Prostate-induced orgasms: A concise review illustrated with a highly relevant case study.

Current medical literature does not describe precisely the activation and mechanisms of prostate orgasms. This brief review describes what we know about the anatomy and physiology of the prostate and its involvement in reproduction and especially its stimulation for sexual recreation. It is illustrated with a highly relevant case history. Clin. Anat. 31:81-85, 2018. © 2017 Wiley Periodicals, Inc.

Do women gain anything from coitus apart from pregnancy? Changes in the human female genital tract activated by coitus.

This article reviews critically studies that describe changes occurring in the female genital tract and pelvic musculature from sexual reflexes activated by stimuli that mimic coitus or induced by sexual arousal. I conclude that apart from the normal erotic pleasure, women gain and maintain vaginal and pelvic functionality from these and, subsequently, from coitus.

A journey through two lumens!

This account describes studies from the Institute of Medical Physiology in the University of Copenhagen, starting in the mid 1970's, which included some of the earliest European laboratory investigations on human female genital function. The measurements involved vaginal pH, pO2, blood flow, motility, fluid and its ionic concentrations, amino-acid concentrations and electrical activity (transvaginal potential difference) usually in both the basal and sexual aroused states. The blood flow monitoring pioneered the use of the heated oxygen electrode. Other studies examined the effects of arousal to orgasm on cervical secretion, on the heart rate as an objective indicator of orgasmic excitement and investigated the actions of TRH and the cholinergic antagonist atropine on a number of vaginal parameters. The work was part of the scientific watershed that divided the previous descriptive era of human genital mechanisms from the now prevalent quantitative assessments.

Opioid growth factor regulates the cell cycle of human neoplasias.

The native opioid growth factor (OGF), [Met5]-enkephalin, is a tonic inhibitory peptide that modulates cell proliferation and migration, as well as tissue organization, during development, cancer, homeostatic cellular renewal, wound healing, and angiogenesis. OGF action is mediated by the OGF receptor (OGFr). To investigate the target of OGF as to cell proliferation, the effects of excess OGF, and a deprivation of OGF-OGFr interaction by an opioid antagonist, naltrexone (NTX), were examined in 3 human cancer cell lines: pancreatic (BxPC-3), colon (HT-29), and head and neck (CAL-27). OGF exposure decreased growth, DNA synthesis, and mitosis, and increased the doubling time from control levels. FACS analysis revealed a marked increase in cells in the G0/G1 phase and compensatory reduction in cells in S and G2/M phases. Consistent with this observation, the percentage of labeled mitosis (PLM) analysis showed a notable increase in the time of the G0/G1 phase. Receptor blockade with NTX increased the rate of growth, length of DNA synthesis and mitotic phases, and decreased doubling time from control values. FACS analysis indicated an increase in the proportion of cells in S and G2/M phases, and a decrease in the number of cells in the G0/G1 phase. PLM evaluation demonstrated a shortening of the length of the S and G2 phases in the 3 cell lines, and decreases in the M and G0/G1 phases in some cancers. These results indicate that OGF action is directed at the G0/G1 phase, but interruption of OGF-OGFr interfacing has widespread repercussions on the cell cycle. The data on blockade of OGF-OGFr during log phase growth suggest a requisite escorting of the growth peptide and its receptor through the cell cycle.

The effectiveness of a "critical pathway" in the management of laryngectomy patients.

BACKGROUND: This is a retrospective review of medical and financial records to test the hypothesis that the use of a critical pathway specifically designed for the management of laryngectomy patients will result in improved patient care, decreased length of hospitalization, and optimal allocation of resources. METHODS: Thirty patients undergoing laryngectomy before the implementation of the laryngectomy critical pathway were compared with 30 patients after implementation of the pathway. Clinical outcomes, length of hospitalization, and cost analyses were performed. RESULTS: Adjusting for two outliers, the average length of stay for pathway patients was 7.3 days vs 12 days for prepathway patients. A total estimated cost-savings of $204,000 was ultimately achieved. CONCLUSIONS: Our laryngectomy critical pathway has resulted in improved patient care and optimized allocation of medical resources.

The opioid growth factor receptor in human head and neck squamous cell carcinoma.

Carcinoma of the head and neck is the sixth leading cause of cancer in the world, and the third most common neoplasia in developing countries. More than 90% of head and neck cancers are squamous cell carcinomas (SCCHN). Approximately half of the patients afflicted die within 5 years of diagnosis and survival rates for cancer of the upper aero-digestive tract have not changed in 25 years. The opioid growth factor (OGF), ¿Met5-enkephalin, inhibits the growth of SCCHN in vitro and in vivo, and acts in a receptor-mediated fashion. Receptor binding assays using CAL-27 human SCCHN cells in culture and ¿3H-¿Met5-enkephalin were employed to identify and characterize the receptor responsible for the growth-regulatory effects of OGF. Specific and saturable binding was recorded, and Scatchard analysis showed that the data were consistent for a single binding site with a binding affinity (Kd) of 5.0+/-0.9 nM and maximal binding capacity (Bmax) of 47.5+/-1.7 fmol/mg protein. Subcellular fractionation studies determined that the optimal binding occurred with the nuclear fraction. Competition experiments demonstrated that cold ¿Met5-enkephalin was at least 7-fold greater than ligands selective for classical opioid receptors. Binding was detected in 4 other SCCHN cell lines. Receptor number in xenografts of CAL-27 was decreased almost 5-fold compared to the same cells grown in vitro. Binding to radiolabeled ¿Met5-enkephalin was recorded in SCCHN obtained from surgical resections. The function, pharmacological and biochemical characteristics, distribution and subcellular location of OGF binding in human SCCHN were consonant with the OGF receptor (OGFr).

Angiosarcoma: current review.

Angiosarcoma (AS) is a rare malignant tumor of the skin and soft tissues. Due to this lesions's histopathologic similarity to other soft tissue and skin neoplasms, several names had been previously used to describe AS. In the following article, we present a comprehensive review of the literature and prior studies pertaining to AS. The purpose of this article is to provide the reader with a better understanding of the causative factors, clinical findings, and histological features of this uncommon but potentially lethal tumor. Furthermore, we discuss present therapeutic options and outcomes as well as summarize recent advances in AS tumor biology and cytogenetics.

Effect of caffeine on neonatal splanchnic blood flow.

Doppler ultrasound was used to study the effect of the first intravenous dose of caffeine on splanchnic haemodynamics in preterm neonates. Peak systolic velocity in the superior measenteric artery and coeliac axis was significantly reduced for 6 hours after caffeine infusion. The effect of this reduction in blood flow to the neonatal gut is not known.

Vagotomy inhibits the jejunal fluid secretion activated by luminal ileal Escherichia coli STa in the rat in vivo.

BACKGROUND: Escherichia coli heat stable enterotoxin (STa) is a major cause of secretory diarrhoea in humans. AIMS: To assess the effects of instilling STa into the ileum on remote fluid secretion in the jejunum and colon in rats in vivo by a gravimetric technique. METHODS AND RESULTS: Ileal STa (55 ng/ml) stimulated fluid secretion in both ileal and jejunal loops but not in the colon. The fluid secretion induced by ileal STa was inhibited by L-NAME (Nomega-nitro-L-arginine methyl ester, 40 mg/kg intraperitoneally) but not by D-NAME (Nomega-nitro-D-arginine methyl ester). Ileal carbachol (183 mg/ml) instilled into the lumen stimulated ileal secretion but not jejunal secretion, and was unaffected by L-NAME. Capsaicin (10 microM), instilled luminally with STa in the ileum, blocked both the ileal and jejunal fluid secretion. Acute bilateral vagotomy prevented luminal ileal STa from inducing jejunal fluid secretion but not from activating ileal fluid secretion. CONCLUSION: Ileal E coli STa stimulates remote secretion in the rat jejunum but not in the colon, probably by a nitrinergic, vagal reflex mediated by C fibres. This neural pathway will amplify the action of the toxin in its generation of secretory diarrhoea.

Regulation of human head and neck squamous cell carcinoma growth in tissue culture by opioid growth factor.

Squamous cell carcinoma of the head and neck (SCCHN) is the sixth most common malignancy worldwide. Approximately half of the patients afflicted die within 5 years of diagnosis, and surviving patients may be left with severe esthetic and functional compromise. In this study, we discovered that an endogenous opioid peptide, [Met5]-enkephalin, inhibited the growth of human SCCHN in vitro; in view of this pentapeptide's action it has been termed opioid growth factor (OGF). OGF was found to be a constitutively expressed, receptor-mediated growth inhibitory agent that appears to be autocrine produced and secreted. Growth regulation was dose-related, reversible, cytostatic, and independent of serum. All 6 human SCCHN cell lines examined exhibited growth modulation by OGF. Blockade of peptide-receptor interaction by opioid antagonists (naltrexone), or addition of antibody to OGF, resulted in substantial increases in cell number compared to control levels, showing the tonic nature of OGF-zeta activity. Immunocytochemical studies detected both OGF and its related receptor, zeta, in these cells, correlating with earlier findings of peptide and receptor in specimens of SCCHN obtained at surgery. These data suggest that a native opioid peptide, OGF, interacts with a novel opioid receptor, zeta, to tonically arrest the growth of human SCCHN.

Effect of feed interval and feed type on splanchnic haemodynamics.

AIM: To study the effect of enteral feeding on splanchnic blood flow velocity in preterm infants. METHOD: Coeliac axis and superior mesenteric artery (SMA) blood flow velocity were measured longitudinally in a cohort of 61 babies using Doppler ultrasound. RESULTS: Babies fed 1 hourly had significantly higher preprandial SMA peak systolic velocity (PSV) than those fed 3 hourly (70 vs 53 cm/s). Those fed 1 hourly showed no postprandial change whereas those fed 3 hourly showed significant postprandial hyperaemia. This hyperaemia had longer latency (42 vs 27 mins) and smaller amplitude (31 vs 25 mins) after expressed breast milk compared with preterm formula. The addition of long chain polyunsaturated fatty acids to the formulas had no effect on the postprandial response. CONCLUSION: Hourly bolus feeding leads to a persistent hyperaemic state in the SMA. The composition of feeds is an important determinant of the postprandial response of the SMA to 3 hourly feeding.

Dopamine-secreting glomus vagale: a case report and histopathologic correlation.

BACKGROUND: Catecholamine secretion by head and neck paragangliomas is uncommon. Dopamine secretion by these tumors has not routinely been assessed. This case report describes a dopamine-secreting glomus vagale and evaluates seven other paragangliomas immunohistochemically for their ability to synthesize dopamine. METHODS: Light microscopic and immunohistochemical studies were performed on eight tumors, and biochemical testing for serum/urine catecholamines was performed on two patients. RESULTS: One patient (case report) had elevated serum dopamine which corrected following surgery. Five tumors stained strongly positive for the presence of tyrosine hydroxylase, the critical enzyme in the biosynthesis of dopamine. CONCLUSION: This case report describes the ability of a glomus vagale to secrete dopamine. Other paragangliomas express the enzymatic machinery necessary to begin catecholamine synthesis. Now that dopamine is routinely screened during catecholamine determination, other cases may be identified.

Plating techniques and plate orientation in repair of mandibular angle fractures: an in vitro study.

A biomechanical model utilizing polystyrene mandibles was devised to evaluate the fixation efficacy of various plating techniques for repair of mandibular angle fractures. A simple angle fracture was created in the mandible models at a standardized location and was repaired using five different plating techniques. Each experimental group consisted of 15 mandibles, with fracture site, plate placement, load application, and fracture displacement measurement standardized to ensure consistency among experimental groups. Measurement of fracture distraction under load application generated a load deformation curve and corresponding slope for each technique. Comparison of load deformation slopes allowed assessment of fixation stability. When applied with a subapical, medially placed monocortical tension band, bicortical compression plating demonstrated the most stable fracture fixation. The data show that biplanar plate placement in both monocortical noncompression and bicortical compression techniques yields a stronger fixation than monoplanar placement.

Hybrid tumors or salivary gland tumors sharing common differentiation pathways? Reexamining adenoid cystic and epithelial-myoepithelial carcinomas.

Three adenoid cystic carcinomas and two epithelial-myoepithelial carcinomas, which focally shared common histologic features, were studied to examine the common differentiation pathways manifested by these tumors and to discuss criteria for hybrid salivary gland tumors. Regions of the adenoid cystic carcinomas had cellular features ranging from simple clear cell change of basal/myoepithelial cells to combined clear cells and prominent ductal structures mimicking epithelial-myoepithelial carcinoma. Conversely, two epithelial-myoepithelial carcinomas had adenoid cystic carcinoma-like regions caused by the formation of "pseudocysts"; this resulted in a focal cribriform pattern. Electron microscopy of two additional but typical epithelial-myoepithelial carcinomas revealed both excess basal lamina at the margins of cellular nests and widened intercellular spaces containing reduplicated basal lamina and accumulations of glycosaminoglycans; these ultrastructural features were identical to those seen in adenoid cystic carcinomas. The five current cases are not examples of hybrid tumors, but they demonstrate the effects of gene expression and the resulting differentiation of synthetic products and tumor cells that are generally restricted to one or the other of these two tumor types by as-yet-unknown means. To avoid misdiagnosis and its prognostic implications, adenoid cystic carcinoma-like regions in epithelial-myoepithelial carcinoma and epithelial-myoepithelial-like regions in adenoid cystic carcinoma should be recognized simply as anomalous differentiation.

Sex and the human female reproductive tract--what really happens during and after coitus.

The scientific study of the interaction of human genitals during coitus and after ejaculation with and without female orgasm has always been difficult and controversial with ethical, technical and social problems. The present brief review examines critically the results from these studies. Early observations utilised changes induced in sexually self-aroused subjects or by coitus with artificial (transparent) penes with few objective measurements. These culminated in the synthesis of the useful unitary descriptive, EPOR (excitation, plateau, orgasm, resolution)-model by Masters and Johnson (1966). Later investigations by other workers developed or employed instrumentation to record objectively the changes induced in the motility and pressures of genital muscles, in genital blood flow, in the ion and fluid movements creating the neurogenic transudate of vaginal lubrication, in its pH and pO2 and in the disposition of the ordered spurting ejaculate with subsequent sperm transport. More recently, studies have begun to use endoscopy and ultrasound imaging to picture what really happens especially during penile thrusting. While the newer techniques have often confirmed selected features of the original EPOR model they have also shown that the characterisation of the coital changes just by a unitary model is inappropriate. New observations suggest a plurality in the changes that can occur. Coital mechanisms are dynamic and our investigations and descriptions of them should match their dynamism. The knowledge gained will be more than helpful in the treatment of infertility, genital dysfunctions and disease transmission.