This study examined the impact of sex reassignment surgery on the satisfaction with sexual experience, partnerships, and relationship with family members in a cohort of Brazilian transsexual patients. A group of 19 patients who received sex reassignment between 2000 and 2004 (18 male-to-female, 1 female-to-male) after a two-year evaluation by a multidisciplinary team, and who agreed to participate in the study, completed a written questionnaire. Mean age at entry into the program was 31.21+/-8.57 years and mean schooling was 9.2+/-1.4 years. None of the patients reported regret for having undergone the surgery. Sexual experience was considered to have improved by 83.3% of the patients, and became more frequent for 64.7% of the patients. For 83.3% of the patients, sex was considered to be pleasurable with the neovagina/neopenis. In addition, 64.7% reported that initiating and maintaining a relationship had become easier. The number of patients with a partner increased from 52.6% to 73.7%. Family relationships improved in 26.3% of the cases, whereas 73.7% of the patients did not report a difference. None of the patients reported worse relationships with family members after sex reassignment. In conclusion, the overall impact of sex reassignment surgery on this cohort of patients was positive.

Epididymal abnormalities in undescended testes are probably more common than suggested in the literature but only sporadic reports are found on this subject. For many years discussions have centered around the ideal age to operate on patients with undescended testes and consequently increase chances for future fertility. We analyzed 66 patients (82 testes) treated for undescended testis in our department, with special distinction between ectopia and cryptorchidism. Abnormalities ranged from simple epididymal elongation to more complex forms, such as complete disruption between the testis and epididymis. Among 49 ectopic testes the epididymides of 19 (38.8%) displayed more severe abnormalities in addition to elongation, while 16 (32.6%) showed only an elongated epididymis and 14 (28.6%) were normal. Among the 33 cryptorchid testes 29 (87.9%) showed the more complex anomalies and elongation, 3 (9.1%) were normal and only 1 (3%) was elongated. Our results demonstrate a much higher incidence of complex epididymal abnormalities in cryptorchidism (p less than 0.001). Elongated epididymis may present problems for sperm maturation and transportation, although with no other associated abnormality most can be regarded as patent. In our theory cases of elongation plus other major abnormalities probably are associated with severe impairment in sperm maturation and hindered transportation, with the future intrascrotal or extrascrotal position of the testis or early surgical repair being of little importance in terms of fertility.

PURPOSE:To design an animal model of ischemia-reperfusion (I/R) in kidneys and evaluate the role that predetermined ranges of local hypothermia plays on markers of stress-oxydative as well as on histologic sections. METHODS:Twenty eight male rats Wistar, under general anesthesia, undergone right nephrectomy (G0, control group) followed by left kidney ischemia during 40 min. Four temperatures groups were designed, with seven animals randomized for each group: normothermic (G1, ±37 o C), mild hypothermia (G2, 26 o C), moderate hypothermia (G3, 15 o C) and deep hypothermia (G4, 4 o C). Left kidney temperature was assessed with an intraparenchymal probe. Left nephrectomy was performed after 240 min of reperfusion. After I/R a blood sample was obtained for f2-IP. Half of each kidney was sent to pathological evaluation and half to analyze CAT, SOD, TBARS, NO 3 , NO 2 . RESULTS:Histopathology showed that all kidneys under I/R were significantly more injured than the G0 (p<0.001). TBARS had increased levels in all I/R groups compared with the G0 (p<0.001). CAT had a significant difference (p<0.03) between G1 and G4. Finally, no difference was found on SOD, NO 3 , NO 2 nor on f2-IP. CONCLUSION:This model of I/R was efficient to produce oxidative-stress in the kidney, showing that 4ºC offered significant decrease in free radicals production, although tissue protection was not observed.

With the steep increase in the use of cross-sectional imaging in recent years, the incidentally detected adrenal lesion, or "incidentaloma", has become an increasingly common diagnostic problem for the radiologist, and a need for an approach to classifying these lesions as benign, malignant or indeterminate with imaging has spurred an explosion of research. While most incidentalomas represent benign disease, typically an adenoma, the possibility of malignant involvement of the adrenal gland necessitates a reliance on imaging to inform management decisions. In this article, we review the literature on adrenal gland imaging, with particular emphasis on computed tomography, magnetic resonance imaging, and photon-emission tomography, and discuss how these findings relate to clinical practice. Emerging technologies, such as contrast-enhanced ultrasonography, dual-energy computed tomography, and magnetic resonance spectroscopic imaging will also be briefly addressed.

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and quetiapine was stopped completely. Sleepiness and general fatigue were resolved after a switch to blonanserin. Hypoglycemia was not detected on Day 167 following a 75-g OGTT. Her auditory hallucinations and persecutory delusions were improved (BPRS score: 21), therefore she was discharged on Day 180.Because complaints of hypoglycemia are similar to the sedative effect of SGA, clinicians may overlook hypoglycemia in patients with schizophrenia. We previously reported another case of hypoglycemia induced by quetiapine.1 In that case, replacement of quetiapine with perospirone improved the symptoms of hypoglycemia but asymptomatic hypoglycemia was still present upon repeat OGTT. In the current case, a switch to blonanserin improved not only the symptoms of hypoglycemia but also hypoglycemia itself upon repeat OGTT. Because blonanserin is a new antipsychotic, its effect on glucose metabolism has not been established. However, this report suggests that a switch to blonanserin may be useful when hypoglycemia induced by SGA occurs. I N JAPAN, THERE were fewer than 25 000 suicides in 1996 and 1997 but more than 30 000 in 1998, a rising trend that has continued. There is evidence that the rapid increase of suicides in recent years in Japan is strongly influenced by economic factors, and that suicide and unemployment are related.1 We previously reported a correlation between the increase of suicides and the change in the ratio of job offers. In another report, we showed that stock prices may be associated with suicide among men.3 It is important to clarify the specific economic factors relevant to suicide if we are to lower suicide rates. Therefore, in this study we examined annual suicide rates 4 by vital statistics and annual growth rates of total amount in cash salary 5 from 1995 to 2009 in Japan, and we assessed the correlation between these factors during that period using single regression analysis in an EXCEL (Microsoft, Japanese, made in Singapore) spreadsheet.During the study period, the annual suicide rates (/100 000 population) ranged from 17.2 to 25.5 overall, from 23.4 to 38.0 among men, and from 11.3 to 14.7 among women. The growth rates of total amount in cash salary during this time ranged from -4.8 to 2.0 (%). The correlation coefficient between suicide rates and the growth rates of total amount in cash salary was r = -0.624 overall, r = -0.627 among men, and r = -0.531 among women. The growth rate of total amount in cash salary was clearly related to the overall suicide rate (R 2 = 0.3897, F = 8.300, P = 0.013, and y = -0.9302x + 22.631) and among both men (R 2 = 0.3933, F = 8.427, P = 0.012, and y = -1.6267x + 32.811) and women (R 2 = 0.2825, F = 5.118, P = 0.041, and y = -0.2663x + 12.909). Given these results, we feel it is helpful to grasp the trends of the growth rate of total amount in cash salaries when attempting to institute suicide-prevention measures, and these trends may be related to the changes in suicide rates among both men and women. A study also reported that socioeconomic variable...

Ligation of the spermatic vessels during stage 1 orchiopexy for intra-abdominal testicles is associated with a significant reduction of spermatogonia. However, no significant changes were observed in the volumetric characteristics of the testicles. Further studies are necessary to evaluate the repercussions of these changes in future fertility.

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