Sexual Problems among Japanese Women: Data from an Online Helpline.

INTRODUCTION: Sexual problems have been more prevalent among East Asian women than those from other areas of the world. However, Japanese women seldom tend to consult their treating physicians as such intimate problems are socially awkward topics to share and may be considered shameful. Presently, there is little data in the literature regarding women's sexual problems in Japan. AIMS: We aimed (i) to investigate the types of sexual problems that were reported among Japanese women who had sought online consultations; and (ii) to examine whether factors such as age and family structure (marital status and presence of children) increased the likelihood of sexual problems. METHODS: An online helpline received a total of 316 messages from Japanese women related to sexual problems over a 3-year period. We evaluated 276 respondents, who provided demographic information such as age and family structure as well as their response to an open-ended question regarding their sexual problems. MAIN OUTCOME MEASURES: Main outcome measures were the types of sexual problems reported by Japanese women. RESULTS: The majority of respondents were in their 30s (53.6%). Sexual aversion accounted for 42.4% of the complaints, partners' sexual issues for 18.5%, and pain during sex for 16.7%. Family structure significantly correlated with sexual problems (P < 0.001). Women with sexual aversion were more likely to be younger (P = 0.003) and have children (P < 0.001). Women whose partners had sexual issues were more likely to be married (P < 0.001) and have no children (P < 0.001). Women who reported pain during sex were more likely to have no children (P = 0.006). CONCLUSION: Sexual aversion was the most common sexual problem among Japanese women who sought help via the online helpline. Family structure was related to sexual problems. More detailed assessments of family structure may be important in better identifying the triggering causes of the reported sexual problems. Ozaki Y, Nagao K, Saigo R, Tai T, Tanaka N, Kobayashi H, Nakajima K, and Takahashi Y. Sexual problems among Japanese women: Data from an online helpline. Sex Med 2015;3:289-295.

Gaps between actual and desired sex life: web survey of 5,665 Japanese women.

To explore issues that heterosexual women have concerning their sex life and desire toward their male partner, the authors conducted an online survey on actual sex life and sexual quality of life. Survey participants included 5,665 women who were 20 years of age and older who (a) lived in or near Tokyo, (b) had a male sex partner, and (c) intended to have sexual activity. Participants were asked to respond to a wide range of questions regarding their sexual fulfillment and desires. Differences between actual and desired duration of sexual activities (foreplay, intercourse, and afterplay) and number of sexual positions were calculated. The authors performed subgroup analyses regarding pain during sexual intercourse and by degree of partner's unilateral action. In addition, the authors investigated the relation between sexual quality of life and each subgroup. Women who participated in this survey tended to desire a longer duration of foreplay and afterplay than was experienced. The greater the pain during sexual intercourse, the percentage of respondents who desired a shorter duration of intercourse and fewer numbers of sexual positions increased and the sexual quality of life decreased. The degree of partner's unilateral action during sexual activity negatively affected the woman's sexual quality of life. The present study suggests the importance of establishing good communication between sex partners.

[Role of androgen in the elderly. Male sexual dysfunction and androgen].

Testosterone enhances DA release in the MPOA at rest and with sexual challenge, possibly by upregulating NOS, which increases NO and thereby increases DA release. Androgens have beneficial effects on endothelial cells and smooth-muscle cells. Testosterone and dihydrotestosterone may also relax penile artery and cavernous smooth muscle through their nongenomic effects. In rats, castration has been reported to decrease arterial flow, induce venous leakage, and reduce the erectile response to stimulation of the cavernous nerve. Hypogonadal patients in whom PDE5 inhibitor failed could be rescued by the administration of testosterone.

Prognostic significance of preoperative serum CYFRA 21-1 in patients with upper urinary tract urothelial carcinoma.

OBJECTIVES: The prognosis for upper urinary tract urothelial carcinoma is generally poorer than that for bladder cancer, and prognostic predictors with a high specificity for upper urinary tract urothelial carcinoma (UUT-UC) are needed to optimize treatment. In fact, the only preoperative predictor currently available is C-reactive protein. In the present study, we investigated the usefulness of pretreatment serum CYFRA 21-1 as a new prognostic predictor in UUT-UC. METHODS: A total of 45 UUT-UC patients for whom serum CYFRA 21-1 was measured before treatment were included in this retrospective analysis. Patients were separated into high and low serum CYFRA 21-1 groups based on a cut-off value of 2.7 ng/mL determined from a receiver operating characteristic curve. Kaplan-Meier survival curves were calculated and the overall survival rate was statistically analyzed for the high and low pretreatment serum CYFRA 21-1 groups using the log-rank test. Multivariable analysis was carried out using the Cox proportional hazards analysis. RESULTS: By the median follow-up period of 14.4 months, 20 patients (44.4%) had died. Of the 45 patients, 23 (51.1%) were in the high pretreatment serum CYFRA 21-1 group, and the overall survival rate of this group was significantly lower (P < 0.001). Multivariable analysis identified only distant metastasis (P < 0.001) and pretreatment serum CYFRA 21-1 (P = 0.039) as independent prognostic predictors. Distant metastasis did not significantly differ between the two groups or correlate with pretreatment serum CYFRA 21-1. CONCLUSION: These findings suggest that pretreatment serum CYFRA 21-1 values could serve as a prognostic predictor of UUT-UC.

Clinical evaluation of urolithiasis in Crohn's disease.

OBJECTIVES: To investigate the characteristics of urolithiasis associated with Crohn's disease in a Japanese population. METHODS: We studied 98 patients with Crohn's disease: 39 with urolithiasis and 59 without urolithiasis. Patients were treated at the Social Insurance Central General Hospital, or at the Toho University Omori, Ohashi, or Sakura Medical Centers. RESULTS: Calculi were more frequent in men (n = 30) than women (n = 9). Mean time from diagnosis of Crohn's disease to diagnosis of calculi was 8.8 years (range 0 to 22 years). Calculi were present on the right side in 19 patients and the left side in 19 patients. Stone were composed of calcium oxalate in nine patients, calcium oxalate and calcium phosphate in two patients, and ammonium urate in five patients. The rate of concurrent calculi was significantly higher in ileostomates. The probability of developing calculi was approximately eight times higher for patients with a urine pH of or=6.5. CONCLUSIONS: The rate of concurrent urolithiasis was higher in patients with a urine pH of

[Management of urinary complication in Crohn's disease].

PURPOSE: Although urinary complications of Crohn's disease are relatively rare, they often present diagnostic and therapeutic dilemmas. However, there is no established strategy for treating urinary complications of Crohn's disease. In the present clinical study, we describe the frequency of urinary complications of Crohn's disease, and discuss various approaches to their diagnosis and treatment. PATIENTS AND METHODS: The subjects were 1,551 patients who underwent medical treatment for Crohn's disease between January 1994 and May 2002 at Social Insurance Central General Hospital. The subjects were retrospectively evaluated. RESULTS: Urinary complications occuered in 75 of the 1,551 patients (4.8%): urolitiasis in 60 patients, urinary fistula in 14 patients, and urachal abscess (Enterourachocutaneous fitulas) in 1 patient. A total of 41 of the 75 patients with urinary complications (55%) consulted a practicing urologist: 26 patients with urolithiasis, 14 patients with urinary fistula and 1 patient with urachal abscess. 26 patients with urolithiasis received medical treatment: 20 patients underwent conservative therapy, 4 patients underwent ESWL, and 2 patients underwent TUL. In all 26 of those cases, the treatment was successful. Twelve of the 14 patients with urinary fistulas (86%) underwent resection of the inflamed intestine combined with reconstruction of the urinary tract. The 1 patient with urachal abscess underwent resection of the urachus and the inflamed intestine, and partial cystectomy. CONCLUSION: All patients with urolithiasis should be treated the same way, whether or not they have Crohn's disease. In patients with Crohn's disease complicated by urinary fistula, surgery should be performed after preoperative medical therapy, as it improves the quality of life of such patients more rapidly than other approaches and may help avoid intestinal resection.

Antioxidative capacity of extracts and constituents in Cornus capitata adventitious roots.

Radical scavenging activities of extracts and constituents in Cornus capitata adventitious root cultures were evaluated by using 1,1-diphenyl-2-pycrylhydrazyl (DPPH) and superoxide anion radicals. Inhibitory activity against peroxidation of linoleic acid was assayed by using the thiobarbituric acid (TBA) method. Ethyl acetate and aqueous fractions were prepared from adventitious roots cultured in Murashige-Skoog liquid medium with 0.1 microM Cu(2+) (0.1CuMS) or 10 microM Cu(2+) (10CuMS). The highest scavenging activities on DPPH and superoxide anion radicals were observed in the ethyl acetate fraction from 0.1CuMS. In the inhibitory activity against linoleic acid oxidation, the ethyl acetate fraction from 10CuMS was highest among the fractions tested. The ethyl acetate fraction of adventitious roots cultured in 0.1CuMS contained mainly galloylglucoses (1,2,3,6-tetragalloylglucose and 1,2,3,4,6-pentagalloylglucose). The ethyl acetate fraction of adventitious roots cultured in 10CuMS contained mainly ellagic acid derivatives [3,3'-di-O-methylellagic acid 4-(5"-acetyl)-alpha-L-arabinofuranoside and stenophyllin H1]. Aqueous fractions prepared from both media contained iridoid glycosides (dihydrocornin and cornin). Tetra- and pentagalloylglucoses showed strong inhibitory activities (61.9 and 85.2%, respectively) against linoleic acid oxidation relative to those of butylated hydroxytoluene (BHT) (91.1%) or alpha-tocopherol (49.5%) at 50 microM concentration. Although both ellagic acid derivatives had weak activities (<50%) on DPPH and superoxide anion radical scavenging, 3,3'-di-O-methylellagic acid 4-(5"-acetyl)-alpha-L-arabinofuranoside was stronger (74.7%) than alpha-tocopherol (49.5%) in inhibiting linoleic acid oxidation at 50 microM concentration. Iridoid glycosides exhibited little activity against DPPH and superoxide anion radicals or against oxidation of linoleic acid.

Polyacetylene glycosides from Pratia nummularia cultures.

Two polyacetylene glycosides, lobetyol 9-O-glc(6)-(1)rha (pratialin-A) and lobetyol 9-O-glc(6)-(1)glc(6)-(1)glc (pratialin-B), were isolated from Pratia nummularia (Campanulaceae) callus and hairy root cultures and their chemical structures were determined by analysis of spectroscopic data. From the methanol extract of the hairy root cultures, together with the known polyacetylene constituents lobetyol, lobetyolin, and lobetyolinin, tryptophan was also isolated. This report is the first example of the isolation and structure elucidation of rutinoside (pratialin-A) and triglucoside (pratialin-B) derivatives of polyacetylene constituents.

[Clinical usefulness of high sensitive PSA with endocrine treatment in the prostate cancer].

PURPOSE: Prostate-specific antigen (PSA) is an important tool in the diagnosis of prostatic cancer and also is an essential marker for observing the therapeutic effect and clinical course. Though the conventional limit of PSA measurement was 0.1 ng/ml it recently became possible to determine PSA by means of a 3rd generation high sensitive PSA assay with the detectable sensitivity as highly as 0.003 ng/ml. The clinical utilities of this highly sensitive PSA was examined in this study. METHODS AND SUBJECT: In 51 patients with fresh untreated prostatic cancer diagnosed during the period from November 1996 to March 2001 and for whom endocrine therapy was selected. PSA (Tandem-R) and highly sensitive PSA (DPC Imrise 3rd generation kit) were determined at regular intervals. RESULTS: According to the nadir for highly sensitive PSA, the subjects were divided into 3 groups, Group, the nadir below 0.01 ng/ml, Group II, the nadir between 0.01 and 0.1 ng/ml and Group III, the nadir of 0.1 ng/ml or more. PSA failure was observed in none of Group I (0/10), 3 out of 19 cases in Group II and 10 out of 21 cases in Group III. Highly sensitive PSA failure was observed 3 out of 11 cases in Group I and 5 out of 19 cases in Group II. Furthermore highly sensitive PSA failure subsequently progressed to PSA failure in 3 cases. CONCLUSION: As for the clinical usefulness of highly sensitive PSA in patients with prostatic cancer during endocrine therapy. We propose that; (1) Nadir of highly sensitive PSA might be useful as an index for predicting the prognosis of prostatic cancer and (2) highly sensitive PSA failure could predict a possible recurrence of cancer relatively earlier than PSA failure.