bluuebunny/crossref_metadata_2025 huggingface dataset:
Sex differences in behavior associated with sex‐biased mortality in an oviparous snake species
Authors: Sperry Jinelle H. , Weatherhead Patrick J.
Published: January 2009

Sex differences in behavior associated with reproduction often result in sex‐biased mortality. Male‐biased mortality appears to be the prevalent pattern for birds and mammals, but recent work suggests that higher female mortality may be the norm for snakes, at least for viviparous species. Here we used radio‐telemetry to examine sex‐biased mortality in Texas ratsnakes Elaphe obsoleta, an oviparous species, and test the hypothesis that differences in behavior are associated with higher rates of mortality. Female ratsnakes had lower survival than male ratsnakes. For both sexes decreased survival was associated with higher activity and increased basking. Male ratsnakes were most active and basked most during the spring when mating occurred, which was when almost all male mortality occurred. Although female ratsnakes also moved and basked most during the mating season, they maintained relatively high levels of movement and basking through the summer and fall, and female mortality occurred throughout that period. Thus, contrary to the expectation that the cost of reproduction should be highest prior to egg laying for females of oviparous snakes, the mortality pattern documented here suggests the cost of reproduction is greatest following egg laying, similar to what has been found for females of viviparous species. As capital breeders (whether oviparous or viviparous), female snakes must rebuild energy reserves following a bout of reproduction, and the associated increase in foraging and basking required to do so increases female susceptibility to predation. Further studies are required to determine if female‐biased mortality is the norm in snakes and if so, to determine the demographic and life‐history consequences.
Human gingival fibroblasts are critical in sustaining inflammation in periodontal disease
Authors: Ara Toshiaki , Kurata Kazuyuki , Hirai Kaname , Uchihashi Takayuki , Uematsu Takashi , Imamura Yasuhiro , Furusawa Kiyohumi , Kurihara Saburo , Wang Pao‐Li
Published: January 2009

Background and Objective:  A major factor in the pathogenesis of periodontal disease, which is one of the biofilm infectious diseases, is thought to be lipopolysaccharide (LPS), owing to its ability to cause inflammation and promote tissue destruction. Moreover, the elimination of pathogens and their component LPSs is essential for the successful treatment of periodontal disease. Lipopolysaccharide tolerance is a mechanism that prevents excessive and prolonged responses of monocytes and macrophages to LPS. Since persistence of inflammation is necessary for inflammatory cytokine production, cells other than monocytes and macrophages are thought to maintain the production of cytokines in the presence of LPS. In this study, we investigated whether human gingival fibroblasts (HGFs), the most abundant structural cell in periodontal tissue, might be able to maintain inflammatory cytokine production in the presence of LPS by not displaying LPS tolerance.

Material and Methods:  Human gingival fibroblasts were pretreated with LPS (from Porphyromonas gingivalis and Escherichia coli) and then treated with LPS, and the amounts of interleukin (IL)‐6 and IL‐8 in the cell culture supernatants were measured. The expression of negative regulators of LPS signalling (suppressor of cytokine signalling‐1, interleukin‐1 receptor‐associated‐kinase M and SH2 domain‐containing inositol‐5‐phosphatase‐1) was also examined in LPS‐treated HGFs.

Results:  Human gingival fibroblasts did not display LPS tolerance but maintained production of IL‐6 and IL‐8 when pretreated with LPS, followed by secondary LPS treatment. Lipopolysaccharide‐treated HGFs did not express negative regulators.

Conclusion:  These results demonstrate that HGFs do not show LPS tolerance and suggest that this characteristic of HGFs sustains the inflammatory response in the presence of virulence factors.
Effects of smoking on the ex vivo cytokine production in periodontitis
Authors: Torres de Heens G. L. , Kikkert R. , Aarden L. A. , Van Der Velden U. , Loos B. G.
Published: January 2009

Background and Objective:  Smoking is associated with increased severity of periodontitis. The underlying mechanisms of this phenomenon are not well understood. The purpose of the present study was to compare the monocyte‐derived T cell directing (Th1/Th2) response and pro‐inflammatory cytokine production in ex vivo whole blood cell cultures (WBCC) of smoking and non‐smoking chronic periodontitis patients.

Material and Methods:  Venous blood was collected from 29 periodontitis patients (18 non‐smokers and 11 smokers) receiving supportive periodontal treatment, and diluted 10‐fold for WBCC. The WBCC were stimulated for 18 h with Neisseria meningitidis lipo‐oligosaccharide (LOS) orPorphyromonas gingivalis sonic extract (Pg‐SE). The production of the T cell directing cytokines interleukin (IL)‐12 p40 and IL‐10, as well as the pro‐inflammatory cytokines IL‐1β, IL‐6 and IL‐8, was measured in the culture supernatants.

Results:  After LOS stimulation of WBCC, smokers showed a lower IL‐12 p40/IL‐10 ratio than non‐smokers (P < 0.05). Interleukin‐1β production was significantly lower in smokers compared with non‐smokers after stimulation with either LOS or Pg‐SE (P < 0.05). Interleukin‐6 and IL‐8 production was similar in WBCC from both smokers and non‐smokers, for both LOS and Pg‐SE.

Conclusion:  A more pronounced Th2 response in smoking periodontitis patients may be related to increased severity of the disease.
Tumor necrosis factor‐α‐stimulated membrane type 1‐matrix metalloproteinase production is modulated by epidermal growth factor receptor signaling in human gingival fibroblasts
Authors: Smith P. C. , Guerrero J. , Tobar N. , Cáceres M. , González M. J. , Martínez J.
Published: January 2009

Background and Objectives:  Membrane type 1‐matrix metalloproteinase (MT1‐MMP) is a collagenolytic enzyme involved in connective tissue remodeling. In periodontal tissues, either cytokines or growth factors regulate the production of proteolytic enzymes. Mice deficient in epidermal growth factor receptor (EGFR) show a reduced expression of MT1‐MMP, suggesting that this receptor may play an important role in MT1‐MMP production. The present study evaluated the role of the inflammatory cytokine tumor necrosis factor‐α (TNF‐α) and EGFR in the production of MT1‐MMP in gingival fibroblasts.

Material and Methods:  Primary cultures of human gingival fibroblasts were cultured over plastic or a type I collagen matrix and stimulated with TNF‐α and EGF. A selective EGFR inhibitor (AG1478) was used to interfere with this signaling pathway. Production of MT1‐MMP and activation of proMMP‐2 were studied using Western blot and gelatin zymography, respectively. Activation of EGFR signaling was assessed through immunoprecipitation and Western blot. Expression of EGFR ligands was determined through reverse transcriptase‐polymerase chain reaction.

Results:  Treatment of gingival fibroblasts cultured over a collagen matrix with TNF‐α stimulated proMMP‐2 activation and MT1‐MMP production. However, after using AG1478, both responses were inhibited. Tumor necrosis factor‐α induced EGFR transactivation and stimulated the expression of the mRNA for the EGFR ligands heparin binding‐epidermal growth factor (HB‐EGF) and transforming growth factor‐α (TGF‐α).

Conclusions:  The present study shows that TNF‐α may stimulate MT1‐MMP production through transactivation of EGFR. Tumor necrosis factor‐α may also modulate the expression of the EGFR ligands TGF‐α and HB‐EGF. Production of MT1‐MMP by TNF‐α requires interaction with EGFR, suggesting that tissue remodeling is controlled by cross‐communication between diverse signaling pathways in gingival fibroblasts.
Human leukocyte histocompatibility antigen class II‐induced cytokines from human gingival fibroblasts promote proliferation of human umbilical vein endothelial cells: potential association with enhanced angiogenesis in chronic periodontal inflammation
Authors: Okada Y. , Meguro M. , Ohyama H. , Yoshizawa S. , Takeuchi‐Hatanaka K. , Kato N. , Matsushita S. , Takashiba S. , Nishimura F.
Published: January 2009

Background and Objective:  The role of human leukocyte histocompatibility antigen (HLA) class II molecules on non‐antigen‐presenting cells has been a matter of controversy. We previously reported that HLA‐II molecules on human gingival fibroblasts (GF) do not present antigens, but transduce signals into the cells, resulting in the expression of several cytokines, such as interleukin‐6 (IL‐6), monocyte chemoattractant protein‐1 (MCP‐1), regulated upon activation, normal T‐cell expressed and secreted (RANTES) and IL‐8. However, the exact role of these cytokines, as well as other cytokines which are potentially secreted from GF, in the pathogenesis of chronic periodontal inflammation is not fully understood. The aim of this study was to observe the effects of HLA‐II‐induced cytokines on the proliferation of human umbilical vein endothelial cells (HUVEC).

Material and Methods:  Antibody‐based cytokine‐microarray analyses were performed to detect potential cytokines associated with angiogenesis. Next, cytokine productivity was confirmed by quantitative methods. Then, cell proliferation assay was performed to see whether these cytokines promoted the proliferation of HUVEC.

Results:  Besides IL‐6, MCP‐1, RANTES and IL‐8, growth‐related gene product (GRO) was newly identified as an HLA‐II‐induced cytokine released from GF. This was confirmed by a quantitative method. Cell culture supernatant from HLA‐II‐stimulated GF cultures promoted the growth of HUVEC. Addition of anti‐IL‐8 neutralizing antibody, anti‐CXC receptor (CXCR)1 antibody and anti‐MCP‐1 antibody inhibited the growth of HUVEC in a dose‐dependent manner, while addition of anti‐GROα antibody did not.

Conclusion:  The HLA‐II‐induced IL‐8, via CXCR1, as well as MCP‐1 from GF, promotes endothelial cell proliferation, which is possibly associated with enhanced angiogenesis in chronic periodontal lesions.
Increased expression of extracellular matrix metalloproteinase inducer is associated with matrix metalloproteinase‐1 and ‐2 in gingival tissues from patients with periodontitis
Authors: Dong W. , Xiang J. , Li C. , Cao Z. , Huang Z.
Published: January 2009

Background and Objective:  Extracellular matrix metalloproteinase inducer (EMMPRIN), an immunoglobulin‐like cell surface glycoprotein, could promote collagenolytic balance in favor of the expression and activation of matrix metalloproteinases (MMPs). This study was to investigate the expression of EMMPRIN in gingival tissues from different periodontal conditions and to correlate it with the production of MMP‐1 and MMP‐2.

Material and Methods:  Gingival biopsies were collected from 15 patients with untreated advanced chronic periodontitis and 15 patients with aggressive periodontitis (AgP). The control group consisted of 12 subjects diagnosed either as periodontally healthy individuals or as individuals with a gingival index of one (H/G1). The peptides and mRNA of EMMPRIN, MMP‐1 and MMP‐2 were detected by immunohistochemistry and semi‐quantitative reverse transcriptase‐polymerase chain reaction, respectively.

Results:  The expression of EMMPRIN, MMP‐1 and MMP‐2 peptides in periodontally healthy tissues was mainly confined to the gingival epithelium. The EMMPRIN was strongly expressed in the cell membrane of the basal layer. Immunoreactivity for EMMPRIN was more intensive and more widespread in periodontitis, extended from the epithelial layers to the underlying connective tissues, and was essential in both inflammatory and fibroblast‐like cells. In addition, MMP‐1 and MMP‐2 showed the same localized expression. The chronic periodontitis group had a significantly higher mRNA expression of EMMPRIN and MMP‐2 compared with the H/G1 subjects (p < 0.05). Production of MMP‐1 and MMP‐2 by gingival tissues was correlated with the mRNA level of EMMPRIN (r = 0.463, p = 0.013 for MMP‐1 and r = 0.404, p = 0.033 for MMP‐2).

Conclusion:  The expression of EMMPRIN in human normal and diseased gingiva might contribute to periodontal physiological and pathological processes; moreover, its increased production might be associated with MMP‐1 and MMP‐2 expression.
Comparative gender differences in local and systemic concentrations of pro‐inflammatory cytokines in rats with experimental periodontitis
Authors: Bain J. L. , Lester S. R. , Henry W. D. , Bishop C. M. , Turnage A. A. , Naftel J. P. , Johnson R. B.
Published: January 2009

Background and Objective:  There have been few studies of gender differences in response to periodontitis. Thus, we compared gender‐specific differences in systemic cytokine concentrations in rats with and without ligature‐induced periodontitis.

Material and Methods:  Experimental periodontal disease was initiated in Sprague–Dawley rats by placing a ligature around the crowns of the second right maxillary molar tooth. Sham‐operated control groups were also created. Two weeks later, the right and left maxillary quadrants of teeth, liver and serum were collected from all the rats, and uterine horns were collected from the female rats. Liver and uterine samples were ground in phosphate‐buffered saline (10 mg of tissue/mL of phosphate‐buffered saline + protease inhibitor) containing a protease inhibitor, and cytokine concentrations were determined by enzyme‐linked immunosorbent assay. Digital radiographs were made of maxillary quadrants, and the distance from cemento–enamel junction to alveolar crest was measured using image analysis software. Data were compared by factorial analysis of variance and a post‐hoc Tukey test.

Results:  Female rats with ligatures had greater, but not significantly different, alveolar bone loss than males with ligatures. However, they had higher serum concentrations of interleukin‐6, tumor necrosis factor‐α and C‐reactive protein, and liver C‐reactive protein (p < 0.05). These females also had higher interleukin‐6, tumor necrosis factor‐α and vascular endothelial growth factor concentrations within the uterine horn, compared to female controls (p < 0.05). Male animals with ligatures had lower serum concentrations of C‐reactive protein and higher interleukin‐6 and tumor necrosis factor‐α concentrations within serum, compared to male controls (p < 0.05).

Conclusion:  Our study suggests that females with periodontal disease have a greater risk for inflammatory‐based systemic diseases than males.
Matrix metalloproteinase‐9 and tissue inhibitor of matrix metalloproteinase‐1 in blood as markers for early atherosclerosis in subjects with chronic periodontitis
Authors: Söder P‐Ö. , Meurman J. H. , Jogestrand T. , Nowak J. , Söder B.
Published: January 2009

Background and Objectives:  An association has been found between periodontal disease and the development of atherosclerosis. We investigated the hypothesis that periodontal disease triggers the expression of matrix metalloproteinase‐9 (MMP‐9) and tissue inhibitor of matrix metalloproteinase‐1 (TIMP‐1) in blood. Increased levels of these parameters might then indicate early atherosclerosis.

Material and Methods:  In this cross‐sectional study, the material comprised 80 subjects with chronic periodontitis and 31 subjects with no periodontal disease. Sixteen years after diagnosis of periodontal disease ultrasonography revealed a statistically significant difference (p < 0.001) of carotid intima–media thickness between the subjects with chronic periodontitis and the periodontally healthy subjects. Matrix metalloproteinase‐9 and TIMP‐1 were analyzed from blood as periodontal and systemic inflammatory markers. The relationship between MMP‐9, TIMP‐1 and MMP‐9/TIMP‐1 as dependent variables and several independent variables (age, sex, smoking, education, body mass index, hypertension, periodontal disease and cholesterol) were analyzed in multiple logistic regression models to assess the value of the inflammatory markers in predicting carotid atherosclerosis.

Results:  Matrix metalloproteinase‐9 and TIMP‐1 were significantly higher in plasma from subjects with periodontal disease and atherosclerosis. Periodontal disease was identified as the principal independent predictor both for atherosclerosis (odds ratio 3.89 for increase in bilateral carotid intima–media thickness) and for increased MMP‐9, TIMP‐1 and MMP‐9/TIMP‐1 (odds ratio 2.58, 5.53 and 3.41, respectively). Classical atherosclerosis risk factors, such as increased total cholesterol, age and sex (women), were significant predictors in the model.

Conclusion:  Matrix metalloproteinase‐9, TIMP‐1 and MMP‐9/TIMP‐1 in blood from subjects with periodontal disease could be useful laboratory markers for increased carotid artery intima–media thickness.
Procyanidins Produce Significant Attenuation of Doxorubicin‐Induced Cardiotoxicity via Suppression of Oxidative Stress
Authors: Li Wei , Xu Bin , Xu Jian , Wu Xiao‐Li
Published: January 2009

Abstract:  Doxorubicin is widely prescribed in the chemotherapy of haematological malignancies and solid tumours. The major side effect of doxorubicin is oxidative injury‐related cardiotoxicity, which has dramatically hindered its usage. Procyanidins from grape seeds are potent free radical scavengers that have been shown to protect against anthracycline‐induced cardiotoxicity. In the present study, we tested whether procyanidins would prevent the doxorubicin‐induced cardiotoxicity in rats. Rats were intraperitoneally treated with doxorubicin at a cumulative dose of 15 mg/kg with and without pre‐administration of procyanidins. Our data showed that doxorubicin led to cardiac function deterioration, myocardial injury and increased oxidative stress in cardiac tissues. The cardiac function deterioration by doxorubicin included increased QT‐interval and ST‐interval in electrocardiograph (ECG) and decreased left ventricular developed pressure. Doxorubicin‐induced myocardial injury was shown by the increased creatine kinase, alanine aminotransferase and aspartate aminotransferase in serum as well as in myocardial lesions. Pretreatment with procyanidin (150 mg/kg daily) effectively hindered the adverse effects of doxorubicin, such as myocardial injury and impaired heart function. Procyanidin pretreatment attenuated cytoplasmic vacuolization, increased left ventricular developed pressure and improved the ECG. The cardioprotective effect of procyanidin corresponded to the decrease of lipid peroxidation and the increase of cardiac antioxidant potency in doxorubicin‐treated rats that were also given procyanidin. An in vitro cytotoxic study showed that procyanidins did not attenuate the antineoplastic activity of doxorubicin to A549 adenocarcinoma cells. All the above lines of evidence suggest that procyanidins protect cardiomyocytes from doxorubicin‐induced cardiotoxicity via suppression of oxidative stress.
Self-Esteem, Confidence, and Relationships in Brazilian Men with Erectile Dysfunction Receiving Sildenafil Citrate: A Randomized, Parallel-Group, Double-Blind, Placebo-Controlled Study in Brazil
Authors: Glina Sidney , Damião Ronaldo , Abdo Carmita , Afif-Abdo João , Tseng Li-Jung , Stecher Vera
Published: January 2009

Introduction

Psychosocial manifestations of erectile dysfunction (ED) differ across cultures. Understanding the treatment response to ED medications within cultural groups can aid in resource allocation and in developing treatment strategies.

Aim

Evaluate the effect of sildenafil treatment on self-esteem, confidence, and sexual relationship satisfaction in Brazilian men with ED.

Main Outcome Measure

The Self-Esteem and Relationship (SEAR) questionnaire, a validated, 14-question instrument developed to specifically address self-esteem and relationship issues within the context of ED.

Methods

Men aged 18 years or older with a clinical diagnosis of ED (≤21 on the Sexual Health Inventory for Men) and in a stable relationship with a partner during the study were eligible. The primary end point was a change from baseline in the self-esteem subscale of the SEAR questionnaire. Thirteen Brazilian sites participated in a randomized, double-blind, placebo-controlled trial of sildenafil treatment for ED. Patients were randomized to receive either 50 mg of sildenafil (adjustable to 25 mg or 100 mg based on patient response) or matching placebo approximately 1 hour before anticipated sexual activity but not more than once a day.

Results

At the end of double-blind treatment, 63 and 66 patients in the placebo and sildenafil groups, respectively, from 13 Brazilian sites were assessed for efficacy. Brazilian patients receiving sildenafil had significantly greater improvements in their scores on the SEAR self-esteem subscale (42.9 [95% confidence interval 35.7–50.0]) compared with placebo (21.1 [95% confidence interval 13.7–28.6]; P < 0.0001). Effect sizes ranged from 0.91 to 1.25 for individual SEAR components.

Conclusions

The psychosocial parameters in Brazilian men with ED assessed by the SEAR questionnaire showed significant improvements in self-esteem, confidence, and relationships after treatment with sildenafil.
Pain, Psychosocial, Sexual, and Psychophysical Characteristics of Women with Primary vs. Secondary Provoked Vestibulodynia
Authors: Sutton Katherine S. , Pukall Caroline F. , Chamberlain Susan
Published: January 2009

Introduction

Women with provoked vestibulodynia (PVD), a common cause of dyspareunia, are typically considered a homogeneous group. However, research suggests that differences on some factors (e.g., medical history, pain characteristics, psychological functioning, treatment response) exist based upon whether the pain was present at first intercourse (primary PVD: PVD1) or developed at some later point (secondary PVD: PVD2).

Aims

The purpose of this study was to examine differences in demographic variables, pain characteristics, psychosocial and psychosexual adjustment, and pain sensitivity between women with PVD1 and PVD2.

Methods

Twenty-six women suffering from PVD (13 with PVD1 and 13 with PVD2) completed a screening assessment, a standardized gynecological examination, an interview, questionnaires, and a quantitative sensory testing session.

Main Outcome Measures

These included pain ratings during the gynecological examination and interview, scores on measures of psychosocial/sexual functioning (e.g., Short Form-36 [SF-36] Health Survey, Female Sexual Function Index), and thresholds and pain ratings during thermal sensory testing over the dominant forearm and vulvar vestibule.

Results

The women with PVD1 were more likely to be nulliparous, but they were not significantly different from the women with PVD2 on other demographic variables or in their pain ratings during the gynecological examination. The women with PVD1 reported lower levels of social and emotional functioning and heightened anxiety surrounding body exposure during sexual activity, and they also displayed lower heat pain tolerance over the forearm and lower heat detection and pain thresholds at the vulvar vestibule than the women with PVD2.

Conclusions

The findings from this study support previous research indicating that women with PVD1 and PVD2 differ in a number of domains. Further research is needed to confirm and elaborate on these findings.
Sexual Function: A Comparison Between Male Renal Transplant Recipients and Hemodialysis Patients
Authors: Tavallaii Seyed Abbass , Mirzamani Mahmood , Heshmatzade Behzadi Ashkan , Assari Shervin , Khoddami Vishteh Hamid Reza , Hajarizadeh Behzad , Einollahi Behzad
Published: January 2009

Introduction

For all the studies into the sexual health of kidney transplant recipients, there is a paucity of controlled studies regarding the difference in the sexual relationship of kidney transplant recipients and end-stage renal disease (ESRD) patients under hemodialysis.

Aim

We compared the sexual function of kidney transplant recipients and ESRD patients under hemodialysis in male patients.

Main Outcome Measures

The patients’ sexual function was assessed using the Relationship and Sexuality Scale.

Method

In this case-controlled study, 89 male renal transplant recipients and 25 male hemodialysis patients were randomly selected from the outpatient clinic of Baqiyatallah Hospital, Tehran, Iran, in 2006. The two groups were not significantly different in terms of age, living place, level of education, duration of ESRD (months), ESRD cause, and somatic comorbidities (Ifudu index).

Results

The renal transplant patients in comparison with the hemodialysis group reported a better overall sexual relationship (17.3 ± 0.6 vs. 21.6 ± 1.4; P = 0.001), and all subscales including sexual function (9.9 ± 0.3 vs. 11.4 ± 0.6; P = 0.03), sexual frequency (6.3 ± 0.3 vs. 7.4 ± 0.6; P = 0.04), and sexual fear (1.1 ± 0.2 vs. 2.8 ± 0.5; P = 0.001). In addition, kidney recipients had significantly more sexual intercourse in a 2-week period prior to the study (P = 0.008).

Conclusions

In our male population, kidney transplant recipients, in comparison with the ESRD patients under hemodialysis, reported a better sexual relationship.
The Effects of Hypoestrogenism on the Vaginal Wall: Interference with the Normal Sexual Response
Authors: Da Silva Lara Lucia Alves , Useche Bernardo , Ferriani Rui Alberto , Reis Rosana Maria , De Sá Marcos Felipe Silva , De Freitas Mauricio Mesquita Sabino , E Silva Julio César Rosa , De Sá Rosa e Silva Ana Carolina Japur
Published: January 2009

Introduction

The sexual response depends on the adequate function of all systems related to the genital and extra-genital organs. Physiological conditions such as menopause can interfere with sexual expression because of central and peripheral changes. Genital effects of estrogen include vaginal trophism, lubrication, and local pleasure sensation in the sexual arousal phase. Hypoestrogenism causes changes in the four layers of the vaginal wall that may result in dyspareunia and a loss in the quality of the genital arousal response.

Aim

The purpose of this review is to highlight the changes in the vaginal wall caused by hypoestrogenism, its possible relationship with dyspareunia, and its repercussions for genital arousal. Treatments for hypoestrogenism are also discussed.

Methods

We evaluated the data available in PubMed (1982–2008) and surveyed the reference list for relevant studies. Two reviewers analyzed the data independently. A study was considered to be of high quality if it had all three of the following characteristics: (i) prospective design; (ii) valid data; and (iii) adequate sample size. Reviews and experimental animal studies were also considered.

Main Outcome Measures

Normal genital morphology, hypoestrogenism and hormone replacement therapy were the focus of the studies reviewed in this paper.

Results

Atrophy of the vaginal wall may be associated with dyspareunia and genital sexual arousal disorder, but psychological and sociocultural aspects must also be considered. Regardless, however, local estrogen therapy is useful in improving vaginal wall trophism and, thus, in improving the sexual response.

Conclusions

There are many possible alterations in the structure of the vaginal wall that are related to estrogen deficiency that may require medical intervention beyond the usual strategies used to attain adequate sexual function. Physicians should attempt to treat these alterations, and more research is needed to elucidate the physiopathology of dyspareunia and genital sexual arousal physiology.
Female Urinary Incontinence During Intercourse: A Review on an Understudied Problem for Women’s Sexuality
Authors: Serati Maurizio , Salvatore Stefano , Uccella Stefano , Nappi Rossella E. , Bolis Pierfrancesco
Published: January 2009

Introduction

Coital urinary incontinence is a frequently underreported symptom, with a relevant impact on women’s sexuality and quality of life.

Aim

This article will review the available evidence on incidence, pathophysiology, and treatment of coital urinary incontinence with the attempt to present the current state of the art.

Methods

PubMed was searched for reports about coital urinary incontinence that were published from 1970 to 2008, and the most relevant articles were reviewed.

Main Outcome Measures

Review on epidemiology, pathophysiology, diagnosis, and treatment of coital incontinence.

Results

The incidence of coital incontinence in incontinent women has been reported to range between 10% and 27%. At present, some evidence suggests an association between urinary leakage at penetration and urodynamic stress (USI) incontinence as well as urinary leakage during orgasm and detrusor overactivity (DO). When treatment for these conditions are based upon urodynamic findings, pelvic floor muscle training, surgery, and pharmacotherapy show satisfactory cure rates.

Conclusions

Coital urinary incontinence deserves much more attention in clinical practice: women should be specifically interviewed for this disturbance because it has a very negative impact on their sexuality. If a reliable urodynamic diagnosis is made, coital urinary incontinence at penetration can be cured in more than 80% of cases by surgery in the presence of USI. The form of coital incontinence during orgasm is curable by antimuscarinic treatment in about 60% of cases when associated with DO.
Atorvastatin Ameliorates Sildenafil-Induced Penile Erections in Experimental Diabetes by Inhibiting Diabetes-Induced RhoA/Rho-Kinase Signaling Hyperactivation
Authors: Morelli Annamaria , Chavalmane Aravinda Krishnappa , Filippi Sandra , Fibbi Benedetta , Silvestrini Enrico , Sarchielli Erica , Zhang Xin-Hua , Vignozzi Linda , Vannelli Gabriella Barbara , Forti Gianni , Maggi Mario
Published: January 2009

Introduction

One of the proposed mechanisms responsible for diabetes-related erectile dysfunction (ED) is overactivity of RhoA/ROCK signaling, as seen in experimental models of chemical diabetes.

Aim

Because statins may interfere with RhoA/Rho-kinase (ROCK) signaling through the reduction of geranyl-geranyl pyrophosphate (GGPP), required for RhoA activation, we investigated whether atorvastatin ameliorated diabetes-related ED.

Methods

Streptozotocin-induced (8 weeks) diabetic rats and alloxan-induced (8 weeks) diabetic rabbits received atorvastatin (5 mg/kg daily) for the last 2 weeks. In vitro contractility studies were conducted in the rabbit model. In the rat model, sildenafil effect on electrical stimulation (ES)-induced erection was investigated. Atorvastatin action was also analyzed using human fetal penile smooth muscle cells (hfPSMCs) exposed to low (5 mM), high (22 mM), and very high (40 mM) glucose.

Main Outcome Measures

Atorvastatin effect on hyperglicemia-induced RhoA/ROCK signaling was evaluated using the ROCK inhibitor Y-27632 in both animal models and by analyzing functional effects downstream to RhoA activation in hfPSMCs.

Results

In both diabetic models, atorvastatin did not affect glycemia, lipid plasma levels, and the hypogonadal state. In diabetic rats, atorvastatin ameliorated the erectile response to the ES of the cavernous nerve and normalized sildenafil effect on erectile function, strongly decreased by diabetes. In penile tissue from diabetic animals, atorvastatin completely restored the diabetes-induced hypersensitivity to Y-27632 and prevented RhoA membrane translocation/activation. In hfPSMCs, high glucose significantly increased not only membrane RhoA expression, but also ROCK activity (increased phosphorylation of the ROCK substrate myosin phosphatase target subunit 1) and several RhoA-dependent functions such as proliferation, migration, and smooth muscle-related gene expression. Atorvastatin restored all the high-glucose-induced effects, an action specifically reverted by GGPP.

Conclusion

Atorvastatin improves diabetes-related ED and restores sildenafil responsiveness, most probably by inhibiting RhoA/ROCK signaling, which underlies several high-glucose-induced derangements in penile smooth muscle cell commitment.
Clinically Relevant Changes in Sexual Desire, Satisfying Sexual Activity and Personal Distress as Measured by the Profile of Female Sexual Function, Sexual Activity Log, and Personal Distress Scale in Postmenopausal Women with Hypoactive Sexual Desire Disorder
Authors: DeRogatis Leonard R. , Graziottin Alessandra , Bitzer Johannes , Schmitt Sonja , Koochaki Patricia E. , Rodenberg Cynthia
Published: January 2009

Introduction

Transdermal testosterone patch (TTP) treatment produced statistically significant improvements in a satisfying sexual activity (SSA), sexual desire, and personal distress in postmenopausal women suffering from hypoactive sexual desire disorder (HSDD), but clinical significance of these changes was not determined.

Aim

To quantify the magnitude of change in three principal outcomes measures determined by HSDD patients as associated with the perception of meaningful benefit with TTP therapy.

Methods

The criteria for defining responders were determined using anchoring methodology and receiver operating characteristics analysis to establish minimum important differences (MIDs) in a representative subsample of 132 patients in two randomized, controlled trials in surgically menopausal women with HSDD (N = 1,094). Perceived benefit was established based upon the question “Overall, would you say that you experienced a meaningful benefit from the study patches?”. These data defined responders and established MIDs for changes in sexual desire, SSA, and personal distress. The MIDs were applied to the two trials to establish responder rates in each treatment group.

Main Outcome Measures

Changes in score that correspond to the MID for sexual desire, SSA, and personal distress, and responder rates in each treatment group based upon these values.

Results

Increases in frequency of SSA of greater than 1 activity/4 weeks, increases in sexual desire score of ≥8.9, and decreases in the personal distress score of ≥20.0 were identified as threshold improvements best able to differentiate responders and nonresponders. The responder rate was significantly higher (P < 0.001) in the testosterone group vs. placebo for all three outcomes measures (sexual desire, 50% vs. 34%; SSA, 44% vs. 30%; personal distress, 51% vs. 39%).

Conclusions

Changes in sexual desire, SSA, and personal distress observed with TTP treatment in surgically menopausal women with HSDD were clinically significant and were associated with a meaningful treatment benefit.
Pulse Pressure, an Index of Arterial Stiffness, is Associated with Androgen Deficiency and Impaired Penile Blood Flow in Men with ED
Authors: Corona Giovanni , Mannucci Edoardo , Lotti Francesco , Fisher Alessandra D. , Bandini Elisa , Balercia Giancarlo , Forti Gianni , Maggi Mario
Published: January 2009

Introduction

Pulse pressure (PP; i.e., the arithmetic difference between systolic and diastolic blood pressure) reflects arterial stiffness and has been suggested to be an independent cardiovascular risk factor.

Aim

The aim of the present study is to asses the possible contribution of PP to arteriogenic erectile dysfunction (ED) and ED-associated hypogonadism.

Methods

A consecutive series of 1,093 (mean age 52.1 ± 13.0 years) male patients with ED and without a previous history of hypertension or not taking any antihypertensive drugs were investigated.

Main Outcome Measures

Several hormonal and biochemical parameters were studied, along with structured interview on erectile dysfunction (SIEDY), ANDROTEST structured interviews, and penile Doppler ultrasound.

Results

Subjects with higher PP quartiles showed worse erectile function and higher prevalence of arteriogenic ED even after adjustment for confounding factors. Furthermore, sex hormone binding globulin-unbound testosterone levels declined as a function of PP quartiles. Accordingly, the prevalence of overt hypogonadism (calculated free testosterone < 180 pmol/L or free testosterone < 37 pmol/L) increased as a function of PP quartiles (17.% vs. 39.7%, and 30.8% vs. 58.6% for the first vs. fourth quartile, respectively, for calculated free testosterone and free testosterone; all P < 0.0001 for trend). This association was confirmed even after adjustment for confounders (Adjusted [Adj]) r = 0.090 and 0.095 for calculated free testosterone < 180 pmol/L and free testosterone < 37 pmol/L, respectively; all P < 0.05).

Conclusions

PP is an easy method to estimate and quantify patient arterial stiffness. We demonstrated here for the first time that elevated PP is associated with arteriogenic ED and male hypogonadism. The calculation of PP should became more and more familiar in the clinical practice of health care professionals involved in sexual medicine.
Alcohol Consumption and Male Erectile Dysfunction: An Unfounded Reputation for Risk?
Authors: Chew Kew-Kim , Bremner Alexandra , Stuckey Bronwyn , Earle Carolyn , Jamrozik Konrad
Published: January 2009

Introduction

Alcohol consumption is a contentious social topic and is often assumed to have deleterious effects on sexual performance. There is a lack of consensus on whether alcohol consumption may in fact be beneficial to erectile function.

Aim

We examined the data from a population-based cross-sectional study of men’s health to assess the association between usual alcohol consumption and erectile dysfunction (ED).

Method

Reply-paid questionnaires were posted to a randomly selected age-stratified male population sample obtained from the Western Australian (WA) Electoral Roll.

Main Outcome Measures

The survey questionnaire included sociodemographic details, self-reported clinical information, and drinking habits. The 5-item International Index of Erectile Function (IIEF-5) was used to assess erectile function.

Results

Most (87%) participants were current alcohol drinkers, with binge drinking, as defined by the Australian National Health and Medical Research Council (NHMRC), reported by 20% of drinkers. Compared with never-drinkers, the age-adjusted odds of ED were lower among current, weekend, and binge drinkers and higher among ex-drinkers. Among current drinkers, the odds were lowest for consumption within the NHMRC guidelines of between 1 and 20 standard drinks a week. On further adjustment for cardiovascular disease (CVD) or for cigarette smoking, age-adjusted odds of ED were reduced by 25–30% among alcohol drinkers.

Conclusions

Our findings suggest a modest negative association between alcohol consumption and ED and confounding of the association by CVD and cigarette smoking. The Western Australia Men’s Health Study certainly provides no justification for advising men with ED whose drinking habits are consistent with NHMRC guidelines that they should cease or reduce their consumption of alcohol.
Testosterone Replacement Therapy in Naturally and Surgically Menopausal Women (CME)
Authors: Panzer Claudia , Guay André
Published: January 2009

Introduction

Testosterone replacement therapy in naturally and surgically menopausal women is a complex and currently highly debated topic. Opposing guidelines for the use of testosterone exist, which create a therapeutic dilemma for clinicians confronted by severely distressed women who experience a decrease in sexual desire after surgical or natural menopause.

Aim

In this review, we will address the current knowledge on androgen physiology, conditions associated with a low androgen state, and risks and benefits of androgen therapy.

Methods

An English-language Medline review was performed.

Main Outcome Measure

Review of available literature.

Results

A review of normal androgen physiology in women is summarized and a brief review of prior use of androgens over the last six decades is included. The data on the use of androgen replacement in pre- and postmenopausal women is evaluated, especially its relationship to sexual functioning. Special concerns about the effect of androgens on cardiovascular disease, breast, and endometrial tissue are discussed. The balance of evidence seems to show that androgens have more of a positive effect than a negative effect in women if used properly.

Conclusions

Testosterone replacement therapy for surgically and naturally menopausal women with low sexual desire can be accomplished physiologically and effectively after ruling out other medical conditions leading to low sexual desire and after proper information of the patient that testosterone therapy is not an FDA-approved medication in the United States. The majority of available data suggests that testosterone replacement in women can be used safely without increased risk of endometrial or breast cancer.
Aspects of Sexual Satisfaction in Men with Erectile Dysfunction: A Factor Analytic and Logistic Regression Approach
Authors: Fugl-Meyer Axel , Althof Stanley , Buvat Jacques , Paget Marie-Ange , Sotomayor Mariano , Stothard Diane
Published: January 2009

Introduction

The International Index of Erectile Function (IIEF), Sexual Encounter Profile (SEP), and Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) assess efficacy of phosphodiesterase type 5 (PDE5) inhibitor treatment of erectile dysfunction (ED).

Aims

To determine the degree that multiplicity of satisfaction questions in ED treatment evaluation instruments are congruent, to better understand the concept of sexual “satisfaction,” and to identify factors that correlate with improvement.

Methods

Questionnaire data from 4,174 placebo- or tadalafil-treated patients with ED were analyzed. Principal component analysis (PCA) was performed on IIEF and SEP satisfaction questions. Spearman correlation coefficients were determined. Data from 431 of the 4,174 patients who completed EDITS questionnaires were analyzed. Logistic regression was used to investigate improvement of each IIEF satisfaction question.

Results

PCA rotated on three factors explained 91% of total variance and separated IIEF Q6 (intercourse frequency) from a SEP and a remaining IIEF factor. All correlations between and among questions were close (ρ = 0.62–0.98; P < 0.0001), except for those with IIEF Q6 (ρ = 0.28–0.34; P < 0.0001). In a sub-sample, PCA of five IIEF, two SEP, and three EDITS questions identified four factors that explained 90% of all variance: EDITS questions, IIEF questions except Q6, SEP questions, and IIEF Q6. Greater improvement in IIEF-EF domain score was consistently and positively associated with satisfaction measures (P < 0.0001).

Conclusions

Factor analysis detected close relationships among satisfaction questions in IIEF, SEP, and EDITS instruments, each of which, apart from IIEF Q6 (intercourse frequency), appeared to be an independent measure of satisfaction. Cultural differences may explain different satisfaction correlations with baseline ED severity in different regions. Clinicians may make use of the correlation between intercourse frequency (Q6) and satisfaction when prescribing a PDE5 inhibitor for ED, by explaining that the inhibitor should enable more frequent intercourse.
Methods for Multimodal Vibration Suppression and Energy Harvesting Using Piezoelectric Actuators
Authors: Wilhelm Justin , Rajamani Rajesh
Published: January 2009

This paper presents a novel method for suppressing multimodal vibrations in structures by using the controlled harvesting and storage of vibration energy as electrical charge. Unlike a traditional semi-active system in which vibration energy is dissipated using a controlled variable dissipater, the proposed system harvests vibration energy for storage. The stored energy can then be recycled enabling the system to achieve a vibration reduction performance superior to that of a traditional semi-active system and approaching that of a fully active system. In the proposed method, an array of one or more precharged capacitors is employed to provide a selection of various voltages, which may be selected to approximate a desired control signal defined by an LQR multimodal vibration controller. The capacitors can apply a control voltage to the piezoelectric actuators and can also collect current generated by the actuators as the structure strains in vibration. Both a single capacitor system and a multi-capacitor system are considered and applied to a cantilevered beam. The response to impulse disturbances and random force disturbances are studied. The results are compared to a previously proposed energy harvesting based semi-active method. Advantages in both vibration suppression and energy harvesting performance over the previously proposed method are demonstrated. The multicapacitor method is found to be most effective due to its ability to apply sufficiently large control voltages while moderating large step inputs therefore reducing the excitation of higher frequency uncontrolled modes, which otherwise parasitically dissipate energy in the circuit resistance.
A Method to Simulate Structural Intensity Fields in Plates and General Structures Induced by Spatially and Temporally Random Excitation Fields
Authors: Daley Michael J. , Hambric Stephen A.
Published: January 2009

The structure-borne power in bending waves is well understood, and has been studied by many investigators in ideal beam and plate structures. Most studies to date, however, have considered only the structural intensity induced by deterministic localized drives. Many structures of practical interest are excited by spatially random pressure fields, such as diffuse and turbulent boundary layer pressure fluctuations. Additionally, such studies typically employ finite differencing techniques to estimate the shear, bending, and twisting components of intensity, and are therefore only applicable to simple homogenous uniform structures such as thin plates and beams. Often, however, finite differencing techniques are not applicable to practical structures of interest. The present study introduces a new analytic method to compute the structural intensity induced by spatially random pressure fields in general structures, which does not require the use of finite differencing techniques. This method uses multiple-input multiple-output random analysis techniques, combining frequency response function matrices generated from analytic or finite element (FE) models with cross-spectral density matrices of spatially random pressure fields to compute intensities in structures. The results of this method are validated using those obtained using finite-difference-based techniques in a flat plate. Both methods show intensity patterns different from those caused by deterministic point drives. The new general method, combined with FE analysis techniques, may be applied in the future to complex nonhomogenous structures, which include discontinuities, curvature, anisotropic materials, and general three-dimensional features.
Finite Element Model Tuning Using Measured Mass Properties and Ground Vibration Test Data
Authors: Pak Chan-gi
Published: January 2009

A simple and efficient approach for tuning finite element models to match computed frequencies, mode shapes, and mass properties to the experimental data is introduced in this study. The model tuning procedure proposed in this study is based on a series of optimizations. This approach has been successfully applied to create an equivalent beam finite element model for the X-37 drogue chute test fixture with the X-planes pylon. The goal was a simple model capable of being analyzed in a captive carry configuration with the B-52H mother ship. This study has shown that natural frequencies, corresponding mode shapes, and mass properties from the updated finite element model achieved at the final optimization iteration have excellent agreement with corresponding measured data.