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BackgroundPatients with end-stage renal disease (ESRD) experience erectile dysfunction (ED). Although it is a benign disorder, ED is related to physical and psychosocial health, and it has a significant impact on the quality of life (QOL). The objective of the present study was to investigate the effects of different renal replacement therapies on ED.MethodsA total of 100 ESRD patients and 50 healthy men were recruited to the present cross-sectional study. The study was consisted of 53 renal transplantation (RT; group I; mean age, 39.01 ± 7.68 years; mean duration of follow-up, 97.72 ± 10.35 months) and 47 hemodialysis (HD) patients (group II; mean age, 38.72 ± 9.12 years; mean duration of follow-up, 89.13 ± 8.65 months). The control group consisted of 50 healthy men (group III; mean age 39.77 ± 8.51 years). Demographic data and laboratory values were obtained. All groups were evaluated with the following scales: International Index of Erectile Function (IIEF)-5 and Short Form (SF)-36 questionnaires, and Beck Depression Inventory (BDI). The patients whose IIEF score were ≤21 were accepted as having ED.ResultsThe mean age of these groups were similar (P > .05). Total IIEF-5 scores of men in groups I, II, and III were 19.5 ± 4.5, 16.4 ± 5.9, and 22.5 ± 3.4, respectively. The mean total IIEF-5 score of control group was higher than those of groups I and II (P < .001). Posttransplant group mean total IIEF-5 score was also higher than the HD group (P < .05). Groups I and II significantly differed from control group in terms of presence of ED (IIEF score ≤21: Group I, n = 28 [52.8%]; group II, n = 29 [61.7%]; and group III, n = 12 [%24], respectively [P < .001]), whereas there was no difference between groups I and II. In the logistic regression analysis (variables included age, BDI, and renal replacement therapy [HD and transplantation]), ED was independently associated with age (odds ratio [OR], 1.1; 95% confidence interval [CI], 1.05–1.2), BDI (OR, 1.1; 95% CI, 1.01–1.13). Additionally, ED was not associated with renal replacement therapy (OR, 1.46; 95% CI, 0.60–3.57). Physiologic health domain of SF-36 was significantly better in healthy controls (P < .001). Patient groups were similar in terms of BDI score (P > .05). ED score was negatively correlated with BDI (r = ?0.368; P < .001), and positively correlated with SF-36 (r = 0.495; P < .001) in all patient groups.ConclusionPatients with ESRD had significantly lower sexual function and lower QOL scores than the healthy control men. Notably, the mode of renal replacement therapy had no impact on male sexual function.  相似文献   
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Gurocak S  Kupeli B  Acar C  Guneri C  Tan MO  Bozkirli I 《The Journal of urology》2006,175(1):270-5; discussion 275
PURPOSE: We aimed to investigate the probable effect of pelvicaliceal anatomical differences between stone bearing and normal contralateral kidneys on the etiology of stone formation in children with a solitary lower pole caliceal stone. MATERIALS AND METHODS: We reviewed the clinical records of 25 pediatric patients who underwent SWL for a solitary lower caliceal stone and 15 healthy pediatric patients who served as controls. Lower pole IPA, IL and IW, together with other caliceal variables obtained from the pelvicaliceal anatomy of the stone bearing and contralateral normal kidneys of patients with urolithiasis, and both kidneys of the control group were measured based on excretory urography. Also, total pelvicaliceal volume for both kidneys was calculated. RESULTS: Mean LIPAs of stone bearing kidneys compared to the normal contralateral kidneys was more acute, equal and wider in 52%, 16% and 32% of the patients, respectively. Mean pelvicaliceal volumes of the stone forming and normal kidneys were 1,553.8 mm(3) (range 242 to 7,107) and 581.0 mm(3) (90 to 2,662), respectively, and there was statistical significance only in pelvicaliceal volumes between the stone bearing and contralateral normal kidneys (p <0.001). CONCLUSIONS: Our results reveal that IPA, IL and IW of calices do not have an effect on stone formation in pediatric patients. However, large pelvicaliceal volume seems to be a significant risk factor for stone formation in the lower calix, probably because it creates abnormal urodynamic and morphological features, especially when accompanied by other metabolic abnormalities.  相似文献   
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OBJECTIVE: Dilation of aortic annulus, sinuses of Valsalva, and sinotubular junction (STJ) diameters are the characteristic lesions of aortic root aneurysm. The remodeling technique reduces STJ diameter and creates three neosinuses of Valsalva. Alternatively, the reimplantation technique reduces both annulus and STJ diameters to the detriment of aortic root dynamics. Although the remodeling technique is recognized as the most physiological valve-sparing procedure, aortic annulus dilation may jeopardize its results. A standardized approach that combines an external subvalvular aortic prosthetic ring annuloplasty with the remodeling technique is suggested. METHODS: Eighty-three patients underwent an elective aortic root remodeling procedure, either isolated (group 1, n=34) or combined with an external subvalvular aortic prosthetic ring annuloplasty (group 2, n=49). Preoperative aortic regurgitation was 1.59+/-1.1 (group 1) and 1.97+/-1.3 (group 2) (NS). The aortic annulus was more dilated in group 2 than in group 1 (27+/-2.77 mm vs 26.4+/-2.3 mm, p<0.01). Residual aortic regurgitation > or =grade II was the conversion criteria for aortic valve replacement. RESULTS: Operative mortality was 3.6% (n=3). Intraoperative conversion for valve replacement was 32.7% in group 1 (n=11) versus 4.2% in group 2 (n=2) (p<0.001). In group 1, preoperative annulus diameter was larger for converted than for valve-spared patients (27.6+/-1.7 mm vs 25.2+/-1.5 mm, p<0.02). In group 2, implanted aortic ring significantly reduced annulus diameter (20.6+/-1.8 mm) without significant aortic valve gradient (8.3+/-3 mmHg). Follow-up was 17.2+/-13.4 months (group 1) and 10.41+/-7.95 months (group 2). Reoperation for recurrent aortic regurgitation was 13% in group 1 (n=3) versus 4.2% in group 2 (n=2). Echocardiographic follow-up found residual aortic regurgitation < or =grade I in 17 patients in group 1 (90%) versus 43 patients in group 2 (95.5%) and of grade II in two patients in group 1 (10%) and two patients in group 2 (4.5%). CONCLUSION: The addition of external aortic prosthetic ring annuloplasty improves the remodeling technique's operative reproducibility and short-term results. Therefore, its use as a systematical adjunct to the remodeling procedure is suggested. However, further long-term evaluation comparing this valve-sparing procedure to composite graft replacement should define the best surgical strategy for aortic root aneurysm.  相似文献   
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PURPOSE: To determine factors that affect healing index and consolidation time following lengthening of congenitally short metacarpals (brachymetacarpia). METHODS: 18 metacarpals of 8 young women (mean age, 18.6 years) were lengthened using the callus distraction technique. The results, including healing index and consolidation time, were analysed and compared with those in the literature. RESULTS: The mean length increase was 16.5 mm (55% of the original length of 30 mm). Age was positively correlated with healing index and consolidation time: younger patients healed faster than older patients. Healing index differed significantly between patients aged 0 to 18 years and those aged 19 to 30 years (p=0.002). Comparison of our results with 9 previous studies confirmed that increased age was associated with a greater healing index and consolidation time. Conversely, the faster the distraction rate, the less the healing index and consolidation time. CONCLUSION: Age has the most effect on healing index and consolidation time. Metacarpal lengthening using callus distraction is recommended. Adolescence is the most appropriate time to perform distraction lengthening of a congenitally short metacarpal. This will avoid additional lengthening of normal metacarpals prior to epiphyseal closure.  相似文献   
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BACKGROUND: We evaluated the safety range of near-infrared spectroscopy (NIRS) in the management of trauma patients who had subdural or epidural hematomas in the emergency room and intensive care unit. METHODS: Thirty cases with the radiologic diagnosis of subdural and epidural hematomas were evaluated pre- and postoperatively by NIRS. The findings were analyzed by comparing the data of 30 minor head trauma patients without hematoma, which was proven by computed tomography imaging using Mann-Whitney U and McNemar tests. RESULTS: The preoperative accuracy of NIRS in detecting the hematoma existence was same as the accuracy of the radiologic imaging but the postoperative findings were not reliable. The sensitivity of the device in detecting abnormality was found to be 0.87. CONCLUSION: NIRS is a good device to predict intracranial subdural and epidural hematomas in the field and emergency units. However, it is not superior to computed tomography or magnetic resonance imaging. It is useful in emergency situations to diagnose an intracranial bleeding but NIRS is not reliable to detect either postoperative hematomas or intracranial status in patients with craniotomy.  相似文献   
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