bluuebunny/crossref_metadata_2025 huggingface dataset:
Raised by Another Mother: Informal Fostering and Kinship Ambiguities in Northwest Ecuador
Authors: Walmsley Emily
Published: October 2008

El estudio del acogimiento familiar en diversos contextos culturales plantea cuestiones sobre los significados locales del parentesco, la niñez y la reproducción doméstica. Empleando el caso de Esmeraldas, una ciudad en el noroeste del Ecuador, este artículo considera cómo la costumbre de acoger a niños de una manera informal subraya tanto la flexibilidad en las redes familiares como la perdurable importancia de la consanguinidad. El material etnográfico indica que, a través de las prácticas culturales cotidianas, muchos de estos niños llegan a ser íntimamente incorporados a las redes de parentesco de las familias que los crian. Al mismo tiempo, el material indica que las experiencias de tales niños varían bastante, sugiriendo que esas redes no son siempre, ni necesariamente, abiertas e inclusivas, y que muchas veces el significado de los lazos de sangre sigue siendo muy fuerte. Para entender las relaciones ambiguas que surgen en esta situación, este estudio se enfoca en los papeles de niños en las casas esmeraldeñas, y en la manera en que los procesos sociales de incorporarlos a las redes familiares pueden, de un lado, reemplazar y, de otro lado, limitar los lazos biogenéticos del parentesco.

The study of fostering practices raises questions about local meanings of kinship, childhood, and household reproduction. Using the case of Esmeraldas, a city in northwest Ecuador, the article considers how the practice of informally fostering children draws attention to a concurrent flexibility in kinship networks and enduring importance of consanguinity. The ethnographic material indicates that, through everyday cultural practices, many of these children become bound into close ties of relatedness with the families that raise them. But it also reveals that the children's experiences are extremely varied, suggesting that kin networks are not always, necessarily open and inclusive, and that the significance of blood ties often remains strong. In order to make sense of the ambiguous relationships that consequently emerge the study focuses on children's roles in Esmeraldan households and on the way in which the social processes of making them kin can both supersede and be limited by biogenetic ties of relatedness.
Essential Commitments: Identity and the Politics of Cofán Conservation
Authors: Cepek Michael L.
Published: October 2008

En este artículo, exploro las implicaciones de los discursos ambientalistas indígenas a partir de una investigaciòn sobre el papel del ambientalismo en la vida cotidiana y proyectos políticos del pueblo Cofán de la Amazonía Ecuatoriana. En mi análisis de los discursos y prácticas Cofánes, me pregunto sobre el valor de una perspectiva “anti‐esencialista”, en la retórica ambientalista de los pueblos indígenas como producto instrumental de la política transnacional de identidad. En este sentido, trato de superar las falencias del anti‐esencialismo con una presentación etnográfica del sistema de valorizaciones propias de la gente de Cofán frente al ambiente Amazónico. Sostengo que la apreciación de las conexiones substantivas entre su cultura, identidad, y territorio tradicional determinan la orientación de su participación política en un proceso de auto‐determinación y que consideran compromisos de conservación en base a derechos políticos. En conclusión, las implicaciones más amplias de las propuestas políticas Cofán se encuentran asociadas a una nueva forma de relación entre la gente indígena, el estado, y los movimientos globales de conservación ambiental.

In this paper, I explore the meaning of indigenous environmental discourses by investigating the role of conservationism in the everyday lives and political projects of the Cofán people of Amazonian Ecuador. In my analysis of Cofán discourse and practice, I question the productivity of “antiessentialist” approaches, which portray indigenous peoples' environmentalist rhetoric as an instrumental product of transnational identity politics. I seek to move past the blind spots of antiessentialism by constructing an ethnographic account of Cofán people's shifting valorizations of the Amazonian environment. I argue that Cofán actors' appreciation of the substantive connections between their culture, their identity, and their traditional territory orients their participation in a process of self‐determination that bases political rights on conservationist commitments. I conclude by considering the broader lessons of Cofán political proposals, which envision a novel form of interaction between indigenous peoples, nation‐states, and global environmental movements.
Acidic pre‐conditioning suppresses apoptosis and increases expression of Bcl‐xL in coronary endothelial cells under simulated ischaemia
Authors: Kumar S. , Reusch H. P. , Ladilov Y.
Published: October 2008

Ischaemic pre‐conditioning has a powerful protective potential against ischaemia‐induced cell death, and acidosis is an important featur of ischaemia and can lead to apoptosis. Here we tested whether pre‐conditioning with acidosis, that is, acidic pre‐conditioning (APC), may protect coronary endothelial cells (EC) against apoptosis induced by simulated ischaemia. For pre‐conditioning, EC were exposed fo 40 min. to acidosis (pH 6.4) followed by a 14‐hrs recovery period (pH 7.4) and finally treated for 2 hrs with simulated ischaemia (glucose‐free anoxia at pH 6.4). Cells undergoing apoptosis were visualized by chromatin staining or by determination of caspase‐3 activit Simulated ischaemia in untreated EC increased caspase‐3 activity and the number of apoptotic cell (31.3 ± 1.3%versus 3.9 ± 0.6% in control). APC significantly reduced the rate of apoptosis (14.2 ± 1.3%) and caspase‐3 activity. Western blot analysis exploring the under lying mechanism leading to this protection revealed suppression of the endoplasmic reticulum‐ (reduced cleavage of caspase‐12) and mitochondria‐mediated (reduced cytochrome C release) pathways of apoptosis. These effects were associated with an over‐expression of the anti‐apoptotic protein Bcl‐xL 14 hrs after APC, whereas no effect on the expression of Bcl‐2, Bax, Bak, procaspase‐12, reticulum‐localized chaperones (GRP78, calreticulin), HSP70, HSP32 and HSP27 could be detected. Knock‐down of Bcl‐xL by siRNA‐treatment prevented the protective effect of APC. In conclusion, short acidic pre‐treatment can protect EC against ischaemic apoptosis. The mechanism of this protection consists of suppression of the endoplasmic reticulum‐ and mitochondria‐mediated pathways. Over‐expression of the anti apoptotic protein Bcl‐xL is responsible for the increased resistance to apoptosis during ischaemic insult.
Mucin immunohistochemistry in the diagnosis and mapping of extramammary Paget's disease
Authors: Smith R. F. , Stern B. H. , Smith A. A.
Published: October 2008

Extramammary Paget's disease (EMPD) is a rare skin cancer of the genital region in which cancer cells with enlarged nuclei and pale cytoplasm are scattered singly in the affected epidermis. These cancer cells, called Paget cells, contain mucin, which is never found in normal epidermis. The oligosaccharide side chains of Paget cell mucin end with sialic acid. Sialic acid is easily detected by zirconyl haematoxylin or alcian blue. The other sugars in the oligosaccharide chains can be detected by the periodic acid‐Shiff reaction. Rarely, the diagnosis of EMPD is complicated by the absence of mucin from the Paget cells. We have examined such an atypical case. The oligosaccharide side chains, including the sialic acids, are absent. In both this case and a typical case, the Paget cells contain epithelial membrane antigen mucin (MUC1) core protein and usually contain gastric surface‐type mucin (MUC5AC) core protein, which can be stained by antibodies. Since neither core protein is found in normal epidermis, epithelial membrane antigen core protein may be the most reliable diagnostic marker for extramammary Paget's disease. In both the atypical case and the typical case of Paget's diseas, some cells that look like keratinocytes contain mucin core proteins. These may be incipient Paget cells. We suggest that using th epithelial membrane antigen core protein as a marker for the true extent of extramammary Paget's disease could facilitate complete excision and reduce the rate of recurrence.
Actinobacillus equulisubsp.equuliassociated with equine valvular endocarditis
Authors: AALBÆK BENT , ØSTERGAARD STINE , BUHL RIKKE , JENSEN HENRIK ELVANG , CHRISTENSEN HENRIK , BISGAARD MAGNE
Published: October 2008

Microbiological and pathological data from a case of equine valvular endocarditis are reported. Limited information is available on the pathogenic potential of equineActinobacillusspecies as several strains originate from apparently healthy horses. After the establishment of two subspecies within this species (1), this seems to be the first report of an etiological association betweenA. equulisubsp.equuliand equine endocarditis. Furthermore, new information on some phenotypical characteristics of this subspecies is reported, compared to previous findings (1).
Dedifferentiated liposarcoma presenting as jejunal polyp
Authors: MANIPADAM MARIE THERESE , SINGH REECHA , VIJAY ABRAHAM
Published: October 2008

We report a case of primary jejunal dedifferentiated liposarcoma presenting as a submucosal polyp mimicking a benign neoplasm. This is an extremely rare presentation. The histological feature of interest was the spindle cell lipoma‐like appearance of the well‐differentiated component. The use of MDM2 immunostaining in differentiating benign lipomatous tumours from well‐differentiated liposarcomas is mentioned, which is of value especially in lipomatous tumours of the gut where ulcerated benign tumours can show varying degrees of atypia.
Short‐term etidronate treatment prevents glucocorticoid‐induced bone debility of the mandible in growing rats
Authors: Fujita Y , Konoo T , Maki K
Published: October 2008

Structured Abstract

Authors –  Fujita Y, Konoo T, Maki K

Objectives –  To analyse the effects of short‐term treatment with etidronate on the glucocorticoid‐induced retardation of bone growth and deterioration of bone structure in the prepubertal rat mandible.

Materials and Methods –  Fifty 5‐week‐old male rats were divided into five groups. Etidronate or vehicle treatment (5 mg/kg/day, daily, subcutaneous injection) was initiated after glucocorticoid administration (30 mg/kg/day, on alternate days, orally) for 6 weeks and was continued for 3 weeks. Then, bone growth was measured using lateral cephalometric analysis. Peripheral quantitative computed tomography was used to determine bone density, bone cross‐sectional area and bone strength.

Results –  Glucocorticoid‐treated rats had significantly lower body weight, mandibular length, cortical bone density, bone strength and cross‐sectional area in trabecular and cortical bone, but had significantly higher trabecular bone density than untreated rats. No significant difference in mandibular height was observed between the glucocorticoid‐treated group and the untreated control group. Etidronate treatment improved the glucocorticoid‐induced decrease in bone strength and increased density in trabecular and cortical bone above the untreated control level, but had no significant effects on the reduction in mandibular length.

Conclusion –  These findings suggest that etidronate can potentially reverse the glucocorticoid‐induced deterioration of internal bone structure, but has no beneficial effects on the glucocorticoid‐induced retardation of bone growth in the growing rat mandible.
Treatment of actinic keratoses with a novel betulin‐based oleogel. A prospective, randomized, comparative pilot study
Authors: Huyke Constance , Reuter Juliane , Rodig Mirko , Kersten Astrid , Laszczyk Melanie , Scheffler Armin , Nashan Dorothee , Schempp Christoph
Published: October 2008

Background: Actinic keratoses (AK) are squamous cell carcinomas in situ and require treatment. Betulin‐based oleogel prepared from a standardized triter‐pene dry extract from birch bark represents a new topical agent with anti‐inflammatory and anti‐tumor potential.

Patients and Methods: In the prospective, randomized, monocentric phase 2a study 45 patients with < 10 AK were included and randomly assigned to one of the three treatment groups. Intervention consisted of topical betulin‐based oleogel twice daily versus cryotherapy with liquid nitrogen versus the combination of cryotherapy with topical betulin‐based oleogel.Treatment response was assessed clinically after three months. The clinical response was graded into complete clearing (100 %), therapy responders (> 75 % clearing of the lesions) and non‐responders (< 75 % clearing). Additionally, punch biopsies were obtained from some patients before and at the end of treatment.

Results: Therapy with betulin‐based oleogel was well tolerated.Three patients discontinued therapy because of personal reasons. After three months, the 100% (and > 75%) clearing rates of the lesions were as follows: 64% (86%) with betulin‐based oleogel (n = 14),79% (93%) with cryotherapy (n = 14),and 71% (71%) with the combined therapy (n = 14). Histological analysis of biopsies taken before and after treatment (n = 8) showed a reduced degree of dys‐plasia in the epidermis in all study arms.

Conclusions: Betulin‐based oleogel seems to be an effective novel approach in the topical treatment of actinic keratoses. However,the clinical and histological findings of the present pilot study have to be verified against placebo with larger case numbers.
Viral exanthems in childhood – infectious (direct) exanthems. Part 1: Classic exanthems
Authors: Fölster‐Holst Regina , Kreth Hans Wolfgang
Published: October 2008

Exanthems during childhood occur quite often and are mostly harmless in nature. Among different trigger factors, viruses are of prime importance. Viral exanthems may manifest as a macular, maculopapular, papular, urticarial or vesicular rash. Exanthems with other causes (bacterial toxins, drugs, autoimmune diseases) as well as those with unclear etiology such as unilateral lat‐erothoracic exanthem or Kawasaki disease must be differentiated from viral exanthems. This review focuses on the classic viral exanthems.
Viral exanthems in childhood – infectious (direct) exanthems. Part 2: Other viral exanthems
Authors: Fölster‐Holst Regina , Kreth Hans Wolfgang
Published: October 2008

The group of the non‐classic infectious exanthems are mostly maculopapular or vesicular. The latter changes are typical for infections with varicella‐zoster virus and Coxsackie viruses. Congenital cytomegalovirus infections are characterized by petechiae and purpura, while the papular‐purpuric gloves and socks syndrome is usually associated with parvovirus B19. Aside from these, the non‐classic infectious exanthems diseases include nonspecific exanthems coupled with respiratory and enteric infections.
Viral exanthems in childhood. Part 3: Parainfectious exanthems and those associated with virus‐drug interactions
Authors: Fölster‐Holst Regina , Kreth Hans Wolfgang
Published: October 2008

Viruses cause not only direct infectious exanthems, but also parainfectious exanthems, which provoke skin alterations via interactions with the immune system. These distinct exanthems, for instance Gianotti‐Crosti syndrome and pityriasis lichenoides group, do not reflect a specific pathogen but can occur in the course of many viral infections. In addition, some exanthems result from the interaction between viruses and drugs.
Severe ROP in twins after blockage of the renin‐angiotensin system during gestation
Authors: Hård Anna‐Lena , Wennerholm Ulla‐Britt , Niklasson Aimon , Hellström Ann
Published: October 2008

Blockage of the renin‐angiotensin system (RAS) during pregnancy is known to cause serious dysfunction of many organs of the foetus and newborn. Angiotensin II is an angiogenic factor and angiotensin‐converting enzyme (ACE) inhibitors prevent retinal neovascularisation and their use in preventing proliferative retinopathy of prematurity has been suggested.

We report on twin girls born after 32 gestational weeks, who were exposed to blockage of the RAS during gestation, had severely reduced retinal vasculature and developed severe retinopathy of prematurity (ROP) despite receiving very little extra oxygen.

Conclusion: It is likely that ACE inhibitors and angiotensin receptor blockers not only reduce pathological neovascularisation but also normal vascularisation of the eyes and other organs.
Preterm birth and maternal smoking in pregnancy are strong risk factors for aortic narrowing in adolescence
Authors: Edstedt Bonamy Anna‐Karin , Bengtsson Johan , Nagy Zoltan , De Keyzer Hans , Norman Mikael
Published: October 2008

Aim: Preterm transition from foetal to neonatal circulation might permanently alter aortic growth and development. To test this hypothesis, we measured aortic dimensions in adolescents born very preterm.

Methods: Eighty‐six healthy 15‐year‐old subjects were studied; 45 born very preterm at an average gestational age of 28 weeks (birth weight < 1500 g) and 41 controls born at term. Using a pulse‐gated Fiesta sequence on a 1.5T MR‐scanner, 25 images were collected within the heart cycle at several levels of the descending aorta. End‐diastolic cross‐sectional areas were semi‐automatically calculated using an active contour model.

Results: Subjects born preterm had narrower aortic lumen. The difference was 16% in the thoracic and 19% in the abdominal aorta after adjustment for body surface area and gender (p < 0.001). Maternal smoking in pregnancy was also found to be an independent risk factor for aortic narrowing in the offspring (difference 10%–13% throughout the aorta vs. offspring to nonsmoking mothers). Adolescents born preterm had higher systolic and diastolic blood pressures; however, blood pressures did not correlate with aortic size or maternal smoking during pregnancy.

Conclusion: Very preterm birth and exposure to maternal smoking in foetal life are independent and strong risk factors for general aortic narrowing 15 years after birth.
Should Caregivers Be Compelled to Disclose Patients' HIV Infection to the Patients' Sex Partners Without Consent?
Authors: Odunsi Babafemi
Published: October 2008

The emergence of the HIV/AIDS pandemic has added to the tension between patients' private interests and public health interests regarding medical confidentiality. Many people become infected with HIV because they are unaware of the positive serostatus of their sexual partners. Informing or warning the sexual partners of HIV‐positive patients of the patients' serostatus could assist in curtailing the spread of HIV/AIDS because sexual partners can thereby choose to avoid having unprotected sex with infected persons. By law, however, doctors have a duty to their patients to protect their medical confidentiality. Doctors, therefore, face a dilemma concerning which should prevail: patients' right to privacy and confidentiality or the importance to society of controlling the spread of the pandemic. Most medical regulatory bodies do not take clear‐cut positions on the issue, leaving the decision to the discretion of individual doctors. The question of whether doctors should be legally empowered to breach the confidence of patients to protect the patients' sexual partners is discussed here with reference to the existing laws of Canada, the United States, and Nigeria.
An Evidence-Based Perspective to Commonly Performed Erectile Dysfunction Investigations
Authors: Ghanem Hussein , Shamloul Rany
Published: October 2008

Introduction

Currently there is no universally accepted gold standard diagnostic test to differentiate psychogenic from physical erectile dysfunction (ED). Instead, sexual health specialists rely on a detailed history, a focused physical examination, and specialized diagnostic tests, to decide if the etiology of the ED is mainly psychogenic or organically caused.

Aim

In this review we point out the status of evidence-based principles in the area of diagnosis in Sexual Medicine.

Methods

We review the concepts of evidence-based medicine (EBM) in the area of medical diagnostic tests. We highlight four of the well-known diagnostic tests (penile duplex, pharmacoarteriography, pharmacocavernosometry/cavernosography [PHCAS/PHCAG], and nocturnal penile tumescence [NPT monitoring]) for ED evaluation within an evidence-based perspective.

Main Outcome Measures

Assessment of diagnostic tests for ED using principles of EBM.

Results

Several good diagnostic tests are useful in the evaluation of men with ED. However, modern evidence-based concepts—mainly the likelihood ratio—have not yet been applied to these tests to obtain their maximum clinical benefits.

Conclusions

While penile duplex/color Doppler has good evidence of supporting its use in the diagnosis of arteriogenic ED, data supporting its diagnosis of a physical disorder associated with cavernous venous occlusion dysfunction are lacking. PHCAS/PHCAG's main drawback is an unknown positive predictive value and a possibility of frequent false-positive results. NPT has many advantages when differentiating psychogenic from organic ED, however, several questions related to its physiological mechanisms do exist.

[Correction added after online publication 14-Dec-2007: In the above reference for this article, the order of the author names has been updated.]
Profile of Serum Testosterone Levels after Application of Testosterone Ointment (Glowmin) and Its Clinical Efficacy in Late-Onset Hypogonadism Patients
Authors: Amano Toshiyasu , Imao Tetsuya , Takemae Katsurou , Iwamoto Teruaki , Yamakawa Katsunori , Baba Katsuyuki , Nakanome Mariko , Sugimori Hiroki , Tanaka Toshiaki , Yoshida Katsumi , Katabami Takuyuki , Tanaka Masami
Published: October 2008

Introduction

Testosterone replacement therapy has been applied to alleviate the various symptoms of late-onset hypogonadism (LOH) patients. Several routes are available for the administration of testosterone to LOH patients, and transdermal delivery is an attractive method above all.

Aim

The aim of this article was to clarify the profile of serum total testosterone (TT) and free testosterone (FT) levels after application of testosterone ointment (Glowmin [GL], Daito Pharmaceutical Co. Ltd., Tokyo, Japan) and its clinical efficacy in LOH patients.

Methods

Serum TT and FT levels were examined in healthy male volunteers and LOH patients after application of 3 mg of GL. Then, 50 LOH patients received 3 mg of GL twice daily on scrotal skin (6 mg/day) for 12 weeks. Subsequently, TT and FT levels immediately prior to GL application were compared with those at 1 hour after GL treatment. Furthermore, the clinical effects of GL in the aforementioned 50 LOH patients were estimated after 12 weeks of GL treatment.

Main Outcome Measures

Hormonal effects of GL were evaluated by serum TT and FT levels. Aging males symptoms (AMS), international index of erectile function (IIEF-5), and MOS 36-item short form Healthy Survey (SF-36) questionnaire were used to assess the clinical efficacy of GL for LOH patients.

Results

Maximum TT and FT values, which were detected 1–2 hours after application of a 2-cm line of GL (3 mg of testosterone) to scrotal skin, were not elevated beyond physiological levels; subsequently, these levels returned to circadian rhythm after 4 hours in four healthy male volunteers. The highest TT and FT levels were also obtained after 1–2 hours in four LOH patients involving identical administration methods; moreover, these levels were maintained within a normal range for 6 hours. After 12 weeks of GL treatment in 50 LOH patients, TT and FT levels demonstrated the same satisfactory response as that of the initial GL administration without GL accumulation effects. GL accumulation after 1 week in healthy men and after 12 weeks in LOH patients was not observed. Furthermore, AMS score decreased markedly; IIEF-5 and four domains of the SF-36 score were elevated significantly following GL application. Severe adverse reactions were not observed.

Conclusions

Accordingly, GL, which is a short-acting testosterone ointment eliciting physiological elevation of TT and FT, appears to be suitable for LOH treatment.
A Brief Historical Survey of “Peyronie's Disease”
Authors: Musitelli Sergio , Bossi Maurizio , Jallous Hussein
Published: October 2008

Introduction

Historians of medicine and urology, sexology, and andrology in particular maintain that many other physicians, surgeons, anatomists, and pathologists have already described “Peyronie's disease” some centuries before the author after whom it has been called, François Gigot de La Peyronie (1678–1747).

Aim

To perform a brief historical survey of Peyronie's disease.

Methods

A literature review was performed.

Results

The main surgeons and anatomists who previously observed and described penile curvature prior to François Gigot de La Peyronie are Theodoricus Borgognoni (1205–1298), Guilielmus of Saliceto (circa 1210–1276), Gabriele Falloppio (or Falloppia) (1523–1562), Andreas Vesalius (1514–1564), Giulio Cesare Aranzi (or Aranzio) (1530–1589), Claas Pieterzoon Tulp (Nicholaus Tulpius) (1593–1674), and Anton Frederik Ruysch (1638–1731), who was said to have left the first “postmortem” illustration of the disease in a copperplate engraving in 1691.

Conclusion

The original texts could easily prove that none of the alleged “precursors” of La Peyronie did ever describe, treat, and cure real cases of Peyronie's disease, and that to award them this merit was somewhat far-fetched, with only Guilielmus of Saliceto and Falloppio possibly excepted.
The Role of BPH, Lower Urinary Tract Symptoms, and PSA Levels on Erectile Function of Brazilian Men Who Undergo Prostate Cancer Screening
Authors: Antunes Alberto A. , Srougi Miguel , Dall'Oglio Marcos F. , Vicentini Fabio , Paranhos Mario , Freire Geraldo C.
Published: October 2008

Introduction

Lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) are common problems in middle-aged and older men. Recently, epidemiologic studies have shown significant associations between severity of LUTS and male sexual dysfunction.

Aim

We analyzed the role of prostate enlargement, LUTS, and prostate specific antigen (PSA) levels in the erectile function of Brazilian men who underwent prostate cancer (PCa) screening.

Method

We analyzed data from 1,008 consecutive patients enrolled in a PCa screening program. Benign prostatic hyperplasia (BPH) was defined as a prostate weight greater than 30 g as defined by digital rectal examination. For statistical analysis, we used the chi-squared and analysis of variance tests. The odds ratios (OR) for correlation of ED with prostate volume LUTS and PSA were estimated using logistic regression models.

Main Outcome Measure

The American Urological Association (AUA) symptom score for LUTS and the International Index of Erectile Function.

Results

Mean patient age was 61.2 years (45–87) and median PSA value was 1.9 ng/mL. BPH was identified in 48.5% of patients. Mild, moderate, and severe LUTS were found in 52.3%, 30.9%, and 16.8% of cases, respectively. ED was classified as absent, mild, mild to moderate, moderate, and severe in 18.6%, 23.1%, 18.6%, 15.2%, and 24.5%, respectively. While only 5.4% of the patients with no ED presented severe LUTS, this finding was observed in 27.1% of patients with severe ED (P < 0.001). Univariate logistic regression analysis demonstrated that age, prostate volume, AUA symptom score, and PSA levels were significant predictors of ED. However, when controlled for patient age, only LUTS remained as an independent predictor of ED.

Conclusions

Controlling for patient age, LUTS are independent risk factors for the development of ED among Brazilian men who undergo PCa screening.
The Role of PDE5 Inhibitors in Heme Oxygenase–cGMP Relationship in Rat Cavernous Tissues
Authors: Aziz M. Talaat Abdel , Mostafa Taymour , Atta Hazem , Rashed Laila , Marzouk Samar A. , Obaia Eman M. , Sabry Dina , Hassouna Amira A. , El-Shehaby Amal M. , Aziz Ahmed T. Abdel
Published: October 2008

Introduction

Heme oxygenase (HO) enzyme catalyzes oxidative degradation of heme to biliverdin and carbon monoxide (CO). CO shares many properties with nitric oxide (NO) including the activation of soluble guanyl cyclase.

Aim

To assess cavernous tissue HO activity and cyclic guanosine monophosphate (cGMP) levels in response to oral phosphodiesterse type 5 (PDE5) inhibitors.

Methods

Seven hundred twenty male Sprague-Dawley rats, divided into six groups, were investigated. Group 1, controls; group 2 received sildenafil citrate orally; group 3 received vardenafil hydrochloride; and group 4 received tadalafil. Group 5 was subdivided into three equal subgroups, received the same dose of each drug added to the HO inhibitor, Zn protoporphyrin. Group 6 was subdivided into three equal subgroups, received the same dose of each drug added to the NO inhibitor, L-nitroarginine methylester. Eight rats from each group/subgroup were sacrificed at 0.5, 1, 2, 3, 4, 6, 18, 24, and 36 hours, respectively.

Main Outcome Measures

HO enzyme activity assay and cGMP tissue levels in dissected rat cavernous tissues.

Results

Both cavernous tissue HO enzyme activity and cGMP levels were increased significantly in sildenafil-, vardenafil-, and tadalafil-treated rats compared with the controls, with significant decreases after either HO or NO inhibition. Cavernous tissue HO enzyme activity and cGMP showed a positive significant correlation (r = 0.854, P < 0.001).

Conclusion

The effects of PDE5 inhibitors in cavernous tissue are partly mediated through HO enzyme activity.
Are Premature Ejaculation Symptoms Curable?
Authors: Vardi Yoram , McMahon Chris G. , Waldinger Marcel D. , Rubio-Aurioles Eusebio , Rabinowitz David
Published: October 2008

Introduction

While premature ejaculation (PE) is the most common sexual dysfunction in men under 40, there is currently no government-approved therapy for its treatment. Is a cure possible?

Methods

Four experts in the area of PE and its treatment were asked to contribute their opinions.

Main Outcome Measure

To provide food for thought, discussion, and possible further research in a poorly understood area of sexual medicine.

Results

Differences among the different types of PE, and the ability to cure them are discussed. One expert examines the possible differences in lifelong and acquired PE as an explanation as to why treatment for the former does not carry over after termination of treatment whereas the latter can be treated successfully. The second and third experts break PE into four categories, explaining that those forms that are curable at present are not true PE or are based on anxiety. The last expert discusses the potential of a combined clinical and research platform to better understand the relative contributions of biological, behavioral, and couple factors to the disorder for potential curability.

Conclusion

Improved understanding of the types of PE and their various etiologies and pathophysiologies would improve the potential for cure.
Sexual Orientation Matters in Sexual Medicine (CME)
Authors: Rubio-Aurioles Eusebio , Wylie Kevan
Published: October 2008

Introduction

Homosexuality is a topic that needs to be integrated into the knowledge base of the practitioner of sexual medicine.

Aim

To present to the reader a summary of the current literature on homosexuality and sexual orientation and address specifically issues that pertain to the relationship sexual orientation and sexual medicine practice.

Main Outcome Measures

The information is presented in a continued medical education format, with a series of evaluation questions at the end of the activity.

Methods

A review of the literature is presented and organized according to the authors' judgment of the value of the information as to provide the reader with an inclusive panorama of the issues covered.

Results

Current concepts, debates, and need for further research are presented.

Conclusions

The professional of sexual medicine needs to be aware of the various topics reviewed in this article as his or her involvement in the area of sexuality can create the expectation on the part of the patients of knowingness of all aspects of human sexuality. Sexual orientation is a complex area but considerable understanding has fortunately been achieved in many issues in reference to homosexuality and heterosexuality.
Tolterodine Immediate Release Improves Sexual Function in Women with Overactive Bladder
Authors: Hajebrahimi Sakineh , Azaripour Arash , Sadeghi-Bazargani Homayoun
Published: October 2008

Introduction

Quality of life studies indicate that overactive bladder (OAB) has a greater negative impact on everyday life than other serious conditions such as diabetes. The detrimental effect of OAB on female sexual health is more prominent than urinary incontinence. We know that tolterodine immediate release (IR) has a beneficial effect on urinary symptoms in OAB.

Aim

To evaluate the impact of tolterodine IR on sexual function in patients with OAB.

Methods

A total of 30 sexually active women with OAB from 20 to 52 years were included. All patients filled out the International Consultation on Incontinence Questionnaire (ICIQ) and the Arizona Sexual Experience Scale (ASEX) before treatment with tolterodine IR and at the end of each month of treatment until 3 months.

Main Outcome Measures

Expected outcomes were improvements in the ICIQ and ASEX total score. All ASEX items were expected to improve individually. These improvements indicate better sexual function after treatment.

Results

The mean of the total ASEX score improved relative to baseline in the first (P < 0.01), second (P < 0.01), and third (P < 0.01) follow-up. The mean of scores for sexual desire, arousal, vaginal lubrication, orgasm, and orgasm satisfaction improved significantly (P < 0.01) with each follow-up.

Conclusion

Tolterodine IR significantly improves sexual function of women with OAB. Improvement is seen in all domains of sexual function.
Maintenance of Erectile Function after Photoselective Vaporization of the Prostate for Obstructive Benign Prostatic Hyperplasia
Authors: Kavoussi Parviz K. , Hermans Michael R.
Published: October 2008

Introduction

Photoselective vaporization of the prostate (PVP) with the greenlight laser has become a popular alternative to the standard transurethral resection of the prostate for patients with benign prostatic hyperplasia (BPH). Our initial results of postoperative erectile function are presented.

Aim

To prospectively evaluate the postoperative erectile function of the first 105 consecutive patients undergoing PVP at Texas A&M Health Sciences Center, Scott & White Memorial Hospital, using the Sexual Health Inventory for Men (SHIM) questionnaire.

Methods

Institutional Review Board approved this case series of 105 consecutive patients who underwent PVP. The men were divided into three groups depending on their preoperative bladder management: Group N—catheter free (N = 86), Group Y—indwelling catheters (N = 8), and Group clean intermittent catheterization (CIC)—performing clean intermittent catheterization (N = 11).

Main Outcome Measures

SHIM scores were obtained and compared preoperatively and at 12-month follow-up visit.

Results

The mean age of the 86 patients in group N, who did not require an indwelling catheter or CIC preoperatively, was 71.8 years. Their mean preoperative SHIM score was 10.7, and was 10.4 postoperatively. The mean age of the eight patients who were in group Y, who did require an indwelling catheter preoperatively, was 76.8. Their mean preoperative SHIM score was 10.5, and improved to 23 postoperatively. The mean age of the 11 patients in group CIC, who performed CIC preoperatively, was 71.8 years. Their mean preoperative SHIM score was 6.0, and was 5.8 postoperatively.

Conclusions

Sexual function was maintained by patients who underwent PVP for obstructive BPH and who were catheter free or required CIC preoperatively, and was improved for men who had indwelling catheters preoperatively. There was no statistically significant difference between preoperative and postoperative sexual function after PVP for men with either mild or no erectile dysfunction preoperatively.
Factors Associated With Gender Differences in Parent‐Adolescent Relationships That Delay First Intercourse in Japan
Authors: Nagamatsu Miyuki , Saito Hisako , Sato Takeshi
Published: October 2008

Background:  To determine the factors associated with gender differences in parent‐adolescent relationships that delay first intercourse in Japan.

Methods:  Japanese high school students aged 15‐18 years (female = 632 and male = 636) completed a questionnaire that evaluated the relationship with their parents. Logistic regression analyses were conducted to investigate the parent‐adolescent relationship (including the quality of parent‐adolescent communication, the frequency of parent‐adolescent sexual communication, parental disapproval of the adolescent’s sexual behavior, parental monitoring, parental psychological control/autonomy, and satisfaction with the parent‐adolescent relationship) and the adolescent’s sexual behavior. We explored student gender differences in each of the relationship patterns: mother‐female student, mother‐male student, father‐female student, and father‐male student.

Results:  Parental monitoring was statistically associated with delay of first intercourse in female students. While the same influences were present for male students, they also were influenced by parental disapproval of the adolescent’s sexual behavior. Furthermore, more parental communication about acquired immunodeficiency syndrome was related to delaying an adolescent’s first intercourse except for the relationship of father‐female student.

Conclusions:  This study suggests that gender differences in parent‐adolescent relationships delay first intercourse in Japan.
Interoperability and Other Issues at the IP–Anti‐trust Interface: The EU Microsoft Case
Authors: Curley Duncan
Published: October 2008

The judgment in 2007 of the Court of First Instance in Microsoft Corporation v European Commission was the culmination of one of the biggest anti‐trust battles ever to have taken place in the European Union. Although most aspects of the European Commission's original decision of 2004 were upheld, the Microsoft case remains interesting at several levels. The judgment deals with the question of when it is permissible, in the public interest, to encroach upon the exclusivity of intellectual property rights‐holders, by requiring the grant of licences to third parties seeking to enter or remain on the market. The case provides an illustration of Community policy objectives being implemented through the medium of the competition rules, namely the opening up of the software industry to more competition and the encouragement of innovation in information technology. It also provides an illustration of differing attitudes to the anti‐trust regulation of unilateral conduct by companies with a dominant market position in Europe and the United States.
Model Predictive Control of a Direct Fire Projectile Equipped With Canards
Authors: Ollerenshaw Douglas , Costello Mark
Published: October 2008

Launch uncertainties in uncontrolled direct fire projectiles can lead to significant impact point dispersion, even at relatively short range. A model predictive control scheme for direct fire projectiles is investigated to reduce impact point dispersion. The control law depends on projectile linear theory to create an approximate linear model of the projectile and quickly predict states into the future. Control inputs are based on minimization of the error between predicted projectile states and a desired trajectory leading to the target. Through simulation, the control law is shown to work well in reducing projectile impact point dispersion. Parametric trade studies on an example projectile configuration are reported that detail the effect of prediction horizon length, gain settings, model update interval, and model step size.
The Controller Output Observer: Estimation of Vehicle Tire Cornering and Normal Forces
Authors: Ozkan Basar , Margolis Donald , Pengov Marco
Published: October 2008

A controller output observer is used for estimating specific outputs from a physical system through the use of alternative outputs that are measured. In most cases these estimated signals can be measured directly using sensors. However, some outputs are either not possible to measure directly or alternative outputs are just easier to measure. This paper focused on a method to estimate immeasurable quantities, in near real time, through the use of physical models and measured quantities. This can be done through the use of classical observers as introduced by Luenberger in 1964 (“Observing the state of a Linear System,” IEEE Trans. Mil. Electron., 8, pp. 74–80) However, since observers estimate the system states, one would have to again estimate the sought after outputs by another method, such as a constitutive relationship. The method proposed here shows that certain signals can be estimated directly by using a controller but without using a constitutive law. These estimated quantities are inputs to a model of the real system. In other words, these inputs drive the observer model. A promising use for the controller output observer is estimation of tire forces in vehicles. This is because tires are very difficult to model accurately, and even if the tire is modeled accurately, the surface conditions of the road must be known to predict tire forces. The controller output observer does not require a model of the tires. The method is tested using a vehicle model. Real measurements from a vehicle are used to show that the method succeeds in estimating quantities from the real vehicle.
Application of CRONE Control to a Sampled Time Varying System With Periodic Coefficients
Authors: Sabatier Jocelyn , Garcia Iturricha Aitor , Moze Mathieu , Oustaloup Alain
Published: October 2008

An application of CRONE robust control extended to discrete-time-varying systems with periodic coefficients is presented. The application is carried out in the frequency domain through the representation of considered systems using time varying z-transforms and time varying pseudofrequency responses.
Negative Input Shaping: Eliminating Overcurrenting and Maximizing the Command Space
Authors: Sorensen Khalid L. , Daftari Aayush , Singhose William E. , Hekman Keith
Published: October 2008

Input shaping is a filtering method used for reducing oscillation in flexible systems. A class of these filters, called negative input shapers, has been developed to improve system rise-time beyond what is achievable using conventional input-shaping filters. However, negative input shapers can cause overcurrenting and subsequent system oscillation, when used with certain reference commands. This class of reference commands is examined in the context of the command space. The command space represents the space of all possible signals that may be issued to a system. It provides insight into how overcurrenting occurs, how overcurrenting can be mitigated, and the influence that mitigation strategies have on system performance. Two overcurrenting mitigation strategies are presented. The operational effects of overcurrenting and overcurrenting mitigation are evaluated using a three-dimensional simulation of a bridge crane, and experimental results from a 10ton industrial bridge crane.
Modeling of Air-Fuel Ratio Dynamics of Gasoline Combustion Engine With ARX Network
Authors: Polóni Tomáš , Johansen Tor Arne , Rohaľ-Ilkiv Boris
Published: October 2008

This article deals with nonlinear modeling of air-fuel ratio (AFR) dynamics of gasoline engines during transient operation. With a collection of input-output data measured near several operating points of the commercial engine, we have identified a global model of the system. The global model structure comes out of the modeling principles based on a weighting of local linear ARX model parameters in dependency on the operating point. It was found that the studied global model has the ability to approximate nonlinear effects and varying response time as well as varying time delay of air-fuel ratio dynamics. The advantage of the local linear approach is that it is flexible to fit experimental data and provides an appropriate structure for advanced nonlinear control algorithm synthesis. Moreover, the proposed nonlinear AFR model with identified numeric values of parameters listed in this article can be used for simulation purposes and also for testing of control algorithms.
Neural Adaptive Sliding Mode Control for a Class of Nonlinear Neutral Delay Systems
Authors: Niu Yugang , Lam James , Wang Xingyu , Ho Daniel W. C.
Published: October 2008

This paper is concerned with the problem of sliding mode control (SMC) for a class of neutral delay systems with unknown nonlinear uncertainties that may not satisfy the norm-bounded condition. A SMC scheme based on neural-network approximation is proposed for the uncertain neutral delay system. By means of linear matrix inequality (LMI) approach, a sufficient condition is given such that the resultant closed-loop system is guaranteed to be stable, and the states asymptotically converge to zero. When the LMI is feasible, the designs of both the sliding surface and the sliding mode control law can be easily obtained via convex optimization. It is shown that the state trajectories are driven toward the specified sliding surface that depends on the current states as well as the delayed states. Finally, a simulation result is given to illustrate the effectiveness of the proposed method.
Dynamic Modeling and Design of a Bulk-Loaded Liquid Monopropellant Powered Rifle
Authors: Adams Mark , Barth Eric J.
Published: October 2008

This paper presents a dynamic model of the interior ballistics of an experimental liquid propellant powered rifle. The liquid propellant powered rifle described utilizes a mixture of hydroxyl ammonium nitrate and hydrocarbon fuel to replace gunpowder typically used in such firearms. The motivation for such a development is to discard the need for a shell casing whereby carrying only propellant and bullets will reduce both the mass and volume per shot carried by the soldier. A first-principles dynamic model of the interior ballistics is derived as a compressible fluid power problem with the chemical liberation of heat within the chamber modeled via a condensed-phase reaction rate law. The model is used to predict the overall performance in terms of ballistic kinetic energy as well as draw design insight regarding the role of friction, chamber geometry, and the profile of chamber pressure with respect to time. Simulation results are presented as well as preliminary experimental results from a proof-of-concept device.
Moving-Boundary Heat Exchanger Models With Variable Outlet Phase
Authors: Eldredge Brian D. , Rasmussen Bryan P. , Alleyne Andrew G.
Published: October 2008

Vapor compression cycle systems using accumulators and receivers inherently operate at or near a transition point involving changes of phase at the heat exchanger outlets. This work introduces a condenser/receiver model and an evaporator/accumulator model developed in the moving-boundary framework. These models use a novel extension of physical variable definitions to account for variations in refrigerant exit phase. System-level model validation results, which demonstrate the validity of the new models, are presented. The model accuracy is improved by recognizing the sensitivity of the models to refrigerant mass flow rate. The approach developed and the validated models provide a valuable tool for dynamic analysis and control design for vapor compression cycle systems.
A Survey/Review of Frequency-Weighted Balanced Model Reduction Techniques
Authors: Ghafoor Abdul , Sreeram Victor
Published: October 2008

In this paper, a survey/review of frequency-weighted balanced model reduction techniques is presented. Several comments regarding their properties are given. A modified frequency interval Gramian based method is also presented. The computational issues are also discussed. The techniques are illustrated and compared using practical numerical examples.