Technological Advances in Penile Implant Surgery

BackgroundDuring the last century, surgical management of erectile dysfunction has evolved from an experimental concept to a core treatment modality with widespread use among the men's health community. Over time, innovations in materials, mechanical design elements, device coatings, and surgical technique have provided patients with low-risk, reliable, and reproducible erectile function with high satisfaction rates.AimTo provide a foundation for future innovation by improving understanding of historical penile prosthetics and the rationale behind incremental technological improvements for the contemporary Men's Health physician.MethodsLiterature review was conducted to generate a comprehensive review of historical technological innovations in penile implant surgery. Companies with FDA approved penile prosthetics in use in the United States were contacted for information regarding technological innovations in the past and future devices in development. A separate literature review was performed to identify any significant future device design elements being tested, even in the ex vivo setting, which may have future clinical applications.OutcomesTechnological innovations in penile implant surgery were described.ResultsCurrent options for the prosthetic surgeon include malleable penile prostheses (MPP), self-contained (2-piece) inflatable penile prostheses, and multicomponent (3-piece) inflatable penile prostheses. Current MPPs consist of a synthetic coated solid core which allow for manipulation of the penis for concealability while maintaining sufficient axial rigidity to achieve penetration when desired. Multi-component (3-Piece) IPPs currently include the Coloplast Titan and Boston Scientific/AMS 700 which consist of a fluid reservoir, intrascrotal pump, and intracavernosal cylinders. The devices have undergone numerous design updates to the cylinders, pump, reservoir, tubing, and external coatings to increase reliability and decrease short- and long-term complications.Clinical ImplicationsFuture innovations in penile prosthetic surgery seek to broaden the indications and applicability to the transgender community and improve both safety and functionality for patient and partner.Strengths & LimitationsThe review is limited primarily to penile prosthetics approved for current or historical clinical use in the United States and may not be representative of the global prosthetic environment. Additionally, the research and development of future innovations, particularly those provided by device manufacturers, is likely limited by non-disclosure to maintain a competitive advantage.ConclusionsPenile prosthetic surgery will undoubtedly remain integral to the treatment of erectile dysfunction, and education regarding the current state of technological innovation will empower the prosthetic surgeon and biomedical engineering community to improve contemporary patient care and drive the development of the next generation of implantable penile prosthetics.Barnard JT, Cakir OO, Ralph D, et al. Technological Advances in Penile Implant Surgery. J Sex Med 2021;18:1158–1166.     

Flexural properties of rectangular nickel-titanium orthodontic wires when used as ribbon archwires

Objective:To compare the flexural properties of rectangular nickel-titanium (Ni-Ti) orthodontic wires in occlusoapical and faciolingual orientations using a standardized test method.Materials and Methods:Twenty-two rectangular Ni-Ti wire groups were tested in occlusoapical (ribbon) orientation: eight conventional Ni-Ti products, five superelastic Ni-Ti products, and nine thermal Ni-Ti products (n = 10 per group). Six products of thermal Ni-Ti wire were tested in faciolingual (edgewise) orientation. A three-point bending test was performed to measure deactivation force at 3.0-, 2.0-, 1.0-, and 0.5-mm deflections of each rectangular wire at 37.0 ± 0.5°C. Analysis of variance and post hoc Student-Newman-Keuls tests were used to compare the mean values of the different groups (α = .05).Results:The ranges of deactivation forces varied greatly with different kinds, sizes, products, and deflections of Ni-Ti wires. One product of conventional and superelastic Ni-Ti wires had steeper force-deflection curves. Four products had similarly shaped flat force-deflection curves, whereas the sixth product had a moderately steep force-deflection curve. Thermal Ni-Ti wires had smaller deactivation forces ranging from 0.773 N (78.8 g) to 2.475 N (252.4 g) between deflections of 1.0 and 0.5 mm, whereas wider ranges of force from 3.371 N (343.7 g) to 9.343 N (952.7 g) were predominantly found among conventional Ni-Ti wires between deflections of 3.0 and 2.0 mm.Conclusions:Clinicians should critically select archwires for use in the occlusoapical orientation not only based on Ni-Ti wire type, size (0.022 × 0.016-in or 0.025 × 0.017-in), and product but also with deactivation deflections from 0.5 and 1.0 mm to obtain light forces in the occlusoapical orientation.     

Life-threatening complications associated with acute monocytic leukaemia after dental treatment

It is highly recommended to conduct a prophylactic check for any dental problems on patients who suffer from leukaemia before chemotherapy begins. Bacteraemia caused by oral microflora may be very dangerous for patients with haematological malignancies. However, it should be noted that the prophylactic process itself might bring about life-threatening complications if there is only a short interval between dental treatment and the beginning of chemotherapy, or if the dental treatment is too aggressive. We present a case where this prophylactic procedure produced life-threatening complications for a patient with acute myeloid leukaemia.     

高时-空分辨力门控螺旋相位对比MR成像评价先天性心脏病快速血流

目的探讨敏感性编码技术(SENSE)前瞻性门控螺旋相位对比MR检查序列在儿童与成人先天性心脏病检查的可行性。材料与方法当地伦理委员会批准该项研究,所有     

冠状动脉斑块与心肌缺血

目的采用心脏MR(CMR)前瞻性研究冠状动脉斑块对心肌缺血的预测价值。方法 52例行冠状动脉造影(CA)后评定为可疑冠心病(CAD)的病人进行了CMR和     

Single nucleotide polymorphisms in the myostatin (MSTN) and muscle creatine kinase (CKM) genes are not associated with elite endurance performance

Maximal oxygen uptake (VO_2max) is one of the most important determinants of elite endurance performance. VO_2max is determined by a whole range of genetic and environmental factors. Single nucleotide polymorphisms (SNPs) in muscle myostatin (MSTN) and creatine kinase (CKM) genes are candidates for VO_2max and skeletal muscle performance phenotypes. Common MSTN (rs3791783, rs11681628 and rs7570532) and CKM (rs344816, rs10410448, rs432979, rs1133190, rs7260359, rs7260463 and rs4884) SNPs, selected from HapMap CEU data in order to tag the genetic variability of the proteins, were genotyped in 316 male Caucasian elite endurance athletes and 304 sedentary controls from the Genathlete study. Association with elite endurance performance was determined by logistic regression analysis. The P‐value for statistical significance was set at <0.01. None of the SNPs or haplotypes showed a significant association with elite endurance status. We conclude that common variants of MSTN and CKM genes do not play a role in attaining high‐level endurance performance in Caucasian populations.     

Network structure of functional hippocampal lateralization in birds

Functional hemispheric asymmetry is a common feature of vertebrate brain organization, yet little is known about how hemispheric dominance is implemented at the neural level. One notable example of hemispheric dominance in birds is the leading role of the left hippocampal formation in controlling navigational processes that support homing in pigeons. Relying on resting state fMRI analyses (where Functional connectivity (FC) can be determined by placing a reference ‘seed’ for connectivity in one hemisphere), we show that following seeding in either an anterior or posterior region of the hippocampal formation of homing pigeons and starlings, the emergent FC maps are consistently larger following seeding of the left hippocampus. Left seedings are also more likely to result in FC maps that extend to the contralateral hippocampus and outside the boundaries of the hippocampus. The data support the hypothesis that broader FC is one neural‐organizational property that confers, with respect to navigation, functional dominance to the left hippocampus of birds. © 2015 Wiley Periodicals, Inc.     

Mental Health Law of the People's Republic of China

The following document is a translation of the first national mental health law of the People''s Republic of China, which was adopted by the National People''s Congress on October 26, 2012. The original Chinese version of the law is available at the official government website: http://www.gov.cn/jrzg/2012-10/26/content_2252122.htm. The translation was completed by a team of translators at the Shanghai Mental Health Center at the Shanghai Jiao Tong University School of Medicine. The translators have added footnotes at the end of the document that explain their choices in sections where alternative translations are possible and that provide background information for sections that may be confusing to readers unfamiliar with China. This translation should be cited as follows:ChenHH, Phillips MR, Cheng H, Chen QQ, Chen XD, Fralick D, Zhang YE, Liu M, Huang J, Bueber M. Mental Health Law of the People''s Republic of China (English translation with annotations). Shanghai Archives of Psychiatry. 2012; 24(6):305-321. doi:10.3969/j.issn.1002-0829.2012.06.001Shanghai Archives of Psychiatry     

Subcutaneous zygomycosis: report of 10 cases from two institutions in North India

Background Subcutaneous zygomycosis is an uncommon condition observed in tropics. Few series have been published, particularly from the northern regions of India. Objectives The aim of this study was to describe clinical, investigative and therapeutic details in subcutaneous zygomycosis observed in two teaching hospitals in Delhi. Patients and methods Ten patients seen over a period of 10 years (1999–2009) form the material for this report. Results There were four children and six adults. In four children, the presentation was a subcutaneous localized mass or gradually spreading plaque. In the others, it was observed over nasal region of face, spreading inward into mucosal sites and paranasal sinuses, and outward to the contiguous areas. Regional lymphadenopathy was present in two with facial lesions. Majority showed a granulomatous infiltrate with admixture of other cells, mainly eosinophils. Aseptate or poorly septate hyphae were observed in seven. In one patient in whom no hyphae were observed, there was dense perivascular inflammation. Organisms were cultured from four patients, Basidiobolus ranarum in two and Syncephalastrum racemosum in two. The main therapy used was a saturated solution of potassium iodide (KI). Four received only KI of which two attained cure after 3 months and 9 months respectively, and the other two showed signs of regression. In one boy subsidence was associated with reduced circumference of thigh. Ketoconazole or itraconazole was given with KI to hasten regression when response was slow or there were side‐effects to KI. Conclusion Awareness and early recognition will prevent disfigurement produced by advanced disease, misdiagnosis and unnecessary surgical intervention.     

Anatomic implications of lesser trochanterplasty

Objective

The aim of this study was to measure the area of iliopsoas tendon attachment and the distance of sciatic nerve, medial circumflex femoral artery (MCFA) and quadratus muscle to lesser trochanter tip, before and after 5, 10, 15 mm depth excision of lesser trochanter.