Pigmented median raphe cyst of the scrotum. A rare pediatric case and review of the literature.

Aim: Median raphe cyst are uncommon malformations of male genitalia, in which are rarely described melanin pigments or melanocytes; less than ten cases have been reported in literature. The aim of our study is to describe a rare ormations, case of pigmented median raphe cyst of the scrotum, successfully treated in our hospital.

Case Experience: A 6-years-old boy underwent surgical removal of a melanocytic lesion of the ventral surface of the scrotum in Day Surgery regimen.

Complete Scrotal Agenesis: New Surgical Approach Using Self-inflating Tissue Expander.

Complete agenesis of the scrotum is an extremely rare entity: to date, only 8 cases have been reported. The authors describe 1 case carrying a heterozygous genomic variant in exon 17 of the MAP3K1 gene, whose surgical treatment included osmotic prosthesis implant to achieve reconstruction of a new scrotum. By constant and gradual expansion, self-inflating prothesis avoids patient discomfort and facilitates orchiopexy.

Snodgrass urethroplasty: grafting the incised plate--10 years later.

Purpose: We report our retrospective, nonrandomized, single center experience with modified tubularized incised urethral plate repair, consisting of grafting the incised urethral plate before tubularization, as first introduced 10 years ago. Indications, technical points and results are described.

Materials And Methods: From 1997 to 2007 at our unit 1,095 cases of hypospadias were treated, including 75% primary and 25% repeat cases.

Simplifying the surgical approach to glanular and coronal hypospadias: longitudinal urethral incision and glanuloplasty.

Objective: Meatal advancement with glanuloplasty incorporated (MAGPI) is an appropriate approach for most glanular and coronal hypospadias. The very low incidence of complications with this technique (i.e.

Surgical approach to concealed penis: technical refinements and outcome.

Objectives: A concealed penis is defined as a phallus of normal size buried in prepubic tissue (buried penis), enclosed in scrotal tissue (webbed penis), or trapped by scar tissue after penile surgery (trapped penis). We report our results using a standardized surgical approach that was highly effective in both functional and cosmetic terms.

Methods: From January 2002 to December 2005, 56 patients (median age 7 years) underwent surgery for a buried penis, 11 (median age 5 years) for a webbed penis, and 20 (median age 8 years) for a trapped penis.

Roux-en-Y feeding jejunostomy in infants and children.

Roux-en-Y jejunostomy (RYJ) permits enteral feeding in children unable to tolerate oral or intragastric feeds. It avoids many of the complications of nasojejunal and gastrojejunal tubes. Here we report our experience of intubated RYJ.

Surgical approach to the congenital megaprepuce.

The megaprepuce (MP) is a very rare malformation of unknown aetiology, with anatomical findings similar to those observed in the congenital buried penis (BP). The aspect of this entity and the symptoms are rather typical: the penis is totally buried and before micturition an evident pubic and scrotal swelling denounces the urine collection in an abnormal preputial cavity surrounding the entire shaft. Early surgery is recommended, in order to deal with functional and cosmetic aspects.

False-positive rate in prenatal diagnosis of surgical anomalies.

Background/purpose: Technical refinements and increasingly sophisticated equipment have led to higher sensitivity in prenatal diagnosis of congenital malformations; however, such progress may be accompanied by decreased specificity. The aim of this study is to evaluate evolution of prenatal diagnosis from the first sonographic suspicion of fetal anomaly until after delivery (diagnosis confirmed, resolution before birth, healthy baby, or affected with different disorder) to document rate of false-positive (FP) results.

Methods: Retrospective review of prenatal ultrasound examinations performed at our institution between 2000 and 2002 was conducted.

Early neurologic complications of pulmonary arteriovenous malformation in a newborn: an indication for surgical resection.

A case report of a neonate with pulmonary arteriovenous malformation is described. The anomaly was prenatally diagnosed, and family history was positive for Rendu-Osler-Weber syndrome. Because neurologic symptoms developed during the second week of life, surgical resection was deemed the best curative option to avoid further embolic events and reoccurrence of the lesion.

The role of laparoscopy in the diagnosis of intestinal vascular anomalies affecting two small infants.

Two infants affected by intestinal vascular anomalies causing lower gastrointestinal hemorrhage are reported. Upper and lower gastrointestinal tract endoscopy and radionuclide scan were negative. The authors found laparoscopic exploration very useful in detecting the cause and the site of bleeding.

Pulmonary torsion after cardiac surgery in two infants: review of pediatric literature.

Torsion of a lung or a lobe (LT) is a severe, sometimes life-threatening event that may occur spontaneously, after trauma, or after cardiac or thoracic surgery. The authors report on 2 prematurely born neonates who had LT after cardiac surgery. Both patients successfully underwent pulmonary lobectomy, which seems to be the best surgical approach.

Lower gastrointestinal bleeding in a newborn caused by isolated intestinal vascular malformation.

We report a 3-week-old neonate with an intestinal vascular malformation. The usual investigations performed for the examination of lower gastrointestinal bleeding had negative results, but ultrasound revealed bowel loops of abnormal calibre and altered flow in the superior mesenteric artery. Ultrasound should be considered a diagnostic study of primary importance when assessing a neonate with gastrointestinal bleeding.

Percutaneous transhepatic alcoholization: a new therapeutic strategy in children with chronic granulomatous disease and liver abscess.

Children affected with chronic granulomatous disease develop severe infections, which frequently evolve to abscess. In most instances the liver is involved. We report a case of liver abscess successfully treated by percutaneous transhepatic alcoholization after antibiotic therapy and percutaneous drainage had failed.

Communicating bronchopulmonary foregut malformation involving a mixed sequestration/cystic adenomatoid malformation: a case report.

The authors report the case of a baby girl with an unusual communicating bronchopulmonary foregut malformation consisting of extralobar pulmonary sequestration and cystic adenomatoid malformation. A well-formed bronchus was the communication between the sequestration and lower esophagus.

[Use of mini-laparoscopy in intraoperative diagnosis of contralateral inguinal hernia in children].

Laparoscopy has been considered by some Workers an useful means of diagnosing patent processus vaginalis in children. This technique is effective in evaluating patency of contralateral internal inguinal ring and requires only five minutes of additional operative time to elective inguinal herniorrhaphy. The Authors report their experience with fifty-six children to whom this procedure was offered.

Statistical properties of flip-flop processes associated to the chaotic behavior of systems with strange attractors.

The chaotic behavior of systems with strange attractors can be discussed by examining the flip-flop process associated to the system dynamics. This was already shown by Lorenz (1963) in his first seminal paper. A somewhat surprising result was obtained by Aizawa (1982), who, studying the same Lorenz attractor at the parameter value r = 28, reached the conclusion that the associated flip-flop was a typical Markov process.

Perceptual ambiguity and stability of reversible figures.

In this work, the results of two experiments on ambiguous patterns are reported, which have been obtained by presenting a series of stimuli designed, in both cases, to reduce gradually the ambiguity of the patterns. Such reduction has been performed by respectively increasing or decreasing the amount of graphic details in the experiments. Data of both experiments show a lengthening of mean reversal time.

Effects of visual angle on perspective reversal for ambiguous patterns.

Reversal rates of an ambiguous figure (the Necker cube) were studied for different pattern sizes covering a range of visual angles theta from approximately 1 to 62 deg. A large number of reversals was obtained for each observer and each pattern in order to examine the statistical distributions of reversal times. A pronounced flattening of the statistical distributions (represented throughout by a gamma distribution) and a growth of the mean duration of each percept, with increasing pattern size was found.

Diffusion and consumption of oxygen in the superfused retina of the drone (Apis mellifera) in darkness.

Double-barreled O2 microelectrodes were used to study O2 diffusion and consumption in the superfused drone (Apis mellifera) retina in darkness at 22 degrees C. Po2 was measured at different sites in the bath and retinas. It was found that diffusion was essentially in one dimension and that the rate of O2 consumption (Q) was practically constant (on the macroscale) down to Po2 s less than 20 mm Hg, a situation that greatly simplified the analysis.

Regulation of antibody formation in chickens escaping from tolerance to human serum albumin.

The immune capacity of chickens made tolerant to human serum albumin just after hatching was studied after a primary and secondary challenge at 7--14 weeks of age, of either 1 mg/kg or 100 mg/kg. The class and avidity of antibody produced by birds "escaping" from tolerance was similar to normal controls. The escaping chickens made a normal peak antibody response to a high dose but not to a low dose (except that the response to a low secondary dose after priming with a high dose was normal); but the decline of the antibody titer was abrupt, indicating inability to maintain the response.