Inflatable penile prosthesis placement in Peyronie's disease: a review of surgical considerations, approaches, and maneuvers.

Peyronie's disease (PD) is a fibrotic disorder of the tunica albuginea that results in penile deformity and/or curvature. Patients usually present complaining of penile pain, shortening and deformity resulting in dissatisfaction with intercourse. Many patients with PD will present with concomitant erectile dysfunction (ED). This disease is a significant concern for patients as it impacts both sexual function and overall quality of life. While there are several interventions available for PD treatment, inflatable penile prosthesis (IPP) implantation is considered the gold standard approach for those with moderate to severe concomitant ED, refractory to medical therapy. The goal of treatment is to give a man a functionally straight erection. Placement of an IPP alone may achieve this. However, when curvature still exists, several adjunct procedures may be performed to include manual modeling, plication, plaque incision or excision and grafting. Additionally, advanced lengthening procedures may also be used. In this paper we will present a comprehensive review of the adjuvant straightening techniques that can be used during IPP placement in men with PD and refractory ED when curvature still exists. Patient selection is a key predictor of implant success, as is preoperative and postoperative management to optimize overall patient care and satisfaction. These topics along with the different surgical approaches to IPP insertion for PD will also be discussed, including the benefits and shortcomings of each. A flowchart to aid surgeons in their intraoperative decision making based on curvature characteristics and specific patient concerns is presented.

Frequency division multiplex-based light spectroscopy.

Light spectrometers are highly versatile state-of-the-art measurement devices. However, using these systems, e.g., in semiconductor device characterization, creates challenging obstacles with respect to measurement time. We present a new, flexible and accurate approach to either characterize optical properties of arbitrary photosensitive devices or examine the spectral components of light reliably. Using a spatial light modulator (SLM) in combination with frequency division multiplexing methods, it is possible to significantly improve signal-to-noise ratios and decrease measurement times. Moreover, the use of SLM ensures a greater reliability of the setup because conventional moving parts are replaced. The feasibility and experimental setup are described in detail. The setup has been validated for various applications by comparative measurements.

ATP release from activated neutrophils occurs via connexin 43 and modulates adenosine-dependent endothelial cell function.

Extracellular ATP liberated during hypoxia and inflammation can either signal directly on purinergic receptors or can activate adenosine receptors following phosphohydrolysis to adenosine. Given the association of polymorphonuclear leukocytes (PMNs) with adenine-nucleotide/nucleoside signaling in the inflammatory milieu, we hypothesized that PMNs are a source of extracellular ATP. Initial studies using high-performance liquid chromatography and luminometric ATP detection assays revealed that PMNs release ATP through activation-dependent pathways. In vitro models of endothelial barrier function and neutrophil/endothelial adhesion indicated that PMN-derived ATP signals through endothelial adenosine receptors, thereby promoting endothelial barrier function and attenuating PMN/endothelial adhesion. Metabolism of extracellular ATP to adenosine required PMNs, and studies addressing these metabolic steps revealed that PMN express surface ecto-apyrase (CD39). In fact, studies with PMNs derived from cd39(-/-) mice showed significantly increased levels of extracellular ATP and lack of ATP dissipation from their supernatants. After excluding lytic ATP release, we used pharmacological strategies to reveal a potential mechanism involved in PMN-dependent ATP release (eg, verapamil, dipyridamole, brefeldin A, 18-alpha-glycyrrhetinic acid, connexin-mimetic peptides). These studies showed that PMN ATP release occurs through connexin 43 (Cx43) hemichannels in a protein/phosphatase-A-dependent manner. Findings in human PMNs were confirmed in PMNs derived from induced Cx43(-/-) mice, whereby activated PMNs release less than 15% of ATP relative to littermate controls, whereas Cx43 heterozygote PMNs were intermediate in their capacity for ATP release (P<0.01). Taken together, our results identify a previously unappreciated role for Cx43 in activated PMN ATP release, therein contributing to the innate metabolic control of the inflammatory milieu.

Dynamic behavior of a liquid metal interface under the influence of a high-frequency magnetic field.

We present experimental results on the stability of a free liquid metal surface influenced by an alternating magnetic field. The field is generated by an inductor fed by a high-frequency electrical current. The experimental setup consists of an annulus filled with the liquid metal galinstan. We observe three kinds of instabilities: exciting of capillary waves, a static high-amplitude surface deformation, and eventually an electromagnetic pinch at a critical inductor current I(cp). The data show that I(cp) correlates directly with the current frequency and the geometric parameters.