IMPOTENCE AND ITS NON-SURGICAL MANAGEMENT

SUMMARY Impotence is a common symptom which can cause considerable distress to both the sufferer and his partner. The use of pharmacotherapy to improve erectile function will continue to increase as safe and effective drugs are developed. However, restoring erectile function should not be the only treatment objective. It is also essential to address personal and emotional factors in the sufferer, conflicts in his relationship with his partner, and sexual problems in his partner, all of which may be instrumental in causing or maintaining the presenting impotence. We advocate a combined approach with appropriate medical treatment and sex and couple therapy     

Improved Cellular Delivery of Antisense Oligonucleotides Using Transferrin Receptor Antibody-Oligonucleotide Conjugates

This work is dedicated to the memory of the late Dr Ian Walker.     

Study on the pathogenicity of Campylobacter jejuni by modifying the medium

Campylobacter jejuni has been documented as one of the major aetiological agents of diarrhoeal illness all over the world. Studies revealed its pathogenicity by different assay methods, but none could be strongly recommended as a tool for differentiating toxigenic strains of C. jejuni. This study was an attempt to demonstrate better its pathogenicity by media modification. Fifteen isolates of C. jejuni recovered from diarrhoeal patients at the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka Hospital were included in this study. The standard medium for C. jejuni was modified by the incorporation of FeCl3 at different concentrations. The pathogenicity of the test isolates were studied by rabbit ileal loop assay; Chinese hamster ovary (CHO), human epithelial cervical carcinoma (HeLa); Y-1 adrenal cell lines and suckling mouse assay. Sonicated extracts of the test organisms, grown with FeCl3 supplement, were also assayed. An enhanced growth of C. jejuni was obtained with the increasing concentration of FeCl3 supplementation in the medium. Only five isolates of C. jejuni produced cytotoxic effect on HeLa cell monolayer. Other cell lines were not affected by the test specimens or sonicates. Rabbit ileal loop assay did not reveal any fluid accumulation but on dissection, the test loops were found highly haemorrhagic. No heat-stable (ST) toxin could be detected. Cell-free culture supernatant of patients' isolates of C. jejuni had an effect on HeLa cell monolayer. Sonicated extracts of patients' extracts had a greater effect on HeLa cell monolayer. Pathogenic strains of C. jejuni might be distinguished on HeLa cell monolayer using its sonicated extracts.     

Perforated colorectal neoplasms: correlation of clinical, contrast enema, and CT examinations

Results of clinical, contrast enema (CE), and computed tomographic (CT) examinations in 39 patients with perforated colorectal neoplasms were retrospectively reviewed. Twenty patients were toxemic at initial presentation, but in only four patients was the diagnosis of perforated colorectal neoplasm initially suspected clinically. CE study was performed in 22 patients and enabled the diagnosis of perforated neoplasm in 11 cases, neoplasm alone in eight, and neither neoplasm nor perforation in three. CT was performed in 38 patients and enabled the diagnosis of perforated neoplasm in 36; pericolic phlegmon but no mass lesion was evident in two. In 16 patients, CT also demonstrated metastatic disease. Because of its reliability in establishing the diagnosis and staging the extent of the inflammatory and neoplastic disease, CT is indicated in cases of suspected or proved perforated colorectal neoplasm and in cases in which CE study findings are indeterminate or suggestive of perforated neoplasm.     

Short-Ti inversion-recovery pulse sequence: analysis and initial experience in cancer imaging

Inversion recovery (IR), commonly considered a pulse sequence capable of producing T1-weighted images with excellent display of normal anatomy, is versatile: The null point and peak time provide a useful, succinct summary of the properties of IR and its capacity for producing both T1- and T2-weighted images. Shortening of the inversion time (TI) and creation of a short-TI inversion-recovery (STIR) pulse sequence increases sensitivity to malignancy and other abnormalities by making the effects of prolonged T1 and T2 on signal intensity additive and by nulling the signal from fat. The authors examined over 300 patients with various malignancies and compared STIR images with T1- and T2-weighted images obtained at 0.5 T. In 43 cases, signal-difference-to-noise ratios (SD/Ns) were calculated between tumor, fat, and muscle. In general, STIR images demonstrated tumor as a conspicuously high-intensity area in a background of muted, discernible anatomic detail. The good contrast achieved with STIR sequences between tumor and fat (SD/N = 18.1) and tumor and muscle (SD/N = 12.9) consolidated into a single image the information contained separately on T1- and T2-weighted images, which facilitates efficient detection and localization of malignancy.     

Congenital duodenal obstruction.

Over the period 1980-1989, 49 patients with congenital duodenal obstruction due to duodenal atresia, duodenal stenosis or annular pancreas were treated. There were three deaths, all related to associated severe congenital anomalies and none related to surgery for duodenal obstruction; 78 per cent of the patients had associated congenital anomalies which, in some instances, complicated their management. Prenatal diagnosis by ultrasonography was made in 18 per cent of the patients and these patients had operations relatively earlier.     

A midface swelling in a child – A possible diagnostic dilemma

A lump on the midface of a child can pose as a diagnostic dilemma. There is a wide variety of possible differential diagnoses, ranging from simple benign conditions such as a sebaceous cyst, dermoid cyst, lipoma, neuroma and neurofibroma, to potentially devastating conditions such as odontogenic myxoma.A case of a child in which the formulation of a definite diagnosis was clinically and histologically challenging is presented.