The object of the study was to investigate the frequency of physiological sexual dysfunction in a population of men with spinal cord injury (SCI). A questionnaire-based survey of admissions during 1980-84 was undertaken at a regional spinal cord injury rehabilitation unit. Male patients aged 20-63 years with complete or incomplete tetraplegia or paraplegia living in their own homes were included in the study; 43 complied with inclusion criteria, and 38 answered the questionnaire. Ninety-five per cent of the patients stated that they could obtain an erection, 61% on a purely reflex basis; 66% stated that erection was sufficient for coitus, and 45% that they could obtain ejaculation/emission. More patients with incomplete than complete lesions reported ability to obtain ejaculation/emission. Significantly, more of the patients aged below 30 years reported erection sufficient for coitus (p less than 0.05). Forty-five per cent of the patients experienced complications of sexual activity, mainly in the form of bladder dysfunction and pain or spasms. In conclusion, SCI is usually accompanied by considerable sexual dysfunction, but most patients are still capable of functioning sexually. Thus, in the rehabilitation process after SCI, sexual counselling and information may be valuable.

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Serological and immunohistochemical determination of von Willebrand factor antigen in serum and biopsy specimens from patients with arteritis temporalis and polymyalgia rheumatica.

Von Willebrand factor antigen (vWF-Ag) levels in serum from patients with untreated polymyalgia rheumatica (PMR) and arteritis temporalis (AT) were measured using an ELISA technique. The level in patients with AT was significantly higher (median 229%, range 182-358%) than in patients with PMR (median 190%, range 131-390%) and in controls (median 179%, range 65-296%). Using an immunoperoxidase technique and biopsy specimens from 21 temporal arteries (7 patients with AT, 7 with PMR and 7 with other diseases), vWF-Ag was localized in the luminal endothelium in all cases. VWF-Ag was also present in many new vessels along the lamina elastica of the artery wall in all patients with AT, but not in patients with PMR. We relate the higher vWF-Ag level in these patients to an increased vWF-Ag production by endothelian cells in new, proliferating vessels in the artery wall.

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