Sexual behavior and sexual function of adults after hypospadias surgery: a comparative study

PURPOSE: We assessed sexual behavior and sexual function in adults operated on for hypospadias. MATERIALS AND METHODS: Long-term psychosexual adjustment was assessed with a standardized questionnaire which was mailed to 57 patients with hypospadias older than 18 years and 60 age matched normal control subjects. RESULTS: A total of 37 patients with hypospadias and 39 controls participated. Self-reported strength of libido on a scale of 1 to 5 was shown to be similar in the 2 groups. Patients with hypospadias did not have problems in achieving erection and average self-rated quality of erection ranging from 1 to 5 was the same as that of controls (mean value 4.5). Patients with hypospadias noted curvature in a downward direction in a significantly higher proportion compared to controls (40% vs 18%, respectively). There were 13 patients with hypospadias who had ejaculation difficulties, of whom 6 had spraying and 7 had only dribbling of ejaculate. Patients with hypospadias masturbated significantly less often, were significantly less sexually active and had a smaller total number of sexual partners compared to control subjects. Control subjects were significantly more completely satisfied with their sexual life compared to patients with hypospadias (76.92% vs 51.35%, respectively). CONCLUSIONS: Sexual function of patients who underwent surgery for hypospadias in general is not affected. However, there is clearly a difference in certain aspects of sexual behavior between patients with hypospadias and controls. Followup and adequate counselling of patients who underwent surgery for hypospadias in adult life is necessary.     

Simultaneously measuring concentrations of a model drug and a model excipient in solution using ultrasonic spectrometry

A newly commercialized high-resolution ultrasonic spectrometer was evaluated for simultaneously measuring concentrations of a model excipient (hypromellose acetate succinate polymer, HPMCAS, CAS No. 71138-97-1) and a model drug (Fenofibrate, CAS No. 49562-28-9) in acetone solution. It was demonstrated that the measurements of both velocity and attenuation had sufficient accuracy and precision. The velocity was found to be directly proportional to concentrations of both HPMCAS polymer and Fenofibrate in solution. The attenuation was found to be directly proportional to concentration of HPMCAS polymer in solution. By establishing linear relationships of measured velocity and attenuation to the concentrations of HPMCAS polymer and the Fenofibrate in a series of standard solutions, it was feasible to simultaneously analyze concentrations of both HPMCAS polymer and Fenofibrate in a test solution. However, it was found that both temperature and moisture had significant influence on the measurement. While the change in velocity was inversely proportional to the change in temperature, the change in velocity was directly proportional to the change in moisture content in solutions.     

Immunization with the glutamate receptor-derived peptide GluR3B induces neuronal death and reactive gliosis, but confers partial protection from pentylenetetrazole-induced seizures

Do autoantibodies (Ab's) against glutamate/AMPA receptor subtype 3 affect the severity of seizures? Rats immunized with the GluR3B-peptide (amino acids (aa) 372-395) or with the control GluR3A-peptide (aa 245-274) produced the respective anti-GluR3B and anti-GluR3A Ab's (both types of Ab's found in some epilepsy patients). The GluR3B-immunized rats exhibited neuronal death and reactive gliosis in the brain, but not overt spontaneous seizures. Surprisingly, in response to the chemoconvulsant pentylenetetrazole, the GluR3B-immunized rats displayed fewer jerks, a lower percentage of generalized seizures, and a lower overall seizure-severity score than GluR3A-immunized, scrambled GluR3B-immunized or non-immunized control rats. These findings, combined with the previously demonstrated ability of anti-GluR3B Ab's to bind, activate, and kill neurons and glia, suggest that if these Ab's are present in the brain they may cause neuronal death, which by itself may be pro-epileptic, but they may also decrease the excitability of seizure-related neural circuits, thereby conferring partial protection from seizures induced by other exogenously applied epileptogenic stimuli. The present results could have clinical implications for epilepsy.     

Surgical treatment of the knee osteoarthritis

Surgical treatment of initial osteoarthritis consists of palliative arthroscopic operation, joint toilet, arthroscopic lavage, chondrectomy, meniscectomy, sinovyectomy, meniscus toilet, abrasion arthroplasty, microfracture, mosaicplasty, transplantation of autologic chondrocytes. To cure deviation of axis it is proposed corrective osteotomy in pre-osteoarthritis phase. Partial or total arthroplasty is recommended in treatment of advanced knee degenerative process.     

User interface of MUDR electronic health record

Development of the electronic health record architecture at the EuroMISE Center was inspired by existing European standards and several European projects. The developed EHR named MUDR implements a 3-layer architecture, using XML for communication between application layer and clients. A decision support module implementing the "1999 WHO/ISH Guidelines for the Management of Hypertension" is part of an application layer. Universal graph structure is used both to represent the set of medical concepts in the EHR and to represent the collected data. Advanced methods of interaction between EHR and its user are studied, software prototypes of client applications are developed and their effectiveness evaluated.     

Bidirectional effects of benzodiazepine binding site ligands in the passive avoidance task: differential antagonism by flumazenil and beta-CCt

Recent research on genetically modified mice has attributed the amnesic effect of benzodiazepines mainly to the alpha1-containing GABA(A) receptor subtypes. The pharmacological approach, using subtype selective ligands, is needed to complement genetic studies. We tested the effects of the non-selective antagonist flumazenil (0-20.0 mg/kg), the preferential alpha1-subunit selective antagonist beta-carboline-3-carboxylate-t-butyl ester (beta-CCt) (0-30.0 mg/kg), the non-selective agonist midazolam (0-2.0 mg/kg), the preferential alpha1-subunit selective agonist zolpidem (0-3.0 mg/kg), and the non-selective inverse agonist methyl 6,7-dimethoxy-4-ethyl-beta-carboline-3-carboxylate (DMCM) (0-2.0 mg/kg) in the one-trial step-through passive avoidance task in rats. The compounds were administered intraperitoneally, before the acquisition test. Flumazenil and beta-CCt did not affect retention performance. Midazolam and zolpidem induced amnesia in a dose-dependent manner. The complete reversal of amnesia was unattainable. The effects of zolpidem were significantly attenuated by the both, flumazenil (10.0 mg/kg) and beta-CCt (30.0 mg/kg); by contrast, only flumazenil was considerably effective when combined with midazolam. DMCM exerted promnesic effects at 0.2mg/kg, in an inverted U-shape manner. Both antagonists tended to abolish this action. The results indicate that some other alpha-subunit(s), in addition to the alpha1-subunit, contribute to the amnesic actions of non-selective benzodiazepine site agonists in the passive avoidance task. On the other hand, a significant part of the DMCM-induced promnesic effect could involve the alpha1-subunit and/or other putative beta-CCt-sensitive binding site(s).     

Vinblastin-carboplatin for metastatic cutaneous melanoma as first-line chemotherapy and in dacarbazine failures

Medical Oncology - First-line treatments of metastatic melanoma are usually decarbazine (DTIC) and/or α-interferon based, with response rates in the range of at most 20–30%. In this...