Therapist-aided exposure for women with lifelong vaginismus: A replicated single-case design.

Vaginismus is commonly described as a persistent difficulty in allowing vaginal entry of a penis or other object. Lifelong vaginismus occurs when a woman has never been able to have intercourse. A replicated single-case A-B-phase design was used to investigate the effectiveness of therapist-aided exposure for lifelong vaginismus. A baseline period (Phase A) was contrasted with exposure + follow-up (Phase B), using random switching between phases. The main outcome measure (intercourse ability) was assessed daily for 24 weeks. Ten women participated. The exposure consisted of a maximum of three 2-hr sessions during 1 week at a university hospital. The participant performed vaginal penetration exercises on herself, in the presence of a female therapist. Two follow-up sessions were scheduled over a 5-week period. Nine of the 10 participants reported having intercourse after treatment, and in 5 of the 9, intercourse was possible within the 1st week of treatment. The results remained at 1-year follow-up. Furthermore, exposure was successful in decreasing fear and negative penetration beliefs posttreatment and at 3-month and 1-year follow-ups. Therapist-aided exposure appears to be an effective treatment for lifelong vaginismus. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychometric procedures and the detection and exploration of behavioural deficits due to cerebral dysfunction in man: II.

There are basically two approaches to the use of psychometric tests in the detection of "brain damage": the first is centred around a view of regional equipotentiality of brain functioning and the second around a unitary view of brain functioning. The former was explored in an earlier paper in this journal (Rubino, 1970). The latter approach is explored here in terms of the utility of three well-known tests: the Bender Gestalt, the Benton Visual Retention Test, and the Graham Kendall Memory for Designs. The influence of such factors as age, diagnoses, hit-rates, etc., are briefly discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Role of T‐regulatory cells in the response to hepatitis B vaccine in hemodialysis patients

Human disease elicits a complex array of biological processes that results in long‐term protective immunological memory to infectious agents. Chronic kidney disease is known to impair induction of sustained immunological memory to hepatitis B vaccine (HBVax) antigens. We asked the question: Does end‐stage renal disease promote changes in subtypes of regulatory T (Treg) cells that correlate with diminished amnestic response to HBVax antigen compared to healthy controls? The study design and setting was a prospective observational cohort at a veterans affairs medical center. End‐stage renal disease patients on hemodialysis (HD) were compared with individuals with self‐reported normal kidney function. All subjects received HBVax. Peripheral blood was sampled for assessment for Treg cells pre and post vaccination. CD4+ FOXP3 Treg numbers were similar between HD and healthy subjects during a 14‐day time period post vaccination. HD subjcts had lower anti‐HBSag antibody than CON (control) subjects (330 ± 108.7 vs. 663.1 ± 129.7 IU/mL; P = 0.063). Hemodialysis subjects with resting Tregs higher than the median value in our cohort demonstrated a significantly lower change in HBsAB at 30 days post booster vaccination (P = 0.030). No such relationship was found for the activated Treg subset among HD subjects, or either subset among CON subsets. In our limited comparison study of 11 HD and 8 CON subjects, Treg subsets did not differ between the two groups; but differences in the suppressive Treg numbers in the HD group could explain the altered antibody response to HBVax and is worthy of further study.     

Motor sequencing deficits in schizophrenia: A comparison with Parkinson's disease.

Motor abnormalities occur in schizophrenia (SZ) and may arise from striatal dysfunction. This study examined whether the pattern of performance on simple and complex motor abilities in SZ was similar to that of patients with Parkinson's disease (PD). Quantitative tests of speeded movement and motor and cognitive sequencing were used to assess 25 SZ, 16 PD, and 84 normal controls (NCs). Sequencing performance was also examined with motor rigidity taken into account. Compared with the NC group, the SZ and PD groups were impaired on measures of motor rigidity and motor sequencing. With rigidity accounted for, the SZ group was significantly more impaired than the PD group on motor sequencing; cognitive and motor processes contributed to the motor deficit. Cognitive sequencing performance predicted motor sequencing performance in PD but not SZ. Although both SZ and PD resulted in significant motor and cognitive sequencing deficits, the pattern and correlates of these deficits differ, suggesting that the affected neural systems underlying motor deficits in SZ are different from those involved in PD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mitochondrial Mechanisms in Septic Cardiomyopathy

Sepsis is the manifestation of the immune and inflammatory response to infection that may ultimately result in multi organ failure. Despite the therapeutic strategies that have been used up to now, sepsis and septic shock remain a leading cause of death in critically ill patients. Myocardial dysfunction is a well-described complication of severe sepsis, also referred to as septic cardiomyopathy, which may progress to right and left ventricular pump failure. Many substances and mechanisms seem to be involved in myocardial dysfunction in sepsis, including toxins, cytokines, nitric oxide, complement activation, apoptosis and energy metabolic derangements. Nevertheless, the precise underlying molecular mechanisms as well as their significance in the pathogenesis of septic cardiomyopathy remain incompletely understood. A well-investigated abnormality in septic cardiomyopathy is mitochondrial dysfunction, which likely contributes to cardiac dysfunction by causing myocardial energy depletion. A number of mechanisms have been proposed to cause mitochondrial dysfunction in septic cardiomyopathy, although it remains controversially discussed whether some mechanisms impair mitochondrial function or serve to restore mitochondrial function. The purpose of this review is to discuss mitochondrial mechanisms that may causally contribute to mitochondrial dysfunction and/or may represent adaptive responses to mitochondrial dysfunction in septic cardiomyopathy.     

腹腔镜保留盆腔自主神经直肠癌根治术对男性功能的影响

目的探讨腹腔镜辅助下保留盆腔自主神经（PANP）直肠癌根治术的方法及应用前景。方法 60例符合条件的男性直肠癌患者60例进行腹腔镜PANP直肠癌根治术（腹腔镜组）,选择同期符合条件的传统开腹直肠癌手术患者75例（开腹组）,比较2组患者的性功能和排尿功能。结果性功能障碍的发生率腹腔镜组为38.33%、开腹组为68.00%,近期排尿功能障碍发生率腹腔镜组为10.00%、开腹组为33.33%,2组比较差异均有统计学意义（均P〈0.05）。结论腹腔镜PANP直肠癌根治术可以有效地减少术后性功能和近期排尿功能障碍的发生率。     

老年患者血清NSE和S-100β蛋白水平变化与术后认知功能障碍的关系

目的观察老年患者手术前后血清神经元特异性烯醇化酶（NSE）及S-100β蛋白水平变化,探讨其与术后认知功能障碍（POCD）的关系。方法选择年龄≥60岁、择期手术患者120例,于术前、术毕、术后12、24、48 h测定血清NSE和S-100β蛋白水平;评估患者POCD发生情况;对POCD组和未发生认知功能障碍（NPCD）组手术前后血清NSE和S-100β蛋白水平变化进行比较。结果 120例患者血清NSE水平在术毕、术后12、24及48 h时均高于术前,血清S-100β蛋白水平在术毕时显著高于术前（P〈0.05或P〈0.01）;POCD组术毕、术后12 h血清NSE和S-100β蛋白水平显著高于NPCD组（均P〈0.01）。结论老年患者术后血清NSE及S-100β蛋白水平明显升高;老年患者术后血清NSE及S-100β蛋白水平升高与术后认知功能障碍发生有关。     

Biomechanics of male erectile function.

Two major branches of engineering mechanics are fluid mechanics and structural mechanics, with many practical problems involving the effect of the first on the second. An example is the design of an aircraft's wings to bend within reasonable limits without breaking under the action of lift forces exerted by the air flowing over them; another is the maintenance of the structural integrity of a dam designed to hold back a water reservoir which would exert very large forces on it. Similarly, fluid and structural mechanics are involved in the engineering analysis of erectile function: it is the hydraulic action of increased blood flow into the corpora cavernosa that creates the structural rigidity necessary to prevent collapse of the penile column.