A diagnostic algorithm for male genital oedema

Male genital oedema can be defined as swelling or the appearance of swelling of the scrotum and/or the penile shaft and prepuce. Despite the various causes of genital oedema reported in the published work, a concise approach to the evaluation and management has not been sufficiently addressed.     

Dilation of the ventriculus terminalis: sonographic findings.

A newborn term male infant was found to have the stigmata of VACTERL syndrome, including cervical and thoracic hemivertebra, partial sacral agenesis, 13 pairs of ribs, high imperforate anus with rectovesical fistula, and tracheoesophageal fistula with proximal esophageal atresia. No open spinal dysraphism or skin dimpling was seen. Ultrasonography of the spinal cord was performed to screen for occult anomalies. The examination revealed a lipoma of the filum terminalis and a low-lying conus medullaris at the L3-L4 level with a large central cystic structure in the terminal cord, which was continuous with the central canal (Fig. 1). This was thought to most likely represent a dilated ventriculus terminalis, and the diagnosis was confirmed on a subsequent MR image (Fig. 2). Fluid in the cyst followed cerebrospinal fluid signal in all sequences. We observed no abnormal signal in the adjacent parenchyma or enhancement associated with the cystic mass. A cranial ultrasonogram did not reveal any intracranial anomalies. The patient demonstrated no neurologic deficits in the lower extremities. Bowel and urinary continence was not assessable in this infant.     

Atrial natriuretic factor in the pleural fluid of congestive heart failure patients

To investigate the possibility that atrial natriuretic factor might be secreted into the pleural fluid of patients with congestive heart failure who are known to have high concentrations of this new peptide hormone circulating in their plasma, six patients with class 2 New York Heart Association classified congestive heart failure had simultaneos measurement of plasma and pleural fluid atrial natriuretic factor concentrations. Atrial natriuretic factor was found in high concentrations in the pleural fluid of all of these patients. The concentration of atrial natriuretic factor in pleural fluid was nearly equal to the concentration in plasma of these patients. Their plasma levels were double the plasma concentration of this peptide hormone in 54 persons without congestive heart failure. These preliminary findings demonstrate that atrial natriuretic factor is present in pleural fluid of patients with congestive heart failure, but whether or not this secretion of atrial natriuretic factor into the pleural fluid helps the lung clear the fluid present in the lung in congestive heart failure cannot be determined from the present investigation.