Development of the human prepuce and its innervation.

Development of the human prepuce was studied over the course of 9-17 weeks of gestation in 30 specimens. Scanning electron microscopy revealed subtle surface features that were associated with preputial development, namely the appearance of epidermal aggregates that appeared to be associated with formation of the preputial fold. Transverse and sagittal sections revealed that the epidermis of the glans is considerably thicker than that of the penile shaft. We described a novel morphogenetic mechanism of formation of the preputial lamina, namely the splitting of the thick epidermis of the glans into the preputial lamina and the epidermis via the intrusion of mesenchyme containing red blood cells and CD31-positive blood vessels. This process begins at 10-11 weeks of gestation in the proximal aspect of the glans and extends distally. The process is likely to be androgen-dependent and mediated via androgen receptors strategically localized to the morphogenetic process, but signaling through estrogen receptor may play a role. Estrogen receptor alpha (ESR1) has a very limited expression in the developing human glans and prepuce, while estrogen receptor beta (ESR2) is expressed more broadly in the developing preputial lamina, epidermis and urethra. Examination of the ontogeny of innervation of the glans penis and prepuce reveals the presence of the dorsal nerve of the penis as early as 9 weeks of gestation. Nerve fibers enter the glans penis proximally and extend distally over several weeks to eventually reach the distal aspect of the glans and prepuce by 14-16 weeks of gestation

Complex Word Identification: Challenges in Data Annotation and System Performance

This paper revisits the problem of complex word identification (CWI) following up the SemEval CWI shared task. We use ensemble classifiers to investigate how well computational methods can discriminate between complex and non-complex words. Furthermore, we analyze the classification performance to understand what makes lexical complexity challenging. Our findings show that most systems performed poorly on the SemEval CWI dataset, and one of the reasons for that is the way in which human annotation was performed.Comment: Proceedings of the 4th Workshop on NLP Techniques for Educational Applications (NLPTEA 2017

Midwifery basics. Infant feeding: Managing baby related challenges

Infant feeding: is the twelfth series of ‘Midwifery basics’ targeted at practising midwives. It aims to provide information to raise awareness of the impact of the work of midwives on women’s experience and encourage midwives to seek further information through a series of activities. In this fifth article Joyce Marshall considers a range of baby related issues that pose challenges for both mothers and midwives in relation to infant feeding

Moths of the Douglas Lake Region (Emmet and Cheboygan Counties), MIchigan: I. Sphingidae - Ctenuchidae (Lepidoptera)

Excerpt: For more than 60 years, workers at the University of Michigan Biological Station have been concerned with the flora and fauna of the Douglas Lake Region - now generally defined, for ease of boundaries. as Emmet and Cheboygan counties, which share the northern tip of the Lower Peninsula of Michigan. In 1915, Paul S. Welch published a list of Lepidoptera taken in the immediate vicinity of Douglas Lake, based on collections made from 19 1 1 to 19 13. The list includes 16 species in the families here considered (those before the Noctuidae in most checklists). A somewhat larger number of species, 55, were attributed to one (usually Cheboygan) or both of these counties in Moore\u27s list of the moths of Michigan (1955) -- a few of them credited solely on the basis of Welch\u27s list. 1 am now able to list 73 species in these families, all represented by extant specimens, and it seems well to assemble the information into compact form, as has been done for the butterflies (Voss. 1954, supplemented by Voss & Wagner, 1956). Additional species will certainly turn up in future years, in the field or in unexamined collections

Lingual frenulum alteration and chewing interference

OBJETIVO: verificar se indivíduos com alteração do frênulo da língua apresentam alteração na mobilidade da língua e na mastigação. MÉTODOS: a casuística desta pesquisa foi composta por dois grupos, um alvo e outro controle, cada um deles com 10 indivíduos. O grupo alvo apresentava alteração de frênulo da língua. Todos foram submetidos aos protocolos de avaliação de frênulo da língua e de mastigação. As provas de mobilidade da língua e de mastigação foram filmadas. Todos os frênulos da língua foram fotografados. RESULTADOS: os dados coletados mostraram que os indivíduos com alteração do frênulo têm 5,447 vezes mais chance de apresentar alteração na mobilidade da língua que indivíduos com frênulo normal. Os indivíduos com alterações da mobilidade da língua não mantiveram constância quanto ao tempo mastigatório. Quanto à mastigação no Modo de Trituração, 100% dos indivíduos do grupo controle utilizaram os dentes posteriores. Entre os indivíduos com alteração do frênulo da língua, 47% mastigaram usando os dentes posteriores e 53% utilizaram os dentes anteriores e/ou fizeram amassamento com a língua. Com relação as atipias musculares, os indivíduos com alteração de frênulo possuíram 5,714 vezes mais chance de apresentá-las durante a mastigação que os indivíduos do grupo controle. CONCLUSÃO: indivíduos com alterações do frênulo da língua apresentaram alterações dos movimentos da língua e alterações na mastigação.PURPOSE: to check if individuals with lingual frenulum alteration demonstrate chewing interference. METHODS: the casuistry of this research was carried out with two groups, a target and a control group, each one with ten individuals. The target group had lingual frenulum alteration. All subjects were submitted to lingual frenulum and chewing evaluation protocols. This procedure was recorded. RESULTS: the collected samples showed that individuals with lingual frenulum alteration have 5.447 times more chances of show tongue mobility alteration than individuals with normal frenulum. Subjects with tongue mobility alteration haven't kept regularity when it comes to mastication period. As for the chewing, on the grinding mode, 100% of the control group used the back teeth. Among the subjects with frenulum alteration, 47% used the back teeth and 53% chewed with the front teeth and/or mashing with the tongue. Regarding muscle atypical movements, individuals with frenulum alteration have 5.714 times more chances to show them during the chewing than individuals from the control group. CONCLUSION: individuals with lingual frenulum alteration showed tongue mobility alteration and mastication alterations

Multidisciplinary management of ankyloglossia in childhood. Treatment of 101 cases. A protocol

Background: Partial ankyloglossia is a limitation which restricts the possibility of protrusion and elevation of the tip of the tongue due to the shortness of either the lingual frenulum or the genioglossus muscles or both. The principal objective of this paper is to present our protocol of action for the treatment of ankyloglossia. The specific objectives are to study patients with ankyloglossia treated by the Service of Maxillofacial Surgery and the Service of Speech Therapy of our pediatric Hospital, describe the diagnostic procedures, the pre-surgical intervention, the surgical technique undertaken and the post-surgical rehabilitation taking into account the level of collaboration of the patients, and finally, describe the surgical complications and the referral of patients. Material and Methods: This is a descriptive study of healthy patients, without any diagnosis of syndrome, ranging between 4 and 14 years that have been surgically treated and rehabilitated post-surgery within a period of 2 years. Results: 101 frenectomies and lingual plasties have been performed and patients have been treated following the protocol of action that we hereby present. After the surgical intervention, the degree of ankyloglossia has been improved, considering correction in 29 (28%) of the patients (95% CI: 20%, 38%), reaching, with the post-surgical orofacial rehabilitation, a correction of 97 (96%) of the participants (95% CI: 90%, 98%). Conclusions: The chosen surgical technique for moderate-severe ankyloglossia in our centre is the frenectomy and lingual plasty. The myofunctional training begins one week before the surgical intervention so that the patients learn the exercises without pain

Subcutaneous Leiomyosarcoma of the Frenulum

Leiomyosarcomas of the penis are rare, with only 29 reported cases to date. We record the case of a patient who presented with a 2-year history of a seemingly indolent penile skin lesion. On histopathology of the local resection, a diagnosis of subcutaneous leiomyosarcoma was made. Specifically, leiomyosarcoma of the penile frenulum has not been clearly reported previously. The patient underwent a further excision to ensure an adequate resection margin and has had no disease recurrence at subsequent follow-up. Our case was of a lesion that, although clinically benign, was malignant and this possibility should be borne in mind when assessing patients

Genital Male Piercings

Body piercing has been practiced for thousands of years all over the world for beautification, religion, initiation rites or status reasons. Genital piercings also have a significant background and have been practiced for enhancing sexual pleasure, chastity, shocking or as a protest against a conservative society. As the popularity of genital piercings increased in the last years, the number of complications is also on the rise. It is therefore important for the medical professionals to have at least basic knowledge regarding this practice, as it might be required in the management of unpredictable complications

A casemix analysis of hospital admissions in six specialties for Barking & Havering Health Authority.

To examine admission rates for Barking & Havering residents to six surgical specialties by first looking at elective, emergency and total workloads, then at the casemix of elective work using Healthcare Resource Groups. To compare findings to other London areas

Oral characteristics of Trisomy 8 and monosomy 18: a case report

Several reports described various mosaic chromosomal syndromes characterized by alterations originated by either an excess or deficit in the number of chromosomes. A case of mosaic trisomy 8 and monosomy 18 with significant involvement of the oral cavity is described, both in terms of general medicine and from a dental-oral perspective, and the treatment plan was planned and discussed. Regular follow-up visits enabled to verify significant improvement in all parameters of the patient’s oral health, which urged us to press on with our quest to protect the right to health of patients affected by disabilities