Recent clinical and imaging studies suggest that sex hormones modulate sexuality according to a psychophysiologic process of lateralization of the brain, with androgens playing a greater role in sexual functioning of left hemibrain/right handedness and estrogens possibly for right hemibrain/left handedness. Based on this perspective, the current study attempted to specify the relationship between hand preference, estrogens, and sexual function in subjects with male breast cancer, taking into account the sexual side effects of tamoxifen as the agent for inhibiting estrogen action. Twenty-eight Romanian men-17 right-handed and 11 left-handed-undergoing treatment with tamoxifen for male breast cancer participated in this study. These men were assessed both prior to and during tamoxifen treatment using the International Index of Erectile Function, a standardized instrument used for the evaluation of various aspects of sexual functioning, including erectile function (EF), orgasmic function (OF), sexual desire (SD), and overall functioning (OF). A main effect for handedness was found on EF, OF, SD, and OS scales, with right-handed men showing higher functioning than left-handed men. Regarding interaction effects, the left-handed group of men showed greater decreased sexual functioning during tamoxifen (on three subscales: OF, SD, OS) compared to right-handed men. Further research should be conducted in order to support and refine this potential lateralized process of sexual neuromodulation within the brain.

This is a video submission for an interesting caseA 66 year-old lady was previously repeated admitted for vomiting and aspiration pneumonia. EGD showed a suspected hiatal hernia with gastric volvus. Endoscopic reduction was performed and the patient was scheduled for operation. Intra-operatively, it was noted that there were no hiatal hernia but a left diaphragmatic hernia was present. The hernial contents were reduced and the sac excised. The diaphragmatic defect was then closed primarily and reinforced with a 10 x 10cm biological mesh. An anterior partial fundoplication was also performed and the hiatus was closed.

This is a video submission for an interesting caseA 66 year-old lady was previously repeated admitted for vomiting and aspiration pneumonia. EGD showed a suspected hiatal hernia with gastric volvus. Endoscopic reduction was performed and the patient was scheduled for operation. Intra-operatively, it was noted that there were no hiatal hernia but a left diaphragmatic hernia was present. The hernial contents were reduced and the sac excised. The diaphragmatic defect was then closed primarily and reinforced with a 10 x 10cm biological mesh. An anterior partial fundoplication was also performed and the hiatus was closed.

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