Latest Treatment of Mental Impotence

Mental Impotence Healer

Mike Millers Mental Impotence Healer is an eBook that utilizes guided imagery to help you cure your psychological impotence. In guided imagery, you will be guided into imagining a scenario to guide you to overcome psychological and physical issues. It commonly uses descriptive language and instructions that have direct affects on the brain. Since the mind greatly influences the body, this technique helps you have rock-hard erections when you need them most. Simply listen to The Mental Impotence Healer Program for 60 days and completely annihilate your sexual fears and in next to no time you will become a brand new You! Recharged with sexual energy, bursting with self-confidence, rock solid on command, and conditioned to be aware that your times of Psychological Impotence have dissapeared, permanently! The Mental Impotence Healer Program provides you with your confidence back and will boost your self-esteem to amazing new heights. Listen to the beautiful, calm and relaxing Guided Imagery session and it definitely will totally transform your sex life. You will have control over your erections without taking any harmful medication or dangerous pills. Grab a set of headphones and the recordings will go to work while you relax. The carefully mastered binaural beats and subliminal messages will reprogram your subconscious mind into a radically altered state of heightened sexual awareness and desire! Read more here...

Mental Impotence Healer Summary


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Author: Mike Miller
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I usually find books written on this category hard to understand and full of jargon. But the author was capable of presenting advanced techniques in an extremely easy to understand language.

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The dietary supplements Asian ginseng (Panax ginseng) and North American ginseng (Panax quinquefolius) are widely used. The latter ginseng is more expensive. A HPLC-evaporative light scattering detection (ELSD) method was used for the identification of both ginsengs. Ginsenoside RF of Asian ginseng and 24 (R)-pseudoginsenoside F11 of North American ginseng can be identified at levels of 32-50 ng.47 HPLC-ELSD is a sensitive method for the identification of the origin of ginsengs. The same markers were used in the study of Chan T.W.D. et al. for the differentiation and authentification of Panax ginseng and Pananx quinquefolius.48 Ginsenosides are separated using HPLC with electrospray mass spectrometry detection. Identification is based on positiveion ionization of the characteristic molecular ions and thermal degradation products. The method is reliable and detection limit is in the nanogram range.

Erectile dysfunction

Failure of normal erections occurs with advancing age and it is estimated that around 20 of men between 50 and 70 years of age have moderate or severe ED. The cause of this impotence may be psychogenic, but organic causes (such as diabetes, smoking and peripheral vascular disease) are more likely with increasing age. The mainstays of treatment are the phosphodiesterase type 5 (PDE 5) inhibitors, such as sildenafil, vardenafil and tadalafil. These drugs inhibit breakdown of cyclic guanosine monophosphate (cGMP), thereby enhancing the normal erectile response. They are effective in psychogenic and organic ED. Other modalities of treatment are occasionally necessary including intracaver-nosal prostaglandin E1 and intraurethral vasoactive drug therapy, and vacuum constriction devices. An uncommon side effect of drug therapy for ED is a prolonged erection lasting several hours (priapism), which may lead to ischaemic injury to the erectile tissue in the corporeal bodies. If priapism does...

Erectile Function

Although reports have noted relatively low rates of impotence after prostate implantation 33 , this endpoint was only evaluated at two years after implantation. There is a paucity of long-term data critically examining this issue. Stock et al. 33 also reported gradually declining erectile function with continued follow-up after brachytherapy in 89 patients. However, the median follow-up in that report was only 15 months. It appears that impotence rates after TPI are probably underestimated in the literature. With longer follow-up observations, Zelefsky et al. 3 reported that whereas the incidence of impotence two years after implantation was 21 , the rate increased to 42 five years after the procedure. Although the development of erectile dysfunction after prostate brachyther-apy is likely to be a multifactorial phenomenon, the influence of the dose of radiation to the penile bulb may be an important variable. Merrick et al. reported a 61 six-year actuarial rate of erectile...

Functional and Pharmacological Components of Foods and Drinks

There is growing interest, particularly in the food and beverage industry, in developing foods and drinks with functional properties (nutraceuticals) attractive to the consumer. These include effects on behavior, such as improvements in cognitive function, mood, and physical performance. Components of interest include caffeine, herbal extracts such as ginkgo biloba and panax ginseng, micronutrients, essential fatty acids, amino-acids, and carbohydrates. There is some support for beneficial effects of these components, but they are not reviewed further here.

Empirical Studies

According to the principles of operant conditioning, and specifically of negative reinforcement, the client should behave in ways that would minimize contact with the aversive stimulus, in this case the precipitative events and the deviant behavior. If the client does pursue the deviant behavior further, hopefully the treatments will have at least reduced the effectiveness of the reinforcement for the deviant behavior, which should lead to a lower frequency of the behavior. It would also be possible for classical conditioning to work alone, if the CR was so powerful that it rendered the person unable to engage in the deviant behavior, or consisted of a response that was incompatible with the deviant behavior. For example, if the CR was extreme anxiety or fear, and the deviant behavior required an erect penis, it may be the case that the CR would preclude the possibility

Reconstructing Sex Australian and New Zealand Transgender Reform Jurisprudence

However, it is the genital factor that proves decisive.3 In relation to reform jurisprudence, on the other hand, it is the surgical removal and reconstruction of genitalia subsequent to birth that proves crucial. Moreover, it is not merely a concern with bodily esthetics that has led to this focus. Rather, legal analysis has also exhibited concern over postoperative sexual functioning. In the biological approach this has manifested itself in terms of judicial horror at the prospect of unnatural sexual intercourse. Within reform jurisprudence it is the capacity for penetrative heterosexual intercourse postoperatively that has been emphasized repeatedly. In New Zealand the judiciary have dispensed with the requirement of postoperative sexual function (Attorney-General v. Otathuhu Family Court 1995 1 NZLR 603). However, New Zealand law still requires genital reassignment surgery (see Sharpe, 2002).

Personality Differences by Gender

An enjoyable activity for young Chinese men is to rank a woman's relative physical beauty. The sexual delight that men take in being aroused visually often leads them to buy pornography or, sometimes, make their own. The male's ability to become sexually aroused by visual stimuli can often result in extremely inappropriate social behavior. The male preference for beauty also affects the pace and growth of their involvement. Chinese men, like American men, fall in love quicker than women.

Smell And Sexual Arousal

Throughout history aromas have been linked with sexual response. Perfume jars were preserved in the chambers designed for sexual relations in volcanic remnants of ancient Pompeii. Ancient Sumarians used perfumes to entice women. Traditional Chinese rituals highlight the relationship between smell and affection. Hieroglyphics also relate the two. Virtually all cultures use perfume in their marriage rites. In the modern world as well, the connection is pervasive. Use of perfumes and colognes as romantic enticements are a multibillion dollar business (8). The prominence of the historical connection between odors and sex among diverse cultures implies a high level of evolutionary This cultural awareness may derive from the unique characteristics of human neuroanatomy. Humans have the largest limbic system compared with body size of any primate (17). The olfactory lobe directly connects with the limbic system (18). The relative size of the limbic system and the extensive olfactory limbic...

Paradoxical Intention

As the name implies this treatment strategy employs a form of reverse psychology to address sleep difficulties. Designed mainly to address the excessive performance anxiety that contributes to sleep onset difficulties, this treatment instructs the insomnia sufferer to remain awake as long as possible after retiring to bed. In essence, the insomnia sufferer is placed in the paradoxical position of having to perform the activity of not sleeping when in bed. If the individual complies and genuinely tries to remain awake in bed, performance anxiety over not sleeping is alleviated and sleep becomes less difficult to initiate. Like the other treatments, an initial visit to provide treatment instructions and follow-up sessions to support the patient and ensure compliance are usually recommended when administering this intervention.

Discovery and Nonclinical Development

The discovery of new products for patient use takes place in laboratories at universities, in the government, or in pharmaceutical companies actually, it starts in the minds of scientists with a scientific innovation or idea for creating a new therapeutic molecule that may be a biological or drug. This research is performed through carefully done studies, either with the physiology of humans or other species, disease models, or some core structure of a molecule, through a host of different scientific technologies. Sometimes, a drug discovery is an accidental finding related to an unexpected action of a drug being studied for other uses, such as Viagra for impotence. Each molecule may have an impact on a general physiologic process such as inflammation and thus have the potential to be used in many organ systems and diseases, or it may impact a specific receptor on a cell, such as a tyrosine kinase, and be used only when the receptor system goes awry. Knowledge of the discovery and...

Reflexology In Disorders Of The Reproductive System

Zone Therapy Reflexology

PROBLEMS OF MEN HyjJfocele Varicocele Enlarged prostate Impotence Oligospermia Impotence means absent or deficient erection of the penis when attempting sexual intercourse. It is mostly psychological, a result of anxiety. The problem is so distressing that victims run helter-skelter for medical help and fall a prey to unscrupulous quacks.

Decreasing endometrial pain Presacral neurectomy

Another way of decreasing pain from the pelvis caused by endometriosis is to interrupt the nerve fibers that carry pain messages from the pelvic organs and covering. These fibers are part of the sympathetic nerve system the tiny nerves come from both sides of the pelvis and form visible nerve fibers on the surface of the sacrum, hence the term presacral. These nerves don't have any other known function, so cutting them only affects pain sensation. For instance, these nerves don't affect labor or pushing during childbirth, nor do they affect sexual response.

Commercial Applications

Certain flavonoids have long been used as drugs in Eastern European and Southeastern Asia. The pharmacological activities of these polyphenols have been less specific and less pronounced than those of alkaloids or steroids. Therefore, doubt and controversy have always surrounded the therapeutic value of polyphenols. Many European countries and Japan have been leaders in the commercial production of herb phytomedicinals consisting mainly of polyphenol compounds. Germany accounts for the largest share of the European Union herbal drug market, with sales of 3 billion of an annual 6 billion total (61). Of the 10 best-selling herbs in the United States today, echinacea, garlic, ginseng, ginkgo, saw palmetto, and eleuthero have been popularized. This is primarily the result of European research, which takes place under a more favorable regulatory climate that permits reasonable evidence of efficacy. In the United States, demand for excess amounts of evidence regarding efficacy has...

Using MAP and other techniques to preserve fresh and minimally processed produce

CAS and MAP have been used to extend the shelf life of a variety of fresh produce. CAS, in particular, has been used extensively with fruits such as apples, peaches and pears. Lopez et al. (1999) reported that the highest emission of volatile components was obtained after five-month storage of Golden Delicious apples under 2 O2 and 2 CO2 at 10C and 92-94 RH, when they are removed from CAS and kept at 20 0C for ripening. Drake (1999) found that Bosc pears were firmer, had less decay, and retained the ability to ripen better when stored in 3 CO2, 1.5 O2 at 10C as compared to those in 1 CO2 and 1.5 O2. MAP has only limited success with whole fruits or vegetables. For example, shelf life of Kolikuttu bananas could be extended to 30 days when packaged in 0.75 mm low density polyethylene (LDPE) with ethylene scavengers such as potassium permanganate and stored at 14 0C and 94 RH (Chamara et al., 2000). Arango et al. (1999) extended the shelf life of naranjilla fruits to a maximum of 50 days...

Primary hyperaldosteronism Conns syndrome

In patients who are on a large dose or who experience side effects of the drug, such as impotence, gynaecomastia, hypotension and weakness due to hypokalaemia, surgery is indicated. Since these tumours are normally unilateral and small, laparoscopic adrenalectomy is the treatment of choice. Total adrenalectomy is normally performed rather than simple extirpation of the tumour from the gland.

Development and Function of the Endosperm

The formation of an endosperm could be a reason why land angiosperms have been most successful in colonizing the planet. In gymnosperms, the female gametophyte consists of a large number of cells and constitutes the main source of nutrients for the developing embryo. In most angiosperms, this role has been taken over by the endosperm, which develops post-fertilization. What is the evolutionary origin of the endosperm There are currently two theories (reviewed in Friedman and Williams 2004). One theory suggests that the endosperm evolved from a supernumerary embryo. This theory is based on the finding that in Ephedra, a taxon belonging to the Gne-tales, double fertilization of the binucleate egg cell leads to the formation of two embryos within one ovule. Often only one of the embryos continues to develop and subsequently outcompetes and consumes the other embryo. Thus, it is possible that the endosperm in angiosperms represents a developmental transformation of an embryo into a source...

Oriental Medicine and Historical Background

The sea cucumber is called haishen in Chinese, which literally means marine ginseng. Ginseng, Panax ginseng, is the most famous plant in Oriental medicine, best known for its multipotent pharmaceutical activities. It contains saponins which show depression effects on the central nervous system, and vasodilator effects. Ancient Japanese names umiko and nameriko for the sea cucumber were found as medications in an antique medical book, Daidoruijuho (808 a.d.). In the 17th century, a Chinese scholar, Xie Qi (1567-1624), reported that sea cucumbers were comparable to ginseng with respect to pharmaceutical activities in a book named Wuzazhu . In Japan, dried and roasted sea cucumbers have been employed as a hemostatic for bleeding such as in hemophilia, a relaxant for convulsions and other remedies since the 11th century. It is recognized in Japan and China that sea cucumbers contain medicinal substances. The historical background described above seems to support pharmaceutical...

External Validity Does Selfperception Occur Outside The Laboratory

A number of others studied romantic attractions that, as far as the participants were concerned, were going to be acted on outside of the laboratory. Many of the studies of drug effects on arousal, such as those on beta-blockers and performance anxiety, also involved real-world experiences such as giving speeches and competing in sports (Mattes, 1985 Noyes, 1985 Slivken & Buss, 1984). Obviously, the experiences of people suffering from panic disorder take place outside the laboratory, in everyday life.

Overall Patterning of Sexual Attitudes and Practices

Interestingly, extramarital sex norms are not related to these attitudes or behaviors. Neither are premarital and extramarital sex norms and behavior predictably related to another cluster of behaviors related to sex. In particular, male concerns about or incidence of impotence, male boasting about sexual exploits, and incidence of homosexuality are all unrelated to the patterning of premarital and extramarital sex. However, these three aspects of human sexuality are related to each other, so that in societies where male impotence is a theme, males boast about their sexual exploits and homosexuality is absent, while, by contrast, where male impotence is not an issue, homosexuality is present and boasting is absent (Broude, 1976).

Robot Assisted Da Vinci Urologic Surgery An Emerging Frontier

It is very important to define the primary outcome and the relative merits of VIP with open and laparoscopic prostatectomy. To address some of these issues, a comparison was conducted of 200 cases of VIP with 100 cases of gold-standard retropubic radical prostatectomy in terms of oncological completeness and preservation of erectile function. Undoubtedly, VIP had the clear edge in terms of less blood loss, less postoperative pain, excellent anatomical anastomosis leading to early achievement of continence, visually superb preservation of neurovascular bundle, shorter hospital stay, and cosmesis 27 . In another report on the outcome of 500 cases of robotic radical prostatectomy, it was observed that the incorporation of robotics resulted in better surgical outcomes in comparison with standard and laparoscopic radical prostatectomy 28 . There are no differences between the procedures in oncological completeness, margin positivity rate, and surgical outcome, in terms of providing...

Witkins Perceptionpersonalitycognitive Style Theory

The disorder (cf., resolution law - attempts to find a partial explanation of behavioral modification whereby the changing of one physiological state into another one becomes easier and quicker after it has taken place a number of times and stages of change theory - suggests the following steps be used to gain the self-control required to change an undesirable behavior pre-contemplation of the advantages and consequences of the change, contemplation of benefits, preparation and action, and maintenance of the change). Wolpe indicates that variables such as food, expression of aggression, and sexual feeling might work, also, to reciprocally inhibit avoidance behavior or anxiety feelings. Wolpe's work on the direct re-education of sexual behavior foreshadowed W. Masters and V. Johnson's widely publicized sexual-response studies, and his emphasis on expression of feeling anticipated the procedure of assertiveness training. See also ALL-OR-NONE LAW PRINCIPLE BEHAVIOR THERAPY COGNITIVE...

Genetic Testing and Alzheimers Disease

Bacterial Lawn Pic Ames Test Plate

The extent of the syndrome ranges from complete androgen insensi-tivity and development of normal external (but not internal) female sexual anatomy, to partial insensitivity, with altered or ambiguous male or female genitals, to mild insensitivity, with normal male genitals, enlarged breasts, and possibly impotence. Treatments depend on the extent of the syndrome, and may include hormone therapy, surgery, and psychological counseling. Gene testing and genetic counseling are available for families with affected members.

Description Of Treatment

By the patient from those reported subsequently. List difficulties the observer recognizes but the patient does not complain of directly. Include both intrusions and omissions from rational consciousness and behavior. Intrusions are episodes of consciousness or action that are unwanted, unbidden, or hard to dispel, such as an impending sense of doom, an unwelcome repetition in memory, images of a traumatic event, or a temper outburst. Omissions include the absence of desired and adaptive experiences or actions, such as inability to become sexually aroused, inability to recollect a loved one, and failure to confront the implications of important situations. Indicate how these symptoms and signs occur in current life outside the session, how they developed in the past, and if and when they were observed directly in the clinical setting.

Gender over the Life Cycle

With the birth of three or four children, mother and fathers become incorporated in the mekrakramtire (those with many children grade). The social reserve and shame that have constrained a man in both the men's house and his wife's house begins to ease during this life stage, and he may become a public orator and intervene most vigorously in discussion in the men's council. He has probably sponsored a name ceremony for his child which enmeshes him in future obligations to provide food and support to others but also gains him recognition as a peacemaker. Wives of this grade have been ceremonial sponsors along with their husbands and also enjoy the respect accorded parents of honored children. With the birth of grandchildren and the gradual recognition of the diminuition of their own sexual potency, men and women become part of the mebenget (social mentors) grade. As they cease to have young children of their own they are less susceptible to restrictions observed by newer parents. Men...

Description Of Behavioral Insomnia Therapies

Formal applications of behavioral interventions to insomnia were first reported in the 1950s but such treatments did not gain much popularity until the 1970s. Over the past 30 years, various behavioral insomnia therapies have been developed, tested, and, at times, modified. The nature and specific focus of these treatments has varied significantly in that some are composed of fairly formalized exercises designed primarily to address sleep-related performance anxiety and excessive bedtime arousal, whereas others include fairly regimented behavioral prescriptions designed to eliminate sleep-disruptive habits. The following discussion provides brief descriptions of the most commonly employed behavioral insomnia therapies.

Peripheral Nervous System

Nervous System Peripheral Neuropathy

Usually, sympathetic and parasympathetic divisions act separately and at times cooperatively. Sweat glands and blood vessels in the limbs have only sympathetic innervation the pupil and bladder are dominated by parasympathetic fibers. Certain disparate domains see both divisions working together in never-ending modulation (with neurohormonal assistance) of cardiac rhythmicity and intermittent assistance in male sexual function (erection is mediated mainly by parasympathetic fibers but ejaculation by sympathetic fibers). Visceral and somatic functions may also be performed cooperatively. This requires the interplay of many parts of the CNS spinal cord, brain stem, limbic system, hypothalamus, basal ganglia, and others. Performances of respiratory, digestive, and sexual functions offer eloquent illustrations of concerted viscerosomatic activity.

Disorders of the Penile Shaft

PRIAPISM Priapism is a persistent and usually painful engorgement of the paired dorsal corpora cavernosa, resulting in a dorsal penile erection, while the glans penis and the ventral surface remain flaccid. The resultant erection is not necessarily associated with sexual stimulation or desire, and it is not relieved by ejaculation. The etiology of the painful engorgement of the corpora cavernosa elements in priapism is thought to center on the autonomic control of blood flow out of the emissary venous system of the penis versus the rate of blood flow into the arterioles and sinusoids of the corpora cavernosa. The flow of blood into the arterioles and sinusoids of the corporal elements may be characterized as either high flow or low flow, reflected in 99mTc penile scan flow studies. The mechanism of high-flow priapism was initially described as a consequence of blunt trauma, whereas the priapism associated with sickle cell disease in adults is usually referred to as low-flow, or...

Cannabis and the cannabinoids

There are conflicting reports on the effects of chronic high doses of THC on human sexual function, but there is some evidence that spermatogenesis and testosterone levels are decreased. In women, a single cannabis cigarette can suppress release of luteinizing hormone, so that lack of ovulation frequently occurs in women who abuse this drug. Lowered birth weight and increased chances of malformations have also been reported in the offspring of women who abuse THC during pregnancy. It is also possible that in utero exposure to this drug causes behavioural abnormalities in childhood.

Calcium antagonists and p blockers in effort angina

Therefore the author has argued that the choice of drug between p blocker and calcium-channel blocker should be geared to the needs and the pathophysiology of the individual patient.28 For example in a middle-aged man athletically active and anxious to avoid impotence, a calcium-channel blocker would be first choice. Grade B In a person with a compromised myocardium or with a previous MI, a p blocker appropriately titrated would be first choice. Grade A In someone at high risk of MI, antihypertensive therapy started with a p blocker is somewhat safer than starting with a calcium-channel blocker, while, if the major aim is prevention of stroke and hence intellectual integrity, a calcium-channel blocker may be preferable (Figure 26.1).29

Clinical consequences of the decline in activity of the hormonal systems

It is not known whether T therapy in older men has beneficial effects on muscle function, sexual function, sense of well-being and quality of life, and whether this therapy can be done safely. Studies involving physiological replacement therapy of testosterone in older men are limited. However, the results of these studies are consistent reported are treatment-related declines in body fat mass ranging from DHEA has received great attention from the general population as potentially being able to increase the sense of well-being and sexual function, and to partially reverse the ageing process. So far, however, results are neither clear nor consistent. It seems prudent to await more trials, in order to be certain that exogenous DHEA is beneficial and can be used safely.

Adrenal Incidentaloma

Obtaining a thorough history and physical examination should be the first step in evaluating the patient found to have an adrenal incidentaloma. Functional tumors, primary adrenocortical cancers, or metastases to the adrenal gland can often be diagnosed on the basis of a detailed history and physical examination alone. Questions should therefore be directed to rule out these entities. The patients should be asked about excessive weakness, extremes of mood, or recent unexplained weight changes. Females should be asked about a deepening of their voice, recent growth of hair on their face, chest, or arms, or changes in menstruation. Likewise, males should be questioned about breast enlargement or impotence. All of these questions are directed at identifying benign or malignant functioning adrenocortical tumors that can secrete steroid hormones such as cortisone, aldosterone, or sex hormones. In addition, the presence of symptoms associated with a pheochromocytoma, such as hypertension,...

Injuries to the Penis

Traumatic rupture of the corpus cavernosum of the penis or fracture of the penis occurs when the erect penis impacts forcibly on a hard object (sexual partner's pubis or the floor), receives a direct blow, or is subjected to abnormal bending. A cracking sound is heard, followed by penile pain, immediate detumescence, rapid swelling, discoloration, and distention. Urethral injuries may accompany penile ruptures. Penile ruptures are managed by immediate surgical evacuation of blood clot and repair of the torn tunica albuginea of the corpus cavernosum and urethra.

Drainagediversion Hypothesis

They should merely be taken at face value ). For Jung, dreams compensate for undeveloped archetypes, and for Freud dreams compensate for unfulfilled wishes. Other theoretical approaches to the functions of dreams are provided by B. Wolman who notes the wide variety and range of viewpoints A. Adler suggests that dreams serve a problem-solving function offering cryptic solutions to difficulties the dreamer faces Adler's idea is that the dream is always interpreted as a reflection of the dreamer's attitudes toward the future, especially one's drive toward superiority, and that they are prodromic (they foretell the future) where the dream is a kind of rehearsal for action H. S. Sullivan asserts that dreams satisfy in symbolic ways the needs that may not be discharged in wakeful states and, thus, reduce tension W. Dement and C. Fisher suggest that dreams are safety vales reducing the danger of emotional disturbance where deprivation of dreaming may produce psychosis R. Hernandez-Peon...

Surgical Procedures A Selective Dorsal Rhizotomy

The procedure is irreversible, with associated risks of paralysis, permanent loss of bowel and bladder control, leakage of spinal fluid, infection, loss of sexual function, and permanent loss of sensation. Temporary side effects, which usually disappear after several weeks, include sensory loss, numbness, or an uncomfortable sensation in the limbs supplied by the severed nerve. Postsurgical treatment involves months of intensive physical therapy to strengthen weak muscles and to develop new movement patterns. Contraindications to SDR suggested by some surgeons include muscle tendon contractures, a history of orthopedic surgery, and hip displacement. The following are guidelines for SDR (from depart-ments orthopaedics orthoed4.htm)

History of Food Folklore

Anatomy Plant

The Doctrine of Signatures, based on the notion that 'like cures like', was also popular in the nineteenth century. Therapies were chosen on the basis of similarities of color, aroma, shape, and other characteristics. For example, beet juice, which is deep red, was thought to be an effective cure for blood diseases, while yellow plants were believed to alleviate jaundice and other liver ailments. The pungent odours of onions and garlic were thought to ward off disease, stimulate strength and bravery, arouse libido, and banish evil spirits. Walnuts resemble the brain and so were eaten to improve intellect. The ginseng root, with its resemblance to the human torso, was used by the Chinese as a panacea (Figure 1). The common names of many foods reflect folklore about their curative properties, as shown in Table 1. For example, the word ginseng is derived from the root words gin, meaning man, and sing, meaning essence. Figure 1 The universal healing properties of ginseng were attributed...

Reproduction And Development

Each ejaculation releases 2 to 5 mL of semen, the fluid containing the sperm. Semen normally contains between 20 and 100 million sperm per milliliter. The sperm consists of a 5-p.m head containing the nucleus, a midpiece containing mitochondria, and a 55-p.m-long flagellum, or tail, which can propel the sperm at a speed of 1 to 4 mm min. The seminal vesicles and the prostate gland produce much of the liquid that makes up semen, which includes fructose to provide energy for the sperm, and alkalinity to counter the acidity of the vagina. When the male becomes sexually excited, nerves of the autonomic nervous system produce dilation of arterioles in the penis, causing blood to enter that organ faster than it can leave. This causes the erectile tissue to become engorged, causing an erection. The male then inserts the penis into the female's vagina in the act of copulation, injecting the semen by rhythmic contractions called ejaculations.

Husband Wife Relationship

Women repudiated by their husbands can never marry again. Even male impotence is not grounds for a Pathan woman to divorce her husband. Obviously, relations between cowives are rarely friendly, and men who can afford to do so will put them under separate roofs, or else maneuver to have the disliked wife return to her family home and then not invite her to return. Since it is assumed that children of a repudiated wife are in danger of poisoning at worst, neglect at best, they accompany their mother, but the boys will return to their father's house when they become young men in order to claim their inheritance rights.

Having a hysterectomy

Most of the time surgery removes the whole uterus, the cervix, and fundus. Some physicians advocate leaving the cervix to enhance pelvic support and improve sexual response after surgery. This is called a partial (or supracervical) hysterectomy. Sometimes, especially in cases of severe adhesions and a frozen pelvis, the surgeon may leave the cervix for reasons of safety because it may be dangerous to risk injury to the major blood vessels, intestines, bladder, or ureter. Occasionally, your doctor decides to leave an ovary in place (see the previous section for reasons).

Nitric Oxide Signaling

The basic components of nitric oxide (NO) signaling involve nitric oxide synthase (NOS) to synthesize NO and the soluble isoform of guanylate cyclase (sGC) to trap NO. Once activated by NO, sGC converts GTP to guanosine 3'5'-cyclic monophosphate (cGMP), leading to cGMP-dependent physiological responses such as vasodilation. Termination of the cGMP signal involves a cyclic nucleotide phosphodiesterase (PDE). There are multiple PDE isoforms, and selective inhibition of specific isoforms has proven to be clinically useful (for example, sidenifil Viagra in the treatment of erectile dysfunction). sGC must also be turned off however, the in vivo mechanism for this remains unknown. Catalytic activity of constitutive NOS isoforms involved in signaling is controlled by Ca2+ and calmodulin via receptor-mediated events that trigger Ca2+ release from intracellular stores or uptake from external sources.

Physiological Effects

Soon after the introduction of tea into England, extreme positive and negative effects were attributed to it. A London teahouse advertisement stated that Tea removeth lassitude, vanquisheth heavy dreams, easeth the frame, and strengtheneth the memory. It overcometh superfluous sleep, and prevents sleepiness in general, so that without trouble whole nights may be passed in study. Though some doctors extolled its curative powers, others attacked tea for causing palsies, impotence, leanness, sterility, and nervousness (83).

Prescription Medications

Certain prescription medications can diminish a man's fertility. High doses of anabolic steroids often reduce sperm count. Additionally, these anabolic steroids can also lead to abnormal sperm, erectile dysfunction, and atrophy of the testicles. Impotence can become a factor for men who take a beta-blocking medication. Beta-blockers are sometimes prescribed to control blood pressure and for certain heart conditions. Examples of beta-blockers include atenolol, propranolol, and nadolol.

Biological Processes Controlled by Nitric Oxide

First defined as EDRF (endothelium-derived relaxing factor), the biological effects of nitric oxide (NO) have now been definitively characterized in a number of tissues. Smooth muscle is often the target of NO action, leading to vasodilation in blood vessels (Figure 1) and penile erection via NO synthesis in the corpus caverno-sum, two well-established functions. Smooth muscle relaxation in the gut is another important function for NO, playing a key role in gastrointestinal tract motility. NO synthesis in the brain is also well established, though the exact role in learning and memory is still under debate. In the CNS, NO acts as a somewhat atypical neurotransmitter in that it is not synthesized and stored and then released with the appropriate signal, but is synthesized on demand. Constitutive nitric oxide synthases (NOSs) are involved in all of these responses and are under the control of Ca2+ and calmodulin. Receptor-mediated events that trigger Ca2+ release or uptake turn on the...

Pharmaceutical and Health Care Product Companies

While using e-technologies has distinct advantages for pharmaceutical companies, some disadvantages and unsafe practices are also associated with these applications. For example, Pill Box Pharmacy, a popular Internet pharmacy, allows visitors to order medications such as Viagra, Propecia, and homeopathic drugs on-line. Visitors connected to the Pill Box Pharmacy Web site can seek an on-line prescription by linking to Medical Center Net a doctor employed by that Web site approves or declines a prescription based on the customer's answers to a preset questionnaire (Weber, 1999). This practice provides potent medication prescriptions without physically evaluating patients. Pamela Gemmel, a spokesperson for Pfizer, the manufacturer of Viagra, has stated that the company does not support such on-line prescription of medication (West, 1998).

Marriage and Other Aspects of Male Female Interaction

Interestingly, patterns of marital interaction are not related to certain other features of male-female interaction. Thus there is no predictable connection between husband-wife day-to-day interaction, mode of choosing marriage partners, honeymoon customs, beliefs about the desirability of frequent sexual activity in marriage, frequency of premarital or extramarital sex for males or females, incidence of or concern about impotence, attitudes toward or frequency of homosexuality, male sexual aggression, rape, or frequency of divorce. There is one exception to this overall pattern. Husband-wife eating arrangements are predictably associated with honeymoon customs and divorce, so that where spouses eat together honeymoon customs are absent and divorce is relatively rare, while where spouses eat apart honeymoon customs are present and divorce is more common. However, the overall lack of a connection between

Reconstructive Surgery

Small defects can be closed by primary suturing, especially where only the pliable scrotal skin is involved. Split thickness skin grafting is most often used and yields acceptable results, even in large defects (Hessel-feldt-Nielsen et al. 1986). Healthy skin from the legs, buttocks, and arms can be used, in a single or multiple settings. Skin defects on the penile shaft should be liberally grafted so as to prevent fibrotic scar formation with future erectile problems.

Neuroendocrine Effects of Alcohol

The development of female secondary sexual characteristics in men (e.g., gynaecomastia and tes-ticular atrophy) generally only occurs after the development of cirrhosis. In women, the hormonal changes may reduce libido, disrupt menstruation, or even induce premature menopause. Sexual dysfunction is also common in men with reduced libido and impotence. Fertility may also be reduced, with decreased sperm counts and motility.

Sexual Arousal Disorder

A Treat decreased lubrication with KY Jelly or Astroglide. a Menopausal symptoms may respond to oral or topical estrogen. a Sildenafil (Viagra) may be helpful. Lack of orgasm during intercourse is considered a normal variation of female sexual response if the woman is able to experience orgasm with a partner using other, noncoital methods. Sildenafil citrate (Viagra) and other vasodilators are currently undergoing clinical trials with women for sexual dysfunction treatment.

Lamberteaton Myasthenic Syndrome

Lambert-Eaton Myasthenic Syndrome (LEMS) is predominantly a disease associated with lung cancer, affecting mostly older men. Patients complain of chronic weakness and fatigue along with autonomic symptoms (e.g. dry mouth and impotence), and the examination shows signs of proximal muscle weakness. Repeated examination of the same limb can sometimes elicit improved strength initially. Eye movements are unaffected except for the pupillary reaction in some cases. Reflexes are diminished. The sensory examination can be normal, but because LEMS is associated with cancer, paraneoplastic or chemotherapy induced neuropathy can lead to a superimposed sensory deficit. Routine laboratory testing may be normal. The differential diagnosis includes myopathies and neuromuscular junction disorders listed above.

Future Directions

The major needs in the field are threefold. First, empirical research is needed on both the process and outcome of sex therapy, especially with minority, gay, and nonmarried populations, as well as multiproblem couples. Second, research on a model to integrate medical interventions (especially Viagra and testosterone) into a couple's intimacy, pleasuring, and eroticism style is imperative. Third, how to prevent relapse and generalize sexual gains to the couple's greater relationship should be explored.

Hypnosishypnotism Theories

Led to his formulation of the neodissociation theory of hypnosis, involving the concepts of divided consciousness and hidden observer whereby multiple control systems of thought and action are hypothesized as operating independently of each other. A hidden observer is a conjectured, concealed consciousness that is inferred to experience events differently from the hypnotized consciousness, although they operate in a parallel fashion. Hilgard's notion of a hidden observer impacts directly on certain central issues in cognitive psychology, such as the problem of serial versus parallel processing of information. The phenomenon of a hidden observer appears to be similar to the concept of ego-state ego-state theory (Watkins, 1994). The typical hypnotizable individual does not seem to be weak-willed, gullible, hysterical, passive, or submissive to the dominant personage of the hypnotist. Rather, he or she (there seem to be no gender sex differences on this issue) is an individual who has...

Groups are different from individuals

Even if the person in front of you is a German woman with acute atopic eczema, the results of the trial may not translate to real clinical benefit to her for several reasons. First, because the treatment effects reported in clinical trials, whether this is a mean change in severity score or proportion of people cleared, refers to groups of people. In a group of patients with a summary treatment effect such as a mean change in SCORAD (SCORing Atopic Dermatitis) of 5 points, there will be some individuals with score changes of 10 or 15 points, some with changes of 3 or 4, some with no change, and possibly some whose disease worsened. For example, closer inspection of the trial data on sildenafil (Viagra) for the treatment of erectile dysfunction7 suggested that some men had all the fun It follows that the patient sitting in front of you might benefit a lot or very little from the proposed treatment, and one has little way of knowing, apart from trying the treatment and seeing what...

Primary pulmonary hypertension

Those with less severe pulmonary hypertension and is largely untried in children. The subcutaneous analogue of prostacyclin treponistil (UT-15) is too painful for use in children. The phosphodiesterase inhibitor sildenafil is untrialled, its effect appears to be relatively short lived in sick children, and there is a risk of irreversible retinal damage linked to phosphodiesterase VI inhibition. The proven treatment of choice for the very sick child is chronic intravenous epoprostenol (prostacyclin) therapy. The dose is titrated according to clinical response, subjective and objective. Children generally need much higher doses of prostacyclin than adults and can become very tolerant of the drug, requiring constant, aggressive, upward adjustment of their dosage. Despite the obvious logistical problems, infants and young children can be managed satisfactorily. Training of two family carers by experienced nursing staff and a network of local support is essential. The side effects of the...

Spinal cord compression

Neurological dysfunction of the bladder (the neurogenic bladder) is particularly important to recognize. In the early phases, there is failure fully to empty the bladder such that the bladder enlarges, eventually building up back pressure on the ureters and kidneys. Finally, the patient goes into urinary retention which is often painless due the involvement of the sensory pathways. In the male, neurogenic bladder is accompanied by failure of penile erection and ejaculation.

High Intensity Focused Ultrasound HIFU for the Treatment of Localized Prostate Cancer

We evaluated 85 patients with localized prostate cancer treated with high-intensity focused ultrasound (HIFU) for biochemical disease-free rate, safety, morbidity, and predictors of biochemical outcome. A total of 85 patients underwent HIFU with the use of Sonablate and with at least 12 months of follow-up. The median age was 70 years (range, 54 to 86 years), and the median preoperative prostate-specific antigen (PSA) level was 10.9ng ml (range, 3.39 to 89.6). The median length of follow-up was 20 months (range, 6 to 56). Biochemical failure was defined according to the criteria recommended by the American Society for Therapeutic Radiology and Oncology Consensus Panel. Biochemical failure developed in 27 (23 85) of the patients. The biochemical disease-free survival rates at 3 years for patients with pretreatment PSA less than 10ng ml, 10.01 to 20.0ng ml, 20.01 to 30.0ng ml,and more than 30.0ng ml were 97 ,75 , 33 , and 0 , respectively. Final follow-up sextant biopsies...

Evolution of Homosexuality

Only small changes needed to occur to move from one system to another. The scent deposits in urine or other bodily secretions that marked territorial boundaries began to mark some animals as subordinate guests in a dominant's territory. In addition to paying homage to dominant individuals by inhaling their markings, subordinates also had to hide or avoid penile erections while observing the erection displays of the dominant males (who had exclusive sexual rights to the group's females), and perhaps also tolerate the dominant's mounting behaviors. In many of these groups adolescent males practiced these dominance displays by alternating roles with each other. In more complex animal societies this adolescent behavior continued among adult males who could mark alliances by alternating subordinate and dominant roles. As these alliances became more complex, the same-sex behaviors came to resemble human homosexuality more and more.

Medical and Ethical Issues

Proponents of circumcision claim several advantages for the procedure, including decreased incidence of urinary tract infections in infancy, decreased risk of penile cancer in adults, and decreased risk of sexually transmitted diseases (Wiswell, 1992 Wiswell et al., 1985). In addition, routine circumcision prevents occasional penile problems such as phimosis (a narrowing of the foreskin that prevents its retraction), balanitis (an infection of the head of the penis), and posthitis (an infection of the foreskin). Significant complications of the procedure are quite rare, occurring in less than 1 percent of circumcised neonates (Kaplan). Until the mid-1980s, circumcision was performed commonly without anesthesia. Current techniques permit the pain of circumcision to be reduced with a number of simple techniques. In contrast to female circumcision, the procedure has no significant effect on sexual function or pleasure (Collins et al.).

Other Phytochemicals of Interest

Phytochemicals found in ginkgo (G. biloba) leaves, including ginkgolic acid, hydroginkgolic acid, gink-gol, bilobol, ginon, ginkgotoxin, ginkgolides (A-C), and a number of flavonoids common to other plants, such as kaempferol, quercetin, and rutin, are currently attracting attention for their possible effects on circulation, particularly cerebral circulation, and this may improve brain function and cognition. Indeed, ginkgo, ginseng, and a combination of the two extracts have been found to improve different aspects of cognition in healthy young volunteers. A number of studies have reported that extracts of ginkgo leaves enhanced brain circulation, increased the tolerance of the brain to hypoxia, and improved cerebral hemodynamics. It has been suggested that these effects are mediated via calcium ion flux over

Range of biomarkers used to investigate health benefits

There are presently available a number of validated tools for measuring health status (Nottingham Health Profile, Hunt et al., 1985), activities of daily living Physical Self Perception Profile (Fox and Corbin, 1989 Fox, 1990) , and quality of life (QOL) MOS General Health Status Questionnaire 36-SF (Ware and Sherbourne, 1992) . Quality of life incorporates the individual's perceptions of health and functional status and is reflective of the perception of his or her health. Its measurement incorporates psychosocial (e.g., daily function, recreation, sexual function, etc.) (see below) as well as physiological (e.g., blood pressure, weight) factors. It is important to point out that the validation of the measure rests with the individual. Several standardized instruments to measure QOL are available including single-item global measures or multi-item health measures generic measures or condition specific measures. Other clinical measures might also be useful although they do not...

Relaxation Therapies

Since the late 1950s a host of formal relaxation therapies including progressive muscle relaxation training, autogenic training, imagery training, biofeedback, and hypnosis have all been used to treat insomnia. Common to these approaches is their focus on such factors as performance anxiety and bedtime arousal, which often perpetuate sleep difficulties. Regardless of the specific relaxation strategy employed, treatment entails teaching the insomnia sufferer a formal exercise or set of exercises designed to reduce anxiety and arousal at bedtime so that sleep initiation is facilitated. Typically multiple weekly or biweekly treatment sessions are required to teach relaxation skills that the patient is encouraged to practice at home in order to gain mastery and facility with self-relaxation. The goal of all such treatments is that of assisting the insomnia sufferer in achieving sufficient relaxation skills so that insomnia resulting from sleep-related performance anxiety and bedtime...

Control of Pupil Size

The pupils also dilate when strong emotions are experienced, such as when we are surprised, afraid, or sexually aroused. This active dilatation is mediated by sympathetic innervation of the dilator pupillae muscle. The final cell bodies are located in the superior cervical ganglion, near the bifurcation of the common carotid artery. The preganglionic cell bodies are in the upper thoracic spinal cord. The pathway descending from the brain is a principally unilateral direct projection from the paraventricular nucleus of the hypothalamus. Interruption of the pupillodilator pathway in the brain stem, the spinal cord, or in the periphery causes an ipsilateral Horner's syndrome, consisting of a small pupil (meiosis) and slight retraction of the eyeball associated with partial closure of the eyelids. The drooping upper eyelid is referred to as a ptosis.

Ethics And Personal Responsibility

Fearing that formal review agencies will hold us accountable after the fact stresses and distresses some of us. Some agencies, such as local, state, and national professional ethics committees, focus specifically on the ethical aspects of our work. Others, such as state licensing boards and the civil courts, enforce professional standards of care that may reflect ethical responsibilities. The prospect of review agencies second-guessing us with the benefit of hindsight can make difficult judgments a nightmare for some therapists. They may suffer a debilitating performance anxiety, dread going to work, and discover that the focus of their work has changed from helping people to avoiding a malpractice suit.

Beta Blockers and Anxiety Fear

Once again, the evidence seems to be contradictory. In laboratory studies of the effects of beta-blockers, the effects seem to be difficult to demonstrate (Reisenzein, 1994). However, extensive reviews demonstrate successful practical uses of beta-blockers for some kinds of anxiety disorders (Noyes, 1985) and also for reducing performance anxiety (Dimsdale, Newton, & Joist, 1989). Despite the mixed results with experimental populations, little question remains that beta-blockers are effective treatments for reducing anxiety in clinical populations. In sum, in a wide variety of studies, beta-blockers have reduced anxiety and aggression, and these effects seem to be due to the peripheral actions of the drugs. The weaker results in experimental studies may be due to the brief administration and often small doses employed (Noyes, 1985). The different results are probably not due to any differences between clinical and nonclin-ical populations, since many of the studies of the effects of...

Cognitive Therapy

Underlying and supporting insomnia sufferers' performance anxiety and sleep-disruptive habits are a host of dysfunctional beliefs and attitudes about sleep. Beliefs that sleep is unpredictable and uncontrollable or that one must obtain 8 hours of sleep at night to function each day can add to anxiety about sleep and, in turn, interfere with the sleep process. Furthermore, insufficient knowledge about how one should respond to a night of poor sleep may lead to practices such as daytime napping or sleeping in, which disrupt the ensuing night's sleep. Given increasing recognition of these types of sleep-related misconceptions, therapeutic strategies that specifically target these cognitions may be useful in insomnia treatment. Hence, cognitive therapy designed to correct these dysfunctional beliefs, either through formalized patient education modules or via the cognitive restructuring method similar to that commonly used in cognitive therapy with clinically depressed individuals, is...

Aspects of

Genital alteration became the subject of controversy toward the close of the twentieth century for a number of reasons. First, it is primarily performed on children and women, two groups perceived to be especially vulnerable. In the case of children, there is obvious lack of informed consent. Second, as immigrants from cultures that performed female genital alteration settled in Western countries, healthcare providers became aware of the procedures and of their negative effects on women's health. Third, a strong international feminist movement produced critics of the female procedures, both from within and without the indigenous cultures. Fourth, a century-long controversy in the United States over the health benefits of the male procedure began to move the practice away from routine recommendation of male circumcision. Fifth, a nascent children's rights movement began to question the ethics of performing surgery to excise healthy, normal tissue, with no proven medical benefit and,...


Broomfield and Espie (2003) recently conducted another investigation of paradoxical intention as a treatment for sleep onset insomnia. This study differed in a significant way from previous similar studies in that the authors employed an objective measure of sleep performance. They found that paradoxical intention was effective in reducing two important components of sleep onset insomnia sleep effort and sleep performance anxiety. Their results were significant when compared to a control group. They suggest, Together, results help determine putative mechanisms underlying PI have important implications for the clinical application of PI.

Electrical Aversion

She was then instructed to turn over the first card and read it aloud. Immediately when she completed reading the phrase she received a shock at the level determined. This procedure was repeated with the following cards every 10 seconds until she had read the phrases on all 10 cards. She then read the final card and did not receive a shock. The aim was that the statement on this card would be reinforced by the relief of knowing when reading it that it would not be followed by a shock. The 10 cards were then shuffled and the procedure repeated four more times. Shuffling the cards was done so that she would not realize when she was about to turn over the card with the eleventh statement so that the relief would not be experienced until she saw the phrase. She received this treatment twice a week for 4 weeks. By the fifth session she reported that the thoughts were less frequent and much less distressing, so that she was able to go out with her boyfriend and not be constantly watching...

HIFU Procedure

Radical Prostatectomy

Patient status and treatment-related complications were followed up by all available means, including periodic patient visits and self-administrated questionnaires dealing with urinary continence and erectile function. Serum PSA was usually assayed every 1 to 6 months during follow-up. Postoperative prostate biopsy was performed in all patients at 6 months postoperatively. The American Society for Therapeutic Radiology and Oncology (ASTRO) Consensus Panel criterion for biochemical failure, i.e., three consecutive increases in posttreat-ment PSA after a nadir has been achieved, was used to define biochemical failure 20 . The time to biochemical failure was defined as midway between the post-

Bupropion Wellbutrin

Common side effects include some initial restlessness and insomnia that typically resolves within 2 weeks. It is noted for having the lowest incidence of sexual side effects, which are common with other antidepressants, including SSRIs. In fact, when bupropion is added for SSRI-induced sexual dysfunction, sexual functioning improves in many patients. One concern with this drug had been a dose-related increase in the incidence of seizures. However, further study has shown no higher incidence at usual therapeutic dosages compared with other antidepressants. Caution should be taken when using this drug in patients with bulimia or metabolic disturbances predisposing to seizures. Likewise, individual doses greater than 200 mg and daily dosages greater than 400 mg should be avoided. Combination with an MAOI is to be avoided as well. Bupropion may be the least likely of all antidepressants to precipitate a switch into mania.


Torn Corpora Cavernosa

PRIAPISM Priapism is a urologic emergency that presents as a painful, hard, pathologic erection in which both corpora cavernosa are engorged with stagnant blood. Even though the glans penis and the corpus spongiosum are characteristically soft and uninvolved, urinary retention may develop. Impotence has been reported to occur in 35 percent of cases who have sustained erections for prolonged periods of time thus, expedient treatment and early urologic consultation is required. The potential for medical-legal liability mandates meticulous documentation in these cases. A large number of cases of priapism in adults are pharmacologically related, either to intracavernosal injection for impotence or oral agents for hypertension or mental disorders. Most cases of priapism in children are due to hematologic disorders, usually sickle cell disease. Case reports have attempted to relate a variety of other drugs, metabolic conditions, and trauma to priapism, although the pathophysiologic...


By contrast, medical complaints of male sexual dysfunction undoubtedly increase with age. While all functional aspects of male sexuality libido, potency and ejaculation are reduced in older men, the major impact of ageing is the exponential increase of erectile dysfunction with age (Ayta et al 1999). The last decade has seen a major paradigm shift in understanding of male sexual dysfunction. This includes a public relations makeover in nomenclature (impotence becoming erectile dysfunction), a shift in beliefs about causation (from prevailing Freudian psychoanalytic beliefs on psychosomatic causation, to erectile dysfunction being due to organic neurovascular disorders of cavernosal hydraulics) and development of the first effective pharmacotherapy. The development of vasoactive cavernosal pharmacotherapy was inaugurated by the accidental discovery of papaverine effects during vascular surgery and soon surpassed by the equally fortuitous discovery of oral sildenafil during clinical...


The treatment of primary aldosteronism is dependent upon the etiology. Unilateral adrenalectomy is the treatment of choice for aldosterone-producing adenomas, a procedure that relieves symptoms or ameliorates hypertension in up to 80 of patients.6 Idiopathic hyperaldosteronism, on the other hand, is best treated with antihypertensive medication. Patients with idiopathic hyperaldosteronism typically do not improve after bilateral adrenalectomy which puts them at risk of an Addiso-nian crisis for the rest of their lives.2,5 Therefore, spironolactone is the preferred treatment in these patients, though the occurrence of side effects such as gyneco-mastia and impotence may require the use of an alternative medication such as Amiloride. Amiloride is a potassium-sparing diuretic that effectively treats hypertension while restoring potassium balance.


Pole Barn Electrical Wiring Diagram

To be transitory and were easily managed by medical treatment such as alpha-blockers or painkillers such as Voltaren suppository. Urethral catheter in all patients was removed 1 to 2 day postoperatively but catheter was re-indwelled in patients who could not urinate spontaneously and were tried to removal of catheter in every 1 to 2 weeks thereafter. The mean median postoperative urinary catheterization time was 11 14 days (range 0-33 days). Final follow-up sextant biopsies showed 91 (77 85) of the patients to be cancer free. Fifteen (18 ) patients developed a urethral stricture, 3 (4 ) patients underwent transurethral resection of the prostate for prolonged urinary retention or ure-thral stricture, 2 (2 ) and 1 (1 ) patients developed epididymitis and a recto-urethral fistula. Twenty-eight (18 25) patients complained postoperative erectile dysfunction. No incontinence was observed in follow-up.


Surgical repair is usually deferred for posterior urethral injuries. Suprapubic cystostomy is favored by most for bladder drainage. Partial posterior urethral lacerations are managed with a urethral catheter placed coaxially over a guide wire under fluoroscopic control or with a suprapubic catheter. In complete posterior urethral lacerations, the management remains controversial. The injury is managed with primary realignment of the lacerated urethra or with suprapubic cystostomy alone. Stricture formation occurs with both techniques. However, the subsequent urethral stricture in patients with primary realignment tends to be less extensive. The advantage of suprapubic cystostomy alone, especially in an unstable patient, is its simplicity. The impotence and incontinence rates are thought to be related to the extent of injury and are the same for both techniques.


Autonomic neuropathy represents the clinical entities of gastroesophageal reflux disease (GERD), gastroparesis, neurogenic bladder, impotence and sexual dysfunction, autonomic diarrhea (nocturnal, often with incontinence), and orthostatic hypotension. Symptoms of GERD include dysphagia, chest pain, and heartburn. Distinction from myocardial ischemia in the emergency department is often impossible, unless GERD has been previously diagnosed. Gastroparesis is the nonprogressive and nonrhythmic contraction of the gastric antrum, often with pylorospasm. Symptoms include epigastric pain, bloating, anorexia, nausea, early satiety, or vomiting.21 Gastroparesis has been shown to respond to erythromycin, cisapride, and metoclopramide, all of which decrease gastric emptying time. Severe cases may not respond to medication. Constipation is probably the most common gastrointestinal symptom in diabetics and is associated with autonomic neuropathy. The diet should include 30 mg of dietary fiber per...

Components Of Food

A Twinkie, a cucumber, and a doughnut are particularly Freudian based on their shape and visual appearance. The texture and viscosity of oysters, likewise, may induce reminiscence of sexual organs. Alternatively, the sexual experience surrounding the ingestion of a food may also cause the food itself to become endowed with a sexual valence, which may be aphrodisiacal in nature. Another possible mechanism is not through achieving a direct sexual meaning, but rather, a food can become sexually charged by becoming indirectly associated with sexual function, for example, by being considered a guilty pleasure. Since in our puritan society, sex and other hedonic pleasures are frowned upon and repressed, one pleasure can be uncon

Marita P McCabe

Sexual arousal in women has been shown to be enhanced using arousal training. Marita McCabe and her colleague have suggested that training focus on both response imagery (that is, sexual fantasy which relates to the woman's own sexual responses) and stimulus imagery (that is, sexual fantasy which relates to sexually stimulating situations), as well as relaxation. Thus, arousal training needs to focus on both a woman's responses to sexual fantasy and her generation of sexually stimulating scripts in order to effectively increase her levels of subjective sexual arousal. They also suggested that arousal training should focus on strategies to decrease performance concerns, since levels of performance anxiety were inversely related to subjective sexual arousal.


Contribute to the regulation of the body's homeostasis. The hypothalamus is the control center of the auto-nomic nervous system, an involuntary portion of the nervous system that regulates aspects of body temperature, digestion, circulation, water balance, and sexual function. The autonomic nervous system is divided into the parasympathetic branch, which is generally associated with the anterior regions of the hypothalamus, and the sympathetic branch, which is associated with posterior sites. Endocrine function is also governed by the hypothalamus by virtue of its strong neural and vascular connections with the two lobes ofthe pituitary gland. Finally, the hypothalamus shares the mammillary bodies in common with the limbic system and, in part because of this linkage, plays a role in emotional function. Hypothalamic lesions in experimental animals and in humans, for example, have sometimes been noted to produce rage behaviors.


This process entails the absorption of ever-widening social arenas and behaviors into the jurisdiction of biomedical treatment through a constant extension of pathological terminology to cover new conditions and behaviors. Health clinics, health maintenance organizations, and other medical provider organizations now offer classes on managing stress, controlling obesity, overcoming sexual impotence, alcoholism, and drug addiction, and promoting smoking cessation. Even the birth experience, not just in the United States but also in many


Consuming alcohol of more than one or two drinks per day can affect the quality and quantity of sperm, lower testosterone levels, and contribute to impotence. A 1996 research study from Finland showed that moderate alcohol consumption can kill off some sperm-producing cells within the testicles and also may cause abnormal sperm shapes. A normally shaped sperm should resemble a streamlined tadpole with an oval head and long tail. Abnormally shaped sperm vary in appearance and may have two tails, a tapered head, a crooked kinky shape, or an unusually large or small head. Any of these abnormalities make it so that the sperm is unable to penetrate the surface of the egg and therefore unable to successfully fertilize the egg. Men who partake in heavy alcohol consumption that is, more than six drinks per day are more likely to suffer from low sperm count, poor sperm motility, and abnormal sperm shape.


The Institute for the Study of Health and Illness is a nonprofit educational and research foundation focused on, among other things, the professional development of physicians who serve people who have life-threatening illnesses. Directed by Rachel Remen, MD, it offers books, tapes, and category I CME credit at small retreats that focus on topics such as loss, grief, personal limitation, impotence, isolation, and the examination of goals, values, and meanings. (Contact ISHI, PO Box 316, Bolinas, CA 94924.)

Surgical Anatomy

Permanent impotence in men has been reported to be almost universal in some series of abdominoperineal excisions of rectum and occurs in up to half of all men after anterior resection of the rectum for rectal cancer. The incidence of permanent bladder denervation after rectal excisional surgery has been reported to be up to 19 in some series. The presumed mechanism for sexual and urinary dysfunction is damage to the pelvic autonomic parasympathetic and or sympathetic nerves during surgery. The risk of sympathetic nerve damage occurs in the abdomen during ligation of the inferior mesenteric artery pedicle, and high in the pelvis during initial posterior rectal dissection adjacent to the large hypogastric nerves. Lower down, risk to the parasympathetic nerves occurs while dissecting laterally near the pelvic plexus, and during deep dissection of the anterior aspect of the rectum away from the seminal vesicles and prostate near the cavernous nerves. The anterior dissection is thought to...


Nitrates (glyceryl trinitrate, isosorbide dinitrate, sodium nitroprusside) are also used to treat autonomic dysreflexia. If the blood pressure remains high an intravenous drip of sodium nitroprusside could be necessary. Before using these drugs (nitrates), the patient should be questioned regarding sildenafil or other PDE-5 inhibitors. If a PDE-5 inhibitor was used in the last 24 h an alternative short-acting, rapid-onset anti-hypertensive drug should be used. Drugs with these characteristics are captopril and prazosin.


Based on its pluripotent functions, arginine has been widely used in supplemental nutrition for surgical patients, patients with burns, and patients with sepsis and cancer in order to modify the inflammatory response, to enhance organ perfusion, and to stimulate wound healing. However, the benefits of argi-nine supplementation in these conditions are not uniformly proven and accepted. Moreover, arginine is never given alone but is always provided in a mixture of amino acids and other nutrients. The use of NO donors that have vasodilatory actions is an established therapeutic modality in coronary artery disease and for erectile dysfunction. Given this fact it remains worthwhile to clarify the need for arginine supplementation as the natural substrate for NO synthesis in other conditions.


Severe human zinc deficiency has been well characterized by the original descriptions in the Middle East and in patients with acrodermatitis enteropathica. The symptoms of mild deficiency are continued and exaggerated. Thus, stunting can be extreme and is accompanied by delayed sexual maturation and impotence. Characteristic skin lesions are found, originating around the mouth and nose but becoming widespread as deficiency develops. Diarrhea is also present. Deficits in taste and smell are accompanied by anorexia and other behavioral changes, including increased irritability and impaired cognitive function. Eye pathologies similar to those seen in vitamin A deficiency are observed.


Already been treated with radiation therapy. In addition, the option of HIFU may be more attractive to the patient who wants to avoid postoperative incontinence and erectile dysfunction for his quality of life. The small number of patients and the relatively short follow-up period in our series limit our ability to draw any definitive conclusions. We believe that the data we present here suggest that HIFU may be a useful treatment option for patients with localized prostate cancer. Our goal to be able to treat patients with localized prostate cancer by HIFU within one hour in an outpatient clinic under local anesthesia.


With any cancer therapy, there is a fine balance between aggressive disease eradication and increased treatment-induced morbidity, with a corresponding negative impact on QOL. This balance applies to any of the treatment modalities available for localized prostate cancer. As the technique of prostate cryoablation is evolving, and as experience with this modality is increasing, the morbidity reported has steadily declined. Sexual dysfunction and bladder and bowel changes have the greatest negative impact on the lives of prostate cancer patients following treatment for their disease. Historically, urorectal fistula formation was a major concern with prostate cryoablation. Advances in technology and technique have virtually eliminated this concern with cryoablation. Among four recent publications 14,24-26 , only one found rectal complications 14 , with a fistula rate of less than 0.1 . Incontinence in these series ranged from 1.3 to 5.4 , and postoperative impotence ranged from 82.4 to...


Other traditions counsel the believers to choose a partner for breeding (al-nutaf) bravery among the people of Khurasan in Iran , sexual potency among the Berber in North Africa , and generosity and envy among the Arabs (al-Amili, 7 29, tradition 6). The Islamic traditions (hadith literature) do reflect explicit knowledge of eugenics in choosing a marriage partner. The source of these eugenic considerations seems to be the Irano-Semitic culture, in which such interests were commonplace. Although these traditions were never used as authoritative precedents for legislation in the Shari'a, they express the popular piety connected with marital relations. For example, the Prophet is quoted saying, Anyone wishing to follow my tradition should know that among my traditions is marriage. Seek children through it Protect your children from the milk of the prostitute and the insane among women, because milk makes inroads in the character of a child (al-Amili, 1969, 7 4, tradition 6). Moreover,...


Since antiquity grapes have played an important role in the European diet. They were eaten fresh, especially in the grape-growing areas, added to dishes dried or in the form of grape juice, or they were made into wine, the drink of choice for anybody who could afford it. The wild grapevine, a climbing plant like the later cultivars, was indigenous to the area between the Black Sea and Afghanistan. The Phoenicians introduced the vine to Greece sometime after 1000 b.c. from there it spread throughout the Mediterranean. The ancient Egyptians grew grapes, as did the Romans, who were especially fond of various grape syrups in their cuisine. Among them were defrutum, or boiled-down unfermented grape juice, passum, a cooking wine that was even sweeter, and mulsum, a mixture of white wine and honey. As the Roman Empire expanded across Europe, so did the cultivation of grapes, and the art of wine making. In the Middle Ages, great quantities of wine were produced, traded, and consumed in...


And its capsule at open operation (radical prostatectomy). This technically demanding procedure can be performed via a standard open lower abdominal approach, a perineal approach or laparoscopically. It requires the urethra and bladder neck to be joined together when the gland has been removed. Side effects are significant and include erectile dysfunction (ED), urinary incontinence, bladder neck stric-turing and damage to the rectum.


Herbs and supplements that promote platelet inhibition include angelica, anise, capsicum, celery, chamomile, clove, fenugreek, feverfew, fish oil, garlic, ginger, horse chestnut, horseradish, licorice, meadowsweet, onion, Panax ginseng, red clover, vitamin E, and willow. Similarly, concomitant administration of drugs, including aspirin, clopido-grel (Plavix), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, indomethacin (Indocin), ticlopi-dine (Ticlid), and warfarin (Coumadin), may increase the risk of bleeding in some people. This is just one example of the interactions between drugs with herbals and herbals with other herbals. There may be an infinite number of interactions.


Saponins from ginseng root (Panax ginseng C.A. Mey.) may also be important. Antioxidant effects have been reported for total ginseng saponins and its individual saponins (ginsenosides Rb1, Rb2, Rc, and Rd others include Re and Rg1). Furthermore, ginsenosides Rb1 and Rb2 protected cultured rat myocardiocytes against superoxide radicals, and the mechanism for this may involve induction of genes responsible for antioxidant defences rather than radical scavenging. Ginsenosides stimulate endogenous production of nitric oxide in rat kidney, and this may contribute to the observed antinephri-tic action of these compounds and suggest a protective role in the kidney. Furthermore, it has been suggested that the observed cardioprotective effects of ginsenosides in animal models may be mediated by nitric oxide release. In addition, ginsenoside enhanced release of nitric oxide from endothelial cells, particularly from perivascular nitric oxidergic nerves in the corpus cavernosum of animal models,...


A second fairly unique assessment procedure used in BMT to gather diagnostic information about the couple is the administration of various questionnaires and inventories to learn about specific strengths and problem areas. The discussion of specific measures is beyond the scope of this article. Suffice it to say that there exist several standardized measures that are designed to assess one or more of the following variables global relationship satisfaction communication skills and deficits areas of change requested by the partners types of conflict intensity levels of conflict and styles of conflict resolution partners' cognitions, expectations, and beliefs about the relationship that may be causing problems sexual function and dissatisfaction participation in pleasurable events and rewarding social activities and steps toward divorce. BMT practitioners typically ask the couple to complete a selected set of these instruments either before or at the very beginning of the evaluation...

Quality of Life

QOL outcome is increasingly being recognized as an important component in evaluating treatment for prostate cancer. In patients for whom different treatments are deemed to be similarly effective, QOL outcomes frequently will determine the choice of treatment from the patient's point of view. We have recently published the long-term outcomes of QOL assessment in patients treated with cryoablation. The results indicate that the outcomes are comparable or superior to QOL outcome following other treatments 27, 28 . Two validated and commonly used measuring instruments were used to follow the patients the Colon Functional Assessment of Prostate Cancer (FACT-P) and the Sexuality Follow-up Questionnaire (SFQ).At 1 year following treatment, patient QOL measurements had returned to pretreatment levels in all areas, with the exception of sexual functioning. At 3 years posttreatment, baseline levels remained constant, with no delayed-onset morbidity.The major change observed at 3 years was the...

Olfactory Receptors

Support Line Array

FIGURE 1 Organization of the olfactory epithelium. (A) Olfactory sensory neurons extend from the paired olfactory epithelial patches, through the cribriform plate into the overlying paired olfactory bulbs. The vomeronasal organ also contains olfactory neurons for pheromone detection and sexual function. (B) Olfactory neurons are embedded in the olfactory epithelium with their odor-sensitive cilia extending into the overlying mucus. They are flanked by supporting cells and basal cells, the latter giving rise to new olfactory neurons. Bowman's glands secrete the mucus that traps and transports airborne chemicals. FIGURE 1 Organization of the olfactory epithelium. (A) Olfactory sensory neurons extend from the paired olfactory epithelial patches, through the cribriform plate into the overlying paired olfactory bulbs. The vomeronasal organ also contains olfactory neurons for pheromone detection and sexual function. (B) Olfactory neurons are embedded in the olfactory epithelium with their...

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