Peyronie's disease:a silent consequence of diabetes mellitus

Aim:To investigate the clinical characteristics of patients with Peyronie's disease(PD)and diabetes mellitus(DM).Methods:During an 8-year period,a total of 307 men seen at our outpatient clinic were diagnosed with PD.Clinicalcharacteristics,penile deformities and the erectile status of patients with PD and DM together(n=102)were retro-spectively analyzed and compared to patients with PD alone with no risk factors for systemic vascular diseases(n=97).Results:The prevalence of PD among men with DM and sexual dysfunction was 10.7%.The mean ageof diabetic patients with PD was(55.9±8.9)years;in the no risk factor group it was(48.5±9.0)years(P<0.05).The median duration of DM was 5 years.The majority of diabetic patients with PD(56.0%)presented in the chronicphase(P<0.05),and they were more likely to have a severe penile deformity(>60°)than the no risk factor group(P<0.05).In the diabetic group,the most common presenting symptom was penile curvature(81.4 %),followedby a palpable nodule on the shaft of the penis(22.5%)and penile pain with erection(14.7 %).A total of 19.6 % ofpatients were not aware of their penile deformities in the diabetic group.Erectile function,provided by history and inresponse to intracavernosal injection and a stimulation test,was significantly diminished in patients with PD and DM(P<0.05).Conclusion:DM probably exaggerates the fibrotic process in PD.Diabetic patients with PD have ahigher risk of severe deformity and erectile dysfunction(ED).PD seems to be a silent consequence of DM andshould be actively sought in diabetic men.(Asian J Androl 2006 Jan;8:75-79)     

The diagnostic value of image guided percutaneous fine needle aspiration biopsy in equivocal mediastinal masses

Background and aims The aim of this study was to assess the diagnostic value of image guided percutaneous fine needle aspiration (FNA) biopsy in equivocal mediastinal masses.Patients Sixty-six patients with an equivocal mediastinal mass who underwent FNA biopsy between 1993 and 2003 were eligible for final analysis. The cytological and definitive diagnosis of masses were grouped as primary 22 (33%)−30 (46%) and secondary (metastatic) neoplasms 18 (27%)−18 (27%) and nonneoplastic lesions 20 (30%)−18 (%27) respectively.Results The diagnostic accuracy (%95 C.I.) of FNA biopsy for primary mediastinal neoplasms, secondary neoplasms and nonneoplastic lesions were found to be 93.3 (83.8–98.2)%, 100 (95.1–100)%, 93.3 (83.8–98.2)%, respectively.Conclusion Image guided percutaneous FNA biopsy is a safe and highly accurate diagnostic method for equivocal mediastinal masses.     

The use of frame fixation in the management of open distal extensor mechanism avulsion fracture in a dislocated knee

An avulsion fracture of the tibial tubercle is a common injury in traffic accident. If the fracture is closed, then a comparatively good prognosis can be expected through reinforcement of the bone via osteosynthesis and the use of artificial ligaments. In this case, an open wound was observed in the tibial tubercle, and the wound was so polluted that the healing process was significantly delayed. It was therefore difficult to provide simultaneous surgical treatment and so three operations were required to perform the reconstruction of the extensor mechanism. The reconstruction of extensor mechanism and the frame fixation between the patella and tibia was performed. Six months after the injury, the patient was able to walk without aid, had a range of movement from 5°to 130°, and did not show any indications of ADL disorder. Using this method of frame fixation between the patella and tibia proved to be an effective technique for the reconstruction of the open knee extension mechanism injury.     

Ultrastructure of experimental candidial lesions in the rabbit esophagus

Although the esophagus is the most frequent site ofCandida infections in the gastrointestinal tract, and many clinical studies about it have been reported, little attention has been directed toward experimental candidiasis of the esophagus, especially with regard to its ultrastructure. Using transmission electron microscopy, this study was performed to clarify the ultrastructure of experimental lesions, obtained from five New Zealand white male rabbits which were given a suspension ofCandida albicans cells (10⁷/ml) for 13 days. The results showed that the lesions consisted of exfoliating, squamous epithelial cells with mycelial elements ofCandida albicans cells penetrating through them, and that a widened intercellular space between individual cells in the area of candidial invasion seems to be a characteristic finding of candidial infection. A part of this study was presented at the 25th Annual Meeting of the Clinical Electron Microscopy Society of Japan, Matsumoto, September 28–30, 1993.     

The role of pneumolysin in pneumococcal pneumonia and meningitis

Diseases caused by Streptococcus pneumoniae include pneumonia, septicaemia and meningitis. All these are associated with high morbidity and mortality. The pneumococcus can colonize the nasopharynx, and this can be a prelude to bronchopneumonia and invasion of the vasculature space. Proliferation in the blood can result in a breach of the blood-brain barrier and entry into the cerebrospinal fluid (CSF) where the bacteria cause inflammation of the meningeal membranes resulting in meningitis. The infected host may develop septicaemia and/or meningitis secondary to bronchopneumonia. Also septicaemia is a common precursor of meningitis. The mechanisms surrounding the sequence of infection are unknown, but will be dependent on the properties of both the host and bacterium. Treatment of these diseases with antibiotics leads to clearance of the bacteria from the infected tissues, but the bacteriolytic nature of antibiotics leads to an acute release of bacterial toxins and thus after antibiotic therapy the patients can be left with organ-specific deficits. One of the main toxins released from pneumococci is the membrane pore forming toxin pneumolysin. Here we review the extensive studies on the role of pneumolysin in the pathogenesis of pneumococcal diseases.     

Role of inflammatory mediators in resistance and susceptibility to pneumococcal infection

Variations in the host response during pneumonia caused by Streptococcus pneumoniae in susceptible (CBA/Ca) and resistant (BALB/c) inbred mouse strains were investigated. Significant differences were detected in survival time, core body temperature, lung-associated and systemic bacterial loads, mast cell numbers, magnitude and location of cytokine production, lung disruption, and ability of isolated lung cells to release the cytokine tumor necrosis factor (TNF) alpha in vitro. Overall, the results indicate that the reduced capacity of CBA/Ca mice to induce rapid TNF activity within the airways following infection with S. pneumoniae may be a factor in their elevated susceptibility to pneumococcal pneumonia.     

利培酮与氯丙嗪治疗精神分裂症对照研究

目的　评价利培酮治疗精神分裂症的疗效和副作用。方法　将 5 9例精神分裂症住院病人随机分为利培酮 ( 4 mg/d)1组 ( 1 9例 )、利培酮 ( 6 mg/d) 2组 ( 2 0例 )和氯丙嗪组 ( 2 0例 ) ,治疗 8周。用阳性与阴性症状量表 ( PANSS)评定疗效 ,用副反应量表 ( BPRS)及锥体外系副反应量表 ( TESS)评定副反应。结果　利培酮两个剂量组与氯丙嗪组之间疗效无显著性差异。在认知因子、阴性因子、PANSS总分减分率方面 ,利培酮组与氯丙嗪组有显著性差异。利培酮的副反应有锥体外系反应、失眠、头昏等。结论　利培酮是一种安全有效的抗精神病药物 ,在改善认知功能和阴性症状方面 ,利培酮优于氯丙嗪 ,少数病例可出现锥体外系反应。