Background: Penile Cancer is a rare and aggressive disease. Related to complex metabolic processes. Objective: This study investigates the effectiveness ­of 18F-FDG PET/CT as a noninvasive method in evaluating penile cancer patients, focusing on the correlation between tissue expression of key tumor markers involved in glucose metabolism and proliferation, and the uptake of 18F-FDG. Methods: Fifty-one patients were selected and underwent 18F-FDG PET/CT-based staging. Semiquantitative analysis wasperformed using the maximum standardized uptake value ­(SUVmax ) and volumetric SUV ­(SUV2SD ). Tissue expressionanalysis of GLUT-1, hexokinase-II, Ki67, p16, and p53 was performed by tissue microarray. PCR evaluated HPV DNA. Results: Warty SCC showed the highest SUV value and significant differences in ­SUVmax (p=0.015). Higher ­SUVmax and SUV2SD values were observed in grade 3 tumors. In typical invasive SCC, grade 3, HPV+, p16-negative, p53-negative,GLUT-1 i-3, and HK-II i-3 tumors showed a higher mean SUV. The Ki-67 value significantly differed for grade 3 tumors (p=0.001) and HK-II i-1 tumors (p=0.036). Ki-67 positivity was also higher in HPV-, p16 i-2, p53 i-3, and GLUT-1 i-3 tumors; none of the differences were statistically significant. Conclusions The study highlights correlations between the uptake of 18F-FDG and the expression of markers associated with glycolytic metabolism in penile cancer. It suggests a potential trend where increased expression of glucose transport markers is linked to higher histological grades and Ki-67 expression. There were no significant differences regarding HPV positivity, demonstrating the complexity of penile cancer molecular biology and need more studies with a higher number of patients.

Background: Penile Cancer is a rare and aggressive disease. Related to complex metabolic processes. Objective: This study investigates the effectiveness ­of 18F-FDG PET/CT as a noninvasive method in evaluating penile cancer patients, focusing on the correlation between tissue expression of key tumor markers involved in glucose metabolism and proliferation, and the uptake of 18F-FDG. Methods: Fifty-one patients were selected and underwent 18F-FDG PET/CT-based staging. Semiquantitative analysis wasperformed using the maximum standardized uptake value ­(SUVmax ) and volumetric SUV ­(SUV2SD ). Tissue expressionanalysis of GLUT-1, hexokinase-II, Ki67, p16, and p53 was performed by tissue microarray. PCR evaluated HPV DNA. Results: Warty SCC showed the highest SUV value and significant differences in ­SUVmax (p=0.015). Higher ­SUVmax and SUV2SD values were observed in grade 3 tumors. In typical invasive SCC, grade 3, HPV+, p16-negative, p53-negative,GLUT-1 i-3, and HK-II i-3 tumors showed a higher mean SUV. The Ki-67 value significantly differed for grade 3 tumors (p=0.001) and HK-II i-1 tumors (p=0.036). Ki-67 positivity was also higher in HPV-, p16 i-2, p53 i-3, and GLUT-1 i-3 tumors; none of the differences were statistically significant. Conclusions The study highlights correlations between the uptake of 18F-FDG and the expression of markers associated with glycolytic metabolism in penile cancer. It suggests a potential trend where increased expression of glucose transport markers is linked to higher histological grades and Ki-67 expression. There were no significant differences regarding HPV positivity, demonstrating the complexity of penile cancer molecular biology and need more studies with a higher number of patients.

Background: Penile Cancer is a rare and aggressive disease. Related to complex metabolic processes. Objective: This study investigates the effectiveness ­of 18F-FDG PET/CT as a noninvasive method in evaluating penile cancer patients, focusing on the correlation between tissue expression of key tumor markers involved in glucose metabolism and proliferation, and the uptake of 18F-FDG. Methods: Fifty-one patients were selected and underwent 18F-FDG PET/CT-based staging. Semiquantitative analysis wasperformed using the maximum standardized uptake value ­(SUVmax ) and volumetric SUV ­(SUV2SD ). Tissue expressionanalysis of GLUT-1, hexokinase-II, Ki67, p16, and p53 was performed by tissue microarray. PCR evaluated HPV DNA. Results: Warty SCC showed the highest SUV value and significant differences in ­SUVmax (p=0.015). Higher ­SUVmax and SUV2SD values were observed in grade 3 tumors. In typical invasive SCC, grade 3, HPV+, p16-negative, p53-negative,GLUT-1 i-3, and HK-II i-3 tumors showed a higher mean SUV. The Ki-67 value significantly differed for grade 3 tumors (p=0.001) and HK-II i-1 tumors (p=0.036). Ki-67 positivity was also higher in HPV-, p16 i-2, p53 i-3, and GLUT-1 i-3 tumors; none of the differences were statistically significant. Conclusions The study highlights correlations between the uptake of 18F-FDG and the expression of markers associated with glycolytic metabolism in penile cancer. It suggests a potential trend where increased expression of glucose transport markers is linked to higher histological grades and Ki-67 expression. There were no significant differences regarding HPV positivity, demonstrating the complexity of penile cancer molecular biology and need more studies with a higher number of patients.

Background: Penile Cancer is a rare and aggressive disease. Related to complex metabolic processes. Objective: This study investigates the effectiveness ­of 18F-FDG PET/CT as a noninvasive method in evaluating penile cancer patients, focusing on the correlation between tissue expression of key tumor markers involved in glucose metabolism and proliferation, and the uptake of 18F-FDG. Methods: Fifty-one patients were selected and underwent 18F-FDG PET/CT-based staging. Semiquantitative analysis wasperformed using the maximum standardized uptake value ­(SUVmax ) and volumetric SUV ­(SUV2SD ). Tissue expressionanalysis of GLUT-1, hexokinase-II, Ki67, p16, and p53 was performed by tissue microarray. PCR evaluated HPV DNA. Results: Warty SCC showed the highest SUV value and significant differences in ­SUVmax (p=0.015). Higher ­SUVmax and SUV2SD values were observed in grade 3 tumors. In typical invasive SCC, grade 3, HPV+, p16-negative, p53-negative,GLUT-1 i-3, and HK-II i-3 tumors showed a higher mean SUV. The Ki-67 value significantly differed for grade 3 tumors (p=0.001) and HK-II i-1 tumors (p=0.036). Ki-67 positivity was also higher in HPV-, p16 i-2, p53 i-3, and GLUT-1 i-3 tumors; none of the differences were statistically significant. Conclusions The study highlights correlations between the uptake of 18F-FDG and the expression of markers associated with glycolytic metabolism in penile cancer. It suggests a potential trend where increased expression of glucose transport markers is linked to higher histological grades and Ki-67 expression. There were no significant differences regarding HPV positivity, demonstrating the complexity of penile cancer molecular biology and need more studies with a higher number of patients.

Background: Penile Cancer is a rare and aggressive disease. Related to complex metabolic processes. Objective: This study investigates the effectiveness ­of 18F-FDG PET/CT as a noninvasive method in evaluating penile cancer patients, focusing on the correlation between tissue expression of key tumor markers involved in glucose metabolism and proliferation, and the uptake of 18F-FDG. Methods: Fifty-one patients were selected and underwent 18F-FDG PET/CT-based staging. Semiquantitative analysis wasperformed using the maximum standardized uptake value ­(SUVmax ) and volumetric SUV ­(SUV2SD ). Tissue expressionanalysis of GLUT-1, hexokinase-II, Ki67, p16, and p53 was performed by tissue microarray. PCR evaluated HPV DNA. Results: Warty SCC showed the highest SUV value and significant differences in ­SUVmax (p=0.015). Higher ­SUVmax and SUV2SD values were observed in grade 3 tumors. In typical invasive SCC, grade 3, HPV+, p16-negative, p53-negative,GLUT-1 i-3, and HK-II i-3 tumors showed a higher mean SUV. The Ki-67 value significantly differed for grade 3 tumors (p=0.001) and HK-II i-1 tumors (p=0.036). Ki-67 positivity was also higher in HPV-, p16 i-2, p53 i-3, and GLUT-1 i-3 tumors; none of the differences were statistically significant. Conclusions The study highlights correlations between the uptake of 18F-FDG and the expression of markers associated with glycolytic metabolism in penile cancer. It suggests a potential trend where increased expression of glucose transport markers is linked to higher histological grades and Ki-67 expression. There were no significant differences regarding HPV positivity, demonstrating the complexity of penile cancer molecular biology and need more studies with a higher number of patients.

Azoospermia is the complete absence of spermatozoa in the ejaculate in two or more semen analyses after centrifugation. Nonobstructive azoospermia (NOA) represents the most severe form of male factor infertility accounting for 10%-15% of cases and stems from an impairment to spermatogenesis. Understanding of the hypothalamic-pituitary-testicular axis has allowed NOA to be subcategorized by anatomic and/or pathophysiologic level. The etiologies of NOA, and therefore, the differential diagnoses when considering NOA as a cause of male factor infertility, can be subcategorized and condensed into several distinct classifications. Etiologies of NOA include primary hypogonadism, secondary hypogonadism, defects in androgen synthesis and/or response, defective spermatogenesis and sperm maturation, or a mixed picture thereof. This review includes up-to-date clinical, diagnostic, cellular, and histologic features pertaining to the multitude of NOA etiologies. This in turn will provide a framework by which physicians practicing infertility can augment their clinical decision-making, patient counseling, thereby improving upon the management of men with NOA.
Humans ; Azoospermia/diagnosis* ; Male ; Spermatogenesis/physiology* ; Hypogonadism/complications* ; Infertility, Male/etiology* ; Testis/pathology*

Background: Combining lidocaine with bupivacaine in brachial plexus blocks seeks to blend rapid onset with extended duration; yet, clinical advantages are uncertain. This systematic review assesses their efficacy against bupivacaine alone in ultrasound-guided brachial plexus blocks. Methods: A systematic search of PubMed, EMBASE, and Cochrane databases was conducted in May 2025. Randomized controlled trials (RCTs) comparing lidocaine-bupivacaine mixtures with bupivacaine alone in ultrasound-guided brachial plexus blocks were included. The primary outcome was sensory block onset time. Secondary outcomes included motor block onset time, sensory and motor block durations, and conversion to general anesthesia. Data were analyzed using a random-effects model, with heterogeneity assessed via I² statistics. Results: Of 1,490 identified articles, 7 RCTs (358 patients) met the inclusion criteria. No significant difference was found in sensory block onset time (mean difference [MD] –1.81 min, 95% confidence interval [CI] –3.92 to 0.29; P = 0.09; I² = 98%) or motor block onset time (MD 0.02 min, 95% CI –2.34 to 2.39; P = 0.99; I² = 95%) between groups. The mixture reduced sensory (MD –172.88 min, 95% CI –215.18 to –130.59; P<0.00001; I² = 90%) and motor block durations (MD –212.13 min, 95% CI –374.99 to –49.28; P = 0.01; I² = 93%). Conclusions No clinical benefit was observed from combining lidocaine with bupivacaine, as there was no improvement in block onset times and a reduction in block durations. Given the very low certainty of evidence, these findings should be interpreted with caution, and further high-quality RCTs are needed.