Diagnostic d'une anéjaculation: à propos de 72 patients

Introduction

Anejaculation is the inability to ejaculate through the urethral meatus despite the presence of adequate erection and sexual stimulation.

Material and Methods

From January 1997 to July 2002, 72 patients (age: 17 to 72 years, mean age: 43 years, 65% under the age of 50) consulted the same urologist because of anejaculation.

Results

Forty seven patients (65%) were unable to achieve orgasm (anorgasmia). Twenty five patients were able to achieve orgasm: retrograde ejaculation (9 cases) or dry ejaculation (7 cases) (depending on the presence or absence spermatozoa in the urine after orgasm), indeterminate anejaculation (7 cases) and sluggish ejaculation (2 cases). Psychological risk factors were detected in 30 patients (42%), neurological risk factors were detected in 34 patients (47%) (especially peripheral neuropathy after pelvic or retroperitoneal surgery or diabetes mellitus) and pharmacological risk factors were detected in 16 patients (22%) (especially selective serotonin reuptake inhibitors). Men with anorgasmia presented psychological risk factors in 57% of cases, neurological risk factors in 36% of cases and pharmacological risk factors in 34% of cases. The percentages of these risk factors in patients with other forms of anejaculation were 12%, 68% and 0%, respectively. Twenty five patients (35%) presented several risk factors with a psychological predominance in 14 of them. No risk factors were detected in 11 patients (5 with retrograde ejaculation and 6 with anorgasmia), but a psychological aetiology appeared likely in 6 patients with anorgasmia, as they were able to achieve orgasm during masturbation. 70% of cases of anorgasmia therefore presented psychological risk factors or aetiologies (primary anorgasmia: 100%, secondary anorgasmia: 63%) versus 12% of patients with other forms of anejaculation.

Conclusion

1. The diagnosis of anejaculation must include the type of anejaculation.
2. The aetiological diagnosis is based on clinical interview.
3. Risk factors and aetiologies are often psychological, but sometimes neurological or pharmacological in patients with anorgasmia, and often neurological in other forms of anejaculation.
4. The term “psychological anejaculation” should be reserved for cases of primary anorgasmia.
5. Anorgasmia requires psychological assessment.

     

The El Niño / Southern Oscillation and Australian vegetation

The El Niño-Southern Oscillation (ENSO) phenomenon has a marked effect on Australia's rainfall. The tendency for major Australian droughts to coincide with ENSO “events” (i.e. anomalously warm sea surface temperatures in the east equatorial Pacific), and for extensive wet periods to accompany “anti-ENSO” events, is well documented. Also well-known is the partial predictability of Australian rainfall anomalies provided by ENSO. Some other ENSO-related characteristics of interannual fluctuations of Australian rainfall are lesswidely recognised, viz:

- rainfall variability is very large

- droughts and wet periods have time scales of about one year

- they exhibit very large (continental) spatial scales

- they tend to be phase-locked with the annual cycle

- they are often followed/preceded by the opposite rainfall anomaly.

The character of Australian rainfall fluctuations is thus very different from that of areas where the influence of ENSO is weak, Europe for instance. Rainfall in some other areas, notably southern Africa and India and parts of the Americas, is also strongly affected by ENSO and shares some of the above characteristics. The relevance of these ENSO-related characteristics of Australian rainfall to its vegetation will be discussed. Australian native vegetation is adapted to these characteristics, especially in the semi-arid inland where ENSO's influence is strong. Most introduced plants are not adapted to ENSO and this has sometimes complicated their use here. The combination of ENSO-related rainfall fluctuations and European land-use strategies has resulted in some very rapid, unpredicted and undesirable changes in vegetation in the past two centuries. It has also increased the risk of soil erosion. Recognition of the real character of Australian rainfall fluctuations may help avoid further degradation of soil and vegetation.     

Erecteur a dépression (Vacuum erection device): Mise au point

The vacuum erection device (VED) is a nonsurgical alternative for the treatment of erectile dysfunction. This method is based on 2 phenomena:

1. an erection-like state occurs when the penis is placed in a vacuum
2. this state can be maintained by a constricting band placed around the base of the penis

The erection-like state thus obtained differs from a normal erection in the following ways:

1. blood flow into the penis decreases
2. penile skin temperature falls
3. congestion of extra-corporeal penile tissues occurs
4. the penis pivots at its base
5. the ejaculate is trapped in the proximal urethra

About 30 to 60% of men who trie the device at home purchase it for continued use. The others are unable to achieve sufficient rigidity, experience side-effects or dislike the use of the device despite good result. About 60 to 80% of the men who purchased the device continue to use it regulary at short or middle term. The VED seems to have lesser drop-out rate than the self injection therapy. The most frequently encountered side-effects of the device are pain, petechiaes, bruising and ecchymosis.     

Organogenesis at the shoot apex: An attempt at modelization

A geometrical model of the emergence of a primordium at the shoot apex in dicotyledons is proposed. It is based on recent fundamental results on plant morphogenesis, i.e.:

1. the emergence is preceded by the reorganization of the microtubules of the cortical cytoskeleton, leading to a new orientation of the synthesis of the cell wall microfibrils;
2. the resulting global stress is related to the general orientation of the cell growth.

So the model sums up the continuous interactions linking the microtubules, the microfibrils and the cell growth axis. This paper tries to answer three questions which are essential from a botanical point of view:

1. Why does the principal stem shift its growth direction after each lateral emergence?
2. Why do the three axes involved in any ramification (namely the old and the new principal stems and the lateral emergence) exhibit a plane configuration whereas this is an essentially three dimensional phenomenon?
3. Does phyllotaxis exclusively depend upon the local emergence of a primordium?

A come and go between the botanical knowledge and the mathematical model leads to an integrated view of the compatibility mechanisms linking the different microtubules and microfibrils networks, without forgetting the apical dome restoration. A geometrical formalism allows a modern redefinition of both the “generating centre” and the “organizing centre” and their field effects.     

Plant morphogenesis: A geometrical model for the ramification

A geometrical model is proposed that describes the emergence of a primordium at the shoot apex in Dicotyledons. It is based on recent fundamental results on plant morphogenesis, viz.:

the emergence is preceded by the reorganization of the microtubules of the cortical cytoskeleton, leading to a new orientation of the synthesis of the cell wall microfibrils;

the resulting global stress is related to the general orientation of the cell growth;

The model sums up the continuous interactions that link the microtubules, the microfibrils and the cell growth axis. The paper tries to answer three essential questions:

Why does the principal stem shifts its growth direction after each lateral emergence?

Why do the three axes involved in any ramification (namely the old and the new principal stems and the lateral emergence) exhibit a plane configuration whereas this is an essentially three dimensional phenomenon?

Does phyllotaxis exclusively depend upon the local emergence of a primordium?

An interactive procedure between empirical botanical knowledge and the mathematical model leads to an insight of the compatibility mechanisms that link the various microtubules and microfibrils networks, and the apical dome restoration. A geometrical formalism allows a redefinition of both the “generating centre” and the “organizing centre”, and their field effect.     

Les violences sexuelles

The penal code severely represses all forms of sexual violence. It distinguishes between sexual aggressions and sexual attacks —The exploitation of 275 psychodynamic assessments of perpetrators of sexual violences jointly carried out by two experts led to the following data: The perpetrators were between 12 and 68 years old, 108 were between 12 and 25, 109 between 26 and 40. The parents had left a void in the infantile history of the perpetrators of aggressions. The aggressors came mostly from large families. The conclusions of the assessment make possible to assert that, 50% of the perpetrators were immature, 90 suffered from psychic troubles, i.e. referring to a form of trouble of the psychiatric nosography. The assessments revealed the existence of a neurotic structure in 20 cases, a perverse structure in 16 cases and a psychotic structure in 9 cases. Studies on the psychopathology of sexual aggressor, in particular Claude Balier’s work, reveal the basic anxiety, the personality split, the early trauma (most sexual aggressors have themselves been aggressed in their childhood), the counter-organization to face anxiety. Bernard Cordier’s work on pedophilia makes possible to outline a clinical approach. Pedophiles can be divided into three groups: primary or chronic pedophiles, pedophiles with a mental anomaly, reactive or transitory pedophiles. The exploitation of 222 assessments of victims (195 women, 33 men) carried out by us brings forth the following elements:

- the large majority of those victims consisted of under 18s, from 3 to 18 years old (72%), out of which 109 were less than 15 years old (47%).

- 106 among the vicitms had an inadequate father, which amounts to 45%, close to the 50% of inadequate fathers among the aggressors.

- 24% of the fathers were described as violent.

- 40.8% of the mothers had died, divorced or separated, which is high for a population of rather young victims.

- 6.5% of the mothers were described as violent.

- More than 40% had ben brought up in a children’s home or fostered.

- 17.6% had bad memories or no memories at all of their childhood, 10% had suffered from maltreatment.

- 36% had had psychic troubles. Those figures show the victims structural fragility, their deficiencies facilitating their aggressors’hold on them.

The conclusions of the assessment assert that in 71% of the cases the aggression had consequences directly linked with it. The 17/06/98 law on the prevention and repression of sexual attacks, and on the protection of under 18s, sets up on the one hand a socio-judicial follow-up for sexual delinquents, on the other hand a real «status» for the child victim of sexual abuse. If the notion of treatment has made real progress with regard to the victims, absent for too long in the judicial process, the treatment of aggressors, even though the texts sem to be firm about it, is still to be established.     

Studien über die Testaceenbesiedlung der Seen und Tümpel des Abisko-Gebietes (Schwedisch-Lappland)

1. From 40 waters of the Abisko-district (Sweden, Lapland) 58 samples were collected (essentially samples from sediments).
2. It is not possible to clear the origin of all discovered tests of sediments. The bottom of most waters was covered with mosses, from which vegetation, tests can come into the sediments. But also tests from other biotopes, can be found at the bottom.
3. Nevertheless we can recognize typical characters of those species living in sediments. The prevalent type is the “Difflugia-type”. Those species of Centropyxis which immigrated into sediments demonstrate a trend towards the “Difflugia-type”. The immigration is possible from Aufwuchs, mosses and soils. 62,7% of the recorded tests belong to Difflugia, 17,8% to Centropyxis.
4. The prevalent species in the sediments of the Abisko-district is Difflugia elegans var. teres, the next is D. glubolosa.
5. A great number of investigated waters contained the oligotrophic species Centropyxis aërophila. Only one lake (Ruontenjaure) shows the association of dystrophic lakes.
6. Some species are described taxonomically, for instance: Centropyxis nauwercki n.sp. C. nauwercki is very much like Difflugia, but is also connected with C. platystoma. The new species shows a trend from Centropyxis to Difflugia.
7. C. aërophila can also immigrate into the Aufwuchs. There the species has membraneous tests.
8. Geographical aspects of the sediment colonization are discussed.

     

Les prélèvements testiculaires dans les azoospermies sécrétoires: indications et bilan andrologique

The management of patients with nonobstructive azoospermia must not be limited to testicular biopsy. A complete andrological assessment must be performed to adapt treatment to each patient, in order to:

-avoid testicular biopsy by screening for “azoospermia-like” syndromes and treat any etiological factors (pituitary hypogonadism, varicoceles, cryptorchidism), and concomitant aggravating factors (spermatic cord infection, obstructive factor of the epididymis or vas deferens).

-screen for clinical or subclinical testicular tumors and demonstrate genetic anomalies involving risks for the offspring.

-establish a prognosis regarding the possible use of medically-assisted reproduction by ICSI (intracytoplasmic sperm injection) with testicular spermatozoa.

     

The reproductive cycle in a typical estuarine mollusc Nausitora hedleyi Schepman based on a study of the Gonad Index

1. Previous work on the methods employed for the determination of the breeding season of shipworms is briefly reviewed.
2. The method adopted for studying the reproductive cycle by using the “gonad index” is described.
3. The reproductive cycle of Nausitora hedleyi is described in detail based on a study of the gonad index of different sexes collected at monthly intervals from the estuarine environment of Cochin harbour.
4. The fact that breeding is restricted as marked by seasonal activity is shown from the size and activity of the gonad during the different months of the year.
5. The environment, and the hydrographic conditions prevailing in the habitat of N. hedleyi in the Cochin harbour are described.

     

Cellular systems as graphs

The definition of an (M,R) is formulated in a way that emphasizes its mathematical properties. Neglecting interactions between the components, it is shown that:

1. An (M,R) contains only one non-reestablishable component.
2. If an (M,R) contains only one non-reestablishable component, then that component is central.

Examples are given to illustrate the biological significance of these two results. The notion of “lag-independence” is introduced, and it is shown that if a system possesses only one non-reestablishable component which is “lag-independent” then all components are lag-independent. The concepts of reestablishability, centrality and lag-independence are applied in order to suggest various criteria for optimal organization of (M,R).     

Galanthamine production in “shoot-clump” cultures of Narcissus confusus in liquid-shake medium

Galanthamine (GAL) is increasingly used in the treatment of Alzheimer's disease. We have attempted to develop a method of producing this alkaloid using in vitro cultures of Narcissus confusus plants. The “shoot-clump” culture in liquid medium was shown to be an appropriate method for the micropropagation of this bulbous plant. The complete process included three steps:

1. culture of “twin-scales” starting from the bulbs;
2. culture of the newly formed shoots in a medium for bud proliferation (Murashige Skoog+1 mg l^-1 of 2,4-dichlorophenoxyacetic acid+5 mg l^-1 of benzyladenine), and
3. culture of “shoot-clumps” in a liquid-shake medium. Here we describe the effect of the addition of trans-cinnamic acid, a precursor in the biosynthesis of the Amaryllidaceae alkaloids, on the production of galanthamine and related alkaloids, and also on the growth of the “shoot-clump” culture. The production of galanthamine was found to be inhibited by the addition of the precursor, which promoted the production of the other alkaloid in the same biosynthetic pathway, N-formyl-norgalanthamine. The total production of galanthamine in the control cultures in day-long photoperiod was 2.50 mg per culture, of which 1.97 mg per culture were released into the medium.

     

Effet des androgènes sur l’activité sportive

Androgenic hormones seem to be of beneficial effects on sports performance:

- they increase motivation, will, aggressiveness, resistance to the stress and to the fatigue, leading to an increase of the training quantity,

- they increase bone mineralization and probably mechanical resistance,

- they stimulate the bone marrow and so, with the erythropoietin, the erythropoiesis,

- they increase the tendancy to hyperglycemia, but with a decrease of the tolerance to the glucose,

- they stimulate the fatty acids mobilization from the adipose tissue, for their utilization in the muscle during the exercise,

- they participate, for the trained sportmen, to a better gestion of the muscle glycogen storage: their utilization during exercise is decreased,

- they increase the lean body mass, with an increase of the protein synthesis and a decrease of the protein catabolism, leading also to an increase of the muscle force under training. There is no beneficial effect upon the tendons,

- they have an immunomodulation action.

     

Elektroortung bei schwach elektrischen fischen: verzerrungen des elektrischen feldes von Gymnotus carapo und Gnathonemus petersii durch gegenstände und ihre wirkungen auf afferente aktivitäten

1. Discharges of the electric organ (EODs) of the weakly electric fishes Gymnotus carapo and Gnathonemus petersii produce alternative electric fields in the surrounding water. Equipotential contures are plotted in order to know the electric field in detail and to mimic it with a dipol model.
2. Either fields are deformed in a characteristic manner by conducting and nonconducting objects. These field distortions, opposite for conductors and nonconductors were measured by using several methods:
   1. Comparisons of undistorted and distorted field patterns issue variable distortions shapes depending on the objects' placement.
   2. Direct measurements of field distortions at a “receptor site” were made by several sets of electrodes.
   The effects measured depend on the conductivity of objects, their size and their distance from the electrical dipole the last being due to the inhomogenous field contures. As a general rule, plastic objects make the field increase, and metal objects decrease. However, considering all positions, either material produces complex field variations (di- and polyphasic curves).
3. Since responses of gymnotids' primary fibers as a function of plates' position strikingly fit to the curves of field distortion, the electroreceptors use obviously quite similar measurement conditions as the field registration arrangements. This evidence is discussed and compared with more general aspects of field distortions in homogenous fields.
4. The field effects decrease exponentially with the lateral distance of objects to the dipole. However, the reaction of primary fibers decreases rather linearly as the lateral distance of objects is increased.
5. Experiments with systematically changed stimulus frequency showed primary fibers to be exited over a much wider range of frequencies (0–1000 cps at least) than to be expected regarding the usual EOD discharge rate of 30–100 cps. However, the peak of the “tuning curve” at best frequency fits well into this range. On the other hand, the change of response over this frequency range is 10–20%, so that there is but minor improvement of the information by an increase of EOD frequency.

     

Les prothèses gonflables dans le traitement de l'impuissance: résultats de 80 implantations

Objective

The goal of this study is the evaluation of the functionnal results and the complications of this type of surgery. Such questions have been poorly discussed in the literature.

Methods

We report our experience on 80 inflatable prostheses that were implanted between october 1987 and october 1994. The mean follow-up is 3 years and the assessment of the objective (mechanical functioning of the prosthesis and complications) and sujective results (sexuality of the patients) is carried out on 68 patients.

Results

The results are the following:

? 54.5% of functioning disturbances,

? 7% of infections,

? 27.5% of prosthesis removals.

Most of the patients considered they were satisfied although only 65% returned to a regular sexual activity.     

Colour preferences of flower-naive honeybees

Flower-naive honeybees Apis mellifera L. flying in an enclosure were tested for their colour preferences. Bees were rewarded once on an achromatic (grey, aluminium or hardboard), or on a chromatic (ultraviolet) disk. Since naive bees never alighted on colour stimuli alone, a scent was given in combination with colour. Their landings on twelve colour stimuli were recorded. Results after one reward (“first test”) were analysed separately from those obtained after few rewards (“late tests”).

1. After pre-training to achromatic signals, bees preferred, in the first test, bee-uv-blue and bee-green colours. With increasing experience, the original preference pattern persisted but the choice of bee-blue and bee-green colours increased.
2. Neither colour distance of the test stimuli to the background or to the pre-training signal, nor their intensity, nor their green contrast, accounted for the colour choice of bees. Choices reflected innate preferences and were only associated with stimulus hue.
3. Bees learned very quickly the pre-trained chromatic stimulus, the original colour preferences being thus erased.
4. Colour preferences were strongly correlated with flower colour and its associated nectar reward, as measured in 154 flower species.
5. Colour preferences also resemble the wavelength dependence of colour learning demonstrated in experienced bees.

     

The chemical identification of root promoters extracted from avocado tissues

From the Avocado Rooting Promoter (ARP) 4 compounds were isolated and identified as:

1. 1 acetoxy - 2,4 dihydroxy-n-heptadeca-16-en;
2. 1 acetoxy - 2,4 dihydroxy-n-heptadeca-16-yn;
3. 1,2,4 trihydroxy-n-heptadeca-16-en;
4. 1,2,4 trihydroxy-n-heptadeca-16-yn.

The rooting activity of the pure compounds was verified using the mung bean rooting bioassay. Compound 2II is the most active.     

Inhibition of carotenoid synthesis in Myxococcus fulvus (Myxobacterales)

1. The inhibitory effects of CPTA, nicotine, DPA, and San 6706 on carotenogenesis in Myxococcus fulvus were investigated.
2. The effects of CPTA, D-nicotine, and L-nicotine were very similar. The action of the drugs wasadditive. The cyclization was inhibited at low doses, the introduction of the hydroxyl group at C-1′ at higher doses. Lycopene accumulated at high drug concentration. The mode of action of the inhibitors is discussed.
3. In a carotenoid mutant of M. fulvus a stimulation of the “7,8-dehydrogenase” by CPTA was observed.
4. The specific carotenoid content of bacteria was increased by DPA due to an enhanced formation of phytoene. At low doses of DPA small amounts of an intermediate carotenoid glucoside ester, a 7,8-dihydro derivative, were detected.
5. DPA was taken up by the plasma membrane. Quantitative removal of DPA by washing was not possible.
6. San 6706 specifically and reversibly blocked the desaturation of phytoene.

     

The use of toxicokinetics for the safety assessment of drugs acting in the brain

Pharmacological and toxicological studies undertaken on drugs that affect the brain are frequently performed in disparate species under various experimental conditions, at doses often greatly in excess of those expected to be administered to humans, and the findings are extrapolated implicitly or explicitly with scant regard to differences in the biodisposition of the drugs. Such considerations are necessary since:

1. Species;
2. Strain;
3. Gender;
4. Route;
5. Dose;
6. Frequency and time of administration;
7. Temperature;
8. Coadministration of drugs; and
9. Surgical manipulation

are but some of the factors that have been shown to influence the kinetics and metabolism of drugs. This article, using MDMA and other phenylethylamines as examples, provides evidence for the need to measure the exoosure of the drugs and their active metabolites in blood and brain (toxicokinetics) in order that conclusions based only on dynamic, biochemical, or histological evidence are more pertinent. Further, the combined use of toxicokinetic-dynamic modeling can lead to a better appreciation of the mechanisms involved and a more useful approach to the calculation of safety margins.     

Beta irradiation may induce stereoselectivity in the crystallization of optical isomers

A novel approach has been introduced to detect the manifestation of symmetry breaking weak interactions at molecular level. In the racemic conglomerate crystallization of D, L-sodium-ammonium tartrate the effect of³²P irradiation was studied by measuring the weight and optical purity of the crystalline phase as well as the size distribution of the crystallites. The high number of independent experiments (over 1000) permitted statistical analysis of the results. The following observations have been made:

1. Beta irradiation influences the crystallization process, irradiated samples yield more crystalline material.
2. The effect involves presumably crystal seed formation because from the irradiated solutions more and smaller crystallites are formed.
3. The presence of beta particles induces stereoselective crystallization, the crystalline phase shows optical activity characteristic of the “unnatural” L-isomer.
4. The above changes are attributed to the beta irradiation as the magnitude of the effects depends on the amount of added radioactivity. Optically active contaminants are highly unlikely sources of the differences between irradiated and control series.
5. In the absence of³²P the tartrate enantiomers have equal probability to form crystals, i.e., the contribution of mixing of weak interaction into the electromagnetic one is not measurable in this system.