accepted procedure in the event of device malfunction or complications, but to our knowledge, there are no data regarding the impact of implant replacement on patients and partner satisfaction. The aim of our study was to assess and to compare the level of satisfaction, with a first or second penile prosthesis implantation (PPI), in men with refractory erectile dysfunction and their partners. A survey study based on a five-item questionnaire was carried out at our center between January 1999 and January 2012. The main outcome measure used was the level of patient and partner satisfaction with sexual intercourse after PPI. Of the 190 eligible patients, 149 (78%) completed the survey (110 underwent a first implant and 39 a reimplant). Seventy-nine percent of first-time implanted patients and 80% of the reimplanted patients (P > 0.05; not significant [ns]) reported satisfactory sexual intercourse (very or moderately satisfied), while 74% and 80% of their partners reported satisfactory intercourses, respectively (P > 0.05; ns). Overall, 73.7% of first implants and 70% of second implants reported that they would undergo the procedure again if the PPI failed (P > 0.05; ns). With regards to cosmetic aspects, 13% of the first implants' and 15% of second implants' partners reported either penile shortness or soft glans as the main causes of their dissatisfaction. Only 2.4% of first implants and 1% of reimplanted patients expressed difficulty in manipulating the device. PPI is successful in returning the ability for satisfactory sexual intercourse to both first implant and reimplanted patients and their respective partners. © 2015 International Society for Sexual Medicine.

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

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    Al-Reshaid Reshaid

    2010-01-01

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

  1. 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

  2. Comparison of efficacy and satisfaction profile, between penile prosthesis implantation and oral PDE5 inhibitor tadalafil therapy, in men with nerve-sparing radical prostatectomy erectile dysfunction.

    Science.gov (United States)

    Megas, Georgios; Papadopoulos, Georgios; Stathouros, Georgios; Moschonas, Dimitrios; Gkialas, Ioannis; Ntoumas, Konstantinos

    2013-07-01

    WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: Erectile dysfunction after nerve-sparing radical retropubic prostatectomy constitutes a challenge to the urologist. The mainstay of medical treatment after radical prostatectomy to restore spontaneous erectile function remains phosphodiesterase (PDE5) inhibitors, despite the fact that data from animal studies suggesting that PDE5 inhibitors can prevent smooth muscle apoptosis and fibrosis have not yet been extrapolated to humans because of a lack of standardized protocols. If the above treatment fails, second-line therapies such as intraurethral prostaglandins, penile injection therapy and vacuum devices are offered. When less invasive therapies are ineffective, interventions that preserve sexual function such as penile prosthesis implantation become the treatment of choice. Our study reveals the alternative of penile prosthesis implantation as first-line treatment in erectile dysfunction after nerve-sparing radical prostatectomy. It also highlights its superiority to the oral PDE5 inhibitor treatment, regarding the erection, frequency, firmness, maintenance and penetration ability. This suggests that a concept of an early penile intervention in the future would be promising for those patients who wish to remain sexually active without depending on oral formulations with doubtful and delayed results. To evaluate the outcome of penile prosthesis surgery in comparison to oral phosphodiesterase type 5 (PDE5) inhibitor administration, in men with erectile dysfunction after nerve-sparing radical prostatectomy, as early penile intervention therapy. A total of 174 patients treated by nerve-sparing retropubic radical prostatectomy (RRP) for clinically localized prostate cancer, between January 2006 and September 2009 enrolled in the study, 153 patients fulfilled the inclusion criteria, and 69 (45%) patients presented with post-RRP erectile dysfunction 6 months after primary surgery. Fifty-four patients were disease

  3. Medline Plus

    Full Text Available ... Springs, Coral Springs, FL, 3/31/2014) Erectile Dysfunction Simultaneous Inflatable Penile Prosthesis (IPP) and Male Sling ... Springs, Coral Springs, FL, 3/31/2014) Erectile Dysfunction Simultaneous Inflatable Penile Prosthesis (IPP) and Male Sling ...

  4. Predicting erectile dysfunction following surgical correction of Peyronie's disease without inflatable penile prosthesis placement: vascular assessment and preoperative risk factors.

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    Taylor, Frederick L; Abern, Michael R; Levine, Laurence A

    2012-01-01

    Surgical therapy remains the gold standard treatment for Peyronie's Disease (PD). Surgical options include plication, grafting, and placement of inflatable penile prosthesis (IPP). Postoperative erectile dysfunction (ED) is a potential complication for PD surgery without IPP. We present our large series follow-up to evaluate preoperative risk factors for postoperative ED. The aim of this study is to evaluate preoperative risk factors for the development of ED following surgical correction of PD taking into account the degree of curvature, graft size, surgical approach, hypertension, hyperlipidemia, diabetes, smoking history, preoperative use of phosphodiesterase 5 inhibitors (PDE5), and preoperative duplex ultrasound findings including peak systolic and end diastolic velocities and resistive index. We identified 218 men undergoing either tunica albuginea plication (TAP) or partial plaque excision with pericardial grafting for PD following a previously published algorithm between November 1992 and April 2007. Preoperative and postoperative erectile function, curvature characteristics, presence of vascular risk factors, and duplex ultrasound findings were available on 109 patients. Our primary outcome measure is the development of ED after surgery for PD. Ten percent of TAP and 21% of plaque excision with grafting patients developed postoperative ED. Neither curve direction (P = 0.76), graft area (P = 0.78), surgical approach (P = 0.12), chronic hypertension (P = 0.51), hyperlipidemia (P = 0.87), diabetes (P = 0.69), nor smoking history (P = 0.99) were significant predictors of postoperative ED. No combination of risk factors was found to be predictive of postoperative ED. Preoperative use of PDE5 was not a significant predictor of postoperative ED (P = 0.33). Neither peak systolic, end diastolic, nor resistive index were significant predictors of ED (P = 0.28, 0.28, and 0.25, respectively). This long-term follow-up of a large published series suggests that neither

  5. Non-infected penile prosthesis cultures during revision surgery; comparison between antibiotic coated and non - coated devices

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    Seyfettin Ciftci

    Full Text Available ABSTRACT Introduction: Aim of this study is to investigate bacterial growth on non-infected devices and compare antibiotic-coated and non-coated implants. Materials and methods: The charts of 71 patients who underwent revision surgeries for penile prosthesis between 1995 and 2013 were reviewed. Of those, 31 devices were antibiotic-coated prostheses, while 40 of the implants were non-coated. Swab cultures were routinely obtained from corporal, pump or reservoir site during the operation. If a bacterial biofilm was determined on the prosthesis, it was also cultured. Results: A total of 5 different organisms were cultured from 18 patients. Of them, 4 devices were antibiotic-coated and the other 14 were non-coated devices. Staphylococcus epidermidis was the most common organism, while Staphylococcus hominis, beta hemolitic streptococcus, Escherichia coli and Proteus mirabilis were also cultured. All patients who had positive cultures were treated with appropriate antibiotics for four weeks postoperatively. Median follow-up time was 41 months, ranging between 8 and 82 months. One prosthesis (non-coated became clinically infected in the follow-up period with a totally different organism. Culture positivity rates of antibiotic-coated and non-coated devices were 13% and 35% respectively and the result was significant (p=0.00254. Conclusions: Positive bacterial cultures are present on non-infected penile prostheses at revision surgeries in some of the patients. Antibiotic coated prostheses have much less positive cultures than non-coated devices.

  6. Quality of Life, Psychological Functioning, and Treatment Satisfaction of Men Who Have Undergone Penile Prosthesis Surgery Following Robot-Assisted Radical Prostatectomy.

    Science.gov (United States)

    Pillay, Brindha; Moon, Daniel; Love, Christopher; Meyer, Denny; Ferguson, Emma; Crowe, Helen; Howard, Nicholas; Mann, Sarah; Wootten, Addie

    2017-12-01

    Penile prosthesis surgery is last-line treatment to regaining erectile function after radical prostatectomy (RP) for localized prostate cancer. To assess quality of life, psychological functioning, and treatment satisfaction of men who underwent penile implantation after RP; the psychosocial correlates of treatment satisfaction and sexual function after surgery; and the relation between patients' and partners' ratings of treatment satisfaction. 98 consecutive patients who underwent penile implantation after RP from 2010 and 2015 and their partners were invited to complete a series of measures at a single time point. Of these, 71 patients and 43 partners completed measures assessing sexual function, psychological functioning, and treatment satisfaction. Proportions of patients who demonstrated good sexual function and satisfaction with treatment and clinical levels of anxiety and depression were calculated. Hierarchical regression analyses were conducted to determine psychosocial factors associated with patient treatment satisfaction and sexual function and patient-partner differences in treatment satisfaction. Patients completed the Expanded Prostate Cancer Index Composite Short Form (EPIC-26), Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS), Prostate Cancer-Related Quality of Life Scale, Self-Esteem and Relationship Questionnaire (SEAR), Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9). Partners completed the GAD-7, PHQ-9, EDITS (partner version), and SEAR. 94% of men reported satisfaction with treatment (EDITS score > 50). 77% of men reported good sexual function (EPIC-26 score > 60). Lower depression scores were associated with higher sexual confidence and sexual intimacy, and these were correlated with better treatment satisfaction and sexual function. Patients experienced higher sexual relationship satisfaction (median score = 90.6) than their partners (median score = 81.2), but there was no difference in

  7. Managing the difficult penile prosthesis patient.

    Science.gov (United States)

    Trost, Landon W; Baum, Neil; Hellstrom, Wayne J G

    2013-04-01

    Inflatable penile prostheses (IPPs) are associated with excellent long-term outcomes and patient/partner satisfaction. A small percentage of patients remain dissatisfied, despite acceptable surgical results. This study aims to evaluate factors associated with patient satisfaction and dissatisfaction, define patient characteristics, which may identify elevated risk of postoperative dissatisfaction, and describe management strategies to optimize functional and psychological patient outcomes. A review of urologic and non-urologic cosmetic surgery literature was performed to identify factors associated with patient satisfaction/dissatisfaction. Emphasis was placed on articles defining "high risk" or psychologically challenging patients. Preoperative factors associated with patient satisfaction/dissatisfaction and character traits, which may identify elevated risk of postoperative dissatisfaction or otherwise indicate a psychologically challenging patient. Contemporary patient and partner satisfaction rates following IPP are 92-100% and 91-95%, respectively. Factors associated with satisfaction include decreased preoperative expectations, favorable female partner sexual function, body mass index ≤30, and absence of Peyronie's disease or prior prostatectomy. Determinants of dissatisfaction include perceived/actual loss of penile length, decreased glanular engorgement, altered erectile/ejaculatory sensation, pain, diminished cosmetic outcome, difficulty with device function, partner dissatisfaction and perception of unnatural sensation, complications, and extent of alternative treatments offered. Personality characteristics which may indicate psychologically challenging IPP patients include obsessive/compulsive tendencies, unrealistic expectations, patients undergoing revision surgery, those seeking multiple surgical opinions, feeling of entitlement, patients in denial of their prior erectile/sexual function and current disease status, or those with other psychiatric

  8. The Decline of Inpatient Penile Prosthesis over the 10‐Year Period, 2000–2010

    Directory of Open Access Journals (Sweden)

    Amjad Alwaal, MD, MSc, FRCSC

    2015-12-01

    Conclusions: The number of PP procedures performed in the inpatient setting declined between 2000 and 2010, likely reflecting a shift toward increasing outpatient procedures. Our data also suggest a better outcome for patients having the procedure done at a high‐volume center in terms of inpatient complications. Alwaal A, Harris CR, Hussein AA, Sanford TH, McCulloch CE, Shindel AW, and Breyer BN. The decline of inpatient penile prosthesis over the 10‐year period, 2000–2010. Sex Med 2015;3:280–286.

  9. Distinguishing Failure to Cure From Complication After Penile Prosthesis Implantation.

    Science.gov (United States)

    Pineda, Miguel; Burnett, Arthur L

    2017-05-01

    A successful penile prosthesis implantation (PPI) surgery can be defined by outcomes beyond the absence of complications. To introduce the concept of failure to cure (FTC) in the context of PPI to more accurately gauge postoperative outcomes after PPI. Consecutive patients from our sexual function registry who underwent PPI from January 2011 to December 2013 were analyzed. Demographics, previous treatment of erectile dysfunction, comorbidities, social history, postoperative problems (POPs), and surgical outcomes were tabulated. Patients completed the International Index of Erection Function (IIEF) and the Erectile Dysfunction Inventory of Treatment Satisfaction questionnaires. We defined a complication, according to the Clavien-Dindo classification, as any deviation from the ideal postoperative course that is not inherent in the procedure and does not constitute an FTC. FTC was defined as a POP that was not a complication. The χ 2 tests, t-tests, or Wilcoxon rank-sum tests were used. Patient-reported and objective outcomes after PPI. Our enrollment consisted of 185 patients, and we contacted 124 (67%). Of these, 16 (12.9%) had a POP requiring reoperation. Eight patients developed surgical complications (three infections, four erosions, and one chronic pain). Eight patients had FTC (four malpositions and four malfunctions). Factors that correlated with POPs were previous PPI, body mass index higher than 30 kg/m 2 , and previous treatment with intracorporal injections (P .05 for all comparisons). POPs after PPI surgery can be more accurately categorized using the Clavien-Dindo classification of surgical complications to more clearly distinguish surgical complications from FTC. Limitations of our study include its retrospective approach. Our series included a large proportion of patients treated for prostate cancer, which limits the generalizability of our findings. We also had a relatively short median follow-up time of 27 months. Patient-reported outcome

  10. 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...

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

    Directory of Open Access Journals (Sweden)

    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.

  12. Why Are Men Satisfied or Dissatisfied with Penile Implants? A Mixed Method Study on Satisfaction with Penile Prosthesis Implantation.

    Science.gov (United States)

    Carvalheira, Ana; Santana, Rita; Pereira, Nuno M

    2015-12-01

    Studies have demonstrated high levels of satisfaction with penile prosthesis implantation (PPI). However, qualitative research exploring the experience of PPI through men's narratives is scarce. The main goals were to analyze (i) the level of sexual satisfaction (quantitatively), and (ii) the reasons for satisfaction and/or dissatisfaction with PPI (qualitatively). Participants were 47 men with erectile dysfunction who underwent surgery between 2003 and 2012, placed by a single surgeon. Structured telephone interviews were carried out. Satisfaction with PPI was a qualitative and quantitative measure assessed through the following four items: (i) "Would you repeat the PPI surgery?"; (ii) "Would you recommend the PPI surgery?"; (iii) "How satisfied are you with the PP?"; and (iv) "Could you explain the motives of your satisfaction/dissatisfaction?". The majority of men (79%) reported to be satisfied with PPI. Content analysis revealed four main themes for men's satisfaction with the PPI: (i) psychological factors were reported 54 times (n = 54) and included positive emotions, self-esteem, confidence, enhancement of male identity, major live change, and self-image; (ii) improvement of sexual function was reported 54 times (n = 54) and referred to achievement of vaginal penetration, increase of sexual desire, sexual satisfaction, penis size, and improvement of erectile function; (iii) relationship factors were reported 11 times (n = 11) and referred to relationship improvement and the possibility of giving pleasure to the partner; and (iv) improvement in urinary function (n = 3). The level of satisfaction with the implementation of penile prostheses is very high, therefore constituting a treatment for erectile dysfunction with a positive impact on the experience of men at sexual, psychological and relational level. © 2015 International Society for Sexual Medicine.

  13. A preliminary report on the usage of an intracorporal antibiotic cast with synthetic high purity CaSO4 for the treatment of infected penile implant.

    Science.gov (United States)

    Swords, Kelly; Martinez, Daniel R; Lockhart, Jorge L; Carrion, Rafael

    2013-04-01

    Currently, the surgical treatment of infected penile prostheses is complete removal and either immediate salvage procedure, which carries a significant infection risk, or delayed implantation. With delayed implantation the risk of infection is lower, but the patient loses penile length and width due to corporal fibrosis. We present our experience with the use of a novel temporary synthetic high purity calcium sulfate (SHPCaSO4) component that acts as a "spacer" at the time of removal of an infected prosthesis while providing constant delivery of local antibiotic elution to the infected area. Demonstrate that the use of a novel material, SHPCaSO4, can be an innovative way to bridge the gap between removal of an infected penile implant and delayed reimplantation. Two patients (Patient A and B) presented with pain and erythema and were found to have infected malleable penile prosthesis. Both underwent removal of all infected components, and sent for tissue culture. The SHPCaSO4 was mixed with vancomycin and tobramycin, allowed to set up for 5 minutes, and then injected into the corporal space followed by closure with 2-0 Vicryl sutures. The injected SHPCaSO4 was palpable in the penile shaft both proximally and distally, as an "intracorporal casts." Patients denied pain postoperatively. Delayed implantation occurred at 6 weeks for patient A. This went uneventful and a new three-piece inflatable implant was inserted. Patient B underwent salvage placement of right malleable implant at 15 weeks, and here significant corporal fibrosis was encountered. Patients have had no infection since their delayed implantation (mean follow-up 4 months). Data in reference to SHPCaSO4 shows that this product dissolves in approximately 4-6 weeks. This may account for the difference in the ease of delayed implantation between the two patients. Further investigation is warranted. © 2013 International Society for Sexual Medicine.

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

    Science.gov (United States)

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

    2015-01-01

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

  15. 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...

  16. 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.

  17. Medline Plus

    Full Text Available ... Return to Patient Quality-of-Life (Washington University School of Medicine in St. Louis, St. Louis, MO, 05/11/2011) Sexual Health Issues Erectile Dysfunction Simultaneous Inflatable Penile Prosthesis (IPP) ...

  18. Medline Plus

    Full Text Available ... Center, New York, NY, 2/13/2008) Heart Health Tests Transesophageal Echocardiogram (TEE) (Shawnee Mission Medical Center, ... Louis, St. Louis, MO, 05/11/2011) Sexual Health Issues Erectile Dysfunction Simultaneous Inflatable Penile Prosthesis (IPP) ...

  19. Medline Plus

    Full Text Available ... Health Center, Greenville, SC, 10/22/2012) Safety Issues Wounds and Injuries Repair of Flexor Tendon and ... St. Louis, MO, 05/11/2011) Sexual Health Issues Erectile Dysfunction Simultaneous Inflatable Penile Prosthesis (IPP) and ...

  20. Medline Plus

    Full Text Available ... Medical Center, Winston-Salem, NC, 2/28/2014) Male Reproductive System Circumcision Circumcision (Broward Health Coral Springs, ... Erectile Dysfunction Simultaneous Inflatable Penile Prosthesis (IPP) and Male Sling Placement: Aiding in a Faster Return to ...

  1. Tackling the Issue of High Postoperative Pacemaker Implantation Rates in Sutureless Aortic Valve Replacement: Should Balloon Inflation be Removed from the Implantation Method of the Perceval Prosthesis?

    Science.gov (United States)

    Charles Blouin, Mathieu; Bouhout, Ismail; Demers, Philippe; Carrier, Michel; Perrault, Louis; Lamarche, Yoan; El-Hamamsy, Ismail; Bouchard, Denis

    2017-05-01

    Sutureless aortic valve replacement (AVR) is an emerging alternative to standard AVR in elderly and high-risk patients. This procedure is associated with a high rate of postoperative permanent pacemaker implantation (PPI). The study aim was to assess the impact on the rate of PPI of implanting the Perceval prosthesis without using balloon inflation. A total of 159 patients who underwent sutureless AVR using the Perceval prosthesis was included. Balloon inflation was used in 132 patients (Balloon group) and not used in the remaining 27 (No-Balloon group). Clinical, echocardiographic and electrocardiographic outcomes were assessed. There was no significant difference in PPI rate between the two groups (26% for Balloon group versus 22% in No-Balloon group; p = 0.700). Balloon inflation had no significant impact on the incidence of paravalvular leaks (p = 0.839), or on the need to return to cardiopulmonary bypass (CPB) intraoperatively due to paravalvular leak or unsatisfactory deployment (p >0.999). Mean and peak transaortic pressure gradients were similar between the two groups (p = 0.417 and p = 0.522, respectively). Cross-clamp and CPB times were shorter in the No-Balloon group (49.6 ± 15.9 min versus 61.1 ± 25.6 min and 64.1 ± 26.3 min versus 79.6 ± 35.4 min, respectively; p = 0.027 and p = 0.012, respectively). The two groups had similar postoperative PPI rates. Implanting the Perceval prosthesis without balloon inflation is safe and had no impact on paravalvular leaks, intraoperative complications or hemodynamic results. Reductions in aortic cross-clamp time and CPB time were observed when the balloon was not used.

  2. Medline Plus

    Full Text Available ... St. Louis, St. Louis, MO, 05/11/2011) Sexual Health Issues Erectile Dysfunction Simultaneous Inflatable Penile Prosthesis ( ... to assist them in their medical needs. BroadcastMed has not conducted an independent investigation or performed other ...

  3. Erectile Dysfunction: MedlinePlus Health Topic

    Science.gov (United States)

    ... Men's Health (Hormone Health Network) Also in Spanish Sex and the Man With Cancer (American Cancer Society) Also in Spanish Specifics Bent Penis (Mayo Foundation for Medical Education and Research) Videos and Tutorials Simultaneous Inflatable Penile Prosthesis (IPP) and ...

  4. 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.

  5. Medline Plus

    Full Text Available ... Medical Center, Winston-Salem, NC, 2/28/2014) Male Reproductive System Circumcision Circumcision (Broward Health Coral Springs, Coral Springs, FL, 3/31/2014) Erectile Dysfunction Simultaneous Inflatable Penile Prosthesis (IPP) and Male Sling Placement: Aiding in a Faster Return to ...

  6. Augmented reality assisted surgery: a urologic training tool

    Science.gov (United States)

    Dickey, Ryan M; Srikishen, Neel; Lipshultz, Larry I; Spiess, Philippe E; Carrion, Rafael E; Hakky, Tariq S

    2016-01-01

    Augmented reality is widely used in aeronautics and is a developing concept within surgery. In this pilot study, we developed an application for use on Google Glass® optical head-mounted display to train urology residents in how to place an inflatable penile prosthesis. We use the phrase Augmented Reality Assisted Surgery to describe this novel application of augmented reality in the setting of surgery. The application demonstrates the steps of the surgical procedure of inflatable penile prosthesis placement. It also contains software that allows for detection of interest points using a camera feed from the optical head-mounted display to enable faculty to interact with residents during placement of the penile prosthesis. Urology trainees and faculty who volunteered to take part in the study were given time to experience the technology in the operative or perioperative setting and asked to complete a feedback survey. From 30 total participants using a 10-point scale, educational usefulness was rated 8.6, ease of navigation was rated 7.6, likelihood to use was rated 7.4, and distraction in operating room was rated 4.9. When stratified between trainees and faculty, trainees found the technology more educationally useful, and less distracting. Overall, 81% of the participants want this technology in their residency program, and 93% see this technology in the operating room in the future. Further development of this technology is warranted before full release, and further studies are necessary to better characterize the effectiveness of Augmented Reality Assisted Surgery in urologic surgical training. PMID:26620455

  7. Augmented reality assisted surgery: a urologic training tool.

    Science.gov (United States)

    Dickey, Ryan M; Srikishen, Neel; Lipshultz, Larry I; Spiess, Philippe E; Carrion, Rafael E; Hakky, Tariq S

    2016-01-01

    Augmented reality is widely used in aeronautics and is a developing concept within surgery. In this pilot study, we developed an application for use on Google Glass ® optical head-mounted display to train urology residents in how to place an inflatable penile prosthesis. We use the phrase Augmented Reality Assisted Surgery to describe this novel application of augmented reality in the setting of surgery. The application demonstrates the steps of the surgical procedure of inflatable penile prosthesis placement. It also contains software that allows for detection of interest points using a camera feed from the optical head-mounted display to enable faculty to interact with residents during placement of the penile prosthesis. Urology trainees and faculty who volunteered to take part in the study were given time to experience the technology in the operative or perioperative setting and asked to complete a feedback survey. From 30 total participants using a 10-point scale, educational usefulness was rated 8.6, ease of navigation was rated 7.6, likelihood to use was rated 7.4, and distraction in operating room was rated 4.9. When stratified between trainees and faculty, trainees found the technology more educationally useful, and less distracting. Overall, 81% of the participants want this technology in their residency program, and 93% see this technology in the operating room in the future. Further development of this technology is warranted before full release, and further studies are necessary to better characterize the effectiveness of Augmented Reality Assisted Surgery in urologic surgical training.

  8. Augmented reality assisted surgery: a urologic training tool

    Directory of Open Access Journals (Sweden)

    Ryan M Dickey

    2016-01-01

    Full Text Available Augmented reality is widely used in aeronautics and is a developing concept within surgery. In this pilot study, we developed an application for use on Google Glass ® optical head-mounted display to train urology residents in how to place an inflatable penile prosthesis. We use the phrase Augmented Reality Assisted Surgery to describe this novel application of augmented reality in the setting of surgery. The application demonstrates the steps of the surgical procedure of inflatable penile prosthesis placement. It also contains software that allows for detection of interest points using a camera feed from the optical head-mounted display to enable faculty to interact with residents during placement of the penile prosthesis. Urology trainees and faculty who volunteered to take part in the study were given time to experience the technology in the operative or perioperative setting and asked to complete a feedback survey. From 30 total participants using a 10-point scale, educational usefulness was rated 8.6, ease of navigation was rated 7.6, likelihood to use was rated 7.4, and distraction in operating room was rated 4.9. When stratified between trainees and faculty, trainees found the technology more educationally useful, and less distracting. Overall, 81% of the participants want this technology in their residency program, and 93% see this technology in the operating room in the future. Further development of this technology is warranted before full release, and further studies are necessary to better characterize the effectiveness of Augmented Reality Assisted Surgery in urologic surgical training.

  9. 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

  10. Percutaneous Revision of a Testicular Prosthesis is Safe, Cost-effective, and Provides Good Patient Satisfaction

    Directory of Open Access Journals (Sweden)

    Eugene B. Cone

    2015-09-01

    Full Text Available Office-based percutaneous revision of a testicular prosthesis has never been reported. A patient received a testicular prosthesis but was dissatisfied with the firmness of the implant. In an office setting, the prosthesis was inflated with additional fluid via a percutaneous approach. Evaluated outcomes included patient satisfaction, prosthesis size, recovery time, and cost savings. The patient was satisfied, with no infection, leak, or complication after more than 1 year of follow-up, at significantly less cost than revision surgery. Percutaneous adjustment of testicular prosthesis fill-volume can be safe, inexpensive, and result in good patient satisfaction.

  11. Penile Paraffinoma

    Directory of Open Access Journals (Sweden)

    Necmi Bayraktar

    2012-01-01

    Full Text Available Penile paraffinoma is an uncommon entity produced by penile paraffin injections for the purpose of penile enlargement by a nonmedical person. Although it is not a current method of penile enlargement procedures, in our opinion dermatologists and urology specialist should be have knowledge of this entity about diagnosis and management. It will be an aim to share our experiences and views in this paper.

  12. Dynamic Penile Corpora Cavernosa Reconstruction Using Bilateral Innervated Gracilis Muscles: A Preclinical Investigation.

    Science.gov (United States)

    Yin, Zhuming; Liu, Liqiang; Xue, Bingjian; Fan, Jincai; Chen, Wenlin; Liu, Zheng

    2018-03-07

    Prosthesis-assisted penile reconstruction has been performed extensively to restore a cosmetically acceptable phallus. However, a large number of patients will undergo revision surgery for various prosthesis-related complications. To develop a 1-stage prosthesis-free dynamic cavernosa reconstruction method using bilateral innervated gracilis muscles and to investigate the feasibility and reliability of the surgical design. 10 fresh cadavers were dissected to assess the availability of bilateral gracilis muscles for functional cavernosa rebuilding. 11 mongrel female dogs were involved in the penile reconstruction surgery. The neophallus consisted of bilateral gracilis muscles as the neo-cavernosa, a right gracilis skin flap as the neourethra, and a lower abdominal flap with an anterior rectus sheath as the skin envelope and neo-tunica albuginea. The function and structure of the neo-phalli were assessed 7 months postoperatively. The neurovascular pedicle length of the gracilis muscles and the volume of the gracilis venter musculi were measured in the cadaveric investigation. The average dimensions of the canine neo-phalli at rest and during electrostimulated erection were obtained and the muscular fatigue-resistant curve was drawn. Histologic evaluations also were performed. The neurovascular pedicle length and volume of the gracilis muscles were sufficient to yield a nearly normal appearance of the neo-cavernosa in the cadaveric and animal studies. The muscular fatigue-resistant curve demonstrated adequate length, stiffness, and duration of erection of the neo-phalli to accomplish normal coitus. Histologic evaluations showed an intact neourethra and nearly normal muscle structure in the inner layer of the canine neo-cavernosa, except for significantly increased amount of collagen fibers and type I/III collagen ratio in the outer layer of the neo-cavernosa. The percentage of type II (fatigue-prone) muscle fibers did not change significantly. Our preclinical

  13. "Stiction Syndrome": Non-Operative Management of Patients With Difficult AMS 700 Series Inflation.

    Science.gov (United States)

    Kavoussi, Nicholas L; Viers, Boyd R; VanDyke, Maia E; Pagliara, Travis J; Morey, Allen F

    2017-09-01

    Static friction (stiction) is a mechanical phenomenon in which a state of increased resistance exists across a control valve mechanism. To present a strategy for non-operative management of inflatable penile prosthesis (IPP) cases with pump malfunction from pump valve stiction. All patients had American Medical Systems (AMS; Minnetonka, MN, USA) 700 series Momentary Squeeze IPPs with transient pump malfunction owing to pump valve stiction after extended periods of device inactivity. Our evolving non-operative management experience with the "forced deflation" maneuver is described. This technique has successfully prevented the need for surgical pump replacement. Of patients with IPP who were instructed to inflate and deflate daily to prevent stiction recurrence, none have re-presented with difficult inflation. Of 306 patients receiving the AMS 700 series IPP at our institution from 2007 through 2015, 6 (1.9%) presented with difficulty activating the Momentary Squeeze pump (from 2011 through 2015). Four additional patients were referred from outside institutions with the same complaint. All patients (10 of 10, 100%) presented after a prolonged period of inactivity (minimum = 6 weeks) during which the IPP was not cycled and remained stagnant. Although the initial four patients (40%) underwent surgical exploration with pump mobilization and replacement, the six most recent patients (60%) were successfully instructed in the forced deflation maneuver in the office, which enabled the device to cycle normally thereafter. Device inactivity, for as little as 6 weeks, can predispose to Momentary Squeeze pump valve malfunction; and a regimen of daily IPP cycling could prevent stiction-related malfunction. Our findings should encourage practitioners to attempt conservative management of patients with "stiction syndrome" whenever possible, thereby avoiding unnecessary surgery. Kavoussi NL, Viers BR, VanDyke ME, et al. "Stiction Syndrome": Non-Operative Management of Patients

  14. Penile suspensory ligament division for penile augmentation: indications and results.

    Science.gov (United States)

    Li, Chi-Ying; Kayes, Oliver; Kell, Phillip D; Christopher, Nim; Minhas, Suks; Ralph, David J

    2006-04-01

    This study assessed the management of patients requesting penile length enhancement by division of the penile suspensory ligament. From September 1998 to January 2005, 42 patients with a variety of etiologies were included; all underwent division of the penile suspensory ligament. The outcome was assessed objectively based on increase in flaccid stretched penile length (SPL) and subjectively using the rates of patient satisfaction. The mean increase in SPL was 1.3+/-0.9 cm (range, -1 to +3 cm), with the addition of a silicone spacer placed between the pubis and penis giving a better outcome (p<0.05). The overall patient satisfaction rate was 35% but lower in the group with penile dysmorphic disorder at 27%. Division of the penile suspensory ligament or other augmentation techniques may increase penile length but usually not to a degree that satisfies the patient. Men with penile dysmorphic disorder often have unrealistic expectations regarding the outcome of surgical intervention and should be encouraged to seek psychological help primarily, with surgery reserved as the last resort.

  15. Penile Cancer—Patient Version

    Science.gov (United States)

    Penile cancer usually forms on or under the foreskin. Human papillomavirus (HPV) causes about one-third of penile cancer cases. When found early, penile cancer is usually curable. Start here to find information on penile cancer treatment and research.

  16. Penile enlargement surgery.

    Science.gov (United States)

    Alter, G J

    1998-06-01

    Aesthetic surgery to improve the appearance of the penis, scrotum, and pubic region has successfully evolved. Penile lengthening is performed by releasing the suspensory ligament of the penis followed by use of penile weights. Girth is increased by wrapping a dermal-fat graft around the penile circumference. The choice of surgery is determined by the patient's anatomy and desires.

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

    Directory of Open Access Journals (Sweden)

    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.

  18. Penile Cancer—Health Professional Version

    Science.gov (United States)

    Penile cancer is most commonly squamous cell carcinoma. When diagnosed early, penile cancer is highly curable. Some studies suggest an association between human papillomavirus (HPV) infection and penile cancer. Find evidence-based information on penile cancer treatment.

  19. Penile epidermal inclusion cyst: a late complication of penile girth enhancement surgery.

    Science.gov (United States)

    Park, Hyun Jun; Park, Nam Cheol; Park, Sung Woo; Jern, Tae Kyung; Choi, Kyung-Un

    2008-09-01

    Epidermal inclusion cysts are benign lesions that can develop in any part of the body. However, the finding of an epidermal inclusion cyst in the penis is rare. The aim of this article was to present the management of a case of a penile epidermal inclusion cyst that occurred because of late complications of a penile girth enhancement surgery. A 52-year-old man presented with a painless, slowly growing mass in the penis, which was first noted after a penile girth enhancement surgery 20 years ago. A cystic mobile mass about 2 cm in depth was found surrounding the coronal sulcus. Excision of the mass was performed for diagnosis and treatment. There was no communication with the urethra. The pathological diagnosis was an epidermal inclusion cyst of the penis. A penile epidermal inclusion cyst in adult men is rare. It can develop after an inadequate procedure for penile girth enhancement, and should be treated by complete resection.

  20. Penile incerceration—A tight affair

    Directory of Open Access Journals (Sweden)

    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.

  1. Penile cancer: epidemiology, pathogenesis and prevention.

    Science.gov (United States)

    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.

  2. Role of penile doppler as a diagnostic tool in penile fracture

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  4. Penile Subcutaneous Fibrolipoma Postaugmentative Phalloplasty

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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.

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

    International Nuclear Information System (INIS)

    Blanco, R.; Saenz de Tejada, I.; Azadzoi, K.; Goldstein, I.; Krane, R.J.; Wotiz, H.H.; Cohen, R.A.

    1986-01-01

    The neuroeffectors which relax penile smooth muscle and lead to erection are unknown; physiological studies of human corpus cavernosum, in vitro, have suggested a significant role of cholinergic neurotransmission. To further characterize the importance of cholinergic nerves, biopsies of human corpus cavernosum were obtained at the time of penile prosthesis implantation. Tissues were incubated in 3 H-choline (10 -5 M, 80 Ci/mmol) in oxygenated physiological salt solution at 37 0 C, pH 7.4 for 1 hour. Radiolabelled compounds were extracted with perchloric acid (0.4 M) and acetylcholine and choline were separated by HPLC; 14 C-acetylcholine was used as internal standard. 3 H-choline was accumulated by the tissues (20 +/- 1.9 fmol/mg), and 3 H-acetylcholine was synthesized (4.0 +/- 1.1 fmol/mg). In control experiments, heating of the tissue blocked synthesis of 3 H-acetylcholine. Inhibition of high affinity choline transport by hemicholinium-3 (10 -5 M) diminished tissue accumulation of 3 H-choline and significantly reduced the synthesis of 3 H-acetylcholine (0.5 +/ 0.2 fmol/mg, p < 0.05). These results provide direct evidence of neuronal accumulation of choline and enzymatic conversion to acetylcholine in human corpus cavernosum. Taken together with the physiological studies, it can be concluded that cholinergic neurotransmission in human corpus cavernosum plays a role in penile erection

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

    Science.gov (United States)

    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

  8. [Penile dimensions in type 2 diabetes].

    Science.gov (United States)

    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.

  9. Our Results in Penile Fractures

    Directory of Open Access Journals (Sweden)

    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.

  10. Penile surgery and reconstruction.

    Science.gov (United States)

    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.

  11. 20-year experience with iatrogenic penile injury.

    Science.gov (United States)

    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.

  12. 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.

  13. 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.

  14. Penile anthropometry in North Indian children

    Directory of Open Access Journals (Sweden)

    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.

  15. 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...

  16. Penile Enhancement Surgery: An Overview

    Directory of Open Access Journals (Sweden)

    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.

  17. 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...

  18. 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

  19. [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.

  20. 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.

  1. Penile Cancer Presenting With Acute Urinary Retantion: Case Report

    Directory of Open Access Journals (Sweden)

    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

  2. Isolated Penile Torsion in Brothers: A Case Report

    Directory of Open Access Journals (Sweden)

    Metin Gunduz

    2012-04-01

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

  3. 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...

  4. Inflation targeting and core inflation

    OpenAIRE

    Julie Smith

    2005-01-01

    This paper examines the interaction of core inflation and inflation targeting as a monetary policy regime. Interest in core inflation has grown because of inflation targeting. Core inflation is defined in numerous ways giving rise to many potential measures; this paper defines core inflation as the best forecaster of inflation. A cross-country study finds before the start of inflation targeting, but not after, core inflation differs between non-inflation targeters and inflation targeters. Thr...

  5. 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.

  6. 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).

  7. 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 ...

  8. 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...

  9. 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

  10. Penile implants among prisoners-a cause for concern?

    Directory of Open Access Journals (Sweden)

    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.

  11. Reconstruction of deformities resulting from penile enlargement surgery.

    Science.gov (United States)

    Alter, G J

    1997-12-01

    More than 30 patients presented for reconstruction of penile deformities secondary to penile enlargement surgery performed by other physicians. Lengthening was performed by releasing the suspensory ligament of the penis and advancing pubic skin with a V-Y advancement flap. Girth was increased by injecting autologous fat. Specific complaints relating to the lengthening procedure involve hypertrophic and/or wide scars, a proximal penile hump from a thick, hair-bearing V-Y flap, and a low hanging penis. Complications relating to autologous fat injections include disappearance of fat, penile lumps and nodules, and shaft deformities. The repair of these deformities is described. From 1994 through October 1996, 19 men underwent 24 various combinations of reconstructive operations, such as scar revisions, V-Y advancement flap reversal, and removal of fat nodules and asymmetrical fat deposits. Penile appearance and function were improved. Complications include 1 hematoma requiring drainage, minor wound complications and 1 inadequately reversed V-Y flap. The methods of various repairs are discussed, including reconstructive limitations, timing and staging. Significant improvement can be achieved with proper reconstruction of penile deformities.

  12. Penile Rehabilitation after Pelvic Cancer Surgery

    Directory of Open Access Journals (Sweden)

    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.

  13. 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.

  14. 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

  15. 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

  16. 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.

  17. 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.

  18. 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

  19. 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.

  20. 500 penile prostheses implanted by a surgeon in Italy in the last 30 years

    Directory of Open Access Journals (Sweden)

    Diego Pozza

    2015-09-01

    Full Text Available Objectives: The aim of our study was to report our experience with patients affected by Erectile Dysfunction (ED and undergoing penile prosthetic implantation (PPI in a single center by a single surgeon. Material and Methods: We retrospectively evaluated the clinical outcome of 500 patients (mean age: 51.5 years, range: 20-86 years affected by ED and referred to our private andrological center from January 1984 to December 2013 who underwent penile prosthesis implantation, including the reported level of patient satisfaction. Results: 182 silicone, 180 malleable, 18 monocomponent hydraulic and 120 multicomponents hydraulic prostheses were implanted by the same experienced surgeon. All patients were hospitalized for the procedure. All patients were evaluated immediately, 1 month (496 patients and, for the great majority, every year after implantation. One hundred twenty five patients were lost to follow-up. Twenty two patients underwent revision surgery for complications in the postoperative period. The most serious postoperative complications were mechanical problems (45 patients, 9.0% and infection (15 patients, 3%. Forty two (8.4% prostheses were explanted. Overall, 80% (400/500 of patients were able to have sexual intercourse and were fully satisfied with the results. Conclusions: In our experience prosthetic surgery should be considered a good solution for men affected by ED and not responsive to other therapeutic solutions. Prosthetic surgery can be performed not only in large public hospitals but also in smaller private facilities.

  1. Penile constriction injury: An experience of four cases

    Directory of Open Access Journals (Sweden)

    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.

  2. Sarcoidosis presenting as penile mass

    Directory of Open Access Journals (Sweden)

    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.

  3. 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

  4. 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.

  5. 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.

  6. Penile hair tourniquet resulting in hypospadias failure

    Directory of Open Access Journals (Sweden)

    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.

  7. Inflation and Inflation Uncertainty in Turkey

    OpenAIRE

    dogru, bulent

    2014-01-01

    Abstract: In this study, the relationship between inflation and inflation uncertainty is analyzed using Granger causality tests with annual inflation series covering the time period 1923 to 2012 for Turkish Economy. Inflation uncertainty is measured by Exponential Generalized Autoregressive Conditional Heteroskedastic model. Econometric findings suggest that although in long run the Friedman's hypothesis that high inflation increases inflation ...

  8. 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.

  9. 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.

  10. 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...

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

    Science.gov (United States)

    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.

  12. 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.

  13. Visualization of HIV-1 interactions with penile and foreskin epithelia: clues for female-to-male HIV transmission.

    Directory of Open Access Journals (Sweden)

    Minh H Dinh

    2015-03-01

    Full Text Available To gain insight into female-to-male HIV sexual transmission and how male circumcision protects against this mode of transmission, we visualized HIV-1 interactions with foreskin and penile tissues in ex vivo tissue culture and in vivo rhesus macaque models utilizing epifluorescent microscopy. 12 foreskin and 14 cadaveric penile specimens were cultured with R5-tropic photoactivatable (PA-GFP HIV-1 for 4 or 24 hours. Tissue cryosections were immunofluorescently imaged for epithelial and immune cell markers. Images were analyzed for total virions, proportion of penetrators, depth of virion penetration, as well as immune cell counts and depths in the tissue. We visualized individual PA virions breaching penile epithelial surfaces in the explant and macaque model. Using kernel density estimated probabilities of localizing a virion or immune cell at certain tissue depths revealed that interactions between virions and cells were more likely to occur in the inner foreskin or glans penis (from local or cadaveric donors, respectively. Using statistical models to account for repeated measures and zero-inflated datasets, we found no difference in total virions visualized at 4 hours between inner and outer foreskins from local donors. At 24 hours, there were more virions in inner as compared to outer foreskin (0.0495 +/- 0.0154 and 0.0171 +/- 0.0038 virions/image, p = 0.001. In the cadaveric specimens, we observed more virions in inner foreskin (0.0507 +/- 0.0079 virions/image than glans tissue (0.0167 +/- 0.0033 virions/image, p<0.001, but a greater proportion was seen penetrating uncircumcised glans tissue (0.0458 +/- 0.0188 vs. 0.0151 +/- 0.0100 virions/image, p = 0.099 and to significantly greater mean depths (29.162 +/- 3.908 vs. 12.466 +/- 2.985 μm. Our in vivo macaque model confirmed that virions can breach penile squamous epithelia in a living model. In summary, these results suggest that the inner foreskin and glans epithelia may be important sites

  14. Prothèses péniennes : taille du pénis implanté et dimensions de la virilité

    OpenAIRE

    Kempeneers, Philippe; Andrianne, Robert; Mormont, Christian; Jeanmart, Fabian; Blochousse, Laurence

    2001-01-01

    The implantation of a penile prosthesis frequently results in a reduction of the erectile length compared with natural erections. Some patients complain about this fact and their satisfaction at prosthesis assisted sexuality is significantly diminished. Obviously, the degree of complaint is not proportional to the objective degree of penile reduction. For an objective reality to lead to complaints, subjective criteria of appreciation have to intervene. A survey questionnaire completed ...

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

    Directory of Open Access Journals (Sweden)

    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.

  16. No evidence of depression, anxiety, and sexual dysfunction following penile fracture.

    Science.gov (United States)

    Penbegul, N; Bez, Y; Atar, M; Bozkurt, Y; Sancaktutar, A A; Soylemez, H; Ozen, S

    2012-01-01

    There is a gap in the literature about psychological status of patients following penile fracture surgery. We aimed to assess the long-term psychological status of penile fracture patients who have been treated by immediate surgical repair. A total of 32 patients with penile fracture have been treated surgically at our center. These 32 patients and 30 healthy control subjects were included in the study. All participants have completed the Hospital Anxiety and Depression Scale (HADS), Glombok-Rust Inventory of Satisfaction Scale (GRISS), and the premature ejaculation diagnostic tool (PEDT). The mean age of patients was 30.4 years and the mean body mass index was 27.3 kg m(-2). Sexual intercourse was the most common cause of the fracture. Immediate surgical repair was performed in all cases using a circumferential subcoronal incision and none of the patients had urethral injury intraoperatively. All tears were unilateral with a mean size of 1.5 cm. Only two patients had superficial dorsal vein rupture. At the day of assessment, the mean time elapsed after penile trauma was 15.9±6.3 months (range: 6-23). Only three patients had complications due to penile fracture including minimal penile curvature, penile nodule, and penile pain during intercourse. The mean scores obtained from PEDT, HADS, and GRISS did not show any statistically significant difference between groups. Anxiety, depression, premature ejaculation, and sexual dyssatisfaction levels were similar in both penile fracture patients who underwent immediate surgical repair and healthy control subjects. Immediate surgical repair of corporal ruptures have not shown any harmful psychogenic sequelae on patients with penile fracture.

  17. A prospective multicentric international study on the surgical outcomes and patients' satisfaction rates of the 'sliding' technique for end-stage Peyronie's disease with severe shortening of the penis and erectile dysfunction.

    Science.gov (United States)

    Rolle, Luigi; Falcone, Marco; Ceruti, Carlo; Timpano, Massimiliano; Sedigh, Omid; Ralph, David J; Kuehhas, Franklin; Oderda, Marco; Preto, Mirko; Sibona, Mattia; Gillo, Arianna; Garaffa, Giulio; Gontero, Paolo; Frea, Bruno

    2016-05-01

    To report the results from a prospective multicentric study of patients with Peyronie's disease (PD) treated with the 'sliding' technique (ST). From June 2010 to January 2014, 28 consecutive patients affected by stable PD with severe penile shortening and end-stage erectile dysfunction (ED) were enrolled in three European PD tertiary referral centres. The validated International Index of Erectile Function (IIEF) questionnaire, the Sexual Encounter Profile (SEP) Questions 2 and 3, and the Peyronie's disease questionnaire (PDQ) were completed preoperatively by all patients. At the follow-up visits (at 3, 6 and 12 months), the IIEF, the SEP Questions 2 and 3, the PDQ, and the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) were completed. The outcome analysis was focused on penile length restoration, and intra- and postoperative complications classified according the Clavien-Dindo Classification. The mean (range) follow-up was 37 (9-60) months. A malleable penile prosthesis (PP) was implanted in seven patients, while an inflatable three-pieces PP was placed in the remainder. In the case of inflatable PP implantation, porcine small intestinal submucosa and acellular porcine dermal matrix were used to cover the tunical defects. While in patients undergoing malleable PP implantation, collagen-fibrin sponge was used. The mean operative time was 145 min in the inflatable PP group and 115 min in the malleable PP group. There were no intraoperative complications. Postoperative complications included profuse bleeding requiring a blood transfusion in one patient (3.5%) on anticoagulation therapy for a mechanical heart valve (Grade II) and PP infection requiring the removal of the device (7%) (Grade III). There were no late recurrences of the shaft deformation. The postoperative functional data showed a progressive improvement in the score of all questionnaires, peaking at 12 months postoperatively. The mean (range) penile lengthening was 3.2 (2.5-4) cm and no

  18. 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.

  19. [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.

  20. 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.

  1. 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.

  2. 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

  3. 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)

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. Robotic lower limb prosthesis design through simultaneous computer optimizations of human and prosthesis costs

    Science.gov (United States)

    Handford, Matthew L.; Srinivasan, Manoj

    2016-02-01

    Robotic lower limb prostheses can improve the quality of life for amputees. Development of such devices, currently dominated by long prototyping periods, could be sped up by predictive simulations. In contrast to some amputee simulations which track experimentally determined non-amputee walking kinematics, here, we explicitly model the human-prosthesis interaction to produce a prediction of the user’s walking kinematics. We obtain simulations of an amputee using an ankle-foot prosthesis by simultaneously optimizing human movements and prosthesis actuation, minimizing a weighted sum of human metabolic and prosthesis costs. The resulting Pareto optimal solutions predict that increasing prosthesis energy cost, decreasing prosthesis mass, and allowing asymmetric gaits all decrease human metabolic rate for a given speed and alter human kinematics. The metabolic rates increase monotonically with speed. Remarkably, by performing an analogous optimization for a non-amputee human, we predict that an amputee walking with an appropriately optimized robotic prosthesis can have a lower metabolic cost - even lower than assuming that the non-amputee’s ankle torques are cost-free.

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

    Directory of Open Access Journals (Sweden)

    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.

  10. 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 ...

  11. Dual long memory of inflation and test of the relationship between inflation and inflation uncertainty

    OpenAIRE

    LIU Jinquan; ZHENG Tingguo; SUI Jianli

    2008-01-01

    This paper uses the ARFIMA-FIGARCH model to investigate the China¡¯s monthly inflation rate from January 1983 to October 2005. It is found that both first moment and second moment of inflation have remarkable long memory, indicating the existence of long memory properties in both inflation level and inflation uncertainty. By the Granger-causality test on inflation rate and inflation uncertainty, it is shown that the inflation level affects the inflation uncertainty and so supports Friedman hy...

  12. 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 ...

  13. Artificial urethral sphincters: Value of plain film radiography in evaluation of prosthesis malfunction

    International Nuclear Information System (INIS)

    Rose, S.C.; Hansen, M.E.; Webster, G.; Dunnick, N.R.

    1987-01-01

    Case records were reviewed to determine the diagnostic efficacy of plain radiographs in the evaluation of inflatable artificial urethral sphincters. Of 84 patients with prostheses, 21 (25%) developed complications. Fluid leaks were found in 16 patients who presented with recurrent incontinence; plain radiographs demonstrated an interval decrease in balloon reservoir diameter. Kinked tubing, which was evident on plain films, caused acute urinary retention in three patients. However, plain radiographs failed to detect evidence of prosthesis erosion into the urethra in either of two patients with this complication. Although urethroscopy is needed to detect urethral erosion, plain radiographs are inexpensive and reliable in the initial evaluation of artifical sphincter malfunction

  14. MRI and its role in the evaluation and surgical decision making in patients with challenging IPP presentations: descriptions of MRI findings and algorithm for patient management.

    Science.gov (United States)

    McPhail, E Fred; Nehra, Ajay; Bruner, Bryan C; Kawashima, Akira; King, Bernard F; Kim, Bohyun

    2012-06-01

    Study Type - Diagnostic (case series) Level of Evidence 4 What's known on the subject? and What does the study add? It is known that magnetic resonance imaging (MRI) is safe and effective for imaging patients with inflatable penile prostheses (IPPs). Previous series have reported results of MRI for imaging series of patients with IPPs. The impact on management in particular with regard to salvage procedures is not well defined. This study represents the largest known experience with MRI evaluation of IPPs. This also provides an algorithm that assists with decisions regarding utilization of MRI and treatment planning based on results. • In some patients who undergo placement of an inflatable penile prosthesis (IPP) the device may function inadequately. We describe the use of magnetic resonance imaging (MRI) for anatomical localization and detection of prosthesis malrotation, angulation, displacement and erosion in IPPs with equivocal clinical examination. • We prospectively performed MRI by a defined protocol including T1-weighted imaging, and transaxial, sagittal and coronal fat-saturated fast spin-echo T2-weighted imaging in both deflated and inflated states to evaluate patients seen at our referral centre for IPP-related complaints. • We retrospectively reviewed 32 such MRI studies performed as a supplement to clinical examination between 2000 and 2008. • Of 32 cases, 75% (24/32) underwent surgical intervention. Of these, 45% (11/24) underwent device salvage procedures including cylinder revision in 33% (8/24), cylinder replacement in 8% (2/24) and pump replacement in 4% (1/24). • MRI was most useful for determination of surgical approach in those with abnormal physical examination, and for justification of either surgical or expectant management in those with indeterminate physical examination. • MRI is safe and effective for imaging genitourinary prostheses. • We found MRI to be a valuable adjunct for evaluation of IPP-related complaints when

  15. Inflation persistence in African countries: Does inflation targeting matter?

    OpenAIRE

    Phiri, Andrew

    2016-01-01

    This study investigates inflation persistence in annual CPI inflation collected between 1994 and 2014 for 46 African countries. We group these countries into panels according to whether they are inflation targeters or not and conduct estimations for pre and post inflation targeting periods. Interestingly enough, we find that inflation persistence was much higher for inflation targeters in periods before adopting their inflation targeting regimes and inflation persistence dropped by 40 percent...

  16. A nonimaging scintillation probe to measure penile hemodynamics.

    Science.gov (United States)

    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.

  17. One-stage and two-stage penile buccal mucosa urethroplasty

    Directory of Open Access Journals (Sweden)

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-08-01

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

  19. The Angelchik prosthesis

    International Nuclear Information System (INIS)

    Fargnoli, R.; Bozza, A.; Magnoli, A.; Villari, N.; Pernice, L.M.; Andreoli, F.; Lombardi, P.

    1989-01-01

    The Angelchik prosthesis is used in the surgical treatment of gastroesophageal reflux. Operated patients are preliminary examined with imaging techniques, but manometric and acidometric techniques are also used. Although the conventional esophagogram still maintains its diagnostic significance, Computed Tomography (CT) has become the first-choice imaging modality. CT allows the correct evaluation of both the state of the prosthesis and its relationship to the esophagus and gastric fundus. The possible postoperative complications following an incorrect placement of the prosthesis can be accurately diagnosed too. The authors report their experience in the study of 5 patients examined with both conventional radiology and CT

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

    Science.gov (United States)

    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.

  1. 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.

  2. 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...

  3. 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

  4. 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

  5. Do inflation-linked bonds contain information about future inflation?

    Directory of Open Access Journals (Sweden)

    José Valentim Machado Vicente

    2013-06-01

    Full Text Available There is a widespread belief that inflation-linked bonds are a direct source of information about inflation expectations. In this paper we address this issue by analyzing the relationship between break-even inflation (the difference between nominal and real yields and future inflation. The dataset is extracted from Brazilian Treasury bonds covering the period from April 2005 to April 2011. We find that break-even inflation is an unbiased forecast only of the 3-month and 6-month ahead inflation. For medium horizons (12 and 18 months, break-even inflation has weak explanatory power of future inflation. Over long horizons (24 and 30 months, we report a significant, but counterintuitive, negative relationship between the break-even and realized inflation rates.

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

    Directory of Open Access Journals (Sweden)

    Sood Suneet

    2010-06-01

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

  7. Inflation and Inflation Uncertainty Revisited: Evidence from Egypt

    Directory of Open Access Journals (Sweden)

    Mesbah Fathy Sharaf

    2015-07-01

    Full Text Available The welfare costs of inflation and inflation uncertainty are well documented in the literature and empirical evidence on the link between the two is sparse in the case of Egypt. This paper investigates the causal relationship between inflation and inflation uncertainty in Egypt using monthly time series data during the period January 1974–April 2015. To endogenously control for any potential structural breaks in the inflation time series, Zivot and Andrews (2002 and Clemente–Montanes–Reyes (1998 unit root tests are used. The inflation–inflation uncertainty relation is modeled by the standard two-step approach as well as simultaneously using various versions of the GARCH-M model to control for any potential feedback effects. The analyses explicitly control for the effect of the Economic Reform and Structural Adjustment Program (ERSAP undertaken by the Egyptian government in the early 1990s, which affected inflation rate and its associated volatility. Results show a high degree of inflation–volatility persistence in the response to inflationary shocks. Granger-causality test along with symmetric and asymmetric GARCH-M models indicate a statistically significant bi-directional positive relationship between inflation and inflation uncertainty, supporting both the Friedman–Ball and the Cukierman–Meltzer hypotheses. The findings are robust to the various estimation methods and model specifications. The findings of this paper support the view of adopting inflation-targeting policy in Egypt, after fulfilling its preconditions, to reduce the welfare cost of inflation and its related uncertainties. Monetary authorities in Egypt should enhance the credibility of monetary policy and attempt to reduce inflation uncertainty, which will help lower inflation rates.

  8. PENILE ENHANCEMENT PROCEDURES: UROLOGICAL AND ETHICOLEGAL ISSUES

    Directory of Open Access Journals (Sweden)

    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.

  9. 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.

  10. Inflation from field theory and string theory perspectives. Matter inflation and slow-walking inflation

    International Nuclear Information System (INIS)

    Halter, Sebastian

    2012-01-01

    This thesis is concerned with aspects of inflation both from a field theory and a string theory perspective. It aims at exploring new approaches to address the problem of moduli destabilization and the η-problem and to realize inflation in the matter sector. The first part is devoted to studying models of inflation in the framework of four-dimensional N=1 supergravity. We begin with investigating a new proposal to solve the problem of moduli destabilization, which seems to force us to choose between low-energy supersymmetry and high-scale inflation. This new approach is based on a particular way to couple the modulus to the F-term driving inflation. Using chaotic inflation with a shift symmetry as an example, we show that we can successfully combine low-energy supersymmetry and high-scale inflation. We construct a class of inflation models in N=1 supergravity where the inflaton resides in gauge non-singlet matter fields. These are extensions of a special class of hybrid inflation models, so-called tribrid inflation, where the η-problem can be solved by a Heisenberg symmetry. Compared to previously studied models, we have generalized our models with some inspiration from string theory. We investigate moduli stabilization during inflation and identify situations in which the inflaton slope is dominated by radiative corrections. We outline under which conditions this class of matter inflation models could be embedded into heterotic orbifold compactifications. In doing so, we suggest a new mechanism to stabilize some Kaehler moduli by F-terms for matter fields. In the second part, we consider models of warped D-brane inflation on a family of ten-dimensional supergravity backgrounds. We consider inflation along the radial direction near the tip of the warped throat and show that generically an inflection point arises for the inflaton potential, which is related to an inflection point of the dilaton profile. A universal scaling behaviour with the parameters of the

  11. Inflation from field theory and string theory perspectives. Matter inflation and slow-walking inflation

    Energy Technology Data Exchange (ETDEWEB)

    Halter, Sebastian

    2012-07-09

    This thesis is concerned with aspects of inflation both from a field theory and a string theory perspective. It aims at exploring new approaches to address the problem of moduli destabilization and the η-problem and to realize inflation in the matter sector. The first part is devoted to studying models of inflation in the framework of four-dimensional N=1 supergravity. We begin with investigating a new proposal to solve the problem of moduli destabilization, which seems to force us to choose between low-energy supersymmetry and high-scale inflation. This new approach is based on a particular way to couple the modulus to the F-term driving inflation. Using chaotic inflation with a shift symmetry as an example, we show that we can successfully combine low-energy supersymmetry and high-scale inflation. We construct a class of inflation models in N=1 supergravity where the inflaton resides in gauge non-singlet matter fields. These are extensions of a special class of hybrid inflation models, so-called tribrid inflation, where the η-problem can be solved by a Heisenberg symmetry. Compared to previously studied models, we have generalized our models with some inspiration from string theory. We investigate moduli stabilization during inflation and identify situations in which the inflaton slope is dominated by radiative corrections. We outline under which conditions this class of matter inflation models could be embedded into heterotic orbifold compactifications. In doing so, we suggest a new mechanism to stabilize some Kaehler moduli by F-terms for matter fields. In the second part, we consider models of warped D-brane inflation on a family of ten-dimensional supergravity backgrounds. We consider inflation along the radial direction near the tip of the warped throat and show that generically an inflection point arises for the inflaton potential, which is related to an inflection point of the dilaton profile. A universal scaling behaviour with the parameters of the

  12. Inflation, its Volatility and the Inflation-Growth Tradeoff in India

    OpenAIRE

    Raghbendra Jha; Varsha S. Kulkarni

    2013-01-01

    This paper amends the New Keynesian Phillips curve model to include inflation volatility. It provides results on the determinants of inflation volatility and expected inflation volatility for OLS and ARDL(1,1) models and for change in inflation volatility and change in expected inflation volatility using ECM models. Output gap affects change in expected inflation volatility alone (in the ECM model) and not in the other models. Major determinants of inflation volatility and expected inflation ...

  13. Revision washout decreases implant capsule tissue culture positivity: a multicenter study.

    Science.gov (United States)

    Henry, Gerard D; Carson, Culley C; Wilson, Steven K; Wiygul, Jeremy; Tornehl, Chris; Cleves, Mario A; Simmons, Caroline J; Donatucci, Craig F

    2008-01-01

    Positive cultures, visible biofilm and confocal micrography confirm bacterial presence on clinically uninfected inflatable penile prostheses at revision surgery. Salvage irrigation has been proved to rescue patients with clinically infected inflatable penile prostheses. Similar washout at revision for noninfectious reasons significantly lowers subsequent infection rates. We investigated a larger series of patients for positive culture rates and evaluated implant capsule tissue culture rates before and after revision washout. At 4 institutions a total of 148 patients with inflatable penile prostheses underwent revision surgery for noninfectious reasons between June 2001 and September 2005. Swab cultures of the fluid around the pump and visible biofilm were obtained. Also, in 65 patients a wedge of tissue from the capsule that forms around the pump was cultured. After implant removal revision washout of the implant spaces was performed and a second wedge of tissue was cultured. Of the 148 patients 97 (66%) had positive bacterial swab cultures of the fluid around the pump or biofilm. A total of 124 isolates were cultured. Of the 65 implant capsule tissue cultures obtained before washout 28 (43%) were positive for bacteria, while 16 (25%) obtained after revision washout were positive. Positive cultures and visible bacterial biofilm are present on clinically uninfected inflatable penile prostheses at revision surgery in most patients. Revision washout appears to decrease the bacterial load on implant capsule tissue at revision surgery of inflatable penile prostheses for noninfectious reasons.

  14. Towards a formal link between inflation perceptions and inflation ...

    African Journals Online (AJOL)

    This paper reports the finding of a survey of inflation perceptions and inflation expectations in South Africa undertaken in 2014. This survey posed questions on perceptions of past inflation (historic inflation) and expectations of future inflation to the same respondents and determined linkages between historic views and ...

  15. Inflation Volatility and the Inflation-Growth Tradeoff in India

    OpenAIRE

    Raghbendra Jha; Varsha S. Kulkarni

    2012-01-01

    This paper amends the New Keynesian Phillips curve model to include inflation volatility and tests the determinants of such volatility for India. It provides results on the determinants of inflation volatility and expected inflation volatility for OLS and ARDL (1,1) models and for change in inflation volatility and change in expected inflation volatility using ECM models. Output gap affects change in expected inflation volatility along (in the ECM model) and not in the other models. Major det...

  16. Eternal hilltop inflation

    International Nuclear Information System (INIS)

    Barenboim, Gabriela; Park, Wan-Il; Kinney, William H.

    2016-01-01

    We consider eternal inflation in hilltop-type inflation models, favored by current data, in which the scalar field in inflation rolls off of a local maximum of the potential. Unlike chaotic or plateau-type inflation models, in hilltop inflation the region of field space which supports eternal inflation is finite, and the expansion rate H EI during eternal inflation is almost exactly the same as the expansion rate H * during slow roll inflation. Therefore, in any given Hubble volume, there is a finite and calculable expectation value for the lifetime of the ''eternal'' inflation phase, during which quantum flucutations dominate over classical field evolution. We show that despite this, inflation in hilltop models is nonetheless eternal in the sense that the volume of the spacetime at any finite time is exponentially dominated by regions which continue to inflate. This is true regardless of the energy scale of inflation, and eternal inflation is supported for inflation at arbitrarily low energy scale.

  17. 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.

  18. Ultrasonographic study of subcutaneous penile granuloma secondary to silicone injection

    Directory of Open Access Journals (Sweden)

    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.

  19. Inflation, inflation uncertainty and output growth in the USA

    Science.gov (United States)

    Bhar, Ramprasad; Mallik, Girijasankar

    2010-12-01

    Employing a multivariate EGARCH-M model, this study investigates the effects of inflation uncertainty and growth uncertainty on inflation and output growth in the United States. Our results show that inflation uncertainty has a positive and significant effect on the level of inflation and a negative and significant effect on the output growth. However, output uncertainty has no significant effect on output growth or inflation. The oil price also has a positive and significant effect on inflation. These findings are robust and have been corroborated by use of an impulse response function. These results have important implications for inflation-targeting monetary policy, and the aim of stabilization policy in general.

  20. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  2. INFLATE: INFlate Landing Apparatus Technology

    Science.gov (United States)

    Koryanov, V. V. K.; Da-Poian, V. D. P.

    2018-02-01

    Our project, named INFLATE (INFlatable Landing Apparatus Technology), aims at reducing space landing risks and constraints and so optimizing space missions (reducing cost, mass, and risk and in the same time improving performance).

  3. Inflation Aversion and the Optimal Inflation Tax

    OpenAIRE

    Gaowang Wang; Heng-fu Zou

    2011-01-01

    The optimal inflation tax is reexamined in the framework of dynamic second best economy populated by individuals with inflation aversion. A simple formula for the optimal inflation rate is derived. Different from the literature, it is shown that if the marginal excess burden of other distorting taxes approaches zero, Friedman's rule for optimum quantity of money is not optimal, and the optimal inflation tax is negative; if the marginal excess burden of other taxes is nonzero, the optimal infl...

  4. Flavon inflation

    International Nuclear Information System (INIS)

    Antusch, S.; King, F.S.; Malinsky, M.; Velasco-Sevilla, L.; Zavala, I.

    2008-04-01

    We propose an entirely new class of particle physics models of inflation based on the phase transition associated with the spontaneous breaking of family symmetry responsible for the generation of the effective quark and lepton Yukawa couplings. We show that the Higgs fields responsible for the breaking of family symmetry, called flavons, are natural candidates for the inflation field in new inflation, or the waterfall fields in hybrid inflation. This opens up a rich vein of possible inflation models, all linked to the physics of flavour, with interesting cosmological and phenomenological implications. Out of these many possibilities we discuss two examples which realise flavon inflation: a model of new inflation based on the discrete non-Abelian family symmetry group A 4 or Δ 27 , and a model of hybrid inflation embedded in an existing flavour model with a continuous SU(3) family symmetry. With the inflation scale and family symmetry breaking scale below the Grand Unification Theory (GUT) scale, these classes of models are free of the monopole (and similar) problems which are often associated with the GUT phase transition. (author)

  5. 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.

  6. 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 ...

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. Inflation perceptions and inflation expectation in South Africa: trends ...

    African Journals Online (AJOL)

    This paper reports the results of a multinomial analysis of inflation perceptions and inflation expectations in South Africa. Inflation perceptions surveys among South African individuals have been undertaken since 2006. The introduction of these surveys followed on domestic inflation expectation surveys conducted in 2000, ...

  12. [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.

  13. CT-angiography-based evaluation of the aortic annulus for prosthesis sizing in transcatheter aortic valve implantation (TAVI-predictive value and optimal thresholds for major anatomic parameters.

    Directory of Open Access Journals (Sweden)

    Florian Schwarz

    Full Text Available BACKGROUND/OBJECTIVES: To evaluate the predictive value of CT-derived measurements of the aortic annulus for prosthesis sizing in transcatheter aortic valve implantation (TAVI and to calculate optimal cutoff values for the selection of various prosthesis sizes. METHODS: The local IRB waived approval for this single-center retrospective analysis. Of 441 consecutive TAVI-patients, 90 were excluded (death within 30 days: 13; more than mild aortic regurgitation: 10; other reasons: 67. In the remaining 351 patients, the CoreValve (Medtronic and the Edwards Sapien XT valve (Edwards Lifesciences were implanted in 235 and 116 patients. Optimal prosthesis size was determined during TAVI by inflation of a balloon catheter at the aortic annulus. All patients had undergone CT-angiography of the heart or body trunk prior to TAVI. Using these datasets, the diameter of the long and short axis as well as the circumference and the area of the aortic annulus were measured. Multi-Class Receiver-Operator-Curve analyses were used to determine the predictive value of all variables and to define optimal cutoff-values. RESULTS: Differences between patients who underwent implantation of the small, medium or large prosthesis were significant for all except the large vs. medium CoreValve (all p's<0.05. Furthermore, mean diameter, annulus area and circumference had equally high predictive value for prosthesis size for both manufacturers (multi-class AUC's: 0.80, 0.88, 0.91, 0.88, 0.88, 0.89. Using the calculated optimal cutoff-values, prosthesis size is predicted correctly in 85% of cases. CONCLUSION: CT-based aortic root measurements permit excellent prediction of the prosthesis size considered optimal during TAVI.

  14. Inflation,Inflation Variability, and Output Performance. Venezuela 1951-2002

    OpenAIRE

    Olivo, Victor

    2014-01-01

    This paper explores the relationship between the level of inflation, inflation variability, and output performance in the Venezuelan economy for the period 1951-2002. The paper examines the mechanism through which higher inflation translates into lower non-oil real GDP growth. We find empirical evidence that supports Friedman's (1977) contention that higher inflation produces more inflation volatility /uncertainty that leads to relative price variability that in turn, is harmful for the prope...

  15. Defining a glycated haemoglobin (HbA1c) level that predicts increased risk of penile implant infection.

    Science.gov (United States)

    Habous, Mohamad; Tal, Raanan; Tealab, Alaa; Soliman, Tarek; Nassar, Mohammed; Mekawi, Zenhom; Mahmoud, Saad; Abdelwahab, Osama; Elkhouly, Mohamed; Kamr, Hatem; Remeah, Abdallah; Binsaleh, Saleh; Ralph, David; Mulhall, John

    2018-02-01

    To re-evaluate the role of diabetes mellitus (DM) as a risk factor for penile implant infection by exploring the association between glycated haemoglobin (HbA1c) levels and penile implant infection rates and to define a threshold value that predicts implant infection. We conducted a multicentre prospective study including all patients undergoing penile implant surgery between 2009 and 2015. Preoperative, perioperative and postoperative management were identical for the entire cohort. Univariate analysis was performed to define predictors of implant infection. The HbA1c levels were analysed as continuous variables and sequential analysis was conducted using 0.5% increments to define a threshold level predicting implant infection. Multivariable analysis was performed with the following factors entered in the model: DM, HbA1C level, patient age, implant type, number of vascular risk factors (VRFs), presence of Peyronie's disease (PD), body mass index (BMI), and surgeon volume. A receiver operating characteristic (ROC) curve was generated to define the optimal HbA1C threshold for infection prediction. In all, 902 implant procedures were performed over the study period. The mean patient age was 56.6 years. The mean HbA1c level was 8.0%, with 81% of men having a HbA1c level of >6%. In all, 685 (76%) implants were malleable and 217 (24%) were inflatable devices; 302 (33.5%) patients also had a diagnosis of PD. The overall infection rate was 8.9% (80/902). Patients who had implant infection had significantly higher mean HbA1c levels, 9.5% vs 7.8% (P HbA1c level, we found infection rates were: 1.3% with HbA1c level of 9.5% (P HbA1c level, whilst a high-volume surgeon had a protective effect and was associated with a reduced infection risk. Using ROC analysis, we determined that a HbA1c threshold level of 8.5% predicted infection with a sensitivity of 80% and a specificity of 65%. Uncontrolled DM is associated with increased risk of infection after penile implant surgery

  16. 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 ...

  17. 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

  18. Flavon inflation

    Energy Technology Data Exchange (ETDEWEB)

    Antusch, S. [Max-Planck-Institut fuer Physik (Werner-Heisenberg-Institut), Foehringer Ring 6, D-80805 Muenchen (Germany); King, S.F.; Malinsky, M. [School of Physics and Astronomy, University of Southampton, Southampton, SO17 1BJ (United Kingdom); Velasco-Sevilla, L. [ICTP, Strada Costiera 11, Trieste 34014 (Italy)], E-mail: lvelasco@ictp.it; Zavala, I. [CPT and IPPP, Durham University, South Road, DH1 3LE, Durham (United Kingdom)

    2008-08-14

    We propose an entirely new class of particle physics models of inflation based on the phase transition associated with the spontaneous breaking of family symmetry responsible for the generation of the effective quark and lepton Yukawa couplings. We show that the Higgs fields responsible for the breaking of family symmetry, called flavons, are natural candidates for the inflaton field in new inflation, or the waterfall fields in hybrid inflation. This opens up a rich vein of possibilities for inflation, all linked to the physics of flavour, with interesting cosmological and phenomenological implications. Out of these, we discuss two examples which realise flavon inflation: a model of new inflation based on the discrete non-Abelian family symmetry group A{sub 4} or {delta}{sub 27}, and a model of hybrid inflation embedded in an existing flavour model with a continuous SU(3) family symmetry. With the inflation scale and family symmetry breaking scale below the Grand Unification Theory (GUT) scale, these classes of models are free of the monopole (and similar) problems which are often associated with the GUT phase transition.

  19. Flavon inflation

    International Nuclear Information System (INIS)

    Antusch, S.; King, S.F.; Malinsky, M.; Velasco-Sevilla, L.; Zavala, I.

    2008-01-01

    We propose an entirely new class of particle physics models of inflation based on the phase transition associated with the spontaneous breaking of family symmetry responsible for the generation of the effective quark and lepton Yukawa couplings. We show that the Higgs fields responsible for the breaking of family symmetry, called flavons, are natural candidates for the inflaton field in new inflation, or the waterfall fields in hybrid inflation. This opens up a rich vein of possibilities for inflation, all linked to the physics of flavour, with interesting cosmological and phenomenological implications. Out of these, we discuss two examples which realise flavon inflation: a model of new inflation based on the discrete non-Abelian family symmetry group A 4 or Δ 27 , and a model of hybrid inflation embedded in an existing flavour model with a continuous SU(3) family symmetry. With the inflation scale and family symmetry breaking scale below the Grand Unification Theory (GUT) scale, these classes of models are free of the monopole (and similar) problems which are often associated with the GUT phase transition

  20. Soft inflation

    Science.gov (United States)

    Berkin, Andrew L.; Maeda, Kei-Ichi; Yokoyama, Junichi

    1990-01-01

    The cosmology resulting from two coupled scalar fields was studied, one which is either a new inflation or chaotic type inflation, and the other which has an exponentially decaying potential. Such a potential may appear in the conformally transformed frame of generalized Einstein theories like the Jordan-Brans-Dicke theory. The constraints necessary for successful inflation are examined. Conventional GUT models such as SU(5) were found to be compatible with new inflation, while restrictions on the self-coupling constant are significantly loosened for chaotic inflation.

  1. CT-angiography-based evaluation of the aortic annulus for prosthesis sizing in transcatheter aortic valve implantation (TAVI)-predictive value and optimal thresholds for major anatomic parameters.

    Science.gov (United States)

    Schwarz, Florian; Lange, Philipp; Zinsser, Dominik; Greif, Martin; Boekstegers, Peter; Schmitz, Christoph; Reiser, Maximilian F; Kupatt, Christian; Becker, Hans C

    2014-01-01

    To evaluate the predictive value of CT-derived measurements of the aortic annulus for prosthesis sizing in transcatheter aortic valve implantation (TAVI) and to calculate optimal cutoff values for the selection of various prosthesis sizes. The local IRB waived approval for this single-center retrospective analysis. Of 441 consecutive TAVI-patients, 90 were excluded (death within 30 days: 13; more than mild aortic regurgitation: 10; other reasons: 67). In the remaining 351 patients, the CoreValve (Medtronic) and the Edwards Sapien XT valve (Edwards Lifesciences) were implanted in 235 and 116 patients. Optimal prosthesis size was determined during TAVI by inflation of a balloon catheter at the aortic annulus. All patients had undergone CT-angiography of the heart or body trunk prior to TAVI. Using these datasets, the diameter of the long and short axis as well as the circumference and the area of the aortic annulus were measured. Multi-Class Receiver-Operator-Curve analyses were used to determine the predictive value of all variables and to define optimal cutoff-values. Differences between patients who underwent implantation of the small, medium or large prosthesis were significant for all except the large vs. medium CoreValve (all p'sprosthesis size for both manufacturers (multi-class AUC's: 0.80, 0.88, 0.91, 0.88, 0.88, 0.89). Using the calculated optimal cutoff-values, prosthesis size is predicted correctly in 85% of cases. CT-based aortic root measurements permit excellent prediction of the prosthesis size considered optimal during TAVI.

  2. Nasal prosthesis rehabilitation: a case report

    DEFF Research Database (Denmark)

    Jain, Sumeet; Maru, Kavita; Shukla, Jyotsana

    2011-01-01

    Facial defects resulting from neoplasm, congenital malformation or trauma can be restored with facial prosthesis using different materials and retention methods to achieve life-like look and function. A nasal prosthesis can re-establish esthetic form and anatomic contours for mid-facial defects...... the non-surgical rehabilitation, with polymethyl meth-acrylate resin, nasal prosthesis for a patient who received partial rhinectomy as a result of squamous cell carcinoma of the nose. The prosthesis was made to restore the esthetic appearance of the patient with a mechanical retained design using...

  3. Generalized Higgs inflation

    Energy Technology Data Exchange (ETDEWEB)

    Kamada, Kohei [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany); Kobayashi, Tsutomu [Kyoto Univ. (Japan). Hakubi Center; Kyoto Univ. (Japan). Dept. of Physics; Takahashi, Tomo [Saga Univ. (Japan). Dept. of Physics; Yamaguchi, Masahide [Tokyo Institute of Technology (Japan). Dept. of Physics; Yokoyama, Jun' ichi [Tokyo Univ. (JP). Research Center for the Early Universe (RESCEU); Tokyo Univ., Chiba (JP). Inst. for the Physics and Mathematics of the Universe (IPMU)

    2012-03-15

    We study Higgs inflation in the context of generalized G-inflation, i.e., the most general single-field inflation model with second-order field equations. The four variants of Higgs inflation proposed so far in the literature can be accommodated at one time in our framework. We also propose yet another class of Higgs inflation, the running Einstein inflation model, that can naturally arise from the generalized G-inflation framework. As a result, five Higgs inflation models in all should be discussed on an equal footing. Concise formulas for primordial fluctuations in these generalized Higgs inflation models are provided, which will be helpful to determine which model is favored from the future experiments and observations such as the Large Hadron Collider and the Planck satellite.

  4. Inflation Forecast Contracts

    OpenAIRE

    Gersbach, Hans; Hahn, Volker

    2012-01-01

    We introduce a new type of incentive contract for central bankers: inflation forecast contracts, which make central bankers’ remunerations contingent on the precision of their inflation forecasts. We show that such contracts enable central bankers to influence inflation expectations more effectively, thus facilitating more successful stabilization of current inflation. Inflation forecast contracts improve the accuracy of inflation forecasts, but have adverse consequences for output. On balanc...

  5. ''Old'' locked inflation

    International Nuclear Information System (INIS)

    Liu, Yang; Piao, Yun-Song; Si, Zong-Guo

    2009-01-01

    In this paper, we revisit the idea of locked inflation, which does not require a potential satisfying the normal slow-roll condition, but suffers from the problems associated with ''saddle inflation''. We propose a scenario based on locked inflation, however, with an alternative evolution mechanism of the ''waterfall field'' φ. Instead of rolling down along the potential, the φ field will tunnel to end the inflation stage like in old inflation, by which the saddle inflation could be avoided. Further, we study a cascade of old locked inflation, which can be motivated by the string landscape. Our model is based on the consideration of making locked inflation feasible so as to give a working model without slow roll; It also can be seen as an effort to embed the old inflation in string landscape

  6. 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.

  7. 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)

  8. 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.

  9. First-order inflation

    International Nuclear Information System (INIS)

    Kolb, E.W.

    1991-01-01

    In the original proposal, inflation occurred in the process of a strongly first-order phase transition. This model was soon demonstrated to be fatally flawed. Subsequent models for inflation involved phase transitions that were second-order, or perhaps weakly first-order; some even involved no phase transition at all. Recently the possibility of inflation during a strongly first-order phase transition has been reviewed. In this talk I will discuss some models for first-order inflation, and emphasize unique signatures that result if inflation is realized in a first-order transition. Before discussing first-order inflation, I will briefly review some of the history of inflation to demonstrate how first-order inflation differs from other models. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-03-15

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

  11. Comparison of Range of Motion After Total Knee Prosthesis According to Different Type of Prosthesis

    Directory of Open Access Journals (Sweden)

    Firat Seyfettinoglu

    2016-07-01

    Full Text Available Aim: The aim of this study is to determine the effectiveness and range of motion of different type of knee prosthesis. Material and Method: This study includes 180 of 225 patients (139 F, 41 M, average age: 65, range of age: 51-82 between April 2005 and September 2007 with the diagnosis of gonarthrosis. All patients underwent to primary total knee arthroplasty. Primary osteoartrhritis is the reason of gonarthrosis. The patients with secondary osteoartrhritis were excluded from the study. All the patients were operated by the same surgical team and rehabilitated after surgery. Patella didnt change any patient. PCL was protected in some of the patients and cut some of patients. Totally seven type prosthesis in 16 subgroup were applied to the patients. All measurement were done by the same surgeon. Average follow up period was 31 months (24-49 months. Results: Patients without subgrouping were tested according to the range of motion before and after surgery to the type of the prosthesis trademark. Range of motion was decreased with the usage of Rotaglide and LCS® type of prosthesis. Range of motion didnt change with the usage of Maxim and Kinemax type. The range of motion increased in the other trademark of prosthesis. Flexion angle was increased statistically significant with nexgen® and scorpio® prosthesis (p

  12. First-order inflation

    International Nuclear Information System (INIS)

    Kolb, E.W.; Chicago Univ., IL

    1990-09-01

    In the original proposal, inflation occurred in the process of a strongly first-order phase transition. This model was soon demonstrated to be fatally flawed. Subsequent models for inflation involved phase transitions that were second-order, or perhaps weakly first-order; some even involved no phase transition at all. Recently the possibility of inflation during a strongly first-order phase transition has been revived. In this talk I will discuss some models for first-order inflation, and emphasize unique signatures that result in inflation is realized in a first-order transition. Before discussing first-order inflation, I will briefly review some of the history of inflation to demonstrate how first-order inflation differs from other models. 58 refs., 3 figs

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

    Science.gov (United States)

    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

  14. Implant-Retained Auricular Prosthesis: A Case Report

    OpenAIRE

    Ozturk, A. Nilgun; Usumez, Aslihan; Tosun, Zekeriya

    2010-01-01

    Extraoral implant retained prosthesis have been proven to be a predictable treatment option for maxillofacial rehabilitation. This case report describes the clinical and laboratory procedures for fabricating an auricular prosthesis. In this case report, an auricular prosthesis was fabricated for a patient who lost the left and right external ear in an electrical burn. Extraoral implants and bar-and-clip retention for the proper connection of the auricular prosthesis to implant were used. This...

  15. Permanent Quadriplegia Following Replacement of Voice Prosthesis.

    Science.gov (United States)

    Ozturk, Kayhan; Erdur, Omer; Kibar, Ertugrul

    2016-11-01

    The authors presented a patient with quadriplegia caused by cervical spine abscess following voice prosthesis replacement. The authors present the first reported permanent quadriplegia patient caused by voice prosthesis replacement. The authors wanted to emphasize that life-threatening complications may be faced during the replacement of voice prosthesis. Care should be taken during the replacement of voice prosthesis and if some problems have been faced during the procedure patients must be followed closely.

  16. Laser-assisted fixation of a nitinol stapes prosthesis.

    Science.gov (United States)

    Schrötzlmair, Florian; Suchan, Fabian; Pongratz, Thomas; Krause, Eike; Müller, Joachim; Sroka, Ronald

    2018-02-01

    Otosclerosis is an inner ear bone disease characterized by fixation of the stapes and consequently progressive hearing loss. One treatment option is the surgical replacement of the stapes by a prosthesis. When so called "smart materials" like nitinol are used, prosthesis fixation can be performed using a laser without manual crimping on the incus. However, specific laser-prosthesis interactions have not been described yet. The aim of the present study was to elucidate the thermo-mechanical properties of the NiTiBOND® prosthesis as a basis for handling instructions for laser-assisted prosthesis fixation. Closure of the NiTiBOND® prosthesis was induced ex vivo by either a diode laser emitting at λ = 940 nm or a CO 2 laser (λ = 10,600 nm). Total energy for closure was determined. Suitable laser parameters (pulse duration, power per pulse, distance between tip of the laser fiber and prosthesis) were assessed. Specific laser-prosthesis interactions were recorded. Especially the diode laser was found to be an appropriate energy source. A total energy deposit of 60 mJ by pulses in near contact application was found to be sufficient for prosthesis closure ex vivo. Energy should be transmitted through a laser fiber equipollent to the prosthesis band diameter. Specific deformation characteristics due to the zonal prosthesis composition have to be taken into account. NiTiBOND® stapes prosthesis can be closed by very little energy when appropriate energy sources like diode lasers are used, suggesting a relatively safe application in vivo. Lasers Surg. Med. 50:153-157, 2018. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  17. 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

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

    Directory of Open Access Journals (Sweden)

    Youngsik Lim

    2015-04-01

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

  19. Patients with hip prosthesis: radiotherapy treatment planning considerations

    International Nuclear Information System (INIS)

    Ganesh, K.M.; Supe, Sanjay S.

    2000-01-01

    The number of patients with hip prosthesis undergoing radiotherapy for pelvic cancer worldwide is increasing. This might be of importance depending on the materials in the prosthesis and whether any of the treatment fields are involved in the prosthesis. Radiotherapy planning involving the pelvic region of patients having total hip prosthesis has been found to be difficult due to the effect of the prosthesis on the dose distribution. This review is intended to project dosimetric considerations and possible solutions to this uncommon problem

  20. Macroeconomic variables and food price inflation, nonfood price inflation and overall inflation: A case of an emerging market

    Directory of Open Access Journals (Sweden)

    Raphael T Mpofu

    2017-03-01

    Full Text Available The paper analyses the association between certain macroeconomic variables and food price inflation, non-food price inflation and overall inflation in Zimbabwe, and also seeks to determine the level of association between these variables, given food security implications and overall well-being of its citizens. The study reveals that during the 2010 to 2016 period, Zimbabwe experienced stable food prices—annual food price inflation for food and non-alcoholic beverages averaged a relatively low growth rate of 0.12% monthly, while non-food inflation monthly growth rate was 0.09% and overall inflation growth rate was 0.11%. Although inflation from 2010 had been declining, of late, the increase in annual inflation has been underpinned by a rise in non-food inflation. Zimbabwe’s annual inflation remains lower than inflation rates in other countries in the region. Despite the increases lately in overall inflation, it remained below zero in January 2016, mostly driven by the depreciation of the South African rand and declining international oil prices. It should also be noted that domestic demand continued to decline in 2015, leading to the observed decline in both food and non-food prices. While food inflation has remained relatively low, it should be noted that non-food expenditures is significant component of the household budget and the rising prices result often lead to declining purchasing power and force households to make difficult choices in terms of their purchases. The findings of the study are food inflation has a low association with the independent variables under study; Zimbabwe broad money supply, rand-dollar exchange rates and the South Africa food inflation. There is, however, a very strong association between non-food inflation and these independent variables, as well as between overall inflation and the independent variables. Given the mostly rural population and the high level of unemployment in Zimbabwe, it can be surmised that

  1. Technical Note: Does Core Inflation Help Forecast Total Inflation? Evidence from Colombia

    OpenAIRE

    John Thornton

    1998-01-01

    In Colombia core and total inflation are both (1) series, and core inflation is cointegrated with total inflation. Granger causality tests using error correction methodology indicate that divergence of total inflation from core inflation is quickly revers

  2. Euro area Inflation as a Predictor of National Inflation Rates

    OpenAIRE

    Antonella Cavallo; Antonio Ribba

    2013-01-01

    The stability of inflation differentials is an important condition for the smooth working of a currency area, such as the European Economic and Monetary Union. In the presence of stability, changes in national inflation rates, while holding Euro-area inflation fixed contemporaneously, should be only transitory. If this is the case, the rate of inflation of the whole area can also be interpreted as a predictor, at least in the long run, of the different national inflation rates. However, in th...

  3. “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.

  4. 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.

  5. 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 ...

  6. 21 CFR 872.3960 - Mandibular condyle prosthesis.

    Science.gov (United States)

    2010-04-01

    ... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3960 Mandibular condyle prosthesis. (a) Identification. A mandibular condyle prosthesis is a device that is intended to be implanted in the human jaw to... requirement for premarket approval for any mandibular condyle prosthesis intended to be implanted in the human...

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

    Directory of Open Access Journals (Sweden)

    Cavalcanti Andre G.

    2006-01-01

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

  8. Warm natural inflation

    International Nuclear Information System (INIS)

    Mishra, Hiranmaya; Mohanty, Subhendra; Nautiyal, Akhilesh

    2013-01-01

    In warm inflation models there is the requirement of generating large dissipative couplings of the inflation with radiation, while at the same Âătime, not de-stabilising the flatness of the inflation potential due to radiative corrections. One way to achieve this without fine tuning unrelated couplings is by supersymmetry. In this talk we will discuss warm inflation with Pseudo-Nambu-Goldstone Bosons (PNGB). In this case inflation and other light fields are PNGB. So, the radiative corrections to the potential are suppressed and the thermal Âăcorrections are small as long as the temperature is below the symmetry breaking scale. In such models it is possible to fulfill the contrary requirements of an inflation potential which is stable under radiative corrections and the generation of a large dissipative coupling of the inflation field with other light fields. This warm inflation model with PNGB gives the observed CMB-anisotropy amplitude and spectral index having the symmetry breaking scale at the GUT scale. (author)

  9. 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.

  10. Multiple inflation

    International Nuclear Information System (INIS)

    Murphy, P.J.

    1987-01-01

    The Theory of Inflation, namely, that at some point the entropy content of the universe was greatly increased, has much promise. It may solve the puzzles of homogeneity and the creation of structure. However, no particle physics model has yet been found that can successfully drive inflation. The difficulty in satisfying the constraint that the isotropy of the microwave background places on the effective potential of prospective models is immense. In this work we have codified the requirements of such models in a most general form. We have carefully calculated the amounts of inflation the various problems of the Standard Model need for their solution. We have derived a completely model independent upper bond on the inflationary Hubble parameter. We have developed a general notation with which to probe the possibilities of Multiple Inflation. We have shown that only in very unlikely circumstances will any evidence of an earlier inflation, survive the de Sitter period of its successor. In particular, it is demonstrated that it is most unlikely that two bouts of inflation will yield high amplitudes of density perturbations on small scales and low amplitudes on large. We conclude that, while multiple inflation will be of great theoretical interest, it is unlikely to have any observational impact

  11. Dosimetry of a silicone breast prosthesis

    International Nuclear Information System (INIS)

    McGinley, P.H.; Powell, W.R.; Bostwick, J.

    1980-01-01

    Dose measurements were conducted in a phantom which simulates breast tissue and in another phantom which simulates a breast containing a silicone prosthesis. No detectable difference was found when the irradiations were carried out with tangential beams of 60 Co radiation. The degree of backscatter and absorption of radiation by the prosthesis and phantom were also similar. A slight decrease in dose of approximately 8% was found at the interface between the prosthesis and muscle-equivalent material

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

    Directory of Open Access Journals (Sweden)

    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.

  13. Conservative management of penile trauma may be complicated by abscess formation

    Directory of Open Access Journals (Sweden)

    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.

  14. 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

  15. 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.

  16. Duocentric® reversed shoulder prosthesis and Personal Fit® templates: innovative strategies to optimize prosthesis positioning and prevent scapular notching.

    Science.gov (United States)

    Trouilloud, P; Gonzalvez, M; Martz, P; Charles, H; Handelberg, F; Nyffeler, R W; Baulot, E

    2014-05-01

    We describe our experience with a new system of patient-specific template called Personal Fit(®), which is unique in shoulder surgery and used in combination with Duocentric(®) prosthesis. The reverse prosthesis's concept is the invention of Paul Grammont, developed with Grammont's team of Dijon University as from 1981, which led to the first reversed total shoulder prosthesis called Trumpet in 1985. The Duocentric(®) prosthesis developed in 2001 is the third-generation prosthesis, coming from the Trumpet and the second-generation prosthesis Delta(®) (DePuy). This prosthesis provides a novel solution to the notching problem with an inferior overhang integrated onto the glenoid baseplate. Personal Fit(®) system is based on reconstructing the shoulder joint bones in three dimensions using CT scan data, placing a landmark on the scapula and locating points on the glenoid and humerus. That will be used as a reference for the patient-specific templates. We study the glenoid position planned with Personal Fit(®) software relative to native glenoid position in 30 cases. On average, the difference between the planned retroversion (or anteversion in one case) and native retroversion was 8.6°.

  17. Malrotation of the McGhan Style 510 prosthesis.

    NARCIS (Netherlands)

    Schots, J.M.; Fechner, M.R.; Hoogbergen, M.M.; Tits, H.W.H.J.

    2010-01-01

    BACKGROUND: Anatomically shaped cohesive silicone breast implants are frequently used in aesthetic and reconstructive surgery. After successful results with the Style 410 prosthesis, McGhan (Natrelle, Allergan) introduced the Style 510 prosthesis. After using this novel prosthesis, the authors

  18. Finger prosthesis: a boon to handicapped.

    Science.gov (United States)

    Gupta, Ridhima; Kumar, Lakshya; Rao, Jitendra; Singh, Kamleshwar

    2013-08-29

    This is a clinical case report of a 52-year-old male patient with four partially missing fingers of the left hand. The article describes the clinical and laboratory procedure of making prosthesis with modern silicone material. A wax pattern was fabricated using the right hand of the patient. A special type of wax was formulated to make the pattern so that it can be easily moulded and carved. Intrinsic and extrinsic staining was also performed to match the adjacent skin colour. The patient was given the finger prosthesis and was asked to use a half glove (sports) to mask the junction between the prosthesis and the normal tissue. It also provides additional retention to the artificial fingers. The patient felt his social acceptance improved after wearing the finger prosthesis.

  19. Remote inflation as hybrid-like sneutrino/MSSM inflation

    International Nuclear Information System (INIS)

    Matsuda, Tomohiro

    2009-01-01

    A new scenario of hybrid-like inflation is considered for sneutrino and MSSM fields. Contrary to the usual hybrid inflation model, the direct coupling between a trigger field and the sneutrino/MSSM inflaton field is not necessary for the scenario. The dissipation and the radiation from the sneutrino/MSSM inflaton can be written explicitly by using the Yukawa couplings. Remote inflation does not require the shift symmetry or cancellation in solving the η problem.

  20. Pseudosmooth tribrid inflation

    International Nuclear Information System (INIS)

    Antusch, Stefan; Nolde, David; Rehman, Mansoor Ur

    2012-01-01

    We explore a new class of supersymmetric models of inflation where the inflaton is realised as a combination of a Higgs field and (gauge non-singlet) matter fields, using a ''tribrid'' structure of the superpotential. Inflation is associated with a phase transition around GUT scale energies. The inflationary trajectory already preselects the later vacuum after inflation, which has the advantage of automatically avoiding the production of dangerous topological defects at the end of inflation. While at first sight the models look similar to smooth inflation, they feature a waterfall and are therefore only pseudosmooth. The new class of models offers novel possibilities for realising inflation in close contact with particle physics, for instance with supersymmetric GUTs or with supersymmetric flavour models based on family symmetries

  1. Pseudosmooth tribrid inflation

    Science.gov (United States)

    Antusch, Stefan; Nolde, David; Rehman, Mansoor Ur

    2012-08-01

    We explore a new class of supersymmetric models of inflation where the inflaton is realised as a combination of a Higgs field and (gauge non-singlet) matter fields, using a ``tribrid'' structure of the superpotential. Inflation is associated with a phase transition around GUT scale energies. The inflationary trajectory already preselects the later vacuum after inflation, which has the advantage of automatically avoiding the production of dangerous topological defects at the end of inflation. While at first sight the models look similar to smooth inflation, they feature a waterfall and are therefore only pseudosmooth. The new class of models offers novel possibilities for realising inflation in close contact with particle physics, for instance with supersymmetric GUTs or with supersymmetric flavour models based on family symmetries.

  2. Inflation Protected Investment Strategies

    Directory of Open Access Journals (Sweden)

    Mirco Mahlstedt

    2016-03-01

    Full Text Available In this paper, a dynamic inflation-protected investment strategy is presented, which is based on traditional asset classes and Markov-switching models. Different stock market, as well as inflation regimes are identified, and within those regimes, the inflation hedging potential of stocks, bonds, real estate, commodities and gold are investigated. Within each regime, we determine optimal investment portfolios driven by the investment idea of protection from losses due to changing inflation if inflation is rising or high, but decoupling the performance from inflation if inflation is low. The results clearly indicate that these asset classes behave differently in different stock market and inflation regimes. Whereas in the long-run, we agree with the general opinion in the literature that stocks and bonds are a suitable hedge against inflation, we observe for short time horizons that the hedging potential of each asset class, especially of real estate and commodities, depend strongly on the state of the current market environment. Thus, our approach provides a possible explanation for different statements in the literature regarding the inflation hedging properties of these asset classes. A dynamic inflation-protected investment strategy is developed, which combines inflation protection and upside potential. This strategy outperforms standard buy-and-hold strategies, as well as the well-known 1 N -portfolio.

  3. Angiosarcoma of penis: Case report of an aggressive penile cancer

    Directory of Open Access Journals (Sweden)

    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.

  4. Penile growth in response to hormone treatment in children with micropenis

    Directory of Open Access Journals (Sweden)

    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.

  5. 21 CFR 878.3800 - External aesthetic restoration prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false External aesthetic restoration prosthesis. 878... External aesthetic restoration prosthesis. (a) Identification. An external aesthetic restoration prosthesis... (general controls). The device is exempt from the premarket notification procedures in subpart E of part...

  6. Pseudosmooth tribrid inflation

    Energy Technology Data Exchange (ETDEWEB)

    Antusch, Stefan; Nolde, David; Rehman, Mansoor Ur, E-mail: stefan.antusch@unibas.ch, E-mail: david.nolde@unibas.ch, E-mail: mansoor-ur.rehman@unibas.ch [Department of Physics, University of Basel, Klingelbergstr. 82, CH-4056 Basel (Switzerland)

    2012-08-01

    We explore a new class of supersymmetric models of inflation where the inflaton is realised as a combination of a Higgs field and (gauge non-singlet) matter fields, using a ''tribrid'' structure of the superpotential. Inflation is associated with a phase transition around GUT scale energies. The inflationary trajectory already preselects the later vacuum after inflation, which has the advantage of automatically avoiding the production of dangerous topological defects at the end of inflation. While at first sight the models look similar to smooth inflation, they feature a waterfall and are therefore only pseudosmooth. The new class of models offers novel possibilities for realising inflation in close contact with particle physics, for instance with supersymmetric GUTs or with supersymmetric flavour models based on family symmetries.

  7. Is Inflation in India an Attractor of Inflation in Nepal?

    OpenAIRE

    Edimon Ginting

    2007-01-01

    The paper attempts to answer some important questions around the inflationary process in Nepal, particularly the transmission of inflation from India. Because the Nepali currency is pegged to the Indian rupee and the two countries share an open border, price developments in Nepal would be expected to mirror to those in India. The results show that inflation in India and inflation in Nepal tend to converge in the long run. Our estimates indicate that the passthrough of inflation from India to ...

  8. Rehabilitation of a Patient with an Intra Oral Prosthesis and an Extra Oral Orbital Prosthesis Retained with Magnets

    OpenAIRE

    Pattanaik, Seema; Wadkar, Aarti P.

    2011-01-01

    This clinical case report deals with a rehabilitation of a patient with an extensive maxillary and orbital defect using an intra oral prosthesis obturating the maxillary defect and extra oral orbital prosthesis retained with rare-earth magnets for secondary retention; primary retention was derived by snug fit of the prosthesis to underlying and adjacent tissues. The rehabilitation resulted in improved function, esthetics and comfort to the patient thus enabling him to lead a normal life.

  9. 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

  10. Penile Girth Enhancement With Polymethylmethacrylate-Based Soft Tissue Fillers.

    Science.gov (United States)

    Casavantes, Luis; Lemperle, Gottfried; Morales, Palmira

    2016-09-01

    An unknown percentage of men will take every risk to develop a larger penis. Thus far, most injectables have caused serious problems. Polymethylmethacrylate (PMMA) microspheres have been injected as a wrinkle filler and volumizer with increasing safety since 1989. To report on a safe and permanently effective method to enhance penile girth and length with an approved dermal filler (ie, PMMA). Since 2007, the senior author has performed penile augmentation in 752 men mainly with Metacrill, a suspension of PMMA microspheres in carboxymethyl-cellulose. The data of 729 patients and 203 completed questionnaires were evaluated statistically. The overall satisfaction rate was 8.7 on a scale of 1 to 10. After one to three injection sessions, average girth increased by 3.5 cm, or 134% (10.2 to 13.7 cm = 134.31%). Penile length also increased by weight and stretching force of the implant from an average of 9.8 to 10.5 cm. Approximately half the patients perceived some irregularities of the implant, which caused no problems. Complications occurred in 0.4%, when PMMA nodules had to be surgically removed in three of the 24% of patients who had a non-circumcised penis. After 5 years of development, penile augmentation with PMMA microspheres appears to be a natural, safe, and permanently effective method. The only complication of nodule formation and other irregularities can be overcome by an improved injection technique and better postimplantation care. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  11. Fluxbrane Inflation

    CERN Document Server

    Hebecker, Arthur; Lust, Dieter; Steinfurt, Stephan; Weigand, Timo

    2012-01-01

    As a first step towards inflation in genuinely F-theoretic setups, we propose a scenario where the inflaton is the relative position of two 7-branes on holomorphic 4-cycles. Non-supersymmetric gauge flux induces an attractive inter-brane potential. The latter is sufficiently flat in the supergravity regime of large volume moduli. Thus, in contrast to brane-antibrane inflation, fluxbrane inflation does not require warping. We calculate the inflaton potential both in the supergravity approximation and via an open-string one-loop computation on toroidal backgrounds. This leads us to propose a generalisation to genuine Calabi-Yau manifolds. We also comment on competing F-term effects. The end of inflation is marked by the condensation of tachyonic recombination fields between the 7-branes, triggering the formation of a bound state described as a stable extension along the 7-brane divisor. Hence our model fits in the framework of hybrid D-term inflation. We work out the main phenomenological properties of our D-te...

  12. Attachment-retained gingival prosthesis for implant-supported fixed dental prosthesis in the maxilla: a clinical report.

    Science.gov (United States)

    Aparecida de Mattias Sartori, Ivete; Uhlendorf, Yuri; Padovan, Luiz Eduardo Marques; Junior, Paulo Domingos Ribeiro; Melo, Ana Cláudia Moreira; Tiossi, Rodrigo

    2014-12-01

    The rehabilitation of edentulous maxillae is a complex procedure due to the involvement of esthetic and functional requirements. A trial maxillary denture can be used to identify the need for adequate upper lip support when replacing removable complete dentures by implant-fixed dental prostheses. This clinical report describes the outcome of the rehabilitation of an edentulous atrophic maxilla with unfavorable maxillomandibular relationship and deficient upper lip support. A trial denture was fabricated and used to diagnose the need for a prosthesis capable of restoring the upper lip support. The reduced upper lip support was also confirmed by a lateral cephalogram. The patient was rehabilitated by an implant-fixed dental prosthesis associated with an attachment-retained gingival prosthesis. The case presented shows that when loss of upper lip support is detected and the patient does not wish to undergo further surgical reconstruction procedure, the retention of a gingival prosthesis using a ball attachment is a satisfactory treatment option. © 2014 by the American College of Prosthodontists.

  13. Estimating core inflation : the role of oil price shocks and imported inflation

    OpenAIRE

    Bjørnland, Hilde Christiane

    1997-01-01

    This paper calculates core inflation, by imposing long run restrictions on a structural vector autoregression (VAR) model containing the growth rate of output, inflation and oil prices. Core inflation is identified as that component in inflation that has no long run effect on output. No restrictions are placed on the response of output and inflation to the oil price shocks. The analysis is applied to Norway and the United Kingdom, both oil producing OECD countries. A model that ...

  14. Surgical reimplantation of penile glans amputation in children during circumcision

    Directory of Open Access Journals (Sweden)

    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.

  15. 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

  16. 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.

  17. Eternal extended inflation and graceful exit from old inflation without Jordan-Brans-Dicke

    International Nuclear Information System (INIS)

    Linde, A.

    1990-01-01

    Recently a possible solution to the graceful exit problem of the old inflation was proposed in the context of the Jordan-Brans-Dicke theory (extended inflation). In this paper we will argue that inflation in this theory occurs in a most natural way if it starts near the Planck density, as in the standard version of chaotic inflation. With most natural initial conditions, the inflationary universe in the JBD theory enters the stage of permanent reproduction of new inflationary domains (eternal extended inflation). In order to realize the extended inflation scenario at least two classical scalar fields driving inflation are necessary, as distinct from the simplest versions of new and chaotic inflation. It is shown that in the theory of two scalar fields one can solve the graceful exit problem even without modifying the Einstein gravity theory, due to the possibility that the decay rate of the false vacuum in old inflation depends on the value of the second scalar field and hence on time. (orig.)

  18. 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.

  19. Prosthesis infections after orthopedic joint replacement

    DEFF Research Database (Denmark)

    Song, Zhijun; Borgwardt, Lotte; Høiby, Niels

    2013-01-01

    Prosthesis-related infection is a serious complication for patients after orthopedic joint replacement, which is currently difficult to treat with antibiotic therapy. Consequently, in most cases, removal of the infected prosthesis is the only solution to cure the infection. It is, therefore...

  20. Double inflation

    International Nuclear Information System (INIS)

    Silk, J.; Turner, M.S.

    1986-04-01

    The Zel'dovich spectrum of adiabatic density perturbations is a generic prediction of inflation. There is increasing evidence that when the spectrum is normalized by observational data on small scales, there is not enough power on large scales to account for the observed large-scale structure in the Universe. Decoupling the spectrum on large and small scales could solve this problem. As a means of decoupling the large and small scales we propose double inflation (i.e., two episodes of inflation). In this scenario the spectrum on large scales is determined by the first episode of inflation and those on small scales by a second episode of inflation. We present three models for such a scenario. By nearly saturating the large angular-scale cosmic microwave anisotropy bound, we can easily account for the observed large-scale structure. We take the perturbations on small scales to be very large, deltarho/rho approx. = 0.1 to 0.01, which results in the production of primordial black holes (PBHs), early formation of structure, reionization of the Universe, and a rich array of astrophysical events. The Ω-problem is also addressed by our scenario. Allowing the density perturbations produced by the second episode of inflation to be large also lessens the fine-tuning required in the scalar potential and makes reheating much easier. We briefly speculate on the possibility that the second episode of inflation proceeds through the nucleation of bubbles, which today manifest themselves as empty bubbles whose surfaces are covered with galaxies. 37 refs., 1 fig

  1. Nonvenereal penile dermatoses: A retrospective study

    Directory of Open Access Journals (Sweden)

    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.

  2. Life Estimation of Hip Joint Prosthesis

    Science.gov (United States)

    Desai, C.; Hirani, H.; Chawla, A.

    2015-07-01

    Hip joint is one of the largest weight-bearing structures in the human body. In the event of a failure of the natural hip joint, it is replaced with an artificial hip joint, known as hip joint prosthesis. The design of hip joint prosthesis must be such so as to resist fatigue failure of hip joint stem as well as bone cement, and minimize wear caused by sliding present between its head and socket. In the present paper an attempt is made to consider both fatigue and wear effects simultaneously in estimating functional-life of the hip joint prosthesis. The finite element modeling of hip joint prosthesis using HyperMesh™ (version 9) has been reported. The static analysis (load due to the dead weight of the body) and dynamic analysis (load due to walking cycle) have been described. Fatigue life is estimated by using the S-N curve of individual materials. To account for progressive wear of hip joint prosthesis, Archard's wear law, modifications in socket geometry and dynamic analysis have been used in a sequential manner. Using such sequential programming reduction in peak stress has been observed with increase in wear. Finally life is estimated on the basis of socket wear.

  3. 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

  4. Inflation targeting and inflation performance : a comparative analysis

    NARCIS (Netherlands)

    Samarina, Anna; De Haan, Jakob; Terpstra, M.

    2014-01-01

    This article examines how the impact of inflation targeting on inflation performance depends on the choice of country samples, adoption dates, time periods and methodological approaches. We apply two different estimation methods - difference-in-differences and propensity score matching - for our

  5. 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.

  6. 21 CFR 872.3950 - Glenoid fossa prosthesis.

    Science.gov (United States)

    2010-04-01

    ...) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3950 Glenoid fossa prosthesis. (a) Identification. A glenoid fossa prosthesis is a device that is intended to be implanted in the temporomandibular...

  7. Eternal extended inflation and graceful exit from old inflation without Jordan-Brans-Dicke

    Science.gov (United States)

    Linde, Andrei

    1990-10-01

    Recently a possible solution to the graceful exit problem of the old inflation was proposed in the context of the Jordan-Brans-Dicke theory (extended inflation). In this paper we will argue that inflation in this theory occurs in a most natural way if it starts near the Planck density, as in the standard version of chaotic inflation. With most natural initial conditions, the inflationary universe in the JBD theory enters the stage of permanent reproduction of new inflationary domains (eternal extended inflation). In order to realize the extended inflation scenario at least two classical scalar fields driving inflation are necessary, as distinct from the simplest versions of new and chaotic inflation. It is shown that in the theory of two scalar fields one can solve the graceful exit problem even without modifying the Einstein gravity theory, due to the possibility that the decay rate of the false rate vacuum in old inflation depends on the value of the second scalar field and hence on time. Address after 1 September 1990: Physics Department, Stanford University, Varian Building, Stanford, CA 94305, USA.

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

    Directory of Open Access Journals (Sweden)

    Larissa Alves Afonso

    2012-02-01

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

  9. Quintessential inflation: A unified scenario of inflation and dark energy

    Directory of Open Access Journals (Sweden)

    Hossain Wali

    2018-01-01

    Full Text Available Quintessential inflation unifies inflation and late time acceleration by a single scalar field. Such a scenario, with canonical and non-canonical scalar fields, has been discussed. The scalar field behaves as an inflaton field during inflation and as a quintessence field during late time. Also the predictions of the models has been compared with the recent Planck data.

  10. 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.

  11. Penisimplantater er en god sidste behandlingsmulighed for erektil dysfunktion

    DEFF Research Database (Denmark)

    Giraldi, Laura; Felbo, Jakob; Sønksen, Jens

    2016-01-01

    When other treatments fail, penile implants represent the last treatment option in erectile dysfunction. The most commonly used implant is the inflatable three-piece device, which allows the penis to be rigid for sexual intercourse and flaccid during the remaining time. Earlier penile implants were...

  12. [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.

  13. Kaehler-driven tribrid inflation

    International Nuclear Information System (INIS)

    Antusch, Stefan; Nolde, David

    2012-01-01

    We discuss a new class of tribrid inflation models in supergravity, where the shape of the inflaton potential is dominated by effects from the Kaehler potential. Tribrid inflation is a variant of hybrid inflation which is particularly suited for connecting inflation with particle physics, since the inflaton can be a D-flat combination of charged fields from the matter sector. In models of tribrid inflation studied so far, the inflaton potential was dominated by either loop corrections or by mixing effects with the waterfall field (as in 'pseudosmooth' tribrid inflation). Here we investigate the third possibility, namely that tribrid inflation is dominantly driven by effects from higher-dimensional operators of the Kaehler potential. We specify for which superpotential parameters the new regime is realized and show how it can be experimentally distinguished from the other two (loop-driven and p seudosmooth ) regimes

  14. Towards inflation targeting in Egypt: the relationship between exchange rate and inflation

    Directory of Open Access Journals (Sweden)

    Aliaa Khodeir

    2012-08-01

    Full Text Available Since the Egyptian economy has recently moved towards inflation targeting, it became very important to know whether exchange rate movements have serious inflationary implications or not. To investigate this subject, the study aims to analyse the relevance of inflation with the exchange rate by using the Granger-causality test. Two indicators of inflation will be used, the consumer price index (CPI and wholesale price index (WPI. In general, the results show a strong relationship between the two variables in a way that may give support to the application of ‘flexible inflation targeting regime instead of strict inflation targeting regime’.

  15. Optimal anaesthesia techniques for penile surgeries

    Directory of Open Access Journals (Sweden)

    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.

  16. Failed total carpometacarpal joint prosthesis of the thumb

    DEFF Research Database (Denmark)

    Hansen, Torben Bæk; Homilius, Morten

    2010-01-01

    Total joint prosthesis in carpometacarpal joint arthritis of the thumb often fails. Loosening of the implant is often treated by resection arthroplasty, and we reviewed 10 patients, mean age 54 years (range 47-63) who were treated by resection arthroplasty after a failed total joint prosthesis. T...... in eight of 10 patients, but the mean Disabilities of the arm, shoulder, and hand (DASH) scores, self-reported pinch-grip-related function, and pain were comparable with our earlier published results with the Elektra carpometacarpal total joint prosthesis.......Total joint prosthesis in carpometacarpal joint arthritis of the thumb often fails. Loosening of the implant is often treated by resection arthroplasty, and we reviewed 10 patients, mean age 54 years (range 47-63) who were treated by resection arthroplasty after a failed total joint prosthesis....... The male:female ratio was 1:4 and the mean duration of observation 32 months (range 6-52). In three patients the revised implant was a MOJE uncemented carpometacarpal joint prosthesis and in seven patients an Elektra uncemented one. At follow-up grip strength was reduced to less than 90% of the other hand...

  17. 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.

  18. Galileon inflation

    Energy Technology Data Exchange (ETDEWEB)

    Burrage, Clare [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany); Rham, Claudia de [Univ. de Geneve (Switzerland). Dept. de Physique Theorique; Seery, David [Sussex Univ., Brigthon (United Kingdom). Dept. of Physics and Astronomy; Tolley, Andrew J. [Case Western Reserve Univ., Cleveland, OH (United States). Dept. of Physics

    2010-09-15

    Galileon inflation is a radiatively stable higher derivative model of inflation. The model is determined by a finite number of relevant operators which are protected by a covariant generalization of the Galileon shift symmetry. We show that the nongaussianity of the primordial density perturbation generated during an epoch of Galileon inflation is a particularly powerful observational probe of these models and that, when the speed of sound is small, f{sub NL} can be larger than the usual result f{sub NL} {proportional_to} C{sup -2}{sub s}. (orig.)

  19. Rehabilitation of amputed thumb with a silicone prosthesis

    OpenAIRE

    Asnani, Pooja; Shivalingappa, Chandu Giriyapura; Mishra, Sunil Kumar; Somkuwar, Kirti; Khan, Faisal

    2015-01-01

    Creating prosthesis, having realistic skin surface and seamless visual integration with the surrounding tissues, requires both artistic and technical skill. Anatomical design, thin margins, lifelike fingernails and realistic color/contours are essential for patient satisfaction. Prosthesis is especially useful in case of lost body parts, as reconstructive surgery cannot fully restore aesthetics. This case report describes a simple technique for fabricating silicon finger prosthesis for a pati...

  20. 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...

  1. Development and clinical application of a new testicular prosthesis.

    Science.gov (United States)

    Ning, Ye; Cai, Zhikang; Chen, Huixing; Ping, Ping; Li, Peng; Wang, Zhong; Li, Zheng

    2011-11-01

    A new type of testicular prosthesis made of silastic with an elliptical shape to mimic a normal testis was developed by our team and submitted for patenting in China. The prosthesis was produced in different sizes to imitate the normal testis of the patient. To investigate the effects and safety of the testicular prosthesis, 20 patients receiving testicular prosthesis implantation were recruited for this study. Follow-up after 6 months revealed no complications in the patients. All the patients answered that they were satisfied with their body image and the position of the implants, 19 patients were satisfied with the size and 16 patients were satisfied with the weight. These results show that the testicular prosthesis used in this study can meet patient's expectations. Patients undergoing orchiectomy should be offered the option to receive a testicular prosthesis implantation. The dimensions and weight of the available prosthetic implants should be further addressed to improve patient satisfaction.

  2. Different techniques in fabrication of ocular prosthesis.

    Science.gov (United States)

    Cevik, Pinar; Dilber, Erhan; Eraslan, Oguz

    2012-11-01

    Loss of an eye caused by cancer, trauma, or congenital defect creates a deep psychological impact on an individual's life especially social and professional life. Custom-made prosthesis, compared to stock prosthesis, provides a better fit to the eye socket, better cosmetic results, and less discomfort to the patient in the long term. The main objective of this article was to describe 3 different alternative and practical techniques of fabricating custom-made ocular prosthesis. An impression of anophthalmic socket was made with the addition of cured silicone-based precision impression material in all techniques. A master cast was prepared and duplicated with condensation silicone. A self-cure acrylic resin was polymerized in the silicone model and was fitted into the patient's eye socket. A digital photograph of the patient's iris was made using a digital camera and printed on good-quality photo paper in various shades and sizes in the first and the second techniques. Then the photo paper was coated with PVC so as not to allow any color flowing. The proper iris was then inserted to the acrylic base. The prosthesis was final processed using orthodontic heat polymerizing clear acrylic resin.In the other technique, after the trying-in process with wax pattern, an acrylic base was fabricated using heat polymerizing scleral acrylic resin. The prosthetic iris was fabricated from a transparent contact lens by painting the lens with watercolor paints and attaching it to an acrylic resin with tissue conditioner. The final process was made with heat polymerizing transparent acrylic resin. Custom-made prosthesis allows better esthetic and functional results to the patient in comparison to stock prosthesis. Further follow-up is necessary to check the condition and fit of the ocular prosthesis in such patients.

  3. Inflation expectations and inflation uncertainty in the Eurozone : Evidence from survey data

    NARCIS (Netherlands)

    Arnold, I.J.M.; Lemmen, J.J.G.

    2006-01-01

    This paper uses the European Commission's Consumer Survey to assess whether inflation expectations have converged and whether inflation uncertainty has diminished following the introduction of the Euro in Europe. Consumers' responses to the survey suggest that inflation expectations depend more on

  4. 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.

  5. Femoral Prosthesis Infection by Rhodotorula mucilaginosa▿

    Science.gov (United States)

    Savini, Vincenzo; Sozio, Federica; Catavitello, Chiara; Talia, Marzia; Manna, Assunta; Febbo, Fabio; Balbinot, Andrea; Di Bonaventura, Giovanni; Piccolomini, Raffaele; Parruti, Giustino; D'Antonio, Domenico

    2008-01-01

    This case report is a case history of a femoral prosthesis infection caused by Rhodotorula mucilaginosa in a human immunodeficiency virus patient. Though the pathogenicity of this organism for bone tissue has been previously reported, this is the first reported case of an orthopedic prosthesis infection by this species of the genus Rhodotorula. PMID:18753353

  6. 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...

  7. Inflation expectations and inflation uncertainty in the eurozone : Evidence from survey data

    NARCIS (Netherlands)

    Arnold, I.J.M.; Lemmen, J.J.G.

    2008-01-01

    This paper uses the European Commission’s Consumer Survey to assess whether inflation expectations have converged and whether inflation uncertainty has diminished following the introduction of the euro in Europe. Consumers’ responses to the survey suggest that inflation expectations depend more on

  8. News on Inflation and the Epidemiology of Inflation Expectations

    DEFF Research Database (Denmark)

    Pfajfar, Damjan; Santoro, Emiliano

    2013-01-01

    This paper examines the nexus between news coverage on inflation and households’ inflation expectations. In doing so, we test the epidemiological foundations of the sticky information model (Carroll ). We use both aggregate and household-level data from the Survey Research Center at the University...... of Michigan. We highlight a fundamental disconnection among news on inflation, consumers’ frequency of expectation updating, and the accuracy of their expectations. Our evidence provides at best weak support to the epidemiological framework, as most of the consumers who update their expectations do not revise...

  9. Kinematic analysis of a posterior-stabilized knee prosthesis.

    Science.gov (United States)

    Zhao, Zhi-Xin; Wen, Liang; Qu, Tie-Bing; Hou, Li-Li; Xiang, Dong; Bin, Jia

    2015-01-20

    The goal of total knee arthroplasty (TKA) is to restore knee kinematics. Knee prosthesis design plays a very important role in successful restoration. Here, kinematics models of normal and prosthetic knees were created and validated using previously published data. Computed tomography and magnetic resonance imaging scans of a healthy, anticorrosive female cadaver were used to establish a model of the entire lower limbs, including the femur, tibia, patella, fibula, distal femur cartilage, and medial and lateral menisci, as well as the anterior cruciate, posterior cruciate, medial collateral, and lateral collateral ligaments. The data from the three-dimensional models of the normal knee joint and a posterior-stabilized (PS) knee prosthesis were imported into finite element analysis software to create the final kinematic model of the TKA prosthesis, which was then validated by comparison with a previous study. The displacement of the medial/lateral femur and the internal rotation angle of the tibia were analyzed during 0-135° flexion. Both the output data trends and the measured values derived from the normal knee's kinematics model were very close to the results reported in a previous in vivo study, suggesting that this model can be used for further analyses. The PS knee prosthesis underwent an abnormal forward displacement compared with the normal knee and has insufficient, or insufficiently aggressive, "rollback" compared with the lateral femur of the normal knee. In addition, a certain degree of reverse rotation occurs during flexion of the PS knee prosthesis. There were still several differences between the kinematics of the PS knee prosthesis and a normal knee, suggesting room for improving the design of the PS knee prosthesis. The abnormal kinematics during early flexion shows that the design of the articular surface played a vital role in improving the kinematics of the PS knee prosthesis.

  10. Kinematic Analysis of a Posterior-stabilized Knee Prosthesis

    Directory of Open Access Journals (Sweden)

    Zhi-Xin Zhao

    2015-01-01

    Full Text Available Background: The goal of total knee arthroplasty (TKA is to restore knee kinematics. Knee prosthesis design plays a very important role in successful restoration. Here, kinematics models of normal and prosthetic knees were created and validated using previously published data. Methods: Computed tomography and magnetic resonance imaging scans of a healthy, anticorrosive female cadaver were used to establish a model of the entire lower limbs, including the femur, tibia, patella, fibula, distal femur cartilage, and medial and lateral menisci, as well as the anterior cruciate, posterior cruciate, medial collateral, and lateral collateral ligaments. The data from the three-dimensional models of the normal knee joint and a posterior-stabilized (PS knee prosthesis were imported into finite element analysis software to create the final kinematic model of the TKA prosthesis, which was then validated by comparison with a previous study. The displacement of the medial/lateral femur and the internal rotation angle of the tibia were analyzed during 0-135° flexion. Results: Both the output data trends and the measured values derived from the normal knee′s kinematics model were very close to the results reported in a previous in vivo study, suggesting that this model can be used for further analyses. The PS knee prosthesis underwent an abnormal forward displacement compared with the normal knee and has insufficient, or insufficiently aggressive, "rollback" compared with the lateral femur of the normal knee. In addition, a certain degree of reverse rotation occurs during flexion of the PS knee prosthesis. Conclusions: There were still several differences between the kinematics of the PS knee prosthesis and a normal knee, suggesting room for improving the design of the PS knee prosthesis. The abnormal kinematics during early flexion shows that the design of the articular surface played a vital role in improving the kinematics of the PS knee prosthesis.

  11. Kinematic Analysis of a Posterior-stabilized Knee Prosthesis

    Science.gov (United States)

    Zhao, Zhi-Xin; Wen, Liang; Qu, Tie-Bing; Hou, Li-Li; Xiang, Dong; Bin, Jia

    2015-01-01

    Background: The goal of total knee arthroplasty (TKA) is to restore knee kinematics. Knee prosthesis design plays a very important role in successful restoration. Here, kinematics models of normal and prosthetic knees were created and validated using previously published data. Methods: Computed tomography and magnetic resonance imaging scans of a healthy, anticorrosive female cadaver were used to establish a model of the entire lower limbs, including the femur, tibia, patella, fibula, distal femur cartilage, and medial and lateral menisci, as well as the anterior cruciate, posterior cruciate, medial collateral, and lateral collateral ligaments. The data from the three-dimensional models of the normal knee joint and a posterior-stabilized (PS) knee prosthesis were imported into finite element analysis software to create the final kinematic model of the TKA prosthesis, which was then validated by comparison with a previous study. The displacement of the medial/lateral femur and the internal rotation angle of the tibia were analyzed during 0–135° flexion. Results: Both the output data trends and the measured values derived from the normal knee's kinematics model were very close to the results reported in a previous in vivo study, suggesting that this model can be used for further analyses. The PS knee prosthesis underwent an abnormal forward displacement compared with the normal knee and has insufficient, or insufficiently aggressive, “rollback” compared with the lateral femur of the normal knee. In addition, a certain degree of reverse rotation occurs during flexion of the PS knee prosthesis. Conclusions: There were still several differences between the kinematics of the PS knee prosthesis and a normal knee, suggesting room for improving the design of the PS knee prosthesis. The abnormal kinematics during early flexion shows that the design of the articular surface played a vital role in improving the kinematics of the PS knee prosthesis. PMID:25591565

  12. Retrofitting models of inflation

    International Nuclear Information System (INIS)

    Kain, Ben

    2009-01-01

    I use the method of retrofitting, developed by Dine, Feng and Silverstein, to generate the scale of inflation dynamically, allowing it to be naturally small. This is a general procedure that may be performed on existing models of supersymmetric inflation. I illustrate this idea on two such models, one an example of F-term inflation and the other an example of D-term inflation.

  13. Prosthetic management of mid-facial defect with magnet-retained silicone prosthesis.

    Science.gov (United States)

    Buzayan, Muaiyed M

    2014-02-01

    Mid-facial defect is one of the most disfiguring and impairing defects. A design of prosthesis that is aesthetic and stable can be precious to a patient who has lost part of his face due to surgical excision. Prosthesis can restore the patients' self-esteem and confidence, which affects the patients and their life style. The aim of this case report is to describe a technique of mid-facial silicone prosthesis fabrication. To provide an aesthetic and stable facial prosthesis, the extra-oral prosthesis was fabricated using silicone material, while the intra-oral defect was restored with obturator prosthesis, and then both prostheses were connected and attached to each other using magnets. This clinical report describes the rehabilitation of a large mid-facial defect with a two-piece prosthesis. The silicone facial prosthesis was made hollow and lighter by using an acrylic framework. Two acrylic channels were included within the facial prosthesis to provide the patient with clean and patent airways. A sectional mid-facial prosthesis was made and retained in place by using magnets, which resulted in a significant improvement in the aesthetical and functional outcome without the need for plastic surgery. Silicone prostheses are reliable alternatives to surgery and should be considered in selected cases.

  14. 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

  15. Scale-invariant extended inflation

    International Nuclear Information System (INIS)

    Holman, R.; Kolb, E.W.; Vadas, S.L.; Wang, Y.

    1991-01-01

    We propose a model of extended inflation which makes use of the nonlinear realization of scale invariance involving the dilaton coupled to an inflaton field whose potential admits a metastable ground state. The resulting theory resembles the Jordan-Brans-Dicke version of extended inflation. However, quantum effects, in the form of the conformal anomaly, generate a mass for the dilaton, thus allowing our model to evade the problems of the original version of extended inflation. We show that extended inflation can occur for a wide range of inflaton potentials with no fine-tuning of dimensionless parameters required. Furthermore, we also find that it is quite natural for the extended-inflation period to be followed by an epoch of slow-rollover inflation as the dilaton settles down to the minimum of its induced potential

  16. 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.

  17. How Big is Too Big? The Girth of Bestselling Insertive Sex Toys to Guide Maximal Neophallus Dimensions.

    Science.gov (United States)

    Isaacson, Dylan; Aghili, Roxana; Wongwittavas, Non; Garcia, Maurice

    2017-11-01

    In our practice we have encountered 4 female-to-male transgender patients seeking neophallus revision surgery for girth precluding penetrative vaginal or anal intercourse. Despite this, there is little evidence available to guide transitioning patients in neophallus sizing. In this work we examined the dimensions of bestselling realistic dildos, presuming that the most popular dimensions would reflect population preferences for penetrative toys and phalluses. To determine a maximal upper limit for girth compatible with penetrative intercourse based on measurements of bestselling realistic dildos and published erect penile dimensions. We collected measurements for "realistic dildos" designated as bestsellers for the top 5 Alexa.com-rated online adult retailers in the United States and for Amazon.com. We compared these with measurements of dildos available at Good Vibrations in San Francisco and with studies of erect natal dimensions. We compared all data with measurements of 4 index patients whose neophallus girth prevented penetrative intercourse. Length and circumference of overall bestselling and largest bestselling realistic dildos as reported on top websites and measured by investigators. The average insertive length of the compiled dildos (16.7 ± 1.6 cm) was 1 SD longer than natal functional erect penile length as reported in the literature (15.7 ± 2.6 cm); however, their average circumference (12.7 ± 0.8 cm) mirrored natal erect penile girth (12.3 ± 1.3). The average girth of vendors' top 3 largest-girth dildos was 15.1 ± 0.9 cm, 2 SD wider than natal erect penile girth. Index patients had an average length of 16.3 ± 3.2 cm and an average girth of 17.6 ± 1.3 cm. Index patient girth was 4 to 5 SD wider than the average natal erect girth. Based on our data, we suggest that a surgically created neophallus should have a girth no wider than 15.1 cm after implantation of an inflatable penile prosthesis. This corresponds to 2 SD wider than the average natal

  18. 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....

  19. News on Inflation and the Epidemiology of Inflation Expectations

    NARCIS (Netherlands)

    Pfajfar, D.; Santoro, E.

    2012-01-01

    Abstract: This paper examines the nexus between news coverage on inflation and households' inflation expectations. In doing so, we test the epidemiological foundations of the sticky information model (Carroll, 2003, 2006). We use both aggregate and household-level data from the Survey Research

  20. 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

  1. Body image and prosthesis satisfaction in the lower limb amputee.

    OpenAIRE

    Murray, Craig; Fox, Jezz

    2002-01-01

    Purpose: This study examines the relationship between prosthesis satisfaction and body image in lower limb prosthesis users, and the gendered variations within these relationships. Method: A total of 44 valid responses were obtained to an Internet survey regarding prosthesis satisfaction, body image, and phantom pain. Spearman Rho correlations were calculated for these three domains. Results: Moderate to high negative correlations were observed between Body Image Disturbance and Prosthesis Sa...

  2. Fabrication of temporary speech bulb prosthesis: A clinical report

    OpenAIRE

    Kasim Mohamed, K.; Anand Kumar, V.; Devi, N.; Padmanaban, T. V.

    2010-01-01

    Maxillofacial prosthesis is an art and science which not only replaces the lost structure sometimes it restores the functions also. Pharyngeal obturator is a prosthesis which closes the palatal and pharyngeal defects and improving the speech and other function. The following case report discusses palatopharyngeal insufficiency, impression procedures, fabrication of prosthesis and improvements in speech.

  3. Attractors, universality, and inflation

    Science.gov (United States)

    Downes, Sean; Dutta, Bhaskar; Sinha, Kuver

    2012-11-01

    Studies of the initial conditions for inflation have conflicting predictions from exponential suppression to inevitability. At the level of phase space, this conflict arises from the competing intuitions of CPT invariance and thermodynamics. After reviewing this conflict, we enlarge the ensemble beyond phase space to include scalar potential data. We show how this leads to an important contribution from inflection point inflation, enhancing the likelihood of inflation to a power law, 1/Ne3. In the process, we emphasize the attractor dynamics of the gravity-scalar system and the existence of universality classes from inflection point inflation. Finally, we comment on the predictivity of inflation in light of these results.

  4. News on inflation and the epidemiology of inflation expectations

    NARCIS (Netherlands)

    Pfajfar, D.; Santoro, E.

    2013-01-01

    This paper examines the nexus between news coverage on inflation and households’ inflation expectations. In doing so, we test the epidemiological foundations of the sticky information model (Carroll 2003, 2006). We use both aggregate and household-level data from the Survey Research Center at the

  5. Femoral hip prosthesis design for Thais using multi-objective shape optimization

    International Nuclear Information System (INIS)

    Virulsri, Chanyaphan; Tangpornprasert, Pairat; Romtrairat, Parineak

    2015-01-01

    Highlights: • A multi-objective shape optimization was proposed to design hip prosthesis for Thais. • The prosthesis design was optimized in terms of safety of both cement and prosthesis. • The objective functions used the Soderberg fatigue strength formulations. • Safety factors of the cement and prosthesis are 1.200 and 1.109 respectively. • The newly designed prosthesis also fits well with chosen small-sized Thai femurs. - Abstract: The long-term success of Total Hip Arthroplasty (THA) depends largely on how well the prosthetic components fit the bones. The majority of cemented femoral hip prosthesis failures are due to aseptic loosening, which is possibly caused by cracking of the cement mantle. The strength of cement components is a function of cement mantles having adequate thickness. Since the size and shape of cemented femoral hip prostheses used in Thailand are based on designs for a Caucasian population, they do not properly conform to most Thai patients’ physical requirements. For these reasons, prostheses designed specifically for Thai patients must consider the longevity and functionality of both cement and prosthesis. The objective of this study was to discover a new design for femoral hip prostheses which is not only optimal and safe in terms of both cement and prosthesis, but also fits the selected Thai femur. This study used a small-sized Thai femoral model as a reference model for a new design. Biocompatible stainless steel 316L (SS316L) and polymethylmethacrylate (PMMA) were selected as raw materials for the prosthesis and bone cement respectively. A multi-objective shape optimization program, which is an interface between optimization C program named NSGA-II and a finite element program named ANSYS, was used to optimize longevity of femoral hip prostheses by varying shape parameters at assigned cross-sections of the selected geometry. Maximum walking loads of sixty-kilograms were applied to a finite element model for stress and

  6. 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.

  7. Quasi-open inflation

    CERN Document Server

    García-Bellido, J; Montes, X; Garcia-Bellido, Juan; Garriga, Jaume; Montes, Xavier

    1998-01-01

    We show that a large class of two-field models of single-bubble open inflation do not lead to infinite open universes, as it was previously thought, but to an ensemble of very large but finite inflating `islands'. The reason is that the quantum tunneling responsible for the nucleation of the bubble does not occur simultaneously along both field directions and equal-time hypersurfaces in the open universe are not synchronized with equal-density or fixed-field hypersurfaces. The most probable tunneling trajectory corresponds to a zero value of the inflaton field; large values, necessary for the second period of inflation inside the bubble, only arise as localized fluctuations. The interior of each nucleated bubble will contain an infinite number of such inflating regions of comoving size of order $\\gamma^{-1}$, where $\\gamma$ depends on the parameters of the model. Each one of these islands will be a quasi-open universe. Since the volume of the hyperboloid is infinite, inflating islands with all possible values...

  8. 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.

  9. Closed-eye orbital prosthesis: a clinical report.

    Science.gov (United States)

    Hatamleh, Muhanad M; Watson, Jason; Srinivasan, Dilip

    2015-03-01

    One of the most challenging prostheses to fabricate is an acceptable orbital prosthesis. Successful reconstruction of the complex missing tissues, the globe, muscle, skin, and bony elements requires time and high levels of practical skill. A good match to the contralateral nondefect side will help mask the underlying defect and give the patient confidence to return to normal, routine life. The contralateral eye opening will commonly dictate the eye opening of such a prosthesis, but because of the expressive nature of the eye and its high levels of mobility, this can be difficult to achieve. This clinical report presents a patient who had an extended orbital exenteration and right maxillectomy to remove a maxillary squamous cell carcinoma. An alternative approach to constructing an orbital prosthesis was undertaken with the eye closed. Compared to the normal method of fabrication, this process was less complex and quicker, made the prosthesis less "staring," camouflaged the defect, and reduced the detection of the prosthesis because of movements in the remaining eye. The patient engaged in his routine daily life, which reinforced his self-esteem, confidence, and reintegration into the community. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  10. Split-Framework in Mandibular Implant-Supported Prosthesis

    Directory of Open Access Journals (Sweden)

    Danny Omar Mendoza Marin

    2015-01-01

    Full Text Available During oral rehabilitation of an edentulous patient with an implant-supported prosthesis, mandibular flexure must be considered an important biomechanical factor when planning the metal framework design, especially if implants are installed posterior to the interforaminal region. When an edentulous mandible is restored with a fixed implant-supported prosthesis connected by a fixed full-arch framework, mandibular flexure may cause needless stress in the overall restorative system and lead to screw loosening, poor fit of prosthesis, loss of the posterior implant, and patient’s discomfort due to deformation properties of the mandible during functional movements. The use of a split-framework could decrease the stress with a precise and passive fit on the implants and restore a more natural functional condition of the mandible, helping in the longevity of the prosthesis. Therefore, the present clinical report describes the oral rehabilitation of an edentulous patient by a mandibular fixed implant-supported prosthesis with a split-framework to compensate for mandibular flexure. Clinical Significance. The present clinical report shows that the use of a split-framework reduced the risk of loss of the posterior implants or screws loosening with acceptable patient comfort over the period of a year. The split-framework might have compensated for the mandibular flexure during functional activities.

  11. 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.

  12. A comparison of inflation expectations and inflation credibility in South Africa: results from survey data

    Directory of Open Access Journals (Sweden)

    Jannie Rossouw

    2011-08-01

    Full Text Available This paper reports a comparison of South African household inflation expectations and inflation credibility surveys undertaken in 2006 and 2008. It tests for possible feed-through between inflation credibility and inflation expectations. It supplements earlier research that focused only on the 2006 survey results. The comparison shows that inflation expectations differed between different income groups in both 2006 and 2008. Inflation credibility differed between male and female respondents, but this difference did not feed through to inflation expectations. More periodic survey data will be required for developing final conclusions on the possibility of feed-through effects. To this end the structure of credibility surveys should be reconsidered, as a large percentage of respondents indicated that they ‘don’t know’ whether the historic rate of inflation is an accurate indication of price increases.

  13. Does a Threshold Inflation Rate Exist? Quantile Inferences for Inflation and Its Variability

    OpenAIRE

    WenShwo Fang; Stephen M. Miller; Chih-Chuan Yeh

    2009-01-01

    Using quantile regressions and cross-sectional data from 152 countries, we examine the relationship between inflation and its variability. We consider two measures of inflation – the mean and median – and three different measures of inflation variability – the standard deviation, relative variation, and median deviation. All results from the mean and standard deviation, the mean and relative variation, or the median and the median deviation support both the hypothesis that higher inflation cr...

  14. Nonminimally coupled hybrid inflation

    International Nuclear Information System (INIS)

    Koh, Seoktae; Minamitsuji, Masato

    2011-01-01

    We discuss the hybrid inflation model where the inflaton field is nonminimally coupled to gravity. In the Jordan frame, the potential contains φ 4 term as well as terms in the original hybrid inflation model. In our model, inflation can be classified into the type (I) and the type (II). In the type (I), inflation is terminated by the tachyonic instability of the waterfall field, while in the type (II) by the violation of slow-roll conditions. In our model, the reheating takes place only at the true minimum and even in the case (II) finally the tachyonic instability occurs after the termination of inflation. For a negative nonminimal coupling, inflation takes place in the vacuum-dominated region, in the large field region, or near the local minimum/maximum. Inflation in the vacuum-dominated region becomes either the type (I) or (II), resulting in a blue or red spectrum of the curvature perturbations, respectively. Inflation around the local maximum can be either the type (I) or the type (II), which results in the red spectrum of the curvature perturbations, while around the local minimum it must be the type (I), which results in the blue spectrum. In the large field region, to terminate inflation, potential in the Einstein frame must be positively tilted, always resulting in the red spectrum. We then numerically solve the equations of motion to investigate the whole dynamics of inflaton and confirm that the spectrum of curvature perturbations changes from red to blue ones as scales become smaller.

  15. CRA Grade Inflation

    OpenAIRE

    Kenneth H. Thomas

    2000-01-01

    Community Reinvestment Act of 1977 (CRA) ratings and performance evaluations are the only bank and thrift exam findings disclosed by financial institution regulators. Inflation of CRA ratings has been alleged by community activists for two decades, but there has been no quantification or empirical investigation of grade inflation. Using a unique grade inflation methodology on actual ratings and evaluation data for 1,407 small banks and thrifts under the revised CRA regulations, this paper con...

  16. Hearing results using the SMart piston prosthesis.

    Science.gov (United States)

    Fayad, Jose N; Semaan, Maroun T; Meier, Josh C; House, John W

    2009-12-01

    SMart, a newly introduced piston prosthesis for stapedotomy, is a nitinol-based, heat-activated, self-crimping prosthesis. We review our hearing results and postoperative complications using this self-crimped piston prosthesis and compare them with those obtained using stainless steel or platinum piston prostheses. Audiometric results using the SMart piston are identical to those obtained using a conventional piston prosthesis. Retrospective chart review. Private neurotologic tertiary referral center. The 416 ears reviewed included 306 with a SMart prosthesis and 110 conventional prostheses. 61% were women. Mean follow-up time was 5.6 (standard deviation [SD], 6.3 mo) and 6.9 months (SD, 7.0 mo) for the 2 groups, respectively. Stapedotomy using the SMart or a conventional (non-SMart) prosthesis. Audiometric hearing results, including pure-tone average (PTA) and air-bone gap (ABG), and prevalence of postoperative complications. Mean postoperative PTA was 32.6 (SD, 16.8) dB for the SMart group and 29.4 (SD, 13.5) dB for the non-SMart group, with ABGs of 7.6 (SD, 8.9) and 6.0 (SD, 5.2) dB, respectively. Mean change (decrease) in ABG was 18.7 (SD, 13.1) dB for the SMart group and 19.9 (SD, 10.3) dB for the non-SMart group. High-frequency bone PTAs showed overclosure of 2.0 (SD, 7.9) dB for the SMart group and 3.6 (SD, 8.6) dB for the non-SMart group. Postoperative vertigo and tinnitus were infrequent. No significant differences in these audiometric outcomes or complication rates were noted between groups. There was no significant difference in rate of gap closure to within 10 dB (78.3 versus 84.2%, SMart and non-SMart, respectively) or 20 dB (94.2 and 98.0%). Compared with conventional stapes prostheses, the nitinol-based SMart is a safe and reliable stapes prosthesis that eliminates manual crimping without significantly altering the audiometric outcome. Complications are rare, but longer follow-up is needed before establishing long-term stability.

  17. 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.)

  18. Difficult factors in Management of Impacted Dental Prosthesis in Esophagus

    Directory of Open Access Journals (Sweden)

    Efiaty A. Soepardi

    2005-03-01

    Full Text Available A dental prosthesis which ingested and impacted in esophagus, is an emergency case and life threatening, so require immediate esophagoscopy intervention for removing. The objective of this study is to assess some factors can caused dtfficulties in diagnosing and treating the ingested and impacted dental prosthesis in the esophagus and their complications. This retrospective study analyzed patient’s chart whose underwent esophagoscopy for removing the impacted dental prosthesis in Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia during a period between January 1997 and December 2003. Neck-chest X-ray and esophagoscopy were performed in all patients to identify the existence of the dental prosthesis as a diagnostic and treatment procedure. The length of time for removing the dental prosthesis was recorded and stated as a less difficult esophagoscopy when it takes time less than 60 minutes and as a difficult  esophagoscopy takes 60 minutes or longer. Some risk difficulties factors were statistically analyzed. There were 53 patients of ingested dental prosthesis in esophagus. Only 51 cases were analyzed According to the length of time for removing the dental prosthesis by esophagoscopy, 22 patients were recorded as less difficult cases and 29 patients as difficult cases. Two cases among the cases needed cervicotomy after unsuccessful esophagoscopy removal. The difficulties to diagnose an impacted dental prosthesis in the esophagus caused by unreliable clinical history, unclear signs and symptoms, unable to be detected by X-ray and was not found during esophagoscopy. The difficulties in treating due to mucosal laceration, edema, bleeding, failure of the first extraction and conformity with the size and shape, the wire outside the dental prosthesis and the length of time stayed in the esophagus. (Med J Indones 2005; 14: 33-6Keywords: ingested dental prosthesis, radioluscent foreign body, length of time of esophagoscopy

  19. Assessing inflation persistence: micro evidence on an inflation targeting economy

    Czech Academy of Sciences Publication Activity Database

    Babecký, Jan; Coricelli, F.; Horváth, R.

    -, č. 353 (2008), s. 1-37 ISSN 1211-3298 Institutional research plan: CEZ:AV0Z70850503 Keywords : inflation dynamics * persistence * inflation targeting Subject RIV: AH - Economics http://www.cerge-ei.cz/pdf/wp/Wp353.pdf

  20. Preheating in new inflation

    International Nuclear Information System (INIS)

    Desroche, Mariel; Felder, Gary N.; Kratochvil, Jan M.; Linde, Andrei

    2005-01-01

    During the last ten years a detailed investigation of preheating was performed for chaotic inflation and for hybrid inflation. However, nonperturbative effects during reheating in the new inflation scenario remained practically unexplored. We investigate preheating in new inflation, using a combination of analytical and numerical methods. We find that the decay of the homogeneous component of the inflaton field and the resulting process of spontaneous symmetry breaking in the simplest models of new inflation usually occurs almost instantly: for the new inflation on the GUT scale it takes only about 5 oscillations of the field distribution. The decay of the homogeneous inflaton field is so efficient because of a combined effect of tachyonic preheating and parametric resonance. At that stage, the homogeneous oscillating inflaton field decays into a collection of waves of the inflaton field, with a typical wavelength of the order of the inverse inflaton mass. This stage usually is followed by a long stage of decay of the inflaton field into other particles, which can be described by the perturbative approach to reheating after inflation. The resulting reheating temperature typically is rather low

  1. Impact of aortic prosthesis-patient mismatch on left ventricular mass regression.

    Science.gov (United States)

    Alassal, Mohamed A; Ibrahim, Bedir M; Elsadeck, Nabil

    2014-06-01

    Prostheses used for aortic valve replacement may be small in relation to body size, causing prosthesis-patient mismatch and delaying left ventricular mass regression. This study examined the effect of prosthesis-patient mismatch on regression of left ventricular mass after aortic valve replacement. We prospectively studied 96 patients undergoing aortic valve replacement between 2007 and 2012. Mean and peak gradients and indexed effective orifice area were measured by transthoracic echocardiography at 3 and 6 months postoperatively. Patient-prosthesis mismatch was defined as indexed effective orifice area ≤0.85 cm(2)·m(-2). Moderate prosthesis-patient mismatch was present in 25% of patients. There were no significant differences in demographic and operative data between patients with and without prosthesis-patient mismatch. Left ventricular dimensions, posterior wall thickness, transvalvular gradients, and left ventricular mass decreased significantly after aortic valve replacement in both groups. The interventricular septal diameter and left ventricular mass index regression, and left ventricular ejection fraction were better in patients without prosthesis-patient mismatch. There was a significant positive correlation between the postoperative indexed effective orifice area of each valve prosthesis and the rate of left ventricular mass regression. Prosthesis-patient mismatch leads to higher transprosthetic gradients and impaired left ventricular mass regression. A small-sized valve prosthesis does not necessarily result in prosthesis-patient mismatch, and may be perfectly adequate in patient with small body size. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  2. [The endo-exo prosthesis for patients with a problematic amputation stump].

    Science.gov (United States)

    Frölke, Jan Paul M; van de Meent, Henk

    2010-01-01

    Following lower limb amputation, quality of life is highly related to the ability to use a prosthetic limb. The conventional way to attach a prosthetic limb to the body is with a socket. Many patients experience serious discomfort wearing a conventional prosthesis because of pain, instability during walking, pressure sores, bad smell or skin irritation. In addition, sitting is uncomfortable and pelvic and lower back pain due to unstable gait is often seen in these patients. The main disadvantage of the current prosthesis is the attachment of a rigid prosthesis socket to a soft and variable body. The socket must fit tightly for stability during walking but should also be comfortable for sitting. The implantation of an osseointegrated, intramedullary, transcutaneously conducted prosthesis is a new procedure for attaching a limb prosthesis to the human body without the disadvantages of the conventional prosthesis. The intramedullary prosthesis is designed with a rough surface resembling cancellous bone to enable a secure solid integration with the long bone. We treated two patients with this new prosthesis, a 44-year-old man after a transfemoral amputation, and a 32-year-old woman after a lower leg amputation; both amputations were necessary because of trauma. Those two patients are now, more than one year after the operation, showing excellent functional results without infectious complications. We assume that endo-exo prosthesis may be a promising option for selected patients unable to use a conventional prosthesis because of a problematic amputation stump.

  3. The History of Nontraditional or Ectopic Placement of Reservoirs in Prosthetic Urology.

    Science.gov (United States)

    Perito, Paul; Wilson, Steven

    2016-04-01

    Reservoir placement during implantation of prosthetic urology devices has been problematic throughout the history of the surgical treatment of erectile dysfunction and urinary incontinence. We thought it would be interesting to review the history of reservoir placement leading up to current surgical techniques. To provide an overview of the past and present techniques for reservoir placement and discuss the evolutionary process leading to safe and effective placement of prosthetic reservoirs. We reviewed data pertaining to inflatable penile prosthesis (IPP) reservoirs and pressure-regulating balloons (PRB) in a chronological fashion, spanning 25 years. Main outcomes included a historical review of techniques for IPP reservoir and PRB placement leading to the subsequent incremental improvements in safety and efficacy when performing penile implants and artificial urinary sphincters. Prosthetic urologic reservoirs have traditionally been placed in the retropubic space. Over the years, urologists have attempted use of alternative spaces including peritoneal, epigastric, "ectopic," posterior to transversalis, and high submuscular. Current advances in prosthetic urologic reservoir placement allow safe and effective abdominal wall placement of reservoirs. These novel approaches appear to be so effective that urologists may now be able to cease using the traditional retropubic space for reservoir placement, even in the case of virgin pelves. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  4. 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.

  5. Inflation persistence and flexible prices

    OpenAIRE

    Robert Dittmar; William T. Gavin; Finn E. Kydland

    2004-01-01

    If the central bank follows an interest rate rule, then inflation is likely to be persistence, even when prices are fully flexible. Any shock, whether persistent or not, may lead to inflation persistence. In equilibrium, the dynamics of inflation are determined by the evolution of the spread between the real interest rate and the central bank’s target. Inflation persistence in U.S. data can be characterized by a vector autocorrelation function relating inflation and deviations of output from ...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-10-15

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

  7. 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.

  8. Clinical predictors of prosthesis-patient mismatch after aortic valve replacement for aortic stenosis

    Directory of Open Access Journals (Sweden)

    Luis M Astudillo

    2012-01-01

    Full Text Available OBJECTIVE: We sought to ascertain predictors of Patient Prosthesis Mismatch, an independent predictor of mortality, in patients with aortic stenosis using bioprosthetic valves. METHOD: We analyzed 2,107 sequential surgeries. Patient Prosthesis Mismatch was calculated using the effective orifice area of the prosthesis divided by the patient's body surface area. We defined nonsignificant, moderate, and severe Patient Prosthesis Mismatch as effective orifice area indexes of .0.85 cm²/m, 0.85-0.66 cm²/m², and <0.65 cm²/m², respectively. RESULTS: A total of 311 bioprosthetic patients were identified. The incidence of nonsignificant, moderate, and severe Patient Prosthesis Mismatch was 41%, 42, and 16%, respectively. Severe Patient Prosthesis Mismatch was significantly more prevalent in females (82%. In severe Patient Prosthesis Mismatch, the perfusion and the crossclamp times were considerably lower when compared with nonsignificant Patient Prosthesis Mismatch and moderate Patient Prosthesis Mismatch. Patients with severe Patient Prosthesis Mismatch had a significantly higher likelihood of spending time in the intensive care unit and a significantly longer length of stay in the hospital. Body surface area was not different in severe Patient Prosthesis Mismatch when compared with nonsignificant Patient Prosthesis Mismatch. In-hospital mortality in patients with nonsignificant, moderate, and severe Patient Prosthesis Mismatch was 2.3%, 6.1%, and 8%, respectively. Minimally invasive surgery was significantly associated with moderate Patient Prosthesis Mismatch in 49% of the patients, but not with severe Patient Prosthesis Mismatch. CONCLUSION: Severe Patient Prosthesis Mismatch is more common in females, but not in those with minimal available body surface area. Though operative times were shorter in these patients, intensive care unit and hospital lengths of stay were longer. Surgeons and cardiologists should be cognizant of these clinical

  9. Modulus D-term inflation

    Science.gov (United States)

    Kadota, Kenji; Kobayashi, Tatsuo; Saga, Ikumi; Sumita, Keigo

    2018-04-01

    We propose a new model of single-field D-term inflation in supergravity, where the inflation is driven by a single modulus field which transforms non-linearly under the U(1) gauge symmetry. One of the notable features of our modulus D-term inflation scenario is that the global U(1) remains unbroken in the vacuum and hence our model is not plagued by the cosmic string problem which can exclude most of the conventional D-term inflation models proposed so far due to the CMB observations.

  10. 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.

  11. 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.

  12. 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.

  13. Racetrack inflation and cosmic strings

    Energy Technology Data Exchange (ETDEWEB)

    Brax, P. [CEA-Saclay, Gif sur Yvette (France). CEA/DSM/SPhT, Unite de Recherche Associee au CNRS, Service de Physique Theorique; Bruck, C. van de [Sheffield Univ. (United Kingdom). Dept. of Applied Mathematics; Davis, A.C.; Davis, S.C. [Cambridge Univ. (United Kingdom). DAMTP, Centre for Mathematical Sciences; Jeannerot, R. [Instituut-Lorentz for Theoretical Physics, Leiden (Netherlands); Postma, M. [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany)]|[Nationaal Inst. voor Kernfysica en Hoge-Energiefysica (NIKHEF), Amsterdam (Netherlands)

    2008-05-15

    We consider the coupling of racetrack inflation to matter fields as realised in the D3/D7 brane system. In particular, we investigate the possibility of cosmic string formation in this system. We find that string formation before or at the onset of racetrack inflation is possible, but they are then inflated away. Furthermore, string formation at the end of inflation is prevented by the presence of the moduli sector. As a consequence, no strings survive racetrack inflation. (orig.)

  14. Racetrack inflation and cosmic strings

    International Nuclear Information System (INIS)

    Brax, P.; Postma, M.

    2008-05-01

    We consider the coupling of racetrack inflation to matter fields as realised in the D3/D7 brane system. In particular, we investigate the possibility of cosmic string formation in this system. We find that string formation before or at the onset of racetrack inflation is possible, but they are then inflated away. Furthermore, string formation at the end of inflation is prevented by the presence of the moduli sector. As a consequence, no strings survive racetrack inflation. (orig.)

  15. Kähler-driven tribrid inflation

    Science.gov (United States)

    Antusch, Stefan; Nolde, David

    2012-11-01

    We discuss a new class of tribrid inflation models in supergravity, where the shape of the inflaton potential is dominated by effects from the Kähler potential. Tribrid inflation is a variant of hybrid inflation which is particularly suited for connecting inflation with particle physics, since the inflaton can be a D-flat combination of charged fields from the matter sector. In models of tribrid inflation studied so far, the inflaton potential was dominated by either loop corrections or by mixing effects with the waterfall field (as in "pseudosmooth" tribrid inflation). Here we investigate the third possibility, namely that tribrid inflation is dominantly driven by effects from higher-dimensional operators of the Kähler potential. We specify for which superpotential parameters the new regime is realized and show how it can be experimentally distinguished from the other two (loop-driven and "pseudosmooth") regimes.

  16. 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.

  17. Inflation with Fayet-Iliopoulos terms

    International Nuclear Information System (INIS)

    Wieck, Clemens; Winkler, Martin Wolfgang

    2014-08-01

    Two of the most attractive realizations of inflation in supergravity are based upon the presence of a constant Fayet-Iliopoulos (FI) term. In D-term hybrid inflation it is the FI term itself which sets the energy scale of inflation. Alternatively, the breaking of a U(1) symmetry induced by the FI term can dynamically generate the quadratic potential of chaotic inflation. The purpose of this note is to study the possible UV embedding of these schemes in terms of the 'field-dependent FI term' related to a string modulus field which is stabilized by a non-perturbative superpotential. We find that in settings where the FI term drives inflation, gauge invariance prevents a decoupling of the modulus from the inflationary dynamics. The resulting inflation models generically contain additional dynamical degrees of freedom compared to D-term hybrid inflation. However, the dynamical realization of chaotic inflation can be obtained in complete analogy to the case of a constant FI term. We present a simple string-inspired toy model of this type.

  18. Anisotropic inflation from charged scalar fields

    International Nuclear Information System (INIS)

    Emami, Razieh; Firouzjahi, Hassan; Movahed, S.M. Sadegh; Zarei, Moslem

    2011-01-01

    We consider models of inflation with U(1) gauge fields and charged scalar fields including symmetry breaking potential, chaotic inflation and hybrid inflation. We show that there exist attractor solutions where the anisotropies produced during inflation becomes comparable to the slow-roll parameters. In the models where the inflaton field is a charged scalar field the gauge field becomes highly oscillatory at the end of inflation ending inflation quickly. Furthermore, in charged hybrid inflation the onset of waterfall phase transition at the end of inflation is affected significantly by the evolution of the background gauge field. Rapid oscillations of the gauge field and its coupling to inflaton can have interesting effects on preheating and non-Gaussianities

  19. 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

  20. Intermittent, noncyclic dysfunction of a mechanical aortic prosthesis by pannus formation.

    Science.gov (United States)

    Giroux, Sylvie K; Labinaz, Marino X; Grisoli, Dominique; Klug, Andrew P; Veinot, John P; Burwash, Ian G

    2010-01-01

    Mechanical aortic prosthesis dysfunction can result from thrombosis or pannus formation. Pannus formation usually restricts systolic excursion of the occluding disk, resulting in progressive stenosis of the aortic prosthesis. Intermittent dysfunction of a mechanical aortic prosthesis is usually ascribed to thrombus formation. We describe an unusual case of intermittent, noncyclic dysfunction of a mechanical aortic prosthesis due to pannus formation in the absence of systolic restriction of disk excursion that presented with intermittent massive aortic regurgitation, severe ischemia, and shock. Pannus formation should be considered as a potential cause of acute intermittent severe aortic regurgitation in a patient with a mechanical aortic prosthesis.

  1. No-scale inflation

    Science.gov (United States)

    Ellis, John; Garcia, Marcos A. G.; Nanopoulos, Dimitri V.; Olive, Keith A.

    2016-05-01

    Supersymmetry is the most natural framework for physics above the TeV scale, and the corresponding framework for early-Universe cosmology, including inflation, is supergravity. No-scale supergravity emerges from generic string compactifications and yields a non-negative potential, and is therefore a plausible framework for constructing models of inflation. No-scale inflation yields naturally predictions similar to those of the Starobinsky model based on R+{R}2 gravity, with a tilted spectrum of scalar perturbations: {n}s∼ 0.96, and small values of the tensor-to-scalar perturbation ratio r\\lt 0.1, as favoured by Planck and other data on the cosmic microwave background (CMB). Detailed measurements of the CMB may provide insights into the embedding of inflation within string theory as well as its links to collider physics.

  2. No-Scale Inflation

    CERN Document Server

    Ellis, John; Nanopoulos, Dimitri V.; Olive, Keith A.

    2016-01-01

    Supersymmetry is the most natural framework for physics above the TeV scale, and the corresponding framework for early-Universe cosmology, including inflation, is supergravity. No-scale supergravity emerges from generic string compactifications and yields a non-negative potential, and is therefore a plausible framework for constructing models of inflation. No-scale inflation yields naturally predictions similar to those of the Starobinsky model based on $R + R^2$ gravity, with a tilted spectrum of scalar perturbations: $n_s \\sim 0.96$, and small values of the tensor-to-scalar perturbation ratio $r < 0.1$, as favoured by Planck and other data on the cosmic microwave background (CMB). Detailed measurements of the CMB may provide insights into the embedding of inflation within string theory as well as its links to collider physics.

  3. 21 CFR 888.3760 - Wrist joint carpal scaphoid polymer prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Wrist joint carpal scaphoid polymer prosthesis. 888.3760 Section 888.3760 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... scaphoid polymer prosthesis. (a) Identification. A wrist joint carpal scaphoid polymer prosthesis is a one...

  4. 21 CFR 888.3750 - Wrist joint carpal lunate polymer prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Wrist joint carpal lunate polymer prosthesis. 888.3750 Section 888.3750 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... lunate polymer prosthesis. (a) Identification. A wrist joint carpal lunate prosthesis is a one-piece...

  5. 21 CFR 888.3770 - Wrist joint carpal trapezium polymer prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Wrist joint carpal trapezium polymer prosthesis. 888.3770 Section 888.3770 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... trapezium polymer prosthesis. (a) Identification. A wrist joint carpal trapezium polymer prosthesis is a one...

  6. 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.

  7. A modified technique for retention of orbital prosthesis

    Directory of Open Access Journals (Sweden)

    Sameera R Shaikh

    2011-01-01

    Full Text Available An orbital defect (congenital or acquired causes severe facial asymmetry and disfigurement, which results in psychological and social disturbances to the patient. It becomes a challenging task for a maxillofacial prosthodontist to fabricate a prosthesis that replicates the healthy side of the face. Success of the prosthesis depends primarily on satisfactory retention of the same. This clinical report illustrates rehabilitation of a patient with an orbital defect by fabricating a hollow orbital prosthesis, utilizing anatomical undercuts for retention using an acrylic resin template relined by a resilient denture liner.

  8. Communication Protocol for Advanced Prosthesis Components

    OpenAIRE

    Karnå, David

    2007-01-01

    It would be of great value for the prosthesis industry to achieve an open standard for communication in upper limb prostheses. Cooperation between NTNU and the University of New Brunswick has resulted in a functional requirements specification for such a standard, SCIP(Standardised Communication Interface in Prostheses). The special challenges for communication in a prosthesis system are possible noisy environments, high demands for light weight, safety for the user and the fact that devices ...

  9. 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 ...

  10. 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.

  11. Extended inflation with induced gravity

    International Nuclear Information System (INIS)

    Accetta, F.S.; Trester, J.J.; Department of Physics, Yale University, New Haven, Connecticut 06520)

    1989-01-01

    We consider a recently proposed extended model of inflation which improves upon the original old inflation scenario by achieving a graceful exit from the false-vacuum phase. In this paper extended inflation is generalized to include a potential V(phi) for the Brans-Dicke-type field phi. We find that whereas a graceful exit can still be had, the inclusion of a potential places constraints on the percolation time scale for exiting the inflationary phase. Additional constraints on V(phi) and the false-vacuum energy density rho /sub F/ from density and gravitational-wave perturbations are discussed. For initially small values of phi the false vacuum undergoes power-law inflation, while for initially large values of phi the expansion is exponential. Within true-vacuum regions slow-rolling inflation can occur. As a result, this model generically leads to multiple episodes of inflation. We discuss the significance these multiple episodes of inflation may have on the formation of large-scale structure and the production of voids

  12. Inflation Rate Modelling in Indonesia

    Directory of Open Access Journals (Sweden)

    Rezzy Eko Caraka

    2016-10-01

    Full Text Available The purposes of this research were to analyse: (i Modelling the inflation rate in Indonesia with parametric regression. (ii Modelling the inflation rate in Indonesia using non-parametric regression spline multivariable (iii Determining the best model the inflation rate in Indonesia (iv Explaining the relationship inflation model parametric and non-parametric regression spline multivariable. Based on the analysis using the two methods mentioned the coefficient of determination (R2 in parametric regression of 65.1% while non-parametric amounted to 99.39%. To begin with, the factor of money supply or money stock, crude oil prices and the rupiah exchange rate against the dollar is significant on the rate of inflation. The stability of inflation is essential to support sustainable economic development and improve people's welfare. In conclusion, unstable inflation will complicate business planning business activities, both in production and investment activities as well as in the pricing of goods and services produced.DOI: 10.15408/etk.v15i2.3260

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

    Directory of Open Access Journals (Sweden)

    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

  14. Quantum fluctuations and inflation

    International Nuclear Information System (INIS)

    Bardeen, J.M.; Bublik, G.J.

    1986-05-01

    We study the effect of quantum fluctuations on the roll-down rate of the inflation field in a semiclassical approximation; this is done by treating the inflation field as a classical random field. The quantum fluctuations are simulated by a noise term in the equation of motion. We consider two different inflationary scenarios (new and chaotic inflation) and find that the roll-down rate of the median value of the inflation field is increased by the quantum fluctuations. Non-linear effects may become important in the later stages of the inflationary regime. 8 refs., 2 figs

  15. Quantum fluctuations and inflation

    International Nuclear Information System (INIS)

    Bardeen, J.M.; Bublik, G.J.

    1987-01-01

    The authors study the effect of quantum fluctuations on the roll-down rate of the inflation field in a semiclassical approximation; this is done by treating the inflation field as a classical random field. The quantum fluctuations are simulated by a noise term in the equation of motion. Two different inflationary scenarios (new and chaotic inflation) are considered and it is found that the roll-down rate of the median value of the inflation field is increased by the quantum fluctuations. Non-linear effects may become important in the later stages of the inflationary regime. (author)

  16. Core inflation indicators for Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Alkhareif Ryadh M.

    2015-01-01

    Full Text Available This paper constructs and analyzes core inflation indicators for Saudi Arabia for the period of March 2012 to May 2014 using two alternative approaches: the exclusion method (ex food and housing/rent and the statistical method. The findings of the analysis suggest that the ex food and housing/ rent inflation is more volatile than the overall CPI inflation over the sample period. In contrast, the statistical core inflation is relatively more stable and less volatile. Moreover, the ex food and housing/rent inflation is only weakly correlated with headline inflation, whereas the statistical core inflation exhibits a stronger correlation. This combination of lower volatility and higher correlation with headline inflation makes the statistical method a much better choice for policymakers. From a monetary policy standpoint, using a bundle of core inflation measures, including both properly constructed exclusion and statistical methods, is more desirable, especially when variation across measures is widespread, as is the case in Saudi Arabia.

  17. 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...

  18. What Drives China's Food-Price Inflation and How does It Affect the Aggregate Inflation?

    OpenAIRE

    Wenlang Zhang; Daniel Law

    2010-01-01

    It is typically argued that China's food-price inflation has been mainly driven by supply-side shocks including natural disasters. Our research, however, shows that demand pressures have played a more important role from a medium-term perspective. This suggests surging food prices may call for policy reactions even if non-food-price inflation is tame. Meanwhile, we find food-price inflation has not generated significant second-round effects on non-food-price inflation. In particular, while fo...

  19. Fabrication of a Cranial Prosthesis Combined with an Ocular Prosthesis Using Rapid Prototyping: A Case Report

    Directory of Open Access Journals (Sweden)

    Gayatri Shankaran

    2016-08-01

    Full Text Available Rapid prototyping (RP is a technique of manufacturing parts by the additive layer manufacturing technology; where, a three-dimensional (3D model created in a computer aided design (CAD system is sectioned into 2D profiles, which are further constructed by RP layer by layer. Its use is not limited to industrial or engineering fields and has extended to the medical field for the manufacturing of custom implants and prostheses, the study of anatomy and surgical planning. Nowadays, dentists are more frequently encountered with the individuals affected with craniofacial defects due to trauma. In such cases, the cranio-maxillofacial rehabilitation is a real challenge to bring the patients back to society and promote their well-being. The conventional impression technique for facial prosthesis fabrication has the disadvantage of deforming the soft tissue and causing discomfort for the patient. Herein, we describe the fabrication of a cranial prosthesis combined with an ocular prosthesis with RP and stereolithography.

  20. Fabrication of a Cranial Prosthesis Combined with an Ocular Prosthesis Using Rapid Prototyping: A Case Report.

    Science.gov (United States)

    Shankaran, Gayatri; Deogade, Suryakant Chhagan; Dhirawani, Rajesh

    2016-01-01

    Rapid prototyping (RP) is a technique of manufacturing parts by the additive layer manufacturing technology; where, a three-dimensional (3D) model created in a computer aided design (CAD) system is sectioned into 2D profiles, which are further constructed by RP layer by layer. Its use is not limited to industrial or engineering fields and has extended to the medical field for the manufacturing of custom implants and prostheses, the study of anatomy and surgical planning. Nowadays, dentists are more frequently encountered with the individuals affected with craniofacial defects due to trauma. In such cases, the craniomaxillofacial rehabilitation is a real challenge to bring the patients back to society and promote their well-being. The conventional impression technique for facial prosthesis fabrication has the disadvantage of deforming the soft tissue and causing discomfort for the patient. Herein, we describe the fabrication of a cranial prosthesis combined with an ocular prosthesis with RP and stereolithography.

  1. 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.

  2. THE ACTUAL IMPLICATIONS OF INFLATION

    Directory of Open Access Journals (Sweden)

    Murăriţa Ilie

    2011-12-01

    Full Text Available The authors have started from the idea that inflationary phenomenon is a companion, the cause and the effect of the globalization of poverty in the broader context of world economy globalization. Therefore, starting from a common definition of inflation, the first objective was to identify causal relationships that singularize contemporary inflationary process. After that, attention was focused on the implications of inflation in the current stage, bearing in mind that monetary financial theory and practice are operating with perfectly anticipated inflation or imperfectly anticipated inflation. Inflation has great implications on the long-term contracts and wage contracts.

  3. Alchemical inflation: inflaton turns into Higgs

    Science.gov (United States)

    Nakayama, Kazunori; Takahashi, Fuminobu

    2012-11-01

    We propose a new inflation model in which a gauge singlet inflaton turns into the Higgs condensate after inflation. The inflationary path is characterized by a moduli space of supersymmetric vacua spanned by the inflaton and Higgs field. The inflation energy scale is related to the soft supersymmetry breaking, and the Hubble parameter during inflation is smaller than the gravitino mass. The initial condition for the successful inflation is naturally realized by the pre-inflation in which the Higgs plays a role of the waterfall field.

  4. Alchemical inflation: inflaton turns into Higgs

    International Nuclear Information System (INIS)

    Nakayama, Kazunori; Takahashi, Fuminobu

    2012-01-01

    We propose a new inflation model in which a gauge singlet inflaton turns into the Higgs condensate after inflation. The inflationary path is characterized by a moduli space of supersymmetric vacua spanned by the inflaton and Higgs field. The inflation energy scale is related to the soft supersymmetry breaking, and the Hubble parameter during inflation is smaller than the gravitino mass. The initial condition for the successful inflation is naturally realized by the pre-inflation in which the Higgs plays a role of the waterfall field

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

    Science.gov (United States)

    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

  6. Metabolics of stair ascent with a powered transfemoral prosthesis.

    Science.gov (United States)

    Ledoux, E D; Lawson, B E; Shultz, A H; Bartlett, H L; Goldfarb, M

    2015-01-01

    This paper evaluates the effectiveness of a powered knee and ankle prosthesis for stair ascent through a metabolic assessment comparing energy expenditure of a single transfemoral amputee subject while ascending stairs with the powered prosthesis relative to his passive daily use device, as well as comparing the kinematics and kinetics obtained with the passive prosthesis to healthy biomechanics. The subject wore a portable system that measured pulmonary gaseous exchange rates of oxygen and carbon dioxide while he ascended stairs with each of the prostheses in alternating tests. The results indicated that the amputee's energy expenditure decreased by 32 percent while climbing with the powered prosthesis as compared to his passive one, and the kinematics and kinetics achieved were representative of healthy biomechanics.

  7. Heterogeneous inflation expectations and learning

    OpenAIRE

    Madeira, Carlos; Zafar, Basit

    2012-01-01

    Using the panel component of the Michigan Survey of Consumers, we estimate a learning model of inflation expectations, allowing for heterogeneous use of both private information and lifetime inflation experience. “Life-experience inflation” has a significant impact on individual expectations, but only for one-year-ahead inflation. Public information is substantially more relevant for longer-horizon expectations. Even controlling for life-experience inflation and public information, idiosyncra...

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

    Directory of Open Access Journals (Sweden)

    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.

  9. Dual Inflation

    CERN Document Server

    García-Bellido, J

    1998-01-01

    We propose a new model of inflation based on the soft-breaking of N=2 supersymmetric SU(2) Yang-Mills theory. The advantage of such a model is the fact that we can write an exact expression for the effective scalar potential, including non-perturbative effects, which preserves the analyticity and duality properties of the Seiberg-Witten solution. We find that the scalar condensate that plays the role of the inflaton can drive a long period of cosmological expansion, produce the right amount of temperature anisotropies in the microwave background, and end inflation when the monopole acquires a vacuum expectation value. Duality properties relate the weak coupling Higgs region where inflation takes place with the strong coupling monopole region, where reheating occurs, creating particles corresponding to the light degrees of freedom in the true vacuum.

  10. 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 ...

  11. Cosmic strings and inflation

    International Nuclear Information System (INIS)

    Vishniac, E.T.

    1987-01-01

    We examine the compatibility of inflation with the cosmic string theory for galaxy formation. There is a general conflict between having sufficient string tension to effect galaxy formation, and reheating after inflation to a high enough temperature that strings may form in a thermal phase transition. To escape this conflict, we propose a class of models where the inflation is coupled to the string-producing field. The strings are formed late in inflation as the inflaton rolls towards its zero-temperature value. A large subset of these models have a novel large-scale distribution of galaxies that is fractal, displays biasing without dynamics or feedback mechanisms, and contains voids. (orig.)

  12. Composantes psychologiques des plaintes relatives à la taille du pénis après implantation d'une prothèse pénienne

    OpenAIRE

    Kempeneers, Philippe; Andrianne, Robert; Mormont, Christian; Jeanmart, F.

    2004-01-01

    A survey questionnaire completed by 39 users of penile prosthesis shows that complaints related to the size of the implanted penis involve a decrease in satisfaction towards the prosthetic device. However, a reduced penile size is not necessary considered as a problem by all patients. Beyond functional considerations, the disappointment concerning the length of the penis is mostly related to the representation of a virility debased by the notions of artifice and assistance which are ass...

  13. Dual-chamber inflatable oil boom

    International Nuclear Information System (INIS)

    Blair, R.M.; Tedeschi, E.T.

    1993-01-01

    An elongated floating material containment boom section is described having a normally vertical ballasted skirt depending from flotation means, and convertible from a flattened collapsed condition to a deployable condition wherein buoyancy chamber means extending along the upper edge of said skirt are inflated to expanded buoyant configuration, including: a gas-impervious sleeve extending along the upper edge of said normally vertical skirt forming a first outer collapsible and inflatable flotation chamber, a first inflation valve connecting the interior of said sleeve with the ambient atmosphere, through which gas under pressure may be introduced into said sleeve to inflate said first buoyant outer flotation chamber, elongated gas-impervious tube means positioned inside said outer flotation chamber and forming second collapsible and inflatable internal flotation bladder chamber means, second inflation valve means connecting the interior of said bladder means through said outer flotation chamber to the ambient atmosphere through which gas under pressure may be introduced into said bladder means to inflate it forming said second flotation chamber means inside said outer flotation chamber

  14. Inflation targeting and the anchoring of inflation expectations in the CEE countries

    Directory of Open Access Journals (Sweden)

    Nedeljković Milan

    2017-01-01

    Full Text Available This paper studies the time evolution in the degree and level of anchoring of inflation expectations in four Central and Eastern European inflation targeting countries. The results suggest that the degree of anchoring of inflation expectations increased gradually in all countries over the last decade, while the level of implied inflation targets moved towards the official target. The extent of anchoring increased more strongly in the first years following the IT adoption and more gradually over the later period. We also find that smooth changes of the official target had a positive impact on anchoring. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. 47028: Advancing Serbia’s Competitiveness in the Process of EU Accession

  15. Automated estimation of hip prosthesis migration: a feasibility study

    Science.gov (United States)

    Vandemeulebroucke, Jef; Deklerck, Rudi; Temmermans, Frederik; Van Gompel, Gert; Buls, Nico; Scheerlinck, Thierry; de Mey, Johan

    2013-09-01

    A common complication associated with hip arthoplasty is prosthesis migration, and for most cemented components a migration greater than 0.85 mm within the first six months after surgery, are an indicator for prosthesis failure. Currently, prosthesis migration is evaluated using X-ray images, which can only reliably estimate migrations larger than 5 mm. We propose an automated method for estimating prosthesis migration more accurately, using CT images and image registration techniques. We report on the results obtained using an experimental set-up, in which a metal prosthesis can be translated and rotated with respect to a cadaver femur, over distances and angles applied using a combination of positioning stages. Images are first preprocessed to reduce artefacts. Bone and prosthesis are extracted using consecutive thresholding and morphological operations. Two registrations are performed, one aligning the bones and the other aligning the prostheses. The migration is estimated as the difference between the found transformations. We use a robust, multi-resolution, stochastic optimization approach, and compare the mean squared intensity differences (MS) to mutual information (MI). 30 high-resolution helical CT scans were acquired for prosthesis translations ranging from 0.05 mm to 4 mm, and rotations ranging from 0.3° to 3° . For the translations, the mean 3D registration error was found to be 0.22 mm for MS, and 0.15 mm for MI. For the rotations, the standard deviation of the estimation error was 0.18° for MS, and 0.08° for MI. The results show that the proposed approach is feasible and that clinically acceptable accuracies can be obtained. Clinical validation studies on patient images will now be undertaken.

  16. Availability of Dental Prosthesis Procedures in Brazilian Primary Health Care

    Directory of Open Access Journals (Sweden)

    Maria Aparecida Gonçalves Melo Cunha

    2018-01-01

    Full Text Available Objectives. To describe dental prosthesis provision in the Brazilian public health service and report the performance of dental prosthesis procedures according to the Brazilian macroregions. Methods. A structured interview was conducted with senior-level health professionals from each of the 18,114 oral health teams (OHT. The dependent variables were performance of removable prostheses and prosthesis procedures, including provision of fixed prostheses by OHT. Descriptive statistics were produced together with performing a cluster analysis using SPSS version 19.0. Results. The manufacture of any type of prosthesis was done by a minority of OHT (43%. The most commonly provided types of dental prosthesis were removable full and partial dentures. Cluster 1 (teams that performed prosthesis procedures the most was composed of a smaller number of teams (n = 5,531, and Cluster 2 (composed of teams that do not perform prosthetics or that perform them in small amounts consisted of 12,583 teams. The geographic distribution of clusters reveals that the largest proportion of Cluster 1 teams is located in the Northeast (33.9% and Southeast (33.6%. Conclusions. A minority of OHT produce dental prostheses. There is an unequal geographical distribution of clusters.

  17. Amputation and prosthesis implantation shape body and peripersonal space representations.

    Science.gov (United States)

    Canzoneri, Elisa; Marzolla, Marilena; Amoresano, Amedeo; Verni, Gennaro; Serino, Andrea

    2013-10-03

    Little is known about whether and how multimodal representations of the body (BRs) and of the space around the body (Peripersonal Space, PPS) adapt to amputation and prosthesis implantation. In order to investigate this issue, we tested BR in a group of upper limb amputees by means of a tactile distance perception task and PPS by means of an audio-tactile interaction task. Subjects performed the tasks with stimulation either on the healthy limb or the stump of the amputated limb, while wearing or not wearing their prosthesis. When patients performed the tasks on the amputated limb, without the prosthesis, the perception of arm length shrank, with a concurrent shift of PPS boundaries towards the stump. Conversely, wearing the prosthesis increased the perceived length of the stump and extended the PPS boundaries so as to include the prosthetic hand, such that the prosthesis partially replaced the missing limb.

  18. 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 ...

  19. The Flavour of Inflation

    International Nuclear Information System (INIS)

    Zavala, I.

    2008-01-01

    A new class of particle physics models of inflation based on the phase transition associated with the spontaneous breaking of family symmetry is proposed. The Higgs fields responsible for the breaking of family symmetry, the flavons, are natural inflaton candidates or waterfall fields in hybrid inflation. This opens up a rich vein of possible inflation models, all linked to the physics of flavour, with several interesting cosmological implications.

  20. Topological defects in extended inflation

    International Nuclear Information System (INIS)

    Copeland, E.J.; Kolb, E.W.; Chicago Univ., IL; Liddle, A.R.

    1990-04-01

    We consider the production of topological defects, especially cosmic strings, in extended inflation models. In extended inflation, the Universe passes through a first-order phase transition via bubble percolation, which naturally allows defects to form at the end of inflation. The correlation length, which determines the number density of the defects, is related to the mean size of bubbles when they collide. This mechanism allows a natural combination of inflation and large-scale structure via cosmic strings. 18 refs

  1. Topological defects in extended inflation

    International Nuclear Information System (INIS)

    Copeland, E.J.; Kolb, E.W.; Liddle, A.R.

    1990-01-01

    We consider the production of topological defects, especially cosmic strings, in extended-inflation models. In extended inflation, the Universe passes through a first-order phase transition via bubble percolation, which naturally allows defects to form at the end of inflation. The correlation length, which determines the number density of the defects, is related to the mean size of the bubbles when they collide. This mechanism allows a natural combination of inflation and large-scale structure via cosmic strings

  2. Accidental inflation from Kaehler uplifting

    International Nuclear Information System (INIS)

    Ben-Dayan, Ido; Westphal, Alexander; Wieck, Clemens; Jing, Shenglin; Toronto Univ., ON

    2013-09-01

    We analyze the possibility of realizing inflation with a subsequent dS vacuum in the Kaehler uplifting scenario. The inclusion of several quantum corrections to the 4d effective action evades previous no-go theorems and allows for construction of simple and successful models of string inflation. The predictions of several benchmark models are in accord with current observations, i.e., a red spectral index, negligible non-gaussianity, and spectral distortions similar to the simplest models of inflation. A particularly interesting subclass of models are ''left-rolling'' ones, where the overall volume of the compactified dimensions shrinks during inflation. We call this phenomenon ''inflation by deflation'' (IBD), where deflation refers to the internal manifold. This subclass has the appealing features of being insensitive to initial conditions, avoiding the overshooting problem, and allowing for observable running α -5 . The latter results differ significantly from many string inflation models.

  3. 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.

  4. Unitarizing Higgs Inflation

    CERN Document Server

    Giudice, Gian F

    2011-01-01

    We consider a simple extension of the Standard Model Higgs inflation with one new real scalar field which preserves unitarity up to the Planck scale. The new scalar field (called sigma) completes in the ultraviolet the theory of Higgs inflation by linearizing the Higgs kinetic term in the Einstein frame, just as the non-linear sigma model is unitarized into its linear version. The unitarity cutoff of the effective theory, obtained by integrating out the sigma field, varies with the background value of the Higgs field. In our setup, both the Higgs field and the sigma field participate in the inflationary dynamics, following the flat direction of the potential. We obtain the same slow-roll parameters and spectral index as in the original Higgs inflation but we find that the Hubble rate during inflation depends not only on the Higgs self-coupling, but also on the unknown couplings of the sigma field.

  5. Unitarizing Higgs inflation

    International Nuclear Information System (INIS)

    Giudice, Gian F.; Lee, Hyun Min

    2011-01-01

    We consider a simple extension of the Standard Model Higgs inflation with one new real scalar field which preserves unitarity up to the Planck scale. The new scalar field (called sigma) completes in the ultraviolet the theory of Higgs inflation by linearizing the Higgs kinetic term in the Einstein frame, just as the non-linear sigma model is unitarized into its linear version. The unitarity cutoff of the effective theory, obtained by integrating out the sigma field, varies with the background value of the Higgs field. In our setup, both the Higgs field and the sigma field participate in the inflationary dynamics, following the flat direction of the potential. We obtain the same slow-roll parameters and spectral index as in the original Higgs inflation but we find that the Hubble rate during inflation depends not only on the Higgs self-coupling, but also on the unknown couplings of the sigma field.

  6. Extended inflation with nonminimally coupled inflation field

    International Nuclear Information System (INIS)

    Panchapakesan, N.; Sethi, S.K.

    1992-01-01

    In this paper, an extended inflation model, in which the inflation field is nonminimally coupled to the gravity, is discussed. It is shown that the nucleation rate of bubbles, during a phase transition in the inflaton field, can increase as the transition proceeds for a wide range of parameters of the inflaton potential. The bounce action for three possible cases - the strong gravity regime, the thick-walled Coleman-DeLuccia bubbles and the thin-walled bubbles - is evaluated. The resulting bubble distribution for all the cases is shown to be in conformity with cosmological constraints for ω < 500

  7. Tribrid Inflation in Supergravity

    Science.gov (United States)

    Antusch, Stefan; Dutta, Koushik; Kostka, Philipp M.

    We propose a novel class of F-term hybrid inflation models in supergravity (SUGRA) where the η-problem is resolved using either a Heisenberg symmetry or a shift symmetry of the Kähler potential. In addition to the inflaton and the waterfall field, this class (referred to as tribrid inflation) contains a third "driving" field which contributes the large vacuum energy during inflation by its F-term. In contrast to the "standard" hybrid scenario, it has several attractive features due to the property of vanishing inflationary superpotential (Winf = 0) during inflation. Quantum corrections induced by symmetry breaking terms in the superpotential generate a slope of the potential and lead to a spectral tilt consistent with recent WMAP observations.

  8. Management of long span partially edentulous maxilla with fixed removable denture prosthesis.

    Science.gov (United States)

    Jeyavalan, Mahilan I; Narasimman, M; Venkatakrishnan, C J; Philip, Jacob M

    2012-07-01

    Restoration of a long span partially edentulous maxilla with tooth supported prosthesis is challenging because of inherent anatomic limitations and unfavourable biomechanics present after the loss of teeth. A tooth supported fixed-removable prosthesis is a treatment option for restoration of such long span partially edentulous maxillary arches. This prosthesis meets the requirements for esthetics, phonetics, comfort, and hygiene, as well as favourable biomechanical stress distribution to the remaining natural tooth abutments. This article presents a procedure for fabrication of a fixed-removable prosthesis that has cement-retained custom cast bar metal substructure and a ball attachment retained removable superstructure prosthesis.

  9. Stochastic effects in hybrid inflation

    Science.gov (United States)

    Martin, Jérôme; Vennin, Vincent

    2012-02-01

    Hybrid inflation is a two-field model where inflation ends due to an instability. In the neighborhood of the instability point, the potential is very flat and the quantum fluctuations dominate over the classical motion of the inflaton and waterfall fields. In this article, we study this regime in the framework of stochastic inflation. We numerically solve the two coupled Langevin equations controlling the evolution of the fields and compute the probability distributions of the total number of e-folds and of the inflation exit point. Then, we discuss the physical consequences of our results, in particular, the question of how the quantum diffusion can affect the observable predictions of hybrid inflation.

  10. 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

  11. A two-states Markov-switching model of inflation in France and the USA: credible target VS inflation spiral

    OpenAIRE

    B. HEITZ

    2005-01-01

    This paper seeks to apply the general framework of Markov-switching models to inflation in France and in the USA. We propose a model where inflation can, alternatively, follow two regimes: the first one, where inflation is stationary, is interpreted as a situation where there exists a credible inflation target, even if it is not explicit; the second one where inflation is integrated. Moreover, observing that the two oil shocks were followed by accelerating inflation periods, we allow dependen...

  12. Dosimetric influence of hip prosthesis during radiotherapeutic treatment

    International Nuclear Information System (INIS)

    Gschwind, R.; Buffard, E.; Masset, H.; Makovicka, L.; David, C.; David, C.; Buffard, E.

    2008-01-01

    As the population become aged, many patients with hip prosthesis are treated for a pelvic cancer. The recommended ballistic must avoid to pass in the prosthesis, but sometimes it is inevitable. So it is essential to quantify with accuracy the dose modifications linked to the presence of metallic implant. The aim of this study is to analyze by Monte Carlo method these modifications in simple and complex models (anthropomorphic phantom) which take into account the geometry and the composition of the prosthesis and its coatings. Then, this methodology was used to study the behaviour of a treatment planning system in theses extreme conditions. (authors)

  13. Impact of hip prosthesis on dose distribution of pelvic radiotherapy

    International Nuclear Information System (INIS)

    Ren Jiangping; Zhang Songfang; Zhu Qibao; Guo Jianxin; Zha Yuanzi

    2011-01-01

    Objective: To study the scattering effect of Co-Cr-Mo hip prosthesis which was high Z material for patients undergoing pelvic irradiation. Methods: The hip prosthesis was set in water phantom (30 cm x 30 cm x 30 cm), determining points were chosen on the entrance side of both 6 MV and 10 MV beams at the distance of 0.5 cm, 1.0 cm, 2.0 cm to the hip prosthesis, and also on the exit side of both 6 MV and 10 MV beams at the distance of 3.0 cm, 5.0 cm, 7.0 cm to the hip prostheses. Dose behind the hip prosthesis at depths of 5.0 cm and 10.0 cm for 6 MV and 10 MV beams are also measured. Results: The dose deviation on the beams' entrance side is between 0 to 5.0%, the backscatter effect was more obviously with the higher energy beam. The dose deviation on the beams' exit side was between 21.6%-30.8%. With the same field size and depth, dose deviation becomes smaller when the beam energy was higher; while with the same energy and depth, dose deviation becomes smaller when the field size was bigger. Dose profiles behind the head of the hip prosthesis indicate obvious attenuation of the beam. Conclusions: Beam arrangements that avoid the prosthesis should be considered first or we should at least reduce the weight of the beam that pass through the prosthesis. (authors)

  14. 21 CFR 888.3810 - Wrist joint ulnar (hemi-wrist) polymer prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Wrist joint ulnar (hemi-wrist) polymer prosthesis. 888.3810 Section 888.3810 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... (hemi-wrist) polymer prosthesis. (a) Identification. A wrist joint ulnar (hemi-wrist) polymer prosthesis...

  15. 21 CFR 888.3730 - Toe joint phalangeal (hemi-toe) polymer prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Toe joint phalangeal (hemi-toe) polymer prosthesis. 888.3730 Section 888.3730 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... (hemi-toe) polymer prosthesis. (a) Identification. A toe joint phalangeal (hemi-toe) polymer prosthesis...

  16. 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

  17. Air-Inflated Fabric Structures

    National Research Council Canada - National Science Library

    Cavallaro, Paul V; Sadegh, Ali M

    2006-01-01

    .... Examples include air ships, weather balloons, inflatable antennas and radomes, temporary shelters, pneumatic muscles and actuators, inflatable boats, temporary bridging, and energy absorbers such as automotive air bags...

  18. Reversal Surgery in Regretful Male-to-Female Transsexuals After Sex Reassignment Surgery.

    Science.gov (United States)

    Djordjevic, Miroslav L; Bizic, Marta R; Duisin, Dragana; Bouman, Mark-Bram; Buncamper, Marlon

    2016-06-01

    Sex reassignment surgery (SRS) has proved an effective intervention for patients with gender identity disorder. However, misdiagnosed patients sometimes regret their decision and request reversal surgery. This review is based on our experience with seven patients who regretted their decision to undergo male-to-female SRS. To analyze retrospectively seven patients who underwent reversal surgery after regretting their decision to undergo male-to-female SRS elsewhere. From November 2010 through November 2014, seven men 33 to 53 years old with previous male-to-female SRS underwent reversal phalloplasty. Preoperatively, they were examined by three independent psychiatrists. Surgery included three steps: removal of female genitalia with scrotoplasty and urethral lengthening, total phalloplasty with microvascular transfer of a musculocutaneous latissimus dorsi flap, and neophallus urethroplasty with penile prosthesis implantation. Self-reported esthetic and psychosexual status after reversion surgery and International Index of Erectile Function scores for sexual health after phalloplasty and penile prosthesis implantation. Follow-up was 13 to 61 months (mean = 31 months). Good postoperative results were achieved in all patients. In four patients, all surgical steps were completed; two patients are currently waiting for penile implants; and one patient decided against the penile prosthesis. Complications were related to urethral lengthening: two fistulas and one stricture were observed. All complications were repaired by minor revision. According to patients' self-reports, all patients were pleased with the esthetic appearance of their genitalia and with their significantly improved psychological status. Reversal surgery in regretful male-to-female transsexuals after SRS represents a complex, multistage procedure with satisfactory outcomes. Further insight into the characteristics of persons who regret their decision postoperatively would facilitate better future

  19. THE INFLATION IMPACT OF SELECTED EUROPEAN UNION MEMBERS ON POLISH INFLATION

    Directory of Open Access Journals (Sweden)

    Jarosław Czaja

    2012-06-01

    Full Text Available The article aims at determining the inflation influence between Poland and selected EU member states. Although for some time the general inflation level in those countries was definitely controllable, the problem seems to be returning. That is why in this article, using the model of Vector AutoRegression (VAR and Granger causality test, we are attempting to determine inflation influences on Poland. The study confirmed the impact of the selected countries on Polish inflation, expressed the general HICP index. However, in the case of Germany, the method has not proved the existence of such interactions. For this reason, it is made an attempt to clarify the reasons for non-compliance findings with data showing Germany as a Polish main trading partner for more than two decades. The authors try to show that lack of influence can be seen in the excessive generality of the main HICP index and predict that the chosen method confirm the effect of foreign trade indices in the HICP.

  20. Changes in Inflation Dynamics under Inflation Targeting? Evidence from Central European Countries

    Czech Academy of Sciences Publication Activity Database

    Baxa, Jaromír; Plašil, M.; Vašíček, B.

    2013-01-01

    Roč. 11, č. 1 (2013), s. 2-5 ISSN 1803-7089 Institutional support: RVO:67985556 Keywords : Inflation Dynamics * Inflation Targeting? Subject RIV: AH - Economics http://library.utia.cas.cz/separaty/2013/E/baxa-0395372.pdf

  1. Supersymmetric Majoron inflation

    Energy Technology Data Exchange (ETDEWEB)

    King, Stephen F.; Ludl, Patrick Otto [School of Physics and Astronomy, University of Southampton,Southampton, SO17 1BJ (United Kingdom)

    2017-03-31

    We propose supersymmetric Majoron inflation in which the Majoron field Φ responsible for generating right-handed neutrino masses may also be suitable for giving low scale “hilltop” inflation, with a discrete lepton number ℤ{sub N} spontaneously broken at the end of inflation, while avoiding the domain wall problem. In the framework of non-minimal supergravity, we show that a successful spectral index can result with small running together with small tensor modes. We show that a range of heaviest right-handed neutrino masses can be generated, m{sub N}∼10{sup 1}−10{sup 16} GeV, consistent with the constraints from reheating and domain walls.

  2. Pre-inflation physics and scalar perturbations

    International Nuclear Information System (INIS)

    Hirai, Shiro

    2005-01-01

    The effect of pre-inflation physics on the power spectrum of scalar perturbations is investigated. Considering various pre-inflation models with radiation-dominated or matter-dominated periods before inflation, the power spectra of curvature perturbations for large scales are calculated, and the spectral index and running spectral index are derived. It is shown that pre-inflation models in which the length of inflation is near 60 e-folds may reproduce some key properties implied by the Wilkinson microwave anisotropy probe data

  3. Design and Control of a Pneumatically Actuated Transtibial Prosthesis.

    Science.gov (United States)

    Zheng, Hao; Shen, Xiangrong

    2015-04-01

    This paper presents the design and control of a pneumatically actuated transtibial prosthesis, which utilizes a pneumatic cylinder-type actuator to power the prosthetic ankle joint to support the user's locomotion. The pneumatic actuator has multiple advantages over the traditional electric motor, such as light weight, low cost, and high power-to-weight ratio. The objective of this work is to develop a compact and lightweight transtibial prosthesis, leveraging the multiple advantages provided by this highly competitive actuator. In this paper, the design details of the prosthesis are described, including the determination of performance specifications, the layout of the actuation mechanism, and the calculation of the torque capacity. Through the authors' design calculation, the prosthesis is able to provide sufficient range of motion and torque capacity to support the locomotion of a 75 kg individual. The controller design is also described, including the underlying biomechanical analysis and the formulation of the finite-state impedance controller. Finally, the human subject testing results are presented, with the data indicating that the prosthesis is able to generate a natural walking gait and sufficient power output for its amputee user.

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

    Directory of Open Access Journals (Sweden)

    Theddeus O.H. Prasetyono

    2011-08-01

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

  5. Prosthesis rejection in acquired major upper-limb amputees: a population-based survey.

    Science.gov (United States)

    Østlie, Kristin; Lesjø, Ingrid Marie; Franklin, Rosemary Joy; Garfelt, Beate; Skjeldal, Ola Hunsbeth; Magnus, Per

    2012-07-01

    To estimate the rates of primary and secondary prosthesis rejection in acquired major upper-limb amputees (ULAs), to describe the most frequently reported reasons for rejection and to estimate the influence of background factors on the risk of rejection. Cross-sectional study analysing population-based questionnaire data (n = 224). Effects were analysed by logistic regression analyses and Cox regression analyses. Primary prosthesis rejection was found in 4.5% whereas 13.4% had discontinued prosthesis use. The main reasons reported for primary non-wear were a perceived lack of need and discrepancies between perceived need and the prostheses available. The main reasons reported for secondary prosthesis rejection were dissatisfaction with prosthetic comfort, function and control. Primary prosthesis rejection was more likely in ULAs amputated at high age and in ULAs with proximal amputations. Secondary prosthesis rejection was more likely in proximal ULAs and in women. Clinicians should be aware of the increased risk of rejection in proximal ULAs, elderly ULAs and in women. Emphasising individual needs will probably facilitate successful prosthetic fitting. Improved prosthesis quality and individualised prosthetic training may increase long-term prosthesis use. Further studies of the effect of prosthetic training and of the reasons for rejection of different prosthetic types are suggested.

  6. IAS15 inflation adjustments and EVA: empirical evidence from a highly variable inflation regime

    Directory of Open Access Journals (Sweden)

    Pierre Erasmus

    2011-08-01

    Full Text Available Inflation can have a pronounced effect on the financial performance of a firm. This study makes inflation adjustments to a firm’s cost of sales, depreciation, level of gearing and assets in line with International Accounting Standard 15 (IAS15 in order to calculate an inflation-adjusted version of the economic value added (EVA measure. The study was conducted using data from South African industrial firms during a period characterised by highly variable inflation levels (1991-2005. The results indicate that during this period there were significant differences between the nominal and real values of the firms’ EVAs

  7. 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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-12-15

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

  9. ''Old'' locked inflation

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Yang; Piao, Yun-Song [College of Physical Sciences, Graduate University of Chinese Academy of Sciences, Beijing 100049 (China); Si, Zong-Guo, E-mail: liuyangbyf@mail.sdu.edu.cn, E-mail: yspiao@gucas.ac.cn, E-mail: zgsi@sdu.edu.cn [Department of Physics, Shandong University, Jinan 250100 (China)

    2009-05-15

    In this paper, we revisit the idea of locked inflation, which does not require a potential satisfying the normal slow-roll condition, but suffers from the problems associated with ''saddle inflation''. We propose a scenario based on locked inflation, however, with an alternative evolution mechanism of the ''waterfall field'' {phi}. Instead of rolling down along the potential, the {phi} field will tunnel to end the inflation stage like in old inflation, by which the saddle inflation could be avoided. Further, we study a cascade of old locked inflation, which can be motivated by the string landscape. Our model is based on the consideration of making locked inflation feasible so as to give a working model without slow roll; It also can be seen as an effort to embed the old inflation in string landscape.

  10. Management of long span partially edentulous maxilla with fixed removable denture prosthesis

    Directory of Open Access Journals (Sweden)

    Mahilan I Jeyavalan

    2012-01-01

    Full Text Available Restoration of a long span partially edentulous maxilla with tooth supported prosthesis is challenging because of inherent anatomic limitations and unfavourable biomechanics present after the loss of teeth. A tooth supported fixed-removable prosthesis is a treatment option for restoration of such long span partially edentulous maxillary arches. This prosthesis meets the requirements for esthetics, phonetics, comfort, and hygiene, as well as favourable biomechanical stress distribution to the remaining natural tooth abutments. This article presents a procedure for fabrication of a fixed-removable prosthesis that has cement-retained custom cast bar metal substructure and a ball attachment retained removable superstructure prosthesis.

  11. Estimating Venezuelas Latent Inflation

    OpenAIRE

    Juan Carlos Bencomo; Hugo J. Montesinos; Hugo M. Montesinos; Jose Roberto Rondo

    2011-01-01

    Percent variation of the consumer price index (CPI) is the inflation indicator most widely used. This indicator, however, has some drawbacks. In addition to measurement errors of the CPI, there is a problem of incongruence between the definition of inflation as a sustained and generalized increase of prices and the traditional measure associated with the CPI. We use data from 1991 to 2005 to estimate a complementary indicator for Venezuela, the highest inflation country in Latin America. Late...

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

    Directory of Open Access Journals (Sweden)

    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.

  13. 21 CFR 872.3970 - Interarticular disc prosthesis (interpositional implant).

    Science.gov (United States)

    2010-04-01

    ... implant). 872.3970 Section 872.3970 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3970 Interarticular disc prosthesis (interpositional implant). (a) Identification. An interarticular disc prosthesis...

  14. 12 CFR 19.240 - Inflation adjustments.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 1 2010-01-01 2010-01-01 false Inflation adjustments. 19.240 Section 19.240... PROCEDURE Civil Money Penalty Inflation Adjustments § 19.240 Inflation adjustments. (a) The maximum amount... Civil Penalties Inflation Adjustment Act of 1990 (28 U.S.C. 2461 note) as follows: ER10NO08.001 (b) The...

  15. Mutated hilltop inflation revisited

    Science.gov (United States)

    Pal, Barun Kumar

    2018-05-01

    In this work we re-investigate pros and cons of mutated hilltop inflation. Applying Hamilton-Jacobi formalism we solve inflationary dynamics and find that inflation goes on along the {W}_{-1} branch of the Lambert function. Depending on the model parameter mutated hilltop model renders two types of inflationary solutions: one corresponds to small inflaton excursion during observable inflation and the other describes large field inflation. The inflationary observables from curvature perturbation are in tune with the current data for a wide range of the model parameter. The small field branch predicts negligible amount of tensor to scalar ratio r˜ O(10^{-4}), while the large field sector is capable of generating high amplitude for tensor perturbations, r˜ O(10^{-1}). Also, the spectral index is almost independent of the model parameter along with a very small negative amount of scalar running. Finally we find that the mutated hilltop inflation closely resembles the α -attractor class of inflationary models in the limit of α φ ≫ 1.

  16. Reading visual braille with a retinal prosthesis.

    Science.gov (United States)

    Lauritzen, Thomas Z; Harris, Jordan; Mohand-Said, Saddek; Sahel, Jose A; Dorn, Jessy D; McClure, Kelly; Greenberg, Robert J

    2012-01-01

    Retinal prostheses, which restore partial vision to patients blinded by outer retinal degeneration, are currently in clinical trial. The Argus II retinal prosthesis system was recently awarded CE approval for commercial use in Europe. While retinal prosthesis users have achieved remarkable visual improvement to the point of reading letters and short sentences, the reading process is still fairly cumbersome. This study investigates the possibility of using an epiretinal prosthesis to stimulate visual braille as a sensory substitution for reading written letters and words. The Argus II retinal prosthesis system, used in this study, includes a 10 × 6 electrode array implanted epiretinally, a tiny video camera mounted on a pair of glasses, and a wearable computer that processes the video and determines the stimulation current of each electrode in real time. In the braille reading system, individual letters are created by a subset of dots from a 3 by 2 array of six dots. For the visual braille experiment, a grid of six electrodes was chosen out of the 10 × 6 Argus II array. Groups of these electrodes were then directly stimulated (bypassing the camera) to create visual percepts of individual braille letters. Experiments were performed in a single subject. Single letters were stimulated in an alternative forced choice (AFC) paradigm, and short 2-4-letter words were stimulated (one letter at a time) in an open-choice reading paradigm. The subject correctly identified 89% of single letters, 80% of 2-letter, 60% of 3-letter, and 70% of 4-letter words. This work suggests that text can successfully be stimulated and read as visual braille in retinal prosthesis patients.

  17. Is non-minimal inflation eternal?

    International Nuclear Information System (INIS)

    Feng, Chao-Jun; Li, Xin-Zhou

    2010-01-01

    The possibility that the non-minimal coupling inflation could be eternal is investigated. We calculate the quantum fluctuation of the inflaton in a Hubble time and find that it has the same value as that in the minimal case in the slow-roll limit. Armed with this result, we have studied some concrete non-minimal inflationary models including the chaotic inflation and the natural inflation, in which the inflaton is non-minimally coupled to the gravity. We find that the non-minimal coupling inflation could be eternal in some parameter spaces.

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

    Directory of Open Access Journals (Sweden)

    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.

  19. Testicular prosthesis: Patient satisfaction and sexual dysfunctions in testis cancer survivors.

    Science.gov (United States)

    Catanzariti, Francesco; Polito, Benedetta; Polito, Massimo

    2016-10-05

    We studied patient satisfaction about sexual activity after prosthesis implantation using validated questionnaires with the aim to discover if testicular prosthesis could be responsible of sexual dysfunctions (erectile dysfunction or premature ejaculation). We evaluated a total of 67 men who underwent radical orchiectomy for testicular cancer and a silicon testicular prosthesis implantation from January 2008 to June 2014 at our Hospital. These patients completed 5 validated questionnaires the day before orchiectomy and 6 months after surgery: the International Index of Erectile Function 5 (IIEF5), the Premature Ejaculation Diagnostic Tool (PEDT), the Body Exposure during Sexual Activities Questionnaire (BESAQ), the Body-Esteem Scale and the Rosenberg Self- Esteem Scale. We also evaluated 6 months after surgery any defects of the prosthesis complained by the patients. The questionnaires completed by patients didn't show statistically significant changes for erectile dysfunction (p > 0.05) and premature ejaculation (p > 0.05). On the contrary the psychological questionnaires showed statistically significant change for the BESAQ (p < 0.001) and the Body Esteem Scale (p < 0.001), but not for the Rosenberg Self-Esteem Scale (p > 0,05). A total of 15 patients (22.37%) were dissatisfied about the prosthesis: the most frequent complaint (8 patients; 11.94%) was that the prosthesis was firmer than the normal testis. Testicular prosthesis implantation is a safe surgical procedure that should be always proposed before orchiectomy for cancer of the testis. The defects complained by patients with testicular prosthesis are few, they don't influence sexual activity and they aren't able to cause erectile dysfunction or premature ejaculation.

  20. Nasal prosthesis for a patient with xeroderma pigmentosum

    Directory of Open Access Journals (Sweden)

    Suresh Kumar

    2013-01-01

    Full Text Available Acquired facial defects caused by extirpation of neoplasms, congenital malformations or traumatic injury results in a huge functional, cosmetic and psychological handicap in those patients. These defects can be restored by facial prosthesis using different materials and retention methods to achieve a lifelike appearance and function. This clinical report describes a treatment schedule using silicone nasal prosthesis, which is mechanically retained for a patient who has undergone a partial rhinectomy due to basal cell carcinoma of the nose. The prosthesis was made to restore the esthetic appearance of patient with a mechanically retained design using a spectacle glass frame without any prosthetic adhesives so that the patient is more comfortable and confident to resume daily activities.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  3. Inflation in AdS/CFT

    Energy Technology Data Exchange (ETDEWEB)

    Freivogel, Ben; /Stanford U., Phys. Dept. /LBL, Berkeley; Hubeny, Veronika E.; /LBL, Berkeley /Durham U., Dept. of Math.; Maloney, Alexander; /Stanford U., Phys. Dept.; Myers, Rob; /Perimeter Inst. Theor. Phys. /Waterloo U.; Rangamani, Mukund; /LBL, Berkeley /Durham U., Dept. of Math.; Shenker, Stephen; /Stanford U., Phys. Dept.

    2005-10-07

    We study the realization of inflation within the AdS/CFT correspondence. We assume the existence of a string landscape containing at least one stable AdS vacuum and a (nearby) metastable de Sitter state. Standard arguments imply that the bulk physics in the vicinity of the AdS minimum is described by a boundary CFT. We argue that large enough bubbles of the dS phase, including those able to inflate, are described by mixed states in the CFT. Inflating degrees of freedom are traced over and do not appear explicitly in the boundary description. They nevertheless leave a distinct imprint on the mixed state. Analytic continuation allows us, in principle, to recover a large amount of nonperturbatively defined information about the inflating regime. Our work also shows that no scattering process can create an inflating region, even by quantum tunneling, since a pure state can never evolve into a mixed state under unitary evolution.We study the realization of inflation within the AdS/CFT correspondence. We assume the existence of a string landscape containing at least one stable AdS vacuum and a (nearby) metastable de Sitter state. Standard arguments imply that the bulk physics in the vicinity of the AdS minimum is described by a boundary CFT. We argue that large enough bubbles of the dS phase, including those able to inflate, are described by mixed states in the CFT. Inflating degrees of freedom are traced over and do not appear explicitly in the boundary description. They nevertheless leave a distinct imprint on the mixed state. Analytic continuation allows us, in principle, to recover a large amount of nonperturbatively defined information about the inflating regime. Our work also shows that no scattering process can create an inflating region, even by quantum tunneling, since a pure state can never evolve into a mixed state under unitary evolution.

  4. Testing Cosmic Inflation

    Science.gov (United States)

    Chuss, David

    2010-01-01

    The Cosmic Microwave Background (CMB) has provided a wealth of information about the history and physics of the early Universe. Much progress has been made on uncovering the emerging Standard Model of Cosmology by such experiments as COBE and WMAP, and ESA's Planck Surveyor will likely increase our knowledge even more. Despite the success of this model, mysteries remain. Currently understood physics does not offer a compelling explanation for the homogeneity, flatness, and the origin of structure in the Universe. Cosmic Inflation, a brief epoch of exponential expansion, has been posted to explain these observations. If inflation is a reality, it is expected to produce a background spectrum of gravitational waves that will leave a small polarized imprint on the CMB. Discovery of this signal would give the first direct evidence for inflation and provide a window into physics at scales beyond those accessible to terrestrial particle accelerators. I will briefly review aspects of the Standard Model of Cosmology and discuss our current efforts to design and deploy experiments to measure the polarization of the CMB with the precision required to test inflation.

  5. 99m technetium-MDP bone scintigraphy in evaluation of painful joint prosthesis

    International Nuclear Information System (INIS)

    Milosevic, D.; Jaukovic, M.; Jaukovic, Lj.; Ajdinovic, B.

    2004-01-01

    In addition of clinical evaluation and x-ray radiography, the diagnosis of a loose joint prosthesis is often made by nuclear medicine imaging techniques. Differentiation between loosening and infected prosthesis is important for better treatment of those patients. Aim: The aim of this study was to reevaluate the scintigraphic patterns in patients with painful hip of knee arthroplasty. Material and Method: From 1996. to 2003. forty patients aged 49-78 years were referred for evaluation of possible loosening/infection joint prosthesis: 36 pts with 39 total/ partial hip prosthesis, 1 pt with knee prosthesis and 3 pts with history of previously extracted hip prosthesis due to infection. Whole body acquisition had been performed with a single head gamma camera three hours after the injection of 740 MBq 99m Tc-MDP. Scans were classified as: positive for loosening if abnormal uptake was shown at the tip of the prosthesis; positive for infection if diffuse abnormal uptake was shown around the implant; negative and indeterminate scans. Scintigraphic findings were compared to clinical follow up, histology or cultures. Results: Positive findings were found in 17 bone scans strongly suggesting loosening in 10 cases, infection of prosthesis in 4 cases and both loosening/infection in 3 cases. Bone scintigraphy was normal in 11pts. Scans of three pts with previously extracted hip prosthesis and scheduled for reimplatation, showed inhomogeneously and mildly increased uptake in femur. Most of scans classified as indeterminate (n=12) showed slightly increased tracer uptake in region of acetabular roof, greater or lesser tho chanter, suggesting bone remodeling due to the presence of implant, rather than loosening. Conclusion: 99m Tc-MDP bone scintigraphy had a significant role in assessing the painful joint prosthesis. Complementary diagnostic procedures should be considered in indeterminate scintiscans. (authors)

  6. Inflation and quantum cosmology

    International Nuclear Information System (INIS)

    Linde, A.

    1991-01-01

    In this article a review of the present status of inflationary cosmology is given. We start with a discussion of the simplest version of the chaotic inflation scenario. Then we discuss some recent develoments in the inflationary cosmology, including the theory of a self-reproducing inflationary universe (eternal chaotic inflation). We do it with the help of stochastic approach to inflation. The results obtained within this approach are compared with the results obtained in the context of Euclidean quantum cosmology. (WL)

  7. Interest Rates and Inflation

    OpenAIRE

    Coopersmith, Michael; Gambardella, Pascal J.

    2016-01-01

    This article is an extension of the work of one of us (Coopersmith, 2011) in deriving the relationship between certain interest rates and the inflation rate of a two component economic system. We use the well-known Fisher relation between the difference of the nominal interest rate and its inflation adjusted value to eliminate the inflation rate and obtain a delay differential equation. We provide computer simulated solutions for this equation over regimes of interest. This paper could be of ...

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

    Directory of Open Access Journals (Sweden)

    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.

  9. Microwave background anisotropies in quasiopen inflation

    Science.gov (United States)

    García-Bellido, Juan; Garriga, Jaume; Montes, Xavier

    1999-10-01

    Quasiopenness seems to be generic to multifield models of single-bubble open inflation. Instead of producing infinite open universes, these models actually produce an ensemble of very large but finite inflating islands. In this paper we study the possible constraints from CMB anisotropies on existing models of open inflation. The effect of supercurvature anisotropies combined with the quasiopenness of the inflating regions make some models incompatible with observations, and severely reduces the parameter space of others. Supernatural open inflation and the uncoupled two-field model seem to be ruled out due to these constraints for values of Ω0<~0.98. Others, such as the open hybrid inflation model with suitable parameters for the slow roll potential can be made compatible with observations.

  10. Control and Evaluation of a Powered Transfemoral Prosthesis for Stair Ascent.

    Science.gov (United States)

    Ledoux, Elissa D; Goldfarb, Michael

    2017-07-01

    This paper assesses the metabolic effort exerted by three transfemoral amputees, when using a powered knee and ankle prosthesis for stair ascent, relative to ascending stairs with passive knee and ankle prostheses. The paper describes a controller that provides step-over stair ascent behavior reflective of healthy stair ascent biomechanics, and describes its implementation in a powered prosthesis prototype. Stair ascent experiments were performed with three unilateral transfemoral amputee subjects, comparing the oxygen consumption required to ascend stairs using the powered prosthesis (with a step-over gait), relative to using their daily-use energetically passive prostheses (with a step-to gait). Results indicate on average a 24% reduction in oxygen consumption and a 30% reduction in stair ascent timewhen using the powered prosthesis, relative to when using the passive prostheses. All subjects expressed a strong preference for ascending stairs using the powered prosthesis.

  11. Outcome and erectile function following treatment of priapism: An institutional experience

    Directory of Open Access Journals (Sweden)

    Dilip Kumar Pal

    2016-01-01

    Conclusion: Patients with late presentation and those patients requiring higher treatment modalities (e.g., proximal shunts for achieving detumescence will subsequently have a poor erectile function. These patients should be counseled about the early penile prosthesis placement during initial surgical management.

  12. Tribrid Inflation in Supergravity

    International Nuclear Information System (INIS)

    Antusch, Stefan; Dutta, Koushik; Kostka, Philipp M.

    2010-01-01

    We propose a novel class of F-term hybrid inflation models in supergravity (SUGRA) where the η-problem is resolved using either a Heisenberg symmetry or a shift symmetry of the Kaehler potential. In addition to the inflaton and the waterfall field, this class (referred to as tribrid inflation) contains a third 'driving' field which contributes the large vacuum energy during inflation by its F-term. In contrast to the 'standard' hybrid scenario, it has several attractive features due to the property of vanishing inflationary superpotential (W inf = 0) during inflation. While the symmetries of the Kaehler potential ensure a flat inflaton potential at tree-level, quantum corrections induced by symmetry breaking terms in the superpotential generate a slope of the potential and lead to a spectral tilt consistent with recent WMAP observations.

  13. Accidental inflation from Kaehler uplifting

    Energy Technology Data Exchange (ETDEWEB)

    Ben-Dayan, Ido; Westphal, Alexander; Wieck, Clemens [Deutsches Elektronen-Synchrotron DESY, Hamburg (Germany). Theory Group; Jing, Shenglin [Toronto Univ., ON (Canada). Canadian Inst. for Theoretical Astrophysics; Toronto Univ., ON (Canada). Dept. of Astronomy and Astrophysics

    2013-09-15

    We analyze the possibility of realizing inflation with a subsequent dS vacuum in the Kaehler uplifting scenario. The inclusion of several quantum corrections to the 4d effective action evades previous no-go theorems and allows for construction of simple and successful models of string inflation. The predictions of several benchmark models are in accord with current observations, i.e., a red spectral index, negligible non-gaussianity, and spectral distortions similar to the simplest models of inflation. A particularly interesting subclass of models are ''left-rolling'' ones, where the overall volume of the compactified dimensions shrinks during inflation. We call this phenomenon ''inflation by deflation'' (IBD), where deflation refers to the internal manifold. This subclass has the appealing features of being insensitive to initial conditions, avoiding the overshooting problem, and allowing for observable running {alpha}<{proportional_to}0.012 and enhanced tensor-to-scalar ratio r{proportional_to}10{sup -5}. The latter results differ significantly from many string inflation models.

  14. 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 ...

  15. 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 ...

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

    Directory of Open Access Journals (Sweden)

    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.

  17. Initial conditions for chaotic inflation

    International Nuclear Information System (INIS)

    Brandenberger, R.; Kung, J.; Feldman, H.

    1991-01-01

    In contrast to many other inflationary Universe models, chaotic inflation does not depend on fine tuning initial conditions. Within the context of linear perturbation theory, it is shown that chaotic inflation is stable towards both metric and matter perturbations. Neglecting gravitational perturbations, it is shown that chaotic inflation is an attractor in initial condition space. (orig.)

  18. [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.

  19. Do axions need inflation?

    International Nuclear Information System (INIS)

    Davis, R.L.; Shellard, E.P.S.; Massachusetts Inst. of Tech., Cambridge

    1989-01-01

    Without inflation the energy density of relic axions in a Robertson-Walker universe arises not from coherent oscillations of a zero-momentum mode but from radiative decay of axion strings. An estimate of the upper bound on the PQ scale coming from these axions is in conflict with the lower bound from SN1987a. We present analytical and numerical evidence supporting this estimate. If true, then the axion needs inflation. With inflation the axion is safe, but the motivation for axion search experiments is weakened. (orig.)

  20. Peyronie's Reconstruction for Maximum Length and Girth Gain: Geometrical Principles

    Directory of Open Access Journals (Sweden)

    Paulo H. Egydio

    2008-01-01

    Full Text Available Peyronie's disease has been associated with penile shortening and some degree of erectile dysfunction. Surgical reconstruction should be based on giving a functional penis, that is, rectifying the penis with rigidity enough to make the sexual intercourse. The procedure should be discussed preoperatively in terms of length and girth reconstruction in order to improve patient satisfaction. The tunical reconstruction for maximum penile length and girth restoration should be based on the maximum length of the dissected neurovascular bundle possible and the application of geometrical principles to define the precise site and size of tunical incision and grafting procedure. As penile rectification and rigidity are required to achieve complete functional restoration of the penis and 20 to 54% of patients experience associated erectile dysfunction, penile straightening alone may not be enough to provide complete functional restoration. Therefore, phosphodiesterase inhibitors, self-injection, or penile prosthesis may need to be added in some cases.

  1. Stability of compactification during inflation

    International Nuclear Information System (INIS)

    Amendola, L.; Litterio, M.; Occhionero, F.; Kolb, E.W.

    1990-03-01

    The possibility that inflation may trigger an instability in compactification of extra spatial dimensions is considered. In old, new, or extended inflation, the false vacuum energy results in a semiclassical instability in which the scalar field representing the radius of the extra dimensions may tunnel through a potential barrier leading to an expansion of the internal space. In chaotic inflation, if the initial value of the scalar field responsible for inflation is large enough, the internal space becomes classically unstable to ever increasing expansion. Restrictions on inflationary models necessary to keep the extra dimensions small are discussed. 15 refs., 5 figs

  2. Penisimplantater er en god sidste behandlingsmulighed for erektil dysfunction

    DEFF Research Database (Denmark)

    Giraldi, Laura; Felbo, Jakob; Sønksen, Jens

    2015-01-01

    When other treatments fail, penile implants represent the last treatment option in erectile dysfunction. The most commonly used implant is the inflatable three-piece device, which allows the penis to be rigid for sexual intercourse and flaccid during the remaining time. Earlier penile implants were...... associated with high rates of infection and mechanical malfunction. However, technical improvements have greatly reduced these problems. This has resulted in a patient satisfaction rate of 80-90% in most studies. Thus, penile implants are a valid option in motivated patients with erectile dysfunction....

  3. Prosthetic rehabilitation of large mid-facial defect with magnet-retained silicone prosthesis

    Directory of Open Access Journals (Sweden)

    Kirti Jajoo Shrivastava

    2015-01-01

    Full Text Available Rehabilitation of maxillofacial defect patients is a challenging task. The most common prosthetic treatment problem with such patients is, getting adequate retention, stability, and support. In cases of large maxillofacial defect, movement of the prosthesis is inevitable. The primary objectives in rehabilitating the maxillofacial defect patients are to restore the function of mastication, deglutition, speech, and to achieve normal orofacial appearance. This clinical report describes maxillofacial prosthetic rehabilitation of large midfacial defect including orbit along with its contents, zygoma and soft tissues including half of the nose, cheeks, upper lip of left side, accompanying postsurgical microstomia and orofacial communication, which resulted from severe fungal infection mucormycosis. The defect in this case was restored with magnet retained two piece maxillofacial prosthesis having hollow acrylic resin framework and an overlying silicone facial prosthesis. The retention of prosthesis was further enhanced with the use of spectacles. This type of combination prosthesis enhanced the cosmesis and functional acceptability of prosthesis.

  4. Function of obturator prosthesis after maxillectomy and prosthetic obturator rehabilitation

    Directory of Open Access Journals (Sweden)

    Cheng Chen

    2016-04-01

    Full Text Available ABSTRACT INTRODUCTION: Maxillary defects are usually rehabilitated by a prosthetic obturator. OBJECTIVE: This study aimed to evaluate the functioning of obturators prosthesis in patients with unilateral defects after maxillectomy. METHODS: Of 49 patients, 28 underwent to maxillectomy as a result of tumor ablative surgery, and acquired unilateral maxillary defects. Evaluation of the function was performed by applying the Obturator Functional Scale (OFS. RESULTS: From a total of 49 patients, 28 were treated as follows: 9 with a conventional retained obturator prosthesis (COP, 11 (39% with an enhanced retentive obturator prosthesis with stud attachment (POP and 8 (28% with an enhanced retentive obturator prosthesis with magnetic attachment (POM. The mean OFS score was 80. Scores on functions of speech, swallowing and chewing reached statistical significances (p < 0.05 among these three subgroups. Comparing COP and MOP groups, the scores of OFS in the domains of "Speech-ability to speak in public" and "Swallowing-leakage with liquids" were significantly higher in AOP group. Comparing COP group, the scores of OFS in "Swallowing-leakage with solid" and "Chewing/eating" domains were increased significantly (p < 0.05 both in MOP and AOP groups. CONCLUSION: Obturator prosthesis improves oral function of patients after maxillary defects; the retention of the obturator prosthesis enhanced by the addition of attachments showed more benefits in oral function.

  5. Higgs-Palatini inflation and unitarity

    International Nuclear Information System (INIS)

    Bauer, Florian; Demir, Durmus A.

    2011-01-01

    In the Higgs inflation scenario the Higgs field is strongly coupled to the Ricci scalar in order to drive primordial inflation. However, in its original form in pure metric formulation of gravity, the ultraviolet (UV) cutoff of the Higgs interactions and the Hubble rate are of the same magnitude, and this makes the whole inflationary evolution dependent of the unknown UV completion of the Higgs sector. This problem, the unitarity violation, plagues the Higgs inflation scenario. In this Letter we show that, in the Palatini formulation of gravitation, Higgs inflation does not suffer from unitarity violation since the UV cutoff lies parametrically much higher than the Hubble rate so that unknown UV physics does not disrupt the inflationary dynamics. Higgs-Palatini inflation, as we call it, is, therefore, UV-safe, minimal and endowed with predictive power.

  6. Formula inflation

    Directory of Open Access Journals (Sweden)

    Antipov Valerij Ivanovich

    2015-10-01

    Full Text Available The article gives a modern interpretation of the Fisher formula, the calculated velocity of circulation of money supply M2 in the interval 1995-2013 and forecast of its changes until 2030 when hypotheses about the rate of inflation and GDP. Points to the fallacy of its direct use to control inflation and money supply. For a more detailed understanding of the inflationary process proposes a new frequency formula and the explanation of the situation with the regulation of prices in the economy.

  7. Testicular prosthesis: Patient satisfaction and sexual dysfunctions in testis cancer survivors

    Directory of Open Access Journals (Sweden)

    Francesco Catanzariti

    2016-10-01

    Full Text Available Purpose: We studied patient satisfaction about sexual activity after prosthesis implantation using validated questionnaires with the aim to discover if testicular prosthesis could be responsible of sexual dysfunctions (erectile dysfunction or premature ejaculation. Materials and Methods: We evaluated a total of 67 men who underwent radical orchiectomy for testicular cancer and a silicon testicular prosthesis implantation from January 2008 to June 2014 at our Hospital. These patients completed 5 validated questionnaires the day before orchiectomy and 6 months after surgery: the International Index of Erectile Function 5 (IIEF5, the Premature Ejaculation Diagnostic Tool (PEDT, the Body Exposure during Sexual Activities Questionnaire (BESAQ, the Body-Esteem Scale and the Rosenberg Self- Esteem Scale. We also evaluated 6 months after surgery any defects of the prosthesis complained by the patients. Results: The questionnaires completed by patients didn’t show statistically significant changes for erectile dysfunction (p > 0.05 and premature ejaculation (p > 0.05. On the contrary the psychological questionnaires showed statistically significant change for the BESAQ (p < 0.001 and the Body Esteem Scale (p < 0.001, but not for the Rosenberg Self-Esteem Scale (p > 0,05. A total of 15 patients (22.37% were dissatisfied about the prosthesis: the most frequent complaint (8 patients; 11.94% was that the prosthesis was firmer than the normal testis. Conclusions: Testicular prosthesis implantation is a safe surgical procedure that should be always proposed before orchiectomy for cancer of the testis. The defects complained by patients with testicular prosthesis are few, they don’t influence sexual activity and they aren’t able to cause erectile dysfunction or premature ejaculation.

  8. Assessing inflation persistence: micro evidence on an inflation targeting economy

    Czech Academy of Sciences Publication Activity Database

    Babecký, Jan; Coricelli, F.; Horváth, R.

    2009-01-01

    Roč. 59, č. 2 (2009), s. 102-127 ISSN 0015-1920 Grant - others:Česká národní banka(CZ) E5/05 Institutional research plan: CEZ:AV0Z70850503 Keywords : inflation dynamics * persistence * inflation targeting Subject RIV: AH - Economics Impact factor: 0.264, year: 2009 http://journal.fsv.cuni.cz/storage/1153_babeck%C3%BD_horv%C3%A1th_coricelli.pdf

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

    Directory of Open Access Journals (Sweden)

    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.

  10. Estimating the Threshold Level of Inflation for Thailand

    OpenAIRE

    Jiranyakul, Komain

    2017-01-01

    Abstract. This paper analyzes the relationship between inflation and economic growth in Thailand using annual dataset during 1990 and 2015. The threshold model is estimated for different levels of threshold inflation rate. The results suggest that the threshold level of inflation above which inflation significantly slow growth is estimated at 3 percent. The negative relationship between inflation and growth is apparent above this threshold level of inflation. In other words, the inflation rat...

  11. Staggered multi-field inflation

    International Nuclear Information System (INIS)

    Battefeld, Diana; Battefeld, Thorsten; Davis, Anne-Christine

    2008-01-01

    We investigate multi-field inflationary scenarios with fields that drop out of the model in a staggered fashion. This feature is natural in certain multi-field inflationary setups within string theory; for instance, it can manifest itself when fields are related to tachyons that condense, or inter-brane distances that become meaningless when branes annihilate. Considering a separable potential, and promoting the number of fields to a smooth time dependent function, we derive the formalism to deal with these models at the background and perturbed level, providing general expressions for the scalar spectral index and the running. We recover known results of e.g. a dynamically relaxing cosmological constant in the appropriate limits. We further show that isocurvature perturbations are suppressed during inflation, and so perturbations are adiabatic and nearly Gaussian. The resulting setup might be interpreted as a novel type of warm inflation, readily implemented within string theory and without many of the shortcomings associated with warm inflation. To exemplify the applicability of the formalism we consider three concrete models: assisted inflation with exponential potentials as a simple toy model (a graceful exit becomes possible), inflation from multiple tachyons (a constant decay rate of the number of fields and negligible slow roll contributions turns out to be in good agreement with observations) and inflation from multiple M5-branes within M-theory (a narrow stacking of branes yields a consistent scenario)

  12. 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 ...

  13. Use of Powered Prosthesis for Children with Upper Limb Deficiency at Hyogo Rehabilitation Center.

    Directory of Open Access Journals (Sweden)

    Mitsunori Toda

    Full Text Available There has been no research investigating the use of powered prosthetic for children in Japan.To gain better insight into the state of powered prosthesis usage and identify a ratio of rejection among children.Subjects were 37 unilateral below elbow amputees between the ages of 0 and 16 at the time of their first experienced fitting with a powered prosthesis at our Center. The information was collected from medical records and through face-to-face interviews, and we examined rejection rate and the factors affecting the use of powered prosthesis.The rate of discontinuation was 21.6% as 8 of the 37 children stopped using powered prosthesis. All of them were fitted their prosthesis after 2 years of age, and they rejected prosthesis between 5 to 19 years. We found that the level of amputation had no influence on the use of a powered prosthesis.Children fitted before 2 years of age tend to accept their powered prosthesis than those fitted after 2 years. Multidisciprinary team approach, adequate rehabilitation, detailed follow-up and involvement of parents are quite important for introducing powered prosthesis for children.

  14. Changes in performance over time while learning to use a myoelectric prosthesis

    NARCIS (Netherlands)

    Bouwsema, Hanneke; van der Sluis, Corry K.; Bongers, Raoul M.

    2014-01-01

    Background: Training increases the functional use of an upper limb prosthesis, but little is known about how people learn to use their prosthesis. The aim of this study was to describe the changes in performance with an upper limb myoelectric prosthesis during practice. The results provide a basis

  15. The relationship between inflation and inflation uncertainty. Empirical evidence for the newest EU countries.

    Science.gov (United States)

    Viorica, Daniela; Jemna, Danut; Pintilescu, Carmen; Asandului, Mircea

    2014-01-01

    The objective of this paper is to verify the hypotheses presented in the literature on the causal relationship between inflation and its uncertainty, for the newest EU countries. To ensure the robustness of the results, in the study four models for inflation uncertainty are estimated in parallel: ARCH (1), GARCH (1,1), EGARCH (1,1,1) and PARCH (1,1,1). The Granger method is used to test the causality between two variables. The working hypothesis is that groups of countries with a similar political and economic background in 1990 and are likely to be characterized by the same causal relationship between inflation and inflation uncertainty. Empirical results partially confirm this hypothesis. C22, E31, E37.

  16. What is the Globalisation of Inflation?

    OpenAIRE

    Altansukh, Gantungalag; Becker, Ralf; Bratsiotis, George J.; Osborn, Denise R.

    2017-01-01

    This paper studies the globalisation of CPI inflation by analysing core, energy and food components, testing for structural breaks in the relationships between domestic inflation and a corresponding country-specific foreign inflation series at the monthly frequency for OECD countries.The iterative methodology employed separates coefficient and variance breaks, while also taking account of outliers. We find that the overall pattern of globalisation in aggregate inflation is largely driven by c...

  17. [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.

  18. Supersymmetry and Inflation

    CERN Document Server

    Ferrara, Sergio

    2017-01-01

    Theories with elementary scalar degrees of freedom seem nowadays required for simple descriptions of the Standard Model and of the Early Universe. It is then natural to embed theories of inflation in supergravity, also in view of their possible ultraviolet completion in String Theory. After some general remarks on inflation in supergravity, we describe examples of minimal inflaton dynamics which are compatible with recent observations, including higher-curvature ones inspired by the Starobinsky model. We also discuss different scenarios for supersymmetry breaking during and after inflation, which include a revived role for non-linear realizations. In this spirit, we conclude with a discussion of the link, in four dimensions, between "brane supersymmetry breaking" and the super--Higgs effect in supergravity.

  19. Design of a power-asymmetric actuator for a transtibial prosthesis.

    Science.gov (United States)

    Bartlett, Harrison L; Lawson, Brian E; Goldfarb, Michael

    2017-07-01

    This paper presents the design and characterization of a power-asymmetric actuator for a transtibial prosthesis. The device is designed to provide the combination of: 1) joint locking, 2) high power dissipation, and 3) low power generation. This actuator functionality allows for a prosthesis to be designed with minimal mass and power consumption relative to a fully-powered robotic prosthesis while maintaining much of the functionality necessary for activities of daily living. The actuator achieves these design characteristics while maintaining a small form factor by leveraging a combination of electromechanical and hydraulic components. The design of the actuator is described herein, and results of an experimental characterization are provided that indicate that the actuator is capable of providing the functional capabilities required of an ankle prosthesis in a compact and lightweight package.

  20. 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

  1. Warm inflation in the stochastic inflation formalism

    International Nuclear Information System (INIS)

    Silva, Leandro A. da; Ramos, Rudnei O.

    2011-01-01

    Full text: The basic assumption of stochastic inflation is the splitting, through the definition of a appropriate window function, of the quantum inflaton field in a long wavelength part (modes outside of the de Sitter horizon) and in a short wavelength (modes inside the de Sitter horizon) part. The inflationary mechanism then continuously shifts more and more modes of the bath field into the system stretching their physical wavelengths beyond the de Sitter horizon size, what generates an effective system-bath interaction. Therefore, the system field develops a stochastic dynamics driven by the bath field, that plays the role of noise source. The resulting equation of motion (EoM) is a Langevin-like equation. Applying this formalism to Warm Inflation scenario (where, alternatively to the cold inflation, we assume that the inflaton evolves in a thermal bath and through a dissipative process continuously generates radiation, thus avoiding the necessity of a reheating mechanism), we contrast the exact numerical solution of thermal power spectrum and two approximations currently used in the literature, and compare this to the quantum power spectrum at horizon crossing. Finally, we consider a more realistic model based on microscopic derivations to estimate the effects of non-Markovianity on the inflaton dynamics and on the thermal power spectrum. (author)

  2. Primordial anisotropies in gauged hybrid inflation

    Science.gov (United States)

    Akbar Abolhasani, Ali; Emami, Razieh; Firouzjahi, Hassan

    2014-05-01

    We study primordial anisotropies generated in the model of gauged hybrid inflation in which the complex waterfall field is charged under a U(1)gauge field. Primordial anisotropies are generated either actively during inflation or from inhomogeneities modulating the surface of end of inflation during waterfall transition. We present a consistent δN mechanism to calculate the anisotropic power spectrum and bispectrum. We show that the primordial anisotropies generated at the surface of end of inflation do not depend on the number of e-folds and therefore do not produce dangerously large anisotropies associated with the IR modes. Furthermore, one can find the parameter space that the anisotropies generated from the surface of end of inflation cancel the anisotropies generated during inflation, therefore relaxing the constrains on model parameters imposed from IR anisotropies. We also show that the gauge field fluctuations induce a red-tilted power spectrum so the averaged power spectrum from the gauge field can change the total power spectrum from blue to red. Therefore, hybrid inflation, once gauged under a U(1) field, can be consistent with the cosmological observations.

  3. Nonthermal gravitino production in tribrid inflation

    Science.gov (United States)

    Antusch, Stefan; Dutta, Koushik

    2015-10-01

    We investigate nonthermal gravitino production after tribrid inflation in supergravity, which is a variant of supersymmetric hybrid inflation where three fields are involved in the inflationary model and where the inflaton field resides in the matter sector of the theory. In contrast to conventional supersymmetric hybrid inflation, where nonthermal gravitino production imposes severe constraints on the inflationary model, we find that the "nonthermal gravitino problem" is generically absent in models of tribrid inflation, mainly due to two effects: (i) With the inflaton in tribrid inflation (after inflation) being lighter than the waterfall field, the latter has a second decay channel with a much larger rate than for the decay into gravitinos. This reduces the branching ratio for the decay of the waterfall field into gravitinos. (ii) The inflaton generically decays later than the waterfall field, and it does not produce gravitinos when it decays. This leads to a dilution of the gravitino population from the decays of the waterfall field. The combination of both effects generically leads to a strongly reduced gravitino production in tribrid inflation.

  4. Primordial anisotropies in gauged hybrid inflation

    International Nuclear Information System (INIS)

    Abolhasani, Ali Akbar; Emami, Razieh; Firouzjahi, Hassan

    2014-01-01

    We study primordial anisotropies generated in the model of gauged hybrid inflation in which the complex waterfall field is charged under a U(1)gauge field. Primordial anisotropies are generated either actively during inflation or from inhomogeneities modulating the surface of end of inflation during waterfall transition. We present a consistent δN mechanism to calculate the anisotropic power spectrum and bispectrum. We show that the primordial anisotropies generated at the surface of end of inflation do not depend on the number of e-folds and therefore do not produce dangerously large anisotropies associated with the IR modes. Furthermore, one can find the parameter space that the anisotropies generated from the surface of end of inflation cancel the anisotropies generated during inflation, therefore relaxing the constrains on model parameters imposed from IR anisotropies. We also show that the gauge field fluctuations induce a red-tilted power spectrum so the averaged power spectrum from the gauge field can change the total power spectrum from blue to red. Therefore, hybrid inflation, once gauged under a U(1) field, can be consistent with the cosmological observations

  5. Graceful exit from Higgs G-inflation

    Energy Technology Data Exchange (ETDEWEB)

    Kamada, Kohei [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany); Kobayashi, Tsutomu [Rikkyo Univ., Tokyo (Japan). Dept. of Physics; Kunimitsu, Taro [Tokyo Univ. (Japan). Dept. of Physics; Tokyo Univ. (Japan). Research Center for the Early Universe (RESCEU); Yamaguchi, Masahide [Tokyo Institute of Technology (Japan). Dept. of Physics; Yokoyama, Jun' ichi [Tokyo Univ. (Japan). Research Center for the Early Universe (RESCEU); Tokyo Univ., Chiba (Japan). Kavli Inst. for the Physics and Mathematics of the Universe (Kavli IPMU)

    2013-09-15

    Higgs G-inflation is a Higgs inflation model with a generalized Galileon term added to the standard model Higgs field, which realizes inflation compatible with observations. Recently, it was claimed that the generalized Galileon term induces instabilities during the oscillation phase, and that the simplest Higgs G-inflation model inevitably suffers from this problem. In this paper, we extend the original Higgs G-inflation Lagrangian to a more general form, namely introducing a higher-order kinetic term and generalizing the form of the Galileon term, so that the Higgs field can oscillate after inflation without encountering instabilities. Moreover, it accommodates a large region of the n{sub s}-r plane, most of which is consistent with current observations, leading us to expect the detection of B-mode polarization in the cosmic microwave background in the near future.

  6. A smooth exit from eternal inflation?

    Science.gov (United States)

    Hawking, S. W.; Hertog, Thomas

    2018-04-01

    The usual theory of inflation breaks down in eternal inflation. We derive a dual description of eternal inflation in terms of a deformed Euclidean CFT located at the threshold of eternal inflation. The partition function gives the amplitude of different geometries of the threshold surface in the no-boundary state. Its local and global behavior in dual toy models shows that the amplitude is low for surfaces which are not nearly conformal to the round three-sphere and essentially zero for surfaces with negative curvature. Based on this we conjecture that the exit from eternal inflation does not produce an infinite fractal-like multiverse, but is finite and reasonably smooth.

  7. Inflation Insurance

    OpenAIRE

    Zvi Bodie

    1989-01-01

    A contract to insure $1 against inflation is equivalent to a European call option on the consumer price index. When there is no deductible this call option is equivalent to a forward contract on the CPI. Its price is the difference between the prices of a zero coupon real bond and a zero coupon nominal bond, both free of default risk. Provided that the risk-free real rate of interest is positive, the price of such an inflation insurance policy first rises and then falls with time to maturity....

  8. 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.

  9. A critical review of inflation

    CERN Document Server

    Turok, N G

    2002-01-01

    The theory of cosmic inflation offers an attractive resolution of some of the great paradoxes in cosmology: why the universe is so large, flat and uniform on large scales, and how density variations arose. Inflation has rightly dominated cosmological thinking for the past two decades, helping stimulate the development of high-precision observational programmes. The survival of simple inflationary models in the face of an impressive observational onslaught has been interpreted as convincing evidence of the correctness of the basic idea. In this paper, I review inflation, but highlight its weaknesses, explaining my reasons for believing that a more complete theory may supersede inflation without necessarily incorporating it.

  10. A critical review of inflation

    International Nuclear Information System (INIS)

    Turok, Neil

    2002-01-01

    The theory of cosmic inflation offers an attractive resolution of some of the great paradoxes in cosmology: why the universe is so large, flat and uniform on large scales, and how density variations arose. Inflation has rightly dominated cosmological thinking for the past two decades, helping stimulate the development of high-precision observational programmes. The survival of simple inflationary models in the face of an impressive observational onslaught has been interpreted as convincing evidence of the correctness of the basic idea. In this paper, I review inflation, but highlight its weaknesses, explaining my reasons for believing that a more complete theory may supersede inflation without necessarily incorporating it

  11. 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.

  12. 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 ...

  13. Inflation and the Higgs Scalar

    Energy Technology Data Exchange (ETDEWEB)

    Green, Dan [Fermi National Accelerator Lab. (FNAL), Batavia, IL (United States)

    2014-12-05

    This note makes a self-contained exposition of the basic facts of big bang cosmology as they relate to inflation. The fundamental problems with that model are then explored. A simple scalar model of inflation is evaluated which provides the solution of those problems and makes predictions which will soon be definitively tested. The possibility that the recently discovered fundamental Higgs scalar field drives inflation is explored.

  14. Cranioplasty prosthesis manufacturing based on reverse engineering technology

    Science.gov (United States)

    Chrzan, Robert; Urbanik, Andrzej; Karbowski, Krzysztof; Moskała, Marek; Polak, Jarosław; Pyrich, Marek

    2012-01-01

    Summary Background Most patients with large focal skull bone loss after craniectomy are referred for cranioplasty. Reverse engineering is a technology which creates a computer-aided design (CAD) model of a real structure. Rapid prototyping is a technology which produces physical objects from virtual CAD models. The aim of this study was to assess the clinical usefulness of these technologies in cranioplasty prosthesis manufacturing. Material/Methods CT was performed on 19 patients with focal skull bone loss after craniectomy, using a dedicated protocol. A material model of skull deficit was produced using computer numerical control (CNC) milling, and individually pre-operatively adjusted polypropylene-polyester prosthesis was prepared. In a control group of 20 patients a prosthesis was manually adjusted to each patient by a neurosurgeon during surgery, without using CT-based reverse engineering/rapid prototyping. In each case, the prosthesis was implanted into the patient. The mean operating times in both groups were compared. Results In the group of patients with reverse engineering/rapid prototyping-based cranioplasty, the mean operating time was shorter (120.3 min) compared to that in the control group (136.5 min). The neurosurgeons found the new technology particularly useful in more complicated bone deficits with different curvatures in various planes. Conclusions Reverse engineering and rapid prototyping may reduce the time needed for cranioplasty neurosurgery and improve the prosthesis fitting. Such technologies may utilize data obtained by commonly used spiral CT scanners. The manufacturing of individually adjusted prostheses should be commonly used in patients planned for cranioplasty with synthetic material. PMID:22207125

  15. How useful are leading indicators of inflation?

    OpenAIRE

    C. Alan Garner

    1995-01-01

    Many economists expect inflation to rise in 1995. These expectations are based on various approaches to forecasting inflation. One approach is based on the standard economic theory that inflation rises when slack is eliminated from the economy and production exceeds capacity constraints. According to this view, measures of economic slack such as unemployment and capacity utilization provide useful information about the inflation outlook. But the relationship between slack and inflation is com...

  16. Ten years of inflation targeting in Serbia

    Directory of Open Access Journals (Sweden)

    Bungin Sanja

    2017-01-01

    Full Text Available Monetary strategy of inflation targeting in Serbia was unofficially introduced in September 2006. The National Bank of Serbia has faced the numerous challenges that are typical for transition countries which apply the same strategy. At the start of inflation targeting, inflation was reduced to a single-digit number, which characterises most other countries. However, the volatility of inflation during the implementation of the strategy has been extremely high, mainly caused by the changes of processed and unprocessed food prices. Moreover, for a country with a high degree of euroisation, such as Serbia, the exchange rate plays an important role in the movement of inflation. Controlling the trends of the exchange rate in order to maintain the stability of inflation is contrary to the assumptions of inflation targeting. However, it can be concluded that despite all the obstacles faced by the NBS, inflation targeting is the optimal choice of a monetary strategy.

  17. 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.

  18. Function of obturator prosthesis after maxillectomy and prosthetic obturator rehabilitation.

    Science.gov (United States)

    Chen, Cheng; Ren, Wenhao; Gao, Ling; Cheng, Zheng; Zhang, Linmei; Li, Shaoming; Zhi, Pro Ke-qian

    2016-01-01

    Maxillary defects are usually rehabilitated by a prosthetic obturator. This study aimed to evaluate the functioning of obturators prosthesis in patients with unilateral defects after maxillectomy. Of 49 patients, 28 underwent to maxillectomy as a result of tumor ablative surgery, and acquired unilateral maxillary defects. Evaluation of the function was performed by applying the Obturator Functional Scale (OFS). From a total of 49 patients, 28 were treated as follows: 9 with a conventional retained obturator prosthesis (COP), 11 (39%) with an enhanced retentive obturator prosthesis with stud attachment (POP) and 8 (28%) with an enhanced retentive obturator prosthesis with magnetic attachment (POM). The mean OFS score was 80. Scores on functions of speech, swallowing and chewing reached statistical significances (p<0.05) among these three subgroups. Comparing COP and MOP groups, the scores of OFS in the domains of "Speech-ability to speak in public" and "Swallowing-leakage with liquids" were significantly higher in AOP group. Comparing COP group, the scores of OFS in "Swallowing-leakage with solid" and "Chewing/eating" domains were increased significantly (p<0.05) both in MOP and AOP groups. Obturator prosthesis improves oral function of patients after maxillary defects; the retention of the obturator prosthesis enhanced by the addition of attachments showed more benefits in oral function. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  19. 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.

  20. 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.

  1. The scale of inflation in the landscape

    International Nuclear Information System (INIS)

    Pedro, F.G.; Westphal, A.

    2013-03-01

    We determine the frequency of regions of small-field inflation in the Wigner landscape as an approximation to random supergravities/type IIB flux compactifications. We show that small-field inflation occurs exponentially more often than large-field inflation The power of primordial gravitational waves from inflation is generically tied to the scale of inflation. For small-field models this is below observational reach. However, we find small-field inflation to be dominated by the highest inflationary energy scales compatible with a sub-Planckian field range. Hence, we expect a typical tensor-to-scalar ratio r∝O(10 -3 ) currently undetectable in upcoming CMB measurements.

  2. The scale of inflation in the landscape

    Energy Technology Data Exchange (ETDEWEB)

    Pedro, F.G.; Westphal, A. [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany). Theory Group

    2013-03-15

    We determine the frequency of regions of small-field inflation in the Wigner landscape as an approximation to random supergravities/type IIB flux compactifications. We show that small-field inflation occurs exponentially more often than large-field inflation The power of primordial gravitational waves from inflation is generically tied to the scale of inflation. For small-field models this is below observational reach. However, we find small-field inflation to be dominated by the highest inflationary energy scales compatible with a sub-Planckian field range. Hence, we expect a typical tensor-to-scalar ratio r{proportional_to}O(10{sup -3}) currently undetectable in upcoming CMB measurements.

  3. A novel stent inflation protocol improves long-term outcomes compared with rapid inflation/deflation deployment method.

    Science.gov (United States)

    Vallurupalli, Srikanth; Kasula, Srikanth; Kumar Agarwal, Shiv; Pothineni, Naga Venkata K; Abualsuod, Amjad; Hakeem, Abdul; Ahmed, Zubair; Uretsky, Barry F

    2017-08-01

    High-pressure inflation for coronary stent deployment is universally performed. However, the duration of inflation is variable and does not take into account differences in lesion compliance. We developed a standardized "pressure optimization protocol" (POP) using inflation pressure stability rather than an arbitrary inflation time or angiographic balloon appearance for stent deployment. Whether this approach improves long-term outcomes is unknown. 792 patients who underwent PCI using either rapid inflation/deflation (n = 376) or POP (n = 416) between January 2009 and March 2014 were included. Exclusion criteria included PCI for acute myocardial infarction, in-stent restenosis, chronic total occlusion, left main, and saphenous vein graft lesions. Primary endpoint was target vessel failure [TVF = combined end point of target vessel revascularization (TVR), myocardial infarction, and cardiac death]. Outcomes were analyzed in the entire cohort and in a propensity analysis. Stent implantation using POP with a median follow-up of 1317 days was associated with lower TVF compared with rapid inflation/deflation (10.1 vs. 17.8%, P inflation/deflation (10 vs. 18%, P < 0.0001). Stent deployment using POP led to reduced TVF compared to rapid I/D. These results recommend this method to improve long-term outcomes. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  4. Design and Characterization of a Quasi-Passive Pneumatic Foot-Ankle Prosthesis.

    Science.gov (United States)

    Lee, Jeffrey D; Mooney, Luke M; Rouse, Elliott J

    2017-07-01

    The majority of commercially available passive prosthetic feet are not capable of providing joint mechanics that match that of the intact human ankle. Due to their cantilever design, their stiffness characteristics contrast with what has been observed in the biological ankle, namely, an increase in stiffness during the stance phase of walking. In this paper, we introduce the design and control of a pneumatic foot-ankle prosthesis that attempts to provide biomimetic mechanics. The prosthesis is comprised of a pneumatic cylinder in series with a fiberglass leaf spring, and a solenoid valve to control the flow of air between the two sides of the cylinder. The solenoid valve acts as a mechanical clutch, enabling resetting of the ankle's equilibrium position. By adjusting the pressure inside the cylinder, the prosthesis can be customized to provide a range of ankle mechanics. A mechanical testing machine is used to compare the torque-angle curve of the pneumatic prosthesis with a low-profile passive prosthetic foot. Finally, data are presented of one transtibial amputee walking with the prosthesis at 1.2 m/s. The testing shows that the pneumatic prosthesis is capable of providing an appropriate range of motion as well a maximum torque of 94 Nm, while returning approximately 11.5 J of energy.

  5. Doppler derived gradient of ST Jude Mechanical Prosthesis, early postoperative assessment

    International Nuclear Information System (INIS)

    Shaikh, A.H.; Hanif, B.; Adil, A.; Hashimi, S.; Qazi, H.A.; Mujtaba, I.

    2010-01-01

    Objective: To determine the doppler derived mean gradients of St Jude mechanical prosthesis in early postoperative period in patients undergoing valve replacement at a tertiary care cardiac centre. Methods: Medical records of 190 consecutive patients who underwent 233 mitral, aortic or dual (mitral and aortic) valve replacement by St Jude bileaflet mechanical prosthesis at Tabba Heart Institute, between March 2006 to December 2008 were reviewed. Doppler derived mean gradients were assessed predischarge and recorded. Results: There were 98 (51.5%) males and 92 (48.5%) females in the study cohort. The mean age was 40 +- 14 years. Of the total, 101 (53%) had mitral, 46 (24.2%) had aortic and 43 (22.6%) patients had dual valve replacement. Doppler derived mean gradient was assessed across 144 mitral and 89 aortic St Jude mechanical prosthesis. Doppler derived mean gradient for St Jude mitral prosthesis was 3.5 mm Hg and for St Jude aortic prosthesis was 10.2 mm Hg. Conclusions: The study determines baseline gradients across mitral and aortic St Jude mechanical prosthesis in our population. These can be used as reference gradients to assess St Jude prosthetic valve function in patients who did not have early postoperative doppler assessment. (author)

  6. The reverse shoulder prosthesis: a review of imaging features and complications

    Energy Technology Data Exchange (ETDEWEB)

    McFarland, Edward G.; Sanguanjit, Prakasit; Tasaki, Atsushi [Johns Hopkins University, Department of Orthopedic Surgery, Lutherville, MD (United States); Keyurapan, Ekavit [Mahidol University, Department of Orthopaedic Surgery, Bangkok (Thailand); Fishman, Elliot K.; Fayad, Laura M. [Johns Hopkins Medical Institutions, Johns Hopkins University, Department of Radiology and Radiological Sciences, Baltimore, MD (United States)

    2006-07-15

    The reverse shoulder prosthesis is a prosthesis that has been in clinical use in Europe since 1985 and was approved for use in the United States in 2004. This unique prosthesis has a baseplate attached to the glenoid, which holds a spherical component, while the humeral component includes a polyethylene insert that is flat. This design is the ''reverse'' configuration of that seen with a conventional arthroplasty, in which the spherical component is part of the humeral component. The indications for the reverse prosthesis are: (1) painful arthritis associated with irreparable rotator cuff tears (cuff tear arthropathy), (2) failed hemiarthroplasty with irreparable rotator cuff tears, (3) pseudoparalysis due to massive, irreparable rotator cuff tears, (4) some reconstructions after tumor resection, and (5) some fractures of the shoulder not repairable or reconstructable with other techniques. This prosthesis can produce a significant reduction in pain and some improvement in function for most of the indications mentioned. However, the unique configuration and the challenge of its insertion can result in a high incidence of a wide variety of unusual complications. Some of these complications, such as dislocation of the components, are similar to conventional shoulder replacement. Other complications, such as notching of the scapula and acromial stress fractures, are unique to this prosthesis. (orig.)

  7. The reverse shoulder prosthesis: a review of imaging features and complications

    International Nuclear Information System (INIS)

    McFarland, Edward G.; Sanguanjit, Prakasit; Tasaki, Atsushi; Keyurapan, Ekavit; Fishman, Elliot K.; Fayad, Laura M.

    2006-01-01

    The reverse shoulder prosthesis is a prosthesis that has been in clinical use in Europe since 1985 and was approved for use in the United States in 2004. This unique prosthesis has a baseplate attached to the glenoid, which holds a spherical component, while the humeral component includes a polyethylene insert that is flat. This design is the ''reverse'' configuration of that seen with a conventional arthroplasty, in which the spherical component is part of the humeral component. The indications for the reverse prosthesis are: (1) painful arthritis associated with irreparable rotator cuff tears (cuff tear arthropathy), (2) failed hemiarthroplasty with irreparable rotator cuff tears, (3) pseudoparalysis due to massive, irreparable rotator cuff tears, (4) some reconstructions after tumor resection, and (5) some fractures of the shoulder not repairable or reconstructable with other techniques. This prosthesis can produce a significant reduction in pain and some improvement in function for most of the indications mentioned. However, the unique configuration and the challenge of its insertion can result in a high incidence of a wide variety of unusual complications. Some of these complications, such as dislocation of the components, are similar to conventional shoulder replacement. Other complications, such as notching of the scapula and acromial stress fractures, are unique to this prosthesis. (orig.)

  8. Inflation experiences of retirees

    NARCIS (Netherlands)

    Kalwij, Adriaan; Alessie, Robertus; Gardner, Jonathan; Ali, Ashik Anwar

    The inflation experience of people depends on their expenditure patterns and price developments. This paper identifies groups of retirees that have experienced relatively high price inflation over the last few decades and could thus be considered most vulnerable when income decreases, as has been

  9. Affleck-Dine baryogenesis just after inflation

    International Nuclear Information System (INIS)

    Yamada, Masaki

    2015-11-01

    We propose a new scenario of Affleck-Dine baryogenesis where a at direction in the MSSM generates B-L asymmetry just after the end of inflation. The resulting amount of baryon asymmetry is independent of low-energy supersymmetric models but is dependent on inflation models. We consider the hybrid and chaotic inflation models and find that reheating temperature is required to be higher than that in the conventional scenario of Affleck-Dine baryogenesis. In particular, non-thermal gravitino-overproduction problem is naturally avoided in the hybrid inflation model. Our results imply that Affleck-Dine baryogenesis can be realized in a broader range of supersymmetry and inflation models than expected in the literature.

  10. Goldstone inflation

    International Nuclear Information System (INIS)

    Croon, Djuna; Sanz, Verónica; Setford, Jack

    2015-01-01

    Identifying the inflaton with a pseudo-Goldstone boson explains the flatness of its potential. Successful Goldstone Inflation should also be robust against UV corrections, such as from quantum gravity: in the language of the effective field theory this implies that all scales are sub-Planckian. In this paper we present scenarios which realise both requirements by examining the structure of Goldstone potentials arising from Coleman-Weinberg contributions. We focus on single-field models, for which we notice that both bosonic and fermionic contributions are required and that spinorial fermion representations can generate the right potential shape. We then evaluate the constraints on non-Gaussianity from higher-derivative interactions, finding that axiomatic constraints on Goldstone boson scattering prevail over the current CMB measurements. The fit to CMB data can be connected to the UV completions for Goldstone Inflation, finding relations in the spectrum of new resonances. Finally, we show how hybrid inflation can be realised in the same context, where both the inflaton and the waterfall fields share a common origin as Goldstones.

  11. Goldstone inflation

    Energy Technology Data Exchange (ETDEWEB)

    Croon, Djuna; Sanz, Verónica; Setford, Jack [Department of Physics and Astronomy, University of Sussex,Brighton BN1 9QH (United Kingdom)

    2015-10-05

    Identifying the inflaton with a pseudo-Goldstone boson explains the flatness of its potential. Successful Goldstone Inflation should also be robust against UV corrections, such as from quantum gravity: in the language of the effective field theory this implies that all scales are sub-Planckian. In this paper we present scenarios which realise both requirements by examining the structure of Goldstone potentials arising from Coleman-Weinberg contributions. We focus on single-field models, for which we notice that both bosonic and fermionic contributions are required and that spinorial fermion representations can generate the right potential shape. We then evaluate the constraints on non-Gaussianity from higher-derivative interactions, finding that axiomatic constraints on Goldstone boson scattering prevail over the current CMB measurements. The fit to CMB data can be connected to the UV completions for Goldstone Inflation, finding relations in the spectrum of new resonances. Finally, we show how hybrid inflation can be realised in the same context, where both the inflaton and the waterfall fields share a common origin as Goldstones.

  12. Goldstone inflation

    Science.gov (United States)

    Croon, Djuna; Sanz, Verónica; Setford, Jack

    2015-10-01

    Identifying the inflaton with a pseudo-Goldstone boson explains the flatness of its potential. Successful Goldstone Inflation should also be robust against UV corrections, such as from quantum gravity: in the language of the effective field theory this implies that all scales are sub-Planckian. In this paper we present scenarios which realise both requirements by examining the structure of Goldstone potentials arising from Coleman-Weinberg contributions. We focus on single-field models, for which we notice that both bosonic and fermionic contributions are required and that spinorial fermion representations can generate the right potential shape. We then evaluate the constraints on non-Gaussianity from higher-derivative interactions, finding that axiomatic constraints on Goldstone boson scattering prevail over the current CMB measurements. The fit to CMB data can be connected to the UV completions for Goldstone Inflation, finding relations in the spectrum of new resonances. Finally, we show how hybrid inflation can be realised in the same context, where both the inflaton and the waterfall fields share a common origin as Goldstones.

  13. 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.

  14. 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.

  15. Dark energy from gravitoelectromagnetic inflation?

    International Nuclear Information System (INIS)

    Membiela, A.; Bellini, M.

    2008-01-01

    Gravitoelectromagnetic Inflation (GI) was introduced to describe in a unified manner electromagnetic, gravitatory and inflation fields from a 5D vacuum state. On the other hand, the primordial origin and evolution of dark energy is today unknown. In this letter we show using GI that the zero modes of some redefined vector fields B i = A i /a produced during inflation could be the source of dark energy in the Universe.

  16. Inflation and Failure of Polymeric Membranes

    DEFF Research Database (Denmark)

    Hassager, Ole; Neergaard, Jesper

    2000-01-01

    We consider the inflation of an axisymmetric polymeric membrane.Some membranes composed of viscoelastic materialsdescribed by a Mooney-Rivlin model show a monotone increasingpressure during inflation. These materialsdevelop a homogeneous membrane thickness in agreement with the Considere...... is found to stabilize the inflated polymer membrane....

  17. 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

  18. 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 ...

  19. Association between dental prosthesis need, nutritional status and quality of life of elderly subjects

    DEFF Research Database (Denmark)

    Pillai, Rajath; Mathur, Vijay Prakash; Jain, Veena

    2015-01-01

    clinic were recruited in the study. Mini-nutritional assessment (MNA), geriatric oral health assessment (GOHAI) indices, prosthesis need according to WHO criteria, and prosthesis want was recorded along with age, gender, socioeconomic status and posterior occluding pair. RESULTS: Significant associations......To determine the effect of prosthesis need on nutritional status and oral health-related quality of life (OHrQoL) in elderly and to check the disparity between prosthesis need and prosthesis want in the Indian elderly. METHODS: A total of 946 geriatric participants reporting to a geriatric medicine...

  20. Anisotropic inflation reexamined: upper bound on broken rotational invariance during inflation

    International Nuclear Information System (INIS)

    Naruko, Atsushi; Yamaguchi, Masahide; Komatsu, Eiichiro

    2015-01-01

    The presence of a light vector field coupled to a scalar field during inflation makes a distinct prediction: the observed correlation functions of the cosmic microwave background (CMB) become statistically anisotropic. We study the implications of the current bound on statistical anisotropy derived from the Planck 2013 CMB temperature data for such a model. The previous calculations based on the attractor solution indicate that the magnitude of anisotropy in the power spectrum is proportional to N 2 , where N is the number of e-folds of inflation counted from the end of inflation. In this paper, we show that the attractor solution is not necessarily compatible with the current bound, and derive new predictions using another branch of anisotropic inflation. In addition, we improve upon the calculation of the mode function of perturbations by including the leading-order slow-roll corrections. We find that the anisotropy is roughly proportional to [2(ε H +4η H )/3−4(c−1)] −2 , where ε H and η H are the usual slow-roll parameters and c is the parameter in the model, regardless of the form of potential of an inflaton field. The bound from Planck implies that breaking of rotational invariance during inflation (characterized by the background homogeneous shear divided by the Hubble rate) is limited to be less than O(10 −9 ). This bound is many orders of magnitude smaller than the amplitude of breaking of time translation invariance, which is observed to be O(10 −2 )