Search

Some men elect castration voluntarily without any clear medical reason. Here we aim to document their perception of genital ablation and injuries to better understand their motivations for castration. Participants completed an online survey with open-ended questions related to their perspectives on castration, genital ablation, and genital injuries. Thematic analyses were performed on the responses to these questions. Responses were obtained from 208 male castrated individuals (51.9 ± 16.0 years old). Among these, 154 were physically castrated, 36 chemically castrated, and 18 nullified (had testicles and penis removed). The majority learned about castration from media (55.8%) or animal castration (23.4%). The circumstances when they first wanted to be castrated varied greatly. Most (46.3%) wished to achieve an idealized self motivated by gender dysphoria, body integrity dysphoria, or wanting to be conspicuously non-sexual. The top themes we identified related to the respondents' perceptions of the pros of genital ablation were physical appearance, psychological benefit (i.e., a "eunuch calm"), and being non-sexual. Conversely, themes related to the cons they saw in having no genitals ranged from no disadvantages to loss of sexual/reproductive capability. Some perceived performing genital injury as a step toward ultimate castration or nullification. The respondents similarly varied in whether they saw any loss in having non-functional testicles. Perceptions in this regard appeared to differ depending on whether the respondents were taking supplemental androgens post-castration. Motivations for castration vary greatly between individuals. Clinicians need to understand men's diverse perceptions on castration in order to provide appropriate care for individuals with strong castration desire., (© 2022. The Author(s).)

Background: Brain networks involved in language, attentional and response processes are detectable by fMRI during lexical decision (LD). Here, we investigated possible abnormalities in the functional networks involved in LD in patients with bipolar disorder (BD)., Methods: fMRI and behavioural data were compared between BD (n = 25) and control (n = 21), with groups matched for age and sex. The functional brain networks involved in LD were extracted by manipulating the "word-likeness" of LD stimuli and using a multidimensional analysis method., Results: Attentional, response and language processes were captured in separate function-specific brain networks (default mode network, response network, linguistic processing network, respectively) in the BD and control groups, replicating the results of our previous study in an independent group of healthy adults. Behaviourally, the BD group showed higher performance than the control group in the LD task. Activity in the default mode network (DMN) and the linguistic processing network (LPN) did not differ between the groups, but the BD group had higher activation than the control group in the response network (RESP)., Limitations: Due to the small sample, the study is underpowered, capable of only detecting large effects., Conclusions: The results suggest that BD may be associated with sustained activity in the RESP network, which might contribute to psychomotor dysfunction in BD. Future studies should investigate the possible link between altered RESP activation and psychomotor disturbances in BD, as well as the basis for altered RESP activity in BD., (Copyright © 2022 Elsevier B.V. All rights reserved.)

In rare cases, some male individuals are sexually attracted to men who have their genitals removed. We investigate here if paraphilic attraction to men without genitals was associated with childhood experience, body image, and thoughts/behaviors related to body modification. An online survey, consisting of both validated questionnaires and questions developed by our team, was launched on the Eunuch Archive and MTurk websites. Out of 875 participants, 48.5 and 32.2% reported being attracted to males without testicles or without a penis, respectively; 49.7 and 31.0% felt they would themselves be attractive without testicles and without a penis, respectively. In terms of body modification, many reported having tattoos (19.0%) and piercings (26.1%). About half (48.3%) had played as children with male action figures without genitals, i.e., GI Joe, and Ken dolls. Additionally, some participants reported having: (1) witnessed animal castration (23.7%); (2) having been threatened with castration during their childhood (11.9%); (3) receiving genital injuries inflicted by others (11.0%); (4) pretending to be castrated (60.2%); (5) thinking of self-castration (54.2%); or (6) injuring their own penis (23.4%). Having received genital injuries inflicted by others was associated with attraction to males without testicles (OR = 1.997, p < .05), but not for attraction to males without a penis. Paraphilic attraction to males without genitals (i.e., castrated or penectomized) was associated with feeling attractive without genitals, having pretended to be castrated, considering self-castration, and having injured one's own penis. In conclusion, paraphilic attraction to males without genitals may be associated with traumatic early life events, body image, and desire for one's own genital ablation., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Prostate cancer (PCa) is often diagnosed early with prolonged survival, which makes sexual quality of life (QoL) an increasingly important treatment consideration, but existing QoL questionnaires have limited applicability for men who-have-sex-with-men (MSM) beyond penile erections and penetrative sex., Aim: We aimed to create a validated survey instrument for assessing a variety of sexual activities beyond penile insertive sex for MSM after PCa treatment., Methods: Based on our previously published survey findings, we have generated a prototype questionnaire with 13 different domains, reviewed by both healthy MSM and pilot-tested by MSM treated for PCa., Outcomes: We report here on progress in developing the questionnaire and demonstrate the complexity of MSM sexual side effects resulting from PCa treatment(s)., Results: Statistical analysis of 204 responses from MSM treated for PCa showed that each domain performed well individually (Cronbach's alpha coefficients ranged from 0.80 to 0.95; item-total correlations ranged from 0.16 to 0.89), with many significant intercorrelations between the domains (ranged from -0.048 to 0.93)., Clinical Implications: The questionnaire can contribute to clinical diagnosis and treatment decisions that best fit the preferred sexual practices of individual MSM., Strengths & Limitations: The current questionnaire considers a much broader repertoire of MSM's sexual practices and preferences than other currently available questionnaires. The high intercorrelations between the many parameters demonstrate that problems in one domain can affect other domains. This preliminary analysis warrants further exploration with a larger sample size., Conclusions: Once validated our questionnaire should help develop tailored psychosocial supports for MSM experiencing sexual dysfunction after PCa treatment and help newly diagnosed MSM with PCa make treatment decisions informed by their preferred sexual practices. Wibowo E, Dowsett GW, Nelson CJ, et al. Development of a Sexual Quality of Life Questionnaire for Men-Who-Have-Sex-With-Men With Prostate Cancer. Sex Med 2022;10:100480., (Copyright © 2021 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.)

Background: Testosterone is associated with sexual desire and performance in men, but little is known about cognitive mechanisms underlying this relationship. Even less is known about the influence of estradiol, despite its production from testosterone, and high receptor density in brain regions related to male sexual behavior., Method: We used eye-tracking to compare men's visual attention to images of fully clothed (i.e. neutral) and minimally clothed (i.e. sexy) models in three groups: androgen-deprived ( n = 6) and not androgen-deprived with prostate cancer ( n = 11), and healthy controls ( n = 7). We also assessed effects of serum testosterone, estradiol, and sex hormone-binding globulin levels., Results: We found no group effect for fixations to sexy compared to neutral images, and no influence of testosterone on either total fixations, or proportion of fixations to sexy images. In contrast, we found that sex hormone binding globulin positively predicted total fixations, and estradiol positively predicted proportion of total fixations on sexy images--regardless of androgen treatment status., Conclusion: Our results suggest that visual attention to sexual stimuli in men may be significantly affected by hormones. This has potential implications for clinical populations that experience sexual side effects, such as prostate cancer patients on androgen deprivation therapy.

Some genetic males undergo voluntary castration, with and without hormonal supplementation. Here, we investigate the sexual function of 163 such individuals (average age = 52 ± 16-years-old). Specifically, we explored how hormonal, social, and psychological factors play a role in their sexual function. In this study, 47% identified their gender as "eunuch", and 36% identified their gender as "man." Furthermore, 64% were in a relationship (80% with a woman), and 28% had a strong attraction for both sexes (Kinsey 2-4). We found that castrated individuals with androgen supplementation have higher sexual function than those without any hormone supplementation. Individuals with anxiety symptoms reported better sexual parameters (better orgasm satisfaction, easier to achieve an erection and an orgasm) than those without anxiety symptoms. Among those low in anxiety, individuals without hormone supplementation had a weaker sex drive and more difficulty in getting sexually aroused than those on supplemental estrogen or androgen. Hierarchical multiple regressions indicated that control variables (i.e., age, depressive symptoms, time since castration, type of hormone supplementation) accounted for 13-30% of the variances in sexual parameters. Including sexual guilt in the models predicted 4-8% additional variances in all sexual parameters except for ease in getting and maintaining an erection. Adding in participants' sexual trauma scores accounted for an additional 3.7% in the strength of their reported sex drive. In conclusion, various factors-hormone therapy, anxiety, sexual guilt, and childhood trauma-may influence the sexual outcomes for castrated individuals., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Some genetic males seek voluntary castration. We designed a survey to compare the psychological, sexual, and childhood experiences for subgroups of men with extreme interest in castration. The survey was posted on the Eunuch Archive, an online platform for individuals interested in the topic. Data from 822 individuals were included in the analyses. Respondents were divided into four groups: Interested (claiming only an interest in castration topics), Fantasy (fantasize about castration sexually, but not desiring castration), Wannabe (considering being castrated in the future), and Castrated (already castrated). More individuals desiring castration (Wannabe and Castrated groups) claimed equal attraction to both sexes than individuals in the Interested group. The Interested group was more religious than the other groups, and the Fantasy group had lower sexual guilt than those with castration desire. All groups had similar psychological well-being and body image acceptance, despite the Castrated group having lower sexual functioning than the others. Childhood trauma was more common in those with castration desire than those without. The Interested group had a lower desire for castration, lower erotic attraction to castration, and pretended to be castrated at a younger age than the others. Childhood trauma and sexual guilt are common, but not limited, predictors for castration desire and erotic attraction to castration, respectively. In conclusion, childhood experiences, as well as psychological and sexual parameters, may vary in different subgroups of males with interests in castration.

Background: This study describes a novel approach in reducing SARS-CoV-2 transmission during tracheostomy., Methods: Five patients underwent tracheostomy between April 1, 2020 and April 17, 2020. A clear and sterile plastic drape was used as an additional physical barrier against droplets and aerosols. Operative diagnosis; droplet count and distribution on plastic sheet and face shields were documented., Results: Tracheostomy was performed for patients with carcinoma of tonsil (n = 2) and nasopharynx (n = 1), and aspiration pneumonia (n = 2). Droplet contamination was noted on all plastic sheets (n = 5). Droplet contamination was most severe over the central surface at 91.5% (86.7%-100.0%) followed by the left and right lateral surfaces at 5.2% (6.7%-10.0%) and 3.3% (6.7%-10.0%), respectively. No droplet contamination was noted on all face shields., Conclusion: Plastic drapes can help reduce viral transmission to health care providers during tracheostomy. Face shields may be spared which in turn helps to conserve resources during the novel coronavirus disease 2019 pandemic., (© 2020 Wiley Periodicals, Inc.)

Nasopharyngeal carcinoma is endemic in southern parts of China including Hong Kong. Primary treatment entails radiotherapy ± chemotherapy depending on disease stage at presentation. Surgery is offered as a means of salvage for persistent and recurrent disease. Comprehensive preoperative work-up, careful patient selection, attention to details perioperation and multidisciplinary approach is essential in ensuring optimal outcomes after salvage surgery for recurrent nasopharyngeal carcinoma patients. Since the COVID-19 outbreak, we are faced with unprecedented challenges with priorities of care and resources being shifted to combat the virus. These include patient selection and timing of treatment, while preventing disease transmission to heath care providers. Practices and recommendations made in this document are intended to support safe clinical practice and efficient use of resources during this challenging time., (© 2020 The Authors. Laryngoscope Investigative Otolaryngology published by Wiley Periodicals, Inc. on behalf of The Triological Society.)

Background: COVID-19 pandemic has led to a global shortage of personal protective equipment (PPE). This study aims to stratify face shield needs when performing head and neck cancer surgery., Methods: Fifteen patients underwent surgery between March 1, 2020 and April 9, 2020. Operative diagnosis and procedure; droplet count and distribution on face shields were documented., Results: Forty-five surgical procedures were performed for neck nodal metastatic carcinoma of unknown origin (n = 3); carcinoma of tonsil (n = 2), tongue (n = 2), nasopharynx (n = 3), maxilla (n = 1), and laryngopharynx (n = 4). Droplet contamination was 57.8%, 59.5%, 8.0%, and 0% for operating, first and second assistant surgeons, and scrub nurse respectively. Droplet count was highest and most widespread during osteotomies. No droplet splash was noted for transoral robotic surgery., Conclusion: Face shield is not a mandatory adjunctive PPE for all head and neck surgical procedures and health care providers. Judicious use helps to conserve resources during such difficult times., (© 2020 Wiley Periodicals, Inc.)

Functional magnetic resonance imaging (fMRI) 5 studies on lexical decision (LD) 6 attempting to isolate the brain network underlying access to lexical representations can be confounded by attentional and response processes. However, manipulating the "wordlikeness" of the LD stimuli can facilitate functional interpretation of each emerging brain network, providing principles for separation of attentional demand from linguistic processing. This is because activation of difficult-to-access lexical representations (for obscure real words), and avoidance of interfering word properties (for wordlike non-words), are both generally attentionally demanding. Therefore, congruent patterns of activation would be predicted for general-attention-responsive networks, but opposing patterns for language-responsive networks. 59 healthy adults performed a LD task, and multidimensional functional connectivity analysis was used to extract three functional brain networks. A linguistic processing network (LPN) was separated from attention/response networks anatomically (LPN included Broca's and Wernicke's areas), but also temporally by showing reduced activation for the most attentionally demanding condition (i.e., wordlike non-words). This demonstrated that during LD in fMRI a network involved in linguistic processing can be disentangled from attention- and response-specific networks, using a combination of experimental design and multidimensional analysis methods., (Copyright © 2019 Elsevier Inc. All rights reserved.)

We report here on survey data from 11 genetic males, who had voluntary penectomies without any explicit medical need, yet did not desire testicular ablation. This group was compared to a control group of men who completed the same survey but had no genital ablation. The penectomy group was less likely to identify as male than the control group. They were also more likely to have attempted self-injury to their penis (at a median age of 41.5 years), been attracted to males without penises, and felt that they were more physically attractive without a penis than the controls. Motivations for voluntary penectomy were aesthetics (i.e., a feeling that the penile removal made them more physically attractive) or eroticism (i.e., at least two individuals thought that a penectomy would make them a better submissive sexual partner). In terms of sexual function, the penectomized and control groups reported comparable sexual function, with six penectomized individuals claiming to still be able to get and keep an erection, suggesting possible incomplete penile ablation. In their childhood, penectomized individuals were more likely than the controls to have pretended to be castrated and to have involved the absence of genitals of their toys in their childhood play. We discuss characteristics and sexual outcomes for individuals who have had a voluntary penectomy. A future study with a larger sample size on men who desire penectomies is warranted.

Background: To study the efficacy of surgery for recurrent T3 nasopharyngeal carcinoma (NPC) and to determine the prognostic significance of various skull base bone invasion., Method: Retrospective view of the surgical outcome for recurrent T3 NPC. Kaplan Meier and log rank tests were used to determine the 5-year overall and disease specific survival. Multivariate analysis was used to identify significant independent prognostic factors that affect the surgical outcome., Results: Between 1990 and 2017, 208 patients with recurrent T3 NPC were recruited. Salvage surgery was performed via the endoscopic endonasal approach (n = 22, 10.6%), endoscopic transpterygoid approach (n = 63, 30.3%) and the maxillary swing approach (n = 123, 59.1%). Thirty-eight (18.3%) patients required vascular bypass. The skull base bone involved by the tumours included: maxillary sinus (n = 13), clivus (n = 36), pterygoid process (n = 61), sphenoid sinus (n = 30), petrous part of the temporal bone (n = 42) and a combination of the above (n = 26). The mean follow-up duration was 41.7 months. Multivariate analysis identified tumours involving with both cortexes of the clivus and the lateral wall of the sphenoid sinus, as well as positive bone resection margins as the significant independent prognostic factors for surgical outcome., Conclusion: Outcome of surgical salvage is significantly worse for tumours that involve multiple bones at the skull base, particularly when both cortexes of the clivus and the lateral wall of the sphenoid sinus are invaded. Indication of aggressive surgery in such circumstances is controversial., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Background: To investigate the role of indocyanine green (ICG) lymphangiography in the reduction of drainage after neck dissection., Methods: Patients with oral cavity squamous cell carcinoma were randomized into Group A (study group) and Group B (control). In the study group, upon the completion of neck dissection, a total of 2.5 mg of ICG was injected submucosally at the four quadrants around the tumour. Another 2.5 mg of ICG was injected subdermally in the groin bilaterally. The neck was screened using Near Infrared fluorescence. The presence of lymphatic leakage was noted and plicated with silk stitches. The total drainage volume of post-operative day 1, day 2 and the total accumulated volume until drain removal was measured., Results: Twenty-two patients (Group A, n = 12; Group B, n = 10) were recruited. All patients in Group A had at least one site of lymphatic leakage identified. One patient in Group B developed chylous fistula and was excluded from analysis. The mean total drain output for day 1 and 2 after surgery, as well as the mean total output before drain removal, were significantly lower in Group A (22.4 ml vs. 86.2 ml [p = .02]; 14.2 ml vs. 72.8 ml [p = .02]; and 58.4 ml vs. 392 ml [p = .01], respectively), allowing earlier drain removal (2.2 days vs. 7.2 days, p = .02)., Conclusions: Intra-operative ICG lymphangiography is useful in the reduction of drainage volume after neck dissection for caners in the head and neck region., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Background: The purpose of this study was to review the efficacy of surgery for patients with osteoradionecrosis (ORN) after radiotherapy for nasopharyngeal carcinoma (NPC)., Methods: Between 2000 and 2016, we identified 162 patients with skull base ORN, among which 58 patients required surgery. A retrospective medical chart review was performed and the indications and results of surgical interventions were recorded., Results: All surgeries were performed for the treatment of secondary complications of ORN, including central nervous system (CNS) infection (48.4%), blowout bleeding (24.1%), and severe pain (17.2%). Endoscopic debridement was done in 12 patients, whereas the rest required either maxillary swing or mandibulotomy, depending on the location of the necrosis. The majority of the patients required free vastus lateralis flap (72.5%) for reconstruction. Surgery was effective in the control of infection, bleeding, and pain. Multivariate analysis identified reirradiation and bone exposure on MRI as the significant independent risk factors predicting the future need of surgery., Conclusion: Surgery is effective in the treatment of secondary complications of skull base ORN after previous radiotherapy for NPC., (© 2017 Wiley Periodicals, Inc.)

Background: The purpose of this study was to assess the predictability of the American Joint Committee on Cancer (AJCC) staging system on patients with stage II recurrent nasopharyngeal carcinoma (NPC)., Method: We conducted a retrospective review of the surgical outcome for patients with recurrent NPC and retropharyngeal lymph node (RLN) metastasis (group I), recurrent NPC and parapharyngeal space (PPS) invasion (group II), and recurrent NPC and internal carotid artery (ICA) encasement (group III)., Results: Between 1990 and 2013, 145 patients received an operation for stage II recurrent NPC (group I, n = 62; group II, n = 65; and group III, n = 18). The rate of local tumor recurrence was significantly higher in groups II and III. The rate of systemic metastasis was significantly higher in group III (16.7%). Accordingly, the 5-year overall survival was significantly worse for patients in group III (group I: 81.2%; group II: 68.4%; and group III: 48.5%)., Conclusion: The significantly worse prognosis of recurrent NPC encasing the ICA warrants an upstage to the T3 classification in the current AJCC staging system., (© 2017 Wiley Periodicals, Inc.)

Background: Sinonasal neoplasms, whether benign and malignant, pose a significant challenge to clinicians and represent a model area for multidisciplinary collaboration in order to optimize patient care. The International Consensus Statement on Allergy and Rhinology: Sinonasal Tumors (ICSNT) aims to summarize the best available evidence and presents 48 thematic and histopathology-based topics spanning the field., Methods: In accordance with prior International Consensus Statement on Allergy and Rhinology documents, ICSNT assigned each topic as an Evidence-Based Review with Recommendations, Evidence-Based Review, and Literature Review based on the level of evidence. An international group of multidisciplinary author teams were assembled for the topic reviews using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses format, and completed sections underwent a thorough and iterative consensus-building process. The final document underwent rigorous synthesis and review prior to publication., Results: The ICSNT document consists of four major sections: general principles, benign neoplasms and lesions, malignant neoplasms, and quality of life and surveillance. It covers 48 conceptual and/or histopathology-based topics relevant to sinonasal neoplasms and masses. Topics with a high level of evidence provided specific recommendations, while other areas summarized the current state of evidence. A final section highlights research opportunities and future directions, contributing to advancing knowledge and community intervention., Conclusion: As an embodiment of the multidisciplinary and collaborative model of care in sinonasal neoplasms and masses, ICSNT was designed as a comprehensive, international, and multidisciplinary collaborative endeavor. Its primary objective is to summarize the existing evidence in the field of sinonasal neoplasms and masses., (© 2023 The Authors. International Forum of Allergy & Rhinology published by Wiley Periodicals LLC on behalf of American Academy of Otolaryngic Allergy and American Rhinologic Society.)

Objective: To evaluate the sensitivities and specificities of Epstein-Barr virus (EBV) DNA in the detection of locally recurrent or persistent nasopharyngeal carcinoma (NPC) through nasopharyngeal (NP) brush biopsy and plasma, respectively, and whether a combination of both would be superior to the individual tests., Study Design: A case-control study was conducted from September 2016 to June 2022., Setting: A multicentre study at 3 tertiary referral centers in Hong Kong was conducted by the Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong., Methods: Twenty-seven patients with biopsy-confirmed locally recurrent NPC were recruited as study subjects. Magnetic resonance imaging was performed to rule out regional recurrence. The control group consisted of 58 patients with a prior history of NPC who were now disease-free based on endoscopic and imaging findings. Patients underwent both the transoral NP brush (NP Screen®) and blood for plasma Epstein-Barr DNA levels., Results: The sensitivity and specificity of the combined modalities were 84.62% and 85.19%, respectively. The positive predictive value was 73.33% and the negative predictive value was 92.0%., Conclusion: The combination of NP brush biopsy and plasma EBV DNA is potentially an additional surveillance modality in detecting the local recurrence of NPC. Further study with a larger sample size would be required to validate the cutoff values., (© 2023 The Authors. Otolaryngology-Head and Neck Surgery published by Wiley Periodicals LLC on behalf of American Academy of Otolaryngology-Head and Neck Surgery Foundation.)

Background Although uncommon, some individuals assigned male at birth (AMAB) seek voluntary genital ablative procedures, and others fantasize about it. Aim To learn more about the views of genital ablation and injuries in those who aspire to be castrated as compared with those who only fantasize about it. Methods A survey was run on the Eunuch Archive internet community. Content analysis was conducted on the responses of 342 AMAB individuals with castration fantasy but no desire for actual surgery (fantasizers) vs 294 AMAB individuals who expressed a desire for genital ablation (aspiring). Outcomes Study outcomes were responses to open-ended questions about genital ablations and injury. Results Aspiring individuals were more likely to perceive a "physical appearance benefit" from orchiectomy, but fewer could recall how they first learned about the procedure. Some reasons that aspiring persons gave for desiring an orchiectomy included "achieving preferred self" and "health reasons." Fantasizers, in contrast, worried about the potential side effects of orchiectomy, and more believed there to be no benefit to it. Clinical Implications Psychiatrists and other clinicians need to understand their patients' views on genital ablation to properly diagnose and provide the best personalized care. Strengths and Limitations Strengths include a large sample of respondents. Limitations include the accuracy of the anonymous survey data. Conclusions This study demonstrates divergent interests on genital ablation among AMAB individuals who have not had an any genital ablation yet have intense interest in the topic. [ABSTRACT FROM AUTHOR]

This study aimed to synthesize the chitosan-based gel microspheres and use them as a sorbent for Basic Blue 41 dye molecules (BB41) from aqueous solutions. For this aim, polymeric gel microspheres were produced from chitosan by a cross-linking method. The produced gel microspheres were characterized by appropriate instrumental methods such as FTIR and SEM. The effects of deacetylation degree and molecular weight of chitosan, type of cross-linking agent, cross-linking rate and time, etc. on sorption yield and sorption capacity of BB41 dye molecules on chitosan-based microsphere were investigated. It was concluded that epichlorohydrin was used as a cross-linking agent that promoted pore formation and significantly increased the sorption yield of BB41 molecules. It was seen that the concentration of the cross-linker solution and cross-linking time were critical parameters. On the other hand, the sorption yield of BB41 molecules was increased when the degree of deacetylation of chitosan is increased. However, while the molecular weight of chitosan is increased, the sorption efficiency and capacity of the microsphere were decreased. According to the experimental results, the optimum conditions of microsphere production were determined as deacetylation degree: 85%; cross-linker: epichlorohydrin; the concentration of the cross-linker solution: 0.75%; and cross-linking time: 5 min. The sorption yield and capacity of BB41 dye molecules on the microsphere were found to be approximately 99.5% and 10 mg/g under optimum conditions. In addition, the desorption yield of BB41 molecules from the chitosan microsphere was determined to be over 90%. It was discovered that the desorption process had no negative effect on the shape of the chitosan microsphere. [ABSTRACT FROM AUTHOR]

Objective: To conduct a systematic review and meta-analysis to compare the efficacy of conservative treatment versus surgical debridement versus debridement followed by vascularized tissue coverage to provide evidence-based guidance on the management of osteoradionecrosis of the anterior and central skull base., Data Sources: PubMed, Embase, and Cochrane Library., Review Methods: Systematic review and data sources including PubMed, Embase, and Cochrane Library were accessed using PRISMA guidelines. Meta-analysis was performed on treatment type and resolution of osteoradionecrosis., Results: A total of 13 articles met the inclusion criteria. Patients were categorized into conservative medical treatment versus surgical treatment. Conservative treatment included patients undergoing hyperbaric oxygen therapy, antibiotics, pentoxifylline-tocopherol-clodronate, or a combination of the three. Eight out of 197 patients treated with conservative therapy had resolution of symptoms (4.1%) while 135 of 188 patients treated with surgical intervention had resolution of symptoms (71.8%). Of these, 104 patients (91.2%) in the vascularized tissue group experienced resolution of symptoms., Conclusion: Surgery was superior to medical treatment alone in the resolution of skull base osteoradionecrosis. Vascularized surgical treatment fared significantly better when compared with both surgical debridement only and/or medical treatment. Our findings suggest that surgical treatment should be considered earlier in patients with skull base osteoradionecrosis to prevent severe or fatal sequelae., Level of Evidence: NA Laryngoscope, 2024., (© 2024 The American Laryngological, Rhinological and Otological Society, Inc.)

Purpose: Carotid blowout syndrome (CBS) is a severe complication of radiotherapy in patients with nasopharyngeal carcinoma (NPC). This study is aimed at analyzing risk factors of post-irradiation CBS in patients with NPC., Methods: We retrospectively analyzed 660 patients with NPC between 2006 and 2019. The patients were divided into those with and without CBS, and their characteristics and outcomes were evaluated. Independent predictors of CBS were determined by multivariate logistic regression analysis., Results: We identified 17 NPC patients with CBS in our study. In multivariate logistic regression analysis, lower body mass index (BMI) (P = 0.018), tumor encasement (P = 0.039), local recurrence (P = 0.006), and skull base osteoradionecrosis (P < 0.001) were independent predictors of CBS, and a predictive equation model was established. Log-rank test revealed that patients with low BMI, tumor encasement of carotid vessels, local recurrence, and skull base osteoradionecrosis all exhibited shorter CBS-free time (all P < 0.001)., Conclusion: We demonstrated that low BMI, tumor encasement, local recurrence, and skull base osteoradionecrosis were independent predictors for CBS in NPC patients. Physicians can use these factors for the early detection and prevention of CBS., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The increasing signal-to-noise ratio (SNR) is the main reason to use ultrahigh field MRI. Here, we investigate the dependence of the SNR on the magnetic field strength, especially for small animal applications, where small surface coils are used and coil noise cannot be ignored. Measurements were performed at five field strengths from 3 to 14.1 T, using 2.2-cm surface coils with an identical coil design for transmit and receive on two water samples with and without salt. SNR was measured in a series of spoiled gradient echo images with varying flip angle and corrected for saturation based on a series of flip angle and T 1 measurements. Furthermore, the noise figure of the receive chain was determined and eliminated to remove instrument dependence. Finally, the coil sensitivity was determined based on the principle of reciprocity to obtain a measure for ultimate SNR. Before coil sensitivity correction, the SNR increase in nonconductive samples is highly supralinear with B 0 1.6-2.7 , depending on distance to the coil, while in the conductive sample, the growth is smaller, being around linear close to the surface coil and increasing up to a B 0 2.0 dependence when moving away from the coil. After sensitivity correction, the SNR increase is independent of loading with B 0 2.1 . This study confirms the supralinear increase of SNR with increasing field strengths. Compared with most human measurements with larger coil sizes, smaller surface coils, as mainly used in animal studies, have a higher contribution of coil noise and thus a different behavior of SNR at high fields., (© 2024 The Authors. NMR in Biomedicine published by John Wiley & Sons Ltd.)

Purpose: To develop a generalized rigid body motion correction method in 3D radial brain MRI to deal with continuous motion pattern through projection moment analysis., Methods: An assumption was made that the multichannel coil moves with the head, which was achieved by using a flexible head coil. A two-step motion correction scheme was proposed to directly extract the motion parameters from the acquired k-space data using the analysis of center-of-mass with high noise robustness, which were used for retrospective motion correction. A recursive least-squares model was introduced to recursively estimate the motion parameters for every single spoke, which used the smoothness of motion and resulted in high temporal resolution and low computational cost. Five volunteers were scanned at 3 T using a 3D radial multidimensional golden-means trajectory with instructed motion patterns. The performance was tested through both simulation and in vivo experiments. Quantitative image quality metrics were calculated for comparison., Results: The proposed method showed good accuracy and precision in both translation and rotation estimation. A better result was achieved using the proposed two-step correction compared to traditional one-step correction without significantly increasing computation time. Retrospective correction showed substantial improvements in image quality among all scans, even for stationary scans., Conclusions: The proposed method provides an easy, robust, and time-efficient tool for motion correction in brain MRI, which may benefit clinical diagnosis of uncooperative patients as well as scientific MRI researches., (© 2024 International Society for Magnetic Resonance in Medicine.)

Glioblastoma (GBM) is a primary malignancy of the central nervous system and is classified as a grade IV astrocytoma by the World Health Organization (WHO). Although GBM rarely metastasizes, its prognosis remains poor. Moreover, the standard treatment for GBM, temozolomide (TMZ), is associated with chemoresistance, which is a major factor behind GBM-related deaths. Investigating drugs with repurposing potential in the context of GBM is worthwhile to bypass lengthy bench-to-bedside research. The field of omics has garnered significant interest in scientific research because of its potential to delineate the intricate regulatory network underlying tumor development. In particular, proteomic and metabolomic analyses are powerful approaches for the investigation of metabolic enzymes and intermediate metabolites since they represent the functional end of the cancer phenotype. We chose two of the most widely prescribed anticancer drugs, cisplatin and paclitaxel. To our knowledge, the current literature lacks studies examining their effects on metabolic and proteomic alterations in GBM. We employed the mass spectrometry technological platform 'UHPLC-Q-TOF-MS/MS' to examine the changes in the proteome and metabolome profiles of the U87 cell line with defined concentrations of cisplatin and/or paclitaxel via an untargeted approach. A total of 1,419 distinct proteins and 90 metabolites were generated, and subsequent analysis was performed. We observed that upon treatment with cisplatin (9.5 μM), U87 cells exhibited apparent efforts to cope with this exogenous stressor, understanding the effect of paclitaxel (5.3 μM) on altering the transport machinery of the cell, and how the combination of cisplatin and/or paclitaxel suggests potential interactions with promising benefits in GBM therapeutics. Our research provides a detailed map of alterations in response to cisplatin and paclitaxel treatment, provides crucial insights into the molecular basis of their action, and paves the way for further research to identify molecular targets for this elusive malignancy. [ABSTRACT FROM AUTHOR]

Aim: To investigate the treatment of intractable epistaxis after radiotherapy for nasopharyngeal carcinoma (NPC).Methods: This review focuses on the anatomy and pathophysiology, mechanism, and clinical treatments of epistaxis after NPC radiotherapy.Results: For treating NPC, radiation therapy is the primary therapeutic modality. However, radiotherapy can lead to varied degrees of harm to the neighboring tissues and is correlated with numerous complications. Among these complications, epistaxis is a common occurrence after NPC radiotherapy, owing to damage to the surrounding tissues caused by radiotherapy. Unfortunately, epistaxis, particularly carotid blowout, can have a dangerous course and a high mortality rate. Accurate understanding of epistaxis following radiotherapy, prompt bleeding cessation, and reduction of bleeding volume are key considerations. Nasal tamponade is a crucial rescue treatment, while tracheotomy is an active and effective method. Intravascular balloon embolization is a reliable and effective treatment method for ICA hemorrhage, and vascular embolization is the primary approach for treating external carotid artery maxillary bleeding. Implantation of a covered stent can achieve hemostasis without altering hemodynamics.Conclusion: A comprehensive approach utilizing these methods can improve the success rate of treating nosebleeds following NPC radiotherapy. The mortality rate for carotid blowout following radiotherapy for NPC is high. Radiation therapy and tumor condition are correlated with epistaxis in NPC. Treatment methods for NPC-related epistaxis include posterior nostril tamponade, endoscopic hemostasis, DSA, selective vascular embolization, and stent implantation. The use of a covered stent for NPC-related carotid blowout achieves hemostasis without altering blood perfusion. Effective and timely application of various hemostasis methods is key to improving the success rate of rescue, considering the characteristics of NPC-related epistaxis. [ABSTRACT FROM AUTHOR]

Background: The management of locally advanced recurrent nasopharyngeal carcinoma (rNPC) is challenging. The objective of our study was to compare salvage endoscopic nasopharyngectomy (ENPG) with intensity-modulated radiotherapy (IMRT) in clinical outcomes and complications of locally advanced rNPC. Methods: Patients with histologically confirmed rNPC in rT3-4N0-3M0 stages were retrospectively enrolled between January 2013 and December 2019 in this multicenter, case-matched study. The baseline clinicopathological characteristics of patients were balanced by propensity score matching between the ENPG and IMRT groups. ENPG was performed in patients with easily or potentially resectable tumors. The oncological outcomes as well as treatment-related complications were compared between two groups. Results: A total of 176 patients were enrolled and 106 patients were matched. The ENPG group (n = 53) and the IMRT group (n = 53) showed comparable outcomes in the 3-year overall survival rate (68.4% vs. 65.4%, P = 0.401), cancer-specific survival rate (80.9% vs. 74.4%, P = 0.076), locoregional failure-free survival rate (36.6% vs. 45.3%, P = 0.076), and progression-free survival rate (27.5% vs. 32.3%, P = 0.216). The incidence of severe treatment-related complications of patients in the ENPG group was lower than that in the IMRT group (37.7% vs. 67.9%, P = 0.002). The most common complications were post perioperative hemorrhage (13.2%) in ENPG group and temporal lobe necrosis (47.2%) in IMRT group, respectively. Conclusion: Salvage ENPG exhibits comparable efficacy but less toxicities than IMRT in carefully screened patients with locally advanced rNPC, which may be a new choice of local treatment. [ABSTRACT FROM AUTHOR]

Purpose: An end‐to‐end differentiable 2D Bloch simulation is used to reduce T2 induced blurring in single‐shot turbo spin echo sequences, also called rapid imaging with refocused echoes (RARE) sequences, by using a joint optimization of refocusing flip angles and a convolutional neural network. Methods: Simulation and optimization were performed in the MR‐zero framework. Variable flip angle train and DenseNet parameters were optimized jointly using the instantaneous transverse magnetization, available in our simulation, at a certain echo time, which serves as ideal blurring‐free target. Final optimized sequences were exported for in vivo measurements at a real system (3 T Siemens, PRISMA) using the Pulseq standard. Results: The optimized RARE was able to successfully lower T2‐induced blurring for single‐shot RARE sequences in proton density‐weighted and T2‐weighted images. In addition to an increased sharpness, the neural network allowed correction of the contrast changes to match the theoretical transversal magnetization. The optimization found flip angle design strategies similar to existing literature, however, visual inspection of the images and evaluation of the respective point spread function demonstrated an improved performance. Conclusions: This work demonstrates that when variable flip angles and a convolutional neural network are optimized jointly in an end‐to‐end approach, sequences with more efficient minimization of T2‐induced blurring can be found. This allows faster single‐ or multi‐shot RARE MRI with longer echo trains. [ABSTRACT FROM AUTHOR]

Background: Surgical robots have innovated the microsurgical field by providing advantages that improve surgical performance. These robots have been adopted by certain specialties more than others. This study discusses the potential advantages of robotics in plastic and reconstructive surgery. Method: This study is a literature review of articles investigating "robotic microsurgery in plastic and reconstructive surgery" using the PubMed database and the Cochrane Library. Result: A total of nineteen relevant articles were found and 5 articles performed a direct comparison between the robotic and manual approaches. Longer operating times were reported in the robotic groups featuring higher learning curves. Reported advantages to robotic use included higher accuracy, precision and flexibility, elimination of tremor and improvement of ergonomic factors. Conclusion: While the results provide an outlook into the outcome of robotic platforms in this field, current research is limited and further studies are required to provide a fundamental analysis. [ABSTRACT FROM AUTHOR]

Purpose: Three‐dimensional UTE MRI has shown the ability to provide simultaneous structural and functional lung imaging, but it is limited by respiratory motion and relatively low lung parenchyma SNR. The purpose of this paper is to improve this imaging by using a respiratory phase‐resolved reconstruction approach, named motion‐compensated low‐rank reconstruction (MoCoLoR), which directly incorporates motion compensation into a low‐rank constrained reconstruction model for highly efficient use of the acquired data. Theory and Methods: The MoCoLoR reconstruction is formulated as an optimization problem that includes a low‐rank constraint using estimated motion fields to reduce the rank, optimizing over both the motion fields and reconstructed images. The proposed reconstruction along with XD and motion state–weighted motion‐compensation (MostMoCo) methods were applied to 18 lung MRI scans of pediatric and young adult patients. The data sets were acquired under free‐breathing and without sedation with 3D radial UTE sequences in approximately 5 min. After reconstruction, they went through ventilation analyses. Performance across reconstruction regularization and motion‐state parameters were also investigated. Results: The in vivo experiments results showed that MoCoLoR made efficient use of the data, provided higher apparent SNR compared with state‐of‐the‐art XD reconstruction and MostMoCo reconstructions, and yielded high‐quality respiratory phase‐resolved images for ventilation mapping. The method was effective across the range of patients scanned. Conclusion: The motion‐compensated low‐rank regularized reconstruction approach makes efficient use of acquired data and can improve simultaneous structural and functional lung imaging with 3D‐UTE MRI. It enables the scanning of pediatric patients under free‐breathing and without sedation. [ABSTRACT FROM AUTHOR]

Chinese calligraphy is one of the excellent expressions of Chinese traditional art. But people without domain knowledge of calligraphy can hardly read, appreciate, or learn this art form, due to it contains many brush strokes with unique shapes and complicate structural topological relationship. In this paper, we explore the solution of text sequence recognition of calligraphy, which is a challenging task because traditional algorithms of text recognition can rarely obtain the satisfied results for the varied styles of calligraphy. Therefore, based on a trainable neural network, this paper proposes an easy recognition method, which combines feature sequence extraction based on DenseNet (Dense Convolutional Network) model, sequence modeling and transcription into a consolidated architecture. Compared with previous algorithms for text recognition, it has two distinctive properties: One is to acquire the artistic features on shapes and structures of different styles of calligraphic characters and the other is to handel sequences in arbitrary lengths without character segmentation. Our experimental results prove that in contrast with several common recognition methods, our method of Chinese calligraphic character in diverse styles demonstrates greater robustness, and the recognition accuracy rate reaches 84.70%. [ABSTRACT FROM AUTHOR]

Purpose: To analyze oncological outcomes of endoscopic surgical treatment of locally recurrent EBV-related undifferentiated non-keratinizing nasopharyngeal carcinoma (uNK-NPC) in a non-endemic area., Methods: Retrospective review of patients affected by recurrent uNK-NPC treated with nasopharyngeal endoscopic resection (NER) in a tertiary-care referral center from 2003 to 2022, by evaluating survival rates, prognostic factors, and follow-up strategies., Results: The oncological outcomes of 41 patients were analyzed, over a mean follow-up period of 57 months. The 5-year overall, disease-specific, and disease-free survival of the cohort were 60.7% ± 8.9%, 69% ± 9%, and 39.7% ± 9.2%, respectively. The local (rT) and regional (rN) extension of recurrent disease, stage of disease, and status of resection margins appeared to significantly influence survivals. After a mean follow-up period of 21 months, a further recurrence after NER was observed in 36.6% of cases. Skull base osteonecrosis induced by previous irradiation and post-surgical bone remodeling represent the major challenges for early detection of further local relapses during postoperative follow-up., Conclusion: NER appeared as a safe and effective treatment for recurrent uNK-NPC. The adequate selection of patients eligible for NER is essential, to maximize the chances to cure and minimize the risk of local complications., (© 2024. The Author(s).)

Purpose: Head and neck sarcomas (HNS) constitute a rare and heterogeneous cancer entity. Management remains a challenge due their rarity and different biological behaviour among tens of subtypes. This systematic review aimed to describe HNS global frequency and distribution in adulthood., Methods: A systematic review was performed using PICOTS search strategies for qualitative question and it was written in accordance with PRISMA 2020 Statement. 70,653 publications were identified, and 15 variables were evaluated for a total of 2428 patients., Results: We identified 47 studies from 21 different countries from 5 different continents. Most of studies (83.3%) were performed in single institutions and America and Asia overruled for number of papers included (21 and 10, respectivelly). Osteosarcoma was more frequent, followed by chondrosarcoma, angiosarcoma and malignant fibrous histiocytoma. Early stage accounted for almost 80% of cases; advanced stage prevailed in developing countries. 1783 patients (90.1%) underwent surgery and 780 (39.4%) had adjuvant therapy. 50.8% of patients experienced tumour recurrence and the lowest mortality rate was reported in Europe (29.9%)., Conclusions: HNS holds a relative poor prognosis possibly explained by the heterogeneity of the disease. Treatment of HNS has shown to be highly diverse among different countries, underlining the importance of uniformed treatment guidelines to achieve better patient management and to improve survival outcomes., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The paper describes the evolution of low-field MRI from the very early pioneering days in the late 70 s until today. It is not meant to give a comprehensive historical account of the development of MRI, but rather to highlight the different research environments then and now. In the early 90 s, when low-field systems below 1.5 T essentially vanished, there were just no reasonable means available to make up for the factor of roughly three in signal-to-noise-ratio (SNR) between 0.5 and 1.5 T. This has drastically changed. Improvements in hardware—closed Helium-free magnets, RF receiver systems and especially much faster gradients, much more flexible sampling schemes including parallel imaging and compressed sensing and especially the use of AI at all stages of the imaging process have made low-field MRI a clinically viable supplement to conventional MRI. Ultralow-field MRI with magnets around 0.05 T are also back and constitute a bold and courageous endeavor to bring MRI to communities, which have neither the means nor the infrastructure to sustain a current standard of care MRI. [ABSTRACT FROM AUTHOR]

Head and neck lymphoedema occurs frequently after head and neck cancer treatment and causes physical and psychosocial disability Imaging is not routinely used to diagnose or inform its conservative treatment. Indocyanine green (ICG) lymphography is used for these purposes in upper and lower limb lymphoedema. Aim: The study aimed to explore the clinical potential of ICG lymphography in diagnosis and conservative management ofhead and neck lymphoedema. Methods: Participants underwent a single examination with ICG lymphography The tracer injection sites were determined by anatomic lymphatic territories. Presence of dermal backflow was used to diagnose lymphoedema. Imaging data were recorded using a bespoke audit tool to document lymphatic movement features and manual lymphatic drainage observations. Results: Six participants underwent head and neck ICG lymphography Lymphatic vessels and dermal backflow were visualised in all participants. Manual lymphatic drainage observations suggested all participants required very firm pressure to move the ICG dye through areas of dermal backflow whereas only light pressure was required in areas with linear lymphatic vessel flow: Conclusion: ICG lymphography can identify lymphatic structures and drainage patterns in the head and neck region and is considered a potential tool for diagnosis and conservative treatment planning for head and neck lymphoedema. [ABSTRACT FROM AUTHOR]

Glioblastoma multiforme (GBM) is a primary type of lethal brain tumor. Over the last two decades, temozolomide (TMZ) has remained the primary chemotherapy for GBM. However, TMZ resistance in GBM constitutes an underlying factor contributing to high rates of mortality. Despite intense efforts to understand the mechanisms of therapeutic resistance, there is currently a poor understanding of the molecular processes of drug resistance. For TMZ, several mechanisms linked to therapeutic resistance have been proposed. In the past decade, significant progress in the field of mass spectrometry-based proteomics has been made. This review article discusses the molecular drivers of GBM, within the context of TMZ resistance with a particular emphasis on the potential benefits and insights of using global proteomic techniques. [ABSTRACT FROM AUTHOR]

Bioactive textile materials are a promising field in the development of functional textiles. The integration of bioactive compounds, such as natural dyes, into textiles offers a range of benefits, including UV protection, anti-microbial properties, and insect repellency. Natural dyes have been shown to have bioactivity, and their integration into textiles has been extensively studied. The application of natural dyes on textile substrates will be an advantage for their inherent functional properties along with their non-toxic and eco-friendly nature. This review addresses the effect of natural dyes on surface modification of most used natural and synthetic fibers and its subsequent effects on their anti-microbial, UV protection and insect repellent properties with natural dyes. Natural dyes have proved to be environmentally friendly in an attempt to improve bioactive functions in textile materials. This review provides a clear view of sustainable resources for the dyeing and finishing of textiles to develop a cleaner pathway of bioactive textiles using natural dyes. Furthermore, the dye source, advantages and disadvantages of natural dye, main dye component, and chemical structure are listed. However, there is still a need for interdisciplinary research to further optimize the integration of natural dyes into textiles and to improve their bioactivity, biocompatibility, and sustainability. The development of bioactive textile materials using natural dyes has the potential to revolutionize the textile industry and to provide a range of benefits to consumers and society. [ABSTRACT FROM AUTHOR]

Background Little is known about childhood experiences, outcomes, and self-recollections of those men who were voluntarily castrated as adults. Aim The study sought to determine how learning about castration before and after 13 years of age is associated with differential childhood experiences, outcomes, and self-recollections of those who were voluntarily castrated as adults. Methods We designed a survey of voluntarily castrated individuals, who learned about castration before and after 13 years of age. Our survey consisted of both validated questionnaires and questions. Data were from 208 individuals. Both descriptive and quantitative statistics were performed. Outcomes Learning about castration before 13 years of age is associated with more adverse childhood experiences (ACEs) such as being threatened with castration and other forms of emotional, physical, and sexual trauma. Results As compared with those who learned about castration after 13 years of age, those who knew about castration earlier were more likely to have self-injured their penis (χ21 = 5.342, P  < 0.05), had thoughts of performing self-castration (χ21 = 10.389, P  < 0.01), witnessed animal castration (χ21 = 10.023, P  < 0.01), been threatened with castration as a child (χ21 = 21.749, P  < 0.001), had childhood physical trauma (χ21 = 4.318, P  < 0.05), had childhood emotional trauma (χ21 = 3.939, P  < 0.05), and had childhood sexual trauma (χ21 = 5.862, P  < 0.05). Clinical Implications Mental health screening and support should be offered to any men seeking emasculating procedures in line with the World Professional Association of Transgender Health's Standards of Care Version 8. Strengths and Limitations This study had a large sample size and used a validated questionnaire to evaluate for ACEs. The average age of respondents was above 50 years of age, which may increase recall bias. Conclusion Understanding how ACEs influence the age when some eunuchs first desire, pretend, and become castrated can help clinicians develop better assessments and treatment protocols for individuals with male-to-eunuch gender dysphoria, and other conditions in which emasculating medical procedures are requested. [ABSTRACT FROM AUTHOR]

The 9.4 T scanner in Maastricht is a whole-body magnet with head gradients and parallel RF transmit capability. At the time of the design, it was conceptualized to be one of the best fMRI scanners in the world, but it has also been used for anatomical and diffusion imaging. 9.4 T offers increases in sensitivity and contrast, but the technical ultra-high field (UHF) challenges, such as field inhomogeneities and constraints set by RF power deposition, are exacerbated compared to 7 T. This article reviews some of the 9.4 T work done in Maastricht. Functional imaging experiments included blood oxygenation level-dependent (BOLD) and blood-volume weighted (VASO) fMRI using different readouts. BOLD benefits from shorter T2* at 9.4 T while VASO from longer T1. We show examples of both ex vivo and in vivo anatomical imaging. For many applications, pTx and optimized coils are essential to harness the full potential of 9.4 T. Our experience shows that, while considerable effort was required compared to our 7 T scanner, we could obtain high-quality anatomical and functional data, which illustrates the potential of MR acquisitions at even higher field strengths. The practical challenges of working with a relatively unique system are also discussed. [ABSTRACT FROM AUTHOR]

The article discusses the diagnosis and medical care of men who seek ablation of their genitalia without a desire for feminization. Topics include reasons for not electing vaginoplasty, subgroups of men who seek genital ablation outside of any desire for feminization, and endocrine treatment considerations.