Administration of daily 5 mg tadalafil improves endothelial function in patients with benign prostatic hyperplasia

Introduction: Tadalafil is a promising phosphodiesterase (PDE) 5 inhibitor prescribed for erectile dysfunction (ED). Daily low dose (5?mg) of tadalafil has also been used for the treatment of male lower urinary tract symptoms (LUTS) associated with benign prostate hyperplasia (BPH). PDE5 inhibitors induce relaxation of smooth muscle cells in the urethra, prostate, bladder neck, and blood vessels. The aim of this study was to investigate the efficacy of tadalafil on vessels endothelial function, in patients with male LUTS symptoms associated with BPH.

Methods: The Institutional Review Board (IRB) approved this clinical study and informed consents had been obtained from 81 BPH patients.

The following male LUTS parameters: international prostate symptom score (IPSS), overactive bladder symptom score (OABSS), voiding volume, max and mean voiding flow on voiding flowmetry examination and post-voiding residual urine (RU) were compared at 0, 1, 3, 6, and 12 months after a daily dose of 5?mg tadalafil.

In addition, erectile function was evaluated by the sexual health inventory for men (SHIM) score and vessels endothelial function and peripheral neuropathy were assessed by the brachial-ankle pulse wave velocity (baPWV), ankle brachial index (ABI), and vibration perception threshold (VPT) at 0, 3, 6, and 12 months after treatment.

Results: The mean age of 81 patients was 66.4?±?11.4 years old. Their prostate size was 30.2?±?22.1?ml.

Male LUTS parameters including IPSS, OABSS, and RU showed significant improvement from 1 to 12 months after tadalafil administration. Max and mean voiding flow was significantly increased at 6 months after tadalafil treatment.

The SHIM score showed significant improvement after 3 months. Whilst, the results of baPWV also showed significant improvement from 3 to 12 months. ABI was also significantly improved at 6 months. However, there was no change in the VPT at any time point.

Conclusions: Tadalafil is effective for both male LUTS and ED. It is also shown that tadalafil improves baPWV, which we can conclude that higher vessels elasticity has been obtained. This major finding of this study shows that tadalafil has the potency to improve vessels endothelial dysfunction in patients with BPH.     

Are urge incontinence and aging risk factors of erectile dysfunction in patients with male lower urinary tract symptoms?

Introduction: Several studies have indicated that erectile dysfunction (ED) patients also suffer from lower urinary tract symptoms (LUTS). We investigated a group of men with LUTS and assessed their sexual function with the aim of being able to predict ED risk factors and introduce ED treatments earlier for this patient group.

Methods: International Prostate Symptom Score (IPSS), Overactive Bladder Symptoms Score (OABSS) and Sexual Health Inventory for Men (SHIM) score were obtained from 236 men with LUTS at their first out-patients visit. Clinical parameters such as body mass index, prostate volume, residual urine volume and prostate specific antigen were also evaluated. The relationship between the SHIM score and other clinical data was analyzed.

Results: According to the SHIM score, ED in men with LUTS was severe 15%, moderate 19%, moderate to mild 28%, mild 17%, normal 7% and data was incomplete in 14%. Based on the results of a multivariate analysis, aging (p?p?=?0.024) were significantly correlated to severe and moderate ED. Furthermore, among OAB symptoms score items, urge urinary incontinence was a risk factor for severe and moderate ED (p?=?0.005).

Conclusion: Aging and OAB (notably urinary urge incontinence) are risk factors for severe and moderate ED in men with LUTS.     

The efficacy and safety of short-acting testosterone ointment (Glowmin) for late-onset hypogonadism in accordance with testosterone circadian rhythm

Introduction: It is well known that there is a reduction of circadian rhythm in blood testosterone levels with aging. Our previous report revealed that 3?mg of short-acting testosterone ointment (Glowmin: GL) elevated serum testosterone levels to within the physiological range for 4–6?h. The aim of this study was to clarify the clinical efficacy and safety of GL used topically once every morning, to enhance the circadian rhythm of testosterone, for late-onset hypogonadism (LOH).

Methods: A total of 61 LOH patients received 3?mg of GL topically once a day in the morning on scrotal skin for 24 weeks. The clinical efficacy of GL was evaluated by the aging males symptoms (AMS) scale, and blood sampling tests were measured before and after GL treatment.

Results: Mean patients age was 55.3?±?9.2 years old. Total AMS scores at 4, 12, and 24 weeks after GL treatments significantly decreased. The results of sub-analysis of AMS, including psychological, physical, and sexual factors also significantly improved after GL treatments. No severe adverse reactions or abnormal laboratory data were reported.

Conclusions: This study shows that TRT for LOH with once daily GL treatment supports testosterone circadian rhythm and should be considered to be an effective and safe therapy for LOH.     

Infant Discrimination of a Morphologically Relevant Word‐Final Contrast

Six‐, 12‐, and 18‐month‐old English‐hearing infants were tested on their ability to discriminate nonword forms ending in the final stop consonants /k/ and /t/ from their counterparts with final /s/ added, resulting in final clusters /ks/ and /ts/, in a habituation–dishabituation, looking time paradigm. Infants at all 3 ages demonstrated an ability to discriminate this type of contrast, a contrast that constitutes one phonetic cue for the English morphological concepts of plural, possession, and person. These results suggest that across a significant portion of the development of infants' speech perception, this type of final contrast is discriminable.     

Classification and similarity analysis of fundamental frequency patterns in infant spoken language acquisition

Fundamental frequency (F0) patterns, which indicate the vibration frequency of vocal cords, reflect the developmental changes in infant spoken language. In previous studies of developmental psychology, however, F0 patterns were manually classified into subjectively specified categories. Furthermore, since F0 has sequential missing and indicates a mean nonstationarity, classification that employs subsequent partition and conventional discriminant analysis based on stationary and local stationary processes is considered inadequate. Consequently, we propose a classification method based on discriminant analysis of time series data with mean nonstationarity and sequential missing, and a measurement technique for investigating the configuration similarities for classification. Using our proposed procedures, we analyse a longitudinal database of recorded conversations between infants and parents over a five-year period. Various F0 patterns were automatically classified into appropriate pattern groups, and the classification similarities calculated. These similarities gradually decreased with infant’s monthly age until a large change occurred around 20 months. The results suggest that our proposed methods are useful for analysing large-scale data and can contribute to studies of infant spoken language acquisition.     

Nonstationary regression models with a lagged dependent variable

This paper studies regression models with a lagged dependent variable when both the dependent and independent variables are nonstationary, and the regression model is misspecified in some dimension. In particular, we discuss the limiting properties of leastsquares estimates of the parameters in such regression models, and the limiting distributions of their test statistics. We show that the estimate of the lagged dependent variable tends to unity asymptotically independent of its true value, while the estimates of the independent variables tend to zero. The limiting distributions of their test statistics are shown to diverge with sample size.     

A small forecasting model of the world oil market

An annual, small-scale econometric model of the world oil market was developed to analyze oil market conditions and oil prices for the period 1986–1991. The model determines the oil price by a market-clearing condition, given world economic activity and the strategic supply behavior of the OPEC core countries. The effects of OPEC production cut in 1987 upon oil prices are evaluated, and alternative oil price profiles are provided. A simulation experiment suggests that if the OPEC core is pressed to defend the OPEC share in oil supply, then wide price swings may become inevitable.