An unusual variant of Zinner syndrome with ureteral ectopia from an atrophied supernumerary kidney.

This case presents an unusual variation of Zinner syndrome with a patient found to have an ectopic ureteral insertion of the seminal vesicle from a supernumerary pelvic kidney and complete duplication of the ipsilateral, otherwise normal renal unit. The case offers an interesting variant of a previously established syndrome with successful treatment involving robotic resection of an ectopic ureter and seminal vesiculectomy, resulting in resolution of the patient's symptoms.

Partial Priapism Treated with Pentoxifylline.

MAIN FINDINGS: A 26-year-old man suffering from partial priapism was successfully treated with a regimen including pentoxifylline, a nonspecific phosphodiesterase inhibitor that is often used to conservatively treat Peyronie's disease. CASE HYPOTHESIS: Partial priapism is an extremely rare urological condition that is characterized by thrombosis within the proximal segment of a single corpus cavernosum. There have only been 36 reported cases to date. Although several factors have been associated with this unusual disorder, such as trauma or bicycle riding, the etiology is still not completely understood. Treatment is usually conservative and consists of a non-steroidal anti-inflammatory and anti-thrombotic. Promising future implications: This case report supports the utilization of pentoxifylline in patients with partial priapism due to its anti-fibrogenic and anti-thrombotic properties.

Partial Priapism Treated with Pentoxifylline

ABSTRACTMain findings:A 26-year-old man suffering from partial priapism was successfully treated with a regimen including pentoxifylline, a nonspecific phosphodiesterase inhibitor that is often used to conservatively treat Peyronie's disease.Case hypothesis:Partial priapism is an extremely rare urological condition that is characterized by thrombosis within the proximal segment of a single corpus cavernosum. There have only been 36 reported cases to date. Although several factors have been associated with this unusual disorder, such as trauma or bicycle riding, the etiology is still not completely understood. Treatment is usually conservative and consists of a non-steroidal anti-inflammatory and anti-thrombotic.Promising future implications:This case report supports the utilization of pentoxifylline in patients with partial priapism due to its anti-fibrogenic and anti-thrombotic properties.

Adult-acquired hidden penis in obese patients: a critical survey of the literature.

CONTEXT: Hidden penis is anatomically defined by a lack of firm attachments of the skin and dartos fascia to the underlying Buck fascia. OBJECTIVE: To critically appraise the research evidence that could support the most effective surgical techniques for adult-acquired hidden penis in obese patients. METHODS: Studies investigating patients with a diagnosis of hidden penis were identified. Of these studies, only those with adult patients classified as overweight or obese (body mass index >25) were included in the review. Three reviewers examined the abstracts of the studies identified in the initial Medline search, and abstracts considered potentially relevant underwent full-text review. Studies that included patients with congenital, iatrogenic (eg, circumcision issues or aesthetic genital surgery), or traumatic causes of hidden penis were excluded. Studies that did not define the diagnostic criteria for hidden penis were excluded to minimize the risk of definition bias. The quality of evidence for each study was determined after considering the following sources of bias: method of allocation to study groups, data analysis, presence of baseline differences between groups, objectivity of outcome, and completeness of follow-up. Using these criteria, studies were then graded as high, moderate, or low in quality. RESULTS: Seven studies with a total of 119 patients met the inclusion criteria. All but 1 of the studies were nonrandomized. One study provided a clear presentation of results and appropriate statistical analysis. Six studies accounted for individual-based differences, and 1 study failed to account for baseline differences altogether. Four studies addressed follow-up. One study was of high quality, 2 were of moderate quality, and 4 were of low quality. CONCLUSION: Building a clinical practice guideline for the surgical management of hidden penis has proven difficult because of a lack of high-quality, statistically significant data in the research synthesis. The authors elucidate the challenges and epitomize the collective wisdom of surgeons who have investigated this problem and emphasize the need for rigorous evaluative studies.

Chewing rates among domestic dog breeds.

The mammalian masticatory rhythm is produced by a brainstem timing network. The rhythm is relatively fixed within individual animals but scales allometrically with body mass (M(b)) across species. It has been hypothesized that sensory feedback and feed-forward adjust the rhythm to match the jaw's natural resonance frequency, with allometric scaling being an observable consequence. However, studies performed with adult animals show that the rhythm is not affected by jaw mass manipulations, indicating that either developmental or evolutionary mechanisms are required for allometry to become manifest. The present study was performed to tease out the relative effects of development versus natural selection on chewing rate allometry. Thirty-one dog breeds and 31 mass-matched non-domestic mammalian species with a range in M(b) from approximately 2 kg to 50 kg were studied. Results demonstrated that the chewing rhythm did not scale with M(b) among dog breeds (R=0.299, P>0.10) or with jaw length (L(j)) (R=0.328, P>0.05). However, there was a significant relationship between the chewing rhythm and M(b) among the non-domestic mammals (R=0.634, P<0.001). These results indicate that scaling is not necessary in the adult animal. We conclude that the central timing network and related sensorimotor systems may be necessary for rhythm generation but they do not explain the 1/3rd to 1/4th allometric scaling observed among adult mammals. The rhythm of the timing network is either adjusted to the physical parameters of the jaw system during early development only, is genetically determined independently of the jaw system or is uniquely hard-wired among dogs and laboratory rodents.

Medical marijuana: a survey of teenagers and their parents.

Parents and their teenage children were questioned about medical marijuana and whether they believed that passage of medical marijuana laws in their states would increase teenage use of marijuana for non-medical purposes. A 24-question written survey was distributed separately to teenager/parent pairs who visited 1 of 2 suburban general pediatric offices located in Vienna, Virginia or Mason, Ohio. Completed surveys were collected from 393 parent-teen pairs. Only 13% of the teenagers admitted to ever smoking marijuana while 6% admitted smoking it in the past 30 days. There was good agreement between parents and teens (81% of parents and 76% of their teenagers who responded to the survey) that regular use of marijuana causes harm to many or most users, not just "potheads." Although there was close agreement in the range of opinions about medical marijuana (i.e., from liberal use to no use) by parents as a group and the teens as a group, agreement between the answers of parents matched with their own children was poor based on K-coefficient analysis (K = 0.20). Twenty-eight percent of the parent group and 55% of the teenagers believed that passage of state laws for medical marijuana would make it easier for teens to smoke marijuana for medical purposes.