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1.
We describe a Libyan boy with an unusual phenotype of multiple congenital anomalies, including triophthalmia, dolichocephaly, porencephaly, cleft lip/palate, facial asymmetry, micrognathia, and VSD. The reported phenotype is likely to represent a new entity of non-chromosomal syndromic triophthalmia. Other possibilities are discussed.  相似文献   

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PURPOSE: We conducted a retrospective study of patients with strictures after hypospadias repair to identify factors contributing to the development of strictures and to attempt to define an optimal strategy for management. MATERIALS AND METHODS: Patients with the diagnosis of hypospadias who had undergone direct vision internal urethrotomy, urethral dilation or urethroplasty were identified. The original location of the meatus, type of initial repair, subsequent procedures and outcome of the interventions were recorded. RESULTS: A total of 38 patients were identified. Of the 29 patients who were initially treated with direct vision internal urethrotomy or urethral dilation 23 (79%) ultimately required open urethroplasty and did well. Of the 8 patients treated with initial urethroplasty 7 had successful outcomes. Overall success, defined as asymptomatic voiding without fistula or residual stricture, was 78% at a mean followup of 6.3 years. CONCLUSIONS: Stricture disease continues to be a significant complication of hypospadias reconstruction. Initial therapy should be urethral dilation but it should be recognized that the majority of these patients will ultimately require open urethroplasty.  相似文献   

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A 90-year-old man with a longstanding bilateral essential tremor presented with right-sided weakness of sudden onset. The CT scan of the brain showed a hypodense area in the left side of the pons consistent with an infarction. The paralysis disappeared without recurrence of the tremor on the right, but the tremor persisted on the left. It is likely that the fronto-rubro-spinal pathway had been interrupted at the level of the pons abolishing the tremor on the right side.  相似文献   

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Fracture of the penis is not an uncommon urological emergency. Six patients with this injury, treated at the Institute of Urology, General Hospital, Kuala Lumpur, since 1988, were reviewed. Their ages ranged from 21 to 30 years old (mean 25). Four cases were self-inflicted by abnormal bending and 2 cases occurred during sexual intercourse. A sudden "cracking sound", violent pain, rapid flaccidity and deformity of the penis were documented. Duration of injury at presentation ranged from 12 to 90 hours (mean 35 hours). Primary repair of the tunica albuginea with absorbable suture was performed in all cases. The results of surgery was excellent, with restoration of normal function in 4 patients (2 patients defaulted follow-up). We advocate immediate surgical repair for this injury.  相似文献   

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On the basis of the histologic analysis of 45 solitary (juvenile) bone-cysts the author reveals new aspects of the pathogenesis. I. Data on sex-age-localisation are referred to. II. Due to the hemosiderosis regularly manifesting itself in the loose connective tissue layer lining the cyst and owing to the similarity to the liquified hematomas to be found elsewhere in the organism, as well as on the basis of the specific blood-supply conditions of the spongiosa of the increasing metaphysis the author presumes the intramedullary hemorrhage--possibly occurring also without fracture--to be the primary change. III. In the lining layer of the cyst, as well as in the adjacent bony tissue the author frequently observed capillary stase and to a considerable degree lymphedemas (resorption insufficiency). On the basis of these data the author presumes that the following mechanism might be hold responsible for the persisting of the cyst: The congestive (anoxic) wall of the capillary gets permeable for the proteins. Hence the fluid of high protein content, filling the cyst is constantly replaced. It is emphasized that solely the lymphatic vessels are apt to convey proteins. On the basis, however, of the histologic phenomena (lymphedema) observed, the pericystic lymphatic system is in the stage of relative insufficiency.  相似文献   

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Histoplasmosis is a common cause of systemic mycosis in endemic areas of the United States. Genitourinary and cutaneous involvement with this dimorphous fungus is rare. We report a case of disseminated histoplasmosis associated with nonpainful ulcerative lesions of the glans and shaft of the penis.  相似文献   

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Paraffinomas of the male genitalia are now rare. We report on a Russian patient with subcutaneous nodules of the penis and the prepuce. Injections of exogenous lipids into the male genitalia are still performed in many Eastern European countries. Thus, a paraffinoma should be considered in the differential diagnosis of subcutaneous nodules of the male genitalia in patients from these areas.  相似文献   

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A series of 120 pathologically verified intraspinal tumors was analyzed for the relative incidence and location of the tumors as well as the distribution of age and sex. These data were compared to series from Taiwan, mainland China, Thailand, Korea, Japan, Iran, India, and countries in the West. The ratio of brain to intraspinal tumors was about 5:1 in Taiwan, higher than those reported in China, Korea, and in the West. The male to female ratio is about six to five. For most tumors, male predominance is noted except for meningioma. The incidence of intraspinal tumors in the order of frequency is nerve sheath cell tumor(NSCT), metastatic tumors, meningioma, glioma, congenital tumors, and vascular tumors. In the East, the incidence of NSCT is about 40%, and meningioma is about 10%. In the West, they are both about 20%. Congenital tumors accounted for only 3.3%. In China, it was about 12% and this is the highest incidence of dysembryoplastic tumors in the world. Glioma has similar incidence (about 10%) in Taiwan, China, Thailand, Japan, and Iran (about 10%), whereas it is about 15% in the West and India. Korea has the highest incidence of glioma, (32.3%). Low incidences of metastatic intraspinal tumors (4.6-5.5%) were noted in China and Japan, but a higher incidence (14.2-24.2%) was seen in Taiwan, Iran, and the West. The most common metastatic tumors in the order of frequency is tumors of unknown origin, lung cancer metastasis, hepatoma, and breast cancer. The high percentage of unknown origin of metastasis may have resulted from loss of follow-up and lack of postmortem studies.  相似文献   

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Although the annular dark field detector in the STEM collects a large fraction of the elastically scattered electrons, it does not use all the information carried by these electrons because it ignores the distribution of electrons over its surface. This information can be obtained by dividing the detector into sections. This paper calculates the number of electrons scattered by a single atom onto each side of an annular dark field detector split in half by a line passing through its center. This scattering problem is unusual becuase the incident wave is not a plane wave in the STEM. The sum and difference signals are calculated for a single atom from its scattering amplitude for a STEM limited by primary or secondary spherical aberration operating at 10 kV, 70kV, or 100 kV. All the cases calculated show that a single thorium atom should give an observable difference signal which is very sensitive to the focal conditions of the STEM.  相似文献   

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Verruciform xanthoma is a rare benign lesion. The most common presentation is at the oral mucosa level, although it has also been described at other locations. Our case is the twelfth verruciform xanthoma of the penis ever published. We highlight the relevance of the differential diagnosis and its excellent prognosis, the choice treatment being the simple exeresis of the lesion.  相似文献   

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Excision of penile carcinoma by chemosurgery (Hohs' technique) is as nearly ideal as can be because it assures removal of the neoplasm with maximal preservation of normal tissue and function.  相似文献   

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Squamous cell carcinoma is the most common tumour of the penis. It is a rare disease in Western countries, and occurs in patients after the sixth decade. The pattern of spread is loco-regional, and prognosis is poor when nodal metastases appear. The etiology of penis cancer is discussed, however human papillomavirus infection, tobacco, poor hygiene and phimosis are often associated with this disease. Radical surgery gives the best control of the primary tumour, but it is mutilating. Conservative therapies (laser, radiotherapy, and particularly brachytherapy...) are an attracting option. Regional lymph nodes management is extremely controversial. Lymph node metastases, invasion of corpus cavernosum, and poor differentiation are pejorative prognostic factors. More than half patients are responsive to modern polychemotherapy combinations. However responses are transient and chemotherapy alone is not curative for metastatic disease. Etiologic factors, clinical presentation, staging work-up requirements, prognostic factors and therapeutic modalities are detailed.  相似文献   

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Thirty-four patients with osteoarthritis (OA) and 32 patients with rheumatoid arthritis (RA) were studied to determine the effects of OA and RA on the laxity of the knee joints. Laxity was measured with the Genucom Knee Analysis System. The antero-posterior laxity of the OA and RA knees was greater than the control, normal knees in the early stage, and decreased with the severity of disease in OA, but not in RA. Severe OA and RA were associated with a restricted internal-external rotation at the knee joint compared with the control. Internal-external rotation decreased with worsening of both diseases. Varus-valgus laxity tended to increase slightly with the severity of disease. While the morphological changes of the cruciate ligaments in advanced OA and RA were not statistically different, the laxity of OA-afflicted knees was affected slightly by the severity of the damage to the cruciate ligaments.  相似文献   

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