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Phalloplasty following penectomy for penile cancer

Asian journal of Urology 2022年第4期9卷 460-466页

作者： Wai Gin Lee A.Nim Christopher david j.ralph University College London Hospital LondonUnited Kingdom St Peter’s Andrology LondonUnited Kingdom

Objective:Penile reconstruction or phalloplasty following penectomy can be offered where the functional penile length is inadequate for a man to void while standing or to have sexual *** is usually staged due to the complex surgical techniques *** narrative review describes the technical concepts and summarises the contemporary outcomes following phalloplasty in this challenging ***:A retrospective review of the English literature was performed between january 1946 till November *** data were synthesised and complemented by the expert opinion of the authors with 20 years of experience in this *** flaps are ideally designed with an integrated urethra or alternatively,a further free flap urethroplasty can be ***-plasty is further complicated following penectomy by scarring from the previous surgery and the potential loss of structures that would normally be present at the recipient ***:There are limited published data with a total of 19 men recorded in the *** the radial artery forearm free flap and anterolateral thigh flap have been described in this cohort of *** outcomes including standing micturition,sensation in the neo-phallus,and the ability to orgasm are *** quality of life and satisfaction was also good despite the high risk for long-term complications of the neophallus and donor ***:Phalloplasty following penectomy requires microsurgical transfer of a free flap or a pedicled flap to reconstruct a *** erectile device is inserted at a later stage to facilitate sexual intercourse,if *** scarring from penectomy and the potential loss of vasculature that would normally be present at the recipient site may further complicate *** and functional outcomes are acceptable based on the limited published experience to date.

关键词： Humans Male Myocutaneous flap or transplantation Penis or surgery Phalloplasty Reconstructive surgical procedures Retrospective study Surgical flap Thigh or surgery Treatment outcome Urethra or surgery

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Penile reconstruction

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Asian journal of Andrology 2013年第1期15卷 16-19页

作者： Giulio Garaffa Salvatore Sansalone david j ralph St Peter's Andrology London WIG 6B J UK Tor Vergata University Rome 00133 Italy

During the most recent years, a variety of new techniques of penile reconstruction have been described in the literature. This paper focuses on the most recent advances in male genital reconstruction after trauma, excision of benign and malignant disease, in gender reassignment surgery and aphallia with emphasis on surgical technique, cosmetic and functional outcome.

关键词： female to male transsexuals fibrosis free flaps glans reconstruction glans sculpture lichen sclerosus lymphoedema of the genitalia penile prosthesis Peyronie's disease phalloplasty scrotoplasty shaft reconstruction skin graft penile reconstruction

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Selective serotonin reuptake inhibitors in the treatment of premature ejaculation

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Chinese Medical journal 2007年第11期120卷 1000-1006页

作者： WANG Wei-fu CHANG Le Suks Minhas david j ralph Department of Urology People＇s Hospital of Hainan Province Haikou 570311 China Department of Gynaecology People＇s Hospital of Hainan Province Haikou 570311China St Peter＇s Department of Andrology Institute of Urology Middlesex Hospital UCL London UK W1T 3AA

Objective To review and assess the update studies regarding selective serotonin reuptake inhibitors （SSRIs） in the treatment of premature ejaculation （PE） and then provide practical recommendations and possible mechanisms concerning state of the art knowledge for the use of SSRIs in alleviating PE. Data sources Using the Medline, 48 articles published from january 1st, 1996 to August 1st, 2006 concerning the use of SSRIs and their possible mechanisms in alleviating PE were found and reviewed. Study selection PE, rapid ejaculation, early ejaculation and SSRIs were employed as the keywords, and relevant articles about the use of SSRIs and their possible mechanisms in the treatment of PE were selected. Results Many kinds of SSRIs, such as fluoxetine, sertraline, paroxetine and citalopram, have widely been employed to treat PE. However, their effects are moderate and there is no a universal agreement about the kind, dose, protocol and duration. Dapoxetine, as the first prescription treatment of PE, may change this bottle-neck situation. SSRIs are suggested to be used in young men with lifelong PE, and acquired PE when etiological factors are removed but PE still exists. Phosphodiesterase 5 inhibitors （PDE5-ls） are suggested to be employed alone or combined with SSRIs when SSRIs fail to treat PE or sexual dysfunction associated with SSRIs occurs. The protocol of taking drugs on demand based on taking them daily for a suitable period is proposed to be chosen firstly. The possible mechanisms include increasing serotonergic neurotransmission and activating 5-hydroxytryptamine 2C （5-HT2c） receptors, then switching the ejaculatory threshold to a higher level, decreasing the penile sensitivity and their own effect of antidepression. Conclusion The efficacies of the current SSRIs are moderate in the treatment of PE and they have not been approved by the FDA, therefore new SSRI like dapoxetine needs to be further evaluated.

关键词： premature ejaculation selective serotonin reuptake inhibitions

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Analysis of ancient mass extinction recoveries in marine environments: generating strategies for managing outcomes of the current mass extinction

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National Science Review 2024年第1期11卷 8-10页

作者： david j.Bottjer Department of Earth Sciences University of Southern California

The defining feature of a mass extinction and its associated recovery is the global amount of extinction that occurred[1]. However, there is finer-scale detail to the story, as seen in the ongoing modern mass extinction(the sixth mass extinction), which exhibits variable effects among marine ecosystems and environments, and hence geographic areas [1].

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Yohimbine in the treatment of orgasmic dysfunction

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Asian journal of Andrology 2007年第3期9卷 403-407页

作者： Ade A. Adeniyi Giles S. Brindley john P. Pryor david j. ralph Institute of Urology and Nephrology London W1P 7EY UK I02 Ferdene Road London SE24 OAA UK

Aim： To study the effect of yohimbine in the treatment of men with orgasmic dysfunction. Methods： A 20-mg dose of yohimbine was first given to 29 men with orgasmic dysfunction of different aetiology in the clinic. Patients were then allowed to increase the dose at home （titration） under more favourable circumstances. The outcome and side effects were subsequently assessed. Results： The patients were classified into three groups of orgasmic dysfunction： primary complete （13）, primary incomplete （8） and secondary （8）. Nocturnal emissions were present in 75%, 40% and 50% of patients in the above groups, respectively （overall average 62%）. The men presented because of fertility problems （52%） or because they wanted to experience the pleasure of orgasm （48%）. Of the 29 patients who completed the treatment, 16 managed to reach orgasm and were able to ejaculate either during masturbation or sexual intercourse. A further three achieved orgasm, but only with the additional stimulation of a vibrator. A history of preceding nocturnal emissions was present in 69% of the men in whom orgasm was induced but only 50% who failed treatment. Of the patients, two have subsequently fathered children （one set of twins） and another 3 men were also cured. Side effects were not sufficient to cause the men to cease treatment. Conclusion： Yohimbine is a useful treatment option in orgasmic dysfunction.

关键词： Yohimbine anorgasmia orgasm orgasmic dysfunction impotence ejaculation

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Management of residual penile curvature after penile prosthesis placement

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Asian journal of Andrology 2021年第2期23卷 129-134页

作者： Denis V Krakhotkin david j ralph Gideon A Blecher Volodymyr A Chernylovskyi Francesco Greco Evgeny E Bakurov Ruslan A Bugaev Central District Hospital Outpatient DepartmentKamenolomniRostov Region 346480Russia University College London St Peter’s Andrology Centre and University College London Hospitals London W1G 6BJUnited Kingdom Monash University Department of SurgeryMelbourne 3168Australia The Alfred Hospital Department of UrologyMelbourne 3004Australia Department of Urology 1 City Clinical Hospital No.4Dnipro 49102Ukraine Department of Urology Humanitas GavazzeniBergamo 24125Italy Department of Surgery No.1 Rostov Regional Hospital ROKB 1Rostov-on-Don 344015Russia

Residual penile curvature is a common situation following the implantation of a penile prosthesis in patients with Peyronie’s ***,there is a variety of options for the correction of residual curvature,including penile modeling,plication techniques,as well as tunical incision/excision with or without grafting.A literature search of PubMed and Medline databases was conducted from 1964 until 2020,using search terms for all articles in the English *** this article,we provide a review of the techniques and the outcomes,according to the published literature.

关键词： grafting modeling penile curvature penile implant penile prosthesis Peyronie’s disease tunical plication

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Long-term results of the surgical treatment of Peyronie＇s disease with plaque incision and grafting

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Asian journal of Andrology 2011年第6期13卷 797-797页

作者： david j ralph Institute of Urology London U K

Peyronie＇s disease is frequently associated with erectile dysfunction, and a variety of other comorbid disorders, including diabetes, hypertension, dyslipidemia and low testosterone. Two-thirds of patients with Peyronie＇s disease are likely to have risk factors for arterial disease and therefore worsening long-term erectile function.

关键词： disease frequently associated erectile dysfunction

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Barosinusitis due to routine weather changes:A cross-sectional analysis of public websites

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World journal of Otorhinolaryngology-Head and Neck Surgery 2024年第1期10卷 18-23页

作者： james C.Campbell julia E.Canick Philip G.Chen ralph Abi Hachem david W.jang Department of Head and Neck Surgery&Communication Sciences Duke University School of MedicineDurhamNorth CarolinaUSA Duke University School of Medicine DurhamNorth CarolinaUSA Department of Otolaryngology-Head and Neck Surgery University of Texas Health Science Center San AntonioSan AntonioTexasUSA

Background:Sinusitis is a common diagnosis that can be erroneously associated with routine weather‐related barometric pressure *** actuality,these pressure changes likely exacerbate migraine headaches,which can cause facial pain and pressure rather than true sinus ***:The present study sought to characterize the representation of both sinusitis and migraine in association with barometric pressure changes across websites on the ***:An Internet search for relevant terms was conducted,and content of the resulting pages was assessed for associations between weather‐related pressure changes and either sinusitis or *** in reported results across different subtypes of Internet sources were *** primary outcomes measured were(1)whether a given media source associated barometric weather changes with sinusitis,(2)whether that source associated barometric weather changes with migraine,and(3)treatment options offered by that ***:Of the 116 included webpages,36(31.03%)associated sinusitis and routine barometric pressure *** these,10(27.77%)were otolaryngology practice ***‐seven webpages(57.76%)associated migraine and routine barometric pressure *** these,nonotolaryngology webpages were more likely to report this ***:Otolaryngology practice sites were observed to be the most frequent professional medical resource reporting the unsubstantiated claim that routine barometric pressure changes are associated with *** sources were more likely to link weather‐related pressure changes to *** results suggest that opportunities exist for otolaryngology practice sites to educate patients about nonrhinogenic headache etiologies.

关键词： acute rhinosinusitis balloon sinus dilation headache migraine sinusitis

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Single-atom Pt on carbon nanotubes for selective electrocatalysis

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Carbon Energy 2024年第1期6卷 63-71页

作者： Samuel S.Hardisty Xiaoqian Lin Anthony R.j.Kucernak david Zitoun Department of Chemistry Bar Ilan Institute of Nanotechnology and Advanced Materials(BINA)Bar Ilan UniversityRamat GanIsrael Department of Chemistry Molecular Science Research HubImperial College LondonLondonUK

Utilizing supported single atoms as catalysts presents an opportunity to reduce the usage of critical raw materials such as platinum,which are essential for electrochemical reactions such as hydrogen oxidation reaction(HOR).Herein,we describe the synthesis of a Pt single electrocatalyst inside single-walled carbon nanotubes(SWCNTs)via a redox *** via electron microscopy,X-ray photoelectron microscopy,and X-ray absorption spectroscopy show the single-atom nature of the *** electrochemical behavior of the sample to hydrogen and oxygen was investigated using the advanced floating electrode technique,which minimizes mass transport limitations and gives a thorough insight into the activity of the *** single-atom samples showed higher HOR activity than state-of-the-art 30%Pt/C while almost no oxygen reduction reaction activity in the proton exchange membrane fuel cell operating *** selective activity toward HOR arose as the main fingerprint of the catalyst confinement in the SWCNTs.

关键词： confinement electrocatalysis hydrogen platinum single atom catalysts

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Solving a bottleneck in animal models of peyronie＇s disease

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Asian journal of Andrology 2014年第4期16卷 639-639页

作者： Selim Cellek William Stebbeds david j ralph Cranfield University Bedfordshire University College London Hospital London UK

Peyronie＇s disease is characterized by the formation of a fibrous plaque in the tunica albuginea （TA） of the penis. It is a benign condition of unclear etiology, resulting in deformities such as curvature, indentation or shortening. The disease has been shown to be prevalent, especially in older men, and affects quality of life, principally through pain during erection, erectile dysfunction and associated psychological impact.

关键词： PROTEIN EXPRESSION RAT INCREASE

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