Growth medium effect on the antifungal activity of LY 303366

The incidence of circumcision in 256 pregnant Nigerian Igbo women was 124 (48.4%). This incidence increased with increasing social class (circumcision index (C.I), 0.06 to 16.50, for social class 1 to 5); was least among the least age range, 16-20 years (C.I, 0.45); and among the primigravidae (C.I, 0.36) compared to the grandmultipara (C.I, 4.43) (P < 0.05.). Simple excision was the commonest type of circumcision, 122 (98.4%). The genital introitus was mildly scarred in 48 (38.7%) respondents, moderately scarred in 47 (37.9%) and severely scarred in 29 (23.4%). Ninety four (36.7%) of the respondents were not aware of their circumcision status, while 91 (96.8%) of the circumcised women had it performed during infancy. On the question of continued practice of female circumcision in their villages, 43 (16.8%) respondents replied, "yes"; 138 (53.9%), "no"; 25 (9.8%) "Sometimes"; and 50 (19.5%), "don't know". The incidence of episiotomy during delivery was similar for both circumcised, 47 (18.4%)and uncircumcised, 46 (18.0%) respondents (P = 0.05). More uncircumcised respondents, 31 (12.1%) were sexually satisfied during intercourse than the circumcised, 11 (4.3%) (P < 0.05). Of the 118 female offsprings of the respondents, 109 (92.4%) were not circumcised while 9 (7.6%) were. Increased public enlightenment on the risks of female circumcision is expected to eradicate the practice by the next generation     

The culture of female circumcision

The issue of female circumcision takes on special significance as more women migrate to the United States from countries where the practice has religious and traditional underpinnings. Female circumcision is a problem unfamiliar to most Western health care practitioners. This article describes an ethnographic study of the types of female circumcision, the reasons for and against the practice, the health implications of this practice, and cultural attitudes of circumcised women both in Western Africa and as migrant refugees living in the United States. Ethical dilemmas in dealing with this practice and implications for nurses and health care providers are discussed.     

Dietary fat intake and the risk of incident dementia in the Rotterdam Study

OBJECTIVE: To document prospectively variation in penile morphology and clinical findings in children. PATIENTS AND METHODS: The study comprised a consecutive sample of 468 boys whose consultation with a physician included a genital examination in a primary-care paediatric practice in rural northern Wisconsin. RESULTS: Circumcised boys under 3 years of age were significantly more likely to have a partially or completely covered glans, a reddened meatus, balanitis, or trapped epithelial debris, and less likely to have a fully exposed glans than were circumcised boys of 3 years or older. Among the 238 boys under 3 years, those circumcised were significantly more likely to have non-cosmetic problems, including coronal adhesions, trapped epithelial debris, a reddened meatus, preputial stenosis (phimosis) and balanitis, than were boys with a foreskin. Findings in the circumcised group under 3 years included: fully exposed glans (n = 78, 35.6%), partially covered glans (n = 67, 30.6%), adhesions (25.6%), completely covered glans (20.1%), entrapped desquamated epithelial debris (24.7%), reddened meatus (19.1%), balanitis (15.5%), and preputial stenosis (0.9%). Only two genital examinations in boys with foreskins revealed pertinent findings. Coronal adhesions develop in circumcised boys at 2-6 months of age and usually resolve by 24 months. The degree of skin covering the glans after neonatal circumcision peaks at 6 months of age. CONCLUSIONS: There are significant variations of appearance in circumcised boys; clinical findings are much more common in these boys than previously reported in retrospective studies. The circumcised penis requires more care than the intact penis during the first 3 years of life. Parents should be instructed to retract and clean any skin covering the glans in circumcised boys, to prevent adhesions forming and debris from accumulating. Penile inflammation (balanitis) may be more common in circumcised boys; preputial stenosis (phimosis) affects circumcised and intact boys with equal frequency. The revision of circumcision for purely cosmetic reasons should be discouraged on both medical and ethical grounds.     

Cohort study on circumcision of newborn boys and subsequent risk of urinary-tract infection

BACKGROUND: A decrease in risk of urinary-tract infection is one of the most commonly given reasons for circumcision of newborn boys. Previous studies have reported rates of UTI to be 10-20 times higher in uncircumcised than in circumcised boys. This population-based cohort study followed neonates in Ontario, Canada, prospectively to study the relation between circumcision and subsequent UTI risk. METHODS: Eligible boys were born to residents of Ontario between April 1, 1993, and March 31, 1994. We used hospital discharge data to follow up boys until March 31, 1996. FINDINGS: Of 69,100 eligible boys, 30,105 (43.6%) were circumcised and 38,995 (56.4%) uncircumcised. 888 boys circumcised after the first month of life were excluded. 29,217 uncircumcised boys were matched to the remaining circumcised boys by date of birth. The 1-year probabilities of hospital admission for UTI were 1.88 per 1000 person-years of observation (83 cases up to end of follow-up) in the circumcised cohort and 7.02 per 1000 person-years (247 cases up to end of follow-up) in the uncircumcised cohort (p<0.0001). The estimated relative risk of admission for UTI by first-year follow-up indicated a significantly higher risk for uncircumcised boys than for circumcised boys (3.7 [2.8-4.9]). 195 circumcisions would be needed to prevent one hospital admission for UTI in the first year of life. INTERPRETATION: Although our findings support the notion that circumcision may protect boys from UTI, the magnitude of this effect may be less than previously estimated.     

Effect of short-term administration of dexamethasone on canine antral gastrin gene expression

In a two-part study of the circumcision status of boys with urinary tract infections (UTIs), we reviewed the occurrence of UTIs in 209,399 infants born in US Army hospitals worldwide from 1985 to 1990. During the first year of life, 1,046 (0.5%: 550 girls and 496 boys) were hospitalized for UTIs. Noncircumcised male infants had a 10-fold greater incidence of infection than did circumcised male infants. The frequency rate of circumcision rose significantly, from 70.3% to 80.2%, during the study period. Among uncircumcised boys younger than 3 months with UTIs, 23% had concomitant bacteremia involving the same organism. The second part of the study consisted of a meta-analysis of all nine previous reports on the circumcision status of boys with UTIs. These studies revealed a fivefold to 89-fold increased risk of infection in uncircumcised boys; the combined data yielded a 12-fold increase in UTIs in this population. Parents should be told of the lower risk of UTIs for circumcised boys during informed-consent counseling.     

Epididymitis in children: the circumcision factor?

PURPOSE: Recommendations for circumcision have significantly altered in the last several years. Studies have objectively established an increased risk of urinary tract infection in uncircumcised boys. We evaluated the relationship between epididymitis and circumcision status. MATERIALS AND METHODS: We studied the relationships among the circumcision status of 36 consecutive boys with epididymitis in a review of 128 with acute scrotal inflammation (group 1), circumcision status of 43 in whom the diagnosis of epididymitis at discharge home had been made elsewhere (group 2), New York State hospital discharge figures for circumcision in newborns (group 3) and the regional prevalence of circumcision in 200 consecutive pediatric emergency department patients at the same institution with nonurological diagnoses (group 4). RESULTS: New York State Department figures indicate that 70% of male newborns are discharged home with a hospital code for circumcision. Similarly an evaluation of 200 consecutive male patients without urological diagnoses younger than 18 years in the emergency department revealed that 131 (65%) were circumcised. Comparatively in groups 1 and 2 only 25 and 26% of patients, respectively, were circumcised. The statistical difference in circumcision status among the 4 groups was significant (p >0.0004). CONCLUSIONS: These data demonstrate with highly statistical significance that a relationship exists between epididymitis and the presence of a foreskin. We found that an intact foreskin is an important etiological factor in boys with epididymitis.     

Prospective evaluation of complications of dorsal penile nerve block for neonatal circumcision

OBJECTIVE: To evaluate the complications of the dorsal penile nerve block (DPNB) when used for routine neonatal circumcisions. METHODS: All male newborns born in a community hospital between November 1, 1989 and August 31, 1990, and circumcised after DPNB were evaluated. Questionnaires were completed at the time of hospital discharge and at a health supervision visit 2 weeks later. RESULTS: Questionnaires were returned for 491 (85%) eligible patients. The only complication of DPNB found was bruising at the site of injection in 54 patients (11%). All bruising had resolved by the 2-week visit, and none was thought to have any clinical significance. CONCLUSION: DPNB is a safe method of decreasing the pain and stress of neonatal circumcision.     

Castration, circumcision, and anti-Semitism.

In this study, the authors look at whether circumcision is a relevant variable in anti-Semitism as measured in a contemporary male gentile population. The 52-item A-S scale described by Levinson and Sanford was administered to 381 students drawn from various psychology courses at Princeton and Rutgers Universities. The subjects (Ss) included in this study are 142 gentile male undergraduates selected from the larger population and divided into two matched groups of 71 each. No reliable differences in attitude were found between circumcised and uncircumcised subjects. These findings indicate the relative unimportance of circumcision as an isolated factor in anti-Semitism. The implications for the relationships involving circumcision, castration, and anti-Semitism are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Subcycling-PCR for multiplex long-distance amplification of regions with high and low GC content: application to the inversion hotspot in the factor VIII gene

OBJECTIVE: Treatment of long or multiple anterior urethral stricture(s) when Monseur technique is not applicable. Our technique entails augmentation of the dorsally slit open stenosed urethra using pedicled non-hair bearing penile skin. PATIENTS AND METHODS: Between June 1991 and May 1996, 26 men (median age 34 years) with anterior urethral strictures underwent roofing urethroplasty. Nine patients had long stricture (average 3.2 cm) and 17 had multiple short segment strictures (average 7 cm). All patients were circumcised, and dorsal urethral augmentation was performed using transversely oriented non-hair bearing penile skin pedicled flap. RESULTS: Median follow-up was 38 months (range 3-50). A successful outcome with no recurrent stricture as evidenced by normal retrograde urethrography and voiding history was achieved in 23 of 26 men (88%). Two patients had fistula in early postoperative period; one of them needed surgical closure. CONCLUSION: Roofing urethroplasty is a practical alternative for repair of long anterior urethral stricture(s) when Monseur technique cannot be applied.     

Urethral advancement and glanuloplasty UAGP vs. MAGPI for distal hypospadias repair

Distal hypospadias is a commonly encountered anomaly. Since its innovation by Duckett the MAGPI procedure has become almost the standard operation for the correction of minor cases. Recently case selection has been advised to avoid possible complications and limitations. Between April 1986 and April 1995, 153 boys were treated for distal hypospadias. In 51 patients (coronal 31, subcoronal 20) a modified technique of urethral advancement and glanuloplasty (UAGP) has been used. The main indications of UAGP were the presence of glanular chordee (7), failed MAGPI (3), circumcised children with distal hypospadias (7), immobile fibrotic urethral meatus (5), and as an alternative to MAGPI (29). The overall complication rate was 4% compared to 3.8% with the MAGPI procedure which has been used in the treatment of 102 patients (glanular 50, coronal 47, and subcoronal 5). We feel this technique can be used effectively in patients with coronal and subcoronal hypospadias, particularly in the presence of distal chordee, fibrotic immobile urethral meatus or MAGPI limitations. Also UAGP could be a useful alternative to MAGPI where tension-free urethral advancement and glanular wrapping can be achieved.     

Topical clobetasol propionate compared with placebo in the treatment of unretractable foreskin

OBJECTIVE: To assess whether it is the steroid alone or the gentle physical retraction combined with ointment that is responsible for the excellent results observed with topical steroid treatment of unretractable foreskin. DESIGN: Prospective, randomised, double-blind study. SETTING: University hospital, Sweden. SUBJECTS: 30 Boys randomised to be treated with clobetasol propionate (n = 15) or placebo (n = 15). INTERVENTIONS: The boys were examined 1, 2 and 6 months, respectively, after treatment. MAIN OUTCOME MEASURES: Comparison between the effects of clobetasol propionate and placebo. RESULTS: Two patients in the steroid group and one in the placebo group withdrew from the study. 10 Boys in the steroid group showed an improvement within 2 months. The remaining 3 boys had no effect and were circumcised. Histopathological examination showed lichen sclerosus et atrophicus. Seven boys in the placebo group improved. The 7 non-responders were prescribed clobetasol propionate ointment, and all 7 improved. CONCLUSION: 17 of 27 boys referred with "phimosis" were successfully treated with an ointment and gentle traction. When clobetasol propionate was given the non-responders success rate was increased to 24/27 (89%).     

Posttraumatic syringomyelia. A report of an atypical case

Isolated congenital lymphoedema of the external genitalia in boys is extremely rare. It can have major physical and emotional consequences for the children. Three male patients with primary lymphoedema of the penis and scrotum are described. The first case presented with lymphoedema of the prepuce and the phallic skin that persisted after the age of 1 year. Circumcision and excision of the subcutaneous tissues of the phallic skin were successful in producing the appearance of a normal circumcised penis. The second case presented with oedema of both phallic and scrotal skin. At age 1 year only a pastous thickening of the prepuce remained, scrotal and phallic skin normalised spontaneously. Routine circumcision was successful with a 5-year follow up. The third case presented with persistent oedema of both the scrotum and the phallus. He suffered leakage of lymph requiring incontinence pads, with complicating skin infections recurring every 4-6 weeks at age 8 years. After complete peeling of the scrotal and phallic skin from subcutaneous tissue some leakage persisted, infections subsided. The cause of this disorder remains unknown, although hypoplasia of the lymphatic vessels is reported in most cases. In the literature, several congenital malformations have been associated with primary lymphoedema. These were not noted in our patients. Rarely, the lymphoedema regresses spontaneously. The treatment of persistent lymphoedema is surgical and consists of meticulous excision of all subcutaneous layers of the affected skin, combined with reconstruction of the penis and/or scrotum. CONCLUSION: Primary lymphoedema of the male external genitalia is an extremely rare malformation of the lymphatic vessels of unknown origin. If persistent, surgical treatment is necessary.     

Risk factors for HIV infection in a rural cohort in Zimbabwe: a pilot study

OBJECTIVE: To identify demographic, sexual behavioural and cultural risk factors for human immunodeficiency virus (HIV) infection in a rural community in Zimbabwe. DESIGN: Prospective study. SETTING: Rural area in Zimbabwe. SUBJECTS: 207 subjects (81 males, 126 females) mean age 31.6 years (SD 15.3), range 12 to 76 years living in the area. MAIN OUTCOME MEASURES: HIV seropositivity and seroconversion, exposure or no exposure to risk factor. RESULTS: Prevalence of HIV was 7.7% and was associated with being divorced or widowed [Odds ratio (OR) 4.26, 95% confidence interval (CI) 1.17 to 14.97] and past history of sexually transmitted diseases (STDs) [(OR 3.54, 95% CI 1.31 to 9.89)]. Seroconversion rate was 3.6% per year and was associated with history of STD [Relative Risk (RR) 13.22, 95% CI 1.15 to 156.1)] during the follow up period. Individuals over 20 years of age, those reporting one or more sexual partners, those reporting irregular use of condoms and those scarified were at greater risk than their counterparts. Individuals who reported being circumcised were at slightly lesser risk than those who did not report circumcision. CONCLUSION: STDs were major determinants of HIV transmission in the study area. In addition being divorced or widowed was a risk factor for HIV infection. Scarification, tattooing and circumcision require further investigations.     

Comparison of ring block, dorsal penile nerve block, and topical anesthesia for neonatal circumcision: a randomized controlled trial

CONTEXT: Beliefs about the safety and effectiveness of current anesthetics have resulted in many newborns being circumcised without the benefit of anesthesia. OBJECTIVE: To compare ring block, dorsal penile nerve block, a topical eutectic mixture of local anesthetics (EMLA), and topical placebo when used for neonatal circumcision. The placebo represented current practice, with no anesthetic for neonatal circumcision. DESIGN: A randomized controlled trial. SETTING: Antenatal units in 2 tertiary care hospitals in Edmonton, Alberta. PARTICIPANTS: A consecutive sample of 52 healthy, full-term, male newborns, aged 1 to 3 days. INTERVENTIONS: Physiological and behavioral monitoring occurred in a series of trials: baseline, drug application, preparation, circumcision, and postcircumcision. Surgical procedures defined the following 4 stages of the circumcision: cleansing, separation, clamp on, and clamp off. Methemoglobin level was assessed 6 hours after surgery. MAIN OUTCOME MEASURES: Heart rate, cry, and methemoglobin level. RESULTS: Newborns in the untreated placebo group exhibited homogeneous responses that consisted of sustained elevation of heart rate and high-pitched cry throughout the circumcision and following. Two newborns in the placebo group became ill following circumcision (choking and apnea). The 3 treatment groups all had significantly less crying and lower heart rates during and following circumcision compared with the untreated group. The ring block was equally effective through all stages of the circumcision, whereas the dorsal penile nerve block and EMLA were not effective during foreskin separation and incision. Methemoglobin levels were highest in the EMLA group, although no newborn required treatment. CONCLUSIONS: The most effective anesthetic is the ring block; EMLA is the least effective. It is our recommendation that an anesthetic should be administered to newborns prior to undergoing circumcision.     

The logic of Ménage à Trois

Recent studies of socially monogamous species have shown that in many cases females do not copulate exclusively with their pair mates, but are also receptive to other males. The explanation usually given for unfaithful female behavior is that most females are unable to bond with a male they would prefer as genetic father to their offspring. To secure male assistance the female therefore pairs with an available male but also copulates with males of supposedly higher genetic quality. Here we offer an alternative evolutionary explanation for female infidelity, which does not rely upon this 'Good Genes hypothesis of female choice. We show with a simple model that in an evolutionary game between three players, a male, a female and a male lover, solutions exist in which the female can secure more assistance from her mate by being receptive to other males. We conclude that female sexuality can have a decisive role in regulating social behaviour, in which the fertile female is the driving force.     

Measuring female mating preferences

Interest in the evolution of female mating preferences has increased greatly in recent years, and numerous hypotheses have been proposed to explain how mating preferences evolve. Despite this interest, little is known about how selection acts on mating preferences in natural populations. One reason for this lack of information may be that experimental designs commonly used for testing female preferences make it difficult to quantify the preferences of individual females. Most commonly used designs share three features: they examine the preferences of populations of females, they test female responses when they are presented simultaneously with two stimuli, and they infer information on female preferences by observing female choices between alternative stimuli. Population-level choice tests, in which each female is tested only once with a set of stimuli, do not evaluate within-female variation in preference, which is necessary to document between-female variation in preference. Two-stimulus designs test only for directional preferences if female responses are tested with only a single pair of stimuli. In addition, dichotomous scoring of female responses makes detection of between-female variation in preference difficult. Simultaneous stimulus presentations can confound female preference and female sampling behaviour. An alternative method to assess female preferences is to measure repeatedly the preference functions of individual females using a single-stimulus design. The shape of a female's preference function indicates how a female's mating response varies with male trait value, and repeated measures of individual preference functions allow measurement of within- and between-female variation in preferences. Copyright 1998 The Association for the Study of Animal Behaviour. Copyright 1998 The Association for the Study of Animal Behaviour.     

Antibacterial effects of levofloxacin, erythromycin, and rifampin in a human monocyte system against Legionella pneumophila

Recently few cases as to female genital tuberculosis were reported, therefore it is considered that the incidence of the female genital tuberculosis was decreased. However it is important to make a right diagnosis of tuberculosis, because the tuberculosis in the female sexual organs is one of the factors of female sterility. The diagnosis is needed to examine bacteriologically or pathologically. The diagnosed genital tract or pelvic tuberculosis was treated by anti-tuberculosis chemotherapy firthtly and by surgical procedures in case of necessity.     

Variation in the sex ratio in cardiovascular mortality

The favorable mortality rate of adult women compared with that of men is well known in western countries. The sex difference varies in different population groups. In Israel there is a low male:female ratio, as compared with Greece, Holland, and England and Wales. This is due to the relatively high female mortality rates in Israel. Within Israel, the Jewish population of North African origin has a relatively low male:female ratio. In this group, the marked increase in mortality due to ischemic heart disease has occurred in both women and men, in contrast to various western countries in which the male:female ratio increased during the 20th century with the rise in the death rate from ischemic heart disease, especially in middle-aged men. Social disequilibrium, especially family disorganization with its selective stressful effects on women, is suggested as an hypothesis on which to base further study in communities with a low male:female ratio associated with high mortality rates in women.     

cDNA cloning, sequencing, and characterization of male and female rat liver aldehyde oxidase (rAOX1). Differences in redox status may distinguish male and female forms of hepatic APX

Molecular characterization of male and female rat liver aldehyde oxidase is reported. As described for the mouse liver, male and female rat liver expressed kinetically distinct forms of aldehyde oxidase. Our data suggest that the two forms arise as a result of differences in redox state and are most simply explained by expression of a single gene encoding aldehyde oxidase in rats. In support of this argument we have sequenced cDNAs from male and female rat liver. We examined mRNA expression by Northern blot analysis with RNA from males and females, from several tissues, and following androgen induction. Purified rat liver enzyme from males or females revealed a single 150-kDa species consistent with cDNA sequence analysis. Both male and female forms were reactive to the same carboxyl-terminal directed antisera. Km(app) values obtained in crude extracts of male or female rat liver and post-benzamidine-purified aldehyde oxidase differed substantially from each other but could be interconverted by chemical reduction with dithiothreitol or oxidation with 4,4'-dithiodipyridine. Our data indicate that a single gene is most likely expressed in male or female rat liver and that the kinetic differences between male and female rat liver aldehyde oxidases are sensitive to redox manipulation.     

Unconditioned sexual incentive motivation in the male Norway Rat (Rattus norvegicus).

Sexual incentive motivation was evaluated in a procedure consisting of a large open field where incentive animals were confined behind wire mesh openings. When sexually inexperienced male rats (Rattus norvegicus) were exposed to the receptive female-male incentives, they spent more time close to the female. If the incentives were receptive female-nonreceptive female, the receptive female was preferred. However, when the alternatives were nonreceptive female-male, no preference was obtained. Castration abolished preference for the receptive female, and treatment with testosterone propionate restored it. Estradiol plus oil is as efficient as estradiol plus progesterone for giving the ovariectomized female incentive properties. The living female can be replaced with female odor. Sexual experience did not have any long-term effects on the female's incentive value, but immediately preceding limited sexual activity enhanced it. (PsycINFO Database Record (c) 2010 APA, all rights reserved)