扩张后交错换位头皮瓣治疗烧伤瘢痕性秃发

我们采用将扩张后呈球面的头皮分割，形成两个或几个皮瓣，以避免球面头皮难以充分展平发挥最大效益的缺点。共治疗大面积瘢痕性秃发８例，７例效果满意，１例因１个扩张器外露而被迫取出，降低了疗效。     

90例阳萎病人阴茎血压和血流测定的结果分析

本文通过运用超声多普勒多功能仪,对90例阳萎患者在静息时,充血性加压试验和运动试验后的阴茎血压进行测定,分别计算出3种情况下的阴茎动脉收缩压与肱动脉收缩压的比值(PBI),同时描记阴茎背动脉的血流图。并据此从PBI值、血流图的升降幅度、年龄等方面分析血管性和非血管性阳萎的结果区别,并探讨联合运用上述无创伤性方法对阳萎病因进行筛选诊断的价值。     

Brain somatostatin depletion by cysteamine attenuates the penile erection induced by serotonergic and dopaminergic, but not by cholinergic, activation in rats

To clarify the role of brain somatostatin in the expression of penile erection, the effects of cysteamine, a somatostatin depletor, on the penile erection induced by serotonergic, cholinergic and dopaminergic stimulants were investigated in rats. Fenfluramine (0.1–10 mg/kg, i.p.), pilocarpine (0.032–3.2 mg/kg, i.p.) and apomorphine (0.01–1 mg/kg, i.p.) induced penile erection in rats, with bell-shaped dose-response curves. Pretreatment with cysteamine (200 mg/kg, s.c.) significantly attenuated the penile erection induced by fenfluramine and apomorphine, but scarcely affected that induced by pilocarpine. Neurochemical measures revealed that cysteamine pretreatment significantly reduced the somatostatin content in all brain regions examined. These results provide the first pharmacological evidence that the brain somatostatin may play an important role in drug-induced penile erection.     

面颈部严重缺损畸形的皮瓣修复

目的：探讨对严重面颈部缺损的修复，在局部功能恢复的同时，如何使其外观与正常相近似，才能让患者和社会予以接受。方法：依据缺损创面的部位、形状、缺损面积的大小、受区和供区色泽反差等，选择吻合血管的皮瓣或真皮下血管网皮瓣、传统皮瓣或带蒂的真皮下血管网皮瓣、岛状皮瓣和扩张后皮瓣转移，修复面颈部各种不同的皮肤软组织缺损。结果：对鼻、眼睑、眉毛的再造效果较佳；对颏颈Ⅲ－Ⅳ度粘连者，被修复区的皮肤柔软，颜色与周围皮肤色泽相近；对肿瘤切除或深度烧伤创面修复，皮瓣外观平整，不显臃肿。结论：应用外科皮瓣在不同部位进行修复，能取得良好的临床效果。     

Oxytocin: an extremely potent inducer of penile erection and yawning in male rats

The intracerebroventricular (i.c.v.) injection of oxytocin, in doses ranging from 5 to 90 ng (5–90 pmol) induced penile erection and yawning in male rats. Such response was not induced by doses of the peptide higher than 100 ng, nor by equimolar doses of i.c.v. [Arg⁸]vasopressin, ACTH-(1–24), -MSH, rat corticotropin-releasing factor (rCRF), delta sleep-inducing peptide, neurotensin or substance P. Oxytocin-induced penile erection and yawning were prevented by atropine and morphine, but not by methylatropine or the opiate antagonist naloxone. Haloperidol, a dopamine receptor antagonist, was ineffective at low doses; it partially prevented penile erection but not yawning at high doses. Since oxytocin is present not only in the neurohypophysis but also in other brain areas, our results suggest that oxytocin is implicated in the regulation of penile erection and yawning, and provide further evidence that oxytocin acts as a neuropeptide in the central nervous system.     

The Measurement of Human Penile Tumescence

The techniques of penile measurement have been developed in numerous laboratories in Europe, Australia, and the United States. Most researchers now use either circumference or volumetric devices, depending on the research rationale. Thermistors have not been adequately evaluated. This paper reviews the important measurement issues associated with each device, as well as relevant construction information. Examples of applied research are provided. With respect to overall efficacy of the transducers, we recommend volumetric procedures where precision of measurement is of critical importance. However, for efficiency and ease of use the circumference devices, particularly the mercury-in-rubber gauge, appear optimal. Penile tumescence measurement is of fundamental importance in determining basic parameters of the psychophysiological process of human sexual arousal.     

Peyronie's disease: An unusual presentation with butterfly shaped calcified plaques

Peyronie's disease is characterized by the formation of a fibrotic plaque in the tunica albugenia of the penis. Two patients with calcified butterfly shaped plaques involving the ventrolateral aspect of the penis are described. These patients were managed by plaque excision and dermal grafting with excellent post-operative results.     

Penile lipomas,cause of sexual dysfunction

We report 2 cases of penile lipomas. although the simultaneous sexual dysfunction proved to be phsychogenic their surgical excision improved their sexual life.     

A retrospective review of 307 men with Peyronie's disease

PURPOSE: We discuss the clinical appearance and natural outcome of Peyronie's disease. MATERIALS AND METHODS: During an 8-year period 307 men with Peyronie's disease were evaluated, and clinical characteristics, risk (factors), penile deformities, erectile status and outcome were analyzed. RESULTS: Mean patient age plus or minus standard deviation was 52.8 +/- 9.3 years (range 23 to 76). Penile deformity, pain on erection and palpable nodule were the most common (85%) presenting symptoms, usually in different combinations. The remaining 15% of men (mean age 59.4 +/- 6.5 years) were not aware of the penile deformity and were diagnosed during standard evaluation for erectile dysfunction. Dorsal (45.6%) and lateral (29.3%) were the most common curvatures. The degree of deformity was less than 30 degrees in 42.7% of patients, 31 to 60 degrees in 38.8% and greater than 60 degrees in 18.6%. At least 1 risk factor for systemic vascular disease was identified in 67.5% of patients, and hypercholesterolemia and diabetes were the most common. Patients with at least 1 risk factor had a significantly higher risk for severe penile deformity. Of the men 54.4% complained of erectile dysfunction and the probability of diminished erectile capacity was 86.7% in patients older than 60 years, with Peyronie's disease for more than 12 months and at least 1 risk factor. Of 63 patients presenting with the acute phase of disease penile deformity deteriorated in 30.2%, did not change in 66.7% and resolved spontaneously in 3.2% without any treatment after a mean followup of 8.4 months. CONCLUSIONS: Our data show that penile deformities are disabling (greater than 30 degrees) in 62.5% of cases. Risk factors, such as serum lipid abnormalities, diabetes and hypertension, seem to have significant impact on the severity of symptoms and outcome. Patients must be informed that Peyronie's disease is progressive in 30.2% without treatment and spontaneous resolution is rare.     

Predictive pathological factors of lymph nodes involvement in the squamous cell carcinoma of the penis

Objectives:To evaluate the predictive role ofprimary tumor histopathological features inpredicting inguinal lymph nodes involvement inpatients with penile squamous cell carcinoma.Material and methods:We retrospectivelyanalysed pathological records from 30consecutive patients who underwent penectomyfor invasive squamous cell carcinoma of thepenis. All histological specimens were reviewedby the same pathologist. We considered thefollowing histological parameters: histologicalgrading, growth pattern, deph invasion, tumourthickness, nuclear grading, poorlydifferentiated cancer rate, vascular andlymphatic embolization, eosinophilic andmononuclear infiltration and pathologicalstage.Results:Lymph nodes involvement occurred in 5patients who underwent `early' lymphadenectomyand in other 4 ones during oncologicalsurveillance. Lymph nodes metastasis resultedsignificantly correlated with histologicalgrading (p = 0.005), lymphatic (p = 0.005) andvenous (p = 0.02) embolization, corporacavernosa (p = 0.03) and urethra (p = 0.03)infiltration. Histological grading andlymphatic embolization were independentpredictive variables of lymph nodes involvement(p = 0.02).Conclusions:The histological grading andlymphatic embolization have to be considered asimportant parameters to select patients withpenile squamous cell carcinoma to undergo an`early' lymphadenectomy.