Noncholinergic penile erection in mice lacking the gene for endothelial nitric oxide synthase.

With the current understanding that nitric oxide (NO) mediates penile erection, the endothelial isoform of NO synthase (eNOS) has been implicated in this function. We undertook this study applying transgenic mice with targeted deletion of the eNOS gene (eNOS-/- mice) as an experimental approach to evaluate the importance of eNOS in cholinergically stimulated erectile function in vivo. Combined pharmacostimulation with intracavernosal carbachol (3 ng) administration and submaximal cavernous nerve (CN) electrical stimulation (16 Hz, 5 millisecond, 1 V) simultaneous with intracavernosal pressure (ICP) monitoring, and both biochemical assay of NO synthase activity and Western blot analysis of eNOS protein content in penile tissue, were performed on eNOS-/- mice and wild-type controls.

Characterization of nucleophosmin (B23) as a Myc target by scanning chromatin immunoprecipitation.

The genetic program through which a specific transcription factor regulates a biological response is fundamental to our understanding how instructions in the genome are implemented. The emergence of DNA microarray technology for gene expression analysis has generated vast numbers of target genes resulting from specific transcription factor activity. We use the oncogenic transcription factor c-Myc as proof-of-principle that human genome sequence analysis and scanning of a specific gene by chromatin immunoprecipitation can be coupled to identify target transcription factor binding sequences.

General use of animal models for investigation of the physiology of erection.

In review, animal models have accounted significantly for the amazing strides made in the field of sexual dysfunction research. Fundamentally, they have offered a unique experimental approach to test many hypotheses regarding sexual function. Since their early use for sexual physiology research, there has been increasing sophistication using animals involving techniques for stimulating and monitoring sexual responses.

Laparoscopic surgery in older adults.

This article provides an overview of the current role of laparoscopic surgery in older patients. A retrospective review and analysis of the recent English-language literature on laparoscopic procedures with special attention devoted to those articles focused on geriatric patients was performed. Laparoscopic surgery has rapidly become the fastest-growing discipline within the surgical arena and new applications for laparoscopy continue to be reported.

Large artery vasculitis following recombinant hepatitis B vaccination: 2 cases.

We describe 2 women who developed large artery vasculitis shortly after receiving recombinant hepatitis B vaccination. One patient developed Takayasu's arteritis, the other a vasculitis involving subclavian and renal arteries. Both developed renal failure.

Renal safety and tolerability of celecoxib, a novel cyclooxygenase-2 inhibitor.

The novel cyclooxygenase- (COX)-2 inhibitor celecoxib is an effective treatment for the signs and symptoms of osteoarthritis and rheumatoid arthritis. Conventional treatment for these debilitating conditions routinely involves the use of conventional nonsteroidal anti-inflammatory drugs (NSAIDs), which are nonspecific inhibitors of COX-1 and COX-2. Numerous studies suggest that inhibition of renal prostaglandin synthesis by NSAIDs is deleterious to kidney function, particularly in high-risk patients.

A method for identifying satiation versus extinction effects under noncontingent reinforcement schedules.

We evaluated one method for determining whether response suppression under noncontingent reinforcement (NCR) is a function of satiation or extinction. Three individuals with developmental disabilities who engaged in self-injurious behavior (SIB) or aggression participated. Results of functional analyses indicated that their problem behavior was maintained by social-positive reinforcement.

Anasarca and small bowel obstruction secondary to endometriosis.

Intestinal involvement by endometriotic tissue occurs in up to 37% of patients with endometriosis. The vast majority of patients do not experience symptoms related to the gastrointestinal tract. In particular, the complications of intestinal obstruction and malabsorption secondary to endometriosis are exceedingly uncommon.

Comparison of single and multiple functional communication training responses for the treatment of problem behavior.

Two functional communication training (FCT) conditions without extinction were compared to treat the problem behavior of a child with developmental disabilities. The individual was taught to emit a single FCT response to obtain one of six items delivered in a randomized order or multiple FCT responses that specified the exact item. Results showed that only the FCT-multiple condition reduced problem behavior and maintained alternative mands.

Nocturnal polyuria in older people: pathophysiology and clinical implications.

Objectives: To review the physiological changes of aging which affect the systems involved in urine formation and to consider how these changes interact with changes in bladder function, thereby leading to the onset of nocturnal polyuria with associated urinary frequency, nocturia, and incontinence. Based on this information, data are presented on the effectiveness of pharmacological interventions which reduce the rate of urine formation and, thus, can be of benefit in reducing symptoms, especially during the nighttime.

Methods: Peer-reviewed journal articles were identified by MEDLINE Search and by review of the literature.

When should learning about hospitalized patients end? Providing housestaff with post-discharge follow-up information.

Purpose: As hospital stays grow shorter, many patients are discharged to follow up with their primary care physicians before their diagnoses and responses to treatment are clear. The authors studied the value and feasibility of providing housestaff with follow-up information about their former inpatients.

Method: Patients included in the study (1) had been admitted to the housestaff service during the study period (January to March 1997), (2) had received follow-up care from a primary care physician in the Johns Hopkins Bayview Physicians' Professional Association, and (3) had been hospitalized for at least three days.

The effects of response cost in the treatment of aberrant behavior maintained by negative reinforcement.

Positive reinforcement contingencies can sometimes be used to decrease problem behavior maintained by negative reinforcement (e.g., escape).

A comparison of procedures for programming noncontingent reinforcement schedules.

We compared two methods for programming and thinning noncontingent reinforcement (NCR) schedules during the treatment of self-injurious behavior (SIB). The participants were 3 individuals who had been diagnosed with mental retardation. Results of functional analyses indicated that all participants' SIB was maintained by positive reinforcement (i.

Minimal uterine serous carcinoma: diagnosis and clinicopathologic correlation.

The clinicopathologic features of uterine serous carcinoma (USC) lacking myometrial invasion, including its putative precursor lesion endometrial intraepithelial carcinoma (EIC), have not been studied extensively. Some USCs may prove fatal even when myometrial invasion is apparently absent, whereas others may be cured with surgery alone. Accordingly, the authors studied eight cases of pure EIC (no invasion identified) and 13 superficial serous carcinomas (SSCs) in which invasion was limited to the endometrial stroma to clarify the behavior of these lesions.

The use of symmetrical "do" and "don't" requests to interrupt ongoing activities.

The results of a modified functional analysis demonstrated that aggression, displayed by a 27-year-old man, was occasioned by the use of "don't" requests to interrupt the client's ongoing and often inappropriate activities (e.g., lying on the floor, pica, inappropriate touching of others).

Toxicity associated with a prolonged half-life of phenytoin in a 97-year-old woman: bezoar formation? Case report and clinical pathological conference.

Phenytoin metabolism is best described using nonlinear (Michaelis-Menton) kinetics. When calculated pharmacokinetic values, including half life and clearance, do not correspond to measured variables, alternative reasons must be sought. We present an interesting case of phenytoin toxicity and suggest that formation of a bezoar may be one possible answer to prolonged toxicity.

Thyrotropin suppression and disease progression in patients with differentiated thyroid cancer: results from the National Thyroid Cancer Treatment Cooperative Registry.

The ideal therapy for differentiated thyroid cancer is uncertain. Although thyroid hormone treatment is pivotal, the degree of thyrotropin (TSH) suppression that is required to prevent recurrences has not been studied in detail. We have examined the relation of TSH suppression to baseline disease characteristics and to the likelihood of disease progression in a cohort of thyroid cancer patients who have been followed in a multicenter thyroid cancer registry that was established in 1986.

Work status and attrition from longitudinal studies are influenced by psychiatric disorder.

Participants (n=95) were assessed at the time of discharge and at 4 and 12 months after discharge in regard to work status and psychiatric history both before and after the burn injury. Complex psychiatric comorbidity and substance abuse disorders that occurred before the burn injury each significantly raised the risk of unemployment before the burn injury; preburn substance abuse also affected unemployment at 4 months after the burn injury. Trends for higher unemployment rates at 12 months after discharge also were noted among those with a preburn history of complex psychiatric comorbidity and alcohol use, anxiety, or mood disorder.

Percutaneous cystolithotomy after augmentation cystoplasty: comparison with open procedures.

Percutaneous procedures for the removal of calculi from reconstructed bladders have not been compared in a single institution with traditional open methods. The records of patients undergoing seven percutaneous and six open procedures for the removal of calculi from augmented bladders were reviewed. Operative time, hospitalization time, complications, stone burden, and recurrence were compared.

Routine pulmonary artery catheterization does not reduce morbidity and mortality of elective vascular surgery: results of a prospective, randomized trial.

Objective: The authors determined whether the preoperative placement of a pulmonary artery catheter (PAC) with optimization of hemodynamics results in outcome improvement after elective vascular surgery.

Summary Background Data: The PAC commonly is used not only in patients who are critically ill, but also perioperatively in major elective surgery. Few prospective studies exist documenting its usefulness.