阴囊Paget病的临床和病理研究

目的：探讨阴囊Paget病的临床特点和诊治方法。方法：对14例阴囊Paget病患的临床、病理资料以及治疗和随访情况进行回顾性研究。结果：14例患均经病理检查证实并行手术治疗，随访期2－12年，1例腹股沟淋巴结阳性1年后死于全身转移，3例死于非癌疾病，3例行腹股沟淋巴结清扫2例发生皮肤坏死、淋巴瘘等并发症。结论：本病的诊断主要依靠病理学检查，阴囊局部扩大切除术是首选治疗方法，预后主要取决于病变浸润和淋巴结转移的程度以及邻近内脏器官癌肿的有无，早期诊断是提高生存率的关键。     

The prevalence of penoscrotal abnormalities and inguinal hernia in elementary-school boys in the west of Iran

AIM: We designed a cross-sectional study in order to determine the prevalence of inguinal hernia and penoscrotal abnormalities in the Lorestan province, situated in the west of Iran. METHODS: We studied 3205 elementary-school boys, aged 6-12 years, who underwent clinical examinations of the groin and genitalia in 2002. RESULTS: Abnormalities were detected in 213 children (6.64%). The most frequent anomaly was indirect inguinal hernia, seen in 78 children (2.4%). The other abnormalities were retractile testes in 39 boys (1.22%), undescended testes in 36 boys (1.12%), hydrocele in 28 boys (0.87%) and hypospadiasis in 25 boys (0.78%). Also, three children had micropenises, two had epispadiasis and another two boys had varicoceles. Ambiguous genitalia and apenia were not seen in the present series. Most of the parents were not aware of their children's anomalies (60.1%). CONCLUSIONS: Education of the public and medical staff about these abnormalities and screening system are needed to improve the outcome.     

二维及彩色多普勒超声诊断阴囊肿块的研究

探讨二维及彩色多普勒超声对阴囊肿块的诊断价值。方法 报告１９５例经病理证实的阴囊肿块的超声检测结果。描述二维图像特征，探讨ＣＤＩ及ＰＤ的应用。结果超声诊断阴囊肿块总符合率为８９．２％，阴囊恶性肿瘤ＲＩ升高，结论西方主为二维超声＋ＣＤＩ＋ＲＩ有助于做出正确诊断。     

Studies on Factors Governing Testicular Decent in the Rat – Particularly the Role of Gubernaculum Testis

In the rat the testicles are abdominal at birth: testicular descent and scrotal development are completed at about 40 days of age. To elucidate mechanisms of testicular descent the following operations were performed in newborn rats: Proximal and distal unlateral gubernaculotomy, and unilateral and bilateral orchidectomy. The operated rats were studied at various time intervals up to 100 days after the operations. Testicular descent was prevented if the distal part of the gubernaculum was cut, presumably because of interference with the growth of the vaginal processes. The gubernaculum does not pull the testicle down into the scrotum, since testicular descent occurred also after proximal gubernaculotomy. The gubernaculum is, however, necessary to anchor the descended testicle to the scrotal floor. Descent of epididymis took place also in the absence of a testicle on the same side. We propose that distal gubernaculotomy can be used in rats to produce an experimental model for studies of cryptorchism.     

口腔黏膜卷管分期修复幼儿期先天性尿道下裂

目的 探讨修复幼儿期先天性尿道下裂的手术方法.方法 矫直阴茎后,应用口腔黏膜卷管游离移植预制缺损段尿道,二期进行吻接,同时应用以阴囊动脉为蒂的阴囊筋膜皮瓣覆盖创面,皮瓣范围包括阴囊中缝区在内的阴囊区域.结果 2007年1月至2010年5月,于临床应用42例.手术过程顺利,应用口腔黏膜卷长3.0～4.0 cm,直径0.6～0.8 cm;阴囊筋膜皮瓣最宽1.5cm,最长3.0 cm.术后除2例患者出现阴囊皮瓣远端血运障碍而漏尿,术后1～2周内经换药后自行愈合外,其余患者均一期愈合.术后有26例获得随访,时间为6个月至3年,阴茎无弯曲,自行排尿通畅,无尿道狭窄及尿瘘,阴茎外形良好.结论 应用口腔黏膜卷管游离移植预制缺损段尿道,二期尿道吻接,同时应用血运良好的阴囊筋膜皮瓣覆盖创面,是一种修复幼儿期尿道下裂的良好方法.

Abstract：

Objective To discuss the treatment of congenital hypospadias in infancy. Methods After correction of chordee, the tubed oral mucosa was used to prefabricate urethra in penis as free graft.The uretheral anastomosis was performed at the second stage. The scrotum fascia flap, pedicled with scrotal artery, was transferred to cover the penile defect. Results From Jan. 2007 to May 2010, 42 cases were treated. The tubed oral mucosa was 3.0-4.0 cm in length ,and 0. 6-0. 8 cm in diameter. The maximum size of scrotum flap was 1.5 cm × 3.0 cm. Uretheral fistula happened in two cases due to necrosis at the distal end of scrotal flap, which was healed spontaneously after dressing for 1-2 weeks. Primary healing was achieved in all the other cases. After operation, the 26 cases have been visited for 6 months to 3 years, no urethra fistula , narrow and the penis curved. There is an universal urinate for oneself and a good form.Conclusions The tubed oral mucosa can be used to prefabricate urethera, which is anastomosed at the second stage. The tubed oral mucosa combined with scrotal fascial flap which has a reliable blood supply,is very suitable for hypospadias in infancy.     

Membranocystic Lesion in Sclerosing Lipogranuloma of the Scrotum: An Ultrastructural Study

Two cases of intrascrotal sclerosing lipogranuloma are reported in which affected adipose tissues showed peculiar membranocystic lesions (MCL) similar to the features described in Nasu-Hakola disease. On light microscopy, the MCL were seen in the degenerative fatty tissues and within multinucleated giant cells, which were positive for periodic acid-Schiff stain and resistant to diastase digestion. Ultrastructurally, two types of MCL were observed; one type was characterized by thick membranes composed of vesicular to minute tubular or fibrillar substructures, and the other type was characterized by thin membranes composed of only small numbers of tiny vesicles. The substructures in both types of MCL contained lipid droplets similar to those in the inner space. These results support the concept that the membranes in the MCL are derived from degenerated fat droplets.     

Penoscrotal transposition: A case report and review

We report on a boy born with complete penoscrotal transposition, normal scrotum, twisted penile shaft with hypoplastic penile urethra, meatal stenosis, normal bladder, and bilateral cystic dysplastic kidneys. The patient died of renal failure at 2.5 months. This is the 13th reported case of complete penoscrotal transposition with normal scrotum. The possible pathogenesis is discussed and the literature is reviewed. © 1994 Wiley-Liss, Inc.     

超声引导精索阻滞下F4.8可视肾镜治疗附睾良性肿物的疗效分析

目的 评估在超声引导精索阻滞下,应用F4.8可视肾镜治疗附睾良性肿物的疗效及安全性。方法 选取 82例附睾肿物患者,采用随机数字表法分为盲探穿刺组和超声引导穿刺组,每组41例。所有患者均应用F4.8可视肾 镜作为阴囊镜施行手术。盲探穿刺组于腹股沟管外环处盲探穿刺进行精索阻滞;超声引导穿刺组利用彩色多普勒 超声诊断仪完成精索阻滞。记录患者的手术时间、围手术期并发症、精索阻滞成功率、血管性并发症、术中麻醉性药 物追加以及麻醉方式更改情况。采用视觉模拟评分（VAS）对患者进行疼痛评估,并对患者进行随访。结果 64例 附睾囊肿患者均予镜下钬激光囊肿去顶术;18例附睾实性肿物患者镜下确诊为附睾附件不全扭转,予钬激光切除。 与盲探穿刺组相比,超声引导穿刺组的精索阻滞成功率更高,血管性并发症发生率、麻醉方式更改率更低（P＜0.05）, 2组术中麻醉性药物追加率差异无统计学意义。超声引导穿刺组在手术5 min、术后2 h的VAS和住院费用低于盲探 穿刺组（P＜0.05）,术后6 h、12 h VAS,住院时间2组差异无统计学意义。随访患者术后1个月、3个月及12个月复查 阴囊彩超,未见患侧睾丸、附睾及精索异常。结论 超声引导精索阻滞下F4.8可视肾镜治疗附睾肿物安全有效,可 作为理想的检查、治疗方法,具有较好的应用价值。