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PubMed1978

[Veneral diseases today].

The venereal diseases gonorrhoe and syphilis showed again in GDR an increasing tendency concerning their frequency by the year 1974, after having reached a low point about 1967. Now they occur relatively constantly. This increase observed throughout the world is caused by acceleration, changes in sexual behavior, homosexuality, increased promiscuity, tourism and other factors. Numerous false diagnoses of syphilitic symptoms such as herpes simplex, balanitis, carcinoma of the penis, angina, haemorrhoides, anal fissure, drug eruption and others cause the delay in the diagnostics and false treatments. Penicillin represents the drug of choice nowadays. Strict registration orders, intensification of the interdisciplinary cooperation, strict investigation of the infectious sources and endangered contact persons as well as enlarged health and sexual education are suitable weapons in the fight against the spreading of the venereal diseases.

Diagnostic Errors↗

PubMed1978

[About the sexual hygiene of mental retarded boys, an exercise of the sexual pedagogic (author's transl)].

The sexual hygiene of mental retarded boys is examinated. In comparison with normal school boys is pointed out the necessity of sexual pedagogic education. The striking more numerous quote of balanitis in mental retarded boys is discussed with a critical review of Literature about the cleanness of the hands while miction of man, about the cleanness of the inferior abdomen, the cleanness of the pants and the hygiene of the toilet. The conclusion is drawn, that the cleaning of the foreskin has also to be observed by the mental retarded men, boys once a week and youths day by day.

Adolescent↗

PubMed1981

[Keratosis lichenoides chronica with mucous membrane involvement and ocular pseudo-pemphigus. Follow-up study over 18 years. Retinoid therapy (author's transl)].

A very uncommon ocular and mucocutaneous syndrome is reported. Cutaneous manifestations include keratotic plugs occasionally disposed into verrucous plaques (in mountainous chain), lichenoid lesions on face, neck and hand's back, and nail's involvement. Histologically three types of lesions are observed: marked hyperkeratosis, lichenoid aspect, and follicular pustulosis. Mucous membranes alterations, present for almost as long as 20 years, include stomatitis, chronic balanitis with ulcerative and keratotic lesions leading to synechiae; ocular abnormalities has had a follow up into lesions similar to those of cicatricial pemphigoid; direct immunofluorescence study in the vicinity of a buccal erosion showed a complement deposit on basement membrane; immunofluorescence studies on involved and uninvolved skin, and indirect immunofluorescence were negative. Several diagnosis were considered, in first place an atypical Reiter's syndrome. A part the possibility of a new entity, the most attractive hypothesis is this of a keratosis lichenoides chronica with severe mucous cicatrical lesions. A large number of treatment had been inefficacious but a clear improvement of keratotic lesions was noted with oral retinoid therapy.

Chronic Disease↗

PubMed1980

[Assessment of the chronic toxic action of the herbicide, balagrin, in continuous and intermittent exposure regimens].

Chronic oral toxicity of the herbicide balagrin, a selective and perspective preparation for rural economy, was experimentally studied on 258 Wistar albino rats. Two treatment schedules using the combined trade product (20 percent balan and 80 percent xylol) were assayed: montonous - 1/20 LD50 balagrin (55 mg/kg) and 1/20 LD50 xylol (235 mg/kg), administered every day and every week for 4 months; intermittent - 4 months' every day application on alternate weeks of 1/10 LD50 balagrin (110 mg/kg) and 1/10 LD50 xylol (470 mg/kg) and 8 weeks' application by the same schedule of 1/20 LD50 balagrin and 1/20 LD50 xylol. The results of clinico-laboratory, biochemical and functional investigations showed that the toxic effect was more pronounced with monotonous administrations of the compound. The enzyme activities of HE, OCT and cellular LAP were increased, serum alpha-globulins were reduced, liver tissue ICDH and GIDH was increased, hepatic weight coefficient was reduced and testicular and brain CO activity was decreased. Proceeding from the experimental data, the compound is recommended for periodic application in agricultural practice.

Administration, Oral↗

PubMed1995

[Bacteriological and clinical studies of SY5555 in pediatric field].

Clinical studies were carried out on SY5555, a new oral penem, in the field of pediatrics. The results obtained are summarized below. The clinical efficacies were examined in a total 31 patients consisting of 4 patients with pharyngitis, 10 with purulent tonsillitis, 4 with scarlet fever, 7 with impetigo, one with balanitis, one with cellulitis and 4 with UTI. The clinical efficacy rate was 96.8% (30/31). Bacteriological efficacies of SY5555 were examined on identified pathogens including 7 strains of Staphylococcus aureus, 6 of Streptococcus pyogenes, 3 of Enterococcus faecalis, 3 of Haemophilus influenzae, one of Escherichia coli and one of Citrobacter freundii. The bacteriological eradication rate was 81.0%. As for side effects, loose stool in one patient was noted. Abnormal laboratory findings test results included eosinophilia in 2 patients, eosinophilia and elevation of serum transaminase in one patient, and thrombocytosis in another.

Administration, Oral↗

PubMed1976

Metastasizing erythroplasia Queyrat. Report of a case.

A typical clinical and histologic case of Queyrat's erythroplasia of the glans penis is presented. For several years the patient had been treated for balanitis and inflammation of the glans. A few months before the patient died, the correct diagnosis was established. Shortly after, metastases to the inguinal lymph nodes were found and treated with X-rays. At autopsy, metastases to other organs were revealed. It is concluded that erythroplasia of Queyrat might be Bowen's disease of a mucosal or mucocutaneous area, and this "carcinoma in situ" may metastasize. Consequently Queyrat's erythroplasia should be treated as a malignant disorder as soon as the diagnosis is established.

Aged↗

PubMed1994

[Urethro-adnexitis in the man and acute urethral syndrome in the woman. Microbiological and immunologic studies of etiologic classification].

Both common pathogens and unconventional, fastidious bacteria, viruses, parasites, and fungi are causative agents in male urethro-adnexitis and in female acute urethral syndrome. Uropathogens, Neisseria gonorrhoeae, Treponema pallidum, Mycobacterium tuberculosis, Chlamydia trachomatis, Mycoplasma spp., Haemophilus ducreyi, Calymmatobacterium granulomatis, Gardnerella vaginalis, anaerobic bacteria, Herpes simplex virus type II (HSV II), papillomaviruses (HPV), Trichomonas vaginalis and Candida spp. must be considered. The various diagnostic procedures and criteria applied for aetiological classification in cases of balanitis, urethritis, prostatitis, epididymitis, orchitis, and acute urethral syndrome are reviewed and evaluated.

Acute Disease↗

PubMedDate not supplied

Reactive arthritis: a paradigm for inflammatory arthritis.

Reactive arthritis (ReA) is an inflammatory arthritis which follows either chlamydia-induced non-specific urethritis or gastroenteritis due to yersinia, salmonella, shigella or campylobacter. It is distinguished from other infection-induced arthritides by its association with the MHC class I antigen HLA-B27, the pattern of arthritis (a lower-limb oligoarthritis often associated with sacroiliitis) and its systemic features (conjunctivitis, circinate balanitis and skin rash). ReA is unique among inflammatory arthritides in the clear definition of its trigger, its onset, its HLA association, and the demonstrating of a triggering antigen-specific cell-mediated immune response in the joint. Clear delineation of these factors makes it possible to test pathogenetic hypotheses which cannot be analysed in other more common forms of arthritis. However, since there are many similarities between these and ReA, the mechanisms established in ReA may have general relevance in understanding synovitis.

Antibody Formation↗

PubMed1995

Common genital dermatoses in male patients attending a public sexually transmitted disease clinic in Singapore.

The male genitalia is a common site of various dermatoses. Male patients attending a sexually transmitted disease (STD) clinic may present with dermatoses that are not due to sexually transmitted diseases. A prospective study on 467 male patients attending a public STD clinic showed various dermatoses which were either anatomical variants (pearly penile papules in 67 patients [14.3%], sebaceous hyperplasia in 16 [3.4%], Tyson's glands in 32 [7%] and penile melanosis in 13 [2.8%]) or pathological conditions (balanitis in 45 [9.6%], eczema in 10 [2.1%], traumatic ulcers in 10 [2.1%], folliculitis and furunculosis in 8 [1.7%], scabietic nodules in 7 [1.5%], genital candidiasis in 7 [1.5%] and a few miscellaneous conditions). Fifty percent of the patients with Tyson's glands also had pearly penile papules. Most of the anatomical variants were incidental findings whereas most patients with the pathological dermatoses presented with these lesions. Unfamiliarity with these dermatoses may cause unnecessary anxiety to the patient and physician, resulting in inappropriate treatment.

Adolescent↗

PubMedDate not supplied

[Urethral recurrence after cysto-prostatectomy for bladder tumor].

OBJECTIVE: To evaluate the frequency, predictive parameters and prognosis of urethral recurrence after cystoprostatectomy for urothelial bladder cancer. MATERIAL AND METHODS: From 1989 to 1994, 8 of a series of 185 patients (4.3%) treated by cystoprostatectomy for bladder carcinoma between 1988 and 1993 developed urethral recurrence revealed by urethral bleeding, with a follow-up of 6 to 36 months (m = 16). RESULTS: The initial bladder tumour was localized in 3 cases and multifocal in 5 cases. The posterior urethra was not involved in 5 cases, but presented lesions of CIS in 1 case and neoplastic infiltration also involving the prostate in 2 cases. These recurrences were treated by urethrectomy, as first-line treatment in 7 cases and after failure of endoscopic treatment in 1 case. A balanic recurrence required distal penectomy following insufficient urethral resection. The course was very rapidly unfavourable for 3 patients with generalized cancer and an intercurrent disease was fatal in 1 other case. With a follow-up of 12 to 44 months (m = 26), 4 patients are alive with no obvious signs of disease progression. CONCLUSION: The indications for prophylactic urethrectomy can be reserved to patients with positive urethral resection margins, provided all other cases are submitted to strict surveillance. In the context of a replacement bladder, it is essential to exclude neoplastic involvement of the posterior urethra or prostate, especially in patients previously treated by intravesical instillations.

Carcinoma↗

PubMedDate not supplied

[Ankylosing spondylitis and urogenital infection: diagnosis of urologic infection and correlation with rheumatologic findings].

We examined 134 male patients with confirmed ankylosing spondylitis. The study protocol included a medical-rheumatological examination and thorough exploration for infections of the urinogential tract. An urethroadnexitis was found in 37 of 134 patients (27.6%): Two patients suffered from balanitis, 17 patients from urethritis, 18 patients from prostatitis, and two patients from epididymitis. Only four patients gave a history of urethritis and eight patients of prostatitis. The microorganisms isolated most frequently from patients with urogenital infection were Chlamydia trachomatis and, in few cases, Ureaplasma urealyticum. By comparing the urethroadnexitis group and the non-infected group with regard to other clinical parameters, we found a significantly increased C-reactive protein in the infected group. Other clinical parameters like involvement of the free spinal column, inflammatory involvement of the joints, and HLA-B27 correlation did not differ significantly.

Adolescent↗

PubMedDate not supplied

Crohn's disease of the prepuce in a 12-year-old boy: a case report and review of the literature.

We report a case of Crohn's disease with involvement of the foreskin in a 12-year-old boy. One year previously, on the basis of clinical features (diarrhea with blood, perianal fissures) and histologic examination, a diagnosis of Crohn's disease was made. Subsequently, he developed phimosis and balanitis and underwent circumcision. Sections submitted from the foreskin revealed noncaseating granulomatous inflammation consistent with Crohn's disease. Crohn's disease with involvement of the genitalia is unusual. Only 26 cases including our case have been reported in the scientific literature. We have analyzed these cases with emphasis on gender, age, clinical features, duration of Crohn's disease, and probable mode of spread to the genitalia. Careful examination of sections from genital lesions, including those submitted from the foreskin, is essential to detect small isolated granulomas that may then lead to the diagnosis of inflammatory bowel disease.

Child↗

PubMed1996

[An electromyographic study of masticatory muscle changes in patients with mandibular protrusion before and after orthognathic surgery].

27 patients with mandibular prognathism were studied with 40 normal people as controls. All subjects were examined with electromyogram. The result shows that the voltage were lower in patients before surgery, the double-silent period inspect rate were much higher than normal subjects. It was concluded that the electromyo-activity of masticatory muscles had some character in patients after surgery: (1) The voltage of masseter and temporal muscle increased significantly during maximal voluntary clenching. (2) During protrusive border movement the voltage of masseter increased while the changes of voltage in the temporal muscle were small. (3) In lateral border movement, the voltage of masseter and temporal muscle increased in the working side, while the balaning side changed slightly. (4) Electromyo-voltage decreased in rest position. (5) The duration of silent period had a tendency of shortening after surgery. It demonstrated the feasibility and necessity of treating mandible deformity through orthognathic surgery, and it provided theoretical and practical support of evaluating the treatment effect of such kind of patients.

Adult↗

PubMed1998

Squamous cell carcinoma of the penis in a circumcised man: a case for dermatology and urology, and review of the literature.

Squamous cell carcinoma of the penis is most frequent in uncircumcised men. Other contributing factors include human papillomavirus infection, phimosis, balanitis, and smoking. We present a patient, circumcised at birth, who showed penile squamous cell carcinoma in situ and was treated with carbon dioxide laser ablation. Squamous cell carcinoma rarely presents in patients circumcised as infants. Factors contributing to chronic inflammation may predispose to this disease. Carbon dioxide and neodymium:YAG lasers are two modalities that are successful in the treatment of in situ and probably early invasive penile carcinoma. Optimal treatment includes coordination with a urologist if urethral disease is present.

Aged↗

PubMedDate not supplied

[Reiter's syndrome--analysis of 187 patients].

The study included 187 patients with positive diagnosis of Reiter's syndrome (RS) examined and treated in the Clinic of Rheumatology of Military Medical Academy in the period of 26 years (1970-1995). There were 176 males and 11 females (16:1) aged from 12 to 65 (average age 28.5) years. The disease diagnosis was made upon the clinical finding of at least two of four RS main features: acute urogenital or enteral infection, arthritis, ophthalmic and mucocutaneous changes. Family disease occurrence was noticed in 5, and juvenile type in 6 patients. HLA-B27 antigen was present in 81.5% patients. In 74.3% patients the urogenital disease type was determined, in 18.2% enterocolitic and in 7.5% initial causative agent was not discovered. Three or two RS main signs were present in approximately same number of patients (42.2% and 42.6%) while all the four disease signs were found in 15% patients. Acute or subacute course was found in 43.8%, recurrent in 34.2% and chronic in 22% patients. Clinically, the disease was revealed in locomotor system, most frequently as the asymmetric oligoartritis localized in lower extremities. Sacroiliac arthritis, partial or more frequently asymmetric mutual, radiologically confirmed, was present in 18.2% patients. Only one patient was with sacroiliitis without peripheral arthritis, pain in heel was present in 31.5%, and dactilitis, more frequently in the feet, in 13.9% patients. Radiological changes were found in 51.8% patients, most frequently in sacroiliac joints and heel bone. Chlamydia trachomatis or genital mycoplasma were isolated in synovial fluid of 33.3% (6/18) patients. The most frequent urogenital change was urethritis (56.7), ophthalmic--conjunctivitis (46.5), and mucocutaneous--balanitis (12.3). Positive damage of heart and kidneys by primary disease was found in 2, i.e. 4 patients, and possible in 7, i.e. 14 patients. No differences in RS clinical demonstration among sexes were observed. Besides conventional therapy, in only 26 (13.9%) patients were applied drugs out of the basic group, so as the radiation synovectomy and surgical methods of treatment.

Adolescent↗

PubMed1998

Anatomical alignment for the correction of buried penis.

PURPOSE: We report a straightforward surgical technique for the correction and anatomical alignment of the skin in patients with various degrees of buried penis. MATERIALS AND METHODS: A combined series of 74 patients 7 months to 10 years old who were treated for buried penis at 2 institutions during a 7-year period. Patients presented with various symptoms, including balanitis, urinary tract infection, painful voiding, ballooning of the foreskin and urinary retention. In 29 patients (38%) trapped penis was due to previous circumcision. In our estimation the major anatomical defect in buried penis is an insufficient attachment of the dartos fascia and penile skin to Buck's fascia. Our technique involves making a circumferential incision of the inner preputial skin layer proximal to the corona, unfurling it from the shaft skin and leaving a coronal collar of approximately 1 cm. The annular band that usually constricts the corpora on retraction of the penile skin is incised, and the remaining proximal penile skin and dartos fascia are dissected off Buck's fascia proximally to the base of the penis. The penile dermis is sutured to the lateral aspect of the tunica albuginea at the penopubic junction and mid shaft of the penis. This technique restores normal anatomical relationships with excellent cosmetic results and negligible complications. RESULTS: At a median 5-year followup cosmesis was excellent in all cases. Two patients with micropenis who required revision responded to endocrine therapy. CONCLUSIONS: Excellent cosmetic results were obtained in all cases using this surgical technique.

Child↗

PubMed1999

Ankylosing spondylitis and genitourinary infection.

One hundred and thirty-four male and 32 female patients with ankylosing spondylitis and 33 women with pure ileitis terminalis Crohn were examined. The study protocol included a medical-rheumatological examination and thorough investigation for genitourinary infection. Urethroadnexitis was found in 37/134 male patients (2 patients suffered from balanitis, 17 patients from urethritis, 18 patients from prostatitis, and 2 patients from epididymitis), 15/32 female patients (11 of them had urethritis and in 4 cases urethritis associated with vaginitis) and 5/33 women with ileitis terminalis (every case with urethritis). The microorganism isolated most frequently from patients with genitourinary infection was Chlamydia trachomatis. The majority of patients with genitourinary infection were HLA-B27 positive. Nevertheless, the following conclusions can be reached: (1) evidence of Chlamydia trachomatis infection is frequent in male and female patients with ankylosing spondylitis, (2) patients with genitourinary infection tend to have HLA-B27, and (3) furthermore, presence of genitourinary infection was not significantly associated with chronic illness.

Adult↗

PubMed1976

Epidemiological and clinical patterns of genital lesions.

A 5-year study of 668 patients with genital lesions revealed that teenagers and those in the age group of 20 to 40 are most vunerable. The poor, the uneducated and unmarried persons are at high risk. Chancroid and syphilis are the majority of cases. Inguinal bubo, herpes pregenitalis, condylomata acuminata, erosive balanitis and traumatic ulcers were seen less frequently. Most of the genital lesions had the classic clinical features. The findings of this study suggest that the pattern of genital lesions is showing borderline changes.

Adolescent↗