Urinary retention with glans hypervascularization after penile arterialization

Penile revascularization is a relatively new treatment for impotence. Glanular hypervascularization is a known complication of a venous arterialization procedure and it requires surgery for cure. A case in which delayed glanular hypervascularization caused urinary retention is presented. Ligation of the distal deep dorsal vein via the retro-coronal plexus resulted in cure.     

Factors associated with penile amputation in Thailand

PURPOSE: To evaluate the feasibility of using the grading algorithm utilized by the Advanced Glaucoma Intervention Study (AGIS) on a Humphrey Field Analyser with program 9 (76/30 degrees Threshold Grid) of a computerized perimeter DICON TKS 4000 and find whether the obtained score can be used to determine the stage of glaucoma. METHODS: Computerized perimetry was performed on 205 eyes with proven or suspected glaucoma. Visual field changes were assessed first subjectively, and then with the scoring method used in AGIS: the size, depth, and location of the visual field defects, and the nasal step were determined using a stencil and then the final score was calculated. RESULTS: Of 205 eyes examined 79 had perimetric changes. These were allocated subjectively into four groups corresponding to four stages of glaucoma: initial, evoluted, advanced and terminal. The mean scores for each group were calculated. There was a statistically significant correlation between the score and the stage of glaucoma. The mean scores for the first 3 stages differed significantly from each other. For stages 3 and 4 the difference was not statistically significant. CONCLUSION: The AGIS scoring method, developed originally for program 30-2 of the Humphrey Field Analyzer, can be applied with the 30 degrees Threshold Grid program of DICON TKS 4000 Perimeter for objective assessment of the glaucoma stage.     

Rare complication of circumcision: penile amputation and reattachment

We report a case of traumatic penile amputation which occurred accidentally during a ritual circumcision in a 10-year-old boy. A successful penile reattachment was accomplished. Additionally, we discussed the causes and prevention of this condition.     

Primary mucinous carcinoma of the skin. Report of case

The authors report a case of a primary mucinous carcinoma of the skin. This is a rare adnexial tumor arising from the eccrine secretory coils. The histologic characteristic finding of this lesion is the heap of abundant mucinous material (sialomucin) in the dermis in which rare epithelial islands are free-floating. In this study we also value the importance of a correct diagnosis for an appropriate therapy.     

Treatment of hemangioma of the glans penis using Nd:Yag laser. Apropos of a case

Hemangioma of urinary tract are unusual, being about 2% of all hemangiomas. We present a case of a glans penis hemangioma. There is controversy concerning their treatment and outcome. Our patient was treated with a Neodymium: Yag laser irradiation, with complete morphological recuperation.     

Isolated avulsion fracture of the lesser tuberosity of the humerus. Apropos of a case

PURPOSE OF THE STUDY: The authors report a rare case of an isolated avulsion fracture of the lesser tuberosity of the humerus in an adult. The aim of the study was to highlight diagnostic features as well as surgical treatment. MATERIAL: A 31 year old woman presented an isolated avulsion fracture of the lesser tuberosity of the humerus. Physical exam, standard radiographs of the shoulder as well as a computed tomographies (CT) were obtained. METHODS: An assessment was made of the patient's complaints, signs and symptoms, diagnosis, surgical treatment, physical therapy and follow-up. Final clinical results were evaluated according to external rotation and muscular strength of the shoulder. RESULTS: The diagnosis was evoked on standard radiographs of the shoulder and confirmed by CT. The patient was operated on the 8th day following trauma and pendular physical therapy was initiated on the third day postoperatively. The patient recovered her daily activities from the 6th week and was back at work by the end of the 2nd month. Follow up at 12 months showed a painless shoulder with external rotation at 50 degrees in adduction and 70 degrees in abduction. Muscular strength was identical to the contralateral side. No antero-medial impingement was detected due to the hardware. DISCUSSION: This observation illustrates the rare aspect of this fracture, already recognized in literature. The fracture mechanism remains unknown. We agree with Haas, Ross and Love that it might be due to a forced external rotation of the shoulder at 60 degrees of abduction. We highlight the role of the "axillary view" and of the magnetic resonance imaging (MRI) in the diagnostic approach. Treatment is surgical by open reduction and internal fixation of the detached fragment. CONCLUSION: Treatment must be surgical whenever there is a slight displacement of the detached fragment, to prevent non union, mal union or an antero-medial impingement that might limit mobility and muscular strength.     

The variants and potentials of reconstructive surgery of the penile skin

This paper is part of a larger study examining the role of the nurse practitioner and its potential utility in mental health nursing. Two methods were employed for data collection: a focus group interview with eight RCN qualified nurse practitioners, the result of which informed the development of a postal questionnaire which was distributed to the remaining RCN qualified nurse practitioners (n = 130). Forty seven respondents did not feel adequately equipped to assess a mental health problem, despite nearly a third identifying mental health issues as a primary problem with which their patients presented. Just over 40 per cent of respondents stated that mental health needs were not met within their community and 78.7 per cent of respondents supported the development of a mental health nurse practitioner. In light of these findings the concept of a mental health nurse practitioner is discussed, alongside the need to clarify other advanced nursing roles.     

Patient-controlled analgesia. PCA in a three year old child after traumatic amputation]

The two Staphylococcus epidermidis plasmids pIP1629 (7.5 kb) and pIP1630 (14.4 kb) contain the vga gene conferring resistance to streptogramin A. All the sequences of pIP1629, except two of the four 22-nt iterons preceding the replication gene, were found in pIP1630. The additional 6.9-kb fragment of pIP1630 is similar to the mobilizable S. epidermidis plasmid pSK639, carrying the dfrA-thyE-orf140 operon and thought to replicate by an iteron controlled theta-type replication mechanism. The replication-mobilization elements of pIP1629 and pSK639 are very similar despite having been isolated in France and in Australia, respectively, showing that they are geographically widely dispersed in S. epidermidis. The gene thyE encoding thymidylate synthetase carried by pSK639 is not present in pIP1630. pIP1630 probably arose by the recombination of two homologous plasmids carrying distinct resistance determinants.     

Fibroadenoma of the vulva. Report of a case

A case of fibroadenoma occurring in the vulva of a 24 year old woman is presented. This rare benign tumor appears as dermal or subcutaneous well circumscribed nodule. Histologically the fibroadenoma is characterized by epithelial and stromal proliferation. Two different concepts concerning histogenesis are cited; the authors believe that this tumor arises in ectopic mammary tissue.     

Recto-cutaneous penile fistula. A description of a clinical case and review of the literature

This describes a newborn with an imperforate anus associated to a fistulous track extending along the scrotal raphe and opening at the penis top. This variant appears to be a low anomaly. The surgical treatment of this pathology is discussed.     

Pseudomembranous colitis complicated with toxic megacolon. Report of a case

We present a patient who developed pseudomembranous colitis a few days after suffering serious multiple traumas and after receiving a variety of antibiotic treatments. The patient, whose condition was further complicated by toxic megacolon, underwent subtotal colectomy and ileostomy. Toxic megacolon is a rare complication of enterocolitis due to C. difficile and is associated with a high rate of mortality. We review the cases published to date, describe the pathogenesis of the condition, and discuss the diagnostic criteria for pseudomembranous colitis, emphasizing treatment and possible complications.