Anaerobic bacteria in bronchoalveolar lavage fluid (BAL) after thoracic surgery

Purpose of this study was to find out what kind of anaerobic bacteria were in lower respiratory tract and how often they were present there considering patients after thoracic surgery. Also, what is susceptibility of bacteria to antibiotics. Research covered 30 patients after operation. Material for research was bronchoalveolar lavage (BAL) taken during bronchoscopy. Collected sample was cultivated in anaerobic and aerobic conditions. Anaerobic bacteria were found in 28 samples (93%). Totally there were 100 anaerobic bacteria strains. The most common Gram-negative rods were from genus Prevotella (24 strains, 24%) and Bacteroides (15 strains, 15%). Gram-negative bacteria except Bacteroides characterised biggest susceptibility to imipenem, piperacillin/tazobactam, amoxicillin/clavulanate, ampicillin/sulbactam, piperacillin, clindamycin and metronidazol. Bacteroides were susceptible to imipenem, piperacillin/tazobactam and metronidazol. Among Gram-positive anaerobic bacteria mostly were isolated from cocci Peptostreptococcus (18 strains, 18%) and were susceptible to all antibiotics. Gram-positive rods were in most cases represented by Actinomyces (12 strains 12%) and were highly susceptible to all antibacterial means except metronidazol (100% is resistant).     

Surgical treatment of balanitis xerotica obliterans

Balanitis xerotica obliterans, or kraurosis penis, is a chronic progressive scleroatrophic process of the penis, prepuce, and urethral meatus. This syndrome is due to lichen sclerosus et atrophicus of the genital region. We have observed 32 patients, whose ages ranged from 24 to 78, with different clinical and pathologic findings. Clinical symptomatology consisted of painful erection with secondary impotence, burning, itching, and urinary disorders. The treatment in the early stages is pharmacologic; stenosis of the meatus, phimosis, scar adhesions, fissures, and erosions of glans and prepuce prescribe a surgical treatment. We have performed modified circumcision, meatotomy and meatoplasty, removal of the scleroatrophic tract and subsequent grafting. The functional results were satisfactory.     

Penile paralysis and paraphimosis associated with reserpine administration in a stallion

Reserpine was administered to an 8-yr-old Thoroughbred stallion at a dosage of 5 mg subcutaneously (s.c.) every 2 wk for a 2-mo period to control unmanageable behavior. Reserpine produced a satisfactory calming effect that lasted for about 2 wk. After the last injection, the stallion developed penile paralysis and was unable to retract his penis, resulting in paraphimosis and attendant penile edema. The prolapsed penis was reduced and kept within the prepuce by placing a purse string suture in the preputial orifice. Phenylbutazone was given orally (1 gm) and the stallion was exercised for 20 to 30 min twice daily. This treatment was continued for 20 d with little improvement. The purse string retention suture cut through the skin 5 d after the stallion was discharged from the clinic. The penis was then supported against the abdominal wall and the stallion was exercised by hand for 30 min each day. The stallion was not used for breeding within 34 mo after the last injection of reserpine. A breeding soundness examination was performed approximately 3 yr after the initial injury. At this time the stallion's penis was noted to extend 5 to 8 cm from the prepuce when in a detumescent state. Although the stallion protruded his penis when exposed to a mare in estrus, a full rigid erection was never attained. Examination of the penis revealed partial engorgement of the corpus cavernosum penis and a 2.5-cm-wide dorsal semi-circumferential depression of the penile shaft approximately 10 to 12 cm proximal to the glans penis. The penile shaft and glans penis distal to this depression were cooler than the proximal portion of the penis. Semen collection was attempted, aided by manual insertion of the penis into the artificial vagina. When serving the artificial vagina, no "belling" of the glans penis was observed, although ejaculation occurred. Semen evaluation indicated normal spermatozoal motility and morphology parameters. The stallion was able to breed several mares with manual assistance to guide the penis into the vagina and one mare was diagnosed pregnant.     

The penis of elephant shrews (Mammalia: Macroscelididae)

The penis of elephant shrews is very long, extending cranially to near the sternum where it emerges from a small caudally-pointing prepuce. The distal half of the penis lies free in a sheath and is termed the glans. In most species the corpus cavernosum is the main vascular body and extends to the tip of the penis while the corpus spongiosum around the urethra becomes much reduced distally, but in Rhynchocyon all vascular bodies are small and most of the penis consists of connective tissue. The distal tip of the penis is elaborated into various shapes, characteristic for each genus as currently defined. These penile features have more similarities with soricids and paenungulates than with archontans and lagomorphs but they are likely to be primitive characters and so should be interpreted cautiously.     

Surgical treatment of erythroplasia of Queyrat.

An operative technique is described for the treatment of large lesions of erythroplasia of the penis. The defect on the glans and on the coronary sulcus is covered by a flap prepared from the external part of the prepuce. This therapy has been effective and has given a good functional result.     

External genitalia of the rat: normal development and the histogenesis of 5 alpha-reductase inhibitor-induced abnormalities

The normal histogenesis of the rat genital tubercle and the effect of exposure in utero to the 5 alpha-reductase inhibitor finasteride (L-652,931; MK-0906; Proscar) on that process were studied. In normal males and females, the genital tubercle was first seen on Day 14.25 of gestation. It contained a urethral plate which extended from the cloaca (and after Day 15.25, from the urogenital sinus) to the tip of the tubercle. On Day 18.25 the glans lamellae, which would separate the glans penis or the clitoris from the prepuce, began to develop in both sexes. Also on Day 18.25 a dense, midline plate of mesenchymal cells was first evident between the urogenital sinus and the rectum in normal males. This plate acted as a wedge, first increasing the separation between the rectum and the urogenital sinus, and subsequently separating the urethral plate from the surface epithelium in the genital tubercle. As a result, by Day 21.25 the urethra in males followed an "S"-shaped course, extending from the pelvis through the center of the glans penis to an orifice near the tip of the genital tubercle. In females, in which a mesenchymal plate did not develop, the urethral orifice remained at the base of the tubercle, and the clitoris contained the remnants of the urethral plate, extending as an open groove from the urethral orifice to the tip of the tubercle. Finasteride did not affect development of the genital tubercle in females. However, in males exposed to finasteride in utero, there was variable failure of the mesenchymal wedge to develop. As a result, the urethral plate remained in contact with the surface epithelium and eventually opened to form a groove on the ventral surface of the glans penis (hypospadias). Also, the persistence of the urethral plate along the ventral midline in finasteride-treated male fetuses and its subsequent opening as a groove interfered with development of the glans lamellae, causing displacement of the frenulum distally on the glans penis and the development of a cleft in the prepuce.     

Histomorphology of the glans penis in Vespertilionidae and Phyllostomidae species (Chiroptera,Mammalia)

The penises of bats are taxonomically distinctive in size and shape. In addition, they are variable in microscopic anatomy, indicating that histomorphological studies of copulatory organs of bats may help understanding their successful reproductive strategies. We studied adult males of 13 species of vespertilionid and phyllostomid bats. Both families exhibited the basic structure of the vascular penis of mammals: the hydrostatic elements of the corpora cavernosa and the corpus spongiosum surrounding the urethra, as well as accessory cavernous tissue. Variation in the position and amount of the tissues were observed in these families. Vespertilionid bats have a small glans penis with abundant accessory cavernous tissue on the prepuce and a highly variable baculum. The baculum varied in size and morphology, even among congeneric species, such as the three Lasiurus species and the two Myotis species. Phyllostomid species possess no bacula, but vascular structures are present to produce penile stiffening, particularly on the glans. Variation in the microscopic anatomy of the phyllostomid prepuce was observed, for example, Artibeus species had accessory cavernous tissue surrounded by a tunica albuginea, but Carollia perspicillata had two bundles of striated musculature and some adipose tissue; abundant pigments were present in the prepuce of most species.     

Phimosis in male dromedary camels: Clinical findings and changes in the hemogram,nitric oxide metabolites,and testosterone concentrations

The objectives of this study were to elucidate the clinical findings in male dromedary camels with phimosis (PHI, n = 43) and to investigate the association of this syndrome with the hemogram, nitric oxide metabolites (NOMs), and testosterone concentrations. History and signalment were obtained, and a breeding soundness examination was performed. The penis was exteriorized after administration of a pudendal nerve block. Abnormal masses obtained from the prepuce and penis were prepared for histopathology. Blood samples for hemogram assessment were taken from the diseased animals and from 10 healthy control males. Total nitrates/nitrites were determined in sera using the Griess assay. Testosterone was estimated in sera using ELISA. Phimosis associated with detectable pathologic lesions, mainly including ulcerative posthitis and lacerated glans penis, was present in 34 (79.1%) of the 43 cases (PHI-P), whereas the remaining nine (20.9%) of the 43 cases had no noticeable lesions (PHI-N). The PHI-P group showed higher leukocyte counts (P = 0.001), especially neutrophils (P = 0.0001), and greater NOM concentrations (P = 0.002) than the PHI-N and control groups. However, testosterone concentrations did not differ among groups. In conclusion, PHI in the male dromedary camels was mainly associated with ulcerative posthitis and laceration of the glans penis. The presence of pathologic lesions in cases with PHI was associated with leukocytosis, neutrophilia, and high NOM concentrations.     

High prevalence and resistance rates to antibiotics in anaerobic bacteria in specimens from patients with chronic balanitis

Aim of the study was to assess both prevalence and antibiotic resistance in anaerobic bacteria from glans penis skin of 70 adults. Strain susceptibility was determined by breakpoint susceptibility test or E test. In 9 asymptomatic, 48 untreated and 13 treated symptomatic patients, anaerobes were found in 22.2%, 70.8% and 53.3%, respectively. Gram-positive strains (GPAs) were 2.2-fold more common than Gram-negative ones. Prevalent Gram-negative (GNAs) and GPAs were Prevotella spp. and anaerobic cocci, respectively. Clostridium difficile strain was found in an untreated patient. In GNAs, resistance rates to amoxicillin, metronidazole, clindamycin, tetracycline, levofloxacin, and amoxicillin/clavulanate were 42.1, 0, 52.6, 53.3, 86.7 and 5.2%, respectively. In GPAs, the resistance rates to metronidazole, clindamycin, tetracycline, levofloxacin and amoxicillin/clavulanate were 18.2, 34.1, 52.6, 36.8 and 0%, respectively. In conclusion, anaerobes were 1.6-fold more frequent in untreated symptomatic patients compared with other patients, suggesting their participation in development of chronic balanitis. GPAs were more common than GNAs. The resistance rates to amoxicillin, clindamycin, tetracycline, and levofloxacin were high. Most active agents were metronidazole and amoxicillin/clavulanate. Resistance in anaerobes varies according to sites of specimens and years of study.     

Anaerobic balanoposthitis.

To assess the causative role of non-sporing anaerobes in cass of erosive balanoposthitis, anaerobic culture was performed on purulent discharges from 104 patients with penile ulceration, a foul-smelling discharge, and a mixed and motile bacterial flora. Most of 29 culturally confirmed infections were due to mixed anaerobes and eight to single anaerobes. A rapid response to treatment with metronidazole also confirmed the anaerobic cause of the infection. Thus, acute anaerobic balanoposthitis can be readily diagnosed clinically and is easily treated.     

Atresia ani with diphallus and separate scrota in a calf: a case report

Atresia ani, a common genetic defect in animals, is often accompanied by urogenital defects in calves. This paper reports a case of atresia ani with diphallus and separate scrota in a calf. The calf was born with atresia ani; surgery (to open the anus) was performed 3 days after birth. No urogenital abnormalities were noticed until 4 months after birth. At that time, two separate scrota (each containing a testis) and a sac-like structure in the middle of two scrota, were visible. The gait was abnormal, with abduction of the hind limbs while walking. Additionally, the hind legs appeared wider than usual at the hip joints. Two weeks later, two peni (diphallia) was observed, each in a separate preputial sheath. The calf had a normal karyotype on cytogenetic examination. Plasma concentrations of testosterone at 5.5, 6, and 7 months of age were 3.5, 1.9, and 1.7 ng/ml, respectively. At necropsy (7 months of age), the prepuce was thick and the glans of the right penis was adhered to the prepuce. The left penis did not have a urethra or retractor penis muscles. The sac-like structure in the middle of the two scrota contained the urinary bladder and a loop of small intestine. The pubic bone had failed to fuse at the pelvic symphysis. In conclusion, this is the first reported case of atresia ani with diphallus, separate scrota, and pubic bone separation in a calf.     

Squamous cell carcinoma and lichen sclerosus et atrophicus of the prepuce.

Two cases of squamous cell carcinoma of the prepuce arising on balanitis xerotica obliterans are described. This event is unusual and not well known. The surgical treatment was a wide circumcision in which the prepuce and part of the shaft skin were removed, performing as well a decortication of the glans base. This technique seemed to be satisfactory in removing the carcinoma and obtaining a definite improvement in the clinical picture of balanitis xerotica obliterans as well.     

The role of encapsulated anaerobic bacteria in synergistic infections

Abstract: The effect of encapsulation on the virulence, survival, and protection of anaerobic bacteria from phagocytosis is reviewed. Support for the importance of encapsulated Gram-negative anaerobic rods ( Bacteroides sp., Prevotella sp. and Porphyromonas sp.), anaerobic and facultative Gram-positive cocci (AFGPC) was provided by their higher recovery rate in oropharyngeal infections, abscesses and blood, compared to their number in the normal flora. The pathogenicity of Bacteroides, Fusobacterium, Clostridium , and AFGPC was studied by inoculating them into mice and observing their ability to induce subcutaneous abscesses. Encapsulated Bacteroides, Fusobacteria , and AFGPC generally induced abscesses, whereas non-encapsulated organisms did not. However, many of the strains that had only a minimal number of encapsulated organisms (< 1%) survived in the abscesses, and they became heavily encapsulated when inoculated with other viable or non-viable encapsulated bacteria. Thereafter, these strains were able to induce abscesses when injected alone. Encapsulated Gram-negative anaerobic rods and AFGPC-induced bacteraemia and translocation, and increased the mortality of the infected animals more often than did the non-encapsulated form of the same strains. As determined by using selective antimicrobial therapy and quantitative cultures of abscesses induced in mice, possession of a capsule generally made Gram-negative anaerobic rods more important than their aerobic counterparts. Synergistic potentials were seen between encapsulated Gram-negative anaerobic rods and all tested aerobic bacteria and most AFGPC, and also between most AFGPC and Pseudomonas aeruginosa or Staphylococcus aureus . These studies demonstrated the importance of encapsulated anaerobes in mixed infections.     

Cancer du pénis au Sénégal : aspects cliniques et thérapeutiques

Objective

Describe the clinical and therapeutic aspects of penile cancer in Senegal.

Patients and methods

We conducted a retrospective study that looked at records of patients followed for penile cancer in the urology service of the Aristide Le Dantec hospital between January 2000 and December 2011.

Results

Eight patients of mean age of 51.5, with extremes of 27 and 77 have been identified. They were all circumcised in childhood. Clinical examination had highlighted ulcerated and burgeoning tumor affecting glans and a part of the penis in five cases; in two cases, it concerned the entire penis, while one case was limited to the glans. Patients were thus classified according cT3 (three cases) and cT1 (one case). The histological type of the tumour was, in all patients, squamous cell carcinoma. There was no secondary location in the thoracic-flow-pelvic scanner. Therapeutically, a partial penectomy was conducted in five cases, a total penectomy with ganglionic flushing in one case. Two patients refused surgical treatment. There was no recurrence in five patients who underwent a partial amputation of the penis. Overall survival was therefore of 83.3 for surgical patients.

Conclusion

cancer of the penis is rare in Senegal. The support is delicate because of late diagnosis associated with advanced lesions, hence the importance of awareness of the population.     

Sex determination in the common marmoset (Callithrix jacchus).

The general morphology of the external genitalia was examined in 43 common marmosets (Callithrix jacchus) ranging in age from newborn to adult. At birth, the scrotum was a small irregular fold of skin on either side of the caudal aspect of the penis. The testes were not present in the scrotum until 8--11 months of age. The scrotum covered the penis in the adult male, was devoid of fur, was covered by pearly while nodules, and presented a median raphe. In the young female, the pudendal pad closely resembled the scrotum of the male. The vulva was pendulous, and the small vestibular opening was located near its most ventral aspect and closely resembled the preputial opening of the male. In the adult female, the pudendal pad was pendulous, was studded with white nodules, and closely resembled the scrotum of the male. Sex determination by casual observation resulted in numerous errors. Accurate sex determination was based on differences in the preputial and vestibular openings, demonstration of the glans penis in the prepuce, and palpation of the testes in the scrotum or inguinal region.     

Necrobacillosis in free-living male European bison in Poland

In the Bialowieza Primeval Forest (Poland) a chronic disease of the external genital organs has been observed in free-living male European bison (Bison bonasus) since 1980. Investigations on this disease started in the late 1980s. The most striking findings are necrotic and ulcerative lesions of the prepuce and penis of bison aged from 6 mo to >10 yr. Histologic examination of tissue samples from the prepuce of six bison (9-mo- to 8-yr-old), and from the penis of two bison (3- and 8-yr-old), were characteristic of necrobacillosis. Masses of slender, Gram-negative, rod-like or filamentous bacteria occurred in necrotic tissue. At the periphery of necrotic tissue filamentous bacteria were often arranged in large clusters and strands that advanced towards healthy tissue. Immunolabeling and electron microscopy also suggest that these organisms are Fusobacterium sp.     

Properties of a cellulolytic Sporolactobacillus and some non-sporing cellulolytic rods, presumptive clostridia, from an anaerobic digester

Anaerobic digesters contain a wide variety of anaerobic cellulolytic bacteria. Many of these are sporing rods. Some isolates from a mesophilic cattle waste anaerobic digester were classified as Sporolactobacillus spp. A further group of bacteria could not be induced to sporulate. In some respects they resembled Eubacterium , but considering all the properties it is suggested that they should be classified as a species of Clostridium.     

Pudendal and caudal rectal nerve blocks in the horse - An anesthetic procedure for reproductive surgery

The pudendal and caudal rectal nerves in four male and five female adult crossbred horses were anesthetized with a local solution. The injection site was located at the foramen for the caudal gluteal artery and vein in the sacrosciatic ligament. Twenty milliliters of local anesthetic solution were injected via a 15-cm, 18-gauge needle. Quantitative data on anesthesia were determined from these injections. Dye was injected with the anesthetic in four additional horses so that accurate placement of the solution could be determined at postmortem examination. Satisfactory anesthesia of the anus, perineum, and vulva in the mare and of the anus, perineum, glans penis and penile layer of the prepuce in the male was achieved by placement of anesthetic near the foramen for the caudal gluteal vessels in the sacrosciatic ligament. Penile extrusion also occurred.     

Corona glans clitoroplasty and urethropreputial vestibuloplasty in male-to-female transsexuals: the vulval aesthetic refinement by the Andalusia Gender Team

For more than a decade the pedicled island neurovascular flap of the glans penis has been the standard procedure for clitoroplasty in intersex anomalies and in male-to-female genital sex reassignment surgery. Most authors focusing on genitoperineal reconstructions have used the island neurovascular flap of the dorsal shaft of the penis, including a variable-sized dorsal chip of the glans penis as the distal and functional portion of the flap. Although this dorsal glans clitoroplasty technique for neoclitoral reconstruction is well known, it nevertheless deserves scientific revision, with a view to improving several neglected aesthetic and functional points. The authors describe a new method for reconstruction of the neoclitoris in male-to-female transsexuals, the corona glans clitoroplasty. It is based on a modification of the original pedicled island neurovascular flap of the glans penis. The main difference compared with the dorsal glans clitoroplasty is that, distally, this method includes a bifid dorsolateral coronal flap designed in the shape of an open lotus flower or a bull's horns. Furthermore, a semicircular preputial flap is retained, attached to the bifid coronal flap of the glans, to improve the cosmetic appearance of the vestibulum and avoid growth of hair around the neoclitoris. Finally, a small dorsal flap of the spongiomucosa urethra designed in the shape of a pencil tip is added to improve the cosmetic appearance of the vestibulum between the neoclitoris and the urethral neomeatus. Since October of 1999, the authors have performed more than 30 genital sex reassignment surgeries in male-to-female transsexuals, of whom 16 underwent their technique of corona glans clitoroplasty. The authors describe and discuss the anatomic basis and clinical implications of this technique and its cosmetic and potential functional advantages. They also consider the anatomic differences among four distal designs of the pedicled island neurovascular flap of the glans penis: dorsal, lateral, ventral, and corona glans clitoroplasty in male-to-female transsexuals.     

Squamous cell carcinoma with metastasis in a rhesus monkey (Macaca mulatta)

A squamous cell carcinoma of the prepuce and penis with metastases to the inguinal lymph nodes and lung occurred in a rhesus monkey (Macaca mulatta). The primary tumor consisted of eroded nodular masses at the mucocutaneous junction of the prepuce and in the epithelium of the prepuce and penis.