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Biomedical subjects

R Blanchard

Publications and source records attributed to R Blanchard.

At least 55 records · Page 3Linked to original sources
PubMed1995

Regulation of the ferredoxin component of renal hydroxylases at transcriptional and postranslational levels and of the protein inhibitor of cyclic AMP-dependent kinase.

We have studied two proteins potentially involved in the regulation of the 25-OH-D-1-hydroxylase, which is located in the renal mitochondria and which is responsible for the production of the steroid hormone 1,25(OH)2D3. The endogenous inhibitor of cyclic AMP-dependent protein kinase, PKI, is down regulated by 1,25(OH)2D3. Having cloned and sequenced PKI cDNA, we studied its message levels and found them to be regulated by 1,25(OH)2D3 tissue specifically in the kidney and in kidney cell culture. In other experiments we over expressed the ferredoxin component of the 1-hydroxylase and found it to be physically and chemically indistinguishable from those of classic steroidogenic tissues. The mRNA encoding the ferredoxin component is up-regulated by chronic vitamin D deficiency, which at the same time leads to sustained elevation in 1-hydroxylase activity; no short term effect of 1,25(OH)2D3 on ferredoxin mRNA in kidney cell culture could be demonstrated. Finally, there was an association between decreased phosphorylation of ferredoxin and decreased 1-hydroxylase activity brought about by treatment of cultured kidney cells with TPA. Control of the renal signaling events involved in the production of 1,25(OH)2D3 remains a fruitful area of investigation in the field of the metabolism and actions of vitamin D and its metabolites.

25-Hydroxyvitamin D3 1-alpha-Hydroxylase↗
PubMed1994

A structural equation model for age at clinical presentation in nonhomosexual male gender dysphorics.

Nonhomosexual male gender dysphorics often make their first requests for clinical assessment when they are in or approaching middle age. This study investigated how well patients' explanations for the timing of these requests fit the objective data. Subjects were 194 outpatients presenting for the first time at a gender identity clinic. Their common explanations for the timing of their requests were incorporated into a formal path model, which was tested using Bentler's structural equations program. The model provided an acceptable fit to the data. The more times a patient has been married and the more children he has fathered, the older he is likely to be when first presenting for clinical attention. This outcome is consistent with the claims of patients that they would have come to a gender clinic sooner if they had not been restrained by commitments to wives and children.

Adolescent↗
PubMed1994

Reanalysis of Bell, Weinberg, and Hammersmith's data on birth order, sibling sex ratio, and parental age in homosexual men.

The authors compared parental age, birth order, and sex ratio of siblings for 575 homosexual men and 284 heterosexual men, matched on age and education. They were originally part of Bell, Weinberg, and Hammersmith's large-scale study of male and female homosexuality. The results confirmed the previous findings that homosexual men have older fathers and later births than do heterosexual men but not the finding that homosexual men have larger proportions of brothers. The collective findings suggest that birth order is perhaps the single most reliable demographic difference between homosexual and heterosexual men.

Adult↗
PubMed1993

Treatment of advanced non-small cell lung cancer with very high-dose cisplatin combined with etoposide and mitomycin C.

BACKGROUND: Treatment options for advanced non-small-cell lung cancer are inadequate. There remains a critical need for more effective systemic therapies. METHODS: Forty-one patients with advanced non-small-cell lung cancer were treated on a 28-day cycle with a very high-dose, cisplatin-based three-drug regimen. A treatment cycle consisted of an intravenous (IV) injection of cisplatin 100 mg/m2 on days 1 and 8; etoposide 60 mg/m2 IV over 30 minutes on days 1, 2, 8, and 9 (cycles 1 and 3 only); and mitomycin C 8 mg/m2 IV bolus on day 1 (cycles 2 and 4 only) (PEM regimen). RESULTS: The median dose intensity of cisplatin delivered was 49 mg/m2/wk, or 98% of the planned dose. One patient achieved a complete response and 16 patients a partial response or regression, yielding an overall objective response rate of 41%. The median duration of response was 21 weeks. Median survival of all patients was 38 weeks. Neurologic toxicity was dose limiting. The frequency of peripheral neuropathy and ototoxicity was directly related to cumulative cisplatin dose. In five patients, a progressive peripheral neuropathy developed after discontinuation of cisplatin. Hematologic toxicity also was significant. CONCLUSIONS: This very high-dose, cisplatin-based chemotherapy regimen has appreciable activity in advanced non-small-cell lung cancer. In comparison with previous reports on the use of very high-dose cisplatin alone, however, this combination appears at best to be only marginally more active, to confer no additional survival advantage, and to be considerably more toxic.

Adult↗
PubMed1993

Varieties of autogynephilia and their relationship to gender dysphoria.

The relationship between gender dysphoria and autogynephilia (erotic arousal in men associated with the thought or image of themselves as women) was investigated. Subjects were 238 nonhomosexual male outpatients divided into three groups: 94 reporting they were most aroused sexually by images of themselves as nude women, 67 most aroused by images of themselves as women in underwear, and 77 most aroused by images of themselves as fully clothed women. These were compared on questionnaire measures of gender dysphoria and other psychosexual variables. The Nude group was significantly more gender dysphoric than the Clothed group, which, in turn, was significantly more gender dysphoric than the Underwear group. These results support the hypothesis that those nonhomosexual men most aroused sexually by the thought of having a woman's body are also those most interested in acquiring a woman's body through some permanent, physical transformation. A secondary finding was that the Nude group was the same age as the Underwear group and significantly younger than the Clothed group. This outcome makes it unlikely that erotic fantasies of having a woman's body are the end result of some progression that necessarily begins with erotic fantasies of wearing women's clothes.

Adult↗
PubMed1993

Partial versus complete autogynephilia and gender dysphoria.

Autogynephilia (sexual arousal in men produced by the thought or image of themselves as women) is often associated with gender dysphoria (the desire to belong to the opposite sex). Previous research has shown that autogynephiles who are principally aroused by images of themselves as nude women are more gender dysphoric than those principally aroused by images of themselves as partially or fully dressed women. This study tested the hypothesis that the feature of the nude self-image most responsible for its correlation with gender dysphoria is the imagined vulva. The subjects were 220 nonhomosexual male outpatients who reported sexual arousal while imagining themselves with one or more features of the female anatomy. Autogynephilia and gender dysphoria were assessed with questionnaires. The findings confirmed that men who are sexually aroused at the thought of having a vulva are more likely to want to be women.

Adolescent↗
PubMed1993

The she-male phenomenon and the concept of partial autogynephilia.

The term autogynephilia denotes a male's propensity to be sexually aroused by the thought or image of himself with female attributes. Some autogynephiles imagine themselves, in their sexual fantasies, as complete women. Others, here called partial autogynephiles, imagine themselves with a mixture of male and female anatomic features, usually women's breasts and men's genitals. Partial autogynephiles evince a particular sexual interest in those individuals known in the vernacular as she-males. These are men, often involved in prostitution or pornography, who have undergone breast augmentation while maintaining their male genitals. Partial autogynephiles appear less likely to pursue surgical sex reassignment than gender-dysphoric men whose erotic self-image includes a vagina. Some patients with a persistent desire for women's breasts but no or conflicted desires to live as women full-time or undergo vaginoplasty may be pacified with mildly feminizing doses of estrogenic hormones.

Adult↗
PubMed1993

Men with sexual interest in transvestites, transsexuals, and she-males.

This study was a preliminary exploration of gynandromorphophilia, that is, sexual interest in cross-dressed or anatomically feminized men. Subjects were male subscribers to a voice mail system devoted to personal advertisements for sexual or romantic partners. These comprised 51 gynandromorphophiles who sought cross-dressers, transvestites, transsexuals, or she-males for such relationships, 37 gynandromorphophilic cross-dressers who identified themselves as cross-dressers and sought similar men, and 31 residual cross-dressers who sought masculine or unspecified male partners. Analysis of advertisement content suggested that gynandromorphophilia constitutes a distinct erotic interest.

Adult↗
PubMed1992

The cellular and molecular regulation of 1,25(OH)2D3 production.

The synthesis of 1,25(OH)2D3 is a critical control point in the regulation of calcium metabolism, and possibly in the growth and differentiation of a number of cell types. This paper reviews our current understanding of the regulation of this process at the cellular and molecular levels, with the emphasis on the mechanisms of feedback control 1,25(OH)2D3 itself, control of parathyroid hormone, the roles of cyclic AMP dependent protein kinase and protein kinase C, and the interaction between the various intracellular regulators of 1,25(OH)2D3 production.

25-Hydroxyvitamin D3 1-alpha-Hydroxylase↗
PubMed1992

Nonmonotonic relation of autogynephilia and heterosexual attraction.

In this study I investigated the relation between normal heterosexual attraction and autogynephilia (a man's propensity to be sexually aroused by the thought or image of himself as a woman). The subjects were 427 adult male outpatients who reported histories of dressing in women's garments, of feeling like women, or both. The data were questionnaire measures of autogynephilia, heterosexual interest, and other psychosexual variables. As predicted, the highest levels of autogynephilia were observed at intermediate rather than high levels of heterosexual interest; that is, the function relating these variables took the form of an inverted U. This finding supports the hypothesis that autogynephilia is a misdirected type of heterosexual impulse, which arises in association with normal heterosexuality but also competes with it.

Adolescent↗
PubMed1992

Sibship size, sibling sex ratio, birth order, and parental age in homosexual and nonhomosexual gender dysphorics.

This study investigated whether demographic variables previously reported to differentiate ordinary homosexuals from heterosexuals also differentiate gender-dysphoric homosexuals from gender-dysphoric persons with other sexual orientations. Subjects were outpatients aged 16 and older who were referred by physicians to a specialty clinic for the assessment of gender identity disorders. The subjects were divided into three groups: 204 homosexual women, 193 homosexual men, and 273 nonhomosexual men; the last category included men sexually attracted to females, to both sexes, and to neither sex. Demographic data on patients' families of origin were extracted from their clinical charts and from structured interview protocols. A multiple-range test at the .05 level showed that the homosexual men had significantly more siblings than the homosexual women, who, in turn, had significantly more siblings than the nonhomosexual men. The sibling sex ratio of the homosexual men, 131 brothers per 100 sisters, was significantly higher than the sex ratio of live births for the population as a whole (106 men per 100 women; p = .01); the sibling sex ratios of the other groups did not differ from the expected value. The homosexual men had a significantly later birth order than the nonhomosexual men (p = .004); the homosexual women, who fell in between, did not differ significantly from either male group. There were no between-groups differences in paternal or maternal age at the time of the subject's birth. The results concerning sibling sex ratio and birth order are consistent with previous findings for homosexual men.

Birth Order↗
PubMed1992

Proportion of unmarried siblings of homosexual and non homosexual gender-dysphoric patients.

Among the siblings of homosexuals, a lack of sexual and romantic interest in women may be independent of erotic feelings for men. This study investigated the sexual histories of siblings of gender-dysphoric outpatients. The patients were classified into three groups: non homosexual males, homosexual males and homosexual females. Their siblings consisted of 301 brothers and 284 sisters over the age of 25. Logistic regression showed that the brothers of the homosexual male patients were significantly less likely to have been married, either legally or common-law, than the brothers of the other gender-dysphoric groups, even with age and relative birth order taken into account. This finding suggests that the low propensity for long term heterosexual relationships seen in homosexual male gender-dysphoric patients also tends to appear in their brothers.

Adult↗
PubMed1991

Interim report of the DSM-IV Subcommittee on Gender Identity Disorders.

This article summarizes the discussions and recommendations of the DSM-IV Subcommittee on Gender Identity Disorders, a subcommittee of the Child Psychiatry Work Group, regarding diagnostic issues. The issues reviewed include placement in the nomenclature, the concept of a spectrum of gender dysphoria rather than discrete levels of symptomatology, criticisms of current diagnostic criteria, subtyping by sexual orientation, and proposed changes in diagnostic criteria for the current DSM-III-R diagnoses of Gender Identity Disorder of Childhood, Transsexualism, and Gender Identity Disorder of Adolescence or Adulthood, Nontranssexual Type.

Adolescent↗
PubMed1991

Clinical observations and systematic studies of autogynephilia.

The term autogynephilia denotes a male's paraphilic tendency to be sexually aroused by the thought or image of himself as a woman. This term subsumes transvestism as well as erotic ideas or situations in which women's garments per se play a small role or none at all. This review article presents clinical examples of the lesser known types of autogynephilia (i.e., those in which the element of cross-dressing is secondary or entirely absent), sketches earlier attempts to label and conceptualize these phenomena, summarizes recent quantitative studies exploring the relationships between autogynephilia and other psychosexual variables (e.g., heterosexual attraction), and speculates on the etiology of autogynephilia and its relationship to transsexualism. It is concluded that the concept of autogynephilia is needed to fill a gap in our current battery of concepts and categories for thinking about gender identity disorders.

Adult↗
PubMed1991

Group therapy for gender-dysphoric heterosexual men.

The treatment and clinical management of gender dysphoric heterosexual men often poses a challenge to the clinician. Gender dysphoric patients pursuing various lifestyle options may seek psychotherapy to deal with some of their conflicts. This paper describes one form of counseling--group therapy--which has been helpful to gender dysphoric heterosexual men and outlines the group psychotherapy program at the Gender Clinic of the Clarke Institute of Psychiatry.

Adult↗
PubMed1991

Age, transvestism, bondage, and concurrent paraphilic activities in 117 fatal cases of autoerotic asphyxia.

Autoerotic asphyxia is the practice of self-inducing cerebral anoxia, usually by hanging, strangulation, or suffocation, during masturbation. This study investigated the relationships between: asphyxiators' ages; two paraphilias commonly accompanying autoerotic asphyxia, bondage and transvestism; and various other types of simultaneous sexual behaviour. Subjects were two concurrent series totalling 117 males aged 10-56 who died accidentally during autoerotic asphyxial activities. Data concerning sexual paraphernalia at the scene of death or among the deceased's effects were extracted from coronors' files using standardised protocols. Anal self-stimulation with dildos, etc., and self-observation with mirrors or cameras were correlated with transvestism. Older asphyxiators were more likely to have been simultaneously engaged in bondage or transvestism, suggesting elaboration of the masturbatory ritual over time. The greatest degree of transvestism was associated with intermediate rather than high levels of bondage, suggesting that response competition from bondage may limit asphyxiators' involvement in a third paraphilia like transvestism.

Accidents↗