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l’origine sensitive de l’impuissance est aussi questionnée : elle est conditionnée par une disparition partielle ou totale des sensations de volupté à la surface de la verge (usure et non-renouvellement des corpuscules de krause), notamment au niveau. du frein, pouvant s’accompagner d’une douleur cutanée ou d’une modification d’aspect de la peau (kératinisation) du prépuce, et peut se manifester dans un premier temps dès l’absence de stimulation visuelle, à la suite des préliminaires
si l’aphanisis peut conduire. à l’impuissance, elle peut également en être la conséquence
l’association avec une maladie cardio-vasculaire doit être systématiquement recherché (au minimum un électrocardiogramme, avec si besoin une épreuve d’effort)
au niveau biologique, la recherche d’un diabète doit être systématique (mesure de la glycémie à jeun)
un dosage du taux de testostérone peut orienter vers une cause endocrinienne
la prise en charge des dysfonctions d’origines psychogène peut faire appel à une psychothérapie individuelle ou de couple mais il n’existe pas de réelle. évaluation de l’efficacité de ce type de traitement
en revanche la prise en charge des dysfonctions d’origines organiques est possible
une étude du professeur pierre lavoisier, publiée dans le journal américain the physiotherapy journal[ 13] , a démontré l’efficacité de sa méthode ic-force[ 14]dans le traitement de l’impuissance
le changement de mode de vie peut avoir un effet bénéfique[ 15]dont l’arrêt du tabac[ 16]
la consommation d’alcool à doses raisonnables ne semblent pas jouer significativement sur la fonction érectile[ 17]
la prise de compléments alimentaires peut réguler ou atténuer des troubles mineurs de la circulation ou du stress (ex: ail, phytothérapie antistress)
les médicaments à prendre par voie orale sont souvent prescrits
proposant un mode de prise « à la demande » pour une utilisation ponctuelle, ou en continu pour un besoin plus quotidien, ils présentent des contre-indications et des précautions d’emploi qu’il est nécessaire de bien respecter
les effets secondaires de ces médicaments sont liés à leur mode d’action, et le. médecin choisit telle ou telle molécule en fonction de son patient
les inhibiteurs de la phosphodiestérase

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63 percent
videogame sales reached $4
2 billion by 1991, nintendo products accounted for $3
in the summer of 1992 japan’s capcom co
released street fighter ii for nintendo, and the game met with immediate success
also in 1992, nintendo produced super mario paint, a drawing program featuring the company’s star character, a game based on the road runner cartoon character, and the long-awaited “zelda’ sequel, the legend of zelda: a link to the past
nintendo hoped eventually to raise its u
household penetration rate from 17 percent to the 35 percent it had achieved in japan and mirror in the united states the profit-producing ten-to-one software-to-hardware ratio that nintendo had achieved in its home country
nintendo’s exports to the united states had grown eightfold from 1987 to 1991, and the company held 60 percent of the 16-bit u
market at the end of 1992
yet sega’s comparative advertising, begun in 1990, pried open nintendo’s grip on consumers
sega branded nintendo’s games as children’s toys, and nintendo of america failed to respond to the ploy
market share fell to 37 percent by the end of 1993
jeopardy continued into 1994 when a new generation of machines hit the market
sega’s and sony’s new game consoles were 32-bit systems utilizing cd-rom disk drives
sega’s saturn and sony’s playstation had inherently large storage capacities, thanks to the cd-roms, but were considered sluggish
nintendo, on the other hand used much faster but more expensive silicon storage cartridges
instead of matching the moves of its competitors, nintendo concentrated on developing, in partnership with california-based silicon graphics, inc
, a 64-bit processor with superior capabilities
faced with consumer desertions to the 32-bit machines, nintendo tried to extend the life of its 16-bit super nintendo system by bringing out hot games
donkey kong country, which had been designed for the 64-bit system, was released in a 16-bit format and became the bestselling game of 1994
the video game machine makers spent millions each year on software development
independently produced games continued to generate the bulk of nintendo’s revenue in this important area: in-house software brought in around 35 percent of sales
in 1995, pressed by the need to produce software for its new machine, nintendo purchased 25 percent of rare ltd
this was nintendo’s first investment in a software maker outside of japan
nintendo’s promise of a cheaper and more exciting video system by early 1996 dampened saturn and playstation sales somewhat during the 1995 christmas season
nevertheless, sega passed nintendo in terms of total sales for the first time in the fiscal year ending march 1996
nintendo’s consolidated sales fell 15 percent and operating profits fell 24 percent
the 32-bit machines, the economic recession in the important japanese market, and the defection of independent software producers to the competition contributed to nintendo’s downward spiral
nintendo 64 (n64) finally hit the market in 1996
japanese consumers were eager to check out the new system
“with preordering rampant and queues outside the stores, some 300,000 nintendo 64 machines were snapped up by eager addicts on the first day,’ according to an august 1996 article in the economist
release, sega and sony cut the prices on their 32-bit units
the n64 japanese launch got off to a fast start but stalled just as quickly: only a few games were ready for the format
nintendo had backpedaled on the n64 release date a number of times, a situation that served to frustrate many independent software makers and led to the defection of some important developers to sony
further complicating matters was the complexity of programming required for the n64 software and programmers’ frustration with the limited storage capacity of the cartridges as compared to the cd-roms used by the competition
another factor in the mix, one which was not there during nintendo’s glory days, was the personal computer (pc)
pc makers were fabricating increasingly sophisticated games, drawing talent from the software developer pool and eating into the market
difficulties aside, nintendo continued to live up to its reputation for quality software and produced another blockbuster game
“this is probably the most perfectly crafted video game ever,’ wrote neil gross in business week
shigeru miyamoto, the designer of the original 8-bit mario game, scored big with super mario 64
mario’s fluid movements through dazzling three-dimensional graphics set the game apart from earlier versions and from competitor’s 32-bit games
sony and sega, on the other hand, were not just waiting for nintendo to rack up points
sega was the first to release a web-browsing device, and sony was way ahead of the pack in number of games available
nintendo continued to feel the pinch and recorded its third straight year of declining financial results in the fiscal year ending march 1996
in the first half of 1996, sales of the 16-bit super nintendo machines and related software plummeted
sales generated by the new system, due in part to the lack of software, did not pick up all the slack
in september 1996 n64, with eight titles on hand, hit north american shelves; by june 1997, 2
6 million machines had been sold, capturing 50 percent of the market
7 million had been sold elsewhere in the world
revenue for fiscal 1997 were up 18 percent to $3
earnings increased nine percent to $54 million
sony, the market leader, had more than 11 million playstations in the hands of consumers worldwide and carried 150 game titles
nintendo 64 offered just 17 titles for play
the importance of the software lay most clearly in its profitability
nintendo’s margins for hardware were one to five percent while software yielded margins of nearly 45 percent
software produced more than 50 percent of the company’s profits
aware of the dilemma it faced, nintendo of america’s chairman personally solicited the services u
in an effort to boost capacity, a sticking point with the game makers, nintendo put an n64 peripheral in the pipeline
the dd64, a magnetic disk drive, was to also contain a communications device
“still,’ wrote seanna browder in business week, “there are risks even to this
historically, add-on devices don’t go over big with gamers, who make one initial hardware investment and call it a day
there’s also the chance that nintendo could split its market into two camps–n64 and dd64
then, game developers will be scratching their heads, wondering which to support
nintendo was headed in the right direction, but the progress was not entirely smooth
sales and profits were boosted in 1997 by pokemon or pocket monsters, a new game played on nintendo’s handheld game boy machines, but the year was marked by a delay in the launch of the new hardware platform, dd64, and the botched delivery of yoshi’s story, a much ballyhooed software title
nintendo came back in early 1998 with the introduction of the game boy camera, a digital offering that sold for $50 and attached to the game boy machine
nintendo sold more than 700,000 of the units in its first five weeks on the japanese market
solidifying its dominance in the handheld market, nintendo also released game boy color and pokemon pikacu, a virtual pet
(the pokemon game had spawned a multibillion-dollar industry of related merchandise
) in late 1998, nintendo spent millions on the rollout of the legend of zelda: ocarina of time and achieved record pre-sales on the game
the future is now: 1999, 2000, and beyond
the next generation of video game machines appeared on the horizon late in 1998, when sega introduced its 128-bit dreamcast machine to japan
the system processed data more quickly than both playstation and nintendo 64 and thus was capable of producing more lifelike graphics
dreamcast was scheduled to hit the united states in the fall of 1999
not to be outdone for long, both sony and nintendo planned for a year 2000 release of their new machines
sony said its playstation ii, which it categorized as a home entertainment system, was even faster than dreamcast and would produce images with graphic quality similar to animated movies
no longer just a game machine, playstation ii would accommodate movies and games recorded on digital video disks (dvd)
breaking with industry convention, the machine would also play games produced for the original playstation
nintendo, in a $1 billion partnership with ibm, said its next generation console, code named dolphin, would also use dvd and exceed the speed of even sony’s offering
hype aside, nintendo faced another unsettled transition period as it again maneuvered from one generation of game systems to the next
principal subsidiaries: nintendo of america, inc
); nintendo of australia pty, ltd
; nintendo of europe gmbh (germany); nintendo france s
; nintendo hong kong limited; nintendo netherlands b
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the nintendo 3ds comes with terms of service (tos) that should not be accepted
to enforce these terms, nintendo uses digital restrictions management (drm) technology
because of the digital millennium copyright act (dmca), users are legally prohibited from modifying their devices to block nintendo’s

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