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Introduction: Perineal schwannomas (PS) are very rare benign tumors with few cases reported in literature and none of these reports erectile dysfunction among clinical presentations. Case description: We report a case of PS with unusual clinical presentation showing erectile dysfunction associated with perineal pain and discomfort during defecation, and the postoperative residual pain and erectile dysfunction treatment. Conclusions: On the basis of a literature review of all cases reported and on our case reported, we have delineated a clinical, diagnostic, and therapeutic profile of PS, summarized in a useful table.

Objective: The aim of our study was to analyze the role of perineural invasion (PNI) as a predictive parameter of outcome after radical prostatectomy (RRP) in pathologically organ-confined prostate cancer (PCa) and to assess its possible correlation with other well-known prognostic features. Patients and Methods: At our institution between January 2000 and December 2007, we prospectively collected data from 251 consecutive patients with pathologically localized PCa after antegrade RRP. In our analysis 239 patients were included. PNI was defined as adenocarcinoma within the perineural space adjacent to a nerve. We evaluated the biochemical progression-free survival rate using the Kaplan-Meier method to establish the correlation between PNI and prognosis, the log-rank test to verify the statistical significance, and χ2 test to investigate the correlation between PNI and other clinicopathological parameters. Results: We found intraprostatic PNI in 157 patients (65.7%). The PNI rate was 73% (149/204) in pT2b–c vs. 26% (8/35) in pT2a surgical specimens (p < 0.001), and it was 78.5% (73/93) in patients with a Gleason score of 7–10 vs. 57% (84/146) in a Gleason score of 2–6 (p < 0.01). The mean follow-up was 65.4 (median 62, range 24–118) months. Overall, 11/239 (4.6%) patients presented biochemical recurrence after surgery and 7 (63.6%) of these patients showed PNI, but this was not statistically higher than in patients free from progression (150/228, 65.7%). The actuarial biochemical progression-free survival rate for all patients was 96.9 and 93.5% at 60 and 84 months, respectively, and the stratification based on the presence or absence of PNI did not allow us to identify different prognostic groups. Conclusions: Perineural infiltration frequently takes part in the pathway of extraprostatic extension. In our series, patients with pathological T2 stages and PNI were found to present a higher pT2 stage and Gleason score, even though our early biochemical-free outcome was not significantly higher than in patients without PNI.

Background: The oncologic safety of blunt tumor enucleation (TE) of renal cell carcinoma (RCC) depends on the presence of a continuous pseudocapsule (PS) around the tumor and on the possibility of obtaining negative surgical margins (SMs). Objective: To investigate the PS and SMs after TE to define the real need to take a rim of healthy parenchyma around the tumor to avoid the risk of positive SMs. The risk of PS invasion related to other clinical and pathologic variables was also evaluated. Design, setting, and participants: Between September 2006 and December 2007, data were gathered prospectively from 187 consecutive patients who had kidney surgery. Overall, 90 consecutive patients who had TE for RCC were eligible for the study. All specimens were evaluated using an image analyzer by a dedicated uropathologist. Intervention: TE was done by blunt dissection using the natural cleavage plane between the tumor and the normal parenchyma. Measurements: PS,SM, and routinely availableclinical andpathologic variableswere recorded.

Using social network methods, this article explores the ways in which individuals with intellectual disability (ID) perceive their family contexts and the social capital that they provide. Based on a subsample of 24 individuals with ID, a subsample of 24 individuals with ID and psychiatric disorders, and a control sample of 24 pre-graduate and postgraduate students matched to the clinical respondents for age and sex, we found that family networks of clinical individuals are distinct both in terms of composition and in terms of social capital made available to them by their family ties. Individuals with ID perceive themselves as less central in their own family; their family networks are perceived as less dense, less centralized, and more disconnected. Individuals with intellectual disabilities and psychiatric disorders have less family-based social capital than individuals with intellectual disabilities only. The composition of their family is also distinct as spouses or partners and children are missing. We discuss the importance of those findings for research on family relationships of individuals with ID.

OBJECTIVES To report on the role of simple enucleation for treating renal angiomyolipoma (AML) in a series of patients treated in our department. PATIENTS AND METHODS We retrospectively reviewed the data of all 37 patients with a histopathological diagnosis of renal AML who had either radical nephrectomy (three) or nephron-sparing surgery by simple enucleation (34) between January 1986 and December 2005. Indications for intervention included either symptomatic AML or a tumour of >4 cm, regardless to the presence of symptoms or renal masses suspicious of malignancy. The patients’ status was evaluated last in October 2006. RESULTS The mean (sd, median, range) pathological tumour size was 5.2 (3.4, 4.8, 1.5–15) cm; five patients (15%) were affected by tuberous sclerosis. Simple enucleation was successful in all patients but in three (9%) a sharp dissection a few millimetres from the tumour was used during critical steps of the procedure where it seemed difficult to define the right plane of enucleation. Warm ischaemia was used in 79% of patients, with a mean ischaemic time of 11.2 min. Two patients (6%) required renal hypothermia. A simple parenchymal compression was used in five cases (15%). The mean (range) intraoperative blood loss was 170 (70–650) mL. None of the patients had postoperative bleeding requiring re-intervention but one (3%) required two units of blood after surgery. There were no major complications, e.g. prolonged acute tubular necrosis/chronic renal insufficiency and urinary leakage/urinoma, but two patients had urosepsis not associated with perirenal fluid collection and that required targeted antibiotic therapy. At a mean (median, range) follow-up of 56 (50.5, 10–120) months none of the patients had local tumour recurrence. Two patients had a small AML elsewhere in the operated kidney, detected 18 and 36 months after surgery, with a kidney recurrence rate of 6%. CONCLUSIONS Our data confirm the optimum results of simple enucleation for renal AMLs; this technique provides excellent long-term local control and no patient had urinary leakage/fistula afterward.

We tested a selected series of patients with single urothelial high-grade pT1 stage (pT1 HG) or urothelial carcinoma in situ (CIS) with a set of immunohistochemical markers to elaborate a risk score for progression. We retrospectively reviewed all first diagnoses of single

Global statistics reports all over the world demonstrates that wind generation is the only renewable energy that could really help in the future on matching the reduction of CO2 emissions (at least in the short and mid term scenario). Thus the TSOs of most European Countries (where this renewable resource is more relevant) have modified their Grid Codes, in order to regulate the behavior of connected wind power.

To evaluate the role of nephron-sparing surgery (NSS) compared to radical nephrectomy (RN) for treating multiple ipsilateral renal tumors.We retrospectively reviewed the clinical and pathological data of 960 patients who had surgery for pathologically confirmed RCC between 1986 and 2006. Thirty-four patients were diagnosed as having at least one ipsilateral smaller solid lesion associated with the primary RCC: 22 had RN while 12 had NSS for tumor enucleation.All patients who had NSS had tumors confined within the kidney, as did 82% of patients treated with RN. The sole presence of concomitant accompanying benign histology to the primary RCC was diagnosed in 20% of patients. The mean (median, range) follow-up for patients treated with RN and NSS was 69 (58, 12-214) and 58 (44, 12-151) months. Tumor stage was significantly associated with tumor-specific survival (TSS) in the RN group (p0.001). None of the patients who had tumor enucleation had positive surgical margins. Two patients recurred locally after NSS, elsewhere in the kidney, resulting in a crude ipsilateral recurrence rate of 17%. The analysis of TSS for patients with multiple ipsilateral tumors with a pT1 primary lesion showed no statistically significant differences between patients who had RN or NSS. Two patients had contralateral recurrence, resulting in a crude rate of 6%.For patients with multiple ipsilateral renal tumors, 20% of the satellite lesions are benign and 6% develop a contralateral metachronous recurrence. We also observed similar TSS for patients treated with NSS and RN.

Using social network methods, this article explores the ways in which individuals with intellectual disability (ID) perceive their family contexts and the social capital that they provide. Based on a subsample of 24 individuals with ID, a subsample of 24 individuals with ID and psychiatric disorders, and a control sample of 24 pre-graduate and postgraduate students matched to the clinical respondents for age and sex, we found that family networks of clinical individuals are distinct both in terms of composition and in terms of social capital made available to them by their family ties. Individuals with ID perceive themselves as less central in their own family; their family networks are perceived as less dense, less centralized, and more disconnected. Individuals with intellectual disabilities and psychiatric disorders have less family-based social capital than individuals with intellectual disabilities only. The composition of their family is also distinct as spouses or partners and children are missing. We discuss the importance of those findings for research on family relationships of individuals with ID.

Public residential facilities were surveyed regarding the roles played by their Human Rights Committees in the review of restrictive/aversive behavior modification procedures. Almost 98% of the responding facilities reported that they had an active Human Rights Committee, with the largest plurality of members being staff members from the facility. Review of restrictive/aversive procedures was a role for over 95% of the committees, even though most committees appeared to lack great degrees of expertise in the clinical use of behavior modification. Other areas of review were discussed.

In order to solve the problem of the complete utilization ofalunitic minerals, we carried out an acid test, permitting the utilization of the soluble part, while leaving a clay residue free of SO3 and thus perfectly utilizable. Our study was performed by using A.T.D., X-ray diffraction and I.R. spectroscopy., Dans le but de résoudre le problème de l'utilisation complète des minerais alunitiques, nous avons effectué un traitement acide, qui permet l'utilisation de la partie soluble, tout en laissant un résidu argileux exempt de SO3 et donc parfaitement utilisable. Notre étude a été réalisée par A.T.D., analyse diffractomé trique aux rayons X et spectroscopic infrarouge., Nicolini L., Lanzi F. Etude des propriétés d'un minéral alunitique en vue de son utilisation technologique complète. In: Bulletin du Groupe français des argiles. Tome 25, fascicule 2, 1973. pp. 173-180.