ObjectivesFournier’s gangrene (FG) is an devastating disease that affects the perineum and genitourinary region, and is commonly a result of poly-microbial infection. This study is aimed to determine the correlation between micrology and prognosis of FG in the past five years.MethodsThis study was a retrospective cohort study that was designed to study the trends in micrology and prognosis of FG. From the PubMed database, articles published in the recent 5 years (from Jan1st, 2009 to Dec 31st, 2013) were reviewed. A total of 19 articles (each with n > 30 and with thorough data descriptions in the topic of Fournier's gangrene), were enrolled in this study. The consolidated data was further analyzed by commercial statistical software (SPSS for Windows).ResultsThe twenty-two studies have covered FG cases from year 1981 to 2011, with a mean duration of 9.2 years. The total number of cases is 4,365. Majority of the cases are male (84.1%). The mean age and mortality rate is 51.8 ± 5 years old and 11.1 ± 8.9%, respectivly. The most commonly found pathogen is poly-microbial organism (54%), followed by Escherichia coli (46.6%) and Streptococcus (36.8%). The major risk factors are diabetes (43.7%), Body mass index of > 30 (40.7%), and hypertension (38.1%). Mortality rate in older patient group (age > 51.8 years old) is significantly higher than those of the younger group (22% vs. 5.5%, p = 0.0001).ConclusionsOlder patients with genital or perineal pain should be examined for crepitus dermis. When a patient is diagnosed with FG, swift consultation with surgeons and administration of broad-spectrum antibiotics are required in order to save the patient’s live.Electronic supplementary materialThe online version of this article (doi:10.1186/s40064-014-0783-8) contains supplementary material, which is available to authorized users.

The present study investigated the role of adenosine in the stimulatory action of paeoniflorin on in vitro glucose transport. Paeoniflorin increased the uptake of a radiolabeled, non-metabolizable glucose derivative into isolated white adipocytes of Wistar rat in a concentration-dependent manner and this action was abolished by the antagonist, 8-cyclopentyltheophylline, at concentrations sufficient to block the adenosine A 1 receptor. However, paeoniflorin failed to displace the binding of [3H]-8-cyclopentyl-1,3-dipropylxanthine in the isolated cerebrocortex of Wistar rat. Direct activation of the adenosine A 1 receptor does not seem to be responsible for the action of paeoniflorin. The stimulatory effect of paeoniflorin on radioactive glucose uptake was abolished in isolated rat white adipocytes pre-incubated with the adenosine deaminase at concentrations sufficient to metabolize endogenous adenosine. Mediation of endogenous adenosine in the action of paeoniflorin was further supported by the assay of adenosine released into the medium from rat white adipocytes incubated with paeoniflorin. These findings suggest that paeoniflorin could induce the release of adenosine from isolated rat white adipocytes and the released adenosine may activate the adenosine A 1 receptor to enhance glucose uptake.

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