Who is the 40-Year-Old Virgin and Where Did He/She Come From? Data from the National Survey of Family Growth

IntroductionLittle is known about young and middle aged adults who have never engaged in sexual intercourse. Individuals who have not engaged in sexual activity may theoretically have diminished overall quality of life, as recent evidence suggests that sexual activity may be related to overall health status in adults.AimWe sought to identify factors related to sexual abstinence in young and middle-aged adults.MethodsWe analyzed data from the male and female sample of the 2002 National Survey of Family Growth to examine sexual abstinence among unmarried participants aged 25–45 (men: N = 2,469; women: N = 5,120).Main Outcome MeasuresMultivariable logistic regression modeling was used to test for independent associations between demographic, medical, and anthropometric variables and abstinence while adjusting for confounding and mediating variables.ResultsA total of 122 (13.9%) men aged 25–45 reported never having had sex, representing approximately 1.1 million American men in this age cohort. Among female participants, a total of 104 (8.9%) women aged 25–45 reported never having sex, representing approximately 800,000 American women in this age cohort. Both men and women who reported that they attend religious services one or more times per week were more likely to be sexually abstinent, independent of their specific religious beliefs. Virgin status was also significantly associated with drinking alcohol within the past year. While a college degree in women predicted virginity, education was not associated with virginity in men. Men showed lower rates of sexual abstinence if they reported having spent time in prison or serving in the military.ConclusionsAmongst young adults, sexual abstinence does not appear to be mediated by health status, anthropometric measures, or age. Attending religious services and avoidance of alcohol consumption are associated with virginity in adults. Other factors associated with abstinence differ between genders and merit further study. Eisenberg ML, Shindel AW, Smith JF, Lue TF, and Walsh TJ. Who is the 40 year old virgin and where did he/she come from? Data from the National Survey of Family Growth. J Sex Med 2009;6:2154–2161.     

小肺癌SCT漏／误诊5例CT征像分析

目的：确定初次SCT漏／误诊而后CT扫描检测到的小肺癌CT征象。材料与方法：复习2490例初次SCT普查中漏／误诊患者的CT征象，回顾性评价其CT征象、检测时间、细胞类型及病理分期。结果：初次SCT扫描漏误诊小肺癌5例，其中4例病检肺癌为1期，1例为Ⅱ期。结论：SCT普查可漏／误诊接近检测阈的小肺癌结节，慎用双窗观察，推荐随访检查。     

Early use of cyclic TPN prevents further deterioration of liver functions for the TPN patients with impaired liver function

BACKGROUND/AIMS: Impaired liver function is frequently found in patients who need prolonged total parenteral nutrition. Cyclic total parenteral nutrition can minimize the adverse effects of long-term total parenteral nutrition, such as hepatic complication. The adequate timing to shift to use cyclic total parenteral nutrition for patients with impaired liver function may prevent further hepatic dysfunction. METHODOLOGY: A prospective study of 65 patients who need total parenteral nutrition and have impaired liver functions was performed. Cyclic total parenteral nutrition was used in different groups of patients, when their total bilirubin levels were just over 5 mg%, 10 mg%, or 20 mg% during the course of total parenteral nutrition. The patients of control groups received straight non-cyclic total parenteral nutrition. All the patients had stable vital signs without major stress, such as sepsis or acute bleeding. Ten patients (A2) in Group A were shifted to cyclic total parenteral nutrition when their total bilirubin was just over 5 mg%; the other 10 patients (A1) continued the non-cyclic total parenteral nutrition. Eleven patients (B2) in Group B were shifted to cyclic total parenteral nutrition when their total bilirubin was just over 10 mg%; the other 11 patients (B1) continued the non-cyclic total parenteral nutrition. Ten patients (C2) in Group C were shifted to cyclic total parenteral nutrition when their total bilirubin was just over 20 mg%; the other 13 patients (C1) continued the non-cyclic total parenteral nutrition. The average energy intake among 3 groups had no difference. Their liver functions were examined each week for 2 weeks. RESULTS: The results showed that the patients with non-cyclic total parenteral nutrition had significant increase of direct-total bilirubin and alkaline phosphatase (P < 0.05) in Group A and significant decrease of albumin accompanied with increase of GOT, GPT, direct/total bilirubin (P < 0.05) in Group B. The patients either using cyclic or non-cyclic total parenteral nutrition showed significant decrease of albumin and increase of direct/total bilirubin (P < 0.05) in Group C. CONCLUSIONS: We conclude that the early use of cyclic total parenteral nutrition may prevent deterioration of liver function for the patients with jaundice and need prolonged total parenteral nutrition.     

Radiofrequency catheter ablation of tachycardia in children with and without congenital heart disease: indications and limitations

From 1993 to 1998, a total of 100 consecutive pediatric patients with tachycardia (45 male and 55 female, aged 1 year 10 months to 17 years, 11+/-4 year) who underwent electrophysiological study were reviewed. Eleven of them were younger than 5 years. Two had tachycardia-related cerebrovascular accident. Congenital heart disease was found in 12 patients. After propofol anesthesia, the clinical tachycardia could not be induced in three (two atrial tachycardia and one AV nodal re-entrant tachycardia) and became nonsustained in five (atrial tachycardia). Mechanical ablation occurred in three and two had subsequent recurrences. Among the 85 cases who received radiofrequency ablation, the overall final success rate of RF ablation for all diagnoses was 94% with a diagnosis-specific success rate ranging from 100 to 57%. Tachycardia cardiomyopathy was noted in four (three atrial tachycardia and one junctional ectopic tachycardia) and all regressed after successful ablation. Success in two patients with left posterioseptal accessory pathway could only be achieved by delivering the energy at the middle cardiac vein. Two patients with right atrial isomerism had an 'AV nodal-to-AV nodal tachycardia' which was eliminated by ablation. Total recurrence rate was 13% but final success was achieved in all during re-study except the three patients who refused re-intervention. The atrial tachycardia developed in postoperative congenital heart disease was associated with the lowest success rate (57%) and highest recurrence rate (25%). Procedure-related complications occurred in four; two with transient brachial palsy, one with first-degree AV block and one with blood loss requiring blood transfusion. In conclusion, the experience of this single center confirmed the efficacy and safety of radiofrequency catheter ablation in treating pediatric arrhythmias, but the limitations in postoperative arrhythmias and the effects of propofol on tachycardia induction (especially the atrial tachycardia) need to be improved.     

Using biorelevant dissolution to obtain IVIVC of solid dosage forms containing a poorly-soluble model compound

The usefulness of selected biorelevant dissolution media (BDM) to predict in vivo drug absorption was studied. Dissolution profiles of solid formulations of a poorly soluble model compound were compared in BDM simulating fasted and two levels of fed state. A non-physiologically relevant medium containing the cationic surfactant, cetrimide, was also investigated. All the media studied were capable of differentiating between the formulations employed, with formulation A consistently ranking high and formulations C and D ranking low. An in vivo dog study was carried out and an attempt was made to obtain a level A correlation between the plasma absorption curves and in vitro dissolution curves, using non-linear regression software. The in vitro-in vivo correlation (IVIVC) models developed indicated that fed state media (BDM 3) containing high levels of both bile salts (BS) and lipolysis products (LP) were best able to predict in vivo pharmacokinetic parameters (Cmax and AUC) with prediction errors lower than 10%. Overall, design and use of appropriate media for in vitro dissolution is extremely important. This study demonstrates the potential of physiologically relevant media containing both BS and LP for use in formulation and early drug development.     

飞行人员救生物品现状与展望

飞行人员救生物品是供被迫跳伞或迫降的飞行人员用于在各种恶劣环境下求救联络和生存的用品。全面介绍了国内外飞行人员救生物品的发展历程，救生物品的种类、携带方式，救生物品在航空救生中的作用，救生物品的发展趋势等内容。指出在相当长的一段时间内，救生物品在航空救生中仍将发挥重要的作用，军事飞行人员救生物品从改进救生物品的性能、增加救生物品的战术使用背景、改进救生物品订货供应体制几个方面进行系统完善势在必行。     

Reliability and validity of using a Brief Psychiatric Symptom Rating Scale in clinical practice

To develop a reliable and valid psychiatric self-rating scale for use in medical practice, the authors modified Derogatis' Symptom Check List-90-R (SCL-90-R) and designed a shorter form, named Brief Symptom Rating Scale (BSRS). The BSRS comprises 50 items, which best reflect the original ten symptom dimensions and three indices of psychopathology from the SCL-90-R. The BSRS has been proven in different populations to have an excellent split-half reliability as well as good internal structure according to factor analysis. In addition, BSRS scores are highly correlated with the parental form SCL-90-R among medical populations for each symptom dimension and the three indices. The rate of accurate classification for BSRS between psychiatric and nonpsychiatric cases was 75.8%, with a sensitivity of 66.7% and a specificity of 86.7% by discriminant analysis based on 10 dimensional scores obtained from 1,638 subjects, randomly selected from the Psychiatric Outpatient Clinic, the Family Medicine Clinic and nonpsychiatric medical inpatients. Therefore, the BSRS is a satisfactory global measure and case-finding screening instrument for psychopathology in both psychiatric and nonpsychiatric medical settings.     

输精管结扎术后附睾瘀积—发生机制及其防治方法的研究

木文对输精管结扎后的“附睾瘀积”进行了系统研究。选用金黄地鼠为实验动物，结扎组８４只，对照组７６只。采用微穿刺、微量分析方法证实扎管后附睾功能受损。组织学检查示附睾管扩张，间质充血，有大量慢性炎细胞浸润。临床收集４９例病人，３９例微波治疗，１０例手术，效果优良。采用Ｂ超、Ｃ超、ＭＲＩ观察瘀积附睾，发现附睾瘀积多位于附睾尾部。人类标本的光镜及电镜检查证实，附睾瘀积的病理实质是附睾对外渗精子的一种无菌性炎症反应。本文根据研究资料，阐明了附睾瘀积的发生机制，提出了防治方法，并定名为“附睾瘀积综合征”。     

Correction of penile curvature using the 16-dot plication technique: a review of 132 patients

PURPOSE: We review the results of 132 cases of congenital and acquired penile curvature corrected with our 16 or 24-dot, minimal tension technique using multiple parallel plications performed under papaverine induced erection. MATERIALS AND METHODS: Chart and telephone interviews were conducted on 132 consecutive patients 16 to 79 years old who underwent penile plication between December 1995 and November 2000. Patient data as well as outcomes were analyzed. RESULTS: We were unable to contact 8 patients. Of the patients 16 had congenital penile curvature, including 4 in whom the Nesbit procedure performed elsewhere had failed, and 116 had Peyronie's disease, including 8 in whom a previous Nesbit procedure had failed. Preoperative complaints included persistent penile pain with erection for more than 1 year in 15 of 132 cases, difficult intercourse or partner discomfort in 106 and poor self-image in 11. Curvature ranged from 30 to 120 degrees. Erections were evaluated preoperatively with duplex ultrasound after intracavernous injection and self-stimulation. Of the patients 63% had good erections, 25% moderate erections requiring sildenafil and 12% poor erections requiring injection therapy. Foreskin edema necessitating subsequent circumcision and an organized hematoma requiring evacuation occurred in 1 case each. At 6 months 93% of patients reported straight erections and 7% reported almost straight but acceptable erections. Recurrence of curvature was reported by 15% of patients at a mean of 2.6 years of followup. Four patients reported worsening of erectile function after the procedure. CONCLUSIONS: Penile plication is a simple, safe method to correct congenital and acquired penile curvature. Using a minimal tension parallel plication technique, excellent durable results can be attained. This simplified repair avoids the neurovascular bundles and has a minimal to no detrimental affect on erectile function. Preoperative counseling must be given regarding penile shortening and the palpable small bumps from the nonabsorbable sutures.     

Long-term survival of autotransplanted major pelvic ganglion in the corpus cavernosum of adult rats

PURPOSE: Neurogenic impotence is a common complication after radical pelvic surgery, irradiation or perineal trauma. Neuronal transplantation is a new frontier for treating neurological disorders. We investigated whether the major pelvic ganglion can survive and become functional after being implanted into the corpus cavernosum in adult rats. MATERIALS AND METHODS: Adult male rats (13) were divided into 3 groups and sacrificed at 3 time points, namely 30 (4), 60 (5) and 90 (4) days. All rats underwent excision of the right major pelvic ganglion and left cavernous nerve. The right ganglion was implanted into the right crus of the penis. Electrostimulation was applied to the left major pelvic ganglion and cavernous nerve (1.5 mA.) and right crus (10 mA.) at sacrifice. The crural region and left ganglion were then excised for immunostaining of neuronal nitric oxide synthase (nNOS), protein gene product 9.5 and growth associated protein 43. Image analysis was used to calculate the area stained in pixels. Electron microscopy of the implanted area was performed to assess neuronal survival. RESULTS: Although the degree varied, all neuronal implants survived after transplantation. The response to electrostimulation was insufficient to produce erection. No difference was noted among the areas of nNOS staining when specimens from the 3 time points were compared. The area of expression of nNOS, protein gene product 9.5 and growth associated protein 43 was larger in the implanted area than in the surrounding cavernous tissue. Under electron microscopy most surviving implants showed normal ultrastructure, although areas of fibrotic replacement were seen in several implants. CONCLUSIONS: Our results show that the autotransplanted major pelvic ganglion expresses nNOS, protein gene product 9.5 and growth associated protein 43, and survived up to 90 days after implantation into the corpus cavernosum. Further studies with fetal neuronal tissue seem warranted.