The purpose of this work was to evaluate the feasibility and clinical use of MR angiography (MRA) for examining the pelvic and lower limb arteries in patients with arterial occlusive disease. Seventy-six patients with clinical signs of peripheral arterial occlusive disease were included in the study. MRA was performed using a fast contrast-enhanced high-resolution 3D technique that covered the area from the distal abdominal aorta to the distal lower limbs in two examination steps. In all patients, diagnostic images comparable with those of conventional intraarterial digital subtraction angiography (DSA) could be obtained. No false-negative findings were seen in the iliac, femoral, or popliteal arteries. Ten to 16% of the mild stenoses and 6-14% of the severe stenoses, mainly in the crural vessels, were overgraded compared with intraarterial DSA. Particularly in patients with proximal severe obstructions or occlusions, the crural segments could be depicted more clearly due to decreased arterial runoff in conventional angiography. The consistency of the excellent depiction of the vascular territories of the distal aorta and the pelvic and lower limb arteries in a standardized setting suggests great potential for the use of MRA in the primary diagnosis of peripheral arterial occlusive disease.

Introduction: Even though lifelong premature ejaculation (PE) is highly prevalent, few studies have investigated the neural mechanisms underlying PE. Aim: This study aimed to investigate whether patients with lifelong PE exhibit macrostructural or microstructural alterations of the parts of the brain involved in the male sexual response. Materials and Methods: We enrolled 42 healthy participants and 54 lifelong PE patients. Lifelong PE was diagnosed according to the Premature Ejaculation Diagnostic Tool (PEDT) and intravaginal ejaculation latency time (IELT). We compared measures of cortical morphology, such as volumes of gray matter, white matter, cerebellum volumes, and subcortical structures (ie, amygdala, caudate, hippocampus, globus pallidus, putamen, and thalamus) between the groups using a voxel-based morphometry method from whole-brain T1-weighted magnetic resonance imaging. Moreover, we evaluated the relationships between the relevant cerebral alterations and the severity of symptoms obtained from participants via self-reported questionnaires. Main Outcome Measures: Cerebral macrostructural and microstructural alterations were assessed in PE patients and controls, along with the correlation of caudate nucleus changes in PE patients with clinical data (including the PEDT and the IELT). Results: The mean volume of the caudate nucleus was significantly larger in the lifelong PE patients compared with healthy controls (P = .048). Moreover, caudate nucleus volume was positively correlated with PEDT score (r = 0.621; P = .0179) and negatively correlated with the IELT (r = −0.592; P = .0101). However, cortex morphology and the other subcortical volumes were not significantly different between the 2 groups (P > .05). Clinical Implications: Microstructural alterations in deep gray matter nuclei might be a useful parameter for studying the mechanism of the neurobiology underlying PE. Strengths and Limitations: There are few studies examining microstructural changes in PE patients. This study furthers our understanding of the etiology of PE. Limitations include the small sample, which limits our ability to make an absolute determination as to whether such subcortical changes are the cause or the consequence of lifelong PE. Conclusions: We found a significant difference in caudate nucleus volume between patients with PE and healthy controls. In addition, the caudate nucleus volume was positively associated with the severity of PE symptoms. More extensive and possibly longitudinal studies are needed to improve our understanding of the mechanism of the neurobiology underlying PE.

This study aims to assess the frequency and factors relevant to metabolic syndrome in workers employed in the collection and disposal of solid waste sector. This cross-sectional study was conducted in the major solid waste collecting and disposal company named İSTAÇ AŞ (İstanbul Environmental Protection and Waste Processing Corporation) in Istanbul, Turkey. All 715 male employees of the company were included in the study without sampling. The study was completed with 619 subjects. Since it was a small group, female workers were not taken into account in the study. Metabolic syndrome frequency was investigated according to the NCEP-ATP III criteria including the levels of systolic and diastolic blood pressure, waist perimeter, HDL, triglyceride, fasting blood glucose values. Metabolic syndrome was present in 40.9% of participating employees. Metabolic syndrome was more common in those working in the excavation field (54.0%), such as caterpillar operators (56.5%), and less common in employees working in administrative offices, such as office staff or managers, who were under 35 years old and who had been working for less than 10 years (p < 0.05). Employees working in work stations other than administrative offices had a 2.60 times higher risk compared to those working in administrative offices. Metabolic syndrome may be related to work station, job, age and period worked by the subjects.

The aim of this study is to investigate whether serum vitamin D level predicts the risk of Peyronie's disease. Calcium and inflammatory cytokines play an important role during fibrocalcification of the plaques in Peyronie's Disease. TGF-β1 is one of the most fibrogenic cytokines. Increasing serum vitamin D levels is considered that induce expression of TGF-β1. Serum vitamin D levels and TGF-β1 are related with calcifications of some soft tissues in previous studies. One hundred and three Peyronie patients and 162 healthy volunteers were included in the study. In both groups, demographic data, medical history, physical examination and erectile capacity were recorded. Serum 25-hydroxyvitamin D, total cholesterol, low-density lipoprotein, high-density lipoprotein, triglyceride and testosterone levels were measured. The mean level of serum 25 (OH) D was significantly higher in men with Peyronie's disease compared with the controls (32.6 ± 7.9 ng/ml vs. 18.5 ± 6.6 ng/ml respectively. p < 0.001). There is a relationship between Peyronie's disease and high serum vitamin D levels. Also, increased low-density lipoprotein and total cholesterol levels, diabetes mellitus, and cardiovascular diseases were associated with Peyronie's disease.

Aims: Laparoscopic pectopexy has emerged as a feasible alternative to sacrocolpopexy (SCP) for treating female genital apical prolapse. Although several previous studies have reported changes in the vaginal axis in women who have undergone SCP, laparoscopic lateral mesh suspension, sacrospinous ligament fixation surgery for prolapse, there is a lack of data on changes in the vaginal axis after pectopexy. This study aimed to evaluate the degree of anatomical correction achieved by laparoscopic pectopexy in patients with apical genital prolapse using magnetic resonance imaging (MRI). Methods: Individuals who experienced pectopexy and a nulliparous control group were enrolled in this prospective observational case-control investigation. MRI scans were conducted on both the control cohort and the study group before and after the procedure. The angles formed by the pubococcygeal line and the inferior vaginal segment, the levator plate and the pubococcygeal line, as well as the inferior and superior vaginal segments, were measured and compared. Results: The change in angle between the lower vagina and upper vagina was statistically significant, with preoperative and postoperative values of 134.91°±6.25° and 166.82°±6.15°, respectively (p=0.0001). The angle between the lower vagina and pubococcygeal line showed a significant change, with preoperative and postoperative values of 44.64°±1.8° and 65.73°±10.19°, respectively (p=0.0001). Postoperative angles were not similar among nulliparous patients based on the MRI findings. The postoperative Urogenital Distress Inventory scores are significantly lower than the preoperative scores (p=0.0001). Conclusion: The pectopexy procedure is not optimal for achieving a normal vaginal axis.