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Study 1: Students (N = 256 women, 129 men, and 13 nonbinary individuals, 61.8% heterosexual) from the same college campus studied 20 years ago (Murnen, 2000) reported on terms they used to refer to male genitals, female genitals, and “having sex” either within the context of an intimate partnership, talking with friends of their gender, or talking with friends in a mixed-gender group. Terms for genitals were coded as degrading or not, and terms for sex as aggressive or not, based on the previous study. Whereas in the past almost three-quarters of men used a degrading term for female genitals, that amount decreased to about one-quarter in the present sample. On the other hand, among women there was a significant increase in the use of a degrading term for women’s genitals in the intimate partner context, particularly among sexual minority women. Degrading and aggressive language use was predicted by pornography use and endorsement of gender stereotyped sexual attitudes. Study 2: Interpretations of sexual terms were studied among 29 sexual minority women, 81 heterosexual women, 16 sexual minority men, and 54 heterosexual men. We found that few terms were perceived as degrading or aggressive today (unlike 20 years ago) and that students believe that societal changes such as sexual education and the #MeToo movement were perceived as responsible for changes in sexual language use.

Zusammenfassung Hintergrund Die lokale Strahlentherapie von Metastasen bei Prostatakarzinompatienten in der oligometastasierten Situation hat in den letzten Jahren an Bedeutung gewonnen. Um die Wirkung auf das Outcome weiter zu evaluieren haben wir oligometastasierte Prostatakarzinompatienten, die eine stereotaktische Strahlentherapie (SBRT) von Knochenmetastasen erhielten, untersucht. Patienten und Methodik Es wurden 24 Patienten mit insgesamt 30 Knochenmetastasen eingeschlossen und das Ansprechen auf die SBRT (biochemisch und bildgebend) sowie das progressionsfreie Überleben und das Zeitintervall bis zum Beginn einer antihormonellen Therapie (aHT) untersucht. Ergebnisse Das mittlere Follow-Up-Intervall nach Abschluss der SBRT lag bei 32,7 Monaten (1,4 – 84 Monate). Die SBRT wurde ohne das Auftreten von Akut- oder Spät-Nebenwirkungen sehr gut vertragen. Bei 16 Patienten kam es zu einem Abfall des PSA-Wertes von im Mittel 4,58 ng/ml (0,05 – 50,25 ng/ml) vor der SBRT auf 1,19 ng/ml (0,01 – 8,85 ng/ml) nach Abschluss der SBRT. Das mittlere biochemische progressionsfreie Überleben dieser Patienten betrug 17,6 Monate (0,7 – 85,0 Monate). 6 Patienten erhielten bereits vor der SBRT oder parallel dazu eine aHT. Bei 10 Patienten wurde die aHT nach einem mittleren Intervall von 20,6 Monaten (1,8 – 85,0 Monate) nach Abschluss der SBRT initiiert, während weitere 6 Patienten keine aHT während des gesamten Beobachtungszeitraumes erhielten. Bei 18 der 30 Metastasen konnte im Bereich der SBRT im PSMA-PET eine Abnahme der PSMA-Expression im Sinne eines partiellen funktionellen Ansprechens beobachtet werden, während bei 5 Patienten nach SBRT eine gleichbleibende PSMA-Überexpression bestand und bei 7 Patienten keine PSMA-Bildgebung vorlag. Bei 17 Patienten kam es im Mittel nach 16,2 Monaten (1,6 – 40,6 Monate) bildgebend zum Progress der Fernmetastasierung, während 3 Patienten ein Lokalrezidiv in der Prostataloge zeigten. Zusammenfassung Die SBRT von Knochenmetastasen bei oligometastasierten Prostatakarzinompatienten stellt eine effektive und gut verträgliche Therapie dar, durch die eine hohe lokale Kontrolle im Bereich der Metastasen sowie eine zeitliche Verzögerung des Beginns oder der Eskalation einer Systemtherapie erzielt werden kann. Jedoch zeigt die hohe Rate an Progression der Fernmetastasierung die Wichtigkeit der richtigen Patientenselektion auf und ggf. die Notwendigkeit der Kombination mit einer aHT.

ZusammenfassungDie Positronenemissionstomografie/Magnetresonanztomografie (PET/MR) ist ein neues Hybridverfahren. Mit integrierten Hybridsystemen ist es möglich, funktionelle PET-Daten und morphologische und funktionelle MR-Daten gleichzeitig zu messen. Daher ergeben sich im Vergleich zu anderen Schnittbildverfahren deutliche Unterschiede, die insbesondere in der onkologischen Bildgebung zu beachten sind.

Introduction. Skin giant neoplastic ulcers are a very serious diagnostic and therapeutic problem. The objective of this work was to present the experiences and strategies of our center concerning the treatment of this type of neoplastic ulcers. Material and methods. In this paper we present and analyze 15 cases of patients treated for giant ulcers. This represented 0.4% of all patients treated surgically for skin cancer in our center (n = 3983). Ulcers in this group of patients were located within the head (n = 6), chest (n = 4), abdomen (n = 2), male genitals (n = 1) and lower limbs (n = 2). Results. Our observations indicate that the treatment of giant skin neoplastic ulcers (although they are relatively rare) is a major clinical challenge and requires individualized multidirectional diagnostic and therapeutic methods.

Mexico is the country with the largest diversity of the genus Phrynus (Amblypygi: Phrynidae); however, many species could remain hidden due to the conservative morphology of the group. Two of the Mexican species, P. operculatus, and P. jalisco show enough variation, between populations from different localities, to be considered as possible species complexes. The scarce taxonomic information of these species and the few analyses of their variation could cause misidentifications and sub estimation of the diversity. Specimens morphologically similar to P. operculatus from different Mexican localities were analyzed, using characters from the male and female genitals. Four new species are described, presenting illustrations of SEM for the male genitals. Details of the morphologic variation in this group of species are discussed, as well as the usefulness of sexual characters like the size proportions, and sclerotization in the female gonopods, and ornaments in males, to improve the diagnoses of the Mexican Phrynus. The known distribution of P. operculatus is large in comparison with those of the other species, after the result of this research, the possibility that it is a larger species complex is evident, thus, it is necessary to increase the morphologic and genetic population studies in this group.

Commissioning a new treatment planning system (TPS) involves many time-consuming tasks. We investigated the role that knowledge-based planning (KBP) can play in aiding a clinic's transition to a new TPS. Sixty clinically treated prostate/prostate bed intensity-modulated radiation therapy (IMRT) plans were exported from an in-house TPS and were used to create a KBP model in a newly implemented commercial application. To determine the benefit that KBP may have in a TPS transition, the model was tested on 2 groups of patients. Group 1 consisted of the first 10 prostate/prostate bed patients treated in the commercial TPS after the transition from the in-house TPS. Group 2 consisted of 10 patients planned in the commercial TPS after 8 months of clinical use. The KBP-generated plan was compared with the clinically used plan in terms of plan quality (ability to meet planning objectives and overall dose metrics) and planning efficiency (time required to generate clinically acceptable plans). The KBP-generated plans provided a significantly improved target coverage (p = 0.01) compared with the clinically used plans for Group 1, but yielded plans of comparable target coverage to the clinically used plans for Group 2. For the organs at risk, the KBP-generated plans produced lower doses, on average, for every normal-tissue objective except for the maximum dose to 0.1 cc of rectum. The time needed for the KBP-generated plans ranged from 6 to 15 minutes compared to 30 to 150 and 15 to 60 minutes for manual planning in Groups 1 and 2, respectively. KBP is a promising tool to aid in the transition to a new TPS. Our study indicates that high-quality treatment plans could have been generated in the newly implemented TPS more efficiently compared with not using KBP. Even after 8 months of the clinical use, KBP still showed an increase in plan quality and planning efficiency compared with manual planning.

Caddis flies of Kazakhstan are studied rather poorly. As for 2018, 151 species of 59 genera of 17 families among 14548 species of World fauna are known in Kazakhstan. The largest numbers of species are found in mountain and submontane regions of Tian Shan and Altay (Southern and Eastern Kazakhstan), caddis flies of Central and Northern Kazakhstan are studied much worse. Nowadays are known 22 caddis flies species from Central Kazakhstan and 13 species from North Kazakhstan. Caddis flies research in 2015-2016 made it possible to expand the list of caddis Central Kazakhstan to 1 species, list caddis North Kazakhstan – to 4 species. Molanna albicans (Zetterstedt, 1840) and Grammotaulius nitidus (Mueller, 1764) are recorded for Kazakhstan at first. Detected species are limnophilous and widely distributed in Holarctic, Transpalearctic and sometimes Transpalearctic-Oriental Regions. Comparative analysis showed, that Central and Northern Kazakhstan are uniform in the biogeographical aspects, which are close to Southern trans-Ural (West Palearctic). The resemblance to South-Western Siberia is much lower. The article is illustrated by original photographs of the male genitalia of these species. Key words: Trichoptera, fauna, male genitals, Central Kazakhstan, North Kazakhstan.

Purpose To evaluate the impact of endorectal balloon (ERB) on anorectal dose during postoperative VMAT of prostate cancer. Methods In ten patients referred for salvage radiotherapy CTs were obtained without ERB and with air-filled ERB of 50ml and 100ml. CTs were repeated weekly (4–6 control CTs) and registered to the respective planning CT. For each planning CT, a VMAT plan was made with defined anorectal dose constraints and propagated on the respective control CTs. The dose volumes V40Gy, V60Gy and V65Gy of the rectal and anal wall (Rwall and Awall, respectively) and the ERB position were obtained from each plan. Results In plans with ERB, the mean Rwall dose volumes V40Gy, V60Gy and V65Gy were higher by 8%, 5% and 2% (ERB 50ml) and 2%, 3% and 3% (ERB 100ml) in comparison to plans without ERB. The respective Awall dose volume differences were 2%, 0%, −1% (ERB 50ml), and −3%, −2%, −2% (ERB 100ml). The dose volume variability of the Rwall was comparable with and without ERB, but was slightly reduced by ERB for the Awall. The mean ERB position variability was >2mm in anterior–posterior and inferior–superior directions. Conclusion The use of ERB during post-operative VMAT has no advantages for anorectal dose.

Penis and scrotum are very rarely affected by tick bites. We present four cases of involvement of male genitals by ticks belonging to the family Ixodidae. Dermatological examination showed an apparently healthy skin around the tick. Anti-Borrelia burgdorferi antibodies were negative. In all patients the entire body of the tick was delicately removed by means of pliers. Antibiotic therapy was unnecessary.

BackgroundMale genitals have repeatedly evolved left-right asymmetries, and the causes of such evolution remain unclear. TheDrosophila nannopteragroup contains four species, among which three exhibit left-right asymmetries of distinct genital organs. In the most studied species,Drosophila pachea, males display asymmetric genital lobes and they mate right-sided on top of the female. Copulation position of the other species is unknown.ResultsTo assess whether the evolution of genital asymmetry could be linked to the evolution of one-sided mating, we examined phallus morphology and copulation position inD. pacheaand closely related species. The phallus was found to be symmetric in all investigated species exceptD. pachea, which display an asymmetric phallus with a right-sided gonopore, andD. acanthoptera, which harbor an asymmetrically bent phallus. In all examined species, males were found to position themselves symmetrically on top of the female, except inD. pacheaandD. nannoptera, where males mated right-sided, in distinctive, species-specific positions. In addition, the copulation duration was found to be increased innannopteragroup species compared to closely related outgroup species.ConclusionOur study shows that gains, and possibly losses, of asymmetry in genital morphology and mating position have evolved repeatedly in thenannopteragroup. Current data does not allow us to conclude whether genital asymmetry has evolved in response to changes in mating position, or vice versa.

To calculate 3D distributions of microdosimetric-based restricted dose-averaged LET (LETd) and dose-mean lineal energy ([Formula: see text]) in order to explore their similarities and differences between each other and with the traditional unrestricted LETd. Additionally, a new expression for optimum restricted LETd calculation is derived, allowing for disregarding straggling-associated functions in the classical microdosimetric theory. Restricted LETd and [Formula: see text] for polyenergetic beams can be obtained by integrating previously developed energy-dependent microdosimetric functions over the energetic spectrum of these beams. This calculation is extended to the entire calculation volume using an algorithm to determine spectral fluence. Equivalently, unrestricted LETd can be obtained integrating the stopping power curve on the spectrum. A new expression to calculate restricted LETd is also derived. Results for traditional and new formulas are compared for a clinical 100 MeV proton beam. Distributions of unrestricted LETd, restricted LETd and [Formula: see text] are analyzed for a prostate case, for microscopic spherical sites of 1 µm and 10 µm in diameter. Traditional and new expressions for restricted LETd remarkably agree, being the mean differences 0.05 ± 0.04 keV µm-1 for the 1 µm site and 0.05 ± 0.02 keV µm-1 for the 10 µm site. In the prostate case, the ratio between the maximum and the central value for central axis (CAX) profiles is around 2 for all the quantities, being the highest for restricted LETd for 1 µm (2.17) and the lowest for [Formula: see text] for 1 µm (1.78). Unrestricted LETd, restricted LETd and [Formula: see text] can be analytically computed and compared for clinical plans. Two important consequences of the calculation of [Formula: see text] are: (1) its distribution can be verified by directly measuring it in clinical beams; and (2), optimization of proton treatments based on these quantities is enabled as well as future developments of RBE models based on them.

Мета дослідження: вивчення еволюції методів діагностики туберкульозу статевих органів чоловіків за останні десятиріччя. Матеріал і методи дослідження. Обстежено 467 чоловіків на туберкульоз статевих органів віком від 16 до 82 років (середній вік склав 49±14 року). Оцінювали симптоматику, дані анамнезу, клінічних, біохімічних і бактеріологічних аналізів, полімеразної ланцюгової реакції на ДНК мікобактерій туберкульозу, імунологічних досліджень, променевої діагностики: (сонографії, рентгенографії, мультиспіральної комп’ютерної томографії, магнітно-резонансної томографії, радіоізотопних) і ендоскопічних методів дослідження, з прицільною аспірацією і біопсією для здобуття біологічного матеріалу. Результати. У 372 (79,7%) пацієнтів з туберкульозом органів мошонки, у 305 (65,3%) діагностовано туберкульоз передміхурової залози та у 280 (59,9%) – сім’яних міхурців. У 94 (20,1%) виявлено туберкульоз внутрішньотазових статевих органів без залучання в процес органів мошонки, простатит діагностовано у 93 (19,9%) спостереженнях, а везикуліт – у 74 (15,8%) хворих. У 2 (2,2%) пацієнтів виявлено туберкульоз статевого члена. Алгоритм діагностики туберкульозу статевих органів чоловіків за останні десятиріччя зазнав змін: замість очищеного туберкуліну застосовували алерген туберкульозний рекомбінантний. З імунологічних методів використовували: визначення в крові протитуберкульозних антитіл по моноклональних антитілах до мікобактерій туберкульозу за допомогою ІФА і методи імунофенотипування з визначенням кількості CD4, CD8 клітин. Також досліджували інші поверхневі маркери Т-лімфоцитів за наявності у пацієнтів поєднання ТБ і ВІЛ інфекції. Провідне місце для візуалізації анатомії статевих органів чоловіків зайняли сонографічні дослідження з проведенням прицільної аспірації біологічних матеріалів і біопсії тканин. На перше місце серед методів верифікації мікобактерій туберкульозу вийшли молекулярно-генетичні дослідження біологічних матеріалів за допомогою ПЛР. Вивчення біоптатів тканин проводиться не лише з використанням класичної гістології, але і мікроскопії тканин на наявність кислотостійких бактерій і ПЛР. Також застосовували фіброуретроцистоскопію з катетеризацією сім’явиприскуючих проток і сім’яних міхурців. Висновки. Ці еволюційні зміни методів діагностики дозволили більш швидко, безпечно і точно обстежувати всі статеві органи чоловіків і виявляти ураження їх туберкульозом.

The Rome Statute of the International Criminal Court (ICC), which was adopted in 1998 and came into force in 2002, enumerates a broader range of sex crimes than any previous instrument of international criminal law. These include rape, sexual slavery, enforced prostitution, forced pregnancy, enforced sterilisation and ‘any other form of sexual violence’ of a comparable gravity, as war crimes and crimes against humanity. In applying the new residual crime of ‘any other form of sexual violence’, judges and prosecutors in the ICC have had to confront the complex question of what makes violence ‘sexual violence’, and how can the ‘gravity’ of sexual violence be determined, where that is a legal requirement. This article examines how these questions have been addressed in two cases currently before the ICC, from the situations in the Central African Republic and Kenya, where attempts have been made to prosecute forced nudity, forced male circumcision and mutilation of the male genitals as ‘sexual violen...

En este estudio se evaluó el efecto de tres tipos de películas plásticas para acolchar el suelo: acolchado plástico transparente calibre 150 (1.5 mm), acolchado plástico negro/blanco calibre 125 (1.25 mm), acolchado plástico blanco/negro calibre 125 (1.25 mm) y el producto sistémico imidacloprid en dosis de 2.0 lt/ha sobre la presencia de estados inmaduros del barrenador del tallo Melanagromyza tomaterae, así como la respuesta productiva del cultivo de tomate de cáscara variedad CHF-1 a estos tratamientos. Se colectaron puparios y se colocaron en recipientes a temperatura ambiente para esperar la emergencia de adultos, los cuales se montaron y etiquetaron, los genitales del macho fueron extraídos para su estudio. Los resultados mostraron que este insecto prefiere infestar plantas vigorosas cultivadas en los plásticos al suelo, sin embargo esta preferencia no redujo el rendimiento de las plantas con mayor presencia del barrenador del tallo, ya que los rendimientos con acolchado plástico mostraron diferencias estadísticas significativas contrastando con los tratamientos sin acolchado plástico. La efectividad del imidacloprid se observó durante 65 días. Se proporcionan fotografías de los genitales del macho, así como una clave taxonómica para la identificación del barrenador del tallo del tomate de cáscara

Background and purpose To develop a class solution for prostate Stereotactic Ablative Radiotherapy (SABR) using Volumetric Modulated Arc Therapy (VMAT). Materials and methods Seven datasets were used to compare plans using one 360° arc (1FA), one 210° arc (1PA), two full arcs and two partial arcs. Subsequently using 1PA, fifteen datasets were compared using (i) 6 mm CTV–PTV margins, (ii) 8 mm CTV–PTV margins and (iii) including the proximal SV within the CTV. Monaco™ 3.2 (Elekta™) was used for planning with the Agility™ MLC system (Elekta™). Results Highly conformal plans were produced using all four arc arrangements. Compared to 1FA, 1PA resulted in significantly reduced rectal doses, and monitor units and estimated delivery times were reduced in six of seven cases. Using 6 mm CTV–PTV margins, planning constraints were met for all fifteen datasets. Using 8 mm margins required relaxation of the uppermost bladder constraint in three cases to achieve adequate coverage, and, compared to 6 mm margins, rectal and bladder doses significantly increased. Including the proximal SV required relaxation of the uppermost bladder and rectal constraints in two cases, and rectal and bladder doses significantly increased. Conclusions Prostate SABR VMAT is optimal using 1PA. 6 mm CTV–PTV margins, compatible with daily fiducial-based IGRT, are consistently feasible in terms of target objectives and OAR constraints.

Volumetric modulated arc therapy (VMAT) is an irradiation method in which the multi-leaf collimator (MLC) shape, gantry speed and dose-rate is continuously varied. Gantry speed and dose-rate are treated as specific dynamic parameters (DPs) in VMAT, so there is a need to confirm the influence of DPs on dose distribution. The purpose of this study was to verify the impact of DPs on the accuracy of dose delivery in VMAT. We adopted an irradiation scenario in which DPs were modified from the original plan without making any changes in the dose distribution. We carried out irradiation and measured the dose distributions using a Delta4 diode array phantom, during which we acquired log files that enabled us to calculate DPs. The results showed that dose errors exceeding 1% or geometric errors greater than 1 mm were not produced by modifying the DPs. We were therefore able to verify the impact of DPs on dose delivery accuracy in VMAT.

To investigate the effect of sclerosis on apparent diffusion coefficient measurements in bone metastases from prostate cancer undergoing treatment. Sixteen patients underwent CT scans and MRI at baseline and 12 weeks following commencement of chemotherapy. For each patient, up to five bone metastases were selected. Hounsfield units were measured on CT and apparent diffusion coefficient (ADC) was measured on diffusion weighted MRI at both time points. Correlations between changes in apparent diffusion coefficient and Hounsfield units were investigated. Corresponding pre- and post-treatment apparent diffusion coefficient and Hounsfield units were available on 60 lesions from 16 patients. Overall, there was no significant correlation between changes in apparent diffusion coefficient with Hounsfield units. However, where changes in Hounsfield units increased by more than 50 %, there was a trend for an associated ADC rise. Increasing sclerosis of bone metastases on treatment does not significantly impede diffusion.

Introduction As the use of fiducial markers (FMs) for the localisation of the prostate during external beam radiation therapy (EBRT) has become part of routine practice, radiation therapists (RTs) have become increasingly responsible for online image interpretation. The aim of this investigation was to quantify the limits of agreement (LoA) between RTs when localising to FMs with orthogonal kilovoltage (kV) imaging. Methods Six patients receiving prostate EBRT utilising FMs were included in this study. Treatment localisation was performed using kV imaging prior to each fraction. Online stereoscopic assessment of FMs, performed by the treating RTs, was compared with the offline assessment by three RTs. Observer agreement was determined by pairwise Bland-Altman analysis. Results Stereoscopic analysis of 225 image pairs was performed online at the time of treatment, and offline by three RT observers. Eighteen pairwise Bland-Altman analyses were completed to assess the level of agreement between observers. Localisation by RTs was found to be within clinically acceptable 95% LoAs. Conclusions Small differences between RTs, in both the online and offline setting, were found to be within clinically acceptable limits. RTs were able to make consistent and reliable judgements when matching FMs on planar kV imaging.

Purpose To study the impact of daily rotations and translations of the prostate on dosimetric coverage during radiation therapy (RT). Methods and Materials Real-time tracking data for 26 patients were obtained during RT. Intensity modulated radiation therapy plans meeting RTOG 0126 dosimetric criteria were created with 0-, 2-, 3-, and 5-mm planning target volume (PTV) margins. Daily translations and rotations were used to reconstruct prostate delivered dose from the planned dose. D95 and V79 were computed from the delivered dose to evaluate target coverage and the adequacy of PTV margins. Prostate equivalent rotation is a new metric introduced in this study to quantify prostate rotations by accounting for prostate shape and length of rotational lever arm. Results Large variations in prostate delivered dose were seen among patients. Adequate target coverage was met in 39%, 65%, and 84% of the patients for plans with 2-, 3-, and 5-mm PTV margins, respectively. Although no correlations between prostate delivered dose and daily rotations were seen, the data showed a clear correlation with prostate equivalent rotation. Conclusions Prostate rotations during RT could cause significant underdosing even if daily translations were managed. These rotations should be managed with rotational tolerances based on prostate equivalent rotations.

ResumenEn nuestro país el cáncer de próstata es la neoplasia más frecuente en hombres de edad avanzada. Por ello, resulta indispensable una adecuada estadificación al momento de establecer la estrategia terapéutica. En este artículo se presenta la 7.a edición del sistema TNM de estadificación para el cáncer de próstata, vigente desde el 1.° de enero de 2010. El mismo ha tenido modificaciones mayores con respecto a la 6.a edición.AbstractIn our country prostate cancer is the most common malignancy in older men. An accurate staging is very important to establish treatment strategies.This article presents the 7th edition TNM staging system for prostate cancer, effective January 1, 2010. This has undergone major changes over the 6th edition.

Introduction Very little has been elucidated about sexual interest in female-to-male (FtM) transsexual persons. Aims To investigate the sexual interest of FtM transsexual persons vs that of men using an eye-tracking system. Methods The study included 15 men and 13 FtM transsexual subjects who viewed three sexual videos (clip 1: sexy clothed young woman kissing the region of the male genitals covered by underwear; clip 2: naked actor and actress kissing and touching each other; and clip 3: heterosexual intercourse between a naked actor and actress) in which several regions were designated for eye-gaze analysis in each frame. The designation of each region was not visible to the participants. Main Outcome Measures Visual attention was measured across each designated region according to gaze duration. Results For clip 1, there was a statistically significant sex difference in the viewing pattern between men and FtM transsexual subjects. Longest gaze time was for the eyes of the actress in men, whereas it was for non-human regions in FtM transsexual subjects. For clip 2, there also was a statistically significant sex difference. Longest gaze time was for the face of the actress in men, whereas it was for non-human regions in FtM transsexual subjects, and there was a significant difference between regions with longest gaze time. The most apparent difference was in the gaze time for the body of the actor: the percentage of time spent gazing at the body of the actor was 8.35% in FtM transsexual subjects, whereas it was only 0.03% in men. For clip 3, there were no statistically significant differences in viewing patterns between men and FtM transsexual subjects, although longest gaze time was for the face of the actress in men, whereas it was for non-human regions in FtM transsexual subjects. Conclusion We suggest that the characteristics of sexual interest of FtM transsexual persons are not the same as those of biological men. Tsujimura A, Kiuchi H, Soda T, et al. The Pattern of Sexual Interest of Female-to-Male Transsexual Persons With Gender Identity Disorder Does Not Resemble That of Biological Men: An Eye-Tracking Study. Sex Med 2017;5:e169–e174.

Information obtained by different methods of image-guided radiotherapy now allows us to reposition the target volume. This evolution causes a change in practice and positioning control. In order to control positioning errors, a systematic control during the first three to five sessions is required. Random repositioning errors and clinical target volume motions can be mastered only by performing a daily imaging. Finally, image-guided radiotherapy allows assessing anatomical changes occurring during treatment, and opens the field of adaptive radiotherapy.

Computer-aided medical interventions and medical robotics for prostate cancer have known an increasing interest and research activity. However before the routine deployment of these procedures in clinical practice becomes a reality, in vivo and in silico validations must be undertaken. In this study, we developed a digital morphologic atlas of the prostate. We were interested by the gland, the peripheral zone and the central gland. Starting from an image base collected from 30 selected patients, a mean shape and most important deformations for each structure were deduced using principal component analysis. The usefulness of this atlas was highlighted in two applications: image simulation and physical phantom design.

This article aims to provide an update on the anatomy of, and some of the conditions affecting, the foreskin. The cultural and religious significance of the foreskin will be explored, as well as nursing care and health promotion needs of men. The possible link between circumcision status and human immunodeficiency virus will be briefly discussed. Maintaining cleanliness of the genitals is advocated to reduce the incidence of inflammatory conditions.

Rapid evolution has led to a large diversity in the sizes and morphology of male genitals across taxa, but the mechanisms driving this evolution remain controversial. In this study, we investigated the function of male genital sclerites in the adzuki bean beetle (Callosobruchus chinensis) and compared the length and morphology of genital sclerites between two populations that vary in their degree of polyandry. We found that the length of male genital sclerites was negatively correlated with copulation duration but positively correlated with the speed of matings with multiple females. Additionally, we found that the average length and number of genital sclerite spines of males from the more polyandrous population were larger than those from the less polyandrous population. We suggest that the genital sclerite of male adzuki bean beetles evolved by sexual selection, and a larger genital sclerite has a selective advantage because it allows for rapid copulations with multiple females.

The aim of this analysis was to compare the biochemical no evidence of disease (bNED) rates in low-risk prostate cancer patients treated at two centers of excellence using different approaches: seed brachytherapy (BT) and external beam radiotherapy (EBRT).A total of 919 low-risk prostate cancer patients, treated from 1998-2008, were identified in the two databases. In Utrecht, 667 patients received I-125 BT applying a dose of 144 Gy. In Vienna, 252 patients were treated with EBRT, applying a local dose of 70 Gy in 82 patients and 74 Gy in 170 patients. bNED rates (Phoenix definition) were assessed.The median follow-up was 46 months (range 1-148 months). The 5-year actuarial bNED rates were 94% for BT patients and 88% for EBRT patients (p = 0.002)-84% for patients receiving 70 Gy and 91% for patients receiving 74 Gy, respectively. In the univariate analysis, patients receiving 70 Gy showed significantly worse outcome compared to BT (p = 0.001) and a difference close to significance compared to 74 Gy (p = 0.06). In the multivariate analysis including tumor stage, Gleason score, initial PSA, hormonal therapy, and dose, patients receiving 70 Gy EBRT showed significantly worse bNED rates compared to BT patients.Low-risk prostate cancer patients receiving 74 Gy by EBRT show comparable biochemical control rates to patients receiving seed brachytherapy, whereas patients receiving 70 Gy show significantly worse outcome.

It is widely believed that younger prostate cancer patients are at greater risk of recurrence following radiotherapy (RT).From 1992 to 2007, 2168 (395 age ≤ 60) men received conformal RT alone for prostate cancer at our institution (median dose=76 Gy, range: 72-80). Multivariable analysis (MVA) was used to identify significant predictors for BF and PCSM. Cumulative incidence was estimated using the competing risk method (Fine and Gray) for BF (Phoenix definition) and PCSM to account for the competing risk of death.With a median follow-up of 72.2 months (range: 24.0-205.1), 8-year BF was 27.1% for age ≤ 60 vs. 23.7% for age60 (p=0.29). Eight-year PCSM was 3.0% for age ≤ 60 vs. 2.0% for age60 (p=0.52). MVA for BF identified initial PSA [adjusted HR=1.7 (PSA 10-20), 2.6 (PSA20), p0.01], Gleason score [adjusted HR=2.1 (G7), 1.9 (G8-10), p0.01], T-stage [adjusted HR=1.7 (T2b-c), 2.6 (T3-4), p0.01], and initial androgen deprivation therapy (ADT) [adjusted HR=0.38 (ADT12 months), p0.01] as significant, but not age or ADT12 months. MVA for PCSM identified Gleason score [adjusted HR=3.0 (G8-10), p=0.01] and T-stage [adjusted HR=8.7 (T3-4), p0.01] as significant, but not age, PSA, or ADT.This is the largest, most mature study of younger men treated with RT for prostate cancer that confirms young age is not prognostic for BF.

To assess the dosimetric and clinical implication when applying the full bladder protocol for the treatment of the localized prostate cancer (PCA).A total of 26 consecutive patients were selected for the present study. Patients underwent two series of CT scans: the day of the simulation and after 40 Gy. Each series consisted of two consecutive scans: (1) full bladder (FB) and (2) empty bladder (EB). The contouring of clinical target volumes (CTVs) and organs at risk (OAR) were compared to evaluate organ motion. Treatment plans were compared by dose distribution and dose-volume histograms (DVH).CTV shifts were negligible in the laterolateral and superior-inferior directions (the maximum shift was 1.85 mm). Larger shifts were recorded in the anterior-posterior direction (95% CI, 0.83-4.41 mm). From the dosimetric point of view, shifts are negligible: the minimum dose to the CTV was 98.5% (median; 95%CI, 95-99%). The potential advantage for GU toxicity in applying the FB treatment protocol was measured: the ratio between full and empty bladder dose-volume points (selected from our protocol) is below 0.61, excluding the higher dose region where DVHs converge.Having a FB during radiotherapy does not affect treatment effectiveness, on the contrary it helps achieve a more favorable DVH and lower GU toxicities.

The aim of this study was to determine the cutoff level of apparent diffusion coefficient (ADC) values for diagnosing prostate cancer.A total of 45 consecutive patients with prostate cancer who underwent diffusion-weighted magnetic resonance imaging (MRI) with ADC maps before radical prostatectomy were included in this retrospective study. MRI findings were correlated retrospectively with histopathological results of surgical specimens. Comparisons of ADC values between cancer and noncancer areas were performed with the two-tailed unequal variance t-test. The cutoff ADC level was determined in a way to achieve the best accuracy for detecting prostate cancer.The mean ADC value of all the cancer lesions (n =60) was 1.04 ± 0.31 (×10(-3) mm(2)/s). In the peripheral zone, the mean ADC values of cancer lesions and noncancer areas were 1.07 ± 0.35 and 1.94 ± 0.31, respectively (P0.001). In the transition zone, the mean ADC values of cancer lesions and noncancer areas were 1.00 ± 0.22 and 1.56 ± 0.14, respectively (P0.001). The cutoff level for the ADC value was determined to be 1.35×10(-3) mm(2)/s. It provided sensitivity, specificity, and accuracy of 88%, 96%, and 93%, respectively.The cutoff ADC level determined on the basis of the results obtained from radical prostatectomy specimens can help differentiate malignant from nonmalignant lesions.

Radiation dose to the testes in the antero-posterior (AP) and postero-anterior (PA) projection of the sacroiliac joint (SIJ) was measured with and without a scrotal shield. Entrance surface dose, the dose received by the testicles and the dose area product (DAP) was used. DAP measurements revealed the dose received by the phantom in the PA position is 12.6% lower than the AP (p≤0.009) with no statistically significant reduction in image quality (p≤0.483). The dose received by the testes in the PA projection in SIJ imaging is 93.1% lower than the AP projection when not using protection (p≤0.020) and 94.9% lower with protection (p≤0.019). The dose received by the testicles was not changed by the use of a scrotal shield in the AP position (p≤0.559); but was lowered by its use in the PA (p≤0.058). Use of the PA projection in SIJ imaging significantly lowers, the dose received by the testes compared to the AP projection without significant loss of image quality.

Radiotherapy is one of the major methods for treating cancer, but many patients undergoing radiotherapy have deep concerns about receiving radiation treatment. This problem is not generally appreciated and has not been adequately studied.The objective of this investigation was to empirically investigate the anxieties that cancer patients feel towards radiotherapy by using questionnaires to classify and quantitatively measure their concerns. A preliminary interview to develop a questionnaire was carried out with 48 patients receiving radiotherapy to discover their anxieties about on-going treatments. Subsequently, a main study was performed using a questionnaire with 185 patients to classify their types of anxiety and to ascertain the reliability and validity of the responses. Confirmatory factor analysis was then carried out with a 17-item Radiotherapy Categorical Anxiety Scale.Three anxiety factors were abstracted by factor analysis: (1) adverse effects of radiotherapy, (2) environment of radiotherapy, and (3) treatment effects of radiotherapy. Reliability, content validity, and concurrent validity were obtained. The adequacy of the three-factor model of anxiety concerning radiotherapy was confirmed.A 17-item Radiotherapy Categorical Anxiety Scale was formulated to quantitatively measure the specific types of anxiety among cancer patients receiving radiotherapy.

This paper reports on an evaluation of 5 RapidArc optimization approaches vs IMRT. This study includes 11 patients with adenocarcinoma of the prostate. Rectal Normal Tissue Complication Probability is used as a constraint in a dose escalation. RapidArc rectal NTCP's are lower than those of IMRT (p = 0.007). This allows a mean dose escalation of 2.1 Gy([0.7 Gy,3.5 Gy]).

Summary The aim of this paper is to detail the experience obtained in implementing an image-guided radiation therapy program at the Northern Sydney Cancer Centre. This required retrofitting a Varian Clinac 21EX with an on-board imager. The commissioning and quality assurance procedures, organisation of a multidisciplinary image guided radiation therapy group, and the development of clinical protocols for orthogonal kV and cone beam computed tomography implementation are described. Reassessment of the image-guided radiation therapy program has continued as new equipment and software versions were made available in the department.

Resume L’institut Bergonie a du faire face au deces d’un patient traite 12 heures auparavant par Quadramet ® . Ce cas inhabituel, et non documente en France, a contribue a une reflexion pluridisciplinaire sur la prise en charge du corps du defunt irradiant qui souhaitait une incineration. En collaboration avec l’ASN et l’IRSN, des recommandations ont ete etablies et appliquees.

Resume Objectif de l’etude La curietherapie par implants d’iode 125 est une des techniques de reference pour la prise en charge des patients atteints d’un cancer de prostate a faible risque de rechute biochimique avec bonne fonction urinaire. Cette analyse retrospective evalue la toxicite urinaire, digestive et sexuelle et les facteurs pouvant influer sur leur duree. Patients et methodes D’aout 2000 a novembre 2007, 176 patients atteints d’un adenocarcinome prostatique ont beneficie d’une curietherapie. La toxicite urinaire, digestive et sexuelle a ete evaluee selon la classification Common toxicities criteria for adverse events, version 3.0 (CTCAE V3.0). Au sein de chaque categorie de toxicite, le nombre de complications urinaires (dysurie, pollakiurie, etc.), digestifs (rectorragie, diarrhees, etc.) et sexuels (dyserection, perte de la libido, etc.) a ete recense et analyse selon des criteres lies au patient, a l’implant, aux donnees dosimetriques et aux caracteristiques de la toxicite. Les facteurs identifies comme pronostiques d’une longue duree de toxicite en analyse unifactorielle (test du Log Rank) ont ete retenus en analyse multifactorielle (modele de Cox). Resultats Le suivi median etait de 26 mois (1–87). Cent quarante-sept patients (83,5 %) ont souffert d’une toxicite urinaire dont 29,5 % (86 patients) de grade 2 et 2,4 % (sept patients) de grade 3. En analyse unifactorielle, ont ete reconnus comme facteurs de risque de duree de la toxicite urinaire le grade superieur ou egal a 2 ( p = 0,037), la presence de troubles initiaux ( p = 0,027) et un nombre de complications superieur ou egal a 2 ( p = 0,00032). Seul le nombre de toxicites urinaires etait identifie comme facteur independant en analyse multifactorielle ( p = 0,04). Soixante et onze patients (40,6 %) ont souffert de toxicite digestive dont 3 % (six patients) de grade 2 et aucun de grade 3. Ont ete reconnus comme facteurs de risque de duree de la toxicite digestive en analyse unifactorielle et analyse multifactorielle : un nombre de complications digestives superieur ou egal a 2 (analyse unifactorielle : p = 0,00129, analyse multifactorielle : p = 0,002) et un âge inferieur ou egal a 65 ans (analyse unifactorielle : p = 0,004, analyse multifactorielle : p = 0,007). Quatre-vingt trois patients (47,4 %) ont souffert d’une toxicite sexuelle dont 26,9 % (49 patients) de grade 2 et 5 % (neuf patients) de grade 3. Un nombre de grains superieur a 75 ( p = 0,032), un grade superieur ou egal a 2 ( p p = 0,0015). Conclusion La duree des complications urinaires, digestives et sexuelles sera d’autant plus longue que le nombre de complications et l’intensite de leur grade seront grands. Cette analyse permet de fournir au patient des informations plus precises quant a la persistance de ses complications post-therapeutiques.

Few parents-to-be consider that their child may be born with ambiguous sex. Still, parents of a newborn child with ambiguous sex are expected to make a far-reaching decision for the child: should the child be operated upon so that it has either female or male genitals? The aim of this article is to examine, phenomenologically, why parents decide to have their children undergo genital surgery when it is not necessary for the child’s physiological functions. Drawing on phenomenological work by Maurice Merleau-Ponty, Simone de Beauvoir and Sara Ahmed, we examine parents’ frustration when their child’s sex is ambiguous and their experiences of the practice of medical sex assignment. We also examine parental identity work when the child has been assigned a sex and the interaction between parents and medical professionals when parents make decisions regarding surgery on their child. Furthermore, we provide a critical perspective on the surgical practice.

Intensity modulated arc therapy offers great advantages with the capability of delivering a fast and highly conformal treatment. However, moving targets represent a major challenge. By monitoring a moving target it is possible to make the beam follow the motion, shaped by a Dynamic MLC (DMLC). The aim of this work was to evaluate the dose delivered to moving targets using the RapidArc (Varian Medical Systems, Inc.) technology with and without a DMLC tracking algorithm.A Varian Clinac iX was equipped with a preclinical RapidArc and a 3D DMLC tracking application. A motion platform was placed on the couch, with the detectors on top: a PTW seven29 and a Scandidos Delta4. One lung plan and one prostate plan were delivered. Motion was monitored using a Real-time Position Management (RPM) system. Reference measurements were performed for both plans with both detectors at state (0) "static, no tracking". Comparing measurements were made at state (1) "motion, no tracking" and state (2) "motion, tracking".Gamma analysis showed a significant improvement from measurements of state (1) to measurements of state (2) compared to the state (0) measurements: Lung plan; from 87 to 97% pass. Prostate plan; from 81 to 88% pass. Sub-beam information gave a much reduced pattern of periodically spatial deviating dose points for state (2) than for state (1). Iso-dose curve comparisons showed a slightly better agreement between state (0) and state (2) than between state (0) and state (1).DMLC tracking together with RapidArc make a feasible combination and is capable of improving the dose distribution delivered to a moving target. It seems to be of importance to minimize noise influencing the tracking, to gain the full benefit from the application.

メタアナリシスで各種悪性腫瘍患者の画像検査にF-18-2-Fluoro-2-deoxy-D-glucose (FDG) PETまたはPET/CTを併用すると，1/3以上の患者で治療方針の変更されることが示されており，本検査は腫瘍診断と治療戦略に重要な役割を担っている．婦人科領域でも，National Comprehensive Cancer Networkの卵巣癌・子宮癌ガイドラインでは，初回治療後に腫瘍マーカー上昇などで再発を疑う場合やCT/MRで再発を疑う病変の診断や再発巣が不明の場合には，FDG PETの使用が推奨されている．泌尿器科領域でも，初回ステージングや術後の再ステージングにおけるFDG PETの有用性を示唆するエビデンスが蓄積しつつある．本稿は，腹部・骨盤部領域のFDG PET/CT検査の意義のレビューの最終章となるが，婦人科/泌尿器科領域の腫瘍を中心に本検査の有用性と限界点の最新知見を総括する．

Pontohedyle milaschewitchii (Kowalevsky, 1901) is one of the most common mesopsammic opisthobranchs in the Mediterranean and Black Seas and has been considered as a comparably well-described acochlidian species. However, data on its complex internal anatomy were fragmentary and little detailed due to inadequate methodology available, and contradictory between different sources. The present study redescribes all major organ systems of P. milaschewitchii in full detail by three-dimensional reconstruction from serial semithin sections using AMIRA software. The prepharyngeal central nervous system (cns) of P. milaschewitchii is highly concentrated and shows a euthyneurous and epiathroid condition. Contrary to earlier reports, the cerebral and pleural ganglia are not fused. Aggregations of precerebral accessory ganglia can be grouped into three complexes supplied by distinct cerebral nerves. Rhinophoral ganglia with thin, double cerebro-rhinophoral connectives are described for the first time in acochlidians. A Hancock's organ is present in the form of a conspicuous, curved fold in the epidermis posterior to the oral tentacles. Cerebral nervous features and sensory structures are discussed comparatively. Our study confirms P. milaschewitchii as having the male genital opening in an unusual position above the mouth. Homology of the ciliated vas deferens of the gonochoristic and aphallic P. milaschewitchii with that of hermaphroditic acochlidian species with cephalic male genitals is discussed. The radula formula of P. milaschewitchii is 41–54×1-1-1, i.e. the single lateral teeth are broad and, contrary to previous descriptions, undivided. SEM examination of the body wall of entire specimens revealed a special and constant ciliary pattern. Providing a novel additional set of characters for taxonomic and phylogenetic purposes, external SEM examination is suggested as the standard method for describing acochlidian species in the future.

Ziel: Charakterisierung des Erscheinungsbildes der chronisch abakteriellen Prostatitis beim chronisch pelvinem Schmerzsyndrom (CPPS) in der MRT mit spektroskopischer Analyse. Material und Methoden: 18 Patienten im Alter zwischen 25 und 67 Jahren (mittleres Alter 46,2 Jahre, PSA kleiner 5 ng/ml, negativer endorektaler digitaler Tastbefund) mit einem unklaren pelvinen rekurrierendem Schmerzsyndrom uber mindestens 3 Monate wurden klinisch nach den Leitlinien der Urologie fur das CPP Syndrom untersucht. Es erfolgte eine retrospektive Analyse von 30 Prostata 1,5 T-MRT-Untersuchungen mit i. v. Kontrastmittel und endorektaler Spule (28 / 30 Untersuchungen). Es erfolgte eine bildmorphologische Charakterisierung der entzundlich verdachtigen Veranderungen sowie eine semiquantitative T 2w-Signalintensitatswertanalyse (SI Analyse) der peripheren, zentralen und entzundlich verdachtigen Areale sowie des Muskelsignals einschlieslich einer Spektroskopie (9 / 18 Patienten). Zusatzlich eine SI Ratioanalyse der verdachtig entzundlichen und der unauffalligen peripheren Areale zum Muskel. Ergebnisse: Es konnten typische bildmorphologische Stigmata beim CPP Syndrom aufgezeigt werden als T 2w-hypointense, streifige, radiare (n = 12, 66,6 %), kontrastmittelaffine, nichtnodulare Veranderungen ohne Kapselunscharfe und ohne perikapsulare Begleitreaktion. 6 Patienten (33,3 %) zeigten flachenhafte, dreiecksformige Signalabsenkungen. Ein periurethrales Enhancement bestand in 16,6 % der Falle. Die T 2w-SI-Werte und die auf das Muskelgewebe normierte SI Ratio der verdachtig entzundlichen Areale waren im Vergleich zur unauffalligen peripheren Zone deutlich erniedrigt (277,29 STD 77,5 zu 432,9 STD 112,02 respektive 4,94 STD 1,47 zu 7,58 STD 2,01). Spektroskopisch zeigten 3 Patienten ein unauffalliges Cholin+Creatin/Citrat SI Verhaltnis (SI 0,7 und 0.7 and < 3.0). Conclusions: We saw typical MR patterns in CPPS patients. However, spectroscopy can mimic findings of cancer so that the knowledge of typical morphological patterns and a solid clinical evaluation play a major role in the diagnosis of CPPS.

To establish an inverse planning set of parameters (class solution) to boost dominant intra-prostatic lesion (DIL) defined by MRI/MRSI.For 15 patients, DIL were contoured on CT or MR images and a class solution was developed to boost the DIL under the dosimetric requirements of the RTOG-0321 protocol. To determine the maximum attainable level of boost for each patient, 5 different levels were considered, at least 110%, 120%, 130%, 140% and 150% of the prescribed dose. The maximum attainable level was compared to the plan without boost using cumulative dose volume histogram (DVH).DIL dose escalation was feasible for 11/15 patients under the requirements. The planning target volume (PTV) dose was slightly increased, while the DIL dose was significantly increased without any violation of requirements. With slight adjustments of the dose constraint parameters, the dose escalation was feasible for 13/15 patients under requirements.Using a class solution, a dose escalation of the MRI/MRSI defined DIL up to 150% while complying with RTOG dosimetric requirements is feasible. This HDR brachytherapy approach to dose escalation allows a significant dose increase to the tumor while maintaining an acceptable risk of complications.

Recently published data indicated (18)F-fluorocholine to be feasible for imaging vulnerable atherosclerotic plaques in an animal model.Five patients undergoing whole-body (18)F-fluoromethylcholine-((18)F-FMCH-) PET/CT for imaging of prostate cancer disease were retrospectively evaluated. Whole-body PET scans were started immediately after i.v. injection of (18)F-FMCH. About 5-15 min after tracer injection, acquisition of scans of the pelvis and abdomen was performed. PET, CT, and PET/CT slices were generated for review and visual analyses of the abdominal aorta and the common iliac arteries were performed. Vascular findings in examined arteries and surrounding structures due to artifacts were excluded from further analysis. The lower threshold of (18)F-FMCH uptake was set above the background activity within the examined vessels. Morphological classification of vessel wall alterations (WA) included structural wall alterations without additional calcification (SWA), structural wall alterations associated with calcifications (SWC), and solely calcified lesions (CL). They were correlated with (18)F-FMCH uptake qualified as present and vice versa.A total of 31 WA were identified. Positive (18)F-FMCH uptake was found in 14 lesions (SWA: n = 5; SWC: n = 9). Sixteen of 17 (18)F-FMCH negative lesions were identified as CL without additional structural vessel wall alteration. One SWA did not show any (18)F-FMCH accumulation. None of the CLs as well as unaltered parts of the vessel wall showed (18)F-FMCH uptake.Our initial data in five patients with a total of 31 vessel wall alterations show promising results indicating for the first time the feasibility of (18)F-FMCH for in vivo imaging of structural WA in humans.

We aimed to investigate the effect of chronic radiation exposure associated with the Fukushima Daiichi Nuclear Power Plant (FNPP) accident on the testes of boar and inobuta (a hybrid of Sus scrofa and Sus scrofa domestica). This study examined the contamination levels of radioactive caesium (Cs), especially (134)Cs and (137)Cs, in the testis of both boar and inobuta during 2012, after the Fukushima accident. Morphological analysis and electron-probe X-ray microanalysis (EPMA) were also undertaken on the testes. The (134)Cs and (137)Cs levels were 6430 ± 23 and 6820 ± 32 Bq/kg in the boar testes, and 755 ± 13 and 747 ± 17 Bq/kg in the inobuta testes, respectively. The internal and external exposure of total (134)Cs and (137)Cs in the boar testes were 47.1 mGy and 176.2 mGy, respectively, whereas in the inobuta testes, these levels were 6.09 mGy and 59.8 mGy, respectively. Defective spermatogenesis was not detected by the histochemical analysis of radiation-exposed testes for either animal. In neither animal were Cs molecules detected, using EPMA. In conclusion, we showed that adverse radiation-induced effects were not detected in the examined boar and inobuta testes following the chronic radiation exposure associated with the FNPP accident.