bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Inhibitory Effects of Nicotine on Physiological Sexual Arousal in Nonsmoking Women: Results from a Randomized, Double-Blind, Placebo-Controlled, Cross-Over Trial
Authors: Harte Christopher B. , Meston Cindy M. 
Published: March 2008

AbstractIntroductionExtensive research suggests that long-term cigarette smoking is an independent risk factor for the introduction of sexual dysfunction in men. However, results of limited data investigating this relationship in women are mixed. No studies have examined the acute effects of tobacco or nicotine on physiological sexual response in women. Controlled experimental studies examining acute effects of isolated nicotine intake on female physiological sexual responses are necessary in order to help elucidate tobacco's potential role in the development and/or maintenance of sexual impairment in women.AimTo examine whether isolated nicotine intake acutely affects sexual arousal responses in nonsmoking women.MethodsTwenty-five sexually functional women (mean age = 20 years) each with less than 100 direct exposures to nicotine completed two counterbalanced conditions in which they were randomized to received either nicotine gum (6 mg) or placebo gum, both administered double-blind and matched for appearance, taste, and consistency, approximately 40 minutes prior to viewing an erotic film.Main Outcome MeasuresPhysiological (changes in vaginal pulse amplitude via vaginal photoplethysmography) and subjective (continuous self-report) sexual responses to erotic stimuli were examined, as well as changes in mood.ResultsNicotine significantly reduced genital responses to the erotic films (P = 0.05), corresponding to a 30% attenuation in physiological sexual arousal. This occurred in 11 of 18 women with valid physiological assessments. Nicotine had no significant effect on continuous self-report ratings of sexual arousal (P = 0.45), or on mood (all Ps &gt; 0.05).ConclusionsAcute nicotine intake significantly attenuates physiological sexual arousal in healthy nonsmoking women. Our findings provide support to the hypothesis that nicotine may be the primary pharmacological agent responsible for genital hemodynamic disruption, thereby facilitating a cascade of biochemical and vascular events which may impair normal sexual arousal responses.
Sex Steroids and Leptin Regulate the “First Kiss” (KiSS 1/G-Protein-Coupled Receptor 54 System) in Human Gonadotropin-Releasing-Hormone-Secreting Neuroblasts
Authors: Morelli Annamaria , Marini Mirca , Mancina Rosa , Luconi Michaela , Vignozzi Linda , Fibbi Benedetta , Filippi Sandra , Pezzatini Anna , Forti Gianni , Vannelli Gabriella B. , Maggi Mario 
Published: March 2008

Abstract

Introduction
The G-protein-coupled receptor 54 (GPR54) and its ligand kisspeptin, encoded by the KiSS-1 gene, have been involved in the molecular mechanisms underlying the reawakening of gonadotropin-releasing hormone (GnRH) neurons at puberty. GPR54 mutations cause hypogonadotropic hypogonadism in human and mice.

Aim
Our aim was to study regulation of the KiSS-1/GPR54 system using a previously characterized primary culture of human fetal GnRH-secreting neuroblasts, FNC-B4.

Methods
KiSS-1/GPR54 gene and protein expressions in FNC-B4 were evaluated by quantitative reverse transcription–polymerase chain reaction (qRT–PCR), immunocytochemistry, and Western blot. Expression of kisspeptin and GPR54 in fetal olfactory mucosa (OM), from which FNC-B4 cells were derived, was analyzed with confocal microscopy.

Main Outcome Measures
Regulation of KiSS-1/GPR54 expression in FNC-B4 was evaluated in response to sexual steroids and leptin. Effect of kisspeptin on GnRH secretion and migration in FNC-B4 was also investigated.

Results
Kisspeptin and GPR54 were immunolocalized and co-expressed with GnRH in OM and FNC-B4 cells. Kisspeptin (1 µM, 24 hours) induced GnRH secretion, but not gene expression, and inhibited migration (IC50 = 6.28 ± 3.71 nM) in FNC-B4. The 24-hour exposure to increasing concentrations of 17-β-estradiol (0.01–1 nM) significantly and dose-dependently decreased, whereas androgens (dihydrotestosterone [DHT], 0.01–1 nM) significantly stimulated KiSS-1/GPR54 mRNA. Testosterone (1 nM) showed a stimulatory effect only after blocking its aromatization with letrozole. In addition, leptin (1 nM, 24 hours), an adipocyte-derived hormone acting on the reproductive axis, significantly increased KiSS-1/GPR54 expression in FNC-B4. Immunocytochemistry and Western blot analysis confirmed the regulatory effects found with qRT–PCR. Interestingly, leptin (1 nM, 24 hours) also significantly increased both leptin receptor (LEPR) and androgen receptor (AR) mRNA. DHT (0.01–1 nM) also up-regulated LEPR and AR genes, suggesting a synergistic action between leptin and androgens aimed to up-regulate the KiSS-1/GPR54 system, which, in contrast, was inhibited by estrogens.

Conclusion
Our results indicate that an interplay between metabolic and sexual hormones may trigger the KiSS-1/GPR54 signaling to GnRH neurons suggesting new mechanisms which regulate puberty onset.
Management of Distal Extrusion of Penile Prosthesis: Partial Disassembly and Tip Reinforcement by Double Breasting or Grafting
Authors: Shaeer Osama 
Published: March 2008

Abstract

Introduction
Distal erosion and perforation of penile prosthesis have been reported in association with neurologic impairment, diabetes mellitus, and following irradiation for prostatic cancer. Once perforation occurs, reimplantation carries a higher risk of reperforation unless adequate preventive measures are taken.

Aim
This is a description of a procedure whereby the point of perforation was exposed and repaired to restore distal support.

Methods
In three patients with distal extrusion of penile prosthesis through the urethra, the glans was mobilized off the tip of the corpus cavernosum and the caverno–urethral fistula was disconnected from the corpus cavernosum. The fistula was sealed by primary sutures. The perforation on the corpus cavernosum side was sealed by double breasting in two cases and by grafting in one case. Prosthesis was reimplanted.

Main Outcome Measures
Complications, recurrence of erosion, and postoperative coital pain.

Results
No complications, recurrence, or persistent pain occurred in any of the three cases.

Conclusion
The management of the distal extrusion of penile prosthesis by partial disassembly, double breasting, or grafting may provide reliable distal support and thereby avoid reperforation and repeated extrusion.
Vaginal Orgasm Is Associated with Less Use of Immature Psychological Defense Mechanisms
Authors: Brody Stuart , Costa Rui Miguel 
Published: March 2008

Abstract

Introduction
Freud implied a link between inability to have a vaginal orgasm and psychosexual immaturity. Since Kinsey, many sexologists have asserted that no such link exists. However, empirical testing of the issue has been lacking.

Aim
The objective was to determine the relationship between different sexual behavior triggers of female orgasm and use of immature psychological defense mechanisms.

Methods
Women reported their past month frequency of different sexual behaviors and corresponding orgasm rates and completed the Defense Style Questionnaire (DSQ-40).

Main Outcome Measure
The association between ability to have vaginal intercourse orgasm (versus clitoral orgasm) and the use of DSQ-40 immature psychological defense mechanisms (associated with various psychopathologies) was examined.

Results
In a sample of 94 healthy Portuguese women, vaginal orgasm (triggered solely by penile–vaginal intercourse) was associated with less use of DSQ-40 immature defenses. Vaginal orgasm was associated with less somatization, dissociation, displacement, autistic fantasy, devaluation, and isolation of affect. Orgasm from clitoral stimulation or combined clitoral-intercourse stimulation was not associated with less use of immature defenses, and was associated with more use of some immature defenses. In one regression analysis, more masturbation and less vaginal orgasm consistency made independent contributions to the statistical prediction of immature defenses. In another regression analysis, any use of extrinsic clitoral stimulation for intercourse orgasm, and lack of any vaginal orgasm, made independent contributions to the statistical prediction of immature defenses. Vaginally anorgasmic women had immature defenses scores comparable to those of established (depression, social anxiety disorder, panic disorder, and obsessive–compulsive disorder) outpatient psychiatric groups. Results were not confounded by social desirability responding or relationship quality.

Conclusions
The results linking penile–vaginal orgasm with less use of immature psychological defense mechanisms are consistent with both early psychoanalytic personality theory and recent advances in sexual physiology. Implications for diagnosis and sex therapy are noted.
Therapeutic Response after First Month of Tadalafil Treatment Predicts 12 Months Treatment Continuation in Patients with Erectile Dysfunction: Results from the DETECT Study
Authors: Roumeguère Thierry , Verheyden Benny , Arver Stefan , Bitton Alain , Belger Mark , Schmitt Henry , for the DETECT study investigators  
Published: March 2008

ABSTRACT

Introduction
The DETECT study is a prospective, 12-month, European, multicenter, observational study of patients with erectile dysfunction (ED) initiating or changing treatment to tadalafil in routine clinical practice.

Aim
To determine the effectiveness of tadalafil and the factors associated with the continuation of treatment for ED at 12 months.

Methods
The DETECT study included 1,900 men aged 18 years and older with a history of ED and who were initiating or changing treatment to tadalafil.

Main Outcome Measures
Sexual function at baseline, 1, 6, and 12 months was assessed using the International Index of Erectile Function-erectile function (IIEF-EF) domain. Factors associated with treatment continuation at 12 months were evaluated using multivariate regression analysis.

Results
At 12 months, 1,319 (84%) of 1,567 patients who completed the questionnaire reported continued use of tadalafil. Among these patients, tadalafil was highly effective: 94%, 95%, and 71% with severe, moderate, and mild ED at baseline, respectively, improved by at least one IIEF-EF category and 65% had normal EF. Five factors were associated with tadalafil continuation at 12 months: (i) ED severity at 1 month (based on IIEF-EF domain score); (ii) tolerance to treatment at 1 month; (iii) age younger than 60 years; (iv) number of sexual attempts in the first month; and (v) no history of pelvic surgery. Patient and partner factors at baseline were not significantly associated with continued tadalafil use.

Conclusions
Tadalafil is an effective treatment for ED in routine clinical practice. The therapeutic response and treatment tolerance after 1-month treatment are the most important factors influencing tadalafil continuation.
Recreational Use of PDE5 Inhibitors by Young Healthy Men: Recognizing This Issue Among Medical Students
Authors: Korkes Fernando , Costa-Matos André , Gasperini Renato , Reginato Pedro V. , Perez Marjo D.C. 
Published: March 2008

ABSTRACT

Introduction
In recent years, recreational use of phosphodiesterase type 5 (PDE5) inhibitors has become popular as a sexual enhancement aid among some men without erectile dysfunction (ED) and even among women.

Aim
The aim of the present study, therefore, was to investigate the recreational use of PDE5 among young and healthy men.

Main Outcome Measures
We evaluated the use of PDE5 inhibitors among young and healthy men, their main reasons for using these drugs, and their expectations regarding its effects.

Methods
A survey was carried out among 167 male medical students (21.2 ± 2.3 years, range 17–31). The surveys were divided into domains, assessing epidemiological data, use of PDE5 inhibitor, and the simplified International Index of Erectile Function (IIEF-5).

Results
All men considered themselves with perfect erectile function. However, 9% reported previous use of PDE5 inhibitors. Of these, 46.7% had used PDE5 inhibitors more than three times, and 71.4% had mixed them with alcohol. Among this group of men, 13.3% had ED according to the IIEF-5. ED occurring with condom use, however, was twice more common, and 71.4% of the men who had taken PDE5 inhibitors thought that the drug had potential to facilitate condom use.

Conclusion
In conclusion, the use of PDE5 inhibitors by young men is more frequent than previously reported. Condom-related ED seems to be an underestimated problem, frequently solved with PDE5 inhibitors. However, potential deleterious effects might exist. Because PDE5 inhibitors are being used as non-prescribed drugs by as much as 9% of young men, further studies must evaluate the effects of these drugs in young and healthy men.
Clinical Implications of a Close Vicinity of Nervus Dorsalis Penis/Clitoridis and Os Pubis
Authors: Šedý Jiří , Naňka Ondřej , Špačková Jana , Jarolím Ladislav 
Published: March 2008

ABSTRACT

Introduction
Close relation of nervus dorsalis penis/clitoris and os pubis has a major impact in surgical disciplines.

Aim
To summarize a current knowledge about this region, represented by the course of sulcus nervi dorsalis penis/clitoridis.

Methods
Literature search of years 1970–2007.

Main Outcome Measures
In male, it accommodates nervus dorsalis penis whereas in female nervus et arteria dorsalis clitoridis. Lateral border of sulcus nervi dorsalis penis corresponds to vertical ridge and lateral border of sulcus nervi dorsalis clitoridis to ventral arc—two parameters, which are parts of the Phenice's method for sexing of isolated os pubis.

Results
Exact preparation of nervus dorsalis penis is crucial in correct performance of conversion of genitalia in patients with transsexualism, in reconstruction of posterior urethra, in hypospadia, during performance of penile blockade during circumcision and in revascularization surgery of erectile dysfunction. Possible role of the sulcus nervi dorsalis penis in the Alcock's syndrome is discussed. Similarly, it is advisable to take care of nervus dorsalis clitoridis during reduction clitoridoplasty in patients with adrenogenital syndrome and during the insertion of transobturator vaginal tape. Injury of nervus dorsalis penis/clitoridis leads to hypestesia or anestesia of glans penis/clitoridis. The injury to arteria dorsalis clitoridis leads to bleeding and/or hematoma.

Conclusions
Clinical anatomy of sulci is important in several situations in urologic surgery. It is possible to use sulcus nervi dorsalis penis/clitoridis for sexing of isolated pubis for antropological or forensic purposes.
Canadian and American Sex Therapists' Perceptions of Normal and Abnormal Ejaculatory Latencies: How Long Should Intercourse Last?
Authors: Corty Eric W. , Guardiani Jenay M. 
Published: March 2008

Abstract

Introduction
Lay public perceptions about how long intercourse should last are discrepant from objective data on ejaculatory latencies. This may be problematic as the subjective interpretation of latency is a factor related to perceived distress with length of intercourse.

Aim
Quantify the opinion of expert sex therapists as to what are “adequate,”“desirable,”“too short,” and “too long” intravaginal ejaculatory latencies.

Method
A random sample of members of the Society for Sex Therapy and Research in the United States and Canada was surveyed.

Main Outcome Measure
Intravaginal ejaculatory latency, in minutes, for four different conditions: coitus that lasts an amount of time that is “adequate,”“desirable,”“too short,” and “too long.”

Results
The interquartile range for the sex therapists' opinions regarding an “adequate” length for ejaculatory latency was from 3 to 7 minutes; “desirable” from 7 to 13 minutes; “too short” from 1 to 2 minutes; “too long” from 10 to 30 minutes.

Conclusions
Therapists' beliefs about ejaculatory latencies were consistent with objective data on ejaculatory latency and were not affected by therapist demographic characteristics such as sex or experience. These results suggest that the average sex therapist believes that intercourse that lasts 3 to 13 minutes is normative and not prima facie worthy of clinical concern. Dissemination to the public of these results may change lay expectations for intravaginal ejaculatory latency and prevent distress. These results may also be beneficial to couples in treatment for sexual problems by normalizing expectations.
Transsexualism in Serbia: A Twenty-Year Follow-Up Study
Authors: Vujovic Svetlana , Popovic Srdjan , Sbutega-Milosevic Gorica , Djordjevic Miroslav , Gooren Louis 
Published: March 2008

ABSTRACTIntroductionGender dysphoria occurs in all societies and cultures. The prevailing social context has a strong impact on its manifestations as well as on applications by individuals with the condition for sex reassignment treatment.AimTo describe a transsexual population seeking sex reassignment treatment in Serbia, part of former Yugoslavia.MethodsData, collated over a period of 20 years, from subjects applying for sex reassignment to the only center in Serbia, were analyzed retrospectively.Main Outcome MeasuresAge at the time of application, demographic data, family background, sex ratio, the prevalence of polycystic ovarian syndrome (PCOS) among female-to-male (FTM) transsexuals, and readiness to undergo surgical sex reassignment were tabulated.ResultsApplicants for sex reassignment in Serbia are relatively young. The sex ratio is close to 1:1. They often come from single-child families. More than 10% do not wish to undergo surgical sex reassignment. The prevalence of PCOS among FTM transsexuals was higher than in the general population but considerably lower than that reported in the literature from other populations. Of those who had undergone sex reassignment, none expressed regret for their decision.ConclusionsAlthough transsexualism is a universal phenomenon, the relatively young age of those applying for sex reassignment and the sex ratio of 1:1 distinguish the population in Serbia from others reported in the literature.
Normal Variations in Personality are Associated with Coital Orgasmic Infrequency in Heterosexual Women: A Population-Based Study
Authors: Harris Juliette M. , Cherkas Lynn F. , Kato Bernet S. , Heiman Julia R. , Spector Tim D. 
Published: March 2008

Abstract

Introduction
As many as 20–30% of women report an inability to orgasm during sexual intercourse. Some female sexual problems have been reported to cluster with psychological and social problems. Underlying personality type may play a role in the development or maintenance of such problems.

Aim
The aim of this study was to investigate whether certain domains of personality are associated with female coital orgasmic infrequency. To our knowledge this is the first such study in a large unselected population.

Methods
A total of 2632 women (mean age 51) from the TwinsUK registry completed questionnaires relating to personality and sexual behavior. Personality domains were assessed using the validated Ten-Item Personality Index (TIPI). Coital orgasmic frequency was measured using a seven-point Likert scale.

Main Outcome Measures
Using logistic regression, we investigated whether variations in five domains of personality are associated with female coital orgasmic infrequency. Discordant twin analysis was used to verify findings.

Results
Introversion (odds ratio [OR] 2.5, 95% confidence interval [CI] 1.7–3.7), emotional instability (OR 2.0, 95% CI 1.3–3.1), and not being open to new experience (OR 2.4, 95% CI 1.6–3.6) were significantly associated with orgasmic infrequency, whereas indices of agreeableness and conscientiousness were not significantly associated with orgasm frequency.

Conclusion
Specific personality subtypes appear to be significant risk factors for orgasmic infrequency. Consideration of these behavioral risk factors may need to be incorporated into research into female orgasmic disorder, and possible approaches to its treatment.
Cigarette Smoking and Erectile Dysfunction: Focus on NO Bioavailability and ROS Generation
Authors: Tostes Rita C. , Carneiro Fernando S. , Lee Anthony J. , Giachini Fernanda R.C. , Leite Romulo , Osawa Yoichi , Webb R. Clinton 
Published: March 2008

AbstractIntroductionThirty million men in the United States suffer from erectile dysfunction (ED) and this number is expected to double by 2025. Considered a major public health problem, which seriously affects the quality of life of patients and their partners, ED becomes increasingly prevalent with age and chronic smoking is a major risk factor in the development of ED.AimTo review available evidence concerning the effects of cigarette smoking on vascular changes associated with decreased nitric oxide (NO) bioavailability and increased reactive oxygen species (ROS) generation.MethodsWe examined epidemiological and clinical data linking cigarette smoking and ED, and the effects of smoking on vascular NO bioavailability and ROS generation.Main Outcome MeasuresThere are strong parallels between smoking and ED and considerable evidence supporting the concept that smoking-related ED is associated with reduced bioavailability of NO because of increased ROS.ResultsCigarette smoking-induced ED in human and animal models is associated with impaired arterial flow to the penis or acute vasospasm of the penile arteries. Long-term smoking produces detrimental effects on the vascular endothelium and peripheral nerves and also causes ultrastructural damage to the corporal tissue, all considered to play a role in chronic smoking-induced ED. Clinical and basic science studies provide strong indirect evidence that smoking may affect penile erection by the impairment of endothelium-dependent smooth muscle relaxation or more specifically by affecting NO production via increased ROS generation. Whether nicotine or other products of cigarette smoke mediate all effects related to vascular damage is still unknown.ConclusionsSmoking prevention represents an important approach for reducing the risk of ED. The characterization of the components of cigarette smoke leading to ED and the mechanisms by which these components alter signaling pathways activated in erectile responses are necessary for a complete comprehension of cigarette smoking-associated ED.