Surgical Treatment of Multiple Large Tuberous and Tendinous Xanthoma Secondary to Familial Hypercholesterolaemia: A Case Report.

Xanthomas are well-circumscribed skin lesions that are commonly seen in patients with familial hypercholesterolemia (FH). The aim of this report is to present a rare case of multiple large tuberous and tendinous xanthomas. A 17-year-old female patient in this report presented with multiple asymptomatic and papulo-nodular masses in both sides of palms, elbows, buttocks, knees, and Achilles tendons. Surgical removal of the masses was carried out in combination with lipid-lowering therapy. A following up of 3 months showed all wounds were healing well, and no recurrence of masses was observed. Therefore, for patients with xanthomas related with familial hypercholesterolaemia, lipid-lowering therapy has reportedly reduced the size of masses, but surgical treatment may be essential for large xanthomas caused pain or limitation of daily activities.

Ocean current redistributed the currently using Organoamine Pesticides in Arctic summer water.

In a comprehensive study on the presence and distribution of Currently Using Organoamine Pesticides (CUOAPs) in the Arctic Ocean, this study collected and analyzed 36 surface seawater samples during the summer of 2021. The study detected 36 CUOAPs, 17 of these compounds at levels exceeding the Method Detection Limits (MDLs). Concentrations of CUOAPs ranged from 0.11 to 2.94 ng/L, exhibiting an average of 1.83 ± 0.83 ng/L. Spatial distribution analysis revealed lower CUOAP concentrations in the central Arctic Ocean, with Cycloate constituting the most abundant component (23.66 %). The investigation identified terrestrial inputs and long-range atmospheric transport as potential sources of CUOAPs in the Arctic Ocean region. The origins of individual CUOAPs appeared to be associated with application procedures and their propensity for co-occurrence at low latitudes. The study also examined the role of ocean currents in the transport and redistribution of CUOAPs in surface seawater across different regions. While ocean currents played a significant role, the influence of sea ice cover on CUOAP distribution was minimal. An ecological risk assessment analysis underscored the need for regional attention to the presence of CUOAPs in the Arctic Ocean.

Spatiotemporal variations, surface inventory, and cross regional impact of current-use organoamine pesticides in Chinese Marginal Seas.

Current-use Organoamine Pesticides (CUOAPs) are a growing concern as emerging pesticide pollutants that were initially discovered on a large scale in Chinese Marginal Seas (CMSs). The highest level was detected in the East China Sea in the late spring and decreased in the following order: East China Sea (early spring) > the South China Sea > the Bohai Sea. The crucial role played by the Yangtze and Yellow rivers as significant terrestrial sources were established. The fluctuations in the land application and riverine input led to variations in the source, distribution, and seasonal patterns of CUOAPs. Terrestrial-exported CUOAPs were transported and redistributed spatially by the surface ocean currents, resulting in significant regional disparities. The results displayed a pronounced terrestrial source signature and a cross-regional impact. By the ocean current transport, CMSs will likely become a secondary source region for the surrounding seas.

Occurrence, sources, and risk assessment of pyrethroid insecticides in surface water and tap water from Taihu Lake, China.

Pyrethroid insecticides are one of the most widely used insecticides globally, posing a severe threat to human health and the environment. In this study, we applied high-throughput organic analysis testing combined with high-volume solid-phase extraction (Hi-throat/Hi-volume SPE) to elucidate the occurrence of 11 pyrethroid insecticides in lake water (n = 37), tributary river water (n = 15), and tap water (n = 6) in the Taihu Lake Basin. Permethrin was found to be the major contributing pyrethroid insecticide (detection rate = 100%). The concentrations of pyrethroid insecticides from different lake regions were revealed in the following descending order: southern > eastern > western > northern. The principal component analysis and multiple linear regression demonstrated that landscape maintenance, agricultural cultivation, and livestock breeding were the main sources of pyrethroid insecticides in the Taihu Lake surface water. Moreover, runoff input plays an important role in their accumulation, while the surrounding rivers contribute 2292 kg of pyrethroid insecticides to Taihu Lake annually. The risk assessment analysis demonstrated that pyrethroid insecticides pose a high risk to both the ecological environment and the surrounding human populations, thereby necessitating effective countermeasures. Furthermore, the pyrethroid insecticides in the Yangtze River Delta region have to be controlled. Overall, this is the first study focused on China that revealed the residue levels in water sources and tap water.

Occurrence, seasonal variations, and eco-risk of currently using organochlorine pesticides in surface seawater of the East China Sea and Western Pacific Ocean.

We studied 19 targets currently using organochlorine pesticides (CUOCPs) from 98 samples in the Western Pacific Ocean and the East China Sea collected in 2019, 2020, and 2021. The samples were analyzed using a novel High-throat/High-volume Solid-Phase Extraction method. Eighteen individual CUOCPs were above the method detection limits. The levels of ∑19CUOCPs ranged from 0.13 to 17.80 ng/L, with an average of 3.13 ± 14.67 ng/L. Dicofol was the main pollutant in the Western Pacific Ocean, while Pyridaben dominated the East China Sea. In the summer, land-source input was the primary source in the Western Pacific Ocean and the East China Sea. Historical residues were the main source in the East China Sea in spring. In the summer, the ecological risk assessment results indicated a relatively low risk to the Western Pacific Ocean and the East China Sea.

Development of Tri-Layered Biomimetic Atelocollagen Scaffolds with Interfaces for Osteochondral Tissue Engineering.

The development of biomimetic scaffolds containing cartilage, calcified cartilage, and bone regeneration for precise osteochondral repair remains a challenge. Herein, a novel tri-layered scaffold-with a top layer containing type II atelocollagen and chondroitin sulphate for cartilage regeneration, an intermediate layer with type II atelocollagen and hydroxyapatite for calcified cartilage formation, and a bottom layer with type I atelocollagen and hydroxyapatite for bone growth-that can be built using liquid-phase cosynthesis, is described. The tri-layered scaffolds are mechanically demonstrably superior and have a lower risk of delamination than monolayer scaffolds. This is due to higher cohesion arising from the interfaces between each layer. In vitro results show that although monolayer scaffolds can stimulate bone marrow stem cells to differentiate and form cartilage, calcified cartilage, and bone separately (detected using quantitative polymerase chain reaction analysis and staining with safranin-O and Alizarin Red S), the tri-layered scaffolds support the regeneration of cartilage, calcified cartilage, and bone simultaneously after 2 and 4 months of implantation (detected using gross and micro-computed tomography images, histological staining, and Avizo, a software used to detect microlevel defects in metals). This work presents data on a promising approach in devising strategies for the precise repair of osteochondral defects.

Application of Hi-throat/Hi-volume SPE technique in assessing organophosphorus pesticides and their degradation products in surface water from Tai Lake, east China.

Organophosphorus pesticides (OPPs) are among the most commonly used pesticides worldwide. However, these compounds pose a serious threat to aquatic environments. Here, thirty-seven pesticides and eight degradation products were determined in surface water samples from Tai Lake, East China, using a high-volume solid phase extraction technique (Hi-throat/Hi-volume SPE). Surface water was pumped in-situ through a portable sampler, and OPPs in the water retained on the Hi-volume SPE adsorption column, finally extracted for analysis. This technique efficiently reduced the detection limits to below 0.3 ng/L. In total, 40 out of 45 OPP congeners were detected, which far exceeded the amount of OPPs in previous studies. The total concentration of OPPs ranged between 101.4 and 1530 ng/L (median: 378.9 ng/L). Parathion exhibited the highest concentration (median: 112.0 ng/L), followed by paraoxon-methyl (median: 90.3 ng/L), as well as carbophenothion, fenthion, and mevinphos. Agricultural areas were more polluted than residential and industrial regions. However, degradation products persisted in residential and industrial waters. The ecological risks of OPPs in these areas were estimated based on the risk quotient index (RQ). Parathion, fenthion, carbophenothion, and tolclofos-methyl occurred at high-risk levels, and the levels of degradation products were also non-trivial. Our findings thus indicated that OPP degradation products pose a potential threat to natural environments and should therefore be closely monitored.

Occurrence, distribution and risk assessment of organophosphate ester flame retardants and plasticizers in surface seawater of the West Pacific.

Twenty-eight samples of surface seawater were collected from the West Pacific Ocean during 2019 using a high-volume solid-phase extraction with high-throughput organic analysis (Hi-throat/Hi-volume SPE) method, and concentrations of 10 organophosphate ester flame retardants and plasticizers (OPEs) were determined. The total OPE concentration in the samples was 3.02-48.4 ng L-1 (mean 25.0 ± 10.5 ng L-1), with tris(2-chloroethyl) phosphate (TCEP) being the largest contributor. Cluster analysis results showed off-shore input from the coast of East and Southeast Asia was an important source of these chemicals. Tri-p-tolyl phosphate (TpTP) should also be considered for long-term monitoring, because of its high detection frequency. Results of a risk assessment indicated low ecological risk to species in the West Pacific Ocean for TPhP and ΣOPEs. Hazard quotients (HQs) were all <1, indicating that the health risk to humans from these chemicals was at acceptable levels.

A Biomimetic Biphasic Scaffold Consisting of Decellularized Cartilage and Decalcified Bone Matrixes for Osteochondral Defect Repair.

It is challenging to develop a biphasic scaffold with biomimetic compositional, structural, and functional properties to achieve concomitant repair of both superficial cartilage and subchondral bone in osteochondral defects (OCDs). This study developed a biomimsubchondraletic biphasic scaffold for OCD repair via an iterative layered lyophilization technique that controlled the composition, substrate stiffness, and pore size in each phase of the scaffold. The biphasic scaffold consisted of a superficial decellularized cartilage matrix (DCM) and underlying decalcified bone matrix (DBM) with distinct but seamlessly integrated phases that mimicked the composition and structure of osteochondral tissue, in which the DCM phase had relative low stiffness and small pores (approximately 134 µm) and the DBM phase had relative higher stiffness and larger pores (approximately 336 µm). In vitro results indicated that the biphasic scaffold was biocompatible for bone morrow stem cells (BMSCs) adhesion and proliferation, and the superficial DCM phase promoted chondrogenic differentiation of BMSCs, as indicated by the up-regulation of cartilage-specific gene expression (ACAN, Collagen II, and SOX9) and sGAG secretion; whereas the DBM phase was inducive for osteogenic differentiation of BMSCs, as indicated by the up-regulation of bone-specific gene expression (Collagen I, OCN, and RUNX2) and ALP deposition. Furthermore, compared with the untreated control group, the biphasic scaffold significantly enhanced concomitant repair of superficial cartilage and underlying subchondral bone in a rabbit OCD model, as evidenced by the ICRS macroscopic and O'Driscoll histological assessments. Our results demonstrate that the biomimetic biphasic scaffold has a good osteochondral repair effect.

Distribution of eight organophosphorus pesticides and their oxides in surface water of the East China Sea based on high volume solid phase extraction method.

In this study, we reported the occurrence of eight organophosphorus pesticides (OPPs) in the East China Sea. Forty samples were collected and analysed with a high volume solid phase extraction method (Hi-throat/Hi-volume SPE) in the early summer of 2020. All the target OPPs were detected in the surface water at one or more stations in the East China Sea, and the concentrations of ΣOPPs were in the range 0.0775-3.09 ng/L (mean: 0.862 ± 0.624 ng/L). Terbufos sulfone and fenthion were the main pollutants in this area, probably resulting from pesticide use in China and other countries. The off-shore input from coastal regions was suggested to be a major source of OPP pollution in the East China Sea, and the movement of ocean currents played an important role in their transportation because around 0.86 t OPPs passed through the Tsushima Strait from the East China Sea each month. An ecological risk assessment showed that these OPPs presented a high risk to species in the East China Sea, whereas they posed no health risk to humans under both the median and high exposure scenario.

Antarctic Adélie penguin feathers as bio-indicators of geographic and temporal variations in heavy metal concentrations in their habitats.

Seabird feathers are effective indicators of heavy metal contamination. To propose a biological detection method suitable for the long-term monitoring of heavy metals in the Antarctic environment, eight heavy metals (As, Cd, Cr, Cu, Hg, Ni, Pb, and Zn) in Adélie penguin feathers from different body parts, years, and molting grounds in the Antarctic were investigated in this study. It is found that the concentrations of heavy metals in the feathers showed differences among the body part of origin. The levels of the eight elements in the abdomen and back feathers were approximately the same, but some elements of them were significantly higher than those in the tail feathers. The Hg and Cd concentrations in the abdomen and back feathers increased from root to tip, regardless of the sampling year or molting ground. Based on a structural analysis of the feathers, Hg and Cd were mainly distributed in the feather vane rather than the shaft. The methylmercury content accounted for 83%-97% of the total mercury content in all feather samples, regardless of location, year, or body part, thereby supporting the assumption that mercury entering the feather was predominantly methylated and indicating that a relatively toxic form of Hg is excreted through the feathers. The heavy metals in feathers from the same molting ground showed significant differences over the sampling years. The average concentrations of As, Cr, Cu, Ni, and Zn increased significantly from 2015 to 2019, whereas those of Cd, Hg, and Pb tended to decrease. The concentrations of the eight elements in Adélie feathers from three molting grounds varied greatly, possibly in relation to their living areas and dietary structures. Feathers from the Ross Sea site had the highest Cd, Cu, Hg, Ni, and Zn concentrations, the highest As and Cr concentrations were detected in feathers from the Zhongshan site, and feathers from the Great Wall site showed higher Pb concentrations than those from the other two sites. This study established a long-term, nondestructive, and efficient method for monitoring heavy metal contamination in the polar environment in the future.

Electrospun nanofibrous membrane of fish collagen/polycaprolactone for cartilage regeneration.

Tissue engineering technology provides a promising approach for cartilage repair, and in this strategy, scaffolds play a pivotal role in directing cartilage regeneration. Fish collagen (FC) is currently considered an alternative source of mammalian collagen (MC) for tissue engineering due to its excellent biocompatibility, suitable biodegradability, inert immunogenicity, rich sources, low price and lack of risk for the transmission of zoonosis. Here, we fabricated three types of electrospun nanofibrous membranes composed of FC and polycaprolactone (PCL) with three different FC/PCL ratios (9/1, 7/3, 5/5) and investigated the feasibility of using the membranes with chondrocytes in cartilage regeneration. Our results demonstrated that increases in the FC content were associated with improvements in biodegradability, absorption, and cell adhesion capacity, but weaker mechanical properties. In addition, all three nanofibrous membranes showed satisfactory biocompatibility as evidenced by supporting chondrocyte proliferation and cartilage formation in vitro. Furthermore, all three membranes seeded with chondrocytes formed mature cartilage-like tissue after 8 weeks of in vivo culture, but satisfactory homogeneous cartilage regeneration was only achieved with the F9P1 group. The current results demonstrated that the electrospun FC/PCL membrane is a promising scaffold for cartilage regeneration and that the F9P1 group might represent a relatively suitable ratio. The research models established in the current study provide detailed information for the regeneration of cartilage and other tissue based on electrospun FC/PCL membranes.

Effect of surgical repair of acquired buried penis on sexual function in adults.

PURPOSE: This study was performed to investigate the effect of surgical repair of acquired buried penis on sexual function in adults and provide a reference for clinical treatment. METHODS: Thirty-two adult patients who underwent surgical treatment of buried penis from August 2010 to August 2017 were selected as the study group. The basic operative method was penile lengthening. Suprapubic liposuction, suspensory ligament release, and preputial plasty were performed according to the clinical manifestations. The changes in erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction sexual function were evaluated according to the International Index of Erectile Function (IIEF) before and after treatment. RESULTS: All 32 patients were analyzed by the IIEF before and after the operation. The results showed statistically significant differences in sexual function before and after the operation (P < 0.05). CONCLUSION: Surgical repair of acquired buried penis in adults can significantly improve patients' sexual function.

Lyophilized Scaffolds Fabricated from 3D-Printed Photocurable Natural Hydrogel for Cartilage Regeneration.

Repair of cartilage defects is highly challenging in clinical treatment. Tissue engineering provides a promising approach for cartilage regeneration and repair. As a core component of tissue engineering, scaffolds have a crucial influence on cartilage regeneration, especially in immunocompetent large animal and human. Native polymers, such as gelatin and hyaluronic acid, have known as ideal biomimetic scaffold sources for cartilage regeneration. However, how to precisely control their structure, degradation rate, and mechanical properties suitable for cartilage regeneration remains a great challenge. To address these issues, a series of strategies were introduced in the current study to optimize the scaffold fabrication. First, gelatin and hyaluronic acid were prepared into a hydrogel and 3D printing was adopted to ensure precise control in both the outer 3D shape and internal pore structure. Second, methacrylic anhydride and a photoinitiator were introduced into the hydrogel system to make the material photocurable during 3D printing. Finally, lyophilization was used to further enhance mechanical properties and prolong degradation time. According to the current results, by integrating photocuring 3D printing and lyophilization techniques, gelatin and hyaluronic acid were successfully fabricated into human ear- and nose-shaped scaffolds, and both scaffolds achieved shape similarity levels over 90% compared with the original digital models. The scaffolds with 50% infill density achieved proper internal pore structure suitable for cell distribution, adhesion, and proliferation. Besides, lyophilization further enhanced mechanical strength of the 3D-printed hydrogel and slowed its degradation rate matching to cartilage regeneration. Most importantly, the scaffolds combined with chondrocytes successfully regenerated mature cartilage with typical lacunae structure and cartilage-specific extracellular matrixes both in vitro and in the autologous goat model. The current study established novel scaffold-fabricated strategies for native polymers and provided a novel natural 3D scaffold with satisfactory outer shape, pore structure, mechanical strength, degradation rate, and weak immunogenicity for cartilage regeneration.

Cell yield, chondrogenic potential, and regenerated cartilage type of chondrocytes derived from ear, nasoseptal, and costal cartilage.

Functional reconstruction of large cartilage defects in subcutaneous sites remains clinically challenging because of limited donor cartilage. Tissue engineering is a promising and widely accepted strategy for cartilage regeneration. To date, however, this strategy has not achieved a significant breakthrough in clinical translation owing to a lack of detailed preclinical data on cell yield and functionality of clinically applicable chondrocytes. To address this issue, the current study investigated the initial cell yield, proliferative potential, chondrogenic capacity, and regenerated cartilage type of human chondrocytes derived from auricular, nasoseptal, and costal cartilage using a scaffold-free cartilage regeneration model (cartilage sheet). Chondrocytes from all sources exhibited high sensitivity to basic fibroblast growth factor within 8 passages. Nasoseptal chondrocytes presented the strongest proliferation rate, whereas auricular chondrocytes obtained the highest total cell amount using comparable cartilage sample weights. Importantly, all chondrocytes at fifth passage showed strong chondrogenic capacity both in vitro and in the subcutaneous environment of nude mice. Although some significant differences in histological structure, cartilage matrix content and cartilage type specific proteins were observed between the in vitro engineered cartilage and original tissue; the in vivo regenerated cartilage showed mature cartilage features with high similarity to their original native tissue, except for minor matrix changes influenced by the in vivo environment. The current study provides detailed preclinical data for choice of chondrocyte source and thus promotes the clinical translation of cartilage regeneration approach.

MicroRNA­185 regulates transforming growth factor­ß1 and collagen­1 in hypertrophic scar fibroblasts.

Transforming growth factor-ß1 (TGF-ß1) and collagen type I (Col-1) serve a critical role in the development and progression of hypertrophic scarring (HS). The present study hypothesized that a post­translational mechanism of microRNAs (miR) regulated the expression of TGF­ß1 and Col­1 in HS fibroblasts (HSFBs). A collection of 20 HS tissues was compared with corresponding normal tissues from clinical patients, and the expression of miR­185 was measured. Using PicTar, TargetScan and miRBase databases, it was identified that miR­185 may be a regulator of TGF­ß1 and Col­1 in humans. Based on these hypotheses, the expression of miR­185, TGF­ß1 and Col­1 in HS tissues was investigated. The results demonstrated that the expression of miR­185 was markedly suppressed, and TGF­ß1 and Col­1 levels were increased, in HS tissues. The expression levels of endogenous miR­185 negatively correlated with the TGF­ß1 and Col­1 mRNA levels (Pearson's correlation coefficient r=­0.674, P<0.01 and r=­0.590, P<0.01, respectively). In vitro, miR­185 can regulate TGF­ß1 and Col­1 through the predicted binding sites in its 3'­untranslated region. miR­185 had an effect on cell proliferation and apoptosis, thereby regulating HSFBs growth. In addition, miR­185 gain­of­function decreased TGF­ß1 and Col­1 protein expression, and miR­185 loss­of­function increased TGF­ß1 and Col­1 protein expression in HSFBs. In conclusion, overexpressed miR­185 could inhibit HSFBs growth, and the underlying mechanism was mediated, at least partly, through the suppression of TGF­ß1 and Col­1 expression. However, above all, miR­185 might serve as a potential therapeutic approach for the treatment of HS.

A murine model of orthotopic periorbital subunit transplantation.

BACKGROUND: Conventional reconstructive methods fail to achieve satisfactory results in total eyelid defect cases. Vascularized composite tissue allotransplantation might provide both good appearance and function for these patients. We developed an orthotopic periorbital transplantation model in rats to facilitate further experimentation in this field. METHODS: In anatomical studies, the vascular distribution to and innervation of the periorbital unit were identified and recorded. Then, according to the anatomical studies, eight orthotopic transplantations and two transplantations with pedicle ligation were performed. The posterior facial vein and the external carotid artery were selected as the graft pedicles, while the temporal and upper zygomatic facial nerves were used for graft innervation. All transplanted eyelids were assessed daily. Micro-CT scanning and hematoxylin and eosin staining of the grafts were performed 60 days after the operation. RESULTS: In total, 90% of recipients tolerated the operation well. All grafts without pedicle ligation survived, and new hair growth was observed. The position of the eyelid was maintained, and eyelid function was partially restored. In the recipients with graft pedicle ligation, the grafts became necrotic and mummified within four to five days. Micro-CT of the surviving grafts showed a good blood supply, and histological staining revealed normal morphology. CONCLUSIONS: A periorbital subunit orthotopic transplantation model was established, which might facilitate future eyelid allotransplantation-related experimentation.

An algorithm for using expanded cervical flaps to resurface facial defects based on five different methods.

BACKGROUND: For patients with healthy skin in the cervical region, the expanded cervical flap method is highly recommended for resurfacing facial skin defects. Many methods exist that use an expanded cervical flap. However, a gold standard for selecting the appropriate method for each patient is lacking. Here, we introduce 5 basic principles for how to use an expanded cervical flap and an algorithm for selecting the appropriate method. METHODS: The authors reviewed the medical records for all patients treated with an expanded cervical flap to restore a facial skin lesion in Shanghai's Ninth People's Hospital between 2010 and 2015. RESULTS: We summarized the 5 techniques according to different types of facial deformities: (1) an advancement of the expanded cervical flap; (2) an expanded cervical flap that is rotated toward the temporal side (the rotation pivot is located in the angle of the mandible); (3) an expanded cervical flap that is rotated toward the nasal side (the rotation pivot is located in the mentum; (4) an expanded cervical flap that is rotated cephalically along the midline toward the lower third of the face (the rotation pivot is located in the bilateral angle of the mandible); and (5) a prefabricated cervical flap that is used with superficial temporal vessels. CONCLUSION: By using this algorithm and following five basic principles, all facial defects except for those on the nose and forehead can be resurfaced using an expanded cervical skin flap.

A new surgical procedure for phallic reconstruction in partial penis necrosis: penile elongation in combination with glanuloplasty.

The radial forearm flap transfer has proved to be the standard technique in penile reconstruction. However, this operation still leads to a residual scar on the forearm. In the reconstruction of partial penis necrosis, achieving a desirable appearance and functional recovery while minimizing donor-site damage remains an unsolved problem. In this study, we report our experience using penile elongation combined with glanuloplasty to rebuild the partially necrotic penis.A retrospective review of a consecutive series of 33 patients with partial penis necrosis after microwave thermotherapy (not from our hospital) from December 2008 to May 2012 was conducted at the Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital. These patients, with an age range from 20 to 36 years, first underwent a scrotal skin flap transfer to cover residual cavernosum. The penis was simultaneously elongated at the proximal end. Six months later, all patients received glanuloplasty using expanded polytetrafluoroethylene that was implanted at the distal end of transferred scrotal skin flap to create the neoglans.Anthropometric measurements of preoperative and postoperative penile length were performed with an average follow-up period of 28 months. The mean extended penile length average was 2.57 cm, ranging from 3.16 to 5.73 cm. Patients' satisfaction rate was 88%. In addition, preoperative and postoperative photographs were reviewed for objective and subjective assessment of outcome parameters such as appearance of neophallus, urination, and erogenous sensation. Most importantly, the rebuilt penis postoperatively showed almost normal shape and restoration of basic physiologic function in most of the patients, with an acceptable complication rate. These preliminary results may provide a useful strategy for the reconstruction of a partially necrotic penis using a novel, simple, and effective approach.