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991.

Objective  

The ATP-binding cassette transporter A1 (ABCA1) is essential protein involved in lipid metabolism. The present study was undertaken to detect the possible association of polymorphisms in the ABCA1 gene [rs2230806 (R219K) and rs2230808 (R1587K)] and lipid profile in Greek young nurses.  相似文献   
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Background

Correction of residual curvature during inflatable penile prosthesis (IPP) implantation in patients with Peyronie's disease (PD) by plaque incision and grafting is a common approach.

Aim

To present a novel technique for residual curvature correction during IPP implantation using collagen fleece (TachoSil, Baxter Healthcare Corp, Deerfield, IL, USA).

Methods

After the IPP (Titan Touch, Coloplast, Minneapolis, MN, USA) is placed, the implant is inflated maximally. When residual curvature exceeds 40°, the PICS (penile implant in combination with the Sealing technique) technique is performed. The device is deflated, and a circumcising skin incision and penile degloving are performed. After elevation of the neurovascular bundle, the device is reinflated maximally. Plaque incision is performed at the point of maximum curvature using electrocautery. This leads to penile straightening because the tension is removed. In the next step, the defect of the tunica is closed with collagen fleece, which sticks to the tunica and defect without any sutures needed. The neurovascular bundle is reapproximated and the Buck fascia is closed. This is followed by closure of penile skin.

Outcomes

Primary outcome measurements were straightening rates, operative times, 5-item International Index of Erectile Function (IIEF-5) scores at follow-up, immediate and late complications, and patient satisfaction.

Results

The PICS technique was applied to 15 patients. Mean patient age was 61.7 years (52–79 years). Mean residual curvature after IPP was 66.7° (50–90°). Mean operative time was 117.3 minutes (100–140 minutes). Mean follow-up was 15.1 months (1–29 months). 12 of 15 patients (80%) showed a totally straight penis. 3 patients (20%) had residual curvature of 10° at follow-up, which did not interfere with sexual intercourse. Mean IIEF-5 score at follow-up was 24.2 (22–25). No immediate or late complications occurred. All patients were satisfied with the surgical outcomes.

Clinical Implications

This novel technique prevents puncture or injury of the device, because the collagen fleece does not require suture fixation into the defect after plaque incision.

Strengths and Limitations

This technique can be applied to patients with severe PD who display residual curvature greater than 40° after IPP placement. It is a fast approach with low complication rates. Limitations include the small patient population and short follow-up.

Conclusion

The PICS technique represents a safe and time-saving approach for residual curvature correction during IPP placement in patients with PD and prevents device puncture.Hatzichristodoulou G. The PICS Technique: A Novel Approach for Residual Curvature Correction During Penile Prosthesis Implantation in Patients With Severe Peyronie's Disease Using the Collagen Fleece TachoSil. J Sex Med 2018;15:416–421  相似文献   
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Epistaxis is a very common ENT event. Apart from the effectiveness of the different treatment options, the discomfort and the financial burden are of great importance. It has been the aim of this study to obtain data regarding the discomfort/pain of the epistaxis treatments and to calculate the financial burden. During the period between April 2010 and July 2011 epistaxis patients at our hospital had the opportunity to rate the discomfort/pain they experienced during their treatment on a 0–10 VAS scale. The costs of epistaxis treatments were calculated in an extended cohort. 84 VAS scores in 61 patients were acquired and the costs of treatment were calculated in 96 patients. The lowest VAS scores were found in chemical and electric coagulation with 1.5 and 2.0, respectively, followed by surgery (3.0), Rapid Rhino® packing (6.0) and balloon pack (7.5). The costs of treatments depended on whether the treatment was in an out- or inpatient setting. Surgery was not significantly more expensive than packing methods in the inpatient setting. Anterior epistaxis could be managed by local coagulation with an acceptable impact/cost ratio. At our institution, surgery was the most cost effective and the least troublesome procedure in posterior bleedings, preceded by Rapid Rhino® packing if required.  相似文献   
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IntroductionCurrent studies indicate that women with type 1 diabetes (T1DM) have a high prevalence of sexual disorders although data on the prevalence of sexual dysfunction are limited when sexual distress is included.AimThe frequency and the possible correlates of distressful sexual disorders in a highly selected group of type 1 diabetic women.MethodsThe sexual function, sexual distress, and general health status were assessed in 44 premenopausal women with uncomplicated T1DM and 47 healthy controls, using the Female Sexual Function Index (FSFI), the Female Sexual Distress Scale (FSDS), and the General Health Questionnaire–28 (GHQ–28).Main Outcome MeasuresThe impact of sexual distress on the frequency of female sexual dysfunction (FSD).ResultsThe frequency of sexual disorders according to the FSFI was significantly higher in diabetic compared to control women (25% vs. 8.5%, respectively, P < 0.05). Diabetic women had significantly lower median (first to third quartile) total FSFI score compared to control group (30.55 [26.08–33.08] vs. 33.50 [30.70–34.30], P = 0.001). Desire, arousal, and satisfaction were the sexual domains significantly affected in the diabetic group. Diabetic women had significantly higher median (first to third quartile) FSDS score compared to control group (6.5 [2.3–15.8] vs. 4.0 [1.0–10.5]P = 0.043). FSD (combined pathological FSFI and FSDS scores) was present in higher proportion of diabetic women (15.9%) compared to controls (2.1%) (P = 0.020). GHQ–28 score was comparable between the groups. However, in the diabetic group, FSD was related with anxiety, depression, and low educational level. Diabetes‐related factors were not associated with FSD.ConclusionsPre‐menopausal women with uncomplicated T1DM have significantly higher frequency of FSD compared to healthy controls, when the criterion of sexual distress is included. Psychosomatic and contextual factors implicated in sexual distress are correlates of FSD. Dimitropoulos K, Bargiota A, Mouzas O, Melekos M, Tzortzis V, and Koukoulis G. Sexual functioning and distress among premenopausal women with uncomplicated type 1 diabetes. J Sex Med 2012;9:1374–1381.  相似文献   
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Background and aims In extended liver resections, the preservation of vascular and biliary structures of the entire remnant liver is of paramount importance. The impact of venous outflow impairment and its consequences for liver regeneration and function are still a matter of debate. Materials and methods Rats (n = 75) were subjected to a 90% partial hepatectomy (PH), to a 70% liver resection with narrowing of the hepatic outflow of an additional 20% parenchyma (70%+ PH) or to an anatomic 70% PH. Postoperatively hepatocyte proliferation (Ki-67), liver function and survival were assessed. Gene expression analysis for markers of regeneration was determined by in-house complementary (DNA) arrays and quantitative real-time polymerase chain reaction (RT-PCR). Results Ninety percent PH led to a greater regenerative response as shown Ki-67 compared to animals with a 70%+PH (p < 0.05). However, liver function was equally impaired in both groups. Rats with 70% PH showed a greater proliferation index with less hepatic injury and better liver function. While mortality was 0% in the group of 70% PH, rats with 90% PH and 70+PH had a reduced survival of 75% (p < 0.05) Conclusion Venous outflow obstruction leads to an impairment of liver regeneration and liver function. In cases with critically small liver remnants, restoration of an adequate venous outflow may be mandatory.  相似文献   
1000.
Congenital seminal vesicle cysts associated with renal agenesis are uncommon, but are currently detected more frequently with the use of sectional imaging procedures. Approximately 200 cases have been reported. The unique feature of our case is the combination of this disorder with an ipsilateral undescended testis. Our patient underwent partial vesiculectomy, in which the cyst was removed and the seminal vesicle remnant with its vas deferens was preserved. A review of the infertile cases and the impact of surgical treatment on fertility are discussed. Features that render partial vesiculectomy applicable and the potential effect of this procedure on fertility are highlighted.  相似文献   
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