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[Bilateral familial anophthalmos].

In the examined family the proband, a 14 months old male, presented a bilateral anophthalmos, bilateral cryptorchism, phimosis and decalcification of the nails. The palpebral fissures and the eyelids are smaller than normal; the orbit was empty, clad by a connective tissue without ocular buds. The testicles are unpalpable in the inguinal canal. The proband have a normal karyotype. Also a brother of the proband, dead for meningitis (age five months), had bilateral anophthalmos. The maternal branch of the family is lacking in hereditary pathology. On the contrary, the anamnesis of the paternal branch present very interesting data. His grandmother married twice; from the first marriage came, at the second generation, the sibship of the father, who had a sister with Franceschetti syndrome and another sister with double lower dental arch. From a second marriage originated, at the second generation, eleven siblings sibship, all seriously malformed and a dead infant, but the first-born having bilateral anophthalmos.

Anophthalmos↗

[Clinical statistics on outpatients at the Urological Clinic of Sanjukai Hospital in 1987].

The total number of new outpatients in 1987 was 8,062 (male 5,056, female: 3,006) and the male to female ratio was 1.68:1. They had urogenital diseases definitely diagnosed (7,197), urogenital diseases indefinitely diagnosed (536), no diseases (269), and diseases other than urogenital (60). Thirty percent of the outpatients were referred to us by other sources. The number of operations on new outpatients was 216, circumcision, resection of condyloma and vasectomy were representative. The peak of the age distribution was in the thirties for males and in the fifties for females. A statistical study was made on new outpatients according to the international classification of disease. There were 125 malignant (urogenital) tumors (1.6%). The major diseases of the new outpatients were cystitis (acute or chronic: 22.0%), upper urinary tract stone (15.9%), prostatitis (13.9%), and benign prostatic hypertrophy (11.9%). In males the major diseases were prostatitis, upper urinary tract stone, benign prostatic hypertrophy, balanoposthitis, phimosis and in females they were cystitis, upper urinary tract stone, pyelonephritis, renoptosis, and neurogenic bladder. We conclude that our hospital plays a major role as a private urological hospital.

Adolescent↗

[Statistical study of penile cancer].

Between 1961 and 1985, 44 cases of penile cancer were experienced at Gunma University Hospital. We statistically analyzed 42 of them. The average age was 56.9 years old, ranging from 28 to 86 years old. Interval from onset of the disease to first visit to our hospital ranged from 0 to 50 months, averaging 9 months. The main chief complaints were mass formation, spontaneous pain, ulceration, and abnormality of urinary stream. More than 75% of them had phimosis. Thirty-one percent had stage 1, 29% stage 2, 38% stage 3, and 2% stage 4 cancer, according to Jackson's classification. All of them were diagnosed with squamous cell carcinoma. Surgical treatment was given to 37 patients (radical or partial penectomy was performed in most cases). Chemotherapy was given to 23 patients (main chemotherapeutic agent was bleomycin or peplomycin) and irradiation to 26 patients. Five-year survival was seen in 77% of the cases, 92% in low stage group (stage 1 and 2) and 63% in high stage group (stage 3 and 4). Ten-year survival was seen in 62% of the cases, 79% in low stage group and 43% in high stage group (Kaplan-Meier method).

Adult↗

[A clinical study of genital herpes and the clinical efficacy of acyclovir tablets].

A clinical study for genital herpes was conducted on 154 patients and the efficacy of treatment with oral acyclovir was investigated in 51 of these patients. The diagnosis was confirmed by direct immunofluorescence or viral isolation from the lesion. This disease has increased in both males and females in recent years and was found in 2.3-2.9% of the out-patients examined in 1986. Seventy percent of the patients were between 20 and 30 years old. About 70% of the male patients had phimosis. In patients with the first infection, bilateral eruption (62%) and lymphadenopathy (54%) were more common than unilateral lesions. However, in those with recurrent infection, unilateral eruption (72%) and lymphadenopathy (52%) were more common. Sixty two percent of those with the first infection had scattered eruption on external genitalia, but 71% with recurrent infection, had lesions concentrated in several areas. Local symptoms such as pain in the external genitalia (male: female, 16%: 85%), pain in the lower extremities (26%: 45%), discomfort in the lower extremities (20%: 41%) and systemic symptoms such as malaise (22%: 48%) and anorexia (4%: 35%) were seen more frequently in females than in males. In addition, systemic symptoms such as fever (first episode: recurrent episode, 36%: 4%), malaise (34%: 9%) and anorexia (18%: 2%) were seen more frequently in patients with the first episode than in those with recurrence. HSV type 1 infections were found in 16% of males and 28% of females with the first episode, but were less common in the recurrent episode, 0% and 13%, respectively. Direct immunofluorescence was positive in 75 (59%) of 128 samples diagnosed by viral isolation. Treatment with oral acyclovir tablets, 200 mg five times daily, was very effective in 26 of 30 patients (87%). No side effects were observed. In this study, acyclovir tablet has been shown to be a very effective and well-tolerated treatment for genital herpes infections.

Acyclovir↗

[Clinical statistics on outpatients at the Urological Clinic of Sanjukai Hospital in 1986].

A statistical study was performed on new outpatients. The total number of new outpatients in 1986 was 8,174 (male: 5,177, female: 2,997) and the male to female ratio was 1.73:1. They had urogenital diseases definitely diagnosed (7,043), urogenital diseases undefinitely diagnosed (689), no diseases (357), and diseases other than urogenital (85). Thirty percent of the outpatients were referred to us by other sources. The number of operations on new outpatients was 182, circumcision, resection of condyloma and vasectomy were representative. The peak of the age distribution was in the thirties for males and in the twenties for females. A statistical study was made on new outpatients according to the international disease classification. There were 109 malignant (urogenital) tumors (1.4%). The major diseases of the new outpatients were cystitis (acute or chronic: 21.4%), upper urinary tract stone (16.8%), prostatitis (14.1%), and benign prostatic hypertrophy (11.3%). In males the major diseases were prostatitis, upper urinary tract stone, benign prostatic hypertrophy, balanoposthitis, phimosis and in females they were cystitis, upper urinary tract stone, pyelonephritis, renoptosis and neurogenic bladder. We conclude that our hospital plays a major role as a private urological hospital.

Adolescent↗

[Tumor of the penis--analysis of 300 cases].

300 cases of penile tumor are reported. The age peak was over 41 years (79.0%). Of these 300 cases, (66.7%) had redundant prepuce and 78 (26.0%) had phimosis which implies that penile tumors are closely related to those two conditions. Surgical treatment consisted of partial resection of penis in 182 (60.7%) patients, total resection in 66 (22.0%) and ilioinguinal lymphadenectomy after resection in 29 (9.7%). The pathological findings showed that in majority of cases, it was squamous cell carcinoma (270, 90.0%). Only 90 (30.0%) patients survived among the followed up patients. 20 patients have survived over 20 years and 32 over 15 years. It seems that the long term result of penile tumors after operation is better than that of other uro-genital neoplasms. Stricture of external meatus occurred in 22 patients and all were promptly relieved by dilation.

Adult↗

[A case of preputial calculi].

A case of a 73-year-old patient with preputial calculi is presented. The patient visited our hospital complaining of consciousness loss. It was impossible to place a catheter because of complete phimosis. Palpatory examination suggested the presence of stones in preputial cavity. Dorsal incision was made. After pus discharge nine small stones were extirpated. Ammonium hydrogen urate (96%) and calcium phosphate (4%) were found in these stones with infrared spectroscopic analysis. Bacteriodes ureolytcus and Peptostreptcoccus asaccharolyticus were isolated from urine specimen.

Aged↗

[Chronology of the surgical repair of inguinal hernia in children].

We have made a revision of 243 cases of inguinal hernia operated in Children Surgery Department of the Military Hospital Gómez Ulla during five years. The conclusion of this work was that once the diagnostic is true the patient must be operated as soon as possible (two weeks). It should be dedicated special attention in case of previous crisis of hernia incarceration and when the symptoms are constipation, frequent cough, phimosis, constant irritability or others process with sudden increase of intraabdominal pressure. There is a description of "distension of intestinal as a sign", which exist in 11,11% of the preoperative studies, and "stomach chamber sign" present in 6,58%, both of them needs treatment as soon as possible. The 6,9% of the patients required a second operation because a new hernia in the contralateral side. We think about unjustified the bilateral systematic surgical exploration.

Child↗

Lesions of the canine penis and prepuce.

In 185 dogs treated for penile or preputial problems, 197 lesions were observed including 86 tumors (of which 84 were transmissible venereal tumors), 40 cases of balanophosthitis, 38 wounds, 14 urethral calculi and one urethral stenosis. In addition, 14 cases of paraphimosis, one phimosis and 4 fractures of the os penis were seen. This report discusses the clinical signs, treatment and results of penile-preputial disease.

Animals↗

[Surgery of senile cataract; technical suggestions (author's transl)].

This study is intended in particular for the isolated specialist complied to practice cataract surgery with limited means. The author proposes his solutions to a series of problems encountered in the course of his long career. The plea for local anesthesia is followed by a paragraph on "potentialized akinesia", a method conceived by the author, resulting in a perfect orbicular relaxation. The following paragraphs deal in turn with matters of lighting, means of magnification, pre-operative hypotony, incidents of shock, phimosis of the conjunctival sac and the different steps of the operation proper with the manyfold problems they arouse and the practical solution for each.

Aged↗

[Clinical statistics on inpatients and operations in the Urological Department of the Wakayama Red Cross Hospital (April, 1979 to March, 1983)].

Statistical observations made on the 1,102 inpatients and 1,127 operations at our clinic between April 1979 and March 1983 were reviewed. The patients were most frequently in their sixties, and lately patients under 10 are increasing. The most frequent diseases of the inpatients were benign prostatic hypertrophies, ureteral calculi, undescended testicles and bladder tumors. The frequently performed operations were those for bladder tumors, phimosis and benign prostatic hypertrophies in order of frequency.

Adult↗

[Ciliary activity of cells of the fallopian tubes (apropos of the sequellae of salpingitis)].

A study was made of ciliary movement in tubal epithelium using microphotooscillography on the tubes of 91 patients who were operated on for tubal, ovarian or uterine pathology. Three groups were classified: 31 with healthy tubes, 47 with tubes that showed the consequences of salpingitis. These patients had been operated on for sterility after much treatment with antibiotics and corticoids. 13 sets of tubes from pregnant women (6 cases had intra-uterine pregnancies and underwent tubal ligation after Caesarean section or after a termination of pregnancy) and 7 cases had extra-uterine pregnancies with salpingectomy. This study has made it possible for us to make several observations: The ciliary activity was not altered by the time in the menstrual cycle. When the tubes were healthy tubal activity was hardly changed when a fibroid was present, nor when an ovarian cyst or endometriosis were present (550 beats a minute). In pregnant women ciliary activity is maintained until the pregnancy becomes intra-uterine. It is always abolished in cases of extra-uterine pregnancy, even if this is at some distance from the site of inflammatory reaction caused by implantation of the oocyte. In cases following salpingitis, ciliary activity in the tubes is often altered and sometimes nil. It therefore seems that if one excludes anatomical lesions such as tubal blocks and ampullary phimosis, salpingitis which is the cause of sterility changes tubal physiology greatly. This is true even at some distance from the site of the infective process as is shown by changes in ciliary activity.

Cilia↗

[Spindle cell carcinoma of the penis--a case report].

Over a 2-month period, a 34-year old man with phimosis developed a pedunculated tumor, measuring 4 X 2.5 X 2 cm in his glans penis. Microscopically the bulk of the tumor was composed of spindle-shaped cells, however, at some parts of the tumor, squamous cell cysts or nests, consistent with well-differentiated squamous cell carcinoma, were noted. Atypical epithelial cells merged imperceptibly with the underlying spindle-shaped cells. The histological diagnosis of spindle cell carcinoma, an uncommon variant of squamous cell carcinoma, was made. Spindle cell carcinoma arising from the penis is very rare and only two reports are available at present.

Adult↗

[Cancer of the penis in Cambodia].

The prevalence of penis cancer in Cambodia is comparable with some Far-East and Latino-American countries. Circumcision performed as a religious observance among Jews or undergone as a regular practice among older Moslems children (the Islam Kmers in Cambodia) might provide an indirect protection against this kind of cancer. It indeed helps in ensuring proper personnal hygiene and in improving the detection, the treatment and the aftercare of all the mild lesions which possibly can pave the way to cancer. Out of of 253 observed cases recorded during a 10 years period (from 1960 to 1970), 164 were treated and followed up by the same surgical team from 1964 to 1970. They stress on those etiopathogenic factors and make possible a description of the reported "anatomoclinical" forms. The use of radiumtherapy either by contact or by means of needles is quite effective; however, when corpora cavernosa are involved, it will be often necessary to perform either a partial amputation or to an emasculation in case of entirely overspreading lesions. As metastases are of rare occurence, it is regarded as a "mild cancer"; however the sequelae due to the treatment are far from small importance. Through better personnal hygiene, detection, treatment, and surveillance of inflammations and benign tumors, with the renforcement of circumcision as a regular practice for every case of phimosis or chronic lesions, an effective prevention of this kind of cancer will expectedly be carried out in Cambodia and its prevalence will be reduced to a rate similar to that in European countries.

Cambodia↗

[Trichomonal balano-posthitis. Report of 16 cases (author's transl)].

Glans penis and foreskin lesions occurred in sixteen patients (+/- 34 p. 100) in a group of 46 males with trichomoniasis and were predominantly of the erosive type. Trichomonal balano-posthitis has been associated with trichomonal uretritis in 7 patients, with syphilis in 4 patients and with genital warts in 4. The dominant complication was phimosis. Long foreskin should be considered a favorable condition in infection of glans penis and foreskin due to T. vaginalis. The dense predominantly lymphocytic infiltration in the upper dermis characterized the histology of the lesions. An inguinal lymph node biopsy specimen demonstrated the features of reactive hyperplasia, a cause of inguinal lymphadenopathy. The condition responded well to treatment with metronidazol during 9-10 days.

Adolescent↗

[Intra-arterial chemotherapy with cisplatin, vincristine, methotrexate and adriamycin for recurrent penile cancer: a case report].

A 60-year-old man visited our hospital with a chief complaint of penile tumor on November 13, 1984. Circumcision of true phimosis was performed and biopsy of the 27 x 27 mm fixed tumor on the glans revealed well differentiated squamous cell carcinoma. Seventy Gy of electron irradiation to the penis revealed a complete response. On February 1, 1985 bilateral inguinal lymph node dissection was performed and revealed metastasis to a left inguinal node. In May 1990, erosive changes occurred on the irradiated region, and local recurrence was confirmed. Since 2 courses of MBD (methotrexate, bleomycin, cisplatin) chemotherapy was not effective, additional wedge dissection was performed. In January 1992, local recurrence was found. Four courses of intra-arterial chemotherapy (cisplatin, vincristine, methotrexate, adriamycin) was performed with a complete response. No evidence of disease has been recognized for more than two years after completion of the treatment.

Antineoplastic Combined Chemotherapy Protocols↗

[Study of risk factors for prostatic cancer].

A case-control study was conducted on 294 prostatic cancer patients and controls. General population controls were chosen from 13 areas in Gunma Prefecture and were matched by age (+/- 2 y.o.) to cases. Odds ratio (O.R.) and 95% confidence interval (C.I.) were calculated on each item according to group; 69 years old or younger and 70 years old or older, and age-adjusted O.R. and 95% C.I. were calculated. Risk factors of prostatic cancer were investigated. There was a significantly higher risk for prostatic cancer in those 1) engaged in agriculture, forestry or fishery (< or = 69, > or = 70, total), 2) shaving 1/3 days or less frequently (> or = 70, total), 3) having thin pubic hair (total), 4) phimosis (< or = 69, total), 5) having history of smoking (> or = 70, total), 6) history of smoking 50 years or more (total), 7) having eaten vegetables rarely (> or = 70, total), 8) having past history or complication of asthma (> or = 70). O.R.s of having past history or complication of benign prostatic hypertrophy, prostatitis and urethral stricture were high significantly, but they were supposed to be caused by bias. Four patients had first degree family members who suffered from prostatic cancer, compared to zero in the control. There was a significantly lower risk for prostatic cancer in those 1) engaged in office work (> or = 70, total), 2) blood type A or AB (< or = 69), 3) having had one child or none (total), 4) having past history or complication of tuberculosis (total).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

Use of Doppler ultrasonography and positive-contrast corpus cavernosography to evaluate a persistent penile hematoma in a bull.

A 32-month-old Angus bull was evaluated because of a 2-month history of a slowly progressive swelling located cranial to the base of the scrotum. The mass was 8 x 8 x 6 cm, and was causing phimosis. The mass was determined to be a penile hematoma on the basis of results of ultrasonography and exploratory surgery. Surgical evacuation was not performed initially because the deep fascia of the penis was intact and the hematoma was small; however, the hematoma enlarged slowly during the ensuring 2 months, despite sexual rest and isolation from other livestock. Doppler ultrasonography and positive-contrast corpus cavernosography were performed, and the hematoma was seen as a space-occupying mass within the corpus cavernosum penis; vascular anomalies were not found. The penile hematoma was surgically excised, and the bull was isolated for 60 days. At follow-up, the owner indicated that the bull had returned to pasture-breeding soundness and was still being used 2 years after surgery. The small penile hematoma in this bull was unusual in that it did not respond to medical treatment. Surgical treatment was apparently curative, even though surgery was not performed until 4 months after the hematoma was first detected.

Animals↗