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OBJECTIVE@#To investigate and analyze the complications of penile augmentation with acellular dermal matrix (ADM) and following management.@*METHODS@#This was a retrospective review of all patients who received penile augmentation with ADM between June 2016 and January 2019. The patients were evaluated with outpatient physical examination. Related complications and following management were summarized and analyzed.@*RESULTS@#Between June 2016 and January 2019, ADM was used as filling material on 78 patients (mean age: 31.14 years, range: 21-66 years), who were successfully received penile augmentation surgery. In the follow-up three months, the penile circumference was increased by 1.1 cm (0.5-2.1 cm) on average. The mean follow-up time was 12.20 months. In this study, there were 47 (60.26%, 47/78) patients with erectile discomfort, 91.49% (43/47) of whom manifested as erectile traction. There were 12 (15.38%, 12/78) patients with delayed healing, improved by daily regular dressing change. There were 10 (12.82%, 10/78) patients with unobvious augmentation effect. There were 9 (11.54%, 9/78) patients with stamp-like changes of ADM. There were 8 (10.26%, 8/78) patients with wound hematoma and 7 (8.97%, 7/78) patients with foreskin edema, relieved by compression with wrap. There were 4 (5.13%, 4/78) patients with wound infection and 3 (3.85%, 3/78) patients with skin necrosis of the dorsal side, which could be treated with ADM removal and repair surgery with bipedicle scrotal flap. And there were 2 (2.56%, 2/78) patients suffering psychological influence. Finally, most patients with various complications recovered successfully, however 7 patients (8.97%, 7/78) underwent ADM removal surgery.@*CONCLUSION@#Using ADM as filling material could achieve positive effect in penile augmentation but the complications are common and cannot be neglected. Standardized surgical methods, rigorous postoperative care, and adequate notification with patients can effectively reduce the complications of penile augmentation with ADM. To treat properly and timely for complications can obtain satisfactory results.
Subject(s)
Adult , Aged , Humans , Male , Middle Aged , Young Adult , Acellular Dermis , Penile Erection , Penis , Retrospective Studies , Surgical FlapsABSTRACT
We have established a novel method named transumbilical two-port laparoscopic varicocele ligation (TTLVL) for varicocele, which is still needed to evaluate. In this study, 90 patients with left idiopathic symptomatic varicoceles of grades II-III according to the Dubin grading system were randomly assigned to TTLVL (n = 45) and conventional laparoscopic varicocele ligation (CLVL) (n = 45). The demographic, intraoperative, postoperative, and follow-up data were recorded and compared between the two groups. All the procedures in the two groups were completed successfully with no intraoperative complications and no conversions to open surgery. No significant difference was found in the operative time, resuming ambulation, bowel recovery, postoperative hospital stay, and postoperative resolution of scrotal pain between the two groups (P > 0.05). However, the postoperative mean visual analog pain scale scores for TTLVL group were all less at 24 h, 48 h, 72 h, and 7 days postoperatively compared to CLVL (P = 0.001, 0.010, 0.006, and 0.027, respectively). The mean patient scar assessment questionnaire score in postoperative month 3 was 29.7 for TTLVL group compared with 32.1 for CLVL group (P < 0.001). There was no testicular atrophy observed in both groups during the follow-up period. The study shows that TTLVL is a safe, feasible, and effective minimally invasive surgical alternative to CLVL for the treatment of varicocele. Compared with CLVL, TTLVL may decrease postoperative pain and improve the cosmetic outcomes.
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<p><b>OBJECTIVE</b>To observe the effects of CMTM2 on cyclophosphamide (CP)-induced reproductive toxicity and the expression of steroidogenic acute regulatory (StAR) protein in the transgenic mouse model.</p><p><b>METHODS</b>Twenty CMTM2 transgenic mice were equally divided into a CMTM2 + CP and a CMTM2 + NS group, the former intraperitoneally injected with CP at 50 mg per kg per d, while the latter with the equivalent dose of normal saline, both for 7 days. Another 20 wild C57BL/6J mice were randomly assigned to a WT + CP and a WT + NS group, treated the same way above. After 30 days, all the mice were sacrificed and their epididymides and testes removed for measurement of the serum testosterone level by radioimmunoassay, determination of sperm concentration and motility by light microscopy and detection of the expression of StAR by Western blot.</p><p><b>RESULTS</b>The levels of serum testosterone, sperm concentration and sperm motility were significantly decreased in the CMTM2 + CP group as compared with the CMTM2 + NS group ([42.98 +/- 3.25] nmol/L vs [46.74 +/- 3.38] nmol/L, [16.89 +/- 1.17 ] x 10(6)/ml vs [24.68 +/- 0.95 ] x 10(6)/ml, [72.75 +/- 1.25]% vs [85.14 +/- 1.12]%, P < 0.05), but remarkably less than in the WT + CP group ([37.97 +/- 4.17] nmol/L, [12.75 +/- 1.02] x 10(6)/ml, [50.52 +/- 1.37] %) (P < 0.05). However, the expression of StAR was significantly higher in the CMTM2 + CP than in the WT + CP group (1.16 +/- 0.07 vs 0.69 +/- 0.08, P < 0.05).</p><p><b>CONCLUSION</b>CMTM2 antagonizes cyclophosphamide-induced reproductive toxicity via regulating the expression of StAR, and hence plays a protective role in the reproductive system.</p>
Subject(s)
Animals , Male , Mice , Cyclophosphamide , Toxicity , MARVEL Domain-Containing Proteins , Genetics , Mice, Inbred C57BL , Mice, Transgenic , Repressor Proteins , Genetics , Sperm Count , Sperm Motility , Testis , MetabolismABSTRACT
<p><b>OBJECTIVE</b>To investigate the management of ischemic priapism (IP) by analyzing the clinical and follow-up data of IP patients.</p><p><b>METHODS</b>We retrospectively reviewed the clinical data of 8 IP patients treated in our hospital from January 2004 to June 2010 and analyzed the results of follow-ups by telephone calls and clinic visits.</p><p><b>RESULTS</b>The average age of the patients was 34.5 (23 -41) years and the mean duration of priapism was 84.5 (36 -132) hours. All the patients had received previous detumescence treatment but failed before referred to our hospital. Irrigation/aspiration was performed at first, which achieved complete detumescence in 1 case and partial or transitional detumescence in the other 7. Subsequently, bilateral Al-Ghorab shunt was tried and succeeded in 2 cases but failed in 5. Finally, T-shunt was conducted, which achieved complete resumption in all the remaining 5 cases. Follow-up data were available in 5 of the cases, which were followed up for 12 -66 (mean 54) months. Of the 5 cases, moderate ED occurred in 2, and complete ED in 3. The latter 3 had suffered a longer duration of IP than the former 2.</p><p><b>CONCLUSION</b>If detumescence failes, early intervention by T-shunt can improve the success rate of IP treatment.</p>
Subject(s)
Adult , Humans , Male , Young Adult , Follow-Up Studies , Penis , Priapism , Therapeutics , Prostheses and Implants , Retrospective StudiesABSTRACT
OBJECTIVE: To investigate factors that affected the distribution of rehydrated particle size of freeze-dried docetaxel liposome and develop a technique of producing docetaxel liposome that can meet clinical requirements. METHODS: The single factor method was utilized in this study. Docetaxel liposome were prepared using different types of negatively charged phospholipids, or lecithins with varying phosphatidylcholine (PC) content, or various cryoprotectants at different gradient concentrations, followed by freeze-drying with different protocols. The particle sizes of corresponding rehydrated products were compared and the effects of different factors were analyzed. RESULTS: The optimal liposomal membrane was composed of dipalmitoyl phosphatidic acid (DPPA), 20% trehalose and lecithin containing 92% PC. The best freeze-drying protocol included following steps; flash freezing, 19 h of sublimation-drying and 9 h of desorption-drying. CONCLUSION: The parameters, including negatively charged phospholipids, cryoprotectants, PC content of lecithin and lyophilization protocols, had various effects on the particle sizes of reconstituted docetaxel liposome.
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<p><b>BACKGROUND</b>As one of the most commonly diagnosed diseases, chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is characterized by a variety of complex symptoms. Anxiety and depression are two of the most prevalent clinical manifestations of patients with CP/CPPS, and have adverse effects on the health of the subjects and prognosis of comorbidities. Such psychological disorders, however, have not been deeply and thoroughly studied in China. The aim of this study was to investigate the prevalence and severity of psychological disorders in Chinese adults with CP/CPPS.</p><p><b>METHODS</b>From April 2008 to June 2009, 80 patients and 40 age-matched healthy men participating in a voluntary health examination were recruited. The majority of the subjects completed the questionnaires on the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) as well as the hospital anxiety and depression scale (HADS).</p><p><b>RESULTS</b>Of all the participants, 77 (96.3%) patients and 37 (92.5%) healthy controls completed the questionnaires. The average NIH-CPSI total score was 21.0 ± 9.5 for the patients and 2.2 ± 1.5 for the controls (P = 0.03). Of the 77 patients with CP/CPPS, 48 (62.3%), 5 (6.5%), and 1 (1.2%) had anxiety symptoms, depression symptoms, or both anxiety and depression symptoms, respectively. For the controls, the average HADS anxiety and depression scores in patients were 14.5 ± 6.8 and 5.2 ± 4.5, which were both significantly higher than in controls. Moreover, the prevalence and the symptom scores of both the HADS anxiety and depression were higher for the younger age group (< 35 years) than for the older age group (< 35 years).</p><p><b>CONCLUSIONS</b>This preliminary study revealed that male patients with CP/CPPS had a higher prevalence of psychological disorders than in the control subjects. Moreover, the differences of the prevalence and severity of the psychological symptoms between the two different age groups may imply that psychological disorders related to CP/CPPS may be relieved with increasing age. The present study indicated that psychological evaluation is important in men with CP/CPPS, especially in younger men.</p>
Subject(s)
Adult , Humans , Male , Middle Aged , Asian People , Chronic Disease , Pelvic Pain , Psychology , Prostatitis , Psychology , Psychometrics , Methods , Surveys and QuestionnairesABSTRACT
<p><b>OBJECTIVE</b>To study the effect on promoter de-methylation, expression of ALDH1a2 gene and cell apoptosis by treated with 5-Aza-dC and TSA in five human bladder cancer cell lines.</p><p><b>METHODS</b>Human bladder cancer cell lines RT-4, 253J, 5637, BIU-87 and T24 were cultured and treated with 5-Aza-dC and(or) TSA. The expression of the ALDH1a2 gene was detected by RT-PCR and Western blot. The methylation status of gene promoter was determined by MSP, and the cell cycle profile was established by flow cytometry.</p><p><b>RESULTS</b>ALDH1a2 was silenced in five human bladder cancer cell lines. Re-expression of ALDH1a2 was detected after treated with 5-Aza-dC alone or TSA in combination. ALDH1a2 transcript was marked in each cell lines combined with 5-Aza-dC and TSA treatment which showed a synergistic effect on expression of ALDH1a2 transcript. Early apoptotic was the main mode of apoptosis and death of human bladder cancer cell lines induced by 5-Aza-dC and TSA. The percentage of early apoptotic cells was 1.4% in control group and 2.8% in TSA group, however, 20.2% in 5-Aza-dC group and 33.8% in 5-Aza-dC + TSA group, respectively. The groups of TSA, 5-Aza-dC and 5-Aza-dC + TSA were significantly different from control group (P < 0.05).</p><p><b>CONCLUSIONS</b>Aberrant methylation of ALDH1a2 gene is the main cause for gene transcriptional inactivation. Re-expression of ALDH1a2 gene and cell apoptosis are detected after either treatment with 5-Aza-dC alone or in combination with TSA.</p>
Subject(s)
Humans , Apoptosis , Azacitidine , Pharmacology , Cell Line, Tumor , Gene Expression Regulation, Neoplastic , Hydroxamic Acids , Pharmacology , Retinal Dehydrogenase , Metabolism , Urinary Bladder Neoplasms , Metabolism , PathologyABSTRACT
To evaluate the clinical outcomes of loupe-assisted intussusception vasoepididymostomy (VE) in the treatment of epididymal obstructive azoospermia (EOA), we retrospectively analyzed data from 49 patients with EOA who underwent two-suture longitudinal intussusception vasoepididymostomy (LIVE) between 2000 and 2007. The data included the surgical method, postoperative motile sperm count per ejaculation, percentage of progressive motile sperm and patency and pregnancy outcomes. There were a total of 49 men undergoing scrotal exploration, and epididymal obstruction was found in all cases. Bilateral or unilateral anastomoses were performed in 40 and 6 men, respectively. The postoperative courses of 42 patients were followed up for more than 6 months, and the courses of 38 patients were followed up for more than 1 year. The overall patency and pregnancy rates were 71.4% and 26.3%, respectively. Moreover, progressive motile sperm was more frequently present in those patients who had undergone anastomosis at cauda than at corpus or caput. Pregnancy was achieved only in those patients who had undergone anastomosis at least on one side of the cauda epididymis. We think that the loupe-assisted method, with a lower overall cost and a simplified surgical procedure, can achieve satisfactory patency outcomes and pregnancy results. Data from this paper also suggest that paternity outcomes occur more frequently after anastomoses at cauda than at corpus or caput.
Subject(s)
Adult , Humans , Male , Anastomosis, Surgical , Azoospermia , Pathology , General Surgery , Constriction, Pathologic , Pathology , General Surgery , Ejaculatory Ducts , Pathology , General Surgery , Epididymis , Pathology , General Surgery , Microsurgery , Methods , Retrospective Studies , Sperm Motility , Treatment Outcome , Vasovasostomy , MethodsABSTRACT
<p><b>OBJECTIVE</b>To explore the effect of Dogwood fruits on tonifying kidney-yang.</p><p><b>METHOD</b>The effect of the water extract of Dogwood fruits on rats model of kidney-yang deficiency with the hydrocortisone was observed.</p><p><b>RESULT</b>The water extract of Dogwood fruits could make normal the liver weight, and mitigate hepatocyte pathologic changes, increase the heptocellular levels of RNA and hepatin, and decrease the malondialdehyde (MDA) in rats model of kidney-yang deficiency. It could also make the viscera quotiety return to normal way and increase the levels of RNA in the interstitial cells of testicle in rats model of kidney-yang deficiency.</p><p><b>CONCLUSION</b>Water extract of Dogwood fruits can protect and improve the functions of the liver and testicle in rats model of kidney-yang deficiency.</p>