A 35-Year-Old Man Presenting Sleep-Related Painful Erections (Erpes): A Case Report and Review of Literature

Introduction: Erectile episodes occurring in the night time are considered normal and are usually related to the REM sleep. Spontaneous painful erections are unusual but they can have a great impact in the patient’s quality of sleep and, for consequence, quality of life. Report: We present a patient who has been presenting painful erections which wake him up almost every night. We discuss the workup and treatment offered to the patient, as well as the short-time response and two months follow-up. Discussion: Although studies still do not explain this relationship, nocturnal erections occur only during rapid eye movement (REM) sleep, which can be confirmed by polysomnography accompanied by Nocturnal Penile Tumescence testing or RigiScan test. However, diagnosis can be established based exclusively on clinical aspects. Based on all literature reviewed, the initial treatment should safely consist in improvement in sleep architecture and pelvis muscles relaxation. Conclusion: After the first suspicion, polysomnography with rigidity measurements of nocturnal erections should be considered although clinical diagnosis and therapeutic test may be acceptable. The management we suggest is usually effective, well tolerated and sustained.

Characteristics of sildenafil erections in healthy young men

Aim： To determine the effect of sildenafil citrate on the nocturnal penile erections （i.e. time to onset, the duration of erection, and the interval between first and second erections） of healthy young men. Methods： Twenty-two potent men, 23-29 years old, were recruited for the study. All subjects completed three sessions over consecutive nights using the RigiScan monitoring device （Dacomed, Minneapolis, USA）. After a first night of adaptation, night 2 records were their baseline values, and on night 3 they received 100 mg of sildenafil citrate. Statistical comparisons were done between the second and third night data. Results： The mean time to onset of the first erection with sildenafil citrate was （34 ± 18） min, whereas it was （74 ± 24） min （P 〈 0.001） without sildenafil citrate. The number of erections observed during the first 5 h after sildenafil citrate medication was 3.6 ± 0.5 in contrast to 2.4 ± 0.5 with no medica- tion （P = 0.001）. The interval between first and second erections was shorter with sildenafil citrate： （52 ± 26） min vs. （85 ± 34） min （P = 0.01）. The duration of the last erection was statistically significantly longer with the sildenafil citrate： （64 ± 33） min vs. （42 ± 28） min （P 〈 0.01）. Conclusion： Healthy young men achieved erection within 34 min after sildenafil citrate administration, which is shorter than the 1 h interval proposed by the manufacturer. The interval between the first and second erections was shorter and the duration of the last nocturnal erection was longer.

Effects of erect panicle genotype and environment interactions on rice yield and yield components

The dense and erect panicle (EP) genotype conferred by DEP1 has been widely used in the breeding of high-yield Chinese japonica rice varieties.However,the breeding value of the EP genotype has rarely been determined at the plant population level.Therefore,the effects of the interaction of EP genotype and the environment at different locations and times on rice yield and its various components were investigated in this study.Two sets of near-isogenic lines (NILs)of EP and non-EP (NEP) genotypes with Liaojing 5 (LG5) and Akitakomachi (AKI) backgrounds were grown in the field in 2016 and 2017 in Shenyang,China,and Kyoto,Japan.In 2018,these sets were grown only in Kyoto,Japan.The average yields of the EP and NEP genotypes were 6.67 and 6.13 t ha^(-1)for the AKI background,and 6.66 and 6.58 t ha^(-1)for the LG5 background,respectively.The EP genotype positively affected panicle number (PN) and grain number per square meter (GNPM),mostly resulting in a positive effect on harvest index (HI).In contrast,the EP genotype exerted a negative effect on thousand-grain weight (KGW).The ratio of the performance of the EP genotype relative to the NEP genotype in terms of yield and total biomass correlated positively with mean daily solar radiation during a 40-day period around heading.These results indicate that the effectiveness of the EP genotype depends on the availability of solar radiation,and the effect of this genotype is consistently positive for sink formation,conditional in terms of source capacity,and positive in a high-radiation environment.

Preliminary Research of the Regular Pattern between Flavonoids Content and the Age of Erect Type Ophiopogon jaonicus

[Objective] The experiment aimed to inquire into the regular pattern of the flavonoids content in erect type Ophiopogon jaonicus preliminarily.[Methods]In the main Ophiopogon jaonicus-producing area,we use the method of home position dynamic method to gather sample for experiments,use UV to determine the flavonoids content in Ophiopogon jaonicus and use correlation and regression method to analyze the relation between flavonoids content and the growth period of Ophiopogon jaonicus.[Results]The relation between flavonoids content(y1)and the growth period(x∥d)of erect type Ophiopogon jaonicus is:y=1.235 6lnx-4.748 9(n=7,50≤x≤730,0≤y≤3.128,r0.001=0.950 7,r=0.954 2).[Conclusion]During a determinate time(50≤x≤730),positive correlation exists between flavonoids content and the growth period of Ophiopogon jaonicus.Our research has a great importance in directing the scientific harvest and GAP production of erect type Ophiopogon jaonicus.

Effects of Aphelenchoides besseyi Infection on Yield Traits of Different Rice Varieties (Lines)

[Objective] This study aimed to reveal the effects of Aphelenchoides besseyi infection on different rice varieties（lines）.[Method] By field observation and indoor phenotypic investigation,four conventional japonica rice varieties（lines） and japonica rice restorer line R161 under natural onset conditions were observed and analyzed.[Result] After being infected by A.besseyi,different rice varieties（lines）exhibited various symptoms.Specifically,Ning 1707,Ning 1818,Zhendao 88 and Nanjing 9108 had withered leaf tips and exhibited the symptoms of ＂small grains and erect panicles＂;japonica rice restorer line R161 only had withered leaf tips without symptoms of ＂small grains and erect panicles＂,and the withering symptoms occurred in flag leaf tip,whole flag leaf and top second leaf,respectively.After being infected by A.besseyi,all the experimental materials could sprout normally,but their plant height,panicle length,seed-setting rate and 1 000-grain weight were affected to varying degrees.In addition,after being infected by A.besseyi,various symptomatic tissues of R161 exerted different effects on rice yield.Especially,panicles with withered and twisted whole flag leaf were most affected.[Conclusion] This study provided the basis for further exploration of the damages of A.besseyi infection to rice and development of corresponding control measures.

Effects of icariin on cGMP-specific PDE5 and cAMP-specific PDE4 activities

Aim: To clarify the mechanism of the therapeutic action of icariin on erectlile dysfunction (ED). Methods: PDE5 was isolated from the human platelet and PDE4 from the rat liver tissue using the FPLC system (Pharmacia, Milton Keynes, UK) and the Mono Q column. The inhibitory effects of icariin on PDE5 and PDE4 activities were investigated by the two-step radioisotope procedure with [3H]-cGMP/[3H]-cAMP. Papaverine served as the control drug. Results: Icariin and papaverine showed dose-dependent inhibitory effects on PDE5 and PDE4 activities. The IC50 of Icariin and papaverine on PDE5 were 0.432 μmol/L and 0.680μmol/L, respectively and those on PDE4, 73.50 μmol/L and 3.07μmol/L, respectively. The potencies of selectivity of icariin and papaverine on PDE5 (PDE4/PDE5 of IC50) were 167.67 times and 4.54 times, respectively. Conclusion: Icariin is a cGMP-specific PDE5 inhibitor that may be developed into an oral effective agent for the treatment of ED.

Rice DENSE AND ERECT PANICLE 2 is essential for determining panicle outgrowth and elongation

The architecture of the panicle, including grain size and panicle morphology, directly determines grain yield. Panicle erectness, which is selected for achieving ideal plant arehitecture in the northern part of China, has drawn increasing attention of rice breeders. Here, dense and erect panicle 2 （dep2） mutant, which shows a dense and erect panicle phenotype, was identified. DEP2 encodes a plant-specific protein without any known functional domain. Expression profiling of DEP2 revealed that it is highly expressed in young tissues, with most abundance in young panicles. Morphological and expression analysis indicated that mutation in DEP2 mainly affects the rapid elongation of rachis and primary and secondary branches, but does not impair the initiation or formation of panicle primordia. Further analysis suggests that decrease of panicle length in dep2 is caused by a defect in cell proliferation during the exponential elongation of panicle. Despite a more compact plant type in the dep2 mutant, no significant alteration in grain production was found between wild type and dep2 mutant. Therefore, the study of DEP2 not only strengthens our understanding of the molecular genetic basis of panicle architecture but also has important implications for rice breeding.

Regaining of morning erection and sexual confidence in patients with erectile dysfunction

Aim： To investigate how erectile dysfunction （ED） medications affect morning erection in patients with ED and how they respond to the return of morning erection. Methods： This study was conducted in 120 patients who experienced successful intercourse with either tadalafil or sildenafil. Using a random face-to-face interview and a questionnaire （about the quality and number of days getting morning erection after using the two medications）, the impact of the medications on the morning erections was investigated, and the participants were asked about their feelings on regaining morning erection. Results： Of the respondents, 81% （68% of those with sildenafil and 99% of those with tadalafil） experienced morning erections after taking an oral ED medication. The men who took tadalafil mainly for 2 days with one dose, while those who took sildenafil experienced morning erections mainly for 1 day. The major sentiment upon regaining a morning erection was, ＂having more confidence as a man＂ （74%）. Among the 96 respondents who experienced morning erections with tadalafil, 52% preferred tadalafil over sildenafil, not only because of freedom from concerns about a specific time to have relations, but also regaining morning erection. Conclusion： Regaining a morning erection affects the recovery of confidence as a man and influences the preference for tadalafil over sildenafil.

The effects of androgen on penile reflex, erectile response to electrical stimulation and penile NOS activity in the rat

Aim: To investigate the effects of androgen on penile erection through the reflex arc and penile corpus cavernosum,and study the respective roles of testosterone (T) and dihydrotestosterone (DHT) in penile erection in rats. Methods:Male Sprague-Dawley rats were castrated and implanted with silastic brand silicone tube containing T or DHT, with orwithout daily injections of a 5α-reductase inhibitor, MK-434. The penile reflex, erectile response to electrical stimula-tion (ES) of the cavernous nerves and penile nitric-oxide synthase (NOS) activity were observed under varying andro-genic status. Results: Penile reflex erection in the rat was, on the whole, related to serum T levels though the numberof glans engorgements was not. The number of cups and flips was significantly decreased by castration, and restoredto the control level by T supplementation. Erectile response to ES and NOS activity in penile tissue was also related toserum T level. T administered together with a 5α-reductase inhibitor no longer restored the number of reflex erection,erectile responses to ES and NOS activity in the corpus cavernosum. Conclusion: Androgen influenced the penile re-flex arc, corpus cavernosum, and the perineal striated muscles. In reflex erection, erectile response to ES and penileNOS activity in the rat, T seems to be first converted to DHT, the more active androgen modality. (Asian J Androl1999 Dec; 1: 169-174)

Study of the efficacy of Korean Red Ginseng in the treatment of erectile dysfunction

Aim： To examine the treatment efficacy of Korean Red Ginseng （KRG） in impotent men with erectile dysfunction （ED）. Methods： A total of 60 patients presenting mild or mild to moderate ED were enrolled in a double-blind, placebo-controlled study in which the efficacies of KRG and a placebo were compared. The patients received either 1 000 mg （3 times daily） of KRG or a placebo. Results： The five-item version of the International Index of Erectile Function （IIEF-5） score after the treatment was significantly higher in the KRG group compared with that before the treatment （from 16.4±2.9 to 21.0±6.3, P 〈 0.0001）. In contrast, there was no difference before and after the treatment in the placebo group （from 17.0±3.1 to 17.7±5.6, P 〉 0.05）. In the KRG group, 20 patients （66.6%）, reported improved erection, significant in the global efficacy question （P 〈 0.01）; in the placebo group there was no significance. Scores on questions 2 （rigidity）, 3 （penetration）, 4 and 5 （maintenance）, were significantly higher for KRG than those for the placebo when those questions were answered after 12 weeks of each treatment （P 〈 0.01）. When the score in the KRG group was compared to the placebo group after the treatment, there was a significant improvement in total score （IIEF-5 score） in questions 3 and 5 for the KRG-treated group （P 〈 0.001 and P 〈 0.0001, respectively）. The levels of serum testosterone, prolactine and cholesterol after the treatment were not statistically significant different between the KRG and the placebo group （P 〉 0.05）. Conclusion： Our data show that KRG can be an effective alternative to the invasive approaches for treating male ED.

Recent insights into androgen action on the anatomical and physiological substrate of penile erection

Erectile response is centrally and peripherally regulated by androgens. The original insights into the mechanisms of action of androgens were that androgens particularly exert effects on libido and that erections in response to erotic stimuli were relatively androgen-independent. It was shown that sexual functions in men required androgen levels at the low end of reference values of testosterone. So it seemed that testosterone was not useful treatment for men with erectile difficulties, particularly following the advent of the phosphodiesterase type 5 （PDE5） inhibitors. However, approximately 50% of those treated with PDE5 inhibitors discontinue their treatment. A number of recent developments shed new light on testosterone treatment of erectile dysfunction （ED） in aging men. （1） A recent insight is that, in contrast to younger men, elderly men might require higher levels of testosterone for normal sexual functioning. （2） Several studies have indicated that PDE5 inhibitors are not always sufficient to restore erectile potency in men, and that testosterone improves the therapeutical response to PDE5 inhibitors considerably. （3） There is growing insight that testosterone has profound effects on tissues of the penis involved in the mechanism of erection and that testosterone deficiency impairs the anatomical and physiological substrate of erectile capacity, reversible upon androgen replacement. The synthesis of PDE5 is upregulated by androgens, and the arterial inflow into the penis is improved by giving androgen. The above invites a re-examination of the merits of giving testosterone to aging men with ED. The beneficial effects of PDE5 inhibitors may only be optimally expressed in a eugonadal environment. （Asian J Androl 2006 Jan; 8： 3-9）

Effects of castration and testosterone replacement on veno-occlusion during penile erection in the rat

Aim: To determine if androgens directly regulate veno-occlusion or if androgens act indirectly to maintain the penilestructures which control outflow. Methods: Using CASTRATE and TESTO rats, measurement was made of meanarterial pressure (MAP), intracavernosal pressure (CCP), and intracavernosal flow (CCF) during erection resultingfrom stimulation of the autonomic innervation of the penis. CCP and CCF were also measured during saline infusioninto the cavernosal sinuses before and after treatment with sodium nitroprusside (SNP, a nitric oxide donor drag) tofully relax cavernosal smooth muscle. Penile tissue was also collected to measure the content of α actin and proline andhydroxyproline to determine if brief withdrawal of androgenic support led to changes in the number of smooth musclecells or the collagen content of the tissue. Results: Infusion of saline into the cavernosal sinuses demonstrated thatveno-occlusion was defective in CASTRATE rats while reno-occlusion was fully functional in TESTO animals.Furthermore, veno-occlusion could be induced in CASTRATE rats if they were first treated with SNP. Thisobservation suggests that failure of veno-occlusion in the CASTRATE rats is due to a deficiency in the production of NOresulting in a reduction in the degree of relaxation of the penile smooth muscle. The measurements of smooth muscleα actin and proline and hydroxyproline content of collagen showed that both were unaffected by castration and that thebasic structure of the penis did not degenerate after one week without androgenic support. Conclusion: Theseresults can be interpreted to mean that androgens control the veno-occlusive mechanism indirectly via a NO dependentmechanism and not by maintaining the structures of the penis which are essential to reno-occlusion.

Study on effect of segments erection tolerance and wedge-shaped segment on segment ring in shield tunnel

Deformation and dislocations of segments of shield tunnel in construction stage have apparent effect on tunnel structure stress and even cause local cracks and breakage in tunnel. 3D finite element method was used to analyze two segment ring models under uniform injected pressure: (1) segment ring without wedge-shaped segment, which has 16 types of preinstall erection tolerance; (2) segment ring with wedge-shaped segment, which has no preinstall erection tolerance. The analysis results indicate that different erection tolerances can cause irregular deformation in segment ring under uniform injected pressure, and that the tolerance values are enlarged further. Wedge-shaped segment apparently affects the overall deformation of segment ring without erection tolerances. The uniform injected pressure can cause deformation of ring with wedge-shaped segment irregular, and dislocations also appear in this situation. The stress of segment with erection tolerances is much larger than that of segment without erection tolerances. Enlarging the central angle of wedge-shaped segment can make the irregular deformation and dis- locations of segments smaller. The analysis results also provide basis for erection tolerance control and improvement of segment constitution.

Description of Aphelenchoides besseyi from Abnormal Rice with ‘Small Grains and Erect Panicles’ Symptom in China

The abnormal rice with small grains and erect panicles were found on a large scale in China, which showed shortend rice panicle and decreased number of grains in comparison with normal rice, and the grain was small and black-brown, and some of them were distorted, while the flag leaf was normal. A kind of nematode of Aphelenchoides was isolated from the grains of rice variety Wuyujing 3 which performed ＇small grains and erect panicles＇ symptom. There were 2014 nematodes in one hundred grains infected, and up to 74 in single grain, 92 percent of the grains tested had nematodes in the infested panicles. The diagnosis characters of nematode include lateral fields about one-fourth as wide as body, with 4 incisures. The terminus bears a mucro of diverse shape with 3-4 pointed processes. The female post-vulval uterine sac extends less than 50% of distance from vulva to anus, no sperm in it. Oocytes usually arrange in 2-4 rows. The male spicules have a moderately developed rostrum. Morphological measurements showed it to be conspecific with Aphelenchoides besseyi Christie, 1942.

Erect panicle super rice varieties enhance yield by harvest index advantages in high nitrogen and density conditions

The erect panicle （Ep） type is an important characteristic for japonica super rice in Northeast China and plays a significant role in enhancing yield. The Ep type is considered to be a genetic ideotype resource to the japonica super rice group by virtue of its agronomic advantages such as grain number per panicle and biomass. This study addresses the effects of nitrogen and planting density conditions on yielding performance regarding panicle type （PT） using the recombinant inbred line （RIL） population derived from the cross between an Ep variety Liaogeng 5 and non-Ep variety Wanlun 422. The genetics underlying the Ep type proved to be robust not only for panicle-type optimization but also plant height, panicle length, flag leaf length and seed density. We also found that regardless of nitrogen and density, correlation between harvest index （HI） and plant height was not significant in Ep type whatever the nitrogen and density. The application of Ep type provides a potential strategy for yield improvement by increasing biomass through HI maintainable in rice.

Dynamic Development of Aphelenchoides besseyi on Rice Plant by Artificial Inoculation in the Greenhouse

A study was done on the relationship between Aphelenchoides besseyi and the symptoms of small grains and erect panicles. This is an important rice disease in Jiangsu Province, China. A. besseyi was extracted from small grains and erect panicles and cultured artificially, and then inoculated into bud and leaf sheaths of seedlings of two Oryza sativa cultivars, namely Zhendao 2 and Wuyunjing 7 in a greenhouse. The effect on rice growth, in particular the small grains and erect panicles, was revealed by the extent of the disease, seed expansion stages, nematode load, and nematode mortality. In contrast to healthy seedlings, the height, length, and the numbers of spikelets of unhealthy panicles of Zhendao 2 were decreased by 6.7, 16.4, and 13.5%, respectively. Before anthesis, nematodes were attracted to the leaf sheath and apical meristem, nematode load increased by 40%; after anthesis, nematodes occurred in spikelets principally and the number increased by 90.8%. The percentages of infected seeds and nematode load were highest in plump seeds and lowest in empty seeds. Nematode mortality on grain with normal endosperm was lower than seeds with abnormal endosperm. Results indicated that A. besseyi was the pathogen in rice with the symptoms of small grains and erect panicles. Wuyunjing 7 manifests only the small grains and erect panicles symptoms and not the symptoms of leaf white-tip. These symptoms of small grains and erect panicles are new symptom records for the disease caused by A. besseyi on rice.

Genetical and Physiological Basis of Plant Type Model of Erect and Large Panicle Japonica Super Rice in Northern China

The historical changes in rice yields across China were explored. The physiological mechanisms and genetic basis of the erect and large panicle super-high-yield plant type model for breeding japonica super rice were analyzed mainly on the panicle type, number of large vascular bundles （LVB） in the panicle neck, and the panicle type index （PTI）. In the production point of view, we suggested that, for the breeding of super-high-yield japonica rice, the erect panicle types with more LVB numbers in the panicle neck and superior upper grains in the secondary branches would be the key factors. The information has potential significance in the rice breeding and productivity not only in China but also throughout the rice production areas of the world.

Effect of Cultural Measures on Nutrient Contellts in Rice Plants with Erect Panicles

Field experiments were carried out with rice variety of Shennong 91 of short culms and erect panicles to study nutrient contents in high-yielding rice plants and to increase rice yield by appropriate fertilization.Nitrogen, phosphorus, potassium, magnesium, zinc, manganese, iron and copper contents in rice plants varied with different treatment factors. The relationship between the nutrient contents and treatment factors could be simulated using a multiple quadratic equation. The nutrient contents in plants should be appropriate for high-yielding rice. If the mean nutrient content in rice plants producing 11 t ha-1 or more of grain (μj) was set as the standard value and the standard deviation (σj) was set as the range of variation, the nutrient content in high-yielding rice plants should be μj±1.99σj. Rice leaves were sensitive to the nutrient elements. Heavy nitrogen dressing increased the content of nitrogen in rice plants. Sparse transplanting also increased nitrogen content. Improper application of nitrogen, phosphorus and potassium could affect the nutrient contents and decrease the grain yield.

Recent advancement in diagnosis of vasculogenic impotence

Several dynamic tests with vasoactive drags are available for evaluating penile vascular inflows and outflows,ranging from simple pharmacologic test to more invasive radiologic sets. However, there is still no perfect single testto reflect the penile vascular flow. All possible efforts should be exerted to get the greatest erectile effect to avoid anunderestimation of blood flow to the corpora due to incomplete relaxation of the trabecular smooth muscle.Appreciation of the type and frequency of anatomical variations and potential collateral routes is important in interpretingpenile arterograms and in evaluating the hemodynamic significance of suspected arterial disease. Choice of the vasculartests should always depend on the purpose of testing.

A Comparative Assessment of Aerodynamic Models for Buffeting and Flutter of Long-Span Bridges

Wind-induced vibrations commonly represent the leading criterion in the design of long-span bridges. The aerodynamic forces in bridge aerodynamics are mainly based on the quasi-steady and linear unsteady theory. This paper aims to investigate different formulations of self-excited and buffeting forces in the time domain by comparing the dynamic response of a multi-span cable-stayed bridge during the critical erection condition. The bridge is selected to represent a typical reference object with a bluff con- crete box girder for large river crossings. The models are viewed from a perspective of model complexity, comparing the influence of the aerodynamic properties implied in the aerodynamic models, such as aerodynamic damping and stiffness, fluid memory in the buffeting and self-excited forces, aerodynamic nonlinearity, and aerodynamic coupling on the bridge response. The selected models are studied for a windspeed range that is typical for the construction stage for two levels of turbulence intensity. Furthermore, a simplified method for the computation of buffeting forces including the aerodynamic admittance is presented, in which rational approximation is avoided. The critical flutter velocities are also compared for the selected models under laminar flow.