Prophylactic application of ilioinguinal block dissection.
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Genital warts (condylomata acuminata) and molluscum contagiosum have a significant sexual mode of transmission. They are considered "minor," nonreportable sexually transmitted diseases. As with most lesions, the differential diagnosis must exclude other malignant and nonmalignant diseases. The etiology, diagnosis, management, and epidemiology of both diseases are presented separately.
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Characteristics of the Verrucous Carcinoma as described by L. V. Ackerman in 1947: strictly lokalized tumor, no metastatic spread, yet strong tendency to recidivity. Note: 1. In the case of inadequate excision a too optimistic evaluation by the pathologist frequently occurs. 2. In the case of lesions of the oral mucosa as a consequence of irradiation a dramatic increase in malignancy has been observed. 3. Therapy of choice: radical excision.
The foregoing statements may invite controversy. At the same time, I hope they will be stimulating enough to lead many physicians to explore the various modalities open to them. Each case of skin cancer is an individual therapeutic problem, and the final decision as to what method should be used can be made only after every factor listed in Table 1 has been carefully weighed.
Nuclear Magnetic Resonance (NMR) is a new diagnostic technique with great opportunities of application in the field of the penile pathologies. A new interest for this diagnostic technique was born when the use of vasoactive agents, like papaverine or PGE1, and the use of para-magnetic contrast agents, like gadolinium, were introduced. The introduction of dynamic NMR in andrology allowed a better definition of anatomical details and a better knowledge of penile micro-circulation. N.M.R. is showing a great diffusion, because of a little invasiveness (X-rays are not used in this technique). The Authors show a wide spread of possible applications of NMR in penile pathologies, helping in the interpretation of the images. In conclusion the authors describe NMR as a diagnostic technique with great possibilities of improvement, even if the high costs don't allow a better diffusion until now.
3000 IgE serum concentrations were determine d radioimmunologically in a large group of 1616 tumor patients and a group of 308 controls. Because of a wide scattering the individual IgE levels do not give a diagnostic indication. On the other hand we have found a highly significant difference (p less than 0.001) between the IgE levels of male and female tumor patient-groups, which does not exist among the controls. Female patients tend to lower, male patients to higher levels. In patients with carcinoma of the testis three times higher IgE levels were found. Their relation to a coincidence with high HCG levels is discussed. Furthermore IgE follow up-studies are described. They correlate close by with the clinical picture. Consequently IgE follow up-studies are applicable to tumor prognosis and possibly to tumor therapy.
Radiation therapy has assumed a role of primary importance in the management of gynecologic and other malignant growths. To be effective, the treatment dosage must be adequate. However, with higher dosages for curative radiation therapy, damage from the treatment may promote prolonged morbidity and even death. The effects of this treatment may be intensified by predisposing conditions within the patient, but the damage seems to be related to the insertion of radium. Prior to therapy, each patient must be individualized, and any predisposing factors should be kept in mind during treatment to recognize and treat these complications early. Once complications have arisen, the most conservative modality of dealing with the irradiated tissue is best, since these areas of intestinal injury do not heal. This requires early diversion or resection as conservative therapy, because fistulas and bleeding will become recurrent and intractable. If diversion fails to control bleeding, resection is necessary, even if it involves an abdominoperineal resection. Therefore, conservative can become radical for this supposedly benign illness.
We examine some surgical techniques proposed for phallic reconstruction. Together with cutaneous flaps, muscle-cutaneous flaps, who present the advantage of more constant results, are progressively listed. We also present a personal technique of phallic reconstruction with double prosthesis: one external, vascular and one internal, for the erection.
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