Introduction: Our aim was to evaluate the procedure and outcome of penile PROSTHESIS surgery in the treatment of men with postpriapism erectile dysfunction.Materials and Methods: During the period between 1997 and 2004, a total of 17 patients with postpriapism erectile dysfunction underwent penile PROSTHESIS IMPLANTATION at our institution. PROSTHESIS IMPLANTATION was done electively 6 to 18 months after priapism, when the patients presented with erectile dysfunction. Of the PROSTHESIS implanted, 11 were malleable, 4 were 2-piece, and 2 were 3-piece prostheses (AMS, Minnetonka, Minnesota, USA).Results: All the 17 patients were successfully implanted with penile PROSTHESIS. Intra-operatively, corporeal dilation was difficult due to extensive corporeal fibrosis, which led to urethral injury in 2 patients. There were no major postoperative complications. The median hospital stay was 5 days. The follow-up period ranged from 2 to 9 years (median, 6 years). All the patients were satisfied with the PROSTHESIS.Conclusion: Penile PROSTHESIS IMPLANTATION is the modality of treatment for patients with postpriapism erectile dysfunction at our institution. It has a high patient satisfaction rate. Although procedure-related complications are common due to corporeal fibrosis, they were mostly minor ones and did not affect the outcome of the procedure.

Total hip arthroplasty (THA) is the replacement of the hip joint by artificial PROSTHESIS. This surgery is one of the most successful orthopaedic surgeries. The most important challenge to the THA is bearing surface of these implants, which is closely related to the survival of the PROSTHESIS. Following the introduction of the first successful implant in THA, there has been great progress in implant production, by increasing the power and reducing the friability and wear of the bearing surfaces. The wear particles can remain in the host tissue, generate osteolysis and reduce the implant survival. These problems with bearing surfaces have led to creation of other bearing surfaces such as metal-on-polyethylene, metal-onmetal, ceramic-on-ceramic and ceramic-on-polyethylene with improved characteristics. Such types of implants can be used for young and more active patient, in addition to the elderly who is less active. In the present review, the different type of bearing surfaces with their advantages and disadvantages has been discussed.

Total Hip Replacement has become one of the very common orthopedic surgeries that provide better life conditions for patients suffering from complex and painful hip problems. Considering the increasing growth of such surgeries, it is necessary to get familiarized with new challenges and threats in the hip arthroplasty. The wear and corrosion in variable design of stems has always been a debated issue. This paper tries to describe the scientific knowledge of problems in wear and corrosion of stem's neck cone region because neglecting this issue may cause a disaster.The corrosion caused by friction and wear in the surface shared between prosthetic head and cone region of prosthetic stem neck is called taperosis. Small particles and metallic ions are released onto the polyethylene liners of a hip arthroplasty and result into metalosis, leading to osteolysis and eventually to instability of PROSTHESIS. Although the clinical importance of taperosis is still unclear; its destructive interaction in hip arthroplasty medium is gaining more importance. This article reviews the key papers of previous and recent studies in this context to describe this challenge, and also tries to clarify the importance of this issue.

Objectives: Redo mitral valve replacement (MVR) is an important therapeutic approach in patients with the malfunction of the prosthetic mitral valve, especially in patients with severe dyspnea or a large thrombus burden. Redo replacement (MVR) and thrombectomy are different surgical approaches in these patients. This study evaluated the outcome of the second mitral valve surgery including mechanical MVR (M-MVR), biologic MVR (B-MVR), and surgical thrombectomy. Materials and Methods: To this end, 71 patients were included in this study, who underwent second mitral valve surgery following the malfunction of the prosthetic mitral valve in the last 10 years. These patients were divided into M-MVR, B-MVR, and surgical thrombectomy groups and their demographic, clinical, echocardiographic, and laboratory findings were gathered as well. Then, the patients were evaluated for their third MV surgery if it was performed, followed by evaluating the pump time and cross-clamp time Results: Fifty-seven, 8, and 6 patients underwent M-MVR, B-MVR, and thrombectomy, respectively. Based on the results, the mortality rate was not significantly different between the 3 groups (P = 0. 059). In addition, 12 patients underwent the third surgery with the highest (100%) and lowest (0%) rates at thrombectomy and B-MVR groups, respectively. Higher pump time and cross-clamp time were significantly associated with an increased mortality rate (P = 0. 014 and P = 0. 026, respectively). Conclusions: In the malfunction of the prosthetic mitral valve, mortality rate failed to significantly differ between the patients undergoing M-MVR, B-MVR, and thrombectomy but third surgery is often needed after thrombectomy. It seems that the replacement of previous prosthetic valve with a new mechanical or biological valve yields better results in the case of prosthetic valve malfunction.

Late complications requiring surgical intervention following pacemaker IMPLANTATION are rare. Pacemaker erosion may be caused by primary infection or a noninfectious process such as mechanical pressure. In this report, a case of severe pacemaker erosion is presented in an 83 yearold female with a history of complete heart block who underwent dual chamber pacemaker IMPLANTATION. One year after the implementation, the patient was referred due to noninfectious erosion of the pacemaker generator. The generator was re-implanted under the pectoralis muscle and the pacemaker erosion was treated without complication.

Introduction: Laryngeal stenosis has various causes and treatment options. Endoscopic resection of the stenotic part with CO2 laser is one of the treatment options of laryngotracheal stenosis. Keels are useful for preventing adhesion formation, restenosis and web formation, which may happen during the later stage. They can be put in place either via the endoscopic approach or through a micro thyroidotomy and are held in place with a heavy suture through cricothyroid and thyrohyoid membranes. They are left in place for two to four weeks, and then removed through the endoscopic approach under general anesthetics.Case Presentation: We report on a case of anterior glottis stenosis with keel aspiration for two weeks, after endoscopic CO2 laser resection of the stenotic section and keel placement. The patient was admitted to our center, where bronchoscopy was performed and the keel was removed. A new custom-made silastic keel was properly placed in raw areas and fixed to the skin with suture through the cricothyroid and thyrohyoid membranes. The keel was removed three weeks later.Conclusions: Endoscopic keel placement should be done with heavy suture through cricothyroid and thyrohyoid membranes. Surgeons should suture the keel to the anterior laryngeal wall with specially designed Lichtenberger’s needle-carriers to prevent complications such as keel aspiration, adhesion formation and imposing a second trip under general anesthetics, which put the patient at increased risk. The false vocal cord microflaps, as biological keels and a relatively new method may replace silastic keel placement in the future.

The authors have addressed an important issue. Congratulation! Type 2 diabetes mellitus (DM) is a complex and multifactor metabolic disorder. One of the complications of type 2 DM is the sexual dysfunction, mainly in the form of erectile dysfunction in men. Hemoglobin A1C (HbA1c) is an invaluable tool for watching long-term glycemic control in patients with DM. In present retrospective study the authors aimed to determine the relationship between sexual activity and serum levels of HbA1c with an inappropriate manner. As a result, the manuscript suffers from some important drawbacks. There are many confounding factors which can interfere with serum HbA1c concentration measurements. Also, there are several situations in which the level of HbA1c may not loyally reflect the actual values. Without adjusting for these confounding factors, the results might not be reliable.

Introduction: Relatively high prevalence of facial deficiencies caused by trauma and the need for ablative surgeries in maxillofacial cancers, cause aesthetic and functional problems for patients which can be rehabilitated with surgery, PROSTHESIS or both of them. Prosthetic reconstruction for these patients has many advantages such as controlling wound healing, aesthetic, easy  and non expensive treatment. In this article the process for nose PROSTHESIS fabrication with silicon materials has been presented step by step.Results: A 49 year-old female patient with past medical history of diabetes mellitus that had rhino-cerebral mucormycosis following by diabetic coma and had under gone ablative surgery in hospital. The resected regions in this surgery included nasal septum, superior, Middle and inferior conchea, anterior wall of ethmoid sinus, middle wall of maxillary sinus and anterior wall of sphenoid sinus, in addition to parts of hardpalate (maxillary anterior alveolar segment). She said that after the surgery, she rarely showed up in the public and always covered the defect with a guaze. Her speech was completely hypernasal and she had difficulty in swallowing. For satisfying her functional and aesthetic needs, a nasal silicon PROSTHESIS attached to obturator PROSTHESIS in maxilla with magnet retention was fabricated.Conclusion: Reconstruction of Midface deficiencies according to defect region, its extension and patient's age can be accompolished with surgery, PROSTHESIS or a combination of both approaches. In this patient, a nasal PROSTHESIS and maxillary obturator was fabricated. In this article nasal PROSTHESIS fabrication step by step was explained.

Purpose: To examine the benefits of sexual activity on glycated hemoglobin (HbA1c)in penile PROSTHESIS implanted patients with type 2 diabetes mellitus (DM). Materials and Methods: Sixty-seven male subjects who had HbA1c levels of ≥ 6. 5% before and could perform regular sexual activity after the IMPLANTATIONs were enrolled. The contribution of sexual activity on glycemic control assessed by HbA1clevel as well as age, duration of DM and frequency of sexual activity were evaluated. Results: Mean age and mean time from the surgery of the study patients was 59. 9 years (range, 30-82) and 22. 6 months (range, 10-63), respectively. The average of penile PROSTHESIS usage for sexual activity was 9. 9 times per month (range, 2-28). Compared with the preIMPLANTATION, the absolute mean change in HbA1c after penile PROSTHESIS IMPLANTATION was found as-0. 2% (P >. 05). This study also revealed that more sexual activity was associated with more reduction in HbA1c. Conclusion: The present study demonstrated that sexual activity is associated with HbA1c reduction, which is clinically important in patients with type 2 DM after penile PROSTHESIS IMPLANTATION.