bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychosocial outcomes in children two years after epilepsy surgery: Has anything changed?
Authors: Elliott Irene M. , Lach Lucyna , Kadis Darren S. , Smith Mary Lou 
Published: March 2008

Summary
Purpose: We prospectively explored psychosocial outcomes in children (7–18 years) 2 years after epilepsy surgery. This study built on our previous one that examined these children 1 year after surgery.
Methods: Twenty children were studied using the Child Behavior Checklist (CBCL; a parent report instrument of potential behavioral and social problems) preoperatively, 1 year and 2 years after surgery. A comparison group of 12 children with medically refractory seizures was examined at comparable times. We conducted mixed factorial ANOVAs to determine group, time, and interaction effects, and regression analyses to assess factors driving significant (p ≤ 0.05) interactions. We also investigated the proportion of children scoring in the abnormal range over time.
Results: Significant main effects of time were observed on total behavior, externalizing, aggression, and delinquent behavior scales, with both groups reporting improvement. Main effects of group were observed for withdrawn and total competence scales, with the surgical group demonstrating favorable scores. Significant group × time interactions were observed on the social and social problems subscales. On both subscales, the surgical group demonstrated improvement over time, whereas the nonsurgical group experienced decline. Fifty percent of the surgical group remained seizure‐free. Seizure status and number of antiepileptic medications predicted changes in social scores. We did not observe a significant regression model for the social problems subscale.
Discussion: These findings suggest that change in social function may take time to develop after surgery. Prospective studies designed for longer periods are required to determine if improvements in other psychosocial domains are seen over time.
Solvent/detergent treatment of platelet concentrates enhances the release of growth factors
Authors: Burnouf Thierry , Tseng Yu H. , Kuo Ya P. , Su Chen Y. 
Published: March 2008

BACKGROUND: Platelet (PLT) growth factors released by thrombin activation of autologous PLT concentrates (PCs) are used in clinics as PLT gels or releasates for tissue repair and wound healing applications. If allogeneic products are to be used for clinical or cell culture applications, a method of viral inactivation of the PC source of growth factors is desirable.STUDY DESIGN AND METHODS: PLT‐derived growth factor‐AB (PDGF‐AB), transforming growth factor‐β1 (TGF‐β1), epidermal growth factor (EGF), and insulinlike growth factor‐1 (IGF‐1) in apheresis PC subjected to solvent/detergent (S/D) treatment with or without prior activation by CaCl2 and/or bovine thrombin were measured.RESULTS: Mean (± standard deviation) PDGF‐AB, TGF‐β1, EGF, and IGF‐1 content was 13.8 ± 14.3, 16.6 ± 14.3, less than 0.0007, and 83.4 ± 33.4 ng per mL, respectively, in the starting PC. They increased to 184.4 ± 80.2, 192.2 ± 37.4, 2.2 ± 1.6, and 88.4 ± 33.5 after 1 percent tri‐n‐butyl phosphate (TnBP)‐1 percent Triton X‐45 treatment, respectively. Mean content was 84.6 ± 35.5, 63.8 ± 14.1, 0.9 ± 0.6, and 117.2 ± 34.9 ng per mL, respectively, in CaCl2‐activated PC and remained stable after subsequent S/D treatment (88.3 ± 45.9, 68.6 ± 27.2, 1.40 ± 1.0, and 112.4 ± 39.7 ng/mL, respectively). Two percent TnBP treatment yielded similar release as with TnBP‐Triton X‐45. Addition of bovine thrombin did not increase the release of growth factors.CONCLUSION: S/D treatment efficiently releases PDGF‐AB, TGF‐β1, and EGF from nonactivated apheresis PCs and may be of interest to prepare virally inactivated allogeneic growth factors for clinical and cell culture applications.
Validation of Computed Tomography Image Integration into the EnSite NavX Mapping System to Perform Catheter Ablation of Atrial Fibrillation
Authors: RICHMOND LAURA , RAJAPPAN KIM , VOTH ERIC , RANGAVAJHALA VAMSEE , EARLEY MARK J. , THOMAS GLYN , HARRIS STUART , SPORTON SIMON C. , SCHILLING RICHARD J. 
Published: March 2008

Introduction: The complex anatomy of the left atrium (LA) makes location of ablation catheters difficult using fluoroscopy alone, and therefore 3D mapping systems are now routinely used. We describe the integration of a CT image into the EnSite NavX System with Fusion and its validation in patients undergoing atrial fibrillation (AF) or left atrial tachycardia (AT) catheter ablation. Methods and Results: Twenty‐three patients (61 ± 9.2 years, 16 male) with paroxysmal (14) and persistent (8) AF and persistent (1) AT underwent ablation using CT image integration into the EnSite NavX mapping system with the EnSite Fusion Dynamic Registration software module. In all cases, segmentation of the CT data was accomplished using the EnSite Verismo segmentation tool, although repeat segmentation attempts were required in seven cases. The CT was registered with the NavX‐created geometry using an average of 24 user‐defined fiducial pairs (range 9 to 48). The average distance from NavX‐measured lesion positions to the CT surface was 3.2 ± 0.9 mm (median 2.4 mm). A large, automated, retrospective test using registrations with random subsets of each patient's fiducial pairs showed this average distance decreasing as the number of fiducial pairs increased, although the improvement ceased to be significant beyond 15 pairs. In confirmation, those studies which had used 16 or more pairs had a smaller average lesion‐to‐surface distance (2.9 ± 0.7 mm) than those using 15 or fewer (4.3 ± 0.8 mm, P < 0.02). Finally, for the 13 patients who underwent left atrial circumferential ablation (LACA), there was no significant difference between the circumference computed using NavX‐measured positions and CT surface positions for either the left pulmonary veins (178 ± 64 vs. 177 ± 60 mm; P = 0.81) or the right pulmonary veins (218 ± 86 vs. 207 ± 81 mm; P = 0.08). Conclusion: CT image integration into the EnSite NavX Fusion system was successful in all patients undergoing catheter ablation. A learning curve exists for the Verismo segmentation tool; but once the 3D model was created, the registration process was easily accomplished, with a registration error that is comparable with registration errors using other mapping systems with CT image integration. All patients went on to have subsequent successful ablation procedures. Where LACA was performed (13 patients), only four patients required segmental ostial lesions to achieve electrical isolation.
Changes in Left Atrial Anatomy Due to Respiration: Impact on Three‐Dimensional Image Integration During Atrial Fibrillation Ablation
Authors: ECTOR JORIS , DE BUCK STIJN , LOECKX DIRK , COUDYZER WALTER , MAES FREDERIK , DYMARKOWSKI STEVEN , BOGAERT JAN , HEIDBÜCHEL HEIN 
Published: March 2008

Introduction: Patient respiration influences the accuracy of image integration approaches used during atrial fibrillation (AF) ablation procedures. We assessed both absolute and relative changes in left atrial (LA) and pulmonary venous (PV) anatomy due to respiration and their implications for 3D image integration. Methods and Results: Intensity‐based segmentation of the LA and PVs was performed on cardiac computed tomography (CT) images obtained during both inspiration and expiration in 16 patients referred for AF ablation. A 3D LA‐PV surface model was reconstructed for each respiratory phase. Absolute and relative respiratory motion components were evaluated from corresponding landmarks in both models. The mean 3D respiratory motion distance for all four PVs was 19 ± 9 mm. The most important motion component was in the inferior direction, with a mean inferior motion distance of 15 ± 8 mm. The mean 3D respiratory motion of the PV centers due to relative geometrical changes was small at the ostial level (2.6 ± 1.4 mm, 95% CI 2.3‐3.0 mm) but significantly larger at the level of the first PV bifurcation (4.0 ± 2.3 mm, 95% CI 3.4‐4.6 mm, P < 0.001). Relative geometrical changes of the LA body were most pronounced in regions near the mitral valve, resulting in a changed configuration of the mitral annulus during inspiration. Conclusions: Respiration causes important movements of the PVs and LA. Relative changes in LA–PV geometry are most pronounced in the distal PVs and in the LA body near the mitral valve. Therefore, these regions should be avoided during registration of pre‐ and per‐procedural images unless they are acquired in the same phase of respiration.
Evaluation of a Novel Ventricular Support Device with Defibrillation Capabilities in Canine and Porcine Animal Models
Authors: KILLINGSWORTH CHERYL R. , RIPPY MARIAN K. , VIRMANI RENU , ROLLINS DENNIS L. , McGIFFIN DAVID C. , IDEKER RAYMOND E. 
Published: March 2008

Introduction: Sudden death is prevalent in heart failure patients. We tested an implantable ventricular support device consisting of a wireform harness with one or two pairs of integrated defibrillation electrode coils. Methods and Results: The device was implanted into six pigs (36–44 kg) through a subxiphoid incision. Peak voltage (V) defibrillation thresholds (DFT) were determined for five test configurations compared with a control transvenous lead (RV to CanPect). Defibrillator can location (abdominal or pectoral) and common coil separation on the implant (0° or 60°) were studied.. The DFT for RV60 to LV60 + CanPect was significantly less than control (348 ± 57 vs 473 ± 27 V, P < 0.05). The DFTs for other vectors were similar to control except for RV0 to LV0 + CanAbd (608 ± 159 V). The device was implanted into 12 adult dogs for 42, 90, or 180 days with DFT and pathological examination performed at the terminal study. Cardiac pressures were determined at baseline, after implantation, and at the terminal study. The DFT was also determined in a separate group of four dogs at 42 days following implantation of the support device with one pair of defibrillation electrodes. The DFTs at implant and explant in dogs with one pair (8 ± 1.5 Joules [J] and 6 ± 1.9 J) or two pairs (8 ± 3.4 J and 7 ± 1.9 J) of defibrillation electrodes were not significantly different from each other but significantly less than control measured at the terminal study (18 ± 3.4 J). Left‐sided pressures were significantly decreased at explant but within expected normal ranges. Right‐sided pressures were not different except for RV systolic. Histopathology indicated mild to moderate epicardial inflammation and fibrosis, consistent with a foreign body healing response. Conclusions: This defibrillation‐enabled ventricular support system maintained mechanical functionality for up to 6 months while inducing typical chronic healing responses. The DFT was equal to or lower than a standard transvenous vector.
Age‐ and Genotype‐Specific Triggers for Life‐Threatening Arrhythmia in the Genotyped Long QT Syndrome
Authors: SAKAGUCHI TOMOKO , SHIMIZU WATARU , ITOH HIDEKI , NODA TAKASHI , MIYAMOTO YOSHIHIRO , NAGAOKA IORI , OKA YUKO , ASHIHARA TAKASHI , ITO MAKOTO , TSUJI KEIKO , OHNO SEIKO , MAKIYAMA TAKERU , KAMAKURA SHIRO , HORIE MINORU 
Published: March 2008

Introduction: Patients with long QT syndrome (LQTS) become symptomatic in adolescence, but some become at age of ≥20 years. Since it remains unknown whether clinical features of symptomatic LQTS patients differ depending on the age of onset, we aimed to examine whether triggers for cardiac events are different depending on the age in genotyped and symptomatic LQTS patients. Methods and Results: We identified 145 symptomatic LQTS patients, divided them into three groups according to the age of first onset of symptoms (young <20, intermediate 20–39, and older ≥40 years), and analyzed triggers of cardiac events (ventricular tachycardia, syncope, or cardiac arrest). The triggers were divided into three categories: (1) adrenergically mediated triggers: exercise, emotional stress, loud noise, and arousal; (2) vagally mediated triggers: rest/sleep; and (3) secondary triggers: drugs, hypokalemia, and atrioventricular (AV) block. In the young group, 78% of the cardiac events were initiated by adrenergically mediated triggers and 22% were vagally mediated, but none by secondary triggers. In contrast, the adrenergically mediated triggers were significantly lower in the intermediate group. The percentage of secondary triggers was significantly larger in the older group than in the other two groups (0% in young vs 23% in intermediate vs 72% in older; P < 0.0001). Concerning the subdivision of secondary triggers on the basis of genotype, hypokalemia was only observed in LQT1, drugs mainly in LQT2, and AV block only in LQT2. Conclusion: Arrhythmic triggers in LQTS differ depending on the age of the patients, stressing the importance of age‐related therapy for genotyped LQTS patients.
Restoration of the Penis Following Amputation at Circumcision: Shaeer's A-Y Plasty
Authors: Shaeer Osama 
Published: March 2008

ABSTRACT

Introduction
Male circumcision is one of the most commonly performed procedures worldwide. It has an estimated complication rate ranging from 0.1% to 35%. Amputation of the shaft is one of the most devastating complications reported, resulting from entrapment of the phallus between the blades of the clamp or from thermal injury due to the application of unipolar diathermy.

Aim
In this work, I describe the guidelines I adopted in the management of 32 male patients afflicted with amputation of the shaft of the penis upon circumcision.

Methods
“Shaeer's A-Y plasty” was performed for all patients, whereby the proximal corpora and crura were released from their attachment to the pubis and were advanced forward by insetting a specially configured fat flap into the resultant cavity. Skin grafts were used to cover the released penis.

Results
In all 32 cases, the released penis was within the normal range of penile length, and was cosmetically and functionally acceptable.

Conclusions
“Shaeer's A-Y plasty” is capable of restoring the native phallus following amputation, with preservation of both gender identity and physiological characteristics of the penis to a large extent.
Male Anorgasmia Treated with Oxytocin
Authors: IsHak Waguih William , Berman Daniel S. , Peters Anne 
Published: March 2008

ABSTRACT

Introduction
This is a case report on male anorgasmia that was successfully treated with oxytocin. Oxytocin is increased during arousal and peaks during orgasm. More recently, a study on humans published in Nature has shown its value in social bonding, increasing trust, and enhancing the sense of well-being.

Aim
To test the effectiveness of administering oxytocin in a case of treatment-resistant anorgasmia.

Methods
The patient underwent a biopsychosocial evaluation by a psychiatrist trained in sexual medicine and sex therapy for male orgasmic disorder, acquired type. Medical conditions, effect of substances, and psychological issues were ruled out. The patient was properly consented to using oxytocin as an off-label trial. Oxytocin was administered using a nasal spray intracoitally because of its ultra-short half-life.

Results
Oxytocin was effective in restoring ejaculation.

Conclusions
A case of treatment-resistant male anorgasmia was successfully treated with intracoital administration of intranasal oxytocin.
Snoring as a Risk Factor for Sexual Dysfunction in Community Men
Authors: Hanak Viktor , Jacobson Debra J. , McGree Michaela E. , Sauver Jennifer St. , Lieber Michael M. , Olson Eric J. , Somers Virend K. , Gades Naomi M. , Jacobsen Steven J. 
Published: March 2008

ABSTRACT

Introduction
Severe obstructive sleep apnea has been associated with sexual dysfunction; however, it is unclear whether milder forms of sleep disturbances might also be associated with sexual problems.

Aim
To evaluate the association between snoring and five measures of sexual dysfunction in a population-based sample of men.

Methods
A stratified random sample of men residing in Olmsted County, Minnesota completed a questionnaire containing questions from the Brief Male Sexual Function Inventory (BMSFI) and a sleep questionnaire.

Main Outcome Measures
Levels of sexual drive (libido), erectile function, ejaculatory function, sexual problem assessment, and sexual satisfaction as assessed by the BMSFI.

Results
Of 827 men with a regular sexual partner, subjects were divided into categories of heavy (N=95), moderate (N=573), and none/mild (N=159) snoring. Their median age was 64 years (range 51–90). The sexual satisfaction domain score was significantly lower in the heavy snoring group (P value=0.01). The odds of low sexual satisfaction was 2.3 (95% CI 1.2, 4.1) among the heavy snorers compared with the none/mild snoring group. This association remained statistically significant after adjustment for smoking, medical comorbidities, and mental health status. However, there was no significant difference in ejaculatory function, erectile function, sexual drive, and sexual problem assessment across snoring categories.

Conclusions
These data provide evidence of an association between snoring severity and reduced sexual satisfaction in a population of elderly community males. Snoring was not associated with biologic measures of sexual dysfunction.
Role of Chloride Channels in the Regulation of Corpus Cavernosum Tone: A Potential Therapeutic Target for Erectile Dysfunction
Authors: Chu Lau Lang , Adaikan P. Ganesan 
Published: March 2008

ABSTRACTIntroductionRecent electrophysiological recordings have identified the existence of outward, excitatory chloride (Cl−) currents in rat, rabbit, and human corpus cavernosum (CC) muscle cells.AimThe aim of this study was to investigate the physiological role of Cl− currents in the maintenance of cavernosal muscle tone in isolated rabbit CC tissues.MethodsCC strips (1 × 1 × 5 mm) were suspended in tissue bath chambers for isometric tension experiments. Spontaneous cavernosal tone and contractions elicited by field stimulation or administration of established smooth muscle constrictors were examined in the presence of chloride channel (ClC) blockers, ni umic acid (NFA), and anthracene-9-carboxylic acid (A9C).Main Outcome MeasureBoth spontaneous myogenic activity and contractile responses to field stimulation, norepinephrine, histamine, and endothelin-1 were reduced by ClC blockers.ResultsIn CC strips exhibiting intrinsic myogenic tone, NFA (30 and 100 µM) and A9C (1 mM) caused a relaxation of the tone. In addition, spontaneous contractile activity in CC was abolished in the presence of either ClC blocker. In CC strips precontracted with norepinephrine, histamine, and endothelin-1, both ClC blockers significantly reversed the tone. The ability of NFA and A9C to reverse norepinephrine-induced tone was unaffected by N ω-nitro-L-arginine, 1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin-1-one, and cis-N-[2-phenylcyclopentyl]-azacyclotridec-1-en-2-amine. In addition, neither indomethacin nor tetraethylammonium affected the relaxant response of NFA. NFA and A9C inhibited the neurogenic and norepinephrine-induced contractions in a concentration-dependent manner. While NFA exerted persistent inhibition on neurogenic contraction, inhibition of neurogenic contractions by A9C was readily reversible. On K+-depolarized CC, NFA induced a concentration-related relaxation, whereas A9C was inert, suggesting an additional mechanism of NFA on voltage-gated calcium channels.ConclusionsThese results underline the importance of Cl− currents as a mechanism in the maintenance of cavernosal tone produced by adrenergic and various endogenous constrictors. Thus, the modulation of Cl− current, as an attractive and effective approach to regulate penile erection, and specific ClC blockers, as potential erectogenic agents, merits further research.
Premature Ejaculation and Pharmaceutical Company-Based Medicine: The Dapoxetine Case
Authors: Waldinger Marcel D. , Schweitzer Dave H. 
Published: March 2008

ABSTRACT

Introduction
The manufacturer of dapoxetine funded randomized clinical trials to study its effect in premature ejaculation (PE). Financial support by pharmaceutical companies, however, may jeopardize the neutrality of clinical research.

Aim
To investigate the scientific process that has been followed in dapoxetine treatment trials and reviews as compared to daily drug treatment trials and reviews with selective serotonin reuptake inhibitors (SSRIs) in men with PE.

Methods
A search of Medline and Embase was conducted using the search terms “dapoxetine” or “SSRI.” References of retrieved articles were searched. Only studies describing the use of these drugs in men with PE were included.

Main Outcome Measures
Compared fold-increase intravaginal ejaculation latency time (IELT), geometric mean IELT, and adverse effect profiles between dapoxetine and SSRIs in PE.

Results
Preclinical studies on dapoxetine, including a multicenter study (category A) and reviews (category B), were compared with clinical studies with daily conventional SSRIs in PE (category C). Categories A/B focused on patient-reported outcomes with less attention for the IELT. The ejaculation-delaying effect of dapoxetine was expressed as natural mean IELT rather than as geometrical mean IELT. Dapoxetine side effects were monthly scored. In contrast, a significant part of category C articles focused on IELT data, used geometric mean IELT outcomes, and one study reported the side effects measured 24–48 hours after drug intake using a validated questionnaire. Without the Food and Drug Administration approval, dapoxetine, as well as other SSRIs in PE, is an off-label drug for PE. However, the off-label use of dapoxetine has never been criticized by clinical investigators in contrast to commentaries against the off-label use of daily SSRI treatment in PE.

Conclusions
Manufacturer-funded drug treatment research (categories A and B) is advantageously treated by some authors as compared with nonfunded trials with daily conventional SSRIs (category C). PE drug treatment research is a young and dynamic field, and its development deserves transparency to its development.
The origin of molecular hydrogen emission in cooling-flow filaments
Authors: Ferland G. J. , Fabian A. C. , Hatch N. A. , Johnstone R. M. , Porter R. L. , Van Hoof P. A. M. , Williams R. J. R. 
Published: March 2008

Abstract
The optical filaments found in many cooling flows in galaxy clusters consist of low-density (∼103 cm−3) cool (∼103 K) gas surrounded by significant amounts of cosmic-ray and magnetic field energy. Their spectra show anomalously strong low-ionization and molecular emission lines when compared with Galactic molecular clouds exposed to ionizing radiation such as the Orion complex. Previous studies have shown that the spectra cannot be produced by O-star photoionization. Here, we calculate the physical conditions in dusty gas that is well shielded from external sources of ionizing photons and is energized either by cosmic rays or dissipative magnetohydrodynamics waves. Strong molecular hydrogen lines, with relative intensities similar to those observed, are produced. Selection effects introduced by the microphysics produce a correlation between the H2 line upper level energy and the population temperature. These selection effects allow a purely collisional gas to produce H2 emission that masquerades as starlight-pumped H2 but with intensities that are far stronger. This physics may find application to any environment where a broad range of gas densities or heating rates occur.