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PubMed2006

Detecting fearful and neutral faces: BOLD latency differences in amygdala-hippocampal junction.

Evolutionary survival and procreation are augmented if an individual organism quickly detects environmental threats and rapidly initiates defensive behavioral reactions. Thus, facial emotions signaling a potential threat, e.g., fear or anger, should be perceived rapidly and automatically, possibly through a subcortical processing route which includes the amygdala. Using event-related functional magnetic resonance imaging (fMRI), we investigated the time course of the response in the amygdala to neutral and fearful faces, which appear from dynamically decreasing random visual noise. We aimed to detect differences of the amygdala response between fearful and neutral faces by estimating the latency of the blood oxygenation level-dependent (BOLD) response. We found that bilateral amygdala-hippocampal junction activation occurred earlier for fearful than for neutral faces. Our findings support the theory of a dual route architecture in which the subcortical thalamic-hippocampal-amygdala route serves fast preconscious threat perception.

Amygdala↗
PubMed2006

Impact of gonadotrophins and steroid hormones on tumour cells derived from borderline ovarian tumours.

BACKGROUND: Conservative surgery is currently proposed for young patients with borderline ovarian tumours (BOT). For those experiencing infertility, the question of medically assisted procreation is raised. We have evaluated in vitro the proliferation of cultured BOT cells in response to FSH or estradiol (E(2)). METHODS: Primary cell cultures were prepared from BOT. The presence of FSH and E(2) receptors was evaluated by immunochemistry. Cultures in vitro were stimulated with FSH (40 and 200 mUI/ml) or E(2) (300 and 2000 pg/ml) for 96 h and proliferation was evaluated with the WST-1 test. RESULTS: Four primary cultures were obtained that expressed FSH and E(2) receptors to different extents. Growth was generally similar to controls when treated with either FSH or E(2) although 300 pg/ml E(2) caused a significant inhibitory effect on cell proliferation (P = 0.035). CONCLUSION: No stimulatory effect of FSH or E(2) on cultured BOT cells was found, despite the presence of receptors. Although preliminary, these results suggest that gonadotrophins and E(2) could be used in patients experiencing infertility after conservative surgery.

Estradiol↗
PubMed2006

Sexual behaviors and mental perception, satisfaction and expectations of sex life in men and women in France.

AIM: To analyze behaviors, mental perception, satisfaction, and expectations relating to sexuality in France. METHODS: A total of 1,002 subjects (483 men and 519 women) aged 35 years and over in a representative sample of the French population were surveyed by phone using a dedicated questionnaire in November 2003. MAIN OUTCOME MEASURES: Sexual behaviors and mental perception, satisfaction and expectations concerning sexual life. RESULTS: Of the population, 80.2% reported having a sexual partner. The mean number of times subjects had sex per week was 1.8 (2.0 in men, 1.6 in women). The decision preceded the act by a few seconds or minutes in 82.7% of subjects. Thinking about sex was "frequent" in 47.1% of subjects, especially for men (60.8%). Regardless of gender, sexuality was more synonymous with pleasure (44.0%) and love (42.1%) than with procreation, children, or motherhood (7.8%). During sexual intercourse, simultaneous orgasms and feelings of closeness were important for the majority of subjects, 35.8% (41.6% of men) and 22.8%, respectively; foreplay, enjoyment, and vaginal penetration were the most important accomplishments for 13.1%. Regardless of gender, 83.0% of subjects expressed relative or full satisfaction with their sex life. However, only 38.7% of subjects (31.6% of men and 45.2% of women) did not wish to change anything, while 17.2% would like to have more time for it. Of the subjects, 63.0% reported a decrease in sexual desire during periods of work-related stress, especially in women (72.3%). The main sexual complaints reported by men were diminution of sexual desire (24.9%), early ejaculation (23.7%), and erectile problems (14.4%). In women, they were diminution of sexual desire (45.7%), orgasm disorders (15.5%), and dyspareunia (15.5%). CONCLUSIONS: This survey showed that the attitude of subjects, especially men, toward sexuality is changing through years and highlighted the extent of sexual problems in the general population.

Age Factors↗
PubMed2002

[Contraception in teenagers. Medico legal implication].

Contraception in adolescence is an issue which, due to its clinical and medico-legal implications, requires an in depth and clear knowledge of the general principles that govern contraception in minors, as stated in a broad body of laws. The position of the physician is complex, since he/she must comply with the law whilst protecting the minor. The physician has to provide answers to many questions: Can health care facilities and guidance centers administer to the minor, by medical prescription, the means necessary for her to make free choices in the area of responsible procreation without parental authorization? How must the gynecologist go about prescribing the morning after pill ? Emergency contraception, that is the morning after pill , has proven to be extremely helpful for adolescents whose physical and psychic health could be undermined by an unwanted pregnancy, so that it is the physicians duty to protect it. In our legislation there are principles that guarantee the right of minors to conscious and responsible motherhood; however, there are no provisions that allow for such principles to be easily enforced. Consequently, only the health worker can actually interpret the law provisions and translate them into concrete action. Laws are therefore the only point of reference for the physician, who is then responsible for enforcing them in clinical practice, always fully respecting the rights of the minor. The aim of paper is to provide experts with a correct legislative framework on contraception in adolescents, in order to facilitate his/her work in prescribing treatment while at the same time protecting the health of the minor.

Adolescent↗
PubMed1997

Fertility in schizophrenia: results from a contemporary US cohort.

To investigate procreation in schizophrenia, as well as gender-related differences, female patients with schizophrenia (n = 79, DSM-III-R criteria) were compared with screened female controls (n = 124) and subsequently with male patients (n = 86). Two outcomes were investigated: (i) the proportion of subjects with one or more children (an index of fertility) and (ii) the number of children per subject among those with one or more children (an index of fecundity). Multivariate analysis was used to control for confounding variables. No significant differences in fertility between female patients and controls were detected, but reduced fecundity was noted among female patients past the reproductive period. Male patients showed a significant reduction in both fertility and fecundity compared to female patients. These results suggest that there is a relatively small impairment of fecundity among female patients compared with controls, but that there are more significant gender-related differences in both fertility and fecundity. The latter have important implications for the genetics of schizophrenia.

Adolescent↗
PubMed2005

[Uterus after irradiation].

Today, the good prognosis of girl's cancers raises the question of her future fertility. Several studies have focused on preservation of ovarian function, but the uterus, irradiated in childhood, is a crucial component to bear in mind because the somatic damages, in terms of endometrial and myometrial atrophy, scar fibrosis and hypovascularization, are negative factors for the establishment and maintenance of a pregnancy and for a convenient labour. Consequences for procreation are related to the morphologic uterine sequelae and its altered function: early miscarriages, abnormal placentation etc. In addition to some spontaneous pregnancies reported in literature, a few pregnancies, for women experiencing a premature iatrogenic ovarian failure due to mild irradiation, have been obtained after in vitro fertilization and oocyte donation with increased estrogen treatment. Recently, a real hope has surged in relation to the opportunity to reverse the radio-induced fibrosis and thus to obtain a better trophic uterus, using the antioxidant pathway. So, a treatment combining pentoxifylline 800 mg/d and tocopherol 1000 IU/d for 12 months allowed improvement of local uterine conditions such as endometrial thickness (x2), myometrial dimensions (x1.5) and uterine vascularization in all six sterile women studied, who have received high irradiation in childhood (>or=45 Gy). Moreover, two women mildly irradiated (#20 Gy) with endometrium resisting to physiological estrogen status, became spontaneously pregnant after using this combined treatment, and gave birth to healthy children. Further studies are in progress to assess, among other questions, the interest of this therapeutic direction.

Female↗
PubMed2005

Beneficence, determinism and justice: an engagement with the argument for the genetic selection of intelligence.

In 2001, Julian Savulescu wrote an article entitled 'Procreative Beneficence: Why We Should Select the Best Children', in which he argued for the genetic selection of intelligence in children. That article contributes to a debate on whether genetic research on intelligence should be undertaken at all and, if so, should intelligence selection be available to potential parents. As such, the question of intelligence selection relates to wider issues concerning the genetic determinism of behavioural traits, i.e. alcoholism. This article is designed as an engagement in the intelligence selection debate using an analysis of Savulescu's arguments to raise a series of problematic issues in relation to the ethics of parental selection of intelligence. These problematic issues relate to wider assumptions that are made in order to put forward intelligence selection as a viable ethical option. Such assumptions are more generic in character, but still relate to Savulescu's article, concerning issues of genetic determinism, private allocation and inequality, and, finally, individual versus aggregate justice. The conclusion focuses on what the implications are for the question of agency, especially if intelligence selection is allowed.

Beneficence↗
PubMed2002

Bilateral cryptorchidism with bilateral inguinal hernia and retrovesical mass in an infertile man: single-stage laparoscopic management.

A 30-year-old married man presented with the complaint of inability to procreate. Examination revealed bilateral nonpalpable testes and bilateral inguinal hernia. Ultrasonography of the abdomen could not locate the testis; instead, a hypoechoic 5 x 5-cm mass was found behind the bladder. A CT scan of the abdomen revealed the right testis near the right inguinal canal. The left testis could not be identified beside the soft tissue mass. The patient was taken for diagnostic as well as therapeutic laparoscopy. The testis on the right was found just proximal to the internal inguinal ring, and right orchidopexy was done. The left testis was small and rudimentary; hence, orchidectomy was done. Bilateral laparoscopic herniorrhaphy was carried out with polypropylene mesh by fixing it intracorporeally to the pubic bone, Cooper's ligament, inguinal ligament, and conjoint tendon. Subsequently, the retrovesical mass was excised and retrieved by dilating the umbilical port site. The operative time was 3.5 hours with minimal blood loss. The postoperative period was uneventful, and the patient was discharged after 24 hours. The histopathology examination of the retrovesical mass showed an extragonadal germ cell tumor compatible with seminoma.

Adult↗
PubMedDate not supplied

[The worrying rise in the frequency of cesarean section].

The rise in the incidence of Cesarean section over the last thirty years is due to several factors. In particular, maternal age is increasing, parity is declining, and situations potentially requiring Cesarean section are more frequently encountered than before (prematurity, medically assisted procreation, antenatal diagnosis, previous Cesarean section, etc.). Medicolegal pressure is also increasing, and the precautionary principle is leading more and more physicians to propose Cesarean section rather than trial labor. However, although the risks of this form of delivery have decreased, they are still higher than those of vaginal delivery, except in the emergency setting. Moreover, various pathophysiologic studies have demonstrated marked changes in the elevator muscles, nerves and pelvic support after vaginal delivery. The maternal morbidity and mortality of elective caesarean delivery at term, before the onset of labor, appear to be similar to those associated with vaginal birth. However, the maternal risks (particularly placenta praevia, placenta accreta, and uterine rupture) during subsequent pregnancies following Cesarean delivery require careful evaluation. After Cesarean section, the risk of placenta praevia during the next pregnancy is between 1% and 4%. There is subsequently a linear increase, with the risk of placenta praevia reaching nearly 10% after four Cesarean deliveries. The risks and benefits of each form of delivery are extremely difficult to weigh up, and predictors of safe vaginal delivery are lacking.

Adult↗
PubMed1992

[Surgical refertilization following vasectomy--an increasing need].

Surgical refertilization by vaso-vasostomy, taking place a long time after vasectomy, gains increasing importance in men whose partnership condition has changed since the time of sterilization. Apart from the surgical technique, the length of time between vasectomy and vaso-vasostomy, the age of the patient and immunological factors are of importance for the success of the vaso-vasostomy, that is the procreation of sound children. From the view of the surgical technique the single-layered anastomosis without splinting, carried out with magnifying glasses, produces satisfactory results comparable to those of more complicated techniques (operation microscope). The success rate of recanalization is between 80 and 95%. However, the rate of refertilization (ejaculation of fertile sperms) is between 50 and 70% only. Firstly, this discrepancy is based on the space of time between vasectomy and vaso-vasostomy. If the vasectomy has taken place more than ten years ago, the prognosis is significantly poorer. Secondly, it is based on the occurrence of circulating sperm antibodies after vasectomy. This rare immunological phenomenon, which is based on a disturbed resorption of sperms, reduces the fertility considerably. Thirdly, the age of the patient is of importance. If the patient is more than 50 years old at the time of surgery, the fertility is significantly reduced, as the spermatogenesis deteriorates in this age group under normal conditions as well. In spite of these reservations the surgical refertilization after vasectomy by means of vasovasostomy is a promising method, that can be recommended to the patient concerned.

Adult↗
PubMed2006

Multicenter quality control of the detection of HIV-1 genome in semen before medically assisted procreation.

Couples in whom the man is HIV-1-positive may use medically assisted procreation in order to conceive a child without contaminating the female partner. But, before medically assisted procreation, the semen has to be processed to exclude HIV and tested for HIV nucleic acid before and after processing. The performance was evaluated of the technical protocols used to detect and quantify HIV-1 in 11 centers providing medically assisted procreation for couples with HIV-1 infected men by testing panels of seminal plasma and cells containing HIV-1 RNA and/or DNA. The performance of these tests varied due to the different assays used. False positive results were obtained in 14-19% of cases. The sensitivity for RNA detection in seminal plasma was 500-1,000 RNA copies/ml, over 500 RNA copies/10(6) cells in semen cells, and for DNA detection in semen cells 50-500 DNA copies/10(6) cells. The use of silica-based extraction seemed to increase the assay performance, whereas the use of internal controls to detect PCR inhibitor did not. This first quality control highlights the need for technical improvements of the assays to detect and quantify HIV in semen fractions and for regular evaluation of their performance.

DNA, Viral↗
PubMed2002

The analysis of a pre-adolescent girl with primal scene fantasies.

This paper presents the analysis of Daphne, a ten-year-old girl whose prominent primal scene fantasies organized the analytic process in a rather unusual way, creating challenging technical problems and offering the analyst the opportunity to learn more about the formation of primal scene fantasies and their potential impact on psychic development and function. The data are consistent with the view that primal scene fantasies become organized in response to the cognitive requirements of development--to answer the enigmas of sexual difference, genital sensations, procreation, and parental rejection; that these fantasies arise from phase-specific libidinal and aggressive struggles such as voyeurism, exhibitionism, sadism, and homoerotic fantasy; and that they influence superego development. Daphne, however, appeared to have used the primal scene fantasy in a rather extraordinary way to organize and integrate the vicissitudes of development and especially to master conflict. Moreover, the analytic work demonstrates the technical difficulty of distinguishing between primal scene fantasy and primal scene exposure. Another technical issue was raised by the remarkable discrepancy between this little girl's relatively high functioning behavior and demeanor both in school and at home, and the outpouring of sexual material that emerged and flooded our sessions. Why was there such a discrepancy? How should I manage the sexualized nature of the material? Several colleagues, reflecting on the overstimulated quality of the analytic productions, questioned whether I "should have done something" to stop it. In the hours, I certainly felt perplexed by the discontinuity between her presentation and her fantasies. Thus, I ask the reader to follow me in the process of uncovering the particular way in which the analytic data revealed themselves.

Child↗
PubMed1998

Creighton Model NaProEducation Technology for avoiding pregnancy. Use effectiveness.

OBJECTIVE: To evaluate the use effectiveness of Creighton Model (CrM) NaProEducation Technology for avoiding pregnancy. STUDY DESIGN: CrM is a medical model of natural procreation education that is a fully standardized modification of the Billings ovulation method. This system has been used as a means to avoid pregnancy and has been prospectively evaluated in five use effectiveness studies. A prospective life-table analysis of the five studies (meta-analysis) was undertaken, yielding both net and gross rates. Discontinuation rates were also calculated. These studies were conducted at CrM centers in Omaha, St. Louis, Wichita, Houston, and Milwaukee. RESULTS: A total of 1,876 couples used CrM NET for a total of 17,130.0 couple months of use. The method and use effectiveness rates for avoiding pregnancy were 99.5 and 96.8 at the 12th ordinal month and 99.5 and 96.4 at the 18th ordinal month, respectively. The discontinuation rate was 11.3% at the 12th ordinal month and 12.1% at the 18th ordinal month. CONCLUSION: CrM is highly effective as a means of avoiding pregnancy in both its method and use effectiveness. The method effectiveness has remained stable over the years of the studies, but the use effectiveness for avoiding pregnancy appears to have improved over the study period.

Adult↗
PubMed1988

[Pregnancy following in vitro fertilization and intratubal embryo transfer].

The intratubar embryotransfer is a variation of the in vitro fertilization, where the procreated preimplantation-embryos are not transferred into the cavum uteri but the tube(s). The intracavitar embryotransfer is the only possibility to treat irreparable tubar sterility in contrary to sterility not caused by the tubes where the transfer can be effected directly into the tubes. Considering the gamete intrafallopian transfer (GIFT) one can assume, that the tubes are the best physiological place for the very young embryo's evolution. In opposition to the GIFT-method the embryotransfer into the tubes will be done only if a fertilization was proved: thereby superfluous operations can be avoided and additional diagnostic hints can be gained. The valuable indications are the following ones: idiopathic sterility, certain cases of andrological subfertility and immunological sterility; probably for some kinds of the last indication from the intratubar embryotransfer there will result a special area of application. It is reported about a viable pregnancy after in vitro fertilization and intratubar embryotransfer. The new method is supposed to be called IVF/IT-ET (i.e. in vitro fertilization and intratubar embryotransfer).

Adult↗
PubMed1997

[Participation of the follicular fluid in follicular development, oocyte maturation and spermatic function].

Follicular fluid (FF) is of great importance in Assisted Procreation Programmes, because it constitutes the micro-environment of the follicle that regulates the development of the oocyte and participates in the capacitation of the spermatozoa. The biochemical composition of FF is influenced by the state of follicle maturation and reciprocally the content of the fluid predicts the success of the subsequent follicular maturation and pregnancy. In most of the species the high concentrations of estradiol are common in the follicles of intermediate maturity, the progesterone in the mature ones and the androgens in the atresics ones. Estradiol concentration is associated with the fertilizing capacity of the oocytes and its metabolites stimulate the progesterone production. Moreover, the FF regulates the action of the gonadotrophins, because it contains factors that help the union of these with its receptor. The FF contributes providing factors that inhibit and stimulate the meiosis. It contains factors that stimulates oocyte maturation, or that block the ability of the cortical granules to modify the components of the pellucid zone. The exposition of spermatozoons with this fluid helps the acrosomal reaction, the spermatic motility and the ovum penetration.

Chorionic Gonadotropin↗
PubMed1991

Differences in leading causes of death, hospitalization and general practice visits among Dutch women and men.

Mortality differences between Dutch women and men were compared to differences in hospitalization and general practitioner visits. Ranks for the top fifteen diagnoses per sex as well as absolute and relative (to total of sex-specific diagnoses per group) sex ratio's were computed for the age groups 15-44 years, 45-64 years and over 65 years. To enhance comparability all procreative and contraceptive management data were excluded. Twice as many men compared to women die in all age groups, resulting in a surviving excess of women in the oldest age group (male/female ratio: 0.67). As expected from these mortality figures relatively more men than women are hospitalized, in particular in the oldest age group, 26.4 versus 19.5/100,000 (relative male/female ratio: 1.35). In a study population of twelve general practices, representative of the total Dutch population, more women sought medical care from the general practitioner than men and the individual women visited the general practitioner more frequently than men, resulting in a relative male/female ratio of 0.6 for general practice visits. Men visit the general practitioner for diseases for which they are also hospitalized and also often die from. Women visit the general practitioner for a wide range of ailments only in part representative of diseases for which they are hospitalized or die from. During aging, women tend to visit primary health care facilities more frequently for chronic, non-fatal disease, which can be explained partly by the absolute longer lifespan of women than men.

Adolescent↗
PubMed2001

[Women's opinion of the risk of breast cancer].

UNLABELLED: The basic element of preparing primary prophylactic is the designation of factors of the risks. In this connexion it has been decided that we acquaint ourselves with the opinions of women. Regarding the factors of the risks of falling ill with breast cancer, to be found on them. The research has been carried out among 149 women in the period of procreation. In order to obtain the material required for the research we hare used the questionnaire of the poll of their proper ownership. The gathered material was subjected to a statistic and descriptive analysis. Most of surveyed (138, it. 92.6%) has estimated the degree of the risks of falling ill with breast cancer. The women associated this fact with the cases of falling in their families or the changes on their breast. When asked, what increases the risks oh falling ill with breast cancer in their it was connected with women's gynaecological and maternity post. CONCLUSIONS: 1. Over halt of the women (53.6%) has estimated the risks of falling ill with breast cancer giving 1-2 points (within the scale 0-5 points). 2. In the families of the surveyed there were cases of falling ill with malignant breast tumour (3%). 3. The vast majority (78.5%) undertakes the steps in order (wholesome falling in advantageous to their health and controlling their state of health) to protect themselves against tumourous disease. 4. The variables accepted while working did not differentiate the surveyed opinions.

Adult↗
PubMed1999

[Impact of the introduction of intracytoplasmic sperm injection (ICSI) on the treatment of severe male sterility].

The introduction of the Intracytoplasmic Single Sperm Injection (ICSI) has been a turning point for the treatment of severe male infertility. ICSI allowed not only to reduce fertilization failure from 35% to 0.7% but created at the same time the opportunity for a group of patients with extremely low sperm counts to procreate. The discovery that breaking the tail of the spermatozoon prior to the injection was the most important step is at the origin of major improvements: fertilization increased from 22% to 77%, pregnancy rate from 16% to 54% and the implantation rate from 7.4% to 26%. From October 1994 to April 1999, 835 ICSI cycles were performed and resulted in 312 ongoing pregnancies (37%), fertilization rate was 75%, with a fertilization failure of only 0.7%. The use of ICSI and IVF on sibling oocytes for semen samples with doubtful fertilizing ability clearly illustrated the superiority of ICSI. No fertilization failures occurred after ICSI and the fertilization rate was 76% versus 27.8% (P < 0.01). Similar benefit of ICSI was shown for crytozoospermia up to then a hopeless situation. A total of 26 pregnancies were obtained out of 87 cycles with a fertilization rate of 58.8%. Similar results were obtained when ICSI was combined with testicular sperm, 20 pregnancies occurred after from 46 transfers (43%) including cycles with cryopreserved testicular sperm. It is now clear that ICSI is the method of choice for the treatment of severe male infertility.

Belgium↗